code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
APR-DRG,001-1,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,23380.28,28056.34,6
APR-DRG,001-2,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,26613.03,31935.64,6
APR-DRG,001-3,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,34436.53,41323.84,6
APR-DRG,001-4,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,66329.56,79595.47,6
APR-DRG,002-1,HEART AND/OR LUNG TRANSPLANT,,,43443.38,52132.06,6
APR-DRG,002-2,HEART AND/OR LUNG TRANSPLANT,,,49153.15,58983.78,6
APR-DRG,002-3,HEART AND/OR LUNG TRANSPLANT,,,64911.19,77893.43,6
APR-DRG,002-4,HEART AND/OR LUNG TRANSPLANT,,,119164.66,142997.59,6
APR-DRG,004-1,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,20425.32,24510.38,6
APR-DRG,004-2,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,29522.72,35427.26,6
APR-DRG,004-3,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,46198.9,55438.68,6
APR-DRG,004-4,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,66996.16,80395.39,6
APR-DRG,005-1,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,11861.19,14233.43,6
APR-DRG,005-2,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,22585.03,27102.04,6
APR-DRG,005-3,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,33871.27,40645.52,6
APR-DRG,005-4,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,46671.81,56006.17,6
APR-DRG,006-1,PANCREAS TRANSPLANT,,,19994.09,23992.91,6
APR-DRG,006-2,PANCREAS TRANSPLANT,,,28786.05,34543.26,6
APR-DRG,006-3,PANCREAS TRANSPLANT,,,33389.73,40067.68,6
APR-DRG,006-4,PANCREAS TRANSPLANT,,,43326.23,51991.48,6
APR-DRG,007-1,ALLOGENEIC BONE MARROW TRANSPLANT,,,27738.53,33286.24,6
APR-DRG,007-2,ALLOGENEIC BONE MARROW TRANSPLANT,,,31423.35,37708.02,6
APR-DRG,007-3,ALLOGENEIC BONE MARROW TRANSPLANT,,,44622.06,53546.47,6
APR-DRG,007-4,ALLOGENEIC BONE MARROW TRANSPLANT,,,70159.55,84191.46,6
APR-DRG,008-1,AUTOLOGOUS BONE MARROW TRANSPLANT,,,14560.66,17472.79,6
APR-DRG,008-2,AUTOLOGOUS BONE MARROW TRANSPLANT,,,17238.93,20686.72,6
APR-DRG,008-3,AUTOLOGOUS BONE MARROW TRANSPLANT,,,21963.35,26356.02,6
APR-DRG,008-4,AUTOLOGOUS BONE MARROW TRANSPLANT,,,31204.86,37445.83,6
APR-DRG,009-1,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,21532.85,25839.42,6
APR-DRG,009-2,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,29405.21,35286.25,6
APR-DRG,009-3,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,58587.99,70305.59,6
APR-DRG,009-4,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,87176.4,104611.68,6
APR-DRG,011-1,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,34745.57,41694.68,6
APR-DRG,011-2,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,70549.09,84658.91,6
APR-DRG,011-3,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,88742.47,106490.96,6
APR-DRG,011-4,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,119243.35,143092.02,6
APR-DRG,020-1,OPEN CRANIOTOMY FOR TRAUMA,,,7571.94,9086.33,6
APR-DRG,020-2,OPEN CRANIOTOMY FOR TRAUMA,,,9790.59,11748.71,6
APR-DRG,020-3,OPEN CRANIOTOMY FOR TRAUMA,,,13991.44,16789.73,6
APR-DRG,020-4,OPEN CRANIOTOMY FOR TRAUMA,,,20264.33,24317.2,6
APR-DRG,021-1,OPEN CRANIOTOMY EXCEPT TRAUMA,,,8934.61,10721.53,6
APR-DRG,021-2,OPEN CRANIOTOMY EXCEPT TRAUMA,,,11817.35,14180.82,6
APR-DRG,021-3,OPEN CRANIOTOMY EXCEPT TRAUMA,,,16324.01,19588.81,6
APR-DRG,021-4,OPEN CRANIOTOMY EXCEPT TRAUMA,,,23195.94,27835.13,6
APR-DRG,022-1,VENTRICULAR SHUNT PROCEDURES,,,5419.05,6502.86,6
APR-DRG,022-2,VENTRICULAR SHUNT PROCEDURES,,,6824.13,8188.96,6
APR-DRG,022-3,VENTRICULAR SHUNT PROCEDURES,,,10017.35,12020.82,6
APR-DRG,022-4,VENTRICULAR SHUNT PROCEDURES,,,18125.81,21750.97,6
APR-DRG,023-1,SPINAL PROCEDURES,,,6533.05,7839.66,6
APR-DRG,023-2,SPINAL PROCEDURES,,,9242.58,11091.1,6
APR-DRG,023-3,SPINAL PROCEDURES,,,14567.49,17480.99,6
APR-DRG,023-4,SPINAL PROCEDURES,,,21149.77,25379.72,6
APR-DRG,024-1,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,3808.43,4570.12,6
APR-DRG,024-2,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,5048.2,6057.84,6
APR-DRG,024-3,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,8992.11,10790.53,6
APR-DRG,024-4,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,14062.24,16874.69,6
APR-DRG,026-1,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,5306.22,6367.46,6
APR-DRG,026-2,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,7899.31,9479.17,6
APR-DRG,026-3,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,10502.12,12602.54,6
APR-DRG,026-4,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,16451.22,19741.46,6
APR-DRG,027-1,OTHER OPEN CRANIOTOMY,,,6867.25,8240.7,6
APR-DRG,027-2,OTHER OPEN CRANIOTOMY,,,9433.04,11319.65,6
APR-DRG,027-3,OTHER OPEN CRANIOTOMY,,,13708.99,16450.79,6
APR-DRG,027-4,OTHER OPEN CRANIOTOMY,,,19522.26,23426.71,6
APR-DRG,029-1,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,6883.42,8260.1,6
APR-DRG,029-2,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,8633.83,10360.6,6
APR-DRG,029-3,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,12398.43,14878.12,6
APR-DRG,029-4,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,16554.0,19864.8,6
APR-DRG,030-1,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,5966.35,7159.62,6
APR-DRG,030-2,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,10246.61,12295.93,6
APR-DRG,030-3,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,13130.79,15756.95,6
APR-DRG,030-4,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,17694.59,21233.51,6
APR-DRG,040-1,SPINAL DISORDERS AND INJURIES,,,4056.38,4867.66,6
APR-DRG,040-2,SPINAL DISORDERS AND INJURIES,,,5540.16,6648.19,6
APR-DRG,040-3,SPINAL DISORDERS AND INJURIES,,,7657.11,9188.53,6
APR-DRG,040-4,SPINAL DISORDERS AND INJURIES,,,10737.49,12884.99,6
APR-DRG,041-1,NERVOUS SYSTEM MALIGNANCY,,,3304.26,3965.11,6
APR-DRG,041-2,NERVOUS SYSTEM MALIGNANCY,,,3858.02,4629.62,6
APR-DRG,041-3,NERVOUS SYSTEM MALIGNANCY,,,5300.83,6361.0,6
APR-DRG,041-4,NERVOUS SYSTEM MALIGNANCY,,,7636.99,9164.39,6
APR-DRG,042-1,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,2933.4,3520.08,6
APR-DRG,042-2,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,3755.24,4506.29,6
APR-DRG,042-3,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,5323.47,6388.16,6
APR-DRG,042-4,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,9807.84,11769.41,6
APR-DRG,043-1,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,4047.76,4857.31,6
APR-DRG,043-2,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,5943.71,7132.45,6
APR-DRG,043-3,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,8750.98,10501.18,6
APR-DRG,043-4,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,15534.15,18640.98,6
APR-DRG,044-1,INTRACRANIAL HEMORRHAGE,,,3281.62,3937.94,6
APR-DRG,044-2,INTRACRANIAL HEMORRHAGE,,,4246.48,5095.78,6
APR-DRG,044-3,INTRACRANIAL HEMORRHAGE,,,6018.1,7221.72,6
APR-DRG,044-4,INTRACRANIAL HEMORRHAGE,,,9280.31,11136.37,6
APR-DRG,045-1,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,2988.02,3585.62,6
APR-DRG,045-2,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,3844.0,4612.8,6
APR-DRG,045-3,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,5356.89,6428.27,6
APR-DRG,045-4,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,8881.07,10657.28,6
APR-DRG,046-1,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,3048.39,3658.07,6
APR-DRG,046-2,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,3777.52,4533.02,6
APR-DRG,046-3,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,4887.57,5865.08,6
APR-DRG,046-4,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,8822.14,10586.57,6
APR-DRG,047-1,TRANSIENT ISCHEMIA,,,2802.24,3362.69,6
APR-DRG,047-2,TRANSIENT ISCHEMIA,,,3202.92,3843.5,6
APR-DRG,047-3,TRANSIENT ISCHEMIA,,,4010.74,4812.89,6
APR-DRG,047-4,TRANSIENT ISCHEMIA,,,6473.04,7767.65,6
APR-DRG,048-1,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,2725.34,3270.41,6
APR-DRG,048-2,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,3302.82,3963.38,6
APR-DRG,048-3,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,4738.08,5685.7,6
APR-DRG,048-4,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,8206.2,9847.44,6
APR-DRG,049-1,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,4519.59,5423.51,6
APR-DRG,049-2,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,5545.91,6655.09,6
APR-DRG,049-3,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,7985.2,9582.24,6
APR-DRG,049-4,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,12367.16,14840.59,6
APR-DRG,050-1,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,3064.93,3677.92,6
APR-DRG,050-2,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,5508.17,6609.8,6
APR-DRG,050-3,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,8378.69,10054.43,6
APR-DRG,050-4,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,14343.61,17212.33,6
APR-DRG,051-1,VIRAL MENINGITIS,,,2452.23,2942.68,6
APR-DRG,051-2,VIRAL MENINGITIS,,,3326.53,3991.84,6
APR-DRG,051-3,VIRAL MENINGITIS,,,5214.22,6257.06,6
APR-DRG,051-4,VIRAL MENINGITIS,,,8280.59,9936.71,6
APR-DRG,052-1,ALTERATION IN CONSCIOUSNESS,,,2426.71,2912.05,6
APR-DRG,052-2,ALTERATION IN CONSCIOUSNESS,,,3111.28,3733.54,6
APR-DRG,052-3,ALTERATION IN CONSCIOUSNESS,,,4507.37,5408.84,6
APR-DRG,052-4,ALTERATION IN CONSCIOUSNESS,,,7882.78,9459.34,6
APR-DRG,053-1,SEIZURE,,,2169.42,2603.3,6
APR-DRG,053-2,SEIZURE,,,2958.2,3549.84,6
APR-DRG,053-3,SEIZURE,,,4673.75,5608.5,6
APR-DRG,053-4,SEIZURE,,,8816.03,10579.24,6
APR-DRG,054-1,MIGRAINE AND OTHER HEADACHES,,,2670.35,3204.42,6
APR-DRG,054-2,MIGRAINE AND OTHER HEADACHES,,,3202.92,3843.5,6
APR-DRG,054-3,MIGRAINE AND OTHER HEADACHES,,,4088.01,4905.61,6
APR-DRG,054-4,MIGRAINE AND OTHER HEADACHES,,,5972.1,7166.52,6
APR-DRG,055-1,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,2783.19,3339.83,6
APR-DRG,055-2,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,3896.11,4675.33,6
APR-DRG,055-3,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,6031.75,7238.1,6
APR-DRG,055-4,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,10442.82,12531.38,6
APR-DRG,056-1,"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",,,2696.23,3235.48,6
APR-DRG,056-2,"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",,,3735.12,4482.14,6
APR-DRG,056-3,"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",,,5695.04,6834.05,6
APR-DRG,056-4,"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",,,10162.89,12195.47,6
APR-DRG,057-1,"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",,,2663.89,3196.67,6
APR-DRG,057-2,"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",,,3852.63,4623.16,6
APR-DRG,057-3,"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",,,5383.12,6459.74,6
APR-DRG,057-4,"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",,,9093.81,10912.57,6
APR-DRG,058-1,OTHER DISORDERS OF NERVOUS SYSTEM,,,3077.5,3693.0,6
APR-DRG,058-2,OTHER DISORDERS OF NERVOUS SYSTEM,,,4485.45,5382.54,6
APR-DRG,058-3,OTHER DISORDERS OF NERVOUS SYSTEM,,,6223.65,7468.38,6
APR-DRG,058-4,OTHER DISORDERS OF NERVOUS SYSTEM,,,8380.85,10057.02,6
APR-DRG,059-1,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,2695.51,3234.61,6
APR-DRG,059-2,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,4368.3,5241.96,6
APR-DRG,059-3,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,6041.1,7249.32,6
APR-DRG,059-4,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,8926.35,10711.62,6
APR-DRG,073-1,ORBIT AND EYE PROCEDURES,,,3867.0,4640.4,6
APR-DRG,073-2,ORBIT AND EYE PROCEDURES,,,5241.53,6289.84,6
APR-DRG,073-3,ORBIT AND EYE PROCEDURES,,,7840.38,9408.46,6
APR-DRG,073-4,ORBIT AND EYE PROCEDURES,,,13889.75,16667.7,6
APR-DRG,082-1,EYE INFECTIONS AND OTHER EYE DISORDERS,,,2363.11,2835.73,6
APR-DRG,082-2,EYE INFECTIONS AND OTHER EYE DISORDERS,,,3062.77,3675.32,6
APR-DRG,082-3,EYE INFECTIONS AND OTHER EYE DISORDERS,,,4505.22,5406.26,6
APR-DRG,082-4,EYE INFECTIONS AND OTHER EYE DISORDERS,,,7731.14,9277.37,6
APR-DRG,089-1,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,6731.41,8077.69,6
APR-DRG,089-2,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,8800.57,10560.68,6
APR-DRG,089-3,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,15101.49,18121.79,6
APR-DRG,089-4,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,20252.11,24302.53,6
APR-DRG,091-1,OTHER MAJOR HEAD AND NECK PROCEDURES,,,6611.39,7933.67,6
APR-DRG,091-2,OTHER MAJOR HEAD AND NECK PROCEDURES,,,10552.43,12662.92,6
APR-DRG,091-3,OTHER MAJOR HEAD AND NECK PROCEDURES,,,15763.06,18915.67,6
APR-DRG,091-4,OTHER MAJOR HEAD AND NECK PROCEDURES,,,23591.23,28309.48,6
APR-DRG,092-1,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,5971.02,7165.22,6
APR-DRG,092-2,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,7479.95,8975.94,6
APR-DRG,092-3,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,10970.35,13164.42,6
APR-DRG,092-4,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,19305.57,23166.68,6
APR-DRG,095-1,CLEFT LIP AND PALATE REPAIR,,,3575.21,4290.25,6
APR-DRG,095-2,CLEFT LIP AND PALATE REPAIR,,,3792.26,4550.71,6
APR-DRG,095-3,CLEFT LIP AND PALATE REPAIR,,,6052.95,7263.54,6
APR-DRG,095-4,CLEFT LIP AND PALATE REPAIR,,,12599.66,15119.59,6
APR-DRG,097-1,TONSIL AND ADENOID PROCEDURES,,,2497.51,2997.01,6
APR-DRG,097-2,TONSIL AND ADENOID PROCEDURES,,,3895.75,4674.9,6
APR-DRG,097-3,TONSIL AND ADENOID PROCEDURES,,,6148.18,7377.82,6
APR-DRG,097-4,TONSIL AND ADENOID PROCEDURES,,,9949.79,11939.75,6
APR-DRG,098-1,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,3579.88,4295.86,6
APR-DRG,098-2,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,5953.41,7144.09,6
APR-DRG,098-3,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,9115.73,10938.88,6
APR-DRG,098-4,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,14622.47,17546.96,6
APR-DRG,110-1,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,3493.63,4192.36,6
APR-DRG,110-2,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,3992.78,4791.34,6
APR-DRG,110-3,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,5495.96,6595.15,6
APR-DRG,110-4,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,9439.51,11327.41,6
APR-DRG,111-1,VERTIGO AND OTHER LABYRINTH DISORDERS,,,2534.52,3041.42,6
APR-DRG,111-2,VERTIGO AND OTHER LABYRINTH DISORDERS,,,2825.24,3390.29,6
APR-DRG,111-3,VERTIGO AND OTHER LABYRINTH DISORDERS,,,3698.83,4438.6,6
APR-DRG,111-4,VERTIGO AND OTHER LABYRINTH DISORDERS,,,6421.29,7705.55,6
APR-DRG,113-1,INFECTIONS OF UPPER RESPIRATORY TRACT,,,1452.5,1743.0,6
APR-DRG,113-2,INFECTIONS OF UPPER RESPIRATORY TRACT,,,2098.98,2518.78,6
APR-DRG,113-3,INFECTIONS OF UPPER RESPIRATORY TRACT,,,3269.76,3923.71,6
APR-DRG,113-4,INFECTIONS OF UPPER RESPIRATORY TRACT,,,6297.67,7557.2,6
APR-DRG,114-1,DENTAL DISEASES AND DISORDERS,,,1764.06,2116.87,6
APR-DRG,114-2,DENTAL DISEASES AND DISORDERS,,,2436.42,2923.7,6
APR-DRG,114-3,DENTAL DISEASES AND DISORDERS,,,3653.19,4383.83,6
APR-DRG,114-4,DENTAL DISEASES AND DISORDERS,,,10129.11,12154.93,6
APR-DRG,115-1,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,2049.03,2458.84,6
APR-DRG,115-2,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,3000.96,3601.15,6
APR-DRG,115-3,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,4476.47,5371.76,6
APR-DRG,115-4,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,8324.79,9989.75,6
APR-DRG,120-1,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,7060.22,8472.26,6
APR-DRG,120-2,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,8744.16,10492.99,6
APR-DRG,120-3,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,13161.69,15794.03,6
APR-DRG,120-4,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,20865.17,25038.2,6
APR-DRG,121-1,OTHER RESPIRATORY AND CHEST PROCEDURES,,,5463.61,6556.33,6
APR-DRG,121-2,OTHER RESPIRATORY AND CHEST PROCEDURES,,,7161.2,8593.44,6
APR-DRG,121-3,OTHER RESPIRATORY AND CHEST PROCEDURES,,,11074.93,13289.92,6
APR-DRG,121-4,OTHER RESPIRATORY AND CHEST PROCEDURES,,,17489.39,20987.27,6
APR-DRG,130-1,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,10563.92,12676.7,6
APR-DRG,130-2,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,12751.67,15302.0,6
APR-DRG,130-3,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,15555.71,18666.85,6
APR-DRG,130-4,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,20619.73,24743.68,6
APR-DRG,131-1,CYSTIC FIBROSIS - PULMONARY DISEASE,,,4076.51,4891.81,6
APR-DRG,131-2,CYSTIC FIBROSIS - PULMONARY DISEASE,,,6673.2,8007.84,6
APR-DRG,131-3,CYSTIC FIBROSIS - PULMONARY DISEASE,,,8914.49,10697.39,6
APR-DRG,131-4,CYSTIC FIBROSIS - PULMONARY DISEASE,,,10484.87,12581.84,6
APR-DRG,132-1,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,1705.85,2047.02,6
APR-DRG,132-2,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,2854.7,3425.64,6
APR-DRG,132-3,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,4806.35,5767.62,6
APR-DRG,132-4,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,6717.76,8061.31,6
APR-DRG,133-1,RESPIRATORY FAILURE,,,2261.77,2714.12,6
APR-DRG,133-2,RESPIRATORY FAILURE,,,3013.54,3616.25,6
APR-DRG,133-3,RESPIRATORY FAILURE,,,4434.06,5320.87,6
APR-DRG,133-4,RESPIRATORY FAILURE,,,7271.16,8725.39,6
APR-DRG,134-1,PULMONARY EMBOLISM,,,2156.84,2588.21,6
APR-DRG,134-2,PULMONARY EMBOLISM,,,2886.33,3463.6,6
APR-DRG,134-3,PULMONARY EMBOLISM,,,4579.6,5495.52,6
APR-DRG,134-4,PULMONARY EMBOLISM,,,7476.0,8971.2,6
APR-DRG,135-1,MAJOR CHEST AND RESPIRATORY TRAUMA,,,2595.97,3115.16,6
APR-DRG,135-2,MAJOR CHEST AND RESPIRATORY TRAUMA,,,3287.37,3944.84,6
APR-DRG,135-3,MAJOR CHEST AND RESPIRATORY TRAUMA,,,4788.03,5745.64,6
APR-DRG,135-4,MAJOR CHEST AND RESPIRATORY TRAUMA,,,8477.87,10173.44,6
APR-DRG,136-1,RESPIRATORY MALIGNANCY,,,3057.38,3668.86,6
APR-DRG,136-2,RESPIRATORY MALIGNANCY,,,3667.92,4401.5,6
APR-DRG,136-3,RESPIRATORY MALIGNANCY,,,5088.09,6105.71,6
APR-DRG,136-4,RESPIRATORY MALIGNANCY,,,7806.24,9367.49,6
APR-DRG,137-1,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,2177.68,2613.22,6
APR-DRG,137-2,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,2684.01,3220.81,6
APR-DRG,137-3,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,3961.51,4753.81,6
APR-DRG,137-4,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,7455.15,8946.18,6
APR-DRG,138-1,BRONCHIOLITIS AND RSV PNEUMONIA,,,1262.41,1514.89,6
APR-DRG,138-2,BRONCHIOLITIS AND RSV PNEUMONIA,,,2077.06,2492.47,6
APR-DRG,138-3,BRONCHIOLITIS AND RSV PNEUMONIA,,,3623.0,4347.6,6
APR-DRG,138-4,BRONCHIOLITIS AND RSV PNEUMONIA,,,7094.0,8512.8,6
APR-DRG,139-1,OTHER PNEUMONIA,,,1825.15,2190.18,6
APR-DRG,139-2,OTHER PNEUMONIA,,,2501.1,3001.32,6
APR-DRG,139-3,OTHER PNEUMONIA,,,3767.46,4520.95,6
APR-DRG,139-4,OTHER PNEUMONIA,,,6160.4,7392.48,6
APR-DRG,140-1,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,2045.44,2454.53,6
APR-DRG,140-2,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,2488.88,2986.66,6
APR-DRG,140-3,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,3373.97,4048.76,6
APR-DRG,140-4,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,5980.72,7176.86,6
APR-DRG,141-1,ASTHMA,,,1699.02,2038.82,6
APR-DRG,141-2,ASTHMA,,,2433.9,2920.68,6
APR-DRG,141-3,ASTHMA,,,3344.5,4013.4,6
APR-DRG,141-4,ASTHMA,,,5654.79,6785.75,6
APR-DRG,142-1,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,2596.33,3115.6,6
APR-DRG,142-2,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,3353.85,4024.62,6
APR-DRG,142-3,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,5080.18,6096.22,6
APR-DRG,142-4,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,7913.33,9496.0,6
APR-DRG,143-1,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,2153.6,2584.32,6
APR-DRG,143-2,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,3057.02,3668.42,6
APR-DRG,143-3,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,4724.42,5669.3,6
APR-DRG,143-4,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,7797.62,9357.14,6
APR-DRG,144-1,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,2203.91,2644.69,6
APR-DRG,144-2,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,3073.91,3688.69,6
APR-DRG,144-3,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,4380.52,5256.62,6
APR-DRG,144-4,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,6985.48,8382.58,6
APR-DRG,145-1,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,1995.85,2395.02,6
APR-DRG,145-2,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,2458.34,2950.01,6
APR-DRG,145-3,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,3338.03,4005.64,6
APR-DRG,145-4,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,5519.31,6623.17,6
APR-DRG,160-1,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,12536.06,15043.27,6
APR-DRG,160-2,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,17726.93,21272.32,6
APR-DRG,160-3,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,23660.94,28393.13,6
APR-DRG,160-4,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,51048.39,61258.07,6
APR-DRG,161-1,IMPLANTABLE HEART ASSIST SYSTEMS,,,51234.89,61481.87,6
APR-DRG,161-2,IMPLANTABLE HEART ASSIST SYSTEMS,,,51234.89,61481.87,6
APR-DRG,161-3,IMPLANTABLE HEART ASSIST SYSTEMS,,,69631.3,83557.56,6
APR-DRG,161-4,IMPLANTABLE HEART ASSIST SYSTEMS,,,88926.1,106711.32,6
APR-DRG,162-1,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,15809.06,18970.87,6
APR-DRG,162-2,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,18972.09,22766.51,6
APR-DRG,162-3,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,25095.12,30114.14,6
APR-DRG,162-4,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,34306.44,41167.73,6
APR-DRG,163-1,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,13348.56,16018.27,6
APR-DRG,163-2,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,15927.64,19113.17,6
APR-DRG,163-3,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,21581.0,25897.2,6
APR-DRG,163-4,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,30019.35,36023.22,6
APR-DRG,165-1,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,14480.52,17376.62,6
APR-DRG,165-2,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,16159.79,19391.75,6
APR-DRG,165-3,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,20041.53,24049.84,6
APR-DRG,165-4,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,26969.51,32363.41,6
APR-DRG,166-1,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,12161.61,14593.93,6
APR-DRG,166-2,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,14124.4,16949.28,6
APR-DRG,166-3,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,17639.25,21167.1,6
APR-DRG,166-4,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,24042.93,28851.52,6
APR-DRG,167-1,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES,,,9707.58,11649.1,6
APR-DRG,167-2,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES,,,12302.84,14763.41,6
APR-DRG,167-3,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES,,,16773.2,20127.84,6
APR-DRG,167-4,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES,,,26425.09,31710.11,6
APR-DRG,169-1,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,9954.1,11944.92,6
APR-DRG,169-2,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,11868.74,14242.49,6
APR-DRG,169-3,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,14983.98,17980.78,6
APR-DRG,169-4,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,21436.18,25723.42,6
APR-DRG,170-1,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,8234.95,9881.94,6
APR-DRG,170-2,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,8836.87,10604.24,6
APR-DRG,170-3,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,11995.59,14394.71,6
APR-DRG,170-4,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,17680.93,21217.12,6
APR-DRG,171-1,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,5711.21,6853.45,6
APR-DRG,171-2,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,6916.84,8300.21,6
APR-DRG,171-3,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,9375.54,11250.65,6
APR-DRG,171-4,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,14378.11,17253.73,6
APR-DRG,174-1,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,6852.88,8223.46,6
APR-DRG,174-2,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,8683.78,10420.54,6
APR-DRG,174-3,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,10197.38,12236.86,6
APR-DRG,174-4,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,14464.71,17357.65,6
APR-DRG,175-1,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,7831.04,9397.25,6
APR-DRG,175-2,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,10349.03,12418.84,6
APR-DRG,175-3,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,11872.69,14247.23,6
APR-DRG,175-4,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,16274.06,19528.87,6
APR-DRG,176-1,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,6591.27,7909.52,6
APR-DRG,176-2,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,8986.0,10783.2,6
APR-DRG,176-3,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,12076.45,14491.74,6
APR-DRG,176-4,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,17024.75,20429.7,6
APR-DRG,177-1,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,5022.33,6026.8,6
APR-DRG,177-2,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,7617.22,9140.66,6
APR-DRG,177-3,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,9514.61,11417.53,6
APR-DRG,177-4,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,13622.03,16346.44,6
APR-DRG,178-1,EXTERNAL HEART ASSIST DEVICES,,,16878.85,20254.62,6
APR-DRG,178-2,EXTERNAL HEART ASSIST DEVICES,,,18754.32,22505.18,6
APR-DRG,178-3,EXTERNAL HEART ASSIST DEVICES,,,23033.51,27640.21,6
APR-DRG,178-4,EXTERNAL HEART ASSIST DEVICES,,,28546.0,34255.2,6
APR-DRG,179-1,DEFIBRILLATOR IMPLANTS,,,12629.49,15155.39,6
APR-DRG,179-2,DEFIBRILLATOR IMPLANTS,,,14940.86,17929.03,6
APR-DRG,179-3,DEFIBRILLATOR IMPLANTS,,,18071.19,21685.43,6
APR-DRG,179-4,DEFIBRILLATOR IMPLANTS,,,23729.58,28475.5,6
APR-DRG,180-1,OTHER CIRCULATORY SYSTEM PROCEDURES,,,5474.03,6568.84,6
APR-DRG,180-2,OTHER CIRCULATORY SYSTEM PROCEDURES,,,6227.24,7472.69,6
APR-DRG,180-3,OTHER CIRCULATORY SYSTEM PROCEDURES,,,9004.33,10805.2,6
APR-DRG,180-4,OTHER CIRCULATORY SYSTEM PROCEDURES,,,14503.52,17404.22,6
APR-DRG,181-1,LOWER EXTREMITY VASCULAR PROCEDURES,,,6605.28,7926.34,6
APR-DRG,181-2,LOWER EXTREMITY VASCULAR PROCEDURES,,,9075.12,10890.14,6
APR-DRG,181-3,LOWER EXTREMITY VASCULAR PROCEDURES,,,12122.08,14546.5,6
APR-DRG,181-4,LOWER EXTREMITY VASCULAR PROCEDURES,,,17641.76,21170.11,6
APR-DRG,182-1,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,6224.01,7468.81,6
APR-DRG,182-2,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,7654.24,9185.09,6
APR-DRG,182-3,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,9779.1,11734.92,6
APR-DRG,182-4,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,15263.2,18315.84,6
APR-DRG,183-1,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,13779.06,16534.87,6
APR-DRG,183-2,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,14964.93,17957.92,6
APR-DRG,183-3,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,18669.15,22402.98,6
APR-DRG,183-4,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,25692.01,30830.41,6
APR-DRG,190-1,ACUTE MYOCARDIAL INFARCTION,,,3117.75,3741.3,6
APR-DRG,190-2,ACUTE MYOCARDIAL INFARCTION,,,3605.75,4326.9,6
APR-DRG,190-3,ACUTE MYOCARDIAL INFARCTION,,,4816.78,5780.14,6
APR-DRG,190-4,ACUTE MYOCARDIAL INFARCTION,,,8051.32,9661.58,6
APR-DRG,191-1,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,3793.34,4552.01,6
APR-DRG,191-2,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,4511.33,5413.6,6
APR-DRG,191-3,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,6148.18,7377.82,6
APR-DRG,191-4,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,9156.69,10988.03,6
APR-DRG,192-1,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,3964.39,4757.27,6
APR-DRG,192-2,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,5082.7,6099.24,6
APR-DRG,192-3,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,7414.19,8897.03,6
APR-DRG,192-4,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,12115.97,14539.16,6
APR-DRG,193-1,ACUTE AND SUBACUTE ENDOCARDITIS,,,4182.16,5018.59,6
APR-DRG,193-2,ACUTE AND SUBACUTE ENDOCARDITIS,,,4563.79,5476.55,6
APR-DRG,193-3,ACUTE AND SUBACUTE ENDOCARDITIS,,,6250.6,7500.72,6
APR-DRG,193-4,ACUTE AND SUBACUTE ENDOCARDITIS,,,9184.72,11021.66,6
APR-DRG,194-1,HEART FAILURE,,,1998.0,2397.6,6
APR-DRG,194-2,HEART FAILURE,,,2795.05,3354.06,6
APR-DRG,194-3,HEART FAILURE,,,4559.12,5470.94,6
APR-DRG,194-4,HEART FAILURE,,,8781.17,10537.4,6
APR-DRG,196-1,CARDIAC ARREST AND SHOCK,,,1814.73,2177.68,6
APR-DRG,196-2,CARDIAC ARREST AND SHOCK,,,2231.22,2677.46,6
APR-DRG,196-3,CARDIAC ARREST AND SHOCK,,,3741.95,4490.34,6
APR-DRG,196-4,CARDIAC ARREST AND SHOCK,,,7417.42,8900.9,6
APR-DRG,197-1,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,2249.91,2699.89,6
APR-DRG,197-2,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,2950.65,3540.78,6
APR-DRG,197-3,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,4646.44,5575.73,6
APR-DRG,197-4,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,8258.67,9910.4,6
APR-DRG,198-1,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,2152.53,2583.04,6
APR-DRG,198-2,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,2541.71,3050.05,6
APR-DRG,198-3,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,3344.14,4012.97,6
APR-DRG,198-4,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,6178.01,7413.61,6
APR-DRG,199-1,HYPERTENSION,,,2221.52,2665.82,6
APR-DRG,199-2,HYPERTENSION,,,2611.78,3134.14,6
APR-DRG,199-3,HYPERTENSION,,,3905.45,4686.54,6
APR-DRG,199-4,HYPERTENSION,,,7347.35,8816.82,6
APR-DRG,200-1,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,2480.26,2976.31,6
APR-DRG,200-2,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,3327.61,3993.13,6
APR-DRG,200-3,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,4913.8,5896.56,6
APR-DRG,200-4,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,8621.26,10345.51,6
APR-DRG,201-1,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,1789.94,2147.93,6
APR-DRG,201-2,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,2408.03,2889.64,6
APR-DRG,201-3,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,3596.77,4316.12,6
APR-DRG,201-4,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,6575.45,7890.54,6
APR-DRG,203-1,CHEST PAIN,,,2243.08,2691.7,6
APR-DRG,203-2,CHEST PAIN,,,2539.91,3047.89,6
APR-DRG,203-3,CHEST PAIN,,,3146.14,3775.37,6
APR-DRG,203-4,CHEST PAIN,,,5012.98,6015.58,6
APR-DRG,204-1,SYNCOPE AND COLLAPSE,,,2509.36,3011.23,6
APR-DRG,204-2,SYNCOPE AND COLLAPSE,,,2845.72,3414.86,6
APR-DRG,204-3,SYNCOPE AND COLLAPSE,,,3650.67,4380.8,6
APR-DRG,204-4,SYNCOPE AND COLLAPSE,,,5891.96,7070.35,6
APR-DRG,205-1,CARDIOMYOPATHY,,,2202.84,2643.41,6
APR-DRG,205-2,CARDIOMYOPATHY,,,2731.09,3277.31,6
APR-DRG,205-3,CARDIOMYOPATHY,,,4289.96,5147.95,6
APR-DRG,205-4,CARDIOMYOPATHY,,,8013.23,9615.88,6
APR-DRG,206-1,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,2805.47,3366.56,6
APR-DRG,206-2,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,3363.91,4036.69,6
APR-DRG,206-3,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,5053.59,6064.31,6
APR-DRG,206-4,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,8803.09,10563.71,6
APR-DRG,207-1,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,2165.1,2598.12,6
APR-DRG,207-2,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,2836.38,3403.66,6
APR-DRG,207-3,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,4100.22,4920.26,6
APR-DRG,207-4,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,7702.75,9243.3,6
APR-DRG,220-1,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,5813.62,6976.34,6
APR-DRG,220-2,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,8348.15,10017.78,6
APR-DRG,220-3,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,12242.11,14690.53,6
APR-DRG,220-4,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,20551.81,24662.17,6
APR-DRG,222-1,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,3220.88,3865.06,6
APR-DRG,222-2,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,5596.93,6716.32,6
APR-DRG,222-3,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,8965.88,10759.06,6
APR-DRG,222-4,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,15242.71,18291.25,6
APR-DRG,223-1,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,4514.56,5417.47,6
APR-DRG,223-2,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,5761.52,6913.82,6
APR-DRG,223-3,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,8111.33,9733.6,6
APR-DRG,223-4,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,14563.53,17476.24,6
APR-DRG,224-1,PERITONEAL ADHESIOLYSIS,,,4958.0,5949.6,6
APR-DRG,224-2,PERITONEAL ADHESIOLYSIS,,,6234.07,7480.88,6
APR-DRG,224-3,PERITONEAL ADHESIOLYSIS,,,9333.14,11199.77,6
APR-DRG,224-4,PERITONEAL ADHESIOLYSIS,,,14338.58,17206.3,6
APR-DRG,226-1,ANAL AND PERINEAL PROCEDURES,,,3300.3,3960.36,6
APR-DRG,226-2,ANAL AND PERINEAL PROCEDURES,,,4155.92,4987.1,6
APR-DRG,226-3,ANAL AND PERINEAL PROCEDURES,,,6483.82,7780.58,6
APR-DRG,226-4,ANAL AND PERINEAL PROCEDURES,,,9666.98,11600.38,6
APR-DRG,227-1,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,4596.13,5515.36,6
APR-DRG,227-2,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,5610.23,6732.28,6
APR-DRG,227-3,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,8318.32,9981.98,6
APR-DRG,227-4,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,14608.45,17530.14,6
APR-DRG,228-1,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,3881.74,4658.09,6
APR-DRG,228-2,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,4857.38,5828.86,6
APR-DRG,228-3,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,6773.46,8128.15,6
APR-DRG,228-4,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,12105.19,14526.23,6
APR-DRG,229-1,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,4480.78,5376.94,6
APR-DRG,229-2,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,6366.31,7639.57,6
APR-DRG,229-3,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,9445.97,11335.16,6
APR-DRG,229-4,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,15132.75,18159.3,6
APR-DRG,230-1,MAJOR SMALL BOWEL PROCEDURES,,,4595.41,5514.49,6
APR-DRG,230-2,MAJOR SMALL BOWEL PROCEDURES,,,7449.76,8939.71,6
APR-DRG,230-3,MAJOR SMALL BOWEL PROCEDURES,,,10953.46,13144.15,6
APR-DRG,230-4,MAJOR SMALL BOWEL PROCEDURES,,,17384.46,20861.35,6
APR-DRG,231-1,MAJOR LARGE BOWEL PROCEDURES,,,5605.56,6726.67,6
APR-DRG,231-2,MAJOR LARGE BOWEL PROCEDURES,,,7186.72,8624.06,6
APR-DRG,231-3,MAJOR LARGE BOWEL PROCEDURES,,,10335.73,12402.88,6
APR-DRG,231-4,MAJOR LARGE BOWEL PROCEDURES,,,15346.21,18415.45,6
APR-DRG,232-1,GASTRIC FUNDOPLICATION,,,4591.82,5510.18,6
APR-DRG,232-2,GASTRIC FUNDOPLICATION,,,5714.44,6857.33,6
APR-DRG,232-3,GASTRIC FUNDOPLICATION,,,9110.34,10932.41,6
APR-DRG,232-4,GASTRIC FUNDOPLICATION,,,14617.08,17540.5,6
APR-DRG,233-1,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,4015.42,4818.5,6
APR-DRG,233-2,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,5182.6,6219.12,6
APR-DRG,233-3,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,7297.76,8757.31,6
APR-DRG,233-4,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,11458.0,13749.6,6
APR-DRG,234-1,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,3753.45,4504.14,6
APR-DRG,234-2,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,4579.6,5495.52,6
APR-DRG,234-3,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,7051.24,8461.49,6
APR-DRG,234-4,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,10174.38,12209.26,6
APR-DRG,240-1,DIGESTIVE MALIGNANCY,,,3006.35,3607.62,6
APR-DRG,240-2,DIGESTIVE MALIGNANCY,,,3741.23,4489.48,6
APR-DRG,240-3,DIGESTIVE MALIGNANCY,,,5452.47,6542.96,6
APR-DRG,240-4,DIGESTIVE MALIGNANCY,,,8698.88,10438.66,6
APR-DRG,241-1,PEPTIC ULCER AND GASTRITIS,,,2648.79,3178.55,6
APR-DRG,241-2,PEPTIC ULCER AND GASTRITIS,,,3189.26,3827.11,6
APR-DRG,241-3,PEPTIC ULCER AND GASTRITIS,,,4729.81,5675.77,6
APR-DRG,241-4,PEPTIC ULCER AND GASTRITIS,,,8998.58,10798.3,6
APR-DRG,242-1,MAJOR ESOPHAGEAL DISORDERS,,,2487.08,2984.5,6
APR-DRG,242-2,MAJOR ESOPHAGEAL DISORDERS,,,3178.12,3813.74,6
APR-DRG,242-3,MAJOR ESOPHAGEAL DISORDERS,,,4739.16,5686.99,6
APR-DRG,242-4,MAJOR ESOPHAGEAL DISORDERS,,,9215.99,11059.19,6
APR-DRG,243-1,OTHER ESOPHAGEAL DISORDERS,,,2422.76,2907.31,6
APR-DRG,243-2,OTHER ESOPHAGEAL DISORDERS,,,3110.2,3732.24,6
APR-DRG,243-3,OTHER ESOPHAGEAL DISORDERS,,,4408.91,5290.69,6
APR-DRG,243-4,OTHER ESOPHAGEAL DISORDERS,,,8145.83,9775.0,6
APR-DRG,244-1,DIVERTICULITIS AND DIVERTICULOSIS,,,1984.71,2381.65,6
APR-DRG,244-2,DIVERTICULITIS AND DIVERTICULOSIS,,,2735.76,3282.91,6
APR-DRG,244-3,DIVERTICULITIS AND DIVERTICULOSIS,,,4292.12,5150.54,6
APR-DRG,244-4,DIVERTICULITIS AND DIVERTICULOSIS,,,7892.85,9471.42,6
APR-DRG,245-1,INFLAMMATORY BOWEL DISEASE,,,2255.66,2706.79,6
APR-DRG,245-2,INFLAMMATORY BOWEL DISEASE,,,3046.24,3655.49,6
APR-DRG,245-3,INFLAMMATORY BOWEL DISEASE,,,4701.78,5642.14,6
APR-DRG,245-4,INFLAMMATORY BOWEL DISEASE,,,8069.29,9683.15,6
APR-DRG,246-1,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,2332.2,2798.64,6
APR-DRG,246-2,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,2978.68,3574.42,6
APR-DRG,246-3,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,4505.22,5406.26,6
APR-DRG,246-4,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,7283.38,8740.06,6
APR-DRG,247-1,INTESTINAL OBSTRUCTION,,,1830.9,2197.08,6
APR-DRG,247-2,INTESTINAL OBSTRUCTION,,,2447.91,2937.49,6
APR-DRG,247-3,INTESTINAL OBSTRUCTION,,,3924.86,4709.83,6
APR-DRG,247-4,INTESTINAL OBSTRUCTION,,,7041.9,8450.28,6
APR-DRG,248-1,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,2121.62,2545.94,6
APR-DRG,248-2,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,2892.79,3471.35,6
APR-DRG,248-3,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,4383.75,5260.5,6
APR-DRG,248-4,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,7656.03,9187.24,6
APR-DRG,249-1,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,1960.63,2352.76,6
APR-DRG,249-2,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,2435.34,2922.41,6
APR-DRG,249-3,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,3626.6,4351.92,6
APR-DRG,249-4,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,6674.28,8009.14,6
APR-DRG,251-1,ABDOMINAL PAIN,,,2158.99,2590.79,6
APR-DRG,251-2,ABDOMINAL PAIN,,,2700.18,3240.22,6
APR-DRG,251-3,ABDOMINAL PAIN,,,3549.69,4259.63,6
APR-DRG,251-4,ABDOMINAL PAIN,,,5574.29,6689.15,6
APR-DRG,252-1,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,2446.84,2936.21,6
APR-DRG,252-2,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,3192.5,3831.0,6
APR-DRG,252-3,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,4842.65,5811.18,6
APR-DRG,252-4,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,8996.06,10795.27,6
APR-DRG,253-1,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,2311.72,2774.06,6
APR-DRG,253-2,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,2978.32,3573.98,6
APR-DRG,253-3,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,4483.65,5380.38,6
APR-DRG,253-4,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,7716.04,9259.25,6
APR-DRG,254-1,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,2283.33,2740.0,6
APR-DRG,254-2,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,2982.63,3579.16,6
APR-DRG,254-3,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,4435.5,5322.6,6
APR-DRG,254-4,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,7488.93,8986.72,6
APR-DRG,260-1,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,7070.28,8484.34,6
APR-DRG,260-2,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,9659.79,11591.75,6
APR-DRG,260-3,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,12804.14,15364.97,6
APR-DRG,260-4,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,21642.45,25970.94,6
APR-DRG,261-1,MAJOR BILIARY TRACT PROCEDURES,,,6125.54,7350.65,6
APR-DRG,261-2,MAJOR BILIARY TRACT PROCEDURES,,,8646.05,10375.26,6
APR-DRG,261-3,MAJOR BILIARY TRACT PROCEDURES,,,10599.14,12718.97,6
APR-DRG,261-4,MAJOR BILIARY TRACT PROCEDURES,,,20123.82,24148.58,6
APR-DRG,263-1,CHOLECYSTECTOMY,,,4543.31,5451.97,6
APR-DRG,263-2,CHOLECYSTECTOMY,,,5622.09,6746.51,6
APR-DRG,263-3,CHOLECYSTECTOMY,,,7737.96,9285.55,6
APR-DRG,263-4,CHOLECYSTECTOMY,,,13025.86,15631.03,6
APR-DRG,264-1,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,5055.03,6066.04,6
APR-DRG,264-2,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,6351.94,7622.33,6
APR-DRG,264-3,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,9546.59,11455.91,6
APR-DRG,264-4,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,17156.27,20587.52,6
APR-DRG,279-1,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,1963.15,2355.78,6
APR-DRG,279-2,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,2836.02,3403.22,6
APR-DRG,279-3,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,4870.32,5844.38,6
APR-DRG,279-4,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,9255.52,11106.62,6
APR-DRG,280-1,ALCOHOLIC LIVER DISEASE,,,2372.09,2846.51,6
APR-DRG,280-2,ALCOHOLIC LIVER DISEASE,,,3158.0,3789.6,6
APR-DRG,280-3,ALCOHOLIC LIVER DISEASE,,,4967.35,5960.82,6
APR-DRG,280-4,ALCOHOLIC LIVER DISEASE,,,9765.44,11718.53,6
APR-DRG,281-1,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,2933.76,3520.51,6
APR-DRG,281-2,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,3922.34,4706.81,6
APR-DRG,281-3,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,5320.59,6384.71,6
APR-DRG,281-4,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,8094.08,9712.9,6
APR-DRG,282-1,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,2057.3,2468.76,6
APR-DRG,282-2,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,2852.91,3423.49,6
APR-DRG,282-3,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,4664.77,5597.72,6
APR-DRG,282-4,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,9913.49,11896.19,6
APR-DRG,283-1,OTHER DISORDERS OF THE LIVER,,,2212.18,2654.62,6
APR-DRG,283-2,OTHER DISORDERS OF THE LIVER,,,3081.46,3697.75,6
APR-DRG,283-3,OTHER DISORDERS OF THE LIVER,,,4697.11,5636.53,6
APR-DRG,283-4,OTHER DISORDERS OF THE LIVER,,,8794.47,10553.36,6
APR-DRG,284-1,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,2707.37,3248.84,6
APR-DRG,284-2,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,3637.02,4364.42,6
APR-DRG,284-3,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,5055.39,6066.47,6
APR-DRG,284-4,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,8483.98,10180.78,6
APR-DRG,299-1,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,14070.86,16885.03,6
APR-DRG,299-2,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,16916.23,20299.48,6
APR-DRG,299-3,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,23000.45,27600.54,6
APR-DRG,299-4,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,29413.84,35296.61,6
APR-DRG,300-1,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,10585.85,12703.02,6
APR-DRG,300-2,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,12024.7,14429.64,6
APR-DRG,300-3,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,15689.75,18827.7,6
APR-DRG,300-4,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,22439.5,26927.4,6
APR-DRG,303-1,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,14937.62,17925.14,6
APR-DRG,303-2,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,17232.1,20678.52,6
APR-DRG,303-3,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,23693.64,28432.37,6
APR-DRG,303-4,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,34140.78,40968.94,6
APR-DRG,304-1,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,9359.37,11231.24,6
APR-DRG,304-2,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,12751.67,15302.0,6
APR-DRG,304-3,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,17749.93,21299.92,6
APR-DRG,304-4,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,24077.43,28892.92,6
APR-DRG,305-1,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,4188.27,5025.92,6
APR-DRG,305-2,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,5702.22,6842.66,6
APR-DRG,305-3,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,8728.34,10474.01,6
APR-DRG,305-4,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,14382.78,17259.34,6
APR-DRG,308-1,HIP AND FEMUR FRACTURE REPAIR,,,4968.42,5962.1,6
APR-DRG,308-2,HIP AND FEMUR FRACTURE REPAIR,,,6406.92,7688.3,6
APR-DRG,308-3,HIP AND FEMUR FRACTURE REPAIR,,,8134.33,9761.2,6
APR-DRG,308-4,HIP AND FEMUR FRACTURE REPAIR,,,11721.04,14065.25,6
APR-DRG,309-1,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,5803.2,6963.84,6
APR-DRG,309-2,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,7602.49,9122.99,6
APR-DRG,309-3,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,10368.8,12442.56,6
APR-DRG,309-4,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,14904.56,17885.47,6
APR-DRG,310-1,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,4825.04,5790.05,6
APR-DRG,310-2,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,6617.5,7941.0,6
APR-DRG,310-3,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,9537.25,11444.7,6
APR-DRG,310-4,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,13911.67,16694.0,6
APR-DRG,312-1,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES,,,5785.24,6942.29,6
APR-DRG,312-2,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES,,,8342.04,10010.45,6
APR-DRG,312-3,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES,,,12767.48,15320.98,6
APR-DRG,312-4,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES,,,20791.86,24950.23,6
APR-DRG,313-1,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,5338.2,6405.84,6
APR-DRG,313-2,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,7111.97,8534.36,6
APR-DRG,313-3,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,10101.44,12121.73,6
APR-DRG,313-4,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,14942.65,17931.18,6
APR-DRG,314-1,FOOT AND TOE PROCEDURES,,,3710.33,4452.4,6
APR-DRG,314-2,FOOT AND TOE PROCEDURES,,,4890.8,5868.96,6
APR-DRG,314-3,FOOT AND TOE PROCEDURES,,,7358.85,8830.62,6
APR-DRG,314-4,FOOT AND TOE PROCEDURES,,,11804.41,14165.29,6
APR-DRG,315-1,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,4766.47,5719.76,6
APR-DRG,315-2,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,6925.47,8310.56,6
APR-DRG,315-3,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,9370.87,11245.04,6
APR-DRG,315-4,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,14677.09,17612.51,6
APR-DRG,316-1,HAND AND WRIST PROCEDURES,,,3744.82,4493.78,6
APR-DRG,316-2,HAND AND WRIST PROCEDURES,,,5009.03,6010.84,6
APR-DRG,316-3,HAND AND WRIST PROCEDURES,,,7486.78,8984.14,6
APR-DRG,316-4,HAND AND WRIST PROCEDURES,,,11894.97,14273.96,6
APR-DRG,317-1,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,4099.51,4919.41,6
APR-DRG,317-2,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,5461.46,6553.75,6
APR-DRG,317-3,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,7792.23,9350.68,6
APR-DRG,317-4,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,13310.47,15972.56,6
APR-DRG,320-1,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,4531.09,5437.31,6
APR-DRG,320-2,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,6329.66,7595.59,6
APR-DRG,320-3,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,9106.38,10927.66,6
APR-DRG,320-4,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,13904.84,16685.81,6
APR-DRG,321-1,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,6380.68,7656.82,6
APR-DRG,321-2,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,8675.88,10411.06,6
APR-DRG,321-3,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,13591.12,16309.34,6
APR-DRG,321-4,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,18137.67,21765.2,6
APR-DRG,322-1,SHOULDER AND ELBOW JOINT REPLACEMENT,,,6002.64,7203.17,6
APR-DRG,322-2,SHOULDER AND ELBOW JOINT REPLACEMENT,,,7256.07,8707.28,6
APR-DRG,322-3,SHOULDER AND ELBOW JOINT REPLACEMENT,,,9909.18,11891.02,6
APR-DRG,322-4,SHOULDER AND ELBOW JOINT REPLACEMENT,,,12708.91,15250.69,6
APR-DRG,323-1,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,5916.76,7100.11,6
APR-DRG,323-2,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,7145.39,8574.47,6
APR-DRG,323-3,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,9609.48,11531.38,6
APR-DRG,323-4,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,13437.68,16125.22,6
APR-DRG,324-1,ELECTIVE HIP JOINT REPLACEMENT,,,5066.17,6079.4,6
APR-DRG,324-2,ELECTIVE HIP JOINT REPLACEMENT,,,6172.98,7407.58,6
APR-DRG,324-3,ELECTIVE HIP JOINT REPLACEMENT,,,9201.25,11041.5,6
APR-DRG,324-4,ELECTIVE HIP JOINT REPLACEMENT,,,12853.37,15424.04,6
APR-DRG,325-1,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,7811.63,9373.96,6
APR-DRG,325-2,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,9674.88,11609.86,6
APR-DRG,325-3,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,11720.33,14064.4,6
APR-DRG,325-4,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,14656.61,17587.93,6
APR-DRG,326-1,ELECTIVE KNEE JOINT REPLACEMENT,,,4994.3,5993.16,6
APR-DRG,326-2,ELECTIVE KNEE JOINT REPLACEMENT,,,5642.93,6771.52,6
APR-DRG,326-3,ELECTIVE KNEE JOINT REPLACEMENT,,,7753.06,9303.67,6
APR-DRG,326-4,ELECTIVE KNEE JOINT REPLACEMENT,,,12206.89,14648.27,6
APR-DRG,340-1,FRACTURE OF FEMUR,,,1953.08,2343.7,6
APR-DRG,340-2,FRACTURE OF FEMUR,,,2468.76,2962.51,6
APR-DRG,340-3,FRACTURE OF FEMUR,,,3735.84,4483.01,6
APR-DRG,340-4,FRACTURE OF FEMUR,,,5760.08,6912.1,6
APR-DRG,341-1,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,2116.59,2539.91,6
APR-DRG,341-2,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,2664.25,3197.1,6
APR-DRG,341-3,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,3960.08,4752.1,6
APR-DRG,341-4,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,7240.98,8689.18,6
APR-DRG,342-1,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,2308.13,2769.76,6
APR-DRG,342-2,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,2961.07,3553.28,6
APR-DRG,342-3,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,4237.14,5084.57,6
APR-DRG,342-4,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,7682.98,9219.58,6
APR-DRG,343-1,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,3474.23,4169.08,6
APR-DRG,343-2,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,4116.4,4939.68,6
APR-DRG,343-3,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,6217.54,7461.05,6
APR-DRG,343-4,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,9685.66,11622.79,6
APR-DRG,344-1,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,2773.13,3327.76,6
APR-DRG,344-2,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,3743.39,4492.07,6
APR-DRG,344-3,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,5531.89,6638.27,6
APR-DRG,344-4,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,8811.71,10574.05,6
APR-DRG,346-1,CONNECTIVE TISSUE DISORDERS,,,2981.2,3577.44,6
APR-DRG,346-2,CONNECTIVE TISSUE DISORDERS,,,4188.27,5025.92,6
APR-DRG,346-3,CONNECTIVE TISSUE DISORDERS,,,6248.44,7498.13,6
APR-DRG,346-4,CONNECTIVE TISSUE DISORDERS,,,11442.19,13730.63,6
APR-DRG,347-1,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,2719.23,3263.08,6
APR-DRG,347-2,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,3459.86,4151.83,6
APR-DRG,347-3,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,4906.61,5887.93,6
APR-DRG,347-4,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,8100.91,9721.09,6
APR-DRG,349-1,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,2457.98,2949.58,6
APR-DRG,349-2,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,3358.52,4030.22,6
APR-DRG,349-3,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,4835.82,5802.98,6
APR-DRG,349-4,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,7987.36,9584.83,6
APR-DRG,351-1,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,2220.08,2664.1,6
APR-DRG,351-2,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,2780.68,3336.82,6
APR-DRG,351-3,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,4091.24,4909.49,6
APR-DRG,351-4,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,7220.85,8665.02,6
APR-DRG,361-1,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,6199.57,7439.48,6
APR-DRG,361-2,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,8267.29,9920.75,6
APR-DRG,361-3,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,11390.08,13668.1,6
APR-DRG,361-4,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,20229.47,24275.36,6
APR-DRG,362-1,MASTECTOMY PROCEDURES,,,5939.4,7127.28,6
APR-DRG,362-2,MASTECTOMY PROCEDURES,,,8934.25,10721.1,6
APR-DRG,362-3,MASTECTOMY PROCEDURES,,,9253.0,11103.6,6
APR-DRG,362-4,MASTECTOMY PROCEDURES,,,11587.72,13905.26,6
APR-DRG,363-1,BREAST PROCEDURES EXCEPT MASTECTOMY,,,5046.76,6056.11,6
APR-DRG,363-2,BREAST PROCEDURES EXCEPT MASTECTOMY,,,8048.45,9658.14,6
APR-DRG,363-3,BREAST PROCEDURES EXCEPT MASTECTOMY,,,10998.74,13198.49,6
APR-DRG,363-4,BREAST PROCEDURES EXCEPT MASTECTOMY,,,11939.17,14327.0,6
APR-DRG,364-1,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,3173.09,3807.71,6
APR-DRG,364-2,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,4187.91,5025.49,6
APR-DRG,364-3,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,6913.61,8296.33,6
APR-DRG,364-4,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,11604.97,13925.96,6
APR-DRG,380-1,SKIN ULCERS,,,2191.7,2630.04,6
APR-DRG,380-2,SKIN ULCERS,,,2807.63,3369.16,6
APR-DRG,380-3,SKIN ULCERS,,,4321.95,5186.34,6
APR-DRG,380-4,SKIN ULCERS,,,7538.16,9045.79,6
APR-DRG,381-1,MAJOR SKIN DISORDERS,,,1792.81,2151.37,6
APR-DRG,381-2,MAJOR SKIN DISORDERS,,,3202.2,3842.64,6
APR-DRG,381-3,MAJOR SKIN DISORDERS,,,5310.53,6372.64,6
APR-DRG,381-4,MAJOR SKIN DISORDERS,,,11014.91,13217.89,6
APR-DRG,382-1,MALIGNANT BREAST DISORDERS,,,2727.13,3272.56,6
APR-DRG,382-2,MALIGNANT BREAST DISORDERS,,,3490.4,4188.48,6
APR-DRG,382-3,MALIGNANT BREAST DISORDERS,,,4700.7,5640.84,6
APR-DRG,382-4,MALIGNANT BREAST DISORDERS,,,7830.68,9396.82,6
APR-DRG,383-1,CELLULITIS AND OTHER SKIN INFECTIONS,,,1803.23,2163.88,6
APR-DRG,383-2,CELLULITIS AND OTHER SKIN INFECTIONS,,,2425.63,2910.76,6
APR-DRG,383-3,CELLULITIS AND OTHER SKIN INFECTIONS,,,3761.71,4514.05,6
APR-DRG,383-4,CELLULITIS AND OTHER SKIN INFECTIONS,,,7202.89,8643.47,6
APR-DRG,384-1,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,2663.17,3195.8,6
APR-DRG,384-2,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,3274.07,3928.88,6
APR-DRG,384-3,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,4657.22,5588.66,6
APR-DRG,384-4,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,7500.43,9000.52,6
APR-DRG,385-1,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,2033.58,2440.3,6
APR-DRG,385-2,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,2635.5,3162.6,6
APR-DRG,385-3,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,4286.73,5144.08,6
APR-DRG,385-4,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,7159.76,8591.71,6
APR-DRG,401-1,ADRENAL PROCEDURES,,,4719.75,5663.7,6
APR-DRG,401-2,ADRENAL PROCEDURES,,,6450.4,7740.48,6
APR-DRG,401-3,ADRENAL PROCEDURES,,,11980.14,14376.17,6
APR-DRG,401-4,ADRENAL PROCEDURES,,,19147.81,22977.37,6
APR-DRG,403-1,PROCEDURES FOR OBESITY,,,4182.52,5019.02,6
APR-DRG,403-2,PROCEDURES FOR OBESITY,,,5171.1,6205.32,6
APR-DRG,403-3,PROCEDURES FOR OBESITY,,,8529.26,10235.11,6
APR-DRG,403-4,PROCEDURES FOR OBESITY,,,16936.71,20324.05,6
APR-DRG,404-1,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,4213.78,5056.54,6
APR-DRG,404-2,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,5936.16,7123.39,6
APR-DRG,404-3,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,9835.87,11803.04,6
APR-DRG,404-4,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,16984.14,20380.97,6
APR-DRG,405-1,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,4979.2,5975.04,6
APR-DRG,405-2,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,6048.28,7257.94,6
APR-DRG,405-3,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,9005.77,10806.92,6
APR-DRG,405-4,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,17189.69,20627.63,6
APR-DRG,420-1,DIABETES,,,1933.68,2320.42,6
APR-DRG,420-2,DIABETES,,,2531.28,3037.54,6
APR-DRG,420-3,DIABETES,,,3831.07,4597.28,6
APR-DRG,420-4,DIABETES,,,7194.62,8633.54,6
APR-DRG,421-1,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,1952.37,2342.84,6
APR-DRG,421-2,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,2870.51,3444.61,6
APR-DRG,421-3,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,4472.87,5367.44,6
APR-DRG,421-4,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,7668.61,9202.33,6
APR-DRG,422-1,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,1641.52,1969.82,6
APR-DRG,422-2,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,2214.33,2657.2,6
APR-DRG,422-3,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,3230.95,3877.14,6
APR-DRG,422-4,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,5280.7,6336.84,6
APR-DRG,423-1,INBORN ERRORS OF METABOLISM,,,2592.37,3110.84,6
APR-DRG,423-2,INBORN ERRORS OF METABOLISM,,,3644.56,4373.47,6
APR-DRG,423-3,INBORN ERRORS OF METABOLISM,,,5577.17,6692.6,6
APR-DRG,423-4,INBORN ERRORS OF METABOLISM,,,14301.92,17162.3,6
APR-DRG,424-1,OTHER ENDOCRINE DISORDERS,,,2259.25,2711.1,6
APR-DRG,424-2,OTHER ENDOCRINE DISORDERS,,,3272.99,3927.59,6
APR-DRG,424-3,OTHER ENDOCRINE DISORDERS,,,4920.99,5905.19,6
APR-DRG,424-4,OTHER ENDOCRINE DISORDERS,,,7983.4,9580.08,6
APR-DRG,425-1,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,1797.84,2157.41,6
APR-DRG,425-2,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,2400.12,2880.14,6
APR-DRG,425-3,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,3552.57,4263.08,6
APR-DRG,425-4,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,6953.14,8343.77,6
APR-DRG,426-1,NON-HYPOVOLEMIC SODIUM DISORDERS,,,1875.46,2250.55,6
APR-DRG,426-2,NON-HYPOVOLEMIC SODIUM DISORDERS,,,2536.67,3044.0,6
APR-DRG,426-3,NON-HYPOVOLEMIC SODIUM DISORDERS,,,3888.21,4665.85,6
APR-DRG,426-4,NON-HYPOVOLEMIC SODIUM DISORDERS,,,6866.17,8239.4,6
APR-DRG,427-1,THYROID DISORDERS,,,2061.61,2473.93,6
APR-DRG,427-2,THYROID DISORDERS,,,2789.3,3347.16,6
APR-DRG,427-3,THYROID DISORDERS,,,4541.87,5450.24,6
APR-DRG,427-4,THYROID DISORDERS,,,8209.08,9850.9,6
APR-DRG,428-1,GENETIC DISORDERS,,,2782.47,3338.96,6
APR-DRG,428-2,GENETIC DISORDERS,,,4327.7,5193.24,6
APR-DRG,428-3,GENETIC DISORDERS,,,11913.66,14296.39,6
APR-DRG,428-4,GENETIC DISORDERS,,,20205.39,24246.47,6
APR-DRG,440-1,KIDNEY TRANSPLANT,,,18214.57,21857.48,6
APR-DRG,440-2,KIDNEY TRANSPLANT,,,19463.69,23356.43,6
APR-DRG,440-3,KIDNEY TRANSPLANT,,,22839.1,27406.92,6
APR-DRG,440-4,KIDNEY TRANSPLANT,,,33592.77,40311.32,6
APR-DRG,441-1,MAJOR BLADDER PROCEDURES,,,8055.63,9666.76,6
APR-DRG,441-2,MAJOR BLADDER PROCEDURES,,,10037.11,12044.53,6
APR-DRG,441-3,MAJOR BLADDER PROCEDURES,,,12966.57,15559.88,6
APR-DRG,441-4,MAJOR BLADDER PROCEDURES,,,18884.77,22661.72,6
APR-DRG,442-1,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,5357.24,6428.69,6
APR-DRG,442-2,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,6280.78,7536.94,6
APR-DRG,442-3,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,9657.27,11588.72,6
APR-DRG,442-4,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,16068.87,19282.64,6
APR-DRG,443-1,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,5082.7,6099.24,6
APR-DRG,443-2,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,6106.14,7327.37,6
APR-DRG,443-3,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,8329.82,9995.78,6
APR-DRG,443-4,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,13712.58,16455.1,6
APR-DRG,444-1,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,4835.82,5802.98,6
APR-DRG,444-2,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,6663.86,7996.63,6
APR-DRG,444-3,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,9470.41,11364.49,6
APR-DRG,444-4,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,15095.02,18114.02,6
APR-DRG,445-1,OTHER BLADDER PROCEDURES,,,4156.64,4987.97,6
APR-DRG,445-2,OTHER BLADDER PROCEDURES,,,5736.36,6883.63,6
APR-DRG,445-3,OTHER BLADDER PROCEDURES,,,7786.84,9344.21,6
APR-DRG,445-4,OTHER BLADDER PROCEDURES,,,11679.72,14015.66,6
APR-DRG,446-1,URETHRAL AND TRANSURETHRAL PROCEDURES,,,3598.57,4318.28,6
APR-DRG,446-2,URETHRAL AND TRANSURETHRAL PROCEDURES,,,4678.07,5613.68,6
APR-DRG,446-3,URETHRAL AND TRANSURETHRAL PROCEDURES,,,7018.9,8422.68,6
APR-DRG,446-4,URETHRAL AND TRANSURETHRAL PROCEDURES,,,11201.78,13442.14,6
APR-DRG,447-1,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES",,,4995.73,5994.88,6
APR-DRG,447-2,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES",,,6197.77,7437.32,6
APR-DRG,447-3,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES",,,9219.58,11063.5,6
APR-DRG,447-4,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES",,,16119.18,19343.02,6
APR-DRG,448-1,"OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES",,,5251.95,6302.34,6
APR-DRG,448-2,"OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES",,,7837.15,9404.58,6
APR-DRG,448-3,"OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES",,,9475.44,11370.53,6
APR-DRG,448-4,"OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES",,,15984.06,19180.87,6
APR-DRG,461-1,KIDNEY AND URINARY TRACT MALIGNANCY,,,2865.12,3438.14,6
APR-DRG,461-2,KIDNEY AND URINARY TRACT MALIGNANCY,,,3421.4,4105.68,6
APR-DRG,461-3,KIDNEY AND URINARY TRACT MALIGNANCY,,,5201.64,6241.97,6
APR-DRG,461-4,KIDNEY AND URINARY TRACT MALIGNANCY,,,8947.55,10737.06,6
APR-DRG,462-1,NEPHRITIS AND NEPHROSIS,,,2186.66,2623.99,6
APR-DRG,462-2,NEPHRITIS AND NEPHROSIS,,,3105.17,3726.2,6
APR-DRG,462-3,NEPHRITIS AND NEPHROSIS,,,5809.31,6971.17,6
APR-DRG,462-4,NEPHRITIS AND NEPHROSIS,,,10361.97,12434.36,6
APR-DRG,463-1,KIDNEY AND URINARY TRACT INFECTIONS,,,1951.29,2341.55,6
APR-DRG,463-2,KIDNEY AND URINARY TRACT INFECTIONS,,,2505.05,3006.06,6
APR-DRG,463-3,KIDNEY AND URINARY TRACT INFECTIONS,,,3420.33,4104.4,6
APR-DRG,463-4,KIDNEY AND URINARY TRACT INFECTIONS,,,5694.68,6833.62,6
APR-DRG,465-1,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,2424.2,2909.04,6
APR-DRG,465-2,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,2970.42,3564.5,6
APR-DRG,465-3,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,4344.23,5213.08,6
APR-DRG,465-4,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,7823.85,9388.62,6
APR-DRG,466-1,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,2178.4,2614.08,6
APR-DRG,466-2,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,2803.67,3364.4,6
APR-DRG,466-3,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,4395.97,5275.16,6
APR-DRG,466-4,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,7415.98,8899.18,6
APR-DRG,468-1,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,2099.34,2519.21,6
APR-DRG,468-2,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,2729.65,3275.58,6
APR-DRG,468-3,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,4227.44,5072.93,6
APR-DRG,468-4,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,7459.11,8950.93,6
APR-DRG,469-1,ACUTE KIDNEY INJURY,,,1874.03,2248.84,6
APR-DRG,469-2,ACUTE KIDNEY INJURY,,,2650.59,3180.71,6
APR-DRG,469-3,ACUTE KIDNEY INJURY,,,4543.31,5451.97,6
APR-DRG,469-4,ACUTE KIDNEY INJURY,,,8742.0,10490.4,6
APR-DRG,470-1,CHRONIC KIDNEY DISEASE,,,2031.78,2438.14,6
APR-DRG,470-2,CHRONIC KIDNEY DISEASE,,,2798.28,3357.94,6
APR-DRG,470-3,CHRONIC KIDNEY DISEASE,,,4405.32,5286.38,6
APR-DRG,470-4,CHRONIC KIDNEY DISEASE,,,8016.46,9619.75,6
APR-DRG,482-1,TRANSURETHRAL PROSTATECTOMY,,,3133.2,3759.84,6
APR-DRG,482-2,TRANSURETHRAL PROSTATECTOMY,,,4431.91,5318.29,6
APR-DRG,482-3,TRANSURETHRAL PROSTATECTOMY,,,7211.15,8653.38,6
APR-DRG,482-4,TRANSURETHRAL PROSTATECTOMY,,,9881.87,11858.24,6
APR-DRG,483-1,"PENIS, TESTES AND SCROTAL PROCEDURES",,,3737.64,4485.17,6
APR-DRG,483-2,"PENIS, TESTES AND SCROTAL PROCEDURES",,,5702.22,6842.66,6
APR-DRG,483-3,"PENIS, TESTES AND SCROTAL PROCEDURES",,,8604.01,10324.81,6
APR-DRG,483-4,"PENIS, TESTES AND SCROTAL PROCEDURES",,,15026.38,18031.66,6
APR-DRG,484-1,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,4583.2,5499.84,6
APR-DRG,484-2,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,5637.9,6765.48,6
APR-DRG,484-3,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,9035.59,10842.71,6
APR-DRG,484-4,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,16552.92,19863.5,6
APR-DRG,485-1,PROSTATECTOMY PROCEDURES,,,5435.22,6522.26,6
APR-DRG,485-2,PROSTATECTOMY PROCEDURES,,,6256.71,7508.05,6
APR-DRG,485-3,PROSTATECTOMY PROCEDURES,,,10013.75,12016.5,6
APR-DRG,485-4,PROSTATECTOMY PROCEDURES,,,16514.11,19816.93,6
APR-DRG,500-1,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,2739.71,3287.65,6
APR-DRG,500-2,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,3244.24,3893.09,6
APR-DRG,500-3,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,4903.02,5883.62,6
APR-DRG,500-4,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,7678.67,9214.4,6
APR-DRG,501-1,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,2064.84,2477.81,6
APR-DRG,501-2,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,2639.09,3166.91,6
APR-DRG,501-3,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,3914.08,4696.9,6
APR-DRG,501-4,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,8059.59,9671.51,6
APR-DRG,511-1,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,5407.55,6489.06,6
APR-DRG,511-2,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,6532.33,7838.8,6
APR-DRG,511-3,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,9995.43,11994.52,6
APR-DRG,511-4,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,18274.22,21929.06,6
APR-DRG,512-1,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,,,5372.7,6447.24,6
APR-DRG,512-2,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,,,6170.82,7404.98,6
APR-DRG,512-3,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,,,10195.59,12234.71,6
APR-DRG,512-4,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,,,17482.57,20979.08,6
APR-DRG,513-1,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,4025.48,4830.58,6
APR-DRG,513-2,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,4956.92,5948.3,6
APR-DRG,513-3,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,8176.02,9811.22,6
APR-DRG,513-4,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,14743.21,17691.85,6
APR-DRG,514-1,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,3984.87,4781.84,6
APR-DRG,514-2,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,5966.71,7160.05,6
APR-DRG,514-3,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,7446.89,8936.27,6
APR-DRG,514-4,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,15455.45,18546.54,6
APR-DRG,517-1,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,3126.73,3752.08,6
APR-DRG,517-2,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,4246.48,5095.78,6
APR-DRG,517-3,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,6386.07,7663.28,6
APR-DRG,517-4,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,9750.71,11700.85,6
APR-DRG,518-1,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,3449.43,4139.32,6
APR-DRG,518-2,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,5782.36,6938.83,6
APR-DRG,518-3,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,9112.49,10934.99,6
APR-DRG,518-4,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,15108.67,18130.4,6
APR-DRG,519-1,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,3740.51,4488.61,6
APR-DRG,519-2,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,4919.91,5903.89,6
APR-DRG,519-3,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,8941.8,10730.16,6
APR-DRG,519-4,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,14796.76,17756.11,6
APR-DRG,520-1,OTHER GYN PROCEDURES FOR MALIGNANCY,,,5171.82,6206.18,6
APR-DRG,520-2,OTHER GYN PROCEDURES FOR MALIGNANCY,,,6593.06,7911.67,6
APR-DRG,520-3,OTHER GYN PROCEDURES FOR MALIGNANCY,,,10142.4,12170.88,6
APR-DRG,520-4,OTHER GYN PROCEDURES FOR MALIGNANCY,,,19077.38,22892.86,6
APR-DRG,530-1,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,2717.43,3260.92,6
APR-DRG,530-2,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,3416.37,4099.64,6
APR-DRG,530-3,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,5240.45,6288.54,6
APR-DRG,530-4,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,8290.29,9948.35,6
APR-DRG,531-1,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,2009.14,2410.97,6
APR-DRG,531-2,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,2650.95,3181.14,6
APR-DRG,531-3,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,4448.08,5337.7,6
APR-DRG,531-4,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,8247.17,9896.6,6
APR-DRG,532-1,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,1973.57,2368.28,6
APR-DRG,532-2,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,2618.25,3141.9,6
APR-DRG,532-3,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,3673.67,4408.4,6
APR-DRG,532-4,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,5900.59,7080.71,6
APR-DRG,539-1,CESAREAN SECTION WITH STERILIZATION,,,2185.23,2622.28,6
APR-DRG,539-2,CESAREAN SECTION WITH STERILIZATION,,,2851.83,3422.2,6
APR-DRG,539-3,CESAREAN SECTION WITH STERILIZATION,,,5562.79,6675.35,6
APR-DRG,539-4,CESAREAN SECTION WITH STERILIZATION,,,10723.48,12868.18,6
APR-DRG,540-1,CESAREAN SECTION WITHOUT STERILIZATION,,,2177.68,2613.22,6
APR-DRG,540-2,CESAREAN SECTION WITHOUT STERILIZATION,,,2782.83,3339.4,6
APR-DRG,540-3,CESAREAN SECTION WITHOUT STERILIZATION,,,4207.31,5048.77,6
APR-DRG,540-4,CESAREAN SECTION WITHOUT STERILIZATION,,,9314.45,11177.34,6
APR-DRG,541-1,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,2162.59,2595.11,6
APR-DRG,541-2,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,2404.43,2885.32,6
APR-DRG,541-3,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,3542.87,4251.44,6
APR-DRG,541-4,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,7284.82,8741.78,6
APR-DRG,542-1,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,1476.58,1771.9,6
APR-DRG,542-2,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,1803.23,2163.88,6
APR-DRG,542-3,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,3390.5,4068.6,6
APR-DRG,542-4,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,9316.25,11179.5,6
APR-DRG,543-1,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,2141.74,2570.09,6
APR-DRG,543-2,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,2721.38,3265.66,6
APR-DRG,543-3,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,4426.88,5312.26,6
APR-DRG,543-4,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,8515.25,10218.3,6
APR-DRG,547-1,ANTEPARTUM WITH O.R. PROCEDURE,,,2191.34,2629.61,6
APR-DRG,547-2,ANTEPARTUM WITH O.R. PROCEDURE,,,4010.39,4812.47,6
APR-DRG,547-3,ANTEPARTUM WITH O.R. PROCEDURE,,,6275.39,7530.47,6
APR-DRG,547-4,ANTEPARTUM WITH O.R. PROCEDURE,,,12056.68,14468.02,6
APR-DRG,548-1,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,1696.86,2036.23,6
APR-DRG,548-2,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,4146.94,4976.33,6
APR-DRG,548-3,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,6522.63,7827.16,6
APR-DRG,548-4,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,12384.05,14860.86,6
APR-DRG,560-1,VAGINAL DELIVERY,,,1297.62,1557.14,6
APR-DRG,560-2,VAGINAL DELIVERY,,,1503.17,1803.8,6
APR-DRG,560-3,VAGINAL DELIVERY,,,2272.19,2726.63,6
APR-DRG,560-4,VAGINAL DELIVERY,,,4534.68,5441.62,6
APR-DRG,561-1,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,1039.97,1247.96,6
APR-DRG,561-2,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,1707.65,2049.18,6
APR-DRG,561-3,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,3069.6,3683.52,6
APR-DRG,561-4,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,6419.49,7703.39,6
APR-DRG,564-1,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,1308.76,1570.51,6
APR-DRG,564-2,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,1833.78,2200.54,6
APR-DRG,564-3,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,3087.56,3705.07,6
APR-DRG,564-4,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,6690.09,8028.11,6
APR-DRG,566-1,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,1136.99,1364.39,6
APR-DRG,566-2,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,1648.71,1978.45,6
APR-DRG,566-3,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,3041.21,3649.45,6
APR-DRG,566-4,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,6384.28,7661.14,6
APR-DRG,580-1,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,1122.98,1347.58,6
APR-DRG,580-2,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,1763.7,2116.44,6
APR-DRG,580-3,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,3481.06,4177.27,6
APR-DRG,580-4,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,4448.08,5337.7,6
APR-DRG,581-1,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,389.89,467.87,6
APR-DRG,581-2,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,609.46,731.35,6
APR-DRG,581-3,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,1154.24,1385.09,6
APR-DRG,581-4,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,2114.07,2536.88,6
APR-DRG,583-1,NEONATE WITH ECMO,,,81748.0,98097.6,6
APR-DRG,583-2,NEONATE WITH ECMO,,,91071.8,109286.16,6
APR-DRG,583-3,NEONATE WITH ECMO,,,118611.61,142333.93,6
APR-DRG,583-4,NEONATE WITH ECMO,,,208261.09,249913.31,6
APR-DRG,588-1,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,62395.71,74874.85,6
APR-DRG,588-2,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,72794.69,87353.63,6
APR-DRG,588-3,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,84952.0,101942.4,6
APR-DRG,588-4,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,127555.93,153067.12,6
APR-DRG,589-1,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,59458.71,71350.45,6
APR-DRG,589-2,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,59458.71,71350.45,6
APR-DRG,589-3,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,59458.71,71350.45,6
APR-DRG,589-4,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,1232.22,1478.66,6
APR-DRG,591-1,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,11490.34,13788.41,6
APR-DRG,591-2,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,54106.85,64928.22,6
APR-DRG,591-3,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,63082.79,75699.35,6
APR-DRG,591-4,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,83645.03,100374.04,6
APR-DRG,593-1,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,32930.12,39516.14,6
APR-DRG,593-2,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,43270.17,51924.2,6
APR-DRG,593-3,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,53796.73,64556.08,6
APR-DRG,593-4,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,73539.99,88247.99,6
APR-DRG,602-1,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,22896.24,27475.49,6
APR-DRG,602-2,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,30735.9,36883.08,6
APR-DRG,602-3,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,38465.25,46158.3,6
APR-DRG,602-4,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,55400.16,66480.19,6
APR-DRG,603-1,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,3060.97,3673.16,6
APR-DRG,603-2,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,18721.26,22465.51,6
APR-DRG,603-3,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,22944.75,27533.7,6
APR-DRG,603-4,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,40520.03,48624.04,6
APR-DRG,607-1,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,15677.17,18812.6,6
APR-DRG,607-2,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,21929.93,26315.92,6
APR-DRG,607-3,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,29361.37,35233.64,6
APR-DRG,607-4,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,42824.57,51389.48,6
APR-DRG,608-1,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,8398.82,10078.58,6
APR-DRG,608-2,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,14566.05,17479.26,6
APR-DRG,608-3,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,21084.37,25301.24,6
APR-DRG,608-4,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,24425.65,29310.78,6
APR-DRG,609-1,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,16158.35,19390.02,6
APR-DRG,609-2,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,20115.91,24139.09,6
APR-DRG,609-3,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,30828.62,36994.34,6
APR-DRG,609-4,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,88871.47,106645.76,6
APR-DRG,611-1,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,6121.23,7345.48,6
APR-DRG,611-2,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,11668.94,14002.73,6
APR-DRG,611-3,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,18995.09,22794.11,6
APR-DRG,611-4,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,35617.73,42741.28,6
APR-DRG,612-1,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,9390.99,11269.19,6
APR-DRG,612-2,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,13606.22,16327.46,6
APR-DRG,612-3,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,19429.55,23315.46,6
APR-DRG,612-4,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,28057.28,33668.74,6
APR-DRG,613-1,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,7198.93,8638.72,6
APR-DRG,613-2,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,11225.14,13470.17,6
APR-DRG,613-3,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,19070.19,22884.23,6
APR-DRG,613-4,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,35290.35,42348.42,6
APR-DRG,614-1,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,4739.16,5686.99,6
APR-DRG,614-2,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,9185.8,11022.96,6
APR-DRG,614-3,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,15903.21,19083.85,6
APR-DRG,614-4,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,23547.03,28256.44,6
APR-DRG,621-1,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,2292.67,2751.2,6
APR-DRG,621-2,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,6936.25,8323.5,6
APR-DRG,621-3,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,13847.7,16617.24,6
APR-DRG,621-4,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,27515.37,33018.44,6
APR-DRG,622-1,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,5922.15,7106.58,6
APR-DRG,622-2,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,8538.61,10246.33,6
APR-DRG,622-3,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,12202.58,14643.1,6
APR-DRG,622-4,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,18194.81,21833.77,6
APR-DRG,623-1,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,4279.18,5135.02,6
APR-DRG,623-2,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,7419.22,8903.06,6
APR-DRG,623-3,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,14783.1,17739.72,6
APR-DRG,623-4,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,19655.58,23586.7,6
APR-DRG,625-1,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,4618.77,5542.52,6
APR-DRG,625-2,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,6731.05,8077.26,6
APR-DRG,625-3,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,11203.22,13443.86,6
APR-DRG,625-4,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,24390.07,29268.08,6
APR-DRG,626-1,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,582.51,699.01,6
APR-DRG,626-2,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,1244.08,1492.9,6
APR-DRG,626-3,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,3592.82,4311.38,6
APR-DRG,626-4,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,7198.57,8638.28,6
APR-DRG,630-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,10107.19,12128.63,6
APR-DRG,630-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,19474.47,23369.36,6
APR-DRG,630-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,42730.78,51276.94,6
APR-DRG,630-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,77520.2,93024.24,6
APR-DRG,631-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,2899.98,3479.98,6
APR-DRG,631-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,14471.9,17366.28,6
APR-DRG,631-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,25123.51,30148.21,6
APR-DRG,631-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,85478.45,102574.14,6
APR-DRG,633-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,936.83,1124.2,6
APR-DRG,633-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,4104.54,4925.45,6
APR-DRG,633-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,10644.78,12773.74,6
APR-DRG,633-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,27983.61,33580.33,6
APR-DRG,634-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,2718.15,3261.78,6
APR-DRG,634-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,4438.02,5325.62,6
APR-DRG,634-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,8865.62,10638.74,6
APR-DRG,634-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,16974.08,20368.9,6
APR-DRG,636-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,2950.65,3540.78,6
APR-DRG,636-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,4776.89,5732.27,6
APR-DRG,636-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,9942.6,11931.12,6
APR-DRG,636-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,9942.6,11931.12,6
APR-DRG,639-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,1386.74,1664.09,6
APR-DRG,639-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,2667.48,3200.98,6
APR-DRG,639-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,7875.96,9451.15,6
APR-DRG,639-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,11818.43,14182.12,6
APR-DRG,640-1,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,418.28,501.94,6
APR-DRG,640-2,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,622.04,746.45,6
APR-DRG,640-3,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,1404.35,1685.22,6
APR-DRG,640-4,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,7773.18,9327.82,6
APR-DRG,650-1,SPLENIC PROCEDURES,,,5548.06,6657.67,6
APR-DRG,650-2,SPLENIC PROCEDURES,,,8083.3,9699.96,6
APR-DRG,650-3,SPLENIC PROCEDURES,,,10032.8,12039.36,6
APR-DRG,650-4,SPLENIC PROCEDURES,,,15920.46,19104.55,6
APR-DRG,651-1,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,4808.87,5770.64,6
APR-DRG,651-2,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,6833.83,8200.6,6
APR-DRG,651-3,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,9264.86,11117.83,6
APR-DRG,651-4,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,17885.04,21462.05,6
APR-DRG,660-1,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,2622.92,3147.5,6
APR-DRG,660-2,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,3345.58,4014.7,6
APR-DRG,660-3,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,5292.2,6350.64,6
APR-DRG,660-4,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,10022.38,12026.86,6
APR-DRG,661-1,COAGULATION AND PLATELET DISORDERS,,,3106.25,3727.5,6
APR-DRG,661-2,COAGULATION AND PLATELET DISORDERS,,,4239.65,5087.58,6
APR-DRG,661-3,COAGULATION AND PLATELET DISORDERS,,,6145.31,7374.37,6
APR-DRG,661-4,COAGULATION AND PLATELET DISORDERS,,,9786.28,11743.54,6
APR-DRG,662-1,SICKLE CELL ANEMIA CRISIS,,,2303.81,2764.57,6
APR-DRG,662-2,SICKLE CELL ANEMIA CRISIS,,,3159.79,3791.75,6
APR-DRG,662-3,SICKLE CELL ANEMIA CRISIS,,,5054.31,6065.17,6
APR-DRG,662-4,SICKLE CELL ANEMIA CRISIS,,,9161.73,10994.08,6
APR-DRG,663-1,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,2119.46,2543.35,6
APR-DRG,663-2,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,2944.54,3533.45,6
APR-DRG,663-3,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,4132.57,4959.08,6
APR-DRG,663-4,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,7271.88,8726.26,6
APR-DRG,680-1,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,6213.59,7456.31,6
APR-DRG,680-2,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,8552.26,10262.71,6
APR-DRG,680-3,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,13562.37,16274.84,6
APR-DRG,680-4,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,24899.27,29879.12,6
APR-DRG,681-1,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,4950.82,5940.98,6
APR-DRG,681-2,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,6645.53,7974.64,6
APR-DRG,681-3,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,10444.98,12533.98,6
APR-DRG,681-4,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,20831.03,24997.24,6
APR-DRG,690-1,ACUTE LEUKEMIA,,,5383.84,6460.61,6
APR-DRG,690-2,ACUTE LEUKEMIA,,,9699.68,11639.62,6
APR-DRG,690-3,ACUTE LEUKEMIA,,,15034.65,18041.58,6
APR-DRG,690-4,ACUTE LEUKEMIA,,,22256.58,26707.9,6
APR-DRG,691-1,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,4044.16,4852.99,6
APR-DRG,691-2,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,5552.01,6662.41,6
APR-DRG,691-3,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,8261.54,9913.85,6
APR-DRG,691-4,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,14013.36,16816.03,6
APR-DRG,692-1,RADIOTHERAPY,,,4455.98,5347.18,6
APR-DRG,692-2,RADIOTHERAPY,,,6782.08,8138.5,6
APR-DRG,692-3,RADIOTHERAPY,,,9791.67,11750.0,6
APR-DRG,692-4,RADIOTHERAPY,,,12296.37,14755.64,6
APR-DRG,694-1,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,2737.91,3285.49,6
APR-DRG,694-2,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,3568.74,4282.49,6
APR-DRG,694-3,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,5427.32,6512.78,6
APR-DRG,694-4,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,8957.97,10749.56,6
APR-DRG,695-1,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,3257.54,3909.05,6
APR-DRG,695-2,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,5192.3,6230.76,6
APR-DRG,695-3,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,10371.31,12445.57,6
APR-DRG,695-4,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,20484.61,24581.53,6
APR-DRG,696-1,OTHER CHEMOTHERAPY,,,2952.45,3542.94,6
APR-DRG,696-2,OTHER CHEMOTHERAPY,,,3687.33,4424.8,6
APR-DRG,696-3,OTHER CHEMOTHERAPY,,,5976.77,7172.12,6
APR-DRG,696-4,OTHER CHEMOTHERAPY,,,11021.74,13226.09,6
APR-DRG,710-1,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,5084.85,6101.82,6
APR-DRG,710-2,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,7499.71,8999.65,6
APR-DRG,710-3,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,11119.13,13342.96,6
APR-DRG,710-4,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,17094.46,20513.35,6
APR-DRG,711-1,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,4314.04,5176.85,6
APR-DRG,711-2,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,6128.78,7354.54,6
APR-DRG,711-3,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,9901.28,11881.54,6
APR-DRG,711-4,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,16666.11,19999.33,6
APR-DRG,720-1,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,2472.35,2966.82,6
APR-DRG,720-2,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,3471.35,4165.62,6
APR-DRG,720-3,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,5518.95,6622.74,6
APR-DRG,720-4,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,10177.26,12212.71,6
APR-DRG,721-1,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,2455.1,2946.12,6
APR-DRG,721-2,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,3429.67,4115.6,6
APR-DRG,721-3,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,5646.17,6775.4,6
APR-DRG,721-4,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,9631.76,11558.11,6
APR-DRG,722-1,FEVER AND INFLAMMATORY CONDITIONS,,,1752.56,2103.07,6
APR-DRG,722-2,FEVER AND INFLAMMATORY CONDITIONS,,,2409.1,2890.92,6
APR-DRG,722-3,FEVER AND INFLAMMATORY CONDITIONS,,,3300.66,3960.79,6
APR-DRG,722-4,FEVER AND INFLAMMATORY CONDITIONS,,,5146.3,6175.56,6
APR-DRG,723-1,VIRAL ILLNESS,,,1645.48,1974.58,6
APR-DRG,723-2,VIRAL ILLNESS,,,2369.58,2843.5,6
APR-DRG,723-3,VIRAL ILLNESS,,,3911.92,4694.3,6
APR-DRG,723-4,VIRAL ILLNESS,,,7548.94,9058.73,6
APR-DRG,724-1,OTHER INFECTIOUS AND PARASITIC DISEASES,,,2069.16,2482.99,6
APR-DRG,724-2,OTHER INFECTIOUS AND PARASITIC DISEASES,,,2976.52,3571.82,6
APR-DRG,724-3,OTHER INFECTIOUS AND PARASITIC DISEASES,,,4691.0,5629.2,6
APR-DRG,724-4,OTHER INFECTIOUS AND PARASITIC DISEASES,,,9207.72,11049.26,6
APR-DRG,740-1,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,3304.97,3965.96,6
APR-DRG,740-2,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,5544.47,6653.36,6
APR-DRG,740-3,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,9711.54,11653.85,6
APR-DRG,740-4,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,21092.28,25310.74,6
APR-DRG,750-1,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS,,,2247.75,2697.3,6
APR-DRG,750-2,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS,,,3108.77,3730.52,6
APR-DRG,750-3,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS,,,4659.74,5591.69,6
APR-DRG,750-4,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS,,,9004.69,10805.63,6
APR-DRG,751-1,DEPRESSIVE DISORDERS,,,1395.01,1674.01,6
APR-DRG,751-2,DEPRESSIVE DISORDERS,,,1874.03,2248.84,6
APR-DRG,751-3,DEPRESSIVE DISORDERS,,,3805.19,4566.23,6
APR-DRG,751-4,DEPRESSIVE DISORDERS,,,7285.54,8742.65,6
APR-DRG,752-1,PERSONALITY DISORDERS,,,1461.13,1753.36,6
APR-DRG,752-2,PERSONALITY DISORDERS,,,1924.34,2309.21,6
APR-DRG,752-3,PERSONALITY DISORDERS,,,4287.09,5144.51,6
APR-DRG,752-4,PERSONALITY DISORDERS,,,10205.65,12246.78,6
APR-DRG,753-1,BIPOLAR DISORDERS,,,1607.74,1929.29,6
APR-DRG,753-2,BIPOLAR DISORDERS,,,2140.67,2568.8,6
APR-DRG,753-3,BIPOLAR DISORDERS,,,3932.05,4718.46,6
APR-DRG,753-4,BIPOLAR DISORDERS,,,6816.58,8179.9,6
APR-DRG,755-1,ADJUSTMENT DISORDERS,,,1036.01,1243.21,6
APR-DRG,755-2,ADJUSTMENT DISORDERS,,,1443.52,1732.22,6
APR-DRG,755-3,ADJUSTMENT DISORDERS,,,2865.12,3438.14,6
APR-DRG,755-4,ADJUSTMENT DISORDERS,,,3949.3,4739.16,6
APR-DRG,756-1,ACUTE ANXIETY AND STRESS SYNDROMES,,,1721.66,2065.99,6
APR-DRG,756-2,ACUTE ANXIETY AND STRESS SYNDROMES,,,2639.81,3167.77,6
APR-DRG,756-3,ACUTE ANXIETY AND STRESS SYNDROMES,,,3695.23,4434.28,6
APR-DRG,756-4,ACUTE ANXIETY AND STRESS SYNDROMES,,,6559.64,7871.57,6
APR-DRG,757-1,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES,,,2069.16,2482.99,6
APR-DRG,757-2,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES,,,3107.33,3728.8,6
APR-DRG,757-3,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES,,,4440.17,5328.2,6
APR-DRG,757-4,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES,,,10922.2,13106.64,6
APR-DRG,758-1,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT,,,1714.47,2057.36,6
APR-DRG,758-2,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT,,,2193.49,2632.19,6
APR-DRG,758-3,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT,,,3588.5,4306.2,6
APR-DRG,758-4,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT,,,12093.69,14512.43,6
APR-DRG,759-1,EATING DISORDERS,,,4032.31,4838.77,6
APR-DRG,759-2,EATING DISORDERS,,,5383.48,6460.18,6
APR-DRG,759-3,EATING DISORDERS,,,7612.91,9135.49,6
APR-DRG,759-4,EATING DISORDERS,,,12762.45,15314.94,6
APR-DRG,760-1,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS,,,2055.5,2466.6,6
APR-DRG,760-2,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS,,,2468.4,2962.08,6
APR-DRG,760-3,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS,,,3876.71,4652.05,6
APR-DRG,760-4,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS,,,7932.38,9518.86,6
APR-DRG,761-1,SCHIZOAFFECTIVE DISORDERS,,,2901.06,3481.27,6
APR-DRG,761-2,SCHIZOAFFECTIVE DISORDERS,,,3069.24,3683.09,6
APR-DRG,761-3,SCHIZOAFFECTIVE DISORDERS,,,5633.23,6759.88,6
APR-DRG,761-4,SCHIZOAFFECTIVE DISORDERS,,,9672.73,11607.28,6
APR-DRG,762-1,OBSESSIVE COMPULSIVE DISORDERS,,,2282.97,2739.56,6
APR-DRG,762-2,OBSESSIVE COMPULSIVE DISORDERS,,,2723.18,3267.82,6
APR-DRG,762-3,OBSESSIVE COMPULSIVE DISORDERS,,,4344.23,5213.08,6
APR-DRG,762-4,OBSESSIVE COMPULSIVE DISORDERS,,,5009.75,6011.7,6
APR-DRG,770-1,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,1045.72,1254.86,6
APR-DRG,770-2,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,1639.37,1967.24,6
APR-DRG,770-3,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,2827.03,3392.44,6
APR-DRG,770-4,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,6054.75,7265.7,6
APR-DRG,772-1,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,1972.13,2366.56,6
APR-DRG,772-2,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,2595.61,3114.73,6
APR-DRG,772-3,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,4017.93,4821.52,6
APR-DRG,772-4,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,8268.01,9921.61,6
APR-DRG,773-1,OPIOID ABUSE AND DEPENDENCE,,,1188.38,1426.06,6
APR-DRG,773-2,OPIOID ABUSE AND DEPENDENCE,,,1762.99,2115.59,6
APR-DRG,773-3,OPIOID ABUSE AND DEPENDENCE,,,3420.33,4104.4,6
APR-DRG,773-4,OPIOID ABUSE AND DEPENDENCE,,,7326.5,8791.8,6
APR-DRG,774-1,COCAINE ABUSE AND DEPENDENCE,,,1320.62,1584.74,6
APR-DRG,774-2,COCAINE ABUSE AND DEPENDENCE,,,1765.14,2118.17,6
APR-DRG,774-3,COCAINE ABUSE AND DEPENDENCE,,,3089.0,3706.8,6
APR-DRG,774-4,COCAINE ABUSE AND DEPENDENCE,,,7680.47,9216.56,6
APR-DRG,775-1,ALCOHOL ABUSE AND DEPENDENCE,,,1521.14,1825.37,6
APR-DRG,775-2,ALCOHOL ABUSE AND DEPENDENCE,,,2312.8,2775.36,6
APR-DRG,775-3,ALCOHOL ABUSE AND DEPENDENCE,,,4194.37,5033.24,6
APR-DRG,775-4,ALCOHOL ABUSE AND DEPENDENCE,,,9470.41,11364.49,6
APR-DRG,776-1,OTHER DRUG ABUSE AND DEPENDENCE,,,1377.76,1653.31,6
APR-DRG,776-2,OTHER DRUG ABUSE AND DEPENDENCE,,,1895.95,2275.14,6
APR-DRG,776-3,OTHER DRUG ABUSE AND DEPENDENCE,,,3586.35,4303.62,6
APR-DRG,776-4,OTHER DRUG ABUSE AND DEPENDENCE,,,6808.32,8169.98,6
APR-DRG,792-1,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,5723.79,6868.55,6
APR-DRG,792-2,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,7257.15,8708.58,6
APR-DRG,792-3,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,10647.65,12777.18,6
APR-DRG,792-4,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,18071.91,21686.29,6
APR-DRG,793-1,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,4289.24,5147.09,6
APR-DRG,793-2,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,5732.77,6879.32,6
APR-DRG,793-3,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,8181.41,9817.69,6
APR-DRG,793-4,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,14262.04,17114.45,6
APR-DRG,794-1,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,3432.54,4119.05,6
APR-DRG,794-2,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,4647.16,5576.59,6
APR-DRG,794-3,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,6675.71,8010.85,6
APR-DRG,794-4,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,13849.86,16619.83,6
APR-DRG,810-1,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,2035.38,2442.46,6
APR-DRG,810-2,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,2830.63,3396.76,6
APR-DRG,810-3,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,4500.9,5401.08,6
APR-DRG,810-4,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,8618.38,10342.06,6
APR-DRG,811-1,ALLERGIC REACTIONS,,,1465.08,1758.1,6
APR-DRG,811-2,ALLERGIC REACTIONS,,,2128.81,2554.57,6
APR-DRG,811-3,ALLERGIC REACTIONS,,,4110.29,4932.35,6
APR-DRG,811-4,ALLERGIC REACTIONS,,,7999.22,9599.06,6
APR-DRG,812-1,POISONING OF MEDICINAL AGENTS,,,1566.06,1879.27,6
APR-DRG,812-2,POISONING OF MEDICINAL AGENTS,,,2339.75,2807.7,6
APR-DRG,812-3,POISONING OF MEDICINAL AGENTS,,,3726.14,4471.37,6
APR-DRG,812-4,POISONING OF MEDICINAL AGENTS,,,7311.41,8773.69,6
APR-DRG,813-1,OTHER COMPLICATIONS OF TREATMENT,,,2288.36,2746.03,6
APR-DRG,813-2,OTHER COMPLICATIONS OF TREATMENT,,,3118.83,3742.6,6
APR-DRG,813-3,OTHER COMPLICATIONS OF TREATMENT,,,4570.26,5484.31,6
APR-DRG,813-4,OTHER COMPLICATIONS OF TREATMENT,,,8047.37,9656.84,6
APR-DRG,815-1,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,1726.69,2072.03,6
APR-DRG,815-2,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,2633.7,3160.44,6
APR-DRG,815-3,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,4402.8,5283.36,6
APR-DRG,815-4,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,9361.53,11233.84,6
APR-DRG,816-1,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,1838.45,2206.14,6
APR-DRG,816-2,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,2538.83,3046.6,6
APR-DRG,816-3,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,4789.11,5746.93,6
APR-DRG,816-4,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,9171.07,11005.28,6
APR-DRG,817-1,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,1559.59,1871.51,6
APR-DRG,817-2,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,2276.5,2731.8,6
APR-DRG,817-3,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,4261.21,5113.45,6
APR-DRG,817-4,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,8677.32,10412.78,6
APR-DRG,841-1,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,16855.85,20227.02,6
APR-DRG,841-2,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,16855.85,20227.02,6
APR-DRG,841-3,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,25725.07,30870.08,6
APR-DRG,841-4,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,79102.08,94922.5,6
APR-DRG,842-1,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,6376.73,7652.08,6
APR-DRG,842-2,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,9610.92,11533.1,6
APR-DRG,842-3,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,17888.28,21465.94,6
APR-DRG,842-4,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,44285.7,53142.84,6
APR-DRG,843-1,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,2746.9,3296.28,6
APR-DRG,843-2,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,3903.3,4683.96,6
APR-DRG,843-3,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,7023.21,8427.85,6
APR-DRG,843-4,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,10123.36,12148.03,6
APR-DRG,844-1,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,2037.89,2445.47,6
APR-DRG,844-2,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,3418.53,4102.24,6
APR-DRG,844-3,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,5363.35,6436.02,6
APR-DRG,844-4,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,9554.5,11465.4,6
APR-DRG,850-1,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,5564.23,6677.08,6
APR-DRG,850-2,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,8753.14,10503.77,6
APR-DRG,850-3,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,13094.5,15713.4,6
APR-DRG,850-4,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,23228.64,27874.37,6
APR-DRG,851-1,GENDER RELATED PROCEDURES,,,7400.17,8880.2,6
APR-DRG,851-2,GENDER RELATED PROCEDURES,,,12635.6,15162.72,6
APR-DRG,851-3,GENDER RELATED PROCEDURES,,,40865.01,49038.01,6
APR-DRG,851-4,GENDER RELATED PROCEDURES,,,40865.01,49038.01,6
APR-DRG,860-1,REHABILITATION,,,4266.25,5119.5,6
APR-DRG,860-2,REHABILITATION,,,5522.55,6627.06,6
APR-DRG,860-3,REHABILITATION,,,7329.38,8795.26,6
APR-DRG,860-4,REHABILITATION,,,9073.68,10888.42,6
APR-DRG,861-1,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,2008.07,2409.68,6
APR-DRG,861-2,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,2628.67,3154.4,6
APR-DRG,861-3,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,3849.04,4618.85,6
APR-DRG,861-4,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,6281.5,7537.8,6
APR-DRG,862-1,OTHER AFTERCARE AND CONVALESCENCE,,,1460.77,1752.92,6
APR-DRG,862-2,OTHER AFTERCARE AND CONVALESCENCE,,,3339.47,4007.36,6
APR-DRG,862-3,OTHER AFTERCARE AND CONVALESCENCE,,,4251.87,5102.24,6
APR-DRG,862-4,OTHER AFTERCARE AND CONVALESCENCE,,,4251.87,5102.24,6
APR-DRG,863-1,NEONATAL AFTERCARE,,,5034.54,6041.45,6
APR-DRG,863-2,NEONATAL AFTERCARE,,,9192.99,11031.59,6
APR-DRG,863-3,NEONATAL AFTERCARE,,,17820.36,21384.43,6
APR-DRG,863-4,NEONATAL AFTERCARE,,,34835.41,41802.49,6
APR-DRG,890-1,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,2977.6,3573.12,6
APR-DRG,890-2,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,4196.89,5036.27,6
APR-DRG,890-3,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,7237.03,8684.44,6
APR-DRG,890-4,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,12896.13,15475.36,6
APR-DRG,892-1,HIV WITH MAJOR HIV RELATED CONDITION,,,2941.31,3529.57,6
APR-DRG,892-2,HIV WITH MAJOR HIV RELATED CONDITION,,,3617.25,4340.7,6
APR-DRG,892-3,HIV WITH MAJOR HIV RELATED CONDITION,,,5178.65,6214.38,6
APR-DRG,892-4,HIV WITH MAJOR HIV RELATED CONDITION,,,8473.92,10168.7,6
APR-DRG,893-1,HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,,,2763.07,3315.68,6
APR-DRG,893-2,HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,,,3903.66,4684.39,6
APR-DRG,893-3,HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,,,4729.81,5675.77,6
APR-DRG,893-4,HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,,,8091.57,9709.88,6
APR-DRG,894-1,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,2529.49,3035.39,6
APR-DRG,894-2,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,3188.54,3826.25,6
APR-DRG,894-3,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,4219.53,5063.44,6
APR-DRG,894-4,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,7002.37,8402.84,6
APR-DRG,910-1,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,9370.87,11245.04,6
APR-DRG,910-2,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,10051.13,12061.36,6
APR-DRG,910-3,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,16535.67,19842.8,6
APR-DRG,910-4,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,25616.19,30739.43,6
APR-DRG,911-1,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,7041.9,8450.28,6
APR-DRG,911-2,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,9198.74,11038.49,6
APR-DRG,911-3,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,14099.25,16919.1,6
APR-DRG,911-4,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,24364.91,29237.89,6
APR-DRG,912-1,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,7607.52,9129.02,6
APR-DRG,912-2,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,10253.44,12304.13,6
APR-DRG,912-3,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,14369.48,17243.38,6
APR-DRG,912-4,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,22654.03,27184.84,6
APR-DRG,930-1,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,3401.28,4081.54,6
APR-DRG,930-2,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,4283.85,5140.62,6
APR-DRG,930-3,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,6629.36,7955.23,6
APR-DRG,930-4,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,11760.21,14112.25,6
APR-DRG,950-1,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,5993.3,7191.96,6
APR-DRG,950-2,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,7800.13,9360.16,6
APR-DRG,950-3,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,12087.59,14505.11,6
APR-DRG,950-4,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,20120.94,24145.13,6
APR-DRG,951-1,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,4472.87,5367.44,6
APR-DRG,951-2,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,6482.02,7778.42,6
APR-DRG,951-3,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,9516.41,11419.69,6
APR-DRG,951-4,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,15776.71,18932.05,6
APR-DRG,952-1,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,3853.35,4624.02,6
APR-DRG,952-2,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,5431.27,6517.52,6
APR-DRG,952-3,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,8260.82,9912.98,6
APR-DRG,952-4,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,14369.84,17243.81,6
CDM,0055TWE,CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI,730.0,474.5,53.0,730.0,18
CDM,0075TWE,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,3898.0,2533.7,53.0,3898.0,18
CDM,0076TWE,TCAT PLMT XTRC VRT CRTD STENT RS&IPRQ EA VSL,2228.0,1448.2,53.0,2228.0,18
CDM,0092TWE,ARTIFIC DISC ADDL,21441.0,13936.65,53.0,21441.0,17
CDM,0095TWE,RMVL TOT DISC ARTHRP ANT APPR CRV EA NTRSPC,16896.0,10982.4,53.0,16896.0,18
CDM,0098TWE,REVJ TOT DISC ARTHRP ANT APPR CRV EA NTRSPC,11653.0,7574.45,53.0,11653.0,18
CDM,0101TWE,"EXTRACORP SHOCKWV TX,HI ENRG",190.0,123.5,53.0,548.14,18
CDM,0184TWE,RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC,7239.0,4705.35,53.0,7239.0,18
CDM,01996RVUWE,DAILY ROUNDS; EPIDURAL,193.0,125.45,53.0,193.0,18
CDM,01996WE,DAILY HOSP MGMT EDRL/SARACH CONT DRUG ADMN,395.0,256.75,53.0,395.0,18
CDM,0200TWE,PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL,6516.0,4235.4,3258.0,6516.0,13
CDM,0201TWE,PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS,12831.0,8340.15,5025.27,12831.0,13
CDM,0232TWE,NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,935.0,607.75,467.5,1496.99,13
CDM,0232TX1WE,PB NJX PLTLT RICH PLASMA ADDTL SAME DAY,876.0,569.4,438.0,1496.99,13
CDM,0234TARAWE,TRLUML PERIP ATHRC RENAL ART,5111.0,3322.15,2555.5,15995.68,13
CDM,0234TATHWE,"TP ATHERECTOMY,PERC; RENAL ARTERY",5111.0,3322.15,2555.5,15995.68,13
CDM,0234TWE,TRLUML PERIPHERAL ATHERECTOMY RENAL ARTERY EA,5111.0,3322.15,2555.5,15995.68,13
CDM,0235TATHWE,"TP ATHERECTOMY,PERC; VISCERAL ARTERY",5131.0,3335.15,2565.5,15995.68,13
CDM,0235TVISWE,TRLUML PERIP ATHRC VISCERAL,5131.0,3335.15,2565.5,15995.68,13
CDM,0235TWE,TRLUML PERIPHERAL ATHERECTOMY VISCERAL ARTERY EA,5131.0,3335.15,2565.5,15995.68,13
CDM,0236TABDWE,TRLUML PERIP ATHRC ABD AORTA,4455.0,2895.75,2227.5,16285.51,13
CDM,0236TATHWE,"TP ATHERECTOMY,PERC; ABDOMINAL AORTA",4455.0,2895.75,2227.5,16285.51,13
CDM,0236TWE,TRLUML PERIPH ATHRC W/RS&I ABDOM AORTA,4455.0,2895.75,2227.5,16285.51,13
CDM,0237TATHWE,"TP ATHERECTOMY,PERC; BRACHIOCEPHALIC",5843.0,3797.95,2921.5,16285.51,13
CDM,0237TBRCWE,TRLUML PERIP ATHRC BRCHIOCPH,5843.0,3797.95,2921.5,16285.51,13
CDM,0237TWE,TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL,5843.0,3797.95,2921.5,16285.51,13
CDM,0238TWE,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,4299.0,2794.35,2149.5,16285.51,13
CDM,0263TWE,AUTO BONE MARRW CELL RX COMPLT BONE MARRW HARVST,3196.0,2077.4,119.49,3196.0,13
CDM,0339TWE,TRANSCATH RENAL SYMP DENERV BILAT,8704.0,5657.6,3310.85,8704.0,13
CDM,0358TWE,BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R,67.0,43.55,33.5,67.0,13
CDM,0408TWE,INSJ/RPLC CAR MODULJ SYS PLS GEN TRANSVNS ELTRD,5227.0,3397.55,1036.3,5227.0,13
CDM,0409TWE,INSJ/RPLC CARDIAC MODULJ SYS PLS GENERATOR ONLY,2334.0,1517.1,713.42,2334.0,13
CDM,0410TWE,INSJ/RPLC CARDIAC MODULJ SYS ATR ELECTRODE ONLY,2460.0,1599.0,740.34,2460.0,13
CDM,0411TWE,INSJ/RPLC CAR MODULJ SYS VENTR ELECTRODE ONLY,2460.0,1599.0,740.34,2460.0,13
CDM,0412TWE,REMOVAL CARDIAC MODULJ SYS PLS GENERATOR ONLY,1436.0,933.4,462.69,1436.0,13
CDM,0413TWE,REMOVAL CARDIAC MODULJ SYS TRANSVENOUS ELECTRODE,3675.0,2388.75,966.65,3675.0,13
CDM,0414TWE,(2017) RMVL & RPL CARDIAC MODULJ SYS PLS GENERATOR ONLY,2330.0,1514.5,744.62,2330.0,13
CDM,0415TWE,(2017) REPOS CARDIAC MODULJ TRANSVENOUS ELECTRODE,2071.0,1346.15,621.65,2071.0,13
CDM,0416TWE,RELOC SKIN POCKET CARDIAC MODULJ PULSE GENERATOR,2121.0,1378.65,683.62,2121.0,13
CDM,0417TWE,PRGRMG DEVICE EVALUATION CARDIAC MODULJ SYSTEM,872.0,566.8,143.87,872.0,13
CDM,0418TWE,INTERRO DEVICE EVALUATION CARDIAC MODULJ SYSTEM,390.0,253.5,96.36,390.0,13
CDM,0437TWE,IMPLTJ NONBIOL/SYNTH IMPLT FASC RNFCMT ABDL WALL,2128.0,1383.2,428.28,2128.0,13
CDM,0439TWE,MYOCARDIAL PERFUSION ECHO ISCHM/VIABILITY ASSMT,652.0,423.8,127.04,652.0,13
CDM,0440TWE,ABLTJ PERC CRYOABLTJ IMG GDN UXTR/PERPH NERVE,983.0,638.95,471.55,983.0,13
CDM,0441TWE,ABLTJ PERC CRYOABLTJ IMG GDN LXTR/PERPH NERVE,1107.0,719.55,471.55,1107.0,13
CDM,0442TWE,ABLTJ PERC CRYOABLTJ IMG GDN NRV PLEX/TRNCL NRV,1517.0,986.05,471.55,1517.0,13
CDM,0474TWE,INSJ ANT SEG AQUEOUS DRG DEV W/IO RSVR,5757.0,3742.05,1588.44,5757.0,13
CDM,0483TWE,TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH,11627.0,7557.55,2443.48,11627.0,13
CDM,0484TWE,TMVI W/PROSTHETIC VALVE TRANSTHORACIC EXPOSURE,26564.0,17266.6,3167.22,26564.0,13
CDM,0515TWE,INSERTION WRLS CAR STIMULATOR LV PACG COMPL SYS,13216.0,8590.4,1036.3,13216.0,13
CDM,0516TWE,INSERTION WRLS CAR STIMULATOR LV PACG ELTRD ONLY,13216.0,8590.4,956.21,13216.0,13
CDM,0517TWE,INSERTION WRLS CAR STIMULATOR LV PACG BTH COMPNT,13216.0,8590.4,676.84,13216.0,13
CDM,0518TWE,REMOVAL PG WCS LV PACG BATTERY COMPONENT ONLY,2529.0,1643.85,462.69,2529.0,13
CDM,0519TWE,REMOVAL&RPLCMT PG WCS LV PACG BOTH COMPONENTS,2529.0,1643.85,678.7,2529.0,13
CDM,0520TWE,RMVL&RPLCMT PG WCS LV PACG BATTERY COMPNT ONLY,2529.0,1643.85,956.21,2529.0,13
CDM,0521TWE,INTERROG DEV EVAL WRLS CAR STIMULATOR IN PERSON,308.0,200.2,96.36,308.0,13
CDM,0522TWE,PRGRMG DEVICE EVAL WRLS CAR STIMULATOR IN PERSON,403.0,261.95,115.58,403.0,13
CDM,0569TWE,TTVR PERCUTANEOUS APPROACH INITIAL PROSTHESIS,11278.0,7330.7,3626.06,11278.0,13
CDM,0570TWE,TTVR PERCUTANEOUS APPROACH EACH ADDL PROSTHESIS,11278.0,7330.7,853.03,11278.0,13
CDM,0571TWE,INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE,9806.0,6373.9,1119.88,9806.0,13
CDM,0572TWE,INSJ SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,2484.0,1614.6,913.6,2484.0,13
CDM,0573TWE,RMVL SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,10278.0,6680.7,694.36,10278.0,13
CDM,0574TWE,REPOS PREV IMPL SS IMPLTBL DFB PACING ELTRD,2835.0,1842.75,808.21,2835.0,13
CDM,0576TWE,INTERROGATION DEV EVAL ICDS W/SS ELTRD IN PERSON,402.0,261.3,96.36,402.0,13
CDM,0577TWE,ELECTROPHYSIOLOGIC EVAL ICDS W/SS ELECTRODE,2414.0,1569.1,327.98,2414.0,13
CDM,0578TWE,REM INTERROG DEV EVAL SS LD ICDS & UP TO 90D PHY/QHP,662.0,430.3,51.25,662.0,13
CDM,0579TWE,REM INTERROG DEV EVAL SS LD ICDS & UP TO 90D TECH,643.0,417.95,36.8,643.0,13
CDM,0580TWE,RMVL SUBSTERNAL IMPLTBL DFB PULSE GENERATOR ONLY,1407.0,914.55,427.73,1407.0,13
CDM,0581TWE-26,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,1740.0,1131.0,870.0,1740.0,12
CDM,0581TWE-TC,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,19146.0,12444.9,9573.0,19146.0,12
CDM,0583TWE,TYMPANOSTOMY AUTOMATED TUBE DELIVERY SYSTEM,1949.0,1266.85,130.98,1949.0,21
CDM,0587TWE,PERQ IMPLTJ/RPLCMT ISDNS BLDR DYSF PTN,3473.0,2257.45,856.04,3473.0,13
CDM,0588TWE,REVJ/ OR RMVL PERQ ISDNS BLDR DYSF PTN,2800.0,1820.0,703.69,2800.0,13
CDM,0589TWE,ELEC ALYS SMPL PRGRMG IINS BLDR DYSF PTN 1-3,351.0,228.15,84.97,351.0,13
CDM,0590TWE,ELEC ALYS CPLX PRGRMG IINS BLDR DYSF PTN 4+,654.0,425.1,100.18,654.0,13
CDM,0591TWE,HEALTH &AMP; WELL-BEING COACHING F2F INDIV 1ST ASSMT,195.0,126.75,80.24,195.0,13
CDM,0592TWE,HEALTH &AMP; WELL-BEING COACHING F2F INDIV F-UP SESS,195.0,126.75,80.24,195.0,13
CDM,0593TWE,HEALTH &AMP; WELL-BEING COACHING FACE TO FACE GROUP,42.0,27.3,17.78,42.0,13
CDM,0620TWE,ENDOVASCULAR VENOUS ARTERIALIZATION TIBL/PRNL VN,12104.0,7867.6,2675.85,12104.0,13
CDM,0644TWE,TCAT RMVL/DEBULK ICAR MASS SUCTION DEVICE PERQ,4358.0,2832.7,2179.0,4358.0,13
CDM,0646TWE,TTVI/RPLCMT PROSTC VLV PERQ W/R HRT CATH&ANGRPH,16980.0,11037.0,3626.06,16980.0,13
CDM,0649TWE,QUAN MR ALYS TISS COMPOSITION W/MRI,305.0,198.25,152.5,1238.62,13
CDM,0654TWE,EGD FLEXIBLE TRANSNASAL W/INSJ INTRAL TUBE/CATH,1055.0,685.75,276.4,1055.0,13
CDM,0707TWE,NJX BONE SUB MATRL INTO SUBCHONDRAL BONE DEFECT,966.0,627.9,483.0,966.0,13
CDM,0724TWE,QMRCP W/DX MRI SAME ANATOMY,72.0,46.8,36.0,72.0,12
CDM,0740TWE,REM AUTON ALG INSULIN DOSE 1ST SETUP& PT EDUCAJ,297.0,193.05,34.96,297.0,13
CDM,0741TWE,REM AUTON ALG NSLN DOS CAL SW DATA COLL TRANSMIS,465.0,302.25,81.11,465.0,13
CDM,0742TWE,AQMBF SPECT W/EXERCISE/RX STRESS & REST,585.0,380.25,119.21,585.0,13
CDM,0743TWE,BONE STRENGTH & FRACTURE RSK CNCRNT VRT FX ASSMT,96.0,62.4,48.0,96.0,13
CDM,0744TWE,INSERTION BIOPROSTHETIC VALVE OPEN FEMORAL VEIN,7136.0,4638.4,1830.51,7136.0,13
CDM,0745TWE,CAR FCL ABLTJ RADJ ARRHYT N-INVAS LOCLZJ & MAPG,12255.0,7965.75,480.69,12255.0,13
CDM,0746TWE,CAR FCL ABLTJ RADJ ARRHYT CONV LOCLZJ & MAPG,12255.0,7965.75,423.41,12255.0,13
CDM,0747TWE,CAR FCL ABLTJ RADJ ARRHYT DLVR RADJ THER,12255.0,7965.75,1857.63,12255.0,13
CDM,0748TWE,NJX STEM CLL PRDCT PERIANAL PERIFISTULAR SFT TIS,997.0,648.05,362.77,997.0,13
CDM,0764TWE,ASSTV ALG ECG RSK-BASED ASSMT RELATED CNCRT ECG,298.0,193.7,7.6,298.0,13
CDM,0765TWE,ASSTV ALG ECG RSK-BASED ASSMT RELATED PREV ECG,298.0,193.7,14.1,298.0,13
CDM,0766TWE,TC MAG STIMJ FCSD LW FRQ EMGNT PLS PN 1ST NERVE,308.0,200.2,154.0,308.0,12
CDM,0767TWE,TC MAG STIMJ FCSD LW FRQ EMGNT PLS PN EA ADD NRV,308.0,200.2,154.0,308.0,12
CDM,0776TWE,THERAPEUTIC INDUCTION OF INTRA-BRAIN HYPOTHERMIA,1906.0,1238.9,953.0,1906.0,12
CDM,0777TWE,R-T PRESSURE SENSING EPIDURAL GUIDANCE SYSTEM,993.0,645.45,43.46,993.0,13
CDM,0778TWE,SMMG CNCRNT APPL IMU SNR MEAS ROM POST GAIT MUSC,174.0,113.1,87.0,174.0,12
CDM,0779TWE,GI MYOELECTRICAL ACTIVITY STUDY STMCH-COLON I&R,69.0,44.85,34.5,746.7,13
CDM,0780TWE,INSTLJ FECAL MICROBIOTA SSP RCT NMA LWR GI TRC,603.0,391.95,43.78,603.0,13
CDM,0781TWE,BRNCHSC RF DSTRJ PULM NRV BI MAINSTEM BRONCHI,1177.0,765.05,588.5,1177.0,12
CDM,0782TWE,BRNCHSC RF DSTRJ PULM NRV UNI MAINSTEM BRONCHUS,1177.0,765.05,588.5,1177.0,12
CDM,0783TWE,TC AURICULAR NSTIMJ SETUP CALIBRATION &PT EDUCAJ,174.0,113.1,24.86,174.0,13
CDM,0784TWE,INSJ/RPLCMT PERQ ELTRD RA SPI W/INTEGRATED NSTIM,3546.0,2304.9,1773.0,3966.56,13
CDM,0785TWE,REVJ/RMVL NSTIM ELTRD RA SPI W/INTEGRATED NSTIM,2574.0,1673.1,464.74,2574.0,13
CDM,0786TWE,INSJ/RPLCMT PERQ ELTRD RA SAC W/INTEGRATED NSTIM,2697.0,1753.05,1348.5,2697.0,13
CDM,0787TWE,REVJ/RMVL NSTIM ELTRD RA SAC W/INTEGRATED NSTIM,1047.0,680.55,464.74,1047.0,13
CDM,0788TWE,ELEC ALYS SMPL PRGRMG IINS SP/SAC NRV 1-3 PARAM,388.0,252.2,33.17,388.0,13
CDM,0789TWE,ELEC ALYS CPLX PRGRMG IINS SP/SAC NRV 4+PARAM,397.0,258.05,49.77,397.0,13
CDM,0795TWE,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,3867.0,2513.55,1418.22,3867.0,13
CDM,0804TWE,PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH REVIEW AND REPORT,246.0,159.9,35.41,246.0,17
CDM,0811TWE,REM MULTI DAY CPLX UROFLOWMETRY SETUP&PT EDUCAJ,84.0,54.6,35.1,84.0,13
CDM,0812TWE,REM MULTI DAY CPLX UROFLOWMETRY DEV SPLY W/REPRT,84.0,54.6,42.0,84.0,12
CDM,0816TWE,OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBQ,2856.0,1856.4,250.15,2856.0,13
CDM,0817TWE,OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBF,2192.0,1424.8,1096.0,4841.13,13
CDM,0818TWE,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBCUTANEOUS,2529.0,1643.85,715.37,2529.0,13
CDM,0819TWE,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBFASCIAL,2529.0,1643.85,1264.5,2529.0,12
CDM,0820TWE,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 1ST,1722.0,1119.3,254.72,1722.0,13
CDM,0821TWE,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 2ND,1722.0,1119.3,254.72,1722.0,13
CDM,0822TWE,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY STAFF,1722.0,1119.3,216.51,1722.0,13
CDM,0823TWE,TCAT INSJ PERM 1CHMBR LDLS PACEMAKER R ATRIAL,3867.0,2513.55,1418.22,3867.0,13
CDM,0824TWE,TCAT RMVL PERM 1CHMBR LDLS PACEMAKER R ATRIAL,1557.0,1012.05,778.5,1557.0,13
CDM,0825TWE,TCAT RMVL&RPLCMT PERM 1CHMBR LDLS PM R ATRIAL,2603.0,1691.95,1301.5,2603.0,13
CDM,0826TWE,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,509.0,330.85,113.05,509.0,13
CDM,0826TWE-26,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,323.0,209.95,30.24,323.0,17
CDM,0826TWE-TC,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,186.0,120.9,34.79,186.0,17
CDM,0857TWE,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,893.0,580.45,39.28,893.0,13
CDM,0857TWE-26,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,362.0,235.3,10.42,362.0,17
CDM,0857TWE-TC,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,531.0,345.15,20.58,531.0,21
CDM,0866TWE,QUAN MRI ALYS BRAIN WITH DIAGNOSTIC MRI,1479.0,961.35,274.7,1479.0,13
CDM,0866TWE-26,QUAN MRI ALYS BRAIN WITH DIAGNOSTIC MRI,270.0,175.5,53.52,270.0,17
CDM,0866TWE-TC,QUAN MRI ALYS BRAIN WITH DIAGNOSTIC MRI,1209.0,785.85,108.29,1209.0,21
CDM,0869TWE,NJX B1 SUB MATRL B1&/SFT TISSUE HW FIXJ AGMNTJ,1118.0,726.7,559.0,1118.0,13
CDM,0894TWE,CANNULJ LVR ALGRFT PREPJ CONNJ NRMTHRMC PRFU DEV,6094.0,3961.1,92.37,6094.0,13
CDM,0895TWE,CONNJ LVR ALGRFT NRMTHRMC PRFUJ DEV 1ST 4 HOURS,3924.0,2550.6,52.13,3924.0,13
CDM,0896TWE,CONNJ LVR ALGRFT NRMTHRMC PRFUJ DEV EA ADDL HOUR,1666.0,1082.9,13.04,1666.0,13
CDM,0908TWE,OPEN IMPLTJ INT NEUROSTIMULATION SYS VAGUS NERVE,4180.0,2717.0,2090.0,4180.0,12
CDM,0909TWE,REPLACEMENT INT NEUROSTIMULATION SYS VAGUS NERVE,5108.0,3320.2,2554.0,5108.0,12
CDM,0910TWE,REMOVAL INT NEUROSTIMULATION SYS VAGUS NERVE,4226.0,2746.9,2113.0,4226.0,12
CDM,0911TWE,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/O PRGRMG,163.0,105.95,81.5,163.0,12
CDM,0912TWE,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/SMPL PRGRMG,363.0,235.95,181.5,363.0,12
CDM,0913TWE,PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART,2708.0,1760.2,955.89,2708.0,13
CDM,0914TWE,PERQ TCAT THER RX DLVR NTRAC RX BALO SEPARATE,2708.0,1760.2,1354.0,2708.0,12
CDM,0915TWE,INSJ PERM CCM-D SYS PG&DUAL TRANSVNS ELTRDS/LDS,5227.0,3397.55,2613.5,5227.0,12
CDM,0916TWE,INSERTION PERM CCM-D SYSTEM PULSE GENERATOR ONLY,2334.0,1517.1,1167.0,2334.0,12
CDM,0917TWE,INSJ PERM CCM-D SYS 1 TRANSVNS LEAD ONLY,2460.0,1599.0,1230.0,2460.0,12
CDM,0918TWE,INSJ PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,2460.0,1599.0,1230.0,2460.0,12
CDM,0919TWE,REMOVAL PERM CCM-D SYSTEM PULSE GENERATOR ONLY,1436.0,933.4,718.0,1436.0,12
CDM,0920TWE,RMVL PERM CCM-D SYS 1 TRANSVNS PACING LEAD ONLY,3675.0,2388.75,1837.5,3675.0,12
CDM,0921TWE,RMVL PERM CCM-D SYS 1 TRANSVNS DFB LEAD ONLY,3675.0,2388.75,1837.5,3675.0,12
CDM,0922TWE,RMVL PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,3675.0,2388.75,1837.5,3675.0,12
CDM,0923TWE,RMVL&RPLCMT PERMANENT CCM-D PULSE GENERATOR ONLY,2330.0,1514.5,1165.0,2330.0,12
CDM,0924TWE,REPOSITIONING PREV IMPL CCM-D TRANSVNS ELTRD/LD,2071.0,1346.15,1035.5,2071.0,12
CDM,0925TWE,RELOCATION SKIN POCKET IMPLANTED CCM-D PG,2926.0,1901.9,1463.0,2926.0,12
CDM,0926TWE,PROGRAMMING DEVICE EVAL IMPL CCM-D SYS IN PERSON,872.0,566.8,436.0,872.0,12
CDM,0927TWE,INTERROG DEV EVAL IMPL CCM-D SYSTEM IN PERSON,390.0,253.5,195.0,390.0,12
CDM,0928TWE,REMOTE INTERROG DEV EVAL CCM-D SYS <90D PHYS/QHP,279.0,181.35,139.5,279.0,12
CDM,0930TWE,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS AT 1ST IMPL,5227.0,3397.55,2613.5,5227.0,12
CDM,0931TWE,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS SEPARATE,5227.0,3397.55,2613.5,5227.0,12
CDM,0933TWE,TCAT IMPLT WRLS L ATR PRS SNR L-T L ATR PRS MNTR,2786.0,1810.9,1393.0,2786.0,12
CDM,0934TWE,REMOTE MNTR WIRELESS L ATRIAL PRESSURE SNR<30 D,325.0,211.25,162.5,325.0,12
CDM,0935TWE,CYSTO W/RNL PEL SYMPATHETIC DNRVTJ RF ABLTJ BI,3715.0,2414.75,1857.5,3715.0,12
CDM,0936TWE,PHOTOBIOMODULATION THERAPY RETINA SINGLE SESSION,28.0,18.2,14.0,1086.71,13
CDM,0937TWE,XTRNL ECG REC>15D<30D REC SCAN ALYS RVW&INTERPJ,256.0,166.4,128.0,256.0,12
CDM,0940TWE,XTRNL ECG REC>15D<30D REVIEW&INTERPJ PHYS/QHP,256.0,166.4,128.0,256.0,12
CDM,0941TWE,CYSTO FLX INSJ&XPNSJ PROSTATIC URTL SCAFFOLD,762.0,495.3,381.0,762.0,12
CDM,0942TWE,CYSTO FLX RMVL&RPLCMT PROSTATIC URTL SCAFFOLD,1306.0,848.9,653.0,1306.0,12
CDM,0943TWE,CYSTO FLX REMOVAL PROSTATIC URETHRAL SCAFFOLD,1306.0,848.9,653.0,1306.0,12
CDM,0950TWE,PR ABLTJ B9 PRST8 TISSUE TRANSRECTAL HIFU W/US GDN,7092.0,4609.8,3546.0,7092.0,12
CDM,0988TWE,OPEN INSJ/RPLCMT INT NSTIMJ SYS PTN SUBQ&SUBF,2192.0,1424.8,1096.0,2192.0,12
CDM,0989TWE,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBQ&SUBF,2529.0,1643.85,1264.5,2529.0,12
CDM,0990TWE,TRANSCRV INSTLJ BIOD HYDROGEL MATRL INTRAUTERINE,387.0,251.55,193.5,387.0,12
CDM,0991TWE,CYSTO LO-NRG LITHOTRP&ACOUS ACTUATED MICROSPHERE,3200.0,2080.0,1600.0,3200.0,12
CDM,0993TWE,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,1535.0,997.75,767.5,1535.0,12
CDM,0993TWE-26,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,316.0,205.4,158.0,316.0,12
CDM,0993TWE-TC,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,1219.0,792.35,609.5,1219.0,12
CDM,0997TWE,PRECUNEUS MAGNETIC STIMULATION TREATMENT PLNG,584.0,379.6,292.0,584.0,12
CDM,0998TWE,PRECUNEUS MAGNETIC STIMULATION TREATMENT DLVR,584.0,379.6,292.0,584.0,12
CDM,10004WE,FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL,320.0,208.0,33.48,240.0,31
CDM,10005WE,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,642.0,417.3,35.67,481.5,31
CDM,10006WE,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,440.0,286.0,26.62,330.0,31
CDM,10007WE,FINE NEEDLE ASPIRATION BX W/FLUORO GDN 1ST LESION,724.0,470.6,43.89,543.0,31
CDM,10008WE,FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL,472.0,306.8,17.52,354.0,31
CDM,10009WE,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,904.0,587.6,58.42,773.17,31
CDM,10010WE,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,660.0,429.0,38.3,495.0,31
CDM,10011WE,FINE NEEDLE ASPIRATION BX W/MR GDN 1ST LESION,1206.0,783.9,96.76,1206.0,16
CDM,10012WE,FINE NEEDLE ASPIRATION BX W/MR GDN EA ADDL,605.0,393.25,96.76,605.0,16
CDM,10021WE,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,453.0,294.45,47.28,339.75,35
CDM,10030WE,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,1100.0,715.0,113.46,1286.95,31
CDM,10035WE,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,680.0,442.0,66.63,884.79,31
CDM,10036WE,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,340.0,221.0,33.57,768.21,31
CDM,10040RVU2WE,MILIA EXTRACTION 1-5,250.0,162.5,44.93,187.5,35
CDM,10040RVU3WE,MILIA EXTRACTION EACH ADDTL 10,100.0,65.0,44.93,145.23,35
CDM,10040WE,ACNE SURGERY,400.0,260.0,44.93,300.0,35
CDM,10060WE,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,537.0,349.05,56.76,402.75,35
CDM,10061WE,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1078.0,700.7,88.77,808.5,35
CDM,10080WE,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,537.0,349.05,50.8,402.75,35
CDM,10081WE,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,1100.0,715.0,83.01,825.0,35
CDM,10120WE,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,537.0,349.05,49.97,402.75,35
CDM,10121WE,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,1206.0,783.9,88.93,904.5,35
CDM,10140WE,I&D HEMATOMA SEROMA/FLUID COLLECTION,695.0,451.75,57.04,521.25,35
CDM,10160WE,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,500.0,325.0,45.87,375.0,35
CDM,10180WE,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,920.0,598.0,86.47,690.0,35
CDM,11000030,ACCOMMODATION PRIVATE SUITE,4191.0,2724.15,1638.68,3981.45,10
CDM,11000WE,DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF,240.0,156.0,19.69,180.0,35
CDM,11001WE,DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF,120.0,78.0,9.99,90.0,35
CDM,11004WE,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR,4320.0,2808.0,414.51,4320.0,35
CDM,11005WE,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL,5696.0,3702.4,564.21,5696.0,35
CDM,11006WE,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL,5240.0,3406.0,521.96,5240.0,35
CDM,11008WE,REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION,2000.0,1300.0,202.25,2000.0,35
CDM,11010WE,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,1844.0,1198.6,133.65,1383.0,35
CDM,11011WE,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,2174.0,1413.1,143.51,1630.5,35
CDM,11012WE,DBRDMT FX&/DISLC SUBQ T/M/F BONE,3023.0,1964.95,201.2,2267.25,35
CDM,11042WE,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,444.0,288.6,28.94,333.0,35
CDM,11043WE,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,1188.0,772.2,74.14,891.0,35
CDM,11044WE,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,1804.0,1172.6,110.39,1353.0,35
CDM,11045WE,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,200.0,130.0,12.66,150.0,35
CDM,11046WE,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,412.0,267.8,26.8,309.0,35
CDM,11047WE,DEBRIDEMENT BONE EA ADDL 20 SQ CM/<,720.0,468.0,46.85,540.0,35
CDM,11055WE,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,154.0,100.1,9.33,115.5,35
CDM,11056WE,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,220.0,143.0,15.63,165.0,35
CDM,11057WE,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,286.0,185.9,20.36,214.5,35
CDM,11102WE,TANGENTIAL BIOPSY SKIN SINGLE LESION,290.0,188.5,24.24,217.5,31
CDM,11103WE,TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,167.0,108.55,14.54,125.25,31
CDM,11104WE,PUNCH BIOPSY SKIN SINGLE LESION,365.0,237.25,29.54,273.75,31
CDM,11105WE,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,198.0,128.7,12.33,148.5,31
CDM,11106WE,INCISIONAL BIOSPY SKIN SINGLE LESION,404.0,262.6,36.84,303.0,31
CDM,11107WE,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,216.0,140.4,22.9,162.0,31
CDM,11200RVU3WE,SKIN TAG REMOVAL 1 - 15,250.0,162.5,41.82,187.5,35
CDM,11200WE,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,361.0,234.65,41.82,270.75,35
CDM,11201RVU1WE,SKIN TAG REMOVAL EA ADDL 10,100.0,65.0,9.94,75.0,35
CDM,11201WE,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10,128.0,83.2,9.94,96.0,35
CDM,11300WE,SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<,264.0,171.6,26.03,198.0,35
CDM,11301WE,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,396.0,257.4,32.99,297.0,35
CDM,11302WE,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,462.0,300.3,40.49,346.5,35
CDM,11303WE,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,550.0,357.5,52.31,412.5,35
CDM,11305WE,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,352.0,228.8,28.27,264.0,35
CDM,11306WE,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,422.0,274.3,36.76,316.5,35
CDM,11307WE,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,528.0,343.2,43.04,396.0,35
CDM,11308WE,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,642.0,417.3,56.15,481.5,35
CDM,11310WE,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,352.0,228.8,35.72,264.0,35
CDM,11311WE,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,484.0,314.6,38.56,363.0,35
CDM,11312WE,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,572.0,371.8,47.01,429.0,35
CDM,11313WE,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM,739.0,480.35,63.17,554.25,35
CDM,11400RVU3WE,"REM LESION TRUNK, ARM, LEG <0.5CM",115.0,74.75,44.86,176.96,35
CDM,11400WE,"REM LESION TRUNK,ARM, LEG <0.5 CM",360.0,234.0,44.86,270.0,35
CDM,11401RVU3WE,"REM LESION TRUNK, ARM, LEG 0.6-1.0CM",130.0,84.5,55.7,213.15,35
CDM,11401WE,"REM LESION TRUNK,ARM,LEG 0.6 -1.0CM",563.0,365.95,55.7,422.25,35
CDM,11402RVU3WE,"REM LESIO TRUNK, ARM, LEG 1.1-2.0CM",145.0,94.25,56.72,237.57,35
CDM,11402WE,"REM LESIO TRUNK,ARM,LEG 1.1 -2.0CM",638.0,414.7,56.72,478.5,35
CDM,11403RVU3WE,"REM LESIO TRUNK, ARM, LEG 2.1-3.0CM",180.0,117.0,71.51,297.48,35
CDM,11403WE,"REM LESIO TRUNK,ARM,LEG 2.1-3.0CM",810.0,526.5,71.51,607.5,35
CDM,11404RVU3WE,"REM LESIO TRUNK, ARM, LEG 3.0-4.0CM",205.0,133.25,79.23,329.68,35
CDM,11404WE,"REM LESIO TRUNK,ARM,LEG 3.0-4.0CM",928.0,603.2,79.23,696.0,35
CDM,11406RVU3WE,"REM LESION TRUNK, ARM, LEG >4.0CM",340.0,221.0,120.17,503.34,35
CDM,11406WE,"REM LESION TRUNK,ARM,LEG > 4.0CM",1549.0,1006.85,120.17,1161.75,35
CDM,11420RVU3WE,"REM LESION NEC, HAND, SCAL <0.5CM",115.0,74.75,44.32,173.96,35
CDM,11420WE,"REM LESION NEC,HAND,SCAL<0.5CM",453.0,294.45,44.32,339.75,35
CDM,11421RVU3WE,"REM LESION NEC, HND, SCAL 0.6-1.0CM",150.0,97.5,55.06,224.63,35
CDM,11421WE,"REM LESION NEC,HND,SCAL 0.6-1.0CM",647.0,420.55,55.06,485.25,35
CDM,11422RVU3WE,"REM LESION NEC, HND, SCAL, FEET, GENITALIA 1.1-2.0CM",175.0,113.75,65.27,268.13,35
CDM,11422WE,"REM LESION NEC,HND,SCAL,FEET,GENITALIA 1.1-2.0CM",739.0,480.35,65.27,554.25,35
CDM,11423RVU3WE,"REM LESION NEC, HND, SCAL 2.1-3.0CM",230.0,149.5,74.96,311.33,35
CDM,11423WE,"REM LESION NEC,HND,SCAL 2.1-3.0CM",906.0,588.9,74.96,679.5,35
CDM,11424RVU3WE,"REM LESION NEC, HND, SCAL 3.1-4.0CM",240.0,156.0,85.82,361.5,35
CDM,11424WE,"REM LESION NEC,HND,SCAL 3.1-4.0CM",1091.0,709.15,85.82,818.25,35
CDM,11426RVU3WE,"REM LESION NECK, HAND, SCAL >4.0CM",400.0,260.0,131.51,537.77,35
CDM,11426WE,"REM LESION NECK,HAND,SCAL >4.0CM",1800.0,1170.0,131.51,1350.0,35
CDM,11440RVU3WE,"REM LESION FACE, EAR, EYEL <5MM",115.0,74.75,52.42,209.13,35
CDM,11440WE,"REM LESION FACE,EAR,EYEL <5MM",462.0,300.3,52.42,346.5,35
CDM,11441RVU3WE,"REM LESION FACE, EAR, EYE 0.6-1CM",155.0,100.75,64.0,263.23,35
CDM,11441WE,"REM LESION FACE,EAR,EYE 0.6-1CM",673.0,437.45,64.0,504.75,35
CDM,11442RVU3WE,"REM LESION FACE, EAR, EYE 1.1-2CM",175.0,113.75,70.52,290.99,35
CDM,11442WE,"REM LESION FACE,EAR,EYE 1.1-2 CM",779.0,506.35,70.52,584.25,35
CDM,11443RVU3WE,"REM LESION FACE, EAR, EYE 2.1-3CM",230.0,149.5,86.98,355.28,35
CDM,11443WE,"REM LESION FACE,EAR,EYE 2.1-3 CM",1030.0,669.5,86.98,772.5,35
CDM,11444RVU4WE,"REM LESION FACE, EAR, EYE 3.1-4CM",305.0,198.25,108.98,448.6,35
CDM,11444WE,"REM LESION FACE,EAR,EYE 3.1-4 CM",1404.0,912.6,108.98,1053.0,35
CDM,11446RVU6WE,"REM LESION FACE, EAR, EYE >4CM",460.0,299.0,154.36,632.7,35
CDM,11446WE,"REM LESION FACE,EAR,EYE >4CM",2112.0,1372.8,154.36,1584.0,35
CDM,11450WE,EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR,1288.0,837.2,127.89,966.0,35
CDM,11451WE,EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR,1772.0,1151.8,160.93,1329.0,35
CDM,11462WE,EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR,1200.0,780.0,124.59,900.0,35
CDM,11463WE,EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR,1772.0,1151.8,162.57,1329.0,35
CDM,11470WE,EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR,1496.0,972.4,139.23,1122.0,35
CDM,11471WE,EXCISION H/P/P/U COMPLEX REPAIR,1956.0,1271.4,171.45,1467.0,35
CDM,11600WE,MAL REM LESION 0.5 CM OR LESS,717.0,466.05,64.32,537.75,35
CDM,11601WE,"MAL LESION TRUNK,ARM,LEG 0.6-1.0CM",911.0,592.15,75.53,683.25,35
CDM,11602WE,"MAL LESION TRUNK,ARM,LEG 1.1-2.0 CM",999.0,649.35,81.39,749.25,35
CDM,11603WE,"MAL LESION TRUNK,ARM,LEG 2.1-3.0 CM",1241.0,806.65,100.83,930.75,35
CDM,11604WE,"MAL LESION TRUNK,ARM,LEG 3.1-4.0 CM",1395.0,906.75,105.21,1046.25,35
CDM,11606WE,EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM,2209.0,1435.85,153.21,1656.75,35
CDM,11620WE,"MAL LESION TRUNK,ARM,LEG<0.5CM",656.0,426.4,65.36,492.0,35
CDM,11621WE,"MAL LESION NECK,HAND,SCAL 0.6-1CM",832.0,540.8,76.03,624.0,35
CDM,11622WE,"MAL LESION NECK,HAND,SCAL 1.1-2CM",964.0,626.6,88.91,723.0,35
CDM,11623WE,"MAL LESION NECK,HAND,SCAL 2.1-3CM",1244.0,808.6,114.34,933.0,35
CDM,11624WE,"MAL LESION NECK,HAND,SCAL 3.1-4CM",1448.0,941.2,127.19,1086.0,35
CDM,11626WE,EXC SKIN MALIG >4CM REMAINDR BODY,1844.0,1198.6,153.34,1383.0,35
CDM,11640WE,"MAL LESION FACE,EAR,EYEL <5MM",668.0,434.2,68.68,501.0,35
CDM,11641WE,"MAL LESION FACE,EAR,EYEL 0.6-1CM",868.0,564.2,107.5,651.0,35
CDM,11642WE,"MAL LESION FACE,EAR,EYEL 1.1-2CM",1048.0,681.2,109.83,786.0,35
CDM,11643WE,"MAL LESION FACE,EAR,EYEL 2.1-3CM",1368.0,889.2,126.69,1026.0,35
CDM,11644WE,"MAL LESION FACE,EAR,EYEL 3.1-4CM",1736.0,1128.4,156.97,1302.0,35
CDM,11646WE,"MAL LESION FACE,EAR,EYEL >4.0CM",2504.0,1627.6,201.96,1878.0,35
CDM,11719WE,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,75.0,48.75,6.67,56.25,34
CDM,11720WE,"DEBRIDEMENT OF NAIL(S), 1-5",141.0,91.65,7.07,105.75,35
CDM,11721WE,"DEBRIDEMENT OF NAILS, 6 OR MORE",238.0,154.7,14.16,178.5,35
CDM,11730WE,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,462.0,300.3,25.81,346.5,35
CDM,11732WE,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,152.0,98.8,15.22,114.0,35
CDM,11740WE,EVAC. SUBUNGUAL HEMATOMA,148.0,96.2,15.12,111.0,35
CDM,11750WE,EXCISION NAIL MATRIX PERMANENT REMOVAL,695.0,451.75,68.22,521.25,35
CDM,11755WE,BIOPSY NAIL UNIT SEPARATE PROCEDURE,500.0,325.0,47.92,375.0,35
CDM,11760WE,"REPAIR OF NAIL BED, SIMPLE",652.0,423.8,53.75,489.0,35
CDM,11762WE,RECONSTRUC OF NAIL BED W GRAFT,1176.0,764.4,105.19,882.0,35
CDM,11765WE,WEDGE EXCISION SKIN NAIL FOLD,488.0,317.2,44.22,366.0,35
CDM,11770WE,EXCISION PILONIDAL CYST/SINUS SIMPLE,1170.0,760.5,107.2,877.5,35
CDM,11771WE,EXCISION PILONIDAL CYST/SINUS EXTENSIVE,2680.0,1742.0,220.9,2010.0,35
CDM,11772WE,EXCISION PILONIDAL CYST/SINUS COMPLICATED,3234.0,2102.1,285.04,2425.5,35
CDM,11900WE,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,229.0,148.85,18.77,171.75,35
CDM,11901WE,INJECTION INTRALESIONAL >7 LESIONS,352.0,228.8,31.49,264.0,35
CDM,11920WE,TATTOOING INCL MICROPIGMENTATION 6.0 CM/<,644.0,418.6,102.72,483.0,35
CDM,11921WE,TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM,772.0,501.8,120.37,579.0,35
CDM,11922WE,TATTOOING INCL MICROPIGMENTATION EA 20.0 CM,196.0,127.4,26.18,147.0,35
CDM,11950WE,SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<,336.0,218.4,34.35,252.0,32
CDM,11951WE,SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC,476.0,309.4,45.59,357.0,32
CDM,11952COLWE,INJECTION COLLAGEN 5.1-10.0 CC,592.0,384.8,67.77,444.0,32
CDM,11952FACWE,FAT INJECTION - FACE 5.1-10CC,568.0,369.2,67.77,426.0,32
CDM,11952LIPWE,LIP AUGMENTATION W/FILLING MAT 5.1-10CC,568.0,369.2,67.77,426.0,32
CDM,11952TRUWE,FAT INJECTION - TRUNK 5.1-10CC,574.0,373.1,67.77,430.5,32
CDM,11952WE,SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC,676.0,439.4,67.77,507.0,32
CDM,11954WE,SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC,740.0,481.0,87.2,555.0,32
CDM,11960WE,INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ,4596.0,2987.4,521.21,4596.0,35
CDM,11970WE,REPLACEMENT TISSUE EXPANDER W/PERMANENT IMPLANT,3296.0,2142.4,342.35,3296.0,35
CDM,11971WE,REMOVAL TISSUE EXPANDER W/O INSERTION IMPLANT,2808.0,1825.2,266.95,2106.0,35
CDM,11976WE,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,712.0,462.8,49.45,534.0,35
CDM,11980WE,SUBCUTANEOUS HORMONE PELLET IMPLANT,440.0,286.0,52.6,330.0,32
CDM,11981WE,INSERT DRUG IMPLANT DEVICE,502.0,326.3,35.54,376.5,35
CDM,11982WE,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,590.0,383.5,47.03,442.5,35
CDM,11983WE,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,840.0,546.0,98.71,630.0,35
CDM,12001WE,"SIMP REPAIR SCALP,NECK,TRK <2.5CM",370.0,240.5,29.32,277.5,35
CDM,12002WE,"SIMP REPAIR SCALP,NECK,TRK 2.6-7.5CM",502.0,326.3,37.14,376.5,35
CDM,12004WE,"SIMP REPAIR SCALP,NECK,TRK 7.6-12.5CM",634.0,412.1,37.35,475.5,35
CDM,12005WE,"SIMP REPAIR SCALP,NECK,TRK 12.6-20CM",867.0,563.55,64.56,650.25,35
CDM,12006WE,REPR SUPERF WND BODY 20.1-30,1052.0,683.8,83.57,789.0,35
CDM,12007WE,REPR SUPERF WND BODY >30CM,1276.0,829.4,96.87,957.0,35
CDM,12011WE,"SIMP REPAIR FACE,EAR,EYE <2.5CM",471.0,306.15,32.99,353.25,35
CDM,12013WE,"SIMP REPAIR FACE,EAR,EYE 2.6-5CM",537.0,349.05,39.71,402.75,35
CDM,12014WE,"SIMP REPAIR FACE,EAR,EYE 5.1-7.5CM",691.0,449.15,51.38,518.25,35
CDM,12015WE,"SIMP REPAIR FAC,EAR,EYE 7.6-12.5CM",871.0,566.15,68.19,653.25,35
CDM,12016WE,"SIMP REPAIR FAC,EAR,EYE 12.6-20CM",1179.0,766.35,93.49,884.25,35
CDM,12020WE,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,1175.0,763.75,90.74,881.25,32
CDM,12021WE,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,832.0,540.8,68.22,624.0,32
CDM,12031WE,"INT REPAIR SCALP,AXL,TRUNK <2.5CM",880.0,572.0,85.37,660.0,35
CDM,12032WE,"INT REPAIR SCALP,AXL,TRUNK 2.6-7.5CM",1109.0,720.85,90.74,831.75,35
CDM,12034WE,"INT REPAIR SCALP,AXL,TRUNK 7.6-12.5CM",1307.0,849.55,98.63,980.25,35
CDM,12035WE,"INT REPAIR SCALP,AXL,TRUNK 12.6-20CM",1540.0,1001.0,116.55,1155.0,35
CDM,12036WE,"LAYR CLOS WND TRUNK,ARM,LEG 20.1-30",1861.0,1209.65,137.43,1395.75,35
CDM,12037WE,"LAYR CLOS WND TRUNK,ARM,LEG >30CM",2200.0,1430.0,159.13,1650.0,35
CDM,12041WE,INT REPAIR NECK/HANDS/FEET/XTRNL GENT <2.5CM,924.0,600.6,69.21,693.0,35
CDM,12042WE,"INT REPAIR NECK,HANDS,FEET, GENIT, 2.6-7.5 CM",1228.0,798.2,93.86,921.0,35
CDM,12044WE,"INT REPAIR SCALP,NEC,TRK 7.6-12.5CM",1404.0,912.6,102.57,1053.0,35
CDM,12045WE,"INT REPAIR SCALP,NEC,TRK 12.6-20CM",1650.0,1072.5,131.18,1237.5,35
CDM,12046WE,LAYR CLOS WND REST BODY 20.1-30,1892.0,1229.8,155.51,1419.0,35
CDM,12047WE,LAYR CLOS WND REST BODY >30CM,2178.0,1415.7,172.77,1633.5,35
CDM,12051WE,"INT REPAIR FACE,EAR,EYE <2.5CM",1025.0,666.25,81.21,768.75,35
CDM,12052WE,"INT REPAIR FACE,EAR,EYE 2.6-5CM",1263.0,820.95,95.5,947.25,35
CDM,12053WE,"INT REPAIR FACE,EAR,EYE 5.1-7.5CM",1395.0,906.75,102.9,1046.25,35
CDM,12054WE,"INT REPAIR FAC,EAR,EYE 7.6-12.5CM",1540.0,1001.0,105.37,1155.0,35
CDM,12055WE,"INT REPAIR FAC,EAR,EYE 12.6-20CM",1980.0,1287.0,144.16,1485.0,35
CDM,12056WE,"LAYR CLOS WND FACE,FACIAL 20.1-30",2332.0,1515.8,186.08,1749.0,35
CDM,12057WE,"LAYR CLOS WND FACE,FACIAL >30CM",2640.0,1716.0,202.84,1980.0,35
CDM,12100010,ACCOMMODATION MED/SURG,4594.0,2986.1,1796.25,4364.3,10
CDM,12100020,ACCOMMODATION MED/SURG,3238.0,2104.7,1266.06,3076.1,10
CDM,13100WE,REPR CMPL WND TRUNK 1.1-2.5CM,1200.0,780.0,96.17,900.0,35
CDM,13101WE,REPR CMPL WND TRUNK 2.6-7.5CM,1400.0,910.0,119.18,1050.0,35
CDM,13102WE,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,496.0,322.4,34.86,372.0,35
CDM,13120WE,"REPR CMPL WND SCALP,EXTR 1.1-2.5",1292.0,839.8,112.11,969.0,35
CDM,13121WE,"REPR CMPL WND SCALP,EXTR 2.6-7.5",1600.0,1040.0,123.29,1200.0,35
CDM,13122WE,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,576.0,374.4,39.67,432.0,35
CDM,13131WE,"REPR CMPL WND HEAD,FAC,HAND 1.1-2.5",1492.0,969.8,116.05,1119.0,35
CDM,13132REPWE,REP COMP 2.6-7.5CM FACE,2115.0,1374.75,145.15,1586.25,35
CDM,13132REVWE,SCAR REVISION,2353.0,1529.45,145.15,1764.75,35
CDM,13132WE,"REPR CMPL WND HEAD,FAC,HAND 2.6-7.5",2103.0,1366.95,145.15,1577.25,35
CDM,13133WE,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,964.0,626.6,62.93,723.0,35
CDM,13151WE,"REPR CMPL WND LID,NOS,EAR 1.1-2.5",1736.0,1128.4,133.65,1302.0,35
CDM,13152WE,"REPR CMPL WND LID,NOS,EAR 2.5-7.5",2136.0,1388.4,160.93,1602.0,35
CDM,13153WE,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,952.0,618.8,67.89,714.0,35
CDM,13160WE,SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC,4816.0,3130.4,426.56,4816.0,35
CDM,14000WE,TISSUE REARRAN TRUNK DEF <10SCM,2548.0,1656.2,242.63,1911.0,35
CDM,14001WE,TISSUE REARRAN TRUNK  10.1-30SCM,3512.0,2282.8,315.29,2634.0,35
CDM,14020WE,"TISSUE REARRA SCALP,EXTRE LT 10SCM",2888.0,1877.2,271.72,2166.0,35
CDM,14021WE,"ADJ TISS XFER SCALP,EXTREM 10.1-30",3888.0,2527.2,340.43,2916.0,35
CDM,14040WE,"TISSUE REARR MOUTH,FORE  <10SCM",3440.0,2236.0,299.01,2580.0,35
CDM,14041WE,"TISSUE REARR MOUTH,FORE 10.1-30SCM",4332.0,2815.8,365.23,3249.0,35
CDM,14060WE,"TISSUE REARR LIP,EAR,EYE GT 10 SCM",4061.0,2639.65,323.71,3045.75,35
CDM,14061WE,"TISSUE REARR LIP,EAR,EYE 10.1-30SCM",5051.0,3283.15,423.29,3788.25,35
CDM,14301WE,ATT/R ANY AREA DEFECT 30.1-60SQCM,5060.0,3289.0,418.67,3795.0,35
CDM,14302WE,ATT/R ANY AREA DEFECT EA ADDL 30SQCM OR PART,1641.0,1066.65,127.4,1641.0,35
CDM,14350WE,FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE,4420.0,2873.0,426.11,4420.0,35
CDM,15002WE,PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT,1606.0,1043.9,106.03,1204.5,35
CDM,15003WE,PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT,320.0,208.0,22.03,240.0,35
CDM,15004WE,PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT,1832.0,1190.8,126.08,1374.0,35
CDM,15005WE,PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT,640.0,416.0,44.05,480.0,35
CDM,15011WE,HRV SKIN FOR SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,929.0,603.85,149.74,929.0,13
CDM,15012WE,HRV SKIN FOR SKIN CELL SSP AGRFT EA ADDL 25 SQCM,929.0,603.85,70.29,929.0,13
CDM,15013WE,PREPARATION SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,1696.0,1102.4,166.45,1696.0,13
CDM,15014WE,PREPARATION SKIN CELL SSP AGRFT EA ADDL 25 SQ CM,1696.0,1102.4,166.45,1696.0,13
CDM,15015WE,APPL SKIN CELL SSP AGRFT T/A/L 1ST 480 SQ CM/<,697.0,453.05,348.5,1500.53,13
CDM,15016WE,APPL SKIN CELL SSP AGRFT T/A/L EA ADDL 480 SQ CM,697.0,453.05,255.19,697.0,13
CDM,15017WE,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT 1ST 480,850.0,552.5,425.0,1728.6,13
CDM,15018WE,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT EA ADDL,850.0,552.5,352.44,850.0,13
CDM,15040WE,HARVEST SKIN TISSUE CLTR SKIN AGRFT 100 CM/<,800.0,520.0,59.84,600.0,32
CDM,15050WE,PINCH GRAFT 1/MLT SM ULCER TIP/OTH AREA 2CM,2228.0,1448.2,224.71,1671.0,35
CDM,15100WE,SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,3960.0,2574.0,347.66,2970.0,35
CDM,15101WE,SPLIT AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,688.0,447.2,54.42,516.0,35
CDM,15115WE,EPI AUTOGRFT FACE/NCK/HND/FT/GEN <100SQCM,4963.0,3225.95,393.65,3722.25,35
CDM,15120WE,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/</1 %,4060.0,2639.0,333.7,3045.0,35
CDM,15121WE,SPLIT AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA 1 %,800.0,520.0,78.19,600.0,35
CDM,15130WE,"DERM AUTOGRFT, TRNK/ARM/LEG <100SQCM",3012.0,1957.8,328.5,2259.0,35
CDM,15131WE,"DERM AUTOGRFT TRNK/ARM/LEG, EA 100SQCM",600.0,390.0,51.16,450.0,35
CDM,15135WE,DERM AUTOGRAFT FACE/NCK/HND/FT/GEN <100SQCM,4412.0,2867.8,430.11,3309.0,35
CDM,15136WE,"DERM AUTOGRAFT FACE/NCK/HND/FT/GEN, EA 100SQCM",600.0,390.0,64.36,450.0,35
CDM,15150WE,CLTR SKIN AUTOGRAFT T/A/L 1ST 25 CM/<,3756.0,2441.4,425.39,2817.0,35
CDM,15151WE,CLTR SKIN AGRFT T/A/L ADDL 1 CM-75 CM,800.0,520.0,82.8,600.0,35
CDM,15152WE,CLTR SKIN AGRFT T/A/L EA 100 CM/EA 1%BODY AREA,1000.0,650.0,87.82,750.0,35
CDM,15155WE,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT 1ST 25CM/<,4056.0,2636.4,448.55,3042.0,35
CDM,15156WE,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT ADDL 1-75CM,1100.0,715.0,93.0,825.0,35
CDM,15157WE,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT EA 100 EA,1200.0,780.0,120.01,900.0,35
CDM,15200WE,FULL GRAFT PROC TRUNK <20 SQCM,3660.0,2379.0,325.15,2745.0,35
CDM,15201WE,FULL GRAFT PROC TRUNK ADD 20 SQCM,581.0,377.65,51.18,435.75,35
CDM,15220WE,"FULL THICKNESS GRAFT SCALP, ARMS LEGS 20 SQ CM OR LESS",3236.0,2103.4,293.09,2427.0,35
CDM,15221WE,"FULL GRAFT PROC SCALP,ARM ADD 20SQCM",476.0,309.4,46.86,357.0,35
CDM,15240WE,SKIN GRAFT HAND <20 SQ CM,4164.0,2706.6,382.02,3123.0,35
CDM,15241WE,SKIN GRAFT HAND ADD'L 20 SCM,818.0,531.7,72.96,613.5,35
CDM,15260WE,SKIN GRAFT NOSE <20 SQ CM,4656.0,3026.4,405.19,3492.0,35
CDM,15261WE,SKIN GRAFT NOSE ADD'L 20SCM,892.0,579.8,101.94,669.0,35
CDM,15271WE,APP SKN SUB GRFT T/A/L AREA/<100SCM /<1ST 25 SCM,660.0,429.0,41.56,495.0,35
CDM,15272WE,APP SKN SUB GRFT T/A/L AREA/<100SCM EA ADL 25SCM,145.0,94.25,8.55,108.75,35
CDM,15273WE,APP SKN SUB GRFT T/A/L AREA/>100SCM 1ST 100SCM,1400.0,910.0,95.67,1050.0,35
CDM,15274WE,APP SKN SUB GRFT T/A/L AREA/>100SCM ADL 100SCM,320.0,208.0,22.03,240.0,35
CDM,15275WE,SUB GRFT F/S/N/H/F/G/M/D /<100SCM /<1ST 25 SCM,732.0,475.8,45.04,549.0,35
CDM,15276WE,SUB GRFT F/S/N/H/F/G/M/D /<100SCM EA ADL 25SCM,200.0,130.0,12.33,150.0,35
CDM,15277WE,SUB GRFT F/S/N/H/F/G/M/D />100SCM 1ST 100SCM,1600.0,1040.0,108.98,1200.0,35
CDM,15278WE,SUB GRFT F/S/N/H/F/G/M/D />100SCM ADL 100SCM,400.0,260.0,27.46,300.0,35
CDM,15570WE,FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK,4084.0,2654.6,355.4,3063.0,35
CDM,15572WE,FRMJ DIRECT/TUBE PEDICLE W/WO TR SCALP ARMS/LEGS,4048.0,2631.2,354.41,3036.0,35
CDM,15574WE,FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F,4280.0,2782.0,357.52,3210.0,35
CDM,15576WE,FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL,3748.0,2436.2,313.8,2811.0,35
CDM,15600WE,DELAY/SECTN FLAP TRUNK,804.0,522.6,103.46,603.0,35
CDM,15610WE,"DELAY/SECTN FLAP SCALP,ARM,LEG",1008.0,655.2,124.99,756.0,35
CDM,15620WE,"DELAY/SECTN FLAP FACE,GENIT,HAND,FT",1500.0,975.0,157.8,1125.0,35
CDM,15630WE,"DELAY/SECTN FLAP LID,NOS,EAR,LIP",1632.0,1060.8,165.37,1224.0,35
CDM,15650WE,TRANSFER SKIN PEDICLE FLAP,1908.0,1240.2,184.27,1431.0,35
CDM,15730WE,MIDFACE FLAP W/PRESERVATION OF VASCULAR PEDICLES,5400.0,3510.0,694.19,4050.0,31
CDM,15731WE,FOREHEAD FLAP W/VASC PEDICLE,5752.0,3738.8,497.71,4314.0,35
CDM,15733WE,MUSC MYOQ/FSCQ FLAP HEAD&NECK W/NAMED VASC PEDCL,6272.0,4076.8,792.27,6272.0,31
CDM,15734WE,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK,9200.0,5980.0,731.65,6900.0,35
CDM,15736WE,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR,6816.0,4430.4,636.53,5112.0,35
CDM,15738WE,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR,8378.0,5445.7,619.55,6283.5,35
CDM,15740WE,FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY,4720.0,3068.0,408.43,3540.0,35
CDM,15750WE,NEUROVASCULAR PEDICLE GRAFT,5184.0,3369.6,621.15,5184.0,35
CDM,15756WE,FREE MUSC FLAP W MICROVASC ANAST,14776.0,9604.4,1745.42,14776.0,35
CDM,15757WE,FREE SKIN FLAP W MICROVASC ANAST,16346.0,10624.9,1665.45,16346.0,35
CDM,15758WE,FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS,14760.0,9594.0,1662.43,14760.0,35
CDM,15760WE,GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA,3944.0,2563.6,337.31,2958.0,35
CDM,15769RVU1WE,FAT INJECTIONS FOR BUTTOCK AUGMENT (BBL) - MODERATE,1500.0,975.0,366.08,1500.0,31
CDM,15769WE,GRAFTING OF AUTOLOGOUS SOFT TISS BY DIRECT EXC,2672.0,1736.8,366.08,2672.0,31
CDM,15770WE,"GRAFT,DERMA-FAT-FASCIA",3942.0,2562.3,396.28,3942.0,35
CDM,15771WE,GRAFTING OF AUTOLOGOUS FAT BY LIPO 50 CC OR LESS,2961.0,1924.65,363.72,2220.75,28
CDM,15772WE,GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 50 CC,1100.0,715.0,108.98,825.0,28
CDM,15773RVU1WE,FAT INJECTION FACE/NECK INC REVOLVE - MODERATE,990.0,643.5,386.07,1007.52,28
CDM,15773WE,GRAFTING OF AUTOLOGOUS FAT BY LIPO 25 CC OR LESS,2732.0,1775.8,386.07,2049.0,28
CDM,15774WE,GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 25 CC,964.0,626.6,104.67,723.0,28
CDM,15775WE,HAIR XPLANT PUNCH GRFT 1-15,1580.0,1027.0,182.13,1185.0,31
CDM,15776WE,HAIR XPLANT PUNCH GRFT >15,2212.0,1437.8,251.64,1659.0,31
CDM,15777WE,IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT,1460.0,949.0,104.22,1460.0,35
CDM,15778WE,IMPL ABSRB MESH/PRSTH DLYD CLSR DFCT INFCTJ/TRMA,2820.0,1833.0,82.15,2820.0,31
CDM,15780ADDWE,COMBINATION DERMABRASION- ADD-ON IN ASC,3639.0,2365.35,548.92,2729.25,31
CDM,15780COMWE,COMBINATION DERMABRASION FACE,3060.0,1989.0,548.92,2295.0,31
CDM,15780TOTWE,DERMABRASION TOTAL FACE,3639.0,2365.35,548.92,2729.25,31
CDM,15781ADDWE,PERIORBITAL DERMABRASION - ADD-ON IN ASC,1876.0,1219.4,375.79,1407.0,34
CDM,15781LASWE,DERMABRASION; PERIORBITAL BY LASER,1411.0,917.15,375.79,1058.25,34
CDM,15781NOSWE,DERMABRASION;NOSE BY LASER,1411.0,917.15,375.79,1058.25,34
CDM,15781ORBWE,PERIORBITAL DERMABRASION,1524.0,990.6,375.79,1143.0,34
CDM,15782WE,DERMABRAS RX SKIN REGIONAL,1954.0,1270.1,335.68,1465.5,31
CDM,15783WE,DERMABRAS RX SKIN SUPERFICIAL,1940.0,1261.0,322.09,1455.0,31
CDM,15786WE,ABRAS SINGLE LESION,832.0,540.8,89.68,624.0,32
CDM,15787RVU1WE,"SCAR REVISION, ABRASION EA ADDL 4 LESIONS OR LESS",150.0,97.5,10.56,112.5,32
CDM,15787WE,"ABRASION, EACH ADDN 4 OR LESS",145.0,94.25,10.56,108.75,32
CDM,15788ADDWE,PERIORBITAL FACE CHEMICAL PEEL-ADD ASC,1252.0,813.8,204.24,939.0,31
CDM,15788EPIWE,FACE PEEL EPDIERMAL FACE,2844.0,1848.6,204.24,2133.0,31
CDM,15788FACWE,CHEMICAL PEEL FACIAL EPIDERMA,1933.0,1256.45,204.24,1449.75,31
CDM,15788OFFWE,PERIORBITAL FACE CHEMICAL PEEL IN OFFICE,1024.0,665.6,204.24,768.0,31
CDM,15788ORAWE,CHEMICAL PEEL; EPIDERAL-PERIORAL,2844.0,1848.6,204.24,2133.0,31
CDM,15788RVU2WE,GLYCOLIC TRADITIONAL,100.0,65.0,50.0,652.77,31
CDM,15788WE,"CHEM PEEL, FACE, EPIDERM",836.0,543.4,204.24,652.77,31
CDM,15789RVU1WE,"CHEMICAL PEEL, FACIAL: DERMAL EA. AREA",250.0,162.5,125.0,805.26,31
CDM,15789RVU2WE,"CHEMICAL PEEL, FACIAL: DERMAL, FULL FACE",700.0,455.0,350.0,805.26,31
CDM,15789WE,"CHEM PEEL, FACE, DERMAL",1964.0,1276.6,366.68,1473.0,31
CDM,15792EPIWE,CHEMICAL PEEL EPIDERMAL,1933.0,1256.45,200.34,1449.75,31
CDM,15792INIWE,CHEMICAL PEEL EPIDERMA INITIAL,853.0,554.45,200.34,639.75,31
CDM,15792RVU4WE,"CHEMICAL PEEL, TCA-NON-FACIAL",250.0,162.5,125.0,614.21,31
CDM,15792WE,"CHEM PEEL, NONFACIAL EPIDERM",744.0,483.6,200.34,614.21,31
CDM,15793RVU1WE,"NON FACIAL, DERMAL (TCA)",250.0,162.5,125.0,703.51,31
CDM,15793WE,"CHEM PEEL, NONFACIAL DERMAL",1584.0,1029.6,316.01,1188.0,31
CDM,15819CERWE,"PLASTIC SURGERY NECK OR UTERUS, CERVICOPL",2501.0,1625.65,667.52,2501.0,19
CDM,15819NECWE,NECKLIFT,10006.0,6503.9,667.52,10006.0,19
CDM,15819RVU4WE,CERVICOPLASTY   (REMOVAL EXCESS NECK SKIN),3000.0,1950.0,667.52,3000.0,19
CDM,15820WE,BLEPHAROPLASTY LOWER LID,2759.0,1793.35,442.48,2069.25,34
CDM,15821WE,BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD,3010.0,1956.5,479.47,2257.5,31
CDM,15822WE,BLEPHAROPLASTY UPPER EYELID,2033.0,1321.45,340.33,1524.75,34
CDM,15823WE,BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN,2996.0,1947.4,338.73,2247.0,35
CDM,15824WE,RHYTIDECTOMY FOREHEAD,4486.0,2915.9,2243.0,4486.0,13
CDM,15825EXCWE,RHYTIDECTOMY (EXC. NECK),3412.0,2217.8,1706.0,3412.0,13
CDM,15825RHYWE,RHYTIDECTOMY NECK W PFLAP,3184.0,2069.6,1592.0,3184.0,13
CDM,15825WE,RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING,5845.0,3799.25,2573.86,5845.0,13
CDM,15826WE,RHYTIDECTOMY GLABELLAR FROWN LINES,6105.0,3968.25,1858.08,6105.0,13
CDM,15828MINWE,MINI-FACELIFT DONE IN OFFICE,8301.0,5395.65,4150.5,8301.0,13
CDM,15828RHYWE,RHYTIDECTOMY CHK CHN NECK,3184.0,2069.6,1592.0,4861.32,13
CDM,15828WE,RHYTIDECTOMY CHEEK CHIN & NECK,8610.0,5596.5,4305.0,8610.0,13
CDM,15828WE-52,RHYTIDECTOMY CHEEK CHIN & NECK,8610.0,5596.5,4305.0,8610.0,12
CDM,15829WE,RHYTIDECTOMY SMAS FLAP,9126.0,5931.9,4563.0,9126.0,13
CDM,15830WE,EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY,6844.0,4448.6,658.15,6844.0,35
CDM,15832WE,EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH,5654.0,3675.1,719.5,5654.0,34
CDM,15833WE,EXCISION EXCESSIVE SKIN & SUBQ TISSUE LEG,5236.0,3403.4,671.06,5236.0,34
CDM,15834WE,EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP,4868.0,3164.2,693.21,4868.0,34
CDM,15835WE,EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK,5196.0,3377.4,722.31,5196.0,34
CDM,15836WE,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM,4668.0,3034.2,618.91,4668.0,34
CDM,15837WE,EXC EXCESSIVE SKIN &SUBQ TISSUE FOREARM/HAND,3820.0,2483.0,625.95,2865.0,34
CDM,15838WE,EXC EXCSV SKIN & SUBQ TISSUE SUBMENTAL FAT PAD,3300.0,2145.0,496.11,3300.0,34
CDM,15839WE,EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA,4200.0,2730.0,505.56,3150.0,35
CDM,15840WE,"GRAFT FACE N PALSY,FREE FASCIA",5996.0,3897.4,736.07,5996.0,35
CDM,15841WE,"GRAFT FACE N PALSY,FREE MUSCLE",10396.0,6757.4,1027.85,10396.0,35
CDM,15842WE,GRF FACIAL NRV PALYSS FR MUSCLE FLAP MICROSURG,16404.0,10662.6,1733.29,16404.0,35
CDM,15845WE,GRF FACIAL NERVE PARALYSIS REGIONAL MUSCLE TR,5728.0,3723.2,703.5,5728.0,35
CDM,15847ABDWE,EXCISION EXCESS SKN ABD,2115.0,1374.75,321.43,2115.0,17
CDM,15847ADDWE,EXC SKIN ABD ADD-ON SPECIAL,3525.0,2291.25,321.43,3525.0,17
CDM,15847MUSWE,MUSCLE TIGHTENING,3525.0,2291.25,321.43,3525.0,17
CDM,15847RVU1WE,ABDOMINOPLASTY ADD-ON  (INCL FLEUR DE LIS),1000.0,650.0,321.43,1000.0,17
CDM,15847WE,"EXCISE EXCESS SKIN TISSUE,ABDOMEN, ADD-ON",5828.0,3788.2,321.43,5828.0,17
CDM,15851WE,REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA,440.0,286.0,32.35,330.0,35
CDM,15852WE,DRESSING CHANGE UNDER ANESTHESIA,344.0,223.6,33.96,344.0,35
CDM,15853WE,REMOVAL SUTURES OR STAPLES NOT REQUIRING ANESTHESIA,364.0,236.6,7.83,364.0,31
CDM,15854WE,REMOVAL SUTURES & STAPLES NOT REQUIRING ANESTHESIA,337.0,219.05,168.5,337.0,12
CDM,15860WE,TEST FOR BLOOD FLOW IN GRAFT,780.0,507.0,81.45,780.0,35
CDM,15876WE,"SUCT ASSIS LIPECTOMY,HEAD/NECK",2456.0,1596.4,82.87,2456.0,16
CDM,15877WE,"SUCT ASSIS LIPECTOMY,TRUNK",4640.0,3016.0,474.61,4640.0,13
CDM,15878WE,"SUCT ASSIS LIPECTOMY,UP EXTREM",4777.0,3105.05,474.61,4777.0,13
CDM,15879WE,"SUCT ASSIS LIPECTOMY,LOW EXTREM",4640.0,3016.0,474.61,4640.0,13
CDM,15931WE,EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE,4028.0,2618.2,350.14,4028.0,35
CDM,15933WE,EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY,4708.0,3060.2,491.27,4708.0,35
CDM,15934WE,EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR,5472.0,3556.8,553.41,5472.0,35
CDM,15936WE,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR,5264.0,3421.6,615.7,5264.0,35
CDM,15937WE,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC,6056.0,3936.4,747.01,6056.0,35
CDM,15940WE,EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE,4080.0,2652.0,364.14,4080.0,35
CDM,15944WE,EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE,4976.0,3234.4,564.69,4976.0,35
CDM,15946WE,EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN,9648.0,6271.2,1028.28,9648.0,35
CDM,15950WE,EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR,3212.0,2087.8,310.02,3212.0,35
CDM,15952WE,EXC TROCHANTERIC PR ULCER W/SKIN FLAP CLOSURE,4924.0,3200.6,505.48,4924.0,35
CDM,15956WE,EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN,6716.0,4365.4,869.9,6716.0,35
CDM,15958WE,EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC,6700.0,4355.0,876.55,6700.0,35
CDM,16000WE,"INITIAL TX, FIRST DEGREE BURN, LOCAL TREATMENT",356.0,231.4,23.13,267.0,32
CDM,16020WE,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,312.0,202.8,31.19,234.0,35
CDM,16025WE,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,696.0,452.4,62.63,522.0,35
CDM,16030WE,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,832.0,540.8,63.62,624.0,35
CDM,16035WE,ESCHAROTOMY; INIT INC,1496.0,972.4,149.36,1496.0,35
CDM,16036WE,ESCHAROTOMY; ADDL INCISION,660.0,429.0,61.87,660.0,35
CDM,16100005,ACCOMMODATION CARE AT HOME,2982.0,1938.3,1491.0,2534.7,5
CDM,17000WE,"DESTRUCTION, 1ST LESION",268.0,174.2,26.47,201.0,35
CDM,17003WE,"DESTRUC BENIGN/PREMAL,2-14 LESIONS",18.0,11.7,1.68,13.5,35
CDM,17004WE,"DESTRUC BENIGN/PREMAL,>15 LESIONS",603.0,391.95,84.08,452.25,35
CDM,17106WE,DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM,1624.0,1055.6,143.39,1218.0,35
CDM,17107RVU1WE,"LASER, DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM",650.0,422.5,266.63,705.87,35
CDM,17107WE,"DESTR,CUTAN VASC LESION 10-50SCM",2108.0,1370.2,266.63,1581.0,35
CDM,17108RVU1WE,"LASER, DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM",1100.0,715.0,347.01,1047.94,35
CDM,17108WE,DESTRUC CUT/VASC >50 SQ CM,3296.0,2142.4,347.01,2472.0,35
CDM,17110RVU3WE,KERATOSES DESTRUCTION UP TO 14,200.0,130.0,34.32,156.23,35
CDM,17110WE,DESTRUCTION BENIGN LESIONS UP TO 14,308.0,200.2,34.32,231.0,35
CDM,17111RVU3WE,KERATOSES DESTRUCTION 15 OR MORE,250.0,162.5,42.27,187.5,35
CDM,17111WE,"DESTRUC FLAT WARTS, 15 OR MORE",427.0,277.55,42.27,320.25,35
CDM,17250WE,CHEM CAUTER GRANULAR TISSUE,220.0,143.0,19.39,165.0,35
CDM,17260WE,"DESTR MALIG TRUNK,EXTREM <0.5 CM",422.0,274.3,47.67,316.5,35
CDM,17261WE,"DESTR MALIG TRUNK,EXTREM 0.6-1 CM",537.0,349.05,41.26,402.75,35
CDM,17262WE,"DESTR MALIG TRUNK,EXTREM 1.1-2 CM",717.0,466.05,65.92,537.75,35
CDM,17263WE,"DESTR MALIG TRUNK,EXTREM 2.1-3 CM",810.0,526.5,78.16,607.5,35
CDM,17264WE,"DESTR MALIG TRUNK,EXTREM 3.1-4 CM",876.0,569.4,89.25,657.0,35
CDM,17266WE,"DESTR MALIG TRUNK,EXTREM >4.0 CM",1052.0,683.8,94.53,789.0,35
CDM,17270WE,"DESTR MALIG SCAL,NCK,HAND <0.5 CM",548.0,356.2,50.8,411.0,35
CDM,17271WE,"DESTR MALIG SCAL,NCK,HAND 0.6-1 CM",616.0,400.4,62.0,462.0,35
CDM,17272WE,"DESTR MALIG SCAL,NCK,HAND 1.1-2 CM",728.0,473.2,76.28,546.0,35
CDM,17273WE,"DESTR MALIG SCAL,NCK,HAND 2.1-3 CM",840.0,546.0,90.71,630.0,35
CDM,17274WE,"DESTR MALIG SCAL,NCK,HAND 3.1-4 CM",1056.0,686.4,110.66,792.0,35
CDM,17276WE,"DESTR MALIG SCAL,NCK,HAND >4 CM",1300.0,845.0,131.43,975.0,35
CDM,17280WE,DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<,488.0,317.2,55.21,366.0,35
CDM,17281WE,"DESTR MALIG FACE,NOSE,LIP 0.6-1 CM",708.0,460.2,73.45,531.0,35
CDM,17282WE,"DESTR MALIG FACE,NOSE,LIP 1.1-2 CM",836.0,543.4,88.86,627.0,35
CDM,17283WE,"DESTR MALIG FACE,NOSE,LIP 2.1-3 CM",1076.0,699.4,109.19,807.0,35
CDM,17284WE,"DESTR MALIG FACE,NOSE,LIP 3.1-4 CM",1280.0,832.0,131.02,960.0,35
CDM,17286WE,"DESTR MALIG FACE,NOSE,LIP >4CM",1792.0,1164.8,173.85,1344.0,35
CDM,17311WE,MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS,2480.0,1612.0,191.61,1860.0,35
CDM,17312WE,MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE,1320.0,858.0,103.58,990.0,35
CDM,17313WE,MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS,2224.0,1445.6,171.86,1668.0,35
CDM,17314WE,MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE,1346.0,874.9,96.24,1009.5,35
CDM,17315WE,MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE,383.0,248.95,34.38,287.25,35
CDM,17340WE,CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE,308.0,200.2,30.89,231.0,35
CDM,17360WE,CHEMICAL EXFOLIATION ACNE,584.0,379.6,62.02,438.0,32
CDM,179991WE,COSMETIC CONSULT,121.0,78.65,60.5,206.51,15
CDM,179992WE,UNILATERAL EAR LOBE REPAIR,424.0,275.6,172.09,424.0,15
CDM,179993WE,BILATERAL EAR LOBE REPAIR,743.0,482.95,172.09,743.0,15
CDM,17999A5XWE,LASER PKG COMPLETE ARMS-5TX,2123.0,1379.95,172.09,2123.0,15
CDM,17999ABDWE,LASER PKG MALE ABDOMEN 5TX,1486.0,965.9,172.09,1486.0,15
CDM,17999ACNWE,ACNE TREATMENT 3TX,636.0,413.4,172.09,636.0,15
CDM,17999AFEWE,LASER HAIR RMVL ABDOMEN-FEMALE,306.0,198.9,153.0,306.0,15
CDM,17999AHDWE,ARMS - HANDS,183.0,118.95,91.5,206.51,15
CDM,17999AMLWE,LASER HAIR RMVL ABDOMEN-MALE,371.0,241.15,172.09,371.0,15
CDM,17999ARCWE,ARMS - ARMS COMPLETE,552.0,358.8,172.09,552.0,15
CDM,17999AREWE,LASER PKG AREOLA ONLY 4TX,530.0,344.5,172.09,530.0,15
CDM,17999ARMWE,LASER HAIR RMVL UPPER ARMS,265.0,172.25,132.5,265.0,15
CDM,17999ASCWE,CONTOUR THREAD LIFT - NECK ** ASC,2840.0,1846.0,172.09,2840.0,15
CDM,17999ATRWE,LASER ACNE TREATMENT,240.0,156.0,120.0,240.0,15
CDM,17999AUNWE,ARMS - UNDERARMS,399.0,259.35,172.09,399.0,15
CDM,17999AXIWE,LASER PKG AXILLAE 5TX,1592.0,1034.8,172.09,1592.0,15
CDM,17999BACWE,BACK AND SHOULDERS,636.0,413.4,172.09,636.0,15
CDM,17999BEAWE,FACE - FULL BEARD,424.0,275.6,172.09,424.0,15
CDM,17999BIKWE,LASER PKG BIKINI ALL 4TX,796.0,517.4,172.09,796.0,15
CDM,17999BKAWE,LASER HAIR RMVL BIKINI ALL,250.0,162.5,125.0,250.0,15
CDM,17999BRDWE,LASER PACKAGE BEARD 4 TX,1354.0,880.1,172.09,1354.0,15
CDM,17999BRWWE,CONTOUR THREAD LIFT - BROW ** IN OFFICE,2017.0,1311.05,172.09,2017.0,15
CDM,17999BSHWE,LASER PKG BACK & SHOUDLERS 5TX,2547.0,1655.55,172.09,2547.0,15
CDM,17999C5XWE,LASER PKG FEMALE CHEST 5X,1061.0,689.65,172.09,1061.0,15
CDM,17999CENWE,LASER HAIR REMOVAL EYEBROW (CENTER),106.0,68.9,53.0,206.51,15
CDM,17999CH4WE,LASER PACKAGE CHIN 4 TX,849.0,551.85,172.09,849.0,15
CDM,17999CHEWE,LASER PACKAGE CHEEKS BOTH,1167.0,758.55,172.09,1167.0,15
CDM,17999CHNWE,FACE - CHIN,265.0,172.25,132.5,265.0,15
CDM,17999CKSWE,LASER HAIR REMOVAL CHEEKS (BOTH),365.0,237.25,172.09,365.0,15
CDM,17999CONWE,CONTOUR THREAD LIFT-NECK* IN OFFICE,2017.0,1311.05,172.09,2017.0,15
CDM,17999COSWE,COSMETIC CONSULT/FEE,121.0,78.65,60.5,206.51,15
CDM,17999EARWE,LASER PACKAGE EARS 4 TX,636.0,413.4,172.09,636.0,15
CDM,17999EBRWE,LASER PACKAGE EYEBROW 4TX,399.0,259.35,172.09,399.0,15
CDM,17999ECHWE,CONTOUR THREAD PROCEDURE; ECH ADDTL 15MIN,212.0,137.8,106.0,212.0,15
CDM,17999FACWE,FACE - NECK/FRONT OR BACK,399.0,259.35,172.09,399.0,15
CDM,17999FARWE,LASER PKG FOREARMS 5TX,1592.0,1034.8,172.09,1592.0,15
CDM,17999FEEWE,FEET,183.0,118.95,91.5,206.51,15
CDM,17999FEMWE,LASER PKG FEMAL ABDOMEN 5 TX,1220.0,793.0,172.09,1220.0,15
CDM,17999FETWE,LASER PKG FEET W/TOES 4TX,583.0,378.95,172.09,583.0,15
CDM,17999FNPWE,LASER HAIR RMVL FACE & NECK PKG,565.0,367.25,172.09,565.0,15
CDM,17999FRTWE,LASER NECK FRONT OR BACK,1273.0,827.45,172.09,1273.0,15
CDM,17999FTXWE,"MICROPEEL, NONFACE SUBSEQUENT TX",187.0,121.55,93.5,206.51,15
CDM,17999FULWE,FACE - UPPER LIP,199.0,129.35,99.5,206.51,15
CDM,17999GLYWE,"GLYCOLIC WASH, ONLY",91.0,59.15,45.5,206.51,15
CDM,17999HANWE,LASER PACKAGE HANDS 4TX,583.0,378.95,172.09,583.0,15
CDM,17999HBTWE,LASER HAIR REMOVAL BUTTOCKS,1061.0,689.65,172.09,1061.0,15
CDM,17999HBUWE,LASER HAIR REMOVAL BUTTOCKS,265.0,172.25,132.5,265.0,15
CDM,17999HERWE,LASER HAIR REMOVAL- EARS,200.0,130.0,100.0,206.51,15
CDM,17999HFAWE,LASER HAIR RMVL-FOREARMS,399.0,259.35,172.09,399.0,15
CDM,17999KDNWE,LEGS ( KNEE DOWN),530.0,344.5,172.09,530.0,15
CDM,17999L7XWE,LASER COMPLETE LEGS 7TX,4245.0,2759.25,172.09,4245.0,15
CDM,17999LCOWE,LASER HAIR RMVL LEGS COMPLETE,759.0,493.35,172.09,759.0,15
CDM,17999LFBWE,CONTOUR THREAD LIFT - BROW ** ASC,2840.0,1846.0,172.09,2840.0,15
CDM,17999LFTWE,CONTOUR THREAD LIFT - MID-FACE ** ASC,4166.0,2707.9,172.09,4166.0,15
CDM,17999LIFWE,"CONTOUR THREAD FACE LIFT, 1ST HOUR",849.0,551.85,172.09,849.0,15
CDM,17999LIPWE,LASER PACKAGE LIP 4 TX,636.0,413.4,172.09,636.0,15
CDM,17999LKDWE,LASER PKG LEGS KNEE DOWN 7TX,2971.0,1931.15,172.09,2971.0,15
CDM,17999MALWE,LASER HAIR RMVL CHEST-MALE,371.0,241.15,172.09,371.0,15
CDM,17999MCHWE,LASER PKG MALE CHEST 5TX,1486.0,965.9,172.09,1486.0,15
CDM,17999MICWE,"MICROPEEL, FACIAL INTITIAL TX",187.0,121.55,93.5,206.51,15
CDM,17999MIDWE,CONTOUR THREAD LIFT-MID-FACE*IN OFFICE,3077.0,2000.05,172.09,3077.0,15
CDM,17999NECWE,LASER PKG FACE/NECK 4 TX,1804.0,1172.6,172.09,1804.0,15
CDM,17999NONWE,"MICROPEEL, NON-FACIAL INITIAL TX",187.0,121.55,93.5,206.51,15
CDM,17999P3TWE,LASER PKG PIGMENTED 3 TX,1008.0,655.2,172.09,1008.0,15
CDM,17999PIGWE,LASER DESTRUCT. PIGMENTED LESIONS/15 MIN,371.0,241.15,172.09,371.0,15
CDM,17999PKGWE,FUNGUS TREATMENT PACKAGE,265.0,172.25,132.5,265.0,15
CDM,17999PS6WE,LASER PKG PSORIASIS 6TX,1273.0,827.45,172.09,1273.0,15
CDM,17999PSOWE,LASER TX PSORIASISPER 15 MINUTES,240.0,156.0,120.0,240.0,15
CDM,17999REJWE,FACIAL REJUVENATION,2335.0,1517.75,172.09,2335.0,15
CDM,17999RVU100WE,FAT PAD BIOPSY (COMP CODE 20200),584.0,379.6,172.09,584.0,15
CDM,17999RVU101WE,STERNOHYOID/OMOHYOID ROTNAL MSCLE FLAP RPR ESOPHAGL INJRY (COMP,9200.0,5980.0,172.09,9200.0,15
CDM,17999RVU10WE,IMPLANTATION OF BIO IMPLANT FOR SOFT TISSUE REINF; OTHER AREAS (,1460.0,949.0,172.09,1460.0,15
CDM,17999RVU13WE,EXTRACTIONS,75.0,48.75,37.5,206.51,15
CDM,17999RVU17WE,LASER HAIR REMOVAL - SIMPLE,275.0,178.75,137.5,275.0,15
CDM,17999RVU18WE,"LASER HAIR REMOVAL, MODERATE",500.0,325.0,172.09,500.0,15
CDM,17999RVU19WE,LASER HAIR REMOVAL - COMPLEX,750.0,487.5,172.09,750.0,15
CDM,17999RVU22WE,"NON INVASIVE RADIOFREQUENCY, SMALL (COMP CODE 15781)",1100.0,715.0,172.09,1100.0,15
CDM,17999RVU23WE,"NON INVASIVE RADIOFREQUENCY, LARGE (COMP CODE 15780)",2800.0,1820.0,172.09,2800.0,15
CDM,17999RVU24WE,"NON INVASIVE RADIOFREQUENCY, MEDIUM (COMP CODE 15781)",2500.0,1625.0,172.09,2500.0,15
CDM,17999RVU25WE,"RADIOFREQUENCY MICRONEEDLING, MEDIUM (COMP CODE 15781)",900.0,585.0,172.09,900.0,15
CDM,17999RVU26WE,"RADIOFREQUENCY MICRONEEDLING, LARGE (COMP CODE 15780)",1200.0,780.0,172.09,1200.0,15
CDM,17999RVU27WE,"RADIOFREQUENCY MICRONEEDLING, XLARGE (COMP CODE 15781)",1600.0,1040.0,172.09,1600.0,15
CDM,17999RVU28WE,"MICROFOCUSED ULTRASOUND, LOWER FACE & SUBMENTUM (COMP CODE 15781",2500.0,1625.0,172.09,2500.0,15
CDM,17999RVU29WE,"MICROFOCUSED ULTRASOUND,NECK (COMP CODE 15782)",1800.0,1170.0,172.09,1800.0,15
CDM,17999RVU30WE,"MICROFOCUSED ULTRASOUND, UPPER FACE (COMP CODE 15781)",1500.0,975.0,172.09,1500.0,15
CDM,17999RVU31WE,"MICROFOCUSED ULTRASOUND, FULL FACE & SUBMENTUM (COMP CODE 15780)",3500.0,2275.0,172.09,3500.0,15
CDM,17999RVU32WE,CONTACT RADIOFREQUENCY (COMP CODE 15781),400.0,260.0,172.09,400.0,15
CDM,17999RVU37WE,COOLSCULPTING CYCLES 1 (COMP 15877),750.0,487.5,172.09,750.0,15
CDM,17999RVU38WE,COOLSCULPTING CYCLES ADV + 1 (COMP 15877),1500.0,975.0,172.09,1500.0,15
CDM,17999RVU39WE,COOLSCULPTING CYCLES 2 (COMP 15877),1500.0,975.0,172.09,1500.0,15
CDM,17999RVU40WE,COOLSCULPTING CYCLES 3 (COMP 15877),2250.0,1462.5,172.09,2250.0,15
CDM,17999RVU41WE,COOLSCULPTING CYCLES 4 (COMP 15877),3000.0,1950.0,172.09,3000.0,15
CDM,17999RVU42WE,COOLSCULPTING CYCLES 5 (COMP 15877),3200.0,2080.0,172.09,3200.0,15
CDM,17999RVU43WE,COOLSCULPTING CYCLES 6 (COMP 15877),3800.0,2470.0,172.09,3800.0,15
CDM,17999RVU44WE,COOLSCULPTING CYCLES 7 (COMP 15877),4200.0,2730.0,172.09,4200.0,15
CDM,17999RVU45WE,COOLSCULPTING CYCLES 8 (COMP 15877),4500.0,2925.0,172.09,4500.0,15
CDM,17999RVU46WE,COOLSCULPTING CYCLES 9 (COMP 15877),4800.0,3120.0,172.09,4800.0,15
CDM,17999RVU47WE,COOLSCULPTING CYCLES 10 (COMP 15877),5000.0,3250.0,172.09,5000.0,15
CDM,17999RVU48WE,COOLSCULPTING CYCLES 11 (COMP 15877),5500.0,3575.0,172.09,5500.0,15
CDM,17999RVU49WE,COOLSCULPTING CYCLES 12 (COMP 15877),6000.0,3900.0,172.09,6000.0,15
CDM,17999RVU50WE,COOLSCULPTING CYCLES 13 (COMP 15877),6500.0,4225.0,172.09,6500.0,15
CDM,17999RVU51WE,COOLSCULPTING CYCLES 14 (COMP 15877),7000.0,4550.0,172.09,7000.0,15
CDM,17999RVU52WE,COOLSCULPTING CYCLES 15 (COMP 15877),7500.0,4875.0,172.09,7500.0,15
CDM,17999RVU53WE,COOLSCULPTING CYCLES ADV + 2 (COMP 15877),2700.0,1755.0,172.09,2700.0,15
CDM,17999RVU54WE,COOLSCULPTING CYCLES ADV + 3 (COMP 15877),3800.0,2470.0,172.09,3800.0,15
CDM,17999RVU55WE,COOLSCULPTING CYCLES ADV + 4 (COMP 15877),4500.0,2925.0,172.09,4500.0,15
CDM,17999RVU56WE,COOLSCULPTING CYCLES ADV + 5 (COMP 15877),5000.0,3250.0,172.09,5000.0,15
CDM,17999RVU57WE,COOLSCULPTING CYCLES ADV + 6 (COMP 15877),6000.0,3900.0,172.09,6000.0,15
CDM,17999RVU58WE,COOLSCULPTING CYCLES ADV + 7 (COMP 15877),7000.0,4550.0,172.09,7000.0,15
CDM,17999RVU5WE,"SUBDERMAL RADIOFREQUENCY, LOWER FACE & NECK SCULPTING (COMP 1578",4375.0,2843.75,172.09,4375.0,15
CDM,17999RVU60WE,LASER VASC & PIGM LESIONS SMALL (COMP CODE 15781),400.0,260.0,172.09,400.0,15
CDM,17999RVU61WE,LASER VASC & PIGM LESIONS FULL FACE/MEDIUM (COMP 15780),600.0,390.0,172.09,600.0,15
CDM,17999RVU62WE,LASER VASC & PIGM LESIONS FACE & NECK/LARGE (COMP 15781),800.0,520.0,172.09,800.0,15
CDM,17999RVU63WE,LASER FRACT NON-ABLATIVE SPOT/PARTIAL FACE (COMP 15781),300.0,195.0,150.0,300.0,15
CDM,17999RVU64WE,LASER FRACT NON-ABLATIVE FULL FACE (COMP 15780),800.0,520.0,172.09,800.0,15
CDM,17999RVU65WE,LASER FRACT NON-ABLATIVE FULL FACE & NECK (COMP 15780),1000.0,650.0,172.09,1000.0,15
CDM,17999RVU66WE,LASER FRACT ABLATIVE SMALL (COMP CODIE 15781),900.0,585.0,172.09,900.0,15
CDM,17999RVU67WE,LASER FRACT ABLATIVE MEDIUM (COMP CODE 15780),2000.0,1300.0,172.09,2000.0,15
CDM,17999RVU68WE,LASER FRACT ABLATIVE LARGE  (COMP CODE 15780),3500.0,2275.0,172.09,3500.0,15
CDM,17999RVU69WE,LASER FRACT ABLAT SINGLE-USE SMALL (COMP CODE 15781),1500.0,975.0,172.09,1500.0,15
CDM,17999RVU6WE,"SUBDERMAL RADIOFREQUENCY, POSTERIOR ARMS, BOTH (COMP 15782)",3125.0,2031.25,172.09,3125.0,15
CDM,17999RVU70WE,LASER FRACT ABLAT SINGLE-USE MEDIUM (COMP CODE 15780),3000.0,1950.0,172.09,3000.0,15
CDM,17999RVU71WE,LASER FRACT ABLAT SINGLE-USE LARGE (COMP CODE 15780),5000.0,3250.0,172.09,5000.0,15
CDM,17999RVU72WE,LASER FRACT NON-ABLAT SINGLE-USE SMALL (COMP CODE 15781),500.0,325.0,172.09,500.0,15
CDM,17999RVU73WE,LASER FRACT NON-ABLAT SINGLE-USE MEDIUM (COMP CODE 15780),800.0,520.0,172.09,800.0,15
CDM,17999RVU74WE,LASER FRACT NON-ABLAT SINGLE-USE LARGE (COMP CODE 15780),1100.0,715.0,172.09,1100.0,15
CDM,17999RVU75WE,MICRONEEDLING SMALL (COMP CODE 15781),250.0,162.5,125.0,250.0,15
CDM,17999RVU76WE,MICRONEEDLING MEDIUM  (COMP CODE 15780),500.0,325.0,172.09,500.0,15
CDM,17999RVU77WE,MICRONEEDLING LARGE (COMP CODE 15780),800.0,520.0,172.09,800.0,15
CDM,17999RVU78WE,PRP & MICRONEEDLING SMALL (COMP CODE 15781 + 0232T),600.0,390.0,172.09,600.0,15
CDM,17999RVU79WE,PRP & MICRONEEDLING MEDIUM (COMP CODE 15780 + 0232T),1100.0,715.0,172.09,1100.0,15
CDM,17999RVU7WE,SUBDERMAL RADIOFREQUENCY ABDOMEN (5X8 AREA) OR UPPER BACK (COMP,1875.0,1218.75,172.09,1875.0,15
CDM,17999RVU80WE,PRP & MICRONEEDLING LARGE (COMP CODE 15780 + 0232T),1300.0,845.0,172.09,1300.0,15
CDM,17999RVU82WE,ABDOMINOPLASY W/ FLEUR-DE-LIS W/O PANNICULECTOMY(COMP CODE 15830,7992.0,5194.8,172.09,7992.0,15
CDM,17999RVU84WE,MICRO-CORING SMALL (COMP CODE 15781),2000.0,1300.0,172.09,2000.0,15
CDM,17999RVU85WE,"MICRO-CORING, MEDIUM (COMP CODE 15781)",3000.0,1950.0,172.09,3000.0,15
CDM,17999RVU87WE,"RADIOFREQUENCY MICRONEEDLING, SMALL (COMP CODE 15781)",800.0,520.0,172.09,800.0,15
CDM,17999RVU89WE,LASER FRACT ABLATIVE FULL FACE SUPERFICIAL /PARTIAL AGGRESSIVE (,900.0,585.0,172.09,900.0,15
CDM,17999RVU8WE,"SUBDERMAL RADIOFREQUENCY, KNEES, BOTH (COMP 15780)",1250.0,812.5,172.09,1250.0,15
CDM,17999RVU92WE,CERVICOPLASTY (REMOVAL EXCESS NECK SKIN),990.0,643.5,172.09,990.0,15
CDM,17999RVU93WE,WOUND ELECTROCAUTERIZATION/CONTROL OF BLEEDING (COMP 20103),1923.0,1249.95,172.09,1923.0,15
CDM,17999RVU96WE,ELECTROHYDROLIC SHOCKWAVE ENERGY LEVEL 3 LARGE (COMP CODE 15780),2200.0,1430.0,172.09,2200.0,15
CDM,17999RVU97WE,CRYOABLATION ABDOMINAL WALL MASS (COMP CODE 20983),2200.0,1430.0,172.09,2200.0,15
CDM,17999RVU98WE,RADIOFREQUENCY ABLATION SUBCUTANEOUS MASS  (COMP CODE 20982),2808.0,1825.2,172.09,2808.0,15
CDM,17999RVU99WE,CRYOABLATION OF SUBCUTANEOOUS MASS (COMP CODE 20983),2752.0,1788.8,172.09,2752.0,15
CDM,17999RVU9WE,"UNLIST PROC, SKIN, MUCOUS MEMBRANE & SUBCUT TISSUE COMP TO 15777",1205.0,783.25,172.09,1205.0,15
CDM,17999SHOWE,LASER HAIR REMOVAL SHOULDERS ONLY,265.0,172.25,132.5,265.0,15
CDM,17999SIDWE,LASER PKG SIDEBURNS 4 TX,636.0,413.4,172.09,636.0,15
CDM,17999SPTWE,TEST SPOT,121.0,78.65,60.5,206.51,15
CDM,17999STNWE,BIKINI- STANDARD,212.0,137.8,106.0,212.0,15
CDM,17999SUBWE,MICROPEEL FACIALSUBCUTANEOUS TX,91.0,59.15,45.5,206.51,15
CDM,17999T7XWE,LASER PKG LEGS THIGHS 7TX,2308.0,1500.2,172.09,2308.0,15
CDM,17999THIWE,LASER HAIR REMOVAL -THIGHS,414.0,269.1,172.09,414.0,15
CDM,17999TOEWE,FUNGUS TREATMENT TOE,106.0,68.9,53.0,206.51,15
CDM,17999TOOWE,LASER PKG TOES ONLY 4TX,399.0,259.35,172.09,399.0,15
CDM,17999VASWE,LASER PKG VASCULAR LSNS 3,1008.0,655.2,172.09,1008.0,15
CDM,17999VSCWE,LASER TX VASCULAR LESIONS/15 MINUTES,371.0,241.15,172.09,371.0,15
CDM,19000WE,PUNCTURE ASPIRATION CYST BREAST,336.0,218.4,27.88,252.0,35
CDM,19001WE,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,168.0,109.2,15.4,126.0,35
CDM,19020WE,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,1532.0,995.8,153.04,1149.0,35
CDM,19030WE,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,612.0,397.8,36.17,459.0,35
CDM,19081WE,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,1448.0,941.2,134.95,1101.88,31
CDM,19082WE,BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID,726.0,471.9,63.88,900.74,31
CDM,19083WE,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,1364.0,886.6,126.35,1084.58,31
CDM,19084WE,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,682.0,443.3,60.0,866.86,31
CDM,19085WE,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,1602.0,1041.3,147.43,1715.34,31
CDM,19086WE,BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID,801.0,520.65,64.74,1355.9,31
CDM,19100WE,BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX,508.0,330.2,38.37,381.0,35
CDM,19101WE,BIOPSY BREAST OPEN INCISIONAL,1292.0,839.8,109.81,969.0,35
CDM,19102GUIWE,"BX-BREAST,PERC,NEEDLE CORE,IMAGE GUIDED",1058.0,687.7,87.8,1058.0,16
CDM,19102PROWE,BX BREAST PERC NDL CORE W/IMAGE,1143.0,742.95,87.8,1143.0,16
CDM,19103GUIWE,"BREAST BX,PERC,VACUUM ASSISTED,IMAGE GUID",2353.0,1529.45,165.09,2353.0,16
CDM,19103PROWE,BX BRST PERC VAC ASSIST W/IMAGE,3503.0,2276.95,165.09,3503.0,16
CDM,19105WE,ABLTJ CRYOSURGICAL W/US GID EA FIBROADENOMA,1476.0,959.4,126.83,4124.29,32
CDM,19110WE,NIPPLE EXPLORATION,1776.0,1154.4,172.61,1332.0,35
CDM,19112WE,EXCISION LACTIFEROUS DUCT FISTULA,1524.0,990.6,158.3,1143.0,35
CDM,19120WE,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,2368.0,1539.2,204.33,1776.0,35
CDM,19125WE,EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES,2944.0,1913.6,226.68,2208.0,35
CDM,19126WE,EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL,1172.0,761.8,118.48,1172.0,35
CDM,19281WE,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,800.0,520.0,74.81,600.0,31
CDM,19282WE,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,440.0,286.0,37.31,330.0,31
CDM,19283WE,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,880.0,572.0,75.53,660.0,31
CDM,19284WE,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,440.0,286.0,37.55,335.53,31
CDM,19285WE,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,748.0,486.2,64.05,736.97,31
CDM,19286WE,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,374.0,243.1,32.24,625.81,31
CDM,19287WE,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,1020.0,663.0,105.15,1446.35,31
CDM,19288WE,PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID,512.0,332.8,45.91,1155.6,31
CDM,19290PROWE,PREOP PLACEMENT NEEDLE LOC 1ST,648.0,421.2,54.84,648.0,16
CDM,19291PLAWE,PREOP PLACEMENT NEEDLE EA AD,297.0,193.05,26.85,297.0,16
CDM,19291PROWE,PREOP PLACEMENT NEEDLE EA ADD''L,648.0,421.2,26.85,648.0,16
CDM,19294WE,PREP TUMOR CAVITY IORT W/PARTIAL MASTECTOMY,1200.0,780.0,125.62,1200.0,31
CDM,19295PROWE,IMG GUID PL METAL LOC CLIP PERC BRST,437.0,284.05,77.11,437.0,16
CDM,19296WE,PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST,1452.0,943.8,157.67,6465.26,35
CDM,19297WE,PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST,688.0,447.2,70.59,688.0,35
CDM,19298WE,PLMT RADTHX BRACHYTX BRST FOLLOWING PRTL MAST,2300.0,1495.0,228.29,1745.21,35
CDM,19300WE,MASTECTOMY FOR GYNECOMASTIA,2124.0,1380.6,217.76,1593.0,35
CDM,19301WE,"MASTECTOMY, PARTIAL",4052.0,2633.8,324.49,4052.0,35
CDM,19302WE,"MASTECTOMY,PARTIAL,  WITH AXILLARY LYMPHADENECTOMY",5596.0,3637.4,480.32,5596.0,35
CDM,19303WE,"MASTECTOMY, SIMPLE, COMPLETE",6000.0,3900.0,525.09,6000.0,35
CDM,19305WE,MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES,6984.0,4539.6,600.85,6984.0,35
CDM,19306WE,MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES,7252.0,4713.8,627.76,7252.0,35
CDM,19307WE,MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN,7196.0,4677.4,634.09,7196.0,35
CDM,19316WE,MASTOPEXY,4880.0,3172.0,436.64,4880.0,35
CDM,19318RVU1WE,BREAST REDUCTION FEMALE - MODERATE,1820.0,1183.0,727.46,2211.49,35
CDM,19318WE,REDUCTION OF LARGE BREAST,7053.0,4584.45,727.46,7053.0,35
CDM,19325RVU8WE,BREAST AUG (GEL) - MODERATE,2500.0,1625.0,353.02,2500.0,35
CDM,19325WE,BREAST AUGMENTATION WITH IMPLANT,3573.0,2322.45,353.02,3573.0,35
CDM,19328WE,REMOVAL OF BREAST IMPLANT,2976.0,1934.4,269.58,2976.0,35
CDM,19330WE,RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS,3600.0,2340.0,328.12,3600.0,35
CDM,19340WE,INSERTION BREAST IMPLANT SAME DAY OF MASTECTOMY,4192.0,2724.8,455.2,4192.0,35
CDM,19342WE,INSJ/RPLCMT BREAST IMPLANT SEP DAY MASTECTOMY,4611.0,2997.15,562.26,4611.0,35
CDM,19350WE,NIPPLE/AREOLA RECONSTRUCTION,4008.0,2605.2,434.27,3006.0,35
CDM,19355RVU1WE,INVERTED NIPPPLE CORRECTION,1600.0,1040.0,376.96,1245.93,32
CDM,19355WE,CORRECT INVERTED NIPPLE(S),3408.0,2215.2,376.96,2556.0,32
CDM,19357WE,BREAST RECONSTRUC W TISS EXPANDR,6530.0,4244.5,833.32,6530.0,35
CDM,19361WE,BREAST RECONSTRUC W LAT DORSI FLAP,9344.0,6073.6,1048.12,9344.0,35
CDM,19364WE,BREAST RECONSTRUC W FREE FLAP,18735.0,12177.75,1499.62,18735.0,35
CDM,19367WE,BREAST RECONSTRUCTION SINGLE PEDICLED TRAM FLAP,10720.0,6968.0,1233.95,10720.0,35
CDM,19368WE,BREAST RECONSTRUCTION 1PEDICLED TRAM FLAP ANAST,13560.0,8814.0,1361.8,13560.0,35
CDM,19369WE,BREAST RECONSTRUCTION BIPEDICLED TRAM FLAP,12524.0,8140.6,1292.17,12524.0,35
CDM,19370WE,REVISION PERI-IMPLANT CAPSULE BREAST,4035.0,2622.75,388.57,4035.0,35
CDM,19371WE,PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE,4391.0,2854.15,469.75,4391.0,35
CDM,19380WE,REVISE BREAST RECONSTRUCTION,4915.0,3194.75,422.97,4915.0,35
CDM,19396WE,PREPARATION MOULAGE CUSTOM BREAST IMPLANT,955.0,620.75,126.95,716.25,32
CDM,19499ABDWE,"THERMAGE, ABDOMEN",2388.0,1552.2,324.44,2388.0,15
CDM,19499ANTWE,"THERMAGE, ANTERIOR THIGHS",3070.0,1995.5,324.44,3070.0,15
CDM,19499ARMWE,"THERMAGE, ARMS",3070.0,1995.5,324.44,3070.0,15
CDM,19499BUTWE,"THERMAGE, BUTTOCKS & UPPER THIGHS",3070.0,1995.5,324.44,3070.0,15
CDM,19499EPIWE,DEEP INFERIOR EPIGASTRIC PERFORATOR,9055.0,5885.75,324.44,9055.0,15
CDM,19499EYEWE,"THERMAGE, EYES",1762.0,1145.3,324.44,1762.0,15
CDM,19499FACWE,"THERMAGE, FULL FACE & NECK",1933.0,1256.45,324.44,1933.0,15
CDM,19499FNEWE,"THERMAGE, FULL FACE , NECK & EYES",2614.0,1699.1,324.44,2614.0,15
CDM,19499INNWE,"THERMAGE, INNER THIGHS",2388.0,1552.2,324.44,2388.0,15
CDM,19499KNEWE,"THERMAGE, KNEES",2047.0,1330.55,324.44,2047.0,15
CDM,19499PARWE,"THERMAGE, PARTIAL FACE & UPPER NECK",1592.0,1034.8,324.44,1592.0,15
CDM,19499RVU1WE,ENDOSCOPIC MASTECTOMY (COMP CODE 19303),6000.0,3900.0,324.44,6000.0,15
CDM,20100WE,EXPLORATION PENETRATING WOUND SPX NECK,4152.0,2698.8,414.61,4152.0,35
CDM,20101WE,EXPLORATION PENETRATING WOUND SPX CHEST,1292.0,839.8,103.4,969.0,35
CDM,20102WE,EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK,1592.0,1034.8,127.63,1194.0,35
CDM,20103WE,EXPLORATION PENETRATING WOUND SPX EXTREMITY,2136.0,1388.4,167.67,1602.0,35
CDM,20200WE,BIOPSY MUSCLE SUPERFICIAL,584.0,379.6,58.27,438.0,35
CDM,20205WE,DEEP MUSCLE BIOPSY,940.0,611.0,77.94,705.0,35
CDM,20206WE,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,396.0,257.4,41.71,426.52,35
CDM,20220WE,"BONE BIOPSY,TROCAR/NEEDLE SUPERF",660.0,429.0,41.75,495.0,35
CDM,20225WE,"BONE BIOPSY,TROCAR/NEEDLE DEEP",980.0,637.0,80.3,949.75,35
CDM,20240WE,BIOPSY BONE OPEN SUPERFICIAL,1148.0,746.2,107.24,1148.0,35
CDM,20245WE,BIOPSY BONE OPEN DEEP,2640.0,1716.0,262.47,2640.0,35
CDM,20250WE,BIOPSY VERTEBRAL BODY OPEN THORACIC,2076.0,1349.4,269.87,2076.0,35
CDM,20251WE,BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL,2288.0,1487.2,307.14,2288.0,35
CDM,20500WE,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,512.0,332.8,64.03,384.0,35
CDM,20501WE,INJECTION SINUS TRACT DIAGNOSTIC,304.0,197.6,27.93,228.0,35
CDM,20520WE,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,760.0,494.0,85.78,570.0,35
CDM,20525WE,RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,1416.0,920.4,120.0,1062.0,35
CDM,20526WE,INJECTION THERAPEUTIC CARPAL TUNNEL,414.0,269.1,33.26,310.5,35
CDM,20527WE,INJECTION ENZYME PALMAR FASCIAL CORD,400.0,260.0,31.73,300.0,35
CDM,20550WE,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,330.0,214.5,31.07,247.5,35
CDM,20551WE,INJECTION SINGLE TENDON ORIGIN/INSERTION,330.0,214.5,32.02,247.5,35
CDM,20552WE,TRIGGER POINT INJECTION MULTI 1-2 MUSCLE GR,290.0,188.5,26.7,217.5,35
CDM,20553WE,TRIGGER POINT INJECTION MULTI 3+ MUSCLE GRP,330.0,214.5,32.19,247.5,35
CDM,20560WE,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,141.0,91.65,11.25,105.75,31
CDM,20560WE-26,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,141.0,91.65,70.5,141.0,12
CDM,20560WE-TC,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,141.0,91.65,70.5,141.0,12
CDM,20561WE,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,211.0,137.15,16.97,158.25,31
CDM,20561WE-26,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,211.0,137.15,105.5,211.0,12
CDM,20561WE-TC,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,141.0,91.65,70.5,141.0,12
CDM,20600030,ACCOMMODATION ICU INT,4434.0,2882.1,1733.69,4212.3,10
CDM,20600040,ACCOMMODATION ICU,10208.0,6635.2,3991.33,9697.6,10
CDM,20600070,ACCOMMODATION CCU,10208.0,6635.2,3991.33,9697.6,10
CDM,20600WE,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,290.0,188.5,24.35,217.5,35
CDM,20604WE,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,392.0,254.8,34.35,294.0,31
CDM,20605WE,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,299.0,194.35,34.49,224.25,35
CDM,20606WE,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,440.0,286.0,38.85,330.0,31
CDM,20610WE,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,348.0,226.2,28.34,261.0,35
CDM,20611WE,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,484.0,314.6,45.64,363.0,31
CDM,20612WE,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,308.0,200.2,29.91,231.0,35
CDM,20615WE,ASPIRATION & INJECTION TREATMENT BONE CYST,932.0,605.8,77.43,699.0,35
CDM,20650WE,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,912.0,592.8,78.25,684.0,35
CDM,20660WE,APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX,1600.0,1040.0,117.04,1600.0,35
CDM,20661WE,APPLICATION HALO CRANIAL INCLUDING REMOVAL,2104.0,1367.6,249.53,2104.0,35
CDM,20665WE,REMOVAL TONG/HALO APPLIED BY ANOTHER INDIVIDUAL,544.0,353.6,69.57,408.0,35
CDM,20670WE,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,788.0,512.2,73.65,692.83,35
CDM,20680WE,REMOVAL DEEP IMPLANT,2622.0,1704.3,203.67,1966.5,35
CDM,20690WE,APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM,3512.0,2282.8,290.62,3512.0,35
CDM,20692WE,APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM,6508.0,4230.2,544.59,6508.0,35
CDM,20693WE,ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES,2424.0,1575.6,253.73,2424.0,35
CDM,20694WE,REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES,1712.0,1112.8,165.53,1284.0,35
CDM,20697WE,XTRNL FIXJ W/STRTCTC ADJUSTMENT EXCHANGE STRUT,8468.0,5504.2,928.75,8468.0,35
CDM,20700WE,MANUAL PREP AND INSERTION DEEP DRUG DELIVERY DEV,600.0,390.0,64.09,600.0,31
CDM,20701WE,REMOVAL DEEP DRUG DELIVERY DEVICE,497.0,323.05,48.75,497.0,31
CDM,20702WE,MANUAL PREP&AMP;INSJ INTRAMEDULLARY DRUG DLVR DEVICE,1000.0,650.0,108.84,1000.0,31
CDM,20703WE,REMOVAL INTRAMEDULLARY DRUG DELIVERY DEVICE,720.0,468.0,77.96,720.0,31
CDM,20704WE,MANUAL PREP&AMP;INSJ I-ARTIC DRUG DELIVERY DEVICE,1040.0,676.0,113.39,1040.0,31
CDM,20705WE,REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE,860.0,559.0,93.26,860.0,31
CDM,20816WE,RPLJ DGT EXCEPT THMB MTCARPHLNGL JT COMPL AMP,14058.0,9137.7,1552.33,14058.0,35
CDM,20822WE,RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP,11730.0,7624.5,1361.69,11730.0,35
CDM,20827WE,RPLJ THUMB DISTAL TIP MP JOINT COMPL AMPUTATION,10992.0,7144.8,1396.52,10992.0,35
CDM,20900WE,BONE GRAFT ANY DONOR AREA MINOR/SMALL,1200.0,780.0,126.39,900.0,35
CDM,20902WE,BONE GRAFT ANY DONOR AREA MAJOR/LARGE,1832.0,1190.8,210.13,1832.0,35
CDM,20910WE,CARTILAGE GRAFT COSTOCHONDRAL,2212.0,1437.8,233.12,2212.0,35
CDM,20912WE,CARTILAGE GRAFT NASAL SEPTUM,2616.0,1700.4,305.51,2616.0,35
CDM,20920WE,FASCIA LATA GRAFT BY STRIPPER,2204.0,1432.6,253.37,2204.0,35
CDM,20922WE,FASCIA LATA GRAFT INCISION & AREA EXPOSURE,2772.0,1801.8,237.37,2079.0,35
CDM,20924WE,TENDON GRAFT FROM A DISTANCE,2672.0,1736.8,329.05,2672.0,35
CDM,20930WE,ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED,767.0,498.55,237.21,767.0,13
CDM,20931WE,ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL,724.0,470.6,85.02,724.0,35
CDM,20932WE,OSTEOARTIUCLAR ALLOGRAFT W/ARTICULAR SURF & BONE,5204.0,3382.6,550.41,5204.0,31
CDM,20933WE,HEMICORTICAL INTERCALARY ALLOGRAFT PARTIAL,4776.0,3104.4,504.84,4776.0,31
CDM,20934WE,INTERCALARY ALLOGRAFT COMPLETE,5200.0,3380.0,550.14,5200.0,31
CDM,20936WE,AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION,1089.0,707.85,253.79,1089.0,13
CDM,20937WE,AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION,1116.0,725.4,128.17,1116.0,35
CDM,20938WE,AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC,1208.0,785.2,140.17,1208.0,35
CDM,20939WE,BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY,464.0,301.6,51.45,464.0,31
CDM,20950WE,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,504.0,327.6,44.96,451.09,35
CDM,20955WE,BONE GRAFT MICROVASCULAR ANASTOMOSIS FIBULA,17714.0,11514.1,1871.78,17714.0,35
CDM,20962WE,BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR,15684.0,10194.6,1895.78,15684.0,35
CDM,20969WE,FREE OSTQ FLAP W/MVASC ANAST METAR/GREAT TOE,18172.0,11811.8,2076.55,18172.0,35
CDM,20974WE,ELECTRICAL STIMULATION BONE HEALING NONINVASIVE,248.0,161.2,33.78,186.0,35
CDM,20975WE,ELECTRICAL STIMULATION BONE HEALING INVASIVE,1040.0,676.0,132.23,1040.0,35
CDM,20979WE,LOW INTENSITY US STIMJ BONE HEALING NONINVASIVE,248.0,161.2,24.59,186.0,32
CDM,20982WE,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,2808.0,1825.2,283.87,6732.98,35
CDM,20983WE,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,2752.0,1788.8,302.31,12424.92,31
CDM,20985WE,CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS,1000.0,650.0,92.55,1000.0,35
CDM,20999AWE,SHOCK WAVE THERAPY,190.0,123.5,95.0,342.38,15
CDM,20999BMAC2WE,BONE MARROW ASPIRATE CONCENTRATE 2 JOINTS,4900.0,3185.0,285.32,4900.0,15
CDM,20999BWE,BONE MARROW ASPIRATION AND INJECTION,3900.0,2535.0,285.32,3900.0,15
CDM,20999LIPO2WE,LIPOGEMS 2 JOINT,5400.0,3510.0,285.32,5400.0,15
CDM,20999LIPOWE,LIPOGEMS ? AUTOLOGOUS ADIPOSE TISSUE HARVESTING/INJECTION,3500.0,2275.0,285.32,3500.0,15
CDM,20999RVU22WE,RFA MSK TUMOR (COMP CODE 20982),2808.0,1825.2,285.32,2808.0,15
CDM,20999RVU23WE,RADIOFREQUENCY ABLATION SOFT TISSUE MASS (COMP CODE 20982),2808.0,1825.2,285.32,2808.0,15
CDM,20999RVU24WE,CRYOABLATION OF SOFT TISSUE  MASS (COMP CODE 20983),2752.0,1788.8,285.32,2752.0,15
CDM,21010WE,ARTHROTOMY TEMPOROMANDIBULAR JOINT,4416.0,2870.4,506.34,4416.0,35
CDM,21011WE,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ < 2CM,1196.0,777.4,125.91,897.0,35
CDM,21012WE,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2+CM,1780.0,1157.0,182.86,1780.0,35
CDM,21013WE,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL < 2CM,2168.0,1409.2,195.45,1626.0,35
CDM,21014WE,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2+CM,2852.0,1853.8,282.87,2852.0,35
CDM,21015WE,RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM,3956.0,2571.4,340.27,3956.0,35
CDM,21016WE,RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2+CM,6104.0,3967.6,572.67,6104.0,35
CDM,21025WE,EXCISION BONE MANDIBLE,4012.0,2607.8,394.78,3009.0,35
CDM,21026WE,EXCISION OF FACIAL BONE(S),2280.0,1482.0,206.96,1710.0,35
CDM,21029WE,REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE,3356.0,2181.4,319.07,2517.0,35
CDM,21030WE,EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG,1964.0,1276.6,199.38,1473.0,35
CDM,21031WE,EXCISION TORUS MANDIBULARIS,1320.0,858.0,132.97,990.0,35
CDM,21032WE,EXCISION MAXILLARY TORUS PALATINUS,1336.0,868.4,134.79,1002.0,35
CDM,21034WE,EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA,7647.0,4970.55,548.05,5735.25,35
CDM,21040WE,EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT,1964.0,1276.6,176.71,1473.0,35
CDM,21044WE,EXCISION MALIGNANT TUMOR MANDIBLE,5120.0,3328.0,568.17,5120.0,35
CDM,21045WE,EXCISION MALIGNANT TUMOR MANDIBLE RADICAL,7348.0,4776.2,789.69,7348.0,35
CDM,21046WE,EXC BENIGN TUMOR/CYST MNDBL INTRA-ORAL OSTEOT,5684.0,3694.6,612.05,5684.0,35
CDM,21047WE,EXC B9 TUM/CST MNDBL XTR-ORAL OSTEOT&PRTL MNDB,8028.0,5218.2,758.52,8028.0,35
CDM,21048WE,EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT,5884.0,3824.6,629.9,5884.0,35
CDM,21049WE,EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC,7728.0,5023.2,718.66,7728.0,35
CDM,21060WE,MENISCECTOMY PRTL/COMPL TEMPOROMANDIBULAR JT SPX,4428.0,2878.2,540.19,4428.0,35
CDM,21070WE,CORONOIDECTOMY SEPARATE PROCEDURE,3448.0,2241.2,402.08,3448.0,35
CDM,21085WE,IMPRESSION & PREPARATION ORAL SURGICAL SPLINT,3596.0,2337.4,306.37,2697.0,35
CDM,21087WE,IMPRESSION & PREPARATION NASAL PROSTHESIS,9952.0,6468.8,824.5,7464.0,35
CDM,21110WE,APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,2396.0,1557.4,518.84,1797.0,35
CDM,21116WE,INJECTION TEMPOROMANDIBULAR JOINT ARTHROGRAPHY,324.0,210.6,29.53,270.51,35
CDM,21120WE,GENIOPLASTY AUGMENTATION,2040.0,1326.0,185.01,1530.0,32
CDM,21121WE,GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE,3436.0,2233.4,269.04,2577.0,35
CDM,21122WE,GENIOPLASTY 2/> SLIDING OSTEOTOMIES,3484.0,2264.6,390.02,3484.0,32
CDM,21125WE,AGMNTJ MNDBLR BODY/ANGLE PROSTHETIC MATERIAL,4320.0,2808.0,385.99,5743.04,35
CDM,21127WE,AGMNTJ MNDBLR BDY/ANGL W/GRF ONLAY/INTERPOSAL,4976.0,3234.4,491.75,7932.76,35
CDM,21137WE,REDUCTION FOREHEAD; CONTOURING ONLY,4096.0,2662.4,457.33,4096.0,35
CDM,21141WE,"RECONST FACE,LEFORT I,1 PIECE",7828.0,5088.2,853.43,7828.0,35
CDM,21182WE,RCNSTJ ORBIT/FHD/NASETHMD EXCBONE TUM GRF<40SQCM,13032.0,8470.8,1519.79,13032.0,35
CDM,21193WE,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/O GRF,7560.0,4914.0,786.03,7560.0,35
CDM,21194WE,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/GRAFT,8728.0,5673.2,919.61,8728.0,35
CDM,21196WE,RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI,8332.0,5415.8,876.58,8332.0,35
CDM,21198WE,OSTEOTOMY MANDIBLE SEGMENTAL,6284.0,4084.6,766.95,6284.0,35
CDM,2120662WE,NM SALIVARY GLAND IMAGING,3372.0,2191.8,92.73,3372.0,32
CDM,2120662WE-26,NM SALIVARY GLAND IMAGING,208.0,135.2,20.3,208.0,31
CDM,21208WE,OSTEOPLASTY FACIAL BONES AUGMENTATION,4568.0,2969.2,559.74,3528.05,35
CDM,21209WE,OSTEOPLASTY FACIAL BONES REDUCTION,3128.0,2033.2,300.66,2346.0,32
CDM,21210RVU1WE,CHEECK IMPLANT W BONE GRAFT,2000.0,1300.0,564.41,4239.08,35
CDM,21210WE,GRAFT BONE NASAL/MAXILLARY/MALAR AREAS,5144.0,3343.6,564.41,4239.08,35
CDM,21215WE,GRAFT BONE MANDIBLE,4892.0,3179.8,593.06,7524.39,35
CDM,21230WE,GRAFT RIB CRTLG AUTOGENOUS FACE/CHIN/NOSE/EAR,4468.0,2904.2,554.36,4468.0,35
CDM,21235WE,GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR,3000.0,1950.0,285.07,2250.0,35
CDM,21240WE,ARTHRP TEMPOROMANDIBULAR JOINT W/WO AUTOGRAFT,6428.0,4178.2,780.79,6428.0,35
CDM,21242WE,ARTHROPLASTY TEMPOROMANDIBULAR JT W/ALLOGRAFT,5836.0,3793.4,693.82,5836.0,35
CDM,21243WE,ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT,9812.0,6377.8,893.91,9812.0,35
CDM,21244WE,RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE,5448.0,3541.2,668.97,5448.0,35
CDM,21245WE,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT PARTIAL,5248.0,3411.2,446.29,3936.0,35
CDM,21246WE,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT COMPLETE,828.0,538.2,414.0,1660.36,35
CDM,21248WE,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL,5096.0,3312.4,454.77,3822.0,35
CDM,21255WE,RCNSTJ ZYGMTC ARCH/GLENOID FOSSA W/BONE CARTLG,7384.0,4799.6,916.99,7384.0,35
CDM,21256WE,RECONSTRUCTION ORBIT W/OSTEOTOMIES & BONE GRAFTS,7770.0,5050.5,865.93,7770.0,35
CDM,21267WE,ORBITAL REPOSITIONING W/BONE GRAFTS EXTRACRANIAL,8276.0,5379.4,956.64,8276.0,35
CDM,21268WE,ORBITAL REPOSITIONING W/BONE GRAFTS ICRA & XTRC,10828.0,7038.2,1129.15,10828.0,35
CDM,21270RVU1WE,CHEECK IMPLANT W/O BONE GRAFT,2000.0,1300.0,390.96,1758.46,35
CDM,21270WE,MALAR AUGMENTATION PROSTHETIC MATERIAL,4252.0,2763.8,390.96,3189.0,35
CDM,21275WE,SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ,4704.0,3057.6,580.63,4704.0,35
CDM,21282RVU1WE,CANTHOPEXY,1538.0,999.7,227.48,1538.0,32
CDM,21282WE,CANTHOPEXY ;LATERAL,1708.0,1110.2,227.48,1708.0,32
CDM,21299RVU5WE,"TRANS-OSTEAL PLATING FOR MANDIBLE RECONSTRUCTION, INTRAORAL, WIT",4904.0,3187.6,610.73,4904.0,15
CDM,21299RVU6WE,COMPLEX SCULPTING & CARVING OF CADAVERIC RIB EAR CARTILAGE FRAME,4022.0,2614.3,610.73,4022.0,15
CDM,21299RVUWE,TRANSCER EXCIS STYLOID PROCESS LIGAMENT (COMP 61605),14005.0,9103.25,610.73,14005.0,15
CDM,21315WE,CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION,422.0,274.3,57.2,512.61,35
CDM,21320WE,CLOSED TX NASAL BONE FX W/MNPJ W/STABILIZATION,700.0,455.0,52.74,525.0,35
CDM,21325WE,OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED,1672.0,1086.8,262.63,1672.0,35
CDM,21330WE,OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI,2316.0,1505.4,322.15,2316.0,35
CDM,21335WE,OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM,3608.0,2345.2,499.63,3608.0,35
CDM,21336WE,OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION,2708.0,1760.2,342.18,2708.0,35
CDM,21337WE,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,1356.0,881.4,145.97,1017.0,32
CDM,21338WE,OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION,2748.0,1786.2,430.1,2748.0,35
CDM,21340WE,PERCUTANEOUS TX NASOETHMOID COMPLEX FRACTURE,4596.0,2987.4,514.61,4596.0,35
CDM,21343WE,OPEN TX DEPRESSED FRONTAL SINUS FRACTURE,5728.0,3723.2,632.74,5728.0,35
CDM,21344WE,OPEN TX COMPLICATED FRONTAL SINUS FRACTURE,8628.0,5608.2,821.87,8628.0,35
CDM,21346WE,OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG & FXJ,4580.0,2977.0,546.41,4580.0,35
CDM,21356WE,OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE,1932.0,1255.8,196.93,1449.0,35
CDM,21360WE,OPEN TX DEPRESSED MALAR FRACTURE,2876.0,1869.4,374.61,2876.0,35
CDM,21365WE,OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG,6708.0,4360.2,741.74,6708.0,35
CDM,21366WE,OPEN TX COMP FRACTURE MALAR AREA W/BONE GRAFT,7440.0,4836.0,817.5,7440.0,35
CDM,21385WE,OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL,3828.0,2488.2,501.73,3828.0,35
CDM,21386WE,OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL,3828.0,2488.2,501.85,3828.0,35
CDM,21390WE,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC,4492.0,2919.8,580.67,4492.0,35
CDM,21395WE,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/BONE GRF,5880.0,3822.0,621.12,5880.0,35
CDM,21400WE,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,600.0,390.0,80.22,450.0,32
CDM,21406WE,OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT,2968.0,1929.2,348.03,2968.0,35
CDM,21407WE,OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT,3608.0,2345.2,436.19,3608.0,35
CDM,21408WE,OPEN TX FX ORBIT EXCEPT BLOWOUT W/BONE GRAFT,5112.0,3322.8,573.69,5112.0,35
CDM,21421WE,CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT,2408.0,1565.2,266.47,1806.0,35
CDM,21422WE,OPEN TREATMENT PALATAL/MAXILLARY FRACTURE,3492.0,2269.8,471.76,3492.0,35
CDM,21423WE,OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR,4340.0,2821.0,541.37,4340.0,35
CDM,21440WE,CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,1376.0,894.4,273.86,1163.83,35
CDM,21445WE,OPTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,2504.0,1627.6,319.72,1878.0,35
CDM,21450WE,CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,1484.0,964.6,238.36,1159.34,32
CDM,21451WE,CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION,2260.0,1469.0,317.91,1695.0,35
CDM,21453WE,CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,2656.0,1726.4,462.07,1992.0,35
CDM,21454WE,OPEN TX MANDIBULAR FX W/EXTERNAL FIXATION,2944.0,1913.6,359.2,2944.0,35
CDM,21455WE,CLSD MANIP TX INTDEN FIX MAND FX,2656.0,1726.4,1328.0,2656.0,12
CDM,21461WE,OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION,3724.0,2420.6,520.92,3932.09,35
CDM,21462WE,OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION,4404.0,2862.6,580.59,4188.31,35
CDM,21465WE,OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE,5248.0,3411.2,547.87,5248.0,35
CDM,21470WE,OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION,7016.0,4560.4,833.11,7016.0,35
CDM,21480WE,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,268.0,174.2,19.48,201.0,35
CDM,21485WE,CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ,1908.0,1240.2,395.17,1499.21,35
CDM,21490WE,OPEN TREATMENT TEMPOROMANDIBULAR DISLOCATION,5180.0,3367.0,498.32,5180.0,35
CDM,21497WE,INTERDENTAL WIRING OTHER THAN FRACTURE,1856.0,1206.4,453.26,1392.0,35
CDM,21501WE,I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX,1592.0,1034.8,162.74,1194.0,35
CDM,21502WE,I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RI,3020.0,1963.0,336.44,3020.0,35
CDM,21550WE,BIOPSY SOFT TISSUE NECK/CHEST,844.0,548.6,75.62,633.0,35
CDM,21552WE,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ 3+CM,2596.0,1687.4,246.31,2596.0,35
CDM,21554WE,EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5+CM,4452.0,2893.8,405.21,4452.0,35
CDM,21555WE,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM,1584.0,1029.6,149.92,1188.0,35
CDM,21556WE,EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM,3064.0,1991.6,259.72,3064.0,35
CDM,21557WE,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM,5900.0,3835.0,477.16,5900.0,35
CDM,21558WE,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5+CM,8632.0,5610.8,762.3,8632.0,35
CDM,21600WE,EXCISION RIB PARTIAL,2904.0,1887.6,343.43,2904.0,35
CDM,21601WE,EXCISION CHEST WALL TUMOR INCLUDING RIBS,7112.0,4622.8,880.1,7112.0,31
CDM,21602WE,EXCISION CH WAL TUM W/RIB W/O MEDSTNL LYMPHADEC,8876.0,5769.4,1186.24,8876.0,31
CDM,21603WE,EXCISION CH WAL TUM W/RIB W/MEDSTNL LYMPHADEC,10068.0,6544.2,1286.32,10068.0,31
CDM,21610WE,COSTOTRANSVERSECTOMY SEPARATE PROCEDURE,6364.0,4136.6,589.14,6364.0,35
CDM,21615WE,EXCISION 1ST &/CERVICAL RIB,4180.0,2717.0,479.75,4180.0,35
CDM,21620WE,OSTECTOMY STERNUM PARTIAL,2912.0,1892.8,372.93,2912.0,35
CDM,21627WE,STERNAL DEBRIDEMENT,2920.0,1898.0,352.83,2920.0,35
CDM,21630WE,RADICAL RESECTN STERNUM,7672.0,4986.8,858.69,7672.0,35
CDM,21685WE,HYOID MYOTOMY AND SUSPENSION,6104.0,3967.6,627.41,6104.0,35
CDM,21700WE,DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB,2524.0,1640.6,272.43,2524.0,35
CDM,21705WE,DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB,3968.0,2579.2,406.22,3968.0,35
CDM,21740WE,REPAIR PECTUS EXCAVATUM/CARINATUM OPEN,7028.0,4568.2,730.99,7028.0,35
CDM,21742WE,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/O THRSC,9670.0,6285.5,538.35,9670.0,17
CDM,21743WE,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC,10772.0,7001.8,538.35,10772.0,17
CDM,21750WE,CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX,4560.0,2964.0,518.31,4560.0,35
CDM,21811WE,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS,4316.0,2805.4,426.25,4316.0,31
CDM,21812WE,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS,5200.0,3380.0,510.09,5200.0,31
CDM,21813WE,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS,7044.0,4578.6,696.36,7044.0,31
CDM,21825WE,OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION,3104.0,2017.6,402.73,3104.0,35
CDM,21920WE,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,844.0,548.6,83.07,633.0,35
CDM,21925WE,BIOPSY SOFT TISSUE BACK/FLANK DEEP,1852.0,1203.8,184.27,1389.0,35
CDM,21930WE,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,1976.0,1284.4,177.86,1482.0,35
CDM,21931WE,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ 3+CM,2752.0,1788.8,258.34,2752.0,35
CDM,21932WE,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM,3928.0,2553.2,371.55,3928.0,35
CDM,21933WE,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM,4452.0,2893.8,410.54,4452.0,35
CDM,21935WE,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM,6288.0,4087.2,690.71,6288.0,35
CDM,21936WE,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5+CM,9020.0,5863.0,795.72,9020.0,35
CDM,22010WE,I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR,5100.0,3315.0,569.72,5100.0,35
CDM,22015WE,I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC,5056.0,3286.4,564.84,5056.0,35
CDM,22100WE,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV,4400.0,2860.0,473.54,4400.0,35
CDM,22101WE,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC,4432.0,2880.8,490.3,4432.0,35
CDM,22102WE,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR,4432.0,2880.8,430.34,4432.0,35
CDM,22103WE,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA,936.0,608.4,101.87,936.0,35
CDM,22110WE,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV,5600.0,3640.0,617.98,5600.0,35
CDM,22112WE,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM THRC,5628.0,3658.2,594.5,5628.0,35
CDM,22114WE,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR,5628.0,3658.2,568.01,5628.0,35
CDM,22116WE,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA,928.0,603.2,109.28,928.0,35
CDM,22206WE,OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC,14872.0,9666.8,1417.76,14872.0,35
CDM,22207WE,OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR,14672.0,9536.8,1399.31,14672.0,35
CDM,22208WE,OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM,3864.0,2511.6,361.12,3864.0,35
CDM,22210WE,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV,10152.0,6598.8,1039.12,10152.0,35
CDM,22212WE,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC,8396.0,5457.4,991.32,8396.0,35
CDM,22214WE,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR,8408.0,5465.2,947.29,8408.0,35
CDM,22216WE,OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM,2653.0,1724.45,278.3,2653.0,35
CDM,22220WE,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM CRV,9176.0,5964.4,1027.17,9176.0,35
CDM,22222WE,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM THRC,9236.0,6003.4,921.7,9236.0,35
CDM,22224WE,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM LUMBAR,9236.0,6003.4,995.41,9236.0,35
CDM,22226WE,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM EA ADDL,2412.0,1567.8,276.01,2412.0,35
CDM,22310WE,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,1380.0,897.0,145.31,1035.0,35
CDM,22315WE,CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ,4044.0,2628.6,376.11,3033.0,35
CDM,22318WE,OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT,9088.0,5907.2,1070.47,9088.0,35
CDM,22325WE,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM,7948.0,5166.2,747.69,7948.0,35
CDM,22326WE,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR,8336.0,5418.4,968.6,8336.0,35
CDM,22327WE,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH,8308.0,5400.2,947.33,8308.0,35
CDM,22328WE,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA,1840.0,1196.0,216.77,1840.0,35
CDM,22510WE,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,3160.0,2054.0,336.9,3196.61,31
CDM,22511WE,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,2932.0,1905.8,315.56,3166.48,31
CDM,22512WE,VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,1600.0,1040.0,154.14,1780.37,31
CDM,22513WE,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,3460.0,2249.0,383.26,13245.19,31
CDM,22514WE,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,3196.0,2077.4,358.0,13170.99,31
CDM,22515WE,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,1760.0,1144.0,160.65,7986.98,31
CDM,22526WE,"PERC INTRADISC ELECTRO ANNULOPLASTY, SINGLE LEVEL",2340.0,1521.0,249.46,4265.33,21
CDM,22527WE,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL,1212.0,787.8,112.46,3547.46,21
CDM,22532WE,ARTHRODESIS LATERAL EXTRACAVITARY THORACIC,10396.0,6757.4,1105.0,10396.0,35
CDM,22533WE,ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR,9916.0,6445.4,1031.41,9916.0,35
CDM,22534WE,ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR,2396.0,1557.4,261.27,2396.0,35
CDM,22551WE,ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2,11000.0,7150.0,1133.74,11000.0,35
CDM,22552WE,ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC,2600.0,1690.0,264.8,2600.0,35
CDM,22554WE,ARTHRD ANT INTERBODY MIN DSC CRV BELOW C2,7784.0,5059.6,980.16,7784.0,35
CDM,22556WE,ARTHRD ANT INTERBODY MIN DSC THORACIC,9880.0,6422.0,1210.15,9880.0,35
CDM,22558WE,ARTHRD ANT INTERBODY MIN DSC LUMBAR,10353.0,6729.45,1138.55,10353.0,35
CDM,22585WE,ARTHRD ANT NTRBD MIN DSC EA ADDL INTERSPACE,2429.0,1578.85,248.18,2429.0,35
CDM,22586WE,ARTHRODESIS PRESACRAL INTRBDY W/INSTRUMENT L5/S1,11248.0,7311.2,1090.77,11248.0,31
CDM,22590WE,ARTHRODESIS POSTERIOR CRANIOCERVICAL,8704.0,5657.6,1120.27,8704.0,35
CDM,22595WE,ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2,8256.0,5366.4,1091.13,8256.0,35
CDM,22600WE,ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT,6960.0,4524.0,913.86,6960.0,35
CDM,22610WE,ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC,7603.0,4941.95,897.42,7603.0,35
CDM,22612WE,ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR,10353.0,6729.45,1113.94,10353.0,35
CDM,22614WE,ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC,2829.0,1838.85,300.26,2829.0,35
CDM,22630WE,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR,9720.0,6318.0,1064.7,9720.0,35
CDM,22632WE,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC EA ADDL,2297.0,1493.05,246.13,2297.0,35
CDM,22633WE,ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR,11792.0,7664.8,902.28,11792.0,35
CDM,22634WE,ARTHRODESIS CMBN TQ 1NTRSPC EACH ADDITIONAL,3502.0,2276.3,240.65,3502.0,35
CDM,22800WE,ARTHRODESIS POSTERIOR SPINAL DFRM <6 VRT SGM,8580.0,5577.0,1029.28,8580.0,35
CDM,22802WE,ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SGM,14128.0,9183.2,1584.59,14128.0,35
CDM,22804WE,ARTHRODESIS POSTERIOR SPINAL DFRM 13+ VRT SGM,16500.0,10725.0,1740.02,16500.0,35
CDM,22808WE,ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SGM,11004.0,7152.6,1219.38,11004.0,35
CDM,22810WE,ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SGM,12600.0,8190.0,1332.35,12600.0,35
CDM,22818WE,"KYPHECTOMY, 1-2 SEGMENTS",13732.0,8925.8,1598.68,13732.0,35
CDM,22819WE,"KYPHECTOMY, 3 & MORE SEGMENT",15752.0,10238.8,1647.8,15752.0,35
CDM,22830WE,EXPLORATION OF SPINAL FUSION,4937.0,3209.05,620.83,4937.0,35
CDM,22836WE,ANT THORACIC VRT BODY TETHERING <7 VRT SEGMENTS,14080.0,9152.0,1245.23,14080.0,28
CDM,22837WE,ANT THORACIC VRT BODY TETHERING 8+ VRT SEGMENTS,15620.0,10153.0,1372.16,15620.0,28
CDM,22838WE,REVJ RPLCMT/RMVL THORACIC VRT BODY TETHERING,15840.0,10296.0,1390.46,15840.0,28
CDM,22840WE,POSTERIOR NON-SEGMENTAL INSTRUMENTATION,5509.0,3580.85,445.37,5509.0,35
CDM,22841WE,INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS,2427.0,1577.55,796.01,2427.0,13
CDM,22842WE,POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG,5526.0,3591.9,445.63,5526.0,35
CDM,22843WE,POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG,5914.0,3844.1,555.77,5914.0,35
CDM,22844WE,POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SE,7225.0,4696.25,679.14,7225.0,35
CDM,22845WE,ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS,5254.0,3415.1,426.84,5254.0,35
CDM,22846WE,ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS,5456.0,3546.4,513.16,5456.0,35
CDM,22847WE,ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS,6063.0,3940.95,570.17,6063.0,35
CDM,22848WE,PELVIC FIXATION OTHER THAN SACRUM,2636.0,1713.4,275.5,2636.0,35
CDM,22849WE,REINSERTION SPINAL FIXATION DEVICE,8435.0,5482.75,781.47,8435.0,35
CDM,22850WE,REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION,3928.0,2553.2,508.9,3928.0,35
CDM,22852WE,REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION,3748.0,2436.2,509.05,3748.0,35
CDM,22853WE,INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD,1870.0,1215.5,197.62,1870.0,31
CDM,22854WE,INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD,2420.0,1573.0,257.37,2420.0,31
CDM,22855WE,REMOVAL ANTERIOR INSTRUMENTATION,6978.0,4535.7,601.44,6978.0,35
CDM,22856WE,TOTAL DISC ARTHRP ANT DSC 1 INTERSPACE CERVICAL,10582.0,6878.3,554.94,10582.0,35
CDM,22858WE,TOT DISC ARTHRP ANT APPR DISC 2ND LEVEL CERVICAL,3360.0,2184.0,388.86,3360.0,31
CDM,22859WE,INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD,2420.0,1573.0,257.11,2420.0,31
CDM,22860WE,TOTAL DISC ARTHRP ANT SECOND INTERSPACE LUMBAR,2752.0,1788.8,316.09,2752.0,30
CDM,22862WE,REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC LMBR,13052.0,8483.8,1851.15,13052.0,31
CDM,22864WE,RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE CERVICAL,11760.0,7644.0,1382.07,11760.0,32
CDM,22865WE,RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE LUMBAR,12700.0,8255.0,1815.84,12700.0,31
CDM,22867WE,INSJ STABLJ DEV W/DCMPRN LUMBAR SINGLE LEVEL,6000.0,3900.0,792.21,6000.0,28
CDM,22868WE,INSJ STABLJ DEV W/DCMPRN LUMBAR SECOND LEVEL,1600.0,1040.0,190.42,1600.0,28
CDM,22869WE,INSJ STABLJ DEV W/O DCMPRN LUMBAR SINGLE LEVEL,2812.0,1827.8,413.16,2812.0,28
CDM,22870WE,INSJ STABLJ DEV W/O DCMPRN LUMBAR SECOND LEVEL,936.0,608.4,107.3,936.0,28
CDM,22899BIOWE,LUMBAR INTERVERTEBRAL DISC BIOPSY,819.0,532.35,409.5,997.43,15
CDM,22899DISWE,CHARITE - ARTIFICIAL DISC,20672.0,13436.8,831.19,20672.0,15
CDM,22899LADWE,"KYPHOPLASTY, LUMBAR EACH ADD VB",7278.0,4730.7,831.19,7278.0,15
CDM,22899LUMWE,KYPHOPLASTY LUMBAR - 1ST VERTEBRAL BODY,8221.0,5343.65,831.19,8221.0,15
CDM,22899RVU3WE,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC THORACIC (COMP CODE 226,10649.0,6921.85,831.19,10649.0,15
CDM,22899RVU4WE,REMOVAL OF AN INTRASPINOUS SPACER (COMP CODE 22867),6450.0,4192.5,831.19,6450.0,15
CDM,22899RVU5WE,TOTAL DISC ARTHRP ANT CERVICAL 3 OR MORE LVL (COMP CODE 22858),3025.0,1966.25,831.19,3025.0,15
CDM,22899RVU6WE,"OPEN VERTEBRAE AUGMENTATION (KYPHOPLASTY), INCLUDING CAVITY CREA",3115.0,2024.75,831.19,3115.0,15
CDM,22899RVU7WE,IMAGE GUIDED VERTEBRAL BODY FIDUCIAL MARKER PLCMNT (COMP CODE 22,2845.0,1849.25,831.19,2845.0,15
CDM,22899TADWE,"KYPHOPLASTY THORACIC, EA ADD VB",7517.0,4886.05,831.19,7517.0,15
CDM,22899THOWE,KYPHOPLASTY THORACIC -1ST VERTEBRAL BODY,8460.0,5499.0,831.19,8460.0,15
CDM,22899VIDWE,VIDEO ASSISTED THORACOSCOPIC SPINAL SURG,1648.0,1071.2,824.0,1648.0,15
CDM,22899WE,UNLISTED SPINE SURGERY OR PROCEDURE,661.0,429.65,330.5,997.43,15
CDM,22900WE,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM,3328.0,2163.2,277.14,3328.0,35
CDM,22901WE,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5+CM,4044.0,2628.6,366.47,4044.0,35
CDM,22902WE,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,1768.0,1149.2,163.56,1326.0,35
CDM,22903WE,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3+CM,2556.0,1661.4,240.87,2556.0,35
CDM,22904WE,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM,6676.0,4339.4,576.36,6676.0,35
CDM,22905WE,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5+CM,8632.0,5610.8,746.87,8632.0,35
CDM,22999RVU2WE,EXPLORATORY OF ABDOMEN (COMP CODE 20102),1592.0,1034.8,538.14,1592.0,15
CDM,22999RVU4WE,I&D ABDOMINAL WALL HEMATOMA (COMP CODE 26990),3180.0,2067.0,538.14,3180.0,15
CDM,22999RVUWE,REMOVAL OF MESH ABD WALL (COMP 20680),2563.0,1665.95,538.14,2563.0,15
CDM,23000115,ECMO DAILY CARE,2276.0,1479.4,382.37,2048.4,21
CDM,23000WE,REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN,1792.0,1164.8,180.82,1344.0,35
CDM,23020WE,CAPSULAR CONTRACTURE RELEASE,3744.0,2433.6,451.43,3744.0,35
CDM,23030WE,I&D SHOULDER DEEP ABSCESS/HEMATOMA,1388.0,902.2,124.76,1041.0,35
CDM,23031WE,I&D SHOULDER INFECTED BURSA,1116.0,725.4,107.02,837.0,35
CDM,23040WE,ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB,4290.0,2788.5,514.14,4290.0,35
CDM,23044WE,ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB,3036.0,1973.4,398.28,3036.0,35
CDM,23065WE,BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL,920.0,598.0,77.92,690.0,35
CDM,23066WE,BIOPSY SOFT TISSUE SHOULDER DEEP,1720.0,1118.0,178.35,1290.0,35
CDM,23071WE,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3+CM,2364.0,1536.6,228.98,2364.0,35
CDM,23073WE,EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5+CM,4052.0,2633.8,380.44,4052.0,35
CDM,23075WE,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM,1684.0,1094.6,161.26,1263.0,35
CDM,23076WE,EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM,2964.0,1926.6,319.87,2964.0,35
CDM,23077WE,RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM,7064.0,4591.6,662.03,7064.0,35
CDM,23078WE,RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5+CM,9020.0,5863.0,777.39,9020.0,35
CDM,23100WE,ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY,2480.0,1612.0,358.09,2480.0,35
CDM,23101WE,ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG,2288.0,1487.2,333.39,2288.0,35
CDM,23105WE,ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY,3392.0,2204.8,480.38,3392.0,35
CDM,23106WE,ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX,2452.0,1593.8,306.61,2452.0,35
CDM,23107WE,ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB,3548.0,2306.2,498.35,3548.0,35
CDM,23120WE,CLAVICULECTOMY PARTIAL,3252.0,2113.8,339.74,3252.0,35
CDM,23125WE,CLAVICULECTOMY TOTAL,4242.0,2757.3,490.29,4242.0,35
CDM,23130WE,PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE,3419.0,2222.35,409.84,3419.0,35
CDM,23140WE,EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA,2848.0,1851.2,314.28,2848.0,35
CDM,23150WE,EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS,3564.0,2316.6,421.34,3564.0,35
CDM,23180WE,PARTIAL EXCISION BONE CLAVICLE,3596.0,2337.4,393.04,3596.0,35
CDM,23182WE,PARTIAL EXCISION BONE SCAPULA,3444.0,2238.6,441.42,3444.0,35
CDM,23184WE,PARTIAL EXCISION BONE PROXIMAL HUMERUS,3960.0,2574.0,532.41,3960.0,35
CDM,23190WE,OSTECTOMY SCAPULA PARTIAL,2988.0,1942.2,371.38,2988.0,35
CDM,23220WE,RADICAL RESECTION BONE TUMOR PROXIMAL HUMERUS,12084.0,7854.6,942.72,12084.0,35
CDM,23333WE,REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM,2400.0,1560.0,344.25,2400.0,31
CDM,23334WE,PROSTHESIS REMOVAL HUMERAL/GLENOID COMPONENT,6200.0,4030.0,777.84,6200.0,31
CDM,23335WE,PROSTHESIS REMOVAL HUMERAL AND GLENOID COMPONENT,7600.0,4940.0,929.01,7600.0,31
CDM,23350WE,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,400.0,260.0,24.01,300.0,35
CDM,23395WE,MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE,7416.0,4820.4,746.28,7416.0,35
CDM,23405WE,TENOTOMY SHOULDER AREA 1 TENDON,3416.0,2220.4,431.98,3416.0,35
CDM,23406WE,TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION,4404.0,2862.6,558.59,4404.0,35
CDM,23410WE,OPEN REPAIR OF ROTATOR CUFF ACUTE,4556.0,2961.4,611.2,4556.0,35
CDM,23412WE,OPEN REPAIR OF ROTATOR CUFF CHRONIC,4772.0,3101.8,665.12,4772.0,35
CDM,23415WE,CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY,3692.0,2399.8,430.45,3692.0,35
CDM,23420WE,RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC,5416.0,3520.4,721.16,5416.0,35
CDM,23430WE,TENODESIS LONG TENDON BICEPS,4068.0,2644.2,486.29,4068.0,35
CDM,23440WE,RESECTION/TRANSPLANTATION LONG TENDON BICEPS,4256.0,2766.4,497.82,4256.0,35
CDM,23450WE,CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON,5480.0,3562.0,710.92,5480.0,35
CDM,23455WE,CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR,5868.0,3814.2,755.25,5868.0,35
CDM,23460WE,CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK,6961.0,4524.65,798.9,6961.0,35
CDM,23462WE,CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR,6288.0,4087.2,782.14,6288.0,35
CDM,23465WE,CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK,6520.0,4238.0,814.53,6520.0,35
CDM,23466WE,CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS,6952.0,4518.8,805.58,6952.0,35
CDM,23470WE,ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY,7156.0,4651.4,913.82,7156.0,35
CDM,23472WE,ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER,9737.0,6329.05,992.84,9737.0,35
CDM,23473WE,REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT,10000.0,6500.0,1137.24,10000.0,31
CDM,23474WE,REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT,10884.0,7074.6,1229.51,10884.0,31
CDM,23480WE,OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION,4616.0,3000.4,500.53,4616.0,35
CDM,23485WE,OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL,5564.0,3616.6,682.53,5564.0,35
CDM,23491WE,PROPH TX W/WO METHYLMETHACRYLATE PROX HUMERUS,5816.0,3780.4,734.92,5816.0,35
CDM,23500WE,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,972.0,631.8,102.77,729.0,35
CDM,23505WE,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,1532.0,995.8,175.15,1149.0,35
CDM,23515WE,OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION,3876.0,2519.4,394.62,3876.0,35
CDM,23530WE,OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC,2992.0,1944.8,376.82,2992.0,35
CDM,23540WE,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,944.0,613.6,116.38,708.0,32
CDM,23545WE,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,1372.0,891.8,156.16,1029.0,35
CDM,23550WE,OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC,3036.0,1973.4,417.38,3036.0,35
CDM,23552WE,OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,3528.0,2293.2,433.23,3528.0,35
CDM,23570WE,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,944.0,613.6,116.22,708.0,35
CDM,23575WE,CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION,1692.0,1099.8,187.72,1269.0,35
CDM,23585WE,OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD,5692.0,3699.8,477.85,5692.0,35
CDM,23600WE,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,1200.0,780.0,165.17,900.0,35
CDM,23605WE,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,2024.0,1315.6,254.07,1518.0,35
CDM,23615WE,OPEN TREATMENT PROXIMAL HUMERAL FRACTURE,4920.0,3198.0,536.65,4920.0,35
CDM,23616WE,OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT,7348.0,4776.2,957.21,7348.0,35
CDM,23620WE,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,1020.0,663.0,153.02,765.0,35
CDM,23625WE,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,1640.0,1066.0,193.56,1230.0,35
CDM,23630WE,OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE,4228.0,2748.2,422.39,4228.0,35
CDM,23650WE,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,1553.0,1009.45,149.91,1164.75,35
CDM,23655WE,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,2094.0,1361.1,205.54,2094.0,35
CDM,23660WE,OPEN RX ACUTE SHLDR DISLOC,3064.0,1991.6,426.18,3064.0,35
CDM,23665WE,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,1864.0,1211.6,216.36,1398.0,35
CDM,23670WE,OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX,4912.0,3192.8,461.38,4912.0,35
CDM,23675WE,CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ,2508.0,1630.2,246.57,1881.0,35
CDM,23680WE,OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE,5260.0,3419.0,576.38,5260.0,35
CDM,23700WE,MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS,1028.0,668.2,152.21,1028.0,35
CDM,23920WE,DISARTICULATION SHOULDER,6492.0,4219.8,775.19,6492.0,35
CDM,23929RVU10WE,SHOULDER AUGMENTATION W/CEMENT (COMP CODE 22513),3460.0,2249.0,371.14,3460.0,15
CDM,23929RVU2WE,REPAIR PECTORALIS MAJOR MUSCLE (COMP 29828),5264.0,3421.6,371.14,5264.0,15
CDM,23930WE,I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA,1196.0,777.4,105.2,897.0,35
CDM,23931WE,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,736.0,478.4,78.25,552.0,35
CDM,23935WE,INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW,2552.0,1658.8,324.4,2552.0,35
CDM,24000WE,ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB,2432.0,1580.8,341.42,2432.0,35
CDM,24006WE,ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX,4286.0,2785.9,451.2,4286.0,35
CDM,24065WE,"BX ARM/ELBOW SOFT TISSUE,SUPERFICIAL",852.0,553.8,85.4,639.0,35
CDM,24066WE,"BX ARM/ELBOW SOFT TISSUE,DEEP",2140.0,1391.0,205.31,1605.0,35
CDM,24071WE,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3+CM,2280.0,1482.0,222.13,2280.0,35
CDM,24073WE,EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM,4052.0,2633.8,381.98,4052.0,35
CDM,24075WE,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,1866.0,1212.9,161.59,1399.5,35
CDM,24076WE,EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM,3260.0,2119.0,283.86,3260.0,35
CDM,24077WE,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM,6288.0,4087.2,600.53,6288.0,35
CDM,24079WE,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5+CM,8244.0,5358.6,716.36,8244.0,35
CDM,24100WE,ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY,2231.0,1450.15,254.55,2231.0,35
CDM,24101WE,ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB,2520.0,1638.0,357.04,2520.0,35
CDM,24102WE,ARTHROTOMY ELBOW W/SYNOVECTOMY,3304.0,2147.6,461.93,3304.0,35
CDM,24105WE,EXCISION OLECRANON BURSA,1512.0,982.8,206.39,1512.0,35
CDM,24110WE,EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS,3032.0,1970.8,417.04,3032.0,35
CDM,24116WE,EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT,4892.0,3179.8,591.95,4892.0,35
CDM,24120WE,EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN,2728.0,1773.2,347.11,2728.0,35
CDM,24126WE,EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/ALGRT,3448.0,2241.2,401.59,3448.0,35
CDM,24130WE,EXCISION RADIAL HEAD,2568.0,1669.2,353.24,2568.0,35
CDM,24138WE,"SEQUESTRECTOMY,OLECRANNON PROCESS",3740.0,2431.0,399.14,3740.0,35
CDM,24140WE,PARTIAL REMOVAL HUMERUS,3820.0,2483.0,523.86,3820.0,35
CDM,24145WE,PARTIAL REMOVAL RADIAL HEAD/NECK,3124.0,2030.6,403.2,3124.0,35
CDM,24147WE,PARTIAL REMOVAL OLECRANNON PROCESS,3136.0,2038.4,406.36,3136.0,35
CDM,24149WE,RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT,7137.0,4639.05,720.11,7137.0,35
CDM,24150WE,RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS,9384.0,6099.6,751.71,9384.0,35
CDM,24160WE,PROSTHESIS REMOVAL HUMERAL AND ULNAR COMPONENTS,7452.0,4843.8,526.73,7452.0,35
CDM,24164WE,PROSTHESIS REMOVAL RADIAL HEAD,4000.0,2600.0,354.57,4000.0,35
CDM,24200WE,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,724.0,470.6,69.05,543.0,35
CDM,24201WE,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,1880.0,1222.0,179.5,1410.0,35
CDM,24220WE,INJECTION FOR ELBOW ARTHROGRAM,524.0,340.6,41.62,393.0,35
CDM,24300WE,MANIPULATION ELBOW W/ANESTH,1616.0,1050.4,253.49,1616.0,35
CDM,24301WE,MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE,4152.0,2698.8,493.99,4152.0,35
CDM,24305WE,"ARM/ELBOW TENDON LENGTHEN,SINGLE,EA",3048.0,1981.2,315.0,3048.0,35
CDM,24310WE,"TENOTOMY,ELBOW-SHLDR,SINGL,EACH",2448.0,1591.2,263.06,2448.0,35
CDM,24330WE,"FLEXORPLASTY,ELBOW",4308.0,2800.2,474.09,4308.0,35
CDM,24332WE,"TENOLYSIS, TRICEPS",3164.0,2056.6,352.88,3164.0,35
CDM,24340WE,TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE,3232.0,2100.8,407.76,3232.0,35
CDM,24341WE,REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA,3796.0,2467.4,406.96,3796.0,35
CDM,24342WE,RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF,4344.0,2823.6,567.58,4344.0,35
CDM,24343WE,REPAIR LATERAL COLLATERAL LIGAMENT ELBOW,3664.0,2381.6,465.0,3664.0,35
CDM,24344WE,RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT,6084.0,3954.6,703.04,6084.0,35
CDM,24345WE,REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW,3664.0,2381.6,465.0,3664.0,35
CDM,24346WE,RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF,6084.0,3954.6,703.04,6084.0,35
CDM,24357WE,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,2176.0,1414.4,264.85,2176.0,35
CDM,24358WE,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN,2664.0,1731.6,311.35,2664.0,35
CDM,24359WE,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR,3592.0,2334.8,383.41,3592.0,35
CDM,24360WE,"ARTHROPLASTY,ELBOW,W MEMBRANE",5575.0,3623.75,694.33,5575.0,35
CDM,24361WE,ARTHROPLASTY ELBOW W/DISTAL HUMRL PROSTC RPLCMT,6340.0,4121.0,716.43,6340.0,35
CDM,24363WE,ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM,8800.0,5720.0,1046.05,8800.0,35
CDM,24365WE,ARTHROPLASTY RADIAL HEAD,3448.0,2241.2,432.7,3448.0,35
CDM,24366WE,ARTHROPLASTY RADIAL HEAD W/IMPLANT,3744.0,2433.6,517.39,3744.0,35
CDM,24370WE,REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT,9420.0,6123.0,1072.9,9420.0,31
CDM,24371WE,REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT,11000.0,7150.0,1237.37,11000.0,31
CDM,24400WE,OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION,4985.0,3240.25,546.03,4985.0,35
CDM,24420WE,OSTEOPLASTY HUMERUS,5492.0,3569.8,716.55,5492.0,35
CDM,24430WE,REPAIR NON/MALUNION HUMERUS W/O GRAFT,6100.0,3965.0,728.2,6100.0,35
CDM,24435WE,REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT,5996.0,3897.4,761.28,5996.0,35
CDM,24495WE,DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL,3364.0,2186.6,398.3,3364.0,35
CDM,24498WE,PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT,4912.0,3192.8,612.84,4912.0,35
CDM,24500WE,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,1500.0,975.0,165.21,1125.0,35
CDM,24505WE,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,2156.0,1401.4,270.29,1617.0,35
CDM,24515WE,OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE,4848.0,3151.2,582.7,4848.0,35
CDM,24516WE,TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE,4876.0,3169.4,587.39,4876.0,35
CDM,24530WE,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,1476.0,959.4,173.58,1107.0,35
CDM,24535WE,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,2844.0,1848.6,279.94,2133.0,35
CDM,24538WE,PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX,4299.0,2794.35,483.51,4299.0,35
CDM,24545WE,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN,5260.0,3419.0,555.53,5260.0,35
CDM,24546WE,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN,5964.0,3876.6,708.42,5964.0,35
CDM,24560WE,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1192.0,774.8,145.97,894.0,35
CDM,24565WE,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ,2312.0,1502.8,247.25,1734.0,35
CDM,24575WE,OPEN TX HUMERAL EPICONDYLAR FRACTURE,3884.0,2524.6,502.82,3884.0,35
CDM,24576WE,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,1346.0,874.9,155.01,1009.5,35
CDM,24577WE,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,2644.0,1718.6,268.95,1983.0,35
CDM,24579WE,OPEN TREATMENT HUMERAL CONDYLAR FRACTURE,4576.0,2974.4,553.48,4576.0,35
CDM,24586WE,OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO,6312.0,4102.8,796.0,6312.0,35
CDM,24587WE,OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR,6316.0,4105.4,769.35,6316.0,35
CDM,24600WE,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,1748.0,1136.2,167.67,1311.0,35
CDM,24605WE,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,2256.0,1466.4,243.1,2256.0,35
CDM,24615WE,OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION,3932.0,2555.8,502.02,3932.0,35
CDM,24620WE,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,2888.0,1877.2,301.72,2888.0,35
CDM,24635WE,OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW,3520.0,2288.0,533.37,3520.0,35
CDM,24640WE,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,550.0,357.5,43.12,412.5,35
CDM,24650WE,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1016.0,660.4,123.74,762.0,35
CDM,24655WE,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,2033.0,1321.45,206.36,1524.75,35
CDM,24665WE,OPEN TX RADIAL HEAD/NECK FRACTURE,3344.0,2173.6,423.56,3344.0,35
CDM,24666WE,OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC,3944.0,2563.6,535.86,3944.0,35
CDM,24670WE,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,1076.0,699.4,133.02,807.0,35
CDM,24675WE,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,1964.0,1276.6,231.69,1473.0,35
CDM,24685WE,OPEN TREATMENT ULNAR FRACTURE PROXIMAL END,3348.0,2176.2,472.26,3348.0,35
CDM,24920WE,AMPUTATE ARM-HUMER; OP CIRCULAR,4052.0,2633.8,464.96,4052.0,35
CDM,24925WE,"AMPUTATN ARM,THRU HUMER,SECOND CL",2920.0,1898.0,366.68,2920.0,35
CDM,25000050,TRIPLE SULFA CRM 75GM,34.0,22.1,5.71,34.0,22
CDM,25000060,WATER-STERILE IRRIG 1000ML BAG,89.0,57.85,14.95,89.0,22
CDM,25000070,NITRIC OXIDE PER HOUR,497.0,323.05,83.5,497.0,22
CDM,25000WE,INCISION EXTENSOR TENDON SHEATH WRIST,1420.0,923.0,218.07,1420.0,35
CDM,25001245,NITRIC OXIDE FOR CHALLENGE,187.5,121.88,31.5,187.5,22
CDM,25001WE,INCISE FLX TENDN SHEATH WRST,1516.0,985.4,212.05,1516.0,35
CDM,25020WE,DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT,2424.0,1575.6,370.35,2424.0,35
CDM,25023WE,DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT,5532.0,3595.8,651.93,5532.0,35
CDM,25024WE,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB,4316.0,2805.4,494.24,4316.0,35
CDM,25025WE,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT,7176.0,4664.4,799.99,7176.0,35
CDM,25028WE,I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA,2156.0,1401.4,347.66,2156.0,35
CDM,25031WE,INCISION & DRAINAGE FOREARM&/WRIST BURSA,1704.0,1107.6,253.87,1704.0,35
CDM,25035WE,INCISION DEEP BONE CORTEX FOREARM&/WRIST,3060.0,1989.0,443.69,3060.0,35
CDM,25040WE,ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB,3000.0,1950.0,366.11,3000.0,35
CDM,25065WE,BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL,816.0,530.4,85.0,612.0,35
CDM,25066WE,BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP,1708.0,1110.2,240.31,1708.0,35
CDM,25071WE,EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3+CM,2364.0,1536.6,232.42,2364.0,35
CDM,25073WE,EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM,2852.0,1853.8,288.52,2852.0,35
CDM,25075WE,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,1584.0,1029.6,154.52,1188.0,35
CDM,25076WE,EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM,2696.0,1752.4,305.62,2696.0,35
CDM,25077WE,RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM,5172.0,3361.8,533.13,5172.0,35
CDM,25078WE,RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3+CM,7076.0,4599.4,624.85,7076.0,35
CDM,25085WE,CAPSULOTOMY WRIST,2256.0,1466.4,306.24,2256.0,35
CDM,25100WE,ARTHROTOMY WRIST JOINT WITH BIOPSY,1608.0,1045.2,240.17,1608.0,35
CDM,25101WE,ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB,1932.0,1255.8,283.83,1932.0,35
CDM,25105WE,ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY,2408.0,1565.2,356.98,2408.0,35
CDM,25107WE,ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE,3080.0,2002.0,345.6,3080.0,35
CDM,25109WE,EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA,2776.0,1804.4,286.06,2776.0,35
CDM,25110WE,"EXCIS TENDON SHEATH LESN,WRIST/FORE",1616.0,1050.4,234.27,1616.0,35
CDM,25111WE,EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY,1412.0,917.8,194.78,1412.0,35
CDM,25112WE,EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT,1868.0,1214.2,241.68,1868.0,35
CDM,25115WE,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS,4036.0,2623.4,507.7,4036.0,35
CDM,25116WE,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS,3024.0,1965.6,444.46,3024.0,35
CDM,25118WE,SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT,1804.0,1172.6,270.09,1804.0,35
CDM,25119WE,SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA,2484.0,1614.6,374.54,2484.0,35
CDM,25120WE,EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA,2508.0,1630.2,382.12,2508.0,35
CDM,25126WE,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT,3096.0,2012.4,442.1,3096.0,35
CDM,25130WE,EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES,2172.0,1411.8,275.84,2172.0,35
CDM,25135WE,EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT,2832.0,1840.8,354.65,2832.0,35
CDM,25136WE,EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT,2456.0,1596.4,306.0,2456.0,35
CDM,25145WE,"SEQUESTRECTOMY,FOREARM/WRIST",2616.0,1700.4,387.82,2616.0,35
CDM,25150WE,"PART REMOVAL BONE,ULNA",2952.0,1918.8,399.26,2952.0,35
CDM,25151WE,"PART REMOVAL BONE,RADIUS",3072.0,1996.8,427.38,3072.0,35
CDM,25170WE,RADICAL RESECTION TUMOR RADIUS OR ULNA,8884.0,5774.6,714.88,8884.0,35
CDM,25210WE,CARPECTOMY 1 BONE,2448.0,1591.2,311.97,2448.0,35
CDM,25215WE,CARPECTOMY ALL BONES PROXIMAL ROW,3256.0,2116.4,469.94,3256.0,35
CDM,25230WE,RADICAL STYLOIDECTOMY SEPARATE PROCEDURE,2148.0,1396.2,305.5,2148.0,35
CDM,25240WE,"EXCIS DISTAL ULNA,PART/COMPLETE",2124.0,1380.6,311.07,2124.0,35
CDM,25246WE,INJECTION FOR WRIST ARTHROGRAM,580.0,377.0,44.74,435.0,35
CDM,25248WE,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,2124.0,1380.6,291.94,2124.0,35
CDM,25250WE,REMOVAL WRIST PROSTHESIS SEPARATE PROCEDURE,2708.0,1760.2,334.62,2708.0,35
CDM,25251WE,REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST,3928.0,2553.2,514.24,3928.0,35
CDM,25259WE,MANIPULATE WRIST W/ANESTHES,1616.0,1050.4,250.51,1616.0,32
CDM,25260WE,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,3216.0,2090.4,447.52,3216.0,35
CDM,25265WE,RPR TDN/MUSC FLXR F/ARM&/WRISTSEC FR GRF EA,4040.0,2626.0,542.07,4040.0,35
CDM,25270WE,RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN,2468.0,1604.2,377.33,2468.0,35
CDM,25272WE,RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU,2884.0,1874.6,416.76,2884.0,35
CDM,25274WE,RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN,3576.0,2324.4,474.92,3576.0,35
CDM,25275WE,RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT,3584.0,2329.6,448.74,3584.0,35
CDM,25280WE,LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN,2956.0,1921.4,417.82,2956.0,35
CDM,25290WE,TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,2172.0,1411.8,345.96,2172.0,35
CDM,25295WE,TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,2688.0,1747.2,393.15,2688.0,35
CDM,25300WE,TENODESIS WRIST FLEXORS FINGERS,3608.0,2345.2,459.28,3608.0,35
CDM,25301WE,TENODESIS WRIST EXTENSORS FINGERS,3436.0,2233.4,426.64,3436.0,35
CDM,25310WE,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN,3960.0,2574.0,460.39,3960.0,35
CDM,25312WE,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR,4321.0,2808.65,516.79,4321.0,35
CDM,25315WE,FLEXOR ORIGIN SLIDE FOREARM &/WRIST,4272.0,2776.8,541.35,4272.0,35
CDM,25316WE,FLEXOR ORIGIN SLIDE F/ARM&/WRST TENDON TRANSFE,5676.0,3689.4,655.43,5676.0,35
CDM,25320WE,CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS,5100.0,3315.0,542.31,5100.0,35
CDM,25332WE,ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ,4696.0,3052.4,591.38,4696.0,35
CDM,25335WE,CENTRALIZATION WRST ULNA,5356.0,3481.4,669.0,5356.0,35
CDM,25337WE,RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ,4692.0,3049.8,534.51,4692.0,35
CDM,25350WE,"OSTEOTOMY RADIUS,DISTAL THIRD",3636.0,2363.4,488.93,3636.0,35
CDM,25360WE,OSTEOTOMY ULNA,3496.0,2272.4,475.11,3496.0,35
CDM,25365WE,OSTEOTOMY RADIUS/ULNA,5164.0,3356.6,646.2,5164.0,35
CDM,25370WE,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS/ULNA,5640.0,3666.0,653.1,5640.0,35
CDM,25390WE,OSTEOPLASTY RADIUS/ULNA SHORTENING,4280.0,2782.0,560.33,4280.0,35
CDM,25391WE,OSTEOPLASTY RADIUS/ULNA LENGTHENING W/AUTOGRAFT,5712.0,3712.8,708.06,5712.0,35
CDM,25392WE,OSTEOPLASTY RADIUS & ULNA SHORTENING,5832.0,3790.8,737.27,5832.0,35
CDM,25394WE,"OSTEOPLSTY CARPAL, SHORTNING",4340.0,2821.0,523.49,4340.0,35
CDM,25400WE,RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT,4512.0,2932.8,596.78,4512.0,35
CDM,25405WE,RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT,6004.0,3902.6,764.85,6004.0,35
CDM,25415WE,RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF,5520.0,3588.0,705.44,5520.0,35
CDM,25420WE,RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT,6816.0,4430.4,871.7,6816.0,35
CDM,25425WE,FIX DEFECT RAD OR ULNA W AUTOGRFT,5488.0,3567.2,685.41,5488.0,35
CDM,25430WE,VASC PEDICL INTO CARPAL BONE,3884.0,2524.6,462.01,3884.0,35
CDM,25431WE,REP NONUNION CARPAL BONE EA,4356.0,2831.4,457.96,4356.0,35
CDM,25440WE,RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC,4272.0,2776.8,541.71,4272.0,35
CDM,25441WE,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS,5316.0,3455.4,651.72,5316.0,35
CDM,25445WE,ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM,3952.0,2568.8,534.17,3952.0,35
CDM,25446WE,ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS,6920.0,4498.0,900.16,6920.0,35
CDM,25447WE,ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION,4200.0,2730.0,554.13,4200.0,35
CDM,25448WE,ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION,5214.0,3389.1,635.47,5214.0,28
CDM,25449WE,REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT,5976.0,3884.4,639.74,5976.0,35
CDM,25450WE,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U,3224.0,2095.6,406.14,3224.0,35
CDM,25500WE,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,1040.0,676.0,131.01,780.0,35
CDM,25505WE,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,2180.0,1417.0,242.73,1635.0,35
CDM,25515WE,OPEN TREATMENT RADIAL SHAFT FRACTURE,3520.0,2288.0,458.63,3520.0,35
CDM,25520WE,CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,2600.0,1690.0,336.22,1950.0,35
CDM,25525WE,OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE,4220.0,2743.0,606.37,4220.0,35
CDM,25526WE,OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE,5260.0,3419.0,706.61,5260.0,35
CDM,25530WE,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,896.0,582.4,124.3,672.0,35
CDM,25535WE,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,2144.0,1393.6,238.72,1608.0,35
CDM,25545WE,OPEN TREATMENT OF ULNAR SHAFT FRACTURE,3176.0,2064.4,455.79,3176.0,35
CDM,25560WE,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,1036.0,673.4,130.0,777.0,35
CDM,25565WE,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,2340.0,1521.0,272.84,1755.0,35
CDM,25574WE,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA,3520.0,2288.0,414.47,3520.0,35
CDM,25575WE,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA,4916.0,3195.4,573.52,4916.0,35
CDM,25600WE,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,1112.0,722.8,162.98,834.0,35
CDM,25605WE,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,2500.0,1625.0,262.13,1875.0,35
CDM,25606WE,PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP,3324.0,2160.6,370.95,3324.0,35
CDM,25607WE,"OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR",4206.0,2733.9,392.58,4206.0,35
CDM,25608WE,"OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 2 FRAG",4871.0,3166.15,450.02,4871.0,35
CDM,25609WE,"OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 3+ FRAG",6327.0,4112.55,574.84,6327.0,35
CDM,25622WE,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,1116.0,725.4,140.54,837.0,35
CDM,25624WE,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,1908.0,1240.2,227.31,1431.0,35
CDM,25628WE,OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE,3868.0,2514.2,432.36,3868.0,35
CDM,25630WE,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1333.0,866.45,141.8,999.75,35
CDM,25635WE,CLTX CARPAL BONE FX W/MANJ EACH BONE,2028.0,1318.2,209.1,1521.0,35
CDM,25645WE,OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA,2968.0,1929.2,385.44,2968.0,35
CDM,25650WE,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1292.0,839.8,164.16,969.0,35
CDM,25651WE,PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE,2328.0,1513.2,274.6,2328.0,35
CDM,25652WE,OPEN TREATMENT ULNAR STYLOID FRACTURE,3224.0,2095.6,404.86,3224.0,35
CDM,25660WE,CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ,1992.0,1294.8,221.26,1992.0,35
CDM,25670WE,OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES,3236.0,2103.4,415.3,3236.0,35
CDM,25671WE,PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION,2584.0,1679.6,333.92,2584.0,35
CDM,25675WE,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ,1956.0,1271.4,200.71,1467.0,35
CDM,25676WE,OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC,3316.0,2155.4,424.09,3316.0,35
CDM,25680WE,CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ,2492.0,1619.8,261.2,2492.0,35
CDM,25685WE,OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC,4036.0,2623.4,509.05,4036.0,35
CDM,25690WE,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,2288.0,1487.2,289.63,2288.0,35
CDM,25695WE,OPEN TREATMENT LUNATE DISLOCATION,3404.0,2212.6,427.16,3404.0,35
CDM,25800040,F NACL .9 1000ML,16.0,10.4,2.35,16.0,31
CDM,25800050,F NACL .9 500ML,13.0,8.45,2.18,13.0,22
CDM,25800060,F NACL .9 250ML,7.75,5.04,1.3,7.75,22
CDM,25800070,F NACL .9 100ML,8.2,5.33,1.38,8.2,22
CDM,25800080,F NACL .9 50ML,7.9,5.14,1.33,7.9,22
CDM,25800130,D5 LRINGERS 1000ML,37.79,24.56,6.35,37.79,22
CDM,25800290,ISOLYTE H D5 1000ML,35.21,22.89,5.92,35.21,22
CDM,25800330,NACL .45 1000ML,32.63,21.21,5.48,32.63,22
CDM,25800580,"INFUSION, NORMAL SALINE 500ML",5.0,3.25,0.84,5.0,31
CDM,25800WE,ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT,4431.0,2880.15,562.58,4431.0,35
CDM,25805WE,ARTHRODESIS WRIST W/SLIDING GRAFT,4692.0,3049.8,647.01,4692.0,35
CDM,25810WE,ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT,4780.0,3107.0,609.55,4780.0,35
CDM,25820WE,ARTHRODESIS WRIST LIMITED W/O BONE GRAFT,3056.0,1986.4,439.7,3056.0,35
CDM,25825WE,ARTHRODESIS WRIST LIMITED W/AUTOGRAFT,3876.0,2519.4,544.34,3876.0,35
CDM,25830WE,ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE,4352.0,2828.8,549.01,4352.0,35
CDM,25900WE,AMPUTATION FOREARM THROUGH RADIUS & ULNA,3844.0,2498.6,471.7,3844.0,35
CDM,25905WE,AMP FOREARM THRU RADIUS & ULNA OPEN CIRCULAR,3836.0,2493.4,481.5,3836.0,35
CDM,25927WE,AMPUTATION TRANSMETACARPAL,3636.0,2363.4,445.93,3636.0,35
CDM,25929WE,TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ,3128.0,2033.2,328.28,3128.0,35
CDM,25999RVU1WE,DECOMPRESSION OF THE DISTAL RADIUS (COMP CODE 25035),2755.0,1790.75,468.68,2755.0,15
CDM,25999RVU2WE,RESURFACING OF THE CAPITATE (COMP CODE 25444),4911.0,3192.15,468.68,4911.0,15
CDM,26000000,REFILL SPINE/BRAIN PUMP,2861.0,1859.65,30.69,2574.9,49
CDM,26000005,REFILL SPINE/BRAIN PUMP PHYS,821.0,533.65,30.69,1801.0,49
CDM,26000010,IV HYDRATE INIT 31-60MIN,391.0,254.15,47.36,1801.0,49
CDM,26000050,IV HYDRATE EA ADD HR,195.0,126.75,18.0,1801.0,49
CDM,26000090,IV INF INIT UP TO 1 HR,421.0,273.65,88.41,1801.0,49
CDM,26000130,IV INF SEQ EA ADD HR,195.0,126.75,29.39,1801.0,49
CDM,26000170,IV INF SEQ UP TO 1HR,241.0,156.65,41.67,1801.0,49
CDM,26000210,IV INF CONCUR THERAPY,241.0,156.65,28.5,1801.0,39
CDM,26000250,INJ SQ/IM,614.0,399.1,20.57,1801.0,49
CDM,26000265,FILL PORTABLE PUMP,1818.0,1181.7,30.69,1801.0,49
CDM,26000275,IRRIG IMP VAD,513.0,333.45,30.69,1801.0,49
CDM,26000290,INJ IVPUSH INIT DRUG,238.0,154.7,30.69,1801.0,49
CDM,26000315,PHLEBOTOMY,447.0,290.55,44.56,1801.0,49
CDM,26000330,INJ IVPUSH SEQ NEW DRUG,200.0,130.0,21.87,1801.0,49
CDM,26000335,"PROLONGED IV INF, REQ PUMP",915.0,594.75,192.15,1801.0,48
CDM,26000370,INJ IV PUSH SEQ SAME DRUG,200.0,130.0,30.69,1801.0,38
CDM,26000380,IRRIG DRUG DELIVERY DEVICE,329.0,213.85,30.69,1801.0,49
CDM,26000385,THERAPEUTIC IV INFUSION 1ST HR,421.0,273.65,88.41,1801.0,49
CDM,26000395,THERAP IV INFUSION EA ADDL HR,195.0,126.75,29.39,1801.0,49
CDM,26000505,IM/SC INJECTION (MONTHLY),614.0,399.1,20.57,1801.0,49
CDM,26000515,INJECTION IV PUSH INIT,1818.0,1181.7,30.69,1801.0,49
CDM,26000525,INJ IV PUSH SEQ NEW DRUG,200.0,130.0,21.87,1801.0,49
CDM,26000545,APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,175.0,113.75,26.03,2849.0,49
CDM,26000575,FILL IMP PUMP SYSTEMIC,1818.0,1181.7,30.69,1801.0,49
CDM,26000605,FILL IMP PUMP RESVOIR IV OR IA,1818.0,1181.7,30.69,1801.0,49
CDM,26000665,THER/PROPH/DIAG INJ IA,1818.0,1181.7,27.02,1801.0,49
CDM,26000875,EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,1350.0,877.5,157.05,1801.0,48
CDM,26000885,"PROLONGED IV INF, REQ PUMP",2384.0,1549.6,222.12,2145.6,48
CDM,26010WE,DRAIN FINGER ABSCESS SIMPLE,700.0,455.0,68.71,525.0,35
CDM,26011WE,DRAIN FINGER ABSCESS COMPL,986.0,640.9,90.57,739.5,35
CDM,26020WE,DRAIN HAND TENDON SHEATH,2736.0,1778.4,272.71,2736.0,35
CDM,26025WE,"DRAINAGE PALM BURSA,SINGLE",2032.0,1320.8,281.52,2032.0,35
CDM,26030WE,"DRAINAGE PALM BURSA,MULTIP/COMPLX",2500.0,1625.0,354.27,2500.0,35
CDM,26034WE,INCIS DEEP FINGR/HAND BONE LESN,2652.0,1723.8,310.01,2652.0,35
CDM,26035WE,"DECOMPRESS FINGERS/HAND,INJECT INJ",4548.0,2956.2,427.28,4548.0,35
CDM,26037WE,DECOMPRESS FASCIOTOMY FINGR/HAND,3028.0,1968.2,399.57,3028.0,35
CDM,26040WE,FASCIOTOMY PALMAR PERCUTANEOUS,1384.0,899.6,189.28,1384.0,35
CDM,26045WE,FASCIOTOMY PALMAR OPEN PARTIAL,2292.0,1489.8,320.63,2292.0,35
CDM,26055WE,INCISE FINGER TENDON SHEATH,1368.0,889.2,142.85,1026.0,35
CDM,26060WE,TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT,1164.0,756.6,139.89,1164.0,35
CDM,26070WE,ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT,1524.0,990.6,191.71,1524.0,35
CDM,26075WE,ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA,1564.0,1016.6,230.0,1564.0,35
CDM,26080WE,ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA,1788.0,1162.2,218.51,1788.0,35
CDM,26100WE,ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH,1516.0,985.4,203.29,1516.0,35
CDM,26105WE,ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH,1532.0,995.8,246.86,1532.0,35
CDM,26110WE,ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH,1460.0,949.0,200.86,1460.0,35
CDM,26111WE,EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5+CM,2168.0,1409.2,223.99,2168.0,35
CDM,26113WE,EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5+CM,2852.0,1853.8,294.58,2852.0,35
CDM,26115WE,EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM,1584.0,1029.6,161.92,1188.0,35
CDM,26116WE,EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM,2696.0,1752.4,280.41,2696.0,35
CDM,26117WE,RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM,4052.0,2633.8,412.85,4052.0,35
CDM,26118WE,RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>,5924.0,3850.6,581.72,5924.0,35
CDM,26121WE,FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT,3092.0,2009.8,445.69,3092.0,35
CDM,26123WE,FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR,4352.0,2828.8,533.28,4352.0,35
CDM,26125WE,FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR,1840.0,1196.0,196.97,1840.0,35
CDM,26130WE,SYNOVECTOMY CARPOMETACARPAL JOINT,2236.0,1453.4,323.14,2236.0,35
CDM,26135WE,SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD,2852.0,1853.8,363.73,2852.0,35
CDM,26140WE,SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT,2536.0,1648.4,324.79,2536.0,35
CDM,26145WE,SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN,2596.0,1687.4,339.68,2596.0,35
CDM,26160WE,EXC LESION TDN SHTH/JT CAPSL HAND/FNGR,1571.0,1021.15,154.68,1178.25,35
CDM,26170WE,EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH,1964.0,1276.6,232.02,1964.0,35
CDM,26180WE,EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH,2140.0,1391.0,272.52,2140.0,35
CDM,26185WE,"SESAMOIDECTOMY, THUMB/FINGER",2608.0,1695.2,273.15,2608.0,35
CDM,26200WE,EXCISION/CURETTAGE CYST/TUMOR METACARPAL,2260.0,1469.0,307.24,2260.0,35
CDM,26205WE,EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT,3172.0,2061.8,422.39,3172.0,35
CDM,26210WE,EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER,2128.0,1383.2,279.85,2128.0,35
CDM,26215WE,EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT,2908.0,1890.2,382.19,2908.0,35
CDM,26230WE,"PART REMV BONE,METACARPAL",2588.0,1682.2,321.31,2588.0,35
CDM,26235WE,"PART REMV BONE,PROX/MID PHALANX",2532.0,1645.8,315.19,2532.0,35
CDM,26236WE,"PART REMV BONE,DISTAL PHALANX",2184.0,1419.6,278.75,2184.0,35
CDM,26250WE,RADICAL RESECTION TUMOR METACARPAL,6084.0,3954.6,519.11,6084.0,35
CDM,26260WE,RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER,4464.0,2901.6,394.79,4464.0,35
CDM,26262WE,RADICAL RESECTION TUMOR DISTAL PHALANX FINGER,3316.0,2155.4,305.69,3316.0,35
CDM,26320WE,REMOVAL OF IMPLANT FROM HAND/FINGR,1640.0,1066.0,230.58,1640.0,35
CDM,26340WE,MANIPULATION FINGER JOINT UNDER ANES EACH JOINT,1120.0,728.0,190.92,1120.0,32
CDM,26341WE,MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD,364.0,236.6,38.3,273.0,35
CDM,26350WE,RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON,2484.0,1614.6,426.48,2484.0,35
CDM,26352WE,RPR/ADVMNT FLXR TDN N/Z/2 W/FR GRAFT EA TENDON,3148.0,2046.2,479.92,3148.0,35
CDM,26356WE,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,3824.0,2485.6,599.58,3824.0,35
CDM,26357WE,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,4400.0,2860.0,508.15,4400.0,35
CDM,26370WE,RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN,2912.0,1892.8,461.12,2912.0,35
CDM,26372WE,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA,3604.0,2342.6,530.34,3604.0,35
CDM,26373WE,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA,3364.0,2186.6,504.86,3364.0,35
CDM,26390WE,EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F,3772.0,2451.8,503.15,3772.0,35
CDM,26392WE,RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD,4200.0,2730.0,570.37,4200.0,35
CDM,26410WE,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,1908.0,1240.2,341.25,1908.0,35
CDM,26412WE,REPAIR EXTENSOR TENDON HAND W/GRAFT EACH,2592.0,1684.8,407.21,2592.0,35
CDM,26415WE,EXC XTNSR TDN W/IMPLTJ SYNTH ROD DLYD GRF H/F EA,3404.0,2212.6,440.3,3404.0,35
CDM,26418WE,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,1788.0,1162.2,341.36,1788.0,35
CDM,26420WE,REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH,2776.0,1804.4,425.47,2776.0,35
CDM,26426WE,RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR,2528.0,1643.2,382.76,2528.0,35
CDM,26432WE,CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING,1664.0,1081.6,295.45,1664.0,35
CDM,26433WE,REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF,1880.0,1222.0,318.05,1880.0,35
CDM,26434WE,REPAIR EXTENSOR TENDON DISTAL INSERTION W/GRAFT,2504.0,1627.6,370.87,2504.0,35
CDM,26437WE,REALIGNMENT EXTENSOR TENDON HAND EACH TENDON,2396.0,1557.4,364.14,2396.0,35
CDM,26440WE,TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON,2064.0,1341.6,377.8,2064.0,35
CDM,26442WE,TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO,4290.0,2788.5,534.85,4290.0,35
CDM,26445WE,TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH,1780.0,1157.0,354.74,1780.0,35
CDM,26449WE,TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA,3436.0,2233.4,503.76,3436.0,35
CDM,26450WE,"TENOTOMY PALM FLEX,SINGLE,OPEN,EACH",1516.0,985.4,232.24,1516.0,35
CDM,26455WE,"TENOTOMY FINGR FLEX,SINGLE,OPEN,EACH",1504.0,977.6,230.28,1504.0,35
CDM,26460WE,"TENOTOMY HAND EXTEN,SINGLE,OPEN,EACH",1432.0,930.8,225.37,1432.0,35
CDM,26471WE,TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH,2360.0,1534.0,356.59,2360.0,35
CDM,26474WE,TENODESIS DISTAL JOINT EACH,2196.0,1427.4,347.07,2196.0,35
CDM,26476WE,"TENDON LENGTHENING,EXTEN,HAND/FINGR",2140.0,1391.0,336.94,2140.0,35
CDM,26477WE,"TENDON SHORTENING,EXTEN,HAND/FINGR",2128.0,1383.2,339.46,2128.0,35
CDM,26478WE,"TENDON LENGTHENING,FLEX,HAND/FINGR",2388.0,1552.2,367.71,2388.0,35
CDM,26479WE,"TENDON SHORTENING,FLEX,HAND/FINGR",2364.0,1536.6,345.71,2364.0,35
CDM,26480WE,TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN,3600.0,2340.0,449.92,3600.0,35
CDM,26483WE,TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT,3392.0,2204.8,506.9,3392.0,35
CDM,26485WE,TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH,3156.0,2051.4,480.38,3156.0,35
CDM,26490WE,OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN,3440.0,2236.0,474.75,3440.0,35
CDM,26492WE,OPPONENSPLASTY TDN TR W/GRF EA TDN,3936.0,2558.4,533.81,3936.0,35
CDM,26496WE,OPPONENSPLASTY OTHER METHODS,3912.0,2542.8,529.42,3912.0,35
CDM,26497WE,TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR,3904.0,2537.6,526.83,3904.0,35
CDM,26498WE,TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS,5684.0,3694.6,744.84,5684.0,35
CDM,26499WE,CORRECTION CLAW FINGER OTHER METHODS,3668.0,2384.2,491.29,3668.0,35
CDM,26500WE,RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX,2452.0,1593.8,365.6,2452.0,35
CDM,26502WE,RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX,2924.0,1900.6,406.94,2924.0,35
CDM,26508WE,RELEASE THENAR MUSCLE,2472.0,1606.8,371.86,2472.0,35
CDM,26510WE,CROSS INTRINSIC TRANSFER EACH TENDON,2240.0,1456.0,349.57,2240.0,35
CDM,26516WE,CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT,2928.0,1903.2,408.83,2928.0,35
CDM,26517WE,CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS,3632.0,2360.8,486.94,3632.0,35
CDM,26520WE,CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH,2188.0,1422.2,394.09,2188.0,35
CDM,26525WE,CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH,2200.0,1430.0,396.47,2200.0,35
CDM,26530WE,ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH,2752.0,1788.8,364.52,2752.0,35
CDM,26531WE,ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT,3252.0,2113.8,450.7,3252.0,35
CDM,26535WE,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,2164.0,1406.6,292.77,2164.0,35
CDM,26536WE,ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA,2624.0,1705.6,413.73,2624.0,35
CDM,26540WE,RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT,2640.0,1716.0,391.74,2640.0,35
CDM,26541WE,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF,3524.0,2290.6,510.99,3524.0,35
CDM,26542WE,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS,2780.0,1807.0,396.01,2780.0,35
CDM,26545WE,RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT,2844.0,1848.6,402.59,2844.0,35
CDM,26546WE,RPR NON-UNION MTCRPL/PHALANX,4332.0,2815.8,545.7,4332.0,35
CDM,26548WE,RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL,3288.0,2137.2,442.52,3288.0,35
CDM,26550WE,POLLICIZATION OF DIGIT,8672.0,5636.8,1157.16,8672.0,35
CDM,26561WE,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT,4440.0,2886.0,585.71,4440.0,35
CDM,26565WE,OSTEOTOMY METACARPAL EACH,2764.0,1796.6,393.4,2764.0,35
CDM,26567WE,OSTEOTOMY PHALANX FINGER EACH,2796.0,1817.4,396.28,2796.0,35
CDM,26568WE,OSTEOPLASTY LENGTHENING METACARPAL/PHALANX,3708.0,2410.2,518.24,3708.0,35
CDM,26587WE,RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE,5800.0,3770.0,542.43,5800.0,35
CDM,26591WE,REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE,1487.0,966.55,264.02,1487.0,35
CDM,26593WE,RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE,2200.0,1430.0,344.76,2200.0,35
CDM,26600WE,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,1144.0,743.6,141.7,858.0,35
CDM,26605WE,CLTX METACARPAL FX W/MANIPULATION EACH BONE,1333.0,866.45,151.13,999.75,35
CDM,26607WE,CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE,2192.0,1424.8,264.01,2192.0,35
CDM,26608WE,PRQ SKELETAL FIXJ METACARPAL FX EACH BONE,2220.0,1443.0,262.0,2220.0,35
CDM,26615WE,OPEN TX METACARPAL FRACTURE SINGLE EA BONE,2828.0,1838.2,289.25,2828.0,35
CDM,26641WE,CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,1652.0,1073.8,189.2,1239.0,35
CDM,26645WE,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,1832.0,1190.8,195.45,1374.0,35
CDM,26650WE,PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB,2140.0,1391.0,282.47,2140.0,35
CDM,26665WE,OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB,3176.0,2064.4,390.99,3176.0,35
CDM,26670WE,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,1532.0,995.8,154.68,1149.0,35
CDM,26675WE,CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES,1932.0,1255.8,208.6,1449.0,35
CDM,26676WE,PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT,2296.0,1492.4,295.27,2296.0,35
CDM,26685WE,OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB,2828.0,1838.2,360.15,2828.0,35
CDM,26686WE,OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ,3268.0,2124.2,397.52,3268.0,35
CDM,26700WE,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,1532.0,995.8,154.02,1149.0,35
CDM,26705WE,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES,1752.0,1138.8,190.03,1314.0,35
CDM,26706WE,PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ,2124.0,1380.6,271.08,2124.0,35
CDM,26715WE,OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION,2812.0,1827.8,283.61,2812.0,35
CDM,26720WE,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,774.0,503.1,93.04,580.5,35
CDM,26725WE,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,1531.0,995.15,150.58,1148.25,35
CDM,26727WE,PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T,2168.0,1409.2,253.17,2168.0,35
CDM,26735WE,OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA,2968.0,1929.2,291.28,2968.0,35
CDM,26740WE,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,828.0,538.2,108.98,621.0,35
CDM,26742WE,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,1596.0,1037.4,171.57,1197.0,35
CDM,26746WE,OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,3920.0,2548.0,363.12,3920.0,35
CDM,26750WE,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,720.0,468.0,92.55,540.0,35
CDM,26755WE,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,1292.0,839.8,135.95,969.0,35
CDM,26756WE,PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA,1832.0,1190.8,223.15,1832.0,35
CDM,26765WE,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,2344.0,1523.6,246.24,2344.0,35
CDM,26770WE,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1260.0,819.0,128.54,945.0,35
CDM,26775WE,CLTX IPHAL JT DISLC W/MANJ REQ ANES,1560.0,1014.0,174.25,1170.0,35
CDM,26776WE,PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ,1996.0,1297.4,238.14,1996.0,35
CDM,26785WE,OPEN TX INTERPHALANGEAL JOINT DISLOCATION,2640.0,1716.0,267.78,2640.0,35
CDM,26841WE,ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ,2940.0,1911.0,429.0,2940.0,35
CDM,26842WE,ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT,3396.0,2207.4,492.58,3396.0,35
CDM,26843WE,ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH,3112.0,2022.8,424.39,3112.0,35
CDM,26844WE,ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT,3592.0,2334.8,480.97,3592.0,35
CDM,26850WE,ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ,2856.0,1856.4,404.34,2856.0,35
CDM,26852WE,ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT,3484.0,2264.6,455.26,3484.0,35
CDM,26860WE,ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ,1952.0,1268.8,330.75,1952.0,35
CDM,26861WE,ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT,696.0,452.4,77.87,696.0,35
CDM,26862WE,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT,3024.0,1965.6,418.04,3024.0,35
CDM,26863WE,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT,1556.0,1011.4,173.37,1556.0,35
CDM,26910WE,AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER,3116.0,2025.4,404.21,3116.0,35
CDM,26951WE,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,2416.0,1570.4,347.99,2416.0,35
CDM,26952WE,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,2592.0,1684.8,378.18,2592.0,35
CDM,26989INJWE,"INJECTION/EXTENSION, XIAFLEX",250.0,162.5,125.0,416.29,15
CDM,26990WE,I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA,3180.0,2067.0,336.0,3180.0,35
CDM,26991WE,I&D PELVIS/HIP JOINT AREA INFECTED BURSA,2824.0,1835.6,256.43,2118.0,35
CDM,26992WE,INCISION BONE CORTEX PELVIS&/HIP JOINT,5392.0,3504.8,591.0,5392.0,35
CDM,27000010,W 101978 DRESS ELASTOPLAST,38.0,24.7,6.38,34.2,21
CDM,27000020,W 4X4 10 PKS,8.0,5.2,1.34,7.2,21
CDM,27000030,W 4X4 RAYTEC,24.0,15.6,4.03,21.6,21
CDM,27000050,W ADAPTOR UNI,10.0,6.5,1.68,9.0,21
CDM,27000060,W ADHES TOPICAL SKIN,173.0,112.45,29.06,155.7,21
CDM,27000070,W ADP TUOHY BORST,116.0,75.4,19.49,104.4,21
CDM,27000080,W ADPT MET DSE IN,14.0,9.1,2.35,12.6,21
CDM,27000100,W ADPT TITANIUM,154.0,100.1,25.87,138.6,21
CDM,27000110,W ADPT TUBE A/S,217.0,141.05,36.46,195.3,21
CDM,27000120,W ADPT Y CATH,41.0,26.65,6.89,36.9,21
CDM,27000130,W AID SHOE HORN,47.0,30.55,7.9,42.3,21
CDM,27000140,W AIRWAY ORAL,9.0,5.85,1.51,8.1,21
CDM,27000150,W ANES CIR EXT,174.0,113.1,29.23,156.6,21
CDM,27000160,W ANS BREATH CIR,85.0,55.25,14.28,76.5,21
CDM,27000170,W ANS ESPH STH,242.0,157.3,40.66,217.8,21
CDM,27000180,W ANS ESPH/NG STH,39.0,25.35,6.55,35.1,21
CDM,27000190,W ANS SPLY GEN,625.0,406.25,105.0,562.5,21
CDM,27000200,W ANS SPLY SDLBLK,329.0,213.85,55.27,296.1,21
CDM,27000210,W AQUAPLAST PERF,14.0,9.1,2.35,12.6,21
CDM,27000230,W AV TUNNLR/SHTH,334.0,217.1,56.11,300.6,21
CDM,27000240,W AW ADPT STR,246.0,159.9,41.33,221.4,21
CDM,27000250,W AW LARYNGL MSK,45.0,29.25,7.56,40.5,21
CDM,27000260,W AW NASL,10.0,6.5,1.68,9.0,21
CDM,27000270,W AW NASO-PHARYNG,51.0,33.15,8.57,45.9,21
CDM,27000280,W BAG AMBU,70.0,45.5,11.76,63.0,21
CDM,27000290,W BALL GYM 53 CM,63.0,40.95,10.58,56.7,21
CDM,27000300,W BALL GYM 65CM,78.0,50.7,13.1,70.2,21
CDM,27000310,W BALL GYM 85CM,122.0,79.3,20.5,109.8,21
CDM,27000320,W BALL GYM 95CM,157.0,102.05,26.38,141.3,21
CDM,27000330,W BAR TRANSV CONN,1475.0,958.75,247.8,1327.5,21
CDM,27000340,W BATH SPNG LNG,24.0,15.6,4.03,21.6,21
CDM,27000370,W BETADINE PREP,47.0,30.55,7.9,42.3,21
CDM,27000380,W BETADINE SCRUB,11.0,7.15,1.85,9.9,21
CDM,27000390,W BG BILE 19 OZ,43.0,27.95,7.22,38.7,21
CDM,27000400,W BG COLL W/TB,88.0,57.2,14.78,79.2,21
CDM,27000410,W BG DRAIN AER,10.0,6.5,1.68,9.0,21
CDM,27000430,W BG FECAL COLLCT,16.0,10.4,2.69,14.4,21
CDM,27000440,W BG FLATUS,15.0,9.75,2.52,13.5,21
CDM,27000450,W BG FLUID COLL,116.0,75.4,19.49,104.4,21
CDM,27000460,W BG ICE DISP CHM,37.0,24.05,6.22,33.3,21
CDM,27000470,W BG ICE DISP PL,8.0,5.2,1.34,7.2,21
CDM,27000480,W BG ICP DRNAGE,153.0,99.45,25.7,137.7,21
CDM,27000490,W BG ISOL DECNTAM,26.0,16.9,4.37,23.4,21
CDM,27000500,W BG LEG ICE PK,17.0,11.05,2.86,15.3,21
CDM,27000510,W BG LEG ICE PK,55.0,35.75,9.24,49.5,21
CDM,27000520,W BG PAK PROTECT,53.0,34.45,8.9,47.7,21
CDM,27000530,W BG PRESS INFU,195.0,126.75,32.76,175.5,21
CDM,27000540,W BG SPONGE COUN,10.0,6.5,1.68,9.0,21
CDM,27000550,W BLADE SURGICAL SCALPEL,3.0,1.95,0.5,2.7,21
CDM,27000560,W BLD AORTIC PNCH,289.0,187.85,48.55,260.1,21
CDM,27000570,W BLD DERMAT HEAD,38.0,24.7,6.38,34.2,21
CDM,27000580,W BLD NEURO CRANI,268.0,174.2,45.02,241.2,21
CDM,27000590,W BLD PREP A/S,2.0,1.3,0.34,1.8,21
CDM,27000610,W BLOOD COIL,142.0,92.3,23.86,127.8,21
CDM,27000620,W BLOOD FLTR,76.0,49.4,12.77,68.4,21
CDM,27000630,W BLT RIB,35.0,22.75,5.88,31.5,21
CDM,27000640,W BLT TRAC PELVIC,53.0,34.45,8.9,47.7,21
CDM,27000650,W BND BIND ABD,53.0,34.45,8.9,47.7,21
CDM,27000660,W BND BTRFLY,34.0,22.1,5.71,30.6,21
CDM,27000670,W BND COBAN 4/5,23.0,14.95,3.86,20.7,21
CDM,27000680,W BND COBAN A/S,12.0,7.8,2.02,10.8,21
CDM,27000690,W BND CSTPAD2/3W,8.0,5.2,1.34,7.2,21
CDM,27000700,W BND CSTPAD4/5W,13.0,8.45,2.18,11.7,21
CDM,27000710,W BND CSTPAD6/7W,16.0,10.4,2.69,14.4,21
CDM,27000730,W BND ESMARK 4IN,269.0,174.85,45.19,242.1,21
CDM,27000740,W BND ESMARK 6IN,172.0,111.8,28.9,154.8,21
CDM,27000770,W BND MUSLIN 4IN,22.0,14.3,3.7,19.8,21
CDM,27000780,W BND RUBBER ALL *,150.0,97.5,25.2,135.0,21
CDM,27000790,W BND STCKIMP ALL,120.0,78.0,20.16,108.0,21
CDM,27000800,W BND STKNET A/S,24.0,15.6,4.03,21.6,21
CDM,27000810,W BND STKNG,55.0,35.75,9.24,49.5,21
CDM,27000820,W BND WEBRIL 2/3,15.0,9.75,2.52,13.5,21
CDM,27000830,W BND WEBRIL 4/6,23.0,14.95,3.86,20.7,21
CDM,27000840,W BOK YES U CAN,206.0,133.9,34.61,185.4,21
CDM,27000850,W BOOT AIR,426.0,276.9,71.57,383.4,21
CDM,27000860,W BOOT BUCK TRAX,109.0,70.85,18.31,98.1,21
CDM,27000870,W BOOT BUNNY,130.0,84.5,21.84,117.0,21
CDM,27000880,W BOTL CLEANSING *,2.0,1.3,0.34,1.8,21
CDM,27000890,W BOX DISP HOOD,109.0,70.85,18.31,98.1,21
CDM,27000930,W BRCE FOOTDROP,370.0,240.5,62.16,333.0,21
CDM,27000950,W BRCE LONG LEG,634.0,412.1,106.51,570.6,21
CDM,27000980,W BRCE WRIST,117.0,76.05,19.66,105.3,21
CDM,27000990,W BRCE WRIST,157.0,102.05,26.38,141.3,21
CDM,27000WE,TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX,2296.0,1492.4,244.82,2296.0,35
CDM,27001000,W BRSH CIL CYSTO,135.0,87.75,22.68,121.5,21
CDM,27001010,W BRSH CYTOLOGY,305.0,198.25,51.24,274.5,21
CDM,27001020,W BRSH ENDO,72.0,46.8,12.1,64.8,21
CDM,27001030,W BSK RETRV,443.0,287.95,74.42,398.7,21
CDM,27001040,W BSK STONE DISP,229.0,148.85,38.47,206.1,21
CDM,27001050,W BUTN HK/ZIP PUL,34.0,22.1,5.71,30.6,21
CDM,27001060,W CA ENTIRE ARM,585.0,380.25,98.28,526.5,21
CDM,27001065,COUDE FOLEY CATHETER,45.0,29.25,7.56,40.5,21
CDM,27001070,W CABLE PACING,121.0,78.65,20.33,108.9,21
CDM,27001075,CATH INDW FOLEY 2WAY SILI,23.0,14.95,3.86,20.7,21
CDM,27001080,W CABLE PM THRESH,119.0,77.35,19.99,107.1,21
CDM,27001085,COUDE CATHETER,10.0,6.5,1.68,9.0,21
CDM,27001090,W CAN ARTHRO,59.0,38.35,9.91,53.1,21
CDM,27001100,W CAN CRNY PER,21.0,13.65,3.53,18.9,21
CDM,27001105,URINARY DRAINAGE BAG,14.0,9.1,2.35,12.6,21
CDM,27001110,W CAN ERCP,148.0,96.2,24.86,133.2,21
CDM,27001115,URINARY LEG BAG,9.0,5.85,1.51,8.1,21
CDM,27001120,W CAN INT SHLY DS,17.0,11.05,2.86,15.3,21
CDM,27001140,W CAN SUCT,38.0,24.7,6.38,34.2,21
CDM,27001150,W CAN VENTRICULAR,226.0,146.9,37.97,203.4,21
CDM,27001160,W CAN WOUND VAC,102.0,66.3,17.14,91.8,21
CDM,27001170,W CANE,116.0,75.4,19.49,104.4,21
CDM,27001180,W CANE QUAD A/S,274.0,178.1,46.03,246.6,21
CDM,27001190,CANN SHOULDE,158.0,102.7,26.54,142.2,21
CDM,27001210,W CANN THREADED,179.0,116.35,30.07,161.1,21
CDM,27001220,W CANNULA,36.0,23.4,6.05,32.4,21
CDM,27001230,W CANULATOR LYMPH,88.0,57.2,14.78,79.2,21
CDM,27001240,W CAP CATH CAPD,24.0,15.6,4.03,21.6,21
CDM,27001250,W CAP DIAL DIS LK,21.0,13.65,3.53,18.9,21
CDM,27001260,W CAP REDUCER,13.0,8.45,2.18,11.7,21
CDM,27001270,W CARA KLENZ,39.0,25.35,6.55,35.1,21
CDM,27001290,W CARTRIDGE COAG,5.0,3.25,0.84,4.5,21
CDM,27001300,W CASSETTE TP,26.0,16.9,4.37,23.4,21
CDM,27001310,W CAST BOOT,62.0,40.3,10.42,55.8,21
CDM,27001320,W CATH BLN,2504.0,1627.6,420.67,2253.6,21
CDM,27001330,W CATH BLN DRNAGE,616.0,400.4,103.49,554.4,21
CDM,27001340,W CATH BLN LRG,913.0,593.45,153.38,821.7,21
CDM,27001350,W CATH BLN PTA,1114.0,724.1,187.15,1002.6,21
CDM,27001360,W CATH CONNECTOR,10.0,6.5,1.68,9.0,21
CDM,27001370,W CATH DUAL INJ,65.0,42.25,10.92,58.5,21
CDM,27001380,W CATH EXT,10.0,6.5,1.68,9.0,21
CDM,27001390,W CATH EXT,28.0,18.2,4.7,25.2,21
CDM,27001400,W CATH FGRT EMBLA,323.0,209.95,54.26,290.7,21
CDM,27001410,W CATH GDE,401.0,260.65,67.37,360.9,21
CDM,27001420,W CATH GLIDE WIRE,175.0,113.75,29.4,157.5,21
CDM,27001430,W CATH IV,8.0,5.2,1.34,7.2,21
CDM,27001440,W CATH IV 16X2,4.0,2.6,0.67,3.6,21
CDM,27001450,W CATH IV 18X2,4.0,2.6,0.67,3.6,21
CDM,27001460,W CATH IV 20X2,4.0,2.6,0.67,3.6,21
CDM,27001470,W CATH IV 24X3/4,8.0,5.2,1.34,7.2,21
CDM,27001480,W CATH IV A/S,35.0,22.75,5.88,31.5,21
CDM,27001485,"INDWELLING CATHETER, SPEC TYPE",275.0,178.75,46.2,247.5,21
CDM,27001490,W CATH IV JELCO,8.0,5.2,1.34,7.2,21
CDM,27001500,W CATH IV PLCMENT,26.0,16.9,4.37,23.4,21
CDM,27001510,W CATH IV20X1-1/4,4.0,2.6,0.67,3.6,21
CDM,27001520,W CATH PM TEMP,351.0,228.15,58.97,315.9,21
CDM,27001530,W CATH RENAL DIL,674.0,438.1,113.23,606.6,21
CDM,27001540,W CATH RETR SNARE,1643.0,1067.95,276.02,1478.7,21
CDM,27001550,W CATH STRP,27.0,17.55,4.54,24.3,21
CDM,27001560,W CATH STRP LEG,26.0,16.9,4.37,23.4,21
CDM,27001570,W CATH SUBCLAVIAN,43.0,27.95,7.22,38.7,21
CDM,27001580,W CAUT ELECTRODE,12.0,7.8,2.02,10.8,21
CDM,27001590,W CAUT OPTH LOTMP,4.0,2.6,0.67,3.6,21
CDM,27001600,W CAUT PRB,83.0,53.95,13.94,74.7,21
CDM,27001610,W CAUT TIP CLEANR,10.0,6.5,1.68,9.0,21
CDM,27001620,W CAUT TIP EXTEND,12.0,7.8,2.02,10.8,21
CDM,27001630,W CELLSAVR BWL/PK,110.0,71.5,18.48,99.0,21
CDM,27001640,W CELLSAVR RSRVOR,67.0,43.55,11.26,60.3,21
CDM,27001650,W CEMT SYR,105.0,68.25,17.64,94.5,21
CDM,27001660,W CHEST TUBE TRAY THAL QUICK,213.0,138.45,35.78,191.7,21
CDM,27001670,W CIRT VOLV,25.0,16.25,4.2,22.5,21
CDM,27001680,W CLEANSR/DISINFC*,44.0,28.6,7.39,39.6,21
CDM,27001690,W CLIP SOFTJAW SPR,25.0,16.25,4.2,22.5,21
CDM,27001700,W CLMP COVER,7.0,4.55,1.18,6.3,21
CDM,27001710,W COIL EMBOLIC #2,1320.0,858.0,221.76,1188.0,21
CDM,27001720,W COLL FLEXISEAL,343.0,222.95,57.62,308.7,21
CDM,27001730,W COLLAR CERV FM,70.0,45.5,11.76,63.0,21
CDM,27001740,W COLLAR PHILA,43.0,27.95,7.22,38.7,21
CDM,27001750,W COLLR CERV PLST,72.0,46.8,12.1,64.8,21
CDM,27001760,W COLLR HARD CERV,211.0,137.15,35.45,189.9,21
CDM,27001770,W COMPRESR DISC,53.0,34.45,8.9,47.7,21
CDM,27001780,W COMPRESS SLV HAND,81.0,52.65,13.61,72.9,21
CDM,27001790,W COMPRESS SLV UPEXT 15-20MMHG,104.0,67.6,17.47,93.6,21
CDM,27001800,W COMPRESS SLV UPEXT 20-30MMHG,105.0,68.25,17.64,94.5,21
CDM,27001810,W CON 3WAY PUDENZ,294.0,191.1,49.39,264.6,21
CDM,27001820,W CON URET CATH,13.0,8.45,2.18,11.7,21
CDM,27001830,W CONDENSER HUMIDIFIER HCH ADLT,27.0,17.55,4.54,24.3,21
CDM,27001850,W CONEC ENDOTUBE,130.0,84.5,21.84,117.0,21
CDM,27001860,W CONEC TB,17.0,11.05,2.86,15.3,21
CDM,27001870,W CONEC Y,85.0,55.25,14.28,76.5,21
CDM,27001880,W CONN FLW SWITCH,65.0,42.25,10.92,58.5,21
CDM,27001890,W CONT CO-SET,76.0,49.4,12.77,68.4,21
CDM,27001900,W CONTAINR SHARPS*,13.0,8.45,2.18,11.7,21
CDM,27001910,W CORD BI-POLAR,62.0,40.3,10.42,55.8,21
CDM,27001920,W CORNEAL PROTECT,72.0,46.8,12.1,64.8,21
CDM,27001930,W COTTON ROLL 1LB,60.0,39.0,10.08,54.0,21
CDM,27001940,W COV HD ISOLT,64.0,41.6,10.75,57.6,21
CDM,27001950,W COV SHOE/BOOT,35.0,22.75,5.88,31.5,21
CDM,27001970,W CRTRDG HEMODIAL,87.0,56.55,14.62,78.3,21
CDM,27001990,W CRUTCH CUSTOM,191.0,124.15,32.09,171.9,21
CDM,27001WE,TENOTOMY ADDUCTOR HIP OPEN,2856.0,1856.4,295.37,2856.0,35
CDM,27002000,W CST AIR A/S,130.0,84.5,21.84,117.0,21
CDM,27002010,W CST FT/ANK/CALF,582.0,378.3,97.78,523.8,21
CDM,27002020,W CST FT/ANK/CF/K,1228.0,798.2,206.3,1105.2,21
CDM,27002040,W CST REMVL/BIVL,106.0,68.9,17.81,95.4,21
CDM,27002050,W CUFF B/P ADLT,23.0,14.95,3.86,20.7,21
CDM,27002060,W CUP,3.0,1.95,0.5,2.7,21
CDM,27002070,W CUP ULTRSNC H2O,26.0,16.9,4.37,23.4,21
CDM,27002080,W CUSH FOAMRING,195.0,126.75,32.76,175.5,21
CDM,27002090,W CUSH GEL FLOAT,308.0,200.2,51.74,277.2,21
CDM,27002100,W CYSTO MANOMETER,95.0,61.75,15.96,85.5,21
CDM,27002110,W DECANTER BAG,40.0,26.0,6.72,36.0,21
CDM,27002120,W DEODERIZER,25.0,16.25,4.2,22.5,21
CDM,27002130,W DETR CP CO2,169.0,109.85,28.39,152.1,21
CDM,27002140,W DIFFUSER AIR,135.0,87.75,22.68,121.5,21
CDM,27002150,W DISC MOLNR ANGIO,43.0,27.95,7.22,38.7,21
CDM,27002160,W DRILL BITS ALL,170.0,110.5,28.56,153.0,21
CDM,27002170,W DRN CHST HEIM,147.0,95.55,24.7,132.3,21
CDM,27002180,W DRN CHSTP/VAC,196.0,127.4,32.93,176.4,21
CDM,27002200,W DRN NASAL BIL,11.0,7.15,1.85,9.9,21
CDM,27002210,W DRN TB ATTCH,31.0,20.15,5.21,27.9,21
CDM,27002220,W DRP ANGIO,294.0,191.1,49.39,264.6,21
CDM,27002230,W DRP FEMORAL,101.0,65.65,16.97,90.9,21
CDM,27002250,W DRP TRNSDU COV,24.0,15.6,4.03,21.6,21
CDM,27002260,W DRS 6X6 ANY,11.0,7.15,1.85,9.9,21
CDM,27002270,W DRS ABD PD,2.0,1.3,0.34,1.8,21
CDM,27002280,W DRS ADHES WND,9.0,5.85,1.51,8.1,21
CDM,27002290,W DRS AQUA PROTEC,12.0,7.8,2.02,10.8,21
CDM,27002300,W DRS BIOBRAN5X15,106.0,68.9,17.81,95.4,21
CDM,27002320,W DRS DUODERM,17.0,11.05,2.86,15.3,21
CDM,27002330,W DRS DUODERM,88.0,57.2,14.78,79.2,21
CDM,27002350,W DRS DUO-DERM8X8,76.0,49.4,12.77,68.4,21
CDM,27002360,W DRS EAR POSTAUR,11.0,7.15,1.85,9.9,21
CDM,27002370,W DRS EYE MSK,102.0,66.3,17.14,91.8,21
CDM,27002390,W DRS EYE SHIELD,26.0,16.9,4.37,23.4,21
CDM,27002400,W DRS EZ DERM,52.0,33.8,8.74,46.8,21
CDM,27002410,W DRS FLUFF KER,15.0,9.75,2.52,13.5,21
CDM,27002430,W DRS GZ OWENS,85.0,55.25,14.28,76.5,21
CDM,27002440,W DRS HEMOSTATIC,161.0,104.65,27.05,144.9,21
CDM,27002450,W DRS HIP/KNEE,63.0,40.95,10.58,56.7,21
CDM,27002460,W DRS INTRA WND,166.0,107.9,27.89,149.4,21
CDM,27002480,W DRS IV SHIELD,10.0,6.5,1.68,9.0,21
CDM,27002490,W DRS KALTOST WND,55.0,35.75,9.24,49.5,21
CDM,27002510,W DRS MESALT 4X4,13.0,8.45,2.18,11.7,21
CDM,27002520,W DRS NUGAUZE,273.0,177.45,45.86,245.7,21
CDM,27002550,W DRS OXYCEL,183.0,118.95,30.74,164.7,21
CDM,27002570,W DRS PET/AD 3X8,10.0,6.5,1.68,9.0,21
CDM,27002600,W DRS PK HELISTAT,181.0,117.65,30.41,162.9,21
CDM,27002610,W DRS PK IODO A/S,76.0,49.4,12.77,68.4,21
CDM,27002620,W DRS PK NUGZ A/S,15.0,9.75,2.52,13.5,21
CDM,27002640,W DRS PK NU-GZ1,4.0,2.6,0.67,3.6,21
CDM,27002650,W DRS SCRLT RED,13.0,8.45,2.18,11.7,21
CDM,27002660,W DRS SKIN BAR 8X,16.0,10.4,2.69,14.4,21
CDM,27002670,W DRS SORB 4X4,13.0,8.45,2.18,11.7,21
CDM,27002690,W DRS STICK,34.0,22.1,5.71,30.6,21
CDM,27002700,W DRS TAPE PATCH,175.0,113.75,29.4,157.5,21
CDM,27002710,W DRS TELFA SM,3.0,1.95,0.5,2.7,21
CDM,27002720,W DRS TUBIGRIP 9,9.0,5.85,1.51,8.1,21
CDM,27002730,W DRS WND,31.0,20.15,5.21,27.9,21
CDM,27002740,W DRS WND 4X4,25.0,16.25,4.2,22.5,21
CDM,27002750,W DRS WND MGT A/S,80.0,52.0,13.44,72.0,21
CDM,27002770,W DURAPREP,50.0,32.5,8.4,45.0,21
CDM,27002780,W DVC PUNCTR CLSR,193.0,125.45,32.42,173.7,21
CDM,27002790,W DVCE CIRC AS,1405.0,913.25,236.04,1264.5,21
CDM,27002800,W DVCE EYE SCLERL,147.0,95.55,24.7,132.3,21
CDM,27002810,W DVCE INFLATN,235.0,152.75,39.48,211.5,21
CDM,27002820,W DVCE PINCH-ON,49.0,31.85,8.23,44.1,21
CDM,27002830,W EDWARDS SLEEVE,294.0,191.1,49.39,264.6,21
CDM,27002840,W ELCTRD,53.0,34.45,8.9,47.7,21
CDM,27002850,W ELCTRD BALL,298.0,193.7,50.06,268.2,21
CDM,27002860,W ELCTRD LITHO,230.0,149.5,38.64,207.0,21
CDM,27002870,W ELCTRD VAPR FLX,521.0,338.65,87.53,468.9,21
CDM,27002880,W ELECTRODES 24FR,641.0,416.65,107.69,576.9,21
CDM,27002890,W ELEVAT ARM,147.0,95.55,24.7,132.3,21
CDM,27002910,W ELLCK EVAC DISP,27.0,17.55,4.54,24.3,21
CDM,27002920,W ELST SHOE LACES,37.0,24.05,6.22,33.3,21
CDM,27002930,W ELST SPLNT WRST,132.0,85.8,22.18,118.8,21
CDM,27002940,W ENDOPOUCH SPEC,235.0,152.75,39.48,211.5,21
CDM,27002950,W ENEMA ADMIN ST,8.0,5.2,1.34,7.2,21
CDM,27002960,W ENEMA PHOS,11.0,7.15,1.85,9.9,21
CDM,27002970,W EPISTICK,17.0,11.05,2.86,15.3,21
CDM,27002980,W EQ BD AIR FLD D,183.0,118.95,30.74,164.7,21
CDM,27003000,W EQ BD KCI BARIK,413.0,268.45,69.38,371.7,21
CDM,27003010,W EQ BD KCI FIRST,94.0,61.1,15.79,84.6,21
CDM,27003020,W EQ BD KCI Q2 PL,65.0,42.25,10.92,58.5,21
CDM,27003030,W EQ BD KINAIR D,127.0,82.55,21.34,114.3,21
CDM,27003040,W EQ BD KINAIRIII,311.25,202.31,52.29,280.13,21
CDM,27003070,W EQ BD ROTOPRONE,1750.0,1137.5,294.0,1575.0,21
CDM,27003080,W EQ BD TRIADYNE,463.0,300.95,77.78,416.7,21
CDM,27003090,W EQ CAUTERY EYE,140.0,91.0,23.52,126.0,21
CDM,27003100,W EQ CELLSAVER,169.0,109.85,28.39,152.1,21
CDM,27003110,W EQ COMMODE BARI,95.0,61.75,15.96,85.5,21
CDM,27003120,W EQ CPM MACHINE *,130.0,84.5,21.84,117.0,21
CDM,27003130,W EQ CPM PD SUTTR*,214.0,139.1,35.95,192.6,21
CDM,27003140,W EQ CRADL W/HT D,15.0,9.75,2.52,13.5,21
CDM,27003150,W EQ CRANIOTM USE,57.0,37.05,9.58,51.3,21
CDM,27003160,W EQ CRUTCH CHLD,191.0,124.15,32.09,171.9,21
CDM,27003170,W EQ CRYOLATH UNT,377.0,245.05,63.34,339.3,21
CDM,27003180,W EQ CT ARTHROWND,491.0,319.15,82.49,441.9,21
CDM,27003190,W EQ CT-ARTHRO,256.0,166.4,43.01,230.4,21
CDM,27003200,W EQ DERMATOME,67.0,43.55,11.26,60.3,21
CDM,27003210,W EQ DRILL CRDLS,85.0,55.25,14.28,76.5,21
CDM,27003220,W EQ EMERSN PMP D,29.0,18.85,4.87,26.1,21
CDM,27003230,W EQ EXCH MOIST,78.0,50.7,13.1,70.2,21
CDM,27003240,W EQ EYE VITRECTR,124.0,80.6,20.83,111.6,21
CDM,27003250,W EQ FT CRDLE D,75.0,48.75,12.6,67.5,21
CDM,27003260,W EQ HOLDER LEG,31.0,20.15,5.21,27.9,21
CDM,27003270,W EQ HOT ICE MACH,545.0,354.25,91.56,490.5,21
CDM,27003280,W EQ HOT ICE S/U,427.0,277.55,71.74,384.3,21
CDM,27003290,W EQ HUMIDIFIER,38.0,24.7,6.38,34.2,21
CDM,27003300,W EQ ILLUM FIBOP,130.0,84.5,21.84,117.0,21
CDM,27003310,W EQ IM BACK SPPR,31.0,20.15,5.21,27.9,21
CDM,27003320,W EQ IRG/ASP,525.0,341.25,88.2,472.5,21
CDM,27003330,W EQ MANOMETR PRE,196.0,127.4,32.93,176.4,21
CDM,27003340,W EQ MANOMETR SPN,393.0,255.45,66.02,353.7,21
CDM,27003350,W EQ MNT SW GZ SU,354.0,230.1,59.47,318.6,21
CDM,27003360,W EQ PAS UNIT,13.0,8.45,2.18,11.7,21
CDM,27003370,W EQ PMP BIO W/ P,1225.0,796.25,205.8,1102.5,21
CDM,27003380,W EQ PMP ENTERNAL,27.0,17.55,4.54,24.3,21
CDM,27003390,W EQ PMP IV D,51.0,33.15,8.57,45.9,21
CDM,27003400,W EQ POSITNR BDY,51.0,33.15,8.57,45.9,21
CDM,27003410,W EQ PUMP CV SPEC,1114.0,724.1,187.15,1002.6,21
CDM,27003430,W EQ RESTRNT A/T,44.0,28.6,7.39,39.6,21
CDM,27003440,W EQ SG DERMABRDR,100.0,65.0,16.8,90.0,21
CDM,27003450,W EQ SUCT MACHINE*,17.0,11.05,2.86,15.3,21
CDM,27003460,W EQ SYS CELLSAVR,343.0,222.95,57.62,308.7,21
CDM,27003470,W EQ TRAPEZE,16.0,10.4,2.69,14.4,21
CDM,27003480,W EQ VACUUM PMP,184.0,119.6,30.91,165.6,21
CDM,27003490,W EQ WALKER A/S,491.0,319.15,82.49,441.9,21
CDM,27003500,W EQ WALKER PLATF,405.0,263.25,68.04,364.5,21
CDM,27003510,W EQ WALKER W/WHL,431.0,280.15,72.41,387.9,21
CDM,27003520,W EQ WHLCHR BARI,95.0,61.75,15.96,85.5,21
CDM,27003530,W EXT DRN BG,39.0,25.35,6.55,35.1,21
CDM,27003560,W EYE INFUSN/GAS,339.0,220.35,56.95,305.1,21
CDM,27003570,W EYE POLISHER,195.0,126.75,32.76,175.5,21
CDM,27003580,W EYE SPHERE,25.0,16.25,4.2,22.5,21
CDM,27003590,W FILIFORM GU,128.0,83.2,21.5,115.2,21
CDM,27003600,W FILTERS ALL,2012.0,1307.8,338.02,1810.8,21
CDM,27003610,W FIX ROD EXTNL D,140.0,91.0,23.52,126.0,21
CDM,27003620,W FLTR ARTHR SPC,47.0,30.55,7.9,42.3,21
CDM,27003630,W FLTR IN-LINE,16.0,10.4,2.69,14.4,21
CDM,27003640,W FLTR LKCYTE,34.0,22.1,5.71,30.6,21
CDM,27003650,W FLTR LUEKCYTE,90.0,58.5,15.12,81.0,21
CDM,27003660,W FLTR MICROTEC,35.0,22.75,5.88,31.5,21
CDM,27003670,W FLTR PLUME,98.0,63.7,16.46,88.2,21
CDM,27003680,W FLTR SUMPDRAIN,117.0,76.05,19.66,105.3,21
CDM,27003690,W FLUID WARMER,33.0,21.45,5.54,29.7,21
CDM,27003700,W FM ABDC LEG BAL,17.0,11.05,2.86,15.3,21
CDM,27003710,W FM CYLINDRICAL,48.0,31.2,8.06,43.2,21
CDM,27003720,W FOOT DROP STOP,16.0,10.4,2.69,14.4,21
CDM,27003730,W FRAME ANDREWS,158.0,102.7,26.54,142.2,21
CDM,27003740,W FRCP BPLR A/S,345.0,224.25,57.96,310.5,21
CDM,27003750,W FRCP SERRATED,1970.0,1280.5,330.96,1773.0,21
CDM,27003760,W FRIDGITONICS,28.0,18.2,4.7,25.2,21
CDM,27003770,W GEL INTRASITE,51.0,33.15,8.57,45.9,21
CDM,27003780,W GELFOAM,85.0,55.25,14.28,76.5,21
CDM,27003790,W GELFOAM SM,325.0,211.25,54.6,292.5,21
CDM,27003800,W GEOMATT,279.0,181.35,46.87,251.1,21
CDM,27003810,"W GLOVE, BIOGEL",52.0,33.8,8.74,46.8,21
CDM,27003820,W GLUCOSCAN STRIP,85.0,55.25,14.28,76.5,21
CDM,27003830,W GLUE FIBRIN DRL,1794.0,1166.1,301.39,1614.6,21
CDM,27003840,W GLV EXAM 100/B *,133.0,86.45,22.34,119.7,21
CDM,27003850,W GLV ISOL,39.0,25.35,6.55,35.1,21
CDM,27003860,W GLV ISOTONER,100.0,65.0,16.8,90.0,21
CDM,27003870,W GLV LINER,3.0,1.95,0.5,2.7,21
CDM,27003880,W GLV LITE,41.0,26.65,6.89,36.9,21
CDM,27003890,W GLV PUNCT RES R,69.0,44.85,11.59,62.1,21
CDM,27003910,W GRANULES HYDRO,24.0,15.6,4.03,21.6,21
CDM,27003920,W GRD CUSA CONTNR,440.0,286.0,73.92,396.0,21
CDM,27003930,W GW EXT,313.0,203.45,52.58,281.7,21
CDM,27003950,W GZ IODOFORM,25.0,16.25,4.2,22.5,21
CDM,27003960,W GZ PACKING VAG,40.0,26.0,6.72,36.0,21
CDM,27003970,W HALTER HD A/S,70.0,45.5,11.76,63.0,21
CDM,27003980,W HANDHELPER,66.0,42.9,11.09,59.4,21
CDM,27003990,W HD SIMPULSE,66.0,42.9,11.09,59.4,21
CDM,27004000,W HEADREST CRANI,31.0,20.15,5.21,27.9,21
CDM,27004010,W HEEL/ELBW PROTC,50.0,32.5,8.4,45.0,21
CDM,27004020,W HEPARIN LOK/WEL,8.0,5.2,1.34,7.2,21
CDM,27004030,W HNDBPC COAG ARG,858.0,557.7,144.14,772.2,21
CDM,27004040,W HOOD RESP W/STP,106.0,68.9,17.81,95.4,21
CDM,27004060,W HOT LNE FLD ST,35.0,22.75,5.88,31.5,21
CDM,27004070,W HUMIDFR O2,10.0,6.5,1.68,9.0,21
CDM,27004080,W HYDROGEN PEROXI,10.0,6.5,1.68,9.0,21
CDM,27004090,W IMBL ANKLE AIR,135.0,87.75,22.68,121.5,21
CDM,27004100,W IMBL KNEE,95.0,61.75,15.96,85.5,21
CDM,27004110,W IMBL KNEE,95.0,61.75,15.96,85.5,21
CDM,27004120,W INCENTIVE SPIRO,6.0,3.9,1.01,5.4,21
CDM,27004130,W INDEFLATOR PLUS,336.0,218.4,56.45,302.4,21
CDM,27004140,W INJECTR/MAN UTR,215.0,139.75,36.12,193.5,21
CDM,27004150,W INSERT GUIDE,229.0,148.85,38.47,206.1,21
CDM,27004160,W INST CURET DISP,44.0,28.6,7.39,39.6,21
CDM,27004170,W INST CURET EAR,4.0,2.6,0.67,3.6,21
CDM,27004180,W INST CYSTO FLEX*,25.0,16.25,4.2,22.5,21
CDM,27004190,W INST DIL FASCL *,567.0,368.55,95.26,510.3,21
CDM,27004200,W INST DRILL BIT *,256.0,166.4,43.01,230.4,21
CDM,27004210,W INST DRILL TWST*,114.0,74.1,19.15,102.6,21
CDM,27004220,W INST ENDO KITNR,56.0,36.4,9.41,50.4,21
CDM,27004230,W INST EXT STN GU*,447.0,290.55,75.1,402.3,21
CDM,27004240,W INST EYE PICK,465.0,302.25,78.12,418.5,21
CDM,27004250,W INST FRCP CLMP *,10.0,6.5,1.68,9.0,21
CDM,27004260,W INST FRCP GRSP *,523.0,339.95,87.86,470.7,21
CDM,27004270,W INST HOLDER NDL*,148.0,96.2,24.86,133.2,21
CDM,27004280,W INST INSERT CV *,83.0,53.95,13.94,74.7,21
CDM,27004290,W INST LYGL MIR,53.0,34.45,8.9,47.7,21
CDM,27004300,W INST OPTH PUNCH,404.0,262.6,67.87,363.6,21
CDM,27004310,W INST PRB BICAP *,718.0,466.7,120.62,646.2,21
CDM,27004320,W INST PRB MICRWV*,641.0,416.65,107.69,576.9,21
CDM,27004330,W INST RET VES CV*,451.0,293.15,75.77,405.9,21
CDM,27004340,W INST RETRACTOR,78.0,50.7,13.1,70.2,21
CDM,27004350,W INST SCISSR A/T*,13.0,8.45,2.18,11.7,21
CDM,27004360,W INST SCISSR MIC,344.0,223.6,57.79,309.6,21
CDM,27004370,W INST SIGMOIDSCP*,50.0,32.5,8.4,45.0,21
CDM,27004380,W INST SPECLM VAG*,21.0,13.65,3.53,18.9,21
CDM,27004390,W INST TAP E SCRW*,301.0,195.65,50.57,270.9,21
CDM,27004400,W INST ULTRTM SPH*,254.0,165.1,42.67,228.6,21
CDM,27004410,W INST WIRE SNARE*,2.0,1.3,0.34,1.8,21
CDM,27004420,W IRG MALIS BPLR,148.0,96.2,24.86,133.2,21
CDM,27004430,W IRR DISP GU,16.0,10.4,2.69,14.4,21
CDM,27004450,W IV ST EXT MCRO,64.0,41.6,10.75,57.6,21
CDM,27004470,W KNF HNDL GRSH E*,106.0,68.9,17.81,95.4,21
CDM,27004480,W KT ADMIT OP,14.0,9.1,2.35,12.6,21
CDM,27004490,W KT ANGIO CUST 2,147.0,95.55,24.7,132.3,21
CDM,27004500,W KT BIOGLUE,1710.0,1111.5,287.28,1539.0,21
CDM,27004510,W KT CRICOTHYRTMY,257.0,167.05,43.18,231.3,21
CDM,27004520,W KT DISP TRNSDU,75.0,48.75,12.6,67.5,21
CDM,27004530,W KT EAR DRS,21.0,13.65,3.53,18.9,21
CDM,27004540,W KT FEM STOP,352.0,228.8,59.14,316.8,21
CDM,27004550,W KT FILL IMPLANT,92.0,59.8,15.46,82.8,21
CDM,27004560,W KT INTRODUC TL,545.0,354.25,91.56,490.5,21
CDM,27004570,W KT INTUBATN,29.0,18.85,4.87,26.1,21
CDM,27004580,W KT IV START,13.0,8.45,2.18,11.7,21
CDM,27004590,W KT IV START,13.0,8.45,2.18,11.7,21
CDM,27004610,W KT MNTR,95.0,61.75,15.96,85.5,21
CDM,27004620,W KT MNTR BIFURC,98.0,63.7,16.46,88.2,21
CDM,27004630,W KT MNTR TRIFURC,147.0,95.55,24.7,132.3,21
CDM,27004640,W KT MOUTH CR W/S,48.0,31.2,8.06,43.2,21
CDM,27004650,W KT MYRINGOT EAR,21.0,13.65,3.53,18.9,21
CDM,27004660,W KT NASO EPISTAX,170.0,110.5,28.56,153.0,21
CDM,27004670,W KT NEURO LUMBAR,298.0,193.7,50.06,268.2,21
CDM,27004680,W KT PAC TRANMYOC,298.0,193.7,50.06,268.2,21
CDM,27004690,W KT PERC ACCESS,76.0,49.4,12.77,68.4,21
CDM,27004700,W KT PERIURTH NDL,256.0,166.4,43.01,230.4,21
CDM,27004710,W KT PHERESIS OPN,683.0,443.95,114.74,614.7,21
CDM,27004730,W KT POSITION,185.0,120.25,31.08,166.5,21
CDM,27004740,W KT SHAVE PREP,10.0,6.5,1.68,9.0,21
CDM,27004750,W KT SHOULDER RX,127.0,82.55,21.34,114.3,21
CDM,27004760,W KT SHOULDER STABILIZATION,101.0,65.65,16.97,90.9,21
CDM,27004780,W KT WRENCH DISP,229.0,148.85,38.47,206.1,21
CDM,27004840,W SUTURE LASSO ARTHREX,226.0,146.9,37.97,203.4,21
CDM,27004850,W LAVAGE PULSE DV,317.0,206.05,53.26,285.3,21
CDM,27004860,W LEG LIFT,88.0,57.2,14.78,79.2,21
CDM,27004870,W LENS GLIDE 10L,254.0,165.1,42.67,228.6,21
CDM,27004880,W LENS MORGAN,131.0,85.15,22.01,117.9,21
CDM,27004890,W LENS/HOOD COMBO,158.0,102.7,26.54,142.2,21
CDM,27004900,W LINER SUCT,28.0,18.2,4.7,25.2,21
CDM,27004920,W LITHO MECH,505.0,328.25,84.84,454.5,21
CDM,27004940,W LNR SUCT W/TB,61.0,39.65,10.25,54.9,21
CDM,27004950,W LOOP IV,9.0,5.85,1.51,8.1,21
CDM,27004960,W LZ FLTR,159.0,103.35,26.71,143.1,21
CDM,27004970,W LZ GUARD,80.0,52.0,13.44,72.0,21
CDM,27004980,W LZ TUBING,665.0,432.25,111.72,598.5,21
CDM,27004990,W MANIFOLD DISP,8.0,5.2,1.34,7.2,21
CDM,27005000,W MANIFOLD DISP,242.0,157.3,40.66,217.8,21
CDM,27005020,W MANOMETER DISP,810.0,526.5,136.08,729.0,21
CDM,27005030,W MARKER TISSUE,23.0,14.95,3.86,20.7,21
CDM,27005050,W MAT MICRO,77.0,50.05,12.94,69.3,21
CDM,27005060,W MED STAYS,220.0,143.0,36.96,198.0,21
CDM,27005070,W METER PEK FLO,60.0,39.0,10.08,54.0,21
CDM,27005080,W MIDS RX DIS TL,425.0,276.25,71.4,382.5,21
CDM,27005090,W MITT HND CNTRL,124.0,80.6,20.83,111.6,21
CDM,27005100,W MIX-E-VAC,158.0,102.7,26.54,142.2,21
CDM,27005110,W MNTR ICP CAMINO,969.0,629.85,162.79,872.1,21
CDM,27005120,W MSK ANS DISP,17.0,11.05,2.86,15.3,21
CDM,27005130,W MSK ARSOL ADLT,3.0,1.95,0.5,2.7,21
CDM,27005140,W MSK CPAP,116.0,75.4,19.49,104.4,21
CDM,27005150,W MSK FACE ISOL,37.0,24.05,6.22,33.3,21
CDM,27005160,W MSK FACE SLD,24.0,15.6,4.03,21.6,21
CDM,27005170,W MSK FACE TNT,23.0,14.95,3.86,20.7,21
CDM,27005180,W MSK NOREBRET,11.0,7.15,1.85,9.9,21
CDM,27005200,W MSK OR,12.0,7.8,2.02,10.8,21
CDM,27005210,W NASAL SEPTAL SPLINT DOYLE II,66.0,42.9,11.09,59.4,21
CDM,27005220,W NDL CHIBA DISP,119.0,77.35,19.99,107.1,21
CDM,27005230,W NDL CUATICO,53.0,34.45,8.9,47.7,21
CDM,27005240,W NDL IV LOCK,10.0,6.5,1.68,9.0,21
CDM,27005250,W NDL TROCAR,66.0,42.9,11.09,59.4,21
CDM,27005260,W NOSE BUTTON,312.0,202.8,52.42,280.8,20
CDM,27005260_IP,W NOSE BUTTON,312.0,202.8,112.63,112.63,3
CDM,27005260_OP,W NOSE BUTTON,312.0,202.8,202.8,305.76,6
CDM,27005280,W NS IRR 1L,47.0,30.55,7.9,42.3,21
CDM,27005290,W NS IRR 3000ML,61.0,39.65,10.25,54.9,21
CDM,27005300,W OCULR PROBE DSB,41.0,26.65,6.89,36.9,21
CDM,27005310,W ONT PERI-CR,55.0,35.75,9.24,49.5,21
CDM,27005320,W O-RING,2.0,1.3,0.34,1.8,21
CDM,27005330,W OST ADHESV MEDC,74.0,48.1,12.43,66.6,21
CDM,27005340,W OST BG URO DRN,269.0,174.85,45.19,242.1,21
CDM,27005350,W OST BLT A/S,34.0,22.1,5.71,30.6,21
CDM,27005360,W OST CLAMP BG,11.0,7.15,1.85,9.9,21
CDM,27005370,W OST IRR CONE,334.0,217.1,56.11,300.6,21
CDM,27005380,W OST PASTE KARYA,15.0,9.75,2.52,13.5,21
CDM,27005390,W OST PASTE STMA,40.0,26.0,6.72,36.0,21
CDM,27005400,W OST PCH DRNBLE,63.0,40.95,10.58,56.7,21
CDM,27005410,W OST PCH FEC,13.0,8.45,2.18,11.7,21
CDM,27005420,W OST POWDR KARYA,53.0,34.45,8.9,47.7,21
CDM,27005430,W OST SKIN BARIER,53.0,34.45,8.9,47.7,21
CDM,27005440,W OST SKIN BOND,65.0,42.25,10.92,58.5,21
CDM,27005450,W OST SKIN GEL 20,13.0,8.45,2.18,11.7,21
CDM,27005460,W OST SKIN PROTEC,131.0,85.15,22.01,117.9,21
CDM,27005470,W OXIMETER PRB,78.0,50.7,13.1,70.2,21
CDM,27005490,W P/M CABLE,180.0,117.0,30.24,162.0,21
CDM,27005500,W PACKING SURGICL,220.0,143.0,36.96,198.0,21
CDM,27005510,W PAIN PUMP LEAD,1389.0,902.85,233.35,1250.1,21
CDM,27005520,W PAPER RECORDER,13.0,8.45,2.18,11.7,21
CDM,27005530,W PASTE ULCER,29.0,18.85,4.87,26.1,21
CDM,27005540,W PCH ILEO ODRPR,40.0,26.0,6.72,36.0,21
CDM,27005545,ICEMAN (COLD THERAPY SYSTEM),261.0,169.65,43.85,234.9,21
CDM,27005550,W PD BED SHEPSKIN,76.0,49.4,12.77,68.4,21
CDM,27005560,W PD BETADINE,11.0,7.15,1.85,9.9,21
CDM,27005570,W PD DEFIB,158.0,102.7,26.54,142.2,21
CDM,27005600,W PD EKG BACKPAD *,17.0,11.05,2.86,15.3,21
CDM,27005610,W PD EXERCISR CPM,274.0,178.1,46.03,246.6,21
CDM,27005620,W PD GROUNDNG BIO,14.0,9.1,2.35,12.6,21
CDM,27005640,W PD KNEE,268.0,174.2,45.02,241.2,21
CDM,27005660,W PD MAGNETIC,148.0,96.2,24.86,133.2,21
CDM,27005680,W PD RESTON A/S,10.0,6.5,1.68,9.0,21
CDM,27005690,W PEEP-FLO VALVE,57.0,37.05,9.58,51.3,21
CDM,27005700,W PERMACATH,1257.0,817.05,211.18,1131.3,21
CDM,27005710,W PILLOW 20X26,128.0,83.2,21.5,115.2,21
CDM,27005720,W PILLW ABDUCTION,147.0,95.55,24.7,132.3,21
CDM,27005730,W PIN OCCLUDER,520.0,338.0,87.36,468.0,21
CDM,27005740,W PK COLD,29.0,18.85,4.87,26.1,21
CDM,27005750,W PK HOT/COLD,25.0,16.25,4.2,22.5,21
CDM,27005770,W PK SHL,99.0,64.35,16.63,89.1,21
CDM,27005780,W PK TRANSFER X2,47.0,30.55,7.9,42.3,21
CDM,27005790,W PK TRANSFER X4,23.0,14.95,3.86,20.7,21
CDM,27005800,W PLAST FBGLS RL2,50.0,32.5,8.4,45.0,21
CDM,27005810,W PLAST FBGLS RL3,70.0,45.5,11.76,63.0,21
CDM,27005820,W PLAST FBGLS RL4,93.0,60.45,15.62,83.7,21
CDM,27005830,W PLAST FBGLS RL5,111.0,72.15,18.65,99.9,21
CDM,27005840,W PLAST ROLL 2IN,13.0,8.45,2.18,11.7,21
CDM,27005850,W PLAST ROLL 3IN,15.0,9.75,2.52,13.5,21
CDM,27005860,W PLAST ROLL 4IN,26.0,16.9,4.37,23.4,21
CDM,27005870,W PLAST ROLL 5IN,24.0,15.6,4.03,21.6,21
CDM,27005890,W POSTN BODY,88.0,57.2,14.78,79.2,21
CDM,27005900,W PRB ANO-RECTAL,90.0,58.5,15.12,81.0,21
CDM,27005910,W PRB LAPAROSCOPC,10219.0,6642.35,1716.79,9197.1,21
CDM,27005920,W PRB LITHOTRIP,1055.0,685.75,177.24,949.5,21
CDM,27005930,W PRB SKIN TEMP,62.0,40.3,10.42,55.8,21
CDM,27005940,W PRB TRANS ECHO,492.0,319.8,82.66,442.8,21
CDM,27005950,W PRB TUNA RADIO,137.0,89.05,23.02,123.3,21
CDM,27005960,W PREP KT,38.0,24.7,6.38,34.2,21
CDM,27005970,W PRESS EYE PATCH,37.0,24.05,6.22,33.3,21
CDM,27005980,W PRESS GUAGE,367.0,238.55,61.66,330.3,21
CDM,27005990,W PRESS INFUSE,77.0,50.05,12.94,69.3,21
CDM,27005WE,TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE,4028.0,2618.2,401.26,4028.0,35
CDM,27006010,W PROS TOE HINGE,1735.0,1127.75,291.48,1561.5,21
CDM,27006020,W PROS TOE TYPII,2694.0,1751.1,452.59,2424.6,21
CDM,27006030,W PRT EYE,8.0,5.2,1.34,7.2,21
CDM,27006040,W REACHR,109.0,70.85,18.31,98.1,21
CDM,27006050,W RESERV BL COLL,493.0,320.45,82.82,443.7,21
CDM,27006060,W RESTRNT WRIST,17.0,11.05,2.86,15.3,21
CDM,27006070,W RETRACTOR SYS,60.0,39.0,10.08,54.0,21
CDM,27006080,W ROD COLOSTOMY,50.0,32.5,8.4,45.0,21
CDM,27006090,W ROTICULATOR,784.0,509.6,131.71,705.6,21
CDM,27006100,W RSTNT VEST,66.0,42.9,11.09,59.4,21
CDM,27006110,W RUBBING ALCOHOL,12.0,7.8,2.02,10.8,21
CDM,27006130,W SACK VEING GAST,229.0,148.85,38.47,206.1,21
CDM,27006140,W SCALPEL,83.0,53.95,13.94,74.7,21
CDM,27006150,W SCALPEL W/BL,190.0,123.5,31.92,171.0,21
CDM,27006160,W SCRN SPECBRD BX,194.0,126.1,32.59,174.6,21
CDM,27006170,W SCRUB SUIT,128.0,83.2,21.5,115.2,21
CDM,27006180,W SEAL COHESIVE,25.0,16.25,4.2,22.5,21
CDM,27006190,W SEAL FEM PRES,132.0,85.8,22.18,118.8,21
CDM,27006200,W SEALANT FLOSEAL KIT,270.0,175.5,45.36,243.0,21
CDM,27006210,W SENSOR DISP BIS,66.0,42.9,11.09,59.4,21
CDM,27006220,W SET CYSTO EXT,29.0,18.85,4.87,26.1,21
CDM,27006230,W SET CYSTO TB,9.0,5.85,1.51,8.1,21
CDM,27006240,W SHEET SILASTIC,423.0,274.95,71.06,380.7,21
CDM,27006250,W SHIELD COLLAGEN,263.0,170.95,44.18,236.7,21
CDM,27006260,W SHIELD SPLSH EN,83.0,53.95,13.94,74.7,21
CDM,27006270,W SHLD FACE DISP,4.0,2.6,0.67,3.6,21
CDM,27006280,W SHLD PHOTO EYE,37.0,24.05,6.22,33.3,21
CDM,27006290,W SHOWR SPRAY TIP,43.0,27.95,7.22,38.7,21
CDM,27006300,W SHPINCTEROTOME,477.0,310.05,80.14,429.3,21
CDM,27006310,W SHTH INTRO,38.0,24.7,6.38,34.2,21
CDM,27006320,W SHTH INTRO,219.0,142.35,36.79,197.1,21
CDM,27006330,W SHTH INTRO LN,339.0,220.35,56.95,305.1,21
CDM,27006340,W SHTH ONE-PIECE,61.0,39.65,10.25,54.9,21
CDM,27006350,W SLING & SWATH,22.0,14.3,3.7,19.8,21
CDM,27006360,W SLING KNEE,26.0,16.9,4.37,23.4,21
CDM,27006370,W SLING PED,10.0,6.5,1.68,9.0,21
CDM,27006380,W SLING PELV DISP,109.0,70.85,18.31,98.1,21
CDM,27006390,W SLNG ARM STRAP,147.0,95.55,24.7,132.3,21
CDM,27006400,W SLNG CRADLE A/S,76.0,49.4,12.77,68.4,21
CDM,27006410,W SLNG CVA,239.0,155.35,40.15,215.1,21
CDM,27006420,W SNARE STERILE,826.0,536.9,138.77,743.4,21
CDM,27006430,W SLING ARM ULTRASLING,86.0,55.9,14.45,77.4,21
CDM,27006450,W SOL BETADINE,17.0,11.05,2.86,15.3,21
CDM,27006460,W SOL PERI WASH,11.0,7.15,1.85,9.9,21
CDM,27006470,W SPACERS ORTHO,52.0,33.8,8.74,46.8,21
CDM,27006490,W SPLNT ACROMCLVC,78.0,50.7,13.1,70.2,21
CDM,27006500,W SPLNT ARM,56.0,36.4,9.41,50.4,21
CDM,27006510,W SPLNT ARM OCL,65.0,42.25,10.92,58.5,21
CDM,27006520,W SPLNT BALL,13.0,8.45,2.18,11.7,21
CDM,27006530,W SPLNT CLAVICLE,24.0,15.6,4.03,21.6,21
CDM,27006540,W SPLNT FINGER,22.0,14.3,3.7,19.8,21
CDM,27006550,W SPLNT FROG,48.0,31.2,8.06,43.2,21
CDM,27006560,W SPLNT HAND A/T,142.0,92.3,23.86,127.8,21
CDM,27006570,W SPLNT IMOBL SHL,80.0,52.0,13.44,72.0,21
CDM,27006580,W SPLNT METACARPL,128.0,83.2,21.5,115.2,21
CDM,27006590,W SPLNT NASAL,240.0,156.0,40.32,216.0,21
CDM,27006600,W SPLNT NASL BRWN,183.0,118.95,30.74,164.7,21
CDM,27006610,W SPLNT ORTHOPLST,15.0,9.75,2.52,13.5,21
CDM,27006620,W SPLNT THMB SP,74.0,48.1,12.43,66.6,21
CDM,27006640,W SPLNT WRST COLS,173.0,112.45,29.06,155.7,21
CDM,27006650,W SPLNT WRST/ARM,22.0,14.3,3.7,19.8,21
CDM,27006660,W SPNG LONG,16.0,10.4,2.69,14.4,21
CDM,27006670,W SPORTSCORD,23.0,14.95,3.86,20.7,21
CDM,27006680,W SPPRT HEAD FOAM,52.0,33.8,8.74,46.8,21
CDM,27006690,W SPPRT KNEE ELAS,213.0,138.45,35.78,191.7,21
CDM,27006700,W SPPRT LUMB/SAC,246.0,159.9,41.33,221.4,21
CDM,27006710,W SPPRT NEO ELBOW,13.0,8.45,2.18,11.7,21
CDM,27006730,W ST ADM BLD/PMP,29.0,18.85,4.87,26.1,21
CDM,27006740,W ST ADM BLOOD,8.0,5.2,1.34,7.2,21
CDM,27006750,W ST BASIN,9.0,5.85,1.51,8.1,21
CDM,27006770,W ST BUTTERFLY,2.0,1.3,0.34,1.8,21
CDM,27006780,W ST CAUTERY DISP,8.0,5.2,1.34,7.2,21
CDM,27006790,W ST CV YTYPE BLD,13.0,8.45,2.18,11.7,21
CDM,27006800,W ST CYSTO IRR,232.0,150.8,38.98,208.8,21
CDM,27006810,W ST DIALYS TRNSF,154.0,100.1,25.87,138.6,21
CDM,27006820,W ST DILAT URETH,361.0,234.65,60.65,324.9,21
CDM,27006830,W ST DIS/MULT ADD,22.0,14.3,3.7,19.8,21
CDM,27006840,W ST DRN SUPRAPUB,234.0,152.1,39.31,210.6,21
CDM,27006850,W ST EXT IRG,174.0,113.1,29.23,156.6,21
CDM,27006860,W ST EXTNSN,26.0,16.9,4.37,23.4,21
CDM,27006870,W ST FLUD/BL WARM,106.0,68.9,17.81,95.4,21
CDM,27006880,W ST FLUID ADMIN,74.0,48.1,12.43,66.6,21
CDM,27006890,W ST FLUID DELIV,23.0,14.95,3.86,20.7,21
CDM,27006900,W ST HEMOR BND,1056.0,686.4,177.41,950.4,21
CDM,27006910,W ST HUMIDRF,88.0,57.2,14.78,79.2,21
CDM,27006920,W ST INFUS APIS,35.0,22.75,5.88,31.5,21
CDM,27006930,W ST INFUSN,34.0,22.1,5.71,30.6,21
CDM,27006940,W ST IRG SEC,16.0,10.4,2.69,14.4,21
CDM,27006950,W ST IRG TUR,48.0,31.2,8.06,43.2,21
CDM,27006960,W ST IRG TUR PK,51.0,33.15,8.57,45.9,21
CDM,27006980,W ST IV ADM,31.0,20.15,5.21,27.9,21
CDM,27006990,W ST IV ADM CNT,70.0,45.5,11.76,63.0,21
CDM,27006WE,TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX,4044.0,2628.6,412.62,4044.0,35
CDM,27007000,W ST IV EXT,65.0,42.25,10.92,58.5,21
CDM,27007010,W ST IV EXT 2,13.0,8.45,2.18,11.7,21
CDM,27007020,W ST IV EXT 3W,31.0,20.15,5.21,27.9,21
CDM,27007030,W ST IV EXT4W A/S,39.0,25.35,6.55,35.1,21
CDM,27007040,W ST IV NITROUS,29.0,18.85,4.87,26.1,21
CDM,27007050,W ST IV SCALP VN,8.0,5.2,1.34,7.2,21
CDM,27007060,W ST IV SEC,26.0,16.9,4.37,23.4,21
CDM,27007070,W ST IV TPN,65.0,42.25,10.92,58.5,21
CDM,27007080,W ST IV Y PCA,23.0,14.95,3.86,20.7,21
CDM,27007100,W ST NEPHROSTOMY,221.0,143.65,37.13,198.9,21
CDM,27007120,W ST POUCH,74.0,48.1,12.43,66.6,21
CDM,27007130,W ST PRIM CNTFLW,23.0,14.95,3.86,20.7,21
CDM,27007140,W ST PRIMARY N/VN,66.0,42.9,11.09,59.4,21
CDM,27007150,W ST PRIMARY VENT,35.0,22.75,5.88,31.5,21
CDM,27007160,W ST START P-DIAL,50.0,32.5,8.4,45.0,21
CDM,27007170,W ST TB BLD VEN,28.0,18.2,4.7,25.2,21
CDM,27007180,W ST TUBING REFIL,21.0,13.65,3.53,18.9,21
CDM,27007190,W ST TUR IRG Y,13.0,8.45,2.18,11.7,21
CDM,27007210,W STIM NERVE,375.0,243.75,63.0,337.5,21
CDM,27007220,W STIM NEURO PROG,8126.0,5281.9,1365.17,7313.4,21
CDM,27007230,W STIM/LOC11 NERV,264.0,171.6,44.35,237.6,21
CDM,27007240,W STKNET,8.0,5.2,1.34,7.2,21
CDM,27007280,W STRAINER URINE,10.0,6.5,1.68,9.0,21
CDM,27007290,W STRL VIEW HOOD,65.0,42.25,10.92,58.5,21
CDM,27007300,W STRP FT ANKLE,213.0,138.45,35.78,191.7,21
CDM,27007310,W STRP MONTGOMERY,16.0,10.4,2.69,14.4,21
CDM,27007320,W STRP PERI,458.0,297.7,76.94,412.2,21
CDM,27007330,W STRP STIRRUP,58.0,37.7,9.74,52.2,21
CDM,27007340,W SU CELL SAVER,72.0,46.8,12.1,64.8,21
CDM,27007350,W SUCT CAN ST,23.0,14.95,3.86,20.7,21
CDM,27007370,W SUCT HAND FRZR,55.0,35.75,9.24,49.5,21
CDM,27007380,W SUCT HAND YANK,10.0,6.5,1.68,9.0,21
CDM,27007390,W SUCT HNDL VACU,33.75,21.94,5.67,30.38,21
CDM,27007400,W SUCT IRRIG,174.0,113.1,29.23,156.6,21
CDM,27007410,W SUCT RESRVR,412.0,267.8,69.22,370.8,21
CDM,27007420,W SUCT VACURET ST,9.0,5.85,1.51,8.1,21
CDM,27007440,W SUPERSTAT,266.0,172.9,44.69,239.4,21
CDM,27007450,W SUPP ULNAR,10.0,6.5,1.68,9.0,21
CDM,27007460,W SURGIBRA,65.0,42.25,10.92,58.5,21
CDM,27007470,W SURGIKIT,307.0,199.55,51.58,276.3,21
CDM,27007480,W SUTURE TRAY,109.0,70.85,18.31,98.1,21
CDM,27007490,W SWAB BETADINE,8.0,5.2,1.34,7.2,21
CDM,27007500,W SYR COLLAGN TX,276.0,179.4,46.37,248.4,21
CDM,27007510,W SYR EAR/ULCER,15.0,9.75,2.52,13.5,21
CDM,27007520,W SYR LEVEEN,339.0,220.35,56.95,305.1,21
CDM,27007530,W SYS BRTH CNTRL,3100.0,2015.0,520.8,2790.0,23
CDM,27007530_IP,W SYS BRTH CNTRL,3100.0,2015.0,1119.1,1119.1,3
CDM,27007530_OP,W SYS BRTH CNTRL,3100.0,2015.0,2015.0,3038.0,6
CDM,27007540,W SYS FOG ELIM,142.0,92.3,23.86,127.8,21
CDM,27007550,W SYS TISS STABLZ,2955.0,1920.75,496.44,2659.5,21
CDM,27007560,W TAMPON NASAL,37.0,24.05,6.22,33.3,21
CDM,27007570,W TAMPON NASAL,92.0,59.8,15.46,82.8,21
CDM,27007580,W TAP CANNLTD LG,604.0,392.6,101.47,543.6,21
CDM,27007590,W TB ANTI SIPHON,392.0,254.8,65.86,352.8,21
CDM,27007600,W TB ARTHO,591.0,384.15,99.29,531.9,21
CDM,27007610,W TB BLAKEMORE,213.0,138.45,35.78,191.7,21
CDM,27007620,W TB CDIS,294.0,191.1,49.39,264.6,21
CDM,27007630,W TB CHST,51.0,33.15,8.57,45.9,21
CDM,27007640,W TB CO2 INSUFF,52.0,33.8,8.74,46.8,21
CDM,27007660,W TB DOBHOFF,17.0,11.05,2.86,15.3,21
CDM,27007680,W TB ENDO LZ,153.0,99.45,25.7,137.7,21
CDM,27007690,W TB EPIDRL PMP,13.0,8.45,2.18,11.7,21
CDM,27007710,W TB FD JEJUNAL,161.0,104.65,27.05,144.9,21
CDM,27007720,W TB FEED,22.0,14.3,3.7,19.8,21
CDM,27007730,W TB FEED,65.0,42.25,10.92,58.5,21
CDM,27007740,W TB FEED,77.0,50.05,12.94,69.3,21
CDM,27007750,W TB FEED 5 FR,57.0,37.05,9.58,51.3,21
CDM,27007760,W TB HEMOCHRM HT,17.0,11.05,2.86,15.3,21
CDM,27007770,W TB HI PRESS,16.0,10.4,2.69,14.4,21
CDM,27007780,W TB HYSTERO PMP,552.0,358.8,92.74,496.8,21
CDM,27007790,W TB IRRIGAT,314.0,204.1,52.75,282.6,21
CDM,27007800,W TB LEVINE,8.0,5.2,1.34,7.2,21
CDM,27007810,W TB LEVINE,11.0,7.15,1.85,9.9,21
CDM,27007820,W TB NAZHAT-DOR,524.0,340.6,88.03,471.6,21
CDM,27007830,W TB NSL ASP,3.0,1.95,0.5,2.7,21
CDM,27007840,W TB O2 CONN,3.0,1.95,0.5,2.7,21
CDM,27007850,W TB PRES LINE,40.0,26.0,6.72,36.0,21
CDM,27007860,W TB RECTAL PLAS,4.0,2.6,0.67,3.6,21
CDM,27007890,W TB TRACH,543.0,352.95,91.22,488.7,21
CDM,27007900,W TB TRACH HLDR,9.0,5.85,1.51,8.1,21
CDM,27007910,W TB URET CONNCT,81.0,52.65,13.61,72.9,21
CDM,27007920,W TB Y-CONNCTR,137.0,89.05,23.02,123.3,21
CDM,27007940,W THERABAND,3.0,1.95,0.5,2.7,21
CDM,27007950,W THERA-BND,4.0,2.6,0.67,3.6,21
CDM,27007960,W THERAPY PUTTY,196.0,127.4,32.93,176.4,21
CDM,27007980,W THERMOMETER,15.0,9.75,2.52,13.5,21
CDM,27007990,W TIP ASP U/SONIC,1357.0,882.05,227.98,1221.3,21
CDM,27008000,W TIP IRRIG/ASP,179.0,116.35,30.07,161.1,21
CDM,27008010,W TOURN INFL DIS,70.0,45.5,11.76,63.0,21
CDM,27008020,W TP DRP STRI,108.0,70.2,18.14,97.2,21
CDM,27008030,W TP GLOW & TELL,93.0,60.45,15.62,83.7,21
CDM,27008040,W TRAC BAL D,47.0,30.55,7.9,42.3,21
CDM,27008050,W TRAC BAL SU,187.0,121.55,31.42,168.3,21
CDM,27008060,W TRAC BCK SNGL D,39.0,25.35,6.55,35.1,21
CDM,27008070,W TRAC BCK SNGL S,160.0,104.0,26.88,144.0,21
CDM,27008080,W TRAC CRV SKLT D,47.0,30.55,7.9,42.3,21
CDM,27008090,W TRAC CRV SKLT S,187.0,121.55,31.42,168.3,21
CDM,27008100,W TRAC PLVC D,39.0,25.35,6.55,35.1,21
CDM,27008110,W TRAC PLVC SLG S,616.0,400.4,103.49,554.4,21
CDM,27008120,W TRAC PLVC SNG D,98.0,63.7,16.46,88.2,21
CDM,27008130,W TRAC PLVC SU,209.0,135.85,35.11,188.1,21
CDM,27008140,W TRACH COLLAR,10.0,6.5,1.68,9.0,20
CDM,27008140_IP,W TRACH COLLAR,10.0,6.5,3.61,3.61,3
CDM,27008140_OP,W TRACH COLLAR,10.0,6.5,6.5,9.8,6
CDM,27008150,W TRACH SHILEY,276.0,179.4,46.37,248.4,21
CDM,27008160,W TRACH SUCT CATH,60.0,39.0,10.08,54.0,21
CDM,27008170,W TRACH TB HLDR,11.0,7.15,1.85,9.9,21
CDM,27008180,W TRACH TUBE FLEX,14.0,9.1,2.35,12.6,21
CDM,27008190,W TRAPEZE SU,172.0,111.8,28.9,154.8,21
CDM,27008200,W TRCR BLDLSS SLV,116.0,75.4,19.49,104.4,21
CDM,27008210,W TRNSDU DBL,906.0,588.9,152.21,815.4,21
CDM,27008220,W TRNSDU DOME,25.0,16.25,4.2,22.5,21
CDM,27008230,W TRNSDU SNGL,90.0,58.5,15.12,81.0,21
CDM,27008240,W TRY ATRIOGRM HP,62.0,40.3,10.42,55.8,21
CDM,27008250,W TRY CATH CAVH/,491.0,319.15,82.49,441.9,21
CDM,27008260,W TRY CUTDOWN HP,60.0,39.0,10.08,54.0,21
CDM,27008280,W TRY EXM NSL H/P,60.0,39.0,10.08,54.0,21
CDM,27008290,W TRY EXM PELV HP,31.0,20.15,5.21,27.9,21
CDM,27008300,W TRY EXM VAG H/P,25.0,16.25,4.2,22.5,21
CDM,27008310,W TRY EYE,25.0,16.25,4.2,22.5,21
CDM,27008320,W TRY FACIAL,48.0,31.2,8.06,43.2,21
CDM,27008330,W TRY IRR EAR H/P,16.0,10.4,2.69,14.4,21
CDM,27008340,W TRY K-WIRE H/P,56.0,36.4,9.41,50.4,21
CDM,27008360,W TRY LYMPHNGM HP,70.0,45.5,11.76,63.0,21
CDM,27008370,W TRY MNTR CVP,38.0,24.7,6.38,34.2,21
CDM,27008380,W TRY MYELOGM H/P,69.0,44.85,11.59,62.1,21
CDM,27008390,W TRY NASAL INST *,14.0,9.1,2.35,12.6,21
CDM,27008400,W TRY PARACENT,159.0,103.35,26.71,143.1,21
CDM,27008410,W TRY PERI-CRD HP,268.0,174.2,45.02,241.2,21
CDM,27008420,W TRY SCRB SKN WT*,89.0,57.85,14.95,80.1,21
CDM,27008430,W TRY SOFT TISSUE,183.0,118.95,30.74,164.7,21
CDM,27008440,W TRY SUT MAJ,69.0,44.85,11.59,62.1,21
CDM,27008450,W TRY SUT MIN H/P,31.0,20.15,5.21,27.9,21
CDM,27008460,W TRY THORCNT H/P,35.0,22.75,5.88,31.5,21
CDM,27008470,W TRY TRACH CLEA,8.0,5.2,1.34,7.2,21
CDM,27008480,W TRY TRACH CLEAN,15.0,9.75,2.52,13.5,21
CDM,27008490,W TRY TRACHSTM HP,50.0,32.5,8.4,45.0,21
CDM,27008500,W TUBING AERSL,14.0,9.1,2.35,12.6,21
CDM,27008510,W TUBING ARTHR IR,295.0,191.75,49.56,265.5,21
CDM,27008520,W TUBING FLO PUMP,420.0,273.0,70.56,378.0,21
CDM,27008530,W TUBING PRESR MN,31.0,20.15,5.21,27.9,21
CDM,27008550,W UNDRPD PANT PK1*,11.0,7.15,1.85,9.9,21
CDM,27008560,W UNISPLNT A/S,88.0,57.2,14.78,79.2,21
CDM,27008570,W URET DIL/MAN SY,93.0,60.45,15.62,83.7,21
CDM,27008580,W URETERAL ILLUM,822.0,534.3,138.1,739.8,21
CDM,27008610,W URO SHTH,25.0,16.25,4.2,22.5,21
CDM,27008620,W UROPUMP DAMPCHM,74.0,48.1,12.43,66.6,21
CDM,27008630,W UTERINE ELEVATR,168.0,109.2,28.22,151.2,21
CDM,27008640,W VALVUTOME DISP,1248.0,811.2,209.66,1123.2,21
CDM,27008650,W VASELINE 60OZ,8.0,5.2,1.34,7.2,21
CDM,27008660,W BLADE RECIPROCATING SAW,59.0,38.35,9.91,53.1,21
CDM,27008670,W VIBRATOR COMPCT,131.0,85.15,22.01,117.9,21
CDM,27008680,W VLV CPAP,43.0,27.95,7.22,38.7,21
CDM,27008690,W VLV HEMOST ROT,262.0,170.3,44.02,235.8,21
CDM,27008700,W WIPE/SPNGE INST*,34.0,22.1,5.71,30.6,21
CDM,27008710,W WIRE GDE,48.0,31.2,8.06,43.2,21
CDM,27008720,W WIRE GDE,451.0,293.15,75.77,405.9,21
CDM,27008730,W WIRE GDE SPHINC,243.0,157.95,40.82,218.7,21
CDM,27008740,W WIRE ZEBRA J TP,366.0,237.9,61.49,329.4,21
CDM,27008750,W WR DIAG LNG,117.0,76.05,19.66,105.3,21
CDM,27008760,W WR DIAG REG,72.0,46.8,12.1,64.8,21
CDM,27008770,W WRAP EZ,118.0,76.7,19.82,106.2,21
CDM,27008780,W CST HAND,585.0,380.25,98.28,526.5,21
CDM,27008790,W SUTURE #2 TIGERLOOP,79.0,51.35,13.27,71.1,21
CDM,27008800,W TUBING ENDOMAT HYSTEROSCOPY,155.0,100.75,26.04,139.5,21
CDM,27008810,W POWDER AEROSOL TALC STERILE,214.0,139.1,35.95,192.6,21
CDM,27008820,W INTRODUCER MICRO COAX NTNL SET,119.0,77.35,19.99,107.1,21
CDM,27008830,W DEVICE HEMO ARISTA BELLOW 1GM,142.0,92.3,23.86,127.8,21
CDM,27008840,W DEVICE HEMO ARISTA BELLOW 3GM,227.0,147.55,38.14,204.3,21
CDM,27008850,W BLADE 2 CUT SAG,66.0,42.9,11.09,59.4,21
CDM,27008870,W SYSTEM RETRACTOR ANTERIOR HIP,201.0,130.65,33.77,180.9,21
CDM,27008880,W SUTURE COTTONY,60.0,39.0,10.08,54.0,21
CDM,27008890,W SUTURE COTTONY II,81.0,52.65,13.61,72.9,21
CDM,27008900,W PACK ULTRASOUND FMS,114.0,74.1,19.15,102.6,21
CDM,27008910,W BLADE ARTHROWAND SIDEWINDER,836.0,543.4,140.45,752.4,21
CDM,27008920,W STAPLER MACH 30MM 4.8 GRN,152.0,98.8,25.54,136.8,21
CDM,27008930,W GUIDEWIRE BALL-TIPPED,316.0,205.4,53.09,284.4,21
CDM,27008940,W DRAINAGE SET ABSCESS THALQK,122.0,79.3,20.5,109.8,21
CDM,27008950,W BURR DRILL FLUTED DRUM LONG,141.0,91.65,23.69,126.9,21
CDM,27008960,W ARTHROWAND EVAC 70 W/CBL TNSL,240.0,156.0,40.32,216.0,21
CDM,27008970,W BLADE LONG HIP AGGRESS PLUS,129.0,83.85,21.67,116.1,21
CDM,27008980,W REAMER LOW PROFILE,270.0,175.5,45.36,243.0,21
CDM,27008990,W SHEATH TUNNELER BULL TIP 20.5,64.0,41.6,10.75,57.6,21
CDM,27009000,W ARTHROWAND ARTHSCP,255.0,165.75,42.84,229.5,21
CDM,27009010,W BUR RND OSTEON ELITE SFT TCH,131.0,85.15,22.01,117.9,21
CDM,27009020,W SHEATH 7F TEARAWAY SIDEPORT,128.0,83.2,21.5,115.2,21
CDM,27009030,W SYS PAIN RELIEF POST 12.5CM,263.0,170.95,44.18,236.7,21
CDM,27009040,W SYSTEM PAIN RELIEF POST 400ML,638.0,414.7,107.18,574.2,21
CDM,27009050,W SILVER SOAKER 5IN,103.0,66.95,17.3,92.7,21
CDM,27009060,W BATTERY SYSTEM 2000 STRYKER,295.0,191.75,49.56,265.5,21
CDM,27009070,W DISSECTOR MIDAS REX M-1,125.0,81.25,21.0,112.5,21
CDM,27009080,W KIT BIOSUTURE TAK 2.4MM,242.0,157.3,40.66,217.8,21
CDM,27009090,W APPLIER ENDOCLIP L176625,140.0,91.0,23.52,126.0,21
CDM,27009100,W INTRO LG RB 16F 0.038IN 30IN,140.0,91.0,23.52,126.0,21
CDM,27009110,W INTRODUCER 12F 0.038IN 13CM,68.0,44.2,11.42,61.2,21
CDM,27009120,W GWIRE LUNDERQUIST 260MM X 7CM,164.0,106.6,27.55,147.6,21
CDM,27009130,W BLADE SUBGLOTTIC TRICUT 4MM,503.0,326.95,84.5,452.7,21
CDM,27009140,W STAPLER RELOAD TA30V3,367.0,238.55,61.66,330.3,21
CDM,27009150,W GDWR GW BENTSON ANG/STIFF .038,117.0,76.05,19.66,105.3,21
CDM,27009160,W SUTURE FIBERWIRE 5 CCS-1,66.0,42.9,11.09,59.4,21
CDM,27009170,W ELECTRODE ROLLERBALL 24FR,232.0,150.8,38.98,208.8,21
CDM,27009180,W ARTHROWAND TURBOVAC 90 3.5 MM,255.0,165.75,42.84,229.5,21
CDM,27009190,W ERASER ESU BPLR ASPIRATOR 20GA,57.0,37.05,9.58,51.3,21
CDM,27009200,W CATHETER VENTRICULAR,220.0,143.0,36.96,198.0,21
CDM,27009210,W BURR ROUND FLUTED 5.0MM,122.0,79.3,20.5,109.8,21
CDM,27009220,W BUR ROUND/BARREL 6FLUTE,91.0,59.15,15.29,81.9,21
CDM,27009230,W IV FL ADMIN SET LEVEL 1,114.0,74.1,19.15,102.6,21
CDM,27009240,W ANCHOR TAP DOWN TOOL 2.4MM,134.0,87.1,22.51,120.6,21
CDM,27009250,W PREFAB AFO,248.0,161.2,41.66,223.2,20
CDM,27009250_IP,W PREFAB AFO,248.0,161.2,89.53,89.53,3
CDM,27009250_OP,W PREFAB AFO,248.0,161.2,161.2,243.04,6
CDM,27009260,VELCRO 1 FOOT,3.0,1.95,0.5,2.7,21
CDM,27010920,INCENTIVE SPIROMETER,139.0,90.35,23.35,125.1,21
CDM,27014240,OXYGEN SUBSEQUENT DAY-HOSP,129.0,83.85,21.67,116.1,21
CDM,27014260,"TRACHEOSTOMY TUBE, ANY TYPE",71.45,46.44,12.0,64.31,21
CDM,27015555,DAVIS CATHETER,133.0,86.45,22.34,119.7,21
CDM,27016635,PD2 SOLUTION 1.5% PER LITER,39.0,25.35,6.55,35.1,21
CDM,27016645,PD2 SOLUTION 2.5% PER LITER,48.0,31.2,8.06,43.2,21
CDM,27017525,SURGICAL BOOT/SHOE EA,19.0,12.35,3.19,17.1,21
CDM,27018695,HELIUM/O2,135.0,87.75,22.68,121.5,21
CDM,27018815,CHEST VEST,115.5,75.08,19.4,103.95,21
CDM,27019045,DISPOSABLE ENDOSEE DEVICE,248.0,161.2,41.66,223.2,21
CDM,27019335,LUNG CLEARANCE DEVICE,50.75,32.99,8.53,45.68,21
CDM,27019355,SUPPLY-BRONCOSCOPE DISPOSABLE,448.5,291.53,75.35,403.65,21
CDM,27020655,IUPC CATH,124.0,80.6,20.83,111.6,21
CDM,27021575,SANE SAEC KIT,31.0,20.15,5.21,27.9,21
CDM,27021685,MISC - SUPPLY,100.0,65.0,16.8,90.0,21
CDM,27023345,"EARMOLDS, ANY TYPE QTY 1",100.0,65.0,16.8,90.0,21
CDM,27023355,"EARMOLDS, ANY TYPE QTY 2",200.0,130.0,21.97,180.0,21
CDM,27023565,"CAST SUPPLIES, LONG ARM CAST, 11 YRS +, FIBERGLASS",116.0,75.4,19.49,104.4,21
CDM,27023585,"CAST SUPPLIES, LONG ARM CAST, PEDS, FIBERGLASS",30.0,19.5,5.04,27.0,21
CDM,27023615,"CAST SUPPLIES, SHORT ARM CAST, PEDS, PLASTER",6.0,3.9,1.01,5.4,21
CDM,27024105,ARCTIC SUN GEL PAD SM/MED/LG,2563.0,1665.95,430.58,2306.7,21
CDM,27024115,ARCTIC SUN GEL PAD UNI,770.0,500.5,129.36,693.0,21
CDM,27024665,HIGH FLOW OXYGEN DAILY,345.0,224.25,57.96,310.5,21
CDM,27024725,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE TIE",1700.0,1105.0,285.6,1530.0,21
CDM,27024785,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 1",2200.0,1430.0,369.6,1980.0,21
CDM,27024795,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 1",1100.0,715.0,184.8,990.0,21
CDM,27024805,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 1",2200.0,1430.0,369.6,1980.0,21
CDM,27024815,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 1",1100.0,715.0,184.8,990.0,21
CDM,27024825,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, BEHIND THE EAR",1100.0,715.0,184.8,990.0,21
CDM,27024845,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR",1100.0,715.0,184.8,990.0,21
CDM,27024855,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 1",2200.0,1430.0,369.6,1980.0,21
CDM,27024865,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 1",1100.0,715.0,184.8,990.0,21
CDM,27024875,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 1",2200.0,1430.0,369.6,1980.0,21
CDM,27024885,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 1",1100.0,715.0,184.8,990.0,21
CDM,27024955,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 2",3600.0,2340.0,604.8,3240.0,21
CDM,27024965,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 2",1800.0,1170.0,302.4,1620.0,21
CDM,27024975,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 2",3600.0,2340.0,604.8,3240.0,21
CDM,27024985,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 2",1800.0,1170.0,302.4,1620.0,21
CDM,27024995,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, BEHIND THE EAR",1100.0,715.0,184.8,1100.0,21
CDM,27025015,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR",1100.0,715.0,184.8,990.0,21
CDM,27025025,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 2",3600.0,2340.0,604.8,3240.0,21
CDM,27025035,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 2",1800.0,1170.0,302.4,1620.0,21
CDM,27025045,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 2",3600.0,2340.0,604.8,3240.0,21
CDM,27025055,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 2",1800.0,1170.0,302.4,1620.0,21
CDM,27025125,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 3",5000.0,3250.0,840.0,4500.0,21
CDM,27025135,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 3",2500.0,1625.0,420.0,2250.0,21
CDM,27025145,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 3",5000.0,3250.0,840.0,4500.0,21
CDM,27025155,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 3",2500.0,1625.0,420.0,2250.0,21
CDM,27025165,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, BEHIND THE EAR",1100.0,715.0,184.8,1100.0,21
CDM,27025185,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR",1100.0,715.0,184.8,990.0,21
CDM,27025195,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 3",5000.0,3250.0,840.0,4500.0,21
CDM,27025205,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 3",2500.0,1625.0,420.0,2250.0,21
CDM,27025215,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 3",5000.0,3250.0,840.0,4500.0,21
CDM,27025225,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 3",2500.0,1625.0,420.0,2250.0,21
CDM,27025245,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE TIE",3900.0,2535.0,655.2,3510.0,21
CDM,27025295,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 4",6400.0,4160.0,1075.2,5760.0,21
CDM,27025305,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 4",3200.0,2080.0,439.47,2880.0,21
CDM,27025315,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 4",6400.0,4160.0,1075.2,5760.0,21
CDM,27025325,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 4",3200.0,2080.0,439.47,2880.0,21
CDM,27025335,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, BEHIND THE EAR",1100.0,715.0,184.8,1100.0,21
CDM,27025355,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR",1100.0,715.0,184.8,990.0,21
CDM,27025365,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 4",6400.0,4160.0,1075.2,5760.0,21
CDM,27025375,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 4",3200.0,2080.0,439.47,2880.0,21
CDM,27025385,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 4",6400.0,4160.0,1075.2,5760.0,21
CDM,27025395,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 4",3200.0,2080.0,439.47,2880.0,21
CDM,27025405,SWIM PLUG BINAURAL,150.0,97.5,25.2,135.0,21
CDM,27025415,SWIM PLUG MONAURAL,75.0,48.75,12.6,67.5,21
CDM,27025435,"ASSISTIVE LISTENING DEVICE, TV AMPLIFIER, ANY TYPE",160.0,104.0,26.88,144.0,21
CDM,27025985,AMBU DISPOSABLE BRONCHOSCOPE,690.0,448.5,115.92,621.0,21
CDM,27025995,SYSTEM CRYO/CUFF IC UNIVERSAL COMPRESSION THERAPY COOLER,261.0,169.65,43.85,234.9,21
CDM,27025WE,FASCIOTOMY HIP/THIGH ANY TYPE,5156.0,3351.4,485.07,5156.0,35
CDM,27027WE,DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI,5216.0,3390.4,624.25,5216.0,35
CDM,27030WE,ARTHROTOMY HIP W/DRAINAGE,5460.0,3549.0,669.23,5460.0,35
CDM,27033WE,ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY,5644.0,3668.6,680.25,5644.0,35
CDM,27036WE,CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC,5752.0,3738.8,668.93,5752.0,35
CDM,27040WE,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,1168.0,759.2,96.0,876.0,35
CDM,27041WE,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,4072.0,2646.8,370.69,4072.0,35
CDM,27043WE,EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3+CM,2752.0,1788.8,257.95,2752.0,35
CDM,27045WE,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5+CM,4452.0,2893.8,410.61,4452.0,35
CDM,27047WE,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM,2174.0,1413.1,203.72,1630.5,35
CDM,27048WE,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM,3540.0,2301.0,301.36,3540.0,35
CDM,27049WE,RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM,8620.0,5603.0,626.85,8620.0,35
CDM,27054WE,ARTHROTOMY W/SYNOVECTOMY HIP JOINT,3684.0,2394.6,510.5,3684.0,35
CDM,27059WE,RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5+CM,11740.0,7631.0,1010.51,11740.0,35
CDM,27060WE,EXCISION ISCHIAL BURSA,2348.0,1526.2,254.7,2348.0,35
CDM,27062WE,EXCISION TROCHANTERIC BURSA/CALCIFICATION,2300.0,1495.0,274.32,2300.0,35
CDM,27066WE,EXCISION BONE CYST/BENIGN TUMOR DEEP,4480.0,2912.0,515.24,4480.0,35
CDM,27070WE,PARTIAL EXCISION SUPERFICIAL PELVIS,4624.0,3005.6,535.64,4624.0,35
CDM,27071WE,PARTIAL EXCISION DEEP PELVIS,5452.0,3543.8,593.66,5452.0,35
CDM,27075WE,RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL,13084.0,8504.6,1267.16,13084.0,35
CDM,27076WE,RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC,16084.0,10454.6,1223.15,16084.0,35
CDM,27080WE,COCCYGECTOMY PRIMARY,2756.0,1791.4,313.88,2756.0,35
CDM,27086WE,RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS,768.0,499.2,88.83,576.0,35
CDM,27087WE,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,3532.0,2295.8,351.19,3532.0,35
CDM,27090WE,REMOVAL OF HIP PROSTHESIS,4676.0,3039.4,560.55,4676.0,35
CDM,27091WE,RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA,9740.0,6331.0,1123.43,9740.0,35
CDM,27093WE,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,520.0,338.0,48.66,390.0,35
CDM,27095WE,INJECTION HIP ARTHROGRAPHY W/ANESTHESIA,600.0,390.0,54.58,450.0,35
CDM,27096WE,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,651.0,423.15,59.25,488.25,35
CDM,27098WE,ADDUCTOR TRANSFER TO ISCHIUM,4101.0,2665.65,458.19,4101.0,35
CDM,27100010,W CAN NASAL O2/CO2,32.0,20.8,5.38,28.8,21
CDM,27100020,W DEVICE INFLATION/LITHO 50620,659.0,428.35,110.71,593.1,21
CDM,27100030,W IMBL KNEE,18.0,11.7,3.02,16.2,21
CDM,27100040,W IMBL KNEE,26.0,16.9,4.37,23.4,21
CDM,27100050,W INFLATOR,126.0,81.9,21.17,113.4,21
CDM,27100060,W KT TRNSDU,43.0,27.95,7.22,38.7,21
CDM,27100070,W POST-OP SHOE,16.0,10.4,2.69,14.4,21
CDM,27100080,W POST-OP SHOE AS,9.0,5.85,1.51,8.1,21
CDM,27100090,W PROGRAMR PERS THERPY MGR 8835,1125.0,731.25,189.0,1012.5,21
CDM,27100100,W SLEEVE FLOWTRON KNEE DVT10,29.0,18.85,4.87,26.1,21
CDM,27100110,W SLEEVE FLOWTRON KNEE DVT20,46.0,29.9,7.73,41.4,21
CDM,27100120,W SLING VOGUE ARM W/STRAP,7.0,4.55,1.18,6.3,21
CDM,27100130,W SURG RADIO-LUCNT,55.0,35.75,9.24,49.5,21
CDM,27100140,W BOOT EXTRM ROOKE HFS,149.0,96.85,25.03,134.1,21
CDM,27100150,W HELMET PREFAB SOFT PROTECT,245.0,159.25,41.16,220.5,21
CDM,27100WE,TR XTRNL OBLQ MUSC TRCHNTR W/FSCAL/TDN XTN GRF,4540.0,2951.0,533.69,4540.0,35
CDM,27105WE,TR PARASPI MUSC HIP FASC/TDN XTN GRF,5298.0,3443.7,512.05,5298.0,35
CDM,27120WE,ACETABULOPLASTY,7700.0,5005.0,967.46,7700.0,35
CDM,27122WE,ACETABULOPLASTY RESECTION FEMORAL HEAD,6436.0,4183.4,813.38,6436.0,35
CDM,27125WE,HEMIARTHROPLASTY HIP PARTIAL,6656.0,4326.4,839.02,6656.0,35
CDM,27130WE,ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT,8624.0,5605.6,993.98,8624.0,35
CDM,27132WE,CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT,11304.0,7347.6,1261.35,11304.0,35
CDM,27134WE,REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT,13323.0,8659.95,1467.09,13323.0,35
CDM,27137WE,REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT,9988.0,6492.2,1132.11,9988.0,35
CDM,27138WE,REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT,10428.0,6778.2,1175.77,10428.0,35
CDM,27140WE,OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX,5112.0,3322.8,635.83,5112.0,35
CDM,27146WE,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE,7568.0,4919.2,762.57,7568.0,35
CDM,27151WE,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT,9648.0,6271.2,1095.52,9648.0,35
CDM,27158WE,OSTEOTOMY PELVIS BILAT,9258.0,6017.7,948.05,9258.0,35
CDM,27161WE,OSTEOTOMY FEMORAL NECK SEPARATE PROCEDURE,7156.0,4651.4,846.88,7156.0,35
CDM,27165WE,OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL,8116.0,5275.4,933.46,8116.0,35
CDM,27170WE,B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA,7044.0,4578.6,875.0,7044.0,35
CDM,27187WE,PROPH TX N/P/PLTWR W/WO MMA FEM NCK & PROX FEMUR,5692.0,3699.8,738.6,5692.0,35
CDM,27197WE,CLSD TX PELVIC RING FX W/O MANIPULATION,673.0,437.45,92.15,673.0,31
CDM,27198WE,CLSD TX PELVIC RING FX W/MANIPULATION W/ANES,2090.0,1358.5,237.4,2090.0,31
CDM,27200010,W ACCESS PORT KIT,893.0,580.45,150.02,803.7,21
CDM,27200020,W ACCESS SET 6F 20CM HVY GDWR J,114.0,74.1,19.15,102.6,21
CDM,27200030,W ACCESSORY PACK CYBX,773.0,502.45,129.86,695.7,21
CDM,27200040,W ACCS TESIO CTH EXTSN ST ARTRL,26.0,16.9,4.37,23.4,21
CDM,27200050,W ACHALASIA BALLOON,675.0,438.75,113.4,607.5,21
CDM,27200060,W ADAPTER HARMONIC HAND HS DISP,87.0,56.55,14.62,78.3,21
CDM,27200070,W ADAPTOR CATHETER,128.0,83.2,21.5,115.2,21
CDM,27200080,W ADHES DERMA,98.0,63.7,16.46,88.2,21
CDM,27200090,W ADHES DERMABOND,48.0,31.2,8.06,43.2,21
CDM,27200100,W ADHES DERMABOND,60.0,39.0,10.08,54.0,21
CDM,27200110,W ADPT & CAP,12.0,7.8,2.02,10.8,21
CDM,27200120,W ADVANCE CAPSULE DELIVERY DEV,149.0,96.85,25.03,134.1,21
CDM,27200130,W ANASTOMIC DEV,375.0,243.75,63.0,337.5,21
CDM,27200140,W ANCHOR DOUBLE LOADED SUTURE,388.0,252.2,65.18,349.2,21
CDM,27200150,W ANCHOR MICRO QA+ #4/0 ETH C-1,485.0,315.25,81.48,436.5,21
CDM,27200160,W ANTENNA RX EXTNL,140.0,91.0,23.52,126.0,21
CDM,27200170,W AORTC ARCH CAN,1069.0,694.85,179.59,962.1,21
CDM,27200180,W AORTC ROOT CANN,51.0,33.15,8.57,45.9,21
CDM,27200190,W APPL SCLP CLP,278.0,180.7,46.7,250.2,21
CDM,27200200,W APPLICATOR EXTENDED TIP,136.0,88.4,22.85,122.4,21
CDM,27200205,STRAIGHT TIP CATH,17.0,11.05,2.86,15.3,21
CDM,27200210,W APPLICATOR FLOSEAL 1500181,100.0,65.0,16.8,90.0,21
CDM,27200220,W ART/FEM CAN,89.0,57.85,14.95,80.1,21
CDM,27200226,OUTBACK ELITE RE-ENTRY CATH 5.9FR X 120CM,2741.0,1781.65,460.49,2466.9,21
CDM,27200230,W ARTHROWAND PROCISE EZ,338.0,219.7,56.78,304.2,21
CDM,27200236,INTRODUCER 9.5FR SAFESHEATH II,375.0,243.75,63.0,337.5,21
CDM,27200240,W ARTHROWAND REFLEX ULTRA 55,323.0,209.95,54.26,290.7,21
CDM,27200246,ACUITY PRO INNER CATH 7FR X 69CM,165.0,107.25,27.72,148.5,21
CDM,27200250,W ARTHROWAND SUPER TURBOVAC 3.5,270.0,175.5,45.36,243.0,21
CDM,27200260,W ARTHRWAND RFLX ULT 45 W/CABLE,238.0,154.7,39.98,214.2,21
CDM,27200266,"CUSTOM CATH PROCEDURE PACKS, LATEX FREE",628.0,408.2,105.5,565.2,21
CDM,27200270,W AS CDEEA-21/31,1384.0,899.6,232.51,1245.6,21
CDM,27200276,VERSACROSS ACCESS KIT SHEATH,1388.0,902.2,233.18,1249.2,21
CDM,27200280,W AS CLIP SKN,2.0,1.3,0.34,1.8,21
CDM,27200290,W PROTACK 5M AUTOSUTURE,603.0,391.95,101.3,542.7,21
CDM,27200300,W AS END GIA VASC,654.0,425.1,109.87,588.6,21
CDM,27200310,W AS END RTC DSCT,737.0,479.05,123.82,663.3,21
CDM,27200315,PERITONEAL TRANSFER SET,105.0,68.25,17.64,94.5,21
CDM,27200320,W AS ENDOGAUGE,57.0,37.05,9.58,51.3,21
CDM,27200330,W AS ENDOSTITCH,720.0,468.0,120.96,648.0,21
CDM,27200340,W AS GIA A/T,262.0,170.3,44.02,235.8,21
CDM,27200350,W AS GIA A/T,647.0,420.55,108.7,582.3,21
CDM,27200360,W AS GIA REFILL,282.0,183.3,47.38,253.8,21
CDM,27200370,W AS LDSXX A/T,505.0,328.25,84.84,454.5,21
CDM,27200380,W AS NDL TROCAR,340.0,221.0,57.12,306.0,21
CDM,27200390,W AS PFS-20W,347.0,225.55,58.3,312.3,21
CDM,27200400,W AS POLY CS-57,577.0,375.05,96.94,519.3,21
CDM,27200410,W AS PREM-12+12W,147.0,95.55,24.7,132.3,21
CDM,27200420,W AS STPL AUTO,646.0,419.9,108.53,581.4,21
CDM,27200430,W AS STPL END,1388.0,902.2,233.18,1249.2,21
CDM,27200440,W AS STPL ILS,556.0,361.4,93.41,500.4,21
CDM,27200450,W AS STPL RELD,226.0,146.9,37.97,203.4,21
CDM,27200460,W AS STPL RELD,360.0,234.0,60.48,324.0,21
CDM,27200470,W AS STPL RELD,527.0,342.55,88.54,474.3,21
CDM,27200480,W AS STPL RELD,645.0,419.25,108.36,580.5,21
CDM,27200490,W AS STPL RELD,784.0,509.6,131.71,705.6,21
CDM,27200500,W AS STPL SKN,124.0,80.6,20.83,111.6,21
CDM,27200510,W AS STPL TA30-90,370.0,240.5,62.16,333.0,21
CDM,27200520,W AS STPL/DV PS,256.0,166.4,43.01,230.4,21
CDM,27200530,W ASP KIT 3 HOLE STD,278.0,180.7,46.7,250.2,21
CDM,27200540,W ASSMB PUMP HND PC SCTN IRR 10,110.0,71.5,18.48,99.0,21
CDM,27200550,W AUTOTOME RX CANNULTNG SPHNCTR,318.0,206.7,53.42,286.2,21
CDM,27200560,W BALL TIP CANNULA,82.0,53.3,13.78,73.8,21
CDM,27200570,W BALL TIP PROBE 2.3MM,246.0,159.9,41.33,221.4,21
CDM,27200576,ASAHI CORSAIR PRO XS MICROCATHETER,825.0,536.25,138.6,742.5,21
CDM,27200580,W BALLOON CATH COOK G31236,543.0,352.95,91.22,488.7,21
CDM,27200590,W BALLOON CATH CRE FIXED WIRE,299.0,194.35,50.23,269.1,21
CDM,27200600,W BALLOON CATHETER 8FR,956.0,621.4,160.61,860.4,21
CDM,27200610,W BALLOON CATHETER WEDGE,68.0,44.2,11.42,61.2,21
CDM,27200620,W BALLOON PREPERITONEAL OMSPDBS,437.0,284.05,73.42,393.3,21
CDM,27200630,W BALLOON RETRIEVAL 450/460,138.0,89.7,23.18,124.2,21
CDM,27200640,W BALLOON RETRIEVAL 6930/6940,233.0,151.45,39.14,209.7,21
CDM,27200646,PRECLUDE SYNC DISTAL RADIAL COMPRESSION DEVICE,263.0,170.95,44.18,236.7,21
CDM,27200650,W BALLOON RETRIEVAL 900/910/920,228.0,148.2,38.3,205.2,21
CDM,27200656,DESTINATION SLENDER GUIDING SHEATH,426.0,276.9,71.57,383.4,21
CDM,27200660,W BALLOON SIZING,542.0,352.3,91.06,487.8,21
CDM,27200666,AGILIS SMALL AND MEDIUM CURL,1200.0,780.0,201.6,1080.0,21
CDM,27200670,W BALLOON SIZING HALO360,570.0,370.5,95.76,513.0,21
CDM,27200680,W BALLOON SPRPUB PERC RUTNER,63.0,40.95,10.58,56.7,21
CDM,27200690,W BAR SKIN 4X4,9.0,5.85,1.51,8.1,21
CDM,27200700,W BAR SKIN 6X6,11.0,7.15,1.85,9.9,21
CDM,27200710,W BARS ARCH,15.0,9.75,2.52,13.5,21
CDM,27200720,W BASKET AIRWAY RETRIEVAL,353.0,229.45,59.3,317.7,21
CDM,27200730,W BASKET AIRWAY RETRIEVAL,374.0,243.1,62.83,336.6,21
CDM,27200740,W BASKET STONE RETRIEVAL,256.0,166.4,43.01,230.4,21
CDM,27200750,W BASKET STONE RETRIEVAL,368.0,239.2,61.82,331.2,21
CDM,27200760,W BASKET STONE SEGURA,342.0,222.3,57.46,307.8,21
CDM,27200770,W BASKET TRAPEZOID,405.0,263.25,68.04,364.5,21
CDM,27200780,W BATTRY LITH SINGLE USE STERIL,66.0,42.9,11.09,59.4,21
CDM,27200790,W BG DRN URO,56.0,36.4,9.41,50.4,21
CDM,27200800,W BG INCNT,156.0,101.4,26.21,140.4,21
CDM,27200810,W BG INTESTINE,37.0,24.05,6.22,33.3,21
CDM,27200820,W BG URETERAL DRN,65.0,42.25,10.92,58.5,21
CDM,27200830,W BG URINE DRN,14.0,9.1,2.35,12.6,21
CDM,27200836,PRELUDE IDEAL HYDROPHILIC SHEATH,380.0,247.0,63.84,342.0,21
CDM,27200840,W BG URINE METER,52.0,33.8,8.74,46.8,21
CDM,27200846,FOGARTY THRU-LUMEN EMBOLECTOMY CATHETER,128.0,83.2,21.5,115.2,21
CDM,27200850,W CANN ERCP .018IN GW 5-4-3 TIP,83.0,53.95,13.94,74.7,21
CDM,27200860,W BIO PUMP PERFUSION,293.0,190.45,49.22,263.7,21
CDM,27200870,W BIOPSY FORCEPS,257.0,167.05,43.18,231.3,21
CDM,27200880,W BIOPSY INSTRMNT BIOPINCE FULL,79.0,51.35,13.27,71.1,21
CDM,27200890,W BIOPSY SET ACKERMANN,358.0,232.7,60.14,322.2,21
CDM,27200900,W BIT DRILL 14MM,495.0,321.75,83.16,445.5,21
CDM,27200910,W BIT DRILL 2.5MM,104.0,67.6,17.47,93.6,21
CDM,27200920,W BIT DRILL QUICK 4.3X180MM,217.0,141.05,36.46,195.3,21
CDM,27200930,W BIT DRILL WRIGHT 2MM,248.0,161.2,41.66,223.2,21
CDM,27200940,W BIT MILLING HXC-STERILE,623.0,404.95,104.66,560.7,21
CDM,27200950,W BKGRND YELLOW,19.0,12.35,3.19,17.1,21
CDM,27200960,W BLADE 18-84016 RAD60 XTR 4.0,231.0,150.15,38.81,207.9,21
CDM,27200970,W BLADE ARTHRO,328.0,213.2,55.1,295.2,21
CDM,27200980,W BLADE BEAVER,4.0,2.6,0.67,3.6,21
CDM,27200990,W BLADE CRANIO,143.0,92.95,24.02,128.7,21
CDM,27200WE,CLOSED TREATMENT COCCYGEAL FRACTURE,768.0,499.2,93.04,576.0,32
CDM,27201000,W BLADE DUAL CUT SAGITTAL,94.0,61.1,15.79,84.6,21
CDM,27201010,W BLADE HARMONIC CRVD SNG CB,408.0,265.2,68.54,367.2,21
CDM,27201020,W BLADE HELICAL 456.305,927.0,602.55,155.74,834.3,21
CDM,27201030,W BLADE INFROR TURBINATE 2.9MM,228.0,148.2,38.3,205.2,21
CDM,27201040,W BLADE NARROW LONG,57.0,37.05,9.58,51.3,21
CDM,27201050,W BLADE OSCILLATING/SAGITL SAW,57.0,37.05,9.58,51.3,21
CDM,27201056,OCTARAY MAPPING CATHETER,2928.0,1903.2,491.9,2635.2,21
CDM,27201060,W BLADE OSCILLATNG/SAGITTAL SAW,57.0,37.05,9.58,51.3,21
CDM,27201066,FLEXNAV DELIVERY SYSTEM SM,2025.0,1316.25,340.2,1822.5,21
CDM,27201070,W BLADE PARALLEL GRFT KNIFE 11M,76.0,49.4,12.77,68.4,21
CDM,27201076,FLEXNAV LOADING SYSTEM SM,750.0,487.5,126.0,675.0,21
CDM,27201080,W BLADE PRO ACCESS 25X100MM,458.0,297.7,76.94,412.2,21
CDM,27201090,W BLADE RAD/TRICUT,220.0,143.0,36.96,198.0,21
CDM,27201100,W BLADE RCPRCTNG OFFSET HVY DTY,69.0,44.85,11.59,62.1,21
CDM,27201110,W BLADE RECIPROCATING 12.5MM,216.0,140.4,36.29,194.4,21
CDM,27201120,W BLADE SAGGITAL SYSTM 6,79.0,51.35,13.27,71.1,21
CDM,27201126,RIGHTSITE FIXED SHAPE CATHETER,528.0,343.2,88.7,475.2,21
CDM,27201130,W BLADE SAW OSCILLATING TIP STR,225.0,146.25,37.8,202.5,21
CDM,27201140,W BLADE SAW SAGITTAL 18/25,74.0,48.1,12.43,66.6,21
CDM,27201150,W BLADE SAW SAGITTAL 22TPI,55.0,35.75,9.24,49.5,21
CDM,27201160,W BLADE SAW STRY 2000 STL GRP22,139.0,90.35,23.35,125.1,21
CDM,27201170,W BLADE SKIMMER 18CM X 3.5MM,504.0,327.6,84.67,453.6,21
CDM,27201176,EVOLUT LOADING SYSTEM,585.0,380.25,98.28,526.5,21
CDM,27201180,W BLADE STERNOTOMY REPEAT,149.0,96.85,25.03,134.1,21
CDM,27201186,Z-MED II BALLOON CATH,1060.0,689.0,178.08,954.0,21
CDM,27201190,W BLADE SUBGLOTTIC SKIMER 3.5MM,701.0,455.65,117.77,630.9,21
CDM,27201196,MULTI-TRACK ANGIOGRAPHIC CATHETER,92.0,59.8,15.46,82.8,21
CDM,27201200,W BLADE TREPHINE BARRON 7.5MM,124.0,80.6,20.83,111.6,21
CDM,27201206,ENSEMBLE II TRANSCATHETER VALVE DELIVERY SYSTEM,8775.0,5703.75,1474.2,7897.5,21
CDM,27201210,W BLADE TREPHINE BARRON 7MM,119.0,77.35,19.99,107.1,21
CDM,27201220,W BLADE TREPHINE BARRON RAD 8MM,112.0,72.8,18.82,100.8,21
CDM,27201230,W BLADE TYMPANAPLASTY,74.0,48.1,12.43,66.6,21
CDM,27201240,W BLADELESS CANN XCEL ENDOPATH,67.0,43.55,11.26,60.3,21
CDM,27201250,W BLADES INFERIOR BORDER,368.0,239.2,61.82,331.2,21
CDM,27201260,W BLD ARTHR CUT/T,85.0,55.25,14.28,76.5,21
CDM,27201270,W BLD ARTHRO CUT,235.0,152.75,39.48,211.5,21
CDM,27201530,W BLOCK NERVE CONTINUOUS SET,144.0,93.6,24.19,129.6,21
CDM,27201546,PERIPHERAL CATH SHOCKWAVE IVL,4658.0,3027.7,782.54,4192.2,21
CDM,27201556,ARROWGUARD BLUE PLUS CATHETER,204.0,132.6,34.27,183.6,21
CDM,27201566,GUIDEWIRE TORAY GUIDE,270.0,175.5,45.36,243.0,21
CDM,27201570,W BONE TIP CLAW,599.0,389.35,100.63,539.1,21
CDM,27201576,PERCLOSE PROSTYLE SUTURE REPAIR SYSTEM,320.0,208.0,53.76,288.0,21
CDM,27201580,W BOOT SUTURE,14.0,9.1,2.35,12.6,21
CDM,27201586,CRYOABLATION ELECTRICAL UMBILICAL,315.0,204.75,52.92,283.5,21
CDM,27201590,W BRONCH CATH ENDOBRONCH TUBE,88.0,57.2,14.78,79.2,21
CDM,27201596,SHEATH DILATOR FIXED CURVE DOUBLE,1350.0,877.5,226.8,1215.0,21
CDM,27201600,W BRSH BRONCHIAL,124.0,80.6,20.83,111.6,21
CDM,27201606,MEGA CATH IAB STATLOCK KIT,1275.0,828.75,214.2,1147.5,21
CDM,27201610,W BRUSH RX CYTOLOGY,156.0,101.4,26.21,140.4,21
CDM,27201620,W BRUSH RX CYTOLOGY,181.0,117.65,30.41,162.9,21
CDM,27201630,W BSK STONE,589.0,382.85,98.95,530.1,21
CDM,27201640,W BSK STONE RETRV,413.0,268.45,69.38,371.7,21
CDM,27201650,W BULLDOG LEAD EXTENDER,249.0,161.85,41.83,224.1,21
CDM,27201660,W BUR ABRADER 4MM,57.0,37.05,9.58,51.3,21
CDM,27201670,W BUR BARREL 12 FLUTE STR,91.0,59.15,15.29,81.9,21
CDM,27201680,W BUR DIAMOND,175.0,113.75,29.4,157.5,21
CDM,27201690,W BUR DIAMOND ATTAC ANGLD 1.5MM,125.0,81.25,21.0,112.5,21
CDM,27201700,W BUR FLUT BALL STD 5MM,125.0,81.25,21.0,112.5,21
CDM,27201710,W BUR HI-SPEED RAD FRONTL 3MM,120.0,78.0,20.16,108.0,21
CDM,27201720,W BUR LINDEMANN,111.0,72.15,18.65,99.9,21
CDM,27201730,W BUR MATCH HD DIAM MIDAS 2.5MM,141.0,91.65,23.69,126.9,21
CDM,27201740,W BUR MATCH HD TUBE MIDAS 2.5MM,124.0,80.6,20.83,111.6,21
CDM,27201750,W BUR MICRO EGG 4MM SS,97.0,63.05,16.3,87.3,21
CDM,27201760,W TOOL DISECT 90MM,141.0,91.65,23.69,126.9,21
CDM,27201770,W BUR MIDAS REX,129.0,83.85,21.67,116.1,21
CDM,27201780,W BUR OVAL 4.0X69,111.0,72.15,18.65,99.9,21
CDM,27201790,W BUR ROUND 3-0MM,91.0,59.15,15.29,81.9,21
CDM,27201800,W BUR ROUND 5.0,390.0,253.5,65.52,351.0,21
CDM,27201810,W BUR ROUND FLUTED MED 3.5MM,165.0,107.25,27.72,148.5,21
CDM,27201816,W CATH EP FJ WEBSTER DEFL,262.0,170.3,44.02,235.8,21
CDM,27201820,W BUR ROUND FLUTED MED 4.0MM,123.0,79.95,20.66,110.7,21
CDM,27201830,W BUR ROUTER TAPR MIDS 16X2.2MM,108.0,70.2,18.14,97.2,21
CDM,27201840,W BUR STRY 5120-10-30 3.0ROUND,126.0,81.9,21.17,113.4,21
CDM,27201850,W BUR TAPER MIDAS 8CM X 2.3MM,105.0,68.25,17.64,94.5,21
CDM,27201860,W BUR TAPR MIDAS 8CMX1.1MM,94.0,61.1,15.79,84.6,21
CDM,27201870,W BURR 5MM FLUTED BALL CUTTING,124.0,80.6,20.83,111.6,21
CDM,27201886,PTS SIZING BALLOON CATHETER,406.0,263.9,68.21,365.4,21
CDM,27201890,W BURR CVD DIAMOND DCR 2.9MM,308.0,200.2,51.74,277.2,21
CDM,27201896,DRYSEAL FLEX INTRODUCER SHEATH,269.0,174.85,45.19,242.1,21
CDM,27201900,W BURR DIAMOND,329.0,213.85,55.27,296.1,21
CDM,27201906,Z-MED II 7 ATM BALLOON CATH,744.0,483.6,124.99,669.6,21
CDM,27201910,W BURR HEAD MIDAS LGND TL TIP,143.0,92.95,24.02,128.7,21
CDM,27201920,W BURR HI-SPEED ROUND 3.2MM,336.0,218.4,56.45,302.4,21
CDM,27201926,INFINITI ANGION CATH JL3,68.0,44.2,11.42,61.2,21
CDM,27201930,W BURR HOLE COVER,317.0,206.05,53.26,285.3,21
CDM,27201940,W BURR MIDAS LEGEND DIAMND BALL,233.0,151.45,39.14,209.7,21
CDM,27201950,W BURR ROUND 2.0MM,158.0,102.7,26.54,142.2,21
CDM,27201960,W BURR STRYKR,235.0,152.75,39.48,211.5,21
CDM,27201966,CATH 7FR 110CM MERIT THERMO CATH,140.0,91.0,23.52,126.0,21
CDM,27201970,W BURR TYPE I,275.0,178.75,46.2,247.5,21
CDM,27201976,CATH 4-LUMEN 7FR 110CM,221.0,143.65,37.13,198.9,21
CDM,27201980,W BUTTON GASTRO 18FR 2.4-3.4 CM,200.0,130.0,33.6,180.0,21
CDM,27201990,W BX FORCEPS,1031.0,670.15,173.21,927.9,21
CDM,27202000,W BX FRCP FB24,2641.0,1716.65,443.69,2376.9,21
CDM,27202010,W BX THERM JAW HT,434.0,282.1,72.91,390.6,21
CDM,27202020,W CABLE ACCESS SJ4 LEAD,89.0,57.85,14.95,80.1,21
CDM,27202030,W CABLE ADPTR PACEL BPLR PACING,58.0,37.7,9.74,52.2,21
CDM,27202040,W CABLE DX RADIA BIDIRECTIONAL,104.0,67.6,17.47,93.6,21
CDM,27202050,W CABLE ELECTRODE EASYMATE,149.0,96.85,25.03,134.1,21
CDM,27202060,W CABLE EXT DOPPLER FLOW PROBE,152.0,98.8,25.54,136.8,21
CDM,27202066,OPTICROSS IVUS HD 60MHZ CATH,1088.0,707.2,182.78,979.2,21
CDM,27202070,W CABLE HF CONNECT 3M 10FT,97.0,63.05,16.3,87.3,21
CDM,27202076,AMPLATZ SS ST GUIDEWIRE,332.0,215.8,55.78,298.8,21
CDM,27202080,W CABLE HYPRTRNICS CARTO 3 10FT,140.0,91.0,23.52,126.0,21
CDM,27202090,W CABLE INTERFACE NAVISTAR,135.0,87.75,22.68,121.5,21
CDM,27202100,W CABLE RSPNSE EXTN RFLXN CATH,193.0,125.45,32.42,173.7,21
CDM,27202106,ST JUDE LEAD CAP,63.0,40.95,10.58,56.7,21
CDM,27202110,W CABLE SET SS 1.6,615.0,399.75,103.32,553.5,21
CDM,27202120,W CABLE SMALL CLIP SAFE CONNECT,24.0,15.6,4.03,21.6,21
CDM,27202130,W CABLE SURELINK EXTN 10 PIN,413.0,268.45,69.38,371.7,21
CDM,27202136,HEMOSTAT SURGICEL,165.0,107.25,27.72,148.5,21
CDM,27202140,W CABLES RESPONSE CATH,165.0,107.25,27.72,148.5,21
CDM,27202150,W CANISTER AC W/GEL ATS 500ML,71.0,46.15,11.93,63.9,21
CDM,27202160,W CANN ANT CHMBR,44.0,28.6,7.39,39.6,21
CDM,27202170,W CANN SEAL,36.0,23.4,6.05,32.4,21
CDM,27202180,W CANNULA AO SOFT FLOW 21/24FR,52.0,33.8,8.74,46.8,21
CDM,27202190,W CANNULA ART PERC 16/18/20 FR,316.0,205.4,53.09,284.4,21
CDM,27202196,TRIEVER24 THROMBECTOMY CATHETER,13500.0,8775.0,2268.0,12150.0,21
CDM,27202200,W CANNULA BALL TIP TANDEM ERCP,110.0,71.5,18.48,99.0,21
CDM,27202210,W CANNULA BALLOON CORONARY,525.0,341.25,88.2,472.5,21
CDM,27202220,W CANNULA CORONARY SNUS PERF,134.0,87.1,22.51,120.6,21
CDM,27202230,W CANNULA DUAL DUPLOTIP,92.0,59.8,15.46,82.8,21
CDM,27202236,150CM CONNECTING CABLE 10-PIN,132.0,85.8,22.18,118.8,21
CDM,27202240,W CANNULA ENDOPATH XCEL STBILTY,52.0,33.8,8.74,46.8,21
CDM,27202250,W CANNULA FEM-FLEX FEM VENOUS,418.0,271.7,70.22,376.2,21
CDM,27202270,W CANNULA RAPID ERCP,88.0,57.2,14.78,79.2,21
CDM,27202280,W CANNULA RETROGRADE CRN SINUS,158.0,102.7,26.54,142.2,21
CDM,27202290,W CANNULA SGL VEN RT ANG 24/28F,64.0,41.6,10.75,57.6,21
CDM,27202300,W CANNULA SHORT TERM SZ 6,167.0,108.55,28.06,150.3,21
CDM,27202310,W CANNULA SINGLE VEN 24/28FR,58.0,37.7,9.74,52.2,21
CDM,27202320,W CANNULA SINUS PERFUSION 15FR,1350.0,877.5,226.8,1215.0,21
CDM,27202330,W CANNULA STRAIGHT 3/8 X 3/8,79.0,51.35,13.27,71.1,21
CDM,27202340,W CANNULA TANDEM 5.5FRX1.8MM,104.0,67.6,17.47,93.6,21
CDM,27202350,W CANNULA VERASPORT 5-12MM,64.0,41.6,10.75,57.6,21
CDM,27202360,W CAP HALO,56.0,36.4,9.41,50.4,21
CDM,27202370,W CAP LOCKING PROTEX,867.0,563.55,145.66,780.3,21
CDM,27202380,W CAPSULE PILLCAM SB2,675.0,438.75,113.4,607.5,21
CDM,27202390,W CARD VERIQ SINGLE USE FULL,449.0,291.85,75.43,404.1,21
CDM,27202400,W CART 50 Q-RING,1908.0,1240.2,320.54,1717.2,21
CDM,27202410,W CARTG 10 Q-RING,613.0,398.45,102.98,551.7,21
CDM,27202420,W CATH DRNG 10FR/14FR 25CM,175.0,113.75,29.4,157.5,21
CDM,27202430,W CATH 12FR TAPERED 2 EYELETS,23.0,14.95,3.86,20.7,21
CDM,27202440,W CATH 14.0FR ULTRATHANE,107.0,69.55,17.98,96.3,21
CDM,27202450,W CATH DRNG 12FR/14FR 25CM,128.0,83.2,21.5,115.2,21
CDM,27202460,W CATH 150CM SUPRM EP EXTN,49.0,31.85,8.23,44.1,21
CDM,27202470,W CATH 16FR TAPERED 2 EYELETS,21.0,13.65,3.53,18.9,21
CDM,27202480,W CATH GLIDECATH 4/5FR,91.0,59.15,15.29,81.9,21
CDM,27202490,W CATH DRNG 6FR 25CM,170.0,110.5,28.56,153.0,21
CDM,27202500,W CATH 7FR DUAL F/TRAY V-CUFF,357.0,232.05,59.98,321.3,21
CDM,27202510,W CATH ABL NAV DS,2565.0,1667.25,430.92,2308.5,21
CDM,27202520,W CATH ABLATION ESOPH,1944.0,1263.6,326.59,1749.6,21
CDM,27202530,W CATH ABLATION ESOPH HALO360 +,1544.0,1003.6,259.39,1389.6,21
CDM,27202540,W CATH ABLATION HALO-90,1539.0,1000.35,258.55,1385.1,21
CDM,27202550,W CATH ABLTN CELSIUS 7FR 115CM,921.0,598.65,154.73,828.9,21
CDM,27202560,W CATH ACUNAV ULTRASOUND,1519.0,987.35,255.19,1367.1,21
CDM,27202570,W CATH ANG SURPAS,912.0,592.8,153.22,820.8,21
CDM,27202580,W CATH ANG TRNSLU,668.0,434.2,112.22,601.2,21
CDM,27202600,W CATH ANGIO XFEEDER 120CM,1448.0,941.2,243.26,1303.2,21
CDM,27202610,W CATH ANGIOJET AVX 50CM,675.0,438.75,113.4,607.5,21
CDM,27202620,W CATH ANGIOJET DVX 90CM,1573.0,1022.45,264.26,1415.7,21
CDM,27202626,6FR X 10CM GLIDESHEATH SLENDER SHEATH ACCESS KIT,154.0,100.1,25.87,138.6,21
CDM,27202630,W CATH ANGIOSCULPT OTW 2-3.5MM,1275.0,828.75,214.2,1147.5,21
CDM,27202636,.018IN X 300CM GLIDEWIRE ADVANTAGE GDWR,330.0,214.5,55.44,297.0,21
CDM,27202640,W CATH ANGIOSCULPT OTW 4-5.0MM,1463.0,950.95,245.78,1316.7,21
CDM,27202650,W CATH ART DILBAL,2321.0,1508.65,389.93,2088.9,21
CDM,27202656,WORLEY HEMOSTATIC SAFESHEATH 9FR X 40CM,450.0,292.5,75.6,405.0,21
CDM,27202660,W CATH ARTHCTMY,1893.0,1230.45,318.02,1703.7,21
CDM,27202666,OPTITORQUE CATHETER 6FR X 110CM,293.0,190.45,49.22,263.7,21
CDM,27202670,W CATH ASPIRATION COR VSL FETCH,488.0,317.2,81.98,439.2,21
CDM,27202676,SHEATH INTRODUCER SET 8 FR,524.0,340.6,88.03,471.6,21
CDM,27202680,W CATH ATHERECTMY,213.0,138.45,35.78,191.7,21
CDM,27202686,OSCOR VV-PLUG PORT,116.0,75.4,19.49,104.4,21
CDM,27202690,W CATH ATHR TRANSLUM DIREC,2095.0,1361.75,351.96,1885.5,21
CDM,27202700,W CATH ATLANTS SR,1812.0,1177.8,304.42,1630.8,21
CDM,27202710,W CATH BACTISEAL PERITONEAL,457.0,297.05,76.78,411.3,21
CDM,27202720,W CATH BAL TEMP P,85.0,55.25,14.28,76.5,21
CDM,27202730,W CATH BALLN 135CM ULTRA THIN,249.0,161.85,41.83,224.1,21
CDM,27202740,W CATH BALLN 5.8 FR XXL,401.0,260.65,67.37,360.9,21
CDM,27202750,W CATH BALLN 75CM SHFT PROFILR,245.0,159.25,41.16,220.5,21
CDM,27202760,W CATH BALLN 90CM SYMTRY GLDX,263.0,170.95,44.18,236.7,21
CDM,27202770,W CATH BALLN AVIATOR PLUS,330.0,214.5,55.44,297.0,21
CDM,27202776,ACCU-VU DIAGNOSTIC CATHETER 5FR X 100CM,183.0,118.95,30.74,164.7,21
CDM,27202780,W CATH BALLN CONQST 75CM SHFT,273.0,177.45,45.86,245.7,21
CDM,27202786,ARROW MULTI-LUMEN CVC KIT 7FR X 20CM,204.0,132.6,34.27,183.6,21
CDM,27202790,W CATH BALLN DORADO 12-20CM PTA,353.0,229.45,59.3,317.7,21
CDM,27202796,M-CATH MICROCATHETER 135CM,750.0,487.5,126.0,675.0,21
CDM,27202800,W CATH BALLN DORADO 2-10CM PTA,260.0,169.0,43.68,234.0,21
CDM,27202810,W CATH BALLN POWERSAIL/VOYAGER,236.0,153.4,39.65,212.4,21
CDM,27202820,W CATH BALLN RELIANT STNT GRAFT,375.0,243.75,63.0,337.5,21
CDM,27202826,DF CURVE OPTRELL MAPPING CATHETER,2928.0,1903.2,491.9,2635.2,21
CDM,27202830,W CATH BALLN SPRINTER OTW,240.0,156.0,40.32,216.0,21
CDM,27202836,PACK SURG PACEMAKER,175.0,113.75,29.4,157.5,21
CDM,27202840,W CATH BALLN ULTRA THIN DIAMOND,236.0,153.4,39.65,212.4,21
CDM,27202846,ASAHI PROWATER PTCA GUIDEWIRE .014 X 180CM,525.0,341.25,88.2,472.5,21
CDM,27202850,W CATH BALLN ULTRA2 MONORAIL,1088.0,707.2,182.78,979.2,21
CDM,27202860,W CATH BALLN VIATRAC 14 PLUS,330.0,214.5,55.44,297.0,21
CDM,27202870,W CATH BALLN XXL 5.8 FR 75CM,300.0,195.0,50.4,270.0,21
CDM,27202876,ROC RADIAL BAND,375.0,243.75,63.0,337.5,21
CDM,27202880,W CATH BALLOON FOX PLUS PTA,193.0,125.45,32.42,173.7,21
CDM,27202886,SAFARI2 GUIDEWIRE 035IN X 275CM,413.0,268.45,69.38,371.7,21
CDM,27202890,W CATH BALLOON MAV/NC/QUA,255.0,165.75,42.84,229.5,21
CDM,27202900,W CATH BALLOON POWERFLEX P3 PTA,193.0,125.45,32.42,173.7,21
CDM,27202910,W CATH BALLOON ULTRAVERSE PTA,263.0,170.95,44.18,236.7,21
CDM,27202920,W CATH BALOON SV,284.0,184.6,47.71,255.6,21
CDM,27202930,W CATH BIL,164.0,106.6,27.55,147.6,21
CDM,27202940,W CATH BIL,462.0,300.3,77.62,415.8,21
CDM,27202950,W CATH BIL DRN,405.0,263.25,68.04,364.5,21
CDM,27202960,W CATH BILI BALLOON DIL RETRV,228.0,148.2,38.3,205.2,21
CDM,27202970,W CATH BILI DIL,782.0,508.3,131.38,703.8,21
CDM,27202980,W CATH BLLN 0.035IN 6X60MM 80CM,61.0,39.65,10.25,54.9,21
CDM,27202990,W CATH BLLN 120CM SAVVY PTA,375.0,243.75,63.0,337.5,21
CDM,27202996,NAMIC LEFT HEART KIT,132.0,85.8,22.18,118.8,21
CDM,27203000,W CATH BLLN 135/150 SYMTRY GLDX,263.0,170.95,44.18,236.7,21
CDM,27203006,VSI MICRO-INTRODUCER KIT 5FR X 40CM,64.0,41.6,10.75,57.6,21
CDM,27203010,W CATH BLLN ANGIOSCULPT 40MMOTW,1418.0,921.7,238.22,1276.2,21
CDM,27203016,SUPER TORQUE PLUS CATHETER 5FR X 125CM,75.0,48.75,12.6,67.5,21
CDM,27203020,W CATH BLLN HYPERFORM 7MMX150CM,1755.0,1140.75,294.84,1579.5,21
CDM,27203030,W CATH BLLN LUMEN BRNSTN OCCLSN,357.0,232.05,59.98,321.3,21
CDM,27203040,W CATH BLLN NC STORMER MX2,240.0,156.0,40.32,216.0,21
CDM,27203050,W CATH BLLN OCCLUSION 10FX35CM,543.0,352.95,91.22,488.7,21
CDM,27203060,W CATH BLLN SAVVY LONG PTA,338.0,219.7,56.78,304.2,21
CDM,27203070,W CATH BLLN SLEEK RX PTA,450.0,292.5,75.6,405.0,21
CDM,27203080,W CATH BLLN SYNERGY,236.0,153.4,39.65,212.4,21
CDM,27203090,W CATH BLLN TORNUS OTW TRNSLMNL,1043.0,677.95,175.22,938.7,21
CDM,27203096,BOTOX CHEMODEVERVATION NEEDLE,95.38,62.0,16.02,85.84,21
CDM,27203100,W CATH BLN,1412.0,917.8,237.22,1270.8,21
CDM,27203110,W CATH BLN ATLAS PTA 12MM/14MM,375.0,243.75,63.0,337.5,21
CDM,27203120,W CATH BLN ATLAS PTA 16MM/18MM,420.0,273.0,70.56,378.0,21
CDM,27203126,CATH LAB PACK,267.0,173.55,44.86,240.3,21
CDM,27203130,W CATH BLN DIL,294.0,191.1,49.39,264.6,21
CDM,27203140,W CATH BLN DIL,656.0,426.4,110.21,590.4,21
CDM,27203150,W CATH BLN DIL GD,508.0,330.2,85.34,457.2,21
CDM,27203160,W CATH BLN DIL GUID CRE,263.0,170.95,44.18,236.7,21
CDM,27203166,ROTAGLIDE PERIPHERAL LUBRICANT,155.0,100.75,26.04,139.5,21
CDM,27203170,W CATH BLN MARSHL,880.0,572.0,147.84,792.0,21
CDM,27203180,W CATH BLN OB/GYN,1319.0,857.35,221.59,1187.1,21
CDM,27203186,"BI-D IRRIGATED ABLATION CATHETER, 115CM, SIZE 8",5130.0,3334.5,861.84,4617.0,21
CDM,27203190,W CATH BLN PCC 10F 35MM 120/40,603.0,391.95,101.3,542.7,21
CDM,27203196,ENSITE X EP SYSTEM CATHETER CONNESTOR CABLE,600.0,390.0,100.8,540.0,21
CDM,27203200,W CATH BLN URO 18FR KIT 225122,506.0,328.9,85.01,455.4,21
CDM,27203210,W CATH BLN UROMAS ULTRA,458.0,297.7,76.94,412.2,21
CDM,27203220,W CATH BLN UROMAX,901.0,585.65,151.37,810.9,21
CDM,27203226,ENSITE X EP SYSTEM SENSOR ENABLED DIAG CATH CABLE,675.0,438.75,113.4,607.5,21
CDM,27203230,W CATH BRAID TIP,1200.0,780.0,201.6,1080.0,21
CDM,27203236,PULMONARY WEDGE PRESSURE MONITOR CATH 7FRX110CM,119.0,77.35,19.99,107.1,21
CDM,27203240,W CATH BRONCH ASP,3.0,1.95,0.5,2.7,21
CDM,27203250,W CATH CARD CON Y,16.0,10.4,2.69,14.4,21
CDM,27203260,W CATH CARD PERI,26.0,16.9,4.37,23.4,21
CDM,27203266,VISTA BRITE TIP 6FR X 125CM X 0.070IN,241.0,156.65,40.49,216.9,21
CDM,27203270,W CATH CEREBRAL,159.0,103.35,26.71,143.1,21
CDM,27203276,SWAN-GANZ OXIMETRY THERMODILUTION CATH 7.5FRX110CM,278.0,180.7,46.7,250.2,21
CDM,27203280,W CATH CHOLNG,158.0,102.7,26.54,142.2,21
CDM,27203290,W CATH CLOSURE,2228.0,1448.2,374.3,2005.2,21
CDM,27203300,W CATH CNTRL VEIN,85.0,55.25,14.28,76.5,21
CDM,27203310,W CATH CONNECTOR,41.0,26.65,6.89,36.9,21
CDM,27203316,CATH LAB BIOPSY RIGHT HEART PK,136.0,88.4,22.85,122.4,21
CDM,27203320,W CATH CONNECTOR,158.0,102.7,26.54,142.2,21
CDM,27203330,W CATH COOK,167.0,108.55,28.06,150.3,21
CDM,27203340,W CATH COPE LOOP,560.0,364.0,94.08,504.0,21
CDM,27203350,W CATH CORONRY SPRT ANG STEWARD,488.0,317.2,81.98,439.2,21
CDM,27203360,W CATH COUDE ALL,83.0,53.95,13.94,74.7,21
CDM,27203370,W CATH CPS LUMINARY LARGE CURL,1235.0,802.75,207.48,1111.5,21
CDM,27203380,W CATH CROSSER CTO,2261.0,1469.65,379.85,2034.9,21
CDM,27203390,W CATH CYSTC DUCT,49.0,31.85,8.23,44.1,21
CDM,27203400,W CATH CYSTO,208.0,135.2,34.94,187.2,21
CDM,27203410,W CATH DBLE LUMEN,129.0,83.85,21.67,116.1,21
CDM,27203416,CPS AIM SL SLITTABLE INNER GUIDING SHEATH CATH 65CM,257.0,167.05,43.18,231.3,21
CDM,27203420,W CATH DIAG STEERABLE ORBITER,1190.0,773.5,199.92,1071.0,21
CDM,27203426,NAVICROSS SUPPORT GUIDING CATH 150CM,293.0,190.45,49.22,263.7,21
CDM,27203430,W CATH DIAMONDBACK ATHRCTMY,3773.0,2452.45,633.86,3395.7,21
CDM,27203436,"VISTA BRITE TIP GUIDING CATHETER, AMPLATZ LT CORONARY 6FRX100CM",65.0,42.25,10.92,58.5,21
CDM,27203440,W CATH DIL,468.0,304.2,78.62,421.2,21
CDM,27203446,COMPATIBLE STEADYSHEATH EVOLUTION TISSUE STABILIZATION SHEATH 11,439.0,285.35,73.75,395.1,21
CDM,27203450,W CATH DIL BALLOON PTA RIVAL,193.0,125.45,32.42,173.7,21
CDM,27203456,"EVOLUTION RL CONTROLLED-ROTATION DILATOR SHEATH SET, LEAD EXTRAC",2358.0,1532.7,396.14,2122.2,21
CDM,27203460,W CATH DIL BLN,1977.0,1285.05,332.14,1779.3,21
CDM,27203466,"EVOLUTION SHORTIE RL CONTROLLED-ROTATIONAL DILATOR SHEATH SET, L",1885.0,1225.25,316.68,1696.5,21
CDM,27203470,W CATH DIL C RX,912.0,592.8,153.22,820.8,21
CDM,27203476,COMPATIBLE STEADYSHEATH EVOLUTION SHORTIE TISSUE STABILIZATION S,395.0,256.75,66.36,355.5,21
CDM,27203480,W CATH DILATION SOEHENDRA,89.0,57.85,14.95,80.1,21
CDM,27203486,"ONE-TIE COMPRESSION COIL, LEAD EXTRACTION",324.0,210.6,54.43,291.6,21
CDM,27203490,W CATH DRAIN PIG LK 10F 25CM,133.0,86.45,22.34,119.7,21
CDM,27203496,"PLASMABLADE X 3.0SL, PINK",413.0,268.45,69.38,371.7,21
CDM,27203500,W CATH DRAINAGE EXODUS BILIARY,131.0,85.15,22.01,117.9,21
CDM,27203506,LEAD EXTRACTION CURVED INNER FEMORAL SHEATH 12FR,349.0,226.85,58.63,314.1,21
CDM,27203510,W CATH DRAINAGE SKATER,100.0,65.0,16.8,90.0,21
CDM,27203516,"CPS COURIER GUIDEWIRE, MED 195CM X 0.014IN",158.0,102.7,26.54,142.2,21
CDM,27203520,W CATH DRN CHAIT PERC CECOSTMY,225.0,146.25,37.8,202.5,21
CDM,27203526,LEAD EXTRACTION CURVED FEMORAL INTRDCR SHEATH SET 16FR,869.0,564.85,145.99,782.1,21
CDM,27203530,W CATH DRNG 8FR 25CM,175.0,113.75,29.4,157.5,21
CDM,27203536,"M ESOPHAGEAL TEMPERATURE PROBE, SINGLE USE, STERILE, 10FR OD",900.0,585.0,151.2,810.0,21
CDM,27203540,W CATH DVX THROMBECTOMY SET,1910.0,1241.5,320.88,1719.0,21
CDM,27203546,"FLEXABILITY SENSOR ENABLED ABLATION CATHETER 8F, D-F CURVE, 2.7M",2498.0,1623.7,419.66,2248.2,21
CDM,27203550,W CATH DX INFINITI/SUPERTORQUE,18.0,11.7,3.02,16.2,21
CDM,27203556,"SAFARI2 GUIDEWIRE, EXTRA SM PRE-SHAPED TAVR/TAVI 0.035IN X 275CM",495.0,321.75,83.16,445.5,21
CDM,27203560,W CATH DX PERFORMA,23.0,14.95,3.86,20.7,21
CDM,27203566,"STYLET KIT, 52CM",112.0,72.8,18.82,100.8,21
CDM,27203570,W CATH ECHO INTRA,2565.0,1667.25,430.92,2308.5,21
CDM,27203576,"CPS COURIER GUIDEWIRE, EXTRA FIRM, 0.014IN X 195CM",123.0,79.95,20.66,110.7,21
CDM,27203580,W CATH EMBO PLUS INFUS MICRO,466.0,302.9,78.29,419.4,21
CDM,27203586,"PULSE 30/CYCLE 10, SHOCKWAVE L6 IVL CATHETER 9.0MM X 30, 7F, 110",4658.0,3027.7,782.54,4192.2,21
CDM,27203590,W CATH EMBOL ART LF 4F 40CM,164.0,106.6,27.55,147.6,21
CDM,27203596,AMBU DISPOSABLE FLEXIBLE CYSTOSCOPE,250.0,162.5,42.0,225.0,21
CDM,27203600,W CATH EMBOL ART LF 80CM,226.0,146.9,37.97,203.4,21
CDM,27203606,INDIRECT CALORIMETRY SUPPLY,56.0,36.4,9.41,50.4,21
CDM,27203610,W CATH EMBOLCT HD,275.0,178.75,46.2,247.5,21
CDM,27203616,CUSTOM CATH LAB PACK,81.0,52.65,13.61,72.9,21
CDM,27203620,W CATH EMBOLECT,183.0,118.95,30.74,164.7,21
CDM,27203626,KIDNEY KIT ORS,4304.0,2797.6,723.07,3873.6,21
CDM,27203630,W CATH EMBOLECTOMY ARTL 2F LONG,311.0,202.15,52.25,279.9,21
CDM,27203636,ORGANOX KIT,57000.0,37050.0,9576.0,51300.0,21
CDM,27203640,W CATH EMBOLECTOMY FOGRTY ARTL,52.0,33.8,8.74,46.8,21
CDM,27203646,HELIX LOCKING TOOL,50.0,32.5,8.4,45.0,21
CDM,27203650,W CATH ENTEROCLYS,514.0,334.1,86.35,462.6,21
CDM,27203656,LEAD DELIVERY CATHETER AND DILATOR,270.0,175.5,45.36,243.0,21
CDM,27203660,W CATH EP COOLTIP,1418.0,921.7,238.22,1276.2,21
CDM,27203670,W CATH EP DECAPOLR,1630.0,1059.5,273.84,1467.0,21
CDM,27203680,W CATH EP DX NOT3,1262.0,820.3,212.02,1135.8,21
CDM,27203690,W CATH EP DX NOT3,4496.0,2922.4,755.33,4046.4,21
CDM,27203700,W CATH EP DX/ABL,2160.0,1404.0,362.88,1944.0,21
CDM,27203710,W CATH EP LASSO,1403.0,911.95,235.7,1262.7,21
CDM,27203720,W CATH EP PENTARAY HIGH DENSTY,2099.0,1364.35,352.63,1889.1,21
CDM,27203730,W CATH EP REFLEXION SPIRAL,2295.0,1491.75,385.56,2065.5,21
CDM,27203740,W CATH EPIDURAL,1014.0,659.1,170.35,912.6,21
CDM,27203750,W CATH EP-XT 6FR X 110CM,617.0,401.05,103.66,555.3,21
CDM,27203760,W CATH ERCP,479.0,311.35,80.47,431.1,21
CDM,27203770,W CATH EXPORT ASPIRATION,1035.0,672.75,173.88,931.5,21
CDM,27203790,W CATH FEM 14FR,105.0,68.25,17.64,94.5,21
CDM,27203800,W CATH FGRT DCLOT,285.0,185.25,47.88,256.5,21
CDM,27203810,W CATH FGRT EMBLA,118.0,76.7,19.82,106.2,21
CDM,27203820,W CATH FGRTY TROM,2599.0,1689.35,436.63,2339.1,21
CDM,27203830,W CATH FLEXTOME CUTTING BALLOON,1088.0,707.2,182.78,979.2,21
CDM,27203840,W CATH FLUSH LONG ACCU-VU,166.0,107.9,27.89,149.4,21
CDM,27203850,W CATH FLX W/PGTL,189.0,122.85,31.75,170.1,21
CDM,27203860,W CATH DRNG BLRY 12FR 35CM,129.0,83.85,21.67,116.1,21
CDM,27203870,W CATH FOGARTY ARTRL EMBLCTMY,52.0,33.8,8.74,46.8,21
CDM,27203880,W CATH FOLWR BOGE,153.0,99.45,25.7,137.7,21
CDM,27203890,W CATH FOLY 30C 2,31.0,20.15,5.21,27.9,21
CDM,27203900,W CATH FOLY 30C 3,55.0,35.75,9.24,49.5,21
CDM,27203910,W CATH FOLY 5C 2W,55.0,35.75,9.24,49.5,21
CDM,27203920,W CATH FOLY COUDE,102.0,66.3,17.14,91.8,21
CDM,27203930,W CATH FOLY SILI,36.0,23.4,6.05,32.4,21
CDM,27203936,DERMABOND 0.7ML ADVANCED TOPICAL SKIN ADHESIVE 2-OCTYL CYANOACRY,81.0,52.65,13.61,72.9,21
CDM,27203940,W CATH FOLY3W ALL,50.0,32.5,8.4,45.0,21
CDM,27203946,ROTAGLIDE SOLUTION,152.0,98.8,25.54,136.8,21
CDM,27203950,W CATH GLIDE,273.0,177.45,45.86,245.7,21
CDM,27203960,W CATH GLIDE,392.0,254.8,65.86,352.8,21
CDM,27203970,W CATH GLIDE JAGWIRE RX 0.025IN,199.0,129.35,33.43,179.1,21
CDM,27203980,W CATH GLIDE WIRE,275.0,178.75,46.2,247.5,21
CDM,27203986,VERSACROSS CONNECT TRANSSEPTAL DILATOR,1493.0,970.45,250.82,1343.7,21
CDM,27203990,W CATH GLIDE WIRE AMPLATZ SS,243.0,157.95,40.82,218.7,21
CDM,27203996,AGILIS HISPRO SLITTER,61.0,39.65,10.25,54.9,21
CDM,27204000,W CATH GORSHANG,249.0,161.85,41.83,224.1,21
CDM,27204006,IMPELLA CP INTRODUCER KIT 14FR X 13CM,750.0,487.5,126.0,675.0,21
CDM,27204010,W CATH GROSHONG,980.0,637.0,164.64,882.0,21
CDM,27204020,W CATH GROSHONG DUAL LUMEN,600.0,390.0,100.8,540.0,21
CDM,27204030,W CATH GROSHONG SINGLE LUMEN,477.0,310.05,80.14,429.3,21
CDM,27204040,W CATH GUIDE BRAIDED,25.0,16.25,4.2,22.5,21
CDM,27204046,WOLVERINE MONORAIL CUTTING BALLOON 3.50MM X 10MM,967.0,628.55,162.46,870.3,21
CDM,27204050,W CATH GUIDE HANDLE SIDEKICK,96.0,62.4,16.13,86.4,21
CDM,27204060,W CATH GUIDING 2,487.0,316.55,81.82,438.3,21
CDM,27204070,W CATH GUIDING 59CM CPS,359.0,233.35,60.31,323.1,21
CDM,27204080,W CATH GUIDING AL1/SPECIAL,241.0,156.65,40.49,216.9,21
CDM,27204086,AMPLATZER TORQVUE DELIVERY SHEATH 14FR,1214.0,789.1,203.95,1092.6,21
CDM,27204090,W CATH GUIDING VISTA BRITE RDC,105.0,68.25,17.64,94.5,21
CDM,27204096,CATH LAB PACK,314.0,204.1,52.75,282.6,21
CDM,27204100,W CATH GUIDING VISTA BRITE TIP,92.0,59.8,15.46,82.8,21
CDM,27204110,W CATH GUIDING WISEGUIDE VL6,83.0,53.95,13.94,74.7,21
CDM,27204120,W CATH HICKMAN,355.0,230.75,59.64,319.5,21
CDM,27204126,NEEDLE'S EYE SNARE W/WORKSTATION 13MM,1612.0,1047.8,270.82,1450.8,21
CDM,27204130,W CATH HICKMAN,541.0,351.65,90.89,486.9,21
CDM,27204140,W CATH HICKMAN,2318.0,1506.7,389.42,2086.2,21
CDM,27204150,W CATH IABP 7.5F,1032.0,670.8,173.38,928.8,21
CDM,27204160,W CATH IMGR II ANGIO CONTRA BRD,21.0,13.65,3.53,18.9,21
CDM,27204170,W CATH IMPRSS HK FLSH NON-BRDED,27.0,17.55,4.54,24.3,21
CDM,27204180,W CATH INF P/C/M,173.0,112.45,29.06,155.7,21
CDM,27204190,W CATH INFU,341.0,221.65,57.29,306.9,21
CDM,27204200,W CATH INFUSION UNIFUSE,179.0,116.35,30.07,161.1,21
CDM,27204210,W CATH INSRT TOOL,78.0,50.7,13.1,70.2,21
CDM,27204220,W CATH INT PRESSR,440.0,286.0,73.92,396.0,21
CDM,27204230,W CATH INTRO SET,303.0,196.95,50.9,272.7,21
CDM,27204240,W CATH IV CUTDOWN,11.0,7.15,1.85,9.9,21
CDM,27204250,W CATH JEJUNS/BKR,135.0,87.75,22.68,121.5,21
CDM,27204256,AMPLATZER TORQVUE DELIVERY SHEATH 12FR,1104.0,717.6,185.47,993.6,21
CDM,27204260,W CATH JUDKINS VIKING GUIDING,105.0,68.25,17.64,94.5,21
CDM,27204266,VICTORY 18 STRAIGHT TIP 18GR 300CM,255.0,165.75,42.84,229.5,21
CDM,27204270,W CATH KIT PICC 2LUM 4F 60CM,119.0,77.35,19.99,107.1,21
CDM,27204276,MIGHTY WIRE DOUBLE CURVE 75MM 15MM,263.0,170.95,44.18,236.7,21
CDM,27204280,W CATH KIT PICC XCELA DUAL LUMN,193.0,125.45,32.42,173.7,21
CDM,27204290,W CATH KT FEMALE,53.0,34.45,8.9,47.7,21
CDM,27204300,W CATH LANGSTON PIGTAIL 6F,207.0,134.55,34.78,186.3,21
CDM,27204306,AERIN STYLUS,1900.0,1235.0,319.2,1710.0,21
CDM,27204310,W CATH LEONARD10F,425.0,276.25,71.4,382.5,21
CDM,27204320,W CATH LVWIRE STRABLE ELECTRPHS,1389.0,902.85,233.35,1250.1,21
CDM,27204330,W CATH MAMMOSITE CAVITY EVAL,261.0,169.65,43.85,234.9,21
CDM,27204336,"PAC TRAY/5, 9 FR X 11CM ONE PIECE INTRDCR (NON-DETACH VALVE)",81.0,52.65,13.61,72.9,21
CDM,27204340,W CATH MICROSHEATH CROSSER,413.0,268.45,69.38,371.7,21
CDM,27204346,INFINITI AMBI ANGIOGRAPHIC CATHETER 100CM,66.0,42.9,11.09,59.4,21
CDM,27204350,W CATH MODEL IMPULSE IM T (SGL),15.0,9.75,2.52,13.5,21
CDM,27204356,CPS UNIVERSAL II SLITTER,64.0,41.6,10.75,57.6,21
CDM,27204360,W CATH MULTIPAC 6F ST PIG6,51.0,33.15,8.57,45.9,21
CDM,27204366,AMBI CATHETER 125CM,63.0,40.95,10.58,56.7,21
CDM,27204370,W CATH MULTIPURPOSE W/BUMPER TP,23.0,14.95,3.86,20.7,21
CDM,27204376,CATH LAB PACK,125.0,81.25,21.0,112.5,21
CDM,27204380,W CATH MUSHROOM,63.0,40.95,10.58,56.7,21
CDM,27204390,W CATH MUSHROOM,78.0,50.7,13.1,70.2,21
CDM,27204400,W CATH NASL BALLN,49.0,31.85,8.23,44.1,21
CDM,27204410,W CATH NASO BILIARY 7.5-8.5,245.0,159.25,41.16,220.5,21
CDM,27204420,W CATH NEPHROSTMY,479.0,311.35,80.47,431.1,21
CDM,27204430,W CATH NON-BRAIDED,23.0,14.95,3.86,20.7,21
CDM,27204440,W CATH NON-BRAIDED PIGTL FLUSH,18.0,11.7,3.02,16.2,21
CDM,27204446,AGENT BALLOON CATHETER-DRUG COATED,22600.0,14690.0,3796.8,20340.0,29
CDM,27204446_OP,AGENT BALLOON CATHETER-DRUG COATED,22600.0,14690.0,7345.0,11074.0,6
CDM,27204450,W CATH OC BLN,492.0,319.8,82.66,442.8,21
CDM,27204460,W CATH OCC,327.0,212.55,54.94,294.3,21
CDM,27204466,"PULSED FIELD ABLATION CATHETER, 31MM",11408.0,7415.2,1916.54,10267.2,21
CDM,27204470,W CATH OPTIPLST5F,637.0,414.05,107.02,573.3,21
CDM,27204476,"STEERABLE SHEATH CLEAR, 13F",1755.0,1140.75,294.84,1579.5,21
CDM,27204480,W CATH OUTBACK LTD RE-ENTRY,2741.0,1781.65,460.49,2466.9,21
CDM,27204486,"CATHETER CONNECTION CABLE, 300CM",300.0,195.0,50.4,270.0,21
CDM,27204490,W CATH PAC BPLR,230.0,149.5,38.64,207.0,21
CDM,27204496,"CPS COURIER GUIDEWIRE, FIRM, 195CM X .014IN",473.0,307.45,79.46,425.7,21
CDM,27204500,W CATH PACEL BPOLAR ADPTR,180.0,117.0,30.24,162.0,21
CDM,27204506,"CPS AIM SL SLIT INNER GUIDING SHEATH CATHETER, INTEGR VALVE (SUB",359.0,233.35,60.31,323.1,21
CDM,27204510,W CATH PACNG QUAD,232.0,150.8,38.98,208.8,21
CDM,27204516,FIGHTER SPECIALITY CROSSING GUIDEWIRE 0.009IN X 190CM,223.0,144.95,37.46,200.7,21
CDM,27204520,W CATH PASSER,779.0,506.35,130.87,701.1,21
CDM,27204526,"SHAFT OD, RADIAL/PRE-SHAPED TIP, BIPAL BIOPSY FORCEP 7FR X 50CM,",263.0,170.95,44.18,236.7,21
CDM,27204530,W CATH PERC,314.0,204.1,52.75,282.6,21
CDM,27204536,"SHAFT OD, STRAIGHT/SHAPABLE TIP, BIPAL BIOPSY FORCEP 7FR X 104CM",263.0,170.95,44.18,236.7,21
CDM,27204540,W CATH PERC W/GW,675.0,438.75,113.4,607.5,21
CDM,27204550,W CATH PERITNL,348.0,226.2,58.46,313.2,21
CDM,27204560,W CATH PERITNL,552.0,358.8,92.74,496.8,21
CDM,27204570,W CATH PEZZAR MAL,51.0,33.15,8.57,45.9,21
CDM,27204580,W CATH PGTL,153.0,99.45,25.7,137.7,21
CDM,27204590,W CATH POLYFLW 18,331.0,215.15,55.61,297.9,21
CDM,27204600,W CATH PORTACATH,2681.0,1742.65,450.41,2412.9,21
CDM,27204610,W CATH PRGRT MCRO W/DISTAL MRKR,413.0,268.45,69.38,371.7,21
CDM,27204620,W CATH PTCA MAV,912.0,592.8,153.22,820.8,21
CDM,27204630,W CATH QUICK CROSS SUPPORT,239.0,155.35,40.15,215.1,21
CDM,27204640,W CATH RADIAL ART,26.0,16.9,4.37,23.4,21
CDM,27204650,W CATH RAPIDO 53/58CM SINUS EXT,142.0,92.3,23.86,127.8,21
CDM,27204660,W CATH RAPIDO 63CM SINUS EXTD,443.0,287.95,74.42,398.7,21
CDM,27204670,W CATH RAPIDO SINUS GUIDING,142.0,92.3,23.86,127.8,21
CDM,27204680,W CATH RECTL PRES,107.0,69.55,17.98,96.3,21
CDM,27204700,W CATH REF STAR,300.0,195.0,50.4,270.0,21
CDM,27204710,W CATH RENAL,177.0,115.05,29.74,159.3,21
CDM,27204720,W CATH RENEGADE HI-FLO KIT,848.0,551.2,142.46,763.2,21
CDM,27204730,W CATH RETROGRADE CARDIOPLEGIA,134.0,87.1,22.51,120.6,21
CDM,27204740,W CATH REUTER SOFTOUCH,35.0,22.75,5.88,31.5,21
CDM,27204750,W CATH RNGD FBR BRD HYDRO PASS,617.0,401.05,103.66,555.3,21
CDM,27204756,PANNUS RETENTION SYSTEM W/4 PADS & 2 STRAPS (STERILE),123.0,79.95,20.66,110.7,21
CDM,27204766,"ASAHI HYDROPHILIC COATED SPRING COIL GUIDE WIRE, 1.5J CE, 0.35IN",70.0,45.5,11.76,63.0,21
CDM,27204770,W CATH SET RADIAL ARTERY,15.0,9.75,2.52,13.5,21
CDM,27204776,AZUR DETACHMENT CONTROLLER (FOR EMBOLIZATION COIL),67.0,43.55,11.26,60.3,21
CDM,27204780,W CATH SET TRANSCRICOTHYROTOMY,232.0,150.8,38.98,208.8,21
CDM,27204790,W CATH SINUS BALLOON 516-716,968.0,629.2,162.62,871.2,21
CDM,27204796,ARROWGUARD BLUE PLUS CATHERIZATION PRESSURE INJECTABLE 7F,83.0,53.95,13.94,74.7,21
CDM,27204800,W CATH SINUS BALLOON 524-724,1020.0,663.0,171.36,918.0,21
CDM,27204806,"WATCHMAN ACCESS SHEATH W/DILATOR, FIXED CURVE SINGLE",1350.0,877.5,226.8,1215.0,21
CDM,27204810,W CATH SINUS GUIDE 000-110S,555.0,360.75,93.24,499.5,21
CDM,27204820,W CATH SINUS IRRIGATION,219.0,142.35,36.79,197.1,21
CDM,27204830,W CATH SPIROFLEX THROMBECTOMY,2491.0,1619.15,418.49,2241.9,21
CDM,27204840,W CATH ST,47.0,30.55,7.9,42.3,21
CDM,27204846,SUPER ARROW-FLEX SHEATH SETW/HEMOSTASIS PORT 9FR X 11CM,80.0,52.0,13.44,72.0,21
CDM,27204850,W CATH ST VENT,146.0,94.9,24.53,131.4,21
CDM,27204856,"CHECK-FLO PERFORMER INTRO SET, 0.035IN GW, 14FR X 45CM",252.0,163.8,42.34,226.8,21
CDM,27204860,W CATH STR,142.0,92.3,23.86,127.8,21
CDM,27204870,W CATH SUCT A/S,11.0,7.15,1.85,9.9,21
CDM,27204880,W CATH SUPRAPUBIC,353.0,229.45,59.3,317.7,21
CDM,27204890,W CATH SUPREME EP QUAD,166.0,107.9,27.89,149.4,21
CDM,27204900,W CATH SUPRPUB/CY,155.0,100.75,26.04,139.5,21
CDM,27204910,W CATH SWAN GANZ CCO,236.0,153.4,39.65,212.4,21
CDM,27204920,W CATH SW-GZ,303.0,196.95,50.9,272.7,21
CDM,27204930,W CATH SW-GZ MNTR,423.0,274.95,71.06,380.7,21
CDM,27204940,W CATH SW-GZ THRM,379.0,246.35,63.67,341.1,21
CDM,27204950,W CATH SYSTEM,116.0,75.4,19.49,104.4,21
CDM,27204960,W CATH TEGWR BALN,1767.0,1148.55,296.86,1590.3,21
CDM,27204970,W CATH TEMPO MPA1,19.0,12.35,3.19,17.1,21
CDM,27204980,W CATH TENCHHOFF,294.0,191.1,49.39,264.6,21
CDM,27205000,W CATH THERMODIL,147.0,95.55,24.7,132.3,21
CDM,27205010,W CATH THORACIC,37.0,24.05,6.22,33.3,21
CDM,27205020,W CATH THRMB/EMB2,3461.0,2249.65,581.45,3114.9,21
CDM,27205030,W CATH THRMB/EMB3,2423.0,1574.95,407.06,2180.7,21
CDM,27205036,"CHECK-FLO INTRODUCER SET, MULLINS TYPE ,0.038IN MAX GW 7FR X 85C",126.0,81.9,21.17,113.4,21
CDM,27205040,W CATH THRMB/EMB4,5035.0,3272.75,845.88,4531.5,21
CDM,27205046,"PINNACLE GUIDING SHEATH W/ DILATOR, MULTI, CROSS-CUT VALVE 7FR X",168.0,109.2,28.22,151.2,21
CDM,27205050,W CATH THROMB/EMB,1262.0,820.3,212.02,1135.8,21
CDM,27205060,W CATH THROMBCTMY,374.0,243.1,62.83,336.6,21
CDM,27205066,VICTORY PERIPHERAL VASCULAR GUIDEWIRE 300CM 25-GAUGE,323.0,209.95,54.26,290.7,21
CDM,27205070,W CATH THROMCTMY ANGIOJET AVX,1050.0,682.5,176.4,945.0,21
CDM,27205076,"CHECK FLO INTRODUCER SET, 0.038IN MAX GUIDEWIRE 16FR X 13CM",76.0,49.4,12.77,68.4,21
CDM,27205080,W CATH TOTAL ABSCESSION DRAIN,121.0,78.65,20.33,108.9,21
CDM,27205090,W CATH TRELLIS-8 PERIPHL INF,2828.0,1838.2,475.1,2545.2,21
CDM,27205096,ALPHAVAC MULTIPURPOSE MECHANICAL ASPIRATION 25FR (C180) X 77CM,12150.0,7897.5,2041.2,10935.0,21
CDM,27205100,W CATH TRIPLE LUMEN ARROW,123.0,79.95,20.66,110.7,21
CDM,27205110,W CATH TRIP-LUMEN,95.0,61.75,15.96,85.5,21
CDM,27205120,W CATH TROCAR KIT,66.0,42.9,11.09,59.4,21
CDM,27205126,PSI KIT WITH ARROWGARD BLUE SHEATH 9FR X 10CM,156.0,101.4,26.21,140.4,21
CDM,27205130,W CATH TWIN 20/22,61.0,39.65,10.25,54.9,21
CDM,27205140,W CATH URET,74.0,48.1,12.43,66.6,21
CDM,27205146,CATHETER SWAN-GANZ 7FR 110CM 4 LUMEN THERMODILUTION,140.0,91.0,23.52,126.0,21
CDM,27205150,W CATH URET 10FR DUAL LUMEN,149.0,96.85,25.03,134.1,21
CDM,27205160,W CATH URET BEVEL,90.0,58.5,15.12,81.0,21
CDM,27205170,W CATH URET PRES,65.0,42.25,10.92,58.5,21
CDM,27205180,W CATH URETERAL,43.0,27.95,7.22,38.7,21
CDM,27205190,W CATH URETERAL,426.0,276.9,71.57,383.4,21
CDM,27205200,W CATH URETERAL,447.0,290.55,75.1,402.3,21
CDM,27205210,W CATH URETERAL,1002.0,651.3,168.34,901.8,21
CDM,27205220,W CATH URETH,82.0,53.3,13.78,73.8,21
CDM,27205230,W CATH URETH,411.0,267.15,69.05,369.9,21
CDM,27205240,W CATH URETHRAL,4.0,2.6,0.67,3.6,21
CDM,27205246,"MAQUET SENSATION FIBER-OPTIC IAB CATHETERINSERTION KIT 7FR, 34CC",1332.0,865.8,223.78,1198.8,21
CDM,27205250,W CATH US INTRVAS,960.0,624.0,161.28,864.0,21
CDM,27205256,INFINITI 6FR AMBI 100CM TG 4.5,60.0,39.0,10.08,54.0,21
CDM,27205260,W CATH VAS,275.0,178.75,46.2,247.5,21
CDM,27205270,W CATH VENTRICULAR CATH PASSER,233.0,151.45,39.14,209.7,21
CDM,27205280,W CATH VERPATH PERIPHERAL GDNG,96.0,62.4,16.13,86.4,21
CDM,27205290,W CATH VERTEBRAL NON-BRAIDED,5.0,3.25,0.84,4.5,21
CDM,27205300,W CATH VSSL STRGHT PRFRM DIAG,192.0,124.8,32.26,172.8,21
CDM,27205310,W CATH XPEEDIOR THROMBECTOMY SET,1640.0,1066.0,275.52,1476.0,21
CDM,27205320,W CATHETER BACTISEAL KIT,808.0,525.2,135.74,727.2,21
CDM,27205330,W CATHETER CTO XP,1411.0,917.15,237.05,1269.9,21
CDM,27205340,W CATHETER GASTRO PEG SAFETY,171.0,111.15,28.73,153.9,21
CDM,27205350,W CATHETER GUIDING MACH 1,83.0,53.95,13.94,74.7,21
CDM,27205360,W CATHETER GUIDING SHERPA EBU,102.0,66.3,17.14,91.8,21
CDM,27205370,W CATHETER HICKMAN,303.0,196.95,50.9,272.7,21
CDM,27205380,W CATHETER KIT PLEURX PLEURAL,690.0,448.5,115.92,621.0,21
CDM,27205390,W CATHETER MAMMOSITE,3713.0,2413.45,623.78,3341.7,21
CDM,27205396,THERMODILUTION 7F CATHETER,219.0,142.35,36.79,197.1,21
CDM,27205400,W CATHETER MICRO GUIDE XP,375.0,243.75,63.0,337.5,21
CDM,27205410,W CATHETER ON-Q 100ML,184.0,119.6,30.91,165.6,21
CDM,27205420,W CATHETER ON-Q PAINBUSTER,421.0,273.65,70.73,378.9,21
CDM,27205426,"LONG CURVED-TIP, ATTAIN SELECT II SUREVALVE DELIVERY CATHETER (6",242.0,157.3,40.66,217.8,21
CDM,27205430,W CATHETER PASSER 38CM/60CM,172.0,111.8,28.9,154.8,21
CDM,27205436,DERMABOND PRINEO SINGLE UNIT SKIN CLOSURE SYSTEM,154.0,100.1,25.87,138.6,21
CDM,27205440,W CATHETER SUPRAPUBIC BONANNO,81.0,52.65,13.61,72.9,21
CDM,27205450,"W CATHETER, COBRA",23.0,14.95,3.86,20.7,21
CDM,27205460,W CAUT BIPOLAR,405.0,263.25,68.04,364.5,21
CDM,27205470,W CAUT COAG SUCT,497.0,323.05,83.5,447.3,21
CDM,27205480,W CAUT HOOK,475.0,308.75,79.8,427.5,21
CDM,27205490,W CAUT PEN+TIP,53.0,34.45,8.9,47.7,21
CDM,27205500,W CAUT SPATULA,300.0,195.0,50.4,270.0,21
CDM,27205506,"MAQUET PERCUTANEOUS INSERTION KIT, W/150CM GUIDEWIRE (PIK 150-US",654.0,425.1,109.87,588.6,21
CDM,27205510,W CAUT TIP BAL/ND,472.0,306.8,79.3,424.8,21
CDM,27205516,"VENOUS HLS CANNULA 0.375IN CONNECTOR, WITH BIOLINE COATING 25FR",655.0,425.75,110.04,589.5,21
CDM,27205520,W CELL SAVER 135ML LOW VOL BOWL,154.0,100.1,25.87,138.6,21
CDM,27205526,OPTISITE ARTERIAL CANNULA 20MM X 15IN,312.0,202.8,52.42,280.8,21
CDM,27205530,W CEMENT CURRETTE,47.0,30.55,7.9,42.3,21
CDM,27205536,PERCUTANEOUS INSERTION KIT-ARTERIAL,81.0,52.65,13.61,72.9,21
CDM,27205540,W CEMT DELIV SYS,273.0,177.45,45.86,245.7,21
CDM,27205546,"MED CLIP, ANASTOCLIP VSC VESSEL CLOSURE SYSTEM W/35 CLIPS (PK/3)",257.0,167.05,43.18,231.3,21
CDM,27205550,W CEMT FEM PRESSR,145.0,94.25,24.36,130.5,21
CDM,27205560,W CEMT GUN KT,169.0,109.85,28.39,152.1,21
CDM,27205570,W CEREBROSPINAL FLUID RESERVOIR,608.0,395.2,102.14,547.2,21
CDM,27205580,W CLAMP 393.361 TUBE-TO-TUBE,1136.0,738.4,190.85,1022.4,21
CDM,27205586,"CATHETER, IVUS OPTICROSS HD 3FR X 135CM BAGLESS NON-CE",1055.0,685.75,177.24,949.5,21
CDM,27205590,W CLAMP BLLDG VASCU-STAT + ANG,257.0,167.05,43.18,231.3,21
CDM,27205600,W CLAMP COMBINATION 390.005,1028.0,668.2,172.7,925.2,21
CDM,27205606,SWITCHBACK INFLATION DEVICE 25CC/40 ATM,71.0,46.15,11.93,63.9,21
CDM,27205610,W CLAMP FRACTURE USS,1761.0,1144.65,295.85,1584.9,21
CDM,27205620,W CLAMP MULTI PIN 390.002,1257.0,817.05,211.18,1131.3,21
CDM,27205630,W CLIP ALLIGATOR CLIP W/CABLE,79.0,51.35,13.27,71.1,21
CDM,27205640,W CLIP APPLIER ENDO LIGAMAX,260.0,169.0,43.68,234.0,21
CDM,27205650,W CLIP APPLIER ENDOPATH ER320,156.0,101.4,26.21,140.4,21
CDM,27205660,W CLIP HEMOSTASIS 235CM,210.0,136.5,35.28,189.0,21
CDM,27205670,W CLIP IRIS MENTR,361.0,234.65,60.65,324.9,21
CDM,27205676,DRYSEAL FLEX INTRODUCER SHEATH 24FR X 33CM,356.0,231.4,59.81,320.4,21
CDM,27205680,W CLIP IRRIGATION ANSPACH,135.0,87.75,22.68,121.5,21
CDM,27205690,W CLIP LIGATING HEM-O-LOK,384.0,249.6,64.51,345.6,21
CDM,27205700,W CLIP MULTI APPLIER LIGACLIP,98.0,63.7,16.46,88.2,21
CDM,27205710,W CLMP DIALYS PRT,21.0,13.65,3.53,18.9,21
CDM,27205720,W CLMP ENDOCLENCH,484.0,314.6,81.31,435.6,21
CDM,27205730,W CLMP INCONTNEN,8.0,5.2,1.34,7.2,21
CDM,27205740,W CLOSESURE GUIDE PILOT C-T XL,236.0,153.4,39.65,212.4,21
CDM,27205750,W CLOSURE SYSTEM THOMASON C-T,202.0,131.3,33.94,181.8,21
CDM,27205760,W CLP APPL DISP,100.0,65.0,16.8,90.0,21
CDM,27205770,W CLP WR ROTABLDR,248.0,161.2,41.66,223.2,21
CDM,27205780,W COAG LAP SHRS,1076.0,699.4,180.77,968.4,21
CDM,27205790,W COLD BIOPSY FORCEP EGD/LARGE,28.0,18.2,4.7,25.2,21
CDM,27205800,W COLLAR CERVICAL FLEX NONADJ,97.0,63.05,16.3,87.3,21
CDM,27205810,W CONEC/VENT RT,230.0,149.5,38.64,207.0,21
CDM,27205820,W CONN TO IMPLANT,460.0,299.0,77.28,414.0,21
CDM,27205826,"LAUNCHER GUIDING CATH, EXTRA BACK UP SUPPORT LEFT 3.75",68.0,44.2,11.42,61.2,21
CDM,27205836,CIRCULO GUIDEWIRE 0.035IN X 275CM (DAIBW-001),278.0,180.7,46.7,250.2,21
CDM,27205840,W CORD DUAL BIPOLAR 12FT,120.0,78.0,20.16,108.0,21
CDM,27205846,STEERABLE DELIVERY SHEATH 14FR,1350.0,877.5,226.8,1215.0,21
CDM,27205850,W CRTDG HEART,49.0,31.85,8.23,44.1,21
CDM,27205860,W CTH 6FRX110CM DYNAMIC LG CURV,611.0,397.15,102.65,549.9,21
CDM,27205870,W CTH ABL DEFL TP,3105.0,2018.25,521.64,2794.5,21
CDM,27205880,W CTH ANGJET RHEO,915.0,594.75,153.72,823.5,21
CDM,27205890,W CTH BLN DIL REN 7F 2.3MMX12CM,492.0,319.8,82.66,442.8,21
CDM,27205900,W CATH DRNG BLRY 8FR/10FR 35CM,138.0,89.7,23.18,124.2,21
CDM,27205920,W CTH SUPER TORQUE DIAG PIGTAIL,26.0,16.9,4.37,23.4,21
CDM,27205930,W CUFF TOURNIQUET 18 STERILE,63.0,40.95,10.58,56.7,21
CDM,27205940,W CUFF TOURNIQUET 34 STERILE,70.0,45.5,11.76,63.0,21
CDM,27205946,CATH LAB RIGHT HEART KIT,136.0,88.4,22.85,122.4,21
CDM,27205950,W CUTTER BALL DMND,121.0,78.65,20.33,108.9,21
CDM,27205956,ARTERIOGRAM PACK,56.0,36.4,9.41,50.4,21
CDM,27205960,W BLADE SHAVER ARTHSCP,91.0,59.15,15.29,81.9,21
CDM,27205970,W CUTTER CANNULA 15MM,570.0,370.5,95.76,513.0,21
CDM,27205980,W CUTTER ENDOPATH FLEX ATS45,307.0,199.55,51.58,276.3,21
CDM,27205990,W CUTTER LIN ENDO RT ANGL 45MM,500.0,325.0,84.0,450.0,21
CDM,27206000,W CUTTER LINEAR 45MM EZ45G,446.0,289.9,74.93,401.4,21
CDM,27206010,W CUTTER LINEAR ECHELON 45 EC45,309.0,200.85,51.91,278.1,21
CDM,27206020,W CUTTER LINEAR PROXIMATE TCR55,101.0,65.65,16.97,90.9,21
CDM,27206030,W CUTTER LINEAR RELOAD,89.0,57.85,14.95,80.1,21
CDM,27206040,W CUTTER LINEAR RELOAD 75MM,134.0,87.1,22.51,120.6,21
CDM,27206050,W CUTTER PROXIMATE LINEAR 100MM,323.0,209.95,54.26,290.7,21
CDM,27206060,W CUTTER RELOAD PRXI LINEAR STD,198.0,128.7,33.26,178.2,21
CDM,27206070,W CUTTER ROTOCUT EXT 15MM STRL,646.0,419.9,108.53,581.4,21
CDM,27206080,W CUTTER SUTURE PUSHER KNOT,216.0,140.4,36.29,194.4,21
CDM,27206090,W CUTTING ANGLED ATTACHMENT,125.0,81.25,21.0,112.5,21
CDM,27206100,W CVC KIT VANTEX AMC TLC,79.0,51.35,13.27,71.1,21
CDM,27206106,MUSTANG OTW PTA BALL DIL CATH 0.035IN MAX GUIDEWIRE 9MM X 60MM B,270.0,175.5,45.36,243.0,21
CDM,27206110,W CYSTOTOME,416.0,270.4,69.89,374.4,21
CDM,27206116,CUSTOM WASTE MANAGEMENT KIT ANGIO TRAY,109.0,70.85,18.31,98.1,21
CDM,27206120,W CYTO/MICRO BRUSH,26.0,16.9,4.37,23.4,21
CDM,27206126,EVOLUT FX DEL CATH SYS W INLINE SHEATH 18 FR EQUIV,2849.0,1851.85,478.63,2564.1,21
CDM,27206140,W DAVINCI MONOPOLAR CORD,285.0,185.25,47.88,256.5,21
CDM,27206150,W DERMACARRIER,90.0,58.5,15.12,81.0,21
CDM,27206156,"VIDE SHORE DRY SUCTION, WATER SEAL CHEST DRAIN",61.0,39.65,10.25,54.9,21
CDM,27206160,W DERMACARRIER II 1.5:1 STERILE,52.0,33.8,8.74,46.8,21
CDM,27206166,"MACH 1 GUIDING CATH 6FR , JR4",68.0,44.2,11.42,61.2,21
CDM,27206170,W DEV CLIP APPLR,42.0,27.3,7.06,37.8,21
CDM,27206176,SWRTZ BRD LMP 8.5FRX85CM 135 TRNSPTL GD INTRO STH W/ HEMOST V &,261.0,169.65,43.85,234.9,21
CDM,27206180,W DEV CUTTING,140.0,91.0,23.52,126.0,21
CDM,27206190,W DEV HAND ACCESS,1307.0,849.55,219.58,1176.3,21
CDM,27206196,"RECOR MEDICAL PARADISE RDN CATHETER(S), INTRAVASCULAR FOR RENAL",27000.0,17550.0,4536.0,24300.0,21
CDM,27206200,W DEV HRT MANIP,1663.0,1080.95,279.38,1496.7,21
CDM,27206206,HRAM 10 CHANNEL CATH,520.0,338.0,87.36,468.0,21
CDM,27206210,W DEV REP URINARY,1356.0,881.4,227.81,1220.4,21
CDM,27206216,ARM 4 CHANNEL CATH,145.0,94.25,24.36,130.5,21
CDM,27206220,W DEV RETRIEV INS,683.0,443.95,114.74,614.7,21
CDM,27206230,W DEV SECURE CATH,50.0,32.5,8.4,45.0,21
CDM,27206240,W DEVICE ELCTRD STARBURST TALON,3564.0,2316.6,598.75,3207.6,21
CDM,27206246,TRICLIP 80CM STEERABLE GUIDE CATHETER,108000.0,70200.0,18144.0,97200.0,21
CDM,27206250,W DEVICE HEMOSTASIS AORTIC PRXM,736.0,478.4,123.65,662.4,21
CDM,27206256,CATH LAB PACK,121.0,78.65,20.33,108.9,21
CDM,27206260,W DEVICE POLYLOOP 2.8 230CM,152.0,98.8,25.54,136.8,21
CDM,27206266,PROGREAT MICROCATH W/ RO MARKER 2.4FR X 130CM,437.0,284.05,73.42,393.3,21
CDM,27206270,W DEVICE SINUS BALLOON INFLAT,131.0,85.15,22.01,117.9,21
CDM,27206276,GLIDEWIRE GT GUIDEWIRE 0.018IN X 180CM 45DEG ANGL 2CM TIP,254.0,165.1,42.67,228.6,21
CDM,27206280,W DEVICE SPACER BC1017RS,1545.0,1004.25,259.56,1390.5,21
CDM,27206286,AVANTI SHEATH INTRODUCER 11FR X 11CM 0.035IN GUIDEWIRE,80.0,52.0,13.44,72.0,21
CDM,27206290,W DEVICE X-POSE 4 XP-4000,5637.0,3664.05,947.02,5073.3,21
CDM,27206296,AGENT BALLOON 3.50MM X 30MM DRUG-COATED,11300.0,7345.0,1898.4,10170.0,33
CDM,27206300,W DIALYS CATH REP,336.0,218.4,56.45,302.4,21
CDM,27206310,W DIL VESSEL,81.0,52.65,13.61,72.9,21
CDM,27206320,W DILATION BALLOON BILIARY,344.0,223.6,57.79,309.6,21
CDM,27206326,AVEIR INTRODUCER 25F X 50CM,900.0,585.0,151.2,810.0,21
CDM,27206330,W DILATION BALLOON CRE 6-20,338.0,219.7,56.78,304.2,21
CDM,27206336,AVEIR DELIVERY SYSTEM CATHETER,2363.0,1535.95,396.98,2126.7,21
CDM,27206340,W DILATOR AQ HYDROPHILIC,16.0,10.4,2.69,14.4,21
CDM,27206350,W DILATOR CANN BIO-COMPRESSION,249.0,161.85,41.83,224.1,21
CDM,27206360,W DILATOR ENDOVAS COOK G13218,229.0,148.85,38.47,206.1,21
CDM,27206370,W DILATOR PUMONARY BALLOON,434.0,282.1,72.91,390.6,21
CDM,27206380,W DILATOR ST RENAL 8FR W/SHEATH,551.0,358.15,92.57,495.9,21
CDM,27206390,W DILATOR VESSEL 5/8FR X 18CM,12.0,7.8,2.02,10.8,21
CDM,27206400,W DILATOR VESSEL 7/9-11FRX18CM,12.0,7.8,2.02,10.8,21
CDM,27206410,W DILATR BALOON,909.0,590.85,152.71,818.1,21
CDM,27206420,W DISC MOLNAR RETENTION,14.0,9.1,2.35,12.6,21
CDM,27206430,W DISCOGRAM PACK,359.0,233.35,60.31,323.1,21
CDM,27206436,TRUSTEER ACCESS SHEATH DILATOR,2025.0,1316.25,340.2,1822.5,21
CDM,27206450,W DISSECTING TOOL 9-M DIAMOND,233.0,151.45,39.14,209.7,21
CDM,27206460,W DISSECTOR ENDO ROTICULATOR,147.0,95.55,24.7,132.3,21
CDM,27206466,SHEATH INTRO 18FR X 6.0 X?33CM,872.0,566.8,146.5,784.8,21
CDM,27206470,W DIV SEAL/DIVDR,1010.0,656.5,169.68,909.0,21
CDM,27206476,BLUE DIAMOND INFL SYR W/ 13IN EXT TUB 30 ATM,126.0,81.9,21.17,113.4,21
CDM,27206480,W DOUBLE BALLOON - BALLOONS,54.0,35.1,9.07,48.6,21
CDM,27206490,W DOUBLE BALLOON OVERTUBE,330.0,214.5,55.44,297.0,21
CDM,27206500,W DRAIN 100ML WOUND BULB,9.0,5.85,1.51,8.1,21
CDM,27206506,POWDER ABSORBABLE HEMOSTAT,277.0,180.05,46.54,249.3,21
CDM,27206510,W DRAIN 24FR BLAKE HUBLESS,66.0,42.9,11.09,59.4,21
CDM,27206520,W DRAIN ACCUDRAIN W/VLV FLTR,262.0,170.3,44.02,235.8,21
CDM,27206526,SENTRANT INTRDCR SHTH W HYDRPHLC COAT 18FR X 28CM WRKNG LGTH,270.0,175.5,45.36,243.0,21
CDM,27206530,W DRAIN ADAPTOR,12.0,7.8,2.02,10.8,21
CDM,27206536,GEN 2 SMART TIP 190,525.0,341.25,88.2,472.5,21
CDM,27206540,W DRAIN CHST DRY SEAL,55.0,35.75,9.24,49.5,21
CDM,27206550,W DRAIN SET TCENTESIS CTH,107.0,69.55,17.98,96.3,21
CDM,27206580,W DRAINAGE CATH W LCKNG PIGTAIL,139.0,90.35,23.35,125.1,21
CDM,27206590,W DRAINAGE SYSTEM,52.0,33.8,8.74,46.8,21
CDM,27206600,W DRESSING CLOSUR PLUS PRESSURE,79.0,51.35,13.27,71.1,21
CDM,27206610,W DRESSING HEMCON 2X2,58.0,37.7,9.74,52.2,21
CDM,27206620,W DRILL 4.0MM 3-FLUTED 315.40,251.0,163.15,42.17,225.9,21
CDM,27206626,AVEIR RETRIEVAL CATHETER 105CM,4050.0,2632.5,680.4,3645.0,21
CDM,27206630,W DRILL 4.9MM FOR 6.5MM SCREW,668.0,434.2,112.22,601.2,21
CDM,27206636,D-F CURVE 7FR X 115CM EZ STEER BI-DIRCTL DIAG/ABLTN DEFLCTBL TIP,1148.0,746.2,192.86,1033.2,21
CDM,27206640,W DRILL 7.0 MULT COMP 5MM CANN,105.0,68.25,17.64,94.5,21
CDM,27206646,EZ STEER 7FR X 115CM NAV BI-DIRCTL NAV DIG/ABLTN DEFLCT TIP CATH,2619.0,1702.35,439.99,2357.1,21
CDM,27206650,"W DRILL BIT 2.0,3.2",735.0,477.75,123.48,661.5,21
CDM,27206656,DESTINO TWST 8.5FR X 90CM X 108CM DEFLCTBL STEERBL GUIDNG SHTH S,975.0,633.75,163.8,877.5,21
CDM,27206660,W DRILL BIT 2.4MM QUICK COUPLNG,278.0,180.7,46.7,250.2,21
CDM,27206666,CHK-FLO PERF INTR SET 11FR X 63CM MULLINS TYPE 0.038IN MAX GUIDE,170.0,110.5,28.56,153.0,21
CDM,27206670,W DRILL BIT 2.5MM,420.0,273.0,70.56,378.0,21
CDM,27206676,"Z-MED II BALLOON CATH, 8MM X 2CM BALLOON, 100CM SHAFT, 15ATM",589.0,382.85,98.95,530.1,21
CDM,27206680,W DRILL BIT 2.7 CALIBRATED,230.0,149.5,38.64,207.0,21
CDM,27206690,W DRILL BIT 3.0MM W/STOP,450.0,292.5,75.6,405.0,21
CDM,27206700,W DRILL BIT 3.2MM,124.0,80.6,20.83,111.6,21
CDM,27206706,CHK-FLO PERFORMER INTRDCR SET 9FR X 63CM MULLINS TYPE 0.038IN MA,133.0,86.45,22.34,119.7,21
CDM,27206710,W DRILL BIT 4.5,171.0,111.15,28.73,153.9,21
CDM,27206716,"EPSTAR FIXED ELCTROPHYSIOLOGY CATH, 8 ELECTRODES, SPACING 5-5-5M",2025.0,1316.25,340.2,1822.5,21
CDM,27206720,W DRILL BIT CALIBRATED 3.2MM,299.0,194.35,50.23,269.1,21
CDM,27206726,EPSTAR ELECTROPHYSIOLOGY CABLE,88.0,57.2,14.78,79.2,21
CDM,27206730,W DRILL BIT CALIBRATED 3.8MM,131.0,85.15,22.01,117.9,21
CDM,27206740,W DRILL BIT CANN 6/10MM X 435MM,857.0,557.05,143.98,771.3,21
CDM,27206750,W DRILL BIT CANN FEM DISP 5.5MM,239.0,155.35,40.15,215.1,21
CDM,27206760,W DRILL BIT CANNL,711.0,462.15,119.45,639.9,21
CDM,27206770,W DRILL BIT CANNUL 2.75MM .066,484.0,314.6,81.31,435.6,21
CDM,27206780,W DRILL BIT CANNULATED 07-40230,486.0,315.9,81.65,437.4,21
CDM,27206790,W DRILL BIT CANNULATED 2.1MM,399.0,259.35,67.03,359.1,21
CDM,27206796,BAYLIS MEDICAL CONNECTOR CABLE,293.0,190.45,49.22,263.7,21
CDM,27206800,W DRILL BIT CANNULATED 2.7MM,732.0,475.8,122.98,658.8,21
CDM,27206806,SWARTZ BRAIDED LAMP 8.5FRX85CM 90 TRNSPTL GUID INTRDCR SHEATH W/,257.0,167.05,43.18,231.3,21
CDM,27206810,W DRILL BIT CHRLT COMPRSS STPLE,245.0,159.25,41.16,220.5,21
CDM,27206816,FARAWAVE 2.0 NAV CATHETER 31 MM,11408.0,7415.2,1916.54,10267.2,21
CDM,27206820,W DRILL BIT CLAW 2.5MM,225.0,146.25,37.8,202.5,21
CDM,27206830,W DRILL BIT DARCO 2.5MM,225.0,146.25,37.8,202.5,21
CDM,27206836,PFA RX GEN 2 CONNECTION CABLE,300.0,195.0,50.4,270.0,21
CDM,27206840,W DRILL BIT MATRIX MANDIBLE,231.0,150.15,38.81,207.9,21
CDM,27206846,LOCATION REFERENCE PATCH KIT,960.0,624.0,161.28,864.0,21
CDM,27206850,W DRILL BIT MODULAR 2.0MM 3.2MM,600.0,390.0,100.8,540.0,21
CDM,27206860,W DRILL BIT QC 2MMX140MM,235.0,152.75,39.48,211.5,21
CDM,27206870,W DRILL BIT QUICK RELEASE 2.8,132.0,85.8,22.18,118.8,21
CDM,27206880,W DRILL BIT TWIST S-CP,81.0,52.65,13.61,72.9,21
CDM,27206886,ARROW PSI KIT 8.5FRX10CM ARROWG+ARD BLUE PSI KIT CATH-GARD FOR U,139.0,90.35,23.35,125.1,21
CDM,27206890,W DRILL BIT W/QK CONNECT 3.5MM,405.0,263.25,68.04,364.5,21
CDM,27206900,W DRILL BT QUICK RELEASE 2.0X5,116.0,75.4,19.49,104.4,21
CDM,27206910,W DRILL FUSION ACUTRAK 24MM,146.0,94.9,24.53,131.4,21
CDM,27206916,SAFESHEATH II 9.5FRX13CM TEAR-AWAY VALVED SYSTEM W SIDE PORT 0.0,57.0,37.05,9.58,51.3,21
CDM,27206920,W DRILL GUIDE PIN RETRO 3MM,234.0,152.1,39.31,210.6,21
CDM,27206926,SAFESHEATH II 8FRX13CM PEEL-AWAY HEMOSTASIS INTRODUCER (MFR?D BY,57.0,37.05,9.58,51.3,21
CDM,27206930,W DRILL MULT COMPR CANN,225.0,146.25,37.8,202.5,21
CDM,27206940,W DRILL NEURO 3MM 5230-107-30,121.0,78.65,20.33,108.9,21
CDM,27206950,W DRILL PILOT,204.0,132.6,34.27,183.6,21
CDM,27206960,W DRILL PILOT 4.0MM LONG,350.0,227.5,58.8,315.0,21
CDM,27206970,W DRILL PIN TRIM-IT AR,62.0,40.3,10.42,55.8,21
CDM,27206980,W DRILL QC 2.8MM X 165MM,210.0,136.5,35.28,189.0,21
CDM,27206990,W DRILL SCRW,380.0,247.0,63.84,342.0,21
CDM,27207000,W DRILL TIP,265.0,172.25,44.52,238.5,21
CDM,27207010,W DRILL TWIST 1.4MM 87MMX27MM,193.0,125.45,32.42,173.7,21
CDM,27207020,W DRILL TWIST 1.5MM,560.0,364.0,94.08,504.0,21
CDM,27207026,"VERSACROSS RF WIRE 180CMX72CM J-TIP D1 SHEATH, SMALL",2228.0,1448.2,374.3,2005.2,21
CDM,27207030,W DRILL TWIST 1.8,600.0,390.0,100.8,540.0,21
CDM,27207036,PRELUDE SNAP SPLITTABLE  10.5FR X 3.5MM HEMOSTATIC INTRODUCER SY,57.0,37.05,9.58,51.3,21
CDM,27207040,W DRILL TWIST AO 1.0MM,211.0,137.15,35.45,189.9,21
CDM,27207050,W DRILL TWIST AO END 2.0X105MM,212.0,137.8,35.62,190.8,21
CDM,27207060,W DRILL TWIST AO SHFT LAG 1.9MM,196.0,127.4,32.93,176.4,21
CDM,27207070,W DRILL TWIST DENTAL 1.4MM,206.0,133.9,34.61,185.4,21
CDM,27207080,W DRILL TWIST WL DNTL END LAG,206.0,133.9,34.61,185.4,21
CDM,27207090,W DRILLBIT 2.0/2.5MM,167.0,108.55,28.06,150.3,21
CDM,27207100,W DRILLBIT 2.5MM 310.243,119.0,77.35,19.99,107.1,21
CDM,27207106,ENDOSCOPE SINGLE USE IE DISPOSABLE URINARY TRACT IMAGING ILLUMIN,25.0,16.25,4.2,22.5,21
CDM,27207110,W DRILLBIT 2.7X125 FLUTE 315.28,244.0,158.6,40.99,219.6,21
CDM,27207116,LRG CURVE 6FRX110CM 2-6-2MM SPCNG DYNAMIC XT STEERABLE DECAPOLAR,555.0,360.75,93.24,499.5,21
CDM,27207120,W DRILLBIT 3.2MM 5085-2-032,206.0,133.9,34.61,185.4,21
CDM,27207130,W DRILLBIT 3-FLT STRL 3.2X100MM,368.0,239.2,61.82,331.2,21
CDM,27207140,W DRILLBIT BONE GRP 24,202.0,131.3,33.94,181.8,21
CDM,27207150,W DRILLBIT BONE STRY,220.0,143.0,36.96,198.0,21
CDM,27207160,W DRILLBIT CANN SYNTH,588.0,382.2,98.78,529.2,21
CDM,27207170,W DRILLBIT CANNULATED,675.0,438.75,113.4,607.5,21
CDM,27207180,W DRILLBIT CANNULATED 2.9,185.0,120.25,31.08,166.5,21
CDM,27207190,W DRILLBIT DISTAL RADI 310.510,250.0,162.5,42.0,225.0,21
CDM,27207200,W DRILLBIT GRAY PT GRP 26,205.0,133.25,34.44,184.5,21
CDM,27207210,W DRILLBIT GRY BI DR END GRP 25,203.0,131.95,34.1,182.7,21
CDM,27207216,DRYSEAL FLEX INTRODUCER SHEATH 12FR X 45CM,1112.0,722.8,186.82,1000.8,21
CDM,27207220,W DRILLBIT GRY TIP KNEE GRP 23,193.0,125.45,32.42,173.7,21
CDM,27207226,PACEMAKER PACK,63.0,40.95,10.58,56.7,21
CDM,27207230,W DRILLBIT QC STERILE,179.0,116.35,30.07,161.1,21
CDM,27207236,AMPLATZ EXTRA STIFF SUPPORT 0.032IN X 260CM WIRE GUIDE,186.0,120.9,31.25,167.4,21
CDM,27207240,W DRILLBIT QUICK COUPLING 3.5,179.0,116.35,30.07,161.1,21
CDM,27207246,ADHESIVE HYPOALLERGENIC PANNUS RETENTION SYSTEM LATEX FREE,131.0,85.15,22.01,117.9,21
CDM,27207250,W DRILLBIT QUIK CPL 2.0L 310.21,123.0,79.95,20.66,110.7,21
CDM,27207256,AGILIS NXT STEERABLE INTRODUCER 13FR MEDIUM CURL,1755.0,1140.75,294.84,1579.5,21
CDM,27207260,W DRILLBIT SYNT,114.0,74.1,19.15,102.6,21
CDM,27207270,W DRILLBIT QUIK CPL 3.2 310.31,110.0,71.5,18.48,99.0,21
CDM,27207280,W DRILLBIT QUIK CPL 3.2X145MM,171.0,111.15,28.73,153.9,21
CDM,27207290,W DRILLBIT QUIK CPL 3.5L,128.0,83.2,21.5,115.2,21
CDM,27207300,W DRILLBIT RADIOLCNT 3.5MM TWST,467.0,303.55,78.46,420.3,21
CDM,27207310,W DRILLBIT SHFT FLEX GRP 56,762.0,495.3,128.02,685.8,21
CDM,27207320,W DRN CHEST,49.0,31.85,8.23,44.1,21
CDM,27207326,GUIDEWIRE MINAMO,131.0,85.15,22.01,117.9,21
CDM,27207330,W DRN HEMOVAC,78.0,50.7,13.1,70.2,21
CDM,27207340,W DRN JACKPRAT,51.0,33.15,8.57,45.9,21
CDM,27207350,W DRN JP W RESV,98.0,63.7,16.46,88.2,21
CDM,27207360,W DRN PENROSE,24.0,15.6,4.03,21.6,21
CDM,27207370,W DRN RESER,62.0,40.3,10.42,55.8,21
CDM,27207376,SSPC NXT PLUS WITH DELIVERY CATHETER AND DILATOR,525.0,341.25,88.2,472.5,21
CDM,27207380,W DRN RESRVR,259.0,168.35,43.51,233.1,21
CDM,27207390,W DRN SUMP,65.0,42.25,10.92,58.5,21
CDM,27207400,W DRN SUMP SHIRL,26.0,16.9,4.37,23.4,21
CDM,27207410,W DRN WOUND FLL PRFRTN HUBLESS,10.0,6.5,1.68,9.0,21
CDM,27207420,W DRP ANGIO FEM,126.0,81.9,21.17,113.4,21
CDM,27207430,W DRP APRON GU,52.0,33.8,8.74,46.8,21
CDM,27207440,W DRP BARRIER,8.0,5.2,1.34,7.2,21
CDM,27207450,W DRP BILAT EXT,77.0,50.05,12.94,69.3,21
CDM,27207460,W DRP BUTTOCK,40.0,26.0,6.72,36.0,21
CDM,27207470,W DRP CAMERA,52.0,33.8,8.74,46.8,21
CDM,27207480,W DRP CAMERA ARM,83.0,53.95,13.94,74.7,21
CDM,27207490,W DRP C-ARM,24.0,15.6,4.03,21.6,21
CDM,27207500,W DRP CLIP,69.0,44.85,11.59,62.1,21
CDM,27207506,PANNUS RETRACTOR CZ-PPR-XL,150.0,97.5,25.2,135.0,21
CDM,27207510,W DRP CUSTOM,50.0,32.5,8.4,45.0,21
CDM,27207516,GALT MICRO-INTRODUCER 4FR X 10CM X 0.018IN KIT W/40CM NITINOL MA,65.0,42.25,10.92,58.5,21
CDM,27207520,W DRP DISP,92.0,59.8,15.46,82.8,21
CDM,27207526,SAFIRE EXTENSION CABLE 150CM FOR IBI 1500 T6,225.0,146.25,37.8,202.5,21
CDM,27207530,W DRP EYE,180.0,117.0,30.24,162.0,21
CDM,27207540,W DRP FOOT SWTC,25.0,16.25,4.2,22.5,21
CDM,27207550,W DRP GOWN ISOL,109.0,70.85,18.31,98.1,21
CDM,27207560,W DRP INST ARM,83.0,53.95,13.94,74.7,21
CDM,27207570,W DRP IOBAN,38.0,24.7,6.38,34.2,21
CDM,27207580,W DRP ISO IOBAN,104.0,67.6,17.47,93.6,21
CDM,27207590,W DRP LAP,89.0,57.85,14.95,80.1,21
CDM,27207600,W DRP LAP,156.0,101.4,26.21,140.4,21
CDM,27207610,W DRP LAP TRANS,76.0,49.4,12.77,68.4,21
CDM,27207620,W DRP LAP T-SHET *,62.0,40.3,10.42,55.8,21
CDM,27207630,W DRP LASER ARM,38.0,24.7,6.38,34.2,21
CDM,27207636,LIGHTNING BOLT 7 ARTERIAL THROMBECTOMY DEVICE W/ ASPIRATION TUBI,10719.0,6967.35,1800.79,9647.1,21
CDM,27207640,W DRP LEGGING,27.0,17.55,4.54,24.3,21
CDM,27207646,DRYSEAL 18FR X 65CM FLEX HYDRO SHEATH AO,1338.0,869.7,224.78,1204.2,21
CDM,27207650,W DRP LIMB ISL AS*,37.0,24.05,6.22,33.3,21
CDM,27207656,SOUNDSTAR 10FR X 90CM ECO DIAGNOSTIC ULTRASOUND CATHETER,6684.0,4344.6,1122.91,6015.6,21
CDM,27207660,W DRP MAGNETIC D *,101.0,65.65,16.97,90.9,21
CDM,27207670,W DRP MAYO COVER *,27.0,17.55,4.54,24.3,21
CDM,27207680,W DRP MICRO,144.0,93.6,24.19,129.6,21
CDM,27207690,W DRP PELVIC,228.0,148.2,38.3,205.2,21
CDM,27207700,W DRP S IOB,65.0,42.25,10.92,58.5,21
CDM,27207710,W DRP SHEET,12.0,7.8,2.02,10.8,21
CDM,27207720,W DRP SHEET 44X60*,74.0,48.1,12.43,66.6,21
CDM,27207730,W DRP SHEET CHST *,74.0,48.1,12.43,66.6,21
CDM,27207740,W DRP SHEET HIP,60.0,39.0,10.08,54.0,21
CDM,27207750,W DRP SHEET LIMB *,41.0,26.65,6.89,36.9,21
CDM,27207760,W DRP SHEET SPLT *,74.0,48.1,12.43,66.6,21
CDM,27207770,W DRP SLEEVE S,74.0,48.1,12.43,66.6,21
CDM,27207780,W DRP STERILE,201.0,130.65,33.77,180.9,21
CDM,27207790,W DRP STRI EYE,109.0,70.85,18.31,98.1,21
CDM,27207796,DOUBLE BASIN SET PACK,114.0,74.1,19.15,102.6,21
CDM,27207800,W DRP STRI VAG,259.0,168.35,43.51,233.1,21
CDM,27207806,COYOTE ES OTW PTA BALLOON DILATION CATH 4MM X 40MM L 145CM SHAFT,251.0,163.15,42.17,225.9,21
CDM,27207810,W DRP STRI X-LG,74.0,48.1,12.43,66.6,21
CDM,27207816,DRYSEAL FLEX INTRODUCER SHEATH 26FR X 33CM,872.0,566.8,146.5,784.8,21
CDM,27207820,W DRP TABLEOVRHD *,74.0,48.1,12.43,66.6,21
CDM,27207830,W DRP TBL,251.0,163.15,42.17,225.9,21
CDM,27207840,W DRP THERMA,74.0,48.1,12.43,66.6,21
CDM,27207846,SAFARI2 GUIDEWIRE X-SM PRE-SHAPED TAVR/TAVI 0.035IN X 275CM (MFR,375.0,243.75,63.0,337.5,21
CDM,27207850,W DRP THYROID,94.0,61.1,15.79,84.6,21
CDM,27207856,THE FLEXOR CHECK-FLO II INTRODUCER SET 9FR X 30CM 0.038IN MAX GU,95.0,61.75,15.96,85.5,21
CDM,27207860,W DRP TOWEL,61.0,39.65,10.25,54.9,21
CDM,27207866,ARMADA 35 PTA CATHETER 14MM X 40MM BALLOON 135CM SHAFT 0.035IN M,180.0,117.0,30.24,162.0,21
CDM,27207870,W DRP TUR,228.0,148.2,38.3,205.2,21
CDM,27207876,MITRACLIP G5 STEERABLE GUIDE CATHETER,90000.0,58500.0,15120.0,81000.0,21
CDM,27207880,W DRS B/A 4X6,10.0,6.5,1.68,9.0,21
CDM,27207890,W DRS BIOBRN15X10,38.0,24.7,6.38,34.2,21
CDM,27207916,PINNACLE R/O II RADIOPAQUE SHEATH INTRODUCER 7 FR X 10CM?W/ 2.5C,75.0,48.75,12.6,67.5,21
CDM,27207920,W DRS GZ 4X4 2PK,36.0,23.4,6.05,32.4,21
CDM,27207926,"WEBSTER CS BI-DIRECTIONAL DEFLECTABLE CATHETER 7FR?D-F CURVE, 12",1431.0,930.15,240.41,1287.9,21
CDM,27207936,ACTIVE FIXATION 46 CM BRADY LEADS STYLET KIT,192.0,124.8,32.26,172.8,21
CDM,27207946,DRYSEAL FLEX 14FR X 33CM INTRODUCER SHEATH,1320.0,858.0,221.76,1188.0,21
CDM,27207950,W DRS PCKNG NASAL,60.0,39.0,10.08,54.0,21
CDM,27207960,W DRS SAFEGUARD PRESSURE,131.0,85.15,22.01,117.9,21
CDM,27207966,ATRION QL4015 INFLATION DEVICE 40CC 15ATM LOW PROFILE,225.0,146.25,37.8,202.5,21
CDM,27207970,W DRS STERI STRIP,27.0,17.55,4.54,24.3,21
CDM,27207980,W DRS WND VAC LG,111.0,72.15,18.65,99.9,21
CDM,27207986,"EPSILA EV STERNAL TUNNELING TOOL, ZONE 1",1800.0,1170.0,302.4,1620.0,21
CDM,27207990,W DRS WND VAC MED,93.0,60.45,15.62,83.7,21
CDM,27207996,REPROCESSED BIOSENSE WEBSTER 10FR X 90CM SOUNDSTAR ECO DIAGNOSTI,3110.0,2021.5,522.48,2799.0,21
CDM,27208000,W DRS WND VAC SM,73.0,47.45,12.26,65.7,21
CDM,27208006,EZ STEER 7.5FR X 115CM 3.5MM SENSOR THERMOCOOL BI-DIRECTIONAL AB,4125.0,2681.25,693.0,3712.5,21
CDM,27208010,W DRSG 1IN DSK,10.0,6.5,1.68,9.0,21
CDM,27208016,MDT ADAPTORS ROTATABLE CONNECTOR,960.0,624.0,161.28,864.0,21
CDM,27208020,W DRSG HYDRO FLOZ,64.0,41.6,10.75,57.6,21
CDM,27208030,W DRSG HYDRO GRM,74.0,48.1,12.43,66.6,21
CDM,27208040,W DRSG HYDRO16<WO,38.0,24.7,6.38,34.2,21
CDM,27208060,W DRSG HYDRO48>WO,105.0,68.25,17.64,94.5,21
CDM,27208070,W DRSNG KIT VAC GRANUFOAM LG,91.0,59.15,15.29,81.9,21
CDM,27208080,W DRSNG KIT VAC GRANUFOAM MED,78.0,50.7,13.1,70.2,21
CDM,27208090,W D-STAT DRY HEMOSTATIC BANDAGE,68.0,44.2,11.42,61.2,21
CDM,27208100,W DUAL BI-POLAR CORD STERILE,200.0,130.0,33.6,180.0,21
CDM,27208110,W DVCE FOLDER IOL,29.0,18.85,4.87,26.1,21
CDM,27208120,W DVCE TORQUE,66.0,42.9,11.09,59.4,21
CDM,27208130,W E TRAPS,18.0,11.7,3.02,16.2,21
CDM,27208140,W ELCTRDE LEVEEN COACCESS 3.5CM,2176.0,1414.4,365.57,1958.4,21
CDM,27208150,W ELCTRDE LEVEEN COACCESS 3CM,1856.0,1206.4,311.81,1670.4,21
CDM,27208160,W ELCTRDE LEVEEN COACCESS 4CM,2410.0,1566.5,404.88,2169.0,21
CDM,27208170,W ELECTRODE COAG 1-STEM 24FR,835.0,542.75,140.28,751.5,21
CDM,27208180,W ELECTRODE COAG POINTED 24FR,162.0,105.3,27.22,145.8,21
CDM,27208190,W ELECTRODE COAG POINTED 27FR,147.0,95.55,24.7,132.3,21
CDM,27208200,W ELECTRODE CUT LOOP 24 MLE,68.0,44.2,11.42,61.2,21
CDM,27208210,W ELECTRODE SPATULA TIP,68.0,44.2,11.42,61.2,21
CDM,27208220,W ELECTRODE VERSAPOINT 00467,521.0,338.65,87.53,468.9,21
CDM,27208230,W EMBLIC PRTCTN RX ACCNT SYS,2093.0,1360.45,351.62,1883.7,21
CDM,27208240,W EMBOLIC PROTECTION SYSTM NAV6,1852.0,1203.8,311.14,1666.8,21
CDM,27208250,W EMBOLIZATION COIL PUSHER,270.0,175.5,45.36,243.0,21
CDM,27208260,W EMBOLZN PROTECT,1748.0,1136.2,293.66,1573.2,21
CDM,27208270,W ENDO BABCOCK,1986.0,1290.9,333.65,1787.4,21
CDM,27208280,W ENDO BLADE SYS,390.0,253.5,65.52,351.0,21
CDM,27208290,W ENDO CATCH/SAC,128.0,83.2,21.5,115.2,21
CDM,27208300,W ENDO DISSECT,504.0,327.6,84.67,453.6,21
CDM,27208310,W ENDO DISSECTOR,728.0,473.2,122.3,655.2,21
CDM,27208320,W ENDO FORCP DISP,1113.0,723.45,186.98,1001.7,21
CDM,27208330,W ENDO GRASPER,413.0,268.45,69.38,371.7,21
CDM,27208340,W ENDO REDUCR CAP,65.0,42.25,10.92,58.5,21
CDM,27208350,W ENDO RETRACTOR,4737.0,3079.05,795.82,4263.3,21
CDM,27208360,W ENDO SHEARS,113.0,73.45,18.98,101.7,21
CDM,27208370,W ENDO SHRS LONG,541.0,351.65,90.89,486.9,21
CDM,27208380,W ENDO STAPLER,498.0,323.7,83.66,448.2,21
CDM,27208390,W ENDOPATH,1986.0,1290.9,333.65,1787.4,21
CDM,27208400,W ENDOPTH PSTLGRP,957.0,622.05,160.78,861.3,21
CDM,27208420,W ENDOWRIST HARMONIC CRVD SHRS,164.0,106.6,27.55,147.6,21
CDM,27208430,W EQ SHAVER ARTHR*,129.0,83.85,21.67,116.1,21
CDM,27208440,W ERCP LOCKING DEVICE,17.0,11.05,2.86,15.3,21
CDM,27208450,W EXFX BAR,130.0,84.5,21.84,117.0,21
CDM,27208460,W EXFX CAP TIP,10.0,6.5,1.68,9.0,21
CDM,27208470,W EXFX CLAMP SM,791.0,514.15,132.89,711.9,21
CDM,27208500,W EXFX SET SM,8436.0,5483.4,1417.25,7592.4,21
CDM,27208510,W EXTR SEGOVERGWR,504.0,327.6,84.67,453.6,21
CDM,27208520,W EYE HYDRODISSECTOR,49.0,31.85,8.23,44.1,21
CDM,27208530,W FEEDING TUBE SET MCLEAN-RING,99.0,64.35,16.63,89.1,21
CDM,27208540,W FELT PTFE 6X6IN,250.0,162.5,42.0,225.0,21
CDM,27208550,W FEM CANAL BRUSH,60.0,39.0,10.08,54.0,21
CDM,27208560,W FEM COMP ARCH,158.0,102.7,26.54,142.2,21
CDM,27208570,W FIAPC PROBE CIRCUMFERENTIAL,320.0,208.0,53.76,288.0,21
CDM,27208580,W FIAPC PROBE SIDEFIRE,320.0,208.0,53.76,288.0,21
CDM,27208590,W FIAPC PROBE STRAIGHT,318.0,206.7,53.42,286.2,21
CDM,27208600,W FIBRWIRE MENISCUS REP NDL 2-0,114.0,74.1,19.15,102.6,21
CDM,27208610,W FILTER GUNTHR TULIP VENA CAVA,376.0,244.4,63.17,338.4,21
CDM,27208620,W FILTER HEATER INSUFLOW 6198,202.0,131.3,33.94,181.8,21
CDM,27208630,W FILTER VENA CAVA RCVRY RMVL,863.0,560.95,144.98,776.7,21
CDM,27208640,W DEV FIX ABSTACK,642.0,417.3,107.86,577.8,21
CDM,27208650,W FIXATOR WRIST MONTUBE,2468.0,1604.2,414.62,2221.2,21
CDM,27208660,W FLTR BLD PALL,63.0,40.95,10.58,56.7,21
CDM,27208670,W FLUSH VSSL SIZNG PERF CTH,55.0,35.75,9.24,49.5,21
CDM,27208680,W FOGARTY DOUBLE HYDRA JAW 86,53.0,34.45,8.9,47.7,21
CDM,27208690,W FOOT TRACTION BOOTS-ADULT,277.0,180.05,46.54,249.3,21
CDM,27208700,W FORCEP BIPOLAR CUTTING 10MM,599.0,389.35,100.63,539.1,21
CDM,27208710,W FORCEP GRSP TRICEP HOOKED,327.0,212.55,54.94,294.3,21
CDM,27208720,W FORCEPS COLD BX COLON JUMBO,18.0,11.7,3.02,16.2,21
CDM,27208730,W FORCEPS DOUBLE BALLOON,126.0,81.9,21.17,113.4,21
CDM,27208740,W FORCEPS MARYLAND DAVINCI S,405.0,263.25,68.04,364.5,21
CDM,27208750,W FORCEPS RAD JAW GP 160CM,74.0,48.1,12.43,66.6,21
CDM,27208760,W FRCP BPSY STRGHT/SHPBLE TIP,261.0,169.65,43.85,234.9,21
CDM,27208770,W FRCP DISP 1,277.5,180.38,46.62,249.75,21
CDM,27208780,W FRCP DISP 2,300.0,195.0,50.4,270.0,21
CDM,27208790,W FRCP DISP 3,405.0,263.25,68.04,364.5,21
CDM,27208800,W FRCP DISP 4,330.0,214.5,55.44,297.0,21
CDM,27208810,W FRCP DISP 5,395.0,256.75,66.36,355.5,21
CDM,27208820,W FRCP GRSP,1638.0,1064.7,275.18,1474.2,21
CDM,27208830,W FRCP GRSPNG,777.0,505.05,130.54,699.3,21
CDM,27208840,W FRCP MICRO DISP,395.0,256.75,66.36,355.5,21
CDM,27208850,W FRCP TRIPOLAR,1056.0,686.4,177.41,950.4,21
CDM,27208860,W FRCP URET BPSY PIRANHA 505160,593.0,385.45,99.62,533.7,21
CDM,27208870,W GASTRO SUTURE ANCHOR SET,101.0,65.65,16.97,90.9,21
CDM,27208880,W GASTROSTMY TUBE,131.0,85.15,22.01,117.9,21
CDM,27208890,W GASTROSTMY TUBE,203.0,131.95,34.1,182.7,21
CDM,27208900,W GCATH CORDIS 8F,229.0,148.85,38.47,206.1,21
CDM,27208910,W GCTH AVE 6F,229.0,148.85,38.47,206.1,21
CDM,27208920,W GCTH AVE 7F,229.0,148.85,38.47,206.1,21
CDM,27208930,W GCTH AVE 8F,229.0,148.85,38.47,206.1,21
CDM,27208940,W GCTH WISEGD 6,229.0,148.85,38.47,206.1,21
CDM,27208950,W GDE CALIBRATED,196.0,127.4,32.93,176.4,21
CDM,27208960,W GDE ENDO,392.0,254.8,65.86,352.8,21
CDM,27208970,W GDEWIRE 150CM FELX ANGLD TIP,81.0,52.65,13.61,72.9,21
CDM,27208980,W GDEWIRE SAFE-T-J COATED CRVD,26.0,16.9,4.37,23.4,21
CDM,27208990,W GDNG INTRDCR FAST CTH 60CM,240.0,156.0,40.32,216.0,21
CDM,27209000,W GDNG INTRDCR FAST CTH 63CM,240.0,156.0,40.32,216.0,21
CDM,27209010,W GDNG SHTH CTH CPS DIRECT SLII,645.0,419.25,108.36,580.5,21
CDM,27209020,W GDNG SHTH STRGHT CRSS-CUT VLV,158.0,102.7,26.54,142.2,21
CDM,27209030,W GDWIRE 180CM FLEX ANGLE TIP,94.0,61.1,15.79,84.6,21
CDM,27209040,W GDWIRE 25CM TIP FTHM STRABLE,495.0,321.75,83.16,445.5,21
CDM,27209050,W GDWIRE INQWIRE FXD CORE PTFE,32.0,20.8,5.38,28.8,21
CDM,27209060,W GDWIRE ROADRUNNER TM EXTRA,156.0,101.4,26.21,140.4,21
CDM,27209070,W GDWIRE SUPER STIFF-FIXED CORE,37.0,24.05,6.22,33.3,21
CDM,27209080,W GDWIRE TRNSND STRBLE HYDRPLC,341.0,221.65,57.29,306.9,21
CDM,27209090,W GDWIRE VNUS MICRO INTRO SHTH,55.0,35.75,9.24,49.5,21
CDM,27209100,W GDWR 150CM FLXBLE ANG/STR TIP,60.0,39.0,10.08,54.0,21
CDM,27209110,W GDWR 15CM TAPER PTFE COATED,33.0,21.45,5.54,29.7,21
CDM,27209120,W GDWR 260CM FLXBLE ANG/STR TIP,90.0,58.5,15.12,81.0,21
CDM,27209130,W GDWR 260CM FLXBLE STR TIP,82.0,53.3,13.78,73.8,21
CDM,27209140,W GDWR 7CM STRGHT TP SUPR STIFF,57.0,37.05,9.58,51.3,21
CDM,27209150,W GDWR ANGLD TP STD ZPWR HDRPLC,66.0,42.9,11.09,59.4,21
CDM,27209160,W GDWR BALL TIPPED STRL 3X800MM,235.0,152.75,39.48,211.5,21
CDM,27209170,W GDWR FINISHING WIRE 90 CM,228.0,148.2,38.3,205.2,21
CDM,27209180,W GDWR FLPPY ANGLD SGWY HYDRPLC,223.0,144.95,37.46,200.7,21
CDM,27209190,W GDWR GLDE CTD 3X.035X150 ANGL,73.0,47.45,12.26,65.7,21
CDM,27209200,W GDWR GLIDE CTD 3X.035X150 STR,80.0,52.0,13.44,72.0,21
CDM,27209210,W GDWR LNDRQST STRGHT EXCHG SS,153.0,99.45,25.7,137.7,21
CDM,27209220,W GDWR PROLN NITINOL MANDRL,40.0,26.0,6.72,36.0,21
CDM,27209230,W GDWR SENSR .035 DUAL FLEX ANG,93.0,60.45,15.62,83.7,21
CDM,27209240,W GDWR STABILIZER EXTRA SUPPORT,40.0,26.0,6.72,36.0,21
CDM,27209250,W GDWR STD ANGL H20 HYDROPHILIC,68.0,44.2,11.42,61.2,21
CDM,27209260,W GDWR STRGHT FXD CORE PTFE INQ,38.0,24.7,6.38,34.2,21
CDM,27209270,W GDWR STRGHT TP AMPLTZ SPR,88.0,57.2,14.78,79.2,21
CDM,27209280,W GDWR SUPER STIFF .035 X 180CM,158.0,102.7,26.54,142.2,21
CDM,27209290,W GDWR THRD 3.2 X 400MM,156.0,101.4,26.21,140.4,21
CDM,27209300,W GDWR TROOPER/PATRT EXTSN WIRE,162.0,105.3,27.22,145.8,21
CDM,27209310,W GDWRE 180CM FLPPY PLTNM PLS,145.0,94.25,24.36,130.5,21
CDM,27209320,W GDWRE 260CM FLPPY PLTNM PLS,170.0,110.5,28.56,153.0,21
CDM,27209330,W GELPORT HAND ACCESS C8XX2,692.0,449.8,116.26,622.8,21
CDM,27209340,W GINTRO EP IC FC,193.0,125.45,32.42,173.7,21
CDM,27209350,W GINTRO EP IC FC,505.0,328.25,84.84,454.5,21
CDM,27209370,W GOWN ISOL,27.0,17.55,4.54,24.3,21
CDM,27209380,W GOWN ISOL UNSTR*,60.0,39.0,10.08,54.0,21
CDM,27209390,W GRASPER COBRA DAVINCI S,330.0,214.5,55.44,297.0,21
CDM,27209400,W GRASPER DBL FENESTRATED,300.0,195.0,50.4,270.0,21
CDM,27209410,W GRASPER ENDOPATH 5MM,131.0,85.15,22.01,117.9,21
CDM,27209420,W GRASPER PROGRASP ENDOWRIST,330.0,214.5,55.44,297.0,21
CDM,27209430,W GUIDE PIN DHS/DCS 2 5MM,79.0,51.35,13.27,71.1,21
CDM,27209440,W GUIDE WIRE,75.0,48.75,12.6,67.5,21
CDM,27209450,W GUIDE WIRE,131.0,85.15,22.01,117.9,21
CDM,27209460,W GUIDE WIRE,197.0,128.05,33.1,177.3,21
CDM,27209470,W GUIDE WIRE,230.0,149.5,38.64,207.0,21
CDM,27209480,W GUIDE WIRE,314.0,204.1,52.75,282.6,21
CDM,27209490,W GUIDE WIRE .035,225.0,146.25,37.8,202.5,21
CDM,27209500,W GUIDE WIRE ATTAIN,255.0,165.75,42.84,229.5,21
CDM,27209510,W GUIDE WIRE J,106.0,68.9,17.81,95.4,21
CDM,27209520,W GUIDE WIRE KIT,762.0,495.3,128.02,685.8,21
CDM,27209530,W GUIDE WIRE SUPER STIFF,301.0,195.65,50.57,270.9,21
CDM,27209540,W GUIDEWIRE,149.0,96.85,25.03,134.1,21
CDM,27209550,W GUIDEWIRE .062X7 LONG,65.0,42.25,10.92,58.5,21
CDM,27209570,W GUIDEWIRE 1.37 MM SHARP/BLNT,228.0,148.2,38.3,205.2,21
CDM,27209580,W GUIDEWIRE 2.8MM X 450MM THRD,141.0,91.65,23.69,126.9,21
CDM,27209590,W GUIDEWIRE 260CM TEF EMERALD,12.0,7.8,2.02,10.8,21
CDM,27209600,W GUIDEWIRE 900.721 1.25X150,57.0,37.05,9.58,51.3,21
CDM,27209610,W GUIDEWIRE 900.722 1.25X150MM,61.0,39.65,10.25,54.9,21
CDM,27209620,W GUIDEWIRE AMPLATX SUPERST,244.0,158.6,40.99,219.6,21
CDM,27209630,W GUIDEWIRE ASAHI GRAND SLAM,131.0,85.15,22.01,117.9,21
CDM,27209640,W GUIDEWIRE ASAHI MIRACLEBROS,245.0,159.25,41.16,220.5,21
CDM,27209650,W GUIDEWIRE BALL-TIPPED STERILE,450.0,292.5,75.6,405.0,21
CDM,27209660,W GUIDEWIRE BEN/STR/PTFE/STRTR,20.0,13.0,3.36,18.0,21
CDM,27209670,W GUIDEWIRE BILI PATHFINDER SS,210.0,136.5,35.28,189.0,21
CDM,27209680,W GUIDEWIRE EMERALD J3MM 150CM,15.0,9.75,2.52,13.5,21
CDM,27209690,W GUIDEWIRE EXCHNGE AMPLTZ SUPR,82.0,53.3,13.78,73.8,21
CDM,27209700,W GUIDEWIRE FLOPPY 185CM,50.0,32.5,8.4,45.0,21
CDM,27209710,W GUIDEWIRE FORTE STRT TIP,131.0,85.15,22.01,117.9,21
CDM,27209720,W GUIDEWIRE HALO,219.0,142.35,36.79,197.1,21
CDM,27209730,W GUIDEWIRE HALO .035 INX260CM,219.0,142.35,36.79,197.1,21
CDM,27209740,W GUIDEWIRE HI-TORQUE FLOPPY II,149.0,96.85,25.03,134.1,21
CDM,27209750,W GUIDEWIRE HI-TORQUE PILOT,149.0,96.85,25.03,134.1,21
CDM,27209760,W GUIDEWIRE HI-TORQUE WIGGLE,149.0,96.85,25.03,134.1,21
CDM,27209770,W GUIDEWIRE II,85.0,55.25,14.28,76.5,21
CDM,27209780,W GUIDEWIRE III,143.0,92.95,24.02,128.7,21
CDM,27209790,W GUIDEWIRE INQWIRE BENTSON,27.0,17.55,4.54,24.3,21
CDM,27209800,W GUIDEWIRE INQWIRE FIXED CORE,13.0,8.45,2.18,11.7,21
CDM,27209810,W GUIDEWIRE IV,227.0,147.55,38.14,204.3,21
CDM,27209820,W GUIDEWIRE JAGWIRE .025 260CM,199.0,129.35,33.43,179.1,21
CDM,27209830,W GUIDEWIRE JAGWIRE .035 450CM,288.0,187.2,48.38,259.2,21
CDM,27209840,W GUIDEWIRE JSFC/PTFE STRTR,23.0,14.95,3.86,20.7,21
CDM,27209850,W GUIDEWIRE KATZEN INFUSION,272.0,176.8,45.7,244.8,21
CDM,27209860,W GUIDEWIRE PORTER,219.0,142.35,36.79,197.1,21
CDM,27209870,W GUIDEWIRE PT2 MS 2CM STRGHT,111.0,72.15,18.65,99.9,21
CDM,27209880,W GUIDEWIRE ROADRUNNER PC FIRM,59.0,38.35,9.91,53.1,21
CDM,27209890,W GUIDEWIRE ROS/PTFE/3/5 STRTR,21.0,13.65,3.53,18.9,21
CDM,27209900,W GUIDEWIRE ROS/PTFE/STARTER,34.0,22.1,5.71,30.6,21
CDM,27209910,W GUIDEWIRE RR 5F 180CM RDRUNNR,142.0,92.3,23.86,127.8,21
CDM,27209920,W GUIDEWIRE SENSOR .035 3CM STR,89.0,57.85,14.95,80.1,21
CDM,27209930,W GUIDEWIRE SHAFT VIPERWIRE ADV,225.0,146.25,37.8,202.5,21
CDM,27209940,W GUIDEWIRE SYNT,65.0,42.25,10.92,58.5,21
CDM,27209950,W GUIDEWIRE VIGOR SINUS,233.0,151.45,39.14,209.7,21
CDM,27209960,W GUIDEWIRE WHISPER VIEW,221.0,143.65,37.13,198.9,21
CDM,27209970,W GUIDEWIRE/HYDRAWIRE,262.0,170.3,44.02,235.8,21
CDM,27209980,W GUIDEWIRED VI,46.25,30.06,7.77,41.63,21
CDM,27209990,W GUIDEWRE 035IN X145CM 11CM,64.0,41.6,10.75,57.6,21
CDM,27210000,W GUIDEWRE STD WHOLEY HI-TORQUE,124.0,80.6,20.83,111.6,21
CDM,27210010,W GUIDWIRE 292.68 THREAD 2.8MM,82.0,53.3,13.78,73.8,21
CDM,27210020,"W GW 0.035 X 260CM, BEN/STR/PTF",42.0,27.3,7.06,37.8,21
CDM,27210030,W GW C HI-TORQ WHISPER,131.0,85.15,22.01,117.9,21
CDM,27210040,W GW FEM CATH,41.0,26.65,6.89,36.9,21
CDM,27210050,W GW HI-TORG CROSSIT 100XT,149.0,96.85,25.03,134.1,21
CDM,27210060,W GW HI-TORQ ALL STAR,149.0,96.85,25.03,134.1,21
CDM,27210070,W GW HI-TORQ BALANCE MW,149.0,96.85,25.03,134.1,21
CDM,27210080,W GW HI-TORQ HW,327.0,212.55,54.94,294.3,21
CDM,27210090,W GW HI-TORQ200XT,327.0,212.55,54.94,294.3,21
CDM,27210100,W GW HI-TORQIRNMN,327.0,212.55,54.94,294.3,21
CDM,27210110,W GW HP JAGWIRE,410.0,266.5,68.88,369.0,21
CDM,27210120,W GW INTR,65.0,42.25,10.92,58.5,21
CDM,27210130,W GW JINDO TAPERD,315.0,204.75,52.92,283.5,21
CDM,27210140,W GW PLATINUM PLS,327.0,212.55,54.94,294.3,21
CDM,27210150,W GW PTCA CHOICE 182/300,131.0,85.15,22.01,117.9,21
CDM,27210160,W GW PTCA LUGE,327.0,212.55,54.94,294.3,21
CDM,27210170,W GW PTCA PATRIOT,327.0,212.55,54.94,294.3,21
CDM,27210180,W GW PTCA PTGRPHX MED182/300,131.0,85.15,22.01,117.9,21
CDM,27210190,W GW SYS WHOLEY,327.0,212.55,54.94,294.3,21
CDM,27210200,W GW SYS WHOLEY,327.0,212.55,54.94,294.3,21
CDM,27210210,W GW SYS WHOLEY,488.0,317.2,81.98,439.2,21
CDM,27210220,W GW TAD,526.0,341.9,88.37,473.4,21
CDM,27210230,W GW TRQ PLX,370.0,240.5,62.16,333.0,21
CDM,27210250,W GWIRE ANG STF 0.035IN X 150CM,364.0,236.6,61.15,327.6,21
CDM,27210260,W GWIRE HYDRA ANG/STR/DRM,262.0,170.3,44.02,235.8,21
CDM,27210280,W GWIRE NON-THRD SHARP 18IN,161.0,104.65,27.05,144.9,21
CDM,27210290,W HANDPIECE ISOLATOR TRANSPOLAR,3794.0,2466.1,637.39,3414.6,21
CDM,27210300,W HARMONIC DISS HOOK DH105,247.0,160.55,41.5,222.3,21
CDM,27210310,W HEMOSTASIS NONEVASIVE PAD,62.0,40.3,10.42,55.8,21
CDM,27210320,W HEMOSTATIC BANDAGE 1 X 3,40.0,26.0,6.72,36.0,21
CDM,27210330,W HEMOSTATIC DRESSING,56.0,36.4,9.41,50.4,21
CDM,27210340,W HEMOSTATIC MATRIX FLOSEAL 5ML,245.0,159.25,41.16,220.5,21
CDM,27210350,W HNDPC ABL RF,7723.0,5019.95,1297.46,6950.7,21
CDM,27210370,W HOOK CAUTERY DAVINCI 420183,300.0,195.0,50.4,270.0,21
CDM,27210380,W HOOK DURA,65.0,42.25,10.92,58.5,21
CDM,27210390,W HOOK STAYS BLUNT 12MM,413.0,268.45,69.38,371.7,21
CDM,27210400,W HOT BIOPSY FORCEP,34.0,22.1,5.71,30.6,21
CDM,27210410,W HYDRATOME CANNLTG SPHNCTME,623.0,404.95,104.66,560.7,21
CDM,27210420,W IABP INSERTION KIT,186.0,120.9,31.25,167.4,21
CDM,27210430,W ICP MONITORING VENTRIC BOLT,907.0,589.55,152.38,816.3,21
CDM,27210440,W INDEFLATOR,262.0,170.3,44.02,235.8,21
CDM,27210450,W INFLATION DEVICE,87.0,56.55,14.62,78.3,21
CDM,27210460,W INFLATION DEVICE BILIARY,126.0,81.9,21.17,113.4,21
CDM,27210470,W INFUSABLE PRSSR INFUSION PUMP,43.0,27.95,7.22,38.7,21
CDM,27210480,W INFUSION LIFEGUARD SAFETY SET,17.0,11.05,2.86,15.3,21
CDM,27210490,W INFUSION THROMOLYTIC SYSTEM,341.0,221.65,57.29,306.9,21
CDM,27210500,W INFUSN PWR PLS DLVRY SPK SET,68.0,44.2,11.42,61.2,21
CDM,27210510,W INSERT SUTURE HOLDER OCTOBASE,93.0,60.45,15.62,83.7,21
CDM,27210520,W INSERTER TIP F/MED 5MM,267.0,173.55,44.86,240.3,21
CDM,27210540,W INST CLAMP MSCL*,135.0,87.75,22.68,121.5,21
CDM,27210550,W INST STAPLR BN *,156.0,101.4,26.21,140.4,21
CDM,27210560,W INTDCR AGILIS STRABLE W/TIP,1499.0,974.35,251.83,1349.1,21
CDM,27210570,W INTDCR MLLNS TRNSPT 67CM DLTR,126.0,81.9,21.17,113.4,21
CDM,27210580,W INTRDCR 16 FR PLEURX CATH KIT,689.0,447.85,115.75,620.1,21
CDM,27210590,W INTRDCR 6/7FRX10CM PINNACLE,47.0,30.55,7.9,42.3,21
CDM,27210600,W INTRDCR GALT PTFE TEARAWAY,88.0,57.2,14.78,79.2,21
CDM,27210610,W INTRDCR GALT STIFFEN MICRO,79.0,51.35,13.27,71.1,21
CDM,27210620,W INTRDCR SHTH MRKR RADIOPAQUE,56.0,36.4,9.41,50.4,21
CDM,27210630,W INTRDCR TRACH 30FR PERC BLLN,64.0,41.6,10.75,57.6,21
CDM,27210640,W INTRO CATH,16.0,10.4,2.69,14.4,21
CDM,27210650,W INTRO COOK CHCK,166.0,107.9,27.89,149.4,21
CDM,27210660,W INTRO EP IC N-L,83.0,53.95,13.94,74.7,21
CDM,27210670,W INTRO EP IC NL2,332.0,215.8,55.78,298.8,21
CDM,27210680,W INTRO HEMO FAST CATH LUER LK,16.0,10.4,2.69,14.4,21
CDM,27210690,W INTROD CHK FLO,358.0,232.7,60.14,322.2,21
CDM,27210700,W INTRODCER SHEATH PERITNL 61CM,58.0,37.7,9.74,52.2,21
CDM,27210710,W INTRODUCER 6FRX45CM,143.0,92.95,24.02,128.7,21
CDM,27210720,W INTRODUCER NDL,119.0,77.35,19.99,107.1,21
CDM,27210730,W INTRODUCER SET,148.0,96.2,24.86,133.2,21
CDM,27210740,W INTRODUCER SHEATH 12FRX30CM,149.0,96.85,25.03,134.1,21
CDM,27210750,W INTRODUCER SHEATH COOK G08957,149.0,96.85,25.03,134.1,21
CDM,27210760,W INTRODUCR W/HEMO 7F 0.035IN,76.0,49.4,12.77,68.4,21
CDM,27210770,W IRRG ST HYDRO-SURG PLUS,72.0,46.8,12.1,64.8,21
CDM,27210780,W ISOLATOR TRANSPOLAR PEN,2565.0,1667.25,430.92,2308.5,21
CDM,27210790,W JAGWIRE PULMONARY,206.0,133.9,34.61,185.4,21
CDM,27210800,W JEJUNOSTOMY SET,89.0,57.85,14.95,80.1,21
CDM,27210810,W KIT ACCESSORY 355063,146.0,94.9,24.53,131.4,21
CDM,27210820,W KIT ACCESSORY ACTICON ABS,780.0,507.0,131.04,702.0,21
CDM,27210830,W KIT ACCESSORY BOOTS FOR DBS,158.0,102.7,26.54,142.2,21
CDM,27210840,W KIT ACCESSORY NEEDLE TOUHY 14,67.0,43.55,11.26,60.3,21
CDM,27210850,W KIT ACCESSORY WRENCH,64.0,41.6,10.75,57.6,21
CDM,27210860,W KIT ANCHOR PUSHLOK 3.5MM DISP,61.0,39.65,10.25,54.9,21
CDM,27210870,W KIT BONE PREP,522.0,339.3,87.7,469.8,21
CDM,27210880,W KIT CATH 25F 35CM,149.0,96.85,25.03,134.1,21
CDM,27210890,W KIT CATH CV DOUBLE LUM ARROW,116.0,75.4,19.49,104.4,21
CDM,27210900,W KIT CATH CV TRIPLE LUM ARROW,82.0,53.3,13.78,73.8,21
CDM,27210910,W KIT CATH VEN HP EDWR,154.0,100.1,25.87,138.6,21
CDM,27210920,W KIT CO2 TMR HEART LASER,3638.0,2364.7,611.18,3274.2,21
CDM,27210930,W KIT COMPONENT ACCESSORY HERO,593.0,385.45,99.62,533.7,21
CDM,27210940,W KIT CRAINIAL ACSS TWIST DRILL,398.0,258.7,66.86,358.2,21
CDM,27210950,W KIT CRANI DRAIN,334.0,217.1,56.11,300.6,21
CDM,27210960,W KIT CTH NEPH STR 7F .038 82CM,359.0,233.35,60.31,323.1,21
CDM,27210970,W KIT DRAINAGE PLEURX,91.0,59.15,15.29,81.9,21
CDM,27210980,W KIT DRNAGE PLEURAL EFFUSION,91.0,59.15,15.29,81.9,21
CDM,27210990,W KIT EXTREMITY IMPLANT,375.0,243.75,63.0,337.5,21
CDM,27211000,W KIT FEEDING TUBE TTP JEJUNAL,293.0,190.45,49.22,263.7,21
CDM,27211010,W KIT HERNIA TROCAR EXTV RD,864.0,561.6,145.15,777.6,21
CDM,27211020,W KIT HTA PROCEDURE SET,1269.0,824.85,213.19,1142.1,21
CDM,27211030,W KIT HTA PROCEDURE SET,1387.5,901.88,233.1,1248.75,21
CDM,27211040,W KIT ICP MONITORING,903.0,586.95,151.7,812.7,21
CDM,27211050,W KIT INSERTION VENOUS/ARTERIAL,77.0,50.05,12.94,69.3,21
CDM,27211060,W KIT MONITOR PRESSURE PX3,55.0,35.75,9.24,49.5,21
CDM,27211070,W KIT NEEDLE ACCSORY CVD TIP,67.0,43.55,11.26,60.3,21
CDM,27211080,W KIT PER-FIT TRACHEOSTOMY,419.0,272.35,70.39,377.1,21
CDM,27211090,W KIT PICC XCELA DUAL 5F CUST,248.0,161.2,41.66,223.2,21
CDM,27211100,W KIT POLAR CARE,277.0,180.05,46.54,249.3,21
CDM,27211110,W KIT RESECTOR TRIVEX,455.0,295.75,76.44,409.5,21
CDM,27211120,W KIT SOFT TISS MARK W/NDL,293.0,190.45,49.22,263.7,21
CDM,27211130,W KIT TOTAL HIP BONE PREP,381.0,247.65,64.01,342.9,21
CDM,27211140,W KIT TROCAR HERNIA EXTVIEW OVL,555.0,360.75,93.24,499.5,21
CDM,27211150,W KIT VEIN HARV USP1 SUTR 60CM,1049.0,681.85,176.23,944.1,21
CDM,27211160,W KIT VENOUS ACCESS CVC ARROW,129.0,83.85,21.67,116.1,21
CDM,27211170,W KNF ANGLED SLIT,145.0,94.25,24.36,130.5,21
CDM,27211180,W KNF DEBRIDEMENT,47.0,30.55,7.9,42.3,21
CDM,27211190,W KNF GRAF,277.0,180.05,46.54,249.3,21
CDM,27211200,W KNF MYRINGOTOMY,233.0,151.45,39.14,209.7,21
CDM,27211210,W KNF SURG EYE,276.0,179.4,46.37,248.4,21
CDM,27211220,W KNIFE LUDVIK WAVEFORM,320.0,208.0,53.76,288.0,21
CDM,27211230,W KT ACCESS,1616.0,1050.4,271.49,1454.4,21
CDM,27211240,W KT ACCESS LD LK,184.0,119.6,30.91,165.6,21
CDM,27211250,W KT ACCESS LD LOCK RMVL,762.0,495.3,128.02,685.8,21
CDM,27211260,W KT ACCY EXT TUNNEL TL 365538,205.0,133.25,34.44,184.5,21
CDM,27211270,W KT ACCY KIT LD REV 355026,437.0,284.05,73.42,393.3,21
CDM,27211280,W KT ACCY NDL EPDL SMLTR 355028,81.0,52.65,13.61,72.9,21
CDM,27211290,W KT ACCY SNP LD CON CBL 355031,372.0,241.8,62.5,334.8,21
CDM,27211300,W KT ACCY STYLET REV 3550R33,399.0,259.35,67.03,359.1,21
CDM,27211310,W KT ACCY TUNNELING TL 355038,131.0,85.15,22.01,117.9,21
CDM,27211320,W KT ACL TRNSTIBL,562.5,365.63,94.5,506.25,21
CDM,27211330,W KT ADAPTR CATH,3.0,1.95,0.5,2.7,21
CDM,27211340,W KT ANS LTA II,55.0,35.75,9.24,49.5,21
CDM,27211360,W KT AUTOTRANSFUS,251.0,163.15,42.17,225.9,21
CDM,27211370,W KT AUTOTRANSFUS,392.0,254.8,65.86,352.8,21
CDM,27211380,W KT BIOPBRSH GIL,334.0,217.1,56.11,300.6,21
CDM,27211390,W KT CANISTR W/IS,16.0,10.4,2.69,14.4,21
CDM,27211400,W KT CATH CARD,51.0,33.15,8.57,45.9,21
CDM,27211410,W KT CATH DIALYSH,237.0,154.05,39.82,213.3,21
CDM,27211420,W KT CRANIOPLAST,358.0,232.7,60.14,322.2,21
CDM,27211430,W KT DRN CATH,195.0,126.75,32.76,175.5,21
CDM,27211440,W KT DRN NRO EXT,342.0,222.3,57.46,307.8,21
CDM,27211450,W KT DRN SUMP,196.0,127.4,32.93,176.4,21
CDM,27211460,W KT DRN/VAC SYS,779.0,506.35,130.87,701.1,21
CDM,27211470,W KT DRSSNG VAC GRANFOAM ABDMNL,489.0,317.85,82.15,440.1,21
CDM,27211480,W KT EMERG INFU,120.0,78.0,20.16,108.0,21
CDM,27211490,W KT GASTRC LAVAG,119.0,77.35,19.99,107.1,21
CDM,27211500,W KT GASTROSTOMY,63.0,40.95,10.58,56.7,21
CDM,27211510,W KT GSENCK SNARE,602.0,391.3,101.14,541.8,21
CDM,27211520,W KT HEMOCONC,1343.0,872.95,225.62,1208.7,21
CDM,27211530,W KT HERNIA TROCAR DIS BLN,819.0,532.35,137.59,737.1,21
CDM,27211540,W KT HICK/BROV,335.0,217.75,56.28,301.5,21
CDM,27211550,W KT ICP DRN SY,678.0,440.7,113.9,610.2,21
CDM,27211560,W KT INT JUG PUNC,28.0,18.2,4.7,25.2,21
CDM,27211570,W KT INTRACRANIAL,1930.0,1254.5,324.24,1737.0,21
CDM,27211580,W KT JEJUCATH+ND,621.0,403.65,104.33,558.9,21
CDM,27211590,W KT LAP CHOLECY,5983.0,3888.95,1005.14,5384.7,21
CDM,27211600,W KT LAPCHOLY ACC,1262.0,820.3,212.02,1135.8,21
CDM,27211610,W KT MAINFOLD,41.53,26.99,6.98,37.38,21
CDM,27211620,W KT MENISC MENDR,441.0,286.65,74.09,396.9,21
CDM,27211630,W KT NEUR LUM DRN,344.0,223.6,57.79,309.6,21
CDM,27211640,W KT PAC BALECTR,307.0,199.55,51.58,276.3,21
CDM,27211650,W KT PACE ELECTRO,146.0,94.9,24.53,131.4,21
CDM,27211660,W KT PEG 16F,147.0,95.55,24.7,132.3,21
CDM,27211670,W KT PEG A/S,471.0,306.15,79.13,423.9,21
CDM,27211680,W KT PERCU NEPHR,573.0,372.45,96.26,515.7,21
CDM,27211690,W KT PERICARDIO,175.0,113.75,29.4,157.5,21
CDM,27211700,W KT PERICRD ASP,301.0,195.65,50.57,270.9,21
CDM,27211710,W KT PERTNL LAVAG,158.0,102.7,26.54,142.2,21
CDM,27211720,W KT PHACO,912.0,592.8,153.22,820.8,21
CDM,27211730,W KT PN MGMT,420.0,273.0,70.56,378.0,21
CDM,27211740,W KT PNEUMOTHORAX,259.0,168.35,43.51,233.1,21
CDM,27211750,W KT PNEUMOTHORAY,470.0,305.5,78.96,423.0,21
CDM,27211760,W KT PRE OP SKN,155.0,100.75,26.04,139.5,21
CDM,27211770,W KT RETRACT ENDO,339.0,220.35,56.95,305.1,21
CDM,27211780,W KT REVISION SCS LD 3550-10,359.0,233.35,60.31,323.1,21
CDM,27211790,W KT SCREEN VIEW,148.0,96.2,24.86,133.2,21
CDM,27211800,W KT STNT OBSTR,544.0,353.6,91.39,489.6,21
CDM,27211810,W KT STYLET DISP,131.0,85.15,22.01,117.9,21
CDM,27211820,W KT SUBDURL MNTR,464.0,301.6,77.95,417.6,21
CDM,27211830,W KT SUCT CATH,68.0,44.2,11.42,61.2,21
CDM,27211850,W KT THROMB ACCES,393.0,255.45,66.02,353.7,21
CDM,27211860,W KT TRANSRTH DEL,256.0,166.4,43.01,230.4,21
CDM,27211870,W KT TRANSU &CATH,193.0,125.45,32.42,173.7,21
CDM,27211880,W KT UNITIZD SHNT,425.0,276.25,71.4,382.5,21
CDM,27211890,W KT VEIN HARVEST,1380.0,897.0,231.84,1242.0,21
CDM,27211900,W KT VEIN HARVEST,1673.33,1087.66,281.12,1506.0,21
CDM,27211910,W KT VEIN HARVEST,2375.0,1543.75,399.0,2137.5,21
CDM,27211920,W KT VENTRICULOST,1240.0,806.0,208.32,1116.0,21
CDM,27211930,W KWIRE CLAW TEMP FIX 1.2MM,70.0,45.5,11.76,63.0,21
CDM,27211940,W K-WIRE NEWDEAL 70MM,52.0,33.8,8.74,46.8,21
CDM,27211950,W KYPHX BONE BIOPSY DEVICE,238.0,154.7,39.98,214.2,21
CDM,27211960,W KYPHX BONE FILLER DEVICE,210.0,136.5,35.28,189.0,21
CDM,27211970,W KYPHX INFLAT BONE TAMP 15/3,1688.0,1097.2,283.58,1519.2,21
CDM,27211980,W KYPHX INFLAT BONE TAMP 20/3,1463.0,950.95,245.78,1316.7,21
CDM,27211990,W KYPHX INTRODUCER TOOK KIT,1418.0,921.7,238.22,1276.2,21
CDM,27212000,W KYPHX LAT CUR 6.5MM WEDG TIP,315.0,204.75,52.92,283.5,21
CDM,27212010,W KYPHX LAT CUR 8.0 T-TIP 5 PK,1373.0,892.45,230.66,1235.7,21
CDM,27212020,W KYPHX XPAND INFLAT SYRINGE,210.0,136.5,35.28,189.0,21
CDM,27212030,W LASER FIBER ARGON BEAM COAG,450.0,292.5,75.6,405.0,21
CDM,27212040,W LASER FIBER GREENLIGHT PVP,1238.0,804.7,207.98,1114.2,21
CDM,27212050,W LASER FIBER HOLMIUM LAP,1238.0,804.7,207.98,1114.2,21
CDM,27212060,W LASER FIBER KTP/AURA,488.0,317.2,81.98,439.2,21
CDM,27212070,W LASER FIBER NM SLV,1238.0,804.7,207.98,1114.2,21
CDM,27212080,W LCS SHEARS I,1333.0,866.45,223.94,1199.7,21
CDM,27212090,"W LD WIRE MDL6005, IS1 & LV1",228.0,148.2,38.3,205.2,21
CDM,27212100,W LEAD 10-PIN GENERATOR CONNCTR,61.0,39.65,10.25,54.9,21
CDM,27212110,W LEAD ACCESSRY REPAIR KIT 6946,175.0,113.75,29.4,157.5,21
CDM,27212120,W LEAD CABLE EXT PIN SHIELD TIP,248.0,161.2,41.66,223.2,21
CDM,27212130,W LEAD CAPS,40.0,26.0,6.72,36.0,21
CDM,27212140,W LEAD DEFIB DF1 PRT PLUG 6996,61.0,39.65,10.25,54.9,21
CDM,27212150,W LEAD DELIVERY SYS ACCESS KIT,119.0,77.35,19.99,107.1,21
CDM,27212160,W LEAD DELIVERY SYSTEM EASYTRAK,998.0,648.7,167.66,898.2,21
CDM,27212170,W LEAD LOCKING DVCE CLRS LLD EZ,763.0,495.95,128.18,686.7,21
CDM,27212180,W LIBERATOR LOCKING STYLET,643.0,417.95,108.02,578.7,21
CDM,27212190,W LIGACLIP APPLIER MLTPLE MCM30,111.0,72.15,18.65,99.9,21
CDM,27212200,W LIGACLIP LG ER420,178.0,115.7,29.9,160.2,21
CDM,27212210,W LIGASURE ADVANCE LF5034,228.0,148.2,38.3,205.2,21
CDM,27212220,W LIGASURE LF4200,1019.0,662.35,171.19,917.1,21
CDM,27212230,W LIGASURE LS1037,635.0,412.75,106.68,571.5,21
CDM,27212240,W LIGATOR BAND SUPER 7 4225-02,438.0,284.7,73.58,394.2,21
CDM,27212250,W LIGATOR EMR MULTIBAND,345.0,224.25,57.96,310.5,21
CDM,27212260,W LIG-GRFT PASSER,92.0,59.8,15.46,82.8,21
CDM,27212270,W LINE ARTERIAL PURGE,70.0,45.5,11.76,63.0,21
CDM,27212280,W LIVER ACCESS AND BIOPSY SET,535.0,347.75,89.88,481.5,21
CDM,27212290,W LOCATOR NERVE NEUROPULSE 0003,81.0,52.65,13.61,72.9,21
CDM,27212300,W LOCKING CAPS 185,707.0,459.55,118.78,636.3,21
CDM,27212310,W LOOP VESSEL 320,17.0,11.05,2.86,15.3,21
CDM,27212320,W LOOP VESSEL AS,16.0,10.4,2.69,14.4,21
CDM,27212330,W LOOPS,315.0,204.75,52.92,283.5,21
CDM,27212340,W LUBRCNT ROTAGLD,246.0,159.9,41.33,221.4,21
CDM,27212350,W MANIPULATOR VCARE UTERINE,138.0,89.7,23.18,124.2,21
CDM,27212360,W MARKER INTRODUCER SYSTEM,173.0,112.45,29.06,155.7,21
CDM,27212370,W MASK NAVIGATION,355.0,230.75,59.64,319.5,21
CDM,27212380,W MCATH CORD TRAN,818.0,531.7,137.42,736.2,21
CDM,27212390,W MENISCUS ARRW I,412.0,267.8,69.22,370.8,21
CDM,27212400,W MENISCUS CUTTER,1103.0,716.95,185.3,992.7,21
CDM,27212410,W MICRO-INTRODUCER KIT 4FR,56.0,36.4,9.41,50.4,21
CDM,27212420,W MINICAP EXT LIFE PD TRANS SET,76.0,49.4,12.77,68.4,21
CDM,27212430,W MISC GUIDE PROC,204.0,132.6,34.27,183.6,21
CDM,27212440,W MIXER BONE CEMENT MIXEVAC 3,74.0,48.1,12.43,66.6,21
CDM,27212450,W MIXER BONE CMNT HI VAC UPGRD,74.0,48.1,12.43,66.6,21
CDM,27212460,W MONITOR SET QUICK PRESSURE,127.0,82.55,21.34,114.3,21
CDM,27212470,W MORCLLTR GYNCR,1349.0,876.85,226.63,1214.1,21
CDM,27212500,W MSK LARYNG ADLT,250.0,162.5,42.0,225.0,21
CDM,27212510,W MULT BND LIGATR,225.0,146.25,37.8,202.5,21
CDM,27212530,W NDL ANGIO,27.0,17.55,4.54,24.3,21
CDM,27212540,W NDL ASP TRANSBRONCH 19-21GA,146.0,94.9,24.53,131.4,21
CDM,27212550,W NDL ASPIRATN,3445.0,2239.25,578.76,3100.5,21
CDM,27212560,W NDL BIOP/ASP,382.0,248.3,64.18,343.8,21
CDM,27212570,W NDL BIOPSY 14/16G MAXCORE,61.0,39.65,10.25,54.9,21
CDM,27212580,W NDL BIOPSY 18/20G MAXCORE,54.0,35.1,9.07,48.6,21
CDM,27212590,W NDL BLUNT IRR,61.0,39.65,10.25,54.9,21
CDM,27212600,W NDL BRACHYTHRPY,43.0,27.95,7.22,38.7,21
CDM,27212610,W NDL BRCHTX BARD,329.0,213.85,55.27,296.1,21
CDM,27212620,W NDL BX,126.0,81.9,21.17,113.4,21
CDM,27212630,W NDL BX LIVER,172.0,111.8,28.9,154.8,21
CDM,27212640,W NDL BX SFTIS,14.0,9.1,2.35,12.6,21
CDM,27212650,W NDL BX T CUT,120.0,78.0,20.16,108.0,21
CDM,27212660,W NDL COUNTER,24.0,15.6,4.03,21.6,21
CDM,27212670,W NDL COURND DISP,66.0,42.9,11.09,59.4,21
CDM,27212680,W NDL ELECTRD INS,50.0,32.5,8.4,45.0,21
CDM,27212690,W NDL ENDO/EUS BIOPSY/ASP,270.0,175.5,45.36,243.0,21
CDM,27212700,W NDL GAGE 18,237.0,154.05,39.82,213.3,21
CDM,27212710,W NDL GUIDE ULTRAPRO II,15.0,9.75,2.52,13.5,21
CDM,27212720,W NDL GUIDE ULTRAPRO II CIVFLEX,33.0,21.45,5.54,29.7,21
CDM,27212730,W NDL HLDR DISP,330.0,214.5,55.44,297.0,21
CDM,27212740,W NDL INFUSAID,26.0,16.9,4.37,23.4,21
CDM,27212750,W NDL INTRAOSS,287.0,186.55,48.22,258.3,21
CDM,27212760,W NDL JAMSHIDI,87.0,56.55,14.62,78.3,21
CDM,27212770,W NDL LAPSCOPE,240.0,156.0,40.32,216.0,21
CDM,27212780,W NDL LOCK DVCE,11.0,7.15,1.85,9.9,21
CDM,27212790,W NDL PERCUTAN,15.0,9.75,2.52,13.5,21
CDM,27212800,W NDL PNEUMOPERIT,235.0,152.75,39.48,211.5,21
CDM,27212810,W NDL RADIOFREQ,78.0,50.7,13.1,70.2,21
CDM,27212820,W NDL RADIOFREQ 2,70.0,45.5,11.76,63.0,21
CDM,27212830,W NDL RETRACTABLE,275.0,178.75,46.2,247.5,21
CDM,27212840,W NDL SMART,314.0,204.1,52.75,282.6,21
CDM,27212860,W NDL SUB-Q,75.0,48.75,12.6,67.5,21
CDM,27212870,W NDL TUOHY,41.0,26.65,6.89,36.9,21
CDM,27212880,W NDL UROPLASTY RIGID MRN-518,60.0,39.0,10.08,54.0,21
CDM,27212890,W NDL WINGED,26.0,16.9,4.37,23.4,21
CDM,27212900,W NDLE ARRW-CLRK PLRA-SEAL KIT,52.0,33.8,8.74,46.8,21
CDM,27212910,W NDLE ECHOTIP DISPOSABLE CHIBA,20.0,13.0,3.36,18.0,21
CDM,27212920,W NEEDLE 1/2 CIR MAYO 824-S-5,68.0,44.2,11.42,61.2,21
CDM,27212930,W NEEDLE 21GA X 15CM,63.0,40.95,10.58,56.7,21
CDM,27212940,W NEEDLE ACC TRNSJUG 10F 40CM,525.0,341.25,88.2,472.5,21
CDM,27212950,W NEEDLE ASPIRATN BONE CELLECT,384.0,249.6,64.51,345.6,21
CDM,27212960,W NEEDLE BIOPSY NASHOED DISP,405.0,263.25,68.04,364.5,21
CDM,27212970,W NEEDLE CHIBA W/ECHO-COATING,16.0,10.4,2.69,14.4,21
CDM,27212980,W NEEDLE CO-AXIAL INTRODUCER,28.0,18.2,4.7,25.2,21
CDM,27212990,W NEEDLE COAXIAL TRUGUIDE,23.0,14.95,3.86,20.7,21
CDM,27213000,W NEEDLE COLORADO STR 3CM,67.0,43.55,11.26,60.3,21
CDM,27213010,W NEEDLE CRYO SEEDNET ICEROD EA,844.0,548.6,141.79,759.6,21
CDM,27213020,W NEEDLE DRIVER LARGE 400006,330.0,214.5,55.44,297.0,21
CDM,27213030,W NEEDLE EASYCORE BIOPSY 15GA,336.0,218.4,56.45,302.4,21
CDM,27213040,W NEEDLE EBUS W SYRINGE,140.0,91.0,23.52,126.0,21
CDM,27213050,W NEEDLE ECHOTIP DISP,25.0,16.25,4.2,22.5,21
CDM,27213060,W NEEDLE EPIDURAL 15GA 3550-04,74.0,48.1,12.43,66.6,21
CDM,27213070,W NEEDLE EPIDURAL STIM 3550-SN6,145.0,94.25,24.36,130.5,21
CDM,27213080,W NEEDLE FASCIAL 18G 5CM 10MM,65.0,42.25,10.92,58.5,21
CDM,27213090,W NEEDLE INJ 25GA CARR-LOCKE,52.0,33.8,8.74,46.8,21
CDM,27213100,W NEEDLE INTERV FRANSEEN BIOPSY,29.0,18.85,4.87,26.1,21
CDM,27213110,W NEEDLE KNIFE SPHINC,270.0,175.5,45.36,243.0,21
CDM,27213120,W NEEDLE LEELOCK TP-115,86.0,55.9,14.45,77.4,21
CDM,27213130,W NEEDLE MULTIFIRE AR13995N,235.0,152.75,39.48,211.5,21
CDM,27213140,W NEEDLE RIGID 21G X 14.6IN,54.0,35.1,9.07,48.6,21
CDM,27213150,W NEEDLE RX KNIFE 5840,270.0,175.5,45.36,243.0,21
CDM,27213160,W NEEDLE SUREFIRE AR13991N,226.0,146.9,37.97,203.4,21
CDM,27213170,W NEEDLE TRANSPTL 71CM BRK,285.0,185.25,47.88,256.5,21
CDM,27213180,W NEEDLE TRNSEPTL NDLE STD CRVE,347.0,225.55,58.3,312.3,21
CDM,27213190,W NEEDLE TROCAR PAK 8670015,353.0,229.45,59.3,317.7,21
CDM,27213200,W NEEDLE TRPLK BONE MARRW BIOPS,39.0,25.35,6.55,35.1,21
CDM,27213210,W NEEDLE'S EYE SNARE 12FR FMRL,746.0,484.9,125.33,671.4,21
CDM,27213220,W NOSECN DCA,893.0,580.45,150.02,803.7,21
CDM,27213230,W OH BALN INT AOR,2548.0,1656.2,428.06,2293.2,21
CDM,27213240,W OH BLOWR MSTR,88.0,57.2,14.78,79.2,21
CDM,27213250,W OH CANULA PRFUS,65.0,42.25,10.92,58.5,21
CDM,27213260,W OH CONN-TB 1,16.0,10.4,2.69,14.4,21
CDM,27213270,W OH FLTR BLD,13.0,8.45,2.18,11.7,21
CDM,27213280,W OH LVAD SUPPLIE,25.0,16.25,4.2,22.5,21
CDM,27213290,W OH PERFUSN KT,846.0,549.9,142.13,761.4,21
CDM,27213300,W OH PRB PARSONET,38.0,24.7,6.38,34.2,21
CDM,27213310,W OH PUNCH AORTIC,65.0,42.25,10.92,58.5,21
CDM,27213330,W OH SUPPORT HRT *,3921.0,2548.65,658.73,3528.9,21
CDM,27213340,W OH TUBING PUMP,43.0,27.95,7.22,38.7,21
CDM,27213350,W OH TUBING PUMP,45.0,29.25,7.56,40.5,21
CDM,27213360,W OH VALV SUCT DIS,52.0,33.8,8.74,46.8,21
CDM,27213370,W OH VEIN HAR KT,715.0,464.75,120.12,643.5,21
CDM,27213380,W OMNITOME FUSION PRELOADED,330.0,214.5,55.44,297.0,21
CDM,27213390,W OPTIVAC MAXIM KNEE KIT,305.0,198.25,51.24,274.5,21
CDM,27213400,W OS BG COLOST,17.0,11.05,2.86,15.3,21
CDM,27213410,W OS UROSTOMY ST,121.0,78.65,20.33,108.9,21
CDM,27213420,W OST FLANGE 1.5,34.0,22.1,5.71,30.6,21
CDM,27213430,W OST PCH & WFR,24.0,15.6,4.03,21.6,21
CDM,27213440,W OST PCH 1.5IN,14.0,9.1,2.35,12.6,21
CDM,27213450,W OST PCH SURFIT,10.0,6.5,1.68,9.0,21
CDM,27213460,W OST PST DDRM,64.0,41.6,10.75,57.6,21
CDM,27213470,W OST REMVR ADHES,40.0,26.0,6.72,36.0,21
CDM,27213480,W OST START ST,93.0,60.45,15.62,83.7,21
CDM,27213490,W OST START ST I,85.0,55.25,14.28,76.5,21
CDM,27213500,W OSTEOTOME DISP,600.0,390.0,100.8,540.0,21
CDM,27213510,W OVERTUBE ESOPH 25CM 8.6-10MM,219.0,142.35,36.79,197.1,21
CDM,27213520,W OVERTUBE GASTRIC,263.0,170.95,44.18,236.7,21
CDM,27213530,W OVERTUBE SPIRUS,563.0,365.95,94.58,506.7,21
CDM,27213540,W OXYGENATOR AFFINITY CB511,743.0,482.95,124.82,668.7,21
CDM,27213550,W PACE ADAPT CBL,158.0,102.7,26.54,142.2,21
CDM,27213560,W PACE ELECT TEMP,84.0,54.6,14.11,75.6,21
CDM,27213570,W PACK CATARACT,345.0,224.25,57.96,310.5,21
CDM,27213580,W PACK CELL SAVER 5 HI SPEED,384.0,249.6,64.51,345.6,21
CDM,27213590,W PACK CLOSURE PROCEDURE,142.0,92.3,23.86,127.8,21
CDM,27213600,W PACK CONSUM NOVADAQ SPY IMAG,1193.0,775.45,200.42,1073.7,21
CDM,27213610,W PACK HAND,69.0,44.85,11.59,62.1,21
CDM,27213620,W PACK HEMOCONCENTRATOR,149.0,96.85,25.03,134.1,21
CDM,27213630,W PACK HIP GDWR AND NEEDLE,391.0,254.15,65.69,351.9,21
CDM,27213640,W PACK MAJOR LAP,90.0,58.5,15.12,81.0,21
CDM,27213650,W PACK SURG BASIN DOUBLE,70.0,45.5,11.76,63.0,21
CDM,27213660,W PAD INTELLI FLO SHOULDER LG,74.0,48.1,12.43,66.6,21
CDM,27213670,W PAD INTELLO FLOW SHOULDER XLG,82.0,53.3,13.78,73.8,21
CDM,27213680,W PAPILLOTOM W GW,343.0,222.95,57.62,308.7,21
CDM,27213690,W PAPILLOTOME,327.0,212.55,54.94,294.3,21
CDM,27213700,W PAS PORTCATH KT,1931.0,1255.15,324.41,1737.9,21
CDM,27213710,W PASSER LIGMNT GRF 9.5 232250,162.0,105.3,27.22,145.8,21
CDM,27213720,W PASSER TUBING NEOSPHINCT ABS,96.0,62.4,16.13,86.4,21
CDM,27213730,W PATCH EXTERNAL CARTO 3,173.25,112.61,29.11,155.93,21
CDM,27213740,W PCK SCROTAL RETRC PENILE STRP,74.0,48.1,12.43,66.6,21
CDM,27213750,W PEG FLOW-20-PULL SET,123.0,79.95,20.66,110.7,21
CDM,27213760,W PEG KIT 20FR GASTRODOME,103.0,66.95,17.3,92.7,21
CDM,27213770,W PEG KIT PULL ENDOVIVE 24FR,105.0,68.25,17.64,94.5,21
CDM,27213780,W PEN MARKER SURG,39.0,25.35,6.55,35.1,21
CDM,27213790,W PEN SKIN SCRIBE,94.0,61.1,15.79,84.6,21
CDM,27213800,W PERIPHERAL INFUSION SYSTEM,2828.0,1838.2,475.1,2545.2,21
CDM,27213810,W PHACOEM TIP STR,509.0,330.85,85.51,458.1,21
CDM,27213820,W PICC LINE 6 FR TRIPLE LUMEN,256.0,166.4,43.01,230.4,21
CDM,27213830,W PICC LINE KIT,75.0,48.75,12.6,67.5,21
CDM,27213840,W PICC LINE TRAY,422.0,274.3,70.9,379.8,21
CDM,27213850,W PICC PFM DUAL LUMEN CT,144.0,93.6,24.19,129.6,21
CDM,27213860,W PIN DRILL RETROBUTTON,186.0,120.9,31.25,167.4,21
CDM,27213870,W PIN GUIDE FEMORAL DISP 3.2MM,63.0,40.95,10.58,56.7,21
CDM,27213880,W PIN SKULL,498.0,323.7,83.66,448.2,21
CDM,27213890,W PK ARTHROSCOPY,86.0,55.9,14.45,77.4,21
CDM,27213900,W PK BASIC,17.0,11.05,2.86,15.3,21
CDM,27213910,W PK BURN,87.0,56.55,14.62,78.3,21
CDM,27213920,W PK CT NEURO,161.0,104.65,27.05,144.9,21
CDM,27213930,W PK CUSA,912.0,592.8,153.22,820.8,21
CDM,27213940,W PK CUSTM SINUS,63.0,40.95,10.58,56.7,21
CDM,27213950,W PK CYSTO,171.0,111.15,28.73,153.9,21
CDM,27213960,W PK EENT,77.0,50.05,12.94,69.3,21
CDM,27213970,W PK ELCTRPHYSLGY,209.0,135.85,35.11,188.1,21
CDM,27213980,W PK EXTREMITY,304.0,197.6,51.07,273.6,21
CDM,27213990,W PK EYE,579.0,376.35,97.27,521.1,21
CDM,27214000,W PK EYE CUSTOM,552.0,358.8,92.74,496.8,21
CDM,27214010,W PK HRT SPECIAL,181.0,117.65,30.41,162.9,21
CDM,27214030,W PK IOL,935.0,607.75,157.08,841.5,21
CDM,27214040,W PK IV DEL MOD,90.0,58.5,15.12,81.0,21
CDM,27214050,W PK LAPAROS,52.0,33.8,8.74,46.8,21
CDM,27214060,W PK LAPSCP CHOLE,382.0,248.3,64.18,343.8,21
CDM,27214070,W PK LUNG PERFUSN,2059.0,1338.35,345.91,1853.1,21
CDM,27214080,W PK ORTHO,861.0,559.65,144.65,774.9,21
CDM,27214090,W PK SETUP,653.0,424.45,109.7,587.7,21
CDM,27214100,W PK TOTAL JOINT,268.0,174.2,45.02,241.2,21
CDM,27214110,W PK VAGINAL,3.0,1.95,0.5,2.7,21
CDM,27214120,W PK VASCULAR,228.0,148.2,38.3,205.2,21
CDM,27214130,W PK VITRECTOMY,158.0,102.7,26.54,142.2,21
CDM,27214140,W PLEDGET CV PTFE,91.0,59.15,15.29,81.9,21
CDM,27214150,W PLEDGET CV TEF,11.0,7.15,1.85,9.9,21
CDM,27214160,W PLEUROVAC CHEST DRAIN,83.0,53.95,13.94,74.7,21
CDM,27214170,W PLUG CATH FOLY,3.0,1.95,0.5,2.7,21
CDM,27214180,W PLUG SURGISIS AFP 0.6X9.5,1611.0,1047.15,270.65,1449.9,20
CDM,27214180_IP,W PLUG SURGISIS AFP 0.6X9.5,1611.0,1047.15,581.57,581.57,3
CDM,27214180_OP,W PLUG SURGISIS AFP 0.6X9.5,1611.0,1047.15,1047.15,1578.78,6
CDM,27214190,W PMP PAIN,1552.0,1008.8,260.74,1396.8,21
CDM,27214200,W PORT SILS CANNULA 5MM-12MM,690.0,448.5,115.92,621.0,21
CDM,27214210,W POSTNR HEART,2839.0,1845.35,476.95,2555.1,21
CDM,27214220,W POUCH SURG TISS 8X10IN 1500ML,92.0,59.8,15.46,82.8,21
CDM,27214230,W POUCH TISS 5X8 750ML LAP,102.0,66.3,17.14,91.8,21
CDM,27214240,W PRB ABL MICROWV,11581.0,7527.65,1945.61,10422.9,21
CDM,27214250,W PRB CRYO,2441.0,1586.65,410.09,2196.9,21
CDM,27214260,W PRB ENDO PH,307.0,199.55,51.58,276.3,21
CDM,27214270,W PRB LITHO,613.0,398.45,102.98,551.7,21
CDM,27214280,W PRB REMOT LIGHT,552.0,358.8,92.74,496.8,21
CDM,27214290,W PRESSURE DOME W/MALE TIP,97.0,63.05,16.3,87.3,21
CDM,27214300,W PROBE CRYO SURGIFROST 60SF2,2349.0,1526.85,394.63,2114.1,21
CDM,27214310,W PROBE CRYOABLAT,622.0,404.3,104.5,559.8,21
CDM,27214320,W PROBE CRYOABLAT,7129.0,4633.85,1197.67,6416.1,21
CDM,27214330,W PROBE CYBERWAND RENA BLADDER,1125.0,731.25,189.0,1012.5,21
CDM,27214340,W PROBE DOPPLER FLOW DP-SDP001,623.0,404.95,104.66,560.7,21
CDM,27214350,W PROBE EFLEX ABLAT INTEG CABLE,746.0,484.9,125.33,671.4,21
CDM,27214360,W PROBE GOLD,214.0,139.1,35.95,192.6,21
CDM,27214370,W PROBE GOLD 10/12F 25GX210CM,366.0,237.9,61.49,329.4,21
CDM,27214380,W PROBE LITHO PNEU 1.0MMX569MM,338.0,219.7,56.78,304.2,21
CDM,27214390,W PROBE LITHO PNEU 2.0MMX425MM,366.0,237.9,61.49,329.4,21
CDM,27214400,W PROBE PH CAPSULE BRAVO W/DEL,326.0,211.9,54.77,293.4,21
CDM,27214410,W PROBE PRASS FLUSH-TIP MONO,173.0,112.45,29.06,155.7,21
CDM,27214420,W PROBE ULTRASOUND 3.8MMX403MM,795.0,516.75,133.56,715.5,21
CDM,27214430,W PROGRAM PT INTERSTIM 3031A,1493.0,970.45,250.82,1343.7,21
CDM,27214440,W PROGRAM PT INTERSTM ICON 3037,1526.0,991.9,256.37,1373.4,21
CDM,27214450,W PROGRAMMER CTRL ACC REV THER,848.0,551.2,142.46,763.2,21
CDM,27214460,W PROGRAMMER DUAL,990.0,643.5,166.32,891.0,21
CDM,27214470,W PROGRAMMER PATIENT NS,1050.0,682.5,176.4,945.0,21
CDM,27214480,W PROGRAMMER PT NEUROSTIM,945.0,614.25,158.76,850.5,21
CDM,27214490,W PROGRMR PT NSTM,2364.0,1536.6,397.15,2127.6,21
CDM,27214500,W PROS ADHESIVE,930.0,604.5,156.24,837.0,21
CDM,27214510,W PROS DURA SUBST,2849.0,1851.85,478.63,2564.1,21
CDM,27214520,W PROS ESOPHO TUB,492.0,319.8,82.66,442.8,21
CDM,27214530,W PROS TESTICULAR,487.0,316.55,81.82,438.3,21
CDM,27214540,W PROS ULNAR HEAD,432.0,280.8,72.58,388.8,21
CDM,27214550,W PROSORBA COLUMN,2345.0,1524.25,393.96,2110.5,21
CDM,27214560,W PUMP SWITCH ADPTR ARISS,112.0,72.8,18.82,100.8,21
CDM,27214570,W PUMP SYSTEM URO 720-100,98.0,63.7,16.46,88.2,21
CDM,27214580,W PUNCH BARRON CORNEA 7.5/7.75,112.0,72.8,18.82,100.8,21
CDM,27214590,W PUNCH BARRON CORNEA VAC,121.0,78.65,20.33,108.9,21
CDM,27214600,W PUNCH BIOSPY 1.5MM DISP,128.0,83.2,21.5,115.2,21
CDM,27214610,W PUNCH BONE BIO-CRK 4.5MM DISP,121.0,78.65,20.33,108.9,21
CDM,27214620,W PURSE STRING,177.0,115.05,29.74,159.3,21
CDM,27214630,W PUSHER KNOT,157.0,102.05,26.38,141.3,21
CDM,27214640,W PUSHER STNT,94.0,61.1,15.79,84.6,21
CDM,27214650,W RAPID REFILL CONT INJECT SYS,44.0,28.6,7.39,39.6,21
CDM,27214660,W RAPIDO DELIV SYS RLDS,1118.0,726.7,187.82,1006.2,21
CDM,27214670,W RAZOR S/P,2.0,1.3,0.34,1.8,21
CDM,27214680,W REAMER IM-9MM/10MM,822.0,534.3,138.1,739.8,21
CDM,27214690,W RECHARGER SYSTEM EXTERNAL RX1,1963.0,1275.95,329.78,1766.7,21
CDM,27214700,W RECHARGING SYSTEM 37651,3227.0,2097.55,542.14,2904.3,21
CDM,27214710,W RELOAD ECHELON STAPLER ECR60G,209.0,135.85,35.11,188.1,21
CDM,27214720,W REPAIR KT GRSHNG DL LUMN CTH,251.0,163.15,42.17,225.9,21
CDM,27214730,W RETENTION DEVICE CELLECT 20CC,806.0,523.9,135.41,725.4,21
CDM,27214740,W RETR STONE,191.0,124.15,32.09,171.9,21
CDM,27214750,W RETRAC/STABLZR,2166.0,1407.9,363.89,1949.4,21
CDM,27214760,W RETRAC/STABLZR,3847.0,2500.55,646.3,3462.3,21
CDM,27214770,W RETRAC/STABLZR,4619.0,3002.35,775.99,4157.1,21
CDM,27214780,W RETRACTOR DISP,275.0,178.75,46.2,247.5,21
CDM,27214790,W RETRACTOR ENDO,395.0,256.75,66.36,355.5,21
CDM,27214800,W RETRACTOR RING W/ STAYS,81.0,52.65,13.61,72.9,21
CDM,27214810,W RETRACTOR SCROTAL 72403867,390.0,253.5,65.52,351.0,21
CDM,27214820,W RETRACTOR WND ALEXIS 11-17CM,137.0,89.05,23.02,123.3,21
CDM,27214830,W RETRACTOR WND ALEXIS C8303,109.0,70.85,18.31,98.1,21
CDM,27214840,W RETRACTOR WOUND ALEXIS,70.0,45.5,11.76,63.0,21
CDM,27214850,W RETRCT EZ DASH SZ 2 7X4,123.0,79.95,20.66,110.7,21
CDM,27214860,W RETRIEVER ROTH NET 160CM,158.0,102.7,26.54,142.2,21
CDM,27214870,W RETRIEVER ROTH NET 230CM,175.0,113.75,29.4,157.5,21
CDM,27214880,W RETROCUTTER DUAL AR1204RD,306.0,198.9,51.41,275.4,21
CDM,27214890,W ROTATION TOOL 6056,50.0,32.5,8.4,45.0,21
CDM,27214900,W ROTH NET FOREIGN BODY,1127.0,732.55,189.34,1014.3,21
CDM,27214910,W ROTIC 55,889.0,577.85,149.35,800.1,21
CDM,27214920,W ROTICULATOR ENDO MINI SHEARS,144.0,93.6,24.19,129.6,21
CDM,27214930,W SCALPEL HARMONIC ACE14S,583.0,378.95,97.94,524.7,21
CDM,27214940,W SCALPEL HARMONIC ACE36P,695.0,451.75,116.76,625.5,21
CDM,27214950,W SCALPEL HARMONIC FCS9,675.0,438.75,113.4,607.5,21
CDM,27214960,W SCALPEL HARMONIC LCS5,587.0,381.55,98.62,528.3,21
CDM,27214970,W SCALPEL HARMONIC LCS5HA,647.0,420.55,108.7,582.3,21
CDM,27214980,W SCISSORS DISP,300.0,195.0,50.4,270.0,21
CDM,27214990,W SCISSORS ROUND TIP,293.0,190.45,49.22,263.7,21
CDM,27215000,W SCREW KIT 5873 C,67.0,43.55,11.26,60.3,21
CDM,27215010,W SEALANT COSEAL SURGICAL,785.0,510.25,131.88,706.5,21
CDM,27215020,W SEALANT TISSEEL 2ML W DUPLSYS,225.0,146.25,37.8,202.5,21
CDM,27215030,W SEALANT TISSEEL 4ML DUPLSYR,299.0,194.35,50.23,269.1,21
CDM,27215040,W SEALANT TISSEEL KIT 10ML FRZD,802.0,521.3,134.74,721.8,21
CDM,27215050,W SEALANT TISSEEL KIT 4ML FRZD,337.0,219.05,56.62,303.3,21
CDM,27215060,W SEALANT TISSEEL KIT 4ML FRZN,308.0,200.2,51.74,277.2,21
CDM,27215070,W SEALER AQUAMANTYS BIPOLAR,713.0,463.45,119.78,641.7,21
CDM,27215080,W SEALER LIGASURE 5MM LS1500,137.0,89.05,23.02,123.3,21
CDM,27215090,W SENSOR PATCH TISSUE OXY2SPD1,1050.0,682.5,176.4,945.0,21
CDM,27215100,W SET BOWL BRAT 2 ADULT 7214100,260.0,169.0,43.68,234.0,21
CDM,27215110,W SET PREFUSION DEL ARISS,98.0,63.7,16.46,88.2,21
CDM,27215120,W SHEAR HARMONIC 36CM HND CNTRL,600.0,390.0,100.8,540.0,21
CDM,27215130,W SHEARS CVD HARMONIC ACE 36CM,651.0,423.15,109.37,585.9,21
CDM,27215140,W SHEARS HARMONIC 5MM LCS PISTL,606.0,393.9,101.81,545.4,21
CDM,27215150,W SHEARS HARMONIC CRV LAP,547.0,355.55,91.9,492.3,21
CDM,27215160,W SHEARS HARMONIC WAVE SCIS GRP,492.0,319.8,82.66,442.8,21
CDM,27215170,W SHEARS HOT DAVINCI S 420179,480.0,312.0,80.64,432.0,21
CDM,27215180,W SHEATH 10.5FR TEARAWAY PORT,123.0,79.95,20.66,110.7,21
CDM,27215190,W SHEATH 15CM PEEL-WY INTRDUCR,43.0,27.95,7.22,38.7,21
CDM,27215200,W SHEATH 30CM GALT PTFE INTRDCR,75.0,48.75,12.6,67.5,21
CDM,27215210,W SHEATH 35CM BRITE TIP,50.0,32.5,8.4,45.0,21
CDM,27215220,W SHEATH 45/55CM BRITE TIP,62.0,40.3,10.42,55.8,21
CDM,27215230,W SHEATH 6FR PINNACLE 25 CM,63.0,40.95,10.58,56.7,21
CDM,27215240,W SHEATH 8FR PINNACLE INTRDCR,69.0,44.85,11.59,62.1,21
CDM,27215250,W SHEATH 9FR TEARAWAY SIDE PORT,138.0,89.7,23.18,124.2,21
CDM,27215260,W SHEATH BYRD DILATOR SET 8.5FR,247.0,160.55,41.5,222.3,21
CDM,27215270,W SHEATH CHECK-FLO PFRMR SET,196.0,127.4,32.93,176.4,21
CDM,27215280,W SHEATH DIALEASE INTRDCR,35.0,22.75,5.88,31.5,21
CDM,27215290,W SHEATH DILATOR 8/10 260120,109.0,70.85,18.31,98.1,21
CDM,27215300,W SHEATH ENDOSCRUB 1912020,107.0,69.55,17.98,96.3,21
CDM,27215310,W SHEATH ENDOSCRUB 4MM 45DEG,142.0,92.3,23.86,127.8,21
CDM,27215320,W SHEATH ENDSCRB 2 4MM 1912000,89.0,57.85,14.95,80.1,21
CDM,27215330,W SHEATH ENDSCRB 2.4MM 1912010,86.0,55.9,14.45,77.4,21
CDM,27215340,W SHEATH FLEX 7F X 24CM,85.0,55.25,14.28,76.5,21
CDM,27215350,W SHEATH FLEX SUPER ARROW 45CM,123.0,79.95,20.66,110.7,21
CDM,27215360,W SHEATH FLEXOR BLKN/ANSL SET,103.0,66.95,17.3,92.7,21
CDM,27215370,W SHEATH GALT PTFE MICROACCESS,42.0,27.3,7.06,37.8,21
CDM,27215380,W SHEATH GALT PTFE TRWY INTRDCR,42.0,27.3,7.06,37.8,21
CDM,27215390,W SHEATH GALT SPECIAL PTFE,88.0,57.2,14.78,79.2,21
CDM,27215400,W SHEATH GUIDING INTRDCR SWARTZ,240.0,156.0,40.32,216.0,21
CDM,27215410,W SHEATH HEMST VALVE SDPRT DLTR,31.0,20.15,5.21,27.9,21
CDM,27215420,W SHEATH INTRO CK FLO,153.0,99.45,25.7,137.7,21
CDM,27215430,W SHEATH INTRO GORE 18F X 30CM,219.0,142.35,36.79,197.1,21
CDM,27215440,W SHEATH INTRO PINNACLE 10CM,16.0,10.4,2.69,14.4,21
CDM,27215450,W SHEATH INTRODUCER 4FR X 11CM,16.0,10.4,2.69,14.4,21
CDM,27215460,W SHEATH LASER SLSII,3051.0,1983.15,512.57,2745.9,21
CDM,27215470,W SHEATH LONG 7FR X 45CM MULTI,88.0,57.2,14.78,79.2,21
CDM,27215480,W SHEATH MULI 8F X 62CM,222.0,144.3,37.3,199.8,21
CDM,27215490,W SHEATH NAVIGATOR URET ACCESS,255.0,165.75,42.84,229.5,21
CDM,27215500,W SHEATH PEELAWAY 16F X 30CM,79.0,51.35,13.27,71.1,21
CDM,27215510,W SHEATH PINNACLE DESTINATION,143.0,92.95,24.02,128.7,21
CDM,27215520,W SHEATH RB BLKN 8F 40CM FLEXOR,74.0,48.1,12.43,66.6,21
CDM,27215530,W SHEATH SET W/INTGR HEMOSTASIS,84.0,54.6,14.11,75.6,21
CDM,27215540,W SHEATH SHUTTLE FLEXOR TOUHY,202.0,131.3,33.94,181.8,21
CDM,27215550,W SHEATH URET NAVIGATOR ACCESS,220.0,143.0,36.96,198.0,21
CDM,27215560,W SHEATH URT ACC 9.5F 28CM HYDR,222.0,144.3,37.3,199.8,21
CDM,27215570,W SHETH CK FLO (RCFW180P3840RB),225.0,146.25,37.8,202.5,21
CDM,27215580,W SHOULDER SPLIT DRAPE,35.0,22.75,5.88,31.5,21
CDM,27215590,W SHTH AXCESS INTRODUCER KIT,37.0,24.05,6.22,33.3,21
CDM,27215600,W SHTH BRD TRANSEPTAL WTIP MRKR,338.0,219.7,56.78,304.2,21
CDM,27215610,W SHTH DAIG OBTUR,107.0,69.55,17.98,96.3,21
CDM,27215620,W SHTH DLTR SSV SPLTAWAY VLV,77.0,50.05,12.94,69.3,21
CDM,27215630,W SHTH FAST GDING INTRDCR RAMP,249.0,161.85,41.83,224.1,21
CDM,27215640,W SHTH HEMST VLV SIDEPORT DLTR,38.0,24.7,6.38,34.2,21
CDM,27215650,W SHTH INTRO,164.0,106.6,27.55,147.6,21
CDM,27215660,W SHTH LSR500-001,70.0,45.5,11.76,63.0,21
CDM,27215670,W SHTH ONE-PIECE,294.0,191.1,49.39,264.6,21
CDM,27215680,W SHTH PEELAWAY,265.0,172.25,44.52,238.5,21
CDM,27215690,W SHTH RETRVL FLTRWRE EZ EMBLIC,140.0,91.0,23.52,126.0,21
CDM,27215700,W SHTH SCANHEAD,2001.0,1300.65,336.17,1800.9,21
CDM,27215710,W SHTH SET DCA,106.0,68.9,17.81,95.4,21
CDM,27215720,W SHTH TEARAWAY PORT 20CM DLTR,123.0,79.95,20.66,110.7,21
CDM,27215730,W SHTH VASCULAR,168.0,109.2,28.22,151.2,21
CDM,27215740,W SHTH/DILTR UTR,388.0,252.2,65.18,349.2,21
CDM,27215750,W SINUS GUIDE CATHETER EXT,96.0,62.4,16.13,86.4,21
CDM,27215770,W SLEVE SWN-GANZ,13.0,8.45,2.18,11.7,21
CDM,27215780,W SLING CRADLE,10.0,6.5,1.68,9.0,21
CDM,27215790,W SLITTER TOOL UNIVERSAL CPS,79.0,51.35,13.27,71.1,21
CDM,27215800,W SNARE 3F X 150CM CATH,923.0,599.95,155.06,830.7,21
CDM,27215810,W SNARE 6F X 100CM,488.0,317.2,81.98,439.2,21
CDM,27215820,W SNARE AMPLATZ GOOSE NECK KT,884.0,574.6,148.51,795.6,21
CDM,27215830,W SNARE AMPLTZ GOOSE NECK KT,428.0,278.2,71.9,385.2,21
CDM,27215840,W SNARE EXPRO ELITE SNARE,593.0,385.45,99.62,533.7,21
CDM,27215850,W SNARE OV/CRS/HX,114.0,74.1,19.15,102.6,21
CDM,27215860,W SNARE POLYP CAPTIVATOR II,62.0,40.3,10.42,55.8,21
CDM,27215870,W SNARE RETRIEVAL SET,1190.0,773.5,199.92,1071.0,21
CDM,27215880,W SNARE STERILE,46.0,29.9,7.73,41.4,21
CDM,27215890,W SPACER RELIEVA STRATS MICRFLW,5366.0,3487.9,901.49,4829.4,21
CDM,27215900,W SPHINCTERTOME/AUTOTOME,318.0,206.7,53.42,286.2,21
CDM,27215910,W SPLINT DOYLE II INTRANASAL,66.0,42.9,11.09,59.4,21
CDM,27215920,W SPNG KITTNER,2.0,1.3,0.34,1.8,21
CDM,27215930,W SPNG LAP 18X18 *,10.0,6.5,1.68,9.0,21
CDM,27215940,W SPNG LAP 4X18,25.0,16.25,4.2,22.5,21
CDM,27215950,W SPNG PEANUT,47.0,30.55,7.9,42.3,21
CDM,27215960,W SPNG RADIOPQUE,24.0,15.6,4.03,21.6,21
CDM,27215970,W SPNG SCLERALS,314.0,204.1,52.75,282.6,21
CDM,27215980,W SPNG SPEAR,15.0,9.75,2.52,13.5,21
CDM,27215990,W SPNG TONSIL,35.0,22.75,5.88,31.5,21
CDM,27216000,W SPY BITE FORCEPS,593.0,385.45,99.62,533.7,21
CDM,27216010,W SPY SCOPE CATH,1140.0,741.0,191.52,1026.0,21
CDM,27216020,W SPYGLASS PROBE,507.0,329.55,85.18,456.3,21
CDM,27216030,W SRGIPRT TRC A/S,449.0,291.85,75.43,404.1,21
CDM,27216040,W ST COLON DECOM,217.0,141.05,36.46,195.3,21
CDM,27216050,W ST COPE INTRO,216.0,140.4,36.29,194.4,21
CDM,27216060,W ST DIL RENAL,439.0,285.35,73.75,395.1,21
CDM,27216070,W ST EXT MIC W/LU,213.0,138.45,35.78,191.7,21
CDM,27216080,W ST INFUSN,83.0,53.95,13.94,74.7,21
CDM,27216090,W ST IV,154.0,100.1,25.87,138.6,21
CDM,27216100,W ST SHTH DIL TEL,338.0,219.7,56.78,304.2,21
CDM,27216110,W ST TB IRR COOL,105.0,68.25,17.64,94.5,21
CDM,27216120,W ST THROMB/EMB,375.0,243.75,63.0,337.5,21
CDM,27216130,W STABILIZER PLATFORM W/XPOSE,2115.0,1374.75,355.32,1903.5,21
CDM,27216140,W STABILIZER VCUM SUV OM-9000S,339.0,220.35,56.95,305.1,21
CDM,27216160,W STAPLE RELOAD ENDOPATH ETS,175.0,113.75,29.4,157.5,21
CDM,27216170,W STAPLE RELOAD ENDOPTH ETS FLX,250.0,162.5,42.0,225.0,21
CDM,27216180,W STAPLE SPIKED LIGAMENT AR,128.0,83.2,21.5,115.2,21
CDM,27216190,W STAPLER 12MM GIA UNIV 030403,144.0,93.6,24.19,129.6,21
CDM,27216200,W STAPLER ARTC FLEX 60,512.0,332.8,86.02,460.8,21
CDM,27216210,W STAPLER AWL 8MM,830.0,539.5,139.44,747.0,21
CDM,27216220,W STAPLER CARTRIDGE ILA-100,168.0,109.2,28.22,151.2,21
CDM,27216230,W STAPLER INTRLUM ENDSCP,455.0,295.75,76.44,409.5,21
CDM,27216240,W STAPLER CURVED CUT RELOAD 4.0,372.0,241.8,62.5,334.8,21
CDM,27216250,W STAPLER CURVED CUTTER CS40G,680.0,442.0,114.24,612.0,21
CDM,27216260,W STAPLER CURVED LOW PROFILE,446.0,289.9,74.93,401.4,21
CDM,27216270,W STAPLER ECHELON 45 RELOAD,197.0,128.05,33.1,177.3,21
CDM,27216280,W STAPLER ECHELON RELOAD,209.0,135.85,35.11,188.1,21
CDM,27216290,W STAPLER ECHELON RELOAD WH/GLD,195.0,126.75,32.76,175.5,21
CDM,27216300,W STAPLER ENDO GIA UNIVERSAL,160.0,104.0,26.88,144.0,21
CDM,27216310,W STAPLER ENDO GIA UNIVERSAL XL,255.0,165.75,42.84,229.5,21
CDM,27216320,W STAPLER ENDOGIA ULT UNIV,156.0,101.4,26.21,140.4,21
CDM,27216330,W STAPLER ENDOPATH ECHELON 60,187.0,121.55,31.42,168.3,21
CDM,27216340,W STAPLER ENDOPATH LINEAR 35MM,474.0,308.1,79.63,426.6,21
CDM,27216350,W STAPLER GIA 60-38S,156.0,101.4,26.21,140.4,21
CDM,27216360,W STAPLER LINEAR 30MM,547.0,355.55,91.9,492.3,21
CDM,27216370,W STAPLER LINEAR CUTTER TLC55,165.0,107.25,27.72,148.5,21
CDM,27216380,W STAPLER LONG LINEAR CUTTER,446.0,289.9,74.93,401.4,21
CDM,27216390,W STAPLER MACH 30MM 3.5,159.0,103.35,26.71,143.1,21
CDM,27216400,W STAPLER MACH 60MM 3.5 BLU,161.0,104.65,27.05,144.9,21
CDM,27216410,W STAPLER POLY GIA 75,466.0,302.9,78.29,419.4,21
CDM,27216420,W STAPLER PRECISE SKIN,17.0,11.05,2.86,15.3,21
CDM,27216430,W STAPLER PROXIMATE LIN 30MM,172.0,111.8,28.9,154.8,21
CDM,27216440,W STAPLER PROXIMATE PPH03,644.0,418.6,108.19,579.6,21
CDM,27216450,W STAPLER PROXIMATE RELOAD 30MM,77.0,50.05,12.94,69.3,21
CDM,27216460,W STAPLER RELOAD 30MM,75.0,48.75,12.6,67.5,21
CDM,27216470,W STAPLER RELOAD 60MM,80.0,52.0,13.44,72.0,21
CDM,27216480,W STAPLER RELOAD 60MM,81.0,52.65,13.61,72.9,21
CDM,27216490,W STAPLER RELOAD ENDPTH ETS FLX,168.0,109.2,28.22,151.2,21
CDM,27216500,W STAPLER RELOAD MULTI GIA 60,80.0,52.0,13.44,72.0,21
CDM,27216510,W STAPLER RELOADING UNIT TCR75,132.0,85.8,22.18,118.8,21
CDM,27216520,W STAPLER RELOADING UNIT TR90,83.0,53.95,13.94,74.7,21
CDM,27216530,W STAPLER RELOADS 3.5 LEG,75.0,48.75,12.6,67.5,21
CDM,27216540,W STAPLER SEPTAL ENTACT 3 PACK,248.0,161.2,41.66,223.2,21
CDM,27216570,W STAPLER SNG SUE 3.8MM,497.0,323.05,83.5,447.3,21
CDM,27216580,W STAPLER SNGL-GIA100MM-3.8,183.0,118.95,30.74,164.7,21
CDM,27216590,W STAY SURGICAL LONE STAR,85.0,55.25,14.28,76.5,21
CDM,27216600,W STONE EXTRACTOR,654.0,425.1,109.87,588.6,21
CDM,27216610,W STOPCOCK 4WAY,12.0,7.8,2.02,10.8,21
CDM,27216620,W STPL COVENTRY,35.0,22.75,5.88,31.5,21
CDM,27216630,W STPL EPIPHYS AS,85.0,55.25,14.28,76.5,21
CDM,27216640,W STPL GIA 30,1351.0,878.15,226.97,1215.9,21
CDM,27216650,W STPL LINEAR CUT,247.0,160.55,41.5,222.3,21
CDM,27216660,W STPL LINEAR CUT,169.0,109.85,28.39,152.1,21
CDM,27216670,W STPL LINEAR CUT,1019.0,662.35,171.19,917.1,21
CDM,27216680,W STPL LINEAR CUTTR,475.0,308.75,79.8,427.5,21
CDM,27216690,W STPL MENISCL BI,307.0,199.55,51.58,276.3,21
CDM,27216700,W STPL RELD ENDO UNIT,425.0,276.25,71.4,382.5,21
CDM,27216710,W STPLR SKN ROTHD,225.0,146.25,37.8,202.5,21
CDM,27216720,W STPLR TACKER,314.0,204.1,52.75,282.6,21
CDM,27216730,W STRIPPER VEIN,366.0,237.9,61.49,329.4,21
CDM,27216750,W STYLET ADLT CURV TRNSP 407206,263.0,170.95,44.18,236.7,21
CDM,27216760,W STYLET BALL TIP 45CM LD .014,68.0,44.2,11.42,61.2,21
CDM,27216770,W STYLET BALL-TIPPED,68.0,44.2,11.42,61.2,21
CDM,27216780,"W STYLET STRGHT 6601,6971,6972",88.0,57.2,14.78,79.2,21
CDM,27216790,W SUCT HNDL POOL,48.0,31.2,8.06,43.2,21
CDM,27216800,W SUCT TUBNG,17.0,11.05,2.86,15.3,21
CDM,27216810,W SUCT/IRR HDL/TB,181.0,117.65,30.41,162.9,21
CDM,27216820,W SUCT/IRR TIP LG,81.0,52.65,13.61,72.9,21
CDM,27216970,W SURGICEL FIBRILLAR #1961 1X2,140.0,91.0,23.52,126.0,21
CDM,27216980,W SURGICEL FIBRILLAR HEMO 4X4,276.0,179.4,46.37,248.4,21
CDM,27216990,W SURGICEL HEMOSTAT ABSORB 4X8,51.0,33.15,8.57,45.9,21
CDM,27217000,W SURGICEL HEMOSTAT ABSORB 6X9,195.0,126.75,32.76,175.5,21
CDM,27217010,W SUT CATG I,15.0,9.75,2.52,13.5,21
CDM,27217020,W SUT CATG III,41.0,26.65,6.89,36.9,21
CDM,27217030,W SUT CATG IV,60.0,39.0,10.08,54.0,21
CDM,27217040,W SUT CATG V,89.0,57.85,14.95,80.1,21
CDM,27217050,W SUT CATG VI,107.0,69.55,17.98,96.3,21
CDM,27217060,W SUT CATG VII,164.0,106.6,27.55,147.6,21
CDM,27217070,W SUT CATG VIII,220.0,143.0,36.96,198.0,21
CDM,27217080,W SUT CLIP ANEUR,669.0,434.85,112.39,602.1,21
CDM,27217090,W SUT CLIP HEMO,24.0,15.6,4.03,21.6,21
CDM,27217100,W SUT CLIP LIGA 6,40.0,26.0,6.72,36.0,21
CDM,27217110,W SUT CLIP SCALP,17.0,11.05,2.86,15.3,21
CDM,27217120,W SUT CLP LIGA AS,70.0,45.5,11.76,63.0,21
CDM,27217130,W SUT ENDOLOOP,100.0,65.0,16.8,90.0,21
CDM,27217140,W SUT GDE,60.0,39.0,10.08,54.0,21
CDM,27217150,W SUT RETEN A/T,49.0,31.85,8.23,44.1,21
CDM,27217160,W SUT RETREIVER,56.0,36.4,9.41,50.4,21
CDM,27217170,W SUT RETREIVER,263.0,170.95,44.18,236.7,21
CDM,27217180,W SUT SKIN CLIPS,41.0,26.65,6.89,36.9,21
CDM,27217190,W SUT SPEC AS,120.0,78.0,20.16,108.0,21
CDM,27217200,W SUT STAPLE REM,16.0,10.4,2.69,14.4,21
CDM,27217220,W SUT SURGICLIP,713.0,463.45,119.78,641.7,21
CDM,27217230,W SUT SURGICLIPII,203.0,131.95,34.1,182.7,21
CDM,27217240,W SUT SURGIGRIP,38.0,24.7,6.38,34.2,21
CDM,27217250,W SUT SURGPRT CNV,94.0,61.1,15.79,84.6,21
CDM,27217260,W SUT SURGRP 5MM,899.0,584.35,151.03,809.1,21
CDM,27217270,W SUT SURGRP12MM,589.0,382.85,98.95,530.1,21
CDM,27217280,W SUTURE CLIP LAPRA-TY XC200,84.0,54.6,14.11,75.6,21
CDM,27217290,W SUTURE ETHIBOND XTRA,4.0,2.6,0.67,3.6,21
CDM,27217300,W SUTURE ETHILON MONO PC,8.0,5.2,1.34,7.2,21
CDM,27217310,W SUTURE LASSO 90DEGW/WIRE LOOP,210.0,136.5,35.28,189.0,21
CDM,27217320,W SUTURE PERMA-HAND SILK,4.0,2.6,0.67,3.6,21
CDM,27217330,W SUTURE PROLENE,4.0,2.6,0.67,3.6,21
CDM,27217340,W SUTURE RETRIEVER 71111579,142.0,92.3,23.86,127.8,21
CDM,27217350,W SUTURE TRANSVAGINAL CAPIO CL,63.0,40.95,10.58,56.7,21
CDM,27217360,W SUTURE VICRYL PLUS UND BR,8.0,5.2,1.34,7.2,21
CDM,27217370,W SUTURE VICRYL UND BR,4.0,2.6,0.67,3.6,21
CDM,27217380,W SWAN GANZ CCO,236.0,153.4,39.65,212.4,21
CDM,27217390,W SYR 10C CONTRL *,14.0,9.1,2.35,12.6,21
CDM,27217400,W SYR 200ML CT 9000,17.0,11.05,2.86,15.3,21
CDM,27217410,W SYR 200ML ILLUMENA,20.0,13.0,3.36,18.0,21
CDM,27217420,W SYR BLDGAS HEP *,10.0,6.5,1.68,9.0,21
CDM,27217430,W SYR BULB,10.0,6.5,1.68,9.0,21
CDM,27217440,W SYR DIS TOOMEY *,8.0,5.2,1.34,7.2,21
CDM,27217450,W SYR EMBO LC BEAD 100-300UM 2ML,2261.0,1469.65,379.85,2034.9,21
CDM,27217460,W SYR EMBOSPHERE 500-900,299.0,194.35,50.23,269.1,21
CDM,27217470,W SYR PERCU PUMP *,77.0,50.05,12.94,69.3,21
CDM,27217480,W SYRINGE ASSBLY BALLOON DIL,60.0,39.0,10.08,54.0,21
CDM,27217490,W SYRINGE INFLATION,62.0,40.3,10.42,55.8,21
CDM,27217500,W SYRINGE INFLATION 25ML,64.0,41.6,10.75,57.6,21
CDM,27217510,W SYRINGE MEDRAD *,18.0,11.7,3.02,16.2,21
CDM,27217520,W SYS AUTOGFT TRN,1989.0,1292.85,334.15,1790.1,21
CDM,27217530,W SYS COR ROTLNK CATH/BURR,1343.0,872.95,225.62,1208.7,21
CDM,27217540,W SYS FLD PROTCTN,1595.0,1036.75,267.96,1435.5,21
CDM,27217550,W SYS ROTLNK ADVN,300.0,195.0,50.4,270.0,21
CDM,27217560,W TAPE RADIOPAQUE W/MM MARKINGS,68.0,44.2,11.42,61.2,21
CDM,27217570,W TB ASP YANKAUER,106.0,68.9,17.81,95.4,21
CDM,27217580,W TB CON 12FT,101.0,65.65,16.97,90.9,21
CDM,27217590,W TB CONN EXT,3.0,1.95,0.5,2.7,21
CDM,27217600,W TB CULTURE,2.0,1.3,0.34,1.8,21
CDM,27217610,W TB ENDOBRON,336.0,218.4,56.45,302.4,21
CDM,27217620,W TB ENDOTRA RT,377.0,245.05,63.34,339.3,21
CDM,27217630,W TB ENDOTRACH,40.0,26.0,6.72,36.0,21
CDM,27217640,W TB ET RAE,170.0,110.5,28.56,153.0,21
CDM,27217650,W TB JEJUNOSTOMY,135.0,87.75,22.68,121.5,21
CDM,27217660,W TB LAVACUATOR,101.0,65.65,16.97,90.9,21
CDM,27217670,W TB STOM LEVINE,266.0,172.9,44.69,239.4,21
CDM,27217680,W TB T DISP,104.0,67.6,17.47,93.6,21
CDM,27217690,W TB TRACH FN,111.0,72.15,18.65,99.9,21
CDM,27217700,W TB TRACH SHILY,114.0,74.1,19.15,102.6,21
CDM,27217710,W TB TRACH TYPEII,55.0,35.75,9.24,49.5,21
CDM,27217715,RACZ CATH,517.0,336.05,86.86,465.3,21
CDM,27217720,W TB TRCH OCF RAE,140.0,91.0,23.52,126.0,21
CDM,27217730,W TB VASC TUNNELR,98.0,63.7,16.46,88.2,21
CDM,27217740,W TEMPLATE BENDING 37 HOLES,54.0,35.1,9.07,48.6,21
CDM,27217750,W TIP POLYMER IA ANGLED,116.0,75.4,19.49,104.4,21
CDM,27217760,W TIP SCISSR DISP,886.0,575.9,148.85,797.4,21
CDM,27217770,W TIP STRAIGHT IRR SILICONE,490.0,318.5,82.32,441.0,21
CDM,27217790,W TISSUE EXTRACTORS TRANS1,893.0,580.45,150.02,803.7,21
CDM,27217800,W TISSUE MANIPUL,209.0,135.85,35.11,188.1,21
CDM,27217810,W TISSUE STABILIZER OCTOPUS 3,1613.0,1048.45,270.98,1451.7,21
CDM,27217820,W TOOL DISCT HD LGND T13 TB 2MM,124.0,80.6,20.83,111.6,21
CDM,27217830,W TORQUE DVCE,16.0,10.4,2.69,14.4,21
CDM,27217840,"W TOURNIQUET CUFF DISP 30""",64.0,41.6,10.75,57.6,21
CDM,27217860,W TRACH TUBE BIV HYPRFLX ADJ,305.0,198.25,51.24,274.5,21
CDM,27217870,W TRACH TUBE BIVONA,305.0,198.25,51.24,274.5,21
CDM,27217880,W TRAY ARTHROSCOPY HIP,1125.0,731.25,189.0,1012.5,21
CDM,27217890,W TRAY CHEST TUBE THAL QUICK,191.0,124.15,32.09,171.9,21
CDM,27217900,W TRAY CUSTOMIZED MULTIPACK,51.0,33.15,8.57,45.9,21
CDM,27217910,W TRAY FOLEY 16FR CRITICORE,55.0,35.75,9.24,49.5,21
CDM,27217920,W TRAY HIP ARTHOSCOPY,525.0,341.25,88.2,472.5,21
CDM,27217930,W TRAY UROLOGIST PROC LTX,263.0,170.95,44.18,236.7,21
CDM,27217940,"W TRAY,LAP/ENDO/BARIATRIC",7486.0,4865.9,1257.65,6737.4,21
CDM,27217960,W TROCAR BLADELESS ENDOPTH XCEL,77.0,50.05,12.94,69.3,21
CDM,27217970,W TROCAR BLADELESS W/SLEEVE,129.0,83.85,21.67,116.1,21
CDM,27217980,W TROCAR BLADELESS XCEL 5X100MM,77.0,50.05,12.94,69.3,21
CDM,27217990,W TROCAR BLADLESS XCEL W/SLEEVE,102.0,66.3,17.14,91.8,21
CDM,27217WE,OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR,6446.0,4189.9,645.72,6446.0,24
CDM,27218000,W TROCAR ENDOPATH,190.0,123.5,31.92,171.0,21
CDM,27218010,W TROCAR SLV THOR,55.0,35.75,9.24,49.5,21
CDM,27218020,W TROCAR SPACEMKR BLN,514.0,334.1,86.35,462.6,21
CDM,27218030,W TROCAR W SHEATH GC020RS,754.0,490.1,126.67,678.6,21
CDM,27218040,W TROCAR XCEL BLADELESS B5XT,87.0,56.55,14.62,78.3,21
CDM,27218050,W TROCAR/CANN KT,474.0,308.1,79.63,426.6,21
CDM,27218060,W TRP FINGER,300.0,195.0,50.4,270.0,21
CDM,27218070,W TRY ANGIOGRAPHY,1018.0,661.7,171.02,916.2,21
CDM,27218080,W TRY ANS CAUDAL,106.0,68.9,17.81,95.4,21
CDM,27218090,W TRY ANS EPIDRL,190.0,123.5,31.92,171.0,21
CDM,27218100,W TRY ANS LCL HP,181.0,117.65,30.41,162.9,21
CDM,27218110,W TRY ANS SPINAL,80.0,52.0,13.44,72.0,21
CDM,27218120,W TRY BN MARROW,52.0,33.8,8.74,46.8,21
CDM,27218130,W TRY BX,10.0,6.5,1.68,9.0,21
CDM,27218140,W TRY BX BASIC,93.0,60.45,15.62,83.7,21
CDM,27218150,W TRY BX TISU,9.0,5.85,1.51,8.1,21
CDM,27218160,W TRY CATH CVP,40.0,26.0,6.72,36.0,21
CDM,27218170,W TRY CATH FOLY,37.0,24.05,6.22,33.3,21
CDM,27218180,W TRY CRANIOTOMY,120.0,78.0,20.16,108.0,21
CDM,27218190,W TRY CVP TRI LUM,12.0,7.8,2.02,10.8,21
CDM,27218200,W TRY DOUCHE STER,56.0,36.4,9.41,50.4,21
CDM,27218210,W TRY ENDO TROCAR,413.0,268.45,69.38,371.7,21
CDM,27218220,W TRY HEMOCLIP,56.0,36.4,9.41,50.4,21
CDM,27218230,W TRY I&D,40.0,26.0,6.72,36.0,21
CDM,27218240,W TRY INST BIOTEN,2062.5,1340.63,346.5,1856.25,21
CDM,27218250,W TRY LINE INSERT,185.0,120.25,31.08,166.5,21
CDM,27218260,W TRY MYELOGRAM,282.0,183.3,47.38,253.8,21
CDM,27218270,W TRY P/M,27.0,17.55,4.54,24.3,21
CDM,27218280,W TRY REMV SUT,25.0,16.25,4.2,22.5,21
CDM,27218300,W TRY SPINE INST,2043.0,1327.95,343.22,1838.7,21
CDM,27218310,W TRY THORACENTES,80.0,52.0,13.44,72.0,21
CDM,27218320,W TRY THORACENTS,94.0,61.1,15.79,84.6,21
CDM,27218330,W TRY TRIP/LUMEN,271.0,176.15,45.53,243.9,21
CDM,27218340,W TRY TROCR CHEST,81.0,52.65,13.61,72.9,21
CDM,27218350,W TUBE CHEST 28FR,27.0,17.55,4.54,24.3,21
CDM,27218360,W TUBE CHEST 32FR,27.0,17.55,4.54,24.3,21
CDM,27218370,W TUBE CHEST 36FR,27.0,17.55,4.54,24.3,21
CDM,27218380,W TUBE EMG ENDOTRACHEAL 7MM,387.0,251.55,65.02,348.3,21
CDM,27218390,W TUBE ENDO CF VITAID 1202530,225.0,146.25,37.8,202.5,21
CDM,27218400,W TUBE ENDOBRONCH CPAP 37F,96.0,62.4,16.13,86.4,21
CDM,27218410,W TUBE ET DBL CUFF N-O LSR,82.0,53.3,13.78,73.8,21
CDM,27218420,W TUBE GASTRO BLN RPLC 18/24,66.0,42.9,11.09,59.4,21
CDM,27218430,W TUBE LARYNECTOMY SZ 8 CUFFED,92.0,59.8,15.46,82.8,21
CDM,27218440,W TUBE NIM ENDOTRACHEAL 6MM,377.0,245.05,63.34,339.3,21
CDM,27218450,W TUBE SAFET MNTGMRY 4200SERIES,240.0,156.0,40.32,216.0,21
CDM,27218460,W TUBE SHILEY LARYNGECTOMY,92.0,59.8,15.46,82.8,21
CDM,27218470,W TUBE TRACH BIVONA 67HA80,264.0,171.6,44.35,237.6,21
CDM,27218480,W TUBE TRACH BIVONA 75HA80,264.0,171.6,44.35,237.6,21
CDM,27218490,W TUBE TRACH CUFF FN W/DIC 8MM,83.0,53.95,13.94,74.7,21
CDM,27218500,W TUBE TRACH CUFF W/DIC,77.0,50.05,12.94,69.3,21
CDM,27218510,W TUBE TRACH UNCUF FEN SHILEY,77.0,50.05,12.94,69.3,21
CDM,27218520,W TUBE TRACH XL FIXD FLANGE 7MM,177.0,115.05,29.74,159.3,21
CDM,27218530,W TUBE TRIFUNNEL RPLC 20FR BLLN,106.0,68.9,17.81,95.4,21
CDM,27218540,W TUBING ARTHROSCOPY PUMP,82.0,53.3,13.78,73.8,21
CDM,27218550,W TUBING EXTENSION,36.0,23.4,6.05,32.4,21
CDM,27218560,W TUBING IRRIGATION ANSPACH,95.0,61.75,15.96,85.5,21
CDM,27218570,W TUBING MTP SET PUNCTURE NDLE,1328.0,863.2,223.1,1195.2,21
CDM,27218580,W TUBING PUMP 6FT,63.0,40.95,10.58,56.7,21
CDM,27218590,W TUBING SET TEM INSUFLATOR,225.0,146.25,37.8,202.5,21
CDM,27218600,W TUBING SET TRIVEX SYSTEM,112.0,72.8,18.82,100.8,21
CDM,27218610,W TUNNELER DBS 355006,158.0,102.7,26.54,142.2,21
CDM,27218620,W TUNNELER SHEATH & BULLET TIP,266.0,172.9,44.69,239.4,21
CDM,27218630,W TUNNELING TOOL CYBX,545.0,354.25,91.56,490.5,21
CDM,27218640,W TWL ST CLOTH,17.0,11.05,2.86,15.3,21
CDM,27218650,W URET DILAT BLN,656.0,426.4,110.21,590.4,21
CDM,27218670,W VACUUM TREPHINE HESSBRG BARRN,111.0,72.15,18.65,99.9,21
CDM,27218680,W VALVE CONTRL CUTAWY BLEEDBACK,88.0,57.2,14.78,79.2,21
CDM,27218700,W VAPR S 90 ELECTRODE,354.0,230.1,59.47,318.6,21
CDM,27218710,W VASCUTAPE STENT GUIDE,42.0,27.3,7.06,37.8,21
CDM,27218720,W VERASTEP PLUS ACESS SYSTM,263.0,170.95,44.18,236.7,21
CDM,27218730,W VERSA PORT PLUS CANULA 5-12MM,329.0,213.85,55.27,296.1,21
CDM,27218740,W VESSEL DILATOR,10.0,6.5,1.68,9.0,21
CDM,27218750,W VESSEL DILATOR,12.0,7.8,2.02,10.8,21
CDM,27218760,W VISIPRT DISP AS,589.0,382.85,98.95,530.1,21
CDM,27218770,W VLV PRESR REL,58.0,37.7,9.74,52.2,21
CDM,27218780,W WAND ARTHRO VAPOR,255.0,165.75,42.84,229.5,21
CDM,27218790,W WAX BONE 2.5GMS,48.0,31.2,8.06,43.2,21
CDM,27218800,W WIRE ARTERL SP,700.0,455.0,117.6,630.0,21
CDM,27218810,W WIRE EXCH,145.0,94.25,24.36,130.5,21
CDM,27218820,W WIRE PAS DRL1.5,258.0,167.7,43.34,232.2,21
CDM,27218830,W WRAP KNEE FOAM THER PKT,53.0,34.45,8.9,47.7,21
CDM,27218840,W WRNCH SCRW ACCRY SET 3550-02,102.0,66.3,17.14,91.8,21
CDM,27218860,W BALLOON EXTRACT OLYM MULTI 3V,206.0,133.9,34.61,185.4,21
CDM,27218870,W BIT DRL 2.0-2.2MM SCREW,128.0,83.2,21.5,115.2,21
CDM,27218880,W BIT DRL 2MM CNN AO,194.0,126.1,32.59,174.6,21
CDM,27218890,W CABLE EXT NEUROSTIM TRL LD,372.0,241.8,62.5,334.8,21
CDM,27218900,W CATHETER ABL HALO ULTRA,1949.0,1266.85,327.43,1754.1,21
CDM,27218910,W CATHETER THERMOPLASTY ATS2-5,3375.0,2193.75,567.0,3037.5,21
CDM,27218920,W CLIP SRG CLS TUBE GAMMA3,218.0,141.7,36.62,196.2,21
CDM,27218930,W CONE BODY 21MM REST +0MM STD,4874.0,3168.1,818.83,4386.6,26
CDM,27218930_OP,W CONE BODY 21MM REST +0MM STD,4874.0,3168.1,3168.1,4776.52,6
CDM,27218940,W CORKSCREW BIOCOMPOSITE #2,636.0,413.4,106.85,572.4,20
CDM,27218940_IP,W CORKSCREW BIOCOMPOSITE #2,636.0,413.4,229.6,229.6,3
CDM,27218940_OP,W CORKSCREW BIOCOMPOSITE #2,636.0,413.4,413.4,623.28,6
CDM,27218950,W CUP ACTB PRSTLC IMP HIP 32X42,1938.0,1259.7,325.58,1744.2,23
CDM,27218950_IP,W CUP ACTB PRSTLC IMP HIP 32X42,1938.0,1259.7,699.62,699.62,3
CDM,27218950_OP,W CUP ACTB PRSTLC IMP HIP 32X42,1938.0,1259.7,1259.7,1899.24,6
CDM,27218960,W DEV FIX SORBAFIX ABS LAPSCP,735.0,477.75,123.48,661.5,21
CDM,27218970,W DISECT ENDSCP REALIZE,257.0,167.05,43.18,231.3,21
CDM,27218980,W DRILL AO 2.7MM,312.0,202.8,52.42,280.8,21
CDM,27218990,W DRILL BIT 11 MM DISPOSABLE,456.0,296.4,76.61,410.4,21
CDM,27218WE,OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD,8372.0,5441.8,885.72,8372.0,24
CDM,27219000,W DRILLBIT 200MM QC CNN NS,464.0,301.6,77.95,417.6,21
CDM,27219010,W DRILL BIT CANNULATED 4.0MM,242.0,157.3,40.66,217.8,21
CDM,27219020,W DRILL PANTA DISP,263.0,170.95,44.18,236.7,21
CDM,27219030,W DRILL SRG 14MM ANT CSPN RFLX,258.0,167.7,43.34,232.2,21
CDM,27219040,W FORCEPS MULTIBITE 240CM,74.0,48.1,12.43,66.6,21
CDM,27219050,W CATH GUID LH GW CRV KIT ATN,827.0,537.55,138.94,744.3,21
CDM,27219060,W GDWR BALL TIP 2.5X800MM,132.0,85.8,22.18,118.8,21
CDM,27219070,W GRAFT BIO MATRIX GENERATE,151.0,98.15,25.37,135.9,20
CDM,27219070_IP,W GRAFT BIO MATRIX GENERATE,151.0,98.15,54.51,54.51,3
CDM,27219070_OP,W GRAFT BIO MATRIX GENERATE,151.0,98.15,98.15,147.98,6
CDM,27219080,W HEAD CONSERVE TOTAL A CLASS,167.0,108.55,28.06,150.3,20
CDM,27219080_IP,W HEAD CONSERVE TOTAL A CLASS,167.0,108.55,60.29,60.29,3
CDM,27219080_OP,W HEAD CONSERVE TOTAL A CLASS,167.0,108.55,108.55,163.66,6
CDM,27219090,W KIT PEG 20FR ENDOVIVE SAFETY,1493.0,970.45,250.82,1343.7,21
CDM,27219100,W KNEE IMMOBILIZER 18,95.0,61.75,15.96,85.5,21
CDM,27219110,W K-WIRE 1.6 MM,7850.0,5102.5,1318.8,7065.0,21
CDM,27219120,W K-WIRE 2.5 MM,77.0,50.05,12.94,69.3,21
CDM,27219130,W LEAD TEMPORARY TRANSVENOUS,420.0,273.0,70.56,378.0,21
CDM,27219140,W LIGASURE ADVNC PISTL 5MMX44CM,1005.0,653.25,168.84,904.5,21
CDM,27219150,W LINER DYNASTY A CLASS,1800.0,1170.0,302.4,1620.0,23
CDM,27219150_IP,W LINER DYNASTY A CLASS,1800.0,1170.0,649.8,649.8,3
CDM,27219150_OP,W LINER DYNASTY A CLASS,1800.0,1170.0,1170.0,1764.0,6
CDM,27219160,W LITHOTRIPTOR LITHOCRUSH V,535.0,347.75,89.88,481.5,21
CDM,27219170,W MESH PHYSIOMESH 15X20 OVAL,1648.0,1071.2,276.86,1483.2,20
CDM,27219170_IP,W MESH PHYSIOMESH 15X20 OVAL,1648.0,1071.2,594.93,594.93,3
CDM,27219170_OP,W MESH PHYSIOMESH 15X20 OVAL,1648.0,1071.2,1071.2,1615.04,6
CDM,27219180,W MESH VENTRALIGHT ST 11.4 CM,1880.0,1222.0,315.84,1692.0,23
CDM,27219180_IP,W MESH VENTRALIGHT ST 11.4 CM,1880.0,1222.0,678.68,678.68,3
CDM,27219180_OP,W MESH VENTRALIGHT ST 11.4 CM,1880.0,1222.0,1222.0,1842.4,6
CDM,27219190,W MESH VENTRALIGHT ST 4X6 INCH,1450.0,942.5,243.6,1305.0,20
CDM,27219190_IP,W MESH VENTRALIGHT ST 4X6 INCH,1450.0,942.5,523.45,523.45,3
CDM,27219190_OP,W MESH VENTRALIGHT ST 4X6 INCH,1450.0,942.5,942.5,1421.0,6
CDM,27219200,W MESH VENTRALIGHT ST 6X8 INCH,2540.0,1651.0,426.72,2286.0,23
CDM,27219200_IP,W MESH VENTRALIGHT ST 6X8 INCH,2540.0,1651.0,916.94,916.94,3
CDM,27219200_OP,W MESH VENTRALIGHT ST 6X8 INCH,2540.0,1651.0,1651.0,2489.2,6
CDM,27219210,W MESH VENTRALIGHT ST 7X9 INCH,3370.0,2190.5,566.16,3033.0,23
CDM,27219210_IP,W MESH VENTRALIGHT ST 7X9 INCH,3370.0,2190.5,1216.57,1216.57,3
CDM,27219210_OP,W MESH VENTRALIGHT ST 7X9 INCH,3370.0,2190.5,2190.5,3302.6,6
CDM,27219220,W MESH VENTRALIGHT ST 8X10 INCH,4300.0,2795.0,722.4,3870.0,23
CDM,27219220_IP,W MESH VENTRALIGHT ST 8X10 INCH,4300.0,2795.0,1552.3,1552.3,3
CDM,27219220_OP,W MESH VENTRALIGHT ST 8X10 INCH,4300.0,2795.0,2795.0,4214.0,6
CDM,27219230,W NAIL KIT LONG,3387.0,2201.55,569.02,3048.3,23
CDM,27219230_IP,W NAIL KIT LONG,3387.0,2201.55,1222.71,1222.71,3
CDM,27219230_OP,W NAIL KIT LONG,3387.0,2201.55,2201.55,3319.26,6
CDM,27219240,W NAIL TIBIAL STANDARD,1986.0,1290.9,333.65,1787.4,23
CDM,27219240_IP,W NAIL TIBIAL STANDARD,1986.0,1290.9,716.95,716.95,3
CDM,27219240_OP,W NAIL TIBIAL STANDARD,1986.0,1290.9,1290.9,1946.28,6
CDM,27219250,W NECK PROFEMUR + COCR MOD,600.0,390.0,100.8,540.0,20
CDM,27219250_IP,W NECK PROFEMUR + COCR MOD,600.0,390.0,216.6,216.6,3
CDM,27219250_OP,W NECK PROFEMUR + COCR MOD,600.0,390.0,390.0,588.0,6
CDM,27219260,W NEEDLE FNA CORE 19G/22G,474.0,308.1,79.63,426.6,21
CDM,27219270,W PASTE GRAFTON PLUS 1CC,408.0,265.2,68.54,367.2,20
CDM,27219270_IP,W PASTE GRAFTON PLUS 1CC,408.0,265.2,147.29,147.29,3
CDM,27219270_OP,W PASTE GRAFTON PLUS 1CC,408.0,265.2,265.2,399.84,6
CDM,27219280,W PIN FIX TEMP NAIL SPNL REFLX,149.0,96.85,25.03,134.1,20
CDM,27219280_IP,W PIN FIX TEMP NAIL SPNL REFLX,149.0,96.85,53.79,53.79,3
CDM,27219280_OP,W PIN FIX TEMP NAIL SPNL REFLX,149.0,96.85,96.85,146.02,6
CDM,27219290,W PINN LINER NEUTRAL 32 X 48,1364.0,886.6,229.15,1227.6,20
CDM,27219290_IP,W PINN LINER NEUTRAL 32 X 48,1364.0,886.6,492.4,492.4,3
CDM,27219290_OP,W PINN LINER NEUTRAL 32 X 48,1364.0,886.6,886.6,1336.72,6
CDM,27219300,W PLATE 14-18 MM,821.0,533.65,137.93,738.9,20
CDM,27219300_IP,W PLATE 14-18 MM,821.0,533.65,296.38,296.38,3
CDM,27219300_OP,W PLATE 14-18 MM,821.0,533.65,533.65,804.58,6
CDM,27219310,W PLATE 6 HOLE CLAVICLE,1605.0,1043.25,269.64,1444.5,20
CDM,27219310_IP,W PLATE 6 HOLE CLAVICLE,1605.0,1043.25,579.41,579.41,3
CDM,27219310_OP,W PLATE 6 HOLE CLAVICLE,1605.0,1043.25,1043.25,1572.9,6
CDM,27219320,W PLATE ATLANTS VISION 21 MM,800.0,520.0,134.4,720.0,20
CDM,27219320_IP,W PLATE ATLANTS VISION 21 MM,800.0,520.0,288.8,288.8,3
CDM,27219320_OP,W PLATE ATLANTS VISION 21 MM,800.0,520.0,520.0,784.0,6
CDM,27219330,W PLATE BOX 2X2 HOLE SQUARE,225.0,146.25,37.8,202.5,20
CDM,27219330_IP,W PLATE BOX 2X2 HOLE SQUARE,225.0,146.25,81.23,81.23,3
CDM,27219330_OP,W PLATE BOX 2X2 HOLE SQUARE,225.0,146.25,146.25,220.5,6
CDM,27219340,W PLATE CNTR BN MEDIAL TIB LT,1476.0,959.4,247.97,1328.4,20
CDM,27219340_IP,W PLATE CNTR BN MEDIAL TIB LT,1476.0,959.4,532.84,532.84,3
CDM,27219340_OP,W PLATE CNTR BN MEDIAL TIB LT,1476.0,959.4,959.4,1446.48,6
CDM,27219350,W PLT LCP LAT DIST FIB 2.7X3.5,1149.0,746.85,193.03,1034.1,20
CDM,27219350_IP,W PLT LCP LAT DIST FIB 2.7X3.5,1149.0,746.85,414.79,414.79,3
CDM,27219350_OP,W PLT LCP LAT DIST FIB 2.7X3.5,1149.0,746.85,746.85,1126.02,6
CDM,27219360,W PORT MRI INF 6.6FR PLAS 1 LUM,538.0,349.7,90.38,484.2,20
CDM,27219360_IP,W PORT MRI INF 6.6FR PLAS 1 LUM,538.0,349.7,194.22,194.22,3
CDM,27219360_OP,W PORT MRI INF 6.6FR PLAS 1 LUM,538.0,349.7,349.7,527.24,6
CDM,27219370,W PROBE ARGON BEAMER,323.0,209.95,54.26,290.7,21
CDM,27219380,W PROS PENL TTN 18 CM INFL CYL,13738.0,8929.7,2307.98,12364.2,29
CDM,27219380_OP,W PROS PENL TTN 18 CM INFL CYL,13738.0,8929.7,8929.7,13463.24,6
CDM,27219390,W PROS PENL TTN ASSEMB KT SCRT,900.0,585.0,151.2,810.0,20
CDM,27219390_IP,W PROS PENL TTN ASSEMB KT SCRT,900.0,585.0,324.9,324.9,3
CDM,27219390_OP,W PROS PENL TTN ASSEMB KT SCRT,900.0,585.0,585.0,882.0,6
CDM,27219400,W PROSTH PENILE TITAN 75CC VLV,2950.0,1917.5,495.6,2655.0,23
CDM,27219400_IP,W PROSTH PENILE TITAN 75CC VLV,2950.0,1917.5,1064.95,1064.95,3
CDM,27219400_OP,W PROSTH PENILE TITAN 75CC VLV,2950.0,1917.5,1917.5,2891.0,6
CDM,27219410,W REAMER METATARSAL 22MM,623.0,404.95,104.66,560.7,21
CDM,27219420,W SCREW 2.7 14 MM LOCKING,624.0,405.6,104.83,561.6,20
CDM,27219420_IP,W SCREW 2.7 14 MM LOCKING,624.0,405.6,225.26,225.26,3
CDM,27219420_OP,W SCREW 2.7 14 MM LOCKING,624.0,405.6,405.6,611.52,6
CDM,27219430,W SCREW 3.5 14 MM CORTICAL,38.0,24.7,6.38,34.2,20
CDM,27219430_IP,W SCREW 3.5 14 MM CORTICAL,38.0,24.7,13.72,13.72,3
CDM,27219430_OP,W SCREW 3.5 14 MM CORTICAL,38.0,24.7,24.7,37.24,6
CDM,27219440,W SCREW BN 5MM/65-70MM,237.0,154.05,39.82,213.3,20
CDM,27219440_IP,W SCREW BN 5MM/65-70MM,237.0,154.05,85.56,85.56,3
CDM,27219440_OP,W SCREW BN 5MM/65-70MM,237.0,154.05,154.05,232.26,6
CDM,27219450,W SCREW LOW PRO TI 6.7 CANN 18,406.0,263.9,68.21,365.4,20
CDM,27219450_IP,W SCREW LOW PRO TI 6.7 CANN 18,406.0,263.9,146.57,146.57,3
CDM,27219450_OP,W SCREW LOW PRO TI 6.7 CANN 18,406.0,263.9,263.9,397.88,6
CDM,27219460,W SCREW LOW PROF TI3X28MM CANN,194.0,126.1,32.59,174.6,20
CDM,27219460_IP,W SCREW LOW PROF TI3X28MM CANN,194.0,126.1,70.03,70.03,3
CDM,27219460_OP,W SCREW LOW PROF TI3X28MM CANN,194.0,126.1,126.1,190.12,6
CDM,27219470,W SCREW SPADE POINT 6.0 MM,129.0,83.85,21.67,116.1,20
CDM,27219470_IP,W SCREW SPADE POINT 6.0 MM,129.0,83.85,46.57,46.57,3
CDM,27219470_OP,W SCREW SPADE POINT 6.0 MM,129.0,83.85,83.85,126.42,6
CDM,27219480,W SCREW VA SELF TAPPNG 4.0X12MM,400.0,260.0,67.2,360.0,20
CDM,27219480_IP,W SCREW VA SELF TAPPNG 4.0X12MM,400.0,260.0,144.4,144.4,3
CDM,27219480_OP,W SCREW VA SELF TAPPNG 4.0X12MM,400.0,260.0,260.0,392.0,6
CDM,27219490,W SCREW 3.5 14 MM LOCKING,219.0,142.35,36.79,197.1,20
CDM,27219490_IP,W SCREW 3.5 14 MM LOCKING,219.0,142.35,79.06,79.06,3
CDM,27219490_OP,W SCREW 3.5 14 MM LOCKING,219.0,142.35,142.35,214.62,6
CDM,27219500,W SCREW 3.5 16 MM LOCKING,75.0,48.75,12.6,67.5,20
CDM,27219500_IP,W SCREW 3.5 16 MM LOCKING,75.0,48.75,27.08,27.08,3
CDM,27219500_OP,W SCREW 3.5 16 MM LOCKING,75.0,48.75,48.75,73.5,6
CDM,27219510,W SHEATH 7FR 45CM GUID STR,143.0,92.95,24.02,128.7,21
CDM,27219520,W SHELL ACTB 52MM PRIM HMSPHR,4390.0,2853.5,737.52,3951.0,23
CDM,27219520_IP,W SHELL ACTB 52MM PRIM HMSPHR,4390.0,2853.5,1584.79,1584.79,3
CDM,27219520_OP,W SHELL ACTB 52MM PRIM HMSPHR,4390.0,2853.5,2853.5,4302.2,6
CDM,27219530,W SHELL DYNASTY-BIOFOAM,2600.0,1690.0,436.8,2340.0,23
CDM,27219530_IP,W SHELL DYNASTY-BIOFOAM,2600.0,1690.0,938.6,938.6,3
CDM,27219530_OP,W SHELL DYNASTY-BIOFOAM,2600.0,1690.0,1690.0,2548.0,6
CDM,27219540,W SHLDR ARTHSCP PACK SRG,183.0,118.95,30.74,164.7,21
CDM,27219550,W SLEEVE CONSERVE TOTAL LONG NECK,1000.0,650.0,168.0,900.0,20
CDM,27219550_IP,W SLEEVE CONSERVE TOTAL LONG NECK,1000.0,650.0,361.0,361.0,3
CDM,27219550_OP,W SLEEVE CONSERVE TOTAL LONG NECK,1000.0,650.0,650.0,980.0,6
CDM,27219560,W SNARE HEX TRXT 2.5CMX4.0CM,62.0,40.3,10.42,55.8,21
CDM,27219570,W STEM FEM CMNTLS COLR,4302.0,2796.3,722.74,3871.8,23
CDM,27219570_IP,W STEM FEM CMNTLS COLR,4302.0,2796.3,1553.02,1553.02,3
CDM,27219570_OP,W STEM FEM CMNTLS COLR,4302.0,2796.3,2796.3,4215.96,6
CDM,27219580,W STEM FEMRAL SUMMIT,3068.0,1994.2,515.42,2761.2,23
CDM,27219580_IP,W STEM FEMRAL SUMMIT,3068.0,1994.2,1107.55,1107.55,3
CDM,27219580_OP,W STEM FEMRAL SUMMIT,3068.0,1994.2,1994.2,3006.64,6
CDM,27219590,W STEM PROFEMUR TL 8,2000.0,1300.0,336.0,1800.0,23
CDM,27219590_IP,W STEM PROFEMUR TL 8,2000.0,1300.0,722.0,722.0,3
CDM,27219590_OP,W STEM PROFEMUR TL 8,2000.0,1300.0,1300.0,1960.0,6
CDM,27219600,W STEM PROSTALAC 3 LT 200,9729.0,6323.85,1634.47,8756.1,29
CDM,27219600_OP,W STEM PROSTALAC 3 LT 200,9729.0,6323.85,6323.85,9534.42,6
CDM,27219610,W STEM TRILOCK FEMORAL,4302.0,2796.3,722.74,3871.8,23
CDM,27219610_IP,W STEM TRILOCK FEMORAL,4302.0,2796.3,1553.02,1553.02,3
CDM,27219610_OP,W STEM TRILOCK FEMORAL,4302.0,2796.3,2796.3,4215.96,6
CDM,27219620,W STENT GRAFT EXCLDR ILIAC EXTN,5580.0,3627.0,937.44,5022.0,29
CDM,27219620_OP,W STENT GRAFT EXCLDR ILIAC EXTN,5580.0,3627.0,3627.0,5468.4,6
CDM,27219630,W TACK BABSR SMALL JNT REPAIR,55.0,35.75,9.24,49.5,20
CDM,27219630_IP,W TACK BABSR SMALL JNT REPAIR,55.0,35.75,19.86,19.86,3
CDM,27219630_OP,W TACK BABSR SMALL JNT REPAIR,55.0,35.75,35.75,53.9,6
CDM,27219640,W TIP APPLICATOR NON-CLOG,166.0,107.9,27.89,149.4,21
CDM,27219650,W TISSUE AMNIOTIC MEMBRANE FRZN,1390.0,903.5,233.52,1251.0,20
CDM,27219650_IP,W TISSUE AMNIOTIC MEMBRANE FRZN,1390.0,903.5,501.79,501.79,3
CDM,27219650_OP,W TISSUE AMNIOTIC MEMBRANE FRZN,1390.0,903.5,903.5,1362.2,6
CDM,27219660,W TISSUE CORTCL BLOCK 5X14X11MM,2110.0,1371.5,354.48,1899.0,23
CDM,27219660_IP,W TISSUE CORTCL BLOCK 5X14X11MM,2110.0,1371.5,761.71,761.71,3
CDM,27219660_OP,W TISSUE CORTCL BLOCK 5X14X11MM,2110.0,1371.5,1371.5,2067.8,6
CDM,27219670,W TOOL DISECT MTCH HD BURR 90MM,145.0,94.25,24.36,130.5,21
CDM,27219680,W TUNNELER & SHEATHES ON Q 8X11IN,60.0,39.0,10.08,54.0,21
CDM,27219690,W WIRE FIX 1MM 100MM KRSH SS,58.0,37.7,9.74,52.2,21
CDM,27219700,W WIRE GDE SMOOTH TIPPD STERILE,229.0,148.85,38.47,206.1,21
CDM,27219710,W WIRE GUIDE 600 MM,142.0,92.3,23.86,127.8,21
CDM,27219720,W SEALER DIV LAP LIGASURE 5MM,713.0,463.45,119.78,641.7,21
CDM,27219730,W BIT DRL 100MM 2MM QC NS,120.0,78.0,20.16,108.0,21
CDM,27219740,W TIP STIM NRMSCLR PLSTRN 2,72.0,46.8,12.1,64.8,21
CDM,27219750,W SUT UHMWP MULT-FI LAMENT COR,75.0,48.75,12.6,67.5,21
CDM,27219760,W CATH EMB 60CM 2FR FGRTY ART,107.0,69.55,17.98,96.3,21
CDM,27219770,W CATH ABLT ST TIP CRYOSPRAY,2019.0,1312.35,339.19,1817.1,21
CDM,27219780,W GDWR ENDSCP 480 CM STR TIP,187.0,121.55,31.42,168.3,21
CDM,27219790,W NDL SCLERO 25GA 2.3MM CNTRST,65.0,42.25,10.92,58.5,21
CDM,27219800,W PERF 14MM 11MM CRAN HDSN END,174.0,113.1,29.23,156.6,21
CDM,27219810,W CATH EMB 120CM 3FR FGRTY OTW,183.0,118.95,30.74,164.7,21
CDM,27219820,W BURR FLUTED ROUND 5.0 MM,184.0,119.6,30.91,165.6,21
CDM,27219830,W STAPLER RELD 45MM ECHLN,191.0,124.15,32.09,171.9,21
CDM,27219840,W CATH BIL INFL DEV,234.0,152.1,39.31,210.6,21
CDM,27219850,W PACK QUICKDRIVE BATTERY,297.0,193.05,49.9,267.3,21
CDM,27219860,W DEL SYST RX NAVI,139.0,90.35,23.35,125.1,21
CDM,27219870,W ACC VEIN HARVEST VASVIEW 6,286.0,185.9,48.05,257.4,21
CDM,27219880,W HEMOSTATIC MATRIX FLOSEAL10ML,456.0,296.4,76.61,410.4,21
CDM,27219890,W SNARE CAPTIVATOR HEX,240.0,156.0,40.32,216.0,21
CDM,27219900,W SYS ENDSCPC VESSEL HARVESTING,1722.0,1119.3,289.3,1549.8,21
CDM,27219910,W TRAY KYPHOPAK 15/3 XPANDER,4852.0,3153.8,815.14,4366.8,21
CDM,27219920,W TRAY KYPHOPAK 20/3 XPANDER,4853.0,3154.45,815.3,4367.7,21
CDM,27219930,W STAPLER ARTIC ATW35,391.0,254.15,65.69,351.9,21
CDM,27219940,W DEV PSTN ALVRD2 FOOT PIECE,58.0,37.7,9.74,52.2,21
CDM,27219950,W INSRT SRG 12MM PLAS,52.0,33.8,8.74,46.8,21
CDM,27219960,W TIP CANNULA DUPLOJECT,65.0,42.25,10.92,58.5,21
CDM,27219970,W TBNG IRR PMP ARTHSCP STRL LF,86.0,55.9,14.45,77.4,21
CDM,27219980,W CATH ABLATION EZ STEER NAV,3105.0,2018.25,521.64,2794.5,21
CDM,27219990,W CATH EP 7FR LASSO CRV VAR,2099.0,1364.35,352.63,1889.1,21
CDM,27220000,W TUBE 80MM 7MM CUF BVN TTS,136.0,88.4,22.85,122.4,21
CDM,27220010,W TUBE FEEDING JEJUNAL MIC,218.0,141.7,36.62,196.2,21
CDM,27220020,W KIT DISP ASPIRATOR TUBING,594.0,386.1,99.79,534.6,21
CDM,27220030,W BURR HIGH SPEED CRVD DMND DCR,304.0,197.6,51.07,273.6,21
CDM,27220040,W RESECTOR FULL CUTTER RADIUS,390.0,253.5,65.52,351.0,21
CDM,27220050,W GW VASC 175CM PRSS RADPQ,987.0,641.55,165.82,888.3,21
CDM,27220060,W CATH BLN DIL RENAL 12CM X30FR,450.0,292.5,75.6,405.0,21
CDM,27220070,W STENT UROPASS URETERL 12FRX54,974.0,633.1,163.63,876.6,21
CDM,27220080,W CATH EP 7FR WEBSTER DEFL CRV,858.0,557.7,144.14,772.2,21
CDM,27220090,W INTRO LD VLV TEARWY SFSHTH,68.0,44.2,11.42,61.2,21
CDM,27220100,W INTRO ORTH KYPHOPAK XPANDER 1,3021.0,1963.65,507.53,2718.9,21
CDM,27220110,W CATH BLLN TREK/NC TREK,196.0,127.4,32.93,176.4,21
CDM,27220120,W CATH HALO XP 7X110,1407.0,914.55,236.38,1266.3,21
CDM,27220130,W TUBE JEJUNAL 45CM 16FR SIL,328.0,213.2,55.1,295.2,21
CDM,27220140,W NEEDLE ASP EUS,278.0,180.7,46.7,250.2,21
CDM,27220150,W BALLOON BILIARY RETRIEVAL,175.0,113.75,29.4,157.5,21
CDM,27220160,W SPHINTOM DRMTOME RX,611.0,397.15,102.65,549.9,21
CDM,27220170,W GW ENDSCP .035,257.0,167.05,43.18,231.3,21
CDM,27220180,W BALLOON TRIEX BIL EXT XLONG,228.0,148.2,38.3,205.2,21
CDM,27220190,W CATH INTRO ENDSCP 7FR,122.0,79.3,20.5,109.8,21
CDM,27220200,W SPHINTOM 25MM CTTN CNLTM 2 2,308.0,200.2,51.74,277.2,21
CDM,27220210,W CATH BIL BLN INFL DEV,339.0,220.35,56.95,305.1,21
CDM,27220220,W NEEDLE KNIFE SPHINTOM,216.0,140.4,36.29,194.4,21
CDM,27220230,W CATH BLLN MUSTANG OTW PTA,258.0,167.7,43.34,232.2,21
CDM,27220240,W ACCESSORY KIT 355080,420.0,273.0,70.56,378.0,21
CDM,27220250,W GUIDEWIRE TENOR STEERABLE,293.0,190.45,49.22,263.7,21
CDM,27220260,W CATH EPIDURAL NEUROTHERM,105.0,68.25,17.64,94.5,21
CDM,27220270,W KIT REFILL SYNCHROMED 8551,56.0,36.4,9.41,50.4,21
CDM,27220280,W CATH PICC DUAL LUMEN,157.0,102.05,26.38,141.3,21
CDM,27220290,W CATH GUIDING ACUITY,254.0,165.1,42.67,228.6,21
CDM,27220300,W CATH PTA 2.5-3MM X 100-120MM,975.0,633.75,163.8,877.5,21
CDM,27220310,W CATH PTA 2-3.5MM X 40-80MM,938.0,609.7,157.58,844.2,21
CDM,27220320,W CATH PTA 4-6MM X 40-80MM,900.0,585.0,151.2,810.0,21
CDM,27220340,W TOOL DISSECT MDSRX 9-M,132.0,85.8,22.18,118.8,21
CDM,27220350,W GDWIRE STD HPERF NITVU,88.0,57.2,14.78,79.2,21
CDM,27220360,W CATH ANGIO MARINER,135.0,87.75,22.68,121.5,21
CDM,27220370,W DRILL BIT 200MM 2.8MM QC,230.0,149.5,38.64,207.0,21
CDM,27220380,W INTRDCR RADIAL ACC GLIDESHT,360.0,234.0,60.48,324.0,21
CDM,27220390,W GDWR NS CORONARY RUNTHROUGH,114.0,74.1,19.15,102.6,21
CDM,27220400,W CATH CORONARY DX OPTITORQUE,93.0,60.45,15.62,83.7,21
CDM,27220410,W INTRDCR KT ECHO NTNL PLTN GWR,83.0,53.95,13.94,74.7,21
CDM,27220420,W CATH EXTRACTION BLLN B5-2C,245.0,159.25,41.16,220.5,21
CDM,27220430,W GDWR HI TORQUE IRON MAN,130.0,84.5,21.84,117.0,21
CDM,27220440,W CATH RENEGADE HI FLO FATHOM,924.0,600.6,155.23,831.6,21
CDM,27220450,W GDWR FLX ANG TP GLIDEWIRE,72.0,46.8,12.1,64.8,21
CDM,27220460,W RING MALYUGIN EXP OPTH6.25MM,219.0,142.35,36.79,197.1,21
CDM,27220470,W DEVICE HEMO ARISTA BELLOW 5GM,304.0,197.6,51.07,273.6,21
CDM,27220480,W INTRO ENDSCP 7 FR 170CM PCRV,122.0,79.3,20.5,109.8,21
CDM,27220490,W SYS INFL QNT TTC BIL PANCR,177.0,115.05,29.74,159.3,21
CDM,27220500,W SPHINTOM 25MM CTTN CNLTM II2,308.0,200.2,51.74,277.2,21
CDM,27220510,W BLLN EXTRACTION TRI-EX,228.0,148.2,38.3,205.2,21
CDM,27220520,W SPHINTOM 25MM 5.5FR FUS,330.0,214.5,55.44,297.0,21
CDM,27220530,W SPHINTOM W/WIRE 25MM TRI,394.0,256.1,66.19,354.6,21
CDM,27220540,W SPHINTOM FUS OMNI W/WIRE,330.0,214.5,55.44,297.0,21
CDM,27220550,W GDWR 260CM STD ANG TIP,139.0,90.35,23.35,125.1,21
CDM,27220560,CATH BLN ESOPH,377.0,245.05,63.34,339.3,21
CDM,27220570,CATH IAB 7FR 221MM SENS 34ML,1313.0,853.45,220.58,1181.7,21
CDM,27220580,CATH GUIDING HEARTRAILIII 6FR,175.0,113.75,29.4,157.5,21
CDM,27220590,ADPT INTRO SEAL SAFSHTH 9FR,95.0,61.75,15.96,85.5,21
CDM,27220600,CATH GUIDING ATTAIN SELECTII,254.0,165.1,42.67,228.6,21
CDM,27220610,W FORCEPS BIOPSY SUPERTRAX,132.0,85.8,22.18,118.8,21
CDM,27220620,W NEEDLE ASP 21G SUPERTRAX,151.0,98.15,25.37,135.9,21
CDM,27220630,W DEVICE RAPTOR GRASPING,167.0,108.55,28.06,150.3,21
CDM,27220640,W KIT LOCATABLE GUIDE,1493.0,970.45,250.82,1343.7,21
CDM,27220650,W BRUSH CYTOLOGY NDL TIPPED,95.0,61.75,15.96,85.5,21
CDM,27220660,W LAVSYS GASTUB-34FR 5,104.0,67.6,17.47,93.6,21
CDM,27220670,W GW TRITOME 7FR TAPERED PRLD,397.0,258.05,66.7,357.3,21
CDM,27220680,W GW FSN OMNITM SPHINCTERTM 7FR,330.0,214.5,55.44,297.0,21
CDM,27220690,W TUBE NG 8IN 20FR ESOPH 3 LUM2,234.0,152.1,39.31,210.6,21
CDM,27220700,W BRUSH CYTO 8FR 2.5CM 2 LUM,256.0,166.4,43.01,230.4,21
CDM,27220710,W BURR SRG 54MM 4MM RND DMND CR,147.0,95.55,24.7,132.3,21
CDM,27220720,W DEV SEAL ENSL G2 SUP JAW,915.0,594.75,153.72,823.5,21
CDM,27220730,W TOOL DISECT 14CM 6MM LGND FLU,137.0,89.05,23.02,123.3,21
CDM,27220740,W BLADE SHVR 110MM 3.5MM TRCT,264.0,171.6,44.35,237.6,21
CDM,27220750,W FRCP BX BIGOPSY BACKLOADING,588.0,382.2,98.78,529.2,21
CDM,27220760,W KIT DRNGE 80CM LMBR CLS,245.0,159.25,41.16,220.5,21
CDM,27220770,W NDL 5IN 20G FORAMEN PROC SPNL,70.0,45.5,11.76,63.0,21
CDM,27220780,W UNIT ESU 45CM ERGO HNDL SHFT,707.0,459.55,118.78,636.3,21
CDM,27220790,W CATH SIN 6MM 16MM BLDL RLV,1026.0,666.9,172.37,923.4,21
CDM,27220800,W DEV SUT 5MM STD 25CM TIP ENSL,535.0,347.75,89.88,481.5,21
CDM,27220810,W KIT HYPOTHERM STARTUP THRMGRD,464.0,301.6,77.95,417.6,21
CDM,27220820,W DRESS KIT RENASYS-G/P LG,65.0,42.25,10.92,58.5,21
CDM,27220830,W DRESS KIT RENASYS D-F ABD,107.0,69.55,17.98,96.3,21
CDM,27220840,W DRSG 9.2X9.2IN ABS SLFADH,87.0,56.55,14.62,78.3,21
CDM,27220850,W DRSG SILV ANTIMIC,87.0,56.55,14.62,78.3,21
CDM,27220860,W CATH GD MICROSTRGHT MAESTRO,525.0,341.25,88.2,472.5,21
CDM,27220870,W CATH ATHRCM G3 CRV CTRL POD,4590.0,2983.5,771.12,4131.0,21
CDM,27220880,W INTRDCR FLEXOR CHECK FLO,65.0,42.25,10.92,58.5,21
CDM,27220890,W DEV RETRV 3MM ALGTR,3207.0,2084.55,538.78,2886.3,21
CDM,27220900,W GDWR ADVANTAGE 180CM SPIRAL,263.0,170.95,44.18,236.7,21
CDM,27220910,W GDWR VASC 300CM 3CM STR,130.0,84.5,21.84,117.0,21
CDM,27220920,W CATH F5INF 100CM,68.0,44.2,11.42,61.2,21
CDM,27220930,W CATH MICRO ASAHI CORSAIR,1493.0,970.45,250.82,1343.7,21
CDM,27220940,W CATH GUID CS LD DLV SYS EXT,276.0,179.4,46.37,248.4,21
CDM,27220950,W CATH ABLT NAV SF UNI CART3 D,3375.0,2193.75,567.0,3037.5,21
CDM,27220960,W CATH BLLN STINGRAY CTO,1553.0,1009.45,260.9,1397.7,21
CDM,27220970,W CATH ANG 135CM CROSSBOSS,1313.0,853.45,220.58,1181.7,21
CDM,27220980,W GDWR VASC 300CM STINGRAY HPC,375.0,243.75,63.0,337.5,21
CDM,27220990,W GDWR VASC 190CM A FLDR XT,207.0,134.55,34.78,186.3,21
CDM,27220WE,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,2420.0,1573.0,287.88,1815.0,35
CDM,27221000,PROBE BICAP F7R,248.0,161.2,41.66,223.2,21
CDM,27221010,W NDL INJ 25G 230CM,54.0,35.1,9.07,48.6,21
CDM,27221020,W CATH GSTRMY LP,160.0,104.0,26.88,144.0,21
CDM,27221030,W PLUNGER FOAM TIP INJECTOR,66.0,42.9,11.09,59.4,21
CDM,27221040,W TRAY CATH 5FR POWRHOHN 1 LUM,338.0,219.7,56.78,304.2,21
CDM,27221050,W BLADE 3MM CAUT SPAT TIP VAR,315.0,204.75,52.92,283.5,21
CDM,27221060,W CATH BLLN EMERGE MONORAIL,193.0,125.45,32.42,173.7,21
CDM,27221070,W CATH BLDL NC QUANTUM APEX,193.0,125.45,32.42,173.7,21
CDM,27221080,W KIT CATH 7FR 16CM 3LUM,187.0,121.55,31.42,168.3,21
CDM,27221090,W INTRO LD 49CM 9FR SSHTH CSG,503.0,326.95,84.5,452.7,21
CDM,27221100,W TOOL LD DLV 3.1MM 338MM TUN,575.0,373.75,96.6,517.5,21
CDM,27221110,W CATH GD 3-2.4FR .021IN 20CM,723.0,469.95,121.46,650.7,21
CDM,27221120,W CATH US 10FR 90CM INTRCRD 4W,1088.0,707.2,182.78,979.2,21
CDM,27221130,W CATH EP 6FR 120CM,67.0,43.55,11.26,60.3,21
CDM,27221140,W CATH EP 7FR 20MM 115CM,468.0,304.2,78.62,421.2,21
CDM,27221150,W SHEATH TEARAWAY 9FRX25CM,110.0,71.5,18.48,99.0,21
CDM,27221160,W KIT DRSG TRBSOAR 30X20CM,456.0,296.4,76.61,410.4,21
CDM,27221170,W CATH ABLT 7FR WEBST CS EZ,303.0,196.95,50.9,272.7,21
CDM,27221180,W GW ENDSCP .035IN 150CM FLX,79.0,51.35,13.27,71.1,21
CDM,27221190,W INTRO/SHEATH 7FRX13CM,507.0,329.55,85.18,456.3,21
CDM,27221200,W CATH EP 6FR 110CM 2-10-2MM,244.0,158.6,40.99,219.6,21
CDM,27221210,W TRAY HMDIAL 20CM 12FR MK 3,211.0,137.15,35.45,189.9,21
CDM,27221220,W ELECTRD ESU 105CM 2MM SPAT,516.0,335.4,86.69,464.4,21
CDM,27221230,W OVRTB ENDSCP CSCP ENTRADA,248.0,161.2,41.66,223.2,21
CDM,27221240,W CATH ABLT HALO 360,2457.0,1597.05,412.78,2211.3,21
CDM,27221250,W SNARE 230CM 25GA 3MM ISNARE,149.0,96.85,25.03,134.1,21
CDM,27221260,W NDL ENDSCP 19GA FLEX US ASP,631.0,410.15,106.01,567.9,21
CDM,27221270,W ENDSCP 22/25GA US ASP,278.0,180.7,46.7,250.2,21
CDM,27221280,W GW ENDSCP TRCR METRO XL BIL,228.0,148.2,38.3,205.2,21
CDM,27221290,W CATH INTVN 8FR 2.24MM 20CM,563.0,365.95,94.58,506.7,21
CDM,27221300,W CATH GUID EP FINECROSS,900.0,585.0,151.2,810.0,21
CDM,27221310,W CATH GUIDING 8FR ACTY EXHK,229.0,148.85,38.47,206.1,21
CDM,27221320,W CATH EP 7FR 110CM HALO XP,501.0,325.65,84.17,450.9,21
CDM,27221330,W DRESS KIT RENASYS-F ABD,456.0,296.4,76.61,410.4,21
CDM,27221340,W CATH ABLT 7FR 115CM 2MM,1329.0,863.85,223.27,1196.1,21
CDM,27221350,W UW VIASPAN SOL 1000ML,542.0,352.3,91.06,487.8,21
CDM,27221360,W_HTK CUSTODIOL SOL 1000ML,306.0,198.9,51.41,275.4,21
CDM,27221370,W PULSATILE PERFUSION SOL 1000ML,296.0,192.4,49.73,266.4,21
CDM,27221380,W SLUSH 0.9% NACL IRR 1000ML,39.0,25.35,6.55,35.1,21
CDM,27221390,W CSS SOL 1000ML,296.0,192.4,49.73,266.4,21
CDM,27221400,W CANN PERFUSION W SUTURE BUMP,59.0,38.35,9.91,53.1,21
CDM,27221410,W SET DUAL ORGAN PERFUSION,61.0,39.65,10.25,54.9,21
CDM,27221420,W SET QUAD ORGAN PERFUSION,73.0,47.45,12.26,65.7,21
CDM,27221430,W CATH GDE 7FR .078 100CM AL2,241.0,156.65,40.49,216.9,21
CDM,27221440,W CATH ABLT 25-15MM LASSO NAV,1315.0,854.75,220.92,1183.5,21
CDM,27221450,W CATH DRNG 18FR 25CM ULTTHN,114.0,74.1,19.15,102.6,21
CDM,27221460,W PARTIC EMBL LIQ SYS ONX,3099.0,2014.35,520.63,2789.1,21
CDM,27221470,W CATH INF 250 PSI 5FR .014,938.0,609.7,157.58,844.2,21
CDM,27221480,W CATH ART 8FR 110CM THRMDIL,266.0,172.9,44.69,239.4,21
CDM,27221490,W SHEATH TEARAWAY 7F 13CM,60.0,39.0,10.08,54.0,21
CDM,27221500,W GW VASC 300CM 11CM STR,207.0,134.55,34.78,186.3,21
CDM,27221510,W COIL DETACHER AXIUM,82.0,53.3,13.78,73.8,21
CDM,27221520,W SNARE 10MM ELITE QUATTRO,659.0,428.35,110.71,593.1,21
CDM,27221530,W INTRO MPNCH NITINOL GW,62.0,40.3,10.42,55.8,21
CDM,27221540,W SET HMDIAL PRISMAFLEX TPE,434.0,282.1,72.91,390.6,21
CDM,27221550,W TUBE BRIDLE FEEDING,149.0,96.85,25.03,134.1,21
CDM,27221560,W CATH CV 9.3FR 38CM ICY,1214.0,789.1,203.95,1092.6,21
CDM,27221570,W KIT IV STRT CLGRD 3K,283.0,183.95,47.54,254.7,21
CDM,27221580,W CATH QUATTRO 9.3F 45CM,1293.0,840.45,217.22,1163.7,21
CDM,27221590,W NDL BIOPSY OSTEO-SITE,68.0,44.2,11.42,61.2,21
CDM,27221600,W CATH FRZR X 3 ABLT AV 108CM,2160.0,1404.0,362.88,1944.0,21
CDM,27221610,W CATH UMB COAX,228.0,148.2,38.3,205.2,21
CDM,27221620,W SHTH LSR 50CM 14FR GLIDLGHT,3726.0,2421.9,625.97,3353.4,21
CDM,27221630,W CATH EP 7FR 2-6-2MM SPC F CRV,2425.0,1576.25,407.4,2182.5,21
CDM,27221640,W CATH GUID ATTN CMND 6250V-EH,318.0,206.7,53.42,286.2,21
CDM,27221650,W CATH GD SLITABLE INNER CATH,488.0,317.2,81.98,439.2,21
CDM,27221660,W CATH GUID ATTN CMND 6250VC,318.0,206.7,53.42,286.2,21
CDM,27221670,W CATH GUD ATN SLT2 6248V-90,242.0,157.3,40.66,217.8,21
CDM,27221680,W GDNG CATH CPS DIRECT,1148.0,746.2,192.86,1033.2,21
CDM,27221690,W SYS EP ENST NVX LG PTCH INST,1425.0,926.25,239.4,1282.5,21
CDM,27221700,W CATH EP BIDIR REFLEXION,2025.0,1316.25,340.2,1822.5,21
CDM,27221710,W CATH ABLT SAFIRE BLU,2025.0,1316.25,340.2,1822.5,21
CDM,27221720,W KIT CATH CV MULTI-LUMEN,148.0,96.2,24.86,133.2,21
CDM,27221730,W INTRO SHTH FLEXCATH ADV STR,1350.0,877.5,226.8,1215.0,21
CDM,27221740,W CATH CRYABL ARCTIC CARDIAC,5670.0,3685.5,952.56,5103.0,21
CDM,27221750,W CATH EP ACHIEVE MAPPING,1200.0,780.0,201.6,1080.0,21
CDM,27221760,W CATH EP ABLT THRMCL BIDIRECT,2037.0,1324.05,342.22,1833.3,21
CDM,27221770,W INTRO SHTH FLEXOR CHECK-FLO,105.0,68.25,17.64,94.5,21
CDM,27221780,W INTRO SHTH RING TRANSJUGULAR,578.0,375.7,97.1,520.2,21
CDM,27221790,W LUB INST VIPERSLIDE DBAK,140.0,91.0,23.52,126.0,21
CDM,27221800,W CATH ATHRCTMY STEALTH 360,4583.0,2978.95,769.94,4124.7,21
CDM,27221810,W GW VASC TRANSEND EX,606.0,393.9,101.81,545.4,21
CDM,27221815,PIC NEEDLE,42.0,27.3,7.06,37.8,21
CDM,27221820,W CATH NAVIEN DSTL INTRCRNL,1418.0,921.7,238.22,1276.2,21
CDM,27221825,MICROINTRODUCER KIT,62.0,40.3,10.42,55.8,21
CDM,27221830,W CATH TEMPO DIAG CRBRL,50.0,32.5,8.4,45.0,21
CDM,27221840,W INTRO SHTH FLEXOR TOUHY-BORST,144.0,93.6,24.19,129.6,21
CDM,27221850,W CATH MICRO DIREXION HI-FLO,1269.0,824.85,213.19,1142.1,21
CDM,27221860,W KT DEV MNRCH INFL CUST,126.0,81.9,21.17,113.4,21
CDM,27221870,W CATH SWAN GZ DBL LUMEN,117.0,76.05,19.66,105.3,21
CDM,27221880,W INTRO SHTH CLASSIC,82.0,53.3,13.78,73.8,21
CDM,27221890,W CATH SWAN GZ DL FLOW DIRECT,122.0,79.3,20.5,109.8,21
CDM,27221900,W CATH BLDL ADMIRAL XTREME,166.0,107.9,27.89,149.4,21
CDM,27221910,W SYS INZONE DETACH HANDLE,263.0,170.95,44.18,236.7,21
CDM,27221920,W CATH GUID MPC CURVE ENVOY,461.0,299.65,77.45,414.9,21
CDM,27221930,W GW VASC STRT TRAXCESS NTL,506.0,328.9,85.01,455.4,21
CDM,27221940,W CATH MICRO HDWAY 21 ADV STR,938.0,609.7,157.58,844.2,21
CDM,27221950,W CABLE BLCKD HH DETCH COIL,140.0,91.0,23.52,126.0,21
CDM,27221960,W GW VASC SFT SYNCH HYDR NTNL,720.0,468.0,120.96,648.0,21
CDM,27221970,W CATH DX EP JOSEPHSON CURVED,306.0,198.9,51.41,275.4,21
CDM,27221980,W CATH MICRO RENEGADE HI FLO,580.0,377.0,97.44,522.0,21
CDM,27221990,W CATH NAV SMARTTCH UNI D CRV,3483.0,2263.95,585.14,3134.7,21
CDM,27222000,W CATH ADVANCED HEADWAY,1008.0,655.2,169.34,907.2,21
CDM,27222010,W PUMP CANISTER W/TUBNG FILT,555.0,360.75,93.24,499.5,21
CDM,27222020,W CATH REPERFUSION 5MAX ACE,2687.0,1746.55,451.42,2418.3,21
CDM,27222030,W TUBING ASPIRATION MAX STRL,555.0,360.75,93.24,499.5,21
CDM,27222040,W CATH BALLN DILAT ADMRL XTRM,278.0,180.7,46.7,250.2,21
CDM,27222050,W CATH BLLN DLTN AMPHRN DEEP,278.0,180.7,46.7,250.2,21
CDM,27222060,W CATH THRMBCTY SOLITAIRE DVC,8320.0,5408.0,1397.76,7488.0,21
CDM,27222070,W CATH ANG MIC REG HEADWAY,1152.0,748.8,193.54,1036.8,21
CDM,27222080,W NEEDLE TRANSSPTL BRK-1 XS,240.0,156.0,40.32,216.0,21
CDM,27222090,W GW VASC ASAHI TREASURE PRPH,255.0,165.75,42.84,229.5,21
CDM,27222100,W CATH GUIDING CS ACUITY,182.0,118.3,30.58,163.8,21
CDM,27222110,W CATH GUIDING SUPPORT CXI,293.0,190.45,49.22,263.7,21
CDM,27222120,W INTRO SHTH 4FR MPNCH PDL,79.0,51.35,13.27,71.1,21
CDM,27222130,W DETACH CONTROLLER VTRAK DLV,263.0,170.95,44.18,236.7,21
CDM,27222140,W CATH GD MULTIPURPOSE ENVOY,573.0,372.45,96.26,515.7,21
CDM,27222150,W GW VASCULAR TRANSEND,726.0,471.9,121.97,653.4,21
CDM,27222160,W CATH ANGIO OCCLSN VNGR BLN,133.0,86.45,22.34,119.7,21
CDM,27222170,W CATH BALLN DLTN PCFC XTREM,300.0,195.0,50.4,270.0,21
CDM,27222180,W CATH INFSN MICRO RDPQ MRKMN,1463.0,950.95,245.78,1316.7,21
CDM,27222190,W CATH BLLN PTA PACIFIC PLUS,263.0,170.95,44.18,236.7,21
CDM,27222200,W GW VASC TRANSND X SUPPORT,810.0,526.5,136.08,729.0,21
CDM,27222210,W CATH BLLN OCCL SCEPTER,1833.0,1191.45,307.94,1649.7,21
CDM,27222250,W APPL IN CLP 10 MED LG,366.0,237.9,61.49,329.4,21
CDM,27222260,W RELD STPLR MED 45 2 THK,263.0,170.95,44.18,236.7,21
CDM,27222270,W STPLR INT 440 45 SHFT PWR,447.0,290.55,75.1,402.3,21
CDM,27222280,W RELD STPLR VASC 45 MM,514.0,334.1,86.35,462.6,21
CDM,27222290,W TROC LAPSCP STD 12 MM,52.0,33.8,8.74,46.8,21
CDM,27222300,W TROC LAPSCP 5-12 MM,170.0,110.5,28.56,153.0,21
CDM,27222310,W DISECT ESU CRDLSS SONICISION,653.0,424.45,109.7,587.7,21
CDM,27222320,W INTRO MICRO SHTH STD SS PT,65.0,42.25,10.92,58.5,21
CDM,27222330,W CATH GD ACUITY CRNRY SINUS,743.0,482.95,124.82,668.7,21
CDM,27222340,W INTRO SET MPNCH 4FR CATH,68.0,44.2,11.42,61.2,21
CDM,27222350,W CATH THRMCTMY ANGIOJET SET,2167.0,1408.55,364.06,1950.3,21
CDM,27222360,W CATH BLLN DIL NC EUPHORA,202.0,131.3,33.94,181.8,21
CDM,27222370,W TBNG CRYOSURG UMB ELEC EP,323.0,209.95,54.26,290.7,21
CDM,27222380,W GW VASC ANG  STNDRD TIP STR,112.0,72.8,18.82,100.8,21
CDM,27222390,W GW VASC ANG NITREX NITL,103.0,66.95,17.3,92.7,21
CDM,27222400,W COIL HANDLE DETACHMENT,375.0,243.75,63.0,337.5,21
CDM,27222410,W TOOL SUBQ ELECTRD QTRAK,1350.0,877.5,226.8,1215.0,21
CDM,27222415,AERONEB NEBULIZER,76.67,49.84,12.88,69.0,21
CDM,27222420,W INTRO ACCUST RO MRKR SS GW,107.0,69.55,17.98,96.3,21
CDM,27222430,W GW VASC ANGLD HYDROPHILIC,97.0,63.05,16.3,87.3,21
CDM,27222440,W PRGMR NRSTM ACTIVA PC RCHG,1350.0,877.5,226.8,1215.0,21
CDM,27222450,W CATH DRNGE AMPLTZ ULTRTHN,127.0,82.55,21.34,114.3,21
CDM,27222460,W GW RETRIEVER QUICK CROSS,750.0,487.5,126.0,675.0,21
CDM,27222470,W KIT CATH MAC 2LUMN CVA,229.0,148.85,38.47,206.1,21
CDM,27222480,W CATH THRMB SOLENT DISTA SET,2599.0,1689.35,436.63,2339.1,21
CDM,27222490,W SHEATH DILATOR VISISHEATH,353.0,229.45,59.3,317.7,21
CDM,27222500,W INTRO MICRO NITINOL GW,67.0,43.55,11.26,60.3,21
CDM,27222510,W HEMSTIC MTRX FLOSEAL ADPT,456.0,296.4,76.61,410.4,21
CDM,27222520,W CATH GD CORONARY ACUITY PRO,368.0,239.2,61.82,331.2,21
CDM,27222530,W SHEATH MINI TEAR AWAY,315.0,204.75,52.92,283.5,21
CDM,27222550,W CABLE CATH MAPPING ACHIEVE,263.0,170.95,44.18,236.7,21
CDM,27222560,W GW ENDSCP BIL PATHFR EXCHG,206.0,133.9,34.61,185.4,21
CDM,27222570,W GASTROPED NEEDLE RADIAL JAW,62.0,40.3,10.42,55.8,21
CDM,27222580,W BLLN DIL BIL 6X4 5FR MAXFRC,346.0,224.9,58.13,311.4,21
CDM,27222590,W BLLN DIL BIL 4X4 MAXFRC,387.0,251.55,65.02,348.3,21
CDM,27222600,W CATH BLLN CRE WIREGD GI DIL,471.0,306.15,79.13,423.9,21
CDM,27222610,W CATH ENDSCP ABLTN RADIOFRQ,1825.0,1186.25,306.6,1642.5,21
CDM,27222620,W KNIFE DUAL ELECTROSURGICAL,797.0,518.05,133.9,717.3,21
CDM,27222630,W FRCP BX RADIAL JAW JMB NDL,63.0,40.95,10.58,56.7,21
CDM,27222640,W BSKT SP RETRIEVAL RTBL SCP,131.0,85.15,22.01,117.9,21
CDM,27222650,W GUIDE WRE STR AQ,174.0,113.1,29.23,156.6,21
CDM,27222660,W PROBE ELECTRSURGICAL FIAPC,318.0,206.7,53.42,286.2,21
CDM,27222670,W CATH ENDSCP FUSION STRL,91.0,59.15,15.29,81.9,21
CDM,27222680,W KIT PICC BIOFLO,103.0,66.95,17.3,92.7,21
CDM,27222690,W CATH CV POWERPICC DUAL LUM,210.0,136.5,35.28,189.0,21
CDM,27222700,W CATH PICC XCELA DUAL LUM,149.0,96.85,25.03,134.1,21
CDM,27222710,W CATH ENDSCP 6MM 16MM SIN BLN,1172.0,761.8,196.9,1054.8,21
CDM,27222720,W RLD STPLR 45MM ARTC VSC/MED,226.0,146.9,37.97,203.4,21
CDM,27222730,W TROC LAPSCP STD 12MM VPRT,51.0,33.15,8.57,45.9,21
CDM,27222740,W RELD STPLR 60MM ARTC VSC/MD,281.0,182.65,47.21,252.9,21
CDM,27222750,W RELD STPLR 45MM ARTC MED,242.0,157.3,40.66,217.8,21
CDM,27222760,W RELD STPLR 60MM ARTC MED,286.0,185.9,48.05,257.4,21
CDM,27222770,W STPLR INT 60MM 34CM SHF PWR,1753.0,1139.45,294.5,1577.7,21
CDM,27222780,W APPL IN CLP MED LG 10MM TI,138.0,89.7,23.18,124.2,21
CDM,27222790,W DISCT ESU CORDLSS SONICSION,653.0,424.45,109.7,587.7,21
CDM,27222800,W STPLR INT 80X3.8MM TI REG,228.0,148.2,38.3,205.2,21
CDM,27222810,W RELD STPLR 80X3.8MM GIA TI,119.0,77.35,19.99,107.1,21
CDM,27222820,W KIT STIM DP BRN TUNNELER,184.0,119.6,30.91,165.6,21
CDM,27222830,W CATH BLN DLTN RIGIFLEX II,662.0,430.3,111.22,595.8,21
CDM,27222840,W CATH ABLT FLX 115CM 8FR 4MM,2228.0,1448.2,374.3,2005.2,21
CDM,27222850,W CATH MICRO DIREXION TORQABL,861.0,559.65,144.65,774.9,21
CDM,27222860,W KIT GSTRMY 20FR INTRO LP FDTB,304.0,197.6,51.07,273.6,21
CDM,27222870,W DIL SHTH 24FR TELSCP PLWY,167.0,108.55,28.06,150.3,21
CDM,27222880,W TB FEED GASTRSMY MIC BOLUS,61.0,39.65,10.25,54.9,21
CDM,27222890,W FIAPC PROBE 300CM,366.0,237.9,61.49,329.4,21
CDM,27222900,W CANNULA ERCP TAP TIP,65.0,42.25,10.92,58.5,21
CDM,27222910,W TOOL EMBLEM S-ICD SUBQ ELCT,170.0,110.5,28.56,153.0,21
CDM,27222920,W FRCP ENDSCP BX PCRV JAWZ,260.0,169.0,43.68,234.0,21
CDM,27222930,W SET GSTRMY ANCHR TFSTNR,196.0,127.4,32.93,176.4,21
CDM,27222940,W CATH IN.PACT ADMIRAL DCB,1604.0,1042.6,269.47,1443.6,21
CDM,27222950,W CATH ABL QT TACTICATH,2970.0,1930.5,498.96,2673.0,21
CDM,27222970,W CATH DLV SYS AMPL TORQ,906.0,588.9,152.21,815.4,21
CDM,27222980,W GW VASC AMPL XSTF SS,63.0,40.95,10.58,56.7,21
CDM,27222990,W CATH BLLN MAXI LD PTA DIL,474.0,308.1,79.63,426.6,21
CDM,27222WE,CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ,5644.0,3668.6,536.37,5644.0,35
CDM,27223000,W CATH US 8FR 90CM INTRCRD 4W,1088.0,707.2,182.78,979.2,21
CDM,27223010,W GUIDEWIRE VIPERWIRE COR FLP,293.0,190.45,49.22,263.7,21
CDM,27223020,W CATH US 5FR INTVASC OPTICROSS,938.0,609.7,157.58,844.2,21
CDM,27223030,W BAND TR BND 29CM LONG BLN,97.0,63.05,16.3,87.3,21
CDM,27223040,W NDL BX 18GA 20CM BPNC COAX,68.0,44.2,11.42,61.2,21
CDM,27223050,W CATH CRBRVASC EXCLS 18CM,1295.0,841.75,217.56,1165.5,21
CDM,27223060,W CTH MICR CBRVSC EXCLS 6CM,1493.0,970.45,250.82,1343.7,21
CDM,27223070,W CATH EXCLS SL-10 INF,1165.0,757.25,195.72,1048.5,21
CDM,27223080,W CATH INF EXCELSIOR SL-10,1250.0,812.5,210.0,1125.0,21
CDM,27223090,W GW NEURVASC ASAHI CHIKAI,663.0,430.95,111.38,596.7,21
CDM,27223100,W GW VASC STRBL SFT AGLTY STR,413.0,268.45,69.38,371.7,21
CDM,27223110,W CATH GUID MPD CRV ENVOY,428.0,278.2,71.9,385.2,21
CDM,27223130,W DRSG ACTCT SILCRYST BRN 13X4IN,75.0,48.75,12.6,67.5,21
CDM,27223140,W CATH ATHER TURBO ELITE OTW,2835.0,1842.75,476.28,2551.5,21
CDM,27223150,W TIP APPL SEALANT EVICEL 3908,93.0,60.45,15.62,83.7,21
CDM,27223160,W CATHETER STRETTA 8800,1890.0,1228.5,317.52,1701.0,21
CDM,27223170,W KIT SEALANT W APPL EVICEL 3905,1045.0,679.25,175.56,940.5,21
CDM,27223180,W CATH CHOLGM SPYSCOPE ACC DLV,3983.0,2588.95,669.14,3584.7,21
CDM,27223190,W CATH SAFE-T-CENTESIS PLUS,120.0,78.0,20.16,108.0,21
CDM,27223200,W NDL BONE BIOPSY OSTEO-SITE,160.0,104.0,26.88,144.0,21
CDM,27223210,W  PULLBACK STRL SLED GALAXY,70.0,45.5,11.76,63.0,21
CDM,27223220,W CATH ABLT 7FR 4MM 110 CM MED,713.0,463.45,119.78,641.7,21
CDM,27223230,W CATH BLLN PERC MITRAL,3105.0,2018.25,521.64,2794.5,21
CDM,27223240,W DEV RETRV TREVO PROVUE NRSC,8498.0,5523.7,1427.66,7648.2,21
CDM,27223250,W H130006 SIZER FENIX CONT RESTOR,50.0,32.5,8.4,45.0,21
CDM,27223260,W APPL IN CLP 5MM TI ENDSCP LIG,229.0,148.85,38.47,206.1,21
CDM,27223270,W BLADE SHVR TRUCLEAR INC+,854.0,555.1,143.47,768.6,21
CDM,27223280,W WATCHMAN ACCESS CAP 1-3 UNITS,1350.0,877.5,226.8,1215.0,21
CDM,27223290,W DEV RF NVSR ENDOMET W/SOUND,1382.0,898.3,232.18,1243.8,21
CDM,27223300,W WATCHMAN ACCESS CAP EA ADD,1350.0,877.5,226.8,1215.0,21
CDM,27223310,W CATH ACTY PRO GUID,203.0,131.95,34.1,182.7,21
CDM,27223320,W MRCLTR ESU TRUCLEAR HYSCP,674.0,438.1,113.23,606.6,21
CDM,27223330,W LGTR ENDSCP FRNG FALOPE RING,3146.0,2044.9,528.53,2831.4,21
CDM,27223340,W MRCLTR SRG 4MM TRUCLEAR ULT,1139.0,740.35,191.35,1025.1,21
CDM,27223350,W KIT TRANSJUGULAR LIVER BIOPSY,563.0,365.95,94.58,506.7,21
CDM,27223360,W GW VASC CHOICE,114.0,74.1,19.15,102.6,21
CDM,27223370,W GW VASC STR MAILMAN,114.0,74.1,19.15,102.6,21
CDM,27223380,W CATH GUID CPS DIRECT,300.0,195.0,50.4,270.0,21
CDM,27223390,W INTRO SHTH FLX CHK FLO II,102.0,66.3,17.14,91.8,21
CDM,27223400,W CATH BLDL ULTRAVERSE,147.0,95.55,24.7,132.3,21
CDM,27223410,W TRAY BIOPSY ONCONTROL SYST,239.0,155.35,40.15,215.1,21
CDM,27223420,W CATH SWAN-GANZ ART THRMDIL,323.0,209.95,54.26,290.7,21
CDM,27223430,W GW SYNCHRO2 STD HYDROPHILIC,886.0,575.9,148.85,797.4,21
CDM,27223440,W GW VASC AMPLTZ JTIP,83.0,53.95,13.94,74.7,21
CDM,27223450,W INTRO HMSTS DISTL GW GSPC,210.0,136.5,35.28,189.0,21
CDM,27223460,W INTRO CATH HEM 60D TRNSPT,70.0,45.5,11.76,63.0,21
CDM,27223470,W INTRO CATH 7FR CURVE TRNSPT,88.0,57.2,14.78,79.2,21
CDM,27223480,W CATH ACUMEN C315 FXD SHP HIS,660.0,429.0,110.88,594.0,21
CDM,27223490,W CATH AMPLATZER SZ BLLN II,414.0,269.1,69.55,372.6,21
CDM,27223500,W GW VASC .035 STRGHT,81.0,52.65,13.61,72.9,21
CDM,27223510,W CATH EMB EXPORTAP BRD ASP,750.0,487.5,126.0,675.0,21
CDM,27223520,W CATH DISTAL ACCESS AXS,2228.0,1448.2,374.3,2005.2,21
CDM,27223530,W STYL LD LMB/DIAM/FINLN II,79.0,51.35,13.27,71.1,21
CDM,27223540,W INTRO SHTH 23FR 55.7CM MICRA,1200.0,780.0,201.6,1080.0,21
CDM,27223550,W GW LUGE VASC STRAIGHT,114.0,74.1,19.15,102.6,21
CDM,27223560,W CATH EKOS SYS ENDOVASCULAR,3234.0,2102.1,543.31,2910.6,21
CDM,27223580,W INTRO SHTH PRELUDE SNAP,54.0,35.1,9.07,48.6,21
CDM,27223590,W CATH PICC BIO FLO KT,173.0,112.45,29.06,155.7,21
CDM,27223600,W TRAY CATH 5FR 2LUM FULL PRC,375.0,243.75,63.0,337.5,21
CDM,27223610,W CATH BLN OTW LUTONIX COATED,2565.0,1667.25,430.92,2308.5,21
CDM,27223620,W KIT LIVER BIOPSY W CATHS,600.0,390.0,100.8,540.0,21
CDM,27223630,W CATH INPACT ADMIRAL DCB/DEB,1796.0,1167.4,301.73,1616.4,21
CDM,27223640,W CATH US VIEWFLEX XTRA BIDIR,2430.0,1579.5,408.24,2187.0,21
CDM,27223650,W GW VASC CONTROLWIRE TAPER SCI,141.0,91.65,23.69,126.9,21
CDM,27223660,W GW VASC MICROPNT PLUSH SS,71.0,46.15,11.93,63.9,21
CDM,27223670,W GW ATHERECTOMY JETSTREAM,175.0,113.75,29.4,157.5,21
CDM,27223680,W CATH GUID MPD CRV ENVOY DA,825.0,536.25,138.6,742.5,21
CDM,27223690,W CATH NEURON SELECT SS,219.0,142.35,36.79,197.1,21
CDM,27223700,W CATH NAV UNI F SMARTTOUCH SF,3574.0,2323.1,600.43,3216.6,21
CDM,27223710,W CATH BLLN DILL STERLING OTW,330.0,214.5,55.44,297.0,21
CDM,27223720,W NDL INTRO PRECIS 13GA MTCH,73.0,47.45,12.26,65.7,21
CDM,27223730,W KIT DRNGE 80CM LMBR LMBR CLS,245.0,159.25,41.16,220.5,21
CDM,27223740,W CATH NEURON MAX SEL SIM,219.0,142.35,36.79,197.1,21
CDM,27223750,W EMBOLI CAPTURE SYS ANGIOGUARD,2228.0,1448.2,374.3,2005.2,21
CDM,27223760,W CATH DLV SYS AMPLATZER,1104.0,717.6,185.47,993.6,21
CDM,27223770,W CATH THROMCTMY 5MAX ACE 64,3861.0,2509.65,648.65,3474.9,21
CDM,27223780,W CATH MICRO VEL 3D DEL SYSTM,1451.0,943.15,243.77,1305.9,21
CDM,27223790,W RETRV ENDSCP TREVO XP PVUE,8863.0,5760.95,1488.98,7976.7,21
CDM,27223800,W CATH STINGRAY LP CTO,2815.0,1829.75,472.92,2533.5,21
CDM,27223810,W CATH INF SEL PLS PRWL TRULMN,1049.0,681.85,176.23,944.1,21
CDM,27223820,W CATH BLLN COYOTE OTW,330.0,214.5,55.44,297.0,21
CDM,27223830,W KNIFE CIRC ARACH STR HNDL,58.0,37.7,9.74,52.2,21
CDM,27223840,W KIT TRUCLEAR HYSTEROSCOPIC,456.0,296.4,76.61,410.4,21
CDM,27223850,W RTRCTR 2-4CM ALEXIS WND SRG,68.0,44.2,11.42,61.2,21
CDM,27223860,W RTRCTR 2.5 W/CAP TROC KII,291.0,189.15,48.89,261.9,21
CDM,27223870,W HNDPC IRR INTPLS ST HFL TIP,67.0,43.55,11.26,60.3,21
CDM,27223880,W BLADE SAW 90X18X1.27MM SAG,79.0,51.35,13.27,71.1,21
CDM,27223890,W TIP ASPTR SNPT UNIV ST DISP,551.0,358.15,92.57,495.9,21
CDM,27223900,W FRCP ENDSCP LO DVNC EWRST,300.0,195.0,50.4,270.0,21
CDM,27223910,W SHR CURV HARM ACE 8MM DVS,96.0,62.4,16.13,86.4,21
CDM,27223920,W SHR ESU 8MM HRMN A CRV,645.0,419.25,108.36,580.5,21
CDM,27223930,W SYS VN HARV VSVW HEMOPRO 2,1350.0,877.5,226.8,1215.0,21
CDM,27223940,W SEAL/DIVR MNPLR 18.8CM LGSR,607.0,394.55,101.98,546.3,21
CDM,27223950,W SEAL/DIV MRYLND LIG 37CM LAP,750.0,487.5,126.0,675.0,21
CDM,27223960,W STPLR INT 26CMX4MM UNV VASC,262.0,170.3,44.02,235.8,21
CDM,27223970,W APPL IN SURGICLIP SM/MED TI,89.0,57.85,14.95,80.1,21
CDM,27223980,W TROC LAPSCP STD 15MM 15MM,64.0,41.6,10.75,57.6,21
CDM,27223990,W RELD EGIA STPLR VASC 45MM,279.0,181.35,46.87,251.1,21
CDM,27224000,W RELD STPLR MTHK 45MM RFRCD,491.0,319.15,82.49,441.9,21
CDM,27224010,W STPLR INT 440MM 45MM SHFT PWR,446.0,289.9,74.93,401.4,21
CDM,27224020,W RELD STPLR THKTIS 4.8MM GIA,118.0,76.7,19.82,106.2,21
CDM,27224030,W STPLR INT 90X4.8MM TI THKTIS,156.0,101.4,26.21,140.4,21
CDM,27224040,W RELD STPLR 3.5MM REG TI DST,62.0,40.3,10.42,55.8,21
CDM,27224050,W STPLR INT 30X3.5MM TI REG,142.0,92.3,23.86,127.8,21
CDM,27224060,W STPLR INT 60X3.5MM TI ENDSCP,146.0,94.9,24.53,131.4,21
CDM,27224070,W STPLR INT 100X3.8MM TI REG,305.0,198.25,51.24,274.5,21
CDM,27224080,W RLD STPLR ENDO GIA RTCLTR,229.0,148.85,38.47,206.1,21
CDM,27224090,W APPL IN CLP LG 13IN TI ENDSCP,84.0,54.6,14.11,75.6,21
CDM,27224100,W APPL IN CLP SM 9IN TI ENDSCP,89.0,57.85,14.95,80.1,21
CDM,27224110,W DRSG SILVERLON WND/ABS,67.0,43.55,11.26,60.3,21
CDM,27224120,W MANIP/ELEV VCARE SM/MD/LG,138.0,89.7,23.18,124.2,21
CDM,27224130,W CANN LAPSCP 12MM 100MM BLDL,123.0,79.95,20.66,110.7,21
CDM,27224140,W PORT HND ACC 120MM LP OBT OPT,138.0,89.7,23.18,124.2,21
CDM,27224150,W TBNG SMKEVC 3 FLTR ST,123.0,79.95,20.66,110.7,21
CDM,27224160,W APPL IN CLP 5MM 11IN TI ENDSCP,232.0,150.8,38.98,208.8,21
CDM,27224170,W SHR MNPLR 31CM E SHRS STD,89.0,57.85,14.95,80.1,21
CDM,27224180,W ANCHOR SWIFT-LOCK LEAD,480.0,312.0,80.64,432.0,21
CDM,27224190,W GW VASC PC COR ASTATO PTFE,248.0,161.2,41.66,223.2,21
CDM,27224200,W INTRO CATH 45CM 16FR CK-FLOW,144.0,93.6,24.19,129.6,21
CDM,27224210,W GW VASC STR SS HYDRO ASAHI,210.0,136.5,35.28,189.0,21
CDM,27224220,W KT ABLTN BONE OSTEOCOOL RF,756.0,491.4,127.01,680.4,21
CDM,27224230,W KT DUAL PRB OSTEOCOOL RF AB,7025.0,4566.25,1180.2,6322.5,21
CDM,27224240,W CEM BN KYPHON XPEDE SPNL MXR,503.0,326.95,84.5,452.7,21
CDM,27224250,W TAMP 20/2 KT 1ST FX SRG BN,6413.0,4168.45,1077.38,5771.7,21
CDM,27224260,W CEMENT BN VRTPLX HV AUTOPLX,741.0,481.65,124.49,666.9,21
CDM,27224270,W KT BONE BX COAX AVAMAX,193.0,125.45,32.42,173.7,21
CDM,27224280,W BALLOON CAREFUSN AVAMX VTBL,4253.0,2764.45,714.5,3827.7,21
CDM,27224290,W BALLOON VERTBRL AVAMAX 13G,1890.0,1228.5,317.52,1701.0,21
CDM,27224300,W SYS EMBL PROTCT SPIDERFX,1493.0,970.45,250.82,1343.7,21
CDM,27224310,W CATH BLLN NANOCROSS,278.0,180.7,46.7,250.2,21
CDM,27224320,W SYS ROTABLATOR RTLNK + ATHRCM,1290.0,838.5,216.72,1161.0,21
CDM,27224330,W POUCH E-CTCH GLD,63.0,40.95,10.58,56.7,21
CDM,27224340,W CANN ERCP RX BIL,86.0,55.9,14.45,77.4,21
CDM,27224350,W PAIN PMP 2ML/HR ONQ PNBSTR,181.0,117.65,30.41,162.9,21
CDM,27224360,W GDWR JAGWIRE STRGHT,257.0,167.05,43.18,231.3,21
CDM,27224370,W STPLR RELD XTHICK 45MM EGIA,283.0,183.95,47.54,254.7,21
CDM,27224380,W STPLR INT 60MM TI XTHICK VASC,398.0,258.7,66.86,358.2,21
CDM,27224390,W NDL ENDSCP BIOPSY 22GA,593.0,385.45,99.62,533.7,21
CDM,27224400,W PROBE/NEEDLE CRYOABLATION,1823.0,1184.95,306.26,1640.7,21
CDM,27226WE,OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ,6228.0,4048.2,795.16,6228.0,35
CDM,27227WE,OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT,10164.0,6606.6,1121.7,10164.0,35
CDM,27228675,PWR BONE MARROW BX NEEDLE102MM,225.75,146.74,37.93,203.18,21
CDM,27228WE,OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT,11732.0,7625.8,1203.96,11732.0,35
CDM,27230315,MIDLINE CATHETER,225.0,146.25,37.8,202.5,21
CDM,27230335,PICC CATHETER,334.0,217.1,56.11,300.6,21
CDM,27230WE,CLTX FEM FX PROX END NCK W/O MANJ,2324.0,1510.6,249.32,1743.0,35
CDM,27232WE,CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ,4688.0,3047.2,540.96,4688.0,35
CDM,27233665,BARD PICC/SHERLOCK 5FR DOUBLE,145.0,94.25,24.36,130.5,21
CDM,27235WE,PRQ SKEL FIXJ FEMORAL FX PROX END NECK,5200.0,3380.0,668.57,5200.0,35
CDM,27236WE,OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT,7044.0,4578.6,874.43,7044.0,35
CDM,27238WE,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,2300.0,1495.0,287.85,2300.0,35
CDM,27240WE,CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ,5524.0,3590.6,612.13,5524.0,35
CDM,27244655,SUPPLY-BIPAP MASK XL,88.11,57.27,14.8,79.3,21
CDM,27244WE,TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT,7272.0,4726.8,869.94,7272.0,35
CDM,27245WE,TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW,7272.0,4726.8,949.87,7272.0,35
CDM,27246WE,CLTX GREATER TROCHANTERIC FX W/O MANJ,1932.0,1255.8,241.11,1449.0,35
CDM,27248WE,OPEN TREATMENT GREATER TROCHANTERIC FRACTURE,4312.0,2802.8,575.04,4312.0,35
CDM,27250WE,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,1681.0,1092.65,137.62,1681.0,35
CDM,27252WE,CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA,4853.0,3154.45,413.27,4853.0,35
CDM,27253WE,OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ,5432.0,3530.8,699.36,5432.0,35
CDM,27261225,DISPOSABLE CPAP SUPPLY,102.0,66.3,17.14,91.8,21
CDM,27265WE,CLTX POST HIP ARTHRP DISLC W/O ANES,2096.0,1362.4,240.07,2096.0,32
CDM,27266WE,CLTX POST HIP ARTHRP DISLC REQ ANES,3112.0,2022.8,336.27,3112.0,35
CDM,27269WE,OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD,7556.0,4911.4,733.57,7556.0,35
CDM,27270015,SUPPLY-OSCILLATOR,350.0,227.5,58.8,315.0,21
CDM,27270075,NN SUPPLY-DSISP IPV CIRCUIT,201.0,130.65,33.77,180.9,21
CDM,27270255,INTRODUCER KCFW 4.0-18/3545 RB-ANLO,43.0,27.95,7.22,38.7,21
CDM,27275WE,MANIPULATION HIP JOINT W ANESTHESIA,928.0,603.2,120.01,928.0,35
CDM,27276345,ARGON ACCESS KIT 34,85.0,55.25,14.28,76.5,21
CDM,27278WE,ARTHRD SI JT PRQ W/PLMT IARTIC IMPLT WO TFXJ DEV,3458.0,2247.7,337.91,23061.26,28
CDM,27279WE,ARTHRODESIS SI JOINT PERCUTANEOUS/MIN INVASIVE,4852.0,3153.8,443.93,4852.0,31
CDM,27280175,"PENETRATION 22MM, 18 GUAGE X 10CM",55.4,36.01,9.31,49.86,21
CDM,27280185,"PENETRATION 22MM, 18 GA X 16CM",55.4,36.01,9.31,49.86,21
CDM,27280195,"PENETRATION 22MM, 18 GUAGE X 20CM",55.32,35.96,9.29,49.79,21
CDM,27280215,COAXIAL QUICK CORE NEEDLE BX SET QCS-20-9.0-10T,73.96,48.07,12.43,66.56,21
CDM,27280775,SANE SAEC KIT,36.0,23.4,6.05,32.4,21
CDM,27280785,SANE DFSA KIT,12.0,7.8,2.02,10.8,21
CDM,27280WE,ARTHRODESIS SI JT OPN W/OBTAINING B1 GRF INSTRMJ,8000.0,5200.0,664.59,8000.0,35
CDM,27283215,CERVICAL RIPENING BALLOON,99.0,64.35,16.63,89.1,21
CDM,27283245,PREVENA PEEL & PLACE 13CM DRSG KI,742.5,482.63,124.74,668.25,21
CDM,27283255,PREVENA CANSTR WND DRNGE 45ML,206.85,134.45,34.75,186.17,21
CDM,27284235,METANEB CIRCUIT,148.75,96.69,24.99,133.88,21
CDM,27284285,SUT CR MPT 7-0 TG140-8 18IN 2,51.0,33.15,8.57,45.9,21
CDM,27284295,SUT PROL MULTIPASS 8-0 BV130-5,51.0,33.15,8.57,45.9,21
CDM,27284305,SUT PROL MULTIPASS 7-0 BV175-6,52.0,33.8,8.74,46.8,21
CDM,27284315,SUT PROLENE 8-0 8732H,52.0,33.8,8.74,46.8,21
CDM,27284325,DEV STRATAFX PDS+ 0 CT1 SPRL36,53.0,34.45,8.9,47.7,21
CDM,27284335,DEV STRATAFIX MCRYL+ 3-0 SH,53.0,34.45,8.9,47.7,21
CDM,27284345,DEV TRCLSN PDS STRATAFIX SPRL,54.0,35.1,9.07,48.6,21
CDM,27284355,DEV STRATAFIX PDS+ SUT 45CM 0,54.0,35.1,9.07,48.6,21
CDM,27284365,DEV STRATAFIX PDS+ SUT 70CM 0,55.0,35.75,9.24,49.5,21
CDM,27284375,DEV STRATAFIX PDS+ 2-0 SH,55.0,35.75,9.24,49.5,21
CDM,27284385,DEV STRATAFX PDS+ 0 CT1 SPRL30,55.0,35.75,9.24,49.5,21
CDM,27284395,SUT PDS2 1 UR-6 30IN MFL D,55.0,35.75,9.24,49.5,21
CDM,27284405,SUT NRLN 2-0 SH-1 30IN BRD,57.0,37.05,9.58,51.3,21
CDM,27284415,DEV STRATAFIX PDS+ 2-0 V-7,61.0,39.65,10.25,54.9,21
CDM,27284425,SUT PROL 4-0 SH 48IN 2 ARM MFL,63.0,40.95,10.58,56.7,21
CDM,27284435,SUT STRATAFIX 15CM RB-1MCRYL+,63.0,40.95,10.58,56.7,21
CDM,27284445,SUT EBND EXC 5 CT 30IN BRD GRN,63.0,40.95,10.58,56.7,21
CDM,27284455,SUT MCRYL 4-0 PS-4 18IN MFL D,63.0,40.95,10.58,56.7,21
CDM,27284465,SUT STRATAFIX 15CM CT-1 MCRYL+,64.0,41.6,10.75,57.6,21
CDM,27284475,SUT STRATAFIX 15CM CT-2 MCRYL+,64.0,41.6,10.75,57.6,21
CDM,27284485,DEV STRATAFIX PDS+ 2-0 FS,64.0,41.6,10.75,57.6,21
CDM,27284495,DEV STRATAFIX MCRYL+ SUT 45CM,64.0,41.6,10.75,57.6,21
CDM,27284505,DEV STRATAFIX PDS+ SUT 15CM 0,64.0,41.6,10.75,57.6,21
CDM,27284515,SUT STRATAFIX 45CM PS-2 MCRYL+,65.0,42.25,10.92,58.5,21
CDM,27284525,DEV STRATAFIX PDS+ SUT 70CM,65.0,42.25,10.92,58.5,21
CDM,27284535,DEV STRATAFIX PDS+ .5 CIR 3-0,66.0,42.9,11.09,59.4,21
CDM,27284545,SUT PDS2 4-0 RB1 36IN MFL 2ARM,66.0,42.9,11.09,59.4,21
CDM,27284555,SUT ETHLN 11-0 BV50-3 5IN MFL,66.0,42.9,11.09,59.4,21
CDM,27284565,SUT PDS+ 0 UR-6 27IN MFL VIOL,70.0,45.5,11.76,63.0,21
CDM,27284575,SUT EBND EXC NABSB 30IN 2-0 SH,70.0,45.5,11.76,63.0,21
CDM,27284585,SUT EBND EXC 2-0 RB1 2 ARM,62.0,40.3,10.42,55.8,21
CDM,27284595,SUT EBND EXC 2 CT1 36IN BRD D,63.0,40.95,10.58,56.7,21
CDM,27284605,SUT PPRO PROL 1 TP-1 48IN 1,67.0,43.55,11.26,60.3,21
CDM,27284615,SUT EBND EXC 2-0 SH 2 ARM,71.0,46.15,11.93,63.9,21
CDM,27284625,SUT NYL NRLN 3-0 27IN CUST BRD,74.0,48.1,12.43,66.6,21
CDM,27284635,SUT EBND EXC THK1.5MM 2-0 SH,79.0,51.35,13.27,71.1,21
CDM,27284645,SUT EBND EXC NABSB 30IN 2-0,90.0,58.5,15.12,81.0,21
CDM,27284655,SUT EBND EXC 2-0 V-7 36IN 2,92.0,59.8,15.46,82.8,21
CDM,27284665,SUT EBND EXC 2-0 V-5 30IN 2,109.0,70.85,18.31,98.1,21
CDM,27284675,SUT PROL 6-0 C-1 30IN 2 ARM,109.0,70.85,18.31,98.1,21
CDM,27284685,SUT PRONOVA 7-0 BV-1 24IN 2,124.0,80.6,20.83,111.6,21
CDM,27284695,SUT PROL 7-0 BV-1 24IN 2 ARM,124.0,80.6,20.83,111.6,21
CDM,27284705,SUT PROL 7-0 BV-1 30IN 2 ARM,124.0,80.6,20.83,111.6,21
CDM,27284715,SUT ETHIBOND EXCEL 2-0 V-7 NDL,127.0,82.55,21.34,114.3,21
CDM,27284725,SUT EBND EXC TPRCT THK1/16IN,128.0,83.2,21.5,115.2,21
CDM,27284735,SUT EBND EXC 2-0 V-5 30IN 2,129.0,83.85,21.67,116.1,21
CDM,27284745,SUT EBND EXC THK1.5MM 2-0 V-5,138.0,89.7,23.18,124.2,21
CDM,27284755,SUT PROL 7-0 BV175-6 18IN 2,173.0,112.45,29.06,155.7,21
CDM,27284765,SUT PROL 5-0 BV 24IN MFL 4,322.0,209.3,54.1,289.8,21
CDM,27285475,DISECT LAPSCP US HNDPC 13CM,555.0,360.75,93.24,499.5,21
CDM,27285485,SEAL/DIV MRYLND LIG 23CM OPEN,750.0,487.5,126.0,675.0,21
CDM,27285495,DEV LGSR NANO 37CM 5MM BLNT TP,682.0,443.3,114.58,613.8,21
CDM,27285505,KIT PINPOINT PROCEDURE 9036,711.0,462.15,119.45,639.9,21
CDM,27285515,HNDPC ESU 10FT ABC 45D FT CTRL,122.0,79.3,20.5,109.8,21
CDM,27285525,PACK SRG LIV TRNSPLNT 1/CA,300.0,195.0,50.4,270.0,21
CDM,27285535,DEVICE SIGNIA POWER SHELL,159.0,103.35,26.71,143.1,21
CDM,27285545,RELD TRI-STPL 2.0 30MM MED THK,232.0,150.8,38.98,208.8,21
CDM,27285555,RELD TRI-STPL 2.0 BLACK 60MM,385.0,250.25,64.68,346.5,21
CDM,27285565,RELD TRI-STPL 2.0 30MM VAS MED,229.0,148.85,38.47,206.1,21
CDM,27285575,RELD TRI-STPL 2.0 BLACK 45MM,273.0,177.45,45.86,245.7,21
CDM,27285585,RELD TRI-STPL 2.0 CRV TP 45MM,271.0,176.15,45.53,243.9,21
CDM,27285595,BLN DISECT LAPSCP PDB SPCMKR,445.0,289.25,74.76,400.5,21
CDM,27285605,EXTR STONE 38CM 10FR 2CM BSKT,193.0,125.45,32.42,173.7,21
CDM,27285615,SEALER ESU ENSL G2 45CM STR,996.0,647.4,167.33,896.4,21
CDM,27285625,KIT CATH CV 9FR 10CM 2 LUM,119.0,77.35,19.99,107.1,21
CDM,27285635,BLADE SAW 40.5MM SFED THK.025,55.0,35.75,9.24,49.5,21
CDM,27285645,BURR FN RND DMND,230.0,149.5,38.64,207.0,21
CDM,27285655,BLADE SHVR 11CM 4MM RAD 40 XPS,474.0,308.1,79.63,426.6,21
CDM,27285665,DEV PT TRACKER NON-INVASIVE,306.0,198.9,51.41,275.4,21
CDM,27285675,BLADE SHVR 13CM 4MM TRCT M4,429.0,278.85,72.07,386.1,21
CDM,27285685,PROBE CRYABL 10CM CRYOICE MAL,2295.0,1491.75,385.56,2065.5,21
CDM,27285695,BURR FLUT RND,225.0,146.25,37.8,202.5,21
CDM,27285705,BURR RND DMND,219.0,142.35,36.79,197.1,21
CDM,27285715,BURR SRG RND,167.0,108.55,28.06,150.3,21
CDM,27285725,BURR SRG FLT/DIA,137.0,89.05,23.02,123.3,21
CDM,27286365,CONVATEC 9CM X 15CM AQUACEL AG SURGICAL COVER DRESSING,53.0,34.45,8.9,47.7,21
CDM,27290215,URETHRAL DILATOR SET - COOK,290.0,188.5,48.72,261.0,21
CDM,27290275,BLADE ESU PLUMEPEN 10MM X 3M,53.0,34.45,8.9,47.7,21
CDM,27290285,DRAPE SLSH WRMR DISC 52X66IN,77.0,50.05,12.94,69.3,21
CDM,27290295,CATH PREM UM 16FR SILV TMP CSD,54.0,35.1,9.07,48.6,21
CDM,27290305,UNIT ESU PRB SUCT RF SERFAS,184.0,119.6,30.91,165.6,21
CDM,27290315,KIT HEMSTAT FLSL 5ML ST PREP,238.0,154.7,39.98,214.2,21
CDM,27290325,KIT HEMSTAT FLSL 10ML ST PREP,373.0,242.45,62.66,335.7,21
CDM,27290335,SYS BNCMNT MXR SPAT SM STRL LF,70.0,45.5,11.76,63.0,21
CDM,27290345,GW 0035IN 150CM REG STR 3CM,65.0,42.25,10.92,58.5,21
CDM,27290355,PORT ACC LP 5X100MM BLDLS ARSL,140.0,91.0,23.52,126.0,21
CDM,27290365,UNIT THER PREVENA INCS MGMT,743.0,482.95,124.82,668.7,21
CDM,27290375,PIN BONE 4.0MM STRL 2PK,101.0,65.65,16.97,90.9,21
CDM,27290385,KIT VIZADISC KN PROC TRACKING,169.0,109.85,28.39,152.1,21
CDM,27290395,KIT FEM/TIB CHECKPOINT STRL,75.0,48.75,12.6,67.5,21
CDM,27290405,KIT RIO DRAPE 1PC W/POCKETS,76.0,49.4,12.77,68.4,21
CDM,27290415,BARR ADH 3X5IN BIORESBL MEMBR,415.0,269.75,69.72,373.5,21
CDM,27290425,TBNG IRR SS BLDE BURR,59.0,38.35,9.91,53.1,21
CDM,27290435,TRAP BIDIR FLTR UNV FIT NO,66.0,42.9,11.09,59.4,21
CDM,27290445,KIT BALLON DILATE INFLATE,330.0,214.5,55.44,297.0,21
CDM,27290455,BLADE SHVR 11CM 4MM RAD 60 XPS,282.0,183.3,47.38,253.8,21
CDM,27290465,BLADE SAW 60X30MM THK.6MM SHRT,55.0,35.75,9.24,49.5,21
CDM,27290475,DRSG WND PAD SILVERLON 2X12IN,73.0,47.45,12.26,65.7,21
CDM,27290485,PORT LAPSCP 12X120MM BLDLS PLM,150.0,97.5,25.2,135.0,21
CDM,27290495,INTRO ORTH 1STP OSTEO INTRO KT,1620.0,1053.0,272.16,1458.0,21
CDM,27290505,BIT DRL 3.8MM 3MM PRECIS NEURO,143.0,92.95,24.02,128.7,21
CDM,27290515,ELECTRD ESU LHK 36CM CLEANCOAT,70.0,45.5,11.76,63.0,21
CDM,27290525,GW ENDSCP .035IN NTNL SOLO,71.0,46.15,11.93,63.9,21
CDM,27290535,SHTH ACC NAV 46CM 13FR 11FR 2,297.0,193.05,49.9,267.3,21
CDM,27290545,EXTR STONE 115CM 2.2FR 1CM,261.0,169.65,43.85,234.9,21
CDM,27290555,PROBE 90MM SERFAS SUP ENDSCP,210.0,136.5,35.28,189.0,21
CDM,27290565,SHTH ACC NAV 36CM 13FR 11FR 2,297.0,193.05,49.9,267.3,21
CDM,27290575,DRSG HDRCLD 25X9CM AQCEL AG,68.0,44.2,11.42,61.2,21
CDM,27290585,SPY ELITE SINGLE VIAL KIT,2154.0,1400.1,361.87,1938.6,21
CDM,27290595,CASS IRR COR LF DISP,93.0,60.45,15.62,83.7,21
CDM,27290605,ELECTRD ESU 90MM 3.5MM SERFAS,184.0,119.6,30.91,165.6,21
CDM,27290615,SET INST TRKR FUS ENT NVG SYS,246.0,159.9,41.33,221.4,21
CDM,27290625,HNDPC BPLR 5.4CM 5MM ISLTR SNG,2869.0,1864.85,481.99,2582.1,21
CDM,27290665,WATER BIRTH SUPPLIES,620.0,403.0,104.16,558.0,21
CDM,27292035,CLIP HEMOSTASIS 360 235CM,329.0,213.85,55.27,296.1,21
CDM,27292045,KIT DCOMPR PUR 175CM 14FR 6FR,194.0,126.1,32.59,174.6,21
CDM,27292055,CANNULA ERCP .018IN 5-4-3 TP GW,80.0,52.0,13.44,72.0,21
CDM,27292065,PROBE BEAMER 1.8MMX320CM,323.0,209.95,54.26,290.7,21
CDM,27292075,NDL INF 700MM 21GA 1.9MM,197.0,128.05,33.1,177.3,21
CDM,27292085,SYR INFL ALN INTGR GA ASSEMB,61.0,39.65,10.25,54.9,21
CDM,27292095,CATH BLLN ELAT 2CM OD 10-12,300.0,195.0,50.4,270.0,21
CDM,27292105,PACK STD TOTAL HIP,266.0,172.9,44.69,239.4,21
CDM,27292115,PACK SRG SHLDR ARTHSCP,91.0,59.15,15.29,81.9,21
CDM,27292125,SET SPNL MN INV LMBR,3038.0,1974.7,510.38,2734.2,21
CDM,27292610,CORVOCET BX SYSTEM,110.0,71.5,18.48,99.0,21
CDM,27292715,PRCSR PNEUM 33-43IN WRP MED,116.0,75.4,19.49,104.4,21
CDM,27292725,CLIP 16MM 235CM DURA HEMCLP,193.0,125.45,32.42,173.7,21
CDM,27292735,TUBE 12IN 20FR 4CM SIL LP BLN,180.0,117.0,30.24,162.0,21
CDM,27292745,PERF CRAN 14MM 11MM HDSN END,273.0,177.45,45.86,245.7,21
CDM,27292755,TIP SUCT FRAZ SM 8FR 4.25IN,53.0,34.45,8.9,47.7,21
CDM,27292765,KIT CONTAINED EXTRACTION SYSTEM,488.0,317.2,81.98,439.2,21
CDM,27292775,SYS RTRCTR 100MM KII FIOS,435.0,282.75,73.08,391.5,21
CDM,27292785,RETRV SUT 10IN LASSO SAF GRP,86.0,55.9,14.45,77.4,21
CDM,27292795,DEV SUT CORKNOT,270.0,175.5,45.36,243.0,21
CDM,27292805,DEV SUT CORKNOT QLU,324.0,210.6,54.43,291.6,21
CDM,27292815,DRSG HDRCLD 35X9CM AQCEL WTPRF,66.0,42.9,11.09,59.4,21
CDM,27292825,SYS ENDOSCP MAINT 8X6IN,71.0,46.15,11.93,63.9,21
CDM,27292835,TROCAR SPCMKR PRO BTT BLN OVL,762.0,495.3,128.02,685.8,21
CDM,27292845,DEV FIX ABSRBATK 5MM 15 TACK,383.0,248.95,64.34,344.7,21
CDM,27292855,DEV LIGASURE L-HOOK 37CM,962.0,625.3,161.62,865.8,21
CDM,27292865,CATH BLDL 10MM 15CM 30 ATM,308.0,200.2,51.74,277.2,21
CDM,27292875,SYS SPRAY MICROMYST,247.0,160.55,41.5,222.3,21
CDM,27292885,KIT 4 ARM DRP ACC DVNC SI DISP,390.0,253.5,65.52,351.0,21
CDM,27292895,SHR ESU 9CM HARM FOCUS+ CRV,1069.0,694.85,179.59,962.1,21
CDM,27292905,MRKR SRG 4MM HOFFER BAYNT,548.0,356.2,92.06,493.2,21
CDM,27292915,BLADE SHVR 11CM 2MM XPS 360D,283.0,183.95,47.54,254.7,21
CDM,27292925,NIM TRIVANT EMG ENDOTRACH TB,523.0,339.95,87.86,470.7,21
CDM,27292935,SET TBNG IRR,88.0,57.2,14.78,79.2,21
CDM,27292945,TIP BN SCPL BLNT,608.0,395.2,102.14,547.2,21
CDM,27292955,TIP IRR STRKFL 2 5MM STRKFL2,99.0,64.35,16.63,89.1,21
CDM,27292965,BURR SRG STRYKER,392.0,254.8,65.86,352.8,21
CDM,27292975,BURR SRG 22MM 2.3MM MED ROUT,261.0,169.65,43.85,234.9,21
CDM,27292985,BURR SRG 5MM PRECIS RND,306.0,198.9,51.41,275.4,21
CDM,27292995,BLADE SAW 73X25X.89MM MED W,55.0,35.75,9.24,49.5,21
CDM,27293005,BLADE MICS SAW STRL,435.0,282.75,73.08,391.5,21
CDM,27293015,BURR SRG 5MM ELT RND SFTCH,149.0,96.85,25.03,134.1,21
CDM,27293025,ROUT SRG BLU RED 2.3MM TAPR,149.0,96.85,25.03,134.1,21
CDM,27293035,MILL BN MED BX DISP,330.0,214.5,55.44,297.0,21
CDM,27293045,RMR SRG SHFT MOD TRNKL 448MM,450.0,292.5,75.6,405.0,21
CDM,27293055,GW VASC .035IN 180CM 3CM STR,81.0,52.65,13.61,72.9,21
CDM,27293065,SHTH GUID 7FR 2.5CM 65CM .038,168.0,109.2,28.22,151.2,21
CDM,27293075,CATH ANG .038IN STR 5FR 100CM,91.0,59.15,15.29,81.9,21
CDM,27293085,RTNR VSCR MED 9INX6IN,63.0,40.95,10.58,56.7,21
CDM,27293095,GW ANGTP HYBRD .035IN,65.0,42.25,10.92,58.5,21
CDM,27293105,UNIT LITHO 2 US PRB BLDR ST,946.0,614.9,158.93,851.4,21
CDM,27293115,SPNG ABS HEMSTAT AGNT PWDR GEL,128.0,83.2,21.5,115.2,21
CDM,27293155,PTNS KIT,96.25,62.56,16.17,86.63,21
CDM,27293755,PAD ELECTRODES,54.0,35.1,9.07,48.6,21
CDM,27293765,CORTICAL BIPOLAR PROBES,583.5,379.28,98.03,525.15,21
CDM,27293995,SIDE BY SIDE BIPOLAR STIMULATOR,201.25,130.81,33.81,181.13,21
CDM,27294005,STAINLESS STEEL GRID 4 X 12,3624.74,2356.08,608.96,3262.27,21
CDM,27294245,SUPPLY - MINI-BAL CATHETER,88.68,57.64,14.9,79.81,21
CDM,27295065,TABLO CARTRIDGE,120.0,78.0,20.16,108.0,21
CDM,27295135,SHEATH INRO PINNACLE RADIO,50.0,32.5,8.4,45.0,21
CDM,27295145,SET MPNCH INTRODUCER,62.0,40.3,10.42,55.8,21
CDM,27295155,CATH GUIDING ADROIT H-STICK,65.0,42.25,10.92,58.5,21
CDM,27295165,CATH DIAG IMPRESS,69.0,44.85,11.59,62.1,21
CDM,27295175,GW VASC AMPLTZ SS PTFE STR,72.0,46.8,12.1,64.8,21
CDM,27295185,KIT COAXIAL MINI ACCESS,74.0,48.1,12.43,66.6,21
CDM,27295195,INTRO SHTH GLIDESHEATH STR,88.0,57.2,14.78,79.2,21
CDM,27295205,GW STRAIGHT-TIP MARVEL,123.0,79.95,20.66,110.7,21
CDM,27295215,SET METRIQ TUBING IRRIGATION,149.0,96.85,25.03,134.1,21
CDM,27295225,CATH BLDL MOZEC PTCA,158.0,102.7,26.54,142.2,21
CDM,27295235,INTRO SHTH CHECK FLO LG,165.0,107.25,27.72,148.5,21
CDM,27295245,GW VASC ROADRUNNER ANG X,172.0,111.8,28.9,154.8,21
CDM,27295255,GW VASC LUNDERQUIST PTFE SS,194.0,126.1,32.59,174.6,21
CDM,27295265,GW VASC SS STR SHRT,212.0,137.8,35.62,190.8,21
CDM,27295275,GW VASC PROSTREAM SS,269.0,174.85,45.19,242.1,21
CDM,27295285,GW COR CONFIDA BRECKER,293.0,190.45,49.22,263.7,21
CDM,27295295,GW CARDIOMEMS STEER,299.0,194.35,50.23,269.1,21
CDM,27295305,CATH SELECTSITE GUIDING,305.0,198.25,51.24,274.5,21
CDM,27295315,SHTH INTRO DRYSEAL,323.0,209.95,54.26,290.7,21
CDM,27295325,CABLE CATH BLZR,338.0,219.7,56.78,304.2,21
CDM,27295335,DEV CLSR 5FR VASCADE MVP FEMRL,338.0,219.7,56.78,304.2,21
CDM,27295345,INTRO LD SAFSHTH CSG,368.0,239.2,61.82,331.2,21
CDM,27295355,CATH DUAL LUMEN POWERPICC,499.0,324.35,83.83,449.1,21
CDM,27295365,CABLE CATH SMARTABLATE,533.0,346.45,89.54,479.7,21
CDM,27295375,GW THREADER OTW MIC DIL,675.0,438.75,113.4,607.5,21
CDM,27295385,CATH SUPERCROSS OTW,681.0,442.65,114.41,612.9,21
CDM,27295395,CABLE CATH INTELLANAV,758.0,492.7,127.34,682.2,21
CDM,27295405,GW VASC OPT PRSS SNSR FR 185CM,900.0,585.0,151.2,810.0,21
CDM,27295415,PROBE ESOPH 12 INTGR SNSR,900.0,585.0,151.2,810.0,21
CDM,27295425,CATH SOFT TIP TURNPIKE,920.0,598.0,154.56,828.0,21
CDM,27295435,CATH BLLN TRUE DILTN,938.0,609.7,157.58,844.2,21
CDM,27295445,KIT ABLT RHYTHMIA LOC REF PTCH,960.0,624.0,161.28,864.0,21
CDM,27295455,CATH THROMCTMY CLEANER15,975.0,633.75,163.8,877.5,21
CDM,27295465,CATH 135CM TURNPIKE,1043.0,677.95,175.22,938.7,21
CDM,27295475,SHEATH HEARTSPAN STEERABLE,1125.0,731.25,189.0,1012.5,21
CDM,27295485,CABLE CATH INTELLAMAP ORN,1200.0,780.0,201.6,1080.0,21
CDM,27295495,SHTH INTRO NAGARE,1238.0,804.7,207.98,1114.2,21
CDM,27295505,CATH STINGRAY LP CTO,1250.0,812.5,210.0,1125.0,21
CDM,27295515,CATH ABLT BLZR2 XP,1688.0,1097.2,283.58,1519.2,21
CDM,27295525,CATH IAB SENSATION PLUS,1388.0,902.2,233.18,1249.2,21
CDM,27295535,KIT ELECTRD ENSITE PRECIS SRFC,1620.0,1053.0,272.16,1458.0,21
CDM,27295545,CATH US SOUNDSTAR 3D,2954.0,1920.1,496.27,2658.6,21
CDM,27295555,CATH MAP ADVISOR HD GRID,2970.0,1930.5,498.96,2673.0,21
CDM,27295565,CATH ABLT XP K2,3645.0,2369.25,612.36,3280.5,21
CDM,27295575,CATH NAV UNI F SMARTTOUCH SF,3776.0,2454.4,634.37,3398.4,21
CDM,27295585,CATH MAP ORION INTELLAMAP,3848.0,2501.2,646.46,3463.2,21
CDM,27295WE,DISARTICULATION OF HIP,7864.0,5111.6,949.47,7864.0,35
CDM,27296005,SET INTRO 30CM 14FR CKFL .038,102.0,66.3,17.14,91.8,21
CDM,27296015,CATH BLDL 2.25MM 15MM RX NC,105.0,68.25,17.64,94.5,21
CDM,27296025,GW VASC .014IN 300CM STR TIP,112.0,72.8,18.82,100.8,21
CDM,27296035,CATH BLDL 1.20MM 12MM 145CM,123.0,79.95,20.66,110.7,21
CDM,27296045,CATH BLDL 1.2MM 15MM COR RX,123.0,79.95,20.66,110.7,21
CDM,27296055,GW VASC .018IN 300CM SHRT TAPR,137.0,89.05,23.02,123.3,21
CDM,27296065,CATH BLDL 5FR 6MM 20MM 135CM,140.0,91.0,23.52,126.0,21
CDM,27296075,GW VASC 260CM .025IN RADPQ,142.0,92.3,23.86,127.8,21
CDM,27296085,CATH BLDL 6 MM X 100MM X135CM,158.0,102.7,26.54,142.2,21
CDM,27296095,INTRO SHTH 16FR 82CM 70CM LG,175.0,113.75,29.4,157.5,21
CDM,27296105,GW VASC 300M JUDO 3 STRAIGHT,184.0,119.6,30.91,165.6,21
CDM,27296115,CATH ART 5FR 90CM SVC INSRT,201.0,130.65,33.77,180.9,21
CDM,27296125,GWIRE .014 300CM STR VICTORY,206.0,133.9,34.61,185.4,21
CDM,27296135,CATH SPRT 132CM .057-.063IN,233.0,151.45,39.14,209.7,21
CDM,27296145,INTRO SHTH 8.5FR 63CM BRAID,233.0,151.45,39.14,209.7,21
CDM,27296155,CATH BLDL 8FR 12MM 4CM 75CM,248.0,161.2,41.66,223.2,21
CDM,27296165,CATH BLDL 3.8FR 6MM 60MM 135MM,251.0,163.15,42.17,225.9,21
CDM,27296175,CATH BLDL 6MM 20MM 80CM,251.0,163.15,42.17,225.9,21
CDM,27296185,CATH BLDL 5FR 6MM 20MM 75CM,258.0,167.7,43.34,232.2,21
CDM,27296195,GUIDEWIRE VICTORY .014IN 12GA STRAIGHT STAINLESS STEEL PTFE HYDR,263.0,170.95,44.18,236.7,21
CDM,27296205,SHTH INTRO 33CM 16FR 6.1MM 5.3,269.0,174.85,45.19,242.1,21
CDM,27296215,GW VASC .035IN 260CM STR STND,270.0,175.5,45.36,243.0,21
CDM,27296225,KIT BRIDGE BALLOON ACCESSORY,318.0,206.7,53.42,286.2,21
CDM,27296235,CELL OXD 3GM ABS HEMSTAT,326.0,211.9,54.77,293.4,21
CDM,27296245,SHTH INTRO 33CM 26FR 9.5MM 8.7,356.0,231.4,59.81,320.4,21
CDM,27296255,SNARE VASC 120CM 7FR 8-30MM,413.0,268.45,69.38,371.7,21
CDM,27296265,CATH PACING C SHAPE TIP SLCTV,525.0,341.25,88.2,472.5,21
CDM,27296275,CATH GUID 8.4FR 5.7FR 43CM,525.0,341.25,88.2,472.5,21
CDM,27296285,CABLE MAP ADVISOR 22-PIN,525.0,341.25,88.2,472.5,21
CDM,27296295,CATH PACNG C SH MLTPURP TIP SLCTV,525.0,341.25,88.2,472.5,21
CDM,27296305,GW VASC .014IN 3CM STR,525.0,341.25,88.2,472.5,21
CDM,27296315,NDL NRG PROC TRNSPT 8.5FR 71CM,705.0,458.25,118.44,634.5,21
CDM,27296325,SYS LOAD COR 26-29 ENVEOR,780.0,507.0,131.04,702.0,21
CDM,27296335,CATH BLLN,938.0,609.7,157.58,844.2,21
CDM,27296345,CATH BLDL 10MMX2.50MM RX,1029.0,668.85,172.87,926.1,21
CDM,27296355,CATH BLDL 7FR 6MM 2CM 90CM,1050.0,682.5,176.4,945.0,21
CDM,27296365,INTRO SHTH 8.5FR 71CM GUID,1206.0,783.9,202.61,1085.4,21
CDM,27296375,CATH BLLN OCC BRIDGE 90CM 20MM,1275.0,828.75,214.2,1147.5,21
CDM,27296385,SYS EMBL PROTCT 3MM 320CM .014,1350.0,877.5,226.8,1215.0,21
CDM,27296395,CONV MEDIA 145CM PB LCK MRKR,1388.0,902.2,233.18,1249.2,21
CDM,27296405,CATH IAB 7.5FR 40CC W/STAT,1388.0,902.2,233.18,1249.2,21
CDM,27296415,CATH EP 7FR 2-6-2MM SPC D CRV,2107.0,1369.55,353.98,1896.3,21
CDM,27296425,SET SHTH FR LD EXTR SUB-C,2288.0,1487.2,384.38,2059.2,21
CDM,27296435,SET SHTH FR LD EXTR GDRL DIL,2558.0,1662.7,429.74,2302.2,21
CDM,27296445,CATH ATHRCM 135CM 4FR .9MM,2835.0,1842.75,476.28,2551.5,21
CDM,27296455,SYS DLV COR23-26-29EVOLUT PRO,2849.0,1851.85,478.63,2564.1,21
CDM,27296465,CATH ABLT OI 7 110 2.5 QUAD K,3173.0,2062.45,533.06,2855.7,21
CDM,27296475,CATH ABLT 115CM 8FR 3.5MM,3645.0,2369.25,612.36,3280.5,21
CDM,27296485,CATH NAV BI FJ SMARTTOUCH SF,3715.0,2414.75,624.12,3343.5,21
CDM,27296495,PACK PRCDR NAVX TACTI SE,4320.0,2808.0,725.76,3888.0,21
CDM,27296505,KIT SPLITTER ADAPTER HV,5400.0,3510.0,907.2,4860.0,21
CDM,27296515,CATH ABLT 28MM PRO CRYO BLN EP,5670.0,3685.5,952.56,5103.0,21
CDM,27296525,SYS DLV COR 16FR ENVEOR PRO,6035.0,3922.75,1013.88,5431.5,21
CDM,27296555,CABLE CATH BLU 150CM SPRM EP,123.0,79.95,20.66,110.7,21
CDM,27296565,INFLATION DEVICE REVISION G,126.0,81.9,21.17,113.4,21
CDM,27296575,CATH ART 8FR 110CM THRMDIL CCO,347.0,225.55,58.3,312.3,21
CDM,27296585,"GW VICTORY .018 300CM 18, 30GM STR",206.0,133.9,34.61,185.4,21
CDM,27296595,GW VASC .014IN 300CM,210.0,136.5,35.28,189.0,21
CDM,27296605,CATH RUBICON 18 SPPRT 4F 135CM,210.0,136.5,35.28,189.0,21
CDM,27296615,GW VASC .014IN 300CM,210.0,136.5,35.28,189.0,21
CDM,27296625,GW VASC 300M JUDO 3 STRAIGHT,214.0,139.1,35.95,192.6,21
CDM,27296635,GW VASC 300M JUDO 6 STRAIGHT,215.0,139.75,36.12,193.5,21
CDM,27296645,GW VASC 98CM ATN HBRD,230.0,149.5,38.64,207.0,21
CDM,27296655,GW HI-TORQUE COMMAND,263.0,170.95,44.18,236.7,21
CDM,27296665,SYS LOAD COR23-26-29ENVEO PRO,585.0,380.25,98.28,526.5,21
CDM,27296675,CATH VASC TWINPASS DUAL ACCESS,623.0,404.95,104.66,560.7,21
CDM,27296685,CATH INTVN 120D .014IN MIC,773.0,502.45,129.86,695.7,21
CDM,27296695,CATH ABLT 7FR 4MM 115CM 2-5-2,900.0,585.0,151.2,810.0,21
CDM,27296705,CATH MICRO MAMBA FLEX 135,900.0,585.0,151.2,810.0,21
CDM,27296715,SET SHTH 11FR LD EXTR SUB-C,2288.0,1487.2,384.38,2059.2,21
CDM,27296725,SET SHTH 13FR LD EXTR GDRL DIL,2558.0,1662.7,429.74,2302.2,21
CDM,27297485,HARMONY DELIVERY CATHETER SYSTEM,11475.0,7458.75,1927.8,10327.5,21
CDM,27297535,POWERGLIDE MIDLINE FULL KIT,191.0,124.15,32.09,171.9,21
CDM,27297545,POWERGLIDE MIDLINE BASIC KIT,118.0,76.7,19.82,106.2,21
CDM,27297555,ACCUCATH 20G/2.25IN,74.0,48.1,12.43,66.6,21
CDM,27297595,GUIDEWIRE .014IN X 300CM SYNCHRO2,912.0,592.8,153.22,820.8,21
CDM,27297605,GW 5FR X 100CM GLIDECATH COBRA 2 (C2) .038,91.0,59.15,15.29,81.9,21
CDM,27297615,GW 0.018IN X 300CM 25GM,206.0,133.9,34.61,185.4,21
CDM,27297625,GW 0.014IN X 185CM COMET II,900.0,585.0,151.2,810.0,21
CDM,27297635,CATHETER 150CM MICROCATHETER,900.0,585.0,151.2,810.0,21
CDM,27297645,GW 0.014IN X 190CM STRAIGHT,131.0,85.15,22.01,117.9,21
CDM,27297655,GW 018IN X 300CM 5CM RADIOPAQUE STRAIGHT TIP,145.0,94.25,24.36,130.5,21
CDM,27297665,9 FR. X 4-1/4IN ARROW-FLEX POLYURETHANE SHEATH,69.0,44.85,11.59,62.1,21
CDM,27297675,"CATHETER, CORONARY IVL SHOCKWAVE",6345.0,4124.25,1065.96,5710.5,21
CDM,27297705,INQUIRY DECAPOLAR STEERABLE EP CATH,450.0,292.5,75.6,405.0,21
CDM,27297715,HYDROPHILIC PTFE 90CM 5CM GUIDING,168.0,109.2,28.22,151.2,21
CDM,27297725,PTFE-NITINOL GUIDEWIRE W HYDROPHILIC TIP,118.0,76.7,19.82,106.2,21
CDM,27297735,INTRODUCER ARROWG+ARD 8.5FR BLUE SHEATH,91.0,59.15,15.29,81.9,21
CDM,27297745,CATHETER F6ST+ 125CM,253.0,164.45,42.5,227.7,21
CDM,27297755,CATHETER ADROIT TRUELUMEN,74.0,48.1,12.43,66.6,21
CDM,27297805,CATH TACTI SEN EN 8FR D C 115CM ABLA C FORCE,3476.0,2259.4,583.97,3128.4,21
CDM,27297815,KIT 7FR 6IN CATH 3 LUMEN PRESS INJ CENTRAL VENOUS,196.0,127.4,32.93,176.4,21
CDM,27297825,GUIDEWIRE HI TORQUE STEELCORE 018IN STRAIGHT PLAT,145.0,94.25,24.36,130.5,21
CDM,27297835,ACQCROSS QX VZ 71 CM INTE TRANSSEPTAL DILATOR/NEEDLE,735.0,477.75,123.48,661.5,21
CDM,27297845,W 035IN X 180CM GLIDEWIRE PERIPHERAL GUIDEWIRE,69.0,44.85,11.59,62.1,21
CDM,27297915,SENTINEL CEREBRAL PROTECTION SYSTEM,2984.0,1939.6,501.31,2685.6,21
CDM,27297925,20MM X 4CM ATLAS GOLD PTA DILITATION CATH,428.0,278.2,71.9,385.2,21
CDM,27297935,GUIDEWIRE VICTORY .014IN 18GA STRAIGHT,206.0,133.9,34.61,185.4,21
CDM,27297945,CATH DECAP 3F 5-5-5 10 ELECT,1185.0,770.25,199.08,1066.5,21
CDM,27297955,CATH ROTALINK 1.5MM X 135CM ATHERECTOMY BURR,2356.0,1531.4,395.81,2120.4,21
CDM,27297965,0.018IN X 300CM 12GM VICTORY 18 GUIDEWIRE STR,206.0,133.9,34.61,185.4,21
CDM,27297975,16FR X 35CM CHECK-FLO INTRO LG VALVE ASSEMBLY,169.0,109.85,28.39,152.1,21
CDM,27297985,6FR X 75CM R2P DESTINATION SLENDER GUIDING SHEATH,426.0,276.9,71.57,383.4,21
CDM,27297995,5FR X 100CM GLIDECATH ANGLE TAPER .038 GUIDEWIRE,91.0,59.15,15.29,81.9,21
CDM,27298005,0.014X180CM ASAHI GRAND SLAM PTCA GUIDEWIRE STR,149.0,96.85,25.03,134.1,21
CDM,27298105,"6FR PERICARDIOCENTESIS PROC KIT, PIGTAIL CATH",166.0,107.9,27.89,149.4,21
CDM,27298115,CATH STERLING 6MM PEBAX BIOSLIDE 80CM 40MM BALLOON DLTN OTW TAPE,251.0,163.15,42.17,225.9,21
CDM,27298125,INTRO SHTH 8.5FR 71CM GUIDE LG,1206.0,783.9,202.61,1085.4,21
CDM,27298135,CUSTOM MANIFOLD KIT,100.0,65.0,16.8,90.0,21
CDM,27299205,BALLOON 110CM CATH TRUE FLOW VALVULOPLASTY PERF CATH,1755.0,1140.75,294.84,1579.5,21
CDM,27299215,7FR X 110CM SWAN-GANZ DIRECTED MONITORING S-TIP CATH,123.0,79.95,20.66,110.7,21
CDM,27299225,VERSACROSS,1249.0,811.85,209.83,1124.1,21
CDM,27299325,0.018IN X 300CM PLATINUM PLUS COR GUIDEWIRE STR,112.0,72.8,18.82,100.8,21
CDM,27299335,CATH TACTICATH SENSOR ENABLED 8FR 2-2-2MM SPACE F-J CURVE 115CM,3645.0,2369.25,612.36,3280.5,21
CDM,27299345,8FR X 80CM AMPLATZER TREVISIO DELIVERY SYSTEM 45DEG,906.0,588.9,152.21,815.4,21
CDM,27299355,"6FR X 80CM, FLEXOR TUOHY-BORST SIDEARM INTRODUCER",149.0,96.85,25.03,134.1,21
CDM,27299365,"12-20MM X 120CM STANDARD EN SNARE, 6FR X 100CM CATH",413.0,268.45,69.38,371.7,21
CDM,27299375,4.00MM X 10MM WOLVERINE MONORAIL CUTTING BALLOON CATH,1029.0,668.85,172.87,926.1,21
CDM,27299445,5GM ARISTA AH ABSORBABLE HEMOSTAT,333.0,216.45,55.94,299.7,21
CDM,27299455,22MM X 3.5CM BALLOON 110CM PERFUSION CATHETER?VALVULOPLASTY,1755.0,1140.75,294.84,1579.5,21
CDM,27299465,"6FR X 100CM ADROIT GUIDING CATHETER, XB 3.5, .072IN ID",65.0,42.25,10.92,58.5,21
CDM,27299475,23MM CATH TIP X 95CM X 10.5FR?ARTIC FRONT PRO CRYOABLATION CATH,5670.0,3685.5,952.56,5103.0,21
CDM,27299485,ANGIOVAC CIRCUIT W/BUBBLE TRAP,2025.0,1316.25,340.2,1822.5,21
CDM,27299495,ANGIOVAC C20 WITH OBTURATOR,17550.0,11407.5,2948.4,15795.0,21
CDM,27299505,ACCESS SET?ARROWG+ARD BLUE(R) PSI KIT?,85.0,55.25,14.28,76.5,21
CDM,27299515,6F RESPONSE QUAD 2-5-2 EP CATHETER,1424.0,925.6,239.23,1281.6,21
CDM,27299525,7FR X 100CM GOODALE-LUBIN WOVEN CORONARY CATHETER,93.0,60.45,15.62,83.7,21
CDM,27299535,10MM DIA X 40 MM EVERCROSS .035 OTW PTA BALLOON,158.0,102.7,26.54,142.2,21
CDM,27299555,PLATINUM PLUS COR GUIDEWIRE STR STNLS STEEL 0.018IN X 300CM,112.0,72.8,18.82,100.8,21
CDM,27299565,CATH TACT SENSOR ENABLED 8FR 2-2-2MM SPACE F-J CURVE 115CM 3.5MM,3645.0,2369.25,612.36,3280.5,21
CDM,27299575,AMPLATZER TREVISIO DELIVERY SYST 45 DEG 8FR X 80CM,906.0,588.9,152.21,815.4,21
CDM,27299585,TORQVUE 2 DELIVERY SHEATH STRAIGHT 6FR X 120CM,906.0,588.9,152.21,815.4,21
CDM,27299615,IMPRESS PERIPHERAL CATHETER,342.0,222.3,57.46,307.8,21
CDM,27299625,INFLATION SYRINGE KIT,110.0,71.5,18.48,99.0,21
CDM,27299635,LUMEN CENTRAL VENOUS ACCESS KIT,124.0,80.6,20.83,111.6,21
CDM,27299675,ACUNAV ULTRASOUND CATH,4725.0,3071.25,793.8,4252.5,21
CDM,27299715,INTRODUCER SHEATH,1362.0,885.3,228.82,1225.8,21
CDM,27299725,BALLOON CATHETER,1260.0,819.0,211.68,1134.0,21
CDM,27299735,SWAN-GANZ,202.0,131.3,33.94,181.8,21
CDM,27299745,BALLOON CATHETER,375.0,243.75,63.0,337.5,21
CDM,27299775,SELECTRA ACCESSORY KIT,219.0,142.35,36.79,197.1,21
CDM,27299785,"SELECTRA GUIDING CATH, EXTENDED HOOK",320.0,208.0,53.76,288.0,21
CDM,27299955,"ICE CATHETER, INTRACARDIAC AND INTRA-LUMINAL VISUALIZATION",4590.0,2983.5,771.12,4131.0,21
CDM,27299AGRVU1WE,"UNLIST PROC, PELVIS OR HIP JOINT COMPARED TO 27000",2420.0,1573.0,509.75,2420.0,15
CDM,27299RVU11WE,ABDUCTOR ANCHOR RECONSTRUCTION (COMP CODE 27100),4880.0,3172.0,509.75,4880.0,15
CDM,27299RVU12WE,OPEN PX TO RPR ABDUCTOR MUSCULATURE TO TUMOR PROSTHESIS (COMP CO,4101.0,2665.65,509.75,4101.0,15
CDM,27299RVU14WE,CT GUIDED ACETABULOPLASTY (COMP CODE 22511),2639.0,1715.35,509.75,2639.0,15
CDM,27299RVU15WE,POSTERIOR CAPSULAR RECONSTRUCTION (COMP CODE 27100),4540.0,2951.0,509.75,4540.0,15
CDM,27299RVU3WE,GLUTEUS MEDIUS/MINIMUS REPAIR (COMP CODE 27385),2458.0,1597.7,509.75,2458.0,15
CDM,27299RVU4WE,SUTURE OF ABDUCTOR TENDON (COMP CODE 27385),2980.0,1937.0,509.75,2980.0,15
CDM,27299RVU9WE,UNLISTED PROC; OPEN TREATMENT TOTAL HIP REPLACEMENT DISLOCATION,2501.0,1625.65,509.75,2501.0,15
CDM,27301WE,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,2712.0,1762.8,248.22,2034.0,35
CDM,27303WE,INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE,3452.0,2243.8,423.13,3452.0,35
CDM,27305WE,"FASCIOTOMY,ILIOTIBIAL,OPEN",2472.0,1606.8,285.77,2472.0,35
CDM,27306WE,TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX,1896.0,1232.4,210.14,1896.0,35
CDM,27307WE,TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON,2424.0,1575.6,258.87,2424.0,35
CDM,27310WE,ARTHRT KNE W/EXPL DRG/RMVL FB,4000.0,2600.0,517.64,4000.0,35
CDM,27323WE,BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL,932.0,605.8,84.33,699.0,35
CDM,27324WE,BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP,2016.0,1310.4,220.23,2016.0,35
CDM,27327WE,EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM,1584.0,1029.6,154.19,1188.0,35
CDM,27328WE,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM,3540.0,2301.0,304.76,3540.0,35
CDM,27329WE,RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM,6288.0,4087.2,713.3,6288.0,35
CDM,27330WE,ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY,2044.0,1328.6,295.43,2044.0,35
CDM,27331WE,ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB,2408.0,1565.2,351.89,2408.0,35
CDM,27332WE,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT,3384.0,2199.6,476.59,3384.0,35
CDM,27333WE,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL&LAT,3020.0,1963.0,419.1,3020.0,35
CDM,27334WE,ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR,3676.0,2389.4,503.98,3676.0,35
CDM,27335WE,ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA,4220.0,2743.0,577.66,4220.0,35
CDM,27337WE,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3+CM,2364.0,1536.6,229.55,2364.0,35
CDM,27339WE,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM,4452.0,2893.8,414.62,4452.0,35
CDM,27340WE,EXCISION PREPATELLAR BURSA,1728.0,1123.2,227.52,1728.0,35
CDM,27345WE,EXCISION SYNOVIAL CYST POPLITEAL SPACE,2436.0,1583.4,323.47,2436.0,35
CDM,27347WE,EXCISION LESION MENISCUS/CAPSULE KNEE,2692.0,1749.8,269.58,2692.0,35
CDM,27350WE,PATELLECTOMY/HEMIPATELLECTOMY,3464.0,2251.6,470.0,3464.0,35
CDM,27355WE,EXCISION/CURETTAGE CYST/TUMOR FEMUR,3200.0,2080.0,426.14,3200.0,35
CDM,27357WE,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT,4464.0,2901.6,537.81,4464.0,35
CDM,27358WE,EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION,1892.0,1229.8,209.37,1892.0,35
CDM,27360WE,PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA,4584.0,2979.6,563.83,4584.0,35
CDM,27364WE,RAD RESECTION TUMOR SOFT TISSUE THIGH/KNEE 5+CM,9796.0,6367.4,868.73,9796.0,35
CDM,27365WE,"RAD RESEC TUMOR,FEMUR OR KNEE",12884.0,8374.6,997.29,12884.0,35
CDM,27369WE,NJX PX CNTRST KNE ARTHG CONTRST ENHNCD CT/MRI KNE,308.0,200.2,31.35,259.0,31
CDM,27372WE,"REMV FOREIGN BODY,KNEE/THIGH,DEEP",2084.0,1354.6,196.93,1563.0,35
CDM,27380WE,SUTURE INFRAPATELLAR TENDON PRIMARY,2980.0,1937.0,415.12,2980.0,35
CDM,27381WE,SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF,4304.0,2797.6,585.28,4304.0,35
CDM,27385WE,SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY,3049.0,1981.85,448.71,3049.0,35
CDM,27386WE,SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ,4452.0,2893.8,606.26,4452.0,35
CDM,27390WE,TENOTOMY OPEN HAMSTRING KNEE HIP SINGLE TENDON,2212.0,1437.8,278.03,2212.0,35
CDM,27391WE,TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG,2996.0,1947.4,357.72,2996.0,35
CDM,27393WE,"LENGTHEN HAMSTR TENDON,SINGLE",2900.0,1885.0,342.11,2900.0,35
CDM,27394WE,"LENGTHEN HAMSTR TENDON,MULTI,ONE LEG",3868.0,2514.2,406.74,3868.0,35
CDM,27396WE,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR 1 TENDON,3260.0,2119.0,419.28,3260.0,35
CDM,27397WE,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN,5064.0,3291.6,559.71,5064.0,35
CDM,27400010,W AFO CUSTOM PLASTIC,581.0,377.65,97.61,522.9,20
CDM,27400010_IP,W AFO CUSTOM PLASTIC,581.0,377.65,209.74,209.74,3
CDM,27400010_OP,W AFO CUSTOM PLASTIC,581.0,377.65,377.65,569.38,6
CDM,27400020,W AIRCAST FP ANKL-FT W/WO JNTS,88.0,57.2,14.78,79.2,20
CDM,27400020_IP,W AIRCAST FP ANKL-FT W/WO JNTS,88.0,57.2,31.77,31.77,3
CDM,27400020_OP,W AIRCAST FP ANKL-FT W/WO JNTS,88.0,57.2,57.2,86.24,6
CDM,27400030,W AIRCAST LEG BRACE,308.0,200.2,51.74,277.2,20
CDM,27400030_IP,W AIRCAST LEG BRACE,308.0,200.2,111.19,111.19,3
CDM,27400030_OP,W AIRCAST LEG BRACE,308.0,200.2,200.2,301.84,6
CDM,27400040,W AIRCAST SP ANKL-FT W/WO JNTS,78.0,50.7,13.1,70.2,20
CDM,27400040_IP,W AIRCAST SP ANKL-FT W/WO JNTS,78.0,50.7,28.16,28.16,3
CDM,27400040_OP,W AIRCAST SP ANKL-FT W/WO JNTS,78.0,50.7,50.7,76.44,6
CDM,27400045,"RUBBER PESSARY, ANY TYPE",109.0,70.85,18.31,98.1,20
CDM,27400045_IP,"RUBBER PESSARY, ANY TYPE",109.0,70.85,39.35,39.35,3
CDM,27400045_OP,"RUBBER PESSARY, ANY TYPE",109.0,70.85,70.85,106.82,6
CDM,27400050,W BRACE ACL T-ROM KO ADJ JNT,1528.0,993.2,256.7,1375.2,20
CDM,27400050_IP,W BRACE ACL T-ROM KO ADJ JNT,1528.0,993.2,551.61,551.61,3
CDM,27400050_OP,W BRACE ACL T-ROM KO ADJ JNT,1528.0,993.2,993.2,1497.44,6
CDM,27400055,"PESSARY, NON RUBBER",115.0,74.75,19.32,103.5,20
CDM,27400055_IP,"PESSARY, NON RUBBER",115.0,74.75,41.52,41.52,3
CDM,27400055_OP,"PESSARY, NON RUBBER",115.0,74.75,74.75,112.7,6
CDM,27400060,W BRACE ELBOW ROM,2098.0,1363.7,352.46,1888.2,23
CDM,27400060_IP,W BRACE ELBOW ROM,2098.0,1363.7,757.38,757.38,3
CDM,27400060_OP,W BRACE ELBOW ROM,2098.0,1363.7,1363.7,2056.04,6
CDM,27400070,W BRACE FEMUR FX,1119.0,727.35,187.99,1007.1,20
CDM,27400070_IP,W BRACE FEMUR FX,1119.0,727.35,403.96,403.96,3
CDM,27400070_OP,W BRACE FEMUR FX,1119.0,727.35,727.35,1096.62,6
CDM,27400080,W BRACE HUMERUS FX,317.0,206.05,53.26,285.3,20
CDM,27400080_IP,W BRACE HUMERUS FX,317.0,206.05,114.44,114.44,3
CDM,27400080_OP,W BRACE HUMERUS FX,317.0,206.05,206.05,310.66,6
CDM,27400090,W BRACE KNEE DJ ROM,849.0,551.85,142.63,764.1,20
CDM,27400090_IP,W BRACE KNEE DJ ROM,849.0,551.85,306.49,306.49,3
CDM,27400090_OP,W BRACE KNEE DJ ROM,849.0,551.85,551.85,832.02,6
CDM,27400100,W BRACE TLSO PREFAB THORAC,1131.0,735.15,190.01,1017.9,20
CDM,27400100_IP,W BRACE TLSO PREFAB THORAC,1131.0,735.15,408.29,408.29,3
CDM,27400100_OP,W BRACE TLSO PREFAB THORAC,1131.0,735.15,735.15,1108.38,6
CDM,27400110,W BRACE TLSO TRPLN CTRL HYPRTSN,482.0,313.3,80.98,433.8,20
CDM,27400110_IP,W BRACE TLSO TRPLN CTRL HYPRTSN,482.0,313.3,174.0,174.0,3
CDM,27400110_OP,W BRACE TLSO TRPLN CTRL HYPRTSN,482.0,313.3,313.3,472.36,6
CDM,27400120,WHO PREFAB WRIST W/O JOINTS,61.0,39.65,10.25,54.9,20
CDM,27400120_IP,WHO PREFAB WRIST W/O JOINTS,61.0,39.65,22.02,22.02,3
CDM,27400120_OP,WHO PREFAB WRIST W/O JOINTS,61.0,39.65,39.65,59.78,6
CDM,27400130,W CERV COLLAR W EXTENSION,84.0,54.6,14.11,75.6,20
CDM,27400130_IP,W CERV COLLAR W EXTENSION,84.0,54.6,30.32,30.32,3
CDM,27400130_OP,W CERV COLLAR W EXTENSION,84.0,54.6,54.6,82.32,6
CDM,27400140,W CERVICAL COLLAR W ADJ BARS,589.0,382.85,98.95,530.1,20
CDM,27400140_IP,W CERVICAL COLLAR W ADJ BARS,589.0,382.85,212.63,212.63,3
CDM,27400140_OP,W CERVICAL COLLAR W ADJ BARS,589.0,382.85,382.85,577.22,6
CDM,27400145,PREFAB TLSO TO SCAPULAR SPINE,348.25,226.36,58.51,313.43,20
CDM,27400145_IP,PREFAB TLSO TO SCAPULAR SPINE,348.25,226.36,125.72,125.72,3
CDM,27400145_OP,PREFAB TLSO TO SCAPULAR SPINE,348.25,226.36,226.36,341.29,6
CDM,27400160,W KO W/ ADJ FLEX/EXT ROTAT CUS,1055.0,685.75,177.24,949.5,20
CDM,27400160_IP,W KO W/ ADJ FLEX/EXT ROTAT CUS,1055.0,685.75,380.86,380.86,3
CDM,27400160_OP,W KO W/ ADJ FLEX/EXT ROTAT CUS,1055.0,685.75,685.75,1033.9,6
CDM,27400170,W LINER BRACE,91.0,59.15,15.29,81.9,20
CDM,27400170_IP,W LINER BRACE,91.0,59.15,32.85,32.85,3
CDM,27400170_OP,W LINER BRACE,91.0,59.15,59.15,89.18,6
CDM,27400180,W LUMBAR ORTHOSIS CORSET,62.0,40.3,10.42,55.8,20
CDM,27400180_IP,W LUMBAR ORTHOSIS CORSET,62.0,40.3,22.38,22.38,3
CDM,27400180_OP,W LUMBAR ORTHOSIS CORSET,62.0,40.3,40.3,60.76,6
CDM,27400185,SIO FLEX PELVISACRAL PREFAB,87.0,56.55,14.62,78.3,20
CDM,27400185_IP,SIO FLEX PELVISACRAL PREFAB,87.0,56.55,31.41,31.41,3
CDM,27400185_OP,SIO FLEX PELVISACRAL PREFAB,87.0,56.55,56.55,85.26,6
CDM,27400200,W ORTHOSIS ADDTL ABOVE KNEE,102.0,66.3,17.14,91.8,20
CDM,27400200_IP,W ORTHOSIS ADDTL ABOVE KNEE,102.0,66.3,36.82,36.82,3
CDM,27400200_OP,W ORTHOSIS ADDTL ABOVE KNEE,102.0,66.3,66.3,99.96,6
CDM,27400210,W ORTHOSIS ANK/FT STATIC,323.0,209.95,54.26,290.7,20
CDM,27400210_IP,W ORTHOSIS ANK/FT STATIC,323.0,209.95,116.6,116.6,3
CDM,27400210_OP,W ORTHOSIS ANK/FT STATIC,323.0,209.95,209.95,316.54,6
CDM,27400220,W ORTHOSIS HIP POSTOP,1043.0,677.95,175.22,938.7,20
CDM,27400220_IP,W ORTHOSIS HIP POSTOP,1043.0,677.95,376.52,376.52,3
CDM,27400220_OP,W ORTHOSIS HIP POSTOP,1043.0,677.95,677.95,1022.14,6
CDM,27400230,W ORTHOSIS KNEE WO JOINT,999.0,649.35,167.83,899.1,20
CDM,27400230_IP,W ORTHOSIS KNEE WO JOINT,999.0,649.35,360.64,360.64,3
CDM,27400230_OP,W ORTHOSIS KNEE WO JOINT,999.0,649.35,649.35,979.02,6
CDM,27400240,WHFO PREFAB W/O JOINTS,256.0,166.4,43.01,230.4,20
CDM,27400240_IP,WHFO PREFAB W/O JOINTS,256.0,166.4,92.42,92.42,3
CDM,27400240_OP,WHFO PREFAB W/O JOINTS,256.0,166.4,166.4,250.88,6
CDM,27400250,W PREFAB WHFO WO JNTS,79.0,51.35,13.27,71.1,20
CDM,27400250_IP,W PREFAB WHFO WO JNTS,79.0,51.35,28.52,28.52,3
CDM,27400250_OP,W PREFAB WHFO WO JNTS,79.0,51.35,51.35,77.42,6
CDM,27400260,W SHOE HEEL RELIEF DARCO,323.0,209.95,54.26,290.7,20
CDM,27400260_IP,W SHOE HEEL RELIEF DARCO,323.0,209.95,116.6,116.6,3
CDM,27400260_OP,W SHOE HEEL RELIEF DARCO,323.0,209.95,209.95,316.54,6
CDM,27400270,W SHRINKER PROST BELOW KNEE,59.0,38.35,9.91,53.1,20
CDM,27400270_IP,W SHRINKER PROST BELOW KNEE,59.0,38.35,21.3,21.3,3
CDM,27400270_OP,W SHRINKER PROST BELOW KNEE,59.0,38.35,38.35,57.82,6
CDM,27400290,W STRAP PAD VARUS/VALGUS T,56.0,36.4,9.41,50.4,20
CDM,27400290_IP,W STRAP PAD VARUS/VALGUS T,56.0,36.4,20.22,20.22,3
CDM,27400290_OP,W STRAP PAD VARUS/VALGUS T,56.0,36.4,36.4,54.88,6
CDM,27400300,W TLSO 2PC PL SHELL W LINER,1975.0,1283.75,331.8,1777.5,23
CDM,27400300_IP,W TLSO 2PC PL SHELL W LINER,1975.0,1283.75,712.98,712.98,3
CDM,27400300_OP,W TLSO 2PC PL SHELL W LINER,1975.0,1283.75,1283.75,1935.5,6
CDM,27400310,W TLSO 2PC PL SHELL WO LINER,1994.0,1296.1,334.99,1794.6,23
CDM,27400310_IP,W TLSO 2PC PL SHELL WO LINER,1994.0,1296.1,719.83,719.83,3
CDM,27400310_OP,W TLSO 2PC PL SHELL WO LINER,1994.0,1296.1,1296.1,1954.12,6
CDM,27400320,W TLSO TRIPLANAR PREFAB,1407.0,914.55,236.38,1266.3,20
CDM,27400320_IP,W TLSO TRIPLANAR PREFAB,1407.0,914.55,507.93,507.93,3
CDM,27400320_OP,W TLSO TRIPLANAR PREFAB,1407.0,914.55,914.55,1378.86,6
CDM,27400330,W TLSO W 1PC PL SHELL WO LINER,1492.0,969.8,250.66,1342.8,20
CDM,27400330_IP,W TLSO W 1PC PL SHELL WO LINER,1492.0,969.8,538.61,538.61,3
CDM,27400330_OP,W TLSO W 1PC PL SHELL WO LINER,1492.0,969.8,969.8,1462.16,6
CDM,27400340,W TUBE TRACH UNCUF W/DIC,84.0,54.6,14.11,75.6,20
CDM,27400340_IP,W TUBE TRACH UNCUF W/DIC,84.0,54.6,30.32,30.32,3
CDM,27400340_OP,W TUBE TRACH UNCUF W/DIC,84.0,54.6,54.6,82.32,6
CDM,27400360,W VALVE TRACH PASSY MUIR,127.0,82.55,21.34,114.3,20
CDM,27400360_IP,W VALVE TRACH PASSY MUIR,127.0,82.55,45.85,45.85,3
CDM,27400360_OP,W VALVE TRACH PASSY MUIR,127.0,82.55,82.55,124.46,6
CDM,27400370,W KNEE ORTH POS LOCKING JOINT,332.0,215.8,55.78,298.8,20
CDM,27400370_IP,W KNEE ORTH POS LOCKING JOINT,332.0,215.8,119.85,119.85,3
CDM,27400370_OP,W KNEE ORTH POS LOCKING JOINT,332.0,215.8,215.8,325.36,6
CDM,27400380,"W ADD TO UE ORTHO,SOCK, FX EACH",35.0,22.75,5.88,31.5,20
CDM,27400380_IP,"W ADD TO UE ORTHO,SOCK, FX EACH",35.0,22.75,12.64,12.64,3
CDM,27400380_OP,"W ADD TO UE ORTHO,SOCK, FX EACH",35.0,22.75,22.75,34.3,6
CDM,27400390,W COLLAR CERV ADJ BAR THRC FRM,541.0,351.65,90.89,486.9,20
CDM,27400390_IP,W COLLAR CERV ADJ BAR THRC FRM,541.0,351.65,195.3,195.3,3
CDM,27400390_OP,W COLLAR CERV ADJ BAR THRC FRM,541.0,351.65,351.65,530.18,6
CDM,27400400,W COLLAR CERV SEMIRIG 2PC THRC,288.0,187.2,48.38,259.2,20
CDM,27400400_IP,W COLLAR CERV SEMIRIG 2PC THRC,288.0,187.2,103.97,103.97,3
CDM,27400400_OP,W COLLAR CERV SEMIRIG 2PC THRC,288.0,187.2,187.2,282.24,6
CDM,27400410,W BRACE TLSO PRFB UPPR THORACIC,212.0,137.8,35.62,190.8,20
CDM,27400410_IP,W BRACE TLSO PRFB UPPR THORACIC,212.0,137.8,76.53,76.53,3
CDM,27400410_OP,W BRACE TLSO PRFB UPPR THORACIC,212.0,137.8,137.8,207.76,6
CDM,27400420,W ORTHOSIS KAFO FEM FX CUSTOM,1425.0,926.25,239.4,1282.5,20
CDM,27400420_IP,W ORTHOSIS KAFO FEM FX CUSTOM,1425.0,926.25,514.43,514.43,3
CDM,27400420_OP,W ORTHOSIS KAFO FEM FX CUSTOM,1425.0,926.25,926.25,1396.5,6
CDM,27400430,W LINER INTERFACE BK SOFT,111.0,72.15,18.65,99.9,20
CDM,27400430_IP,W LINER INTERFACE BK SOFT,111.0,72.15,40.07,40.07,3
CDM,27400430_OP,W LINER INTERFACE BK SOFT,111.0,72.15,72.15,108.78,6
CDM,27400440,W LINER INTERFACE AK SOFT,125.0,81.25,21.0,112.5,20
CDM,27400440_IP,W LINER INTERFACE AK SOFT,125.0,81.25,45.13,45.13,3
CDM,27400440_OP,W LINER INTERFACE AK SOFT,125.0,81.25,81.25,122.5,6
CDM,27400450,W BRACE LSO SAG-CORONL PNL PRFB,1534.0,997.1,257.71,1380.6,20
CDM,27400450_IP,W BRACE LSO SAG-CORONL PNL PRFB,1534.0,997.1,553.77,553.77,3
CDM,27400450_OP,W BRACE LSO SAG-CORONL PNL PRFB,1534.0,997.1,997.1,1503.32,6
CDM,27400460,W BRACE CYBERTECH PREMIUM PLUS,340.0,221.0,57.12,306.0,20
CDM,27400460_IP,W BRACE CYBERTECH PREMIUM PLUS,340.0,221.0,122.74,122.74,3
CDM,27400460_OP,W BRACE CYBERTECH PREMIUM PLUS,340.0,221.0,221.0,333.2,6
CDM,27400470,W BRACE CYBERTECH SPINE FLEX PLUS,160.0,104.0,26.88,144.0,20
CDM,27400470_IP,W BRACE CYBERTECH SPINE FLEX PLUS,160.0,104.0,57.76,57.76,3
CDM,27400470_OP,W BRACE CYBERTECH SPINE FLEX PLUS,160.0,104.0,104.0,156.8,6
CDM,27400480,W CUSTOM HIP ABDUCTION CONTRL,1555.0,1010.75,261.24,1399.5,20
CDM,27400480_IP,W CUSTOM HIP ABDUCTION CONTRL,1555.0,1010.75,561.36,561.36,3
CDM,27400480_OP,W CUSTOM HIP ABDUCTION CONTRL,1555.0,1010.75,1010.75,1523.9,6
CDM,27400490,W A.L. EXT PCC HIP JNT,437.0,284.05,73.42,393.3,20
CDM,27400490_IP,W A.L. EXT PCC HIP JNT,437.0,284.05,157.76,157.76,3
CDM,27400490_OP,W A.L. EXT PCC HIP JNT,437.0,284.05,284.05,428.26,6
CDM,27400500,W A.L. EXT PC BAND/BELT,259.0,168.35,43.51,233.1,20
CDM,27400500_IP,W A.L. EXT PC BAND/BELT,259.0,168.35,93.5,93.5,3
CDM,27400500_OP,W A.L. EXT PC BAND/BELT,259.0,168.35,168.35,253.82,6
CDM,27400505,PREFAB ELASTIC KO W JNTS,175.0,113.75,29.4,157.5,20
CDM,27400505_IP,PREFAB ELASTIC KO W JNTS,175.0,113.75,63.18,63.18,3
CDM,27400505_OP,PREFAB ELASTIC KO W JNTS,175.0,113.75,113.75,171.5,6
CDM,27400510,EO PREFAB W ADJ LOCK JNTS,513.0,333.45,86.18,461.7,20
CDM,27400510_IP,EO PREFAB W ADJ LOCK JNTS,513.0,333.45,185.19,185.19,3
CDM,27400510_OP,EO PREFAB W ADJ LOCK JNTS,513.0,333.45,333.45,502.74,6
CDM,27400515,PLAYMAKER KNEE BRACE,167.28,108.73,28.1,150.55,20
CDM,27400515_IP,PLAYMAKER KNEE BRACE,167.28,108.73,60.39,60.39,3
CDM,27400515_OP,PLAYMAKER KNEE BRACE,167.28,108.73,108.73,163.93,6
CDM,27400520,W TLSO WITH T-BAR,340.0,221.0,57.12,306.0,20
CDM,27400520_IP,W TLSO WITH T-BAR,340.0,221.0,122.74,122.74,3
CDM,27400520_OP,W TLSO WITH T-BAR,340.0,221.0,221.0,333.2,6
CDM,27400530,"W POCKET CTRL,HEARTMATE,106762",11000.0,7150.0,1848.0,11000.0,29
CDM,27400530_OP,"W POCKET CTRL,HEARTMATE,106762",11000.0,7150.0,7150.0,10780.0,6
CDM,27400540,W MODULE POWER HEARTMATE,12480.0,8112.0,2096.64,12480.0,29
CDM,27400540_OP,W MODULE POWER HEARTMATE,12480.0,8112.0,8112.0,12230.4,6
CDM,27400550,W CHARGER BATTERY UNIVERSAL,11520.0,7488.0,1935.36,10368.0,29
CDM,27400550_OP,W CHARGER BATTERY UNIVERSAL,11520.0,7488.0,7488.0,11289.6,6
CDM,27400560,"W CABLE,PATIENT POWR MODULE,14V",2500.0,1625.0,420.0,2250.0,23
CDM,27400560_IP,"W CABLE,PATIENT POWR MODULE,14V",2500.0,1625.0,902.5,902.5,3
CDM,27400560_OP,"W CABLE,PATIENT POWR MODULE,14V",2500.0,1625.0,1625.0,2450.0,6
CDM,27400565,KO SINGLE UPRIGHT CUSTOM FIT,893.0,580.45,150.02,803.7,20
CDM,27400565_IP,KO SINGLE UPRIGHT CUSTOM FIT,893.0,580.45,322.37,322.37,3
CDM,27400565_OP,KO SINGLE UPRIGHT CUSTOM FIT,893.0,580.45,580.45,875.14,6
CDM,27400570,"W CABLE,PWR MODULE,DC INPUT,2230",360.0,234.0,60.48,324.0,20
CDM,27400570_IP,"W CABLE,PWR MODULE,DC INPUT,2230",360.0,234.0,129.96,129.96,3
CDM,27400570_OP,"W CABLE,PWR MODULE,DC INPUT,2230",360.0,234.0,234.0,352.8,6
CDM,27400575,"KO DBL UPRIGHT ADJ, CUSTOM FAB",1276.0,829.4,214.37,1148.4,20
CDM,27400575_IP,"KO DBL UPRIGHT ADJ, CUSTOM FAB",1276.0,829.4,460.64,460.64,3
CDM,27400575_OP,"KO DBL UPRIGHT ADJ, CUSTOM FAB",1276.0,829.4,829.4,1250.48,6
CDM,27400580,W BATTERY SET 14V LI-ION,1000.0,650.0,168.0,900.0,20
CDM,27400580_IP,W BATTERY SET 14V LI-ION,1000.0,650.0,361.0,361.0,3
CDM,27400580_OP,W BATTERY SET 14V LI-ION,1000.0,650.0,650.0,980.0,6
CDM,27400590,W BATTERY CLIP SET 14V LI-ION,880.0,572.0,147.84,792.0,20
CDM,27400590_IP,W BATTERY CLIP SET 14V LI-ION,880.0,572.0,317.68,317.68,3
CDM,27400590_OP,W BATTERY CLIP SET 14V LI-ION,880.0,572.0,572.0,862.4,6
CDM,27400595,AFO ANKLE GAUNTLET,80.0,52.0,13.44,72.0,20
CDM,27400595_IP,AFO ANKLE GAUNTLET,80.0,52.0,28.88,28.88,3
CDM,27400595_OP,AFO ANKLE GAUNTLET,80.0,52.0,52.0,78.4,6
CDM,27400600,"W HOLSTR,GOGEAR HM,ALL SZ 1042XX",632.0,410.8,106.18,568.8,20
CDM,27400600_IP,"W HOLSTR,GOGEAR HM,ALL SZ 1042XX",632.0,410.8,228.15,228.15,3
CDM,27400600_OP,"W HOLSTR,GOGEAR HM,ALL SZ 1042XX",632.0,410.8,410.8,619.36,6
CDM,27400610,"W BELT,MODULAR,14V,10422X,ALL SZ",552.0,358.8,92.74,496.8,20
CDM,27400610_IP,"W BELT,MODULAR,14V,10422X,ALL SZ",552.0,358.8,199.27,199.27,3
CDM,27400610_OP,"W BELT,MODULAR,14V,10422X,ALL SZ",552.0,358.8,358.8,540.96,6
CDM,27400620,"W SHOWER BAG,PKT CNTLR,104232",900.0,585.0,151.2,810.0,20
CDM,27400620_IP,"W SHOWER BAG,PKT CNTLR,104232",900.0,585.0,324.9,324.9,3
CDM,27400620_OP,"W SHOWER BAG,PKT CNTLR,104232",900.0,585.0,585.0,882.0,6
CDM,27400630,"W BTTRY BCKUP,PKT CTRL,HM 106128",1000.0,650.0,168.0,900.0,20
CDM,27400630_IP,"W BTTRY BCKUP,PKT CTRL,HM 106128",1000.0,650.0,361.0,361.0,3
CDM,27400630_OP,"W BTTRY BCKUP,PKT CTRL,HM 106128",1000.0,650.0,650.0,980.0,6
CDM,27400640,W THORATEC STABILIZATION BELT,160.0,104.0,26.88,144.0,20
CDM,27400640_IP,W THORATEC STABILIZATION BELT,160.0,104.0,57.76,57.76,3
CDM,27400640_OP,W THORATEC STABILIZATION BELT,160.0,104.0,104.0,156.8,6
CDM,27400650,"W BAG,GOGEAR CONSOLID,L/R,HRTMT",520.0,338.0,87.36,468.0,20
CDM,27400650_IP,"W BAG,GOGEAR CONSOLID,L/R,HRTMT",520.0,338.0,187.72,187.72,3
CDM,27400650_OP,"W BAG,GOGEAR CONSOLID,L/R,HRTMT",520.0,338.0,338.0,509.6,6
CDM,27400660,"W VEST,HOLSTER,14V,ALL SZ",790.0,513.5,132.72,711.0,20
CDM,27400660_IP,"W VEST,HOLSTER,14V,ALL SZ",790.0,513.5,285.19,285.19,3
CDM,27400660_OP,"W VEST,HOLSTER,14V,ALL SZ",790.0,513.5,513.5,774.2,6
CDM,27400670,"W TRAVEL CASE,HRTMT DEV,1260",256.0,166.4,43.01,230.4,20
CDM,27400670_IP,"W TRAVEL CASE,HRTMT DEV,1260",256.0,166.4,92.42,92.42,3
CDM,27400670_OP,"W TRAVEL CASE,HRTMT DEV,1260",256.0,166.4,166.4,250.88,6
CDM,27400680,W BRACE CASH,236.0,153.4,39.65,212.4,20
CDM,27400680_IP,W BRACE CASH,236.0,153.4,85.2,85.2,3
CDM,27400680_OP,W BRACE CASH,236.0,153.4,153.4,231.28,6
CDM,27400690,W LSO BACK BRACE,174.0,113.1,29.23,156.6,20
CDM,27400690_IP,W LSO BACK BRACE,174.0,113.1,62.81,62.81,3
CDM,27400690_OP,W LSO BACK BRACE,174.0,113.1,113.1,170.52,6
CDM,27400730,W KIT WEARABLE ACCESSORIES,272.0,176.8,45.7,244.8,20
CDM,27400730_IP,W KIT WEARABLE ACCESSORIES,272.0,176.8,98.19,98.19,3
CDM,27400730_OP,W KIT WEARABLE ACCESSORIES,272.0,176.8,176.8,266.56,6
CDM,27400740,W HRTW PUMP IMP ACCSSRY KIT 1153,10600.0,6890.0,1780.8,9540.0,29
CDM,27400740_OP,W HRTW PUMP IMP ACCSSRY KIT 1153,10600.0,6890.0,6890.0,10388.0,6
CDM,27400760,W HRTW CONTROLLER KIT 1403US,12800.0,8320.0,2150.4,12800.0,29
CDM,27400760_OP,W HRTW CONTROLLER KIT 1403US,12800.0,8320.0,8320.0,12544.0,6
CDM,27400770,W HRTW CONVERTIBLE PT PACK 1475,850.0,552.5,142.8,765.0,20
CDM,27400770_IP,W HRTW CONVERTIBLE PT PACK 1475,850.0,552.5,306.85,306.85,3
CDM,27400770_OP,W HRTW CONVERTIBLE PT PACK 1475,850.0,552.5,552.5,833.0,6
CDM,27400800,W HRTW CONTROLLER ADAPTER 1435,3600.0,2340.0,604.8,3240.0,23
CDM,27400800_IP,W HRTW CONTROLLER ADAPTER 1435,3600.0,2340.0,1299.6,1299.6,3
CDM,27400800_OP,W HRTW CONTROLLER ADAPTER 1435,3600.0,2340.0,2340.0,3528.0,6
CDM,27400840,VAR/VAL KNEE CAP,101.0,65.65,16.97,90.9,20
CDM,27400840_IP,VAR/VAL KNEE CAP,101.0,65.65,36.46,36.46,3
CDM,27400840_OP,VAR/VAL KNEE CAP,101.0,65.65,65.65,98.98,6
CDM,27400870,W KIT DRESSING MCS VAD,25.0,16.25,4.2,22.5,20
CDM,27400870_IP,W KIT DRESSING MCS VAD,25.0,16.25,9.03,9.03,3
CDM,27400870_OP,W KIT DRESSING MCS VAD,25.0,16.25,16.25,24.5,6
CDM,27400880,W HRTW SHOWER BAG,600.0,390.0,100.8,540.0,20
CDM,27400880_IP,W HRTW SHOWER BAG,600.0,390.0,216.6,216.6,3
CDM,27400880_OP,W HRTW SHOWER BAG,600.0,390.0,390.0,588.0,6
CDM,27400890,W HRTW SHOULDER PACK,900.0,585.0,151.2,810.0,20
CDM,27400890_IP,W HRTW SHOULDER PACK,900.0,585.0,324.9,324.9,3
CDM,27400890_OP,W HRTW SHOULDER PACK,900.0,585.0,585.0,882.0,6
CDM,27400900,W HRTW BATTERY 1650,375.0,243.75,63.0,337.5,20
CDM,27400900_IP,W HRTW BATTERY 1650,375.0,243.75,135.38,135.38,3
CDM,27400900_OP,W HRTW BATTERY 1650,375.0,243.75,243.75,367.5,6
CDM,27400910,W HRTW WAIST PACK,850.0,552.5,142.8,765.0,20
CDM,27400910_IP,W HRTW WAIST PACK,850.0,552.5,306.85,306.85,3
CDM,27400910_OP,W HRTW WAIST PACK,850.0,552.5,552.5,833.0,6
CDM,27400920,W HRTW BATTERY CHARGER 1600US,12200.0,7930.0,2049.6,10980.0,29
CDM,27400920_OP,W HRTW BATTERY CHARGER 1600US,12200.0,7930.0,7930.0,11956.0,6
CDM,27400930,W UNIT MOBILE POWER W/AC CABLE,16000.0,10400.0,2688.0,16000.0,29
CDM,27400930_OP,W UNIT MOBILE POWER W/AC CABLE,16000.0,10400.0,10400.0,15680.0,6
CDM,27401315,EO PREFAB RIGID W/O JOINTS,77.4,50.31,13.0,69.66,20
CDM,27401315_IP,EO PREFAB RIGID W/O JOINTS,77.4,50.31,27.94,27.94,3
CDM,27401315_OP,EO PREFAB RIGID W/O JOINTS,77.4,50.31,50.31,75.85,6
CDM,27401320,EO CUSTOM W/WRIST,267.47,173.86,44.93,240.72,20
CDM,27401320_IP,EO CUSTOM W/WRIST,267.47,173.86,96.56,96.56,3
CDM,27401320_OP,EO CUSTOM W/WRIST,267.47,173.86,173.86,262.12,6
CDM,27401335,WHFO CUSTOM W/JOINTS,475.0,308.75,79.8,427.5,20
CDM,27401335_IP,WHFO CUSTOM W/JOINTS,475.0,308.75,171.48,171.48,3
CDM,27401335_OP,WHFO CUSTOM W/JOINTS,475.0,308.75,308.75,465.5,6
CDM,27401340,WHFO CUSTOM RIGID W/OUT JOINTS,141.0,91.65,23.69,126.9,20
CDM,27401340_IP,WHFO CUSTOM RIGID W/OUT JOINTS,141.0,91.65,50.9,50.9,3
CDM,27401340_OP,WHFO CUSTOM RIGID W/OUT JOINTS,141.0,91.65,91.65,138.18,6
CDM,27401355,WHO CUSTOM W/NONTORSION JOINTS,310.0,201.5,52.08,279.0,20
CDM,27401355_IP,WHO CUSTOM W/NONTORSION JOINTS,310.0,201.5,111.91,111.91,3
CDM,27401355_OP,WHO CUSTOM W/NONTORSION JOINTS,310.0,201.5,201.5,303.8,6
CDM,27401360,WHO CUSTOM W/O JOINTS,72.04,46.83,12.1,64.84,20
CDM,27401360_IP,WHO CUSTOM W/O JOINTS,72.04,46.83,26.01,26.01,3
CDM,27401360_OP,WHO CUSTOM W/O JOINTS,72.04,46.83,46.83,70.6,6
CDM,27401365,WHFO PREFAB FLEXION GLOVE,30.0,19.5,5.04,27.0,20
CDM,27401365_IP,WHFO PREFAB FLEXION GLOVE,30.0,19.5,10.83,10.83,3
CDM,27401365_OP,WHFO PREFAB FLEXION GLOVE,30.0,19.5,19.5,29.4,6
CDM,27401370,HFO CUSTOM W/O JOINTS,175.0,113.75,29.4,157.5,20
CDM,27401370_IP,HFO CUSTOM W/O JOINTS,175.0,113.75,63.18,63.18,3
CDM,27401370_OP,HFO CUSTOM W/O JOINTS,175.0,113.75,113.75,171.5,6
CDM,27401380,HO CUSTOM W/O FINGERS,50.0,32.5,8.4,45.0,20
CDM,27401380_IP,HO CUSTOM W/O FINGERS,50.0,32.5,18.05,18.05,3
CDM,27401380_OP,HO CUSTOM W/O FINGERS,50.0,32.5,32.5,49.0,6
CDM,27401385,HFO CUSTOM W/JOINTS,300.0,195.0,50.4,270.0,20
CDM,27401385_IP,HFO CUSTOM W/JOINTS,300.0,195.0,108.3,108.3,3
CDM,27401385_OP,HFO CUSTOM W/JOINTS,300.0,195.0,195.0,294.0,6
CDM,27401395,HFO PREFAB W/O JOINTS SOFT,30.0,19.5,5.04,27.0,20
CDM,27401395_IP,HFO PREFAB W/O JOINTS SOFT,30.0,19.5,10.83,10.83,3
CDM,27401395_OP,HFO PREFAB W/O JOINTS SOFT,30.0,19.5,19.5,29.4,6
CDM,27401400,FO PREFAB SPRING TENSION FINGER,25.0,16.25,4.2,22.5,20
CDM,27401400_IP,FO PREFAB SPRING TENSION FINGER,25.0,16.25,9.03,9.03,3
CDM,27401400_OP,FO PREFAB SPRING TENSION FINGER,25.0,16.25,16.25,24.5,6
CDM,27401405,FO PREFAB STATIC FINGER,27.0,17.55,4.54,24.3,20
CDM,27401405_IP,FO PREFAB STATIC FINGER,27.0,17.55,9.75,9.75,3
CDM,27401405_OP,FO PREFAB STATIC FINGER,27.0,17.55,17.55,26.46,6
CDM,27401410,HFO PREFAB HINGED W/ JOINTS,97.84,63.6,16.44,88.06,20
CDM,27401410_IP,HFO PREFAB HINGED W/ JOINTS,97.84,63.6,35.32,35.32,3
CDM,27401410_OP,HFO PREFAB HINGED W/ JOINTS,97.84,63.6,63.6,95.88,6
CDM,27401420,WHFO PREFAB W/ JOINTS,107.0,69.55,17.98,96.3,20
CDM,27401420_IP,WHFO PREFAB W/ JOINTS,107.0,69.55,38.63,38.63,3
CDM,27401420_OP,WHFO PREFAB W/ JOINTS,107.0,69.55,69.55,104.86,6
CDM,27401425,FO CUSTOM STATIC FINGER,25.0,16.25,4.2,22.5,20
CDM,27401425_IP,FO CUSTOM STATIC FINGER,25.0,16.25,9.03,9.03,3
CDM,27401425_OP,FO CUSTOM STATIC FINGER,25.0,16.25,16.25,24.5,6
CDM,27401430,"FO CUSTOM STATIC-PROGRESSIVE, DYNAMIC",266.0,172.9,44.69,239.4,20
CDM,27401430_IP,"FO CUSTOM STATIC-PROGRESSIVE, DYNAMIC",266.0,172.9,96.03,96.03,3
CDM,27401430_OP,"FO CUSTOM STATIC-PROGRESSIVE, DYNAMIC",266.0,172.9,172.9,260.68,6
CDM,27401485,ORTH DEV REPAIR/REPL MINOR P,100.0,65.0,16.8,90.0,20
CDM,27401485_IP,ORTH DEV REPAIR/REPL MINOR P,100.0,65.0,36.1,36.1,3
CDM,27401485_OP,ORTH DEV REPAIR/REPL MINOR P,100.0,65.0,65.0,98.0,6
CDM,27401495,PREFAB ANKLE AIRCAST,271.58,176.53,45.63,244.42,20
CDM,27401495_IP,PREFAB ANKLE AIRCAST,271.58,176.53,98.04,98.04,3
CDM,27401495_OP,PREFAB ANKLE AIRCAST,271.58,176.53,176.53,266.15,6
CDM,27402435,HMII SYSTEM DRIVER,7425.0,4826.25,1247.4,7425.0,29
CDM,27402435_OP,HMII SYSTEM DRIVER,7425.0,4826.25,4826.25,7276.5,6
CDM,27402730,TRACH-ESOPH VOICE PROS MD IN,329.0,213.85,55.27,296.1,20
CDM,27402730_IP,TRACH-ESOPH VOICE PROS MD IN,329.0,213.85,118.77,118.77,3
CDM,27402730_OP,TRACH-ESOPH VOICE PROS MD IN,329.0,213.85,213.85,322.42,6
CDM,27403185,LUMBOSACRAL SUPPORT,57.0,37.05,9.58,51.3,20
CDM,27403185_IP,LUMBOSACRAL SUPPORT,57.0,37.05,20.58,20.58,3
CDM,27403185_OP,LUMBOSACRAL SUPPORT,57.0,37.05,37.05,55.86,6
CDM,27403385,OA KNEE BRACE,1041.52,676.99,174.98,937.37,20
CDM,27403385_IP,OA KNEE BRACE,1041.52,676.99,375.99,375.99,3
CDM,27403385_OP,OA KNEE BRACE,1041.52,676.99,676.99,1020.69,6
CDM,27403415,OTS BRACE - ACL/PCL,1041.52,676.99,174.98,937.37,20
CDM,27403415_IP,OTS BRACE - ACL/PCL,1041.52,676.99,375.99,375.99,3
CDM,27403415_OP,OTS BRACE - ACL/PCL,1041.52,676.99,676.99,1020.69,6
CDM,27403425,CUSTOM ACL/PCL W/PNEUMATIC KNE,1276.0,829.4,214.37,1148.4,20
CDM,27403425_IP,CUSTOM ACL/PCL W/PNEUMATIC KNE,1276.0,829.4,460.64,460.64,3
CDM,27403425_OP,CUSTOM ACL/PCL W/PNEUMATIC KNE,1276.0,829.4,829.4,1250.48,6
CDM,27403635,CUSTOM FOOT ORTHOTIC/ ORTHOTICS METARSAL SUPPORT,120.0,78.0,20.16,108.0,20
CDM,27403635_IP,CUSTOM FOOT ORTHOTIC/ ORTHOTICS METARSAL SUPPORT,120.0,78.0,43.32,43.32,3
CDM,27403635_OP,CUSTOM FOOT ORTHOTIC/ ORTHOTICS METARSAL SUPPORT,120.0,78.0,78.0,117.6,6
CDM,27403735,EO CUSTOM W/O WRIST,267.47,173.86,44.93,240.72,20
CDM,27403735_IP,EO CUSTOM W/O WRIST,267.47,173.86,96.56,96.56,3
CDM,27403735_OP,EO CUSTOM W/O WRIST,267.47,173.86,173.86,262.12,6
CDM,27403WE,ARTHROTOMY W/MENISCUS REPAIR KNEE,3448.0,2241.2,467.35,3448.0,35
CDM,27404025,HFO PREFAB W/O JOINTS RIGID,54.0,35.1,9.07,48.6,20
CDM,27404025_IP,HFO PREFAB W/O JOINTS RIGID,54.0,35.1,19.49,19.49,3
CDM,27404025_OP,HFO PREFAB W/O JOINTS RIGID,54.0,35.1,35.1,52.92,6
CDM,27404085,"UE FX ORTHOSIS, HUMERAL",604.0,392.6,101.47,543.6,20
CDM,27404085_IP,"UE FX ORTHOSIS, HUMERAL",604.0,392.6,218.04,218.04,3
CDM,27404085_OP,"UE FX ORTHOSIS, HUMERAL",604.0,392.6,392.6,591.92,6
CDM,27404455,"LVAD ACCESSORY KIT, 106129",544.0,353.6,91.39,489.6,27
CDM,27405WE,RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL,3632.0,2360.8,499.03,3632.0,35
CDM,27406005,HUMERAL FRACT CUFF FIT & ADJ,110.0,71.5,18.48,99.0,20
CDM,27406005_IP,HUMERAL FRACT CUFF FIT & ADJ,110.0,71.5,39.71,39.71,3
CDM,27406005_OP,HUMERAL FRACT CUFF FIT & ADJ,110.0,71.5,71.5,107.8,6
CDM,27406695,CUSTOM FOOT ORTHOTIC,120.0,78.0,20.16,108.0,20
CDM,27406695_IP,CUSTOM FOOT ORTHOTIC,120.0,78.0,43.32,43.32,3
CDM,27406695_OP,CUSTOM FOOT ORTHOTIC,120.0,78.0,78.0,117.6,6
CDM,27406965,UE PREFAB HUMERAL BRACE,273.6,177.84,45.96,246.24,20
CDM,27406965_IP,UE PREFAB HUMERAL BRACE,273.6,177.84,98.77,98.77,3
CDM,27406965_OP,UE PREFAB HUMERAL BRACE,273.6,177.84,177.84,268.13,6
CDM,27407025,EO PREFAB ELASTIC W METAL JOINTS,123.9,80.54,20.82,111.51,20
CDM,27407025_IP,EO PREFAB ELASTIC W METAL JOINTS,123.9,80.54,44.73,44.73,3
CDM,27407025_OP,EO PREFAB ELASTIC W METAL JOINTS,123.9,80.54,80.54,121.42,6
CDM,27407305,HEARTMATE 3 CONTROLLER AND EBB CAT#106531US,7425.0,4826.25,1247.4,7425.0,29
CDM,27407305_OP,HEARTMATE 3 CONTROLLER AND EBB CAT#106531US,7425.0,4826.25,4826.25,7276.5,6
CDM,27407315,HEARTMATE MOBILE POWER UNIT CAT#107754,11664.0,7581.6,1959.55,11664.0,33
CDM,27407325,HEARTMATE UNIVERSAL BATTERY CHARGER CAT#1440,8398.0,5458.7,1410.86,8398.0,33
CDM,27407335,HEARTMATE MODULAR CABLE CAT#10652US,6682.0,4343.3,1122.58,6013.8,29
CDM,27407335_OP,HEARTMATE MODULAR CABLE CAT#10652US,6682.0,4343.3,4343.3,6548.36,6
CDM,27407345,HEARTMATE TRAVEL CASE CAT#1260,224.0,145.6,37.63,201.6,27
CDM,27407355,HEARTMATE 14 VOLT LI-ION BATTERIES SET OF 4 CAT#2465,2916.0,1895.4,489.89,2624.4,30
CDM,27407365,HEARTMATE 14 VOLT LI-ION BATTERY CLIPS SET OF 2 CAT#2865,1426.0,926.9,239.57,1283.4,27
CDM,27407405,HEARTMATE STANDALONE BACK-UP BATTERY CAT#106128,750.0,487.5,126.0,675.0,20
CDM,27407405_IP,HEARTMATE STANDALONE BACK-UP BATTERY CAT#106128,750.0,487.5,270.75,270.75,3
CDM,27407405_OP,HEARTMATE STANDALONE BACK-UP BATTERY CAT#106128,750.0,487.5,487.5,735.0,6
CDM,27407475,LVAD DRIVELINE CARE KIT PACK MCS (DAILY) CAT#SBA29VACCG,22.0,14.3,3.7,19.8,20
CDM,27407475_IP,LVAD DRIVELINE CARE KIT PACK MCS (DAILY) CAT#SBA29VACCG,22.0,14.3,7.94,7.94,3
CDM,27407475_OP,LVAD DRIVELINE CARE KIT PACK MCS (DAILY) CAT#SBA29VACCG,22.0,14.3,14.3,21.56,6
CDM,27407485,LVAD DRIVELINE CARE KIT PACK MCS (BIWEEKLY) CAT#03-6487,24.0,15.6,4.03,21.6,20
CDM,27407485_IP,LVAD DRIVELINE CARE KIT PACK MCS (BIWEEKLY) CAT#03-6487,24.0,15.6,8.66,8.66,3
CDM,27407485_OP,LVAD DRIVELINE CARE KIT PACK MCS (BIWEEKLY) CAT#03-6487,24.0,15.6,15.6,23.52,6
CDM,27407575,DEV LVAD HRTMT 3 EMER PWR 106531US,11000.0,7150.0,1848.0,11000.0,29
CDM,27407575_OP,DEV LVAD HRTMT 3 EMER PWR 106531US,11000.0,7150.0,7150.0,10780.0,6
CDM,27407605,FO STATIC FINGER CUSTOM,25.0,16.25,4.2,22.5,20
CDM,27407605_IP,FO STATIC FINGER CUSTOM,25.0,16.25,9.03,9.03,3
CDM,27407605_OP,FO STATIC FINGER CUSTOM,25.0,16.25,16.25,24.5,6
CDM,27407615,"FO STATIC-PROGRESSIVE, DYNAMIC CUSTOM",266.0,172.9,44.69,239.4,20
CDM,27407615_IP,"FO STATIC-PROGRESSIVE, DYNAMIC CUSTOM",266.0,172.9,96.03,96.03,3
CDM,27407615_OP,"FO STATIC-PROGRESSIVE, DYNAMIC CUSTOM",266.0,172.9,172.9,260.68,6
CDM,27407695,WALKING BOOT MAXTRAX,60.0,39.0,10.08,54.0,20
CDM,27407695_IP,WALKING BOOT MAXTRAX,60.0,39.0,21.66,21.66,3
CDM,27407695_OP,WALKING BOOT MAXTRAX,60.0,39.0,39.0,58.8,6
CDM,27407865,POWER MODULE,11880.0,7722.0,1995.84,11880.0,29
CDM,27407865_OP,POWER MODULE,11880.0,7722.0,7722.0,11642.4,6
CDM,27407875,POCKET CONTROLLER INCLUDING EMERGENCY BACK-UP-BATTERY,8168.0,5309.2,1372.22,8168.0,29
CDM,27407875_OP,POCKET CONTROLLER INCLUDING EMERGENCY BACK-UP-BATTERY,8168.0,5309.2,5309.2,8004.64,6
CDM,27407885,DISPLAY MODULE,18753.0,12189.45,3150.5,18753.0,29
CDM,27407885_OP,DISPLAY MODULE,18753.0,12189.45,12189.45,18377.94,6
CDM,27407895,UNIVERSAL BATTERY CHARGER (UBC),10692.0,6949.8,1796.26,9622.8,29
CDM,27407895_OP,UNIVERSAL BATTERY CHARGER (UBC),10692.0,6949.8,6949.8,10478.16,6
CDM,27407905,14V BATTERY CLIPS (SET OF 2),428.0,278.2,71.9,385.2,20
CDM,27407905_IP,14V BATTERY CLIPS (SET OF 2),428.0,278.2,154.51,154.51,3
CDM,27407905_OP,14V BATTERY CLIPS (SET OF 2),428.0,278.2,278.2,419.44,6
CDM,27407915,"LVAD HOLSTER VEST (SMALL, MEDIUM, LARGE)",652.0,423.8,109.54,586.8,20
CDM,27407915_IP,"LVAD HOLSTER VEST (SMALL, MEDIUM, LARGE)",652.0,423.8,235.37,235.37,3
CDM,27407915_OP,"LVAD HOLSTER VEST (SMALL, MEDIUM, LARGE)",652.0,423.8,423.8,638.96,6
CDM,27407925,LVAD BATTERY HOLSTER,593.0,385.45,99.62,533.7,20
CDM,27407925_IP,LVAD BATTERY HOLSTER,593.0,385.45,214.07,214.07,3
CDM,27407925_OP,LVAD BATTERY HOLSTER,593.0,385.45,385.45,581.14,6
CDM,27407935,"LVAD CONSOLIDATED BAG (RIGHT, LEFT)",488.0,317.2,81.98,439.2,20
CDM,27407935_IP,"LVAD CONSOLIDATED BAG (RIGHT, LEFT)",488.0,317.2,176.17,176.17,3
CDM,27407935_OP,"LVAD CONSOLIDATED BAG (RIGHT, LEFT)",488.0,317.2,317.2,478.24,6
CDM,27407945,LVAD SHOWER BAG,675.0,438.75,113.4,607.5,20
CDM,27407945_IP,LVAD SHOWER BAG,675.0,438.75,243.68,243.68,3
CDM,27407945_OP,LVAD SHOWER BAG,675.0,438.75,438.75,661.5,6
CDM,27407955,BATTERY FOR PNEUMATIC VENTRICULAR ASSIST DEVICE,990.0,643.5,166.32,891.0,20
CDM,27407955_IP,BATTERY FOR PNEUMATIC VENTRICULAR ASSIST DEVICE,990.0,643.5,357.39,357.39,3
CDM,27407955_OP,BATTERY FOR PNEUMATIC VENTRICULAR ASSIST DEVICE,990.0,643.5,643.5,970.2,6
CDM,27407965,BACKUP BATTERY FOR (11V) (FOR CONTROLLER),825.0,536.25,138.6,742.5,20
CDM,27407965_IP,BACKUP BATTERY FOR (11V) (FOR CONTROLLER),825.0,536.25,297.83,297.83,3
CDM,27407965_OP,BACKUP BATTERY FOR (11V) (FOR CONTROLLER),825.0,536.25,536.25,808.5,6
CDM,27407975,14V BATTERIES (SET OF 4),3375.0,2193.75,567.0,3037.5,23
CDM,27407975_IP,14V BATTERIES (SET OF 4),3375.0,2193.75,1218.38,1218.38,3
CDM,27407975_OP,14V BATTERIES (SET OF 4),3375.0,2193.75,2193.75,3307.5,6
CDM,27407985,LVAD STABILIZATION BELT,175.0,113.75,29.4,157.5,20
CDM,27407985_IP,LVAD STABILIZATION BELT,175.0,113.75,63.18,63.18,3
CDM,27407985_OP,LVAD STABILIZATION BELT,175.0,113.75,113.75,171.5,6
CDM,27407995,LVAD TRAVEL BAG,240.0,156.0,40.32,216.0,20
CDM,27407995_IP,LVAD TRAVEL BAG,240.0,156.0,86.64,86.64,3
CDM,27407995_OP,LVAD TRAVEL BAG,240.0,156.0,156.0,235.2,6
CDM,27407WE,REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT,4340.0,2821.0,525.99,4340.0,35
CDM,27408005,POWER MODULE CABLE,1688.0,1097.2,283.58,1519.2,20
CDM,27408005_IP,POWER MODULE CABLE,1688.0,1097.2,609.37,609.37,3
CDM,27408005_OP,POWER MODULE CABLE,1688.0,1097.2,1097.2,1654.24,6
CDM,27408015,"DRIVELINE MANGEMENT SYSTEM (E.G., DRESSINGS)",22.0,14.3,3.7,19.8,20
CDM,27408015_IP,"DRIVELINE MANGEMENT SYSTEM (E.G., DRESSINGS)",22.0,14.3,7.94,7.94,3
CDM,27408015_OP,"DRIVELINE MANGEMENT SYSTEM (E.G., DRESSINGS)",22.0,14.3,14.3,21.56,6
CDM,27409755,FRESNEL PRISM PRESS-ON LENS,44.0,28.6,7.39,44.0,27
CDM,27409WE,RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE,5484.0,3564.6,734.69,5484.0,35
CDM,27412WE,AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE,9896.0,6432.4,1172.07,9896.0,35
CDM,27415WE,OSTEOCHONDRAL KNEE ALLOGRAFT,8000.0,5200.0,977.86,8000.0,35
CDM,27416WE,OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY,5664.0,3681.6,575.2,5664.0,32
CDM,27418WE,ANTERIOR TIBIAL TUBERCLEPLASTY,4640.0,3016.0,616.49,4640.0,35
CDM,27420WE,RCNSTJ DISLOCATING PATELLA,4104.0,2667.6,559.14,4104.0,35
CDM,27422WE,RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL,4084.0,2654.6,558.4,4084.0,35
CDM,27425WE,LATERAL RETINACULAR RELEASE OPEN,2156.0,1401.4,309.04,2156.0,35
CDM,27427WE,LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR,3916.0,2545.4,544.61,3916.0,35
CDM,27428WE,LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR,6232.0,4050.8,761.17,6232.0,35
CDM,27429WE,LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR,7016.0,4560.4,733.17,7016.0,35
CDM,27430WE,QUADRICEPSPLASTY,4064.0,2641.6,519.1,4064.0,35
CDM,27435WE,CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE,4352.0,2828.8,459.11,4352.0,35
CDM,27437WE,ARTHROPLASTY PATELLA W/O PROSTHESIS,3572.0,2321.8,490.31,3572.0,35
CDM,27438WE,ARTHROPLASTY PATELLA W/PROSTHESIS,4756.0,3091.4,640.4,4756.0,35
CDM,27443WE,ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL,5020.0,3263.0,605.57,5020.0,35
CDM,27446WE,ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT,6852.0,4453.8,873.2,6852.0,35
CDM,27447WE,ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS,7840.0,5096.0,992.7,7840.0,35
CDM,27448WE,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/O FIXATION,4640.0,3016.0,605.76,4640.0,35
CDM,27450WE,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION,5844.0,3798.6,743.23,5844.0,35
CDM,27454WE,OSTEOT MLT W/RELIGNMT IMED ROD FEM SHFT,7668.0,4984.2,902.35,7668.0,35
CDM,27455WE,OSTEOT PROX TIBIA FIB EXC/OSTEOT BEFORE EPIPHYSL,5344.0,3473.6,679.9,5344.0,35
CDM,27457WE,OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL,5612.0,3647.8,720.39,5612.0,35
CDM,27458WE,OSTEOT FEMUR UNI INSJ XTRNL CTRLD IMED LNGTH DEV,11726.0,7621.9,1888.03,11726.0,21
CDM,27470WE,RPR NON/MAL FEMUR DSTL H/N W/O GRF,6856.0,4456.4,886.21,6856.0,35
CDM,27472WE,RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE,8237.0,5354.05,954.04,8237.0,35
CDM,27486WE,REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT,8448.0,5491.2,1045.89,8448.0,35
CDM,27487WE,REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE,10844.0,7048.6,1353.22,10844.0,35
CDM,27488WE,RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER,7040.0,4576.0,860.05,7040.0,35
CDM,27495WE,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE FEMUR,6616.0,4300.4,842.09,6616.0,35
CDM,27496WE,DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT,2712.0,1762.8,294.32,2712.0,35
CDM,27497WE,DCMPRN FASCT THIGH&/KNEE DBRDMT MUSCLE&/NERVE,3116.0,2025.4,352.48,3116.0,35
CDM,27498WE,DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS,3464.0,2251.6,397.4,3464.0,35
CDM,27499WE,DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE,3772.0,2451.8,448.08,3772.0,35
CDM,27500010,W DEFIBRILLATOR CONCERTO,36000.0,23400.0,6048.0,32400.0,29
CDM,27500010_OP,W DEFIBRILLATOR CONCERTO,36000.0,23400.0,23400.0,35280.0,6
CDM,27500020,W ICD ATLAS II V-366,36000.0,23400.0,6048.0,32400.0,29
CDM,27500020_OP,W ICD ATLAS II V-366,36000.0,23400.0,23400.0,35280.0,6
CDM,27500030,W ICD CURRENT DR 220736,25800.0,16770.0,4334.4,23220.0,29
CDM,27500030_OP,W ICD CURRENT DR 220736,25800.0,16770.0,16770.0,25284.0,6
CDM,27500040,W LD FNLINEII STRX EZ4472/4473,720.0,468.0,120.96,648.0,20
CDM,27500040_IP,W LD FNLINEII STRX EZ4472/4473,720.0,468.0,259.92,259.92,3
CDM,27500040_OP,W LD FNLINEII STRX EZ4472/4473,720.0,468.0,468.0,705.6,6
CDM,27500050,W LD PM CAPSR FIX,794.0,516.1,133.39,714.6,20
CDM,27500050_IP,W LD PM CAPSR FIX,794.0,516.1,286.63,286.63,3
CDM,27500050_OP,W LD PM CAPSR FIX,794.0,516.1,516.1,778.12,6
CDM,27500060,W LD PM CAPSUR SP,3123.0,2029.95,524.66,2810.7,23
CDM,27500060_IP,W LD PM CAPSUR SP,3123.0,2029.95,1127.4,1127.4,3
CDM,27500060_OP,W LD PM CAPSUR SP,3123.0,2029.95,2029.95,3060.54,6
CDM,27500070,W LD PM CAPSURE,2614.0,1699.1,439.15,2352.6,23
CDM,27500070_IP,W LD PM CAPSURE,2614.0,1699.1,943.65,943.65,3
CDM,27500070_OP,W LD PM CAPSURE,2614.0,1699.1,1699.1,2561.72,6
CDM,27500080,W LD PM ENDOCARDIAL FLEXION,730.0,474.5,122.64,657.0,20
CDM,27500080_IP,W LD PM ENDOCARDIAL FLEXION,730.0,474.5,263.53,263.53,3
CDM,27500080_OP,W LD PM ENDOCARDIAL FLEXION,730.0,474.5,474.5,715.4,6
CDM,27500090,W LD PM FLEXION,2751.0,1788.15,462.17,2475.9,23
CDM,27500090_IP,W LD PM FLEXION,2751.0,1788.15,993.11,993.11,3
CDM,27500090_OP,W LD PM FLEXION,2751.0,1788.15,1788.15,2695.98,6
CDM,27500100,W LD PM SELUTE,2751.0,1788.15,462.17,2475.9,23
CDM,27500100_IP,W LD PM SELUTE,2751.0,1788.15,993.11,993.11,3
CDM,27500100_OP,W LD PM SELUTE,2751.0,1788.15,1788.15,2695.98,6
CDM,27500110,W LD PMDX1336T/52,2227.0,1447.55,374.14,2004.3,23
CDM,27500110_IP,W LD PMDX1336T/52,2227.0,1447.55,803.95,803.95,3
CDM,27500110_OP,W LD PMDX1336T/52,2227.0,1447.55,1447.55,2182.46,6
CDM,27500120,W LD PMDX1388T/85,2227.0,1447.55,374.14,2004.3,23
CDM,27500120_IP,W LD PMDX1388T/85,2227.0,1447.55,803.95,803.95,3
CDM,27500120_OP,W LD PMDX1388T/85,2227.0,1447.55,1447.55,2182.46,6
CDM,27500130,W LD PMSDX1488T52,2227.0,1447.55,374.14,2004.3,23
CDM,27500130_IP,W LD PMSDX1488T52,2227.0,1447.55,803.95,803.95,3
CDM,27500130_OP,W LD PMSDX1488T52,2227.0,1447.55,1447.55,2182.46,6
CDM,27500140,W LEAD ACUITY 4554-4555,4200.0,2730.0,705.6,3780.0,23
CDM,27500140_IP,W LEAD ACUITY 4554-4555,4200.0,2730.0,1516.2,1516.2,3
CDM,27500140_OP,W LEAD ACUITY 4554-4555,4200.0,2730.0,2730.0,4116.0,6
CDM,27500150,W LEAD ACUITY SPIRAL 4591-4593,2350.0,1527.5,394.8,2115.0,23
CDM,27500150_IP,W LEAD ACUITY SPIRAL 4591-4593,2350.0,1527.5,848.35,848.35,3
CDM,27500150_OP,W LEAD ACUITY SPIRAL 4591-4593,2350.0,1527.5,1527.5,2303.0,6
CDM,27500160,W LEAD ADAPTOR 6986,700.0,455.0,117.6,630.0,20
CDM,27500160_IP,W LEAD ADAPTOR 6986,700.0,455.0,252.7,252.7,3
CDM,27500160_OP,W LEAD ADAPTOR 6986,700.0,455.0,455.0,686.0,6
CDM,27500170,W LEAD ADAPTOR 6987,800.0,520.0,134.4,720.0,20
CDM,27500170_IP,W LEAD ADAPTOR 6987,800.0,520.0,288.8,288.8,3
CDM,27500170_OP,W LEAD ADAPTOR 6987,800.0,520.0,520.0,784.0,6
CDM,27500180,W LEAD ATTAIN OTW STARFIX 4195,3000.0,1950.0,504.0,2700.0,23
CDM,27500180_IP,W LEAD ATTAIN OTW STARFIX 4195,3000.0,1950.0,1083.0,1083.0,3
CDM,27500180_OP,W LEAD ATTAIN OTW STARFIX 4195,3000.0,1950.0,1950.0,2940.0,6
CDM,27500200,W LEAD EASYTRAK LFT VENT COR,4200.0,2730.0,705.6,3780.0,23
CDM,27500200_IP,W LEAD EASYTRAK LFT VENT COR,4200.0,2730.0,1516.2,1516.2,3
CDM,27500200_OP,W LEAD EASYTRAK LFT VENT COR,4200.0,2730.0,2730.0,4116.0,6
CDM,27500210,W LEAD ELAFIX P2P 752,1000.0,650.0,168.0,900.0,20
CDM,27500210_IP,W LEAD ELAFIX P2P 752,1000.0,650.0,361.0,361.0,3
CDM,27500210_OP,W LEAD ELAFIX P2P 752,1000.0,650.0,650.0,980.0,6
CDM,27500220,W LEAD ELAFIX P2P 758,1000.0,650.0,168.0,900.0,20
CDM,27500220_IP,W LEAD ELAFIX P2P 758,1000.0,650.0,361.0,361.0,3
CDM,27500220_OP,W LEAD ELAFIX P2P 758,1000.0,650.0,650.0,980.0,6
CDM,27500240,W LEAD PACEMAKER 1699,730.0,474.5,122.64,657.0,20
CDM,27500240_IP,W LEAD PACEMAKER 1699,730.0,474.5,263.53,263.53,3
CDM,27500240_OP,W LEAD PACEMAKER 1699,730.0,474.5,474.5,715.4,6
CDM,27500250,W LEAD PACING DEXTRUS STRD ELUT,720.0,468.0,120.96,648.0,20
CDM,27500250_IP,W LEAD PACING DEXTRUS STRD ELUT,720.0,468.0,259.92,259.92,3
CDM,27500250_OP,W LEAD PACING DEXTRUS STRD ELUT,720.0,468.0,468.0,705.6,6
CDM,27500260,W LEAD PM TENDRIL 1788,730.0,474.5,122.64,657.0,20
CDM,27500260_IP,W LEAD PM TENDRIL 1788,730.0,474.5,263.53,263.53,3
CDM,27500260_OP,W LEAD PM TENDRIL 1788,730.0,474.5,474.5,715.4,6
CDM,27500270,W LEAD PM TENDRIL SDX/STS,544.0,353.6,91.39,489.6,20
CDM,27500270_IP,W LEAD PM TENDRIL SDX/STS,544.0,353.6,196.38,196.38,3
CDM,27500270_OP,W LEAD PM TENDRIL SDX/STS,544.0,353.6,353.6,533.12,6
CDM,27500310,W LEAD QUICKFLEX 1158T,3000.0,1950.0,504.0,2700.0,23
CDM,27500310_IP,W LEAD QUICKFLEX 1158T,3000.0,1950.0,1083.0,1083.0,3
CDM,27500310_OP,W LEAD QUICKFLEX 1158T,3000.0,1950.0,1950.0,2940.0,6
CDM,27500320,W LEAD TENDRIL 1788-52,858.0,557.7,144.14,772.2,20
CDM,27500320_IP,W LEAD TENDRIL 1788-52,858.0,557.7,309.74,309.74,3
CDM,27500320_OP,W LEAD TENDRIL 1788-52,858.0,557.7,557.7,840.84,6
CDM,27500330,PACEMAKER DUAL CHAMBER TIER 0,2674.0,1738.1,449.23,2406.6,23
CDM,27500330_IP,PACEMAKER DUAL CHAMBER TIER 0,2674.0,1738.1,965.31,965.31,3
CDM,27500330_OP,PACEMAKER DUAL CHAMBER TIER 0,2674.0,1738.1,1738.1,2620.52,6
CDM,27500340,W PACEMAKER ACCENT DR 2110,5000.0,3250.0,840.0,4500.0,26
CDM,27500340_OP,W PACEMAKER ACCENT DR 2110,5000.0,3250.0,3250.0,4900.0,6
CDM,27500350,W PACEMAKER CONTAK RENEWAL H120,12600.0,8190.0,2116.8,11340.0,29
CDM,27500350_OP,W PACEMAKER CONTAK RENEWAL H120,12600.0,8190.0,8190.0,12348.0,6
CDM,27500360,W PACEMAKER CONTAK RENEWAL H125,12600.0,8190.0,2116.8,11340.0,29
CDM,27500360_OP,W PACEMAKER CONTAK RENEWAL H125,12600.0,8190.0,8190.0,12348.0,6
CDM,27500370,W PACEMAKER DC ADAPTA ADDRSI,7650.0,4972.5,1285.2,6885.0,29
CDM,27500370_OP,W PACEMAKER DC ADAPTA ADDRSI,7650.0,4972.5,4972.5,7497.0,6
CDM,27500380,W PACEMAKER DC RATE-RESP,17822.0,11584.3,2994.1,16039.8,29
CDM,27500380_OP,W PACEMAKER DC RATE-RESP,17822.0,11584.3,11584.3,17465.56,6
CDM,27500390,W PACEMAKER DC RR$,6600.0,4290.0,1108.8,5940.0,29
CDM,27500390_OP,W PACEMAKER DC RR$,6600.0,4290.0,4290.0,6468.0,6
CDM,27500400,W PACEMAKER DUAL 5326L ST J,18624.0,12105.6,3128.83,16761.6,29
CDM,27500400_OP,W PACEMAKER DUAL 5326L ST J,18624.0,12105.6,12105.6,18251.52,6
CDM,27500410,W PACEMAKER INSYNC III 8042,13600.0,8840.0,2284.8,12240.0,29
CDM,27500410_OP,W PACEMAKER INSYNC III 8042,13600.0,8840.0,8840.0,13328.0,6
CDM,27500420,W PACER DC FRONTIER II 5586,13600.0,8840.0,2284.8,12240.0,29
CDM,27500420_OP,W PACER DC FRONTIER II 5586,13600.0,8840.0,8840.0,13328.0,6
CDM,27500430,W PM ACCENT RF DR,5650.0,3672.5,949.2,5085.0,29
CDM,27500430_OP,W PM ACCENT RF DR,5650.0,3672.5,3672.5,5537.0,6
CDM,27500440,W PM ACCENT SR,4500.0,2925.0,756.0,4050.0,23
CDM,27500440_IP,W PM ACCENT SR,4500.0,2925.0,1624.5,1624.5,3
CDM,27500440_OP,W PM ACCENT SR,4500.0,2925.0,2925.0,4410.0,6
CDM,27500450,W PM ACCENT SR RF,4500.0,2925.0,756.0,4050.0,23
CDM,27500450_IP,W PM ACCENT SR RF,4500.0,2925.0,1624.5,1624.5,3
CDM,27500450_OP,W PM ACCENT SR RF,4500.0,2925.0,2925.0,4410.0,6
CDM,27500460,W PM ADAPTA ADSR01,5300.0,3445.0,890.4,4770.0,29
CDM,27500460_OP,W PM ADAPTA ADSR01,5300.0,3445.0,3445.0,5194.0,6
CDM,27500470,W PM AFNTY 5330L,14546.0,9454.9,2443.73,13091.4,29
CDM,27500470_OP,W PM AFNTY 5330L,14546.0,9454.9,9454.9,14255.08,6
CDM,27500480,W PM AFNTY 5330R,14546.0,9454.9,2443.73,13091.4,29
CDM,27500480_OP,W PM AFNTY 5330R,14546.0,9454.9,9454.9,14255.08,6
CDM,27500490,W PM AFNTY5131M/S,12863.0,8360.95,2160.98,11576.7,29
CDM,27500490_OP,W PM AFNTY5131M/S,12863.0,8360.95,8360.95,12605.74,6
CDM,27500500,W PM ALTRUA 60 DDDR S603,5650.0,3672.5,949.2,5085.0,29
CDM,27500500_OP,W PM ALTRUA 60 DDDR S603,5650.0,3672.5,3672.5,5537.0,6
CDM,27500510,W PM ALTRUA DR S203/S208/S404,5000.0,3250.0,840.0,4500.0,26
CDM,27500510_OP,W PM ALTRUA DR S203/S208/S404,5000.0,3250.0,3250.0,4900.0,6
CDM,27500520,W PM ALTRUA S201,4000.0,2600.0,672.0,3600.0,23
CDM,27500520_IP,W PM ALTRUA S201,4000.0,2600.0,1444.0,1444.0,3
CDM,27500520_OP,W PM ALTRUA S201,4000.0,2600.0,2600.0,3920.0,6
CDM,27500530,W PM ALTRUA S202,5000.0,3250.0,840.0,4500.0,26
CDM,27500530_OP,W PM ALTRUA S202,5000.0,3250.0,3250.0,4900.0,6
CDM,27500540,W PM ALTRUA S204,4000.0,2600.0,672.0,3600.0,23
CDM,27500540_IP,W PM ALTRUA S204,4000.0,2600.0,1444.0,1444.0,3
CDM,27500540_OP,W PM ALTRUA S204,4000.0,2600.0,2600.0,3920.0,6
CDM,27500550,W PM ALTRUA S205,5000.0,3250.0,840.0,4500.0,26
CDM,27500550_OP,W PM ALTRUA S205,5000.0,3250.0,3250.0,4900.0,6
CDM,27500560,W PM ALTRUA S401,4500.0,2925.0,756.0,4050.0,23
CDM,27500560_IP,W PM ALTRUA S401,4500.0,2925.0,1624.5,1624.5,3
CDM,27500560_OP,W PM ALTRUA S401,4500.0,2925.0,2925.0,4410.0,6
CDM,27500570,W PM ALTRUA S402,5000.0,3250.0,840.0,4500.0,26
CDM,27500570_OP,W PM ALTRUA S402,5000.0,3250.0,3250.0,4900.0,6
CDM,27500580,W PM ALTRUA S403,5000.0,3250.0,840.0,4500.0,26
CDM,27500580_OP,W PM ALTRUA S403,5000.0,3250.0,3250.0,4900.0,6
CDM,27500590,W PM ALTRUA S601,4500.0,2925.0,756.0,4050.0,23
CDM,27500590_IP,W PM ALTRUA S601,4500.0,2925.0,1624.5,1624.5,3
CDM,27500590_OP,W PM ALTRUA S601,4500.0,2925.0,2925.0,4410.0,6
CDM,27500600,W PM ALTRUA S602,5650.0,3672.5,949.2,5085.0,29
CDM,27500600_OP,W PM ALTRUA S602,5650.0,3672.5,3672.5,5537.0,6
CDM,27500610,W PM ALTRUA S606 DC IS-1,5650.0,3672.5,949.2,5085.0,29
CDM,27500610_OP,W PM ALTRUA S606 DC IS-1,5650.0,3672.5,3672.5,5537.0,6
CDM,27500620,W PM ANTHEM CRT,13200.0,8580.0,2217.6,11880.0,29
CDM,27500620_OP,W PM ANTHEM CRT,13200.0,8580.0,8580.0,12936.0,6
CDM,27500630,W PM DC DISCOVERY,19118.0,12426.7,3211.82,17206.2,29
CDM,27500630_OP,W PM DC DISCOVERY,19118.0,12426.7,12426.7,18735.64,6
CDM,27500640,W PM DC DR ADAPTA,7650.0,4972.5,1285.2,6885.0,29
CDM,27500640_OP,W PM DC DR ADAPTA,7650.0,4972.5,4972.5,7497.0,6
CDM,27500650,W PM DC ELA BR112,13307.0,8649.55,2235.58,11976.3,29
CDM,27500650_OP,W PM DC ELA BR112,13307.0,8649.55,8649.55,13040.86,6
CDM,27500660,W PM DC IDENTITY ADX,15982.0,10388.3,2684.98,14383.8,29
CDM,27500660_OP,W PM DC IDENTITY ADX,15982.0,10388.3,10388.3,15662.36,6
CDM,27500670,W PM DC PULSR MAX,18624.0,12105.6,3128.83,16761.6,29
CDM,27500670_OP,W PM DC PULSR MAX,18624.0,12105.6,12105.6,18251.52,6
CDM,27500680,W PM DC RR ATR/VNT BI/UNI,15982.0,10388.3,2684.98,14383.8,29
CDM,27500680_OP,W PM DC RR ATR/VNT BI/UNI,15982.0,10388.3,10388.3,15662.36,6
CDM,27500690,W PM DC RR DISCOVERY II,9375.0,6093.75,1575.0,8437.5,29
CDM,27500690_OP,W PM DC RR DISCOVERY II,9375.0,6093.75,6093.75,9187.5,6
CDM,27500700,W PM DC RR ENPULSE 2,16000.0,10400.0,2688.0,14400.0,29
CDM,27500700_OP,W PM DC RR ENPULSE 2,16000.0,10400.0,10400.0,15680.0,6
CDM,27500710,W PM DC RR ENRYTHM P1501DR,6300.0,4095.0,1058.4,5670.0,29
CDM,27500710_OP,W PM DC RR ENRYTHM P1501DR,6300.0,4095.0,4095.0,6174.0,6
CDM,27500720,W PM DC RR ENTRA INSIGNIA 1295,10875.0,7068.75,1827.0,9787.5,29
CDM,27500720_OP,W PM DC RR ENTRA INSIGNIA 1295,10875.0,7068.75,7068.75,10657.5,6
CDM,27500730,W PM DC RR INSIGNA ENTR DR,10875.0,7068.75,1827.0,9787.5,29
CDM,27500730_OP,W PM DC RR INSIGNA ENTR DR,10875.0,7068.75,7068.75,10657.5,6
CDM,27500740,W PM DC RR INSIGNA PLUS,10875.0,7068.75,1827.0,9787.5,29
CDM,27500740_OP,W PM DC RR INSIGNA PLUS,10875.0,7068.75,7068.75,10657.5,6
CDM,27500750,W PM DC RR INSIGNA SR,10875.0,7068.75,1827.0,9787.5,29
CDM,27500750_OP,W PM DC RR INSIGNA SR,10875.0,7068.75,7068.75,10657.5,6
CDM,27500760,W PM DC RR INSIGNA ULTRA,7000.0,4550.0,1176.0,6300.0,29
CDM,27500760_OP,W PM DC RR INSIGNA ULTRA,7000.0,4550.0,4550.0,6860.0,6
CDM,27500770,W PM DC RR INSIGNA ULTRA DR,7000.0,4550.0,1176.0,6300.0,29
CDM,27500770_OP,W PM DC RR INSIGNA ULTRA DR,7000.0,4550.0,4550.0,6860.0,6
CDM,27500780,W PM DC RR KAPPA KDR701,15750.0,10237.5,2646.0,14175.0,29
CDM,27500780_OP,W PM DC RR KAPPA KDR701,15750.0,10237.5,10237.5,15435.0,6
CDM,27500790,W PM DC RR KAPPA KDR901,14750.0,9587.5,2478.0,13275.0,29
CDM,27500790_OP,W PM DC RR KAPPA KDR901,14750.0,9587.5,9587.5,14455.0,6
CDM,27500800,W PM DC RR VICTORY DR,6600.0,4290.0,1108.8,5940.0,29
CDM,27500800_OP,W PM DC RR VICTORY DR,6600.0,4290.0,4290.0,6468.0,6
CDM,27500810,W PM DC RR VITATRON,16000.0,10400.0,2688.0,14400.0,29
CDM,27500810_OP,W PM DC RR VITATRON,16000.0,10400.0,10400.0,15680.0,6
CDM,27500820,W PM DC VERSA VEDR01,6450.0,4192.5,1083.6,5805.0,29
CDM,27500820_OP,W PM DC VERSA VEDR01,6450.0,4192.5,4192.5,6321.0,6
CDM,27500830,W PM DC ZEPHYR,5800.0,3770.0,974.4,5220.0,29
CDM,27500830_OP,W PM DC ZEPHYR,5800.0,3770.0,3770.0,5684.0,6
CDM,27500840,W PM DR INTEGRITY,16931.0,11005.15,2844.41,15237.9,29
CDM,27500840_OP,W PM DR INTEGRITY,16931.0,11005.15,11005.15,16592.38,6
CDM,27500850,W PM INSYNC III DC 8042,16200.0,10530.0,2721.6,14580.0,29
CDM,27500850_OP,W PM INSYNC III DC 8042,16200.0,10530.0,10530.0,15876.0,6
CDM,27500860,W PM INTG AFX5342,15445.0,10039.25,2594.76,13900.5,29
CDM,27500860_OP,W PM INTG AFX5342,15445.0,10039.25,10039.25,15136.1,6
CDM,27500870,W PM INTG SR 5142,14257.0,9267.05,2395.18,12831.3,29
CDM,27500870_OP,W PM INTG SR 5142,14257.0,9267.05,9267.05,13971.86,6
CDM,27500880,W PM KAPPA 700DR,19010.0,12356.5,3193.68,17109.0,29
CDM,27500880_OP,W PM KAPPA 700DR,19010.0,12356.5,12356.5,18629.8,6
CDM,27500890,W PM KAPPA 700SR,16992.0,11044.8,2854.66,15292.8,29
CDM,27500890_OP,W PM KAPPA 700SR,16992.0,11044.8,11044.8,16652.16,6
CDM,27500900,W PM NOT SC/DC,28812.0,18727.8,4840.42,25930.8,29
CDM,27500900_OP,W PM NOT SC/DC,28812.0,18727.8,18727.8,28235.76,6
CDM,27500910,W PM PULSAR DDD,17588.0,11432.2,2954.78,15829.2,29
CDM,27500910_OP,W PM PULSAR DDD,17588.0,11432.2,11432.2,17236.24,6
CDM,27500920,W PM SC DSCVRY SR,18201.0,11830.65,3057.77,16380.9,29
CDM,27500920_OP,W PM SC DSCVRY SR,18201.0,11830.65,11830.65,17836.98,6
CDM,27500930,W PM SC INTEGRITY,14257.0,9267.05,2395.18,12831.3,29
CDM,27500930_OP,W PM SC INTEGRITY,14257.0,9267.05,9267.05,13971.86,6
CDM,27500940,W PM SC NRATE-RES,10396.0,6757.4,1746.53,9356.4,29
CDM,27500940_OP,W PM SC NRATE-RES,10396.0,6757.4,6757.4,10188.08,6
CDM,27500950,W PM SC RATE-RESP,13069.0,8494.85,2195.59,11762.1,29
CDM,27500950_OP,W PM SC RATE-RESP,13069.0,8494.85,8494.85,12807.62,6
CDM,27500960,W PM SC RR ATR/VNT BI,11750.0,7637.5,1974.0,10575.0,29
CDM,27500960_OP,W PM SC RR ATR/VNT BI,11750.0,7637.5,7637.5,11515.0,6
CDM,27500970,W PM SC RR IDENTITY ADX,5700.0,3705.0,957.6,5130.0,29
CDM,27500970_OP,W PM SC RR IDENTITY ADX,5700.0,3705.0,3705.0,5586.0,6
CDM,27500980,W PM SC RR INSIGNA,8625.0,5606.25,1449.0,7762.5,29
CDM,27500980_OP,W PM SC RR INSIGNA,8625.0,5606.25,5606.25,8452.5,6
CDM,27500990,W PM SC RR INSIGNA ENTR,8625.0,5606.25,1449.0,7762.5,29
CDM,27500990_OP,W PM SC RR INSIGNA ENTR,8625.0,5606.25,5606.25,8452.5,6
CDM,27500WE,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,2520.0,1638.0,309.57,1890.0,35
CDM,27501000,W PM SC RR INSIGNA ENTR 5/6,8625.0,5606.25,1449.0,7762.5,29
CDM,27501000_OP,W PM SC RR INSIGNA ENTR 5/6,8625.0,5606.25,5606.25,8452.5,6
CDM,27501010,W PM SC RR INSIGNIA ULTRA,10250.0,6662.5,1722.0,9225.0,29
CDM,27501010_OP,W PM SC RR INSIGNIA ULTRA,10250.0,6662.5,6662.5,10045.0,6
CDM,27501020,W PM SC SR1180,15223.0,9894.95,2557.46,13700.7,29
CDM,27501020_OP,W PM SC SR1180,15223.0,9894.95,9894.95,14918.54,6
CDM,27501030,W PM SENSIA DR,5800.0,3770.0,974.4,5220.0,29
CDM,27501030_OP,W PM SENSIA DR,5800.0,3770.0,3770.0,5684.0,6
CDM,27501040,W PM SENSIA SESR01,5300.0,3445.0,890.4,4770.0,29
CDM,27501040_OP,W PM SENSIA SESR01,5300.0,3445.0,3445.0,5194.0,6
CDM,27501050,W PM SYMPHONY DR 2550,7000.0,4550.0,1176.0,6300.0,29
CDM,27501050_OP,W PM SYMPHONY DR 2550,7000.0,4550.0,4550.0,6860.0,6
CDM,27501060,W PM TEMPO VR1102,10876.0,7069.4,1827.17,9788.4,29
CDM,27501060_OP,W PM TEMPO VR1102,10876.0,7069.4,7069.4,10658.48,6
CDM,27501070,W PM VICTORY SC5610 ST JUDE,5700.0,3705.0,957.6,5130.0,29
CDM,27501070_OP,W PM VICTORY SC5610 ST JUDE,5700.0,3705.0,3705.0,5586.0,6
CDM,27501080,W PM ZEPHYR 5820,5000.0,3250.0,840.0,4500.0,26
CDM,27501080_OP,W PM ZEPHYR 5820,5000.0,3250.0,3250.0,4900.0,6
CDM,27501090,W PM ZEPHYR SR,4500.0,2925.0,756.0,4050.0,23
CDM,27501090_IP,W PM ZEPHYR SR,4500.0,2925.0,1624.5,1624.5,3
CDM,27501090_OP,W PM ZEPHYR SR,4500.0,2925.0,2925.0,4410.0,6
CDM,27501150,PACEMAKER CONSULTA CRT-P,14000.0,9100.0,2352.0,12600.0,29
CDM,27501150_OP,PACEMAKER CONSULTA CRT-P,14000.0,9100.0,9100.0,13720.0,6
CDM,27501160,W PM REVO SURESCAN DC RR,7850.0,5102.5,1318.8,7065.0,29
CDM,27501160_OP,W PM REVO SURESCAN DC RR,7850.0,5102.5,5102.5,7693.0,6
CDM,27501180,W PM INGENIO DDDR RF PPM,6850.0,4452.5,1150.8,6165.0,29
CDM,27501180_OP,W PM INGENIO DDDR RF PPM,6850.0,4452.5,4452.5,6713.0,6
CDM,27501190,W PM INVIVE IS-1 CONN RSYN,13200.0,8580.0,2217.6,11880.0,29
CDM,27501190_OP,W PM INVIVE IS-1 CONN RSYN,13200.0,8580.0,8580.0,12936.0,6
CDM,27501200,W PM ADVANTIO SR K062,4500.0,2925.0,756.0,4050.0,23
CDM,27501200_IP,W PM ADVANTIO SR K062,4500.0,2925.0,1624.5,1624.5,3
CDM,27501200_OP,W PM ADVANTIO SR K062,4500.0,2925.0,2925.0,4410.0,6
CDM,27501220,W PM ADVANTIO DR K063,5650.0,3672.5,949.2,5085.0,29
CDM,27501220_OP,W PM ADVANTIO DR K063,5650.0,3672.5,3672.5,5537.0,6
CDM,27501230,W PM ADVISA DR MRI,8250.0,5362.5,1386.0,7425.0,29
CDM,27501230_OP,W PM ADVISA DR MRI,8250.0,5362.5,5362.5,8085.0,6
CDM,27501240,W PM INGENIO CHMBR IS-1,4400.0,2860.0,739.2,3960.0,23
CDM,27501240_IP,W PM INGENIO CHMBR IS-1,4400.0,2860.0,1588.4,1588.4,3
CDM,27501240_OP,W PM INGENIO CHMBR IS-1,4400.0,2860.0,2860.0,4312.0,6
CDM,27501250,W PM EVIA DR-T 2CH,5650.0,3672.5,949.2,5085.0,29
CDM,27501250_OP,W PM EVIA DR-T 2CH,5650.0,3672.5,3672.5,5537.0,6
CDM,27501260,W LEAD PACE SETROX S BRDYCRD,720.0,468.0,120.96,648.0,20
CDM,27501260_IP,W LEAD PACE SETROX S BRDYCRD,720.0,468.0,259.92,259.92,3
CDM,27501260_OP,W LEAD PACE SETROX S BRDYCRD,720.0,468.0,468.0,705.6,6
CDM,27501270,W PM ALLURE QUADRA RF,7600.0,4940.0,1276.8,6840.0,29
CDM,27501270_OP,W PM ALLURE QUADRA RF,7600.0,4940.0,4940.0,7448.0,6
CDM,27501280,W PM ASSURITY DR,4000.0,2600.0,672.0,3600.0,23
CDM,27501280_IP,W PM ASSURITY DR,4000.0,2600.0,1444.0,1444.0,3
CDM,27501280_OP,W PM ASSURITY DR,4000.0,2600.0,2600.0,3920.0,6
CDM,27501290,W PM ASSURITY SR VVIR,4400.0,2860.0,739.2,3960.0,23
CDM,27501290_IP,W PM ASSURITY SR VVIR,4400.0,2860.0,1588.4,1588.4,3
CDM,27501290_OP,W PM ASSURITY SR VVIR,4400.0,2860.0,2860.0,4312.0,6
CDM,27501300,W PACEMAKER INTUA CRT-P IS-1,9800.0,6370.0,1646.4,8820.0,29
CDM,27501300_OP,W PACEMAKER INTUA CRT-P IS-1,9800.0,6370.0,6370.0,9604.0,6
CDM,27501310,W PACEMKR ACCOLDE 2CH IS CONN,4224.0,2745.6,709.63,3801.6,23
CDM,27501310_IP,W PACEMKR ACCOLDE 2CH IS CONN,4224.0,2745.6,1524.86,1524.86,3
CDM,27501310_OP,W PACEMKR ACCOLDE 2CH IS CONN,4224.0,2745.6,2745.6,4139.52,6
CDM,27501315,"QUADRA ALLURE MP CARDIAC RESYNCH THERAPY DEVICE, PULSE GEN DDDRV",7900.0,5135.0,1327.2,7110.0,29
CDM,27501315_OP,"QUADRA ALLURE MP CARDIAC RESYNCH THERAPY DEVICE, PULSE GEN DDDRV",7900.0,5135.0,5135.0,7742.0,6
CDM,27501320,W PM ELUNA DR PROMRI UNI/BI,8730.0,5674.5,1466.64,7857.0,29
CDM,27501320_OP,W PM ELUNA DR PROMRI UNI/BI,8730.0,5674.5,5674.5,8555.4,6
CDM,27501325,MICRA AV2 DUAL CHAMBER TRANSCATHETER PACING SYSTEM,24440.0,15886.0,4105.92,21996.0,29
CDM,27501325_OP,MICRA AV2 DUAL CHAMBER TRANSCATHETER PACING SYSTEM,24440.0,15886.0,15886.0,23951.2,6
CDM,27501330,W PACEMKR ACCLDE 1 CHMBR IS-1,3344.0,2173.6,561.79,3009.6,23
CDM,27501330_IP,W PACEMKR ACCLDE 1 CHMBR IS-1,3344.0,2173.6,1207.18,1207.18,3
CDM,27501330_OP,W PACEMKR ACCLDE 1 CHMBR IS-1,3344.0,2173.6,2173.6,3277.12,6
CDM,27501340,W ICD GENRTR PACEMKR 83.1X69,3400.0,2210.0,571.2,3060.0,23
CDM,27501340_IP,W ICD GENRTR PACEMKR 83.1X69,3400.0,2210.0,1227.4,1227.4,3
CDM,27501340_OP,W ICD GENRTR PACEMKR 83.1X69,3400.0,2210.0,2210.0,3332.0,6
CDM,27501350,W PM ESSENTIO DC DR,3608.0,2345.2,606.14,3247.2,23
CDM,27501350_IP,W PM ESSENTIO DC DR,3608.0,2345.2,1302.49,1302.49,3
CDM,27501350_OP,W PM ESSENTIO DC DR,3608.0,2345.2,2345.2,3535.84,6
CDM,27501360,W PM VALITUDE X4 IS-4,8624.0,5605.6,1448.83,7761.6,29
CDM,27501360_OP,W PM VALITUDE X4 IS-4,8624.0,5605.6,5605.6,8451.52,6
CDM,27501365,PACEMAKER TRANSCATHETER DUAL CHAMBER MICRA AV VDD,26500.0,17225.0,4452.0,23850.0,29
CDM,27501365_OP,PACEMAKER TRANSCATHETER DUAL CHAMBER MICRA AV VDD,26500.0,17225.0,17225.0,25970.0,6
CDM,27501370,W PM CARD ADVISA SR MR,6800.0,4420.0,1142.4,6120.0,29
CDM,27501370_OP,W PM CARD ADVISA SR MR,6800.0,4420.0,4420.0,6664.0,6
CDM,27501375,MICRA VR2 DUAL CHAMBER TRANSCATHETER PACING SYSTEM,18820.0,12233.0,3161.76,16938.0,29
CDM,27501375_OP,MICRA VR2 DUAL CHAMBER TRANSCATHETER PACING SYSTEM,18820.0,12233.0,12233.0,18443.6,6
CDM,27501380,W LEAD PM SELECTSECURE,794.0,516.1,133.39,714.6,20
CDM,27501380_IP,W LEAD PM SELECTSECURE,794.0,516.1,286.63,286.63,3
CDM,27501380_OP,W LEAD PM SELECTSECURE,794.0,516.1,516.1,778.12,6
CDM,27501385,ULTIPACE PACING LEAD,500.0,325.0,84.0,450.0,20
CDM,27501385_IP,ULTIPACE PACING LEAD,500.0,325.0,180.5,180.5,3
CDM,27501385_OP,ULTIPACE PACING LEAD,500.0,325.0,325.0,490.0,6
CDM,27501390,W LEAD PM INGEVITY MRI IS-1,680.0,442.0,114.24,612.0,20
CDM,27501390_IP,W LEAD PM INGEVITY MRI IS-1,680.0,442.0,245.48,245.48,3
CDM,27501390_OP,W LEAD PM INGEVITY MRI IS-1,680.0,442.0,442.0,666.4,6
CDM,27501395,CARDIAC RESYNCHRONIZATION THERAPY PACEMAKER,11136.0,7238.4,1870.85,10022.4,29
CDM,27501395_OP,CARDIAC RESYNCHRONIZATION THERAPY PACEMAKER,11136.0,7238.4,7238.4,10913.28,6
CDM,27501400,W PM ACCOLADE/ESSNT DR EL MRI,6100.0,3965.0,1024.8,5490.0,29
CDM,27501400_OP,W PM ACCOLADE/ESSNT DR EL MRI,6100.0,3965.0,3965.0,5978.0,6
CDM,27501410,W PM ESSENTIO SR MRI,5168.0,3359.2,868.22,4651.2,29
CDM,27501410_OP,W PM ESSENTIO SR MRI,5168.0,3359.2,3359.2,5064.64,6
CDM,27501420,W PM ESSENTIO DR MRI,5608.0,3645.2,942.14,5047.2,29
CDM,27501420_OP,W PM ESSENTIO DR MRI,5608.0,3645.2,3645.2,5495.84,6
CDM,27501430,W PM MICRA LEADLESS,22500.0,14625.0,3780.0,20250.0,29
CDM,27501430_OP,W PM MICRA LEADLESS,22500.0,14625.0,14625.0,22050.0,6
CDM,27501440,W PACEMKR ACCOLADE SR MRI,5344.0,3473.6,897.79,4809.6,29
CDM,27501440_OP,W PACEMKR ACCOLADE SR MRI,5344.0,3473.6,3473.6,5237.12,6
CDM,27501450,W LEAD PACE 45CM ATR VENT BPLR,794.0,516.1,133.39,714.6,20
CDM,27501450_IP,W LEAD PACE 45CM ATR VENT BPLR,794.0,516.1,286.63,286.63,3
CDM,27501450_OP,W LEAD PACE 45CM ATR VENT BPLR,794.0,516.1,516.1,778.12,6
CDM,27501460,W PACEMAKER INTUA CRT P LV1,8624.0,5605.6,1448.83,7761.6,29
CDM,27501460_OP,W PACEMAKER INTUA CRT P LV1,8624.0,5605.6,5605.6,8451.52,6
CDM,27501470,W PACEMAKER VIVA CRT-P,13700.0,8905.0,2301.6,12330.0,29
CDM,27501470_OP,W PACEMAKER VIVA CRT-P,13700.0,8905.0,8905.0,13426.0,6
CDM,27501505,"CAPSURE SENSE, TRANSVENOUS TINED PACING LEAD, STERIOD ELUTING, B",850.0,552.5,142.8,765.0,20
CDM,27501505_IP,"CAPSURE SENSE, TRANSVENOUS TINED PACING LEAD, STERIOD ELUTING, B",850.0,552.5,306.85,306.85,3
CDM,27501505_OP,"CAPSURE SENSE, TRANSVENOUS TINED PACING LEAD, STERIOD ELUTING, B",850.0,552.5,552.5,833.0,6
CDM,27501515,AVEIR LEADLESS AR PACEMAKER,25300.0,16445.0,4250.4,22770.0,33
CDM,27501525,AVEIR LEADLESS DUAL PACEMAKER,41300.0,26845.0,6938.4,37170.0,33
CDM,27501535,ISOFLEX OPTIM PASSIVE-FIXATION LEAD BIPOLAR J-SHAPED IS-1 7FR X,604.0,392.6,101.47,543.6,27
CDM,27501545,AVEIR LEADLESS VENTRICAL PACEMAKER,16000.0,10400.0,2688.0,14400.0,33
CDM,27501565,AVEIR DUAL CHAMBER LEADLESS PACEMAKER SYSTEM MFG DR-SYSTEM-AVEIR,41300.0,26845.0,6938.4,37170.0,33
CDM,27501575,AVEIR AR LEADLESS PACER SYSTEM MFG AR-SYSTEM-AVEIR,25300.0,16445.0,4250.4,22770.0,33
CDM,27501585,AVEIR VR LEADLESS PACER SYSTEM MFG VR-SYSTEM-AVEIR,16000.0,10400.0,2688.0,14400.0,33
CDM,27501745,S DX 65/15 PAMIRA ICD LEAD,4600.0,2990.0,772.8,4140.0,30
CDM,27501WE,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,2580.0,1677.0,333.39,1935.0,35
CDM,27502495,"AICD, DUAL C1721 9000",18000.0,11700.0,3024.0,16200.0,29
CDM,27502495_OP,"AICD, DUAL C1721 9000",18000.0,11700.0,11700.0,17640.0,6
CDM,27502WE,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,4544.0,2953.6,509.11,4544.0,35
CDM,27503WE,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,4508.0,2930.2,509.41,4508.0,35
CDM,27504385,MICRA AV LEADLESS PACEMAKER,24440.0,15886.0,4105.92,21996.0,29
CDM,27504385_OP,MICRA AV LEADLESS PACEMAKER,24440.0,15886.0,15886.0,23951.2,6
CDM,27504405,LEAD PM CAPSUREFIX,794.0,516.1,133.39,714.6,20
CDM,27504405_IP,LEAD PM CAPSUREFIX,794.0,516.1,286.63,286.63,3
CDM,27504405_OP,LEAD PM CAPSUREFIX,794.0,516.1,516.1,778.12,6
CDM,27504415,PACEMKR AZURE XT DR MRI,8036.0,5223.4,1350.05,7232.4,29
CDM,27504415_OP,PACEMKR AZURE XT DR MRI,8036.0,5223.4,5223.4,7875.28,6
CDM,27504425,PACEMKR SERENA MRI QUAD DF,12650.0,8222.5,2125.2,11385.0,29
CDM,27504425_OP,PACEMKR SERENA MRI QUAD DF,12650.0,8222.5,8222.5,12397.0,6
CDM,27504435,PACEMKR PERCEPTA MRI QUAD DF,12936.0,8408.4,2173.25,11642.4,29
CDM,27504435_OP,PACEMKR PERCEPTA MRI QUAD DF,12936.0,8408.4,8408.4,12677.28,6
CDM,27504455,LEAD PACE STR ATR MRI,680.0,442.0,114.24,612.0,20
CDM,27504455_IP,LEAD PACE STR ATR MRI,680.0,442.0,245.48,245.48,3
CDM,27504455_OP,LEAD PACE STR ATR MRI,680.0,442.0,442.0,666.4,6
CDM,27504465,LEAD PACE ATR TRNSVEN BPLR,810.0,526.5,136.08,729.0,20
CDM,27504465_IP,LEAD PACE ATR TRNSVEN BPLR,810.0,526.5,292.41,292.41,3
CDM,27504465_OP,LEAD PACE ATR TRNSVEN BPLR,810.0,526.5,526.5,793.8,6
CDM,27504475,PACEMKR AZURE XT SR MRI,6664.0,4331.6,1119.55,5997.6,29
CDM,27504475_OP,PACEMKR AZURE XT SR MRI,6664.0,4331.6,4331.6,6530.72,6
CDM,27505105,DEFIBRILLATORS & LEADSMOMENTUM EL ICD DR,21600.0,14040.0,3628.8,19440.0,29
CDM,27505105_OP,DEFIBRILLATORS & LEADSMOMENTUM EL ICD DR,21600.0,14040.0,14040.0,21168.0,6
CDM,27505115,DEFIBRILLATORS & LEADS?COBALT DF4 DUAL CHAMBER,28841.0,18746.65,4845.29,25956.9,29
CDM,27505115_OP,DEFIBRILLATORS & LEADS?COBALT DF4 DUAL CHAMBER,28841.0,18746.65,18746.65,28264.18,6
CDM,27505135,COBALT XT QUAD CRT-D (W/ PERFORMA LV LEAD),42100.0,27365.0,7072.8,37890.0,29
CDM,27505135_OP,COBALT XT QUAD CRT-D (W/ PERFORMA LV LEAD),42100.0,27365.0,24857.3,37477.16,6
CDM,27505145,ATTAIN STABILITY QUAD MRI SURESCAN LV PACING LEAD,3862.0,2510.3,648.82,3475.8,23
CDM,27505145_IP,ATTAIN STABILITY QUAD MRI SURESCAN LV PACING LEAD,3862.0,2510.3,1394.18,1394.18,3
CDM,27505145_OP,ATTAIN STABILITY QUAD MRI SURESCAN LV PACING LEAD,3862.0,2510.3,2510.3,3784.76,6
CDM,27505155,"GALLANT DR ICD, SINGLE",19400.0,12610.0,3259.2,17460.0,29
CDM,27505155_OP,"GALLANT DR ICD, SINGLE",19400.0,12610.0,12610.0,19012.0,6
CDM,27505165,GALLANT HF CRT-D,19400.0,12610.0,3259.2,17460.0,29
CDM,27505165_OP,GALLANT HF CRT-D,19400.0,12610.0,12610.0,19012.0,6
CDM,27505175,COBALT DF1 HF CARDIAC RESYNCHRO THERAPY DEFIB,38242.0,24857.3,6424.66,34417.8,29
CDM,27505175_OP,COBALT DF1 HF CARDIAC RESYNCHRO THERAPY DEFIB,38242.0,24857.3,24857.3,37477.16,6
CDM,27505185,LEADS ICD RV LEAD,6174.0,4013.1,1037.23,5556.6,29
CDM,27505185_OP,LEADS ICD RV LEAD,6174.0,4013.1,4013.1,6050.52,6
CDM,27505195,RESONATE EL ICD VR SINGLE CHAMBER ICD,19114.0,12424.1,3211.15,17202.6,29
CDM,27505195_OP,RESONATE EL ICD VR SINGLE CHAMBER ICD,19114.0,12424.1,12424.1,18731.72,6
CDM,27505205,"COBALT DR MRI SURESCAN ICD, IS1, DF4",26460.0,17199.0,4445.28,23814.0,29
CDM,27505205_OP,"COBALT DR MRI SURESCAN ICD, IS1, DF4",26460.0,17199.0,17199.0,25930.8,6
CDM,27505215,PACEMAKER COBALT HF CARDIAC 2 CHAMBER,35084.0,22804.6,5894.11,31575.6,29
CDM,27505215_OP,PACEMAKER COBALT HF CARDIAC 2 CHAMBER,35084.0,22804.6,22804.6,34382.32,6
CDM,27505225,PACEMAKER QUADRA ALLURE MP BIVEN PULSE GEN 2 CHAMBER,9478.0,6160.7,1592.3,8530.2,29
CDM,27505225_OP,PACEMAKER QUADRA ALLURE MP BIVEN PULSE GEN 2 CHAMBER,9478.0,6160.7,6160.7,9288.44,6
CDM,27505235,DEFIB COBALT XT 57SQ CM 13MM TIT DIOX POLYUR,24141.0,15691.65,4055.69,21726.9,29
CDM,27505235_OP,DEFIB COBALT XT 57SQ CM 13MM TIT DIOX POLYUR,24141.0,15691.65,15691.65,23658.18,6
CDM,27505245,VIGILANT X4 CRT D CARDIAC RESYNCH DEFIB,26736.0,17378.4,4491.65,24062.4,29
CDM,27505245_OP,VIGILANT X4 CRT D CARDIAC RESYNCH DEFIB,26736.0,17378.4,17378.4,26201.28,6
CDM,27505275,LEAD PACE ACTY X4 STP SPR 95CM,2450.0,1592.5,411.6,2205.0,23
CDM,27505275_IP,LEAD PACE ACTY X4 STP SPR 95CM,2450.0,1592.5,884.45,884.45,3
CDM,27505275_OP,LEAD PACE ACTY X4 STP SPR 95CM,2450.0,1592.5,1592.5,2401.0,6
CDM,27505285,"VISIONIST X4 CRT-P, MODEL U228",10124.0,6580.6,1700.83,9111.6,29
CDM,27505285_OP,"VISIONIST X4 CRT-P, MODEL U228",10124.0,6580.6,6580.6,9921.52,6
CDM,27505375,COBALT QUAD MRI SURESCAN,35084.0,22804.6,5894.11,31575.6,29
CDM,27505375_OP,COBALT QUAD MRI SURESCAN,35084.0,22804.6,22804.6,34382.32,6
CDM,27505385,CRD-T DEFIBRILLATOR,26736.0,17378.4,4491.65,24062.4,29
CDM,27505385_OP,CRD-T DEFIBRILLATOR,26736.0,17378.4,17378.4,26201.28,6
CDM,27505395,DEFIBRILLATOR VIGILANT,14114.0,9174.1,2371.15,12702.6,29
CDM,27505395_OP,DEFIBRILLATOR VIGILANT,14114.0,9174.1,9174.1,13831.72,6
CDM,27505405,SOLIA S 53 PACEMAKER LEAD,563.0,365.95,94.58,506.7,20
CDM,27505405_IP,SOLIA S 53 PACEMAKER LEAD,563.0,365.95,203.24,203.24,3
CDM,27505405_OP,SOLIA S 53 PACEMAKER LEAD,563.0,365.95,365.95,551.74,6
CDM,27505415,SENTUS PRO MRI,3650.0,2372.5,613.2,3285.0,23
CDM,27505415_IP,SENTUS PRO MRI,3650.0,2372.5,1317.65,1317.65,3
CDM,27505415_OP,SENTUS PRO MRI,3650.0,2372.5,2372.5,3577.0,6
CDM,27505425,EDORA 8 DR-T PACEMAKER,6500.0,4225.0,1092.0,5850.0,29
CDM,27505425_OP,EDORA 8 DR-T PACEMAKER,6500.0,4225.0,4225.0,6370.0,6
CDM,27505495,AVEIR LEADLESS DUAL PACEMAKER,41300.0,26845.0,6938.4,37170.0,33
CDM,27505535,S 275 C1786 ABBOTT AVIER VR LEADLESS,16000.0,10400.0,2688.0,14400.0,33
CDM,27505545,MICRA VR LEADLESS PACEMAKER,22500.0,14625.0,3780.0,20250.0,29
CDM,27505545_OP,MICRA VR LEADLESS PACEMAKER,22500.0,14625.0,14625.0,22050.0,6
CDM,27505555,ATTAIN PERFORMA S QUAD TRANSVENOUS LEAD STR 88CM,3000.0,1950.0,504.0,2700.0,23
CDM,27505555_IP,ATTAIN PERFORMA S QUAD TRANSVENOUS LEAD STR 88CM,3000.0,1950.0,1083.0,1083.0,3
CDM,27505555_OP,ATTAIN PERFORMA S QUAD TRANSVENOUS LEAD STR 88CM,3000.0,1950.0,1950.0,2940.0,6
CDM,27505565,SOLIA S 45 PACEMAKER LEAD,778.0,505.7,130.7,700.2,20
CDM,27505565_IP,SOLIA S 45 PACEMAKER LEAD,778.0,505.7,280.86,280.86,3
CDM,27505565_OP,SOLIA S 45 PACEMAKER LEAD,778.0,505.7,505.7,762.44,6
CDM,27505575,SOLIA S 60  PACEMAKER LEAD,778.0,505.7,130.7,700.2,20
CDM,27505575_IP,SOLIA S 60  PACEMAKER LEAD,778.0,505.7,280.86,280.86,3
CDM,27505575_OP,SOLIA S 60  PACEMAKER LEAD,778.0,505.7,505.7,762.44,6
CDM,27505585,EDORA 8 HF-T QP CRT-P,10400.0,6760.0,1747.2,9360.0,29
CDM,27505585_OP,EDORA 8 HF-T QP CRT-P,10400.0,6760.0,6760.0,10192.0,6
CDM,27505595,S 275 C1605 ABBOTT AVIER DR LEADLESS,41300.0,26845.0,6938.4,37170.0,33
CDM,27505625,"ASSURITY MRI PACEMAKER MODEL PM1272, SINGLE CHAMBER, SR",3200.0,2080.0,537.6,2880.0,23
CDM,27505625_IP,"ASSURITY MRI PACEMAKER MODEL PM1272, SINGLE CHAMBER, SR",3200.0,2080.0,1155.2,1155.2,3
CDM,27505625_OP,"ASSURITY MRI PACEMAKER MODEL PM1272, SINGLE CHAMBER, SR",3200.0,2080.0,2080.0,3136.0,6
CDM,27505635,ABBOTT AVERI AR LEADLESS PACEMAKER,25300.0,16445.0,4250.4,22770.0,29
CDM,27505635_OP,ABBOTT AVERI AR LEADLESS PACEMAKER,25300.0,16445.0,19500.0,29400.0,6
CDM,27505645,S 275 C1786 ABBOTT AVERI AR LEADLESS,25300.0,16445.0,4250.4,22770.0,33
CDM,27506015,"TERMINAL CAPS, MODEL 4033",108.0,70.2,18.14,97.2,27
CDM,27506WE,OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW,7860.0,5109.0,901.78,7860.0,35
CDM,27507WE,OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,5792.0,3764.8,751.16,5792.0,35
CDM,27508WE,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,2480.0,1612.0,281.07,1860.0,35
CDM,27509WE,PRQ SKELETAL FIXJ FEMORAL FX DISTAL END,3256.0,2116.4,353.93,3256.0,35
CDM,27510WE,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,3920.0,2548.0,434.44,3920.0,35
CDM,27511WE,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN,6648.0,4321.2,742.08,6648.0,35
CDM,27513WE,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN,8470.0,5505.5,923.26,8470.0,35
CDM,27514WE,OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE,5840.0,3796.0,748.61,5840.0,35
CDM,27520WE,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1216.0,790.4,164.71,912.0,35
CDM,27524WE,OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR,4148.0,2696.2,547.7,4148.0,35
CDM,27530WE,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1166.0,757.9,194.92,874.5,35
CDM,27532WE,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,3322.0,2159.3,327.71,2491.5,35
CDM,27535WE,OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR,5364.0,3486.6,637.25,5364.0,35
CDM,27536WE,OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ,6956.0,4521.4,743.76,6956.0,35
CDM,27540WE,OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE,4520.0,2938.0,619.42,4520.0,35
CDM,27550WE,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,2392.0,1554.8,233.42,1794.0,35
CDM,27552WE,CLOSED TX KNEE DISLOCATION W/ANESTHESIA,3272.0,2126.8,336.59,3272.0,35
CDM,27556WE,OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR,5200.0,3380.0,679.16,5200.0,35
CDM,27557WE,OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR,6996.0,4547.4,807.85,6996.0,35
CDM,27560WE,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,1596.0,1037.4,166.35,1197.0,35
CDM,27562WE,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,2392.0,1554.8,296.06,2392.0,35
CDM,27566WE,OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY,5084.0,3304.6,617.83,5084.0,35
CDM,27570WE,MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,716.0,465.4,101.53,716.0,35
CDM,27580WE,ARTHRODESIS KNEE ANY TECHNIQUE,8440.0,5486.0,894.11,8440.0,35
CDM,27590WE,AMPUTATION THIGH THROUGH FEMUR ANY LEVEL,5927.0,3852.55,585.22,5927.0,35
CDM,27592WE,AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR,4392.0,2854.8,506.95,4392.0,35
CDM,27594WE,AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION,2916.0,1895.4,303.57,2916.0,35
CDM,27596WE,AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION,4516.0,2935.4,504.81,4516.0,35
CDM,27598WE,DISARTICULATION KNEE,4488.0,2917.2,535.67,4488.0,35
CDM,27599RVU20WE,PERCUTANEOUS ULTRASOUND GUIDED TENOTOMY OF LEFT KNEE (COMP TO 24,2632.0,1710.8,355.42,2632.0,15
CDM,27599RVU23WE,STAGE 1 OSSEOINTEGRATION (COMP CODE 27495),7112.0,4622.8,355.42,7112.0,15
CDM,27599RVU24WE,MANIPULATION KNEE JOINT NOT UNDER GENERAL ANESTHESIA (COMP CODE,769.0,499.85,355.42,769.0,15
CDM,27599RVU25WE,"ARTHROPLASTY FEMORAL/FEMUR/PATELLA, KNEE (COMP CODE 27446)",7365.0,4787.25,355.42,7365.0,15
CDM,27599RVU26WE,"ALLOGRAFT STRUT, FEMUR (COMP CODE 27472)",8050.0,5232.5,355.42,8050.0,15
CDM,27599RVU27WE,OPEN REPAIR OF MEDIAL RETINACULUM (COMP CODE 27424),4096.0,2662.4,355.42,4096.0,15
CDM,27600050,W LENS AC MTA3U0 ALL SZS,130.0,84.5,21.84,117.0,21
CDM,27600060,W LENS AC MTA4U0 ALL SZS,130.0,84.5,21.84,117.0,21
CDM,27600070,W LENS AC MTA5U0 ALL SZS,130.0,84.5,21.84,117.0,21
CDM,27600110,W LENS ASTIGMATISM CORRECTING,495.0,321.75,83.16,445.5,21
CDM,27600115,CRYSTAL LENS,950.0,617.5,159.6,855.0,21
CDM,27600125,RESTOR LENS,895.0,581.75,150.36,805.5,21
CDM,27600130,W LENS PC CZ70BD ALL SZS,130.0,84.5,21.84,117.0,21
CDM,27600135,TORIC LENS,495.0,321.75,83.16,445.5,21
CDM,27600140,W LENS PC MA60AC ALL SZS,248.0,161.2,41.66,223.2,21
CDM,27600150,W LENS PC MN60MA ALL SZS,298.0,193.7,50.06,268.2,21
CDM,27600160,W LENS PC SA60AT ALL SZS,268.0,174.2,45.02,241.2,21
CDM,27600170,W LENS PC SN60WF ALL SZS,298.0,193.7,50.06,268.2,21
CDM,27600180,W LENS POSTERIOR CHAMBER,298.0,193.7,50.06,268.2,21
CDM,27600210,W LENS PRESBYOPIA CORRECTING,895.0,581.75,150.36,805.5,21
CDM,27600220,W VISIAN ICL LENS,1698.0,1103.7,285.26,1528.2,21
CDM,27600230,W LENS PRESBYOPIA CRYSTALENS,950.0,617.5,159.6,855.0,21
CDM,27600260,*W LENS ASTIGMASTISM TRULIGN,950.0,617.5,159.6,855.0,21
CDM,27600335,LENS IOL SYMFONY ZXR00,745.0,484.25,125.16,670.5,21
CDM,27600345,LENS IOL RESTOR SV25TX,895.0,581.75,150.36,805.5,21
CDM,27600355,LENS IOL RESTOR SV25TX,895.0,581.75,150.36,805.5,21
CDM,27600385,LENS SYMFONY TORIC ZXT,895.0,581.75,150.36,805.5,21
CDM,27600WE,DECOMPRESS ANT/LAT LEG CMPART,2412.0,1567.8,258.3,2412.0,35
CDM,27601WE,DECOMPRESS POST LEG COMPARTMT,2420.0,1573.0,259.02,2420.0,35
CDM,27602WE,DECOMPRESS ANT/LAT+POST LEG CMPART,3128.0,2033.2,321.21,3128.0,35
CDM,27603WE,INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA,2092.0,1359.8,192.0,1569.0,35
CDM,27604WE,INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA,1836.0,1193.4,156.32,1377.0,35
CDM,27605WE,TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES,1168.0,759.2,88.44,876.0,35
CDM,27606WE,TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES,1672.0,1086.8,187.18,1672.0,35
CDM,27607WE,INCISION LEG/ANKLE,3448.0,2241.2,412.82,3448.0,35
CDM,27610WE,ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB,3652.0,2373.8,440.56,3652.0,35
CDM,27612WE,ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH,3260.0,2119.0,417.82,3260.0,35
CDM,27613WE,BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL,888.0,577.2,77.76,666.0,35
CDM,27614WE,BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP,2320.0,1508.0,201.2,1740.0,35
CDM,27615WE,RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM,6288.0,4087.2,593.24,6288.0,35
CDM,27618WE,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM,1584.0,1029.6,149.59,1188.0,35
CDM,27619WE,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM,2764.0,1796.6,352.81,2764.0,35
CDM,27620WE,ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB,2460.0,1599.0,334.69,2460.0,35
CDM,27625WE,ARTHROTOMY W/SYNOVECTOMY ANKLE,3396.0,2207.4,441.74,3396.0,35
CDM,27630WE,EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK,1976.0,1284.4,174.9,1482.0,35
CDM,27632WE,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3+CM,2364.0,1536.6,226.5,2364.0,35
CDM,27634WE,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5+CM,4052.0,2633.8,369.64,4052.0,35
CDM,27635WE,EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA,3212.0,2087.8,441.62,3212.0,35
CDM,27637WE,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT,4124.0,2680.6,515.92,4124.0,35
CDM,27638WE,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT,4396.0,2857.4,553.85,4396.0,35
CDM,27640WE,PARTIAL EXCISION BONE TIBIA,4896.0,3182.4,610.25,4896.0,35
CDM,27641WE,PARTIAL EXCISION BONE FIBULA,3936.0,2558.4,485.15,3936.0,35
CDM,27645WE,"RAD RESEC TUMOR,TIBIA",10884.0,7074.6,858.89,10884.0,35
CDM,27646WE,"RAD RESEC TUMOR,FIBULA",9284.0,6034.6,746.45,9284.0,35
CDM,27647WE,RADICAL RESECTION OF TUMOR TALUS OR CALCANEUS,8104.0,5267.6,598.92,8104.0,35
CDM,27648WE,INJECTION ANKLE ARTHROGRAPHY,384.0,249.6,36.47,295.31,35
CDM,27650WE,REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON,3684.0,2394.6,484.59,3684.0,35
CDM,27652WE,RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT,4312.0,2802.8,518.82,4312.0,35
CDM,27654WE,REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT,4212.0,2737.8,536.24,4212.0,35
CDM,27656WE,REPAIR FASCIAL DEFECT LEG,1884.0,1224.6,171.94,1413.0,35
CDM,27658WE,REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH,2048.0,1331.2,264.86,2048.0,35
CDM,27659WE,RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH,2840.0,1846.0,350.88,2840.0,35
CDM,27664WE,RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH,1892.0,1229.8,242.98,1892.0,35
CDM,27675WE,RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY,2940.0,1911.0,377.18,2940.0,35
CDM,27676WE,REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT,3492.0,2269.8,435.46,3492.0,35
CDM,27680WE,TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH,2352.0,1528.8,281.22,2352.0,35
CDM,27681WE,TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN,2820.0,1833.0,356.45,2820.0,35
CDM,27685WE,"LENGTH/SHORT LEG/ANKL TENDON,SINGLE",2676.0,1739.4,226.02,2007.0,35
CDM,27687WE,GASTROCNEMIUS RECESSION,2564.0,1666.6,325.76,2564.0,35
CDM,27690WE,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC,3668.0,2384.2,424.77,3668.0,35
CDM,27691WE,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP,4196.0,2727.4,496.6,4196.0,35
CDM,27692WE,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN,748.0,486.2,78.38,748.0,35
CDM,27695WE,RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL,2680.0,1742.0,365.96,2680.0,35
CDM,27696WE,RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS,3432.0,2230.8,405.77,3432.0,35
CDM,27698WE,REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL,3844.0,2498.6,497.37,3844.0,35
CDM,27700WE,ARTHROPLASTY ANKLE JOINT,3864.0,2511.6,445.28,3864.0,35
CDM,27702WE,ARTHROPLASTY ANKLE W/IMPLANT,5768.0,3749.2,746.57,5768.0,35
CDM,27703WE,ARTHROPLASTY ANKLE REVISION TOTAL ANKLE,6776.0,4404.4,793.14,6776.0,35
CDM,27704WE,REMOVAL OF ANKLE IMPLANT,3124.0,2030.6,372.92,3124.0,35
CDM,27705WE,OSTEOTOMY TIBIA,4344.0,2823.6,577.88,4344.0,35
CDM,27707WE,OSTEOTOMY FIBULA,1912.0,1242.8,263.6,1912.0,35
CDM,27709WE,OSTEOTOMY TIBIA & FIBULA,6992.0,4544.8,579.54,6992.0,35
CDM,27713WE,OSTEOT TIBIA UNI INSJ XTRNL CTRLD IMED LNGTH DEV,12320.0,8008.0,1912.09,12320.0,21
CDM,27715WE,OSTEOPLASTY TIBIA & FIBULA LENGTHENING/SHORTENIN,6200.0,4030.0,740.56,6200.0,35
CDM,27720WE,REPAIR NONUNION/MALUNION TIBIA W/O GRAFT,4944.0,3213.6,647.92,4944.0,35
CDM,27724WE,RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT,7724.0,5020.6,836.5,7724.0,35
CDM,27726WE,REPAIR FIBULA NONUNION/MALUNION W/INT FIXATION,5736.0,3728.4,537.94,5736.0,35
CDM,27734WE,ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA,3532.0,2295.8,440.61,3532.0,35
CDM,27740WE,ARREST EPIPHYSEAL ANY METHOD TIBIA & FIBULA,3844.0,2498.6,456.19,3844.0,35
CDM,27745WE,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA,4196.0,2727.4,527.71,4196.0,35
CDM,27750WE,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1348.0,876.2,177.09,1011.0,35
CDM,27752WE,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,2508.0,1630.2,247.32,1881.0,35
CDM,27756WE,PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE,2980.0,1937.0,412.8,2980.0,35
CDM,27758WE,OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,5016.0,3260.4,667.21,5016.0,35
CDM,27759WE,TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA,5780.0,3757.0,746.29,5780.0,35
CDM,27760WE,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1284.0,834.6,151.89,963.0,35
CDM,27762WE,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,2188.0,1422.2,234.3,1641.0,35
CDM,27766WE,OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE,3156.0,2051.4,443.6,3156.0,35
CDM,27767WE,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1056.0,686.4,143.17,792.0,35
CDM,27768WE,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,2056.0,1336.4,235.1,2056.0,35
CDM,27769WE,OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE,4056.0,2636.4,407.07,4056.0,35
CDM,27780WE,CLTX PROX FIBULA/SHFT FX W/O MANJ,1132.0,735.8,141.21,849.0,35
CDM,27781WE,CLTX PROX FIBULA/SHFT FX W/MANJ,1836.0,1193.4,208.36,1377.0,35
CDM,27784WE,OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE,3868.0,2514.2,356.92,3868.0,35
CDM,27786WE,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1208.0,785.2,142.68,906.0,35
CDM,27788WE,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,1856.0,1206.4,215.45,1392.0,35
CDM,27792WE,OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS,3500.0,2275.0,411.62,3500.0,35
CDM,27800010,W ACTABLAR INSERT TRIDNT GRP 28,3034.0,1972.1,509.71,2730.6,23
CDM,27800010_IP,W ACTABLAR INSERT TRIDNT GRP 28,3034.0,1972.1,1095.27,1095.27,3
CDM,27800010_OP,W ACTABLAR INSERT TRIDNT GRP 28,3034.0,1972.1,1972.1,2973.32,6
CDM,27800020,W ADAPTER OFFSET KNEE GRP 69,1214.0,789.1,203.95,1092.6,20
CDM,27800020_IP,W ADAPTER OFFSET KNEE GRP 69,1214.0,789.1,438.25,438.25,3
CDM,27800020_OP,W ADAPTER OFFSET KNEE GRP 69,1214.0,789.1,789.1,1189.72,6
CDM,27800030,W ADAPTER SIGMA FEM 5DEG,2555.0,1660.75,429.24,2299.5,23
CDM,27800030_IP,W ADAPTER SIGMA FEM 5DEG,2555.0,1660.75,922.36,922.36,3
CDM,27800030_OP,W ADAPTER SIGMA FEM 5DEG,2555.0,1660.75,1660.75,2503.9,6
CDM,27800040,W ADAPTER SIGMA FEM NEUT BOLT,351.0,228.15,58.97,315.9,20
CDM,27800040_IP,W ADAPTER SIGMA FEM NEUT BOLT,351.0,228.15,126.71,126.71,3
CDM,27800040_OP,W ADAPTER SIGMA FEM NEUT BOLT,351.0,228.15,228.15,343.98,6
CDM,27800050,W ADPTR UNIVERSAL SLEEVE 6519-T,250.0,162.5,42.0,225.0,20
CDM,27800050_IP,W ADPTR UNIVERSAL SLEEVE 6519-T,250.0,162.5,90.25,90.25,3
CDM,27800050_OP,W ADPTR UNIVERSAL SLEEVE 6519-T,250.0,162.5,162.5,245.0,6
CDM,27800090,W ALLOGRAFT 2 SYR MIX 10CC,2917.0,1896.05,490.06,2625.3,23
CDM,27800090_IP,W ALLOGRAFT 2 SYR MIX 10CC,2917.0,1896.05,1053.04,1053.04,3
CDM,27800090_OP,W ALLOGRAFT 2 SYR MIX 10CC,2917.0,1896.05,1896.05,2858.66,6
CDM,27800100,W ALLOGRAFT 2 SYR MIX 5CC,1459.0,948.35,245.11,1313.1,20
CDM,27800100_IP,W ALLOGRAFT 2 SYR MIX 5CC,1459.0,948.35,526.7,526.7,3
CDM,27800100_OP,W ALLOGRAFT 2 SYR MIX 5CC,1459.0,948.35,948.35,1429.82,6
CDM,27800110,W ALLOGRAFT ADV NERVE 4-5MM 5CM,4300.0,2795.0,722.4,3870.0,23
CDM,27800110_IP,W ALLOGRAFT ADV NERVE 4-5MM 5CM,4300.0,2795.0,1552.3,1552.3,3
CDM,27800110_OP,W ALLOGRAFT ADV NERVE 4-5MM 5CM,4300.0,2795.0,2795.0,4214.0,6
CDM,27800120,W ALLOGRAFT BIOSET DISC 3X20MM,408.0,265.2,68.54,367.2,20
CDM,27800120_IP,W ALLOGRAFT BIOSET DISC 3X20MM,408.0,265.2,147.29,147.29,3
CDM,27800120_OP,W ALLOGRAFT BIOSET DISC 3X20MM,408.0,265.2,265.2,399.84,6
CDM,27800130,W ALLOGRAFT FLEX HD 471816,7760.0,5044.0,1303.68,6984.0,29
CDM,27800130_OP,W ALLOGRAFT FLEX HD 471816,7760.0,5044.0,5044.0,7604.8,6
CDM,27800140,W ALLOGRAFT FLEXHD 16X20 472620,21193.0,13775.45,3560.42,19073.7,29
CDM,27800140_OP,W ALLOGRAFT FLEXHD 16X20 472620,21193.0,13775.45,13775.45,20769.14,6
CDM,27800150,W ALUMINA C-TAPER HEAD GRP-6,1400.0,910.0,235.2,1260.0,20
CDM,27800150_IP,W ALUMINA C-TAPER HEAD GRP-6,1400.0,910.0,505.4,505.4,3
CDM,27800150_OP,W ALUMINA C-TAPER HEAD GRP-6,1400.0,910.0,910.0,1372.0,6
CDM,27800160,W ANCH SUT FASTAK,218.0,141.7,36.62,196.2,20
CDM,27800160_IP,W ANCH SUT FASTAK,218.0,141.7,78.7,78.7,3
CDM,27800160_OP,W ANCH SUT FASTAK,218.0,141.7,141.7,213.64,6
CDM,27800170,W ANCH/SCRW BN/BN,855.0,555.75,143.64,769.5,20
CDM,27800170_IP,W ANCH/SCRW BN/BN,855.0,555.75,308.66,308.66,3
CDM,27800170_OP,W ANCH/SCRW BN/BN,855.0,555.75,555.75,837.9,6
CDM,27800180,W ANCHOR BIO SWIVEL LOCK,701.0,455.65,117.77,630.9,20
CDM,27800180_IP,W ANCHOR BIO SWIVEL LOCK,701.0,455.65,253.06,253.06,3
CDM,27800180_OP,W ANCHOR BIO SWIVEL LOCK,701.0,455.65,455.65,686.98,6
CDM,27800190,W ANCHOR BIOCORKSCREW FBRWIRE,554.0,360.1,93.07,498.6,20
CDM,27800190_IP,W ANCHOR BIOCORKSCREW FBRWIRE,554.0,360.1,199.99,199.99,3
CDM,27800190_OP,W ANCHOR BIOCORKSCREW FBRWIRE,554.0,360.1,360.1,542.92,6
CDM,27800200,W ANCHOR BIOCORKSCREW FT SUTURE,544.0,353.6,91.39,489.6,20
CDM,27800200_IP,W ANCHOR BIOCORKSCREW FT SUTURE,544.0,353.6,196.38,196.38,3
CDM,27800200_OP,W ANCHOR BIOCORKSCREW FT SUTURE,544.0,353.6,353.6,533.12,6
CDM,27800210,W ANCHOR BIOSUTURE TAK 3X14MM,471.0,306.15,79.13,423.9,20
CDM,27800210_IP,W ANCHOR BIOSUTURE TAK 3X14MM,471.0,306.15,170.03,170.03,3
CDM,27800210_OP,W ANCHOR BIOSUTURE TAK 3X14MM,471.0,306.15,306.15,461.58,6
CDM,27800220,W ANCHOR CORKSCREW FT 2 5.5MM,461.0,299.65,77.45,414.9,20
CDM,27800220_IP,W ANCHOR CORKSCREW FT 2 5.5MM,461.0,299.65,166.42,166.42,3
CDM,27800220_OP,W ANCHOR CORKSCREW FT 2 5.5MM,461.0,299.65,299.65,451.78,6
CDM,27800230,W ANCHOR MICRO QA+ #3/0 ETH V-4,616.0,400.4,103.49,554.4,20
CDM,27800230_IP,W ANCHOR MICRO QA+ #3/0 ETH V-4,616.0,400.4,222.38,222.38,3
CDM,27800230_OP,W ANCHOR MICRO QA+ #3/0 ETH V-4,616.0,400.4,400.4,603.68,6
CDM,27800240,W ANCHOR MINI 2.4X7MM 2 FIBRWRE,416.0,270.4,69.89,374.4,20
CDM,27800240_IP,W ANCHOR MINI 2.4X7MM 2 FIBRWRE,416.0,270.4,150.18,150.18,3
CDM,27800240_OP,W ANCHOR MINI 2.4X7MM 2 FIBRWRE,416.0,270.4,270.4,407.68,6
CDM,27800250,W ANCHOR SUTURE 5.5,1000.0,650.0,168.0,900.0,20
CDM,27800250_IP,W ANCHOR SUTURE 5.5,1000.0,650.0,361.0,361.0,3
CDM,27800250_OP,W ANCHOR SUTURE 5.5,1000.0,650.0,650.0,980.0,6
CDM,27800260,W ANCHOR TITAN,300.0,195.0,50.4,270.0,20
CDM,27800260_IP,W ANCHOR TITAN,300.0,195.0,108.3,108.3,3
CDM,27800260_OP,W ANCHOR TITAN,300.0,195.0,195.0,294.0,6
CDM,27800280,W ANCHR CORKSCRW FT II #2 FBRWR,424.0,275.6,71.23,381.6,20
CDM,27800280_IP,W ANCHR CORKSCRW FT II #2 FBRWR,424.0,275.6,153.06,153.06,3
CDM,27800280_OP,W ANCHR CORKSCRW FT II #2 FBRWR,424.0,275.6,275.6,415.52,6
CDM,27800290,W APERFIX TIBIAL IMPLANT 10X30,724.0,470.6,121.63,651.6,20
CDM,27800290_IP,W APERFIX TIBIAL IMPLANT 10X30,724.0,470.6,261.36,261.36,3
CDM,27800290_OP,W APERFIX TIBIAL IMPLANT 10X30,724.0,470.6,470.6,709.52,6
CDM,27800300,W ARTERIAL GRAFT COMPONENT HERO,1750.0,1137.5,294.0,1575.0,23
CDM,27800300_IP,W ARTERIAL GRAFT COMPONENT HERO,1750.0,1137.5,631.75,631.75,3
CDM,27800300_OP,W ARTERIAL GRAFT COMPONENT HERO,1750.0,1137.5,1137.5,1715.0,6
CDM,27800310,W AUGMENT FEM MRH DIS GRP 65,1128.0,733.2,189.5,1015.2,20
CDM,27800310_IP,W AUGMENT FEM MRH DIS GRP 65,1128.0,733.2,407.21,407.21,3
CDM,27800310_OP,W AUGMENT FEM MRH DIS GRP 65,1128.0,733.2,733.2,1105.44,6
CDM,27800320,W AUGMENT PFC SIGMA DIST,1242.0,807.3,208.66,1117.8,20
CDM,27800320_IP,W AUGMENT PFC SIGMA DIST,1242.0,807.3,448.36,448.36,3
CDM,27800320_OP,W AUGMENT PFC SIGMA DIST,1242.0,807.3,807.3,1217.16,6
CDM,27800330,W AXLE KRH/HRHK GRP 82,1568.0,1019.2,263.42,1411.2,20
CDM,27800330_IP,W AXLE KRH/HRHK GRP 82,1568.0,1019.2,566.05,566.05,3
CDM,27800330_OP,W AXLE KRH/HRHK GRP 82,1568.0,1019.2,1019.2,1536.64,6
CDM,27800340,W AXLE SM DISTL FEM GRP 85,1728.0,1123.2,290.3,1555.2,23
CDM,27800340_IP,W AXLE SM DISTL FEM GRP 85,1728.0,1123.2,623.81,623.81,3
CDM,27800340_OP,W AXLE SM DISTL FEM GRP 85,1728.0,1123.2,1123.2,1693.44,6
CDM,27800350,W BALLOON 61-70CM AMS800,3006.0,1953.9,505.01,2705.4,23
CDM,27800350_IP,W BALLOON 61-70CM AMS800,3006.0,1953.9,1085.17,1085.17,3
CDM,27800350_OP,W BALLOON 61-70CM AMS800,3006.0,1953.9,1953.9,2945.88,6
CDM,27800360,W BALLOON REG ACTICON NEOSPH,4700.0,3055.0,789.6,4230.0,23
CDM,27800360_IP,W BALLOON REG ACTICON NEOSPH,4700.0,3055.0,1696.7,1696.7,3
CDM,27800360_OP,W BALLOON REG ACTICON NEOSPH,4700.0,3055.0,3055.0,4606.0,6
CDM,27800370,W BALLOON ULTRATHIN DIAMOND BS,572.0,371.8,96.1,514.8,20
CDM,27800370_IP,W BALLOON ULTRATHIN DIAMOND BS,572.0,371.8,206.49,206.49,3
CDM,27800370_OP,W BALLOON ULTRATHIN DIAMOND BS,572.0,371.8,371.8,560.56,6
CDM,27800380,W BAND-C REALIZE GAST W/DISECT,5778.0,3755.7,970.7,5200.2,29
CDM,27800380_OP,W BAND-C REALIZE GAST W/DISECT,5778.0,3755.7,3755.7,5662.44,6
CDM,27800390,W BAR ARCH ERICH 1M,72.0,46.8,12.1,64.8,20
CDM,27800390_IP,W BAR ARCH ERICH 1M,72.0,46.8,25.99,25.99,3
CDM,27800390_OP,W BAR ARCH ERICH 1M,72.0,46.8,46.8,70.56,6
CDM,27800400,W BAR TRANSVERSE 15MM/20MM,400.0,260.0,67.2,360.0,20
CDM,27800400_IP,W BAR TRANSVERSE 15MM/20MM,400.0,260.0,144.4,144.4,3
CDM,27800400_OP,W BAR TRANSVERSE 15MM/20MM,400.0,260.0,260.0,392.0,6
CDM,27800410,W BAR TRANSVERSE TI ALLOY,400.0,260.0,67.2,360.0,20
CDM,27800410_IP,W BAR TRANSVERSE TI ALLOY,400.0,260.0,144.4,144.4,3
CDM,27800410_OP,W BAR TRANSVERSE TI ALLOY,400.0,260.0,260.0,392.0,6
CDM,27800420,W BARRIER ADHESION,521.0,338.65,87.53,468.9,20
CDM,27800420_IP,W BARRIER ADHESION,521.0,338.65,188.08,188.08,3
CDM,27800420_OP,W BARRIER ADHESION,521.0,338.65,338.65,510.58,6
CDM,27800430,W BARRIER SEPARFILM 508602,980.0,637.0,164.64,882.0,20
CDM,27800430_IP,W BARRIER SEPARFILM 508602,980.0,637.0,353.78,353.78,3
CDM,27800430_OP,W BARRIER SEPARFILM 508602,980.0,637.0,637.0,960.4,6
CDM,27800440,W BARRIER SEPRAFILM 430102,480.0,312.0,80.64,432.0,20
CDM,27800440_IP,W BARRIER SEPRAFILM 430102,480.0,312.0,173.28,173.28,3
CDM,27800440_OP,W BARRIER SEPRAFILM 430102,480.0,312.0,312.0,470.4,6
CDM,27800450,W BASEPLATE BP BEAD GRP 106,2552.0,1658.8,428.74,2296.8,23
CDM,27800450_IP,W BASEPLATE BP BEAD GRP 106,2552.0,1658.8,921.27,921.27,3
CDM,27800450_OP,W BASEPLATE BP BEAD GRP 106,2552.0,1658.8,1658.8,2500.96,6
CDM,27800460,W BASEPLATE KNEE TIB BP GRP 97,1950.0,1267.5,327.6,1755.0,23
CDM,27800460_IP,W BASEPLATE KNEE TIB BP GRP 97,1950.0,1267.5,703.95,703.95,3
CDM,27800460_OP,W BASEPLATE KNEE TIB BP GRP 97,1950.0,1267.5,1267.5,1911.0,6
CDM,27800470,W BASEPLATE MRH TIB GRP 132,4702.0,3056.3,789.94,4231.8,23
CDM,27800470_IP,W BASEPLATE MRH TIB GRP 132,4702.0,3056.3,1697.42,1697.42,3
CDM,27800470_OP,W BASEPLATE MRH TIB GRP 132,4702.0,3056.3,3056.3,4607.96,6
CDM,27800480,W BASEPLATE REV STD POST 15 MM,2800.0,1820.0,470.4,2520.0,23
CDM,27800480_IP,W BASEPLATE REV STD POST 15 MM,2800.0,1820.0,1010.8,1010.8,3
CDM,27800480_OP,W BASEPLATE REV STD POST 15 MM,2800.0,1820.0,1820.0,2744.0,6
CDM,27800490,W BASEPLATE TRI PRIM GRP 78,1351.0,878.15,226.97,1215.9,20
CDM,27800490_IP,W BASEPLATE TRI PRIM GRP 78,1351.0,878.15,487.71,487.71,3
CDM,27800490_OP,W BASEPLATE TRI PRIM GRP 78,1351.0,878.15,878.15,1323.98,6
CDM,27800500,W BASEPLATE TRI TS GRP 119,3532.0,2295.8,593.38,3178.8,23
CDM,27800500_IP,W BASEPLATE TRI TS GRP 119,3532.0,2295.8,1275.05,1275.05,3
CDM,27800500_OP,W BASEPLATE TRI TS GRP 119,3532.0,2295.8,2295.8,3461.36,6
CDM,27800510,W BASEPLT STD NONPOR TIB GRP 66,1178.0,765.7,197.9,1060.2,20
CDM,27800510_IP,W BASEPLT STD NONPOR TIB GRP 66,1178.0,765.7,425.26,425.26,3
CDM,27800510_OP,W BASEPLT STD NONPOR TIB GRP 66,1178.0,765.7,765.7,1154.44,6
CDM,27800520,W BASEPLTE TIBL UNI LM/RM/LL/RL,2957.0,1922.05,496.78,2661.3,23
CDM,27800520_IP,W BASEPLTE TIBL UNI LM/RM/LL/RL,2957.0,1922.05,1067.48,1067.48,3
CDM,27800520_OP,W BASEPLTE TIBL UNI LM/RM/LL/RL,2957.0,1922.05,1922.05,2897.86,6
CDM,27800530,W BEARING TIB COMP GRP 127,4354.0,2830.1,731.47,3918.6,23
CDM,27800530_IP,W BEARING TIB COMP GRP 127,4354.0,2830.1,1571.79,1571.79,3
CDM,27800530_OP,W BEARING TIB COMP GRP 127,4354.0,2830.1,2830.1,4266.92,6
CDM,27800540,W BILIARY STENT,326.0,211.9,54.77,293.4,20
CDM,27800540_IP,W BILIARY STENT,326.0,211.9,117.69,117.69,3
CDM,27800540_OP,W BILIARY STENT,326.0,211.9,211.9,319.48,6
CDM,27800550,W BIO PUSH LOCK 35MM X 14MM,920.0,598.0,154.56,828.0,20
CDM,27800550_IP,W BIO PUSH LOCK 35MM X 14MM,920.0,598.0,332.12,332.12,3
CDM,27800550_OP,W BIO PUSH LOCK 35MM X 14MM,920.0,598.0,598.0,901.6,6
CDM,27800560,W BIOLOX DELTA HEAD GRP-7,1400.0,910.0,235.2,1260.0,20
CDM,27800560_IP,W BIOLOX DELTA HEAD GRP-7,1400.0,910.0,505.4,505.4,3
CDM,27800560_OP,W BIOLOX DELTA HEAD GRP-7,1400.0,910.0,910.0,1372.0,6
CDM,27800570,W BIOLOX DELTA V40 HEAD 36,1400.0,910.0,235.2,1260.0,20
CDM,27800570_IP,W BIOLOX DELTA V40 HEAD 36,1400.0,910.0,505.4,505.4,3
CDM,27800570_OP,W BIOLOX DELTA V40 HEAD 36,1400.0,910.0,910.0,1372.0,6
CDM,27800580,W BIOSET 5X45,1955.0,1270.75,328.44,1759.5,23
CDM,27800580_IP,W BIOSET 5X45,1955.0,1270.75,705.76,705.76,3
CDM,27800580_OP,W BIOSET 5X45,1955.0,1270.75,1270.75,1915.9,6
CDM,27800590,W BIPOLAR DEFIB. LEAD 6931,8500.0,5525.0,1428.0,7650.0,29
CDM,27800590_OP,W BIPOLAR DEFIB. LEAD 6931,8500.0,5525.0,5525.0,8330.0,6
CDM,27800600,W BI-POLAR HIP,3850.0,2502.5,646.8,3465.0,23
CDM,27800600_IP,W BI-POLAR HIP,3850.0,2502.5,1389.85,1389.85,3
CDM,27800600_OP,W BI-POLAR HIP,3850.0,2502.5,2502.5,3773.0,6
CDM,27800610,W BLOCK TS DISTL GRP 68,1206.0,783.9,202.61,1085.4,20
CDM,27800610_IP,W BLOCK TS DISTL GRP 68,1206.0,783.9,435.37,435.37,3
CDM,27800610_OP,W BLOCK TS DISTL GRP 68,1206.0,783.9,783.9,1181.88,6
CDM,27800620,W BLOCK TS HALF GRP 75,1301.0,845.65,218.57,1170.9,20
CDM,27800620_IP,W BLOCK TS HALF GRP 75,1301.0,845.65,469.66,469.66,3
CDM,27800620_OP,W BLOCK TS HALF GRP 75,1301.0,845.65,845.65,1274.98,6
CDM,27800630,W BN GRANUELS 15CC,2031.0,1320.15,341.21,1827.9,23
CDM,27800630_IP,W BN GRANUELS 15CC,2031.0,1320.15,733.19,733.19,3
CDM,27800630_OP,W BN GRANUELS 15CC,2031.0,1320.15,1320.15,1990.38,6
CDM,27800640,W BODY BOLT HIP 19MM GRP 134,4874.0,3168.1,818.83,4386.6,26
CDM,27800640_OP,W BODY BOLT HIP 19MM GRP 134,4874.0,3168.1,3168.1,4776.52,6
CDM,27800650,W BODY FEM MRS GRP 142,5288.0,3437.2,888.38,4759.2,29
CDM,27800650_OP,W BODY FEM MRS GRP 142,5288.0,3437.2,3437.2,5182.24,6
CDM,27800660,W BODY HIP SYS MLD GRP 137,5152.0,3348.8,865.54,4636.8,29
CDM,27800660_OP,W BODY HIP SYS MLD GRP 137,5152.0,3348.8,3348.8,5048.96,6
CDM,27800670,W BODY HIP SYS MLD GRP 138,5152.0,3348.8,865.54,4636.8,29
CDM,27800670_OP,W BODY HIP SYS MLD GRP 138,5152.0,3348.8,3348.8,5048.96,6
CDM,27800680,W BODY MRS HIP/KNEE GRP 126,4266.0,2772.9,716.69,3839.4,23
CDM,27800680_IP,W BODY MRS HIP/KNEE GRP 126,4266.0,2772.9,1540.03,1540.03,3
CDM,27800680_OP,W BODY MRS HIP/KNEE GRP 126,4266.0,2772.9,2772.9,4180.68,6
CDM,27800690,W BODY MRS MM FEM BODY GRP 154,6954.0,4520.1,1168.27,6258.6,29
CDM,27800690_OP,W BODY MRS MM FEM BODY GRP 154,6954.0,4520.1,4520.1,6814.92,6
CDM,27800700,W BODY MRS PROX FEM GRP 156,7724.0,5020.6,1297.63,6951.6,29
CDM,27800700_OP,W BODY MRS PROX FEM GRP 156,7724.0,5020.6,5020.6,7569.52,6
CDM,27800710,W BODY MT3 REV HIP GRP 133,4713.0,3063.45,791.78,4241.7,23
CDM,27800710_IP,W BODY MT3 REV HIP GRP 133,4713.0,3063.45,1701.39,1701.39,3
CDM,27800710_OP,W BODY MT3 REV HIP GRP 133,4713.0,3063.45,3063.45,4618.74,6
CDM,27800720,W BODY REST MOD CALCAR GRP 143,5372.0,3491.8,902.5,4834.8,29
CDM,27800720_OP,W BODY REST MOD CALCAR GRP 143,5372.0,3491.8,3491.8,5264.56,6
CDM,27800730,W BODY REST MOD MLLD GRP 139,5158.0,3352.7,866.54,4642.2,29
CDM,27800730_OP,W BODY REST MOD MLLD GRP 139,5158.0,3352.7,3352.7,5054.84,6
CDM,27800740,W BONE ALLOGRAFT CERVICAL,2542.0,1652.3,427.06,2287.8,23
CDM,27800740_IP,W BONE ALLOGRAFT CERVICAL,2542.0,1652.3,917.66,917.66,3
CDM,27800740_OP,W BONE ALLOGRAFT CERVICAL,2542.0,1652.3,1652.3,2491.16,6
CDM,27800750,W BONE CANCELLOUS,105.0,68.25,17.64,94.5,20
CDM,27800750_IP,W BONE CANCELLOUS,105.0,68.25,37.91,37.91,3
CDM,27800750_OP,W BONE CANCELLOUS,105.0,68.25,68.25,102.9,6
CDM,27800760,W BONE CEMENT,120.0,78.0,20.16,108.0,20
CDM,27800760_IP,W BONE CEMENT,120.0,78.0,43.32,43.32,3
CDM,27800760_OP,W BONE CEMENT,120.0,78.0,78.0,117.6,6
CDM,27800770,W BONE CEMENT 15CC HYDROSET,7770.0,5050.5,1305.36,6993.0,29
CDM,27800770_OP,W BONE CEMENT 15CC HYDROSET,7770.0,5050.5,5050.5,7614.6,6
CDM,27800780,W BONE CEMENT KYPHX HV-R,200.0,130.0,33.6,180.0,20
CDM,27800780_IP,W BONE CEMENT KYPHX HV-R,200.0,130.0,72.2,72.2,3
CDM,27800780_OP,W BONE CEMENT KYPHX HV-R,200.0,130.0,130.0,196.0,6
CDM,27800790,W BONE CHIP CORTICO CANC 4-6MM,830.0,539.5,139.44,747.0,20
CDM,27800790_IP,W BONE CHIP CORTICO CANC 4-6MM,830.0,539.5,299.63,299.63,3
CDM,27800790_OP,W BONE CHIP CORTICO CANC 4-6MM,830.0,539.5,539.5,813.4,6
CDM,27800800,W BONE CHIPS CANCELLOUS 15CC,657.0,427.05,110.38,591.3,20
CDM,27800800_IP,W BONE CHIPS CANCELLOUS 15CC,657.0,427.05,237.18,237.18,3
CDM,27800800_OP,W BONE CHIPS CANCELLOUS 15CC,657.0,427.05,427.05,643.86,6
CDM,27800810,W BONE CHIPS CANCELLOUS 30CC,1044.0,678.6,175.39,939.6,20
CDM,27800810_IP,W BONE CHIPS CANCELLOUS 30CC,1044.0,678.6,376.88,376.88,3
CDM,27800810_OP,W BONE CHIPS CANCELLOUS 30CC,1044.0,678.6,678.6,1023.12,6
CDM,27800840,W BONE ILIAC BLOCK 14-17MM,1330.0,864.5,223.44,1197.0,20
CDM,27800840_IP,W BONE ILIAC BLOCK 14-17MM,1330.0,864.5,480.13,480.13,3
CDM,27800840_OP,W BONE ILIAC BLOCK 14-17MM,1330.0,864.5,864.5,1303.4,6
CDM,27800850,W BONE PASTE BIOSET 20CC,5920.0,3848.0,994.56,5328.0,29
CDM,27800850_OP,W BONE PASTE BIOSET 20CC,5920.0,3848.0,3848.0,5801.6,6
CDM,27800860,W BONE PLUGS,1844.0,1198.6,309.79,1659.6,23
CDM,27800860_IP,W BONE PLUGS,1844.0,1198.6,665.68,665.68,3
CDM,27800860_OP,W BONE PLUGS,1844.0,1198.6,1198.6,1807.12,6
CDM,27800870,W BONE TAP,562.0,365.3,94.42,505.8,20
CDM,27800870_IP,W BONE TAP,562.0,365.3,202.88,202.88,3
CDM,27800870_OP,W BONE TAP,562.0,365.3,365.3,550.76,6
CDM,27800880,W BONE VOID FILLER 5 GRAM,1300.0,845.0,218.4,1170.0,20
CDM,27800880_IP,W BONE VOID FILLER 5 GRAM,1300.0,845.0,469.3,469.3,3
CDM,27800880_OP,W BONE VOID FILLER 5 GRAM,1300.0,845.0,845.0,1274.0,6
CDM,27800890,W BUMPER KNEE INSERT GRP 53,938.0,609.7,157.58,844.2,20
CDM,27800890_IP,W BUMPER KNEE INSERT GRP 53,938.0,609.7,338.62,338.62,3
CDM,27800890_OP,W BUMPER KNEE INSERT GRP 53,938.0,609.7,609.7,919.24,6
CDM,27800900,W BURR HOLE COVER 20MM,294.0,191.1,49.39,264.6,20
CDM,27800900_IP,W BURR HOLE COVER 20MM,294.0,191.1,106.13,106.13,3
CDM,27800900_OP,W BURR HOLE COVER 20MM,294.0,191.1,191.1,288.12,6
CDM,27800910,W BURR HOLE COVER NEURO TI 12MM,464.0,301.6,77.95,417.6,20
CDM,27800910_IP,W BURR HOLE COVER NEURO TI 12MM,464.0,301.6,167.5,167.5,3
CDM,27800910_OP,W BURR HOLE COVER NEURO TI 12MM,464.0,301.6,301.6,454.72,6
CDM,27800920,W BUSHING DIS FEM GMRS GRP 36,504.0,327.6,84.67,453.6,20
CDM,27800920_IP,W BUSHING DIS FEM GMRS GRP 36,504.0,327.6,181.94,181.94,3
CDM,27800920_OP,W BUSHING DIS FEM GMRS GRP 36,504.0,327.6,327.6,493.92,6
CDM,27800930,W BUSHING FM DURA GRP 33,436.0,283.4,73.25,392.4,20
CDM,27800930_IP,W BUSHING FM DURA GRP 33,436.0,283.4,157.4,157.4,3
CDM,27800930_OP,W BUSHING FM DURA GRP 33,436.0,283.4,283.4,427.28,6
CDM,27800940,W CABLE W CRIMP ST 750MM,904.0,587.6,151.87,813.6,20
CDM,27800940_IP,W CABLE W CRIMP ST 750MM,904.0,587.6,326.34,326.34,3
CDM,27800940_OP,W CABLE W CRIMP ST 750MM,904.0,587.6,587.6,885.92,6
CDM,27800950,W CAGE 5DEG LEOPARD LRDTC28X7,450.0,292.5,75.6,405.0,20
CDM,27800950_IP,W CAGE 5DEG LEOPARD LRDTC28X7,450.0,292.5,162.45,162.45,3
CDM,27800950_OP,W CAGE 5DEG LEOPARD LRDTC28X7,450.0,292.5,292.5,441.0,6
CDM,27800960,W CAGE FUSION SPN MEDT GRP 19,6226.0,4046.9,1045.97,5603.4,29
CDM,27800960_OP,W CAGE FUSION SPN MEDT GRP 19,6226.0,4046.9,4046.9,6101.48,6
CDM,27800970,W CAGE LEOPARD LORDOTIC IMPLNT,5000.0,3250.0,840.0,4500.0,26
CDM,27800970_OP,W CAGE LEOPARD LORDOTIC IMPLNT,5000.0,3250.0,3250.0,4900.0,6
CDM,27800980,W CAGE SNGL SPINE MEDT GRP 20,7357.0,4782.05,1235.98,6621.3,29
CDM,27800980_OP,W CAGE SNGL SPINE MEDT GRP 20,7357.0,4782.05,4782.05,7209.86,6
CDM,27800990,W CANCELLOUS SCREW 4.5 GRP-8,141.0,91.65,23.69,126.9,20
CDM,27800990_IP,W CANCELLOUS SCREW 4.5 GRP-8,141.0,91.65,50.9,50.9,3
CDM,27800990_OP,W CANCELLOUS SCREW 4.5 GRP-8,141.0,91.65,91.65,138.18,6
CDM,27801000,W CANCELLOUS SCREW 6.5 GRP-9,30.0,19.5,5.04,27.0,20
CDM,27801000_IP,W CANCELLOUS SCREW 6.5 GRP-9,30.0,19.5,10.83,10.83,3
CDM,27801000_OP,W CANCELLOUS SCREW 6.5 GRP-9,30.0,19.5,19.5,29.4,6
CDM,27801010,W CANNULATED 3.0MM COUNTERSINK,517.0,336.05,86.86,465.3,20
CDM,27801010_IP,W CANNULATED 3.0MM COUNTERSINK,517.0,336.05,186.64,186.64,3
CDM,27801010_OP,W CANNULATED 3.0MM COUNTERSINK,517.0,336.05,336.05,506.66,6
CDM,27801020,W CANNULATED TAP 5.0MM,1170.0,760.5,196.56,1053.0,20
CDM,27801020_IP,W CANNULATED TAP 5.0MM,1170.0,760.5,422.37,422.37,3
CDM,27801020_OP,W CANNULATED TAP 5.0MM,1170.0,760.5,760.5,1146.6,6
CDM,27801030,W CAP LOCK SPINE GLOB GRP 1,50.0,32.5,8.4,45.0,20
CDM,27801030_IP,W CAP LOCK SPINE GLOB GRP 1,50.0,32.5,18.05,18.05,3
CDM,27801030_OP,W CAP LOCK SPINE GLOB GRP 1,50.0,32.5,32.5,49.0,6
CDM,27801040,W CAP PIN PROTECTIVE BLACK 5MM,6.0,3.9,1.01,5.4,20
CDM,27801040_IP,W CAP PIN PROTECTIVE BLACK 5MM,6.0,3.9,2.17,2.17,3
CDM,27801040_OP,W CAP PIN PROTECTIVE BLACK 5MM,6.0,3.9,3.9,5.88,6
CDM,27801045,BRACHYTX NON-STR HDR IR-192,500.0,325.0,129.5,742.36,36
CDM,27801045_IP,BRACHYTX NON-STR HDR IR-192,500.0,325.0,180.5,180.5,3
CDM,27801045_OP,BRACHYTX NON-STR HDR IR-192,500.0,325.0,325.0,490.0,6
CDM,27801050,W CARDIOVRTR/DFIB,53242.0,34607.3,8944.66,47917.8,29
CDM,27801050_OP,W CARDIOVRTR/DFIB,53242.0,34607.3,34607.3,52177.16,6
CDM,27801060,W CARDIOVRTR/DFIB,66088.0,42957.2,11102.78,59479.2,29
CDM,27801060_OP,W CARDIOVRTR/DFIB,66088.0,42957.2,42957.2,64766.24,6
CDM,27801070,W CARDIOVRTR/DFIB,70915.0,46094.75,11913.72,63823.5,29
CDM,27801070_OP,W CARDIOVRTR/DFIB,70915.0,46094.75,46094.75,69496.7,6
CDM,27801080,W CATH 13.5 FR HICKMAN DIALYSIS,660.0,429.0,110.88,594.0,20
CDM,27801080_IP,W CATH 13.5 FR HICKMAN DIALYSIS,660.0,429.0,238.26,238.26,3
CDM,27801080_OP,W CATH 13.5 FR HICKMAN DIALYSIS,660.0,429.0,429.0,646.8,6
CDM,27801085,"H980006 BRACHYTX,NON-STR,90 TH",33432.0,21730.8,6962.14,37910.58,48
CDM,27801085_OP,"H980006 BRACHYTX,NON-STR,90 TH",33432.0,21730.8,21730.8,32763.36,6
CDM,27801090,W CATH 16CM MAHURKAR TRPL LMEN,198.0,128.7,33.26,178.2,20
CDM,27801090_IP,W CATH 16CM MAHURKAR TRPL LMEN,198.0,128.7,71.48,71.48,3
CDM,27801090_OP,W CATH 16CM MAHURKAR TRPL LMEN,198.0,128.7,128.7,194.04,6
CDM,27801100,W CATH 20 CM MAHURKAR TRPL LMEN,195.0,126.75,32.76,175.5,20
CDM,27801100_IP,W CATH 20 CM MAHURKAR TRPL LMEN,195.0,126.75,70.4,70.4,3
CDM,27801100_OP,W CATH 20 CM MAHURKAR TRPL LMEN,195.0,126.75,126.75,191.1,6
CDM,27801110,W CATH 23 CM HEMOSPLIT STD KIT,814.0,529.1,136.75,732.6,20
CDM,27801110_IP,W CATH 23 CM HEMOSPLIT STD KIT,814.0,529.1,293.85,293.85,3
CDM,27801110_OP,W CATH 23 CM HEMOSPLIT STD KIT,814.0,529.1,529.1,797.72,6
CDM,27801120,W CATH 27 CM HEMOSPLIT STD KIT,806.0,523.9,135.41,725.4,20
CDM,27801120_IP,W CATH 27 CM HEMOSPLIT STD KIT,806.0,523.9,290.97,290.97,3
CDM,27801120_OP,W CATH 27 CM HEMOSPLIT STD KIT,806.0,523.9,523.9,789.88,6
CDM,27801130,W CATH BROVIAC,354.0,230.1,59.47,318.6,20
CDM,27801130_IP,W CATH BROVIAC,354.0,230.1,127.79,127.79,3
CDM,27801130_OP,W CATH BROVIAC,354.0,230.1,230.1,346.92,6
CDM,27801140,W CATH DECATH GOLD HD,690.0,448.5,115.92,621.0,20
CDM,27801140_IP,W CATH DECATH GOLD HD,690.0,448.5,249.09,249.09,3
CDM,27801140_OP,W CATH DECATH GOLD HD,690.0,448.5,448.5,676.2,6
CDM,27801150,W CATH DECATHLON KIT,752.0,488.8,126.34,676.8,20
CDM,27801150_IP,W CATH DECATHLON KIT,752.0,488.8,271.47,271.47,3
CDM,27801150_OP,W CATH DECATHLON KIT,752.0,488.8,488.8,736.96,6
CDM,27801160,W CATH DIALYS 2LUMN SPIRL Z TIP,640.0,416.0,107.52,576.0,20
CDM,27801160_IP,W CATH DIALYS 2LUMN SPIRL Z TIP,640.0,416.0,231.04,231.04,3
CDM,27801160_OP,W CATH DIALYS 2LUMN SPIRL Z TIP,640.0,416.0,416.0,627.2,6
CDM,27801170,W CATH DIALYSIS KIT DUAL LUMEN,700.0,455.0,117.6,630.0,20
CDM,27801170_IP,W CATH DIALYSIS KIT DUAL LUMEN,700.0,455.0,252.7,252.7,3
CDM,27801170_OP,W CATH DIALYSIS KIT DUAL LUMEN,700.0,455.0,455.0,686.0,6
CDM,27801180,W CATH DIALYSIS RUBY VENTRC KT,890.0,578.5,149.52,801.0,20
CDM,27801180_IP,W CATH DIALYSIS RUBY VENTRC KT,890.0,578.5,321.29,321.29,3
CDM,27801180_OP,W CATH DIALYSIS RUBY VENTRC KT,890.0,578.5,578.5,872.2,6
CDM,27801190,W CATH DIALYSIS SAPPHIRE PLNDRM,1253.0,814.45,210.5,1127.7,20
CDM,27801190_IP,W CATH DIALYSIS SAPPHIRE PLNDRM,1253.0,814.45,452.33,452.33,3
CDM,27801190_OP,W CATH DIALYSIS SAPPHIRE PLNDRM,1253.0,814.45,814.45,1227.94,6
CDM,27801200,W CATH DIALYSIS SPORTPAC VENTRC,640.0,416.0,107.52,576.0,20
CDM,27801200_IP,W CATH DIALYSIS SPORTPAC VENTRC,640.0,416.0,231.04,231.04,3
CDM,27801200_OP,W CATH DIALYSIS SPORTPAC VENTRC,640.0,416.0,416.0,627.2,6
CDM,27801210,W CATH DRUG ADMIN 8709,1050.0,682.5,176.4,945.0,20
CDM,27801210_IP,W CATH DRUG ADMIN 8709,1050.0,682.5,379.05,379.05,3
CDM,27801210_OP,W CATH DRUG ADMIN 8709,1050.0,682.5,682.5,1029.0,6
CDM,27801220,W CATH GASTROJEJUN SET,627.0,407.55,105.34,564.3,20
CDM,27801220_IP,W CATH GASTROJEJUN SET,627.0,407.55,226.35,226.35,3
CDM,27801220_OP,W CATH GASTROJEJUN SET,627.0,407.55,407.55,614.46,6
CDM,27801230,W CATH GASTROJEJUN SHETTY SET,500.0,325.0,84.0,450.0,20
CDM,27801230_IP,W CATH GASTROJEJUN SHETTY SET,500.0,325.0,180.5,180.5,3
CDM,27801230_OP,W CATH GASTROJEJUN SHETTY SET,500.0,325.0,325.0,490.0,6
CDM,27801240,W CATH GASTROSTOMY FR ULTR,127.0,82.55,21.34,114.3,20
CDM,27801240_IP,W CATH GASTROSTOMY FR ULTR,127.0,82.55,45.85,45.85,3
CDM,27801240_OP,W CATH GASTROSTOMY FR ULTR,127.0,82.55,82.55,124.46,6
CDM,27801250,W CATH GASTROSTOMY SET,246.0,159.9,41.33,221.4,20
CDM,27801250_IP,W CATH GASTROSTOMY SET,246.0,159.9,88.81,88.81,3
CDM,27801250_OP,W CATH GASTROSTOMY SET,246.0,159.9,159.9,241.08,6
CDM,27801260,W CATH HEMODIAL,600.0,390.0,100.8,540.0,20
CDM,27801260_IP,W CATH HEMODIAL,600.0,390.0,216.6,216.6,3
CDM,27801260_OP,W CATH HEMODIAL,600.0,390.0,390.0,588.0,6
CDM,27801270,W CATH INFUSEAPRT,1649.0,1071.85,277.03,1484.1,20
CDM,27801270_IP,W CATH INFUSEAPRT,1649.0,1071.85,595.29,595.29,3
CDM,27801270_OP,W CATH INFUSEAPRT,1649.0,1071.85,1071.85,1616.02,6
CDM,27801280,W CATH INTRATHECAL SUTURELESS,1290.0,838.5,216.72,1161.0,20
CDM,27801280_IP,W CATH INTRATHECAL SUTURELESS,1290.0,838.5,465.69,465.69,3
CDM,27801280_OP,W CATH INTRATHECAL SUTURELESS,1290.0,838.5,838.5,1264.2,6
CDM,27801290,W CATH JEJUNOSTOMY GDWIRE,275.0,178.75,46.2,247.5,20
CDM,27801290_IP,W CATH JEJUNOSTOMY GDWIRE,275.0,178.75,99.28,99.28,3
CDM,27801290_OP,W CATH JEJUNOSTOMY GDWIRE,275.0,178.75,178.75,269.5,6
CDM,27801300,W CATH PERI DIALY,362.0,235.3,60.82,325.8,20
CDM,27801300_IP,W CATH PERI DIALY,362.0,235.3,130.68,130.68,3
CDM,27801300_OP,W CATH PERI DIALY,362.0,235.3,235.3,354.76,6
CDM,27801310,W CATH PORT,63.0,40.95,10.58,56.7,20
CDM,27801310_IP,W CATH PORT,63.0,40.95,22.74,22.74,3
CDM,27801310_OP,W CATH PORT,63.0,40.95,40.95,61.74,6
CDM,27801320,W CATH PORTACATH,1615.0,1049.75,271.32,1453.5,20
CDM,27801320_IP,W CATH PORTACATH,1615.0,1049.75,583.02,583.02,3
CDM,27801320_OP,W CATH PORTACATH,1615.0,1049.75,1049.75,1582.7,6
CDM,27801330,W CATH REDDICK,264.0,171.6,44.35,237.6,20
CDM,27801330_IP,W CATH REDDICK,264.0,171.6,95.3,95.3,3
CDM,27801330_OP,W CATH REDDICK,264.0,171.6,171.6,258.72,6
CDM,27801340,W CATH SWAN NECK PERTNL 2 CUFF,374.0,243.1,62.83,336.6,20
CDM,27801340_IP,W CATH SWAN NECK PERTNL 2 CUFF,374.0,243.1,135.01,135.01,3
CDM,27801340_OP,W CATH SWAN NECK PERTNL 2 CUFF,374.0,243.1,243.1,366.52,6
CDM,27801350,W CATH VENTR,72.0,46.8,12.1,64.8,20
CDM,27801350_IP,W CATH VENTR,72.0,46.8,25.99,25.99,3
CDM,27801350_OP,W CATH VENTR,72.0,46.8,46.8,70.56,6
CDM,27801370,W CEMENT BONE HYDROSET INJ 10CC,5554.0,3610.1,933.07,4998.6,29
CDM,27801370_OP,W CEMENT BONE HYDROSET INJ 10CC,5554.0,3610.1,3610.1,5442.92,6
CDM,27801380,W CEMENT SIMP FULL GRP 67,1200.0,780.0,201.6,1080.0,20
CDM,27801380_IP,W CEMENT SIMP FULL GRP 67,1200.0,780.0,433.2,433.2,3
CDM,27801380_OP,W CEMENT SIMP FULL GRP 67,1200.0,780.0,780.0,1176.0,6
CDM,27801390,W CEMENT SIMPL HLF DOSE GRP 51,900.0,585.0,151.2,810.0,20
CDM,27801390_IP,W CEMENT SIMPL HLF DOSE GRP 51,900.0,585.0,324.9,324.9,3
CDM,27801390_OP,W CEMENT SIMPL HLF DOSE GRP 51,900.0,585.0,585.0,882.0,6
CDM,27801400,W CEMENT SIMPLEX W/TOB GRP 34,760.0,494.0,127.68,684.0,20
CDM,27801400_IP,W CEMENT SIMPLEX W/TOB GRP 34,760.0,494.0,274.36,274.36,3
CDM,27801400_OP,W CEMENT SIMPLEX W/TOB GRP 34,760.0,494.0,494.0,744.8,6
CDM,27801410,W CEMENT SIMPLX W/TOB GRP 130,4500.0,2925.0,756.0,4050.0,23
CDM,27801410_IP,W CEMENT SIMPLX W/TOB GRP 130,4500.0,2925.0,1624.5,1624.5,3
CDM,27801410_OP,W CEMENT SIMPLX W/TOB GRP 130,4500.0,2925.0,2925.0,4410.0,6
CDM,27801420,"W CEMENT,BONE",7815.0,5079.75,1312.92,7033.5,29
CDM,27801420_OP,"W CEMENT,BONE",7815.0,5079.75,5079.75,7658.7,6
CDM,27801430,W CEMENTED KNEE/ALL POLY TIBIA,3836.0,2493.4,644.45,3452.4,23
CDM,27801430_IP,W CEMENTED KNEE/ALL POLY TIBIA,3836.0,2493.4,1384.8,1384.8,3
CDM,27801430_OP,W CEMENTED KNEE/ALL POLY TIBIA,3836.0,2493.4,2493.4,3759.28,6
CDM,27801440,W CEMT PLUG,214.0,139.1,35.95,192.6,20
CDM,27801440_IP,W CEMT PLUG,214.0,139.1,77.25,77.25,3
CDM,27801440_OP,W CEMT PLUG,214.0,139.1,139.1,209.72,6
CDM,27801450,W CEMT RSTR SET,184.0,119.6,30.91,165.6,20
CDM,27801450_IP,W CEMT RSTR SET,184.0,119.6,66.42,66.42,3
CDM,27801450_OP,W CEMT RSTR SET,184.0,119.6,119.6,180.32,6
CDM,27801460,W CENTRALIZER FEM/DIS GRP 12,10.0,6.5,1.68,9.0,20
CDM,27801460_IP,W CENTRALIZER FEM/DIS GRP 12,10.0,6.5,3.61,3.61,3
CDM,27801460_OP,W CENTRALIZER FEM/DIS GRP 12,10.0,6.5,6.5,9.8,6
CDM,27801470,W CLAMP CERV GLOB GRP 9,2500.0,1625.0,420.0,2250.0,23
CDM,27801470_IP,W CLAMP CERV GLOB GRP 9,2500.0,1625.0,902.5,902.5,3
CDM,27801470_OP,W CLAMP CERV GLOB GRP 9,2500.0,1625.0,1625.0,2450.0,6
CDM,27801480,W CLAMP SPINE STRY GRP 3,800.0,520.0,134.4,720.0,20
CDM,27801480_IP,W CLAMP SPINE STRY GRP 3,800.0,520.0,288.8,288.8,3
CDM,27801480_OP,W CLAMP SPINE STRY GRP 3,800.0,520.0,520.0,784.0,6
CDM,27801490,W CLIP ANEURANEUR,3.0,1.95,0.5,2.7,20
CDM,27801490_IP,W CLIP ANEURANEUR,3.0,1.95,1.08,1.08,3
CDM,27801490_OP,W CLIP ANEURANEUR,3.0,1.95,1.95,2.94,6
CDM,27801510,W CLIP BENJAMIN-HAVAS,1178.0,765.7,197.9,1060.2,20
CDM,27801510_IP,W CLIP BENJAMIN-HAVAS,1178.0,765.7,425.26,425.26,3
CDM,27801510_OP,W CLIP BENJAMIN-HAVAS,1178.0,765.7,765.7,1154.44,6
CDM,27801520,W CLIP DISC ILIZAROV 1/2PIN 5MM,11.0,7.15,1.85,9.9,20
CDM,27801520_IP,W CLIP DISC ILIZAROV 1/2PIN 5MM,11.0,7.15,3.97,3.97,3
CDM,27801520_OP,W CLIP DISC ILIZAROV 1/2PIN 5MM,11.0,7.15,7.15,10.78,6
CDM,27801530,W CLIP HEMOLOK POLYMR LIGATNG,790.0,513.5,132.72,711.0,20
CDM,27801530_IP,W CLIP HEMOLOK POLYMR LIGATNG,790.0,513.5,285.19,285.19,3
CDM,27801530_OP,W CLIP HEMOLOK POLYMR LIGATNG,790.0,513.5,513.5,774.2,6
CDM,27801540,W CLIP PERM TI STD/STR/NAR/FEN,680.0,442.0,114.24,612.0,20
CDM,27801540_IP,W CLIP PERM TI STD/STR/NAR/FEN,680.0,442.0,245.48,245.48,3
CDM,27801540_OP,W CLIP PERM TI STD/STR/NAR/FEN,680.0,442.0,442.0,666.4,6
CDM,27801550,W CLIP PERM TI STD/STR/SLT,610.0,396.5,102.48,549.0,20
CDM,27801550_IP,W CLIP PERM TI STD/STR/SLT,610.0,396.5,220.21,220.21,3
CDM,27801550_OP,W CLIP PERM TI STD/STR/SLT,610.0,396.5,396.5,597.8,6
CDM,27801560,W CLIP RND DISC ILIZAROV WIRE,11.0,7.15,1.85,9.9,20
CDM,27801560_IP,W CLIP RND DISC ILIZAROV WIRE,11.0,7.15,3.97,3.97,3
CDM,27801560_OP,W CLIP RND DISC ILIZAROV WIRE,11.0,7.15,7.15,10.78,6
CDM,27801570,W CLIP SOFTJAW SP,34.0,22.1,5.71,30.6,20
CDM,27801570_IP,W CLIP SOFTJAW SP,34.0,22.1,12.27,12.27,3
CDM,27801570_OP,W CLIP SOFTJAW SP,34.0,22.1,22.1,33.32,6
CDM,27801580,W CLIP TI FT650T/FT220T,647.0,420.55,108.7,582.3,20
CDM,27801580_IP,W CLIP TI FT650T/FT220T,647.0,420.55,233.57,233.57,3
CDM,27801580_OP,W CLIP TI FT650T/FT220T,647.0,420.55,420.55,634.06,6
CDM,27801590,W COIL EMBOLIC,210.0,136.5,35.28,189.0,20
CDM,27801590_IP,W COIL EMBOLIC,210.0,136.5,75.81,75.81,3
CDM,27801590_OP,W COIL EMBOLIC,210.0,136.5,136.5,205.8,6
CDM,27801600,W COLLAGEN MATRIX VERITAS SQCM,44.0,28.6,7.39,39.6,20
CDM,27801600_IP,W COLLAGEN MATRIX VERITAS SQCM,44.0,28.6,15.88,15.88,3
CDM,27801600_OP,W COLLAGEN MATRIX VERITAS SQCM,44.0,28.6,28.6,43.12,6
CDM,27801610,W COLLAGEN MATRIX VERITAS SQCM,44.0,28.6,7.39,39.6,20
CDM,27801610_IP,W COLLAGEN MATRIX VERITAS SQCM,44.0,28.6,15.88,15.88,3
CDM,27801610_OP,W COLLAGEN MATRIX VERITAS SQCM,44.0,28.6,28.6,43.12,6
CDM,27801620,W COLLAGEN MATRIX VERITAS SQCM,44.0,28.6,7.39,39.6,20
CDM,27801620_IP,W COLLAGEN MATRIX VERITAS SQCM,44.0,28.6,15.88,15.88,3
CDM,27801620_OP,W COLLAGEN MATRIX VERITAS SQCM,44.0,28.6,28.6,43.12,6
CDM,27801630,W COLLAGEN MATRIX VERITAS SQCM,49.0,31.85,8.23,44.1,20
CDM,27801630_IP,W COLLAGEN MATRIX VERITAS SQCM,49.0,31.85,17.69,17.69,3
CDM,27801630_OP,W COLLAGEN MATRIX VERITAS SQCM,49.0,31.85,31.85,48.02,6
CDM,27801640,W COLLARS/NUTS IMP SS USS,20.0,13.0,3.36,18.0,20
CDM,27801640_IP,W COLLARS/NUTS IMP SS USS,20.0,13.0,7.22,7.22,3
CDM,27801640_OP,W COLLARS/NUTS IMP SS USS,20.0,13.0,13.0,19.6,6
CDM,27801650,W CONN ADJUSTCRS SPN GLOB GRP 4,800.0,520.0,134.4,720.0,20
CDM,27801650_IP,W CONN ADJUSTCRS SPN GLOB GRP 4,800.0,520.0,288.8,288.8,3
CDM,27801650_OP,W CONN ADJUSTCRS SPN GLOB GRP 4,800.0,520.0,520.0,784.0,6
CDM,27801660,W CONN ROD SPINE MEDT GRP 15,1831.0,1190.15,307.61,1647.9,23
CDM,27801660_IP,W CONN ROD SPINE MEDT GRP 15,1831.0,1190.15,660.99,660.99,3
CDM,27801660_OP,W CONN ROD SPINE MEDT GRP 15,1831.0,1190.15,1190.15,1794.38,6
CDM,27801670,W CONN SS/TI CRS SPN GLOB GRP 3,750.0,487.5,126.0,675.0,20
CDM,27801670_IP,W CONN SS/TI CRS SPN GLOB GRP 3,750.0,487.5,270.75,270.75,3
CDM,27801670_OP,W CONN SS/TI CRS SPN GLOB GRP 3,750.0,487.5,487.5,735.0,6
CDM,27801680,W CONNECTOR ACCU-FLO 17MM,120.0,78.0,20.16,108.0,20
CDM,27801680_IP,W CONNECTOR ACCU-FLO 17MM,120.0,78.0,43.32,43.32,3
CDM,27801680_OP,W CONNECTOR ACCU-FLO 17MM,120.0,78.0,78.0,117.6,6
CDM,27801690,W CONNECTOR CROSSLINK 15MM,800.0,520.0,134.4,720.0,20
CDM,27801690_IP,W CONNECTOR CROSSLINK 15MM,800.0,520.0,288.8,288.8,3
CDM,27801690_OP,W CONNECTOR CROSSLINK 15MM,800.0,520.0,520.0,784.0,6
CDM,27801700,W CONNECTOR DOMINO 3.5X3.5,1140.0,741.0,191.52,1026.0,20
CDM,27801700_IP,W CONNECTOR DOMINO 3.5X3.5,1140.0,741.0,411.54,411.54,3
CDM,27801700_OP,W CONNECTOR DOMINO 3.5X3.5,1140.0,741.0,741.0,1117.2,6
CDM,27801710,W CONNECTOR PARALLEL 6.0X3.5,1490.0,968.5,250.32,1341.0,20
CDM,27801710_IP,W CONNECTOR PARALLEL 6.0X3.5,1490.0,968.5,537.89,537.89,3
CDM,27801710_OP,W CONNECTOR PARALLEL 6.0X3.5,1490.0,968.5,968.5,1460.2,6
CDM,27801720,W CONNECTOR PROTEX OFFSET,892.0,579.8,149.86,802.8,20
CDM,27801720_IP,W CONNECTOR PROTEX OFFSET,892.0,579.8,322.01,322.01,3
CDM,27801720_OP,W CONNECTOR PROTEX OFFSET,892.0,579.8,579.8,874.16,6
CDM,27801730,W CONNECTOR SPINE STRY GRP 11,400.0,260.0,67.2,360.0,20
CDM,27801730_IP,W CONNECTOR SPINE STRY GRP 11,400.0,260.0,144.4,144.4,3
CDM,27801730_OP,W CONNECTOR SPINE STRY GRP 11,400.0,260.0,260.0,392.0,6
CDM,27801740,W CONNECTOR TITANIUM PARALLEL,1236.0,803.4,207.65,1112.4,20
CDM,27801740_IP,W CONNECTOR TITANIUM PARALLEL,1236.0,803.4,446.2,446.2,3
CDM,27801740_OP,W CONNECTOR TITANIUM PARALLEL,1236.0,803.4,803.4,1211.28,6
CDM,27801750,W CONNECTORS SPINE STRY GRP 4,800.0,520.0,134.4,720.0,20
CDM,27801750_IP,W CONNECTORS SPINE STRY GRP 4,800.0,520.0,288.8,288.8,3
CDM,27801750_OP,W CONNECTORS SPINE STRY GRP 4,800.0,520.0,520.0,784.0,6
CDM,27801760,W CORKSCREW SUTURE ANCHOR W/#2,360.0,234.0,60.48,324.0,20
CDM,27801760_IP,W CORKSCREW SUTURE ANCHOR W/#2,360.0,234.0,129.96,129.96,3
CDM,27801760_OP,W CORKSCREW SUTURE ANCHOR W/#2,360.0,234.0,234.0,352.8,6
CDM,27801770,W CORONARY SHUNT AXIUS,200.0,130.0,33.6,180.0,20
CDM,27801770_IP,W CORONARY SHUNT AXIUS,200.0,130.0,72.2,72.2,3
CDM,27801770_OP,W CORONARY SHUNT AXIUS,200.0,130.0,130.0,196.0,6
CDM,27801780,W COUPLER MICROVASCULAR,400.0,260.0,67.2,360.0,20
CDM,27801780_IP,W COUPLER MICROVASCULAR,400.0,260.0,144.4,144.4,3
CDM,27801780_OP,W COUPLER MICROVASCULAR,400.0,260.0,260.0,392.0,6
CDM,27801790,W COVER BURR HOLE TI,370.0,240.5,62.16,333.0,20
CDM,27801790_IP,W COVER BURR HOLE TI,370.0,240.5,133.57,133.57,3
CDM,27801790_OP,W COVER BURR HOLE TI,370.0,240.5,240.5,362.6,6
CDM,27801800,W CRUCIFORM M/P PAT REP,981.0,637.65,164.81,882.9,20
CDM,27801800_IP,W CRUCIFORM M/P PAT REP,981.0,637.65,354.14,354.14,3
CDM,27801800_OP,W CRUCIFORM M/P PAT REP,981.0,637.65,637.65,961.38,6
CDM,27801810,"W CRX,PRECONNECT,MS,IZ,72404261",12278.0,7980.7,2062.7,11050.2,29
CDM,27801810_OP,"W CRX,PRECONNECT,MS,IZ,72404261",12278.0,7980.7,7980.7,12032.44,6
CDM,27801820,W C-TAPER COCR LFIT HEAD GRP-3,1000.0,650.0,168.0,900.0,20
CDM,27801820_IP,W C-TAPER COCR LFIT HEAD GRP-3,1000.0,650.0,361.0,361.0,3
CDM,27801820_OP,W C-TAPER COCR LFIT HEAD GRP-3,1000.0,650.0,650.0,980.0,6
CDM,27801830,W C-TAPER COCR LFIT HEAD GRP-4,1400.0,910.0,235.2,1260.0,20
CDM,27801830_IP,W C-TAPER COCR LFIT HEAD GRP-4,1400.0,910.0,505.4,505.4,3
CDM,27801830_OP,W C-TAPER COCR LFIT HEAD GRP-4,1400.0,910.0,910.0,1372.0,6
CDM,27801840,W CTH PORT 8FR PLS 2 HP PUR KIT,500.0,325.0,84.0,450.0,20
CDM,27801840_IP,W CTH PORT 8FR PLS 2 HP PUR KIT,500.0,325.0,180.5,180.5,3
CDM,27801840_OP,W CTH PORT 8FR PLS 2 HP PUR KIT,500.0,325.0,325.0,490.0,6
CDM,27801850,W CUBE RANCHO 1 HOLE,384.0,249.6,64.51,345.6,20
CDM,27801850_IP,W CUBE RANCHO 1 HOLE,384.0,249.6,138.62,138.62,3
CDM,27801850_OP,W CUBE RANCHO 1 HOLE,384.0,249.6,249.6,376.32,6
CDM,27801860,W CUFF BELT AMS800 W/IZ,6552.0,4258.8,1100.74,5896.8,29
CDM,27801860_OP,W CUFF BELT AMS800 W/IZ,6552.0,4258.8,4258.8,6420.96,6
CDM,27801870,W CUFF BOWEL ACTICON,5360.0,3484.0,900.48,4824.0,29
CDM,27801870_OP,W CUFF BOWEL ACTICON,5360.0,3484.0,3484.0,5252.8,6
CDM,27801880,W CUP DXTEND STAND PE D42 +3MM,1827.0,1187.55,306.94,1644.3,23
CDM,27801880_IP,W CUP DXTEND STAND PE D42 +3MM,1827.0,1187.55,659.55,659.55,3
CDM,27801880_OP,W CUP DXTEND STAND PE D42 +3MM,1827.0,1187.55,1187.55,1790.46,6
CDM,27801890,W CUP PINN SECTOR GRIPTION 54MM,2623.0,1704.95,440.66,2360.7,23
CDM,27801890_IP,W CUP PINN SECTOR GRIPTION 54MM,2623.0,1704.95,946.9,946.9,3
CDM,27801890_OP,W CUP PINN SECTOR GRIPTION 54MM,2623.0,1704.95,1704.95,2570.54,6
CDM,27801900,W DBX MIX 5CC,1712.0,1112.8,287.62,1540.8,20
CDM,27801900_IP,W DBX MIX 5CC,1712.0,1112.8,618.03,618.03,3
CDM,27801900_OP,W DBX MIX 5CC,1712.0,1112.8,1112.8,1677.76,6
CDM,27801910,W DEFIBRILLATOR DC ATLAS V265,27800.0,18070.0,4670.4,25020.0,29
CDM,27801910_OP,W DEFIBRILLATOR DC ATLAS V265,27800.0,18070.0,18070.0,27244.0,6
CDM,27801920,W DEFIBRILLATOR DC VITALITY 2DR,26000.0,16900.0,4368.0,23400.0,29
CDM,27801920_OP,W DEFIBRILLATOR DC VITALITY 2DR,26000.0,16900.0,16900.0,25480.0,6
CDM,27801930,W DEFIBRILLATOR RENEWAL H219,38000.0,24700.0,6384.0,34200.0,29
CDM,27801930_OP,W DEFIBRILLATOR RENEWAL H219,38000.0,24700.0,24700.0,37240.0,6
CDM,27801940,W DEFIRBRILLATOR EPIC II HFV355,36000.0,23400.0,6048.0,32400.0,29
CDM,27801940_OP,W DEFIRBRILLATOR EPIC II HFV355,36000.0,23400.0,23400.0,35280.0,6
CDM,27801950,W DERMA MATRIX 6CMX16CM,7980.0,5187.0,1340.64,7182.0,29
CDM,27801950_OP,W DERMA MATRIX 6CMX16CM,7980.0,5187.0,5187.0,7820.4,6
CDM,27801960,W DERMAMATRIX-6CMX16CM,6398.0,4158.7,1074.86,5758.2,29
CDM,27801960_OP,W DERMAMATRIX-6CMX16CM,6398.0,4158.7,4158.7,6270.04,6
CDM,27801970,W DEV CAPIO SUT,2126.0,1381.9,357.17,1913.4,23
CDM,27801970_IP,W DEV CAPIO SUT,2126.0,1381.9,767.49,767.49,3
CDM,27801970_OP,W DEV CAPIO SUT,2126.0,1381.9,1381.9,2083.48,6
CDM,27801980,W DEV CLOSR VASC 6/7FR MYNX,420.0,273.0,70.56,378.0,20
CDM,27801980_IP,W DEV CLOSR VASC 6/7FR MYNX,420.0,273.0,151.62,151.62,3
CDM,27801980_OP,W DEV CLOSR VASC 6/7FR MYNX,420.0,273.0,273.0,411.6,6
CDM,27801990,W DEV LD LOCKING,1180.0,767.0,198.24,1062.0,20
CDM,27801990_IP,W DEV LD LOCKING,1180.0,767.0,425.98,425.98,3
CDM,27801990_OP,W DEV LD LOCKING,1180.0,767.0,767.0,1156.4,6
CDM,27802000,W DEVICE CAPIO REPAIR WO SLING,650.0,422.5,109.2,585.0,20
CDM,27802000_IP,W DEVICE CAPIO REPAIR WO SLING,650.0,422.5,234.65,234.65,3
CDM,27802000_OP,W DEVICE CAPIO REPAIR WO SLING,650.0,422.5,422.5,637.0,6
CDM,27802010,W DEVICE CLSURE 8FR ANGIO-SEAL,350.0,227.5,58.8,315.0,20
CDM,27802010_IP,W DEVICE CLSURE 8FR ANGIO-SEAL,350.0,227.5,126.35,126.35,3
CDM,27802010_OP,W DEVICE CLSURE 8FR ANGIO-SEAL,350.0,227.5,227.5,343.0,6
CDM,27802020,W DEVICE CLSURE VASC IMP/INSRT,380.0,247.0,63.84,342.0,20
CDM,27802020_IP,W DEVICE CLSURE VASC IMP/INSRT,380.0,247.0,137.18,137.18,3
CDM,27802020_OP,W DEVICE CLSURE VASC IMP/INSRT,380.0,247.0,247.0,372.4,6
CDM,27802030,W DEVICE IPG RESTRE ULTRA 37712,27000.0,17550.0,4536.0,24300.0,29
CDM,27802030_OP,W DEVICE IPG RESTRE ULTRA 37712,27000.0,17550.0,17550.0,26460.0,6
CDM,27802040,W DFIB ATLAS+ HF,36000.0,23400.0,6048.0,32400.0,29
CDM,27802040_OP,W DFIB ATLAS+ HF,36000.0,23400.0,23400.0,35280.0,6
CDM,27802050,W DFIB ATLAS+ HF,52500.0,34125.0,8820.0,47250.0,29
CDM,27802050_OP,W DFIB ATLAS+ HF,52500.0,34125.0,34125.0,51450.0,6
CDM,27802060,W DFIB DC ATLAS,40000.0,26000.0,6720.0,36000.0,29
CDM,27802060_OP,W DFIB DC ATLAS,40000.0,26000.0,26000.0,39200.0,6
CDM,27802070,W DFIB DC ATLAS+,27800.0,18070.0,4670.4,25020.0,29
CDM,27802070_OP,W DFIB DC ATLAS+,27800.0,18070.0,18070.0,27244.0,6
CDM,27802080,W DFIB DC ENTRUST,30210.0,19636.5,5075.28,27189.0,29
CDM,27802080_OP,W DFIB DC ENTRUST,30210.0,19636.5,19636.5,29605.8,6
CDM,27802090,W DFIB DC EPIC+,27800.0,18070.0,4670.4,25020.0,29
CDM,27802090_OP,W DFIB DC EPIC+,27800.0,18070.0,18070.0,27244.0,6
CDM,27802100,W DFIB DC GEM II,72581.0,47177.65,12193.61,65322.9,29
CDM,27802100_OP,W DFIB DC GEM II,72581.0,47177.65,47177.65,71129.38,6
CDM,27802110,W DFIB DC INTRNSC,58500.0,38025.0,9828.0,52650.0,29
CDM,27802110_OP,W DFIB DC INTRNSC,58500.0,38025.0,38025.0,57330.0,6
CDM,27802120,W DFIB DC MAXIMO,26000.0,16900.0,4368.0,23400.0,29
CDM,27802120_OP,W DFIB DC MAXIMO,26000.0,16900.0,16900.0,25480.0,6
CDM,27802130,W DFIB DC VITALTY,25200.0,16380.0,4233.6,22680.0,29
CDM,27802130_OP,W DFIB DC VITALTY,25200.0,16380.0,16380.0,24696.0,6
CDM,27802140,W DFIB DC VITALTY,25200.0,16380.0,4233.6,22680.0,29
CDM,27802140_OP,W DFIB DC VITALTY,25200.0,16380.0,16380.0,24696.0,6
CDM,27802150,W DFIB DC VITALTY,25200.0,16380.0,4233.6,22680.0,29
CDM,27802150_OP,W DFIB DC VITALTY,25200.0,16380.0,16380.0,24696.0,6
CDM,27802160,W DFIB DC VITALTY,27800.0,18070.0,4670.4,25020.0,29
CDM,27802160_OP,W DFIB DC VITALTY,27800.0,18070.0,18070.0,27244.0,6
CDM,27802170,W DFIB DC VNTK,36250.0,23562.5,6090.0,32625.0,29
CDM,27802170_OP,W DFIB DC VNTK,36250.0,23562.5,23562.5,35525.0,6
CDM,27802180,W DFIB EPIC HF,57500.0,37375.0,9660.0,51750.0,29
CDM,27802180_OP,W DFIB EPIC HF,57500.0,37375.0,37375.0,56350.0,6
CDM,27802190,W DFIB EPIC II DR,27800.0,18070.0,4670.4,25020.0,29
CDM,27802190_OP,W DFIB EPIC II DR,27800.0,18070.0,18070.0,27244.0,6
CDM,27802200,W DFIB MAXIMO,57250.0,37212.5,9618.0,51525.0,29
CDM,27802200_OP,W DFIB MAXIMO,57250.0,37212.5,37212.5,56105.0,6
CDM,27802210,W DFIB RENEW 3 HE,52500.0,34125.0,8820.0,47250.0,29
CDM,27802210_OP,W DFIB RENEW 3 HE,52500.0,34125.0,34125.0,51450.0,6
CDM,27802220,W DFIB RENEW 3 RF,36000.0,23400.0,6048.0,32400.0,29
CDM,27802220_OP,W DFIB RENEW 3 RF,36000.0,23400.0,23400.0,35280.0,6
CDM,27802230,W DFIB RENEW 3 RF,38000.0,24700.0,6384.0,34200.0,29
CDM,27802230_OP,W DFIB RENEW 3 RF,38000.0,24700.0,24700.0,37240.0,6
CDM,27802240,W DFIB RENEW 3 RF,56250.0,36562.5,9450.0,50625.0,29
CDM,27802240_OP,W DFIB RENEW 3 RF,56250.0,36562.5,36562.5,55125.0,6
CDM,27802250,W DFIB RENEW 3 SE,50000.0,32500.0,8400.0,45000.0,29
CDM,27802250_OP,W DFIB RENEW 3 SE,50000.0,32500.0,32500.0,49000.0,6
CDM,27802260,W DFIB RENEWAL,47500.0,30875.0,7980.0,42750.0,29
CDM,27802260_OP,W DFIB RENEWAL,47500.0,30875.0,30875.0,46550.0,6
CDM,27802270,W DFIB RENEWAL,50000.0,32500.0,8400.0,45000.0,29
CDM,27802270_OP,W DFIB RENEWAL,50000.0,32500.0,32500.0,49000.0,6
CDM,27802280,W DFIB RENEWAL 3,52500.0,34125.0,8820.0,47250.0,29
CDM,27802280_OP,W DFIB RENEWAL 3,52500.0,34125.0,34125.0,51450.0,6
CDM,27802290,W DFIB SC ATLAS+,24700.0,16055.0,4149.6,22230.0,29
CDM,27802290_OP,W DFIB SC ATLAS+,24700.0,16055.0,16055.0,24206.0,6
CDM,27802300,W DFIB SC ATLAS+,49600.0,32240.0,8332.8,44640.0,29
CDM,27802300_OP,W DFIB SC ATLAS+,49600.0,32240.0,32240.0,48608.0,6
CDM,27802310,W DFIB SC ENTRUST,41000.0,26650.0,6888.0,36900.0,29
CDM,27802310_OP,W DFIB SC ENTRUST,41000.0,26650.0,26650.0,40180.0,6
CDM,27802320,W DFIB SC EPIC+,49600.0,32240.0,8332.8,44640.0,29
CDM,27802320_OP,W DFIB SC EPIC+,49600.0,32240.0,32240.0,48608.0,6
CDM,27802330,W DFIB SC MAXIMO,47750.0,31037.5,8022.0,42975.0,29
CDM,27802330_OP,W DFIB SC MAXIMO,47750.0,31037.5,31037.5,46795.0,6
CDM,27802340,W DFIB SC VITALTY,22800.0,14820.0,3830.4,20520.0,29
CDM,27802340_OP,W DFIB SC VITALTY,22800.0,14820.0,14820.0,22344.0,6
CDM,27802350,W DFIB SC VITALTY,22800.0,14820.0,3830.4,20520.0,29
CDM,27802350_OP,W DFIB SC VITALTY,22800.0,14820.0,14820.0,22344.0,6
CDM,27802360,W DFIB SC VITALTY,22800.0,14820.0,3830.4,20520.0,29
CDM,27802360_OP,W DFIB SC VITALTY,22800.0,14820.0,14820.0,22344.0,6
CDM,27802370,W DFIB SENTRY,70750.0,45987.5,11886.0,63675.0,29
CDM,27802370_OP,W DFIB SENTRY,70750.0,45987.5,45987.5,69335.0,6
CDM,27802380,W DFIB SENTRY,71250.0,46312.5,11970.0,64125.0,29
CDM,27802380_OP,W DFIB SENTRY,71250.0,46312.5,46312.5,69825.0,6
CDM,27802390,W DURAGEN 1 X 1 ID1105,330.0,214.5,55.44,297.0,20
CDM,27802390_IP,W DURAGEN 1 X 1 ID1105,330.0,214.5,119.13,119.13,3
CDM,27802390_OP,W DURAGEN 1 X 1 ID1105,330.0,214.5,214.5,323.4,6
CDM,27802400,W DURAGEN 3X3 ID3301,1200.0,780.0,201.6,1080.0,20
CDM,27802400_IP,W DURAGEN 3X3 ID3301,1200.0,780.0,433.2,433.2,3
CDM,27802400_OP,W DURAGEN 3X3 ID3301,1200.0,780.0,780.0,1176.0,6
CDM,27802410,W DURAGEN 4 X 5 ID4501,2078.0,1350.7,349.1,1870.2,23
CDM,27802410_IP,W DURAGEN 4 X 5 ID4501,2078.0,1350.7,750.16,750.16,3
CDM,27802410_OP,W DURAGEN 4 X 5 ID4501,2078.0,1350.7,1350.7,2036.44,6
CDM,27802420,W DURAMATRIX COLLAGEN 4X5,1962.0,1275.3,329.62,1765.8,23
CDM,27802420_IP,W DURAMATRIX COLLAGEN 4X5,1962.0,1275.3,708.28,708.28,3
CDM,27802420_OP,W DURAMATRIX COLLAGEN 4X5,1962.0,1275.3,1275.3,1922.76,6
CDM,27802440,W EAR STRP T,1028.0,668.2,172.7,925.2,20
CDM,27802440_IP,W EAR STRP T,1028.0,668.2,371.11,371.11,3
CDM,27802440_OP,W EAR STRP T,1028.0,668.2,668.2,1007.44,6
CDM,27802460,W EAR TUBE,76.0,49.4,12.77,68.4,20
CDM,27802460_IP,W EAR TUBE,76.0,49.4,27.44,27.44,3
CDM,27802460_OP,W EAR TUBE,76.0,49.4,49.4,74.48,6
CDM,27802470,W EAR TUBE,132.0,85.8,22.18,118.8,20
CDM,27802470_IP,W EAR TUBE,132.0,85.8,47.65,47.65,3
CDM,27802470_OP,W EAR TUBE,132.0,85.8,85.8,129.36,6
CDM,27802480,W EAR TUBE,187.0,121.55,31.42,168.3,20
CDM,27802480_IP,W EAR TUBE,187.0,121.55,67.51,67.51,3
CDM,27802480_OP,W EAR TUBE,187.0,121.55,121.55,183.26,6
CDM,27802490,W EAR TUBE B,64.0,41.6,10.75,57.6,20
CDM,27802490_IP,W EAR TUBE B,64.0,41.6,23.1,23.1,3
CDM,27802490_OP,W EAR TUBE B,64.0,41.6,41.6,62.72,6
CDM,27802500,W ELECTRDE SUBDERMAL 2.5MM PIN,142.0,92.3,23.86,127.8,21
CDM,27802510,W EMBLIZATION 2MMX5MM VRTX DMND,210.0,136.5,35.28,189.0,20
CDM,27802510_IP,W EMBLIZATION 2MMX5MM VRTX DMND,210.0,136.5,75.81,75.81,3
CDM,27802510_OP,W EMBLIZATION 2MMX5MM VRTX DMND,210.0,136.5,136.5,205.8,6
CDM,27802520,W EMBLIZATN 2MMX3MM VRTX DMND,189.0,122.85,31.75,170.1,20
CDM,27802520_IP,W EMBLIZATN 2MMX3MM VRTX DMND,189.0,122.85,68.23,68.23,3
CDM,27802520_OP,W EMBLIZATN 2MMX3MM VRTX DMND,189.0,122.85,122.85,185.22,6
CDM,27802530,W EMBLIZATN COILS OCCLDNG SPRNG,104.0,67.6,17.47,93.6,20
CDM,27802530_IP,W EMBLIZATN COILS OCCLDNG SPRNG,104.0,67.6,37.54,37.54,3
CDM,27802530_OP,W EMBLIZATN COILS OCCLDNG SPRNG,104.0,67.6,67.6,101.92,6
CDM,27802540,W EMBLIZTN COILS TORNADO/NESTER,150.0,97.5,25.2,135.0,20
CDM,27802540_IP,W EMBLIZTN COILS TORNADO/NESTER,150.0,97.5,54.15,54.15,3
CDM,27802540_OP,W EMBLIZTN COILS TORNADO/NESTER,150.0,97.5,97.5,147.0,6
CDM,27802550,W EMBLZTN COIL FIBERED PLTNM,174.0,113.1,29.23,156.6,20
CDM,27802550_IP,W EMBLZTN COIL FIBERED PLTNM,174.0,113.1,62.81,62.81,3
CDM,27802550_OP,W EMBLZTN COIL FIBERED PLTNM,174.0,113.1,113.1,170.52,6
CDM,27802560,W EMBLZTN COIL VTX35,174.0,113.1,29.23,156.6,20
CDM,27802560_IP,W EMBLZTN COIL VTX35,174.0,113.1,62.81,62.81,3
CDM,27802560_OP,W EMBLZTN COIL VTX35,174.0,113.1,113.1,170.52,6
CDM,27802580,W EPIPHYSIS HUM SZ 1 130708110,7068.0,4594.2,1187.42,6361.2,29
CDM,27802580_OP,W EPIPHYSIS HUM SZ 1 130708110,7068.0,4594.2,4594.2,6926.64,6
CDM,27802590,"W EVENT RECORDER,CARDIAC IMPLAN",8375.0,5443.75,1407.0,7537.5,29
CDM,27802590_OP,"W EVENT RECORDER,CARDIAC IMPLAN",8375.0,5443.75,5443.75,8207.5,6
CDM,27802600,"W EVENT RECORDER,CARDIAC IMPLAN",8500.0,5525.0,1428.0,7650.0,29
CDM,27802600_OP,"W EVENT RECORDER,CARDIAC IMPLAN",8500.0,5525.0,5525.0,8330.0,6
CDM,27802610,W EXETER FEMEROL HEAD GRP-2,1000.0,650.0,168.0,900.0,20
CDM,27802610_IP,W EXETER FEMEROL HEAD GRP-2,1000.0,650.0,361.0,361.0,3
CDM,27802610_OP,W EXETER FEMEROL HEAD GRP-2,1000.0,650.0,650.0,980.0,6
CDM,27802620,W EXETER HIP STEM GRP-1,2499.0,1624.35,419.83,2249.1,23
CDM,27802620_IP,W EXETER HIP STEM GRP-1,2499.0,1624.35,902.14,902.14,3
CDM,27802620_OP,W EXETER HIP STEM GRP-1,2499.0,1624.35,1624.35,2449.02,6
CDM,27802640,W EXPAND TISS SLTX CNT LO/MD/TL,2000.0,1300.0,336.0,1800.0,23
CDM,27802640_IP,W EXPAND TISS SLTX CNT LO/MD/TL,2000.0,1300.0,722.0,722.0,3
CDM,27802640_OP,W EXPAND TISS SLTX CNT LO/MD/TL,2000.0,1300.0,1300.0,1960.0,6
CDM,27802650,W EXPAND TISS STYLE 133MV 700CC,2394.0,1556.1,402.19,2154.6,23
CDM,27802650_IP,W EXPAND TISS STYLE 133MV 700CC,2394.0,1556.1,864.23,864.23,3
CDM,27802650_OP,W EXPAND TISS STYLE 133MV 700CC,2394.0,1556.1,1556.1,2346.12,6
CDM,27802660,W EXPANDER TISSUE BREAST,1990.0,1293.5,334.32,1791.0,23
CDM,27802660_IP,W EXPANDER TISSUE BREAST,1990.0,1293.5,718.39,718.39,3
CDM,27802660_OP,W EXPANDER TISSUE BREAST,1990.0,1293.5,1293.5,1950.2,6
CDM,27802670,W EXT GMRS CONT PIECE GRP 153,6884.0,4474.6,1156.51,6195.6,29
CDM,27802670_OP,W EXT GMRS CONT PIECE GRP 153,6884.0,4474.6,4474.6,6746.32,6
CDM,27802680,W EXT PIECE GMRS GRP 141,5234.0,3402.1,879.31,4710.6,29
CDM,27802680_OP,W EXT PIECE GMRS GRP 141,5234.0,3402.1,3402.1,5129.32,6
CDM,27802690,W EXT SYN/VERS/QUAD/NLINE/ITREL,930.0,604.5,156.24,837.0,20
CDM,27802690_IP,W EXT SYN/VERS/QUAD/NLINE/ITREL,930.0,604.5,335.73,335.73,3
CDM,27802690_OP,W EXT SYN/VERS/QUAD/NLINE/ITREL,930.0,604.5,604.5,911.4,6
CDM,27802700,W EXTEN INTERSTIM QUAD,940.0,611.0,157.92,846.0,20
CDM,27802700_IP,W EXTEN INTERSTIM QUAD,940.0,611.0,339.34,339.34,3
CDM,27802700_OP,W EXTEN INTERSTIM QUAD,940.0,611.0,611.0,921.2,6
CDM,27802710,W EXTENSION CONNECTOR 6.0,1406.0,913.9,236.21,1265.4,20
CDM,27802710_IP,W EXTENSION CONNECTOR 6.0,1406.0,913.9,507.57,507.57,3
CDM,27802710_OP,W EXTENSION CONNECTOR 6.0,1406.0,913.9,913.9,1377.88,6
CDM,27802720,W EXTENSION DBS NEUROSTIM 7482A,1190.0,773.5,199.92,1071.0,20
CDM,27802720_IP,W EXTENSION DBS NEUROSTIM 7482A,1190.0,773.5,429.59,429.59,3
CDM,27802720_OP,W EXTENSION DBS NEUROSTIM 7482A,1190.0,773.5,773.5,1166.2,6
CDM,27802730,W EXTN KT NEURO PAIN 40CM,930.0,604.5,156.24,837.0,20
CDM,27802730_IP,W EXTN KT NEURO PAIN 40CM,930.0,604.5,335.73,335.73,3
CDM,27802730_OP,W EXTN KT NEURO PAIN 40CM,930.0,604.5,604.5,911.4,6
CDM,27802740,W FABRIC HEMASHLD KNTTD DOUBLE,202.0,131.3,33.94,181.8,20
CDM,27802740_IP,W FABRIC HEMASHLD KNTTD DOUBLE,202.0,131.3,72.92,72.92,3
CDM,27802740_OP,W FABRIC HEMASHLD KNTTD DOUBLE,202.0,131.3,131.3,197.96,6
CDM,27802750,W FALLOPIAN RING,140.0,91.0,23.52,126.0,20
CDM,27802750_IP,W FALLOPIAN RING,140.0,91.0,50.54,50.54,3
CDM,27802750_OP,W FALLOPIAN RING,140.0,91.0,91.0,137.2,6
CDM,27802760,W FASCIA TUTOPLAST 937201,1320.0,858.0,221.76,1188.0,20
CDM,27802760_IP,W FASCIA TUTOPLAST 937201,1320.0,858.0,476.52,476.52,3
CDM,27802760_OP,W FASCIA TUTOPLAST 937201,1320.0,858.0,858.0,1293.6,6
CDM,27802770,W FASCIA TUTOPLAST 937227,825.0,536.25,138.6,742.5,20
CDM,27802770_IP,W FASCIA TUTOPLAST 937227,825.0,536.25,297.83,297.83,3
CDM,27802770_OP,W FASCIA TUTOPLAST 937227,825.0,536.25,536.25,808.5,6
CDM,27802780,W FEM DURACON N-BD GRP 41,657.0,427.05,110.38,591.3,20
CDM,27802780_IP,W FEM DURACON N-BD GRP 41,657.0,427.05,237.18,237.18,3
CDM,27802780_OP,W FEM DURACON N-BD GRP 41,657.0,427.05,427.05,643.86,6
CDM,27802790,W FEMORAL COMP PKR RM/LL/LM/RL,5001.0,3250.65,840.17,4500.9,26
CDM,27802790_OP,W FEMORAL COMP PKR RM/LL/LM/RL,5001.0,3250.65,3250.65,4900.98,6
CDM,27802800,W FEMORAL DISTAL AUGMENT RIGHT,1387.0,901.55,233.02,1248.3,20
CDM,27802800_IP,W FEMORAL DISTAL AUGMENT RIGHT,1387.0,901.55,500.71,500.71,3
CDM,27802800_OP,W FEMORAL DISTAL AUGMENT RIGHT,1387.0,901.55,901.55,1359.26,6
CDM,27802810,W FEMORAL HEAD 40MM 40MM/+7MM,2006.0,1303.9,337.01,1805.4,23
CDM,27802810_IP,W FEMORAL HEAD 40MM 40MM/+7MM,2006.0,1303.9,724.17,724.17,3
CDM,27802810_OP,W FEMORAL HEAD 40MM 40MM/+7MM,2006.0,1303.9,1303.9,1965.88,6
CDM,27802820,W FEMORAL IMPLANT 29MM,1960.0,1274.0,329.28,1764.0,23
CDM,27802820_IP,W FEMORAL IMPLANT 29MM,1960.0,1274.0,707.56,707.56,3
CDM,27802820_OP,W FEMORAL IMPLANT 29MM,1960.0,1274.0,1274.0,1920.8,6
CDM,27802830,W FEMORAL NAIL,349.0,226.85,58.63,314.1,20
CDM,27802830_IP,W FEMORAL NAIL,349.0,226.85,125.99,125.99,3
CDM,27802830_OP,W FEMORAL NAIL,349.0,226.85,226.85,342.02,6
CDM,27802840,W FEMORAL PFC TC3 LT/RT,7605.0,4943.25,1277.64,6844.5,29
CDM,27802840_OP,W FEMORAL PFC TC3 LT/RT,7605.0,4943.25,4943.25,7452.9,6
CDM,27802850,W FEMUR DURA BEADED GRP 71,1255.0,815.75,210.84,1129.5,20
CDM,27802850_IP,W FEMUR DURA BEADED GRP 71,1255.0,815.75,453.06,453.06,3
CDM,27802850_OP,W FEMUR DURA BEADED GRP 71,1255.0,815.75,815.75,1229.9,6
CDM,27802860,W FEMUR GMRS STD PROX GRP 161,8500.0,5525.0,1428.0,7650.0,29
CDM,27802860_OP,W FEMUR GMRS STD PROX GRP 161,8500.0,5525.0,5525.0,8330.0,6
CDM,27802870,W FEMUR GMRS TROC PRX GRP 160,8497.0,5523.05,1427.5,7647.3,29
CDM,27802870_OP,W FEMUR GMRS TROC PRX GRP 160,8497.0,5523.05,5523.05,8327.06,6
CDM,27802880,W FEMUR KNEE AVON COMP GRP 163,9562.0,6215.3,1606.42,8605.8,29
CDM,27802880_OP,W FEMUR KNEE AVON COMP GRP 163,9562.0,6215.3,6215.3,9370.76,6
CDM,27802890,W FEMUR MRH KNEE GRP 157,7910.0,5141.5,1328.88,7119.0,29
CDM,27802890_OP,W FEMUR MRH KNEE GRP 157,7910.0,5141.5,5141.5,7751.8,6
CDM,27802900,W FEMUR MRS STM W/O BODY GRP147,5876.0,3819.4,987.17,5288.4,29
CDM,27802900_OP,W FEMUR MRS STM W/O BODY GRP147,5876.0,3819.4,3819.4,5758.48,6
CDM,27802910,W FEMUR POST AUG TRAITH 5MM,1387.0,901.55,233.02,1248.3,20
CDM,27802910_IP,W FEMUR POST AUG TRAITH 5MM,1387.0,901.55,500.71,500.71,3
CDM,27802910_OP,W FEMUR POST AUG TRAITH 5MM,1387.0,901.55,901.55,1359.26,6
CDM,27802920,W FEMUR POST/DISTAL AUG TRAITH,1456.0,946.4,244.61,1310.4,20
CDM,27802920_IP,W FEMUR POST/DISTAL AUG TRAITH,1456.0,946.4,525.62,525.62,3
CDM,27802920_OP,W FEMUR POST/DISTAL AUG TRAITH,1456.0,946.4,946.4,1426.88,6
CDM,27802930,W FEMUR PS WAFFLE LFIT GRP 86,1729.0,1123.85,290.47,1556.1,23
CDM,27802930_IP,W FEMUR PS WAFFLE LFIT GRP 86,1729.0,1123.85,624.17,624.17,3
CDM,27802930_OP,W FEMUR PS WAFFLE LFIT GRP 86,1729.0,1123.85,1123.85,1694.42,6
CDM,27802940,W FEMUR SCRPIO TX FEM GRP 152,6379.0,4146.35,1071.67,5741.1,29
CDM,27802940_OP,W FEMUR SCRPIO TX FEM GRP 152,6379.0,4146.35,4146.35,6251.42,6
CDM,27802950,W FEMUR TRI CEM PS/CR GRP 107,2400.0,1560.0,403.2,2160.0,23
CDM,27802950_IP,W FEMUR TRI CEM PS/CR GRP 107,2400.0,1560.0,866.4,866.4,3
CDM,27802950_OP,W FEMUR TRI CEM PS/CR GRP 107,2400.0,1560.0,1560.0,2352.0,6
CDM,27802960,W FILTER BIRDS NEST PUSH BUTTON,2117.0,1376.05,355.66,1905.3,23
CDM,27802960_IP,W FILTER BIRDS NEST PUSH BUTTON,2117.0,1376.05,764.24,764.24,3
CDM,27802960_OP,W FILTER BIRDS NEST PUSH BUTTON,2117.0,1376.05,1376.05,2074.66,6
CDM,27802970,W FILTER FEMORAL 65CM,2200.0,1430.0,369.6,1980.0,23
CDM,27802970_IP,W FILTER FEMORAL 65CM,2200.0,1430.0,794.2,794.2,3
CDM,27802970_OP,W FILTER FEMORAL 65CM,2200.0,1430.0,1430.0,2156.0,6
CDM,27802980,W FILTER FEMORAL KIT GEN2,2200.0,1430.0,369.6,1980.0,23
CDM,27802980_IP,W FILTER FEMORAL KIT GEN2,2200.0,1430.0,794.2,794.2,3
CDM,27802980_OP,W FILTER FEMORAL KIT GEN2,2200.0,1430.0,1430.0,2156.0,6
CDM,27802990,W FILTER GNTHR TULP VNA CAVA ST,1900.0,1235.0,319.2,1710.0,23
CDM,27802990_IP,W FILTER GNTHR TULP VNA CAVA ST,1900.0,1235.0,685.9,685.9,3
CDM,27802990_OP,W FILTER GNTHR TULP VNA CAVA ST,1900.0,1235.0,1235.0,1862.0,6
CDM,27803000,W FILTER JUGLAR REC GEN2,2200.0,1430.0,369.6,1980.0,23
CDM,27803000_IP,W FILTER JUGLAR REC GEN2,2200.0,1430.0,794.2,794.2,3
CDM,27803000_OP,W FILTER JUGLAR REC GEN2,2200.0,1430.0,1430.0,2156.0,6
CDM,27803010,W FILTER KIT VENA CAVA JUGULAR,2000.0,1300.0,336.0,1800.0,23
CDM,27803010_IP,W FILTER KIT VENA CAVA JUGULAR,2000.0,1300.0,722.0,722.0,3
CDM,27803010_OP,W FILTER KIT VENA CAVA JUGULAR,2000.0,1300.0,1300.0,1960.0,6
CDM,27803020,W FILTER VENA G2 CAVA EXPR FEM,2000.0,1300.0,336.0,1800.0,23
CDM,27803020_IP,W FILTER VENA G2 CAVA EXPR FEM,2000.0,1300.0,722.0,722.0,3
CDM,27803020_OP,W FILTER VENA G2 CAVA EXPR FEM,2000.0,1300.0,1300.0,1960.0,6
CDM,27803030,W FILTER VENCAV FEM JUG 150CM,2174.0,1413.1,365.23,1956.6,23
CDM,27803030_IP,W FILTER VENCAV FEM JUG 150CM,2174.0,1413.1,784.81,784.81,3
CDM,27803030_OP,W FILTER VENCAV FEM JUG 150CM,2174.0,1413.1,1413.1,2130.52,6
CDM,27803050,W FINGER JOINT/HAND IMPLANT,1998.0,1298.7,335.66,1798.2,23
CDM,27803050_IP,W FINGER JOINT/HAND IMPLANT,1998.0,1298.7,721.28,721.28,3
CDM,27803050_OP,W FINGER JOINT/HAND IMPLANT,1998.0,1298.7,1298.7,1958.04,6
CDM,27803060,W FLTR LW PRFL VNA CAVA IVC SYS,2103.0,1366.95,353.3,1892.7,23
CDM,27803060_IP,W FLTR LW PRFL VNA CAVA IVC SYS,2103.0,1366.95,759.18,759.18,3
CDM,27803060_OP,W FLTR LW PRFL VNA CAVA IVC SYS,2103.0,1366.95,1366.95,2060.94,6
CDM,27803070,W FLTR VENA CAVA,2590.0,1683.5,435.12,2331.0,23
CDM,27803070_IP,W FLTR VENA CAVA,2590.0,1683.5,934.99,934.99,3
CDM,27803070_OP,W FLTR VENA CAVA,2590.0,1683.5,1683.5,2538.2,6
CDM,27803080,W FLTR VENA CAVA,3018.0,1961.7,507.02,2716.2,23
CDM,27803080_IP,W FLTR VENA CAVA,3018.0,1961.7,1089.5,1089.5,3
CDM,27803080_OP,W FLTR VENA CAVA,3018.0,1961.7,1961.7,2957.64,6
CDM,27803090,W GASTRIC BAND REALIZE RLZB32,5760.0,3744.0,967.68,5184.0,29
CDM,27803090_OP,W GASTRIC BAND REALIZE RLZB32,5760.0,3744.0,3744.0,5644.8,6
CDM,27803100,W GASTRIC BAND REALIZE W/DISECT,6480.0,4212.0,1088.64,5832.0,29
CDM,27803100_OP,W GASTRIC BAND REALIZE W/DISECT,6480.0,4212.0,4212.0,6350.4,6
CDM,27803110,W GEN INS/IPG CSTM SYNERGY VEST,16000.0,10400.0,2688.0,14400.0,29
CDM,27803110_OP,W GEN INS/IPG CSTM SYNERGY VEST,16000.0,10400.0,10400.0,15680.0,6
CDM,27803120,W GEN NEURO INTRSTM II IPG 3058,17720.0,11518.0,2976.96,15948.0,29
CDM,27803120_OP,W GEN NEURO INTRSTM II IPG 3058,17720.0,11518.0,11518.0,17365.6,6
CDM,27803140,W GEN NEUROSTIM & EXT CHG SYS,24828.0,16138.2,4171.1,22345.2,29
CDM,27803140_OP,W GEN NEUROSTIM & EXT CHG SYS,24828.0,16138.2,16138.2,24331.44,6
CDM,27803150,W GEN NEUROSTIM ENTERRA 3116,16900.0,10985.0,2839.2,15210.0,29
CDM,27803150_OP,W GEN NEUROSTIM ENTERRA 3116,16900.0,10985.0,10985.0,16562.0,6
CDM,27803160,W GEN NEUROSTIM IPG 3023,15840.0,10296.0,2661.12,14256.0,29
CDM,27803160_OP,W GEN NEUROSTIM IPG 3023,15840.0,10296.0,10296.0,15523.2,6
CDM,27803170,W GEN RESTORE ADV IPG 37713,25000.0,16250.0,4200.0,22500.0,29
CDM,27803170_OP,W GEN RESTORE ADV IPG 37713,25000.0,16250.0,16250.0,24500.0,6
CDM,27803180,W GEN STIMULATOR RECHRG 37711,18000.0,11700.0,3024.0,16200.0,29
CDM,27803180_OP,W GEN STIMULATOR RECHRG 37711,18000.0,11700.0,11700.0,17640.0,6
CDM,27803190,W GENERATOR DEMIPULSE,37310.0,24251.5,6268.08,33579.0,29
CDM,27803190_OP,W GENERATOR DEMIPULSE,37310.0,24251.5,24251.5,36563.8,6
CDM,27803200,W GENERATOR PULSE SOLTRA 7426,17090.0,11108.5,2871.12,15381.0,29
CDM,27803200_OP,W GENERATOR PULSE SOLTRA 7426,17090.0,11108.5,11108.5,16748.2,6
CDM,27803210,W GENERATOR VAGUS NERVE SNG/DL,27302.0,17746.3,4586.74,24571.8,29
CDM,27803210_OP,W GENERATOR VAGUS NERVE SNG/DL,27302.0,17746.3,17746.3,26755.96,6
CDM,27803220,W GLEN EQNX SHLDR KLD/PGD M/L,1400.0,910.0,235.2,1260.0,20
CDM,27803220_IP,W GLEN EQNX SHLDR KLD/PGD M/L,1400.0,910.0,505.4,505.4,3
CDM,27803220_OP,W GLEN EQNX SHLDR KLD/PGD M/L,1400.0,910.0,910.0,1372.0,6
CDM,27803230,W GLEN PEG 56,1400.0,910.0,235.2,1260.0,20
CDM,27803230_IP,W GLEN PEG 56,1400.0,910.0,505.4,505.4,3
CDM,27803230_OP,W GLEN PEG 56,1400.0,910.0,910.0,1372.0,6
CDM,27803240,W GLEN PLT,2800.0,1820.0,470.4,2520.0,23
CDM,27803240_IP,W GLEN PLT,2800.0,1820.0,1010.8,1010.8,3
CDM,27803240_OP,W GLEN PLT,2800.0,1820.0,1820.0,2744.0,6
CDM,27803250,W GLENOSPHERE,1500.0,975.0,252.0,1350.0,20
CDM,27803250_IP,W GLENOSPHERE,1500.0,975.0,541.5,541.5,3
CDM,27803250_OP,W GLENOSPHERE,1500.0,975.0,975.0,1470.0,6
CDM,27803260,W GLENOSPHERE 42MM DIA.,2993.0,1945.45,502.82,2693.7,23
CDM,27803260_IP,W GLENOSPHERE 42MM DIA.,2993.0,1945.45,1080.47,1080.47,3
CDM,27803260_OP,W GLENOSPHERE 42MM DIA.,2993.0,1945.45,1945.45,2933.14,6
CDM,27803270,W GLENOSPHERE ECC D42MM,3371.0,2191.15,566.33,3033.9,23
CDM,27803270_IP,W GLENOSPHERE ECC D42MM,3371.0,2191.15,1216.93,1216.93,3
CDM,27803270_OP,W GLENOSPHERE ECC D42MM,3371.0,2191.15,2191.15,3303.58,6
CDM,27803280,W GLENOSPHERE STD D38MM,2000.0,1300.0,336.0,1800.0,23
CDM,27803280_IP,W GLENOSPHERE STD D38MM,2000.0,1300.0,722.0,722.0,3
CDM,27803280_OP,W GLENOSPHERE STD D38MM,2000.0,1300.0,1300.0,1960.0,6
CDM,27803290,W GRAF DIST FLX CUF 6MM X 80CM,5092.0,3309.8,855.46,4582.8,26
CDM,27803290_OP,W GRAF DIST FLX CUF 6MM X 80CM,5092.0,3309.8,3309.8,4990.16,6
CDM,27803300,W GRAFT BYPASS DISTAFLO,2604.0,1692.6,437.47,2343.6,23
CDM,27803300_IP,W GRAFT BYPASS DISTAFLO,2604.0,1692.6,940.04,940.04,3
CDM,27803300_OP,W GRAFT BYPASS DISTAFLO,2604.0,1692.6,1692.6,2551.92,6
CDM,27803310,W GRAFT BYPASS PTFE PRPHL ACTV,2480.0,1612.0,416.64,2232.0,23
CDM,27803310_IP,W GRAFT BYPASS PTFE PRPHL ACTV,2480.0,1612.0,895.28,895.28,3
CDM,27803310_OP,W GRAFT BYPASS PTFE PRPHL ACTV,2480.0,1612.0,1612.0,2430.4,6
CDM,27803320,W GRAFT CSAH8H20X20 SURGISI GLD,8640.0,5616.0,1451.52,7776.0,29
CDM,27803320_OP,W GRAFT CSAH8H20X20 SURGISI GLD,8640.0,5616.0,5616.0,8467.2,6
CDM,27803330,W GRAFT DISTAFLO BYPS 8MMX80CM,3428.0,2228.2,575.9,3085.2,23
CDM,27803330_IP,W GRAFT DISTAFLO BYPS 8MMX80CM,3428.0,2228.2,1237.51,1237.51,3
CDM,27803330_OP,W GRAFT DISTAFLO BYPS 8MMX80CM,3428.0,2228.2,2228.2,3359.44,6
CDM,27803340,W GRAFT DURAGEN 1X3 ID1305,552.0,358.8,92.74,496.8,20
CDM,27803340_IP,W GRAFT DURAGEN 1X3 ID1305,552.0,358.8,199.27,199.27,3
CDM,27803340_OP,W GRAFT DURAGEN 1X3 ID1305,552.0,358.8,358.8,540.96,6
CDM,27803350,W GRAFT FLEXHD 0.8-1.7MM 6X16CM,5502.0,3576.3,924.34,4951.8,29
CDM,27803350_OP,W GRAFT FLEXHD 0.8-1.7MM 6X16CM,5502.0,3576.3,3576.3,5391.96,6
CDM,27803360,W GRAFT FLEXHD 1.8-4MM 6X16CM,5726.0,3721.9,961.97,5153.4,29
CDM,27803360_OP,W GRAFT FLEXHD 1.8-4MM 6X16CM,5726.0,3721.9,3721.9,5611.48,6
CDM,27803370,W GRAFT HEMA MPV 2X6IN,505.0,328.25,84.84,454.5,20
CDM,27803370_IP,W GRAFT HEMA MPV 2X6IN,505.0,328.25,182.31,182.31,3
CDM,27803370_OP,W GRAFT HEMA MPV 2X6IN,505.0,328.25,328.25,494.9,6
CDM,27803380,W GRAFT HERNIA W/PERF SURGISIS,4680.0,3042.0,786.24,4212.0,23
CDM,27803380_IP,W GRAFT HERNIA W/PERF SURGISIS,4680.0,3042.0,1689.48,1689.48,3
CDM,27803380_OP,W GRAFT HERNIA W/PERF SURGISIS,4680.0,3042.0,3042.0,4586.4,6
CDM,27803390,W GRAFT HMDV STRGHT 8MM X 15CM,496.0,322.4,83.33,446.4,20
CDM,27803390_IP,W GRAFT HMDV STRGHT 8MM X 15CM,496.0,322.4,179.06,179.06,3
CDM,27803390_OP,W GRAFT HMDV STRGHT 8MM X 15CM,496.0,322.4,322.4,486.08,6
CDM,27803400,W GRAFT HWDVS PLAT 24MM X 30CM,735.0,477.75,123.48,661.5,20
CDM,27803400_IP,W GRAFT HWDVS PLAT 24MM X 30CM,735.0,477.75,265.34,265.34,3
CDM,27803400_OP,W GRAFT HWDVS PLAT 24MM X 30CM,735.0,477.75,477.75,720.3,6
CDM,27803410,W GRAFT HWDVS PLAT 30CM,702.0,456.3,117.94,631.8,20
CDM,27803410_IP,W GRAFT HWDVS PLAT 30CM,702.0,456.3,253.42,253.42,3
CDM,27803410_OP,W GRAFT HWDVS PLAT 30CM,702.0,456.3,456.3,687.96,6
CDM,27803420,W GRAFT HWDVS PLAT 30CM,784.0,509.6,131.71,705.6,20
CDM,27803420_IP,W GRAFT HWDVS PLAT 30CM,784.0,509.6,283.02,283.02,3
CDM,27803420_OP,W GRAFT HWDVS PLAT 30CM,784.0,509.6,509.6,768.32,6
CDM,27803430,W GRAFT HWDVS PLAT 30MM X 30CM,752.0,488.8,126.34,676.8,20
CDM,27803430_IP,W GRAFT HWDVS PLAT 30MM X 30CM,752.0,488.8,271.47,271.47,3
CDM,27803430_OP,W GRAFT HWDVS PLAT 30MM X 30CM,752.0,488.8,488.8,736.96,6
CDM,27803440,W GRAFT HWDVS PLAT 32MM X 60CM,1012.0,657.8,170.02,910.8,20
CDM,27803440_IP,W GRAFT HWDVS PLAT 32MM X 60CM,1012.0,657.8,365.33,365.33,3
CDM,27803440_OP,W GRAFT HWDVS PLAT 32MM X 60CM,1012.0,657.8,657.8,991.76,6
CDM,27803450,W GRAFT IMPRA FLEX 10MM X 80CM,2670.0,1735.5,448.56,2403.0,23
CDM,27803450_IP,W GRAFT IMPRA FLEX 10MM X 80CM,2670.0,1735.5,963.87,963.87,3
CDM,27803450_OP,W GRAFT IMPRA FLEX 10MM X 80CM,2670.0,1735.5,1735.5,2616.6,6
CDM,27803460,W GRAFT IMPRA FLEX 8MM X 60CM,1950.0,1267.5,327.6,1755.0,23
CDM,27803460_IP,W GRAFT IMPRA FLEX 8MM X 60CM,1950.0,1267.5,703.95,703.95,3
CDM,27803460_OP,W GRAFT IMPRA FLEX 8MM X 60CM,1950.0,1267.5,1267.5,1911.0,6
CDM,27803470,W GRAFT IMPRA VASCLR 10MMX60CM,1729.0,1123.85,290.47,1556.1,23
CDM,27803470_IP,W GRAFT IMPRA VASCLR 10MMX60CM,1729.0,1123.85,624.17,624.17,3
CDM,27803470_OP,W GRAFT IMPRA VASCLR 10MMX60CM,1729.0,1123.85,1123.85,1694.42,6
CDM,27803480,W GRAFT PROPATEN 7MM X 40CM,2250.0,1462.5,378.0,2025.0,23
CDM,27803480_IP,W GRAFT PROPATEN 7MM X 40CM,2250.0,1462.5,812.25,812.25,3
CDM,27803480_OP,W GRAFT PROPATEN 7MM X 40CM,2250.0,1462.5,1462.5,2205.0,6
CDM,27803490,W GRAFT PROPATEN 7MM X 50CM,3294.0,2141.1,553.39,2964.6,23
CDM,27803490_IP,W GRAFT PROPATEN 7MM X 50CM,3294.0,2141.1,1189.13,1189.13,3
CDM,27803490_OP,W GRAFT PROPATEN 7MM X 50CM,3294.0,2141.1,2141.1,3228.12,6
CDM,27803500,W GRAFT PROPATEN H060040A,1970.0,1280.5,330.96,1773.0,23
CDM,27803500_IP,W GRAFT PROPATEN H060040A,1970.0,1280.5,711.17,711.17,3
CDM,27803500_OP,W GRAFT PROPATEN H060040A,1970.0,1280.5,1280.5,1930.6,6
CDM,27803510,W GRAFT PROPATEN HT087080A,5216.0,3390.4,876.29,4694.4,29
CDM,27803510_OP,W GRAFT PROPATEN HT087080A,5216.0,3390.4,3390.4,5111.68,6
CDM,27803530,W GRAFT TENDON,9577.0,6225.05,1608.94,8619.3,29
CDM,27803530_OP,W GRAFT TENDON,9577.0,6225.05,6225.05,9385.46,6
CDM,27803540,W GRAFT TIBIALI POSTERIOR,4800.0,3120.0,806.4,4320.0,26
CDM,27803540_OP,W GRAFT TIBIALI POSTERIOR,4800.0,3120.0,3120.0,4704.0,6
CDM,27803550,W GRAFT VAS BIF 50CM,922.0,599.3,154.9,829.8,20
CDM,27803550_IP,W GRAFT VAS BIF 50CM,922.0,599.3,332.84,332.84,3
CDM,27803550_OP,W GRAFT VAS BIF 50CM,922.0,599.3,599.3,903.56,6
CDM,27803560,W GRAFT VASC TAP 7-4MM ID 40CM,1200.0,780.0,201.6,1080.0,20
CDM,27803560_IP,W GRAFT VASC TAP 7-4MM ID 40CM,1200.0,780.0,433.2,433.2,3
CDM,27803560_OP,W GRAFT VASC TAP 7-4MM ID 40CM,1200.0,780.0,780.0,1176.0,6
CDM,27803570,W GRAFT VASCLR HEMSHLD VLR FBRC,245.0,159.25,41.16,220.5,20
CDM,27803570_IP,W GRAFT VASCLR HEMSHLD VLR FBRC,245.0,159.25,88.45,88.45,3
CDM,27803570_OP,W GRAFT VASCLR HEMSHLD VLR FBRC,245.0,159.25,159.25,240.1,6
CDM,27803600,W GRAFTON CRUNCH 15CC 124115,2816.0,1830.4,473.09,2534.4,23
CDM,27803600_IP,W GRAFTON CRUNCH 15CC 124115,2816.0,1830.4,1016.58,1016.58,3
CDM,27803600_OP,W GRAFTON CRUNCH 15CC 124115,2816.0,1830.4,1830.4,2759.68,6
CDM,27803610,W GRAFTON CRUNCH 5CC,2080.0,1352.0,349.44,1872.0,23
CDM,27803610_IP,W GRAFTON CRUNCH 5CC,2080.0,1352.0,750.88,750.88,3
CDM,27803610_OP,W GRAFTON CRUNCH 5CC,2080.0,1352.0,1352.0,2038.4,6
CDM,27803620,W GRF ARTR SYN AS,936.0,608.4,157.25,842.4,20
CDM,27803620_IP,W GRF ARTR SYN AS,936.0,608.4,337.9,337.9,3
CDM,27803620_OP,W GRF ARTR SYN AS,936.0,608.4,608.4,917.28,6
CDM,27803630,W GRF GRTX PTCH1M,796.0,517.4,133.73,716.4,20
CDM,27803630_IP,W GRF GRTX PTCH1M,796.0,517.4,287.36,287.36,3
CDM,27803630_OP,W GRF GRTX PTCH1M,796.0,517.4,517.4,780.08,6
CDM,27803640,W GRF GRTX PTCH2M,2351.0,1528.15,394.97,2115.9,23
CDM,27803640_IP,W GRF GRTX PTCH2M,2351.0,1528.15,848.71,848.71,3
CDM,27803640_OP,W GRF GRTX PTCH2M,2351.0,1528.15,1528.15,2303.98,6
CDM,27803650,W GRF GRTX SFTTIS,2544.0,1653.6,427.39,2289.6,23
CDM,27803650_IP,W GRF GRTX SFTTIS,2544.0,1653.6,918.38,918.38,3
CDM,27803650_OP,W GRF GRTX SFTTIS,2544.0,1653.6,1653.6,2493.12,6
CDM,27803660,W GRF GRTX STR,913.0,593.45,153.38,821.7,20
CDM,27803660_IP,W GRF GRTX STR,913.0,593.45,329.59,329.59,3
CDM,27803660_OP,W GRF GRTX STR,913.0,593.45,593.45,894.74,6
CDM,27803670,W GRF GRTX STR,4203.0,2731.95,706.1,3782.7,23
CDM,27803670_IP,W GRF GRTX STR,4203.0,2731.95,1517.28,1517.28,3
CDM,27803670_OP,W GRF GRTX STR,4203.0,2731.95,2731.95,4118.94,6
CDM,27803680,W GRF PATCH DACRN,179.0,116.35,30.07,161.1,20
CDM,27803680_IP,W GRF PATCH DACRN,179.0,116.35,64.62,64.62,3
CDM,27803680_OP,W GRF PATCH DACRN,179.0,116.35,116.35,175.42,6
CDM,27803690,W GRFT 8MMX80CM,2812.0,1827.8,472.42,2530.8,23
CDM,27803690_IP,W GRFT 8MMX80CM,2812.0,1827.8,1015.13,1015.13,3
CDM,27803690_OP,W GRFT 8MMX80CM,2812.0,1827.8,1827.8,2755.76,6
CDM,27803700,W GRFT BARD FSL14,784.0,509.6,131.71,705.6,20
CDM,27803700_IP,W GRFT BARD FSL14,784.0,509.6,283.02,283.02,3
CDM,27803700_OP,W GRFT BARD FSL14,784.0,509.6,509.6,768.32,6
CDM,27803710,W GRFT CV FELT 4,146.0,94.9,24.53,131.4,20
CDM,27803710_IP,W GRFT CV FELT 4,146.0,94.9,52.71,52.71,3
CDM,27803710_OP,W GRFT CV FELT 4,146.0,94.9,94.9,143.08,6
CDM,27803720,W GRFT CV FELT 6,282.0,183.3,47.38,253.8,20
CDM,27803720_IP,W GRFT CV FELT 6,282.0,183.3,101.8,101.8,3
CDM,27803720_OP,W GRFT CV FELT 6,282.0,183.3,183.3,276.36,6
CDM,27803730,W GRFT CV PLEDGET,87.0,56.55,14.62,78.3,20
CDM,27803730_IP,W GRFT CV PLEDGET,87.0,56.55,31.41,31.41,3
CDM,27803730_OP,W GRFT CV PLEDGET,87.0,56.55,56.55,85.26,6
CDM,27803740,W GRFT GRTX PTCH,608.0,395.2,102.14,547.2,20
CDM,27803740_IP,W GRFT GRTX PTCH,608.0,395.2,219.49,219.49,3
CDM,27803740_OP,W GRFT GRTX PTCH,608.0,395.2,395.2,595.84,6
CDM,27803750,W GRFT HOMO,206.0,133.9,34.61,185.4,20
CDM,27803750_IP,W GRFT HOMO,206.0,133.9,74.37,74.37,3
CDM,27803750_OP,W GRFT HOMO,206.0,133.9,133.9,201.88,6
CDM,27803760,W GRFT MESH MRSLN,119.0,77.35,19.99,107.1,20
CDM,27803760_IP,W GRFT MESH MRSLN,119.0,77.35,42.96,42.96,3
CDM,27803760_OP,W GRFT MESH MRSLN,119.0,77.35,77.35,116.62,6
CDM,27803770,W GRFT MESH SS,1407.0,914.55,236.38,1266.3,20
CDM,27803770_IP,W GRFT MESH SS,1407.0,914.55,507.93,507.93,3
CDM,27803770_OP,W GRFT MESH SS,1407.0,914.55,914.55,1378.86,6
CDM,27803780,W GRFT PATCH,373.0,242.45,62.66,335.7,20
CDM,27803780_IP,W GRFT PATCH,373.0,242.45,134.65,134.65,3
CDM,27803780_OP,W GRFT PATCH,373.0,242.45,242.45,365.54,6
CDM,27803790,W GRFT PERICARDL,1950.0,1267.5,327.6,1755.0,23
CDM,27803790_IP,W GRFT PERICARDL,1950.0,1267.5,703.95,703.95,3
CDM,27803790_OP,W GRFT PERICARDL,1950.0,1267.5,1267.5,1911.0,6
CDM,27803800,W GRFT STD TAPERED 4-7MM X 30CM,820.0,533.0,137.76,738.0,20
CDM,27803800_IP,W GRFT STD TAPERED 4-7MM X 30CM,820.0,533.0,296.02,296.02,3
CDM,27803800_OP,W GRFT STD TAPERED 4-7MM X 30CM,820.0,533.0,533.0,803.6,6
CDM,27803810,W GRFT V ACCESS,2889.0,1877.85,485.35,2600.1,23
CDM,27803810_IP,W GRFT V ACCESS,2889.0,1877.85,1042.93,1042.93,3
CDM,27803810_OP,W GRFT V ACCESS,2889.0,1877.85,1877.85,2831.22,6
CDM,27803820,W GRFT V CNTRFLX,1772.0,1151.8,297.7,1594.8,23
CDM,27803820_IP,W GRFT V CNTRFLX,1772.0,1151.8,639.69,639.69,3
CDM,27803820_OP,W GRFT V CNTRFLX,1772.0,1151.8,1151.8,1736.56,6
CDM,27803830,W GRFT V EXXCEL,4133.0,2686.45,694.34,3719.7,23
CDM,27803830_IP,W GRFT V EXXCEL,4133.0,2686.45,1492.01,1492.01,3
CDM,27803830_OP,W GRFT V EXXCEL,4133.0,2686.45,2686.45,4050.34,6
CDM,27803840,W GRFT V IMP VEN,2114.0,1374.1,355.15,1902.6,23
CDM,27803840_IP,W GRFT V IMP VEN,2114.0,1374.1,763.15,763.15,3
CDM,27803840_OP,W GRFT V IMP VEN,2114.0,1374.1,1374.1,2071.72,6
CDM,27803850,W GRFT VASC BIF C,2114.0,1374.1,355.15,1902.6,23
CDM,27803850_IP,W GRFT VASC BIF C,2114.0,1374.1,763.15,763.15,3
CDM,27803850_OP,W GRFT VASC BIF C,2114.0,1374.1,1374.1,2071.72,6
CDM,27803860,W GRFT VASC BIF D,2636.0,1713.4,442.85,2372.4,23
CDM,27803860_IP,W GRFT VASC BIF D,2636.0,1713.4,951.6,951.6,3
CDM,27803860_OP,W GRFT VASC BIF D,2636.0,1713.4,1713.4,2583.28,6
CDM,27803870,W GRFT VASC STR G,1312.0,852.8,220.42,1180.8,20
CDM,27803870_IP,W GRFT VASC STR G,1312.0,852.8,473.63,473.63,3
CDM,27803870_OP,W GRFT VASC STR G,1312.0,852.8,852.8,1285.76,6
CDM,27803880,W GRFT VASC STR M,2127.0,1382.55,357.34,1914.3,23
CDM,27803880_IP,W GRFT VASC STR M,2127.0,1382.55,767.85,767.85,3
CDM,27803880_OP,W GRFT VASC STR M,2127.0,1382.55,1382.55,2084.46,6
CDM,27803890,W GRFT VASC STR M,2127.0,1382.55,357.34,1914.3,23
CDM,27803890_IP,W GRFT VASC STR M,2127.0,1382.55,767.85,767.85,3
CDM,27803890_OP,W GRFT VASC STR M,2127.0,1382.55,1382.55,2084.46,6
CDM,27803900,W GRFT VASC STR W,2758.0,1792.7,463.34,2482.2,23
CDM,27803900_IP,W GRFT VASC STR W,2758.0,1792.7,995.64,995.64,3
CDM,27803900_OP,W GRFT VASC STR W,2758.0,1792.7,1792.7,2702.84,6
CDM,27803910,W GRFT VASCULAR,6063.0,3940.95,1018.58,5456.7,29
CDM,27803910_OP,W GRFT VASCULAR,6063.0,3940.95,3940.95,5941.74,6
CDM,27803920,W GRFT VASCULAR 2,19756.0,12841.4,3319.01,17780.4,29
CDM,27803920_OP,W GRFT VASCULAR 2,19756.0,12841.4,12841.4,19360.88,6
CDM,27803930,W GRFT VASCULAR 3,20574.0,13373.1,3456.43,18516.6,29
CDM,27803930_OP,W GRFT VASCULAR 3,20574.0,13373.1,13373.1,20162.52,6
CDM,27803940,W GRIP DM CABLE GRP 89,1825.0,1186.25,306.6,1642.5,23
CDM,27803940_IP,W GRIP DM CABLE GRP 89,1825.0,1186.25,658.83,658.83,3
CDM,27803940_OP,W GRIP DM CABLE GRP 89,1825.0,1186.25,1186.25,1788.5,6
CDM,27803950,W GRIP DM VIT CABLE GRP 60,1055.0,685.75,177.24,949.5,20
CDM,27803950_IP,W GRIP DM VIT CABLE GRP 60,1055.0,685.75,380.86,380.86,3
CDM,27803950_OP,W GRIP DM VIT CABLE GRP 60,1055.0,685.75,685.75,1033.9,6
CDM,27803960,W HD ECC HMRL,1400.0,910.0,235.2,1260.0,20
CDM,27803960_IP,W HD ECC HMRL,1400.0,910.0,505.4,505.4,3
CDM,27803960_OP,W HD ECC HMRL,1400.0,910.0,910.0,1372.0,6
CDM,27803970,W HD EQNX HMRAL EXP/TALL/SH,1400.0,910.0,235.2,1260.0,20
CDM,27803970_IP,W HD EQNX HMRAL EXP/TALL/SH,1400.0,910.0,505.4,505.4,3
CDM,27803970_OP,W HD EQNX HMRAL EXP/TALL/SH,1400.0,910.0,910.0,1372.0,6
CDM,27803980,W HEAD 32MM +0 NECK,1947.0,1265.55,327.1,1752.3,23
CDM,27803980_IP,W HEAD 32MM +0 NECK,1947.0,1265.55,702.87,702.87,3
CDM,27803980_OP,W HEAD 32MM +0 NECK,1947.0,1265.55,1265.55,1908.06,6
CDM,27803990,W HEAD ART M 40MM 12/14,1100.0,715.0,184.8,990.0,20
CDM,27803990_IP,W HEAD ART M 40MM 12/14,1100.0,715.0,397.1,397.1,3
CDM,27803990_OP,W HEAD ART M 40MM 12/14,1100.0,715.0,715.0,1078.0,6
CDM,27804000,W HEAD ARTICUL/EZESROM 36MM,565.0,367.25,94.92,508.5,20
CDM,27804000_IP,W HEAD ARTICUL/EZESROM 36MM,565.0,367.25,203.97,203.97,3
CDM,27804000_OP,W HEAD ARTICUL/EZESROM 36MM,565.0,367.25,367.25,553.7,6
CDM,27804010,W HEAD C-TAPER 28MM +5MM,1000.0,650.0,168.0,900.0,20
CDM,27804010_IP,W HEAD C-TAPER 28MM +5MM,1000.0,650.0,361.0,361.0,3
CDM,27804010_OP,W HEAD C-TAPER 28MM +5MM,1000.0,650.0,650.0,980.0,6
CDM,27804020,W HEAD FEM ANATMIC 40MM GRP 94,1400.0,910.0,235.2,1260.0,20
CDM,27804020_IP,W HEAD FEM ANATMIC 40MM GRP 94,1400.0,910.0,505.4,505.4,3
CDM,27804020_OP,W HEAD FEM ANATMIC 40MM GRP 94,1400.0,910.0,910.0,1372.0,6
CDM,27804030,W HEAD FEM CER DELTA +0 28MM,585.0,380.25,98.28,526.5,20
CDM,27804030_IP,W HEAD FEM CER DELTA +0 28MM,585.0,380.25,211.19,211.19,3
CDM,27804030_OP,W HEAD FEM CER DELTA +0 28MM,585.0,380.25,380.25,573.3,6
CDM,27804040,W HEAD FEM LFIT V40 26MM +8MM,1000.0,650.0,168.0,900.0,20
CDM,27804040_IP,W HEAD FEM LFIT V40 26MM +8MM,1000.0,650.0,361.0,361.0,3
CDM,27804040_OP,W HEAD FEM LFIT V40 26MM +8MM,1000.0,650.0,650.0,980.0,6
CDM,27804050,W HEAD FEM ORTHINOX GRP 168,1000.0,650.0,168.0,900.0,20
CDM,27804050_IP,W HEAD FEM ORTHINOX GRP 168,1000.0,650.0,361.0,361.0,3
CDM,27804050_OP,W HEAD FEM ORTHINOX GRP 168,1000.0,650.0,650.0,980.0,6
CDM,27804060,W HEAD FEMORAL UNIV TAPER 40MM,2400.0,1560.0,403.2,2160.0,23
CDM,27804060_IP,W HEAD FEMORAL UNIV TAPER 40MM,2400.0,1560.0,866.4,866.4,3
CDM,27804060_OP,W HEAD FEMORAL UNIV TAPER 40MM,2400.0,1560.0,1560.0,2352.0,6
CDM,27804070,W HEAD FEMORAL V40 GRP 54,1000.0,650.0,168.0,900.0,20
CDM,27804070_IP,W HEAD FEMORAL V40 GRP 54,1000.0,650.0,361.0,361.0,3
CDM,27804070_OP,W HEAD FEMORAL V40 GRP 54,1000.0,650.0,650.0,980.0,6
CDM,27804080,W HEAD FEMRL UNIVRSL TAPRD 28MM,2177.0,1415.05,365.74,1959.3,23
CDM,27804080_IP,W HEAD FEMRL UNIVRSL TAPRD 28MM,2177.0,1415.05,785.9,785.9,3
CDM,27804080_OP,W HEAD FEMRL UNIVRSL TAPRD 28MM,2177.0,1415.05,1415.05,2133.46,6
CDM,27804090,W HEAD HIP OFFSET GRP 81,1520.0,988.0,255.36,1368.0,20
CDM,27804090_IP,W HEAD HIP OFFSET GRP 81,1520.0,988.0,548.72,548.72,3
CDM,27804090_OP,W HEAD HIP OFFSET GRP 81,1520.0,988.0,988.0,1489.6,6
CDM,27804100,W HEAD HUM EPI 1 DXTEND MOD HA,4092.0,2659.8,687.46,3682.8,23
CDM,27804100_IP,W HEAD HUM EPI 1 DXTEND MOD HA,4092.0,2659.8,1477.21,1477.21,3
CDM,27804100_OP,W HEAD HUM EPI 1 DXTEND MOD HA,4092.0,2659.8,2659.8,4010.16,6
CDM,27804110,W HEAD SELF CENT BIPL 52X28 BLU,1842.0,1197.3,309.46,1657.8,23
CDM,27804110_IP,W HEAD SELF CENT BIPL 52X28 BLU,1842.0,1197.3,664.96,664.96,3
CDM,27804110_OP,W HEAD SELF CENT BIPL 52X28 BLU,1842.0,1197.3,1197.3,1805.16,6
CDM,27804120,W HEAD UHR UNIVSL GRP 87,1734.0,1127.1,291.31,1560.6,23
CDM,27804120_IP,W HEAD UHR UNIVSL GRP 87,1734.0,1127.1,625.97,625.97,3
CDM,27804120_OP,W HEAD UHR UNIVSL GRP 87,1734.0,1127.1,1127.1,1699.32,6
CDM,27804130,W HEAD UNITRAX MOD/ENDO GRP55,1002.0,651.3,168.34,901.8,20
CDM,27804130_IP,W HEAD UNITRAX MOD/ENDO GRP55,1002.0,651.3,361.72,361.72,3
CDM,27804130_OP,W HEAD UNITRAX MOD/ENDO GRP55,1002.0,651.3,651.3,981.96,6
CDM,27804140,W HEMI PATELLA TENDON,4500.0,2925.0,756.0,4050.0,23
CDM,27804140_IP,W HEMI PATELLA TENDON,4500.0,2925.0,1624.5,1624.5,3
CDM,27804140_OP,W HEMI PATELLA TENDON,4500.0,2925.0,2925.0,4410.0,6
CDM,27804150,W HIGH DEMAND BI-POLAR HIP,5560.0,3614.0,934.08,5004.0,29
CDM,27804150_OP,W HIGH DEMAND BI-POLAR HIP,5560.0,3614.0,3614.0,5448.8,6
CDM,27804160,W HIGH DEMAND UNI-POLAR HIP,4640.0,3016.0,779.52,4176.0,23
CDM,27804160_IP,W HIGH DEMAND UNI-POLAR HIP,4640.0,3016.0,1675.04,1675.04,3
CDM,27804160_OP,W HIGH DEMAND UNI-POLAR HIP,4640.0,3016.0,3016.0,4547.2,6
CDM,27804170,W HIP 1249-52 DURALOC LOCK RING,397.0,258.05,66.7,357.3,20
CDM,27804170_IP,W HIP 1249-52 DURALOC LOCK RING,397.0,258.05,143.32,143.32,3
CDM,27804170_OP,W HIP 1249-52 DURALOC LOCK RING,397.0,258.05,258.05,389.06,6
CDM,27804180,W HIP FEM HEAD MOD ARCOM 36MM,8390.0,5453.5,1409.52,7551.0,29
CDM,27804180_OP,W HIP FEM HEAD MOD ARCOM 36MM,8390.0,5453.5,5453.5,8222.2,6
CDM,27804190,W HIP FEMORAL HEAD ARTICUL/EZE,360.0,234.0,60.48,324.0,20
CDM,27804190_IP,W HIP FEMORAL HEAD ARTICUL/EZE,360.0,234.0,129.96,129.96,3
CDM,27804190_OP,W HIP FEMORAL HEAD ARTICUL/EZE,360.0,234.0,234.0,352.8,6
CDM,27804230,"W HIP,FEMORAL ACETABULAR",597.0,388.05,100.3,537.3,20
CDM,27804230_IP,"W HIP,FEMORAL ACETABULAR",597.0,388.05,215.52,215.52,3
CDM,27804230_OP,"W HIP,FEMORAL ACETABULAR",597.0,388.05,388.05,585.06,6
CDM,27804240,"W HIP,FEMORAL STEM",2389.0,1552.85,401.35,2150.1,23
CDM,27804240_IP,"W HIP,FEMORAL STEM",2389.0,1552.85,862.43,862.43,3
CDM,27804240_OP,"W HIP,FEMORAL STEM",2389.0,1552.85,1552.85,2341.22,6
CDM,27804250,W HLDR CERVPLYAXS SPN GLOB GRP6,1250.0,812.5,210.0,1125.0,20
CDM,27804250_IP,W HLDR CERVPLYAXS SPN GLOB GRP6,1250.0,812.5,451.25,451.25,3
CDM,27804250_OP,W HLDR CERVPLYAXS SPN GLOB GRP6,1250.0,812.5,812.5,1225.0,6
CDM,27804260,W HOOK LAMINA /LEFT,1260.0,819.0,211.68,1134.0,20
CDM,27804260_IP,W HOOK LAMINA /LEFT,1260.0,819.0,454.86,454.86,3
CDM,27804260_OP,W HOOK LAMINA /LEFT,1260.0,819.0,819.0,1234.8,6
CDM,27804270,W HOOK SPINE MEDT GRP 11,1250.0,812.5,210.0,1125.0,20
CDM,27804270_IP,W HOOK SPINE MEDT GRP 11,1250.0,812.5,451.25,451.25,3
CDM,27804270_OP,W HOOK SPINE MEDT GRP 11,1250.0,812.5,812.5,1225.0,6
CDM,27804280,W HOOK SS SPINE GLOB GRP 7,1250.0,812.5,210.0,1125.0,20
CDM,27804280_IP,W HOOK SS SPINE GLOB GRP 7,1250.0,812.5,451.25,451.25,3
CDM,27804280_OP,W HOOK SS SPINE GLOB GRP 7,1250.0,812.5,812.5,1225.0,6
CDM,27804290,W HOOK SS USS TP,1280.0,832.0,215.04,1152.0,20
CDM,27804290_IP,W HOOK SS USS TP,1280.0,832.0,462.08,462.08,3
CDM,27804290_OP,W HOOK SS USS TP,1280.0,832.0,832.0,1254.4,6
CDM,27804300,W HOOKS SPINE STRY GRP 5,800.0,520.0,134.4,720.0,20
CDM,27804300_IP,W HOOKS SPINE STRY GRP 5,800.0,520.0,288.8,288.8,3
CDM,27804300_OP,W HOOKS SPINE STRY GRP 5,800.0,520.0,520.0,784.0,6
CDM,27804310,W HOOKS SPINE STRY GRP 8,1200.0,780.0,201.6,1080.0,20
CDM,27804310_IP,W HOOKS SPINE STRY GRP 8,1200.0,780.0,433.2,433.2,3
CDM,27804310_OP,W HOOKS SPINE STRY GRP 8,1200.0,780.0,780.0,1176.0,6
CDM,27804330,W HYDROSET BONE SUBSTITUTE,2810.0,1826.5,472.08,2529.0,23
CDM,27804330_IP,W HYDROSET BONE SUBSTITUTE,2810.0,1826.5,1014.41,1014.41,3
CDM,27804330_OP,W HYDROSET BONE SUBSTITUTE,2810.0,1826.5,1826.5,2753.8,6
CDM,27804340,W ICD ATLAS V-268,27800.0,18070.0,4670.4,25020.0,29
CDM,27804340_OP,W ICD ATLAS V-268,27800.0,18070.0,18070.0,27244.0,6
CDM,27804350,W ICD BI V COGNIS,30000.0,19500.0,5040.0,27000.0,29
CDM,27804350_OP,W ICD BI V COGNIS,30000.0,19500.0,19500.0,29400.0,6
CDM,27804360,W ICD COGNIS N118,30000.0,19500.0,5040.0,27000.0,29
CDM,27804360_OP,W ICD COGNIS N118,30000.0,19500.0,19500.0,29400.0,6
CDM,27804370,W ICD CONFIENT DR E030,24500.0,15925.0,4116.0,22050.0,29
CDM,27804370_OP,W ICD CONFIENT DR E030,24500.0,15925.0,15925.0,24010.0,6
CDM,27804380,W ICD CONSULTA CRT-D D224TRK,37200.0,24180.0,6249.6,33480.0,29
CDM,27804380_OP,W ICD CONSULTA CRT-D D224TRK,37200.0,24180.0,24180.0,36456.0,6
CDM,27804390,W ICD CURRENT,17700.0,11505.0,2973.6,15930.0,29
CDM,27804390_OP,W ICD CURRENT,17700.0,11505.0,11505.0,17346.0,6
CDM,27804400,W ICD CURRENT 120730,20000.0,13000.0,3360.0,18000.0,29
CDM,27804400_OP,W ICD CURRENT 120730,20000.0,13000.0,13000.0,19600.0,6
CDM,27804410,W ICD CURRENT 2207-30,22400.0,14560.0,3763.2,20160.0,29
CDM,27804410_OP,W ICD CURRENT 2207-30,22400.0,14560.0,14560.0,21952.0,6
CDM,27804420,W ICD CURRENT DR 2211-36,24500.0,15925.0,4116.0,22050.0,29
CDM,27804420_OP,W ICD CURRENT DR 2211-36,24500.0,15925.0,15925.0,24010.0,6
CDM,27804430,W ICD CURRENT PLUS DR SJ4 CONTR,24500.0,15925.0,4116.0,22050.0,29
CDM,27804430_OP,W ICD CURRENT PLUS DR SJ4 CONTR,24500.0,15925.0,15925.0,24010.0,6
CDM,27804440,W ICD FORTIFY DR DUAL CHAMBER,24500.0,15925.0,4116.0,22050.0,29
CDM,27804440_OP,W ICD FORTIFY DR DUAL CHAMBER,24500.0,15925.0,15925.0,24010.0,6
CDM,27804450,W ICD FORTIFY VR SJ4,17700.0,11505.0,2973.6,15930.0,29
CDM,27804450_OP,W ICD FORTIFY VR SJ4,17700.0,11505.0,11505.0,17346.0,6
CDM,27804460,W ICD INSYNC SENTRY 7299ID,38000.0,24700.0,6384.0,34200.0,29
CDM,27804460_OP,W ICD INSYNC SENTRY 7299ID,38000.0,24700.0,24700.0,37240.0,6
CDM,27804470,W ICD LIVIAN H 220,29000.0,18850.0,4872.0,26100.0,29
CDM,27804470_OP,W ICD LIVIAN H 220,29000.0,18850.0,18850.0,28420.0,6
CDM,27804480,W ICD LIVIAN H 227,30000.0,19500.0,5040.0,27000.0,29
CDM,27804480_OP,W ICD LIVIAN H 227,30000.0,19500.0,19500.0,29400.0,6
CDM,27804490,W ICD LIVIAN RF H225,29000.0,18850.0,4872.0,26100.0,29
CDM,27804490_OP,W ICD LIVIAN RF H225,29000.0,18850.0,18850.0,28420.0,6
CDM,27804500,W ICD LIVIAN RF HE H229,30000.0,19500.0,5040.0,27000.0,29
CDM,27804500_OP,W ICD LIVIAN RF HE H229,30000.0,19500.0,19500.0,29400.0,6
CDM,27804510,W ICD PROMOTE CRT/RF 36 JOULES,30000.0,19500.0,5040.0,27000.0,29
CDM,27804510_OP,W ICD PROMOTE CRT/RF 36 JOULES,30000.0,19500.0,19500.0,29400.0,6
CDM,27804520,W ICD PROMOTE RF 3207,29000.0,18850.0,4872.0,26100.0,29
CDM,27804520_OP,W ICD PROMOTE RF 3207,29000.0,18850.0,18850.0,28420.0,6
CDM,27804530,W ICD SECURA D224VRC,23000.0,14950.0,3864.0,20700.0,29
CDM,27804530_OP,W ICD SECURA D224VRC,23000.0,14950.0,14950.0,22540.0,6
CDM,27804540,W ICD SECURA DR DC D224DRG,29700.0,19305.0,4989.6,26730.0,29
CDM,27804540_OP,W ICD SECURA DR DC D224DRG,29700.0,19305.0,19305.0,29106.0,6
CDM,27804550,W ICD TELIGEN E102,17700.0,11505.0,2973.6,15930.0,29
CDM,27804550_OP,W ICD TELIGEN E102,17700.0,11505.0,11505.0,17346.0,6
CDM,27804560,W ICD TELIGEN E110,24500.0,15925.0,4116.0,22050.0,29
CDM,27804560_OP,W ICD TELIGEN E110,24500.0,15925.0,15925.0,24010.0,6
CDM,27804570,W ICD UNIFY CRT-D SJ4,30000.0,19500.0,5040.0,27000.0,29
CDM,27804570_OP,W ICD UNIFY CRT-D SJ4,30000.0,19500.0,19500.0,29400.0,6
CDM,27804580,W ICD VIRTUOSO DR DC,28500.0,18525.0,4788.0,25650.0,29
CDM,27804580_OP,W ICD VIRTUOSO DR DC,28500.0,18525.0,18525.0,27930.0,6
CDM,27804590,W ICD VIRTUOSO VR,23700.0,15405.0,3981.6,21330.0,29
CDM,27804590_OP,W ICD VIRTUOSO VR,23700.0,15405.0,15405.0,23226.0,6
CDM,27804600,W LEAD INTERSTIM 3093/3889,5170.0,3360.5,868.56,4653.0,29
CDM,27804600_OP,W LEAD INTERSTIM 3093/3889,5170.0,3360.5,3360.5,5066.6,6
CDM,27804610,W IMP ANCH BIOROC,863.0,560.95,144.98,776.7,20
CDM,27804610_IP,W IMP ANCH BIOROC,863.0,560.95,311.54,311.54,3
CDM,27804610_OP,W IMP ANCH BIOROC,863.0,560.95,560.95,845.74,6
CDM,27804620,W IMP ANCH CONTCK,818.0,531.7,137.42,736.2,20
CDM,27804620_IP,W IMP ANCH CONTCK,818.0,531.7,295.3,295.3,3
CDM,27804620_OP,W IMP ANCH CONTCK,818.0,531.7,531.7,801.64,6
CDM,27804630,W IMP ANCH FSTN,571.0,371.15,95.93,513.9,20
CDM,27804630_IP,W IMP ANCH FSTN,571.0,371.15,206.13,206.13,3
CDM,27804630_OP,W IMP ANCH FSTN,571.0,371.15,371.15,559.58,6
CDM,27804640,W IMP ANCH FSTNRC,756.0,491.4,127.01,680.4,20
CDM,27804640_IP,W IMP ANCH FSTNRC,756.0,491.4,272.92,272.92,3
CDM,27804640_OP,W IMP ANCH FSTNRC,756.0,491.4,491.4,740.88,6
CDM,27804650,W IMP ANCH KNTLES,737.0,479.05,123.82,663.3,20
CDM,27804650_IP,W IMP ANCH KNTLES,737.0,479.05,266.06,266.06,3
CDM,27804650_OP,W IMP ANCH KNTLES,737.0,479.05,479.05,722.26,6
CDM,27804660,W IMP ANCH MICRO,776.0,504.4,130.37,698.4,20
CDM,27804660_IP,W IMP ANCH MICRO,776.0,504.4,280.14,280.14,3
CDM,27804660_OP,W IMP ANCH MICRO,776.0,504.4,504.4,760.48,6
CDM,27804670,W IMP ANCH MINI,827.0,537.55,138.94,744.3,20
CDM,27804670_IP,W IMP ANCH MINI,827.0,537.55,298.55,298.55,3
CDM,27804670_OP,W IMP ANCH MINI,827.0,537.55,537.55,810.46,6
CDM,27804680,W IMP ANCH MINIRO,737.0,479.05,123.82,663.3,20
CDM,27804680_IP,W IMP ANCH MINIRO,737.0,479.05,266.06,266.06,3
CDM,27804680_OP,W IMP ANCH MINIRO,737.0,479.05,479.05,722.26,6
CDM,27804690,W IMP ANCH MITEK,818.0,531.7,137.42,736.2,20
CDM,27804690_IP,W IMP ANCH MITEK,818.0,531.7,295.3,295.3,3
CDM,27804690_OP,W IMP ANCH MITEK,818.0,531.7,531.7,801.64,6
CDM,27804700,W IMP ANCH PANALK,832.0,540.8,139.78,748.8,20
CDM,27804700_IP,W IMP ANCH PANALK,832.0,540.8,300.35,300.35,3
CDM,27804700_OP,W IMP ANCH PANALK,832.0,540.8,540.8,815.36,6
CDM,27804710,W IMP ANCH PANALK,832.0,540.8,139.78,748.8,20
CDM,27804710_IP,W IMP ANCH PANALK,832.0,540.8,300.35,300.35,3
CDM,27804710_OP,W IMP ANCH PANALK,832.0,540.8,540.8,815.36,6
CDM,27804720,W IMP ANCH ROC EZ,863.0,560.95,144.98,776.7,20
CDM,27804720_IP,W IMP ANCH ROC EZ,863.0,560.95,311.54,311.54,3
CDM,27804720_OP,W IMP ANCH ROC EZ,863.0,560.95,560.95,845.74,6
CDM,27804730,W IMP ANCH ROC XS,797.0,518.05,133.9,717.3,20
CDM,27804730_IP,W IMP ANCH ROC XS,797.0,518.05,287.72,287.72,3
CDM,27804730_OP,W IMP ANCH ROC XS,797.0,518.05,518.05,781.06,6
CDM,27804740,W IMP ANCH ROTATR,853.0,554.45,143.3,767.7,20
CDM,27804740_IP,W IMP ANCH ROTATR,853.0,554.45,307.93,307.93,3
CDM,27804740_OP,W IMP ANCH ROTATR,853.0,554.45,554.45,835.94,6
CDM,27804750,W IMP ANCH SUPER,814.0,529.1,136.75,732.6,20
CDM,27804750_IP,W IMP ANCH SUPER,814.0,529.1,293.85,293.85,3
CDM,27804750_OP,W IMP ANCH SUPER,814.0,529.1,529.1,797.72,6
CDM,27804760,W IMP ANCH TACIT,737.0,479.05,123.82,663.3,20
CDM,27804760_IP,W IMP ANCH TACIT,737.0,479.05,266.06,266.06,3
CDM,27804760_OP,W IMP ANCH TACIT,737.0,479.05,479.05,722.26,6
CDM,27804770,W IMP COLLAGN A/S,1721.0,1118.65,289.13,1548.9,23
CDM,27804770_IP,W IMP COLLAGN A/S,1721.0,1118.65,621.28,621.28,3
CDM,27804770_OP,W IMP COLLAGN A/S,1721.0,1118.65,1118.65,1686.58,6
CDM,27804790,W IMP DEV PRT/RES,1126.0,731.9,189.17,1013.4,20
CDM,27804790_IP,W IMP DEV PRT/RES,1126.0,731.9,406.49,406.49,3
CDM,27804790_OP,W IMP DEV PRT/RES,1126.0,731.9,731.9,1103.48,6
CDM,27804800,W IMP GEN NSTIM,31866.0,20712.9,5353.49,28679.4,29
CDM,27804800_OP,W IMP GEN NSTIM,31866.0,20712.9,20712.9,31228.68,6
CDM,27804810,W IMP LD CARDV/DF,2822.0,1834.3,474.1,2539.8,23
CDM,27804810_IP,W IMP LD CARDV/DF,2822.0,1834.3,1018.74,1018.74,3
CDM,27804810_OP,W IMP LD CARDV/DF,2822.0,1834.3,1834.3,2765.56,6
CDM,27804820,W IMP LD CARDV/DF,8500.0,5525.0,1428.0,7650.0,29
CDM,27804820_OP,W IMP LD CARDV/DF,8500.0,5525.0,5525.0,8330.0,6
CDM,27804830,W IMP LD CARDV/DF 6931 BIPLOAR,8500.0,5525.0,1428.0,7650.0,29
CDM,27804830_OP,W IMP LD CARDV/DF 6931 BIPLOAR,8500.0,5525.0,5525.0,8330.0,6
CDM,27804840,W IMP LD CARDV-DF 0184 ENDO REL,8500.0,5525.0,1428.0,7650.0,29
CDM,27804840_OP,W IMP LD CARDV-DF 0184 ENDO REL,8500.0,5525.0,5525.0,8330.0,6
CDM,27804850,W IMP LD NSTIM,7614.0,4949.1,1279.15,6852.6,29
CDM,27804850_OP,W IMP LD NSTIM,7614.0,4949.1,4949.1,7461.72,6
CDM,27804860,W IMP LD NSTM TST,950.0,617.5,159.6,855.0,20
CDM,27804860_IP,W IMP LD NSTM TST,950.0,617.5,342.95,342.95,3
CDM,27804860_OP,W IMP LD NSTM TST,950.0,617.5,617.5,931.0,6
CDM,27804870,W IMP MESH,436.0,283.4,73.25,392.4,20
CDM,27804870_IP,W IMP MESH,436.0,283.4,157.4,157.4,3
CDM,27804870_OP,W IMP MESH,436.0,283.4,283.4,427.28,6
CDM,27804880,W IMP PMP CONSFLW,30826.0,20036.9,5178.77,27743.4,29
CDM,27804880_OP,W IMP PMP CONSFLW,30826.0,20036.9,20036.9,30209.48,6
CDM,27804890,W IMP PORT INDWEL,1126.0,731.9,189.17,1013.4,20
CDM,27804890_IP,W IMP PORT INDWEL,1126.0,731.9,406.49,406.49,3
CDM,27804890_OP,W IMP PORT INDWEL,1126.0,731.9,731.9,1103.48,6
CDM,27804900,W IMP PROSTH BRST,1799.0,1169.35,302.23,1619.1,23
CDM,27804900_IP,W IMP PROSTH BRST,1799.0,1169.35,649.44,649.44,3
CDM,27804900_OP,W IMP PROSTH BRST,1799.0,1169.35,1169.35,1763.02,6
CDM,27804910,W IMP RCRDR CARD,7829.0,5088.85,1315.27,7046.1,29
CDM,27804910_OP,W IMP RCRDR CARD,7829.0,5088.85,5088.85,7672.42,6
CDM,27804920,W IMPL SYNTH VOCAL CORD,7540.0,4901.0,1266.72,6786.0,29
CDM,27804920_OP,W IMPL SYNTH VOCAL CORD,7540.0,4901.0,4901.0,7389.2,6
CDM,27804940,W IMPLANT BONE DOWEL,1158.0,752.7,194.54,1042.2,20
CDM,27804940_IP,W IMPLANT BONE DOWEL,1158.0,752.7,418.04,418.04,3
CDM,27804940_OP,W IMPLANT BONE DOWEL,1158.0,752.7,752.7,1134.84,6
CDM,27804950,W IMPLANT BONE DOWEL,1434.0,932.1,240.91,1290.6,20
CDM,27804950_IP,W IMPLANT BONE DOWEL,1434.0,932.1,517.67,517.67,3
CDM,27804950_OP,W IMPLANT BONE DOWEL,1434.0,932.1,932.1,1405.32,6
CDM,27804960,W IMPLANT BONE SYN A/S,1922.0,1249.3,322.9,1729.8,23
CDM,27804960_IP,W IMPLANT BONE SYN A/S,1922.0,1249.3,693.84,693.84,3
CDM,27804960_OP,W IMPLANT BONE SYN A/S,1922.0,1249.3,1249.3,1883.56,6
CDM,27804970,W IMPLANT BREAST SALINE SMRDMOD,850.0,552.5,142.8,765.0,20
CDM,27804970_IP,W IMPLANT BREAST SALINE SMRDMOD,850.0,552.5,306.85,306.85,3
CDM,27804970_OP,W IMPLANT BREAST SALINE SMRDMOD,850.0,552.5,552.5,833.0,6
CDM,27804980,W IMPLANT BREAST SALINE SMTHRND,750.0,487.5,126.0,675.0,20
CDM,27804980_IP,W IMPLANT BREAST SALINE SMTHRND,750.0,487.5,270.75,270.75,3
CDM,27804980_OP,W IMPLANT BREAST SALINE SMTHRND,750.0,487.5,487.5,735.0,6
CDM,27804990,W IMPLANT BREAST SILICONE GEL I,1450.0,942.5,243.6,1305.0,20
CDM,27804990_IP,W IMPLANT BREAST SILICONE GEL I,1450.0,942.5,523.45,523.45,3
CDM,27804990_OP,W IMPLANT BREAST SILICONE GEL I,1450.0,942.5,942.5,1421.0,6
CDM,27805000,W IMPLANT BREAST SILICONE GELII,1500.0,975.0,252.0,1350.0,20
CDM,27805000_IP,W IMPLANT BREAST SILICONE GELII,1500.0,975.0,541.5,541.5,3
CDM,27805000_OP,W IMPLANT BREAST SILICONE GELII,1500.0,975.0,975.0,1470.0,6
CDM,27805010,W IMPLANT DIST FEM GMRS GRP 165,12590.0,8183.5,2115.12,11331.0,29
CDM,27805010_OP,W IMPLANT DIST FEM GMRS GRP 165,12590.0,8183.5,8183.5,12338.2,6
CDM,27805020,W IMPLANT GMRS TIB GRP 167,13938.0,9059.7,2341.58,12544.2,29
CDM,27805020_OP,W IMPLANT GMRS TIB GRP 167,13938.0,9059.7,9059.7,13659.24,6
CDM,27805030,W IMPLANT INFUSION PUMP,30285.0,19685.25,5087.88,27256.5,29
CDM,27805030_OP,W IMPLANT INFUSION PUMP,30285.0,19685.25,19685.25,29679.3,6
CDM,27805040,W IMPLANT KNEE FEM XL RT GRP158,7910.0,5141.5,1328.88,7119.0,29
CDM,27805040_OP,W IMPLANT KNEE FEM XL RT GRP158,7910.0,5141.5,5141.5,7751.8,6
CDM,27805050,W IMPLANT MRS CONDYLE GRP 164,11878.0,7720.7,1995.5,10690.2,29
CDM,27805050_OP,W IMPLANT MRS CONDYLE GRP 164,11878.0,7720.7,7720.7,11640.44,6
CDM,27805060,W IMPLANT MRS PROX TIB GRP 166,13558.0,8812.7,2277.74,12202.2,29
CDM,27805060_OP,W IMPLANT MRS PROX TIB GRP 166,13558.0,8812.7,8812.7,13286.84,6
CDM,27805070,W IMPLANT PEEK LORDTC STRL,6570.0,4270.5,1103.76,5913.0,29
CDM,27805070_OP,W IMPLANT PEEK LORDTC STRL,6570.0,4270.5,4270.5,6438.6,6
CDM,27805080,W IMPLNT FLT/BRIDGE/FIX GRP32,374.0,243.1,62.83,336.6,20
CDM,27805080_IP,W IMPLNT FLT/BRIDGE/FIX GRP32,374.0,243.1,135.01,135.01,3
CDM,27805080_OP,W IMPLNT FLT/BRIDGE/FIX GRP32,374.0,243.1,243.1,366.52,6
CDM,27805090,W IMPLT GMRS SM TIB GRP 136,5000.0,3250.0,840.0,4500.0,26
CDM,27805090_OP,W IMPLT GMRS SM TIB GRP 136,5000.0,3250.0,3250.0,4900.0,6
CDM,27805100,W INJ BULK AGENT COLLAGEN IMP U,600.0,390.0,100.8,540.0,20
CDM,27805100_IP,W INJ BULK AGENT COLLAGEN IMP U,600.0,390.0,216.6,216.6,3
CDM,27805100_OP,W INJ BULK AGENT COLLAGEN IMP U,600.0,390.0,390.0,588.0,6
CDM,27805110,W INJ BULKING AGENT 1ML MPQ-2.5,330.0,214.5,55.44,297.0,20
CDM,27805110_IP,W INJ BULKING AGENT 1ML MPQ-2.5,330.0,214.5,119.13,119.13,3
CDM,27805110_OP,W INJ BULKING AGENT 1ML MPQ-2.5,330.0,214.5,214.5,323.4,6
CDM,27805120,W INSERT CONSTRND ACTBLR GRP118,3481.0,2262.65,584.81,3132.9,23
CDM,27805120_IP,W INSERT CONSTRND ACTBLR GRP118,3481.0,2262.65,1256.64,1256.64,3
CDM,27805120_OP,W INSERT CONSTRND ACTBLR GRP118,3481.0,2262.65,2262.65,3411.38,6
CDM,27805130,W INSERT DUR TIB GRP 47,801.0,520.65,134.57,720.9,20
CDM,27805130_IP,W INSERT DUR TIB GRP 47,801.0,520.65,289.16,289.16,3
CDM,27805130_OP,W INSERT DUR TIB GRP 47,801.0,520.65,520.65,784.98,6
CDM,27805140,W INSERT DURA STAB TIB GRP 92,1866.0,1212.9,313.49,1679.4,23
CDM,27805140_IP,W INSERT DURA STAB TIB GRP 92,1866.0,1212.9,673.63,673.63,3
CDM,27805140_OP,W INSERT DURA STAB TIB GRP 92,1866.0,1212.9,1212.9,1828.68,6
CDM,27805150,W INSERT DURA STAB XLG GRP 80,1463.0,950.95,245.78,1316.7,20
CDM,27805150_IP,W INSERT DURA STAB XLG GRP 80,1463.0,950.95,528.14,528.14,3
CDM,27805150_OP,W INSERT DURA STAB XLG GRP 80,1463.0,950.95,950.95,1433.74,6
CDM,27805160,W INSERT DURS/PS TIB GRP 35,502.0,326.3,84.34,451.8,20
CDM,27805160_IP,W INSERT DURS/PS TIB GRP 35,502.0,326.3,181.22,181.22,3
CDM,27805160_OP,W INSERT DURS/PS TIB GRP 35,502.0,326.3,326.3,491.96,6
CDM,27805170,W INSERT ENCAP DURA GRP 101,2222.0,1444.3,373.3,1999.8,23
CDM,27805170_IP,W INSERT ENCAP DURA GRP 101,2222.0,1444.3,802.14,802.14,3
CDM,27805170_OP,W INSERT ENCAP DURA GRP 101,2222.0,1444.3,1444.3,2177.56,6
CDM,27805180,W INSERT FLEX PS TIB GRP 77,1350.0,877.5,226.8,1215.0,20
CDM,27805180_IP,W INSERT FLEX PS TIB GRP 77,1350.0,877.5,487.35,487.35,3
CDM,27805180_OP,W INSERT FLEX PS TIB GRP 77,1350.0,877.5,877.5,1323.0,6
CDM,27805190,W INSERT GMRS SM TIB GRP 100,2200.0,1430.0,369.6,1980.0,23
CDM,27805190_IP,W INSERT GMRS SM TIB GRP 100,2200.0,1430.0,794.2,794.2,3
CDM,27805190_OP,W INSERT GMRS SM TIB GRP 100,2200.0,1430.0,1430.0,2156.0,6
CDM,27805200,W INSERT HRHK TIB GRP 90,1828.0,1188.2,307.1,1645.2,23
CDM,27805200_IP,W INSERT HRHK TIB GRP 90,1828.0,1188.2,659.91,659.91,3
CDM,27805200_OP,W INSERT HRHK TIB GRP 90,1828.0,1188.2,1188.2,1791.44,6
CDM,27805210,W INSERT PINN METAL NEUTRAL,1797.0,1168.05,301.9,1617.3,23
CDM,27805210_IP,W INSERT PINN METAL NEUTRAL,1797.0,1168.05,648.72,648.72,3
CDM,27805210_OP,W INSERT PINN METAL NEUTRAL,1797.0,1168.05,1168.05,1761.06,6
CDM,27805220,W INSERT PINN METAL NTRL HIP,3591.0,2334.15,603.29,3231.9,23
CDM,27805220_IP,W INSERT PINN METAL NTRL HIP,3591.0,2334.15,1296.35,1296.35,3
CDM,27805220_OP,W INSERT PINN METAL NTRL HIP,3591.0,2334.15,2334.15,3519.18,6
CDM,27805230,W INSERT SCRPIO PS TIB GRP 102,2252.0,1463.8,378.34,2026.8,23
CDM,27805230_IP,W INSERT SCRPIO PS TIB GRP 102,2252.0,1463.8,812.97,812.97,3
CDM,27805230_OP,W INSERT SCRPIO PS TIB GRP 102,2252.0,1463.8,1463.8,2206.96,6
CDM,27805240,W INSERT SCRPIO TS TIBIAL GRP91,1837.0,1194.05,308.62,1653.3,23
CDM,27805240_IP,W INSERT SCRPIO TS TIBIAL GRP91,1837.0,1194.05,663.16,663.16,3
CDM,27805240_OP,W INSERT SCRPIO TS TIBIAL GRP91,1837.0,1194.05,1194.05,1800.26,6
CDM,27805250,W INSERT TIB STAB+ 1.5 17.5MM,627.0,407.55,105.34,564.3,20
CDM,27805250_IP,W INSERT TIB STAB+ 1.5 17.5MM,627.0,407.55,226.35,226.35,3
CDM,27805250_OP,W INSERT TIB STAB+ 1.5 17.5MM,627.0,407.55,407.55,614.46,6
CDM,27805260,W INSERT TIBIAL BRNG CS GRP 169,2860.0,1859.0,480.48,2574.0,23
CDM,27805260_IP,W INSERT TIBIAL BRNG CS GRP 169,2860.0,1859.0,1032.46,1032.46,3
CDM,27805260_OP,W INSERT TIBIAL BRNG CS GRP 169,2860.0,1859.0,1859.0,2802.8,6
CDM,27805270,W INSERT TIBIAL UNI 8MM STRY,1800.0,1170.0,302.4,1620.0,23
CDM,27805270_IP,W INSERT TIBIAL UNI 8MM STRY,1800.0,1170.0,649.8,649.8,3
CDM,27805270_OP,W INSERT TIBIAL UNI 8MM STRY,1800.0,1170.0,1170.0,1764.0,6
CDM,27805280,W INSERT TRDNT 0DEG ALUM GRP108,2634.0,1712.1,442.51,2370.6,23
CDM,27805280_IP,W INSERT TRDNT 0DEG ALUM GRP108,2634.0,1712.1,950.87,950.87,3
CDM,27805280_OP,W INSERT TRDNT 0DEG ALUM GRP108,2634.0,1712.1,1712.1,2581.32,6
CDM,27805290,W INSERT TRDNT 36MM ECC GRP122,3952.0,2568.8,663.94,3556.8,23
CDM,27805290_IP,W INSERT TRDNT 36MM ECC GRP122,3952.0,2568.8,1426.67,1426.67,3
CDM,27805290_OP,W INSERT TRDNT 36MM ECC GRP122,3952.0,2568.8,2568.8,3872.96,6
CDM,27805300,W INSERT TRI CR/PS/ TIB GRP 52,933.0,606.45,156.74,839.7,20
CDM,27805300_IP,W INSERT TRI CR/PS/ TIB GRP 52,933.0,606.45,336.81,336.81,3
CDM,27805300_OP,W INSERT TRI CR/PS/ TIB GRP 52,933.0,606.45,606.45,914.34,6
CDM,27805310,W INSERT TRID ECC CRSFIRE GRP83,1675.0,1088.75,281.4,1507.5,20
CDM,27805310_IP,W INSERT TRID ECC CRSFIRE GRP83,1675.0,1088.75,604.68,604.68,3
CDM,27805310_OP,W INSERT TRID ECC CRSFIRE GRP83,1675.0,1088.75,1088.75,1641.5,6
CDM,27805320,W INSERT TRIDNT CONST GRP 120,3544.0,2303.6,595.39,3189.6,23
CDM,27805320_IP,W INSERT TRIDNT CONST GRP 120,3544.0,2303.6,1279.38,1279.38,3
CDM,27805320_OP,W INSERT TRIDNT CONST GRP 120,3544.0,2303.6,2303.6,3473.12,6
CDM,27805330,W INSERT TRIDNT CRSFIRE GRP 95,1904.0,1237.6,319.87,1713.6,23
CDM,27805330_IP,W INSERT TRIDNT CRSFIRE GRP 95,1904.0,1237.6,687.34,687.34,3
CDM,27805330_OP,W INSERT TRIDNT CRSFIRE GRP 95,1904.0,1237.6,1237.6,1865.92,6
CDM,27805340,W INSERT TRIDNT DEG X3 GRP103,2284.0,1484.6,383.71,2055.6,23
CDM,27805340_IP,W INSERT TRIDNT DEG X3 GRP103,2284.0,1484.6,824.52,824.52,3
CDM,27805340_OP,W INSERT TRIDNT DEG X3 GRP103,2284.0,1484.6,1484.6,2238.32,6
CDM,27805350,W INSERT TRIDNT ELVTD RIM GRP88,1824.0,1185.6,306.43,1641.6,23
CDM,27805350_IP,W INSERT TRIDNT ELVTD RIM GRP88,1824.0,1185.6,658.46,658.46,3
CDM,27805350_OP,W INSERT TRIDNT ELVTD RIM GRP88,1824.0,1185.6,1185.6,1787.52,6
CDM,27805360,W INSERT TRIDNT ELVTD RIM GRP96,1934.0,1257.1,324.91,1740.6,23
CDM,27805360_IP,W INSERT TRIDNT ELVTD RIM GRP96,1934.0,1257.1,698.17,698.17,3
CDM,27805360_OP,W INSERT TRIDNT ELVTD RIM GRP96,1934.0,1257.1,1257.1,1895.32,6
CDM,27805370,W INSERTER COLPOPEXY STRGHT-IN,680.0,442.0,114.24,612.0,20
CDM,27805370_IP,W INSERTER COLPOPEXY STRGHT-IN,680.0,442.0,245.48,245.48,3
CDM,27805370_OP,W INSERTER COLPOPEXY STRGHT-IN,680.0,442.0,442.0,666.4,6
CDM,27805380,W INSRT TDNT X3 ELV RIM GRP110,2783.0,1808.95,467.54,2504.7,23
CDM,27805380_IP,W INSRT TDNT X3 ELV RIM GRP110,2783.0,1808.95,1004.66,1004.66,3
CDM,27805380_OP,W INSRT TDNT X3 ELV RIM GRP110,2783.0,1808.95,1808.95,2727.34,6
CDM,27805390,W INSRT TRD CRSSFR CNSTD GRP121,3588.0,2332.2,602.78,3229.2,23
CDM,27805390_IP,W INSRT TRD CRSSFR CNSTD GRP121,3588.0,2332.2,1295.27,1295.27,3
CDM,27805390_OP,W INSRT TRD CRSSFR CNSTD GRP121,3588.0,2332.2,2332.2,3516.24,6
CDM,27805400,W INSRT TRDNT ELV RIM X3 GRP114,2960.0,1924.0,497.28,2664.0,23
CDM,27805400_IP,W INSRT TRDNT ELV RIM X3 GRP114,2960.0,1924.0,1068.56,1068.56,3
CDM,27805400_OP,W INSRT TRDNT ELV RIM X3 GRP114,2960.0,1924.0,1924.0,2900.8,6
CDM,27805410,W INSRT TRDT ECC36MM 0DG GRP113,2930.0,1904.5,492.24,2637.0,23
CDM,27805410_IP,W INSRT TRDT ECC36MM 0DG GRP113,2930.0,1904.5,1057.73,1057.73,3
CDM,27805410_OP,W INSRT TRDT ECC36MM 0DG GRP113,2930.0,1904.5,1904.5,2871.4,6
CDM,27805420,W INSRT TRI 0DG X3 ETRC GRP109,2753.0,1789.45,462.5,2477.7,23
CDM,27805420_IP,W INSRT TRI 0DG X3 ETRC GRP109,2753.0,1789.45,993.83,993.83,3
CDM,27805420_OP,W INSRT TRI 0DG X3 ETRC GRP109,2753.0,1789.45,1789.45,2697.94,6
CDM,27805430,W INSRT TRI 10DEG X3 ECC GRP128,4360.0,2834.0,732.48,3924.0,23
CDM,27805430_IP,W INSRT TRI 10DEG X3 ECC GRP128,4360.0,2834.0,1573.96,1573.96,3
CDM,27805430_OP,W INSRT TRI 10DEG X3 ECC GRP128,4360.0,2834.0,2834.0,4272.8,6
CDM,27805440,W INSRT TRI CR/PS TIB X3 GRP84,1683.0,1093.95,282.74,1514.7,20
CDM,27805440_IP,W INSRT TRI CR/PS TIB X3 GRP84,1683.0,1093.95,607.56,607.56,3
CDM,27805440_OP,W INSRT TRI CR/PS TIB X3 GRP84,1683.0,1093.95,1093.95,1649.34,6
CDM,27805450,W INSRT TRNT 10DG X3 ECC GRP123,4006.0,2603.9,673.01,3605.4,23
CDM,27805450_IP,W INSRT TRNT 10DG X3 ECC GRP123,4006.0,2603.9,1446.17,1446.17,3
CDM,27805450_OP,W INSRT TRNT 10DG X3 ECC GRP123,4006.0,2603.9,2603.9,3925.88,6
CDM,27805460,W INTRODUCER STENT OASIS,120.0,78.0,20.16,108.0,20
CDM,27805460_IP,W INTRODUCER STENT OASIS,120.0,78.0,43.32,43.32,3
CDM,27805460_OP,W INTRODUCER STENT OASIS,120.0,78.0,78.0,117.6,6
CDM,27805470,W IODINE 1-125 SEEDS NONSTRANDE,140.0,91.0,35.24,177.28,36
CDM,27805470_IP,W IODINE 1-125 SEEDS NONSTRANDE,140.0,91.0,50.54,50.54,3
CDM,27805470_OP,W IODINE 1-125 SEEDS NONSTRANDE,140.0,91.0,91.0,137.2,6
CDM,27805480,W JOINT PROX INTERPHALANGEAL,2952.0,1918.8,495.94,2656.8,23
CDM,27805480_IP,W JOINT PROX INTERPHALANGEAL,2952.0,1918.8,1065.67,1065.67,3
CDM,27805480_OP,W JOINT PROX INTERPHALANGEAL,2952.0,1918.8,1918.8,2892.96,6
CDM,27805490,W K WIRE,48.0,31.2,8.06,43.2,20
CDM,27805490_IP,W K WIRE,48.0,31.2,17.33,17.33,3
CDM,27805490_OP,W K WIRE,48.0,31.2,31.2,47.04,6
CDM,27805500,W KIT ACCESSORY AMS800,888.0,577.2,149.18,799.2,20
CDM,27805500_IP,W KIT ACCESSORY AMS800,888.0,577.2,320.57,320.57,3
CDM,27805500_OP,W KIT ACCESSORY AMS800,888.0,577.2,577.2,870.24,6
CDM,27805510,W KIT ACCESSORY ANCHOR LD MULTI,248.0,161.2,41.66,223.2,20
CDM,27805510_IP,W KIT ACCESSORY ANCHOR LD MULTI,248.0,161.2,89.53,89.53,3
CDM,27805510_OP,W KIT ACCESSORY ANCHOR LD MULTI,248.0,161.2,161.2,243.04,6
CDM,27805520,W KIT ACCESSRY 72401850 PENILE,858.0,557.7,144.14,772.2,20
CDM,27805520_IP,W KIT ACCESSRY 72401850 PENILE,858.0,557.7,309.74,309.74,3
CDM,27805520_OP,W KIT ACCESSRY 72401850 PENILE,858.0,557.7,557.7,840.84,6
CDM,27805530,W KIT ADAPT POCKET TIP 74002,1980.0,1287.0,332.64,1782.0,23
CDM,27805530_IP,W KIT ADAPT POCKET TIP 74002,1980.0,1287.0,714.78,714.78,3
CDM,27805530_OP,W KIT ADAPT POCKET TIP 74002,1980.0,1287.0,1287.0,1940.4,6
CDM,27805540,W KIT ANCHOR ACCSORY EZ 355016,76.0,49.4,12.77,68.4,20
CDM,27805540_IP,W KIT ANCHOR ACCSORY EZ 355016,76.0,49.4,27.44,27.44,3
CDM,27805540_OP,W KIT ANCHOR ACCSORY EZ 355016,76.0,49.4,49.4,74.48,6
CDM,27805550,W KIT ATTAIN ACCESS LEAD DELVRY,782.0,508.3,131.38,703.8,20
CDM,27805550_IP,W KIT ATTAIN ACCESS LEAD DELVRY,782.0,508.3,282.3,282.3,3
CDM,27805550_OP,W KIT ATTAIN ACCESS LEAD DELVRY,782.0,508.3,508.3,766.36,6
CDM,27805560,W KIT CANN TITANIUM SYNDESMOSIS,914.0,594.1,153.55,822.6,20
CDM,27805560_IP,W KIT CANN TITANIUM SYNDESMOSIS,914.0,594.1,329.95,329.95,3
CDM,27805560_OP,W KIT CANN TITANIUM SYNDESMOSIS,914.0,594.1,594.1,895.72,6
CDM,27805570,W KIT EXTENSION DUAL QUAD,2600.0,1690.0,436.8,2340.0,23
CDM,27805570_IP,W KIT EXTENSION DUAL QUAD,2600.0,1690.0,938.6,938.6,3
CDM,27805570_OP,W KIT EXTENSION DUAL QUAD,2600.0,1690.0,1690.0,2548.0,6
CDM,27805580,W KIT NAIL LONG GAMMA 3,4881.0,3172.65,820.01,4392.9,26
CDM,27805580_OP,W KIT NAIL LONG GAMMA 3,4881.0,3172.65,3172.65,4783.38,6
CDM,27805590,W KIT PLUG RSTRE ACCSSRY 355029,266.0,172.9,44.69,239.4,20
CDM,27805590_IP,W KIT PLUG RSTRE ACCSSRY 355029,266.0,172.9,96.03,96.03,3
CDM,27805590_OP,W KIT PLUG RSTRE ACCSSRY 355029,266.0,172.9,172.9,260.68,6
CDM,27805610,W KNEE IMPLANT MBT REVISION CEM,5733.0,3726.45,963.14,5159.7,29
CDM,27805610_OP,W KNEE IMPLANT MBT REVISION CEM,5733.0,3726.45,3726.45,5618.34,6
CDM,27805640,W KT ACSSRY BOOTS&ANCHRS 355024,82.0,53.3,13.78,73.8,20
CDM,27805640_IP,W KT ACSSRY BOOTS&ANCHRS 355024,82.0,53.3,29.6,29.6,3
CDM,27805640_OP,W KT ACSSRY BOOTS&ANCHRS 355024,82.0,53.3,53.3,80.36,6
CDM,27805650,W KT ACSSRY NEURSTIM SYS 355009,248.0,161.2,41.66,223.2,20
CDM,27805650_IP,W KT ACSSRY NEURSTIM SYS 355009,248.0,161.2,89.53,89.53,3
CDM,27805650_OP,W KT ACSSRY NEURSTIM SYS 355009,248.0,161.2,161.2,243.04,6
CDM,27805660,W EXTENSION NEUROSTIM,1390.0,903.5,233.52,1251.0,20
CDM,27805660_IP,W EXTENSION NEUROSTIM,1390.0,903.5,501.79,501.79,3
CDM,27805660_OP,W EXTENSION NEUROSTIM,1390.0,903.5,903.5,1362.2,6
CDM,27805670,W KT IPG ITREL 3 STIMULATR 7425,15590.0,10133.5,2619.12,14031.0,29
CDM,27805670_OP,W KT IPG ITREL 3 STIMULATR 7425,15590.0,10133.5,10133.5,15278.2,6
CDM,27805680,W KT LEAD PISCES QUAD,2090.0,1358.5,351.12,1881.0,23
CDM,27805680_IP,W KT LEAD PISCES QUAD,2090.0,1358.5,754.49,754.49,3
CDM,27805680_OP,W KT LEAD PISCES QUAD,2090.0,1358.5,1358.5,2048.2,6
CDM,27805690,W KT STM INTERSTM,915.0,594.75,153.72,823.5,20
CDM,27805690_IP,W KT STM INTERSTM,915.0,594.75,330.32,330.32,3
CDM,27805690_OP,W KT STM INTERSTM,915.0,594.75,594.75,896.7,6
CDM,27805700,W KWIRE 1.6MM TORCAR/BAYONET TP,20.0,13.0,3.36,18.0,20
CDM,27805700_IP,W KWIRE 1.6MM TORCAR/BAYONET TP,20.0,13.0,7.22,7.22,3
CDM,27805700_OP,W KWIRE 1.6MM TORCAR/BAYONET TP,20.0,13.0,13.0,19.6,6
CDM,27805710,W K-WIRE 3.2X450 THREADED,168.0,109.2,28.22,151.2,20
CDM,27805710_IP,W K-WIRE 3.2X450 THREADED,168.0,109.2,60.65,60.65,3
CDM,27805710_OP,W K-WIRE 3.2X450 THREADED,168.0,109.2,109.2,164.64,6
CDM,27805720,W KWIRE 7.0 MULTI 2.5X230MM THD,35.0,22.75,5.88,31.5,20
CDM,27805720_IP,W KWIRE 7.0 MULTI 2.5X230MM THD,35.0,22.75,12.64,12.64,3
CDM,27805720_OP,W KWIRE 7.0 MULTI 2.5X230MM THD,35.0,22.75,22.75,34.3,6
CDM,27805730,W K-WIRE BLUNT TIP,212.0,137.8,35.62,190.8,20
CDM,27805730_IP,W K-WIRE BLUNT TIP,212.0,137.8,76.53,76.53,3
CDM,27805730_OP,W K-WIRE BLUNT TIP,212.0,137.8,137.8,207.76,6
CDM,27805740,W KWIRE CONDYLE T2 1.8X310MM,218.0,141.7,36.62,196.2,20
CDM,27805740_IP,W KWIRE CONDYLE T2 1.8X310MM,218.0,141.7,78.7,78.7,3
CDM,27805740_OP,W KWIRE CONDYLE T2 1.8X310MM,218.0,141.7,141.7,213.64,6
CDM,27805760,W KWIRE RECON T2 3.2MM X 400MM,333.0,216.45,55.94,299.7,20
CDM,27805760_IP,W KWIRE RECON T2 3.2MM X 400MM,333.0,216.45,120.21,120.21,3
CDM,27805760_OP,W KWIRE RECON T2 3.2MM X 400MM,333.0,216.45,216.45,326.34,6
CDM,27805770,W KWIRE SNG/DBL TROCAR WMT,32.0,20.8,5.38,28.8,20
CDM,27805770_IP,W KWIRE SNG/DBL TROCAR WMT,32.0,20.8,11.55,11.55,3
CDM,27805770_OP,W KWIRE SNG/DBL TROCAR WMT,32.0,20.8,20.8,31.36,6
CDM,27805780,W KWIRE STAINLESS STEEL 1.6MM,40.0,26.0,6.72,36.0,20
CDM,27805780_IP,W KWIRE STAINLESS STEEL 1.6MM,40.0,26.0,14.44,14.44,3
CDM,27805780_OP,W KWIRE STAINLESS STEEL 1.6MM,40.0,26.0,26.0,39.2,6
CDM,27805790,W KWIRE T2 RECON 3.2MM X 400MM,550.0,357.5,92.4,495.0,20
CDM,27805790_IP,W KWIRE T2 RECON 3.2MM X 400MM,550.0,357.5,198.55,198.55,3
CDM,27805790_OP,W KWIRE T2 RECON 3.2MM X 400MM,550.0,357.5,357.5,539.0,6
CDM,27805800,W KWIRE T2 STERILE 3MM X 285MM,223.0,144.95,37.46,200.7,20
CDM,27805800_IP,W KWIRE T2 STERILE 3MM X 285MM,223.0,144.95,80.5,80.5,3
CDM,27805800_OP,W KWIRE T2 STERILE 3MM X 285MM,223.0,144.95,144.95,218.54,6
CDM,27805810,W KWIRE TROCAR DBL END MICROAIR,39.0,25.35,6.55,35.1,20
CDM,27805810_IP,W KWIRE TROCAR DBL END MICROAIR,39.0,25.35,14.08,14.08,3
CDM,27805810_OP,W KWIRE TROCAR DBL END MICROAIR,39.0,25.35,25.35,38.22,6
CDM,27805820,W K-WIRE TROCAR PT 2.0MMX150MM,11.0,7.15,1.85,9.9,20
CDM,27805820_IP,W K-WIRE TROCAR PT 2.0MMX150MM,11.0,7.15,3.97,3.97,3
CDM,27805820_OP,W K-WIRE TROCAR PT 2.0MMX150MM,11.0,7.15,7.15,10.78,6
CDM,27805830,W KWIRE W/THRD TOCAR PT 1.6MM,34.0,22.1,5.71,30.6,20
CDM,27805830_IP,W KWIRE W/THRD TOCAR PT 1.6MM,34.0,22.1,12.27,12.27,3
CDM,27805830_OP,W KWIRE W/THRD TOCAR PT 1.6MM,34.0,22.1,22.1,33.32,6
CDM,27805840,W K-WIRE W/TROC PT,18.0,11.7,3.02,16.2,20
CDM,27805840_IP,W K-WIRE W/TROC PT,18.0,11.7,6.5,6.5,3
CDM,27805840_OP,W K-WIRE W/TROC PT,18.0,11.7,11.7,17.64,6
CDM,27805850,W KYPHX BONE CEMENT & MIX PACK,350.0,227.5,58.8,315.0,20
CDM,27805850_IP,W KYPHX BONE CEMENT & MIX PACK,350.0,227.5,126.35,126.35,3
CDM,27805850_OP,W KYPHX BONE CEMENT & MIX PACK,350.0,227.5,227.5,343.0,6
CDM,27805860,W LAP-BAND AP STD W/PORT I,5806.0,3773.9,975.41,5225.4,29
CDM,27805860_OP,W LAP-BAND AP STD W/PORT I,5806.0,3773.9,3773.9,5689.88,6
CDM,27805870,W LCS COMPLETE REVISION FEMORAL,6266.0,4072.9,1052.69,5639.4,29
CDM,27805870_OP,W LCS COMPLETE REVISION FEMORAL,6266.0,4072.9,4072.9,6140.68,6
CDM,27805880,W LD ADPTR KIT BPLR PLSE GNRTR,1750.0,1137.5,294.0,1575.0,23
CDM,27805880_IP,W LD ADPTR KIT BPLR PLSE GNRTR,1750.0,1137.5,631.75,631.75,3
CDM,27805880_OP,W LD ADPTR KIT BPLR PLSE GNRTR,1750.0,1137.5,1137.5,1715.0,6
CDM,27805890,W LD ENDTK SQ ARRY XP MODEL0085,7550.0,4907.5,1268.4,6795.0,29
CDM,27805890_OP,W LD ENDTK SQ ARRY XP MODEL0085,7550.0,4907.5,4907.5,7399.0,6
CDM,27805900,W LD ICD DF1 TRANSVENE 65CM,2400.0,1560.0,403.2,2160.0,23
CDM,27805900_IP,W LD ICD DF1 TRANSVENE 65CM,2400.0,1560.0,866.4,866.4,3
CDM,27805900_OP,W LD ICD DF1 TRANSVENE 65CM,2400.0,1560.0,1560.0,2352.0,6
CDM,27805910,W LD KT RESUME II INLNE 3587A25,3024.0,1965.6,508.03,2721.6,23
CDM,27805910_IP,W LD KT RESUME II INLNE 3587A25,3024.0,1965.6,1091.66,1091.66,3
CDM,27805910_OP,W LD KT RESUME II INLNE 3587A25,3024.0,1965.6,1965.6,2963.52,6
CDM,27805920,W LD LFT VNT COR2,7600.0,4940.0,1276.8,6840.0,29
CDM,27805920_OP,W LD LFT VNT COR2,7600.0,4940.0,4940.0,7448.0,6
CDM,27805930,W LD NEURSTM MONARCH/MNPRO/SCS,10400.0,6760.0,1747.2,9360.0,29
CDM,27805930_OP,W LD NEURSTM MONARCH/MNPRO/SCS,10400.0,6760.0,6760.0,10192.0,6
CDM,27805940,W LD NSTIM INTRST,5555.0,3610.75,933.24,4999.5,29
CDM,27805940_OP,W LD NSTIM INTRST,5555.0,3610.75,3610.75,5443.9,6
CDM,27805950,W LD NSTIM INTRST,5555.0,3610.75,933.24,4999.5,29
CDM,27805950_OP,W LD NSTIM INTRST,5555.0,3610.75,3610.75,5443.9,6
CDM,27805960,W LD OCTAD/SUBCMPT/STD NEURSTIM,3230.0,2099.5,542.64,2907.0,23
CDM,27805960_IP,W LD OCTAD/SUBCMPT/STD NEURSTIM,3230.0,2099.5,1166.03,1166.03,3
CDM,27805960_OP,W LD OCTAD/SUBCMPT/STD NEURSTIM,3230.0,2099.5,2099.5,3165.4,6
CDM,27805970,W LD PM ADAPTOR,372.0,241.8,62.5,334.8,20
CDM,27805970_IP,W LD PM ADAPTOR,372.0,241.8,134.29,134.29,3
CDM,27805970_OP,W LD PM ADAPTOR,372.0,241.8,241.8,364.56,6
CDM,27805980,W LD PM EXTENSION,1470.0,955.5,246.96,1323.0,20
CDM,27805980_IP,W LD PM EXTENSION,1470.0,955.5,530.67,530.67,3
CDM,27805980_OP,W LD PM EXTENSION,1470.0,955.5,955.5,1440.6,6
CDM,27805990,W LEAD 8 CHANNEL NS PRECISION,3230.0,2099.5,542.64,2907.0,23
CDM,27805990_IP,W LEAD 8 CHANNEL NS PRECISION,3230.0,2099.5,1166.03,1166.03,3
CDM,27805990_OP,W LEAD 8 CHANNEL NS PRECISION,3230.0,2099.5,2099.5,3165.4,6
CDM,27806000,W LEAD AICD DURATA SINGLE COIL,6000.0,3900.0,1008.0,5400.0,29
CDM,27806000_OP,W LEAD AICD DURATA SINGLE COIL,6000.0,3900.0,3900.0,5880.0,6
CDM,27806040,W LEAD ATTAIN LFT VENT COR,3300.0,2145.0,554.4,2970.0,23
CDM,27806040_IP,W LEAD ATTAIN LFT VENT COR,3300.0,2145.0,1191.3,1191.3,3
CDM,27806040_OP,W LEAD ATTAIN LFT VENT COR,3300.0,2145.0,2145.0,3234.0,6
CDM,27806050,W LEAD ATTN ABILITY MULTPLR,2794.0,1816.1,469.39,2514.6,23
CDM,27806050_IP,W LEAD ATTN ABILITY MULTPLR,2794.0,1816.1,1008.63,1008.63,3
CDM,27806050_OP,W LEAD ATTN ABILITY MULTPLR,2794.0,1816.1,1816.1,2738.12,6
CDM,27806060,W LEAD BIPOLAR VAGUS NERVE CYBX,9168.0,5959.2,1540.22,8251.2,29
CDM,27806060_OP,W LEAD BIPOLAR VAGUS NERVE CYBX,9168.0,5959.2,5959.2,8984.64,6
CDM,27806070,W LEAD CORONARY VENOUS 4555,7528.0,4893.2,1264.7,6775.2,29
CDM,27806070_OP,W LEAD CORONARY VENOUS 4555,7528.0,4893.2,4893.2,7377.44,6
CDM,27806080,W LEAD DBS 1-4ELECT,6476.0,4209.4,1087.97,5828.4,29
CDM,27806080_OP,W LEAD DBS 1-4ELECT,6476.0,4209.4,4209.4,6346.48,6
CDM,27806090,W LEAD DEFIB SINGLE COIL,7900.0,5135.0,1327.2,7110.0,29
CDM,27806090_OP,W LEAD DEFIB SINGLE COIL,7900.0,5135.0,5135.0,7742.0,6
CDM,27806100,W LEAD DURATA AICD DUAL COIL,6000.0,3900.0,1008.0,5400.0,29
CDM,27806100_OP,W LEAD DURATA AICD DUAL COIL,6000.0,3900.0,3900.0,5880.0,6
CDM,27806110,W LEAD ENDOTACK RELIANCE SG,6000.0,3900.0,1008.0,5400.0,29
CDM,27806110_OP,W LEAD ENDOTACK RELIANCE SG,6000.0,3900.0,3900.0,5880.0,6
CDM,27806120,W LEAD ENDOTAK RELIANCE G,6000.0,3900.0,1008.0,5400.0,29
CDM,27806120_OP,W LEAD ENDOTAK RELIANCE G,6000.0,3900.0,3900.0,5880.0,6
CDM,27806140,W LEAD ICD SPRINT QUATTRO SECUR,6600.0,4290.0,1108.8,5940.0,29
CDM,27806140_OP,W LEAD ICD SPRINT QUATTRO SECUR,6600.0,4290.0,4290.0,6468.0,6
CDM,27806150,W LEAD INTRO KT INTRSTIM 355018,420.0,273.0,70.56,378.0,21
CDM,27806160,W LEAD KIT MEDT ACTIVA DBS 40CM,5950.0,3867.5,999.6,5355.0,29
CDM,27806160_OP,W LEAD KIT MEDT ACTIVA DBS 40CM,5950.0,3867.5,3867.5,5831.0,6
CDM,27806170,W LEAD KIT TST INTERSTM 3065USC,610.0,396.5,102.48,549.0,20
CDM,27806170_IP,W LEAD KIT TST INTERSTM 3065USC,610.0,396.5,220.21,220.21,3
CDM,27806170_OP,W LEAD KIT TST INTERSTM 3065USC,610.0,396.5,396.5,597.8,6
CDM,27806180,W LEAD KT LOW IMPED 45CM,3230.0,2099.5,542.64,2907.0,23
CDM,27806180_IP,W LEAD KT LOW IMPED 45CM,3230.0,2099.5,1166.03,1166.03,3
CDM,27806180_OP,W LEAD KT LOW IMPED 45CM,3230.0,2099.5,2099.5,3165.4,6
CDM,27806190,W LEAD MONARCH 30/45/60,5800.0,3770.0,974.4,5220.0,29
CDM,27806190_OP,W LEAD MONARCH 30/45/60,5800.0,3770.0,3770.0,5684.0,6
CDM,27806200,W LEAD NS EXTNS PRECISIN LINEAR,930.0,604.5,156.24,837.0,20
CDM,27806200_IP,W LEAD NS EXTNS PRECISIN LINEAR,930.0,604.5,335.73,335.73,3
CDM,27806200_OP,W LEAD NS EXTNS PRECISIN LINEAR,930.0,604.5,604.5,911.4,6
CDM,27806210,W LEAD PERENNIA CYBX,10580.0,6877.0,1777.44,9522.0,29
CDM,27806210_OP,W LEAD PERENNIA CYBX,10580.0,6877.0,6877.0,10368.4,6
CDM,27806220,W LEAD PERENNIA SINGLE PIN 2.0M,11004.0,7152.6,1848.67,9903.6,29
CDM,27806220_OP,W LEAD PERENNIA SINGLE PIN 2.0M,11004.0,7152.6,7152.6,10783.92,6
CDM,27806230,W LEAD QUICKFLEX LFT VENT COR,2350.0,1527.5,394.8,2115.0,23
CDM,27806230_IP,W LEAD QUICKFLEX LFT VENT COR,2350.0,1527.5,848.35,848.35,3
CDM,27806230_OP,W LEAD QUICKFLEX LFT VENT COR,2350.0,1527.5,1527.5,2303.0,6
CDM,27806240,W LEAD QUICKSITE LEFT HEART,2550.0,1657.5,428.4,2295.0,23
CDM,27806240_IP,W LEAD QUICKSITE LEFT HEART,2550.0,1657.5,920.55,920.55,3
CDM,27806240_OP,W LEAD QUICKSITE LEFT HEART,2550.0,1657.5,1657.5,2499.0,6
CDM,27806250,W LEAD RESUME TO IN-LINE 3986A,3420.0,2223.0,574.56,3078.0,23
CDM,27806250_IP,W LEAD RESUME TO IN-LINE 3986A,3420.0,2223.0,1234.62,1234.62,3
CDM,27806250_OP,W LEAD RESUME TO IN-LINE 3986A,3420.0,2223.0,2223.0,3351.6,6
CDM,27806260,W LEAD RIATA DEFIB,6600.0,4290.0,1108.8,5940.0,29
CDM,27806260_OP,W LEAD RIATA DEFIB,6600.0,4290.0,4290.0,6468.0,6
CDM,27806270,W LEAD SPECIFY 20CM 3998,3420.0,2223.0,574.56,3078.0,23
CDM,27806270_IP,W LEAD SPECIFY 20CM 3998,3420.0,2223.0,1234.62,1234.62,3
CDM,27806270_OP,W LEAD SPECIFY 20CM 3998,3420.0,2223.0,2223.0,3351.6,6
CDM,27806280,W LEAD TEST STIM 30576SC,1380.0,897.0,231.84,1242.0,20
CDM,27806280_IP,W LEAD TEST STIM 30576SC,1380.0,897.0,498.18,498.18,3
CDM,27806280_OP,W LEAD TEST STIM 30576SC,1380.0,897.0,897.0,1352.4,6
CDM,27806290,W LEAD TST OCT STIM/SC TRL,2780.0,1807.0,467.04,2502.0,23
CDM,27806290_IP,W LEAD TST OCT STIM/SC TRL,2780.0,1807.0,1003.58,1003.58,3
CDM,27806290_OP,W LEAD TST OCT STIM/SC TRL,2780.0,1807.0,1807.0,2724.4,6
CDM,27806300,W LEAD TST STIM 30571SC,230.0,149.5,38.64,207.0,20
CDM,27806300_IP,W LEAD TST STIM 30571SC,230.0,149.5,83.03,83.03,3
CDM,27806300_OP,W LEAD TST STIM 30571SC,230.0,149.5,149.5,225.4,6
CDM,27806310,W LEAD TST STIM PK TL22,840.0,546.0,141.12,756.0,20
CDM,27806310_IP,W LEAD TST STIM PK TL22,840.0,546.0,303.24,303.24,3
CDM,27806310_OP,W LEAD TST STIM PK TL22,840.0,546.0,546.0,823.2,6
CDM,27806320,W LEAD UNIPOLAR IM 435135,4400.0,2860.0,739.2,3960.0,23
CDM,27806320_IP,W LEAD UNIPOLAR IM 435135,4400.0,2860.0,1588.4,1588.4,3
CDM,27806320_OP,W LEAD UNIPOLAR IM 435135,4400.0,2860.0,2860.0,4312.0,6
CDM,27806330,"W LGX PRECONNECT PS,IZ,72404252",12278.0,7980.7,2062.7,11050.2,29
CDM,27806330_OP,"W LGX PRECONNECT PS,IZ,72404252",12278.0,7980.7,7980.7,12032.44,6
CDM,27806340,W LIGACLIP LG TITANIUM,22.0,14.3,3.7,19.8,20
CDM,27806340_IP,W LIGACLIP LG TITANIUM,22.0,14.3,7.94,7.94,3
CDM,27806340_OP,W LIGACLIP LG TITANIUM,22.0,14.3,14.3,21.56,6
CDM,27806350,W LIGACLIP MED TITANIUM,11.0,7.15,1.85,9.9,20
CDM,27806350_IP,W LIGACLIP MED TITANIUM,11.0,7.15,3.97,3.97,3
CDM,27806350_OP,W LIGACLIP MED TITANIUM,11.0,7.15,7.15,10.78,6
CDM,27806360,W LINER HIP FEM ACET 36MM,3148.0,2046.2,528.86,2833.2,23
CDM,27806360_IP,W LINER HIP FEM ACET 36MM,3148.0,2046.2,1136.43,1136.43,3
CDM,27806360_OP,W LINER HIP FEM ACET 36MM,3148.0,2046.2,2046.2,3085.04,6
CDM,27806370,W LINER LONGEVITY 52X32X10,3096.0,2012.4,520.13,2786.4,23
CDM,27806370_IP,W LINER LONGEVITY 52X32X10,3096.0,2012.4,1117.66,1117.66,3
CDM,27806370_OP,W LINER LONGEVITY 52X32X10,3096.0,2012.4,2012.4,3034.08,6
CDM,27806380,W LINER PIN CON NEUT +4 36X56MM,5370.0,3490.5,902.16,4833.0,29
CDM,27806380_OP,W LINER PIN CON NEUT +4 36X56MM,5370.0,3490.5,3490.5,5262.6,6
CDM,27806390,W LINER PINN MAR 28X48MM NEUTRL,364.0,236.6,61.15,327.6,20
CDM,27806390_IP,W LINER PINN MAR 28X48MM NEUTRL,364.0,236.6,131.4,131.4,3
CDM,27806390_OP,W LINER PINN MAR 28X48MM NEUTRL,364.0,236.6,236.6,356.72,6
CDM,27806400,W LINER PINN MAR 36X56MM,797.0,518.05,133.9,717.3,20
CDM,27806400_IP,W LINER PINN MAR 36X56MM,797.0,518.05,287.72,287.72,3
CDM,27806400_OP,W LINER PINN MAR 36X56MM,797.0,518.05,518.05,781.06,6
CDM,27806410,W LINER REF XLPE 32MM 50-52 E,4394.0,2856.1,738.19,3954.6,23
CDM,27806410_IP,W LINER REF XLPE 32MM 50-52 E,4394.0,2856.1,1586.23,1586.23,3
CDM,27806410_OP,W LINER REF XLPE 32MM 50-52 E,4394.0,2856.1,2856.1,4306.12,6
CDM,27806420,W LINER SHLDR REV HMRALLN,1500.0,975.0,252.0,1350.0,20
CDM,27806420_IP,W LINER SHLDR REV HMRALLN,1500.0,975.0,541.5,541.5,3
CDM,27806420_OP,W LINER SHLDR REV HMRALLN,1500.0,975.0,975.0,1470.0,6
CDM,27806430,W LOOP RECORDER REVEAL DX 9528,7200.0,4680.0,1209.6,6480.0,29
CDM,27806430_OP,W LOOP RECORDER REVEAL DX 9528,7200.0,4680.0,4680.0,7056.0,6
CDM,27806440,W LOOP RECORDER SLEUTH AT 9006,8600.0,5590.0,1444.8,7740.0,29
CDM,27806440_OP,W LOOP RECORDER SLEUTH AT 9006,8600.0,5590.0,5590.0,8428.0,6
CDM,27806450,W MESH 3D MAX LG RIGHT 4X6IN LF,314.0,204.1,52.75,282.6,20
CDM,27806450_IP,W MESH 3D MAX LG RIGHT 4X6IN LF,314.0,204.1,113.35,113.35,3
CDM,27806450_OP,W MESH 3D MAX LG RIGHT 4X6IN LF,314.0,204.1,204.1,307.72,6
CDM,27806460,W MESH 3DMAX MD/ PERFIX PLUG,258.0,167.7,43.34,232.2,20
CDM,27806460_IP,W MESH 3DMAX MD/ PERFIX PLUG,258.0,167.7,93.14,93.14,3
CDM,27806460_OP,W MESH 3DMAX MD/ PERFIX PLUG,258.0,167.7,167.7,252.84,6
CDM,27806470,W MESH APOGEE W/INTEPRO LITE,2240.0,1456.0,376.32,2016.0,23
CDM,27806470_IP,W MESH APOGEE W/INTEPRO LITE,2240.0,1456.0,808.64,808.64,3
CDM,27806470_OP,W MESH APOGEE W/INTEPRO LITE,2240.0,1456.0,1456.0,2195.2,6
CDM,27806480,W MESH BARD 3DMAX,538.0,349.7,90.38,484.2,20
CDM,27806480_IP,W MESH BARD 3DMAX,538.0,349.7,194.22,194.22,3
CDM,27806480_OP,W MESH BARD 3DMAX,538.0,349.7,349.7,527.24,6
CDM,27806490,W MESH BARD 3DMAX,576.0,374.4,96.77,518.4,20
CDM,27806490_IP,W MESH BARD 3DMAX,576.0,374.4,207.94,207.94,3
CDM,27806490_OP,W MESH BARD 3DMAX,576.0,374.4,374.4,564.48,6
CDM,27806500,W MESH COMPOSIX,710.0,461.5,119.28,639.0,20
CDM,27806500_IP,W MESH COMPOSIX,710.0,461.5,256.31,256.31,3
CDM,27806500_OP,W MESH COMPOSIX,710.0,461.5,461.5,695.8,6
CDM,27806510,W MESH COMPOSIX EX ELLIP 6X8IN,1500.0,975.0,252.0,1350.0,20
CDM,27806510_IP,W MESH COMPOSIX EX ELLIP 6X8IN,1500.0,975.0,541.5,541.5,3
CDM,27806510_OP,W MESH COMPOSIX EX ELLIP 6X8IN,1500.0,975.0,975.0,1470.0,6
CDM,27806520,W MESH COMPOSIX EX ELLIP 7X9IN,1988.0,1292.2,333.98,1789.2,23
CDM,27806520_IP,W MESH COMPOSIX EX ELLIP 7X9IN,1988.0,1292.2,717.67,717.67,3
CDM,27806520_OP,W MESH COMPOSIX EX ELLIP 7X9IN,1988.0,1292.2,1292.2,1948.24,6
CDM,27806530,W MESH COMPOSIX KUGEL 8X12CM,533.0,346.45,89.54,479.7,20
CDM,27806530_IP,W MESH COMPOSIX KUGEL 8X12CM,533.0,346.45,192.41,192.41,3
CDM,27806530_OP,W MESH COMPOSIX KUGEL 8X12CM,533.0,346.45,346.45,522.34,6
CDM,27806540,W MESH COMPOSIX VNTRL HERNIA,2480.0,1612.0,416.64,2232.0,23
CDM,27806540_IP,W MESH COMPOSIX VNTRL HERNIA,2480.0,1612.0,895.28,895.28,3
CDM,27806540_OP,W MESH COMPOSIX VNTRL HERNIA,2480.0,1612.0,1612.0,2430.4,6
CDM,27806550,W MESH COMPOSIX LP CIRCLE 4.5IN,1120.0,728.0,188.16,1008.0,20
CDM,27806550_IP,W MESH COMPOSIX LP CIRCLE 4.5IN,1120.0,728.0,404.32,404.32,3
CDM,27806550_OP,W MESH COMPOSIX LP CIRCLE 4.5IN,1120.0,728.0,728.0,1097.6,6
CDM,27806560,W MESH COMPOSXKUG,4316.0,2805.4,725.09,3884.4,23
CDM,27806560_IP,W MESH COMPOSXKUG,4316.0,2805.4,1558.08,1558.08,3
CDM,27806560_OP,W MESH COMPOSXKUG,4316.0,2805.4,2805.4,4229.68,6
CDM,27806570,W MESH COMPSX 80,4360.0,2834.0,732.48,3924.0,23
CDM,27806570_IP,W MESH COMPSX 80,4360.0,2834.0,1573.96,1573.96,3
CDM,27806570_OP,W MESH COMPSX 80,4360.0,2834.0,2834.0,4272.8,6
CDM,27806580,W MESH COMPSX E/X,967.0,628.55,162.46,870.3,20
CDM,27806580_IP,W MESH COMPSX E/X,967.0,628.55,349.09,349.09,3
CDM,27806580_OP,W MESH COMPSX E/X,967.0,628.55,628.55,947.66,6
CDM,27806590,W MESH COMPSX E/X,2044.0,1328.6,343.39,1839.6,23
CDM,27806590_IP,W MESH COMPSX E/X,2044.0,1328.6,737.88,737.88,3
CDM,27806590_OP,W MESH COMPSX E/X,2044.0,1328.6,1328.6,2003.12,6
CDM,27806600,W MESH COMPSX E/X,2709.0,1760.85,455.11,2438.1,23
CDM,27806600_IP,W MESH COMPSX E/X,2709.0,1760.85,977.95,977.95,3
CDM,27806600_OP,W MESH COMPSX E/X,2709.0,1760.85,1760.85,2654.82,6
CDM,27806610,W MESH COMPSX E/X,4722.0,3069.3,793.3,4249.8,23
CDM,27806610_IP,W MESH COMPSX E/X,4722.0,3069.3,1704.64,1704.64,3
CDM,27806610_OP,W MESH COMPSX E/X,4722.0,3069.3,3069.3,4627.56,6
CDM,27806620,W MESH DUAL 285CM,2733.0,1776.45,459.14,2459.7,23
CDM,27806620_IP,W MESH DUAL 285CM,2733.0,1776.45,986.61,986.61,3
CDM,27806620_OP,W MESH DUAL 285CM,2733.0,1776.45,1776.45,2678.34,6
CDM,27806630,W MESH DUAL+150CM,1598.0,1038.7,268.46,1438.2,20
CDM,27806630_IP,W MESH DUAL+150CM,1598.0,1038.7,576.88,576.88,3
CDM,27806630_OP,W MESH DUAL+150CM,1598.0,1038.7,1038.7,1566.04,6
CDM,27806640,W MESH DUAL+285CM,2733.0,1776.45,459.14,2459.7,23
CDM,27806640_IP,W MESH DUAL+285CM,2733.0,1776.45,986.61,986.61,3
CDM,27806640_OP,W MESH DUAL+285CM,2733.0,1776.45,1776.45,2678.34,6
CDM,27806650,W MESH DUAL+432CM,4219.0,2742.35,708.79,3797.1,23
CDM,27806650_IP,W MESH DUAL+432CM,4219.0,2742.35,1523.06,1523.06,3
CDM,27806650_OP,W MESH DUAL+432CM,4219.0,2742.35,2742.35,4134.62,6
CDM,27806660,W MESH DUALMESH PLUS 20X30X1,3372.0,2191.8,566.5,3034.8,23
CDM,27806660_IP,W MESH DUALMESH PLUS 20X30X1,3372.0,2191.8,1217.29,1217.29,3
CDM,27806660_OP,W MESH DUALMESH PLUS 20X30X1,3372.0,2191.8,2191.8,3304.56,6
CDM,27806670,W MESH ELEVATE ANTERIOR,3790.0,2463.5,636.72,3411.0,23
CDM,27806670_IP,W MESH ELEVATE ANTERIOR,3790.0,2463.5,1368.19,1368.19,3
CDM,27806670_OP,W MESH ELEVATE ANTERIOR,3790.0,2463.5,2463.5,3714.2,6
CDM,27806680,W MESH FLAT 7.5X15CM 3X6IN,210.0,136.5,35.28,189.0,20
CDM,27806680_IP,W MESH FLAT 7.5X15CM 3X6IN,210.0,136.5,75.81,75.81,3
CDM,27806680_OP,W MESH FLAT 7.5X15CM 3X6IN,210.0,136.5,136.5,205.8,6
CDM,27806690,W MESH GORTX15X19,1516.0,985.4,254.69,1364.4,20
CDM,27806690_IP,W MESH GORTX15X19,1516.0,985.4,547.28,547.28,3
CDM,27806690_OP,W MESH GORTX15X19,1516.0,985.4,985.4,1485.68,6
CDM,27806700,W MESH H POLYPRO,1215.0,789.75,204.12,1093.5,20
CDM,27806700_IP,W MESH H POLYPRO,1215.0,789.75,438.62,438.62,3
CDM,27806700_OP,W MESH H POLYPRO,1215.0,789.75,789.75,1190.7,6
CDM,27806710,W MESH H PTCH BRD,1049.0,681.85,176.23,944.1,20
CDM,27806710_IP,W MESH H PTCH BRD,1049.0,681.85,378.69,378.69,3
CDM,27806710_OP,W MESH H PTCH BRD,1049.0,681.85,681.85,1028.02,6
CDM,27806720,W MESH H PTCH BRD,1189.0,772.85,199.75,1070.1,20
CDM,27806720_IP,W MESH H PTCH BRD,1189.0,772.85,429.23,429.23,3
CDM,27806720_OP,W MESH H PTCH BRD,1189.0,772.85,772.85,1165.22,6
CDM,27806730,W MESH H PTCH BRD,1451.0,943.15,243.77,1305.9,20
CDM,27806730_IP,W MESH H PTCH BRD,1451.0,943.15,523.81,523.81,3
CDM,27806730_OP,W MESH H PTCH BRD,1451.0,943.15,943.15,1421.98,6
CDM,27806740,W MESH H PTCH BRD,1649.0,1071.85,277.03,1484.1,20
CDM,27806740_IP,W MESH H PTCH BRD,1649.0,1071.85,595.29,595.29,3
CDM,27806740_OP,W MESH H PTCH BRD,1649.0,1071.85,1071.85,1616.02,6
CDM,27806750,W MESH H PTCH BRD,2718.0,1766.7,456.62,2446.2,23
CDM,27806750_IP,W MESH H PTCH BRD,2718.0,1766.7,981.2,981.2,3
CDM,27806750_OP,W MESH H PTCH BRD,2718.0,1766.7,1766.7,2663.64,6
CDM,27806760,W MESH HIATAL PTCH,877.0,570.05,147.34,789.3,20
CDM,27806760_IP,W MESH HIATAL PTCH,877.0,570.05,316.6,316.6,3
CDM,27806760_OP,W MESH HIATAL PTCH,877.0,570.05,570.05,859.46,6
CDM,27806770,W MESH HIATAL PTCH,1191.0,774.15,200.09,1071.9,20
CDM,27806770_IP,W MESH HIATAL PTCH,1191.0,774.15,429.95,429.95,3
CDM,27806770_OP,W MESH HIATAL PTCH,1191.0,774.15,774.15,1167.18,6
CDM,27806780,W MESH HRNIA PRLN,621.0,403.65,104.33,558.9,20
CDM,27806780_IP,W MESH HRNIA PRLN,621.0,403.65,224.18,224.18,3
CDM,27806780_OP,W MESH HRNIA PRLN,621.0,403.65,403.65,608.58,6
CDM,27806790,W MESH KUGEL COMPOSIX XLG,2676.0,1739.4,449.57,2408.4,23
CDM,27806790_IP,W MESH KUGEL COMPOSIX XLG,2676.0,1739.4,966.04,966.04,3
CDM,27806790_OP,W MESH KUGEL COMPOSIX XLG,2676.0,1739.4,1739.4,2622.48,6
CDM,27806800,W MESH MARLEX PLG,912.0,592.8,153.22,820.8,20
CDM,27806800_IP,W MESH MARLEX PLG,912.0,592.8,329.23,329.23,3
CDM,27806800_OP,W MESH MARLEX PLG,912.0,592.8,592.8,893.76,6
CDM,27806810,W MESH MYCRO 5X10CM OVAL,2278.0,1480.7,382.7,2050.2,23
CDM,27806810_IP,W MESH MYCRO 5X10CM OVAL,2278.0,1480.7,822.36,822.36,3
CDM,27806810_OP,W MESH MYCRO 5X10CM OVAL,2278.0,1480.7,1480.7,2232.44,6
CDM,27806820,W MESH MYCRO PLUS OVAL 6X12X1,350.0,227.5,58.8,315.0,20
CDM,27806820_IP,W MESH MYCRO PLUS OVAL 6X12X1,350.0,227.5,126.35,126.35,3
CDM,27806820_OP,W MESH MYCRO PLUS OVAL 6X12X1,350.0,227.5,227.5,343.0,6
CDM,27806830,W MESH MYCRO RECT,2086.0,1355.9,350.45,1877.4,23
CDM,27806830_IP,W MESH MYCRO RECT,2086.0,1355.9,753.05,753.05,3
CDM,27806830_OP,W MESH MYCRO RECT,2086.0,1355.9,1355.9,2044.28,6
CDM,27806840,W MESH OVL COMPOSIX KUGEL 11X14,1584.0,1029.6,266.11,1425.6,20
CDM,27806840_IP,W MESH OVL COMPOSIX KUGEL 11X14,1584.0,1029.6,571.82,571.82,3
CDM,27806840_OP,W MESH OVL COMPOSIX KUGEL 11X14,1584.0,1029.6,1029.6,1552.32,6
CDM,27806850,W MESH OVL COMPOSIX KUGEL 14X18,2158.0,1402.7,362.54,1942.2,23
CDM,27806850_IP,W MESH OVL COMPOSIX KUGEL 14X18,2158.0,1402.7,779.04,779.04,3
CDM,27806850_OP,W MESH OVL COMPOSIX KUGEL 14X18,2158.0,1402.7,1402.7,2114.84,6
CDM,27806860,W MESH OVL COMPOSIX KUGEL 8X10,1600.0,1040.0,268.8,1440.0,20
CDM,27806860_IP,W MESH OVL COMPOSIX KUGEL 8X10,1600.0,1040.0,577.6,577.6,3
CDM,27806860_OP,W MESH OVL COMPOSIX KUGEL 8X10,1600.0,1040.0,1040.0,1568.0,6
CDM,27806870,W MESH PATCH CRURASFT 2.8X2.4IN,698.0,453.7,117.26,628.2,20
CDM,27806870_IP,W MESH PATCH CRURASFT 2.8X2.4IN,698.0,453.7,251.98,251.98,3
CDM,27806870_OP,W MESH PATCH CRURASFT 2.8X2.4IN,698.0,453.7,453.7,684.04,6
CDM,27806880,W MESH PATCH CRURASOFT 4.3X3.1,447.0,290.55,75.1,402.3,20
CDM,27806880_IP,W MESH PATCH CRURASOFT 4.3X3.1,447.0,290.55,161.37,161.37,3
CDM,27806880_OP,W MESH PATCH CRURASOFT 4.3X3.1,447.0,290.55,290.55,438.06,6
CDM,27806890,W MESH PERFIX PLUG SM/MD,268.0,174.2,45.02,241.2,20
CDM,27806890_IP,W MESH PERFIX PLUG SM/MD,268.0,174.2,96.75,96.75,3
CDM,27806890_OP,W MESH PERFIX PLUG SM/MD,268.0,174.2,174.2,262.64,6
CDM,27806900,W MESH PERIGEE W/INTERPRO,2668.0,1734.2,448.22,2401.2,23
CDM,27806900_IP,W MESH PERIGEE W/INTERPRO,2668.0,1734.2,963.15,963.15,3
CDM,27806900_OP,W MESH PERIGEE W/INTERPRO,2668.0,1734.2,1734.2,2614.64,6
CDM,27806910,W MESH PLUG PERFX,330.0,214.5,55.44,297.0,20
CDM,27806910_IP,W MESH PLUG PERFX,330.0,214.5,119.13,119.13,3
CDM,27806910_OP,W MESH PLUG PERFX,330.0,214.5,214.5,323.4,6
CDM,27806920,W MESH PROCEED 6X8 OVAL,2553.0,1659.45,428.9,2297.7,23
CDM,27806920_IP,W MESH PROCEED 6X8 OVAL,2553.0,1659.45,921.63,921.63,3
CDM,27806920_OP,W MESH PROCEED 6X8 OVAL,2553.0,1659.45,1659.45,2501.94,6
CDM,27806930,W MESH PROLENE,1312.0,852.8,220.42,1180.8,20
CDM,27806930_IP,W MESH PROLENE,1312.0,852.8,473.63,473.63,3
CDM,27806930_OP,W MESH PROLENE,1312.0,852.8,852.8,1285.76,6
CDM,27806940,W MESH PROLENE 12 X 12,170.0,110.5,28.56,153.0,20
CDM,27806940_IP,W MESH PROLENE 12 X 12,170.0,110.5,61.37,61.37,3
CDM,27806940_OP,W MESH PROLENE 12 X 12,170.0,110.5,110.5,166.6,6
CDM,27806950,W MESH PROLENE 3X6 PMII,65.0,42.25,10.92,58.5,20
CDM,27806950_IP,W MESH PROLENE 3X6 PMII,65.0,42.25,23.47,23.47,3
CDM,27806950_OP,W MESH PROLENE 3X6 PMII,65.0,42.25,42.25,63.7,6
CDM,27806960,W MESH PROLENE 6X6 PMH,243.0,157.95,40.82,218.7,20
CDM,27806960_IP,W MESH PROLENE 6X6 PMH,243.0,157.95,87.72,87.72,3
CDM,27806960_OP,W MESH PROLENE 6X6 PMH,243.0,157.95,157.95,238.14,6
CDM,27806970,W MESH PROLENE HERNIA EXTENDED,426.0,276.9,71.57,383.4,20
CDM,27806970_IP,W MESH PROLENE HERNIA EXTENDED,426.0,276.9,153.79,153.79,3
CDM,27806970_OP,W MESH PROLENE HERNIA EXTENDED,426.0,276.9,276.9,417.48,6
CDM,27806980,W MESH PROLENE HERNIA SYS PHSE6,427.0,277.55,71.74,384.3,20
CDM,27806980_IP,W MESH PROLENE HERNIA SYS PHSE6,427.0,277.55,154.15,154.15,3
CDM,27806980_OP,W MESH PROLENE HERNIA SYS PHSE6,427.0,277.55,277.55,418.46,6
CDM,27806990,W MESH PROLENE SOFT 3INX6IN,819.0,532.35,137.59,737.1,20
CDM,27806990_IP,W MESH PROLENE SOFT 3INX6IN,819.0,532.35,295.66,295.66,3
CDM,27806990_OP,W MESH PROLENE SOFT 3INX6IN,819.0,532.35,532.35,802.62,6
CDM,27807000,W MESH PROLENE SOFT 6INX6IN,990.0,643.5,166.32,891.0,20
CDM,27807000_IP,W MESH PROLENE SOFT 6INX6IN,990.0,643.5,357.39,357.39,3
CDM,27807000_OP,W MESH PROLENE SOFT 6INX6IN,990.0,643.5,643.5,970.2,6
CDM,27807010,W MESH SURG PROCEED OVAL,1410.0,916.5,236.88,1269.0,20
CDM,27807010_IP,W MESH SURG PROCEED OVAL,1410.0,916.5,509.01,509.01,3
CDM,27807010_OP,W MESH SURG PROCEED OVAL,1410.0,916.5,916.5,1381.8,6
CDM,27807020,W MESH VENTRALEX SMALL,731.0,475.15,122.81,657.9,20
CDM,27807020_IP,W MESH VENTRALEX SMALL,731.0,475.15,263.89,263.89,3
CDM,27807020_OP,W MESH VENTRALEX SMALL,731.0,475.15,475.15,716.38,6
CDM,27807030,W MESH VICRYL 12 X 12IN VWML,2235.0,1452.75,375.48,2011.5,23
CDM,27807030_IP,W MESH VICRYL 12 X 12IN VWML,2235.0,1452.75,806.84,806.84,3
CDM,27807030_OP,W MESH VICRYL 12 X 12IN VWML,2235.0,1452.75,1452.75,2190.3,6
CDM,27807040,"W MESH,SURGICAL",3733.0,2426.45,627.14,3359.7,23
CDM,27807040_IP,"W MESH,SURGICAL",3733.0,2426.45,1347.61,1347.61,3
CDM,27807040_OP,"W MESH,SURGICAL",3733.0,2426.45,2426.45,3658.34,6
CDM,27807050,"W MESH,SURGICAL",3826.0,2486.9,642.77,3443.4,23
CDM,27807050_IP,"W MESH,SURGICAL",3826.0,2486.9,1381.19,1381.19,3
CDM,27807050_OP,"W MESH,SURGICAL",3826.0,2486.9,2486.9,3749.48,6
CDM,27807070,W METAGLENE DTLA XTEND,2363.0,1535.95,396.98,2126.7,23
CDM,27807070_IP,W METAGLENE DTLA XTEND,2363.0,1535.95,853.04,853.04,3
CDM,27807070_OP,W METAGLENE DTLA XTEND,2363.0,1535.95,1535.95,2315.74,6
CDM,27807080,W MICROFIBRILLA COLLAGEN HEMSTA,1212.0,787.8,203.62,1090.8,20
CDM,27807080_IP,W MICROFIBRILLA COLLAGEN HEMSTA,1212.0,787.8,437.53,437.53,3
CDM,27807080_OP,W MICROFIBRILLA COLLAGEN HEMSTA,1212.0,787.8,787.8,1187.76,6
CDM,27807090,W MITRAL RING PHYSIO II-5200,7790.0,5063.5,1308.72,7011.0,29
CDM,27807090_OP,W MITRAL RING PHYSIO II-5200,7790.0,5063.5,5063.5,7634.2,6
CDM,27807100,W MOLD TIB KNEE CEMT 75MM,1940.0,1261.0,325.92,1746.0,23
CDM,27807100_IP,W MOLD TIB KNEE CEMT 75MM,1940.0,1261.0,700.34,700.34,3
CDM,27807100_OP,W MOLD TIB KNEE CEMT 75MM,1940.0,1261.0,1261.0,1901.2,6
CDM,27807110,W MOLDED FEMORAL CEMENTED KNEE,4092.0,2659.8,687.46,3682.8,23
CDM,27807110_IP,W MOLDED FEMORAL CEMENTED KNEE,4092.0,2659.8,1477.21,1477.21,3
CDM,27807110_OP,W MOLDED FEMORAL CEMENTED KNEE,4092.0,2659.8,2659.8,4010.16,6
CDM,27807120,W MSH PLYTETFLUTH,352.0,228.8,59.14,316.8,20
CDM,27807120_IP,W MSH PLYTETFLUTH,352.0,228.8,127.07,127.07,3
CDM,27807120_OP,W MSH PLYTETFLUTH,352.0,228.8,228.8,344.96,6
CDM,27807130,W MTF DBX MIX 10CC 058100,2688.0,1747.2,451.58,2419.2,23
CDM,27807130_IP,W MTF DBX MIX 10CC 058100,2688.0,1747.2,970.37,970.37,3
CDM,27807130_OP,W MTF DBX MIX 10CC 058100,2688.0,1747.2,1747.2,2634.24,6
CDM,27807140,W NAIL BONE FEM 130DEG 11X360MM,3494.0,2271.1,586.99,3144.6,23
CDM,27807140_IP,W NAIL BONE FEM 130DEG 11X360MM,3494.0,2271.1,1261.33,1261.33,3
CDM,27807140_OP,W NAIL BONE FEM 130DEG 11X360MM,3494.0,2271.1,2271.1,3424.12,6
CDM,27807150,W NAIL BONE FIX SMALL,440.0,286.0,73.92,396.0,20
CDM,27807150_IP,W NAIL BONE FIX SMALL,440.0,286.0,158.84,158.84,3
CDM,27807150_OP,W NAIL BONE FIX SMALL,440.0,286.0,286.0,431.2,6
CDM,27807160,W NAIL EX CANN TIBIAL TI STERL,2980.0,1937.0,500.64,2682.0,23
CDM,27807160_IP,W NAIL EX CANN TIBIAL TI STERL,2980.0,1937.0,1075.78,1075.78,3
CDM,27807160_OP,W NAIL EX CANN TIBIAL TI STERL,2980.0,1937.0,1937.0,2920.4,6
CDM,27807180,W NAIL KT GAMMA 3 125DEG STRY,2194.0,1426.1,368.59,1974.6,23
CDM,27807180_IP,W NAIL KT GAMMA 3 125DEG STRY,2194.0,1426.1,792.03,792.03,3
CDM,27807180_OP,W NAIL KT GAMMA 3 125DEG STRY,2194.0,1426.1,1426.1,2150.12,6
CDM,27807190,W NAIL KUNTH/CLOV,193.0,125.45,32.42,173.7,20
CDM,27807190_IP,W NAIL KUNTH/CLOV,193.0,125.45,69.67,69.67,3
CDM,27807190_OP,W NAIL KUNTH/CLOV,193.0,125.45,125.45,189.14,6
CDM,27807200,W NAIL RECONSTRUCTION,3426.0,2226.9,575.57,3083.4,23
CDM,27807200_IP,W NAIL RECONSTRUCTION,3426.0,2226.9,1236.79,1236.79,3
CDM,27807200_OP,W NAIL RECONSTRUCTION,3426.0,2226.9,2226.9,3357.48,6
CDM,27807210,W NAIL SCHN11&12M,208.0,135.2,34.94,187.2,20
CDM,27807210_IP,W NAIL SCHN11&12M,208.0,135.2,75.09,75.09,3
CDM,27807210_OP,W NAIL SCHN11&12M,208.0,135.2,135.2,203.84,6
CDM,27807220,W NAIL SCHN13&15M,179.0,116.35,30.07,161.1,20
CDM,27807220_IP,W NAIL SCHN13&15M,179.0,116.35,64.62,64.62,3
CDM,27807220_OP,W NAIL SCHN13&15M,179.0,116.35,116.35,175.42,6
CDM,27807230,W NAIL TROCHANTERC 11X180MMX130,2886.0,1875.9,484.85,2597.4,23
CDM,27807230_IP,W NAIL TROCHANTERC 11X180MMX130,2886.0,1875.9,1041.85,1041.85,3
CDM,27807230_OP,W NAIL TROCHANTERC 11X180MMX130,2886.0,1875.9,1875.9,2828.28,6
CDM,27807240,W NEUROSPHINC ACTICON 72402287,9100.0,5915.0,1528.8,8190.0,29
CDM,27807240_OP,W NEUROSPHINC ACTICON 72402287,9100.0,5915.0,5915.0,8918.0,6
CDM,27807250,W NEUROSTIM PRIME ADVANCE 37702,22000.0,14300.0,3696.0,19800.0,29
CDM,27807250_OP,W NEUROSTIM PRIME ADVANCE 37702,22000.0,14300.0,14300.0,21560.0,6
CDM,27807260,W NEUROSTIMLTOR ACTIVA RC 37612,53800.0,34970.0,9038.4,48420.0,29
CDM,27807260_OP,W NEUROSTIMLTOR ACTIVA RC 37612,53800.0,34970.0,34970.0,52724.0,6
CDM,27807270,W NEUROSTIMULATOR KINETRA 7428,34190.0,22223.5,5743.92,30771.0,29
CDM,27807270_OP,W NEUROSTIMULATOR KINETRA 7428,34190.0,22223.5,22223.5,33506.2,6
CDM,27807280,W NEURSTM+EXT ITR,25544.0,16603.6,4291.39,22989.6,29
CDM,27807280_OP,W NEURSTM+EXT ITR,25544.0,16603.6,16603.6,25033.12,6
CDM,27807290,W NUT BONE HEX RANCHO 10X6MM,10.0,6.5,1.68,9.0,20
CDM,27807290_IP,W NUT BONE HEX RANCHO 10X6MM,10.0,6.5,3.61,3.61,3
CDM,27807290_OP,W NUT BONE HEX RANCHO 10X6MM,10.0,6.5,6.5,9.8,6
CDM,27807300,W OH PATCH BOVINE,1267.0,823.55,212.86,1140.3,20
CDM,27807300_IP,W OH PATCH BOVINE,1267.0,823.55,457.39,457.39,3
CDM,27807300_OP,W OH PATCH BOVINE,1267.0,823.55,823.55,1241.66,6
CDM,27807310,W OH PATCH TUTOPS,491.0,319.15,82.49,441.9,20
CDM,27807310_IP,W OH PATCH TUTOPS,491.0,319.15,177.25,177.25,3
CDM,27807310_OP,W OH PATCH TUTOPS,491.0,319.15,319.15,481.18,6
CDM,27807320,W OH RNG MITRAL,7426.0,4826.9,1247.57,6683.4,29
CDM,27807320_OP,W OH RNG MITRAL,7426.0,4826.9,4826.9,7277.48,6
CDM,27807330,W OH VALV SPECIAL,18460.0,11999.0,3101.28,16614.0,29
CDM,27807330_OP,W OH VALV SPECIAL,18460.0,11999.0,11999.0,18090.8,6
CDM,27807340,W OH VALV ST JUDE,17627.0,11457.55,2961.34,15864.3,29
CDM,27807340_OP,W OH VALV ST JUDE,17627.0,11457.55,11457.55,17274.46,6
CDM,27807350,W OH VALVE AORTIC,15683.0,10193.95,2634.74,14114.7,29
CDM,27807350_OP,W OH VALVE AORTIC,15683.0,10193.95,10193.95,15369.34,6
CDM,27807360,W OH VALVE CONDUI,18868.0,12264.2,3169.82,16981.2,29
CDM,27807360_OP,W OH VALVE CONDUI,18868.0,12264.2,12264.2,18490.64,6
CDM,27807370,W OH VALVE MITRAL,18624.0,12105.6,3128.83,16761.6,29
CDM,27807370_OP,W OH VALVE MITRAL,18624.0,12105.6,12105.6,18251.52,6
CDM,27807380,W OMNIFT/CROSSFIRE INSERT GRP10,1534.0,997.1,257.71,1380.6,20
CDM,27807380_IP,W OMNIFT/CROSSFIRE INSERT GRP10,1534.0,997.1,553.77,553.77,3
CDM,27807380_OP,W OMNIFT/CROSSFIRE INSERT GRP10,1534.0,997.1,997.1,1503.32,6
CDM,27807390,W PACING PORT PLUG BRADY/TACHY,50.0,32.5,8.4,45.0,20
CDM,27807390_IP,W PACING PORT PLUG BRADY/TACHY,50.0,32.5,18.05,18.05,3
CDM,27807390_OP,W PACING PORT PLUG BRADY/TACHY,50.0,32.5,32.5,49.0,6
CDM,27807400,W PACK KYPHOPLASTY,108.0,70.2,18.14,97.2,20
CDM,27807400_IP,W PACK KYPHOPLASTY,108.0,70.2,38.99,38.99,3
CDM,27807400_OP,W PACK KYPHOPLASTY,108.0,70.2,70.2,105.84,6
CDM,27807410,W PALLADIUM NONSTRANDED SEEDS,147.0,95.55,38.07,2050.09,36
CDM,27807410_IP,W PALLADIUM NONSTRANDED SEEDS,147.0,95.55,53.07,53.07,3
CDM,27807410_OP,W PALLADIUM NONSTRANDED SEEDS,147.0,95.55,95.55,144.06,6
CDM,27807420,W PASTE ORTHOBLEND 5CC GRAFTON,1520.0,988.0,255.36,1368.0,20
CDM,27807420_IP,W PASTE ORTHOBLEND 5CC GRAFTON,1520.0,988.0,548.72,548.72,3
CDM,27807420_OP,W PASTE ORTHOBLEND 5CC GRAFTON,1520.0,988.0,988.0,1489.6,6
CDM,27807430,W PATCH COMPOSIX KUGEL CIR 12CM,1210.0,786.5,203.28,1089.0,20
CDM,27807430_IP,W PATCH COMPOSIX KUGEL CIR 12CM,1210.0,786.5,436.81,436.81,3
CDM,27807430_OP,W PATCH COMPOSIX KUGEL CIR 12CM,1210.0,786.5,786.5,1185.8,6
CDM,27807440,W PATCH COMPOSIX KUGEL SM CIR,1890.0,1228.5,317.52,1701.0,23
CDM,27807440_IP,W PATCH COMPOSIX KUGEL SM CIR,1890.0,1228.5,682.29,682.29,3
CDM,27807440_OP,W PATCH COMPOSIX KUGEL SM CIR,1890.0,1228.5,1228.5,1852.2,6
CDM,27807450,W PATCH DURA-GUARD DURAL 6X8CM,660.0,429.0,110.88,594.0,20
CDM,27807450_IP,W PATCH DURA-GUARD DURAL 6X8CM,660.0,429.0,238.26,238.26,3
CDM,27807450_OP,W PATCH DURA-GUARD DURAL 6X8CM,660.0,429.0,429.0,646.8,6
CDM,27807460,W PATCH PERICARDIAL 10X15 4700,350.0,227.5,58.8,315.0,20
CDM,27807460_IP,W PATCH PERICARDIAL 10X15 4700,350.0,227.5,126.35,126.35,3
CDM,27807460_OP,W PATCH PERICARDIAL 10X15 4700,350.0,227.5,227.5,343.0,6
CDM,27807470,W PATCH PROCEED VENTRL MD 6.4CM,825.0,536.25,138.6,742.5,20
CDM,27807470_IP,W PATCH PROCEED VENTRL MD 6.4CM,825.0,536.25,297.83,297.83,3
CDM,27807470_OP,W PATCH PROCEED VENTRL MD 6.4CM,825.0,536.25,536.25,808.5,6
CDM,27807480,W PATCH PROCEED VENTRL SM 4.3CM,987.0,641.55,165.82,888.3,20
CDM,27807480_IP,W PATCH PROCEED VENTRL SM 4.3CM,987.0,641.55,356.31,356.31,3
CDM,27807480_OP,W PATCH PROCEED VENTRL SM 4.3CM,987.0,641.55,641.55,967.26,6
CDM,27807490,W PATCH VASC PERICARDIUM 1X6CM,236.0,153.4,39.65,212.4,20
CDM,27807490_IP,W PATCH VASC PERICARDIUM 1X6CM,236.0,153.4,85.2,85.2,3
CDM,27807490_OP,W PATCH VASC PERICARDIUM 1X6CM,236.0,153.4,153.4,231.28,6
CDM,27807500,W PATCH VASC PERICARDIUM 2X9CM,370.0,240.5,62.16,333.0,20
CDM,27807500_IP,W PATCH VASC PERICARDIUM 2X9CM,370.0,240.5,133.57,133.57,3
CDM,27807500_OP,W PATCH VASC PERICARDIUM 2X9CM,370.0,240.5,240.5,362.6,6
CDM,27807510,W PATCH VASCU-GUARD VG-0108N,420.0,273.0,70.56,378.0,20
CDM,27807510_IP,W PATCH VASCU-GUARD VG-0108N,420.0,273.0,151.62,151.62,3
CDM,27807510_OP,W PATCH VASCU-GUARD VG-0108N,420.0,273.0,273.0,411.6,6
CDM,27807520,W PATCH VENTRALEX LG CIR 8CM,1152.0,748.8,193.54,1036.8,20
CDM,27807520_IP,W PATCH VENTRALEX LG CIR 8CM,1152.0,748.8,415.87,415.87,3
CDM,27807520_OP,W PATCH VENTRALEX LG CIR 8CM,1152.0,748.8,748.8,1128.96,6
CDM,27807530,W PATCH VENTRALEX MD CIR 6.4CM,890.0,578.5,149.52,801.0,20
CDM,27807530_IP,W PATCH VENTRALEX MD CIR 6.4CM,890.0,578.5,321.29,321.29,3
CDM,27807530_OP,W PATCH VENTRALEX MD CIR 6.4CM,890.0,578.5,578.5,872.2,6
CDM,27807540,W PATCH VENTRIO LG OV 13.8X17.8,1910.0,1241.5,320.88,1719.0,23
CDM,27807540_IP,W PATCH VENTRIO LG OV 13.8X17.8,1910.0,1241.5,689.51,689.51,3
CDM,27807540_OP,W PATCH VENTRIO LG OV 13.8X17.8,1910.0,1241.5,1241.5,1871.8,6
CDM,27807550,W PATELLA KINEMATIC DURA GRP 73,1260.0,819.0,211.68,1134.0,20
CDM,27807550_IP,W PATELLA KINEMATIC DURA GRP 73,1260.0,819.0,454.86,454.86,3
CDM,27807550_OP,W PATELLA KINEMATIC DURA GRP 73,1260.0,819.0,819.0,1234.8,6
CDM,27807560,W PATELLA PFC SIGMA OV 3PEG,393.0,255.45,66.02,353.7,20
CDM,27807560_IP,W PATELLA PFC SIGMA OV 3PEG,393.0,255.45,141.87,141.87,3
CDM,27807560_OP,W PATELLA PFC SIGMA OV 3PEG,393.0,255.45,255.45,385.14,6
CDM,27807570,W PATELLA POLY MED GRP 99,2144.0,1393.6,360.19,1929.6,23
CDM,27807570_IP,W PATELLA POLY MED GRP 99,2144.0,1393.6,773.98,773.98,3
CDM,27807570_OP,W PATELLA POLY MED GRP 99,2144.0,1393.6,1393.6,2101.12,6
CDM,27807580,W PATELLA SCORPIO M-DOME GRP 48,843.0,547.95,141.62,758.7,20
CDM,27807580_IP,W PATELLA SCORPIO M-DOME GRP 48,843.0,547.95,304.32,304.32,3
CDM,27807580_OP,W PATELLA SCORPIO M-DOME GRP 48,843.0,547.95,547.95,826.14,6
CDM,27807590,W PATELLA TRI ASYM/ SYMM GRP 43,682.0,443.3,114.58,613.8,20
CDM,27807590_IP,W PATELLA TRI ASYM/ SYMM GRP 43,682.0,443.3,246.2,246.2,3
CDM,27807590_OP,W PATELLA TRI ASYM/ SYMM GRP 43,682.0,443.3,443.3,668.36,6
CDM,27807600,W PATLLA DURA PLY/SYM/ASY GRP50,892.0,579.8,149.86,802.8,20
CDM,27807600_IP,W PATLLA DURA PLY/SYM/ASY GRP50,892.0,579.8,322.01,322.01,3
CDM,27807600_OP,W PATLLA DURA PLY/SYM/ASY GRP50,892.0,579.8,579.8,874.16,6
CDM,27807610,W PATLLA TRTHLN SYM/ASYM GRP 37,532.0,345.8,89.38,478.8,20
CDM,27807610_IP,W PATLLA TRTHLN SYM/ASYM GRP 37,532.0,345.8,192.05,192.05,3
CDM,27807610_OP,W PATLLA TRTHLN SYM/ASYM GRP 37,532.0,345.8,345.8,521.36,6
CDM,27807620,W PEG FULLY THREADED 28MM,180.0,117.0,30.24,162.0,20
CDM,27807620_IP,W PEG FULLY THREADED 28MM,180.0,117.0,64.98,64.98,3
CDM,27807620_OP,W PEG FULLY THREADED 28MM,180.0,117.0,117.0,176.4,6
CDM,27807630,W PEG SMOOTH 2.0X18MM,173.0,112.45,29.06,155.7,20
CDM,27807630_IP,W PEG SMOOTH 2.0X18MM,173.0,112.45,62.45,62.45,3
CDM,27807630_OP,W PEG SMOOTH 2.0X18MM,173.0,112.45,112.45,169.54,6
CDM,27807640,W PENILE IMP,5938.0,3859.7,997.58,5344.2,29
CDM,27807640_OP,W PENILE IMP,5938.0,3859.7,3859.7,5819.24,6
CDM,27807650,W PERI-STRIP DRY W/VERITAS 45MM,1872.0,1216.8,314.5,1684.8,23
CDM,27807650_IP,W PERI-STRIP DRY W/VERITAS 45MM,1872.0,1216.8,675.79,675.79,3
CDM,27807650_OP,W PERI-STRIP DRY W/VERITAS 45MM,1872.0,1216.8,1216.8,1834.56,6
CDM,27807660,W PERMACOL 0.5MM-2CM X 5CM,880.0,572.0,147.84,792.0,20
CDM,27807660_IP,W PERMACOL 0.5MM-2CM X 5CM,880.0,572.0,317.68,317.68,3
CDM,27807660_OP,W PERMACOL 0.5MM-2CM X 5CM,880.0,572.0,572.0,862.4,6
CDM,27807670,W PERMACOL 1.5MM-10CM X 15CM,3654.0,2375.1,613.87,3288.6,23
CDM,27807670_IP,W PERMACOL 1.5MM-10CM X 15CM,3654.0,2375.1,1319.09,1319.09,3
CDM,27807670_OP,W PERMACOL 1.5MM-10CM X 15CM,3654.0,2375.1,2375.1,3580.92,6
CDM,27807680,W PERMACOL 1.5MM-10CM X 20CM,4020.0,2613.0,675.36,3618.0,23
CDM,27807680_IP,W PERMACOL 1.5MM-10CM X 20CM,4020.0,2613.0,1451.22,1451.22,3
CDM,27807680_OP,W PERMACOL 1.5MM-10CM X 20CM,4020.0,2613.0,2613.0,3939.6,6
CDM,27807690,W PERMACOL 1.5MM-15CM X 20CM,5670.0,3685.5,952.56,5103.0,29
CDM,27807690_OP,W PERMACOL 1.5MM-15CM X 20CM,5670.0,3685.5,3685.5,5556.6,6
CDM,27807700,W PERMACOL 1.5MM-18CM X 28CM,9976.0,6484.4,1675.97,8978.4,29
CDM,27807700_OP,W PERMACOL 1.5MM-18CM X 28CM,9976.0,6484.4,6484.4,9776.48,6
CDM,27807710,W PERMACOL 1.5MM-20CM X 30CM,11866.0,7712.9,1993.49,10679.4,29
CDM,27807710_OP,W PERMACOL 1.5MM-20CM X 30CM,11866.0,7712.9,7712.9,11628.68,6
CDM,27807720,W PERMACOL 1.5MM-20CM X 40CM,19278.0,12530.7,3238.7,17350.2,29
CDM,27807720_OP,W PERMACOL 1.5MM-20CM X 40CM,19278.0,12530.7,12530.7,18892.44,6
CDM,27807730,W PERMACOL 1.5MM-20CM X 50CM,24102.0,15666.3,4049.14,21691.8,29
CDM,27807730_OP,W PERMACOL 1.5MM-20CM X 50CM,24102.0,15666.3,15666.3,23619.96,6
CDM,27807740,W PERMACOL 1MM-10CM X 10CM,2436.0,1583.4,409.25,2192.4,23
CDM,27807740_IP,W PERMACOL 1MM-10CM X 10CM,2436.0,1583.4,879.4,879.4,3
CDM,27807740_OP,W PERMACOL 1MM-10CM X 10CM,2436.0,1583.4,1583.4,2387.28,6
CDM,27807750,W PERMACOL 1MM-10CM X 15CM,3654.0,2375.1,613.87,3288.6,23
CDM,27807750_IP,W PERMACOL 1MM-10CM X 15CM,3654.0,2375.1,1319.09,1319.09,3
CDM,27807750_OP,W PERMACOL 1MM-10CM X 15CM,3654.0,2375.1,2375.1,3580.92,6
CDM,27807760,W PERMACOL 1MM-15CM X 20CM,5670.0,3685.5,952.56,5103.0,29
CDM,27807760_OP,W PERMACOL 1MM-15CM X 20CM,5670.0,3685.5,3685.5,5556.6,6
CDM,27807770,W PERMACOL 1MM-18CM X 28CM,9976.0,6484.4,1675.97,8978.4,29
CDM,27807770_OP,W PERMACOL 1MM-18CM X 28CM,9976.0,6484.4,6484.4,9776.48,6
CDM,27807780,W PERMACOL 1MM-1CM X 4CM,410.0,266.5,68.88,369.0,20
CDM,27807780_IP,W PERMACOL 1MM-1CM X 4CM,410.0,266.5,148.01,148.01,3
CDM,27807780_OP,W PERMACOL 1MM-1CM X 4CM,410.0,266.5,266.5,401.8,6
CDM,27807790,W PERMACOL 1MM-2CM X 4CM,710.0,461.5,119.28,639.0,20
CDM,27807790_IP,W PERMACOL 1MM-2CM X 4CM,710.0,461.5,256.31,256.31,3
CDM,27807790_OP,W PERMACOL 1MM-2CM X 4CM,710.0,461.5,461.5,695.8,6
CDM,27807800,W PERMACOL 1MM-2CM X 5CM,880.0,572.0,147.84,792.0,20
CDM,27807800_IP,W PERMACOL 1MM-2CM X 5CM,880.0,572.0,317.68,317.68,3
CDM,27807800_OP,W PERMACOL 1MM-2CM X 5CM,880.0,572.0,572.0,862.4,6
CDM,27807810,W PERMACOL 1MM-3CM X 8CM,1340.0,871.0,225.12,1206.0,20
CDM,27807810_IP,W PERMACOL 1MM-3CM X 8CM,1340.0,871.0,483.74,483.74,3
CDM,27807810_OP,W PERMACOL 1MM-3CM X 8CM,1340.0,871.0,871.0,1313.2,6
CDM,27807820,W PERMACOL 1MM-5CM X 10CM,1848.0,1201.2,310.46,1663.2,23
CDM,27807820_IP,W PERMACOL 1MM-5CM X 10CM,1848.0,1201.2,667.13,667.13,3
CDM,27807820_OP,W PERMACOL 1MM-5CM X 10CM,1848.0,1201.2,1201.2,1811.04,6
CDM,27807830,W PERMACOL 1MM-5CM X 5CM,946.0,614.9,158.93,851.4,20
CDM,27807830_IP,W PERMACOL 1MM-5CM X 5CM,946.0,614.9,341.51,341.51,3
CDM,27807830_OP,W PERMACOL 1MM-5CM X 5CM,946.0,614.9,614.9,927.08,6
CDM,27807840,W PIN 2.5 GUIDE CNTRL METAGLENE,280.0,182.0,47.04,252.0,20
CDM,27807840_IP,W PIN 2.5 GUIDE CNTRL METAGLENE,280.0,182.0,101.08,101.08,3
CDM,27807840_OP,W PIN 2.5 GUIDE CNTRL METAGLENE,280.0,182.0,182.0,274.4,6
CDM,27807850,W PIN ABSORBABLE,428.0,278.2,71.9,385.2,20
CDM,27807850_IP,W PIN ABSORBABLE,428.0,278.2,154.51,154.51,3
CDM,27807850_OP,W PIN ABSORBABLE,428.0,278.2,278.2,419.44,6
CDM,27807860,W PIN AMK FIXATION 1/8DIAX3,168.0,109.2,28.22,151.2,20
CDM,27807860_IP,W PIN AMK FIXATION 1/8DIAX3,168.0,109.2,60.65,60.65,3
CDM,27807860_OP,W PIN AMK FIXATION 1/8DIAX3,168.0,109.2,109.2,164.64,6
CDM,27807870,W PIN BALL JURGAN,10.0,6.5,1.68,9.0,20
CDM,27807870_IP,W PIN BALL JURGAN,10.0,6.5,3.61,3.61,3
CDM,27807870_OP,W PIN BALL JURGAN,10.0,6.5,6.5,9.8,6
CDM,27807880,W PIN BONE POSITIONING 4.5MM,328.0,213.2,55.1,295.2,20
CDM,27807880_IP,W PIN BONE POSITIONING 4.5MM,328.0,213.2,118.41,118.41,3
CDM,27807880_OP,W PIN BONE POSITIONING 4.5MM,328.0,213.2,213.2,321.44,6
CDM,27807890,W PIN GD TP THRD 3.2MM,348.0,226.2,58.46,313.2,20
CDM,27807890_IP,W PIN GD TP THRD 3.2MM,348.0,226.2,125.63,125.63,3
CDM,27807890_OP,W PIN GD TP THRD 3.2MM,348.0,226.2,226.2,341.04,6
CDM,27807900,W PIN HEADED FIXATION GRP 30,148.0,96.2,24.86,133.2,20
CDM,27807900_IP,W PIN HEADED FIXATION GRP 30,148.0,96.2,53.43,53.43,3
CDM,27807900_OP,W PIN HEADED FIXATION GRP 30,148.0,96.2,96.2,145.04,6
CDM,27807910,W PIN HEADLESS GRP 49,890.0,578.5,149.52,801.0,20
CDM,27807910_IP,W PIN HEADLESS GRP 49,890.0,578.5,321.29,321.29,3
CDM,27807910_OP,W PIN HEADLESS GRP 49,890.0,578.5,578.5,872.2,6
CDM,27807920,W PIN HEMORRAGIC OCCLUDER,750.0,487.5,126.0,675.0,20
CDM,27807920_IP,W PIN HEMORRAGIC OCCLUDER,750.0,487.5,270.75,270.75,3
CDM,27807920_OP,W PIN HEMORRAGIC OCCLUDER,750.0,487.5,487.5,735.0,6
CDM,27807930,W PIN KNOWLES AS,106.0,68.9,17.81,95.4,20
CDM,27807930_IP,W PIN KNOWLES AS,106.0,68.9,38.27,38.27,3
CDM,27807930_OP,W PIN KNOWLES AS,106.0,68.9,68.9,103.88,6
CDM,27807940,W PIN MLT FIXATN,305.0,198.25,51.24,274.5,20
CDM,27807940_IP,W PIN MLT FIXATN,305.0,198.25,110.11,110.11,3
CDM,27807940_OP,W PIN MLT FIXATN,305.0,198.25,198.25,298.9,6
CDM,27807960,W PIN RETAINER SYNT,516.0,335.4,86.69,464.4,20
CDM,27807960_IP,W PIN RETAINER SYNT,516.0,335.4,186.28,186.28,3
CDM,27807960_OP,W PIN RETAINER SYNT,516.0,335.4,335.4,505.68,6
CDM,27807970,W PIN RSH 3/32IN,95.0,61.75,15.96,85.5,20
CDM,27807970_IP,W PIN RSH 3/32IN,95.0,61.75,34.3,34.3,3
CDM,27807970_OP,W PIN RSH 3/32IN,95.0,61.75,61.75,93.1,6
CDM,27807980,W PIN SKULL MAYFL,31.0,20.15,5.21,27.9,20
CDM,27807980_IP,W PIN SKULL MAYFL,31.0,20.15,11.19,11.19,3
CDM,27807980_OP,W PIN SKULL MAYFL,31.0,20.15,20.15,30.38,6
CDM,27807985,TISSUE MARKER,180.0,117.0,30.24,162.0,20
CDM,27807985_IP,TISSUE MARKER,180.0,117.0,64.98,64.98,3
CDM,27807985_OP,TISSUE MARKER,180.0,117.0,117.0,176.4,6
CDM,27807990,W PIN STEINMAN II,632.0,410.8,106.18,568.8,20
CDM,27807990_IP,W PIN STEINMAN II,632.0,410.8,228.15,228.15,3
CDM,27807990_OP,W PIN STEINMAN II,632.0,410.8,410.8,619.36,6
CDM,27808000,W PIN STEINMAN PL,29.0,18.85,4.87,26.1,20
CDM,27808000_IP,W PIN STEINMAN PL,29.0,18.85,10.47,10.47,3
CDM,27808000_OP,W PIN STEINMAN PL,29.0,18.85,18.85,28.42,6
CDM,27808010,W PIN STEINMANN CNTR THR 293.67,154.0,100.1,25.87,138.6,20
CDM,27808010_IP,W PIN STEINMANN CNTR THR 293.67,154.0,100.1,55.59,55.59,3
CDM,27808010_OP,W PIN STEINMANN CNTR THR 293.67,154.0,100.1,100.1,150.92,6
CDM,27808020,W PIN STEINMN THR,108.0,70.2,18.14,97.2,20
CDM,27808020_IP,W PIN STEINMN THR,108.0,70.2,38.99,38.99,3
CDM,27808020_OP,W PIN STEINMN THR,108.0,70.2,70.2,105.84,6
CDM,27808030,W PIN STNMN CNTRL THRD 5X30MM,262.0,170.3,44.02,235.8,20
CDM,27808030_IP,W PIN STNMN CNTRL THRD 5X30MM,262.0,170.3,94.58,94.58,3
CDM,27808030_OP,W PIN STNMN CNTRL THRD 5X30MM,262.0,170.3,170.3,256.76,6
CDM,27808040,W PIN STRL FLTD HEADLESS GRP 70,1216.0,790.4,204.29,1094.4,20
CDM,27808040_IP,W PIN STRL FLTD HEADLESS GRP 70,1216.0,790.4,438.98,438.98,3
CDM,27808040_OP,W PIN STRL FLTD HEADLESS GRP 70,1216.0,790.4,790.4,1191.68,6
CDM,27808050,W PINN SECTOR ACETABULAR CUP,2622.0,1704.3,440.5,2359.8,23
CDM,27808050_IP,W PINN SECTOR ACETABULAR CUP,2622.0,1704.3,946.54,946.54,3
CDM,27808050_OP,W PINN SECTOR ACETABULAR CUP,2622.0,1704.3,1704.3,2569.56,6
CDM,27808060,W PINN SECTOR SHELL W/GRIPTION,424.0,275.6,71.23,381.6,20
CDM,27808060_IP,W PINN SECTOR SHELL W/GRIPTION,424.0,275.6,153.06,153.06,3
CDM,27808060_OP,W PINN SECTOR SHELL W/GRIPTION,424.0,275.6,275.6,415.52,6
CDM,27808070,W PISTON BIG EASY TI PLATNM,357.0,232.05,59.98,321.3,20
CDM,27808070_IP,W PISTON BIG EASY TI PLATNM,357.0,232.05,128.88,128.88,3
CDM,27808070_OP,W PISTON BIG EASY TI PLATNM,357.0,232.05,232.05,349.86,6
CDM,27808080,W PLATE 1 LVL 14MM 1868-01-014,2940.0,1911.0,493.92,2646.0,23
CDM,27808080_IP,W PLATE 1 LVL 14MM 1868-01-014,2940.0,1911.0,1061.34,1061.34,3
CDM,27808080_OP,W PLATE 1 LVL 14MM 1868-01-014,2940.0,1911.0,1911.0,2881.2,6
CDM,27808090,W PLATE 100 TUBLR 5 HOLE 143555,75.0,48.75,12.6,67.5,20
CDM,27808090_IP,W PLATE 100 TUBLR 5 HOLE 143555,75.0,48.75,27.08,27.08,3
CDM,27808090_OP,W PLATE 100 TUBLR 5 HOLE 143555,75.0,48.75,48.75,73.5,6
CDM,27808100,W PLATE 100 TUBLR 7 HOLE 143557,84.0,54.6,14.11,75.6,20
CDM,27808100_IP,W PLATE 100 TUBLR 7 HOLE 143557,84.0,54.6,30.32,30.32,3
CDM,27808100_OP,W PLATE 100 TUBLR 7 HOLE 143557,84.0,54.6,54.6,82.32,6
CDM,27808110,W PLATE 100 TUBLR 8 HOLE 143558,88.0,57.2,14.78,79.2,20
CDM,27808110_IP,W PLATE 100 TUBLR 8 HOLE 143558,88.0,57.2,31.77,31.77,3
CDM,27808110_OP,W PLATE 100 TUBLR 8 HOLE 143558,88.0,57.2,57.2,86.24,6
CDM,27808120,W PLATE 100 TUBULAR 4 HOLE,71.0,46.15,11.93,63.9,20
CDM,27808120_IP,W PLATE 100 TUBULAR 4 HOLE,71.0,46.15,25.63,25.63,3
CDM,27808120_OP,W PLATE 100 TUBULAR 4 HOLE,71.0,46.15,46.15,69.58,6
CDM,27808130,W PLATE 100 TUBULAR 6 HOLE,80.0,52.0,13.44,72.0,20
CDM,27808130_IP,W PLATE 100 TUBULAR 6 HOLE,80.0,52.0,28.88,28.88,3
CDM,27808130_OP,W PLATE 100 TUBULAR 6 HOLE,80.0,52.0,52.0,78.4,6
CDM,27808140,W PLATE 25MM INTERA X 4-HOLE,2764.0,1796.6,464.35,2487.6,23
CDM,27808140_IP,W PLATE 25MM INTERA X 4-HOLE,2764.0,1796.6,997.8,997.8,3
CDM,27808140_OP,W PLATE 25MM INTERA X 4-HOLE,2764.0,1796.6,1796.6,2708.72,6
CDM,27808150,W PLATE 4.5MM LCP PROX 4H RT,2504.0,1627.6,420.67,2253.6,23
CDM,27808150_IP,W PLATE 4.5MM LCP PROX 4H RT,2504.0,1627.6,903.94,903.94,3
CDM,27808150_OP,W PLATE 4.5MM LCP PROX 4H RT,2504.0,1627.6,1627.6,2453.92,6
CDM,27808160,W PLATE 445.19 RECON 9HOLE,1012.0,657.8,170.02,910.8,20
CDM,27808160_IP,W PLATE 445.19 RECON 9HOLE,1012.0,657.8,365.33,365.33,3
CDM,27808160_OP,W PLATE 445.19 RECON 9HOLE,1012.0,657.8,657.8,991.76,6
CDM,27808170,W PLATE 6 HOLE,492.0,319.8,82.66,442.8,20
CDM,27808170_IP,W PLATE 6 HOLE,492.0,319.8,177.61,177.61,3
CDM,27808170_OP,W PLATE 6 HOLE,492.0,319.8,319.8,482.16,6
CDM,27808180,W PLATE 75MM,1590.0,1033.5,267.12,1431.0,20
CDM,27808180_IP,W PLATE 75MM,1590.0,1033.5,573.99,573.99,3
CDM,27808180_OP,W PLATE 75MM,1590.0,1033.5,1033.5,1558.2,6
CDM,27808190,W PLATE ADPT TI NEURO 5 HOLE,406.0,263.9,68.21,365.4,20
CDM,27808190_IP,W PLATE ADPT TI NEURO 5 HOLE,406.0,263.9,146.57,146.57,3
CDM,27808190_OP,W PLATE ADPT TI NEURO 5 HOLE,406.0,263.9,263.9,397.88,6
CDM,27808200,W PLATE BONE HEAVY,1531.0,995.15,257.21,1377.9,20
CDM,27808200_IP,W PLATE BONE HEAVY,1531.0,995.15,552.69,552.69,3
CDM,27808200_OP,W PLATE BONE HEAVY,1531.0,995.15,995.15,1500.38,6
CDM,27808210,W PLATE BONE SMALL,2027.0,1317.55,340.54,1824.3,23
CDM,27808210_IP,W PLATE BONE SMALL,2027.0,1317.55,731.75,731.75,3
CDM,27808210_OP,W PLATE BONE SMALL,2027.0,1317.55,1317.55,1986.46,6
CDM,27808220,W PLATE BOX 4 HOLE,478.0,310.7,80.3,430.2,20
CDM,27808220_IP,W PLATE BOX 4 HOLE,478.0,310.7,172.56,172.56,3
CDM,27808220_OP,W PLATE BOX 4 HOLE,478.0,310.7,310.7,468.44,6
CDM,27808230,W PLATE BRD COMP GRP 57,1024.0,665.6,172.03,921.6,20
CDM,27808230_IP,W PLATE BRD COMP GRP 57,1024.0,665.6,369.66,369.66,3
CDM,27808230_OP,W PLATE BRD COMP GRP 57,1024.0,665.6,665.6,1003.52,6
CDM,27808240,W PLATE BUTTON TI 7 HOLE,692.0,449.8,116.26,622.8,20
CDM,27808240_IP,W PLATE BUTTON TI 7 HOLE,692.0,449.8,249.81,249.81,3
CDM,27808240_OP,W PLATE BUTTON TI 7 HOLE,692.0,449.8,449.8,678.16,6
CDM,27808250,W PLATE CALCANEAL SM 814113001,470.0,305.5,78.96,423.0,20
CDM,27808250_IP,W PLATE CALCANEAL SM 814113001,470.0,305.5,169.67,169.67,3
CDM,27808250_OP,W PLATE CALCANEAL SM 814113001,470.0,305.5,305.5,460.6,6
CDM,27808260,W PLATE CERVICAL SPINE,3788.0,2462.2,636.38,3409.2,23
CDM,27808260_IP,W PLATE CERVICAL SPINE,3788.0,2462.2,1367.47,1367.47,3
CDM,27808260_OP,W PLATE CERVICAL SPINE,3788.0,2462.2,2462.2,3712.24,6
CDM,27808270,W PLATE CLAW COMP 4HL 3.5X20MM,2310.0,1501.5,388.08,2079.0,23
CDM,27808270_IP,W PLATE CLAW COMP 4HL 3.5X20MM,2310.0,1501.5,833.91,833.91,3
CDM,27808270_OP,W PLATE CLAW COMP 4HL 3.5X20MM,2310.0,1501.5,1501.5,2263.8,6
CDM,27808280,W PLATE CLAW INTERA 2H 3.5X25MM,1864.0,1211.6,313.15,1677.6,23
CDM,27808280_IP,W PLATE CLAW INTERA 2H 3.5X25MM,1864.0,1211.6,672.9,672.9,3
CDM,27808280_OP,W PLATE CLAW INTERA 2H 3.5X25MM,1864.0,1211.6,1211.6,1826.72,6
CDM,27808290,W PLATE CSLP,1000.0,650.0,168.0,900.0,20
CDM,27808290_IP,W PLATE CSLP,1000.0,650.0,361.0,361.0,3
CDM,27808290_OP,W PLATE CSLP,1000.0,650.0,650.0,980.0,6
CDM,27808300,W PLATE CURVED 16 HOLE,2062.0,1340.3,346.42,1855.8,23
CDM,27808300_IP,W PLATE CURVED 16 HOLE,2062.0,1340.3,744.38,744.38,3
CDM,27808300_OP,W PLATE CURVED 16 HOLE,2062.0,1340.3,1340.3,2020.76,6
CDM,27808310,W PLATE CVR BUR HOLE LP,285.0,185.25,47.88,256.5,20
CDM,27808310_IP,W PLATE CVR BUR HOLE LP,285.0,185.25,102.89,102.89,3
CDM,27808310_OP,W PLATE CVR BUR HOLE LP,285.0,185.25,185.25,279.3,6
CDM,27808320,W PLATE DBL Y XRIGD 2HOLE 12MM,70.0,45.5,11.76,63.0,20
CDM,27808320_IP,W PLATE DBL Y XRIGD 2HOLE 12MM,70.0,45.5,25.27,25.27,3
CDM,27808320_OP,W PLATE DBL Y XRIGD 2HOLE 12MM,70.0,45.5,45.5,68.6,6
CDM,27808330,W PLATE DCP TI 3.5MM 9 HOLE,382.0,248.3,64.18,343.8,20
CDM,27808330_IP,W PLATE DCP TI 3.5MM 9 HOLE,382.0,248.3,137.9,137.9,3
CDM,27808330_OP,W PLATE DCP TI 3.5MM 9 HOLE,382.0,248.3,248.3,374.36,6
CDM,27808340,W PLATE DCP TIT 3.5MM 7H 423.57,326.0,211.9,54.77,293.4,20
CDM,27808340_IP,W PLATE DCP TIT 3.5MM 7H 423.57,326.0,211.9,117.69,117.69,3
CDM,27808340_OP,W PLATE DCP TIT 3.5MM 7H 423.57,326.0,211.9,211.9,319.48,6
CDM,27808350,W PLATE DOUBLE Y LW PROF 530608,294.0,191.1,49.39,264.6,20
CDM,27808350_IP,W PLATE DOUBLE Y LW PROF 530608,294.0,191.1,106.13,106.13,3
CDM,27808350_OP,W PLATE DOUBLE Y LW PROF 530608,294.0,191.1,191.1,288.12,6
CDM,27808360,W PLATE DVR NARROW SHORT RT,1782.0,1158.3,299.38,1603.8,23
CDM,27808360_IP,W PLATE DVR NARROW SHORT RT,1782.0,1158.3,643.3,643.3,3
CDM,27808360_OP,W PLATE DVR NARROW SHORT RT,1782.0,1158.3,1158.3,1746.36,6
CDM,27808370,W PLATE DVR NARROW SHOT LEFT,173.0,112.45,29.06,155.7,20
CDM,27808370_IP,W PLATE DVR NARROW SHOT LEFT,173.0,112.45,62.45,62.45,3
CDM,27808370_OP,W PLATE DVR NARROW SHOT LEFT,173.0,112.45,112.45,169.54,6
CDM,27808380,W PLATE DVRA EXT/SR/STD,1604.0,1042.6,269.47,1443.6,20
CDM,27808380_IP,W PLATE DVRA EXT/SR/STD,1604.0,1042.6,579.04,579.04,3
CDM,27808380_OP,W PLATE DVRA EXT/SR/STD,1604.0,1042.6,1042.6,1571.92,6
CDM,27808390,W PLATE E COMP DCP,386.0,250.9,64.85,347.4,20
CDM,27808390_IP,W PLATE E COMP DCP,386.0,250.9,139.35,139.35,3
CDM,27808390_OP,W PLATE E COMP DCP,386.0,250.9,250.9,378.28,6
CDM,27808400,W PLATE E MINI T/L,262.0,170.3,44.02,235.8,20
CDM,27808400_IP,W PLATE E MINI T/L,262.0,170.3,94.58,94.58,3
CDM,27808400_OP,W PLATE E MINI T/L,262.0,170.3,170.3,256.76,6
CDM,27808410,W PLATE FEMORAL 6 HOLE RIGHT,3350.0,2177.5,562.8,3015.0,23
CDM,27808410_IP,W PLATE FEMORAL 6 HOLE RIGHT,3350.0,2177.5,1209.35,1209.35,3
CDM,27808410_OP,W PLATE FEMORAL 6 HOLE RIGHT,3350.0,2177.5,2177.5,3283.0,6
CDM,27808420,W PLATE FIBULA 10 HOLE 81412301,177.0,115.05,29.74,159.3,20
CDM,27808420_IP,W PLATE FIBULA 10 HOLE 81412301,177.0,115.05,63.9,63.9,3
CDM,27808420_OP,W PLATE FIBULA 10 HOLE 81412301,177.0,115.05,115.05,173.46,6
CDM,27808430,W PLATE FIBULA 5 HOLE,1350.0,877.5,226.8,1215.0,20
CDM,27808430_IP,W PLATE FIBULA 5 HOLE,1350.0,877.5,487.35,487.35,3
CDM,27808430_OP,W PLATE FIBULA 5 HOLE,1350.0,877.5,877.5,1323.0,6
CDM,27808440,W PLATE FIBULA 8HOLE 814123008,163.0,105.95,27.38,146.7,20
CDM,27808440_IP,W PLATE FIBULA 8HOLE 814123008,163.0,105.95,58.84,58.84,3
CDM,27808440_OP,W PLATE FIBULA 8HOLE 814123008,163.0,105.95,105.95,159.74,6
CDM,27808450,W PLATE FIBULAR COMPOSITE 11H,185.0,120.25,31.08,166.5,20
CDM,27808450_IP,W PLATE FIBULAR COMPOSITE 11H,185.0,120.25,66.79,66.79,3
CDM,27808450_OP,W PLATE FIBULAR COMPOSITE 11H,185.0,120.25,120.25,181.3,6
CDM,27808460,W PLATE FIBULAR COMPOSITE 14H,206.0,133.9,34.61,185.4,20
CDM,27808460_IP,W PLATE FIBULAR COMPOSITE 14H,206.0,133.9,74.37,74.37,3
CDM,27808460_OP,W PLATE FIBULAR COMPOSITE 14H,206.0,133.9,133.9,201.88,6
CDM,27808470,W PLATE FUSION MTP SM RIGHT,1284.0,834.6,215.71,1155.6,20
CDM,27808470_IP,W PLATE FUSION MTP SM RIGHT,1284.0,834.6,463.52,463.52,3
CDM,27808470_OP,W PLATE FUSION MTP SM RIGHT,1284.0,834.6,834.6,1258.32,6
CDM,27808480,W PLATE LCP 1/3 TUBLAR 12 HOLE,394.0,256.1,66.19,354.6,20
CDM,27808480_IP,W PLATE LCP 1/3 TUBLAR 12 HOLE,394.0,256.1,142.23,142.23,3
CDM,27808480_OP,W PLATE LCP 1/3 TUBLAR 12 HOLE,394.0,256.1,256.1,386.12,6
CDM,27808490,W PLATE LCP 1/3 TUBULAR,354.0,230.1,59.47,318.6,20
CDM,27808490_IP,W PLATE LCP 1/3 TUBULAR,354.0,230.1,127.79,127.79,3
CDM,27808490_OP,W PLATE LCP 1/3 TUBULAR,354.0,230.1,230.1,346.92,6
CDM,27808500,W PLATE LCP 1/3 TUBULAR,350.0,227.5,58.8,315.0,20
CDM,27808500_IP,W PLATE LCP 1/3 TUBULAR,350.0,227.5,126.35,126.35,3
CDM,27808500_OP,W PLATE LCP 1/3 TUBULAR,350.0,227.5,227.5,343.0,6
CDM,27808510,W PLATE LCP 1/3 TUBULAR 7 HOLE,362.0,235.3,60.82,325.8,20
CDM,27808510_IP,W PLATE LCP 1/3 TUBULAR 7 HOLE,362.0,235.3,130.68,130.68,3
CDM,27808510_OP,W PLATE LCP 1/3 TUBULAR 7 HOLE,362.0,235.3,235.3,354.76,6
CDM,27808520,W PLATE LCP 3.5MM 6 HOLE,610.0,396.5,102.48,549.0,20
CDM,27808520_IP,W PLATE LCP 3.5MM 6 HOLE,610.0,396.5,220.21,220.21,3
CDM,27808520_OP,W PLATE LCP 3.5MM 6 HOLE,610.0,396.5,396.5,597.8,6
CDM,27808530,W PLATE LCP 3.5MM 7 HOLE,636.0,413.4,106.85,572.4,20
CDM,27808530_IP,W PLATE LCP 3.5MM 7 HOLE,636.0,413.4,229.6,229.6,3
CDM,27808530_OP,W PLATE LCP 3.5MM 7 HOLE,636.0,413.4,413.4,623.28,6
CDM,27808540,W PLATE LCP 3.5MM 8 HOLE,722.0,469.3,121.3,649.8,20
CDM,27808540_IP,W PLATE LCP 3.5MM 8 HOLE,722.0,469.3,260.64,260.64,3
CDM,27808540_OP,W PLATE LCP 3.5MM 8 HOLE,722.0,469.3,469.3,707.56,6
CDM,27808550,W PLATE LCP 3.5MM RECON 8 HOLE,1154.0,750.1,193.87,1038.6,20
CDM,27808550_IP,W PLATE LCP 3.5MM RECON 8 HOLE,1154.0,750.1,416.59,416.59,3
CDM,27808550_OP,W PLATE LCP 3.5MM RECON 8 HOLE,1154.0,750.1,750.1,1130.92,6
CDM,27808560,W PLATE LCP 4 HOLE L 3.5MM,1856.0,1206.4,311.81,1670.4,23
CDM,27808560_IP,W PLATE LCP 4 HOLE L 3.5MM,1856.0,1206.4,670.02,670.02,3
CDM,27808560_OP,W PLATE LCP 4 HOLE L 3.5MM,1856.0,1206.4,1206.4,1818.88,6
CDM,27808570,W PLATE LCP BROAD 12 HOLES,1354.0,880.1,227.47,1218.6,20
CDM,27808570_IP,W PLATE LCP BROAD 12 HOLES,1354.0,880.1,488.79,488.79,3
CDM,27808570_OP,W PLATE LCP BROAD 12 HOLES,1354.0,880.1,880.1,1326.92,6
CDM,27808580,W PLATE LCP HUM 114MM 241.903,3234.0,2102.1,543.31,2910.6,23
CDM,27808580_IP,W PLATE LCP HUM 114MM 241.903,3234.0,2102.1,1167.47,1167.47,3
CDM,27808580_OP,W PLATE LCP HUM 114MM 241.903,3234.0,2102.1,2102.1,3169.32,6
CDM,27808590,W PLATE LEFT LEVEL 1 54-25376,1837.0,1194.05,308.62,1653.3,23
CDM,27808590_IP,W PLATE LEFT LEVEL 1 54-25376,1837.0,1194.05,663.16,663.16,3
CDM,27808590_OP,W PLATE LEFT LEVEL 1 54-25376,1837.0,1194.05,1194.05,1800.26,6
CDM,27808600,W PLATE LOCKING CLAW W/DRILLBIT,280.0,182.0,47.04,252.0,20
CDM,27808600_IP,W PLATE LOCKING CLAW W/DRILLBIT,280.0,182.0,101.08,101.08,3
CDM,27808600_OP,W PLATE LOCKING CLAW W/DRILLBIT,280.0,182.0,182.0,274.4,6
CDM,27808610,W PLATE LPC METAL 3.5MM 9 HOLE,1872.0,1216.8,314.5,1684.8,23
CDM,27808610_IP,W PLATE LPC METAL 3.5MM 9 HOLE,1872.0,1216.8,675.79,675.79,3
CDM,27808610_OP,W PLATE LPC METAL 3.5MM 9 HOLE,1872.0,1216.8,1216.8,1834.56,6
CDM,27808620,W PLATE LW PROF 2HOLE 16MM BAR,80.0,52.0,13.44,72.0,20
CDM,27808620_IP,W PLATE LW PROF 2HOLE 16MM BAR,80.0,52.0,28.88,28.88,3
CDM,27808620_OP,W PLATE LW PROF 2HOLE 16MM BAR,80.0,52.0,52.0,78.4,6
CDM,27808630,W PLATE MESH,3000.0,1950.0,504.0,2700.0,23
CDM,27808630_IP,W PLATE MESH,3000.0,1950.0,1083.0,1083.0,3
CDM,27808630_OP,W PLATE MESH,3000.0,1950.0,1950.0,2940.0,6
CDM,27808640,W PLATE MTP FUSION STD RIGHT,2570.0,1670.5,431.76,2313.0,23
CDM,27808640_IP,W PLATE MTP FUSION STD RIGHT,2570.0,1670.5,927.77,927.77,3
CDM,27808640_OP,W PLATE MTP FUSION STD RIGHT,2570.0,1670.5,1670.5,2518.6,6
CDM,27808660,W PLATE NEURO STRT 20HL TI LOW,1186.0,770.9,199.25,1067.4,20
CDM,27808660_IP,W PLATE NEURO STRT 20HL TI LOW,1186.0,770.9,428.15,428.15,3
CDM,27808660_OP,W PLATE NEURO STRT 20HL TI LOW,1186.0,770.9,770.9,1162.28,6
CDM,27808670,W PLATE NEURO STRT 2HL,76.0,49.4,12.77,68.4,20
CDM,27808670_IP,W PLATE NEURO STRT 2HL,76.0,49.4,27.44,27.44,3
CDM,27808670_OP,W PLATE NEURO STRT 2HL,76.0,49.4,49.4,74.48,6
CDM,27808680,W PLATE NEURO STRT 4HL,120.0,78.0,20.16,108.0,20
CDM,27808680_IP,W PLATE NEURO STRT 4HL,120.0,78.0,43.32,43.32,3
CDM,27808680_OP,W PLATE NEURO STRT 4HL,120.0,78.0,78.0,117.6,6
CDM,27808690,W PLATE PROFYLE L COMP STR 4H,452.0,293.8,75.94,406.8,20
CDM,27808690_IP,W PLATE PROFYLE L COMP STR 4H,452.0,293.8,163.17,163.17,3
CDM,27808690_OP,W PLATE PROFYLE L COMP STR 4H,452.0,293.8,293.8,442.96,6
CDM,27808700,W PLATE PROFYLE L COMP STR 5H,480.0,312.0,80.64,432.0,20
CDM,27808700_IP,W PLATE PROFYLE L COMP STR 5H,480.0,312.0,173.28,173.28,3
CDM,27808700_OP,W PLATE PROFYLE L COMP STR 5H,480.0,312.0,312.0,470.4,6
CDM,27808710,W PLATE PROFYLE M STR 4H 2.3,153.0,99.45,25.7,137.7,20
CDM,27808710_IP,W PLATE PROFYLE M STR 4H 2.3,153.0,99.45,55.23,55.23,3
CDM,27808710_OP,W PLATE PROFYLE M STR 4H 2.3,153.0,99.45,99.45,149.94,6
CDM,27808720,W PLATE PROX HUM LCP SS,3136.0,2038.4,526.85,2822.4,23
CDM,27808720_IP,W PLATE PROX HUM LCP SS,3136.0,2038.4,1132.1,1132.1,3
CDM,27808720_OP,W PLATE PROX HUM LCP SS,3136.0,2038.4,2038.4,3073.28,6
CDM,27808730,W PLATE PROXIMAL HUMERAL 3.5,3136.0,2038.4,526.85,2822.4,23
CDM,27808730_IP,W PLATE PROXIMAL HUMERAL 3.5,3136.0,2038.4,1132.1,1132.1,3
CDM,27808730_OP,W PLATE PROXIMAL HUMERAL 3.5,3136.0,2038.4,2038.4,3073.28,6
CDM,27808750,W PLATE SHLDR REPLCTR EQUINOXE,1514.0,984.1,254.35,1362.6,20
CDM,27808750_IP,W PLATE SHLDR REPLCTR EQUINOXE,1514.0,984.1,546.55,546.55,3
CDM,27808750_OP,W PLATE SHLDR REPLCTR EQUINOXE,1514.0,984.1,984.1,1483.72,6
CDM,27808760,"W PLATE SKY 1,2,3,4 LEVEL TI",1000.0,650.0,168.0,900.0,20
CDM,27808760_IP,"W PLATE SKY 1,2,3,4 LEVEL TI",1000.0,650.0,361.0,361.0,3
CDM,27808760_OP,"W PLATE SKY 1,2,3,4 LEVEL TI",1000.0,650.0,650.0,980.0,6
CDM,27808770,W PLATE SMALL BONE FIXATION SYS,650.0,422.5,109.2,585.0,20
CDM,27808770_IP,W PLATE SMALL BONE FIXATION SYS,650.0,422.5,234.65,234.65,3
CDM,27808770_OP,W PLATE SMALL BONE FIXATION SYS,650.0,422.5,422.5,637.0,6
CDM,27808780,W PLATE SPINE MEDT GRP 5,800.0,520.0,134.4,720.0,20
CDM,27808780_IP,W PLATE SPINE MEDT GRP 5,800.0,520.0,288.8,288.8,3
CDM,27808780_OP,W PLATE SPINE MEDT GRP 5,800.0,520.0,520.0,784.0,6
CDM,27808790,W PLATE SPINE STRY GRP 6,1000.0,650.0,168.0,900.0,20
CDM,27808790_IP,W PLATE SPINE STRY GRP 6,1000.0,650.0,361.0,361.0,3
CDM,27808790_OP,W PLATE SPINE STRY GRP 6,1000.0,650.0,650.0,980.0,6
CDM,27808800,W PLATE STRUT 6 HOLE,778.0,505.7,130.7,700.2,20
CDM,27808800_IP,W PLATE STRUT 6 HOLE,778.0,505.7,280.86,280.86,3
CDM,27808800_OP,W PLATE STRUT 6 HOLE,778.0,505.7,505.7,762.44,6
CDM,27808810,W PLATE SYNTHES,2073.0,1347.45,348.26,1865.7,23
CDM,27808810_IP,W PLATE SYNTHES,2073.0,1347.45,748.35,748.35,3
CDM,27808810_OP,W PLATE SYNTHES,2073.0,1347.45,1347.45,2031.54,6
CDM,27808820,W PLATE T OC 60MM,2500.0,1625.0,420.0,2250.0,23
CDM,27808820_IP,W PLATE T OC 60MM,2500.0,1625.0,902.5,902.5,3
CDM,27808820_OP,W PLATE T OC 60MM,2500.0,1625.0,1625.0,2450.0,6
CDM,27808830,W PLATE T PROFYLE L COMP NAR 6H,536.0,348.4,90.05,482.4,20
CDM,27808830_IP,W PLATE T PROFYLE L COMP NAR 6H,536.0,348.4,193.5,193.5,3
CDM,27808830_OP,W PLATE T PROFYLE L COMP NAR 6H,536.0,348.4,348.4,525.28,6
CDM,27808840,W PLATE TACK PLPTACK,90.0,58.5,15.12,81.0,20
CDM,27808840_IP,W PLATE TACK PLPTACK,90.0,58.5,32.49,32.49,3
CDM,27808840_OP,W PLATE TACK PLPTACK,90.0,58.5,58.5,88.2,6
CDM,27808850,W PLATE TI CERVICAL SPINE LKING,1100.0,715.0,184.8,990.0,20
CDM,27808850_IP,W PLATE TI CERVICAL SPINE LKING,1100.0,715.0,397.1,397.1,3
CDM,27808850_OP,W PLATE TI CERVICAL SPINE LKING,1100.0,715.0,715.0,1078.0,6
CDM,27808860,W PLATE TITANIUM FUSION,3404.0,2212.6,571.87,3063.6,23
CDM,27808860_IP,W PLATE TITANIUM FUSION,3404.0,2212.6,1228.84,1228.84,3
CDM,27808860_OP,W PLATE TITANIUM FUSION,3404.0,2212.6,2212.6,3335.92,6
CDM,27808870,W PLATE VOLAR RADIUS 6 HOLE,1500.0,975.0,252.0,1350.0,20
CDM,27808870_IP,W PLATE VOLAR RADIUS 6 HOLE,1500.0,975.0,541.5,541.5,3
CDM,27808870_OP,W PLATE VOLAR RADIUS 6 HOLE,1500.0,975.0,975.0,1470.0,6
CDM,27808890,"W PLATE, DECOMPRESSION",428.0,278.2,71.9,385.2,20
CDM,27808890_IP,"W PLATE, DECOMPRESSION",428.0,278.2,154.51,154.51,3
CDM,27808890_OP,"W PLATE, DECOMPRESSION",428.0,278.2,278.2,419.44,6
CDM,27808900,W PLT ANT CRV SPINE MEDT GRP 8,1000.0,650.0,168.0,900.0,20
CDM,27808900_IP,W PLT ANT CRV SPINE MEDT GRP 8,1000.0,650.0,361.0,361.0,3
CDM,27808900_OP,W PLT ANT CRV SPINE MEDT GRP 8,1000.0,650.0,650.0,980.0,6
CDM,27808920,W PLT STRNL LOK 20H STR TI,2261.0,1469.65,379.85,2034.9,23
CDM,27808920_IP,W PLT STRNL LOK 20H STR TI,2261.0,1469.65,816.22,816.22,3
CDM,27808920_OP,W PLT STRNL LOK 20H STR TI,2261.0,1469.65,1469.65,2215.78,6
CDM,27808930,W PLUG BONE GRP 20,132.0,85.8,22.18,118.8,20
CDM,27808930_IP,W PLUG BONE GRP 20,132.0,85.8,47.65,47.65,3
CDM,27808930_OP,W PLUG BONE GRP 20,132.0,85.8,85.8,129.36,6
CDM,27808940,W PLUG DOME HOLE GRP 18,102.0,66.3,17.14,91.8,20
CDM,27808940_IP,W PLUG DOME HOLE GRP 18,102.0,66.3,36.82,36.82,3
CDM,27808940_OP,W PLUG DOME HOLE GRP 18,102.0,66.3,66.3,99.96,6
CDM,27808950,W PLUG SURGISIS R-V FISTULA 4MM,1800.0,1170.0,302.4,1620.0,23
CDM,27808950_IP,W PLUG SURGISIS R-V FISTULA 4MM,1800.0,1170.0,649.8,649.8,3
CDM,27808950_OP,W PLUG SURGISIS R-V FISTULA 4MM,1800.0,1170.0,1170.0,1764.0,6
CDM,27808960,W PLUG VIT FREEZE GRP 15,30.0,19.5,5.04,27.0,20
CDM,27808960_IP,W PLUG VIT FREEZE GRP 15,30.0,19.5,10.83,10.83,3
CDM,27808960_OP,W PLUG VIT FREEZE GRP 15,30.0,19.5,19.5,29.4,6
CDM,27808970,W PMP DRUG THERP,17299.0,11244.35,2906.23,15569.1,29
CDM,27808970_OP,W PMP DRUG THERP,17299.0,11244.35,11244.35,16953.02,6
CDM,27808980,W PORT 9F DUAL CHMBR,590.0,383.5,99.12,531.0,20
CDM,27808980_IP,W PORT 9F DUAL CHMBR,590.0,383.5,212.99,212.99,3
CDM,27808980_OP,W PORT 9F DUAL CHMBR,590.0,383.5,383.5,578.2,6
CDM,27808990,W PORT CT 8FR,490.0,318.5,82.32,441.0,20
CDM,27808990_IP,W PORT CT 8FR,490.0,318.5,176.89,176.89,3
CDM,27808990_OP,W PORT CT 8FR,490.0,318.5,318.5,480.2,6
CDM,27808WE,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1212.0,787.8,151.39,909.0,35
CDM,27809000,W PORT HICKMAN TI 1LUMEN 9.6F,460.0,299.0,77.28,414.0,20
CDM,27809000_IP,W PORT HICKMAN TI 1LUMEN 9.6F,460.0,299.0,166.06,166.06,3
CDM,27809000_OP,W PORT HICKMAN TI 1LUMEN 9.6F,460.0,299.0,299.0,450.8,6
CDM,27809020,W PORT INJECTION REALIZE RLZPT2,1710.0,1111.5,287.28,1539.0,20
CDM,27809020_IP,W PORT INJECTION REALIZE RLZPT2,1710.0,1111.5,617.31,617.31,3
CDM,27809020_OP,W PORT INJECTION REALIZE RLZPT2,1710.0,1111.5,1111.5,1675.8,6
CDM,27809030,W PORT PWRPRT MRI SILICONE 8F,1067.0,693.55,179.26,960.3,20
CDM,27809030_IP,W PORT PWRPRT MRI SILICONE 8F,1067.0,693.55,385.19,385.19,3
CDM,27809030_OP,W PORT PWRPRT MRI SILICONE 8F,1067.0,693.55,693.55,1045.66,6
CDM,27809040,W PORT TITANIUM CHRFLEX ATT 8FR,656.0,426.4,110.21,590.4,20
CDM,27809040_IP,W PORT TITANIUM CHRFLEX ATT 8FR,656.0,426.4,236.82,236.82,3
CDM,27809040_OP,W PORT TITANIUM CHRFLEX ATT 8FR,656.0,426.4,426.4,642.88,6
CDM,27809050,W PORT VASC,490.0,318.5,82.32,441.0,20
CDM,27809050_IP,W PORT VASC,490.0,318.5,176.89,176.89,3
CDM,27809050_OP,W PORT VASC,490.0,318.5,318.5,480.2,6
CDM,27809060,W PORT W OPEN-ENDED 9.6FR CATH,648.0,421.2,108.86,583.2,20
CDM,27809060_IP,W PORT W OPEN-ENDED 9.6FR CATH,648.0,421.2,233.93,233.93,3
CDM,27809060_OP,W PORT W OPEN-ENDED 9.6FR CATH,648.0,421.2,421.2,635.04,6
CDM,27809070,W PORTACATH,1575.0,1023.75,264.6,1417.5,20
CDM,27809070_IP,W PORTACATH,1575.0,1023.75,568.58,568.58,3
CDM,27809070_OP,W PORTACATH,1575.0,1023.75,1023.75,1543.5,6
CDM,27809080,W PRODISC-C IMP MED DEEP 5MM,10580.0,6877.0,1777.44,9522.0,29
CDM,27809080_OP,W PRODISC-C IMP MED DEEP 5MM,10580.0,6877.0,6877.0,10368.4,6
CDM,27809090,W PRODISC-C IMPLANT LG 5MM STRL,10580.0,6877.0,1777.44,9522.0,29
CDM,27809090_OP,W PRODISC-C IMPLANT LG 5MM STRL,10580.0,6877.0,6877.0,10368.4,6
CDM,27809100,W PROS AMBICOR 16CM X 11CM,12070.0,7845.5,2027.76,10863.0,29
CDM,27809100_OP,W PROS AMBICOR 16CM X 11CM,12070.0,7845.5,7845.5,11828.6,6
CDM,27809110,W PROS BRST SILTX,1799.0,1169.35,302.23,1619.1,23
CDM,27809110_IP,W PROS BRST SILTX,1799.0,1169.35,649.44,649.44,3
CDM,27809110_OP,W PROS BRST SILTX,1799.0,1169.35,1169.35,1763.02,6
CDM,27809120,W PROS PENILE CX PRECONNECT MS,12278.0,7980.7,2062.7,11050.2,29
CDM,27809120_OP,W PROS PENILE CX PRECONNECT MS,12278.0,7980.7,7980.7,12032.44,6
CDM,27809130,W PROS PENILE INF,13824.0,8985.6,2322.43,12441.6,29
CDM,27809130_OP,W PROS PENILE INF,13824.0,8985.6,8985.6,13547.52,6
CDM,27809140,W PROS PENILE INFLATABLE,12070.0,7845.5,2027.76,10863.0,29
CDM,27809140_OP,W PROS PENILE INFLATABLE,12070.0,7845.5,7845.5,11828.6,6
CDM,27809150,W PROS PENILE N-I,13818.0,8981.7,2321.42,12436.2,29
CDM,27809150_OP,W PROS PENILE N-I,13818.0,8981.7,8981.7,13541.64,6
CDM,27809160,W PROS URINRY SPH,17806.0,11573.9,2991.41,16025.4,29
CDM,27809160_OP,W PROS URINRY SPH,17806.0,11573.9,11573.9,17449.88,6
CDM,27809180,W PROSTHESIS ENT STRUT INCUS,670.0,435.5,112.56,603.0,20
CDM,27809180_IP,W PROSTHESIS ENT STRUT INCUS,670.0,435.5,241.87,241.87,3
CDM,27809180_OP,W PROSTHESIS ENT STRUT INCUS,670.0,435.5,435.5,656.6,6
CDM,27809190,W PROSTHESIS OSSICULAR ALTO+HA,666.0,432.9,111.89,599.4,20
CDM,27809190_IP,W PROSTHESIS OSSICULAR ALTO+HA,666.0,432.9,240.43,240.43,3
CDM,27809190_OP,W PROSTHESIS OSSICULAR ALTO+HA,666.0,432.9,432.9,652.68,6
CDM,27809220,W PROSTHESIS TESTICULAR,2900.0,1885.0,487.2,2610.0,23
CDM,27809220_IP,W PROSTHESIS TESTICULAR,2900.0,1885.0,1046.9,1046.9,3
CDM,27809220_OP,W PROSTHESIS TESTICULAR,2900.0,1885.0,1885.0,2842.0,6
CDM,27809240,W PROXIMAL HUMERAL,4841.0,3146.65,813.29,4356.9,26
CDM,27809240_OP,W PROXIMAL HUMERAL,4841.0,3146.65,3146.65,4744.18,6
CDM,27809250,W PULSE GENERATOR POUCH LG,187.0,121.55,31.42,168.3,20
CDM,27809250_IP,W PULSE GENERATOR POUCH LG,187.0,121.55,67.51,67.51,3
CDM,27809250_OP,W PULSE GENERATOR POUCH LG,187.0,121.55,121.55,183.26,6
CDM,27809260,W PULSE GENERATOR POUCH XLG,221.0,143.65,37.13,198.9,20
CDM,27809260_IP,W PULSE GENERATOR POUCH XLG,221.0,143.65,79.78,79.78,3
CDM,27809260_OP,W PULSE GENERATOR POUCH XLG,221.0,143.65,143.65,216.58,6
CDM,27809270,W PUMP SYNCH II US MKTJUN,20800.0,13520.0,3494.4,18720.0,29
CDM,27809270_OP,W PUMP SYNCH II US MKTJUN,20800.0,13520.0,13520.0,20384.0,6
CDM,27809280,W PUSHLOCK 3.5X14 AR-1926PS,627.0,407.55,105.34,564.3,20
CDM,27809280_IP,W PUSHLOCK 3.5X14 AR-1926PS,627.0,407.55,226.35,226.35,3
CDM,27809280_OP,W PUSHLOCK 3.5X14 AR-1926PS,627.0,407.55,407.55,614.46,6
CDM,27809290,W PUSHLOCK BIO SP 4.5MMX18.5MM,683.0,443.95,114.74,614.7,20
CDM,27809290_IP,W PUSHLOCK BIO SP 4.5MMX18.5MM,683.0,443.95,246.56,246.56,3
CDM,27809290_OP,W PUSHLOCK BIO SP 4.5MMX18.5MM,683.0,443.95,443.95,669.34,6
CDM,27809300,W PUTTY DBX 10CC 038100,2850.0,1852.5,478.8,2565.0,23
CDM,27809300_IP,W PUTTY DBX 10CC 038100,2850.0,1852.5,1028.85,1028.85,3
CDM,27809300_OP,W PUTTY DBX 10CC 038100,2850.0,1852.5,1852.5,2793.0,6
CDM,27809310,W PUTTY DBX 1CC 038010,386.0,250.9,64.85,347.4,20
CDM,27809310_IP,W PUTTY DBX 1CC 038010,386.0,250.9,139.35,139.35,3
CDM,27809310_OP,W PUTTY DBX 1CC 038010,386.0,250.9,250.9,378.28,6
CDM,27809320,W PUTTY DBX BONE 5CC DEMIN,1562.0,1015.3,262.42,1405.8,20
CDM,27809320_IP,W PUTTY DBX BONE 5CC DEMIN,1562.0,1015.3,563.88,563.88,3
CDM,27809320_OP,W PUTTY DBX BONE 5CC DEMIN,1562.0,1015.3,1015.3,1530.76,6
CDM,27809330,W PUTTY DBX MATRX ALLGRFT 0.5CC,250.0,162.5,42.0,225.0,20
CDM,27809330_IP,W PUTTY DBX MATRX ALLGRFT 0.5CC,250.0,162.5,90.25,90.25,3
CDM,27809330_OP,W PUTTY DBX MATRX ALLGRFT 0.5CC,250.0,162.5,162.5,245.0,6
CDM,27809340,W PUTTY OP1 BMP7,2316.0,1505.4,389.09,2084.4,23
CDM,27809340_IP,W PUTTY OP1 BMP7,2316.0,1505.4,836.08,836.08,3
CDM,27809340_OP,W PUTTY OP1 BMP7,2316.0,1505.4,1505.4,2269.68,6
CDM,27809350,W RADIESSE 1CC INJECT IMP 8044M0,590.0,383.5,99.12,531.0,20
CDM,27809350_IP,W RADIESSE 1CC INJECT IMP 8044M0,590.0,383.5,212.99,212.99,3
CDM,27809350_OP,W RADIESSE 1CC INJECT IMP 8044M0,590.0,383.5,383.5,578.2,6
CDM,27809360,W RADIESSE VOICEGEL 1CC INJ IMP,440.0,286.0,73.92,396.0,20
CDM,27809360_IP,W RADIESSE VOICEGEL 1CC INJ IMP,440.0,286.0,158.84,158.84,3
CDM,27809360_OP,W RADIESSE VOICEGEL 1CC INJ IMP,440.0,286.0,286.0,431.2,6
CDM,27809370,W RESER OMAYA,626.0,406.9,105.17,563.4,20
CDM,27809370_IP,W RESER OMAYA,626.0,406.9,225.99,225.99,3
CDM,27809370_OP,W RESER OMAYA,626.0,406.9,406.9,613.48,6
CDM,27809380,"W RESERVOIR, PC/IZ",2662.0,1730.3,447.22,2395.8,23
CDM,27809380_IP,"W RESERVOIR, PC/IZ",2662.0,1730.3,960.98,960.98,3
CDM,27809380_OP,"W RESERVOIR, PC/IZ",2662.0,1730.3,1730.3,2608.76,6
CDM,27809390,W RETRO BUTTON AR1588,434.0,282.1,72.91,390.6,20
CDM,27809390_IP,W RETRO BUTTON AR1588,434.0,282.1,156.67,156.67,3
CDM,27809390_OP,W RETRO BUTTON AR1588,434.0,282.1,282.1,425.32,6
CDM,27809400,W REV GLEN 36MM,1500.0,975.0,252.0,1350.0,20
CDM,27809400_IP,W REV GLEN 36MM,1500.0,975.0,541.5,541.5,3
CDM,27809400_OP,W REV GLEN 36MM,1500.0,975.0,975.0,1470.0,6
CDM,27809410,W REV SHLDR HMRAL ADAPT TY,3000.0,1950.0,504.0,2700.0,23
CDM,27809410_IP,W REV SHLDR HMRAL ADAPT TY,3000.0,1950.0,1083.0,1083.0,3
CDM,27809410_OP,W REV SHLDR HMRAL ADAPT TY,3000.0,1950.0,1950.0,2940.0,6
CDM,27809420,W RING MITRAL COSGR-DURAFLO,2700.0,1755.0,453.6,2430.0,23
CDM,27809420_IP,W RING MITRAL COSGR-DURAFLO,2700.0,1755.0,974.7,974.7,3
CDM,27809420_OP,W RING MITRAL COSGR-DURAFLO,2700.0,1755.0,1755.0,2646.0,6
CDM,27809430,W ROD 3D AXIAL 40MM 10X11,16630.0,10809.5,2793.84,14967.0,29
CDM,27809430_OP,W ROD 3D AXIAL 40MM 10X11,16630.0,10809.5,10809.5,16297.4,6
CDM,27809440,W ROD ATTACHMT M/P CLAMP,938.0,609.7,157.58,844.2,20
CDM,27809440_IP,W ROD ATTACHMT M/P CLAMP,938.0,609.7,338.62,338.62,3
CDM,27809440_OP,W ROD ATTACHMT M/P CLAMP,938.0,609.7,609.7,919.24,6
CDM,27809450,W ROD CARBON FIBER,498.0,323.7,83.66,448.2,20
CDM,27809450_IP,W ROD CARBON FIBER,498.0,323.7,179.78,179.78,3
CDM,27809450_OP,W ROD CARBON FIBER,498.0,323.7,323.7,488.04,6
CDM,27809460,W ROD CARBON FIBER 200MM,500.0,325.0,84.0,450.0,20
CDM,27809460_IP,W ROD CARBON FIBER 200MM,500.0,325.0,180.5,180.5,3
CDM,27809460_OP,W ROD CARBON FIBER 200MM,500.0,325.0,325.0,490.0,6
CDM,27809470,W ROD CARBON FIBER 400MM,588.0,382.2,98.78,529.2,20
CDM,27809470_IP,W ROD CARBON FIBER 400MM,588.0,382.2,212.27,212.27,3
CDM,27809470_OP,W ROD CARBON FIBER 400MM,588.0,382.2,382.2,576.24,6
CDM,27809480,W ROD CRV TI 5.5,829.0,538.85,139.27,746.1,20
CDM,27809480_IP,W ROD CRV TI 5.5,829.0,538.85,299.27,299.27,3
CDM,27809480_OP,W ROD CRV TI 5.5,829.0,538.85,538.85,812.42,6
CDM,27809490,W ROD CRV/STR PIVT/CONE,1618.0,1051.7,271.82,1456.2,20
CDM,27809490_IP,W ROD CRV/STR PIVT/CONE,1618.0,1051.7,584.1,584.1,3
CDM,27809490_OP,W ROD CRV/STR PIVT/CONE,1618.0,1051.7,1051.7,1585.64,6
CDM,27809500,W ROD GD BALL TP 3 X 1000MM,72.0,46.8,12.1,64.8,20
CDM,27809500_IP,W ROD GD BALL TP 3 X 1000MM,72.0,46.8,25.99,25.99,3
CDM,27809500_OP,W ROD GD BALL TP 3 X 1000MM,72.0,46.8,46.8,70.56,6
CDM,27809510,W ROD HUNTER TENDON 24.5CM,2674.0,1738.1,449.23,2406.6,23
CDM,27809510_IP,W ROD HUNTER TENDON 24.5CM,2674.0,1738.1,965.31,965.31,3
CDM,27809510_OP,W ROD HUNTER TENDON 24.5CM,2674.0,1738.1,1738.1,2620.52,6
CDM,27809520,W ROD PROTEX STR 6.5X200MM,400.0,260.0,67.2,360.0,20
CDM,27809520_IP,W ROD PROTEX STR 6.5X200MM,400.0,260.0,144.4,144.4,3
CDM,27809520_OP,W ROD PROTEX STR 6.5X200MM,400.0,260.0,260.0,392.0,6
CDM,27809530,W ROD REAMING W BALL 2.5X950MM,232.0,150.8,38.98,208.8,20
CDM,27809530_IP,W ROD REAMING W BALL 2.5X950MM,232.0,150.8,83.75,83.75,3
CDM,27809530_OP,W ROD REAMING W BALL 2.5X950MM,232.0,150.8,150.8,227.36,6
CDM,27809540,W ROD REVOLVE 5.5X100MM,892.0,579.8,149.86,802.8,20
CDM,27809540_IP,W ROD REVOLVE 5.5X100MM,892.0,579.8,322.01,322.01,3
CDM,27809540_OP,W ROD REVOLVE 5.5X100MM,892.0,579.8,579.8,874.16,6
CDM,27809550,W ROD REVOLVE 5.5X110MM,1850.0,1202.5,310.8,1665.0,23
CDM,27809550_IP,W ROD REVOLVE 5.5X110MM,1850.0,1202.5,667.85,667.85,3
CDM,27809550_OP,W ROD REVOLVE 5.5X110MM,1850.0,1202.5,1202.5,1813.0,6
CDM,27809560,W ROD SPINE GLOB GRP 2,400.0,260.0,67.2,360.0,20
CDM,27809560_IP,W ROD SPINE GLOB GRP 2,400.0,260.0,144.4,144.4,3
CDM,27809560_OP,W ROD SPINE GLOB GRP 2,400.0,260.0,260.0,392.0,6
CDM,27809570,W ROD SPINE MEDT GRP 2,400.0,260.0,67.2,360.0,20
CDM,27809570_IP,W ROD SPINE MEDT GRP 2,400.0,260.0,144.4,144.4,3
CDM,27809570_OP,W ROD SPINE MEDT GRP 2,400.0,260.0,260.0,392.0,6
CDM,27809580,W ROD SPINE MEDT GRP 6,830.0,539.5,139.44,747.0,20
CDM,27809580_IP,W ROD SPINE MEDT GRP 6,830.0,539.5,299.63,299.63,3
CDM,27809580_OP,W ROD SPINE MEDT GRP 6,830.0,539.5,539.5,813.4,6
CDM,27809590,W ROD SPINE STRY GRP 1,400.0,260.0,67.2,360.0,20
CDM,27809590_IP,W ROD SPINE STRY GRP 1,400.0,260.0,144.4,144.4,3
CDM,27809590_OP,W ROD SPINE STRY GRP 1,400.0,260.0,260.0,392.0,6
CDM,27809600,W ROD TI PRE-LORD/STR,400.0,260.0,67.2,360.0,20
CDM,27809600_IP,W ROD TI PRE-LORD/STR,400.0,260.0,144.4,144.4,3
CDM,27809600_OP,W ROD TI PRE-LORD/STR,400.0,260.0,260.0,392.0,6
CDM,27809610,W ROD TITANIUM SYNT,400.0,260.0,67.2,360.0,20
CDM,27809610_IP,W ROD TITANIUM SYNT,400.0,260.0,144.4,144.4,3
CDM,27809610_OP,W ROD TITANIUM SYNT,400.0,260.0,260.0,392.0,6
CDM,27809620,W ROD VIPER II 35MM,1750.0,1137.5,294.0,1575.0,23
CDM,27809620_IP,W ROD VIPER II 35MM,1750.0,1137.5,631.75,631.75,3
CDM,27809620_OP,W ROD VIPER II 35MM,1750.0,1137.5,1137.5,1715.0,6
CDM,27809630,W RSTCTR UNV CMNT W/INSRT GRP31,324.0,210.6,54.43,291.6,20
CDM,27809630_IP,W RSTCTR UNV CMNT W/INSRT GRP31,324.0,210.6,116.96,116.96,3
CDM,27809630_OP,W RSTCTR UNV CMNT W/INSRT GRP31,324.0,210.6,210.6,317.52,6
CDM,27809640,W RUSH PIN E-6IN,204.0,132.6,34.27,183.6,20
CDM,27809640_IP,W RUSH PIN E-6IN,204.0,132.6,73.64,73.64,3
CDM,27809640_OP,W RUSH PIN E-6IN,204.0,132.6,132.6,199.92,6
CDM,27809650,W SAPR ENDOVENTR,4634.0,3012.1,778.51,4170.6,23
CDM,27809650_IP,W SAPR ENDOVENTR,4634.0,3012.1,1672.87,1672.87,3
CDM,27809650_OP,W SAPR ENDOVENTR,4634.0,3012.1,3012.1,4541.32,6
CDM,27809660,W SCREW 1.7 X 10 59-17010,111.0,72.15,18.65,99.9,20
CDM,27809660_IP,W SCREW 1.7 X 10 59-17010,111.0,72.15,40.07,40.07,3
CDM,27809660_OP,W SCREW 1.7 X 10 59-17010,111.0,72.15,72.15,108.78,6
CDM,27809670,W SCREW 2.0X14MM,112.0,72.8,18.82,100.8,20
CDM,27809670_IP,W SCREW 2.0X14MM,112.0,72.8,40.43,40.43,3
CDM,27809670_OP,W SCREW 2.0X14MM,112.0,72.8,72.8,109.76,6
CDM,27809680,W SCREW 207 LONG/SHRT THRD,348.0,226.2,58.46,313.2,20
CDM,27809680_IP,W SCREW 207 LONG/SHRT THRD,348.0,226.2,125.63,125.63,3
CDM,27809680_OP,W SCREW 207 LONG/SHRT THRD,348.0,226.2,226.2,341.04,6
CDM,27809690,W SCREW 4.0 CANN LAG 24-50MM,165.0,107.25,27.72,148.5,20
CDM,27809690_IP,W SCREW 4.0 CANN LAG 24-50MM,165.0,107.25,59.57,59.57,3
CDM,27809690_OP,W SCREW 4.0 CANN LAG 24-50MM,165.0,107.25,107.25,161.7,6
CDM,27809700,W SCREW 4.5MM CANN FULLY THRD,408.0,265.2,68.54,367.2,20
CDM,27809700_IP,W SCREW 4.5MM CANN FULLY THRD,408.0,265.2,147.29,147.29,3
CDM,27809700_OP,W SCREW 4.5MM CANN FULLY THRD,408.0,265.2,265.2,399.84,6
CDM,27809710,W SCREW 400.689 MOD HAND 1.3X9M,162.0,105.3,27.22,145.8,20
CDM,27809710_IP,W SCREW 400.689 MOD HAND 1.3X9M,162.0,105.3,58.48,58.48,3
CDM,27809710_OP,W SCREW 400.689 MOD HAND 1.3X9M,162.0,105.3,105.3,158.76,6
CDM,27809720,W SCREW 40081196 MOD HAND 1.5X,113.0,73.45,18.98,101.7,20
CDM,27809720_IP,W SCREW 40081196 MOD HAND 1.5X,113.0,73.45,40.79,40.79,3
CDM,27809720_OP,W SCREW 40081196 MOD HAND 1.5X,113.0,73.45,73.45,110.74,6
CDM,27809730,W SCREW 5.0MM SELF DRILLING,334.0,217.1,56.11,300.6,20
CDM,27809730_IP,W SCREW 5.0MM SELF DRILLING,334.0,217.1,120.57,120.57,3
CDM,27809730_OP,W SCREW 5.0MM SELF DRILLING,334.0,217.1,217.1,327.32,6
CDM,27809740,W SCREW 6.5X35 TI LO PROF,284.0,184.6,47.71,255.6,20
CDM,27809740_IP,W SCREW 6.5X35 TI LO PROF,284.0,184.6,102.52,102.52,3
CDM,27809740_OP,W SCREW 6.5X35 TI LO PROF,284.0,184.6,184.6,278.32,6
CDM,27809750,W SCREW 7.0 MULT COMP 16MM,594.0,386.1,99.79,534.6,20
CDM,27809750_IP,W SCREW 7.0 MULT COMP 16MM,594.0,386.1,214.43,214.43,3
CDM,27809750_OP,W SCREW 7.0 MULT COMP 16MM,594.0,386.1,386.1,582.12,6
CDM,27809760,W SCREW 7.0 MULT COMP 85X16MM,2050.0,1332.5,344.4,1845.0,23
CDM,27809760_IP,W SCREW 7.0 MULT COMP 85X16MM,2050.0,1332.5,740.05,740.05,3
CDM,27809760_OP,W SCREW 7.0 MULT COMP 85X16MM,2050.0,1332.5,1332.5,2009.0,6
CDM,27809770,W SCREW ACUTRAK FUSION 24MM,398.0,258.7,66.86,358.2,20
CDM,27809770_IP,W SCREW ACUTRAK FUSION 24MM,398.0,258.7,143.68,143.68,3
CDM,27809770_OP,W SCREW ACUTRAK FUSION 24MM,398.0,258.7,258.7,390.04,6
CDM,27809780,W SCREW AMS SELFTP 51CM SUTURE,550.0,357.5,92.4,495.0,20
CDM,27809780_IP,W SCREW AMS SELFTP 51CM SUTURE,550.0,357.5,198.55,198.55,3
CDM,27809780_OP,W SCREW AMS SELFTP 51CM SUTURE,550.0,357.5,357.5,539.0,6
CDM,27809790,W SCREW BIOCOMPOSITE-TENODESIS,581.0,377.65,97.61,522.9,20
CDM,27809790_IP,W SCREW BIOCOMPOSITE-TENODESIS,581.0,377.65,209.74,209.74,3
CDM,27809790_OP,W SCREW BIOCOMPOSITE-TENODESIS,581.0,377.65,377.65,569.38,6
CDM,27809800,W SCREW BIO-COMPRESSION,258.0,167.7,43.34,232.2,20
CDM,27809800_IP,W SCREW BIO-COMPRESSION,258.0,167.7,93.14,93.14,3
CDM,27809800_OP,W SCREW BIO-COMPRESSION,258.0,167.7,167.7,252.84,6
CDM,27809810,W SCREW BIOTENODESIS,526.0,341.9,88.37,473.4,20
CDM,27809810_IP,W SCREW BIOTENODESIS,526.0,341.9,189.89,189.89,3
CDM,27809810_OP,W SCREW BIOTENODESIS,526.0,341.9,341.9,515.48,6
CDM,27809820,W SCREW BONE,613.0,398.45,102.98,551.7,20
CDM,27809820_IP,W SCREW BONE,613.0,398.45,221.29,221.29,3
CDM,27809820_OP,W SCREW BONE,613.0,398.45,398.45,600.74,6
CDM,27809830,W SCREW BONE 6.5MM X 35MM,30.0,19.5,5.04,27.0,20
CDM,27809830_IP,W SCREW BONE 6.5MM X 35MM,30.0,19.5,10.83,10.83,3
CDM,27809830_OP,W SCREW BONE 6.5MM X 35MM,30.0,19.5,19.5,29.4,6
CDM,27809840,W SCREW BONE CORT FT 4.5X46MM,27.0,17.55,4.54,24.3,20
CDM,27809840_IP,W SCREW BONE CORT FT 4.5X46MM,27.0,17.55,9.75,9.75,3
CDM,27809840_OP,W SCREW BONE CORT FT 4.5X46MM,27.0,17.55,17.55,26.46,6
CDM,27809850,W SCREW BONE CORT FT 4.5X52MM,86.0,55.9,14.45,77.4,20
CDM,27809850_IP,W SCREW BONE CORT FT 4.5X52MM,86.0,55.9,31.05,31.05,3
CDM,27809850_OP,W SCREW BONE CORT FT 4.5X52MM,86.0,55.9,55.9,84.28,6
CDM,27809860,W SCREW BONE HERBERT,599.0,389.35,100.63,539.1,20
CDM,27809860_IP,W SCREW BONE HERBERT,599.0,389.35,216.24,216.24,3
CDM,27809860_OP,W SCREW BONE HERBERT,599.0,389.35,389.35,587.02,6
CDM,27809870,W SCREW BONE LOCK SLFTP T8,242.0,157.3,40.66,217.8,20
CDM,27809870_IP,W SCREW BONE LOCK SLFTP T8,242.0,157.3,87.36,87.36,3
CDM,27809870_OP,W SCREW BONE LOCK SLFTP T8,242.0,157.3,157.3,237.16,6
CDM,27809880,W SCREW BONE NON LK RAD 2.7,155.0,100.75,26.04,139.5,20
CDM,27809880_IP,W SCREW BONE NON LK RAD 2.7,155.0,100.75,55.96,55.96,3
CDM,27809880_OP,W SCREW BONE NON LK RAD 2.7,155.0,100.75,100.75,151.9,6
CDM,27809890,W SCREW BONE PINN CANN 6.5,107.0,69.55,17.98,96.3,20
CDM,27809890_IP,W SCREW BONE PINN CANN 6.5,107.0,69.55,38.63,38.63,3
CDM,27809890_OP,W SCREW BONE PINN CANN 6.5,107.0,69.55,69.55,104.86,6
CDM,27809900,W SCREW BONE RECON INT 6.4X95MM,718.0,466.7,120.62,646.2,20
CDM,27809900_IP,W SCREW BONE RECON INT 6.4X95MM,718.0,466.7,259.2,259.2,3
CDM,27809900_OP,W SCREW BONE RECON INT 6.4X95MM,718.0,466.7,466.7,703.64,6
CDM,27809910,W SCREW BONE VIT 6.5MM GRP 14,30.0,19.5,5.04,27.0,20
CDM,27809910_IP,W SCREW BONE VIT 6.5MM GRP 14,30.0,19.5,10.83,10.83,3
CDM,27809910_OP,W SCREW BONE VIT 6.5MM GRP 14,30.0,19.5,19.5,29.4,6
CDM,27809920,W SCREW CANC FL THRD 4.0MM,34.0,22.1,5.71,30.6,20
CDM,27809920_IP,W SCREW CANC FL THRD 4.0MM,34.0,22.1,12.27,12.27,3
CDM,27809920_OP,W SCREW CANC FL THRD 4.0MM,34.0,22.1,22.1,33.32,6
CDM,27809930,W SCREW CANC PARTIAL THRD 4.0MM,34.0,22.1,5.71,30.6,20
CDM,27809930_IP,W SCREW CANC PARTIAL THRD 4.0MM,34.0,22.1,12.27,12.27,3
CDM,27809930_OP,W SCREW CANC PARTIAL THRD 4.0MM,34.0,22.1,22.1,33.32,6
CDM,27809940,W SCREW CANC PARTIAL THREADED,67.0,43.55,11.26,60.3,20
CDM,27809940_IP,W SCREW CANC PARTIAL THREADED,67.0,43.55,24.19,24.19,3
CDM,27809940_OP,W SCREW CANC PARTIAL THREADED,67.0,43.55,43.55,65.66,6
CDM,27809950,W SCREW CANC SLFTAP 4.35X14MM,500.0,325.0,84.0,450.0,20
CDM,27809950_IP,W SCREW CANC SLFTAP 4.35X14MM,500.0,325.0,180.5,180.5,3
CDM,27809950_OP,W SCREW CANC SLFTAP 4.35X14MM,500.0,325.0,325.0,490.0,6
CDM,27809960,W SCREW CANC TI FL THRD 4.0MM,32.0,20.8,5.38,28.8,20
CDM,27809960_IP,W SCREW CANC TI FL THRD 4.0MM,32.0,20.8,11.55,11.55,3
CDM,27809960_OP,W SCREW CANC TI FL THRD 4.0MM,32.0,20.8,20.8,31.36,6
CDM,27809970,W SCREW CANC TI FL THRD 4.0MM,37.0,24.05,6.22,33.3,20
CDM,27809970_IP,W SCREW CANC TI FL THRD 4.0MM,37.0,24.05,13.36,13.36,3
CDM,27809970_OP,W SCREW CANC TI FL THRD 4.0MM,37.0,24.05,24.05,36.26,6
CDM,27809980,W SCREW CANC TITM FL THRD 6.5MM,69.0,44.85,11.59,62.1,20
CDM,27809980_IP,W SCREW CANC TITM FL THRD 6.5MM,69.0,44.85,24.91,24.91,3
CDM,27809980_OP,W SCREW CANC TITM FL THRD 6.5MM,69.0,44.85,44.85,67.62,6
CDM,27809990,W SCREW CANCELLOUS TI 4.0MM,44.0,28.6,7.39,39.6,20
CDM,27809990_IP,W SCREW CANCELLOUS TI 4.0MM,44.0,28.6,15.88,15.88,3
CDM,27809990_OP,W SCREW CANCELLOUS TI 4.0MM,44.0,28.6,28.6,43.12,6
CDM,27810000,W SCREW CANCELLUS SLFTP 14/16MM,480.0,312.0,80.64,432.0,20
CDM,27810000_IP,W SCREW CANCELLUS SLFTP 14/16MM,480.0,312.0,173.28,173.28,3
CDM,27810000_OP,W SCREW CANCELLUS SLFTP 14/16MM,480.0,312.0,312.0,470.4,6
CDM,27810010,W SCREW CANN INTERFRNCE ARTHREX,175.0,113.75,29.4,157.5,20
CDM,27810010_IP,W SCREW CANN INTERFRNCE ARTHREX,175.0,113.75,63.18,63.18,3
CDM,27810010_OP,W SCREW CANN INTERFRNCE ARTHREX,175.0,113.75,113.75,171.5,6
CDM,27810020,W SCREW CANN LOCK 7.3MM X 55MM,606.0,393.9,101.81,545.4,20
CDM,27810020_IP,W SCREW CANN LOCK 7.3MM X 55MM,606.0,393.9,218.77,218.77,3
CDM,27810020_OP,W SCREW CANN LOCK 7.3MM X 55MM,606.0,393.9,393.9,593.88,6
CDM,27810030,W SCREW CANN LOCKING 8.0X75MM,594.0,386.1,99.79,534.6,20
CDM,27810030_IP,W SCREW CANN LOCKING 8.0X75MM,594.0,386.1,214.43,214.43,3
CDM,27810030_OP,W SCREW CANN LOCKING 8.0X75MM,594.0,386.1,386.1,582.12,6
CDM,27810040,W SCREW CANN MS LEG 6.5 X 50 5,3508.0,2280.2,589.34,3157.2,23
CDM,27810040_IP,W SCREW CANN MS LEG 6.5 X 50 5,3508.0,2280.2,1266.39,1266.39,3
CDM,27810040_OP,W SCREW CANN MS LEG 6.5 X 50 5,3508.0,2280.2,2280.2,3437.84,6
CDM,27810050,W SCREW CANN PT THREAD 3.75,369.0,239.85,61.99,332.1,20
CDM,27810050_IP,W SCREW CANN PT THREAD 3.75,369.0,239.85,133.21,133.21,3
CDM,27810050_OP,W SCREW CANN PT THREAD 3.75,369.0,239.85,239.85,361.62,6
CDM,27810060,W SCREW CANN SPINE MEDT GRP 18,3509.0,2280.85,589.51,3158.1,23
CDM,27810060_IP,W SCREW CANN SPINE MEDT GRP 18,3509.0,2280.85,1266.75,1266.75,3
CDM,27810060_OP,W SCREW CANN SPINE MEDT GRP 18,3509.0,2280.85,2280.85,3438.82,6
CDM,27810070,W SCREW CANN SYNT 4.5MM,342.0,222.3,57.46,307.8,20
CDM,27810070_IP,W SCREW CANN SYNT 4.5MM,342.0,222.3,123.46,123.46,3
CDM,27810070_OP,W SCREW CANN SYNT 4.5MM,342.0,222.3,222.3,335.16,6
CDM,27810080,W SCREW CANN SYNT 6.5 MM,492.0,319.8,82.66,442.8,20
CDM,27810080_IP,W SCREW CANN SYNT 6.5 MM,492.0,319.8,177.61,177.61,3
CDM,27810080_OP,W SCREW CANN SYNT 6.5 MM,492.0,319.8,319.8,482.16,6
CDM,27810090,W SCREW CANN SYNT 7.3 MM,492.0,319.8,82.66,442.8,20
CDM,27810090_IP,W SCREW CANN SYNT 7.3 MM,492.0,319.8,177.61,177.61,3
CDM,27810090_OP,W SCREW CANN SYNT 7.3 MM,492.0,319.8,319.8,482.16,6
CDM,27810100,W SCREW CANNLATED 6.5MM X 115MM,512.0,332.8,86.02,460.8,20
CDM,27810100_IP,W SCREW CANNLATED 6.5MM X 115MM,512.0,332.8,184.83,184.83,3
CDM,27810100_OP,W SCREW CANNLATED 6.5MM X 115MM,512.0,332.8,332.8,501.76,6
CDM,27810110,W SCREW CANNLTD PARTIALLY THRD,332.0,215.8,55.78,298.8,20
CDM,27810110_IP,W SCREW CANNLTD PARTIALLY THRD,332.0,215.8,119.85,119.85,3
CDM,27810110_OP,W SCREW CANNLTD PARTIALLY THRD,332.0,215.8,215.8,325.36,6
CDM,27810120,W SCREW CANNULATED 3.0,355.0,230.75,59.64,319.5,20
CDM,27810120_IP,W SCREW CANNULATED 3.0,355.0,230.75,128.16,128.16,3
CDM,27810120_OP,W SCREW CANNULATED 3.0,355.0,230.75,230.75,347.9,6
CDM,27810130,W SCREW CANNULATED 3.2X22,508.0,330.2,85.34,457.2,20
CDM,27810130_IP,W SCREW CANNULATED 3.2X22,508.0,330.2,183.39,183.39,3
CDM,27810130_OP,W SCREW CANNULATED 3.2X22,508.0,330.2,330.2,497.84,6
CDM,27810140,W SCREW CANNULATED 6.2,1770.0,1150.5,297.36,1593.0,23
CDM,27810140_IP,W SCREW CANNULATED 6.2,1770.0,1150.5,638.97,638.97,3
CDM,27810140_OP,W SCREW CANNULATED 6.2,1770.0,1150.5,1150.5,1734.6,6
CDM,27810150,W SCREW CERV/SS/TI GLOB GRP 8,1250.0,812.5,210.0,1125.0,20
CDM,27810150_IP,W SCREW CERV/SS/TI GLOB GRP 8,1250.0,812.5,451.25,451.25,3
CDM,27810150_OP,W SCREW CERV/SS/TI GLOB GRP 8,1250.0,812.5,812.5,1225.0,6
CDM,27810160,W SCREW CERVICAL LOCKING 1.8MM,20.0,13.0,3.36,18.0,20
CDM,27810160_IP,W SCREW CERVICAL LOCKING 1.8MM,20.0,13.0,7.22,7.22,3
CDM,27810160_OP,W SCREW CERVICAL LOCKING 1.8MM,20.0,13.0,13.0,19.6,6
CDM,27810170,W SCREW CLAW LK HEX 3.5,286.0,185.9,48.05,257.4,20
CDM,27810170_IP,W SCREW CLAW LK HEX 3.5,286.0,185.9,103.25,103.25,3
CDM,27810170_OP,W SCREW CLAW LK HEX 3.5,286.0,185.9,185.9,280.28,6
CDM,27810180,W SCREW CLICKX 6.2X65MM,1060.0,689.0,178.08,954.0,20
CDM,27810180_IP,W SCREW CLICKX 6.2X65MM,1060.0,689.0,382.66,382.66,3
CDM,27810180_OP,W SCREW CLICKX 6.2X65MM,1060.0,689.0,689.0,1038.8,6
CDM,27810190,W SCREW COMPR LK CAP,256.0,166.4,43.01,230.4,20
CDM,27810190_IP,W SCREW COMPR LK CAP,256.0,166.4,92.42,92.42,3
CDM,27810190_OP,W SCREW COMPR LK CAP,256.0,166.4,166.4,250.88,6
CDM,27810200,W SCREW COMPRESSION CHARLOTTE,344.0,223.6,57.79,309.6,20
CDM,27810200_IP,W SCREW COMPRESSION CHARLOTTE,344.0,223.6,124.18,124.18,3
CDM,27810200_OP,W SCREW COMPRESSION CHARLOTTE,344.0,223.6,223.6,337.12,6
CDM,27810210,W SCREW COMPRESSION OMEGA 32MM,179.0,116.35,30.07,161.1,20
CDM,27810210_IP,W SCREW COMPRESSION OMEGA 32MM,179.0,116.35,64.62,64.62,3
CDM,27810210_OP,W SCREW COMPRESSION OMEGA 32MM,179.0,116.35,116.35,175.42,6
CDM,27810220,W SCREW CONICAL EXTRACTION,1858.0,1207.7,312.14,1672.2,23
CDM,27810220_IP,W SCREW CONICAL EXTRACTION,1858.0,1207.7,670.74,670.74,3
CDM,27810220_OP,W SCREW CONICAL EXTRACTION,1858.0,1207.7,1207.7,1820.84,6
CDM,27810230,W SCREW CONSTRNED SELF DRL16MM,1000.0,650.0,168.0,900.0,20
CDM,27810230_IP,W SCREW CONSTRNED SELF DRL16MM,1000.0,650.0,361.0,361.0,3
CDM,27810230_OP,W SCREW CONSTRNED SELF DRL16MM,1000.0,650.0,650.0,980.0,6
CDM,27810240,W SCREW CORT SLFTAP HEX 4.5,60.0,39.0,10.08,54.0,20
CDM,27810240_IP,W SCREW CORT SLFTAP HEX 4.5,60.0,39.0,21.66,21.66,3
CDM,27810240_OP,W SCREW CORT SLFTAP HEX 4.5,60.0,39.0,39.0,58.8,6
CDM,27810250,W SCREW CORTCL THRD UPGRD 3.5MM,43.0,27.95,7.22,38.7,20
CDM,27810250_IP,W SCREW CORTCL THRD UPGRD 3.5MM,43.0,27.95,15.52,15.52,3
CDM,27810250_OP,W SCREW CORTCL THRD UPGRD 3.5MM,43.0,27.95,27.95,42.14,6
CDM,27810260,W SCREW CORTCL THRD UPGRD 3.5MM,47.0,30.55,7.9,42.3,20
CDM,27810260_IP,W SCREW CORTCL THRD UPGRD 3.5MM,47.0,30.55,16.97,16.97,3
CDM,27810260_OP,W SCREW CORTCL THRD UPGRD 3.5MM,47.0,30.55,30.55,46.06,6
CDM,27810270,W SCREW CORTCL/CANC LOCKING,276.0,179.4,46.37,248.4,20
CDM,27810270_IP,W SCREW CORTCL/CANC LOCKING,276.0,179.4,99.64,99.64,3
CDM,27810270_OP,W SCREW CORTCL/CANC LOCKING,276.0,179.4,179.4,270.48,6
CDM,27810280,W SCREW CORTEX 2.4MM,110.0,71.5,18.48,99.0,20
CDM,27810280_IP,W SCREW CORTEX 2.4MM,110.0,71.5,39.71,39.71,3
CDM,27810280_OP,W SCREW CORTEX 2.4MM,110.0,71.5,71.5,107.8,6
CDM,27810290,W SCREW CORTEX 2.7MM TI 10/12MM,112.0,72.8,18.82,100.8,20
CDM,27810290_IP,W SCREW CORTEX 2.7MM TI 10/12MM,112.0,72.8,40.43,40.43,3
CDM,27810290_OP,W SCREW CORTEX 2.7MM TI 10/12MM,112.0,72.8,72.8,109.76,6
CDM,27810300,W SCREW CORTEX 3.5MM,47.0,30.55,7.9,42.3,20
CDM,27810300_IP,W SCREW CORTEX 3.5MM,47.0,30.55,16.97,16.97,3
CDM,27810300_OP,W SCREW CORTEX 3.5MM,47.0,30.55,30.55,46.06,6
CDM,27810310,W SCREW CORTEX 4.5/214,42.0,27.3,7.06,37.8,20
CDM,27810310_IP,W SCREW CORTEX 4.5/214,42.0,27.3,15.16,15.16,3
CDM,27810310_OP,W SCREW CORTEX 4.5/214,42.0,27.3,27.3,41.16,6
CDM,27810320,W SCREW CORTEX SELF-TAP 2.7,58.0,37.7,9.74,52.2,20
CDM,27810320_IP,W SCREW CORTEX SELF-TAP 2.7,58.0,37.7,20.94,20.94,3
CDM,27810320_OP,W SCREW CORTEX SELF-TAP 2.7,58.0,37.7,37.7,56.84,6
CDM,27810330,W SCREW CORTEX SELFTAPING 4.5MM,38.0,24.7,6.38,34.2,20
CDM,27810330_IP,W SCREW CORTEX SELFTAPING 4.5MM,38.0,24.7,13.72,13.72,3
CDM,27810330_OP,W SCREW CORTEX SELFTAPING 4.5MM,38.0,24.7,24.7,37.24,6
CDM,27810340,W SCREW CORTEX SLF TAPPNG 3.5MM,52.0,33.8,8.74,46.8,20
CDM,27810340_IP,W SCREW CORTEX SLF TAPPNG 3.5MM,52.0,33.8,18.77,18.77,3
CDM,27810340_OP,W SCREW CORTEX SLF TAPPNG 3.5MM,52.0,33.8,33.8,50.96,6
CDM,27810350,W SCREW CORTEX SLFTP LOCKING,310.0,201.5,52.08,279.0,20
CDM,27810350_IP,W SCREW CORTEX SLFTP LOCKING,310.0,201.5,111.91,111.91,3
CDM,27810350_OP,W SCREW CORTEX SLFTP LOCKING,310.0,201.5,201.5,303.8,6
CDM,27810360,W SCREW CORTEX TI 2.7X20MM,242.0,157.3,40.66,217.8,20
CDM,27810360_IP,W SCREW CORTEX TI 2.7X20MM,242.0,157.3,87.36,87.36,3
CDM,27810360_OP,W SCREW CORTEX TI 2.7X20MM,242.0,157.3,157.3,237.16,6
CDM,27810370,W SCREW CORTEX TI 4.5MM,32.0,20.8,5.38,28.8,20
CDM,27810370_IP,W SCREW CORTEX TI 4.5MM,32.0,20.8,11.55,11.55,3
CDM,27810370_OP,W SCREW CORTEX TI 4.5MM,32.0,20.8,20.8,31.36,6
CDM,27810380,W SCREW CORTEX TI SLFTP 4.5,46.0,29.9,7.73,41.4,20
CDM,27810380_IP,W SCREW CORTEX TI SLFTP 4.5,46.0,29.9,16.61,16.61,3
CDM,27810380_OP,W SCREW CORTEX TI SLFTP 4.5,46.0,29.9,29.9,45.08,6
CDM,27810390,W SCREW CORTICAL 3.5 DPY,180.0,117.0,30.24,162.0,20
CDM,27810390_IP,W SCREW CORTICAL 3.5 DPY,180.0,117.0,64.98,64.98,3
CDM,27810390_OP,W SCREW CORTICAL 3.5 DPY,180.0,117.0,117.0,176.4,6
CDM,27810400,W SCREW CORTICAL 3.5MM,33.0,21.45,5.54,29.7,20
CDM,27810400_IP,W SCREW CORTICAL 3.5MM,33.0,21.45,11.91,11.91,3
CDM,27810400_OP,W SCREW CORTICAL 3.5MM,33.0,21.45,21.45,32.34,6
CDM,27810410,W SCREW CORTICAL 3.5MM,150.0,97.5,25.2,135.0,20
CDM,27810410_IP,W SCREW CORTICAL 3.5MM,150.0,97.5,54.15,54.15,3
CDM,27810410_OP,W SCREW CORTICAL 3.5MM,150.0,97.5,97.5,147.0,6
CDM,27810420,W SCREW CORTICAL 3.5MM X 20MM,140.0,91.0,23.52,126.0,20
CDM,27810420_IP,W SCREW CORTICAL 3.5MM X 20MM,140.0,91.0,50.54,50.54,3
CDM,27810420_OP,W SCREW CORTICAL 3.5MM X 20MM,140.0,91.0,91.0,137.2,6
CDM,27810430,W SCREW CORTICAL 3.5X20MM,192.0,124.8,32.26,172.8,20
CDM,27810430_IP,W SCREW CORTICAL 3.5X20MM,192.0,124.8,69.31,69.31,3
CDM,27810430_OP,W SCREW CORTICAL 3.5X20MM,192.0,124.8,124.8,188.16,6
CDM,27810440,W SCREW CORTICAL FT 2.7,100.0,65.0,16.8,90.0,20
CDM,27810440_IP,W SCREW CORTICAL FT 2.7,100.0,65.0,36.1,36.1,3
CDM,27810440_OP,W SCREW CORTICAL FT 2.7,100.0,65.0,65.0,98.0,6
CDM,27810450,W SCREW CORTICAL S/T 4.5MM,61.0,39.65,10.25,54.9,20
CDM,27810450_IP,W SCREW CORTICAL S/T 4.5MM,61.0,39.65,22.02,22.02,3
CDM,27810450_OP,W SCREW CORTICAL S/T 4.5MM,61.0,39.65,39.65,59.78,6
CDM,27810460,W SCREW CRANIAL 1.5MMX5MM,136.0,88.4,22.85,122.4,20
CDM,27810460_IP,W SCREW CRANIAL 1.5MMX5MM,136.0,88.4,49.1,49.1,3
CDM,27810460_OP,W SCREW CRANIAL 1.5MMX5MM,136.0,88.4,88.4,133.28,6
CDM,27810470,W SCREW DARCO LOCK 2.7X16,254.0,165.1,42.67,228.6,20
CDM,27810470_IP,W SCREW DARCO LOCK 2.7X16,254.0,165.1,91.69,91.69,3
CDM,27810470_OP,W SCREW DARCO LOCK 2.7X16,254.0,165.1,165.1,248.92,6
CDM,27810480,W SCREW DARCO LOCKED 2.7,262.0,170.3,44.02,235.8,20
CDM,27810480_IP,W SCREW DARCO LOCKED 2.7,262.0,170.3,94.58,94.58,3
CDM,27810480_OP,W SCREW DARCO LOCKED 2.7,262.0,170.3,170.3,256.76,6
CDM,27810490,W SCREW DISTRACTION 12MM,90.0,58.5,15.12,81.0,20
CDM,27810490_IP,W SCREW DISTRACTION 12MM,90.0,58.5,32.49,32.49,3
CDM,27810490_OP,W SCREW DISTRACTION 12MM,90.0,58.5,58.5,88.2,6
CDM,27810500,W SCREW DISTRACTION 14MM STRL,1362.0,885.3,228.82,1225.8,20
CDM,27810500_IP,W SCREW DISTRACTION 14MM STRL,1362.0,885.3,491.68,491.68,3
CDM,27810500_OP,W SCREW DISTRACTION 14MM STRL,1362.0,885.3,885.3,1334.76,6
CDM,27810510,W SCREW DURA DIS FEM LCKG GRP19,113.0,73.45,18.98,101.7,20
CDM,27810510_IP,W SCREW DURA DIS FEM LCKG GRP19,113.0,73.45,40.79,40.79,3
CDM,27810510_OP,W SCREW DURA DIS FEM LCKG GRP19,113.0,73.45,73.45,110.74,6
CDM,27810520,W SCREW DXTEND NOLOCK D4.5,300.0,195.0,50.4,270.0,20
CDM,27810520_IP,W SCREW DXTEND NOLOCK D4.5,300.0,195.0,108.3,108.3,3
CDM,27810520_OP,W SCREW DXTEND NOLOCK D4.5,300.0,195.0,195.0,294.0,6
CDM,27810530,W SCREW DXTEND NOLOCK D4.5,378.0,245.7,63.5,340.2,20
CDM,27810530_IP,W SCREW DXTEND NOLOCK D4.5,378.0,245.7,136.46,136.46,3
CDM,27810530_OP,W SCREW DXTEND NOLOCK D4.5,378.0,245.7,245.7,370.44,6
CDM,27810540,W SCREW EXP 6.35 TI UNI/POLY,1300.0,845.0,218.4,1170.0,20
CDM,27810540_IP,W SCREW EXP 6.35 TI UNI/POLY,1300.0,845.0,469.3,469.3,3
CDM,27810540_OP,W SCREW EXP 6.35 TI UNI/POLY,1300.0,845.0,845.0,1274.0,6
CDM,27810550,W SCREW EXP TI MONO,1100.0,715.0,184.8,990.0,20
CDM,27810550_IP,W SCREW EXP TI MONO,1100.0,715.0,397.1,397.1,3
CDM,27810550_OP,W SCREW EXP TI MONO,1100.0,715.0,715.0,1078.0,6
CDM,27810560,W SCREW HYBRID STRYK,393.0,255.45,66.02,353.7,20
CDM,27810560_IP,W SCREW HYBRID STRYK,393.0,255.45,141.87,141.87,3
CDM,27810560_OP,W SCREW HYBRID STRYK,393.0,255.45,255.45,385.14,6
CDM,27810570,W SCREW FUSION MTP CHARLTTE 2.7,198.0,128.7,33.26,178.2,20
CDM,27810570_IP,W SCREW FUSION MTP CHARLTTE 2.7,198.0,128.7,71.48,71.48,3
CDM,27810570_OP,W SCREW FUSION MTP CHARLTTE 2.7,198.0,128.7,128.7,194.04,6
CDM,27810580,W SCREW GAMMA 3 SET TI,321.0,208.65,53.93,288.9,20
CDM,27810580_IP,W SCREW GAMMA 3 SET TI,321.0,208.65,115.88,115.88,3
CDM,27810580_OP,W SCREW GAMMA 3 SET TI,321.0,208.65,208.65,314.58,6
CDM,27810590,W SCREW GUIDE PIN 1.2MM,480.0,312.0,80.64,432.0,20
CDM,27810590_IP,W SCREW GUIDE PIN 1.2MM,480.0,312.0,173.28,173.28,3
CDM,27810590_OP,W SCREW GUIDE PIN 1.2MM,480.0,312.0,312.0,470.4,6
CDM,27810600,W SCREW HERBT WHPL 22MM 1152-22,470.0,305.5,78.96,423.0,20
CDM,27810600_IP,W SCREW HERBT WHPL 22MM 1152-22,470.0,305.5,169.67,169.67,3
CDM,27810600_OP,W SCREW HERBT WHPL 22MM 1152-22,470.0,305.5,305.5,460.6,6
CDM,27810610,W SCREW INTERFER ARTHX,262.0,170.3,44.02,235.8,20
CDM,27810610_IP,W SCREW INTERFER ARTHX,262.0,170.3,94.58,94.58,3
CDM,27810610_OP,W SCREW INTERFER ARTHX,262.0,170.3,170.3,256.76,6
CDM,27810620,W SCREW INTERNAL HEX,430.0,279.5,72.24,387.0,20
CDM,27810620_IP,W SCREW INTERNAL HEX,430.0,279.5,155.23,155.23,3
CDM,27810620_OP,W SCREW INTERNAL HEX,430.0,279.5,279.5,421.4,6
CDM,27810630,W SCREW INTERNAL HEX 5.0,430.0,279.5,72.24,387.0,20
CDM,27810630_IP,W SCREW INTERNAL HEX 5.0,430.0,279.5,155.23,155.23,3
CDM,27810630_OP,W SCREW INTERNAL HEX 5.0,430.0,279.5,279.5,421.4,6
CDM,27810640,W SCREW LAG GAMMA 10.5 X 100MM,913.0,593.45,153.38,821.7,20
CDM,27810640_IP,W SCREW LAG GAMMA 10.5 X 100MM,913.0,593.45,329.59,329.59,3
CDM,27810640_OP,W SCREW LAG GAMMA 10.5 X 100MM,913.0,593.45,593.45,894.74,6
CDM,27810650,W SCREW LAG RECON 6.5X90MM,1297.0,843.05,217.9,1167.3,20
CDM,27810650_IP,W SCREW LAG RECON 6.5X90MM,1297.0,843.05,468.22,468.22,3
CDM,27810650_OP,W SCREW LAG RECON 6.5X90MM,1297.0,843.05,843.05,1271.06,6
CDM,27810660,W SCREW LAG T2 6.5X95MM,447.0,290.55,75.1,402.3,20
CDM,27810660_IP,W SCREW LAG T2 6.5X95MM,447.0,290.55,161.37,161.37,3
CDM,27810660_OP,W SCREW LAG T2 6.5X95MM,447.0,290.55,290.55,438.06,6
CDM,27810670,W SCREW LAG TI/GAMMA/BONE,914.0,594.1,153.55,822.6,20
CDM,27810670_IP,W SCREW LAG TI/GAMMA/BONE,914.0,594.1,329.95,329.95,3
CDM,27810670_OP,W SCREW LAG TI/GAMMA/BONE,914.0,594.1,594.1,895.72,6
CDM,27810680,W SCREW LK HEX CLAW 3.5X20MM,520.0,338.0,87.36,468.0,20
CDM,27810680_IP,W SCREW LK HEX CLAW 3.5X20MM,520.0,338.0,187.72,187.72,3
CDM,27810680_OP,W SCREW LK HEX CLAW 3.5X20MM,520.0,338.0,338.0,509.6,6
CDM,27810690,W SCREW LOCK 5.0MM,410.0,266.5,68.88,369.0,20
CDM,27810690_IP,W SCREW LOCK 5.0MM,410.0,266.5,148.01,148.01,3
CDM,27810690_OP,W SCREW LOCK 5.0MM,410.0,266.5,266.5,401.8,6
CDM,27810700,W SCREW LOCK EQUINOXE 3201505,256.0,166.4,43.01,230.4,20
CDM,27810700_IP,W SCREW LOCK EQUINOXE 3201505,256.0,166.4,92.42,92.42,3
CDM,27810700_OP,W SCREW LOCK EQUINOXE 3201505,256.0,166.4,166.4,250.88,6
CDM,27810710,W SCREW LOCK FULL THRD STRY,242.0,157.3,40.66,217.8,20
CDM,27810710_IP,W SCREW LOCK FULL THRD STRY,242.0,157.3,87.36,87.36,3
CDM,27810710_OP,W SCREW LOCK FULL THRD STRY,242.0,157.3,157.3,237.16,6
CDM,27810720,W SCREW LOCK POLY/SHFT DPY,143.0,92.95,24.02,128.7,20
CDM,27810720_IP,W SCREW LOCK POLY/SHFT DPY,143.0,92.95,51.62,51.62,3
CDM,27810720_OP,W SCREW LOCK POLY/SHFT DPY,143.0,92.95,92.95,140.14,6
CDM,27810730,W SCREW LOCK SYNTHES 5.0MM,410.0,266.5,68.88,369.0,20
CDM,27810730_IP,W SCREW LOCK SYNTHES 5.0MM,410.0,266.5,148.01,148.01,3
CDM,27810730_OP,W SCREW LOCK SYNTHES 5.0MM,410.0,266.5,266.5,401.8,6
CDM,27810740,W SCREW LOCK TI 3.0MM,450.0,292.5,75.6,405.0,20
CDM,27810740_IP,W SCREW LOCK TI 3.0MM,450.0,292.5,162.45,162.45,3
CDM,27810740_OP,W SCREW LOCK TI 3.0MM,450.0,292.5,292.5,441.0,6
CDM,27810750,W SCREW LOCKING 2.7 X 22MM,198.0,128.7,33.26,178.2,20
CDM,27810750_IP,W SCREW LOCKING 2.7 X 22MM,198.0,128.7,71.48,71.48,3
CDM,27810750_OP,W SCREW LOCKING 2.7 X 22MM,198.0,128.7,128.7,194.04,6
CDM,27810760,W SCREW LOCKING 3.5X18MM,218.0,141.7,36.62,196.2,20
CDM,27810760_IP,W SCREW LOCKING 3.5X18MM,218.0,141.7,78.7,78.7,3
CDM,27810760_OP,W SCREW LOCKING 3.5X18MM,218.0,141.7,141.7,213.64,6
CDM,27810770,W SCREW LOCKING 5.0X14MM,440.0,286.0,73.92,396.0,20
CDM,27810770_IP,W SCREW LOCKING 5.0X14MM,440.0,286.0,158.84,158.84,3
CDM,27810770_OP,W SCREW LOCKING 5.0X14MM,440.0,286.0,286.0,431.2,6
CDM,27810780,W SCREW LOCKING SYNTHS 3.5MM,256.0,166.4,43.01,230.4,20
CDM,27810780_IP,W SCREW LOCKING SYNTHS 3.5MM,256.0,166.4,92.42,92.42,3
CDM,27810780_OP,W SCREW LOCKING SYNTHS 3.5MM,256.0,166.4,166.4,250.88,6
CDM,27810790,W SCREW LOCKING TI 4.0MM,402.0,261.3,67.54,361.8,20
CDM,27810790_IP,W SCREW LOCKING TI 4.0MM,402.0,261.3,145.12,145.12,3
CDM,27810790_OP,W SCREW LOCKING TI 4.0MM,402.0,261.3,261.3,393.96,6
CDM,27810800,W SCREW LOK TI STRDRV 4.0X38MM,70.0,45.5,11.76,63.0,20
CDM,27810800_IP,W SCREW LOK TI STRDRV 4.0X38MM,70.0,45.5,25.27,25.27,3
CDM,27810800_OP,W SCREW LOK TI STRDRV 4.0X38MM,70.0,45.5,45.5,68.6,6
CDM,27810810,W SCREW MIS CANN POLYTI,2940.0,1911.0,493.92,2646.0,23
CDM,27810810_IP,W SCREW MIS CANN POLYTI,2940.0,1911.0,1061.34,1061.34,3
CDM,27810810_OP,W SCREW MIS CANN POLYTI,2940.0,1911.0,1911.0,2881.2,6
CDM,27810820,W SCREW MIS SINGLE INNER,387.0,251.55,65.02,348.3,20
CDM,27810820_IP,W SCREW MIS SINGLE INNER,387.0,251.55,139.71,139.71,3
CDM,27810820_OP,W SCREW MIS SINGLE INNER,387.0,251.55,251.55,379.26,6
CDM,27810830,W SCREW MTP FUSION 16MM,94.0,61.1,15.79,84.6,20
CDM,27810830_IP,W SCREW MTP FUSION 16MM,94.0,61.1,33.93,33.93,3
CDM,27810830_OP,W SCREW MTP FUSION 16MM,94.0,61.1,61.1,92.12,6
CDM,27810840,W SCREW MTP FUSION HEX CHAROLET,190.0,123.5,31.92,171.0,20
CDM,27810840_IP,W SCREW MTP FUSION HEX CHAROLET,190.0,123.5,68.59,68.59,3
CDM,27810840_OP,W SCREW MTP FUSION HEX CHAROLET,190.0,123.5,123.5,186.2,6
CDM,27810850,W SCREW MULT COMP 4.3MM,720.0,468.0,120.96,648.0,20
CDM,27810850_IP,W SCREW MULT COMP 4.3MM,720.0,468.0,259.92,259.92,3
CDM,27810850_OP,W SCREW MULT COMP 4.3MM,720.0,468.0,468.0,705.6,6
CDM,27810860,W SCREW MULT COMPR 3X30MM,600.0,390.0,100.8,540.0,20
CDM,27810860_IP,W SCREW MULT COMPR 3X30MM,600.0,390.0,216.6,216.6,3
CDM,27810860_OP,W SCREW MULT COMPR 3X30MM,600.0,390.0,390.0,588.0,6
CDM,27810870,W SCREW MULT SPINE MEDT GRP 17,2474.0,1608.1,415.63,2226.6,23
CDM,27810870_IP,W SCREW MULT SPINE MEDT GRP 17,2474.0,1608.1,893.11,893.11,3
CDM,27810870_OP,W SCREW MULT SPINE MEDT GRP 17,2474.0,1608.1,1608.1,2424.52,6
CDM,27810880,W SCREW OC 4.5,200.0,130.0,33.6,180.0,20
CDM,27810880_IP,W SCREW OC 4.5,200.0,130.0,72.2,72.2,3
CDM,27810880_OP,W SCREW OC 4.5,200.0,130.0,130.0,196.0,6
CDM,27810890,W SCREW OMEGA+ LAG 80MM,523.0,339.95,87.86,470.7,20
CDM,27810890_IP,W SCREW OMEGA+ LAG 80MM,523.0,339.95,188.8,188.8,3
CDM,27810890_OP,W SCREW OMEGA+ LAG 80MM,523.0,339.95,339.95,512.54,6
CDM,27810900,W SCREW OSTEOLOCK BONE GRP 21,143.0,92.95,24.02,128.7,20
CDM,27810900_IP,W SCREW OSTEOLOCK BONE GRP 21,143.0,92.95,51.62,51.62,3
CDM,27810900_OP,W SCREW OSTEOLOCK BONE GRP 21,143.0,92.95,92.95,140.14,6
CDM,27810910,W SCREW PEDCL MA PROTEX,2614.0,1699.1,439.15,2352.6,23
CDM,27810910_IP,W SCREW PEDCL MA PROTEX,2614.0,1699.1,943.65,943.65,3
CDM,27810910_OP,W SCREW PEDCL MA PROTEX,2614.0,1699.1,1699.1,2561.72,6
CDM,27810920,W SCREW PEG FULL THREAD 2.5MM,173.0,112.45,29.06,155.7,20
CDM,27810920_IP,W SCREW PEG FULL THREAD 2.5MM,173.0,112.45,62.45,62.45,3
CDM,27810920_OP,W SCREW PEG FULL THREAD 2.5MM,173.0,112.45,112.45,169.54,6
CDM,27810930,W SCREW PIVOT PA PEDICLE 6X35MM,1618.0,1051.7,271.82,1456.2,20
CDM,27810930_IP,W SCREW PIVOT PA PEDICLE 6X35MM,1618.0,1051.7,584.1,584.1,3
CDM,27810930_OP,W SCREW PIVOT PA PEDICLE 6X35MM,1618.0,1051.7,1051.7,1585.64,6
CDM,27810940,W SCREW PIVOT PEDICLE PA,3816.0,2480.4,641.09,3434.4,23
CDM,27810940_IP,W SCREW PIVOT PEDICLE PA,3816.0,2480.4,1377.58,1377.58,3
CDM,27810940_OP,W SCREW PIVOT PEDICLE PA,3816.0,2480.4,2480.4,3739.68,6
CDM,27810950,W SCREW PLT 6.5MM GAP II,30.0,19.5,5.04,27.0,20
CDM,27810950_IP,W SCREW PLT 6.5MM GAP II,30.0,19.5,10.83,10.83,3
CDM,27810950_OP,W SCREW PLT 6.5MM GAP II,30.0,19.5,19.5,29.4,6
CDM,27810960,W SCREW RETRO STL 20MM,358.0,232.7,60.14,322.2,20
CDM,27810960_IP,W SCREW RETRO STL 20MM,358.0,232.7,129.24,129.24,3
CDM,27810960_OP,W SCREW RETRO STL 20MM,358.0,232.7,232.7,350.84,6
CDM,27810970,W SCREW REV 4.5MM CAN LOCKING,300.0,195.0,50.4,270.0,20
CDM,27810970_IP,W SCREW REV 4.5MM CAN LOCKING,300.0,195.0,108.3,108.3,3
CDM,27810970_OP,W SCREW REV 4.5MM CAN LOCKING,300.0,195.0,195.0,294.0,6
CDM,27810980,W SCREW RND BIO-INTERFERENCE,358.0,232.7,60.14,322.2,20
CDM,27810980_IP,W SCREW RND BIO-INTERFERENCE,358.0,232.7,129.24,129.24,3
CDM,27810980_OP,W SCREW RND BIO-INTERFERENCE,358.0,232.7,232.7,350.84,6
CDM,27810990,W SCREW SCHANZ 6.2,1100.0,715.0,184.8,990.0,20
CDM,27810990_IP,W SCREW SCHANZ 6.2,1100.0,715.0,397.1,397.1,3
CDM,27810990_OP,W SCREW SCHANZ 6.2,1100.0,715.0,715.0,1078.0,6
CDM,27810WE,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,2128.0,1383.2,260.51,1596.0,35
CDM,27811000,W SCREW SCHANZ 80MM 294.30,158.0,102.7,26.54,142.2,20
CDM,27811000_IP,W SCREW SCHANZ 80MM 294.30,158.0,102.7,57.04,57.04,3
CDM,27811000_OP,W SCREW SCHANZ 80MM 294.30,158.0,102.7,102.7,154.84,6
CDM,27811010,W SCREW SELF DRILLING 1.5X5MM,94.0,61.1,15.79,84.6,20
CDM,27811010_IP,W SCREW SELF DRILLING 1.5X5MM,94.0,61.1,33.93,33.93,3
CDM,27811010_OP,W SCREW SELF DRILLING 1.5X5MM,94.0,61.1,61.1,92.12,6
CDM,27811020,W SCREW SELFTAP 1.5 X 5MM,70.0,45.5,11.76,63.0,20
CDM,27811020_IP,W SCREW SELFTAP 1.5 X 5MM,70.0,45.5,25.27,25.27,3
CDM,27811020_OP,W SCREW SELFTAP 1.5 X 5MM,70.0,45.5,45.5,68.6,6
CDM,27811030,W SCREW SET EXP 635 TI SI,106.0,68.9,17.81,95.4,20
CDM,27811030_IP,W SCREW SET EXP 635 TI SI,106.0,68.9,38.27,38.27,3
CDM,27811030_OP,W SCREW SET EXP 635 TI SI,106.0,68.9,68.9,103.88,6
CDM,27811040,W SCREW SET HEX FIX,28.0,18.2,4.7,25.2,20
CDM,27811040_IP,W SCREW SET HEX FIX,28.0,18.2,10.11,10.11,3
CDM,27811040_OP,W SCREW SET HEX FIX,28.0,18.2,18.2,27.44,6
CDM,27811050,W SCREW SET HEX W/G4,410.0,266.5,68.88,369.0,20
CDM,27811050_IP,W SCREW SET HEX W/G4,410.0,266.5,148.01,148.01,3
CDM,27811050_OP,W SCREW SET HEX W/G4,410.0,266.5,266.5,401.8,6
CDM,27811060,W SCREW SHAFT 3.5MMX26MM,36.0,23.4,6.05,32.4,20
CDM,27811060_IP,W SCREW SHAFT 3.5MMX26MM,36.0,23.4,13.0,13.0,3
CDM,27811060_OP,W SCREW SHAFT 3.5MMX26MM,36.0,23.4,23.4,35.28,6
CDM,27811070,W SCREW SKY VARIABLE S-D/LRG-D,500.0,325.0,84.0,450.0,20
CDM,27811070_IP,W SCREW SKY VARIABLE S-D/LRG-D,500.0,325.0,180.5,180.5,3
CDM,27811070_OP,W SCREW SKY VARIABLE S-D/LRG-D,500.0,325.0,325.0,490.0,6
CDM,27811080,W SCREW SLF TAP X-PIN 2.7X12MM,31.0,20.15,5.21,27.9,20
CDM,27811080_IP,W SCREW SLF TAP X-PIN 2.7X12MM,31.0,20.15,11.19,11.19,3
CDM,27811080_OP,W SCREW SLF TAP X-PIN 2.7X12MM,31.0,20.15,20.15,30.38,6
CDM,27811090,W SCREW SLFTP LOW PROF,144.0,93.6,24.19,129.6,20
CDM,27811090_IP,W SCREW SLFTP LOW PROF,144.0,93.6,51.98,51.98,3
CDM,27811090_OP,W SCREW SLFTP LOW PROF,144.0,93.6,93.6,141.12,6
CDM,27811100,W SCREW SPINE MEDT GRP 1,50.0,32.5,8.4,45.0,20
CDM,27811100_IP,W SCREW SPINE MEDT GRP 1,50.0,32.5,18.05,18.05,3
CDM,27811100_OP,W SCREW SPINE MEDT GRP 1,50.0,32.5,32.5,49.0,6
CDM,27811110,W SCREW SPINE MEDT GRP 12,1250.0,812.5,210.0,1125.0,20
CDM,27811110_IP,W SCREW SPINE MEDT GRP 12,1250.0,812.5,451.25,451.25,3
CDM,27811110_OP,W SCREW SPINE MEDT GRP 12,1250.0,812.5,812.5,1225.0,6
CDM,27811120,W SCREW SPINE MEDT GRP 13,1280.0,832.0,215.04,1152.0,20
CDM,27811120_IP,W SCREW SPINE MEDT GRP 13,1280.0,832.0,462.08,462.08,3
CDM,27811120_OP,W SCREW SPINE MEDT GRP 13,1280.0,832.0,832.0,1254.4,6
CDM,27811130,W SCREW SPINE MEDT GRP 3,500.0,325.0,84.0,450.0,20
CDM,27811130_IP,W SCREW SPINE MEDT GRP 3,500.0,325.0,180.5,180.5,3
CDM,27811130_OP,W SCREW SPINE MEDT GRP 3,500.0,325.0,325.0,490.0,6
CDM,27811140,W SCREW SPINE STRY GRP 2,500.0,325.0,84.0,450.0,20
CDM,27811140_IP,W SCREW SPINE STRY GRP 2,500.0,325.0,180.5,180.5,3
CDM,27811140_OP,W SCREW SPINE STRY GRP 2,500.0,325.0,325.0,490.0,6
CDM,27811150,W SCREW SPINE STRY GRP 7,1000.0,650.0,168.0,900.0,20
CDM,27811150_IP,W SCREW SPINE STRY GRP 7,1000.0,650.0,361.0,361.0,3
CDM,27811150_OP,W SCREW SPINE STRY GRP 7,1000.0,650.0,650.0,980.0,6
CDM,27811160,W SCREW SPINE STRY GRP 9,1200.0,780.0,201.6,1080.0,20
CDM,27811160_IP,W SCREW SPINE STRY GRP 9,1200.0,780.0,433.2,433.2,3
CDM,27811160_OP,W SCREW SPINE STRY GRP 9,1200.0,780.0,780.0,1176.0,6
CDM,27811170,W SCREW SQ TORQ DEFINING KT,884.0,574.6,148.51,795.6,20
CDM,27811170_IP,W SCREW SQ TORQ DEFINING KT,884.0,574.6,319.12,319.12,3
CDM,27811170_OP,W SCREW SQ TORQ DEFINING KT,884.0,574.6,574.6,866.32,6
CDM,27811180,W SCREW SS MONO SPN GLOB GRP 5,1050.0,682.5,176.4,945.0,20
CDM,27811180_IP,W SCREW SS MONO SPN GLOB GRP 5,1050.0,682.5,379.05,379.05,3
CDM,27811180_OP,W SCREW SS MONO SPN GLOB GRP 5,1050.0,682.5,682.5,1029.0,6
CDM,27811190,W SCREW STARDRVE RECSS/LK SLFTP,278.0,180.7,46.7,250.2,20
CDM,27811190_IP,W SCREW STARDRVE RECSS/LK SLFTP,278.0,180.7,100.36,100.36,3
CDM,27811190_OP,W SCREW STARDRVE RECSS/LK SLFTP,278.0,180.7,180.7,272.44,6
CDM,27811200,W SCREW STRNL LOCK TI,204.0,132.6,34.27,183.6,20
CDM,27811200_IP,W SCREW STRNL LOCK TI,204.0,132.6,73.64,73.64,3
CDM,27811200_OP,W SCREW STRNL LOCK TI,204.0,132.6,132.6,199.92,6
CDM,27811210,W SCREW SYNAPSE,1180.0,767.0,198.24,1062.0,20
CDM,27811210_IP,W SCREW SYNAPSE,1180.0,767.0,425.98,425.98,3
CDM,27811210_OP,W SCREW SYNAPSE,1180.0,767.0,767.0,1156.4,6
CDM,27811220,W SCREW SYNAPSE LOCKING CAP,20.0,13.0,3.36,18.0,20
CDM,27811220_IP,W SCREW SYNAPSE LOCKING CAP,20.0,13.0,7.22,7.22,3
CDM,27811220_OP,W SCREW SYNAPSE LOCKING CAP,20.0,13.0,13.0,19.6,6
CDM,27811230,W SCREW TI CORTEX 4.5 MM,49.0,31.85,8.23,44.1,20
CDM,27811230_IP,W SCREW TI CORTEX 4.5 MM,49.0,31.85,17.69,17.69,3
CDM,27811230_OP,W SCREW TI CORTEX 4.5 MM,49.0,31.85,31.85,48.02,6
CDM,27811240,W SCREW TI CORTEX SLFTP 3.5MM,52.0,33.8,8.74,46.8,20
CDM,27811240_IP,W SCREW TI CORTEX SLFTP 3.5MM,52.0,33.8,18.77,18.77,3
CDM,27811240_OP,W SCREW TI CORTEX SLFTP 3.5MM,52.0,33.8,33.8,50.96,6
CDM,27811250,W SCREW TI LAG GRP 44,719.0,467.35,120.79,647.1,20
CDM,27811250_IP,W SCREW TI LAG GRP 44,719.0,467.35,259.56,259.56,3
CDM,27811250_OP,W SCREW TI LAG GRP 44,719.0,467.35,467.35,704.62,6
CDM,27811260,W SCREW TITANIUM CORTEX SLFTP,113.0,73.45,18.98,101.7,20
CDM,27811260_IP,W SCREW TITANIUM CORTEX SLFTP,113.0,73.45,40.79,40.79,3
CDM,27811260_OP,W SCREW TITANIUM CORTEX SLFTP,113.0,73.45,73.45,110.74,6
CDM,27811270,W SCREW TITANIUM MATRIX NEURO,84.0,54.6,14.11,75.6,20
CDM,27811270_IP,W SCREW TITANIUM MATRIX NEURO,84.0,54.6,30.32,30.32,3
CDM,27811270_OP,W SCREW TITANIUM MATRIX NEURO,84.0,54.6,54.6,82.32,6
CDM,27811280,W SCREW TSRH SPINE MEDT GRP 7,835.0,542.75,140.28,751.5,20
CDM,27811280_IP,W SCREW TSRH SPINE MEDT GRP 7,835.0,542.75,301.44,301.44,3
CDM,27811280_OP,W SCREW TSRH SPINE MEDT GRP 7,835.0,542.75,542.75,818.3,6
CDM,27811290,W SCREW TWIN FIX 58-30420,536.0,348.4,90.05,482.4,20
CDM,27811290_IP,W SCREW TWIN FIX 58-30420,536.0,348.4,193.5,193.5,3
CDM,27811290_OP,W SCREW TWIN FIX 58-30420,536.0,348.4,348.4,525.28,6
CDM,27811300,W SCREW USS,1060.0,689.0,178.08,954.0,20
CDM,27811300_IP,W SCREW USS,1060.0,689.0,382.66,382.66,3
CDM,27811300_OP,W SCREW USS,1060.0,689.0,689.0,1038.8,6
CDM,27811310,W SCREW VIPER 2 X-TAB 6X50,5370.0,3490.5,902.16,4833.0,29
CDM,27811310_OP,W SCREW VIPER 2 X-TAB 6X50,5370.0,3490.5,3490.5,5262.6,6
CDM,27811320,W SCREW VIPER X-TAB 6X45,3380.0,2197.0,567.84,3042.0,23
CDM,27811320_IP,W SCREW VIPER X-TAB 6X45,3380.0,2197.0,1220.18,1220.18,3
CDM,27811320_OP,W SCREW VIPER X-TAB 6X45,3380.0,2197.0,2197.0,3312.4,6
CDM,27811330,W SCREW W 51CM POLYP SUTURE,550.0,357.5,92.4,495.0,20
CDM,27811330_IP,W SCREW W 51CM POLYP SUTURE,550.0,357.5,198.55,198.55,3
CDM,27811330_OP,W SCREW W 51CM POLYP SUTURE,550.0,357.5,357.5,539.0,6
CDM,27811340,W SCREW XPIN SLFTAP NLOK,137.0,89.05,23.02,123.3,20
CDM,27811340_IP,W SCREW XPIN SLFTAP NLOK,137.0,89.05,49.46,49.46,3
CDM,27811340_OP,W SCREW XPIN SLFTAP NLOK,137.0,89.05,89.05,134.26,6
CDM,27811350,W SCREW XPIN SLFTAP NLOK 1.4,140.0,91.0,23.52,126.0,20
CDM,27811350_IP,W SCREW XPIN SLFTAP NLOK 1.4,140.0,91.0,50.54,50.54,3
CDM,27811350_OP,W SCREW XPIN SLFTAP NLOK 1.4,140.0,91.0,91.0,137.2,6
CDM,27811360,W SCRW ATL/FIX SPN MEDT GRP 10,1050.0,682.5,176.4,945.0,20
CDM,27811360_IP,W SCRW ATL/FIX SPN MEDT GRP 10,1050.0,682.5,379.05,379.05,3
CDM,27811360_OP,W SCRW ATL/FIX SPN MEDT GRP 10,1050.0,682.5,682.5,1029.0,6
CDM,27811370,W SCRW BONE CRTCL LK 3.5 X 14MM,176.0,114.4,29.57,158.4,20
CDM,27811370_IP,W SCRW BONE CRTCL LK 3.5 X 14MM,176.0,114.4,63.54,63.54,3
CDM,27811370_OP,W SCRW BONE CRTCL LK 3.5 X 14MM,176.0,114.4,114.4,172.48,6
CDM,27811380,W SCRW BONE LK RAD 2.7 X 14MM,177.0,115.05,29.74,159.3,20
CDM,27811380_IP,W SCRW BONE LK RAD 2.7 X 14MM,177.0,115.05,63.9,63.9,3
CDM,27811380_OP,W SCRW BONE LK RAD 2.7 X 14MM,177.0,115.05,115.05,173.46,6
CDM,27811390,W SCRW CANN FLL THRD 3.5MMX30MM,386.0,250.9,64.85,347.4,20
CDM,27811390_IP,W SCRW CANN FLL THRD 3.5MMX30MM,386.0,250.9,139.35,139.35,3
CDM,27811390_OP,W SCRW CANN FLL THRD 3.5MMX30MM,386.0,250.9,250.9,378.28,6
CDM,27811410,W SCRW COMPRESS,421.0,273.65,70.73,378.9,20
CDM,27811410_IP,W SCRW COMPRESS,421.0,273.65,151.98,151.98,3
CDM,27811410_OP,W SCRW COMPRESS,421.0,273.65,273.65,412.58,6
CDM,27811420,W SCRW COMPRS/LAG,378.0,245.7,63.5,340.2,20
CDM,27811420_IP,W SCRW COMPRS/LAG,378.0,245.7,136.46,136.46,3
CDM,27811420_OP,W SCRW COMPRS/LAG,378.0,245.7,245.7,370.44,6
CDM,27811450,W SCRW CRUCIATE 3,638.0,414.7,107.18,574.2,20
CDM,27811450_IP,W SCRW CRUCIATE 3,638.0,414.7,230.32,230.32,3
CDM,27811450_OP,W SCRW CRUCIATE 3,638.0,414.7,414.7,625.24,6
CDM,27811460,W SCRW E HIP LAG,606.0,393.9,101.81,545.4,20
CDM,27811460_IP,W SCRW E HIP LAG,606.0,393.9,218.77,218.77,3
CDM,27811460_OP,W SCRW E HIP LAG,606.0,393.9,393.9,593.88,6
CDM,27811470,W SCRW E MALEOLA,89.0,57.85,14.95,80.1,20
CDM,27811470_IP,W SCRW E MALEOLA,89.0,57.85,32.13,32.13,3
CDM,27811470_OP,W SCRW E MALEOLA,89.0,57.85,57.85,87.22,6
CDM,27811480,W SCRW E SCHANZ,232.0,150.8,38.98,208.8,20
CDM,27811480_IP,W SCRW E SCHANZ,232.0,150.8,83.75,83.75,3
CDM,27811480_OP,W SCRW E SCHANZ,232.0,150.8,150.8,227.36,6
CDM,27811490,W SCRW HD/CRNI,289.0,187.85,48.55,260.1,20
CDM,27811490_IP,W SCRW HD/CRNI,289.0,187.85,104.33,104.33,3
CDM,27811490_OP,W SCRW HD/CRNI,289.0,187.85,187.85,283.22,6
CDM,27811500,W SCRW HIP ASNI,159.0,103.35,26.71,143.1,20
CDM,27811500_IP,W SCRW HIP ASNI,159.0,103.35,57.4,57.4,3
CDM,27811500_OP,W SCRW HIP ASNI,159.0,103.35,103.35,155.82,6
CDM,27811510,W SCRW HIP CMP LG,155.0,100.75,26.04,139.5,20
CDM,27811510_IP,W SCRW HIP CMP LG,155.0,100.75,55.96,55.96,3
CDM,27811510_OP,W SCRW HIP CMP LG,155.0,100.75,100.75,151.9,6
CDM,27811520,W SCRW OLECRENON,214.0,139.1,35.95,192.6,20
CDM,27811520_IP,W SCRW OLECRENON,214.0,139.1,77.25,77.25,3
CDM,27811520_OP,W SCRW OLECRENON,214.0,139.1,139.1,209.72,6
CDM,27811530,W SCRW PLY TSRH SPN MEDT GRP 4,750.0,487.5,126.0,675.0,20
CDM,27811530_IP,W SCRW PLY TSRH SPN MEDT GRP 4,750.0,487.5,270.75,270.75,3
CDM,27811530_OP,W SCRW PLY TSRH SPN MEDT GRP 4,750.0,487.5,487.5,735.0,6
CDM,27811540,W SCRW TITAN,360.0,234.0,60.48,324.0,20
CDM,27811540_IP,W SCRW TITAN,360.0,234.0,129.96,129.96,3
CDM,27811540_OP,W SCRW TITAN,360.0,234.0,234.0,352.8,6
CDM,27811550,W SEALANT DURASEAL 20-2050,884.0,574.6,148.51,795.6,21
CDM,27811560,W SECUR-FIT HA XTRA GRP-11,2317.0,1506.05,389.26,2085.3,23
CDM,27811560_IP,W SECUR-FIT HA XTRA GRP-11,2317.0,1506.05,836.44,836.44,3
CDM,27811560_OP,W SECUR-FIT HA XTRA GRP-11,2317.0,1506.05,1506.05,2270.66,6
CDM,27811570,W SFT TISS FIX,518.0,336.7,87.02,466.2,20
CDM,27811570_IP,W SFT TISS FIX,518.0,336.7,187.0,187.0,3
CDM,27811570_OP,W SFT TISS FIX,518.0,336.7,336.7,507.64,6
CDM,27811580,W SHAFT COLPOPEXY STRGHT-IN,210.0,136.5,35.28,189.0,20
CDM,27811580_IP,W SHAFT COLPOPEXY STRGHT-IN,210.0,136.5,75.81,75.81,3
CDM,27811580_OP,W SHAFT COLPOPEXY STRGHT-IN,210.0,136.5,136.5,205.8,6
CDM,27811590,W SHAFT FIBULA RTI,1350.0,877.5,226.8,1215.0,20
CDM,27811590_IP,W SHAFT FIBULA RTI,1350.0,877.5,487.35,487.35,3
CDM,27811590_OP,W SHAFT FIBULA RTI,1350.0,877.5,877.5,1323.0,6
CDM,27811600,W SHAFT STRAIGHT-IN SACRAL 28CM,210.0,136.5,35.28,189.0,20
CDM,27811600_IP,W SHAFT STRAIGHT-IN SACRAL 28CM,210.0,136.5,75.81,75.81,3
CDM,27811600_OP,W SHAFT STRAIGHT-IN SACRAL 28CM,210.0,136.5,136.5,205.8,6
CDM,27811610,W SHELL HEMI CLUSTER HOLE,4390.0,2853.5,737.52,3951.0,23
CDM,27811610_IP,W SHELL HEMI CLUSTER HOLE,4390.0,2853.5,1584.79,1584.79,3
CDM,27811610_OP,W SHELL HEMI CLUSTER HOLE,4390.0,2853.5,2853.5,4302.2,6
CDM,27811620,W SHELL HIP ACTBLR CUP GRP 46,801.0,520.65,134.57,720.9,20
CDM,27811620_IP,W SHELL HIP ACTBLR CUP GRP 46,801.0,520.65,289.16,289.16,3
CDM,27811620_OP,W SHELL HIP ACTBLR CUP GRP 46,801.0,520.65,520.65,784.98,6
CDM,27811630,W SHELL SYS/TRID GRP 98,2099.0,1364.35,352.63,1889.1,23
CDM,27811630_IP,W SHELL SYS/TRID GRP 98,2099.0,1364.35,757.74,757.74,3
CDM,27811630_OP,W SHELL SYS/TRID GRP 98,2099.0,1364.35,1364.35,2057.02,6
CDM,27811640,W SHELL TRI HEMI MULTI GRP 104,2306.0,1498.9,387.41,2075.4,23
CDM,27811640_IP,W SHELL TRI HEMI MULTI GRP 104,2306.0,1498.9,832.47,832.47,3
CDM,27811640_OP,W SHELL TRI HEMI MULTI GRP 104,2306.0,1498.9,1498.9,2259.88,6
CDM,27811650,W SHELL TRIT HEMP GRP 151,6340.0,4121.0,1065.12,5706.0,29
CDM,27811650_OP,W SHELL TRIT HEMP GRP 151,6340.0,4121.0,4121.0,6213.2,6
CDM,27811660,W SHNT CAROTD BYP,249.0,161.85,41.83,224.1,20
CDM,27811660_IP,W SHNT CAROTD BYP,249.0,161.85,89.89,89.89,3
CDM,27811660_OP,W SHNT CAROTD BYP,249.0,161.85,161.85,244.02,6
CDM,27811670,W SHNT CAROTID,388.0,252.2,65.18,349.2,20
CDM,27811670_IP,W SHNT CAROTID,388.0,252.2,140.07,140.07,3
CDM,27811670_OP,W SHNT CAROTID,388.0,252.2,252.2,380.24,6
CDM,27811680,W SHNT LAVEEN,1524.0,990.6,256.03,1371.6,20
CDM,27811680_IP,W SHNT LAVEEN,1524.0,990.6,550.16,550.16,3
CDM,27811680_OP,W SHNT LAVEEN,1524.0,990.6,990.6,1493.52,6
CDM,27811690,W SHNT PERITO-VEN,872.0,566.8,146.5,784.8,20
CDM,27811690_IP,W SHNT PERITO-VEN,872.0,566.8,314.79,314.79,3
CDM,27811690_OP,W SHNT PERITO-VEN,872.0,566.8,566.8,854.56,6
CDM,27811700,W SHNT SUNDT EXT,217.0,141.05,36.46,195.3,20
CDM,27811700_IP,W SHNT SUNDT EXT,217.0,141.05,78.34,78.34,3
CDM,27811700_OP,W SHNT SUNDT EXT,217.0,141.05,141.05,212.66,6
CDM,27811710,W SHNT VALVE FL M,1510.0,981.5,253.68,1359.0,20
CDM,27811710_IP,W SHNT VALVE FL M,1510.0,981.5,545.11,545.11,3
CDM,27811710_OP,W SHNT VALVE FL M,1510.0,981.5,981.5,1479.8,6
CDM,27811720,W SHNT VENTRICLR,307.0,199.55,51.58,276.3,20
CDM,27811720_IP,W SHNT VENTRICLR,307.0,199.55,110.83,110.83,3
CDM,27811720_OP,W SHNT VENTRICLR,307.0,199.55,199.55,300.86,6
CDM,27811730,W SHNT-PERI DENVE,1563.0,1015.95,262.58,1406.7,20
CDM,27811730_IP,W SHNT-PERI DENVE,1563.0,1015.95,564.24,564.24,3
CDM,27811730_OP,W SHNT-PERI DENVE,1563.0,1015.95,1015.95,1531.74,6
CDM,27811740,W SHOULDER HUMRL POLY CUP XTEND,3000.0,1950.0,504.0,2700.0,23
CDM,27811740_IP,W SHOULDER HUMRL POLY CUP XTEND,3000.0,1950.0,1083.0,1083.0,3
CDM,27811740_OP,W SHOULDER HUMRL POLY CUP XTEND,3000.0,1950.0,1950.0,2940.0,6
CDM,27811770,W SHOULDER INTERSPACE KIT W CEM,7800.0,5070.0,1310.4,7020.0,29
CDM,27811770_OP,W SHOULDER INTERSPACE KIT W CEM,7800.0,5070.0,5070.0,7644.0,6
CDM,27811780,W SHUNT,8332.0,5415.8,1399.78,7498.8,29
CDM,27811780_OP,W SHUNT,8332.0,5415.8,5415.8,8165.36,6
CDM,27811790,W SHUNT CAROTID 3 X 4/5MM,600.0,390.0,100.8,540.0,20
CDM,27811790_IP,W SHUNT CAROTID 3 X 4/5MM,600.0,390.0,216.6,216.6,3
CDM,27811790_OP,W SHUNT CAROTID 3 X 4/5MM,600.0,390.0,390.0,588.0,6
CDM,27811800,W SHUNT CSF LUMBOPERITONEAL,1296.0,842.4,217.73,1166.4,20
CDM,27811800_IP,W SHUNT CSF LUMBOPERITONEAL,1296.0,842.4,467.86,467.86,3
CDM,27811800_OP,W SHUNT CSF LUMBOPERITONEAL,1296.0,842.4,842.4,1270.08,6
CDM,27811810,W SILASTIC EYE IMPLANT,21.0,13.65,3.53,18.9,20
CDM,27811810_IP,W SILASTIC EYE IMPLANT,21.0,13.65,7.58,7.58,3
CDM,27811810_OP,W SILASTIC EYE IMPLANT,21.0,13.65,13.65,20.58,6
CDM,27811820,W SLEEVE DM VIT CABLE GRP 29,289.0,187.85,48.55,260.1,20
CDM,27811820_IP,W SLEEVE DM VIT CABLE GRP 29,289.0,187.85,104.33,104.33,3
CDM,27811820_OP,W SLEEVE DM VIT CABLE GRP 29,289.0,187.85,187.85,283.22,6
CDM,27811830,W SLEEVE HRHK TIB GRP 45,774.0,503.1,130.03,696.6,20
CDM,27811830_IP,W SLEEVE HRHK TIB GRP 45,774.0,503.1,279.41,279.41,3
CDM,27811830_OP,W SLEEVE HRHK TIB GRP 45,774.0,503.1,503.1,758.52,6
CDM,27811840,W SLEEVE MED CBL 2.0 6704,385.0,250.25,64.68,346.5,20
CDM,27811840_IP,W SLEEVE MED CBL 2.0 6704,385.0,250.25,138.99,138.99,3
CDM,27811840_OP,W SLEEVE MED CBL 2.0 6704,385.0,250.25,250.25,377.3,6
CDM,27811850,W SLEEVE S-ROM PROX,1506.0,978.9,253.01,1355.4,20
CDM,27811850_IP,W SLEEVE S-ROM PROX,1506.0,978.9,543.67,543.67,3
CDM,27811850_OP,W SLEEVE S-ROM PROX,1506.0,978.9,978.9,1475.88,6
CDM,27811860,W SLEEVE STAB FIXATION 5MM,340.0,221.0,57.12,306.0,20
CDM,27811860_IP,W SLEEVE STAB FIXATION 5MM,340.0,221.0,122.74,122.74,3
CDM,27811860_OP,W SLEEVE STAB FIXATION 5MM,340.0,221.0,221.0,333.2,6
CDM,27811870,W SLEEVE UNITRAX V40 GRP 27,254.0,165.1,42.67,228.6,20
CDM,27811870_IP,W SLEEVE UNITRAX V40 GRP 27,254.0,165.1,91.69,91.69,3
CDM,27811870_OP,W SLEEVE UNITRAX V40 GRP 27,254.0,165.1,165.1,248.92,6
CDM,27811880,W SLEEVE UNIV FEM SZ 34,4046.0,2629.9,679.73,3641.4,23
CDM,27811880_IP,W SLEEVE UNIV FEM SZ 34,4046.0,2629.9,1460.61,1460.61,3
CDM,27811880_OP,W SLEEVE UNIV FEM SZ 34,4046.0,2629.9,2629.9,3965.08,6
CDM,27811890,W SLEEVE VIT BD CBLE SET GRP 40,652.0,423.8,109.54,586.8,20
CDM,27811890_IP,W SLEEVE VIT BD CBLE SET GRP 40,652.0,423.8,235.37,235.37,3
CDM,27811890_OP,W SLEEVE VIT BD CBLE SET GRP 40,652.0,423.8,423.8,638.96,6
CDM,27811900,W SLEEVE VIT CABLE GRP 38,537.0,349.05,90.22,483.3,20
CDM,27811900_IP,W SLEEVE VIT CABLE GRP 38,537.0,349.05,193.86,193.86,3
CDM,27811900_OP,W SLEEVE VIT CABLE GRP 38,537.0,349.05,349.05,526.26,6
CDM,27811910,W SLEEVE VIT CABLE SET GRP 39,613.0,398.45,102.98,551.7,20
CDM,27811910_IP,W SLEEVE VIT CABLE SET GRP 39,613.0,398.45,221.29,221.29,3
CDM,27811910_OP,W SLEEVE VIT CABLE SET GRP 39,613.0,398.45,398.45,600.74,6
CDM,27811920,W SLEEVE&CABLE 3704-0-510 2.0M,820.0,533.0,137.76,738.0,20
CDM,27811920_IP,W SLEEVE&CABLE 3704-0-510 2.0M,820.0,533.0,296.02,296.02,3
CDM,27811920_OP,W SLEEVE&CABLE 3704-0-510 2.0M,820.0,533.0,533.0,803.6,6
CDM,27811930,W SLING ADVANCE MALE,8002.0,5201.3,1344.34,7201.8,29
CDM,27811930_OP,W SLING ADVANCE MALE,8002.0,5201.3,5201.3,7841.96,6
CDM,27811940,W SLING BIOARC SYSTEM,3000.0,1950.0,504.0,2700.0,23
CDM,27811940_IP,W SLING BIOARC SYSTEM,3000.0,1950.0,1083.0,1083.0,3
CDM,27811940_OP,W SLING BIOARC SYSTEM,3000.0,1950.0,1950.0,2940.0,6
CDM,27811950,W SLING FEMALE ISTOP IS-5,1390.0,903.5,233.52,1251.0,20
CDM,27811950_IP,W SLING FEMALE ISTOP IS-5,1390.0,903.5,501.79,501.79,3
CDM,27811950_OP,W SLING FEMALE ISTOP IS-5,1390.0,903.5,903.5,1362.2,6
CDM,27811960,W SLING MALE INVANCE,9300.0,6045.0,1562.4,8370.0,29
CDM,27811960_OP,W SLING MALE INVANCE,9300.0,6045.0,6045.0,9114.0,6
CDM,27811970,W SLING MINIARC,2520.0,1638.0,423.36,2268.0,23
CDM,27811970_IP,W SLING MINIARC,2520.0,1638.0,909.72,909.72,3
CDM,27811970_OP,W SLING MINIARC,2520.0,1638.0,1638.0,2469.6,6
CDM,27811980,W SLING MONARC,1700.0,1105.0,285.6,1530.0,20
CDM,27811980_IP,W SLING MONARC,1700.0,1105.0,613.7,613.7,3
CDM,27811980_OP,W SLING MONARC,1700.0,1105.0,1105.0,1666.0,6
CDM,27811990,W SLING TRANSOBTURATOR ARIS,1600.0,1040.0,268.8,1440.0,20
CDM,27811990_IP,W SLING TRANSOBTURATOR ARIS,1600.0,1040.0,577.6,577.6,3
CDM,27811990_OP,W SLING TRANSOBTURATOR ARIS,1600.0,1040.0,1040.0,1568.0,6
CDM,27812000,W SLING TRANSPLAST FASCA 2X12CM,1187.0,771.55,199.42,1068.3,20
CDM,27812000_IP,W SLING TRANSPLAST FASCA 2X12CM,1187.0,771.55,428.51,428.51,3
CDM,27812000_OP,W SLING TRANSPLAST FASCA 2X12CM,1187.0,771.55,771.55,1163.26,6
CDM,27812010,W SLING TRANSPLAST FASCA 4X7CM,1319.0,857.35,221.59,1187.1,20
CDM,27812010_IP,W SLING TRANSPLAST FASCA 4X7CM,1319.0,857.35,476.16,476.16,3
CDM,27812010_OP,W SLING TRANSPLAST FASCA 4X7CM,1319.0,857.35,857.35,1292.62,6
CDM,27812020,W SLING TVT DEVICE 810041B,1709.0,1110.85,287.11,1538.1,20
CDM,27812020_IP,W SLING TVT DEVICE 810041B,1709.0,1110.85,616.95,616.95,3
CDM,27812020_OP,W SLING TVT DEVICE 810041B,1709.0,1110.85,1110.85,1674.82,6
CDM,27812030,W SOLUSTAPLE 8MM,368.0,239.2,61.82,331.2,20
CDM,27812030_IP,W SOLUSTAPLE 8MM,368.0,239.2,132.85,132.85,3
CDM,27812030_OP,W SOLUSTAPLE 8MM,368.0,239.2,239.2,360.64,6
CDM,27812040,W SPACER ANTERIOR ALIF,8820.0,5733.0,1481.76,7938.0,29
CDM,27812040_OP,W SPACER ANTERIOR ALIF,8820.0,5733.0,5733.0,8643.6,6
CDM,27812050,W SPACER DIST ACCO C 14MM,10.0,6.5,1.68,9.0,20
CDM,27812050_IP,W SPACER DIST ACCO C 14MM,10.0,6.5,3.61,3.61,3
CDM,27812050_OP,W SPACER DIST ACCO C 14MM,10.0,6.5,6.5,9.8,6
CDM,27812060,W SPACER DURA FULL XLG GRP 64,1116.0,725.4,187.49,1004.4,20
CDM,27812060_IP,W SPACER DURA FULL XLG GRP 64,1116.0,725.4,402.88,402.88,3
CDM,27812060_OP,W SPACER DURA FULL XLG GRP 64,1116.0,725.4,725.4,1093.68,6
CDM,27812070,W SPACER DURA TIB LT FLT GRP 63,1114.0,724.1,187.15,1002.6,20
CDM,27812070_IP,W SPACER DURA TIB LT FLT GRP 63,1114.0,724.1,402.15,402.15,3
CDM,27812070_OP,W SPACER DURA TIB LT FLT GRP 63,1114.0,724.1,724.1,1091.72,6
CDM,27812080,W SPACER DURA TIB WDG GRP 61,1062.0,690.3,178.42,955.8,20
CDM,27812080_IP,W SPACER DURA TIB WDG GRP 61,1062.0,690.3,383.38,383.38,3
CDM,27812080_OP,W SPACER DURA TIB WDG GRP 61,1062.0,690.3,690.3,1040.76,6
CDM,27812090,W SPACER FRA SMALL STATURE,6150.0,3997.5,1033.2,5535.0,29
CDM,27812090_OP,W SPACER FRA SMALL STATURE,6150.0,3997.5,3997.5,6027.0,6
CDM,27812100,W SPACER FRA SPINAL ALLGRFT LAT,7694.0,5001.1,1292.59,6924.6,29
CDM,27812100_OP,W SPACER FRA SPINAL ALLGRFT LAT,7694.0,5001.1,5001.1,7540.12,6
CDM,27812110,W SPACER FRA SPINAL ALLGRFT PRL,6150.0,3997.5,1033.2,5535.0,29
CDM,27812110_OP,W SPACER FRA SPINAL ALLGRFT PRL,6150.0,3997.5,3997.5,6027.0,6
CDM,27812120,W SPACER FRA SPINAL ALLOGRAFT,7336.0,4768.4,1232.45,6602.4,29
CDM,27812120_OP,W SPACER FRA SPINAL ALLOGRAFT,7336.0,4768.4,4768.4,7189.28,6
CDM,27812130,W SPACER HUM DXTEND +9MM,2237.0,1454.05,375.82,2013.3,23
CDM,27812130_IP,W SPACER HUM DXTEND +9MM,2237.0,1454.05,807.56,807.56,3
CDM,27812130_OP,W SPACER HUM DXTEND +9MM,2237.0,1454.05,1454.05,2192.26,6
CDM,27812140,W SPACER INTERSPACE HIP 46MM,5980.0,3887.0,1004.64,5382.0,29
CDM,27812140_OP,W SPACER INTERSPACE HIP 46MM,5980.0,3887.0,3887.0,5860.4,6
CDM,27812150,W SPACER LORDOTIC ALLOGRAFT ACF,2110.0,1371.5,354.48,1899.0,23
CDM,27812150_IP,W SPACER LORDOTIC ALLOGRAFT ACF,2110.0,1371.5,761.71,761.71,3
CDM,27812150_OP,W SPACER LORDOTIC ALLOGRAFT ACF,2110.0,1371.5,1371.5,2067.8,6
CDM,27812160,W SPACER LORDTC ADVANCED ACF,2720.0,1768.0,456.96,2448.0,23
CDM,27812160_IP,W SPACER LORDTC ADVANCED ACF,2720.0,1768.0,981.92,981.92,3
CDM,27812160_OP,W SPACER LORDTC ADVANCED ACF,2720.0,1768.0,1768.0,2665.6,6
CDM,27812170,W SPACER OSTEO UNV DSTL GRP 13,10.0,6.5,1.68,9.0,20
CDM,27812170_IP,W SPACER OSTEO UNV DSTL GRP 13,10.0,6.5,3.61,3.61,3
CDM,27812170_OP,W SPACER OSTEO UNV DSTL GRP 13,10.0,6.5,6.5,9.8,6
CDM,27812180,W SPACER PLIF FD,5272.0,3426.8,885.7,4744.8,29
CDM,27812180_OP,W SPACER PLIF FD,5272.0,3426.8,3426.8,5166.56,6
CDM,27812190,W SPACER POST FEM GRP 62,1063.0,690.95,178.58,956.7,20
CDM,27812190_IP,W SPACER POST FEM GRP 62,1063.0,690.95,383.74,383.74,3
CDM,27812190_OP,W SPACER POST FEM GRP 62,1063.0,690.95,690.95,1041.74,6
CDM,27812200,W SPACER SCRPIO TS WDG GRP 93,1887.0,1226.55,317.02,1698.3,23
CDM,27812200_IP,W SPACER SCRPIO TS WDG GRP 93,1887.0,1226.55,681.21,681.21,3
CDM,27812200_OP,W SPACER SCRPIO TS WDG GRP 93,1887.0,1226.55,1226.55,1849.26,6
CDM,27812210,W SPACER SPINE STRY GRP 10,5000.0,3250.0,840.0,4500.0,26
CDM,27812210_OP,W SPACER SPINE STRY GRP 10,5000.0,3250.0,3250.0,4900.0,6
CDM,27812220,W SPACER T-PLIF FD,8946.0,5814.9,1502.93,8051.4,29
CDM,27812220_OP,W SPACER T-PLIF FD,8946.0,5814.9,5814.9,8767.08,6
CDM,27812230,W SPCR BMRG SPINE MEDT GRP 21,8883.0,5773.95,1492.34,7994.7,29
CDM,27812230_OP,W SPCR BMRG SPINE MEDT GRP 21,8883.0,5773.95,5773.95,8705.34,6
CDM,27812240,W SPHINCTER ARTIFICIAL BOWEL,1400.0,910.0,235.2,1260.0,20
CDM,27812240_IP,W SPHINCTER ARTIFICIAL BOWEL,1400.0,910.0,505.4,505.4,3
CDM,27812240_OP,W SPHINCTER ARTIFICIAL BOWEL,1400.0,910.0,910.0,1372.0,6
CDM,27812280,W STAB TOTAL STAB FEM GRP 148,6042.0,3927.3,1015.06,5437.8,29
CDM,27812280_OP,W STAB TOTAL STAB FEM GRP 148,6042.0,3927.3,3927.3,5921.16,6
CDM,27812290,W STABILIZATION SYSTEM AXIALIF,16630.0,10809.5,2793.84,14967.0,29
CDM,27812290_OP,W STABILIZATION SYSTEM AXIALIF,16630.0,10809.5,10809.5,16297.4,6
CDM,27812300,W STABILIZER FEMUR COMP,7336.0,4768.4,1232.45,6602.4,29
CDM,27812300_OP,W STABILIZER FEMUR COMP,7336.0,4768.4,4768.4,7189.28,6
CDM,27812310,W STAPLE 2PRG SPN MEDT GRP 16,2337.0,1519.05,392.62,2103.3,23
CDM,27812310_IP,W STAPLE 2PRG SPN MEDT GRP 16,2337.0,1519.05,843.66,843.66,3
CDM,27812310_OP,W STAPLE 2PRG SPN MEDT GRP 16,2337.0,1519.05,1519.05,2290.26,6
CDM,27812320,W STAPLE ATL SPINE MEDT GRP 9,1000.0,650.0,168.0,900.0,20
CDM,27812320_IP,W STAPLE ATL SPINE MEDT GRP 9,1000.0,650.0,361.0,361.0,3
CDM,27812320_OP,W STAPLE ATL SPINE MEDT GRP 9,1000.0,650.0,650.0,980.0,6
CDM,27812330,W STAPLE COMPRESSION CHARLOTTE,434.0,282.1,72.91,390.6,20
CDM,27812330_IP,W STAPLE COMPRESSION CHARLOTTE,434.0,282.1,156.67,156.67,3
CDM,27812330_OP,W STAPLE COMPRESSION CHARLOTTE,434.0,282.1,282.1,425.32,6
CDM,27812340,W STAPLE SPINE XIA II ANTER TI,1228.0,798.2,206.3,1105.2,20
CDM,27812340_IP,W STAPLE SPINE XIA II ANTER TI,1228.0,798.2,443.31,443.31,3
CDM,27812340_OP,W STAPLE SPINE XIA II ANTER TI,1228.0,798.2,798.2,1203.44,6
CDM,27812350,W STAPLE TITANIUM 6.2MM,1000.0,650.0,168.0,900.0,20
CDM,27812350_IP,W STAPLE TITANIUM 6.2MM,1000.0,650.0,361.0,361.0,3
CDM,27812350_OP,W STAPLE TITANIUM 6.2MM,1000.0,650.0,650.0,980.0,6
CDM,27812360,W STAPLES PISTON MCGEE .5X4.25,276.0,179.4,46.37,248.4,20
CDM,27812360_IP,W STAPLES PISTON MCGEE .5X4.25,276.0,179.4,99.64,99.64,3
CDM,27812360_OP,W STAPLES PISTON MCGEE .5X4.25,276.0,179.4,179.4,270.48,6
CDM,27812370,W STBLZR DURA MONO FM STB GRP42,680.0,442.0,114.24,612.0,20
CDM,27812370_IP,W STBLZR DURA MONO FM STB GRP42,680.0,442.0,245.48,245.48,3
CDM,27812370_OP,W STBLZR DURA MONO FM STB GRP42,680.0,442.0,442.0,666.4,6
CDM,27812380,W STEM ACCOLADE OFFSET,2537.0,1649.05,426.22,2283.3,23
CDM,27812380_IP,W STEM ACCOLADE OFFSET,2537.0,1649.05,915.86,915.86,3
CDM,27812380_OP,W STEM ACCOLADE OFFSET,2537.0,1649.05,1649.05,2486.26,6
CDM,27812390,W STEM BOW CONICAL GRP 149,6260.0,4069.0,1051.68,5634.0,29
CDM,27812390_OP,W STEM BOW CONICAL GRP 149,6260.0,4069.0,4069.0,6134.8,6
CDM,27812400,W STEM CMNTD DEF PM HIP GRP 79,1456.0,946.4,244.61,1310.4,20
CDM,27812400_IP,W STEM CMNTD DEF PM HIP GRP 79,1456.0,946.4,525.62,525.62,3
CDM,27812400_OP,W STEM CMNTD DEF PM HIP GRP 79,1456.0,946.4,946.4,1426.88,6
CDM,27812410,W STEM CORAIL2 NON COL HO,4302.0,2796.3,722.74,3871.8,23
CDM,27812410_IP,W STEM CORAIL2 NON COL HO,4302.0,2796.3,1553.02,1553.02,3
CDM,27812410_OP,W STEM CORAIL2 NON COL HO,4302.0,2796.3,2796.3,4215.96,6
CDM,27812420,W STEM DIS BOW-PLS GRP 131,4604.0,2992.6,773.47,4143.6,23
CDM,27812420_IP,W STEM DIS BOW-PLS GRP 131,4604.0,2992.6,1662.04,1662.04,3
CDM,27812420_OP,W STEM DIS BOW-PLS GRP 131,4604.0,2992.6,2992.6,4511.92,6
CDM,27812430,W STEM DIST BOWED PLSM GRP 129,4385.0,2850.25,736.68,3946.5,23
CDM,27812430_IP,W STEM DIST BOWED PLSM GRP 129,4385.0,2850.25,1582.99,1582.99,3
CDM,27812430_OP,W STEM DIST BOWED PLSM GRP 129,4385.0,2850.25,2850.25,4297.3,6
CDM,27812440,W STEM EQNX HMRAL PRESS FIT,3000.0,1950.0,504.0,2700.0,23
CDM,27812440_IP,W STEM EQNX HMRAL PRESS FIT,3000.0,1950.0,1083.0,1083.0,3
CDM,27812440_OP,W STEM EQNX HMRAL PRESS FIT,3000.0,1950.0,1950.0,2940.0,6
CDM,27812450,W STEM EXTNDR X155MM GRP 59,1038.0,674.7,174.38,934.2,20
CDM,27812450_IP,W STEM EXTNDR X155MM GRP 59,1038.0,674.7,374.72,374.72,3
CDM,27812450_OP,W STEM EXTNDR X155MM GRP 59,1038.0,674.7,674.7,1017.24,6
CDM,27812460,W STEM EXTNDR X80MM GRP 58,1027.0,667.55,172.54,924.3,20
CDM,27812460_IP,W STEM EXTNDR X80MM GRP 58,1027.0,667.55,370.75,370.75,3
CDM,27812460_OP,W STEM EXTNDR X80MM GRP 58,1027.0,667.55,667.55,1006.46,6
CDM,27812470,W STEM FEMORAL ACCOLADE C CMNT,1456.0,946.4,244.61,1310.4,20
CDM,27812470_IP,W STEM FEMORAL ACCOLADE C CMNT,1456.0,946.4,525.62,525.62,3
CDM,27812470_OP,W STEM FEMORAL ACCOLADE C CMNT,1456.0,946.4,946.4,1426.88,6
CDM,27812480,W STEM FEMORAL CORAIL2 STD,4302.0,2796.3,722.74,3871.8,23
CDM,27812480_IP,W STEM FEMORAL CORAIL2 STD,4302.0,2796.3,1553.02,1553.02,3
CDM,27812480_OP,W STEM FEMORAL CORAIL2 STD,4302.0,2796.3,2796.3,4215.96,6
CDM,27812490,W STEM FLTD TRIATHLON PRESSFIT,1446.0,939.9,242.93,1301.4,20
CDM,27812490_IP,W STEM FLTD TRIATHLON PRESSFIT,1446.0,939.9,522.01,522.01,3
CDM,27812490_OP,W STEM FLTD TRIATHLON PRESSFIT,1446.0,939.9,939.9,1417.08,6
CDM,27812500,W STEM FLTED EXTND X155MM GRP74,1269.0,824.85,213.19,1142.1,20
CDM,27812500_IP,W STEM FLTED EXTND X155MM GRP74,1269.0,824.85,458.11,458.11,3
CDM,27812500_OP,W STEM FLTED EXTND X155MM GRP74,1269.0,824.85,824.85,1243.62,6
CDM,27812510,W STEM FLUTED X80MM GRP 72,1257.0,817.05,211.18,1131.3,20
CDM,27812510_IP,W STEM FLUTED X80MM GRP 72,1257.0,817.05,453.78,453.78,3
CDM,27812510_OP,W STEM FLUTED X80MM GRP 72,1257.0,817.05,817.05,1231.86,6
CDM,27812520,W STEM HEAD/NECT HIP GRP 124,4105.0,2668.25,689.64,3694.5,23
CDM,27812520_IP,W STEM HEAD/NECT HIP GRP 124,4105.0,2668.25,1481.91,1481.91,3
CDM,27812520_OP,W STEM HEAD/NECT HIP GRP 124,4105.0,2668.25,2668.25,4022.9,6
CDM,27812530,W STEM HIP ACCOLADE TMZF,3066.0,1992.9,515.09,2759.4,23
CDM,27812530_IP,W STEM HIP ACCOLADE TMZF,3066.0,1992.9,1106.83,1106.83,3
CDM,27812530_OP,W STEM HIP ACCOLADE TMZF,3066.0,1992.9,1992.9,3004.68,6
CDM,27812540,W STEM HIP FEM MRDIAN GRP 105,2466.0,1602.9,414.29,2219.4,23
CDM,27812540_IP,W STEM HIP FEM MRDIAN GRP 105,2466.0,1602.9,890.23,890.23,3
CDM,27812540_OP,W STEM HIP FEM MRDIAN GRP 105,2466.0,1602.9,1602.9,2416.68,6
CDM,27812550,W STEM HUM MOD DXTEND D10 HA,2132.0,1385.8,358.18,1918.8,23
CDM,27812550_IP,W STEM HUM MOD DXTEND D10 HA,2132.0,1385.8,769.65,769.65,3
CDM,27812550_OP,W STEM HUM MOD DXTEND D10 HA,2132.0,1385.8,1385.8,2089.36,6
CDM,27812560,W STEM HUMERAL AFFINITI STD,5000.0,3250.0,840.0,4500.0,26
CDM,27812560_OP,W STEM HUMERAL AFFINITI STD,5000.0,3250.0,3250.0,4900.0,6
CDM,27812570,W STEM HUMERAL REV/FX CEMENTED,5000.0,3250.0,840.0,4500.0,26
CDM,27812570_OP,W STEM HUMERAL REV/FX CEMENTED,5000.0,3250.0,3250.0,4900.0,6
CDM,27812580,W STEM MERDN/ACCLD GRP 115,3066.0,1992.9,515.09,2759.4,23
CDM,27812580_IP,W STEM MERDN/ACCLD GRP 115,3066.0,1992.9,1106.83,1106.83,3
CDM,27812580_OP,W STEM MERDN/ACCLD GRP 115,3066.0,1992.9,1992.9,3004.68,6
CDM,27812590,W STEM MOD CON DIST GRP 144,5398.0,3508.7,906.86,4858.2,29
CDM,27812590_OP,W STEM MOD CON DIST GRP 144,5398.0,3508.7,3508.7,5290.04,6
CDM,27812600,W STEM MOD FLUTED GRP 116,3179.0,2066.35,534.07,2861.1,23
CDM,27812600_IP,W STEM MOD FLUTED GRP 116,3179.0,2066.35,1147.62,1147.62,3
CDM,27812600_OP,W STEM MOD FLUTED GRP 116,3179.0,2066.35,2066.35,3115.42,6
CDM,27812610,W STEM MOD FLUTED X167MM GRP117,3398.0,2208.7,570.86,3058.2,23
CDM,27812610_IP,W STEM MOD FLUTED X167MM GRP117,3398.0,2208.7,1226.68,1226.68,3
CDM,27812610_OP,W STEM MOD FLUTED X167MM GRP117,3398.0,2208.7,2208.7,3330.04,6
CDM,27812620,W STEM MRS GRP 146,5778.0,3755.7,970.7,5200.2,29
CDM,27812620_OP,W STEM MRS GRP 146,5778.0,3755.7,3755.7,5662.44,6
CDM,27812630,W STEM MRS WO BODY GRP 125,4184.0,2719.6,702.91,3765.6,23
CDM,27812630_IP,W STEM MRS WO BODY GRP 125,4184.0,2719.6,1510.42,1510.42,3
CDM,27812630_OP,W STEM MRS WO BODY GRP 125,4184.0,2719.6,2719.6,4100.32,6
CDM,27812640,W STEM MRS X203 FEMORAL GRP 155,7554.0,4910.1,1269.07,6798.6,29
CDM,27812640_OP,W STEM MRS X203 FEMORAL GRP 155,7554.0,4910.1,4910.1,7402.92,6
CDM,27812650,W STEM OMIFIT CMNTD EON GRP111,2789.0,1812.85,468.55,2510.1,23
CDM,27812650_IP,W STEM OMIFIT CMNTD EON GRP111,2789.0,1812.85,1006.83,1006.83,3
CDM,27812650_OP,W STEM OMIFIT CMNTD EON GRP111,2789.0,1812.85,1812.85,2733.22,6
CDM,27812660,W STEM OMNFIT CEM LONG GRP 150,6262.0,4070.3,1052.02,5635.8,29
CDM,27812660_OP,W STEM OMNFIT CEM LONG GRP 150,6262.0,4070.3,4070.3,6136.76,6
CDM,27812670,W STEM OMNIFIT HD/NK LG GRP 145,5637.0,3664.05,947.02,5073.3,29
CDM,27812670_OP,W STEM OMNIFIT HD/NK LG GRP 145,5637.0,3664.05,3664.05,5524.26,6
CDM,27812680,W STEM PRS FIT BOWED GRP 162,8568.0,5569.2,1439.42,7711.2,29
CDM,27812680_OP,W STEM PRS FIT BOWED GRP 162,8568.0,5569.2,5569.2,8396.64,6
CDM,27812690,W STEM PRS FIT FLTD STM GRP 159,8128.0,5283.2,1365.5,7315.2,29
CDM,27812690_OP,W STEM PRS FIT FLTD STM GRP 159,8128.0,5283.2,5283.2,7965.44,6
CDM,27812700,W STEM REL CM DRG HIP GRP 16,56.0,36.4,9.41,50.4,20
CDM,27812700_IP,W STEM REL CM DRG HIP GRP 16,56.0,36.4,20.22,20.22,3
CDM,27812700_OP,W STEM REL CM DRG HIP GRP 16,56.0,36.4,36.4,54.88,6
CDM,27812710,W STEM RELIANCE PF HIP GRP 17,66.0,42.9,11.09,59.4,20
CDM,27812710_IP,W STEM RELIANCE PF HIP GRP 17,66.0,42.9,23.83,23.83,3
CDM,27812710_OP,W STEM RELIANCE PF HIP GRP 17,66.0,42.9,42.9,64.68,6
CDM,27812720,W STEM REST MHS GRP 135,4874.0,3168.1,818.83,4386.6,26
CDM,27812720_OP,W STEM REST MHS GRP 135,4874.0,3168.1,3168.1,4776.52,6
CDM,27812730,W STEM S-ROM MOD HIP,2000.0,1300.0,336.0,1800.0,23
CDM,27812730_IP,W STEM S-ROM MOD HIP,2000.0,1300.0,722.0,722.0,3
CDM,27812730_OP,W STEM S-ROM MOD HIP,2000.0,1300.0,1300.0,1960.0,6
CDM,27812740,W STEM TRI CEMENTED KNEE GRP 76,1304.0,847.6,219.07,1173.6,20
CDM,27812740_IP,W STEM TRI CEMENTED KNEE GRP 76,1304.0,847.6,470.74,470.74,3
CDM,27812740_OP,W STEM TRI CEMENTED KNEE GRP 76,1304.0,847.6,847.6,1277.92,6
CDM,27812750,W STEM TRIATH CEMENTED 15X50,1304.0,847.6,219.07,1173.6,20
CDM,27812750_IP,W STEM TRIATH CEMENTED 15X50,1304.0,847.6,470.74,470.74,3
CDM,27812750_OP,W STEM TRIATH CEMENTED 15X50,1304.0,847.6,847.6,1277.92,6
CDM,27812760,W STEM UNIV FLUTED DPY,1957.0,1272.05,328.78,1761.3,23
CDM,27812760_IP,W STEM UNIV FLUTED DPY,1957.0,1272.05,706.48,706.48,3
CDM,27812760_OP,W STEM UNIV FLUTED DPY,1957.0,1272.05,1272.05,1917.86,6
CDM,27812770,W STENT AAA BIFUR 22F 36X95MM,16424.0,10675.6,2759.23,14781.6,29
CDM,27812770_OP,W STENT AAA BIFUR 22F 36X95MM,16424.0,10675.6,10675.6,16095.52,6
CDM,27812780,W STENT AAA EXT LEG 14 X 56MM,5992.0,3894.8,1006.66,5392.8,29
CDM,27812780_OP,W STENT AAA EXT LEG 14 X 56MM,5992.0,3894.8,3894.8,5872.16,6
CDM,27812790,W STENT ABSLT BILRY SLF-EXPDNG,2150.0,1397.5,361.2,1935.0,23
CDM,27812790_IP,W STENT ABSLT BILRY SLF-EXPDNG,2150.0,1397.5,776.15,776.15,3
CDM,27812790_OP,W STENT ABSLT BILRY SLF-EXPDNG,2150.0,1397.5,1397.5,2107.0,6
CDM,27812800,W STENT AERO BRONCHIAL 10X20MM,3600.0,2340.0,604.8,3240.0,23
CDM,27812800_IP,W STENT AERO BRONCHIAL 10X20MM,3600.0,2340.0,1299.6,1299.6,3
CDM,27812800_OP,W STENT AERO BRONCHIAL 10X20MM,3600.0,2340.0,2340.0,3528.0,6
CDM,27812810,W STENT AORTIC EXT 28X28X29MM,6152.0,3998.8,1033.54,5536.8,29
CDM,27812810_OP,W STENT AORTIC EXT 28X28X29MM,6152.0,3998.8,3998.8,6028.96,6
CDM,27812820,W STENT AORTIC EXT 32X32X28MM,6750.0,4387.5,1134.0,6075.0,29
CDM,27812820_OP,W STENT AORTIC EXT 32X32X28MM,6750.0,4387.5,4387.5,6615.0,6
CDM,27812830,W STENT AORTIC EXT 36X36X26MM,7350.0,4777.5,1234.8,6615.0,29
CDM,27812830_OP,W STENT AORTIC EXT 36X36X26MM,7350.0,4777.5,4777.5,7203.0,6
CDM,27812840,W STENT BIFUR GRFT 24X14X140MM,17500.0,11375.0,2940.0,15750.0,29
CDM,27812840_OP,W STENT BIFUR GRFT 24X14X140MM,17500.0,11375.0,11375.0,17150.0,6
CDM,27812850,W STENT BIFUR GRFT 26X18X140MM,18200.0,11830.0,3057.6,16380.0,29
CDM,27812850_OP,W STENT BIFUR GRFT 26X18X140MM,18200.0,11830.0,11830.0,17836.0,6
CDM,27812860,W STENT BIFUR GRFT 28X16X140MM,17500.0,11375.0,2940.0,15750.0,29
CDM,27812860_OP,W STENT BIFUR GRFT 28X16X140MM,17500.0,11375.0,11375.0,17150.0,6
CDM,27812870,W STENT BIFUR GRFT 30X14X140MM,19100.0,12415.0,3208.8,17190.0,29
CDM,27812870_OP,W STENT BIFUR GRFT 30X14X140MM,19100.0,12415.0,12415.0,18718.0,6
CDM,27812880,W STENT BIFUR GRFT 30X16X170MM,18500.0,12025.0,3108.0,16650.0,29
CDM,27812880_OP,W STENT BIFUR GRFT 30X16X170MM,18500.0,12025.0,12025.0,18130.0,6
CDM,27812890,W STENT BIFUR GRFT 32X16X155MM,18700.0,12155.0,3141.6,16830.0,29
CDM,27812890_OP,W STENT BIFUR GRFT 32X16X155MM,18700.0,12155.0,12155.0,18326.0,6
CDM,27812900,W STENT BIFUR GRFT 32X16X155MM,18100.0,11765.0,3040.8,16290.0,29
CDM,27812900_OP,W STENT BIFUR GRFT 32X16X155MM,18100.0,11765.0,11765.0,17738.0,6
CDM,27812910,W STENT BIFUR GRFT 34X16X170MM,19100.0,12415.0,3208.8,17190.0,29
CDM,27812910_OP,W STENT BIFUR GRFT 34X16X170MM,19100.0,12415.0,12415.0,18718.0,6
CDM,27812920,W STENT BIFUR GRFT 36X18X155MM,18700.0,12155.0,3141.6,16830.0,29
CDM,27812920_OP,W STENT BIFUR GRFT 36X18X155MM,18700.0,12155.0,12155.0,18326.0,6
CDM,27812930,W STENT BILAIRY ZIMMON,79.0,51.35,13.27,71.1,20
CDM,27812930_IP,W STENT BILAIRY ZIMMON,79.0,51.35,28.52,28.52,3
CDM,27812930_OP,W STENT BILAIRY ZIMMON,79.0,51.35,51.35,77.42,6
CDM,27812940,W STENT BILIARY LUMINEXX,2000.0,1300.0,336.0,1800.0,23
CDM,27812940_IP,W STENT BILIARY LUMINEXX,2000.0,1300.0,722.0,722.0,3
CDM,27812940_OP,W STENT BILIARY LUMINEXX,2000.0,1300.0,1300.0,1960.0,6
CDM,27812950,W STENT BILIARY XPERT,2800.0,1820.0,470.4,2520.0,23
CDM,27812950_IP,W STENT BILIARY XPERT,2800.0,1820.0,1010.8,1010.8,3
CDM,27812950_OP,W STENT BILIARY XPERT,2800.0,1820.0,1820.0,2744.0,6
CDM,27812960,W STENT BILIARY ZIMMON,211.0,137.15,35.45,189.9,20
CDM,27812960_IP,W STENT BILIARY ZIMMON,211.0,137.15,76.17,76.17,3
CDM,27812960_OP,W STENT BILIARY ZIMMON,211.0,137.15,137.15,206.78,6
CDM,27812970,W STENT BRONCHIAL ULTRAFLEX COV,5119.0,3327.35,859.99,4607.1,26
CDM,27812970_OP,W STENT BRONCHIAL ULTRAFLEX COV,5119.0,3327.35,3327.35,5016.62,6
CDM,27812980,W STENT COR ELUT,3840.0,2496.0,645.12,3456.0,23
CDM,27812980_IP,W STENT COR ELUT,3840.0,2496.0,1386.24,1386.24,3
CDM,27812980_OP,W STENT COR ELUT,3840.0,2496.0,2496.0,3763.2,6
CDM,27812990,W STENT CORONARY ABBT,1324.0,860.6,222.43,1191.6,20
CDM,27812990_IP,W STENT CORONARY ABBT,1324.0,860.6,477.96,477.96,3
CDM,27812990_OP,W STENT CORONARY ABBT,1324.0,860.6,860.6,1297.52,6
CDM,27813000,W STENT COVERED 80CM ICAST PTFE,3500.0,2275.0,588.0,3150.0,23
CDM,27813000_IP,W STENT COVERED 80CM ICAST PTFE,3500.0,2275.0,1263.5,1263.5,3
CDM,27813000_OP,W STENT COVERED 80CM ICAST PTFE,3500.0,2275.0,2275.0,3430.0,6
CDM,27813010,W STENT COVERED W DEL SYS GORE,6570.0,4270.5,1103.76,5913.0,29
CDM,27813010_OP,W STENT COVERED W DEL SYS GORE,6570.0,4270.5,4270.5,6438.6,6
CDM,27813020,W STENT CYPHER RX,2900.0,1885.0,487.2,2610.0,23
CDM,27813020_IP,W STENT CYPHER RX,2900.0,1885.0,1046.9,1046.9,3
CDM,27813020_OP,W STENT CYPHER RX,2900.0,1885.0,1885.0,2842.0,6
CDM,27813030,W STENT DES XIENCE,2958.0,1922.7,496.94,2662.2,23
CDM,27813030_IP,W STENT DES XIENCE,2958.0,1922.7,1067.84,1067.84,3
CDM,27813030_OP,W STENT DES XIENCE,2958.0,1922.7,1922.7,2898.84,6
CDM,27813040,W STENT ENDOPROS 23X12MMX14CM,16330.0,10614.5,2743.44,14697.0,29
CDM,27813040_OP,W STENT ENDOPROS 23X12MMX14CM,16330.0,10614.5,10614.5,16003.4,6
CDM,27813045,PIPELINE EMBOLIZATION DEVICE,24000.0,15600.0,4032.0,21600.0,29
CDM,27813045_OP,PIPELINE EMBOLIZATION DEVICE,24000.0,15600.0,15600.0,23520.0,6
CDM,27813050,W STENT ENDOPROS 26X14.5MMX16CM,15558.0,10112.7,2613.74,14002.2,29
CDM,27813050_OP,W STENT ENDOPROS 26X14.5MMX16CM,15558.0,10112.7,10112.7,15246.84,6
CDM,27813060,W STENT ESOPHAGEAL,3960.0,2574.0,665.28,3564.0,23
CDM,27813060_IP,W STENT ESOPHAGEAL,3960.0,2574.0,1429.56,1429.56,3
CDM,27813060_OP,W STENT ESOPHAGEAL,3960.0,2574.0,2574.0,3880.8,6
CDM,27813070,W STENT EXPRESS LD BILIARY,1750.0,1137.5,294.0,1575.0,23
CDM,27813070_IP,W STENT EXPRESS LD BILIARY,1750.0,1137.5,631.75,631.75,3
CDM,27813070_OP,W STENT EXPRESS LD BILIARY,1750.0,1137.5,1137.5,1715.0,6
CDM,27813080,W STENT EXPRESS SD BILIARY,1800.0,1170.0,302.4,1620.0,23
CDM,27813080_IP,W STENT EXPRESS SD BILIARY,1800.0,1170.0,649.8,649.8,3
CDM,27813080_OP,W STENT EXPRESS SD BILIARY,1800.0,1170.0,1170.0,1764.0,6
CDM,27813090,W STENT GRAFT 6MM 10X120CM,6100.0,3965.0,1024.8,5490.0,29
CDM,27813090_OP,W STENT GRAFT 6MM 10X120CM,6100.0,3965.0,3965.0,5978.0,6
CDM,27813100,W STENT GRAFT ANEURX,10570.0,6870.5,1775.76,9513.0,29
CDM,27813100_OP,W STENT GRAFT ANEURX,10570.0,6870.5,6870.5,10358.6,6
CDM,27813110,W STENT GRAFT ENDPRSTHESIS 10CM,5780.0,3757.0,971.04,5202.0,29
CDM,27813110_OP,W STENT GRAFT ENDPRSTHESIS 10CM,5780.0,3757.0,3757.0,5664.4,6
CDM,27813120,W STENT GRAFT ENDPRSTHESIS 15CM,6780.0,4407.0,1139.04,6102.0,29
CDM,27813120_OP,W STENT GRAFT ENDPRSTHESIS 15CM,6780.0,4407.0,4407.0,6644.4,6
CDM,27813130,W STENT GRAFT FLUENCY,3990.0,2593.5,670.32,3591.0,23
CDM,27813130_IP,W STENT GRAFT FLUENCY,3990.0,2593.5,1440.39,1440.39,3
CDM,27813130_OP,W STENT GRAFT FLUENCY,3990.0,2593.5,2593.5,3910.2,6
CDM,27813140,W STENT GRAFT VIABAHN END 120CM,6920.0,4498.0,1162.56,6228.0,29
CDM,27813140_OP,W STENT GRAFT VIABAHN END 120CM,6920.0,4498.0,4498.0,6781.6,6
CDM,27813150,W STENT GRAFT VIABIL BILIARY,4740.0,3081.0,796.32,4266.0,23
CDM,27813150_IP,W STENT GRAFT VIABIL BILIARY,4740.0,3081.0,1711.14,1711.14,3
CDM,27813150_OP,W STENT GRAFT VIABIL BILIARY,4740.0,3081.0,3081.0,4645.2,6
CDM,27813160,W STENT GRAFT VIATORR ENDOPRTHS,7536.0,4898.4,1266.05,6782.4,29
CDM,27813160_OP,W STENT GRAFT VIATORR ENDOPRTHS,7536.0,4898.4,4898.4,7385.28,6
CDM,27813170,W STENT GRAFT W/XCELERANT,4800.0,3120.0,806.4,4320.0,26
CDM,27813170_OP,W STENT GRAFT W/XCELERANT,4800.0,3120.0,3120.0,4704.0,6
CDM,27813180,W STENT GRFT 14X24X105,9050.0,5882.5,1520.4,8145.0,29
CDM,27813180_OP,W STENT GRFT 14X24X105,9050.0,5882.5,5882.5,8869.0,6
CDM,27813190,W STENT GRFT ABD/ILIAC EXTN,7950.0,5167.5,1335.6,7155.0,29
CDM,27813190_OP,W STENT GRFT ABD/ILIAC EXTN,7950.0,5167.5,5167.5,7791.0,6
CDM,27813200,W STENT GRFT ABDM 18X10X80,8650.0,5622.5,1453.2,7785.0,29
CDM,27813200_OP,W STENT GRFT ABDM 18X10X80,8650.0,5622.5,5622.5,8477.0,6
CDM,27813210,W STENT GRFT CONT LIMB 14X16X75,7550.0,4907.5,1268.4,6795.0,29
CDM,27813210_OP,W STENT GRFT CONT LIMB 14X16X75,7550.0,4907.5,4907.5,7399.0,6
CDM,27813220,W STENT GRFT CONTRA LIMB 105MM,8350.0,5427.5,1402.8,7515.0,29
CDM,27813220_OP,W STENT GRFT CONTRA LIMB 105MM,8350.0,5427.5,5427.5,8183.0,6
CDM,27813230,W STENT GRFT CONTRAL LIMB 90MM,8650.0,5622.5,1453.2,7785.0,29
CDM,27813230_OP,W STENT GRFT CONTRAL LIMB 90MM,8650.0,5622.5,5622.5,8477.0,6
CDM,27813240,W STENT GRFT ILIAC 18X12X80MM,8950.0,5817.5,1503.6,8055.0,29
CDM,27813240_OP,W STENT GRFT ILIAC 18X12X80MM,8950.0,5817.5,5817.5,8771.0,6
CDM,27813250,W STENT GRFT MAIN BODY BIFUR,16424.0,10675.6,2759.23,14781.6,29
CDM,27813250_OP,W STENT GRFT MAIN BODY BIFUR,16424.0,10675.6,10675.6,16095.52,6
CDM,27813260,W STENT GRFT XCELERANT AAA,8250.0,5362.5,1386.0,7425.0,29
CDM,27813260_OP,W STENT GRFT XCELERANT AAA,8250.0,5362.5,5362.5,8085.0,6
CDM,27813270,W STENT ICAST PTFE COVERED,3500.0,2275.0,588.0,3150.0,23
CDM,27813270_IP,W STENT ICAST PTFE COVERED,3500.0,2275.0,1263.5,1263.5,3
CDM,27813270_OP,W STENT ICAST PTFE COVERED,3500.0,2275.0,2275.0,3430.0,6
CDM,27813280,W STENT JOSTENT OTW,4790.0,3113.5,804.72,4311.0,26
CDM,27813280_OP,W STENT JOSTENT OTW,4790.0,3113.5,3113.5,4694.2,6
CDM,27813290,W STENT LIFE FLEXSTAR SELF EXP,1850.0,1202.5,310.8,1665.0,23
CDM,27813290_IP,W STENT LIFE FLEXSTAR SELF EXP,1850.0,1202.5,667.85,667.85,3
CDM,27813290_OP,W STENT LIFE FLEXSTAR SELF EXP,1850.0,1202.5,1202.5,1813.0,6
CDM,27813300,W STENT LUMINEXX 3 BILIARY,2200.0,1430.0,369.6,1980.0,23
CDM,27813300_IP,W STENT LUMINEXX 3 BILIARY,2200.0,1430.0,794.2,794.2,3
CDM,27813300_OP,W STENT LUMINEXX 3 BILIARY,2200.0,1430.0,1430.0,2156.0,6
CDM,27813310,W STENT LUMINEXX BILIARY,2200.0,1430.0,369.6,1980.0,23
CDM,27813310_IP,W STENT LUMINEXX BILIARY,2200.0,1430.0,794.2,794.2,3
CDM,27813310_OP,W STENT LUMINEXX BILIARY,2200.0,1430.0,1430.0,2156.0,6
CDM,27813340,W STENT PRECISE PRO RX NITINOL,4400.0,2860.0,739.2,3960.0,23
CDM,27813340_IP,W STENT PRECISE PRO RX NITINOL,4400.0,2860.0,1588.4,1588.4,3
CDM,27813340_OP,W STENT PRECISE PRO RX NITINOL,4400.0,2860.0,2860.0,4312.0,6
CDM,27813350,W STENT RX BILIARY SET,186.0,120.9,31.25,167.4,20
CDM,27813350_IP,W STENT RX BILIARY SET,186.0,120.9,67.15,67.15,3
CDM,27813350_OP,W STENT RX BILIARY SET,186.0,120.9,120.9,182.28,6
CDM,27813360,W STENT SELF EXPND FLEXSTAR XL,2700.0,1755.0,453.6,2430.0,23
CDM,27813360_IP,W STENT SELF EXPND FLEXSTAR XL,2700.0,1755.0,974.7,974.7,3
CDM,27813360_OP,W STENT SELF EXPND FLEXSTAR XL,2700.0,1755.0,1755.0,2646.0,6
CDM,27813370,W STENT SENTINEL 7X59X1350,1600.0,1040.0,268.8,1440.0,20
CDM,27813370_IP,W STENT SENTINEL 7X59X1350,1600.0,1040.0,577.6,577.6,3
CDM,27813370_OP,W STENT SENTINEL 7X59X1350,1600.0,1040.0,1040.0,1568.0,6
CDM,27813380,W STENT SMART BILIARY 120MM,2400.0,1560.0,403.2,2160.0,23
CDM,27813380_IP,W STENT SMART BILIARY 120MM,2400.0,1560.0,866.4,866.4,3
CDM,27813380_OP,W STENT SMART BILIARY 120MM,2400.0,1560.0,1560.0,2352.0,6
CDM,27813390,W STENT SMART BILIARY 150MM,2600.0,1690.0,436.8,2340.0,23
CDM,27813390_IP,W STENT SMART BILIARY 150MM,2600.0,1690.0,938.6,938.6,3
CDM,27813390_OP,W STENT SMART BILIARY 150MM,2600.0,1690.0,1690.0,2548.0,6
CDM,27813400,W STENT SMART BILIARY/ILIAC,1650.0,1072.5,277.2,1485.0,20
CDM,27813400_IP,W STENT SMART BILIARY/ILIAC,1650.0,1072.5,595.65,595.65,3
CDM,27813400_OP,W STENT SMART BILIARY/ILIAC,1650.0,1072.5,1072.5,1617.0,6
CDM,27813410,W STENT TAXUS,3000.0,1950.0,504.0,2700.0,23
CDM,27813410_IP,W STENT TAXUS,3000.0,1950.0,1083.0,1083.0,3
CDM,27813410_OP,W STENT TAXUS,3000.0,1950.0,1950.0,2940.0,6
CDM,27813420,W STENT TRACHEOBRONCHIAL,4000.0,2600.0,672.0,3600.0,23
CDM,27813420_IP,W STENT TRACHEOBRONCHIAL,4000.0,2600.0,1444.0,1444.0,3
CDM,27813420_OP,W STENT TRACHEOBRONCHIAL,4000.0,2600.0,2600.0,3920.0,6
CDM,27813430,W STENT ULTRAFLEX,3780.0,2457.0,635.04,3402.0,23
CDM,27813430_IP,W STENT ULTRAFLEX,3780.0,2457.0,1364.58,1364.58,3
CDM,27813430_OP,W STENT ULTRAFLEX,3780.0,2457.0,2457.0,3704.4,6
CDM,27813440,W STENT ULTRAFLEX ESOPHAG METAL,3140.0,2041.0,527.52,2826.0,23
CDM,27813440_IP,W STENT ULTRAFLEX ESOPHAG METAL,3140.0,2041.0,1133.54,1133.54,3
CDM,27813440_OP,W STENT ULTRAFLEX ESOPHAG METAL,3140.0,2041.0,2041.0,3077.2,6
CDM,27813450,W STENT ULTRAFLEX TRACHEOBRNCHL,3500.0,2275.0,588.0,3150.0,23
CDM,27813450_IP,W STENT ULTRAFLEX TRACHEOBRNCHL,3500.0,2275.0,1263.5,1263.5,3
CDM,27813450_OP,W STENT ULTRAFLEX TRACHEOBRNCHL,3500.0,2275.0,2275.0,3430.0,6
CDM,27813460,W STENT UR DIVERSION 7FR 90CM,260.0,169.0,43.68,234.0,20
CDM,27813460_IP,W STENT UR DIVERSION 7FR 90CM,260.0,169.0,93.86,93.86,3
CDM,27813460_OP,W STENT UR DIVERSION 7FR 90CM,260.0,169.0,169.0,254.8,6
CDM,27813470,W STENT URETH POLARIS,406.0,263.9,68.21,365.4,20
CDM,27813470_IP,W STENT URETH POLARIS,406.0,263.9,146.57,146.57,3
CDM,27813470_OP,W STENT URETH POLARIS,406.0,263.9,263.9,397.88,6
CDM,27813480,W STENT VIABAHN VBH061502,7120.0,4628.0,1196.16,6408.0,29
CDM,27813480_OP,W STENT VIABAHN VBH061502,7120.0,4628.0,4628.0,6977.6,6
CDM,27813490,W STENT WALL 5570/5580/5590,3380.0,2197.0,567.84,3042.0,23
CDM,27813490_IP,W STENT WALL 5570/5580/5590,3380.0,2197.0,1220.18,1220.18,3
CDM,27813490_OP,W STENT WALL 5570/5580/5590,3380.0,2197.0,2197.0,3312.4,6
CDM,27813500,W STENT WALL PERMALUNE,3700.0,2405.0,621.6,3330.0,23
CDM,27813500_IP,W STENT WALL PERMALUNE,3700.0,2405.0,1335.7,1335.7,3
CDM,27813500_OP,W STENT WALL PERMALUNE,3700.0,2405.0,2405.0,3626.0,6
CDM,27813510,W STENT WALLFLEX BILIARY,3190.0,2073.5,535.92,2871.0,23
CDM,27813510_IP,W STENT WALLFLEX BILIARY,3190.0,2073.5,1151.59,1151.59,3
CDM,27813510_OP,W STENT WALLFLEX BILIARY,3190.0,2073.5,2073.5,3126.2,6
CDM,27813520,W STENT WALLFLEX BILIARY,3700.0,2405.0,621.6,3330.0,23
CDM,27813520_IP,W STENT WALLFLEX BILIARY,3700.0,2405.0,1335.7,1335.7,3
CDM,27813520_OP,W STENT WALLFLEX BILIARY,3700.0,2405.0,2405.0,3626.0,6
CDM,27813530,W STENT WALLFLEX BILIARY,5557.0,3612.05,933.58,5001.3,29
CDM,27813530_OP,W STENT WALLFLEX BILIARY,5557.0,3612.05,3612.05,5445.86,6
CDM,27813540,W STENT WALLFLEX BILIARY NONCOV,2900.0,1885.0,487.2,2610.0,23
CDM,27813540_IP,W STENT WALLFLEX BILIARY NONCOV,2900.0,1885.0,1046.9,1046.9,3
CDM,27813540_OP,W STENT WALLFLEX BILIARY NONCOV,2900.0,1885.0,1885.0,2842.0,6
CDM,27813550,W STENT WALLFLEX BILIARY/ESOP,3190.0,2073.5,535.92,2871.0,23
CDM,27813550_IP,W STENT WALLFLEX BILIARY/ESOP,3190.0,2073.5,1151.59,1151.59,3
CDM,27813550_OP,W STENT WALLFLEX BILIARY/ESOP,3190.0,2073.5,2073.5,3126.2,6
CDM,27813560,W STENT WALLFLEX COLONIC,3800.0,2470.0,638.4,3420.0,23
CDM,27813560_IP,W STENT WALLFLEX COLONIC,3800.0,2470.0,1371.8,1371.8,3
CDM,27813560_OP,W STENT WALLFLEX COLONIC,3800.0,2470.0,2470.0,3724.0,6
CDM,27813570,W STENT WALLFLEX DUODENAL,3800.0,2470.0,638.4,3420.0,23
CDM,27813570_IP,W STENT WALLFLEX DUODENAL,3800.0,2470.0,1371.8,1371.8,3
CDM,27813570_OP,W STENT WALLFLEX DUODENAL,3800.0,2470.0,2470.0,3724.0,6
CDM,27813580,W STENT WALLFLEX ESOP,3300.0,2145.0,554.4,2970.0,23
CDM,27813580_IP,W STENT WALLFLEX ESOP,3300.0,2145.0,1191.3,1191.3,3
CDM,27813580_OP,W STENT WALLFLEX ESOP,3300.0,2145.0,2145.0,3234.0,6
CDM,27813590,W STENT WALLFLEX ESOP,3590.0,2333.5,603.12,3231.0,23
CDM,27813590_IP,W STENT WALLFLEX ESOP,3590.0,2333.5,1295.99,1295.99,3
CDM,27813590_OP,W STENT WALLFLEX ESOP,3590.0,2333.5,2333.5,3518.2,6
CDM,27813600,W STENT WLLGRFT ENDPRSTHS DLVRY,3200.0,2080.0,537.6,2880.0,23
CDM,27813600_IP,W STENT WLLGRFT ENDPRSTHS DLVRY,3200.0,2080.0,1155.2,1155.2,3
CDM,27813600_OP,W STENT WLLGRFT ENDPRSTHS DLVRY,3200.0,2080.0,2080.0,3136.0,6
CDM,27813610,W STENT XCD BLIRY NTNL SLF-XPND,3000.0,1950.0,504.0,2700.0,23
CDM,27813610_IP,W STENT XCD BLIRY NTNL SLF-XPND,3000.0,1950.0,1083.0,1083.0,3
CDM,27813610_OP,W STENT XCD BLIRY NTNL SLF-XPND,3000.0,1950.0,1950.0,2940.0,6
CDM,27813620,W STM CIT FEM MRDN TMZF GRP112,2866.0,1862.9,481.49,2579.4,23
CDM,27813620_IP,W STM CIT FEM MRDN TMZF GRP112,2866.0,1862.9,1034.63,1034.63,3
CDM,27813620_OP,W STM CIT FEM MRDN TMZF GRP112,2866.0,1862.9,1862.9,2808.68,6
CDM,27813630,W STNT ABSLT BLRY SLF-EXPNDNG,2050.0,1332.5,344.4,1845.0,23
CDM,27813630_IP,W STNT ABSLT BLRY SLF-EXPNDNG,2050.0,1332.5,740.05,740.05,3
CDM,27813630_OP,W STNT ABSLT BLRY SLF-EXPNDNG,2050.0,1332.5,1332.5,2009.0,6
CDM,27813640,W STNT ACCLNK CAROTID RPD EXCH,4100.0,2665.0,688.8,3690.0,23
CDM,27813640_IP,W STNT ACCLNK CAROTID RPD EXCH,4100.0,2665.0,1480.1,1480.1,3
CDM,27813640_OP,W STNT ACCLNK CAROTID RPD EXCH,4100.0,2665.0,2665.0,4018.0,6
CDM,27813650,W STNT AVTR BLLN 135CM PLMZ MED,1600.0,1040.0,268.8,1440.0,20
CDM,27813650_IP,W STNT AVTR BLLN 135CM PLMZ MED,1600.0,1040.0,577.6,577.6,3
CDM,27813650_OP,W STNT AVTR BLLN 135CM PLMZ MED,1600.0,1040.0,1040.0,1568.0,6
CDM,27813660,W STNT B BLN PLMZ,4238.0,2754.7,711.98,3814.2,23
CDM,27813660_IP,W STNT B BLN PLMZ,4238.0,2754.7,1529.92,1529.92,3
CDM,27813660_OP,W STNT B BLN PLMZ,4238.0,2754.7,2754.7,4153.24,6
CDM,27813670,W STNT B PALMAZ,4477.0,2910.05,752.14,4029.3,23
CDM,27813670_IP,W STNT B PALMAZ,4477.0,2910.05,1616.2,1616.2,3
CDM,27813670_OP,W STNT B PALMAZ,4477.0,2910.05,2910.05,4387.46,6
CDM,27813680,W STNT BLN EXP DS,2100.0,1365.0,352.8,1890.0,23
CDM,27813680_IP,W STNT BLN EXP DS,2100.0,1365.0,758.1,758.1,3
CDM,27813680_OP,W STNT BLN EXP DS,2100.0,1365.0,1365.0,2058.0,6
CDM,27813690,W STNT C BXVELOC,4235.0,2752.75,711.48,3811.5,23
CDM,27813690_IP,W STNT C BXVELOC,4235.0,2752.75,1528.84,1528.84,3
CDM,27813690_OP,W STNT C BXVELOC,4235.0,2752.75,2752.75,4150.3,6
CDM,27813700,W STNT C BXVELOC,4235.0,2752.75,711.48,3811.5,23
CDM,27813700_IP,W STNT C BXVELOC,4235.0,2752.75,1528.84,1528.84,3
CDM,27813700_OP,W STNT C BXVELOC,4235.0,2752.75,2752.75,4150.3,6
CDM,27813710,W STNT C BXVELOC,4235.0,2752.75,711.48,3811.5,23
CDM,27813710_IP,W STNT C BXVELOC,4235.0,2752.75,1528.84,1528.84,3
CDM,27813710_OP,W STNT C BXVELOC,4235.0,2752.75,2752.75,4150.3,6
CDM,27813720,W STNT C BXVELOC,4235.0,2752.75,711.48,3811.5,23
CDM,27813720_IP,W STNT C BXVELOC,4235.0,2752.75,1528.84,1528.84,3
CDM,27813720_OP,W STNT C BXVELOC,4235.0,2752.75,2752.75,4150.3,6
CDM,27813730,W STNT C BXVELOC,4235.0,2752.75,711.48,3811.5,23
CDM,27813730_IP,W STNT C BXVELOC,4235.0,2752.75,1528.84,1528.84,3
CDM,27813730_OP,W STNT C BXVELOC,4235.0,2752.75,2752.75,4150.3,6
CDM,27813740,W STNT C BXVELOC,4235.0,2752.75,711.48,3811.5,23
CDM,27813740_IP,W STNT C BXVELOC,4235.0,2752.75,1528.84,1528.84,3
CDM,27813740_OP,W STNT C BXVELOC,4235.0,2752.75,2752.75,4150.3,6
CDM,27813750,W STNT CNTRLT EXCDR BFRCTD END,7182.0,4668.3,1206.58,6463.8,29
CDM,27813750_OP,W STNT CNTRLT EXCDR BFRCTD END,7182.0,4668.3,4668.3,7038.36,6
CDM,27813760,W STNT COAT/COV,2495.0,1621.75,419.16,2245.5,23
CDM,27813760_IP,W STNT COAT/COV,2495.0,1621.75,900.7,900.7,3
CDM,27813760_OP,W STNT COAT/COV,2495.0,1621.75,1621.75,2445.1,6
CDM,27813770,W STNT CRWN PALMZ,2472.0,1606.8,415.3,2224.8,23
CDM,27813770_IP,W STNT CRWN PALMZ,2472.0,1606.8,892.39,892.39,3
CDM,27813770_OP,W STNT CRWN PALMZ,2472.0,1606.8,1606.8,2422.56,6
CDM,27813780,W STNT DBL J,621.0,403.65,104.33,558.9,20
CDM,27813780_IP,W STNT DBL J,621.0,403.65,224.18,224.18,3
CDM,27813780_OP,W STNT DBL J,621.0,403.65,403.65,608.58,6
CDM,27813790,W STNT DBL J URET,679.0,441.35,114.07,611.1,20
CDM,27813790_IP,W STNT DBL J URET,679.0,441.35,245.12,245.12,3
CDM,27813790_OP,W STNT DBL J URET,679.0,441.35,441.35,665.42,6
CDM,27813800,W STNT DBL J URET,1294.0,841.1,217.39,1164.6,20
CDM,27813800_IP,W STNT DBL J URET,1294.0,841.1,467.13,467.13,3
CDM,27813800_OP,W STNT DBL J URET,1294.0,841.1,841.1,1268.12,6
CDM,27813810,W STNT DBL PGTL,182.0,118.3,30.58,163.8,20
CDM,27813810_IP,W STNT DBL PGTL,182.0,118.3,65.7,65.7,3
CDM,27813810_OP,W STNT DBL PGTL,182.0,118.3,118.3,178.36,6
CDM,27813820,W STNT ELITE PM15,4969.0,3229.85,834.79,4472.1,26
CDM,27813820_OP,W STNT ELITE PM15,4969.0,3229.85,3229.85,4869.62,6
CDM,27813830,W STNT ELITE PM25,4969.0,3229.85,834.79,4472.1,26
CDM,27813830_OP,W STNT ELITE PM25,4969.0,3229.85,3229.85,4869.62,6
CDM,27813840,W STNT ELITE PM31,4969.0,3229.85,834.79,4472.1,26
CDM,27813840_OP,W STNT ELITE PM31,4969.0,3229.85,3229.85,4869.62,6
CDM,27813850,W STNT ENDOPYLTMY,3986.0,2590.9,669.65,3587.4,23
CDM,27813850_IP,W STNT ENDOPYLTMY,3986.0,2590.9,1438.95,1438.95,3
CDM,27813850_OP,W STNT ENDOPYLTMY,3986.0,2590.9,2590.9,3906.28,6
CDM,27813860,W STNT HERCULINK BILIARY 135CM,2400.0,1560.0,403.2,2160.0,23
CDM,27813860_IP,W STNT HERCULINK BILIARY 135CM,2400.0,1560.0,866.4,866.4,3
CDM,27813860_OP,W STNT HERCULINK BILIARY 135CM,2400.0,1560.0,1560.0,2352.0,6
CDM,27813870,W STNT MLTLNK TET,5228.0,3398.2,878.3,4705.2,29
CDM,27813870_OP,W STNT MLTLNK TET,5228.0,3398.2,3398.2,5123.44,6
CDM,27813880,W STNT MLTLNK TRI,4248.0,2761.2,713.66,3823.2,23
CDM,27813880_IP,W STNT MLTLNK TRI,4248.0,2761.2,1533.53,1533.53,3
CDM,27813880_OP,W STNT MLTLNK TRI,4248.0,2761.2,2761.2,4163.04,6
CDM,27813890,W STNT NCOAT/COV,4248.0,2761.2,713.66,3823.2,23
CDM,27813890_IP,W STNT NCOAT/COV,4248.0,2761.2,1533.53,1533.53,3
CDM,27813890_OP,W STNT NCOAT/COV,4248.0,2761.2,2761.2,4163.04,6
CDM,27813900,W STNT NCOAT/COV2,1990.0,1293.5,334.32,1791.0,23
CDM,27813900_IP,W STNT NCOAT/COV2,1990.0,1293.5,718.39,718.39,3
CDM,27813900_OP,W STNT NCOAT/COV2,1990.0,1293.5,1293.5,1950.2,6
CDM,27813910,W STNT NCOAT/COV3,1990.0,1293.5,334.32,1791.0,23
CDM,27813910_IP,W STNT NCOAT/COV3,1990.0,1293.5,718.39,718.39,3
CDM,27813910_OP,W STNT NCOAT/COV3,1990.0,1293.5,1293.5,1950.2,6
CDM,27813920,W STNT NCOAT/COV4,2614.0,1699.1,439.15,2352.6,23
CDM,27813920_IP,W STNT NCOAT/COV4,2614.0,1699.1,943.65,943.65,3
CDM,27813920_OP,W STNT NCOAT/COV4,2614.0,1699.1,1699.1,2561.72,6
CDM,27813930,W STNT NEPHR MALC,458.0,297.7,76.94,412.2,20
CDM,27813930_IP,W STNT NEPHR MALC,458.0,297.7,165.34,165.34,3
CDM,27813930_OP,W STNT NEPHR MALC,458.0,297.7,297.7,448.84,6
CDM,27813940,W STNT PERCU SFT,718.0,466.7,120.62,646.2,20
CDM,27813940_IP,W STNT PERCU SFT,718.0,466.7,259.2,259.2,3
CDM,27813940_OP,W STNT PERCU SFT,718.0,466.7,466.7,703.64,6
CDM,27813960,W STNT RENAL,373.0,242.45,62.66,335.7,20
CDM,27813960_IP,W STNT RENAL,373.0,242.45,134.65,134.65,3
CDM,27813960_OP,W STNT RENAL,373.0,242.45,242.45,365.54,6
CDM,27813970,W STNT TAPER RPD EXCH RX ACCLNK,4500.0,2925.0,756.0,4050.0,23
CDM,27813970_IP,W STNT TAPER RPD EXCH RX ACCLNK,4500.0,2925.0,1624.5,1624.5,3
CDM,27813970_OP,W STNT TAPER RPD EXCH RX ACCLNK,4500.0,2925.0,2925.0,4410.0,6
CDM,27813980,W STNT U INLAY DB,425.0,276.25,71.4,382.5,20
CDM,27813980_IP,W STNT U INLAY DB,425.0,276.25,153.43,153.43,3
CDM,27813980_OP,W STNT U INLAY DB,425.0,276.25,276.25,416.5,6
CDM,27813990,W STNT U PERCUFLX,212.0,137.8,35.62,190.8,20
CDM,27813990_IP,W STNT U PERCUFLX,212.0,137.8,76.53,76.53,3
CDM,27813990_OP,W STNT U PERCUFLX,212.0,137.8,137.8,207.76,6
CDM,27814000,W STNT U UROLUME,6137.0,3989.05,1031.02,5523.3,29
CDM,27814000_OP,W STNT U UROLUME,6137.0,3989.05,3989.05,6014.26,6
CDM,27814010,W STNT URETERAL,211.0,137.15,35.45,189.9,20
CDM,27814010_IP,W STNT URETERAL,211.0,137.15,76.17,76.17,3
CDM,27814010_OP,W STNT URETERAL,211.0,137.15,137.15,206.78,6
CDM,27814020,W STNT URETERAL,221.0,143.65,37.13,198.9,20
CDM,27814020_IP,W STNT URETERAL,221.0,143.65,79.78,79.78,3
CDM,27814020_OP,W STNT URETERAL,221.0,143.65,143.65,216.58,6
CDM,27814030,W STNT URETERAL,585.0,380.25,98.28,526.5,20
CDM,27814030_IP,W STNT URETERAL,585.0,380.25,211.19,211.19,3
CDM,27814030_OP,W STNT URETERAL,585.0,380.25,380.25,573.3,6
CDM,27814040,W STNT URETHRAL,382.0,248.3,64.18,343.8,20
CDM,27814040_IP,W STNT URETHRAL,382.0,248.3,137.9,137.9,3
CDM,27814040_OP,W STNT URETHRAL,382.0,248.3,248.3,374.36,6
CDM,27814050,W STNT UROPAS,739.0,480.35,124.15,665.1,20
CDM,27814050_IP,W STNT UROPAS,739.0,480.35,266.78,266.78,3
CDM,27814050_OP,W STNT UROPAS,739.0,480.35,480.35,724.22,6
CDM,27814060,W STNT URTRL TRAC,779.0,506.35,130.87,701.1,20
CDM,27814060_IP,W STNT URTRL TRAC,779.0,506.35,281.22,281.22,3
CDM,27814060_OP,W STNT URTRL TRAC,779.0,506.35,506.35,763.42,6
CDM,27814070,W STNT WALL,4147.0,2695.55,696.7,3732.3,23
CDM,27814070_IP,W STNT WALL,4147.0,2695.55,1497.07,1497.07,3
CDM,27814070_OP,W STNT WALL,4147.0,2695.55,2695.55,4064.06,6
CDM,27814080,W STNT WALL,6318.0,4106.7,1061.42,5686.2,29
CDM,27814080_OP,W STNT WALL,6318.0,4106.7,4106.7,6191.64,6
CDM,27814090,W STNT XCEED NITINL SLF-EXPNDNG,2600.0,1690.0,436.8,2340.0,23
CDM,27814090_IP,W STNT XCEED NITINL SLF-EXPNDNG,2600.0,1690.0,938.6,938.6,3
CDM,27814090_OP,W STNT XCEED NITINL SLF-EXPNDNG,2600.0,1690.0,1690.0,2548.0,6
CDM,27814100,W SUPPORT SYS AVAULTA PLUS ANT,3100.0,2015.0,520.8,2790.0,23
CDM,27814100_IP,W SUPPORT SYS AVAULTA PLUS ANT,3100.0,2015.0,1119.1,1119.1,3
CDM,27814100_OP,W SUPPORT SYS AVAULTA PLUS ANT,3100.0,2015.0,2015.0,3038.0,6
CDM,27814110,W SUTURE ANCHOR BIOCRK FT 5.5MM,3050.0,1982.5,512.4,2745.0,23
CDM,27814110_IP,W SUTURE ANCHOR BIOCRK FT 5.5MM,3050.0,1982.5,1101.05,1101.05,3
CDM,27814110_OP,W SUTURE ANCHOR BIOCRK FT 5.5MM,3050.0,1982.5,1982.5,2989.0,6
CDM,27814120,W SUTURE FIBERTAPE AR-7237,154.0,100.1,25.87,138.6,21
CDM,27814130,W SYS REP TRANSVG,5164.0,3356.6,867.55,4647.6,29
CDM,27814130_OP,W SYS REP TRANSVG,5164.0,3356.6,3356.6,5060.72,6
CDM,27814140,W TAP DYNLK SPN MEDT GRP 14,1756.0,1141.4,295.01,1580.4,23
CDM,27814140_IP,W TAP DYNLK SPN MEDT GRP 14,1756.0,1141.4,633.92,633.92,3
CDM,27814140_OP,W TAP DYNLK SPN MEDT GRP 14,1756.0,1141.4,1141.4,1720.88,6
CDM,27814150,W TAPER HEAD MORSE +5 OFFSET,2296.0,1492.4,385.73,2066.4,23
CDM,27814150_IP,W TAPER HEAD MORSE +5 OFFSET,2296.0,1492.4,828.86,828.86,3
CDM,27814150_OP,W TAPER HEAD MORSE +5 OFFSET,2296.0,1492.4,1492.4,2250.08,6
CDM,27814160,W TENDO-GRAFT,4433.0,2881.45,744.74,3989.7,23
CDM,27814160_IP,W TENDO-GRAFT,4433.0,2881.45,1600.31,1600.31,3
CDM,27814160_OP,W TENDO-GRAFT,4433.0,2881.45,2881.45,4344.34,6
CDM,27814170,W TENDON SPACER,678.0,440.7,113.9,610.2,20
CDM,27814170_IP,W TENDON SPACER,678.0,440.7,244.76,244.76,3
CDM,27814170_OP,W TENDON SPACER,678.0,440.7,440.7,664.44,6
CDM,27814180,W TENDON TIBIALIS BIOCLEANSE,4800.0,3120.0,806.4,4320.0,26
CDM,27814180_OP,W TENDON TIBIALIS BIOCLEANSE,4800.0,3120.0,3120.0,4704.0,6
CDM,27814190,W THR ASR XL HIP,9470.0,6155.5,1590.96,8523.0,29
CDM,27814190_OP,W THR ASR XL HIP,9470.0,6155.5,6155.5,9280.6,6
CDM,27814200,W THR CERAMIC ON CERAMIC HIP,8520.0,5538.0,1431.36,7668.0,29
CDM,27814200_OP,W THR CERAMIC ON CERAMIC HIP,8520.0,5538.0,5538.0,8349.6,6
CDM,27814210,W THR HYBRID HIP,4200.0,2730.0,705.6,3780.0,23
CDM,27814210_IP,W THR HYBRID HIP,4200.0,2730.0,1516.2,1516.2,3
CDM,27814210_OP,W THR HYBRID HIP,4200.0,2730.0,2730.0,4116.0,6
CDM,27814220,W THR HYBRID/HIGH DEMAND HIP,6484.0,4214.6,1089.31,5835.6,29
CDM,27814220_OP,W THR HYBRID/HIGH DEMAND HIP,6484.0,4214.6,4214.6,6354.32,6
CDM,27814230,W THR METAL ON METAL HIP,8500.0,5525.0,1428.0,7650.0,29
CDM,27814230_OP,W THR METAL ON METAL HIP,8500.0,5525.0,5525.0,8330.0,6
CDM,27814240,W THR POROUS HIP,5628.0,3658.2,945.5,5065.2,29
CDM,27814240_OP,W THR POROUS HIP,5628.0,3658.2,3658.2,5515.44,6
CDM,27814250,W THR UNCEMENTED/NEW TECH HIP,6484.0,4214.6,1089.31,5835.6,29
CDM,27814250_OP,W THR UNCEMENTED/NEW TECH HIP,6484.0,4214.6,4214.6,6354.32,6
CDM,27814260,W TI SLEEVE BIOLOX HEAD GRP-5,508.0,330.2,85.34,457.2,20
CDM,27814260_IP,W TI SLEEVE BIOLOX HEAD GRP-5,508.0,330.2,183.39,183.39,3
CDM,27814260_OP,W TI SLEEVE BIOLOX HEAD GRP-5,508.0,330.2,330.2,497.84,6
CDM,27814270,W TIBIA ART SURFACE SZ 3 8 MM,1844.0,1198.6,309.79,1659.6,23
CDM,27814270_IP,W TIBIA ART SURFACE SZ 3 8 MM,1844.0,1198.6,665.68,665.68,3
CDM,27814270_OP,W TIBIA ART SURFACE SZ 3 8 MM,1844.0,1198.6,1198.6,1807.12,6
CDM,27814280,W TIBIA SHORT SPLIT 20.0CM,842.0,547.3,141.46,757.8,20
CDM,27814280_IP,W TIBIA SHORT SPLIT 20.0CM,842.0,547.3,303.96,303.96,3
CDM,27814280_OP,W TIBIA SHORT SPLIT 20.0CM,842.0,547.3,547.3,825.16,6
CDM,27814290,W TIBIAL COMP NEXGEN 59864702,4486.0,2915.9,753.65,4037.4,23
CDM,27814290_IP,W TIBIAL COMP NEXGEN 59864702,4486.0,2915.9,1619.45,1619.45,3
CDM,27814290_OP,W TIBIAL COMP NEXGEN 59864702,4486.0,2915.9,2915.9,4396.28,6
CDM,27814300,W TIBIAL IMPLANT 11MMX30MM,950.0,617.5,159.6,855.0,20
CDM,27814300_IP,W TIBIAL IMPLANT 11MMX30MM,950.0,617.5,342.95,342.95,3
CDM,27814300_OP,W TIBIAL IMPLANT 11MMX30MM,950.0,617.5,617.5,931.0,6
CDM,27814310,W TIBIAL INSERT PLUS X3 POLY TS,2959.0,1923.35,497.11,2663.1,23
CDM,27814310_IP,W TIBIAL INSERT PLUS X3 POLY TS,2959.0,1923.35,1068.2,1068.2,3
CDM,27814310_OP,W TIBIAL INSERT PLUS X3 POLY TS,2959.0,1923.35,1923.35,2899.82,6
CDM,27814320,W TIBIAL INSERT TC3 RP,3075.0,1998.75,516.6,2767.5,23
CDM,27814320_IP,W TIBIAL INSERT TC3 RP,3075.0,1998.75,1110.08,1110.08,3
CDM,27814320_OP,W TIBIAL INSERT TC3 RP,3075.0,1998.75,1998.75,3013.5,6
CDM,27814330,W TIBIAL ML/LT SZ3 LEFT,4348.0,2826.2,730.46,3913.2,23
CDM,27814330_IP,W TIBIAL ML/LT SZ3 LEFT,4348.0,2826.2,1569.63,1569.63,3
CDM,27814330_OP,W TIBIAL ML/LT SZ3 LEFT,4348.0,2826.2,2826.2,4261.04,6
CDM,27814340,W TIBIAL NAIL T2 STANDARD,2032.0,1320.8,341.38,1828.8,23
CDM,27814340_IP,W TIBIAL NAIL T2 STANDARD,2032.0,1320.8,733.55,733.55,3
CDM,27814340_OP,W TIBIAL NAIL T2 STANDARD,2032.0,1320.8,1320.8,1991.36,6
CDM,27814350,W TIBIAL STRUT 25MMX200MM FD,2416.0,1570.4,405.89,2174.4,23
CDM,27814350_IP,W TIBIAL STRUT 25MMX200MM FD,2416.0,1570.4,872.18,872.18,3
CDM,27814350_OP,W TIBIAL STRUT 25MMX200MM FD,2416.0,1570.4,1570.4,2367.68,6
CDM,27814360,W TIP EXTNDR PRECON PENILE PROS,198.0,128.7,33.26,178.2,20
CDM,27814360_IP,W TIP EXTNDR PRECON PENILE PROS,198.0,128.7,71.48,71.48,3
CDM,27814360_OP,W TIP EXTNDR PRECON PENILE PROS,198.0,128.7,128.7,194.04,6
CDM,27814370,W TISS CONN N-HUM,2495.0,1621.75,419.16,2245.5,23
CDM,27814370_IP,W TISS CONN N-HUM,2495.0,1621.75,900.7,900.7,3
CDM,27814370_OP,W TISS CONN N-HUM,2495.0,1621.75,1621.75,2445.1,6
CDM,27814380,W TISS CONN NHUM2,2316.0,1505.4,389.09,2084.4,23
CDM,27814380_IP,W TISS CONN NHUM2,2316.0,1505.4,836.08,836.08,3
CDM,27814380_OP,W TISS CONN NHUM2,2316.0,1505.4,1505.4,2269.68,6
CDM,27814390,W TISSUE AMNIOTIC MEMBRN DRY,1190.0,773.5,199.92,1071.0,20
CDM,27814390_IP,W TISSUE AMNIOTIC MEMBRN DRY,1190.0,773.5,429.59,429.59,3
CDM,27814390_OP,W TISSUE AMNIOTIC MEMBRN DRY,1190.0,773.5,773.5,1166.2,6
CDM,27814400,W TISSUE CONN APOGEE W/INTEXEN,3324.0,2160.6,558.43,2991.6,23
CDM,27814400_IP,W TISSUE CONN APOGEE W/INTEXEN,3324.0,2160.6,1199.96,1199.96,3
CDM,27814400_OP,W TISSUE CONN APOGEE W/INTEXEN,3324.0,2160.6,2160.6,3257.52,6
CDM,27814410,W TISSUE CONN ELEVATE AP/POS,4400.0,2860.0,739.2,3960.0,23
CDM,27814410_IP,W TISSUE CONN ELEVATE AP/POS,4400.0,2860.0,1588.4,1588.4,3
CDM,27814410_OP,W TISSUE CONN ELEVATE AP/POS,4400.0,2860.0,2860.0,4312.0,6
CDM,27814420,W TISSUE CONN PERIGEE W/INTEXEN,3732.0,2425.8,626.98,3358.8,23
CDM,27814420_IP,W TISSUE CONN PERIGEE W/INTEXEN,3732.0,2425.8,1347.25,1347.25,3
CDM,27814420_OP,W TISSUE CONN PERIGEE W/INTEXEN,3732.0,2425.8,2425.8,3657.36,6
CDM,27814430,W TISSUE MEND REPAIR GRP 140,5190.0,3373.5,871.92,4671.0,29
CDM,27814430_OP,W TISSUE MEND REPAIR GRP 140,5190.0,3373.5,3373.5,5086.2,6
CDM,27814440,W TKR CEM PFC HIGHDEMAND KNEE,5136.0,3338.4,862.85,4622.4,26
CDM,27814440_OP,W TKR CEM PFC HIGHDEMAND KNEE,5136.0,3338.4,3338.4,5033.28,6
CDM,27814450,W TKR CEMENTED PFC KNEE,4536.0,2948.4,762.05,4082.4,23
CDM,27814450_IP,W TKR CEMENTED PFC KNEE,4536.0,2948.4,1637.5,1637.5,3
CDM,27814450_OP,W TKR CEMENTED PFC KNEE,4536.0,2948.4,2948.4,4445.28,6
CDM,27814460,W TKR HYBRI PFC HIGHDEMAND KNEE,5808.0,3775.2,975.74,5227.2,29
CDM,27814460_OP,W TKR HYBRI PFC HIGHDEMAND KNEE,5808.0,3775.2,3775.2,5691.84,6
CDM,27814470,W TKR HYBRID PFC KNEE,5208.0,3385.2,874.94,4687.2,29
CDM,27814470_OP,W TKR HYBRID PFC KNEE,5208.0,3385.2,3385.2,5103.84,6
CDM,27814480,W TKR LCS COMP CEMENTED KNEE,6216.0,4040.4,1044.29,5594.4,29
CDM,27814480_OP,W TKR LCS COMP CEMENTED KNEE,6216.0,4040.4,4040.4,6091.68,6
CDM,27814490,W TKR LCS COMP NONCEMHYBRI KNEE,7056.0,4586.4,1185.41,6350.4,29
CDM,27814490_OP,W TKR LCS COMP NONCEMHYBRI KNEE,7056.0,4586.4,4586.4,6914.88,6
CDM,27814500,W TKR NONCEM PFC KNEE,5880.0,3822.0,987.84,5292.0,29
CDM,27814500_OP,W TKR NONCEM PFC KNEE,5880.0,3822.0,3822.0,5762.4,6
CDM,27814510,W TKR NONCEMPFC HIGHDEMAND KNEE,6480.0,4212.0,1088.64,5832.0,29
CDM,27814510_OP,W TKR NONCEMPFC HIGHDEMAND KNEE,6480.0,4212.0,4212.0,6350.4,6
CDM,27814520,W TKR PFC SIGMA ROTATING KNEE,5880.0,3822.0,987.84,5292.0,29
CDM,27814520_OP,W TKR PFC SIGMA ROTATING KNEE,5880.0,3822.0,3822.0,5762.4,6
CDM,27814530,W TKR ROTATING PLATFORM KNEE,6680.0,4342.0,1122.24,6012.0,29
CDM,27814530_OP,W TKR ROTATING PLATFORM KNEE,6680.0,4342.0,4342.0,6546.4,6
CDM,27814540,W T-PLATE TI 3H/5H SHAFT 441.15,332.0,215.8,55.78,298.8,20
CDM,27814540_IP,W T-PLATE TI 3H/5H SHAFT 441.15,332.0,215.8,119.85,119.85,3
CDM,27814540_OP,W T-PLATE TI 3H/5H SHAFT 441.15,332.0,215.8,215.8,325.36,6
CDM,27814550,W TRANSCONNECTOR 31MM,800.0,520.0,134.4,720.0,20
CDM,27814550_IP,W TRANSCONNECTOR 31MM,800.0,520.0,288.8,288.8,3
CDM,27814550_OP,W TRANSCONNECTOR 31MM,800.0,520.0,520.0,784.0,6
CDM,27814560,W TRAY IMP KNEE SLEEVE M/L 29MM,3146.0,2044.9,528.53,2831.4,23
CDM,27814560_IP,W TRAY IMP KNEE SLEEVE M/L 29MM,3146.0,2044.9,1135.71,1135.71,3
CDM,27814560_OP,W TRAY IMP KNEE SLEEVE M/L 29MM,3146.0,2044.9,2044.9,3083.08,6
CDM,27814570,W TROCHANTERIC NAIL KIT,500.0,325.0,84.0,450.0,20
CDM,27814570_IP,W TROCHANTERIC NAIL KIT,500.0,325.0,180.5,180.5,3
CDM,27814570_OP,W TROCHANTERIC NAIL KIT,500.0,325.0,325.0,490.0,6
CDM,27814580,W TROCHANTERIC NAIL TI KIT,10157.0,6602.05,1706.38,9141.3,29
CDM,27814580_OP,W TROCHANTERIC NAIL TI KIT,10157.0,6602.05,6602.05,9953.86,6
CDM,27814590,W ULTRA FAST-FIX AB CURVED,653.0,424.45,109.7,587.7,20
CDM,27814590_IP,W ULTRA FAST-FIX AB CURVED,653.0,424.45,235.73,235.73,3
CDM,27814590_OP,W ULTRA FAST-FIX AB CURVED,653.0,424.45,424.45,639.94,6
CDM,27814600,W UNI-KNEE,4260.0,2769.0,715.68,3834.0,23
CDM,27814600_IP,W UNI-KNEE,4260.0,2769.0,1537.86,1537.86,3
CDM,27814600_OP,W UNI-KNEE,4260.0,2769.0,2769.0,4174.8,6
CDM,27814610,W UNI-POLAR HIP,2774.0,1803.1,466.03,2496.6,23
CDM,27814610_IP,W UNI-POLAR HIP,2774.0,1803.1,1001.41,1001.41,3
CDM,27814610_OP,W UNI-POLAR HIP,2774.0,1803.1,1803.1,2718.52,6
CDM,27814620,W VALVE AORTIC MAGNA EASE 27MM,15558.0,10112.7,2613.74,14002.2,29
CDM,27814620_OP,W VALVE AORTIC MAGNA EASE 27MM,15558.0,10112.7,10112.7,15246.84,6
CDM,27814630,W VALVE AORTIC/MITRAL MAGNA,8390.0,5453.5,1409.52,7551.0,29
CDM,27814630_OP,W VALVE AORTIC/MITRAL MAGNA,8390.0,5453.5,5453.5,8222.2,6
CDM,27814640,W $ VALVE HEART IMP,66000.0,42900.0,11088.0,59400.0,29
CDM,27814640_OP,W $ VALVE HEART IMP,66000.0,42900.0,42900.0,64680.0,6
CDM,27814650,W VALVE HEART OPEN PIVOT 22MM,3990.0,2593.5,670.32,3591.0,23
CDM,27814650_IP,W VALVE HEART OPEN PIVOT 22MM,3990.0,2593.5,1440.39,1440.39,3
CDM,27814650_OP,W VALVE HEART OPEN PIVOT 22MM,3990.0,2593.5,2593.5,3910.2,6
CDM,27814660,W VALVE MITRAL 25MM,15000.0,9750.0,2520.0,13500.0,29
CDM,27814660_OP,W VALVE MITRAL 25MM,15000.0,9750.0,9750.0,14700.0,6
CDM,27814670,W VALVE PROGRAM INLINE,5200.0,3380.0,873.6,4680.0,29
CDM,27814670_OP,W VALVE PROGRAM INLINE,5200.0,3380.0,3380.0,5096.0,6
CDM,27814680,W VALVE PROGRAM INLINE,6359.0,4133.35,1068.31,5723.1,29
CDM,27814680_OP,W VALVE PROGRAM INLINE,6359.0,4133.35,4133.35,6231.82,6
CDM,27814690,W VALVE STRATA REGULAR 42866,5778.0,3755.7,970.7,5200.2,29
CDM,27814690_OP,W VALVE STRATA REGULAR 42866,5778.0,3755.7,3755.7,5662.44,6
CDM,27814700,W VAS CLS 610097,875.0,568.75,147.0,787.5,20
CDM,27814700_IP,W VAS CLS 610097,875.0,568.75,315.88,315.88,3
CDM,27814700_OP,W VAS CLS 610097,875.0,568.75,568.75,857.5,6
CDM,27814710,W VAS CLS ANGIOSL,736.0,478.4,123.65,662.4,20
CDM,27814710_IP,W VAS CLS ANGIOSL,736.0,478.4,265.7,265.7,3
CDM,27814710_OP,W VAS CLS ANGIOSL,736.0,478.4,478.4,721.28,6
CDM,27814720,W VAS CLS ANGIOSL,736.0,478.4,123.65,662.4,20
CDM,27814720_IP,W VAS CLS ANGIOSL,736.0,478.4,265.7,265.7,3
CDM,27814720_OP,W VAS CLS ANGIOSL,736.0,478.4,478.4,721.28,6
CDM,27814730,W VAS CLS ART CLS,736.0,478.4,123.65,662.4,20
CDM,27814730_IP,W VAS CLS ART CLS,736.0,478.4,265.7,265.7,3
CDM,27814730_OP,W VAS CLS ART CLS,736.0,478.4,478.4,721.28,6
CDM,27814740,W VAS CLS ART PER,881.0,572.65,148.01,792.9,20
CDM,27814740_IP,W VAS CLS ART PER,881.0,572.65,318.04,318.04,3
CDM,27814740_OP,W VAS CLS ART PER,881.0,572.65,572.65,863.38,6
CDM,27814750,W VAS CLS VASOSL,1061.0,689.65,178.25,954.9,20
CDM,27814750_IP,W VAS CLS VASOSL,1061.0,689.65,383.02,383.02,3
CDM,27814750_OP,W VAS CLS VASOSL,1061.0,689.65,689.65,1039.78,6
CDM,27814760,W VENOUS OUTFLOW COMP VAD HERO,3390.0,2203.5,569.52,3051.0,23
CDM,27814760_IP,W VENOUS OUTFLOW COMP VAD HERO,3390.0,2203.5,1223.79,1223.79,3
CDM,27814760_OP,W VENOUS OUTFLOW COMP VAD HERO,3390.0,2203.5,2203.5,3322.2,6
CDM,27814770,W VERITAS COLLAGEN MATRIX 4X7CM,1190.0,773.5,199.92,1071.0,20
CDM,27814770_IP,W VERITAS COLLAGEN MATRIX 4X7CM,1190.0,773.5,429.59,429.59,3
CDM,27814770_OP,W VERITAS COLLAGEN MATRIX 4X7CM,1190.0,773.5,773.5,1166.2,6
CDM,27814780,W VERTEBRAL IMPLT CONCORDE,5000.0,3250.0,840.0,4500.0,26
CDM,27814780_OP,W VERTEBRAL IMPLT CONCORDE,5000.0,3250.0,3250.0,4900.0,6
CDM,27814790,W WASHER,72.0,46.8,12.1,64.8,20
CDM,27814790_IP,W WASHER,72.0,46.8,25.99,25.99,3
CDM,27814790_OP,W WASHER,72.0,46.8,46.8,70.56,6
CDM,27814800,W WASHER CANCL,102.0,66.3,17.14,91.8,20
CDM,27814800_IP,W WASHER CANCL,102.0,66.3,36.82,36.82,3
CDM,27814800_OP,W WASHER CANCL,102.0,66.3,66.3,99.96,6
CDM,27814810,W WASHER FOR 1.2MM SCREW,55.0,35.75,9.24,49.5,20
CDM,27814810_IP,W WASHER FOR 1.2MM SCREW,55.0,35.75,19.86,19.86,3
CDM,27814810_OP,W WASHER FOR 1.2MM SCREW,55.0,35.75,35.75,53.9,6
CDM,27814820,W WASHER LGE FOR CANCLLS SCREWS,51.0,33.15,8.57,45.9,20
CDM,27814820_IP,W WASHER LGE FOR CANCLLS SCREWS,51.0,33.15,18.41,18.41,3
CDM,27814820_OP,W WASHER LGE FOR CANCLLS SCREWS,51.0,33.15,33.15,49.98,6
CDM,27814830,W WASHER SPIKED,47.0,30.55,7.9,42.3,20
CDM,27814830_IP,W WASHER SPIKED,47.0,30.55,16.97,16.97,3
CDM,27814830_OP,W WASHER SPIKED,47.0,30.55,30.55,46.06,6
CDM,27814840,W WASHER SYNT CANN SCREW,43.0,27.95,7.22,38.7,20
CDM,27814840_IP,W WASHER SYNT CANN SCREW,43.0,27.95,15.52,15.52,3
CDM,27814840_OP,W WASHER SYNT CANN SCREW,43.0,27.95,27.95,42.14,6
CDM,27814850,W WASHER TITANIUM 13.0 MM,61.0,39.65,10.25,54.9,20
CDM,27814850_IP,W WASHER TITANIUM 13.0 MM,61.0,39.65,22.02,22.02,3
CDM,27814850_OP,W WASHER TITANIUM 13.0 MM,61.0,39.65,39.65,59.78,6
CDM,27814860,W WIRE CERCLAGE,25.0,16.25,4.2,22.5,20
CDM,27814860_IP,W WIRE CERCLAGE,25.0,16.25,9.03,9.03,3
CDM,27814860_OP,W WIRE CERCLAGE,25.0,16.25,16.25,24.5,6
CDM,27814870,W WIRE FIX BOLT SLOTTED,122.0,79.3,20.5,109.8,20
CDM,27814870_IP,W WIRE FIX BOLT SLOTTED,122.0,79.3,44.04,44.04,3
CDM,27814870_OP,W WIRE FIX BOLT SLOTTED,122.0,79.3,79.3,119.56,6
CDM,27814880,W WIRE LORENZ LIG 25G SS 4 OZ,116.0,75.4,19.49,104.4,20
CDM,27814880_IP,W WIRE LORENZ LIG 25G SS 4 OZ,116.0,75.4,41.88,41.88,3
CDM,27814880_OP,W WIRE LORENZ LIG 25G SS 4 OZ,116.0,75.4,75.4,113.68,6
CDM,27814890,W WIRE TROCAR CHARLOTTE 150MM,35.0,22.75,5.88,31.5,20
CDM,27814890_IP,W WIRE TROCAR CHARLOTTE 150MM,35.0,22.75,12.64,12.64,3
CDM,27814890_OP,W WIRE TROCAR CHARLOTTE 150MM,35.0,22.75,22.75,34.3,6
CDM,27814900,W WIRE W/STOPPER 400MM,582.0,378.3,97.78,523.8,20
CDM,27814900_IP,W WIRE W/STOPPER 400MM,582.0,378.3,210.1,210.1,3
CDM,27814900_OP,W WIRE W/STOPPER 400MM,582.0,378.3,378.3,570.36,6
CDM,27814910,W WSTNT B ENDPR,4938.0,3209.7,829.58,4444.2,26
CDM,27814910_OP,W WSTNT B ENDPR,4938.0,3209.7,3209.7,4839.24,6
CDM,27814920,W WSTNT ILIAC END,4938.0,3209.7,829.58,4444.2,26
CDM,27814920_OP,W WSTNT ILIAC END,4938.0,3209.7,3209.7,4839.24,6
CDM,27814930,W WSTNT TBRNC END,2625.0,1706.25,441.0,2362.5,23
CDM,27814930_IP,W WSTNT TBRNC END,2625.0,1706.25,947.63,947.63,3
CDM,27814930_OP,W WSTNT TBRNC END,2625.0,1706.25,1706.25,2572.5,6
CDM,27814940,W WSTNT TIPS ENDP,4938.0,3209.7,829.58,4444.2,26
CDM,27814940_OP,W WSTNT TIPS ENDP,4938.0,3209.7,3209.7,4839.24,6
CDM,27814950,W WSTNT TRNSHEPAT,826.0,536.9,138.77,743.4,20
CDM,27814950_IP,W WSTNT TRNSHEPAT,826.0,536.9,298.19,298.19,3
CDM,27814950_OP,W WSTNT TRNSHEPAT,826.0,536.9,536.9,809.48,6
CDM,27814960,W X-STOP IPD SYSTEM,8800.0,5720.0,1478.4,7920.0,29
CDM,27814960_OP,W X-STOP IPD SYSTEM,8800.0,5720.0,5720.0,8624.0,6
CDM,27814970,W ZENITH FLX MAIN BODY GFT 36X9,15244.0,9908.6,2560.99,13719.6,29
CDM,27814970_OP,W ZENITH FLX MAIN BODY GFT 36X9,15244.0,9908.6,9908.6,14939.12,6
CDM,27814980,W ZENITH ILIAC LEG GRAFT 16X54,5562.0,3615.3,934.42,5005.8,29
CDM,27814980_OP,W ZENITH ILIAC LEG GRAFT 16X54,5562.0,3615.3,3615.3,5450.76,6
CDM,27814990,W ZENITH ILIAC LEG GRAFT 16X71,5562.0,3615.3,934.42,5005.8,29
CDM,27814990_OP,W ZENITH ILIAC LEG GRAFT 16X71,5562.0,3615.3,3615.3,5450.76,6
CDM,27814WE,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE,4248.0,2761.2,565.31,4248.0,35
CDM,27815000,W SLING UPHOLD VAG SUPPORT SYS,3168.0,2059.2,532.22,2851.2,23
CDM,27815000_IP,W SLING UPHOLD VAG SUPPORT SYS,3168.0,2059.2,1143.65,1143.65,3
CDM,27815000_OP,W SLING UPHOLD VAG SUPPORT SYS,3168.0,2059.2,2059.2,3104.64,6
CDM,27815010,W STENT 130CM FLEXSTAR SELF EXP,2500.0,1625.0,420.0,2250.0,23
CDM,27815010_IP,W STENT 130CM FLEXSTAR SELF EXP,2500.0,1625.0,902.5,902.5,3
CDM,27815010_OP,W STENT 130CM FLEXSTAR SELF EXP,2500.0,1625.0,1625.0,2450.0,6
CDM,27815020,W PEEK SPACE STR,2500.0,1625.0,420.0,2250.0,23
CDM,27815020_IP,W PEEK SPACE STR,2500.0,1625.0,902.5,902.5,3
CDM,27815020_OP,W PEEK SPACE STR,2500.0,1625.0,1625.0,2450.0,6
CDM,27815030,W TISSUE PROKERA 16MM,1790.0,1163.5,300.72,1611.0,23
CDM,27815030_IP,W TISSUE PROKERA 16MM,1790.0,1163.5,646.19,646.19,3
CDM,27815030_OP,W TISSUE PROKERA 16MM,1790.0,1163.5,1163.5,1754.2,6
CDM,27815040,W STEM FEM ACCOLADE CEMENT,1456.0,946.4,244.61,1310.4,20
CDM,27815040_IP,W STEM FEM ACCOLADE CEMENT,1456.0,946.4,525.62,525.62,3
CDM,27815040_OP,W STEM FEM ACCOLADE CEMENT,1456.0,946.4,946.4,1426.88,6
CDM,27815050,W KIT OSTEOSET RES BEAD FST CURE,1710.0,1111.5,287.28,1539.0,20
CDM,27815050_IP,W KIT OSTEOSET RES BEAD FST CURE,1710.0,1111.5,617.31,617.31,3
CDM,27815050_OP,W KIT OSTEOSET RES BEAD FST CURE,1710.0,1111.5,1111.5,1675.8,6
CDM,27815060,W STEM CORAIL DEP,4302.0,2796.3,722.74,3871.8,23
CDM,27815060_IP,W STEM CORAIL DEP,4302.0,2796.3,1553.02,1553.02,3
CDM,27815060_OP,W STEM CORAIL DEP,4302.0,2796.3,2796.3,4215.96,6
CDM,27815070,W LINER ACTB,1800.0,1170.0,302.4,1620.0,23
CDM,27815070_IP,W LINER ACTB,1800.0,1170.0,649.8,649.8,3
CDM,27815070_OP,W LINER ACTB,1800.0,1170.0,1170.0,1764.0,6
CDM,27815080,W HEAD FEM CER BIOLOX DELTA,585.0,380.25,98.28,526.5,20
CDM,27815080_IP,W HEAD FEM CER BIOLOX DELTA,585.0,380.25,211.19,211.19,3
CDM,27815080_OP,W HEAD FEM CER BIOLOX DELTA,585.0,380.25,380.25,573.3,6
CDM,27815090,W SCREW PINN CANCELL BONE DEP,107.0,69.55,17.98,96.3,20
CDM,27815090_IP,W SCREW PINN CANCELL BONE DEP,107.0,69.55,38.63,38.63,3
CDM,27815090_OP,W SCREW PINN CANCELL BONE DEP,107.0,69.55,69.55,104.86,6
CDM,27815095,4 X 4 STNLESS STEEL SD GRID,1093.0,710.45,183.62,983.7,20
CDM,27815095_IP,4 X 4 STNLESS STEEL SD GRID,1093.0,710.45,394.57,394.57,3
CDM,27815095_OP,4 X 4 STNLESS STEEL SD GRID,1093.0,710.45,710.45,1071.14,6
CDM,27815100,W HEAD FEM ARTICULEZE MOM,565.0,367.25,94.92,508.5,20
CDM,27815100_IP,W HEAD FEM ARTICULEZE MOM,565.0,367.25,203.97,203.97,3
CDM,27815100_OP,W HEAD FEM ARTICULEZE MOM,565.0,367.25,367.25,553.7,6
CDM,27815110,W SLING I-STOP TOMS MALE,6000.0,3900.0,1008.0,5400.0,29
CDM,27815110_OP,W SLING I-STOP TOMS MALE,6000.0,3900.0,3900.0,5880.0,6
CDM,27815120,W BONE SUBSTITUTE HYDROSET 3CC,1711.0,1112.15,287.45,1539.9,20
CDM,27815120_IP,W BONE SUBSTITUTE HYDROSET 3CC,1711.0,1112.15,617.67,617.67,3
CDM,27815120_OP,W BONE SUBSTITUTE HYDROSET 3CC,1711.0,1112.15,1112.15,1676.78,6
CDM,27815130,W K-WIRE W OLIVE STOP STRY,50.0,32.5,8.4,45.0,20
CDM,27815130_IP,W K-WIRE W OLIVE STOP STRY,50.0,32.5,18.05,18.05,3
CDM,27815130_OP,W K-WIRE W OLIVE STOP STRY,50.0,32.5,32.5,49.0,6
CDM,27815140,W IMPL TNPROFILE GLD EYELID 1.2,500.0,325.0,84.0,450.0,20
CDM,27815140_IP,W IMPL TNPROFILE GLD EYELID 1.2,500.0,325.0,180.5,180.5,3
CDM,27815140_OP,W IMPL TNPROFILE GLD EYELID 1.2,500.0,325.0,325.0,490.0,6
CDM,27815150,W STEM FEMORAL SROM DEP,2796.0,1817.4,469.73,2516.4,23
CDM,27815150_IP,W STEM FEMORAL SROM DEP,2796.0,1817.4,1009.36,1009.36,3
CDM,27815150_OP,W STEM FEMORAL SROM DEP,2796.0,1817.4,1817.4,2740.08,6
CDM,27815160,W SLEEVE S-ROM PROX 18D-SM,1506.0,978.9,253.01,1355.4,20
CDM,27815160_IP,W SLEEVE S-ROM PROX 18D-SM,1506.0,978.9,543.67,543.67,3
CDM,27815160_OP,W SLEEVE S-ROM PROX 18D-SM,1506.0,978.9,978.9,1475.88,6
CDM,27815170,W IMPL APERFIX FEMORAL WINSERTR,1960.0,1274.0,329.28,1764.0,23
CDM,27815170_IP,W IMPL APERFIX FEMORAL WINSERTR,1960.0,1274.0,707.56,707.56,3
CDM,27815170_OP,W IMPL APERFIX FEMORAL WINSERTR,1960.0,1274.0,1274.0,1920.8,6
CDM,27815180,W IMPL APERFIX TIBIAL W INSERTR,950.0,617.5,159.6,855.0,20
CDM,27815180_IP,W IMPL APERFIX TIBIAL W INSERTR,950.0,617.5,342.95,342.95,3
CDM,27815180_OP,W IMPL APERFIX TIBIAL W INSERTR,950.0,617.5,617.5,931.0,6
CDM,27815190,W SLING Y INTEPRO,724.0,470.6,121.63,651.6,20
CDM,27815190_IP,W SLING Y INTEPRO,724.0,470.6,261.36,261.36,3
CDM,27815190_OP,W SLING Y INTEPRO,724.0,470.6,470.6,709.52,6
CDM,27815200,W PUMP CONTROL AMS800 W/IZ,6552.0,4258.8,1100.74,5896.8,29
CDM,27815200_OP,W PUMP CONTROL AMS800 W/IZ,6552.0,4258.8,4258.8,6420.96,6
CDM,27815210,W CUFF BELT AMS800 W/IZ,6300.0,4095.0,1058.4,5670.0,21
CDM,27815220,W ANCHOR SUTURE TAK 3MM,590.0,383.5,99.12,531.0,20
CDM,27815220_IP,W ANCHOR SUTURE TAK 3MM,590.0,383.5,212.99,212.99,3
CDM,27815220_OP,W ANCHOR SUTURE TAK 3MM,590.0,383.5,383.5,578.2,6
CDM,27815230,W LAP-BAND AP SYS LG W/ACCS PORT,6614.0,4299.1,1111.15,5952.6,29
CDM,27815230_OP,W LAP-BAND AP SYS LG W/ACCS PORT,6614.0,4299.1,4299.1,6481.72,6
CDM,27815240,W TISSUE TIBIALIS ANTERIOR,2808.0,1825.2,471.74,2527.2,23
CDM,27815240_IP,W TISSUE TIBIALIS ANTERIOR,2808.0,1825.2,1013.69,1013.69,3
CDM,27815240_OP,W TISSUE TIBIALIS ANTERIOR,2808.0,1825.2,1825.2,2751.84,6
CDM,27815250,W STENT EXPRESS LD 7X17MM,1750.0,1137.5,294.0,1575.0,23
CDM,27815250_IP,W STENT EXPRESS LD 7X17MM,1750.0,1137.5,631.75,631.75,3
CDM,27815250_OP,W STENT EXPRESS LD 7X17MM,1750.0,1137.5,1137.5,1715.0,6
CDM,27815260,W FILTER VENA CAVA ECLIPSE,1500.0,975.0,252.0,1350.0,20
CDM,27815260_IP,W FILTER VENA CAVA ECLIPSE,1500.0,975.0,541.5,541.5,3
CDM,27815260_OP,W FILTER VENA CAVA ECLIPSE,1500.0,975.0,975.0,1470.0,6
CDM,27815280,W STENT 6MMX170MM LIFESTENT XL,3300.0,2145.0,554.4,2970.0,23
CDM,27815280_IP,W STENT 6MMX170MM LIFESTENT XL,3300.0,2145.0,1191.3,1191.3,3
CDM,27815280_OP,W STENT 6MMX170MM LIFESTENT XL,3300.0,2145.0,2145.0,3234.0,6
CDM,27815290,W STENT INTEGRITY RX,1200.0,780.0,201.6,1080.0,20
CDM,27815290_IP,W STENT INTEGRITY RX,1200.0,780.0,433.2,433.2,3
CDM,27815290_OP,W STENT INTEGRITY RX,1200.0,780.0,780.0,1176.0,6
CDM,27815310,W STENT GRAFT ENDVSC BIFUR,19950.0,12967.5,3351.6,17955.0,29
CDM,27815310_OP,W STENT GRAFT ENDVSC BIFUR,19950.0,12967.5,12967.5,19551.0,6
CDM,27815320,W STENT GRAFT ENDVSC BIFUR,19000.0,12350.0,3192.0,17100.0,29
CDM,27815320_OP,W STENT GRAFT ENDVSC BIFUR,19000.0,12350.0,12350.0,18620.0,6
CDM,27815330,W STENT GRFT ENDVSC LIMB CONTRA,9950.0,6467.5,1671.6,8955.0,29
CDM,27815330_OP,W STENT GRFT ENDVSC LIMB CONTRA,9950.0,6467.5,6467.5,9751.0,6
CDM,27815340,W STENT GRFT ENDVSC LIMB CONTRA,9850.0,6402.5,1654.8,8865.0,29
CDM,27815340_OP,W STENT GRFT ENDVSC LIMB CONTRA,9850.0,6402.5,6402.5,9653.0,6
CDM,27815350,W STENT GRFT ENDVSC LIMB CONTRA,7200.0,4680.0,1209.6,6480.0,29
CDM,27815350_OP,W STENT GRFT ENDVSC LIMB CONTRA,7200.0,4680.0,4680.0,7056.0,6
CDM,27815360,W STEM FEM TRILOCK,4302.0,2796.3,722.74,3871.8,23
CDM,27815360_IP,W STEM FEM TRILOCK,4302.0,2796.3,1553.02,1553.02,3
CDM,27815360_OP,W STEM FEM TRILOCK,4302.0,2796.3,2796.3,4215.96,6
CDM,27815370,W SCREW BN 5MM LCP SS,310.0,201.5,52.08,279.0,20
CDM,27815370_IP,W SCREW BN 5MM LCP SS,310.0,201.5,111.91,111.91,3
CDM,27815370_OP,W SCREW BN 5MM LCP SS,310.0,201.5,201.5,303.8,6
CDM,27815380,W KIT ARTHSCP FIX DIST BICEPS,1568.0,1019.2,263.42,1411.2,20
CDM,27815380_IP,W KIT ARTHSCP FIX DIST BICEPS,1568.0,1019.2,566.05,566.05,3
CDM,27815380_OP,W KIT ARTHSCP FIX DIST BICEPS,1568.0,1019.2,1019.2,1536.64,6
CDM,27815390,W ANCHOR BIOCOMPOSITE,800.0,520.0,134.4,720.0,20
CDM,27815390_IP,W ANCHOR BIOCOMPOSITE,800.0,520.0,288.8,288.8,3
CDM,27815390_OP,W ANCHOR BIOCOMPOSITE,800.0,520.0,520.0,784.0,6
CDM,27815400,W PLATE 3HOLES HD 2.0MM 10HOLES,444.0,288.6,74.59,399.6,20
CDM,27815400_IP,W PLATE 3HOLES HD 2.0MM 10HOLES,444.0,288.6,160.28,160.28,3
CDM,27815400_OP,W PLATE 3HOLES HD 2.0MM 10HOLES,444.0,288.6,288.6,435.12,6
CDM,27815410,W CAP END STD STRL T2 8MM,237.0,154.05,39.82,213.3,20
CDM,27815410_IP,W CAP END STD STRL T2 8MM,237.0,154.05,85.56,85.56,3
CDM,27815410_OP,W CAP END STD STRL T2 8MM,237.0,154.05,154.05,232.26,6
CDM,27815420,W ELIM H APEX HIP MRTHN POS STP,210.0,136.5,35.28,189.0,20
CDM,27815420_IP,W ELIM H APEX HIP MRTHN POS STP,210.0,136.5,75.81,75.81,3
CDM,27815420_OP,W ELIM H APEX HIP MRTHN POS STP,210.0,136.5,136.5,205.8,6
CDM,27815430,W SCREW BN 2MM LCP DCP SS,54.0,35.1,9.07,48.6,20
CDM,27815430_IP,W SCREW BN 2MM LCP DCP SS,54.0,35.1,19.49,19.49,3
CDM,27815430_OP,W SCREW BN 2MM LCP DCP SS,54.0,35.1,35.1,52.92,6
CDM,27815450,W COIL EMBOL AZUR 4/6MM X 20CM,2035.0,1322.75,341.88,1831.5,23
CDM,27815450_IP,W COIL EMBOL AZUR 4/6MM X 20CM,2035.0,1322.75,734.64,734.64,3
CDM,27815450_OP,W COIL EMBOL AZUR 4/6MM X 20CM,2035.0,1322.75,1322.75,1994.3,6
CDM,27815460,W COIL EMBOL AZUR 4MM X 10CM,1802.0,1171.3,302.74,1621.8,23
CDM,27815460_IP,W COIL EMBOL AZUR 4MM X 10CM,1802.0,1171.3,650.52,650.52,3
CDM,27815460_OP,W COIL EMBOL AZUR 4MM X 10CM,1802.0,1171.3,1171.3,1765.96,6
CDM,27815470,W CLIP SUTURE 8840.764,23.0,14.95,3.86,20.7,20
CDM,27815470_IP,W CLIP SUTURE 8840.764,23.0,14.95,8.3,8.3,3
CDM,27815470_OP,W CLIP SUTURE 8840.764,23.0,14.95,14.95,22.54,6
CDM,27815480,W CATH KT DIALYSIS VAXCEL PLUS,988.0,642.2,165.98,889.2,20
CDM,27815480_IP,W CATH KT DIALYSIS VAXCEL PLUS,988.0,642.2,356.67,356.67,3
CDM,27815480_OP,W CATH KT DIALYSIS VAXCEL PLUS,988.0,642.2,642.2,968.24,6
CDM,27815490,W RING CAPSULAR TENSION,210.0,136.5,35.28,189.0,20
CDM,27815490_IP,W RING CAPSULAR TENSION,210.0,136.5,75.81,75.81,3
CDM,27815490_OP,W RING CAPSULAR TENSION,210.0,136.5,136.5,205.8,6
CDM,27815500,W IMP THYROPLASTY MONTGOMERY,690.0,448.5,115.92,621.0,20
CDM,27815500_IP,W IMP THYROPLASTY MONTGOMERY,690.0,448.5,249.09,249.09,3
CDM,27815500_OP,W IMP THYROPLASTY MONTGOMERY,690.0,448.5,448.5,676.2,6
CDM,27815510,W PLATE 4.5MM LCP PROX 6H RT,2534.0,1647.1,425.71,2280.6,23
CDM,27815510_IP,W PLATE 4.5MM LCP PROX 6H RT,2534.0,1647.1,914.77,914.77,3
CDM,27815510_OP,W PLATE 4.5MM LCP PROX 6H RT,2534.0,1647.1,1647.1,2483.32,6
CDM,27815520,W SLING GYNCR TVT OBTURATOR SYS,1873.0,1217.45,314.66,1685.7,23
CDM,27815520_IP,W SLING GYNCR TVT OBTURATOR SYS,1873.0,1217.45,676.15,676.15,3
CDM,27815520_OP,W SLING GYNCR TVT OBTURATOR SYS,1873.0,1217.45,1217.45,1835.54,6
CDM,27815530,W TIBIALIS POSTERIOR IMP,2950.0,1917.5,495.6,2655.0,23
CDM,27815530_IP,W TIBIALIS POSTERIOR IMP,2950.0,1917.5,1064.95,1064.95,3
CDM,27815530_OP,W TIBIALIS POSTERIOR IMP,2950.0,1917.5,1917.5,2891.0,6
CDM,27815540,W KNEE IMP FAST-FIX REPAIR SYS,512.0,332.8,86.02,460.8,20
CDM,27815540_IP,W KNEE IMP FAST-FIX REPAIR SYS,512.0,332.8,184.83,184.83,3
CDM,27815540_OP,W KNEE IMP FAST-FIX REPAIR SYS,512.0,332.8,332.8,501.76,6
CDM,27815550,W ANCHOR SUT 1 BSUT TK FBRWR S,544.0,353.6,91.39,489.6,20
CDM,27815550_IP,W ANCHOR SUT 1 BSUT TK FBRWR S,544.0,353.6,196.38,196.38,3
CDM,27815550_OP,W ANCHOR SUT 1 BSUT TK FBRWR S,544.0,353.6,353.6,533.12,6
CDM,27815560,W PLATE LCP 137MM SS 3.5MM 10H,661.0,429.65,111.05,594.9,20
CDM,27815560_IP,W PLATE LCP 137MM SS 3.5MM 10H,661.0,429.65,238.62,238.62,3
CDM,27815560_OP,W PLATE LCP 137MM SS 3.5MM 10H,661.0,429.65,429.65,647.78,6
CDM,27815570,W MESH SRG MRLX 6X6 GROIN HERN,271.0,176.15,45.53,243.9,20
CDM,27815570_IP,W MESH SRG MRLX 6X6 GROIN HERN,271.0,176.15,97.83,97.83,3
CDM,27815570_OP,W MESH SRG MRLX 6X6 GROIN HERN,271.0,176.15,176.15,265.58,6
CDM,27815580,W STENT BIL ADVANIX 2 PGTL CRV,102.0,66.3,17.14,91.8,20
CDM,27815580_IP,W STENT BIL ADVANIX 2 PGTL CRV,102.0,66.3,36.82,36.82,3
CDM,27815580_OP,W STENT BIL ADVANIX 2 PGTL CRV,102.0,66.3,66.3,99.96,6
CDM,27815590,W STENT T FRONTAL SINUS,56.0,36.4,9.41,50.4,20
CDM,27815590_IP,W STENT T FRONTAL SINUS,56.0,36.4,20.22,20.22,3
CDM,27815590_OP,W STENT T FRONTAL SINUS,56.0,36.4,36.4,54.88,6
CDM,27815600,W FILTER IVC RTRVBL 10F,1600.0,1040.0,268.8,1440.0,20
CDM,27815600_IP,W FILTER IVC RTRVBL 10F,1600.0,1040.0,577.6,577.6,3
CDM,27815600_OP,W FILTER IVC RTRVBL 10F,1600.0,1040.0,1040.0,1568.0,6
CDM,27815610,W HEAD FEM +0MM 32MM COCR,1100.0,715.0,184.8,990.0,20
CDM,27815610_IP,W HEAD FEM +0MM 32MM COCR,1100.0,715.0,397.1,397.1,3
CDM,27815610_OP,W HEAD FEM +0MM 32MM COCR,1100.0,715.0,715.0,1078.0,6
CDM,27815620,W GRAFT DURA 2X2IN PTCH RSRB,502.0,326.3,84.34,451.8,20
CDM,27815620_IP,W GRAFT DURA 2X2IN PTCH RSRB,502.0,326.3,181.22,181.22,3
CDM,27815620_OP,W GRAFT DURA 2X2IN PTCH RSRB,502.0,326.3,326.3,491.96,6
CDM,27815630,W MESH SRG PRTX 12CM RND,750.0,487.5,126.0,675.0,20
CDM,27815630_IP,W MESH SRG PRTX 12CM RND,750.0,487.5,270.75,270.75,3
CDM,27815630_OP,W MESH SRG PRTX 12CM RND,750.0,487.5,487.5,735.0,6
CDM,27815640,W SLEEVE CNTR SROM 20D FEM HIP,1506.0,978.9,253.01,1355.4,20
CDM,27815640_IP,W SLEEVE CNTR SROM 20D FEM HIP,1506.0,978.9,543.67,543.67,3
CDM,27815640_OP,W SLEEVE CNTR SROM 20D FEM HIP,1506.0,978.9,978.9,1475.88,6
CDM,27815650,W GRAFT VASC 40CM 8MM GORE,2636.0,1713.4,442.85,2372.4,23
CDM,27815650_IP,W GRAFT VASC 40CM 8MM GORE,2636.0,1713.4,951.6,951.6,3
CDM,27815650_OP,W GRAFT VASC 40CM 8MM GORE,2636.0,1713.4,1713.4,2583.28,6
CDM,27815660,W VALVE AORTIC ATS,3990.0,2593.5,670.32,3591.0,23
CDM,27815660_IP,W VALVE AORTIC ATS,3990.0,2593.5,1440.39,1440.39,3
CDM,27815660_OP,W VALVE AORTIC ATS,3990.0,2593.5,2593.5,3910.2,6
CDM,27815670,W GEN NEUROSTIM ACTIVA SC,17090.0,11108.5,2871.12,15381.0,29
CDM,27815670_OP,W GEN NEUROSTIM ACTIVA SC,17090.0,11108.5,11108.5,16748.2,6
CDM,27815680,W ICD PROTECTA XT DR D314DRG,31700.0,20605.0,5325.6,28530.0,29
CDM,27815680_OP,W ICD PROTECTA XT DR D314DRG,31700.0,20605.0,20605.0,31066.0,6
CDM,27815690,W ICD PROTECTA DR D334DRG,28500.0,18525.0,4788.0,25650.0,29
CDM,27815690_OP,W ICD PROTECTA DR D334DRG,28500.0,18525.0,18525.0,27930.0,6
CDM,27815700,W ICD PROTECTA XT VR D314VRG,23000.0,14950.0,3864.0,20700.0,29
CDM,27815700_OP,W ICD PROTECTA XT VR D314VRG,23000.0,14950.0,14950.0,22540.0,6
CDM,27815710,W ICD PROTECTA VR D334VRG,21700.0,14105.0,3645.6,19530.0,29
CDM,27815710_OP,W ICD PROTECTA VR D334VRG,21700.0,14105.0,14105.0,21266.0,6
CDM,27815720,W ICD PROTECTA XT CRTD D314TRG,39200.0,25480.0,6585.6,35280.0,29
CDM,27815720_OP,W ICD PROTECTA XT CRTD D314TRG,39200.0,25480.0,25480.0,38416.0,6
CDM,27815730,W ICD PROTECTA CRTD D334TRG,36000.0,23400.0,6048.0,32400.0,29
CDM,27815730_OP,W ICD PROTECTA CRTD D334TRG,36000.0,23400.0,23400.0,35280.0,6
CDM,27815740,W STENT BIL DDNL BND RX,258.0,167.7,43.34,232.2,20
CDM,27815740_IP,W STENT BIL DDNL BND RX,258.0,167.7,93.14,93.14,3
CDM,27815740_OP,W STENT BIL DDNL BND RX,258.0,167.7,167.7,252.84,6
CDM,27815750,W STENT VASC 8-6MM 40MM TAPR,3870.0,2515.5,650.16,3483.0,23
CDM,27815750_IP,W STENT VASC 8-6MM 40MM TAPR,3870.0,2515.5,1397.07,1397.07,3
CDM,27815750_OP,W STENT VASC 8-6MM 40MM TAPR,3870.0,2515.5,2515.5,3792.6,6
CDM,27815770,W MESH SRG PRTX SKRTD 15X10CM,952.0,618.8,159.94,856.8,20
CDM,27815770_IP,W MESH SRG PRTX SKRTD 15X10CM,952.0,618.8,343.67,343.67,3
CDM,27815770_OP,W MESH SRG PRTX SKRTD 15X10CM,952.0,618.8,618.8,932.96,6
CDM,27815780,W MESH SRG PRTX 20X15CM,1202.0,781.3,201.94,1081.8,20
CDM,27815780_IP,W MESH SRG PRTX 20X15CM,1202.0,781.3,433.92,433.92,3
CDM,27815780_OP,W MESH SRG PRTX 20X15CM,1202.0,781.3,781.3,1177.96,6
CDM,27815790,W MESH SRG PRTX SKRTD 20X15CM,1467.0,953.55,246.46,1320.3,20
CDM,27815790_IP,W MESH SRG PRTX SKRTD 20X15CM,1467.0,953.55,529.59,529.59,3
CDM,27815790_OP,W MESH SRG PRTX SKRTD 20X15CM,1467.0,953.55,953.55,1437.66,6
CDM,27815800,W MESH SRG PRTX 25X20CM,1827.0,1187.55,306.94,1644.3,23
CDM,27815800_IP,W MESH SRG PRTX 25X20CM,1827.0,1187.55,659.55,659.55,3
CDM,27815800_OP,W MESH SRG PRTX 25X20CM,1827.0,1187.55,1187.55,1790.46,6
CDM,27815810,W MESH SRG PRTX SKRTD 25X20CM,2451.0,1593.15,411.77,2205.9,23
CDM,27815810_IP,W MESH SRG PRTX SKRTD 25X20CM,2451.0,1593.15,884.81,884.81,3
CDM,27815810_OP,W MESH SRG PRTX SKRTD 25X20CM,2451.0,1593.15,1593.15,2401.98,6
CDM,27815820,W MESH SRG PRTX SKRTD 30X20CM,2997.0,1948.05,503.5,2697.3,23
CDM,27815820_IP,W MESH SRG PRTX SKRTD 30X20CM,2997.0,1948.05,1081.92,1081.92,3
CDM,27815820_OP,W MESH SRG PRTX SKRTD 30X20CM,2997.0,1948.05,1948.05,2937.06,6
CDM,27815830,W MESH SRG PRTX 37X28CM,2966.0,1927.9,498.29,2669.4,23
CDM,27815830_IP,W MESH SRG PRTX 37X28CM,2966.0,1927.9,1070.73,1070.73,3
CDM,27815830_OP,W MESH SRG PRTX 37X28CM,2966.0,1927.9,1927.9,2906.68,6
CDM,27815840,W MESH SRG PRTX SKRTD RND 8CM,752.0,488.8,126.34,676.8,20
CDM,27815840_IP,W MESH SRG PRTX SKRTD RND 8CM,752.0,488.8,271.47,271.47,3
CDM,27815840_OP,W MESH SRG PRTX SKRTD RND 8CM,752.0,488.8,488.8,736.96,6
CDM,27815850,W MESH SRG PRTX 9CM RND,547.0,355.55,91.9,492.3,20
CDM,27815850_IP,W MESH SRG PRTX 9CM RND,547.0,355.55,197.47,197.47,3
CDM,27815850_OP,W MESH SRG PRTX 9CM RND,547.0,355.55,355.55,536.06,6
CDM,27815860,W MESH SRG PRTX 15CM RND,981.0,637.65,164.81,882.9,20
CDM,27815860_IP,W MESH SRG PRTX 15CM RND,981.0,637.65,354.14,354.14,3
CDM,27815860_OP,W MESH SRG PRTX 15CM RND,981.0,637.65,637.65,961.38,6
CDM,27815870,W MESH SRG PRTX 20CM RND,1442.0,937.3,242.26,1297.8,20
CDM,27815870_IP,W MESH SRG PRTX 20CM RND,1442.0,937.3,520.56,520.56,3
CDM,27815870_OP,W MESH SRG PRTX 20CM RND,1442.0,937.3,937.3,1413.16,6
CDM,27815880,W MESH SRG PRTX 30X20CM,2497.0,1623.05,419.5,2247.3,23
CDM,27815880_IP,W MESH SRG PRTX 30X20CM,2497.0,1623.05,901.42,901.42,3
CDM,27815880_OP,W MESH SRG PRTX 30X20CM,2497.0,1623.05,1623.05,2447.06,6
CDM,27815890,W MESH SRG PRTX STOMY HOLE 15CM,1249.0,811.85,209.83,1124.1,20
CDM,27815890_IP,W MESH SRG PRTX STOMY HOLE 15CM,1249.0,811.85,450.89,450.89,3
CDM,27815890_OP,W MESH SRG PRTX STOMY HOLE 15CM,1249.0,811.85,811.85,1224.02,6
CDM,27815900,W MESH SRG PRTX 15X10CM,750.0,487.5,126.0,675.0,20
CDM,27815900_IP,W MESH SRG PRTX 15X10CM,750.0,487.5,270.75,270.75,3
CDM,27815900_OP,W MESH SRG PRTX 15X10CM,750.0,487.5,487.5,735.0,6
CDM,27815910,W MESH SRG SURGIPRO 2.5X10CM,46.0,29.9,7.73,41.4,20
CDM,27815910_IP,W MESH SRG SURGIPRO 2.5X10CM,46.0,29.9,16.61,16.61,3
CDM,27815910_OP,W MESH SRG SURGIPRO 2.5X10CM,46.0,29.9,29.9,45.08,6
CDM,27815920,W MESH SRG SURGIPRO 35X20CM,138.0,89.7,23.18,124.2,20
CDM,27815920_IP,W MESH SRG SURGIPRO 35X20CM,138.0,89.7,49.82,49.82,3
CDM,27815920_OP,W MESH SRG SURGIPRO 35X20CM,138.0,89.7,89.7,135.24,6
CDM,27815930,W MESH SRG SURGIPRO 7.5X12.5CM,48.0,31.2,8.06,43.2,20
CDM,27815930_IP,W MESH SRG SURGIPRO 7.5X12.5CM,48.0,31.2,17.33,17.33,3
CDM,27815930_OP,W MESH SRG SURGIPRO 7.5X12.5CM,48.0,31.2,31.2,47.04,6
CDM,27815940,W MESH SRG SURGIPRO 15X15CM,56.0,36.4,9.41,50.4,20
CDM,27815940_IP,W MESH SRG SURGIPRO 15X15CM,56.0,36.4,20.22,20.22,3
CDM,27815940_OP,W MESH SRG SURGIPRO 15X15CM,56.0,36.4,36.4,54.88,6
CDM,27815950,W MESH SRG SURGIPRO 15X10CM,52.0,33.8,8.74,46.8,20
CDM,27815950_IP,W MESH SRG SURGIPRO 15X10CM,52.0,33.8,18.77,18.77,3
CDM,27815950_OP,W MESH SRG SURGIPRO 15X10CM,52.0,33.8,33.8,50.96,6
CDM,27815960,W MESH SRG PRTX 20X20/30X30,217.0,141.05,36.46,195.3,20
CDM,27815960_IP,W MESH SRG PRTX 20X20/30X30,217.0,141.05,78.34,78.34,3
CDM,27815960_OP,W MESH SRG PRTX 20X20/30X30,217.0,141.05,141.05,212.66,6
CDM,27815970,W MESH SRG PRTX W/SLIT 15X10CM,250.0,162.5,42.0,225.0,20
CDM,27815970_IP,W MESH SRG PRTX W/SLIT 15X10CM,250.0,162.5,90.25,90.25,3
CDM,27815970_OP,W MESH SRG PRTX W/SLIT 15X10CM,250.0,162.5,162.5,245.0,6
CDM,27815980,W MESH SRG ANATOMICAL 15X10CM,266.0,172.9,44.69,239.4,20
CDM,27815980_IP,W MESH SRG ANATOMICAL 15X10CM,266.0,172.9,96.03,96.03,3
CDM,27815980_OP,W MESH SRG ANATOMICAL 15X10CM,266.0,172.9,172.9,260.68,6
CDM,27815990,W MESH SRG ANATOMICAL 15X10CM,242.0,157.3,40.66,217.8,20
CDM,27815990_IP,W MESH SRG ANATOMICAL 15X10CM,242.0,157.3,87.36,87.36,3
CDM,27815990_OP,W MESH SRG ANATOMICAL 15X10CM,242.0,157.3,157.3,237.16,6
CDM,27816000,W MESH SRG ANAT W/SLIT & GRIP,274.0,178.1,46.03,246.6,20
CDM,27816000_IP,W MESH SRG ANAT W/SLIT & GRIP,274.0,178.1,98.91,98.91,3
CDM,27816000_OP,W MESH SRG ANAT W/SLIT & GRIP,274.0,178.1,178.1,268.52,6
CDM,27816005,2 X 6 STNLESS STEEL SD GRID,811.0,527.15,136.25,729.9,20
CDM,27816005_IP,2 X 6 STNLESS STEEL SD GRID,811.0,527.15,292.77,292.77,3
CDM,27816005_OP,2 X 6 STNLESS STEEL SD GRID,811.0,527.15,527.15,794.78,6
CDM,27816010,W MESH SRG PRTX PROGRIP,366.0,237.9,61.49,329.4,20
CDM,27816010_IP,W MESH SRG PRTX PROGRIP,366.0,237.9,132.13,132.13,3
CDM,27816010_OP,W MESH SRG PRTX PROGRIP,366.0,237.9,237.9,358.68,6
CDM,27816020,W MESH SRG ANAT EASGRIP 12X8CM,235.0,152.75,39.48,211.5,20
CDM,27816020_IP,W MESH SRG ANAT EASGRIP 12X8CM,235.0,152.75,84.84,84.84,3
CDM,27816020_OP,W MESH SRG ANAT EASGRIP 12X8CM,235.0,152.75,152.75,230.3,6
CDM,27816030,W MESH SRG ANAT EASGRIP 14X9CM,258.0,167.7,43.34,232.2,20
CDM,27816030_IP,W MESH SRG ANAT EASGRIP 14X9CM,258.0,167.7,93.14,93.14,3
CDM,27816030_OP,W MESH SRG ANAT EASGRIP 14X9CM,258.0,167.7,167.7,252.84,6
CDM,27816040,W MESH SRG PRTX 3D 50X50CM,1249.0,811.85,209.83,1124.1,20
CDM,27816040_IP,W MESH SRG PRTX 3D 50X50CM,1249.0,811.85,450.89,450.89,3
CDM,27816040_OP,W MESH SRG PRTX 3D 50X50CM,1249.0,811.85,811.85,1224.02,6
CDM,27816050,W MESH SRG PRTX LTWT 6X11CM,48.0,31.2,8.06,43.2,20
CDM,27816050_IP,W MESH SRG PRTX LTWT 6X11CM,48.0,31.2,17.33,17.33,3
CDM,27816050_OP,W MESH SRG PRTX LTWT 6X11CM,48.0,31.2,31.2,47.04,6
CDM,27816060,W MESH SRG PRTX 3D 15X15CM,243.0,157.95,40.82,218.7,20
CDM,27816060_IP,W MESH SRG PRTX 3D 15X15CM,243.0,157.95,87.72,87.72,3
CDM,27816060_OP,W MESH SRG PRTX 3D 15X15CM,243.0,157.95,157.95,238.14,6
CDM,27816070,W MESH SRG PRTX 3D 15X10CM,242.0,157.3,40.66,217.8,20
CDM,27816070_IP,W MESH SRG PRTX 3D 15X10CM,242.0,157.3,87.36,87.36,3
CDM,27816070_OP,W MESH SRG PRTX 3D 15X10CM,242.0,157.3,157.3,237.16,6
CDM,27816080,W MESH SRG PRTX 3D 20X20CM,281.0,182.65,47.21,252.9,20
CDM,27816080_IP,W MESH SRG PRTX 3D 20X20CM,281.0,182.65,101.44,101.44,3
CDM,27816080_OP,W MESH SRG PRTX 3D 20X20CM,281.0,182.65,182.65,275.38,6
CDM,27816090,W MESH SRG PRTX 3D 30X30CM,313.0,203.45,52.58,281.7,20
CDM,27816090_IP,W MESH SRG PRTX 3D 30X30CM,313.0,203.45,112.99,112.99,3
CDM,27816090_OP,W MESH SRG PRTX 3D 30X30CM,313.0,203.45,203.45,306.74,6
CDM,27816100,W MESH SRG PRTX LTWT 20X20CM,199.0,129.35,33.43,179.1,20
CDM,27816100_IP,W MESH SRG PRTX LTWT 20X20CM,199.0,129.35,71.84,71.84,3
CDM,27816100_OP,W MESH SRG PRTX LTWT 20X20CM,199.0,129.35,129.35,195.02,6
CDM,27816110,W MESH SRG PRTX LTWT 30X30CM,446.0,289.9,74.93,401.4,20
CDM,27816110_IP,W MESH SRG PRTX LTWT 30X30CM,446.0,289.9,161.01,161.01,3
CDM,27816110_OP,W MESH SRG PRTX LTWT 30X30CM,446.0,289.9,289.9,437.08,6
CDM,27816120,W MESH SRG PRTX LTWT 45X30CM,661.0,429.65,111.05,594.9,20
CDM,27816120_IP,W MESH SRG PRTX LTWT 45X30CM,661.0,429.65,238.62,238.62,3
CDM,27816120_OP,W MESH SRG PRTX LTWT 45X30CM,661.0,429.65,429.65,647.78,6
CDM,27816130,W MESH SRG PRTX HEART SHP 8X8CM,742.0,482.3,124.66,667.8,20
CDM,27816130_IP,W MESH SRG PRTX HEART SHP 8X8CM,742.0,482.3,267.86,267.86,3
CDM,27816130_OP,W MESH SRG PRTX HEART SHP 8X8CM,742.0,482.3,482.3,727.16,6
CDM,27816140,W MESH SRG PRTX HRSHOE 9X8CM,796.0,517.4,133.73,716.4,20
CDM,27816140_IP,W MESH SRG PRTX HRSHOE 9X8CM,796.0,517.4,287.36,287.36,3
CDM,27816140_OP,W MESH SRG PRTX HRSHOE 9X8CM,796.0,517.4,517.4,780.08,6
CDM,27816150,W MESH SRG STOMY NO HOLE 15CM,1405.0,913.25,236.04,1264.5,20
CDM,27816150_IP,W MESH SRG STOMY NO HOLE 15CM,1405.0,913.25,507.21,507.21,3
CDM,27816150_OP,W MESH SRG STOMY NO HOLE 15CM,1405.0,913.25,913.25,1376.9,6
CDM,27816160,W MESH SRG STOMY NO HOLE 20CM,1561.0,1014.65,262.25,1404.9,20
CDM,27816160_IP,W MESH SRG STOMY NO HOLE 20CM,1561.0,1014.65,563.52,563.52,3
CDM,27816160_OP,W MESH SRG STOMY NO HOLE 20CM,1561.0,1014.65,1014.65,1529.78,6
CDM,27816170,W MESH SRG PRTX PLUG 6CM,206.0,133.9,34.61,185.4,20
CDM,27816170_IP,W MESH SRG PRTX PLUG 6CM,206.0,133.9,74.37,74.37,3
CDM,27816170_OP,W MESH SRG PRTX PLUG 6CM,206.0,133.9,133.9,201.88,6
CDM,27816180,W MESH SRG PRTX PLUG 8CM,215.0,139.75,36.12,193.5,20
CDM,27816180_IP,W MESH SRG PRTX PLUG 8CM,215.0,139.75,77.62,77.62,3
CDM,27816180_OP,W MESH SRG PRTX PLUG 8CM,215.0,139.75,139.75,210.7,6
CDM,27816190,W MESH SRG SURGIPRO PATCH LG,154.0,100.1,25.87,138.6,20
CDM,27816190_IP,W MESH SRG SURGIPRO PATCH LG,154.0,100.1,55.59,55.59,3
CDM,27816190_OP,W MESH SRG SURGIPRO PATCH LG,154.0,100.1,100.1,150.92,6
CDM,27816200,W MESH SRG SURGIPRO PATCH SM,122.0,79.3,20.5,109.8,20
CDM,27816200_IP,W MESH SRG SURGIPRO PATCH SM,122.0,79.3,44.04,44.04,3
CDM,27816200_OP,W MESH SRG SURGIPRO PATCH SM,122.0,79.3,79.3,119.56,6
CDM,27816210,W MESH SRG PRTX 13X9CM,136.0,88.4,22.85,122.4,20
CDM,27816210_IP,W MESH SRG PRTX 13X9CM,136.0,88.4,49.1,49.1,3
CDM,27816210_OP,W MESH SRG PRTX 13X9CM,136.0,88.4,88.4,133.28,6
CDM,27816220,W MESH SRG FLDNG W/SLIT 14X10CM,264.0,171.6,44.35,237.6,20
CDM,27816220_IP,W MESH SRG FLDNG W/SLIT 14X10CM,264.0,171.6,95.3,95.3,3
CDM,27816220_OP,W MESH SRG FLDNG W/SLIT 14X10CM,264.0,171.6,171.6,258.72,6
CDM,27816230,W MESH SRG PRTX FLDNG 14X10CM,233.0,151.45,39.14,209.7,20
CDM,27816230_IP,W MESH SRG PRTX FLDNG 14X10CM,233.0,151.45,84.11,84.11,3
CDM,27816230_OP,W MESH SRG PRTX FLDNG 14X10CM,233.0,151.45,151.45,228.34,6
CDM,27816240,W MESH SRG PRTX 15X10CM,149.0,96.85,25.03,134.1,20
CDM,27816240_IP,W MESH SRG PRTX 15X10CM,149.0,96.85,53.79,53.79,3
CDM,27816240_OP,W MESH SRG PRTX 15X10CM,149.0,96.85,96.85,146.02,6
CDM,27816250,W MESH SRG PRTX 15X15CM,180.0,117.0,30.24,162.0,20
CDM,27816250_IP,W MESH SRG PRTX 15X15CM,180.0,117.0,64.98,64.98,3
CDM,27816250_OP,W MESH SRG PRTX 15X15CM,180.0,117.0,117.0,176.4,6
CDM,27816260,W MESH SRG RGD KNITTED 15X10CM,129.0,83.85,21.67,116.1,20
CDM,27816260_IP,W MESH SRG RGD KNITTED 15X10CM,129.0,83.85,46.57,46.57,3
CDM,27816260_OP,W MESH SRG RGD KNITTED 15X10CM,129.0,83.85,83.85,126.42,6
CDM,27816270,W MESH SRG RGD KNITTED 15X15CM,114.0,74.1,19.15,102.6,20
CDM,27816270_IP,W MESH SRG RGD KNITTED 15X15CM,114.0,74.1,41.15,41.15,3
CDM,27816270_OP,W MESH SRG RGD KNITTED 15X15CM,114.0,74.1,74.1,111.72,6
CDM,27816280,W MESH SRG PRTX 3D 13X9CM,175.0,113.75,29.4,157.5,20
CDM,27816280_IP,W MESH SRG PRTX 3D 13X9CM,175.0,113.75,63.18,63.18,3
CDM,27816280_OP,W MESH SRG PRTX 3D 13X9CM,175.0,113.75,113.75,171.5,6
CDM,27816290,W MESH SRG 3D W/SLIT 13X9CM,193.0,125.45,32.42,173.7,20
CDM,27816290_IP,W MESH SRG 3D W/SLIT 13X9CM,193.0,125.45,69.67,69.67,3
CDM,27816290_OP,W MESH SRG 3D W/SLIT 13X9CM,193.0,125.45,125.45,189.14,6
CDM,27816300,W CATH VENTRICULAR F8 15CM,370.0,240.5,62.16,333.0,20
CDM,27816300_IP,W CATH VENTRICULAR F8 15CM,370.0,240.5,133.57,133.57,3
CDM,27816300_OP,W CATH VENTRICULAR F8 15CM,370.0,240.5,240.5,362.6,6
CDM,27816340,W H060002 IBV VALVE HU-VS 5-7,5500.0,3575.0,924.0,4950.0,29
CDM,27816340_OP,W H060002 IBV VALVE HU-VS 5-7,5500.0,3575.0,3575.0,5390.0,6
CDM,27816350,W GEN NEUROSTIM ACTIVA DUAL PC,34400.0,22360.0,5779.2,30960.0,29
CDM,27816350_OP,W GEN NEUROSTIM ACTIVA DUAL PC,34400.0,22360.0,22360.0,33712.0,6
CDM,27816360,W STEM PLASMA CLASSIC,2800.0,1820.0,470.4,2520.0,23
CDM,27816360_IP,W STEM PLASMA CLASSIC,2800.0,1820.0,1010.8,1010.8,3
CDM,27816360_OP,W STEM PLASMA CLASSIC,2800.0,1820.0,1820.0,2744.0,6
CDM,27816370,W SCREW CANCELLOUS SLF-TAP BONE,288.0,187.2,48.38,259.2,20
CDM,27816370_IP,W SCREW CANCELLOUS SLF-TAP BONE,288.0,187.2,103.97,103.97,3
CDM,27816370_OP,W SCREW CANCELLOUS SLF-TAP BONE,288.0,187.2,187.2,282.24,6
CDM,27816380,W LEAD PACE LV QUARTET,2720.0,1768.0,456.96,2448.0,23
CDM,27816380_IP,W LEAD PACE LV QUARTET,2720.0,1768.0,981.92,981.92,3
CDM,27816380_OP,W LEAD PACE LV QUARTET,2720.0,1768.0,1768.0,2665.6,6
CDM,27816390,W DEFIB UNIFY QUADRA ICD CARD,31200.0,20280.0,5241.6,28080.0,29
CDM,27816390_OP,W DEFIB UNIFY QUADRA ICD CARD,31200.0,20280.0,20280.0,30576.0,6
CDM,27816400,DEV CLSR 6FR EXOSEAL VASC,350.0,227.5,58.8,315.0,20
CDM,27816400_IP,DEV CLSR 6FR EXOSEAL VASC,350.0,227.5,126.35,126.35,3
CDM,27816400_OP,DEV CLSR 6FR EXOSEAL VASC,350.0,227.5,227.5,343.0,6
CDM,27816410,W STENT COR RX XIENCE,3108.0,2020.2,522.14,2797.2,23
CDM,27816410_IP,W STENT COR RX XIENCE,3108.0,2020.2,1121.99,1121.99,3
CDM,27816410_OP,W STENT COR RX XIENCE,3108.0,2020.2,2020.2,3045.84,6
CDM,27816420,W STENT OASIS PRLDED CTTN LEUNG,202.0,131.3,33.94,181.8,20
CDM,27816420_IP,W STENT OASIS PRLDED CTTN LEUNG,202.0,131.3,72.92,72.92,3
CDM,27816420_OP,W STENT OASIS PRLDED CTTN LEUNG,202.0,131.3,131.3,197.96,6
CDM,27816430,W DFIB CARD ENERGEN CRT-D PLS,30000.0,19500.0,5040.0,27000.0,29
CDM,27816430_OP,W DFIB CARD ENERGEN CRT-D PLS,30000.0,19500.0,19500.0,29400.0,6
CDM,27816440,W EMBO PARTICLES LC BEAD 2ML,6000.0,3900.0,1008.0,5400.0,29
CDM,27816440_OP,W EMBO PARTICLES LC BEAD 2ML,6000.0,3900.0,3900.0,5880.0,6
CDM,27816450,W CATH 23CM 16FR EQUISTREAM,620.0,403.0,104.16,558.0,20
CDM,27816450_IP,W CATH 23CM 16FR EQUISTREAM,620.0,403.0,223.82,223.82,3
CDM,27816450_OP,W CATH 23CM 16FR EQUISTREAM,620.0,403.0,403.0,607.6,6
CDM,27816460,W PORT 8FR VACCESS,670.0,435.5,112.56,603.0,20
CDM,27816460_IP,W PORT 8FR VACCESS,670.0,435.5,241.87,241.87,3
CDM,27816460_OP,W PORT 8FR VACCESS,670.0,435.5,435.5,656.6,6
CDM,27816470,W ADPT INTRO SEAL EXT WNG,422.0,274.3,70.9,379.8,20
CDM,27816470_IP,W ADPT INTRO SEAL EXT WNG,422.0,274.3,152.34,152.34,3
CDM,27816470_OP,W ADPT INTRO SEAL EXT WNG,422.0,274.3,274.3,413.56,6
CDM,27816480,W ICD UNIFY ASSURA CRTD IS1,19400.0,12610.0,3259.2,17460.0,29
CDM,27816480_OP,W ICD UNIFY ASSURA CRTD IS1,19400.0,12610.0,12610.0,19012.0,6
CDM,27816490,W ICD QUADRA ASSURA CRTD IS4,31200.0,20280.0,5241.6,28080.0,29
CDM,27816490_OP,W ICD QUADRA ASSURA CRTD IS4,31200.0,20280.0,20280.0,30576.0,6
CDM,27816500,W ICD ELLIPSE DR,15000.0,9750.0,2520.0,13500.0,29
CDM,27816500_OP,W ICD ELLIPSE DR,15000.0,9750.0,9750.0,14700.0,6
CDM,27816510,W ICD ASSURA/ELLIPSE VR,17700.0,11505.0,2973.6,15930.0,29
CDM,27816510_OP,W ICD ASSURA/ELLIPSE VR,17700.0,11505.0,11505.0,17346.0,6
CDM,27816520,W GEN NEUROSTM RESTR 37714,26600.0,17290.0,4468.8,23940.0,29
CDM,27816520_OP,W GEN NEUROSTM RESTR 37714,26600.0,17290.0,17290.0,26068.0,6
CDM,27816530,W STENT DRUG ELUTING PROMUS,2600.0,1690.0,436.8,2340.0,23
CDM,27816530_IP,W STENT DRUG ELUTING PROMUS,2600.0,1690.0,938.6,938.6,3
CDM,27816530_OP,W STENT DRUG ELUTING PROMUS,2600.0,1690.0,1690.0,2548.0,6
CDM,27816540,W ADPT 25CM Y UNPLR PIN PLG,200.0,130.0,33.6,180.0,20
CDM,27816540_IP,W ADPT 25CM Y UNPLR PIN PLG,200.0,130.0,72.2,72.2,3
CDM,27816540_OP,W ADPT 25CM Y UNPLR PIN PLG,200.0,130.0,130.0,196.0,6
CDM,27816550,W LEAD PACE 58CM 7.5FR SUBQ,3200.0,2080.0,537.6,2880.0,23
CDM,27816550_IP,W LEAD PACE 58CM 7.5FR SUBQ,3200.0,2080.0,1155.2,1155.2,3
CDM,27816550_OP,W LEAD PACE 58CM 7.5FR SUBQ,3200.0,2080.0,2080.0,3136.0,6
CDM,27816560,W ANCHR SUT 3.5MM 2USP STATAK,393.0,255.45,66.02,353.7,20
CDM,27816560_IP,W ANCHR SUT 3.5MM 2USP STATAK,393.0,255.45,141.87,141.87,3
CDM,27816560_OP,W ANCHR SUT 3.5MM 2USP STATAK,393.0,255.45,255.45,385.14,6
CDM,27816570,W HEAD RADL 24MM EXPLOR ELB,1250.0,812.5,210.0,1125.0,20
CDM,27816570_IP,W HEAD RADL 24MM EXPLOR ELB,1250.0,812.5,451.25,451.25,3
CDM,27816570_OP,W HEAD RADL 24MM EXPLOR ELB,1250.0,812.5,812.5,1225.0,6
CDM,27816580,W STEM RADL 24MM EXPLOR ELB,1750.0,1137.5,294.0,1575.0,23
CDM,27816580_IP,W STEM RADL 24MM EXPLOR ELB,1750.0,1137.5,631.75,631.75,3
CDM,27816580_OP,W STEM RADL 24MM EXPLOR ELB,1750.0,1137.5,1137.5,1715.0,6
CDM,27816590,W PROS PENL RSVR CONCEAL INHB,3237.0,2104.05,543.82,2913.3,23
CDM,27816590_IP,W PROS PENL RSVR CONCEAL INHB,3237.0,2104.05,1168.56,1168.56,3
CDM,27816590_OP,W PROS PENL RSVR CONCEAL INHB,3237.0,2104.05,2104.05,3172.26,6
CDM,27816600,W PROS PENL AMS 700MS 18CM,12769.0,8299.85,2145.19,11492.1,29
CDM,27816600_OP,W PROS PENL AMS 700MS 18CM,12769.0,8299.85,8299.85,12513.62,6
CDM,27816610,W SLING URTH VIRT VNTRL SYS,8800.0,5720.0,1478.4,7920.0,29
CDM,27816610_OP,W SLING URTH VIRT VNTRL SYS,8800.0,5720.0,5720.0,8624.0,6
CDM,27816650,W CATH INTRATHECAL ASCENDA,1800.0,1170.0,302.4,1620.0,23
CDM,27816650_IP,W CATH INTRATHECAL ASCENDA,1800.0,1170.0,649.8,649.8,3
CDM,27816650_OP,W CATH INTRATHECAL ASCENDA,1800.0,1170.0,1170.0,1764.0,6
CDM,27816660,W EMBL COIL 50MM FBR COMPLEX,170.0,110.5,28.56,153.0,20
CDM,27816660_IP,W EMBL COIL 50MM FBR COMPLEX,170.0,110.5,61.37,61.37,3
CDM,27816660_OP,W EMBL COIL 50MM FBR COMPLEX,170.0,110.5,110.5,166.6,6
CDM,27816670,W EMBL COIL 18 FBRD IDC 2D,818.0,531.7,137.42,736.2,20
CDM,27816670_IP,W EMBL COIL 18 FBRD IDC 2D,818.0,531.7,295.3,295.3,3
CDM,27816670_OP,W EMBL COIL 18 FBRD IDC 2D,818.0,531.7,531.7,801.64,6
CDM,27816680,W EMBL COIL 35 FBRD 2D OCCL,1800.0,1170.0,302.4,1620.0,23
CDM,27816680_IP,W EMBL COIL 35 FBRD 2D OCCL,1800.0,1170.0,649.8,649.8,3
CDM,27816680_OP,W EMBL COIL 35 FBRD 2D OCCL,1800.0,1170.0,1170.0,1764.0,6
CDM,27816690,W STENT BIL HERCULNK ELITE,2010.0,1306.5,337.68,1809.0,23
CDM,27816690_IP,W STENT BIL HERCULNK ELITE,2010.0,1306.5,725.61,725.61,3
CDM,27816690_OP,W STENT BIL HERCULNK ELITE,2010.0,1306.5,1306.5,1969.8,6
CDM,27816700,W COIL EMBL 20CM 6MM INTLK,1500.0,975.0,252.0,1350.0,20
CDM,27816700_IP,W COIL EMBL 20CM 6MM INTLK,1500.0,975.0,541.5,541.5,3
CDM,27816700_OP,W COIL EMBL 20CM 6MM INTLK,1500.0,975.0,975.0,1470.0,6
CDM,27816710,W LEAD PACE 55CM 1COIL SQ SCR,6174.0,4013.1,1037.23,5556.6,29
CDM,27816710_OP,W LEAD PACE 55CM 1COIL SQ SCR,6174.0,4013.1,4013.1,6050.52,6
CDM,27816720,W PLUG CV 100CM 6FR 12MM AMPL,1600.0,1040.0,268.8,1440.0,20
CDM,27816720_IP,W PLUG CV 100CM 6FR 12MM AMPL,1600.0,1040.0,577.6,577.6,3
CDM,27816720_OP,W PLUG CV 100CM 6FR 12MM AMPL,1600.0,1040.0,1040.0,1568.0,6
CDM,27816730,W KIT CTH 20CM 12FR MAK 3 LUM,180.0,117.0,30.24,162.0,20
CDM,27816730_IP,W KIT CTH 20CM 12FR MAK 3 LUM,180.0,117.0,64.98,64.98,3
CDM,27816730_OP,W KIT CTH 20CM 12FR MAK 3 LUM,180.0,117.0,117.0,176.4,6
CDM,27816740,W TRAY CTH 19.5CM 11.5FR MAK,206.0,133.9,34.61,185.4,20
CDM,27816740_IP,W TRAY CTH 19.5CM 11.5FR MAK,206.0,133.9,74.37,74.37,3
CDM,27816740_OP,W TRAY CTH 19.5CM 11.5FR MAK,206.0,133.9,133.9,201.88,6
CDM,27816750,W DEFIB VIVA S CRT-D DF1,37000.0,24050.0,6216.0,33300.0,29
CDM,27816750_OP,W DEFIB VIVA S CRT-D DF1,37000.0,24050.0,24050.0,36260.0,6
CDM,27816760,W DEFIB EVERA S DR DF4,31300.0,20345.0,5258.4,28170.0,29
CDM,27816760_OP,W DEFIB EVERA S DR DF4,31300.0,20345.0,20345.0,30674.0,6
CDM,27816770,W STENT VASC 6MM 6FR 120CM,1780.0,1157.0,299.04,1602.0,23
CDM,27816770_IP,W STENT VASC 6MM 6FR 120CM,1780.0,1157.0,642.58,642.58,3
CDM,27816770_OP,W STENT VASC 6MM 6FR 120CM,1780.0,1157.0,1157.0,1744.4,6
CDM,27816780,W STENT VASC EPIC SE NTNL,1450.0,942.5,243.6,1305.0,20
CDM,27816780_IP,W STENT VASC EPIC SE NTNL,1450.0,942.5,523.45,523.45,3
CDM,27816780_OP,W STENT VASC EPIC SE NTNL,1450.0,942.5,942.5,1421.0,6
CDM,27816790,W DEFIB CARD VIVA XT DF-1,38000.0,24700.0,6384.0,34200.0,29
CDM,27816790_OP,W DEFIB CARD VIVA XT DF-1,38000.0,24700.0,24700.0,37240.0,6
CDM,27816800,W DEFIB CARD EVERA XT DR DF1,32500.0,21125.0,5460.0,29250.0,29
CDM,27816800_OP,W DEFIB CARD EVERA XT DR DF1,32500.0,21125.0,21125.0,31850.0,6
CDM,27816810,W COIL EMBL 30CM 14MM CONCRTO,1972.0,1281.8,331.3,1774.8,23
CDM,27816810_IP,W COIL EMBL 30CM 14MM CONCRTO,1972.0,1281.8,711.89,711.89,3
CDM,27816810_OP,W COIL EMBL 30CM 14MM CONCRTO,1972.0,1281.8,1281.8,1932.56,6
CDM,27816820,W DEFIB CARD EVERA XT VR DF4,26000.0,16900.0,4368.0,23400.0,29
CDM,27816820_OP,W DEFIB CARD EVERA XT VR DF4,26000.0,16900.0,16900.0,25480.0,6
CDM,27816830,W TRAY PROC UNV AVAMAX + VRTBPL,1300.0,845.0,218.4,1170.0,20
CDM,27816830_IP,W TRAY PROC UNV AVAMAX + VRTBPL,1300.0,845.0,469.3,469.3,3
CDM,27816830_OP,W TRAY PROC UNV AVAMAX + VRTBPL,1300.0,845.0,845.0,1274.0,6
CDM,27816840,W DEFIB SC EVER S VR,24700.0,16055.0,4149.6,22230.0,29
CDM,27816840_OP,W DEFIB SC EVER S VR,24700.0,16055.0,16055.0,24206.0,6
CDM,27816850,YTTRIUM-90,33000.0,21450.0,6962.14,37910.58,48
CDM,27816850_OP,YTTRIUM-90,33000.0,21450.0,21450.0,32340.0,6
CDM,27816860,W STENT BIL SMART CNTRL ILIAC,1300.0,845.0,218.4,1170.0,20
CDM,27816860_IP,W STENT BIL SMART CNTRL ILIAC,1300.0,845.0,469.3,469.3,3
CDM,27816860_OP,W STENT BIL SMART CNTRL ILIAC,1300.0,845.0,845.0,1274.0,6
CDM,27816870,W OCCLUSION SYS STD INTERLOCK,1020.0,663.0,171.36,918.0,20
CDM,27816870_IP,W OCCLUSION SYS STD INTERLOCK,1020.0,663.0,368.22,368.22,3
CDM,27816870_OP,W OCCLUSION SYS STD INTERLOCK,1020.0,663.0,663.0,999.6,6
CDM,27816880,W OCCLUSION SYS INTERLOCK IDC,820.0,533.0,137.76,738.0,20
CDM,27816880_IP,W OCCLUSION SYS INTERLOCK IDC,820.0,533.0,296.02,296.02,3
CDM,27816880_OP,W OCCLUSION SYS INTERLOCK IDC,820.0,533.0,533.0,803.6,6
CDM,27816890,"W HEARTMATE,LVAD IMPL KT,106015",157500.0,102375.0,26460.0,141750.0,29
CDM,27816890_OP,"W HEARTMATE,LVAD IMPL KT,106015",157500.0,102375.0,102375.0,154350.0,6
CDM,27816900,W COIL EMBL SYST BARRICADE,1700.0,1105.0,285.6,1530.0,20
CDM,27816900_IP,W COIL EMBL SYST BARRICADE,1700.0,1105.0,613.7,613.7,3
CDM,27816900_OP,W COIL EMBL SYST BARRICADE,1700.0,1105.0,1105.0,1666.0,6
CDM,27816910,W COIL EMBL TARGET SOFT 360D,3060.0,1989.0,514.08,2754.0,23
CDM,27816910_IP,W COIL EMBL TARGET SOFT 360D,3060.0,1989.0,1104.66,1104.66,3
CDM,27816910_OP,W COIL EMBL TARGET SOFT 360D,3060.0,1989.0,1989.0,2998.8,6
CDM,27816920,W COIL EMBL TRGT 360 STD,3240.0,2106.0,544.32,2916.0,23
CDM,27816920_IP,W COIL EMBL TRGT 360 STD,3240.0,2106.0,1169.64,1169.64,3
CDM,27816920_OP,W COIL EMBL TRGT 360 STD,3240.0,2106.0,2106.0,3175.2,6
CDM,27816930,W COIL EMBL AZUR DTCH  PLTNM,1929.0,1253.85,324.07,1736.1,23
CDM,27816930_IP,W COIL EMBL AZUR DTCH  PLTNM,1929.0,1253.85,696.37,696.37,3
CDM,27816930_OP,W COIL EMBL AZUR DTCH  PLTNM,1929.0,1253.85,1253.85,1890.42,6
CDM,27816940,W SYS CARD MNTR RVL LINQ INS,9290.0,6038.5,1560.72,8361.0,29
CDM,27816940_OP,W SYS CARD MNTR RVL LINQ INS,9290.0,6038.5,6038.5,9104.2,6
CDM,27816950,W COIL EMBL AZUR HYDRO,1896.0,1232.4,318.53,1706.4,23
CDM,27816950_IP,W COIL EMBL AZUR HYDRO,1896.0,1232.4,684.46,684.46,3
CDM,27816950_OP,W COIL EMBL AZUR HYDRO,1896.0,1232.4,1232.4,1858.08,6
CDM,27816960,W STENT INTRCRN SYS HUD 020002,10791.0,7014.15,1812.89,9711.9,29
CDM,27816960_OP,W STENT INTRCRN SYS HUD 020002,10791.0,7014.15,7014.15,10575.18,6
CDM,27816970,W COIL EMBL MICRPLX COLS 10,2827.0,1837.55,474.94,2544.3,23
CDM,27816970_IP,W COIL EMBL MICRPLX COLS 10,2827.0,1837.55,1020.55,1020.55,3
CDM,27816970_OP,W COIL EMBL MICRPLX COLS 10,2827.0,1837.55,1837.55,2770.46,6
CDM,27816980,W COIL EMBL HYDRFM STCH REST,4501.0,2925.65,756.17,4050.9,23
CDM,27816980_IP,W COIL EMBL HYDRFM STCH REST,4501.0,2925.65,1624.86,1624.86,3
CDM,27816980_OP,W COIL EMBL HYDRFM STCH REST,4501.0,2925.65,2925.65,4410.98,6
CDM,27816990,W COIL EMBL HYDRSFT LRG PLT,2790.0,1813.5,468.72,2511.0,23
CDM,27816990_IP,W COIL EMBL HYDRSFT LRG PLT,2790.0,1813.5,1007.19,1007.19,3
CDM,27816990_OP,W COIL EMBL HYDRSFT LRG PLT,2790.0,1813.5,1813.5,2734.2,6
CDM,27816WE,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1351.0,878.15,181.7,1013.25,35
CDM,27817000,W COIL EMBL STRETCH RESIS,2892.0,1879.8,485.86,2602.8,23
CDM,27817000_IP,W COIL EMBL STRETCH RESIS,2892.0,1879.8,1044.01,1044.01,3
CDM,27817000_OP,W COIL EMBL STRETCH RESIS,2892.0,1879.8,1879.8,2834.16,6
CDM,27817010,W COIL EMBL VFC MCROPLX,2753.0,1789.45,462.5,2477.7,23
CDM,27817010_IP,W COIL EMBL VFC MCROPLX,2753.0,1789.45,993.83,993.83,3
CDM,27817010_OP,W COIL EMBL VFC MCROPLX,2753.0,1789.45,1789.45,2697.94,6
CDM,27817020,W LEAD OPTISR DFB OPTM INSLTN,6000.0,3900.0,1008.0,5400.0,29
CDM,27817020_OP,W LEAD OPTISR DFB OPTM INSLTN,6000.0,3900.0,3900.0,5880.0,6
CDM,27817030,W KIT CATH LT DLYS GLIDEPATH,620.0,403.0,104.16,558.0,20
CDM,27817030_IP,W KIT CATH LT DLYS GLIDEPATH,620.0,403.0,223.82,223.82,3
CDM,27817030_OP,W KIT CATH LT DLYS GLIDEPATH,620.0,403.0,403.0,607.6,6
CDM,27817040,W COIL EMBL AZUR PLTM HYDRGL,2698.0,1753.7,453.26,2428.2,23
CDM,27817040_IP,W COIL EMBL AZUR PLTM HYDRGL,2698.0,1753.7,973.98,973.98,3
CDM,27817040_OP,W COIL EMBL AZUR PLTM HYDRGL,2698.0,1753.7,1753.7,2644.04,6
CDM,27817050,W ICD EVERA XT VR SNGL CHAMBER,22000.0,14300.0,3696.0,19800.0,29
CDM,27817050_OP,W ICD EVERA XT VR SNGL CHAMBER,22000.0,14300.0,14300.0,21560.0,6
CDM,27817060,"BRACHY SOURCE TX, STRANDED I-125",210.0,136.5,36.04,189.0,36
CDM,27817060_IP,"BRACHY SOURCE TX, STRANDED I-125",210.0,136.5,75.81,75.81,3
CDM,27817060_OP,"BRACHY SOURCE TX, STRANDED I-125",210.0,136.5,136.5,205.8,6
CDM,27817070,W CANN PERF ATR LONG RT ANG,5600.0,3640.0,940.8,5040.0,29
CDM,27817070_OP,W CANN PERF ATR LONG RT ANG,5600.0,3640.0,3640.0,5488.0,6
CDM,27817080,W VENTRICULAR CANNULA,5600.0,3640.0,940.8,5040.0,29
CDM,27817080_OP,W VENTRICULAR CANNULA,5600.0,3640.0,3640.0,5488.0,6
CDM,27817090,W CANN PERF ART RT OUTFLOW,7400.0,4810.0,1243.2,6660.0,29
CDM,27817090_OP,W CANN PERF ART RT OUTFLOW,7400.0,4810.0,4810.0,7252.0,6
CDM,27817100,W CANN PERF ART LT OUTFLOW,7890.0,5128.5,1325.52,7101.0,29
CDM,27817100_OP,W CANN PERF ART LT OUTFLOW,7890.0,5128.5,5128.5,7732.2,6
CDM,27817110,W DEV VENT ASST PARACORPOREAL,96000.0,62400.0,16128.0,86400.0,29
CDM,27817110_OP,W DEV VENT ASST PARACORPOREAL,96000.0,62400.0,62400.0,94080.0,6
CDM,27817120,W COIL EMBL MCPLX10 COSMOS,3014.0,1959.1,506.35,2712.6,23
CDM,27817120_IP,W COIL EMBL MCPLX10 COSMOS,3014.0,1959.1,1088.05,1088.05,3
CDM,27817120_OP,W COIL EMBL MCPLX10 COSMOS,3014.0,1959.1,1959.1,2953.72,6
CDM,27817130,W COIL VFC MCROPLX3,2604.0,1692.6,437.47,2343.6,23
CDM,27817130_IP,W COIL VFC MCROPLX3,2604.0,1692.6,940.04,940.04,3
CDM,27817130_OP,W COIL VFC MCROPLX3,2604.0,1692.6,1692.6,2551.92,6
CDM,27817140,W DFIB CRD INOGN X4 CRT-D DF4,25600.0,16640.0,4300.8,23040.0,29
CDM,27817140_OP,W DFIB CRD INOGN X4 CRT-D DF4,25600.0,16640.0,16640.0,25088.0,6
CDM,27817150,W STENT VASC SE ILIAC  NTNL,1150.0,747.5,193.2,1035.0,20
CDM,27817150_IP,W STENT VASC SE ILIAC  NTNL,1150.0,747.5,415.15,415.15,3
CDM,27817150_OP,W STENT VASC SE ILIAC  NTNL,1150.0,747.5,747.5,1127.0,6
CDM,27817160,W STENT SMART CNTRL SE ILIAC,950.0,617.5,159.6,855.0,20
CDM,27817160_IP,W STENT SMART CNTRL SE ILIAC,950.0,617.5,342.95,342.95,3
CDM,27817160_OP,W STENT SMART CNTRL SE ILIAC,950.0,617.5,617.5,931.0,6
CDM,27817170,W STENT SMART FLEX BIL SE,1250.0,812.5,210.0,1125.0,20
CDM,27817170_IP,W STENT SMART FLEX BIL SE,1250.0,812.5,451.25,451.25,3
CDM,27817170_OP,W STENT SMART FLEX BIL SE,1250.0,812.5,812.5,1225.0,6
CDM,27817180,W STENT BIL PLMZ GN TRNS  SS GW,1200.0,780.0,201.6,1080.0,20
CDM,27817180_IP,W STENT BIL PLMZ GN TRNS  SS GW,1200.0,780.0,433.2,433.2,3
CDM,27817180_OP,W STENT BIL PLMZ GN TRNS  SS GW,1200.0,780.0,780.0,1176.0,6
CDM,27817190,W STENT BIL UNMTD TRNSH PLMZ,1600.0,1040.0,268.8,1440.0,20
CDM,27817190_IP,W STENT BIL UNMTD TRNSH PLMZ,1600.0,1040.0,577.6,577.6,3
CDM,27817190_OP,W STENT BIL UNMTD TRNSH PLMZ,1600.0,1040.0,1040.0,1568.0,6
CDM,27817200,W LEAD PACE ATTN IS4 C CRV,3234.0,2102.1,543.31,2910.6,23
CDM,27817200_IP,W LEAD PACE ATTN IS4 C CRV,3234.0,2102.1,1167.47,1167.47,3
CDM,27817200_OP,W LEAD PACE ATTN IS4 C CRV,3234.0,2102.1,2102.1,3169.32,6
CDM,27817210,W DFIB CARD VIVA QUAD S,33600.0,21840.0,5644.8,30240.0,29
CDM,27817210_OP,W DFIB CARD VIVA QUAD S,33600.0,21840.0,21840.0,32928.0,6
CDM,27817220,W EMBL COIL MREYE MAX,136.0,88.4,22.85,122.4,20
CDM,27817220_IP,W EMBL COIL MREYE MAX,136.0,88.4,49.1,49.1,3
CDM,27817220_OP,W EMBL COIL MREYE MAX,136.0,88.4,88.4,133.28,6
CDM,27817230,W COIL EMBLTN PENUMBR RUBY,1990.0,1293.5,334.32,1791.0,23
CDM,27817230_IP,W COIL EMBLTN PENUMBR RUBY,1990.0,1293.5,718.39,718.39,3
CDM,27817230_OP,W COIL EMBLTN PENUMBR RUBY,1990.0,1293.5,1293.5,1950.2,6
CDM,27817240,W DFIB CARD SQRXS-ICD,32000.0,20800.0,5376.0,28800.0,29
CDM,27817240_OP,W DFIB CARD SQRXS-ICD,32000.0,20800.0,20800.0,31360.0,6
CDM,27817250,W ELECTRODE Q-TRAK,8000.0,5200.0,1344.0,7200.0,29
CDM,27817250_OP,W ELECTRODE Q-TRAK,8000.0,5200.0,5200.0,7840.0,6
CDM,27817260,W CTH EMBL SE PIPLIN DEVICE,25000.0,16250.0,4200.0,22500.0,29
CDM,27817260_OP,W CTH EMBL SE PIPLIN DEVICE,25000.0,16250.0,16250.0,24500.0,6
CDM,27817270,W TIBIAL COMPNT PRECOAT LM/RL,1520.0,988.0,255.36,1368.0,20
CDM,27817270_IP,W TIBIAL COMPNT PRECOAT LM/RL,1520.0,988.0,548.72,548.72,3
CDM,27817270_OP,W TIBIAL COMPNT PRECOAT LM/RL,1520.0,988.0,988.0,1489.6,6
CDM,27817280,W ARTICULR SURFACE INSRTR TIP,280.0,182.0,47.04,252.0,20
CDM,27817280_IP,W ARTICULR SURFACE INSRTR TIP,280.0,182.0,101.08,101.08,3
CDM,27817280_OP,W ARTICULR SURFACE INSRTR TIP,280.0,182.0,182.0,274.4,6
CDM,27817290,W COMPNT FEMORAL HIGH FLEX,2470.0,1605.5,414.96,2223.0,23
CDM,27817290_IP,W COMPNT FEMORAL HIGH FLEX,2470.0,1605.5,891.67,891.67,3
CDM,27817290_OP,W COMPNT FEMORAL HIGH FLEX,2470.0,1605.5,1605.5,2420.6,6
CDM,27817300,W SURFACE ARTICULAR FEM KNEE,1710.0,1111.5,287.28,1539.0,20
CDM,27817300_IP,W SURFACE ARTICULAR FEM KNEE,1710.0,1111.5,617.31,617.31,3
CDM,27817300_OP,W SURFACE ARTICULAR FEM KNEE,1710.0,1111.5,1111.5,1675.8,6
CDM,27817310,W NRSTM IMP PRIME ADV MRI,19800.0,12870.0,3326.4,17820.0,29
CDM,27817310_OP,W NRSTM IMP PRIME ADV MRI,19800.0,12870.0,12870.0,19404.0,6
CDM,27817320,W NRSTM LD ANCHR BW INJEX,248.0,161.2,41.66,223.2,20
CDM,27817320_IP,W NRSTM LD ANCHR BW INJEX,248.0,161.2,89.53,89.53,3
CDM,27817320_OP,W NRSTM LD ANCHR BW INJEX,248.0,161.2,161.2,243.04,6
CDM,27817330,W LEAD NRSTM 60CM SS MRI 1X8,3158.0,2052.7,530.54,2842.2,23
CDM,27817330_IP,W LEAD NRSTM 60CM SS MRI 1X8,3158.0,2052.7,1140.04,1140.04,3
CDM,27817330_OP,W LEAD NRSTM 60CM SS MRI 1X8,3158.0,2052.7,2052.7,3094.84,6
CDM,27817340,W NRSTM IMP RESTORE SNSR MRI,25000.0,16250.0,4200.0,22500.0,29
CDM,27817340_OP,W NRSTM IMP RESTORE SNSR MRI,25000.0,16250.0,16250.0,24500.0,6
CDM,27817350,W ADAPTR RECPTCLE BIPLR EXTND,550.0,357.5,92.4,495.0,20
CDM,27817350_IP,W ADAPTR RECPTCLE BIPLR EXTND,550.0,357.5,198.55,198.55,3
CDM,27817350_OP,W ADAPTR RECPTCLE BIPLR EXTND,550.0,357.5,357.5,539.0,6
CDM,27817360,W STENT EZ NEUROFORM SE,10992.0,7144.8,1846.66,9892.8,29
CDM,27817360_OP,W STENT EZ NEUROFORM SE,10992.0,7144.8,7144.8,10772.16,6
CDM,27817370,W STENT STONETOME 20MM,607.0,394.55,101.98,546.3,20
CDM,27817370_IP,W STENT STONETOME 20MM,607.0,394.55,219.13,219.13,3
CDM,27817370_OP,W STENT STONETOME 20MM,607.0,394.55,394.55,594.86,6
CDM,27817380,W APPL IN CLP 135D 230CM ROT,130.0,84.5,21.84,117.0,20
CDM,27817380_IP,W APPL IN CLP 135D 230CM ROT,130.0,84.5,46.93,46.93,3
CDM,27817380_OP,W APPL IN CLP 135D 230CM ROT,130.0,84.5,84.5,127.4,6
CDM,27817390,W FLTR EMBL FEM VC DLV KIT,1900.0,1235.0,319.2,1710.0,23
CDM,27817390_IP,W FLTR EMBL FEM VC DLV KIT,1900.0,1235.0,685.9,685.9,3
CDM,27817390_OP,W FLTR EMBL FEM VC DLV KIT,1900.0,1235.0,1235.0,1862.0,6
CDM,27817400,W STENT SOF-FLEX DOUBLE PIGTL,209.0,135.85,35.11,188.1,20
CDM,27817400_IP,W STENT SOF-FLEX DOUBLE PIGTL,209.0,135.85,75.45,75.45,3
CDM,27817400_OP,W STENT SOF-FLEX DOUBLE PIGTL,209.0,135.85,135.85,204.82,6
CDM,27817410,W LEAD PACE ATTN IS4 S CRV,3234.0,2102.1,543.31,2910.6,23
CDM,27817410_IP,W LEAD PACE ATTN IS4 S CRV,3234.0,2102.1,1167.47,1167.47,3
CDM,27817410_OP,W LEAD PACE ATTN IS4 S CRV,3234.0,2102.1,2102.1,3169.32,6
CDM,27817420,W STENT WALLFLEX COLONIC,4891.0,3179.15,821.69,4401.9,26
CDM,27817420_OP,W STENT WALLFLEX COLONIC,4891.0,3179.15,3179.15,4793.18,6
CDM,27817430,W PROS PENL AMCR 18CM CYL,18040.0,11726.0,3030.72,16236.0,29
CDM,27817430_OP,W PROS PENL AMCR 18CM CYL,18040.0,11726.0,11726.0,17679.2,6
CDM,27817440,W ICD INOGEN MIN VR DF4,13114.0,8524.1,2203.15,11802.6,29
CDM,27817440_OP,W ICD INOGEN MIN VR DF4,13114.0,8524.1,8524.1,12851.72,6
CDM,27817450,W ICD DYNAGEN D152 DR DF4,18600.0,12090.0,3124.8,16740.0,29
CDM,27817450_OP,W ICD DYNAGEN D152 DR DF4,18600.0,12090.0,12090.0,18228.0,6
CDM,27817460,W MARKER FIDUCIAL 2 NODE,250.0,162.5,42.0,225.0,20
CDM,27817460_IP,W MARKER FIDUCIAL 2 NODE,250.0,162.5,90.25,90.25,3
CDM,27817460_OP,W MARKER FIDUCIAL 2 NODE,250.0,162.5,162.5,245.0,6
CDM,27817470,W STENT CORONARY XIENCE ALPN,2100.0,1365.0,352.8,1890.0,23
CDM,27817470_IP,W STENT CORONARY XIENCE ALPN,2100.0,1365.0,758.1,758.1,3
CDM,27817470_OP,W STENT CORONARY XIENCE ALPN,2100.0,1365.0,1365.0,2058.0,6
CDM,27817480,W DEFIB CARD INOGEN EL VR DF4,13114.0,8524.1,2203.15,11802.6,29
CDM,27817480_OP,W DEFIB CARD INOGEN EL VR DF4,13114.0,8524.1,8524.1,12851.72,6
CDM,27817490,W OCCLUDER CV SEPT SLFEXP DLV,11232.0,7300.8,1886.98,10108.8,29
CDM,27817490_OP,W OCCLUDER CV SEPT SLFEXP DLV,11232.0,7300.8,7300.8,11007.36,6
CDM,27817500,W DEFIB EVERA MRI XT DR DF4,26460.0,17199.0,4445.28,23814.0,29
CDM,27817500_OP,W DEFIB EVERA MRI XT DR DF4,26460.0,17199.0,17199.0,25930.8,6
CDM,27817510,W COIL EMBLZ TRGT XL 360 SOFT,3902.0,2536.3,655.54,3511.8,23
CDM,27817510_IP,W COIL EMBLZ TRGT XL 360 SOFT,3902.0,2536.3,1408.62,1408.62,3
CDM,27817510_OP,W COIL EMBLZ TRGT XL 360 SOFT,3902.0,2536.3,2536.3,3823.96,6
CDM,27817520,W DEV VENT ASST IMPELLA 005042,50000.0,32500.0,8400.0,45000.0,29
CDM,27817520_OP,W DEV VENT ASST IMPELLA 005042,50000.0,32500.0,32500.0,49000.0,6
CDM,27817530,W TISSUE MATRIX ALLDRM 152064,3378.0,2195.7,567.5,3040.2,23
CDM,27817530_IP,W TISSUE MATRIX ALLDRM 152064,3378.0,2195.7,1219.46,1219.46,3
CDM,27817530_OP,W TISSUE MATRIX ALLDRM 152064,3378.0,2195.7,2195.7,3310.44,6
CDM,27817540,W HRTW HVAD PUMP IMP SET 5400,155692.0,101199.8,26156.26,140122.8,29
CDM,27817540_OP,W HRTW HVAD PUMP IMP SET 5400,155692.0,101199.8,101199.8,152578.16,6
CDM,27817550,W TISSUE MATRIX ALLDRM 102082,3378.0,2195.7,567.5,3040.2,23
CDM,27817550_IP,W TISSUE MATRIX ALLDRM 102082,3378.0,2195.7,1219.46,1219.46,3
CDM,27817550_OP,W TISSUE MATRIX ALLDRM 102082,3378.0,2195.7,2195.7,3310.44,6
CDM,27817560,W DEV VENT ASST IMPELLA 00480003,50000.0,32500.0,8400.0,45000.0,29
CDM,27817560_OP,W DEV VENT ASST IMPELLA 00480003,50000.0,32500.0,32500.0,49000.0,6
CDM,27817570,W TISSUE MATRIX ALLDRM CM1520P,7566.0,4917.9,1271.09,6809.4,29
CDM,27817570_OP,W TISSUE MATRIX ALLDRM CM1520P,7566.0,4917.9,4917.9,7414.68,6
CDM,27817580,W FLTR EMBL VC JUG NAVALIGN DLV,1398.0,908.7,234.86,1258.2,20
CDM,27817580_IP,W FLTR EMBL VC JUG NAVALIGN DLV,1398.0,908.7,504.68,504.68,3
CDM,27817580_OP,W FLTR EMBL VC JUG NAVALIGN DLV,1398.0,908.7,908.7,1370.04,6
CDM,27817590,W STENT OTW SUPERA,1960.0,1274.0,329.28,1764.0,23
CDM,27817590_IP,W STENT OTW SUPERA,1960.0,1274.0,707.56,707.56,3
CDM,27817590_OP,W STENT OTW SUPERA,1960.0,1274.0,1274.0,1920.8,6
CDM,27817600,W H130006 IMP FENIX CONT RESTOR,10500.0,6825.0,1764.0,9450.0,29
CDM,27817600_OP,W H130006 IMP FENIX CONT RESTOR,10500.0,6825.0,6825.0,10290.0,6
CDM,27817610,W TISSUE MTRX STRATTICE 1016002,7548.0,4906.2,1268.06,6793.2,29
CDM,27817610_OP,W TISSUE MTRX STRATTICE 1016002,7548.0,4906.2,4906.2,7397.04,6
CDM,27817620,W DEFIB CARD QUAD ASSURA MP DF4,19400.0,12610.0,3259.2,17460.0,29
CDM,27817620_OP,W DEFIB CARD QUAD ASSURA MP DF4,19400.0,12610.0,12610.0,19012.0,6
CDM,27817630,W TISSUE MTRX STRATTICE 1010002,4718.0,3066.7,792.62,4246.2,23
CDM,27817630_IP,W TISSUE MTRX STRATTICE 1010002,4718.0,3066.7,1703.2,1703.2,3
CDM,27817630_OP,W TISSUE MTRX STRATTICE 1010002,4718.0,3066.7,3066.7,4623.64,6
CDM,27817640,W TISSUE MTRX STRATTICE 2030002,28298.0,18393.7,4754.06,25468.2,29
CDM,27817640_OP,W TISSUE MTRX STRATTICE 2030002,28298.0,18393.7,18393.7,27732.04,6
CDM,27817650,W IMP TISSUE MARKER BREAST,270.0,175.5,45.36,243.0,20
CDM,27817650_IP,W IMP TISSUE MARKER BREAST,270.0,175.5,97.47,97.47,3
CDM,27817650_OP,W IMP TISSUE MARKER BREAST,270.0,175.5,175.5,264.6,6
CDM,27817660,W TISSUE MTRX STRATTICE 1620002,15094.0,9811.1,2535.79,13584.6,29
CDM,27817660_OP,W TISSUE MTRX STRATTICE 1620002,15094.0,9811.1,9811.1,14792.12,6
CDM,27817670,W WATCHMAN DEVICE CAP 1-3 UNITS,34000.0,22100.0,5712.0,30600.0,29
CDM,27817670_OP,W WATCHMAN DEVICE CAP 1-3 UNITS,34000.0,22100.0,22100.0,33320.0,6
CDM,27817680,W WATCHMAN DEVICE CAP EA ADD,34000.0,22100.0,5712.0,30600.0,29
CDM,27817680_OP,W WATCHMAN DEVICE CAP EA ADD,34000.0,22100.0,22100.0,33320.0,6
CDM,27817690,W PORT INF MINI DTCH PU,500.0,325.0,84.0,450.0,20
CDM,27817690_IP,W PORT INF MINI DTCH PU,500.0,325.0,180.5,180.5,3
CDM,27817690_OP,W PORT INF MINI DTCH PU,500.0,325.0,325.0,490.0,6
CDM,27817700,W STENT VASCULAR SE INNOVA,1790.0,1163.5,300.72,1611.0,23
CDM,27817700_IP,W STENT VASCULAR SE INNOVA,1790.0,1163.5,646.19,646.19,3
CDM,27817700_OP,W STENT VASCULAR SE INNOVA,1790.0,1163.5,1163.5,1754.2,6
CDM,27817710,W DEFIB EVERA MRI XT DR DF4,29600.0,19240.0,4972.8,26640.0,29
CDM,27817710_OP,W DEFIB EVERA MRI XT DR DF4,29600.0,19240.0,19240.0,29008.0,6
CDM,27817720,W DEFIB EVERA MRI XT VR DF4,23600.0,15340.0,3964.8,21240.0,29
CDM,27817720_OP,W DEFIB EVERA MRI XT VR DF4,23600.0,15340.0,15340.0,23128.0,6
CDM,27817730,W COIL EMBL 10CM 6MM AZUR DET,2506.0,1628.9,421.01,2255.4,23
CDM,27817730_IP,W COIL EMBL 10CM 6MM AZUR DET,2506.0,1628.9,904.67,904.67,3
CDM,27817730_OP,W COIL EMBL 10CM 6MM AZUR DET,2506.0,1628.9,1628.9,2455.88,6
CDM,27817740,W OCCLUDER SEPTL 20MM CARDIFRM,16530.0,10744.5,2777.04,14877.0,29
CDM,27817740_OP,W OCCLUDER SEPTL 20MM CARDIFRM,16530.0,10744.5,10744.5,16199.4,6
CDM,27817750,W LEAD PACE ACUITY X4 LV,2450.0,1592.5,411.6,2205.0,23
CDM,27817750_IP,W LEAD PACE ACUITY X4 LV,2450.0,1592.5,884.45,884.45,3
CDM,27817750_OP,W LEAD PACE ACUITY X4 LV,2450.0,1592.5,1592.5,2401.0,6
CDM,27817760,W NRSTM IMP RESTORE ADV MRI,18000.0,11700.0,3024.0,16200.0,29
CDM,27817760_OP,W NRSTM IMP RESTORE ADV MRI,18000.0,11700.0,11700.0,17640.0,6
CDM,27817770,W TISSUE POCKET VASC CANGAROO,1950.0,1267.5,327.6,1755.0,23
CDM,27817770_IP,W TISSUE POCKET VASC CANGAROO,1950.0,1267.5,703.95,703.95,3
CDM,27817770_OP,W TISSUE POCKET VASC CANGAROO,1950.0,1267.5,1267.5,1911.0,6
CDM,27817780,W DEFIB CARD INOGEN EL DR,16600.0,10790.0,2788.8,14940.0,29
CDM,27817780_OP,W DEFIB CARD INOGEN EL DR,16600.0,10790.0,10790.0,16268.0,6
CDM,27817790,W DEFIB SURESCAN MRI CRTD AMPLIA,37400.0,24310.0,6283.2,33660.0,29
CDM,27817790_OP,W DEFIB SURESCAN MRI CRTD AMPLIA,37400.0,24310.0,24310.0,36652.0,6
CDM,27817800,W DEFIB CARD INCEPTA DR DF4,18600.0,12090.0,3124.8,16740.0,29
CDM,27817800_OP,W DEFIB CARD INCEPTA DR DF4,18600.0,12090.0,12090.0,18228.0,6
CDM,27817810,W DEFIB-VR VISIA AF/DF4,22000.0,14300.0,3696.0,19800.0,29
CDM,27817810_OP,W DEFIB-VR VISIA AF/DF4,22000.0,14300.0,14300.0,21560.0,6
CDM,27817820,W PLUG CV 18MM 22MM AMPLZ 2,1600.0,1040.0,268.8,1440.0,20
CDM,27817820_IP,W PLUG CV 18MM 22MM AMPLZ 2,1600.0,1040.0,577.6,577.6,3
CDM,27817820_OP,W PLUG CV 18MM 22MM AMPLZ 2,1600.0,1040.0,1040.0,1568.0,6
CDM,27817830,W STENT BIL 10MM 7FR 25MM 135CM,1400.0,910.0,235.2,1260.0,20
CDM,27817830_IP,W STENT BIL 10MM 7FR 25MM 135CM,1400.0,910.0,505.4,505.4,3
CDM,27817830_OP,W STENT BIL 10MM 7FR 25MM 135CM,1400.0,910.0,910.0,1372.0,6
CDM,27817840,W TRAY CATH 20CM 12FR MAHRK 3,245.0,159.25,41.16,220.5,20
CDM,27817840_IP,W TRAY CATH 20CM 12FR MAHRK 3,245.0,159.25,88.45,88.45,3
CDM,27817840_OP,W TRAY CATH 20CM 12FR MAHRK 3,245.0,159.25,159.25,240.1,6
CDM,27817850,W STENT VIABAHN ENDOPROS DEL,6788.0,4412.2,1140.38,6109.2,29
CDM,27817850_OP,W STENT VIABAHN ENDOPROS DEL,6788.0,4412.2,4412.2,6652.24,6
CDM,27817860,W PLUG CV 7MM 10MM AMPLZR,1100.0,715.0,184.8,990.0,20
CDM,27817860_IP,W PLUG CV 7MM 10MM AMPLZR,1100.0,715.0,397.1,397.1,3
CDM,27817860_OP,W PLUG CV 7MM 10MM AMPLZR,1100.0,715.0,715.0,1078.0,6
CDM,27817870,W STENT COR PRECISE PRO RX,3900.0,2535.0,655.2,3510.0,23
CDM,27817870_IP,W STENT COR PRECISE PRO RX,3900.0,2535.0,1407.9,1407.9,3
CDM,27817870_OP,W STENT COR PRECISE PRO RX,3900.0,2535.0,2535.0,3822.0,6
CDM,27817880,W OCCL CV AMPLATZER DUCTAL,8200.0,5330.0,1377.6,7380.0,29
CDM,27817880_OP,W OCCL CV AMPLATZER DUCTAL,8200.0,5330.0,5330.0,8036.0,6
CDM,27817890,W STENT COR MULTI LINK VIS RX,760.0,494.0,127.68,684.0,20
CDM,27817890_IP,W STENT COR MULTI LINK VIS RX,760.0,494.0,274.36,274.36,3
CDM,27817890_OP,W STENT COR MULTI LINK VIS RX,760.0,494.0,494.0,744.8,6
CDM,27817900,W STENT COR MULTI-LINK VIS LOW,2750.0,1787.5,462.0,2475.0,23
CDM,27817900_IP,W STENT COR MULTI-LINK VIS LOW,2750.0,1787.5,992.75,992.75,3
CDM,27817900_OP,W STENT COR MULTI-LINK VIS LOW,2750.0,1787.5,1787.5,2695.0,6
CDM,27817910,W COIL AX PRIME BARE HELIX ES,3390.0,2203.5,569.52,3051.0,23
CDM,27817910_IP,W COIL AX PRIME BARE HELIX ES,3390.0,2203.5,1223.79,1223.79,3
CDM,27817910_OP,W COIL AX PRIME BARE HELIX ES,3390.0,2203.5,2203.5,3322.2,6
CDM,27817920,W COIL 3D AXIUM PRIME DES,4550.0,2957.5,764.4,4095.0,23
CDM,27817920_IP,W COIL 3D AXIUM PRIME DES,4550.0,2957.5,1642.55,1642.55,3
CDM,27817920_OP,W COIL 3D AXIUM PRIME DES,4550.0,2957.5,2957.5,4459.0,6
CDM,27817930,W COIL 3D AXIUM PRIME SS,1972.0,1281.8,331.3,1774.8,23
CDM,27817930_IP,W COIL 3D AXIUM PRIME SS,1972.0,1281.8,711.89,711.89,3
CDM,27817930_OP,W COIL 3D AXIUM PRIME SS,1972.0,1281.8,1281.8,1932.56,6
CDM,27817940,W H060001 STENT CODEMAN ENF,4975.0,3233.75,835.8,4477.5,26
CDM,27817940_OP,W H060001 STENT CODEMAN ENF,4975.0,3233.75,3233.75,4875.5,6
CDM,27817950,W PLUG MCR VASC MVP 5/7Q,3390.0,2203.5,569.52,3051.0,23
CDM,27817950_IP,W PLUG MCR VASC MVP 5/7Q,3390.0,2203.5,1223.79,1223.79,3
CDM,27817950_OP,W PLUG MCR VASC MVP 5/7Q,3390.0,2203.5,2203.5,3322.2,6
CDM,27817960,W DEFIB CARD DYNAGEN CON STRL,22736.0,14778.4,3819.65,20462.4,29
CDM,27817960_OP,W DEFIB CARD DYNAGEN CON STRL,22736.0,14778.4,14778.4,22281.28,6
CDM,27817970,W DEFIB ICD EMBLEM MRI,34000.0,22100.0,5712.0,30600.0,29
CDM,27817970_OP,W DEFIB ICD EMBLEM MRI,34000.0,22100.0,22100.0,33320.0,6
CDM,27817980,W STENT URET INLAY OPTIMA,134.0,87.1,22.51,120.6,20
CDM,27817980_IP,W STENT URET INLAY OPTIMA,134.0,87.1,48.37,48.37,3
CDM,27817980_OP,W STENT URET INLAY OPTIMA,134.0,87.1,87.1,131.32,6
CDM,27817990,W LEAD NRSTM 90CM OCTRDE KT 8,5816.0,3780.4,977.09,5234.4,29
CDM,27817990_OP,W LEAD NRSTM 90CM OCTRDE KT 8,5816.0,3780.4,3780.4,5699.68,6
CDM,27818000,W CAGE CERVICAL AERO C,10038.0,6524.7,1686.38,9034.2,29
CDM,27818000_OP,W CAGE CERVICAL AERO C,10038.0,6524.7,6524.7,9837.24,6
CDM,27818010,W DEVICE PIPELN FLX PLTINM TNGSTN,25800.0,16770.0,4334.4,23220.0,29
CDM,27818010_OP,W DEVICE PIPELN FLX PLTINM TNGSTN,25800.0,16770.0,16770.0,25284.0,6
CDM,27818020,W KIT NRSTM 60CM OCTRODE PERC,2908.0,1890.2,488.54,2617.2,23
CDM,27818020_IP,W KIT NRSTM 60CM OCTRODE PERC,2908.0,1890.2,1049.79,1049.79,3
CDM,27818020_OP,W KIT NRSTM 60CM OCTRODE PERC,2908.0,1890.2,1890.2,2849.84,6
CDM,27818030,W OCCL CV AMPLATZER PFO 2 DISK,19990.0,12993.5,3358.32,17991.0,29
CDM,27818030_OP,W OCCL CV AMPLATZER PFO 2 DISK,19990.0,12993.5,12993.5,19590.2,6
CDM,27818040,W STENT SMART BIL NINTL MMKR,950.0,617.5,159.6,855.0,20
CDM,27818040_IP,W STENT SMART BIL NINTL MMKR,950.0,617.5,342.95,342.95,3
CDM,27818040_OP,W STENT SMART BIL NINTL MMKR,950.0,617.5,617.5,931.0,6
CDM,27818050,W STENT INNOVA VASC SE TRIAXL,2000.0,1300.0,336.0,1800.0,23
CDM,27818050_IP,W STENT INNOVA VASC SE TRIAXL,2000.0,1300.0,722.0,722.0,3
CDM,27818050_OP,W STENT INNOVA VASC SE TRIAXL,2000.0,1300.0,1300.0,1960.0,6
CDM,27818060,W PLUG MCR VASC MVP 3Q,3000.0,1950.0,504.0,2700.0,23
CDM,27818060_IP,W PLUG MCR VASC MVP 3Q,3000.0,1950.0,1083.0,1083.0,3
CDM,27818060_OP,W PLUG MCR VASC MVP 3Q,3000.0,1950.0,1950.0,2940.0,6
CDM,27818070,W DEFIB CARD QUAD ASSURA MP DF1,24426.0,15876.9,4103.57,21983.4,29
CDM,27818070_OP,W DEFIB CARD QUAD ASSURA MP DF1,24426.0,15876.9,15876.9,23937.48,6
CDM,27818080,W STENT BILIARY ADVANIX PGTL,154.0,100.1,25.87,138.6,20
CDM,27818080_IP,W STENT BILIARY ADVANIX PGTL,154.0,100.1,55.59,55.59,3
CDM,27818080_OP,W STENT BILIARY ADVANIX PGTL,154.0,100.1,100.1,150.92,6
CDM,27818090,W TEMP LEAD PACE 200CM BPLR,560.0,364.0,94.08,504.0,20
CDM,27818090_IP,W TEMP LEAD PACE 200CM BPLR,560.0,364.0,202.16,202.16,3
CDM,27818090_OP,W TEMP LEAD PACE 200CM BPLR,560.0,364.0,364.0,548.8,6
CDM,27818100,W STENT BILIARY AXIOS W DLVRY,8800.0,5720.0,1478.4,7920.0,29
CDM,27818100_OP,W STENT BILIARY AXIOS W DLVRY,8800.0,5720.0,5720.0,8624.0,6
CDM,27818695,C1764 LOOP RECORDER TIER 2,9990.0,6493.5,1678.32,8991.0,29
CDM,27818695_OP,C1764 LOOP RECORDER TIER 2,9990.0,6493.5,6493.5,9790.2,6
CDM,27818935,SUBDERMAL NEEDLE ELECTRODES,5.0,3.25,0.84,4.5,20
CDM,27818935_IP,SUBDERMAL NEEDLE ELECTRODES,5.0,3.25,1.81,1.81,3
CDM,27818935_OP,SUBDERMAL NEEDLE ELECTRODES,5.0,3.25,3.25,4.9,6
CDM,27818WE,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,2504.0,1627.6,304.85,1878.0,35
CDM,27822WE,OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP,4484.0,2914.6,615.53,4484.0,35
CDM,27823WE,OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP,5264.0,3421.6,754.57,5264.0,35
CDM,27824WE,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1324.0,860.6,187.19,993.0,35
CDM,27825WE,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,2676.0,1739.4,319.81,2007.0,35
CDM,27826WE,OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA,4440.0,2886.0,551.86,4440.0,35
CDM,27827WE,OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY,5916.0,3845.4,688.58,5916.0,35
CDM,27828WE,OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA,7372.0,4791.8,797.39,7372.0,35
CDM,27829WE,OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION,3520.0,2288.0,366.17,3520.0,35
CDM,27832645,CARDIOMEMS SENSOR/DELIV SYSTEM,35000.0,22750.0,5880.0,31500.0,29
CDM,27832645_OP,CARDIOMEMS SENSOR/DELIV SYSTEM,35000.0,22750.0,22750.0,34300.0,6
CDM,27840WE,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,1908.0,1240.2,188.39,1908.0,35
CDM,27842WE,CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ,2584.0,1679.6,258.48,2584.0,35
CDM,27846WE,OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ,4112.0,2672.8,502.13,4112.0,35
CDM,27848WE,OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ,4672.0,3036.8,592.15,4672.0,35
CDM,27852455,H020002- ?NF ATLAS STENT 3.0 X 21MM NO TIP,6155.6,4001.14,1034.14,5540.04,29
CDM,27852455_OP,H020002- ?NF ATLAS STENT 3.0 X 21MM NO TIP,6155.6,4001.14,4001.14,6032.49,6
CDM,27852465,H020002- ?NF ATLAS STENT 3.0 X 24MM NO TIP,6155.6,4001.14,1034.14,5540.04,29
CDM,27852465_OP,H020002- ?NF ATLAS STENT 3.0 X 24MM NO TIP,6155.6,4001.14,4001.14,6032.49,6
CDM,27852475,H020002- ?NF ATLAS STENT 4.0 X 21MM NO TIP,6155.6,4001.14,1034.14,5540.04,29
CDM,27852475_OP,H020002- ?NF ATLAS STENT 4.0 X 21MM NO TIP,6155.6,4001.14,4001.14,6032.49,6
CDM,27852485,H020002-NF ATLAS STENT 4.0 X 24MM NO TIP,6155.6,4001.14,1034.14,5540.04,29
CDM,27852485_OP,H020002-NF ATLAS STENT 4.0 X 24MM NO TIP,6155.6,4001.14,4001.14,6032.49,6
CDM,27852495,H020002- NF ATLAS STENT 4.5 X 21MM NO TIP,6155.6,4001.14,1034.14,5540.04,29
CDM,27852495_OP,H020002- NF ATLAS STENT 4.5 X 21MM NO TIP,6155.6,4001.14,4001.14,6032.49,6
CDM,27852505,H020002- NF ATLAS STENT 4.5 X 30MM NO TIP,6155.6,4001.14,1034.14,5540.04,29
CDM,27852505_OP,H020002- NF ATLAS STENT 4.5 X 30MM NO TIP,6155.6,4001.14,4001.14,6032.49,6
CDM,27852515,H020002-NF ATLAS STENT 3.0 X 15MM NO TIP,6155.6,4001.14,1034.14,5540.04,29
CDM,27852515_OP,H020002-NF ATLAS STENT 3.0 X 15MM NO TIP,6155.6,4001.14,4001.14,6032.49,6
CDM,27860WE,MANIPULATION ANKLE UNDER GENERAL ANESTHESIA,956.0,621.4,109.32,956.0,35
CDM,27870WE,ARTHRODESIS ANKLE OPEN,6164.0,4006.6,744.35,6164.0,35
CDM,27871WE,ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL,3816.0,2480.4,472.78,3816.0,35
CDM,27875285,GRAFT ST TIS 12X7CM TTPLST,3702.0,2406.3,621.94,3331.8,23
CDM,27875285_IP,GRAFT ST TIS 12X7CM TTPLST,3702.0,2406.3,1336.42,1336.42,3
CDM,27875285_OP,GRAFT ST TIS 12X7CM TTPLST,3702.0,2406.3,2406.3,3627.96,6
CDM,27875295,STENT PROPEL SINUS IMPLANT,1590.0,1033.5,267.12,1431.0,20
CDM,27875295_IP,STENT PROPEL SINUS IMPLANT,1590.0,1033.5,573.99,573.99,3
CDM,27875295_OP,STENT PROPEL SINUS IMPLANT,1590.0,1033.5,1033.5,1558.2,6
CDM,27877255,STENT BIL 7FR 5CM POLYETH C-L,90.0,58.5,15.12,81.0,20
CDM,27877255_IP,STENT BIL 7FR 5CM POLYETH C-L,90.0,58.5,32.49,32.49,3
CDM,27877255_OP,STENT BIL 7FR 5CM POLYETH C-L,90.0,58.5,58.5,88.2,6
CDM,27877265,STENT BIL 10FR 10CM .035IN,242.0,157.3,40.66,217.8,20
CDM,27877265_IP,STENT BIL 10FR 10CM .035IN,242.0,157.3,87.36,87.36,3
CDM,27877265_OP,STENT BIL 10FR 10CM .035IN,242.0,157.3,157.3,237.16,6
CDM,27877275,STENT BIL 7FR 12CM PLAS RX BL,205.0,133.25,34.44,184.5,20
CDM,27877275_IP,STENT BIL 7FR 12CM PLAS RX BL,205.0,133.25,74.01,74.01,3
CDM,27877275_OP,STENT BIL 7FR 12CM PLAS RX BL,205.0,133.25,133.25,200.9,6
CDM,27877285,STENT TRCHBR 10MM 30MM FULL,4000.0,2600.0,672.0,3600.0,23
CDM,27877285_IP,STENT TRCHBR 10MM 30MM FULL,4000.0,2600.0,1444.0,1444.0,3
CDM,27877285_OP,STENT TRCHBR 10MM 30MM FULL,4000.0,2600.0,2600.0,3920.0,6
CDM,27877295,STENT TRCHBR 10MM 40MM FULL,4400.0,2860.0,739.2,3960.0,23
CDM,27877295_IP,STENT TRCHBR 10MM 40MM FULL,4400.0,2860.0,1588.4,1588.4,3
CDM,27877295_OP,STENT TRCHBR 10MM 40MM FULL,4400.0,2860.0,2860.0,4312.0,6
CDM,27877305,STENT PANCREATIC 5FR X 3CM,154.0,100.1,25.87,138.6,20
CDM,27877305_IP,STENT PANCREATIC 5FR X 3CM,154.0,100.1,55.59,55.59,3
CDM,27877305_OP,STENT PANCREATIC 5FR X 3CM,154.0,100.1,100.1,150.92,6
CDM,27877405,DEV TISS CLSR LP 40MM ATRICLIP,1900.0,1235.0,319.2,1710.0,23
CDM,27877405_IP,DEV TISS CLSR LP 40MM ATRICLIP,1900.0,1235.0,685.9,685.9,3
CDM,27877405_OP,DEV TISS CLSR LP 40MM ATRICLIP,1900.0,1235.0,1235.0,1862.0,6
CDM,27877415,PATCH CV 8X.8CM VSGRD TAPR,385.0,250.25,64.68,346.5,20
CDM,27877415_IP,PATCH CV 8X.8CM VSGRD TAPR,385.0,250.25,138.99,138.99,3
CDM,27877415_OP,PATCH CV 8X.8CM VSGRD TAPR,385.0,250.25,250.25,377.3,6
CDM,27877425,SLING DESARA BLU URINARY INCON,1587.0,1031.55,266.62,1428.3,20
CDM,27877425_IP,SLING DESARA BLU URINARY INCON,1587.0,1031.55,572.91,572.91,3
CDM,27877425_OP,SLING DESARA BLU URINARY INCON,1587.0,1031.55,1031.55,1555.26,6
CDM,27877435,MESH SRG RESTORELLE L 24X8CM,1440.0,936.0,241.92,1296.0,20
CDM,27877435_IP,MESH SRG RESTORELLE L 24X8CM,1440.0,936.0,519.84,519.84,3
CDM,27877435_OP,MESH SRG RESTORELLE L 24X8CM,1440.0,936.0,936.0,1411.2,6
CDM,27877445,MESH SRG SRGPRO PLG/PTCH LG,168.0,109.2,28.22,151.2,20
CDM,27877445_IP,MESH SRG SRGPRO PLG/PTCH LG,168.0,109.2,60.65,60.65,3
CDM,27877445_OP,MESH SRG SRGPRO PLG/PTCH LG,168.0,109.2,109.2,164.64,6
CDM,27877455,MESH SRG PARIETENE 15X15CM,92.0,59.8,15.46,82.8,20
CDM,27877455_IP,MESH SRG PARIETENE 15X15CM,92.0,59.8,33.21,33.21,3
CDM,27877455_OP,MESH SRG PARIETENE 15X15CM,92.0,59.8,59.8,90.16,6
CDM,27877465,MESH SRG PARTENE DS 25X20CM,1645.0,1069.25,276.36,1480.5,20
CDM,27877465_IP,MESH SRG PARTENE DS 25X20CM,1645.0,1069.25,593.85,593.85,3
CDM,27877465_OP,MESH SRG PARTENE DS 25X20CM,1645.0,1069.25,1069.25,1612.1,6
CDM,27877475,GRAFT BN INFS RHBMP-2 2XS KT,1850.0,1202.5,310.8,1665.0,23
CDM,27877475_IP,GRAFT BN INFS RHBMP-2 2XS KT,1850.0,1202.5,667.85,667.85,3
CDM,27877475_OP,GRAFT BN INFS RHBMP-2 2XS KT,1850.0,1202.5,1202.5,1813.0,6
CDM,27877485,PLUG BN CMNT,100.0,65.0,16.8,90.0,20
CDM,27877485_IP,PLUG BN CMNT,100.0,65.0,36.1,36.1,3
CDM,27877485_OP,PLUG BN CMNT,100.0,65.0,65.0,98.0,6
CDM,27877495,RESTRICTOR CEM INSRT,100.0,65.0,16.8,90.0,20
CDM,27877495_IP,RESTRICTOR CEM INSRT,100.0,65.0,36.1,36.1,3
CDM,27877495_OP,RESTRICTOR CEM INSRT,100.0,65.0,65.0,98.0,6
CDM,27877505,GRAFT VASC 45CM 4-7MM GORE,2466.0,1602.9,414.29,2219.4,23
CDM,27877505_IP,GRAFT VASC 45CM 4-7MM GORE,2466.0,1602.9,890.23,890.23,3
CDM,27877505_OP,GRAFT VASC 45CM 4-7MM GORE,2466.0,1602.9,1602.9,2416.68,6
CDM,27877705,VALVE KIT SAPIEN 3 CERTITUDE,65000.0,42250.0,10920.0,58500.0,29
CDM,27877705_OP,VALVE KIT SAPIEN 3 CERTITUDE,65000.0,42250.0,42250.0,63700.0,6
CDM,27877745,SURPASS FLOWDIVERTER <40MM,25200.0,16380.0,4233.6,22680.0,29
CDM,27877745_OP,SURPASS FLOWDIVERTER <40MM,25200.0,16380.0,16380.0,24696.0,6
CDM,27877755,SURPASS FLOWDIVERTER >40MM,27600.0,17940.0,4636.8,24840.0,29
CDM,27877755_OP,SURPASS FLOWDIVERTER >40MM,27600.0,17940.0,17940.0,27048.0,6
CDM,27877915,GRAFT MATRISTEM PORCINE URNARY BLADDER EXTRACELLULAR MATRIX PER,12.3,8.0,3.08,198.19,25
CDM,27877915_IP,GRAFT MATRISTEM PORCINE URNARY BLADDER EXTRACELLULAR MATRIX PER,12.3,8.0,4.44,4.44,3
CDM,27877915_OP,GRAFT MATRISTEM PORCINE URNARY BLADDER EXTRACELLULAR MATRIX PER,12.3,8.0,8.0,12.05,6
CDM,27877925,MATRIX ALLODERM SELECT THK.4-2.4MM THICK LARGE CONTOUR PER CM TI,16.13,10.48,4.03,198.19,24
CDM,27877925_IP,MATRIX ALLODERM SELECT THK.4-2.4MM THICK LARGE CONTOUR PER CM TI,16.13,10.48,5.82,5.82,3
CDM,27877925_OP,MATRIX ALLODERM SELECT THK.4-2.4MM THICK LARGE CONTOUR PER CM TI,16.13,10.48,10.48,15.81,6
CDM,27877995,ALLOGRFT 7X10CM DERMAPURE,2450.0,1592.5,40.41,2205.0,28
CDM,27877995_IP,ALLOGRFT 7X10CM DERMAPURE,2450.0,1592.5,884.45,884.45,3
CDM,27877995_OP,ALLOGRFT 7X10CM DERMAPURE,2450.0,1592.5,1592.5,2401.0,6
CDM,27878035,"GENERATOR, CARDIAC CONTRACTILITY MODULATION (IMPLANTABLE)",46000.0,29900.0,7728.0,41400.0,29
CDM,27878035_OP,"GENERATOR, CARDIAC CONTRACTILITY MODULATION (IMPLANTABLE)",46000.0,29900.0,29900.0,45080.0,6
CDM,27878275,SYS CMPR VASCADE VASC,346.0,224.9,58.13,311.4,20
CDM,27878275_IP,SYS CMPR VASCADE VASC,346.0,224.9,124.91,124.91,3
CDM,27878275_OP,SYS CMPR VASCADE VASC,346.0,224.9,224.9,339.08,6
CDM,27878285,STENT BARE METAL PRO-KINETIC ENERGY,620.0,403.0,104.16,558.0,20
CDM,27878285_IP,STENT BARE METAL PRO-KINETIC ENERGY,620.0,403.0,223.82,223.82,3
CDM,27878285_OP,STENT BARE METAL PRO-KINETIC ENERGY,620.0,403.0,403.0,607.6,6
CDM,27878295,SYS COR STNT XIENCE SIERRA,1000.0,650.0,168.0,900.0,20
CDM,27878295_IP,SYS COR STNT XIENCE SIERRA,1000.0,650.0,361.0,361.0,3
CDM,27878295_OP,SYS COR STNT XIENCE SIERRA,1000.0,650.0,650.0,980.0,6
CDM,27878305,SYSTEM CORONARY RESOLUTE ONYX,1650.0,1072.5,277.2,1485.0,20
CDM,27878305_IP,SYSTEM CORONARY RESOLUTE ONYX,1650.0,1072.5,595.65,595.65,3
CDM,27878305_OP,SYSTEM CORONARY RESOLUTE ONYX,1650.0,1072.5,1072.5,1617.0,6
CDM,27878315,ENV DEFIB AIGISRX R MED ABS,1790.0,1163.5,300.72,1611.0,23
CDM,27878315_IP,ENV DEFIB AIGISRX R MED ABS,1790.0,1163.5,646.19,646.19,3
CDM,27878315_OP,ENV DEFIB AIGISRX R MED ABS,1790.0,1163.5,1163.5,1754.2,6
CDM,27878325,STENT COR MR SYNERGY,1800.0,1170.0,302.4,1620.0,23
CDM,27878325_IP,STENT COR MR SYNERGY,1800.0,1170.0,649.8,649.8,3
CDM,27878325_OP,STENT COR MR SYNERGY,1800.0,1170.0,1170.0,1764.0,6
CDM,27878335,LEAD RELIANCE 4-FRONT AF,5200.0,3380.0,873.6,4680.0,29
CDM,27878335_OP,LEAD RELIANCE 4-FRONT AF,5200.0,3380.0,3380.0,5096.0,6
CDM,27878345,ICD RESONATE EL DR,22600.0,14690.0,3796.8,20340.0,29
CDM,27878345_OP,ICD RESONATE EL DR,22600.0,14690.0,14690.0,22148.0,6
CDM,27878355,DEFIB CLARIA MRI CRT-D,35084.0,22804.6,5894.11,31575.6,29
CDM,27878355_OP,DEFIB CLARIA MRI CRT-D,35084.0,22804.6,22804.6,34382.32,6
CDM,27878365,DEFIB CLARIA MRI CRT-D VENT,36800.0,23920.0,6182.4,33120.0,29
CDM,27878365_OP,DEFIB CLARIA MRI CRT-D VENT,36800.0,23920.0,23920.0,36064.0,6
CDM,27878375,VALVE COR TAVI EVLT PR,60000.0,39000.0,10080.0,54000.0,29
CDM,27878375_OP,VALVE COR TAVI EVLT PR,60000.0,39000.0,39000.0,58800.0,6
CDM,27878385,IMP SYSTEM KIT SGC + NTR/XTR,60000.0,39000.0,10080.0,54000.0,29
CDM,27878385_OP,IMP SYSTEM KIT SGC + NTR/XTR,60000.0,39000.0,39000.0,58800.0,6
CDM,27878395,VALVE KIT SAPIEN,68000.0,44200.0,11424.0,61200.0,29
CDM,27878395_OP,VALVE KIT SAPIEN,68000.0,44200.0,44200.0,66640.0,6
CDM,27878495,OCCL CV 20MM EPTFE SEPT GORE,16530.0,10744.5,2777.04,14877.0,29
CDM,27878495_OP,OCCL CV 20MM EPTFE SEPT GORE,16530.0,10744.5,10744.5,16199.4,6
CDM,27878505,MNTR CARD BIOMONITOR 3 SIL IR,8400.0,5460.0,1411.2,7560.0,29
CDM,27878505_OP,MNTR CARD BIOMONITOR 3 SIL IR,8400.0,5460.0,5460.0,8232.0,6
CDM,27878515,SYS CARD MNTR RVL LINQ,9290.0,6038.5,1560.72,8361.0,29
CDM,27878515_OP,SYS CARD MNTR RVL LINQ,9290.0,6038.5,6038.5,9104.2,6
CDM,27878525,STENT ENDOPROS 25CM 6MM HPRN,12000.0,7800.0,2016.0,10800.0,29
CDM,27878525_OP,STENT ENDOPROS 25CM 6MM HPRN,12000.0,7800.0,7800.0,11760.0,6
CDM,27878535,DEFIB DYNAGEN EL VR DF4,15114.0,9824.1,2539.15,13602.6,29
CDM,27878535_OP,DEFIB DYNAGEN EL VR DF4,15114.0,9824.1,9824.1,14811.72,6
CDM,27878545,DEFIB CARD .99CM 5.37X7.79CM,18600.0,12090.0,3124.8,16740.0,29
CDM,27878545_OP,DEFIB CARD .99CM 5.37X7.79CM,18600.0,12090.0,12090.0,18228.0,6
CDM,27878555,DEFIB EVERA MRI XT DR DF4,27000.0,17550.0,4536.0,24300.0,29
CDM,27878555_OP,DEFIB EVERA MRI XT DR DF4,27000.0,17550.0,17550.0,26460.0,6
CDM,27878565,GRAFT THORACIC STNT VALIANT NAVION,36990.0,24043.5,6214.32,33291.0,29
CDM,27878565_OP,GRAFT THORACIC STNT VALIANT NAVION,36990.0,24043.5,24043.5,36250.2,6
CDM,27878775,BARD US BIOPSY CLIP,110.0,71.5,18.48,99.0,20
CDM,27878775_IP,BARD US BIOPSY CLIP,110.0,71.5,39.71,39.71,3
CDM,27878775_OP,BARD US BIOPSY CLIP,110.0,71.5,71.5,107.8,6
CDM,27878785,HYDROMARK US BIOPSY CLIP,136.0,88.4,22.85,122.4,20
CDM,27878785_IP,HYDROMARK US BIOPSY CLIP,136.0,88.4,49.1,49.1,3
CDM,27878785_OP,HYDROMARK US BIOPSY CLIP,136.0,88.4,88.4,133.28,6
CDM,27878795,HOLOGIC STEREO BIOPSY CLIP,90.0,58.5,15.12,81.0,20
CDM,27878795_IP,HOLOGIC STEREO BIOPSY CLIP,90.0,58.5,32.49,32.49,3
CDM,27878795_OP,HOLOGIC STEREO BIOPSY CLIP,90.0,58.5,58.5,88.2,6
CDM,27878805,NEEDLE LOC WIRE,33.0,21.45,5.54,29.7,20
CDM,27878805_IP,NEEDLE LOC WIRE,33.0,21.45,11.91,11.91,3
CDM,27878805_OP,NEEDLE LOC WIRE,33.0,21.45,21.45,32.34,6
CDM,27878895,EMBLEM S ICD ELECTRODE DELIVERY SYSTEM,2000.0,1300.0,336.0,1800.0,23
CDM,27878895_IP,EMBLEM S ICD ELECTRODE DELIVERY SYSTEM,2000.0,1300.0,722.0,722.0,3
CDM,27878895_OP,EMBLEM S ICD ELECTRODE DELIVERY SYSTEM,2000.0,1300.0,1300.0,1960.0,6
CDM,27878915,ELUVIA 6MM X 100MM X 130CM DRUG-ELUTING STENT,5190.0,3373.5,871.92,4671.0,29
CDM,27878915_OP,ELUVIA 6MM X 100MM X 130CM DRUG-ELUTING STENT,5190.0,3373.5,3373.5,5086.2,6
CDM,27878925,XIENCE SKYPOINT RX EVEROLIMUS ELUTING CORONARY STENT,1000.0,650.0,168.0,900.0,20
CDM,27878925_IP,XIENCE SKYPOINT RX EVEROLIMUS ELUTING CORONARY STENT,1000.0,650.0,361.0,361.0,3
CDM,27878925_OP,XIENCE SKYPOINT RX EVEROLIMUS ELUTING CORONARY STENT,1000.0,650.0,650.0,980.0,6
CDM,27878935,DEFIBRILLATORS & LEADS VIGILANT EL ICD DR DF4-LLHH IS-1,21600.0,14040.0,3628.8,19440.0,29
CDM,27878935_OP,DEFIBRILLATORS & LEADS VIGILANT EL ICD DR DF4-LLHH IS-1,21600.0,14040.0,14040.0,21168.0,6
CDM,27878965,CORMATRIX CANGAROO CARD DEVICE POCKET XXLG,2400.0,1560.0,403.2,2160.0,23
CDM,27878965_IP,CORMATRIX CANGAROO CARD DEVICE POCKET XXLG,2400.0,1560.0,866.4,866.4,3
CDM,27878965_OP,CORMATRIX CANGAROO CARD DEVICE POCKET XXLG,2400.0,1560.0,1560.0,2352.0,6
CDM,27878975,STENT ELUVIA 7MM 40MM 130CM VASCULAR DRUG ELUTE DELIVERY SYST,3990.0,2593.5,670.32,3591.0,23
CDM,27878975_IP,STENT ELUVIA 7MM 40MM 130CM VASCULAR DRUG ELUTE DELIVERY SYST,3990.0,2593.5,1440.39,1440.39,3
CDM,27878975_OP,STENT ELUVIA 7MM 40MM 130CM VASCULAR DRUG ELUTE DELIVERY SYST,3990.0,2593.5,2593.5,3910.2,6
CDM,27878985,LEAD OPTISURE 8FR 65CM DEFIBRILLATOR 1 COIL DF4,4200.0,2730.0,705.6,3780.0,23
CDM,27878985_IP,LEAD OPTISURE 8FR 65CM DEFIBRILLATOR 1 COIL DF4,4200.0,2730.0,1516.2,1516.2,3
CDM,27878985_OP,LEAD OPTISURE 8FR 65CM DEFIBRILLATOR 1 COIL DF4,4200.0,2730.0,2730.0,4116.0,6
CDM,27878995,ICD COBALT XT VR MRI IS1 DF1,30870.0,20065.5,5186.16,27783.0,29
CDM,27878995_OP,ICD COBALT XT VR MRI IS1 DF1,30870.0,20065.5,20065.5,30252.6,6
CDM,27879225,"GALLANT DR ICD, DUAL",15000.0,9750.0,2520.0,13500.0,29
CDM,27879225_OP,"GALLANT DR ICD, DUAL",15000.0,9750.0,9750.0,14700.0,6
CDM,27879285,2MM X 15MM XIENCE SKYPOINT RX EVEROLIMUS DRUG ELUTING STENT,730.0,474.5,122.64,657.0,20
CDM,27879285_IP,2MM X 15MM XIENCE SKYPOINT RX EVEROLIMUS DRUG ELUTING STENT,730.0,474.5,263.53,263.53,3
CDM,27879285_OP,2MM X 15MM XIENCE SKYPOINT RX EVEROLIMUS DRUG ELUTING STENT,730.0,474.5,474.5,715.4,6
CDM,27879295,MULTI-SYNERGY XD EVEROLIMUS DRUG ELUTING STENT MONORAIL PLATINUM,1300.0,845.0,218.4,1170.0,20
CDM,27879295_IP,MULTI-SYNERGY XD EVEROLIMUS DRUG ELUTING STENT MONORAIL PLATINUM,1300.0,845.0,469.3,469.3,3
CDM,27879295_OP,MULTI-SYNERGY XD EVEROLIMUS DRUG ELUTING STENT MONORAIL PLATINUM,1300.0,845.0,845.0,1274.0,6
CDM,27879315,EVOLUT PROPLUS TRANSCATHETER AORTIC VALVE,60000.0,39000.0,10080.0,54000.0,29
CDM,27879315_OP,EVOLUT PROPLUS TRANSCATHETER AORTIC VALVE,60000.0,39000.0,39000.0,58800.0,6
CDM,27879325,MULTI-SYNGERY XD EVEROLIMUS ELUTING COR STENT MONORAIL PLAT CHRO,2000.0,1300.0,336.0,1800.0,23
CDM,27879325_IP,MULTI-SYNGERY XD EVEROLIMUS ELUTING COR STENT MONORAIL PLAT CHRO,2000.0,1300.0,722.0,722.0,3
CDM,27879325_OP,MULTI-SYNGERY XD EVEROLIMUS ELUTING COR STENT MONORAIL PLAT CHRO,2000.0,1300.0,1300.0,1960.0,6
CDM,27879335,OPTIMIZER SMART IPG,52000.0,33800.0,8736.0,46800.0,29
CDM,27879335_OP,OPTIMIZER SMART IPG,52000.0,33800.0,33800.0,50960.0,6
CDM,27879345,CARDIOFRM OCCLUDER,16302.0,10596.3,2738.74,14671.8,29
CDM,27879345_OP,CARDIOFRM OCCLUDER,16302.0,10596.3,10596.3,15975.96,6
CDM,27879365,INTICA NEO 7 ICD,28200.0,18330.0,4737.6,25380.0,29
CDM,27879365_OP,INTICA NEO 7 ICD,28200.0,18330.0,18330.0,27636.0,6
CDM,27879505,AMPLATZER MUSCULAR VSD OCCLUDER,17540.0,11401.0,2946.72,15786.0,33
CDM,27879575,ELUVIA DRUG-ELUTING STENT 6MM X 120MM X 130CM,5790.0,3763.5,972.72,5211.0,29
CDM,27879575_OP,ELUVIA DRUG-ELUTING STENT 6MM X 120MM X 130CM,5790.0,3763.5,3763.5,5674.2,6
CDM,27879605,INNOVA SELF EXPANDING STENT,1220.0,793.0,204.96,1098.0,20
CDM,27879605_IP,INNOVA SELF EXPANDING STENT,1220.0,793.0,440.42,440.42,3
CDM,27879605_OP,INNOVA SELF EXPANDING STENT,1220.0,793.0,793.0,1195.6,6
CDM,27879635,VALVE TENDYNE 35S SP,60000.0,39000.0,10080.0,54000.0,29
CDM,27879635_OP,VALVE TENDYNE 35S SP,60000.0,39000.0,39000.0,58800.0,6
CDM,27879665,PAPYRUS COVERED CORONARY STENT,5400.0,3510.0,907.2,4860.0,29
CDM,27879665_OP,PAPYRUS COVERED CORONARY STENT,5400.0,3510.0,3510.0,5292.0,6
CDM,27879735,PORTICO TRANSCATHETER AORTIC VALVE,50000.0,32500.0,8400.0,45000.0,29
CDM,27879735_OP,PORTICO TRANSCATHETER AORTIC VALVE,50000.0,32500.0,32500.0,49000.0,6
CDM,27879775,STENT VIABAHN ENDOPROS W HEP,5510.0,3581.5,925.68,4959.0,29
CDM,27879775_OP,STENT VIABAHN ENDOPROS W HEP,5510.0,3581.5,3581.5,5399.8,6
CDM,27879885,DRSG BOVINE COLL GLYCOSAMINOGLYCAN 5X4IN,43.11,28.02,10.78,198.19,25
CDM,27879885_IP,DRSG BOVINE COLL GLYCOSAMINOGLYCAN 5X4IN,43.11,28.02,15.56,15.56,3
CDM,27879885_OP,DRSG BOVINE COLL GLYCOSAMINOGLYCAN 5X4IN,43.11,28.02,28.02,42.25,6
CDM,27880125,NUDEL STENT GRAFT DELIVERY SYSTEM,16486.0,10715.9,2769.65,14837.4,29
CDM,27880125_OP,NUDEL STENT GRAFT DELIVERY SYSTEM,16486.0,10715.9,10715.9,16156.28,6
CDM,27880135,MELODY TPV SYSTEM,51000.0,33150.0,8568.0,45900.0,29
CDM,27880135_OP,MELODY TPV SYSTEM,51000.0,33150.0,33150.0,49980.0,6
CDM,27880465,PLEXA PROMRI ICD LEAD,5400.0,3510.0,907.2,4860.0,29
CDM,27880465_OP,PLEXA PROMRI ICD LEAD,5400.0,3510.0,3510.0,5292.0,6
CDM,27880475,DEFIB ACTICOR 7 VR-T DX ICD,24200.0,15730.0,4065.6,21780.0,29
CDM,27880475_OP,DEFIB ACTICOR 7 VR-T DX ICD,24200.0,15730.0,15730.0,23716.0,6
CDM,27880495,FILTER FEMORAL W NAVALIGN,1700.0,1105.0,285.6,1530.0,20
CDM,27880495_IP,FILTER FEMORAL W NAVALIGN,1700.0,1105.0,613.7,613.7,3
CDM,27880495_OP,FILTER FEMORAL W NAVALIGN,1700.0,1105.0,1105.0,1666.0,6
CDM,27880505,COBALT HF MRI SURESCAN,30400.0,19760.0,5107.2,27360.0,29
CDM,27880505_OP,COBALT HF MRI SURESCAN,30400.0,19760.0,19760.0,29792.0,6
CDM,27880525,14 FR NUDEL STENT DELIVERY SYSTEM,15656.0,10176.4,2630.21,14090.4,29
CDM,27880525_OP,14 FR NUDEL STENT DELIVERY SYSTEM,15656.0,10176.4,10176.4,15342.88,6
CDM,27880535,"GALLANT VR ICD, SINGLE",15000.0,9750.0,2520.0,13500.0,29
CDM,27880535_OP,"GALLANT VR ICD, SINGLE",15000.0,9750.0,9750.0,14700.0,6
CDM,27880635,CARTO 3 EXTERNAL PATCH,623.0,404.95,104.66,560.7,20
CDM,27880635_IP,CARTO 3 EXTERNAL PATCH,623.0,404.95,224.9,224.9,3
CDM,27880635_OP,CARTO 3 EXTERNAL PATCH,623.0,404.95,404.95,610.54,6
CDM,27880655,STENT COVERED STRAIGHT 6MM X 80CM,4800.0,3120.0,806.4,4320.0,26
CDM,27880655_OP,STENT COVERED STRAIGHT 6MM X 80CM,4800.0,3120.0,3120.0,4704.0,6
CDM,27880725,VIABAHN VBX BALLOON-ENDOPROS,5460.0,3549.0,917.28,4914.0,29
CDM,27880725_OP,VIABAHN VBX BALLOON-ENDOPROS,5460.0,3549.0,3549.0,5350.8,6
CDM,27880735,HARMONY TPV 25,66000.0,42900.0,11088.0,59400.0,29
CDM,27880735_OP,HARMONY TPV 25,66000.0,42900.0,42900.0,64680.0,6
CDM,27880755,INTICA NEO 7 PROMRI ICD,16980.0,11037.0,2852.64,15282.0,29
CDM,27880755_OP,INTICA NEO 7 PROMRI ICD,16980.0,11037.0,11037.0,16640.4,6
CDM,27880765,NAVITOR 25MM VALVE,52500.0,34125.0,8820.0,47250.0,29
CDM,27880765_OP,NAVITOR 25MM VALVE,52500.0,34125.0,34125.0,51450.0,6
CDM,27880795,MOMENTUM EL ICD VR MODEL D120,19925.0,12951.25,3347.4,17932.5,29
CDM,27880795_OP,MOMENTUM EL ICD VR MODEL D120,19925.0,12951.25,12951.25,19526.5,6
CDM,27880805,PASCAL PRECISION ACE IMPLANT SYSTEM,67320.0,43758.0,11309.76,60588.0,29
CDM,27880805_OP,PASCAL PRECISION ACE IMPLANT SYSTEM,67320.0,43758.0,43758.0,65973.6,6
CDM,27880885,GRAFT EPIFIX  18MM DISC 2.5CM2,502.0,326.3,125.5,451.8,25
CDM,27880885_IP,GRAFT EPIFIX  18MM DISC 2.5CM2,502.0,326.3,181.22,181.22,3
CDM,27880885_OP,GRAFT EPIFIX  18MM DISC 2.5CM2,502.0,326.3,326.3,491.96,6
CDM,27880895,GRAFT EPIFIX  2X4CM 8CM2,353.0,229.45,88.25,317.7,25
CDM,27880895_IP,GRAFT EPIFIX  2X4CM 8CM2,353.0,229.45,127.43,127.43,3
CDM,27880895_OP,GRAFT EPIFIX  2X4CM 8CM2,353.0,229.45,229.45,345.94,6
CDM,27880905,GRAFT EPIFIX 3X4CM 12CM2,420.0,273.0,105.0,378.0,25
CDM,27880905_IP,GRAFT EPIFIX 3X4CM 12CM2,420.0,273.0,151.62,151.62,3
CDM,27880905_OP,GRAFT EPIFIX 3X4CM 12CM2,420.0,273.0,273.0,411.6,6
CDM,27880915,GRAFT EPIFIX 3.5X3.5CM 8SQ CM,328.0,213.2,82.0,295.2,25
CDM,27880915_IP,GRAFT EPIFIX 3.5X3.5CM 8SQ CM,328.0,213.2,118.41,118.41,3
CDM,27880915_OP,GRAFT EPIFIX 3.5X3.5CM 8SQ CM,328.0,213.2,213.2,321.44,6
CDM,27880925,GRAFT EPIFIX 4X4.5CM 10.1SQ CM,285.0,185.25,71.25,256.5,25
CDM,27880925_IP,GRAFT EPIFIX 4X4.5CM 10.1SQ CM,285.0,185.25,102.89,102.89,3
CDM,27880925_OP,GRAFT EPIFIX 4X4.5CM 10.1SQ CM,285.0,185.25,185.25,279.3,6
CDM,27880935,GRAFT ST TIS EPIFIX 14MM AMNIO,329.0,213.85,82.25,296.1,25
CDM,27880935_IP,GRAFT ST TIS EPIFIX 14MM AMNIO,329.0,213.85,118.77,118.77,3
CDM,27880935_OP,GRAFT ST TIS EPIFIX 14MM AMNIO,329.0,213.85,213.85,322.42,6
CDM,27880945,GRAFT EPIFIX 2X2CM 4 SQ CM,542.0,352.3,129.95,487.8,25
CDM,27880945_IP,GRAFT EPIFIX 2X2CM 4 SQ CM,542.0,352.3,195.66,195.66,3
CDM,27880945_OP,GRAFT EPIFIX 2X2CM 4 SQ CM,542.0,352.3,352.3,531.16,6
CDM,27880955,GRAFT EPIFIX 2X3CM 6 SQ CM,419.0,272.35,104.75,377.1,25
CDM,27880955_IP,GRAFT EPIFIX 2X3CM 6 SQ CM,419.0,272.35,151.26,151.26,3
CDM,27880955_OP,GRAFT EPIFIX 2X3CM 6 SQ CM,419.0,272.35,272.35,410.62,6
CDM,27880965,GRAFT ST TIS EPIFIX 16SQ CM,398.0,258.7,99.5,358.2,25
CDM,27880965_IP,GRAFT ST TIS EPIFIX 16SQ CM,398.0,258.7,143.68,143.68,3
CDM,27880965_OP,GRAFT ST TIS EPIFIX 16SQ CM,398.0,258.7,258.7,390.04,6
CDM,27880975,GRAFT ST TIS 6X5CM EPIFIX,403.0,261.95,100.75,362.7,25
CDM,27880975_IP,GRAFT ST TIS 6X5CM EPIFIX,403.0,261.95,145.48,145.48,3
CDM,27880975_OP,GRAFT ST TIS 6X5CM EPIFIX,403.0,261.95,261.95,394.94,6
CDM,27880985,GRAFT EPIFIX 7X7CM 49 SQ CM,413.0,268.45,103.25,371.7,25
CDM,27880985_IP,GRAFT EPIFIX 7X7CM 49 SQ CM,413.0,268.45,149.09,149.09,3
CDM,27880985_OP,GRAFT EPIFIX 7X7CM 49 SQ CM,413.0,268.45,268.45,404.74,6
CDM,27880WE,AMPUTATION LOW LEG THRU TIB/FIB,6148.0,3996.2,559.65,6148.0,35
CDM,27881235,POWER-TRIALYSIS SHORT TERM DIALYSIS CATH TRAY 13FR,380.0,247.0,63.84,342.0,20
CDM,27881235_IP,POWER-TRIALYSIS SHORT TERM DIALYSIS CATH TRAY 13FR,380.0,247.0,137.18,137.18,3
CDM,27881235_OP,POWER-TRIALYSIS SHORT TERM DIALYSIS CATH TRAY 13FR,380.0,247.0,247.0,372.4,6
CDM,27881275,AMPLATZER DUCT OCCLUDER II 6MM X 6MM,10290.0,6688.5,1728.72,9261.0,29
CDM,27881275_OP,AMPLATZER DUCT OCCLUDER II 6MM X 6MM,10290.0,6688.5,6688.5,10084.2,6
CDM,27881285,LUX-DX INSERTABLE CARDIAC MONITOR SYSTEM,9000.0,5850.0,1512.0,8100.0,29
CDM,27881285_OP,LUX-DX INSERTABLE CARDIAC MONITOR SYSTEM,9000.0,5850.0,5850.0,8820.0,6
CDM,27881405,"PERCIVA ICD DR, MODEL D401",23760.0,15444.0,3991.68,21384.0,29
CDM,27881405_OP,"PERCIVA ICD DR, MODEL D401",23760.0,15444.0,15444.0,23284.8,6
CDM,27881415,RIVACOR 7 HF-T QP DF4/IS4 PROMRI DEFIBRILLATOR,21980.0,14287.0,3692.64,19782.0,29
CDM,27881415_OP,RIVACOR 7 HF-T QP DF4/IS4 PROMRI DEFIBRILLATOR,21980.0,14287.0,14287.0,21540.4,6
CDM,27881435,XIENCE SKYPOINT RX EVEROLIMUS ELUTING CORONARY STENT SYSTEM 3MM,440.0,286.0,73.92,396.0,20
CDM,27881435_IP,XIENCE SKYPOINT RX EVEROLIMUS ELUTING CORONARY STENT SYSTEM 3MM,440.0,286.0,158.84,158.84,3
CDM,27881435_OP,XIENCE SKYPOINT RX EVEROLIMUS ELUTING CORONARY STENT SYSTEM 3MM,440.0,286.0,286.0,431.2,6
CDM,27881445,SYNERGY MEGA EVEROLIMUS-ELUTING CORONARY STENT 4.00MM X 12MM,1400.0,910.0,235.2,1260.0,20
CDM,27881445_IP,SYNERGY MEGA EVEROLIMUS-ELUTING CORONARY STENT 4.00MM X 12MM,1400.0,910.0,505.4,505.4,3
CDM,27881445_OP,SYNERGY MEGA EVEROLIMUS-ELUTING CORONARY STENT 4.00MM X 12MM,1400.0,910.0,910.0,1372.0,6
CDM,27881455,"BIOTRONIK CRT-DEFIBRILLATOR, ACTICOR HF-T CRT-DX DF4 IS1",21980.0,14287.0,3692.64,19782.0,29
CDM,27881455_OP,"BIOTRONIK CRT-DEFIBRILLATOR, ACTICOR HF-T CRT-DX DF4 IS1",21980.0,14287.0,14287.0,21540.4,6
CDM,27881465,AMPLATZER AMULET LEFT ATRIAL APPENDAGE OCCLUDER 25MM,34000.0,22100.0,5712.0,30600.0,29
CDM,27881465_OP,AMPLATZER AMULET LEFT ATRIAL APPENDAGE OCCLUDER 25MM,34000.0,22100.0,22100.0,33320.0,6
CDM,27881525,"OTW DELIVERY, ZILVER PTX DRUG-ELUTING PERIPHERAL STENT, 0.035IN",2350.0,1527.5,394.8,2115.0,23
CDM,27881525_IP,"OTW DELIVERY, ZILVER PTX DRUG-ELUTING PERIPHERAL STENT, 0.035IN",2350.0,1527.5,848.35,848.35,3
CDM,27881525_OP,"OTW DELIVERY, ZILVER PTX DRUG-ELUTING PERIPHERAL STENT, 0.035IN",2350.0,1527.5,1527.5,2303.0,6
CDM,27881605,"SYNERGY XD EVEROLIMUS-ELUTING CORONARY STENT, MONORAIL, PLAT CHR",700.0,455.0,117.6,630.0,20
CDM,27881605_IP,"SYNERGY XD EVEROLIMUS-ELUTING CORONARY STENT, MONORAIL, PLAT CHR",700.0,455.0,252.7,252.7,3
CDM,27881605_OP,"SYNERGY XD EVEROLIMUS-ELUTING CORONARY STENT, MONORAIL, PLAT CHR",700.0,455.0,455.0,686.0,6
CDM,27881645,"BRACHYTHERAPY SOURCE, NON-STRANDED, CESIUM-131, PER SOURCE",241.0,156.65,62.42,2050.09,36
CDM,27881645_IP,"BRACHYTHERAPY SOURCE, NON-STRANDED, CESIUM-131, PER SOURCE",241.0,156.65,87.0,87.0,3
CDM,27881645_OP,"BRACHYTHERAPY SOURCE, NON-STRANDED, CESIUM-131, PER SOURCE",241.0,156.65,156.65,236.18,6
CDM,27881655,"BRACHYTHERAPY SOURCE, STRANDED, CESIUM-131, PER SOURCE",293.0,190.45,75.89,2050.09,36
CDM,27881655_IP,"BRACHYTHERAPY SOURCE, STRANDED, CESIUM-131, PER SOURCE",293.0,190.45,105.77,105.77,3
CDM,27881655_OP,"BRACHYTHERAPY SOURCE, STRANDED, CESIUM-131, PER SOURCE",293.0,190.45,190.45,287.14,6
CDM,27881665,SYNERGY MEGA EVEROLIMUS-ELUTING PLTNM CHRMM CORONARY STENT 3.50M,2000.0,1300.0,336.0,1800.0,23
CDM,27881665_IP,SYNERGY MEGA EVEROLIMUS-ELUTING PLTNM CHRMM CORONARY STENT 3.50M,2000.0,1300.0,722.0,722.0,3
CDM,27881665_OP,SYNERGY MEGA EVEROLIMUS-ELUTING PLTNM CHRMM CORONARY STENT 3.50M,2000.0,1300.0,1300.0,1960.0,6
CDM,27881715,"AZUR CX PERIPHERAL DETACHABLE COIL SYSTEM, 0.035IN, 16MM X 32CM",2100.0,1365.0,352.8,1890.0,23
CDM,27881715_IP,"AZUR CX PERIPHERAL DETACHABLE COIL SYSTEM, 0.035IN, 16MM X 32CM",2100.0,1365.0,758.1,758.1,3
CDM,27881715_OP,"AZUR CX PERIPHERAL DETACHABLE COIL SYSTEM, 0.035IN, 16MM X 32CM",2100.0,1365.0,1365.0,2058.0,6
CDM,27881905,"ILIVIA NEO 7 PROMRI ICD, DR-T, DF-1",16980.0,11037.0,2852.64,15282.0,29
CDM,27881905_OP,"ILIVIA NEO 7 PROMRI ICD, DR-T, DF-1",16980.0,11037.0,11037.0,16640.4,6
CDM,27881925,DEVICE VES CLOS MYNX CONTROL VCD 6FR-12FR,430.0,279.5,72.24,387.0,27
CDM,27881935,KERECIS PER SQ CM,232.0,150.8,58.0,208.8,31
CDM,27881955,WATCHMAN FLX LT ATRIAL APPENDAGE CLOSURE DEVICE W/DEL SYST 27MM,34000.0,22100.0,5712.0,30600.0,29
CDM,27881955_OP,WATCHMAN FLX LT ATRIAL APPENDAGE CLOSURE DEVICE W/DEL SYST 27MM,34000.0,22100.0,22100.0,33320.0,6
CDM,27881965,AMPLATZER POST INFARCT MUSCULAR VSD OCCLUDER 45 DEG,12900.0,8385.0,2167.2,11610.0,29
CDM,27881965_OP,AMPLATZER POST INFARCT MUSCULAR VSD OCCLUDER 45 DEG,12900.0,8385.0,8385.0,12642.0,6
CDM,27881975,ZILVER PTX DRUG-ELUTING PERIPHERAL STENT 0.035 IN MAX GW,2990.0,1943.5,502.32,2691.0,23
CDM,27881975_IP,ZILVER PTX DRUG-ELUTING PERIPHERAL STENT 0.035 IN MAX GW,2990.0,1943.5,1079.39,1079.39,3
CDM,27881975_OP,ZILVER PTX DRUG-ELUTING PERIPHERAL STENT 0.035 IN MAX GW,2990.0,1943.5,1943.5,2930.2,6
CDM,27881985,"ZILVER PTX DRUG-ELUTING PERIPHERAL STENT 7.0MM X 120MM, 125CM OT",3190.0,2073.5,535.92,2871.0,23
CDM,27881985_IP,"ZILVER PTX DRUG-ELUTING PERIPHERAL STENT 7.0MM X 120MM, 125CM OT",3190.0,2073.5,1151.59,1151.59,3
CDM,27881985_OP,"ZILVER PTX DRUG-ELUTING PERIPHERAL STENT 7.0MM X 120MM, 125CM OT",3190.0,2073.5,2073.5,3126.2,6
CDM,27881WE,AMP LEG THRU TIBFIB W/IMMT FITG TQ W/1ST CST,5388.0,3502.2,635.76,5388.0,35
CDM,27882095,XIENCE SKYPOINT RX EVEROLIMUS ELUTING CORONARY STENT SYSTEM 3.0M,528.0,343.2,88.7,475.2,20
CDM,27882095_IP,XIENCE SKYPOINT RX EVEROLIMUS ELUTING CORONARY STENT SYSTEM 3.0M,528.0,343.2,190.61,190.61,3
CDM,27882095_OP,XIENCE SKYPOINT RX EVEROLIMUS ELUTING CORONARY STENT SYSTEM 3.0M,528.0,343.2,343.2,517.44,6
CDM,27882165,AMPLATZER DUCT OCCLUDER,9470.0,6155.5,1590.96,8523.0,29
CDM,27882165_OP,AMPLATZER DUCT OCCLUDER,9470.0,6155.5,6155.5,9280.6,6
CDM,27882255,ACCUCATH 20G 2.25IN POWER INJECTIBLE,87.0,56.55,14.62,78.3,27
CDM,27882265,ACCUCATH 20G X 2-1/4IN,107.0,69.55,17.98,96.3,27
CDM,27882275,PERCIVA ICD VR MODEL D412,19926.0,12951.9,3347.57,17933.4,33
CDM,27882285,PALMAZ GENESIS TRANSHEPATIC BILIARY STENT 10-12MM X 19MM UNMNTD,1800.0,1170.0,302.4,1620.0,30
CDM,27882295,TRUMPET TUBE,56.0,36.4,9.41,50.4,27
CDM,27882325,RICHARDS T TUBE,43.0,27.95,7.22,38.7,27
CDM,27882365,PAPYRUS COVERED CORONARY STENT 5FR 3.5MM X 15MM X 140CM PK,5940.0,3861.0,997.92,5346.0,33
CDM,27882375,PAPYRUS COVERED CORONARY STENT 5FR 2.5MM X 15MM X 140CM PK,5940.0,3861.0,997.92,5346.0,33
CDM,27882405,FIDUCIAL MARKER DOUBLE STRANDED,395.0,256.75,66.36,355.5,27
CDM,27882415,FIDUCIAL MARKER SINGLE STRANDED,206.0,133.9,34.61,185.4,27
CDM,27882425,VIABAHN ENDOPROSTHESIS STENT GRAFT W RADIOPAQUE MARKERS 7MM DIAX,5768.0,3749.2,969.02,5191.2,33
CDM,27882465,AZUR CX PERIPHERAL COIL SYSTEM 2MM X 2CM,2618.0,1701.7,439.82,2356.2,30
CDM,27882495,MAGSEED 7CM - TISSUE MARKER IMPLANTABLE,1940.0,1261.0,325.92,1746.0,30
CDM,27882505,"EPIC VASCULAR STENT SELF-EXPANDING, NITINOL, 12MM X 40MM, 120CM",1170.0,760.5,196.56,1053.0,27
CDM,27882515,EVOQUE VALVE 44MM,172000.0,111800.0,28896.0,154800.0,33
CDM,27882585,"INTICA NEO 7 ICD, HF-T, DF-1/IS-1",43600.0,28340.0,7324.8,39240.0,33
CDM,27882605,MODEL 9750TFX SAPIEN 3 ULTRA THV PERICARDIAL TISSUE HEART VALVE,130000.0,84500.0,21840.0,117000.0,33
CDM,27882615,MEDTRONIC 63CM CARDIAC DEFIBRILLATOR LEAD,21560.0,14014.0,3622.08,19404.0,33
CDM,27882625,AURORA EV-ICD MRI SURESCAN DEVICE,80000.0,52000.0,13440.0,72000.0,33
CDM,27882665,SYNERGY 3.50MM X 28MM MEGATRON EVEROLIMUS-ELUTING PLATINUM CHROM,2800.0,1820.0,470.4,2520.0,30
CDM,27882WE,AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR,3916.0,2545.4,439.12,3916.0,35
CDM,27884WE,AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV,3504.0,2277.6,336.6,3504.0,35
CDM,27886WE,AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION,4008.0,2605.2,461.19,4008.0,35
CDM,27892WE,DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE,3176.0,2064.4,298.02,3176.0,35
CDM,27894WE,DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS,5068.0,3294.2,451.77,5068.0,35
CDM,27899LOCWE,"WIRE NEEDLE LOC, FB, LEG/ANKLE UNLISTED",1114.0,724.1,340.23,1114.0,15
CDM,27899RVU3WE,"EXCISION OF ACCESSORY SOLEUS MUSCLE, LEG OR ANKLE AREA (COMP COD",2972.0,1931.8,340.23,2972.0,15
CDM,27899RVU5WE,ASPIRATION OF INTRAMUSCULAR HEMATOMA (COMP CODE 10160),451.0,293.15,225.5,451.0,15
CDM,27899RVU6WE,REPAIR/SUTURE MUSCLE LOWER LEG (COMP CODE 27658),1844.0,1198.6,340.23,1844.0,15
CDM,28001WE,INCIS/DRAINAGE BURSA OF FOOT,800.0,520.0,73.04,600.0,35
CDM,28002WE,I&D BELOW FASCIA FOOT 1 BURSAL SPACE,1116.0,725.4,125.22,837.0,35
CDM,28003WE,I&D BELOW FASCIA FOOT MULTIPLE AREAS,2112.0,1372.8,236.95,1584.0,35
CDM,28005WE,INCISION BONE CORTEX FOOT,3776.0,2454.4,364.27,3776.0,35
CDM,28008WE,FASCIOTOMY FOOT&/TOE,1836.0,1193.4,142.19,1377.0,35
CDM,28010WE,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,1188.0,772.2,149.95,891.0,35
CDM,28020WE,ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT,2060.0,1339.0,236.87,1545.0,35
CDM,28022WE,ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT,1924.0,1250.6,157.98,1443.0,35
CDM,28024WE,ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT,1808.0,1175.2,146.79,1356.0,35
CDM,28035WE,RELEASE TARSAL TUNNEL,2092.0,1359.8,190.64,1569.0,35
CDM,28039WE,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ 1.5+CM,2168.0,1409.2,168.33,1626.0,35
CDM,28041WE,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5+CM,2852.0,1853.8,243.82,2852.0,35
CDM,28043WE,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM,1584.0,1029.6,125.43,1188.0,35
CDM,28045WE,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM,2180.0,1417.0,166.69,1635.0,35
CDM,28046WE,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM,4952.0,3218.8,439.76,4952.0,35
CDM,28047WE,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3+CM,6980.0,4537.0,515.74,6980.0,35
CDM,28060WE,FASCIECTOMY PLANTAR FASCIA PARTIAL SPX,2160.0,1404.0,174.73,1620.0,35
CDM,28072WE,SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH,1888.0,1227.2,157.15,1416.0,35
CDM,28080WE,EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH,1944.0,1263.6,181.97,1458.0,35
CDM,28086WE,"SYNOVECTOMY FLEX TENDN SHEATH,FOOT",1968.0,1279.2,172.77,1476.0,35
CDM,28088WE,"SYNOVECTOMY EXTEN TENDN SHEATH,FOOT",1592.0,1034.8,139.23,1194.0,35
CDM,28090WE,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT,1820.0,1183.0,148.44,1365.0,35
CDM,28092WE,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA,1512.0,982.8,130.03,1134.0,35
CDM,28100WE,EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS,2332.0,1515.8,203.99,1749.0,35
CDM,28103WE,EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT,2668.0,1734.2,300.77,2668.0,35
CDM,28104WE,EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL,2104.0,1367.6,170.63,1578.0,35
CDM,28108WE,EXC/CURTG CST/B9 TUM PHALANGES FOOT,1720.0,1118.0,138.9,1290.0,35
CDM,28110WE,OSTECTOMY PRTL 5TH METAR HEAD SPX,1688.0,1097.2,140.38,1266.0,35
CDM,28111WE,OSTECTOMY COMPLETE 1ST METATARSAL HEAD,2060.0,1339.0,158.68,1545.0,35
CDM,28112WE,OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4,1852.0,1203.8,151.23,1389.0,35
CDM,28113WE,OSTECTOMY COMPLETE 5TH METATARSAL HEAD,2444.0,1588.6,205.15,1833.0,35
CDM,28114WE,OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC,4800.0,3120.0,405.69,3600.0,35
CDM,28116WE,OSTECTOMY TARSAL COALITION,3656.0,2376.4,283.06,2742.0,35
CDM,28118WE,OSTECTOMY CALCANEUS,2452.0,1593.8,204.16,1839.0,35
CDM,28119WE,OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS,2224.0,1445.6,175.89,1668.0,35
CDM,28120WE,PARTIAL EXCISION BONE TALUS/CALCANEUS,2924.0,1900.6,241.15,2193.0,35
CDM,28122WE,PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS,2704.0,1757.6,249.72,2028.0,35
CDM,28124WE,PARTICAL EXCISION BONE PHALANX TOE,2000.0,1300.0,160.6,1500.0,35
CDM,28126WE,RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH,1456.0,946.4,119.51,1092.0,35
CDM,28140WE,METATARSECTOMY,2856.0,1856.4,208.44,2142.0,35
CDM,28150WE,PHALANGECTOMY TOE EACH TOE,1692.0,1099.8,133.97,1269.0,35
CDM,28153WE,RESECTION CONDYLE DISTAL END PHALANX EACH TOE,1520.0,988.0,127.73,1140.0,35
CDM,28160WE,HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE,1552.0,1008.8,129.2,1164.0,35
CDM,28175WE,RADICAL RESECTION TUMOR PHALANX OR TOE,3316.0,2155.4,317.94,3316.0,35
CDM,28190WE,"REMV FOOT FOREIGN BODY,SUBCUTANEOUS",884.0,574.6,70.46,663.0,35
CDM,28192WE,"REMV FOOT FOREIGN BODY,DEEP",1912.0,1242.8,149.92,1434.0,35
CDM,28193WE,"REMV FOOT FOREIGN BODY,COMPLEX",2360.0,1534.0,176.71,1770.0,35
CDM,28200WE,RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON,1896.0,1232.4,158.63,1422.0,35
CDM,28208WE,REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON,1804.0,1172.6,154.68,1353.0,35
CDM,28220WE,TENOLYSIS FLEXOR FOOT SINGLE TENDON,1868.0,1214.2,146.96,1401.0,35
CDM,28222WE,TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS,2304.0,1497.6,191.24,1728.0,35
CDM,28225WE,TENOLYSIS EXTENSOR FOOT SINGLE TENDON,1512.0,982.8,127.73,1134.0,35
CDM,28226WE,TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON,1868.0,1214.2,194.79,1401.0,35
CDM,28230WE,TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX,1744.0,1133.6,136.93,1308.0,35
CDM,28232WE,TX OPEN TENDON FLEXOR TOE 1 TENDON SPX,1404.0,912.6,116.05,1053.0,35
CDM,28234WE,TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON,1416.0,920.4,128.88,1062.0,35
CDM,28238WE,RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR,3184.0,2069.6,250.25,2388.0,35
CDM,28240WE,TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC,1792.0,1164.8,141.7,1344.0,35
CDM,28250WE,DIVISN PLANTAR FASCIA/MUSCLE,2424.0,1575.6,196.43,1818.0,35
CDM,28262WE,CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH,7572.0,4921.8,548.21,5679.0,35
CDM,28270WE,CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX,1972.0,1281.8,161.09,1479.0,35
CDM,28272WE,CAPSULOTOMY IPHAL JOINT EACH JOINT SPX,1568.0,1019.2,120.82,1176.0,35
CDM,28280WE,SYNDACTYLIZATION TOES,2132.0,1385.8,168.16,1599.0,35
CDM,28285WE,CORRECTION HAMMERTOE,2473.0,1607.45,185.42,1854.75,35
CDM,28286WE,CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE,1880.0,1222.0,143.17,1410.0,35
CDM,28288WE,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,2408.0,1565.2,209.91,1806.0,35
CDM,28289WE,HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/O IMPLT,2760.0,1794.0,221.75,2070.0,35
CDM,28291WE,HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/IMPLT,3524.0,2290.6,366.15,2643.0,31
CDM,28292WE,CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE,2976.0,1934.4,238.31,2232.0,35
CDM,28295WE,CORRJ HLX VLGS BNCTY SESMDC PROX METAR OSTEOT,3428.0,2228.2,427.22,2571.0,31
CDM,28296WE,CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT,3300.0,2145.0,298.59,2475.0,35
CDM,28297WE,CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS,3716.0,2415.4,297.81,2787.0,35
CDM,28298WE,CORRJ HLX VLGS BNCTY SESMDC PROX PHLX OSTEOT,3100.0,2015.0,270.86,2325.0,35
CDM,28299WE,CORRJ HLX VLGS BNCTY SESMDC W/DOUBLE OSTEOTOMY,3716.0,2415.4,314.16,2787.0,35
CDM,28300WE,OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION,3892.0,2529.8,467.04,3892.0,35
CDM,28304WE,OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS,4140.0,2691.0,296.88,3105.0,35
CDM,28305WE,OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT,4308.0,2800.2,522.9,4308.0,35
CDM,28306WE,OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR,2400.0,1560.0,195.28,1800.0,35
CDM,28308WE,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA,2192.0,1424.8,186.41,1644.0,35
CDM,28309WE,OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT,5664.0,3681.6,497.52,5664.0,35
CDM,28310WE,OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE,2228.0,1448.2,174.73,1671.0,35
CDM,28313WE,RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY,2266.0,1472.9,173.92,1699.5,35
CDM,28315WE,SESAMOIDECTOMY FIRST TOE SPX,2000.0,1300.0,158.14,1500.0,35
CDM,28320WE,REPAIR NONUNION/MALUNION TARSAL BONES,3748.0,2436.2,455.44,3748.0,35
CDM,28322WE,RPR NON/MALUNION METARSAL W/WO BONE GRAFT,3412.0,2217.8,280.11,2559.0,35
CDM,28344WE,RECONSTRUCTION TOE POLYDACTYLY,1936.0,1258.4,134.14,1452.0,35
CDM,28345WE,RCNSTJ TOE SYNDACTYLY W/WO SKIN GRAFT EACH WEB,2436.0,1583.4,187.18,1827.0,35
CDM,28400WE,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,924.0,600.6,134.51,693.0,35
CDM,28405WE,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,1896.0,1232.4,219.53,1422.0,35
CDM,28406WE,PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ,2624.0,1705.6,350.18,2624.0,35
CDM,28415WE,OPEN TREATMENT CALCANEAL FRACTURE,6476.0,4209.4,697.85,6476.0,35
CDM,28430WE,CLOSED TX TALUS FRACTURE W/O MANIPULATION,888.0,577.2,125.21,666.0,35
CDM,28435WE,CLOSED TX TALUS FRACTURE W/MANIPULATION,1416.0,920.4,161.42,1062.0,35
CDM,28445WE,OPEN TREATMENT TALUS FRACTURE,6304.0,4097.6,631.66,6304.0,35
CDM,28446WE,OPEN OSTEOCHONDRAL AUTOGRAFT TALUS,7084.0,4604.6,703.22,7084.0,32
CDM,28450WE,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,893.0,580.45,99.49,669.75,35
CDM,28455WE,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,1426.0,926.9,141.08,1069.5,35
CDM,28456WE,PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ,1144.0,743.6,183.28,1144.0,35
CDM,28465WE,OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA,3520.0,2288.0,379.13,3520.0,35
CDM,28470WE,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,893.0,580.45,110.79,669.75,35
CDM,28475WE,CLTX METAR FX W/MANJ,1204.0,782.6,134.68,903.0,35
CDM,28476WE,PRQ SKEL FIXJ METAR FX W/MANJ,1440.0,936.0,196.26,1440.0,35
CDM,28485WE,OPEN TREATMENT METATARSAL FRACTURE EACH,2976.0,1934.4,310.93,2976.0,35
CDM,28490WE,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,468.0,304.2,60.66,351.0,35
CDM,28495WE,CLTX FX GRT TOE PHLX/PHLG W/MANJ,672.0,436.8,72.49,504.0,35
CDM,28496WE,PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ,992.0,644.8,133.89,825.12,35
CDM,28505WE,OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES,2976.0,1934.4,241.97,2232.0,35
CDM,28510WE,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,468.0,304.2,57.86,351.0,35
CDM,28515WE,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,624.0,405.6,69.37,468.0,35
CDM,28525WE,OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE,2248.0,1461.2,196.6,1686.0,35
CDM,28530WE,CLOSED TREATMENT SESAMOID FRACTURE,444.0,288.6,53.27,333.0,35
CDM,28531WE,OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION,1028.0,668.2,124.56,771.0,35
CDM,28545WE,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES,1040.0,676.0,133.15,780.0,35
CDM,28555WE,OPEN TREATMENT TARSAL BONE DISLOCATION,3860.0,2509.0,320.22,2895.0,35
CDM,28570WE,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,704.0,457.6,96.33,528.0,35
CDM,28575WE,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,1396.0,907.4,166.85,1047.0,35
CDM,28576WE,PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ,1840.0,1196.0,204.27,1840.0,35
CDM,28585WE,OPEN TREATMENT TALOTARSAL JOINT DISLOCATION,4452.0,2893.8,338.3,3339.0,35
CDM,28605WE,CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES,1156.0,751.4,149.75,867.0,35
CDM,28615WE,OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION,4280.0,2782.0,403.55,4280.0,35
CDM,28630WE,CLTX METATARSOPHLNGL JT DISLC W/O ANES,700.0,455.0,53.59,525.0,32
CDM,28635WE,CLTX METATARSOPHLNGL JT DISLC REQ ANES,784.0,509.6,64.28,588.0,35
CDM,28636WE,PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ,1108.0,720.2,96.82,831.0,35
CDM,28645WE,OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION,2976.0,1934.4,234.9,2232.0,35
CDM,28660WE,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,512.0,332.8,45.21,384.0,32
CDM,28665WE,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,788.0,512.2,67.32,591.0,35
CDM,28675WE,OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION,2248.0,1461.2,199.56,1686.0,35
CDM,28705WE,ARTHRODESIS PANTALAR,8132.0,5285.8,812.85,8132.0,35
CDM,28715WE,ARTHRODESIS TRIPLE,5368.0,3489.2,690.83,5368.0,35
CDM,28725WE,ARTHRODESIS SUBTALAR,4488.0,2917.2,575.03,4488.0,35
CDM,28730WE,ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS,4280.0,2782.0,542.47,4280.0,35
CDM,28735WE,ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT,4892.0,3179.8,557.27,4892.0,35
CDM,28737WE,ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR,4412.0,2867.8,501.39,4412.0,35
CDM,28740WE,ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT,3716.0,2415.4,299.83,2787.0,35
CDM,28750WE,ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT,3428.0,2228.2,281.1,2571.0,35
CDM,28755WE,ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT,1952.0,1268.8,162.08,1464.0,35
CDM,28760WE,ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK,3656.0,2376.4,274.68,2742.0,35
CDM,28800WE,"AMPUTATION FOOT,MIDTARSAL-CHOPART",3516.0,2285.4,392.81,3516.0,35
CDM,28805WE,"AMPUTATION FOOT,TRANSMETATARSAL",5084.0,3304.6,408.31,5084.0,35
CDM,28810WE,"AMPUTATION METATARSAL+TOE,SINGLE",2656.0,1726.4,288.51,2656.0,35
CDM,28820WE,AMPUTATION TOE METATARSOPHALANGEAL JOINT,1544.0,1003.6,133.97,1158.0,35
CDM,28825WE,AMPUTATION TOE INTERPHALANGEAL JOINT,1500.0,975.0,131.1,1125.0,35
CDM,28899RVU12WE,TALUS DECOMPRESSION W/DRILLING (COMP CODE 28005),1836.0,1193.4,323.14,1836.0,15
CDM,28899RVU19WE,COMPLETE REMOVAL OF TARSAL BONE (COMP CODE 28130),4085.0,2655.25,323.14,4085.0,15
CDM,28899RVU21WE,SUBTALAR JOINT?ARTHROEREISIS (COMP CODE 28725),4040.0,2626.0,323.14,4040.0,15
CDM,28899RVU22WE,PERINEURAL TARSAL TUNNEL INJECTION (COMP CODE 64450),330.0,214.5,165.0,387.77,15
CDM,28899RVU6WE,REPAIR LIGAMENT FOOT (COMP CODE 27695),2413.0,1568.45,323.14,2413.0,15
CDM,28899RVU9WE,UNLISTED PLANTAR PLATE REPAIR 2ND METATARSOPHALANGEAL JOINT OF L,1700.0,1105.0,323.14,1700.0,15
CDM,29000095,"PEAK EXPIRE FLOW MTR,HAND HELD",37.0,24.05,6.22,33.3,21
CDM,29000110,SPACER BAG/RESERVOIR,48.0,31.2,8.06,43.2,21
CDM,29000345,DELUXE HOME TRACTION KIT,631.0,410.15,106.01,567.9,21
CDM,29055WE,"APPLY SHOULDER CAST,SPICA",712.0,462.8,52.72,534.0,35
CDM,29058WE,"APPLY SHOULDER CAST,PLASTR VELPEAU",712.0,462.8,53.41,534.0,35
CDM,29065WE,APPLICATION CAST SHOULDER HAND LONG ARM,348.0,226.2,51.62,261.0,35
CDM,29075WE,APPLICATION CAST ELBOW FINGER SHORT ARM,308.0,200.2,47.03,231.0,35
CDM,29085WE,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,348.0,226.2,50.76,261.0,35
CDM,29086WE,APPLICATION FINGER CAST,248.0,161.2,38.41,186.0,32
CDM,29105WE,APPLICATION LONG ARM SPLINT SHOULDER HAND,320.0,208.0,40.11,240.0,35
CDM,29125WE,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,220.0,143.0,29.87,165.0,35
CDM,29126WE,"APPLY FOREARM SPLINT,DYNAMIC",299.0,194.35,23.67,224.25,35
CDM,29130WE,APPLICATION FINGER SPLINT STATIC,220.0,143.0,22.02,165.0,35
CDM,29131WE,"APPLY FINGER SPLINT,DYNAMIC",242.0,157.3,16.61,181.5,35
CDM,29240WE,STRAPPING SHOULDER,172.0,111.8,15.74,129.0,35
CDM,29345WE,APPLICATION LONG LEG CAST THIGH-TOE,560.0,364.0,48.65,420.0,35
CDM,29355WE,APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE,612.0,397.8,53.78,459.0,35
CDM,29365WE,APPLICATION CYLINDER CAST THIGH ANKLE,472.0,306.8,66.97,354.0,35
CDM,29405WE,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,320.0,208.0,45.23,240.0,35
CDM,29425WE,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,320.0,208.0,42.92,240.0,35
CDM,29435WE,APPLICATION PATELLAR TENDON BEARING CAST,472.0,306.8,46.9,354.0,35
CDM,29445WE,APPLICATION RIGID TOTAL CONTACT LEG CAST,712.0,462.8,76.3,534.0,35
CDM,29505WE,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,304.0,197.6,37.96,228.0,35
CDM,29515WE,APPLICATION SHORT LEG SPLINT CALF FOOT,321.0,208.65,37.99,240.75,35
CDM,29530WE,STRAPPING KNEE,172.0,111.8,15.74,129.0,35
CDM,29540WE,STRAPPING ANKLE &/FOOT,172.0,111.8,13.12,129.0,35
CDM,29550WE,STRAPPING OF TOES,110.0,71.5,10.29,82.5,35
CDM,29580WE,STRAPPING UNNA BOOT,242.0,157.3,20.6,181.5,35
CDM,29581WE,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,264.0,171.6,10.66,198.0,35
CDM,29700WE,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,228.0,148.2,15.95,171.0,32
CDM,29705WE,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,304.0,197.6,21.54,228.0,32
CDM,29730WE,WINDOWING CAST,300.0,195.0,21.38,225.0,32
CDM,29740WE,WEDGING CAST EXCEPT CLUBFOOT CASTS,448.0,291.2,33.54,336.0,32
CDM,29805WE,DIAGNOSTIC ARTHROSCOPY SHOULDER +- SYNOVIAL BX,2412.0,1567.8,261.6,2412.0,35
CDM,29806WE,SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY,6056.0,3936.4,726.33,6056.0,35
CDM,29807WE,SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION,5868.0,3814.2,706.83,5868.0,35
CDM,29819WE,SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB,3116.0,2025.4,449.86,3116.0,35
CDM,29820WE,SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY,2884.0,1874.6,402.41,2884.0,35
CDM,29821WE,SURGICAL ARTHROSCOPY SHOULDER COMPL SYNOVECTOMY,3156.0,2051.4,442.88,3156.0,35
CDM,29822WE,SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2,3093.0,2010.45,420.16,3093.0,35
CDM,29823WE,SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+,3511.0,2282.15,463.92,3511.0,35
CDM,29824WE,SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC,3592.0,2334.8,441.97,3592.0,35
CDM,29825WE,SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS,3116.0,2025.4,434.73,3116.0,35
CDM,29826WE,SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS,1320.0,858.0,131.49,1320.0,35
CDM,29827WE,SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR,6236.0,4053.4,720.99,6236.0,35
CDM,29828WE,SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS,5790.0,3763.5,543.77,5790.0,35
CDM,29830WE,ARTHROSCOPY ELBOW DIAG W/WO SYNOVIAL BIOPSY SPX,2352.0,1528.8,303.43,2352.0,35
CDM,29834WE,ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB,2568.0,1669.2,334.54,2568.0,35
CDM,29835WE,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL,2648.0,1721.2,343.84,2648.0,35
CDM,29836WE,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE,3088.0,2007.2,400.19,3088.0,35
CDM,29837WE,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED,2804.0,1822.6,365.67,2804.0,35
CDM,29838WE,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE,3152.0,2048.8,403.17,3152.0,35
CDM,29840WE,ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX,2272.0,1476.8,262.68,2272.0,35
CDM,29843WE,ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE,2460.0,1599.0,330.38,2460.0,35
CDM,29844WE,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL,2604.0,1692.6,342.43,2604.0,35
CDM,29845WE,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE,3076.0,1999.4,413.25,3076.0,35
CDM,29846WE,ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT,2756.0,1791.4,405.85,2756.0,35
CDM,29848WE,NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM,2556.0,1661.4,263.12,2556.0,35
CDM,29850WE,ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ,3308.0,2150.2,465.1,3308.0,35
CDM,29851WE,ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ,5304.0,3447.6,654.54,5304.0,35
CDM,29855WE,ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR,4304.0,2797.6,573.5,4304.0,35
CDM,29856WE,ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR,5712.0,3712.8,703.4,5712.0,35
CDM,29860WE,ARTHROSCOPY HIP DIAGNOSTIC W/WO SYNOVIAL BYP SPX,3600.0,2340.0,360.72,3600.0,35
CDM,29861WE,ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB,4040.0,2626.0,506.35,4040.0,35
CDM,29862WE,ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG,4468.0,2904.2,554.81,4468.0,35
CDM,29863WE,ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY,4915.0,3194.75,517.24,4915.0,35
CDM,29866WE,ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST,5868.0,3814.2,761.25,5868.0,35
CDM,29867WE,ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT,7356.0,4781.4,909.82,7356.0,35
CDM,29868WE,ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT,10040.0,6526.0,1235.3,10040.0,35
CDM,29870WE,ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX,2284.0,1484.6,199.23,1713.0,35
CDM,29871WE,ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE,2944.0,1913.6,364.85,2944.0,35
CDM,29873WE,ARTHRS KNEE W LAT RELEASE,2746.0,1784.9,331.77,2746.0,35
CDM,29874WE,ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY,3164.0,2056.6,409.38,3164.0,35
CDM,29875WE,ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX,2838.0,1844.7,374.38,2838.0,35
CDM,29876WE,ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS,3548.0,2306.2,465.96,3548.0,35
CDM,29877WE,ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG,3652.0,2373.8,431.99,3652.0,35
CDM,29879WE,ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX,3596.0,2337.4,474.73,3596.0,35
CDM,29880WE,ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING,3252.0,2113.8,440.69,3252.0,35
CDM,29881WE,ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG,3093.0,2010.45,424.86,3093.0,35
CDM,29882WE,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL,4224.0,2745.6,499.72,4224.0,35
CDM,29883WE,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL,4708.0,3060.2,560.59,4708.0,35
CDM,29884WE,ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX,3312.0,2152.8,428.21,3312.0,35
CDM,29885WE,ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG,4084.0,2654.6,477.57,4084.0,35
CDM,29886WE,ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION,3736.0,2428.4,399.06,3736.0,35
CDM,29887WE,ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ,4064.0,2641.6,518.13,4064.0,35
CDM,29888WE,ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,6292.0,4089.8,755.76,6292.0,35
CDM,29889WE,ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,6964.0,4526.6,666.81,6964.0,35
CDM,29891WE,ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT,3868.0,2514.2,477.72,3868.0,35
CDM,29894WE,ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY,2940.0,1911.0,394.99,2940.0,35
CDM,29895WE,ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL,2852.0,1853.8,358.22,2852.0,35
CDM,29897WE,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED,2928.0,1903.2,384.26,2928.0,35
CDM,29898WE,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE,3736.0,2428.4,436.35,3736.0,35
CDM,29899WE,ARTHRS ANKLE W ARTHRODESIS,6164.0,4006.6,662.51,6164.0,35
CDM,29900WE,ARTHROSCOPY METACARPOPHALANGEAL SYNOVIAL BIOPSY,2587.0,1681.55,298.41,2587.0,35
CDM,29901WE,ARTHRS METACARPOPHALANGEAL JOINT DEBRIDEMENT,2900.0,1885.0,345.56,2900.0,35
CDM,29902WE,ARTHRS MTCARPHLNGL JT W/RDCTJ UR COLTRL LIGM,3150.0,2047.5,371.02,3150.0,35
CDM,29914WE,ARTHROSCOPY HIP W/FEMOROPLASTY,6455.0,4195.75,604.0,6455.0,35
CDM,29915WE,ARTHROSCOPY HIP W/ACETABULOPLASTY,6000.0,3900.0,615.29,6000.0,35
CDM,29916WE,ARTHROSCOPY HIP W/LABRAL REPAIR,6000.0,3900.0,615.29,6000.0,35
CDM,29999RVU13WE,ILIOPSOAS TENDON RELEASE; SCOPE (COMP 27306),1896.0,1232.4,467.7,1896.0,15
CDM,29999RVU37WE,TENOTOMY OF HIP FLEXORS (COMP CODE 27005),4330.0,2814.5,467.7,4330.0,15
CDM,29999RVU38WE,ARTHROSCOPY SHOULDER - BALLOON SPACER IMPLANTATION (COMP CODE 29,3432.0,2230.8,467.7,3432.0,15
CDM,29999RVU39WE,ARTHROSCOPIC REMOVAL OF IMPLANT (COMP CODE 20680),2622.0,1704.3,467.7,2622.0,15
CDM,29999RVU40WE,ARTHROSCOPIC TENOTOMY (COMP CODE 23405),3416.0,2220.4,467.7,3416.0,15
CDM,29999RVU41WE,ARTHROSCOPIC AC JOINT RECONSTRUCTION (COMP CODE 23462),6288.0,4087.2,467.7,6288.0,15
CDM,29999RVU42WE,ENDOSCOPIC ILIOPSOAS TENDON RELEASE (COMP CODE 29862),4468.0,2904.2,467.7,4468.0,15
CDM,29999RVU43WE,ARTHROSCOPIC EXCISION OF MENISCAL CYST OF THE KNEE (COMP CODE 29,2838.0,1844.7,467.7,2838.0,15
CDM,29999RVU44WE,ARTHROSCOPICALLY AIDED CARPAL DECOMPRESSION/BONE DRILLING (COMP,3060.0,1989.0,467.7,3060.0,15
CDM,29999RVU45WE,ARTHROSCOPIC CORACOPLASTY SHOULDER (COMP CODE 23182),3444.0,2238.6,467.7,3444.0,15
CDM,29999RVU46WE,ARTHROSCOPIC BONE EXCISION WITH GRAFTING (COMP CODE 27360),4584.0,2979.6,467.7,4584.0,15
CDM,29999RVU8WE,ARTHROSCOPIC REMPLISSAGE REPAIR (COMP CODE 29827),5613.0,3648.45,467.7,5613.0,15
CDM,30000020,*BORDTL AB,29.0,18.85,5.23,26.1,37
CDM,30000030,*BRUCELLA AB,55.0,35.75,5.23,49.5,37
CDM,30000040,*CHLAMY PNEU IGA,22.0,14.3,5.23,19.8,37
CDM,30000055,COLL CAP BLOOD SPECIMEN,60.0,39.0,2.52,261.0,35
CDM,30000065,COLL BLOOD OFF PICC VENOUS,926.0,601.9,44.56,3920.0,46
CDM,30000070,*COXIELLA ABS,20.0,13.0,5.0,20.0,37
CDM,30000075,%AMITRIPTYLINE,238.0,154.7,33.04,214.2,37
CDM,30000085,CARBAMAZEPINE FREE,26.0,16.9,5.81,23.4,37
CDM,30000105,%IMIPRAMINE PL,157.0,102.05,33.04,157.0,37
CDM,30000125,TOPIRAMATE,40.0,26.0,5.81,36.0,37
CDM,30000135,VANCOMYCIN,178.0,115.7,5.81,160.2,37
CDM,30000145,%ACTH STIMULATION PANEL,244.0,158.6,16.61,219.6,37
CDM,30000150,*GLIADIN ANTIBODY,25.0,16.25,5.78,22.5,37
CDM,30000160,*HELICOBACTER PYLORI AB,37.0,24.05,5.23,33.3,37
CDM,30000180,PHENYTOIN FREE,26.0,16.9,5.81,23.4,37
CDM,30000190,*KAPPA LAM LTCHN,47.0,30.55,5.23,42.3,37
CDM,30000195,GROWTH HORMONE STIM,591.0,384.15,16.61,531.9,37
CDM,30000200,*PARTCL AGGLUT SCREEN EA,17.0,11.05,4.25,17.0,37
CDM,30000210,*LYME AB IGG/IGM CSF,45.0,29.25,5.23,40.5,37
CDM,30000235,PREGNANCY TEST URINE (POINT OF CARE LAB),40.0,26.0,1.43,36.0,37
CDM,30000300,*TOXOPLASMOSIS,56.0,36.4,5.23,50.4,37
CDM,30000310,ALDOLASE,19.0,12.35,2.59,17.1,37
CDM,30000315,ADMIN DRUG H PYLORI (POINT OF CARE LAB),52.0,33.8,2.59,46.8,37
CDM,30000320,*ALKA PHOSPHTAS ISOENZYME,24.0,15.6,5.78,24.0,37
CDM,30000330,*VAP CHOLESTE,50.0,32.5,2.59,45.0,37
CDM,30000335,HCG TEST QUAL,94.0,61.1,2.59,84.6,37
CDM,30000340,"ALPHA-1-ANTITRYPSIN,STOOL",166.0,107.9,5.78,149.4,37
CDM,30000350,17 HYDROXYPREGNENOLONE,76.0,49.4,6.33,68.4,37
CDM,30000360,24HR URINE FOR ALA,40.0,26.0,5.78,36.0,37
CDM,30000365,FIBRINOLYSINS SCREEN I&R,51.0,33.15,2.12,45.9,37
CDM,30000370,HYDRXINDOL ACD5(HIAA)QT,39.0,25.35,6.33,35.1,37
CDM,30000380,ALUMINUM,40.0,26.0,5.78,40.0,37
CDM,30000390,AMIKACIN ASSAY,131.0,85.15,5.81,117.9,37
CDM,30000400,AMINO ACIDS QNT UR/BLD,392.0,254.8,5.78,352.8,37
CDM,30000420,LYME ANTIBODY TITER,34.0,22.1,5.23,30.6,37
CDM,30000425,RBC ANTIB ELUTION,549.0,356.85,81.35,494.1,37
CDM,30000435,AGT DIR MONOSPECIF C3,173.0,112.45,2.08,155.7,37
CDM,30000445,ANTIBODY TITER,189.0,122.85,2.08,371.54,37
CDM,30000450,ANDROSTENEDIONE,44.0,28.6,6.33,44.0,37
CDM,30000455,SALVAGED BL PROCESSING EA,805.0,523.25,51.52,1771.17,37
CDM,30000460,HELICOBACTER PYLORI AB,75.0,48.75,5.23,67.5,37
CDM,30000465,SPECIAL ANTIGEN SCREEN,359.0,233.35,2.08,779.93,37
CDM,30000470,STRONGYLOIDES IGG AB,142.0,92.3,5.23,127.8,37
CDM,30000475,RBC ANTIGEN TYPING,359.0,233.35,2.08,779.93,37
CDM,30000485,INCUBATION CROSSMATCH,186.0,120.9,48.17,371.54,37
CDM,30000490,ARBOVIRUS AB,56.0,36.4,5.23,50.4,37
CDM,30000495,ELECTRONIC CROSSMATCH,188.0,122.2,48.69,371.54,37
CDM,30000500,ARSENIC QUANTITATIVE,35.0,22.75,5.78,31.7,37
CDM,30000510,ASCORB ACD-VT,23.0,14.95,2.59,20.7,37
CDM,30000520,ASPERGILLUS AB,34.0,22.1,5.23,30.6,37
CDM,30000535,PREWARM MODIFICATION,98.0,63.7,24.58,88.2,37
CDM,30000540,RUBELLA TITER,50.0,32.5,5.23,45.0,37
CDM,30000545,R E S ABSORP TEST,180.0,117.0,46.62,371.54,37
CDM,30000555,TRIPLE ABSORPTION X3,442.0,287.3,51.52,397.8,37
CDM,30000560,BLASTOMYCES AB,25.0,16.25,5.23,22.5,37
CDM,30000565,SPLITTING BLOOD/BLOOD PRODUCTS EACH UNIT,189.0,122.85,48.95,371.54,37
CDM,30000580,TREPONEMA PALLIDUM,19.0,12.35,4.75,19.0,37
CDM,30000595,KRUGER'S TEST,81.0,52.65,4.02,72.9,37
CDM,30000600,CAROTENE,14.0,9.1,2.59,14.0,37
CDM,30000610,CATECHL TOT URN,50.0,32.5,6.33,45.62,37
CDM,30000620,CATH COLL SPEC SNGL PATIENT,20.0,13.0,2.52,2849.0,37
CDM,30000625,STREP A ASSAY W/OPTIC,176.0,114.4,4.02,158.4,37
CDM,30000630,ANGIOTENSIN CONV ENZYME,24.0,15.6,5.78,24.0,37
CDM,30000640,ACTH,56.0,36.4,14.0,56.0,37
CDM,30000650,ACUTE HEP PAN,97.0,63.05,4.31,87.3,37
CDM,30000660,*ADENOVIRUS AB,23.0,14.95,5.23,21.51,37
CDM,30000670,CHLORIDE STOOL,11.0,7.15,2.59,9.9,37
CDM,30000690,CHEMILUMINESCENT ASY,188.0,122.2,5.78,169.2,37
CDM,30000695,PERCUTANEOUS SPERM ASPIRATION,1166.0,757.9,53.63,1049.4,37
CDM,30000700,CHOLINESTERASE PSEUDO,21.0,13.65,2.59,18.9,37
CDM,30000710,CHOLINESTERASE RBC,21.0,13.65,2.59,18.9,37
CDM,30000715,CRYOPRESERVATION SPERM,624.0,405.6,59.1,561.6,37
CDM,30000720,CHROMIUM,32.0,20.8,5.78,32.0,37
CDM,30000725,SPERM WASH FOR INSEMINATI,310.0,201.5,53.63,279.0,37
CDM,30000730,"CHYLOSCREEN, BODY FLUID",19.0,12.35,4.75,18.82,37
CDM,30000735,SPERM WASH SECOND INSEM,578.0,375.7,53.63,520.2,37
CDM,30000740,CITRIC ACID URINE,44.0,28.6,11.0,44.0,37
CDM,30000745,TESTICULAR BIOPSY PREP,1870.0,1215.5,53.63,1683.0,37
CDM,30000750,*COL CHROMOTOGRAPHY QUAL/QUAN,101.0,65.65,5.78,90.9,37
CDM,30000760,CMV AB IGM,24.0,15.6,5.23,24.0,37
CDM,30000780,COBALT QUANT,32.0,20.8,5.78,32.0,37
CDM,30000800,COCCIDIOIDES AB,32.0,20.8,5.23,28.8,37
CDM,30000810,COLL SPUTUM AEROSOL,180.0,117.0,30.94,371.54,38
CDM,30000820,COLL/STORE AUTOLOGOUS BLOOD,345.0,224.25,51.52,371.54,37
CDM,30000825,SPERM COUNT/MOTILITY SEMEN,188.0,122.2,2.34,169.2,37
CDM,30000830,COMPATIBILITY TEST ANTIGLOB,281.0,182.65,72.78,371.54,37
CDM,30000835,CASA,262.0,170.3,2.34,235.8,37
CDM,30000840,COMPATIBILITY TEST SPIN,197.0,128.05,51.02,371.54,37
CDM,30000845,SEMEN ANAL POST VASEC,243.0,157.95,2.34,218.7,37
CDM,30000855,SPERM DIFFERENTIAL,138.0,89.7,2.34,124.2,37
CDM,30000860,COOMBS TEST DIR EA ANTISERUM,138.0,89.7,2.08,128.79,37
CDM,30000865,ANTI SPERM AB TYPING,281.0,182.65,2.34,252.9,37
CDM,30000900,CORTICOSTERONE,164.0,106.6,6.33,147.6,37
CDM,30000905,CITRIC ACID URINE,46.0,29.9,11.5,46.0,37
CDM,30000910,CORTISOL TOTAL,28.0,18.2,6.33,27.24,37
CDM,30000915,STORAGE SEMEN/SPERM PER YEAR,367.0,238.55,59.1,371.54,37
CDM,30000920,CORTISOL URINE FREE,28.0,18.2,5.78,27.92,37
CDM,30000930,COXSACKIE A AB,55.0,35.75,5.23,49.5,37
CDM,30000940,C-PEPTID,32.0,20.8,5.78,32.0,37
CDM,30000945,THAW CRYOPRESERVE SPERM/SEMEN,266.0,172.9,53.63,239.4,37
CDM,30000950,*CREATINE KINASE ISOENZYME,58.0,37.7,5.78,52.2,37
CDM,30000960,CREATINE URINE,36.0,23.4,2.59,32.4,37
CDM,30000970,*CREATININE BLOOD,86.0,55.9,2.59,77.4,37
CDM,30000980,ALPHA FETO PROTEIN SERUM,62.0,40.3,5.78,55.8,37
CDM,30000995,SPECIMEN ACQUISITION KIT- DD WAIT LIST,41.0,26.65,2.52,36.9,27
CDM,30000WE,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,592.0,384.8,60.7,444.0,35
CDM,30001000,CYANIDE,33.0,21.45,5.78,32.42,37
CDM,30001050,"AMINOLEVULINIC ACID, UR",46.0,29.9,5.78,41.4,37
CDM,30001060,DEOXYCORTISL 11,73.0,47.45,6.33,65.7,37
CDM,30001080,DEHYDROEPIANDRSTRONE,36.0,23.4,5.78,36.0,37
CDM,30001090,DEHYDROEPIANDRST SULFATE,32.0,20.8,6.33,32.0,37
CDM,30001095,LIBRIUM & METABOLITE,569.0,369.85,33.04,512.1,37
CDM,30001100,*DIBUCAINE NUMBER ASSAY,21.0,13.65,5.25,20.47,37
CDM,30001120,*DIPHTHERIA ABMA,25.0,16.25,5.23,25.0,37
CDM,30001150,E HISTOLYTICA AB,73.0,47.45,5.23,65.7,37
CDM,30001160,EBV EARLY AG EA,19.0,12.35,4.75,19.0,37
CDM,30001165,CANNABANOIDS,246.0,159.9,33.04,221.4,37
CDM,30001170,EBV EBNA,24.0,15.6,5.23,24.0,37
CDM,30001175,GM1 ANTIBODY PANEL X2,216.0,140.4,5.78,194.4,37
CDM,30001180,ECHO VIRUS(ENTEROVIRUS),29.0,18.85,5.23,26.1,37
CDM,30001190,ELECTROLYTE PANEL,144.0,93.6,4.31,129.6,37
CDM,30001200,ENCEPH EASTERN,56.0,36.4,5.23,50.4,37
CDM,30001210,ENCEPH WESTERN,56.0,36.4,5.23,50.4,37
CDM,30001220,RBC AG NOT ABO/RH(D) EA,400.0,260.0,2.08,779.93,37
CDM,30001230,CARBAMAZEPINE,26.0,16.9,5.81,23.4,37
CDM,30001240,*ENCEPHALITIS AB,56.0,36.4,5.23,50.4,37
CDM,30001280,ANTITRYPSIN ALPHA 1 TOTL,19.0,12.35,4.75,19.0,37
CDM,30001290,ESTRADIOL,44.0,28.6,6.33,44.0,37
CDM,30001300,ESTRIOL,37.0,24.05,6.33,37.0,37
CDM,30001310,ESTROGENS TOTAL,67.0,43.55,6.33,60.3,37
CDM,30001320,ESTRONE,43.0,27.95,6.33,41.69,37
CDM,30001325,CAPILLARY STICK (POINT OF CARE),60.0,39.0,2.52,261.0,35
CDM,30001330,ETHOSUXIMIDE,25.0,16.25,5.81,25.0,37
CDM,30001340,ETHYLENE GLYCOL,70.0,45.5,5.78,63.0,37
CDM,30001360,FLETCHER FACTOR ASSAY,124.0,80.6,2.12,111.6,37
CDM,30001380,FOLLICLE STIMLAT HORMONE,34.0,22.1,6.33,31.05,37
CDM,30001390,FOLIC ACID RBC,24.0,15.6,5.78,24.0,37
CDM,30001400,FRUCTOSE SEME,83.0,53.95,5.78,74.7,37
CDM,30001410,FAT OR LIPID FECES QUANT,45.0,29.25,5.78,40.5,37
CDM,30001420,FAT OR LIPID FECES QUAL,45.0,29.25,2.59,40.5,37
CDM,30001430,G6PD QUANT,24.0,15.6,2.59,21.6,37
CDM,30001440,G6PD SREEN,21.0,13.65,2.59,18.9,37
CDM,30001450,GAMMAGLOBULIN ASSAY IGE,111.0,72.15,5.78,99.9,37
CDM,30001460,*GAMMAGLOBULIN IGG SUBCLASS EA,22.0,14.3,2.59,19.8,37
CDM,30001470,GASTRIN,24.0,15.6,6.0,24.0,37
CDM,30001480,GLUCOSE BLD BY MONIT DEV (POINT OF CARE LAB),24.0,15.6,2.59,21.6,37
CDM,30001490,GLUCAGON,46.0,29.9,6.33,41.4,37
CDM,30001500,GLUCOSE QUANT,80.0,52.0,2.59,72.0,37
CDM,30001520,GONA CHR(HCG),249.0,161.85,6.33,224.1,37
CDM,30001530,GONADOTROPIN LH,182.0,118.3,6.33,163.8,37
CDM,30001540,H PYLORI BRTH TST,132.0,85.8,32.49,118.8,37
CDM,30001550,H.INFLUENZA A,40.0,26.0,5.23,36.0,37
CDM,30001560,HALDOL LEVEL,83.0,53.95,5.81,74.7,37
CDM,30001570,HBC AB IGG &I,144.0,93.6,5.23,129.6,37
CDM,30001590,HBC AB(IGM),23.0,14.95,5.23,20.7,37
CDM,30001595,HEMATOCRIT,44.0,28.6,2.37,39.6,37
CDM,30001610,HEMOGLOBIN PLASMA,12.0,7.8,2.59,12.0,37
CDM,30001620,HEMOGLOBIN URINE,8.0,5.2,2.0,7.2,37
CDM,30001640,HEMOSIDERIN QUAL,14.0,9.1,2.59,12.6,37
CDM,30001650,HEP A AB IGGI,28.0,18.2,5.23,25.2,37
CDM,30001660,HEP A AB IGM,20.0,13.0,5.0,18.82,37
CDM,30001680,HEP DELTA AB,29.0,18.85,5.23,28.67,37
CDM,30001690,HEPATITIS BE,19.0,12.35,4.75,19.0,37
CDM,30001700,HEPATITIS C A,24.0,15.6,5.23,23.85,37
CDM,30001710,HER-2/NEU PLA,95.0,61.75,13.39,95.0,37
CDM,30001720,HERP SIMP DNA RAPID CSF,146.0,94.9,25.65,131.4,37
CDM,30001730,HERPES I&II IGG AB,45.0,29.25,5.23,40.5,37
CDM,30001740,CARNITINE,100.0,65.0,5.78,90.0,37
CDM,30001745,PROTHROMBIN TIME AND INR (POINT OF CARE LAB),107.0,69.55,2.12,96.3,37
CDM,30001750,"IMMUNOASSAY, FECAL OCCULT BLOOD",39.0,25.35,5.78,35.1,37
CDM,30001760,HGB UNSTABLE SCREEN,43.0,27.95,2.59,38.7,37
CDM,30001770,GROWTH HORMONE(HGH),24.0,15.6,6.0,24.0,37
CDM,30001790,HIV CONFIRM WESTERN BLOT,70.0,45.5,5.23,63.0,37
CDM,30001800,HIV ANTIBODY,109.0,70.85,5.23,98.1,37
CDM,30001810,*VAP CHOLESTEROL,50.0,32.5,12.5,50.0,37
CDM,30001820,HIV1 HIV2 SNGL ASSAY AB,83.0,53.95,5.23,74.7,37
CDM,30001830,HIV-2 AB,74.0,48.1,5.23,66.6,37
CDM,30001840,HYDRXYPRGSTRONE 17-D,37.0,24.05,6.33,37.0,37
CDM,30001850,HOMOVNLLC ACID(HVA),36.0,23.4,6.33,36.0,37
CDM,30001855,URINALYSIS (POINT OF CARE LAB),56.0,36.4,1.43,50.4,37
CDM,30001860,*HYDROXYCORTICOSTEROID17,68.0,44.2,6.33,61.2,37
CDM,30001870,HYDRXYPROLINE TOTAL,56.0,36.4,6.33,50.4,37
CDM,30001875,LAB-IP VALPORIC ACID,178.0,115.7,5.81,160.2,37
CDM,30001930,INFLUENZA A AB,33.0,21.45,5.23,29.7,37
CDM,30001940,B-TUP NATRIURETC PEPTIDE (POINT OF CARE LAB),177.0,115.05,13.39,159.3,37
CDM,30001950,*INFLUENZA A,74.0,48.1,4.02,66.6,37
CDM,30001960,*INSULIN FREE ASSAY,19.0,12.35,4.75,19.0,37
CDM,30001970,INSULIN TOTAL,19.0,12.35,4.75,19.0,37
CDM,30001980,IRRADIATION BLOOD PRODUCT,95.0,61.75,24.61,85.5,37
CDM,30002000,KETOGENIC STEROIDS FRACT,129.0,83.85,6.33,116.1,37
CDM,30002010,KETOSTEROID 17 TOTAL,32.0,20.8,6.33,28.8,37
CDM,30002020,KETOSTRD 17 FRCT,386.0,250.9,6.33,347.4,37
CDM,30002030,*LAC (LD)(LDH) ASSAY ENZYME,19.0,12.35,4.75,19.0,37
CDM,30002040,LACTATE(LACTIC ACID),178.0,115.7,5.78,160.2,37
CDM,30002060,LAP-LEUCNE AMINO-PPTIDSE,76.0,49.4,2.59,68.4,37
CDM,30002070,LDL CHOLESTEROL,24.0,15.6,2.59,21.6,37
CDM,30002080,LEGIONELLA AB,24.0,15.6,5.23,24.0,37
CDM,30002090,LEISHMANIA AB,196.0,127.4,5.23,176.4,37
CDM,30002100,LEPTOSPIROSIS,41.0,26.65,5.23,36.9,37
CDM,30002110,LEUKO ASSESS FECAL QUAL,92.0,59.8,2.34,82.8,37
CDM,30002120,LIDOCAINE,50.0,32.5,5.81,45.0,37
CDM,30002130,PRO-INSULIN,43.0,27.95,6.33,43.0,37
CDM,30002140,LIPOPROTEIN BLD ELP QN,34.0,22.1,5.78,30.6,37
CDM,30002150,VERY LNG CHN FATTY ACID,287.0,186.55,5.78,258.3,37
CDM,30002160,*LYME WESTERN BLOT,24.0,15.6,5.23,24.0,37
CDM,30002170,MYCOPLASMA IGM TITER,25.0,16.25,5.23,22.5,37
CDM,30002190,MALARIA AB SCREEN,69.0,44.85,5.23,62.1,37
CDM,30002210,HEAVY METAL; QUAN,164.0,106.6,5.78,147.6,37
CDM,30002220,HEMGLBN METHEMOGLBN QUAN,11.0,7.15,2.59,11.0,37
CDM,30002240,METHYLMALONIC SERUM,35.0,22.75,5.78,35.0,37
CDM,30002250,MICROALBUMIN UR SEMI QNT (POINT OF CARE LAB),28.0,18.2,1.43,25.2,37
CDM,30002260,MICROALB UR QNT,44.0,28.6,1.43,39.6,37
CDM,30002280,BILIRUBIN STOOL QL,13.0,8.45,2.59,11.7,37
CDM,30002285,"METHADONE QNT, UR",200.0,130.0,33.04,191.21,37
CDM,30002365,MISC SENDOUT CPT 87186,99.0,64.35,4.02,89.1,37
CDM,30002415,%UQNTPP COCAINE,35.0,22.75,8.75,125.87,37
CDM,30002425,%UQNTPP BUPRENORPHINE,65.0,42.25,16.25,125.87,37
CDM,30002430,ANTITRYPSIN ALPHA PHENO,50.0,32.5,5.78,45.0,37
CDM,30002440,MUCIN SYNOVIAL FLUID(ROP,12.0,7.8,2.59,10.8,37
CDM,30002450,MUMPS AB IGM,24.0,15.6,5.23,21.81,37
CDM,30002470,MYELIN BASIC PROTEIN CSF,37.0,24.05,5.78,33.3,37
CDM,30002480,NASAL SMEAR FOR EOSINOPHILS,28.0,18.2,2.34,25.2,37
CDM,30002490,ALKALOIDS NOS,143.0,92.95,33.04,143.0,37
CDM,30002510,ANTIDEPRESSANT TRICYCLIC 1/2,143.0,92.95,33.04,143.0,37
CDM,30002515,GQ1B AUTOANTIBODY,337.0,219.05,5.78,303.3,37
CDM,30002520,NUCLEOTIDASE 5-,20.0,13.0,5.0,18.63,37
CDM,30002530,OCCLT BLD GST (POINT OF CARE LAB),57.0,37.05,2.59,51.3,37
CDM,30002550,OLIGOCLONAL BANDS,47.0,30.55,11.75,45.77,37
CDM,30002555,"6-MAM CONF, UR",242.0,157.3,33.04,217.8,37
CDM,30002560,OXYCODONE,143.0,92.95,33.04,143.0,37
CDM,30002570,ASSAY ORGANIC ACD QNT,425.0,276.25,5.78,382.5,37
CDM,30002580,OSTEOCALCIN,55.0,35.75,13.75,49.88,37
CDM,30002590,OXALATE,19.0,12.35,4.75,19.0,37
CDM,30002595,%UQNTPP TRAMADOL,57.0,37.05,14.25,125.87,37
CDM,30002600,PAP SMEAR INTRP,45.0,29.25,7.56,40.5,28
CDM,30002610,*PARVOVIRUS AB,24.0,15.6,5.23,24.0,37
CDM,30002620,PH BODY FLUID EXCEPT BLD (POINT OF CARE),39.0,25.35,2.59,35.1,37
CDM,30002625,%IOHWC CULTURE,111.0,72.15,4.02,99.9,37
CDM,30002630,STOOL PH,20.0,13.0,2.59,18.0,37
CDM,30002640,RICKETTSIAL AB,53.0,34.45,5.23,47.7,37
CDM,30002645,%UQNTPP FENTANYL,65.0,42.25,16.25,125.87,37
CDM,30002650,PHOSPHATASE ACID TOTAL,21.0,13.65,2.59,18.9,37
CDM,30002655,%SENNRO SENSRY NEU IMMX6,372.0,241.8,5.78,334.8,37
CDM,30002660,POOLING BLOOD PLT OR OTHER BLD PRD,180.0,117.0,46.62,371.54,37
CDM,30002665,SENMOT IMMUNOASSAY X11,267.0,173.55,5.78,240.3,37
CDM,30002675,RECOMBX MA TA AUTOAB,561.0,364.65,5.78,504.9,37
CDM,30002695,CELL SALVAGE SUPPLY,805.0,523.25,51.52,1771.17,37
CDM,30002700,*PORPHYRINS URINE QUAL,19.0,12.35,4.75,19.0,37
CDM,30002705,CELL SALVAGE 1 UNIT,805.0,523.25,51.52,1771.17,37
CDM,30002710,POTASSIUM BLOOD (POINT OF CARE LAB),56.0,36.4,2.59,50.4,37
CDM,30002715,"5-FLUCYTOSINE, S",129.0,83.85,5.81,116.1,37
CDM,30002720,*PREGNANETRIOL ASSAY,131.0,85.15,6.33,117.9,37
CDM,30002725,DTT TREATMENT,202.0,131.3,51.52,181.8,37
CDM,30002730,PREGNENOLONE,122.0,79.3,6.33,109.8,37
CDM,30002741,PRETREAT RBC AB ID DENSITYSEP,323.0,209.95,51.52,371.54,37
CDM,30002750,PRETREAT RBC AB ID DRUG,178.0,115.7,46.1,160.2,37
CDM,30002760,PRETREAT SERUM AB ID ABSORP,409.0,265.85,51.52,368.1,37
CDM,30002770,PRETREAT SERUM AB ID INCUBATE,180.0,117.0,46.62,371.54,37
CDM,30002780,*PRIMIDONE ASSAY,72.0,46.8,5.81,64.8,37
CDM,30002790,PROCAIN & NAP,85.0,55.25,5.81,76.5,37
CDM,30002830,PROSTATIC ACID PHOS,14.0,9.1,2.59,14.0,37
CDM,30002840,PROSTAGLANDIN EACH,370.0,240.5,16.61,333.0,37
CDM,30002850,PROSTATE SCREEN,127.0,82.55,5.23,114.3,37
CDM,30002860,PROTEIN ELCTRC SERUM QN,77.0,50.05,2.59,69.3,37
CDM,30002870,*PROTOZOA AB NOS,33.0,21.45,5.23,29.7,37
CDM,30002880,PSA FREE,53.0,34.45,5.78,47.7,37
CDM,30002890,PSA TOTAL,111.0,72.15,5.78,99.9,37
CDM,30002900,PYRUVATE,26.0,16.9,5.78,24.2,37
CDM,30002920,QUINIDINE,24.0,15.6,5.81,24.0,37
CDM,30002950,RBC AB ID EA PANL,374.0,243.1,81.35,779.93,37
CDM,30002970,*RBC AB SCREEN EA SERUM,105.0,68.25,2.08,115.85,37
CDM,30003010,*CHLAMYDIA IGG AB,55.0,35.75,5.23,49.5,37
CDM,30003020,*CHLAMYDIA IGM,50.0,32.5,5.23,45.0,37
CDM,30003030,REVERSE T3,25.0,16.25,6.25,25.0,37
CDM,30003070,*RICKETTSIAL AB IGG,32.0,20.8,5.23,32.0,37
CDM,30003090,RSV IA W DIR OBSERV,109.0,70.85,4.02,98.1,37
CDM,30003100,"SELENIUM, PLASMA",77.0,50.05,5.78,69.3,37
CDM,30003120,SEROTONIN,50.0,32.5,12.5,50.0,37
CDM,30003140,SILICA,176.0,114.4,5.78,158.4,37
CDM,30003150,SODIUM BLOOD (POINT OF CARE LAB),73.0,47.45,2.59,65.7,37
CDM,30003160,SODIUM FLUID,11.0,7.15,2.59,9.9,37
CDM,30003170,RIBOFLAVIN(VITAMIN B2),88.0,57.2,5.78,79.2,37
CDM,30003180,SOMATOMEDIN,106.0,68.9,6.33,95.4,37
CDM,30003200,SPEC FAT STAIN,11.0,7.15,2.34,9.9,37
CDM,30003210,SP-GR EXCEPT URINE,19.0,12.35,2.59,17.1,37
CDM,30003220,SERUM PROCESSING AND STORAGE,28.0,18.2,2.52,25.2,27
CDM,30003240,SYPHILIS TEST QUANT,45.0,29.25,4.4,40.5,37
CDM,30003250,CA 19-9,36.0,23.4,5.23,34.77,37
CDM,30003260,SYPHILIS TEST QUAL,109.0,70.85,4.27,98.1,37
CDM,30003280,T3 FREE,46.0,29.9,6.33,41.4,37
CDM,30003300,TBG-THYROXINE BND GLOBLN,23.0,14.95,5.75,23.0,37
CDM,30003310,TEST SPERM AB,57.0,37.05,2.34,51.3,37
CDM,30003320,TESTOSTER TOT,55.0,35.75,6.33,49.5,37
CDM,30003330,*TESTOSTERONE FREE ASSAY,57.0,37.05,6.33,51.3,37
CDM,30003340,THAW FFP EA UNIT,180.0,117.0,46.62,371.54,37
CDM,30003350,THIOCYANATE,28.0,18.2,5.78,25.2,37
CDM,30003360,THYRD STIM IMMUNGLBN(TSI,91.0,59.15,16.61,84.99,37
CDM,30003370,THYROGLOBULIN,24.0,15.6,6.0,24.0,37
CDM,30003380,THRYOGLOB ANTIBODY,24.0,15.6,5.23,24.0,37
CDM,30003390,TOPIRAMATE LV,41.0,26.65,5.81,36.9,37
CDM,30003400,TRANSFERRIN,19.0,12.35,4.75,19.0,37
CDM,30003410,TRICHINOSIS AB,45.0,29.25,5.23,40.5,37
CDM,30003420,*TROPONIN - I,178.0,115.7,5.78,160.2,37
CDM,30003430,TSH,156.0,101.4,6.33,140.4,37
CDM,30003440,UA NON-AUTO W/O MICRO (POINT OF CARE LAB),39.0,25.35,1.43,35.1,37
CDM,30003450,URINALYSIS AUTO WO SCPE (POINT OF CARE LAB),56.0,36.4,1.43,50.4,37
CDM,30003460,VALPROIC ACID ASSAY,182.0,118.3,5.81,163.8,37
CDM,30003470,VARICELLA IMMUNITY,46.0,29.9,5.23,41.4,37
CDM,30003480,AMOEBIC AB,41.0,26.65,5.23,36.9,37
CDM,30003490,VASOPRESSIN (ADH),58.0,37.7,14.5,56.71,37
CDM,30003500,ROUTINE VENIPUNCTURE,20.0,13.0,2.52,261.0,45
CDM,30003510,BIOTINIDASE EA SPEC,48.0,31.2,5.78,43.2,37
CDM,30003520,VASOACTIVE INTST POLYPEP,84.0,54.6,16.61,75.6,37
CDM,30003530,VIT A,21.0,13.65,5.25,19.4,37
CDM,30003540,VIT B-12,144.0,93.6,6.33,129.6,37
CDM,30003550,VIT B12 UNSATURATED,34.0,22.1,5.78,30.6,37
CDM,30003560,VITAMIN K,116.0,75.4,5.78,104.4,37
CDM,30003570,VITAMIN B6,56.0,36.4,13.39,50.4,37
CDM,30003580,VITAMIN E,21.0,13.65,5.25,21.0,37
CDM,30003590,VMA URINE,55.0,35.75,6.33,49.5,37
CDM,30003600,VOL MEASUREMNT TIMED,13.0,8.45,1.43,11.7,37
CDM,30003610,XYLOSE ABSORPTION URINE,29.0,18.85,5.78,26.1,37
CDM,30003620,YERSINIA ANTIBODY TITER,85.0,55.25,5.23,76.5,37
CDM,30003630,CALCITONIN,39.0,25.35,6.33,39.0,37
CDM,30003640,CALCIUM IONIZED (POINT OF CARE LAB),75.0,48.75,5.78,67.5,37
CDM,30003650,CALCULUS INFRSP,23.0,14.95,5.75,21.56,37
CDM,30003660,CARBON MONOXIDE QUAN,19.0,12.35,4.75,19.0,37
CDM,30003670,CERULOPLASMIN,23.0,14.95,2.59,20.7,37
CDM,30003680,B-HEXOSAMINIDASE EA ASSA,213.0,138.45,5.78,191.7,37
CDM,30003690,RENIN,80.0,52.0,6.33,72.0,37
CDM,30003700,EPSTEIN-BARR VIRUS IGM,55.0,35.75,5.23,49.5,37
CDM,30003710,RUBEOLA IGM,28.0,18.2,5.23,25.2,37
CDM,30003720,TETANUS AB,33.0,21.45,5.23,29.7,37
CDM,30003730,TOXOPLSMOSIS IGG AB TITR,55.0,35.75,5.23,49.5,37
CDM,30003740,TOXOPLSMOSIS IGM AB TITR,24.0,15.6,5.23,24.0,37
CDM,30003750,*WEST NILE IGM,95.0,61.75,5.23,85.5,37
CDM,30003760,*WEST NILE VIRUS SEROLOGY,95.0,61.75,5.23,85.5,37
CDM,30007770,RBC AG NOT AB,87.0,56.55,2.08,779.93,37
CDM,30007780,BSC METABLC P,154.0,100.1,4.31,138.6,37
CDM,30007790,CHLORIDE,73.0,47.45,2.59,65.7,37
CDM,30007800,ABO BLOOD TYPING,145.0,94.25,2.08,279.48,37
CDM,30007810,*BLOOD TYPING RH(D),56.0,36.4,2.08,85.1,37
CDM,30007820,AG SCREEN W P,154.0,100.1,2.08,138.6,37
CDM,30007830,CELL COUNT FLUID DIFF COUNT,109.0,70.85,2.34,98.1,37
CDM,30007850,*HYPERSENSITIVITY PNEU II,24.0,15.6,5.23,24.0,37
CDM,30007860,*TOXOPLSMOSIS IGM AB CSF,34.0,22.1,5.23,30.6,37
CDM,30007870,HELICOBACTER PYLORI AB,24.0,15.6,5.23,24.0,37
CDM,30007880,*CHLAMYDIA AB,19.0,12.35,4.75,19.0,37
CDM,30007890,CMV AB IGG EIA,52.0,33.8,5.23,46.8,37
CDM,30007900,CRYOFIBRINOGEN,19.0,12.35,4.75,19.0,37
CDM,30007910,CRYOGLOBULIN QUAL/SEMIQUANT,41.0,26.65,2.59,36.9,37
CDM,30007920,PROGESTERONE,32.0,20.8,6.33,32.0,37
CDM,30007930,SEX HORMONE BIND GLOBULI,92.0,59.8,5.78,82.8,37
CDM,30007940,SOMATOSTATIN,44.0,28.6,6.33,39.6,37
CDM,30007950,*FAB TITER EA AB,19.0,12.35,4.75,19.0,37
CDM,30007960,VDRL/RPR QUAN,21.0,13.65,4.4,18.9,37
CDM,30007970,SYPHILIS TEST QUANT,11.0,7.15,2.75,9.9,37
CDM,30007980,*CANDIDA AB QUAL,84.0,54.6,5.23,75.6,37
CDM,30007990,RBC AB ELUTION EA ELUTION,209.0,135.85,54.13,371.54,37
CDM,30008000,RBC AB ID EA PANL,374.0,243.1,81.35,779.93,37
CDM,30008010,LIPOPROTEIN (A),29.0,18.85,5.78,26.1,37
CDM,30008040,EXAM SYNOVIAL FLUID CRYSTALS,64.0,41.6,2.34,57.6,37
CDM,30008050,AMIKACIN,41.0,26.65,5.81,36.9,37
CDM,30008060,LYME AB IGM,86.0,55.9,5.23,77.4,37
CDM,30008070,ECHINOCOCCUS AB,43.0,27.95,5.23,38.7,37
CDM,30008080,CYSTICERCOS IGG AB SERUM,101.0,65.65,5.23,90.9,37
CDM,30008090,FILARIA AB (HAI),216.0,140.4,5.23,194.4,37
CDM,30008100,SCHISTOSOMIASIS AB,202.0,131.3,5.23,181.8,37
CDM,30008110,PARAGPMONUS WESTERMAN AB,121.0,78.65,5.23,108.9,37
CDM,30008120,TOXOCARA,128.0,83.2,5.23,115.2,37
CDM,30008130,ARSENIC ASSAY,57.0,37.05,5.78,51.3,37
CDM,30008140,RUBELLA VIRUS IGM,50.0,32.5,5.23,45.0,37
CDM,30008150,CHLAMYDIA PSIT TOTAL,97.0,63.05,4.31,87.3,37
CDM,30008170,*ENCEPHALITIS EAST EQUINE AB,19.0,12.35,4.75,19.0,37
CDM,30008180,ENCEPHALITIS WEST EQUINE AB,19.0,12.35,4.75,19.0,37
CDM,30008190,IG-E SERUM,111.0,72.15,5.78,99.9,37
CDM,30008200,LUTEINING HORMONE,34.0,22.1,6.33,30.95,37
CDM,30008210,HEP B CORE AB(IGG & IGM),19.0,12.35,4.75,19.0,37
CDM,30008220,HERPES IGM,19.0,12.35,4.75,19.0,37
CDM,30008230,HTLV AB CONFIRM,47.0,30.55,5.23,42.3,37
CDM,30008240,HIV I AB,12.0,7.8,3.0,12.0,37
CDM,30008250,HIV-1/HIV2 SNG ASSY (POINT OF CARE LAB),19.0,12.35,4.75,19.0,37
CDM,30008270,PORPHYRINS FECES QUANT,157.0,102.05,13.39,141.3,37
CDM,30008280,LACTATE(LACTIC ACID),22.0,14.3,5.5,19.8,37
CDM,30008290,*MASS SPECTRMTRY QUANT EA,55.0,35.75,5.78,49.5,37
CDM,30008300,ANTIPSYCHOTICS NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30008310,MASS SPECTRMTRY QUANT EA,300.0,195.0,5.78,270.0,37
CDM,30008320,MASS SPECTRMTRY QUANT EA,59.0,38.35,5.78,53.1,37
CDM,30008390,RBC AB SCREEN EA SERUM,105.0,68.25,2.08,115.85,37
CDM,30008400,RBC AB SCREEN EA SERUM,105.0,68.25,2.08,115.85,37
CDM,30008410,*RICKETTSIA AB,26.0,16.9,5.23,26.0,37
CDM,30008420,*RICKETTSIA AB,26.0,16.9,5.23,26.0,37
CDM,30008460,*RICKETTSIA AB,32.0,20.8,5.23,32.0,37
CDM,30008470,SODIUM FECES,12.0,7.8,2.59,10.8,37
CDM,30008480,VDRL/RPR QUAL,34.0,22.1,4.27,30.6,37
CDM,30008490,VDRL-CSF QUAL,9.0,5.85,2.25,8.1,37
CDM,30008500,"VALPROIC ACID, FREE",34.0,22.1,5.81,30.6,37
CDM,30008510,VARICELLA ZOSTER IGM,58.0,37.7,5.23,52.2,37
CDM,30008530,VENIPUNCTURE,20.0,13.0,2.52,261.0,45
CDM,30008540,CYANOCOBLMN(VIT B12),62.0,40.3,6.33,55.8,37
CDM,30008550,RUBEOLA IGG,19.0,12.35,4.75,19.0,37
CDM,30008560,MUMPS AB IGM,22.0,14.3,5.23,21.81,37
CDM,30008580,*HELICOBACTER PYLORI AB,37.0,24.05,5.23,33.3,37
CDM,30008600,*LYME AB IGG/IGM CSF,45.0,29.25,5.23,40.5,37
CDM,30008610,*TOXO IGG CSF,34.0,22.1,5.23,30.6,37
CDM,30008630,*INFLUENZA B,74.0,48.1,4.02,66.6,37
CDM,30008640,*PARVOVIRUS AB,24.0,15.6,5.23,24.0,37
CDM,30008650,*PROTOZOA AB NOS,33.0,21.45,5.23,29.7,37
CDM,30008660,*BRUCELLA AB,55.0,35.75,5.23,49.5,37
CDM,30008670,*BORDTL AB,29.0,18.85,5.23,26.1,37
CDM,30008700,TEST SPERM AB,39.0,25.35,2.34,35.1,37
CDM,30008710,OCCLT BLD GSTRC,19.0,12.35,2.59,17.1,37
CDM,30008720,"SELENIUM, PLASMA",69.0,44.85,5.78,62.1,37
CDM,30008730,MYCOPLASMA IGM TITER,19.0,12.35,4.75,19.0,37
CDM,30008740,COMPATIBILITY TEST SPIN,197.0,128.05,51.02,371.54,37
CDM,30008750,POOLING BLOOD PLT,180.0,117.0,46.62,371.54,37
CDM,30008760,*TESTOSTERONE FREE ASSAY,57.0,37.05,6.33,51.3,37
CDM,30008770,*SODIUM BLOOD,73.0,47.45,2.59,65.7,37
CDM,30008780,*POTASSIUM SERUM,56.0,36.4,2.59,50.4,37
CDM,30008790,*CALCIUM IONIZED,133.0,86.45,5.78,119.7,37
CDM,30008800,*CHLORIDE,73.0,47.45,2.59,65.7,37
CDM,30008810,*PRETREAT SERUM AB ID INCUBATE,180.0,117.0,46.62,371.54,37
CDM,30008820,*RBC AB SCREEN EA SERUM,105.0,68.25,2.08,115.85,37
CDM,30008830,*INCUBATION CROSSMATCH,180.0,117.0,46.62,371.54,37
CDM,30008840,*BLOOD TYPING ABO,145.0,94.25,2.08,279.48,37
CDM,30008850,*BLOOD TYPING RH(D),58.0,37.7,2.08,85.1,37
CDM,30008860,HGB FECAL IA,36.0,23.4,5.78,32.4,37
CDM,30008870,*GLUCOSE QUANT,80.0,52.0,2.59,72.0,37
CDM,30008880,*LACTATE (LACTIC ACID),178.0,115.7,5.78,160.2,37
CDM,30008890,COMPATABILITY TEST ELECTR,188.0,122.2,48.69,371.54,37
CDM,30008900,COOMBS; DIRECT,52.0,33.8,2.08,128.79,37
CDM,30008910,COOMBS; DIRECT,52.0,33.8,2.08,128.79,37
CDM,30008920,COOMBS; DIRECT,52.0,33.8,2.08,128.79,37
CDM,30008930,COOMBS TEST INDIRECT TITER,189.0,122.85,2.08,371.54,37
CDM,30008940,COMPATIBILITY TEST INCUBATE,387.0,251.55,81.35,371.54,37
CDM,30008945,SEMEN CRYOPRESERVATION INITIAL-BW,624.0,405.6,59.1,561.6,37
CDM,30008975,PLATELET CROSSMATCH,197.0,128.05,51.02,371.54,37
CDM,30008985,RETRO AN SPERM COUNT,326.0,211.9,2.34,293.4,37
CDM,30009115,"CRC AB ID, EACH CELL",133.0,86.45,2.08,371.54,37
CDM,30009295,CRC AB ID PANEL,307.0,199.55,79.51,779.93,37
CDM,30009345,HERPES SIMPLEX IGM ABS,131.0,85.15,5.23,117.9,37
CDM,30009355,COOMBS TEST INDIRECT QUAL,146.0,94.9,2.08,371.54,37
CDM,30009415,OB PANEL,406.0,263.9,4.31,365.4,37
CDM,30009425,PRETREATMENT W/ENZYME,257.0,167.05,51.52,371.54,37
CDM,30009465,CJD NEURO CSF QUAL,674.0,438.1,168.5,674.0,37
CDM,30010000,RA FACTOR QUANT,19.0,12.35,4.75,17.1,37
CDM,30010001,*COXSACKIE B ANTIBODY,24.0,15.6,5.23,21.77,37
CDM,30010002,*EHRLICHIA AB TITER,73.0,47.45,5.23,65.7,37
CDM,30010003,*COXSACKIE B AB,24.0,15.6,5.23,21.6,37
CDM,30010004,*EHRLICHIA AB,73.0,47.45,5.23,65.7,37
CDM,30020165,BLOOD DRAW VENOUS ACCESS DEV,926.0,601.9,44.56,3920.0,46
CDM,30020255,WHIVF BLD TYPE RHD,7.0,4.55,1.81,85.1,37
CDM,30020275,WHIVF RBC AB ACRN,13.0,8.45,2.08,115.85,37
CDM,30020285,WEAK RHD ANLYS UNLISTED,435.0,282.75,22.32,391.5,27
CDM,30020295,WKD D AG TYPING,19.0,12.35,2.08,85.1,37
CDM,30020305,RED CELL GENOTYPING,397.0,258.05,76.88,357.3,37
CDM,30020315,RCGP UNLISTED MOL PATH,42.0,27.3,7.06,37.8,27
CDM,30020325,PARD UNLISTED MOL PATH,446.0,289.9,22.32,401.4,27
CDM,30020335,ARCDL HEMOLYSINS/AGG AU,121.0,78.65,2.08,108.9,37
CDM,30020345,ARCDL HEMOLYSINS INCUB,160.0,104.0,2.08,144.0,37
CDM,30020375,PHARMACOGENOMICS CYP3A5,366.0,237.9,76.88,329.4,37
CDM,30020385,PHARMACOGENOMICS CYP2C9,366.0,237.9,76.88,329.4,37
CDM,30020395,DYPD GENOTYPING,363.0,235.95,76.88,326.7,37
CDM,30020405,UGT1A1 GENOTYPING,363.0,235.95,76.88,363.0,37
CDM,30020415,DPYDAO-DYPD GTYP AN ON,363.0,235.95,76.88,326.7,37
CDM,30020425,UGT1A1 GENOTYPING ANALYSIS ONLY,363.0,235.95,76.88,363.0,37
CDM,30020465,HETEROPHILE ANTIBODIES SCREEN,219.0,142.35,5.18,197.1,37
CDM,30020485,"CHYLOSCREEN, BF ELECTROPHORESIS, REFLEX",182.0,118.3,13.39,163.8,37
CDM,30020505,GENOMIC SEQUENCING AHUS1,6121.0,3978.65,1109.84,5508.9,37
CDM,30020555,ABSENCE/PRESENCE SPERM (POC) (POINT OF CARE LAB),57.0,37.05,2.34,51.3,37
CDM,30020565,RED CELL GENOTYPING,1800.0,1170.0,325.19,1620.0,37
CDM,30020595,FLT3 ITD MRD ASSAY,2852.0,1853.8,170.1,2566.8,37
CDM,30020605,CHITOTRIOSIDASE,288.0,187.2,5.78,259.2,27
CDM,30020615,"SEQUENCING, INFLUENZA PLUS",189.0,122.85,25.65,170.1,37
CDM,30020WE,"DRAIN ABSCESS/HEMATOMA,NASAL SEPTUM",592.0,384.8,62.19,444.0,35
CDM,30100010,COMPRE META PANL,306.0,198.9,4.31,275.4,37
CDM,30100015,BMP I STAT ANALYZER,157.0,102.05,4.31,141.3,37
CDM,30100020,LIPID-LIPO PANEL 1,178.0,115.7,4.31,160.2,37
CDM,30100025,BASIC METABOLIC PANEL,154.0,100.1,4.31,138.6,37
CDM,30100030,RENAL FUNC PANL,144.0,93.6,4.31,129.6,37
CDM,30100035,ELECTROLYTE PANEL,142.0,92.3,4.31,127.8,37
CDM,30100040,HEP FUNC PANL,144.0,93.6,4.31,129.6,37
CDM,30100055,DESIPRAMINE PLASMA,164.0,106.6,33.04,164.0,37
CDM,30100065,DOXEPIN/NORDOXEPIN,146.0,94.9,33.04,146.0,37
CDM,30100070,COLUMN CHROM QUANT,120.0,78.0,30.0,125.87,37
CDM,30100085,LIDOCAINE PLASMA,48.0,31.2,5.81,43.2,37
CDM,30100095,NORTRIPTYLINE PLASMA,143.0,92.95,33.04,143.0,37
CDM,30100105,PHENYTOIN FREE PLASMA,26.0,16.9,5.81,23.4,37
CDM,30100115,%FREE PRIMIDONE PLASMA,33.0,21.45,5.81,29.7,37
CDM,30100135,ACTH STIM W/2 TIME PTS,262.0,170.3,16.61,235.8,37
CDM,30100165,GROWTH HORMONE STIM PEDS,591.0,384.15,16.61,531.9,37
CDM,30100175,GROWTH HORMONE SUPPRESS,806.0,523.9,16.61,725.4,37
CDM,30100195,BILIRUBIN SCREEN URINE,35.0,22.75,1.43,31.5,37
CDM,30100200,BENZODIAZEPINES1-12,143.0,92.95,33.04,143.0,37
CDM,30100205,BCR/ABL QUANT BLOOD TEST,1008.0,655.2,76.88,907.2,37
CDM,30100215,P190PCR BLOOD,1344.0,873.6,76.88,1209.6,37
CDM,30100235,CFSCRN TEST,681.0,442.65,170.1,681.0,37
CDM,30100255,2C19PL TEST,2000.0,1300.0,76.88,1800.0,37
CDM,30100265,2D6 TEST,616.0,400.4,154.0,616.0,37
CDM,30100270,CARBAZEPINE TEGRETOL,196.0,127.4,5.81,176.4,37
CDM,30100290,DIGOXIN ASSAY,142.0,92.3,5.81,127.8,37
CDM,30100310,GENTAMICIN ASSAY,144.0,93.6,5.81,129.6,37
CDM,30100315,PTGENEO TEST,800.0,520.0,22.32,720.0,37
CDM,30100325,FACT V LEIDEN TEST,101.0,65.65,22.32,101.0,37
CDM,30100330,PHENOBARBITAL ASSAY,182.0,118.3,5.81,163.8,37
CDM,30100335,%FRAX FMR 1 TEST,733.0,476.45,22.32,659.7,37
CDM,30100345,HEMDNA TEST,188.0,122.2,22.32,169.2,37
CDM,30100350,PHENYTOIN-DILANTIN,144.0,93.6,5.81,129.6,37
CDM,30100355,ALPHA THALASSEMIA TEST,754.0,490.1,22.32,678.6,37
CDM,30100360,SIROLIMUS ASSAY,100.0,65.0,5.81,90.0,37
CDM,30100365,BCBMD I TEST,1559.0,1013.35,76.88,1403.1,37
CDM,30100370,ANALGESICS NON-OPIOID 1 OR 2,143.0,92.95,33.04,143.0,37
CDM,30100375,IGHSB TEST,616.0,400.4,22.32,554.4,37
CDM,30100390,THEOPHYLLINE ASSAY,182.0,118.3,5.81,163.8,37
CDM,30100400,TOBRAMYCIN ASSAY,182.0,118.3,5.81,163.8,37
CDM,30100405,POST-TX FOLLOW-UP ENGRAFTMENT MONITORING,2336.0,1518.4,76.88,2102.4,37
CDM,30100420,VANCOMYCIN ASSAY,182.0,118.3,5.81,163.8,37
CDM,30100430,DRUG SCREEN QUANT GABAPENTIN,62.0,40.3,5.81,55.8,37
CDM,30100445,MTHFR BY PCR TEST,136.0,88.4,22.32,122.4,37
CDM,30100485,APLPCR RTPCR TEST,1430.0,929.5,76.88,1287.0,37
CDM,30100495,TCBMD II TEST,1454.0,945.1,76.88,1308.6,37
CDM,30100515,T GAMMA TEST,1075.0,698.75,76.88,967.5,37
CDM,30100560,FE ASSAY,80.0,52.0,2.59,72.0,37
CDM,30100580,ACETONE/KETONE SERUM QUAL,74.0,48.1,2.59,66.6,37
CDM,30100590,ALBUMIN SERUM ASSAY,74.0,48.1,2.59,66.6,37
CDM,30100595,BCR/ABL KINASE DOMAIN RT-PCR,1062.0,690.3,22.32,955.8,27
CDM,30100600,ALBUMIN URINE/OTHER QUANT,109.0,70.85,2.59,98.1,37
CDM,30100615,ACTH,59.0,38.35,14.75,59.0,37
CDM,30100620,*MICROALBUMIN URINE QUANT,95.0,61.75,1.43,85.5,37
CDM,30100630,ALDOSTERONE ASSAY,56.0,36.4,14.0,56.0,37
CDM,30100640,ALKA PHOSPHTA,144.0,93.6,2.59,129.6,37
CDM,30100645,ETHANOL PLASMA,161.0,104.65,33.04,161.0,37
CDM,30100650,ALPHA-FETOPROTEIN SERUM,144.0,93.6,5.78,129.6,37
CDM,30100660,ALT/SGPT,116.0,75.4,2.59,104.4,37
CDM,30100665,ALDOSTERONE,63.0,40.95,15.75,63.0,37
CDM,30100675,%SERPINA1 A1A,132.0,85.8,5.78,118.8,37
CDM,30100680,AMINO ACID >=6 QUANT EA,403.0,261.95,5.78,362.7,37
CDM,30100690,AMINO ACID SNGL QUANT,34.0,22.1,5.78,34.0,37
CDM,30100695,AMINO ACID>=6 QUANT EA,506.0,328.9,5.78,455.4,37
CDM,30100700,AMYLASE ASSAY,182.0,118.3,2.59,163.8,37
CDM,30100710,AMMONIA,182.0,118.3,5.78,163.8,37
CDM,30100715,%UQNTPP AMPHET,65.0,42.25,16.25,125.87,37
CDM,30100725,ANDROSTENEDIONE,47.0,30.55,6.33,47.0,37
CDM,30100735,ANGIOTENSIN CONV ENZYM,31.0,20.15,5.78,27.9,37
CDM,30100745,APOLIPOPROTEIN A1+B X2,37.0,24.05,5.78,35.24,37
CDM,30100750,APOLIPOPROTEIN EA ASSAY,32.0,20.8,5.78,32.0,37
CDM,30100755,PENTOBARBITAL,158.0,102.7,33.04,158.0,37
CDM,30100760,ARSENIC ASSAY,168.0,109.2,5.78,151.2,37
CDM,30100765,BETA 2 MICROGLOBULIN BLD,32.0,20.8,6.33,28.8,37
CDM,30100770,CA URINE QUANT TIMED,74.0,48.1,2.59,66.6,37
CDM,30100775,BIOTINIDASE ASSAY EA,145.0,94.25,5.78,130.5,37
CDM,30100785,%FGSTRO GSTRC OCCULT BLD,56.0,36.4,2.59,50.4,37
CDM,30100790,AST/SGOT,109.0,70.85,2.59,98.1,37
CDM,30100795,ASSAY IONIZED CA,124.0,80.6,5.78,111.6,37
CDM,30100800,ATOMIC ABSORP SPECTROSCOPY EA,81.0,52.65,5.78,72.9,37
CDM,30100805,CALCULI (STONE) ANALYSIS,23.0,14.95,5.75,21.56,37
CDM,30100810,BARBITURATES,143.0,92.95,33.04,143.0,37
CDM,30100815,CARBOXYHEMOGLOBIN,17.0,11.05,4.25,17.0,37
CDM,30100825,CARNITINE FR & TOT PLASMA,145.0,94.25,5.78,130.5,37
CDM,30100830,BETA 2 MICROGLOBULIN ASSAY,32.0,20.8,6.33,28.8,37
CDM,30100835,CAROTENE,14.0,9.1,2.59,14.0,37
CDM,30100845,CATECHOLAMINE FRACT PL,173.0,112.45,6.33,155.7,37
CDM,30100850,BILIRUBIN TOTAL,131.0,85.15,2.59,117.9,37
CDM,30100855,CERULOPLASMIN LEVEL,23.0,14.95,2.59,20.7,37
CDM,30100860,BILIRUBIN DIR,131.0,85.15,2.59,117.9,37
CDM,30100865,CHEMILUMINESCENT ASSAY,122.0,79.3,5.78,109.8,37
CDM,30100870,OCCULT BLOOD FECES COLORECT,57.0,37.05,2.59,51.3,37
CDM,30100875,ASSAY BLOOD CHLORIDE,36.0,23.4,2.59,32.4,37
CDM,30100880,OCCULT BLOOD FECES 1-3 TEST,57.0,37.05,2.59,51.3,37
CDM,30100885,AMIODARONE,41.0,26.65,5.78,40.25,37
CDM,30100890,CADMIUM ASSAY,37.0,24.05,5.78,37.0,37
CDM,30100895,CHROMIUM BLOOD,26.0,16.9,5.78,26.0,37
CDM,30100910,VIT D 25 HYDROXY ASSAY,53.0,34.45,13.25,49.46,37
CDM,30100925,CROSS-LINK N-TELOPEPTIDES,200.0,130.0,5.78,180.0,37
CDM,30100935,COPPER BLOOD,98.0,63.7,5.78,88.2,37
CDM,30100940,CALCIUM,74.0,48.1,2.59,66.6,37
CDM,30100945,COPPER URINE,158.0,102.7,5.78,142.2,37
CDM,30100960,PSEUDOCHOLINESTERASE TOTAL,21.0,13.65,2.59,18.9,37
CDM,30100970,CARNITINE TOTAL & FREE QUANT,100.0,65.0,5.78,90.0,37
CDM,30100975,CRYOGLOBULIN QL,87.0,56.55,2.59,78.3,37
CDM,30100980,CO2 BLOOD ASSAY,74.0,48.1,2.59,66.6,37
CDM,30100985,DHEA-S,39.0,25.35,6.33,37.15,37
CDM,30100990,CEA AG,182.0,118.3,5.78,163.8,37
CDM,30100WE,"BIOPSY,INTRANASAL",376.0,244.4,46.1,282.0,35
CDM,30101005,VIT D 1 25 DIHYDROXY,59.0,38.35,13.39,59.0,37
CDM,30101015,ISOELECTRIC FOCUSING HB,353.0,229.45,13.39,317.7,37
CDM,30101020,*CATECHOLAMINE FRACT ASSAY,37.0,24.05,6.33,37.0,37
CDM,30101025,ERYTHROPOIETIN,32.0,20.8,5.78,31.4,37
CDM,30101035,ESTRADIOL-17B,123.0,79.95,6.33,110.7,37
CDM,30101050,CL URINE ASSAY,92.0,59.8,2.59,82.8,37
CDM,30101055,FECAL FAT QUALITATIVE,44.0,28.6,2.59,39.6,37
CDM,30101065,FETAL FIBRONECTIN,543.0,352.95,32.49,488.7,37
CDM,30101070,CL OTHER SOURCE ASSAY,92.0,59.8,2.59,82.8,37
CDM,30101075,FOLIC ACID RBC TEST,140.0,91.0,5.78,126.0,37
CDM,30101080,CHOLESTEROL BLOOD TOTAL,109.0,70.85,2.59,98.1,37
CDM,30101085,%IGG SUBCLASSES X4,70.0,45.5,2.59,63.0,37
CDM,30101095,BLOOD GAS VENOUS (POINT OF CARE LAB),231.0,150.15,13.39,207.9,37
CDM,30101105,BLOOD GAS O2 SATUR ONLY (POINT OF CARE LAB),76.0,49.4,2.59,68.4,37
CDM,30101125,GASTRIN,153.0,99.45,6.33,137.7,37
CDM,30101130,DRUG SCRN QUAN LEVETIRACETAM,142.0,92.3,5.81,127.8,37
CDM,30101135,GLUC BLOOD QUANT ASSAY,41.0,26.65,2.59,36.9,37
CDM,30101165,GLUC BLOOD TEST BY DVC (POINT OF CARE LAB),24.0,15.6,2.59,21.6,37
CDM,30101175,GROWTH HORMONE HUMAN,33.0,21.45,6.33,29.7,37
CDM,30101185,HAPTOGLOBIN QUANT,109.0,70.85,5.78,98.1,37
CDM,30101195,H.PYLORI BREATH TEST,130.0,84.5,32.49,117.0,37
CDM,30101205,HEMOGLOBIN FRACT AND QUANT,180.0,117.0,5.78,162.0,37
CDM,30101215,HEMOGLOBIN A2 ASCAA,33.0,21.45,2.81,30.18,37
CDM,30101225,METHEMOGLOBIN QUANT,65.0,42.25,2.59,58.5,37
CDM,30101255,%BRAFBM TEST,1009.0,655.85,76.88,908.1,37
CDM,30101265,HEMOSIDERIN URINE,43.0,27.95,2.59,38.7,37
CDM,30101295,%ANCA C+P EIA X2,74.0,48.1,5.78,66.6,37
CDM,30101305,%FLT3 ITD TEST,616.0,400.4,76.88,554.4,37
CDM,30101315,INSULIN FREE,121.0,78.65,6.33,108.9,37
CDM,30101325,ASSAY LACTIC ACID,98.0,63.7,5.78,88.2,37
CDM,30101335,%OSHA LEAD,106.0,68.9,5.78,95.4,37
CDM,30101350,COLLAGEN CROSS LINKS,161.0,104.65,5.78,144.9,37
CDM,30101355,LP (A),119.0,77.35,5.78,107.1,37
CDM,30101360,CA URINE QUANT TIMED,74.0,48.1,2.59,66.6,37
CDM,30101365,MANGANESE BLOOD,209.0,135.85,5.78,188.1,37
CDM,30101375,ATMS MASS SPEC QUAL,227.0,147.55,5.78,204.3,37
CDM,30101380,"COPPER, FREE, SERUM OR PLASMA",100.0,65.0,5.78,90.0,37
CDM,30101385,METANEPHRINES URINE,51.0,33.15,6.33,45.9,37
CDM,30101395,%UQNTPP METHADONE,65.0,42.25,16.25,125.87,37
CDM,30101400,CORTISOL TOTAL,144.0,93.6,6.33,129.6,37
CDM,30101415,MYOGLOBIN BLOOD,136.0,88.4,5.78,122.4,37
CDM,30101425,KAPPA & LAMBDA SERUM X2,46.0,29.9,5.23,41.4,37
CDM,30101430,ANTIDEPRESSANTS CLASS 1 OR 2,156.0,101.4,33.04,156.0,37
CDM,30101435,NICOTINE/COTININE,238.0,154.7,33.04,214.2,37
CDM,30101445,%AJPWO NIEMANN PICK,130.0,84.5,22.32,117.0,37
CDM,30101455,PRADER-WILLI METH,906.0,588.9,22.32,815.4,37
CDM,30101465,OLIGOCLONAL BAND TEST,46.0,29.9,11.5,45.77,37
CDM,30101475,METHYLMALONIC ACID BL,176.0,114.4,5.78,158.4,37
CDM,30101480,*CREATINE KINASE TOTAL ASSAY,107.0,69.55,2.59,96.3,37
CDM,30101495,OXALATE URINE,29.0,18.85,5.78,26.1,37
CDM,30101500,*CREATINE KINASE MB FRACT,215.0,139.75,5.78,193.5,37
CDM,30101510,*CREATININE OTHER SOURCE ASSAY,107.0,69.55,2.59,96.3,37
CDM,30101525,PORPHOBILINOGEN UR SCN,15.0,9.75,2.59,13.5,37
CDM,30101555,POTASSIUM,35.0,22.75,2.59,31.5,37
CDM,30101565,PROGESTERONE,37.0,24.05,6.33,34.86,37
CDM,30101575,PROCALCITONIN,202.0,131.3,6.33,181.8,37
CDM,30101585,PROLACTIN,202.0,131.3,6.33,181.8,37
CDM,30101590,CREATININE CLEARANCE TEST,109.0,70.85,2.59,98.1,37
CDM,30101595,ACETOACETATE,206.0,133.9,2.59,185.4,37
CDM,30101600,*DRUG SCREEN QUAL SNGL,143.0,92.95,33.04,143.0,37
CDM,30101605,PSA FREE,34.0,22.1,5.78,30.73,37
CDM,30101625,INNER EAR 68KD ANTIBODY,249.0,161.85,5.23,224.1,37
CDM,30101640,DIHYDROXYVITAMIN D 1 25 ASSAY,56.0,36.4,13.39,56.0,37
CDM,30101645,ALDOLASE,24.0,15.6,2.59,21.6,37
CDM,30101655,ALPHA-1 ANTITRYPSIN TOTAL,28.0,18.2,5.78,25.2,37
CDM,30101660,EPO ASSAY,33.0,21.45,5.78,31.4,37
CDM,30101670,FERRITIN ASSAY,147.0,95.55,5.78,132.3,37
CDM,30101675,%SEQ2 ALPHA FETOPROTEIN,83.0,53.95,5.78,74.7,37
CDM,30101680,FOLIC ACID SERUM ASSAY,111.0,72.15,5.78,99.9,37
CDM,30101685,RENIN PLASMA,79.0,51.35,6.33,71.1,37
CDM,30101690,GAMMAGLOBULIN ASSAY,92.0,59.8,2.59,82.8,37
CDM,30101705,SODIUM FLUID,45.0,29.25,2.59,40.5,37
CDM,30101715,AMINOLEVULINIC ACID (ALA) URINE,197.0,128.05,5.78,177.3,37
CDM,30101725,TESTOSTERONE FREE,43.0,27.95,6.33,42.56,37
CDM,30101745,THYROGLOBULIN,154.0,100.1,6.33,138.6,37
CDM,30101760,BLD GAS PH/PO2/PCO2 W SAT (POINT OF CARE LAB),261.0,169.65,32.49,234.9,37
CDM,30101765,VIT E ALPHA-TOCO TEST,21.0,13.65,5.25,21.0,37
CDM,30101770,GLUCOSE BF,57.0,37.05,2.59,51.3,37
CDM,30101775,ASSAY OF ASCORBIC ACID,189.0,122.85,2.59,170.1,37
CDM,30101785,%T4TFI T4 UPTAKE,68.0,44.2,6.33,61.2,37
CDM,30101795,TROPONIN T,178.0,115.7,5.78,160.2,37
CDM,30101805,"TYROSINE, PLASMA, EA",143.0,92.95,2.59,128.7,37
CDM,30101815,UREA CLEARANCE 24 HR UR,37.0,24.05,6.33,37.0,37
CDM,30101820,GTT 3SPEC,182.0,118.3,5.78,163.8,37
CDM,30101830,GTT EA ADD SPEC BEYOND 3,51.0,33.15,2.59,45.9,37
CDM,30101835,CARBOHYDRATE DEF TRANSF,389.0,252.85,5.78,350.1,37
CDM,30101840,GGT ASSAY,144.0,93.6,2.59,129.6,37
CDM,30101845,VIT A (RETINAL) TEST,21.0,13.65,5.25,19.4,37
CDM,30101850,GLYCATED PROTEIN,25.0,16.25,5.78,25.0,37
CDM,30101865,C-PEPTIDE SERUM,37.0,24.05,5.78,34.77,37
CDM,30101870,GONADOTROPIN FSH,182.0,118.3,6.33,163.8,37
CDM,30101875,HCG QUANT SERUM,249.0,161.85,6.33,224.1,37
CDM,30101885,ASSAY HCG,123.0,79.95,2.59,110.7,37
CDM,30101890,HAPTOGLOBIN QUANT ASSAY,47.0,30.55,5.78,42.3,37
CDM,30101900,HGB ELECPHRSIS FRACT/QUANT,20.0,13.0,5.0,20.0,37
CDM,30101915,DRUG TEST PRSMV CHEM ANLYZR,349.0,226.85,33.04,314.1,37
CDM,30101935,%PCA3 INTERP REPORT PC,73.0,47.45,2.59,65.7,37
CDM,30101965,%NMRLIP CHOLESTEROL,26.0,16.9,4.31,23.4,37
CDM,30101970,HGB A1C GLYCOSYLATED,107.0,69.55,2.59,96.3,37
CDM,30101975,ETHOSUXIMIDE ZARONTIN,25.0,16.25,5.81,25.0,37
CDM,30101980,HISTAMINE,62.0,40.3,13.39,55.8,37
CDM,30101985,HALOPERIDOL,33.0,21.45,5.78,29.7,37
CDM,30101995,QUINIDINE,111.0,72.15,5.81,99.9,37
CDM,30102000,HOMOCYSTEINE ASSAY,81.0,52.65,6.33,72.9,37
CDM,30102005,DEHYDROEPIANDROSTERONE,35.0,22.75,5.78,35.0,37
CDM,30102020,IMMUNOASSY NONINF QUAL/SEMI,473.0,307.45,5.78,425.7,37
CDM,30102025,11-DEOXYCORTISOL,72.0,46.8,6.33,64.8,37
CDM,30102095,ESTRIOL SERUM,36.0,23.4,6.33,36.0,37
CDM,30102100,*IMMUNOASSAY NONINF QUANT RIA,388.0,252.2,5.78,349.2,37
CDM,30102105,ESTRONE SERUM,41.0,26.65,6.33,41.0,37
CDM,30102115,ETHYLENE GLYCOL,69.0,44.85,5.78,62.1,37
CDM,30102125,FECAL FAT QUANT FECES,44.0,28.6,5.78,39.6,37
CDM,30102155,FLUORIDE SERUM,436.0,283.4,5.78,392.4,37
CDM,30102230,IMMUNOASSAY QUANT NOS NONAB,432.0,280.8,5.78,388.8,37
CDM,30102235,GLUCAGON,45.0,29.25,6.33,40.5,37
CDM,30102245,GLUCOSE 6 PHOS DEHYD QT,24.0,15.6,2.59,21.6,37
CDM,30102285,F(FETAL) QUAL,19.0,12.35,2.59,17.1,37
CDM,30102295,HEMOGLOBIN PLASMA,35.0,22.75,2.59,31.5,37
CDM,30102325,HOMOVANILLIC ACID (HVA),325.0,211.25,6.33,292.5,37
CDM,30102345,5 HIAA URINE,128.0,83.2,6.33,115.2,37
CDM,30102375,%U17K 17KETOSTEROIDS 24UR,31.0,20.15,6.33,27.9,37
CDM,30102390,FE ASSAY,144.0,93.6,2.59,129.6,37
CDM,30102400,FE BINDING CAPACITY,80.0,52.0,2.59,72.0,37
CDM,30102405,%LDISO LD ISOENZYMES,28.0,18.2,5.78,25.2,37
CDM,30102410,LAC (LD)(LDH),121.0,78.65,2.59,108.9,37
CDM,30102415,"LACTOFERRIN, FECAL",143.0,92.95,5.78,128.7,37
CDM,30102425,HUMAN PLACENTAL LACTOGEN,540.0,351.0,5.78,486.0,37
CDM,30102430,LEAD ASSAY,51.0,33.15,5.78,45.9,37
CDM,30102450,LIPASE ASSAY,215.0,139.75,2.59,193.5,37
CDM,30102455,HDL CHOL SUBFRACTIONS,230.0,149.5,13.39,207.0,37
CDM,30102480,*LIPOPROTEIN MR SPECTROSCOPY,44.0,28.6,11.0,44.0,37
CDM,30102490,HDL CHOLESTEROL DIR ASSAY,74.0,48.1,2.59,66.6,37
CDM,30102500,LDL CHOLESTE,109.0,70.85,2.59,98.1,37
CDM,30102510,MAG ASSAY,129.0,83.85,2.59,116.1,37
CDM,30102515,MYELIN BASIC PROTEIN,36.0,23.4,5.78,32.4,37
CDM,30102525,MYELOPEROXIDASE (MPO),318.0,206.7,13.39,286.2,37
CDM,30102535,NICKEL SERUM,87.0,56.55,5.78,78.3,37
CDM,30102545,NICOTINE AND METAB UR,158.0,102.7,33.04,158.0,37
CDM,30102555,NUCLEOTIDASE-5,20.0,13.0,5.0,18.63,37
CDM,30102575,%UORA ORG ACIDS UR QNT,158.0,102.7,5.78,142.2,37
CDM,30102585,"OXYCODONE CONF/QT, URINE",196.0,127.4,33.04,191.21,37
CDM,30102595,OSTEOCALCIN,216.0,140.4,16.61,194.4,37
CDM,30102600,MERCURY QUANT ASSAY,33.0,21.45,5.78,29.7,37
CDM,30102605,HER-2/NEU SERUM,669.0,434.85,13.39,602.1,37
CDM,30102615,"%SSAT24 PH, UR",50.0,32.5,2.59,45.0,37
CDM,30102620,METANEPHRINES ASSAY,52.0,33.8,6.33,46.8,37
CDM,30102645,ACID PHOSPHATASE TOTL,72.0,46.8,2.59,64.8,37
CDM,30102655,PROSTATIC ACID PHOS,14.0,9.1,2.59,14.0,37
CDM,30102660,MYOGLOBIN ASSAY,26.0,16.9,5.78,23.4,37
CDM,30102665,%STCATH PHOSPOROUS,88.0,57.2,2.59,79.2,37
CDM,30102680,NATRIURETIC PEPTIDE ASSAY,215.0,139.75,13.39,193.5,37
CDM,30102685,PORPHYRINS URINE,523.0,339.95,5.78,470.7,37
CDM,30102695,PORPHYRINS STOOL,193.0,125.45,13.39,173.7,37
CDM,30102700,*NEPHELOMETRY ASSAY EA NOS,79.0,51.35,5.23,71.1,37
CDM,30102715,PREGNENOLONE SERUM,120.0,78.0,6.33,108.0,37
CDM,30102725,HYDROXYPREGNENELONE-17,75.0,48.75,6.33,67.5,37
CDM,30102745,PROTEIN TOTAL,73.0,47.45,2.59,65.7,37
CDM,30102755,"PROTEIN TOTAL, OTHER SOURCE",14.0,9.1,2.59,12.6,37
CDM,30102765,PAPP-A,358.0,232.7,5.78,322.2,37
CDM,30102785,PROINSULIN SERUM,41.0,26.65,6.33,41.0,37
CDM,30102795,VITAMIN B6 PLASMA,182.0,118.3,13.39,163.8,37
CDM,30102825,SELENIUM BLOOD,76.0,49.4,5.78,68.4,37
CDM,30102855,SOMATOSTATIN,43.0,27.95,6.33,38.7,37
CDM,30102905,THYROXINE BIND GLOBULIN,23.0,14.95,5.75,23.0,37
CDM,30102925,CORTICOSTEROID-BINDING GLOGULIN,118.0,76.7,6.33,106.2,37
CDM,30102965,T3 DIAL FREE,74.0,48.1,6.33,66.6,37
CDM,30102975,REVERSE T3,25.0,16.25,6.25,25.0,37
CDM,30103005,VIP,83.0,53.95,16.61,74.7,37
CDM,30103015,"COPEPTIN PROAVP, PLASMA",57.0,37.05,14.25,56.71,37
CDM,30103025,VITAMIN K,112.0,72.8,5.78,100.8,37
CDM,30103055,C1 ESTERASE INHIBITOR,105.0,68.25,5.23,94.5,37
CDM,30103065,%CEPHAL FLOUR AB X3,333.0,216.45,5.23,299.7,37
CDM,30103095,CANNABINOIDS CONF UR,270.0,175.5,33.04,243.0,37
CDM,30103155,SEX-HORMONE BIND GLOBULIN,26.0,16.9,5.78,26.0,37
CDM,30103165,INSULIN LIK GR FAC 1,201.0,130.65,6.33,180.9,37
CDM,30103195,%SERPINA1 GENE ANALYSIS,374.0,243.1,22.32,336.6,37
CDM,30103215,"TRAMADOL & METAB, QUANT",262.0,170.3,33.04,235.8,37
CDM,30103300,ORGANIC ACID SNGL QUANT,125.0,81.25,5.78,112.5,37
CDM,30103315,DRGTOF TAPENTADOL AND MET,162.0,105.3,33.04,162.0,37
CDM,30103340,OSMOLALITY BLOOD ASSAY,109.0,70.85,2.59,98.1,37
CDM,30103360,OSMOLALITY URINE ASSAY,109.0,70.85,2.59,98.1,37
CDM,30103380,PARATHYROID HORMONE ASSAY,110.0,71.5,16.61,99.0,37
CDM,30103420,ANTIPSYCHOTICS NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30103435,11 DEOXYCORTICOSTERONE,250.0,162.5,16.61,225.0,37
CDM,30103460,PHOSPHOROUS ASSAY,107.0,69.55,2.59,96.3,37
CDM,30103480,PHOSPHOROUS URINE ASSAY,109.0,70.85,2.59,98.1,37
CDM,30103500,*PORPHOBILINOGEN URINE QUANT,15.0,9.75,2.59,13.5,37
CDM,30103515,THYROGLOB AB INTERFERENCE,244.0,158.6,6.33,219.6,37
CDM,30103525,URIC ACID BODY FLUID,55.0,35.75,2.59,49.5,37
CDM,30103540,K URINE ASSAY,92.0,59.8,2.59,82.8,37
CDM,30103545,EVEROLIMUS,67.0,43.55,5.81,60.3,37
CDM,30103555,GABAPENTIN,39.0,25.35,5.81,36.21,37
CDM,30103565,MYCOPHENOLIC ACID,34.0,22.1,5.81,30.6,37
CDM,30103575,OXCARBAZEPINE,77.0,50.05,5.81,69.3,37
CDM,30103580,PREALBUMIN ASSAY,144.0,93.6,5.78,129.6,37
CDM,30103585,ZONISAMIDE,74.0,48.1,5.81,66.6,37
CDM,30103595,CRMSNP TEST,2035.0,1322.75,508.75,1938.36,37
CDM,30103605,MGMT TEST,979.0,636.35,22.32,881.1,37
CDM,30103630,PROTEIN TOTAL SERUM ASSAY,74.0,48.1,2.59,66.6,37
CDM,30103635,INSULIN ASSAY,25.0,16.25,6.25,22.5,37
CDM,30103640,*PROTEIN TOTAL URINE ASSAY,73.0,47.45,2.59,65.7,37
CDM,30103645,PHENYLALANINE (PKU) EA,143.0,92.95,2.59,128.7,37
CDM,30103655,CAFFEINE,233.0,151.45,5.81,209.7,37
CDM,30103675,%AJPWO CANVAN,130.0,84.5,22.32,117.0,37
CDM,30103685,%AJPWO BLOOM,108.0,70.2,22.32,97.2,37
CDM,30103690,PROTEIN TOTAL OTHER ASSAY,74.0,48.1,2.59,66.6,37
CDM,30103695,%AJPWO FANCONI,101.0,65.65,22.32,90.9,37
CDM,30103710,PROTEIN ELECPHRSIS SERUM,182.0,118.3,2.59,163.8,37
CDM,30103715,%AJPWO TAY SACHS,142.0,92.3,22.32,127.8,37
CDM,30103720,PROTEIN ELECPHRSIS OTHER,64.0,41.6,5.78,57.6,37
CDM,30103725,%AJPWO FAMILIAL DYSAUTO,108.0,70.2,22.32,97.2,37
CDM,30103750,WESTERN BLOT BLOOD OR BODY FL,322.0,209.3,5.23,289.8,37
CDM,30103755,%AJPWO MUCOLIPIDOSIS IV,108.0,70.2,22.32,97.2,37
CDM,30103780,*WESTERN BLOT TEST I&R BAND ID,228.0,148.2,19.47,205.2,37
CDM,30103785,PTEN ANALYSIS TEST,2225.0,1446.25,325.19,2002.5,37
CDM,30103805,PMP22,2186.0,1420.9,325.19,1967.4,37
CDM,30103820,PROTOPORPHYRIN RBC QUANT,173.0,112.45,5.78,155.7,37
CDM,30103825,%HLAA29 TEST,883.0,573.95,22.32,794.7,37
CDM,30103840,ENDOCRINE RECEPTOR ASSAY,95.0,61.75,16.61,95.0,37
CDM,30103845,%CYP21A2 COMMON VARI,1309.0,850.85,76.88,1178.1,37
CDM,30103850,NONENDOCRINE RECEPTOR ASSAY,11.0,7.15,2.59,9.9,37
CDM,30103860,VIT B-2 ASSAY,76.0,49.4,5.78,68.4,37
CDM,30103885,AFP AMNIOTIC FLUID,200.0,130.0,5.78,180.0,37
CDM,30103890,NA URINE ASSAY,109.0,70.85,2.59,98.1,37
CDM,30103895,%NEO AMINO ACIDS X3,35.0,22.75,5.78,31.5,37
CDM,30103905,ANGIOTENSIN II,630.0,409.5,6.33,567.0,37
CDM,30103910,SOMATOMEDIN ASSAY,37.0,24.05,6.33,35.53,37
CDM,30103920,SPECTROPHOTOMETRY NOS,32.0,20.8,2.59,28.8,37
CDM,30103925,%UMUCPO CHONDRO QUANT,416.0,270.4,6.33,374.4,37
CDM,30103935,"SMITH - LEMLI-OPITZ SCREEN, PL",748.0,486.2,5.78,673.2,37
CDM,30103945,CRYOFIBRINOGEN,63.0,40.95,5.78,56.7,37
CDM,30103955,CYANIDE BLOOD,153.0,99.45,5.78,137.7,37
CDM,30103965,MISC SENDOUT CPT 83080,1371.0,891.15,5.78,1233.9,37
CDM,30103975,PIVKA II,545.0,354.25,13.39,490.5,37
CDM,30104030,TESTOSTERONE TOTAL ASSAY,55.0,35.75,6.33,49.5,37
CDM,30104060,VIT B-1 ASSAY,51.0,33.15,5.78,45.9,37
CDM,30104080,THYROXINE TOTAL ASSAY,74.0,48.1,6.33,66.6,37
CDM,30104090,THYROXINE FREE ASSAY,81.0,52.65,6.33,72.9,37
CDM,30104095,%TADID AMITRIPTYLINE,158.0,102.7,33.04,158.0,37
CDM,30104125,ISOPROPANOL,226.0,146.9,33.04,203.4,37
CDM,30104130,TRIGLYCERIDES ASSAY,109.0,70.85,2.59,98.1,37
CDM,30104145,"AMPHETAMINE CONF, UR",375.0,243.75,33.04,337.5,37
CDM,30104150,TRIIODOTHYRONINE TOTAL(TT-3),144.0,93.6,6.33,129.6,37
CDM,30104160,TRIIODOTHYRONINE FREE(FT-3),75.0,48.75,6.33,67.5,37
CDM,30104170,TROPONIN ASSAY QUAL (POINT OF CARE LAB),109.0,70.85,2.59,98.1,37
CDM,30104175,VALPROIC ACID-DEPAKENE,178.0,115.7,5.81,160.2,37
CDM,30104180,BUN,80.0,52.0,2.59,72.0,37
CDM,30104185,VALPROIC ACID FREE,29.0,18.85,5.81,26.1,37
CDM,30104195,LAMOTRIGINE,24.0,15.6,6.0,125.87,37
CDM,30104200,UREA NITROGEN URINE ASSAY,131.0,85.15,2.59,117.9,37
CDM,30104205,LEVETIRACETAM/KEPPRA,140.0,91.0,5.81,126.0,37
CDM,30104215,THERAPEUTIC DRUG LEVEL,221.0,143.65,5.81,198.9,37
CDM,30104220,URIC ACID BLOOD ASSAY,107.0,69.55,2.59,96.3,37
CDM,30104230,URIC ACID OTHER SOURCE ASSAY,57.0,37.05,2.59,51.3,37
CDM,30104235,17-OH PROGESTERONE,98.0,63.7,6.33,88.2,37
CDM,30104250,VOLATILES ASSAY,150.0,97.5,5.78,135.0,37
CDM,30104255,%PORPHYRIN SCREEN,28.0,18.2,5.78,25.2,37
CDM,30104265,PSA DIAGNOSTIC,109.0,70.85,5.78,98.1,37
CDM,30104270,XYLOSE ABSORP TEST,41.0,26.65,5.78,36.9,37
CDM,30104275,PROTEIN ELECTRO.FLUID QT,34.0,22.1,5.78,30.6,37
CDM,30104280,ZINC ASSAY,73.0,47.45,5.78,65.7,37
CDM,30104285,ZINC PROTOPORPHYRINS,132.0,85.8,5.78,118.8,37
CDM,30104295,PYRUVIC ACID CSF,89.0,57.85,5.78,80.1,37
CDM,30104305,SPECIFIC GRAVITY BDY FLD,19.0,12.35,2.59,17.1,37
CDM,30104315,THIOCYANATE,77.0,50.05,5.78,69.3,37
CDM,30104325,%TRAB THYROID STIM IMMUN,89.0,57.85,16.61,84.99,37
CDM,30104335,VMA URINE,145.0,94.25,6.33,130.5,37
CDM,30104345,ZINC BLOOD,25.0,16.25,5.78,22.5,37
CDM,30104355,HCG QUAL FLUID/URINE,109.0,70.85,1.43,98.1,37
CDM,30104365,PSA SCREENING,107.0,69.55,5.78,96.3,37
CDM,30104385,BRWK ACETAMINOPHEN BL,219.0,142.35,33.04,197.1,37
CDM,30104395,ASSAY NONENDOCRINE RECEPTOR,314.0,204.1,13.39,282.6,37
CDM,30104405,CALR EXON 9 MUTATION,437.0,284.05,22.32,393.3,37
CDM,30104435,LEVAMISOLE,304.0,197.6,33.04,273.6,37
CDM,30104470,*GAMMAGLOBULIN IGG SUBC EA,22.0,14.3,2.59,19.8,37
CDM,30104505,%A1APHE A1A PHENOTYPE,46.0,29.9,5.78,41.4,37
CDM,30104515,%2ND TRI AFP,178.0,115.7,5.78,160.2,37
CDM,30104525,AMYLASE,178.0,115.7,2.59,160.2,37
CDM,30104545,CRYOGLOBULIN QL,40.0,26.0,2.59,36.0,37
CDM,30104555,GLUCOSE SCRN POST DOSE,36.0,23.4,2.59,32.4,37
CDM,30104575,%CELCMP TRANSGLUT IGA,79.0,51.35,5.78,71.1,37
CDM,30104595,%1ST TRI PAPP-A,145.0,94.25,5.78,130.5,37
CDM,30104615,%UQNTPP HEROIN METABOLITE,85.0,55.25,21.25,125.87,37
CDM,30104635,VITAMIN B12 BLOOD,142.0,92.3,6.33,127.8,37
CDM,30104645,PSA FREE,34.0,22.1,5.78,30.73,37
CDM,30104685,JAK2 TEST,748.0,486.2,22.32,673.2,37
CDM,30104715,%CELCMP HLADQ2 TEST,535.0,347.75,22.32,481.5,37
CDM,30104745,%CELCMP GAMMALOBULIN,79.0,51.35,2.59,71.1,37
CDM,30104755,URIC ACID BLOOD,110.0,71.5,2.59,99.0,37
CDM,30104815,GBL MYL NGS 5-50 GENE,1742.0,1132.3,325.19,1567.8,37
CDM,30104825,%A1APHE A1A TOTAL,43.0,27.95,5.78,38.7,37
CDM,30104885,"SULFONYLUREA HYPOGLY, SER",315.0,204.75,33.04,283.5,37
CDM,30104905,MPL MUTATION ANLYS BLD,1175.0,763.75,76.88,1057.5,37
CDM,30104915,POTASSIUM (POINT OF CARE LAB),56.0,36.4,2.59,50.4,37
CDM,30104925,%NGSCOL BRAF,364.0,236.6,76.88,327.6,37
CDM,30104935,"%NGSCOL KRAS 12,13",364.0,236.6,76.88,327.6,37
CDM,30104955,%KRASGN KRAS ADD VAR,605.0,393.25,76.88,544.5,37
CDM,30104975,%NGSCOL KRAS 61,400.0,260.0,76.88,360.0,37
CDM,30104995,CFNGS 139 VAR,681.0,442.65,170.1,681.0,37
CDM,30105115,%BCRQL BCR/ABL1 MAJ BRKPT,872.0,566.8,76.88,784.8,37
CDM,30105225,%CELCMP HLADQ8 TEST,164.0,106.6,22.32,164.0,37
CDM,30105315,TROPONIN I,178.0,115.7,5.78,160.2,37
CDM,30105325,%BCRQL BCR/ABL1 MIN BRKPT,770.0,500.5,76.88,693.0,37
CDM,30105335,%BCRQL BCR/ABL1 OTH BRKPT,849.0,551.85,76.88,764.1,37
CDM,30105345,NT PRO BNP,215.0,139.75,13.39,193.5,37
CDM,30105375,ADMARK PHOS TAU CSF X3,762.0,495.3,5.78,685.8,37
CDM,30105385,MATRIX METALLOPRO-9 MMP-9,206.0,133.9,5.78,185.4,37
CDM,30105435,"HLA-A-B,CW,DR,DQ,DRB345-RSSOP-Q9 VERIF",1327.0,862.55,170.1,1194.3,37
CDM,30105465,RHCE VARIANT ANTIGEN,645.0,419.25,76.88,580.5,37
CDM,30105475,BCR ABL QUAL MPLEX PCR,1170.0,760.5,22.32,1053.0,27
CDM,30105485,%FLT3 TKD TEST,551.0,358.15,22.32,495.9,37
CDM,30105525,FHHE TEST,4125.0,2681.25,76.88,3712.5,37
CDM,30105535,P53MUT TEST,2770.0,1800.5,76.88,2493.0,37
CDM,30105545,SLC2A1 TEST,2283.0,1483.95,76.88,2054.7,37
CDM,30105585,SHOX DNA DX,1839.0,1195.35,76.88,1655.1,37
CDM,30105655,CADASL TEST,5699.0,3704.35,76.88,5129.1,37
CDM,30105735,GALACTOSYLCERAMDE,1122.0,729.3,76.88,1009.8,37
CDM,30105765,CLOTTING TEST,105.0,68.25,2.12,94.5,37
CDM,30105785,3 METHYLGLUTACONIC ACID,748.0,486.2,5.78,673.2,37
CDM,30105795,PIPECOLIC ACID SERUM,539.0,350.35,5.78,485.1,37
CDM,30105800,IMMUNOASSAY NONINF QUANT RIA,44.0,28.6,5.78,39.6,37
CDM,30105805,MUSK ANTIBODY,1442.0,937.3,5.78,1297.8,37
CDM,30105810,CYCLOSPORINE ASSAY,57.0,37.05,5.81,51.3,37
CDM,30105815,MUSCLE MODULATING AB,1064.0,691.6,5.78,957.6,37
CDM,30105820,CYSTATIN C,83.0,53.95,5.78,74.7,37
CDM,30105825,GANGLIONIC NACHR ANTIBOD,991.0,644.15,5.78,891.9,37
CDM,30105830,"DEOXYCORTICOSTERONE, 11",135.0,87.75,16.61,121.5,37
CDM,30105835,PROCOL TYPEL N TARMINAL,869.0,564.85,5.78,782.1,37
CDM,30105840,ENZYME ACTIVITY NRADIOAC NOS,337.0,219.05,5.78,303.3,37
CDM,30105845,VOLTAGE-GATED CAL IGG AB,395.0,256.75,5.78,355.5,37
CDM,30105850,IMMUNOASSAY QUANT NOS,206.0,133.9,6.33,185.4,37
CDM,30105855,GANGLIONIC ACHR AUTOAB,789.0,512.85,5.78,710.1,37
CDM,30105860,IMMUNOASSAY,154.0,100.1,5.78,138.6,37
CDM,30105865,MELANOCYTE STIM HORMONE ALP,392.0,254.8,5.78,352.8,37
CDM,30105870,*INSULIN TOTAL ASSAY,19.0,12.35,4.75,19.0,37
CDM,30105875,PANCREASTATIN,361.0,234.65,5.78,324.9,37
CDM,30105880,"PORPHOBILINOGEN, QN, RANDOM UR",43.0,27.95,2.59,38.7,37
CDM,30105885,NEURO VG K CHAN ABS MOD,711.0,462.15,5.78,639.9,37
CDM,30105890,PANC ELASTASE FECAL QUAL/SEMI,289.0,187.85,5.78,260.1,37
CDM,30105895,MELATONIN,267.0,173.55,5.78,240.3,37
CDM,30105900,PARATHYROID HORMONE ASSAY,73.0,47.45,16.61,68.98,37
CDM,30105905,%MYGRAV ACHR ABX2,97.0,63.05,5.78,87.3,37
CDM,30105910,*PORPHYRINS URINE QUAL,19.0,12.35,4.75,19.0,37
CDM,30105915,%CEPHAL IA/RIA,397.0,258.05,5.78,357.3,37
CDM,30105920,*PROLACTIN ASSAY,58.0,37.7,6.33,52.2,37
CDM,30105925,IGF-II INSULIN LIKE GR,120.0,78.0,5.78,108.0,37
CDM,30105935,VOLTAGE-GATED KCHANNEL AB,455.0,295.75,5.78,409.5,37
CDM,30105945,%LAMBRT IA;QNT RIA X4 MOD,328.0,213.2,5.78,295.2,37
CDM,30105960,IMMUNOASSY QUANT NOS,152.0,98.8,5.78,136.8,37
CDM,30105965,PANCREATIC POLYPE,263.0,170.95,5.78,236.7,37
CDM,30105975,ACETYLCHOL REC MOD,180.0,117.0,5.78,162.0,37
CDM,30105980,K URINE ASSAY,11.0,7.15,2.59,9.9,37
CDM,30105985,IGFBP-3 INSULIN,47.0,30.55,5.78,42.3,37
CDM,30105990,*LAC (LD)(LDH),11.0,7.15,2.59,10.09,37
CDM,30105995,%PARNEO AB BIND X2 MOD,92.0,59.8,5.78,82.8,37
CDM,30106000,LIPASE ASSAY,21.0,13.65,2.59,18.9,37
CDM,30106005,IGF BINDING PROTEIN 2,166.0,107.9,5.78,149.4,37
CDM,30106010,LIPOPROTEIN (LP-PLA2) ASSAY,110.0,71.5,13.39,99.0,37
CDM,30106020,LITHIUM ASSAY,50.0,32.5,5.81,45.0,37
CDM,30106030,MAG ASSAY,15.0,9.75,2.59,13.5,37
CDM,30106035,GALACTOSE-1-PHOSPHATE,474.0,308.1,5.78,426.6,37
CDM,30106045,VASC ENDO GROWTH FACT,287.0,186.55,5.78,258.3,37
CDM,30106060,*MASS SPECTRMTRY QUANT EA,55.0,35.75,5.78,49.5,37
CDM,30106085,VITAMIN B1 PLASMA,135.0,87.75,5.78,121.5,37
CDM,30106095,KINASE TEST,383.0,248.95,76.88,383.0,37
CDM,30106115,MPL TEST,1434.0,932.1,76.88,1290.6,37
CDM,30106135,JAKNON TEST,758.0,492.7,76.88,682.2,37
CDM,30106225,"CHYMOTRYPSIN, STOOL",190.0,123.5,2.59,171.0,37
CDM,30106245,PBG DEAMINASE,487.0,316.55,2.59,438.3,37
CDM,30106265,PORPHYRINS PLASMA,97.0,63.05,2.59,87.3,37
CDM,30106275,PHOSPHOLIPIDS,131.0,85.15,2.59,117.9,37
CDM,30106295,PORPHYRINS SERUM TOTAL,109.0,70.85,2.59,98.1,37
CDM,30106375,PURINE&PYRIMIDINE,686.0,445.9,5.78,617.4,37
CDM,30106385,THIOPURINE METHYLT TPMT,281.0,182.65,5.78,252.9,37
CDM,30106395,BILE ACIDS FRACTIONATED,622.0,404.3,5.78,559.8,37
CDM,30106405,N-METHYLHISTAMINE UR,609.0,395.85,5.78,548.1,37
CDM,30106425,PLTHY MASS SPEC QUANT,437.0,284.05,5.78,393.3,37
CDM,30106435,SILVER UR QUANT,392.0,254.8,5.78,352.8,37
CDM,30106445,%UMPSSC QUAL,232.0,150.8,5.78,208.8,37
CDM,30106455,IODIDE SERUM,108.0,70.2,5.78,97.2,37
CDM,30106465,"IODINE, RANDOM URINE",76.0,49.4,5.78,68.4,37
CDM,30106485,SEROTONIN SERUM,171.0,111.15,16.61,153.9,37
CDM,30106545,"PAN.ELASTASE, FECAL",834.0,542.1,5.78,750.6,37
CDM,30106555,ADIPONECTIN,402.0,261.3,5.78,361.8,37
CDM,30106565,ANTI-IGA ANTIBODY,790.0,513.5,5.78,711.0,37
CDM,30106575,ADAMTS13 ANTIBODY,200.0,130.0,5.78,180.0,37
CDM,30106585,INTERLEUKIN 2 RECEPTOR,411.0,267.15,5.78,369.9,37
CDM,30106595,INTERLEUKIN 2,616.0,400.4,5.78,554.4,37
CDM,30106615,ANTI MULLERIAN HORMONE,262.0,170.3,5.78,235.8,37
CDM,30106620,NATRIURETIC PEPTIDE ASSAY,83.0,53.95,13.39,74.7,37
CDM,30106630,NEPHELOMETRY ASSAY EA NOS,23.0,14.95,5.23,22.73,37
CDM,30106635,INTERLEUKIN 6,523.0,339.95,5.78,470.7,37
CDM,30106645,INTERLEUKIN 5,534.0,347.1,5.78,480.6,37
CDM,30106655,ALPHA SUBUNIT,122.0,79.3,5.78,109.8,37
CDM,30106660,SEROTONIN ASSAY,84.0,54.6,16.61,75.6,37
CDM,30106665,LEPTIN,110.0,71.5,5.78,99.0,37
CDM,30106670,SPECIFIC GRAVITY NOT URINE,10.0,6.5,2.5,9.0,37
CDM,30106675,SULFATIDE AUTOANTIBODYX2,480.0,312.0,5.78,432.0,37
CDM,30106680,SPECTROPHOTOMETRY NOS,194.0,126.1,2.59,174.6,37
CDM,30106685,ANTI IGE,124.0,80.6,5.78,111.6,37
CDM,30106690,*T3/T4 UPTAKE ASSAY,12.0,7.8,3.0,10.81,37
CDM,30106695,NEURON SPECIFIC ENO CSF,142.0,92.3,5.78,127.8,37
CDM,30106700,TACROLIMUS ASSAY,124.0,80.6,5.81,111.6,37
CDM,30106705,%IBDSER SACCH CEREV X2,83.0,53.95,5.23,74.7,37
CDM,30106710,*BIOAVAILABLE TESTOSTERONE,55.0,35.75,6.33,49.5,37
CDM,30106715,MANNOSE BINDING PROTEIN,385.0,250.25,5.78,346.5,37
CDM,30106725,COLLAGEN TYPE II AB,355.0,230.75,5.78,319.5,37
CDM,30106730,THYROXINE FREE ASSAY,84.0,54.6,6.33,75.6,37
CDM,30106740,*THYROXINE TOTAL ASSAY,12.0,7.8,3.0,11.48,37
CDM,30106745,TUMOR NECROSIS SERUM,136.0,88.4,5.78,122.4,37
CDM,30106755,INHIBIN B,239.0,155.35,5.78,215.1,37
CDM,30106760,TOBRAMYCIN ASSAY,113.0,73.45,5.81,101.7,37
CDM,30106765,GLOM BASE MEM AB IGG,167.0,108.55,5.78,150.3,37
CDM,30106770,VIT B-1 ASSAY,45.0,29.25,5.78,40.5,37
CDM,30106780,*VIT D 25 HYDROXY ASSAY,53.0,34.45,13.25,49.46,37
CDM,30106785,%INHAB IMMUNO QT,184.0,119.6,5.78,165.6,37
CDM,30106795,%PARNEO STRIATIONAL AB,95.0,61.75,5.78,85.5,37
CDM,30106800,WESTERN BLOT TEST I&R BAND ID,333.0,216.45,19.47,299.7,37
CDM,30106805,%CROHN ELISA X5,105.0,68.25,5.78,94.5,37
CDM,30106820,LITHIUM ASSAY,53.0,34.45,5.81,47.7,37
CDM,30106825,IBDSGI ELISA X6,66.0,42.9,5.78,59.4,37
CDM,30106830,IMMUNOASSAY N,176.0,114.4,5.78,158.4,37
CDM,30106885,COQ10 LEUKOCYTES,374.0,243.1,5.78,336.6,37
CDM,30106895,5 METHYLTETRAHYDROFOLATE,802.0,521.3,5.78,721.8,37
CDM,30106905,"SUCCINYLADENOSINE, CSF",785.0,510.25,5.78,706.5,37
CDM,30106910,PROC CHEM UNL,44.0,28.6,5.78,39.6,37
CDM,30106915,PYRIDOXAL 5 PHOSPHATE,785.0,510.25,5.78,706.5,37
CDM,30106925,NEOPTERIN CSF,572.0,371.8,5.78,514.8,37
CDM,30106960,TOBRAMYCIN AS,165.0,107.25,5.81,148.5,37
CDM,30106980,TOTAL BILIRUBIN,9.0,5.85,2.25,8.39,37
CDM,30106990,IMMUNOASSAY NONINF QUANT RIA,146.0,94.9,5.78,131.4,37
CDM,30106995,CPT2 TEST,1940.0,1261.0,76.88,1746.0,37
CDM,30107000,CORTISOL FREE,77.0,50.05,5.78,69.3,37
CDM,30107015,%PANCPL PRSS1,1241.0,806.65,76.88,1116.9,37
CDM,30107025,MEN2 TEST,583.0,378.95,76.88,524.7,37
CDM,30107030,MANGANESE,100.0,65.0,5.78,90.0,37
CDM,30107040,VITAMIN NOS,145.0,94.25,5.78,130.5,37
CDM,30107055,COL3 TEST,2917.0,1896.05,22.32,2625.3,27
CDM,30107070,CANNABINOIDS NATURAL,143.0,92.95,33.04,143.0,37
CDM,30107075,MUCKLE TEST,2199.0,1429.35,22.32,1979.1,27
CDM,30107095,TRAPS TEST,1076.0,699.4,22.32,968.4,27
CDM,30107100,COCAINE,143.0,92.95,33.04,143.0,37
CDM,30107115,SCA17 TEST,836.0,543.4,76.88,752.4,37
CDM,30107140,BENZODIAZEPINES1-12,143.0,92.95,33.04,143.0,37
CDM,30107160,BENZODIAZEPINES1-12,143.0,92.95,33.04,143.0,37
CDM,30107170,PHENOBARBITAL FREE (UNBOUND),64.0,41.6,5.81,57.6,37
CDM,30107185,C9ORF72 EXPANSION ASSAY,378.0,245.7,22.32,340.2,27
CDM,30107190,DRUG QUANT NOS ASSAY,62.0,40.3,5.81,55.8,37
CDM,30107200,DRUG SCRN QUANT OXCARBAZEPIN,79.0,51.35,5.81,71.1,37
CDM,30107210,ACETAZOLAMIDE,136.0,88.4,5.81,122.4,37
CDM,30107220,DRUG QUANT NOS ASSAY,90.0,58.5,5.81,81.0,37
CDM,30107230,DRUG SCREEN QUANT CLOZAPINE,85.0,55.25,5.81,76.5,37
CDM,30107240,DRUG QUANT NOS ASSAY,62.0,40.3,5.81,55.8,37
CDM,30107250,DRUG QUANT NOS ASSAY,80.0,52.0,5.81,72.0,37
CDM,30107260,ANTIDEPRESSANTS CLASS 1 OR 2,152.0,98.8,33.04,152.0,37
CDM,30107270,DRUG QUANT NOS ASSAY,30.0,19.5,5.81,30.0,37
CDM,30107280,DRUG QUANT NOS ASSAY,98.0,63.7,5.81,88.2,37
CDM,30107290,DRUG QUANT NOS ASSAY,94.0,61.1,5.81,84.6,37
CDM,30107295,IBDSGI UNLISTED MOL PATH,150.0,97.5,22.32,135.0,27
CDM,30107300,DRUG QUANT NOS ASSAY,75.0,48.75,5.81,67.5,37
CDM,30107310,DRUG QUANT NOS ASSAY,69.0,44.85,5.81,62.1,37
CDM,30107320,ALDOSTERONE ASSAY,72.0,46.8,16.61,68.09,37
CDM,30107325,DYSTONIA DNA TEST,1571.0,1021.15,22.32,1413.9,37
CDM,30107330,*ALKA PHOSPHTAS ASSAY,12.0,7.8,2.59,10.8,37
CDM,30107345,MCADD TEST,343.0,222.95,76.88,309.47,37
CDM,30107350,*AMYLASE ASSAY,19.0,12.35,2.59,17.1,37
CDM,30107360,*AMYLASE ASSAY,19.0,12.35,2.59,17.1,37
CDM,30107365,PAIGEN TEST,217.0,141.05,22.32,195.3,37
CDM,30107370,APOLIPOPROTEIN EA ASSAY,32.0,20.8,5.78,32.0,37
CDM,30107375,GAUCHR TEST,661.0,429.65,22.32,594.9,37
CDM,30107380,ARSENIC,77.0,50.05,5.78,69.3,37
CDM,30107385,%AJPWO GAUCHER,130.0,84.5,22.32,117.0,37
CDM,30107400,BETA 2 MICROGLOBULIN ASSAY,24.0,15.6,6.0,24.0,37
CDM,30107410,BILIRUBIN DIRECT,142.0,92.3,2.59,127.8,37
CDM,30107420,CADMIUM ASSAY,47.0,30.55,5.78,42.3,37
CDM,30107425,YCMICR TEST,318.0,206.7,76.88,309.47,37
CDM,30107440,CATECHOLAMINE FRACT ASSAY,37.0,24.05,6.33,37.0,37
CDM,30107450,*CATECHOLAMINE FRACT ASSAY,37.0,24.05,6.33,37.0,37
CDM,30107455,XCISE AMPD1 TEST,524.0,340.6,76.88,471.6,37
CDM,30107460,*CHOLESTEROL BLOOD TOTAL,29.0,18.85,2.59,26.1,37
CDM,30107470,DRUG SCREEN QUAN LAMOTRIGINE,24.0,15.6,5.81,22.14,37
CDM,30107480,DRUG/SUBSTANCE NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30107485,LHON TEST,2059.0,1338.35,76.88,1853.1,37
CDM,30107490,DRUG/SUBSTANCE NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30107500,DRUG SCREEN QUANT ZONISAMIDE,75.0,48.75,5.81,67.5,37
CDM,30107510,QUANTITATIVE ASSAY DRUG,98.0,63.7,5.81,88.2,37
CDM,30107515,SCA2 DNA TEST,675.0,438.75,76.88,607.5,37
CDM,30107520,ANTIEPILEPTICS NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30107530,QUANTITATIVE ASSAY DRUG,83.0,53.95,5.81,74.7,37
CDM,30107535,SCA3 DNA TEST,651.0,423.15,76.88,585.9,37
CDM,30107540,ANTIDEPRESSANT NOT SPECIFIED,143.0,92.95,33.04,143.0,37
CDM,30107545,SCA1 DNA TEST,629.0,408.85,76.88,566.1,37
CDM,30107560,DRUG/SUBSTANCE NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30107575,FRIED TEST,950.0,617.5,76.88,855.0,37
CDM,30107580,ANALGESICS NON-OPIOID 1 OR 2,143.0,92.95,33.04,143.0,37
CDM,30107590,DRUG SCRN QUAN MYCOPHENOLATE,63.0,40.95,5.81,56.7,37
CDM,30107600,ANTIDEPRESSANT TRICYCLIC 1/2,143.0,92.95,33.04,143.0,37
CDM,30107610,HEAVY METAL; QUAN,110.0,71.5,5.78,99.0,37
CDM,30107615,CROHN TEST,691.0,449.15,76.88,621.9,37
CDM,30107620,COL CHROMOTOGRAPHY QUAL/QUAN,167.0,108.55,5.78,150.3,37
CDM,30107625,APOEG TEST,179.0,116.35,44.75,179.0,37
CDM,30107630,ANTIEPILEPTICS NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30107640,ANTIDEPRESSANT TRICYCLIC 1/2,143.0,92.95,33.04,143.0,37
CDM,30107645,CFTR TEST,750.0,487.5,76.88,675.0,37
CDM,30107650,COL CHROMOTOGRAPHY QUAL/QUAN,32.0,20.8,5.78,32.0,37
CDM,30107660,QUANTITATIVE ASSAY DRUG,96.0,62.4,5.81,86.4,37
CDM,30107670,COLLAGEN CROSS LINKS,62.0,40.3,5.78,55.8,37
CDM,30107675,TETRAHYDROBIO NECPT CFS,846.0,549.9,5.78,761.4,37
CDM,30107680,COLLAGEN CROSS LINKS,43.0,27.95,5.78,38.7,37
CDM,30107685,COENZYME Q10,658.0,427.7,5.78,592.2,37
CDM,30107690,COLLAGEN CROSS LINKS,135.0,87.75,5.78,121.5,37
CDM,30107700,COPPER ASSAY,19.0,12.35,4.75,19.0,37
CDM,30107705,FLUCONAZOLE SERUM,221.0,143.65,5.81,198.9,37
CDM,30107710,CORTISOL TOTAL,469.0,304.85,6.33,422.1,37
CDM,30107730,COLUMN CHROM QUANT,121.0,78.65,5.78,108.9,37
CDM,30107735,"KAPPA FREE, URINE",145.0,94.25,5.23,130.5,37
CDM,30107745,"LAMBDA FREE, URINE",145.0,94.25,5.23,130.5,37
CDM,30107750,*CREATINE KINASE TOTAL ASSAY,13.0,8.45,2.59,11.7,37
CDM,30107760,CREATININE OTHER SOURCE,129.0,83.85,2.59,116.1,37
CDM,30107765,%NGSCOL NRAS,506.0,328.9,76.88,494.27,37
CDM,30107770,*CREATININE OTHER SOURCE ASSAY,67.0,43.55,2.59,60.3,37
CDM,30107780,*CREATININE OTHER SOURCE ASSAY,29.0,18.85,2.59,26.1,37
CDM,30107790,*CREATININE OTHER SOURCE ASSAY,28.0,18.2,2.59,25.2,37
CDM,30107800,*CREATININE OTHER SOURCE ASSAY,53.0,34.45,2.59,47.7,37
CDM,30107825,LEFLUNOMIDE METABOLITE,185.0,120.25,5.81,166.5,37
CDM,30107850,*GAMMAGLOBULIN ASSAY,57.0,37.05,2.59,51.3,37
CDM,30107855,LYSO ACID LIPASE ACT,337.0,219.05,5.78,303.3,37
CDM,30107860,*GAMMAGLOBULIN EA ASSAY,57.0,37.05,2.59,51.3,37
CDM,30107870,GAMMAGLOBULIN ASSAY,69.0,44.85,2.59,62.1,37
CDM,30107875,"GLUCOSE RANDOM, UR",56.0,36.4,2.59,50.4,37
CDM,30107880,GLUC BODY FLUID NOT BLOOD,22.0,14.3,2.59,19.8,37
CDM,30107885,"CARBOHYDRATE, UR",125.0,81.25,2.59,112.5,37
CDM,30107890,GLYCATED PROTEIN,43.0,27.95,5.78,38.7,37
CDM,30107900,HGB ELECPHRSIS FRACT/QUANT,19.0,12.35,4.75,19.0,37
CDM,30107910,HGB ELECPHRSIS FRACT/QUANT,50.0,32.5,5.78,45.0,37
CDM,30107915,FLECAINIDE BLOOD,141.0,91.65,5.81,126.9,37
CDM,30107920,HGB CHROMO FRACT/QUANT,34.0,22.1,2.81,30.6,37
CDM,30107925,DEXAMETHASONE SERUM,377.0,245.05,5.81,339.3,37
CDM,30107930,HGB CHROMO FRACT/QUANT,64.0,41.6,2.81,57.6,37
CDM,30107935,SULFONAMIDES,130.0,84.5,5.81,117.0,37
CDM,30107940,HISTAMINE ASSAY,72.0,46.8,13.39,64.8,37
CDM,30107950,*IMMUNOASSAY NONINF QUAL/SEMI,25.0,16.25,5.78,22.5,37
CDM,30107960,IMMUNOASSAY NONINF QUAL/SEMI,128.0,83.2,5.78,115.2,37
CDM,30107970,*IMMUNOASSAY NONINF QUAL/SEMI,388.0,252.2,5.78,349.2,37
CDM,30107975,IBUPROFEN,129.0,83.85,5.81,116.1,37
CDM,30107980,IMMUNOASSY NONINF QUAL/SEMI,50.0,32.5,5.78,45.0,37
CDM,30107985,MEXILETINE PLASMA,195.0,126.75,5.81,175.5,37
CDM,30107990,*IMMUNOASSY NONINF QUAL/SEMI,81.0,52.65,5.78,72.9,37
CDM,30108000,*IMMUNOASSY NONINF QUAL/SEMI,81.0,52.65,5.78,72.9,37
CDM,30108005,WARFARIN/COUMADIN CHRM,239.0,155.35,5.81,215.1,37
CDM,30108010,*IMMUNOASSY NONINF QUAL/SEMI,25.0,16.25,5.78,22.5,37
CDM,30108020,IMMUNOASSY NONINF QUAL/SEMI,28.0,18.2,5.78,25.2,37
CDM,30108030,IMMUNOASSY NONINF QUAL/SEMI,77.0,50.05,5.78,69.3,37
CDM,30108035,DIGITOXIN,128.0,83.2,5.81,115.2,37
CDM,30108040,IMMUNOASSY NONINF QUANT RIA,37.0,24.05,5.78,33.3,37
CDM,30108050,IMMUNOASSY NONINF QUANT RIA,103.0,66.95,5.78,92.7,37
CDM,30108060,IMMUNOASSY NONINF QUANT RIA,84.0,54.6,5.78,75.6,37
CDM,30108070,IMMUNOASSY NONINF QUANT RIA,186.0,120.9,5.78,167.4,37
CDM,30108080,RADIOIMMUNOASSAY (RIA),330.0,214.5,5.78,297.0,37
CDM,30108090,IMMUNOASSY NONINF QUANT RIA,50.0,32.5,5.78,45.0,37
CDM,30108100,IMMUNOASSY NONINF QUANT RIA,28.0,18.2,5.78,28.0,37
CDM,30108110,IMMUNOASSY NONINF QUANT RIA,185.0,120.25,5.78,166.5,37
CDM,30108120,IMMUNOASSY NONINF QUANT RIA,140.0,91.0,5.78,126.0,37
CDM,30108130,IMMUNOASSY NONINF QUANT RIA,43.0,27.95,5.78,38.7,37
CDM,30108140,*IMMUNOASSAY QUANT NOS,121.0,78.65,5.78,108.9,37
CDM,30108145,FREE CORTISOL URINE LCM,120.0,78.0,5.78,108.0,37
CDM,30108150,*IMMUNOASSAY QUANT NOS,24.0,15.6,5.78,24.0,37
CDM,30108155,FREE CORTISOL UR LCM X3,81.0,52.65,5.78,72.9,37
CDM,30108160,*IMMUNOASSAY QUANT NOS,110.0,71.5,5.78,99.0,37
CDM,30108170,*IMMUNOASSY QUANT NOS,110.0,71.5,5.78,99.0,37
CDM,30108175,"ALPHA GALACTOSIDASE, WBC",960.0,624.0,5.78,864.0,37
CDM,30108180,IMMUNOASSAY QUANT NOS,131.0,85.15,5.78,117.9,37
CDM,30108190,IMMUNOASSAY QUANT NOS,230.0,149.5,5.78,207.0,37
CDM,30108195,"ARYLSULFATASE A, WBC",766.0,497.9,5.78,689.4,37
CDM,30108200,IMMUNOASSAY QUANT NOS,570.0,370.5,5.78,513.0,37
CDM,30108205,NEURO CEROID LIPOFUCIN,648.0,421.2,5.78,583.2,37
CDM,30108210,IMMUNOASSAY QUANT NOS,275.0,178.75,5.78,247.5,37
CDM,30108220,IMMUNOASSAY QUANT NOS,98.0,63.7,5.78,88.2,37
CDM,30108230,IMMUNOASSAY QUANT NOS,140.0,91.0,5.78,126.0,37
CDM,30108240,IMMUNOASSAY QUANT NOS,133.0,86.45,5.78,119.7,37
CDM,30108250,IMMUNOASSAY QUANT NOS,47.0,30.55,5.78,42.3,37
CDM,30108260,IMMUNOASSAY QUANT NOS,245.0,159.25,5.78,220.5,37
CDM,30108265,NEURO CEROID LIPO CLN2,648.0,421.2,5.78,583.2,37
CDM,30108270,IMMUNOASSAY QUANT NOS,81.0,52.65,5.78,72.9,37
CDM,30108275,ALPHA GALACTOS SERUM,1154.0,750.1,5.78,1038.6,37
CDM,30108280,IMMUNOASSAY QUANT NOS,108.0,70.2,5.78,97.2,37
CDM,30108285,SIALIC ACID URINE,1417.0,921.05,5.78,1275.3,37
CDM,30108290,IMMUNOASSAY QUANT NOS,58.0,37.7,5.78,52.2,37
CDM,30108295,PORPHOBILINOGEN SERUM,449.0,291.85,5.78,404.1,37
CDM,30108300,*IMMUNOASSAY QUANT NOS,39.0,25.35,5.78,35.1,37
CDM,30108310,IMMUNOASSAY QUANT NOS,70.0,45.5,5.78,63.0,37
CDM,30108315,LONG CHAIN FATTY ACIDS,185.0,120.25,5.78,166.5,37
CDM,30108320,*IMMUNOASSAY QUANT NOS,39.0,25.35,5.78,35.1,37
CDM,30108325,HBSCN1 REFLEX,120.0,78.0,5.78,108.0,37
CDM,30108330,*IMMUNOASSAY QUANT NOS,39.0,25.35,5.78,35.1,37
CDM,30108335,TYSABRI ANTIBODIES,932.0,605.8,5.78,838.8,37
CDM,30108340,MAG ASSAY,108.0,70.2,2.59,97.2,37
CDM,30108345,IMMUNOASSAY (MYOSPL),51.0,33.15,5.78,45.9,37
CDM,30108350,MERCURY QUANT ASSAY,32.0,20.8,5.78,28.8,37
CDM,30108355,MAG ANTIBODY IGM,52.0,33.8,5.78,46.8,37
CDM,30108360,METANEPHRINES ASSAY,43.0,27.95,6.33,38.7,37
CDM,30108365,%CEPHAL IA QNTNOS NONABX4,319.0,207.35,5.78,287.1,37
CDM,30108370,METANEPHRINES ASSAY,48.0,31.2,6.33,43.2,37
CDM,30108375,RNA POLYMER III IGG,354.0,230.1,5.78,318.6,37
CDM,30108380,MYOGLOBIN ASSAY,19.0,12.35,4.75,19.0,37
CDM,30108385,U3 RNP AB,143.0,92.95,5.23,128.7,37
CDM,30108390,*NEPHELOMETRY ASSAY EA NOS,20.0,13.0,5.0,20.0,37
CDM,30108395,IMMUNOASSAY NONANTIBODY,123.0,79.95,5.78,110.7,37
CDM,30108400,NEPHELOMETRY ASSAY EA NOS,221.0,143.65,5.23,198.9,37
CDM,30108410,*NEPHELOMETRY ASSAY EA NOS,47.0,30.55,5.23,42.3,37
CDM,30108415,GANGLIOSIDE ABS X6,89.0,57.85,5.78,80.1,37
CDM,30108455,HU AUTOANTIBODY,340.0,221.0,5.78,306.0,37
CDM,30108465,NEOSEN NEURO PARANEO X3,294.0,191.1,5.78,264.6,37
CDM,30108495,%NGSMEL KIT,703.0,456.95,76.88,632.7,37
CDM,30108505,%NGSMEL NRAS,470.0,305.5,76.88,470.0,37
CDM,30108555,"14.3.3 ETA PROTEIN, SER",47.0,30.55,5.78,42.3,37
CDM,30108565,ETHYL GLUC UR SCRN,182.0,118.3,33.04,163.8,37
CDM,30108630,ORGANIC ACID SNGL QUANT,43.0,27.95,5.78,38.7,37
CDM,30108640,ORGANIC ACID SNGL QUANT,67.0,43.55,5.78,60.3,37
CDM,30108650,OSMOLALITY URINE ASSAY,10.0,6.5,2.5,10.0,37
CDM,30108660,PARATHYROID HORMONE ASSAY,73.0,47.45,16.61,68.98,37
CDM,30108670,*PHOSPHOROUS URINE ASSAY,128.0,83.2,2.59,115.2,37
CDM,30108680,*PORPHOBILINOGEN URINE QUANT,15.0,9.75,2.59,13.5,37
CDM,30108685,METHYLMALONIC ACID URINE,189.0,122.85,5.78,170.1,37
CDM,30108690,K URINE ASSAY,7.0,4.55,1.75,7.0,37
CDM,30108710,*PROTEIN TOTAL URINE ASSAY,8.0,5.2,2.0,7.2,37
CDM,30108720,*PROTEIN TOTAL URINE ASSAY,20.0,13.0,2.59,18.0,37
CDM,30108730,*PROTEIN ELECPHRSIS OTHER,59.0,38.35,5.78,53.1,37
CDM,30108735,CRMP-5 WB BAND ID,791.0,514.15,19.47,711.9,37
CDM,30108740,*PROTEIN ELECPHRSIS OTHER,59.0,38.35,5.78,53.1,37
CDM,30108745,%CEPHAL ISLET CELL AB,572.0,371.8,5.23,514.8,37
CDM,30108750,WESTERN BLOT TEST I&R,224.0,145.6,5.23,201.6,37
CDM,30108755,YO AUTOANTIBODY,890.0,578.5,5.78,801.0,37
CDM,30108760,WESTERN BLOT TEST I&R,64.0,41.6,5.23,57.6,37
CDM,30108765,CRMP 5 IGG WEST BLOT CSF,870.0,565.5,19.47,783.0,37
CDM,30108770,WESTERN BLOT TEST I&R BAND ID,224.0,145.6,19.47,201.6,37
CDM,30108775,%CJD WESTERN BLOT,75.0,48.75,18.75,67.5,37
CDM,30108780,WESTERN BLOT TEST I&R BAND ID,281.0,182.65,19.47,252.9,37
CDM,30108790,PROTOPORPHYRIN RBC QUANT,24.0,15.6,5.78,23.98,37
CDM,30108795,%SEQ2 HCG QUANT,73.0,47.45,6.33,65.7,37
CDM,30108800,NONENDOCRINE RECEPTOR ASSAY,56.0,36.4,13.39,56.0,37
CDM,30108805,BETA HCG QUANT SERUM,77.0,50.05,6.33,69.3,37
CDM,30108810,VIT B-2 ASSAY,176.0,114.4,5.78,158.4,37
CDM,30108820,SPECTROPHOTOMETRY NOS,97.0,63.05,2.59,87.3,37
CDM,30108825,B27PCR TEST,628.0,408.2,22.32,565.2,37
CDM,30108830,SPECTROPHOTOMETRY NOS,51.0,33.15,2.59,45.9,37
CDM,30108840,SPECTROPHOTOMETRY NOS,190.0,123.5,2.59,171.0,37
CDM,30108845,X C4 ACYLCARNITINE U,556.0,361.4,5.78,500.4,37
CDM,30108850,SPECTROPHOTOMETRY NOS,19.0,12.35,2.59,17.1,37
CDM,30108860,SPECTROPHOTOMETRY NOS,36.0,23.4,2.59,32.4,37
CDM,30108870,SPECTROPHOTOMETRY NOS,58.0,37.7,2.59,52.2,37
CDM,30108890,SPECTROPHOTOMETRY NOS,101.0,65.65,2.59,90.9,37
CDM,30108900,DRUG SCREEN QUANTALCOHOLS,143.0,92.95,33.04,143.0,37
CDM,30108910,ZINC ASSAY,73.0,47.45,5.78,65.7,37
CDM,30108920,ENZYME ACTIVITY NRADIOAC NOS,343.0,222.95,5.78,308.7,37
CDM,30108930,OXYCODONE,143.0,92.95,33.04,143.0,37
CDM,30108940,PROLACTIN ASSAY,47.0,30.55,6.33,42.3,37
CDM,30108945,HOMOVANILLIC ACID URINE,142.0,92.3,6.33,127.8,37
CDM,30108950,PROLACTIN ASSAY,32.0,20.8,6.33,32.0,37
CDM,30108960,MAGNESIUM RBC,149.0,96.85,2.59,134.1,37
CDM,30108965,RETINOL BINDING PROTEIN,129.0,83.85,5.23,116.1,37
CDM,30108970,*MAG ASSAY,67.0,43.55,2.59,60.3,37
CDM,30108975,PROLACTIN MACROADENOMA,67.0,43.55,6.33,60.3,37
CDM,30108980,MASS SPECTRMTRY QUANT EA,295.0,191.75,5.78,265.5,37
CDM,30108985,FECAL WT 24HR WET WEIGHT,19.0,12.35,3.19,17.1,27
CDM,30109015,MATRNL TEST,392.0,254.8,76.88,389.46,37
CDM,30109055,T GAMMA TEST,1572.0,1021.8,76.88,1414.8,37
CDM,30109065,HLADQ8 TEST,571.0,371.15,22.32,513.9,37
CDM,30109075,HLADQ2 TEST,571.0,371.15,22.32,513.9,37
CDM,30109085,CATHARITIC LAXATIVE UR,319.0,207.35,33.04,287.1,37
CDM,30109095,BLOOD GAS ARTERIAL (POINT OF CARE LAB),231.0,150.15,13.39,207.9,37
CDM,30109205,COLA12 COL1A2 TEST,2456.0,1596.4,614.0,2456.0,37
CDM,30109215,ALPHA 1 ANTRY STOOL,162.0,105.3,5.78,145.8,37
CDM,30109245,ARSENIC HAIR OR NAILS,440.0,286.0,5.78,396.0,37
CDM,30109255,ARSENIC URINE,145.0,94.25,5.78,130.5,37
CDM,30109275,CARBOHYDRATE DEF TRANSFER,505.0,328.25,5.78,454.5,37
CDM,30109285,CARBOHYDR DEF TRANS PED,242.0,157.3,5.78,217.8,37
CDM,30109295,CATECHOLAMINE FRAC UR,59.0,38.35,6.33,53.1,37
CDM,30109305,TOTAL ANTIOXIDANT CAPACITY,312.0,202.8,5.78,280.8,37
CDM,30109315,IBDSGI CHEMILUM X4,80.0,52.0,5.78,72.0,37
CDM,30109325,"COPPER, TISSUE",179.0,116.35,5.78,161.1,37
CDM,30109335,"CREATINE, URINE",98.0,63.7,2.59,88.2,37
CDM,30109340,T3/T4 UPTAKE,12.0,7.8,3.0,10.81,37
CDM,30109345,SULFONYLUREA HYPO URINE,256.0,166.4,33.04,230.4,37
CDM,30109350,*TESTOSTERONE TOTAL ASSAY,55.0,35.75,6.33,49.5,37
CDM,30109355,"DIURETIC SURVEY, URINE",231.0,150.15,33.04,207.9,37
CDM,30109365,18 HYDROXYCORTICOSTERONE,705.0,458.25,5.78,634.5,37
CDM,30109375,CHOLESTEROL BIO INTERMED,748.0,486.2,5.78,673.2,37
CDM,30109380,CAR AUTOANTIBODY,315.0,204.75,5.78,283.5,37
CDM,30109390,*CRYSTAL EXAM FLUID/TIS,72.0,46.8,2.59,64.8,37
CDM,30109395,PURINE PROFILE URINARYX2,419.0,272.35,2.59,377.1,37
CDM,30109400,*IMMUNOASSY NONINF QUAL/SEMI,25.0,16.25,5.78,22.5,37
CDM,30109410,AMYLASE,39.0,25.35,2.59,35.1,37
CDM,30109420,*GAMMAGLOBULIN ASSAY,57.0,37.05,2.59,51.3,37
CDM,30109430,HGB CHROMO FRACT/QUANT,25.0,16.25,2.81,25.0,37
CDM,30109435,%U17K CREATININE,47.0,30.55,2.59,42.3,37
CDM,30109450,COL CHROMOTOGRAPHY QUAL/QUAN,56.0,36.4,5.78,50.4,37
CDM,30109460,QUANT SERUM ACETONES/KETONES,55.0,35.75,2.59,49.5,37
CDM,30109465,CHYLOMICRON SCREEN,246.0,159.9,13.39,221.4,37
CDM,30109470,ASSAY FOR CALPROTECTIN FECAL,273.0,177.45,5.78,245.7,37
CDM,30109475,%SEQ2 ESTRIOL,117.0,76.05,6.33,105.3,37
CDM,30109495,GLYCOPROTEINS,312.0,202.8,5.78,280.8,37
CDM,30109500,*IMMUNOASSAY QUANT NOS,52.0,33.8,5.78,46.8,37
CDM,30109505,TITANIUM SER/PLAS,603.0,391.95,5.78,542.7,37
CDM,30109510,*IMMUNOASSY QUANT NOS,52.0,33.8,5.78,46.8,37
CDM,30109520,IMMUNOASSY QUANT NOS,40.0,26.0,5.78,36.0,37
CDM,30109525,NMRLIPO PARTICLE QT,50.0,32.5,12.5,50.0,37
CDM,30109530,AB ID PLT IG ASSAY,207.0,134.55,5.23,186.3,37
CDM,30109535,%STCATH MAGNESIUM,88.0,57.2,2.59,79.2,37
CDM,30109540,DRUG QUANT NOS ASSAY,74.0,48.1,5.81,66.6,37
CDM,30109545,MANGANESE URINE,190.0,123.5,5.78,171.0,37
CDM,30109555,%UTXM4 MERCURY,80.0,52.0,5.78,72.0,37
CDM,30109565,MERCURY URINE,128.0,83.2,5.78,115.2,37
CDM,30109575,%UTXM3 MERCURY,80.0,52.0,5.78,72.0,37
CDM,30109585,MYOGLOBIN URINE,83.0,53.95,5.78,74.7,37
CDM,30109595,ALK-P BONE SPECIFIC,86.0,55.9,5.78,77.4,37
CDM,30109600,PTH RELATED PEPTIDE,182.0,118.3,5.78,163.8,37
CDM,30109610,IMMUNOASSAY QUANT NOS,124.0,80.6,5.78,111.6,37
CDM,30109620,DRGTOF BENZODIAZEPINES1-12,143.0,92.95,33.04,143.0,37
CDM,30109630,PREGABALIN,143.0,92.95,33.04,143.0,37
CDM,30109635,THYROGLOBULIN FLUID,56.0,36.4,6.33,50.4,37
CDM,30109640,ALUM ASSAY,44.0,28.6,5.78,42.58,37
CDM,30109645,VITAMIN B5,583.0,378.95,5.78,524.7,37
CDM,30109650,ANGIOTENSIN 1 ENZYME TEST,21.0,13.65,5.25,21.0,37
CDM,30109655,VITAMIN B7 (BIOTIN),561.0,364.65,5.78,504.9,37
CDM,30109660,LDL CHOLESTEROL DIR ASSAY,19.0,12.35,2.59,17.55,37
CDM,30109665,PROPYLENE GLYCOL,536.0,348.4,5.78,482.4,37
CDM,30109670,FRUCTOSE SEMEN ASSAY,39.0,25.35,5.78,35.1,37
CDM,30109675,TOLUENE BLOOD,352.0,228.8,5.78,316.8,37
CDM,30109680,OSMOLALITY URINE ASSAY,10.0,6.5,2.5,10.0,37
CDM,30109695,COMPLEMENT FACTOR B,321.0,208.65,5.23,288.9,37
CDM,30109705,%ABLQUL BCR/ABL1 MAJ,1198.0,778.7,76.88,1078.2,37
CDM,30109735,HUMAN TGB-B1,231.0,150.15,5.78,207.9,37
CDM,30109745,LP-PLA2 ACTIVITY,83.0,53.95,13.39,77.38,37
CDM,30109750,*ALBUMIN SERUM ASSAY,26.0,16.9,2.59,23.4,37
CDM,30109755,DRGTOF FENTANYL AND METABOLITE,162.0,105.3,33.04,162.0,37
CDM,30109760,VIT D 25 HYDROXY ASSAY,53.0,34.45,13.25,49.46,37
CDM,30109770,CORTISOL TOTAL,103.0,66.95,6.33,92.7,37
CDM,30109775,GROWTH DIFF FACTOR 15,204.0,132.6,5.78,183.6,37
CDM,30109780,*IMMUNOASSAY QUANT NOS,39.0,25.35,5.78,35.1,37
CDM,30109785,PROCAINAMIDE/NAPA,33.0,21.45,5.81,29.7,37
CDM,30109790,LEAD ASSAY,21.0,13.65,5.25,20.24,37
CDM,30109795,%NGSMEL BRAF,338.0,219.7,76.88,304.2,37
CDM,30109800,NEPHELOMETRY ASSAY EA NOS,20.0,13.0,5.0,20.0,37
CDM,30109810,*NEPHELOMETRY ASSAY EA NOS,79.0,51.35,5.23,71.1,37
CDM,30109820,MAG ASSAY,47.0,30.55,2.59,42.3,37
CDM,30109830,ANTIEPILEPTICS NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30109840,PHENOBARBITAL ASSAY,40.0,26.0,5.81,36.0,37
CDM,30109845,COL3A1 DELETION/DUP ANLS,2012.0,1307.8,325.19,1810.8,37
CDM,30109850,PHOSPHOROUS URINE ASSAY,128.0,83.2,2.59,115.2,37
CDM,30109855,%KITGN KIT TARGET SEQ,867.0,563.55,76.88,780.3,37
CDM,30109860,"TOXIC METAL, QUANT EA",46.0,29.9,5.78,41.4,37
CDM,30109865,HLABC TEST,1498.0,973.7,170.1,1348.2,37
CDM,30109870,GABITRIL SERUM,43.0,27.95,5.81,43.0,37
CDM,30109880,"THYROGLOBULIN, FNA",57.0,37.05,6.33,51.3,37
CDM,30109885,HLADR TEST,729.0,473.85,22.32,656.1,37
CDM,30109890,"PH BODY FLUID, NES",20.0,13.0,2.59,18.0,37
CDM,30109900,"*PROTEIN ELECT, UR 24 HR",8.0,5.2,2.0,7.2,37
CDM,30109910,"*PROTEIN ELECT, UR 24 HR",8.0,5.2,2.0,7.2,37
CDM,30109930,*PRO-PREDICTR METAB,180.0,117.0,5.78,162.0,37
CDM,30109940,INTERLEUKIN 2 RECEPTOR,172.0,111.8,13.39,154.8,37
CDM,30109950,COL CHROMOTOGRAPHY QUAL/QUAN,254.0,165.1,5.78,228.6,37
CDM,30109960,MANNOSE BINDING LECTIN,143.0,92.95,5.78,128.7,37
CDM,30109970,CREATININE BLOOD ASSAY,86.0,55.9,2.59,77.4,37
CDM,30109980,COL CHROMOTOGRAPHY QUAL/QUAN,333.0,216.45,5.78,299.7,37
CDM,30109985,MYENGS PANEL NGS,5217.0,3391.05,1109.84,4878.65,37
CDM,30109990,IA 2 AB,79.0,51.35,5.78,71.1,37
CDM,30109995,ERBB2 GENE ANALYSIS,54.0,35.1,9.07,48.6,27
CDM,30110020,*CYSTIC FIBROSIS CARRIER SCR,699.0,454.35,170.1,699.0,37
CDM,30110025,BICARONATE URINE,56.0,36.4,2.59,50.4,37
CDM,30110035,CORTISOL PLASMA,188.0,122.2,6.33,169.2,37
CDM,30110045,TRIMETHYLAMINE N-OXIDE,131.0,85.15,5.78,117.9,37
CDM,30110055,%NEUR CHROMAT QN,286.0,185.9,5.78,257.4,37
CDM,30110065,ESTRADIOL TANDEM MASS SP,206.0,133.9,6.33,185.4,37
CDM,30110075,"IMGLB IGG, A, M X3",81.0,52.65,2.59,72.9,37
CDM,30110085,"IMMUNOGLOB D QT, SERUM",119.0,77.35,2.59,107.1,37
CDM,30110095,OXY DISSOC P50 BY HEMOX,1098.0,713.7,2.81,988.2,37
CDM,30110125,SGPG ANTIBODY IGM,197.0,128.05,5.78,177.3,37
CDM,30110135,ANTI-C1Q AB IGG,426.0,276.9,5.78,383.4,37
CDM,30110155,ANTI-HMGCR AUTO AB,829.0,538.85,5.78,746.1,37
CDM,30110165,LIPOPROTEIN ELECTROPHOR,327.0,212.55,5.78,294.3,37
CDM,30110185,RFLX IMMUNBLOT PARCSF,168.0,109.2,19.47,151.2,37
CDM,30110190,ALPHA-FETOPROTEIN L3,318.0,206.7,13.39,286.2,37
CDM,30110195,PARA AB WB CSF,878.0,570.7,19.47,790.2,37
CDM,30110200,IMMUNOASSAY QUANT NOS,330.0,214.5,5.78,297.0,37
CDM,30110210,IMMUNOASSAY NONINF QUAL/SEMI,75.0,48.75,5.78,67.5,37
CDM,30110215,"ADENOSINE DEAMINASE, PF",188.0,122.2,2.59,169.2,37
CDM,30110220,"TOTAL LIPID FATTY ACID PROFILE, RBC",237.0,154.05,5.78,213.3,37
CDM,30110230,*TESTOSTERONE TOTAL ASSAY,55.0,35.75,6.33,49.5,37
CDM,30110235,"ADENOSINE DEAMINASE, SER",172.0,111.8,2.59,154.8,37
CDM,30110240,*SEX HORMONE BINDING GLOBULIN,166.0,107.9,5.78,149.4,37
CDM,30110245,GLYCOMARK,81.0,52.65,5.78,72.9,37
CDM,30110250,*TESTOSTERONE TOTAL ASSAY,55.0,35.75,6.33,49.5,37
CDM,30110260,*SEX HORMONE BINDING GLOBULIN,32.0,20.8,5.78,32.0,37
CDM,30110265,"OXYCODONE SCRN, UR",99.0,64.35,24.75,99.0,37
CDM,30110305,CANVAN TEST,1620.0,1053.0,22.32,1458.0,37
CDM,30110380,BLOOD GAS,261.0,169.65,32.49,234.9,37
CDM,30110390,THYROID STIMULATING HORMONE (TSH),156.0,101.4,6.33,140.4,37
CDM,30110400,*FE ASSAY,144.0,93.6,2.59,129.6,37
CDM,30110410,*FE BINDING CAPACITY,80.0,52.0,2.59,72.0,37
CDM,30110420,*GAMMAGLOBULIN IGG SUBCLASS EA,12.0,7.8,2.59,12.0,37
CDM,30110430,*GAMMAGLOBULIN IGG SUBCLASS EA,12.0,7.8,2.59,12.0,37
CDM,30110440,*GAMMAGLOBULIN ASSAY IGE,111.0,72.15,5.78,99.9,37
CDM,30110450,*GAMMAGLOBULIN ASSAY,57.0,37.05,2.59,51.3,37
CDM,30110460,*GAMMAGLOBULIN ASSAY,57.0,37.05,2.59,51.3,37
CDM,30110470,VITAMIN D 25 HYDROXY,169.0,109.85,13.39,152.1,37
CDM,30110690,*CFTR GENE FULL SEQUENCE,1241.0,806.65,170.1,1116.9,37
CDM,30110700,*MOPATH PROCEDURE LEVEL 5,1576.0,1024.4,76.88,1418.4,37
CDM,30110710,*UNLISTED MOLECULAR PATHOLOGY,1419.0,922.35,22.32,1277.1,27
CDM,30110720,*EGFR GENE COM VARIANTS,1310.0,851.5,170.1,1179.0,37
CDM,30110730,*MICRODISSECTION MANUAL,182.0,118.3,22.32,163.8,37
CDM,30110740,*TRB@ GENE REARRANGE DIRPROBE,182.0,118.3,22.32,163.8,37
CDM,30110750,CFTR GENE COM VARIANTS,699.0,454.35,170.1,699.0,37
CDM,30110760,CFTR GENE COM VARIANTS,699.0,454.35,170.1,699.0,37
CDM,30110770,F2 GENE,86.0,55.9,21.5,86.0,37
CDM,30110780,MTHFR BY PCR,140.0,91.0,22.32,126.0,37
CDM,30110790,SERPINA1 GENE,77.0,50.05,19.25,72.94,37
CDM,30110800,MOPATH PROCEDURE LEVEL 5,1051.0,683.15,76.88,945.9,37
CDM,30110810,FMR1 GENE DETECTION,414.0,269.1,22.32,372.6,37
CDM,30110820,MOPATH PROCEDURE LEVEL 1,762.0,495.3,22.32,685.8,37
CDM,30110830,GBA GENE,675.0,438.75,22.32,607.5,37
CDM,30110840,MOPATH PROCEDURE LEVEL 4,636.0,413.4,76.88,572.4,37
CDM,30110850,MOPATH PROCEDURE LEVEL 2,1456.0,946.4,76.88,1310.4,37
CDM,30110860,HFE GENE,191.0,124.15,22.32,171.9,37
CDM,30110870,F5 GENE,95.0,61.75,22.32,95.0,37
CDM,30110880,BCR/ABL1 GENE MAJOR BP,1029.0,668.85,76.88,926.1,37
CDM,30110890,MOPATH PROCEDURE LEVEL 2,883.0,573.95,76.88,794.7,37
CDM,30110900,HLA I TYPING 1 LOCUS HR,471.0,306.15,76.88,423.9,37
CDM,30110910,HLA II TYPING 1 LOCUS LR,454.0,295.1,22.32,408.6,37
CDM,30110920,KRAS GENE,783.0,508.95,76.88,704.7,37
CDM,30110930,UNLISTED MOLECULAR PATHOLOGY,362.0,235.3,22.32,325.8,27
CDM,30110940,TRG GENE REARRANGEMENT ANAL,281.0,182.65,70.25,281.0,37
CDM,30110950,JAK2 GENE,233.0,151.45,22.32,209.7,37
CDM,30110960,"HLA ALLELE, EA",681.0,442.65,76.88,612.9,37
CDM,30110970,*EGFR GENE COM VARIANTS,619.0,402.35,154.75,557.1,37
CDM,30110980,GAMMAGLOBULIN ASSAY,57.0,37.05,2.59,51.3,37
CDM,30110990,IMMUNOASSY NONINF QUAL/SEMI,47.0,30.55,5.78,42.3,37
CDM,30110WE,"EXCISION NOSE POLYP(S),SIMPLE",672.0,436.8,84.04,504.0,35
CDM,30111000,DRUG SCREEN QUANT EVEROLIMUS,68.0,44.2,5.81,61.2,37
CDM,30111010,UNLISTED MOLECULAR PATHOLOGY,406.0,263.9,22.32,365.4,27
CDM,30111020,EGFR GENE COM VARIANTS,1091.0,709.15,170.1,981.9,37
CDM,30111030,MOPATH PROCEDURE LEVEL 2,353.0,229.45,76.88,317.7,37
CDM,30111040,ALKA PHOSPHTAS ISOENZYME,87.0,56.55,5.78,78.3,37
CDM,30111050,MOPATH PROCEDURE LEVEL 1,168.0,109.2,22.32,151.2,37
CDM,30111060,UNLISTED MOLECULAR PATHOLOGY,779.0,506.35,22.32,701.1,27
CDM,30111070,LAC (LD)(LDH),22.0,14.3,2.59,19.8,37
CDM,30111080,*CA URINE QUANT TIMED,10.0,6.5,2.5,10.0,37
CDM,30111090,*CREATININE OTHER SOURCE ASSAY,10.0,6.5,2.5,9.0,37
CDM,30111100,*CITRATE ASSAY,50.0,32.5,12.5,46.45,37
CDM,30111110,*OXALATE ASSAY,22.0,14.3,5.5,22.0,37
CDM,30111120,*NA URINE ASSAY,9.0,5.85,2.25,8.46,37
CDM,30111130,*ARSENIC ASSAY,35.0,22.75,5.78,31.7,37
CDM,30111140,LEAD UR 24HR,21.0,13.65,5.25,20.24,37
CDM,30111150,MERCURY QUANT,28.0,18.2,5.78,27.17,37
CDM,30111160,"CADMIUM, WHOLE BLOOD",41.0,26.65,5.78,39.5,37
CDM,30111170,AMINO ACID SINGL QUANT,77.0,50.05,5.78,69.3,37
CDM,30111190,HBA1/HBA2 GENE,769.0,499.85,22.32,692.1,37
CDM,30111200,*GAMMAGLOBULIN ASSAY,186.0,120.9,2.59,167.4,37
CDM,30111210,*IMMUNOASSAY NONINF QUAL/SEMI,186.0,120.9,5.78,167.4,37
CDM,30111220,IMMUNOASSAY NONINF QUAL/SEMI,56.0,36.4,5.78,50.4,37
CDM,30111230,IMMUNOASSAY NONINF QUAL/SEMI,44.0,28.6,5.78,39.6,37
CDM,30111240,*HLA I TYPING COMPLETE LR,565.0,367.25,141.25,565.0,37
CDM,30111250,*HLA II TYPING AG EQUIV LR,382.0,248.3,76.88,368.86,37
CDM,30111260,*HLA II TYPING 1 LOCUS LR,545.0,354.25,22.32,490.5,37
CDM,30111270,"HLA-A,B,CW,DR,DQ,DRB345-RSSOP",1164.0,756.6,170.1,1047.6,37
CDM,30111280,*URIC ACID OTHER SOURCE ASSAY,9.0,5.85,2.25,8.49,37
CDM,30111340,*DRUG QUANT NOS ASSAY,76.0,49.4,5.81,68.4,37
CDM,30111350,TACROLIMUS ASSAY,77.0,50.05,5.81,69.3,37
CDM,30111360,SIROLIMUS ASSAY,74.0,48.1,5.81,66.6,37
CDM,30111370,CYCLOSPORINE ASSAY,95.0,61.75,5.81,85.5,37
CDM,30111380,HEPATITIS ACUTE PANEL,255.0,165.75,4.31,229.5,37
CDM,30111390,MOPATH PROCEDURE LEVEL 4,636.0,413.4,76.88,572.4,37
CDM,30111400,*TRB@GENE REARRANGE AMPLIFY,515.0,334.75,76.88,463.5,37
CDM,30111410,*TRG GENE REARRANGEMENT ANAL,515.0,334.75,76.88,463.5,37
CDM,30111420,*GAMMAGLOBULIN ASSAY IGE,111.0,72.15,5.78,99.9,37
CDM,30111430,DRUG/SUBSTANCE NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30111440,HLA I TYPING COMPLETE LR,629.0,408.85,157.25,629.0,37
CDM,30111450,HLA II TYPING 1 LOCUS LR,629.0,408.85,22.32,566.1,37
CDM,30111490,COLUMN CHROM QUANT,190.0,123.5,5.78,171.0,37
CDM,30111500,MOLEC PATH LEVEL II,1278.0,830.7,76.88,1150.2,37
CDM,30111510,NEPHELOMETRY EA ANALYTE NES,79.0,51.35,5.23,71.1,37
CDM,30111520,NEPHELOMETRY EA ANALYTE NES,79.0,51.35,5.23,71.1,37
CDM,30111530,PROTEIN E-PHORESIS/URINE/CSF,40.0,26.0,5.78,36.0,37
CDM,30111540,MOPATH PROCEDURE LEVEL 2,1299.0,844.35,76.88,1169.1,37
CDM,30111550,GALECTIN 3,105.0,68.25,13.39,94.5,37
CDM,30111560,RIA NONANTIBODY,1472.0,956.8,5.78,1324.8,37
CDM,30111570,OXALATE,195.0,126.75,5.78,175.5,37
CDM,30111580,COPPER TISSUE,169.0,109.85,5.78,152.1,37
CDM,30111590,UNLISTED MOLECULAR PATHOLOGY,57.0,37.05,9.58,51.3,27
CDM,30111600,*MOPATH PROCEDURE LEVEL5,1208.0,785.2,76.88,1087.2,37
CDM,30111610,*CFTR GENE INTRON POLY T,1208.0,785.2,76.88,1087.2,37
CDM,30111620,PROINSULIN,147.0,95.55,6.33,132.3,37
CDM,30111630,TRANSFERRIN,68.0,44.2,5.78,61.2,37
CDM,30111640,HLA I & II TYPING LR,1164.0,756.6,170.1,1047.6,37
CDM,30111650,WESTERN BLOT TEST I&R BAND ID,281.0,182.65,19.47,252.9,37
CDM,30111660,IMMUNOASSAY NONINF QUAL/SEMI,281.0,182.65,5.78,252.9,37
CDM,30111670,WESTERN BLOT TEST I&R,330.0,214.5,5.23,297.0,37
CDM,30111680,IMMUNOASSAY NONINF QUAL/SEMI,53.0,34.45,5.78,47.7,37
CDM,30111690,IGH VARI REGIONAL MUTATION,859.0,558.35,76.88,773.1,37
CDM,30111700,CREATINE,74.0,48.1,2.59,66.6,37
CDM,30111710,HLA 1 & II TYPING LR,1164.0,756.6,170.1,1047.6,37
CDM,30111720,*LIPID PANEL,28.0,18.2,4.31,25.2,37
CDM,30111730,*TSI ASSAY,74.0,48.1,16.61,74.0,37
CDM,30111740,*IMMUNOASSAY QUANT NOS,98.0,63.7,5.78,88.2,37
CDM,30111750,*IMMUNOASSAY NONINF QUAL/SEMI,65.0,42.25,5.78,58.5,37
CDM,30111760,*IMMUNOASSAY NONINF QUAL/SEMI,65.0,42.25,5.78,58.5,37
CDM,30111770,*IMMUNOASSAY QUANT NOS,98.0,63.7,5.78,88.2,37
CDM,30111780,IMMUNOASSAY QUANT NOS,124.0,80.6,5.78,111.6,37
CDM,30111790,DRUG QUANT NOS ASSAY,94.0,61.1,5.81,84.6,37
CDM,30111800,AMINO ACID >=6 QUANT EA,392.0,254.8,5.78,352.8,37
CDM,30111810,"*ACTH STIMULATION, 3 TIME POINT",290.0,188.5,16.61,261.0,37
CDM,30111820,HLA I TYPING 1 ALLELE HR,318.0,206.7,76.88,286.2,37
CDM,30111830,IMMUNOASSAY NONINF QUAL/SEMI,75.0,48.75,5.78,67.5,37
CDM,30111840,IMMUNOASSAY NONINF QUAL/SEMI,75.0,48.75,5.78,67.5,37
CDM,30111850,*APOLIPOPROTEIN EA ASSAY,67.0,43.55,5.78,60.3,37
CDM,30111860,*TOTAL BILIRUBIN,67.0,43.55,2.59,60.3,37
CDM,30111870,*GLUTAMYLTRANSFERASE GAMMA,67.0,43.55,2.59,60.3,37
CDM,30111880,*HAPTOGLOBIN QUANT ASSAY,67.0,43.55,5.78,60.3,37
CDM,30111890,*NEPHELOMETRY ASSAY EA NOS,67.0,43.55,5.23,60.3,37
CDM,30111900,*TRANSFERASE; ALANINE AMINO,67.0,43.55,2.59,60.3,37
CDM,30111910,LDL CHOLESTEROL DIR ASSAY,59.0,38.35,2.59,53.1,37
CDM,30111920,*BLOOD GAS MIXED WO O2 SAT,237.0,154.05,13.39,213.3,37
CDM,30111930,SODIUM,73.0,47.45,2.59,65.7,37
CDM,30111940,*POTASSIUM SERUM,56.0,36.4,2.59,50.4,37
CDM,30111950,*GLUCOSE QUANT,80.0,52.0,2.59,72.0,37
CDM,30111960,*CALCIUM IONIZED,133.0,86.45,5.78,119.7,37
CDM,30111970,CHIMERISM ANAL NO CELL SELEC,364.0,236.6,76.88,346.67,37
CDM,30111980,CHIMERISM ANAL NO CELL SELEC,530.0,344.5,76.88,477.0,37
CDM,30112000,SPECTROPHOTOMETRY NOS,12.0,7.8,2.59,12.0,37
CDM,30112010,MOPATH PROCEDURE LEVEL 2,174.0,113.1,43.5,174.0,37
CDM,30112020,*IMMUNOASSAY NONINF QUAL/SEMI,34.0,22.1,5.78,30.6,37
CDM,30112030,*IMMUNOASSAY NONINF QUAL/SEMI,34.0,22.1,5.78,30.6,37
CDM,30112040,IMMUNOASSAY NONINF QUAL/SEMI,44.0,28.6,5.78,39.6,37
CDM,30112050,IMMUNOASSAY NONINF QUAL/SEMI,44.0,28.6,5.78,39.6,37
CDM,30112060,*IMMUNOASSAY NONINF QUAL/SEMI,116.0,75.4,5.78,104.4,37
CDM,30112070,UNLISTED CHEMISTRY TEST,191.0,124.15,5.78,171.9,27
CDM,30112080,*ALPHA-1-ANTITRYPSIN; TOTAL,19.0,12.35,4.75,19.0,37
CDM,30112090,*ALPHA-1-ANTITRYPSIN PHENOTYPE,24.0,15.6,5.78,24.0,37
CDM,30112100,*HEAVY METAL; QUAN,212.0,137.8,5.78,190.8,37
CDM,30112120,UREA NITROGEN; QUAN,8.0,5.2,2.0,7.2,37
CDM,30112130,ASSAY OF HOMOCYSTINE,24.0,15.6,6.0,24.0,37
CDM,30112140,DRUG TEST DEF 1-7 CLASSES,143.0,92.95,33.04,143.0,37
CDM,30112150,ASSAY OF HOMOCYSTINE,25.0,16.25,6.25,25.0,37
CDM,30112160,SPECTROPHOTOMETRY NOS,99.0,64.35,2.59,89.1,37
CDM,30112170,COPPER,80.0,52.0,5.78,72.0,37
CDM,30112180,DIGOXIN FREE,276.0,179.4,5.81,248.4,37
CDM,30112190,VALPROIC ACID FREE,29.0,18.85,5.81,26.1,37
CDM,30112270,ALCOHOLS,143.0,92.95,33.04,143.0,37
CDM,30112280,ALCOHOLS,143.0,92.95,33.04,143.0,37
CDM,30112290,ALKALOIDS NOS,143.0,92.95,33.04,143.0,37
CDM,30112300,AMPHETAMINES; 1 OR 2,143.0,92.95,33.04,143.0,37
CDM,30112310,ANABOLIC STEROID 1 OR 2,143.0,92.95,33.04,143.0,37
CDM,30112320,ANALGESICS NON-OPIOID 1 OR 2,143.0,92.95,33.04,143.0,37
CDM,30112330,ANALGESICS NON-OPIOID 1 OR 2,143.0,92.95,33.04,143.0,37
CDM,30112340,ANALGESICS NON-OPIOID 1 OR 2,143.0,92.95,33.04,143.0,37
CDM,30112350,ANTIDEPRESSANT TRICYCLIC 1/2,143.0,92.95,33.04,143.0,37
CDM,30112360,ANTIDEPRESSANT TRICYCLIC 1/2,143.0,92.95,33.04,143.0,37
CDM,30112370,ANTIDEPRESSANT TRICYCLIC 1/2,143.0,92.95,33.04,143.0,37
CDM,30112380,ANTIDEPRESSANT TRICYCLIC 1/2,143.0,92.95,33.04,143.0,37
CDM,30112390,ANTIEPILEPTICS NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30112400,ANTIPSYCHOTICS NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30112410,BARBITURATES,143.0,92.95,33.04,143.0,37
CDM,30112420,BARBITURATES,143.0,92.95,33.04,143.0,37
CDM,30112430,BENZODIAZEPINES1-12,143.0,92.95,33.04,143.0,37
CDM,30112440,COCAINE,143.0,92.95,33.04,143.0,37
CDM,30112450,METHADONE,143.0,92.95,33.04,143.0,37
CDM,30112460,OPIATES 1 OR MORE,143.0,92.95,33.04,143.0,37
CDM,30112470,OPIOIDS & OPIATE ANALOGS 1/2,143.0,92.95,33.04,143.0,37
CDM,30112480,OPIOIDS & OPIATE ANALOGS 3/4,143.0,92.95,33.04,143.0,37
CDM,30112490,OPIOID &OPIATE ANALOG 5/MORE,143.0,92.95,33.04,143.0,37
CDM,30112500,DRUG/SUBSTANCE NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30112510,FLT3 GENE ANALYSIS,107.0,69.55,22.32,107.0,37
CDM,30112520,MLH1 GENE,747.0,485.55,76.88,672.3,37
CDM,30112530,PCA3/KLK3 ANTIGEN,866.0,562.9,76.88,779.4,37
CDM,30112540,GNMC SEQ ANLYS SOLID ORGAN 5-50 G,743.0,482.95,170.1,743.0,37
CDM,30112550,GNMC SEQ ANLYS HMTLYMPHD 5-50 G,942.0,612.3,235.5,942.0,37
CDM,30112560,GNMC SEQ ANLYS 51+ GENES,3581.0,2327.65,895.25,3581.0,37
CDM,30112570,PHENCYCLIDINE (PCP),76.0,49.4,19.0,125.87,37
CDM,30112580,ANTIDEPRESSANT TRICYCLIC 1/2,143.0,92.95,33.04,143.0,37
CDM,30112590,ANTIDEPRESSANT TRICYCLIC 1/2,143.0,92.95,33.04,143.0,37
CDM,30112600,BENZODIAZEPINES1-12,143.0,92.95,33.04,143.0,37
CDM,30112610,DRUG QUANT NOS ASSAY,114.0,74.1,5.81,102.6,37
CDM,30112620,IMMUNOASSAY QUANT NOS,98.0,63.7,5.78,88.2,37
CDM,30112630,UNLISTED MOLECULAR PATHOLOGY,594.0,386.1,22.32,534.6,27
CDM,30112640,BENZODIAZEPINES1-12,143.0,92.95,33.04,143.0,37
CDM,30112650,DRUG SCREENING BARBITURATES,143.0,92.95,33.04,143.0,37
CDM,30112660,PCP QUAN ASSAY,76.0,49.4,19.0,125.87,37
CDM,30112670,MOPATH PROCEDURE LEVEL 5,343.0,222.95,76.88,343.0,37
CDM,30112680,SERPINA1 GENE,80.0,52.0,20.0,72.94,37
CDM,30112690,ALPHA-1-ANTITRYPSIN; TOTAL,36.0,23.4,5.78,32.4,37
CDM,30112700,KIT GENE TARGETED SEQ ANALYS,1103.0,716.95,76.88,992.7,37
CDM,30112710,ESTROGENS; FRACTIONATED,69.0,44.85,16.61,62.1,37
CDM,30112720,ENZYME ACTIVITY BC; NOT RA,267.0,173.55,5.78,240.3,37
CDM,30112730,UNLISTED MOLECULAR PATHOLOGY,686.0,445.9,22.32,617.4,27
CDM,30112740,MAGNESIUM,88.0,57.2,2.59,79.2,37
CDM,30112750,PHOSPHATE,88.0,57.2,2.59,79.2,37
CDM,30112760,DRUG/SUBSTANCE NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30112770,NICKEL,64.0,41.6,5.78,57.6,37
CDM,30112780,IMMUNOASSAY QUANT NOS NONAB,350.0,227.5,5.78,315.0,37
CDM,30112790,BCR/ABL1 GENE MAJOR BP,231.0,150.15,57.75,231.0,37
CDM,30112800,BCR/ABL1 GENE MINOR BP,206.0,133.9,51.5,206.0,37
CDM,30112810,CREATININE BLOOD ASSAY,86.0,55.9,2.59,77.4,37
CDM,30112820,DRUG QUANT NOS ASSAY,94.0,61.1,5.81,84.6,37
CDM,30112830,ANTIDEPRESSANT TRICYCLIC 1/2,143.0,92.95,33.04,143.0,37
CDM,30112840,CANNABINOIDS NATURAL,143.0,92.95,33.04,143.0,37
CDM,30112850,CFTR GENE COM VARIANTS,798.0,518.7,170.1,798.0,37
CDM,30112860,CYP2D6 GENE COM VARIANTS,616.0,400.4,154.0,616.0,37
CDM,30112870,FLT3 GENE,484.0,314.6,76.88,435.6,37
CDM,30112880,FLT3 GENE ANALYSIS,107.0,69.55,22.32,107.0,37
CDM,30112890,IGH GENE REARRANGE AMP METH,492.0,319.8,76.88,442.8,37
CDM,30112900,IGH VARI REGIONAL MUTATION,624.0,405.6,76.88,561.6,37
CDM,30112910,IGK REARRANGEABN CLONAL POP,492.0,319.8,76.88,442.8,37
CDM,30112920,JAK2 GENE,382.0,248.3,22.32,343.8,37
CDM,30112930,NPM1 GENE,425.0,276.25,76.88,411.93,37
CDM,30112940,TRG GENE REARRANGEMENT ANAL,362.0,235.3,76.88,336.71,37
CDM,30112950,HLA II TYPING 1 ALLELE HR,446.0,289.9,22.32,401.4,37
CDM,30112960,MOPATH PROCEDURE LEVEL 2,496.0,322.4,76.88,446.4,37
CDM,30112970,ABL1 GENE,389.0,252.85,76.88,389.0,37
CDM,30112980,MOPATH PROCEDURE LEVEL 4,455.0,295.75,76.88,409.5,37
CDM,30112990,MOPATH PROCEDURE LEVEL 4,231.0,150.15,57.75,231.0,37
CDM,30113000,CALR GENE COM VARIANTS,446.0,289.9,22.32,401.4,37
CDM,30113010,UNLISTED MOLECULAR PATHOLOGY,447.0,290.55,22.32,402.3,27
CDM,30113020,UNLISTED MAAA,356.0,231.4,22.32,320.4,27
CDM,30113030,TRICYCLIC & CYCLICALS 6/MORE,143.0,92.95,33.04,143.0,37
CDM,30113040,ENZYME ACTIVITY BC; NOT RA,486.0,315.9,5.78,437.4,37
CDM,30113060,SPECTROPHOTOMETRY ANALYTE NES,176.0,114.4,2.59,158.4,37
CDM,30113070,SPECTROPHOTOMETRY ANALYTE NES,130.0,84.5,2.59,117.0,37
CDM,30113080,SPECTROPHOTOMETRY ANALYTE NES,86.0,55.9,2.59,77.4,37
CDM,30113090,SPECTROPHOTOMETRY ANALYTE NES,86.0,55.9,2.59,77.4,37
CDM,30113100,SUGARS; SINGLE QUAL EA SPECIMEN,19.0,12.35,2.59,17.1,37
CDM,30113110,COL CHROMOTOGRAPHY QUAL/QUAN,378.0,245.7,5.78,340.2,37
CDM,30113120,DRUG/SUBSTANCE NOS 1-3,143.0,92.95,33.04,143.0,37
CDM,30113150,BLOOD GAS O2 SATUR ONLY,89.0,57.85,2.59,80.1,37
CDM,30113160,DRUG QUANT NOS ASSAY,146.0,94.9,5.81,131.4,37
CDM,30113170,CREATININE BLOOD ASSAY,86.0,55.9,2.59,77.4,37
CDM,30113180,BCR/ABL1 GENE MAJOR BP,299.0,194.35,74.75,273.98,37
CDM,30113190,BCR/ABL1 GENE MINOR BP,299.0,194.35,74.75,269.1,37
CDM,30113200,BCR/ABL1 GENE OTHER BP,299.0,194.35,74.75,299.0,37
CDM,30113210,BRAF GENE,424.0,275.6,76.88,381.6,37
CDM,30113220,KRAS GENE VARIANTS EXON 2,370.0,240.5,76.88,333.0,37
CDM,30113230,KRAS GENE ADDL VARIANTS,370.0,240.5,76.88,333.0,37
CDM,30113240,MGMT GENE METHYLATION ANAL,999.0,649.35,22.32,899.1,37
CDM,30113250,HLA II TYPING 1 LOCUS LR,254.0,165.1,22.32,228.6,37
CDM,30113260,MOPATH PROCEDURE LEVEL 4,1198.0,778.7,76.88,1078.2,37
CDM,30113270,MOPATH PROCEDURE LEVEL 4,382.0,248.3,76.88,343.8,37
CDM,30113280,UNLISTED MOLECULAR PATHOLOGY,11.0,7.15,1.85,28.19,27
CDM,30113290,CHEMILUMINESCENT ASSAY,48.0,31.2,5.78,43.2,37
CDM,30113300,CHEMILUMINESCENT ASSAY,230.0,149.5,5.78,207.0,37
CDM,30113310,CHROMIUM,100.0,65.0,5.78,90.0,37
CDM,30113320,HGB; PLASMA,36.0,23.4,2.59,32.4,37
CDM,30113330,IMMUNOASSAY QUANT NOS NONAB,113.0,73.45,5.78,101.7,37
CDM,30113340,LEUCINE AMINOPEPTIDASE,164.0,106.6,2.59,147.6,37
CDM,30113350,PROTEIN WB; IM ID FOR BANDS,76.0,49.4,19.0,68.4,37
CDM,30113360,TESTOSTERONE; FREE,63.0,40.95,6.33,56.7,37
CDM,30113370,TRANSCORTIN,120.0,78.0,6.33,108.0,37
CDM,30113380,*BRAF GENE,311.0,202.15,76.88,293.09,37
CDM,30113390,*KRAS GENE VARIANTS EXON 2,311.0,202.15,76.88,311.0,37
CDM,30113400,*MOPATH PROCEDURE LEVEL 5,343.0,222.95,76.88,343.0,37
CDM,30113405,%T2BPCR UNLISTED MOLEC,303.0,196.95,33.04,272.7,37
CDM,30113410,*MOPATH PROCEDURE LEVEL 4,311.0,202.15,76.88,309.47,37
CDM,30113420,ASSAY PH BODY FLUID NOS,12.0,7.8,2.59,10.8,37
CDM,30113425,%AJPWO BCKDHB,261.0,169.65,22.32,234.9,37
CDM,30113430,"POTASSIUM, BODY FLUID",26.0,16.9,4.37,23.4,27
CDM,30113435,%AJPWO G6PC,161.0,104.65,22.32,144.9,37
CDM,30113440,DRUG TEST PRSMV DIR OPT OBS,227.0,147.55,6.62,204.3,37
CDM,30113445,%AJPWO MOL PATH LVL 1,176.0,114.4,22.32,158.4,37
CDM,30113450,DRUG TEST PRSMV CHEM ANLYZR,257.0,167.05,33.04,231.3,37
CDM,30113455,%AJPWO MOL PATH LVL 2,377.0,245.05,76.88,339.3,37
CDM,30113460,DRUG TEST PRSMV CHEM ANLYZR,106.0,68.9,26.5,103.84,37
CDM,30113470,DRUG TEST PRSMV CHEM ANLYZR,125.0,81.25,31.25,112.5,37
CDM,30113475,CALCITONIN FNA LYMPH ND,734.0,477.1,6.33,660.6,37
CDM,30113480,ALBUMIN FLUID,46.0,29.9,2.59,41.4,37
CDM,30113490,AMYLASE FLUID,43.0,27.95,2.59,38.7,37
CDM,30113495,OMEGACHECK,50.0,32.5,5.78,45.0,37
CDM,30113500,CEA FLUID,41.0,26.65,5.78,36.9,37
CDM,30113505,"GFR, RENAL FUNCTION",188.0,122.2,5.78,169.2,37
CDM,30113510,CHOLESTEROL FLUID,12.0,7.8,2.59,10.8,37
CDM,30113515,OVA1,2027.0,1317.55,325.19,1824.3,37
CDM,30113520,CREATININE FLUID,39.0,25.35,2.59,35.1,37
CDM,30113525,BENZODIAZEPINES1-12,460.0,299.0,33.04,414.0,37
CDM,30113530,GLUCOSE BODY FLUID,12.0,7.8,2.59,10.8,37
CDM,30113540,LDH BODY FLUID,55.0,35.75,2.59,49.5,37
CDM,30113550,TRIGLYCERIDES FLUID,12.0,7.8,2.59,10.8,37
CDM,30113560,PH FLUID,12.0,7.8,2.59,10.8,37
CDM,30113570,NRAS GENE VARIANTS EXON 2&3,374.0,243.1,76.88,374.0,37
CDM,30113580,KRAS GENE ADDL VARIANTS,311.0,202.15,76.88,311.0,37
CDM,30113590,TROFILE CO-RECEPT PROFILE,3094.0,2011.1,4.02,2784.6,27
CDM,30113615,AMPCQ METHYLENDIOXY%,143.0,92.95,33.04,143.0,37
CDM,30113645,"DIPHENHYDRAMINE, URINE",589.0,382.85,33.04,530.1,37
CDM,30113665,OCCULT BLOOD SCREEN,48.0,31.2,2.59,43.2,37
CDM,30113685,%BTKMUT MOL PATH LVL7,1217.0,791.05,76.88,1095.3,37
CDM,30113695,TARGETED B-ALL FUS ANLYS,2742.0,1782.3,325.19,2467.8,37
CDM,30113705,%BTKNUT UNLIST MOL PATH,350.0,227.5,22.32,315.0,27
CDM,30113725,"DRUG SCRN, BLD",103.0,66.95,25.75,103.0,37
CDM,30113785,"VOLATILE SCRN, UR",158.0,102.7,33.04,158.0,37
CDM,30113795,DRUG ANALYSIS UR,144.0,93.6,33.04,129.6,37
CDM,30113805,SYNTH CANNABINOID METAB,194.0,126.1,33.04,191.21,37
CDM,30113825,DATE RAPE PANEL,479.0,311.35,33.04,431.1,37
CDM,30113935,TCRB TEST,1511.0,982.15,76.88,1359.9,37
CDM,30114015,"KIT MUT EX 18-11, 17 SEQ",636.0,413.4,76.88,572.4,37
CDM,30114025,KIT D816V MUTATION PCR,428.0,278.2,22.32,385.2,37
CDM,30114035,MLH1 PROMOTER HYPERMETH,733.0,476.45,76.88,659.7,37
CDM,30114045,VWF TYPE 2A EX 28,762.0,495.3,76.88,685.8,37
CDM,30114055,TTR GENE FULL ANALYSIS,705.0,458.25,76.88,634.5,37
CDM,30114075,BLAU SYNDROME,1683.0,1093.95,22.32,1514.7,27
CDM,30114085,METHAQUALONE GC/MS UR,204.0,132.6,33.04,191.21,37
CDM,30114115,%FLT3MD TKD VARIANTS,287.0,186.55,22.32,258.3,37
CDM,30114125,FLUOXETINE/NORFLUOXETINE,190.0,123.5,33.04,190.0,37
CDM,30114135,%FLT3MD VARIANTS,746.0,484.9,76.88,671.4,37
CDM,30114155,ANTIMONY BLOOD,202.0,131.3,5.78,181.8,37
CDM,30114165,BILE ACIDS TOTAL,86.0,55.9,5.78,77.4,37
CDM,30114175,%CSFPE PROTEIN TOTAL CSF,21.0,13.65,2.59,18.9,37
CDM,30114185,%CSFPE PROT ELEC SCF QT,26.0,16.9,5.78,26.0,37
CDM,30114205,TESTOSTERONE FR AD MALE,157.0,102.05,6.33,141.3,37
CDM,30114215,GALECTIN-3 SERUM,101.0,65.65,13.39,90.9,37
CDM,30114555,THYROXIN FREE,182.0,118.3,6.33,163.8,37
CDM,30114585,"LEUKOTRIENE E4, UR",851.0,553.15,5.78,765.9,37
CDM,30114595,PARA AB WB BND ID,724.0,470.6,19.47,651.6,37
CDM,30114685,MERCAPTOPURINE,516.0,335.4,33.04,464.4,37
CDM,30114695,MITOTANE,506.0,328.9,33.04,455.4,37
CDM,30114705,%UQNTPP CANNABINOID NAT,85.0,55.25,21.25,125.87,37
CDM,30114715,%UQNTPP OPIATE,98.0,63.7,24.5,125.87,37
CDM,30114725,%UQNTPP OPIOIDS 5+,98.0,63.7,24.5,125.87,37
CDM,30114735,%UQNTPP OXYCODONE,34.0,22.1,8.5,125.87,37
CDM,30115295,DPB1 LOCUS HI RES SBT,653.0,424.45,22.32,587.7,37
CDM,30115375,"NITROGEN, TOTAL, FECES",732.0,475.8,5.78,658.8,27
CDM,30115415,LIPID ASSOC SIALIC ACID,147.0,95.55,5.78,132.3,37
CDM,30115445,NEOPTERIN BLD/CSF,638.0,414.7,5.78,574.2,37
CDM,30115455,QUETIAPINE,303.0,196.95,5.81,272.7,37
CDM,30115495,%5FLUO TEST,216.0,140.4,22.32,194.4,27
CDM,30115505,%F2 MS/MS QUANTITATIVE,166.0,107.9,5.78,149.4,37
CDM,30115555,METHYL ETHYL KETONE URIN,243.0,157.95,5.78,218.7,37
CDM,30115595,FLUVOXAMINE,583.0,378.95,33.04,524.7,37
CDM,30115645,HYPEROXALURIA,1174.0,763.1,5.78,1056.6,37
CDM,30115665,ETHAMBUTOL,736.0,478.4,5.81,662.4,37
CDM,30115705,INTERLEUKIN 4,534.0,347.1,5.78,480.6,37
CDM,30115725,%NRAST BY PYROSEQ,913.0,593.45,76.88,821.7,37
CDM,30115WE,"EXCISION NOSE POLYP(S),EXTENSIVE",1776.0,1154.4,231.78,1776.0,35
CDM,30116150,HBA1/HBA2 GENE DUP/DEL VRNTS,782.0,508.3,76.88,703.8,37
CDM,30116160,ISAVUCONAZOLE,94.0,61.1,5.81,84.6,37
CDM,30116170,TPMT GENOTYPE ASSAY,619.0,402.35,76.88,557.1,37
CDM,30116180,"BJP, QT FR KAPPA LAMBDA UR 83883",56.0,36.4,5.23,50.4,37
CDM,30116190,"BJP, QT FR KAPPA LAMBDA UR 84156",55.0,35.75,2.59,49.5,37
CDM,30116200,MYELOID NGS PANEL,1224.0,795.6,306.0,1224.0,37
CDM,30116210,COMPREHENSIVE CELIAC PANEL 81382,271.0,176.15,22.32,243.9,37
CDM,30116220,COMPREHENSIVE CELIAC PANEL 82784,86.0,55.9,2.59,77.4,37
CDM,30116230,COMPREHENSIVE CELIAC PANEL 83516,80.0,52.0,5.78,72.0,37
CDM,30116240,MYELOPEROXIDASE ABS,83.0,53.95,5.78,74.7,37
CDM,30117175,%HA1AT SERPINA1 GENE ANLY,79.0,51.35,19.75,72.94,37
CDM,30117385,CHSER,98.0,63.7,5.78,88.2,37
CDM,30117415,"OSMOLALITY, BODY FLUID",107.0,69.55,2.59,96.3,37
CDM,30117425,"OSMOLALITY, STOOL",72.0,46.8,5.78,64.8,27
CDM,30117435,"POTASSIUM, BODY FLUID",53.0,34.45,5.78,47.7,27
CDM,30117445,"POTASSIUM, STOOL",59.0,38.35,5.78,53.1,27
CDM,30117465,DRGTOF METHYLENEDIOXYAMPHETAMINE,173.0,112.45,33.04,173.0,37
CDM,30117525,FTTESM TESTOSTERONE,91.0,59.15,6.33,81.9,37
CDM,30117535,FTTESM TESTO FR AD MALE,97.0,63.05,6.33,87.3,37
CDM,30117685,%UTXM3 ARSENIC,92.0,59.8,5.78,82.8,37
CDM,30117695,%UTXM3 LEAD,74.0,48.1,5.78,66.6,37
CDM,30117705,%UTXM4 ARSENIC,92.0,59.8,5.78,82.8,37
CDM,30117715,%UTXM4 LEAD,74.0,48.1,5.78,66.6,37
CDM,30117725,%UTXM4 CADMIUM,99.0,64.35,5.78,89.1,37
CDM,30117765,"FATTY ACID PROFILE,SER PL",333.0,216.45,33.04,299.7,37
CDM,30117785,"BROMIDE, SER PL",110.0,71.5,5.81,99.0,37
CDM,30117825,HLA B5701,667.0,433.55,76.88,600.3,37
CDM,30117845,RFLX IMBLOT PARNEO AIDYSA,168.0,109.2,19.47,151.2,37
CDM,30117855,"HLA-A,B,CW,DR,DQ,DP-NGS-BMT",1341.0,871.65,76.88,1206.9,37
CDM,30117895,DPD 5FU GENOTYPR,796.0,517.4,76.88,716.4,37
CDM,30117905,HBA1 HBA2 DEL/DUP,673.0,437.45,76.88,605.7,37
CDM,30117915,HBB GENE SEQUENCING,1051.0,683.15,76.88,945.9,37
CDM,30117925,IL28B ASSOC VAR 2 SNP,484.0,314.6,22.32,435.6,37
CDM,30117945,%IDH12 IDH1,504.0,327.6,76.88,453.6,37
CDM,30117955,%IDH12 IDH2,504.0,327.6,76.88,494.27,37
CDM,30117WE,"EXCIS INTRANASAL LESN,INTERN APPRCH",1564.0,1016.6,168.64,1366.21,35
CDM,30118075,%PANCPL SPINK1,1241.0,806.65,76.88,1116.9,37
CDM,30118085,%PANCPL MOPATH LVL 6,1241.0,806.65,76.88,1116.9,37
CDM,30118135,TPMT GENOTYPE ASSAY,607.0,394.55,76.88,546.3,37
CDM,30118145,FLOW SCRN TUBE 1ST MKR,129.0,83.85,33.41,779.93,38
CDM,30118155,LNG550 LUNG CANCER GENE PNL,2253.0,1464.45,170.1,2027.7,37
CDM,30118175,DIHYDROTESTOSTERONE,91.0,59.15,5.78,81.9,37
CDM,30118235,THIOPURINE METAB LC-MS/MS,152.0,98.8,5.81,136.8,37
CDM,30118255,"ALCOHOL CONF, UR",158.0,102.7,33.04,158.0,37
CDM,30118265,APOL1 SEQUENCING,426.0,276.9,22.32,383.4,27
CDM,30118285,GLUTATHIONE TOTAL,120.0,78.0,5.78,108.0,37
CDM,30118305,MNGS PATHOGEN DX,7250.0,4712.5,22.32,6525.0,27
CDM,30118315,APOE GENOTYPING ALZHEIMER,486.0,315.9,76.88,437.4,37
CDM,30118345,PREGABALIN,143.0,92.95,33.04,143.0,37
CDM,30118355,HSP-70 AB,227.0,147.55,5.78,204.3,37
CDM,30118375,HLA-B*15:02,1062.0,690.3,76.88,955.8,37
CDM,30118425,TIN,160.0,104.0,5.78,144.0,37
CDM,30118485,MYELOPROLIF NEOPL PNL BM,932.0,605.8,22.32,838.8,27
CDM,30118495,MYELOPROLIF NEOPL PNL BLD,932.0,605.8,22.32,838.8,27
CDM,30118515,DRUG TESTS PRESUMPTIVE,406.0,263.9,33.04,365.4,37
CDM,30118535,ALCOHOLS,213.0,138.45,33.04,191.7,37
CDM,30118565,HNMNGS HN NGS SEQ PANEL BM,1811.0,1177.15,452.75,3211.56,37
CDM,30118575,HNPNGS HN NGS SEQ PANEL P BLD,1811.0,1177.15,452.75,3211.56,37
CDM,30118625,CYP2C9 GENE COM VARIANTS (WARSEN),351.0,228.15,76.88,315.9,37
CDM,30118635,VKORCI GENE (WARSEN),351.0,228.15,22.32,315.9,37
CDM,30118655,OXIDIZED LDL,54.0,35.1,5.78,48.6,37
CDM,30118675,ADANEU THEARP DRG QNT,239.0,155.35,5.81,215.1,37
CDM,30118685,ADANEU CHEMILUMINESCENT,265.0,172.25,5.78,238.5,37
CDM,30118695,IFXNEU THEARP DRG QNT,227.0,147.55,5.81,204.3,37
CDM,30118705,IFXNEU CHEMILUMINESCENT,265.0,172.25,5.78,238.5,37
CDM,30118715,"FAT, FECAL QUAL",44.0,28.6,2.59,39.6,37
CDM,30118725,"BACLOFEN (BACLOF), SKELETAL MUSCLE RELAXANT 1 OR 2",370.0,240.5,33.04,333.0,37
CDM,30118755,BRUCELLA AB TOTAL,81.0,52.65,5.23,72.9,37
CDM,30118795,"NITROGEN, URINE 24 HR",110.0,71.5,5.78,99.0,37
CDM,30118875,"SULFONYLUREA HYPOGLY PANEL,QT, UR",212.0,137.8,33.04,191.21,37
CDM,30118885,SULFONYLUREA HYPOGLY SER,143.0,92.95,33.04,143.0,37
CDM,30118895,"ETHYL GLUCURONIDE, UR CONFIRM, QT",143.0,92.95,33.04,143.0,37
CDM,30118905,HEMATOLOGIC NEOPLASM NGS MARROW,3677.0,2390.05,919.25,3677.0,37
CDM,30118915,HEMATOLOGIC NEOPLASM NGS BLD,3677.0,2390.05,919.25,3677.0,37
CDM,30118925,MICROSATELLITE INSTABILITY (MSICCT),437.0,284.05,76.88,437.0,37
CDM,30118935,LNG 550 LUNG CANCER GENE PNL,1099.0,714.35,170.1,999.11,37
CDM,30118985,DRGTOF DRG SCRN BARBITURATES,238.0,154.7,33.04,214.2,37
CDM,30118WE,"EXCIS INTRANASAL LESN,EXT APPRCH",3100.0,2015.0,478.45,3100.0,35
CDM,30119005,DRGTOF DRG SCRN BUPRENORPHINE,238.0,154.7,33.04,214.2,37
CDM,30119025,DRGTOF DRG SCRN COCAINE,238.0,154.7,33.04,214.2,37
CDM,30119035,DRGTOF DRG SCRN METHADONE,238.0,154.7,33.04,214.2,37
CDM,30119065,DRGTOF PHENCYCLIDINE,238.0,154.7,33.04,214.2,37
CDM,30119075,CSPNL ASPA GENE,58.0,37.7,14.5,58.0,37
CDM,30119085,CSPNL BCKDHB GENE,117.0,76.05,22.32,117.0,37
CDM,30119095,CSPNL BLM GENE,48.0,31.2,12.0,48.0,37
CDM,30119105,CSPNL CFTR GENE COM VARS,681.0,442.65,170.1,681.0,37
CDM,30119115,CSPNL FANCC GENE,45.0,29.25,11.25,45.0,37
CDM,30119125,CSPNL FMR1 GENE DETECTION,72.0,46.8,18.0,72.0,37
CDM,30119135,CSPNL G6PC GENE,73.0,47.45,18.25,73.0,37
CDM,30119145,CSPNL GBA GENE,58.0,37.7,14.5,58.0,37
CDM,30119155,CSPNL HEXA GENE,64.0,41.6,16.0,64.0,37
CDM,30119165,CSPNL IKBKAP GENE,48.0,31.2,12.0,48.0,37
CDM,30119175,CSPNL MCOLN1 GENE,48.0,31.2,12.0,48.0,37
CDM,30119185,CSPNL SMPD1 GENE COMMON VARS,57.0,37.05,14.25,57.0,37
CDM,30119195,CSPNL MOPATH PROC LVL 1,79.0,51.35,19.75,79.0,37
CDM,30119205,CSPNL MOPATH PROC LVL 2,167.0,108.55,41.75,167.0,37
CDM,30119215,CSPNL UNLISTED MOPATH,72.0,46.8,12.1,64.8,27
CDM,30119225,AJPNL ASPA GENE,58.0,37.7,14.5,58.0,37
CDM,30119235,AJPNL BCKDHB GENE,117.0,76.05,22.32,117.0,37
CDM,30119245,AJPNL BLM GENE,48.0,31.2,12.0,48.0,37
CDM,30119255,AJPNL FANCC GENE,45.0,29.25,11.25,45.0,37
CDM,30119265,AJPNL G6PC GENE,73.0,47.45,18.25,73.0,37
CDM,30119275,AJPNL GBA GENE,58.0,37.7,14.5,58.0,37
CDM,30119285,AJPNL HEXA GENE,64.0,41.6,16.0,64.0,37
CDM,30119295,AJPNL IKBKAP GENE,48.0,31.2,12.0,48.0,37
CDM,30119305,AJPNL MCOLN1 GENE,48.0,31.2,12.0,48.0,37
CDM,30119325,AJPNL MOPATH PROC LVL 1,79.0,51.35,19.75,79.0,37
CDM,30119335,AJPNL MOPATH PROC LVL 2,167.0,108.55,41.75,167.0,37
CDM,30119425,5FUDPD DPYD GENE COMMON VARS,779.0,506.35,76.88,701.1,37
CDM,30119465,SOTAL DRUG NOS 1-3,742.0,482.3,33.04,667.8,37
CDM,30119485,CF PATHOGENIC VARIANT,681.0,442.65,170.1,681.0,37
CDM,30119495,DIHYDROTESTOSTERONE,83.0,53.95,6.33,74.7,37
CDM,30119525,DERMATOMYOSITIS PANEL X6,47.0,30.55,5.78,42.3,37
CDM,30119575,PHOSPHATIDYLETHANOL,314.0,204.1,33.04,282.6,37
CDM,30119605,VITAMIN B WHOLE BLOOD,131.0,85.15,5.78,117.9,37
CDM,30119615,TRYPSINOGEN,136.0,88.4,5.78,122.4,37
CDM,30119625,"OREXIN A, SPINAL FLUID (ORXCSF)",1164.0,756.6,5.78,1047.6,37
CDM,30119665,KAPPA/LAMDA FR LT CH UR,56.0,36.4,5.23,50.4,37
CDM,30119675,CYTOKINE PANEL,31.0,20.15,5.78,28.86,37
CDM,30119755,%SSAT24 AMMONIUM,41.0,26.65,5.78,36.9,37
CDM,30119775,CRYOGLOBULN QI W/REFLX T,48.0,31.2,2.59,43.2,37
CDM,30119815,ZINC WHOL BLOOD,268.0,174.2,5.78,241.2,37
CDM,30119825,AIDYSA RIA NONAB,121.0,78.65,5.78,108.9,37
CDM,30119835,AIDYSA IMMUNO QNT NOS NONAB,72.0,46.8,5.78,64.8,37
CDM,30119855,METHOTREXATE IRL,167.0,108.55,5.81,150.3,37
CDM,30119865,BTSTFC TESTOSTERONE FR,112.0,72.8,6.33,100.8,37
CDM,30119885,"SSAT24 CALCIUM, UR",18.0,11.7,2.59,16.2,37
CDM,30119895,"SSAT24 CHLORIDE, UR",17.0,11.05,2.59,15.3,37
CDM,30119905,"SSAT24 CITRATE EXCR, UR",77.0,50.05,13.39,69.3,37
CDM,30119915,"SSAT24 CREATININE, UR",14.0,9.1,2.59,12.6,37
CDM,30119925,"SSAT24 MAGNESIUM, UR",19.0,12.35,2.59,17.1,37
CDM,30119935,"SSAT24 OSMOLALITY, UR",20.0,13.0,2.59,18.0,37
CDM,30119945,"SSAT24 OXOLATE, UR",41.0,26.65,5.78,36.9,37
CDM,30119955,"SSAT24 PHOSPHORUS, UR",17.0,11.05,2.59,15.3,37
CDM,30119965,"SSAT24 POTASSIUM, UR",13.0,8.45,2.59,11.7,37
CDM,30119975,"SSAT24 SODIUM, UR",14.0,9.1,2.59,12.6,37
CDM,30119985,"SSAT24 SULFATE, UR",15.0,9.75,1.43,13.5,37
CDM,30119995,SSAT24 UREA NITROGEN,15.0,9.75,2.59,13.5,37
CDM,30120005,"SSAT24 URIC ACID, UR",14.0,9.1,2.59,12.6,37
CDM,30120225,SSAT24 PH,10.0,6.5,2.5,9.0,37
CDM,30120255,ALPHA-GALACTOSIDASE,570.0,370.5,5.78,513.0,37
CDM,30120265,ADALIMUMAB ACT NEUT AB,243.0,157.95,5.81,218.7,37
CDM,30120275,INFLIXIMAB/BIOSIMILAR ACT NEUT AB,243.0,157.95,5.81,218.7,37
CDM,30120285,POSACONAZOLE,230.0,149.5,5.81,207.0,37
CDM,30120295,LACOSAMIDE,418.0,271.7,5.81,376.2,37
CDM,30120305,VORICONAZOLE,241.0,156.65,5.81,216.9,37
CDM,30120315,BETA HCG QNT TUMOR MKR,69.0,44.85,5.78,62.1,37
CDM,30120365,SOLUBLE TRANSFERRINE RECEPTOR,314.0,204.1,13.39,282.6,37
CDM,30120375,D2D3 25-OH VITAMIN,273.0,177.45,13.39,245.7,37
CDM,30120385,OPISEC OPIATES 1 OR MORE,246.0,159.9,33.04,221.4,37
CDM,30120395,DRGTOF OPISEC DRG SCRN OXYCODONE,246.0,159.9,33.04,221.4,37
CDM,30120405,DRGTOF ORLOPI OPIATES 1 OR MORE,246.0,159.9,33.04,221.4,37
CDM,30120415,TESTOSTERONE TOTAL ASSAY,217.0,141.05,6.33,195.3,37
CDM,30120435,OPIATE CONFIRMATION UR,226.0,146.9,33.04,203.4,37
CDM,30120445,HYDROXYLASE-21 AB,118.0,76.7,5.78,106.2,37
CDM,30120455,UFLCKL IMMUNO QNT NOS NAB,61.0,39.65,5.78,54.9,37
CDM,30120465,UFLCKL PROTEIN UR,26.0,16.9,2.59,23.4,37
CDM,30120485,ASSAY OF GLYCATED PROTEIN,50.0,32.5,5.78,45.0,37
CDM,30120495,CYSTATIN C WITH GFR,275.0,178.75,5.78,247.5,37
CDM,30120515,GOLD SERUM,370.0,240.5,33.04,333.0,37
CDM,30120535,"METHYLONE CONF, UR",152.0,98.8,33.04,152.0,37
CDM,30120545,CPEPSP INSULIN SUPPRESSION PANEL,578.0,375.7,76.88,520.2,37
CDM,30120555,UC5DC ACYLCARNITINES QUANT,370.0,240.5,5.78,333.0,37
CDM,30120565,UCYS24 AMINO ACIDS QUANT 2-5,437.0,284.05,5.78,393.3,37
CDM,30120575,CPALMT ENZYME CELL ACTIVITY,212.0,137.8,5.78,190.8,37
CDM,30120585,FAOSCM ENZYME CELL ACTIVITY X4,119.0,77.35,5.78,107.1,37
CDM,30120595,FAOACM ENZYME CELL ACTIVITY X8,119.0,77.35,5.78,107.1,37
CDM,30120605,CPALMT ENZYME CELL ACTIVITY RA X2,210.0,136.5,13.39,189.0,37
CDM,30120615,17-HYDROXYPROGESTERONE UR,289.0,187.85,6.33,260.1,37
CDM,30120625,GBMGP IMMUNOASSAY NONANTIBODY,67.0,43.55,5.78,60.3,37
CDM,30120635,ACESTR IMMUNOASSAY NONANTIBODY X2,69.0,44.85,5.78,62.1,37
CDM,30120645,ACETYLCHOL REC MOD,197.0,128.05,5.78,177.3,37
CDM,30120655,ACESTR RIA NONANTIBODY,135.0,87.75,5.78,121.5,37
CDM,30120665,STFRTP ASSAY OF FECES PORPHYRINS,210.0,136.5,13.39,189.0,37
CDM,30120675,CPALMT ASSAY OF PROTEIN OTHER,48.0,31.2,2.59,43.2,37
CDM,30120685,FAOSCM ASSAY OF PROTEIN OTHER,63.0,40.95,2.59,56.7,37
CDM,30120695,FAOACM ASSAY OF PROTEIN OTHER,63.0,40.95,2.59,56.7,37
CDM,30120705,HUWB WESTERN BLOT TEST,173.0,112.45,5.23,155.7,37
CDM,30120715,FAOSCM SPECTROPHOTOMETRY X4,69.0,44.85,2.59,62.1,37
CDM,30120725,FAOACM SPECTROPHOTOMETRY X8,69.0,44.85,2.59,62.1,37
CDM,30120735,USO4 ASSAY OF URINE SULFATE,33.0,21.45,1.43,29.7,37
CDM,30120745,UMHISR COL CHROMOTOGRAPHY,109.0,70.85,5.78,98.1,37
CDM,30120755,UMHISR UR CREATININE,22.0,14.3,2.59,19.8,37
CDM,30120765,DIGITOXIN,289.0,187.85,33.04,260.1,37
CDM,30120775,REFLEX IMMUNOBLOT SER FOR PARNEO,168.0,109.2,19.47,151.2,37
CDM,30120785,BETA-GLUCOSIDASE LEUK,570.0,370.5,5.78,513.0,37
CDM,30120795,"PORPHYRINS, FECAL",196.0,127.4,13.39,176.4,37
CDM,30120805,PBGDEP ENZYME CELL ACT,109.0,70.85,5.78,98.1,37
CDM,30120815,PROMETHEUS ANSER IFX,2008.0,1305.2,5.78,1807.2,27
CDM,30120825,PROMETHEUS ANSER ADA,2008.0,1305.2,5.78,1807.2,27
CDM,30120835,PROMETHEUS ANSER VDZ,2008.0,1305.2,5.78,1807.2,27
CDM,30120845,PROMETHEUS ANSER UST,2008.0,1305.2,5.78,1807.2,27
CDM,30120855,MCROHN IMM QNT NOS NONAB,51.0,33.15,5.78,45.9,37
CDM,30120865,NEURONAL NUC AB IGG X4,51.0,33.15,12.75,48.81,37
CDM,30120875,AT1R-ANTIBODY-REFERENCE SAMPLE,289.0,187.85,5.78,260.1,37
CDM,30120885,ENCAINIDE,184.0,119.6,33.04,184.0,37
CDM,30120895,PROT WB IMMUNO (MYOSPL),112.0,72.8,19.47,100.8,37
CDM,30120905,DERMYO PROT WB IMMUNO,112.0,72.8,19.47,100.8,37
CDM,30120915,"PLATELET RECIP HLA A,B TYPING",1469.0,954.85,170.1,1322.1,37
CDM,30120925,BETA-HCG QNT TM CSF,74.0,48.1,6.33,66.6,37
CDM,30120935,FLECAINIDE,153.0,99.45,5.81,137.7,37
CDM,30120945,LEFLUNOMIDE METABOLITE,121.0,78.65,5.81,108.9,37
CDM,30120955,ACETAMINOPHEN BL TEST,120.0,78.0,5.81,108.0,37
CDM,30120965,SALICYLATE,58.0,37.7,5.81,52.2,37
CDM,30120975,AMIODARONE,169.0,109.85,5.81,152.1,37
CDM,30120985,CARBAMAZEPINE-10-11-EPOXI,153.0,99.45,5.81,137.7,37
CDM,30120995,FELBAMATE,173.0,112.45,5.81,155.7,37
CDM,30120WE,EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA,2156.0,1401.4,214.57,1617.0,35
CDM,30121005,RUFINAMIDE,281.0,182.65,5.81,252.9,37
CDM,30121015,METHOTREXATE,277.0,180.05,5.81,249.3,37
CDM,30121025,ITRACONAZOLE,241.0,156.65,5.81,216.9,37
CDM,30121035,GALACTOSE QUANT UR,329.0,213.85,5.78,296.1,37
CDM,30121045,GLUCOSE RANDOM UR,86.0,55.9,2.59,77.4,37
CDM,30121055,ETHANOL PLASMA,173.0,112.45,6.62,155.7,37
CDM,30121065,MCROHN SAA CHEMILUM,43.0,27.95,5.78,38.7,37
CDM,30121075,ANSADA MEAS SER ADA,678.0,440.7,5.81,610.2,37
CDM,30121085,ANSADA MEAS AB ATI,422.0,274.3,5.78,379.8,37
CDM,30121095,ANSIFX MEAS SER ADA,678.0,440.7,5.81,610.2,37
CDM,30121105,ANSIFX MEAS AB ATI,422.0,274.3,5.78,379.8,37
CDM,30121115,ANSVDZ MEAS SER VDZ,678.0,440.7,5.81,610.2,37
CDM,30121125,ANSVDZ MEAS AB ATI,422.0,274.3,5.78,379.8,37
CDM,30121135,ANSUST MEAS SER UST,431.0,280.15,5.81,387.9,37
CDM,30121145,ANSUST MEAS AB ATI,620.0,403.0,5.78,558.0,37
CDM,30121155,ANTI IGE,157.0,102.05,5.78,141.3,37
CDM,30121165,ENCSER RIA NON AB X3,98.0,63.7,5.78,88.2,37
CDM,30121175,"ZINC, UR QNT",44.0,28.6,5.78,39.6,37
CDM,30121185,"MG/LES EVAL, SER",134.0,87.1,5.78,120.6,37
CDM,30121195,MYASTHENIA GRAVIS EVAL,47.0,30.55,5.78,42.3,37
CDM,30121205,"FILM ARRAY, MENINGITIS/ENCEPHALITIS",1076.0,699.4,92.55,968.4,37
CDM,30121215,ALLOGEN AUTOANTIBODY,1059.0,688.35,5.78,953.1,37
CDM,30121225,"ECULIZUMAB, SERUM",270.0,175.5,5.81,243.0,37
CDM,30121235,BETA HCG QUANT TUMOR MARKER,63.0,40.95,6.33,56.7,37
CDM,30121245,ANTI ALPHA FODRIN AB IGG IGA X2,109.0,70.85,5.78,98.1,37
CDM,30121255,ANTI ALPHA FODRIN AB IGA,121.0,78.65,5.78,108.9,37
CDM,30121265,ANTI ALPHA FODRIN AB IGG,121.0,78.65,5.78,108.9,37
CDM,30121275,CPALMF ENZYME CELL ACTIVITY RA X2,188.0,122.2,13.39,169.2,37
CDM,30121285,CPALMF ENZYME CELL ACTIVITY,95.0,61.75,5.78,85.5,37
CDM,30121295,CPALMF ASSAY OF PROTEIN OTHER,19.0,12.35,2.59,17.1,37
CDM,30121305,ETHAMBUTOL,353.0,229.45,33.04,317.7,37
CDM,30121315,OLANZAPINE,277.0,180.05,33.04,249.3,37
CDM,30121425,ASSAY OF INTERLEUKIN-6 (IL-6),167.0,108.55,5.78,150.3,37
CDM,30121435,IMMUNOGL LT CHNS FR EA,142.0,92.3,5.78,127.8,37
CDM,30121445,ELASTASE PANCREATIC FECAL,191.0,124.15,5.78,171.9,37
CDM,30121455,CYTOKP INTERLEUKIN-6,67.0,43.55,5.78,60.3,37
CDM,30121465,G HYDROXYBUTYRIC,237.0,154.05,33.04,213.3,37
CDM,30121475,SYNTH CANNABINOID METAB,188.0,122.2,33.04,188.0,37
CDM,30121485,SERTRALINE,250.0,162.5,33.04,225.0,37
CDM,30121495,QUETIAPINE,327.0,212.55,33.04,294.3,37
CDM,30121505,MITOTANE,209.0,135.85,5.81,188.1,37
CDM,30121515,MEPHEDRONE MDPV CONF UR,152.0,98.8,33.04,152.0,37
CDM,30121525,UR BARBITURATE CONF RFLX,164.0,106.6,33.04,147.6,37
CDM,30121535,UR BENZODIAZ CONF RFLX,164.0,106.6,33.04,147.6,37
CDM,30121545,UR FLUNITRAZ CONF RFLX,164.0,106.6,33.04,147.6,37
CDM,30121555,UR KETAMINE CONF RFLX,164.0,106.6,33.04,147.6,37
CDM,30121565,UR ALCOHOL CONF RFLX,164.0,106.6,33.04,147.6,37
CDM,30121575,GHB CONF RFLX,156.0,101.4,33.04,156.0,37
CDM,30121585,AMITRIPTYLINE,345.0,224.25,33.04,310.5,37
CDM,30121595,DESIPRAMINE,345.0,224.25,33.04,310.5,37
CDM,30121605,DOXEPIN/NORDOXEPIN,345.0,224.25,33.04,310.5,37
CDM,30121615,IMIPRAMINE,345.0,224.25,33.04,310.5,37
CDM,30121625,NORTRIPTYLINE,345.0,224.25,33.04,310.5,37
CDM,30121635,STCATH ASSAY OF MAGNESIUM,237.0,154.05,2.59,213.3,37
CDM,30121645,MECDRG AMPHETAMINES 5 OR MORE,59.0,38.35,14.75,172.25,37
CDM,30121655,MECDRG DRUG SCRN BENZODIAZ 13 OR MORE,59.0,38.35,14.75,172.25,37
CDM,30121665,MECDRG OPIOIDS AND OPIATE ANALOGS 5 OR MORE,59.0,38.35,14.75,172.25,37
CDM,30121675,DTOFMP GABAPENTIN,59.0,38.35,14.75,172.25,37
CDM,30121715,DRGTOF AMPHETAMINES 5 OR MORE,59.0,38.35,14.75,125.87,37
CDM,30121725,DRGTOF DRUG SCRN BENZODIAZ 13 OR MORE,59.0,38.35,14.75,125.87,37
CDM,30121735,DRGTOF OPIOIDS AND OPIATE ANALOGS 5 OR MORE,59.0,38.35,14.75,125.87,37
CDM,30121745,DRGTOF DRUG SCRN GABAPENTIN NON-BLOOD,59.0,38.35,14.75,125.87,37
CDM,30121755,BTSTFC ASSAY OF SEX HORMONE GLOBUL,75.0,48.75,5.78,67.5,37
CDM,30121775,ACETONE,53.0,34.45,2.59,47.7,37
CDM,30121785,GVHPRE GROWTH STIMULATION GENE 2,825.0,536.25,16.61,742.5,37
CDM,30121795,GVHPRE IMMUNOASSAY QUANT NOS NONAB,165.0,107.25,5.78,148.5,37
CDM,30121805,GVHSYM GROWTH STIMULATION GENE 2,825.0,536.25,16.61,742.5,37
CDM,30121815,GVHSYM IMMUNOASSAY QUANT NOS NONAB,165.0,107.25,5.78,148.5,37
CDM,30121825,GVHPST GROWTH STIMULATION GENE 2,825.0,536.25,16.61,742.5,37
CDM,30121835,GVHPST IMMUNOASSAY QUANT NOS NONAB,165.0,107.25,5.78,148.5,37
CDM,30121845,PLASMA THYMIDINE DETERMINATION,281.0,182.65,5.78,252.9,37
CDM,30121855,"PRIMARY MEMBRANOUS NEPHROPATHY DIAG CASCADE, SER",330.0,214.5,5.78,297.0,37
CDM,30121865,DUPNL DPYD GENE COMMON VARIANTS,330.0,214.5,76.88,297.0,37
CDM,30121875,DUPNL UGT1A1 GENE COMMON VARIANTS,443.0,287.95,76.88,398.7,37
CDM,30121885,ANTI-CN-1A (NT5C1A) IBM,231.0,150.15,5.78,207.9,37
CDM,30121975,TPMT ASY THIOPURIN S-MTHYLTRNSFRS,253.0,164.45,5.78,227.7,37
CDM,30121985,"PHOSPHOLIPASE A2 RECEPTOR AB, ELISA, SERUM",237.0,154.05,5.78,213.3,37
CDM,30121995,TRIGLYCERIDES BF W REFLEX TO CHYLOMICRON ELECTROPH,35.0,22.75,2.59,31.5,37
CDM,30122005,"RBC FOLATE (REFLAB ONLY, REQUIRES HCT WITHIN 24 HRS)",33.0,21.45,5.78,29.7,37
CDM,30122035,"LH, PEDIATRIC",281.0,182.65,6.33,252.9,37
CDM,30122045,CLOZAPINE,97.0,63.05,5.81,87.3,37
CDM,30122055,CAHSP ASSAY OF ANDROSTENEDIONE,84.0,54.6,6.33,75.6,37
CDM,30122065,CAHSP DEOXYCORTISOL,84.0,54.6,6.33,75.6,37
CDM,30122075,CAHSP TOTAL CORTISOL,47.0,30.55,6.33,42.3,37
CDM,30122085,CAHSP DEHYDROEPIANDROSTERONE,69.0,44.85,5.78,62.1,37
CDM,30122095,CAHSP ASSAY OF 17-HYDROXYPREGNENO,63.0,40.95,6.33,56.7,37
CDM,30122105,CAHSP ASSAY OF PROGESTERONE,61.0,39.65,6.33,54.9,37
CDM,30122115,CAHSP ASY HYDROXYPROGESTERONE 17-D,75.0,48.75,6.33,67.5,37
CDM,30122125,CAHSP ASSAY OF TOTAL TESTOSTERONE,72.0,46.8,6.33,64.8,37
CDM,30122135,CAHSP DESOXYCORTICOSTERONE,85.0,55.25,16.61,76.5,37
CDM,30122145,"15AGTL - 1,5 ANHYDROGLUCITOL",44.0,28.6,5.78,39.6,37
CDM,30122155,"BENZO, SER PL, QNT RFLX",315.0,204.75,33.04,283.5,37
CDM,30122165,"COCAINE METABOLITE, SER OR PL, QNT RFLX",315.0,204.75,33.04,283.5,37
CDM,30122175,"PCP SER OR PL, QNT RFLX",315.0,204.75,33.04,283.5,37
CDM,30122185,DRG SCRN 9 PANEL SER OR PL,171.0,111.15,33.04,153.9,37
CDM,30122195,"IOHEXOL GLOMERULAR FILTRATION RATE (GFR), PLASMA",717.0,466.05,5.78,645.3,37
CDM,30122205,"PREGABALIN, URINE",315.0,204.75,6.62,283.5,27
CDM,30122215,"INFLIXIMAB, SERUM",96.0,62.4,5.81,86.4,37
CDM,30122225,"ADALIMUMAB, SERUM",43.0,27.95,5.78,38.7,37
CDM,30122235,CANNABINOIDS NATURAL,45.0,29.25,6.62,40.5,27
CDM,30122245,"AMMONIUM, 24 HOUR, URINE",459.0,298.35,5.78,413.1,37
CDM,30122255,"AMMONIUM, RANDOM, URINE",459.0,298.35,5.78,413.1,37
CDM,30122265,ASPARAGINASE ENZYME ACTIVITY,463.0,300.95,5.78,416.7,37
CDM,30122275,"MITRAGYNINE (KRATOM), URINE",186.0,120.9,33.04,167.4,37
CDM,30122285,KRATOM (MITRAGYNINE) CONFIRMATION,286.0,185.9,6.62,257.4,27
CDM,30122295,ASSAY OF ANTI-MULLERIAN HORMONE,56.0,36.4,5.78,56.0,37
CDM,30122305,"ZINC, URINE QUANTITATIVE",34.0,22.1,5.78,30.6,37
CDM,30122315,NEUROFILAMENT LIGHT (NFL),498.0,323.7,5.78,448.2,37
CDM,30122325,ORGANIC ACID SNGL QUANT-LABCORP,191.0,124.15,5.78,171.9,37
CDM,30122335,"CREATININE, UR (LABCORP PORPHOBILINOGEN, QN, RANDOM UR)",26.0,16.9,2.59,23.4,37
CDM,30122345,UA DIP URINE HCG (POINT OF CARE LAB),81.0,52.65,2.59,72.9,37
CDM,30122365,"ACYLCARNITINES, QUANTIT, P-MAYO",103.0,66.95,5.78,92.7,37
CDM,30122375,"5-HIAA, PLASMA - LABCORP",45.0,29.25,6.33,40.5,37
CDM,30122385,"HYDROXYCHLOROQUINE, BLOOD",388.0,252.2,5.81,349.2,37
CDM,30122395,"CARNITINE, P",72.0,46.8,5.78,64.8,37
CDM,30122405,VENLAFAXINE SERUM/PLASMA - ARUP,136.0,88.4,6.62,122.4,27
CDM,30122415,IMMUNOASSAY QUANT NOS NONAB,120.0,78.0,5.78,108.0,37
CDM,30122425,ADIPONECTIN,202.0,131.3,5.78,181.8,37
CDM,30122435,BLOOD GAS MIXED WO O2 SAT,52.0,33.8,13.0,46.8,37
CDM,30122445,"VEDOLIZUMAB QN, S",347.0,225.55,5.81,312.3,37
CDM,30122455,"VEDOLIZUMAB AB, S",127.0,82.55,5.78,114.3,37
CDM,30122465,"USTEKINUMAB QN, S",205.0,133.25,5.81,184.5,37
CDM,30122475,"USTEKINUMAB AB, S",190.0,123.5,5.78,171.0,37
CDM,30122485,ASSAY OF LACTIC ACID,35.0,22.75,5.78,31.5,37
CDM,30122495,"NEURONAL AB (TR/DNER) IGG, SER",204.0,132.6,19.47,183.6,37
CDM,30122505,"NEURONAL NUCLEAR AB (HU) IGG, IB, SERUM",204.0,132.6,19.47,183.6,37
CDM,30122525,"NEURONAL AB (TR/DNER) IGG, CSF",204.0,132.6,19.47,183.6,37
CDM,30122535,MPS ELECTROPHORESIS,185.0,120.25,13.39,166.5,37
CDM,30122545,MUCOPOLYSACCHARIDES MG/MMOL CRT,86.0,55.9,13.39,77.4,37
CDM,30122555,ATLANTIC RESPIRATORY PANEL IGE TOTAL,41.0,26.65,5.78,36.9,37
CDM,30122565,"BULLOUS PEMPHIGOID, BP180 AND BP230, IGG ANTIBODIES",35.0,22.75,5.78,31.5,37
CDM,30122575,CHRONIC VIRAL HEPATITIS NEPHELOMETRY (ARUP),85.0,55.25,5.23,76.5,37
CDM,30122585,"ASPARTATE AMINOTRANSFERASE, FIBROMETER",16.0,10.4,2.59,14.4,37
CDM,30122595,"ALANINE AMINOTRANSFERASE, FIBROMETER",16.0,10.4,2.59,14.4,37
CDM,30122605,"UREA NITROGEN, SERUM, FIBROMETER",12.0,7.8,2.59,10.8,37
CDM,30122615,"GAMMA GLUTAMYL TRANSFERASE, FIBROMETER",22.0,14.3,2.59,19.8,37
CDM,30122625,SENMOT IMMUNOASSAY (ARUP),35.0,22.75,5.78,31.5,37
CDM,30122635,SENNRO IMMUNOASSAY (ARUP),35.0,22.75,5.78,31.5,37
CDM,30122645,INHIBIN B,52.0,33.8,5.78,46.8,37
CDM,30122655,GAUCHER GBA ACTIVITY LEUKOCYTES,200.0,130.0,5.78,180.0,37
CDM,30122665,VITAMIN B3 (NIACIN AND METABOLITES),136.0,88.4,5.78,122.4,37
CDM,30122675,7ALPHAC4,289.0,187.85,5.78,260.1,37
CDM,30122685,PHI PROST SPEC AG TOT,40.0,26.0,5.78,36.0,37
CDM,30122695,ADIPONECTIN,202.0,131.3,5.78,181.8,37
CDM,30122705,DRGTOF OPIATE CONFIRMATION,53.0,34.45,13.25,125.87,37
CDM,30122715,DRGTOF TRAMADOL,53.0,34.45,13.25,125.87,37
CDM,30122725,OPIOIDS AND OPIATE ANALOGS (DRGTOF),53.0,34.45,13.25,125.87,37
CDM,30122735,DRGTOF GABAPENTIN,53.0,34.45,13.25,125.87,37
CDM,30122745,DRGTOF AMPHETAMINES,53.0,34.45,13.25,125.87,37
CDM,30122755,DRGTOF ZOLPIDEM,53.0,34.45,13.25,125.87,37
CDM,30122765,OPIATE CONFIRMATION (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30122775,TRAMADOL (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30122785,OPIOIDS AND OPIATE ANALOGS (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30122795,GABAPENTIN (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30122805,AMPHETAMINES (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30122815,METHYLPHENIDATE (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30122825,ALKALOID DRUGS (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30122835,ZOLPIDEM (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30122845,LORAZEPAM,210.0,136.5,33.04,191.21,37
CDM,30122865,"SYNTHETIC GLUCOCORTICOID SCREEN, URINE",180.0,117.0,5.81,162.0,37
CDM,30122875,CORTISOL,162.0,105.3,6.33,145.8,37
CDM,30122885,"IMMUNOASSAY, LACTOFERRIN, FECAL, QUALITATIVE",65.0,42.25,5.78,58.5,37
CDM,30122895,ARIPIPRAZOLE AND METABOLITE,85.0,55.25,21.25,125.87,37
CDM,30122905,"ANTI-SP100 AND ANTI-GP210 ANTIBODIES, IGG",120.0,78.0,5.78,108.0,37
CDM,30122915,HEX4 GLC4,500.0,325.0,5.78,450.0,37
CDM,30122925,HEX4 CREATININE,500.0,325.0,2.59,450.0,37
CDM,30122935,OXYSTEROLS,345.0,224.25,5.78,310.5,37
CDM,30122945,RUFINAMIDE,68.0,44.2,5.81,61.2,37
CDM,30122955,PREGABALIN,68.0,44.2,17.0,125.87,37
CDM,30122965,ETHOSUXIMIDE LEVEL,49.0,31.85,5.81,44.1,37
CDM,30122975,BRIVARACETAM - QUANTITATIVE ASSAY DRUG,68.0,44.2,5.81,61.2,37
CDM,30122985,PERAMPANEL - QUANTITATIVE ASSAY DRUG,68.0,44.2,5.81,61.2,37
CDM,30122995,DRGTOF OPIOIDS AND OPIATE ANALOGS,53.0,34.45,13.25,125.87,37
CDM,30123005,DRGTOF PROPOXYPHENE,53.0,34.45,13.25,125.87,37
CDM,30123015,DTOFMP BENZODIAZEPINES,53.0,34.45,13.25,125.87,37
CDM,30123025,DTOFMP BUPRENORPHINE,53.0,34.45,13.25,125.87,37
CDM,30123035,DTOFMP COCAINE METABOLITE,53.0,34.45,13.25,125.87,37
CDM,30123045,DTOFMP HYDROCODONE,53.0,34.45,13.25,125.87,37
CDM,30123055,DTOFMP HEROIN METABOLITE,53.0,34.45,13.25,125.87,37
CDM,30123065,DTOFMP OXYCODONE AND METABOLITE,53.0,34.45,13.25,125.87,37
CDM,30123075,DTOFMP OPIOIDS,53.0,34.45,13.25,125.87,37
CDM,30123085,DTOFMP OPIOIDS AND OPIATE ANALOGS,53.0,34.45,13.25,125.87,37
CDM,30123095,DTOFMP MDMA,53.0,34.45,13.25,125.87,37
CDM,30123105,DTOFMP AMPHETAMINES,53.0,34.45,13.25,125.87,37
CDM,30123115,DTOFMP BARBITURATES,53.0,34.45,13.25,125.87,37
CDM,30123125,DTOFMP TAPENTADOL,53.0,34.45,13.25,125.87,37
CDM,30123135,DTOFMP METHADONE,53.0,34.45,13.25,125.87,37
CDM,30123145,DTOFMP PHENCYCLIDINE,53.0,34.45,13.25,125.87,37
CDM,30123155,DTOFMP SEDATIVE HYPNOTICS,53.0,34.45,13.25,125.87,37
CDM,30123165,DTOFMP PROPOXYPHENE,53.0,34.45,13.25,125.87,37
CDM,30123175,DTOFMP MARIJUANA METABOLITE,53.0,34.45,13.25,125.87,37
CDM,30123185,BILE ACIDS TOTAL,43.0,27.95,5.78,38.7,37
CDM,30123195,"PHENOLPHTHALEIN, STOOL",53.0,34.45,13.25,125.87,37
CDM,30123205,MELATONIN,295.0,191.75,33.04,265.5,37
CDM,30123215,MLPTHY CRMP-5 WB,146.0,94.9,19.47,131.4,37
CDM,30123225,"MA2/TA ANTIBODY, IGG SERUM",409.0,265.85,19.47,368.1,37
CDM,30123235,"MA2/TA ANTIBODY, IGG CSF",409.0,265.85,19.47,368.1,37
CDM,30123275,INTERLEUKIN 4,121.0,78.65,5.78,108.9,37
CDM,30123285,CREATININE SERUM (TRPHOS),50.0,32.5,2.59,45.0,37
CDM,30123295,CREATININE URINE (TRPHOS),50.0,32.5,2.59,45.0,37
CDM,30123305,"INORGANIC PHOSPHATE, SERUM (TRPHOS)",50.0,32.5,2.59,45.0,37
CDM,30123315,"INORGANIC PHOSPHATE, URINE (TRPHOS)",50.0,32.5,2.59,45.0,37
CDM,30123325,BETA-AMYLOID; 1-42 (ABETA 42),112.0,72.8,28.0,141.81,30
CDM,30123335,"DIURETIC SURVEY, URINE",739.0,480.35,33.04,665.1,37
CDM,30123345,"SULFONYLUREA HYPOGLYCEMIA PANEL, QUANTITATIVE, URINE",739.0,480.35,33.04,665.1,37
CDM,30123355,HUMAN ANTI-MOUSE AB (HAMA),112.0,72.8,5.78,100.8,37
CDM,30123365,AMPHETAMINES CONF URINE,739.0,480.35,33.04,665.1,37
CDM,30123375,METHYLENEDIOXYAMPHETAMINES CONF URINE,739.0,480.35,33.04,665.1,37
CDM,30123385,PCP CONFIRM URINE,739.0,480.35,33.04,665.1,37
CDM,30123395,FENTANYL URINE,739.0,480.35,33.04,665.1,37
CDM,30123405,"TRAMADOL & METAB, QUANT",739.0,480.35,33.04,665.1,37
CDM,30123415,CANNABINOIDS CONF UR,739.0,480.35,33.04,665.1,37
CDM,30123425,UQNTOX AMPHETAMINES,78.0,50.7,19.5,125.87,37
CDM,30123435,UQNTOX BUPRENORPHINE,78.0,50.7,19.5,125.87,37
CDM,30123445,UQNTOX CANNABINOIDS NATURAL,78.0,50.7,19.5,125.87,37
CDM,30123455,UQNTOX COCCAINE,78.0,50.7,19.5,125.87,37
CDM,30123465,UQNTOX FENTANYL,78.0,50.7,19.5,125.87,37
CDM,30123475,UQNTOX HEROINE METABOLITE,78.0,50.7,19.5,125.87,37
CDM,30123485,UQNTOX METHADONE,78.0,50.7,19.5,125.87,37
CDM,30123495,UQNTOX METHYLENEDIOXYAMPHETAMINES,78.0,50.7,19.5,125.87,37
CDM,30123505,UQNTOX OPIATES,78.0,50.7,19.5,125.87,37
CDM,30123515,UQNTOX OPIOIDS 5+,78.0,50.7,19.5,125.87,37
CDM,30123525,UQNTOX OXYCODONE,78.0,50.7,19.5,125.87,37
CDM,30123535,UQNTOX TRAMADOL,78.0,50.7,19.5,125.87,37
CDM,30123545,UQNTOX PHENCYCLIDINE,78.0,50.7,19.5,125.87,37
CDM,30123555,LYMRFX SERUM ALBUMIN,32.0,20.8,2.59,28.8,37
CDM,30123565,LYMRFX CSF ALBUMIN,50.0,32.5,2.59,45.0,37
CDM,30123575,LYMRFX IGG QUANT,60.0,39.0,2.59,54.0,37
CDM,30123585,3-METHYLGLUTACONIC ACID,137.0,89.05,5.78,123.3,37
CDM,30123595,ALPRAZOLAM,739.0,480.35,33.04,665.1,37
CDM,30123605,DERMATOMYOSITIS PANEL,75.0,48.75,5.78,67.5,37
CDM,30123615,IMMUNOBLOT (POLMYO),188.0,122.2,19.47,169.2,37
CDM,30123625,DTOFMP FENTANYL,53.0,34.45,13.25,125.87,37
CDM,30123635,ANTIBODY IMMUNOASSAY (POLMYO),75.0,48.75,5.78,67.5,37
CDM,30123645,"PT AB, IGG",75.0,48.75,5.78,67.5,37
CDM,30123655,DISACCHARIDASE IN TISSUE,144.0,93.6,5.78,129.6,37
CDM,30123665,OXIDIZED LOW-DENSITY LIPOPROTEIN (OXLDL),59.0,38.35,2.59,53.1,37
CDM,30123675,"TESTOSTERONE, TOTAL, SERUM",72.0,46.8,6.33,64.8,37
CDM,30123685,"TESTOSTERONE, FREE, SERUM",112.0,72.8,6.33,100.8,37
CDM,30123695,ENHANCED LIVER FIBROSIS (ELF) SCORE,1142.0,742.3,76.88,1027.8,37
CDM,30123705,"CXCL9 QUANTITATION, SERUM",154.0,100.1,5.78,138.6,37
CDM,30123715,GLUCOSE QUANT (POINT OF CARE LAB),80.0,52.0,2.59,72.0,37
CDM,30123725,BMP I STAT ANALYZER (POINT OF CARE LAB),157.0,102.05,4.31,141.3,37
CDM,30123735,LIPID-LIPO PANEL 1 (POINT OF CARE LAB),178.0,115.7,4.31,160.2,37
CDM,30123745,ASSAY IONIZED CA (POINT OF CARE LAB),124.0,80.6,5.78,111.6,37
CDM,30123755,BILIRUBIN TOTAL (BACK OFFICE),131.0,85.15,2.59,117.9,37
CDM,30123765,OCCULT BLOOD FECES 1-3 TEST (POINT OF CARE LAB),57.0,37.05,2.59,51.3,37
CDM,30123775,ASSAY LACTIC ACID (POINT OF CARE LAB),98.0,63.7,5.78,88.2,37
CDM,30123785,HGB A1C GLYCOSYLATED (POINT OF CARE LAB),107.0,69.55,2.59,96.3,37
CDM,30123795,"PH BODY FLUID, NES (POINT OF CARE LAB)",20.0,13.0,2.59,18.0,37
CDM,30123805,BLOOD GAS (POINT OF CARE LAB),261.0,169.65,32.49,234.9,37
CDM,30123815,HCG TEST QUAL (POINT OF CARE LAB),94.0,61.1,2.59,84.6,37
CDM,30123835,"DRUG TEST, DEFINITVE, PER DAY?1-7?DRUG CLASSES",742.0,482.3,33.04,667.8,37
CDM,30123845,"DRUG TEST, DEFINITVE, PER DAY?8-14?DRUG CLASSES",1015.0,659.75,74.65,913.5,37
CDM,30123855,"DRUG TEST, DEFINITVE, PER DAY?15-21 DRUG CLASSES",1288.0,837.2,74.65,1159.2,37
CDM,30123865,"DRUG TEST, DEFINITVE, PER DAY?22 OR MORE DRUG CLASSES",1600.0,1040.0,74.65,1440.0,37
CDM,30123875,URDRG GABAPENTIN,68.0,44.2,17.0,125.87,37
CDM,30123885,URDRG PREGABALIN,68.0,44.2,17.0,125.87,37
CDM,30123895,URDRG BENZODIAZEPINES,68.0,44.2,17.0,125.87,37
CDM,30123905,URDRG BUPRENORPHINE,68.0,44.2,17.0,125.87,37
CDM,30123915,URDRG CANNABINOIDS,68.0,44.2,17.0,125.87,37
CDM,30123925,URDRG FENTANYL,68.0,44.2,17.0,125.87,37
CDM,30123935,URDRG 6-MONOACETYLMORPHINE,68.0,44.2,17.0,125.87,37
CDM,30123945,URDRG KETAMINE AND NORKETAMINE,68.0,44.2,17.0,125.87,37
CDM,30123955,URDRG METHADONE,68.0,44.2,17.0,125.87,37
CDM,30123965,URDRG OPIATES,68.0,44.2,17.0,125.87,37
CDM,30123975,URDRG SKELETAL MUSCLE RELAXANTS,68.0,44.2,17.0,125.87,37
CDM,30123985,URDRG COCAINE,68.0,44.2,17.0,125.87,37
CDM,30123995,URDRG OPIOIDS,68.0,44.2,17.0,125.87,37
CDM,30124005,URDRG OXYCODONE,68.0,44.2,17.0,125.87,37
CDM,30124015,URDRG DRUGS NOT OTHERWISE SPECIFIED,68.0,44.2,17.0,125.87,37
CDM,30124025,URDRG ZOLPIDEM,68.0,44.2,17.0,125.87,37
CDM,30124035,URDRG TRAMADOL,68.0,44.2,17.0,125.87,37
CDM,30124045,"CENOBAMATE (XCOPRI), PLASMA",121.0,78.65,5.81,108.9,37
CDM,30124055,URDRG AMPHETAMINES,68.0,44.2,17.0,125.87,37
CDM,30124065,URDRG METHYLENEDIOXYAMPHETAMINES,68.0,44.2,17.0,125.87,37
CDM,30124625,BENZODIAZEPINES1-12 (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30124635,CARBOXY-THC (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30124645,DRG BUPRENORPHINE (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30124655,DRG COCAINE (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30124665,ORLOPI OPIATES 1 OR MORE (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30124675,OPISEC OXYCODONE (MEDDRG),64.4,41.86,16.1,125.87,37
CDM,30124685,FENTANYL AND METABOLITE (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30124695,METHYLEEDIOXAMPHETAMINE (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30124705,BARBITURATES (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30124715,TAPENTADOL AND MET (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30124725,METHADONE (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30124735,PHENCYCLIDINE (MECDRG),64.4,41.86,16.1,125.87,37
CDM,30124755,LEAD CONCENTRATION,79.0,51.35,5.78,71.1,37
CDM,30124765,CHLORIDE (POINT OF CARE LAB),73.0,47.45,2.59,65.7,37
CDM,30124775,CREATININE BLOOD (POINT OF CARE LAB),86.0,55.9,2.59,77.4,37
CDM,30124785,BLOOD GAS O2 SATUR ONLY (POINT OF CARE LAB),89.0,57.85,2.59,80.1,37
CDM,30124795,CARBOXYHEMOGLOBIN (POINT OF CARE LAB),17.0,11.05,4.25,17.0,37
CDM,30124805,METHEMOGLOBIN QUANT (POINT OF CARE LAB),65.0,42.25,2.59,58.5,37
CDM,30124835,"ANTI-HMGCR ANTIBODY, IGG",121.0,78.65,5.78,108.9,37
CDM,30124845,"ANTI-HMGCR ANTIBODY, IGG",97.0,63.05,5.78,87.3,37
CDM,30124855,PHOSPHOLIPASE A2 RECEPTOR IGG ANTIBODY ELISA,237.0,154.05,5.78,213.3,37
CDM,30124865,GLUC NON GEST TOLERANCE,36.0,23.4,2.59,32.4,37
CDM,30124875,"GLUC, FASTING",80.0,52.0,2.59,72.0,37
CDM,30124885,NEUROFILAMENT LIGHT (NFL),498.0,323.7,76.88,448.2,30
CDM,30124905,"DIPHENHYDRAMINE, SERUM/PLASMA",115.0,74.75,28.75,125.87,37
CDM,30124915,"METOPROLOL, SER/PL",115.0,74.75,28.75,125.87,37
CDM,30124WE,EXCISION DERMOID CYST NOSE SIMPLE SUBCUTANEOUS,1280.0,832.0,149.43,1280.0,35
CDM,30125205,PTH RELATED PEPTIDE,166.0,107.9,5.78,149.4,37
CDM,30125215,"URDRG STIMULANTS, SYNTHETIC",68.0,44.2,17.0,125.87,37
CDM,30125225,URDRG ALKALOIDS NOS,68.0,44.2,17.0,125.87,37
CDM,30125235,URDRG ASSAY FOR PHENCYCLIDINE,68.0,44.2,17.0,125.87,37
CDM,30125245,"URDRG DRUG SCREENING, TAPENTADOL",68.0,44.2,17.0,125.87,37
CDM,30125WE,EXC DERMOID CYST NOSE COMPLEX UNDER BONE/CRTLG,2920.0,1898.0,351.48,2920.0,35
CDM,30130WE,EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE,1527.0,992.55,207.28,1527.0,35
CDM,30140WE,SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL,1320.0,858.0,166.27,1320.0,35
CDM,30150WE,RHINECTOMY PARTIAL,3820.0,2483.0,464.36,3820.0,35
CDM,30160WE,RHINECTOMY TOTAL,3996.0,2597.4,542.36,3996.0,35
CDM,30200005,ANTI PLATELET FACT 4 X2,189.0,122.85,5.23,170.1,37
CDM,30200010,*AGGLUT FEBRILE EA AG,26.0,16.9,5.23,23.4,37
CDM,30200015,*%ANA,14.0,9.1,3.5,14.0,37
CDM,30200020,*ALLERGEN IGG QUANT/SEMI EA,13.0,8.45,3.25,13.0,37
CDM,30200025,ANTI-STREPTOLYSIN O,17.0,11.05,4.25,15.3,37
CDM,30200030,ALLERGEN IGE QUANT/SEMI EA,14.0,9.1,3.5,12.6,37
CDM,30200035,BETA2 GLYCOPROT IGG/MX2,43.0,27.95,5.23,42.53,37
CDM,30200045,CARDIOLIPIN AB SCREEN,43.0,27.95,5.23,42.53,37
CDM,30200070,AB ID LEUKO AB,83.0,53.95,5.23,74.7,37
CDM,30200075,COLD AGGLUTININS,13.0,8.45,3.25,13.0,37
CDM,30200085,C3 COMPLEMENT B1C/B1A,26.0,16.9,5.23,23.4,37
CDM,30200090,*PLATELET AB SCREEN,41.0,26.65,5.23,36.9,37
CDM,30200105,COMPLEMENT DEFICIENCY,176.0,114.4,5.23,158.4,37
CDM,30200115,CYCLIC CITRU PEPT ANTI IG,23.0,14.95,5.23,21.64,37
CDM,30200125,DNA ANTIBODY,29.0,18.85,5.23,26.1,37
CDM,30200130,*AB ID PLT IG ASSAY RPT,70.0,45.5,5.23,63.0,37
CDM,30200135,ENA ANY METHOD,34.0,22.1,5.23,30.6,37
CDM,30200140,ANTINUCLEAR AB(ANA),51.0,33.15,5.23,45.9,37
CDM,30200145,FLUORESCENT ANTIBODY TITER,24.0,15.6,5.23,21.6,37
CDM,30200150,ANTINUCLEAR AB(ANA) TITER,17.0,11.05,4.25,17.0,37
CDM,30200155,HEPATITIS B SUR AB QUANT,160.0,104.0,5.23,144.0,37
CDM,30200170,*ANTISTREPTOLYSIN 0 TITER,17.0,11.05,4.25,15.3,37
CDM,30200175,%IMMUNOFIXATION,28.0,18.2,5.23,28.0,37
CDM,30200180,C-REACTIVE PROTEIN,142.0,92.3,5.18,127.8,37
CDM,30200185,"MONOCLONAL PROTEIN,FLUID",44.0,28.6,11.0,44.0,37
CDM,30200190,C-REACTIVE PROTEIN HIGH SENSE,65.0,42.25,5.23,58.5,37
CDM,30200200,*BETA 2 GLYCOPROTEIN I AB EA,59.0,38.35,5.23,53.1,37
CDM,30200205,INSULIN ANTIBODY,195.0,126.75,5.23,175.5,37
CDM,30200215,GAD65 ANTIBODY,470.0,305.5,5.23,423.0,37
CDM,30200220,*CARDIOLIPIN AB EA IG CLASS,58.0,37.7,5.23,52.2,37
CDM,30200225,%RETROVIR LYMPH TRANSF,416.0,270.4,19.47,374.4,37
CDM,30200230,*PHOSPHOLIPID AB,46.0,29.9,5.23,41.4,37
CDM,30200235,B CELLS TOTAL COUNT,353.0,229.45,19.47,317.7,37
CDM,30200240,*CHEMOTAXIS ASSAY,64.0,41.6,5.23,57.6,37
CDM,30200245,%PNH CELL AG,204.0,132.6,19.47,183.6,37
CDM,30200250,COLD AGGLUT TITER,13.0,8.45,3.25,13.0,37
CDM,30200255,NK CELLS TOTAL COUNT,249.0,161.85,19.47,224.1,37
CDM,30200260,"COMPLEMENT AG, EA",98.0,63.7,5.23,88.2,37
CDM,30200265,T CELLS TOTAL COUNT,58.0,37.7,14.5,58.0,37
CDM,30200285,T CELL ABSOLUTE COUNT/RATIO,415.0,269.75,19.47,373.5,37
CDM,30200295,%CD4ABS ABSOLUTE COUNT,45.0,29.25,11.25,44.75,37
CDM,30200310,COMPLEMENT/FUNC ACTIVITY EA,209.0,135.85,5.23,188.1,37
CDM,30200315,PB STEM CELL COUNT,399.0,259.35,19.47,359.1,37
CDM,30200325,THYROID PEROXIDASE AB,169.0,109.85,5.23,152.1,37
CDM,30200340,COMPLEMENT TOTAL(CH50),32.0,20.8,5.23,32.0,37
CDM,30200350,COMPLEMENT FIXATION EA AG,97.0,63.05,5.23,87.3,37
CDM,30200355,CRYPTOCOCCAL ANTIGEN,79.0,51.35,5.23,71.1,37
CDM,30200365,TB GOLD PLUS,156.0,101.4,19.47,140.4,37
CDM,30200370,CCP AB,23.0,14.95,5.23,21.64,37
CDM,30200390,*DEOXYRIBONUCLEASE AB,19.0,12.35,4.75,19.0,37
CDM,30200395,TUBERCULOSIS INTRADERMAL (POINT OF CARE LAB),58.0,37.7,5.23,53.1,38
CDM,30200400,DNA AB NATIVE/DOUBLE STRAND,55.0,35.75,5.23,49.5,37
CDM,30200410,DNA AB SNGL STRAND,44.0,28.6,5.23,39.6,37
CDM,30200415,ASPERGILLUS ID,33.0,21.45,5.23,29.7,37
CDM,30200420,EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30200425,BLASTOMYCES ID,25.0,16.25,5.23,22.5,37
CDM,30200435,LYME WESTERN BLOT,100.0,65.0,5.23,90.0,37
CDM,30200445,LYME IGG & IGM SERUM,154.0,100.1,5.23,138.6,37
CDM,30200455,COCCIDIOIDES ID,31.0,20.15,5.23,27.9,37
CDM,30200465,CMV IGG ANTIBODY,29.0,18.85,5.23,26.1,37
CDM,30200475,CMV IGM EIA AB,33.0,21.45,5.23,29.7,37
CDM,30200485,EBV-EA IFA,28.0,18.2,5.23,25.2,37
CDM,30200495,EBV-NA IFA,31.0,20.15,5.23,27.9,37
CDM,30200505,EBV-VCA IFA IGG,34.0,22.1,5.23,30.6,37
CDM,30200515,H PYLORI AB,125.0,81.25,5.23,112.5,37
CDM,30200525,%IDM ANTI HTLV I,62.0,40.3,5.23,55.8,37
CDM,30200540,FAB SCREEN E,131.0,85.15,5.23,117.9,37
CDM,30200545,HIV  CONFIRMATION,98.0,63.7,5.23,88.2,37
CDM,30200575,HISTO ID,25.0,16.25,5.23,23.04,37
CDM,30200605,INFLUENZA A+B CF X2,107.0,69.55,5.23,96.3,37
CDM,30200625,MUMPS IGG ANTIBODY,22.0,14.3,5.23,21.81,37
CDM,30200635,MYCOPLASMA IGM AB,116.0,75.4,5.23,104.4,37
CDM,30200645,PARVO B19 AB IGG & IGMX2,31.0,20.15,5.23,27.9,37
CDM,30200650,*FAB TITER EA AB,56.0,36.4,5.23,50.4,37
CDM,30200655,%IDM CHAGAS,59.0,38.35,5.23,53.1,37
CDM,30200665,RUBELLA IGG SEMI-QUANT,29.0,18.85,5.23,26.1,37
CDM,30200675,MEASLES-RUBEOLA IGG AB,112.0,72.8,5.23,100.8,37
CDM,30200685,TOXOPLAS IGG,141.0,91.65,5.23,126.9,37
CDM,30200695,TOXOPLASMOSIS IGM AB,125.0,81.25,5.23,112.5,37
CDM,30200705,SYPHILIS T PALLIDUM IGG,141.0,91.65,5.23,126.9,37
CDM,30200710,IMMUNOASSY TUMOR CA 15-3,95.0,61.75,5.23,85.5,37
CDM,30200715,VARICELLA ZOSTER IGG AB,28.0,18.2,5.23,25.2,37
CDM,30200725,%CNILE WEST NILE VRS IGM,92.0,59.8,5.23,82.8,37
CDM,30200730,IMMUNOASSY TUMOR CA 19-9,118.0,76.7,5.23,106.2,37
CDM,30200735,%CNILE WEST NILE VRS IGG,92.0,59.8,5.23,82.8,37
CDM,30200740,IMMUNOASSY TUMOR CA 125,92.0,59.8,5.23,82.8,37
CDM,30200750,HTEROPHIL AB SCREEN,219.0,142.35,5.18,197.1,37
CDM,30200755,THYROGLOBULIN AB,131.0,85.15,5.23,117.9,37
CDM,30200770,TUMOR OR OTHER AG QUANT,146.0,94.9,5.23,131.4,37
CDM,30200790,*IMMUNOASSY INFECT AB QUANT,47.0,30.55,5.23,42.3,37
CDM,30200805,HLA ABCDR TT UPDATE,476.0,309.4,28.87,428.4,37
CDM,30200810,*IMMUNOASSY INFECT AB QUAL/SQ,64.0,41.6,5.23,57.6,37
CDM,30200820,IMMUNODIFFUSION NOS,33.0,21.45,5.23,29.7,37
CDM,30200840,IMMUNE CMPLX ASSAY,121.0,78.65,5.23,108.9,37
CDM,30200870,*IMMUNOFIX ELECPHRSIS SERUM,62.0,40.3,5.23,55.8,37
CDM,30200885,*%HEP HBSAG,55.0,35.75,4.02,49.5,37
CDM,30200890,*IMMUNOFIX ELECPHRSIS OTHER,72.0,46.8,18.0,64.8,37
CDM,30200895,HEPATITIS HBSAG CONF,68.0,44.2,4.02,61.2,37
CDM,30200905,AG DETECT NOS IA MULT,153.0,99.45,4.02,137.7,37
CDM,30200920,INHIBIN A,77.0,50.05,5.23,69.3,37
CDM,30200930,*INSULIN AB,32.0,20.8,5.23,32.0,37
CDM,30200935,TH/TO ANTIBODY,561.0,364.65,5.78,504.9,37
CDM,30200945,HUMAN ANTI-MOUSE AB (HAMA),741.0,481.65,5.78,666.9,37
CDM,30200950,INT FAC AB,45.0,29.25,5.23,40.5,37
CDM,30200955,%IBDSGI C REAC PROTEIN,26.0,16.9,5.18,23.4,37
CDM,30200960,ISLET CELL AB,117.0,76.05,5.23,105.3,37
CDM,30200965,HE4,619.0,402.35,5.23,557.1,37
CDM,30200990,LYMPHOCYTE TRANSFORMATION,91.0,59.15,19.47,81.93,37
CDM,30200WE,INJECTION TURBINATE THERAPEUTIC,312.0,202.8,28.44,234.0,35
CDM,30201010,*B CELL TOTAL COUNT,56.0,36.4,14.0,56.0,37
CDM,30201015,RHEUMATOID FACTOR QUANT,98.0,63.7,5.23,88.2,37
CDM,30201020,*NATURAL KILLER TOTAL COUNT,56.0,36.4,14.0,56.0,37
CDM,30201030,*T CELL TOTAL COUNT,56.0,36.4,14.0,56.0,37
CDM,30201035,ADENOVIRUS ANTIBODY,97.0,63.05,5.23,87.3,37
CDM,30201045,ASPERGILLUS QUAL OR SEMI-QUANT,61.0,39.65,5.23,54.9,37
CDM,30201050,*T CELL ABSOLUTE COUNT W RATIO,69.0,44.85,17.25,69.0,37
CDM,30201055,STREPTO.PNEUM.X14,70.0,45.5,5.23,63.0,37
CDM,30201060,*T CELL ABSOLUTE CD4 COUNT,37.0,24.05,9.25,37.0,37
CDM,30201065,%FABCSF BLASTOMYCES,25.0,16.25,5.23,22.5,37
CDM,30201070,MICROSOMAL ANTIBODIES EA,59.0,38.35,5.23,53.1,37
CDM,30201085,BORELIA BURGDORFERI LYME,44.0,28.6,5.23,39.6,37
CDM,30201095,CAMPY JEJUNI AB IGG,239.0,155.35,5.23,215.1,37
CDM,30201100,NEUTRALIZATION TEST VIRAL,318.0,206.7,5.23,286.2,37
CDM,30201110,*NITROBLUE TETRAZLIUM DYE TEST,479.0,311.35,5.23,431.1,37
CDM,30201115,%FABCSF COCCIDIODE IGG/M ABS,31.0,20.15,5.23,27.9,37
CDM,30201130,PARTCL AGGLUT SCREEN EA,133.0,86.45,5.23,119.7,37
CDM,30201145,%TORCHM AB CMV IGM,45.0,29.25,5.23,40.5,37
CDM,30201155,%DIPHTHERIA,25.0,16.25,5.23,25.0,37
CDM,30201165,EHRLICHIA,72.0,46.8,5.23,64.8,37
CDM,30201170,RHEUMATOID FACTOR TEST QUANT,109.0,70.85,5.23,98.1,37
CDM,30201175,GIARDIA LAMBLIA IG/GAM X3,41.0,26.65,5.23,36.9,37
CDM,30201185,"HELMINTH, NES",146.0,94.9,5.23,131.4,37
CDM,30201190,SYPHILIS TEST QUAL,15.0,9.75,3.75,13.5,37
CDM,30201195,HAEMOPHILUS INFLU B IGG,57.0,37.05,5.23,51.3,37
CDM,30201205,HEPATITIS DELTA AB,29.0,18.85,5.23,28.67,37
CDM,30201210,SYPHILIS TEST NON-TREP QUANT,69.0,44.85,4.4,62.1,37
CDM,30201225,HEPATITIS BE ANTIBODY,26.0,16.9,5.23,23.4,37
CDM,30201240,BARTONELLA,47.0,30.55,5.23,42.3,37
CDM,30201245,LEGIONELLA IGM ABS,97.0,63.05,5.23,87.3,37
CDM,30201250,*BRUCELLA AB,17.0,11.05,4.25,15.3,37
CDM,30201255,LEISHMANIASIS,208.0,135.2,5.23,187.2,37
CDM,30201260,CHLAMYDIA,19.0,12.35,4.75,19.0,37
CDM,30201265,LEPTOSPIRA ANTIBODY,177.0,115.05,5.23,159.3,37
CDM,30201275,LISTERIA ANTIBODY,532.0,345.8,5.23,478.8,37
CDM,30201280,*Q FEVER (COXIELLA) AB,29.0,18.85,5.23,26.1,37
CDM,30201285,MUMPS VIRUS AB IGM,76.0,49.4,5.23,68.4,37
CDM,30201295,MYCOPLASMA AB,119.0,77.35,5.23,107.1,37
CDM,30201310,ARBOVIRUS ST LOUIS,56.0,36.4,5.23,50.4,37
CDM,30201335,ENTAMOEBA HISTO IGG,72.0,46.8,5.23,64.8,37
CDM,30201355,RUBELLA IGM IFA,63.0,40.95,5.23,56.7,37
CDM,30201360,*FUNGI AB NOS,69.0,44.85,5.23,62.1,37
CDM,30201365,MEASLES-RUBEOLA IGM AB,101.0,65.65,5.23,90.9,37
CDM,30201390,AB; HSV I,55.0,35.75,5.23,49.5,37
CDM,30201395,TRICHINELLA IGG AB,44.0,28.6,5.23,39.6,37
CDM,30201405,VARICELLA ZOSTER IGM,40.0,26.0,5.23,36.0,37
CDM,30201410,*AB; HSV II,56.0,36.4,5.23,50.4,37
CDM,30201430,HISTOPLASMA AB RPT,25.0,16.25,5.23,23.04,37
CDM,30201450,*INFLUENZA VIRUS AB,103.0,66.95,5.23,92.7,37
CDM,30201460,*LYMPH CHORIOMENINGITIS AB,39.0,25.35,5.23,35.1,37
CDM,30201465,"PT AB, IGG & IGM X2",314.0,204.1,5.23,282.6,27
CDM,30201480,AB; SALMONELLA,92.0,59.8,5.23,82.8,37
CDM,30201485,HISTOPLASMA CAPSULA AG,182.0,118.3,4.02,163.8,37
CDM,30201495,NORWALK-LIKE VIRUS AG,639.0,415.35,4.02,575.1,37
CDM,30201515,"IMMUNOASSAY, CAD TITER",88.0,57.2,4.02,79.2,37
CDM,30201525,HIV 1&2 ANTIGEN/ANTIBODY,186.0,120.9,4.02,167.4,37
CDM,30201545,%HSVG12 IGG 2,35.0,22.75,5.23,32.33,37
CDM,30201555,%HSVG12 IGG 1,28.0,18.2,5.23,25.2,37
CDM,30201570,*VIRUS AB NOS,106.0,68.9,5.23,95.4,37
CDM,30201585,PHOSPHOLIP A2-R AB IGG,255.0,165.75,5.23,229.5,37
CDM,30201595,N-METHYL-D-ASP CSF,729.0,473.85,5.23,656.1,37
CDM,30201605,%ABPA2 IGG TOTAL,25.0,16.25,5.23,22.5,37
CDM,30201615,DNA AB DOUBLE STRANDED,609.0,395.85,5.23,548.1,37
CDM,30201625,SS DNA ANTIBODY IGG,149.0,96.85,5.23,134.1,37
CDM,30201635,BABESIA MICROTI G+M X2,32.0,20.8,5.23,28.8,37
CDM,30201650,HEP C CONFIRM TEST,97.0,63.05,5.23,87.3,37
CDM,30201660,AB SCREEN CYTOTOXIC PRA,209.0,135.85,28.87,188.1,37
CDM,30201670,HLA TYPING DR/DQ MULT AG,430.0,279.5,28.87,387.0,37
CDM,30201675,N MENINGITIIDIS IGG X4,158.0,102.7,5.23,142.2,37
CDM,30201680,HLA TYPING A/B/C MULT AG,154.0,100.1,28.87,138.6,37
CDM,30201685,TETANUS TOXOID IGG,92.0,59.8,5.23,82.8,37
CDM,30201705,DIPHTHERIA TOXOID IGG,64.0,41.6,5.23,57.6,37
CDM,30201725,STREP PNEUMO ABS X14,31.0,20.15,5.23,27.9,37
CDM,30201735,PNEUMO ABS SEROTYPES X23,31.0,20.15,7.75,101.23,30
CDM,30201775,%RHEUMA IMMUNO X2,207.0,134.55,5.78,186.3,37
CDM,30201785,PLATELET AB DETECTION,414.0,269.1,5.23,372.6,37
CDM,30201805,ISLET CELL ANTIBODY,191.0,124.15,5.23,171.9,37
CDM,30201815,GAD65 ANTIBODY,735.0,477.75,5.23,661.5,37
CDM,30201835,%CANDA ALBICAN AB X3,149.0,96.85,5.23,134.1,37
CDM,30201865,C1Q BINDING ASSAY,32.0,20.8,5.23,32.0,37
CDM,30202005,ALLERGEN IGG EACH,76.0,49.4,5.23,68.4,37
CDM,30202015,ALLERGEN IGE EACH,79.0,51.35,5.22,71.1,37
CDM,30202025,COMPLEMENT C2,44.0,28.6,5.23,39.6,37
CDM,30202035,COMPLEMENT COMP4A,541.0,351.65,5.23,486.9,37
CDM,30202045,COMPLEMENT COMP3A,355.0,230.75,5.23,319.5,37
CDM,30202055,COMPLEMENT FUNCT ACT C8,70.0,45.5,5.23,63.0,37
CDM,30202075,PM - 1 ANTIBODY,191.0,124.15,5.23,171.9,37
CDM,30202085,ENA (MYOSPL),74.0,48.1,5.23,66.6,37
CDM,30202095,RETICULIN IGA IGG ABS,124.0,80.6,5.23,111.6,37
CDM,30202105,%IBDSER NEUTROPH SP ABS,83.0,53.95,5.23,74.7,37
CDM,30202115,NMDA IGG,294.0,191.1,5.23,264.6,37
CDM,30202120,*IMMUNODIF QUAL EA AB/AG,53.0,34.45,5.23,47.7,37
CDM,30202125,EPIDERMAL ABS & REFLEXX2,355.0,230.75,5.23,319.5,37
CDM,30202135,NMO AQUAPORIN4 IGG CSF,406.0,263.9,5.23,365.4,37
CDM,30202145,NMO AQUAPORIN4 IGG,264.0,171.6,5.23,237.6,37
CDM,30202165,SKELETAL MUSCLE AB SCREEN,124.0,80.6,5.23,111.6,37
CDM,30202175,ADRENAL ANTIBODY,25.0,16.25,5.23,22.5,37
CDM,30202185,ENDOMYSTAL AB IGG,315.0,204.75,5.23,283.5,37
CDM,30202190,*ADENOVIRUS AB,23.0,14.95,5.23,21.51,37
CDM,30202195,PARANEOPLAST ABS CSF X9,77.0,50.05,5.23,69.3,37
CDM,30202200,ASPERGILLUS AB RPT,32.0,20.8,5.23,28.8,37
CDM,30202205,NMDAG TITER,176.0,114.4,5.23,158.4,37
CDM,30202225,%PARNEO FLUORESCENT X9,59.0,38.35,5.23,53.1,37
CDM,30202245,S-100B PROTEIN,715.0,464.75,5.23,643.5,37
CDM,30202250,BLASTOMYCES AB RPT,25.0,16.25,5.23,22.5,37
CDM,30202255,AFP CSF TUMOR MARKER,85.0,55.25,5.23,76.5,37
CDM,30202265,%HUMOR PNEUMO IGG X14,53.0,34.45,5.23,47.7,37
CDM,30202270,*LYME WESTERN BLOT,24.0,15.6,5.23,24.0,37
CDM,30202275,%ABPA2 ASPERG QUAL OUCHT,97.0,63.05,5.23,87.3,37
CDM,30202285,INHIBIN A,119.0,77.35,5.23,107.1,37
CDM,30202300,COCCIDIOIDES AB RPT,32.0,20.8,5.23,28.8,37
CDM,30202325,URTICARIA-IND ACTIVITY,206.0,133.9,19.47,206.0,37
CDM,30202330,DNA AB SNGL STRAND,43.0,27.95,5.23,38.7,37
CDM,30202335,IMMUNE FUN ASSY ATP,358.0,232.7,19.47,322.2,37
CDM,30202340,ADENOVIRUS AB,99.0,64.35,5.23,89.1,37
CDM,30202345,LPT TO BERYLLIUM,425.0,276.25,19.47,382.5,37
CDM,30202350,PARVOVIRUS AB,83.0,53.95,5.23,74.7,37
CDM,30202355,LYMPH TRANS TEST,425.0,276.25,19.47,382.5,37
CDM,30202360,PARVOVIRUS AB,35.0,22.75,5.23,31.5,37
CDM,30202395,PERTUSSIS/PARAPERT GAM X3,29.0,18.85,5.23,26.1,37
CDM,30202405,B PERTUSSIS AB IGA IB,107.0,69.55,5.23,96.3,37
CDM,30202415,B PERTUSSIS AB IGG IB,107.0,69.55,5.23,96.3,37
CDM,30202425,B PERTUSSIS AB IGM IB,107.0,69.55,5.23,96.3,37
CDM,30202445,%CIGIM ABS X3,53.0,34.45,5.23,47.7,37
CDM,30202465,%CIGIM IGM ABS X3,48.0,31.2,5.23,43.2,37
CDM,30202475,CHLAMYDIA IGM PANEL X3,37.0,24.05,5.23,33.3,37
CDM,30202485,COCCIDIODES IGG/M ABS X2,63.0,40.95,5.23,56.7,37
CDM,30202505,COXIELLA BURNETII IGG X2,110.0,71.5,5.23,99.0,37
CDM,30202515,CMV IGG AVIDITY,133.0,86.45,5.23,119.7,37
CDM,30202520,*CANDIDA AB,84.0,54.6,5.23,75.6,37
CDM,30202525,%IDM CMV,70.0,45.5,5.23,63.0,37
CDM,30202535,COXSACKIE A ABS,53.0,34.45,5.23,47.7,37
CDM,30202545,ECHOVIRUS ANTIBODIES X5,32.0,20.8,5.23,28.8,37
CDM,30202560,*BRUCELLA AB,17.0,11.05,4.25,15.3,37
CDM,30202565,EHRLICHIA CHAF IGG/IGMX2,29.0,18.85,5.23,26.1,37
CDM,30202575,"A PHAGO AB, IGG/IGM X2",62.0,40.3,5.23,55.8,37
CDM,30202580,DIPTHERIA TETANUS AB,57.0,37.05,5.23,51.3,37
CDM,30202585,STRONGYLOIDES IGG ABS,140.0,91.0,5.23,126.0,37
CDM,30202595,FILARIASIS ABS IGG4,528.0,343.2,5.23,475.2,37
CDM,30202605,SCHISTOSOMA IGG AB,652.0,423.8,5.23,586.8,37
CDM,30202615,TOXOCARA ANTIBODIES,182.0,118.3,5.23,163.8,37
CDM,30202635,%CSFTOX TOXOPLAS IGG,33.0,21.45,5.23,29.7,37
CDM,30202645,%CSFTOX TOXOPLAS IGM,68.0,44.2,5.23,61.2,37
CDM,30202655,"VZV IGG AB, CSF",29.0,18.85,5.23,26.1,37
CDM,30202665,HERPES VIRUS 6 IGG AB,176.0,114.4,5.23,158.4,37
CDM,30202670,ANTINUCLEAR,125.0,81.25,5.23,112.5,37
CDM,30202675,DENGUE VIRUS IGM AB,92.0,59.8,5.23,82.8,37
CDM,30202680,"BJP, QT FR KAPPA LAMBDA UR 86335",56.0,36.4,14.0,50.4,37
CDM,30202685,DENGUE FEVER ABS IGG/M X2,118.0,76.7,5.23,106.2,37
CDM,30202695,HV6 HUMAN IGG/IGM ABSX2,349.0,226.85,5.23,314.1,37
CDM,30202705,HERPESVIRUS 6 IGM AB,273.0,177.45,5.23,245.7,37
CDM,30202725,DENGUE VIRUS IGG AB,91.0,59.15,5.23,81.9,37
CDM,30202735,HATAVIRUS IGG & IGM,116.0,75.4,5.23,104.4,37
CDM,30202755,HEPATITIS E IGG/IGM ABX2,286.0,185.9,5.23,257.4,37
CDM,30202765,HTLV I/II ANTIBODY EIA,25.0,16.25,5.23,22.5,37
CDM,30202775,HEPATITIS E IGM,123.0,79.95,5.23,110.7,37
CDM,30202785,HEPATITIS E IGG,123.0,79.95,5.23,110.7,37
CDM,30202805,CHIKUNGUNYA IGM TITER,207.0,134.55,5.23,186.3,37
CDM,30202815,CHIKUNGUNYA IGG TITER,200.0,130.0,5.23,180.0,37
CDM,30202925,XM POST-TX DSA MONITORING  CLASS I,360.0,234.0,81.35,360.0,37
CDM,30202945,XM POST-TX DSA MONITORING  CLASS II,462.0,300.3,81.35,462.0,37
CDM,30202965,MYELIN ANTIBODY IGG,510.0,331.5,5.23,459.0,37
CDM,30202975,NMO/AQP4 FACS TITER,140.0,91.0,5.23,126.0,37
CDM,30203035,"COMPLEMENT C7, FUNC",648.0,421.2,5.23,583.2,37
CDM,30203075,PLA2R AB IGG TITER,595.0,386.75,5.23,535.5,37
CDM,30203085,IMMUNOFIX ELEC GEL,65.0,42.25,5.23,58.5,37
CDM,30203095,"LYME REFLEX PNL, CSF",188.0,122.2,5.23,169.2,37
CDM,30203115,"CANDIDA ABS IGA,G,M X3",129.0,83.85,5.23,116.1,37
CDM,30203125,HIV2 AB CONF SERUM,355.0,230.75,5.23,319.5,37
CDM,30204005,BIRD FANCIERS PRECIPITIN,35.0,22.75,5.23,31.5,37
CDM,30204015,LYME DISEASE AB RFLX,103.0,66.95,5.23,92.7,37
CDM,30204025,LRP4 AB TEST,1042.0,677.3,5.23,937.8,37
CDM,30204035,TRYPANOSOMA CRUZI AB IGG,46.0,29.9,5.23,41.4,37
CDM,30204045,TRYPANOSOMA CRUZI AB IGM,46.0,29.9,5.23,41.4,37
CDM,30204095,COMPLEMENT C1,206.0,133.9,5.23,185.4,37
CDM,30204115,LEGIONELLA PNEUMOPHILA AB,124.0,80.6,5.23,111.6,37
CDM,30204135,HIV 1&2 ANTIBODY SCREEN,145.0,94.25,5.23,130.5,37
CDM,30204145,POLIOVIRUS ABS NEUTRAL X2,64.0,41.6,5.23,57.6,37
CDM,30204445,TEICHOIC ACID ANTIBODIES,113.0,73.45,5.23,101.7,37
CDM,30204455,COXSACKIE A DIFF AB X6,188.0,122.2,5.23,169.2,37
CDM,30204475,HETEROPHILE AB TITER,142.0,92.3,5.23,127.8,37
CDM,30204485,"COMPLEMENT C3, SER",561.0,364.65,5.23,504.9,37
CDM,30204495,"COMPLEMENT C4, SER",207.0,134.55,5.23,186.3,37
CDM,30204535,STRIATED MUSCLE TITER,250.0,162.5,5.23,225.0,37
CDM,30204545,AMPA RECEPTOR AB CBA,1573.0,1022.45,5.23,1415.7,37
CDM,30204595,CASPR2 IGG REFLEX,374.0,243.1,5.23,336.6,37
CDM,30204605,LGI1 IGG,374.0,243.1,5.23,336.6,37
CDM,30204615,%HIVIFA HSV 1 IGM,73.0,47.45,5.23,65.7,37
CDM,30204645,%HSVIFA HSV 2 IGM,87.0,56.55,5.23,78.3,37
CDM,30204775,"GALAC-ALPHA 1,3-GALAC IGE",94.0,61.1,5.23,84.6,37
CDM,30204785,ZIKA VIRUS IGM,135.0,87.75,5.23,121.5,37
CDM,30204805,NMOA4 AQUAPORIN4 IGG,428.0,278.2,5.23,385.2,37
CDM,30204815,%PNUTCP ALLG IGE RECOMBX5,59.0,38.35,5.23,53.1,37
CDM,30204825,NEURO OPTICA/AQP4 IGG REF,136.0,88.4,5.23,122.4,37
CDM,30204845,AQUAPORIN4 REC AB IGG CSF,397.0,258.05,5.23,357.3,37
CDM,30204855,SEROTONIN RELEASE LMWH,420.0,273.0,5.23,378.0,37
CDM,30204865,"A FUMIGATUS AB, IGG",116.0,75.4,5.23,104.4,37
CDM,30204875,PARIETAL CELL AB SCR,146.0,94.9,5.23,131.4,37
CDM,30204885,ALLG SPEC IGE IN HOUSE,107.0,69.55,5.23,96.3,37
CDM,30204915,ASPERGILLUS ID,117.0,76.05,5.23,105.3,37
CDM,30204925,BLASOMYCES DERMATITIDIS AB,56.0,36.4,5.23,50.4,37
CDM,30204935,"COCCIDOIDES AB, CF",94.0,61.1,5.23,84.6,37
CDM,30204945,FUNCF ASPERGILLUS ID,83.0,53.95,5.23,74.7,37
CDM,30204955,FUNCF BLASOMYCES DERMATITIDIS AB,56.0,36.4,5.23,50.4,37
CDM,30204965,FUNCF COCCIDOIDES AB,55.0,35.75,5.23,49.5,37
CDM,30204975,FUNCF HISTOPLASMA AB X2,55.0,35.75,5.23,49.5,37
CDM,30204985,"HISTOPLASMA AB, CF X2",70.0,45.5,5.23,63.0,37
CDM,30204995,BLASTOMYCES D AB RFLX,46.0,29.9,5.23,41.4,37
CDM,30205005,ACHR MODULATING FL RFLX,129.0,83.85,5.23,116.1,37
CDM,30205015,SC5B-9 LEVEL MAC COMPLEX,358.0,232.7,5.23,322.2,37
CDM,30205025,CNSE IMMUNOASSAY TUMOR OT,128.0,83.2,5.23,115.2,37
CDM,30205035,"NEURON SPECIFIC ENOLASE, SER",153.0,99.45,5.23,137.7,37
CDM,30205045,MITOCHONDRIAL ANTIBODY EACH,130.0,84.5,5.23,117.0,37
CDM,30205055,TISSUE TRANSGLUTAMINASE EA,144.0,93.6,5.23,129.6,37
CDM,30205065,GLIADIN ANTIBODY EACH,120.0,78.0,5.23,108.0,37
CDM,30205075,ANTINEUT CYT AB SCR EA,130.0,84.5,5.23,117.0,37
CDM,30205085,ACTIN SMOOTH MUSCLE AB EA,130.0,84.5,5.23,117.0,37
CDM,30205095,CDS1SE AQ4 AB FL CYT EA,402.0,261.3,19.47,361.8,37
CDM,30205105,CDS1SE MOG-IGG1 AB FL EA,402.0,261.3,19.47,361.8,37
CDM,30205115,"MOG AB IGG CBA-IFA SCREEN, SERUM",721.0,468.65,19.47,648.9,37
CDM,30205125,"MOG FACS TITNER, SERUM RFLX",133.0,86.45,19.47,119.7,37
CDM,30205135,NMOA4 FACS ASSAY SERUM,424.0,275.6,19.47,381.6,37
CDM,30205145,NMO/AQP4 FACS SER RFLX,128.0,83.2,19.47,115.2,37
CDM,30205155,VOLTAGE-GATED NA CH AB EA,384.0,249.6,5.23,345.6,37
CDM,30205165,AQPCSF AQ-4 AB EA,394.0,256.1,5.23,354.6,37
CDM,30205175,NMOIFA AQ-4 AB EA,188.0,122.2,5.23,169.2,37
CDM,30205185,IBDSER ANTINEUT CYT AB SCR EA,144.0,93.6,5.23,129.6,37
CDM,30205195,HYPERSENSITIVITY PNEUMONITIS EVALUATION X8,28.0,18.2,5.23,25.2,37
CDM,30205205,"THSD7A AB, S",440.0,286.0,5.23,396.0,37
CDM,30205215,"PLA2R, IMMUNOFLUORESCENCE, S (REFLEX ONLY)",330.0,214.5,5.23,297.0,37
CDM,30205225,CD45RR B CELLS TOTAL COUNT,110.0,71.5,19.47,99.0,37
CDM,30205235,CD45RR NK CELLS TOTAL COUNT,110.0,71.5,19.47,99.0,37
CDM,30205245,CD45RR T CELLS TOTAL COUNT,110.0,71.5,19.47,99.0,37
CDM,30205255,CD45RR T CELL ABSOLUTE COUNT/RATIO,132.0,85.8,19.47,118.8,37
CDM,30205265,CD45RR MONONUCLEAR CELL ANTIGEN X2,77.0,50.05,19.25,69.3,37
CDM,30209950,TREPONEMA PALLIDUM,69.0,44.85,5.23,62.1,37
CDM,30209960,TB TEST CELL IMMUNITY MEAS,157.0,102.05,19.47,141.3,37
CDM,30209970,LHR TEST,185.0,120.25,5.23,166.5,37
CDM,30209980,ENCEPH CALIF LACROSSE,56.0,36.4,5.23,50.4,37
CDM,30210000,HLA TYPING A/B/C SNGL AG,40.0,26.0,2.08,40.0,37
CDM,30210010,CHLAMYDIA IGM,19.0,12.35,4.75,19.0,37
CDM,30210020,BORDETELLA QUAL OR SEMI-QUANT,109.0,70.85,5.23,98.1,37
CDM,30210030,LYMPHOCYTE TRANSFORMATION,437.0,284.05,19.47,393.3,37
CDM,30210040,HEP B SURFACE AB,19.0,12.35,4.75,17.95,37
CDM,30210050,*ALLERG SP IGE;QT OR QUAL,26.0,16.9,5.22,23.4,37
CDM,30210060,*ALLERG SP IGE;QT OR QUAL,26.0,16.9,5.22,23.4,37
CDM,30210070,*ALLERGEN IGE QUANT/SEMI,17.0,11.05,4.25,15.3,37
CDM,30210080,*ALLERGEN IGE QUANT/SEMI,17.0,11.05,4.25,15.3,37
CDM,30210090,*ALLERGEN IGE QUANT/SEMI EA,11.0,7.15,2.75,9.9,37
CDM,30210100,AB ID LEUKO AB,185.0,120.25,5.23,166.5,37
CDM,30210110,*PLATELET AB SCREEN,41.0,26.65,5.23,36.9,37
CDM,30210120,*AB ID PLT RPT,268.0,174.2,5.23,241.2,37
CDM,30210130,*AB ID PLT RPT,51.0,33.15,5.23,45.9,37
CDM,30210140,*AB ID PLT AB,231.0,150.15,5.23,207.9,37
CDM,30210150,*AB ID PLT AB,231.0,150.15,5.23,207.9,37
CDM,30210160,*AB ID PLT AB,134.0,87.1,5.23,120.6,37
CDM,30210170,AB ID PLT AB,56.0,36.4,5.23,50.4,37
CDM,30210180,*AB ID PLT AB,268.0,174.2,5.23,241.2,37
CDM,30210190,*AB ID PLT IG ASSAY,70.0,45.5,5.23,63.0,37
CDM,30210200,ANTINUCLEAR AB(ANA) TITER,17.0,11.05,4.25,17.0,37
CDM,30210210,COMPLEMENT AG EA,80.0,52.0,5.23,72.0,37
CDM,30210220,COMPLEMENT AG EA,47.0,30.55,5.23,42.3,37
CDM,30210230,COMPLEMENT AG EA,47.0,30.55,5.23,42.3,37
CDM,30210240,COMPLEMENT AG EA,98.0,63.7,5.23,88.2,37
CDM,30210250,COMPLEMENT/FUNC ACTIVITY EA,72.0,46.8,5.23,64.8,37
CDM,30210260,COMPLEMENT/FUNC ACTIVITY EA,53.0,34.45,5.23,47.7,37
CDM,30210270,*EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30210280,*EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30210290,EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30210300,EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30210310,EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30210320,EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30210330,*EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30210340,EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30210350,EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30210360,EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30210370,EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30210380,*EX NUC AB,56.0,36.4,5.23,50.4,37
CDM,30210390,EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30210400,FAB SCREEN EA AB,25.0,16.25,5.23,22.5,37
CDM,30210410,FAB SCREEN EA AB,70.0,45.5,5.23,63.0,37
CDM,30210420,FAB SCREEN EA AB,19.0,12.35,4.75,19.0,37
CDM,30210430,FAB SCREEN EA AB,24.0,15.6,5.23,21.6,37
CDM,30210440,FAB SCREEN EA AB,17.0,11.05,4.25,17.0,37
CDM,30210450,FAB SCREEN EA AB,20.0,13.0,5.0,20.0,37
CDM,30210460,FAB SCREEN EA AB,83.0,53.95,5.23,74.7,37
CDM,30210470,FAB SCREEN EA AB,35.0,22.75,5.23,31.5,37
CDM,30210480,FAB SCREEN EA AB,41.0,26.65,5.23,36.9,37
CDM,30210490,FAB SCREEN EA AB,34.0,22.1,5.23,30.6,37
CDM,30210500,*FAB TITER EA AB,37.0,24.05,5.23,33.3,37
CDM,30210510,FAB TITER EA AB,24.0,15.6,5.23,21.6,37
CDM,30210520,*FAB TITER EA AB,37.0,24.05,5.23,33.3,37
CDM,30210530,FAB TITER EA AB,56.0,36.4,5.23,50.4,37
CDM,30210540,FAB TITER EA AB,24.0,15.6,5.23,21.6,37
CDM,30210550,IMMUNOASSY TUMOR CA 15-3,36.0,23.4,5.23,34.77,37
CDM,30210560,HETRPHL AB SCRN,149.0,96.85,5.18,134.1,37
CDM,30210570,IMMUNOASSY TUMOR AG QUANT,68.0,44.2,5.23,61.2,37
CDM,30210580,IMMUNOASSY INFECT AB QUANT,157.0,102.05,5.23,141.3,37
CDM,30210590,IMMUNE CMPLX ASSAY,130.0,84.5,5.23,117.0,37
CDM,30210600,IMMUNE CMPLX ASSAY,37.0,24.05,5.23,37.0,37
CDM,30210610,IMMUNOFIX ELECPHRSIS SERUM,36.0,23.4,5.23,36.0,37
CDM,30210620,*IMMUNOFIX ELECPHRSIS SERUM,72.0,46.8,5.23,64.8,37
CDM,30210630,IMMUNOFIX ELECPHRSIS OTHER,73.0,47.45,18.25,65.7,37
CDM,30210640,IMMUNOFIX ELECPHRSIS OTHER,45.0,29.25,11.25,45.0,37
CDM,30210650,INSULIN AB,32.0,20.8,5.23,32.0,37
CDM,30210660,ISLET CELL AB,124.0,80.6,5.23,111.6,37
CDM,30210670,ISLET CELL AB,37.0,24.05,5.23,37.0,37
CDM,30210680,LYMPHOCYTE TRANSFORMATION,86.0,55.9,19.47,81.93,37
CDM,30210690,*T CELL TOTAL COUNT,56.0,36.4,14.0,56.0,37
CDM,30210700,*T CELL TOTAL COUNT,56.0,36.4,14.0,56.0,37
CDM,30210710,MICROSOMAL AB EA,213.0,138.45,5.23,191.7,37
CDM,30210720,MICROSOMAL AB EA,52.0,33.8,5.23,46.8,37
CDM,30210730,*NITROBLUE TETRAZLIUM DYE TEST,64.0,41.6,5.23,57.6,37
CDM,30210740,NITROBLUE TETRAZLIUM DYE TEST,318.0,206.7,5.23,286.2,37
CDM,30210750,*PARTCL AGGLUT SCREEN EA,24.0,15.6,5.23,21.6,37
CDM,30210760,*PARTCL AGGLUT SCREEN EA,17.0,11.05,4.25,17.0,37
CDM,30210770,PARTCL AGGLUT SCREEN EA,80.0,52.0,5.23,72.0,37
CDM,30210780,*PARTCL AGGLUT SCREEN EA,17.0,11.05,4.25,17.0,37
CDM,30210790,ENCEPH ST LOUIS AB,46.0,29.9,5.23,41.4,37
CDM,30210800,*ENCEPH AB STL,19.0,12.35,4.75,19.0,37
CDM,30210810,ENCEPH AB STL IGG,233.0,151.45,5.23,209.7,37
CDM,30210820,FUNGI AB NOS,121.0,78.65,5.23,108.9,37
CDM,30210830,*FUNGI AB NOS,69.0,44.85,5.23,62.1,37
CDM,30210850,HISTOPLASMA,23.0,14.95,5.23,23.0,37
CDM,30210860,*HISTOPLASMA AB,23.0,14.95,5.23,23.0,37
CDM,30210870,*HISTOPLASMA AB,25.0,16.25,5.23,23.04,37
CDM,30210880,HISTOPLASMA AB,25.0,16.25,5.23,23.04,37
CDM,30210890,*AB; SALMONELLA,34.0,22.1,5.23,30.6,37
CDM,30210900,*AB; SALMONELLA,34.0,22.1,5.23,30.6,37
CDM,30210910,*AB; SALMONELLA,19.0,12.35,4.75,19.0,37
CDM,30210920,*AB; SALMONELLA,19.0,12.35,4.75,19.0,37
CDM,30210930,*VIRUS AB NOS,191.0,124.15,5.23,171.9,37
CDM,30210940,VIRUS AB NOS,57.0,37.05,5.23,51.3,37
CDM,30210950,VIRUS AB NOS,40.0,26.0,5.23,36.0,37
CDM,30210960,*VIRUS AB NOS,58.0,37.7,5.23,52.2,37
CDM,30210970,*VIRUS AB NOS,58.0,37.7,5.23,52.2,37
CDM,30210980,VIRUS AB NOS,97.0,63.05,5.23,87.3,37
CDM,30210990,*VIRUS AB NOS,106.0,68.9,5.23,95.4,37
CDM,30210WE,DISPLACEMENT THERAPY PROETZ TYPE,452.0,293.8,49.97,339.0,35
CDM,30211000,VIRUS AB NOS,39.0,25.35,5.23,35.1,37
CDM,30211010,VIRUS AB NOS,41.0,26.65,5.23,36.9,37
CDM,30211020,VIRUS AB NOS,25.0,16.25,5.23,22.5,37
CDM,30211030,VIRUS AB NOS,213.0,138.45,5.23,191.7,37
CDM,30211040,VIRUS AB NOS,63.0,40.95,5.23,56.7,37
CDM,30211050,*VIRUS AB NOS,191.0,124.15,5.23,171.9,37
CDM,30211060,*ASPERGILLUS AB,25.0,16.25,5.23,25.0,37
CDM,30211070,*BLASTOMYCES AB,25.0,16.25,5.23,22.5,37
CDM,30211080,*COCCIDIOIDES AB,25.0,16.25,5.23,22.5,37
CDM,30211090,*ENTEROVIRUS AB,33.0,21.45,5.23,29.7,37
CDM,30211100,*ENTEROVIRUS AB,20.0,13.0,5.0,20.0,37
CDM,30211110,POLIOVIRUS AB,25.0,16.25,5.23,22.5,37
CDM,30211120,BRUCELLA AB,178.0,115.7,5.23,160.2,37
CDM,30211130,TREPONEMA PALLIDUM,43.0,27.95,5.23,38.7,37
CDM,30211140,TB TEST CELL IMMUNITY MEAS,157.0,102.05,19.47,141.3,37
CDM,30211150,*ALLERGEN IGG QUANT/SEMI EA,13.0,8.45,3.25,13.0,37
CDM,30211160,*CARDIOLIPIN AB EA IG CLASS,58.0,37.7,5.23,52.2,37
CDM,30211170,*PHOSPHOLIPID AB,46.0,29.9,5.23,41.4,37
CDM,30211180,*BARTONELLA AB,47.0,30.55,5.23,42.3,37
CDM,30211190,*Q FEVER (COXIELLA) AB,29.0,18.85,5.23,26.1,37
CDM,30211200,*INFLUENZA VIRUS AB,103.0,66.95,5.23,92.7,37
CDM,30211210,*IMMUNODIF QUAL EA AB/AG,22.0,14.3,5.23,20.02,37
CDM,30211220,BARTONELLA AB,47.0,30.55,5.23,42.3,37
CDM,30211230,*AB ID PLT IG ASSAY,70.0,45.5,5.23,63.0,37
CDM,30211240,*LYMPHOCYTE TRANSFORMATION,182.0,118.3,19.47,163.8,37
CDM,30211250,ANTINUCLEAR AB (ANA),51.0,33.15,5.23,45.9,37
CDM,30211260,*MONONUCLEAR CELL ANTIGEN,131.0,85.15,19.47,117.9,37
CDM,30211270,*MONONUCLEAR CELL ANTIGEN,131.0,85.15,19.47,117.9,37
CDM,30211280,FRANCISELLA TULARENSIS AB,48.0,31.2,5.23,43.2,37
CDM,30211290,FRANCISELLA TULARENSIS AB,75.0,48.75,5.23,67.5,37
CDM,30211300,ANTINUCLEAR AB (ANA),51.0,33.15,5.23,45.9,37
CDM,30211310,ANTINUCLEAR AB (ANA) TITER,53.0,34.45,5.23,47.7,37
CDM,30211320,HIV AB CONFIRM/WESTERN BLOT,35.0,22.75,5.23,32.33,37
CDM,30211330,ANTINUCLEAR AB(ANA) TITER,19.0,12.35,4.75,18.65,37
CDM,30211340,HERPES SIMPLEX TYPE I,55.0,35.75,5.23,49.5,37
CDM,30211350,HLA TYPING A/B/C MULT AG,318.0,206.7,28.87,286.2,37
CDM,30211360,"MONOCLONAL PROTEIN, UR,24HR",95.0,61.75,6.33,85.5,37
CDM,30211370,*ALLERGEN IGE QUANT/SEMI EA,10.0,6.5,2.5,9.0,37
CDM,30211380,*IMMUNOASSAY INFECT AB QUANT,47.0,30.55,5.23,42.3,37
CDM,30211390,*EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30211400,*EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,37
CDM,30211410,"HELICO PYLORI AB, IGM",125.0,81.25,5.23,112.5,37
CDM,30211420,*H PYLORI AB,53.0,34.45,5.23,47.7,37
CDM,30211430,*H PYLORI AB,125.0,81.25,5.23,112.5,37
CDM,30211440,NMO AUTOANTIBODY IGG,268.0,174.2,5.23,241.2,37
CDM,30211450,*CHLAMYDIA IGM AB,39.0,25.35,5.23,35.1,37
CDM,30211460,*CHLAMYDIA IGM AB,39.0,25.35,5.23,35.1,37
CDM,30211470,*CHLAMYDIA AB,39.0,25.35,5.23,35.1,37
CDM,30211480,*CHLAMYDIA AB,39.0,25.35,5.23,35.1,37
CDM,30211490,*HEP B CORE AB TOTAL,24.0,15.6,5.23,21.6,37
CDM,30211500,*HEP B SURFACE AB,24.0,15.6,5.23,21.6,37
CDM,30211510,*HEP C AB,24.0,15.6,5.23,23.85,37
CDM,30211520,*HEP C AB,47.0,30.55,5.23,42.3,37
CDM,30211530,*IMMUNOASSAY INFECT AB QUANT,47.0,30.55,5.23,42.3,37
CDM,30211540,SYPHILIS TEST QUANT,12.0,7.8,3.0,10.8,37
CDM,30211550,VIRUS AB NOS,47.0,30.55,5.23,42.3,37
CDM,30211560,AB PRA FLOW,81.0,52.65,20.25,81.0,37
CDM,30211570,AB ID & VPRA -CLASS I LUMINEX,406.0,263.9,81.35,406.0,37
CDM,30211580,AB ID & VPRA -CLASS II LUMINEX,411.0,267.15,81.35,411.0,37
CDM,30211590,*HLA X-MATCH NON-CYTOTOXIC,463.0,300.95,28.87,416.7,37
CDM,30211600,*HLA X-MATCH NON-CYTOTOXIC,295.0,191.75,28.87,265.5,37
CDM,30211610,*HLA X-MATCH NON-CYTOTOXIC,1052.0,683.8,28.87,946.8,37
CDM,30211620,XM T & B FLOW ALLO- ADD SERUM SAMPLE,579.0,376.35,28.87,521.1,37
CDM,30211630,HLA CLASS I&II ANTIBODY QUAL,178.0,115.7,28.87,160.2,37
CDM,30211640,HLA CLASS I HIGH DEFIN QUAL,406.0,263.9,81.35,406.0,37
CDM,30211650,HLA CLASS II HIGH DEFIN QUAL,411.0,267.15,81.35,411.0,37
CDM,30211660,HLA CLASS I SEMIQUANT PANEL,498.0,323.7,81.35,498.0,37
CDM,30211670,HLA CLASS II SEMIQUANT PANEL,843.0,547.95,81.35,758.7,37
CDM,30211680,*HEP B CORE AB TOTAL,65.0,42.25,5.23,58.5,37
CDM,30211690,*HEP B SURFACE AB,57.0,37.05,5.23,51.3,37
CDM,30211700,*HEP C AB,76.0,49.4,5.23,68.4,37
CDM,30211710,"HEP A, HEP A AB IGM",62.0,40.3,5.23,55.8,37
CDM,30211720,HEP B CORE IGM AB,64.0,41.6,5.23,57.6,37
CDM,30211730,HEP A AB TOTAL,65.0,42.25,5.23,58.5,37
CDM,30211740,EIA HIV-1/HIV-2 SCREEN,80.0,52.0,4.02,72.0,37
CDM,30211750,*FAB SCREEN EA AB,45.0,29.25,5.23,40.5,37
CDM,30211760,*FAB SCREEN EA AB,45.0,29.25,5.23,40.5,37
CDM,30211770,FAB TITER EA AB,68.0,44.2,5.23,61.2,37
CDM,30211780,FAB TITER EA AB,68.0,44.2,5.23,61.2,37
CDM,30211790,*ALLERGEN IGE QUANT/SEMI IGGE,46.0,29.9,5.22,41.4,37
CDM,30211800,*IMMUNODIFFUSION QUAL EA AB/AG,46.0,29.9,5.23,41.4,37
CDM,30211810,*ASPERGILLUS AB,46.0,29.9,5.23,41.4,37
CDM,30211820,ASPERGILLUS AB,134.0,87.1,5.23,120.6,37
CDM,30211830,ISLET CELL AB,262.0,170.3,5.23,235.8,37
CDM,30211840,IA INFECTIOUS AGENT AB QUAN,79.0,51.35,5.23,71.1,37
CDM,30211850,HLA TYPE; A B C MULTI AG,103.0,66.95,25.75,96.92,37
CDM,30211860,CELL FUNCTION ASSAY W/STIM,209.0,135.85,19.47,209.0,37
CDM,30211870,HLA CLASS I&II ANTIBODY QUAL,318.0,206.7,28.87,286.2,37
CDM,30211880,*WEST NILE VIRUS AB,24.0,15.6,5.23,24.0,37
CDM,30211890,*FAB SCREEN EA AB,21.0,13.65,5.23,20.14,37
CDM,30211900,*FAB SCREEN EA AB,21.0,13.65,5.23,20.14,37
CDM,30211910,*ENCEPHALITIS CALIF AB,56.0,36.4,5.23,50.4,37
CDM,30211920,*ENCEPHALITIS EAST EQUINE AB,55.0,35.75,5.23,49.5,37
CDM,30211930,*ENCEPHALITIS ST LOUIS AB,55.0,35.75,5.23,49.5,37
CDM,30211940,*ENCEPHALITIS WEST EQUINE AB,55.0,35.75,5.23,49.5,37
CDM,30211950,"*WEST NILE VIRUS AB, IGM",55.0,35.75,5.23,49.5,37
CDM,30211960,*HERPES SIMPLEX NONSPECIFIC AB,39.0,25.35,5.23,35.1,37
CDM,30211970,*HERPES SIMPLEX TYPE 1 AB,55.0,35.75,5.23,49.5,37
CDM,30211980,*HERPES SIMPLEX TYPE 2 AB,56.0,36.4,5.23,50.4,37
CDM,30211990,*HLA CLASS I&II ANTIBODY QUAL,86.0,55.9,21.5,86.0,37
CDM,30212000,*HLA CLASS I HIGH DEFIN QUAL,406.0,263.9,81.35,406.0,37
CDM,30212010,*HLA CLASS I&II ANTIBODY QUAL,91.0,59.15,22.75,91.0,37
CDM,30212020,*HLA CLASS II HIGH DEFIN QUAL,411.0,267.15,81.35,411.0,37
CDM,30212030,*HLA CLASS I&II ANTIBODY QUAL,81.0,52.65,20.25,81.0,37
CDM,30212040,*HLA CLASS I HIGH DEFIN QUAL,406.0,263.9,81.35,406.0,37
CDM,30212050,*HLA CLASS II HIGH DEFIN QUAL,411.0,267.15,81.35,411.0,37
CDM,30212060,VIRUS AB NOS,92.0,59.8,5.23,82.8,37
CDM,30212070,VIRUS AB NOS,95.0,61.75,5.23,85.5,37
CDM,30212080,FAB TITER EA AB,44.0,28.6,5.23,39.6,37
CDM,30212090,*RHEUMATOID FACTOR QUANT,116.0,75.4,5.23,104.4,37
CDM,30212100,*VIRUS AB NOS,44.0,28.6,5.23,39.6,37
CDM,30212110,*VIRUS AB NOS,44.0,28.6,5.23,39.6,37
CDM,30212120,CELL ENUMERATION & ID,1042.0,677.3,76.88,937.8,37
CDM,30212130,*MONONUCLEAR CELL ANTIGEN,37.0,24.05,9.25,37.0,37
CDM,30212140,*MONONUCLEAR CELL ANTIGEN,37.0,24.05,9.25,37.0,37
CDM,30212150,HLA CLASS  I SEMIQUANT PANEL,843.0,547.95,81.35,758.7,37
CDM,30212160,HLA CLASS II SEMIQUANT PANEL,843.0,547.95,81.35,758.7,37
CDM,30212170,HLA CLASS I HIGH DEFIN QUAL,738.0,479.7,81.35,664.2,37
CDM,30212180,HLA CLASS II HIGH DEFIN QUAL,636.0,413.4,81.35,572.4,37
CDM,30212190,TREPONEMA PALLIDUM,26.0,16.9,5.23,23.4,37
CDM,30212200,VIRUS AB NOS,140.0,91.0,5.23,126.0,37
CDM,30212210,LEISHMANIA AB,97.0,63.05,5.23,87.3,37
CDM,30212220,DNA AB,58.0,37.7,5.23,52.2,37
CDM,30212230,AB; HTLV OR HIV WB,100.0,65.0,5.23,90.0,37
CDM,30212240,AB; CHLAMYDIA IGM,19.0,12.35,4.75,19.0,37
CDM,30212250,FLUORESCENT AB; SCRN EA AB,25.0,16.25,5.23,22.5,37
CDM,30212260,FLUORESCENT AB; SCRN EA AB,20.0,13.0,5.0,20.0,37
CDM,30212270,ALLERG SP IGG QUAN OR SEMIQUAN,13.0,8.45,3.25,13.0,37
CDM,30212280,BETA 2 GLYCOPROTEIN I AB EA,59.0,38.35,5.23,53.1,37
CDM,30212290,CARDIOLIPIN AB EA IG CLASS,58.0,37.7,5.23,52.2,37
CDM,30212300,ALLERG SP IGG QUAN OR SEMIQUAN,46.0,29.9,5.23,41.4,37
CDM,30212310,AB; VARICELLA-ZOSTER,57.0,37.05,5.23,51.3,37
CDM,30212320,AB; VARICELLA-ZOSTER,58.0,37.7,5.23,52.2,37
CDM,30212330,FLUORESCENT AB; SCRN EA AB,261.0,169.65,5.23,234.9,37
CDM,30212340,PA; TITER EA AB,113.0,73.45,5.23,101.7,37
CDM,30212350,IA; OTHER TUMOR AGA QUAN EA,76.0,49.4,5.23,68.4,37
CDM,30212360,ANTINUCLEAR AB (ANA); TITER,17.0,11.05,4.25,17.0,37
CDM,30212370,AB; LEPTOSPIRA,67.0,43.55,5.23,60.3,37
CDM,30212380,DNA CRITHIDIA ANTIBODY,19.0,12.35,4.75,19.0,37
CDM,30212390,AB; VIRUS NES,92.0,59.8,5.23,82.8,37
CDM,30212400,IA QUANT; CA 125,105.0,68.25,5.23,94.5,37
CDM,30212405,GABA-B RECEPTOR AB CBA,1122.0,729.3,5.23,1009.8,37
CDM,30212410,ID; GEL QUAL; EA AB/AG,36.0,23.4,5.23,32.4,37
CDM,30212415,CHROMOGRANIN A,144.0,93.6,5.23,129.6,37
CDM,30212420,AB; ENTEROVIRUS,65.0,42.25,5.23,58.5,37
CDM,30212430,PEMPHIGUS BASIC SCREEN,174.0,113.1,5.23,156.6,37
CDM,30212440,IMMUNOFIXATION SCREEN SERUM,62.0,40.3,5.23,55.8,37
CDM,30212485,CHROMOGRANIN A,144.0,93.6,5.23,129.6,37
CDM,30212495,ALGN FOOD PANEL IGG X19,13.0,8.45,3.25,13.0,37
CDM,30212500,ZIKA VIRUS IGM ANTIBODY,105.0,68.25,5.23,94.5,37
CDM,30212525,"NERUON SPEC ENOLASE, SER",154.0,100.1,5.78,138.6,37
CDM,30212545,MOG-IGG1 FACS,741.0,481.65,5.23,666.9,37
CDM,30212565,DIPTHERIA TETANUS AB,25.0,16.25,5.23,25.0,37
CDM,30212575,B BURGDO AB IGG IGM X2,57.0,37.05,5.23,51.3,37
CDM,30212635,ANTI NEUT CY AB,84.0,54.6,5.23,75.6,37
CDM,30212675,ASPERGILLUS AB IMDIFF,80.0,52.0,5.23,72.0,37
CDM,30212685,NEUTROPHIL OX BURST BLD,303.0,196.95,19.47,272.7,37
CDM,30212695,CHIKUNGUNYA AB IGG IGM X2,83.0,53.95,5.23,74.7,37
CDM,30212755,PARIETAL CELL TITER,59.0,38.35,5.23,53.1,37
CDM,30212765,ADRENAL AB TITER RFLX,57.0,37.05,5.23,51.3,37
CDM,30212775,CJD IMASSAY IA AB QNT,64.0,41.6,5.23,57.6,37
CDM,30212855,DPPX AB CBA CSF RFLX,673.0,437.45,5.23,605.7,37
CDM,30212865,DPPX AB IFA TITER CSF RFLX,184.0,119.6,5.23,165.6,37
CDM,30212885,MGLUR1 AB CBA CSF RFLX,673.0,437.45,5.23,605.7,37
CDM,30212895,MGLUR1 AB IFA TITER CSF RFLX,184.0,119.6,5.23,165.6,37
CDM,30212915,IDM HEP B CORE AB TOTAL,36.0,23.4,5.23,32.4,37
CDM,30212925,IDM HEP C AB,43.0,27.95,5.23,38.7,37
CDM,30212985,PARANEOPLSTC AB PANEL X2,165.0,107.25,5.23,148.5,37
CDM,30213015,AIDYSA FLUOR AB SCRN,80.0,52.0,5.23,72.0,37
CDM,30213025,AIDYSA ISLET CELL AB,101.0,65.65,5.23,90.9,37
CDM,30213055,DPCBAX FLUOR AB SCRN,629.0,408.85,5.23,566.1,37
CDM,30213065,DPIFAX FLUOR AB TITER,165.0,107.25,5.23,148.5,37
CDM,30213095,"MGLUR1 AB CBA, SER",673.0,437.45,5.23,605.7,37
CDM,30213115,"MGLUR1 AB IFA TITER, SER",184.0,119.6,5.23,165.6,37
CDM,30213135,WHIIVF SYPHILIS TEST,8.0,5.2,2.0,7.2,37
CDM,30213165,WHIIVF2 RUBELLA IGG SEMI-QUANT,12.0,7.8,3.0,15.83,37
CDM,30213185,WHIIVF2 CMV IGG AB,22.0,14.3,5.23,22.0,37
CDM,30213195,WHIIVF2 CMV IGM EIA AB,17.0,11.05,4.25,18.54,37
CDM,30213205,C5COMF COMPLEMENT/FUNCTION ACTIVITY,234.0,152.1,5.23,210.6,37
CDM,30213215,GBMGP FLUORESCENT ANTIBODY SCREEN,67.0,43.55,5.23,60.3,37
CDM,30213225,HUANT FLUORESCENT ANTIBODY SCREEN,86.0,55.9,5.23,77.4,37
CDM,30213235,ACESTR FLUORESCENT ANTIBODY SCREEN,84.0,54.6,5.23,75.6,37
CDM,30213245,GABTTR FLUORESCENT ANTIBODY TITER,271.0,176.15,5.23,243.9,37
CDM,30213255,AMPIFC FLUORESCENT ANTIBODY TITER,156.0,101.4,5.23,140.4,37
CDM,30213265,NANNTR FLUORESCENT ANTIBODY TITER,168.0,109.2,5.23,151.2,37
CDM,30213275,HUTIT FLUORESCENT ANTIBODY TITER,86.0,55.9,5.23,77.4,37
CDM,30213285,COVID19 IGG QUAL BY CIA,124.0,80.6,5.23,111.6,37
CDM,30213295,MCROHN C-REAC PROTEIN HS,37.0,24.05,5.23,33.3,37
CDM,30213305,TULRFX AB AGG RFLX,64.0,41.6,5.23,57.6,37
CDM,30213315,AMPA-RECEP AB TITER,275.0,178.75,5.23,247.5,37
CDM,30213325,"HLA-A,B TYPING",444.0,288.6,28.87,399.6,37
CDM,30213335,"HLA-DR,DQ,DRW TYPING",645.0,419.25,28.87,580.5,37
CDM,30213345,XM T&B FLOW ALLO DECEASED DONOR,714.0,464.1,28.87,642.6,37
CDM,30213355,AB PRA FLOW REPEAT,227.0,147.55,28.87,204.3,37
CDM,30213365,AB ID & VPRA -CLASS I LUMINEX REPEAT,971.0,631.15,81.35,873.9,37
CDM,30213375,AB ID DILUTION - CLASS I LUMINEX,971.0,631.15,81.35,873.9,37
CDM,30213385,AB ID CLASS I PHENO BEADS,971.0,631.15,81.35,873.9,37
CDM,30213395,AB ID & VPRA -CLASS II LUMINEX REPEAT,518.0,336.7,81.35,518.0,37
CDM,30213405,AB ID DILUTION - CLASS II LUMINEX,518.0,336.7,81.35,518.0,37
CDM,30213415,AB ID CLASS II PHENO BEADS,518.0,336.7,81.35,518.0,37
CDM,30213425,CNS DEMYELINATING DIS EVAL SER X2,406.0,263.9,5.23,365.4,37
CDM,30213435,"ALGN FOOD, ALPHA-GAL IGE",98.0,63.7,5.23,88.2,37
CDM,30213495,ENCSER FLUORESCENT AB SCRN,64.0,41.6,5.23,57.6,37
CDM,30213505,ENCSER ISLET CELL AB,123.0,79.95,5.23,110.7,37
CDM,30213515,ENCCSF FLUORESCENT AB X21,50.0,32.5,5.23,45.0,37
CDM,30213525,ENCCSF ISLET CELL AB,81.0,52.65,5.23,72.9,37
CDM,30213535,GFAP CBA RFLX,673.0,437.45,5.23,605.7,37
CDM,30213545,GFAP IFA TITER RFLX,184.0,119.6,5.23,165.6,37
CDM,30213555,IGLON5 CBA RFLX,673.0,437.45,5.23,605.7,37
CDM,30213565,IGLON5 IFA TITER RFLX,184.0,119.6,5.23,165.6,37
CDM,30213575,NIF HEAVY CHAIN CBA RFLX,673.0,437.45,5.23,605.7,37
CDM,30213585,NIF IFA TITER RFLX,184.0,119.6,5.23,165.6,37
CDM,30213595,NIF LIGHT CHAIN CBA RFLX,673.0,437.45,5.23,605.7,37
CDM,30213605,ALPHA INTERNEXIN CBA,673.0,437.45,5.23,605.7,37
CDM,30213615,%PARNEO VOLTAGE-GTD CA CHNL ANTB EA,91.0,59.15,5.23,81.9,37
CDM,30213625,ASPERGILLUS FUMIGATUS ANTIBODY IGG,129.0,83.85,5.23,116.1,37
CDM,30213635,WHIIVF SYPHILIS,17.0,11.05,4.25,17.0,37
CDM,30213645,WHIIVF SYPHILIS T PALLIDUM REFLEX,17.0,11.05,4.25,17.0,37
CDM,30213655,PATHOGEN TEST FOR PLTS - LVDS PLTS,1967.0,1278.55,11.52,1770.3,37
CDM,30213665,"AGNTFX - AGNA-1 TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213675,"AN1TFX - ANNA-1 TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213685,"AN2TFX - ANNA-2 TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213695,"AN3TFX - ANNA-3 TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213705,"APHCFX - AMPHIPHYSIN AB TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213715,"CRMCFX - CRMP-5 IGG TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213725,"NCDCFX - NEUROCHONDRIN AB CB ASSAY, SF, REFLEX ONLY",438.0,284.7,5.23,394.2,37
CDM,30213735,"NCTCFX - NEUROCHONDRIN AB TISS IMMFL TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213745,"PCA1FX - PCA-1 TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213755,"PCA2FX - PCA-2 TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213765,"SP7CFX - SEPTIN-7 AB CB ASSAY, SF, REFLEX ONLY",438.0,284.7,5.23,394.2,37
CDM,30213775,"SP7TFX - SEPTIN-7 AB, TISS IMMFL TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213785,"AGNTSR - AGNA-1 TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213795,"AN1TSR - ANNA-1 TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213805,"AN2TSR- ANNA-2 TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213815,"AN3TSR - ANNA-3 TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213825,"APHTSR - AMPHIPHYSIN AB TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213835,"CRMTSR - CRMP-5 NEURONAL IGG TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213845,"NCDCSR - NEUROCHONDRIN AB CB ASSAY, SER, REFLEX ONLY",438.0,284.7,5.23,394.2,37
CDM,30213855,"NCDTSR - NEUROCHONDRIN AB, TISS IMMFL TITER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213865,"PC1TSR - PCA-1 TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213875,"PC2TSR  - PCA-2 TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213885,"SP7CSR - SEPTIN-7 AB CB ASSAY, SER, REFLEX ONLY",438.0,284.7,5.23,394.2,37
CDM,30213895,"SP7TSR - SEPTIN-7 AB, TISS IMMFL TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213905,"APBCSR - AP3B2 AB, CB ASSAY, SER, REFLEX ONLY",438.0,284.7,5.23,394.2,37
CDM,30213915,"APBTSR - AP3B2 AB, TISS IMMFL TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213925,"BRUCELLA IGG/IGM CONF, REFLEX ONLY",197.0,128.05,5.23,177.3,37
CDM,30213935,"PCCTFX - PCA-TR TITER SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213945,"PCTTSR - PCATR TITER SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
CDM,30213955,HUMORAL IMMUNITY PANELS 1/2,18.0,11.7,4.5,18.0,37
CDM,30213995,ZINC TRANSPORTER 8 ANTIBODY,385.0,250.25,5.23,346.5,37
CDM,30214005,C3 NEPHRITIC FACTOR,99.0,64.35,5.23,89.1,37
CDM,30214015,COMPLEMENT FACTOR H,341.0,221.65,5.23,306.9,37
CDM,30214025,COMPLEMENT FACTOR I,341.0,221.65,5.23,306.9,37
CDM,30214035,"ALLERGEN, SESAME SEED RSES I 1 COMPONENT",50.0,32.5,5.23,45.0,37
CDM,30214045,"ALLERGEN, WHEAT, RTRI A OMEGA-5-GLIADIN COMPONENT",50.0,32.5,5.23,45.0,37
CDM,30214055,"ALLERGEN, SESAME SEED WITH COMPONENT REFLEX",14.0,9.1,3.5,12.6,37
CDM,30214065,"ALLERGEN, WHEAT WITH COMPONENT REFLEX",14.0,9.1,3.5,12.6,37
CDM,30214075,"QUANTIFERON-TB GOLD PLUS, BLOOD",136.0,88.4,19.47,122.4,37
CDM,30214085,"ALLERGEN, PAPER WASP COMPONENT IGE",45.0,29.25,5.23,40.5,37
CDM,30214095,"ALLERGEN, HONEY BEE IGE WITH REFLEX TO COMPONENTS",15.0,9.75,3.75,13.5,37
CDM,30214105,"ALLERGEN, YELLOW JACKET (COMMON WASP) IGE WITH REFLEX TO COMPONE",15.0,9.75,3.75,13.5,37
CDM,30214115,"ALLERGEN, PAPER WASP IGE WITH REFLEX TO COMPONENT",15.0,9.75,3.75,13.5,37
CDM,30214125,"ALLERGEN, TOTAL VENOM PANEL IGE WITH REFLEX TO COMPONENTS",15.0,9.75,3.75,13.5,37
CDM,30214135,"ALLERGEN, YELLOW JACKET (COMMON WASP) COMPONENTS IGE",45.0,29.25,5.23,40.5,37
CDM,30214145,ACETYLCHOLINE RECEPTOR MODULATING ANTIBODY,60.0,39.0,5.23,54.0,37
CDM,30214155,ACETYLCHOLINE RECEPTOR (ACHR) BINDING ANTIBODY,46.0,29.9,5.23,41.4,37
CDM,30214165,ACETYLCHOLINE RECEPTOR (ACHR) BLOCKING ANTIBODY,46.0,29.9,5.23,41.4,37
CDM,30214175,"MUSCLE-SPECIFIC KINASE (MUSK) AUTOANTIBODY, SERUM",1238.0,804.7,5.23,1114.2,37
CDM,30214185,ACETYLCHOLINE RECEPTOR BINDING ANTIBODY,55.0,35.75,5.23,49.5,37
CDM,30214195,ACETYLCHOLINE RECEPTOR BLOCKING ANTIBODY,55.0,35.75,5.23,49.5,37
CDM,30214205,B CELL TOTAL-ARUP,264.0,171.6,19.47,237.6,37
CDM,30214215,BPHENO MONONUCLEAR AG - ARUP,187.0,121.55,19.47,168.3,37
CDM,30214225,PLATELET ANTIBODIES,50.0,32.5,5.23,45.0,37
CDM,30214235,PLATELET ANTIBODIES,55.0,35.75,5.23,49.5,37
CDM,30214245,BAL FCM MARKERS,67.0,43.55,16.75,60.3,37
CDM,30214265,"B CELLS, TOTAL COUNT",189.0,122.85,19.47,170.1,37
CDM,30214275,"CD20 MONONUCLEAR CELL ANTIGEN, QUANT",107.0,69.55,19.47,96.3,37
CDM,30214285,F324-IGE HOP (FOOD),16.0,10.4,4.0,14.4,37
CDM,30214295,LUPINE SEED (LUPINUS ALBUS) IGE,42.0,27.3,5.22,37.8,37
CDM,30214305,CHEESE MOZZARELLA IGE,16.0,10.4,4.0,14.4,37
CDM,30214315,CHEESE PARMESAN IGE,16.0,10.4,4.0,14.4,37
CDM,30214325,CHEESE SWISS IGE,16.0,10.4,4.0,14.4,37
CDM,30214335,"ALLERGEN, FOOD, ASPARAGUS IGE",16.0,10.4,4.0,14.4,37
CDM,30214345,"ALLERGEN, FUNGI/MOLD, B. SPICIFERA IGE",16.0,10.4,4.0,14.4,37
CDM,30214355,"ALLERGEN, FUNGI/MOLD, CURVULARIA LUNATA",16.0,10.4,4.0,14.4,37
CDM,30214365,"PDE10A AB IFA TITER, S",121.0,78.65,5.23,108.9,37
CDM,30214375,"TRIM46 AB CBA, S",950.0,617.5,5.23,855.0,37
CDM,30214385,"TRIM46 AB IFA TITER, S",121.0,78.65,5.23,108.9,37
CDM,30214395,"PDE10A AB IFA TITER, CSF",121.0,78.65,5.23,108.9,37
CDM,30214405,"TRIM46 AB CBA, CSF",950.0,617.5,5.23,855.0,37
CDM,30214415,"TRIM46 AB IFA TITER, CSF",121.0,78.65,5.23,108.9,37
CDM,30214425,GLUTAMIC ACID DECARBOXYLASE ANTIBODY,71.0,46.15,5.23,63.9,37
CDM,30214435,"MOG AB IGG CBA-IFA SCREEN, SERUM",121.0,78.65,5.23,108.9,37
CDM,30214445,"NMO/AQP4 AB IGG CBA-IFA SCREEN, SERUM",121.0,78.65,5.23,108.9,37
CDM,30214455,"FLUORESCENT IMMUNOASSAY SCREEN QUAL, SERUM",121.0,78.65,5.23,108.9,37
CDM,30214465,GLUTAMIC ACID DECARBOXYLASE ANTIBODY CSF,71.0,46.15,5.23,63.9,37
CDM,30214475,"NMO/AQP4 AB IGG CBA-IFA SCREEN, CSF",121.0,78.65,5.23,108.9,37
CDM,30214485,"FLUORESCENT IMMUNOASSAY SCREEN QUAL, CSF",121.0,78.65,5.23,108.9,37
CDM,30214495,"REFLEX MGLUR1 AB IGG CBA-IFA TITER, SERUM",559.0,363.35,5.23,503.1,37
CDM,30214505,"GABA-A RECE$TOR IGG CBA-IFA TITER, SERUM",623.0,404.95,5.23,560.7,37
CDM,30214515,"NEURONAL NUCLEAR AB (ANNA) IFA TITER, IGG",121.0,78.65,5.23,108.9,37
CDM,30214525,"PURKINJE CELL ANTIBODY, TITER",121.0,78.65,5.23,108.9,37
CDM,30214535,"MOG AB IGG TITER BY CBA-IFA, SER",375.0,243.75,5.23,337.5,37
CDM,30214545,"LGI1 AB IGG TITER BY CBA-IFA, SER",303.0,196.95,5.23,272.7,37
CDM,30214555,"GABA-BR AB IGG CBA-IFA TITER, SER",375.0,243.75,5.23,337.5,37
CDM,30214565,"DPPX AB IGG TITER BY CBA-IFA, SER",420.0,273.0,5.23,378.0,37
CDM,30214575,"CASPR2 AB IGG TITER BY CBA-IFA, SER",275.0,178.75,5.23,247.5,37
CDM,30214585,"NEURONAL NUCLEAR ANTIBODY (ANNA) IFA TITER, IGG, CSF",185.0,120.25,5.23,166.5,37
CDM,30214595,"PURKINJE CELL ANTIBODY, TITER, CSF",186.0,120.9,5.23,167.4,37
CDM,30214605,"GABA-BR AB IGG CBA-IFA TITER, CSF",375.0,243.75,5.23,337.5,37
CDM,30214615,"CASPR2 AB IGG CBA-IFA TITER, CSF",312.0,202.8,5.23,280.8,37
CDM,30214625,"LGI1 AB IGG CBA-IFA TITER, CSF",345.0,224.25,5.23,310.5,37
CDM,30214635,"DPPX AB IGG CBA-IFA TITER, CSF",420.0,273.0,5.23,378.0,37
CDM,30214645,"GABA-AR AB IGG CBA-IFA TITER, CSF",806.0,523.9,5.23,725.4,37
CDM,30214655,"MGLUR1 AB IGG CBA-IFA TITER, CSF",723.0,469.95,5.23,650.7,37
CDM,30214665,"NEURONAL NUCLEAR AB (HU) IGG, IB, CSF",204.0,132.6,19.47,183.6,37
CDM,30214675,"ALLERGEN, FOOD, APRICOT",16.0,10.4,4.0,14.4,37
CDM,30214685,"ALLERGEN, INSECT, MOSQUITO, IGE",16.0,10.4,4.0,14.4,37
CDM,30214695,"ALLERGEN, FOOD, NUTMEG IGE",16.0,10.4,4.0,14.4,37
CDM,30214705,"NMO/AQP4 AB IGG CBA-IFA SCREEN, SERUM",203.0,131.95,5.23,182.7,37
CDM,30214715,"MOG AB IGG CBA-IFA SCREEN, SERUM",203.0,131.95,5.23,182.7,37
CDM,30214725,"ALLERGEN, WEED, SAGEBRUSH/WORMWOOD IGE",16.0,10.4,4.0,14.4,37
CDM,30214735,"ALLERGEN, FOOD, SUMMER SQUASH IGE",26.0,16.9,5.22,23.4,37
CDM,30214745,"ALLERGEN, FOOD, SPINACH",16.0,10.4,4.0,14.4,37
CDM,30214755,"ALLERGEN, FOOD, TEA IGE",16.0,10.4,4.0,14.4,37
CDM,30214765,"ALLERGEN, FOOD, TURMERIC IGE",31.0,20.15,5.22,27.9,37
CDM,30214775,"ALLERGEN, FOOD, BLACK OLIVE IGE",16.0,10.4,4.0,14.4,37
CDM,30214785,"ALLERGEN, FOOD, CAULIFLOWER IGE",16.0,10.4,4.0,14.4,37
CDM,30214795,"ALLERGEN, FOOD, GOAT MILK IGE",16.0,10.4,4.0,14.4,37
CDM,30214805,"N. MENINGITIDIS A, C, W-135 AND Y IGG",79.0,51.35,5.23,71.1,37
CDM,30214815,"ALLERGEN, FOOD, GINGER IGE",16.0,10.4,4.0,14.4,37
CDM,30214825,"ALLERGEN, FOOD, LIMA BEAN/WHITE BEAN",16.0,10.4,4.0,14.4,37
CDM,30214835,"ALLERGEN, FOOD, LAMB",16.0,10.4,4.0,14.4,37
CDM,30214845,"ALLERGEN, FOOD, NAVY BEAN IGE",16.0,10.4,4.0,14.4,37
CDM,30214855,"ALLERGEN, FOOD, ANCHOVY IGE",16.0,10.4,4.0,14.4,37
CDM,30214865,"ALLERGEN, FOOD, ANNATTO SEED IGE",37.0,24.05,5.22,33.3,37
CDM,30214875,"ALLERGEN, FOOD, EGGPLANT",16.0,10.4,4.0,14.4,37
CDM,30214885,"ALLERGEN, INSECT, FIRE ANT, IMPORTED",16.0,10.4,4.0,14.4,37
CDM,30214895,"ALLERGEN, FOOD, SARDINE IGE",16.0,10.4,4.0,14.4,37
CDM,30214905,"ALLERGEN, INSECT, BUMBLE BEE VENOM IGE",16.0,10.4,4.0,14.4,37
CDM,30214915,"ALLERGEN, FOOD, CAROB GUM IGE",16.0,10.4,4.0,14.4,37
CDM,30214925,"ALLERGEN, TREE, PALM/QUEEN TREE IGE",16.0,10.4,4.0,14.4,37
CDM,30214935,"HOPS, IGE ALLERGEN",37.0,24.05,5.22,33.3,37
CDM,30214945,"ALLERGEN, REGION 3 SOUTH ATLANTIC RESPIRATORY PANEL IGE",13.0,8.45,3.25,11.7,37
CDM,30214955,PLATELET SURFACE GLYCOPROTEIN EXPRESSION,55.0,35.75,5.23,49.5,37
CDM,30214965,HYPERSENSITIVITY PNEUMO IGE QUANT,16.0,10.4,4.0,14.4,37
CDM,30214975,HYPERSENSITIVITY PNEUMO IGE QUAL,24.0,15.6,5.23,21.6,37
CDM,30214985,HYPERSENSITIVITY PNEUMO IA QUAL,45.0,29.25,5.23,40.5,37
CDM,30214995,HYPERSENSITIVITY PNEUMO ID QUAL,36.0,23.4,5.23,32.4,37
CDM,30215005,%ABPA IMMDIFF QUAL,45.0,29.25,5.23,40.5,37
CDM,30215015,"CV2 ANTIBODY TITER, IGG",241.0,156.65,5.23,216.9,37
CDM,30215025,SENMOT FLUORESCENT ANTIBODY (ARUP),36.0,23.4,5.23,32.4,37
CDM,30215035,SENNRO FLUORESCENT AB (ARUP),36.0,23.4,5.23,32.4,37
CDM,30215045,SPSDEV GAD65 AB,71.0,46.15,5.23,63.9,37
CDM,30215055,SPSDEV FLUORESCENT AB SCREEN,36.0,23.4,5.23,32.4,37
CDM,30215065,SPSDEV GLYCINE RECEPTOR ALPHA1 IGG,700.0,455.0,5.78,630.0,37
CDM,30215075,MLPTHY GAD65 AB,118.0,76.7,5.23,106.2,37
CDM,30215085,MLPTHY FLUORESCENT AB SCREEN,121.0,78.65,5.23,108.9,37
CDM,30215095,MLPTHY NMO/AQP4 FACS,189.0,122.85,19.47,170.1,37
CDM,30215105,MLPTHY MOG FACS,189.0,122.85,19.47,170.1,37
CDM,30215115,LYME IGG CSF,110.0,71.5,5.23,99.0,37
CDM,30215125,LYMRFX BORRELIA ANTIBODY,110.0,71.5,5.23,99.0,37
CDM,30215135,SEMIQUANTITATIVE ANA (DERMYO),75.0,48.75,5.23,67.5,37
CDM,30215145,SEMIQUANTITATIVE ANA (MYOSPL),75.0,48.75,5.23,67.5,37
CDM,30215155,ANA (POLMYO),75.0,48.75,5.23,67.5,37
CDM,30215165,IMMUNOASSAY ENA (POLMYO),117.0,76.05,5.23,105.3,37
CDM,30215175,LYMPHOCYTE ANTIGEN PROLIFERATION,318.0,206.7,19.47,286.2,37
CDM,30215185,COMPLEMENT C9 FUNCTIONAL,78.0,50.7,5.23,70.2,37
CDM,30215195,FLOW CD107A CELL FUNCTION,881.0,572.65,19.47,792.9,37
CDM,30215205,PSTAT5 CELL FUNCTION,881.0,572.65,19.47,792.9,37
CDM,30215215,"LYMPHOCYTE SUBSET 2, CD4 PCT. AND ABSL",45.0,29.25,11.25,44.75,37
CDM,30215225,"PCCA/ANNA BY IFA, SERUM",167.0,108.55,5.23,150.3,37
CDM,30215235,"AMPA RECEPTOR AB IGG TITER, CSF",78.0,50.7,5.23,70.2,37
CDM,30215245,"AMPA RECEPTOR AB IGG TITER, SERUM - REFLEX",78.0,50.7,5.23,70.2,37
CDM,30215255,H PYLORI AB (BACK OFFICE),125.0,81.25,5.23,112.5,37
CDM,30215265,HTEROPHIL AB SCREEN (POINT OF CARE LAB),219.0,142.35,5.18,197.1,37
CDM,30215275,"ALLERGEN, BROMELAIN IGE",155.0,100.75,5.23,139.5,37
CDM,30215285,"SEND-OUT PHOSPHOLIPASE A2 RECEPTOR (PLA2R) ANTIBODY, IGG BY IMMU",255.0,165.75,5.23,229.5,37
CDM,30215295,"PHOSPHOLIPASE RECEPTOR A2 ANTIBODY, IGG TITER",83.0,53.95,5.23,74.7,37
CDM,30215365,ALLG SPEC IGE RECOMB EA,36.0,23.4,5.23,32.4,37
CDM,30220WE,INSERTION NASAL SEPTAL PROSTHESIS BUTTON,636.0,413.4,85.7,477.0,35
CDM,30300WE,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,480.0,312.0,60.82,360.0,35
CDM,30310WE,REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES,804.0,522.6,107.62,804.0,35
CDM,30400WE,RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI,4778.0,3105.7,611.82,4778.0,32
CDM,30410WE,RHINP PRIM COMPLETE XTRNL PARTS,5600.0,3640.0,702.56,5600.0,32
CDM,30420WE,RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR,6760.0,4394.0,605.89,6760.0,35
CDM,30430WE,RHINOPLASTY SECONDARY MINOR REVISION,3296.0,2142.4,535.88,3296.0,32
CDM,30435WE,RHINOPLASTY SECONDARY INTERMEDIATE REVISION,5601.0,3640.65,666.8,5601.0,32
CDM,30450WE,RHINOPLASTY SECONDARY MAJOR REVISION,7864.0,5111.6,872.74,7864.0,32
CDM,30460WE,RHINP DFRM W/COLUM LNGTH TIP ONLY,4128.0,2683.2,498.73,4128.0,35
CDM,30462WE,RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT,8112.0,5272.8,966.62,8112.0,35
CDM,30465WE,NASAL VESTIBUL STENOS REPAIR,4944.0,3213.6,599.06,4944.0,35
CDM,30469WE,RPR NSL VLV COLLAPSE LW NRG SUBQ/SBMCSL RMDLG,976.0,634.4,109.38,4101.83,31
CDM,30500020,WBC COUNT MANUAL DIFF,74.0,48.1,2.81,66.6,37
CDM,30500025,BUFFY COAT SEZARY CELL,34.0,22.1,2.81,30.6,37
CDM,30500030,*BLOOD COUNT HCT,44.0,28.6,2.37,39.6,37
CDM,30500040,*BLOOD COUNT HGB,44.0,28.6,2.37,39.6,37
CDM,30500045,STAFF REVIEW,23.0,14.95,2.81,28.44,28
CDM,30500050,CBC AUTO W AUTO DIFF,154.0,100.1,2.81,138.6,37
CDM,30500060,CBC AUTO WO DIFF,144.0,93.6,2.81,129.6,37
CDM,30500065,COAG FACT ASSAY 5,80.0,52.0,2.12,72.0,37
CDM,30500070,MANUAL CELL COUNT EA,123.0,79.95,2.81,110.7,37
CDM,30500075,COAG FACT ASSAY 8,209.0,135.85,2.12,188.1,37
CDM,30500080,RETICULOCTYE COUNT MANUAL,74.0,48.1,2.81,66.6,37
CDM,30500085,VON WILLEBRAND ANTIGEN,289.0,187.85,12.26,260.1,37
CDM,30500090,LEUKO (WBC) COUNT AUTO,51.0,33.15,2.54,45.9,37
CDM,30500095,COAG FACT ASSAY 9,166.0,107.9,12.26,149.4,37
CDM,30500100,COAG FACT ASSAY 10,134.0,87.1,2.12,120.6,37
CDM,30500105,COAG FACT ASSAY 11,76.0,49.4,2.12,68.4,37
CDM,30500110,PLT COUNT AUTO,86.0,55.9,2.81,77.4,37
CDM,30500115,COAG FACTOR ASSAY 13,32.0,20.8,2.12,28.8,37
CDM,30500120,BLOOD SMEAR PERIPH PHYS I&R,23.0,14.95,2.81,28.44,28
CDM,30500125,ANTITHROMBIN 3,20.0,13.0,2.12,19.8,37
CDM,30500130,FACTOR II TEST PRO SPECIFIC,83.0,53.95,2.12,74.7,37
CDM,30500135,PROTEIN C FUNCTIONAL,51.0,33.15,2.12,45.9,37
CDM,30500140,FACTOR V TEST LABILE FACTOR,81.0,52.65,2.12,72.9,37
CDM,30500145,PROTEIN S FREE,25.0,16.25,2.12,25.0,37
CDM,30500150,FACTOR VII TEST STABLE FACTOR,80.0,52.0,2.12,72.0,37
CDM,30500155,APC RESISTANCE,37.0,24.05,2.81,33.3,37
CDM,30500160,FACTOR VIII TEST 1 STAGE,83.0,53.95,2.12,74.7,37
CDM,30500165,%AD13IN FACTR INHIB TEST,173.0,112.45,2.12,155.7,37
CDM,30500180,FACTOR VIII TEST VW FACTOR,50.0,32.5,12.26,45.0,37
CDM,30500185,EUGLOBULIN LYSIS TIME,67.0,43.55,2.81,60.3,37
CDM,30500190,FACTOR VIII TEST VW AG,51.0,33.15,12.26,45.9,37
CDM,30500195,DEGRADATION PRODUCTS,59.0,38.35,2.12,53.1,37
CDM,30500205,COAGULOPATHY INTERPRET,131.0,85.15,2.12,117.9,37
CDM,30500220,FACTOR VIII TEST VW MULT,89.0,57.85,12.26,80.1,37
CDM,30500225,%AD13AC COAG/FIBFUNC ACT,270.0,175.5,12.26,243.0,37
CDM,30500230,FACTOR IX TEST PTC,169.0,109.85,12.26,152.1,37
CDM,30500235,ALPHA 2 ANTIPLASMIN,103.0,66.95,2.12,92.7,37
CDM,30500240,FACTOR X TEST STUART-PROWER,79.0,51.35,2.12,71.1,37
CDM,30500245,PLASMINOGEN FUNCTIONAL,39.0,25.35,2.12,35.1,37
CDM,30500250,FACTOR XI TEST PTA,77.0,50.05,2.12,69.3,37
CDM,30500255,HEINZ BODY STAIN,33.0,21.45,2.81,29.7,37
CDM,30500260,FACTOR XII TEST HAGEMAN,77.0,50.05,12.26,69.3,37
CDM,30500265,KLEIHAUER BETKE ST,68.0,44.2,2.81,61.2,37
CDM,30500270,FACTOR XIII TEST FIBRIN STABL,24.0,15.6,2.12,24.0,37
CDM,30500280,ANTITHROMBIN III ACTIVITY,20.0,13.0,2.12,19.8,37
CDM,30500285,IRON STAIN MISC,84.0,54.6,2.81,75.6,37
CDM,30500290,ANTITHROMBIN III AG ASSAY,33.0,21.45,2.12,29.7,37
CDM,30500300,PROTEIN C AG,39.0,25.35,2.12,35.1,37
CDM,30500310,PROTEIN C ACTIVITY,52.0,33.8,2.12,46.8,37
CDM,30500315,PLATELET NEUTRALIZATION,147.0,95.55,2.12,132.3,37
CDM,30500320,*PROTEIN S TOTAL,25.0,16.25,2.12,22.5,37
CDM,30500325,DILUTE RVVT X2,164.0,106.6,2.12,147.6,37
CDM,30500330,*PROTEIN S FREE,25.0,16.25,2.12,25.0,37
CDM,30500335,REPTILASE R TIME,55.0,35.75,2.81,49.5,37
CDM,30500345,VISCOSITY BLOOD,22.0,14.3,2.81,19.8,37
CDM,30500350,APC RESISTANCE ASSAY,39.0,25.35,2.81,35.1,37
CDM,30500360,FACTOR INHIBITOR TEST,386.0,250.9,2.12,347.4,37
CDM,30500380,ACTIVATED COAGULATION,109.0,70.85,2.12,98.1,37
CDM,30500390,EUGLOBULIN LYSIS,34.0,22.1,2.81,30.6,37
CDM,30500400,D-DIMER QUANT,143.0,92.95,2.12,128.7,37
CDM,30500405,PREKALLIKREIN FLETCHER,652.0,423.8,2.12,586.8,37
CDM,30500410,FIBRINOGEN,144.0,93.6,2.12,129.6,37
CDM,30500420,FIBRIN AG,56.0,36.4,2.12,50.4,37
CDM,30500440,FIBRIN ALPHA-2 ANTIPLASMIN,106.0,68.9,2.12,95.4,37
CDM,30500450,FIBRIN PLASMINOGEN ACTIVATOR,169.0,109.85,2.12,152.1,37
CDM,30500455,RETICULOCYTE HEMOGLOBIN,55.0,35.75,2.81,49.5,37
CDM,30500460,FIBRIN PLASMINOGEN NOT AG,40.0,26.0,2.12,36.0,37
CDM,30500470,HGB FETAL DIFF LYSIS,23.0,14.95,2.81,20.7,37
CDM,30500475,COAG FACT ASSAY 2,81.0,52.65,2.12,72.9,37
CDM,30500485,VWF MULTIMER,88.0,57.2,12.26,79.2,37
CDM,30500495,COAG FACT ASSAY 12,76.0,49.4,12.26,68.4,37
CDM,30500505,PROTEIN C IMMUNO,37.0,24.05,2.12,33.3,37
CDM,30500510,HEPARIN ASSAY,64.0,41.6,2.12,57.6,37
CDM,30500515,PROTEIN S TOTAL,25.0,16.25,2.12,22.5,37
CDM,30500525,COAG FACT ASSAY 7,79.0,51.35,2.12,71.1,37
CDM,30500535,CLOT FACTOR VIII VW RISTOCTN,48.0,31.2,12.0,43.2,37
CDM,30500540,WBC ALKA PHOSPHTAS W COUNT,28.0,18.2,2.81,25.2,37
CDM,30500550,MURAMIDASE,32.0,20.8,2.81,31.33,37
CDM,30500560,OSMOTIC FRAGILITY INCUBATED,34.0,22.1,2.81,30.6,37
CDM,30500565,CLOTTING TEST (POINT OF CARE LAB),107.0,69.55,2.12,96.3,37
CDM,30500570,PLT NEUTRALIZATION,56.0,36.4,2.12,50.4,37
CDM,30500580,*PRO TIME,107.0,69.55,2.12,96.3,37
CDM,30500585,D-DIMER (POINT OF CARE LAB),143.0,92.95,2.12,128.7,37
CDM,30500590,*PRO TIME TEST PLASMA FRACT EA,62.0,40.3,2.12,55.8,37
CDM,30500600,RUSSELL VIPER VENOM UNDILUTED,24.0,15.6,2.12,24.0,37
CDM,30500610,RUSSELL VIPER VENOM DILUTED,57.0,37.05,2.12,51.3,37
CDM,30500615,OSMOTIC FRAG ERYTHRO,107.0,69.55,2.81,96.3,37
CDM,30500620,REPTILASE TEST,56.0,36.4,2.81,50.4,37
CDM,30500630,SEDIMENTATION RATE AUTO,57.0,37.05,2.7,51.3,37
CDM,30500640,RBC SICKLING REDUC,109.0,70.85,2.81,98.1,37
CDM,30500645,%VWD2N ONE STAGE,206.0,133.9,2.12,185.4,37
CDM,30500655,%VWD2N FACTOR ANTIGEN,892.0,579.8,12.26,802.8,37
CDM,30500660,TT PLASMA,50.0,32.5,2.12,45.0,37
CDM,30500670,*PTT PLASMA/WHOLE BLOOD,121.0,78.65,2.12,108.9,37
CDM,30500690,*PTT PLASMA FRACT EA,55.0,35.75,2.12,49.5,37
CDM,30500720,VISCOSITY EXAM,22.0,14.3,2.81,19.8,37
CDM,30500730,CLOTTING FUNCT ACTIVITY,343.0,222.95,12.26,308.7,37
CDM,30500740,HGB FETAL ROS,74.0,48.1,2.81,66.6,37
CDM,30500760,BLOOD TYPE AN,359.0,233.35,2.08,779.93,37
CDM,30500770,CLOTTING; HMW KININOGEN ASSAY,306.0,198.9,2.12,275.4,37
CDM,30500780,*BLOOD PLT AGGREGATION EA,123.0,79.95,12.26,110.7,37
CDM,30500790,FACTOR VIII TEST VW AG,177.0,115.05,12.26,159.3,37
CDM,30500800,*FACTOR VIII TEST VW AG,293.0,190.45,12.26,263.7,37
CDM,30500810,PROTEIN S FREE,44.0,28.6,2.12,39.6,37
CDM,30500820,FACTOR INHIBITOR TEST,129.0,83.85,2.12,116.1,37
CDM,30500830,HEPARIN ASSAY,52.0,33.8,2.12,46.8,37
CDM,30500840,HEPARIN ASSAY,29.0,18.85,2.12,26.1,37
CDM,30500850,RBC SICKLING REDUC,75.0,48.75,2.81,67.5,37
CDM,30500860,*PTT PLASMA/WHOLE BLOOD,32.0,20.8,2.12,28.8,37
CDM,30500870,PTT PLASMA FRACT EA,55.0,35.75,2.12,49.5,37
CDM,30500880,*PTT PLASMA FRACT EA,55.0,35.75,2.12,49.5,37
CDM,30500890,PTT PLASMA FRACT EA,55.0,35.75,2.12,49.5,37
CDM,30500900,*LEUKO (WBC) COUNT AUTO,20.0,13.0,2.54,18.0,37
CDM,30500910,*FACTOR VII TEST 1 STAGE,293.0,190.45,2.12,263.7,37
CDM,30500920,PRO TIME TEST PLASMA FRACT EA,57.0,37.05,2.12,51.3,37
CDM,30500930,BLOOD PLT AGGREGATION EA,121.0,78.65,12.26,108.9,37
CDM,30500940,*BLOOD PLT AGGREGATION EA,121.0,78.65,12.26,108.9,37
CDM,30500950,*BLOOD PLT AGGREGATION EA,121.0,78.65,12.26,108.9,37
CDM,30500960,P2Y12 RESPONSE ASSAY,123.0,79.95,12.26,110.7,37
CDM,30500970,*PRO TIME,12.0,7.8,2.12,10.8,37
CDM,30500980,*PTT PLASMA/WHOLE BLOOD,12.0,7.8,2.12,10.8,37
CDM,30500990,*PTT PLASMA FRACT EA,55.0,35.75,2.12,49.5,37
CDM,30501000,*PTT PLASMA FRACT EA,55.0,35.75,2.12,49.5,37
CDM,30501010,*TT PLASMA,50.0,32.5,2.12,45.0,37
CDM,30501020,*HEPARIN ASSAY,19.0,12.35,2.12,19.0,37
CDM,30501030,*FIBRINOLYSINS SCREEN I&R,51.0,33.15,2.12,45.9,37
CDM,30501040,TT PLASMA,50.0,32.5,2.12,45.0,37
CDM,30501050,D-DIMER QUANT,144.0,93.6,2.12,129.6,37
CDM,30501060,RETICULOCYTE COUNT AUTO,74.0,48.1,2.81,66.6,37
CDM,30501070,FACTOR VIII TEST 1 STAGE,128.0,83.2,2.12,115.2,37
CDM,30501080,*PHYS SVC EVAL IRREGULAR AB,44.0,28.6,11.4,71.74,38
CDM,30501090,*BLOOD PLT AGGREGATION EA,51.0,33.15,12.26,45.9,37
CDM,30501100,THROMBIN TIME,50.0,32.5,2.12,45.0,37
CDM,30501110,ANTIXA,51.0,33.15,2.12,45.9,37
CDM,30501120,*CLOTTING FUNCT ACTIVITY,86.0,55.9,12.26,77.4,37
CDM,30501130,*FIBRINOLYSINS SCREEN I&R,51.0,33.15,2.12,45.9,37
CDM,30501140,*FACTOR INHIBITOR TEST,81.0,52.65,2.12,72.9,37
CDM,30501150,*PTT;SUBSTITU PLASMA FRAC EA,55.0,35.75,2.12,49.5,37
CDM,30501160,*FIBRINOLYSINS OR COAG SCREEN,51.0,33.15,2.12,45.9,37
CDM,30501170,*FACTOR VIII TEST 1 STAGE,80.0,52.0,2.12,72.0,37
CDM,30501180,*FACTOR VIII TEST VW FACTOR,105.0,68.25,12.26,94.5,37
CDM,30501190,*FACTOR VIII TEST VW AG,39.0,25.35,9.75,38.33,37
CDM,30501200,*FACTOR VIII TEST VW MULT,116.0,75.4,12.26,104.4,37
CDM,30501210,*FIBRINOLYSINS SCREEN I&R,107.0,69.55,2.12,96.3,37
CDM,30501220,PRO TIME (POINT OF CARE LAB),56.0,36.4,2.12,50.4,37
CDM,30501230,*PTT PLASMA WHOLE BLOOD,37.0,24.05,2.12,33.3,37
CDM,30501240,*FACTOR VIII TEST 1 STAGE,79.0,51.35,2.12,71.1,37
CDM,30501250,*FACTOR VIII TEST VW FACTOR,79.0,51.35,12.26,71.1,37
CDM,30501260,*FACTOR VIII TEST VW AG,79.0,51.35,12.26,71.1,37
CDM,30501270,*FACTOR VIII TEST VW MULT,79.0,51.35,12.26,71.1,37
CDM,30501280,LEUKO (WBC) COUNT AUTO,51.0,33.15,2.54,45.9,37
CDM,30501290,*BLOOD COUNT HCT,44.0,28.6,2.37,39.6,37
CDM,30501300,*COAG TIME ACTIVATED,109.0,70.85,2.12,98.1,37
CDM,30501310,*FIBRINOGEN ACTIVITY,144.0,93.6,2.12,129.6,37
CDM,30501320,*FIBRINOLYSINS OR COAG SCREEN,51.0,33.15,2.12,45.9,37
CDM,30501330,*BLOOD PLT AGGREGATION EA,121.0,78.65,12.26,108.9,37
CDM,30501340,HEPARIN ASSAY,51.0,33.15,2.12,45.9,37
CDM,30501350,COAG TIME ACTIVATED,109.0,70.85,2.12,98.1,37
CDM,30501360,BLOOD COUNT SPUN MICRO HCT,34.0,22.1,2.81,30.6,37
CDM,30501370,FIBRINOLYSINS OR COAG SCREEN,103.0,66.95,2.12,92.7,37
CDM,30501380,FACTOR INHIBITOR TEST,110.0,71.5,2.12,99.0,37
CDM,30501390,FIBRINOLYSINS OR COAG SCREEN,103.0,66.95,2.12,92.7,37
CDM,30501400,CLOTTING FUNCT ACTIVITY,110.0,71.5,12.26,99.0,37
CDM,30501410,FIBRINOLYSINS OR COAG SCREEN,107.0,69.55,2.12,96.3,37
CDM,30501420,PLATELET NEUTRALIZATION,56.0,36.4,2.12,50.4,37
CDM,30501430,PROTHROMBIN TIME,56.0,36.4,2.12,50.4,37
CDM,30501440,RUSSELL VIPER VENOM TIME DILUT,57.0,37.05,2.12,51.3,37
CDM,30501450,THROMBIN TIME; PLASMA,50.0,32.5,2.12,45.0,37
CDM,30501460,PTT; PLASMA OR WHOLE BLOOD,19.0,12.35,2.12,17.1,37
CDM,30501470,PTT; SUBST PLASMA FRACTIONS EA,55.0,35.75,2.12,49.5,37
CDM,30501480,BLOOD COUNT HGB,44.0,28.6,2.37,39.6,37
CDM,30501490,PRO TIME TEST PLASMA FRACT EA,47.0,30.55,2.12,42.3,37
CDM,30501500,OSMOTIC FRAG RBC; UNINCUBATED,109.0,70.85,2.81,98.1,37
CDM,30501510,BLOOD TYPE ANTIGEN DONOR EA,359.0,233.35,2.08,779.93,37
CDM,30501520,BLOOD TYPING RBC ANTIGENS,359.0,233.35,2.08,779.93,37
CDM,30501530,HGB EVAL CASCADE,107.0,69.55,2.81,96.3,37
CDM,30501555,AVN MANUAL DIFF,73.0,47.45,2.81,65.7,37
CDM,30501655,IMMATURE PLATELET FRACT,166.0,107.9,12.26,149.4,37
CDM,30501685,AUTOMATED RBC COUNT,105.0,68.25,2.81,94.5,37
CDM,30501775,PROTHROMBIN TIME,51.0,33.15,2.12,45.9,37
CDM,30501785,EUGLOBULIN LYSIS TIME,108.0,70.2,2.81,97.2,37
CDM,30501795,VISCOSITY SERUM,95.0,61.75,2.81,85.5,37
CDM,30501805,REPTILASE TIME 1:1 MIX BILL,91.0,59.15,2.81,81.9,37
CDM,30501815,PLASMINOGEN ACTIV INHIB AG,440.0,286.0,2.12,396.0,37
CDM,30501825,VWF GPIBM ACTIVITY,176.0,114.4,12.26,158.4,37
CDM,30501835,PLTEMS FIBRINOLYSINS SCREEN I&R,67.0,43.55,2.12,60.3,37
CDM,30501845,MANUAL HEME - PRO TIME,58.0,37.7,2.12,52.2,37
CDM,30501855,MANUAL HEME - PTT PLASMA/WHOLE BLOOD,69.0,44.85,2.12,62.1,37
CDM,30501885,HEXAGOAL PHASE PHOSPHOLIPID NEUTRALIZATION,50.0,32.5,2.12,45.0,37
CDM,30501895,LUPUS ANTICOAG INTERP PANEL,50.0,32.5,2.12,45.0,37
CDM,30501925,ACTIVATED COAGULATION,17.0,11.05,2.12,15.3,37
CDM,30501935,*BLOOD PLT AGGREGATION EA,100.0,65.0,12.26,90.0,37
CDM,30501945,FIBRINOGEN,39.0,25.35,2.12,35.1,37
CDM,30501955,COAGULATION/FIBRINOLYSIS,73.0,47.45,12.26,65.7,28
CDM,30501965,"SMEAR, PARASITEMIA CELL COUNT",28.0,18.2,2.81,25.2,37
CDM,30501975,MANUAL HEME- FIBRINOGEN,39.0,25.35,2.12,35.1,37
CDM,30501985,MANUAL HEME - FIBRINOGEN,62.0,40.3,2.12,55.8,37
CDM,30501995,HEMATOCRIT (POINT OF CARE LAB),44.0,28.6,2.37,39.6,37
CDM,30502005,BLOOD COUNT HCT (POINT OF CARE LAB),44.0,28.6,2.37,39.6,37
CDM,30502015,BLOOD COUNT HGB (POINT OF CARE LAB),44.0,28.6,2.37,39.6,37
CDM,30502025,PRO TIME (POINT OF CARE LAB),107.0,69.55,2.12,96.3,37
CDM,30502035,"CARBOHYDRATE, UR",74.0,48.1,5.78,66.6,37
CDM,30520WE,SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF,2804.0,1822.6,333.86,2804.0,35
CDM,30560WE,LYSIS INTRANASAL SYNECHIA,524.0,340.6,74.3,419.83,35
CDM,30580WE,REPAIR FISTULA OROMAXILLARY,2752.0,1788.8,223.39,2064.0,35
CDM,30600005,"CULTURE, BACTERIAL, STOOL, EACH PLATE",96.0,62.4,4.02,86.4,37
CDM,30600010,"PROCESSING, AFB CONCENTRATION",45.0,29.25,4.02,40.5,37
CDM,30600015,"CULTURE, BACTERIAL, AEROBIC, QUANTITATIVE",89.0,57.85,4.02,80.1,37
CDM,30600030,"CULTURE, BACTERIAL, BLOOD, AEROBIC AND ANAEROBIC",249.0,161.85,4.02,224.1,37
CDM,30600035,"IDENTIFICATION, ANAEROBIC ISOLATE",77.0,50.05,4.02,69.3,37
CDM,30600050,"CULTURE, BACTERIAL, STOOL, SALMONELLA SHIGELLA",73.0,47.45,4.02,65.7,37
CDM,30600055,CULT FUNGI SKIN HAIR NAIL,24.0,15.6,4.02,21.6,37
CDM,30600065,"CULTURE, FUNGAL ISOLATION",13.0,8.45,3.25,13.0,37
CDM,30600075,"CULTURE, FUNGAL ISOLATION, BLOOD",48.0,31.2,4.02,43.2,37
CDM,30600080,*CULT AEROBIC ADD PATH PRES ID,13.0,8.45,3.25,13.0,37
CDM,30600085,"IDENTIFICATION, YEAST",131.0,85.15,4.02,117.9,37
CDM,30600095,"IDENTIFICATION, MOLD",33.0,21.45,4.02,29.7,37
CDM,30600100,"CULTURE, BACTERIAL, AEROBIC",215.0,139.75,4.02,193.5,37
CDM,30600105,"CULTURE, MYCOPLASMA",143.0,92.95,4.02,128.7,37
CDM,30600115,"CULTURE, ACID FAST",56.0,36.4,4.02,50.4,37
CDM,30600155,MICRO ID BY PNA FISH,172.0,111.8,4.02,154.8,37
CDM,30600160,"CULTURE, BACTERIAL, ANAEROBIC",253.0,164.45,4.02,227.7,37
CDM,30600170,CULT ANAEROBIC DEFIN ID EA,68.0,44.2,4.02,61.2,37
CDM,30600175,ID BY PYROSEQUENCING,176.0,114.4,4.02,158.4,37
CDM,30600180,"IDENTIFICATION, AEROBIC ISOLATE",64.0,41.6,4.02,57.6,37
CDM,30600185,"MACROSCOPIC EXAM, ARTHROPOD",50.0,32.5,4.02,45.0,37
CDM,30600195,"MACROSCOPIC EXAM, PARASITE",14.0,9.1,3.5,12.6,37
CDM,30600205,PINWORM PREP PERIANAL,36.0,23.4,4.02,32.4,37
CDM,30600215,"PROCESSING, TISSUE HOMOGENIZATION",44.0,28.6,4.02,39.6,37
CDM,30600225,"CONCENTRATION AND ID, OVA AND PARASITE",12.0,7.8,3.0,12.0,37
CDM,30600235,SENSITIVITY - DISK PER PLATE,64.0,41.6,4.02,57.6,37
CDM,30600240,"CULTURE, PRESUMPTIVE SCREENING",182.0,118.3,4.02,163.8,37
CDM,30600245,"SUSCEPTIBILITY, ENZYME DETECTION, PER ENZYME",34.0,22.1,4.02,30.6,37
CDM,30600260,CULT/COLONY COUNT QUANT URINE,142.0,92.3,4.02,127.8,37
CDM,30600265,"SMEAR, FUNGAL FLUORESCENT",12.0,7.8,3.0,10.8,37
CDM,30600270,*CULT FUNGI PRES ID OTHER,13.0,8.45,3.25,13.0,37
CDM,30600275,KOH EXAM (POINT OF CARE LAB),37.0,24.05,4.02,33.3,37
CDM,30600285,ENTEROVIRUS CULTURE,227.0,147.55,4.02,204.3,37
CDM,30600295,VIRUS CULTURE W/STAIN,230.0,149.5,4.02,207.0,37
CDM,30600300,*CULT FUNGI PRES ID BLOOD,48.0,31.2,4.02,43.2,37
CDM,30600305,HERPES SIMPLEX CULTURE,362.0,235.3,25.65,325.8,37
CDM,30600310,CULT FUNGI DEFIN ID YEAST,68.0,44.2,4.02,61.2,37
CDM,30600315,*%DFA ADENO,95.0,61.75,4.02,85.5,37
CDM,30600330,CULT FUNGI DEFIN ID MOLD,34.0,22.1,4.02,30.6,37
CDM,30600340,CULT MYCOPLASMA ANY SOURCE,40.0,26.0,4.02,36.0,37
CDM,30600360,*CULT TUBERCLE PRES ID,57.0,37.05,4.02,51.3,37
CDM,30600365,VARICELLA ZOSTER DFA,103.0,66.95,4.02,92.7,37
CDM,30600380,CULT MYCOBACTERIA DEFIN ID,99.0,64.35,4.02,89.1,37
CDM,30600385,HERPES SIMPLEX DFA,123.0,79.95,4.02,110.7,37
CDM,30600395,HEPATITIS BE ANTIGEN,26.0,16.9,4.02,23.4,37
CDM,30600410,MACROSCOPIC EXAM PARASITE,14.0,9.1,3.5,12.6,37
CDM,30600415,"IMMUNOASSAY, ROTAVIRUS",22.0,14.3,4.02,20.02,37
CDM,30600420,PINWORM EXAM,14.0,9.1,3.5,12.6,37
CDM,30600425,%STOOL SHIGA LIKE TOX X2,146.0,94.9,4.02,131.4,37
CDM,30600430,*OVA & PARASITE DIR SMEAR ID,12.0,7.8,3.0,12.0,37
CDM,30600445,%VAGONA CANDIDA,215.0,139.75,4.02,193.5,37
CDM,30600455,CHLAMYDIA TRACH AMPLIFY,55.0,35.75,13.75,55.0,37
CDM,30600465,"AMPLIFICATION, CLOSTRIDIUM DIFFICILE",347.0,225.55,25.65,312.3,37
CDM,30600475,"QUANTIFICATION, CYTOMEGALOVIRUS",624.0,405.6,25.65,561.6,37
CDM,30600480,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL",107.0,69.55,4.02,96.3,37
CDM,30600485,ENTEROVIRUS PCR,352.0,228.8,25.65,316.8,37
CDM,30600490,"SMEAR, GRAM STAIN",74.0,48.1,4.02,66.6,37
CDM,30600500,*SMEAR FLUORESCENT/ACID STAIN,12.0,7.8,3.0,10.8,37
CDM,30600505,%IDM HBVNAT,166.0,107.9,25.65,149.4,37
CDM,30600515,"QUANTIFICATION, HEPATITIS B VIRUS",188.0,122.2,25.65,169.2,37
CDM,30600525,HEPATITIS C AMPLIFIED PROBE,166.0,107.9,25.65,149.4,37
CDM,30600530,SMEAR SPECIAL STAIN,109.0,70.85,4.02,98.1,37
CDM,30600535,"QUANTIFICATION, HEPATITIS C VIRUS",131.0,85.15,25.65,117.9,37
CDM,30600545,"AMPLIFIED PROBE, HERPES SIMPLEX VIRUS",105.0,68.25,25.65,94.5,37
CDM,30600555,HIV-1 DNA BY PCR,306.0,198.9,25.65,275.4,37
CDM,30600565,"QUANTIFICATION, HIV-1",121.0,78.65,25.65,121.0,37
CDM,30600570,SMEAR WET MOUNT,74.0,48.1,4.02,66.6,37
CDM,30600575,LEGIONELLA PNEUM PCR,59.0,38.35,14.75,58.64,37
CDM,30600580,TISSUE CULTURE,75.0,48.75,4.02,67.5,37
CDM,30600585,ID-PROBE M GORDONAE,169.0,109.85,4.02,152.1,37
CDM,30600595,ID MTB COMPLEX VS NTM,304.0,197.6,25.65,273.6,37
CDM,30600620,*VIRUS INOCULATION ADD STUDY,479.0,311.35,4.02,431.1,37
CDM,30600625,GC AMPLIFICATION,55.0,35.75,13.75,55.0,37
CDM,30600645,"AMPLIFICATION, STAPHYLOCOCCUS AUREUS",298.0,193.7,25.65,268.2,37
CDM,30600655,"AMPLIFICATION, METHICILLIN RESISTANCE",251.0,163.15,25.65,225.9,37
CDM,30600675,"AMPLIFICATION, STREPTOCOCCUS, GROUP B",373.0,242.45,25.65,335.7,37
CDM,30600695,BORDETELLA PERTUSSIS,295.0,191.75,25.65,265.5,37
CDM,30600705,"QUANTIFICATION, EPSTEIN-BARR VIRUS",323.0,209.95,25.65,290.7,37
CDM,30600715,INFLUENZA OIA (POINT OF CARE LAB),74.0,48.1,4.02,66.6,37
CDM,30600725,RSV DIRECT OPTICAL,109.0,70.85,4.02,98.1,37
CDM,30600730,VIRUS ID NON-IMMUNOLOGIC,362.0,235.3,25.65,325.8,37
CDM,30600735,"GENOTYPE, HEPATITIS C VIRUS",1346.0,874.9,76.88,1211.4,37
CDM,30600740,*ADENOVIRUS AG IF,25.0,16.25,4.02,24.11,37
CDM,30600760,*BORDATELLA P AG BY DFA,17.0,11.05,4.02,17.0,37
CDM,30600770,*PARAINFLUENZA AG IF,29.0,18.85,4.02,27.45,37
CDM,30600790,POLYVALENT MULT ORGANISM IF,44.0,28.6,4.02,39.6,37
CDM,30600810,"IMMUNOASSAY, CLOSTRIDIUM DIFFICILE TOXIN",109.0,70.85,4.02,98.1,37
CDM,30600820,"IMMUNOASSAY, CRYPTOSPORIDIUM",52.0,33.8,4.02,46.8,37
CDM,30600825,BORDETELLA PERTUSS DFA X2,17.0,11.05,4.02,17.0,37
CDM,30600830,GIARDIA AG EIA,75.0,48.75,4.02,67.5,37
CDM,30600835,HPV DNA 16 18 PCR,69.0,44.85,17.25,62.1,37
CDM,30600840,"IMMUNOASSAY, H. PYLORI",56.0,36.4,4.02,50.4,37
CDM,30600845,%ROTAD ADENOV 40-41,67.0,43.55,4.02,60.3,37
CDM,30600855,ENTAMOEBA HISTOLYT AG,321.0,208.65,4.02,288.9,37
CDM,30600860,HEP B SURFACE AG NEUTRAL,69.0,44.85,4.02,62.1,37
CDM,30600865,HPV DNA PROBE REFLEX,80.0,52.0,20.0,72.0,37
CDM,30600870,HEP BE AG EIA,19.0,12.35,4.02,19.0,37
CDM,30600875,TRICHOMONAS VAG AMP,75.0,48.75,18.75,67.5,37
CDM,30600880,HISTOPLASMA CAPSUL AG EIA,209.0,135.85,4.02,188.1,37
CDM,30600910,*INFECT AGENT NOS EIA MULT,109.0,70.85,4.02,98.1,37
CDM,30600915,HHV-6 PCR,505.0,328.25,25.65,454.5,37
CDM,30600935,LIMULUS AMEBOCYTE LT,425.0,276.25,4.02,382.5,37
CDM,30600945,CYTSEQ NFCT AGT GNTYP ALYS CMV,710.0,461.5,92.55,639.0,37
CDM,30600955,HEPATITIS B GENOTYPING,1213.0,788.45,92.55,1091.7,37
CDM,30600965,HISTOPLASMA ANTIGEN UR,160.0,104.0,4.02,144.0,37
CDM,30600970,*BARTONELLA DNA AMPL PROBE,648.0,421.2,25.65,583.2,37
CDM,30600975,%E18RP CHLAMYDIA PNEU AMP,208.0,135.2,25.65,187.2,37
CDM,30600980,LYME DISEASE DNA AMPL PROBE,249.0,161.85,25.65,224.1,37
CDM,30600985,"IMMUNOASSAY, GIARDIA",74.0,48.1,4.02,66.6,37
CDM,30600995,%E18RP MYCOPLAS PNEU AMP,185.0,120.25,25.65,166.5,37
CDM,30600WE,REPAIR FISTULA ORONASAL,2464.0,1601.6,185.42,1848.0,35
CDM,30601000,CHLAMYDIA PNEUM DNA AMPL PROB,112.0,72.8,25.65,100.8,37
CDM,30601005,RVP BY PCR,521.0,338.65,92.55,521.0,37
CDM,30601010,CHLAMYDIA TRACH DNA DIR PROBE,32.0,20.8,4.02,32.0,37
CDM,30601015,HIV ANTIGEN W/HIV ANTIBODIES,172.0,111.8,25.65,154.8,37
CDM,30601020,CMV DNA AMPL PROB,125.0,81.25,25.65,112.5,37
CDM,30601030,CMV DNA QUANT,109.0,70.85,25.65,98.1,37
CDM,30601040,ENTEROVIRUS DNA AMPL PROBE,360.0,234.0,25.65,324.0,37
CDM,30601050,HEP B DNA QUANT,191.0,124.15,25.65,171.9,37
CDM,30601055,"HIV-1 RNA QUAL, TMA",215.0,139.75,25.65,193.5,37
CDM,30601060,HEP C DIR PROBE,224.0,145.6,25.65,201.6,37
CDM,30601070,*HEP C AMP PROBE,326.0,211.9,25.65,293.4,37
CDM,30601085,CLARITHROMYCIN RESIST,419.0,272.35,25.65,377.1,37
CDM,30601090,HEP C QUANT,133.0,86.45,25.65,119.7,37
CDM,30601100,*HERPES SIMPLEX DNA AMPL,146.0,94.9,25.65,131.4,37
CDM,30601105,TRICHOMONAS ANTIGEN,105.0,68.25,4.02,94.5,37
CDM,30601110,HIV-1 DNA AMPL PROBE,152.0,98.8,25.65,136.8,37
CDM,30601115,DENGUE VIRUS PCR,81.0,52.65,20.25,72.9,37
CDM,30601120,*HIV 1 DNA QUANT,123.0,79.95,25.65,123.0,37
CDM,30601125,CHIKUNGUNYA BY PCR,241.0,156.65,25.65,216.9,37
CDM,30601150,HIV-2 DNA AMPL PROBE,408.0,265.2,25.65,367.2,37
CDM,30601160,MYCOBACTERIA TB DNA AMPL PROB,334.0,217.1,25.65,300.6,37
CDM,30601180,MYCOPLASMA PNEUM DNA AMPL,189.0,122.85,25.65,170.1,37
CDM,30601190,NEISSERIA GONORR DNA DIR,37.0,24.05,4.02,37.0,37
CDM,30601200,HPV HIGH-RISK TYPES,91.0,59.15,22.75,81.9,37
CDM,30601205,TISSUE EXAM KOH,41.0,26.65,4.02,36.9,37
CDM,30601210,INFECT AGENT NOS AMPL PROBE,265.0,172.25,25.65,238.5,37
CDM,30601215,"AMPLIFICATION, STREPTOCOCCUS, GROUP A",255.0,165.75,25.65,229.5,37
CDM,30601245,INFLUENZA RAPID PCR,639.0,415.35,92.55,575.1,37
CDM,30601255,STREP SCREEN,58.0,37.7,4.02,52.2,37
CDM,30601285,"IDENTIFICATION, NUCLEIC ACID SEQUENCING",856.0,556.4,92.55,770.4,37
CDM,30601295,"IDENTIFICATION, MYCOBACTERIAL",97.0,63.05,4.02,87.3,37
CDM,30601305,RAPID FLU X2,74.0,48.1,4.02,66.6,37
CDM,30601360,EBV BY PCR QUANT CSF,330.0,214.5,25.65,297.0,37
CDM,30601365,FLUPCR RAPID PCR FLU,241.0,156.65,60.25,216.9,37
CDM,30601385,%IOHWC GRAM STAIN,56.0,36.4,4.02,50.4,37
CDM,30601395,ENTEROVIRUS BY PCR,312.0,202.8,25.65,280.8,37
CDM,30601415,"IDENTIFICATION, URINE, PRESUMPTIVE",101.0,65.65,4.02,90.9,37
CDM,30601420,MULT ORGANISMS DNA AMPL PROBE,209.0,135.85,25.65,188.1,37
CDM,30601425,"CULTURE,  BACTERIAL, URINE, QUANTITATIVE",142.0,92.3,4.02,127.8,37
CDM,30601430,STREP ASSAY (POINT OF CARE LAB),176.0,114.4,4.02,158.4,37
CDM,30601440,"IMMUNOASSAY, CAD",65.0,42.25,4.02,58.5,37
CDM,30601465,STAPH AUREUS AMPLIFICATION,263.0,170.95,25.65,236.7,37
CDM,30601470,%HIVGEN HIV GENOTYPING,362.0,235.3,76.88,362.0,37
CDM,30601475,%IDM W NILE RNA PCR,150.0,97.5,25.65,135.0,37
CDM,30601490,*HEP C GENOTYPE DNA REVERSE,464.0,301.6,76.88,430.2,37
CDM,30601495,P JIROVECI PCR,163.0,105.95,25.65,146.7,37
CDM,30601500,*HIV PHENOTYPE DNA DRUGS 1-10,680.0,442.0,170.0,680.0,37
CDM,30601520,*HIV PHENOTYPE DNA DRUG EA ADD,131.0,85.15,22.32,117.9,37
CDM,30601535,"IMMUNOASSAY, PAN-MALARIAL",96.0,62.4,4.02,86.4,37
CDM,30601545,"IMMUNOASSAY, MALARIA P. FALCIPARUM",91.0,59.15,4.02,81.9,37
CDM,30601555,"IMMUNOASSAY, STREP PNEUMONIAE ANTIGEN",150.0,97.5,4.02,135.0,37
CDM,30601565,FUNGI ASSAY FOR B-D GLUC,249.0,161.85,4.02,224.1,37
CDM,30601575,BLASTOMYCES ANTIGEN,190.0,123.5,4.02,171.0,37
CDM,30601605,STREP A ASSAY W/OPTIC N/C,176.0,114.4,4.02,158.4,37
CDM,30601615,STREP SCREEN,425.0,276.25,4.02,382.5,37
CDM,30601625,CMV PCR M4,942.0,612.3,25.65,847.8,37
CDM,30601655,HPV DNA HI RISK ANL RECT,162.0,105.3,25.65,145.8,37
CDM,30601675,%MTBAM1 PROBE PCR,629.0,408.85,25.65,566.1,37
CDM,30601685,HTLV I/II DNA PCR X2,801.0,520.65,25.65,720.9,37
CDM,30601705,TOXOPLASMA PCR,616.0,400.4,25.65,554.4,37
CDM,30601710,ASPERGILLUS GALACT SERUM,182.0,118.3,4.02,163.8,37
CDM,30601715,JC VIRUS DNA PCR,315.0,204.75,25.65,283.5,37
CDM,30601720,*CULT CHLAMYDIA ANY SOURCE,63.0,40.95,4.02,56.7,37
CDM,30601725,VARICELLA ZOSTER PCR,96.0,62.4,24.0,86.4,37
CDM,30601730,*CULT TYPE IF EA ANTISERUM,63.0,40.95,4.02,56.7,37
CDM,30601735,WHIPPLE DNA WHOLE BLD,253.0,164.45,25.65,227.7,37
CDM,30601740,"HIV-1 AG, EIA",237.0,154.05,4.02,213.3,37
CDM,30601745,PARVO B19 PLASMA PCR,300.0,195.0,25.65,270.0,37
CDM,30601750,*PHENOTYPE INFECT AGENT DRUG,180.0,117.0,45.0,180.0,37
CDM,30601770,CULTURE ANTIGEN DFA,77.0,50.05,4.02,69.3,37
CDM,30601775,WEST NILE VIRUS PCR PLS,168.0,109.2,25.65,151.2,37
CDM,30601780,*CONC FOR INFECTIOUS AGENT,14.0,9.1,3.5,12.6,37
CDM,30601785,M HOMINTS PCR,485.0,315.25,25.65,436.5,37
CDM,30601790,CULT BLOOD ISOL W PRES ID,59.0,38.35,4.02,53.1,37
CDM,30601800,*CULT STOOL AEROBIC SALM SHIG,13.0,8.45,3.25,13.0,37
CDM,30601810,CULT AEROBIC ADD PATH,32.0,20.8,4.02,28.8,37
CDM,30601820,CULT AEROBIC ADD PATH,19.0,12.35,4.02,17.1,37
CDM,30601825,HUMAN METAPNEUM RT-PCR,348.0,226.2,25.65,313.2,37
CDM,30601830,*CULT AEROBIC ADD PATH PRES ID,21.0,13.65,4.02,18.9,37
CDM,30601835,NOROVIR 1 & 2 DETECT X2,132.0,85.8,25.65,118.8,37
CDM,30601840,CULT AEROBIC OTHER PRES ID,47.0,30.55,4.02,42.3,37
CDM,30601845,JC VIRUS BY PCR,315.0,204.75,25.65,283.5,37
CDM,30601850,CULTURE AEROBIC OTHER PRES ID,20.0,13.0,4.02,18.0,37
CDM,30601860,CULT AEROBIC OTHER PRES ID,22.0,14.3,4.02,19.8,37
CDM,30601865,UNIVERSAL FUNGAL PCR,624.0,405.6,25.65,561.6,37
CDM,30601870,CULT AEROBIC DEFIN ID EA ISOL,62.0,40.3,4.02,55.8,37
CDM,30601880,CULT AEROBIC DEFIN ID EA ISOL,40.0,26.0,4.02,36.0,37
CDM,30601885,%CHROMO CULT AMNIOTIC,413.0,268.45,101.52,371.7,37
CDM,30601890,CULT SCREEN ONLY,19.0,12.35,4.02,17.1,37
CDM,30601895,MOLD SUSCEPT 2 DRUG X2,103.0,66.95,4.02,92.7,37
CDM,30601900,CULT FUNGI PRES ID OTHER,19.0,12.35,4.02,17.1,37
CDM,30601905,AZOLE PANEL X4,207.0,134.55,4.02,186.3,37
CDM,30601910,CULT FUNGI PRES ID OTHER,24.0,15.6,4.02,21.6,37
CDM,30601915,%HIVPHE ANALYSIS NUCLEIC ACID,1672.0,1086.8,170.1,1504.8,37
CDM,30601920,*CULT FUNGI PRES ID OTHER,24.0,15.6,4.02,21.6,37
CDM,30601930,CULT FUNGI DEFIN ID YEAST,33.0,21.45,4.02,29.7,37
CDM,30601935,"CULTURE, FUNGAL ISOLATION, HAIR, SKIN, NAIL",24.0,15.6,4.02,21.6,37
CDM,30601945,"ASPER GALACTOMAN, BAL",250.0,162.5,4.02,225.0,37
CDM,30601950,OVA & PARASITE DIR SMEAR ID,12.0,7.8,3.0,12.0,37
CDM,30601960,*SUSCEPTIBILITY MIC,22.0,14.3,4.02,19.8,37
CDM,30601970,SUSCEPTIBILITY MIC,35.0,22.75,4.02,31.5,37
CDM,30601980,SUSCEPTIBILITY MIC,23.0,14.95,4.02,20.7,37
CDM,30601985,%AFBPCR MYCOBACT PROBE,777.0,505.05,25.65,699.3,37
CDM,30601990,*SUSCEPTIBILITY MIC,63.0,40.95,4.02,56.7,37
CDM,30602000,*SMEAR FLUORESCENT/ACID STAIN,9.0,5.85,2.25,9.0,37
CDM,30602005,BK VIRUS QUANT URINE,270.0,175.5,25.65,243.0,37
CDM,30602010,SMEAR FLUORESCENT/ACID STAIN,9.0,5.85,2.25,9.0,37
CDM,30602015,HERPESVIRUS 7 PCR QUANT,993.0,645.45,25.65,893.7,37
CDM,30602020,SMEAR FLUORESCENT/ACID STAIN,15.0,9.75,3.75,13.5,37
CDM,30602025,ADENOVIRUS PCR QUANT,405.0,263.25,25.65,364.5,37
CDM,30602030,SMEAR FLUORESCENT/ACID STAIN,23.0,14.95,4.02,20.7,37
CDM,30602035,ZIKA RT-PCR,146.0,94.9,25.65,131.4,37
CDM,30602040,*VIRUS INOCULATION TIS CYTPATH,77.0,50.05,4.02,69.3,37
CDM,30602050,VIRUS INOCULATION ADD STUDY,52.0,33.8,4.02,46.8,37
CDM,30602060,VIRUS INOCULATION ADD STUDY,57.0,37.05,4.02,51.3,37
CDM,30602070,VIRUS INOCULATION ADD STUDY,62.0,40.3,4.02,55.8,37
CDM,30602080,VIRUS INOCULATION ADD STUDY,62.0,40.3,4.02,55.8,37
CDM,30602090,VIRUS INOCULATION ADD STUDY,79.0,51.35,4.02,71.1,37
CDM,30602100,*PARAINFLUENZA AG IF,29.0,18.85,4.02,27.45,37
CDM,30602110,*PARAINFLUENZA AG IF,25.0,16.25,4.02,25.0,37
CDM,30602120,*PARAINFLUENZA AG IF,25.0,16.25,4.02,25.0,37
CDM,30602130,HISTOPLASMA CAPSUL AG EIA,106.0,68.9,4.02,95.4,37
CDM,30602140,INFECT AGENT NOS EIA MULT,176.0,114.4,4.02,158.4,37
CDM,30602150,*INFECT AGENT NOS EIA MULT,19.0,12.35,4.02,19.0,37
CDM,30602160,INFECT AGENT NOS EIA MULT,26.0,16.9,4.02,23.4,37
CDM,30602170,*INFECT AGENT NOS EIA MULT,84.0,54.6,4.02,75.6,37
CDM,30602180,INFECT AGENT NOS QUANT,111.0,72.15,25.65,99.9,37
CDM,30602190,INFECT AGENT NOS QUANT,176.0,114.4,25.65,158.4,37
CDM,30602200,INFECT AGENT NOS QUANT,330.0,214.5,25.65,297.0,37
CDM,30602220,TROFILE CO-RECEPTOR,116.0,75.4,4.02,104.4,27
CDM,30602230,*HIV PHENOTYPE DNA DRUG EA ADD,131.0,85.15,22.32,117.9,37
CDM,30602240,*HIV PHENOTYPE DNA DRUG EA ADD,129.0,83.85,22.32,116.1,37
CDM,30602250,*HIV PHENOTYPE DNA DRUG EA ADD,129.0,83.85,22.32,116.1,37
CDM,30602260,*HIV PHENOTYPE DNA DRUG EA ADD,53.0,34.45,13.25,47.7,37
CDM,30602270,HIV-1 AG EIA,118.0,76.7,4.02,106.2,37
CDM,30602280,*VIRUS INOCULATION SHELL VIAL,75.0,48.75,4.02,67.5,37
CDM,30602290,CULT TUBERCLE PRES ID,29.0,18.85,4.02,26.1,37
CDM,30602310,*BARTONELLA DNA AMPL PROBE,123.0,79.95,25.65,110.7,37
CDM,30602320,INFECT AGENT NOS W DIR OPTIC,65.0,42.25,4.02,58.5,37
CDM,30602330,INFECT AGENT NOS AMPL PROBE,259.0,168.35,25.65,233.1,37
CDM,30602340,INFECT AGENT NOS AMPL PROBE,89.0,57.85,22.25,80.1,37
CDM,30602350,*INFECT AGENT NOS AMPL PROBE,46.0,29.9,11.5,46.0,37
CDM,30602360,*INFECT AGENT NOS AMPL PROBE,46.0,29.9,11.5,46.0,37
CDM,30602370,C DIFF AMPLIFIED PROBE,103.0,66.95,25.65,92.7,37
CDM,30602380,*HERPES SIMPLEX DNA AMPL PROBE,146.0,94.9,25.65,131.4,37
CDM,30602390,HIV 1 DNA QUANT,130.0,84.5,25.65,130.0,37
CDM,30602400,*INFECT AGENT NOS AMPL,70.0,45.5,17.5,63.0,37
CDM,30602410,INFECT AGENT NOS AMPL PROBE,146.0,94.9,25.65,131.4,37
CDM,30602420,*INFECT AGENT NOS AMPL PROBE,144.0,93.6,25.65,129.6,37
CDM,30602430,*INFECT AGENT NOS AMPL PROBE,160.0,104.0,25.65,144.0,37
CDM,30602440,INFECT AGENT NOS AMPL PROBE,306.0,198.9,25.65,275.4,37
CDM,30602450,*INFECT AGENT NOS AMPL PROBE,46.0,29.9,11.5,46.0,37
CDM,30602460,INFECT AGENT NOS AMPL PROBE,83.0,53.95,20.75,74.7,37
CDM,30602470,*INFECT AGENT NOS AMPL PROBE,204.0,132.6,25.65,183.6,37
CDM,30602480,INFECT AGENT NOS AMPL PROBE,419.0,272.35,25.65,377.1,37
CDM,30602490,INFECT AGENT NOS AMPL PROBE,329.0,213.85,25.65,296.1,37
CDM,30602500,INFECT AGENT NOS AMPL PROBE,172.0,111.8,25.65,154.8,37
CDM,30602510,HEP B SURFACE AG EIA,101.0,65.65,4.02,90.9,37
CDM,30602520,ROTAVIRUS AG EIA,22.0,14.3,4.02,20.02,37
CDM,30602530,INFECT AGENT NOS AMPL PROBE,321.0,208.65,25.65,288.9,37
CDM,30602540,INFECT AGENT NOS AMPL PROBE,480.0,312.0,25.65,432.0,37
CDM,30602550,INFECT AGENT NOS W DIR OPTIC,53.0,34.45,4.02,47.7,37
CDM,30602560,INFECT AGENT NOS W DIR OPTIC,53.0,34.45,4.02,47.7,37
CDM,30602570,CULT TUBERCLE PRES ID,34.0,22.1,4.02,30.6,37
CDM,30602580,"SMEAR, BLOOD PARASITE",109.0,70.85,4.02,98.1,37
CDM,30602590,ADENOVIRUS AG IF,35.0,22.75,4.02,31.5,37
CDM,30602600,*BORDATELLA PERTUSSIS AG BY DFA,17.0,11.05,4.02,17.0,37
CDM,30602610,MYCOBACTERIA TB DNA AMPL PROB,446.0,289.9,25.65,401.4,37
CDM,30602620,CULT MYCOPLASMA ANY SOURCE,172.0,111.8,4.02,154.8,37
CDM,30605770,LEGIONELLA PCR,62.0,40.3,15.5,58.64,37
CDM,30605780,*MYCOBACTERIA TB DNA AMPL PROB,81.0,52.65,20.25,72.9,37
CDM,30605790,*MYCOBACTERIA AMPL NA PROBE,81.0,52.65,20.25,72.9,37
CDM,30605800,ASPERGILLUS AG EIA,116.0,75.4,4.02,104.4,37
CDM,30605810,ASPERGILLUS AG EIA,185.0,120.25,4.02,166.5,37
CDM,30605820,ASPERGILLUS AG EIA,254.0,165.1,4.02,228.6,37
CDM,30605830,VARICELLA ZOSTER DFA,40.0,26.0,4.02,36.0,37
CDM,30605840,*HEP B SURF AG EIA,24.0,15.6,4.02,21.6,37
CDM,30605850,HIV 1 DNA QUANT,371.0,241.15,25.65,333.9,37
CDM,30605860,*CHLAMYDIA TRACH DNA AMPL PROB,50.0,32.5,12.5,50.0,37
CDM,30605870,*NEISSERIA GONORR DNA AMPL,50.0,32.5,12.5,50.0,37
CDM,30605880,HHV-6A HHV-6B QT PCR,426.0,276.9,25.65,383.4,37
CDM,30605890,HIV PHENOTYPE DNA DRUGS 1-10,3438.0,2234.7,170.1,3094.2,37
CDM,30605900,GENOSURE INTEGRASE,446.0,289.9,92.55,401.4,37
CDM,30606000,DNA/RNA;MULTI ORG-AMP PR,636.0,413.4,25.65,572.4,37
CDM,30606010,DNA/RNA;MULTI ORG-AMP PR,636.0,413.4,25.65,572.4,37
CDM,30606020,*MYCOBACTERIA AMPLIF NA PROBE,317.0,206.05,25.65,285.3,37
CDM,30606030,*MYCOBACTERIA AMPLIF NA PROBE,317.0,206.05,25.65,285.3,37
CDM,30606040,*MYCOBACTERIA TB DNA AMP PROB,317.0,206.05,25.65,285.3,37
CDM,30606050,*DNA/RNA;MULTI ORG-AMP PR,403.0,261.95,25.65,362.7,37
CDM,30606060,*MYCOBACTERIA AMPLIF NA PROBE,403.0,261.95,25.65,362.7,37
CDM,30606070,MYCOBACTERIA TB AMPLIFIED PROBE,403.0,261.95,25.65,362.7,37
CDM,30606080,CULT TYPE ID BY NUCLEIC ACID,56.0,36.4,4.02,50.4,37
CDM,30606090,SUSCEPTIBILITY MIC,32.0,20.8,4.02,28.8,37
CDM,30606100,MYCOBACTERIA AVIUM DNA DIRPRO,240.0,156.0,4.02,216.0,37
CDM,30606110,SUSCEPTIBILITY MACROBROTH,172.0,111.8,4.02,154.8,37
CDM,30606120,*HEP B SURFACE AG EIA,56.0,36.4,4.02,50.4,37
CDM,30606130,INFECT AGENT NOS W DIR OPTIC,153.0,99.45,4.02,137.7,37
CDM,30606140,INFECT AGENT NOS W DIR OPTIC,135.0,87.75,4.02,121.5,37
CDM,30606150,CULT TYPE IF EA ANTISERUM,122.0,79.3,4.02,109.8,37
CDM,30606160,BARTONELLA AMPLIF NAP,312.0,202.8,25.65,280.8,37
CDM,30606170,RESP VIRUS 12-25 TARGETS,580.0,377.0,92.55,580.0,37
CDM,30606180,*CULTURE P PATHOG-SCREEN,43.0,27.95,4.02,38.7,37
CDM,30606190,*CONCENTRATION FOR INFECT AGNT,43.0,27.95,4.02,38.7,37
CDM,30606200,*CULT FUNGUS W P ID; SKIN HR NL,24.0,15.6,4.02,21.6,37
CDM,30606210,INFECT AGENT NOS AMPL PROBE,272.0,176.8,25.65,244.8,37
CDM,30606220,HIV 1 GENOTYPE RNA REVERSE,721.0,468.65,76.88,648.9,37
CDM,30606230,NEISSERIA GONORR DNA AMPL,59.0,38.35,14.75,58.64,37
CDM,30606240,CHLAMYDIA T AMPLIF NA PROBE,59.0,38.35,14.75,58.64,37
CDM,30606250,*PHENOTYPE INFECT AGENT DRUG,295.0,191.75,73.75,265.5,37
CDM,30606260,*HIV 1 GENOTYPE DNA REVERSE,362.0,235.3,76.88,362.0,37
CDM,30606270,BACTERIAL CULTURE OTHR SOURCE,215.0,139.75,4.02,193.5,37
CDM,30606280,BACTERIAL CULTURE OTHR SOURCE,215.0,139.75,4.02,193.5,37
CDM,30606290,INFECT AGENT NOS AMPL PROBE,127.0,82.55,25.65,114.3,37
CDM,30606300,"PROCESSING, FLUID CONCENTRATION",74.0,48.1,4.02,66.6,37
CDM,30606310,*BACTERIAL CULTURE OTHR SOURCE,80.0,52.0,4.02,72.0,37
CDM,30606320,*SMEAR GRAM STAIN,74.0,48.1,4.02,66.6,37
CDM,30606330,GENOTYPE DNA HEPATITIS B,515.0,334.75,92.55,463.5,37
CDM,30606340,TRICHOMONAS VAGINALIS AMPLIF,173.0,112.45,25.65,155.7,37
CDM,30606360,MACROSCOPIC EXAM ARTHROPOD,57.0,37.05,4.02,51.3,37
CDM,30606370,SUSCEPTIBILITY MACROBROTH,318.0,206.7,4.02,286.2,37
CDM,30606380,*LEGIONELLA AMPLIF NA PROBE,50.0,32.5,12.5,50.0,37
CDM,30606390,*BACTERIAL CULTURE-OTHR SOURCE,44.0,28.6,4.02,39.6,37
CDM,30606400,VIRUS INOCULATION ADD STUDY,44.0,28.6,4.02,39.6,37
CDM,30606410,INFECT AGENT NOS EIA MULT,253.0,164.45,4.02,227.7,37
CDM,30606420,NFCT AGENT DETECTION GI,542.0,352.3,92.55,487.8,37
CDM,30606430,IADNA-DNA/RNA PROBE TQ 6-11,334.0,217.1,83.5,334.0,37
CDM,30606440,IADNA-DNA/RNA PROBE TQ 12-25,2613.0,1698.45,92.55,2351.7,37
CDM,30606450,HPV LOW-RISK TYPES,55.0,35.75,13.75,55.0,37
CDM,30606460,HPV HIGH-RISK TYPES,50.0,32.5,12.5,50.0,37
CDM,30606470,HPV TYPES 16 & 18 ONLY,63.0,40.95,15.75,63.0,37
CDM,30606480,HIV ANTIGEN W/HIV ANTIBODIES (POINT OF CARE LAB),172.0,111.8,25.65,154.8,37
CDM,30606490,GENOTYPE CYTOMEGALOVIRUS,979.0,636.35,92.55,881.1,37
CDM,30606500,HEPATITIS B GENOTYPING,515.0,334.75,92.55,463.5,37
CDM,30606510,GENOTYPE DNA HIV OTHER REGION,312.0,202.8,78.0,280.8,37
CDM,30606520,HISTOPLASMA CAPSUL AG EIA,128.0,83.2,4.02,115.2,37
CDM,30606530,AB; BLASTOMYCES,197.0,128.05,5.23,177.3,37
CDM,30606540,CONCENTRATION FOR INFECT AGNT,37.0,24.05,4.02,33.3,37
CDM,30606550,SMEAR SPECIAL STAIN,37.0,24.05,4.02,33.3,37
CDM,30606560,SMEAR - INFECTIOUS WET MOUNT,9.0,5.85,2.25,9.0,37
CDM,30606570,KOH FOR FUNGI/PARASITES/MITES,9.0,5.85,2.25,8.1,37
CDM,30606580,SMEAR - GRAM OR GIEMSA,34.0,22.1,4.02,30.6,37
CDM,30606590,ENTAMOEB HIST GROUP AG EIA,125.0,81.25,4.02,112.5,37
CDM,30606600,AMPLIF NA PROBE NOS AGENT,230.0,149.5,25.65,207.0,37
CDM,30606610,AMPLIF NA PROBE NOS AGENT,166.0,107.9,25.65,149.4,37
CDM,30606620,DNA/RNA AMPLIFIED PROBE,428.0,278.2,25.65,385.2,37
CDM,30606630,DNA/RNA AMPLIFIED PROBE,426.0,276.9,25.65,383.4,37
CDM,30606640,CULTURE;OTHER METHODS,179.0,116.35,4.02,161.1,37
CDM,30606650,CYTOMEGALOVIRUS NA QUAN,310.0,201.5,25.65,279.0,37
CDM,30606660,INFLUENZA DNA AMP PROBE,124.0,80.6,31.0,124.0,37
CDM,30606670,RESP VIRUS 3-5 TARGETS,180.0,117.0,45.0,180.0,37
CDM,30606680,AMPLIF NA PROBE NOS AGENT,155.0,100.75,25.65,139.5,37
CDM,30606685,UREAPLASMA SPECIES BY PCR,295.0,191.75,25.65,265.5,37
CDM,30606690,NA QUAN NOS AGENT,413.0,268.45,25.65,371.7,37
CDM,30606700,INFLUENZA DNA AMP PROBE,273.0,177.45,68.25,245.7,37
CDM,30606705,HIV I/II POST EXP AG SRN,84.0,54.6,4.02,75.6,37
CDM,30606710,AMPLIF NA PROBE NOS AGENT,131.0,85.15,25.65,117.9,37
CDM,30606720,CHLAMYDIA T AMPLIF NA PROBE,210.0,136.5,25.65,189.0,37
CDM,30606730,NEISSERIA AMPLIF NA PROBE,209.0,135.85,25.65,188.1,37
CDM,30606735,"GIARDIA ANTIGEN, STOOL",75.0,48.75,4.02,67.5,37
CDM,30606740,HPV HIGH-RISK TYPES,70.0,45.5,17.5,63.0,37
CDM,30606745,"QUANTIFICATION, BK VIRUS",109.0,70.85,25.65,98.1,37
CDM,30606750,TRICHOMONAS VAGINALIS AMPLIF,76.0,49.4,19.0,68.4,37
CDM,30606755,INFLUENZA A&B MOLECULAR (POINT OF CARE LAB),243.0,157.95,60.75,218.7,37
CDM,30606760,SMEAR - GRAM OR GIEMSA,58.0,37.7,4.02,52.2,37
CDM,30606770,TRICHOMONAS ASSAY W/OPTIC,69.0,44.85,4.02,62.1,37
CDM,30606925,"AMPLIFICATION, MYCOBACTERIA TUBERCULOSIS",238.0,154.7,25.65,214.2,37
CDM,30606935,%CTNG CTRACH SUREPATH TMA,328.0,213.2,25.65,295.2,37
CDM,30606955,%HIVPHS PHENO EA ADD X12,72.0,46.8,18.0,64.8,37
CDM,30606965,%HIVPHS PHENO 1-10 DRUGS,1339.0,870.35,170.1,1205.1,37
CDM,30606985,%CTNG CTRACH SUREPATH TMA,157.0,102.05,25.65,141.3,37
CDM,30606995,CARBAPENEM RESISTANCE GENE PCR,295.0,191.75,25.65,265.5,37
CDM,30607020,TYPING BY IMMUNOLOGIC METHOD,56.0,36.4,4.02,50.4,37
CDM,30607080,ID BY PYROSEQUENCING,41.0,26.65,4.02,36.9,37
CDM,30607090,"RT-QUIC ANALYSIS, CSF",132.0,85.8,25.65,118.8,37
CDM,30607100,CLARITHROMYCIN RESISTANCE,129.0,83.85,25.65,116.1,37
CDM,30607105,%CTNGAO CHLAMYDIA OCULAR,107.0,69.55,25.65,96.3,37
CDM,30607110,ID M. CHEL ABSC GRP 2,129.0,83.85,25.65,116.1,37
CDM,30607115,%CTNGAO NGONORRHOEAE OCUL,107.0,69.55,25.65,96.3,37
CDM,30607120,EHRLICHIA AND ANAPLASMA MICRO,176.0,114.4,4.02,158.4,37
CDM,30607130,BARTONELLA PCR,273.0,177.45,25.65,245.7,37
CDM,30607145,STOOL GASTROINT PNL PCR,2613.0,1698.45,92.55,2351.7,37
CDM,30607155,CYTOCHROME P450 2D6 GENO,564.0,366.6,141.0,564.0,37
CDM,30607205,EHRLICHIA/ANAPLASMA PCR,97.0,63.05,24.25,87.3,37
CDM,30607225,NFCT AGENT DETECTION GI,542.0,352.3,92.55,487.8,37
CDM,30607235,JC VIRUS QUANT PCR,359.0,233.35,25.65,323.1,37
CDM,30607255,ZIKA VIRUS RT-PCR,162.0,105.3,25.65,145.8,37
CDM,30607265,"ZIKA VIRUS RT-PCR, UR",210.0,136.5,25.65,189.0,37
CDM,30607295,MOLD SUSCEPT 3 DRUGS X3,103.0,66.95,4.02,92.7,37
CDM,30607305,MUMPS VIRUS BY PCR,362.0,235.3,25.65,325.8,37
CDM,30607315,GNB BLD CULT ID VERIGENE,172.0,111.8,4.02,154.8,37
CDM,30607325,GPC BLD CULT ID VERIGENE,172.0,111.8,4.02,154.8,37
CDM,30607335,%HSVCUL VIR INNOC TISSUE,56.0,36.4,4.02,50.4,37
CDM,30607345,%HSVCUL VIR INNOC TIS ADD,56.0,36.4,4.02,50.4,37
CDM,30607355,HSV PCR MISC SPEC,132.0,85.8,25.65,118.8,37
CDM,30607365,HCV NS5A DRG RES SEQ,688.0,447.2,76.88,619.2,37
CDM,30607425,"BACTERIAL PCR, DIRECT SPEC",624.0,405.6,25.65,561.6,37
CDM,30607445,CULTURE TYPE IMMUNOLOGIC,48.0,31.2,4.02,43.2,37
CDM,30607495,URMPCR DETECT AGENT NOS DNA AMP,99.0,64.35,24.75,89.1,37
CDM,30607505,ID BACT/YST/MALD TOF,12.0,7.8,3.0,12.0,37
CDM,30607515,MICRO SENSITIVITY,43.0,27.95,4.02,38.7,37
CDM,30607535,ROTAD ADENOV 40-41,63.0,40.95,4.02,56.7,37
CDM,30607555,ID DNA PROBE 1,32.0,20.8,4.02,32.0,37
CDM,30607565,ID DNA PROBE 2,79.0,51.35,4.02,71.1,37
CDM,30607585,IN HOUSE CULT ANTIGEN DFA,150.0,97.5,4.02,135.0,37
CDM,30607595,HEPATITIS E QNT PCR,229.0,148.85,25.65,206.1,37
CDM,30607615,HBV DRUG RESISTANCE SEQ,1309.0,850.85,92.55,1178.1,37
CDM,30607625,IDM HIV-1 DNA BY PCR,166.0,107.9,25.65,149.4,37
CDM,30607635,JCV DNA QNT RT-PCR CSF,363.0,235.95,25.65,326.7,37
CDM,30607645,NY BK VIRUS QNT PCR BLD,168.0,109.2,25.65,151.2,37
CDM,30607675,C DIFF CYTOTOX CELL ASY,157.0,102.05,4.02,141.3,37
CDM,30607695,CYTOMEGALOVIRUS,109.0,70.85,4.02,98.1,37
CDM,30607705,MYCOPLASMA GENITALIUM PCR,215.0,139.75,25.65,193.5,37
CDM,30607715,URMPCR MYCOPLAS GENITALIUM AMP,109.0,70.85,25.65,98.1,37
CDM,30607725,"AMPLIFIED PROBE, VARICELLA ZOSTER VIRUS",289.0,187.85,25.65,260.1,37
CDM,30607735,HSV DNA AMP PROBE X2,293.0,190.45,25.65,263.7,37
CDM,30607745,WHIIVF HIV 1&2 AG/AB,29.0,18.85,4.02,29.0,37
CDM,30607765,WHIIVF CHLAMYDIA TRACH AM,26.0,16.9,6.5,38.6,37
CDM,30607775,WHIIVF GC AMP,23.0,14.95,5.75,38.6,37
CDM,30607785,COVID19 SENDOUT,141.0,91.65,4.02,126.9,37
CDM,30607795,COVID19 INHOUSE,138.0,89.7,4.02,124.2,37
CDM,30607805,RPRAPD CHLAMYDIA PNEU AMP,86.0,55.9,21.5,77.4,37
CDM,30607815,RPRAPD M.PNEUM AMP PRB,86.0,55.9,21.5,77.4,37
CDM,30607825,RPRAPD INFLUENZA RAPID PCR,349.0,226.85,87.25,314.1,37
CDM,30607835,RPRAPD INFECT AGENT NOS AMP,156.0,101.4,25.65,140.4,37
CDM,30607845,COVID19 INHOUSE,156.0,101.4,25.65,140.4,37
CDM,30607855,COVID19 SENDOUT,156.0,101.4,25.65,140.4,37
CDM,30607865,AG DETECT NOS IA MULT,153.0,99.45,4.02,137.7,37
CDM,30607875,ASPERGILLUS DNA QL PCR,130.0,84.5,25.65,117.0,37
CDM,30607885,HPVSFX HPV HIGH-RISK TYPE,131.0,85.15,25.65,117.9,37
CDM,30607935,COVID19 SENDOUT,141.0,91.65,4.02,126.9,37
CDM,30607945,COVID19 INHOUSE,138.0,89.7,4.02,124.2,37
CDM,30607955,"FILM ARRAY, RESPIRATORY 22 TARGETS",1144.0,743.6,170.1,1029.6,37
CDM,30607965,UCTGC CHLAMYDIA TRACH AMP,173.0,112.45,25.65,155.7,37
CDM,30607975,UCTGC GC AMPLIFICATION,173.0,112.45,25.65,155.7,37
CDM,30608005,SARSCOV2 & INF A&B AMP PRB,627.0,407.55,25.65,564.3,37
CDM,30608025,SARSCOV2 & INF A&B AMP PRB,471.0,306.15,25.65,423.9,37
CDM,30608035,ADENOVIRUS QT RT-PCR,209.0,135.85,25.65,188.1,37
CDM,30608045,BCID DNA/RNA AMP PROBE,107.0,69.55,25.65,96.3,37
CDM,30608065,CNS DNA AMP PROBE TYPE 12-25,1076.0,699.4,92.55,968.4,37
CDM,30608075,HIVNGS PHENOTYPE INFECT AGENT DRUG,397.0,258.05,92.55,357.3,37
CDM,30608085,HIVNGS GENOTYPE DNA HIV REVERSE T,781.0,507.65,76.88,702.9,37
CDM,30608095,HIVNGS GENOTYPE DNA/RNA HIV,391.0,254.15,92.55,351.9,37
CDM,30608105,CANDIDA DNA AMP PROBE,275.0,178.75,25.65,247.5,37
CDM,30608115,"SUSCEPTIBILITY, AGAR DILUTION, PER AGENT",35.0,22.75,4.02,31.5,37
CDM,30608125,"SUSCEPTIBILITY, DISK METHOD, PER PLATE",72.0,46.8,4.02,64.8,37
CDM,30608135,CYTOMEGALOVIRUS CMV,240.0,156.0,25.65,216.0,37
CDM,30608145,"IDENTIFICATION, BLOOD PATHOGEN PANEL",351.0,228.15,87.75,351.0,37
CDM,30608155,BACTERIAL VAGINOSIS AMPLIFICATION,448.0,291.2,76.88,403.2,37
CDM,30608195,HSVCUL GENETIC VIRUS ISOLATION HSV,109.0,70.85,25.65,98.1,37
CDM,30608205,PCRHSV HSV DNA AMP PROBE X2,108.0,70.2,25.65,97.2,37
CDM,30608215,MYPCRF DETECT AGENT NOS DNA AMP,422.0,274.3,25.65,379.8,37
CDM,30608225,MONKEYPOX VIRUS QUAL PCR,166.0,107.9,25.65,149.4,37
CDM,30608235,MONKEYPOX VIRUS QUAL PCR,183.0,118.95,25.65,164.7,37
CDM,30608245,BK VIRUS QUANT URINE,155.0,100.75,25.65,139.5,37
CDM,30608255,LYMPHOGRANULOMA VENEREUM PCR,215.0,139.75,25.65,193.5,37
CDM,30608265,CRYPTOCOCCUS AG DETECTION,93.0,60.45,4.02,83.7,37
CDM,30608275,"AMPLIFICATION, ORTHOPOX VIRUS",183.0,118.95,25.65,164.7,37
CDM,30608285,UREAPLASMA SPECIES MOLEC DETEC PCR FLU TIS,88.0,57.2,22.0,79.2,37
CDM,30608305,ADENOVIRUS PCR,202.0,131.3,25.65,181.8,37
CDM,30608315,EHRANA ANAPLSMA PHGCYTOPHLM AMP PRB,97.0,63.05,24.25,87.3,37
CDM,30608325,EHRANA EHRLICHA CHAFFEENSIS AMP PRB,97.0,63.05,24.25,87.3,37
CDM,30608335,"EPSTEIN-BARR VIRUS BY QUALITATIVE PCR, CSF",140.0,91.0,25.65,126.0,37
CDM,30608345,AMBCAN AMPHOTERICIN B/CANDIN SUSCEPTIBILITY PANEL X4,69.0,44.85,4.02,62.1,37
CDM,30608355,CYTSEQ PHENOTYPE INFECT AGENT DRUG,358.0,232.7,89.5,322.2,37
CDM,30608365,"CYTOMEGALOVIRUS (CMV) PCR, AMNIOTIC FLUID",135.0,87.75,25.65,121.5,37
CDM,30608375,"PARVOVIRUS B19 PCR, AMNIOTIC FLUID",275.0,178.75,25.65,247.5,37
CDM,30608385,"TOXOPLASMA GONDII, PCR, AMNIOTIC FLUID",275.0,178.75,25.65,247.5,37
CDM,30608395,"AMPLIFICATION, EXPEDITED, COVID, FLU A/B, RSV",393.0,255.45,25.65,353.7,37
CDM,30608405,"COVID & INFLUENZA A/B & RSV NAAT, ROUTINE",285.0,185.25,25.65,308.08,37
CDM,30608415,HPV SCREEN BY TMA (ARUP),88.0,57.2,22.0,79.2,37
CDM,30608425,HEPATITIS DELTA VIRUS BY QUANTITATIVE PCR,495.0,321.75,25.65,445.5,37
CDM,30608435,HPV GENOTYPE BY TMA (ARUP REFLEX),122.0,79.3,25.65,109.8,37
CDM,30608455,POTASSIUM HYDROXIDE (KOH) PREPS (POC) (POINT OF CARE LAB),47.0,30.55,2.34,42.3,37
CDM,30608465,"HISTOPLASMA GALACTOMANNAN EIA, BAL",338.0,219.7,4.02,304.2,37
CDM,30608475,"HISTOPLASMA GALACTOMANNAN EIA, CSF",338.0,219.7,4.02,304.2,37
CDM,30608485,OIL TEST (SCABIES) (POC) (POINT OF CARE LAB),191.0,124.15,2.34,171.9,37
CDM,30608495,"ACANTHAMOEBA SPECIES DETECTION, PCR",351.0,228.15,25.65,315.9,37
CDM,30608505,MUCORALES BY PCR,351.0,228.15,25.65,315.9,37
CDM,30608515,HHV8 BY QUANTITATIVE PCR,214.0,139.1,25.65,192.6,37
CDM,30608555,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL VITEK",93.0,60.45,4.02,83.7,37
CDM,30608565,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL PHOENIX",93.0,60.45,4.02,83.7,37
CDM,30608575,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL SENSITITRE",93.0,60.45,4.02,83.7,37
CDM,30608585,"PROCESSING, CYTOSPIN",40.0,26.0,4.02,36.0,37
CDM,30608595,"AMPLIFICATION, RIFAMPIN RESISTANCE",263.0,170.95,25.65,236.7,37
CDM,30608605,"IDENTIFICATION, OTHER METHODS",102.0,66.3,4.02,91.8,37
CDM,30608615,"SMEAR, ACID FAST FLUORESCENT",32.0,20.8,4.02,28.8,37
CDM,30608625,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL AFB",93.0,60.45,4.02,83.7,37
CDM,30608635,PROCESSING AFB REDIGESTION,40.0,26.0,4.02,36.0,37
CDM,30608645,"AMPLIFICATION, RIFAMPIN RESISTANCE",175.0,113.75,25.65,157.5,37
CDM,30608665,HIV-1 RNA,227.0,147.55,25.65,204.3,37
CDM,30608675,HIV-2 RNA,227.0,147.55,25.65,204.3,37
CDM,30608685,COVID-19 MOLECULAR (POINT OF CARE LAB),333.0,216.45,25.65,299.7,37
CDM,30608695,COVID-19 MOLECULAR (POC) & INFLUENZA A&B MOLECULAR (POC),925.0,601.25,25.65,832.5,37
CDM,30608705,RSV RAPID PCR (POINT OF CARE LAB),455.0,295.75,25.65,409.5,37
CDM,30608715,IADNA HPV SEP RPRT HI-RSK TYP&HI-RSK POOLD RSLTS,455.0,295.75,25.65,409.5,37
CDM,30608725,"AMPLIFIED PROBE, PNEUMOCYSTIS JIROVECII",227.0,147.55,25.65,204.3,37
CDM,30608735,"AMPLIFICATION, MYCOBACTERIUM TUBERCULOSIS",497.0,323.05,25.65,447.3,37
CDM,30608745,MTB RIF RES,497.0,323.05,25.65,447.3,37
CDM,30608755,STREP PNEUMO ABS X14,123.0,79.95,19.47,110.7,30
CDM,30608775,"SEQUENCING, INFLUENZA",620.0,403.0,92.55,558.0,37
CDM,30608785,RSV IA W DIR OBSERV (POINT OF CARE LAB),109.0,70.85,4.02,98.1,37
CDM,30608795,"IDENTIFICATION, AEROBIC ISOLATE (POINT OF CARE LAB)",64.0,41.6,4.02,57.6,37
CDM,30608805,PINWORM PREP PERIANAL (POINT OF CARE LAB),36.0,23.4,4.02,32.4,37
CDM,30608815,MEASLES VIRUS QUAL NAAT,227.0,147.55,25.65,204.3,37
CDM,30608835,GROUP A STREP PCR (POINT OF CARE LAB),255.0,165.75,25.65,229.5,37
CDM,30608845,FLUPCR RAPID PCR FLU (POINT OF CARE LAB),241.0,156.65,60.25,216.9,37
CDM,30608855,COVID19 INHOUSE (POINT OF CARE LAB),156.0,101.4,25.65,140.4,37
CDM,30608865,PLASMODIUM SP DIFF PCR X5,285.0,185.25,25.65,256.5,37
CDM,30608875,"GASTROINTESTINAL PANEL, 5 VIRAL TARGETS",832.0,540.8,92.55,748.8,37
CDM,30608915,"SUSCEPTIBILITY, CARBAPENAMASE ENZYME DETECTION, PER ISOLATE",260.0,169.0,4.02,234.0,27
CDM,30608925,"AMPLIFIED PROBE, GC/CT",484.0,314.6,4.02,435.6,30
CDM,30608945,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, OTHER",484.0,314.6,4.02,435.6,30
CDM,30608955,"ENTEROVIRUS, REAL-TIME PCR, AMNIOTIC FLUID",352.0,228.8,25.65,316.8,37
CDM,30608965,"AMPLIFICATION, STREPTOCOCCUS, GROUP B WITH LIM BROTH",242.0,157.3,25.65,217.8,37
CDM,30620WE,SEPTAL/OTHER INTRANASAL DERMATOPLASTY,2464.0,1601.6,345.73,2464.0,35
CDM,30630WE,REPAIR NASAL SEPTAL PERFORATIONS,2916.0,1895.4,364.39,2916.0,35
CDM,30700005,URINALYSIS NONAUTO W SCPE (POINT OF CARE LAB),26.0,16.9,1.43,23.4,37
CDM,30700010,URINALYSIS AUTO W SCPE,56.0,36.4,1.43,50.4,37
CDM,30700015,N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB),37.0,24.05,1.43,33.3,37
CDM,30700020,URINALYSIS AUTO WO SCPE,56.0,36.4,1.43,50.4,37
CDM,30700025,"URINANALYSIS, QUAL OR SEMI-QUANT",35.0,22.75,1.43,31.5,37
CDM,30700030,PREGNANCY TEST URINE (POINT OF CARE LAB),40.0,26.0,1.43,36.0,37
CDM,30700035,URINALYSIS MICROSCOP ONLY,25.0,16.25,1.43,22.5,37
CDM,30700045,VOL MEASURE TIMED UR OUT,13.0,8.45,1.43,11.7,37
CDM,30700055,URINALYSIS WITH MICRO (POINT OF CARE LAB),56.0,36.4,1.43,50.4,37
CDM,30700065,URINALYSIS ONLY,56.0,36.4,1.43,50.4,37
CDM,30700075,HCG URINE (POINT OF CARE LAB),40.0,26.0,1.43,36.0,37
CDM,30700195,URINALYSIS AUTO WO SCPE (POINT OF CARE LAB),56.0,36.4,1.43,50.4,37
CDM,30700205,URINALYSIS MICROSCOP ONLY (POINT OF CARE LAB),25.0,16.25,1.43,22.5,37
CDM,30801WE,ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC,456.0,296.4,75.78,357.25,35
CDM,30802WE,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,832.0,540.8,100.43,624.0,35
CDM,30808765,"PROCESSING, THICK SMEAR PREPARATION",40.0,26.0,4.02,36.0,37
CDM,30900025,LAMELLAR BODY COUNT,141.0,91.65,5.78,126.9,37
CDM,30900045,CELL COUNT & DIFF,107.0,69.55,2.34,96.3,37
CDM,30900055,EXAM SYNOVIAL FLUID CRYSTALS,64.0,41.6,2.34,57.6,37
CDM,30900065,EOSINOPHIL SMEAR MISC,36.0,23.4,2.34,32.4,37
CDM,30900355,FECAL LEUKOCYTES,142.0,92.3,2.34,127.8,37
CDM,30900375,HIV-1/2 AG/AB COMBO,91.0,59.15,4.02,81.9,37
CDM,30900395,EXECUTIVE PANEL WESTON FEMALE,349.0,226.85,58.63,314.1,21
CDM,30900405,EXECUTIVE HCV/HIV WESTON,63.0,40.95,10.58,56.7,21
CDM,30900415,EXECUTIVE PANEL WESTON MALE,427.0,277.55,71.74,384.3,21
CDM,30901WE,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,440.0,286.0,27.46,330.0,35
CDM,30903WE,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,678.0,440.7,56.13,508.5,35
CDM,30905WE,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,867.0,563.55,71.05,650.25,35
CDM,30906WE,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,1078.0,700.7,65.75,808.5,35
CDM,30915WE,LIGATION ARTERIES ETHMOIDAL,2976.0,1934.4,337.18,2976.0,35
CDM,30920WE,LIGATION ARTERIES INT MAXILLARY TRANSANTRAL,4902.0,3186.3,522.48,4902.0,35
CDM,30930WE,FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC,524.0,340.6,62.6,524.0,35
CDM,30999RVU6WE,UNLISTED PROC; NASAL SURG PROC (COMP TO 30465),4079.0,2651.35,311.77,4079.0,15
CDM,31000020,NECROPSY COMPLT W BRAIN,651.0,423.15,92.91,585.9,27
CDM,31000045,%CHROMO BLD TISSUE CULT,488.0,317.2,101.52,439.2,37
CDM,31000055,CHROM TISSUE CULT PROCESS,1247.0,810.55,101.52,1122.3,37
CDM,31000075,CHROM LEUK BLD CULT PROC,1178.0,765.7,101.52,1060.2,37
CDM,31000085,%CHROMO SOL TUMOR CULTURE,340.0,221.0,85.0,306.0,37
CDM,31000100,SPEC STN GRP II,85.0,55.25,19.72,279.48,38
CDM,31000105,%CHROMO POC KARY 15-20,745.0,484.25,22.32,670.5,37
CDM,31000115,%UROFISH MOLE GEN DNA X4,309.0,200.85,21.42,278.1,37
CDM,31000140,CISH EA PROBE,383.0,248.95,94.71,371.54,38
CDM,31000160,PAP SMR THN PRP,109.0,70.85,9.95,98.1,37
CDM,31000170,SURG PATH GROSS MICRO LVL IV,254.0,165.1,19.72,228.6,38
CDM,31000175,%AHTBX PATH LVL V,517.0,336.05,94.71,779.93,38
CDM,31000180,SPEC STN GRP I,95.0,61.75,19.72,163.29,38
CDM,31000185,"SPECIAL STAIN GRP I EA, SEMEN",232.0,150.8,19.72,208.8,38
CDM,31000195,"SPECIAL STAIN GRP II EA, SEMEN",145.0,94.25,19.72,279.48,38
CDM,31000205,%REFMYL IHC REFLEX MY X2,240.0,156.0,62.16,371.54,38
CDM,31000210,HISTOCHEMICAL STAIN,141.0,91.65,19.72,126.9,28
CDM,31000215,DIRECT IMMUNOFLUOR-EACH,374.0,243.1,94.71,371.54,38
CDM,31000220,INSITU HYBRID EA PROBE MANUAL,498.0,323.7,94.71,779.93,38
CDM,31000230,"MICRODISSECTION, MANUAL",303.0,196.95,19.72,284.47,28
CDM,31000240,"*SPEC STN GRP II, REV TO 312",44.0,28.6,11.4,279.48,38
CDM,31000250,SAT BIOPSY PROSTATE 1-20 SPC,1517.0,986.05,19.72,1365.3,38
CDM,31000260,SAT BIOPSY PROSTATE 21-40,2387.0,1551.55,19.72,2148.3,38
CDM,31000265,ATMS MICRODISECTION,369.0,239.85,61.99,332.1,28
CDM,31000270,SAT BIOPSY PROSTATE 41-60,4121.0,2678.65,19.72,3708.9,38
CDM,31000280,SAT BIOPSY PROSTATE: >60,4987.0,3241.55,19.72,4488.3,38
CDM,31000285,PARATHYROID GLAND CRYOPRESERVA,2188.0,1422.2,11.52,1969.2,37
CDM,31000290,CYTOLOGY SUREPATH PAP,32.0,20.8,8.0,32.0,37
CDM,31000295,CRYOPS WITHDRAW,107.0,69.55,11.52,115.85,37
CDM,31000300,SURGERY PATH GROSS MICRO LEVEL 4,254.0,165.1,19.72,228.6,38
CDM,31000310,PAP SMEAR THIN PREP,90.0,58.5,9.95,81.0,37
CDM,31000320,*IMMUNOFLUOR ANTB 1ST STAIN,359.0,233.35,92.98,371.54,38
CDM,31000325,"LABCORP CMBP CHROMOSOME ANALYSIS, CHORIONIC VILLUS",413.0,268.45,101.52,371.7,37
CDM,31000330,*IMMUNOFLUOR ANTB ADDL STAIN,131.0,85.15,19.72,158.86,28
CDM,31000340,*MICRODISSECTION MANUAL,29.0,18.85,4.87,284.47,28
CDM,31000345,BMHSNP MOPATH LVL 7,4275.0,2778.75,76.88,3847.5,37
CDM,31000350,MICRODISSECTION MANUAL,1310.0,851.5,19.72,1179.0,28
CDM,31000355,%INV16F PROBE X2,309.0,200.85,21.42,278.1,37
CDM,31000360,*MICRODISECTION MANUAL,619.0,402.35,19.72,557.1,28
CDM,31000370,INSITU HYBRID EA PROBE,426.0,276.9,94.71,383.4,38
CDM,31000380,IMMUNOHISTOCHEM EA AB,204.0,132.6,52.84,371.54,38
CDM,31000390,INSITU HYBRID EA PROBE MAN,498.0,323.7,94.71,779.93,38
CDM,31000395,%CHROMO HEM KAROTYPES,363.0,235.95,22.32,326.7,37
CDM,31000400,IMMUNOHISTOCHEM EA AB,188.0,122.2,48.69,371.54,38
CDM,31000410,IMMUNOHISTOCHEM EA AB,188.0,122.2,48.69,371.54,38
CDM,31000415,%CVC CHROMOSOME ANALYSIS,523.0,339.95,76.88,470.7,37
CDM,31000450,CYTP URINE 3-5 PROBES CMPTR,688.0,447.2,101.52,619.2,38
CDM,31000460,PROSTATE NDL BIOPSY ANY METHOD,1517.0,986.05,19.72,1365.3,38
CDM,31000465,"CHROMOSOME ANAL, KAROTYPE EA",133.0,86.45,22.32,119.7,37
CDM,31000470,IMMUNO H/C EA ADDTL AB STAIN,244.0,158.6,19.72,219.6,28
CDM,31000480,IMMUNO H/C EA ADDTL AB STAIN,257.0,167.05,19.72,231.3,28
CDM,31000490,IMMUNO H/C EA MULTIPLEX AB STAIN,359.0,233.35,92.98,779.93,38
CDM,31000500,IMMUNO H/C EA MULTIPLEX AB STAIN,359.0,233.35,92.98,779.93,38
CDM,31000510,INSITU HYBRID EA ADDTL SNGL PRB,906.0,588.9,19.72,815.4,28
CDM,31000520,INSITU HYBRID EA ADDTL MULTI PRB,359.0,233.35,92.98,397.21,38
CDM,31000530,M/PHMTRC ALYS CAT INTL SNG PROBE,359.0,233.35,92.98,779.93,38
CDM,31000560,M/PHMTRC ALYS CAT EA MULTIPLEX PR,343.0,222.95,88.84,403.02,38
CDM,31000570,M/PHMTRC ALYS EA MULTIPLEX PROBE,596.0,387.4,94.71,580.48,38
CDM,31000580,M/PHMTRC ALYS ISHQUANT/SEMIQ,343.0,222.95,88.84,403.02,38
CDM,31000590,NG FISH MANUAL TC MULTIPLEX PROBE,330.0,214.5,85.47,580.48,38
CDM,31000600,CYTP URNE 3-5 PROBES EA SPEC,661.0,429.65,101.52,828.6,38
CDM,31000610,INSITU HYBRIDIZATION MANUAL,498.0,323.7,94.71,779.93,38
CDM,31000620,INSITU HYBRIDIZATION DUAL,1029.0,668.85,94.71,926.1,38
CDM,31000630,INSITU HYBRIDIZATION AUTO,359.0,233.35,92.98,779.93,38
CDM,31000640,INSITU  HYBRIDIZATION AUTO,359.0,233.35,92.98,779.93,38
CDM,31000650,M/PHMTRC ALYS ISHQUANT/SEMIQ,729.0,473.85,94.71,656.1,38
CDM,31000660,M/PHMTRC ALYS ISHQUANT/SEMIQ,1026.0,666.9,94.71,923.4,38
CDM,31000670,IMMUNOFLUOR ADDTL,98.0,63.7,16.46,158.86,28
CDM,31000680,IMMUNOFLUOR ANTB ADDL STAIN,237.0,154.05,19.72,213.3,28
CDM,31000690,CYTP URNE 3-5 PROBES EA SPEC,1026.0,666.9,101.52,923.4,38
CDM,31000700,INSITU HYBRIDIZATION (FISH),1029.0,668.85,94.71,926.1,38
CDM,31000710,INSITU HYBRIDIZATION (FISH),180.0,117.0,46.62,371.54,38
CDM,31000720,IMMUNOFLUOR ANTB ADDL STAIN,100.0,65.0,16.8,158.86,28
CDM,31000730,M/PHMTRC ALYS ISHQUANT/SEMIQ,1351.0,878.15,94.71,1215.9,38
CDM,31000835,CHRCON BLD TISSUE CULT,363.0,235.95,90.75,326.7,37
CDM,31000865,CISH KAPPA,789.0,512.85,94.71,710.1,38
CDM,31000875,CISH LAMDA,789.0,512.85,94.71,710.1,38
CDM,31000895,CISH EACH PROBE,784.0,509.6,94.71,705.6,38
CDM,31000905,CISH FOR EPSTEIN BARR,761.0,494.65,94.71,684.9,38
CDM,31000915,CISH EACH PROBE,317.0,206.05,82.1,371.54,38
CDM,31000WE,LAVAGE CANNULATION MAXILLARY SINUS,480.0,312.0,53.1,360.0,35
CDM,31001035,ISIGHT DNA PROBE,76.0,49.4,19.0,68.4,37
CDM,31001115,FISH FOR BCR/ABL 1 PROBE X2,277.0,180.05,21.42,249.3,37
CDM,31001125,%CLLFSH PROBE X7,277.0,180.05,21.42,249.3,37
CDM,31001135,%FAMLPN PROBE,277.0,180.05,21.42,249.3,37
CDM,31001165,%FSHPCM DNA PROBE,259.0,168.35,21.42,233.1,37
CDM,31001185,FISH FOR PDGFRA PROBE X3,239.0,155.35,21.42,215.1,37
CDM,31001195,FISH FOR PDGFRB PROBE X2,239.0,155.35,21.42,215.1,37
CDM,31001215,%FSHMDS PROBE X6,277.0,180.05,21.42,249.3,37
CDM,31001235,%ISIGHT TIS CULT AM FLX2,309.0,200.85,21.42,278.1,37
CDM,31001275,FHT410 100-300,348.0,226.2,22.32,313.2,37
CDM,31001295,%IBDSGI IFA FIRST,109.0,70.85,28.23,371.54,38
CDM,31001305,%CROHN IFA FIRST,134.0,87.1,34.71,371.54,38
CDM,31001325,%IBDSGI IFA ADDTL,109.0,70.85,18.31,158.86,28
CDM,31001335,%CROHN IFA ADDTL,134.0,87.1,19.72,158.86,28
CDM,31001355,%PEMGUS IFL ADDTL,450.0,292.5,19.72,405.0,28
CDM,31001365,%ENTERO AB ADDTL X2,303.0,196.95,19.72,272.7,28
CDM,31001405,PATHOLOGY LEVEL 3 MOD,222.0,144.3,19.72,199.8,38
CDM,31001565,%BCRFSH ANALY 100-300,391.0,254.15,22.32,351.9,37
CDM,31001575,%CLLFSH ANALY 100-300 X3,391.0,254.15,22.32,351.9,37
CDM,31001635,%PDGFRA ANALY 100-300,338.0,219.7,22.32,304.2,37
CDM,31001645,%PDGFRB ANALY 100-300,338.0,219.7,22.32,304.2,37
CDM,31001665,%FSHMDS ANALY 100-300 X3,391.0,254.15,22.32,351.9,37
CDM,31001725,FISH FOR AGG B CL LYM,778.0,505.7,94.71,700.2,38
CDM,31001735,ALK FISH LUNG NSCLC,909.0,590.85,94.71,818.1,38
CDM,31001785,%IGH/CCND1 BM 100-300,411.0,267.15,22.32,369.9,37
CDM,31001865,%IGH/CCND1 BM PROBE X2,293.0,190.45,21.42,263.7,37
CDM,31001965,%PEMGUS IFL FIRST,491.0,319.15,94.71,441.9,38
CDM,31002105,%20Q8FH PROBE X2,274.0,178.1,21.42,246.6,37
CDM,31002165,%20Q8FH ANALY 100-300,365.0,237.25,22.32,328.5,37
CDM,31002195,%HIVPHS PHENOTYPE,359.0,233.35,89.75,323.1,37
CDM,31002205,%HIVPHS GENOTYPE,707.0,459.55,76.88,636.3,37
CDM,31002215,%NRAST MICRODISSECT,406.0,263.9,19.72,365.4,28
CDM,31002335,JAK2 MUTATION,248.0,161.2,22.32,223.2,37
CDM,31002455,FERN TEST (POINT OF CARE LAB),53.0,34.45,2.34,47.7,37
CDM,31002475,FISH FOR PML/RARA ANALY 100-300,530.0,344.5,22.32,477.0,37
CDM,31002485,FISH FOR PML/RARA PROBE,530.0,344.5,21.42,477.0,37
CDM,31002495,FISH FOR CCND1 PROBE,354.0,230.1,21.42,318.6,37
CDM,31002505,FISH FOR CCND1 ANALY 100-300,354.0,230.1,22.32,318.6,37
CDM,31002515,FISH FOR AML 1/ETO PROBE,347.0,225.55,21.42,312.3,37
CDM,31002525,FISH FOR AML 1/ETO ANALY 100-300,347.0,225.55,22.32,312.3,37
CDM,31002535,FISH FOR CLL PROBE,110.0,71.5,21.42,99.0,37
CDM,31002545,"FISH FOR CLL ANALY, 100-300",110.0,71.5,22.32,99.0,37
CDM,31002555,H&E UNSTAINED SLIDES,62.0,40.3,11.52,115.85,37
CDM,31002565,MICRODISECTION MANUAL,40.0,26.0,6.72,284.47,28
CDM,31002575,MYELOPROLIF NEOPL PNL MARROW,978.0,635.7,22.32,880.2,27
CDM,31002585,MYELOPROLIF NEOPL PNL BLOOD,978.0,635.7,22.32,880.2,27
CDM,31002605,FAMILAL MEDITER FEVER SEQ,1150.0,747.5,76.88,1035.0,37
CDM,31002615,DRPLA DNA TEST,945.0,614.25,76.88,850.5,37
CDM,31002625,SCA1 DNA TEST,597.0,388.05,76.88,537.3,37
CDM,31002635,SCA2 EXPANSION,641.0,416.65,76.88,576.9,37
CDM,31002645,SCA3 DNA TEST,620.0,403.0,76.88,558.0,37
CDM,31002655,SCA7 DNA TEST,663.0,430.95,76.88,596.7,37
CDM,31002665,SCA6 DNA TEST,629.0,408.85,76.88,566.1,37
CDM,31002675,HEMMIG CACNA1A,1398.0,908.7,325.19,1398.0,37
CDM,31002685,DM2 DNA TEST,517.0,336.05,76.88,465.3,37
CDM,31002695,KENNEDY'S DIS DNA,805.0,523.25,76.88,724.5,37
CDM,31002705,DM1 DNA TEST,517.0,336.05,76.88,465.3,37
CDM,31002715,HUNTINGTON'S DISEASE,844.0,548.6,76.88,759.6,37
CDM,31002725,FRIEDREICH ATAX DNA,640.0,416.0,76.88,576.0,37
CDM,31002735,MYD88 L265P MUT ANLS,867.0,563.55,76.88,780.3,37
CDM,31002745,OPMD DNA TEST,605.0,393.25,76.88,544.5,37
CDM,31002755,SMA CARRIER SCRN DIAG,606.0,393.9,76.88,545.4,37
CDM,31002765,SCA17 DNA TEST,806.0,523.9,76.88,725.4,37
CDM,31002775,LIVER FIBRO AND ACTI,503.0,326.95,22.32,452.7,37
CDM,31002805,BTK GENE ANALYISIS,987.0,641.55,76.88,888.3,37
CDM,31002815,PLCG2 GENE ANALYSIS,666.0,432.9,76.88,599.4,37
CDM,31002825,DMD SEQUENCING,1975.0,1283.75,22.32,1777.5,27
CDM,31002835,SARCOMA FUSION NGS PANEL,3438.0,2234.7,170.1,3094.2,37
CDM,31002845,NTRK GENE ANALYSIS,3280.0,2132.0,170.1,2952.0,37
CDM,31002875,PAN-SOLID TUMOR NGS,4706.0,3058.9,1109.84,4706.0,37
CDM,31002905,CYTOCHROME P450 2C19,774.0,503.1,76.88,696.6,37
CDM,31002935,WRFSEN TPMT GENE VAR,141.0,91.65,22.32,141.0,37
CDM,31002975,SHOX DNA DIAGNOSTIC,505.0,328.25,22.32,454.5,27
CDM,31003025,CSPNL SMN1 GENE DOS/DEL,166.0,107.9,41.5,166.0,37
CDM,31003035,MATERNIT21 PLUS,2650.0,1722.5,325.19,2385.0,37
CDM,31003095,PGPAIN CYP2D6 GENE COM VAR,564.0,366.6,141.0,564.0,37
CDM,31003245,HLA-B51,826.0,536.9,22.32,743.4,37
CDM,31003335,RETTFG MECP2 GENE FULL SEQ,1836.0,1193.4,170.1,1652.4,37
CDM,31003345,RETTFG MECP2 GENE DUP/DELET VARIANT,521.0,338.65,76.88,468.9,37
CDM,31003355,CIFAB AB IGG FIRST,359.0,233.35,92.98,371.54,38
CDM,31003365,CIFAB AB IGG ADDTL,99.0,64.35,16.63,158.86,28
CDM,31003375,HLA-B58,883.0,573.95,22.32,794.7,37
CDM,31003385,EM PROCESSING AND HOLD,55.0,35.75,11.52,115.85,37
CDM,31003395,EM THICK ONLY,158.0,102.7,19.72,142.2,38
CDM,31003405,CHIMERISM/ENGRAFTMENT ANALY W/COMP TO BASLINE,3960.0,2574.0,76.88,3564.0,37
CDM,31003415,STR GENOTYPING,1401.0,910.65,76.88,1260.9,37
CDM,31003425,"HLA-A,B,C,DR,DQ,DRB345_RT-PCR",2361.0,1534.65,170.1,2124.9,37
CDM,31003435,SOLID ORGAN NGS FEE,1417.0,921.05,170.1,1275.3,37
CDM,31003445,FISH FOR TP63 TISSUE,801.0,520.65,94.71,720.9,38
CDM,31003455,FISH FOR DUSP22-IRF4 TISS,801.0,520.65,94.71,720.9,38
CDM,31003465,FISH TP63 DUSP22 PANEL,801.0,520.65,94.71,720.9,38
CDM,31003475,JK VARIANT DETERMINATION,550.0,357.5,22.32,495.0,27
CDM,31003485,KITPB KIT TARGET SEQ,849.0,551.85,76.88,764.1,37
CDM,31003495,KITPB MUT ANLYS,452.0,293.8,22.32,406.8,37
CDM,31003505,KITBM KIT TARGET SEQ,849.0,551.85,76.88,764.1,37
CDM,31003515,KITBM MUT ANLYS,452.0,293.8,22.32,406.8,37
CDM,31003525,CSF3R MUTATION ANLYS BLD,2294.0,1491.1,76.88,2064.6,37
CDM,31003535,CSF3R MUTATION ANLYS BM,2294.0,1491.1,76.88,2064.6,37
CDM,31003545,SF3B1 MUTATION ANLYS BLD,2294.0,1491.1,76.88,2064.6,37
CDM,31003555,SF3B1 MUTATION ANLYS BM,2294.0,1491.1,76.88,2064.6,37
CDM,31003565,HEAD AND NECK NGS,1788.0,1162.2,170.1,1609.2,37
CDM,31003575,SARCOMA FUSION NGS,1788.0,1162.2,447.0,3211.56,37
CDM,31003585,NTRK NGS,1914.0,1244.1,22.32,1722.6,27
CDM,31003595,HOTSPOT DESMOID NGS,1914.0,1244.1,22.32,1722.6,27
CDM,31003605,ARC ABO COM ALL DETERMIN,557.0,362.05,76.88,501.3,37
CDM,31003615,ARC ABO VARIANTS,807.0,524.55,76.88,726.3,37
CDM,31003625,FISH FOR BIRC3/MALT1,801.0,520.65,94.71,720.9,38
CDM,31003635,MPL MUTATION ANSYS BLD,1434.0,932.1,76.88,1290.6,37
CDM,31003645,MPL MUTATION ANSYS BM,1434.0,932.1,76.88,1290.6,37
CDM,31003655,JAKNON EX 12-16 SEQ BLD,758.0,492.7,76.88,682.2,37
CDM,31003665,JAK2 EX 12-16 MUT DET BLD,758.0,492.7,76.88,682.2,37
CDM,31003675,TP53 SOMATIC MUT PROG,1571.0,1021.15,325.19,1413.9,37
CDM,31003685,WRFSEN UNLISTED MOPATH,61.0,39.65,10.25,54.9,27
CDM,31003695,SF3B1 MUTATION ANALYS BM,2294.0,1491.1,76.88,2064.6,37
CDM,31003705,NTRK NGS,2126.0,1381.9,170.1,1913.4,37
CDM,31003715,SF3B1 MUTATION ANALYS BLD,2294.0,1491.1,76.88,2064.6,37
CDM,31003725,190PCR BONE MARROW TEST,1344.0,873.6,76.88,1209.6,37
CDM,31003735,BCR/ABL QUANT BONE MARROW,1396.0,907.4,76.88,1256.4,37
CDM,31003745,TCBMDM GENE REARRANGE AMP,1466.0,952.9,76.88,1319.4,37
CDM,31003755,TCBMDM GENE REARRANGE ANAL,1466.0,952.9,76.88,1319.4,37
CDM,31003765,TCBMDO GENE REARRANGE AMP,1466.0,952.9,76.88,1319.4,37
CDM,31003775,TCBMDO GENE REARRANGE ANAL,1466.0,952.9,76.88,1319.4,37
CDM,31003785,BCBMDM LGH REARR HCL,1406.0,913.9,76.88,1265.4,37
CDM,31003795,BCBMDM LGK REARR KLCL,1406.0,913.9,76.88,1265.4,37
CDM,31003805,BCBMDO LGH REARR HCL,1406.0,913.9,76.88,1265.4,37
CDM,31003815,BCBMDO LGK REARR KLCL,1406.0,913.9,76.88,1265.4,37
CDM,31003825,IGHM LGH REARR HCL,1406.0,913.9,76.88,1265.4,37
CDM,31003835,IGHO LGH REARR HCL,1406.0,913.9,76.88,1265.4,37
CDM,31003845,IGKM LGK REARR KLCL,1406.0,913.9,76.88,1265.4,37
CDM,31003855,IGKO LGK REARR KLCL,1406.0,913.9,76.88,1265.4,37
CDM,31003865,TCRBM GENE REARRANGE AMP,1466.0,952.9,76.88,1319.4,37
CDM,31003875,TCRBO GENE REARRANGE AMP,1466.0,952.9,76.88,1319.4,37
CDM,31003885,TCRGM GENE REARRANGE ANAL,1466.0,952.9,76.88,1319.4,37
CDM,31003895,TCRGO GENE REARRANGE ANAL,1466.0,952.9,76.88,1319.4,37
CDM,31003905,MYD88 L265P MUT ANLS BM,1007.0,654.55,76.88,906.3,37
CDM,31003915,MYD88 L265P MUT ANLS OTH,1007.0,654.55,76.88,906.3,37
CDM,31003925,ALLPB ALL PANEL NGS BLD,2068.0,1344.2,325.19,1861.2,37
CDM,31003935,ALLBM ALL PANEL NGS BM,2068.0,1344.2,325.19,1861.2,37
CDM,31003945,FLT3 ITD MUT ANSYS BLD,678.0,440.7,76.88,610.2,37
CDM,31003955,FLT3 ITD MUT ANSYS BM,678.0,440.7,76.88,610.2,37
CDM,31003965,FLT3PB MUT ANSYS BLD,678.0,440.7,76.88,610.2,37
CDM,31003975,FLT3PB GENE ANSYS BLD,524.0,340.6,22.32,471.6,37
CDM,31003985,F3MRW MUT ANSYS BM,678.0,440.7,76.88,610.2,37
CDM,31003995,F3MRW GENE ANSYS BM,524.0,340.6,22.32,471.6,37
CDM,31004005,1P19Q FISH FOR 1P/19Q,801.0,520.65,94.71,720.9,38
CDM,31004015,POCHF PROD CONCEPT+SNP,2262.0,1470.3,565.5,2035.8,37
CDM,31004025,MTHRF 2 VARIANTS,255.0,165.75,22.32,229.5,37
CDM,31004035,EIHC ISH TECH ONLY,334.0,217.1,86.51,371.54,38
CDM,31004045,EIHC EACH ADD AB/BLK,168.0,109.2,19.72,151.2,28
CDM,31004055,EIMMUNOCYTOCHEM TC,158.0,102.7,40.92,371.54,38
CDM,31004065,"E IHC QUANTITATIVE, TC",138.0,89.7,35.74,371.54,38
CDM,31004075,GISTCY BRAF GENE,426.0,276.9,76.88,383.4,37
CDM,31004085,GISTCY KIT GENE,872.0,566.8,76.88,784.8,37
CDM,31004095,GISTCY PDGFRA GENE,872.0,566.8,76.88,784.8,37
CDM,31004105,GISTCY NGS UNLIST MOLEC,193.0,125.45,22.32,173.7,27
CDM,31004115,IDH1 COMMON VARIANTS,878.0,570.7,76.88,790.2,37
CDM,31004125,IDH2 COMMON VARIANTS,878.0,570.7,76.88,790.2,37
CDM,31004145,LUNG CANCER HOTSPOT CYTO,2048.0,1331.2,170.1,1843.2,37
CDM,31004155,NGSCCY BRAF,364.0,236.6,76.88,327.6,37
CDM,31004165,"NGSCCY KRAS 12,13",364.0,236.6,76.88,327.6,37
CDM,31004175,NGSCCY KRAS 61,400.0,260.0,76.88,360.0,37
CDM,31004185,NGSCCY NRAS,506.0,328.9,76.88,494.27,37
CDM,31004195,NGSMCY BRAF,400.0,260.0,76.88,360.0,37
CDM,31004205,NGSMCY KIT,657.0,427.05,76.88,591.3,37
CDM,31004215,NGSMCY NRAS,506.0,328.9,76.88,494.27,37
CDM,31004225,FISH FOR IGH/BCL2 TIS X2,801.0,520.65,94.71,720.9,38
CDM,31004235,FISH FOR IGH/CCND1 TIS X2,801.0,520.65,94.71,720.9,38
CDM,31004245,CELIAC GLUTEN FREE PANEL X2,476.0,309.4,22.32,428.4,37
CDM,31004255,CSF3RP MUTATION ANANLYSIS BLD,1250.0,812.5,22.32,1125.0,27
CDM,31004265,CSF3RM MUTATION ANANLYSIS BM,1250.0,812.5,22.32,1125.0,27
CDM,31004275,CP2C19-CYP2C19 GENOTYPING,363.0,235.95,76.88,363.0,37
CDM,31004285,2C19AO-CYP2C19 GTYP AN ON,363.0,235.95,76.88,363.0,37
CDM,31004295,2D6AO-CYP2D6 GTYP AN ON,557.0,362.05,139.25,557.0,37
CDM,31004305,3B1AO-HSD3B1 GTYP AN ON,330.0,214.5,22.32,297.0,27
CDM,31004315,VWFSEQ VON WILLEBRAND DISEASE SEQ,3207.0,2084.55,801.75,3207.0,37
CDM,31004325,CVCYTO CHROMOSOME COUNT ADDITIONAL,63.0,40.95,15.75,56.7,37
CDM,31004335,ISIGHT CYTOGENETICS 25-99,152.0,98.8,22.32,136.8,37
CDM,31004345,FAMCYT CHROMOSOME ANALYSIS AMNIOTIC,512.0,332.8,76.88,460.8,37
CDM,31004355,FAMCYT CHROMOSOME COUNT ADDITIONAL,63.0,40.95,15.75,56.7,37
CDM,31004365,PLTEMS ELECTRON MICROSCOPY,1507.0,979.55,94.71,1771.17,38
CDM,31004375,"CXCR4 MUTATION ANALYSIS, SOMATIC",908.0,590.2,22.32,817.2,27
CDM,31004385,HFPNGS HN FUSION NGS PNL BLD,1811.0,1177.15,452.75,3211.56,37
CDM,31004395,HFMNGS HN FUSION NGS PNL BLD,1811.0,1177.15,452.75,3211.56,37
CDM,31004405,HFONGS HN FUSION NGS PNL OTHER,1811.0,1177.15,452.75,3211.56,37
CDM,31004415,HDPNGS ACUTE LEUK NGS PNL BLD,3000.0,1950.0,750.0,3211.56,37
CDM,31004425,HDMNGS ACUTE LEUK NGS PNL BM,3000.0,1950.0,750.0,3211.56,37
CDM,31004435,HDONGS ACUTE LEUK NGS PNL OTHER,3000.0,1950.0,750.0,3211.56,37
CDM,31004445,MYNGSM MYELOID PANEL NGS BM,1811.0,1177.15,452.75,3211.56,37
CDM,31004455,MYNGSP MYELOID PANEL NGS P BLD,1811.0,1177.15,452.75,3211.56,37
CDM,31004465,MYNGSO MYELOID PANEL NGS OTHER,1811.0,1177.15,452.75,3211.56,37
CDM,31004475,LPMNGS CHRONIC LYMPHOPRO NGS BM,1811.0,1177.15,452.75,3211.56,37
CDM,31004485,LPPNGS CHRONIC LYMPHOPRO NGS P BLD,1811.0,1177.15,452.75,3211.56,37
CDM,31004495,LPONGS CHRONIC LYMPHOPRO NGS OTHER,1811.0,1177.15,452.75,3211.56,37
CDM,31004505,HNONGS HN NGS SEQ PANEL OTHER,1811.0,1177.15,452.75,3211.56,37
CDM,31004515,BRAF V600E MUT DETECT BM,484.0,314.6,76.88,435.6,37
CDM,31004525,KIT D816V MUT DETECT BLD,369.0,239.85,22.32,332.1,37
CDM,31004535,KIT D816V MUT DETECT BM,369.0,239.85,22.32,332.1,37
CDM,31004545,KIT D816V MUT DETECT OTHER,369.0,239.85,22.32,332.1,37
CDM,31004555,BRAF V600E MUT DETECT OTHER,484.0,314.6,76.88,435.6,37
CDM,31004565,CYP2D6 UNLISTED MOLEC PATH,550.0,357.5,22.32,495.0,27
CDM,31004575,CYP2D6 REFLX ONLY UNLIST MOLEC PATH,550.0,357.5,22.32,495.0,27
CDM,31004585,BRAF V600E MUT DETECT BLOOD,484.0,314.6,76.88,435.6,37
CDM,31004595,BMENGS SNP MARKERS SPECIMEN ANAL,1319.0,857.35,76.88,1187.1,37
CDM,31004605,BMFUNG CHIMERISM ANAL W/CELL SELECT,1187.0,771.55,76.88,1068.3,37
CDM,31004615,BCRPB BCR/ABL1 GENE MAJOR BP,1257.0,817.05,76.88,1131.3,37
CDM,31004625,BCRPB BCR/ABL1 GENE MINOR BP,1210.0,786.5,76.88,1089.0,37
CDM,31004635,BCRBM BCR/ABL1 GENE MAJOR BP,1257.0,817.05,76.88,1131.3,37
CDM,31004645,BCRBM BCR/ABL1 GENE MINOR BP,1210.0,786.5,76.88,1089.0,37
CDM,31004655,BM ENGRAFT F/U TEST,2103.0,1366.95,76.88,1892.7,37
CDM,31004665,"TP53 SOMATIC MUT, PROGNOSTIC",1414.0,919.1,76.88,1272.6,37
CDM,31004675,TISSUE DNA FP FOR MOLAR PREG - IHC SENDOUT,660.0,429.0,76.88,594.0,37
CDM,31004685,CILIARY MOTILITY - EM DIAG,2362.0,1535.3,94.71,2125.8,38
CDM,31004695,"TOPPB TGT ONC NGS, PER BLD",3300.0,2145.0,825.0,3300.0,37
CDM,31004705,"TOPBM TGT ONC NGS, BM",3300.0,2145.0,825.0,3300.0,37
CDM,31004715,"TOPTO TGT ONC NGS, OTH",3300.0,2145.0,825.0,3300.0,37
CDM,31004725,"TOPCY TGT ONC NGS, CYTO",3300.0,2145.0,825.0,3300.0,37
CDM,31004735,NMP1 MUTATION DETECTION BY RT-PCR,678.0,440.7,76.88,610.2,37
CDM,31004745,"PRENATAL SNP MICROARRAY, AMNIOTIC FLUID, CVS",4580.0,2977.0,1109.84,4122.0,37
CDM,31004755,UBA1 MUTATION TESTING FOR VEXAS SYNDROME,3443.0,2237.95,76.88,3098.7,37
CDM,31004765,NEOTYPE MDS/CMML PROFILE,2244.0,1458.6,325.19,2019.6,37
CDM,31004775,PRENATAL QUAD SCREEN,383.0,248.95,76.88,344.7,37
CDM,31004785,NARCOLEPSY GENOTYPING (HLADQB1* 06:02),309.0,200.85,22.32,278.1,37
CDM,31004795,HPA-1 GENOTYPING,305.0,198.25,22.32,274.5,37
CDM,31004805,HPA-2 GENOTYPING,305.0,198.25,22.32,274.5,37
CDM,31004815,HPA-3 GENOTYPING,305.0,198.25,22.32,274.5,37
CDM,31004825,HPA-4 GENOTYPING,305.0,198.25,22.32,274.5,37
CDM,31004835,HPA-5 GENOTYPING,305.0,198.25,22.32,274.5,37
CDM,31004845,HPA-6 GENOTYPING,305.0,198.25,22.32,274.5,37
CDM,31004855,HPA-9 GENOTYPING,305.0,198.25,22.32,274.5,37
CDM,31004865,HPA-15 GENOTYPING,305.0,198.25,22.32,274.5,37
CDM,31004875,NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (NAIT)-INITIAL TESTING MATE,2490.0,1618.5,22.32,2241.0,27
CDM,31004885,HPA-1 GENOTYPING,367.0,238.55,22.32,330.3,37
CDM,31004895,HPA-2 GENOTYPING,367.0,238.55,22.32,330.3,37
CDM,31004905,HPA-3 GENOTYPING,367.0,238.55,22.32,330.3,37
CDM,31004915,HPA-4 GENOTYPING,367.0,238.55,22.32,330.3,37
CDM,31004925,HPA-5 GENOTYPING,367.0,238.55,22.32,330.3,37
CDM,31004935,HPA-6 GENOTYPING,367.0,238.55,22.32,330.3,37
CDM,31004945,HPA-9 GENOTYPING,367.0,238.55,22.32,330.3,37
CDM,31004955,HPA-15 GENOTYPING,367.0,238.55,22.32,330.3,37
CDM,31004965,NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (NAIT)-INITIAL TESTING MATE,2964.0,1926.6,22.32,2667.6,27
CDM,31004975,NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (NAIT)-INITIAL TESTING MATE,2964.0,1926.6,22.32,2667.6,27
CDM,31004985,"MORPHOMETRIC ANALYSIS, IN SITU HYBRID (HER2FGAST)",747.0,485.55,94.71,672.3,38
CDM,31004995,EGFR GENETIC ANALYSIS,811.0,527.15,170.1,729.9,37
CDM,31005005,EXOME SEQUENCING AHUS1,11950.0,7767.5,1109.84,10755.0,37
CDM,31005015,KRAS GENETIC ANALYSIS,483.0,313.95,76.88,434.7,37
CDM,31005025,KRAS ADDITIONAL VARIANTS,483.0,313.95,76.88,434.7,37
CDM,31005035,ONKOSIGHT ADVANCED CHRONIC LYMPHOID NGS PANEL,3038.0,1974.7,325.19,2734.2,37
CDM,31005045,NPM1 GENE ANALYSIS PB,493.0,320.45,76.88,443.7,37
CDM,31005055,NPM1 GENE ANALYSIS BM,493.0,320.45,76.88,443.7,37
CDM,31005065,NPM1 GENE ANALYSIS OTHER,493.0,320.45,76.88,443.7,37
CDM,31005075,MICROSATELLITE INSTABILITY DET (MSIID),696.0,452.4,76.88,626.4,37
CDM,31005085,%PEMGUS IFL ADDTL,231.0,150.15,19.72,207.9,28
CDM,31005095,"LIVER FIBROSIS, CHRONIC VIRAL HEPATITIS (ARUP)",106.0,68.9,17.81,95.4,27
CDM,31005105,POLE DROPLET DIGITAL PCR,378.0,245.7,22.32,340.2,27
CDM,31005115,PARD UNLISTED MOL PATH,463.0,300.95,76.88,416.7,37
CDM,31005125,IDH1&2-COMMON VARIANTS,1160.0,754.0,22.32,1044.0,27
CDM,31005135,TARGETED ONCOLOGY PANEL - FINE NEEDLE ASPIRATE,4400.0,2860.0,1100.0,4400.0,37
CDM,31005145,IDH1 HOTSPOT VARIANT BM,483.0,313.95,76.88,434.7,37
CDM,31005155,IHD2 HOTSPOT VARIANT BM,592.0,384.8,76.88,532.8,37
CDM,31005165,IDH1 HOTSPOT VARIANT PB,483.0,313.95,76.88,434.7,37
CDM,31005175,IDH2 HOTSPOT VARIANT PB,592.0,384.8,76.88,532.8,37
CDM,31005185,"HISTIOCYTIC NEOPLASMS, NGS",2279.0,1481.35,325.19,2051.1,37
CDM,31005195,"T-CELL LYMPHOMA, NGS",3798.0,2468.7,325.19,3418.2,37
CDM,31005205,"B-CELL LYMPHOMA, NGS",3798.0,2468.7,325.19,3418.2,37
CDM,31005215,"ACUTE LEUKEMIA RAPID NGS PANEL, BLOOD",3000.0,1950.0,750.0,3211.56,37
CDM,31005225,"ACUTE LEUKEMIA RAPID NGS PANEL, BONE MARROW",3000.0,1950.0,750.0,3211.56,37
CDM,31005275,"TAU, PHOSPHORYLATED (EG, PTAU 181, PTAU 217), EACH",112.0,72.8,5.23,141.81,30
CDM,31005285,"TAU, TOTAL (TTAU)",112.0,72.8,28.0,141.81,30
CDM,31005295,RUNX1-RUNX1T1,888.0,577.2,76.88,799.2,37
CDM,31005305,CBFB-MYH11 INV(16),888.0,577.2,76.88,799.2,37
CDM,31005315,MICROBIAL CELL-FREE DNA BY NGS,13778.0,8955.7,1109.84,12400.2,37
CDM,31005325,UBA1 MUT DET BY DDPCR BLOOD,463.0,300.95,76.88,416.7,37
CDM,31005335,UBA1 MUT DET BY DDPCR BONE MARROW,463.0,300.95,76.88,416.7,37
CDM,31005345,UBA1 MUT DET BY DDPCR OTHER,463.0,300.95,76.88,416.7,37
CDM,31005355,DNA FINGERPRNT TEST-NGS-GENOTYPING,4128.0,2683.2,22.32,3715.2,27
CDM,31005365,DNA FINGERPRNT TEST-NGS-FOLLOW UP,4128.0,2683.2,22.32,3715.2,27
CDM,31005485,TARGETED ONCOLOGY PANEL LOW PURITY,4400.0,2860.0,1100.0,4400.0,37
CDM,31005495,FLT3 TKDM BONE MARROW,537.0,349.05,22.32,483.3,37
CDM,31005505,"ISH, QUANT/SEMI QUANT, MULTIPLEX PROBE STAIN",1182.0,768.3,94.71,1063.8,38
CDM,31005515,INTESTINAL TRANSPLANT REJECTION RISK EVALUATION (PLEXIMMUNE),4152.0,2698.8,28.87,3736.8,37
CDM,31005525,CYTOGENOMIC SNP MICROARRAY - FETAL,4500.0,2925.0,1109.84,4050.0,37
CDM,31005535,FETAL CELL CONTAMINATION (FCC),1511.0,982.15,76.88,1359.9,37
CDM,31005545,"TAU, PHOSPHORYLATED (EG, PTAU 181, PTAU 217), EACH",112.0,72.8,5.23,141.81,30
CDM,31005565,BRAF V600E/D AND V600K/R MUTATION DETECTION CIRCULATING TUMOR DN,1335.0,867.75,76.88,1201.5,37
CDM,31005575,"MICROARRAY ANALYSIS, SNP, FORMALIN FIXED PARAFFIN EMBEDDED TISSU",1335.0,867.75,333.75,1401.9,37
CDM,31005585,"MICROARRAY ANALYSIS, POC FFPE",1335.0,867.75,333.75,1401.9,37
CDM,31005595,CALR GENE ANALYSIS,839.0,545.35,22.32,755.1,37
CDM,31005605,"JAK2 GENE ANALYSIS, VAL617PHE VARIANT",632.0,410.8,22.32,568.8,37
CDM,31005615,MPL GENE ANALYSIS,1278.0,830.7,76.88,1150.2,37
CDM,31005625,"JAK2 GENE ANALYSIS, EXONS 12 AND 13",1278.0,830.7,76.88,1150.2,37
CDM,31005635,"STR ANALYSIS FOR MOL PREG, BLD",1608.0,1045.2,76.88,1447.2,37
CDM,31005645,"STR ANALYSIS FOR MOL PREG, OTHER",1608.0,1045.2,76.88,1447.2,37
CDM,31005655,MICORARRAY SNP FFPET,3317.0,2156.05,829.25,2985.3,37
CDM,31005665,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, BLOOD",1608.0,1045.2,76.88,1447.2,37
CDM,31005675,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, OTHER",1608.0,1045.2,76.88,1447.2,37
CDM,31005685,BCR-ABL1 KINASE MUT DET SANGER BLD,2070.0,1345.5,76.88,1863.0,37
CDM,31005695,BCR-ABL1 KINASE MUT DET BY SANGER SEQ BM,2070.0,1345.5,76.88,1863.0,37
CDM,31005705,SERPINA1 TARG MUT BY SANGER SEQ,301.0,195.65,22.32,270.9,37
CDM,31005715,UGT1A1 TARG MUT DET BY SANGER,1615.0,1049.75,76.88,1453.5,37
CDM,31005725,UBA1 TARG MUT DET BY SANGER OTHER,1278.0,830.7,76.88,1150.2,37
CDM,31005735,UGTA1 TARG MUT DET BY SANGER BLD,1278.0,830.7,76.88,1150.2,37
CDM,31005745,UBA1 TARG MUT DET BY SANGER BM,1278.0,830.7,76.88,1150.2,37
CDM,31005755,POLE TARG MUT DET BY SANGER,378.0,245.7,22.32,340.2,27
CDM,31005765,ONC PAN-TUMOR DNA&RNA NEXT-GENERATION SEQUENCING-CARIS,58339.0,37920.35,1109.84,52505.1,30
CDM,31005775,HFE TARGETED MUT BY SANGER SEQ,451.0,293.15,22.32,405.9,37
CDM,31005785,"TP53 SOMATIC MUT, PROGNOSTIC",1414.0,919.1,76.88,1272.6,37
CDM,31005798,FULL GENE SEQUENCE ANALYSIS OF THE TP53 (TUMOR PROTEIN 53) GENE,1571.0,1021.15,325.19,1413.9,37
CDM,31005805,MATERNAL CELL CONTAMINATION,1608.0,1045.2,76.88,1447.2,37
CDM,31005815,ADDITIONAL CELLS COUNTED,37.0,24.05,9.25,37.0,37
CDM,31005825,INTER FISH ANALYSIS 25-99 CELLS,157.0,102.05,22.32,141.3,37
CDM,31005835,SANGER SEQ DNA BLD,1278.0,830.7,76.88,1150.2,37
CDM,31005845,SANGER SQ DNA BONE MARROW,1278.0,830.7,76.88,1150.2,37
CDM,31005855,SANGER SEQ DNA OTHER,1278.0,830.7,76.88,1150.2,37
CDM,31005865,SANGER SEQ RNA BLD,1278.0,830.7,76.88,1150.2,37
CDM,31005875,SANGER SEQ RNA BONE MARROW,1278.0,830.7,76.88,1150.2,37
CDM,31020WE,SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL,1228.0,798.2,182.96,921.0,35
CDM,31030WE,SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS,2404.0,1562.6,251.34,1803.0,35
CDM,31032WE,SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS,2676.0,1739.4,371.71,2676.0,35
CDM,31040WE,PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH,4299.0,2794.35,460.05,4299.0,35
CDM,31050WE,SINUSOTOMY SPHENOID W/WO BIOPSY,2148.0,1396.2,296.66,2148.0,35
CDM,31051WE,SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP,2900.0,1885.0,396.25,2900.0,35
CDM,31070WE,SINUSOTOMY FRONTAL EXTERNAL SIMPLE,1760.0,1144.0,244.44,1760.0,32
CDM,31075WE,SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL,3804.0,2472.6,509.05,3804.0,35
CDM,31081WE,SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC,5676.0,3689.4,639.94,5676.0,35
CDM,31085WE,SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC,6256.0,4066.4,777.63,6256.0,35
CDM,31086WE,SINUSOT FRNT NONOBLIT W/OSTPL FLAP BROW INC,5744.0,3733.6,604.63,5744.0,35
CDM,31087WE,SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC,5828.0,3788.2,635.43,5828.0,35
CDM,31100005,CRYOPRSRV/STRGE HEMATOPOIE CELL,2186.0,1420.9,438.83,4214.0,45
CDM,31100010,CYTPATH NONGYN SMEAR INTERP,109.0,70.85,11.52,123.52,38
CDM,31100015,CYTOLOGY FLUID TP,232.0,150.8,11.52,208.8,38
CDM,31100035,CYTO IMAGER GYN TP DIAG,191.0,124.15,9.95,171.9,37
CDM,31100045,CYTO SECOND PASS ADEQ,37.0,24.05,6.22,40.01,28
CDM,31100050,CYTPATH SACCOMENNO SMEAR,111.0,72.15,11.52,101.35,38
CDM,31100065,%CD2 CD3 MONITOR 1ST MARK,374.0,243.1,96.87,779.93,38
CDM,31100070,SEX CHROMATIN ID BARR BODIES,39.0,25.35,2.34,35.1,37
CDM,31100075,ADDITIONAL MARKERS,138.0,89.7,11.52,124.2,28
CDM,31100090,CYTOLOGY GYN SCREENING,109.0,70.85,9.95,98.1,37
CDM,31100100,CYTPATH HORMONAL EVAL,39.0,25.35,9.75,35.1,37
CDM,31100110,CYTPATH SMEAR OTHER,109.0,70.85,11.52,120.07,38
CDM,31100130,CYTPATH SMEAR OTHER W PREP,86.0,55.9,11.52,122.16,38
CDM,31100150,CYTPATH SMEAR OTHER EXTENDED,69.0,44.85,11.52,188.54,38
CDM,31100155,CYTOLOGY GYN SC THIN PREP,167.0,108.55,9.95,150.3,37
CDM,31100160,CYTPATH CERV/VAG SCREENING,28.0,18.2,7.0,28.0,37
CDM,31100170,CYTPATH FNA IMMEDIATE EVAL,188.0,122.2,48.69,371.54,38
CDM,31100175,CYTO IMAGER GYN TP SCREEN,196.0,127.4,9.95,176.4,37
CDM,31100180,CYTPATH FNA I&R,186.0,120.9,48.17,241.64,38
CDM,31100185,CYTOLOGY GYN SCREEN,107.0,69.55,9.95,96.3,37
CDM,31100190,"FLOW CYTO, DNA",173.0,112.45,11.52,221.05,38
CDM,31100200,"FLOW CYTOMETRY TC, 1ST MARKER",374.0,243.1,96.87,779.93,38
CDM,31100240,"FLOW CYTOMETRY TC, ADD MARKER",39.0,25.35,6.55,35.89,28
CDM,31100290,TISS CULT F/NON,167.0,108.55,41.75,167.0,37
CDM,31100300,TIS CULT SKIN/BX,472.0,306.8,101.52,424.8,37
CDM,31100310,TISS CULT BONE MARROW,273.0,177.45,68.25,245.7,37
CDM,31100370,CHROMO ANALYSIS 15-20CELL BAND,446.0,289.9,22.32,401.4,37
CDM,31100400,CHROMO ANALYSIS 20-25 CELLS,197.0,128.05,49.25,197.0,37
CDM,31100420,CYTOGEN DNA PROBE EA,157.0,102.05,21.42,141.3,37
CDM,31100430,CYTOGEN INTERPHASE 25-99CELL,157.0,102.05,22.32,141.3,37
CDM,31100440,CYTOGEN INTERPHASE 100-300,289.0,187.85,22.32,260.1,37
CDM,31100450,CHROMO ANALYSIS ADD KAROTYPE,51.0,33.15,12.75,51.0,37
CDM,31100480,MOL CYTOGEN I&R,241.0,156.65,40.49,216.9,28
CDM,31100490,CHROM ANAL 5 CELL BAND,337.0,219.05,76.88,337.0,37
CDM,31100500,CHROMO ANALYSIS 15-20CELL BAND,265.0,172.25,22.32,238.5,37
CDM,31100510,CHROMO ANALYSIS 20-25 CELLS,190.0,123.5,47.5,190.0,37
CDM,31100520,CHROMO ANALYSIS ADD KAROTYPE,44.0,28.6,11.0,44.0,37
CDM,31100530,CHROMO COUNT ADD,37.0,24.05,9.25,37.0,37
CDM,31100540,TIS CULT SOLID TUMOR,340.0,221.0,85.0,306.0,37
CDM,31100590,*FLOW CYTOMETRY 2-8 MARKERS,46.0,29.9,7.73,51.08,28
CDM,31100600,*FLOW CYTOMETRY TC 1ST MARKER,374.0,243.1,96.87,779.93,38
CDM,31100610,"FLOW CYTO, EA ADD MARKER",43.0,27.95,7.22,38.7,28
CDM,31100620,*FLOW CYTOMETRY 2-8 MARKERS,43.0,27.95,7.22,51.08,28
CDM,31100630,LYMPH TISS FIRST MARKER,374.0,243.1,96.87,779.93,38
CDM,31100640,"FLOW CYTOMETRY TC, 1ST MARKER",230.0,149.5,59.57,779.93,38
CDM,31100650,"*FLOW CYTOMETRY TC, 1ST MARKER",374.0,243.1,96.87,779.93,38
CDM,31100660,FLOW CYTO CEL FIRST MRKR,374.0,243.1,96.87,779.93,38
CDM,31100670,FLOW EA ADD MARK 10,21.0,13.65,3.53,35.89,28
CDM,31100680,"FLOW CYTOMETRY TC, ADD MARKER",64.0,41.6,10.75,57.6,28
CDM,31100690,"*FLOW CYTOMETRY TC, ADD MARKER",46.0,29.9,7.73,41.4,28
CDM,31100700,FLOW EA ADD MARKER,4.0,2.6,0.67,35.89,28
CDM,31100710,FLOW EA ADD MARKER,180.0,117.0,11.52,162.0,28
CDM,31100720,TISS CULT BONE MARROW,446.0,289.9,101.52,401.4,37
CDM,31100730,TISSUE CULT F/BN MARROW,180.0,117.0,45.0,180.0,37
CDM,31100740,TISSUE CULT F/BN MARROW,216.0,140.4,54.0,216.0,37
CDM,31100750,CHRMSM ANAL 2 KARYO BAND,216.0,140.4,22.32,209.69,37
CDM,31100760,"FLOW CYTO, 1ST MARKER",374.0,243.1,96.87,779.93,38
CDM,31100770,*CIRCULATING TUMOR CELLS,101.0,65.65,11.52,90.9,28
CDM,31100780,*CIRCULATING TUMOR CELLS,101.0,65.65,11.52,90.9,28
CDM,31100790,*CIRCULATING TUMOR CELLS,101.0,65.65,11.52,90.9,28
CDM,31100800,*CHROMO ANALYSS 15-20CELL BAND,388.0,252.2,22.32,349.2,37
CDM,31100810,*TIS CULT LYMPHOCYTE,388.0,252.2,97.0,349.2,37
CDM,31100820,*MOL CYTOGEN I&R,259.0,168.35,43.51,233.1,28
CDM,31100830,*TIS CULT BONE MARROW,994.0,646.1,101.52,894.6,37
CDM,31100840,*CHROM ANALYSS 15-20CELL BAND,968.0,629.2,22.32,871.2,37
CDM,31100850,*MOL CYTOGEN I&R,309.0,200.85,43.55,278.1,28
CDM,31100860,FLOW CYTOMETRY TC 1ST MARKER,374.0,243.1,96.87,779.93,38
CDM,31100870,*FLOW CYTOMETRY>16 MARKER,23.0,14.95,3.86,115.8,28
CDM,31100880,FLOW CYTOMETRY TC ADD MARKER,23.0,14.95,3.86,35.89,28
CDM,31100890,*FLOW CYTOMETRY TC ADD MARKER,23.0,14.95,3.86,35.89,28
CDM,31100900,*FLOW CYTOMETRY TC 1ST MARKER,374.0,243.1,96.87,779.93,38
CDM,31100910,*FLOW CYTOMETRY TC ADD MARKER,19.0,12.35,3.19,35.89,28
CDM,31100920,*FLOW CYTOMETRY TC ADD MARKER,19.0,12.35,3.19,35.89,28
CDM,31100930,*FLOW CYTOMETRY>16 MARKER,19.0,12.35,3.19,115.8,28
CDM,31100950,CYTPATH NONGYN SMEAR INTERP,194.0,126.1,11.52,174.6,38
CDM,31100960,*TIS CULT BONE MARROW,994.0,646.1,101.52,894.6,37
CDM,31100970,*CHROMO ANALYSS 15-20CELL BAND,969.0,629.85,22.32,872.1,37
CDM,31100980,*MOL CYTOGEN I&R,120.0,78.0,20.16,108.0,28
CDM,31100990,*TIS CULT BONE MARROW,233.0,151.45,58.25,233.0,37
CDM,31101000,*CHROMO ANALYSIS 20-25 CELLS,265.0,172.25,66.25,241.64,37
CDM,31101010,*TIS CULT SOLID TISSUE,340.0,221.0,85.0,306.0,37
CDM,31101020,*CHROMO ANALYSS 15-20CELL BAND,340.0,221.0,22.32,306.0,37
CDM,31101030,*MOL CYTOGEN I&R,340.0,221.0,43.55,306.0,28
CDM,31101040,FLOW CYTOMETRY TC 1ST MRK,374.0,243.1,96.87,779.93,38
CDM,31101050,FLOW CYTOMETRY TC ADD MKR,15.0,9.75,2.52,35.89,28
CDM,31101060,*TIS CULT SKIN/BX,311.0,202.15,77.75,279.9,37
CDM,31101070,*CHROMO ANALYSS 15-20CELL BAND,311.0,202.15,22.32,279.9,37
CDM,31101080,*MOL CYTOGEN I&R,311.0,202.15,43.55,279.9,28
CDM,31101090,FLOW CYTOMETRY TC 1ST MARKER,374.0,243.1,96.87,779.93,38
CDM,31101100,CYTP FNA EVAL EA ADDL,39.0,25.35,6.55,40.01,28
CDM,31101110,CYTOPATH C/V AUTO FLUID REDO,40.0,26.0,9.95,40.0,37
CDM,31101120,CYTOPATH C/V AUTO FLUID REDO,40.0,26.0,9.95,40.0,37
CDM,31101130,TIS CULT SOLID TUMOR,340.0,221.0,85.0,306.0,37
CDM,31101140,FISH FOR MDS 88271,1560.0,1014.0,21.42,1404.0,37
CDM,31101150,FISH FOR MDS 88275,1560.0,1014.0,22.32,1404.0,37
CDM,31101160,FISH FOR IGH/CCND1 88271,330.0,214.5,21.42,297.0,37
CDM,31101170,FISH FOR IGH/CCND1 88275,330.0,214.5,22.32,297.0,37
CDM,31101180,FISH FOR MYELOPROF NEOP 88275,343.0,222.95,22.32,308.7,37
CDM,31101190,FISH FOR MYELOPROF NEOP 88271,343.0,222.95,21.42,308.7,37
CDM,31101200,FISH FOR BCR/ABL 88271,530.0,344.5,21.42,477.0,37
CDM,31101210,FISH FOR BCR/ABL 88275,530.0,344.5,22.32,477.0,37
CDM,31101215,BILIARY TRACT MALIG,597.0,388.05,11.52,537.3,38
CDM,31101220,NUCLEAR TDT BY FLOW CYTOMETRY,374.0,243.1,96.87,779.93,38
CDM,31101230,PLASMA CELL MYELOMA BY FISH 88271,1044.0,678.6,21.42,939.6,37
CDM,31101240,PLASMA CELL MYELOMA BY FISH 88275,1044.0,678.6,22.32,939.6,37
CDM,31101355,CYTOLOGY FLUID,109.0,70.85,11.52,101.35,38
CDM,31101365,%PLAFLW FLOW 1ST MARKER,132.0,85.8,34.19,779.93,38
CDM,31101375,%NKFUNC FIRST MARKER,789.0,512.85,101.52,779.93,38
CDM,31101385,%PLAFLW FLW ADD MARKER X5,132.0,85.8,11.52,118.8,28
CDM,31101405,%NKFUNC ADDTL MARKERS X2,252.0,163.8,11.52,226.8,28
CDM,31101415,RBCB3 PROTEIN RED,374.0,243.1,96.87,779.93,38
CDM,31101475,%PNH BY FCM 1ST MARK X2,122.0,79.3,31.6,779.93,38
CDM,31101485,%PNH BY FCM ADD MARK X7,62.0,40.3,10.42,55.8,28
CDM,31101525,%CHROMO AMNIOTIC FL,637.0,414.05,76.88,573.3,37
CDM,31101595,%CVID FLOW FIRST MARKER,374.0,243.1,96.87,779.93,38
CDM,31101665,%NUCLEAR TDT BY FCM 1ST MARKER,374.0,243.1,96.87,779.93,38
CDM,31101675,%ACLUK2 1ST MARK,374.0,243.1,96.87,779.93,38
CDM,31101695,%T CELL VBETA 1ST MARKER,374.0,243.1,96.87,779.93,38
CDM,31101705,%SURFACE/CYTO IGM 1ST MARKER,374.0,243.1,96.87,779.93,38
CDM,31101715,%PNH PANEL 1ST MARKER,374.0,243.1,96.87,779.93,38
CDM,31101745,%BLYMPHOMA 1ST MARKER,209.0,135.85,54.13,779.93,38
CDM,31101755,%LGLYM 1ST MRK,226.0,146.9,58.53,779.93,38
CDM,31101765,%RLLLIP 1ST MARKER,374.0,243.1,96.87,779.93,38
CDM,31101795,%ZAP70 ADDTL MARKERS,185.0,120.25,11.52,166.5,28
CDM,31101805,%ZAP70 FIRST MARKER,374.0,243.1,96.87,779.93,38
CDM,31101815,%DGEORG DNA PROBEX2,355.0,230.75,21.42,319.5,37
CDM,31101855,%CRMCON CHROMANALY SCELL,1568.0,1019.2,76.88,1411.2,37
CDM,31101885,CYTOPATH CELL ENHANCE TECH,238.0,154.7,11.52,214.2,38
CDM,31101895,TISSUE CULT SOLID TUMOR,340.0,221.0,85.0,306.0,37
CDM,31101905,TISSUE CULTURE BONE MAR/BLOOD (NG),180.0,117.0,45.0,180.0,37
CDM,31102345,20Q8 TISSUE CULT BLD,484.0,314.6,101.52,435.6,37
CDM,31102455,PDGFRB TISSUE CULT BLOOD,428.0,278.2,101.52,385.2,37
CDM,31102495,PDGFRA TISSUE CULT BLOOD,428.0,278.2,101.52,385.2,37
CDM,31102695,BCRFSH TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
CDM,31103055,CVCYTO CHROMOSOME KARYOTYPE,234.0,152.1,22.32,210.6,37
CDM,31103085,CHRBLD CHROMO STDY ADD,123.0,79.95,22.32,110.7,37
CDM,31103095,CHRBLL CHROM ANLY 20-25,650.0,422.5,76.88,585.0,37
CDM,31103155,BMCHFX CHROM ANLY 20-25,564.0,366.6,76.88,507.6,37
CDM,31103165,CHRMOS TIS CUL LYMPHOCYTE,488.0,317.2,101.52,439.2,37
CDM,31103175,CHRMOS CHROM ANLS 45,864.0,561.6,76.88,777.6,37
CDM,31103185,CELL PROCESSING AND STORAGE,250.0,162.5,2.34,225.0,37
CDM,31103195,POCHF CHROM TIS CUL PROC,754.0,490.1,101.52,678.6,37
CDM,31103205,POCHF CHR ANLS KARY 15-20,607.0,394.55,22.32,546.3,37
CDM,31103215,CLLFSH TISSUE CULT BLD,440.0,286.0,101.52,396.0,37
CDM,31103225,CHROMS STUDY ADDTL,132.0,85.8,22.32,118.8,37
CDM,31103235,CELL CRYOPRESERVE/STORAGE,157.0,102.05,2.34,141.3,37
CDM,31103245,CPALMF TISSUE CULTURE SKIN/BIOPSY,596.0,387.4,101.52,536.4,37
CDM,31103255,CPALMF CELL CRYOPRESERVE/STORAGE,56.0,36.4,2.34,50.4,37
CDM,31103265,B CELL CD20 1ST MRK,230.0,149.5,59.57,779.93,38
CDM,31103275,B CELL CD20 ADDTL MRK,174.0,113.1,11.52,156.6,28
CDM,31103285,CHRMDS CHROM ANLY 20-25,602.0,391.3,76.88,541.8,37
CDM,31103295,CHRAML CULT PROC,781.0,507.65,101.52,702.9,37
CDM,31103305,CHRAML CHROM ANLY 20-25,602.0,391.3,76.88,541.8,37
CDM,31103315,FL CYT LAB1243 1ST MKR,230.0,149.5,59.57,779.93,38
CDM,31103325,FLW CYT LYMP WKUP LAB2500,230.0,149.5,59.57,779.93,38
CDM,31103335,CRL2FB PROBE X2,234.0,152.1,21.42,210.6,37
CDM,31103345,CRLF2M ANALY 100-300,328.0,213.2,22.32,295.2,37
CDM,31103355,CRLF2M TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
CDM,31103365,CRL2FB PROBE,234.0,152.1,21.42,210.6,37
CDM,31103375,CRL2FB ANALY 100-300,328.0,213.2,22.32,295.2,37
CDM,31103385,CRL2FB TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
CDM,31103395,CRIGMP PROBE X4,234.0,152.1,21.42,210.6,37
CDM,31103405,CRIGMP ANALY 100-300 X2,328.0,213.2,22.32,295.2,37
CDM,31103415,CRIGMP TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
CDM,31103425,CRIGHM PROBE,234.0,152.1,21.42,210.6,37
CDM,31103435,CRIGHM ANALY 100-300,328.0,213.2,22.32,295.2,37
CDM,31103445,CRIGHM TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
CDM,31103455,CRIGHB PROBE,234.0,152.1,21.42,210.6,37
CDM,31103465,CRIGHB ANALY 100-300,328.0,213.2,22.32,295.2,37
CDM,31103475,CRIGHB TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
CDM,31103485,CRIGBP PROBE X4,234.0,152.1,21.42,210.6,37
CDM,31103495,CRIGBP ANALY 100-300 X2,328.0,213.2,22.32,295.2,37
CDM,31103505,CRIGBP TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
CDM,31103515,ISIGHT CYTOGENETICS 25-99,105.0,68.25,22.32,94.5,37
CDM,31103525,CLLFSM TISSUE CULT BLD,396.0,257.4,99.0,356.4,37
CDM,31103535,CLLFSM PROBE X7,234.0,152.1,21.42,210.6,37
CDM,31103545,CLLFSM ANALY 100-300 X3,328.0,213.2,22.32,295.2,37
CDM,31103555,PAP SMEAR,123.0,79.95,9.95,110.7,38
CDM,31103565,DDIT3 PROBE X2,253.0,164.45,21.42,227.7,37
CDM,31103575,DDIT3 ANALY 100-300,338.0,219.7,22.32,304.2,37
CDM,31103585,PAP AND REFLEX HPV SCREEN- ARUP,51.0,33.15,9.95,45.9,37
CDM,31103595,PAP WITH REFLEX HPV SCREEN-ARUP,51.0,33.15,9.95,45.9,37
CDM,31103605,ALPS FLOW CYTOMETRY,175.0,113.75,45.33,779.93,38
CDM,31103615,ALPS FLOW MARKERS,53.0,34.45,8.9,47.7,28
CDM,31103625,ALPS FLOW INTERP,151.0,98.15,11.52,135.9,28
CDM,31103635,TELOMERE LENGTH MEASUREMENT,639.0,415.35,11.52,575.1,38
CDM,31103645,MAML2 FISH DNA PROBES,600.0,390.0,21.42,540.0,37
CDM,31103655,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),86.0,55.9,21.42,77.4,37
CDM,31103665,SET 3 DNA PROBES MAYO (IF APPROPRIATE),86.0,55.9,21.42,77.4,37
CDM,31103675,SET 4 DNA PROBES MAYO (IF APPROPRIATE),86.0,55.9,21.42,77.4,37
CDM,31103685,SET 5 DNA PROBES MAYO (IF APPROPRIATE),86.0,55.9,21.42,77.4,37
CDM,31103695,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),170.0,110.5,22.32,153.0,37
CDM,31103705,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),170.0,110.5,22.32,153.0,37
CDM,31103715,FISH MAYO GREATER THAN 100 CELLS (IF APPROPRIATE),205.0,133.25,22.32,184.5,37
CDM,31103725,"RET GENE REARRANGEMENTS, FISH",472.0,306.8,94.71,424.8,38
CDM,31103735,"I(12P), GERM CELL TUMOR, FISH, TS",715.0,464.75,21.42,643.5,37
CDM,31103745,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-I(12P), GERM CELL",64.0,41.6,16.0,57.6,37
CDM,31103755,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",64.0,41.6,16.0,57.6,37
CDM,31103765,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",64.0,41.6,16.0,57.6,37
CDM,31103775,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",64.0,41.6,16.0,57.6,37
CDM,31103785,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-I(12P), GERM CELL",106.0,68.9,22.32,95.4,37
CDM,31103795,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-I(12P), GERM CELL TUMO",106.0,68.9,22.32,95.4,37
CDM,31103805,"PDGFB (22Q13), FISH, TS",715.0,464.75,21.42,643.5,37
CDM,31103815,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PDGFB (22Q13), FI",64.0,41.6,16.0,57.6,37
CDM,31103825,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",64.0,41.6,16.0,57.6,37
CDM,31103835,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",64.0,41.6,16.0,57.6,37
CDM,31103845,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",64.0,41.6,16.0,57.6,37
CDM,31103855,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PDGFB (22Q13), FIS",106.0,68.9,22.32,95.4,37
CDM,31103865,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PDGFB (22Q13), FISH, T",106.0,68.9,22.32,95.4,37
CDM,31103875,"PLASMA CELL PROLIFERATIVE DISORDER, FISH",1050.0,682.5,21.42,945.0,37
CDM,31103885,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PLASMA CELL PROLI,64.0,41.6,16.0,57.6,37
CDM,31103895,SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,64.0,41.6,16.0,57.6,37
CDM,31103905,SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,64.0,41.6,16.0,57.6,37
CDM,31103915,SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,64.0,41.6,16.0,57.6,37
CDM,31103925,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PLASMA CELL PROLIF,106.0,68.9,22.32,95.4,37
CDM,31103935,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PLASMA CELL PROLIFERAT,106.0,68.9,22.32,95.4,37
CDM,31103945,FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-PLASMA CELL PROLIFE,106.0,68.9,22.32,95.4,37
CDM,31103955,"PRKACA, REARRANGEMENT, FISH",1050.0,682.5,21.42,945.0,37
CDM,31103965,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PRKACA, REARRANGE",64.0,41.6,16.0,57.6,37
CDM,31103975,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",64.0,41.6,16.0,57.6,37
CDM,31103985,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",64.0,41.6,16.0,57.6,37
CDM,31103995,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",64.0,41.6,16.0,57.6,37
CDM,31104005,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PRKACA, REARRANGEM",106.0,68.9,22.32,95.4,37
CDM,31104015,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PRKACA, REARRANGEMENT,",106.0,68.9,22.32,95.4,37
CDM,31104025,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-PRKACA, REARRANGEME",106.0,68.9,22.32,95.4,37
CDM,31104035,"JAK2 (9P24.1), FISH",1050.0,682.5,21.42,945.0,37
CDM,31104045,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FI",64.0,41.6,16.0,57.6,37
CDM,31104055,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",64.0,41.6,16.0,57.6,37
CDM,31104065,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",64.0,41.6,16.0,57.6,37
CDM,31104075,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",64.0,41.6,16.0,57.6,37
CDM,31104085,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FIS",106.0,68.9,22.32,95.4,37
CDM,31104095,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FISH",106.0,68.9,22.32,95.4,37
CDM,31104105,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FISH",106.0,68.9,22.32,95.4,37
CDM,31104115,"NR4A3, REARRANGEMENT, FISH",750.0,487.5,21.42,675.0,37
CDM,31104125,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-NR4A3, REARRANGEM",43.0,27.95,10.75,38.7,37
CDM,31104135,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",43.0,27.95,10.75,38.7,37
CDM,31104145,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",43.0,27.95,10.75,38.7,37
CDM,31104155,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",43.0,27.95,10.75,38.7,37
CDM,31104165,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-NR4A3, REARRANGEME",85.0,55.25,21.25,76.5,37
CDM,31104175,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-NR4A3, REARRANGEMENT,",85.0,55.25,21.25,76.5,37
CDM,31104185,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-NR4A3, REARRANGEMEN",102.0,66.3,22.32,91.8,37
CDM,31104195,"T-LYMPHOBLASTIC LEUKEMIA/LYMPHOMA, FISH",500.0,325.0,21.42,450.0,37
CDM,31104205,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),64.0,41.6,16.0,57.6,37
CDM,31104215,SET 3 DNA PROBES MAYO (IF APPROPRIATE),64.0,41.6,16.0,57.6,37
CDM,31104225,SET 4 DNA PROBES MAYO (IF APPROPRIATE),64.0,41.6,16.0,57.6,37
CDM,31104235,SET 5 DNA PROBES MAYO (IF APPROPRIATE),64.0,41.6,16.0,57.6,37
CDM,31104245,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),127.0,82.55,22.32,114.3,37
CDM,31104255,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),127.0,82.55,22.32,114.3,37
CDM,31104265,FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE),154.0,100.1,22.32,138.6,37
CDM,31104275,"ALK, (2P23), IMT, FISH",700.0,455.0,21.42,630.0,37
CDM,31104285,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),64.0,41.6,16.0,57.6,37
CDM,31104295,SET 3 DNA PROBES MAYO (IF APPROPRIATE),64.0,41.6,16.0,57.6,37
CDM,31104305,SET 4 DNA PROBES MAYO (IF APPROPRIATE),64.0,41.6,16.0,57.6,37
CDM,31104315,SET 5 DNA PROBES MAYO (IF APPROPRIATE),64.0,41.6,16.0,57.6,37
CDM,31104325,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),127.0,82.55,22.32,114.3,37
CDM,31104335,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),127.0,82.55,22.32,114.3,37
CDM,31104345,"FUS (16P11.2), FISH",700.0,455.0,21.42,630.0,37
CDM,31104355,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),64.0,41.6,16.0,57.6,37
CDM,31104365,SET 3 DNA PROBES MAYO (IF APPROPRIATE),64.0,41.6,16.0,57.6,37
CDM,31104375,SET 4 DNA PROBES MAYO (IF APPROPRIATE),64.0,41.6,16.0,57.6,37
CDM,31104385,SET 5 DNA PROBES MAYO (IF APPROPRIATE),64.0,41.6,16.0,57.6,37
CDM,31104395,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),127.0,82.55,22.32,114.3,37
CDM,31104405,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),127.0,82.55,22.32,114.3,37
CDM,31104415,FISH 3Q26 BLD PROBE,43.0,27.95,10.75,38.7,37
CDM,31104425,FISH 3Q26 BLD ANALYSIS,102.0,66.3,22.32,91.8,37
CDM,31104435,FISH3Q36 TISSUE CULT BLOOD,288.0,187.2,72.0,259.2,37
CDM,31104445,FISH 3Q36 BM PROBE,43.0,27.95,10.75,38.7,37
CDM,31104455,FISH 3Q26 BM ANALYSIS,102.0,66.3,22.32,91.8,37
CDM,31104465,FISH 3Q26 TISSUE CULT BM,288.0,187.2,72.0,259.2,37
CDM,31104475,T-CELL ALL FISH 10 PROBE SETS,139.0,90.35,21.42,125.1,37
CDM,31104485,TALLAF FISH 100-300 CELLS,332.0,215.8,22.32,298.8,37
CDM,31104495,T-CELL ALL FISH ADDITIONAL PROBE SET,139.0,90.35,21.42,125.1,37
CDM,31104505,T-CELL ALL FISH 100-300 CELLS ADDITIONAL PROBE SET,332.0,215.8,22.32,298.8,37
CDM,31104515,FLOW TH17,865.0,562.25,101.52,779.93,38
CDM,31104525,FLOW TH17 ADDITIONAL,83.0,53.95,11.52,74.7,28
CDM,31104535,FLOW CD107A,865.0,562.25,101.52,779.93,38
CDM,31104545,FLOW CD107A ADDITIONAL,83.0,53.95,11.52,74.7,28
CDM,31104555,CD52EX FIRST MARKER,865.0,562.25,101.52,779.93,38
CDM,31104565,CD52EX ADDITIONAL MARKERS,83.0,53.95,11.52,74.7,28
CDM,31104575,"KIRFLW FLOW CYTOMETRY; FIRST CELL SURFACE, CYTOPLASMIC OR NUCLEA",865.0,562.25,101.52,779.93,38
CDM,31104585,"KIRFLW FLOW CYTOMETRY; ADDITIONAL CELL SURFACE, CYTOPLASMIC OR N",83.0,53.95,11.52,74.7,28
CDM,31104595,FLOW PERFORIN/GRANZYME B,865.0,562.25,101.52,779.93,38
CDM,31104605,FLOW PERFORIN/GRANZYME B ADDITIONAL,611.0,397.15,11.52,549.9,28
CDM,31104615,FLOW SAP (XLP1) AND XIAP (XLP2),865.0,562.25,101.52,779.93,38
CDM,31104625,FLOW SAP (XLP1) AND XIAP (XLP2) ADDITIONAL,611.0,397.15,11.52,549.9,28
CDM,31104635,FLOW PSTAT5,865.0,562.25,101.52,779.93,38
CDM,31104645,FLOW PSTAT5 ADDITIONAL,611.0,397.15,11.52,549.9,28
CDM,31104765,PAP WITH REFLEX HPV SCREEN-ARUP,216.0,140.4,9.95,194.4,37
CDM,31104775,CHROMOSOME ANALYSIS AMNIOTIC FLUID,1126.0,731.9,76.88,1013.4,37
CDM,31104785,AMNIOTIC FLUID FETAL CELL CULTURE,974.0,633.1,101.52,876.6,37
CDM,31104795,REFLEX AMNIOTIC FLUID CULTURE,974.0,633.1,101.52,876.6,37
CDM,31104805,"REFLEX COUNT 5, 1 KARYOTYPE",1713.0,1113.45,76.88,1541.7,37
CDM,31104815,CVS FETAL CELL CULTURE,974.0,633.1,101.52,876.6,37
CDM,31104825,CHROMOSOME ANALYSIS CVS,1222.0,794.3,76.88,1099.8,37
CDM,31104835,"REFLEX COUNT 5, 1 KARYOTYPE",1713.0,1113.45,76.88,1541.7,37
CDM,31104845,REFLEX AMNIOTIC FLUID CULTURE PROCESSING FEE,974.0,633.1,101.52,876.6,37
CDM,31104855,CHROMOSOME FISH PRENATAL,139.0,90.35,21.42,125.1,37
CDM,31104865,CHROMOSOME ANALYSIS AMNIOTIC FLUID,332.0,215.8,22.32,298.8,37
CDM,31104875,MOLECULAR CYTOGENETIC TEST,139.0,90.35,21.42,125.1,37
CDM,31104885,INTERPHASE IN SITU HYBRIDIZATION,332.0,215.8,22.32,298.8,37
CDM,31104895,SEND OUT ROS1 BY FISH,1182.0,768.3,94.71,1063.8,38
CDM,31104905,"SEND OUT ALK GENE REARRANGEMENTS BY FISH, LUNG",1182.0,768.3,94.71,1063.8,38
CDM,31104915,CHROMOSOME AMNIOTIC FLUID,974.0,633.1,101.52,876.6,37
CDM,31104925,"CHROMOSOME ANALYSIS 6-12 COLONIES, 1 KARYOTYPE",1126.0,731.9,76.88,1013.4,37
CDM,31104935,CHROMOSOME ANALYSIS ADDITIONAL KARYOTYPE,51.0,33.15,12.75,51.0,37
CDM,31104945,"18, XY AMNIO ANEUPLOID FISH",148.0,96.2,21.42,133.2,37
CDM,31104955,"13, 21 AMNIO ANEUPLOID FISH",148.0,96.2,21.42,133.2,37
CDM,31200005,FISH FOR BLADDER CANCER W/URINARY CYTO,2124.0,1380.6,101.52,1911.6,38
CDM,31200010,SURG PATH GROSS ONLY LVL I,103.0,66.95,19.72,92.7,38
CDM,31200015,PATH TOUCH PREP INIT,255.0,165.75,11.52,229.5,38
CDM,31200020,SURG PATH GROSS MICRO LVL II,195.0,126.75,19.72,175.5,38
CDM,31200025,SPECIAL STAIN ON FS,138.0,89.7,19.72,124.2,28
CDM,31200030,SURG PATH GROSS MICRO LVL III,241.0,156.65,19.72,216.9,38
CDM,31200050,TISSUE EXAM BY PATH LVL V,359.0,233.35,92.98,779.93,38
CDM,31200060,TISSUE EXAM BY PATH LVL VI,791.0,514.15,94.71,1771.17,38
CDM,31200065,IMMUNOHISTOCHEM QT,391.0,254.15,94.71,371.54,38
CDM,31200080,DECALCIFICATION PROC,84.0,54.6,14.11,75.6,28
CDM,31200105,"GLOM BASE AB, IGG IFA",167.0,108.55,5.23,150.3,37
CDM,31200130,HISTOCHEMISTRY FOR ENZYME,779.0,506.35,94.71,1771.17,38
CDM,31200145,IHC EA ADDTL AB/BLOCK,244.0,158.6,19.72,219.6,28
CDM,31200160,CONSULT SLIDE PREP ELSEWHERE,117.0,76.05,30.3,105.3,38
CDM,31200165,IHC EA MULTIPLEX AB,359.0,233.35,92.98,779.93,38
CDM,31200170,CONSULT SLIDE W PREP,149.0,96.85,38.59,157.41,38
CDM,31200175,CISH ADDTL,926.0,601.9,19.72,833.4,28
CDM,31200180,CONSULT COMPRE DATA REVIEW,289.0,187.85,56.79,371.54,38
CDM,31200190,PATH CONSULT OR 1ST BLOCK,353.0,229.45,56.79,371.54,38
CDM,31200200,PATH CONSULT OR ADD TIS BLOCK,177.0,115.05,29.74,159.3,28
CDM,31200205,SP BIOPSY PROSTATE,1151.0,748.15,19.72,1035.9,38
CDM,31200210,PATH CONSULT CYTO EXAM INIT,779.0,506.35,56.79,1771.17,38
CDM,31200220,PATH CONSULT CYTO EXAM ADD,117.0,76.05,19.66,105.3,28
CDM,31200230,IMMUNOHISTOCHEM EA AB,244.0,158.6,63.2,371.54,38
CDM,31200245,"SMEAR, PARASITE SPECIAL STAIN",63.0,40.95,4.02,56.7,37
CDM,31200250,IF STUDY EA AB DIR METHOD,359.0,233.35,92.98,371.54,38
CDM,31200255,"SMEAR, TRICHROME STAIN",149.0,96.85,4.02,134.1,37
CDM,31200275,IMMUNOHISTOCHEM EA AB,282.0,183.3,73.04,371.54,38
CDM,31200285,PATH TOUCH PREP EA ADD,113.0,73.45,18.98,101.7,28
CDM,31200290,ELECTRON MICRO DX,779.0,506.35,94.71,1771.17,38
CDM,31200295,O/S PATHOL/HYSTOL,142.0,92.3,19.72,279.48,38
CDM,31200300,TUMOR IMMUNOHISTOCHEM CAD,359.0,233.35,92.98,779.93,38
CDM,31200310,NERVE TEASING PREP,779.0,506.35,94.71,1771.17,38
CDM,31200320,MICRODISSECTION LASER CAPTURE,131.0,85.15,22.01,168.5,28
CDM,31200330,*INSITU HYBRID EA PROBE MANUAL,498.0,323.7,94.71,779.93,38
CDM,31200335,PATH TOUCH PREP INIT,779.0,506.35,56.79,1771.17,38
CDM,31200340,*INSITU HYBRID EA PROBE MANUAL,498.0,323.7,94.71,779.93,38
CDM,31200350,SPEC STN GRP II,44.0,28.6,11.4,279.48,38
CDM,31200360,SPEC STN GRP II,99.0,64.35,19.72,279.48,38
CDM,31200365,FISH HER-2,778.0,505.7,94.71,700.2,38
CDM,31200370,PEROXIDASE STAIN LEUKOCT,779.0,506.35,94.71,1771.17,38
CDM,31200380,HISTOCHEM ID EN,779.0,506.35,94.71,1771.17,38
CDM,31200390,IMMUNOCYTOCHEM EA AB,188.0,122.2,48.69,371.54,38
CDM,31200400,*IMMUNOFLUOR ANTB 1ST STAIN,303.0,196.95,78.48,371.54,38
CDM,31200410,*IMMUNOFLUOR ANTB ADDL STAIN,282.0,183.3,19.72,253.8,28
CDM,31200420,*IMMUNOFLUOR ANTB ADDL STAIN,282.0,183.3,19.72,253.8,28
CDM,31200430,IMMUNOFLUOR ANTB 1ST STAIN,359.0,233.35,92.98,371.54,38
CDM,31200450,INSITU HYBRID EA PROBE,628.0,408.2,94.71,565.2,38
CDM,31200460,TUMOR IMMUNOHISTOCHEM MANUAL,216.0,140.4,55.94,371.54,38
CDM,31200470,INSITU HYBRID EA PROBE MANUAL,498.0,323.7,94.71,779.93,38
CDM,31200480,TUMOR IMMUNOHISTOCHEM MANUAL,276.0,179.4,71.48,371.54,38
CDM,31200490,INSITU HYBRID EA PROBE MANUAL,498.0,323.7,94.71,779.93,38
CDM,31200500,INSITU HYBRID EA PROBE MANUAL,498.0,323.7,94.71,779.93,38
CDM,31200510,INSITU HYBRID EA PROBE MANUAL,498.0,323.7,94.71,779.93,38
CDM,31200520,INSITU HYBRID EA PROBE MANUAL,498.0,323.7,94.71,779.93,38
CDM,31200530,INSITU HYBRID EA PROBE,628.0,408.2,94.71,565.2,38
CDM,31200540,SPECIAL STAIN GROUP 1,177.0,115.05,19.72,163.29,38
CDM,31200550,SURG PATH GROSS ONLY LVL I MOD,103.0,66.95,19.72,92.7,38
CDM,31200560,SURG PATH GROSS MICRO LVL II MOD,195.0,126.75,19.72,175.5,38
CDM,31200570,SURG PATH GROSS MICRO LVL III MOD,241.0,156.65,19.72,216.9,38
CDM,31200580,SURG PATH GROSS MICRO LVL IV MOD,254.0,165.1,19.72,228.6,38
CDM,31200590,SURG PATH GROSS MICRO LVL V MOD,359.0,233.35,92.98,779.93,38
CDM,31200600,SURG PATH GROSS MICRO LVL VI MOD,791.0,514.15,94.71,1771.17,38
CDM,31200610,TUMOR IMMUNOHISTOCHEM/MANUAL,691.0,449.15,94.71,621.9,38
CDM,31200615,FISH FOR ANGIO MYC AMP,801.0,520.65,94.71,720.9,38
CDM,31200625,FISH FOR 1P36,817.0,531.05,94.71,735.3,38
CDM,31200655,FISH FOR EGFR,801.0,520.65,94.71,720.9,38
CDM,31200665,FISH FOR 19Q,801.0,520.65,94.71,720.9,38
CDM,31200675,FISH FOR ALK TRANS,817.0,531.05,94.71,735.3,38
CDM,31200685,FISH FOR MDM2,801.0,520.65,94.71,720.9,38
CDM,31200705,FISH FOR RET PRFN,817.0,531.05,94.71,735.3,38
CDM,31200715,FISH FOR ROS1 PRFN,801.0,520.65,94.71,720.9,38
CDM,31200795,FISH CUTANE MELANOMA,604.0,392.6,94.71,580.48,38
CDM,31200825,FISH FOR MALT 1 18Q21,778.0,505.7,94.71,700.2,38
CDM,31200WE,ETHMOIDECTOMY INTRANASAL ANTERIOR,2056.0,1336.4,307.89,2056.0,35
CDM,31201035,FISH FOR RET CYTO BLOCK,778.0,505.7,94.71,700.2,38
CDM,31201045,FISH FOR ROS1 CYTO BLOCK,817.0,531.05,94.71,735.3,38
CDM,31201055,FISH FOR ALK CYTO BLOCK,817.0,531.05,94.71,735.3,38
CDM,31201075,QFEVER AB IGG IGM PH I&II,36.0,23.4,5.23,32.4,37
CDM,31201115,QFEVER ABS IGG PH2 RFLX,498.0,323.7,94.71,779.93,38
CDM,31201125,FISH FOR ROS1,906.0,588.9,94.71,815.4,38
CDM,31201135,EPATH CONSULT 1-7 SLIDES,362.0,235.3,39.0,325.8,38
CDM,31201145,EPATH CONSULT 8+ SLIDES,392.0,254.8,39.0,352.8,38
CDM,31201155,E SPEC STAIN GP I TECH,145.0,94.25,19.72,163.29,38
CDM,31201165,E SPEC STAIN GRP II TECH,152.0,98.8,19.72,279.48,38
CDM,31201175,SKIN MICRO LVL III,246.0,159.9,19.72,221.4,38
CDM,31201185,SKIN MICRO LEVEL 4,278.0,180.7,19.72,250.2,38
CDM,31201205,"MYCN (N-MYC), FISH",590.0,383.5,94.71,580.48,38
CDM,31201215,"MDM2, FISH",896.0,582.4,94.71,806.4,38
CDM,31201225,"PD-L1 (SP142) SEMIQUANT IHC, MANUAL",504.0,327.6,94.71,453.6,38
CDM,31201235,"PD-L1 (SP263) SEMIQUANT IHC, MANUAL",504.0,327.6,94.71,453.6,38
CDM,31201245,"PD-L1 (28-8), SEMIQUANT IHC, MANUAL",504.0,327.6,94.71,453.6,38
CDM,31201255,"HER2 AMPLIFICATION, MISCELLANEOUS TUMOR, FISH",1494.0,971.1,94.71,1344.6,38
CDM,31201265,"SLL, FISH",1490.0,968.5,94.71,1341.0,38
CDM,31201275,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
CDM,31201285,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
CDM,31201295,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
CDM,31201305,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
CDM,31201315,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
CDM,31201325,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
CDM,31201335,"7 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
CDM,31201345,"8 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
CDM,31201355,"T-CELL LYMPHOMA, FISH",1490.0,968.5,94.71,1341.0,38
CDM,31201365,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, FISH",1490.0,968.5,94.71,1341.0,38
CDM,31201375,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
CDM,31201385,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
CDM,31201395,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
CDM,31201405,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
CDM,31201415,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
CDM,31201425,"7 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
CDM,31201435,"8 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
CDM,31201445,"B-CELL LYMPHOMA, FISH, TISSUE",1490.0,968.5,94.71,1341.0,38
CDM,31201455,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, FISH",1490.0,968.5,94.71,1341.0,38
CDM,31201465,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
CDM,31201475,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
CDM,31201485,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
CDM,31201495,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
CDM,31201505,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
CDM,31201665,SPEC STN GRP II,126.0,81.9,19.72,279.48,38
CDM,31201WE,ETHMOIDECTOMY INTRANASAL TOTAL,3440.0,2236.0,417.38,3440.0,35
CDM,31205WE,ETHMOIDECTOMY EXTRANASAL TOTAL,4232.0,2750.8,494.54,4232.0,35
CDM,31225WE,MAXILLECTOMY W/O ORBITAL EXENTERATION,10680.0,6942.0,1034.63,10680.0,35
CDM,31230WE,MAXILLECTOMY W/ORBITAL EXENTERATION,12328.0,8013.2,1170.17,12328.0,35
CDM,31231WE,"NASAL ENDOS,DIAG,UNI/ BILATERAL",484.0,314.6,30.74,363.0,35
CDM,31233WE,"NASAL/SINUS ENDOS,DIAG W/ MAX SI",872.0,566.8,65.09,654.0,35
CDM,31235WE,"NASAL/SPHENOID SINUS ENDOSCOPY,DX",1162.0,755.3,76.44,871.5,35
CDM,31237WE,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,1144.0,743.6,79.51,858.0,35
CDM,31238WE,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,1206.0,783.9,90.1,904.5,35
CDM,31239WE,NASAL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY,3978.0,2585.7,458.45,3978.0,35
CDM,31240WE,NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION,1148.0,746.2,122.3,1148.0,35
CDM,31241WE,NASAL/SINUS NDSC W/LIG SPHENOPALATINE ARTERY,3520.0,2288.0,338.56,3520.0,31
CDM,31242WE,NASAL/SINUS NDSC DSTRJ RF ABLATION PST NSL NRV,1188.0,772.2,114.2,4077.75,28
CDM,31243WE,NASAL/SINUS NDSC DSTRJ CRYOABLATION PST NSL NRV,1188.0,772.2,114.2,3958.55,28
CDM,31253WE,NASAL/SINUS NDSC TOT W/FRNT SINS EXPL TISS RMVL,3960.0,2574.0,380.94,3960.0,31
CDM,31254WE,NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY,1879.0,1221.35,223.66,1879.0,35
CDM,31255WE,NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY,2530.0,1644.5,246.64,2530.0,35
CDM,31256WE,NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY,1368.0,889.2,138.64,1368.0,35
CDM,31257WE,NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY,3520.0,2288.0,339.84,3520.0,31
CDM,31259WE,NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL,3731.0,2425.15,359.75,3731.0,31
CDM,31267WE,NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS,2059.0,1338.35,202.47,2059.0,35
CDM,31276WE,NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS,2970.0,1930.5,288.52,2970.0,35
CDM,31287WE,NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY,1540.0,1001.0,153.96,1540.0,35
CDM,31288WE,NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS,1640.0,1066.0,178.98,1640.0,35
CDM,31290WE,NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID,7444.0,4838.6,841.03,7444.0,35
CDM,31291WE,NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID,7824.0,5085.6,883.5,7824.0,35
CDM,31292WE,NASAL/SINUS NDSC SURG MEDIAL/INF ORB WALL DCMPRN,6996.0,4547.4,738.83,6996.0,35
CDM,31293WE,NASAL/SINUS NDSC SURG MEDIAL&INF ORB WALL DCMPRN,6988.0,4542.2,808.41,6988.0,35
CDM,31294WE,NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN,8124.0,5280.6,923.88,8124.0,35
CDM,31295WE,NSL/SINUS NDSC SURG W/DILAT MAXILLARY SINUS,1080.0,702.0,80.2,3172.88,32
CDM,31296WE,NSL/SINUS NDSC SURG W/DILAT FRONTAL SINUS,1364.0,886.6,165.21,3219.26,32
CDM,31297WE,NSL/SINUS NDSC SURG W/DILAT SPHENOID SINUS,976.0,634.4,134.38,3158.7,32
CDM,31298WE,NASAL/SINUS NDSC SURG W/DILATION FRNT&SPHN SINUS,1800.0,1170.0,194.43,5967.54,28
CDM,31299RVU4WE,MAXILLECTOMY; WITHOUT ORBITAL EXENTERATION (COMP 31225),9613.0,6248.45,344.78,9613.0,15
CDM,31300WE,LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY,6364.0,4136.6,731.1,6364.0,35
CDM,31360WE,LARYNGECTOMY TOTAL W/O RADICAL NECK DISSECTION,11964.0,7776.6,1004.36,11964.0,35
CDM,31365WE,LARYNGECTOMY TOTAL W/RADICAL NECK DISSECTION,15524.0,10090.6,1366.41,15524.0,35
CDM,31367WE,LARYNGECTOMY STOT SUPRAGLOTTIC W/O RAD NECK DSJ,12228.0,7948.2,1112.0,12228.0,35
CDM,31368WE,LARYNGECTOMY STOT SUPRAGLOTTIC W/RAD NCK DSJ,13676.0,8889.4,1477.51,13676.0,35
CDM,31370WE,PARTIAL LARYNGECTOMY HEMILARYGECTOMY HORIZONTAL,11028.0,7168.2,1073.66,11028.0,35
CDM,31375WE,PARTIAL LARYNGECTOMY HEMILARYNG LATEROVERTICAL,10428.0,6778.2,991.75,10428.0,35
CDM,31380WE,PARTIAL LARYNGECTOMY HEMILARYNG ANTEROVERTICAL,10228.0,6648.2,1042.27,10228.0,35
CDM,31382WE,PARTIAL LARYNG HEMILARYNG ANTERO-LATERO-VERTICAL,11428.0,7428.2,1065.4,11428.0,35
CDM,31390WE,PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/O RCNSTJ,17004.0,11052.6,1515.66,17004.0,35
CDM,31395WE,PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/RCNSTJ,17520.0,11388.0,1775.57,17520.0,35
CDM,31500WE,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1200.0,780.0,89.91,1200.0,35
CDM,31502WE,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,260.0,169.0,25.93,260.0,35
CDM,31505WE,"LARYNGOSCOPY,INDIRECT,DIAGNOSTIC",244.0,158.6,23.67,183.0,35
CDM,31510WE,"LARYNGOSCOPY,INDIRECT WITH BIOPSY",768.0,499.2,57.86,576.0,35
CDM,31511WE,"LARYNGOSCOPY,INDIRECT+REMV FOR.BODY",864.0,561.6,63.78,648.0,35
CDM,31512WE,"LARYNGOSCOPY,INDIRECT+REMV LESN",911.0,592.15,61.98,683.25,35
CDM,31513WE,LARYNGOSCOPY INDIRECT W/VOCAL CORD INJECTION,840.0,546.0,100.6,840.0,35
CDM,31515WE,LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION,720.0,468.0,53.75,540.0,35
CDM,31525WE,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,1052.0,683.8,77.09,789.0,35
CDM,31526WE,LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE,1028.0,668.2,120.77,1028.0,35
CDM,31527WE,LARYNGOSCOPY W/WO TRACHEOSCOPY INSERT OBTURATOR,1439.0,935.35,149.62,1439.0,35
CDM,31528WE,LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN,948.0,616.2,110.81,948.0,35
CDM,31529WE,LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ,1072.0,696.8,123.32,1072.0,35
CDM,31530WE,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,1352.0,878.8,152.17,1352.0,35
CDM,31531WE,LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE,1432.0,930.8,161.11,1432.0,35
CDM,31535WE,LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY,1264.0,821.6,145.28,1264.0,35
CDM,31536WE,LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE,1420.0,923.0,160.6,1420.0,35
CDM,31540WE,LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT,1648.0,1071.2,184.34,1648.0,35
CDM,31541WE,LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP,1808.0,1175.2,200.68,1808.0,35
CDM,31545WE,LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP,2772.0,1801.8,267.86,2772.0,35
CDM,31546WE,LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD GRAFT,4281.0,2782.65,394.79,4281.0,35
CDM,31551WE,LARYNGOPLASTY LARYNGEAL STEN W/O STENT < 12 YRS,8600.0,5590.0,1128.28,8600.0,31
CDM,31552WE,LARYNGOPLASTY LARYNGEAL STEN W/O STENT 12 YRS >,8200.0,5330.0,1137.44,8200.0,31
CDM,31553WE,LARYNGOPLASTY LARYNGEAL STEN W/STENT < 12 YRS,8800.0,5720.0,1239.25,8800.0,31
CDM,31560WE,LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY,2398.0,1558.7,238.22,2398.0,35
CDM,31561WE,LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE,2396.0,1557.4,259.66,2396.0,35
CDM,31570WE,LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC,1544.0,1003.6,124.57,1158.0,35
CDM,31571WE,LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE,1704.0,1107.6,190.22,1704.0,35
CDM,31572WE,LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI,1324.0,860.6,138.13,993.0,31
CDM,31573WE,LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,972.0,631.8,113.88,729.0,31
CDM,31574WE,LARYNGOSCOPY FLEXIBLE W/INJECTION AGMNTJ UNI,972.0,631.8,113.88,1588.78,31
CDM,31575WE,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,414.0,269.1,41.66,310.5,35
CDM,31576WE,LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES),756.0,491.4,57.04,567.0,35
CDM,31577WE,LARYNGOSCOPY FLX RMVL FOREIGN BODY(S),964.0,626.6,70.62,723.0,35
CDM,31578WE,LARYNGOSCOPY FLEXIBLE RMVL LESION(S) NON-LASER,972.0,631.8,72.43,729.0,35
CDM,31579WE,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,827.0,537.55,69.36,620.25,35
CDM,31580WE,LARYNGOPLASTY LARYN WEB W/KEEL STENT INSERTION,5840.0,3796.0,730.65,5840.0,35
CDM,31584WE,LARYNGOPLASTY W/OPEN REDUCTION FRACTURE W/TRACHS,7032.0,4570.8,901.1,7032.0,35
CDM,31591WE,LARYNGOPLASTY MEDIALIZATION UNLIATERAL,5424.0,3525.6,820.91,5424.0,31
CDM,31592WE,CRICOTRACHEAL RESECTION,10000.0,6500.0,1272.71,10000.0,31
CDM,31599RVU14WE,ESOPHAGOSCOPY WITH ESOPHAGEAL STENT (COMP CODE 43212),1360.0,884.0,680.0,1772.22,15
CDM,31599RVU15WE,UNLISTED ENDOSCOPIC LARYNGOPLASTY WITH PLACEMENT OF POSTERIOR CR,7741.0,5031.65,1476.85,7741.0,15
CDM,31599RVU1WE,MICRODRCT LARYN W VOCAL CORDOTOMY (COMP CODE 31541),1836.0,1193.4,918.0,1836.0,15
CDM,31599RVU9WE,DIRECT LARYNGOSCOPY WITH LYSIS LARYNGEAL STENOSIS (COMP 31541),1630.0,1059.5,815.0,1772.22,15
CDM,31600WE,"TRACHEOSTOMY, PLANNED",2446.0,1589.9,226.21,2446.0,35
CDM,31603WE,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,2400.0,1560.0,193.33,2400.0,35
CDM,31605WE,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,2580.0,1677.0,161.42,2580.0,35
CDM,31610WE,TRACHEOSTOMY FENESTRATION W/SKIN FLAPS,4800.0,3120.0,471.28,4800.0,35
CDM,31611WE,CONSTJ TRACHEOESOPHGL FSTL&INSJ SP PROSTH,2400.0,1560.0,357.13,2400.0,35
CDM,31612WE,TRACHEAL PNXR PRQ W/TRANSTRACHEAL ASPIR&/NJX,400.0,260.0,23.18,300.0,35
CDM,31613WE,TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION,1884.0,1224.6,229.34,1884.0,35
CDM,31614WE,TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION,3452.0,2243.8,397.49,3452.0,35
CDM,31615WE,TRACHEOBRNCHSC THRU EST TRACHS INC,810.0,526.5,70.64,607.5,35
CDM,31622WE,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,1113.0,723.45,63.29,834.75,35
CDM,31623WE,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,1157.0,752.05,63.62,867.75,35
CDM,31624WE,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,1157.0,752.05,64.28,867.75,35
CDM,31625WE,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,1368.0,889.2,75.13,1026.0,35
CDM,31626WE,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,1564.0,1016.6,94.35,1173.0,35
CDM,31627WE,BRNCHSC W/CPTR-ASST IMAGE-GUIDED NAVIGATION,800.0,520.0,46.36,2178.82,35
CDM,31628WE,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,1562.0,1015.3,84.33,1171.5,35
CDM,31629WE,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,1650.0,1072.5,121.93,1237.5,35
CDM,31630WE,BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX,1524.0,990.6,149.36,1524.0,35
CDM,31631WE,BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT,1744.0,1133.6,170.3,1744.0,35
CDM,31632WE,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,412.0,267.8,28.37,309.0,35
CDM,31633WE,BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE,528.0,343.2,36.64,396.0,35
CDM,31634WE,BRONCHOSCOPY BALLOON OCCLUSION,1500.0,975.0,91.89,2910.19,32
CDM,31635WE,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,1505.0,978.25,84.16,1128.75,35
CDM,31636WE,BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,1720.0,1118.0,163.41,1720.0,35
CDM,31637WE,BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED,632.0,410.8,56.94,632.0,35
CDM,31638WE,BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,1952.0,1268.8,184.85,1952.0,35
CDM,31640WE,BRONCHOSCOPY W/EXCISION TUMOR,1972.0,1281.8,184.85,1972.0,35
CDM,31641WE,BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC,2008.0,1305.2,189.45,2008.0,35
CDM,31643WE,BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL,1396.0,907.4,119.01,1396.0,35
CDM,31645WE,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST,1267.0,823.55,70.36,950.25,35
CDM,31646WE,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ,1223.0,794.95,68.06,917.25,35
CDM,31647WE,BRNCHSC OCCLUSION&INSERT BRONCH VALVE INIT LOBE,1660.0,1079.0,149.75,1660.0,28
CDM,31648WE,BRNCHSC REMOVAL BRONCHIAL VALVE INITIAL,1580.0,1027.0,155.63,1580.0,28
CDM,31649WE,BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL,576.0,374.4,48.61,576.0,28
CDM,31651WE,BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE,632.0,410.8,54.21,632.0,28
CDM,31652WE,BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX,1962.0,1275.3,180.12,1471.5,31
CDM,31653WE,BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX,2182.0,1418.3,198.84,1636.5,31
CDM,31654WE,BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES,560.0,364.0,52.14,420.0,31
CDM,31660WE,BRONCHOSCOPIC THERMOPLASTY ONE LOBE,1600.0,1040.0,149.79,1600.0,28
CDM,31661WE,BRONCHOSCOPIC THERMOPLASTY 2/> LOBES,1700.0,1105.0,158.49,1700.0,28
CDM,31720WE,"CATHETER ASPIRATN,NASOTRACH",424.0,275.6,40.6,424.0,35
CDM,31750WE,TRACHEOPLASTY CERVICAL,6772.0,4401.8,697.49,6772.0,35
CDM,31755WE,TRACHEOPLASTY TRACHEOPHARYNGEAL FSTLJ EA STG,7718.0,5016.7,886.55,7718.0,35
CDM,31780WE,EXCISION TRACHEAL STENOSIS&ANASTOMOSIS CERVICA,7936.0,5158.4,902.15,7936.0,35
CDM,31781WE,EXC TRACHEAL STENOSIS&ANAST CERVICOTHORACIC,9940.0,6461.0,1071.33,9940.0,35
CDM,31785WE,EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL,7340.0,4771.0,760.83,7340.0,35
CDM,31800WE,SUTURE TRACHEAL WOUND/INJURY CERVICAL,3272.0,2126.8,373.43,3272.0,35
CDM,31805WE,SUTURE TRACHEAL WOUND/INJURY INTRATHORACIC,5368.0,3489.2,608.66,5368.0,35
CDM,31820WE,SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR,1856.0,1206.4,161.92,1392.0,35
CDM,31825WE,SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR,2828.0,1838.2,236.22,2121.0,35
CDM,31830WE,REVISE TRACHEOSTOMY SCAR,1848.0,1201.2,179.01,1386.0,35
CDM,31899INIWE,BRONCHIAL THERMOPL INITIAL,1802.0,1171.3,288.87,1802.0,15
CDM,31899RVU2WE,UNLISTED PROC; TRACHEOSTOMY TUBE EXCHANGE FOLLOWING ESTABLISHED,260.0,169.0,130.0,346.64,15
CDM,31899SUBWE,BRONCHIAL THERMOPL SUBSEQUENT,1802.0,1171.3,288.87,1802.0,15
CDM,32000010,CISTERNOGRAPHY POSITIVE CONTRAST RS&I,6814.0,4429.1,146.0,6132.6,49
CDM,32000020,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,760.0,494.0,33.81,684.0,49
CDM,32000030,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000040,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000050,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,918.0,596.7,33.81,826.2,49
CDM,32000060,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,918.0,596.7,33.81,826.2,49
CDM,32000070,RADEX INTERNAL AUDITORY MEATI COMPLETE,4729.0,3073.85,33.81,4256.1,49
CDM,32000080,RADEX FACIAL BONES < 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000085,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000090,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000095,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000100,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000110,RADEX OPTIC FORAMINA,760.0,494.0,33.81,684.0,49
CDM,32000115,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000120,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000130,RADEX SINUSES PARANASAL <3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000140,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000145,THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ,1535.0,997.75,71.29,1381.5,49
CDM,32000150,RADIOLOGIC EXAMINATION SELLA TURCICA,760.0,494.0,33.81,684.0,49
CDM,32000160,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000170,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000180,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,760.0,494.0,33.81,684.0,49
CDM,32000190,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,760.0,494.0,33.81,684.0,49
CDM,32000200,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,760.0,494.0,33.81,684.0,49
CDM,32000210,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,760.0,494.0,33.81,684.0,49
CDM,32000215,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,27148.0,17646.2,146.0,24433.2,48
CDM,32000220,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,760.0,494.0,33.81,684.0,49
CDM,32000225,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,13399.0,8709.35,146.0,12059.1,49
CDM,32000230,SIALOGRAPHY RS&I,2085.0,1355.25,71.29,1876.5,49
CDM,32000250,RADEX RIBS UNILATERAL 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000260,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000270,RADEX RIBS BILATERAL 3 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000280,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000290,RADEX STERNUM MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000300,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000320,RADEX SPINE 1 VIEW SPECIFY LEVEL,760.0,494.0,32.77,684.0,49
CDM,32000330,RADEX SPINE CERVICAL 2 OR 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000340,RADEX SPINE CERVICAL 4 OR 5 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000350,RADEX SPINE CERVICAL 6 OR MORE VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000370,RADEX SPINE THORACIC 2 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000380,RADEX SPINE THORACIC 3 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000385,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,918.0,596.7,33.81,826.2,49
CDM,32000390,RADEX SPINE THORACIC MINIMUM 4 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000400,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000420,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000430,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000440,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,918.0,596.7,33.81,826.2,49
CDM,32000450,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000455,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,333.0,216.45,55.47,349.0,36
CDM,32000460,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000470,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000480,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000490,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000500,MYELOGRAPHY CERVICAL RS&I,6814.0,4429.1,146.0,6132.6,49
CDM,32000510,MYELOGRAPHY THORACIC RS&I,6814.0,4429.1,142.75,6132.6,49
CDM,32000530,MYELOGRAPY LUMBOSACRAL RS&I,6814.0,4429.1,146.0,6132.6,49
CDM,32000535,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000550,MYELOGRAPY 2/MORE REGIONS RS&I,6814.0,4429.1,146.0,6132.6,49
CDM,32000570,DISKOGRAPY CERVICAL/THORACIC RS&I,16843.0,10947.95,146.0,15158.7,49
CDM,32000575,DXA BONE DENSITY STUDY AXIAL SKELETON,918.0,596.7,44.5,826.2,49
CDM,32000590,DISKOGRAPY LUMBAR RS&I,16843.0,10947.95,146.0,15158.7,49
CDM,32000600,RADEX CLAVICLE COMPLETE,760.0,494.0,33.81,684.0,49
CDM,32000610,RADEX SCAPULA COMPLETE,918.0,596.7,33.81,826.2,49
CDM,32000620,RADEX SHOULDER 1 VIEW,760.0,494.0,29.91,684.0,49
CDM,32000630,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000640,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,760.0,494.0,33.81,684.0,49
CDM,32000650,RADEX HUMERUS MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000660,RADEX ELBOW 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000665,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,760.0,494.0,33.81,684.0,49
CDM,32000670,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000675,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,918.0,596.7,33.81,826.2,49
CDM,32000680,RADEX FOREARM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000685,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,918.0,596.7,33.81,826.2,49
CDM,32000690,RADEX WRIST 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000695,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,918.0,596.7,33.81,826.2,49
CDM,32000700,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000710,RADEX HAND 2 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000715,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,760.0,494.0,33.81,684.0,49
CDM,32000720,RADEX HAND MINIMUM 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000725,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000730,RADEX FINGR MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000735,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000745,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000755,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000765,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000775,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,760.0,494.0,33.81,684.0,49
CDM,32000780,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,760.0,494.0,33.81,684.0,49
CDM,32000785,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000790,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000800,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000805,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,1118.0,726.7,136.83,1006.2,35
CDM,32000810,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,918.0,596.7,33.81,826.2,49
CDM,32000820,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,760.0,494.0,33.81,684.0,49
CDM,32000830,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000840,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000850,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000860,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000870,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000880,RADEX CALCANEUS MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000890,RADEX TOE MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32000920,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,918.0,596.7,33.81,826.2,49
CDM,32000930,PERITONEOGRAM RS&I,4729.0,3073.85,71.29,4256.1,48
CDM,32000940,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,1535.0,997.75,33.81,1381.5,49
CDM,32000950,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,1535.0,997.75,71.29,1381.5,49
CDM,32000960,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,1535.0,997.75,71.29,1381.5,49
CDM,32001010,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,1535.0,997.75,71.29,1381.5,49
CDM,32001015,RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY,1535.0,997.75,33.81,1381.5,49
CDM,32001020,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,1535.0,997.75,71.29,1381.5,49
CDM,32001030,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,1535.0,997.75,71.29,1381.5,49
CDM,32001040,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,1535.0,997.75,71.29,1381.5,49
CDM,32001050,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,1376.0,894.4,136.83,1238.4,35
CDM,32001060,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,268.0,174.2,45.02,349.0,35
CDM,32001110,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,1159.0,753.35,136.83,1043.1,35
CDM,32001120,INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I,790.0,513.5,132.72,711.0,35
CDM,32001130,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,534.0,347.1,89.71,480.6,35
CDM,32001140,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,1118.0,726.7,136.83,1006.2,35
CDM,32001150,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,2056.0,1336.4,136.83,1850.4,35
CDM,32001160,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,1535.0,997.75,71.29,1381.5,49
CDM,32001170,UROGRAPHY NFS DRIP &/BOLUS W/NEPHROTOMOGRAPHY,1535.0,997.75,71.29,1381.5,49
CDM,32001180,UROGRAPHY RETROGRADE WITH/WO KUB,3080.0,2002.0,71.29,2772.0,49
CDM,32001190,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,3080.0,2002.0,71.29,2772.0,49
CDM,32001200,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,3080.0,2002.0,57.54,2772.0,49
CDM,32001210,URETHROCYSTOGRAPHY RETROGRADE RS&I,2085.0,1355.25,71.29,1876.5,48
CDM,32001220,URETHROCYSTOGRAPHY VOIDING RS&I,2085.0,1355.25,71.29,1876.5,49
CDM,32001240,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,4729.0,3073.85,71.29,4256.1,48
CDM,32001270,DILATION URETERS/URETHRA RS&I,17669.0,11484.85,136.83,15902.1,49
CDM,32001280,HYSTEROSALPINGOGRAPHY RS&I,2085.0,1355.25,71.29,1876.5,49
CDM,32001290,TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I,524.0,340.6,88.03,471.6,35
CDM,32001300,PERINEOGRAM,2085.0,1355.25,71.29,1876.5,48
CDM,32001320,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,46624.0,30305.6,220.58,41961.6,49
CDM,32001330,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,27148.0,17646.2,146.0,24433.2,48
CDM,32001340,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,918.0,596.7,71.29,826.2,49
CDM,32001350,SPLENOPORTOGRAPY RS&I,27148.0,17646.2,146.0,24433.2,48
CDM,32001360,VENOGRAPHY EXTREMITY UNILATERAL RS&I,13399.0,8709.35,144.79,12059.1,49
CDM,32001390,VENOGRAPHY EXTREMITY BILATERAL RS&I,13399.0,8709.35,146.0,12059.1,49
CDM,32001420,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,27148.0,17646.2,146.0,24433.2,49
CDM,32001430,VENO SUPR W SERIAL SI,1965.0,1277.25,146.0,1768.5,29
CDM,32001450,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,27148.0,17646.2,146.0,24433.2,49
CDM,32001460,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,27148.0,17646.2,146.0,24433.2,49
CDM,32001470,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,27148.0,17646.2,146.0,24433.2,49
CDM,32001490,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,27148.0,17646.2,146.0,24433.2,49
CDM,32001510,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,27148.0,17646.2,146.0,24433.2,49
CDM,32001520,VENOGRAPHY EPIDURAL RS&I,5333.0,3466.45,146.0,4799.7,49
CDM,32001530,VENOGRAPHY ORBITAL RS&I,5333.0,3466.45,146.0,4799.7,49
CDM,32001540,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,27148.0,17646.2,146.0,24433.2,49
CDM,32001550,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,27148.0,17646.2,146.0,24433.2,49
CDM,32001560,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,27148.0,17646.2,146.0,24433.2,49
CDM,32001570,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,27148.0,17646.2,146.0,24433.2,49
CDM,32001580,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,46624.0,30305.6,146.0,41961.6,49
CDM,32001590,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3891.0,2529.15,136.83,3501.9,36
CDM,32001620,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,900.0,585.0,136.83,810.0,36
CDM,32001630,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,524.0,340.6,88.03,471.6,36
CDM,32001800,TRANSCATHETER BIOPSY RS&I,4588.0,2982.2,136.83,4129.2,35
CDM,32001850,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,1314.0,854.1,127.97,1182.6,36
CDM,32001860,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2659.0,1728.35,136.83,2393.1,36
CDM,32001910,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,2085.0,1355.25,60.81,1876.5,49
CDM,32001950,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,760.0,494.0,33.81,684.0,49
CDM,32001960,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,4729.0,3073.85,71.29,4256.1,49
CDM,32001980,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,4729.0,3073.85,59.64,4256.1,49
CDM,32001990,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,918.0,596.7,33.81,826.2,49
CDM,32002000,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,918.0,596.7,33.81,826.2,49
CDM,32002020,PROC XR UNLISTD,205.0,133.25,33.81,349.0,48
CDM,32002030,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,1029.0,668.85,136.83,926.1,36
CDM,32002050,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,1048.0,681.2,136.83,943.2,36
CDM,32002070,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,1245.0,809.25,136.83,1120.5,36
CDM,32002110,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,2085.0,1355.25,71.29,1876.5,49
CDM,32002120,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,2085.0,1355.25,71.29,1876.5,49
CDM,32002130,MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS,760.0,494.0,80.06,684.0,43
CDM,32002140,BONE AGE STUDIES,918.0,596.7,33.81,826.2,49
CDM,32002150,BONE LENGTH STUDIES,918.0,596.7,33.81,826.2,49
CDM,32002160,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,918.0,596.7,33.81,826.2,49
CDM,32002170,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,918.0,596.7,71.29,826.2,49
CDM,32002180,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,918.0,596.7,33.81,826.2,49
CDM,32002190,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,918.0,596.7,44.5,826.2,49
CDM,32002210,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2659.0,1728.35,136.83,2393.1,36
CDM,32002220,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2659.0,1728.35,136.83,2393.1,36
CDM,32002230,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,905.0,588.25,33.81,814.5,49
CDM,32002240,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,760.0,494.0,44.22,684.0,49
CDM,32002260,XR DEXA WHOLE BODY COMPOSITION,918.0,596.7,33.81,826.2,48
CDM,32002270,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,1535.0,997.75,71.29,1381.5,49
CDM,32002290,DXA BONE DENSITY STUDY AXIAL SKELETON,918.0,596.7,44.5,826.2,49
CDM,32002300,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,760.0,494.0,44.5,684.0,49
CDM,32002310,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,1118.0,726.7,136.83,1006.2,35
CDM,32002320,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,760.0,494.0,33.81,684.0,49
CDM,32002330,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,918.0,596.7,33.81,826.2,49
CDM,32002340,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,918.0,596.7,33.81,826.2,49
CDM,32002350,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,918.0,596.7,33.81,826.2,49
CDM,32002360,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,760.0,494.0,33.81,684.0,49
CDM,32002370,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,760.0,494.0,33.81,684.0,49
CDM,32002380,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32002390,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32002400,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32002410,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32002420,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32002430,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32002440,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32002450,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,760.0,494.0,33.81,684.0,49
CDM,32002460,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,760.0,494.0,33.81,684.0,49
CDM,32002470,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32002480,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32002485,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,27148.0,17646.2,146.0,24433.2,49
CDM,32002525,US GUIDANCE NEEDLE PLACEMENT IMG S&I,1079.0,701.35,65.54,971.1,36
CDM,32002545,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,545.0,354.25,91.56,490.5,35
CDM,32002705,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,946.0,614.9,136.83,851.4,35
CDM,32002735,BRONCHOGRAPHY,242.0,157.3,33.81,349.0,48
CDM,32002745,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,1535.0,997.75,71.29,1381.5,49
CDM,32002925,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32003165,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,918.0,596.7,33.81,826.2,49
CDM,32003365,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,918.0,596.7,33.81,826.2,49
CDM,32004105,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32004405,VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I,2085.0,1355.25,71.29,1876.5,49
CDM,32004415,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32004425,RADEX STERNUM MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32004435,RADEX HUMERUS MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32004445,RADEX ELBOW 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32004455,RADEX WRIST 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32004465,RADEX FINGR MINIMUM 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32004475,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32004485,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32004585,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,2085.0,1355.25,60.81,1876.5,49
CDM,32004625,RADIOLOGIC EXAM ABDOMEN 1 VIEW,760.0,494.0,33.81,684.0,49
CDM,32004635,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32004645,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,918.0,596.7,33.81,826.2,49
CDM,32004705,RADIOLOGIC EXAM CHEST 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32004845,CORPORA CAVERNOSOGRAPY RS&I,918.0,596.7,71.29,826.2,48
CDM,32004895,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,1535.0,997.75,71.29,1381.5,49
CDM,32004905,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,994.0,646.1,71.29,894.6,36
CDM,32004915,UNLISTED FLUOROSCOPIC PROCEDURE,298.0,193.7,33.81,349.0,48
CDM,32004925,LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I,13399.0,8709.35,146.0,12059.1,48
CDM,32004975,TBS TECHNICAL CALCULATION ONLY,760.0,494.0,39.38,684.0,49
CDM,32005005,LYMPHANGIOGRAPHY EXTREMITY ONLY UNILAT RS&I,5333.0,3466.45,146.0,4799.7,48
CDM,32005085,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,531.0,345.15,66.35,477.9,48
CDM,32005115,CT ABDOMEN W/O SCREENING,918.0,596.7,33.81,826.2,48
CDM,32005125,3D RENDERING LIVER (DONOR) S&I,1795.0,1166.75,33.81,1615.5,48
CDM,32005135,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE,3466.0,2252.9,33.81,3119.4,48
CDM,32005145,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP",27148.0,17646.2,33.81,24433.2,48
CDM,32005155,UNLISTED DXA BODY COMPOSITION STUDY,918.0,596.7,33.81,826.2,48
CDM,32005165,LYMPHANGIOGRAPHY OF FACE & NECK,13399.0,8709.35,33.81,12059.1,48
CDM,32005175,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),24601.0,15990.65,33.81,22140.9,48
CDM,32005185,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),4841.0,3146.65,33.81,4356.9,48
CDM,32005195,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),42412.0,27567.8,33.81,38170.8,48
CDM,32005205,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),42412.0,27567.8,33.81,38170.8,48
CDM,32005215,VENOGRAM AZYGOS VEIN (COMP COMP CODE 75705),42412.0,27567.8,33.81,38170.8,48
CDM,32005225,VENOGRAM GASTRIC VEIN (COMP CODE 75891),24601.0,15990.65,33.81,22140.9,48
CDM,32005235,VENOGRAM GONADAL VEIN (COMP CODE 75831),24601.0,15990.65,33.81,22140.9,48
CDM,32005245,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),24601.0,15990.65,33.81,22140.9,48
CDM,32005255,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),27148.0,17646.2,33.81,24433.2,48
CDM,32005265,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),27148.0,17646.2,33.81,24433.2,48
CDM,32005275,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),46624.0,30305.6,33.81,41961.6,48
CDM,32005285,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",27148.0,17646.2,33.81,24433.2,48
CDM,32005295,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),27148.0,17646.2,33.81,24433.2,48
CDM,32005305,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),46624.0,30305.6,33.81,41961.6,48
CDM,32005315,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),46624.0,30305.6,33.81,41961.6,48
CDM,32005325,VENOGRAM SPLENIC VEIN (COMP CODE 75891),27148.0,17646.2,33.81,24433.2,48
CDM,32005335,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),46624.0,30305.6,33.81,41961.6,48
CDM,32005345,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),5228.0,3398.2,33.81,4705.2,48
CDM,32005355,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),27148.0,17646.2,33.81,24433.2,48
CDM,32005365,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),13399.0,8709.35,33.81,12059.1,48
CDM,32005375,VENOGRAM CARDINAL VARIX (COMP CODE 75891),27148.0,17646.2,33.81,24433.2,48
CDM,32005385,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,4729.0,3073.85,59.64,4256.1,49
CDM,32005395,COR ANGIO W/ FLOW RESRV,34836.0,22643.4,1513.2,37851.0,35
CDM,32035WE,"THORACOSTOMY,RIB RESECT,EMPYEMA",4516.0,2935.4,427.72,4516.0,35
CDM,32036WE,"THORACOSTOMY,OPEN DRAIN/EMPYEMA",4920.0,3198.0,470.68,4920.0,35
CDM,32096WE,THORACTOMY W/DX BX LUNG INFILTRATE UNILATERAL,5500.0,3575.0,386.62,5500.0,35
CDM,32097WE,THORACTOMY W/DX BX LUNG NODULE/MASS UNILATERAL,5500.0,3575.0,387.45,5500.0,35
CDM,32098WE,THORACOTOMY W/BIOPSY OF PLEURA,5164.0,3356.6,367.06,5164.0,35
CDM,32100WE,THORACOTOMY WITH EXPLORATION,5500.0,3575.0,609.24,5500.0,35
CDM,32110WE,THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR,10112.0,6572.8,806.66,10112.0,35
CDM,32120WE,"THORACOTOMY,POSTOP COMPLICATNS",5756.0,3741.4,588.46,5756.0,35
CDM,32124WE,THORACOTOMY OPN INTRAPLEURAL PNEUMONOLYSIS,6180.0,4017.0,659.18,6180.0,35
CDM,32140WE,"THORACOTOMY,CYST REMOVAL",6664.0,4331.6,726.66,6664.0,35
CDM,32141WE,THORACOTOMY W/RESECTION BULLAE,10872.0,7066.8,771.3,10872.0,35
CDM,32150WE,THORCOM W/RMVL INTRAPLEURAL FB/FIBRIN DEP,6728.0,4373.2,684.29,6728.0,35
CDM,32160WE,THORACOTOMY W/CARDIAC MASSAGE,5240.0,3406.0,513.13,5240.0,35
CDM,32200010,RADEX SHOULDER ARTHROGRAPHY RS&I,3080.0,2002.0,71.29,2772.0,49
CDM,32200015,RADEX ELBOW ARTHROGRAPHY RS&I,3080.0,2002.0,71.29,2772.0,49
CDM,32200020,RADEX ELBOW ARTHROGRAPHY RS&I,3080.0,2002.0,71.29,2772.0,49
CDM,32200025,RADEX WRIST ARTHROGRAPHY RS&I,3080.0,2002.0,71.29,2772.0,49
CDM,32200030,RADEX WRIST ARTHROGRAPHY RS&I,3080.0,2002.0,71.29,2772.0,49
CDM,32200035,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,3080.0,2002.0,71.29,2772.0,49
CDM,32200040,RADEX HIP ARTHROGRAPHY RS&I,3080.0,2002.0,71.29,2772.0,49
CDM,32200070,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,3080.0,2002.0,71.29,2772.0,49
CDM,32200080,RADEX ANKLE ARTHROGRAPHY RS&I,3080.0,2002.0,71.29,2772.0,49
CDM,32200WE,PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST,7472.0,4856.8,617.4,7472.0,35
CDM,32220WE,DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE,10660.0,6929.0,971.04,10660.0,35
CDM,32225WE,DECORTICATION PULMONARY PARTIAL SEPARATE PROC,6700.0,4355.0,731.2,6700.0,35
CDM,32300010,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,27148.0,17646.2,255.14,24433.2,49
CDM,32300015,ANGIOGRAPHY ADRENAL UNILATERAL SLCTV RS&I,27148.0,17646.2,208.44,24433.2,49
CDM,32300020,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,46624.0,30305.6,162.54,41961.6,49
CDM,32300025,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,27148.0,17646.2,183.95,24433.2,49
CDM,32300030,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,27148.0,17646.2,163.18,24433.2,49
CDM,32300050,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,27148.0,17646.2,201.74,24433.2,49
CDM,32300200,ANGIOGRAPHY SPINAL SELECTIVE RS&I,46624.0,30305.6,392.18,41961.6,49
CDM,32300210,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,27148.0,17646.2,194.43,24433.2,49
CDM,32300230,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,27148.0,17646.2,212.5,24433.2,49
CDM,32300310,ANGIOGRAPHY ADRENAL BILATERAL SLCTV RS&I,27148.0,17646.2,242.83,24433.2,49
CDM,32300320,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,46624.0,30305.6,196.72,41961.6,49
CDM,32300330,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,27148.0,17646.2,171.96,24433.2,49
CDM,32300340,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,27148.0,17646.2,193.93,24433.2,49
CDM,32300350,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,27148.0,17646.2,183.95,24433.2,49
CDM,32300370,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,5228.0,3398.2,127.7,4705.2,36
CDM,32300400,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,27148.0,17646.2,371.35,24433.2,49
CDM,32300410,ANGIO ILIAC ARTERY W CATH,8613.0,5598.45,15.36,7751.7,36
CDM,32300420,ANGIOGRAPHY INTERNAL MAMMARY RS&I,27148.0,17646.2,231.18,24433.2,49
CDM,32300445,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3891.0,2529.15,136.83,3501.9,36
CDM,32310WE,PLEURECTOMY PARIETAL SEPARATE PROCEDURE,6112.0,3972.8,669.52,6112.0,35
CDM,32320WE,DECORTICATION & PARIETAL PLEURECTOMY,10900.0,7085.0,1059.89,10900.0,35
CDM,32400080,RADIOLOGIC EXAM CHEST SINGLE VIEW,760.0,494.0,33.81,684.0,49
CDM,32400090,RADIOLOGIC EXAM CHEST 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32400100,RADIOLOGIC EXAM CHEST 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32400105,RADIOLOGIC EXAM CHEST SINGLE VIEW,760.0,494.0,33.81,684.0,49
CDM,32400110,RADIOLOGIC EXAM CHEST 4+ VIEWS,918.0,596.7,33.81,826.2,49
CDM,32400115,RADIOLOGIC EXAM CHEST 2 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32400120,RADIOLOGIC EXAM ABDOMEN 1 VIEW,760.0,494.0,33.81,684.0,49
CDM,32400125,RADIOLOGIC EXAM CHEST 3 VIEWS,760.0,494.0,33.81,684.0,49
CDM,32400130,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,918.0,596.7,33.81,826.2,49
CDM,32400135,RADIOLOGIC EXAM CHEST 4+ VIEWS,918.0,596.7,33.81,826.2,49
CDM,32400140,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,918.0,596.7,33.81,826.2,49
CDM,32400WE,BIOPSY PLEURA PERCUTANEOUS NEEDLE,704.0,457.6,40.76,528.0,35
CDM,32408WE,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,1399.0,909.35,111.91,1756.64,31
CDM,32440WE,REMOVAL OF LUNG PNEUMONECTOMY,10912.0,7092.8,1083.93,10912.0,35
CDM,32445WE,REMOVAL LUNG PNEUMONECTOMY EXTRAPLEURAL,25536.0,16598.4,1723.7,25536.0,35
CDM,32480WE,RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT,10328.0,6713.2,956.15,10328.0,35
CDM,32482WE,RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC,10976.0,7134.4,1002.7,10976.0,35
CDM,32484WE,RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY,10152.0,6598.8,1031.02,10152.0,35
CDM,32488WE,RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC,17196.0,11177.4,1258.76,17196.0,35
CDM,32491WE,RMVL LUNG OTH/THN PNUMEC RESXN-PLCTJ EMPHY LUNG,10096.0,6562.4,1350.23,10096.0,31
CDM,32501WE,RESCJ&BRONCHOPLASTY PFRMD TM LOBEC/SGMECTOMY,1872.0,1216.8,182.3,1872.0,35
CDM,32504WE,RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ,14616.0,9500.4,1498.05,14616.0,35
CDM,32505WE,THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL,6300.0,4095.0,450.57,6300.0,35
CDM,32506WE,THORACOTOMY W/THERAP WEDGE RESEXN ADDL IPSILATRL,1200.0,780.0,75.45,1200.0,35
CDM,32507WE,THORACOTOMY W/DX WEDGE RESEXN &ANTOM LUNG RESEXN,1200.0,780.0,75.45,1200.0,35
CDM,32540WE,EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY,12140.0,7891.0,879.35,12140.0,35
CDM,32550WE,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,1568.0,1019.2,150.83,1429.66,35
CDM,32551INSWE,INSERTION OF CHEST TUBE,921.0,598.65,112.77,921.0,35
CDM,32551THOWE,THORACOSTOMY W/ OR W/O WATER SEAL,819.0,532.35,112.77,819.0,35
CDM,32551WE,TUBE THORACOSTOMY INCLUDES WATER SEAL,1216.0,790.4,112.77,1216.0,35
CDM,32552REMWE,REMOVAL CATHETER,948.0,616.2,75.94,711.0,35
CDM,32552TUNWE,REMOVE TUNNELED PLEURAL CATH,815.0,529.75,75.94,611.25,35
CDM,32552WE,RMVL NDWELLG TUN PLEURAL CATH W/CUFF,1012.0,657.8,75.94,759.0,35
CDM,32553WE,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,1562.0,1015.3,118.56,1171.5,35
CDM,32554WE,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,801.0,520.65,49.14,600.75,31
CDM,32555WE,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,999.0,649.35,61.53,749.25,31
CDM,32556WE,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,1100.0,715.0,67.5,1003.36,31
CDM,32557WE,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,1373.0,892.45,92.73,1029.75,31
CDM,32560WE,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,616.0,400.4,37.15,462.0,35
CDM,32561WE,INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY,556.0,361.4,32.88,417.0,35
CDM,32562WE,INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY,496.0,322.4,28.77,372.0,35
CDM,32601WE,THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX,2200.0,1430.0,233.11,2200.0,35
CDM,32604WE,THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX,3508.0,2280.2,336.21,3508.0,35
CDM,32606WE,THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX,3356.0,2181.4,342.94,3356.0,35
CDM,32607WE,THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL,2200.0,1430.0,148.28,2200.0,35
CDM,32608WE,THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL,2736.0,1778.4,182.47,2736.0,35
CDM,32609WE,THORACOSCOPY WITH BIOPSYIES OF PLEURA,1832.0,1190.8,123.29,1832.0,35
CDM,32650WE,THORACOSCOPY SURG W PLEURODESIS,4332.0,2815.8,492.96,4332.0,35
CDM,32651CORWE,THORACOSCOPY REMOVE CORTEX,4869.0,3164.85,684.73,4869.0,35
CDM,32651PULWE,THORACOSCOPY W PART PULMONAY DECORTICATIO,4935.0,3207.75,684.73,4935.0,35
CDM,32651WE,THORACOSCOPY SURG PART PULM DECORT,7512.0,4882.8,684.73,7512.0,35
CDM,32652WE,THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS,11652.0,7573.8,948.89,11652.0,35
CDM,32653WE,THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT,7268.0,4724.2,651.99,7268.0,35
CDM,32654WE,THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE,8208.0,5335.2,669.1,8208.0,35
CDM,32655WE,THORACOSCOPY W/RESECTION BULLAE W/WO PLEURAL PX,6468.0,4204.2,701.08,6468.0,35
CDM,32656WE,THORACOSCOPY SURG PART PLEURECTOMY,5304.0,3447.6,613.03,5304.0,35
CDM,32658WE,THORACOSCOPY W/RMVL CLOT/FB FROM PERICARDIAL SAC,4684.0,3044.6,545.37,4684.0,35
CDM,32659WE,THRSC CRTJ PRCRD WINDOW/PRTL RESCJ PRCRD SAC,4776.0,3104.4,560.18,4776.0,35
CDM,32660WE,THORACOSCOPY SURG TOTL PERICARDIECTM,6185.0,4020.25,3092.5,6185.0,12
CDM,32661WE,THORACOSCOPY W/EXC PERICARDIAL CYST TUMOR/MASS,5332.0,3465.8,598.69,5332.0,35
CDM,32662WE,THORACOSCOPY W/EXC MEDIASTINAL CYST TUMOR/MASS,5996.0,3897.4,680.44,5996.0,35
CDM,32663WE,THORACOSCOPY W/LOBECTOMY SINGLE LOBE,9856.0,6406.4,970.13,9856.0,35
CDM,32664WE,THORACOSCOPY W/THORACIC SYMPATHECTOMY,6283.0,4083.95,645.2,6283.0,35
CDM,32665WE,THORACOSCOPY W/ESOPHAGOMYOTOMY HELLER TYPE,8612.0,5597.8,812.88,8612.0,35
CDM,32666WE,THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT,5800.0,3770.0,420.81,5800.0,35
CDM,32667WE,THORACOSCOPY W/THERA WEDGE RESEXN ADDL IPSILATRL,1200.0,780.0,75.62,1200.0,35
CDM,32668WE,THORACOSCOPY W/DX WEDGE RESEXN ANATO LUNG RESEXN,1200.0,780.0,75.78,1200.0,35
CDM,32669WE,THORACOSCOPY W/SEGMENTECTOMY,9412.0,6117.8,648.15,9412.0,35
CDM,32670WE,THORACOSCOPY W/BILOBECTOMY,11408.0,7415.2,774.39,11408.0,35
CDM,32671WE,THORACOSCOPY W/PNEUMONECTOMY,12768.0,8299.2,854.77,12768.0,35
CDM,32672WE,THORACOSCOPY W/RESEXN-PLICAJ EMPHYSEMA LUNG UNIL,10800.0,7020.0,733.3,10800.0,35
CDM,32673WE,THORACOSCOPY RESEXN THYMUS UNI/BILATERAL,8452.0,5493.8,586.83,8452.0,35
CDM,32674WE,THORCOSCPY W/MEDIASTINL &REGIONL LYMPHADENECTOMY,1648.0,1071.2,103.56,1648.0,35
CDM,32701WE,THORAX STEREOTACTIC RADIATION TARGET W/TX COURSE,1672.0,1086.8,158.67,1672.0,28
CDM,32800WE,REPAIR LUNG HERNIA THROUGH CHEST WALL,6284.0,4084.6,619.52,6284.0,35
CDM,32815WE,OPEN CLOSURE MAJOR BRONCHIAL FISTULA,20012.0,13007.8,1361.86,20012.0,35
CDM,32820WE,MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC,9004.0,5852.6,1053.15,9004.0,35
CDM,32900WE,RESECTION RIBS EXTRAPLEURAL ALL STAGES,9524.0,6190.6,811.61,9524.0,35
CDM,32905WE,THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL,9316.0,6055.4,936.81,9316.0,35
CDM,32940WE,PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX,8536.0,5548.4,843.93,8536.0,35
CDM,32994WE,ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION,3612.0,2347.8,372.71,11107.24,31
CDM,32997WE,TOTAL LUNG LAVAGE (UNILATERAL),2924.0,1900.6,238.31,2924.0,35
CDM,32998WE,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,37160.0,24154.0,211.38,27870.0,35
CDM,32998WE-26,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,3612.0,2347.8,1806.0,3612.0,12
CDM,32999ABLWE,UNLISTED RADIO FREQUENCY ABLATION LUNG,2115.0,1374.75,629.03,2115.0,15
CDM,32999BROWE,UNLISTED FLUORESCENCE BRONCHOSCOPY,2115.0,1374.75,629.03,2115.0,15
CDM,32999GUIWE,GUIDE WIRE LOCALIZATION FOR LUNG,648.0,421.2,324.0,754.84,15
CDM,32999RVU3WE,IMAGE GUIDED CHEST TUBE EXCHANGE REPOSITION (COMP CODE 49423),628.0,408.2,314.0,754.84,15
CDM,32999RVU4WE,IMAGE GUIDED LUNG LOCALIZATION (COMP CODE 32553),1562.0,1015.3,629.03,1562.0,15
CDM,33016WE,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,1760.0,1144.0,175.92,1760.0,31
CDM,33017WE,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,2033.0,1321.45,185.11,2033.0,31
CDM,33018WE,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,2160.0,1404.0,217.28,2160.0,31
CDM,33019WE,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,1888.0,1227.2,157.02,1888.0,31
CDM,33020WE,PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY,5724.0,3720.6,628.86,5724.0,35
CDM,33025WE,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,5808.0,3775.2,585.46,5808.0,35
CDM,33030WE,PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS,14400.0,9360.0,1070.49,14400.0,35
CDM,33031WE,PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS,18000.0,11700.0,1193.56,18000.0,35
CDM,33050WE,RESECTION PERICARDIAL CYST/TUMOR,6788.0,4412.2,656.15,6788.0,35
CDM,33100015,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,2861.0,1859.65,30.69,2574.9,49
CDM,33100020,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,2861.0,1859.65,93.33,2574.9,49
CDM,33100025,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7,614.0,399.1,30.69,1089.0,49
CDM,33100030,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,2861.0,1859.65,30.69,2574.9,49
CDM,33100035,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL >7,1818.0,1181.7,30.69,1636.2,49
CDM,33100040,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,614.0,399.1,30.69,1089.0,49
CDM,33100050,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,614.0,399.1,30.69,1089.0,49
CDM,33100060,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,614.0,399.1,30.69,1089.0,49
CDM,33100070,CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ,2861.0,1859.65,30.69,2574.9,49
CDM,33100080,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,614.0,399.1,30.69,1089.0,49
CDM,33100090,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,2861.0,1859.65,30.69,2574.9,49
CDM,33100100,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,614.0,399.1,30.69,1089.0,49
CDM,33100110,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,614.0,399.1,30.69,1089.0,49
CDM,33120WE,EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP,15380.0,9997.0,1375.89,15380.0,35
CDM,33140WE,TRANSMYOCARDIAL LASER REVASCULAR THORACOTOMY SPX,11336.0,7368.4,910.44,11336.0,35
CDM,33141WE,TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX,1016.0,660.4,99.07,1016.0,35
CDM,33202WE,"INSERT EPICARDIAL ELECTRODE, OPEN",5808.0,3775.2,463.58,5808.0,35
CDM,33203WE,INSERT EPICARD ELTRD ENDO,5588.0,3632.2,475.12,5588.0,35
CDM,33206WE,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,3142.0,2042.3,343.92,3142.0,35
CDM,33207WE,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,3120.0,2028.0,361.79,3120.0,35
CDM,33208WE,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,3408.0,2215.2,390.65,3408.0,35
CDM,33210WE,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,1342.0,872.3,121.02,1342.0,35
CDM,33211WE,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,1256.0,816.4,125.62,1256.0,35
CDM,33212WE,INS PM PLS GEN W/EXIST SINGLE LEAD,2004.0,1302.6,245.62,2004.0,35
CDM,33213WE,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,2112.0,1372.8,255.58,2112.0,35
CDM,33214WE,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,3036.0,1973.4,362.31,3036.0,35
CDM,33215WE,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,1968.0,1279.2,207.55,1968.0,35
CDM,33216WE,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,2248.0,1461.2,278.02,2248.0,35
CDM,33217WE,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,2236.0,1453.4,277.19,2236.0,35
CDM,33218WE,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,2328.0,1513.2,270.43,2328.0,35
CDM,33220WE,RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB,2360.0,1534.0,274.73,2360.0,35
CDM,33221WE,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,2220.0,1443.0,175.89,2220.0,35
CDM,33222WE,RELOCATION OF SKIN POCKET FOR PACEMAKER,1940.0,1261.0,260.94,1940.0,35
CDM,33223WE,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,2520.0,1638.0,309.45,2520.0,35
CDM,33224WE,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,3616.0,2350.4,336.17,3616.0,35
CDM,33225WE,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,3332.0,2165.8,298.12,3332.0,35
CDM,33226WE,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,3472.0,2256.8,323.75,3472.0,35
CDM,33227WE,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,2100.0,1365.0,165.37,2100.0,35
CDM,33228WE,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,2208.0,1435.2,173.09,2208.0,35
CDM,33229WE,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,2316.0,1505.4,182.79,2316.0,35
CDM,33233WE,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,1256.0,816.4,159.0,1256.0,35
CDM,33234WE,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,3064.0,1991.6,295.6,3064.0,35
CDM,33235WE,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,3960.0,2574.0,365.88,3960.0,35
CDM,33236WE,RMVL PRM EPICAR PM&ELTRDS THORCOM 1 LEAD SYS,5092.0,3309.8,473.81,5092.0,35
CDM,33237WE,RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SY,5536.0,3598.4,629.15,5536.0,35
CDM,33238WE,RMVL PRM TRANSVENOUS ELECTRODE THORACOTOMY,6160.0,4004.0,705.18,6160.0,35
CDM,33240WE,INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD,2320.0,1508.0,272.18,2320.0,35
CDM,33241WE,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,1216.0,790.4,157.74,1216.0,35
CDM,33243WE,RMVL 1/DUAL CHAMBER DEFIB ELECTRODE BY THORACOM,9428.0,6128.2,874.13,9428.0,35
CDM,33244WE,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,5496.0,3572.4,496.3,5496.0,35
CDM,33249WE,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,6565.0,4267.25,687.33,6565.0,35
CDM,33251WE,ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/BYPASS,11568.0,7519.2,1113.44,11568.0,35
CDM,33254WE,ABLATION & RECONSTRUCTION ATRIA LIMITED,9484.0,6164.6,811.6,9484.0,35
CDM,33256WE,ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS,13960.0,9074.0,1169.81,13960.0,35
CDM,33257WE,ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE,3852.0,2503.8,368.7,3852.0,35
CDM,33258WE,ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTENSIV W/O BYP,4400.0,2860.0,417.14,4400.0,35
CDM,33259WE,ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS,5656.0,3676.4,549.23,5656.0,35
CDM,33262WE,REM PAC CVDFB PLSE GEN &REPL PLSE GEN SNGL LEAD,2324.0,1510.6,182.13,2324.0,35
CDM,33263WE,REM PAC CVDFB PLSE GEN &REPL PLSE GEN DUAL LEAD,2432.0,1580.8,189.36,2432.0,35
CDM,33264WE,REM PAC CVDFB PLS GEN &REPL PLSE GEN MULTI LEAD,2540.0,1651.0,197.26,2540.0,35
CDM,33265WE,NDSC ABLATION & RCNSTJ ATRIA LIMITED W/O BYPAS,9484.0,6164.6,811.6,9484.0,35
CDM,33266WE,NDSC ABLATION & RCNSTJ ATRIA EXTEN W/O BYPASS,13216.0,8590.4,1112.82,13216.0,35
CDM,33267WE,EXCLUSION LEFT ATRIAL APPENDAGE OPEN ANY METHOD,7400.0,4810.0,81.91,7400.0,31
CDM,33268WE,EXCLUSION LAA OPEN TM STRNT/THRCM ANY METHOD,1000.0,650.0,10.23,1000.0,31
CDM,33269WE,EXCLUSION L ATR APPENDAGE THORACOSCOPIC ANY METH,5724.0,3720.6,59.46,5724.0,31
CDM,33270WE,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,4004.0,2602.6,422.82,4004.0,31
CDM,33271WE,INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,3000.0,1950.0,344.18,3000.0,31
CDM,33272WE,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,2385.0,1550.25,264.01,2385.0,31
CDM,33273WE,REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB,2600.0,1690.0,297.21,2600.0,31
CDM,33274WE,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,3432.0,2230.8,360.26,3432.0,31
CDM,33275WE,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,3436.0,2233.4,380.94,3436.0,31
CDM,33285WE,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,673.0,437.45,69.4,9245.47,31
CDM,33286WE,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,600.0,390.0,68.05,450.0,31
CDM,33289WE,TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR,2400.0,1560.0,255.58,2400.0,28
CDM,33300010,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,1145.0,744.25,71.21,1482.0,49
CDM,33300020,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,3158.0,2052.7,110.51,2842.2,49
CDM,33300030,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,3158.0,2052.7,110.51,2842.2,49
CDM,33300040,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,11801.0,7670.65,635.48,10620.9,49
CDM,33300050,BASIC RADIATION DOSIMETRY CALCULATION,1145.0,744.25,91.62,1482.0,49
CDM,33300060,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,11801.0,7670.65,635.48,10620.9,49
CDM,33300085,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,3158.0,2052.7,110.51,2842.2,49
CDM,33300100,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,3158.0,2052.7,110.51,2842.2,49
CDM,33300110,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,1145.0,744.25,71.21,1482.0,49
CDM,33300120,TX DEVICES DESIGN & CONSTRUCTION SIMPLE,1145.0,744.25,54.56,1482.0,49
CDM,33300125,INTRAOP RADIAJ TX DELIVER XRAY SINGLE TX SESSION,65934.0,42857.1,832.44,59340.6,48
CDM,33300130,TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE,1145.0,744.25,71.21,1482.0,49
CDM,33300135,INTRAOP RADIAJ TX DELIVER ELECTRONS SNGL TX SESS,65934.0,42857.1,832.44,59340.6,48
CDM,33300140,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,3158.0,2052.7,110.51,2842.2,49
CDM,33300145,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,2269.0,1474.85,107.19,2042.1,49
CDM,33300150,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,1145.0,744.25,71.21,1482.0,49
CDM,33300160,SPEC MEDICAL RADJ PHYSICS CONSLTJ,1145.0,744.25,71.21,1482.0,49
CDM,33300170,RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR,65934.0,42857.1,0.01,59340.6,49
CDM,33300180,STEREOTACTIC BODY RADIATION DELIVERY,15145.0,9844.25,0.01,13630.5,49
CDM,33300230,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,4236.0,2753.4,107.19,3812.4,49
CDM,33300270,RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX,6068.0,3944.2,107.19,5461.2,49
CDM,33300295,STEREOTACTIC BODY RADIATION DELIVERY,15145.0,9844.25,0.01,13630.5,49
CDM,33300310,THERAPEUTIC RADIOLOGY PORT IMAGES(S),604.0,392.6,33.81,1482.0,38
CDM,33300335,RESPIRATORY MOTION MANAGEMENT SIMULATION,3726.0,2421.9,71.21,3353.4,39
CDM,33300340,STEREOTACTIC BODY RADIATION MANAGEMENT,1159.0,753.35,187.77,1482.0,39
CDM,33300345,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,3158.0,2052.7,71.21,2842.2,49
CDM,33300350,SPECIAL TREATMENT PROCEDURE,4989.0,3242.85,189.57,4490.1,49
CDM,33300355,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,3158.0,2052.7,110.51,2842.2,49
CDM,33300360,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,1490.0,968.5,65.54,1482.0,39
CDM,33300365,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,3158.0,2052.7,71.21,2842.2,49
CDM,33300370,RESPIRATORY MOTION MANAGEMENT SIMULATION,3726.0,2421.9,71.21,3353.4,39
CDM,33300375,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,3158.0,2052.7,110.51,2842.2,49
CDM,33300380,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,3158.0,2052.7,71.21,2842.2,49
CDM,33300390,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,3158.0,2052.7,110.51,2842.2,49
CDM,33300400,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,3158.0,2052.7,71.21,2842.2,49
CDM,33300410,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,3158.0,2052.7,110.51,2842.2,49
CDM,33300415,GUIDANCE FOR LOCLZJ TARGET VOL FOR RADJ TX DLVR,490.0,318.5,49.58,1482.0,39
CDM,33300420,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,3158.0,2052.7,110.51,2842.2,49
CDM,33300425,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,1121.0,728.65,106.55,1482.0,49
CDM,33300430,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,3158.0,2052.7,110.51,2842.2,49
CDM,33300435,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,4236.0,2753.4,107.19,3812.4,49
CDM,33300445,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,5984.0,3889.6,280.79,5385.6,49
CDM,33300455,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,5984.0,3889.6,696.43,5385.6,49
CDM,33300460,GUIDANCE FOR LOCLZJ TARGET VOL FOR RADJ TX DLVR,490.0,318.5,49.58,1482.0,39
CDM,33300470,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,1121.0,728.65,106.55,1482.0,49
CDM,33300480,INTRAOP RADIAJ TX DELIVER XRAY SINGLE TX SESSION,65934.0,42857.1,832.44,59340.6,48
CDM,33300490,INTRAOP RADIAJ TX DELIVER ELECTRONS SNGL TX SESS,65934.0,42857.1,832.44,59340.6,48
CDM,33300495,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,3158.0,2052.7,110.51,2842.2,49
CDM,33300500,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,2269.0,1474.85,107.19,2042.1,49
CDM,33300510,HYPERTHERMIA EXTERNAL GENERATED DEEP,5984.0,3889.6,280.79,5385.6,49
CDM,33300520,HYPERTHERMIA INTERSTITIAL PROBE 5/< APPLICATORS,4989.0,3242.85,280.79,4490.1,49
CDM,33300530,HYPERTHERMIA INTERSTIAL PROBE 5/> APPLICATORS,4989.0,3242.85,280.79,4490.1,49
CDM,33300535,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,2269.0,1474.85,263.97,2042.1,49
CDM,33300540,HYPERTHERMIA INTRACAVITARY PROBES,4989.0,3242.85,280.79,4490.1,49
CDM,33300550,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,4989.0,3242.85,280.79,4490.1,49
CDM,33300555,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,2269.0,1474.85,263.97,2042.1,49
CDM,33300560,INTRACAVITARY RADIATION SOURCE APPLIC INTERMED,4989.0,3242.85,577.01,4490.1,49
CDM,33300570,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,5984.0,3889.6,696.43,5385.6,49
CDM,33300600,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,5984.0,3889.6,696.43,5385.6,49
CDM,33300615,STEREOTACTIC BODY RADIATION DELIVERY,15145.0,9844.25,0.01,13630.5,49
CDM,33300625,THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX,1419.0,922.35,71.21,1482.0,39
CDM,33300WE,REPAIR CARDIAC WOUND W/O BYPASS,17988.0,11692.2,1203.0,17988.0,35
CDM,33305WE,REPAIR CARDIAC WOUND W/CARDIOPULMONARY BYPASS,30772.0,20001.8,1969.6,30772.0,35
CDM,33310WE,CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP,8136.0,5288.4,830.89,8136.0,35
CDM,33315WE,CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP,14000.0,9100.0,1039.72,14000.0,35
CDM,33320WE,SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP,7416.0,4820.4,810.65,7416.0,35
CDM,33321WE,SUTR RPR AORTA/GREAT VESSEL W/SHUNT BYPASS,8324.0,5410.6,864.15,8324.0,35
CDM,33322WE,SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS,9768.0,6349.2,1049.38,9768.0,35
CDM,33340WE,PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT,6160.0,4004.0,619.52,6160.0,28
CDM,33361WE,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,9887.0,6426.55,906.66,9887.0,31
CDM,33362WE,REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH,9816.0,6380.4,989.38,9816.0,31
CDM,33363WE,REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH,10188.0,6622.2,1024.62,10188.0,31
CDM,33364WE,REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPROACH,10388.0,6752.2,1022.06,10388.0,31
CDM,33365WE,REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH,10636.0,6913.4,1067.26,10636.0,31
CDM,33366WE,TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE,12914.0,8394.1,1177.3,12914.0,31
CDM,33367WE,REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH,4752.0,3088.8,446.03,4752.0,31
CDM,33368WE,REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH,5756.0,3741.4,525.67,5756.0,31
CDM,33369WE,REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH,7600.0,4940.0,693.84,7600.0,31
CDM,33370WE,TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,1000.0,650.0,10.38,1000.0,31
CDM,33390WE,VALVULOPLASTY AORTIC VALVE OPEN CARD BYP SIMPLE,14000.0,9100.0,1451.01,14000.0,31
CDM,33391WE,(2017) VALVULOPLASTY AORTIC VALVE OPEN CARD BYP COMPLEX,16600.0,10790.0,1719.61,16600.0,31
CDM,33405WE,RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT,18181.0,11817.65,1664.33,18181.0,35
CDM,33406WE,RPLCMT AORTIC VALVE OPN ALLOGRAFT VALVE FREEHAND,21072.0,13696.8,1862.82,21072.0,35
CDM,33410WE,RPLCMT AORTIC VALVE OPN W/STENTLESS TISSUE VALVE,20420.0,13273.0,1602.69,20420.0,35
CDM,33411WE,RPLCMT AORTIC VALVE ANNULUS ENLGMENT NONC SINUS,24828.0,16138.2,1874.09,24828.0,35
CDM,33412WE,REPLACEMENT AORTIC VALVE KONNO PROCEDURE,23600.0,15340.0,1977.93,23600.0,35
CDM,33413WE,REPLACEMENT AORTIC&PULMON VALVES ROSS PROCEDUR,23948.0,15566.2,2025.93,23948.0,35
CDM,33415WE,RESECTION/INCISION SUBVALVULAR TISSUE,14908.0,9690.2,1527.86,14908.0,35
CDM,33416WE,VENTRICULOMYOTOMY-MYECTOMY,14624.0,9505.6,1525.7,14624.0,35
CDM,33417WE,AORTOPLASTY SUPRAVALVULAR STENOSIS,11732.0,7625.8,1263.35,11732.0,35
CDM,33418WE,TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS,14190.0,9223.5,1322.27,14190.0,28
CDM,33419WE,TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS,3489.0,2267.85,408.98,3489.0,28
CDM,33422WE,VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS,11892.0,7729.8,1254.41,11892.0,35
CDM,33425WE,VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS,19984.0,12989.6,1547.5,19984.0,35
CDM,33426WE,VLVP MITRAL VALVE W/CARD BYP W/PROSTC RING,17312.0,11252.8,1721.57,17312.0,35
CDM,33427WE,VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING,17932.0,11655.8,1782.37,17932.0,35
CDM,33430WE,REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP,20372.0,13241.8,1795.9,20372.0,35
CDM,33440WE,RPLCMT AORTIC VALVE BY TLCJ AUTOL PULM VALVE,25600.0,16640.0,2548.65,25600.0,31
CDM,33460WE,VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP,17880.0,11622.0,1361.77,17880.0,35
CDM,33463WE,VALVULOPLAS TRICUS NO RING INSERT,22832.0,14840.8,1555.74,22832.0,35
CDM,33464WE,VALVULOPLAS TRICUS W RING INSERT,17848.0,11601.2,1573.41,17848.0,35
CDM,33465WE,REPLACEMENT TRICUSPID VALVE W/CARD BYPASS,20288.0,13187.2,1648.35,20288.0,35
CDM,33475WE,"REPLACEMENT, PULMONARY VALVE",16960.0,11024.0,1627.2,16960.0,35
CDM,33477WE,TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH,10000.0,6500.0,974.32,10000.0,31
CDM,33478WE,OUTFLOW TRACT AGMNTJ W/WO COMMISSUR/INFUND RESCJ,11016.0,7160.4,1193.39,11016.0,35
CDM,33496WE,RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS,11936.0,7758.4,1254.41,11936.0,35
CDM,33500000,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,2861.0,1859.65,166.76,2574.9,49
CDM,33500005,CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH,2861.0,1859.65,26.04,2574.9,49
CDM,33500010,CHEMOTHERAPY ADMN IV INFUSION TQ EA HR,614.0,399.1,39.38,1089.0,49
CDM,33500020,CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR,614.0,399.1,71.44,1089.0,49
CDM,33500025,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,2861.0,1859.65,30.69,2574.9,49
CDM,33500030,CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,2861.0,1859.65,193.36,2574.9,49
CDM,33500035,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,614.0,399.1,30.69,1089.0,49
CDM,33500040,CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR,614.0,399.1,71.44,1089.0,49
CDM,33500045,CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS </1 HR,2861.0,1859.65,166.76,2574.9,49
CDM,33500050,CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,2861.0,1859.65,193.36,2574.9,49
CDM,33500055,CONCURRENT CHEMO INFUSION UNLISTED,136.0,88.4,28.56,1089.0,48
CDM,33500060,CHEMOTHERAPY ADMN IV INFUSION TQ EA HR,614.0,399.1,39.38,1089.0,49
CDM,33500065,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,2861.0,1859.65,156.76,2574.9,49
CDM,33500070,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,2861.0,1859.65,166.76,2574.9,49
CDM,33500115,CHEMO EXTEND IV INFUS W/PUMP,2614.0,1699.1,307.14,2352.6,48
CDM,33500125,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,614.0,399.1,30.69,1089.0,49
CDM,33500135,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,614.0,399.1,30.69,1089.0,49
CDM,33500195,CHEMOTHERAPY ADMIN INTRA-ARTERIAL  INFUSION TECHNIQUE >8 HR PRTB,2861.0,1859.65,253.09,2574.9,49
CDM,33500205,CHEMOTHERAPY ADMN INTRAARTERIAL INFUSION EA HR,398.0,258.7,46.31,1089.0,49
CDM,33502WE,RPR ANOM CORONARY ART PULM ART ORIGIN LIGATION,8740.0,5681.0,937.41,8740.0,35
CDM,33503WE,RPR ANOM CORONARY ARTERY PULM ART ORIGIN GRAFT,9004.0,5852.6,926.89,9004.0,35
CDM,33504WE,RPR ANOM CORONARY ART PULM ART ORIGIN GRF W/BYP,10184.0,6619.6,1113.47,10184.0,35
CDM,33505WE,RPR ANOM CORON ART W/CONSTJ INTRAPULM ART TUNNEL,15360.0,9984.0,1107.57,15360.0,35
CDM,33506WE,RPR ANOM CORONARY ART FROM PULM ART TO AORTA,15140.0,9841.0,1487.07,15140.0,35
CDM,33507WE,RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ,12560.0,8164.0,1264.47,12560.0,35
CDM,33508WE,NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG,124.0,80.6,11.39,124.0,35
CDM,33510WE,CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT,13992.0,9094.8,1441.52,13992.0,35
CDM,33511WE,CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS,15380.0,9997.0,1571.34,15380.0,35
CDM,33512WE,CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS,17592.0,11434.8,1700.56,17592.0,35
CDM,33513WE,CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS,18148.0,11796.2,1832.09,18148.0,35
CDM,33514WE,CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS,19232.0,12500.8,1898.85,19232.0,35
CDM,33516WE,CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT,19904.0,12937.6,1978.98,19904.0,35
CDM,33517WE,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN,1588.0,1032.2,132.06,1588.0,35
CDM,33518WE,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN,3489.0,2267.85,249.33,3489.0,35
CDM,33519WE,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN,4616.0,3000.4,365.89,4616.0,35
CDM,33521WE,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN,5540.0,3601.0,483.5,5540.0,35
CDM,33522WE,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN,6222.0,4044.3,547.67,6222.0,35
CDM,33523WE,CORONARY ARTERY BYP W/VEIN &ARTERY GRAFT 6 VEIN,7075.0,4598.75,616.61,7075.0,35
CDM,33530WE,ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ,4052.0,2633.8,286.76,4052.0,35
CDM,33533WE,CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT,14850.0,9652.5,1412.2,14850.0,35
CDM,33534WE,"CABG, ARTERIAL, TWO",17547.0,11405.55,1658.84,17547.0,35
CDM,33535WE,"CABG, ARTERIAL, THREE",19690.0,12798.5,1396.22,19690.0,35
CDM,33536WE,"CABG, ARTERIAL, FOUR+",21309.0,13850.85,1984.89,21309.0,35
CDM,33542WE,MYOCARD RESECTN,19284.0,12534.6,1636.82,19284.0,35
CDM,33545WE,RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT,22824.0,14835.6,1976.8,22824.0,35
CDM,33548WE,SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD,21656.0,14076.4,1661.79,21656.0,35
CDM,33572WE,CORONARY ENDARTERCOMY OPEN ANY METHOD,1776.0,1154.4,171.83,1776.0,35
CDM,33602WE,CLOSURE SEMILUNAR VALVE AORTIC/PULM SUTURE/PATCH,11906.0,7738.9,1263.86,11906.0,35
CDM,33615WE,RPR CAR ANOMAL CLSR SEPTL DFCT SMPL FONTAN PX,14356.0,9331.4,1508.46,14356.0,35
CDM,33620WE,APPLICATION RIGHT & LEFT PULMONARY ARTERY BANDS,13200.0,8580.0,1242.66,13200.0,35
CDM,33621WE,TRANSTHORACIC CATHETER INSERTION FOR STENT PLMT,6472.0,4206.8,667.85,6472.0,35
CDM,33622WE,RECONSTRUCTION COMPLEX CARDIAC ANOMALY,25600.0,16640.0,2496.3,25600.0,35
CDM,33641WE,REPR ASD W BYPASS,11832.0,7690.8,1236.79,11832.0,35
CDM,33645WE,DIR/PTCH CLS SINUS VENOSUS W/WO ANOM PUL VEN DRG,12520.0,8138.0,1305.98,12520.0,35
CDM,33647WE,RPR ATRIAL & VENTRIC SEPTAL DFCT DIR/PATCH CLS,14520.0,9438.0,1369.3,14520.0,35
CDM,33660WE,RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR,14005.0,9103.25,1324.11,14005.0,35
CDM,33681WE,CLSR 1 VENTRICULAR SEPTAL DEFECT W/WO PATCH,14230.0,9249.5,1396.37,14230.0,35
CDM,33720WE,RPR SINUS VALSALVA ANEURYSM,10904.0,7087.6,1172.96,10904.0,35
CDM,33724WE,REPAIR ISOLATED PARTIAL PULM VENOUS RETURN,11052.0,7183.8,927.85,11052.0,35
CDM,33741WE,TAS CONGENITAL CARDIAC ANOMALIES ANY METHOD,5600.0,3640.0,562.22,5600.0,31
CDM,33745WE,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL 1ST SHUNT,8000.0,5200.0,800.26,8000.0,31
CDM,33746WE,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL EA ADDL,3200.0,2080.0,299.64,3200.0,31
CDM,33813WE,OBLTRJ AORTOPULMONARY SEPTAL DEFECT W/O BYPASS,7830.0,5089.5,1153.06,7830.0,19
CDM,33814WE,OBLTRJ AORTOPULMONARY SEPTAL DFCT W/CARD BYPASS,10628.0,6908.2,1156.36,10628.0,35
CDM,33820WE,REPAIR PATENT DUCTUS ARTERIOSUS LIGATION,6676.0,4339.4,735.08,6676.0,35
CDM,33845WE,EXCISION COARCTATION AORTA W/WO PDA W/GRAFT,9172.0,5961.8,1014.91,9172.0,35
CDM,33851WE,EXC COARCJ AORTA W/L SUBCLAV ART/PROSTC GUSSET,8792.0,5714.8,967.42,8792.0,35
CDM,33858WE,AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION,25360.0,16484.0,2547.88,25360.0,31
CDM,33859WE,AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ,18052.0,11733.8,1831.95,18052.0,31
CDM,33863WE,AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT,23516.0,15285.4,1947.56,23516.0,35
CDM,33864WE,ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL,24032.0,15620.8,2000.23,24032.0,35
CDM,33866WE,AORTIC HEMIARCH GRAFT W/ISOL & CTRL ARCH VESSELS,7810.0,5076.5,688.87,7810.0,31
CDM,33871WE,TRANSVRS A-ARCH GRF W/CARD BYP PRFD HYPOTHERMIA,24352.0,15828.8,2441.92,24352.0,31
CDM,33875WE,DESCENDING THORACIC AORTA GRAFT W/WO BYPASS,20288.0,13187.2,1756.61,20288.0,35
CDM,33877WE,RPR THORACOABDOMINAL AORTIC ANEURYS W/WO BYPASS,27612.0,17947.8,2375.33,27612.0,35
CDM,33880WE,EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH,13832.0,8990.8,1306.7,13832.0,35
CDM,33881WE,EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN,11832.0,7690.8,1121.84,11832.0,35
CDM,33882WE,EVASC RPR TA DPLMNT BRNCHD NDGFT MULTIPIECE SYS,15400.0,10010.0,1994.81,15400.0,21
CDM,33883WE,PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN,8436.0,5483.4,829.27,8436.0,35
CDM,33886WE,PLMT DSTL XTN PROSTH DLYD AFTER EVASC RPR DTA,7236.0,4703.4,715.6,7236.0,35
CDM,33900WE,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,4412.0,2867.8,113.21,4412.0,31
CDM,33901WE,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,5800.0,3770.0,148.92,5800.0,31
CDM,33902WE,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,5600.0,3640.0,143.68,5600.0,31
CDM,33903WE,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,6600.0,4290.0,169.52,6600.0,31
CDM,33904WE,PERQ P-ART REVSC ST EA ADDL VSL/SEP LES NM/ABNL,2212.0,1437.8,56.89,2212.0,31
CDM,33910WE,PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS,19284.0,12534.6,1268.35,19284.0,35
CDM,33915WE,PULMONARY ARTERY EMBOLECTOMY W/O CARD BYPASS,9980.0,6487.0,929.63,9980.0,35
CDM,33916WE,PULMONARY ENDARTERCOMY W/WO EMBOLECTOMY W/BYPASS,31200.0,20280.0,2011.02,31200.0,35
CDM,33917WE,RPR PULMONARY ART STENOSIS RCNSTJ W/PATCH/GRAFT,10120.0,6578.0,1106.32,10120.0,35
CDM,33922WE,TRANSECTION PULMONARY ARTERY W/CARD BYPASS,9688.0,6297.2,1053.98,9688.0,35
CDM,33924WE,LIG&TKDN SYSIC-TO-PULM ART SHUNT W/CGEN HEART,2196.0,1427.4,213.96,2196.0,35
CDM,33927WE,IMPLTJ TOTAL RPLCMT HEART SYS W/RCP CARDIECTOMY,19600.0,12740.0,1977.58,19600.0,28
CDM,33928WE,REMOVAL & RPLCMT TOTAL RPLCMT HEART SYS,20031.0,13020.15,6835.08,20031.0,13
CDM,33929WE,REMOVAL TOTAL RPLCMT HEART SYS FOR HEART TRNSPL,27438.0,17834.7,2558.01,27438.0,13
CDM,33944WE,BKBENCH PREPJ CADAVER DONOR HEART ALLOGRAFT,6741.0,4381.65,114.02,6741.0,14
CDM,33945WE,HEART TRANSPLANT W/WO REC CARDIECTOMY,35800.0,23270.0,2456.48,35800.0,35
CDM,33946WE,ECMO/ECLS INITIATION VENO-VENOUS,2640.0,1716.0,232.35,2640.0,31
CDM,33947WE,ECMO/ECLS INITIATION VENO-ARTERIAL,2917.0,1896.05,257.62,2917.0,31
CDM,33948WE,ECMO/ECLS DAILY MANAGEMENT EACH DAY VENO-VENOUS,2081.0,1352.65,179.75,2081.0,31
CDM,33949WE,ECMO/ECLS DAILY MANAGEMENT EA DAY VENO-ARTERIAL,1840.0,1196.0,175.41,1840.0,31
CDM,33952WE,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ,3260.0,2119.0,306.0,3260.0,31
CDM,33954WE,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER OPEN,3644.0,2368.6,340.77,3644.0,31
CDM,33956WE,ECMO/ECLS INSJ OF CENTRAL CANNULA 6 YRS & OLDER,6400.0,4160.0,624.52,6400.0,31
CDM,33958WE,ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER,1404.0,912.6,137.88,1404.0,31
CDM,33962WE,ECMO/ECLS REPOS PERPH CANNULA OPEN 6 YRS & OLDER,1788.0,1162.2,174.9,1788.0,31
CDM,33964WE,ECMO/ECLS ECLS REPOS CENTRAL CNULA 6YRS & OLDER,3800.0,2470.0,367.16,3800.0,31
CDM,33966WE,ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER,1800.0,1170.0,177.45,1800.0,31
CDM,33967WE,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,1936.0,1258.4,188.21,1936.0,35
CDM,33968WE,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,256.0,166.4,25.53,256.0,35
CDM,33970WE,INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN,2696.0,1752.4,264.26,2696.0,35
CDM,33971WE,RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF,4796.0,3117.4,397.66,4796.0,35
CDM,33973WE,INSJ I-AORT BALO ASSIST DEV VIA ASCENDING AORTA,3900.0,2535.0,374.31,3900.0,35
CDM,33975WE,INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE,10000.0,6500.0,978.66,10000.0,35
CDM,33976WE,INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR,12300.0,7995.0,1169.06,12300.0,35
CDM,33977WE,REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE,8344.0,5423.6,845.12,8344.0,35
CDM,33978WE,REMOVAL VENTR ASSIST DEVICE XTRCORP BIVENTR,10000.0,6500.0,958.74,10000.0,35
CDM,33979WE,INSJ VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC,15000.0,9750.0,1453.56,15000.0,35
CDM,33980WE,RMVL VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC,13400.0,8710.0,1711.52,13400.0,32
CDM,33981WE,REPLACE XTRA CORP VAD BIVENTRICLE PUMP,6444.0,4188.6,529.06,6444.0,35
CDM,33982WE,PLCMT VAD PMP IMPLTBL ICORP 1 VENTR W/O BYPASS,15144.0,9843.6,619.36,15144.0,35
CDM,33983WE,RPLCMT VAD PMP IMPLTBL ICORP 1 VNTR W/BYPASS,17816.0,11580.4,810.23,17816.0,35
CDM,33984WE,ECMO/ECLS RMVL PRPH CANNULA OPEN 6 YRS & OLDER,2184.0,1419.6,212.69,2184.0,31
CDM,33986WE,ECMO/ECLS RMVL OF CENTRAL CANNULA 6 YRS & OLDER,4000.0,2600.0,393.45,4000.0,31
CDM,33987WE,ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS,1616.0,1050.4,154.73,1616.0,31
CDM,33988WE,INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS,6000.0,3900.0,572.23,6000.0,31
CDM,33989WE,RMVL LEFT HEART VENT BY THORACIC INCIS ECMO/ECLS,3800.0,2470.0,367.16,3800.0,31
CDM,33990WE,INSJ PERQ VAD W/IMAGING ARTERY ACCESS ONLY,2970.0,1930.5,269.62,2970.0,31
CDM,33991WE,INSJ PERQ VAD TRNSPTAL W/IMAGE ART&VENOUS ACCESS,3890.0,2528.5,339.07,3890.0,31
CDM,33992WE,REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ,1420.0,923.0,140.68,1420.0,31
CDM,33993WE,REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ,1240.0,806.0,124.08,1240.0,31
CDM,33995WE,INSJ PERQ VAD W/RS&I R HEART VENOUS ACCESS ONLY,2700.0,1755.0,265.03,2700.0,31
CDM,33997WE,REMOVAL PERQ R HEART VAD VENOUS CANNULA SEP INSJ,1200.0,780.0,115.11,1200.0,31
CDM,33999MAZWE,MODIFIED MAZE PROCEDURE,3991.0,2594.15,1302.32,3991.0,15
CDM,34000045,BRAIN IMAGING VASCULAR FLOW ONLY,4643.0,3017.95,225.17,4178.7,49
CDM,34000065,NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS,3466.0,2252.9,58.03,3119.4,49
CDM,34000125,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,1933.0,1256.45,125.49,2409.0,48
CDM,34051WE,EMBLC/THRMBC INNOMINATE SUBCLAVIAN ARTERY,6796.0,4417.4,652.53,6796.0,35
CDM,34100000,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,3466.0,2252.9,115.65,3119.4,49
CDM,34100005,THYROID IMAGING WITH VASCULAR FLOW,3466.0,2252.9,225.17,3119.4,49
CDM,34100025,THYROID CARCINOMA METASTASES UPTAKE,1104.0,717.6,109.59,2409.0,36
CDM,34100035,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,4643.0,3017.95,225.17,4178.7,49
CDM,34100050,THYROID CARCINOMA METASTASES IMG WHOLE BODY,4643.0,3017.95,225.17,4178.7,49
CDM,34100060,PARATHYROID PLANAR IMAGING,3466.0,2252.9,376.04,3119.4,49
CDM,34100065,SALIVARY GLAND IMAGING SERIAL IMAGES,3466.0,2252.9,148.39,3119.4,49
CDM,34100070,ADRENAL IMAGING CORTEX &/MEDULLA,11260.0,7319.0,533.79,10134.0,49
CDM,34100080,BONE MARROW IMAGING LIMITED AREA,3466.0,2252.9,225.17,3119.4,49
CDM,34100090,BONE MARROW IMAGING MULTIPLE AREAS,3466.0,2252.9,225.17,3119.4,49
CDM,34100100,BONE MARROW IMAGING WHOLE BODY,3466.0,2252.9,225.17,3119.4,49
CDM,34100105,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,4643.0,3017.95,289.84,4178.7,49
CDM,34100110,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,4643.0,3017.95,143.42,4178.7,49
CDM,34100115,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,4643.0,3017.95,307.1,4178.7,49
CDM,34100120,SPLEEN IMAGING ONLY W/WO VASCULAR FLOW,3466.0,2252.9,223.18,3119.4,49
CDM,34100130,LYMPHATICS & LYMPH NODES IMAGING,4643.0,3017.95,446.06,4178.7,49
CDM,34100140,LIVER IMAGING STATIC ONLY,4643.0,3017.95,248.21,4178.7,49
CDM,34100150,LIVER IMAGING W/VASCULAR FLOW,4643.0,3017.95,277.36,4178.7,49
CDM,34100170,LIVER & SPLEEN IMAGING STATIC ONLY,3466.0,2252.9,257.25,3119.4,49
CDM,34100180,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,3466.0,2252.9,187.38,3119.4,49
CDM,34100190,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,11260.0,7319.0,533.79,10134.0,49
CDM,34100205,ESOPHAGEAL MOTILITY,3466.0,2252.9,225.17,3119.4,49
CDM,34100210,SALIVARY GLAND FUNCTION STUDY,3466.0,2252.9,146.48,3119.4,49
CDM,34100215,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,3466.0,2252.9,225.17,3119.4,49
CDM,34100220,GASTROESOPHAGEAL REFLUX STUDY,3466.0,2252.9,225.17,3119.4,49
CDM,34100225,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,4643.0,3017.95,225.17,4178.7,49
CDM,34100230,GASTRIC EMPTYING IMAGING STUDY,3466.0,2252.9,225.17,3119.4,49
CDM,34100235,BONE &/JOINT IMAGING LIMITED AREA,3466.0,2252.9,225.17,3119.4,49
CDM,34100240,UREA BREATH TEST C-14 ISOTOPIC ACQUISJ ANALYSIS,2123.0,1379.95,5.78,2409.0,48
CDM,34100245,PULMONARY PERFUSION IMAGING PARTICULATE,3466.0,2252.9,300.33,3119.4,49
CDM,34100250,ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,3466.0,2252.9,403.35,3119.4,49
CDM,34100255,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,4643.0,3017.95,381.11,4178.7,49
CDM,34100260,INTESTINE IMAGING,3466.0,2252.9,225.17,3119.4,49
CDM,34100265,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,4643.0,3017.95,225.17,4178.7,49
CDM,34100270,PERITONEAL-VENOUS SHUNT PATENCY TEST,3466.0,2252.9,225.17,3119.4,49
CDM,34100275,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,3466.0,2252.9,334.09,3119.4,49
CDM,34100280,BONE &/JOINT IMAGING LIMITED AREA,3466.0,2252.9,225.17,3119.4,49
CDM,34100285,SALIVARY GLAND IMAGING,3466.0,2252.9,225.17,3119.4,49
CDM,34100290,BONE &/JOINT IMAGING WHOLE BODY,3466.0,2252.9,225.17,3119.4,49
CDM,34100300,BONE &/JOINT IMAGING 3 PHASE STUDY,3466.0,2252.9,225.17,3119.4,49
CDM,34100320,CARDIAC SHUNT DETECTION,3466.0,2252.9,225.17,3119.4,49
CDM,34100330,NONCARDIAC VASCULAR FLOW IMAGING,3466.0,2252.9,225.17,3119.4,49
CDM,34100340,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,11260.0,7319.0,443.82,10134.0,49
CDM,34100350,MYOCARDIAL SPECT MULTIPLE STUDIES,11260.0,7319.0,533.79,10134.0,49
CDM,34100360,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,11260.0,7319.0,225.17,10134.0,49
CDM,34100370,VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL,4643.0,3017.95,237.8,4178.7,49
CDM,34100380,VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL,3466.0,2252.9,225.17,3119.4,49
CDM,34100390,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,3466.0,2252.9,225.17,3119.4,49
CDM,34100400,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,3466.0,2252.9,225.17,3119.4,49
CDM,34100410,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,3466.0,2252.9,225.17,3119.4,49
CDM,34100420,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,4643.0,3017.95,225.17,4178.7,49
CDM,34100500,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,3466.0,2252.9,225.17,3119.4,49
CDM,34100510,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,4643.0,3017.95,225.17,4178.7,49
CDM,34100530,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,4643.0,3017.95,426.89,4178.7,49
CDM,34100540,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,4643.0,3017.95,414.77,4178.7,49
CDM,34100560,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,11260.0,7319.0,355.21,10134.0,49
CDM,34100570,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,4643.0,3017.95,225.17,4178.7,49
CDM,34100580,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,4643.0,3017.95,225.17,4178.7,49
CDM,34100590,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,4643.0,3017.95,225.17,4178.7,49
CDM,34100610,TESTICULAR IMAGING WITH VASCULAR FLOW,3466.0,2252.9,225.17,3119.4,49
CDM,34100620,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,3466.0,2252.9,334.09,3119.4,49
CDM,34100640,RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D,3466.0,2252.9,346.09,3119.4,49
CDM,34100660,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,11260.0,7319.0,389.94,10134.0,49
CDM,34100670,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,11260.0,7319.0,483.35,10134.0,49
CDM,34100680,RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING,11260.0,7319.0,533.79,10134.0,49
CDM,34100720,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,3466.0,2252.9,225.17,3119.4,49
CDM,34100730,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,3466.0,2252.9,225.17,3119.4,49
CDM,34100740,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,4643.0,3017.95,225.17,4178.7,49
CDM,34100750,PULMONARY VENTILATION IMAGING,3466.0,2252.9,239.7,3119.4,49
CDM,34100760,PULMONARY VENTILATION & PERFUSION IMAGING,4643.0,3017.95,416.3,4178.7,49
CDM,34100770,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,3466.0,2252.9,257.18,3119.4,49
CDM,34100780,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,3466.0,2252.9,225.17,3119.4,49
CDM,34100790,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,3466.0,2252.9,225.17,3119.4,49
CDM,34100800,MYOCRD SYMPATHETIC INNERVAJ IMG PLNR QUAL&QUANT,6528.0,4243.2,533.79,5875.2,45
CDM,34100810,MYOCRD SYMP INNERVAJ IMG PLNR QUAL&QUANT W/SPECT,6528.0,4243.2,533.79,5875.2,45
CDM,34100820,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,4643.0,3017.95,289.84,4178.7,49
CDM,34100840,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,3466.0,2252.9,225.17,3119.4,49
CDM,34100850,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,4643.0,3017.95,225.17,4178.7,49
CDM,34100885,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,2009.0,1305.85,38.23,2849.0,46
CDM,34100895,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,12580.0,8177.0,859.52,11322.0,48
CDM,34100905,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,12580.0,8177.0,859.52,11322.0,48
CDM,34100915,MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT,19410.0,12616.5,859.52,17469.0,48
CDM,34100925,MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER,15960.0,10374.0,859.52,14364.0,48
CDM,34100935,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,16823.0,10934.95,859.52,15140.7,48
CDM,34100945,AQMBF PET REST AND PHARMACOLOGIC STRESS,4011.0,2607.15,673.85,3609.9,35
CDM,34100955,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,11260.0,7319.0,533.79,10134.0,49
CDM,34100965,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,11260.0,7319.0,533.79,10134.0,49
CDM,34100975,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,12580.0,8177.0,533.79,11322.0,49
CDM,34100985,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,513.0,333.45,86.18,2409.0,36
CDM,34101055,MRI FUSION TO PET (COMP CODE 76376),524.0,340.6,135.72,2409.0,48
CDM,34101WE,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,4372.0,2841.8,448.6,4372.0,35
CDM,34111WE,EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC,4372.0,2841.8,419.51,4372.0,35
CDM,34151WE,EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART,10608.0,6895.2,828.06,10608.0,35
CDM,34200010,RP THERAPY ORAL ADMINISTRATION,1933.0,1256.45,125.49,2409.0,49
CDM,34200015,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,5984.0,3889.6,696.43,5385.6,46
CDM,34200025,SUPERVISION HANDLING LOADING RADIATION SOURCE,1201.0,780.65,27.16,2409.0,36
CDM,34200030,RP THERAPY INTRAVENOUS ADMINISTRATION,1933.0,1256.45,125.49,2409.0,49
CDM,34200035,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,1933.0,1256.45,125.49,2409.0,49
CDM,34200040,RP THERAPY INRACAVITARY ADMINISTRATION,1934.0,1257.1,125.49,2409.0,49
CDM,34200060,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,1933.0,1256.45,125.49,2409.0,48
CDM,34200070,SUPERVISION HANDLING LOADING RADIATION SOURCE,1201.0,780.65,27.16,2409.0,36
CDM,34201WE,EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART,7792.0,5064.8,548.73,7792.0,35
CDM,34203WE,EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC,7144.0,4643.6,575.86,7144.0,35
CDM,34300005,TC99M TETROFOSMIN/PER DOSE,68.0,44.2,11.42,2409.0,29
CDM,34300020,TC99M SESTAMIBI PER DOSE,73.0,47.45,12.26,2409.0,29
CDM,34300030,TC99M MEDRONATE<30MCI,62.0,40.3,10.42,2409.0,29
CDM,34300050,TC99 PERTECHNET,37.0,24.05,6.22,2409.0,26
CDM,34300060,I-123 SODIUM CAP 200 UCI,231.0,150.15,38.81,2409.0,29
CDM,34300070,TC99M EXAMETAZIME<25MCI,3441.0,2236.65,802.34,3096.9,36
CDM,34300075,TC99M PYROPHOSPHATE<25MCI,130.0,84.5,21.84,2409.0,29
CDM,34300080,I131 DX CAPSL /MCI,198.0,128.7,33.26,2409.0,26
CDM,34300090,TC99M MEBROFENIN<15MCI,68.0,44.2,11.42,2409.0,29
CDM,34300100,TC99M PENTETATE<25MCI,264.0,171.6,44.35,2409.0,26
CDM,34300110,TC99M MAA<10MCI,1201.0,780.65,201.77,2409.0,29
CDM,34300120,TC99M SULFUR COLLOID =< 20MCI,220.0,143.0,36.96,2409.0,29
CDM,34300135,RB82<60MCI,800.0,520.0,134.4,2409.0,26
CDM,34300140,IN111 OXYQUINOLINE 0.5MCI,5533.0,3596.45,772.64,4979.7,39
CDM,34300150,IN111 DTPA.5MCI,4970.0,3230.5,715.29,4473.0,39
CDM,34300155,IN111 AUTO WBC DIAG/PER DOSE,5421.0,3523.65,1031.39,4878.9,36
CDM,34300160,F18 FDG DOSE,275.0,178.75,46.2,2409.0,26
CDM,34300170,GA67 CITRTE1MCI,2889.0,1877.85,485.35,2600.1,29
CDM,34300180,TC99M BICISATE<25MCI,4143.0,2692.95,683.8,3728.7,39
CDM,34300190,TC99 RBC DOSE,385.0,250.25,64.68,2409.0,29
CDM,34300200,TC99M MERTIATIDE<15MCI,625.0,406.25,105.0,2409.0,29
CDM,34300210,IND111 PENTETREOTIDE DOSE,11614.0,7549.1,1390.0,10452.6,39
CDM,34300220,I-123 MIBG DOSE UP TO 15MCI,9698.0,6303.7,1390.0,8728.2,39
CDM,34300240,TC99M FILTERED SULFUR COLLOID,220.0,143.0,36.96,2409.0,29
CDM,34300250,TC99M FILTERED SULFR COLLOID,220.0,143.0,36.96,2409.0,29
CDM,34300260,TC99M FILTERED SULFR COLLOID,220.0,143.0,36.96,2409.0,29
CDM,34300270,TC99M FILTERED SULFR COLLOID,220.0,143.0,36.96,2409.0,29
CDM,34300280,TC99M SESTAMIBI PER DOSE,73.0,47.45,12.26,2409.0,29
CDM,34300290,TC99M OXIDRONATE<30MCI,90.0,58.5,15.12,2409.0,26
CDM,34300300,TC99M AERO<75MCI,264.0,171.6,44.35,2409.0,29
CDM,34300310,IOFLUPANE I-123 UP TO 5 MCI,4620.0,3003.0,1387.74,4158.0,39
CDM,34300330,TC99M CERETEC WBC,2568.0,1669.2,934.13,2409.0,39
CDM,34300340,I-123 CAP PER 1 MCI,231.0,150.15,38.81,2409.0,26
CDM,34300350,TC99 TILMANOCEPT DIAG 0.5MCI,1309.0,850.85,219.91,2409.0,29
CDM,34300360,TC99M TETROFOSMIN PER DOSE 1 SYR,68.0,44.2,11.42,2409.0,29
CDM,34300370,TC99M TETROFOSMIN PER DOSE 2 SYR,68.0,44.2,11.42,2409.0,29
CDM,34300380,TC99M PYROPHOSPHATE =< 25 MCI,130.0,84.5,21.84,2409.0,29
CDM,34300390,I131 SERUM ALBUMIN DX PER 5UCI,198.0,128.7,33.26,2409.0,26
CDM,34300400,FLORBETAPAIR F18 AMYVID TO 10MCI,6292.0,4089.8,1825.64,6292.0,36
CDM,34300420,"FLORBETABEN F18, DX, UP TO 8.1 MCI",6820.0,4433.0,1273.76,6138.0,36
CDM,34300455,PET SCAN ISOTP UP TO 45MCI,275.0,178.75,46.2,2409.0,26
CDM,34300495,NETSPOT (GA-68 DOTATATE),154.0,100.1,49.63,2409.0,36
CDM,34300505,"AXUMIN FLUCICLOVINE F-18, DIAGNOSTIC, 1 MILLICURE",1089.0,707.85,268.42,2409.0,36
CDM,34300575,"TECHNETIUM TC-99M EXAMETAZIME LBLD AUTO WHT BLD CELLS,DIAG,PER S",2568.0,1669.2,934.13,2409.0,39
CDM,34300605,"IODINE I-131 SODIUM IODID SOLUTION, DIAG, PER MCI",180.0,117.0,30.24,2409.0,26
CDM,34300665,NON-HEU TC-99M ADD-ON/DOSE,12.0,7.8,3.0,2409.0,32
CDM,34300705,"COPPER CU-64, DOTATATE, DIAGNOSTIC, 1 MILLICURIE",2119.0,1377.35,594.28,2409.0,36
CDM,34300715,GA-64 PSMA,2068.0,1344.2,534.91,2409.0,36
CDM,34300735,F-18 PSMA PYLARIFY,1206.0,783.9,332.44,2409.0,36
CDM,34300745,"FLUOROESTRADIOL F 18, DIAGNOSTIC, 1 MCI",1562.0,1015.3,460.42,2409.0,36
CDM,34300755,GENERIC IOFLUPANE1-123 UP TO 5 MCI,4620.0,3003.0,1387.74,4158.0,39
CDM,34300765,"GA-68 GOZETOTIDE, DIAGNOSTIC",2068.0,1344.2,478.52,2409.0,36
CDM,34300785,FLUOROESTRADIOL F 18 DIAGNOSTIC 1 MCI,1562.0,1015.3,460.42,2409.0,36
CDM,34300805,"FLOTUFOLASTAT F18, DIAGNOSTIC, 1 MILLICURIE",1230.0,799.5,318.57,2409.0,39
CDM,34300815,FLUTEMETAMOL F18 DIAGNOSTIC,8400.0,5460.0,874.4,7560.0,36
CDM,34400010,I131 THERA CAPSL /MCI,198.0,128.7,23.13,581.52,37
CDM,34400025,QUADRAMET INJ SAMARIUM 153,39662.0,25780.3,3159.8,35695.8,37
CDM,34400030,RADIUM RA 223 DICHLORIDE INJ,10285.0,6685.25,1727.88,9256.5,21
CDM,34400040,RADIUM 223 DICHLORIDE PER UCI,337.0,219.05,87.28,10192.6,37
CDM,34400085,I-123 SODIUM CAP 100 UCI,231.0,150.15,38.81,2409.0,29
CDM,34400095,"LUTETIUM LU 177 DOTATATE, TX",671.0,436.15,296.25,25906.15,36
CDM,34400115,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC",512.0,332.8,241.24,25906.15,35
CDM,34401WE,THRMBC DIR/W/CATH VENA CAVA ILIAC VEIN ABDL INC,10608.0,6895.2,826.3,10608.0,35
CDM,34421WE,THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN LEG INC,5348.0,3476.2,471.29,5348.0,35
CDM,34490WE,THRMBC DIR/W/CATH AXILL&SUBCLAVIAN VEIN ARM IN,4364.0,2836.6,401.0,4364.0,35
CDM,34502WE,RECONSTRUCTION VENA CAVA ANY METHOD,11228.0,7298.2,1166.07,11228.0,35
CDM,34510WE,VENOUS VALVE TRANSPOSITION ANY VEIN DONOR,7964.0,5176.6,642.6,7964.0,35
CDM,34520WE,CROSS-OVER VEIN GRAFT VENOUS SYSTEM,7672.0,4986.8,592.05,7672.0,35
CDM,34701WE,EVASC RPR DPLMNT AORTO-AORTIC NDGFT,9484.0,6164.6,925.55,9484.0,31
CDM,34702WE,EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT,14400.0,9360.0,1341.98,14400.0,31
CDM,34703WE,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT,10608.0,6895.2,1025.64,10608.0,31
CDM,34704WE,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT RPT,18000.0,11700.0,1704.03,18000.0,31
CDM,34705WE,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT,11832.0,7690.8,1139.77,11832.0,31
CDM,34706WE,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT,18000.0,11700.0,1701.74,18000.0,31
CDM,34707WE,EVASC RPR DPLMNT ILIO-ILIAC NDGFT,8912.0,5792.8,869.63,8912.0,31
CDM,34708WE,EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT,14600.0,9490.0,1359.86,14600.0,31
CDM,34709WE,PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR,2600.0,1690.0,240.0,2600.0,31
CDM,34710WE,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL,6000.0,3900.0,595.93,6000.0,31
CDM,34711WE,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL,2400.0,1560.0,219.83,2400.0,31
CDM,34712WE,TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I,4800.0,3120.0,490.99,4800.0,31
CDM,34713WE,PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT,1000.0,650.0,91.92,1000.0,31
CDM,34714WE,OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH,2100.0,1365.0,201.45,2100.0,31
CDM,34715WE,OPN AX/SUBCLA ART EXPOS DLVR EVASC PROSTH UNI,2400.0,1560.0,222.39,2400.0,31
CDM,34716WE,OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ,2876.0,1869.4,278.81,2876.0,31
CDM,34717WE,EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI,3960.0,2574.0,329.37,3960.0,31
CDM,34718WE,EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI,10560.0,6864.0,923.76,10560.0,31
CDM,34808WE,EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE,1648.0,1071.2,150.9,1648.0,35
CDM,34812WE,OPN FEM ART EXPOS DLVR EVASC PROSTH UNI,1652.0,1073.8,153.45,1652.0,35
CDM,34813WE,PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR,1916.0,1245.4,174.9,1916.0,35
CDM,34820WE,OPN ILIAC ART EXPOS PROSTH/ILIAC OCCLS EVASC UNI,2800.0,1820.0,251.49,2800.0,35
CDM,34831WE,OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH,15192.0,9874.8,1430.55,15192.0,35
CDM,34833WE,OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP,3264.0,2121.6,293.11,3264.0,35
CDM,34834WE,OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI,1166.0,757.9,96.26,1166.0,35
CDM,34841WE,ENDOVASC VISCER AORTA REPAIR FENEST 1 ENDOGRAFT,12429.0,8078.85,923.01,12429.0,14
CDM,34848WE,VISCER AND INFRARENAL ABDOM AORTA 4+ PROSTHESIS,11885.0,7725.25,3771.56,11885.0,13
CDM,35000015,CT HRT W/O DYE W/CA TEST,760.0,494.0,64.08,1746.0,50
CDM,35000105,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,3080.0,2002.0,196.56,2772.0,50
CDM,35000110,CT GUIDANCE STEREOTACTIC LOCALIZATION,1909.0,1240.85,47.94,1746.0,36
CDM,35000115,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,708.0,460.2,34.79,1746.0,30
CDM,35000120,CT GUIDANCE NEEDLE PLACEMENT,2741.0,1781.65,47.94,2466.9,36
CDM,35000125,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1795.0,1166.75,106.1,1746.0,30
CDM,35000130,CT GUIDANCE &MONITORING VISC TISS ABLATION,3241.0,2106.65,47.94,2916.9,35
CDM,35000165,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2659.0,1728.35,136.83,2393.1,36
CDM,35000315,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,32064.0,20841.6,489.0,28857.6,46
CDM,35000400,CT LIMITED/LOCALIZED FOLLOW UP STUDY,760.0,494.0,64.08,1746.0,49
CDM,35000410,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,3080.0,2002.0,196.56,2772.0,50
CDM,35000420,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,3080.0,2002.0,196.56,2772.0,50
CDM,35000430,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35000440,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,918.0,596.7,64.08,1746.0,49
CDM,35000450,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35000460,CT CERVICAL SPINE W/O CONTRAST MATERIAL,918.0,596.7,64.08,1746.0,49
CDM,35000470,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,3080.0,2002.0,242.66,2772.0,50
CDM,35000480,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,1535.0,997.75,178.69,1746.0,49
CDM,35000490,PROC CT UNLISTD,1137.0,739.05,64.08,1746.0,48
CDM,35000500,CT CHEST WO SCREENING,99.0,64.35,27.82,1746.0,48
CDM,35000510,CT CALCIUM SCORING,65.0,42.25,18.27,1746.0,48
CDM,35000665,CT ABDOMEN SCREENING,99.0,64.35,27.82,1746.0,48
CDM,35000675,CT PELVIS SCREENING,99.0,64.35,27.82,1746.0,48
CDM,35000705,LOW DOSE WHOLE BODY CT,12580.0,8177.0,64.08,11322.0,48
CDM,35000785,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,8775.0,5703.75,242.66,7897.5,49
CDM,35000815,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,8198.0,5328.7,489.0,7378.2,36
CDM,35000825,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,1219.0,792.35,64.08,1746.0,38
CDM,35001WE,DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY,8324.0,5410.6,832.1,8324.0,35
CDM,35011WE,DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION,7432.0,4830.8,651.22,7432.0,35
CDM,35013WE,DIR RPR RUPTD ANEURYSM AXIL-BRACHIAL ARM INCIS,9292.0,6039.8,856.34,9292.0,35
CDM,35021WE,DIR RPR ANEURYSM INNOMINATE/SUBCLAVIAN ARTERY,8868.0,5764.2,951.33,8868.0,35
CDM,35045WE,DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY,7204.0,4682.6,627.37,7204.0,35
CDM,35081WE,DIR RPR ANEURYSM ABDOMINAL AORTA,13412.0,8717.8,1258.7,13412.0,35
CDM,35082WE,DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA,16836.0,10943.4,1593.11,16836.0,35
CDM,35091WE,DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS,14140.0,9191.0,1332.03,14140.0,35
CDM,35092WE,DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS,20388.0,13252.2,1736.42,20388.0,35
CDM,35100010,CT HEAD/BRAIN W/O CONTRAST MATERIAL,918.0,596.7,106.74,1746.0,49
CDM,35100020,CT HEAD/BRAIN W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35100030,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35100040,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,918.0,596.7,64.08,1746.0,49
CDM,35100050,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,1535.0,997.75,178.69,1746.0,49
CDM,35100060,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,1535.0,997.75,178.69,1746.0,49
CDM,35100070,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,918.0,596.7,64.08,1746.0,49
CDM,35100080,CT MAXILLOFACIAL W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35100090,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35100100,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,1535.0,997.75,178.69,1746.0,49
CDM,35102WE,DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS,14612.0,9497.8,1405.56,14612.0,35
CDM,35103WE,DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS,17448.0,11341.2,1594.93,17448.0,35
CDM,35111WE,DIR RPR ANEURYSM SPLENIC ARTERY,10512.0,6832.8,908.3,10512.0,35
CDM,35112WE,DIR RPR RUPTD ANEURYSM SPLENIC ARTERY,13028.0,8468.2,948.78,13028.0,35
CDM,35121WE,DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC,12608.0,8195.2,1149.76,12608.0,35
CDM,35122WE,DIR RPR RUPTD ANEURSM HEPATIC/CELIAC/RENAL/MESEN,15156.0,9851.4,1398.15,15156.0,35
CDM,35131WE,DIR RPR ANEURYSM & GRAFT ILIAC ARTERY,10560.0,6864.0,923.39,10560.0,35
CDM,35141WE,DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY,8364.0,5436.6,775.6,8364.0,35
CDM,35142WE,DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART,10064.0,6541.6,849.56,10064.0,35
CDM,35151WE,DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY,9488.0,6167.2,865.15,9488.0,35
CDM,35152WE,DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY,11064.0,7191.6,868.79,11064.0,35
CDM,35188WE,RPR/TRAUMATIC AV FISTULA HEAD & NECK,7200.0,4680.0,583.91,7200.0,35
CDM,35190WE,RPR/TRAUMATIC AV FISTULA EXTREMITIES,5368.0,3489.2,568.35,5368.0,35
CDM,35200010,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,918.0,596.7,64.08,1746.0,49
CDM,35200020,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1535.0,997.75,178.69,1746.0,49
CDM,35200025,CT CERVICAL SPINE W/O CONTRAST MATERIAL,918.0,596.7,64.08,1746.0,49
CDM,35200030,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,1535.0,997.75,178.69,1746.0,49
CDM,35200035,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,2085.0,1355.25,64.08,1876.5,49
CDM,35200040,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,1535.0,997.75,178.69,1746.0,49
CDM,35200050,CT CERVICAL SPINE W/CONTRAST MATERIAL,3080.0,2002.0,196.56,2772.0,49
CDM,35200060,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35200070,CT THORACIC SPINE W/O CONTRAST MATERIAL,918.0,596.7,64.08,1746.0,49
CDM,35200080,CT THORACIC SPINE W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35200085,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,1535.0,997.75,178.69,1746.0,49
CDM,35200090,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35200095,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,918.0,596.7,64.08,1746.0,49
CDM,35200100,CT LUMBAR SPINE W/O CONTRAST MATERIAL,918.0,596.7,64.08,1746.0,49
CDM,35200110,CT LUMBAR SPINE W/CONTRAST MATERIAL,3080.0,2002.0,196.56,2772.0,49
CDM,35200120,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35200130,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,1535.0,997.75,178.69,1746.0,49
CDM,35200140,CT PELVIS W/O CONTRAST MATERIAL,918.0,596.7,64.08,1746.0,49
CDM,35200150,CT PELVIS W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35200160,CT PELVIS W/O & W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35200170,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,918.0,596.7,64.08,1746.0,49
CDM,35200180,CT UPPER EXTREMITY W/CONTRAST MATERIAL,3080.0,2002.0,196.56,2772.0,49
CDM,35200190,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35200200,CT ANGIOGRAPHY UPPER EXTREMITY,1535.0,997.75,178.69,1746.0,49
CDM,35200210,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,918.0,596.7,64.08,1746.0,49
CDM,35200220,CT LOWER EXTREMITY W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35200230,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,1535.0,997.75,178.69,1746.0,49
CDM,35200240,CT ANGIOGRAPHY LOWER EXTREMITY,1535.0,997.75,178.69,1746.0,49
CDM,35200250,CT ABDOMEN W/O CONTRAST MATERIAL,918.0,596.7,64.08,1746.0,49
CDM,35200260,CT ABDOMEN W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35200270,CT ABDOMEN W/O & W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
CDM,35200280,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,1535.0,997.75,178.69,1746.0,49
CDM,35200290,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,1535.0,997.75,178.69,1746.0,49
CDM,35200300,CT ABDOMEN & PELVIS W/CONTRAST MATERIAL,3080.0,2002.0,196.56,2772.0,49
CDM,35200310,CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL,2085.0,1355.25,196.56,1876.5,49
CDM,35200320,CT ABDOMEN & PELVIS W/WO CONTRST 1/> BODY RE,3080.0,2002.0,196.56,2772.0,49
CDM,35200330,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG,3080.0,2002.0,242.66,2772.0,49
CDM,35200345,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,918.0,596.7,64.08,1746.0,49
CDM,35200365,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,3074.0,1998.1,242.66,2766.6,42
CDM,35200375,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,1535.0,997.75,196.56,1746.0,36
CDM,35200385,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,1545.0,1004.25,183.17,1746.0,42
CDM,35201WE,REPAIR BLOOD VESSEL DIRECT NECK,6772.0,4401.8,555.58,6772.0,35
CDM,35206WE,REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY,5536.0,3598.4,519.16,5536.0,35
CDM,35207WE,REPAIR BLOOD VESSEL DIRECT HAND FINGER,4376.0,2844.4,571.85,4376.0,35
CDM,35216WE,RPR BLOOD VESSEL DIRECT INTRATHORACIC W/O BYPASS,14644.0,9518.6,1017.74,14644.0,35
CDM,35221WE,RPR BLOOD VESSEL DIRECT INTRA-ABDOMINAL,10648.0,6921.2,817.74,10648.0,35
CDM,35226WE,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,6120.0,3978.0,512.54,6120.0,35
CDM,35231WE,REPAIR BLOOD VESSEL W/VEIN GRAFT NECK,8464.0,5501.6,688.92,8464.0,35
CDM,35236WE,REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY,7208.0,4685.2,596.43,7208.0,35
CDM,35251WE,REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL,12764.0,8296.6,978.48,12764.0,35
CDM,35256WE,REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY,7624.0,4955.6,633.61,7624.0,35
CDM,35261WE,REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK,7584.0,4929.6,649.7,7584.0,35
CDM,35266WE,RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY,6332.0,4115.8,579.56,6332.0,35
CDM,35271WE,RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP,9832.0,6390.8,1006.84,9832.0,35
CDM,35281WE,RPR BLVSL W/GRFT OTHER/THAN VEIN INTRA-ABDOMINAL,12024.0,7815.6,934.72,12024.0,35
CDM,35286WE,RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY,6876.0,4469.4,632.68,6876.0,35
CDM,35301WE,TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC,8464.0,5501.6,845.63,8464.0,35
CDM,35302WE,TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY,8540.0,5551.0,692.66,8540.0,35
CDM,35303WE,TEAEC W/GRAFT POPLITEAL ARTERY,9440.0,6136.0,761.41,9440.0,35
CDM,35304WE,TEAEC W/GRAFT TIBIOPERONEAL TRUNK ARTERY,9840.0,6396.0,792.39,9840.0,35
CDM,35305WE,TEAEC W/GRAFT TIBIAL/PERONEAL ART 1ST VESSEL,9440.0,6136.0,761.41,9440.0,35
CDM,35321WE,TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL,6636.0,4313.4,659.78,6636.0,35
CDM,35331WE,TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA,11088.0,7207.2,1001.41,11088.0,35
CDM,35341WE,TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL,10484.0,6814.6,1030.49,10484.0,35
CDM,35351WE,TEAEC W/WO PATCH GRAFT ILIAC,9844.0,6398.6,944.42,9844.0,35
CDM,35355WE,TEAEC W/WO PATCH GRAFT ILIOFEMORAL,7944.0,5163.6,769.8,7944.0,35
CDM,35361WE,TEAEC W/WO PATCH GRAFT COMBINED AORTOILIAC,12096.0,7862.4,1140.79,12096.0,35
CDM,35371WE,TEAEC W/WO PATCH GRAFT COMMON FEMORAL,6124.0,3980.6,609.97,6124.0,35
CDM,35372WE,TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL,7432.0,4830.8,665.05,7432.0,35
CDM,35390WE,ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO,1276.0,829.4,118.98,1276.0,35
CDM,35400WE,ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS THER IVNTJ,1200.0,780.0,107.49,1200.0,35
CDM,35500WE,HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX,2576.0,1674.4,231.1,2576.0,35
CDM,35501WE,BYPASS W/VEIN COMMON-IPSILATERAL CAROTID,11636.0,7563.4,1011.07,11636.0,35
CDM,35506WE,BYPASS W/VEIN CAROTID-SUBCLV/SUBCLAVIAN CAROTID,10132.0,6585.8,955.42,10132.0,35
CDM,35509WE,BYPASS W/VEIN CAROTID-CONTRALATERAL CAROTID,11236.0,7303.4,980.38,11236.0,35
CDM,35518WE,BYPASS W/VEIN AXILLARY-AXILLARY,9966.0,6477.9,852.42,9966.0,35
CDM,35521WE,BYPASS W/VEIN AXILLARY-FEMORAL,10617.0,6901.05,847.93,10617.0,35
CDM,35522WE,BYPASS W/VEIN AXILLARY-BRACHIAL,9260.0,6019.0,857.93,9260.0,35
CDM,35523WE,BYPASS W/VEIN BRACHIAL-ULNAR/-RADIAL,9652.0,6273.8,812.25,9652.0,35
CDM,35525WE,BYPASS W/VEIN BRACHIAL-BRACHIAL,8676.0,5639.4,819.29,8676.0,35
CDM,35531WE,BYPASS W/VEIN AORTOCELIAC/AORTOMESENTERIC,15644.0,10168.6,1223.14,15644.0,35
CDM,35533WE,BYPASS W/VEIN AXILLARY-FEMORAL-FEMORAL,11968.0,7779.2,1106.49,11968.0,35
CDM,35536WE,BYPASS W/VEIN SPLENORENAL,13492.0,8769.8,1181.35,13492.0,35
CDM,35539WE,"VEIN BYPASS GRAFT,AORTOFEMORAL",17644.0,11468.6,1407.25,17644.0,35
CDM,35540WE,"VEIN BYPASS GRAFT,AORTOBIFEMORAL",19732.0,12825.8,1569.4,19732.0,35
CDM,35556WE,BYPASS W/VEIN FEMORAL-POPLITEAL,10700.0,6955.0,1028.55,10700.0,35
CDM,35558WE,BYPASS W/VEIN FEMORAL-FEMORAL,9252.0,6013.8,784.57,9252.0,35
CDM,35560WE,BYPASS W/VEIN AORTORENAL,13612.0,8847.8,1111.6,13612.0,35
CDM,35565WE,BYPASS W/VEIN ILIOFEMORAL,10052.0,6533.8,848.09,10052.0,35
CDM,35566WE,BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL,12940.0,8411.0,1223.08,12940.0,35
CDM,35571WE,BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL,11229.0,7298.85,967.17,11229.0,35
CDM,35572WE,HARVEST FEMPOP VEIN 1 SGM VASC RCNSTJ PX,2724.0,1770.6,252.83,2724.0,35
CDM,35583WE,IN-SITU VEIN BYPASS FEMORAL-POPLITEAL,11100.0,7215.0,1078.23,11100.0,35
CDM,35585WE,IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART,12940.0,8411.0,1248.28,12940.0,35
CDM,35587WE,IN-SITU VEIN BYP POP-TIBL PRONEAL,10484.0,6814.6,999.34,10484.0,35
CDM,35600WE,OPEN HARVEST UPPER EXTREMITY ART 1 SEGMENT CAB,1580.0,1027.0,139.15,1580.0,35
CDM,35601WE,BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID,10836.0,7043.4,949.73,10836.0,35
CDM,35602WE,BPG OTH/THN VEIN CAROTID-CONTRALATERAL CAROTID,10353.0,6729.45,1325.39,10353.0,21
CDM,35606WE,BYP OTH/THN VEIN CAROTID-SUBCLAVIAN,8984.0,5839.6,879.34,8984.0,35
CDM,35612WE,BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN,8140.0,5291.0,785.38,8140.0,35
CDM,35616WE,BYP OTH/THN VEIN SUBCLAVIAN-AXILLARY,8728.0,5673.2,818.93,8728.0,35
CDM,35621WE,BYP OTH/THN VEIN AXILLARY-FEMORAL,8412.0,5467.8,819.59,8412.0,35
CDM,35623WE,BYP OTH/THN VEIN AXILLARY-POPLITEAL/-TIBIAL,10368.0,6739.2,813.82,10368.0,35
CDM,35626WE,BYPASS NOT VEIN AORTOSUBCLA/CAROTID/INNOMINATE,11656.0,7576.4,1180.63,11656.0,35
CDM,35631WE,BYP OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL,14412.0,9367.8,1142.15,14412.0,35
CDM,35633WE,BYPASS GRAFT W/OTHER THAN VEIN ILIO-MESENTERIC,15644.0,10168.6,1478.58,15644.0,35
CDM,35636WE,BYP OTH/THN VEIN SPLENORENAL,12700.0,8255.0,935.23,12700.0,35
CDM,35638WE,"BYPASS GRAFT OTHR,AORTOBI-ILIAC",13440.0,8736.0,1082.52,13440.0,35
CDM,35646WE,BYP OTH/THN VEIN AORTOBIFEMORAL,13192.0,8574.8,1257.31,13192.0,35
CDM,35647WE,BYP OTH/THN VEIN AORTOFEMORAL,11892.0,7729.8,1132.55,11892.0,35
CDM,35650WE,BYP OTH/THN VEIN AXILLARY-AXILLARY,8064.0,5241.6,766.48,8064.0,35
CDM,35654WE,BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL,10512.0,6832.8,991.88,10512.0,35
CDM,35656WE,BYP OTH/THN VEIN FEMORAL-POPLITEAL,8188.0,5322.2,801.72,8188.0,35
CDM,35661WE,BYP OTH/THN VEIN FEMORAL-FEMORAL,8140.0,5291.0,741.57,8140.0,35
CDM,35663WE,BYP OTH/THN VEIN ILIOILIAC,9572.0,6221.8,806.59,9572.0,35
CDM,35665WE,BYP OTH/THN VEIN ILIOFEMORAL,8940.0,5811.0,863.22,8940.0,35
CDM,35666WE,BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL,9464.0,6151.6,961.55,9464.0,35
CDM,35671WE,BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART,8308.0,5400.2,838.7,8308.0,35
CDM,35681WE,BYPASS COMPOSITE GRAFT PROSTHETIC & VEIN,640.0,416.0,59.24,640.0,35
CDM,35682WE,BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS,2876.0,1869.4,262.22,2876.0,35
CDM,35683WE,BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATION,3396.0,2207.4,301.43,3396.0,35
CDM,35685WE,PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT,1616.0,1050.4,147.83,1616.0,35
CDM,35686WE,CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO,1336.0,868.4,120.0,1336.0,35
CDM,35691WE,TRPOS&/RIMPLTJ VERTEBRAL CAROTID ART,7364.0,4786.6,710.57,7364.0,35
CDM,35694WE,TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART,7712.0,5012.8,742.48,7712.0,35
CDM,35695WE,TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART,8024.0,5215.6,743.63,8024.0,35
CDM,35697WE,RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART,1200.0,780.0,107.89,1200.0,35
CDM,35700WE,ROPRTJ > 1 MO AFTER ORIGINAL OPRATION,1232.0,800.8,113.11,1232.0,35
CDM,35701WE,EXPLORATION N/FLWD SURG NECK ARTERY,3300.0,2145.0,314.59,3300.0,35
CDM,35702WE,EXPLORATION N/FLWD SURG UPPER EXTREMITY ARTERY,2848.0,1851.2,310.99,2848.0,31
CDM,35703WE,EXPLORATION N/FLWD SURG LOWER EXTREMITY ARTERY,3000.0,1950.0,315.58,3000.0,31
CDM,35800WE,EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK,4800.0,3120.0,353.58,4800.0,35
CDM,35820WE,EXPL PO HEMRRG THROMBOSIS/INFCTJ CH,14756.0,9591.4,977.76,14756.0,35
CDM,35840WE,EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD,8300.0,5395.0,587.66,8300.0,35
CDM,35860WE,EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR,6100.0,3965.0,405.53,6100.0,35
CDM,35875WE,THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL,4288.0,2787.2,443.24,4288.0,35
CDM,35876WE,THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF,7128.0,4633.2,672.0,7128.0,35
CDM,35879WE,REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP,6964.0,4526.6,675.66,6964.0,35
CDM,35881WE,REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS,7740.0,5031.0,741.67,7740.0,35
CDM,35883WE,REVJ FEM ANAST BPG GRN OPN W/NONAUTOG PATCH GRF,9260.0,6019.0,776.1,9260.0,35
CDM,35884WE,"REVISE FEMORAL GRAFT, AUTOGENOUS GRAFT",9860.0,6409.0,824.28,9860.0,35
CDM,35900020,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,918.0,596.7,64.08,1746.0,49
CDM,35900030,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,2085.0,1355.25,64.08,1876.5,49
CDM,35900040,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,760.0,494.0,64.08,1746.0,50
CDM,35900050,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1795.0,1166.75,106.1,1746.0,30
CDM,35900060,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,708.0,460.2,34.79,1746.0,30
CDM,35900070,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1795.0,1166.75,106.1,1746.0,30
CDM,35900330,CT CALCIUM SCORING - SELF PAY,760.0,494.0,64.08,1746.0,50
CDM,35901WE,"EXCISION, INFEC GRAFT, NECK",3352.0,2178.8,360.77,3352.0,35
CDM,35903WE,"EXCISION, INFEC GRAFT, EXTREMITY",3812.0,2477.8,423.84,3812.0,35
CDM,35905WE,"EXCISION, INFEC GRAFT, THORAX",13408.0,8715.2,1044.11,13408.0,35
CDM,35907WE,"EXCISION, INFEC GRAFT, ABDOMEN",14908.0,9690.2,1149.42,14908.0,35
CDM,36000015,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,11516.0,7485.4,1934.69,10364.4,30
CDM,36000030,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,9916.0,6445.4,163.56,8924.4,49
CDM,36000040,TRACHEOBRNCHSC THRU EST TRACHS INC,2929.0,1903.85,134.12,6317.0,48
CDM,36000050,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,9916.0,6445.4,164.87,8924.4,49
CDM,36000060,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,9916.0,6445.4,194.29,8924.4,49
CDM,36000070,BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX,21200.0,13780.0,241.57,19080.0,42
CDM,36000080,THORACENTESIS FOR ASPIRATION,867.0,563.55,145.66,780.3,21
CDM,36000090,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,20293.0,13190.45,247.1,18263.7,42
CDM,36000100,TUBE THORACOSTOMY INCLUDES WATER SEAL,8933.0,5806.45,191.38,8370.0,49
CDM,36000120,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,21200.0,13780.0,233.07,19080.0,49
CDM,36000140,PLC NDL WIRE BREAST,810.0,526.5,136.08,729.0,21
CDM,36000150,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,21200.0,13780.0,219.98,19080.0,49
CDM,36000160,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1335.0,867.75,181.19,4151.0,49
CDM,36000170,TUBE THORACOSTOMY INCLUDES WATER SEAL,8933.0,5806.45,191.38,8370.0,49
CDM,36000180,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,11165.0,7257.25,78.99,10048.5,49
CDM,36000190,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,9916.0,6445.4,217.13,8924.4,49
CDM,36000210,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,9916.0,6445.4,166.71,8924.4,49
CDM,36000230,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,1116.0,725.4,78.52,4151.0,49
CDM,36000240,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,3923.0,2549.95,297.94,46695.0,32
CDM,36000250,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,2758.0,1792.7,56.89,3920.0,38
CDM,36000260,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,9548.0,6206.2,324.04,8593.2,38
CDM,36000265,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,2639.0,1715.35,163.62,4151.0,49
CDM,36000270,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,5656.0,3676.4,297.53,5090.4,38
CDM,36000280,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,5016.0,3260.4,279.75,4514.4,38
CDM,36000285,I&D HEMATOMA SEROMA/FLUID COLLECTION,6076.0,3949.4,147.52,5468.4,49
CDM,36000290,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,1060.0,689.0,57.98,3920.0,38
CDM,36000295,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1499.0,974.35,98.33,4151.0,49
CDM,36000300,INTRODUCTION CATHETER AORTA,3844.0,2498.6,164.27,3920.0,38
CDM,36000305,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,1499.0,974.35,73.55,4214.0,49
CDM,36000310,PLC TXCATH STENT PERC ADD,11370.0,7390.5,1910.16,10233.0,21
CDM,36000320,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,6836.0,4443.4,354.59,6152.4,38
CDM,36000330,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1861.0,1209.65,57.95,3920.0,38
CDM,36000340,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,9381.0,6097.65,256.22,8442.9,38
CDM,36000350,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,10156.0,6601.4,390.0,9140.4,38
CDM,36000375,PUNCTURE ASPIRATION CYST BREAST,2639.0,1715.35,50.26,4151.0,49
CDM,36000385,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,321.0,208.65,25.04,3920.0,38
CDM,36000395,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,608.0,395.2,89.99,3920.0,38
CDM,36000410,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,22623.0,14704.95,106.52,20360.7,49
CDM,36000420,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,1238.0,804.7,61.88,3920.0,38
CDM,36000430,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,32690.0,21248.5,388.55,29421.0,42
CDM,36000440,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,33489.0,21767.85,421.12,30140.1,42
CDM,36000450,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,38396.0,24957.4,422.66,34556.4,42
CDM,36000460,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,26158.0,17002.7,551.48,36332.0,49
CDM,36000465,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,9316.0,6055.4,68.63,8384.4,49
CDM,36000475,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,9316.0,6055.4,104.99,8384.4,49
CDM,36000480,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,34699.0,22554.35,545.53,31229.1,42
CDM,36000485,BIOPSY BONE TROCAR/NEEDLE DEEP,9316.0,6055.4,155.38,8384.4,49
CDM,36000490,PLC TXCATH STENT PERC INIT,12932.0,8405.8,2172.58,11638.8,21
CDM,36000495,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,8518.0,5536.7,107.66,7666.2,49
CDM,36000500,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,26158.0,17002.7,726.96,36332.0,49
CDM,36000510,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,59484.0,38664.6,266.09,53535.6,49
CDM,36000515,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,1698.0,1103.7,45.97,3920.0,49
CDM,36000520,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,70055.0,45535.75,1032.4,76175.0,42
CDM,36000525,INJECTION SINGLE TENDON ORIGIN/INSERTION,1698.0,1103.7,45.78,3920.0,49
CDM,36000530,RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER,2217.0,1441.05,372.46,1995.3,21
CDM,36000535,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1698.0,1103.7,47.54,3920.0,49
CDM,36000540,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,26158.0,17002.7,248.83,36332.0,49
CDM,36000545,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,1698.0,1103.7,42.6,3920.0,49
CDM,36000550,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,36888.0,23977.2,579.44,39131.0,42
CDM,36000555,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1698.0,1103.7,43.64,3920.0,49
CDM,36000560,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,32059.0,20838.35,590.0,39131.0,42
CDM,36000565,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1698.0,1103.7,52.83,3920.0,49
CDM,36000570,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,59484.0,38664.6,193.69,53535.6,42
CDM,36000575,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,1698.0,1103.7,48.88,3920.0,49
CDM,36000580,INS PM PLS GEN W/EXIST SINGLE LEAD,28421.0,18473.65,373.11,25578.9,42
CDM,36000590,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,32231.0,20950.15,547.29,39131.0,42
CDM,36000600,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,22623.0,14704.95,353.58,36332.0,49
CDM,36000605,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,73984.0,48089.6,436.1,66585.6,42
CDM,36000610,BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT,39804.0,25872.6,274.22,35823.6,42
CDM,36000615,PROC MUSSKL SYS UNLISTD,2797.0,1818.05,240.79,8370.0,48
CDM,36000620,IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER,7244.0,4708.6,1216.99,6519.6,21
CDM,36000625,BIOPSY SOFT TISSUE NECK/THORAX,9316.0,6055.4,183.07,8384.4,49
CDM,36000630,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,26158.0,17002.7,916.39,36332.0,49
CDM,36000640,RELOCATION OF SKIN POCKET FOR PACEMAKER,13148.0,8546.2,391.36,11833.2,49
CDM,36000650,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,13148.0,8546.2,465.79,11833.2,49
CDM,36000660,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,20768.0,13499.2,520.45,39131.0,31
CDM,36000670,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,22623.0,14704.95,555.28,36332.0,49
CDM,36000680,INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD,62500.0,40625.0,412.38,76175.0,42
CDM,36000690,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,33616.0,21850.4,516.47,30254.4,42
CDM,36000700,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,26158.0,17002.7,443.48,36332.0,49
CDM,36000710,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,1734.0,1127.1,39.41,46695.0,32
CDM,36000730,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,3801.0,2470.65,129.05,3920.0,38
CDM,36000740,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,4501.0,2925.65,186.1,4050.9,38
CDM,36000750,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,4880.0,3172.0,208.76,4392.0,38
CDM,36000760,INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY,4571.0,2971.15,105.67,4113.9,38
CDM,36000770,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,59484.0,38664.6,187.2,53535.6,42
CDM,36000775,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,951.0,618.15,59.24,3920.0,38
CDM,36000785,INJECTION ELBOW ARTHROGRAPHY,553.0,359.45,78.41,3920.0,38
CDM,36000790,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,3678.0,2390.7,152.85,3920.0,38
CDM,36000795,INJECTION WRIST ARTHROGRAPHY,796.0,517.4,86.05,3920.0,38
CDM,36000800,RTREV TXCATH INTRVAS FB,3898.0,2533.7,654.86,3508.2,21
CDM,36000815,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,910.0,591.5,79.74,3920.0,38
CDM,36000830,PERFUSION EA ADD 30 MIN,1418.0,921.7,238.22,1276.2,21
CDM,36000840,SURGERY LEVEL 6 EA ADD 30 MIN,7976.0,5184.4,1339.97,7178.4,21
CDM,36000845,INJECTION ANKLE ARTHROGRAPHY,814.0,529.1,59.59,3920.0,38
CDM,36000850,DRESSING CHANGE UNDER ANESTHESIA,1215.0,789.75,52.95,3920.0,48
CDM,36000860,SURGERY LEVEL 2 1ST 30 MIN,5230.0,3399.5,878.64,4707.0,21
CDM,36000870,SURGERY LEVEL 4 1ST 30 MIN,7233.0,4701.45,1215.14,6509.7,21
CDM,36000880,SURGERY LEVEL 5 1ST 30 MIN,7464.0,4851.6,1253.95,6717.6,21
CDM,36000890,SURGERY LEVEL 6 1ST 30 MIN,7976.0,5184.4,1339.97,7178.4,21
CDM,36000900,SURGERY LEVEL 1 EA ADD 30 MIN,4234.0,2752.1,711.31,3810.6,21
CDM,36000910,SURGERY LEVEL 2 EA ADD 30 MIN,4856.0,3156.4,815.81,4370.4,21
CDM,36000920,SURGERY LEVEL 3 EA ADD 30 MIN,5918.0,3846.7,994.22,5326.2,21
CDM,36000930,SURGERY LEVEL 4 EA ADD 30 MIN,7233.0,4701.45,1215.14,6509.7,21
CDM,36000985,BIOPSY PLEURA PERCUTANEOUS NEEDLE,9316.0,6055.4,102.06,8384.4,49
CDM,36000990,SURGERY LEVEL 5 EA ADD 30 MIN,7464.0,4851.6,1253.95,6717.6,21
CDM,36000WE,INTRODUCTION NEEDLE/INTRACATHETER VEIN,72.0,46.8,6.97,54.0,24
CDM,36001000,PERFUSION INIT HOUR,12326.0,8011.9,2070.77,11093.4,21
CDM,36001015,SURGERY LEVEL 2 1ST 30 MIN ASC,5230.0,3399.5,878.64,4707.0,21
CDM,36001020,BIOPSY BONE TROCAR/NEEDLE DEEP,9316.0,6055.4,155.38,8384.4,49
CDM,36001025,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,20293.0,13190.45,247.1,18263.7,42
CDM,36001030,CELL SAVER EA ADD 15 MIN,190.0,123.5,31.92,171.0,21
CDM,36001040,CELL SAVER INIT HOUR,3641.0,2366.65,611.69,3276.9,21
CDM,36001045,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,3555.0,2310.75,192.55,4151.0,48
CDM,36001050,SURGERY LEVEL 1 1ST 30 MIN,4243.0,2757.95,712.82,3818.7,21
CDM,36001055,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,3555.0,2310.75,109.61,4268.0,48
CDM,36001065,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,3555.0,2310.75,132.14,4268.0,48
CDM,36001075,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,10908.0,7090.2,152.72,9817.2,49
CDM,36001080,SURGERY LEVEL 3 1ST 30 MIN,5918.0,3846.7,994.22,5326.2,21
CDM,36001085,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,8933.0,5806.45,181.46,8039.7,49
CDM,36001095,SURGERY LEVEL 4 1ST 30 MIN ASC,6469.0,4204.85,1086.79,5822.1,21
CDM,36001115,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,33548.0,21806.2,531.35,30193.2,42
CDM,36001125,SURGERY LEVEL 5 1ST 30 MIN ASC,7269.0,4724.85,1221.19,6542.1,21
CDM,36001145,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,33616.0,21850.4,516.47,30254.4,42
CDM,36001155,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,34699.0,22554.35,545.53,31229.1,42
CDM,36001160,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,18098.0,11763.7,262.69,36332.0,49
CDM,36001165,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,32059.0,20838.35,590.0,39131.0,42
CDM,36001170,AUTOTRN TECH,1690.0,1098.5,283.92,1521.0,21
CDM,36001175,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,59484.0,38664.6,187.2,53535.6,42
CDM,36001185,SURGERY LEVEL 1 EA ADD 30 MIN ASC,3124.0,2030.6,524.83,2811.6,21
CDM,36001200,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,2384.0,1549.6,55.93,3920.0,49
CDM,36001205,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,32690.0,21248.5,388.55,29421.0,42
CDM,36001210,NJX RETROGRADE URETHROCSTOGRAPY,1669.0,1084.85,76.53,4268.0,38
CDM,36001215,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,32231.0,20950.15,547.29,39131.0,42
CDM,36001220,INJ PX CHOLANGIOGRAPHY VIA CATHETER/T-TUBE,703.0,456.95,118.1,632.7,21
CDM,36001225,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,22623.0,14704.95,353.58,36332.0,49
CDM,36001230,BX BRS NEED GUI,1421.0,923.65,238.73,1278.9,21
CDM,36001235,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,38396.0,24957.4,422.66,34556.4,42
CDM,36001240,BX BRS PERC W/DV,3690.0,2398.5,619.92,3321.0,21
CDM,36001245,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,33489.0,21767.85,421.12,30140.1,42
CDM,36001250,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,1698.0,1103.7,42.6,3920.0,49
CDM,36001255,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,26158.0,17002.7,443.48,36332.0,49
CDM,36001260,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1698.0,1103.7,43.64,3920.0,49
CDM,36001265,RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB,26158.0,17002.7,436.45,36332.0,49
CDM,36001270,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,1310.0,851.5,52.31,4151.0,38
CDM,36001275,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,56296.0,36592.4,407.68,50666.4,42
CDM,36001280,INJECTION WRIST ARTHROGRAPHY,796.0,517.4,86.05,3920.0,38
CDM,36001285,RELOCATION OF SKIN POCKET FOR PACEMAKER,13148.0,8546.2,391.36,11833.2,49
CDM,36001290,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,2410.0,1566.5,100.04,18285.0,39
CDM,36001295,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,13148.0,8546.2,465.79,11833.2,49
CDM,36001300,BIOPSY BONE TROCAR/NEEDLE DEEP,9316.0,6055.4,155.38,8384.4,49
CDM,36001305,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,36888.0,23977.2,579.44,39131.0,42
CDM,36001310,INJECTION ANKLE ARTHROGRAPHY,814.0,529.1,59.59,3920.0,38
CDM,36001315,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,20768.0,13499.2,520.45,39131.0,31
CDM,36001320,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,608.0,395.2,89.99,3920.0,38
CDM,36001330,INJECTION ELBOW ARTHROGRAPHY,553.0,359.45,78.41,3920.0,38
CDM,36001335,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,26869.0,17464.85,386.45,24182.1,42
CDM,36001340,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,910.0,591.5,79.74,3920.0,38
CDM,36001345,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,33420.0,21723.0,403.75,30078.0,42
CDM,36001355,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,53705.0,34908.25,422.66,48334.5,42
CDM,36001360,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,1974.0,1283.1,98.4,3920.0,38
CDM,36001365,SURGERY LEVEL 3 EA ADD 30 MIN ASC,4789.0,3112.85,804.55,4310.1,21
CDM,36001370,INJECTION PROCEDURE SIALOGRAPHY,247.0,160.55,41.5,36332.0,38
CDM,36001380,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,951.0,618.15,59.24,3920.0,38
CDM,36001385,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,59484.0,38664.6,266.09,53535.6,49
CDM,36001390,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,1039.0,675.35,67.55,36332.0,38
CDM,36001395,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,26158.0,17002.7,551.48,36332.0,49
CDM,36001400,THORA W INS TUBE,1786.0,1160.9,300.05,1607.4,21
CDM,36001405,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,26158.0,17002.7,726.96,36332.0,49
CDM,36001410,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,5391.0,3504.15,22.93,6289.0,49
CDM,36001415,SURGERY LEVEL 4 EA ADD 30 MIN ASC,5371.0,3491.15,902.33,4833.9,21
CDM,36001420,PLC BREAST CLIP PERC,692.0,449.8,116.26,622.8,21
CDM,36001425,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,26158.0,17002.7,248.83,36332.0,49
CDM,36001430,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,1399.0,909.35,121.48,6317.0,49
CDM,36001435,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,26158.0,17002.7,916.39,36332.0,49
CDM,36001440,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,2546.0,1654.9,134.17,6317.0,49
CDM,36001445,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,70055.0,45535.75,1032.4,76175.0,42
CDM,36001450,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,5973.0,3882.45,77.17,5375.7,49
CDM,36001455,RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD,52578.0,34175.7,422.44,76175.0,42
CDM,36001460,PLC NDL WIRE BREAST,813.0,528.45,136.58,731.7,21
CDM,36001465,RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD,50610.0,32896.5,439.54,70939.0,42
CDM,36001470,PLC NDL WIRE BREAST ADD,448.0,291.2,75.26,403.2,21
CDM,36001475,RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD,65906.0,42838.9,456.66,76175.0,42
CDM,36001480,INJECTION SINUS TRACT DIAGNOSTIC,1348.0,876.2,43.91,4151.0,38
CDM,36001500,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,826.0,536.9,45.01,4214.0,38
CDM,36001510,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,9316.0,6055.4,68.63,8384.4,49
CDM,36001515,SURGERY LEVEL 5 EA ADD 30 MIN ASC,6208.0,4035.2,1042.94,5587.2,21
CDM,36001540,DRN PERC RENAL ABSCESS,2522.0,1639.3,423.7,2269.8,21
CDM,36001545,SURGERY LEVEL 1 1ST 30 MIN ASC,4243.0,2757.95,712.82,3818.7,21
CDM,36001550,DRN PERITON ABSCESS PERC,2522.0,1639.3,423.7,2269.8,21
CDM,36001560,INTRO INTRACATH/CATH IN RNL PELVIS DRG&/NJX PRQ,2109.0,1370.85,354.31,1898.1,21
CDM,36001565,SURGERY LEVEL 3 1ST 30 MIN ASC,5894.0,3831.1,990.19,5304.6,21
CDM,36001570,DRN LIVER ABSCESS/LESION PERC,2522.0,1639.3,423.7,2269.8,21
CDM,36001575,SURGERY LEVEL 6 EA ADD 30 MIN ASC,3458.0,2247.7,580.94,3112.2,21
CDM,36001585,SURGERY LEVEL 6 1ST 30 MIN ASC,3458.0,2247.7,580.94,3112.2,21
CDM,36001590,BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,39804.0,25872.6,269.26,35823.6,42
CDM,36001595,SURGERY LEVEL 2 EA ADD 30 MIN ASC,4104.0,2667.6,689.47,3693.6,21
CDM,36001600,BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE,13975.0,9083.75,308.55,12577.5,49
CDM,36001605,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,3923.0,2549.95,297.94,46695.0,32
CDM,36001610,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,8101.0,5265.65,102.26,7290.9,49
CDM,36001620,BIOPSY LIVER NEEDLE PERCUTANEOUS,9316.0,6055.4,104.99,8384.4,49
CDM,36001625,INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY,9876.0,6419.4,414.73,23296.25,32
CDM,36001630,BIOPSY PANCREA PERCUTANEOUS NEEDLE,9316.0,6055.4,283.37,8384.4,49
CDM,36001640,DIAGNOSTIC BONE MARROW BIOPSIES,8101.0,5265.65,80.14,7290.9,49
CDM,36001645,REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ,5570.0,3620.5,218.28,18285.0,32
CDM,36001650,BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE,1782.0,1158.3,299.38,1603.8,27
CDM,36001660,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,3518.0,2286.7,91.56,4151.0,49
CDM,36001670,BIOPSY PLEURA PERCUTANEOUS NEEDLE,9316.0,6055.4,102.06,8384.4,49
CDM,36001680,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,9316.0,6055.4,104.99,8384.4,49
CDM,36001690,BIOPSY BONE TROCAR/NEEDLE DEEP,9316.0,6055.4,155.38,8384.4,49
CDM,36001700,ABLTJ 1/> LVR TUM PRQ RF,33548.0,21806.2,892.23,30193.2,42
CDM,36001710,DRN APPENDICEAL ABSCESS,3690.0,2398.5,619.92,3321.0,21
CDM,36001720,RENAL BIOPSY PRQ TROCAR/NEEDLE,9316.0,6055.4,151.39,8384.4,49
CDM,36001730,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,9316.0,6055.4,831.56,8384.4,49
CDM,36001740,UNLISTED PROCEDURE URINARY SYSTEM,346.0,224.9,97.23,6317.0,48
CDM,36001750,DRG PRIVESICAL/PREVESICAL SPACE ABSC,16456.0,10696.4,498.51,14810.4,49
CDM,36001760,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,32064.0,20841.6,550.27,28857.6,42
CDM,36001770,DRAINAGE PERIRENAL/RENAL ABSCESS OPEN,11779.0,7656.35,1228.71,10601.1,42
CDM,36001780,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,18098.0,11763.7,262.69,36332.0,49
CDM,36001800,DRAINAGE OF RETROPERITONEAL ABSCESS OPEN,2460.0,1599.0,413.28,18285.0,32
CDM,36001810,DRAINAGE SUBDIAPHRAGMATIC/SUBPHREN ABSCESS OPEN,2460.0,1599.0,413.28,18285.0,32
CDM,36001820,DRAINAGE PERITON ABSCESS/LOCAL PERITONITIS OPEN,2627.0,1707.55,441.34,18285.0,32
CDM,36001825,INTRODUCTION NEEDLE/INTRACATHETER VEIN,308.0,200.2,44.56,3920.0,37
CDM,36001830,HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES,2460.0,1599.0,413.28,18285.0,39
CDM,36001840,THORA W INS TUBE,1786.0,1160.9,300.05,1607.4,21
CDM,36001845,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,2758.0,1792.7,56.89,3920.0,38
CDM,36001850,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,16456.0,10696.4,605.45,14810.4,49
CDM,36001855,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,3801.0,2470.65,129.05,3920.0,38
CDM,36001860,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,9316.0,6055.4,235.47,8384.4,49
CDM,36001865,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,4501.0,2925.65,186.1,4050.9,38
CDM,36001870,PERQ VERTEBRAL AUGMENTATION EA ADDL THRC/LMBR,11928.0,7753.2,2003.9,10735.2,21
CDM,36001875,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,4880.0,3172.0,208.76,4392.0,38
CDM,36001880,PERCUTANEOUS VERTEBRAL AUGMENTATION LUMBAR,11928.0,7753.2,2003.9,10735.2,21
CDM,36001890,PERCUTANEOUS VERTEBRAL AUGMENTATION THORACIC,11928.0,7753.2,2003.9,10735.2,21
CDM,36001895,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,3469.0,2254.85,178.77,3920.0,38
CDM,36001900,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,73984.0,48089.6,436.1,66585.6,42
CDM,36001905,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,4031.0,2620.15,205.93,3920.0,38
CDM,36001910,EXCHNG ABSC/CST DRG CATH RAD GID SPX,10908.0,7090.2,85.11,9817.2,49
CDM,36001920,DRN SUBDIPHRGMC ABSCESS PERC,2522.0,1639.3,423.7,2269.8,21
CDM,36001925,INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY,4571.0,2971.15,105.67,4113.9,38
CDM,36001930,DRN PELV ABSCESS PERC,3583.0,2328.95,601.94,3224.7,21
CDM,36001940,DRN EXTRNL PANC PSEUDCYST,2522.0,1639.3,423.7,2269.8,21
CDM,36001950,TRANSRECTAL DRAINAGE OF PELVIC ABSCESS,6780.0,4407.0,524.76,36332.0,49
CDM,36001960,ASPIRATION BLADDER NEEDLE,1399.0,909.35,46.78,3920.0,49
CDM,36001965,INTRODUCTION CATHETER AORTA,3844.0,2498.6,164.27,3920.0,38
CDM,36001970,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,9316.0,6055.4,100.15,8384.4,49
CDM,36001975,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,9381.0,6097.65,256.22,8442.9,38
CDM,36001980,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,4046.0,2629.9,113.54,6317.0,49
CDM,36001985,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,9548.0,6206.2,324.04,8593.2,38
CDM,36001990,I&D HEMATOMA SEROMA/FLUID COLLECTION,6076.0,3949.4,147.52,5468.4,49
CDM,36001995,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,10156.0,6601.4,390.0,9140.4,38
CDM,36002000,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,745.0,484.25,98.33,4151.0,49
CDM,36002005,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,1238.0,804.7,61.88,3920.0,38
CDM,36002015,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,22623.0,14704.95,236.54,20360.7,42
CDM,36002020,PERCUTANEOUS VERTEBROPLASTY EA ADDL THRC/LMBR,3469.0,2254.85,582.79,3122.1,21
CDM,36002025,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,22623.0,14704.95,330.9,20360.7,42
CDM,36002030,PERCUTANEOUS VERTEBROPLASTY LUMBAR W/WO BNE BX,5334.0,3467.1,896.11,4800.6,21
CDM,36002035,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,38854.0,25255.1,398.36,34968.6,42
CDM,36002040,PERCUTANEOUS VERTEBROPLSTY THORACIC W/WO BONE BX,5334.0,3467.1,896.11,4800.6,21
CDM,36002045,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,38854.0,25255.1,447.73,34968.6,42
CDM,36002050,BIOPSY SALIVARY GLAND NEEDLE,4046.0,2629.9,62.36,4151.0,49
CDM,36002055,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,22623.0,14704.95,394.12,20360.7,42
CDM,36002060,PNEUMONSTMY W PERC DRN,1229.0,798.85,206.47,1106.1,21
CDM,36002065,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,38854.0,25255.1,442.82,34968.6,42
CDM,36002075,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,8083.0,5253.95,146.44,7274.7,31
CDM,36002080,PUNCTURE ASPIRATION CYST BREAST,2639.0,1715.35,50.26,4151.0,49
CDM,36002085,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,7308.0,4750.2,308.39,6577.2,31
CDM,36002095,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,5016.0,3260.4,279.75,4514.4,38
CDM,36002100,PNEUMONSTMY W PERC DRN,1229.0,798.85,206.47,1106.1,21
CDM,36002105,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,5656.0,3676.4,297.53,5090.4,38
CDM,36002115,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,6836.0,4443.4,354.59,6152.4,38
CDM,36002120,FINE NEEDLE ASPIRATION WITH IMAGING GUIDANCE,890.0,578.5,149.52,801.0,21
CDM,36002125,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,1060.0,689.0,57.98,3920.0,38
CDM,36002135,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,22623.0,14704.95,303.79,20360.7,49
CDM,36002145,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,22623.0,14704.95,411.79,20360.7,49
CDM,36002150,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,9316.0,6055.4,68.63,8384.4,49
CDM,36002155,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,38854.0,25255.1,425.5,34968.6,49
CDM,36002160,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,4444.0,2888.6,124.03,4151.0,48
CDM,36002170,BIOPSY PANCREA PERCUTANEOUS NEEDLE,9316.0,6055.4,283.37,8384.4,49
CDM,36002180,EXCHNG ABSC/CST DRG CATH RAD GID SPX,10908.0,7090.2,85.11,9817.2,49
CDM,36002190,RENAL BIOPSY PRQ TROCAR/NEEDLE,9316.0,6055.4,151.39,8384.4,49
CDM,36002210,SURGERY 1 HOUR,9165.0,5957.25,1539.72,8248.5,21
CDM,36002230,DRN PERCUT ABSCESS,2522.0,1639.3,423.7,2269.8,21
CDM,36002235,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,1709.0,1110.85,287.11,3920.0,38
CDM,36002240,PERC DRN LIVER ABSC/,2522.0,1639.3,423.7,2269.8,21
CDM,36002245,VEN CATHJ SLCTV ORGAN BLD SAMPLING,2075.0,1348.75,215.2,3920.0,38
CDM,36002250,DRN RENAL ABSC PERC,2522.0,1639.3,423.7,2269.8,21
CDM,36002255,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,22623.0,14704.95,106.52,20360.7,49
CDM,36002260,BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE,1782.0,1158.3,299.38,1603.8,27
CDM,36002275,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,22623.0,14704.95,310.73,20360.7,42
CDM,36002280,BIOPSY SOFT TISSUE NECK/THORAX,9316.0,6055.4,183.07,8384.4,49
CDM,36002285,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,22623.0,14704.95,396.78,20360.7,42
CDM,36002290,DRN EXTRNL PANC PSEUDCYST,2522.0,1639.3,423.7,2269.8,21
CDM,36002300,DRN PELVIC ABSC P,3583.0,2328.95,601.94,3224.7,21
CDM,36002305,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,22623.0,14704.95,406.29,20360.7,42
CDM,36002320,DRN PERC RETPERITONL ABSCESS,2522.0,1639.3,423.7,2269.8,21
CDM,36002335,INSERTION PICC W/O IMG GDN 5 YR/>,11165.0,7257.25,116.38,10048.5,49
CDM,36002340,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,341.0,221.65,18.23,3920.0,49
CDM,36002345,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,22623.0,14704.95,377.73,20360.7,42
CDM,36002355,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,4444.0,2888.6,41.1,6289.0,48
CDM,36002360,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1499.0,974.35,98.33,4151.0,49
CDM,36002370,BRST NDL ADD LS,448.0,291.2,75.26,403.2,21
CDM,36002375,RPLCMT CATH CTR VAD SUBQ PORT/PMP,22623.0,14704.95,243.92,20360.7,42
CDM,36002380,BX BREAST PERC W DVC W IMAGE,3690.0,2398.5,619.92,3321.0,21
CDM,36002385,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,11165.0,7257.25,78.99,10048.5,49
CDM,36002390,TRANSCATHETER BIOPSY,38854.0,25255.1,260.94,34968.6,42
CDM,36002395,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,22623.0,14704.95,220.17,20360.7,42
CDM,36002400,BX BREAST PERC W IMAGE GUIDE,1425.0,926.25,239.4,1282.5,21
CDM,36002405,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,22623.0,14704.95,342.53,20360.7,42
CDM,36002410,ASPIRATION AND/OR INJECTION THYROID CYST,3518.0,2286.7,58.07,4151.0,49
CDM,36002425,COMPLETE REPLACEMENT PICC RS&I,11165.0,7257.25,70.91,10048.5,49
CDM,36002435,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,22623.0,14704.95,370.78,20360.7,42
CDM,36002445,RMVL TUN CVC W/O SUBQ PORT/PMP,4444.0,2888.6,164.43,6289.0,48
CDM,36002455,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,11165.0,7257.25,225.25,10048.5,49
CDM,36002460,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,2009.0,1305.85,38.23,3920.0,49
CDM,36002470,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,22623.0,14704.95,377.73,20360.7,42
CDM,36002475,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,22623.0,14704.95,217.89,20360.7,42
CDM,36002480,INSERTION PICC W/O IMG GDN 5 YR/>,11165.0,7257.25,116.38,10048.5,49
CDM,36002485,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,11165.0,7257.25,54.04,10048.5,49
CDM,36002490,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,38854.0,25255.1,437.08,34968.6,42
CDM,36002495,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,11165.0,7257.25,72.16,10048.5,49
CDM,36002500,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,22623.0,14704.95,406.29,20360.7,42
CDM,36002505,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,1514.0,984.1,42.88,4151.0,49
CDM,36002510,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,22623.0,14704.95,310.73,20360.7,42
CDM,36002515,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1861.0,1209.65,57.95,3920.0,38
CDM,36002520,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,22623.0,14704.95,396.78,20360.7,42
CDM,36002530,INSJ TUNNELED CTR VAD W/SUBQ PUMP,38854.0,25255.1,438.02,34968.6,42
CDM,36002540,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,4444.0,2888.6,41.1,6289.0,48
CDM,36002550,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,11165.0,7257.25,220.84,10048.5,49
CDM,36002555,INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT,21414.0,13919.1,984.02,21057.68,35
CDM,36002560,RPLCMT CATH CTR VAD SUBQ PORT/PMP,22623.0,14704.95,243.92,20360.7,42
CDM,36002565,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,25485.0,16565.25,451.16,22936.5,42
CDM,36002570,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,11165.0,7257.25,78.99,10048.5,49
CDM,36002575,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,63035.0,40972.75,508.93,56731.5,42
CDM,36002580,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,22623.0,14704.95,220.17,20360.7,42
CDM,36002590,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,22623.0,14704.95,342.53,20360.7,42
CDM,36002600,RPLCMT COMPL TUN CTR VAD W/SUBQ PMP,38854.0,25255.1,398.22,34968.6,42
CDM,36002605,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,37218.0,24191.7,469.64,33496.2,42
CDM,36002610,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,22623.0,14704.95,370.78,20360.7,42
CDM,36002615,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,22623.0,14704.95,335.67,20360.7,42
CDM,36002620,RMVL TUN CVC W/O SUBQ PORT/PMP,4444.0,2888.6,164.43,6289.0,48
CDM,36002625,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,22974.0,14933.1,263.36,20676.6,42
CDM,36002630,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,11165.0,7257.25,225.25,10048.5,49
CDM,36002640,COMPLETE REPLACEMENT PICC RS&I,11165.0,7257.25,70.91,10048.5,49
CDM,36002645,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,22623.0,14704.95,415.85,20360.7,42
CDM,36002650,CHANGE PERCUTANEOUS BILIARY DRAINAGE CATHETER,3095.0,2011.75,519.96,2785.5,21
CDM,36002655,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,22623.0,14704.95,359.58,20360.7,42
CDM,36002665,TRANSCATHETER BIOPSY,38854.0,25255.1,260.94,34968.6,42
CDM,36002690,CHG INTRVAS C,3738.0,2429.7,627.98,3364.2,21
CDM,36002710,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,11779.0,7656.35,93.26,10601.1,49
CDM,36002720,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,35879.0,23321.35,353.76,32291.1,42
CDM,36002730,INJECTION SINUS TRACT DIAGNOSTIC,1348.0,876.2,43.91,4151.0,38
CDM,36002740,INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX,406.0,263.9,68.21,4214.0,38
CDM,36002750,INJECTION PROCEDURE LYMPHANGIOGRAPHY,4696.0,3052.4,98.49,4226.4,38
CDM,36002755,THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX,38854.0,25255.1,457.76,34968.6,49
CDM,36002760,INJECTION PX PRQ TRANSHEPATIC CHOLANGIOGRAPHY,1125.0,731.25,189.0,1012.5,21
CDM,36002765,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,22623.0,14704.95,401.13,20360.7,49
CDM,36002770,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,8101.0,5265.65,102.26,7290.9,49
CDM,36002775,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,22623.0,14704.95,276.29,36332.0,49
CDM,36002780,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,20293.0,13190.45,387.96,18263.7,42
CDM,36002785,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,22623.0,14704.95,145.66,36332.0,49
CDM,36002790,RENAL BIOPSY PRQ TROCAR/NEEDLE,9316.0,6055.4,151.39,8384.4,49
CDM,36002795,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,26835.0,17442.75,1165.81,24151.5,32
CDM,36002800,INTRO GUIDE PELVIS&/URETER W/DILAT NFROS TRACT,5529.0,3593.85,928.87,4976.1,21
CDM,36002805,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,24600.0,15990.0,1940.0,22140.0,31
CDM,36002820,DRN PERC RENAL ABSCESS,2522.0,1639.3,423.7,2269.8,21
CDM,36002830,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,4046.0,2629.9,113.54,6317.0,49
CDM,36002840,DRN PERITON ABSCESS PERC,2522.0,1639.3,423.7,2269.8,21
CDM,36002860,INJECTION PROCEDURE PYELOGRAPHY VIA TUBE/CATH,845.0,549.25,141.96,760.5,21
CDM,36002870,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,11779.0,7656.35,171.65,13665.0,49
CDM,36002880,DRN LIVER ABSCESS/LESION PERC,2522.0,1639.3,423.7,2269.8,21
CDM,36002890,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,25485.0,16565.25,451.16,22936.5,42
CDM,36002910,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,4031.0,2620.15,205.93,3920.0,38
CDM,36002920,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,26835.0,17442.75,1165.81,24151.5,32
CDM,36002930,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,24600.0,15990.0,1940.0,22140.0,31
CDM,36002940,ABLTJ 1/> LVR TUM PRQ RF,33548.0,21806.2,892.23,30193.2,42
CDM,36002950,CHANGE NEPHROSTOMY/PYELOSTOMY TUBE,2109.0,1370.85,354.31,1898.1,21
CDM,36002960,EMBLIZ UTERINE FIBROID,12932.0,8405.8,2172.58,11638.8,21
CDM,36002990,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,9316.0,6055.4,104.99,8384.4,49
CDM,36002WE,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,784.0,509.6,55.12,588.0,35
CDM,36003020,BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE,1782.0,1158.3,299.38,1603.8,27
CDM,36003025,DIAGNOSTIC BONE MARROW BIOPSIES,8101.0,5265.65,80.14,7290.9,49
CDM,36003030,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,9316.0,6055.4,68.63,8384.4,49
CDM,36003035,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,8101.0,5265.65,102.26,7290.9,49
CDM,36003040,BIOPSY PANCREA PERCUTANEOUS NEEDLE,9316.0,6055.4,283.37,8384.4,49
CDM,36003045,INJECTION PROCEDURE LYMPHANGIOGRAPHY,4696.0,3052.4,98.49,4226.4,38
CDM,36003050,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,33548.0,21806.2,531.35,30193.2,42
CDM,36003060,BIOPSY EPIDIDYMIS NEEDLE,9316.0,6055.4,151.03,8384.4,49
CDM,36003070,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,7679.0,4991.35,109.08,6911.1,49
CDM,36003080,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,2171.0,1411.15,61.24,4214.0,38
CDM,36003090,DRN PELV ABSCESS PERC,3583.0,2328.95,601.94,3224.7,21
CDM,36003110,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,1910.0,1241.5,184.81,3920.0,38
CDM,36003125,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,2295.0,1491.75,47.97,4151.0,49
CDM,36003130,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,745.0,484.25,98.33,4151.0,49
CDM,36003145,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,1399.0,909.35,121.48,6317.0,49
CDM,36003150,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,3469.0,2254.85,178.77,3920.0,38
CDM,36003170,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,61270.0,39825.5,693.16,55143.0,42
CDM,36003175,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,5391.0,3504.15,22.93,6289.0,49
CDM,36003180,CHANGE CYSTOSTOMY TUBE SIMPLE,1399.0,909.35,53.02,4151.0,49
CDM,36003190,INSERT GASTROSTOMY TUBE PERCUTANEOUS,10908.0,7090.2,181.25,9817.2,49
CDM,36003200,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,5973.0,3882.45,112.86,5375.7,49
CDM,36003205,BIOPSY LIVER NEEDLE PERCUTANEOUS,9316.0,6055.4,104.99,8384.4,49
CDM,36003210,CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GDNCE,703.0,456.95,118.1,632.7,21
CDM,36003220,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,1399.0,909.35,121.48,6317.0,49
CDM,36003230,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,11165.0,7257.25,72.16,10048.5,49
CDM,36003235,ABLTJ 1/> LVR TUM PRQ RF,33548.0,21806.2,892.23,30193.2,42
CDM,36003240,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,2384.0,1549.6,55.93,3920.0,49
CDM,36003250,PNEUMONSTMY W PERC DRN,1229.0,798.85,206.47,1106.1,21
CDM,36003255,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,20293.0,13190.45,387.96,18263.7,42
CDM,36003260,INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT,21414.0,13919.1,984.02,21057.68,35
CDM,36003300,THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL,38854.0,25255.1,700.33,34968.6,42
CDM,36003310,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN,22623.0,14704.95,327.43,20360.7,42
CDM,36003320,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS,14280.0,9282.0,157.5,12852.0,31
CDM,36003325,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,35879.0,23321.35,353.76,32291.1,42
CDM,36003330,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,22623.0,14704.95,328.86,20360.7,42
CDM,36003335,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,35879.0,23321.35,355.15,32291.1,42
CDM,36003340,IV US NON-C VSL DX EVAL&/THER IVNTJ 1ST VSL,703.0,456.95,118.1,632.7,21
CDM,36003345,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,20293.0,13190.45,422.92,18263.7,42
CDM,36003350,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,11165.0,7257.25,54.04,10048.5,49
CDM,36003355,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,59865.0,38912.25,479.26,53878.5,42
CDM,36003370,XTRNL CANNULA DECLTNG SPX W/O BALO CATH,11165.0,7257.25,128.64,10048.5,49
CDM,36003380,XTRNL CANNULA DECLTNG SPX W/BALO CATH,38854.0,25255.1,162.32,34968.6,42
CDM,36003390,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,6924.0,4500.6,192.43,6231.6,31
CDM,36003395,BIOPSY PANCREA PERCUTANEOUS NEEDLE,9316.0,6055.4,283.37,8384.4,49
CDM,36003400,SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL,8789.0,5712.85,291.97,8399.88,31
CDM,36003410,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,22623.0,14704.95,335.67,20360.7,42
CDM,36003420,PLC TXCATH INVAS STENT,19492.0,12669.8,3274.66,17542.8,21
CDM,36003430,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,14280.0,9282.0,159.87,12852.0,31
CDM,36003440,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,10908.0,7090.2,181.25,9817.2,49
CDM,36003445,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,5391.0,3504.15,127.33,4851.9,49
CDM,36003465,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,9316.0,6055.4,100.15,8384.4,49
CDM,36003470,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,5391.0,3504.15,58.84,6289.0,49
CDM,36003480,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,1390.0,903.5,36.13,4151.0,49
CDM,36003485,INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX,406.0,263.9,68.21,4214.0,38
CDM,36003490,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,2295.0,1491.75,47.97,4151.0,49
CDM,36003495,INSJ INTRAPERITONEAL CATHETER W/IMG GUID,20293.0,13190.45,241.61,18263.7,42
CDM,36003500,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,10908.0,7090.2,176.9,9817.2,49
CDM,36003515,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,18098.0,11763.7,262.69,36332.0,49
CDM,36003520,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,22623.0,14704.95,217.89,20360.7,42
CDM,36003525,EXCHNG ABSC/CST DRG CATH RAD GID SPX,10908.0,7090.2,85.11,9817.2,49
CDM,36003535,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,826.0,536.9,45.01,4214.0,38
CDM,36003540,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,5391.0,3504.15,79.18,6289.0,49
CDM,36003545,INSERT GASTROSTOMY TUBE PERCUTANEOUS,10908.0,7090.2,181.25,9817.2,49
CDM,36003550,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,5391.0,3504.15,106.62,6289.0,49
CDM,36003555,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,10908.0,7090.2,181.25,9817.2,49
CDM,36003560,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,5391.0,3504.15,164.69,6289.0,49
CDM,36003565,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,6780.0,4407.0,244.06,36332.0,49
CDM,36003570,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,8518.0,5536.7,107.66,7666.2,49
CDM,36003575,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,10908.0,7090.2,176.9,9817.2,49
CDM,36003580,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,3555.0,2310.75,93.49,6289.0,48
CDM,36003585,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,5391.0,3504.15,79.18,6289.0,49
CDM,36003590,UNLISTED PROCEDURE LUNGS AND PLEURA,1151.0,748.15,298.11,1754.0,40
CDM,36003600,TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD,821.0,533.65,137.93,18285.0,32
CDM,36003605,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,5391.0,3504.15,106.62,6289.0,49
CDM,36003610,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,1575.0,1023.75,62.72,4214.0,38
CDM,36003615,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,5391.0,3504.15,164.69,6289.0,49
CDM,36003620,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,6780.0,4407.0,548.66,36332.0,49
CDM,36003625,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,5391.0,3504.15,58.84,6289.0,49
CDM,36003630,I&D PERIANAL ABSCESS SUPERFICIAL,5243.0,3407.95,132.49,4718.7,49
CDM,36003640,DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH,2052.0,1333.8,344.74,18285.0,32
CDM,36003665,RENAL BIOPSY PRQ TROCAR/NEEDLE,9316.0,6055.4,151.39,8384.4,49
CDM,36003670,PLC TXCATH INVAS STENT ADD,12932.0,8405.8,2172.58,11638.8,21
CDM,36003675,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,11779.0,7656.35,304.33,10601.1,42
CDM,36003680,PUNC ASPIR LUNG PNEUMOCENTSIS,1786.0,1160.9,300.05,1607.4,21
CDM,36003685,REMOVAL INDWELLING URETERAL STENT PRQ,11779.0,7656.35,275.36,10601.1,49
CDM,36003710,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,6069.0,3944.85,186.04,5462.1,49
CDM,36003715,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,11779.0,7656.35,101.0,10601.1,49
CDM,36003720,UNLISTED PROCEDURE URINARY SYSTEM,346.0,224.9,97.23,6317.0,48
CDM,36003725,RMVL NFROS TUBE REQ FLUORO GUIDANCE,3838.0,2494.7,64.09,6289.0,49
CDM,36003730,BIOPSY SOFT TISSUE NECK/THORAX,9316.0,6055.4,183.07,8384.4,49
CDM,36003735,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,4046.0,2629.9,113.54,6317.0,49
CDM,36003740,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,2629.0,1708.85,195.7,3920.0,38
CDM,36003750,PLACEMENT CHOLEDOCHAL STENT,2460.0,1599.0,413.28,18285.0,32
CDM,36003760,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,6780.0,4407.0,244.06,36332.0,49
CDM,36003770,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,11779.0,7656.35,304.33,10601.1,42
CDM,36003780,REMOVAL INDWELLING URETERAL STENT PRQ,11779.0,7656.35,275.36,10601.1,49
CDM,36003790,REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL,11779.0,7656.35,260.11,10601.1,42
CDM,36003800,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,11779.0,7656.35,101.0,10601.1,49
CDM,36003810,MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH,3838.0,2494.7,136.91,4151.0,49
CDM,36003815,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,32064.0,20841.6,550.27,28857.6,42
CDM,36003820,I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC,6780.0,4407.0,701.42,8370.0,49
CDM,36003825,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,11779.0,7656.35,93.26,10601.1,49
CDM,36003830,DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL,14310.0,9301.5,275.69,12879.0,49
CDM,36003835,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,11779.0,7656.35,354.99,10601.1,42
CDM,36003840,TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING,18283.0,11883.95,334.14,16454.7,49
CDM,36003855,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,11779.0,7656.35,171.65,13665.0,49
CDM,36003865,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,1310.0,851.5,52.31,4151.0,38
CDM,36003875,NJX RETROGRADE URETHROCSTOGRAPY,1669.0,1084.85,76.53,4268.0,38
CDM,36003880,REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP SM VSL,57312.0,37252.8,2345.0,51580.8,38
CDM,36003895,CHANGE CYSTOSTOMY TUBE SIMPLE,1399.0,909.35,53.02,4151.0,49
CDM,36003920,REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP UNI EA VSL,61559.0,40013.35,1810.0,55403.1,30
CDM,36003990,REVISION &/REINSERTION TRANSHEPATC TUBE,3095.0,2011.75,519.96,2785.5,21
CDM,36004005,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,1039.0,675.35,67.55,36332.0,38
CDM,36004010,VEN CATHJ SLCTV ORGAN BLD SAMPLING,2075.0,1348.75,215.2,3920.0,38
CDM,36004015,TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING,18283.0,11883.95,334.14,16454.7,49
CDM,36004040,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,1249.0,811.85,82.94,4214.0,38
CDM,36004050,INTRODUCJ PERCUT TRANSHEPATC STENT BILIARY DRG,5238.0,3404.7,879.98,4714.2,21
CDM,36004060,INTRO INTRACATH/CATH IN RNL PELVIS DRG&/NJX PRQ,2109.0,1370.85,354.31,1898.1,21
CDM,36004070,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,5391.0,3504.15,22.93,6289.0,49
CDM,36004160,INTRO URETER CATH/STNT RENAL PELVIS DRG&/NJX,3376.0,2194.4,567.17,3038.4,21
CDM,36004170,INJECTION PROCEDURE SPLENOPORTOGRAPY,4288.0,2787.2,154.03,3920.0,38
CDM,36004180,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,1974.0,1283.1,98.4,3920.0,38
CDM,36004185,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,3518.0,2286.7,91.56,4151.0,49
CDM,36004195,ASPIRATION AND/OR INJECTION THYROID CYST,3518.0,2286.7,58.07,4151.0,49
CDM,36004200,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,5973.0,3882.45,77.17,5375.7,49
CDM,36004210,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,1310.0,851.5,52.31,4151.0,38
CDM,36004215,CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,2546.0,1654.9,95.37,6317.0,49
CDM,36004220,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,63035.0,40972.75,508.93,56731.5,42
CDM,36004230,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1698.0,1103.7,52.83,3920.0,49
CDM,36004240,INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY,1456.0,946.4,178.54,3920.0,38
CDM,36004250,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,1514.0,984.1,42.88,4151.0,49
CDM,36004255,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,61270.0,39825.5,693.16,55143.0,42
CDM,36004260,INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR,1457.0,947.05,147.69,3920.0,38
CDM,36004265,TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS,17130.0,11134.5,1418.83,21057.68,35
CDM,36004270,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,1709.0,1110.85,287.11,3920.0,38
CDM,36004275,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,65300.0,42445.0,994.94,58770.0,42
CDM,36004280,TCAT THER INFUSION OTH/THN THROMBOLYSIS ANY TYPE,1969.0,1279.85,330.79,1772.1,21
CDM,36004285,BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS,32905.0,21388.25,1663.92,29614.5,32
CDM,36004290,INTRO PRQ TRANSHEPATC CATH BILIARY DRG,3775.0,2453.75,634.2,3397.5,21
CDM,36004295,TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD,47365.0,30787.25,1793.67,42628.5,32
CDM,36004300,INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN,20293.0,13190.45,269.94,18263.7,42
CDM,36004310,RMVL NFROS TUBE REQ FLUORO GUIDANCE,3838.0,2494.7,64.09,6289.0,49
CDM,36004320,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,37218.0,24191.7,469.64,33496.2,42
CDM,36004330,BILIARY DUCT STONE XTRJ PRQ VIA BASKET/SNARE,3775.0,2453.75,634.2,3397.5,21
CDM,36004340,OCCL TXCATH,14350.0,9327.5,2410.8,12915.0,21
CDM,36004345,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,6069.0,3944.85,186.04,5462.1,49
CDM,36004355,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,5973.0,3882.45,77.17,5375.7,49
CDM,36004365,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,5973.0,3882.45,112.86,5375.7,49
CDM,36004375,INJECTION EPIDURAL BLOOD/CLOT PATCH,5973.0,3882.45,139.83,6317.0,49
CDM,36004380,TXCATH TX INF THROMBLYS,2179.0,1416.35,366.07,1961.1,21
CDM,36004390,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,20293.0,13190.45,422.92,18263.7,42
CDM,36004395,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,1974.0,1283.1,98.4,3920.0,38
CDM,36004400,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,59865.0,38912.25,479.26,53878.5,42
CDM,36004430,BX LVR NDL DONE PURPOSE TM OTH MAJOR PX,1151.0,748.15,120.86,13665.0,38
CDM,36004440,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,33548.0,21806.2,409.88,30193.2,42
CDM,36004450,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,826.0,536.9,45.01,4214.0,38
CDM,36004460,DRN PERC RETPERITONL ABSCESS,2522.0,1639.3,423.7,2269.8,21
CDM,36004470,INJ PX CHOLANGIOGRAPHY VIA CATHETER/T-TUBE,703.0,456.95,118.1,632.7,21
CDM,36004475,IMPLTJ/RPLCMT FS NON-PRGRBL PUMP,44131.0,28685.15,596.59,46695.0,42
CDM,36004490,INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT,957.0,622.05,49.91,4214.0,38
CDM,36004510,PROSTATE NEEDLE BIOPSY ANY APPROACH,9704.0,6307.6,1043.57,8733.6,45
CDM,36004540,LASER GREENLIGHT PVP,1402.0,911.3,235.54,1261.8,21
CDM,36004550,LASER 980 NM SLV,1402.0,911.3,235.54,1261.8,21
CDM,36004560,LASER KTP/AURA,1402.0,911.3,235.54,1261.8,21
CDM,36004570,LASER HOLMIUM LAP,1202.0,781.3,201.94,1081.8,21
CDM,36004575,INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ,50596.0,32887.4,406.7,66071.77,42
CDM,36004580,LASER HOLMIUM YAG,1202.0,781.3,201.94,1081.8,21
CDM,36004590,LASER CARBON DIOXIDE W ADAPTER,2116.0,1375.4,355.49,1904.4,21
CDM,36004600,LASER CARBON DIOXIDE,1202.0,781.3,201.94,1081.8,21
CDM,36004610,LASER ARGON BEAM COAGULATOR,1304.0,847.6,219.07,1173.6,21
CDM,36004615,INJECTION AA&/STRD SUPRASCAPULAR NERVE,5973.0,3882.45,66.83,5375.7,49
CDM,36004620,PLC OCCL DVC ARTERY VEIN,1048.0,681.2,176.06,3920.0,31
CDM,36004625,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,5973.0,3882.45,71.65,5375.7,49
CDM,36004640,"BRONCHIAL THERMO, 1 LOBE",3953.0,2569.45,664.1,3557.7,21
CDM,36004680,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,1480.0,962.0,60.81,7730.0,38
CDM,36004690,BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,39804.0,25872.6,303.1,35823.6,42
CDM,36004700,BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE,1768.0,1149.2,78.73,7730.0,38
CDM,36004705,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,7679.0,4991.35,126.8,6911.1,49
CDM,36004710,BRONCHOSCOPY W/EXCISION TUMOR,21200.0,13780.0,303.46,19080.0,42
CDM,36004715,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,820.0,533.0,70.66,4214.0,38
CDM,36004720,ENDOBRNCL US BRONCHOSCOPIC DX/THER IVNTJ,355.0,230.75,59.64,319.5,21
CDM,36004730,TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS,17130.0,11134.5,1418.83,21057.68,35
CDM,36004740,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,65300.0,42445.0,994.94,58770.0,42
CDM,36004745,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,7679.0,4991.35,109.08,6911.1,49
CDM,36004760,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,47980.0,31187.0,5529.0,43182.0,40
CDM,36004765,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,2171.0,1411.15,61.24,4214.0,38
CDM,36004770,TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL,25380.0,16497.0,3342.0,24588.22,40
CDM,36004780,TRLUML PERIPH ATHRC W/RS&I ABDOM AORTA,56703.0,36856.95,3342.0,51032.7,40
CDM,36004790,TRLUML PERIPHERAL ATHERECTOMY VISCERAL ARTERY EA,20758.0,13492.7,1940.0,18682.2,30
CDM,36004800,TRLUML PERIPHERAL ATHERECTOMY RENAL ARTERY EA,29888.0,19427.2,3342.0,26899.2,40
CDM,36004810,REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP EA VSL,29771.0,19351.15,1810.0,26793.9,30
CDM,36004820,REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP UNI EA VSL,29772.0,19351.8,1810.0,26794.8,30
CDM,36004835,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,7679.0,4991.35,101.9,6911.1,49
CDM,36004840,REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI EA VSL,7772.0,5051.8,1305.7,15651.0,30
CDM,36004850,REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP SM VSL,57312.0,37252.8,2345.0,51580.8,38
CDM,36004855,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,17111.0,11122.15,396.27,15651.0,42
CDM,36004860,REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP SM VSL,57312.0,37252.8,2345.0,51580.8,38
CDM,36004880,REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI,45051.0,29283.15,2345.0,40545.9,38
CDM,36004890,REVSC OPN/PRQ FEM/POP W/STNT/ATHRC/ANGIOP SM VSL,57312.0,37252.8,2345.0,51580.8,38
CDM,36004900,REVSC OPN/PRQ FEM/POP W/STNT/ANGIOP SM VSL,57312.0,37252.8,2345.0,51580.8,38
CDM,36004910,REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIOP SM VSL,57312.0,37252.8,2345.0,51580.8,38
CDM,36004915,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,29661.0,19279.65,174.82,26694.9,49
CDM,36004920,REVSC OPN/PRG FEM/POP W/ANGIOPLASTY UNI,26097.0,16963.05,2345.0,23487.3,38
CDM,36004925,INSERTION/RPLCMT PERIPHERAL/GASTRIC NPGR,34865.0,22662.25,354.22,46695.0,42
CDM,36004930,REVSC OPN/PRQ ILIAC ART W/STNT & ANGIOP IPSILATL,8241.0,5356.65,1384.49,15651.0,30
CDM,36004940,REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL,9336.0,6068.4,1568.45,15651.0,30
CDM,36004950,REVSC OPN/PRQ ILIAC ART W/STNT PLMT & ANGIOPLSTY,45051.0,29283.15,2345.0,40545.9,38
CDM,36004960,REVASCULARIZATION ILIAC ARTERY ANGIOP 1ST VSL,36761.0,23894.65,2345.0,33084.9,38
CDM,36004970,"BRONCHIAL THERMO, >1 LOBE",3953.0,2569.45,664.1,3557.7,21
CDM,36004980,THORACENTESIS FOR ASPIRATION,867.0,563.55,145.66,780.3,21
CDM,36004985,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,16843.0,10947.95,232.6,15158.7,49
CDM,36004990,TUBE THORACOSTOMY INCLUDES WATER SEAL,8933.0,5806.45,191.38,8370.0,49
CDM,36005000,BIOPSY LIVER NEEDLE PERCUTANEOUS,9316.0,6055.4,104.99,8384.4,49
CDM,36005005,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,1143.0,742.95,80.57,4214.0,38
CDM,36005020,VNPNXR 3 YEARS/> PHYS/QHP SKILL,278.0,180.7,11.13,3920.0,35
CDM,36005025,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,16843.0,10947.95,233.15,15158.7,49
CDM,36005040,THORACENTESIS FOR ASPIRATION,867.0,563.55,145.66,780.3,21
CDM,36005045,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,4084.0,2654.6,70.66,6317.0,38
CDM,36005050,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,1039.0,675.35,67.55,36332.0,38
CDM,36005060,PLC BREAST CLIP PERC,692.0,449.8,116.26,622.8,21
CDM,36005070,PLC NDL WIRE BREAST,813.0,528.45,136.58,731.7,21
CDM,36005080,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,8101.0,5265.65,102.26,7290.9,49
CDM,36005085,PARS INTERARTICULARIS INJ,946.0,614.9,249.83,8550.0,48
CDM,36005090,BIOPSY LIVER NEEDLE PERCUTANEOUS,9316.0,6055.4,104.99,8384.4,49
CDM,36005100,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,3518.0,2286.7,91.56,4151.0,49
CDM,36005110,BIOPSY PLEURA PERCUTANEOUS NEEDLE,9316.0,6055.4,102.06,8384.4,49
CDM,36005120,THORA W INS,1786.0,1160.9,300.05,1607.4,21
CDM,36005130,FINE NEEDLE ASPIRATION WITH IMAGING GUIDANCE,890.0,578.5,149.52,801.0,21
CDM,36005140,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,3518.0,2286.7,91.56,4151.0,49
CDM,36005150,EXCHNG ABSC/CST DRG CATH RAD GID SPX,10908.0,7090.2,85.11,9817.2,49
CDM,36005160,DRN SUBDIPHRGMC ABSCESS PERC,2522.0,1639.3,423.7,2269.8,21
CDM,36005165,SIJ INJ - ARTHROGR/ANESTHETIC,3463.0,2250.95,275.41,6317.0,47
CDM,36005170,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,9316.0,6055.4,100.15,8384.4,49
CDM,36005180,BIOPSY PLEURA PERCUTANEOUS NEEDLE,9316.0,6055.4,102.06,8384.4,49
CDM,36005190,PARACENTESIS ABD INIT,1749.0,1136.85,293.83,1574.1,21
CDM,36005200,PLC BREAST CLIP PERC,692.0,449.8,116.26,622.8,21
CDM,36005210,INSJ INTRAPERITONEAL CATHETER W/IMG GUID,20293.0,13190.45,241.61,18263.7,42
CDM,36005220,BX BREAST PERC W DVC W IMAGE,3690.0,2398.5,619.92,3321.0,21
CDM,36005230,BX BREAST PERC W IMAGE GUIDE,1425.0,926.25,239.4,1282.5,21
CDM,36005240,DRN PERC RETPERITONL ABSCESS,2522.0,1639.3,423.7,2269.8,21
CDM,36005250,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,321.0,208.65,25.04,3920.0,38
CDM,36005260,BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC,21200.0,13780.0,310.73,19080.0,42
CDM,36005270,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,7679.0,4991.35,101.9,6911.1,49
CDM,36005280,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,7679.0,4991.35,133.87,6911.1,49
CDM,36005290,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,2586.0,1680.9,40.74,3920.0,49
CDM,36005300,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,2586.0,1680.9,29.6,3920.0,49
CDM,36005330,INJECTION EPIDURAL BLOOD/CLOT PATCH,5973.0,3882.45,139.83,6317.0,49
CDM,36005340,INSERT BRONCHIAL VALVE,9128.0,5933.2,1533.5,8215.2,21
CDM,36005350,BRONCH W/RMV VALVE INIT LOBE,3457.0,2247.05,580.78,3111.3,21
CDM,36005360,BRONCH W/RMV VALVE ADD LOBE,3457.0,2247.05,580.78,3111.3,21
CDM,36005370,INSERT BRONCHIAL VALVE,9128.0,5933.2,1533.5,8215.2,21
CDM,36005380,BRONCH W/RMV VALVE INIT LOBE,3457.0,2247.05,580.78,3111.3,21
CDM,36005390,BRONCH W/RMV VALVE ADD LOBE,3457.0,2247.05,580.78,3111.3,21
CDM,36005400,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,3555.0,2310.75,192.55,4151.0,48
CDM,36005410,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,22623.0,14704.95,106.52,20360.7,49
CDM,36005420,DRN SUBDIPHRGMC ABSCESS PERC,2522.0,1639.3,423.7,2269.8,21
CDM,36005430,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,9316.0,6055.4,100.15,8384.4,49
CDM,36005440,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1499.0,974.35,98.33,4151.0,49
CDM,36005450,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1698.0,1103.7,52.83,3920.0,49
CDM,36005460,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,33548.0,21806.2,409.88,30193.2,42
CDM,36005470,THORA W INS TUBE,1786.0,1160.9,300.05,1607.4,21
CDM,36005480,PROSTATE NEEDLE BIOPSY ANY APPROACH,9704.0,6307.6,1043.57,8733.6,45
CDM,36005490,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,4444.0,2888.6,124.03,4151.0,48
CDM,36005500,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,22623.0,14704.95,303.79,20360.7,49
CDM,36005510,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,22623.0,14704.95,411.79,20360.7,49
CDM,36005520,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,38854.0,25255.1,425.5,34968.6,49
CDM,36005530,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,22623.0,14704.95,482.17,20360.7,49
CDM,36005540,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,56296.0,36592.4,407.68,50666.4,42
CDM,36005550,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,26869.0,17464.85,386.45,24182.1,42
CDM,36005560,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,33420.0,21723.0,403.75,30078.0,42
CDM,36005570,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,53705.0,34908.25,422.66,48334.5,42
CDM,36005580,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS,53369.0,34689.85,428.95,70939.0,42
CDM,36005590,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS,81923.0,53249.95,456.32,76175.0,42
CDM,36005600,RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD,52578.0,34175.7,422.44,76175.0,42
CDM,36005610,RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD,50610.0,32896.5,439.54,70939.0,42
CDM,36005620,RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD,65906.0,42838.9,456.66,76175.0,42
CDM,36005630,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,22623.0,14704.95,303.79,20360.7,49
CDM,36005640,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,22623.0,14704.95,411.79,20360.7,49
CDM,36005650,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,38854.0,25255.1,425.5,34968.6,49
CDM,36005660,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,22623.0,14704.95,482.17,20360.7,49
CDM,36005670,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,22974.0,14933.1,263.36,20676.6,42
CDM,36005680,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,22623.0,14704.95,414.12,20360.7,42
CDM,36005690,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,22623.0,14704.95,415.85,20360.7,42
CDM,36005700,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,5391.0,3504.15,127.33,4851.9,49
CDM,36005710,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,5391.0,3504.15,127.33,4851.9,49
CDM,36005715,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,5973.0,3882.45,51.82,5375.7,49
CDM,36005720,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,5391.0,3504.15,127.33,4851.9,49
CDM,36005730,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,5391.0,3504.15,92.62,4851.9,49
CDM,36005740,EXC THROMBOSED HEMORRHOID XTRNL,6780.0,4407.0,137.7,6102.0,49
CDM,36005750,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,39804.0,25872.6,244.52,35823.6,42
CDM,36005760,BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION,2030.0,1319.5,119.08,3920.0,32
CDM,36005770,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,9916.0,6445.4,163.56,8924.4,49
CDM,36005775,BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID,3188.0,2072.2,97.29,8370.0,38
CDM,36005780,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,9916.0,6445.4,164.87,8924.4,49
CDM,36005785,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,13975.0,9083.75,182.44,12577.5,49
CDM,36005790,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,9916.0,6445.4,194.29,8924.4,49
CDM,36005795,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,3286.0,2135.9,91.22,8370.0,38
CDM,36005800,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,21200.0,13780.0,219.98,19080.0,49
CDM,36005805,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,13975.0,9083.75,212.91,12577.5,49
CDM,36005810,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1335.0,867.75,181.19,4151.0,49
CDM,36005815,BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID,3129.0,2033.85,106.29,8370.0,38
CDM,36005820,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,9916.0,6445.4,217.13,8924.4,49
CDM,36005830,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,9916.0,6445.4,166.71,8924.4,49
CDM,36005835,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,6076.0,3949.4,117.05,5468.4,49
CDM,36005840,I&D SUBMUCOSAL ABSCESS RECTUM,4056.0,2636.4,219.57,36332.0,49
CDM,36005845,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,2639.0,1715.35,100.44,3920.0,49
CDM,36005850,I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC,6780.0,4407.0,701.42,8370.0,49
CDM,36005855,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,2639.0,1715.35,50.4,3920.0,38
CDM,36005860,I&D VULVA/PERINEAL ABSCESS,1749.0,1136.85,132.47,4151.0,49
CDM,36005865,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,2639.0,1715.35,149.34,3920.0,49
CDM,36005870,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,745.0,484.25,98.33,4151.0,49
CDM,36005880,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,7679.0,4991.35,114.19,6911.1,49
CDM,36005885,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,1698.0,1103.7,54.21,3920.0,49
CDM,36005890,BRNCHSC OCCLUSION&INSERT BRONCH VALVE INIT LOBE,39804.0,25872.6,256.87,35823.6,49
CDM,36005895,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,1698.0,1103.7,54.67,3920.0,49
CDM,36005900,BRNCHSC REMOVAL BRONCHIAL VALVE INITIAL,21200.0,13780.0,245.26,19080.0,49
CDM,36005905,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,3983.0,2588.95,61.65,3920.0,49
CDM,36005910,BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL,9916.0,6445.4,86.26,8924.4,49
CDM,36005915,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,1698.0,1103.7,68.5,3920.0,49
CDM,36005920,BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE,4108.0,2670.2,94.04,13665.0,38
CDM,36005925,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,41076.0,26699.4,417.69,36968.4,42
CDM,36005930,BRONCHOSCOPIC THERMOPLASTY ONE LOBE,39804.0,25872.6,238.48,35823.6,49
CDM,36005935,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,18656.0,12126.4,484.51,16790.4,42
CDM,36005940,BRONCHOSCOPIC THERMOPLASTY 2/> LOBES,39804.0,25872.6,251.61,35823.6,49
CDM,36005945,VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,5626.0,3656.9,244.58,5063.4,31
CDM,36005950,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,3555.0,2310.75,109.61,4268.0,48
CDM,36005955,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,41076.0,26699.4,595.96,36968.4,42
CDM,36005960,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,10908.0,7090.2,152.72,9817.2,49
CDM,36005965,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,41076.0,26699.4,556.44,40475.0,42
CDM,36005970,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,1749.0,1136.85,107.08,4151.0,49
CDM,36005975,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,13671.0,8886.15,251.77,40475.0,31
CDM,36005980,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1499.0,974.35,98.33,4151.0,49
CDM,36005985,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,18656.0,12126.4,491.13,16790.4,42
CDM,36005990,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,2295.0,1491.75,47.97,4151.0,49
CDM,36005WE,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,418.0,271.7,33.48,584.83,35
CDM,36005WE-50,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,836.0,543.4,418.0,836.0,12
CDM,36006000,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,3555.0,2310.75,132.14,4268.0,48
CDM,36006010,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,3555.0,2310.75,132.14,4268.0,48
CDM,36006020,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,3555.0,2310.75,132.14,4268.0,48
CDM,36006030,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,3555.0,2310.75,132.14,4268.0,48
CDM,36006040,THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX,38854.0,25255.1,457.76,34968.6,49
CDM,36006050,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,22623.0,14704.95,401.13,20360.7,49
CDM,36006060,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,22623.0,14704.95,276.29,36332.0,49
CDM,36006065,INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,24650.0,16022.5,523.98,76175.0,42
CDM,36006070,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,22623.0,14704.95,145.66,36332.0,49
CDM,36006075,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,26158.0,17002.7,397.64,76175.0,42
CDM,36006080,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,22623.0,14704.95,359.58,20360.7,42
CDM,36006090,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,22623.0,14704.95,236.54,20360.7,42
CDM,36006095,TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS,21259.0,13818.35,1940.0,44585.0,39
CDM,36006100,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,22623.0,14704.95,330.9,20360.7,42
CDM,36006105,TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS,9843.0,6397.95,390.0,44585.0,39
CDM,36006110,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,38854.0,25255.1,398.36,34968.6,42
CDM,36006115,ECMO/ECLS INITIATION VENO-VENOUS,3119.0,2027.35,371.93,18285.0,32
CDM,36006120,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,38854.0,25255.1,447.73,34968.6,42
CDM,36006125,ECMO/ECLS INITIATION VENO-ARTERIAL,3446.0,2239.9,409.92,18285.0,32
CDM,36006130,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,22623.0,14704.95,394.12,20360.7,42
CDM,36006140,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,38854.0,25255.1,442.82,34968.6,42
CDM,36006150,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,8083.0,5253.95,146.44,7274.7,31
CDM,36006155,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ,3341.0,2171.65,508.87,18285.0,32
CDM,36006160,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,7308.0,4750.2,308.39,6577.2,31
CDM,36006170,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,22623.0,14704.95,330.9,20360.7,42
CDM,36006180,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,38854.0,25255.1,398.36,34968.6,42
CDM,36006185,TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE,19734.0,12827.1,965.65,44585.0,39
CDM,36006190,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,38854.0,25255.1,447.73,34968.6,42
CDM,36006200,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,22623.0,14704.95,394.12,20360.7,42
CDM,36006205,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL,17553.0,11409.45,250.19,44585.0,39
CDM,36006210,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,38854.0,25255.1,442.82,34968.6,42
CDM,36006215,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,46168.0,30009.2,363.36,44585.0,49
CDM,36006220,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,8083.0,5253.95,146.44,7274.7,31
CDM,36006225,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,17290.0,11238.5,177.32,44585.0,39
CDM,36006230,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,7308.0,4750.2,308.39,6577.2,31
CDM,36006240,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,22623.0,14704.95,359.58,20360.7,42
CDM,36006245,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,81510.0,52981.5,512.26,73359.0,42
CDM,36006250,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,22623.0,14704.95,330.9,20360.7,42
CDM,36006255,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,73334.0,47667.1,570.49,66000.6,42
CDM,36006260,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,38854.0,25255.1,398.36,34968.6,42
CDM,36006265,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,81510.0,52981.5,677.43,73359.0,42
CDM,36006270,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,38854.0,25255.1,447.73,34968.6,42
CDM,36006275,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,57033.0,37071.45,794.67,51329.7,42
CDM,36006280,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,22623.0,14704.95,394.12,20360.7,42
CDM,36006290,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,38854.0,25255.1,442.82,34968.6,42
CDM,36006295,BIOPSY SALIVARY GLAND NEEDLE,4046.0,2629.9,62.36,4151.0,49
CDM,36006300,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,22623.0,14704.95,330.9,20360.7,42
CDM,36006310,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,38854.0,25255.1,398.36,34968.6,42
CDM,36006320,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,38854.0,25255.1,447.73,34968.6,42
CDM,36006330,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,22623.0,14704.95,394.12,20360.7,42
CDM,36006340,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,38854.0,25255.1,442.82,34968.6,42
CDM,36006350,UNLISTED PROCEDURE STOMACH,898.0,583.7,252.34,7730.0,48
CDM,36006360,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,8933.0,5806.45,181.46,8039.7,49
CDM,36006380,INJECTION KNEE ARTHROGRAPHY,547.0,355.55,91.9,492.3,21
CDM,36006400,UNLISTED PROCEDURE STOMACH,898.0,583.7,252.34,7730.0,48
CDM,36006405,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,59865.0,38912.25,552.03,53878.5,42
CDM,36006415,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,9316.0,6055.4,233.77,8550.0,49
CDM,36006420,DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL,6780.0,4407.0,239.39,36332.0,49
CDM,36006425,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,9316.0,6055.4,233.77,8550.0,49
CDM,36006430,SURG TX ANAL FISTULA SUBQ,15769.0,10249.85,520.54,36332.0,49
CDM,36006440,ORGAN PRESERVATION INIT HOUR,1783.0,1158.95,299.54,1604.7,21
CDM,36006445,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,9316.0,6055.4,250.42,8384.4,49
CDM,36006450,ORGAN PRESERVATION EA ADD 30 MIN,451.0,293.15,75.77,405.9,21
CDM,36006460,CADAVERIC COLD STORAGE,1605.0,1043.25,269.64,1444.5,21
CDM,36006470,PULSATILE PERFUSION,6335.0,4117.75,1064.28,5701.5,21
CDM,36006475,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,6814.0,4429.1,141.41,6132.6,49
CDM,36006480,BIOPSY LIVER NEEDLE PERCUTANEOUS,9316.0,6055.4,104.99,8384.4,49
CDM,36006485,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,6814.0,4429.1,139.53,6132.6,49
CDM,36006490,VENO-VENO PERFUSION EA 30 MIN,491.0,319.15,82.49,441.9,21
CDM,36006495,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,6814.0,4429.1,145.43,6132.6,49
CDM,36006500,UNLISTED PROCEDURE LUNGS AND PLEURA,1151.0,748.15,298.11,1754.0,40
CDM,36006520,PERCUTANEOUS VERTEBROPLSTY THORACIC W/WO BONE BX,5334.0,3467.1,896.11,4800.6,21
CDM,36006530,PERCUTANEOUS VERTEBROPLASTY LUMBAR W/WO BNE BX,5334.0,3467.1,896.11,4800.6,21
CDM,36006535,LIVER ELASTOGRAPHY W/O IMAG W/I&R,900.0,585.0,47.19,810.0,41
CDM,36006540,PERCUTANEOUS VERTEBROPLASTY EA ADDL THRC/LMBR,3469.0,2254.85,582.79,3122.1,21
CDM,36006550,PERCUTANEOUS VERTEBRAL AUGMENTATION THORACIC,11928.0,7753.2,2003.9,10735.2,21
CDM,36006560,PERCUTANEOUS VERTEBRAL AUGMENTATION LUMBAR,11928.0,7753.2,2003.9,10735.2,21
CDM,36006570,PERQ VERTEBRAL AUGMENTATION EA ADDL THRC/LMBR,11928.0,7753.2,2003.9,10735.2,21
CDM,36006580,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,1156.0,751.4,107.75,4151.0,49
CDM,36006590,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,2639.0,1715.35,163.62,4151.0,49
CDM,36006600,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,2639.0,1715.35,163.62,4151.0,49
CDM,36006610,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,2639.0,1715.35,163.62,4151.0,49
CDM,36006620,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,13975.0,9083.75,193.54,12577.5,49
CDM,36006630,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,13975.0,9083.75,193.54,12577.5,49
CDM,36006650,BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID,3188.0,2072.2,97.29,8370.0,38
CDM,36006655,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,2639.0,1715.35,99.88,3259.0,42
CDM,36006660,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,13975.0,9083.75,182.44,12577.5,49
CDM,36006665,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,771.0,501.15,50.78,2849.0,31
CDM,36006670,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,13975.0,9083.75,182.44,12577.5,49
CDM,36006680,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,3286.0,2135.9,91.22,8370.0,38
CDM,36006690,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,13975.0,9083.75,212.91,12577.5,49
CDM,36006695,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,2639.0,1715.35,117.8,3920.0,49
CDM,36006700,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,13975.0,9083.75,212.91,12577.5,49
CDM,36006705,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,2639.0,1715.35,59.26,3920.0,38
CDM,36006710,BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID,3129.0,2033.85,106.29,8370.0,38
CDM,36006715,PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID,2639.0,1715.35,75.21,3920.0,38
CDM,36006720,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,6076.0,3949.4,117.05,5468.4,49
CDM,36006725,INJECTION THERAPEUTIC CARPAL TUNNEL,1698.0,1103.7,64.98,3920.0,49
CDM,36006730,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,6076.0,3949.4,117.05,5468.4,49
CDM,36006735,ASPIRATION & INJECTION TREATMENT BONE CYST,4046.0,2629.9,187.83,4214.0,49
CDM,36006740,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,6076.0,3949.4,58.68,5468.4,38
CDM,36006750,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,2639.0,1715.35,117.8,3920.0,49
CDM,36006760,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,2639.0,1715.35,117.8,3920.0,49
CDM,36006770,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,2639.0,1715.35,59.26,3920.0,38
CDM,36006780,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,2639.0,1715.35,100.44,3920.0,49
CDM,36006790,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,2639.0,1715.35,100.44,3920.0,49
CDM,36006795,TUBE THORACOSTOMY INCLUDES WATER SEAL,8933.0,5806.45,191.38,8370.0,49
CDM,36006800,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,2639.0,1715.35,50.4,3920.0,38
CDM,36006805,UNLISTED PROC LUNG/PLEURA,1542.0,1002.3,399.38,1754.0,40
CDM,36006810,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,2639.0,1715.35,149.34,3920.0,49
CDM,36006820,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,2639.0,1715.35,149.34,3920.0,49
CDM,36006825,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,22623.0,14704.95,555.28,36332.0,49
CDM,36006830,PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID,2639.0,1715.35,75.21,3920.0,38
CDM,36006835,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS,53369.0,34689.85,428.95,70939.0,42
CDM,36006840,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,50080.0,32552.0,520.77,45072.0,49
CDM,36006845,TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH,22769.0,14799.85,1525.52,20492.1,32
CDM,36006850,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL,17553.0,11409.45,250.19,44585.0,39
CDM,36006855,REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ,3610.0,2346.5,191.02,18285.0,32
CDM,36006860,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,46168.0,30009.2,363.36,44585.0,49
CDM,36006865,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,4444.0,2888.6,124.03,4151.0,48
CDM,36006870,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,17290.0,11238.5,177.32,44585.0,39
CDM,36006875,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,22623.0,14704.95,482.17,20360.7,49
CDM,36006880,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,81510.0,52981.5,512.26,73359.0,42
CDM,36006890,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,73334.0,47667.1,570.49,66000.6,42
CDM,36006895,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,11165.0,7257.25,220.84,10048.5,49
CDM,36006900,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,81510.0,52981.5,677.43,73359.0,42
CDM,36006905,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,6924.0,4500.6,192.43,6231.6,31
CDM,36006910,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,57033.0,37071.45,794.67,51329.7,42
CDM,36006915,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,22623.0,14704.95,414.12,20360.7,42
CDM,36006920,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,9316.0,6055.4,233.77,8550.0,49
CDM,36006930,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,9316.0,6055.4,233.77,8550.0,49
CDM,36006940,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,9316.0,6055.4,233.77,8550.0,49
CDM,36006945,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,8546.0,5554.9,106.64,7691.4,32
CDM,36006950,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,9316.0,6055.4,233.77,8550.0,49
CDM,36006955,INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL,5839.0,3795.35,84.51,5255.1,32
CDM,36006960,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,9316.0,6055.4,233.77,8550.0,49
CDM,36006965,OCCLUSION OF VASC DEVICE,2729.0,1773.85,620.6,13665.0,47
CDM,36006970,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,9316.0,6055.4,233.77,8550.0,49
CDM,36006975,DIAGNOSTIC BONE MARROW ASPIRATIONS,8101.0,5265.65,76.74,7290.9,49
CDM,36006980,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,9316.0,6055.4,250.42,8384.4,49
CDM,36006990,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,9316.0,6055.4,250.42,8384.4,49
CDM,36006995,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,20293.0,13190.45,84.32,18263.7,42
CDM,36007000,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,9316.0,6055.4,250.42,8384.4,49
CDM,36007005,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,20293.0,13190.45,253.71,18263.7,42
CDM,36007010,UNLISTED PROCEDURE STOMACH,2324.0,1510.6,653.04,7730.0,48
CDM,36007015,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,20293.0,13190.45,317.27,18263.7,42
CDM,36007020,INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH,658.0,427.7,60.96,4214.0,38
CDM,36007025,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,20293.0,13190.45,444.09,18263.7,42
CDM,36007030,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,33548.0,21806.2,531.35,30193.2,42
CDM,36007035,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,20293.0,13190.45,235.78,18263.7,42
CDM,36007040,ABLATE PULM TUMORS W/PLEURA/CHEST WALL EXTSN,6528.0,4243.2,1096.7,5875.2,21
CDM,36007045,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,20293.0,13190.45,158.73,18263.7,42
CDM,36007050,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,1698.0,1103.7,54.67,3920.0,49
CDM,36007055,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,5391.0,3504.15,115.22,6289.0,49
CDM,36007060,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,3983.0,2588.95,61.65,3920.0,49
CDM,36007065,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,33548.0,21806.2,282.12,30193.2,42
CDM,36007070,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,1698.0,1103.7,68.5,3920.0,49
CDM,36007075,PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH,33548.0,21806.2,512.45,30193.2,42
CDM,36007080,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,41076.0,26699.4,417.69,36968.4,42
CDM,36007085,PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH,33548.0,21806.2,527.64,30193.2,42
CDM,36007090,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,41076.0,26699.4,417.69,36968.4,42
CDM,36007095,PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW,35879.0,23321.35,405.5,32291.1,42
CDM,36007100,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,18656.0,12126.4,514.97,16790.4,42
CDM,36007105,BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT,5161.0,3354.65,164.37,4644.9,31
CDM,36007110,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,18656.0,12126.4,484.51,16790.4,42
CDM,36007115,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH 1/MLT,4763.0,3095.95,172.84,4330.07,31
CDM,36007120,VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,5626.0,3656.9,244.58,5063.4,31
CDM,36007125,REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I,5826.0,3786.9,189.01,5243.4,31
CDM,36007130,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,41076.0,26699.4,595.96,36968.4,42
CDM,36007135,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,9316.0,6055.4,144.38,8384.4,49
CDM,36007140,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,41076.0,26699.4,556.44,40475.0,42
CDM,36007150,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,13671.0,8886.15,251.77,40475.0,31
CDM,36007155,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,3838.0,2494.7,185.09,4214.0,49
CDM,36007160,TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE,19734.0,12827.1,965.65,44585.0,39
CDM,36007165,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,3838.0,2494.7,78.74,4214.0,49
CDM,36007170,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,59865.0,38912.25,552.03,53878.5,42
CDM,36007175,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,11779.0,7656.35,245.69,10601.1,49
CDM,36007180,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,59865.0,38912.25,552.03,53878.5,42
CDM,36007185,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,19831.0,12890.15,304.97,17847.9,49
CDM,36007190,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,6814.0,4429.1,141.59,6132.6,49
CDM,36007195,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,11779.0,7656.35,230.35,10601.1,49
CDM,36007200,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,6814.0,4429.1,141.59,6132.6,49
CDM,36007205,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,11779.0,7656.35,119.32,10601.1,49
CDM,36007210,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,6814.0,4429.1,141.41,6132.6,49
CDM,36007215,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,33548.0,21806.2,409.88,30193.2,42
CDM,36007220,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,6814.0,4429.1,141.41,6132.6,49
CDM,36007225,ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC,755.0,490.75,126.84,5474.5,31
CDM,36007230,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,6814.0,4429.1,139.53,6132.6,49
CDM,36007235,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,19831.0,12890.15,243.79,17847.9,42
CDM,36007240,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,6814.0,4429.1,139.53,6132.6,49
CDM,36007245,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,19831.0,12890.15,318.24,17847.9,42
CDM,36007250,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,6814.0,4429.1,145.43,6132.6,49
CDM,36007255,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,19831.0,12890.15,408.35,17847.9,42
CDM,36007260,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,6814.0,4429.1,145.43,6132.6,49
CDM,36007265,URETERAL EMBOLIZATION/OCCLUSION W/IMG GID RS&I,755.0,490.75,126.84,5474.5,31
CDM,36007270,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,65285.0,42435.25,636.76,76175.0,42
CDM,36007275,BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I,1633.0,1061.45,218.64,5474.5,31
CDM,36007280,INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,24650.0,16022.5,523.98,76175.0,42
CDM,36007290,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,26158.0,17002.7,397.64,76175.0,42
CDM,36007295,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,2546.0,1654.9,134.17,6317.0,49
CDM,36007300,REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB,26158.0,17002.7,462.22,36332.0,49
CDM,36007310,INTRO CATH RENAL DRN PERC BILAT,4220.0,2743.0,708.96,3798.0,21
CDM,36007315,PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL,14993.0,9745.45,1010.46,18285.0,32
CDM,36007320,INJ PYELOGRAPHY BILAT,1690.0,1098.5,283.92,1521.0,21
CDM,36007325,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST,8501.0,5525.65,710.74,18285.0,39
CDM,36007335,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL,7801.0,5070.65,304.24,18285.0,39
CDM,36007340,CHG NEPHROSTOMY TUBE BILAT,4220.0,2743.0,708.96,3798.0,21
CDM,36007350,I&D HEMATOMA SEROMA/FLUID COLLECTION,6076.0,3949.4,147.52,5468.4,49
CDM,36007380,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,1390.0,903.5,36.13,4151.0,49
CDM,36007390,BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS,32905.0,21388.25,1663.92,29614.5,32
CDM,36007400,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,3555.0,2310.75,192.55,4151.0,48
CDM,36007410,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,7868.0,5114.2,121.59,7081.2,49
CDM,36007420,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,7868.0,5114.2,121.59,7081.2,49
CDM,36007430,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,7868.0,5114.2,121.59,7081.2,49
CDM,36007440,INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT,7868.0,5114.2,219.38,7730.0,49
CDM,36007450,INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT,7868.0,5114.2,219.38,7730.0,49
CDM,36007460,INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT,7868.0,5114.2,219.38,7730.0,49
CDM,36007465,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,7679.0,4991.35,157.7,6911.1,49
CDM,36007470,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,7868.0,5114.2,211.77,7730.0,49
CDM,36007480,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,7868.0,5114.2,211.77,7730.0,49
CDM,36007490,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,7868.0,5114.2,211.77,7730.0,49
CDM,36007500,INJECTION SCLEROSANT SINGLE INCMPTNT VEIN,2871.0,1866.15,45.28,4151.0,49
CDM,36007510,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,35879.0,23321.35,355.15,32291.1,42
CDM,36007520,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,50080.0,32552.0,520.77,45072.0,49
CDM,36007530,UNLISTED CARDIAC SURGERY,5158.0,3352.7,620.6,4642.2,40
CDM,36007540,TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS,21259.0,13818.35,1940.0,44585.0,39
CDM,36007550,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,18896.0,12282.4,1418.68,18285.0,32
CDM,36007560,BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX,21200.0,13780.0,274.76,19080.0,49
CDM,36007570,BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX,21200.0,13780.0,304.48,19080.0,49
CDM,36007580,BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES,2221.0,1443.65,83.79,7730.0,38
CDM,36007590,ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT,34229.0,22248.85,318.03,30806.1,42
CDM,36007600,DIAGNOSTIC BONE MARROW BIOPSIES,8101.0,5265.65,80.14,7290.9,49
CDM,36007610,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,2639.0,1715.35,99.88,3259.0,42
CDM,36007620,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,2639.0,1715.35,99.88,3259.0,42
CDM,36007630,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,2639.0,1715.35,99.88,3259.0,42
CDM,36007640,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,2639.0,1715.35,99.88,3259.0,42
CDM,36007650,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,2639.0,1715.35,99.88,3259.0,42
CDM,36007660,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,771.0,501.15,50.78,2849.0,31
CDM,36007670,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,771.0,501.15,50.78,2849.0,31
CDM,36007680,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,771.0,501.15,50.78,2849.0,31
CDM,36007690,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,771.0,501.15,50.78,2849.0,31
CDM,36007700,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,771.0,501.15,50.78,2849.0,31
CDM,36007710,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,8546.0,5554.9,106.64,7691.4,32
CDM,36007720,INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL,5839.0,3795.35,84.51,5255.1,32
CDM,36007730,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,20293.0,13190.45,84.32,18263.7,42
CDM,36007740,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,20293.0,13190.45,253.71,18263.7,42
CDM,36007750,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,20293.0,13190.45,317.27,18263.7,42
CDM,36007760,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,20293.0,13190.45,444.09,18263.7,42
CDM,36007770,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,20293.0,13190.45,235.78,18263.7,42
CDM,36007780,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,20293.0,13190.45,158.73,18263.7,42
CDM,36007790,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,5391.0,3504.15,115.22,6289.0,49
CDM,36007800,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,33548.0,21806.2,282.12,30193.2,42
CDM,36007810,PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH,33548.0,21806.2,512.45,30193.2,42
CDM,36007820,PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH,33548.0,21806.2,527.64,30193.2,42
CDM,36007830,PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW,35879.0,23321.35,405.5,32291.1,42
CDM,36007840,BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT,5161.0,3354.65,164.37,4644.9,31
CDM,36007850,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH 1/MLT,4763.0,3095.95,172.84,4330.07,31
CDM,36007860,REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I,5826.0,3786.9,189.01,5243.4,31
CDM,36007870,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,9316.0,6055.4,144.38,8384.4,49
CDM,36007880,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,3838.0,2494.7,185.09,4214.0,49
CDM,36007890,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,3838.0,2494.7,78.74,4214.0,49
CDM,36007900,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,3838.0,2494.7,78.74,4214.0,49
CDM,36007910,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,11779.0,7656.35,245.69,10601.1,49
CDM,36007920,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,11779.0,7656.35,245.69,10601.1,49
CDM,36007930,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,19831.0,12890.15,304.97,17847.9,49
CDM,36007940,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,11779.0,7656.35,230.35,10601.1,49
CDM,36007950,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,11779.0,7656.35,119.32,10601.1,49
CDM,36007960,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,11779.0,7656.35,119.32,10601.1,49
CDM,36007970,ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC,755.0,490.75,126.84,5474.5,31
CDM,36007980,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,19831.0,12890.15,243.79,17847.9,42
CDM,36007990,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,19831.0,12890.15,318.24,17847.9,42
CDM,36008000,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,19831.0,12890.15,408.35,17847.9,42
CDM,36008010,URETERAL EMBOLIZATION/OCCLUSION W/IMG GID RS&I,755.0,490.75,126.84,5474.5,31
CDM,36008020,BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I,1633.0,1061.45,218.64,5474.5,31
CDM,36008030,PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL,14993.0,9745.45,1010.46,18285.0,32
CDM,36008040,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST,8501.0,5525.65,710.74,18285.0,39
CDM,36008050,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL,7801.0,5070.65,304.24,18285.0,39
CDM,36008070,INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY,9876.0,6419.4,414.73,23296.25,32
CDM,36008080,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,2639.0,1715.35,130.58,4214.0,49
CDM,36008090,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,1499.0,974.35,169.35,4214.0,49
CDM,36008100,LARYNGOSCOPY FLEXIBLE RMVL LESION(S) NON-LASER,21200.0,13780.0,170.9,19080.0,42
CDM,36008110,TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD,47365.0,30787.25,1793.67,42628.5,32
CDM,36008120,LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,9916.0,6445.4,170.53,13665.0,49
CDM,36008130,LARYNGOSCOPY FLEXIBLE W/INJECTION AGMNTJ UNI,9916.0,6445.4,170.9,13665.0,49
CDM,36008140,PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT,16325.0,10611.25,786.51,18285.0,32
CDM,36008150,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I,11165.0,7257.25,201.64,10048.5,49
CDM,36008155,PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT,16325.0,10611.25,786.51,18285.0,32
CDM,36008160,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,40980.0,26637.0,288.21,36882.0,42
CDM,36008165,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I,11165.0,7257.25,201.64,10048.5,49
CDM,36008170,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT,40299.0,26194.35,379.49,36269.1,42
CDM,36008175,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,40980.0,26637.0,288.21,36882.0,42
CDM,36008180,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH,40980.0,26637.0,441.15,36882.0,42
CDM,36008185,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT,40299.0,26194.35,379.49,36269.1,42
CDM,36008190,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP,81510.0,52981.5,531.77,73359.0,42
CDM,36008195,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH,40980.0,26637.0,441.15,36882.0,42
CDM,36008200,PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT,66481.0,43212.65,613.92,59832.9,42
CDM,36008205,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP,81510.0,52981.5,531.77,73359.0,42
CDM,36008210,TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,20284.0,13184.6,175.85,18255.6,31
CDM,36008215,PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT,66481.0,43212.65,613.92,59832.9,42
CDM,36008220,STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR,30508.0,19830.2,249.07,27457.2,31
CDM,36008225,TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,20284.0,13184.6,175.85,18255.6,31
CDM,36008230,DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I,28463.0,18500.95,241.03,25616.7,31
CDM,36008235,STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR,30508.0,19830.2,249.07,27457.2,31
CDM,36008240,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,40980.0,26637.0,416.7,36882.0,42
CDM,36008245,DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I,28463.0,18500.95,241.03,25616.7,31
CDM,36008255,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,40980.0,26637.0,416.7,36882.0,42
CDM,36008260,TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART,9008.0,5855.2,206.77,8107.2,31
CDM,36008265,TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART,9008.0,5855.2,206.77,8107.2,31
CDM,36008275,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN,40980.0,26637.0,356.52,36882.0,42
CDM,36008280,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN,40980.0,26637.0,356.52,36882.0,42
CDM,36008285,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN,6755.0,4390.75,174.54,6079.5,31
CDM,36008300,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN,6755.0,4390.75,174.54,6079.5,31
CDM,36008320,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,5973.0,3882.45,118.99,6317.0,49
CDM,36008330,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,5973.0,3882.45,130.04,6317.0,49
CDM,36008335,SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY,5024.0,3265.6,844.03,18285.0,32
CDM,36008340,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,7679.0,4991.35,101.28,6911.1,49
CDM,36008350,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,5973.0,3882.45,121.16,6317.0,49
CDM,36008360,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,5973.0,3882.45,119.23,6317.0,49
CDM,36008370,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,7679.0,4991.35,139.46,6911.1,49
CDM,36008380,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,7679.0,4991.35,113.52,7730.0,49
CDM,36008390,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,7679.0,4991.35,126.55,7730.0,49
CDM,36008400,LAPAROTOMY ISLET CELL TRANSP,10860.0,7059.0,1485.52,9774.0,28
CDM,36008410,LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT,21200.0,13780.0,275.24,19080.0,49
CDM,36008420,LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI,21200.0,13780.0,206.25,19080.0,42
CDM,36008430,BRONCHOSCOPY BALLOON OCCLUSION,39804.0,25872.6,235.26,35823.6,49
CDM,36008440,REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ,5570.0,3620.5,218.28,18285.0,32
CDM,36008450,REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ,3610.0,2346.5,191.02,18285.0,32
CDM,36008460,RMVL FECAL IMPACTION/FB SPX UNDER ANES,6780.0,4407.0,289.85,8370.0,49
CDM,36008470,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,1249.0,811.85,82.94,4214.0,38
CDM,36008480,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,5973.0,3882.45,66.8,6289.0,49
CDM,36008575,ANES PRE-POST OP BLOCK,824.0,535.6,138.43,741.6,21
CDM,36008600,ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION,33369.0,21689.85,531.7,30032.1,42
CDM,36008610,ENDOVEN ABLTI THER CHEM ADHESIVE 1ST VEIN,38854.0,25255.1,211.81,34968.6,42
CDM,36008620,ENDOVEN ABLTI THER CHEM ADHESIVE SBSQ VEIN,4924.0,3200.6,105.72,4431.6,38
CDM,36008630,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,14310.0,9301.5,87.17,12879.0,49
CDM,36009205,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,1910.0,1241.5,184.81,3920.0,38
CDM,36009235,OPEN IMPLANTATION NEA SACRAL NERVE,22811.0,14827.15,792.35,20773.0,42
CDM,36009275,UNLISTED PROCEDURE SPINE,2233.0,1451.45,240.79,3909.18,41
CDM,36009285,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,18656.0,12126.4,514.97,16790.4,42
CDM,36009515,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,1698.0,1103.7,477.14,9115.0,42
CDM,36009525,INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH,658.0,427.7,60.96,4214.0,38
CDM,36009585,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,47980.0,31187.0,5529.0,43182.0,40
CDM,36009625,XTRNL CANNULA DECLTNG SPX W/BALO CATH,38854.0,25255.1,162.32,34968.6,42
CDM,36009635,XTRNL CANNULA DECLTNG SPX W/O BALO CATH,11165.0,7257.25,128.64,10048.5,49
CDM,36009705,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,3678.0,2390.7,152.85,3920.0,38
CDM,36009905,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT,38066.0,24742.9,1812.0,34259.4,32
CDM,36010445,RMVL PERITONEAL-VENOUS SHUNT,18098.0,11763.7,555.02,36332.0,49
CDM,36010825,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,745.0,484.25,91.06,3920.0,49
CDM,36010975,EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM,2639.0,1715.35,173.17,4214.0,49
CDM,36010WE,INTRO. OF CATH SUP/INF VENA CAVA,872.0,566.8,82.95,914.77,35
CDM,36011115,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,5006.0,3253.9,88.91,4505.4,49
CDM,36011125,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,559.0,363.35,47.59,4151.0,38
CDM,36011735,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,13975.0,9083.75,193.54,12577.5,49
CDM,36011775,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,65285.0,42435.25,636.76,76175.0,42
CDM,36011785,INJECTION SINUS TRACT DIAGNOSTIC,1348.0,876.2,43.91,4151.0,38
CDM,36011795,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,38854.0,25255.1,893.37,34968.6,42
CDM,36011WE,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,1256.0,816.4,113.62,1517.12,35
CDM,36012595,EVASC RPR DPLMNT AORTO-AORTIC NDGFT,37216.0,24190.4,1467.9,33494.4,32
CDM,36012605,EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT,8097.0,5263.05,1360.3,18285.0,32
CDM,36012615,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT,19796.0,12867.4,1630.09,18285.0,32
CDM,36012625,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT RPT,19796.0,12867.4,1940.0,18285.0,32
CDM,36012635,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT,38065.0,24742.25,1812.0,34258.5,32
CDM,36012645,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT,19796.0,12867.4,1940.0,18285.0,32
CDM,36012665,EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT,19796.0,12867.4,1940.0,18285.0,32
CDM,36012675,PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR,12828.0,8338.2,383.32,18285.0,32
CDM,36012685,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL,12828.0,8338.2,946.9,18285.0,32
CDM,36012695,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL,12828.0,8338.2,351.55,18285.0,32
CDM,36012705,TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I,12828.0,8338.2,775.08,18285.0,32
CDM,36012715,PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT,12050.0,7832.5,146.82,10845.0,31
CDM,36012725,OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH,23326.0,15161.9,322.92,20993.4,25
CDM,36012795,TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH,18805.0,12223.25,1940.0,16924.5,30
CDM,36012805,TMVI W/PROSTHETIC VALVE TRANSTHORACIC EXPOSURE,18804.0,12222.6,1940.0,16923.6,30
CDM,36012815,ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION,33369.0,21689.85,531.7,30032.1,42
CDM,36012845,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,14310.0,9301.5,87.17,12879.0,49
CDM,36012945,EVASC RPR DPLMNT ILIO-ILIAC NDGFT,19797.0,12868.05,1381.69,18285.0,32
CDM,36012WE,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,1404.0,912.6,125.34,1566.79,35
CDM,36013075,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS,81923.0,53249.95,456.32,76175.0,42
CDM,36013085,INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD,62500.0,40625.0,412.38,76175.0,42
CDM,36013095,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,59484.0,38664.6,193.69,53535.6,42
CDM,36013115,OPN FEM ART EXPOS DLVR EVASC PROSTH UNI,23325.0,15161.25,245.96,20992.5,32
CDM,36013135,EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE,33429.0,21728.85,241.89,30086.1,32
CDM,36013235,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,7679.0,4991.35,101.28,6911.1,49
CDM,36013325,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,5973.0,3882.45,118.99,6317.0,49
CDM,36013345,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,5973.0,3882.45,121.16,6317.0,49
CDM,36013765,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,7679.0,4991.35,133.87,6911.1,49
CDM,36013945,I&D HEMATOMA,4733.0,3076.45,795.14,4259.7,21
CDM,36013WE,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,1008.0,655.2,89.8,1412.72,35
CDM,36014235,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,38853.0,25254.45,707.92,34967.7,42
CDM,36014255,CATHJ UMBILICAL VEIN DX/THER NB,161.0,104.65,27.05,3920.0,38
CDM,36014655,"UNLISTED PROCEDURE, VASCULAR INJECTION",463.0,300.95,77.78,521.0,30
CDM,36014815,TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY,32739.0,21280.35,1328.39,29465.1,32
CDM,36014885,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,1734.0,1127.1,39.41,46695.0,32
CDM,36014915,CT BIOPSY ADRENAL,2233.0,1451.45,627.47,15651.0,41
CDM,36014WE,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,1329.0,863.85,110.79,1473.31,35
CDM,36015245,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,50080.0,32552.0,520.77,45072.0,49
CDM,36015865,SALPINGECTOMY COMPLETE/PARTIAL UNI/BI SPX,5024.0,3265.6,844.03,18285.0,32
CDM,36015WE,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,1404.0,912.6,126.81,1561.54,35
CDM,36016355,CYSTO W/INSERT URETERAL STENT,19831.0,12890.15,187.94,17847.9,42
CDM,36016525,CHANGE CYSTOSTOMY TUBE COMPLICATED,3838.0,2494.7,96.98,6289.0,49
CDM,36016585,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,18896.0,12282.4,1418.68,18285.0,32
CDM,36016745,NJX PX CNTRST KNE ARTHG CNTRST ENHNCD CT/MRI KNE,978.0,635.7,47.18,3920.0,38
CDM,36016755,INSERTION PICC W/RS&I < 5 YR,4444.0,2888.6,103.21,6317.0,48
CDM,36016765,INSERTION PICC W/RS&I 5 YR/>,11165.0,7257.25,100.8,10048.5,49
CDM,36016775,PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG,19831.0,12890.15,183.86,17847.9,42
CDM,36016785,PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS,19831.0,12890.15,306.56,17847.9,42
CDM,36016815,EXCISION INFECTED GRAFT EXTREMITY,22623.0,14704.95,665.39,20360.7,42
CDM,36016845,REMOVAL COMPLETE IIMS INCL IMG S&I,18196.0,11827.4,3342.0,16376.4,40
CDM,36016855,REMOVAL IIMS ELECTRODE ONLY INCL IMG S&I,18196.0,11827.4,916.39,16376.4,40
CDM,36016865,REMOVAL IIMS IMPLANTABLE MNTR ONLY INCL IMG S&I,18196.0,11827.4,3342.0,16376.4,40
CDM,36016905,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,19831.0,12890.15,461.62,17847.9,49
CDM,36016945,NJX PX CNTRST KNE ARTHG CNTRST ENHNCD CT/MRI KNE,978.0,635.7,47.18,3920.0,38
CDM,36016955,INSERTION PICC W/RS&I < 5 YR,4444.0,2888.6,103.21,6317.0,48
CDM,36016965,INSERTION PICC W/RS&I 5 YR/>,11165.0,7257.25,100.8,10048.5,49
CDM,36016975,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,19831.0,12890.15,461.62,17847.9,49
CDM,36016985,REMOVAL OF SINUS TARSI IMPLANT,16223.0,10544.95,1342.37,14600.7,40
CDM,36016995,REMOVAL AND REINSERTION OF SINUS TARSI IMPLANT,18213.0,11838.45,3342.0,16391.7,40
CDM,36017015,INSERTION WRLS CAR STIMULATOR LV PACG COMPL SYS,34791.0,22614.15,3686.0,70939.0,40
CDM,36017025,INSERTION WRLS CAR STIMULATOR LV PACG ELTRD ONLY,20025.0,13016.25,916.39,22690.56,40
CDM,36017035,INSERTION WRLS CAR STIMULATOR LV PACG BTH COMPNT,13500.0,8775.0,3496.5,22690.56,40
CDM,36017045,REMOVAL PG WCS LV PACG BATTERY COMPONENT ONLY,18196.0,11827.4,3653.06,16376.4,40
CDM,36017055,REMOVAL&RPLCMT PG WCS LV PACG BOTH COMPONENTS,52326.0,34011.9,3686.0,47093.4,40
CDM,36017065,RMVL&RPLCMT PG WCS LV PACG BATTERY COMPNT ONLY,22830.0,14839.5,3686.0,70939.0,40
CDM,36017075,INSERTION/REPLACEMENT COMPLETE IIMS,18738.0,12179.7,4706.22,41349.42,40
CDM,36017085,INSERTION/REPLACEMENT IIMS ELECTRODE ONLY,13548.0,8806.2,916.39,20773.0,40
CDM,36017095,INSERTION/REPLACEMENT IIMS IMPLANTABLE MNTR ONLY,41380.0,26897.0,3686.0,37242.0,40
CDM,36017115,PLC OF ENDOBRONCHIAL BLOCKER,1008.0,655.2,194.87,2849.0,41
CDM,36017135,TANGENTIAL BIOPSY SKIN SINGLE LESION,745.0,484.25,41.49,4151.0,49
CDM,36017145,TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,199.0,129.35,24.25,3920.0,38
CDM,36017155,PUNCH BIOPSY SKIN SINGLE LESION,1499.0,974.35,52.3,4151.0,49
CDM,36017165,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,230.0,149.5,28.8,3920.0,38
CDM,36017175,INCISIONAL BIOPSY SKIN SINGLE LESION,2295.0,1491.75,63.47,4151.0,48
CDM,36017185,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,354.0,230.1,34.35,3920.0,38
CDM,36017205,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,18214.0,11839.1,99.11,20773.0,42
CDM,36017215,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,5058.0,3287.7,97.55,6317.0,49
CDM,36017265,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,47510.0,30881.5,542.77,46695.0,42
CDM,36017275,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,22623.0,14704.95,580.64,20360.7,42
CDM,36017285,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,18214.0,11839.1,99.11,20773.0,42
CDM,36017295,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,5058.0,3287.7,97.55,6317.0,49
CDM,36017315,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,4046.0,2629.9,86.76,4268.0,49
CDM,36017335,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,4046.0,2629.9,131.08,4268.0,49
CDM,36017445,TRIGEMINAL BALLOON COMPRESSION,3094.0,2011.1,249.83,8550.0,48
CDM,36017485,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,5973.0,3882.45,130.04,6317.0,49
CDM,36017525,INS TUNNEL CVAD W SUB Q PORT < 5,8949.0,5816.85,1503.43,8054.1,21
CDM,36017555,REPLACE TRICUSPID VALVE PERQ,13191.0,8574.15,620.6,11871.9,40
CDM,36017635,PERCUTANEOUS CRYOABLATION ABDOMEN,7452.0,4843.8,454.96,8370.0,48
CDM,36017905,TTVR PERCUTANEOUS APPROACH INITIAL PROSTHESIS,18896.0,12282.4,1940.0,17006.4,30
CDM,36017915,TTVR PERCUTANEOUS APPROACH EACH ADDL PROSTHESIS,9843.0,6397.95,1653.62,10785.67,30
CDM,36017975,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,19146.0,12444.9,816.59,17231.4,40
CDM,36018005,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,141.0,91.65,17.96,3920.0,49
CDM,36018015,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,141.0,91.65,17.96,3920.0,49
CDM,36018025,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,11165.0,7257.25,270.56,10048.5,49
CDM,36018035,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,6766.0,4397.9,283.81,18285.0,39
CDM,36018045,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,6643.0,4317.95,332.3,18285.0,39
CDM,36018055,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,6643.0,4317.95,250.29,18285.0,39
CDM,36018065,EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI,43282.0,28133.3,527.59,38953.8,32
CDM,36018105,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,5973.0,3882.45,102.71,6317.0,49
CDM,36018115,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,5973.0,3882.45,125.3,6317.0,49
CDM,36018125,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,5973.0,3882.45,99.18,6317.0,49
CDM,36018135,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,5973.0,3882.45,100.09,5375.7,49
CDM,36018145,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,16843.0,10947.95,178.82,15158.7,49
CDM,36018175,EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI,39377.0,25595.05,1466.48,35439.3,32
CDM,36018185,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,6643.0,4317.95,332.3,18285.0,39
CDM,36018195,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,6643.0,4317.95,250.29,18285.0,39
CDM,36018265,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,3555.0,2310.75,93.49,6289.0,48
CDM,36018285,EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX,1963.0,1275.95,329.78,18285.0,39
CDM,36018305,DISRUPTION-FIBRIN SHEATH W/BALLOON,4310.0,2801.5,620.6,13665.0,47
CDM,36018355,REVASC ENDOV W/IVL INCL ANGIOPLASTY,81510.0,52981.5,2345.0,73359.0,40
CDM,36018365,REVASC ENDOV W/IVL W/STENT INCL ANGIOPLASTY,46639.0,30315.35,2345.0,41975.1,40
CDM,36018375,REVASC ENDOV W/IVL W/ATHERECTOMY INCL ANGIOPLASTY,129064.0,83891.6,2772.0,116157.6,40
CDM,36018385,REVASC ENDOV W/IVL W/STENT-ATHER INCL ANGIOPLASTY,43076.0,27999.4,2772.0,38933.13,40
CDM,36018455,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,9316.0,6055.4,183.64,8384.4,49
CDM,36018495,INSJ PERQ VAD W/RS&I R HEART VENOUS ACCESS ONLY,9580.0,6227.0,414.88,23296.25,32
CDM,36018555,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES), W/IVL,",33536.0,21798.4,2345.0,30182.4,40
CDM,36018565,"REVASC ENDOV, OPEN OR PERC,  TIBIAL/PERONEAL ARTERY(IES); W/IVL,",57686.0,37495.9,2345.0,51917.4,40
CDM,36018575,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",45430.0,29529.5,2345.0,40887.0,40
CDM,36018585,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",48549.0,31556.85,2345.0,43694.1,40
CDM,36018595,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,2546.0,1654.9,60.57,4151.0,49
CDM,36018605,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,1701.0,1105.65,73.82,4268.0,38
CDM,36018615,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,7679.0,4991.35,153.57,6911.1,49
CDM,36018625,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,7679.0,4991.35,114.19,6911.1,49
CDM,36018635,CANNULATION THORACIC DUCT,8934.0,5807.1,341.56,8040.6,38
CDM,36018755,TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE,37234.0,24202.1,1843.28,33510.6,32
CDM,36018915,TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,3918.0,2546.7,153.57,10785.67,31
CDM,36019055,THERMAL DSTRJ INTRAOSSEOUS BVN 1ST 2 LMBR/SAC,55999.0,36399.35,491.67,50399.1,42
CDM,36019345,ART BYPASS CAROTID-SUBCLAVIAN,35547.0,23105.55,1397.3,31992.3,32
CDM,36019365,VISC & INFRAREN ABD 1 PROSTH,39377.0,25595.05,1940.0,35439.3,31
CDM,36019375,VISC & INFRAREN ABD 2 PROSTH,43282.0,28133.3,1940.0,38953.8,31
CDM,36019385,VISC & INFRAREN ABD 3 PROSTH,47188.0,30672.2,1940.0,42469.2,31
CDM,36019395,"EMBO/THROM FEM/POP, AORTAILIAC ART",38853.0,25254.45,1215.71,34967.7,42
CDM,36019415,ART BYP FEMORAL-FEMORAL,26455.0,17195.75,1285.35,23809.5,32
CDM,36019465,ARTVEN ANAST OPN UPR ARM BASLILIC VEN TRANS,38854.0,25255.1,863.44,34968.6,42
CDM,36019475,TAVR OPEN FEMORAL APPROACH,35547.0,23105.55,1545.24,31992.3,32
CDM,36019835,THERMAL DSTRJ INTRAOSSEOUS BVN EA ADDL LMBR/SAC,24250.0,15762.5,231.74,21825.0,31
CDM,36019865,EMBO/THROM POP/TIBIO/PERONEAL ART,38853.0,25254.45,1128.06,34967.7,42
CDM,36019875,"INJ SCLEROSING SOLUTION, SINGLE VEIN",2871.0,1866.15,45.28,4151.0,49
CDM,36019925,"OPN BRACH ART EXPOS PROS, UNLAT",24733.0,16076.45,154.98,22259.7,32
CDM,36019935,REPAIR BLOOD VESSEL UPPER EXT,22623.0,14704.95,940.87,20360.7,42
CDM,36019955,VISC & INFRAREN ABD 4+ PROSTH,51094.0,33211.1,1940.0,45984.6,31
CDM,36020015,BYP OTH/THN VEIN CAROTID-VERTEBRAL,20633.0,13411.45,1185.76,18569.7,32
CDM,36020035,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,22623.0,14704.95,444.55,20360.7,42
CDM,36020045,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,5058.0,3287.7,706.25,6317.0,49
CDM,36020095,RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP,2546.0,1654.9,30.69,2291.4,41
CDM,36020105,ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER,2722.0,1769.3,284.18,18285.0,32
CDM,36020115,AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION,20633.0,13411.45,1940.0,18569.7,32
CDM,36020135,TAVR TRANSAORTIC APPROACH,51028.0,33168.2,1674.78,45925.2,32
CDM,36020145,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,81510.0,52981.5,890.12,73359.0,42
CDM,36020155,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,81510.0,52981.5,676.74,73359.0,42
CDM,36020165,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,129064.0,83891.6,859.26,116157.6,42
CDM,36020175,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,81510.0,52981.5,1013.41,73359.0,42
CDM,36020195,PERQ AV FISTULA CREATION UXTR SINGLE ACCESS,129064.0,83891.6,430.88,116157.6,42
CDM,36020205,PERQ AV FISTULA CREATION UXTR SEP ACCESS SITES,129064.0,83891.6,550.47,116157.6,42
CDM,36020265,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,38854.0,25255.1,955.66,34968.6,42
CDM,36024015,TRANSCERVICAL ABLATION UTERINE FIBROID RF,42520.0,27638.0,478.98,38268.0,42
CDM,36024025,INSJ/RPLCMT PERQ ELTRD RA SPI W/INTEGRATED NSTIM,62351.0,40528.15,2126.0,56115.9,40
CDM,36024035,REVJ/RMVL NSTIM ELTRD RA SPI W/INTEGRATED NSTIM,17195.0,11176.75,1810.0,15475.5,40
CDM,36024045,INSJ/RPLCMT PERQ ELTRD RA SAC W/INTEGRATED NSTIM,64895.0,42181.75,2126.0,58405.5,33
CDM,36024055,REVJ/RMVL NSTIM ELTRD RA SAC W/INTEGRATED NSTIM,17195.0,11176.75,1810.0,15475.5,40
CDM,36024105,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,7868.0,5114.2,211.77,7730.0,49
CDM,36024165,BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN,5898.0,3833.7,990.86,18285.0,32
CDM,36024195,LOOP REVISION,4905.0,3188.25,620.6,4414.5,40
CDM,36024245,OPEN CAROTID TAVR (COMP CODE 33362),32914.0,21394.1,620.6,29622.6,40
CDM,36024255,REPAIR BLOOD VESSEL DIRECT NECK,38854.0,25255.1,1103.7,34968.6,42
CDM,36024345,ABLTJ 1/+THYROID NODULE 1 LOBE/ISTHMUS PERQ RF,8101.0,5265.65,372.73,8550.0,46
CDM,36024455,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,11125.0,7231.25,948.29,18285.0,32
CDM,36024525,TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY,5773.0,3752.45,969.86,18285.0,32
CDM,36024535,STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY,5238.0,3404.7,581.93,18285.0,29
CDM,36024545,MICRODISSECTION TESTICULAR SPERM EXTRACTION (54522),16609.0,10795.85,244.13,14948.1,48
CDM,36024555,BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION,18648.0,12121.2,165.97,16783.2,42
CDM,36024565,IMAGE GUIDED VERTEBRAL BODY FIDUCIAL MARKER PLCMNT (COMP CODE 22,16656.0,10826.4,240.79,14990.4,41
CDM,36024595,CT GUIDED ACETABULOPLASTY (COMP CODE 22511),16656.0,10826.4,240.79,14990.4,48
CDM,36024615,IMAGE GUIDED CHEST TUBE EXCHANGE REPOSITION (COMP CODE 49423),9792.0,6364.8,599.03,8812.8,40
CDM,36024625,CRYOABLATION ABDOMINAL WALL MASS (COMP CODE 20983),36809.0,23925.85,98.33,33128.1,48
CDM,36024635,IMAGE GUIDED - CRYOABLATION OF ADRENAL GLAND (COMP CODE 50593),49041.0,31876.65,1810.0,44136.9,41
CDM,36024645,DIRECT PUNCTURE JUGULAR VEIN (COMP CODE 36005),2554.0,1660.1,390.0,2298.6,30
CDM,36024655,RF ABLATION BILIARY TRACT (COMP CODE 47556),52963.0,34425.95,941.1,47666.7,48
CDM,36024665,PLCMNT RETRO NEPHROURETERAL CATHETER (COMP CODE 50688),11779.0,7656.35,244.13,10601.1,48
CDM,36024675,RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/O BYP,6108.0,3970.2,1026.14,18285.0,32
CDM,36024685,RFA MSK TUMOR (COMP CODE 20982),73984.0,48089.6,240.79,66585.6,48
CDM,36024695,IMPAR GANGLION COCCYGEAL NEUROLYSIS (COMP CODE 64680),7679.0,4991.35,249.83,8550.0,48
CDM,36024705,REPOSITION PERITONEAL DIALYSIS CATH (COMP CODE 36597),11165.0,7257.25,454.96,10048.5,48
CDM,36024715,SHOULDER AUGMENTATION W/CEMENT (COMP CODE 22513),41076.0,26699.4,240.79,36968.4,41
CDM,36024725,PERCUTANEOUS HEPATIC PERFUSION DELIVERY OF INTRA-ARTERIAL HIGH D,1861.0,1209.65,522.94,13665.0,47
CDM,36024735,PREOP WIRE LOCALIZATION INTRAPERITONEAL (COMP CODE 49411),7868.0,5114.2,454.96,8370.0,48
CDM,36024745,MICROWAVE ABLATION ADRENAL GLAND (COMP CODE 50592),33548.0,21806.2,1810.0,30193.2,41
CDM,36024755,VAGINAL CUFF BIOPSY (COMP CODE 57100),5006.0,3253.9,201.93,8550.0,48
CDM,36024765,RADIOFREQUENCY ABLATION SOFT TISSUE MASS (COMP CODE 20982),73984.0,48089.6,240.79,66585.6,48
CDM,36024775,RADIOFREQUENCY ABLATION SUBCUTANEOUS MASS  (COMP CODE 20982),73984.0,48089.6,98.33,66585.6,48
CDM,36024785,RADIOFREQUENCY ABLATION INTRA ABDOMINAL MASS (COMP CODE 50592),33548.0,21806.2,454.96,30193.2,48
CDM,36024795,CRYOABLATION OF INTRA ABDOMINAL MASS (COMP CODE 50593),32064.0,20841.6,454.96,28857.6,48
CDM,36024805,CRYOABLATION OF SUBCUTANEOOUS MASS (COMP CODE 20983),41076.0,26699.4,98.33,36968.4,48
CDM,36024815,CRYOABLATION OF SOFT TISSUE  MASS (COMP CODE 20983),41076.0,26699.4,240.79,36968.4,48
CDM,36024825,FIBRIN SHEATH DISRUPTION W/BALLOON (COMP CODE 36595),22623.0,14704.95,620.6,20360.7,47
CDM,36024835,SELECTIVE EXTERNAL CAROTID ANGIOGRAPHY (COMP CODE 36227),8083.0,5253.95,620.6,13665.0,47
CDM,36024845,FAT PAD BIOPSY (COMP CODE 20200),9316.0,6055.4,98.33,8384.4,48
CDM,36024865,SPINAL ACCESSORY NERVE BLOCK (COMP CODE 64405),2546.0,1654.9,249.83,8550.0,48
CDM,36024875,PERINEURAL TARSAL TUNNEL INJECTION (COMP CODE 64450),5972.0,3881.8,240.79,36332.0,48
CDM,36024885,RADIOFREQUENCY ABLATION PARATHYROID ADENOMA (COMP CODE 20982),73984.0,48089.6,1810.0,66585.6,41
CDM,36024895,SUPRA PUBIC CATHETER REPOSITION (COMP CODE 36597),11165.0,7257.25,244.13,10048.5,48
CDM,36024905,CRYOABLATION AVM (COMP CODE 20983),41076.0,26699.4,620.6,36968.4,47
CDM,36024915,VENOUS SINUS TEST BALLOON OCCLUSION (COMP CODE 61623),61270.0,39825.5,620.6,55143.0,47
CDM,36024925,IMAGE GUIDED LUNG LOCALIZATION (COMP CODE 32553),7868.0,5114.2,599.03,7081.2,40
CDM,36024935,BILAT MIDDLE MENINGEAL ARTERY LIDOCAINE INFUSION (COMP CODE 6165,8501.0,5525.65,620.6,13665.0,47
CDM,36024945,INJECTION HEPATIC ARTERY INFUSION PUMP (COMP CODE 36598),1514.0,984.1,254.35,1362.6,30
CDM,36024955,IMAGE GUIDED REPOSITION G-TUBE (COMP CODE 43761),1399.0,909.35,393.12,7730.0,48
CDM,36024965,"INCISION AND DRAINAGE HEMATOMA, VAGINAL OB/POSTPARTUM",4833.0,3141.45,206.8,7730.0,49
CDM,36024985,TEAEC W/WO PATCH GRAFT ILIOFEMORAL,8323.0,5409.95,1225.51,18285.0,32
CDM,36024995,CLTX POST HIP ARTHRP DISLC REQ ANES,8271.0,5376.15,632.74,8370.0,49
CDM,36025005,BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED,20708.0,13460.2,182.66,18637.2,31
CDM,36025015,BX PROSTATE TRANSRECTAL US GID W/MRI FUS GDN 1ST,20708.0,13460.2,229.26,18637.2,31
CDM,36025025,BX PROSTATE TRANSPERINEAL ULTRASOUND-GUIDED,20708.0,13460.2,219.71,18637.2,31
CDM,36025035,BX PROSTATE TRANSPERINEAL US GID W/MRI FUS GDN 1,20708.0,13460.2,255.17,18637.2,31
CDM,36025045,BX PROSTATE TRANSRECTAL MRI-US GID TRGT LES 1ST,20708.0,13460.2,181.63,18637.2,31
CDM,36025055,BX PROSTATE TPRNL MRI-US GID TRGT LES 1ST,20708.0,13460.2,212.45,18637.2,31
CDM,36025065,BX PROSTATE IN-BORE CT/MRI BX ADDL TRGT LES 1ST,31498.0,20473.7,254.73,28348.2,31
CDM,36025075,BX PROSTATE IN-BORE CT/MRI TRGT LES ONLY 1ST,31498.0,20473.7,231.43,28348.2,31
CDM,36025085,BX PROSTATE EA ADDL MRI-US FUSION/IN-BORE CT/MRI,31498.0,20473.7,64.9,28348.2,28
CDM,36025115,ABLATION IRE LIVER 1+ TUMORS W/IMG GDN PERQ,62445.0,40589.25,586.34,56200.5,31
CDM,36025135,BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS,20293.0,13190.45,544.8,22573.24,42
CDM,36025145,EV FEMPOP ARTL REVSC TCAT PLMT IV ST GRF & CLSR,58971.0,38331.15,3686.0,53073.9,40
CDM,36025155,OOPHORECTOMY PARTIAL/TOTAL UNI/BI,28385.0,18450.25,655.69,25546.5,39
CDM,36100010,DIAGNOSTIC BONE MARROW ASPIRATIONS,8101.0,5265.65,76.74,7290.9,49
CDM,36100050,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,7679.0,4991.35,133.87,6911.1,49
CDM,36100055,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,1853.0,1204.45,61.24,4268.0,38
CDM,36100065,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,2298.0,1493.7,63.06,4151.0,49
CDM,36100075,INJECTION HIP ARTHROGRAPHY W/ANESTHESIA,1091.0,709.15,94.53,3920.0,38
CDM,36100105,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,1390.0,903.5,36.13,4151.0,49
CDM,36100135,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,1249.0,811.85,82.94,4214.0,38
CDM,36100195,PERCUTANEOUS ASPIRATION SPINAL CORD CYST/SYRINX,7679.0,4991.35,434.11,6911.1,49
CDM,36100255,PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL,23624.0,15355.6,3094.77,21261.6,40
CDM,36100265,PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS,35719.0,23217.35,3094.77,32147.1,40
CDM,36100285,INSERTION PERITONEAL-VENOUS SHUNT,14631.0,9510.15,946.42,18285.0,32
CDM,36100375,EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH,15739.0,10230.35,1689.76,18285.0,32
CDM,36100435,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,2629.0,1708.85,195.7,3920.0,38
CDM,36100565,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,2410.0,1566.5,100.04,18285.0,39
CDM,36100805,BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY,1050.0,682.5,81.71,7758.12,38
CDM,36100845,INJECTION PROCEDURE SPLENOPORTOGRAPY,4288.0,2787.2,154.03,3920.0,38
CDM,36100855,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,4046.0,2629.9,86.76,4268.0,49
CDM,36100865,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,1178.0,765.7,59.99,4268.0,38
CDM,36100875,FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION,4046.0,2629.9,109.5,4268.0,49
CDM,36100885,FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL,906.0,588.9,66.22,4268.0,38
CDM,36100895,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,4046.0,2629.9,131.08,4268.0,49
CDM,36100905,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,1839.0,1195.35,92.56,4268.0,38
CDM,36100915,FINE NEEDLE ASPIRATION BX W/MR GDN 1ST LESION,4046.0,2629.9,409.06,4268.0,48
CDM,36100925,FINE NEEDLE ASPIRATION BX W/MR GDN EA ADDL,1820.0,1183.0,305.76,4268.0,37
CDM,36100935,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,47510.0,30881.5,542.77,46695.0,42
CDM,36100945,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,22623.0,14704.95,580.64,20360.7,42
CDM,36100955,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,18214.0,11839.1,99.11,20773.0,42
CDM,36100965,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,5058.0,3287.7,97.55,6317.0,49
CDM,36100985,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,933.0,606.45,30.09,2849.0,31
CDM,36100WE,INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY,1208.0,785.2,105.48,906.92,35
CDM,36101055,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,11165.0,7257.25,270.56,10048.5,49
CDM,36101065,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,6766.0,4397.9,283.81,18285.0,39
CDM,36101075,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,5973.0,3882.45,102.71,6317.0,49
CDM,36101085,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,5973.0,3882.45,125.3,6317.0,49
CDM,36101095,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,5973.0,3882.45,99.18,6317.0,49
CDM,36101105,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,16843.0,10947.95,178.82,15158.7,49
CDM,36101115,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,9316.0,6055.4,183.64,8384.4,49
CDM,36101175,MINOR SURGERY LEVEL 1 1ST 30 MIN,4243.0,2757.95,712.82,3818.7,21
CDM,36101185,MINOR SURGERY LEVEL 1 EA ADD 30 MIN,4234.0,2752.1,711.31,3810.6,21
CDM,36101195,MINOR SURGERY LEVEL 2 1ST 30 MIN,5230.0,3399.5,878.64,4707.0,21
CDM,36101205,MINOR SURGERY LEVEL 2 EA ADD 30 MIN,4856.0,3156.4,815.81,4370.4,21
CDM,36101215,MINOR SURGERY LEVEL 3 1ST 30 MIN,5918.0,3846.7,994.22,5326.2,21
CDM,36101225,MINOR SURGERY LEVEL 3 EA ADD 30 MIN,5918.0,3846.7,994.22,5326.2,21
CDM,36140WE,INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY,704.0,457.6,68.26,799.45,35
CDM,36160WE,INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR,1008.0,655.2,93.96,899.66,35
CDM,36200WE,INTRODUCTION CATHETER AORTA,1108.0,720.2,103.17,1147.33,35
CDM,36215WE,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,1835.0,1192.75,157.75,2048.41,35
CDM,36216WE,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,2108.0,1370.2,168.17,2142.09,35
CDM,36217WE,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,2516.0,1635.4,214.3,3448.01,35
CDM,36218WE,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,404.0,262.6,36.76,337.98,35
CDM,36221WE,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,1568.0,1019.2,121.1,1996.85,31
CDM,36222WE,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,2323.0,1509.95,162.76,2321.53,31
CDM,36222WE-50,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,4646.0,3019.9,2323.0,4646.0,12
CDM,36223WE,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,2530.0,1644.5,175.98,2780.4,31
CDM,36223WE-50,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,5060.0,3289.0,2530.0,5060.0,12
CDM,36224WE,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,2750.0,1787.5,191.26,3468.24,31
CDM,36224WE-50,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,5500.0,3575.0,2750.0,5500.0,12
CDM,36225WE,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,2530.0,1644.5,175.23,2687.48,31
CDM,36225WE-50,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,5060.0,3289.0,2530.0,5060.0,12
CDM,36226WE,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,2750.0,1787.5,191.6,3387.33,31
CDM,36226WE-50,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,5500.0,3575.0,2750.0,5500.0,12
CDM,36227WE,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,920.0,598.0,60.49,690.0,31
CDM,36227WE-50,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,1840.0,1196.0,920.0,1840.0,12
CDM,36228WE,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,1700.0,1105.0,123.22,2304.73,31
CDM,36228WE-50,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,3400.0,2210.0,1700.0,3400.0,12
CDM,36245WE,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,1860.0,1209.0,155.62,2489.18,35
CDM,36246WE,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,2008.0,1305.2,170.2,1640.83,35
CDM,36247WE,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,2658.0,1727.7,200.23,2874.49,35
CDM,36248WE,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,404.0,262.6,34.97,303.0,35
CDM,36251WE,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UNI,2244.0,1458.6,217.14,2595.99,35
CDM,36252INSWE,INS CATH RENAL ART 1ST BILAT,1287.0,836.55,282.59,2832.5,35
CDM,36252REMWE,THORACSCOPY REM TOTAL CORTEX,5357.0,3482.05,282.59,4017.75,35
CDM,36252WE,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BILAT,2966.0,1927.9,282.59,2832.5,35
CDM,36253WE,SUPSLCTV CATH 2ND+ORD RENL&ACCES ARTERY/S&I UNI,3212.0,2087.8,301.55,4104.79,35
CDM,36254WE,SUPSLCTV CATH 2ND+ORD RENL&ACCES ARTER/S&I BILAT,3160.0,2054.0,325.39,4026.28,35
CDM,36260WE,INSJ IMPLANTABLE INTRA-ARTERIAL INFUSION PUM,3964.0,2576.6,448.88,3964.0,35
CDM,36261WE,REVIS IMPLANT INTRA-ART INFUS PUMP,2252.0,1463.8,216.32,2252.0,35
CDM,36262WE,REMOV IMPLANT INTRA-ART INFUS PUMP,1644.0,1068.6,160.69,1644.0,35
CDM,36299RVU1WE,INJECTION FOR EGD W/ ECHO TIP (COMP CODE 36481),2893.0,1880.45,139.8,2893.0,15
CDM,36299RVU2WE,DIRECT PUNCTURE JUGULAR VEIN (COMP CODE 36005),409.0,265.85,139.8,409.0,15
CDM,36299RVU3WE,INJECTION HEPATIC ARTERY INFUSION PUMP (COMP CODE 36598),296.0,192.4,139.8,296.0,15
CDM,36400WE,"VENIPUNC <3 Y/O,FEM,JUG,SAG SINUS",152.0,98.8,10.52,114.0,32
CDM,36410WE,VNPNXR 3 YEARS/> PHYS/QHP SKILL,79.0,51.35,7.12,59.25,32
CDM,36415AWE,VENIPUNCTURE (LAB DRAW),37.0,24.05,2.34,37.0,17
CDM,36415FAMWE,ROUTINE VENIPUNCTURE,37.0,24.05,2.34,37.0,17
CDM,36415WE,COLLECTION VENOUS BLOOD VENIPUNCTURE,37.0,24.05,2.34,37.0,17
CDM,36416WE,COLLECTION CAPILLARY BLOOD,31.0,20.15,3.45,31.0,14
CDM,36425WE,VENOUS CUTDOWN >1 Y/O,304.0,197.6,27.7,304.0,35
CDM,36430WE,TRANSFUSION BLOOD/BLOOD COMPONENTS,1057.0,687.05,27.55,1057.0,35
CDM,36456WE,PRTL EXCHANGE TRANSFUSE BLOOD/PLSM/CRYST NEWBORN,880.0,572.0,82.42,880.0,28
CDM,36465WE,NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN,940.0,611.0,92.65,2633.48,31
CDM,36466WE,NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS,1200.0,780.0,117.83,2754.26,31
CDM,36468WE,INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK,257.0,167.05,31.27,257.0,15
CDM,36470WE,INJECTION SCLEROSANT SINGLE INCMPTNT VEIN,300.0,195.0,36.49,254.09,35
CDM,36471LV1WE,COSMETIC SCHLEROTHERAPY MLT VNS LEV 1,189.0,122.85,55.05,298.43,35
CDM,36471LV2WE,COSMETIC SCHLEROTHERAPY MLT VNS LEV 2,375.0,243.75,55.05,298.43,35
CDM,36471LV3WE,COSMETIC SCHLEROTHERAPY MLT VNS LEV 3,590.0,383.5,55.05,442.5,35
CDM,36471MULWE,SCLEROTHERAP MULTIPLE VEINS,819.0,532.35,55.05,614.25,35
CDM,36471WE,INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS,660.0,429.0,55.05,495.0,35
CDM,36473WE,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM 1ST VEIN,1400.0,910.0,134.51,2477.91,28
CDM,36474WE,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM SBSQ VEINS,700.0,455.0,67.38,525.0,28
CDM,36475WE,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN,2120.0,1378.0,257.61,2568.07,35
CDM,36476WE,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS,1060.0,689.0,119.96,795.0,35
CDM,36478WE,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,2332.0,1515.8,266.63,2015.31,35
CDM,36479WE,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,1166.0,757.9,118.83,874.5,35
CDM,36481WE,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,2692.0,1749.8,241.07,3421.6,35
CDM,36482WE,ENDOVEN ABLTI THER CHEM ADHESIVE 1ST VEIN,1400.0,910.0,137.38,3507.2,28
CDM,36483WE,ENDOVEN ABLTI THER CHEM ADHESIVE SBSQ VEIN,700.0,455.0,68.54,525.0,28
CDM,36500WE,VEN CATHJ SLCTV ORGAN BLD SAMPLING,1404.0,912.6,104.0,1404.0,35
CDM,36510WE,CATHJ UMBILICAL VEIN DX/THER NB,436.0,283.4,26.48,327.0,35
CDM,36511WE,THR APHERESIS WHITE BLD CELL,880.0,572.0,63.15,880.0,35
CDM,36514WE,THERAPEUTIC APHERESIS PLASMA,796.0,517.4,49.22,883.95,35
CDM,36556WE,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,770.0,500.5,46.28,577.5,35
CDM,36558WE,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,2020.0,1313.0,187.6,1515.0,35
CDM,36561WE,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,2548.0,1656.2,228.07,1976.13,35
CDM,36565WE,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,2548.0,1656.2,227.16,1911.0,35
CDM,36566WE,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,2768.0,1799.2,239.0,9179.05,35
CDM,36569WE,INSERTION PICC W/O IMG GDN 5 YR/>,836.0,543.4,63.51,627.0,35
CDM,36571WE,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,2240.0,1456.0,206.82,2193.82,35
CDM,36572WE,INSERTION PICC W/RS&I < 5YR,801.0,520.65,71.08,693.82,31
CDM,36573WE,INSERTION PICC W/RS&I 5 YR >,748.0,486.2,65.84,654.16,31
CDM,36575WE,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,268.0,174.2,27.25,276.89,35
CDM,36576WE,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,1196.0,777.4,89.42,897.0,35
CDM,36578WE,RPLCMT CATH CTR VAD SUBQ PORT/PMP,1316.0,855.4,98.31,987.0,35
CDM,36580WE,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,576.0,374.4,47.07,432.0,35
CDM,36581WE,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,1292.0,839.8,134.83,1281.29,35
CDM,36582WE,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,1996.0,1297.4,192.52,1842.45,35
CDM,36583WE,RPLCMT COMPL TUN CTR VAD W/SUBQ PMP,2218.0,1441.7,205.6,2299.72,35
CDM,36584WE,COMPLETE REPLACEMENT PICC RS&I,480.0,312.0,43.66,360.0,35
CDM,36585WE,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,1836.0,1193.4,181.51,1937.56,35
CDM,36589WE,RMVL TUN CVC W/O SUBQ PORT/PMP,1003.0,651.95,86.25,752.25,35
CDM,36590WE,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,1364.0,886.6,104.56,1023.0,35
CDM,36591WE,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,36.0,23.4,13.08,52.66,32
CDM,36592WE,COLLECT BLOOD FROM CATHETER VENOUS NOS,59.0,38.35,16.16,59.0,32
CDM,36593WE,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,512.0,332.8,24.57,512.0,35
CDM,36595WE,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,1436.0,933.4,129.36,1077.0,35
CDM,36596WE,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,300.0,195.0,31.55,225.0,35
CDM,36597WE,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,484.0,314.6,28.6,363.0,35
CDM,36598WE,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,296.0,192.4,26.46,222.0,35
CDM,36600WE,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,128.0,83.2,7.56,96.0,35
CDM,36620WE,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,440.0,286.0,32.94,440.0,35
CDM,36625WE,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN,844.0,548.6,78.86,844.0,35
CDM,36680WE,PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION,528.0,343.2,45.45,528.0,35
CDM,36800WE,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,1069.0,694.85,90.9,1069.0,35
CDM,36810WE,INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL,1584.0,1029.6,145.79,1584.0,35
CDM,36815WE,INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR,1048.0,681.2,101.87,1048.0,35
CDM,36818WE,ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS,4956.0,3221.4,513.3,4956.0,35
CDM,36819WE,ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS,5316.0,3455.4,547.16,5316.0,35
CDM,36820WE,ARVEN ANAST OPN F/ARM VEIN TRPOS,5228.0,3398.2,548.18,5228.0,35
CDM,36821WE,ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT,4760.0,3094.0,435.06,4760.0,35
CDM,36822WE,INSERT CANNULA PROLONG CP INSUFF,2362.0,1535.3,351.08,2362.0,16
CDM,36825WE,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF,5668.0,3684.2,514.51,5668.0,35
CDM,36830WE,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF,4812.0,3127.8,501.2,4812.0,35
CDM,36831WE,THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF,4400.0,2860.0,297.2,4400.0,35
CDM,36832WE,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,5400.0,3510.0,462.73,5400.0,35
CDM,36833WE,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,5800.0,3770.0,390.56,5800.0,35
CDM,36836WE,PERQ AV FISTULA CREATION UXTR SINGLE ACCESS,2880.0,1872.0,257.0,12223.71,28
CDM,36837WE,PERQ AV FISTULA CREATION UXTR SEP ACCESS SITES,3720.0,2418.0,336.06,17400.7,28
CDM,36838WE,DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS,8676.0,5639.4,841.63,8676.0,35
CDM,36901WE,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I,1344.0,873.6,118.39,1008.0,31
CDM,36902WE,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,1932.0,1255.8,176.42,2017.13,31
CDM,36903WE,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT,2556.0,1661.4,230.04,9186.44,31
CDM,36904WE,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH,3000.0,1950.0,264.89,2943.52,31
CDM,36905WE,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP,3600.0,2340.0,332.5,3766.14,31
CDM,36906WE,PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT,4168.0,2709.2,388.04,11153.24,31
CDM,36907WE,(2017) TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,1200.0,780.0,101.69,1206.75,31
CDM,36908WE,STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR,1700.0,1105.0,152.43,4419.65,31
CDM,36909WE,DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I,1648.0,1071.2,144.66,3227.48,31
CDM,37000170,ANES-PARAVERT BLOCK 15MIN,405.0,263.25,68.04,364.5,21
CDM,37000180,ANES-GENERAL 15MIN,516.0,335.4,86.69,464.4,21
CDM,37000190,ANES-MAC 15MIN,570.0,370.5,95.76,513.0,21
CDM,37000200,ANES-SP-EPI COMBO 15MIN,409.0,265.85,68.71,368.1,21
CDM,37000210,ANES-BIER BLOCK 15MIN,405.0,263.25,68.04,364.5,21
CDM,37000220,ANES-REGIONAL BLOCK 15MIN,476.0,309.4,79.97,428.4,21
CDM,37000270,ANES-EPIDURAL 15MIN,376.0,244.4,63.17,338.4,21
CDM,37000280,ANES-SPINAL 15MIN,424.0,275.6,71.23,381.6,21
CDM,37000290,MODERATE SEDATION FOR ENDOSCOPY,876.0,569.4,13.94,788.4,28
CDM,37001225,MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS,1461.0,949.65,13.94,1314.9,28
CDM,37001235,MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,876.0,569.4,13.94,788.4,28
CDM,37001245,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,345.0,224.25,13.94,310.5,28
CDM,37001255,MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS,730.0,474.5,13.94,657.0,28
CDM,37001265,MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS,345.0,224.25,13.94,310.5,28
CDM,37001275,MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS,896.0,582.4,13.94,806.4,28
CDM,37001295,MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,876.0,569.4,13.94,788.4,28
CDM,37001305,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,345.0,224.25,13.94,310.5,28
CDM,37001325,MOD SEDAT ENDO SERVICE >5 YRS,876.0,569.4,7.13,788.4,28
CDM,37001375,ANES-GENERAL 15MIN ASC,516.0,335.4,86.69,464.4,21
CDM,37001385,ANES-MAC 15MIN ASC,570.0,370.5,95.76,513.0,21
CDM,37001395,ANES-REGIONAL BLOCK 15MIN ASC,477.0,310.05,80.14,429.3,21
CDM,37001405,ANES-SPINAL 15MIN ASC,424.0,275.6,71.23,381.6,21
CDM,37001415,ANES-SP-EPI COMBO 15MIN ASC,409.0,265.85,68.71,368.1,21
CDM,37001425,ANES-BIER BLOCK 15MIN ASC,406.0,263.9,68.21,365.4,21
CDM,37001435,ANES-EPIDURAL 15MIN ASC,377.0,245.05,63.34,339.3,21
CDM,37001445,ANES-PARAVERT BLOCK 15MIN ASC,406.0,263.9,68.21,365.4,21
CDM,37140WE,VENOUS ANASTOMOSIS OPEN PORTOCAVAL,16000.0,10400.0,1136.03,16000.0,35
CDM,37160WE,VENOUS ANASTOMOSIS OPEN CAVAL-MESENTERIC,15200.0,9880.0,1082.28,15200.0,35
CDM,37181WE,VENOUS ANASTOMOSIS OPEN SPLENORENAL DISTAL,16000.0,10400.0,1106.92,16000.0,35
CDM,37182WE,INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT,6788.0,4412.2,597.44,6788.0,35
CDM,37183WE,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,3096.0,2012.4,231.76,9773.73,35
CDM,37184WE,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,3700.0,2405.0,315.59,3817.03,35
CDM,37185WE,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,1443.0,937.95,116.26,1211.76,35
CDM,37186WE,SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL,2165.0,1407.25,178.83,2309.66,35
CDM,37187WE,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,3423.0,2224.95,288.8,3452.66,35
CDM,37188WE,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,2402.0,1561.3,204.43,2938.49,35
CDM,37191WE,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,1962.0,1275.3,184.18,4761.12,35
CDM,37192WE,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,2840.0,1846.0,283.65,3040.72,35
CDM,37193WE,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,2840.0,1846.0,284.13,2919.11,35
CDM,37195WE,THROMBOLYSIS CEREBRAL IV INFUSION,2075.0,1348.75,118.18,2075.0,17
CDM,37197WE,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,2658.0,1727.7,167.98,2544.73,31
CDM,37200WE,TRANSVASCULAR BIOPSY,1820.0,1183.0,161.37,1820.0,35
CDM,37211WE,THROMBOLYSIS ARTERIAL INFUSION W/IMAGING INIT TX,3100.0,2015.0,286.43,3100.0,31
CDM,37212WE,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,2724.0,1770.6,252.52,2724.0,31
CDM,37213WE,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,1900.0,1235.0,168.51,1900.0,31
CDM,37214WE,CESSATION THROMBOLYTIC THRPY W/CATHETER REMOVAL,1096.0,712.4,91.66,1096.0,31
CDM,37215WE,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,7810.0,5076.5,740.7,7810.0,35
CDM,37216WE,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,7192.0,4674.8,747.59,7192.0,23
CDM,37217WE,TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE,8152.0,5298.8,811.93,8152.0,31
CDM,37218WE,TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE,5900.0,3835.0,623.76,5900.0,31
CDM,37224FEMWE,FEM/POPL REVAS W/TLA,17752.0,11538.8,224.51,13314.0,26
CDM,37224REVWE,"REVASC, FEM/POP ARTERY(S), UNILAT W/PTA",1623.0,1054.95,224.51,6958.3,26
CDM,37228REVWE,"REVASC, TIB, PER ARTERY, UNILAT, W/PTA",1984.0,1289.6,274.85,9885.22,26
CDM,37228TIBWE,TIB/PER REVASC W/TLA,25229.0,16398.85,274.85,18921.75,26
CDM,37236WE,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,3500.0,2275.0,347.06,7515.0,31
CDM,37237WE,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL,1700.0,1105.0,162.49,4504.25,31
CDM,37238WE,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,2658.0,1727.7,243.1,7433.23,31
CDM,37239WE,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,1307.0,849.55,113.42,3671.84,31
CDM,37241WE,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,3850.0,2502.5,332.04,8293.38,31
CDM,37242WE,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,4312.0,2802.8,370.79,13960.99,31
CDM,37243WE,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,5166.0,3357.9,442.11,17621.07,31
CDM,37244WE,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,6050.0,3932.5,515.72,12351.49,31
CDM,37246WE,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,3080.0,2002.0,275.96,3868.11,31
CDM,37247WE,TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART,1540.0,1001.0,136.85,1568.7,31
CDM,37248WE,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN,2640.0,1716.0,237.29,2685.83,31
CDM,37249WE,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN,1307.0,849.55,116.44,1153.13,31
CDM,37252WE,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,792.0,514.8,72.32,2323.69,31
CDM,37253WE,INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL,634.0,412.1,57.88,475.5,31
CDM,37254WE,REVSC EVASC IVT ANGIOP UNI SF LES 1ST VSL,3212.0,2087.8,384.19,3212.0,21
CDM,37255WE,REVSC EVASC IVT ANGIOP UNI SF LES EA ADDL VSL,1320.0,858.0,156.03,1320.0,21
CDM,37256WE,REVSC EVASC IVT ANGIOP UNI CPLX LES 1ST VSL,4730.0,3074.5,563.17,4730.0,21
CDM,37257WE,REVSC EVASC IVT ANGIOP UNI CPLX LES EA ADDL VSL,1712.0,1112.8,202.05,1712.0,21
CDM,37258WE,REVSC EVASC IVT ST PLMT UNI SF LES 1ST VSL,3850.0,2502.5,460.34,3850.0,21
CDM,37259WE,REVSC EVASC IVT ST PLMT UNI SF LES EA ADDL VSL,1760.0,1144.0,209.05,1760.0,21
CDM,37260WE,REVSC EVASC IVT ST PLMT UNI CPLX LES 1ST VSL,5584.0,3629.6,665.36,5584.0,21
CDM,37261WE,REVSC EVASC IVT ST PLMT UNI CPLX LES EA ADDL VSL,1870.0,1215.5,222.1,1870.0,21
CDM,37262WE,INTRAVASCULAR LITHOTRIPSY IVT WITHIN SAME ARTERY,1320.0,858.0,153.1,1320.0,21
CDM,37263WE,REVSC EVASC FPVT ANGIOP UNI SF LES 1ST VSL,3410.0,2216.5,407.94,3410.0,21
CDM,37264WE,REVSC EVASC FPVT ANGIOP UNI SF LES EA ADDL VSL,1320.0,858.0,156.11,1320.0,21
CDM,37265WE,REVSC EVASC FPVT ANGIOP UNI CPLX LES 1ST VSL,4620.0,3003.0,551.94,4620.0,21
CDM,37266WE,REVSC EVASC FPVT ANGIOP UNI CPLX LES EA ADDL VSL,1760.0,1144.0,207.71,1760.0,21
CDM,37267WE,REVSC EVASC FPVT ST PLMT UNI SF LES 1ST VSL,3850.0,2502.5,460.68,3850.0,21
CDM,37268WE,REVSC EVASC FPVT ST PLMT UNI SF LES EA ADDL VSL,1641.0,1066.65,194.86,1641.0,21
CDM,37269WE,REVSC EVASC FPVT ST PLMT UNI CPLX LES 1ST VSL,6490.0,4218.5,774.64,6490.0,21
CDM,37270WE,REVSC EVASC FPVT ST PLMT UNI CPLX LES EA ADD VSL,2200.0,1430.0,261.75,2200.0,21
CDM,37271WE,REVSC EVASC FPVT ATHRC UNI SF LES 1ST VSL,3960.0,2574.0,468.37,3960.0,21
CDM,37272WE,REVSC EVASC FPVT ATHRC UNI SF LES EA ADDL VSL,1760.0,1144.0,206.65,1760.0,21
CDM,37273WE,REVSC EVASC FPVT ATHRC UNI CPLX LES 1ST VSL,5557.0,3612.05,656.04,5557.0,21
CDM,37274WE,REVSC EVASC FPVT ATHRC UNI CPLX LES EA ADDL VSL,2420.0,1573.0,284.77,2420.0,21
CDM,37275WE,REVSC EVASC FPVT ST ATHRC UNI SF LES 1ST VSL,4840.0,3146.0,572.58,4840.0,21
CDM,37276WE,REVSC EVASC FPVT ST ATHRC UNI SF LES EA ADDL VSL,1870.0,1215.5,220.5,1870.0,21
CDM,37277WE,REVSC EVASC FPVT ST ATHRC UNI CPLX LES 1ST VSL,6600.0,4290.0,778.47,6600.0,21
CDM,37278WE,REVSC EVSC FPVT ST ATHRC UNI CPLX LES EA ADD VSL,2640.0,1716.0,309.18,2640.0,21
CDM,37279WE,INTRAVASCULAR LITHOTRIPSY FPVT W/IN SAME ARTERY,1760.0,1144.0,204.85,1760.0,21
CDM,37280WE,REVSC EVASC TPVT ANGIOP UNI SF LES 1ST VSL,4312.0,2802.8,513.02,4312.0,21
CDM,37281WE,REVSC EVASC TPVT ANGIOP UNI SF LES EA ADDL VSL,1320.0,858.0,153.34,1320.0,21
CDM,37282WE,REVSC EVASC TPVT ANGIOP UNI CPLX LES 1ST VSL,5416.0,3520.4,643.62,5416.0,21
CDM,37283WE,REVSC EVASC TPVT ANGIOP UNI CPLX LES EA ADDL VSL,1874.0,1218.1,218.68,1874.0,21
CDM,37284WE,REVSC EVASC TPVT ST PLMT UNI SF LES 1ST VSL,4400.0,2860.0,526.95,4400.0,21
CDM,37285WE,REVSC EVASC TPVT ST PLMT UNI SF LES EA ADDL VSL,1470.0,955.5,173.08,1470.0,21
CDM,37286WE,REVSC EVASC TPVT ST PLMT UNI CPLX LES 1ST VSL,5922.0,3849.3,706.14,5922.0,21
CDM,37287WE,REVSC EVASC TPVT ST PLMT UNI CPLX LES EA ADD VSL,2200.0,1430.0,260.97,2200.0,21
CDM,37288WE,REVSC EVASC TPVT ATHRC UNI SF LES 1ST VSL,5940.0,3861.0,690.47,5940.0,21
CDM,37289WE,REVSC EVASC TPVT ATHRC UNI SF LES EA ADDL VSL,2090.0,1358.5,243.53,2090.0,21
CDM,37290WE,REVSC EVASC TPVT ATHRC UNI CPLX LES 1ST VSL,7480.0,4862.0,868.85,7480.0,21
CDM,37291WE,REVSC EVASC TPVT ATHRC UNI CPLX LES EA ADDL VSL,2860.0,1859.0,331.4,2860.0,21
CDM,37292WE,REVSC EVASC TPVT ST ATHRC UNI SF LES 1ST VSL,6600.0,4290.0,765.88,6600.0,21
CDM,37293WE,REVSC EVASC TPVT ST ATHRC UNI SF LES EA ADDL VSL,2860.0,1859.0,336.92,2860.0,21
CDM,37294WE,REVSC EVASC TPVT ST ATHRC UNI CPLX LES 1ST VSL,7920.0,5148.0,918.22,7920.0,21
CDM,37295WE,REVSC EVSC TPVT ST ATHRC UNI CPLX LES EA ADD VSL,3590.0,2333.5,425.56,3590.0,21
CDM,37296WE,REVSC EVASC IMVT ANGIOP UNI SF LES 1ST VSL,4840.0,3146.0,574.18,4840.0,21
CDM,37297WE,REVSC EVASC IMVT ANGIOP UNI SF LES EA ADDL VSL,1760.0,1144.0,204.68,1760.0,21
CDM,37298WE,REVSC EVASC IMVT ANGIOP UNI CPLX LES 1ST VSL,6028.0,3918.2,705.17,6028.0,21
CDM,37299WE,REVSC EVASC IMVT ANGIOP UNI CPLX LES EA ADDL VSL,2200.0,1430.0,254.2,2200.0,21
CDM,37501RECWE,ENDOSCOPIC HARVEST ARTERY IN BREAST RECON,1058.0,687.7,421.06,1058.0,16
CDM,37565WE,LIGATION INTERNAL JUGULAR VEIN,4820.0,3133.0,389.55,4820.0,35
CDM,37600WE,LIGATION EXTERNAL CAROTID ARTERY,4968.0,3229.2,413.39,4968.0,35
CDM,37605WE,LIGATION INTERNAL/COMMON CAROTID ARTERY,5712.0,3712.8,472.16,5712.0,35
CDM,37607WE,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,2500.0,1625.0,254.97,2500.0,35
CDM,37609WE,LIGATION/BIOPSY TEMPORAL ARTERY,1220.0,793.0,99.46,915.0,35
CDM,37615WE,LIGATION MAJOR ARTERY NECK,3120.0,2028.0,309.41,3120.0,35
CDM,37616WE,LIGATION MAJOR ARTERY CHEST,7588.0,4932.2,606.42,7588.0,35
CDM,37617WE,LIGATION MAJOR ARTERY ABDOMEN,9516.0,6185.4,735.95,9516.0,35
CDM,37618WE,LIGATION MAJOR ARTERY EXTREMITY,2412.0,1567.8,267.65,2412.0,35
CDM,37619WE,LIGATION OF INFERIOR VENA CAVA,12000.0,7800.0,845.07,12000.0,35
CDM,37650WE,LIGATION OF FEMORAL VEIN,3396.0,2207.4,290.07,3396.0,35
CDM,37660WE,LIGATION OF COMMON ILIAC VEIN,8912.0,5792.8,693.39,8912.0,35
CDM,37700WE,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ,1528.0,993.2,186.39,1528.0,35
CDM,37718WE,LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN,2852.0,1853.8,289.32,2852.0,35
CDM,37722WE,LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW,3590.0,2333.5,345.08,3590.0,35
CDM,37760WE,LIG PRFRATR VEIN SUBFSCAL RAD INCL SKN GRF 1 LEG,4312.0,2802.8,435.33,4312.0,35
CDM,37761WE,LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG,3652.0,2373.8,325.0,3652.0,35
CDM,37765WE,STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS,2112.0,1372.8,262.02,1584.0,35
CDM,37766WE,STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS,2640.0,1716.0,320.87,1980.0,35
CDM,37780WE,LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX,1572.0,1021.8,159.93,1572.0,35
CDM,37785WE,LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG,1729.0,1123.85,124.44,1296.75,35
CDM,37799AGRVU2WE,"UNLISTED PROCEDURE, VASCULAR SURGERY (COMPARISON CODE 37765)",2420.0,1573.0,1210.0,2561.04,15
CDM,37799EXTWE,PERCUTANEOUS SCLEROTHERAPY EXTREMITY,4230.0,2749.5,2115.0,4230.0,15
CDM,37799RVU10WE,EXCISION OF VEIN (COMP CODE 35206),3121.0,2028.65,1560.5,3121.0,15
CDM,37799RVU11WE,PORTAL/HEPATIC VEIN THROMBECTOMY (COMP CODE 34401),10608.0,6895.2,2134.2,10608.0,15
CDM,37799RVU14WE,EXCISION /LIGATION ABDOMINAL VEINS (COMP CODE 35221),9584.0,6229.6,2134.2,9584.0,15
CDM,37799RVU24WE,"UNLISTED PROCEDURE, VASCULAR SURGERY",2218.0,1441.7,1109.0,2561.04,15
CDM,37799RVU2WE,STAB PHLEB VARICOSE LESS THAN 10,2662.0,1730.3,1331.0,2662.0,15
CDM,37799RVU33WE,AORTIC ARTERIAL JUMP GRAFT (COMP CODE 47147),2521.0,1638.65,1260.5,2561.04,15
CDM,37799RVU34WE,CREATION OF MESORENAL SHUNT (SUP MESENTERIC VEIN TO RENAL VEIN),14401.0,9360.65,2134.2,14401.0,15
CDM,37799RVU36WE,PERCUTANEOUS HEPATIC PERFUSION DELIVERY OF INTRA-ARTERIAL HIGH D,440.0,286.0,220.0,2561.04,15
CDM,37799RVU37WE,FIBRIN SHEATH DISRUPTION W/BALLOON (COMP CODE 36595),1436.0,933.4,718.0,2561.04,15
CDM,37799RVU38WE,SELECTIVE EXTERNAL CAROTID ANGIOGRAPHY (COMP CODE 36227),920.0,598.0,460.0,2561.04,15
CDM,37799RVU39WE,CRYOABLATION AVM (COMP CODE 20983),2752.0,1788.8,1376.0,2752.0,15
CDM,37799RVU40WE,VENOUS SINUS TEST BALLOON OCCLUSION (COMP CODE 61623),3980.0,2587.0,1990.0,3980.0,15
CDM,37799RVU41WE,BILAT MIDDLE MENINGEAL ARTERY LIDOCAINE INFUSION (COMP CODE 6165,4000.0,2600.0,2000.0,4000.0,15
CDM,37799RVU42WE,"EXPLORATION OF VEIN, NOT FOLLOWED BY SURGICAL REPAIR (COMP CODE",2848.0,1851.2,1424.0,2848.0,15
CDM,37799RVU6WE,STAB INCISION UNDER 10 (COMP CODE 37765),1920.0,1248.0,960.0,2561.04,15
CDM,37799SAPWE,ENDOVENOUS RF ABLATION SAPHENOUS VEIN,4697.0,3053.05,2134.2,4697.0,15
CDM,37799SVMWE,SCLEROTHERAPY VENOUS MALFORMATION,699.0,454.35,349.5,2561.04,15
CDM,38100WE,SPLENECTOMY TOTAL SEPARATE PROCEDURE,7820.0,5083.0,584.12,7820.0,35
CDM,38102WE,SPLENC TOT EN BLOC EXTNSV DS CONJUNCT W/OTH PX,1916.0,1245.4,197.94,1916.0,35
CDM,38115WE,RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT,8752.0,5688.8,635.84,8752.0,35
CDM,38120NAPWE,LAPAROSCOPIC SPLENECTOMY- NAPLES,4697.0,3053.05,657.59,4697.0,35
CDM,38120SPLWE,LAPAROSCOPIC SPLENECTOMY,4697.0,3053.05,657.59,4697.0,35
CDM,38120WE,"LAPAROSCOPY, SURGICAL, SPLENECTOMY",6828.0,4438.2,657.59,6828.0,35
CDM,38200WE,INJECTION PROCEDURE SPLENOPORTOGRAPY,1056.0,686.4,98.04,1056.0,35
CDM,38220WE,DIAGNOSTIC BONE MARROW ASPIRATIONS,480.0,312.0,40.26,360.0,35
CDM,38221WE,DIAGNOSTIC BONE MARROW BIOPSIES,512.0,332.8,34.03,384.0,35
CDM,38222WE,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,634.0,412.1,59.32,475.5,31
CDM,38230WE,BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC,1400.0,910.0,159.97,1400.0,32
CDM,38232WE,BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS,1400.0,910.0,95.5,1400.0,35
CDM,38300WE,DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL,944.0,613.6,102.9,708.0,35
CDM,38305WE,DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV,2672.0,1736.8,242.79,2672.0,35
CDM,38308WE,LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS,2724.0,1770.6,233.9,2724.0,35
CDM,38380WE,SUTR&/LIG THORACIC DUCT CERVICAL APPROACH,3384.0,2199.6,334.27,3384.0,35
CDM,38381WE,SUTR&/LIG THORACIC DUCT THORACIC APPROACH,5352.0,3478.8,581.91,5352.0,35
CDM,38500WE,BX/EXC LYMPH NODE OPEN SUPERFICIAL,1516.0,985.4,125.1,1137.0,35
CDM,38505WE,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,636.0,413.4,41.1,477.0,35
CDM,38510WE,BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE,2696.0,1752.4,204.16,2022.0,35
CDM,38520WE,BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD,2812.0,1827.8,243.94,2812.0,35
CDM,38525WE,BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE,2572.0,1671.8,217.47,2572.0,35
CDM,38530WE,BX/EXC LYMPH NODE OPEN INT MAMMARY NODE,3336.0,2168.4,284.43,3336.0,35
CDM,38531WE,OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES,2696.0,1752.4,334.83,2696.0,31
CDM,38542WE,DISSECTION DEEP JUGULAR NODE,3180.0,2067.0,283.44,3180.0,35
CDM,38550WE,EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ,2844.0,1848.6,272.13,2844.0,35
CDM,38555WE,EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ,6236.0,4053.4,597.95,6236.0,35
CDM,38562WE,LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC,4424.0,2875.6,474.0,4424.0,35
CDM,38564WE,LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC,4552.0,2958.8,497.13,4552.0,35
CDM,38570WE,LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT,3736.0,2428.4,377.26,3736.0,35
CDM,38571WE,LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY,5280.0,3432.0,507.84,5280.0,35
CDM,38572WE,LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1,6240.0,4056.0,660.12,6240.0,35
CDM,38573WE,LAPS W/BI TOT PEL LMPHADEC & OMNTC LYMPH BX,8000.0,5200.0,891.03,8000.0,31
CDM,38589RVU1WE,"UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM (COMPARISON COD",3650.0,2372.5,334.22,3650.0,15
CDM,38589RVU5WE,UNLISTED PROC; LAP INGUINAL LYMPH NODE DISSECTION (COMPARED TO 3,5448.0,3541.2,334.22,5448.0,15
CDM,38589RVU6WE,LAP ROBOTIC RETROPERITONEAL LYMPHADENECTOMY COMP 38780,7016.0,4560.4,334.22,7016.0,15
CDM,38700WE,SUPRAHYOID LYMPHADENECTOMY,5124.0,3330.6,502.83,5124.0,35
CDM,38720WE,CERVICAL LYMPHADENECTOMY,8780.0,5707.0,793.73,8780.0,35
CDM,38724WE,CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ,9580.0,6227.0,806.35,9580.0,35
CDM,38740WE,AXILLARY LYMPHADENECTOMY SUPERFICIAL,4280.0,2782.0,349.51,4280.0,35
CDM,38745WE,AXILLARY LYMPHADENECTOMY COMPLETE,5548.0,3606.2,465.42,5548.0,35
CDM,38746WE,THORCOM THRC W/MEDSTNL & REGIONAL LMPHADEC,1648.0,1071.2,160.85,1648.0,35
CDM,38747WE,ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC,1952.0,1268.8,202.47,1952.0,35
CDM,38760WE,INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX,5448.0,3541.2,441.6,5448.0,35
CDM,38765WE,INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC,8764.0,5696.6,778.59,8764.0,35
CDM,38770WE,PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR,5624.0,3655.6,619.16,5624.0,35
CDM,38780WE,RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL,7080.0,4602.0,813.46,7080.0,35
CDM,38790WE,INJECTION PROCEDURE LYMPHANGIOGRAPHY,568.0,369.2,63.07,568.0,35
CDM,38792WE,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,260.0,169.0,21.5,260.0,35
CDM,38900LYMWE,IO MAP OF SENT LYMPH NODE,478.0,310.7,70.13,478.0,35
CDM,38900WE,INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION,1000.0,650.0,70.13,1000.0,35
CDM,38999LNWE,LYMPH NODE NEEDLE LOCALIZATION,2178.0,1415.7,624.86,2178.0,15
CDM,38999RVU12WE,"LVA/LVB MICROSURGERY - THERAPEUTIC (COMP 35206, 38308, 69990)",10367.0,6738.55,624.86,10367.0,15
CDM,38999RVU14WE,UNLISTED MAGTRACE INJECTION ADMINISTRATION (COMP CODE 38900),1000.0,650.0,500.0,1000.0,15
CDM,39000010,WHOLE BLOOD TXFUS PER UNIT,999.0,649.35,74.43,899.1,40
CDM,39000020,CRYOPRECIPITATE EA UNIT,189.0,122.85,48.95,813.0,40
CDM,39000040,RBC LR EA UNIT,843.0,547.95,74.43,813.0,40
CDM,39000050,FFP SNGL DONOR WITHIN 8 HR,327.0,212.55,74.43,813.0,40
CDM,39000060,PLT EA UNIT,319.0,207.35,54.35,813.0,40
CDM,39000070,RBC EA UNIT,606.0,393.9,74.43,813.0,40
CDM,39000090,PLT LR EA UNIT,485.0,315.25,125.62,813.0,40
CDM,39000100,PLT PHERESIS LR EA UNIT,2233.0,1451.45,172.65,2009.7,40
CDM,39000110,RBC DEGLYCEROLIZED EA UNIT,1484.0,964.6,74.43,1417.42,40
CDM,39000120,RBC LR IRRAD EA UNIT,1071.0,696.15,74.43,963.9,40
CDM,39000125,SPLIT UNIT,330.0,214.5,74.43,813.0,40
CDM,39000130,WSH LR FROZ DW WB/RBC EA UNIT,905.0,588.25,74.43,814.5,40
CDM,39000140,WASHED RED BLOOD CELLS EA UNIT,583.0,378.95,151.0,860.48,40
CDM,39000150,PLTS PHERESIS PER UNIT,1351.0,878.15,172.65,1215.9,40
CDM,39000195,RED CELLS WASHED EA UNIT,750.0,487.5,172.65,860.48,40
CDM,39000255,PLTS PHERESIS LEUKOR IRR,2841.0,1846.65,172.65,2556.9,40
CDM,39000305,PLTS PHERESIS LEUKOR HLA,1111.0,722.15,172.65,1685.73,40
CDM,39000385,RBC IRRADIATED EACH UNIT,625.0,406.25,74.43,813.0,40
CDM,39000395,GRANUL LEUK 1U TRANSFUSED,6811.0,4427.15,172.65,6129.9,30
CDM,39000405,RED CELL FROZ/THAW 1 UNIT,859.0,558.35,74.43,1417.42,40
CDM,39000455,PLATELET RICH PLASMA UNIT,499.0,324.35,74.43,1208.36,40
CDM,39000465,PLATELETS IRRADIATED EA UNIT,558.0,362.7,136.29,813.0,40
CDM,39000475,PLATELETS LEUKORED IRRAD EA UNIT,867.0,563.55,172.65,813.0,40
CDM,39000485,PLATELET PHERESIS IRRAD EA UNIT,2762.0,1795.3,172.65,2485.8,40
CDM,39000495,PLASMA CRYOPRECIPITATE REDUCED EA UNIT,365.0,237.25,74.43,813.0,40
CDM,39000505,WH BLD OR RBC L/R CMV NEG EA UNIT,750.0,487.5,74.43,813.0,40
CDM,39000515,PLT PHER IRR L/R CMV NEG EA UNIT,2004.0,1302.6,172.65,1803.6,40
CDM,39000525,RBC L/R IRR CMV NEG EA UNIT,985.0,640.25,74.43,886.5,40
CDM,39000535,FR FRZ PLASMA FRZN 8-24 HOURS EA UNIT,303.0,196.95,71.36,813.0,40
CDM,39000545,FR FRZ PLASMA DONOR RETESTED EA UNIT,200.0,130.0,49.12,813.0,40
CDM,39000555,PLASMA SNGL DONOR PATHOGEN REDUCED FRZN EACH UNIT,321.0,208.65,74.43,813.0,40
CDM,39000565,PLT PHER PATH-RED EA,2395.0,1556.75,172.65,2155.5,40
CDM,39000575,CONVALESCENT PLASMA,1210.0,786.5,71.36,1089.0,40
CDM,39000655,RED CELL LEUKOREDUCED DEGLYCEROLIZED IRRADIATED,3145.0,2044.25,74.43,2830.5,40
CDM,39000WE,MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR,3028.0,1968.2,354.26,3028.0,35
CDM,39010WE,MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR,5276.0,3429.4,602.57,5276.0,35
CDM,39100000,TXFUS BLOOD/BLOOD COMPONENT,3143.0,2042.95,69.51,3920.0,49
CDM,39100010,TRANSFUSION BLOOD OR BLOOD COMPONENTS,3143.0,2042.95,69.51,3920.0,49
CDM,39100045,BLOOD TRANSFUSION 1 HOUR,3143.0,2042.95,69.51,3920.0,49
CDM,39100055,BLOOD TRANSFUSION 2 HOURS,3143.0,2042.95,69.51,3920.0,49
CDM,39100065,BLOOD TRANSFUSION 3 HOURS,3143.0,2042.95,69.51,3920.0,49
CDM,39100075,BLOOD TRANSFUSION 4 HOURS,3143.0,2042.95,69.51,3920.0,49
CDM,39100085,BLOOD TRANSFUSION 5 HOURS,3143.0,2042.95,69.51,3920.0,49
CDM,39100095,BLOOD TRANSFUSION 6 HOURS,3143.0,2042.95,69.51,3920.0,49
CDM,39100105,BLOOD TRANSFUSION 7 HOURS,3143.0,2042.95,69.51,3920.0,49
CDM,39100115,BLOOD TRANSFUSION 8 HOURS,3143.0,2042.95,69.51,3920.0,49
CDM,39100125,BLOOD TRANSFUSION 9 HOURS,3143.0,2042.95,69.51,3920.0,49
CDM,39100135,BLOOD TRANSFUSION 10 HRS,3143.0,2042.95,69.51,3920.0,49
CDM,39100145,BLOOD TRANSFUSION 11 HRS,3143.0,2042.95,69.51,3920.0,49
CDM,39100155,BLOOD TRANSFUSION 12 HRS,3143.0,2042.95,69.51,3920.0,49
CDM,39100165,BLOOD TRANSFUSION 13 HRS,3143.0,2042.95,69.51,3920.0,49
CDM,39100175,BLOOD TRANSFUSION 14 HRS,3143.0,2042.95,69.51,3920.0,49
CDM,39100185,BLOOD TRANSFUSION 15 HRS,3143.0,2042.95,69.51,3920.0,49
CDM,39100195,BLOOD TRANSFUSION 16 HRS,3143.0,2042.95,69.51,3920.0,49
CDM,39200WE,RESECTION OF MEDIASTINAL CYST,6036.0,3923.4,660.03,6036.0,35
CDM,39220WE,RESECTION MEDIASTINAL TUMOR,7820.0,5083.0,840.27,7820.0,35
CDM,39401WE,MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY,2176.0,1414.4,234.39,2176.0,31
CDM,39402WE,MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES,2900.0,1885.0,305.62,2900.0,31
CDM,39501WE,REPAIR LACERATION DIAPHRAGM ANY APPROACH,5592.0,3634.8,651.31,5592.0,35
CDM,39540WE,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT,5828.0,3788.2,657.72,5828.0,35
CDM,39541WE,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC,6300.0,4095.0,718.74,6300.0,35
CDM,39545WE,IMBRICATION DIAPHRAGM EVENTRATION,5868.0,3814.2,588.37,5868.0,35
CDM,39560WE,RESCJ DIAPHRAGM W/SIMPLE REPAIR,5224.0,3395.6,587.28,5224.0,35
CDM,39561WE,RESCJ DIAPHRAGM W/COMPLEX REPAIR,7996.0,5197.4,807.22,7996.0,35
CDM,39599RVU1WE,VATS PLICATION OF DIAPHRAGM (COMP CODE 39545),4841.0,3146.65,1183.3,4841.0,15
CDM,39599RVU2WE,UNLISTED PROC; LAP DIAPHRAGM RESECTION (COMP TO 39560),5224.0,3395.6,1183.3,5224.0,15
CDM,39599RVU4WE,LAP OR ROBOTIC REPAIR OF DIAPHRAGMATIC HERNIA; CHRONIC (COMP COD,5671.0,3686.15,1183.3,5671.0,15
CDM,39599RVU6WE,UNLISTED THORACOSCOPIC REPAIR CONGENITAL DIAPHRAGMATIC HERNIA-NE,43564.0,28316.6,1183.3,43564.0,15
CDM,40100005,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,139.0,90.35,23.35,212.74,38
CDM,40100015,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,168.0,109.2,27.88,271.22,38
CDM,40100045,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,704.0,457.6,27.88,633.6,49
CDM,40100055,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,883.0,573.95,27.88,794.7,49
CDM,40100065,BREAST TOMO,122.0,79.3,31.6,212.0,48
CDM,40100070,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,139.0,90.35,23.35,212.74,38
CDM,40100080,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,168.0,109.2,27.88,271.22,38
CDM,40200010,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,708.0,460.2,34.79,637.2,30
CDM,40200015,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,918.0,596.7,66.35,826.2,49
CDM,40200020,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,918.0,596.7,66.35,826.2,49
CDM,40200030,US CHEST REAL TIME W/IMAGE DOCUMENTATION,918.0,596.7,66.35,826.2,49
CDM,40200045,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,918.0,596.7,65.53,826.2,49
CDM,40200050,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,918.0,596.7,100.02,826.2,49
CDM,40200055,DX OPHTHALMIC US ANT SEGMENT IMMERSION UNI/BI,918.0,596.7,66.35,826.2,49
CDM,40200060,US ABDOMINAL REAL TIME W/IMAGE LIMITED,918.0,596.7,66.35,826.2,49
CDM,40200070,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,918.0,596.7,100.02,826.2,49
CDM,40200080,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,918.0,596.7,66.35,826.2,49
CDM,40200090,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,918.0,596.7,66.35,826.2,49
CDM,40200095,ULTRASOUND SPINAL CANAL & CONTENTS,918.0,596.7,66.35,826.2,49
CDM,40200100,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,918.0,596.7,59.68,826.2,49
CDM,40200105,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,889.0,577.85,59.68,800.1,36
CDM,40200110,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,918.0,596.7,59.68,826.2,49
CDM,40200120,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,889.0,577.85,59.68,800.1,36
CDM,40200130,US PREGNANT UTERUS LIMITED 1/> FETUSES,918.0,596.7,59.68,826.2,49
CDM,40200140,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,918.0,596.7,59.68,826.2,49
CDM,40200150,US TRANSVAGINAL,918.0,596.7,66.35,826.2,49
CDM,40200160,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,2085.0,1355.25,100.02,1876.5,49
CDM,40200170,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,918.0,596.7,100.02,826.2,49
CDM,40200180,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,918.0,596.7,66.35,826.2,49
CDM,40200185,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,918.0,596.7,59.68,826.2,49
CDM,40200190,US SCROTUM & CONTENTS,918.0,596.7,66.35,826.2,49
CDM,40200200,US TRANSRECTAL,918.0,596.7,66.35,826.2,49
CDM,40200210,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,918.0,596.7,100.02,826.2,49
CDM,40200215,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,4729.0,3073.85,59.68,4256.1,49
CDM,40200220,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,918.0,596.7,66.35,826.2,49
CDM,40200225,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,2085.0,1355.25,59.68,1876.5,49
CDM,40200240,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,2686.0,1745.9,136.83,2417.4,49
CDM,40200245,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,918.0,596.7,59.68,826.2,49
CDM,40200250,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,333.0,216.45,55.47,385.0,36
CDM,40200265,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,760.0,494.0,66.35,684.0,49
CDM,40200270,US &MNTR PARENCHYMAL TISSUE ABLATION,873.0,567.45,65.54,785.7,35
CDM,40200280,US GUIDANCE NEEDLE PLACEMENT IMG S&I,1079.0,701.35,65.54,971.1,36
CDM,40200300,ULTRASONIC GUIDANCE INTRAOPERATIVE,1054.0,685.1,65.54,948.6,35
CDM,40200320,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,918.0,596.7,66.35,826.2,49
CDM,40200330,US UNLISTED SOFT TISSUE,329.0,213.85,66.35,385.0,48
CDM,40200340,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,918.0,596.7,59.68,826.2,49
CDM,40200355,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,918.0,596.7,66.35,826.2,49
CDM,40200360,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,918.0,596.7,66.35,826.2,49
CDM,40200365,US BREAST UNI REAL TIME WITH IMAGE LIMITED,760.0,494.0,66.35,684.0,49
CDM,40200370,US BREAST UNI REAL TIME WITH IMAGE LIMITED,760.0,494.0,66.35,684.0,49
CDM,40200390,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,918.0,596.7,66.35,826.2,49
CDM,40200400,US BREAST UNI REAL TIME WITH IMAGE LIMITED,760.0,494.0,66.35,684.0,49
CDM,40200425,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,918.0,596.7,66.35,826.2,49
CDM,40200435,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,918.0,596.7,59.68,826.2,49
CDM,40200445,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2659.0,1728.35,136.83,2393.1,36
CDM,40201075,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,760.0,494.0,66.35,684.0,49
CDM,40201105,US MICROBUBBLE  CONTR CHARACTER (NON-CARDIAC) INITIAL LESION,663.0,430.95,111.38,596.7,29
CDM,40201115,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDL LES,958.0,622.7,100.02,862.2,36
CDM,40201125,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,918.0,596.7,66.35,826.2,49
CDM,40201135,ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION,1288.0,837.2,66.35,1159.2,36
CDM,40201145,ULTRASOUND ELASTOGRAPHY PARENCHYMA,918.0,596.7,66.35,826.2,49
CDM,40201155,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,1535.0,997.75,100.02,1381.5,49
CDM,40201165,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDL LES,958.0,622.7,100.02,862.2,36
CDM,40201175,ULTRASOUND ELASTOGRAPHY PARENCHYMA,918.0,596.7,66.35,826.2,49
CDM,40201185,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,918.0,596.7,66.35,826.2,49
CDM,40201195,USE EA ADDL TARGET LESION,1288.0,837.2,66.35,1159.2,36
CDM,40201215,US ENDOMYOCARDIAL BIOPSY RS&I,1047.0,680.55,65.54,942.3,35
CDM,40300005,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,175.0,113.75,27.88,212.0,49
CDM,40300025,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,761.0,494.65,27.88,684.9,49
CDM,40300040,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,175.0,113.75,27.88,212.0,49
CDM,40400005,PET IMAGING SKULL BASE TO MID-THIGH,12580.0,8177.0,859.52,11322.0,48
CDM,40400010,MYOCRD IMG PET METAB EVAL SINGLE STUDY,11260.0,7319.0,859.52,10134.0,48
CDM,40400015,PET IMAGING WHOLE BODY,12580.0,8177.0,859.52,11322.0,48
CDM,40400020,MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS,12580.0,8177.0,859.52,11322.0,48
CDM,40400025,PET IMAGING LIMITED AREA CHEST HEAD/NECK,11260.0,7319.0,859.52,10134.0,48
CDM,40400030,MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS,12580.0,8177.0,859.52,11322.0,48
CDM,40400040,BRAIN IMAGING PET METABOLIC EVALUATION,12580.0,8177.0,859.52,11322.0,48
CDM,40400055,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,12580.0,8177.0,859.52,11322.0,48
CDM,40400065,PET IMAGING FOR CT ATTENUATION WHOLE BODY,12580.0,8177.0,859.52,11322.0,48
CDM,40400110,PET IMAGING CT FOR ATTENUATION LIMITED AREA,12580.0,8177.0,859.52,11322.0,48
CDM,40400140,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,12580.0,8177.0,859.52,11322.0,48
CDM,40400170,PET IMAGING FOR CT ATTENUATION WHOLE BODY,12580.0,8177.0,859.52,11322.0,48
CDM,40400180,BRAIN IMAGING PET METABOLIC EVALUATION,12580.0,8177.0,859.52,11322.0,48
CDM,40400190,BRAIN IMAGING PET METABOLIC EVALUATION,12580.0,8177.0,859.52,11322.0,48
CDM,40400200,PET IMAGING CT FOR ATTENUATION LIMITED AREA,12580.0,8177.0,859.52,11322.0,48
CDM,40400210,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,12580.0,8177.0,859.52,11322.0,48
CDM,40400220,PET IMAGING FOR CT ATTENUATION WHOLE BODY,12580.0,8177.0,859.52,11322.0,48
CDM,40400230,PET IMAGING CT FOR ATTENUATION LIMITED AREA,12580.0,8177.0,859.52,11322.0,48
CDM,40490WE,BIOPSY OF LIP,488.0,317.2,59.81,366.0,35
CDM,40500WE,VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT,1788.0,1162.2,250.73,1341.0,35
CDM,40510WE,EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR,1928.0,1253.2,260.04,1446.0,35
CDM,40520WE,EXC LIP V-EXC W/PRIM DIR LINR CLSR,1916.0,1245.4,259.09,1437.0,35
CDM,40525WE,EXC LIP FULL THKNS RCNSTJ W/LOCAL FLAP,3088.0,2007.2,416.66,3088.0,35
CDM,40527WE,EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP,3728.0,2423.2,486.65,3728.0,35
CDM,40530WE,RESCJ LIP > ONE-FOURTH W/O RCNSTJ,2216.0,1440.4,285.39,1662.0,35
CDM,40650WE,RPR LIP FULL THICKNESS VERMILION ONLY,1512.0,982.8,210.95,1134.0,35
CDM,40652WE,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,1772.0,1151.8,250.77,1329.0,35
CDM,40654WE,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,2192.0,1424.8,308.84,1644.0,35
CDM,40702WE,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 2 STGS,5708.0,3710.2,601.53,5708.0,35
CDM,40761WE,PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP,6336.0,4118.4,673.69,6336.0,35
CDM,40800WE,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,492.0,319.8,81.46,369.0,35
CDM,40801WE,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,1052.0,683.8,148.76,789.0,35
CDM,40804WE,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,520.0,338.0,91.52,390.0,35
CDM,40805WE,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,1116.0,725.4,140.95,837.0,35
CDM,40806WE,INCISION LABIAL FRENUM FRENOTOMY,124.0,80.6,20.06,170.91,32
CDM,40808WE,"BIOPSY, MOUTH, VESTIBULE",420.0,273.0,78.99,315.0,35
CDM,40810WE,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR,544.0,353.6,72.63,408.0,35
CDM,40812WE,EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR,948.0,616.2,106.84,711.0,35
CDM,40814WE,EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR,1408.0,915.2,179.43,1056.0,35
CDM,40816WE,EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC,1508.0,980.2,197.15,1131.0,35
CDM,40818WE,EXC MUCOSA VESTIBULE MOUTH AS DON GRF,1132.0,735.8,142.98,849.0,35
CDM,40819WE,EXC FRENUM LABIAL/BUCCAL,1004.0,652.6,121.68,753.0,35
CDM,40820WE,DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS,536.0,348.4,82.75,424.12,35
CDM,40830WE,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,728.0,473.2,84.27,546.0,35
CDM,40831WE,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,1028.0,668.2,120.7,771.0,35
CDM,40840WE,VESTIBULOPLASTY ANTERIOR,3660.0,2379.0,398.82,2745.0,35
CDM,40842WE,VESTIBULOPLASTY POSTERIOR UNILATERAL,3660.0,2379.0,398.76,2745.0,35
CDM,40845WE,VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG,7744.0,5033.6,938.96,5808.0,35
CDM,40899RVU2WE,TRANSORAL MYECTOMY OF DEPRESSOR ANGULI ORIS MUSCLE (COMP CODE 21,2168.0,1409.2,194.57,2168.0,15
CDM,40900000,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,708.0,460.2,34.79,637.2,30
CDM,40900005,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1795.0,1166.75,106.1,1615.5,30
CDM,41000005,RT MONITORING TRANSPORT,515.0,334.75,38.83,509.0,40
CDM,41000010,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,1335.0,867.75,41.35,4151.0,49
CDM,41000020,CATHETER ASPIRATION NASOTRACHEAL SPX,1170.0,760.5,38.83,3920.0,49
CDM,41000025,PROC RESP FUNC GROUP,196.0,127.4,21.02,509.0,41
CDM,41000030,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,926.0,601.9,18.57,3920.0,49
CDM,41000040,CARDIOPULMONARY RESUSCITATION,2239.0,1455.35,225.48,2015.1,41
CDM,41000050,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,3801.0,2470.65,120.76,3420.9,41
CDM,41000060,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA,3801.0,2470.65,83.23,3420.9,41
CDM,41000070,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,1170.0,760.5,12.59,1053.0,41
CDM,41000110,PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH,1170.0,760.5,38.83,1053.0,40
CDM,41000115,RT DAILY ASSESSMENT,533.0,346.45,38.83,509.0,40
CDM,41000120,CONTINUOUS INHALATION TREATMENT 1ST HR,741.0,481.65,38.83,666.9,41
CDM,41000130,CONTINUOUS INHALATION TREATMENT EA ADDL HR,203.0,131.95,24.49,509.0,31
CDM,41000140,CPAP VENTILATION CPAP INITIATION&MGMT,1170.0,760.5,45.56,1053.0,41
CDM,41000155,RESPIRATORY THERAPY EVAL-HOSP,365.0,237.25,38.83,509.0,40
CDM,41000160,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,1170.0,760.5,29.14,1053.0,41
CDM,41000210,MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL,741.0,481.65,38.83,666.9,41
CDM,41000220,MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ,741.0,481.65,38.83,666.9,41
CDM,41000230,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,1170.0,760.5,12.59,1053.0,41
CDM,41000425,MECHANICAL CHEST WALL OSCILLATION LUNG FUNCTION,1170.0,760.5,37.57,1053.0,41
CDM,41000855,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1335.0,867.75,181.19,4151.0,49
CDM,41000865,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1861.0,1209.65,57.95,3920.0,38
CDM,41000WE,INTRAORAL I&D TONGUE/FLOOR LINGUAL,540.0,351.0,93.73,405.0,35
CDM,41001135,DAILY PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,3627.0,2357.55,12.59,3264.3,41
CDM,41005WE,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,524.0,340.6,90.8,393.0,35
CDM,41008WE,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,1384.0,899.6,181.73,1038.0,35
CDM,41009WE,INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE,1632.0,1060.8,183.81,1224.0,35
CDM,41010WE,INCISION LINGUAL FRENUM FRENOTOMY,444.0,288.6,56.15,333.0,35
CDM,41016WE,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT,1676.0,1089.4,217.27,1257.0,35
CDM,41017WE,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB,1676.0,1089.4,185.5,1257.0,35
CDM,41018WE,XTRORAL I&D FLOOR MASTICATOR SPACE,2088.0,1357.2,240.64,1566.0,35
CDM,41100WE,BIOPSY TONGUE ANTERIOR 2/3,568.0,369.2,72.4,426.0,35
CDM,41105WE,"BIOPSY TONGUE,POSTER 1/3",588.0,382.2,71.49,441.0,35
CDM,41108WE,"BIOPSY, MOUTH, FLOOR",484.0,314.6,56.84,363.0,35
CDM,41110WE,EXCISION LESION TONGUE W/O CLOSURE,624.0,405.6,95.06,468.0,35
CDM,41112WE,EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS,1132.0,735.8,140.15,849.0,35
CDM,41113WE,EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD,1316.0,855.4,175.48,987.0,35
CDM,41114WE,EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP,3528.0,2293.2,398.84,3528.0,35
CDM,41115WE,EXCISION OF LINGUAL FRENUM (FRENECTOMY),716.0,465.4,97.13,537.0,35
CDM,41116WE,EXCISION LESION FLOOR MOUTH,1008.0,655.2,134.57,756.0,35
CDM,41120WE,GLOSSECTOMY <ONE-HALF TONGUE,4902.0,3186.3,553.45,4902.0,35
CDM,41130WE,GLOSSECTOMY HEMIGLOSSECTOMY,6296.0,4092.4,671.58,6296.0,35
CDM,41135WE,GLOSSECTOMY PRTL W/UNI RADICAL NECK DSJ,12056.0,7836.4,1125.3,12056.0,35
CDM,41140WE,GLSSC COMPL/TOT W/WOTRACHS W/O RAD NECK DSJ,11660.0,7579.0,1195.93,11660.0,35
CDM,41145WE,GLSSC COMPL/TOT W/WO TRACHS W/UNI RAD NECK DSJ,15172.0,9861.8,1448.61,15172.0,35
CDM,41150WE,GLSSC COMPOSIT W/RESCJ FLOOR & MANDIBULAR RESCJ,11944.0,7763.6,1150.34,11944.0,35
CDM,41153WE,GLSSC COMPOSIT RESCJ FLOOR SUPRAHYOID NCK DSJ,13436.0,8733.4,1283.53,13436.0,35
CDM,41155WE,GLSSC COMPOSIT RESCJ FLR MNDBLR RESCJ & RAD NECK,17720.0,11518.0,1514.82,17720.0,35
CDM,41250WE,"REPAIR TONGUE LACER,<2.5CM",784.0,509.6,85.93,588.0,35
CDM,41252WE,"REPAIR TONGUE LACER,2.6CM+/COMPLX",1208.0,785.2,146.15,906.0,35
CDM,41520WE,FRENOPLASTY SURG REVJ FRENUM EG W/Z-PLASTY,1132.0,735.8,148.16,849.0,35
CDM,41530WE,SUBMUCOSAL ABLTJ TONGUE RF 1/> SITES PR SESSION,1400.0,910.0,355.35,5025.8,32
CDM,41599RVUWE,LASER DESTRUCTION/TONGUE LESION (COMP 41110),624.0,405.6,249.67,624.0,15
CDM,41599TONWE,RADIOFREQUENCY ABLATION TONGUE,2582.0,1678.3,249.67,2582.0,15
CDM,41800WE,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,508.0,330.2,74.63,427.3,35
CDM,41805WE,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,536.0,348.4,96.99,402.0,35
CDM,41821WE,OPRCULECTOMY EXC PRICORONAL TISSUE,282.0,183.3,80.62,282.0,16
CDM,41823WE,EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS,1508.0,980.2,207.04,1131.0,35
CDM,41825WE,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/O RPR,564.0,366.6,77.95,423.0,35
CDM,41826WE,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/SMPL RPR,1060.0,689.0,117.92,795.0,35
CDM,41827WE,EXC LESION/TUMOR DENTALVEOLAR STRUX W/CMPLX RPR,1685.0,1095.25,188.99,1263.75,35
CDM,41830WE,ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY,1380.0,897.0,244.47,1035.0,34
CDM,41850WE,DESTRUCTION LESION DENTOALVEOLAR STRUCTURES,625.0,406.25,17.04,625.0,16
CDM,41872WE,GINGIVOPLASTY EACH QUADRANT SPECIFY,1204.0,782.6,256.96,903.0,34
CDM,41874WE,ALVEOLOPLASTY EACH QUADRANT SPECIFY,1404.0,912.6,219.76,1053.0,34
CDM,41899RVU4WE,SCLEROTHERAPY TO THE ORAL CAVITY (COMP CODE 36470),300.0,195.0,150.0,300.0,15
CDM,42000020,THERA EXER 1,323.0,209.95,20.97,723.0,49
CDM,42000030,NEURMSCL THERAPY 15MIN,326.0,211.9,20.97,723.0,49
CDM,42000040,GAIT TRAINING THERAPY 15M,285.0,185.25,17.96,723.0,49
CDM,42000050,THERA ACTIVITY DIR 15MIN,343.0,222.95,20.97,723.0,49
CDM,42000060,TX WOUND<=20CM,1143.0,742.95,44.41,2849.0,49
CDM,42000070,TX WOUND>21CM,933.0,606.45,30.09,2849.0,39
CDM,42000080,EDUC HOME MGMT EA 15MIN GP,343.0,222.95,17.96,723.0,49
CDM,42000165,BIOFDBK TRAIN ANY METHOD GP,399.0,259.35,23.22,723.0,49
CDM,42000195,CANALITH REPOSITIONING PROCEDURE,300.0,195.0,20.97,723.0,49
CDM,42000205,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,395.0,256.75,66.36,723.0,38
CDM,42000235,APPLY TRACTION MECH GP,243.0,157.95,17.96,723.0,49
CDM,42000255,VASOPNEUMATIC DVC GP,254.0,165.1,14.87,723.0,49
CDM,42000265,WHIRLPOOL GP,224.0,145.6,17.96,723.0,49
CDM,42000275,ELECTR STIM 15MIN GP,299.0,194.35,17.96,723.0,49
CDM,42000280,PT IONTOPHORESIS 15MIN GP,236.0,153.4,17.96,723.0,49
CDM,42000285,US 15MIN GP,218.0,141.7,17.72,723.0,49
CDM,42000290,HUBBARD 15MIN GP,290.0,188.5,20.97,723.0,49
CDM,42000305,MANUAL THERAPY 15MIN GP,301.0,195.65,20.97,723.0,49
CDM,42000335,PT/OT WORK CONDITION,1255.0,815.75,17.96,1129.5,38
CDM,42000445,P.T. COMMUNITY REINTEG 15 MIN,220.0,143.0,20.97,723.0,49
CDM,42000565,"PT THERAPEUT PROC/EXER, 15 MIN",323.0,209.95,20.97,723.0,49
CDM,42000615,PT SENSORY INTEGRATIVE TCH/15M,235.0,152.75,20.97,723.0,49
CDM,42000810,CANALITH REPOSITIONING PROCEDURE,300.0,195.0,20.97,723.0,49
CDM,42000815,ELECTRICAL STIM. UNATTENDED,221.0,143.65,17.96,723.0,38
CDM,42000820,WHIRLPOOL GP,224.0,145.6,17.96,723.0,49
CDM,42000835,MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES,301.0,195.65,20.97,723.0,49
CDM,42000845,WHEELCHAIR MGMT EA 15 MIN,318.0,206.7,20.97,723.0,49
CDM,42000865,TEST PHYSCL PERF EA 15MIN GP,340.0,221.0,20.97,723.0,49
CDM,42000870,ASSTV TECHNOL ASSMT DIR CNTCT W/REPRT EA 15 MIN,370.0,240.5,48.65,723.0,49
CDM,42000875,ORTHO MGMT EXT/TRUNK 15MN GP,369.0,239.85,20.97,723.0,49
CDM,42000895,WND CARE UNATT ELECT STIM 15M,184.0,119.6,14.52,723.0,49
CDM,42001075,PARAFFIN,208.0,135.2,7.7,723.0,49
CDM,42001085,APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN,158.0,102.7,17.37,723.0,49
CDM,42001095,WORK HARDENING (ADDL HR),629.0,408.85,17.96,723.0,38
CDM,42001255,"CONTRAST BATH, EA 15 MIN",158.0,102.7,17.37,723.0,49
CDM,42001375,SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES,343.0,222.95,17.96,723.0,49
CDM,42001435,ORTH/PROS MGMT EA 15 MIN GP,400.0,260.0,20.97,723.0,49
CDM,42001645,DEVLOPMENT TEST INTERPT&REP,531.0,345.15,18.05,723.0,49
CDM,42001665,DEVEL TST PHYS/QHP EA ADDL,378.0,245.7,63.5,723.0,39
CDM,42001675,NEUROELTRD STIM POST TIBIAL,2546.0,1654.9,36.17,2849.0,49
CDM,42001825,BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT,334.0,217.1,52.06,723.0,49
CDM,42001835,BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT,334.0,217.1,29.16,723.0,49
CDM,42001845,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,256.0,166.4,20.97,723.0,49
CDM,42001855,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,256.0,166.4,20.97,723.0,49
CDM,42001895,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,141.0,91.65,17.96,2849.0,49
CDM,42001905,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,141.0,91.65,17.96,2849.0,49
CDM,42002045,VV THERAPEUTIC EXERCISE PT (97110),323.0,209.95,20.97,723.0,49
CDM,42002055,VV NEUROMUSCULAR EDUCATION PT (97112),326.0,211.9,20.97,723.0,49
CDM,42002065,VV GAIT TRAINING THERAPY  (97116),285.0,185.25,17.96,723.0,49
CDM,42002075,VV EVALUATION LOW COMPLEXITY  (97161),756.0,491.4,126.19,723.0,49
CDM,42002085,VV EVALUATION MODERATE COMPLEXITY  (97162),756.0,491.4,126.19,723.0,49
CDM,42002095,VV EVALUATION HIGH COMPLEXITY (97163),756.0,491.4,126.19,723.0,49
CDM,42002105,VV THERAPEUTIC ACTIVITIES (97530),343.0,222.95,20.97,723.0,49
CDM,42002125,VV SELF-CARE HOME MANAGEMENT  PT (97535),343.0,222.95,17.96,723.0,49
CDM,42002135,LOW INTENSITY ESWT CORPUS CAVERNOSUM LOW ENERGY,1216.0,790.4,53.02,2849.0,48
CDM,42002185,RTM DEV SPLY DATA MUSCSKEL SYS 2-15 D IN 30D PD,329.0,213.85,23.85,723.0,42
CDM,42002195,REMOTE THERAPEUTIC MNTR 1ST SET-UP&PT EDUCAJ EQP,741.0,481.65,31.62,723.0,49
CDM,42002205,REM THER MNTR DEV SPLY DATA MUSCSKEL SYS EA 30 D,215.0,139.75,23.85,723.0,49
CDM,42002215,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,90.0,58.5,22.5,723.0,42
CDM,42002225,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,90.0,58.5,22.5,723.0,42
CDM,42100015,MIST WOUND ULTRASOUND,1143.0,742.95,22.52,1028.7,49
CDM,42100185,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,256.0,166.4,20.97,723.0,49
CDM,42100195,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,256.0,166.4,20.97,723.0,49
CDM,42100WE,BIOPSY PALATE UVULA,598.0,388.7,62.69,448.5,35
CDM,42104WE,EXC LESION PALATE UVULA W/O CLOSURE,676.0,439.4,90.22,507.0,35
CDM,42106WE,EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE,860.0,559.0,115.76,645.0,35
CDM,42107WE,EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE,1824.0,1185.6,243.12,1368.0,35
CDM,42120WE,RESCJ PALATE/EXTENSIVE RESCJ LESION,4744.0,3083.6,498.0,4744.0,35
CDM,42140WE,UVULECTOMY EXCISION UVULA,680.0,442.0,89.21,510.0,35
CDM,42145MINWE,PALATOPHARYNGOPLASTY,3639.0,2365.35,459.6,3639.0,35
CDM,42145PALWE,PALATOPHARYNGOPLASTY,3060.0,1989.0,459.6,3060.0,35
CDM,42145WE,PALATOPHAYNGOPLASTY,3912.0,2542.8,459.6,3912.0,35
CDM,42160WE,DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM,740.0,481.0,94.1,555.0,35
CDM,42180WE,REPAIR PALATE LACER <2CM,1020.0,663.0,129.54,765.0,35
CDM,42200WE,PALATOP CL PALATE SOFT&/HARD PALATE ONLY,5012.0,3257.8,514.99,5012.0,35
CDM,42205WE,PALATOPLASTY W/CLSR ALVEOLAR RIDGE SOFT TISSUE,5464.0,3551.6,512.79,5464.0,35
CDM,42210WE,PALATOP CLSR ALVEOLAR RIDGE GRF ALVEOLAR RIDGE,6012.0,3907.8,685.42,6012.0,35
CDM,42215WE,PALATOPLASTY CLEFT PALATE MAJOR REVJ,3596.0,2337.4,447.54,3596.0,35
CDM,42220WE,PALATOPLASTY CLEFT PALATE SEC LNGTH PX,2864.0,1861.6,341.8,2864.0,35
CDM,42225WE,PALATOP CL PALATE ATTACHMENT PHARYNGEAL FLAP,3908.0,2540.2,551.18,3908.0,35
CDM,42226WE,LENGTHENING PALATE+PHARY FLAP,4140.0,2691.0,525.14,4140.0,35
CDM,42227WE,LENGTHENING PALATE+ISLAND FLAP,3960.0,2574.0,520.1,3960.0,35
CDM,42235WE,REPAIR ANTER PALATE W VOMER FLAP,3204.0,2082.6,420.37,3204.0,35
CDM,42299UVUWE,LASER ASSISTED UVULOPALATOPLASTY,4697.0,3053.05,259.15,4697.0,15
CDM,42300WE,"DRAIN ABSCESS PAROTID,SIMPLE",792.0,514.8,116.52,594.0,35
CDM,42305WE,"DRAIN ABSCESS PAROTID,COMPLIC",2524.0,1640.6,237.84,2524.0,35
CDM,42310WE,"DRAIN ABSC-SUBMAX,SUBLING-INTRAORAL",644.0,418.6,100.56,483.0,35
CDM,42320WE,DRAIN ABSC-SUBMAX-EXTERNAL,960.0,624.0,133.85,720.0,35
CDM,42330WE,SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL,904.0,587.6,95.16,678.0,35
CDM,42335WE,SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL,1364.0,886.6,158.72,1023.0,35
CDM,42340WE,SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL,1888.0,1227.2,236.37,1416.0,35
CDM,42400010,PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS,756.0,491.4,126.19,723.0,49
CDM,42400035,PT EVAL - LOW,756.0,491.4,126.19,723.0,49
CDM,42400045,PT EVAL - MOD,756.0,491.4,126.19,723.0,49
CDM,42400055,PT EVAL - HIGH,756.0,491.4,126.19,723.0,49
CDM,42400065,PT RE-EVAL,479.0,311.35,86.04,723.0,49
CDM,42400WE,"BIOPSY SALIVARY GLAND,NEEDLE",343.0,222.95,45.49,257.25,35
CDM,42405WE,BIOPSY SALIVARY GLAND INCISIONAL,1336.0,868.4,137.01,1002.0,35
CDM,42408WE,EXC SUBLINGUAL SALIVARY CYST RANULA,1864.0,1211.6,212.69,1398.0,35
CDM,42409WE,MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA,1164.0,756.6,151.23,873.0,35
CDM,42410WE,EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ,3828.0,2488.2,428.03,3828.0,35
CDM,42415WE,EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR,6864.0,4461.6,802.61,6864.0,35
CDM,42420WE,EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR,7812.0,5077.8,885.17,7812.0,35
CDM,42425WE,EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL,5368.0,3489.2,621.95,5368.0,35
CDM,42426WE,EXC PRTD TUM/PRTD GLND TOT W/UNI RAD NCK DSJ,9064.0,5891.6,1039.17,9064.0,35
CDM,42440WE,EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND,2702.0,1756.3,322.47,2702.0,35
CDM,42450WE,EXCISION SUBLINGUAL GLAND,1896.0,1232.4,218.6,1422.0,35
CDM,42500WE,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM,1768.0,1149.2,237.52,1326.0,35
CDM,42505WE,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP,2528.0,1643.2,341.88,1896.0,35
CDM,42550WE,INJECTION PROCEDURE SIALOGRAPHY,500.0,325.0,48.76,375.0,35
CDM,42650WE,DILATION OF SALIVARY DUCT,308.0,200.2,48.41,231.0,35
CDM,42660WE,DILAT&CATHJ SALIVARY DUCT W/WO INJECTION,452.0,293.8,63.22,339.0,35
CDM,42665WE,LIGATION SALIVARY DUCT INTRAORAL,1052.0,683.8,129.52,789.0,35
CDM,42699ENDWE,UNLISTED SALIVARY GLAND OR DUCTS ENDOSCOP,1137.0,739.05,217.79,1137.0,15
CDM,42699RVU1WE,SIALOENDOSCOPY W SALIVARY DUCT STONE EXTRACTION (COMP 31255),2473.0,1607.45,217.79,2473.0,15
CDM,42700WE,"I & D ABSCESS, PERITONSILLAR",668.0,434.2,103.53,501.0,35
CDM,42720WE,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL,2524.0,1640.6,214.04,1893.0,35
CDM,42725WE,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR,4964.0,3226.6,436.31,4964.0,35
CDM,42800WE,BIOPSY OROPHARYNX,576.0,374.4,63.68,432.0,35
CDM,42804WE,"BIOPSY NASOPHARYNX,SIMPLE",516.0,335.4,69.88,387.0,35
CDM,42806WE,BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION,652.0,423.8,87.94,489.0,35
CDM,42808WE,EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD,940.0,611.0,127.93,705.0,35
CDM,42809WE,REMOVE PHARYNX FOREIGN BODY,744.0,483.6,78.52,558.0,35
CDM,42810WE,EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS,1352.0,878.8,164.16,1014.0,35
CDM,42815WE,EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX,2924.0,1900.6,408.65,2924.0,35
CDM,42820WE,TONSILLECTOMY & ADENOIDECTOMY <AGE 12,1688.0,1097.2,185.09,1688.0,35
CDM,42821WE,TONSILLECTOMY & ADENOIDECTOMY AGE 12/>,1744.0,1133.6,224.65,1744.0,35
CDM,42825WE,TONSILLECTOMY PRIMARY/SECONDARY <AGE 12,1404.0,912.6,170.32,1404.0,35
CDM,42826WE,TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>,1380.0,897.0,193.48,1380.0,35
CDM,42830WE,ADENOIDECTOMY PRIMARY <AGE 12,1060.0,689.0,125.84,1060.0,35
CDM,42831WE,ADENOIDECTOMY PRIMARY AGE 12/>,1124.0,730.6,139.77,1124.0,35
CDM,42836WE,ADENOIDECTOMY SECONDARY AGE 12/>,1304.0,847.6,166.27,1304.0,35
CDM,42842WE,RADICAL RESECTION TONSIL W/O CLOSURE,4892.0,3179.8,495.77,4892.0,35
CDM,42844WE,RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP,7112.0,4622.8,716.65,7112.0,35
CDM,42845WE,RADICAL RESCJ TONSIL CLOSURE W/OTHER FLAP,13024.0,8465.6,1173.88,13024.0,35
CDM,42860WE,EXCISION OF TONSIL TAGS,920.0,598.0,117.33,920.0,35
CDM,42870WE,EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX,2208.0,1435.2,299.08,2208.0,35
CDM,42890WE,LIMITED PHARYNGECTOMY,7652.0,4973.8,707.83,7652.0,35
CDM,42892WE,RESCJ LAT PHRNGL WALL/PYRIFORM SINUS DIR CLSR,10412.0,6767.8,919.7,10412.0,35
CDM,42894WE,RESCJ PHRNGL WALL CLSR W/FLP OR FLP W/MVASC ANAS,13568.0,8819.2,1189.48,13568.0,35
CDM,42900WE,SUTURE PHARYNX WOUND/INJURY,2116.0,1375.4,245.26,2116.0,35
CDM,42950WE,PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX,3308.0,2150.2,454.94,3308.0,35
CDM,42953WE,PHARYNGOESOPHAGEAL REPAIR,3780.0,2457.0,553.5,3780.0,35
CDM,42960WE,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,952.0,618.8,99.04,952.0,35
CDM,42961WE,CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ,2308.0,1500.2,226.77,2308.0,35
CDM,42962WE,CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,3256.0,2116.4,354.67,3256.0,35
CDM,42972WE,CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,3036.0,1973.4,327.07,3036.0,35
CDM,42975WE,DISE DYN EVAL SLEEP DISORDERED BREATHING FLX DX,695.0,451.75,82.78,695.0,28
CDM,42999RVU1WE,NASOPHARYNGOSOCOPY W/BX NASOPHARYNX (COMP CODE 31237),1040.0,676.0,239.34,1040.0,15
CDM,43000050,DEVELOPMENTAL TEST LIMITED,395.0,256.75,66.36,723.0,38
CDM,43000075,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,221.0,143.65,17.96,723.0,38
CDM,43000080,PARAFFIN BATH GO,208.0,135.2,7.7,723.0,49
CDM,43000095,IONTOPHORESIS 15MIN GO,236.0,153.4,17.96,723.0,49
CDM,43000105,US 15MIN GO,218.0,141.7,17.72,723.0,49
CDM,43000160,WORK HARDENING INIT 2HR GO,1255.0,815.75,17.96,1129.5,38
CDM,43000170,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,933.0,606.45,30.09,2849.0,39
CDM,43000325,OT WK CNDITIONNG PER 15 MIN,303.0,196.95,50.9,723.0,32
CDM,43000435,THERA FUNC ACTIVITIES 15M,343.0,222.95,20.97,723.0,49
CDM,43000465,OT WHEELCHAIR MANAGEMENT 15 MI,318.0,206.7,20.97,723.0,49
CDM,43000475,SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES,343.0,222.95,17.96,723.0,49
CDM,43000495,OT ELECTRICAL STIMULATION 15 M,299.0,194.35,17.96,723.0,49
CDM,43000500,THERA EXER 15MIN,323.0,209.95,20.97,723.0,49
CDM,43000510,NEURMSCL THERAPY 15MIN,326.0,211.9,20.97,723.0,49
CDM,43000520,MANUAL THERAPY 15MIN,301.0,195.65,20.97,723.0,49
CDM,43000530,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,343.0,222.95,20.97,723.0,49
CDM,43000550,SENSORY INTEGRATN EA 15M,235.0,152.75,20.97,723.0,49
CDM,43000560,EDUC HOME MGMT EA 15MIN GO,343.0,222.95,17.96,723.0,49
CDM,43000570,COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN,220.0,143.0,20.97,723.0,49
CDM,43000580,WHEELCHAIR MGMT EA 15 MIN,318.0,206.7,20.97,723.0,49
CDM,43000675,OT COMMUNITY REINTEGRATION/15M,220.0,143.0,20.97,723.0,49
CDM,43000780,WHIRLPOOL GO,224.0,145.6,17.96,723.0,49
CDM,43000790,GROUP THERAPY GO,293.0,190.45,20.97,723.0,49
CDM,43000800,TEST PHYSCL PERF EA 15MIN GO,340.0,221.0,20.97,723.0,49
CDM,43000805,ORTHO MGMT EXT/TRUNK 15MN GO,369.0,239.85,20.97,723.0,49
CDM,43000810,PROSTHTIC TRAINING EXT 15M GO,338.0,219.7,20.97,723.0,49
CDM,43000825,COGNITIVE TEST BY HC PRO,828.0,538.2,126.0,745.2,49
CDM,43000845,WC/WH EA ADDTL HR,629.0,408.85,17.96,723.0,38
CDM,43000925,JOBST COMPRESSION UT,254.0,165.1,14.87,723.0,49
CDM,43000995,"CONTRAST BATH, EA 15 MIN",158.0,102.7,17.37,723.0,49
CDM,43001205,ORTH/PROS MGMT EA 15 MIN GO,400.0,260.0,20.97,723.0,49
CDM,43001265,DEVLOPMENT TEST INTERPT&REP,531.0,345.15,18.05,723.0,49
CDM,43001275,DEVEL TST PHYS/QHP 1ST HR,1350.0,877.5,126.0,1215.0,49
CDM,43001285,DEVEL TST PHYS/QHP EA ADDL,378.0,245.7,63.5,723.0,39
CDM,43001345,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,256.0,166.4,20.97,723.0,49
CDM,43001355,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,256.0,166.4,20.97,723.0,49
CDM,43001465,VV THERAPEUTIC EXERCISE  OT (97110),323.0,209.95,20.97,723.0,49
CDM,43001475,VV NEUROMUSCULAR EDUCATION  OT (97112),326.0,211.9,20.97,723.0,49
CDM,43001485,VV EVALUATION LOW COMPLEXITY (97165),843.0,547.95,126.0,758.7,49
CDM,43001495,VV EVALUATION MODERATE COMPLEXITY (97166),843.0,547.95,126.0,758.7,49
CDM,43001505,VV EVALUATION HIGH COMPLEXITY (97167),843.0,547.95,126.0,758.7,49
CDM,43001515,VV SELF-CARE HOME MANAGEMENT OT (97535),343.0,222.95,17.96,723.0,49
CDM,43001605,OT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,1109.0,720.85,41.57,998.1,49
CDM,43001655,RTM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,741.0,481.65,16.43,723.0,42
CDM,43001665,RTM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,215.0,139.75,16.43,723.0,42
CDM,43001675,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,90.0,58.5,22.5,723.0,42
CDM,43001685,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,90.0,58.5,22.5,723.0,42
CDM,43030WE,CRICOPHAYNGEAL MYOTOMY,3196.0,2077.4,406.22,3196.0,35
CDM,43045WE,ESOPHAGOTOMY THORACIC APPR W/RMVL FB,8752.0,5688.8,852.64,8752.0,35
CDM,43100000,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,256.0,166.4,20.97,723.0,49
CDM,43100010,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,256.0,166.4,20.97,723.0,49
CDM,43100WE,EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR,3864.0,2511.6,437.17,3864.0,35
CDM,43101WE,EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR,6828.0,4438.2,709.36,6828.0,35
CDM,43107WE,TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY,20820.0,13533.0,1439.96,20820.0,35
CDM,43108WE,TOT ESOPHG W/O THORCOM COLON NTRPSTJ/INT RCNSTJ,33148.0,21546.2,2035.28,33148.0,35
CDM,43112WE,TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY,24800.0,16120.0,1678.16,24800.0,35
CDM,43116WE,PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF,37196.0,24177.4,2398.96,37196.0,35
CDM,43117WE,PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY,23000.0,14950.0,1574.1,23000.0,35
CDM,43121WE,PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY,20572.0,13371.8,1444.04,20572.0,35
CDM,43122WE,PRTL ESOPHG THORACOABD W/WO PROXGASTREC/PYLOROPL,17672.0,11486.8,1374.79,17672.0,35
CDM,43123WE,PRTL ESPHG THORACOABDL/ABDL APPR NTRPSTJ/RCNSTJ,33248.0,21611.2,2173.59,33248.0,35
CDM,43124WE,TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY,27636.0,17963.4,1838.1,27636.0,35
CDM,43130WE,DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR,5513.0,3583.45,581.91,5513.0,35
CDM,43135WE,DIVERTICULECTOMY HYPOPHARYNX/ESOPH THRC APPR,10468.0,6804.2,764.85,10468.0,35
CDM,43180WE,ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH,3612.0,2347.8,403.81,3612.0,31
CDM,43191WE,ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH,996.0,647.4,96.43,996.0,31
CDM,43192WE,ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL,1116.0,725.4,115.17,1116.0,31
CDM,43193WE,ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY,1116.0,725.4,130.73,1116.0,31
CDM,43194WE,ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY,1404.0,912.6,125.41,1404.0,31
CDM,43195WE,ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION,1228.0,798.2,137.67,1228.0,31
CDM,43196WE,ESOPHAGOSCOPY RIG TRANSORAL GUIDE WIRE DILATION,1324.0,860.6,144.14,1324.0,31
CDM,43197WE,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC,608.0,395.2,61.73,456.0,31
CDM,43198WE,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL WITH BIOPSY,728.0,473.2,73.54,546.0,31
CDM,43200WE,ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC,625.0,406.25,83.13,468.75,35
CDM,43201WE,ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ,688.0,447.2,98.99,516.0,35
CDM,43202WE,ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,688.0,447.2,92.57,611.77,35
CDM,43204WE,ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,932.0,605.8,102.64,932.0,35
CDM,43210WE,EGD PARTIAL/COMPL ESOPHAGOGASTRIC FUNDOPLASTY,3100.0,2015.0,326.05,3100.0,31
CDM,43211WE,ESOPHAGOSCOPY FLEXIBLE TRANSORAL MUCOSAL RESEXN,1680.0,1092.0,169.85,1680.0,31
CDM,43212WE,ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT,1360.0,884.0,142.33,1360.0,31
CDM,43213WE,ESOPHAGOSCOPY RETROGRADE DILATE BALLOON/OTHER,1852.0,1203.8,200.0,2070.28,31
CDM,43214WE,ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM,1360.0,884.0,144.61,1360.0,31
CDM,43215WE,ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,976.0,634.4,125.41,732.0,35
CDM,43216WE,ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS,920.0,598.0,121.67,708.3,35
CDM,43217WE,ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE,1120.0,728.0,144.99,840.0,35
CDM,43220WE,ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM,800.0,520.0,102.94,1894.64,35
CDM,43226WE,ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,896.0,582.4,114.83,672.0,35
CDM,43227WE,ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL,1156.0,751.4,153.78,867.0,35
CDM,43229WE,ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION,1396.0,907.4,152.86,1226.73,31
CDM,43231WE,ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM,1120.0,728.0,117.7,840.0,35
CDM,43232WE,ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX,1436.0,933.4,149.62,1077.0,35
CDM,43233WE,EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER,1628.0,1058.2,171.67,1628.0,31
CDM,43235WE,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,836.0,543.4,118.03,627.0,35
CDM,43236WE,ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION,1052.0,683.8,132.0,789.0,35
CDM,43237WE,ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS,1527.0,992.55,142.94,1527.0,35
CDM,43238WE,EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS,1830.0,1189.5,175.66,1830.0,35
CDM,43239WE,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,1052.0,683.8,132.0,789.0,35
CDM,43240WE,EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST,3146.0,2044.9,290.04,3146.0,35
CDM,43241WE,EGD INTRALUMINAL TUBE/CATHETER INSERTION,1096.0,712.4,108.0,1096.0,35
CDM,43242WE,EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY,2081.0,1352.65,197.88,2081.0,35
CDM,43243WE,EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,1879.0,1221.35,179.75,1879.0,35
CDM,43244WE,EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,1936.0,1258.4,184.6,1936.0,35
CDM,43245WE,EGD DILATION GASTRIC/DUODENAL STRICTURE,1355.0,880.75,131.93,1041.1,35
CDM,43246WE,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,1566.0,1017.9,151.66,1566.0,35
CDM,43247WE,EGD FLEXIBLE FOREIGN BODY REMOVAL,1368.0,889.2,163.66,1026.0,35
CDM,43248WE,EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS,1280.0,832.0,154.19,960.0,35
CDM,43249WE,EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM,1175.0,763.75,138.33,1812.24,35
CDM,43250WE,EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS,1307.0,849.55,153.15,980.25,35
CDM,43251WE,EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH,1527.0,992.55,177.97,1145.25,35
CDM,43252WE,EGD FLEX TRANSORAL W/OPTICAL ENDOMICROSCOPY,1302.0,846.3,135.19,976.5,28
CDM,43253WE,EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER,2081.0,1352.65,198.13,2081.0,31
CDM,43254WE,EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION,2143.0,1392.95,203.75,2143.0,31
CDM,43255WE,"EGD WITH CONTROL OF BLEED,",1566.0,1017.9,186.44,1174.5,35
CDM,43259WE,EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM,1616.0,1050.4,170.81,1616.0,35
CDM,43260WE,ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING,2340.0,1521.0,242.81,2340.0,35
CDM,43261WE,ERCP W/BIOPSY SINGLE/MULTIPLE,2460.0,1599.0,254.56,2460.0,35
CDM,43262WE,ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,2600.0,1690.0,268.6,2600.0,35
CDM,43263WE,ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI,2600.0,1690.0,269.11,2600.0,35
CDM,43264WE,ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT,2917.0,1896.05,274.22,2917.0,35
CDM,43265WE,ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD,3489.0,2267.85,325.03,3489.0,35
CDM,43266WE,EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION,1568.0,1019.2,164.43,1568.0,31
CDM,43270WE,EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE,1604.0,1042.6,179.77,1279.18,31
CDM,43273WE,ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC,896.0,582.4,89.62,896.0,35
CDM,43274WE,ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT,3731.0,2425.15,347.75,3731.0,31
CDM,43275WE,ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT,3018.0,1961.7,283.15,3018.0,31
CDM,43276WE,ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE,3890.0,2528.5,361.79,3890.0,31
CDM,43277WE,ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA,2760.0,1794.0,284.69,2760.0,31
CDM,43278WE,ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE,3168.0,2059.2,325.54,3168.0,31
CDM,43279WE,LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED,8840.0,5746.0,917.86,8840.0,35
CDM,43280WE,LAPS SURG ESOPG/GSTR FUNDOPLASTY,7240.0,4706.0,795.62,7240.0,35
CDM,43281WE,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH,10640.0,6916.0,877.14,10640.0,35
CDM,43282WE,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH,12040.0,7826.0,987.04,12040.0,35
CDM,43283WE,LAPS ESOPHAGEAL LENGTHENING ADDL,1298.0,843.7,101.25,1298.0,35
CDM,43285WE,REMOVAL ESOPHAGEAL SPHINCTER AGMNTJ DEVICE,4188.0,2722.2,504.88,4188.0,28
CDM,43286WE,ESOPHAGECTOMY TOTAL NEAR TOTAL W/LAPS MOBLJ,22000.0,14300.0,2419.45,22000.0,31
CDM,43287WE,ESOPHAGECTOMY DISTAL 2/3 W/LAPAROSCOPIC MOBLJ,25200.0,16380.0,2688.31,25200.0,31
CDM,43288WE,ESOPHAGECTOMY TOTAL NEAR TOTAL W/THRSC MOBLJ,26568.0,17269.2,2838.19,26568.0,31
CDM,43289RVU1WE,LIG/STAPLING G-ESOP JUNCT PRE-ESOPHGL PRF8J (COMP CODE 43405),9892.0,6429.8,1494.7,9892.0,15
CDM,43289RVU3WE,"UNLISTED LAP RESECTION, ESOPHAGEAL DUPLICATION CYST (COMP CODE 4",7340.0,4771.0,1494.7,7340.0,15
CDM,43289WE,UNLISTED LAPAROSCOPIC PROCEDURE ESOPHAGUS,17952.0,11668.8,1494.7,17952.0,15
CDM,43290WE,EGD FLX TRNSORL W/DPLMNT NTRGSTR BARIATRIC BALO,1244.0,808.6,132.01,4711.11,28
CDM,43291WE,EGD FLX TRNSORL W/RMVL NTRGSTR BARIATRIC BALO,1120.0,728.0,115.48,840.0,28
CDM,43300WE,ESPHGP CRV APPR W/O RPR TRACHEOESOPHGL FSTL,3732.0,2425.8,485.63,3732.0,35
CDM,43305WE,ESPHGP CRV APPR W/RPR TRACHEOESOPHGL FSTL,7240.0,4706.0,818.54,7240.0,35
CDM,43310WE,ESPHGP THRC APPR W/O RPR TRACHEOESOPHGL FSTL,10504.0,6827.6,1108.57,10504.0,35
CDM,43312WE,ESPHGP THRC APPR W/RPR TRACHEOESOPHGL FSTL,11700.0,7605.0,1190.7,11700.0,35
CDM,43313WE,ESPHGP CGEN DFCT THRC APPR W/O RPR FSTL,19380.0,12597.0,1914.93,19380.0,35
CDM,43314WE,ESPHGP CGEN DFCT THRC APPR W/RPR FSTL,21372.0,13891.8,2103.7,21372.0,35
CDM,43320WE,EGST W/WO VAGOTOMY&PYLOROPLASTY TABDL/TTHRC AP,9324.0,6060.6,755.51,9324.0,35
CDM,43325WE,ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH,9040.0,5876.0,761.55,9040.0,35
CDM,43327WE,ESOPG/GSTR FUNDOPLASTY W/LAPT,5340.0,3471.0,410.22,5340.0,35
CDM,43328WE,ESOPG/GSTR FUNDOPLASTY W/THORCOM,7964.0,5176.6,606.04,7964.0,35
CDM,43330WE,ESOPHAGOMYOTOMY HELLER TYPE ABDOMINAL APPROACH,8876.0,5769.4,751.16,8876.0,35
CDM,43331WE,ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH,9224.0,5995.6,827.15,9224.0,35
CDM,43332WE,RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH,7848.0,5101.2,588.05,7848.0,35
CDM,43333WE,LAPT RPR PARAESOPH HIATAL HERNIA W/ MESH,8584.0,5579.6,638.63,8584.0,35
CDM,43334WE,RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH,8848.0,5751.2,646.29,8848.0,35
CDM,43335WE,RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH,9588.0,6232.2,696.41,9588.0,35
CDM,43336WE,RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH,10324.0,6710.6,764.14,10324.0,35
CDM,43337WE,RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/MESH,11060.0,7189.0,833.35,11060.0,35
CDM,43338WE,ESOPHAGUS LENGTHENING,884.0,574.6,67.71,884.0,35
CDM,43340WE,ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT ABDL APPR,9196.0,5977.4,777.93,9196.0,35
CDM,43341WE,ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT THRC APPR,9692.0,6299.8,731.24,9692.0,35
CDM,43352WE,ESOPHAGOSTOMY FSTLJ ESOPH XTRNL CRV APPR,7124.0,4630.6,584.31,7124.0,35
CDM,43360WE,GI RCNSTJ PREV ESPHG/EXCLUSION W/STOMACH,16044.0,10428.6,1352.03,16044.0,35
CDM,43361WE,GI RCNSTJ PREV ESPHG/EXCLUSION W/COLON SM INT,18272.0,11876.8,1554.17,18272.0,35
CDM,43400035,OT EVAL - LOW,843.0,547.95,126.0,758.7,49
CDM,43400045,OT EVAL - MOD,843.0,547.95,126.0,758.7,49
CDM,43400055,OT EVAL - HIGH,843.0,547.95,126.0,758.7,49
CDM,43400065,OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS,479.0,311.35,87.79,723.0,49
CDM,43405WE,LIG/STAPLING G-ESOP JUNCT PRE-ESOPHGL PRF8J,9892.0,6429.8,821.71,9892.0,35
CDM,43410WE,SUTR ESOPHGL WND/INJ CRV APPR,6564.0,4266.6,543.71,6564.0,35
CDM,43415WE,SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR,17952.0,11668.8,1238.93,17952.0,35
CDM,43420WE,CLSR ESOPHAGOSTOMY/FSTL CRV APPR,6712.0,4362.8,525.34,6712.0,35
CDM,43425WE,CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR,10016.0,6510.4,787.38,10016.0,35
CDM,43450WE,DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS,563.0,365.95,71.64,422.25,35
CDM,43453WE,DILATION ESOPHAGUS GUIDE WIRE,564.0,366.6,71.34,1626.52,35
CDM,43460WE,ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE,1516.0,985.4,121.44,1516.0,32
CDM,43496WE,"FREE JEJUNUM XFER,MICROVASC ANAST",5238.0,3404.7,1254.58,5238.0,14
CDM,43497WE,TRANSORAL LOWER ESOPHAGEAL MYOTOMY,5316.0,3455.4,584.02,5316.0,28
CDM,43499RVU11WE,ENDOSCOPIC SUBMUCOSAL DISSECTION OF  ESOPHAGUS - (COMP CODE 4304,8752.0,5688.8,611.56,8752.0,15
CDM,43499RVU12WE,UNLISTED MIN INVASIVE FOKER - ANASTOMOSIS (COMP CODE 43313),19380.0,12597.0,611.56,19380.0,15
CDM,43499RVU14WE,UNLISTED MIN INVASIVE FOKER - STRETCHING (COMP CODE 43425),10016.0,6510.4,611.56,10016.0,15
CDM,43499RVU16WE,"ENDOVAC, ESOPH; EGD (COMP 43235, 97605)",990.0,643.5,495.0,990.0,15
CDM,43499RVU17WE,"ENDOVAC, ESOPH; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,611.56,2092.0,15
CDM,43499RVU18WE,THORACOSCOPY W/ LIGATION OF TRACHEOESOPH FISTULA & REP OF ESOPHA,19235.0,12502.75,611.56,19235.0,15
CDM,43499RVU1WE,ZENKERS DIVERTICULOPEXY,3883.0,2523.95,611.56,3883.0,15
CDM,43499RVU2WE,PERORAL ENDOSCOPIC MYOTOMY,5731.0,3725.15,611.56,5731.0,15
CDM,43499RVU4WE,ESD ESOPHAGUS (COMP 43211),1680.0,1092.0,611.56,1680.0,15
CDM,43499RVU5WE,UNLISTED PROC; ORAL ENDOSCOPIC MYOTOMY (COMP TO 43279),9503.0,6176.95,611.56,9503.0,15
CDM,43499RVU6WE,EGD REPAIR ESOPHAGEAL PERFORATION W/HEMOCLIPS (COMP 43235),836.0,543.4,418.0,836.0,15
CDM,43499RVU7WE,"ENDOVAC, ESOPH; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,567.0,1134.0,15
CDM,43500WE,GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL,5116.0,3325.4,397.59,5116.0,35
CDM,43501WE,GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER,9040.0,5876.0,691.08,9040.0,35
CDM,43502WE,GASTROTOMY W/SUTR RPR PRE-ESOPG/GASTRIC LAC,10002.0,6501.3,786.82,10002.0,35
CDM,43605WE,"BIOPSY OF STOMACH,BY LAPAROTOMY",5488.0,3567.2,425.4,5488.0,35
CDM,43610WE,EXC LOCAL ULCER/BENIGN TUMOR STOMACH,6536.0,4248.4,523.61,6536.0,35
CDM,43611WE,EXC LOCAL MALIGNANT TUMOR STOMACH,8152.0,5298.8,624.58,8152.0,35
CDM,43620WE,GSTRCT TOT W/ESOPHAGOENTEROSTOMY,13616.0,8850.4,1024.27,13616.0,35
CDM,43621WE,GSTRCT TOT W/ROUX-EN-Y RCNSTJ,15812.0,10277.8,1148.14,15812.0,35
CDM,43622WE,GSTRCT TOT W/FRMJ INTSTINAL POUCH ANY TYPE,16012.0,10407.8,1174.39,16012.0,35
CDM,43631WE,GSTRCT PRTL DSTL W/GASTRODUODENOSTOMY,9804.0,6372.6,869.0,9804.0,35
CDM,43632WE,GSTRCT PRTL DSTL W/GASTROJEJUNOSTOMY,14056.0,9136.4,994.83,14056.0,35
CDM,43633WE,GSTRCT PRTL DSTL W/ROUX-EN-Y RCNSTJ,13256.0,8616.4,945.75,13256.0,35
CDM,43634WE,GSTRCT PRTL DSTL W/FRMJ INTSTINAL POUCH,14656.0,9526.4,1142.38,14656.0,35
CDM,43635WE,VAGOTOMY PFRMD W/PRTL DSTL GSTRCT,824.0,535.6,85.35,824.0,35
CDM,43640WE,VGTMY W/PYLORPLSTY W/WO GASTROST TRUNCAL/SLCTV,7824.0,5085.6,679.51,7824.0,35
CDM,43644WE,LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM,12936.0,8408.4,975.58,12936.0,35
CDM,43645WE,LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ,12612.0,8197.8,1043.12,12612.0,35
CDM,43647WE,LAP IMPLANT/ REPLACE GASTRIC NEUROSTIM ANTRUM,1499.0,974.35,166.16,1835.37,17
CDM,43648WE,LAP REVISE/REMOVE GASTRIC NEUROSTIM ANTRUM,1543.0,1002.95,166.16,1835.37,14
CDM,43651WE,LAPS SURG TRNSXJ VAGUS NRV TRUNCAL,4052.0,2633.8,417.72,4052.0,35
CDM,43652WE,LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV,4852.0,3153.8,504.36,4852.0,35
CDM,43653WE,LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX,3392.0,2204.8,375.34,3392.0,35
CDM,43659AGRVU1WE,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43840)",6454.0,4195.1,757.54,6454.0,15
CDM,43659AGRVU3WE,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43611)",6181.0,4017.65,757.54,6181.0,15
CDM,43659AGRVU4WE,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43631)",9804.0,6372.6,757.54,9804.0,15
CDM,43659AGRVU6WE,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH",3775.0,2453.75,757.54,3775.0,15
CDM,43659AGRVU8WE,"UNLIST LAP PROC, STOMACH COMPARED TO 43820",6324.0,4110.6,757.54,6324.0,15
CDM,43659BOWWE,LAP GASTRIC BYPASS W/SMALL BOWEL RECONSTR,6572.0,4271.8,757.54,6572.0,15
CDM,43659BYPWE,LAPAROSCOPIC GASTRIC BYPASS,9393.0,6105.45,757.54,9393.0,15
CDM,43659GASWE,LAPAROSCOPIC GASTROPLASTY,9871.0,6416.15,757.54,9871.0,15
CDM,43659LAPWE,LAP GASTRIC REST PROCEDURE (LAP BAND),4469.0,2904.85,757.54,4469.0,15
CDM,43659PLIWE,UNLIST. LAP.GASTRIC PLICATION,5640.0,3666.0,757.54,5640.0,15
CDM,43659REMWE,LAPAROSCOPIC REMOVAL GASTRIC BANDING,2353.0,1529.45,757.54,2353.0,15
CDM,43659REVWE,LAP REVISION GASTRIC PROCEDURE,6572.0,4271.8,757.54,6572.0,15
CDM,43659RVU11WE,ESO/GASTRECTOMY W RY ESO/JEJUNOSTOMY,14637.0,9514.05,757.54,14637.0,15
CDM,43659RVU12WE,LAPAROSCOPIC TOTAL GASTRECTOMY W/ROUX-EN Y ANASTOMOSIS (COMPARIS,15812.0,10277.8,757.54,15812.0,15
CDM,43659RVU13WE,UNLISTED LAPAROSCOPIC PYLOROPLASTY (COMPARED TO 43800),6172.0,4011.8,757.54,6172.0,15
CDM,43659RVU14WE,"UNLIST LAP PROC, STOMACH COMPARED TO 43633",13256.0,8616.4,757.54,13256.0,15
CDM,43659RVU16WE,"LAPAROSCOPIC GASTROJEJUNOSTOMY, WITHOUT VAGOTOMY (COMP 43820)",9012.0,5857.8,757.54,9012.0,15
CDM,43659RVU18WE,LAPAROSCOPIC EXCISION MALIGNANT TUMOR OF STOMACH (COMP 43611),6181.0,4017.65,757.54,6181.0,15
CDM,43659RVU20WE,LAPAROSCOPIC EXCISION ULCER OR BENIGN TUMOR STOMACH (COMP CODE 4,5113.0,3323.45,757.54,5113.0,15
CDM,43659RVU22WE,"UNLISTED PROC, LAP DISTAL GASTRECTOMY W/GASTROJEJUNOSTOMY (COMP",14056.0,9136.4,757.54,14056.0,15
CDM,43659RVU23WE,LAP EXC. OF GASTRIC TUMOR (COMP 43610),5113.0,3323.45,757.54,5113.0,15
CDM,43659RVU24WE,LAP GASTROTOMY (COMP 43500),4605.0,2993.25,757.54,4605.0,15
CDM,43659RVU25WE,LAP REPAIR GASTRIC FISTULA (COMP 43880),10872.0,7066.8,757.54,10872.0,15
CDM,43659RVU26WE,LAP DUODENAL SWITCH PROCEDURE (COMP 43845),10659.0,6928.35,757.54,10659.0,15
CDM,43659RVU27WE,LAP PARTIAL GASTRECTOMY W RNY RECONSTRUC (COMP 43633),13256.0,8616.4,757.54,13256.0,15
CDM,43659RVU32WE,UNLISTED PROC; LAPARSCOPIC REVISION ROUX-EN-Y GASTRIC BYPASS GAS,9681.0,6292.65,757.54,9681.0,15
CDM,43659RVU33WE,LAPAROSCOPIC REVISION GASTROJEJUNAL ANASTOMOSIS W/EXCISION GASTR,8328.0,5413.2,757.54,8328.0,15
CDM,43659RVU36WE,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH (COMP CODE 43843),9120.0,5928.0,757.54,9120.0,15
CDM,43659RVU37WE,GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ (COMP CODE 4384,12112.0,7872.8,757.54,12112.0,15
CDM,43659RVU38WE,LAPAROSCOPIC GASTROPEXY (COMP CODE 43338),950.0,617.5,475.0,950.0,15
CDM,43659RVU39WE,LAPAROSCOPIC PYLOROMYOTOMY (COMP CODE 43520),4854.0,3155.1,757.54,4854.0,15
CDM,43659RVU3WE,LAPAROSCOPIC PYLOROPLASTY,4484.0,2914.6,757.54,4484.0,15
CDM,43659RVU40WE,LAPAROSCOPIC PARTIAL GASTRECTOMY FOR EXCISION OF GASTROCUTANEOUS,8713.0,5663.45,757.54,8713.0,15
CDM,43659RVU41WE,LAP TOTAL GASTRECTOMY W/RESECTION OF THE GASTROJEJUNOSTOMY (COMP,13616.0,8850.4,757.54,13616.0,15
CDM,43659RVU4WE,LAP. OVERSEW GASTR ULCER,9132.0,5935.8,757.54,9132.0,15
CDM,43659RVU5WE,LAP PARTIAL GASTRECTOMY (COMP CODE 43611),8152.0,5298.8,757.54,8152.0,15
CDM,43659RVU6WE,"LAP, GASTROJEJUNOSTOMY (COMP 43820)",6115.0,3974.75,757.54,6115.0,15
CDM,43659RVU7WE,LAP REVISION GASTROJEJUNOSTOMY (COMP 43860),6423.0,4174.95,757.54,6423.0,15
CDM,43659RVUWE,LAPAROSCOPIC PYLOROMYOTOMY (COMP 43800),3728.0,2423.2,757.54,3728.0,15
CDM,43659SURWE,LAPAROSCOPIC GASTRIC BYPASS SURGERY,7517.0,4886.05,757.54,7517.0,15
CDM,43752WE,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,356.0,231.4,30.38,356.0,34
CDM,43753WE,GASTRIC TUBE PLMT W/ASPIR & LAVAGE,180.0,117.0,10.69,180.0,35
CDM,43754WE,GASTRIC TUBE DX PLMT W/ASPIR 1 SPECIMEN,180.0,117.0,27.36,218.44,35
CDM,43755WE,GASTRIC TUBE DX PLMT W/ASPIR MULT SPECIMENS,376.0,244.4,46.51,282.0,35
CDM,43756WE,DUODENAL TUBE DX PLMT W/IMG GID 1 SPECIMEN,339.0,220.35,44.31,344.82,35
CDM,43757WE,DUODENAL TUBE DX PLMT W/IMG GID MULT SPECIMEN,504.0,327.6,67.2,493.55,35
CDM,43761WE,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,884.0,574.6,78.32,663.0,35
CDM,43762WE,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,330.0,214.5,29.35,369.23,31
CDM,43763WE,PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC,564.0,366.6,64.22,549.2,31
CDM,43770WE,LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE,7200.0,4680.0,624.95,7200.0,35
CDM,43771WE,LAPS GASTRIC RESTRICTIVE PX REVISION DEVICE,8316.0,5405.4,654.76,8316.0,35
CDM,43772WE,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE,6280.0,4082.0,492.56,6280.0,35
CDM,43773WE,LAPS GASTRIC RESTRICTIVE PX REMOVE&RPLCMT DEVICE,8316.0,5405.4,654.44,8316.0,35
CDM,43774WE,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT,6304.0,4097.6,495.56,6304.0,35
CDM,43775WE,LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY,8967.0,5828.55,667.38,8967.0,35
CDM,43800WE,PYLOROPLASTY,6172.0,4011.8,477.64,6172.0,35
CDM,43810WE,GASTRODUODENOSTOMY,6752.0,4388.8,516.31,6752.0,35
CDM,43820WE,GASTROJEJUNOSTOMY W/O VAGOTOMY,9012.0,5857.8,658.83,9012.0,35
CDM,43825WE,GASTROJEJUNOSTOMY+VAGOTOMY,8704.0,5657.6,693.06,8704.0,35
CDM,43830WE,GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX,4340.0,2821.0,358.44,4340.0,35
CDM,43832WE,GASTROSTOMY OPN W/CONSTJ GSTR TUBE,6936.0,4508.4,541.73,6936.0,35
CDM,43840WE,GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ,9132.0,5935.8,666.56,9132.0,35
CDM,43842WE,GASTRIC RSTCV W/O BYP VERTICAL-BANDED GASTROPLY,8412.0,5467.8,739.44,8412.0,24
CDM,43843WE,GSTR RSTCV W/O BYP OTH/THN VER-BANDED GSTP,8484.0,5514.6,983.13,8484.0,35
CDM,43845WE,GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM,13320.0,8658.0,1100.12,13320.0,32
CDM,43846WE,GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<,10964.0,7126.6,916.31,10964.0,35
CDM,43847WE,GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ,12112.0,7872.8,1385.41,12112.0,35
CDM,43848WE,REVISION OPEN GASTRIC RESTRICTIVE PX NOT DEVICE,13100.0,8515.0,1478.46,13100.0,35
CDM,43860WE,REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY,11156.0,7251.4,853.05,11156.0,35
CDM,43865WE,REVJ GSTR/JJ ANAST W/RCNSTJ W/VGTMY,11620.0,7553.0,936.1,11620.0,35
CDM,43870WE,"CLOSURE OF GASTROSTOMY,SURGICAL",4576.0,2974.4,357.76,4576.0,35
CDM,43880WE,CLOSURE GASTROCOLIC FISTULA,10872.0,7066.8,829.81,10872.0,35
CDM,43882WE,REVISION/RMVL GASTRIC NSTIM ELTRDE ANTRUM OPEN,1772.0,1151.8,334.01,1835.37,14
CDM,43886WE,GSTR RSTCV PX OPN REVJ SUBQ PORT COMPONENT ONLY,1856.0,1206.4,287.24,1856.0,35
CDM,43887WE,GSTR RSTCV PX OPN RMVL SUBQ PORT COMPONENT ONLY,1728.0,1123.2,236.48,1728.0,35
CDM,43888WE,GSTR RSTCV OPN RMVL & RPLCMT SUBQ PORT,2576.0,1674.4,330.56,2576.0,35
CDM,43999ADJWE,GASTRIC BANDING ADJUSTMENTS,323.0,209.95,161.5,1079.52,15
CDM,43999BNDWE,GASTRIC BANDING ADJUSTMENTS,266.0,172.9,133.0,1079.52,15
CDM,43999RVU10WE,"PARTIAL GATRECTOMY, PROXIMAL (COMP 43610)",7026.0,4566.9,899.6,7026.0,15
CDM,43999RVU11WE,ENDOSCOPIC PYLOROMYOTOMY (COMP 43520),4700.0,3055.0,899.6,4700.0,15
CDM,43999RVU12WE,EGD W SUTURE OF GASTROCUTANEOUS FISTULA (COMP 43255),1531.0,995.15,765.5,1531.0,15
CDM,43999RVU16WE,EGD W/ GASTRO/GASTRIC FISTULA REPAIR (COMP CODE 44650),10048.0,6531.2,899.6,10048.0,15
CDM,43999RVU19WE,EGD W/ SUTURE REPAIR OF STOMACH (COMP CODE 43840),9816.0,6380.4,899.6,9816.0,15
CDM,43999RVU21WE,ENDOSCOPIC WOUND VAC PLACEMENT (COMP CODE 43235 & 97605),567.0,368.55,283.5,1079.52,15
CDM,43999RVU22WE,TRANS ORAL GASTRIC OUTLET REDUCTION TORE (COMP CODE 43771),8939.0,5810.35,899.6,8939.0,15
CDM,43999RVU24WE,ENDOSCOPIC SUBMUCOSAL DISSECTION OF STOMACH - (COMP CODE 43611),8152.0,5298.8,899.6,8152.0,15
CDM,43999RVU25WE,OPEN GASTRIC BAND REMOVAL (COMP CODE 43774),6776.0,4404.4,899.6,6776.0,15
CDM,43999RVU26WE,CENTRAL GASTRECTOMY WITH GASTROGASTROSTOMY (COMP 43631),8824.0,5735.6,899.6,8824.0,15
CDM,43999RVU27WE,"ENDOVAC, STOMACH; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,567.0,1134.0,15
CDM,43999RVU28WE,"ENDOVAC, STOMACH; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,899.6,2092.0,15
CDM,43999RVU29WE,"LIGATION OF GASTRIC VARIED, OPEN (COMP CODE 43244)",1893.0,1230.45,899.6,1893.0,15
CDM,43999RVU30WE,IMAGE GUIDED REPOSITION G-TUBE (COMP CODE 43761),884.0,574.6,442.0,1079.52,15
CDM,43999RVU31WE,SLEEVE GASTRECTOMY TO SINGLE ANASTOMOSIS DUODENAL SWITCH (SADIS),13320.0,8658.0,899.6,13320.0,15
CDM,43999RVU32WE,TRANSNASAL EGD W/REMOVAL OF FOREIGN BODY (COMP 43247),1368.0,889.2,684.0,1368.0,15
CDM,43999RVU3WE,"LAP, REVISION NISSEN FUNDOPLASTY (COMP 43280)",7240.0,4706.0,899.6,7240.0,15
CDM,43999RVU4WE,EXC GASTROCUTANEOUS FISTULA (COMP 44640),10406.0,6763.9,899.6,10406.0,15
CDM,43999RVU5WE,"UNLISTED PROCEDURE, STOMACH (COMPARISON CODE 43880)",11687.0,7596.55,899.6,11687.0,15
CDM,43999RVU7WE,PARTIAL GASTRECTOMY (COMP CODE 43610),2880.0,1872.0,899.6,2880.0,15
CDM,43999RVU9WE,ESD STOMACH (COMP 43254),1948.0,1266.2,899.6,1948.0,15
CDM,44000080,ASSESS APHASIA PER HR,600.0,390.0,124.17,723.0,49
CDM,44000090,SPEECH/HEARING THERAPY INDIV,591.0,384.15,98.27,723.0,49
CDM,44000160,TREAT SWALLOWING DYSFUNCTION,830.0,539.5,20.97,747.0,49
CDM,44000165,SLT-SPEECH/LANGUAG THERAPY GRP,354.0,230.1,20.97,723.0,49
CDM,44000225,SLT-THERA SVC COM DEV PRG MOD,786.0,510.9,20.97,723.0,49
CDM,44000265,BEHAV QUAL ANLYS VOICE MO,680.0,442.0,126.0,723.0,49
CDM,44000410,BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE,680.0,442.0,126.0,723.0,49
CDM,44000435,"SLT-DEVELOPMENTAL TEST,LIM",395.0,256.75,66.36,723.0,38
CDM,44000500,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,2233.0,1451.45,137.09,3259.0,49
CDM,44000510,FIT PROSTHTIC VOICE DVC 440,795.0,516.75,93.3,723.0,49
CDM,44000515,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,713.0,463.45,80.26,723.0,49
CDM,44000520,MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,1036.0,673.4,71.29,932.4,49
CDM,44000525,FEES W CINE OR VIDEO,1355.0,880.75,74.78,1219.5,49
CDM,44000530,COGNITIVE TEST BY HCPRO GN,828.0,538.2,126.0,745.2,49
CDM,44000550,"SENSORY INTEGRATION, EA 1",235.0,152.75,20.97,723.0,49
CDM,44000565,FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V REC,522.0,339.3,110.4,723.0,49
CDM,44000570,FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC,1355.0,880.75,74.78,1219.5,49
CDM,44000585,LARYNGEAL FUNCTION STUDIES,645.0,419.25,46.11,723.0,49
CDM,44000695,DEVLOPMENT TEST INTERPT&REP,531.0,345.15,18.05,723.0,49
CDM,44000705,DEVEL TST PHYS/QHP 1ST HR,1350.0,877.5,126.0,1215.0,49
CDM,44000715,DEVEL TST PHYS/QHP EA ADDL,378.0,245.7,63.5,723.0,39
CDM,44000755,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,256.0,166.4,20.97,723.0,49
CDM,44000765,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,256.0,166.4,20.97,723.0,49
CDM,44000885,VV SPEECH THERAPY (92507),591.0,384.15,98.27,723.0,49
CDM,44000895,VV FLUENCY EVAL (92521),741.0,481.65,126.0,723.0,49
CDM,44000905,VV SOUND PRODUCTION EVALUATION (92522),716.0,465.4,126.0,723.0,49
CDM,44000915,VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVAL (92523),1253.0,814.45,126.0,1127.7,49
CDM,44000925,VV VOICE EVAL (92524),680.0,442.0,126.0,723.0,49
CDM,44000935,SLT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,1109.0,720.85,41.57,998.1,49
CDM,44000945,SLT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,1109.0,720.85,30.26,998.1,49
CDM,44000955,SLT GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,1109.0,720.85,13.13,998.1,49
CDM,44000985,REMOTE THERAPEUTIC MNTR 1ST SET-UP&PT EDUCAJ EQ,741.0,481.65,31.62,723.0,49
CDM,44000995,REM THER MNTR DEV SPLY DATA MUSCSKEL SYS EA 30 D,215.0,139.75,23.85,723.0,49
CDM,44001005,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,90.0,58.5,22.5,723.0,42
CDM,44001015,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,90.0,58.5,22.5,723.0,42
CDM,44005WE,ENTEROLSS FRING INTSTINAL ADHESION SPX,7384.0,4799.6,572.87,7384.0,35
CDM,44010WE,"DUODENOTOMY FOR EXPLOR,BX,FB REMOV",5704.0,3707.6,457.7,5704.0,35
CDM,44015WE,TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD,1048.0,681.2,107.24,1048.0,35
CDM,44020WE,ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL,6488.0,4217.2,536.11,6488.0,35
CDM,44021WE,ENTEROTOMY SM INT OTH/THN DUO DCMPRN,6524.0,4240.6,520.58,6524.0,35
CDM,44025WE,COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL,6604.0,4292.6,539.95,6604.0,35
CDM,44050WE,RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT,6208.0,4035.2,519.89,6208.0,35
CDM,44055WE,CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS,10252.0,6663.8,768.02,10252.0,35
CDM,44100065,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,256.0,166.4,20.97,723.0,49
CDM,44100075,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,256.0,166.4,20.97,723.0,49
CDM,44100WE,BX INTESTINE CAPSULE TUBE PRORAL 1/> SPECIMENS,884.0,574.6,80.17,884.0,35
CDM,44110WE,EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM,5616.0,3650.4,480.28,5616.0,35
CDM,44111WE,EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE,6608.0,4295.2,594.83,6608.0,35
CDM,44120WE,ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST,8328.0,5413.2,649.6,8328.0,35
CDM,44121WE,ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA,1776.0,1154.4,183.07,1776.0,35
CDM,44125WE,ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY,8813.0,5728.45,693.92,8813.0,35
CDM,44126WE,ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING,16892.0,10979.8,1420.16,16892.0,35
CDM,44127WE,ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING,19720.0,12818.0,1633.29,19720.0,35
CDM,44128WE,ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS,1776.0,1154.4,176.3,1776.0,35
CDM,44130WE,ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX,8844.0,5748.6,643.71,8844.0,35
CDM,44139WE,MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT,892.0,579.8,91.41,892.0,35
CDM,44140COLWE,COLECTOMY PARTIAL W ANASTOM,6106.0,3968.9,805.51,6106.0,35
CDM,44140PARWE,COLECTOMY PARTIAL W ANASTOM,6572.0,4271.8,805.51,6572.0,35
CDM,44140WE,COLECTOMY PARTIAL W/ANASTOMOSIS,9036.0,5873.4,805.51,9036.0,35
CDM,44141WE,COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY,11964.0,7776.6,888.31,11964.0,35
CDM,44143WE,COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT,11116.0,7225.4,880.35,11116.0,35
CDM,44144WE,COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA,11964.0,7776.6,878.54,11964.0,35
CDM,44145COLWE,COLECTOMY W COLOPROCTOSTOMY,7517.0,4886.05,990.73,7517.0,35
CDM,44145PROWE,COLECTOMY W COLOPROCTOSTOMY,7051.0,4583.15,990.73,7051.0,35
CDM,44145WE,COLECTOMY PRTL W/COLOPROCTOSTOMY,11432.0,7430.8,990.73,11432.0,35
CDM,44146COLWE,COLECTOMY W COLOSTOMY,9039.0,5875.35,1074.59,9039.0,35
CDM,44146STOWE,COLECTOMY W COLOSTOMY,7982.0,5188.3,1074.59,7982.0,35
CDM,44146WE,COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY,14120.0,9178.0,1074.59,14120.0,35
CDM,44147WE,COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH,13476.0,8759.4,941.74,13476.0,35
CDM,44150WE,COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS,12072.0,7846.8,983.56,12072.0,35
CDM,44151WE,COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST,13968.0,9079.2,1072.05,13968.0,35
CDM,44155WE,COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY,13768.0,8949.2,1122.73,13768.0,35
CDM,44156WE,COLECTOMY TOT ABDL W/PROCTECTOMY W/CONTNT ILEOST,14968.0,9729.2,1107.17,14968.0,35
CDM,44157WE,COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST,14280.0,9282.0,1212.32,14280.0,35
CDM,44158WE,COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR,14680.0,9542.0,1243.99,14680.0,35
CDM,44160WE,COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS,8356.0,5431.4,763.42,8356.0,35
CDM,44180WE,LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE,6108.0,3970.2,597.06,6108.0,35
CDM,44186WE,LAPAROSCOPY SURGICAL JEJUNOSTOMY,4152.0,2698.8,419.24,4152.0,35
CDM,44187WE,LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE,6960.0,4524.0,692.05,6960.0,35
CDM,44188WE,LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY,7740.0,5031.0,759.44,7740.0,35
CDM,44202WE,LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA,9356.0,6081.4,954.14,9356.0,35
CDM,44203WE,LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS,1776.0,1154.4,171.7,1776.0,35
CDM,44204WE,LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS,10568.0,6869.2,985.77,10568.0,35
CDM,44205WE,LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM,10098.0,6563.7,873.12,10098.0,35
CDM,44206WE,LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM,11916.0,7745.4,1014.46,11916.0,35
CDM,44207WE,LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST,14045.0,9129.25,1110.74,14045.0,35
CDM,44208WE,LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST,14956.0,9721.4,1200.53,14956.0,35
CDM,44210WE,LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS,12036.0,7823.4,1062.59,12036.0,35
CDM,44211WE,LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS,14832.0,9640.8,1319.57,14832.0,35
CDM,44212WE,LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY,13832.0,8990.8,1232.88,13832.0,35
CDM,44213WE,LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY,1400.0,910.0,137.22,1400.0,35
CDM,44227WE,LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS,11448.0,7441.2,1075.29,11448.0,35
CDM,44238AGRVU3WE,"UNLIST LAP PROC, INTEST (EXC RECTUM) COMPARED TO 44050",4710.0,3061.5,855.0,4710.0,16
CDM,44238AGRVUWE,"UNLISTED LAPAROSCOPIC PROCEDURE, INTESTINE (EXCEPT RECTUM)  (COM",4972.0,3231.8,855.0,4972.0,16
CDM,44238AWE,"LX PROCTOSIGMOID, CAA, ILEOSTOMY",7104.0,4617.6,855.0,7104.0,16
CDM,44238RVU10WE,LAP EXCISION OF LARGE BOWEL LESION(S) (COMP 44110),5616.0,3650.4,855.0,5616.0,16
CDM,44238RVU11WE,LX EXCISION OF MECKEL'S DIVERTICULUM (COMP CODE 44800),4820.0,3133.0,855.0,4820.0,16
CDM,44238RVU13WE,LAP EXCISION SM BOWEL LESION,4739.0,3080.35,855.0,4739.0,16
CDM,44238RVU14WE,"LAP SUTURE OF SM INTESTINE, SINGLE (COMP 44602)",4495.0,2921.75,855.0,4495.0,16
CDM,44238RVU15WE,"UNLISTED LAPAROSCOPIC PROCEDURE, INTESTINE (EXCEPT RECTUM)  (COM",7103.0,4616.95,855.0,7103.0,16
CDM,44238RVU16WE,"UNLIST LAP PROC, INTEST (EXC RECTUM) COMPARED TO 44050",5181.0,3367.65,855.0,5181.0,16
CDM,44238RVU17WE,"UNLIST LAP PROC, INTESTINE (EXCEPT RECTUM) (COMP CODE 44144)",9461.0,6149.65,855.0,9461.0,16
CDM,44238RVU18WE,LAP REPAIR ENTEROCUTANEOUS FISTULA (COMP 44640),9680.0,6292.0,855.0,9680.0,16
CDM,44238RVU19WE,"LAP REDUCE VOLVULUS,INTUSS,INTERNAL HERNIA (COMP 44050)",6674.0,4338.1,855.0,6674.0,16
CDM,44238RVU1WE,LAPAROSCOPIC STRICTUROPLASTY (COMP 44615),6538.0,4249.7,855.0,6538.0,16
CDM,44238RVU20WE,LAP CLOSURE OF ILEOSIGMOID FISTULA (COMP 44650),10048.0,6531.2,855.0,10048.0,16
CDM,44238RVU21WE,"LAP SUTURE OF LG INTESTINE, SINGLE/MULT (COMP 44604)",7264.0,4721.6,855.0,7264.0,16
CDM,44238RVU22WE,UNLISTED PROC; LAP REVISION OF ILEOSTOMY; COMPLICATED (COMP TO 4,7198.0,4678.7,855.0,7198.0,16
CDM,44238RVU23WE,"UNLISTED PROC, LAP REPAIR OF DUODENAL PERFORATION (COMP TO 44602",9988.0,6492.2,855.0,9988.0,16
CDM,44238RVU24WE,UNLISTED LAPAROSCOPIC COMPLETION PROCTECTOMY WITH ILEOANAL POUCH,13288.0,8637.2,855.0,13288.0,16
CDM,44238RVU27WE,SUTURE OF MESENTERY (SEPARATE PROCEDURE) (COMP CODE 44850),4845.0,3149.25,855.0,4845.0,16
CDM,44238RVU28WE,LAP CLOSURE OF ENTEROVESICAL FISTULA W/O RESECTION (COMP 44660),10281.0,6682.65,716.97,10281.0,35
CDM,44238RVU29WE,LAPAROSCOPIC BRAUN ENTEROENTEROSTOMY (COMP 44130),9507.0,6179.55,855.0,9507.0,16
CDM,44238RVU30WE,LAP EXCISION OF CECUM W/O ANASTOMOSIS (COMP 44110),6037.0,3924.05,855.0,6037.0,16
CDM,44238RVU31WE,LAP REVISION COLOSTOMY W/RPR PARACOLOSTOMY HERNIA (COMP 44346),5035.0,3272.75,855.0,5035.0,16
CDM,44238RVU32WE,LAPAROSCOPIC EXCISION SMALL BOWEL LESION/S (COMP 44110),6037.0,3924.05,855.0,6037.0,16
CDM,44238RVU33WE,LAPAROSCOPIC PARTIAL COLECTOMY WITHOUT ANASTOMOSIS (COMP CODE 44,11360.0,7384.0,855.0,11360.0,16
CDM,44238RVU34WE,UNLISTED LAP LADDS PROCEDURE (COMP CODE 44055),9227.0,5997.55,855.0,9227.0,16
CDM,44238RVU35WE,LAPAROSCOPIC ILEOCOLOSTOMY PEXY (COMP 44312),3395.0,2206.75,855.0,3395.0,16
CDM,44238RVU36WE,LAP GRAHAM PATCH INTESTINE (COMP 43840),8219.0,5342.35,855.0,8219.0,16
CDM,44238RVU37WE,LAPAROSCOPIC REMOVAL OF FOREIGN BODY; SMALL INTESTINE (COMP 4402,5840.0,3796.0,855.0,5840.0,16
CDM,44238RVU38WE,LAP REVISION OF ILEAL POUCH W/ RESECTION (COMP 46712),13123.0,8529.95,855.0,13123.0,16
CDM,44238RVU39WE,LAPAROSCOPIC CECOPEXY (COMP CODE 44680),6466.0,4202.9,855.0,6466.0,16
CDM,44238RVU3WE,LAPARSCOPIC CLOSURE ENTEROCOLIC FISTULA (COMP 44650),10940.0,7111.0,855.0,10940.0,16
CDM,44238RVU40WE,LAP COLECTOMY W/REMOVAL OF TI; NO ANASTOMOSIS W/ STOMA (COMP 442,10725.0,6971.25,855.0,10725.0,16
CDM,44238RVU4WE,LAP/MALROTATION OF BOWEL,8044.0,5228.6,855.0,8044.0,16
CDM,44238RVU6WE,LX TAKEDOWN OF COLOVESICLE FIST W/RESECT (COMP CODE 44661),7924.0,5150.6,855.0,7924.0,16
CDM,44238RVUWE,LAPAROSCOPIC ENTEROENTEROSTOMY,5243.0,3407.95,855.0,5243.0,16
CDM,44238WE,UNLISTED LAPAROSCOPY PX INTESTINE XCP RECTUM,4308.0,2800.2,855.0,4308.0,16
CDM,44300WE,PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN,5500.0,3575.0,430.1,5500.0,35
CDM,44310ILEWE,ILEOSTOMY OR JEJUNOSTOMY,4469.0,2904.85,544.64,4469.0,35
CDM,44310UNUWE,ILEOST/JEJUNO UNUSUAL PX,3764.0,2446.6,544.64,3764.0,35
CDM,44310WE,"ILEOSTOMY/JEJUNOSTOMY,NONTUBE",7740.0,5031.0,544.64,7740.0,35
CDM,44312WE,REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX,3772.0,2451.8,298.46,3772.0,35
CDM,44314WE,REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX,6696.0,4352.4,517.43,6696.0,35
CDM,44316WE,CONTINENT ILEOSTOMY KOCK PROCEDURE SPX,9436.0,6133.4,715.56,9436.0,35
CDM,44320WE,COLOSTOMY/SKIN LEVEL CECOSTOMY,7964.0,5176.6,614.1,7964.0,35
CDM,44322WE,COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX,5328.0,3463.2,589.15,5328.0,35
CDM,44340WE,REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX,3712.0,2412.8,306.57,3712.0,35
CDM,44345WE,REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX,6888.0,4477.2,537.01,6888.0,35
CDM,44346WE,REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX,7852.0,5103.8,600.93,7852.0,35
CDM,44360WE,ENDOSCOPY UPPER SMALL INTESTINE,996.0,647.4,107.94,996.0,35
CDM,44361WE,ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY,1108.0,720.2,120.0,1108.0,35
CDM,44363WE,ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY,1356.0,881.4,144.51,1356.0,35
CDM,44364WE,ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE,1452.0,943.8,154.22,1452.0,35
CDM,44365WE,ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY,1284.0,834.6,137.62,1284.0,35
CDM,44366WE,ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING,1720.0,1118.0,180.77,1720.0,35
CDM,44369WE,ENTEROSCOPY > 2ND PRTN ABLTJ LESION,1764.0,1146.6,185.11,1764.0,35
CDM,44370WE,ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT,1876.0,1219.4,172.02,1876.0,35
CDM,44372WE,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,1720.0,1118.0,181.28,1720.0,35
CDM,44373WE,ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE,1356.0,881.4,144.19,1356.0,35
CDM,44376WE,ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX,2060.0,1339.0,214.22,2060.0,35
CDM,44377WE,ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE,2168.0,1409.2,224.69,2168.0,35
CDM,44378WE,ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING,2808.0,1825.2,289.28,2808.0,35
CDM,44379WE,ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT,2944.0,1913.6,267.68,2944.0,35
CDM,44380WE,ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD,348.0,226.2,44.39,348.0,35
CDM,44381WE,ILEOSCOPY STOMA W/BALLOON DILATION,552.0,358.8,64.39,552.0,30
CDM,44382WE,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,468.0,304.2,53.41,468.0,35
CDM,44384WE,ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT,1140.0,741.0,64.58,1140.0,30
CDM,44385WE,NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX,528.0,343.2,70.02,446.93,35
CDM,44386WE,NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE,660.0,429.0,86.14,594.62,35
CDM,44388WE,COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX,1088.0,707.2,75.29,816.0,35
CDM,44389WE,COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE,1329.0,863.85,150.52,996.75,35
CDM,44390WE,COLONOSCOPY STOMA W/RMVL FOREIGN BODY,1496.0,972.4,170.37,1122.0,35
CDM,44391WE,COLONOSCOPY STOMA CONTROL BLEEDING,1648.0,1071.2,205.29,1236.0,35
CDM,44392WE,COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS,1412.0,917.8,178.14,1059.0,35
CDM,44394WE,COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE,1612.0,1047.8,209.63,1209.0,35
CDM,44400005,SWALLOW EVAL FUNC FLUORO GN,1036.0,673.4,71.29,932.4,49
CDM,44400030,EVALUATE SWALLOWING FUNCTION,713.0,463.45,80.26,723.0,49
CDM,44400040,EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER),741.0,481.65,126.0,723.0,49
CDM,44400045,EVAL OF SPEECH PRODUCTION,716.0,465.4,126.0,723.0,49
CDM,44400050,EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE,716.0,465.4,126.0,723.0,49
CDM,44400055,EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION,1253.0,814.45,126.0,1127.7,49
CDM,44400060,EVAL SPEECH SOUND LANG COMPREH,1253.0,814.45,126.0,1127.7,49
CDM,44400075,EVAL OF SPEECH FLUENCY,741.0,481.65,126.0,723.0,49
CDM,44400145,EVAL SPCH - GEN DEV 1 HR,1775.0,1153.75,126.0,1597.5,49
CDM,44400155,EVAL SPCH - GEN DEV 30 MN,215.0,139.75,53.75,723.0,49
CDM,44401WE,COLONOSCOPY STOMA ABLATION LESION,1736.0,1128.4,199.26,1302.0,31
CDM,44402WE,COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT,1880.0,1222.0,196.86,1880.0,31
CDM,44403WE,COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ,2200.0,1430.0,228.77,2200.0,30
CDM,44404WE,COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION,1208.0,785.2,164.86,1208.0,30
CDM,44405WE,COLONOSCOPY STOMA W/BALLOON DILATION,1292.0,839.8,173.83,1292.0,30
CDM,44406WE,COLONOSCOPY STOMA W/ENDOSCOPIC ULTRASOUND EXAM,1640.0,1066.0,173.37,1640.0,30
CDM,44407WE,COLONOSCOPY STOMA W/US GID NDL ASPIR/BX,1984.0,1289.6,207.58,1984.0,30
CDM,44408WE,COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION,1656.0,1076.4,168.09,1656.0,31
CDM,44500WE,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,172.0,111.8,14.55,172.0,35
CDM,44602WE,ENTERORRHAPHY SINGLE PERFORATION,9888.0,6427.2,691.14,9888.0,35
CDM,44603WE,ENTERORRHAPHY MULTIPLE PERFORATIONS,11264.0,7321.6,788.37,11264.0,35
CDM,44604WE,SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY,7264.0,4721.6,606.28,7264.0,35
CDM,44605WE,SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY,8832.0,5740.8,679.15,8832.0,35
CDM,44615WE,INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ,7264.0,4721.6,579.1,7264.0,35
CDM,44620WE,CLOSURE ENTEROSTOMY LG/SMALL INTESTINE,6349.0,4126.85,461.5,6349.0,35
CDM,44625WE,CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT,6912.0,4492.8,621.66,6912.0,35
CDM,44626WE,CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS,11160.0,7254.0,922.26,11160.0,35
CDM,44640WE,CLOSURE INTESTINAL CUTANEOUS FISTULA,9680.0,6292.0,731.72,9680.0,35
CDM,44650WE,CLSR ENTEROENTERIC/ENTEROCOLIC FSTL,10048.0,6531.2,760.16,10048.0,35
CDM,44660WE,CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ,9564.0,6216.6,716.97,9564.0,35
CDM,44661WE,CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ,10940.0,7111.0,822.93,10940.0,35
CDM,44680WE,INTESTINAL PLICATION SEPARATE PROCEDURE,7184.0,4669.6,639.25,7184.0,35
CDM,44700WE,EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS,6992.0,4544.8,696.14,6992.0,35
CDM,44701WE,INTRAOPERATIVE COLONIC LAVAGE,1240.0,806.0,110.5,1240.0,35
CDM,44705WE,PREPARE FECAL MICROBIOTA FOR INSTILLATION,568.0,369.2,73.17,568.0,17
CDM,44799PERWE,PERC JEJUNOSTOMY TUBE CHANGE,353.0,229.45,147.38,353.0,15
CDM,44799RVU10WE,"UNLISTED PROCEDURE, SMALL INTESTINE (COMPARISON CODE 15860)",780.0,507.0,147.38,780.0,15
CDM,44799RVU13WE,ESD SMALL INTESTINE (COMP 44364),1452.0,943.8,147.38,1452.0,15
CDM,44799RVU14WE,POUCHOSCOPY W/INJECTION (COMP 44386),646.0,419.9,147.38,646.0,15
CDM,44799RVU15WE,POUCHOSCOPY WITH DILATION (COMP 44386),600.0,390.0,147.38,600.0,15
CDM,44799RVU16WE,POUCHOSCOPY W/STRICTUROTOMY/FISTULOTOMY (COMP 44386),600.0,390.0,147.38,600.0,15
CDM,44799RVU18WE,POUCHOSCOPY W/SNARE (COMP 44386),1887.0,1226.55,147.38,1887.0,15
CDM,44799RVU20WE,REPAIR DUODENAL FISTULA (COMP 44650),10801.0,7020.65,147.38,10801.0,15
CDM,44799RVU27WE,RETROGRADE SMALL INTESTINE ENTEROSCOPY W/BIOPSY (COMP 44377),2168.0,1409.2,147.38,2168.0,15
CDM,44799RVU28WE,RETROGRADE ENTEROSCOPY W/CONTROL OF BLEEDING (COMP 44378),2346.0,1524.9,147.38,2346.0,15
CDM,44799RVU29WE,ENTEROSCOPY W/DILATION (COMP CODE 43249),1148.0,746.2,147.38,1148.0,15
CDM,44799RVU30WE,ENTEROSCOPY W/SUBMUCOSAL INJECTION (COMP CODE 43236),2016.0,1310.4,147.38,2016.0,15
CDM,44799RVU31WE,BAE W/ENDOSCOPIC MUCOSAL RESECTION (COMP CODE 43254),1948.0,1266.2,147.38,1948.0,15
CDM,44799RVU33WE,"LOWER BAE, RETROGRADE, W/O FLUORO (COMP 45378)",1304.0,847.6,147.38,1304.0,15
CDM,44799RVU34WE,RETROGRADE ENTEROSCOPY SUBMUCOSAL INJECTION (COMP 45381),1308.0,850.2,147.38,1308.0,15
CDM,44799RVU35WE,ENDOSCOPIC SUBMUCOSAL DISSECTION OF SMALL INSTESTINE - (COMP COD,9356.0,6081.4,147.38,9356.0,15
CDM,44799RVU36WE,CORRECTION OF GUT MALROTATION (EG. KAREEM'S PROCEDURE) - (COMP C,11020.0,7163.0,147.38,11020.0,15
CDM,44799RVU38WE,ILEOSCOPY W/ CONTROL OF BLEEDING THROUGH THE STOMA (COMP 44378),3018.0,1961.7,147.38,3018.0,15
CDM,44799RVU39WE,"ENDOVAC, SMALL INT; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,147.38,1134.0,15
CDM,44799RVU40WE,"ENDOVAC, SMALL INT; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,147.38,2092.0,15
CDM,44799RVU41WE,"ENDOVAC, SMALL INT; EGD (COMP 43235, 97605)",990.0,643.5,147.38,990.0,15
CDM,44799RVU42WE,"ENDOVAC, SMALL INT; POUCHOSCOPY (COMP 44385, 97605)",2203.0,1431.95,147.38,2203.0,15
CDM,44799RVU43WE,POUCHOSCOPY W/ STENT PLACEMENT (COMP 44402),1693.0,1100.45,147.38,1693.0,15
CDM,44799RVU44WE,EGD THROUGH ARTIFICIAL STOMA (COMP 44369),1588.0,1032.2,147.38,1588.0,15
CDM,44799RVU45WE,SMALL INTESTINE MYRIAD COLLAGEN MATRIX IMPLANT (COMP 15777),1315.0,854.75,147.38,1315.0,15
CDM,44799RVU46WE,RETROGRADE ENTEROSCOPY W/DILATION (COMP 45386),1659.0,1078.35,147.38,1659.0,15
CDM,44799RVU47WE,EGD W/ CLIPPING OF INTESTINAL FISTULA (COMP 43255),1566.0,1017.9,147.38,1566.0,15
CDM,44799RVU48WE,POUCHOSCOPY W/DECOMPRESSION (COMP 45393),2059.0,1338.35,147.38,2059.0,15
CDM,44799RVU49WE,REVISION OF JEJUNOSTOMY (COMP 44314),6696.0,4352.4,147.38,6696.0,15
CDM,44799RVU4WE,REVISION OF ANASTOMOSIS (COMP 44125),8813.0,5728.45,147.38,8813.0,15
CDM,44799RVU5WE,REVISION JEJUNOJEJUNOSTOMY,2016.0,1310.4,147.38,2016.0,15
CDM,44799RVU8WE,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 44394",1732.0,1125.8,147.38,1732.0,15
CDM,44799RVU9WE,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 43236",2016.0,1310.4,147.38,2016.0,15
CDM,44800WE,EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT,4820.0,3133.0,452.19,4820.0,35
CDM,44820WE,EXCISION LESION MESENTERY SEPARATE PROCEDURE,5492.0,3569.8,440.8,5492.0,35
CDM,44850WE,SUTURE MESENTERY SEPARATE PROCEDURE,4844.0,3148.6,416.35,4844.0,35
CDM,44899RVUWE,"UNLISTED PROCEDURE, MECKEL'S DIVERTICULUM AND THE MESENTERY (COM",5492.0,3569.8,576.65,5492.0,15
CDM,44900WE,INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN,5028.0,3268.2,386.13,5028.0,35
CDM,44950WE,APPENDECTOMY,4240.0,2756.0,352.33,4240.0,35
CDM,44955WE,APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX,612.0,397.8,63.58,612.0,35
CDM,44960WE,APPENDEC RPTD APPENDIX ABSC/PRITONITIS,5800.0,3770.0,456.57,5800.0,35
CDM,44970WE,LAPAROSCOPIC APPENDECTOMY,3780.0,2457.0,352.33,3780.0,35
CDM,44979RVU1WE,UNLISTED PROC; LAP DRAINAGE OF APPENDICEAL ABSCESS W/DEBRIDEMENT,5405.0,3513.25,430.18,5405.0,15
CDM,44979RVUWE,LAP APPENDECTOMY AT TIME OTHER SURGERY (COMP CODE 44955),612.0,397.8,306.0,612.0,15
CDM,45000000,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,2298.0,1493.7,63.06,4151.0,49
CDM,45000005,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,745.0,484.25,98.33,4151.0,49
CDM,45000015,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,2639.0,1715.35,98.33,4151.0,49
CDM,45000020,TEMPORARY TRANSCUTANEOUS PACING,4704.0,3057.6,1.58,4233.6,41
CDM,45000025,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,2639.0,1715.35,213.06,4268.0,49
CDM,45000030,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,4704.0,3057.6,130.58,4233.6,41
CDM,45000035,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,1499.0,974.35,98.33,4151.0,49
CDM,45000040,CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX,4704.0,3057.6,282.29,4233.6,41
CDM,45000055,I&D HEMATOMA SEROMA/FLUID COLLECTION,6076.0,3949.4,147.52,5468.4,49
CDM,45000060,ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG,1446.0,939.9,102.77,1764.0,35
CDM,45000065,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1499.0,974.35,98.33,4151.0,49
CDM,45000070,IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED,230.0,149.5,38.64,1764.0,25
CDM,45000075,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,10733.0,6976.45,219.77,13665.0,49
CDM,45000080,EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP,760.0,494.0,15.31,1764.0,43
CDM,45000090,EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM,1366.0,887.9,56.31,1764.0,43
CDM,45000100,EMERGENCY DEPARTMENT VISIT LOW MDM,2389.0,1552.85,96.61,2150.1,43
CDM,45000110,EMERGENCY DEPARTMENT VISIT MODERATE MDM,3673.0,2387.45,164.52,3732.0,43
CDM,45000115,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,1499.0,974.35,73.55,4214.0,49
CDM,45000120,EMERGENCY DEPARTMENT VISIT HIGH MDM,5288.0,3437.2,239.33,4759.2,43
CDM,45000130,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,7268.0,4724.2,277.57,6541.2,43
CDM,45000135,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,6076.0,3949.4,269.11,6317.0,49
CDM,45000140,CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN,3109.0,2020.85,139.52,2798.1,25
CDM,45000145,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,745.0,484.25,19.58,3920.0,49
CDM,45000150,VAGINAL DELIVERY ONLY,15898.0,10333.7,853.0,14308.2,49
CDM,45000160,UNLISTED PROCEDURE FEMALE GENITAL SYS,354.0,230.1,99.47,8550.0,48
CDM,45000170,REMOVAL INTRAUTERINE DEVICE IUD,1749.0,1136.85,78.23,3920.0,49
CDM,45000180,DELIVERY PLACENTA SEPARATE PROCEDURE,15898.0,10333.7,111.43,14308.2,49
CDM,45000185,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,745.0,484.25,91.06,3920.0,49
CDM,45000190,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,5973.0,3882.45,77.17,5375.7,49
CDM,45000200,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,5973.0,3882.45,112.86,5375.7,49
CDM,45000210,I&D OF BARTHOLINS GLAND ABSCESS,1156.0,751.4,126.63,4151.0,49
CDM,45000215,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,223.0,144.95,9.69,3920.0,49
CDM,45000220,INJECTION EPIDURAL BLOOD/CLOT PATCH,5973.0,3882.45,139.83,6317.0,49
CDM,45000230,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,2546.0,1654.9,60.57,4151.0,49
CDM,45000235,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,745.0,484.25,40.61,3920.0,49
CDM,45000245,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,670.0,435.5,21.5,3920.0,38
CDM,45000250,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2546.0,1654.9,60.62,4151.0,49
CDM,45000255,EVACUATION SUBUNGUAL HEMATOMA,484.0,314.6,40.61,3920.0,49
CDM,45000260,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,1719.0,1117.35,133.22,4214.0,49
CDM,45000265,EXCISION NAIL MATRIX PERMANENT REMOVAL,1499.0,974.35,123.89,4214.0,49
CDM,45000270,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,5973.0,3882.45,51.82,5375.7,49
CDM,45000275,REPAIR NAIL BED,2295.0,1491.75,40.61,3920.0,48
CDM,45000280,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,741.0,481.65,33.58,3920.0,49
CDM,45000285,WEDGE EXCISION SKIN NAIL FOLD,1499.0,974.35,40.61,3920.0,49
CDM,45000290,UNLISTED PROCEDURE ORBIT,887.0,576.55,169.69,2093.0,41
CDM,45000295,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,745.0,484.25,57.45,3920.0,49
CDM,45000300,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,2295.0,1491.75,45.31,3920.0,49
CDM,45000305,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,745.0,484.25,75.39,3920.0,49
CDM,45000310,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,741.0,481.65,45.31,3920.0,49
CDM,45000315,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,1499.0,974.35,115.89,3920.0,49
CDM,45000320,I&D VULVA/PERINEAL ABSCESS,1749.0,1136.85,132.47,4151.0,49
CDM,45000330,UNLISTED PROCEDURE ANT SEG OF EYE,2096.0,1362.4,588.98,7730.0,48
CDM,45000340,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,5391.0,3504.15,151.21,4851.9,49
CDM,45000345,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,745.0,484.25,71.21,3920.0,49
CDM,45000350,RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS,13114.0,8524.1,599.44,11802.6,49
CDM,45000355,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,745.0,484.25,74.22,3920.0,49
CDM,45000360,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,2295.0,1491.75,41.27,3920.0,49
CDM,45000365,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,745.0,484.25,95.67,3920.0,49
CDM,45000370,ASPIRATION BLADDER NEEDLE,1399.0,909.35,46.78,3920.0,49
CDM,45000375,SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM,745.0,484.25,115.89,3920.0,49
CDM,45000380,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,8518.0,5536.7,499.08,7666.2,49
CDM,45000390,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,2929.0,1903.85,112.01,6317.0,48
CDM,45000395,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,2295.0,1491.75,227.32,4268.0,48
CDM,45000400,THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR,13135.0,8537.75,853.0,18285.0,32
CDM,45000410,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK,13415.0,8719.75,486.84,12073.5,49
CDM,45000415,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,1499.0,974.35,171.31,4214.0,49
CDM,45000420,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,4046.0,2629.9,153.45,4151.0,49
CDM,45000425,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,1499.0,974.35,213.21,4214.0,49
CDM,45000430,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,2929.0,1903.85,241.44,6317.0,48
CDM,45000435,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,1499.0,974.35,233.99,4214.0,49
CDM,45000440,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,2929.0,1903.85,237.28,6289.0,48
CDM,45000445,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,1499.0,974.35,241.35,4214.0,49
CDM,45000450,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,2929.0,1903.85,247.97,6317.0,48
CDM,45000460,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,1335.0,867.75,112.01,4214.0,49
CDM,45000465,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,1499.0,974.35,168.05,3920.0,49
CDM,45000470,RPR LAC 2.5 CM/< PST ONE-THIRD TONGUE,1335.0,867.75,112.01,4214.0,49
CDM,45000475,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,1499.0,974.35,220.06,4214.0,49
CDM,45000480,UNLISTED PROCEDURE MALE GENITAL SYSTEM,592.0,384.8,166.35,8370.0,48
CDM,45000485,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,2295.0,1491.75,241.35,4214.0,48
CDM,45000490,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,11779.0,7656.35,171.65,13665.0,49
CDM,45000495,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,1499.0,974.35,192.62,4214.0,49
CDM,45000500,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,1399.0,909.35,36.17,4151.0,49
CDM,45000505,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1499.0,974.35,225.31,4214.0,49
CDM,45000510,INSJ NON-NDWELLG BLADDER CATHETER,741.0,481.65,30.28,3920.0,49
CDM,45000515,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,1499.0,974.35,241.35,4214.0,49
CDM,45000520,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,741.0,481.65,31.01,3920.0,49
CDM,45000525,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,1499.0,974.35,241.35,3920.0,49
CDM,45000530,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,900.0,585.0,53.02,3920.0,49
CDM,45000540,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,341.0,221.65,18.23,3920.0,49
CDM,45000550,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,1399.0,909.35,53.02,3920.0,49
CDM,45000560,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,11779.0,7656.35,261.56,36332.0,49
CDM,45000570,DRAINAGE SCROTAL WALL ABSCESS,9316.0,6055.4,208.95,8384.4,49
CDM,45000580,RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG,2295.0,1491.75,112.01,3920.0,49
CDM,45000585,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,1499.0,974.35,254.67,4214.0,49
CDM,45000590,CLTX METATARSOPHLNGL JT DISLC W/O ANES,1379.0,896.35,142.11,4151.0,49
CDM,45000595,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,2295.0,1491.75,254.67,4268.0,48
CDM,45000600,CLTX FX GRT TOE PHLX/PHLG W/MANJ,1379.0,896.35,204.23,4151.0,49
CDM,45000610,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45000620,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45000625,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,2295.0,1491.75,254.67,4268.0,48
CDM,45000630,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,9203.0,5981.95,807.83,8370.0,49
CDM,45000635,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,2295.0,1491.75,254.67,4268.0,48
CDM,45000640,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,18656.0,12126.4,748.04,16790.4,49
CDM,45000650,TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45000655,INITIAL TX 1ST DEGREE BURN LOCAL TX,745.0,484.25,56.54,3920.0,49
CDM,45000660,ARREST EPIPHYSEAL DISTAL FEMUR,41076.0,26699.4,785.71,36968.4,42
CDM,45000665,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,745.0,484.25,69.24,4151.0,49
CDM,45000670,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45000675,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,745.0,484.25,115.89,4151.0,49
CDM,45000680,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,9203.0,5981.95,310.03,8550.0,49
CDM,45000685,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,1499.0,974.35,157.61,4151.0,49
CDM,45000690,CLTX PROX FIBULA/SHFT FX W/MANJ,9203.0,5981.95,310.03,8550.0,49
CDM,45000695,CHEMICAL CAUTERIZATION OF GRANULATION TISSUE,745.0,484.25,44.93,4151.0,49
CDM,45000700,REM FB SHOULDER COMPLIC,4006.0,2603.9,673.01,3605.4,24
CDM,45000705,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,6076.0,3949.4,398.52,13665.0,49
CDM,45000710,PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY,7770.0,5050.5,853.0,18285.0,32
CDM,45000720,REPAIR CARDIAC WOUND W/O BYPASS,23369.0,15189.85,853.0,21032.1,32
CDM,45000725,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1698.0,1103.7,47.54,3920.0,49
CDM,45000730,VENIPUNCTURE CUTDOWN AGE 1 YR/>,2868.0,1864.2,44.56,3920.0,49
CDM,45000735,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,1698.0,1103.7,42.6,3920.0,49
CDM,45000740,RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION,5569.0,3619.85,78.55,5012.1,49
CDM,45000745,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1698.0,1103.7,43.64,3920.0,49
CDM,45000750,ED SURG PROCEDURE,393.0,255.45,66.02,1764.0,24
CDM,45000755,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1698.0,1103.7,52.83,3920.0,49
CDM,45000760,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,22623.0,14704.95,112.14,20360.7,49
CDM,45000770,VENIPUNCTURE CUTDOWN UNDER AGE 1 YR,926.0,601.9,44.56,3920.0,49
CDM,45000780,RPR LIP FULL THICKNESS VERMILION ONLY,2929.0,1903.85,112.01,6317.0,48
CDM,45000790,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45000800,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,3518.0,2286.7,112.01,4151.0,49
CDM,45000805,APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,8518.0,5536.7,844.88,7666.2,49
CDM,45000810,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,8101.0,5265.65,186.22,7290.9,49
CDM,45000820,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,3518.0,2286.7,112.01,4151.0,49
CDM,45000830,RMVL FB XTRNL AUDITORY CANAL W/O ANES,645.0,419.25,55.07,3920.0,43
CDM,45000840,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,298.0,193.7,37.27,3920.0,43
CDM,45000845,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,1379.0,896.35,39.87,3920.0,49
CDM,45000850,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,16456.0,10696.4,499.74,14810.4,49
CDM,45000855,INTERDENTAL WIRING OTHER THAN FRACTURE,8518.0,5536.7,767.22,8370.0,49
CDM,45000860,REMOVAL EMBEDDED FOREIGN BODY EYELID,1719.0,1117.35,131.54,4151.0,49
CDM,45000870,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,18656.0,12126.4,202.0,16790.4,42
CDM,45000880,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,9316.0,6055.4,179.46,8384.4,49
CDM,45000885,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,9203.0,5981.95,310.03,8550.0,49
CDM,45000890,STRAPPING UNNA BOOT,908.0,590.2,32.49,3920.0,49
CDM,45000900,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,2295.0,1491.75,183.62,4214.0,48
CDM,45000905,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45000910,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,6076.0,3949.4,269.11,6317.0,49
CDM,45000915,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45000920,REM FB SHOULDER DEEP,4006.0,2603.9,673.01,3605.4,24
CDM,45000930,UNLISTED PROCEDURE NOSE,425.0,276.25,119.43,7730.0,48
CDM,45000935,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,9316.0,6055.4,204.29,13665.0,49
CDM,45000940,STRAPPING TOES,341.0,221.65,13.86,3920.0,49
CDM,45000945,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,9203.0,5981.95,310.03,8282.7,49
CDM,45000950,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,1528.0,993.2,39.77,3920.0,49
CDM,45000960,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,1528.0,993.2,53.48,3920.0,49
CDM,45000965,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45000970,UNLISTED PROCEDURE CASTING OR STRAPPING,307.0,199.55,47.31,1974.0,41
CDM,45000975,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,9203.0,5981.95,310.03,8550.0,49
CDM,45000980,DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,2929.0,1903.85,142.7,4214.0,48
CDM,45000985,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,1379.0,896.35,95.43,4151.0,49
CDM,45000990,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,741.0,481.65,112.01,3920.0,49
CDM,45000995,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,9203.0,5981.95,310.03,8282.7,49
CDM,45000WE,TRANSRECTAL DRAINAGE OF PELVIC ABSCESS,2520.0,1638.0,209.42,2520.0,35
CDM,45001000,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,741.0,481.65,67.25,3920.0,49
CDM,45001010,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,741.0,481.65,94.07,3920.0,49
CDM,45001020,TUBE THORACOSTOMY INCLUDES WATER SEAL,8933.0,5806.45,191.38,8370.0,49
CDM,45001030,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,1335.0,867.75,112.01,3920.0,49
CDM,45001040,APPLICATION SHORT LEG SPLINT CALF FOOT,908.0,590.2,47.31,3920.0,49
CDM,45001050,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1335.0,867.75,181.19,4151.0,49
CDM,45001060,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,1335.0,867.75,41.35,4151.0,49
CDM,45001065,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45001070,LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,1116.0,725.4,57.56,3920.0,49
CDM,45001080,LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY,1116.0,725.4,112.01,4151.0,49
CDM,45001085,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,9203.0,5981.95,310.03,8282.7,49
CDM,45001090,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,8518.0,5536.7,374.02,7666.2,49
CDM,45001095,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1379.0,896.35,240.79,4151.0,49
CDM,45001100,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,1335.0,867.75,233.1,6317.0,49
CDM,45001110,UNLISTED PROCEDURE TRACHEA BRONCHI,2553.0,1659.45,194.87,2297.7,41
CDM,45001120,THORACENTESIS FOR ASPIRATION,867.0,563.55,145.66,1764.0,24
CDM,45001130,THORA W INS TUBE SEP,1786.0,1160.9,300.05,1764.0,24
CDM,45001140,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,741.0,481.65,112.01,3920.0,49
CDM,45001150,STRAPPING SHOULDER,741.0,481.65,22.36,3920.0,49
CDM,45001160,UNLISTED VASC PROCEDURE,2302.0,1496.3,620.6,13665.0,47
CDM,45001170,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,1379.0,896.35,206.85,4151.0,49
CDM,45001180,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,1379.0,896.35,127.75,4151.0,49
CDM,45001190,APPLICATION CAST SHOULDER HAND LONG ARM,1528.0,993.2,80.74,4151.0,49
CDM,45001200,APPLICATION CAST ELBOW FINGER SHORT ARM,1528.0,993.2,74.39,4151.0,49
CDM,45001210,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,908.0,590.2,79.56,3920.0,49
CDM,45001220,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,741.0,481.65,47.31,3920.0,49
CDM,45001230,APPLICATION FINGER SPLINT STATIC,741.0,481.65,34.13,3920.0,49
CDM,45001240,STRAPPING ANKLE &/FOOT,908.0,590.2,22.01,3920.0,49
CDM,45001250,STRAPPING THORAX,908.0,590.2,22.36,3920.0,49
CDM,45001260,STRAPPING KNEE,741.0,481.65,22.36,3920.0,49
CDM,45001270,STRAPPING ELBOW/WRIST,341.0,221.65,22.56,3920.0,49
CDM,45001280,STRAPPING HAND/FINGER,341.0,221.65,23.67,3920.0,49
CDM,45001290,APPLICATION LONG LEG CAST THIGH-TOE,1528.0,993.2,114.84,4151.0,49
CDM,45001300,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,1528.0,993.2,70.57,4151.0,49
CDM,45001310,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,1528.0,993.2,66.14,3920.0,49
CDM,45001320,APPLICATION PATELLAR TENDON BEARING CAST,1528.0,993.2,102.0,4151.0,49
CDM,45001330,APPLICATION RIGID TOTAL CONTACT LEG CAST,1528.0,993.2,114.84,4151.0,49
CDM,45001340,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,908.0,590.2,47.31,3920.0,49
CDM,45001350,APPLICATION SHORT ARM SPLINT DYNAMIC,741.0,481.65,47.31,3920.0,49
CDM,45001360,APPLICATION FINGER SPLINT DYNAMIC,341.0,221.65,40.74,3920.0,49
CDM,45001370,CHANGE NEPHROSTOMY/PYELOSTOMY TUBE,2109.0,1370.85,354.31,1898.1,24
CDM,45001390,I&D SUBMUCOSAL ABSCESS RECTUM,4056.0,2636.4,219.57,36332.0,49
CDM,45001400,UNLISTED PROCEDURE RECTUM,1480.0,962.0,415.88,7730.0,48
CDM,45001410,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,6780.0,4407.0,548.66,36332.0,49
CDM,45001420,I&D PERIANAL ABSCESS SUPERFICIAL,5243.0,3407.95,132.49,4718.7,49
CDM,45001430,INCISION THROMBOSED HEMORRHOID EXTERNAL,1399.0,909.35,134.91,4151.0,49
CDM,45001440,EXC THROMBOSED HEMORRHOID XTRNL,6780.0,4407.0,137.7,6102.0,49
CDM,45001450,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,741.0,481.65,51.37,3920.0,49
CDM,45001460,ANOSCOPY W/RMVL FOREIGN BODY,6780.0,4407.0,103.52,6289.0,49
CDM,45001470,CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS,1335.0,867.75,112.01,3920.0,49
CDM,45001480,UNLISTED PROCEDURE ABD PERITONEUM,2923.0,1899.95,454.96,8370.0,48
CDM,45001490,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,22623.0,14704.95,220.17,20360.7,42
CDM,45001500,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,11165.0,7257.25,220.84,10048.5,49
CDM,45001510,RPLCMT CATH CTR VAD SUBQ PORT/PMP,22623.0,14704.95,243.92,20360.7,42
CDM,45001520,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,11165.0,7257.25,78.99,10048.5,49
CDM,45001530,COMPLETE REPLACEMENT PICC RS&I,11165.0,7257.25,70.91,10048.5,49
CDM,45001540,THORACOTOMY W/CARDIAC MASSAGE,7376.0,4794.4,853.0,18285.0,32
CDM,45001550,APPLICATION LONG ARM SPLINT SHOULDER HAND,908.0,590.2,47.31,3920.0,49
CDM,45001560,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,11165.0,7257.25,225.25,10048.5,49
CDM,45001570,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,926.0,601.9,18.57,3920.0,49
CDM,45001580,THROMBOLYSIS CEREBRAL IV INFUSION,2384.0,1549.6,166.76,4268.0,48
CDM,45001590,PLACEMENT NEEDLE INTRAOSSEOUS INFUSION,2868.0,1864.2,76.83,4151.0,49
CDM,45001610,RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX,1335.0,867.75,112.01,6317.0,49
CDM,45001630,VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN,198.0,128.7,2.52,3920.0,38
CDM,45001640,COLLECTION CAPILLARY BLOOD SPECIMEN,60.0,39.0,2.52,3920.0,37
CDM,45001650,VNPNXR <3 YEARS PHYS/QHP SKILL SCALP VEIN,161.0,104.65,2.52,3920.0,38
CDM,45001660,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,926.0,601.9,44.56,3920.0,49
CDM,45001670,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,2929.0,1903.85,187.92,3920.0,48
CDM,45001680,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,22623.0,14704.95,106.52,20360.7,49
CDM,45001690,VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN,161.0,104.65,2.52,3920.0,38
CDM,45001700,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,22623.0,14704.95,310.73,20360.7,42
CDM,45001710,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,4444.0,2888.6,41.1,6289.0,48
CDM,45001720,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,741.0,481.65,112.01,4151.0,49
CDM,45001730,DRAINAGE ABSCESS PALATE UVULA,1335.0,867.75,112.01,4214.0,49
CDM,45001740,COLLECTION VENOUS BLOOD VENIPUNCTURE,20.0,13.0,2.52,18285.0,48
CDM,45001750,REPAIR LACERATION PALATE </2 CM,2929.0,1903.85,215.93,4214.0,48
CDM,45001760,VNPNXR 3 YEARS/> PHYS/QHP SKILL,278.0,180.7,11.13,3920.0,38
CDM,45001770,REPAIR LACERATION PALATE >2 CM/COMPLEX,34015.0,22109.75,296.75,30613.5,42
CDM,45001780,UNLISTED PROCEDURE PALATE UVULA,425.0,276.25,119.43,8370.0,48
CDM,45001790,I&D ABSCESS PERITONSILLAR,1335.0,867.75,112.01,4214.0,49
CDM,45001800,REMOVAL FOREIGN BODY PHARYNX,2295.0,1491.75,112.01,3920.0,49
CDM,45001810,INSERTION PICC W/O IMG GDN 5 YR/>,11040.0,7176.0,116.38,9936.0,49
CDM,45001820,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,2295.0,1491.75,254.67,4214.0,48
CDM,45001840,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,754.0,490.1,126.67,4214.0,38
CDM,45001850,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,2295.0,1491.75,254.67,4268.0,48
CDM,45001860,REPAIR CMPLX NOSE<1.0CM,1671.0,1086.15,280.73,1764.0,24
CDM,45001870,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,908.0,590.2,91.62,3920.0,38
CDM,45001890,DESTRUCTION PREMALIGNANT LESION 1ST,745.0,484.25,62.34,3920.0,49
CDM,45001900,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,1449.0,941.85,139.37,4214.0,38
CDM,45001905,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,18648.0,12121.2,310.33,16783.2,49
CDM,45001910,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,2295.0,1491.75,254.67,4268.0,48
CDM,45001915,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,9203.0,5981.95,310.03,8282.7,49
CDM,45001920,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,1499.0,974.35,254.67,4214.0,49
CDM,45001925,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,9203.0,5981.95,285.25,8282.7,49
CDM,45001930,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,2295.0,1491.75,254.67,4268.0,48
CDM,45001935,EXPLORATION PENETRATING WOUND SPX EXTREMITY,9316.0,6055.4,241.35,8384.4,49
CDM,45001945,CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT,18648.0,12121.2,675.37,16783.2,42
CDM,45001955,REMOVAL FOREIGN BODY FOOT DEEP,9316.0,6055.4,383.66,8384.4,49
CDM,45001965,RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON,18656.0,12126.4,815.24,16790.4,42
CDM,45001975,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,9316.0,6055.4,181.5,8384.4,49
CDM,45001985,TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA,16654.0,10825.1,853.0,18285.0,32
CDM,45001990,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,1499.0,974.35,157.61,4151.0,49
CDM,45001995,INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE,8518.0,5536.7,266.76,8370.0,49
CDM,45002000,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,745.0,484.25,115.89,4151.0,49
CDM,45002005,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45002015,DRAINAGE FINGER ABSCESS SIMPLE,1143.0,742.95,98.33,4151.0,49
CDM,45002020,INITIAL TX 1ST DEGREE BURN LOCAL TX,745.0,484.25,56.54,3920.0,49
CDM,45002025,DRAINAGE FINGER ABSCESS COMPLICATED,9316.0,6055.4,232.56,8384.4,49
CDM,45002030,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,745.0,484.25,69.24,4151.0,49
CDM,45002040,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,2295.0,1491.75,254.67,4214.0,48
CDM,45002045,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,9203.0,5981.95,807.83,8370.0,49
CDM,45002060,RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,2295.0,1491.75,241.35,4214.0,48
CDM,45002065,CLTX METACARPAL FX W/MANIPULATION EACH BONE,1379.0,896.35,240.79,4151.0,49
CDM,45002070,CHEMICAL CAUTERIZATION OF GRANULATION TISSUE,745.0,484.25,44.93,4151.0,49
CDM,45002075,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45002085,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45002095,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45002130,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,1499.0,974.35,241.35,4214.0,49
CDM,45002140,REPAIR INTERMEDIATE S/A/T/E >30.0 CM,6860.0,4459.0,241.35,6174.0,49
CDM,45002150,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,1499.0,974.35,168.05,3920.0,49
CDM,45002160,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,1499.0,974.35,220.06,4214.0,49
CDM,45002170,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,2295.0,1491.75,241.35,4214.0,48
CDM,45002180,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,2295.0,1491.75,241.35,4214.0,48
CDM,45002190,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,393.0,255.45,66.02,4214.0,38
CDM,45002200,REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,6860.0,4459.0,241.35,6174.0,49
CDM,45002210,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,1499.0,974.35,192.62,4214.0,49
CDM,45002220,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1499.0,974.35,225.31,4214.0,49
CDM,45002230,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,1499.0,974.35,241.35,4214.0,49
CDM,45002240,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,1499.0,974.35,241.35,3920.0,49
CDM,45002250,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,1499.0,974.35,241.35,4214.0,49
CDM,45002260,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM,1499.0,974.35,241.35,4214.0,49
CDM,45002270,REPAIR INTERMEDIATE F/E/E/N/L&/MUC >30.0 CM,1499.0,974.35,241.35,4214.0,49
CDM,45002280,REPAIR COMPLEX TRUNK 1.1-2.5 CM,2295.0,1491.75,225.44,4268.0,48
CDM,45002290,REPAIR COMPLEX TRUNK 2.6-7.5 CM,2295.0,1491.75,254.67,4268.0,48
CDM,45002300,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,2295.0,1491.75,241.35,4214.0,48
CDM,45002310,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,670.0,435.5,21.5,3920.0,38
CDM,45002330,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,1499.0,974.35,115.89,3920.0,49
CDM,45002340,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,1499.0,974.35,115.89,3920.0,49
CDM,45002350,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,745.0,484.25,94.26,3920.0,49
CDM,45002360,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,745.0,484.25,75.39,3920.0,49
CDM,45002370,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,745.0,484.25,57.45,3920.0,49
CDM,45002380,EXCISION PILONIDAL CYST/SINUS SIMPLE,10733.0,6976.45,226.56,36332.0,49
CDM,45002390,WEDGE EXCISION SKIN NAIL FOLD,1499.0,974.35,40.61,3920.0,49
CDM,45002400,REPAIR NAIL BED,2295.0,1491.75,40.61,3920.0,48
CDM,45002410,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,745.0,484.25,71.21,3920.0,49
CDM,45002420,EVACUATION SUBUNGUAL HEMATOMA,484.0,314.6,40.61,3920.0,49
CDM,45002430,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,745.0,484.25,74.22,3920.0,49
CDM,45002440,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,745.0,484.25,40.61,3920.0,49
CDM,45002450,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45002460,DEBRIDEMENT NAIL ANY METHOD 1-5,223.0,144.95,18.04,3920.0,49
CDM,45002470,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,1499.0,974.35,73.55,4214.0,49
CDM,45002500,DBRDMT FX&/DISLC SUBQ T/M/F BONE,10733.0,6976.45,474.46,9659.7,49
CDM,45002510,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,2639.0,1715.35,241.35,4268.0,49
CDM,45002520,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,10733.0,6976.45,219.77,13665.0,49
CDM,45002530,EXCISION NAIL MATRIX PERMANENT REMOVAL,1499.0,974.35,123.89,4214.0,49
CDM,45002540,UNLISTED PROC SKIN MM & SQ TISS,369.0,239.85,98.33,7730.0,48
CDM,45002640,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,745.0,484.25,115.89,3920.0,49
CDM,45002650,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,1499.0,974.35,213.21,4214.0,49
CDM,45002660,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,6076.0,3949.4,221.56,8370.0,49
CDM,45002670,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,1499.0,974.35,169.35,4214.0,49
CDM,45002680,CLSD TX PELVIC RING FX W/O MANIPULATION,1379.0,896.35,157.19,4214.0,49
CDM,45002690,SIMPLE REPAIR F/E/E/N/L/M >30.0 CM,745.0,484.25,115.89,4214.0,49
CDM,45002700,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,1379.0,896.35,192.33,4151.0,49
CDM,45002710,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,1499.0,974.35,115.89,3920.0,49
CDM,45002720,CLOSED TREATMENT SESAMOID FRACTURE,1379.0,896.35,137.22,4151.0,49
CDM,45002730,SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM,1499.0,974.35,115.89,3920.0,49
CDM,45002740,SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM,745.0,484.25,115.89,3920.0,49
CDM,45002750,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,745.0,484.25,95.67,3920.0,49
CDM,45002760,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,1499.0,974.35,233.99,4214.0,49
CDM,45002770,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1499.0,974.35,98.33,4151.0,49
CDM,45002780,CLSD TX PELVIC RING FX W/MANIPULATION W/ANES,1379.0,896.35,240.79,4214.0,49
CDM,45002790,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,1379.0,896.35,178.13,4151.0,49
CDM,45002800,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,1379.0,896.35,167.84,4151.0,49
CDM,45002810,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,1499.0,974.35,171.31,4214.0,49
CDM,45002820,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,1499.0,974.35,98.33,4151.0,49
CDM,45002830,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,2639.0,1715.35,213.06,4268.0,49
CDM,45002840,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,2639.0,1715.35,98.33,4151.0,49
CDM,45002850,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1499.0,974.35,98.33,4151.0,49
CDM,45002860,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,745.0,484.25,98.33,4151.0,49
CDM,45002870,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,2298.0,1493.7,63.06,4151.0,49
CDM,45002880,SURG PROC SUBMN,143.0,92.95,24.02,1764.0,24
CDM,45002890,SURG PRC EXT/CMP,1025.0,666.25,172.2,1764.0,24
CDM,45002900,SURG PRC MULT/IN,395.0,256.75,66.36,1764.0,24
CDM,45002910,SURG PRC SNGL/MI,239.0,155.35,40.15,1764.0,24
CDM,45002920,I&D HEMATOMA SEROMA/FLUID COLLECTION,6076.0,3949.4,147.52,5468.4,49
CDM,45002930,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45002940,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45002950,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,9203.0,5981.95,537.31,8370.0,49
CDM,45002960,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45002970,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,9316.0,6055.4,204.29,13665.0,49
CDM,45002980,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,9316.0,6055.4,181.5,8384.4,49
CDM,45002990,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,2295.0,1491.75,227.32,4268.0,48
CDM,45003000,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,9203.0,5981.95,310.03,8282.7,49
CDM,45003005,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,1379.0,896.35,240.79,4151.0,49
CDM,45003015,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45003020,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,18656.0,12126.4,753.37,16790.4,42
CDM,45003025,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,1379.0,896.35,240.79,4151.0,49
CDM,45003030,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45003040,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,1379.0,896.35,240.79,4268.0,49
CDM,45003050,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45003055,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45003060,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,9203.0,5981.95,611.67,8370.0,49
CDM,45003070,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,9203.0,5981.95,310.03,8550.0,49
CDM,45003075,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,18656.0,12126.4,815.24,16790.4,49
CDM,45003080,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,1379.0,896.35,95.43,4151.0,49
CDM,45003090,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45003100,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,9203.0,5981.95,310.03,8282.7,49
CDM,45003110,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45003120,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45003130,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,9203.0,5981.95,512.15,13665.0,49
CDM,45003140,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45003150,CLOSED TREATMENT NASAL FRACTURE W/O MANIPULATION,519.0,337.35,87.19,1764.0,30
CDM,45003160,EXPLORATION PENETRATING WOUND SPX CHEST,10518.0,6836.7,254.87,13665.0,49
CDM,45003170,EXPLORATION PENETRATING WOUND SPX EXTREMITY,9316.0,6055.4,241.35,8384.4,49
CDM,45003180,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,9316.0,6055.4,181.29,8384.4,49
CDM,45003190,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,1698.0,1103.7,45.97,3920.0,49
CDM,45003200,INJECTION SINGLE TENDON ORIGIN/INSERTION,1698.0,1103.7,45.78,3920.0,49
CDM,45003210,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1698.0,1103.7,47.54,3920.0,49
CDM,45003220,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,1698.0,1103.7,54.21,3920.0,49
CDM,45003230,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,1698.0,1103.7,42.6,3920.0,49
CDM,45003240,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1698.0,1103.7,43.64,3920.0,49
CDM,45003250,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,9203.0,5981.95,310.03,8550.0,49
CDM,45003260,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,1698.0,1103.7,48.88,3920.0,49
CDM,45003270,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45003280,CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION,8518.0,5536.7,70.23,8370.0,49
CDM,45003290,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,18648.0,12121.2,310.03,16783.2,49
CDM,45003300,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,1379.0,896.35,39.87,3920.0,49
CDM,45003310,CLOSED TX RIB FRACTURE UNCOMPLICATED EACH,724.0,470.6,121.63,1764.0,24
CDM,45003320,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,9316.0,6055.4,213.46,8384.4,49
CDM,45003330,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45003340,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,9203.0,5981.95,310.03,8282.7,49
CDM,45003350,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45003360,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45003370,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1698.0,1103.7,52.83,3920.0,49
CDM,45003380,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45003520,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45003610,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45003630,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,9203.0,5981.95,310.03,8282.7,49
CDM,45003640,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45003650,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,1379.0,896.35,240.79,4151.0,49
CDM,45003660,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45003670,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,9203.0,5981.95,310.03,8282.7,49
CDM,45003680,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45003690,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1379.0,896.35,240.79,4151.0,49
CDM,45003700,CLTX CARPAL BONE FX W/MANJ EACH BONE,9203.0,5981.95,310.03,8282.7,49
CDM,45003710,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1379.0,896.35,240.79,4151.0,49
CDM,45003730,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45003750,UNLISTED PROCEDURE FOREARM OR WRIST,592.0,384.8,166.35,2093.0,41
CDM,45004005,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,1379.0,896.35,231.38,4151.0,49
CDM,45004015,CLTX POST HIP ARTHRP DISLC W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45004035,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,9203.0,5981.95,310.03,8550.0,49
CDM,45004055,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45004075,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,1379.0,896.35,240.79,4151.0,49
CDM,45004085,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,1379.0,896.35,240.79,4151.0,49
CDM,45004095,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,9203.0,5981.95,310.03,8550.0,49
CDM,45004105,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,9203.0,5981.95,310.03,8550.0,49
CDM,45004125,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45004225,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45004335,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,9203.0,5981.95,310.03,8282.7,49
CDM,45004355,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,1379.0,896.35,240.79,4151.0,49
CDM,45004365,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,4046.0,2629.9,165.58,4268.0,49
CDM,45004385,CLOSED TX TALUS FRACTURE W/MANIPULATION,9203.0,5981.95,310.03,8282.7,49
CDM,45004415,CLTX METAR FX W/MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45004435,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,1379.0,896.35,192.33,4151.0,49
CDM,45004445,CLTX METATARSOPHLNGL JT DISLC W/O ANES,1379.0,896.35,142.11,4151.0,49
CDM,45004455,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,1379.0,896.35,127.75,4151.0,49
CDM,45004485,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,908.0,590.2,79.56,3920.0,49
CDM,45004495,APPLICATION LONG ARM SPLINT SHOULDER HAND,908.0,590.2,47.31,3920.0,49
CDM,45004505,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,741.0,481.65,47.31,3920.0,49
CDM,45004515,APPLICATION SHORT ARM SPLINT DYNAMIC,741.0,481.65,47.31,3920.0,49
CDM,45004525,APPLICATION FINGER SPLINT STATIC,741.0,481.65,34.13,3920.0,49
CDM,45004545,STRAPPING SHOULDER,741.0,481.65,22.36,3920.0,49
CDM,45004605,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,1528.0,993.2,66.14,3920.0,49
CDM,45004615,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,908.0,590.2,47.31,3920.0,49
CDM,45004625,APPLICATION SHORT LEG SPLINT CALF FOOT,908.0,590.2,47.31,3920.0,49
CDM,45004675,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,1528.0,993.2,53.48,3920.0,49
CDM,45004715,DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,2929.0,1903.85,142.7,4214.0,48
CDM,45004725,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,741.0,481.65,112.01,3920.0,49
CDM,45004735,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,741.0,481.65,67.25,3920.0,49
CDM,45004745,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,741.0,481.65,94.07,3920.0,49
CDM,45004755,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,741.0,481.65,112.01,3920.0,49
CDM,45004765,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,1335.0,867.75,112.01,3920.0,49
CDM,45004775,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,1116.0,725.4,73.27,4151.0,49
CDM,45004805,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,9916.0,6445.4,191.34,13665.0,49
CDM,45004815,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1335.0,867.75,181.19,4151.0,49
CDM,45004825,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,1335.0,867.75,41.35,4151.0,49
CDM,45004845,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,9916.0,6445.4,182.55,13665.0,49
CDM,45004875,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,1116.0,725.4,78.52,4151.0,49
CDM,45004915,TRACHEOBRNCHSC THRU EST TRACHS INC,2929.0,1903.85,134.12,6317.0,48
CDM,45004925,CATHETER ASPIRATION NASOTRACHEAL SPX,1170.0,760.5,38.83,3920.0,49
CDM,45004955,TUBE THORACOSTOMY INCLUDES WATER SEAL,8933.0,5806.45,191.38,8370.0,49
CDM,45004965,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,3555.0,2310.75,109.61,4268.0,48
CDM,45004975,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,3555.0,2310.75,132.14,4268.0,48
CDM,45005015,REPAIR BLOOD VESSEL DIRECT HAND FINGER,22623.0,14704.95,853.0,20360.7,42
CDM,45005045,INTRODUCTION NEEDLE/INTRACATHETER VEIN,308.0,200.2,44.56,3920.0,37
CDM,45005055,VNPNXR 3 YEARS/> PHYS/QHP SKILL,278.0,180.7,11.13,3920.0,38
CDM,45005075,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,22623.0,14704.95,106.52,20360.7,49
CDM,45005085,INSERTION PICC W/O IMG GDN 5 YR/>,11165.0,7257.25,116.38,10048.5,49
CDM,45005145,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,926.0,601.9,44.56,3920.0,49
CDM,45005185,COLLECT BLOOD FROM CATHETER VENOUS NOS,926.0,601.9,44.56,3920.0,49
CDM,45005195,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,2384.0,1549.6,55.93,3920.0,49
CDM,45005205,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,926.0,601.9,18.57,3920.0,49
CDM,45005225,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1861.0,1209.65,57.95,3920.0,38
CDM,45005235,PLACEMENT NEEDLE INTRAOSSEOUS INFUSION,2868.0,1864.2,76.83,4151.0,49
CDM,45005255,THROMBOLYSIS CEREBRAL IV INFUSION,2384.0,1549.6,166.76,4268.0,48
CDM,45005295,RPR LIP FULL THICKNESS VERMILION ONLY,2929.0,1903.85,112.01,6317.0,48
CDM,45005305,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,2929.0,1903.85,112.01,6317.0,48
CDM,45005315,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,8518.0,5536.7,499.08,7666.2,49
CDM,45005325,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,4046.0,2629.9,153.45,4151.0,49
CDM,45005335,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,2929.0,1903.85,241.44,6317.0,48
CDM,45005365,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,2929.0,1903.85,247.97,6317.0,48
CDM,45005385,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT,34015.0,22109.75,419.02,30613.5,49
CDM,45005395,RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG,2295.0,1491.75,112.01,3920.0,49
CDM,45005415,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,741.0,481.65,112.01,4151.0,49
CDM,45005425,DRAINAGE ABSCESS PALATE UVULA,1335.0,867.75,112.01,4214.0,49
CDM,45005445,I&D ABSCESS PERITONSILLAR,1335.0,867.75,112.01,4214.0,49
CDM,45005465,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,2929.0,1903.85,187.92,3920.0,48
CDM,45005505,EGD FLEXIBLE FOREIGN BODY REMOVAL,5391.0,3504.15,211.19,6317.0,49
CDM,45005575,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,6780.0,4407.0,548.66,36332.0,49
CDM,45005585,I&D PERIANAL ABSCESS SUPERFICIAL,5243.0,3407.95,132.49,4718.7,49
CDM,45005595,INCISION THROMBOSED HEMORRHOID EXTERNAL,1399.0,909.35,134.91,4151.0,49
CDM,45005645,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,5391.0,3504.15,92.62,4851.9,49
CDM,45005655,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,5391.0,3504.15,127.33,4851.9,49
CDM,45005685,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,5391.0,3504.15,106.62,6289.0,49
CDM,45005725,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,11779.0,7656.35,171.65,13665.0,49
CDM,45005735,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,1399.0,909.35,36.17,4151.0,49
CDM,45005745,INSJ NON-NDWELLG BLADDER CATHETER,741.0,481.65,30.28,3920.0,49
CDM,45005755,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,741.0,481.65,31.01,3920.0,49
CDM,45005765,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,900.0,585.0,53.02,3920.0,49
CDM,45005775,CHANGE CYSTOSTOMY TUBE SIMPLE,1399.0,909.35,53.02,4151.0,49
CDM,45005785,CYSTOURETHROSCOPY,3838.0,2494.7,96.8,12928.0,49
CDM,45005795,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,19831.0,12890.15,344.65,17847.9,49
CDM,45005805,CYSTO BLADDER W/URETERAL CATHETERIZATION,11779.0,7656.35,160.61,12928.0,42
CDM,45005815,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,11779.0,7656.35,183.6,10601.1,49
CDM,45005855,IRRIGATION CORPORA CAVERNOSA PRIAPISM,1399.0,909.35,53.02,4151.0,49
CDM,45005865,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,1399.0,909.35,53.02,3920.0,49
CDM,45005895,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,1399.0,909.35,68.99,4214.0,49
CDM,45005995,DRAINAGE SCROTAL WALL ABSCESS,9316.0,6055.4,208.95,8384.4,49
CDM,45005WE,I&D SUBMUCOSAL ABSCESS RECTUM,808.0,525.2,101.98,606.0,35
CDM,45006005,I&D VULVA/PERINEAL ABSCESS,1749.0,1136.85,132.47,4151.0,49
CDM,45006015,I&D OF BARTHOLINS GLAND ABSCESS,1156.0,751.4,126.63,4151.0,49
CDM,45006045,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,1156.0,751.4,136.27,4151.0,49
CDM,45006055,COLPORRHAPHY SUTURE INJURY VAGINA,18283.0,11883.95,384.5,16454.7,49
CDM,45006065,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,5006.0,3253.9,88.91,4505.4,49
CDM,45006085,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,1156.0,751.4,74.4,4151.0,49
CDM,45006095,REMOVAL INTRAUTERINE DEVICE IUD,1749.0,1136.85,78.23,3920.0,49
CDM,45006105,VAGINAL DELIVERY ONLY,15898.0,10333.7,853.0,14308.2,49
CDM,45006135,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,5973.0,3882.45,66.8,6289.0,49
CDM,45006145,TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE,10834.0,7042.1,405.91,18285.0,32
CDM,45006165,RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS,55235.0,35902.75,853.0,49711.5,42
CDM,45006175,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,2586.0,1680.9,21.15,3920.0,49
CDM,45006185,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,5973.0,3882.45,77.17,5375.7,49
CDM,45006195,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,5973.0,3882.45,112.86,5375.7,49
CDM,45006205,INJECTION EPIDURAL BLOOD/CLOT PATCH,5973.0,3882.45,139.83,6317.0,49
CDM,45006265,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,2546.0,1654.9,60.57,4151.0,49
CDM,45006285,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2546.0,1654.9,60.62,4151.0,49
CDM,45006295,INJECTION AA&/STRD FEM NRV CONT NFS CATH IMG GDN,7679.0,4991.35,96.45,6911.1,49
CDM,45006305,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,5973.0,3882.45,51.82,5375.7,49
CDM,45006315,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,741.0,481.65,33.58,3920.0,49
CDM,45006345,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,741.0,481.65,45.31,3920.0,49
CDM,45006385,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,1719.0,1117.35,133.22,4214.0,49
CDM,45006395,CANTHOTOMY SEPARATE PROCEDURE,13415.0,8719.75,132.03,12073.5,49
CDM,45006415,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK,13415.0,8719.75,486.84,12073.5,49
CDM,45006425,PROBE LACRIMAL CANALICULI W/WO IRRIGATION,1719.0,1117.35,137.97,4151.0,49
CDM,45006435,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,3518.0,2286.7,112.01,4151.0,49
CDM,45006445,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,8101.0,5265.65,186.22,7290.9,49
CDM,45006455,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,3518.0,2286.7,112.01,4151.0,49
CDM,45006465,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,298.0,193.7,37.27,3920.0,43
CDM,45006485,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,971.0,631.15,44.03,1764.0,41
CDM,45006495,CARDIOPULMONARY RESUSCITATION,2239.0,1455.35,225.48,2015.1,41
CDM,45006525,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,614.0,399.1,20.57,1801.0,49
CDM,45006585,DILAT URETHRAL STRIX DILATOR MALE 1ST,1399.0,909.35,53.02,3920.0,49
CDM,45006595,RMVL FB XTRNL AUDITORY CANAL W/O ANES,645.0,419.25,55.07,3920.0,43
CDM,45006655,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,745.0,484.25,46.34,3920.0,49
CDM,45006665,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,745.0,484.25,71.99,3920.0,49
CDM,45006675,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,2639.0,1715.35,169.34,4214.0,49
CDM,45006685,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,745.0,484.25,94.26,3920.0,49
CDM,45006705,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45006715,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,9203.0,5981.95,310.03,8550.0,49
CDM,45006725,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45006735,LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION,2233.0,1451.45,133.13,13665.0,49
CDM,45006745,RPLCMT CATH CTR VAD SUBQ PORT/PMP,22623.0,14704.95,243.92,20360.7,42
CDM,45006765,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,11779.0,7656.35,261.56,36332.0,49
CDM,45006775,INJECTION AA&/STRD BRACHIAL PLEXUS,7679.0,4991.35,92.64,6911.1,49
CDM,45006785,INJECTION AA&/STRD SCIATIC NRV CONT NFS CATH IMG,7679.0,4991.35,100.61,6911.1,49
CDM,45006795,INJECTION AA&/STRD FEMORAL NERVE,5973.0,3882.45,84.16,5375.7,49
CDM,45006835,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,2546.0,1654.9,112.01,4214.0,48
CDM,45006935,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,1499.0,974.35,169.35,4214.0,49
CDM,45006945,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,2295.0,1491.75,254.67,4214.0,48
CDM,45006955,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,9316.0,6055.4,181.29,8384.4,49
CDM,45006965,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,18648.0,12121.2,310.03,16783.2,49
CDM,45006975,CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,18648.0,12121.2,840.23,16783.2,49
CDM,45006985,CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION,9203.0,5981.95,310.03,8282.7,49
CDM,45006995,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45007005,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45007015,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,18656.0,12126.4,310.03,16790.4,49
CDM,45007025,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,1528.0,993.2,156.91,8370.0,49
CDM,45007035,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,1528.0,993.2,39.77,3920.0,49
CDM,45007045,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,9916.0,6445.4,183.15,13665.0,49
CDM,45007055,LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,1116.0,725.4,57.56,3920.0,49
CDM,45007065,LARYNGOSCOPY FLX RMVL FOREIGN BODY(S),2233.0,1451.45,156.45,4268.0,49
CDM,45007075,THORACOTOMY W/CARDIAC MASSAGE,7376.0,4794.4,853.0,18285.0,32
CDM,45007085,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,5058.0,3287.7,706.25,6317.0,49
CDM,45007095,COMPLETE REPLACEMENT PICC RS&I,11165.0,7257.25,70.91,10048.5,49
CDM,45007105,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,11165.0,7257.25,225.25,10048.5,49
CDM,45007115,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,22623.0,14704.95,401.13,20360.7,49
CDM,45007125,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,5391.0,3504.15,151.21,4851.9,49
CDM,45007135,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,1335.0,867.75,112.01,4214.0,49
CDM,45007145,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,2295.0,1491.75,47.97,4151.0,49
CDM,45007155,GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE,1790.0,1163.5,27.52,3920.0,43
CDM,45007165,EXC THROMBOSED HEMORRHOID XTRNL,6780.0,4407.0,137.7,6102.0,49
CDM,45007175,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,741.0,481.65,51.37,3920.0,49
CDM,45007185,CHANGE CYSTOSTOMY TUBE COMPLICATED,3838.0,2494.7,96.98,6289.0,49
CDM,45007195,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,341.0,221.65,18.23,3920.0,49
CDM,45007205,CYSTO W/SIMPLE REMOVAL STONE & STENT,11779.0,7656.35,182.3,10601.1,49
CDM,45007215,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,1156.0,751.4,54.7,3920.0,49
CDM,45007225,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX,7679.0,4991.35,129.69,6911.1,49
CDM,45007235,REMOVAL EMBEDDED FOREIGN BODY EYELID,1719.0,1117.35,131.54,4151.0,49
CDM,45008560,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,18656.0,12126.4,622.68,16790.4,42
CDM,45008570,CLTX METAR FX W/MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45008580,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,9203.0,5981.95,310.03,8550.0,49
CDM,45008590,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,9203.0,5981.95,310.03,8550.0,49
CDM,45008600,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45008610,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,9203.0,5981.95,310.03,8550.0,49
CDM,45008620,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45008630,CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ,6091.0,3959.15,310.03,18285.0,42
CDM,45008640,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45008650,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45008660,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45008680,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,1379.0,896.35,240.79,4151.0,49
CDM,45008690,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,1379.0,896.35,240.79,8370.0,49
CDM,45008700,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,1379.0,896.35,240.79,4151.0,49
CDM,45008710,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES,9203.0,5981.95,420.39,8370.0,49
CDM,45008720,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,1379.0,896.35,231.38,4151.0,49
CDM,45008730,OPEN TX INTERPHALANGEAL JOINT DISLOCATION,18656.0,12126.4,666.35,16790.4,42
CDM,45008740,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45008750,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,1379.0,896.35,240.79,4151.0,49
CDM,45008760,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45008770,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45008780,CLOSED TX TALUS FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45008790,CLTX PROX FIBULA/SHFT FX W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45008800,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,1379.0,896.35,240.79,4151.0,49
CDM,45008810,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,1379.0,896.35,240.79,4151.0,49
CDM,45008820,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45008830,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45008840,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,1379.0,896.35,240.79,4151.0,49
CDM,45008850,CLTX METACARPAL FX W/MANIPULATION EACH BONE,1379.0,896.35,240.79,4151.0,49
CDM,45008860,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45008870,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45008880,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45008890,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45008900,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45008910,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,1379.0,896.35,240.79,4151.0,49
CDM,45008920,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,1379.0,896.35,240.79,4151.0,49
CDM,45008930,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45008940,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45008950,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45008960,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45008970,REMOVAL FOREIGN BODY DEEP THIGH/KNEE,16456.0,10696.4,490.04,36332.0,49
CDM,45008980,RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS,16456.0,10696.4,214.71,14810.4,49
CDM,45008990,REMOVAL FOREIGN BODY FOOT DEEP,9316.0,6055.4,383.66,8384.4,49
CDM,45009900,REMOVAL FOREIGN BODY FOOT COMPLICATED,9316.0,6055.4,450.76,8384.4,49
CDM,45009910,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,4046.0,2629.9,165.58,4268.0,49
CDM,45009920,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,9203.0,5981.95,815.24,8370.0,49
CDM,45009930,UNLISTED PROCEDURE HANDS OR FINGERS,651.0,423.15,182.93,13665.0,48
CDM,45009940,DRAINAGE FINGER ABSCESS SIMPLE,1143.0,742.95,98.33,4151.0,49
CDM,45009950,DRAINAGE FINGER ABSCESS COMPLICATED,9316.0,6055.4,232.56,8384.4,49
CDM,45009970,UNLISTED PROCEDURE LEG OR ANKLE,651.0,423.15,182.93,13665.0,48
CDM,45009980,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,18656.0,12126.4,815.24,16790.4,49
CDM,45009990,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,18656.0,12126.4,853.0,16790.4,49
CDM,45010000,GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE,1790.0,1163.5,27.52,3920.0,43
CDM,45010010,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45010020,CLTX POST HIP ARTHRP DISLC W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45010030,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,18656.0,12126.4,310.03,16790.4,49
CDM,45010040,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,9203.0,5981.95,310.03,8550.0,49
CDM,45010050,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,9203.0,5981.95,310.03,8282.7,49
CDM,45010060,CLOSED TX TALUS FRACTURE W/MANIPULATION,9203.0,5981.95,310.03,8282.7,49
CDM,45010070,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45010090,EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP,760.0,494.0,15.31,1764.0,43
CDM,45010100,EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM,1366.0,887.9,56.31,1764.0,43
CDM,45010110,EMERGENCY DEPARTMENT VISIT LOW MDM,2389.0,1552.85,96.61,2150.1,43
CDM,45010120,EMERGENCY DEPARTMENT VISIT MODERATE MDM,3673.0,2387.45,164.52,3732.0,43
CDM,45010130,EMERGENCY DEPARTMENT VISIT HIGH MDM,5288.0,3437.2,239.33,4759.2,43
CDM,45010140,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,7268.0,4724.2,277.57,6541.2,43
CDM,45010150,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,933.0,606.45,30.09,1764.0,31
CDM,45010160,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,1143.0,742.95,44.41,1764.0,41
CDM,45010170,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,18656.0,12126.4,446.23,16790.4,49
CDM,45010180,CLTX POST HIP ARTHRP DISLC REQ ANES,9203.0,5981.95,632.74,8370.0,49
CDM,45010190,CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA,9203.0,5981.95,632.74,8370.0,49
CDM,45010240,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,5391.0,3504.15,92.62,4851.9,49
CDM,45010250,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,3555.0,2310.75,109.61,4268.0,48
CDM,45010260,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,5391.0,3504.15,127.33,4851.9,49
CDM,45010320,STRAIGHT CATH - SPECIMEN COLLECTION,20.0,13.0,2.52,2849.0,37
CDM,45010330,TRACHEOBRNCHSC THRU EST TRACHS INC,2929.0,1903.85,134.12,6317.0,48
CDM,45010340,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,3555.0,2310.75,132.14,4268.0,48
CDM,45010345,CLTX POST HIP ARTHRP DISLC REQ ANES,9203.0,5981.95,632.74,8370.0,49
CDM,45010355,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,5391.0,3504.15,126.21,4851.9,49
CDM,45010365,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45010395,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,1335.0,867.75,112.01,4214.0,49
CDM,45010405,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,2233.0,1451.45,137.09,4214.0,49
CDM,45010415,THORACOTOMY WITH EXPLORATION,3138.0,2039.7,527.18,18285.0,32
CDM,45010425,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,4444.0,2888.6,124.03,4151.0,48
CDM,45010435,BIOPSY OROPHARYNX,8518.0,5536.7,135.22,7666.2,49
CDM,45010445,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,5391.0,3504.15,165.65,6317.0,49
CDM,45010455,"UNLISTED PROCEDURE, LIPS",592.0,384.8,166.35,8550.0,48
CDM,45010465,INJECTION AA&/STRD BRACH PLEX CONT NFS CATH IMG,7679.0,4991.35,103.2,6911.1,49
CDM,45010475,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,2295.0,1491.75,45.31,3920.0,49
CDM,45010485,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK,13415.0,8719.75,263.25,12073.5,49
CDM,45010525,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,9203.0,5981.95,537.31,8370.0,49
CDM,45010535,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45010545,CLTX POST HIP ARTHRP DISLC REQ ANES,9203.0,5981.95,632.74,8370.0,49
CDM,45010555,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45010565,CLTX FX GRT TOE PHLX/PHLG W/MANJ,1379.0,896.35,204.23,4151.0,49
CDM,45010585,LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES),9916.0,6445.4,136.89,13665.0,49
CDM,45010595,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,2233.0,1451.45,137.09,4214.0,49
CDM,45010605,THORACOTOMY WITH EXPLORATION,3138.0,2039.7,527.18,18285.0,32
CDM,45010635,RMVL TUN CVC W/O SUBQ PORT/PMP,4444.0,2888.6,164.43,6289.0,48
CDM,45010655,BIOPSY OROPHARYNX,8518.0,5536.7,135.22,7666.2,49
CDM,45010665,REMOVAL FOREIGN BODY PHARYNX,2295.0,1491.75,112.01,3920.0,49
CDM,45010675,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,5391.0,3504.15,147.56,6317.0,49
CDM,45010685,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,5391.0,3504.15,165.65,6317.0,49
CDM,45010695,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,5391.0,3504.15,126.21,4851.9,49
CDM,45010705,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,11779.0,7656.35,119.32,10601.1,49
CDM,45010715,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT,29231.0,19000.15,499.16,26307.9,42
CDM,45010725,INJECTION AA&/STRD BRACH PLEX CONT NFS CATH IMG,7679.0,4991.35,103.2,6911.1,49
CDM,45010735,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK,13415.0,8719.75,263.25,12073.5,49
CDM,45010755,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB,18648.0,12121.2,413.38,16783.2,49
CDM,45010765,LIGATION/BIOPSY TEMPORAL ARTERY,11645.0,7569.25,239.23,10480.5,49
CDM,45010775,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,22623.0,14704.95,310.73,20360.7,42
CDM,45010785,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,2929.0,1903.85,112.01,6317.0,48
CDM,45010795,ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA,9203.0,5981.95,499.98,8370.0,49
CDM,45010805,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,22623.0,14704.95,310.73,20360.7,42
CDM,45010815,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,9203.0,5981.95,285.25,8282.7,49
CDM,45010825,CLTX IPHAL JT DISLC W/MANJ REQ ANES,1528.0,993.2,266.58,4268.0,49
CDM,45010835,LIGATION/BIOPSY TEMPORAL ARTERY,11645.0,7569.25,239.23,10480.5,49
CDM,45010845,TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA,16654.0,10825.1,853.0,18285.0,32
CDM,45010895,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,22623.0,14704.95,310.73,20360.7,42
CDM,45010905,OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,18656.0,12126.4,866.01,16790.4,42
CDM,45010915,REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES,18648.0,12121.2,251.66,16783.2,49
CDM,45011005,EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<,2639.0,1715.35,100.13,4151.0,49
CDM,45011025,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,16456.0,10696.4,605.45,14810.4,49
CDM,45011155,CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45011165,CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45011175,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES,1379.0,896.35,223.94,4151.0,49
CDM,45011205,TRANSFUSION BLOOD/BLOOD COMPONENTS,3143.0,2042.95,69.51,3920.0,49
CDM,45011295,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,11779.0,7656.35,354.99,10601.1,42
CDM,45011305,DRG OF SKENE'S GLAND ABSCESS OR CYST,11779.0,7656.35,194.52,10601.1,49
CDM,45011315,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,15898.0,10333.7,363.79,14308.2,49
CDM,45011345,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,298.0,193.7,24.99,3920.0,43
CDM,45011355,US ABDOMINAL REAL TIME W/IMAGE LIMITED,918.0,596.7,66.35,826.2,49
CDM,45011365,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,918.0,596.7,66.35,1764.0,41
CDM,45011385,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,1170.0,760.5,12.59,1764.0,41
CDM,45011535,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1499.0,974.35,98.33,4151.0,49
CDM,45011575,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,1379.0,896.35,240.79,4151.0,49
CDM,45011585,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,1379.0,896.35,240.79,4151.0,49
CDM,45011595,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,1379.0,896.35,178.13,4151.0,49
CDM,45011605,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,6076.0,3949.4,221.56,8370.0,49
CDM,45011615,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,2639.0,1715.35,241.35,4268.0,49
CDM,45011625,DBRDMT FX&/DISLC SUBQ T/M/F BONE,10733.0,6976.45,474.46,9659.7,49
CDM,45011635,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,2295.0,1491.75,183.62,4214.0,48
CDM,45011645,DEBRIDEMENT NAIL ANY METHOD 1-5,223.0,144.95,18.04,3920.0,49
CDM,45011655,EXCISION PILONIDAL CYST/SINUS SIMPLE,10733.0,6976.45,226.56,36332.0,49
CDM,45011665,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,1499.0,974.35,115.89,3920.0,49
CDM,45011675,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,745.0,484.25,115.89,3920.0,49
CDM,45011685,SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM,1499.0,974.35,115.89,3920.0,49
CDM,45011695,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,1499.0,974.35,115.89,3920.0,49
CDM,45011705,SIMPLE REPAIR F/E/E/N/L/M >30.0 CM,745.0,484.25,115.89,4214.0,49
CDM,45011715,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,2295.0,1491.75,241.35,4214.0,48
CDM,45011725,REPAIR INTERMEDIATE S/A/T/E >30.0 CM,6860.0,4459.0,241.35,6174.0,49
CDM,45011735,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,2295.0,1491.75,241.35,4214.0,48
CDM,45011745,RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,2295.0,1491.75,241.35,4214.0,48
CDM,45011755,REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,6860.0,4459.0,241.35,6174.0,49
CDM,45011765,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,1499.0,974.35,241.35,4214.0,49
CDM,45011775,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM,1499.0,974.35,241.35,4214.0,49
CDM,45011785,REPAIR INTERMEDIATE F/E/E/N/L&/MUC >30.0 CM,1499.0,974.35,241.35,4214.0,49
CDM,45011795,REPAIR COMPLEX TRUNK 1.1-2.5 CM,2295.0,1491.75,225.44,4268.0,48
CDM,45011805,REPAIR COMPLEX TRUNK 2.6-7.5 CM,2295.0,1491.75,254.67,4268.0,48
CDM,45011815,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,393.0,255.45,66.02,4214.0,38
CDM,45011825,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,2295.0,1491.75,254.67,4214.0,48
CDM,45011835,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,908.0,590.2,91.62,3920.0,38
CDM,45011845,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,1449.0,941.85,139.37,4214.0,38
CDM,45011855,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,754.0,490.1,126.67,4214.0,38
CDM,45011865,DESTRUCTION PREMALIGNANT LESION 1ST,745.0,484.25,62.34,3920.0,49
CDM,45011885,UNLISTED PROC SKIN MM & SQ TISS,369.0,239.85,98.33,7730.0,48
CDM,45011895,EXPLORATION PENETRATING WOUND SPX CHEST,10518.0,6836.7,254.87,13665.0,49
CDM,45011905,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,1698.0,1103.7,45.97,3920.0,49
CDM,45011915,INJECTION SINGLE TENDON ORIGIN/INSERTION,1698.0,1103.7,45.78,3920.0,49
CDM,45011925,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,1698.0,1103.7,54.21,3920.0,49
CDM,45011935,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,1698.0,1103.7,48.88,3920.0,49
CDM,45011945,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,18656.0,12126.4,202.0,16790.4,42
CDM,45011955,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,9316.0,6055.4,179.46,8384.4,49
CDM,45011975,CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION,8518.0,5536.7,70.23,8370.0,49
CDM,45011995,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012005,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,9203.0,5981.95,310.03,8550.0,49
CDM,45012015,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,9203.0,5981.95,310.03,8282.7,49
CDM,45012025,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012035,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,1379.0,896.35,240.79,4268.0,49
CDM,45012045,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012055,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,16456.0,10696.4,499.74,14810.4,49
CDM,45012065,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012075,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45012085,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45012095,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45012105,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45012115,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,9203.0,5981.95,611.67,8370.0,49
CDM,45012125,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45012135,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45012145,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,9203.0,5981.95,512.15,13665.0,49
CDM,45012155,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,18656.0,12126.4,753.37,16790.4,42
CDM,45012165,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012175,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,9203.0,5981.95,310.03,8282.7,49
CDM,45012185,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012195,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012205,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,1379.0,896.35,240.79,4151.0,49
CDM,45012235,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45012245,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45012255,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1379.0,896.35,240.79,4151.0,49
CDM,45012265,CLTX CARPAL BONE FX W/MANJ EACH BONE,9203.0,5981.95,310.03,8282.7,49
CDM,45012275,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1379.0,896.35,240.79,4151.0,49
CDM,45012285,UNLISTED PROCEDURE FOREARM OR WRIST,592.0,384.8,166.35,2093.0,41
CDM,45012295,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,9203.0,5981.95,815.24,8370.0,49
CDM,45012305,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45012315,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45012335,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,1379.0,896.35,240.79,4151.0,49
CDM,45012345,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45012355,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,18656.0,12126.4,622.68,16790.4,42
CDM,45012365,OPEN TX INTERPHALANGEAL JOINT DISLOCATION,18656.0,12126.4,666.35,16790.4,42
CDM,45012375,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,18656.0,12126.4,853.0,16790.4,49
CDM,45012385,UNLISTED PROCEDURE HANDS OR FINGERS,651.0,423.15,182.93,13665.0,48
CDM,45012395,RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS,16456.0,10696.4,214.71,14810.4,49
CDM,45012405,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,18656.0,12126.4,748.04,16790.4,49
CDM,45012415,CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ,6091.0,3959.15,310.03,18285.0,42
CDM,45012425,CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA,9203.0,5981.95,632.74,8370.0,49
CDM,45012435,TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45012445,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES,9203.0,5981.95,420.39,8370.0,49
CDM,45012455,REMOVAL FOREIGN BODY DEEP THIGH/KNEE,16456.0,10696.4,490.04,36332.0,49
CDM,45012465,ARREST EPIPHYSEAL DISTAL FEMUR,41076.0,26699.4,785.71,36968.4,42
CDM,45012475,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45012485,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45012495,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012505,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012515,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,1379.0,896.35,240.79,8370.0,49
CDM,45012525,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012535,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012545,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45012555,CLTX PROX FIBULA/SHFT FX W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45012565,CLTX PROX FIBULA/SHFT FX W/MANJ,9203.0,5981.95,310.03,8550.0,49
CDM,45012575,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45012585,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012595,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45012605,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,9203.0,5981.95,310.03,8550.0,49
CDM,45012615,UNLISTED PROCEDURE LEG OR ANKLE,651.0,423.15,182.93,13665.0,48
CDM,45012625,REMOVAL FOREIGN BODY FOOT DEEP,9316.0,6055.4,383.66,8384.4,49
CDM,45012635,REMOVAL FOREIGN BODY FOOT COMPLICATED,9316.0,6055.4,450.76,8384.4,49
CDM,45012645,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012655,CLOSED TX TALUS FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012665,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45012675,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45012685,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,1379.0,896.35,167.84,4151.0,49
CDM,45012695,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,18656.0,12126.4,446.23,16790.4,49
CDM,45012705,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,1379.0,896.35,206.85,4151.0,49
CDM,45012715,CLTX METATARSOPHLNGL JT DISLC W/O ANES,1379.0,896.35,142.11,4151.0,49
CDM,45012725,APPLICATION CAST SHOULDER HAND LONG ARM,1528.0,993.2,80.74,4151.0,49
CDM,45012735,APPLICATION CAST ELBOW FINGER SHORT ARM,1528.0,993.2,74.39,4151.0,49
CDM,45012745,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,741.0,481.65,47.31,3920.0,49
CDM,45012755,APPLICATION FINGER SPLINT STATIC,741.0,481.65,34.13,3920.0,49
CDM,45012765,APPLICATION FINGER SPLINT DYNAMIC,341.0,221.65,40.74,3920.0,49
CDM,45012775,STRAPPING THORAX,908.0,590.2,22.36,3920.0,49
CDM,45012785,STRAPPING SHOULDER,741.0,481.65,22.36,3920.0,49
CDM,45012795,STRAPPING ELBOW/WRIST,341.0,221.65,22.56,3920.0,49
CDM,45012805,STRAPPING HAND/FINGER,341.0,221.65,23.67,3920.0,49
CDM,45012815,APPLICATION LONG LEG CAST THIGH-TOE,1528.0,993.2,114.84,4151.0,49
CDM,45012825,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,1528.0,993.2,70.57,4151.0,49
CDM,45012835,APPLICATION PATELLAR TENDON BEARING CAST,1528.0,993.2,102.0,4151.0,49
CDM,45012845,APPLICATION RIGID TOTAL CONTACT LEG CAST,1528.0,993.2,114.84,4151.0,49
CDM,45012855,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,908.0,590.2,47.31,3920.0,49
CDM,45012865,APPLICATION SHORT LEG SPLINT CALF FOOT,908.0,590.2,47.31,3920.0,49
CDM,45012875,STRAPPING KNEE,741.0,481.65,22.36,3920.0,49
CDM,45012885,STRAPPING ANKLE &/FOOT,908.0,590.2,22.01,3920.0,49
CDM,45012895,STRAPPING TOES,341.0,221.65,13.86,3920.0,49
CDM,45012905,STRAPPING UNNA BOOT,908.0,590.2,32.49,3920.0,49
CDM,45012915,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,1528.0,993.2,39.77,3920.0,49
CDM,45012925,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,1528.0,993.2,53.48,3920.0,49
CDM,45012935,UNLISTED PROCEDURE CASTING OR STRAPPING,307.0,199.55,47.31,1974.0,41
CDM,45012945,UNLISTED PROCEDURE NOSE,425.0,276.25,119.43,7730.0,48
CDM,45012955,LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY,1116.0,725.4,112.01,4151.0,49
CDM,45012965,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,8518.0,5536.7,374.02,7666.2,49
CDM,45012975,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,1335.0,867.75,233.1,6317.0,49
CDM,45012985,UNLISTED PROCEDURE TRACHEA BRONCHI,2553.0,1659.45,194.87,2297.7,41
CDM,45012995,THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR,13135.0,8537.75,853.0,18285.0,32
CDM,45013005,PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY,7770.0,5050.5,853.0,18285.0,32
CDM,45013015,REPAIR CARDIAC WOUND W/O BYPASS,23369.0,15189.85,853.0,21032.1,32
CDM,45013025,INTRODUCTION NEEDLE/INTRACATHETER VEIN,308.0,200.2,44.56,3920.0,37
CDM,45013035,VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN,198.0,128.7,2.52,3920.0,38
CDM,45013045,VNPNXR <3 YEARS PHYS/QHP SKILL SCALP VEIN,161.0,104.65,2.52,3920.0,38
CDM,45013055,VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN,161.0,104.65,2.52,3920.0,38
CDM,45013065,VNPNXR 3 YEARS/> PHYS/QHP SKILL,278.0,180.7,11.13,3920.0,38
CDM,45013075,VENIPUNCTURE CUTDOWN UNDER AGE 1 YR,926.0,601.9,44.56,3920.0,49
CDM,45013085,VENIPUNCTURE CUTDOWN AGE 1 YR/>,2868.0,1864.2,44.56,3920.0,49
CDM,45013095,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,22623.0,14704.95,112.14,20360.7,49
CDM,45013105,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,4444.0,2888.6,41.1,6289.0,48
CDM,45013115,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,11165.0,7257.25,220.84,10048.5,49
CDM,45013125,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,11165.0,7257.25,78.99,10048.5,49
CDM,45013135,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,22623.0,14704.95,220.17,20360.7,42
CDM,45013145,COLLECT BLOOD FROM CATHETER VENOUS NOS,926.0,601.9,44.56,3920.0,49
CDM,45013155,UNLISTED VASC PROCEDURE,2302.0,1496.3,620.6,13665.0,47
CDM,45013165,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,2929.0,1903.85,237.28,6289.0,48
CDM,45013175,RPR LAC 2.5 CM/< PST ONE-THIRD TONGUE,1335.0,867.75,112.01,4214.0,49
CDM,45013185,RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX,1335.0,867.75,112.01,6317.0,49
CDM,45013195,REPAIR LACERATION PALATE </2 CM,2929.0,1903.85,215.93,4214.0,48
CDM,45013205,REPAIR LACERATION PALATE >2 CM/COMPLEX,34015.0,22109.75,296.75,30613.5,42
CDM,45013215,UNLISTED PROCEDURE PALATE UVULA,425.0,276.25,119.43,8370.0,48
CDM,45013225,CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS,1335.0,867.75,112.01,3920.0,49
CDM,45013235,I&D SUBMUCOSAL ABSCESS RECTUM,6780.0,4407.0,219.57,36332.0,49
CDM,45013245,UNLISTED PROCEDURE RECTUM,1358.0,882.7,381.6,7730.0,48
CDM,45013255,ANOSCOPY W/RMVL FOREIGN BODY,5243.0,3407.95,103.52,6289.0,49
CDM,45013265,UNLISTED PROCEDURE ABD PERITONEUM,2923.0,1899.95,454.96,8370.0,48
CDM,45013275,ASPIRATION BLADDER NEEDLE,1399.0,909.35,46.78,3920.0,49
CDM,45013285,UNLISTED PROCEDURE MALE GENITAL SYSTEM,592.0,384.8,166.35,8370.0,48
CDM,45013295,UNLISTED PROCEDURE FEMALE GENITAL SYS,354.0,230.1,99.47,8550.0,48
CDM,45013305,DELIVERY PLACENTA SEPARATE PROCEDURE,15898.0,10333.7,111.43,14308.2,49
CDM,45013315,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,2295.0,1491.75,41.27,3920.0,49
CDM,45013325,RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS,13114.0,8524.1,599.44,11802.6,49
CDM,45013335,RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION,5569.0,3619.85,78.55,5012.1,49
CDM,45013345,UNLISTED PROCEDURE ANT SEG OF EYE,3813.0,2478.45,599.44,7730.0,48
CDM,45013355,UNLISTED PROCEDURE ORBIT,599.0,389.35,168.32,2093.0,41
CDM,45014615,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45014625,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45014665,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,3983.0,2588.95,61.65,3920.0,49
CDM,45014685,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,2639.0,1715.35,241.35,4268.0,49
CDM,45014695,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,2929.0,1903.85,233.01,6317.0,48
CDM,45014705,CLOSED TREATMENT STERNUM FRACTURE,1379.0,896.35,226.8,4151.0,49
CDM,45014715,PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ,22391.0,14554.15,651.49,20151.9,42
CDM,45014725,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,1335.0,867.75,112.01,4214.0,49
CDM,45014735,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,8518.0,5536.7,263.88,7666.2,49
CDM,45014795,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,95.0,61.75,17.96,1764.0,41
CDM,45014815,INTRAORAL I&D TONGUE/FLOOR LINGUAL,2929.0,1903.85,132.11,4214.0,48
CDM,45014825,CLTX PROX TIBFIB JT DISLC W/O ANES,1379.0,896.35,240.79,4151.0,49
CDM,45014835,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,745.0,484.25,33.12,3920.0,49
CDM,45014865,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,1698.0,1103.7,68.5,3920.0,49
CDM,45014875,CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45014885,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,4046.0,2629.9,106.11,4151.0,49
CDM,45014895,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45014905,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,1143.0,742.95,30.98,1764.0,41
CDM,45014915,EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM,2639.0,1715.35,174.78,4268.0,49
CDM,45014925,INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE,2929.0,1903.85,336.1,4214.0,48
CDM,45014935,CANALITH REPOSITIONING PROCEDURE,300.0,195.0,20.97,1764.0,41
CDM,45014955,CLOSED TX OF MANDIBULAR FRACTURE W/O MANIPULATION,2929.0,1903.85,310.03,4214.0,48
CDM,45014965,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,1379.0,896.35,240.79,4268.0,49
CDM,45014975,CLTX GREATER TROCHANTERIC FX W/O MANJ,1379.0,896.35,240.79,4268.0,49
CDM,45014985,INJECTION AA&/STRD PUDENDAL NERVE,7679.0,4991.35,66.22,6911.1,49
CDM,45014995,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,1379.0,896.35,240.79,4151.0,49
CDM,45015055,CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ,2275.0,1478.75,310.03,18285.0,42
CDM,45015085,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,49
CDM,45015095,CLTX FEM FX PROX END NCK W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45015105,HYMENOTOMY SIMPLE INCISION,18283.0,11883.95,55.75,16454.7,49
CDM,45015125,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,95.0,61.75,17.96,1764.0,41
CDM,45015135,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,18656.0,12126.4,532.22,16790.4,42
CDM,45015175,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,268.0,174.2,21.15,1764.0,41
CDM,45015185,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,1399.0,909.35,46.01,4151.0,49
CDM,45015195,PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC,1399.0,909.35,106.78,4151.0,49
CDM,45015205,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45015215,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,9203.0,5981.95,310.03,8282.7,49
CDM,45015225,EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM,1499.0,974.35,121.13,4151.0,49
CDM,45015235,CLOSED TREATMENT SESAMOID FRACTURE,1379.0,896.35,137.22,4151.0,49
CDM,45015245,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,9203.0,5981.95,310.03,8550.0,49
CDM,45015255,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,59484.0,38664.6,187.2,53535.6,42
CDM,45015265,OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,95.0,61.75,17.96,1764.0,41
CDM,45015275,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,6076.0,3949.4,98.26,5468.4,49
CDM,45015285,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,1496.0,972.4,84.79,3920.0,49
CDM,45015295,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,13114.0,8524.1,98.22,11802.6,49
CDM,45015305,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,513.0,333.45,30.69,1764.0,41
CDM,45015315,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,1379.0,896.35,240.79,4268.0,49
CDM,45015325,CLOSED TREATMENT COCCYGEAL FRACTURE,1379.0,896.35,240.79,4151.0,49
CDM,45015335,"UNLISTED PROCEDURE, ANUS",777.0,505.05,218.34,8370.0,48
CDM,45015365,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,9916.0,6445.4,163.56,8924.4,49
CDM,45015395,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,2161.0,1404.65,30.28,4214.0,38
CDM,45015445,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,11165.0,7257.25,270.56,10048.5,49
CDM,45015455,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,6766.0,4397.9,283.81,18285.0,39
CDM,45015465,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,6643.0,4317.95,332.3,9248.0,39
CDM,45015485,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,141.0,91.65,17.96,3920.0,49
CDM,45015495,PUNCH BIOPSY SKIN SINGLE LESION,1499.0,974.35,52.3,4151.0,49
CDM,45015505,INJECTION AA&/STRD SUPRASCAPULAR NERVE,5973.0,3882.45,66.83,5375.7,49
CDM,45015515,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,9916.0,6445.4,230.15,13665.0,49
CDM,45015525,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,926.0,601.9,66.35,1764.0,41
CDM,45015565,PVB THORACIC CONT CATHETER INFUSION W/IMG GID,5973.0,3882.45,108.76,5375.7,49
CDM,45015575,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,1379.0,896.35,240.79,4151.0,49
CDM,45015585,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,18283.0,11883.95,650.73,16454.7,42
CDM,45015595,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,2586.0,1680.9,40.74,3920.0,49
CDM,45015605,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,2639.0,1715.35,130.58,4214.0,49
CDM,45015615,DRAINAGE TENDON SHEATH DIGIT&/PALM EACH,18656.0,12126.4,673.26,16790.4,49
CDM,45015625,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,3065.0,1992.25,64.0,4214.0,38
CDM,45015635,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,1379.0,896.35,240.79,8550.0,49
CDM,45015645,PUNCTURE ASPIRATION CYST BREAST,2639.0,1715.35,50.26,4151.0,49
CDM,45015655,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,9316.0,6055.4,213.46,8384.4,49
CDM,45015665,I&D THYROGLOSSAL DUCT CYST INFECTED,7406.0,4813.9,188.4,6665.4,49
CDM,45015675,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,3555.0,2310.75,192.55,4151.0,48
CDM,45015685,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,2586.0,1680.9,29.6,3920.0,49
CDM,45015695,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,10908.0,7090.2,152.72,9817.2,49
CDM,45015705,CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ,18656.0,12126.4,310.03,16790.4,49
CDM,45015715,INJECTION AA&/STRD SCIATIC NERVE,5973.0,3882.45,90.25,5375.7,49
CDM,45015735,BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,5701.0,3705.65,473.75,18285.0,32
CDM,45015775,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,614.0,399.1,30.69,1764.0,41
CDM,45016625,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,11125.0,7231.25,853.0,18285.0,32
CDM,45020WE,I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC,3424.0,2225.6,280.92,3424.0,35
CDM,45100WE,BX ANORECTAL WALL ANAL APPROACH,1616.0,1050.4,163.62,1616.0,35
CDM,45108WE,ANORECTAL MYOMECTOMY,2048.0,1331.2,217.64,2048.0,35
CDM,45110WE,PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST,12304.0,7997.6,1084.23,12304.0,35
CDM,45111WE,PRCTECT PRTL RESCJ RECTUM TABDL APPR,7204.0,4682.6,768.02,7204.0,35
CDM,45112WE,PRCTECT CMBN ABDOMINOPRNL PULL-THRU PX,13272.0,8626.8,1137.83,13272.0,35
CDM,45113WE,PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR,13288.0,8637.2,1135.51,13288.0,35
CDM,45114WE,PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH,12316.0,8005.4,1045.53,12316.0,35
CDM,45116WE,PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY,11088.0,7207.2,865.3,11088.0,35
CDM,45119WE,PRCTECT CMBN PULL-THRU W/RSVR W/NTRSTM,13392.0,8704.8,1144.82,13392.0,35
CDM,45120WE,PRCTECT COMPL W/PULL-THRU PX & ANASTOMOSIS,10560.0,6864.0,1110.84,10560.0,35
CDM,45121WE,PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS,11632.0,7560.8,1035.77,11632.0,35
CDM,45123WE,PRCTECT PRTL W/O ANAST PRNL APPR,7544.0,4903.6,700.64,7544.0,35
CDM,45126WE,PELVIC EXENTERATION COLORECTAL MALIGNANCY,19640.0,12766.0,1488.81,19640.0,35
CDM,45130WE,EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH,7400.0,4810.0,618.81,7400.0,35
CDM,45135WE,EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH,8944.0,5813.6,866.19,8944.0,35
CDM,45136WE,EXC ILEOANAL RESVR W/ILEOSTMY,12328.0,8013.2,1110.88,12328.0,35
CDM,45150WE,DIVISION STRICTURE RECTUM,2340.0,1521.0,254.08,2340.0,35
CDM,45160WE,EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL,6532.0,4245.8,558.48,6532.0,35
CDM,45171WE,EXC RCT TUM NOT INCL MUSCULARIS PROPRIA,3252.0,2113.8,324.87,3252.0,35
CDM,45172WE,EXC RCT TUM INCL MUSCULARIS PROPRIA,4852.0,3153.8,448.69,4852.0,35
CDM,45190WE,DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH,4168.0,2709.2,363.57,4168.0,35
CDM,45300WE,PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX,320.0,208.0,41.06,240.0,35
CDM,45303WE,PROCTOSGMDSC RIGID W/DILATION,560.0,364.0,40.94,1609.5,35
CDM,45305WE,PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE,460.0,299.0,53.71,345.0,35
CDM,45307WE,PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY,640.0,416.0,53.43,480.0,35
CDM,45308WE,PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY,520.0,338.0,47.51,390.0,35
CDM,45309WE,PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ,560.0,364.0,81.82,420.0,35
CDM,45315WE,PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE,680.0,442.0,75.67,510.0,35
CDM,45317WE,PROCTOSGMDSC RIGID CONTROL BLEEDING,760.0,494.0,103.41,570.0,35
CDM,45320WE,PROCTOSGMDSC RIGID ABLATION LESION,672.0,436.8,80.86,504.0,35
CDM,45321WE,PROCTOSGMDSC RIGID DCMPRN VOLVULUS,660.0,429.0,64.89,660.0,35
CDM,45330WE,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,370.0,240.5,49.8,277.5,35
CDM,45331WE,SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,502.0,326.3,60.33,376.5,35
CDM,45332WE,SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY,774.0,503.1,92.42,580.5,35
CDM,45333WE,SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,682.0,443.3,88.34,511.5,35
CDM,45334WE,SIGMOIDOSCOPY FLX CONTROL BLEEDING,880.0,572.0,112.81,880.0,35
CDM,45335WE,SGMDSC FLX DIRED SBMCSL NJX ANY SBST,458.0,297.7,63.45,460.89,35
CDM,45337WE,SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE,924.0,600.6,86.55,924.0,35
CDM,45338WE,SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,902.0,586.3,114.83,676.5,35
CDM,45340WE,SIGMOIDOSCOPY FLX TNDSC BALO DILAT,550.0,357.5,75.29,812.87,35
CDM,45341WE,SIGMOIDOSCOPY FLX NDSC US XM,933.0,606.45,93.96,933.0,35
CDM,45342WE,SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX,1311.0,852.15,128.68,1311.0,35
CDM,45346WE,SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES,1236.0,803.4,133.83,927.0,31
CDM,45347WE,SIGMOIDOSCOPY W/PLACEMENT OF STENT,1197.0,778.05,116.43,1197.0,31
CDM,45349WE,SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION,1549.0,1006.85,135.43,1549.0,30
CDM,45350WE,SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S),739.0,480.35,98.4,739.0,30
CDM,45378COLWE,COLONOSCPY FLX DX,1648.0,1071.2,88.77,1236.0,35
CDM,45378DISWE,COLONOSCPY FLX DX DISCONT,592.0,384.8,88.77,657.34,35
CDM,45378WE,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,1434.0,932.1,88.77,1075.5,35
CDM,45378WE-53,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,1434.0,932.1,55.82,1434.0,34
CDM,45379WE,COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S),1883.0,1223.95,220.88,1412.25,35
CDM,45380WE,COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,1566.0,1017.9,190.59,1174.5,35
CDM,45381WE,COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST,1566.0,1017.9,190.59,1174.5,35
CDM,45382WE,COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD,1864.0,1211.6,242.25,1398.0,35
CDM,45384WE,COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,1628.0,1058.2,220.27,1221.0,35
CDM,45385WE,COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,2011.0,1307.15,239.15,1508.25,35
CDM,45386WE,COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT,1659.0,1078.35,200.9,1244.25,35
CDM,45388WE,COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES,2147.0,1395.55,93.68,1610.25,31
CDM,45389WE,COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT,2096.0,1362.4,218.05,2096.0,31
CDM,45390WE,COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION,2416.0,1570.4,250.22,2416.0,31
CDM,45391WE,COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX,1856.0,1206.4,194.3,1856.0,35
CDM,45392WE,COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL,2200.0,1430.0,229.03,2200.0,35
CDM,45393WE,COLONOSCOPY FLEXIBLE WITH DECOMPRESSION,2059.0,1338.35,189.45,2059.0,31
CDM,45395WE,LAPS PROCTECTOMY ABDOMINOPERINEAL W/COLOSTOMY,13200.0,8580.0,1267.19,13200.0,35
CDM,45397WE,LAPS PROCTECTOMY COMBINED PULL-THRU W/RESERVOIR,14600.0,9490.0,1377.88,14600.0,35
CDM,45398WE,COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S),1680.0,1092.0,183.11,1680.0,31
CDM,45399RVU10WE,"ENDOVAC, COLON; COLONOSCOPY VIA STOMA (COMP 45388, 97605)",2336.0,1518.4,731.82,2336.0,15
CDM,45399RVU11WE,OPEN RESECTION OF CECUM W/O ANASTOMOSIS (COMP 44110),5055.0,3285.75,731.82,5055.0,15
CDM,45399RVU12WE,SERIAL TRANVERSE COLOPLASTY (COMP 44604),6538.0,4249.7,731.82,6538.0,15
CDM,45399RVU2WE,ESD COLON (COMP 45390),2416.0,1570.4,731.82,2416.0,15
CDM,45399RVU4WE,DILATION OF COLOSTOMY (COMP 57800),308.0,200.2,154.0,878.18,15
CDM,45399RVU5WE,ENDOSCOPIC SUBMUCOSAL DISSECTION OF COLON - (COMP CODE 44204),10568.0,6869.2,731.82,10568.0,15
CDM,45399RVU6WE,ENDOSCOPIC DEFECT CLOSURE (COMP CODE 44604),7808.0,5075.2,731.82,7808.0,15
CDM,45399RVU7WE,EDOSCOPIC STRICTUROTOMY (COMP 46700),4218.0,2741.7,731.82,4218.0,15
CDM,45399RVU8WE,"ENDOVAC, COLON; FLEX-SIG (COMP 45330, 97605)",599.0,389.35,299.5,878.18,15
CDM,45399RVU9WE,"ENDOVAC, COLON; COLONOSCOPY (COMP 45378, 97605)",1639.0,1065.35,731.82,1639.0,15
CDM,45400WE,LAPAROSCOPY PROCTOPEXY PROLAPSE,7776.0,5054.4,740.5,7776.0,35
CDM,45402WE,LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ,10604.0,6892.6,1004.65,10604.0,35
CDM,45499RVU1WE,LX COMP. PROC. IPAA +-ILEOSTOMY (COMP CODE 44211),14832.0,9640.8,892.83,14832.0,15
CDM,45499RVU2WE,LAP EXCISION  RETRORECTAL MASS/TUMOR (COMP 45172),6239.0,4055.35,892.83,6239.0,15
CDM,45499RVU3WE,LAPAROSCOPIC ABDOMINAL PERINEAL EXCISION OF ILEAL J POUCH (COMP,12328.0,8013.2,892.83,12328.0,15
CDM,45499RVU4WE,UNLISTED LAP SWENSON PROCEDURE (COMP CODE 45120),10560.0,6864.0,892.83,10560.0,15
CDM,45499RVU5WE,LAP PARTIAL PROCTECTOMY (COMP 45111),7744.0,5033.6,892.83,7744.0,15
CDM,45499RVU6WE,LAP COMPLETE PROCTECTOMY W/WO COLOANAL ANASTOMOSIS (COMP 45112),14267.0,9273.55,892.83,14267.0,15
CDM,45500WE,PROCTOPLASTY STENOSIS,3092.0,2009.8,357.31,3092.0,35
CDM,45505WE,PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE,3344.0,2173.6,325.59,3344.0,35
CDM,45520WE,PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE,220.0,143.0,34.34,264.32,35
CDM,45540WE,PROCTOPEXY ABDOMINAL APPROACH,7248.0,4711.2,616.73,7248.0,35
CDM,45541WE,PROCTOPEXY PERINEAL APPROACH,5940.0,3861.0,555.44,5940.0,35
CDM,45550WE,PROCTOPEXY W/SIGMOID RESCJ ABDL APPR,9920.0,6448.0,802.37,9920.0,35
CDM,45560WE,REPAIR RECTOCELE SEPARATE PROCEDURE,4600.0,2990.0,367.28,4600.0,35
CDM,45562WE,EXPL RPR & PRESACRAL DRG RECTAL INJURY,7192.0,4674.8,557.87,7192.0,35
CDM,45563WE,EXPL RPR & PRESACRAL DRG RECTAL INJ W/COLOSTOMY,10552.0,6858.8,845.16,10552.0,35
CDM,45800WE,CLOSURE RECTOVESICAL FISTULA,8124.0,5280.6,632.99,8124.0,35
CDM,45805WE,CLSR RECTOVESICAL FISTULA W/COLOSTOMY,9328.0,6063.2,774.41,9328.0,35
CDM,45820WE,CLOSURE RECTOURETHRAL FISTULA,8148.0,5296.2,627.28,8148.0,35
CDM,45825WE,CLOSURE RECTOURETHRAL FISTULA W/COLOSTOMY,9668.0,6284.2,718.67,9668.0,35
CDM,45900WE,RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE,1196.0,777.4,104.55,1196.0,35
CDM,45905WE,DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL,940.0,611.0,110.71,940.0,35
CDM,45910WE,DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL,1140.0,741.0,131.56,1140.0,35
CDM,45915WE,RMVL FECAL IMPACTION/FB SPX UNDER ANES,1276.0,829.4,175.82,957.0,35
CDM,45990WE,ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX,720.0,468.0,73.07,720.0,35
CDM,45999RVU1WE,ESD RECTUM (COMP 45390),1212.0,787.8,606.0,1212.0,15
CDM,45999RVU2WE,TRANSANAL RPR COLOANAL ANASTOMOSIS (COMP 45505),3344.0,2173.6,682.21,3344.0,15
CDM,45999RVU4WE,"ENDOVAC, RECTUM; COLONOSCOPY VIA STOMA (COMP 44388, 97605)",1217.0,791.05,608.5,1217.0,15
CDM,45999RVU5WE,"ENDOVAC, RECTUM; COLONOSCOPY (COMP 45378, 97605)",1639.0,1065.35,682.21,1639.0,15
CDM,45999RVU6WE,"ENDOVAC, RECTUM; FLEX-SIG (COMP 45330, 97605)",599.0,389.35,299.5,818.65,15
CDM,45999RVU7WE,"OPEN REPAIR OF RECTAL FISTULA WO ANASTOMOSIS, TRANS-PERINEAL APP",6484.0,4214.6,682.21,6484.0,15
CDM,45999RVU8WE,REVISION/REDO POUCH AP APPROACH W/W/O STOMA (COMP 46712),13123.0,8529.95,682.21,13123.0,15
CDM,45999RVUWE,REV ILEOANAL RES W/W/O ST (COMP 45113),14000.0,9100.0,682.21,14000.0,15
CDM,46000010,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,900.0,585.0,38.83,1272.0,49
CDM,46000020,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,1790.0,1163.5,61.47,1611.0,49
CDM,46000025,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,1790.0,1163.5,65.68,1611.0,49
CDM,46000030,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,435.0,282.75,5.64,1272.0,33
CDM,46000035,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,900.0,585.0,38.83,1272.0,48
CDM,46000040,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,435.0,282.75,6.14,1272.0,33
CDM,46000055,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,741.0,481.65,38.83,1272.0,49
CDM,46000060,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,900.0,585.0,35.41,1272.0,49
CDM,46000065,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,741.0,481.65,38.83,1272.0,49
CDM,46000085,CARDIOPULMONARY EXERCISE TESTING,1790.0,1163.5,65.68,1611.0,49
CDM,46000090,NITRIC OXIDE EXPIRED GAS DETERMINATION,148.0,96.2,28.95,1272.0,49
CDM,46000100,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,1790.0,1163.5,65.68,1611.0,49
CDM,46000110,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,1790.0,1163.5,65.68,1611.0,49
CDM,46000115,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V,900.0,585.0,38.83,1272.0,49
CDM,46000120,AIRWAY RESISTANCE BY OSCILLOMETRY,900.0,585.0,65.68,1272.0,49
CDM,46000125,CO DIFFUSING CAPACITY,756.0,491.4,38.83,1272.0,39
CDM,46000145,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,435.0,282.75,5.64,1272.0,33
CDM,46000165,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,435.0,282.75,6.14,1272.0,33
CDM,46000205,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,341.0,221.65,23.11,1272.0,49
CDM,46000215,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,1990.0,1293.5,25.14,1791.0,49
CDM,46000285,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,741.0,481.65,38.83,1272.0,49
CDM,46000295,PULMONARY STRESS TESTING,741.0,481.65,38.83,1272.0,49
CDM,46001055,PATIENT-INITIATED SPIROMETRIC RECORDING,1790.0,1163.5,51.78,1611.0,49
CDM,46001125,RTM DEV SPLY DATA RESPIR SYS 2-15 DAYS IN 30D PD,329.0,213.85,23.85,1272.0,42
CDM,46020WE,PLACEMENT OF SETON,818.0,531.7,112.43,613.5,35
CDM,46030WE,REMOVAL ANAL SETON OTHER MARKER,592.0,384.8,49.51,444.0,35
CDM,46040WE,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,2148.0,1396.2,209.26,1611.0,35
CDM,46045WE,I&D INTRAMURAL IM/ABSC TRANSANAL ANES,2348.0,1526.2,216.32,2348.0,35
CDM,46050WE,"I/D PERIANAL ABSCESS, SUPERFICIAL",546.0,354.9,72.98,409.5,35
CDM,46060WE,I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON,2548.0,1656.2,297.01,2548.0,35
CDM,46070WE,"INCISION OF ANAL SEPTUM, INFANT",1228.0,798.2,134.8,1228.0,35
CDM,46080WE,SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX,1008.0,655.2,121.36,756.0,35
CDM,46083WE,INCISION THROMBOSED HEMORRHOID EXTERNAL,580.0,377.0,60.85,435.0,35
CDM,46200WE,FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED,1436.0,933.4,184.71,1077.0,35
CDM,46220WE,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,644.0,418.6,61.73,483.0,35
CDM,46221WE,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,944.0,613.6,113.84,708.0,35
CDM,46230WE,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,1048.0,681.2,102.83,786.0,35
CDM,46250WE,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,1700.0,1105.0,210.25,1275.0,35
CDM,46255URVUWE,HEMORRHOIDECTOMY (COMP CODE 46255),2132.0,1385.8,272.69,1599.0,35
CDM,46255WE,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,1984.0,1289.6,272.69,1488.0,35
CDM,46257WE,HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO,2304.0,1497.6,308.68,2304.0,35
CDM,46258WE,HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY,2564.0,1666.6,335.7,2564.0,35
CDM,46260WE,HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO,2692.0,1749.8,362.4,2692.0,35
CDM,46261WE,HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU,3104.0,2017.6,397.84,3104.0,35
CDM,46262WE,HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY,3164.0,2056.6,415.47,3164.0,35
CDM,46270WE,SURG TX ANAL FISTULA SUBQ,1968.0,1279.2,196.76,1476.0,35
CDM,46275WE,SURG TX ANAL FISTULA INTERSPHINCTERIC,2168.0,1409.2,233.23,1626.0,35
CDM,46280WE,TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON,2556.0,1661.4,322.11,2556.0,35
CDM,46285WE,SURG TX ANAL FISTULA 2ND STAGE,2168.0,1409.2,206.96,1626.0,35
CDM,46288WE,CLSR ANAL FSTL W/RCT ADVMNT FLAP,3124.0,2030.6,295.97,3124.0,35
CDM,46320WE,EXC THROMBOSED HEMORRHOID XTRNL,656.0,426.4,70.67,492.0,35
CDM,46500WE,INJECTION SCLEROSING SOLUTION HEMORRHOIDS,696.0,452.4,91.23,522.0,35
CDM,46505WE,CHEMODENERVATION INTERNAL ANAL SPHINCTER,1272.0,826.8,158.06,954.0,35
CDM,46600WE,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,242.0,157.3,34.77,181.5,35
CDM,46601WE,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT,640.0,416.0,69.86,640.0,30
CDM,46604WE,ANOSCOPY W/DILATION,412.0,267.8,47.6,1041.09,35
CDM,46606WE,ANOSCOPY W/BX SINGLE/MULTIPLE,528.0,343.2,36.5,396.0,35
CDM,46607WE,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX,968.0,629.2,95.22,968.0,30
CDM,46608WE,"ANOSCOPY,REMOVE FOREIGN BODY",520.0,338.0,68.67,403.88,35
CDM,46610WE,ANOSCOPY W/RMVL LESION CAUTERY,512.0,332.8,58.94,384.0,35
CDM,46611WE,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,520.0,338.0,72.16,390.0,35
CDM,46612WE,ANOSC RMVL MULT TUMORS CAUTERY/SNARE,600.0,390.0,83.53,467.0,35
CDM,46614WE,"ANOSCOPY,CONTROL BLEEDING",400.0,260.0,56.38,300.0,35
CDM,46615WE,"ANOSCOPY,ABLATE LESION",600.0,390.0,82.96,450.0,35
CDM,46700WE,ANOPLASTY PLASTIC OPERATION STRICTURE ADULT,3924.0,2550.6,358.49,3924.0,35
CDM,46705WE,ANOPLASTY PLASTIC OPERATION STRICTURE INFANT,2972.0,1931.8,302.01,2972.0,35
CDM,46706WE,REPAIR ANAL FISTULA W/FIBRIN GLUE,976.0,634.4,95.49,976.0,35
CDM,46707WE,RPR ANORECTAL FISTULA W/ PLUG,2556.0,1661.4,249.53,2556.0,35
CDM,46710WE,RPR ILEOANAL POUCH FSTL/POUCH ADVMNT TPRNL APPR,6856.0,4456.4,634.1,6856.0,35
CDM,46712WE,RPR ILEOANAL POUCH FSTL/POUCH ADVMNT CMBN APPR,14580.0,9477.0,1397.64,14580.0,35
CDM,46716WE,RPR LW IMPERFORATE ANUS W/TRPOS FISTULA,7016.0,4560.4,607.22,7016.0,35
CDM,46730WE,RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR,12260.0,7969.0,976.25,12260.0,35
CDM,46750WE,SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT,4860.0,3159.0,383.76,4860.0,35
CDM,46753WE,GRAFT THIERSCH RCT INCONTINENCE &/PROLAPSE,3556.0,2311.4,309.01,3556.0,35
CDM,46754WE,RMVL THIERSCH WIRE/SUTURE ANAL CANAL,1204.0,782.6,116.71,903.0,35
CDM,46760ANAWE,SPINCTEROPLASTY ANAL,4582.0,2978.3,516.06,4582.0,35
CDM,46760WE,SPHINCTEROPLASTY ANAL MUSCLE TRANSPLANT,6980.0,4537.0,516.06,6980.0,35
CDM,46761WE,SPHNCTROP ANAL LEVATOR MUSC IMBRCJ,6116.0,3975.4,459.32,6116.0,35
CDM,46900WE,DSTRJ LESION ANUS SIMPLE CHEMICAL,764.0,496.6,119.69,573.0,35
CDM,46910WE,DSTRJ LESION ANUS SMPL ELTRDSICCATION,764.0,496.6,99.49,573.0,35
CDM,46916WE,DSTRJ LESION ANUS SIMPLE CRYOSURGERY,764.0,496.6,75.13,573.0,35
CDM,46917WE,DSTRJ LESION ANUS SIMPLE LASER SURG,764.0,496.6,106.44,753.63,35
CDM,46922WE,DSTRJ LESION ANUS SIMPLE SURG EXCISION,764.0,496.6,95.87,573.0,35
CDM,46924WE,DSTRJ LESION ANUS EXTENSIVE,1124.0,730.6,139.05,901.85,35
CDM,46930WE,DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY,644.0,418.6,129.31,483.0,35
CDM,46940WE,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST,940.0,611.0,99.24,705.0,35
CDM,46942WE,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ,828.0,538.2,89.73,621.0,35
CDM,46945WE,INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN,1476.0,959.4,167.01,1107.0,35
CDM,46946WE,INT HRHC BY LIGATION 2+ HROID W/O IMG GDN,1800.0,1170.0,188.21,1350.0,35
CDM,46947WE,HEMORRHOIDOPEXY BY STAPLING,2228.0,1448.2,240.14,2228.0,35
CDM,46948WE,INT HRHC TRANSANAL HROID DARTLZJ 2+ W/US GDN,2228.0,1448.2,334.7,2228.0,31
CDM,46999RVU10WE,"UNLIST PROC, ANUS COMPARED TO 45100",1737.0,1129.05,219.02,1737.0,15
CDM,46999RVU11WE,POST OP CONTROL OF BLEEDING ANUS (COMP 46945),1586.0,1030.9,219.02,1586.0,15
CDM,46999RVU12WE,"UNLISTED PROC; TRANSANAL HEMORRHOIDAL DEARTERIALIZATION, SINGLE",1838.0,1194.7,219.02,1838.0,15
CDM,46999RVU13WE,SUBMUCOSAL ANAL INJECTION FOR INFLAMMATION/PAIN (COMP CODE 46505,1367.0,888.55,219.02,1367.0,15
CDM,46999RVU14WE,"REPAIR, CLOSURE OF ANAL FISTULA-OTHER THAN GLUE (COMP 46706)",1049.0,681.85,219.02,1049.0,15
CDM,46999RVU15WE,"HEMORRHOIDECTOMY, EXTERNAL, SINGLE COLUMN (COMP 46255)",1786.0,1160.9,219.02,1786.0,15
CDM,46999RVU16WE,POST OP CONTROL OF BLEEDING-ANUS (COMP CODE 46614),361.0,234.65,180.5,361.0,15
CDM,46999RVU17WE,EXPLANATION OF ARTIFICIAL BOWEL SPHINCTER (COMP 53446),3968.0,2579.2,219.02,3968.0,15
CDM,46999RVU18WE,"ANOSCOPY W/SUBMUCOSAL INJECTION, ANY SUBSTANCE (COMP 45381)",1566.0,1017.9,219.02,1566.0,15
CDM,46999RVU19WE,LAP ASSISTED CLOACA REPAIR (COMP 46748),27852.0,18103.8,219.02,27852.0,15
CDM,46999RVU1WE,POST OP CONTROL OF BLEEDING,781.0,507.65,219.02,781.0,15
CDM,46999RVU3WE,"HEMORROIDECTOMY, EXTERNAL, SINGLE (COMP CODE 46220)",2147.0,1395.55,219.02,2147.0,15
CDM,46999RVU9WE,"UNLIST PROC, ANUS COMPARED TO 46947",2395.0,1556.75,219.02,2395.0,15
CDM,46999RVUWE,ANAL BIOPSY (COMP 45100),236.0,153.4,118.0,262.82,15
CDM,47000255,AUDIOMETRY EVAL & SPEECH RECOG,783.0,508.95,37.02,704.7,41
CDM,47000455,HEARING AID REPAIR/MODIFYING,50.0,32.5,8.4,450.0,30
CDM,47000465,HEARING AID REPAIR/MODIFYING,100.0,65.0,16.8,450.0,30
CDM,47000475,HEARING AID REPAIR/MODIFYING,300.0,195.0,19.1,450.0,30
CDM,47000485,HEARING AID MAINTENANCE,35.0,22.75,5.88,450.0,30
CDM,47000535,SPONTANEOUS NYSTAGMUS STUDY,1310.0,851.5,19.1,1179.0,30
CDM,47000545,EVALUATION HEARING AID CANDIDACY 1ST 30 MINUTES,391.0,254.15,19.1,450.0,30
CDM,47000555,EVALUATION HEARING AID CANDIDACY EA ADDL 15 MIN,196.0,127.4,19.1,450.0,30
CDM,47000565,HEARING AID SELECTION SERVICES 1ST 30 MINUTES,391.0,254.15,19.1,450.0,30
CDM,47000575,HEARING AID SELECTION SERVICES EA ADDL 15 MIN,196.0,127.4,19.1,450.0,30
CDM,47000585,HEARING AID FITTING SERVICES 1ST 60 MINUTES,783.0,508.95,19.1,704.7,30
CDM,47000595,HEARING AID FITTING SERVICES EA ADDL 15 MINUTES,196.0,127.4,19.1,450.0,30
CDM,47000605,HEARING AID POST-FITTING F-UP SVC 1ST 30 MINUTES,391.0,254.15,19.1,450.0,30
CDM,47000615,HEARING AID POST-FITTING F-UP SVC EA ADDL 15 MIN,196.0,127.4,19.1,450.0,30
CDM,47000625,BEHAVIORAL VERIFICATION OF AMPLIFICATION,783.0,508.95,19.1,704.7,30
CDM,47000635,HEARING AID MEAS VERIF W/PROBE MICROPHONE,783.0,508.95,19.1,704.7,30
CDM,47000645,HEARING DEVICE VERIFICATION ELECTROACOUSTIC ALYS,783.0,508.95,19.1,704.7,30
CDM,47000655,HEARING ASSISTIVE DEVICE SUPPL TECH FITTING SVC,783.0,508.95,19.1,704.7,30
CDM,47000WE,BIOPSY LIVER NEEDLE PERCUTANEOUS,660.0,429.0,81.7,604.87,35
CDM,47001WE,BX LVR NDL DONE PURPOSE TM OTH MAJOR PX,836.0,543.4,79.41,836.0,35
CDM,47010WE,HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES,7760.0,5044.0,608.95,7760.0,35
CDM,47015WE,LAPT W/ASPIR &/NJX HEPATC PARASITIC CYST/ABSCESS,7400.0,4810.0,574.92,7400.0,35
CDM,47100000,BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE,116.0,75.4,10.95,450.0,25
CDM,47100015,SPONTANEOUS NYSTAGMUS TEST,645.0,419.25,19.1,580.5,41
CDM,47100020,POSITIONAL NYSTAGMUS TEST,645.0,419.25,19.1,580.5,41
CDM,47100035,OPTOKINETIC NYSTAGMUS TEST,900.0,585.0,19.1,810.0,41
CDM,47100040,OSCILLATING TRACKING TEST,1790.0,1163.5,19.1,1611.0,41
CDM,47100045,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,900.0,585.0,81.82,810.0,41
CDM,47100060,TYMP & REFLEX THRESH,783.0,508.95,28.88,704.7,41
CDM,47100070,AUDIOMETRY THRESHOLD TEST,645.0,419.25,19.1,580.5,41
CDM,47100075,AUDIOMETRY AIR AND BONE,783.0,508.95,47.57,704.7,41
CDM,47100080,SPEECH AUDIOMETRY THRESHOLD,298.0,193.7,19.1,450.0,41
CDM,47100085,SPEECH RECEPTION THRESHOLD,298.0,193.7,19.1,450.0,41
CDM,47100090,COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ,783.0,508.95,37.02,704.7,41
CDM,47100105,TYMPANOMETRY,196.0,127.4,12.34,450.0,41
CDM,47100140,AUDIOMETRY CONDITION PLAY,783.0,508.95,47.57,704.7,41
CDM,47100150,ELECTROCOCHLEOGRAPHY,783.0,508.95,47.57,704.7,41
CDM,47100155,TEST EVOKED AUDITORY LTD,1558.0,1012.7,29.07,1402.2,41
CDM,47100160,TEST EVOKED AUDITORY COMPR,1558.0,1012.7,44.89,1402.2,41
CDM,47100175,EVAL AUD REHAB STATUS,783.0,508.95,86.36,704.7,41
CDM,47100200,BASIC VESTIBULAR EVAL,783.0,508.95,81.82,704.7,41
CDM,47100205,CALORIC VEST TEST BITHERMAL,783.0,508.95,51.71,704.7,41
CDM,47100215,CALORIC VEST TEST MONOTHERMAL,783.0,508.95,28.31,704.7,41
CDM,47100235,ACOUSTIC REFLEX THRESHOLD,196.0,127.4,18.09,450.0,41
CDM,47100325,VIDEO HEAD IMPULSE TEST,319.0,207.35,24.58,450.0,40
CDM,47100615,CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT,741.0,481.65,62.4,666.9,41
CDM,47100635,CERVICAL VEMP TESTING W/I&R,783.0,508.95,48.33,704.7,41
CDM,47100655,CERVICAL & OCULAR VEMP TESTING W/I&R,1558.0,1012.7,73.04,1402.2,41
CDM,47100665,AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS,789.0,512.85,19.1,710.1,30
CDM,47100675,AEP HEARING STATUS DETER BROADBAND STIMULI I&R,1558.0,1012.7,47.57,1402.2,41
CDM,47100685,AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R,1558.0,1012.7,47.57,1402.2,41
CDM,47100695,AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT,1558.0,1012.7,47.57,1402.2,41
CDM,47100WE,WEDGE BIOPSY OF LIVER,5164.0,3356.6,423.37,5164.0,35
CDM,47120WE,HEPATECTOMY RESCJ PARTIAL LOBECTOMY,15604.0,10142.6,1208.51,15604.0,35
CDM,47122WE,HEPATECTOMY RESCJ TRISEGMENTECTOMY,23792.0,15464.8,1808.17,23792.0,35
CDM,47125WE,HEPATECTOMY RESCJ TOTAL LEFT LOBECTOMY,21216.0,13790.4,1620.69,21216.0,35
CDM,47130WE,HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY,22876.0,14869.4,1744.35,22876.0,35
CDM,47135WE,LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE,39600.0,25740.0,3324.44,39600.0,35
CDM,47140WE,DONOR HEPATECTOMY LIVING DONOR SEG II & III,23760.0,15444.0,2011.14,23760.0,32
CDM,47141WE,DONOR HEPATECTOMY LIVING DONOR SEG II III & IV,28600.0,18590.0,2430.2,28600.0,32
CDM,47142WE,DONOR HEPATECTOMY LIVING DONOR SEG V VI VII &VI,31776.0,20654.4,2809.29,31776.0,32
CDM,47143WE,BKBENCH PREP CADAVER DONOR,2673.0,1737.45,161.3,2673.0,14
CDM,47146WE,BKBENCH RCNSTJ LVR GRF VENOUS ANAST EA,2400.0,1560.0,247.51,2400.0,32
CDM,47147WE,BKBENCH RCNSTJ LVR GRF ARTL ANAST EA,2800.0,1820.0,288.9,2800.0,32
CDM,47300WE,MARSUPIALIZE LIVER CYST/ABSCESS,7256.0,4716.4,566.05,7256.0,35
CDM,47350WE,MGMT LVR HEMRRG SMPL SUTR LVR WND/INJ,8996.0,5847.4,700.44,8996.0,35
CDM,47360WE,MGMT LVR HEMRRG CPLX SUTR WND/INJ,12524.0,8140.6,953.64,12524.0,35
CDM,47361WE,MGMT LVR HEMRRG EXPL WND DBRDMT COAGJ/SUTR,21040.0,13676.0,1581.4,21040.0,35
CDM,47370WE,LAPS SURG ABLTJ 1/> LVR TUM RF,8320.0,5408.0,687.33,8320.0,35
CDM,47371WE,LAPS SURG ABLTJ 1 > LVR TUM CRYOSURG,8320.0,5408.0,650.93,8320.0,35
CDM,47379AGRVU1WE,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47120)",11828.0,7688.2,848.68,11828.0,15
CDM,47379AGRVUWE,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47100)",4438.0,2884.7,848.68,4438.0,15
CDM,47379RVU11WE,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47001)",817.0,531.05,408.5,1018.42,15
CDM,47379RVU12WE,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47000)",660.0,429.0,330.0,1018.42,15
CDM,47379RVU13WE,LAP LT LOBECTOMY LIVER (COMP 47125),22807.0,14824.55,848.68,22807.0,15
CDM,47379RVU14WE,LAP EXCISION LIVER CYST (COMP 47010),8342.0,5422.3,848.68,8342.0,15
CDM,47379RVU17WE,LAPAROSCOPIC PARTIAL HEPATIC LOBECTOMY W/ PARTIAL HEPATIC LOBECT,15604.0,10142.6,848.68,15604.0,15
CDM,47379RVU19WE,LAPRO DONOR HEPATECTOMY LIVING DONOR LT SEG II & III (47140),25542.0,16602.3,848.68,25542.0,15
CDM,47379RVU1WE,LAPAROSCOPIC LIVER BIOPSY (COMP 47001),760.0,494.0,380.0,1018.42,15
CDM,47379RVU20WE,LAPAROSCOPIC POSTOPERATIVE LIVER HEMORRHAGE(COMP CODE 47361),22618.0,14701.7,848.68,22618.0,15
CDM,47379RVU2WE,LAP MARSUPIALIZATION HEPATIC CYST (COMP CODE 47300),7800.0,5070.0,848.68,7800.0,15
CDM,47379RVU7WE,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47010)",5919.0,3847.35,848.68,5919.0,15
CDM,47380WE,ABLTJ OPN 1/> LVR TUM RF,9824.0,6385.6,807.3,9824.0,35
CDM,47381WE,ABLTJ OPN 1/> LVR TUM CRYOSURG,9651.0,6273.15,798.09,9651.0,35
CDM,47382WE,ABLTJ 1/> LVR TUM PRQ RF,5988.0,3892.2,480.42,8300.09,35
CDM,47383WE,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,3552.0,2308.8,367.57,12529.05,31
CDM,47384WE,ABLATION IRE LIVER 1+ TUMORS W/IMG GDN PERQ,3045.0,1979.25,457.63,3045.0,21
CDM,47399RVU1WE,DESTRUCTION/FULGURATION LIVER LESION(S) (COMP 44005),6718.0,4366.7,1135.87,6718.0,15
CDM,47399RVU4WE,FLUSHING OF LIVER IN SITU (COMP 47146),2400.0,1560.0,1135.87,2400.0,15
CDM,47420WE,CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP,9693.0,6300.45,716.16,9693.0,35
CDM,47425WE,CHOLEDOCHOT/OST W/SPHNCTROTOMY/SPHNCTROP,8924.0,5800.6,772.45,8924.0,35
CDM,47460WE,TRANSDUOL SPHINCTEROT/PLASTY W/WO RMVL CALCULUS,8208.0,5335.2,752.59,8208.0,35
CDM,47480WE,CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX,5300.0,3445.0,458.08,5300.0,35
CDM,47490WE,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,2094.0,1361.1,252.01,2094.0,35
CDM,47531WE,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,572.0,371.8,66.09,618.2,31
CDM,47532WE,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,1870.0,1215.5,166.87,1402.5,31
CDM,47533WE,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,2367.0,1538.55,236.84,2224.66,31
CDM,47534WE,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,3344.0,2173.6,314.1,2743.21,31
CDM,47535WE,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,1738.0,1129.7,180.21,1839.67,31
CDM,47536WE,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,1148.0,746.2,113.94,1351.78,31
CDM,47537WE,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,810.0,526.5,76.82,671.93,31
CDM,47538WE,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,2090.0,1358.5,217.05,7442.55,31
CDM,47539WE,PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH,3500.0,2275.0,343.93,8136.16,31
CDM,47540WE,PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH,3612.0,2347.8,405.0,8461.13,31
CDM,47541WE,PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW,2700.0,1755.0,229.62,2025.0,31
CDM,47542WE,BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT,1140.0,741.0,103.52,871.79,31
CDM,47543WE,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH SNG/MLT,1200.0,780.0,130.6,2211.23,31
CDM,47544WE,REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I,1443.0,937.95,145.51,1361.17,31
CDM,47550WE,BILIARY NDSC INTRAOPERATIVE,1208.0,785.2,123.65,1208.0,35
CDM,47552WE,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,2412.0,1567.8,200.46,2412.0,35
CDM,47553WE,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,2536.0,1648.4,210.9,2536.0,35
CDM,47554WE,BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS,3620.0,2353.0,329.19,3620.0,35
CDM,47555WE,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,3020.0,1963.0,250.22,3020.0,35
CDM,47556WE,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,3420.0,2223.0,280.42,3420.0,35
CDM,47562WE,LAPAROSCOPY SURG CHOLECYSTECTOMY,4188.0,2722.2,489.9,4188.0,35
CDM,47563WE,LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,4588.0,2982.2,550.01,4588.0,35
CDM,47564WE,LAPS SURG CHOLECSTC W/EXPL COMMON DUCT,7200.0,4680.0,639.65,7200.0,35
CDM,47570WE,LAPAROSCOPY SURG CHOLECYSTOENETEROSTOMY,5024.0,3265.6,586.67,5024.0,35
CDM,47579AGRVU1WE,"UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT (COMPARISON CODE 4",14924.0,9700.6,611.77,14924.0,15
CDM,47579RVU1WE,"UNLISTED PROC, LAP COMMON BILE DUCT EXPLORATION (COMP CODE 47420",9473.0,6157.45,611.77,9473.0,15
CDM,47579RVU3WE,UNLISTED PROC; LAP REPAIR OF COMMON BILE DUCT INJURY. (COMP TO 4,9649.0,6271.85,611.77,9649.0,15
CDM,47579RVU6WE,LAPAROSCOPIC CHOLECYSTOSTOMY TUBE PLACEMENT (COMP CODE 47480),5300.0,3445.0,611.77,5300.0,15
CDM,47600WE,CHOLECYSTECTOMY,6992.0,4544.8,528.61,6992.0,35
CDM,47605WE,CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,7392.0,4804.8,558.32,7392.0,35
CDM,47610WE,CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT,8368.0,5439.2,687.84,8368.0,35
CDM,47612WE,CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY,8484.0,5514.6,807.26,8484.0,35
CDM,47620WE,CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP,9228.0,5998.2,740.41,9228.0,35
CDM,47700WE,EXPLOR CONG ATRESIA BILE DUCTS,6600.0,4290.0,622.2,6600.0,35
CDM,47711WE,EXC BILE DUX TUM W/WO PRIM RPR XTRHEPATC,10360.0,6734.0,855.25,10360.0,35
CDM,47712WE,EXC BILE DUX TUM W/WO PRIM RPR INTRAHEPATC,13488.0,8767.2,1030.05,13488.0,35
CDM,47715WE,EXCISION OF CHOLEDOCHAL CYST,8620.0,5603.0,670.52,8620.0,35
CDM,47721WE,CHOLECYSTOENTEROSTOMY+GASTROENTERO,8635.0,5612.75,712.75,8635.0,35
CDM,47740WE,CHOLECYSTOENTEROSTOMY+ROUX-EN-Y,8492.0,5519.8,701.98,8492.0,35
CDM,47760WE,ANAST EXTRAHEP DUCT TO GI TRACT,15328.0,9963.2,1101.68,15328.0,35
CDM,47765WE,ANAST INTRAHEP DUCT TO GI TRACT,20876.0,13569.4,1486.16,20876.0,35
CDM,47780WE,"ANAST,ROUX-EN-Y,EXTRAHEP TO GI TRCT",16928.0,11003.2,1209.5,16928.0,35
CDM,47785WE,"ANAST,ROUX-EN-Y,INTRAHEP TO GI TRCT",22476.0,14609.4,1576.56,22476.0,35
CDM,47799WE,UNLISTED-JEJUN TUBE CHANGE,1069.0,694.85,534.5,1069.0,12
CDM,47800WE,RCNSTJ PLSTC BILIARY DUCTS W/END-TO-END ANAST,10468.0,6804.2,883.47,10468.0,35
CDM,47801WE,PLACEMENT CHOLEDOCHAL STENT,7040.0,4576.0,551.28,7040.0,35
CDM,47900WE,SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY,8976.0,5834.4,801.13,8976.0,35
CDM,47999FBRWE,"FOREIGN BODY RETRIEVAL, BILIARY TRACT",1051.0,683.15,525.5,1051.0,15
CDM,47999RVU2WE,BILE DUCT RECONSTRUCTION (COMP CODE 47760),16477.0,10710.05,763.14,16477.0,15
CDM,47999RVU5WE,"UNLISTED PROCEDURE, BILIARY TRACT (COMPARISON CODE 47900)",9649.0,6271.85,763.14,9649.0,15
CDM,47999RVU7WE,ERCP W/CONTROL OF BLEED (COMP CODE 44378),3019.0,1962.35,763.14,3019.0,15
CDM,47999RVU8WE,ERCP W/ SUBMUCOSAL INJECTION (TATTOOING) (COMP 43236),1028.0,668.2,514.0,1028.0,15
CDM,47999RVU9WE,RF ABLATION BILIARY TRACT (COMP CODE 47556),3079.0,2001.35,763.14,3079.0,15
CDM,48000050,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,268.0,174.2,21.15,2693.0,49
CDM,48000055,PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH,40980.0,26637.0,512.69,44585.0,49
CDM,48000060,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,268.0,174.2,21.15,2693.0,49
CDM,48000065,PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH,37755.0,24540.75,621.79,44585.0,49
CDM,48000070,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,268.0,174.2,21.15,2693.0,49
CDM,48000080,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,268.0,174.2,21.15,2693.0,49
CDM,48000085,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,56518.0,36736.7,733.03,50866.2,49
CDM,48000090,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,268.0,174.2,21.15,2693.0,49
CDM,48000100,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,268.0,174.2,21.15,2693.0,49
CDM,48000110,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,268.0,174.2,21.15,2693.0,49
CDM,48000120,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,268.0,174.2,21.15,2693.0,49
CDM,48000130,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,268.0,174.2,21.15,2693.0,49
CDM,48000145,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,378.0,245.7,21.15,2693.0,39
CDM,48000150,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,176.0,114.4,21.15,2693.0,49
CDM,48000155,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,424.0,275.6,21.15,2693.0,39
CDM,48000165,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,268.0,174.2,21.15,2693.0,49
CDM,48000170,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1738.0,1129.7,143.13,2693.0,49
CDM,48000185,REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW,268.0,174.2,21.15,2693.0,49
CDM,48000200,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,1666.0,1082.9,71.54,2693.0,39
CDM,48000210,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,750.0,487.5,35.68,2693.0,39
CDM,48000220,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3941.0,2561.65,256.93,3546.9,49
CDM,48000240,BUNDLE OF HIS RECORDING,25934.0,16857.1,1199.0,44585.0,48
CDM,48000245,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,3941.0,2561.65,284.16,3546.9,49
CDM,48000250,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,7454.0,4845.1,1199.0,44585.0,38
CDM,48000260,INDUCTION ARRHYTHMIA ELECTRICAL PACING,8725.0,5671.25,1199.0,44585.0,48
CDM,48000265,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,5663.0,3680.95,30.69,5096.7,39
CDM,48000270,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,54540.0,35451.0,1199.0,49086.0,48
CDM,48000275,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,11165.0,7257.25,115.4,10048.5,49
CDM,48000280,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,54540.0,35451.0,1199.0,49086.0,48
CDM,48000290,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,18235.0,11852.75,1199.0,44585.0,38
CDM,48000300,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,13143.0,8542.95,1199.0,44585.0,38
CDM,48000305,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,2155.0,1400.75,82.56,2693.0,49
CDM,48000310,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,12080.0,7852.0,1199.0,44585.0,38
CDM,48000315,INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS,660.0,429.0,21.15,2693.0,49
CDM,48000320,ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT,54540.0,35451.0,1199.0,49086.0,48
CDM,48000330,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,4436.0,2883.4,745.25,26432.0,38
CDM,48000335,2DTTE W CONTR LTD,2566.0,1667.9,284.16,2693.0,48
CDM,48000340,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,4923.0,3199.95,827.06,26432.0,38
CDM,48000350,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,8725.0,5671.25,412.87,26432.0,49
CDM,48000355,2D TTE W CONTR STRESS,5679.0,3691.35,284.16,5111.1,48
CDM,48000360,ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION,27614.0,17949.1,652.99,44585.0,49
CDM,48000365,STRESS ECHO W/CONTRAST,5679.0,3691.35,284.16,5111.1,48
CDM,48000390,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,3814.0,2479.1,103.01,3432.6,49
CDM,48000395,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,268.0,174.2,21.15,2693.0,49
CDM,48000405,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,268.0,174.2,21.15,2693.0,49
CDM,48000415,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,7216.0,4690.4,249.91,6494.4,39
CDM,48000WE,PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS,12780.0,8307.0,965.16,12780.0,35
CDM,48001WE,PLACE DRAIN PERIPANCREATIC W/CHOLECYSTOSTOMY,15876.0,10319.4,1196.82,15876.0,35
CDM,48008870,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,4704.0,3057.6,130.58,4233.6,49
CDM,48008880,TEMPORARY TRANSCUTANEOUS PACING,4704.0,3057.6,1.58,4233.6,49
CDM,48008890,ECHO R-T 2D W/PROBE PLACEMENT ONLY,3941.0,2561.65,14.75,3546.9,49
CDM,48008900,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1738.0,1129.7,143.13,2693.0,49
CDM,48008910,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3941.0,2561.65,256.93,3546.9,49
CDM,48008920,COMPRE EP EVAL ABLTJ 3D MAPG TX SVT,98284.0,63884.6,938.35,88455.6,49
CDM,48008930,COMPRE EP EVAL ABLTJ 3D MAPG TX VT,93506.0,60778.9,1131.28,84155.4,49
CDM,48008940,ICAR CATHETER ABLATION ARRHYTHMIA ADD ON,8596.0,5587.4,343.91,44585.0,39
CDM,48008950,COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION,87035.0,56572.75,1063.81,78331.5,49
CDM,48008960,ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN,8334.0,5417.1,343.91,44585.0,39
CDM,48008970,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,3941.0,2561.65,284.16,3546.9,49
CDM,48008980,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,3941.0,2561.65,284.16,3546.9,49
CDM,48008990,INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS,660.0,429.0,21.15,2693.0,49
CDM,48009000,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,2796.0,1817.4,284.16,2693.0,39
CDM,48009010,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,7216.0,4690.4,249.91,6494.4,39
CDM,48009020,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,3941.0,2561.65,284.16,3546.9,49
CDM,48009030,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,3941.0,2561.65,284.16,3546.9,49
CDM,48009040,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,3941.0,2561.65,218.62,3546.9,49
CDM,48009050,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,3941.0,2561.65,218.62,3546.9,49
CDM,48009060,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,3941.0,2561.65,284.16,3546.9,48
CDM,48009070,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,3941.0,2561.65,284.16,3546.9,48
CDM,48009080,ECHO TRANSESOPHAG CONGEN PROBE PLCMT ONLY,3941.0,2561.65,34.69,3546.9,49
CDM,48011995,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,4923.0,3199.95,827.06,26432.0,38
CDM,48012055,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,268.0,174.2,21.15,2693.0,49
CDM,48012415,"PREPOST- CARDIOVERSION, THROUGH DEVICE 93799",1432.0,930.8,16.03,2693.0,48
CDM,48012455,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,16678.0,10840.7,326.79,44585.0,39
CDM,48012465,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,8591.0,5584.15,284.16,7731.9,38
CDM,48012505,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,47510.0,30881.5,542.77,42759.0,49
CDM,48012515,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,22623.0,14704.95,580.64,20360.7,49
CDM,48012525,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,18214.0,11839.1,99.11,17943.69,49
CDM,48012535,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,5058.0,3287.7,97.55,4552.2,49
CDM,48012545,TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR,48283.0,31383.95,378.3,61637.3,49
CDM,48012555,INTERROG DEV EVAL WRLS CAR STIMULATOR IN PERSON,123.0,79.95,21.15,2693.0,48
CDM,48012565,PRGRMG DEVICE EVAL WRLS CAR STIMULATOR IN PERSON,186.0,120.9,21.15,2693.0,48
CDM,48012585,PRGRMG DEVICE EVAL IIMS IN PERSON,186.0,120.9,21.15,2693.0,48
CDM,48012595,INTERROGATION DEVICE EVAL IIMS IN PERSON,186.0,120.9,21.15,2693.0,48
CDM,48012615,REM INTERROG ICPMS <30 D PHYS/QHP,268.0,174.2,23.85,2693.0,49
CDM,48012805,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,26158.0,17002.7,397.64,23542.2,49
CDM,48012885,PROCAINAMIDE INFUSION CHALLENGE,4779.0,3106.35,16.03,4301.1,48
CDM,48012905,CAR FCL ABLTJ RADJ ARRHYT DLVR RADJ THER,68981.0,44837.65,1190.0,62082.9,38
CDM,48012915,CAR FCL ABLTJ RADJ ARRHYT N-INVAS LOCLZJ & MAPG,68981.0,44837.65,1190.0,62082.9,38
CDM,48012925,CAR FCL ABLTJ RADJ ARRHYT CONV LOCLZJ & MAPG,68981.0,44837.65,1190.0,62082.9,38
CDM,48012935,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,36216.0,23540.4,1190.0,41349.42,48
CDM,48013035,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,186.0,120.9,21.15,2693.0,48
CDM,48013045,TCAT INSJ PERM 1CHMBR LDLS PACEMAKER R ATRIAL,28428.0,18478.2,1190.0,41349.42,48
CDM,48013055,TCAT RMVL PERM 1CHMBR LDLS PACEMAKER R ATRIAL,15738.0,10229.7,1190.0,14164.2,48
CDM,48013065,TCAT RMVL&RPLCMT PERM 1CHMBR LDLS PM R ATRIAL,28428.0,18478.2,1190.0,41349.42,48
CDM,48013075,TRANSCATHETER RENAL SYMPATH DENERVATION UNILAT,28508.0,18530.2,1190.0,25657.2,48
CDM,48013085,TRANSCATHETER RENAL SYMPATH DENERVATION BILAT,16224.0,10545.6,1190.0,14601.6,48
CDM,48013095,REM INTERROG SCRMS <30 D PHYS/QHP,268.0,174.2,23.85,2693.0,49
CDM,48013175,REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D,268.0,174.2,23.85,2693.0,49
CDM,48013195,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP W/,1134.0,737.1,21.15,2693.0,42
CDM,48013205,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP WO,1134.0,737.1,21.15,2693.0,42
CDM,48020WE,REMOVAL OF PANCREATIC STONE,7636.0,4963.4,589.45,7636.0,35
CDM,48100010,PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY,4776.0,3104.4,107.91,37851.0,39
CDM,48100040,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,6328.0,4113.2,136.83,37851.0,38
CDM,48100050,ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,4881.0,3172.65,136.83,37851.0,38
CDM,48100140,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,11165.0,7257.25,115.4,37851.0,49
CDM,48100160,ENDOMYOCARDIAL BIOPSY,22623.0,14704.95,902.85,37851.0,49
CDM,48100185,RMVL TUN CVC W/O SUBQ PORT/PMP,4444.0,2888.6,164.43,37851.0,49
CDM,48100245,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,50080.0,32552.0,520.77,45072.0,49
CDM,48100255,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,46168.0,30009.2,363.36,44585.0,49
CDM,48100305,PRQ BALLOON VALVULOPLASTY AORTIC VALVE,26199.0,17029.35,1519.68,44585.0,49
CDM,48100310,INTRA-ATRIAL RECORDING,54540.0,35451.0,2932.0,49086.0,48
CDM,48100315,PRQ BALLOON VALVULOPLASTY MITRAL VALVE,45019.0,29262.35,1569.43,44585.0,49
CDM,48100320,RIGHT VENTRICULAR RECORDING,8725.0,5671.25,1218.58,44585.0,48
CDM,48100330,INTRA-ATRIAL PACING,54540.0,35451.0,1199.0,49086.0,48
CDM,48100340,INTRAVENTRICULAR PACING,54540.0,35451.0,2932.0,49086.0,48
CDM,48100350,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,16678.0,10840.7,326.79,44585.0,39
CDM,48100370,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,8591.0,5584.15,284.16,37851.0,38
CDM,48100375,PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL,81510.0,52981.5,733.75,73359.0,49
CDM,48100385,PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL,7243.0,4707.95,365.77,44585.0,39
CDM,48100395,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU,3539.0,2300.35,103.01,37851.0,39
CDM,48100585,PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT,42320.0,27508.0,1116.27,39131.0,49
CDM,48100595,PRQ TCAT CLSR CGEN VENTR SEPTAL DFCT W/IMPLT,52800.0,34320.0,1511.8,47520.0,49
CDM,48100650,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,23118.0,15026.7,1223.92,37851.0,49
CDM,48100655,PERC DES W/ ANGIO SINGLE MAJOR,52061.0,33839.65,5298.24,46854.9,48
CDM,48100660,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,23118.0,15026.7,1223.05,37851.0,49
CDM,48100665,PERC DES W/ANGIO ADDTL BRANCH,23253.0,15114.45,521.0,44585.0,38
CDM,48100670,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,23118.0,15026.7,1513.2,37851.0,49
CDM,48100675,PERC DES/ATHER/ANGIO 1 MAJ ART,55871.0,36316.15,5298.24,50283.9,48
CDM,48100680,CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I,23118.0,15026.7,1224.45,37851.0,49
CDM,48100685,PERC DES/ ATHER/ANGIO ADDTL BR,18221.0,11843.65,521.0,44585.0,38
CDM,48100690,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,23118.0,15026.7,1361.94,37851.0,49
CDM,48100695,PERC DES REVASC CABG 1 VSL,53235.0,34602.75,5298.24,47911.5,48
CDM,48100700,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,23118.0,15026.7,1513.2,37851.0,49
CDM,48100705,PERC DES  REVASC CABG ADDTL BR,23253.0,15114.45,521.0,44585.0,38
CDM,48100710,CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I,23118.0,15026.7,1513.2,37851.0,49
CDM,48100715,PERC DES REVASC W/AMI 1 VSL,41313.0,26853.45,2932.0,44585.0,38
CDM,48100720,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,23118.0,15026.7,1402.59,37851.0,49
CDM,48100725,PERC DES REVASC CTO SINGLE VSL,64068.0,41644.2,5298.24,57661.2,48
CDM,48100730,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,23118.0,15026.7,1504.36,37851.0,49
CDM,48100740,R & L HRT CATH WINJX HRT ART& L VENTR IMG,23118.0,15026.7,1513.2,37851.0,49
CDM,48100750,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,23118.0,15026.7,1513.2,37851.0,49
CDM,48100760,LEFT HEART CATH BY TRANSEPTAL PUNCTURE,11866.0,7712.9,233.45,37851.0,39
CDM,48100770,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,5663.0,3680.95,30.69,37851.0,39
CDM,48100820,NJX SEL HRT ART CONGENITAL HRT CATH W/S&I,6676.0,4339.4,60.56,37851.0,39
CDM,48100830,NJX SEL HRT ART/GRFT CONGENITAL HRT CATH W/S&I,6990.0,4543.5,62.92,37851.0,39
CDM,48100840,NJX SEL L VENT/ATRIAL ANGIO HRT CATH W/S&I,5283.0,3433.95,30.86,37851.0,39
CDM,48100850,NJX SEL R VENT/ATRIAL ANGIO HRT CATH W/S&I,5035.0,3272.75,30.47,37851.0,39
CDM,48100860,NJX SUPRAVALV AORTOG HRT CATH W/S&I,5733.0,3726.45,42.89,37851.0,39
CDM,48100870,NJX DRG C-CATHJ NSLCTV P-ART ANGIOGRAPHY,5674.0,3688.1,54.02,37851.0,39
CDM,48100WE,OPEN BIOPSY OF PANCREAS,5784.0,3759.6,448.46,5784.0,35
CDM,48101015,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,5656.0,3676.4,297.53,37851.0,39
CDM,48101035,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,22623.0,14704.95,106.52,37851.0,49
CDM,48101075,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,22623.0,14704.95,359.58,37851.0,49
CDM,48101085,PERCUTAN TRANSCATH CLOSURE PAT DUCT ARTERIOSUS,64106.0,41668.9,755.73,57695.4,49
CDM,48101125,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,73334.0,47667.1,570.49,66000.6,49
CDM,48101130,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,5781.0,3757.65,390.0,37851.0,38
CDM,48101140,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,5938.0,3859.7,390.0,37851.0,38
CDM,48101150,PRQ CARD ANGIOPLAST 1 ART LC,40980.0,26637.0,512.69,44585.0,49
CDM,48101160,PRQ CARD ANGIOPLAST 1 ART LD,40980.0,26637.0,512.69,44585.0,49
CDM,48101170,PRQ CARD ANGIOPLAST 1 ART LM,40980.0,26637.0,512.69,44585.0,49
CDM,48101180,PRQ CARD ANGIOPLAST 1 ART RC,40980.0,26637.0,512.69,44585.0,49
CDM,48101190,PRQ CARD ANGIOPLAST 1 ART RI,40980.0,26637.0,512.69,44585.0,49
CDM,48101210,PRQ CARD ANGIO/ATHREC 1 ART LC,37755.0,24540.75,621.79,44585.0,49
CDM,48101220,PRQ CARD ANGIO/ATHREC 1 ART LD,37755.0,24540.75,621.79,44585.0,49
CDM,48101230,PRQ CARD ANGIO/ATHREC 1 ART LM,37755.0,24540.75,621.79,44585.0,49
CDM,48101240,PRQ CARD ANGIO/ATHREC 1 ART RC,37755.0,24540.75,621.79,44585.0,49
CDM,48101250,PRQ CARD ANGIO/ATHREC 1 ART RI,37755.0,24540.75,621.79,44585.0,49
CDM,48101310,PRQ PLC BM STNT W/ANG 1 VSL LC,52851.0,34353.15,614.16,47565.9,49
CDM,48101350,PRQ PLC BM STNT W/ANG 1 VSL RI,52851.0,34353.15,614.16,47565.9,49
CDM,48101410,PRQ PLC BM STENT/ATH/ANGIO LC,56518.0,36736.7,733.03,50866.2,49
CDM,48101420,PRQ PLC BM STENT/ATH/ANGIO LD,56518.0,36736.7,733.03,50866.2,49
CDM,48101430,PRQ PLC BM STENT/ATH/ANGIO LM,56518.0,36736.7,733.03,50866.2,49
CDM,48101440,PRQ PLC BM STENT/ATH/ANGIO RC,56518.0,36736.7,733.03,50866.2,49
CDM,48101450,PRQ PLC BM STENT/ATH/ANGIO RI,56518.0,36736.7,733.03,50866.2,49
CDM,48101510,PRQ BM REVASC CABG 1 VSL,55843.0,36297.95,693.62,50258.7,49
CDM,48101530,PRQ BM REVASC CAGB 1 VSL LM,55843.0,36297.95,693.62,50258.7,49
CDM,48101550,PRQ BM REVASC CABG 1 VSL RI,55843.0,36297.95,693.62,50258.7,49
CDM,48101620,PRQ BM REVASC W/AMI 1 VSL LD,41313.0,26853.45,780.97,44585.0,39
CDM,48101630,PRQ BM REVASC W/AMI 1 VSL LM,41313.0,26853.45,780.97,44585.0,39
CDM,48101640,PRQ BM REVASC W/AMI 1 VSL RC,41313.0,26853.45,780.97,44585.0,39
CDM,48101650,PRQ BM REVASC W/AMI 1 VSL RI,41313.0,26853.45,780.97,44585.0,39
CDM,48101670,PRQ BM REVASC CTO 1 VSL LD,47928.0,31153.2,840.03,44585.0,49
CDM,48101680,PRQ BM REVASC CTO 1 VSL LM,47928.0,31153.2,840.03,44585.0,49
CDM,48101700,PRQ BM REVASC CTO 1 VSL RI,47928.0,31153.2,840.03,44585.0,49
CDM,48101900,PRQ PLC DES/ATH/ANGIO 1 ART RI,56518.0,36736.7,733.03,50866.2,49
CDM,48102150,PRQ DES REVASC CTO 1 VSL RI,47928.0,31153.2,840.03,44585.0,49
CDM,48102210,EXERCISE W/HEMODYNAMIC MEAS,3539.0,2300.35,103.01,37851.0,39
CDM,48102240,PTCA AORTIC VALVE,26199.0,17029.35,1519.68,44585.0,49
CDM,48102250,PTCA MITRAL VALVE,45019.0,29262.35,1569.43,44585.0,49
CDM,48102260,CLSR ASD TX CATH W IMP,42320.0,27508.0,1116.27,39131.0,49
CDM,48102325,"CARDIOVERSION, INTERNAL",4704.0,3057.6,282.29,37851.0,49
CDM,48102365,PRQ CARDIAC ANGIOPLAST 1 ART,40980.0,26637.0,512.69,44585.0,49
CDM,48102385,PRQ CARDIAC ANGIO/ARTHRECT 1 ART,37755.0,24540.75,621.79,44585.0,49
CDM,48102405,PRQ CARDIAC STENT W/ANGIO 1 VSL,52851.0,34353.15,614.16,47565.9,49
CDM,48102445,PRQ CARD REVASC MI 1 VSL,41313.0,26853.45,780.97,44585.0,39
CDM,48102455,PRQ DES REVASC CHRONIC 1VSL,47928.0,31153.2,840.03,44585.0,49
CDM,48102485,PERQ TRANSCATH CLS PARAVALVR LEAK 1 MITRAL VALVE,76729.0,49873.85,1286.52,69056.1,49
CDM,48102495,PERQ TRANSCATH CLS PARAVALVR LEAK 1 AORTIC VALVE,81633.0,53061.45,1062.89,73469.7,49
CDM,48102505,PERQ TRANSCATH CLS PARAVALVR LEAK EACH OCCLS DEV,4218.0,2741.7,390.0,37851.0,39
CDM,48102515,INSJ/RPLC CAR MODULJ SYS PLS GEN TRANSVNS ELTRD,36165.0,23507.25,4706.22,70939.0,48
CDM,48102565,REMOVAL CARDIAC MODULJ SYS TRANSVENOUS ELECTRODE,18196.0,11827.4,916.39,37851.0,48
CDM,48102685,INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY,9876.0,6419.4,414.73,37851.0,39
CDM,48102715,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,3923.0,2549.95,297.94,46695.0,39
CDM,48102765,PERC DES REVASC CTO ADDTL VESSEL,41313.0,26853.45,521.0,44585.0,38
CDM,48102805,PERCUTANEOUS TRANSCATHETER SEPTAL REDUCTION THER,7276.0,4729.4,847.21,37851.0,39
CDM,48102WE,BIOPSY PANCREA PERCUTANEOUS NEEDLE,1880.0,1222.0,199.06,1410.0,35
CDM,48103055,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,1734.0,1127.1,39.41,46695.0,39
CDM,48103155,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,11165.0,7257.25,270.56,37851.0,49
CDM,48103165,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,6766.0,4397.9,283.81,37851.0,39
CDM,48103175,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,6643.0,4317.95,332.3,37851.0,39
CDM,48103185,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,6643.0,4317.95,250.29,37851.0,39
CDM,48103305,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,32059.0,20838.35,590.0,39131.0,49
CDM,48103315,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,22623.0,14704.95,353.58,37851.0,49
CDM,48103355,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,26869.0,17464.85,386.45,37851.0,49
CDM,48103365,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,33420.0,21723.0,403.75,37851.0,49
CDM,48103375,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,53705.0,34908.25,422.66,48334.5,49
CDM,48103395,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,26158.0,17002.7,551.48,37851.0,49
CDM,48103405,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,26158.0,17002.7,726.96,37851.0,49
CDM,48103445,RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD,52578.0,34175.7,422.44,76175.0,49
CDM,48103895,R HRT CATH CHD W/IMG CATH TRGT ZONE NML NT CONNJ,23118.0,15026.7,1513.2,37851.0,48
CDM,48103905,R HRT CATH CHD W/IMG CATH TRGT ZON ABNL NT CONNJ,23118.0,15026.7,1513.2,37851.0,48
CDM,48103915,L HRT CATH CHD IMG CATH TRGT ZON NML/ABNL NT CNJ,23118.0,15026.7,1513.2,37851.0,48
CDM,48103925,R&L HRT CATH CHD IMG CATH TRGT ZONE NML NT CONNJ,23118.0,15026.7,1513.2,37851.0,48
CDM,48103935,R&L HRT CATH CHD IMG CATH TRGT ZON ABNL NT CONNJ,23118.0,15026.7,1513.2,37851.0,48
CDM,48103945,CAR OUTP MEAS DRG CAR CATH EVAL CGEN HRT DEFECT,841.0,546.65,141.29,37851.0,38
CDM,48103985,TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,3918.0,2546.7,153.57,37851.0,39
CDM,48103995,TCAT RMVL/DEBULK ICAR MASS SUCTION DEVICE PERQ,28508.0,18530.2,3519.0,37851.0,48
CDM,48104015,ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG,8725.0,5671.25,1218.58,44585.0,48
CDM,48104025,EVASC ST RPR COARCJ THRC/AA ACRS MAJ SIDE BRNCH,6399.0,4159.35,1075.03,37851.0,39
CDM,48104035,EVASC ST RPR COARCJ THRC/AA XCRSG MAJ SIDE BRNCH,28474.0,18508.1,892.74,37851.0,39
CDM,48104045,PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECR COA,8410.0,5466.5,663.5,37851.0,39
CDM,48104055,REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH,28206.0,18333.9,1604.66,37851.0,39
CDM,48104105,"TRANSCATHETER TRICUSPID VALVE REPAIR,PERCUTANEOUS APPROACH; INIT",21259.0,13818.35,1940.0,37851.0,38
CDM,48104125,CARDIOVASCULAR PROCEDURE,1432.0,930.8,16.03,37851.0,48
CDM,48104175,IVL W/ANGIOPLASTY,81510.0,52981.5,2345.0,73359.0,48
CDM,48104185,IVL & STENT W/ANGIOPLASTY,46639.0,30315.35,2345.0,41975.1,48
CDM,48104195,IVL & ATHERECTOMY W/ANGIOPLASTY,129064.0,83891.6,2772.0,116157.6,48
CDM,48104205,IVL STENT  ATHERECTOMY W/ANGIOPLASTY,43076.0,27999.4,2772.0,38933.13,48
CDM,48104225,INSJ PERQ VAD W/RS&I L HRT ARTERIAL&VEN ACCESS,11880.0,7722.0,548.73,37851.0,39
CDM,48104275,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY BI,21486.0,13965.9,75.85,37851.0,39
CDM,48104285,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY UNI,16128.0,10483.2,45.86,37851.0,39
CDM,48104315,NJX DRG C-CATHJ SLCTV PULM VEN ANGIOGRAPHY,1709.0,1110.85,83.84,37851.0,39
CDM,48104325,NJX DRG C-CATHJ SLCTV PULM ANGRPH MAPCA CHD EA,5779.0,3756.35,111.79,37851.0,39
CDM,48104335,SUBCLAVIAN TRANS-CAROTID TAVR,21984.0,14289.6,620.6,37851.0,48
CDM,48104475,VENOGRAPHY CHD AZYGOS/HEMIAZYGOS VENOUS SYSTEM,74426.0,48376.9,65.79,66983.4,36
CDM,48104485,VENOGRAPHY CHD CORONARY SINUS,74426.0,48376.9,84.6,66983.4,36
CDM,48104495,VENOGRAPHY CHD VENOVENOUS COLTRL AT/ABOVE HRT,74426.0,48376.9,123.07,66983.4,36
CDM,48104505,VENOGRAPHY CHD VENOVENOUS COLLATERAL BELOW HEART,74426.0,48376.9,124.1,66983.4,36
CDM,48104515,PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY,6328.0,4113.2,173.78,37851.0,36
CDM,48104525,VENOGRAPHY CHD ANOMALOUS/PERSISTENT SVC NT DRG,74426.0,48376.9,69.76,66983.4,36
CDM,48104615,RMVL 1/DUAL CHAMBER DEFIB ELECTRODE BY THORACOM,13093.0,8510.45,1673.99,37851.0,39
CDM,48104625,"STAND ALONE IVUS, ADD'L VESSEL (COMP TO 92979)",1206.0,783.9,16.03,37851.0,48
CDM,48104635,IABP REPOSITION (COMP CODE 33993),3343.0,2172.95,620.6,37851.0,48
CDM,48104705,PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART PERQ TCAT THER,28508.0,18530.2,3519.0,37851.0,45
CDM,48104715,PERQ TCAT THER RX DLVR NTRAC RX BALO SEPARATE,15658.0,10177.7,1810.0,37851.0,35
CDM,48104725,INSERTION OF ENDOVASCULAR IVC FLOW REGULATOR DEVICE (COMP CODE 3,35343.0,22972.95,620.6,37851.0,48
CDM,48104755,CEREBRAL PROTECTION (COMP CODE 33370),3628.0,2358.2,16.03,37851.0,48
CDM,48104765,PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS,161535.0,104997.75,718.72,145381.5,39
CDM,48104775,PERQ TRLUML REVSC CHRNC TOT OCCLS 1 ANTGRD&RTRGR,101725.0,66121.25,898.59,91552.5,39
CDM,48104785,REVSC EVASC FPVT ANGIOP UNI CPLX LES EA ADDL VSL,41794.0,27166.1,242.37,37851.0,36
CDM,48104795,REVSC EVASC FPVT ST PLMT UNI SF LES 1ST VSL,84771.0,55101.15,534.39,76293.9,39
CDM,48104805,REVSC EVASC FPVT ST PLMT UNI SF LES EA ADDL VSL,84771.0,55101.15,226.21,76293.9,36
CDM,48104815,REVSC EVASC FPVT ST PLMT UNI CPLX LES 1ST VSL,84771.0,55101.15,898.43,76293.9,39
CDM,48104825,REVSC EVASC FPVT ST PLMT UNI CPLX LES EA ADD VSL,84771.0,55101.15,303.49,76293.9,36
CDM,48104835,REVSC EVASC FPVT ATHRC UNI SF LES 1ST VSL,134613.0,87498.45,550.71,121151.7,39
CDM,48104845,REVSC EVASC FPVT ATHRC UNI SF LES EA ADDL VSL,134613.0,87498.45,243.07,121151.7,36
CDM,48104855,REVSC EVASC FPVT ATHRC UNI CPLX LES 1ST VSL,134613.0,87498.45,771.35,121151.7,39
CDM,48104865,REVSC EVASC FPVT ATHRC UNI CPLX LES EA ADDL VSL,134613.0,87498.45,334.62,121151.7,36
CDM,48104875,REVSC EVASC FPVT ST ATHRC UNI SF LES 1ST VSL,134613.0,87498.45,670.19,121151.7,39
CDM,48104885,REVSC EVASC FPVT ST ATHRC UNI SF LES EA ADDL VSL,134613.0,87498.45,257.69,121151.7,36
CDM,48104895,REVSC EVASC FPVT ST ATHRC UNI CPLX LES 1ST VSL,134613.0,87498.45,911.98,121151.7,39
CDM,48104905,REVSC EVSC FPVT ST ATHRC UNI CPLX LES EA ADD VSL,134613.0,87498.45,363.06,121151.7,36
CDM,48104925,REVSC EVASC TPVT ANGIOP UNI SF LES 1ST VSL,84771.0,55101.15,596.77,76293.9,39
CDM,48104935,REVSC EVASC TPVT ANGIOP UNI SF LES EA ADDL VSL,84771.0,55101.15,180.88,76293.9,36
CDM,48104945,REVSC EVASC TPVT ANGIOP UNI CPLX LES 1ST VSL,84771.0,55101.15,748.84,76293.9,39
CDM,48104955,REVSC EVASC TPVT ANGIOP UNI CPLX LES EA ADDL VSL,84771.0,55101.15,257.26,76293.9,36
CDM,48104965,REVSC EVASC TPVT ST PLMT UNI SF LES 1ST VSL,134613.0,87498.45,615.33,121151.7,39
CDM,48104975,REVSC EVASC TPVT ST PLMT UNI SF LES EA ADDL VSL,134613.0,87498.45,204.15,121151.7,36
CDM,48104985,REVSC EVASC TPVT ST PLMT UNI CPLX LES 1ST VSL,134613.0,87498.45,826.07,121151.7,39
CDM,48104995,REVSC EVASC TPVT ST PLMT UNI CPLX LES EA ADD VSL,134613.0,87498.45,306.36,121151.7,36
CDM,48105005,REVSC EVASC TPVT ATHRC UNI SF LES 1ST VSL,134613.0,87498.45,820.48,121151.7,39
CDM,48105015,REVSC EVASC TPVT ATHRC UNI SF LES EA ADDL VSL,134613.0,87498.45,288.81,121151.7,36
CDM,48105025,REVSC EVASC TPVT ATHRC UNI CPLX LES 1ST VSL,134613.0,87498.45,1032.34,121151.7,39
CDM,48105035,REVSC EVASC TPVT ATHRC UNI CPLX LES EA ADDL VSL,134613.0,87498.45,394.73,121151.7,36
CDM,48105045,REVSC EVASC TPVT ST ATHRC UNI SF LES 1ST VSL,134613.0,87498.45,915.6,121151.7,39
CDM,48105055,REVSC EVASC TPVT ST ATHRC UNI SF LES EA ADDL VSL,134613.0,87498.45,401.13,121151.7,36
CDM,48105065,REVSC EVASC TPVT ST ATHRC UNI CPLX LES 1ST VSL,134613.0,87498.45,1097.72,121151.7,39
CDM,48105075,REVSC EVSC TPVT ST ATHRC UNI CPLX LES EA ADD VSL,134613.0,87498.45,504.63,121151.7,36
CDM,48105085,REVSC EVASC IMVT ANGIOP UNI SF LES 1ST VSL,84771.0,55101.15,669.13,76293.9,39
CDM,48105095,REVSC EVASC IMVT ANGIOP UNI SF LES EA ADDL VSL,84771.0,55101.15,241.42,76293.9,36
CDM,48105105,REVSC EVASC IMVT ANGIOP UNI CPLX LES 1ST VSL,84771.0,55101.15,829.64,76293.9,39
CDM,48105115,REVSC EVASC IMVT ANGIOP UNI CPLX LES EA ADDL VSL,84771.0,55101.15,301.39,76293.9,36
CDM,48105125,REVSC EVASC IVT ANGIOP UNI SF LES 1ST VSL,41794.0,27166.1,447.24,37851.0,39
CDM,48105135,REVSC EVASC IVT ANGIOP UNI SF LES EA ADDL VSL,41794.0,27166.1,181.47,37851.0,36
CDM,48105145,REVSC EVASC IVT ANGIOP UNI CPLX LES 1ST VSL,41794.0,27166.1,656.18,37851.0,39
CDM,48105155,REVSC EVASC IVT ANGIOP UNI CPLX LES EA ADDL VSL,41794.0,27166.1,235.04,37851.0,36
CDM,48105165,REVSC EVASC IVT ST PLMT UNI SF LES 1ST VSL,84771.0,55101.15,534.02,76293.9,39
CDM,48105175,REVSC EVASC IVT ST PLMT UNI SF LES EA ADDL VSL,84771.0,55101.15,241.48,76293.9,36
CDM,48105185,REVSC EVASC IVT ST PLMT UNI CPLX LES 1ST VSL,84771.0,55101.15,772.56,76293.9,39
CDM,48105195,REVSC EVASC IVT ST PLMT UNI CPLX LES EA ADDL VSL,84771.0,55101.15,256.62,76293.9,36
CDM,48105215,REVSC EVASC FPVT ANGIOP UNI SF LES 1ST VSL,41794.0,27166.1,474.19,37851.0,39
CDM,48105225,REVSC EVASC FPVT ANGIOP UNI SF LES EA ADDL VSL,41794.0,27166.1,182.0,37851.0,36
CDM,48105235,REVSC EVASC FPVT ANGIOP UNI CPLX LES 1ST VSL,41794.0,27166.1,641.62,37851.0,39
CDM,48105265,INITIAL OPEN IMPLANTATION BAT MODULATION SYSTEM,225003.0,146251.95,728.98,202502.7,39
CDM,48105275,REVISION/RPLCMT BAT MODULATION SYSTEM LEAD ONLY,17859.0,11608.35,830.08,37851.0,39
CDM,48105285,REVISION/RPLCMT BAT MODULATION SYSTEM PG ONLY,39408.0,25615.2,553.47,37851.0,39
CDM,48105295,VESSEL EXPLORATION AND REMOVAL OF FOREIGN OBJECT,22623.0,14704.95,620.6,37851.0,48
CDM,48105WE,RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS,19704.0,12807.6,1559.0,19704.0,35
CDM,48120WE,EXCISION OF PANCREAS LESION,7364.0,4786.6,654.19,7364.0,35
CDM,48140WE,PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY,10528.0,6843.2,924.31,10528.0,35
CDM,48145WE,PNCRTECT DSTL STOT W/PNCRTCOJEJUNOSTOMY,10956.0,7121.4,1008.81,10956.0,35
CDM,48148WE,EXCISION AMPULLA VATER,8156.0,5301.4,656.84,8156.0,35
CDM,48150WE,PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY,21136.0,13738.4,1806.07,21136.0,35
CDM,48152WE,PNCRTECT WHIPPLE W/O PANCREATOJEJUNOSTOMY,19460.0,12649.0,1705.88,19460.0,35
CDM,48153WE,PNCRTECT W/PANCREATOJEJUNOSTOMY,21116.0,13725.4,1802.7,21116.0,35
CDM,48154WE,PNCRTECT PROX STOT W/O PANCREATOJEJUNOSTOMY,19552.0,12708.8,1706.36,19552.0,35
CDM,48155WE,PANCREATECTOMY TOTAL,11780.0,7657.0,1158.04,11780.0,35
CDM,48160WE,PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS,13636.0,8863.4,6336.68,13636.0,13
CDM,48200010,CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,2239.0,1455.35,57.42,2693.0,49
CDM,48300010,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,1738.0,1129.7,193.04,2693.0,49
CDM,48300015,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,3941.0,2561.65,284.16,3546.9,49
CDM,48300020,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,3941.0,2561.65,284.16,3546.9,49
CDM,48300025,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,3941.0,2561.65,218.62,3546.9,49
CDM,48300030,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,1333.0,866.45,34.42,2693.0,39
CDM,48300035,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1738.0,1129.7,143.13,2693.0,49
CDM,48300040,ECHO TTHRC R-T 2D M-MODE COMPL SPEC&COLR D W/O CONTRAST,3941.0,2561.65,273.49,3546.9,49
CDM,48300045,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,3941.0,2561.65,284.16,3546.9,48
CDM,48300050,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,3941.0,2561.65,273.49,3546.9,49
CDM,48300060,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,3941.0,2561.65,284.16,3546.9,49
CDM,48300065,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,3941.0,2561.65,284.16,3546.9,48
CDM,48300070,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,1666.0,1082.9,71.54,2693.0,39
CDM,48300075,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,750.0,487.5,35.68,2693.0,39
CDM,48300080,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3941.0,2561.65,256.93,3546.9,49
CDM,48300090,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,5060.0,3289.0,272.61,4554.0,39
CDM,48300095,"TTE W/DOPPLER, COMPLETE W/CONT",5679.0,3691.35,284.16,5111.1,48
CDM,48300100,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,5060.0,3289.0,272.61,4554.0,39
CDM,48300105,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,5060.0,3289.0,272.61,4554.0,39
CDM,48300215,TEE W/CONTRAST 2D,5679.0,3691.35,284.16,5111.1,48
CDM,48300225,TEE W/CONTRAST CONGENITAL ANOMALIES,5679.0,3691.35,284.16,5111.1,48
CDM,48300235,TTE CONGENITAL ANOMALIES W/CONTRAST,5679.0,3691.35,284.16,5111.1,48
CDM,48300245,"TTE CONGENITAL ANOMALIES, LIMITED W/CONTRAST",5679.0,3691.35,284.16,5111.1,48
CDM,48300295,2D TTE W CONTR STRESS,5679.0,3691.35,284.16,5111.1,48
CDM,48300305,MYOCRD STRAIN IMG SPECKLE TRCK ASSMT MYOCRD MECH,86.0,55.9,14.08,2693.0,39
CDM,48300315,HOSPITAL MYOCRD STRAIN,86.0,55.9,14.08,2693.0,39
CDM,48300325,3D ECHO IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,648.0,421.2,29.34,2693.0,39
CDM,48400WE,INJECTION INTRAOPERATIVE PANCREATOGRAPHY,858.0,557.7,78.67,858.0,35
CDM,48510WE,EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN,6876.0,4469.4,560.72,6876.0,35
CDM,48520WE,INT ANAST PANCREATIC CYST GI TRACT DIRECT,7260.0,4719.0,686.58,7260.0,35
CDM,48540WE,INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y,8776.0,5704.4,823.57,8776.0,35
CDM,48545WE,PANCREATORRHAPHY INJURY,8892.0,5779.8,672.43,8892.0,35
CDM,48548WE,PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST,11236.0,7303.4,908.16,11236.0,35
CDM,48999RVU10WE,PANCREAS STONE SHOCK WAVE LITHOTRIPSY (COMP 50590),4201.0,2730.65,1120.55,4201.0,15
CDM,48999RVU12WE,UNLISTED PROC; ENDOSCOPIC DEBRIDEMENT OF PANCREATIC PSEUDOCYST (,2860.0,1859.0,1120.55,2860.0,15
CDM,48999RVU14WE,LAP PANCREAS DEBRIDEMENT (COMP 48105),16256.0,10566.4,1120.55,16256.0,15
CDM,48999RVU15WE,LAP ENUCLEATION PANCREAS LESION (COMP 48120),6075.0,3948.75,1120.55,6075.0,15
CDM,48999RVU18WE,UNLISTED PROC; DUNKING PANCREATIC JEJUNAL ANASTOMOSIS (COMP CODE,6180.0,4017.0,1120.55,6180.0,15
CDM,48999RVU19WE,LAPAROSCOPIC PYLORUS PRESERVING PANCREATICODUODENECTOMY (COMP CO,22699.0,14754.35,1120.55,22699.0,15
CDM,48999RVU2WE,LAP REMOVAL PANCREAS W/OR W/O SPLENECTOM (COMP CODE 48140),10528.0,6843.2,1120.55,10528.0,15
CDM,48999RVU4WE,LAPAROSCOPIC WHIPPLE,21776.0,14154.4,1120.55,21776.0,15
CDM,48999RVU5WE,UNLISTED LAP DEBRIDEMENT OF PANCREATIC CYST (COMP CODE 48105),15817.0,10281.05,1120.55,15817.0,15
CDM,48999RVUWE,EGD-PSEUDOCYST NECROSECTOMY (COMP 48105),19704.0,12807.6,1120.55,19704.0,15
CDM,49000070,INJECTION PEYRONIE DISEASE,1399.0,909.35,53.02,4151.0,46
CDM,49000WE,EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX,5016.0,3260.4,502.61,5016.0,35
CDM,49002WE,REOPENING RECENT LAPAROTOMY,7052.0,4583.8,510.57,7052.0,35
CDM,49005165,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,19831.0,12890.15,461.62,26432.0,49
CDM,49005175,FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL,1271.0,826.15,49.68,26432.0,38
CDM,49005185,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,4046.0,2629.9,86.76,26432.0,49
CDM,49005195,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,1178.0,765.7,59.99,26432.0,38
CDM,49005205,FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION,4046.0,2629.9,109.5,26432.0,49
CDM,49005215,FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL,906.0,588.9,66.22,26432.0,38
CDM,49005225,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,4046.0,2629.9,131.08,26432.0,49
CDM,49005235,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,1839.0,1195.35,92.56,26432.0,38
CDM,49005245,FINE NEEDLE ASPIRATION BX W/MR GDN 1ST LESION,4046.0,2629.9,409.06,26432.0,48
CDM,49005255,FINE NEEDLE ASPIRATION BX W/MR GDN EA ADDL,1820.0,1183.0,305.76,26432.0,37
CDM,49005265,TANGENTIAL BIOPSY SKIN SINGLE LESION,745.0,484.25,41.49,26432.0,49
CDM,49005275,TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,199.0,129.35,24.25,26432.0,38
CDM,49005285,PUNCH BIOPSY SKIN SINGLE LESION,1499.0,974.35,52.3,26432.0,49
CDM,49005295,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,230.0,149.5,28.8,26432.0,38
CDM,49005305,INCISIONAL BIOPSY SKIN SINGLE LESION,2295.0,1491.75,63.47,26432.0,48
CDM,49005315,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,354.0,230.1,34.35,26432.0,38
CDM,49005325,PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG,19831.0,12890.15,183.86,26432.0,42
CDM,49005335,PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS,19831.0,12890.15,306.56,26432.0,42
CDM,49005425,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,19146.0,12444.9,816.59,26432.0,40
CDM,49005545,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,141.0,91.65,17.96,26432.0,49
CDM,49005555,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,141.0,91.65,17.96,26432.0,49
CDM,49005625,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,11165.0,7257.25,270.56,26432.0,49
CDM,49005645,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,5973.0,3882.45,102.71,26432.0,49
CDM,49005655,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,5973.0,3882.45,125.3,26432.0,49
CDM,49005665,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,5973.0,3882.45,99.18,26432.0,49
CDM,49005675,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,5973.0,3882.45,100.09,26432.0,49
CDM,49005685,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,16843.0,10947.95,178.82,26432.0,49
CDM,49005725,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,12580.0,8177.0,859.52,26432.0,40
CDM,49005735,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,12580.0,8177.0,859.52,26432.0,40
CDM,49005745,MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT,19410.0,12616.5,859.52,26432.0,40
CDM,49005755,MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER,15960.0,10374.0,859.52,26432.0,40
CDM,49005765,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,16823.0,10934.95,859.52,26432.0,40
CDM,49005775,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,11260.0,7319.0,533.79,26432.0,41
CDM,49005785,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,11260.0,7319.0,533.79,26432.0,41
CDM,49005795,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,12580.0,8177.0,533.79,26432.0,41
CDM,49005805,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,1738.0,1129.7,66.35,26432.0,45
CDM,49005815,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,764.0,496.6,66.35,26432.0,45
CDM,49006135,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,81510.0,52981.5,676.74,73359.0,42
CDM,49006145,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,81510.0,52981.5,890.12,73359.0,42
CDM,49006235,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,129064.0,83891.6,859.26,116157.6,42
CDM,49006345,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,81510.0,52981.5,1013.41,73359.0,42
CDM,49006355,PERQ AV FISTULA CREATION UXTR SINGLE ACCESS,129064.0,83891.6,430.88,116157.6,42
CDM,49006365,PERQ AV FISTULA CREATION UXTR SEP ACCESS SITES,129064.0,83891.6,550.47,116157.6,42
CDM,49007225,PTCA W/ IVUS OR OCT,52189.0,33922.85,5298.24,46970.1,35
CDM,49007235,COR ANGIO W/ FFR & 3D MAP,28899.0,18784.35,1513.2,37851.0,35
CDM,49007245,PCTA W/ COR LITHOTRIP,59179.0,38466.35,5298.24,53261.1,35
CDM,49010WE,EXPL RETROPERITONEUM W/WO BX SPX,6424.0,4175.6,522.95,6424.0,35
CDM,49013WE,PREPERITONEAL PEL PACK F/HEMRRG ASSOC PEL TRMA,3340.0,2171.0,341.8,3340.0,31
CDM,49014WE,REEXPL PEL WND W/RMVL PREPERITONEAL PEL PACKING,2692.0,1749.8,282.19,2692.0,31
CDM,49020WE,DRG PERITONEAL ABSCESS/LOCAL PERITONITIS OPEN,10668.0,6934.2,815.84,10668.0,35
CDM,49040WE,DRAINAGE SUBDIAPHRAGMATIC/SUBPHREN ABSCESS OPEN,6608.0,4295.2,508.23,6608.0,35
CDM,49060WE,DRAINAGE OF RETROPERITONEAL ABSCESS OPEN,7412.0,4817.8,569.86,7412.0,35
CDM,49062WE,DRG XTRAPERITONEAL LYMPHOCELE PERITON CAVITY OPN,4888.0,3177.2,511.91,4888.0,35
CDM,49082WE,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,546.0,354.9,46.97,409.5,35
CDM,49083WE,ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE,880.0,572.0,84.22,660.0,35
CDM,49084WE,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,880.0,572.0,51.95,880.0,35
CDM,49180WE,BX ABDL/RPR MASS PRQ NDL,761.0,494.65,74.44,570.75,35
CDM,49185WE,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,940.0,611.0,94.97,1646.18,31
CDM,49186WE,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5 CM OR LESS,9680.0,6292.0,936.76,9680.0,28
CDM,49187WE,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5.1-10 CM,12606.0,8193.9,1200.07,12606.0,28
CDM,49188WE,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 10.1-20 CM,14960.0,9724.0,1433.45,14960.0,28
CDM,49189WE,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 20.1-30 CM,17600.0,11440.0,1668.68,17600.0,28
CDM,49190WE,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CYST >30 CM,22000.0,14300.0,2057.98,22000.0,28
CDM,49215WE,EXCISE PRESACRAL/SACRAL TUMOR,15124.0,9830.6,1154.26,15124.0,35
CDM,49250WE,UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX,3604.0,2342.6,353.93,3604.0,35
CDM,49255WE,OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX,5024.0,3265.6,403.11,5024.0,35
CDM,49320WE,LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX,2262.0,1470.3,245.54,2262.0,35
CDM,49321WE,L'SCOPE W/BIOPSY SINGLE/MULTIPLE,2176.0,1414.4,258.5,2176.0,35
CDM,49322WE,L'SCOPE CAVITY/CYST SINGLE/MULTIPLE,2404.0,1562.6,275.69,2404.0,35
CDM,49323WE,L'SCOPE W/DRNG  LYMPHOCELE TO PERIT,4092.0,2659.8,420.98,4092.0,35
CDM,49324WE,LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER,2528.0,1643.2,215.74,2528.0,35
CDM,49325WE,LAPS W/REVISION INTRAPERITONEAL CATHETER,2728.0,1773.2,232.47,2728.0,35
CDM,49326WE,LAPAROSCOPY W/OMENTOPEXY,1400.0,910.0,107.41,1400.0,35
CDM,49327WE,LAPS W/INSERTION NTRSTL DEV W/IMG GID 1+,952.0,618.8,60.78,952.0,35
CDM,49329AGRVU1WE,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",4034.0,2622.1,252.02,4034.0,15
CDM,49329AGRVU2WE,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",8575.0,5573.75,252.02,8575.0,15
CDM,49329AGRVU7WE,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",1545.0,1004.25,252.02,1545.0,15
CDM,49329RVU10WE,"UNLISTED LAP REMOVAL FOREIGN BODY , ABD (COMP CODE 49402)",4739.0,3080.35,252.02,4739.0,15
CDM,49329RVU11WE,"LAP LYSIS ADHESIONS,PERITONEAL (COMP CODE 44180)",5013.0,3258.45,252.02,5013.0,15
CDM,49329RVU13WE,LX EXCISION OF RETROPERITONEAL TUMOR (COMP 49203),8655.0,5625.75,252.02,8655.0,15
CDM,49329RVU14WE,LAP DRAINAGE OF ABD ABSCESS (COMP 49020),3987.0,2591.55,252.02,3987.0,15
CDM,49329RVU16WE,"UNLISTED LAPAROSCOPY, ABDOMEN, PERITONEUM AND OMENTUM (COMP CODE",2728.0,1773.2,252.02,2728.0,15
CDM,49329RVU17WE,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",10452.0,6793.8,252.02,10452.0,15
CDM,49329RVU19WE,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",8052.0,5233.8,252.02,8052.0,15
CDM,49329RVU20WE,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",5024.0,3265.6,252.02,5024.0,15
CDM,49329RVU22WE,LAP RELEASE MEDIAN ARCUATE LIGAMENT (COMP 49320),2056.0,1336.4,252.02,2056.0,15
CDM,49329RVU23WE,POST OP LAP EXPLOR & CONTROL HEMORRHAGE ABD (COMP TO 35840),8923.0,5799.95,252.02,8923.0,15
CDM,49329RVU26WE,LAPAROSCOPIC RELEASE OF MEDIAN ARCUATE LIGAMENT (MALS PROC) (COM,7783.0,5058.95,252.02,7783.0,15
CDM,49329RVU27WE,LAPAROPSCOPIC URACHAL CYST EXCISION (COMP CODE 39545),5868.0,3814.2,252.02,5868.0,15
CDM,49329RVU28WE,"LAP EXCISION ABD, PERITONEUM, OMENTUM 5CM OR LESS (COMP 49186)",9460.0,6149.0,252.02,9460.0,15
CDM,49329RVU29WE,"LAP,EXCISION ABD, PERITONEUM, OMENTUM 5.1-10CM (COMP 49187)",12320.0,8008.0,252.02,12320.0,15
CDM,49329RVU2WE,LAPAROSCOPIC EVACUATION HEMATOMA (COMP 49002),1967.0,1278.55,252.02,1967.0,15
CDM,49329RVU30WE,"LAP EXCISION ABD, PERITONEUM, OMENTUM 10.1-20CM (COMP 49188)",14620.0,9503.0,252.02,14620.0,15
CDM,49329RVU31WE,"LAP EXCISION ABD, PERITONEUM, OMENTUM 20.1-30CM (COMP 49189)",17200.0,11180.0,252.02,17200.0,15
CDM,49329RVU32WE,"LAP EXCISION ABD, PERITONEUM, OMENTUM GREATER THAN 30CM (COMP 49",21500.0,13975.0,252.02,21500.0,15
CDM,49329RVU33WE,LAP EXCISION OF A PRESACRAL SINUS(FISTULA) TRACT/ABSCESS (COMP 4,15124.0,9830.6,252.02,15124.0,15
CDM,49329RVU3WE,LAPROSCOPIC OMENTAL FLAP INTRA-ABDOMINAL (COMP CODE 49905),968.0,629.2,252.02,968.0,15
CDM,49329RVU5WE,LAP EXPLORATION FOR POST OP HEMORRHAGE,3851.0,2503.15,252.02,3851.0,15
CDM,49329RVU9WE,LAPAROSCOPIC EXCISION OMENTUM (49255),5024.0,3265.6,252.02,5024.0,15
CDM,49402WE,REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY,5636.0,3663.4,467.2,5636.0,35
CDM,49405WE,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,1600.0,1040.0,157.0,1453.54,31
CDM,49406WE,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,1760.0,1144.0,157.23,1455.28,31
CDM,49407WE,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,1700.0,1105.0,167.42,1275.0,31
CDM,49411WE,INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT,1428.0,928.2,111.82,1071.0,35
CDM,49412WE,PLMT INTRSTL DEV OPN W/IMG GID 1+,600.0,390.0,45.54,600.0,35
CDM,49418WE,INSJ INTRAPERITONEAL CATHETER W/IMG GID,1584.0,1029.6,187.9,2375.72,35
CDM,49419WE,INSERTION TUNNEL INTRAPERITONEAL CATH SUBQ PORT,2832.0,1840.8,276.65,2832.0,35
CDM,49421WE,INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN,1684.0,1094.6,172.6,1684.0,35
CDM,49422WE,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,1760.0,1144.0,168.26,1760.0,35
CDM,49423WE,EXCHNG ABSC/CST DRG CATH RAD GID SPX,642.0,417.3,63.08,909.96,35
CDM,49424WE,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,304.0,197.6,33.68,242.88,35
CDM,49425WE,INSERTION PERITONEAL-VENOUS SHUNT,4888.0,3177.2,512.25,4888.0,35
CDM,49426WE,REVIS PERITONEAL-VENOUS SHUNT,4164.0,2706.6,412.6,4164.0,35
CDM,49427WE,INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT,392.0,254.8,29.87,392.0,35
CDM,49428WE,LIGATION OF ABD-VENOUS SHUNT,2748.0,1786.2,223.43,2748.0,35
CDM,49429WE,RMVL PERITONEAL-VENOUS SHUNT,2976.0,1934.4,298.65,2976.0,35
CDM,49440WE,INSERT GASTROSTOMY TUBE PERCUTANEOUS,1729.0,1123.85,191.38,1728.39,35
CDM,49441WE,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,1808.0,1175.2,223.47,1939.43,35
CDM,49442WE,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,1500.0,975.0,180.78,1606.43,35
CDM,49446WE,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,1224.0,795.6,136.57,1658.48,35
CDM,49450WE,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,544.0,353.6,57.96,1104.19,35
CDM,49451WE,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,736.0,478.4,80.41,1205.15,35
CDM,49452WE,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,1144.0,743.6,123.16,1492.27,35
CDM,49460WE,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,384.0,249.6,41.51,1212.45,35
CDM,49465WE,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,248.0,161.2,26.28,269.04,35
CDM,49496WE,RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER,3768.0,2449.2,384.17,3768.0,35
CDM,49505WE,RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE,3184.0,2069.6,298.01,3184.0,35
CDM,49507WE,RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED,3636.0,2363.4,364.74,3636.0,35
CDM,49520WE,RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE,3996.0,2597.4,367.48,3996.0,35
CDM,49521WE,RPR RECRT INGUN HERNIA ANY AGE INCARCERATED,4592.0,2984.8,418.51,4592.0,35
CDM,49525WE,RPR INGUN HERNIA SLIDING ANY AGE,3572.0,2321.8,348.86,3572.0,35
CDM,49540WE,REPAIR LUMBAR HERNIA,4296.0,2792.4,385.22,4296.0,35
CDM,49550WE,RPR 1ST FEM HRNA ANY AGE REDUCIBLE,3596.0,2337.4,325.53,3596.0,35
CDM,49553WE,RPR 1ST FEM HERNIA ANY AGE INCARCERATED,3968.0,2579.2,347.3,3968.0,35
CDM,49555WE,RPR RECRT FEM HERNIA REDUCIBLE,3756.0,2441.4,373.63,3756.0,35
CDM,49557WE,RPR RECRT FEM HRNA INCARCERATED,4648.0,3021.2,423.54,4648.0,35
CDM,49591WE,RPR AA HERNIA 1ST < 3 CM REDUCIBLE,2622.0,1704.3,80.98,2622.0,31
CDM,49592WE,RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED,3722.0,2419.3,105.95,3722.0,31
CDM,49593WE,RPR AA HERNIA 1ST 3-10 CM REDUCIBLE,4514.0,2934.1,126.28,4514.0,31
CDM,49594WE,RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED,5922.0,3849.3,159.64,5922.0,31
CDM,49595WE,RPR AA HERNIA 1ST > 10 CM REDUCIBLE,6134.0,3987.1,165.45,6134.0,31
CDM,49596WE,RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED,8215.0,5339.75,215.38,8215.0,31
CDM,49613WE,RPR AA HERNIA RECR < 3 CM REDUCIBLE,2968.0,1929.2,98.12,2968.0,31
CDM,49614WE,RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED,4100.0,2665.0,125.4,4100.0,31
CDM,49615WE,RPR AA HERNIA RECR 3-10 CM REDUCIBLE,4584.0,2979.6,140.49,4584.0,31
CDM,49616WE,RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED,6842.0,4447.3,182.3,6842.0,31
CDM,49617WE,RPR AA HERNIA RECR > 10 CM REDUCIBLE,6412.0,4167.8,190.71,6412.0,31
CDM,49618WE,RPR AA HERNIA RECR > 10 CM NCRC8/STRANGULATED,9068.0,5894.2,258.35,9068.0,31
CDM,49621WE,RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE,5480.0,3562.0,159.07,5480.0,31
CDM,49622WE,RPR PARASTOMAL HRNA 1ST/RECR NCRC8/STRANGULATED,6824.0,4435.6,191.87,6824.0,31
CDM,49623WE,RMVL NONINFCT MESH/PROSTH AA/PARASTOMAL HRNA RPR,1500.0,975.0,38.91,1500.0,31
CDM,49650WE,LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA,2544.0,1653.6,291.85,2544.0,35
CDM,49651WE,LAPS SURG RPR RECURRENT INGUINAL HERNIA,3352.0,2178.8,366.65,3352.0,35
CDM,49659RVU10WE,LAPAROSCOPIC CONGENITAL HERNIA REPAIR W/ MESH (COMP 43282),10837.0,7044.05,447.39,10837.0,15
CDM,49659RVU4WE,LAP. PERISTOMAL HERNIA REPAIR,5891.0,3829.15,447.39,5891.0,15
CDM,49659RVU5WE,"UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HER",3359.0,2183.35,447.39,3359.0,15
CDM,49659RVU6WE,LAP REPAIR OF FEMORAL HERNIA (COMP 49550),3359.0,2183.35,447.39,3359.0,15
CDM,49659RVU7WE,LAP REPAIR INITIAL FEMORAL HERNIA; INCAR OR STRANG (COMP CODE 49,3572.0,2321.8,447.39,3572.0,15
CDM,49659RVU8WE,LAPAROSCOPIC REPAIR RECURRENT FEMORAL HERNIA (COMP CODE 49555),4038.0,2624.7,447.39,4038.0,15
CDM,49659RVU9WE,LAP REPAIR OF ACUTE TRAUMATIC DIAPHRAGMATIC HERNIA (COMP 39540),6265.0,4072.25,447.39,6265.0,15
CDM,49900WE,SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN,4964.0,3226.6,417.64,4964.0,35
CDM,49904WE,OMENTAL FLAP EXTRA-ABDOMINAL,8940.0,5811.0,948.99,8940.0,35
CDM,49905WE,OMENTAL FLAP INTRA-ABDOMINAL,2616.0,1700.4,259.46,2616.0,35
CDM,49999RVU11WE,UNLISTED PROC OPEN DRAINAGE OF INTRA ABD FLUID (COMP CODE 49062),4888.0,3177.2,665.51,4888.0,15
CDM,49999RVU12WE,"UNLISTED PROCEDURE, ABDOMEN, PERITONEUM & OMENTUM COMPARED TO 44",5588.0,3632.2,665.51,5588.0,15
CDM,49999RVU14WE,MESENTERIC OR OMENTUM BIOPSY (COMP 49000),5016.0,3260.4,665.51,5016.0,15
CDM,49999RVU16WE,"OMENTAL FLAP, LAPARCOCOPIC (COMP CODE 49905)",2616.0,1700.4,665.51,2616.0,15
CDM,49999RVU17WE,EXPL OF GROIN WOUND W/ RELEASE OF SCAR FORMATION (COMP CODE 3584,7471.0,4856.15,665.51,7471.0,15
CDM,49999RVU18WE,CORE NEEDLE BIOPSY ABDOMEN/PERITONEUM/OMENTUM AT TIME OF OTHER P,818.0,531.7,409.0,818.0,15
CDM,49999RVU20WE,REPOSITION PERITONEAL DIALYSIS CATH (COMP CODE 36597),484.0,314.6,242.0,798.61,15
CDM,49999RVU21WE,PREOP WIRE LOCALIZATION INTRAPERITONEAL (COMP CODE 49411),1428.0,928.2,665.51,1428.0,15
CDM,49999RVU22WE,RADIOFREQUENCY ABLATION INTRA ABDOMINAL MASS (COMP CODE 50592),2620.0,1703.0,665.51,2620.0,15
CDM,49999RVU23WE,CRYOABLATION OF INTRA ABDOMINAL MASS (COMP CODE 50593),3552.0,2308.8,665.51,3552.0,15
CDM,49999RVU3WE,"REMOVAL FOREIGN BODY, ABD WALL (COMP CODE 11008)",2000.0,1300.0,665.51,2000.0,15
CDM,50010WE,RNL EXPL X NECESSITATING OTH SPEC PX,4912.0,3192.8,508.77,4912.0,35
CDM,50020WE,"ABCESS DRAINAGE,RENAL/PERIRENA",7232.0,4700.8,591.63,7232.0,35
CDM,50040WE,NEPHROSTOMY/NEPHROTOMY W/DRAINAGE,6672.0,4336.8,599.52,6672.0,35
CDM,50060WE,NEPHROLITHOTOMY REMOVAL STAGE 1,8380.0,5447.0,790.77,8380.0,35
CDM,50070WE,NEPHROLITHOTOMY COMP CGEN KDN ABNORMALITY,9614.0,6249.1,822.77,9614.0,35
CDM,50075WE,NEPHROLITHOTOMY RMVL LG STAGHORN STAGE 1,10836.0,7043.4,1091.45,10836.0,35
CDM,50080WE,PERQ NL/PL LITHOTRP SIMPLE UP TO 2 CM 1 LOCATION,5460.0,3549.0,534.39,5460.0,35
CDM,50081WE,PERQ NL/PL LITHOTRP COMPLEX >2 CM MLT LOCATIONS,9200.0,5980.0,858.4,9200.0,35
CDM,50130WE,PYELOTOMY W/REMOVAL CALCULUS,7528.0,4893.2,777.25,7528.0,35
CDM,50200WE,RENAL BIOPSY PRQ TROCAR/NEEDLE,1047.0,680.55,96.41,992.41,35
CDM,50205WE,RENAL BIOPSY SURG EXPOSURE KIDNEY,4916.0,3195.4,454.47,4916.0,35
CDM,50220WE,NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ,7472.0,4856.8,787.53,7472.0,35
CDM,50225WE,NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL,8752.0,5688.8,897.75,8752.0,35
CDM,50230WE,NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD,9524.0,6190.6,976.36,9524.0,35
CDM,50234WE,NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC,10582.0,6878.3,956.58,10582.0,35
CDM,50236WE,NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN,10776.0,7004.4,1107.35,10776.0,35
CDM,50240WE,NEPHRECTOMY PARTIAL,9684.0,6294.6,992.49,9684.0,35
CDM,50250WE,OPEN ABLATION RENAL MASS CRYOSURG ULTRASOUND,8888.0,5777.2,770.45,8888.0,35
CDM,50280WE,EXCIS/UNROOF RENAL CYST,6836.0,4443.4,691.92,6836.0,35
CDM,50290WE,EXCISION PERINEPHRIC CYST,6460.0,4199.0,624.28,6460.0,35
CDM,50300WE,DONOR NEPHRECTOMY CADAVER DONOR UNI/BILATERAL,9502.0,6176.3,1834.5,9502.0,13
CDM,50320WE,"LIVING DONOR NEPHRECTOMY, OPEN",8972.0,5831.8,1009.16,8972.0,32
CDM,50323WE,BKBENCH PREPJ CADAVER DONOR RENAL ALLOGRAFT,1136.0,738.4,108.32,1136.0,14
CDM,50325WE,BKBENCH PREPJ LIVING RENAL DONOR ALLOGRAFT,1136.0,738.4,108.32,1136.0,14
CDM,50327WE,BKBENCH RCNSTJ RENAL ALGRFT VENOUS ANAST EA,1760.0,1144.0,157.36,1760.0,32
CDM,50328WE,BKBENCH RCNSTJ RENAL ALLOGRAFT ARTERIAL ANAST EA,1400.0,910.0,137.8,1400.0,32
CDM,50329WE,BKBENCH RCNSTJ ALGRFT URETERAL ANAST EA,1336.0,868.4,131.55,1336.0,32
CDM,50340WE,RECIPIENT NEPHRECTOMY SEPARATE PROCEDURE,6178.0,4015.7,628.59,6178.0,35
CDM,50360WE,RENAL ALLOTRANSPLANTATION W/ GRAFT W/O RECIPIENT NEPHRECTOMY,17547.0,11405.55,1495.2,17547.0,35
CDM,50365WE,"RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT; WITH RECIPIENT",18452.0,11993.8,1769.96,18452.0,35
CDM,50370WE,RMVL TRNSPLED RENAL ALLOGRAFT,7552.0,4908.8,665.67,7552.0,35
CDM,50380WE,RENAL AUTOTRNSPLJ REIMPLANTATION KIDNEY,12044.0,7828.6,997.45,12044.0,35
CDM,50382WE,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,2100.0,1365.0,192.56,1913.82,35
CDM,50384WE,REMOVAL INDWELLING URETERAL STENT PRQ,1900.0,1235.0,177.52,1524.54,35
CDM,50385WE,REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL,1676.0,1089.4,159.26,1839.69,35
CDM,50387WE,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,700.0,455.0,69.78,874.94,35
CDM,50389WE,RMVL NFROS TUBE REQ FLUORO GUIDANCE,484.0,314.6,38.44,477.88,35
CDM,50390WE,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,784.0,509.6,70.98,784.0,35
CDM,50391WE,INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB,784.0,509.6,69.03,588.0,35
CDM,50400WE,PYELOPLASTY SIMPLE,9359.0,6083.35,857.58,9359.0,35
CDM,50405WE,PYELOPLASTY COMPLICATED,11378.0,7395.7,1019.23,11378.0,35
CDM,50430WE,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,1160.0,754.0,128.34,870.0,31
CDM,50431WE,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,440.0,286.0,50.65,330.0,31
CDM,50432WE,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,1600.0,1040.0,169.72,1360.88,31
CDM,50433WE,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,2020.0,1313.0,209.77,1831.14,31
CDM,50434WE,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,1500.0,975.0,160.65,1448.82,31
CDM,50435WE,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,801.0,520.65,77.63,759.73,31
CDM,50436WE,PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG,1112.0,722.8,114.64,1112.0,31
CDM,50437WE,PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS,1940.0,1261.0,190.47,1940.0,31
CDM,50500WE,NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY,8488.0,5517.2,848.82,8488.0,35
CDM,50525WE,CLSR NEPHROVISCERAL FISTULA W/VISC RPR ABDL APPR,9756.0,6341.4,891.74,9756.0,35
CDM,50541WE,LAPAROSCOPY SURG ABLATION RENAL CYSTS,6744.0,4383.6,632.2,6744.0,35
CDM,50542WE,LAPS ABLTJ RENAL MASS LESION W/INTRAOP US,8544.0,5553.6,748.69,8544.0,35
CDM,50543WE,LAPAROSC PARTIAL NEPHRECTOMY,10964.0,7126.6,941.74,10964.0,35
CDM,50544WE,"LAPAROSCOPY, SURGICAL; PYELOPLASTY",9348.0,6076.2,871.33,9348.0,35
CDM,50545WE,LAPAROSCOPY RADICAL NEPHRECTOMY,10024.0,6515.6,985.45,10024.0,35
CDM,50546WE,LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT,8748.0,5686.2,808.6,8748.0,35
CDM,50547WE,LAPAROSCOPY DONOR NEPHRECTOMY LIVING DONOR,10536.0,6848.4,1038.14,10536.0,32
CDM,50548WE,LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY,10144.0,6593.6,948.58,10144.0,35
CDM,50549RVU10WE,LAPAROSCOPIC RENAL AUTOTRANSPLANTATION (COMP CODE 50380),10840.0,7046.0,887.64,10840.0,15
CDM,50549RVU11WE,LAPAROSCOPIC URETEROPLASTY (COMP CODE 50700),6009.0,3905.85,887.64,6009.0,15
CDM,50549RVU12WE,LAPAROSCOPIC RENAL CYST EXCISION (COMP CODE 50280),6836.0,4443.4,887.64,6836.0,15
CDM,50549RVU9WE,"UNLISTED LAPAROSCOPY PROCEDURE, RENAL (COMP CODE 50234)",10341.0,6721.65,887.64,10341.0,15
CDM,50551WE,RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION,2236.0,1453.4,160.9,1677.0,35
CDM,50553WE,RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA,2392.0,1554.8,169.76,1794.0,35
CDM,50555WE,RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY,2608.0,1695.2,239.79,1956.0,35
CDM,50557WE,RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI,2644.0,1718.6,236.23,1983.0,35
CDM,50561WE,RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS,3032.0,1970.8,273.42,2274.0,35
CDM,50562WE,RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR,4360.0,2834.0,398.28,4360.0,35
CDM,50570WE,RENAL NDSC NEPHROTOMY W/WO IRRIGATION,3812.0,2477.8,298.19,3812.0,35
CDM,50572WE,RNL NDSC NFROT W/URTRL CATHJ W/WO DILAT URETER,4132.0,2685.8,401.88,4132.0,35
CDM,50574WE,RENAL NDSC NEPHROTOMY W/BIOPSY,4400.0,2860.0,392.38,4400.0,35
CDM,50575WE,RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY,5584.0,3629.6,538.99,5584.0,35
CDM,50580WE,RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS,4736.0,3078.4,409.36,4736.0,35
CDM,50590WE,LITHOTRIPSY XTRCORP SHOCK WAVE,3908.0,2540.2,331.09,2931.0,35
CDM,50592WE,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,2620.0,1703.0,251.03,5049.2,35
CDM,50593WE,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,3552.0,2308.8,228.17,7438.55,35
CDM,50600WE,URTROTOMY W/EXPL/DRG SEPARATE PROCEDURE,6868.0,4464.2,669.77,6868.0,35
CDM,50605WE,URETEROTOMY INSERTION INDWELLING STENT ALL TYPES,6716.0,4365.4,579.22,6716.0,35
CDM,50606WE,ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC,1264.0,821.6,121.75,948.0,31
CDM,50630WE,URTROLITHOTOMY LOWER ONE-THIRD URETER,6484.0,4214.6,675.95,6484.0,35
CDM,50650WE,URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE,8281.0,5382.65,766.41,8281.0,35
CDM,50660WE,URETERECTOMY TOT ECTOPIC URETER CMBN APPR,8408.0,5465.2,801.13,8408.0,35
CDM,50684WE,INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH,304.0,197.6,30.79,228.0,35
CDM,50688WE,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,480.0,312.0,60.0,480.0,35
CDM,50690WE,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,464.0,301.6,33.2,348.0,35
CDM,50693WE,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,1584.0,1029.6,168.13,1702.97,31
CDM,50694WE,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,2100.0,1365.0,217.5,1877.2,31
CDM,50695WE,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,2720.0,1768.0,275.72,2289.16,31
CDM,50700WE,URETEROPLASTY PLASTIC OPERATION URETER,6676.0,4339.4,682.2,6676.0,35
CDM,50705WE,URETERAL EMBOLIZATION/OCCLUSION W/IMG GID RS&I,1612.0,1047.8,155.93,2741.52,31
CDM,50706WE,BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I,1520.0,988.0,144.7,1232.21,31
CDM,50715WE,URETEROLYSIS W/WORPSG URETER RETROPERIT FIBROSIS,8256.0,5366.4,805.26,8256.0,35
CDM,50722WE,URETEROLYSIS FOR OVARIAN VEIN SYNDROME,7898.0,5133.7,721.94,7898.0,35
CDM,50727WE,REVJ URINARY-CUTANEOUS ANASTAMOSIS,3312.0,2152.8,362.36,3312.0,35
CDM,50728WE,REVJ UR-CUTAN ANAST RPR FSCAL DFCT & HERNIA,4872.0,3166.8,525.15,4872.0,35
CDM,50740WE,URETEROPYELOSTOMY ANAST URETER RENAL PELVIS,8028.0,5218.2,826.41,8028.0,35
CDM,50750WE,URETEROCALYCOSTOMY ANAST URETER RENAL CALYX,8488.0,5517.2,800.4,8488.0,35
CDM,50760WE,URETEROURETEROSTOMY,8028.0,5218.2,828.2,8028.0,35
CDM,50770WE,TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR,8488.0,5517.2,852.72,8488.0,35
CDM,50780WE,URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER,8778.0,5705.7,831.9,8778.0,35
CDM,50782WE,URETERONEOCYSTOSTOMY ANAST DUPLICATE URETER BLDR,7864.0,5111.6,821.63,7864.0,35
CDM,50785WE,URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP,8892.0,5779.8,887.98,8892.0,35
CDM,50800WE,URETEROENTEROSTOMY ANAST URETER INTESTINE,7220.0,4693.0,647.14,7220.0,35
CDM,50810WE,URETEROSIGMOIDOSTOMY W/SIGMOID BLADDER & COLOSTO,9044.0,5878.6,869.71,9044.0,35
CDM,50815WE,URETEROCOLON CONDUIT INTESTINE ANASTOMOSIS,8904.0,5787.6,914.73,8904.0,35
CDM,50820WE,URETEROILEAL CONDUIT W/INTESTINE ANASTOMOSIS,9628.0,6258.2,1003.17,9628.0,35
CDM,50825WE,CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN,12272.0,7976.8,1255.17,12272.0,35
CDM,50830WE,URINARY UN-DIVERSION,13508.0,8780.2,1357.96,13508.0,35
CDM,50840WE,RPLCMT ALL/PART URETER INTESTINE SGM W/ANAST,8956.0,5821.4,871.36,8956.0,35
CDM,50845WE,CUTANANEOUS APPENDICO-VESICOSTOMY,8984.0,5839.6,906.81,8984.0,35
CDM,50860WE,URETEROSTOMY TRANSPLANTATION URETER SKIN,6832.0,4440.8,685.11,6832.0,35
CDM,50900WE,URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE,6016.0,3910.4,616.78,6016.0,35
CDM,50920WE,CLOSURE URETEROCUTANEOUS FISTULA,6324.0,4110.6,623.6,6324.0,35
CDM,50930WE,CLOSURE URETEROCUTANEOUS FISTULA W/VISC RPR,8076.0,5249.4,771.65,8076.0,35
CDM,50940WE,DELIGATION OF URETER,6372.0,4141.8,635.45,6372.0,35
CDM,50945WE,"LAPAROSCOPY, SURGICAL, URETEROLITHO",7188.0,4672.2,668.35,7188.0,35
CDM,50947WE,LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT,11343.0,7372.95,1009.39,11343.0,35
CDM,50948WE,LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT,10481.0,6812.65,923.26,10481.0,35
CDM,50949RVU1WE,LAP URETEROURETEROSTOMY (COMP 50760),8630.0,5609.5,821.04,8630.0,15
CDM,50949RVU2WE,LAPAROSCOPIC URETEROLYSIS (COMP 50715),7431.0,4830.15,821.04,7431.0,15
CDM,50949RVU3WE,LAP ILEAL CONDUIT (COMP 50820),9628.0,6258.2,821.04,9628.0,15
CDM,50949RVU5WE,LAPAROSCOPIC DISSECTION'S OF THE URETER AND REIMPLANTATION INTO,9558.0,6212.7,821.04,9558.0,15
CDM,50949RVU6WE,LAPAROSCOPIC URETERECTOMY WITH BLADDER CUFF (COMP CODE 50650),8093.0,5260.45,821.04,8093.0,15
CDM,50949RVU7WE,LAPAROSCOPIC URETEROCALICOSTOMY (COMP CODE 50750),8488.0,5517.2,821.04,8488.0,15
CDM,50951WE,URETERAL ENDOSCOPY VIA URETEROSTOMY,2332.0,1515.8,149.42,1749.0,35
CDM,50955WE,URETERAL ENDOSCOPY VIA URETEROSTOMY W/BIOPSY,2696.0,1752.4,209.75,2022.0,35
CDM,50961WE,URETERAL ENDOSCOPY VIA URETEROST W/RMVL FB/STONE,2416.0,1570.4,201.12,1812.0,35
CDM,50970WE,URETERAL ENDOSCOPY VIA URETEROTOMY W/O IMAGING,2852.0,1853.8,279.96,2852.0,35
CDM,50976WE,URETERAL ENDOSC VIA URETEROT W/DEST&/INC W/WO BX,3612.0,2347.8,323.33,3612.0,35
CDM,51000000,OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT,741.0,481.65,54.22,666.9,32
CDM,51000005,OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST,741.0,481.65,111.9,666.9,32
CDM,51000015,OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT,741.0,481.65,58.67,666.9,32
CDM,51000020,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,188.0,122.2,10.95,169.2,22
CDM,51000025,OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>,741.0,481.65,88.69,666.9,32
CDM,51000185,INITIAL PREVENTIVE MEDICINE NEW PT AGE 12-17 YR,233.0,151.45,39.14,209.7,21
CDM,51000190,INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS,230.0,149.5,38.64,207.0,21
CDM,51000195,INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS,318.0,206.7,53.42,286.2,21
CDM,51000200,INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>,364.0,236.6,61.15,327.6,21
CDM,51000210,PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS,191.0,124.15,32.09,171.9,21
CDM,51000220,PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS,264.0,171.6,44.35,237.6,21
CDM,51000225,PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS,391.0,254.15,65.69,351.9,21
CDM,51000230,PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS,288.0,187.2,48.38,259.2,21
CDM,51000235,PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER,304.0,197.6,51.07,273.6,21
CDM,51000240,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN,155.0,100.75,26.04,158.0,27
CDM,51000245,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN,278.0,180.7,40.76,250.2,27
CDM,51000265,TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE,1111.0,722.15,75.64,999.9,38
CDM,51000270,TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE,1111.0,722.15,75.64,999.9,38
CDM,51000300,INIT PREVENTIVE EXAM NEW,644.0,418.6,129.36,579.6,32
CDM,51000405,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN,188.0,122.2,31.58,169.2,22
CDM,51000410,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN,188.0,122.2,31.58,169.2,22
CDM,51000415,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN,234.0,152.1,39.31,210.6,22
CDM,51000420,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN,300.0,195.0,50.4,270.0,22
CDM,51000495,CHRONIC CARE MGMT SVCS STAFF 1ST 20 MIN CAL MO,798.0,518.7,34.32,718.2,38
CDM,51000515,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,188.0,122.2,10.95,169.2,22
CDM,51001055,OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES,170.0,110.5,28.56,158.0,22
CDM,51001065,OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES,174.0,113.1,29.23,158.0,22
CDM,51001075,OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES,218.0,141.7,36.62,196.2,22
CDM,51001085,OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES,294.0,191.1,49.39,264.6,22
CDM,51001095,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,188.0,122.2,10.95,169.2,22
CDM,51001105,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN,188.0,122.2,31.58,169.2,22
CDM,51001115,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN,188.0,122.2,31.58,169.2,22
CDM,51001125,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN,234.0,152.1,39.31,210.6,22
CDM,51001235,OFFICE VISIT,644.0,418.6,129.36,579.6,31
CDM,51001305,ADVANCE CARE PLANNING FIRST 30 MINS,798.0,518.7,75.64,718.2,38
CDM,51001315,ADVANCE CARE PLANNING EA ADDL 30 MINS,123.0,79.95,20.66,158.0,28
CDM,51001545,CHRONIC CARE MGMT SVC STAF EA ADDL 20 MIN CAL MO,309.0,200.85,34.32,278.1,28
CDM,51001605,PRINCIPAL CARE MGMT SVC 1ST 30 STAFF CAL MO,798.0,518.7,34.32,718.2,38
CDM,51001615,PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO,798.0,518.7,34.32,718.2,28
CDM,51001665,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,1790.0,1163.5,61.47,1611.0,38
CDM,51001815,COMPLX CHRON CARE COORD W/O PT VST 1ST HR PER MO,1386.0,900.9,34.32,1247.4,38
CDM,51001825,DEPRESSION SCREEN ANNUAL,149.0,96.85,11.31,158.0,38
CDM,51001845,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING 1ST 60,306.0,198.9,24.57,275.4,38
CDM,51001855,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING EA ADDL,74.0,48.1,6.91,183.42,38
CDM,51001865,ANNUAL ALCOHOL SCREEN 15 MIN,258.0,167.7,11.31,232.2,38
CDM,51001875,BRIEF ALCOHOL MISUSE COUNSEL,798.0,518.7,37.21,718.2,38
CDM,51001885,HIGH INTEN BEH COUNS STD 30M,798.0,518.7,37.58,718.2,38
CDM,51001895,INTENS BEHAVE THER CARDIO DX,258.0,167.7,12.84,232.2,38
CDM,51001905,BEHAVIOR COUNSEL OBESITY 15M,798.0,518.7,37.21,718.2,38
CDM,51001925,CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,1109.0,720.85,41.57,998.1,38
CDM,51001935,CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,1109.0,720.85,30.26,998.1,38
CDM,51001945,GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,1109.0,720.85,13.13,998.1,38
CDM,51001985,SLT GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE?,1109.0,720.85,13.13,998.1,38
CDM,51001995,PT/OT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,1109.0,720.85,41.57,998.1,38
CDM,51002005,PT/OT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,1109.0,720.85,30.26,998.1,38
CDM,51002595,COMPLX CHRON CARE COORD EA ADDL 30 MIN PER MONTH,267.0,173.55,34.32,240.3,28
CDM,51002705,MCHNL SCLP COOL CAP SPLY HEAD MEAS FITG&EDUCAJ,12510.0,8131.5,110.51,11259.0,31
CDM,51002715,MCHNL SCLP COOL HAIR PREPJ CAP PLMT THER&PRECOOL,15098.0,9813.7,14.57,13588.2,28
CDM,51002725,MCHNL SCLP COOL AFTER CHEMO EACH 30 MINUTES,3775.0,2453.75,9.42,3397.5,28
CDM,51002735,SCREENING DARK ADAPTATION MEASUREMENT W/I&R,2295.0,1491.75,45.31,2065.5,27
CDM,51002745,REM MNTR PHYSIOL PARAM DEV SPLY W/REC 2-15 DAYS,329.0,213.85,23.85,296.1,31
CDM,51002755,RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,244.0,158.6,18.94,219.6,28
CDM,51002765,RTM DEV SPLY DATA CBT 2-15 DAYS IN 30 D PD,329.0,213.85,23.85,296.1,30
CDM,51020WE,CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL,3076.0,1999.4,327.9,3076.0,35
CDM,51040WE,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,1796.0,1167.4,226.22,1796.0,35
CDM,51045WE,CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX,3124.0,2030.6,312.88,3124.0,35
CDM,51050WE,CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS,3188.0,2072.2,344.95,3188.0,35
CDM,51080WE,DRG PRIVESICAL/PREVESICAL SPACE ABSC,2684.0,1744.6,295.61,2684.0,35
CDM,51100WE,ASPIRATION BLADDER NEEDLE,312.0,202.8,24.33,234.0,35
CDM,51101WE,ASPIRATION BLADDER TROCAR/INTRACATHETER,408.0,265.2,34.63,306.0,35
CDM,51102WE,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,1080.0,702.0,91.22,810.0,35
CDM,51500WE,EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR,4420.0,2873.0,457.6,4420.0,35
CDM,51525WE,CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE,6168.0,4009.2,638.03,6168.0,35
CDM,51530WE,"CYSTOTOMY,EXCIS BLADDER TUMOR",5484.0,3564.6,565.06,5484.0,35
CDM,51535WE,CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE,5560.0,3614.0,544.05,5560.0,35
CDM,51550WE,CYSTECTOMY PARTIAL SIMPLE,6892.0,4479.8,688.23,6892.0,35
CDM,51555WE,CYSTECTOMY PARTIAL COMPLICATED,9272.0,6026.8,878.16,9272.0,35
CDM,51565WE,CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST,9472.0,6156.8,970.09,9472.0,35
CDM,51570WE,CYSTECTOMY COMPLETE SEPARATE PROCEDURE,10984.0,7139.6,1039.41,10984.0,35
CDM,51575WE,CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY,13672.0,8886.8,1371.13,13672.0,35
CDM,51590WE,CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST,14532.0,9445.8,1401.67,14532.0,35
CDM,51595WE,CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC,16528.0,10743.2,1662.67,16528.0,35
CDM,51596WE,CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR,17704.0,11507.6,1796.21,17704.0,35
CDM,51597WE,PELVIC EXENTERATION COMPLETE MALIGNANCY,17144.0,11143.6,1706.44,17144.0,35
CDM,51600WE,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,352.0,228.8,32.67,294.93,35
CDM,51610WE,NJX RETROGRADE URETHROCSTOGRAPY,420.0,273.0,30.58,315.0,35
CDM,51700WE,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,264.0,171.6,24.33,198.0,35
CDM,51701WE,INSJ NON-NDWELLG BLADDER CATHETER,220.0,143.0,18.59,165.0,35
CDM,51702WE,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,220.0,143.0,22.72,165.0,35
CDM,51703WE,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,588.0,382.2,41.9,441.0,35
CDM,51705WE,CHANGE CYSTOSTOMY TUBE SIMPLE,360.0,234.0,35.48,270.0,35
CDM,51710WE,CHANGE CYSTOSTOMY TUBE COMPLICATED,540.0,351.0,59.13,405.0,35
CDM,51715WE,NDSC NJX IMPLT MATRL URT&/BLDR NCK,1492.0,969.8,103.81,1119.0,35
CDM,51720WE,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,383.0,248.95,41.33,287.25,35
CDM,51721WE,INSJ TRURL ABLTJ TRNSDCR DLVR THRM US PRST8 TISS,1782.0,1158.3,153.57,1336.5,25
CDM,51725CMPWE,COMPLEX CMG,1648.0,1071.2,145.77,1648.0,35
CDM,51725CYSWE,"CYSTOMETROGRAM, SIMPLE",1172.0,761.8,145.77,1172.0,35
CDM,51725PROWE,CMG SIMPLE,410.0,266.5,145.77,438.27,35
CDM,51725WE,"CYSTOMETROGRAM, SIMPLE",2063.0,1340.95,145.77,2063.0,35
CDM,51725WE-26,"CYSTOMETROGRAM, SIMPLE",664.0,431.6,65.64,664.0,31
CDM,51726PROWE,COMPLEX CMG,752.0,488.8,195.83,752.0,35
CDM,51726WE,BLADDER PRESSURE MEASUREMENT DURING FILLING,2151.0,1398.15,195.83,2151.0,35
CDM,51726WE-26,BLADDER PRESSURE MEASUREMENT DURING FILLING,752.0,488.8,74.17,752.0,31
CDM,51727WE,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,844.0,548.6,180.82,844.0,35
CDM,51728WE,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,928.0,603.2,182.13,928.0,35
CDM,51729WE,COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE,1104.0,717.6,192.49,1104.0,35
CDM,51741PROWE,COMPLEX UROFLOWMETRY,68.0,44.2,12.95,68.0,35
CDM,51741WE,COMPLEX UROFLOMETRY,1858.0,1207.7,12.95,1858.0,35
CDM,51741WE-26,COMPLEX UROFLOMETRY,68.0,44.2,8.58,68.0,31
CDM,51784PROWE,EMG ANAL SPHINCTER,330.0,214.5,49.02,330.0,35
CDM,51784WE,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,1230.0,799.5,49.02,1230.0,35
CDM,51784WE-26,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,330.0,214.5,36.73,330.0,31
CDM,51785PROWE,EMG NEEDLE STUDY ANAL URETH,673.0,437.45,202.48,849.68,35
CDM,51785WE,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,2072.0,1346.8,202.48,2072.0,35
CDM,51785WE-26,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,673.0,437.45,67.07,673.0,31
CDM,51797INTWE,VOIDING PRESSURE INTRAABD,352.0,228.8,97.32,360.39,35
CDM,51797WE,VOID PRESSURE STUDIES INTRAABDOMINAL,1771.0,1151.15,97.32,1771.0,35
CDM,51797WE-26,VOID PRESSURE STUDIES INTRAABDOMINAL,352.0,228.8,34.53,352.0,31
CDM,51798CAPWE,US URINE BLADDER CAPACTIY NON-IMG,42.0,27.3,8.94,42.0,35
CDM,51798POSWE,POST VOID RESIDUAL U.S.,42.0,27.3,8.94,42.0,35
CDM,51798WE,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,42.0,27.3,8.94,42.0,35
CDM,51800WE,CSTOPLASTY/CSTOURTP PLSTC ANY,7556.0,4911.4,770.48,7556.0,35
CDM,51840WE,ANT VESICOURETHROPEXY/URETHROPEXY SMPL,4544.0,2953.6,523.14,4544.0,35
CDM,51841WE,ANT VESICOURETHROPEXY/URETHROPEXY COMP,5472.0,3556.8,600.83,5472.0,35
CDM,51845WE,ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL,4060.0,2639.0,448.86,4060.0,35
CDM,51860WE,CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE,5040.0,3276.0,521.27,5040.0,35
CDM,51865WE,CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED,6320.0,4108.0,679.96,6320.0,35
CDM,51880WE,CLOSE CYSTOSTOMY,3148.0,2046.2,336.46,3148.0,35
CDM,51900WE,CLSR VESICOVAGINAL FISTUL AABDL APPROACH,5852.0,3803.8,610.08,5852.0,35
CDM,51960WE,ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS,11176.0,7264.4,1056.79,11176.0,35
CDM,51980WE,CUTANEOUS VESICOSTOMY,5028.0,3268.2,495.81,5028.0,35
CDM,51990WE,LAPAROSCOPY URETHRAL SUSPENSION STRESS INCONT,5344.0,3473.6,517.43,5344.0,35
CDM,51992WE,"LAPAROSCOPY, SURGICAL; SLING OPERAT",5948.0,3866.2,563.45,5948.0,35
CDM,51999RVU10WE,LAP CYSTECTOMY W/ PELVIC LYMPHADENECTOMY (COMP 51575),13672.0,8886.8,566.99,13672.0,15
CDM,51999RVU11WE,LAPAROSCOPIC DIVERTICULECTOMY (COMP 51525),6168.0,4009.2,566.99,6168.0,15
CDM,51999RVU15WE,UNLISTED PROC; LAPAROSCOPIC PARTICAL CYSTECTOMY (COMP TO 51550),6892.0,4479.8,566.99,6892.0,15
CDM,51999RVU16WE,"EXCISION OF URACHAL CYST OR SINUS, W/WO UMBILICAL HERNIA REPAIR",4420.0,2873.0,566.99,4420.0,15
CDM,51999RVU17WE,"STONE REMOVAL FROM BLADDER, LAPAROSCOPIC APPROACH WITH ROBOTIC A",3427.0,2227.55,566.99,3427.0,15
CDM,51999RVU18WE,"LAPAROSCOPIC CLOSURE OF VESICOVAGINAL FISTULA, ABDOMINAL APPROAC",6290.0,4088.5,566.99,6290.0,15
CDM,51999RVU19WE,UNLISTED LAPAROSCOPIC PROCEDURE BLADDER (COMP CODE 51590),15621.0,10153.65,566.99,15621.0,15
CDM,51999RVU20WE,LAPAROSCOPIC ANTERIOR VAGINECTOMY (COMP CODE 57106),3225.0,2096.25,566.99,3225.0,15
CDM,51999RVU2WE,LAP REPAIR BLADDER REPAIR (COMP 51860),5040.0,3276.0,566.99,5040.0,15
CDM,51999RVU3WE,LAPAROSCOPY PARTIAL CYSTECTOMY (COMP 51555),14126.0,9181.9,566.99,14126.0,15
CDM,51999RVU6WE,ROBOTIC CYSTECTOMY W/ CONDUIT & PELVIC LYMPHADENECTOMY (COMP 515,16528.0,10743.2,566.99,16528.0,15
CDM,51999RVUWE,LAPAROSCOPIC BLADDER REPAIR,3427.0,2227.55,566.99,3427.0,15
CDM,52000WE,CYSTOURETHROSCOPY,673.0,437.45,49.25,504.75,35
CDM,52001WE,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,2176.0,1414.4,136.76,1632.0,35
CDM,52005WE,CYSTO BLADDER W/URETERAL CATHETERIZATION,1043.0,677.95,63.29,782.25,35
CDM,52007WE,CYSTO W/URTRL CATHJ BRUSH BX URTR&/RENAL PELVIS,1208.0,785.2,114.79,906.0,35
CDM,52204WE,"CYSTOURETHROSCOPY,BIOPSY",1036.0,673.4,102.25,777.0,35
CDM,52214WE,CYSTO W/DESTRUCTION OF LESIONS,1400.0,910.0,130.57,1056.53,35
CDM,52224WE,CYSTO W/REMOVAL OF LESIONS MINOR <0.5CM,1620.0,1053.0,127.33,1215.0,35
CDM,52234WE,CYSTO W/REMOVAL OF TUMORS SMALL,1848.0,1201.2,186.39,1848.0,35
CDM,52235WE,CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM,2176.0,1414.4,218.3,2176.0,35
CDM,52240WE,CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE,3300.0,2145.0,296.18,3300.0,35
CDM,52260WE,CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH,1564.0,1016.6,157.48,1564.0,35
CDM,52265WE,"CYSTOSCOPY,DIL BLADDER,LOCAL ANESTH",1176.0,764.4,100.06,882.0,35
CDM,52270WE,"CYSTOSCOPY,INTERN URETHROTOMY,FEMALE",1344.0,873.6,86.47,1008.0,35
CDM,52275WE,"CYSTOSCOPY,INTERN URETHROTOMY,MALE",1876.0,1219.4,118.35,1407.0,35
CDM,52276WE,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE,1996.0,1297.4,200.43,1996.0,35
CDM,52277WE,"CYSTOSCOPY,RESEC EXTERN SPHINCTER",2464.0,1601.6,244.6,2464.0,35
CDM,52281WE,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,1210.0,786.5,72.49,907.5,35
CDM,52282WE,CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT,2556.0,1661.4,255.32,2556.0,35
CDM,52283WE,"CYSTOSCOPY,STEROID INJ,STRICTURE",1492.0,969.8,98.3,1119.0,35
CDM,52284WE,CYSTO W/DILAT RX BALO CATH URTL STRIX/STEN MALE,1364.0,886.6,118.2,4532.03,28
CDM,52285WE,"CYSTOSCOPY,RX FEMALE URETHRAL SYND",1440.0,936.0,109.35,1080.0,35
CDM,52287WE,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,1280.0,832.0,98.97,960.0,31
CDM,52290WE,CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI,1832.0,1190.8,180.77,1832.0,35
CDM,52300WE,CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI,2120.0,1378.0,211.92,2120.0,35
CDM,52301WE,CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI,2200.0,1430.0,219.58,2200.0,35
CDM,52305WE,CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT,2120.0,1378.0,210.39,2120.0,35
CDM,52310WE,CYSTO W/SIMPLE REMOVAL STONE & STENT,1124.0,730.6,99.28,843.0,35
CDM,52315WE,CYSTO W/COMPLEX REMOVAL STONE & STENT,2080.0,1352.0,149.55,1560.0,35
CDM,52317WE,LITHOLAPAXY SMPL/SM <2.5 CM,2684.0,1744.6,165.21,2013.0,35
CDM,52318WE,LITHOLAPAXY COMP/LG > 2.5 CM,3672.0,2386.8,357.96,3672.0,35
CDM,52320WE,CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS,1876.0,1219.4,186.9,1876.0,35
CDM,52325WE,CYSTO FRAGMENTATION URETERAL STONE,2460.0,1599.0,242.05,2460.0,35
CDM,52327WE,CYSTO W/SUBURTRIC NJX IMPLT MATRL,2072.0,1346.8,195.83,2072.0,35
CDM,52330WE,CYSTO MANJ W/O RMVL URETERAL STONE,2012.0,1307.8,125.43,1509.0,35
CDM,52332WE,CYSTO W/INSERT URETERAL STENT,1128.0,733.2,115.16,846.0,35
CDM,52334WE,CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR,1483.0,963.95,139.41,1483.0,35
CDM,52341WE,CYSTO W/URETER STRICTURE TX,2140.0,1391.0,214.98,2140.0,35
CDM,52342WE,CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE,2340.0,1521.0,234.13,2340.0,35
CDM,52343WE,CYSTO W/TX INTRA-RENAL STRICTURE,2620.0,1703.0,260.69,2620.0,35
CDM,52344WE,CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE,2820.0,1833.0,279.58,2820.0,35
CDM,52345WE,CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX,3020.0,1963.0,298.22,3020.0,35
CDM,52346WE,CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE,3432.0,2230.8,337.28,3432.0,35
CDM,52351WE,CYSTO W/URTROSCOPY&/PYELOSCOPY DX,2530.0,1644.5,229.54,2530.0,35
CDM,52352WE,CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES,2700.0,1755.0,268.35,2700.0,35
CDM,52353WE,CYSTO W/URETEROSCOPY W/LITHOTRIPSY,3000.0,1950.0,296.18,3000.0,35
CDM,52354WE,CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION,3200.0,2080.0,312.27,3200.0,35
CDM,52355WE,CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR,3600.0,2340.0,349.73,3600.0,35
CDM,52356WE,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT,3200.0,2080.0,301.79,3200.0,31
CDM,52400WE,CYSTO INC FULG/RESCJ URTL VALVES/FOLDS,3476.0,2259.4,365.11,3476.0,35
CDM,52441WE,CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE,1760.0,1144.0,179.86,1978.57,31
CDM,52442WE,CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL,444.0,288.6,47.93,1507.15,31
CDM,52443WE,CYSTO 1ST TRURL ANT PRST8 COMIS NONRX BALO CATH,1593.0,1035.45,186.16,1593.0,21
CDM,52450WE,TRANSURETHRAL INCISION OF PROSTATE,3112.0,2022.8,340.72,3112.0,35
CDM,52500WE,TRANSURETHRAL RESEC BLADDER NECK,3256.0,2116.4,376.47,3256.0,35
CDM,52597WE,TRURL ROBOTIC-ASSISTED WATERJET RESECTION PRST8,4510.0,2931.5,589.1,4510.0,21
CDM,52601WE,TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE,5790.0,3763.5,558.14,5790.0,35
CDM,52630WE,TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS,2620.0,1703.0,314.3,2620.0,35
CDM,52640WE,TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE,1916.0,1245.4,251.24,1916.0,35
CDM,52648WE,LASER VAPORIZATION OF PROSTATE FOR URINE FLOW,4860.0,3159.0,456.57,3645.0,35
CDM,52649WE,LASER ENUCLEATION PROSTATE W/MORCELLATION,5824.0,3785.6,603.59,5824.0,35
CDM,52700WE,TRURL DRAINAGE PROSTATIC ABSCESS,2996.0,1947.4,280.66,2996.0,35
CDM,53000000,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,95.0,61.75,17.96,85.5,38
CDM,53000005,OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,95.0,61.75,17.96,85.5,38
CDM,53000010,OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS,95.0,61.75,17.96,85.5,38
CDM,53000015,OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS,95.0,61.75,17.96,85.5,38
CDM,53000025,OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS,95.0,61.75,17.96,89.37,38
CDM,53010WE,URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA,1780.0,1157.0,193.15,1780.0,35
CDM,53020WE,MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT,708.0,460.2,73.79,708.0,35
CDM,53040WE,DRAINAGE DEEP PERIURETHRAL ABSCESS,2620.0,1703.0,238.52,2620.0,35
CDM,53060WE,DRG OF SKENE'S GLAND ABSCESS OR CYST,1072.0,696.8,81.63,804.0,35
CDM,53200WE,BIOPSY OF URETHRA,1036.0,673.4,92.84,777.0,35
CDM,53210WE,URETHRECTOMY TOT W/CYSTOST FEMALE,5488.0,3567.2,513.04,5488.0,35
CDM,53215WE,URETHRECTOMY TOT W/CYSTOST MALE,6740.0,4381.0,667.89,6740.0,35
CDM,53220WE,EXC/FULGURATION CARCINOMA URETHRA,3052.0,1983.8,314.13,3052.0,35
CDM,53230WE,EXC URETHRAL DIVERTICULUM SPX FEMALE,4176.0,2714.4,455.26,4176.0,35
CDM,53235WE,EXC URETHRAL DIVERTICULUM SPX MALE,4396.0,2857.4,406.36,4396.0,35
CDM,53240WE,MARSUPIALIZATION URTL DIVERTICULUM MALE/FEMALE,2832.0,1840.8,289.26,2832.0,35
CDM,53250WE,EXCISION OF BULBOURETHRAL GLAND,2608.0,1695.2,264.29,2608.0,35
CDM,53260WE,EXC/FULGURATION URETHRAL POLYP DSTL URETHRA,1212.0,787.8,93.98,909.0,35
CDM,53265WE,EXC/FULGURATION URETHRAL CARUNCLE,1268.0,824.2,121.92,951.0,35
CDM,53270WE,EXCISION OR FULGURATION SKENES GLANDS,1256.0,816.4,95.73,942.0,35
CDM,53275WE,EXCISION/FULGURATION URETHRAL PROLAPSE,1828.0,1188.2,188.17,1828.0,35
CDM,53400WE,URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX,5652.0,3673.8,535.2,5652.0,35
CDM,53410WE,URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA,7072.0,4596.8,660.91,7072.0,35
CDM,53415WE,URTP TRANSPUBIC/PRNL 1 STG RCNSTJ/RPR URT,8280.0,5382.0,802.13,8280.0,35
CDM,53420WE,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 1ST STAGE,6068.0,3944.2,615.95,6068.0,35
CDM,53425WE,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 2ND STAGE,6828.0,4438.2,631.63,6828.0,35
CDM,53430WE,URETHROPLASTY RCNSTJ FEMALE URETHRA,6972.0,4531.8,629.05,6972.0,35
CDM,53431WE,URTP W/TUBULARIZATION POST URT&/LWR BLDR,8472.0,5506.8,767.49,8472.0,35
CDM,53440WE,SLING OPRATION CORRJ MALE URINARY INCONTINENCE,5344.0,3473.6,578.05,5344.0,35
CDM,53442WE,RMVL/REVJ SLING MALE URINARY INCONTINENCE,5396.0,3507.4,420.46,5396.0,35
CDM,53444WE,INSERTION TANDEM CUFF,5676.0,3689.4,549.21,5676.0,35
CDM,53445WE,INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,5200.0,3380.0,582.39,5200.0,35
CDM,53446WE,REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,4408.0,2865.2,481.79,4408.0,35
CDM,53447WE,RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC,5712.0,3712.8,582.84,5712.0,35
CDM,53448WE,RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD,9376.0,6094.4,871.0,9376.0,35
CDM,53449WE,RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER,4224.0,2745.6,446.98,4224.0,32
CDM,53450WE,URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT,2708.0,1760.2,244.2,2708.0,35
CDM,53452WE,PERIURETHRL TPRNL ADJTBL BALO CNTNC DEV UNI INSJ,6037.0,3924.05,739.38,6037.0,13
CDM,53500WE,URETHROLSS TRVG SEC OPN W/CSTO,5200.0,3380.0,493.36,5200.0,35
CDM,53502WE,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE,3304.0,2147.6,337.8,3304.0,35
CDM,53505WE,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE,3304.0,2147.6,339.68,3304.0,35
CDM,53510WE,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PERINEAL,4384.0,2849.6,449.88,4384.0,35
CDM,53520WE,CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX,3792.0,2464.8,384.21,3792.0,35
CDM,53600WE,DILAT URETHRAL STRIX DILATOR MALE 1ST,484.0,314.6,38.89,363.0,35
CDM,53601WE,DILAT URETHRAL STRIX DILATOR MALE SBSQ,392.0,254.8,30.33,294.0,35
CDM,53605WE,DILAT URETHRAL STRIX/VESICAL NCK DILAT MALE ANES,512.0,332.8,47.34,512.0,35
CDM,53620WE,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST,648.0,421.2,52.7,486.0,35
CDM,53621WE,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ,540.0,351.0,41.85,405.0,35
CDM,53660WE,DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI,284.0,184.6,23.94,213.0,35
CDM,53661WE,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,288.0,187.2,23.2,216.0,35
CDM,53665WE,DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES,304.0,197.6,28.34,304.0,35
CDM,53850WE,TRURL DSTRJ PRSTATE TISS MICROWAVE THERMOTH,2168.0,1409.2,325.8,3319.22,35
CDM,53852WE,TRURL DSTRJ PRSTATE TISS RF THERMOTH,2372.0,1541.8,339.96,3064.05,35
CDM,53854WE,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,2609.0,1695.85,288.66,2948.92,28
CDM,53855WE,INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT,656.0,426.4,39.45,1235.21,35
CDM,53860WE,TRURL RF FEMALE BLADDER NECK STRS URIN INCONT,1747.0,1135.55,177.43,2497.45,32
CDM,53865WE,CYSTO INSJ TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,1364.0,886.6,116.62,4966.83,25
CDM,53866WE,CATHJ RMVL TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,651.0,423.15,58.25,488.25,25
CDM,53899DILWE,URETERAL DILATION,2353.0,1529.45,57.24,2353.0,15
CDM,53899PERWE,PERCU RADIOFREQUENCY ABLATION RENAL SYSTE,2115.0,1374.75,57.24,2115.0,15
CDM,53899RVU17WE,ITIND DEVICE INSERTION (COMP CODE 52441),1539.0,1000.35,57.24,1539.0,15
CDM,53899RVU20WE,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT (COMP CODE 5235,3440.0,2236.0,57.24,3440.0,15
CDM,53899RVU21WE,PLCMNT RETRO NEPHROURETERAL CATHETER (COMP CODE 50688),480.0,312.0,57.24,480.0,15
CDM,53899RVU22WE,SUPRA PUBIC CATHETER REPOSITION (COMP CODE 36597),484.0,314.6,57.24,484.0,15
CDM,53899RVU23WE,INJECTION INTO BLADDER LESIONS (NON CHEMODENERVATION) (COMP CODE,1280.0,832.0,57.24,1280.0,15
CDM,53899SCLWE,CYST SCLEROSIS,466.0,302.9,57.24,466.0,15
CDM,54001WE,SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN,896.0,582.4,67.23,672.0,35
CDM,54015WE,"INCIS/DRAIN PENIS,DEEP",2144.0,1393.6,180.93,2144.0,35
CDM,54055WE,DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION,500.0,325.0,55.39,375.0,35
CDM,54056WE,DSTRJ LESION PENIS SIMPLE CRYOSURGERY,568.0,369.2,52.77,426.0,35
CDM,54057WE,DSTRJ LESION PENIS SIMPLE LASER,516.0,335.4,46.52,387.0,35
CDM,54060DESWE,DEST LESION PENIS SURGICAL,792.0,514.8,67.37,594.0,35
CDM,54060WE,DSTRJ LESION PENIS SIMPLE SURG EXCISION,792.0,514.8,67.37,594.0,35
CDM,54065WE,DSTRJ LESION PENIS EXTENSIVE,988.0,642.2,97.72,741.0,35
CDM,54100WE,BIOPSY PENIS SEPARATE PROCEDURE,760.0,494.0,57.7,570.0,35
CDM,54105WE,"BIOPSY OF PENIS,DEEP STRUCT",1416.0,920.4,102.08,1062.0,35
CDM,54110WE,EXCIS PENILE PLAQUE,4368.0,2839.2,416.79,4368.0,35
CDM,54111WE,"EXCIS PENILE PLAQUE,GRAFT <5CM",5768.0,3749.2,603.77,5768.0,35
CDM,54112WE,"EXCIS PENILE PLAQUE,GRAFT >5CM",6792.0,4414.8,650.99,6792.0,35
CDM,54115WE,REMV FOR.BODY DEEP PENILE TISS,2780.0,1807.0,275.79,2085.0,35
CDM,54120WE,"REMOVAL PENIS,PARTIAL",4404.0,2862.6,442.94,4404.0,35
CDM,54125WE,"REMOVAL PENIS,TOTAL",5824.0,3785.6,623.37,5824.0,35
CDM,54135WE,AMPUTATION PENIS RADICAL W/LYMPH NODES,11268.0,7324.2,1048.91,11268.0,35
CDM,54150WE,CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,760.0,494.0,48.41,570.0,35
CDM,54161WE,CIRCUMCISION AGE >28 DAYS,1328.0,863.2,143.79,1328.0,35
CDM,54162WE,LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS,1328.0,863.2,104.7,996.0,35
CDM,54163WE,REP INCOMPLETE CIRCUMCISION,1328.0,863.2,149.77,1328.0,35
CDM,54164WE,FRENULOTOMY OF PENIS,1128.0,733.2,131.34,1128.0,35
CDM,54200INJWE,INJECTION FOR PEYRONIE DIS,444.0,288.6,52.58,333.0,35
CDM,54200TREWE,TREATMENT OF PENIS LESION,444.0,288.6,52.58,333.0,35
CDM,54200WE,INJECTION PEYRONIE DISEASE,444.0,288.6,52.58,333.0,35
CDM,54205WE,NJX PEYRONIE W/SURG EXPOS PLAQUE,3947.0,2565.55,336.68,3947.0,35
CDM,54220WE,IRRIGATION CORPORA CAVERNOSA PRIAPISM,968.0,629.2,64.11,726.0,35
CDM,54230WE,INJECTION CORPORA CAVERNOSOGRAPY,536.0,348.4,49.45,402.0,35
CDM,54231WE,DYNAMIC CAVERNOSOMETRY NJX VASOACTIVE DRUGS,898.0,583.7,71.31,673.5,35
CDM,54235WE,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,476.0,309.4,35.0,357.0,35
CDM,54240WE,PENILE PLETHYSMOGRAPHY,524.0,340.6,61.92,524.0,35
CDM,54250WE,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,888.0,577.2,81.17,888.0,32
CDM,54250WE-26,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,888.0,577.2,94.05,888.0,31
CDM,54300WE,PENIS STRAIGHTENING CHORDEE,4480.0,2912.0,470.6,4480.0,35
CDM,54304WE,PENIS CORRJ CHORDEE/1ST STAGE HYPOSPADIAS RPR,5312.0,3452.8,540.11,5312.0,35
CDM,54360WE,PLASTIC RPR PENIS CORRECT ANGULATION,5112.0,3322.8,510.96,5112.0,35
CDM,54400WE,INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID,3668.0,2384.2,381.71,3668.0,32
CDM,54401WE,INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED,4176.0,2714.4,435.81,4176.0,32
CDM,54405WE,INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH,5808.0,3775.2,547.09,5808.0,32
CDM,54406WE,RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH,5156.0,3351.4,500.19,5156.0,35
CDM,54408WE,RPR COMPONENT INFLATABLE PENILE PROSTHESIS,5564.0,3616.6,527.01,5564.0,32
CDM,54410WE,RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS,6072.0,3946.8,623.68,6072.0,32
CDM,54411WE,RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL,7340.0,4771.0,678.39,7340.0,32
CDM,54415WE,RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT,3552.0,2308.8,370.47,3552.0,35
CDM,54416WE,RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI,4832.0,3140.8,482.59,4832.0,32
CDM,54417WE,RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD,6440.0,4186.0,595.53,6440.0,32
CDM,54420WE,CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI,4956.0,3221.4,513.29,4956.0,35
CDM,54430WE,CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI,4424.0,2875.6,459.09,4424.0,35
CDM,54435WE,CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM,2724.0,1770.6,282.52,2724.0,35
CDM,54437WE,REPAIR OF TRAUMATIC CORPOREAL TEAR(S),4600.0,2990.0,518.32,4600.0,31
CDM,54440WE,PLASTIC OPERATION PENIS INJURY,5550.0,3607.5,151.04,5550.0,16
CDM,54450WE,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,448.0,291.2,36.79,336.0,35
CDM,54500WE,BIOPSY TESTIS NEEDLE SEPARATE PROCEDURE,524.0,340.6,51.71,524.0,35
CDM,54505WE,BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE,1400.0,910.0,145.6,1400.0,35
CDM,54512WE,EXC XTRPARENCHYMAL LESION TESTIS,3732.0,2425.8,388.68,3732.0,35
CDM,54520WE,ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH,2332.0,1515.8,254.05,2332.0,35
CDM,54522WE,PARTIAL ORCHIECTOMY,4100.0,2665.0,441.34,4100.0,35
CDM,54530WE,ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH,3384.0,2199.6,392.75,3384.0,35
CDM,54535WE,ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL,5276.0,3429.4,543.98,5276.0,35
CDM,54550WE,EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA,3364.0,2186.6,344.97,3364.0,35
CDM,54600WE,RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS,3056.0,1986.4,306.88,3056.0,35
CDM,54620WE,FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE,2084.0,1354.6,217.05,2084.0,35
CDM,54640WE,ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,3401.0,2210.65,333.45,3401.0,35
CDM,54650WE,ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS,5452.0,3543.8,508.19,5452.0,35
CDM,54660WE,INSJ TESTICULAR PROSTH SEPARATE PROCEDURE,2296.0,1492.4,225.79,2296.0,32
CDM,54690WE,"LAPAROSCOPY, SURGICAL; ORCHIECTOMY",4680.0,3042.0,476.62,4680.0,35
CDM,54692WE,LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS,5496.0,3572.4,517.97,5496.0,35
CDM,54700WE,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,1388.0,902.2,130.25,1388.0,35
CDM,54800WE,"BIOPSY OF EPIDIDYMIS,NEEDLE",932.0,605.8,89.98,932.0,35
CDM,54830WE,EXCISION LOCAL LESION EPIDIDYMIS,2404.0,1562.6,237.51,2404.0,35
CDM,54840WE,EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY,2108.0,1370.2,248.68,2108.0,35
CDM,54860WE,EPIDIDYMECTOMY UNILATERAL,2780.0,1807.0,299.9,2780.0,35
CDM,54861WE,EPIDIDYMECTOMY BILATERAL,3880.0,2522.0,418.96,3880.0,35
CDM,54865WE,EXPLORATION OF EPIDIDYMIS W/WO BIOPSY,2539.0,1650.35,227.72,2539.0,35
CDM,54900WE,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI,5680.0,3692.0,576.17,5680.0,32
CDM,54901WE,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS BI,7640.0,4966.0,747.69,7640.0,32
CDM,55000WE,PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED,572.0,371.8,50.46,429.0,35
CDM,55040WE,EXCISION HYDROCELE UNILATERAL,2180.0,1417.0,253.81,2180.0,35
CDM,55041WE,EXCISION HYDROCELE BILATERAL,3758.0,2442.7,372.5,3758.0,35
CDM,55060WE,RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE,2460.0,1599.0,254.87,2460.0,35
CDM,55100WE,DRAINAGE SCROTAL WALL ABSCESS,980.0,637.0,96.6,735.0,35
CDM,55110WE,EXPLORE SCROTUM,2532.0,1645.8,244.44,2532.0,35
CDM,55120WE,REMOVAL FOREIGN BODY SCROTUM,2288.0,1487.2,192.73,2288.0,35
CDM,55150WE,RESECTION SCROTUM,3256.0,2116.4,332.54,3256.0,35
CDM,55175WE,SCROTOPLASTY SIMPLE,2348.0,1526.2,255.25,2348.0,35
CDM,55180WE,SCROTOPLASTY COMPLICATED,4712.0,3062.8,466.36,4712.0,35
CDM,55200WE,VASOTOMY CANNULIZATION W/WO VAS INC UNI/BI SPX,1820.0,1183.0,90.05,1365.0,35
CDM,55250WE,VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS,1348.0,876.2,154.3,1011.0,35
CDM,55300WE,VASOTOMY VASOGRAMS UNI/BI,1400.0,910.0,130.15,1400.0,35
CDM,55400WE,VASOVASOSTOMY VASOVASORRHAPHY,3788.0,2462.2,276.03,3788.0,32
CDM,55500WE,EXC HYDROCELE SPRMATIC CORD UNI SPX,2488.0,1617.2,261.12,2488.0,35
CDM,55520WE,EXC LESION SPERMATIC CORD SEPARATE PROCEDURE,2664.0,1731.6,248.93,2664.0,35
CDM,55530WE,EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX,2300.0,1495.0,269.71,2300.0,35
CDM,55535WE,EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL,2876.0,1869.4,290.39,2876.0,35
CDM,55540WE,EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR,3320.0,2158.0,331.79,3320.0,35
CDM,55550WE,LAPS LIGATION SPERMATIC VEINS VARICOCELE,2880.0,1872.0,286.8,2880.0,35
CDM,55559RVU1WE,LAPAROSCOPIC EXCISION OF SPERMATIC CORD LESION (COMP 55520),2664.0,1731.6,305.68,2664.0,15
CDM,55650WE,VESICULECTOMY ANY APPROACH,5060.0,3289.0,500.0,5060.0,35
CDM,55705WE,BIOPSY PROSTATE INCISIONAL ANY APPROACH,1844.0,1198.6,106.99,1844.0,35
CDM,55706WE,BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID,2512.0,1632.8,219.41,2512.0,35
CDM,55707WE,BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED,1157.0,752.05,146.93,1157.0,21
CDM,55708WE,BX PROSTATE TRANSRECTAL US GID W/MRI FUS GDN 1ST,1492.0,969.8,182.74,1492.0,21
CDM,55709WE,BX PROSTATE TRANSPERINEAL ULTRASOUND-GUIDED,1421.0,923.65,175.74,1421.0,21
CDM,55710WE,BX PROSTATE TRANSPERINEAL US GID W/MRI FUS GDN 1,1676.0,1089.4,202.93,1676.0,21
CDM,55711WE,BX PROSTATE TRANSRECTAL MRI-US GID TRGT LES 1ST,1148.0,746.2,146.26,1148.0,21
CDM,55712WE,BX PROSTATE TPRNL MRI-US GID TRGT LES 1ST,1364.0,886.6,170.43,1364.0,21
CDM,55713WE,BX PROSTATE IN-BORE CT/MRI BX ADDL TRGT LES 1ST,1760.0,1144.0,200.66,1760.0,21
CDM,55714WE,BX PROSTATE IN-BORE CT/MRI TRGT LES ONLY 1ST,1593.0,1035.45,182.76,1593.0,21
CDM,55715WE,BX PROSTATE EA ADDL MRI-US FUSION/IN-BORE CT/MRI,462.0,300.3,51.22,462.0,21
CDM,55801WE,PROSTATECTOMY PERINEAL SUBTOTAL,7920.0,5148.0,759.74,7920.0,35
CDM,55810WE,PROSTATECTOMY PERINEAL RADICAL,9716.0,6315.4,989.29,9716.0,35
CDM,55812WE,PROSTATECTOMY PERINEAL RADICAL W/LYMPH NODE BX,11204.0,7282.6,1116.74,11204.0,35
CDM,55815WE,PROSTATECTOMY PERINEAL RAD W/BI PELVIC LYMPH EXC,12421.0,8073.65,1341.73,12421.0,35
CDM,55821WE,PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1/2 STAGES,6072.0,3946.8,642.65,6072.0,35
CDM,55831WE,PROSTATECTOMY RETROPUBIC SUBTOTAL,6240.0,4056.0,658.99,6240.0,35
CDM,55840WE,PROSTATECTOMY RETROPUBIC W/WO NERVE SPARING,8544.0,5553.6,895.17,8544.0,35
CDM,55842WE,PROSTECT RETROPUBIC RAD W/WO NRV SPAR W/LYMPH BX,8544.0,5553.6,893.12,8544.0,35
CDM,55845WE,PROSTECT RETROPUB RAD W/WO NRV SPAR & BI PLV LYM,11079.0,7201.35,1039.43,11079.0,35
CDM,55860WE,EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST,6970.0,4530.5,547.31,6970.0,35
CDM,55866WE,LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT,9882.0,6423.3,913.04,9882.0,35
CDM,55867WE,LAPS SURG PRST8ECT SMPL STOT ROBOTIC ASSISTANCE,7812.0,5077.8,759.87,7812.0,31
CDM,55868WE,LAPS SURG PRST8ECT RPBIC RADICAL W/LYMPH NODE BX,9882.0,6423.3,1195.42,9882.0,21
CDM,55869WE,LAPS SURG PRST8ECT RPBIC RAD W/BI PEL LYMPHADEC,12060.0,7839.0,1435.45,12060.0,21
CDM,55873WE,CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI,5440.0,3536.0,606.7,11333.29,35
CDM,55874WE,TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX,1212.0,787.8,127.67,5953.0,28
CDM,55875WE,TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ,5384.0,3499.6,464.33,5384.0,35
CDM,55876WE,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,692.0,449.8,56.57,519.0,35
CDM,55877WE,ABLATION IRE PRST8 1 OR MORE TUMORS PERCUTANEOUS,5940.0,3861.0,720.55,5940.0,21
CDM,55880WE,TRANSRECTAL ABLTJ MAL PRST8 TISSUE HIFU W/US,7092.0,4609.8,694.5,7092.0,31
CDM,55881WE,ABLATION TRANSURETHRAL PRST8 TISSUE W/THERMAL US,4312.0,2802.8,346.93,14849.53,25
CDM,55882WE,ABLT TRURL PRST8 TIS THRM US INS TRURL US TRNSDC,5060.0,3289.0,426.05,15376.36,25
CDM,55899RVU18WE,ASPIRATION OF SPERMATOCELE (COMP CODE 55000),572.0,371.8,127.34,572.0,15
CDM,55899RVU19WE,FREE FLAP PHALLOPLASTY (COMP CODE 15757),15975.0,10383.75,127.34,15975.0,15
CDM,55899RVU20WE,MICRODISSECTION TESTICULAR SPERM EXTRACTION (54522),3691.0,2399.15,127.34,3691.0,15
CDM,55899RVU21WE,LAPAROSCOPIC VESICULECTOMY (COMP CODE 55650),5060.0,3289.0,127.34,5060.0,15
CDM,55899RVU22WE,MICROSCOPIC CREMASTERIC LYSIS (COMP CODE 64722),3434.0,2232.1,127.34,3434.0,15
CDM,56405WE,I&D VULVA/PERINEAL ABSCESS,596.0,387.4,65.79,447.0,35
CDM,56420WE,I&D OF BARTHOLINS GLAND ABSCESS,576.0,374.4,54.74,432.0,35
CDM,56440WE,MARSUP BARTHOLIN GLAND CYST,1156.0,751.4,140.43,1156.0,35
CDM,56441WE,LYSIS LABIAL ADHESIONS,808.0,525.2,104.49,606.0,35
CDM,56442WE,"HYMENOTOMY, SIMPLE INCISION",272.0,176.8,27.81,272.0,35
CDM,56501WE,DESTRUCTION LESIONS VULVA SIMPLE,632.0,410.8,65.27,474.0,35
CDM,56515WE,DESTRUCTION LESIONS VULVA EXTENSIVE,1355.0,880.75,104.22,1016.25,35
CDM,56605WE,BIOPSY VULVA/PERINEUM 1 LESION SPX,440.0,286.0,28.79,330.0,35
CDM,56606WE,BIOPSY VULVA/PERINEUM EACH ADDL LESION,220.0,143.0,19.23,165.0,35
CDM,56620WE,VULVECTOMY SIMPLE PARTIAL,3313.0,2153.45,378.82,3313.0,35
CDM,56625WE,VULVECTOMY SIMPLE COMPLETE,4259.0,2768.35,478.98,4259.0,35
CDM,56630WE,VULVECTOMY RADICAL PARTIAL,6512.0,4232.8,700.63,6512.0,35
CDM,56631WE,VULVECTOMY RAD PRTL UNI INGUINOFEM LMPHADECTOMY,7596.0,4937.4,883.28,7596.0,35
CDM,56632WE,VULVECTOMY RAD PRTL BI INGUINOFEM LMPHADECTOMY,8744.0,5683.6,1033.32,8744.0,35
CDM,56633WE,VULVECTOMY RADICAL COMPLETE,7848.0,5101.2,824.53,7848.0,35
CDM,56634WE,VULVECTOMY RAD COMPL UNI INGUINOFEM LMPHADECTOMY,8264.0,5371.6,888.94,8264.0,35
CDM,56637WE,VULVECTOMY RAD COMPL BI INGUINOFEM LMPHADECTOMY,9900.0,6435.0,1035.44,9900.0,35
CDM,56640WE,VULVECTOMY RAD COMPL ILIAC & PELVIC LMPHADECTOMY,9912.0,6442.8,1111.21,9912.0,35
CDM,56700WE,PRTL HYMENECTOMY/REVJ HYMENAL RING,1136.0,738.4,125.25,1136.0,35
CDM,56740WE,EXC BARTHOLINS GLAND/CYST,1952.0,1268.8,184.24,1952.0,35
CDM,56800WE,PLASTIC REPAIR INTROITUS,1572.0,1021.8,186.98,1572.0,35
CDM,56810WE,PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX,1716.0,1115.4,185.35,1716.0,35
CDM,56820WE,"COLPOSCOPY, VULVA",600.0,390.0,57.43,450.0,35
CDM,56821WE,COLPOSCOPY VULVA W/BIOPSY,820.0,533.0,74.42,615.0,35
CDM,57000WE,COLPOTOMY W/EXPLORATION,1208.0,785.2,137.98,1208.0,35
CDM,57010WE,COLPOTOMY W/DRAINAGE PELVIC ABSCESS,2736.0,1778.4,240.87,2736.0,35
CDM,57020WE,COLPOCENTESIS SEPARATE PROCEDURE,600.0,390.0,58.66,450.0,35
CDM,57023WE,I&D VAGINAL HEMATOMA NON-OBSTETRICAL,2072.0,1346.8,170.79,2072.0,35
CDM,57061WE,DESTRUCTION VAGINAL LESIONS SIMPLE,572.0,371.8,56.38,429.0,35
CDM,57065WE,DESTRUCTION VAGINAL LESIONS EXTENSIVE,1170.0,760.5,121.3,877.5,35
CDM,57100WE,BIOPSY VAGINAL MUCOSA SIMPLE,480.0,312.0,37.55,360.0,35
CDM,57105WE,BIOPSY VAGINAL MUCOSA EXTENSIVE,696.0,452.4,88.2,522.0,35
CDM,57106WE,VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL,3000.0,1950.0,264.16,3000.0,35
CDM,57107WE,VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T,9824.0,6385.6,771.93,9824.0,35
CDM,57109WE,VAGNC PRTL RMVL VAG WALL W/BI TOT PEL LMPHADEC,11360.0,7384.0,880.13,11360.0,35
CDM,57110WE,VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL,6192.0,4024.8,604.1,6192.0,35
CDM,57111WE,VAGINECTOMY COMPL RMVL VAG WALL & PARAVAG TISS,11360.0,7384.0,900.22,11360.0,35
CDM,57120WE,COLPOCLEISIS LE FORT TYPE,3312.0,2152.8,389.4,3312.0,35
CDM,57130WE,EXCIS VAGINAL SEPTUM,984.0,639.6,115.8,738.0,35
CDM,57135WE,EXCIS VAGINAL CYST/TUMOR,1080.0,702.0,109.43,810.0,35
CDM,57150WE,IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE,200.0,130.0,23.69,150.0,35
CDM,57155WE,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,2266.0,1472.9,153.61,1699.5,35
CDM,57156WE,INSERTION VAGINAL RADIATION DEVICE,1076.0,699.4,72.33,807.0,35
CDM,57160WE,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,356.0,231.4,30.08,267.0,35
CDM,57170WE,DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS,364.0,236.6,27.47,273.0,35
CDM,57180WE,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,652.0,423.8,59.67,489.0,35
CDM,57200WE,COLPORRHAPHY SUTURE INJURY VAGINA,1768.0,1149.2,185.47,1768.0,35
CDM,57210WE,COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU,2284.0,1484.6,232.19,2284.0,35
CDM,57220WE,PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH,1940.0,1261.0,236.47,1940.0,35
CDM,57230WE,PLASTIC REPAIR URETHROCELE,2520.0,1638.0,258.7,2520.0,35
CDM,57240WE,ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO,4032.0,2620.8,348.57,4032.0,35
CDM,57250WE,POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY,4435.0,2882.75,330.35,4435.0,35
CDM,57260WE,CMBND ANTERPOST COLPORRAPHY W/CYSTO,5830.0,3789.5,454.2,5830.0,35
CDM,57265WE,CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR,6000.0,3900.0,554.77,6000.0,35
CDM,57267WE,INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE,1952.0,1268.8,190.73,1952.0,35
CDM,57268WE,REPAIR ENTEROCELE VAGINAL APPROACH SPX,3028.0,1968.2,370.99,3028.0,35
CDM,57270WE,REPAIR ENTEROCELE ABDOMINAL APPROACH SPX,5468.0,3554.2,459.99,5468.0,35
CDM,57280WE,COLPOPEXY ABDOMINAL APPROACH,6688.0,4347.2,550.9,6688.0,35
CDM,57282WE,COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH,4652.0,3023.8,342.39,4652.0,35
CDM,57283WE,COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH,4664.0,3031.6,492.76,4664.0,35
CDM,57284WE,PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR,5732.0,3725.8,556.04,5732.0,35
CDM,57285WE,PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH,4640.0,3016.0,396.41,4640.0,35
CDM,57287WE,RMVL/REVJ SLING STRESS INCONTINENCE,4460.0,2899.0,510.9,4460.0,35
CDM,57288WE,SLING OPER STRES INCONTINENCE,5337.0,3469.05,572.95,5337.0,35
CDM,57289WE,PEREYA PROC+ANTER COLPORRHAPHY,5120.0,3328.0,438.13,5120.0,35
CDM,57291WE,CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT,3456.0,2246.4,366.54,3456.0,35
CDM,57292WE,CONSTRUCTION ARTIFICIAL VAGINA W/GRAFT,5604.0,3642.6,539.42,5604.0,35
CDM,57295WE,REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP,3128.0,2033.2,337.77,3128.0,35
CDM,57296WE,REVJ W/RMVL PROSTHETIC VAGINAL GRAFT ABDML APPR,6624.0,4305.6,548.39,6624.0,35
CDM,57300WE,CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR,3484.0,2264.6,416.24,3484.0,35
CDM,57305WE,CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH,6140.0,3991.0,582.23,6140.0,35
CDM,57307WE,CLSR RECTOVAG FSTL ABDL APPR W/CONCOMITANT CLST,6868.0,4464.2,609.45,6868.0,35
CDM,57308WE,CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ,4236.0,2753.4,457.85,4236.0,35
CDM,57310WE,CLOSE URETHROVAGINAL FISTULA,3060.0,1989.0,297.54,3060.0,35
CDM,57311WE,CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL,3564.0,2316.6,353.39,3564.0,35
CDM,57320WE,CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH,3552.0,2308.8,419.36,3552.0,35
CDM,57330WE,CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR,5284.0,3434.6,539.72,5284.0,35
CDM,57400WE,DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL,908.0,590.2,97.13,908.0,35
CDM,57410WE,PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL,700.0,455.0,81.45,700.0,35
CDM,57415WE,REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL,996.0,647.4,86.14,996.0,35
CDM,57420WE,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,640.0,416.0,60.29,480.0,35
CDM,57421WE,COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX,880.0,572.0,78.64,660.0,35
CDM,57423WE,PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH,6432.0,4180.8,556.67,6432.0,35
CDM,57425WE,LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX,6812.0,4427.8,618.48,6812.0,35
CDM,57426WE,REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC,5720.0,3718.0,481.86,5720.0,35
CDM,57452WE,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,600.0,390.0,67.74,450.0,35
CDM,57454WE,COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE,932.0,605.8,97.88,699.0,35
CDM,57455WE,COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX,796.0,517.4,72.04,597.0,35
CDM,57456WE,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,740.0,481.0,67.25,555.0,35
CDM,57460WE,COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX,1132.0,735.8,94.59,849.0,35
CDM,57461WE,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,1372.0,891.8,115.13,1029.0,35
CDM,57465WE,COMPUTER-AIDED MAPG CERVIX UTERI DRG COLPOSCOPY,324.0,210.6,32.02,243.0,31
CDM,57500WE,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,528.0,343.2,41.49,396.0,35
CDM,57505WE,ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C,476.0,309.4,53.75,357.0,35
CDM,57510WE,CAUTERY CERVIX ELECTRO/THERMAL,760.0,494.0,58.59,570.0,35
CDM,57511WE,CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT,780.0,507.0,101.74,585.0,35
CDM,57513WE,CAUTERY CERVIX LASER ABLATION,780.0,507.0,99.29,585.0,35
CDM,57520WE,CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER,1644.0,1068.6,176.04,1233.0,35
CDM,57522WE,CONIZATION CERVIX W/WO D&C RPR ELTRD EXC,1468.0,954.2,172.24,1101.0,35
CDM,57530WE,TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX,2108.0,1370.2,232.59,2108.0,35
CDM,57531WE,RAD TRACHELECTOMY W/BI PEL LMPHADEC,11980.0,7787.0,1231.91,11980.0,35
CDM,57540WE,EXCISION CERVICAL STUMP ABDOMINAL APPROACH,5848.0,3801.2,430.26,5848.0,35
CDM,57545WE,EXC CERVICAL STUMP ABDL APPR W/PELVIC FLOOR RPR,5694.0,3701.1,457.63,5694.0,35
CDM,57550WE,EXCISION CERVICAL STUMP VAGINAL APPROACH,2536.0,1648.4,318.77,2536.0,35
CDM,57555WE,EXC CRV STUMP VAG APPR W/ANT &/POST REPAIR,3976.0,2584.4,476.44,3976.0,35
CDM,57556WE,EXC CRV STUMP VAG APPR W/RPR NTRCL,4118.0,2676.7,406.57,4118.0,35
CDM,57558WE,DILATION & CURETTAGE CERVICAL STUMP,688.0,447.2,63.29,516.0,35
CDM,57700WE,CERCLAGE UTERINE CERVIX NONOBSTETRICAL,1740.0,1131.0,176.05,1740.0,35
CDM,57720WE,TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG,1844.0,1198.6,191.24,1844.0,35
CDM,57800WE,DILATION CERVICAL CANAL INSTRUMENTAL SPX,308.0,200.2,30.26,231.0,35
CDM,58100WE,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,532.0,345.8,56.98,399.0,35
CDM,58110WE,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,308.0,200.2,29.1,231.0,35
CDM,58120WE,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,1436.0,933.4,128.25,1077.0,35
CDM,58140WE,MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR,6316.0,4105.4,518.63,6316.0,35
CDM,58145WE,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,3564.0,2316.6,432.33,3564.0,35
CDM,58146WE,MYOMECTOMY 5/> MYOMAS &/>250 GM ABDOMINA,8136.0,5288.4,745.58,8136.0,35
CDM,58150WE,TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY,6924.0,4500.6,671.32,6924.0,35
CDM,58152WE,TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY,8744.0,5683.6,726.38,8744.0,35
CDM,58180WE,SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY,6640.0,4316.0,615.33,6640.0,35
CDM,58200WE,TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM,9240.0,6006.0,939.04,9240.0,35
CDM,58210WE,RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY,12364.0,8036.6,1261.1,12364.0,35
CDM,58240WE,PEL EXNTJ GYNECOLOGIC MAL,19732.0,12825.8,1799.8,19732.0,35
CDM,58260WE,VAGINAL HYSTERECTOMY UTERUS 250 GM/<,5660.0,3679.0,580.02,5660.0,35
CDM,58262WE,VAG HYST 250 GM/< W/RMVL TUBE&/OVARY,6376.0,4144.4,630.28,6376.0,35
CDM,58263WE,VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL,6892.0,4479.8,688.28,6892.0,35
CDM,58267WE,VAG HYST 250 GM/< W/COLPO-URTCSTOPEXY,7344.0,4773.6,709.35,7344.0,35
CDM,58270WE,VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE,6120.0,3978.0,637.77,6120.0,35
CDM,58275WE,VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY,6812.0,4427.8,695.49,6812.0,35
CDM,58280WE,VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE,7332.0,4765.8,663.66,7332.0,35
CDM,58290WE,VAGINAL HYSTERECTOMY UTERUS > 250 GM,8108.0,5270.2,745.07,8108.0,35
CDM,58291WE,VAG HYST > 250 GM RMVL TUBE&/OVARY,8824.0,5735.6,819.34,8824.0,35
CDM,58292WE,VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE,9340.0,6071.0,867.99,9340.0,35
CDM,58294WE,VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE,8620.0,5603.0,799.15,8620.0,35
CDM,58300WE,INSERT INTRAUTERINE DEVICE,444.0,288.6,35.32,333.0,24
CDM,58301WE,REMOVE INTRAUTERINE DEVICE,559.0,363.35,33.29,419.25,35
CDM,58340WE,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,387.0,251.55,27.29,290.25,35
CDM,58345WE,TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING,1880.0,1222.0,248.69,1880.0,31
CDM,58346WE,INSERTION HEYMAN CAPSULES CLINICAL BRACHYTHERAPY,3326.0,2161.9,296.27,3326.0,35
CDM,58350WE,CHROMOTUBATION OVIDUCT W/MATERIALS,424.0,275.6,69.84,318.0,31
CDM,58353WE,ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID,1440.0,936.0,131.22,1540.59,35
CDM,58356WE,ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR,2564.0,1666.6,268.45,2876.23,35
CDM,58400WE,UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX,2856.0,1856.4,324.17,2856.0,32
CDM,58410WE,UTERINE SUSP W/WO SHORT LIGAMNTS W/SYMPATHECTOMY,5520.0,3588.0,423.1,5520.0,32
CDM,58520WE,HYSTERORRHAPHY REPAIR RUPT UTERUS NONOBSTETRICAL,5392.0,3504.8,429.65,5392.0,35
CDM,58540WE,REVISION OF UTERINE ANOMALY,6284.0,4084.6,500.63,6284.0,35
CDM,58541WE,LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<,4916.0,3195.4,492.98,4916.0,35
CDM,58542WE,LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR,6230.0,4049.5,545.89,6230.0,35
CDM,58543WE,"LAP, SUPRACERVIAL HYSTERECTOMY, >250G",6332.0,4115.8,555.17,6332.0,35
CDM,58544WE,LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY,6240.0,4056.0,601.52,6240.0,35
CDM,58545WE,LAPS MYOMECTOMY EXC 1-4 MYOMAS 250 GM/<,6220.0,4043.0,598.84,6220.0,35
CDM,58546WE,LAPS MYOMECTOMY EXC 5/> MYOMAS >250 GRAMS,7976.0,5184.4,754.9,7976.0,35
CDM,58548WE,LAPS W/RAD HYST W/BILAT LMPHADEC RMVL TUBE/OVARY,12652.0,8223.8,1051.09,12652.0,35
CDM,58550WE,LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<,6040.0,3926.0,635.18,6040.0,35
CDM,58552WE,LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES,6764.0,4396.6,583.06,6764.0,35
CDM,58553WE,LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS,8024.0,5215.6,749.98,8024.0,35
CDM,58554WE,LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR,9244.0,6008.6,742.47,9244.0,35
CDM,58555WE,"HYSTEROSCOPY, DIAGNOSTIC (SEPARATE",1166.0,757.9,77.16,874.5,35
CDM,58558WE,HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C,1835.0,1192.75,111.78,1376.25,35
CDM,58559WE,HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS,2080.0,1352.0,216.77,2080.0,35
CDM,58560WE,HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM,2300.0,1495.0,227.72,2300.0,35
CDM,58561WE,HYSTEROSCOPY REMOVAL LEIOMYOMATA,2904.0,1887.6,273.2,2904.0,35
CDM,58562WE,HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY,1600.0,1040.0,107.34,1200.0,35
CDM,58563WE,HYSTEROSCOPY ENDOMETRIAL ABLATION,1967.0,1278.55,219.1,2547.18,35
CDM,58565WE,HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS,2848.0,1851.2,314.29,2863.41,32
CDM,58570WE,LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<,5344.0,3473.6,554.44,5344.0,35
CDM,58571WE,LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY,6600.0,4290.0,606.07,6600.0,35
CDM,58572WE,LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM,7792.0,5064.8,688.89,7792.0,35
CDM,58573WE,LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR,8316.0,5405.4,774.73,8316.0,35
CDM,58575WE,LAPS TOT HYSTERECTOMY RESJ MALIGNANCY W/OMNTC,13040.0,8476.0,1422.46,13040.0,31
CDM,58578ABLWE,LAPAROSCOPIC FIBROID ABLATION,3525.0,2291.25,745.31,3525.0,15
CDM,58578FIBWE,LAPAROSCOPIC FIBROID EMBOLIZATION,3525.0,2291.25,745.31,3525.0,15
CDM,58578HYSWE,LAPARASCOPIC SUPRACERVICAL HYSTERECTOMY,5640.0,3666.0,745.31,5640.0,15
CDM,58578RVU5WE,UNLISTED PROC; ROBOTIC LAPAROSCOPIC TRACHELECTOMY AMPUTATION OF,2266.0,1472.9,745.31,2266.0,15
CDM,58578RVU8WE,LAPAROSCOPIC ISTHMOCELE REPAIR (COMP CODE 58520),5392.0,3504.8,745.31,5392.0,15
CDM,58578RVU9WE,LAPAROSCOPIC CERVICAL STOMA CREATION (COMP CODE 44187),6960.0,4524.0,745.31,6960.0,15
CDM,58578UTEWE,LAPAROSCOPIC UTEROSACRAL NERVE ABLATION,1411.0,917.15,705.5,1411.0,15
CDM,58579OCCWE,HYSTEROSCOPIC TRANSVAG TUBAL OCCLUSION,1848.0,1201.2,274.4,1848.0,15
CDM,58580WE,TRANSCERVICAL ABLATION UTERINE FIBROID RF,3172.0,2061.8,289.36,5040.03,31
CDM,58600WE,LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI,2364.0,1536.6,228.1,2364.0,35
CDM,58611WE,LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG,638.0,414.7,44.64,638.0,35
CDM,58615WE,OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR,1576.0,1024.4,180.93,1576.0,35
CDM,58660WE,LAPAROSCOPY W/LYSIS OF ADHESION,4636.0,3013.4,373.32,4636.0,35
CDM,58661WE,LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES,4994.0,3246.1,421.73,4994.0,35
CDM,58662WE,LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE,4860.0,3159.0,394.61,4860.0,35
CDM,58670WE,LAPAROSCOPY FULGURATION OVIDUCTS,2364.0,1536.6,284.53,2364.0,35
CDM,58671WE,LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS,2364.0,1536.6,224.49,2364.0,35
CDM,58672WE,LAPAROSCOPY FIMBRIOPLASTY,5164.0,3356.6,420.78,5164.0,35
CDM,58673WE,LAPAROSCOPY SALPINGOSTOMY,5616.0,3650.4,454.33,5616.0,35
CDM,58679RVU1WE,"UNLISTED PROC, LAPAROSCOPIC BIL OVARIAN TRANSPOSITION (COMP CODE",4137.0,2689.05,441.14,4137.0,15
CDM,58679RVU2WE,UNLISTED LAPAROSCOPIC DETORSION OF OVARY (COMP CODE 49322),2164.0,1406.6,441.14,2164.0,15
CDM,58679RVU3WE,LAPAROSCOPIC TUBAL RE-ANASTOMOSIS (COMP CODE 58750),5631.0,3660.15,441.14,5631.0,15
CDM,58679RVU4WE,LAPAROSCOPIC UTERINE AND OVARIAN TRANSPOSITION (COMP CODE 58571),6600.0,4290.0,441.14,6600.0,15
CDM,58679RVUWE,"UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT OVARY (COMPARISON CODE 5",4540.0,2951.0,441.14,4540.0,15
CDM,58679SALWE,"LAPAROSCOPIC SALPINOOOPHORECTOMY, UNLISTE",2277.0,1480.05,441.14,2277.0,15
CDM,58679WE,"UNLISTED LAPAROSCOPY PROCEDURE, OVI",2605.0,1693.25,441.14,2605.0,15
CDM,58700WE,SALPINGECTOMY COMPLETE/PARTIAL UNI/BI SPX,5180.0,3367.0,419.21,5180.0,35
CDM,58720WE,SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX,4864.0,3161.6,450.3,4864.0,35
CDM,58740WE,LYSIS OF ADHESIONS SALPINX/OVARY,5960.0,3874.0,484.65,5960.0,35
CDM,58750WE,TUBOTUBAL ANASTOMOSIS,6256.0,4066.4,804.16,6256.0,31
CDM,58760WE,FIMBRIOPLASTY,5572.0,3621.8,722.3,5572.0,31
CDM,58770WE,SALPINGOSTOMY,5908.0,3840.2,661.55,5908.0,34
CDM,58800WE,DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR,1848.0,1201.2,155.34,1386.0,35
CDM,58805WE,DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL,2568.0,1669.2,327.35,2568.0,35
CDM,58822WE,DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH,4724.0,3070.6,373.63,4724.0,35
CDM,58825WE,"TRANSPOSITION, OVARY(S)",4712.0,3062.8,385.78,4712.0,35
CDM,58900WE,BIOPSY OVARY UNI/BI SEPARATE PROCEDURE,2636.0,1713.4,301.23,2636.0,35
CDM,58920WE,WEDGE RESCJ/BISCTJ OVARY UNI/BI,4780.0,3107.0,389.68,4780.0,35
CDM,58925WE,OVARIAN CYSTECTOMY UNI/BI,4972.0,3231.8,421.68,4972.0,35
CDM,58940WE,OOPHORECTOMY PARTIAL/TOTAL UNI/BI,3617.0,2351.05,368.73,3617.0,35
CDM,58943WE,OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MALIGNANCY,7808.0,5075.2,827.72,7808.0,35
CDM,58950WE,RESCJ OVARIAN/TUBAL/PERITONEAL MALIGNANCY W/BSO,7348.0,4776.2,717.05,7348.0,35
CDM,58951WE,RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD,9704.0,6307.6,1075.5,9704.0,35
CDM,58952WE,RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING,10916.0,7095.4,1160.81,10916.0,35
CDM,58953WE,BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION,13652.0,8873.8,1337.83,13652.0,35
CDM,58954WE,BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY,14852.0,9653.8,1454.28,14852.0,35
CDM,58956WE,BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC,9120.0,5928.0,973.61,9120.0,35
CDM,58958WE,RESCJ RECR OVR TBL PP UTR MAL OMNTC PEL LMPHADEC,11688.0,7597.2,943.89,11688.0,35
CDM,58960WE,LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK,6316.0,4105.4,746.73,6316.0,35
CDM,58999RVU12WE,"UNLISTED PROC, EXCISION OF VAGINAL CUFF LESION (COMP TO 57135)",891.0,579.15,123.54,891.0,15
CDM,58999RVU18WE,UNLISTED LAPOROSCOPIC RADICAL PARTIAL VAGINECTOMY (COMP CODE 571,9944.0,6463.6,123.54,9944.0,15
CDM,58999RVU19WE,UNLISTED TRANSVAGINAL REPAIR OF CESAREAN SCAR DEFECT (COMP CODE,3255.0,2115.75,123.54,3255.0,15
CDM,58999RVU1WE,LYSIS OF ADHESIONS OF VAGINAL (COMP CODE 56441),398.0,258.7,123.54,398.0,15
CDM,58999RVU20WE,LAPAROSCOPIC RESECTION OF NEOVAGINA (COMP 57110),6656.0,4326.4,123.54,6656.0,15
CDM,58999RVU22WE,VAGINAL CUFF BIOPSY (COMP CODE 57100),480.0,312.0,123.54,480.0,15
CDM,58999RVU2WE,UNLISTED VAGINAL CUFF REPAIR (COMP CODE 57200),1768.0,1149.2,123.54,1768.0,15
CDM,58999RVU5WE,LAPAROSCOPIC PARTIAL VAGINECTOMY (COMP CODE 57106),3094.0,2011.1,123.54,3094.0,15
CDM,58999RVUWE,LAPAROSCOPIC REPAIR COLOVAGINAL FISTULA (COMP 57305),3655.0,2375.75,123.54,3655.0,15
CDM,59000WE,AMNIOCENTESIS DIAGNOSIC,520.0,338.0,39.44,390.0,35
CDM,59100WE,HYSTEROTOMY ABDOMINAL,5348.0,3476.2,468.07,5348.0,35
CDM,59120WE,TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR,5068.0,3294.2,483.65,5068.0,35
CDM,59150WE,LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY,4916.0,3195.4,432.22,4916.0,35
CDM,59151WE,LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY,4844.0,3148.6,426.65,4844.0,35
CDM,59160WE,CURETTAGE POSTPARTUM,1104.0,717.6,118.16,828.0,35
CDM,59300WE,EPISIOTOMY/VAG RPR OTH/THN ATTENDING,868.0,564.2,71.17,651.0,35
CDM,59620WE,CESAREAN DELIVERY ATTEMPTED VBAC,6664.0,4331.6,776.99,6664.0,32
CDM,59812WE,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,1776.0,1154.4,161.43,1332.0,35
CDM,59820WE,TX MISSED ABORTION FIRST TRIMESTER SURGICAL,1936.0,1258.4,190.59,1452.0,35
CDM,59821WE,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,2036.0,1323.4,184.93,1527.0,35
CDM,59830WE,TX SEPTIC ABORTION SURGICAL,2636.0,1713.4,281.03,2636.0,35
CDM,59840WE,INDUCED ABORTION DILATION AND CURETTAGE,1204.0,782.6,169.81,903.0,35
CDM,59870WE,UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE,2628.0,1708.2,263.83,2628.0,35
CDM,59899RVU4WE,JADA PROCEDURE (COMP CODE43460),1629.0,1058.85,82.79,1629.0,15
CDM,60100WE,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,624.0,405.6,42.86,468.0,35
CDM,60200WE,EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS,4008.0,2605.2,427.89,4008.0,35
CDM,60210WE,PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,4492.0,2919.8,528.63,4492.0,35
CDM,60212WE,PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC,6572.0,4271.8,681.11,6572.0,35
CDM,60220WE,TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,4924.0,3200.6,516.29,4924.0,35
CDM,60225WE,TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC,6508.0,4230.2,666.11,6508.0,35
CDM,60240WE,THYROIDECTOMY TOTAL/COMPLETE,6618.0,4301.7,689.42,6618.0,35
CDM,60252WE,THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT,8804.0,5722.6,862.42,8804.0,35
CDM,60254WE,THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT,11368.0,7389.2,1142.61,11368.0,35
CDM,60260WE,THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL,7304.0,4747.6,587.65,7304.0,35
CDM,60270WE,THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC,9280.0,6032.0,862.92,9280.0,35
CDM,60271WE,THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH,7048.0,4581.2,730.35,7048.0,35
CDM,60280WE,EXCISION THYROGLOSSAL DUCT CYST/SINUS,2464.0,1601.6,347.5,2464.0,35
CDM,60281WE,EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT,3528.0,2293.2,375.91,3528.0,35
CDM,60300WE,ASPIRATION AND/OR INJECTION THYROID CYST,388.0,252.2,23.51,291.0,35
CDM,60500WE,PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS,6864.0,4461.6,744.56,6864.0,35
CDM,60502WE,PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR,8460.0,5499.0,863.15,8460.0,35
CDM,60512WE,PARATHYROID AUTOTRANSPLANTATION ADD-ON,1776.0,1154.4,183.58,1776.0,35
CDM,60520WE,THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX,6864.0,4461.6,774.22,6864.0,35
CDM,60521WE,THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX,7672.0,4986.8,838.05,7672.0,35
CDM,60522WE,THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX,9392.0,6104.8,998.21,9392.0,35
CDM,60540WE,ADRENALECTOMY W/EXPL W/WO BX ABDL/LMBR/DRSAL SPX,7929.0,5153.85,774.51,7929.0,35
CDM,60545WE,ADRENALECTOMY EXPL W/EXC RETROPERTINEAL TUMOR,8372.0,5441.8,906.78,8372.0,35
CDM,60600WE,EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY,10036.0,6523.4,809.68,10036.0,35
CDM,60605WE,EXC CAROTID BODY TUMOR W EXC CAROTID ARTERY,12784.0,8309.6,963.78,12784.0,35
CDM,60650WE,LAPAROSCOPY ADRENALECTOMY PARTIAL OR COM,8292.0,5389.8,757.23,8292.0,35
CDM,60660WE,ABLTJ 1/+THYROID NODULE 1 LOBE/ISTHMUS PERQ RF,2530.0,1644.5,225.77,4320.23,25
CDM,60661WE,ABLTJ 1/+THYR NDUL ADDL LOBE PERQ RADIOFREQUENCY,1870.0,1215.5,156.85,1402.5,25
CDM,60699RVU7WE,IMAGE GUIDED - CRYOABLATION OF ADRENAL GLAND (COMP CODE 50593),3197.0,2078.05,586.19,3197.0,15
CDM,60699RVU8WE,MICROWAVE ABLATION ADRENAL GLAND (COMP CODE 50592),2620.0,1703.0,586.19,2620.0,15
CDM,60699RVU9WE,RADIOFREQUENCY ABLATION PARATHYROID ADENOMA (COMP CODE 20982),2808.0,1825.2,586.19,2808.0,15
CDM,60699RVUWE,AUTOTRANS OF CRYO TISSUE (COMP CODE 60512),1599.0,1039.35,586.19,1599.0,15
CDM,61000010,MRI PELVIS W/O CONTRAST MATERIAL,2085.0,1355.25,145.46,1903.0,41
CDM,61000020,MRI PELVIS W/CONTRAST MATERIAL,3080.0,2002.0,241.9,2772.0,41
CDM,61000030,CARDIAC MRI W/W/O CONTRAST W/STRESS,6814.0,4429.1,241.9,6132.6,41
CDM,61000040,MRI SPECTROSCOPY,760.0,494.0,88.38,1903.0,40
CDM,61000045,MRI PRE- OP MAPPING W/WO CONTR,760.0,494.0,88.38,1903.0,40
CDM,61000050,MRI GUIDANCE NEEDLE PLACEMENT RS&I,2566.0,1667.9,124.2,2309.4,28
CDM,61000060,MRI GUIDANCE FOR PARENCHYMAL TISSUE ABLATION,2043.0,1327.95,124.2,1903.0,27
CDM,61000120,BONE MARROW BLOOD SUPPLY,2085.0,1355.25,145.46,1903.0,41
CDM,61000165,MRI SPECTROSCOPY,760.0,494.0,88.38,1903.0,40
CDM,61000185,MRI BREAST BIL W/ CONTR,7480.0,4862.0,241.9,6732.0,31
CDM,61000205,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,13975.0,9083.75,212.91,12577.5,46
CDM,61000375,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,2085.0,1355.25,145.46,1903.0,41
CDM,61000385,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,2085.0,1355.25,145.46,1903.0,41
CDM,61000395,MRI BREAST W/OUT&WITH CONTRAST W/CAD UNILATERAL,6213.0,4038.45,241.9,5591.7,31
CDM,61000405,MRI BREAST BILAT WO/W CONTR,7480.0,4862.0,241.9,6732.0,31
CDM,61000415,MAGNETIC RESONANCE ELASTOGRAPHY,2085.0,1355.25,145.46,1903.0,41
CDM,61000425,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,2085.0,1355.25,145.46,1903.0,41
CDM,61000435,MRI BREAST W/OUT&WITH CONTRAST W/CAD UNILATERAL,6213.0,4038.45,241.9,5591.7,31
CDM,61000445,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,7480.0,4862.0,241.9,6732.0,31
CDM,61000455,MRI CERVICAL LOCALIZATION W IVCON,2572.0,1671.8,88.38,2314.8,40
CDM,61000465,MRI THORACIC LOCALIZATION W IVCON,2572.0,1671.8,88.38,2314.8,40
CDM,61000475,MRI LUMBAR LOCALIZATION W IVCON,438.0,284.7,88.38,1903.0,40
CDM,61000495,WHOLE BODY MRI,12580.0,8177.0,88.38,11322.0,40
CDM,61000505,QUAN MR ALYS TISS COMPOSITION W/MRI,4753.0,3089.45,145.46,4277.7,37
CDM,61000515,MRI GAMMA KNIFE LOCAL W CONT,2455.0,1595.75,88.38,2209.5,40
CDM,61000665,MRI BREAST LIMITED,281.0,182.65,78.96,1903.0,40
CDM,61000675,MRI 3D CAD,1231.0,800.15,88.38,1903.0,40
CDM,61000695,MRI BRAIN LOCALIZATION W IVCON,2572.0,1671.8,88.38,2314.8,40
CDM,61000705,MRI PRE-OP MAPPING W/O CONTRAST,760.0,494.0,88.38,1903.0,40
CDM,61000715,MRI PRE-OP MAPPING W/CONTRAST,760.0,494.0,88.38,1903.0,40
CDM,61000725,MRI BRAIN W/WO CONTAST PC,3080.0,2002.0,88.38,2772.0,40
CDM,61000735,MMR BRAIN WITH PC,3080.0,2002.0,88.38,2772.0,40
CDM,61000745,MRI BRAIN LOCALIZATION WWO CONT,2572.0,1671.8,88.38,2314.8,40
CDM,61000755,MRI BREAST 3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1663.0,1080.95,279.38,1903.0,21
CDM,61020WE,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX,604.0,392.6,79.76,604.0,35
CDM,61026WE,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ,676.0,439.4,87.32,676.0,35
CDM,61050WE,CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,604.0,392.6,61.53,604.0,35
CDM,61055WE,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,840.0,546.0,88.34,840.0,35
CDM,61070WE,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,392.0,254.8,43.15,392.0,35
CDM,61100000,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,4729.0,3073.85,145.46,4256.1,48
CDM,61100005,MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL,1535.0,997.75,178.69,2109.0,48
CDM,61100010,MRI ORBIT FACE &/NECK W/O CONTRAST,2085.0,1355.25,145.46,2109.0,49
CDM,61100015,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,1535.0,997.75,178.69,2109.0,48
CDM,61100020,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,3080.0,2002.0,241.9,2772.0,49
CDM,61100025,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,2085.0,1355.25,145.46,2109.0,49
CDM,61100030,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,3080.0,2002.0,241.9,2772.0,49
CDM,61100040,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,2085.0,1355.25,145.46,2109.0,49
CDM,61100050,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,3080.0,2002.0,241.9,2772.0,49
CDM,61100060,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,3080.0,2002.0,241.9,2772.0,49
CDM,61100070,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,2085.0,1355.25,145.46,2109.0,49
CDM,61100080,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,2085.0,1355.25,145.46,2109.0,48
CDM,61100090,MRI BRAIN LOCALIZATION WO CONT,2124.0,1380.6,88.38,2109.0,48
CDM,61105WE,TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE,2180.0,1417.0,293.72,2180.0,35
CDM,61107WE,TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE,1996.0,1297.4,241.03,1996.0,35
CDM,61108WE,TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA,4656.0,3026.4,575.96,4656.0,35
CDM,61120WE,BURR HOLE VENTRICULAR PUNCTURE,3840.0,2496.0,402.67,3840.0,35
CDM,61140WE,BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION,6892.0,4479.8,808.17,6892.0,35
CDM,61150WE,BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST,7560.0,4914.0,867.68,7560.0,35
CDM,61151WE,BURR HOLE/TREPHINE W/SBSQ TAPPING ICRA ABSC/CST,5396.0,3507.4,508.77,5396.0,35
CDM,61154WE,BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL,6828.0,4438.2,843.7,6828.0,35
CDM,61156WE,BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL,6980.0,4537.0,871.63,6980.0,35
CDM,61200010,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,2085.0,1355.25,145.46,2109.0,49
CDM,61200020,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,3080.0,2002.0,241.9,2772.0,49
CDM,61200030,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,2085.0,1355.25,145.46,2109.0,49
CDM,61200040,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,3080.0,2002.0,241.9,2772.0,49
CDM,61200050,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,2085.0,1355.25,145.46,2109.0,49
CDM,61200060,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,3080.0,2002.0,241.9,2772.0,49
CDM,61200070,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,3080.0,2002.0,241.9,2772.0,49
CDM,61200080,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,3080.0,2002.0,241.9,2772.0,49
CDM,61200090,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,3080.0,2002.0,241.9,2772.0,49
CDM,61210WE,BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,2332.0,1515.8,282.64,2332.0,35
CDM,61215WE,INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH,2340.0,1521.0,293.93,2340.0,35
CDM,61304WE,CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL,9364.0,6086.6,1231.65,9364.0,35
CDM,61305WE,CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL,12602.0,8191.3,1469.42,12602.0,35
CDM,61312WE,CRANIECTOMY HMTMA SUPRATENTORIAL EXTRA/SUBDURAL,12068.0,7844.2,1299.8,12068.0,35
CDM,61313WE,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,11236.0,7303.4,1309.52,11236.0,35
CDM,61314WE,CRANIECTOMY HMTMA INFRATENTORIAL EXTRA/SUBDURAL,10360.0,6734.0,1326.24,10360.0,35
CDM,61315WE,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,11860.0,7709.0,1399.61,11860.0,35
CDM,61316WE,INCISION & SUBCUTANEOUS PLMT CRANIAL BONE GRAF,556.0,361.4,60.04,556.0,35
CDM,61320WE,CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL,10968.0,7129.2,1202.55,10968.0,35
CDM,61321WE,CRANIECTOMY/CRANIOTMY DRG ABSCESS INFRATENTORIAL,12212.0,7937.8,1307.54,12212.0,35
CDM,61322WE,CRANIECT/CRANIOT W/WO DURAPLASTY W/O LOBECTOMY,13704.0,8907.6,1216.84,13704.0,35
CDM,61323WE,CRANIECT/CRANIOT W/WO DURAPLASTY W/LOBECTOMY,14024.0,9115.6,1260.05,14024.0,35
CDM,61330WE,DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH,10120.0,6578.0,876.96,10120.0,35
CDM,61343WE,CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD,12744.0,8283.6,1594.03,12744.0,35
CDM,61345WE,OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA,11692.0,7599.8,1260.5,11692.0,35
CDM,61400000,MRI PELVIS W/O CONTRAST MATERIAL,2085.0,1355.25,145.46,2109.0,49
CDM,61400005,MRI PELVIS W/CONTRAST MATERIAL,3080.0,2002.0,241.9,2772.0,49
CDM,61400010,MRI TEMPOROMANDIBULAR JOINT,2085.0,1355.25,145.46,2109.0,49
CDM,61400015,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,708.0,460.2,34.79,2109.0,30
CDM,61400020,MRI CHEST W/O CONTRAST MATERIAL,2085.0,1355.25,145.46,2109.0,49
CDM,61400025,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1795.0,1166.75,106.1,2109.0,30
CDM,61400030,MRI CHEST W/CONTRAST MATERIAL,6814.0,4429.1,241.9,6132.6,49
CDM,61400040,MRI CHEST W/O & W/CONTRAST MATERIAL,3080.0,2002.0,241.9,2772.0,49
CDM,61400050,MRI PELVIS W/O & W/CONTRAST MATERIAL,3080.0,2002.0,241.9,2772.0,49
CDM,61400060,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,2085.0,1355.25,145.46,2109.0,49
CDM,61400070,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,3080.0,2002.0,241.9,2772.0,49
CDM,61400075,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,3080.0,2002.0,241.9,2772.0,49
CDM,61400080,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,3080.0,2002.0,241.9,2772.0,49
CDM,61400090,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,2085.0,1355.25,145.46,2109.0,49
CDM,61400100,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,6814.0,4429.1,241.9,6132.6,49
CDM,61400110,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,3080.0,2002.0,241.9,2772.0,49
CDM,61400120,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,2085.0,1355.25,145.46,2109.0,49
CDM,61400130,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,3080.0,2002.0,241.9,2772.0,49
CDM,61400140,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,3080.0,2002.0,241.9,2772.0,49
CDM,61400150,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,2085.0,1355.25,145.46,2109.0,49
CDM,61400160,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,6814.0,4429.1,241.9,6132.6,49
CDM,61400170,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,3080.0,2002.0,241.9,2772.0,49
CDM,61400180,MRI ABDOMEN W/O CONTRAST MATERIAL,2085.0,1355.25,145.46,2109.0,49
CDM,61400190,MRI ABDOMEN W/CONTRAST MATERIAL,3080.0,2002.0,241.9,2772.0,49
CDM,61400200,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,3080.0,2002.0,241.9,2772.0,49
CDM,61400210,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,2085.0,1355.25,145.46,2109.0,49
CDM,61400220,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,4729.0,3073.85,145.46,4256.1,49
CDM,61400230,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,3080.0,2002.0,241.9,2772.0,49
CDM,61400240,CARDIAC MRI FOR VELOCITY FLOW MAPPING,708.0,460.2,64.42,2109.0,36
CDM,61400250,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1795.0,1166.75,106.1,2109.0,30
CDM,61400365,MAGNETIC RESONANCE ELASTOGRAPHY,2085.0,1355.25,145.46,2109.0,49
CDM,61400375,QMRCP W/DX MRI SAME ANATOMY,4753.0,3089.45,145.46,4277.7,45
CDM,61400385,QUANTITATIVE MRI ANALYSIS OF THE BRAIN,1209.0,785.85,145.46,2109.0,48
CDM,61400395,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,791.0,514.15,92.14,2109.0,43
CDM,61400405,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,513.0,333.45,59.62,2109.0,43
CDM,61400415,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,211.0,137.15,16.06,2109.0,43
CDM,61400425,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,425.0,276.25,71.4,2109.0,30
CDM,61400435,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,760.0,494.0,88.38,2109.0,43
CDM,61400445,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,2085.0,1355.25,242.63,2109.0,43
CDM,61450WE,CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION,11076.0,7199.4,1246.75,11076.0,35
CDM,61458WE,CRNEC SOPL EXPL/DCMPRN CRNL NRV,11536.0,7498.4,1453.84,11536.0,35
CDM,61500010,MRA HEAD W/O CONTRST MATERIAL,2085.0,1355.25,242.63,2109.0,49
CDM,61500020,MRA HEAD W/CONTRAST MATERIAL,3080.0,2002.0,285.23,2772.0,49
CDM,61500030,MRA HEAD W/O & W/CONTRAST MATERIAL,3080.0,2002.0,285.23,2772.0,49
CDM,61500040,MRA NECK W/O CONTRST MATERIAL,2085.0,1355.25,242.63,2109.0,49
CDM,61500050,MRA NECK W/CONTRAST MATERIAL,3080.0,2002.0,285.23,2772.0,49
CDM,61500060,MRA NECK W/O &W/CONTRAST MATERIAL,3080.0,2002.0,285.23,2772.0,49
CDM,61500WE,CRANIECTOMY W/EXCISION TUMOR/LESION SKULL,7672.0,4986.8,954.99,7672.0,35
CDM,61501WE,CRANIECTOMY OSTEOMYELITIS,6540.0,4251.0,840.56,6540.0,35
CDM,61510WE,CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR,13565.0,8817.25,1484.19,13565.0,35
CDM,61512WE,CRNEC TREPHINE BONE FLAP MENINGIOMA SUPRATENTOR,14856.0,9656.4,1717.9,14856.0,35
CDM,61514WE,CRNEC TREPHINE BONE FLAP BRAIN ABSC SUPRATENTOR,10892.0,7079.8,1354.8,10892.0,35
CDM,61516WE,CRNEC TREPHINE BONE FLAP FENEST CYST SUPRATENTOR,10632.0,6910.8,1353.42,10632.0,35
CDM,61517WE,IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT,552.0,358.8,50.99,552.0,35
CDM,61518WE,CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA,15956.0,10371.4,1818.99,15956.0,35
CDM,61519WE,CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA,17372.0,11291.8,1967.23,17372.0,35
CDM,61520WE,CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM,22836.0,14843.4,2296.28,22836.0,35
CDM,61521WE,CRNEC TUM INFRATTL/PFOSSA MIDLINE TUM BASE SKULL,18796.0,12217.4,2093.62,18796.0,35
CDM,61522WE,CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS,12616.0,8200.4,1349.34,12616.0,35
CDM,61524WE,CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST,13152.0,8548.8,1480.5,13152.0,35
CDM,61526WE,CRNEC TRANSTEMPOR EXC CEREBELLOPONTINE ANGLE TUM,23795.0,15466.75,2007.27,23795.0,35
CDM,61530WE,CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA,20046.0,13029.9,1557.26,20046.0,35
CDM,61531WE,SUBDURAL IMPLTJ ELECTRODES SEIZURE MONITORING,6564.0,4266.6,771.83,6564.0,35
CDM,61533WE,CRANIOT SUBDURAL IMPLT ELCTRD SEIZURE MONITORING,8584.0,5579.6,996.46,8584.0,35
CDM,61534WE,CRANIOT EPILEPTOGENIC FOC W/O ELECTRCORTICOGRPHY,9204.0,5982.6,848.14,9204.0,35
CDM,61535WE,CRANIOT RMVL EPID/SUBDURL ELCTRD W/O EXC TIS SPX,5260.0,3419.0,529.51,5260.0,35
CDM,61536WE,CRANIOT EPILEPTOGENIC FOCUS W/ELECTROCORTCOGRPHY,15088.0,9807.2,1574.44,15088.0,35
CDM,61537WE,CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY,16038.0,10424.7,1221.15,16038.0,35
CDM,61538WE,CRANIOT LOBEC TEMPORAL LOBE W/ELECTROCORTCOGRPHY,15780.0,10257.0,1482.65,15780.0,35
CDM,61539WE,CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/ECOG,13712.0,8912.8,1491.71,13712.0,35
CDM,61540WE,CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG,13829.0,8988.85,1415.17,13829.0,35
CDM,61541WE,CRANIOTOMY TRANSECTION CORPUS CALLOSUM,13614.0,8849.1,1326.8,13614.0,35
CDM,61545WE,CRANIOTOMY EXCISION CRANIOPHARYNGIOMA,18572.0,12071.8,1902.4,18572.0,35
CDM,61546WE,CRANIOT HYPOPHYSEC/EXC PITUITARY TUMOR ICRL APPR,13376.0,8694.4,1566.64,13376.0,35
CDM,61548WE,HYPOPHYSEC/EXC PITUITARY TUM TRANSNASAL/SEPTAL,9348.0,6076.2,1201.44,9348.0,35
CDM,61550WE,CRANIECTOMY CRANIOSYNOSTOSIS 1 CRANIAL SUTURE,6236.0,4053.4,679.89,6236.0,35
CDM,61552WE,CRANIECT CRANIOSYNOSTOSIS MULT CRANIAL SUTURES,8160.0,5304.0,895.08,8160.0,35
CDM,61556WE,CRANIEC CRANIOSYNOSTOSIS FRONT/PARIET BONE FLAP,9636.0,6263.4,1072.65,9636.0,35
CDM,61557WE,CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP,9324.0,6060.6,1102.79,9324.0,35
CDM,61558WE,XTN CRANIECT MULTIPLE SUTURE CRANIOSYNOSTOSIS,10600.0,6890.0,1273.71,10600.0,35
CDM,61559WE,XTN CRNEC MLT SUTR CRANIOSYNOSTOSIS W/BONE GRAFT,13608.0,8845.2,1601.17,13608.0,35
CDM,61563WE,EXC BENIGN TUM CRANIAL BONE W/O OPTIC NRV DCMPRN,11376.0,7394.4,1325.75,11376.0,35
CDM,61564WE,EXC BENIGN TUM CRANIAL BONE W/OPTIC NRV DCMPRN,17247.0,11210.55,1584.06,17247.0,35
CDM,61566WE,CRANIOTOMY SELECTIVE AMYGDALOHIPPOCAMPECTOMY,14278.0,9280.7,1401.49,14278.0,35
CDM,61567WE,CRAN SUBPIAL TRANSE ELECTROC,18959.0,12323.35,1525.01,18959.0,35
CDM,61571WE,CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN,11368.0,7389.2,1211.13,11368.0,35
CDM,61575WE,TRNSRAL SKULL BSE/BR STEM/CORD BX/DCOMPR/EXC LES,14624.0,9505.6,1790.09,14624.0,35
CDM,61576WE,TRNSRL SKUL BSE/BR STM/CORD BX/DCMP/ SPLT TONGUE,23976.0,15584.4,1845.98,23976.0,35
CDM,61580WE,CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ,13804.0,8972.6,1407.98,13804.0,35
CDM,61581WE,CRANIOFACIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ,15652.0,10173.8,1535.55,15652.0,35
CDM,61582WE,CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT,14056.0,9136.4,1485.83,14056.0,35
CDM,61583WE,CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE,15400.0,10010.0,1667.27,15400.0,35
CDM,61584WE,ORBITOCRANIAL ANT CRANIAL FOSSA W/O ORBIT EXNTJ,16588.0,10782.2,1598.42,16588.0,35
CDM,61585WE,ORBITOCRANIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ,17028.0,11068.2,1779.08,17028.0,35
CDM,61590WE,INFRATEMPORAL MID CRANIAL FOSSA W/WO DISARTICLTN,20698.0,13453.7,1946.57,20698.0,35
CDM,61591WE,INFRATEMPO MID CRANIAL FOSSA W/WO DCOMPR&/MOBI,20689.0,13447.85,2024.83,20689.0,35
CDM,61592WE,ORBITOCRNL APPR MID CRANIAL FOSSA TEMPORAL LOBE,17232.0,11200.8,1839.61,17232.0,35
CDM,61595WE,TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV,13496.0,8772.4,1382.51,13496.0,35
CDM,61597WE,TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL,16328.0,10613.2,1726.33,16328.0,35
CDM,61598WE,TRANSPTRSAL POST CRNL FOSSA CLIVUS/FORAMN MAGNUM,14612.0,9497.8,1553.48,14612.0,35
CDM,61600000,MRA LWR EXT W CONTR,7508.0,4880.2,285.23,6757.2,39
CDM,61600005,MRA LWR EXT WO CONTR,7508.0,4880.2,285.23,6757.2,39
CDM,61600010,MRA LWR EXT WO/W CONTR,7508.0,4880.2,285.23,6757.2,39
CDM,61600050,MRA LWR EX WO/W,7508.0,4880.2,285.23,6757.2,39
CDM,61600060,MRA LWR EXT W,7508.0,4880.2,285.23,6757.2,39
CDM,61600070,MRA LWR EXT WO,7508.0,4880.2,285.23,6757.2,39
CDM,61600WE,RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL,12004.0,7802.6,1197.26,12004.0,35
CDM,61601WE,RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF,13702.0,8906.3,1284.78,13702.0,35
CDM,61605WE,RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL,14331.0,9315.15,1357.76,14331.0,35
CDM,61606WE,RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR,18502.0,12026.3,1792.44,18502.0,35
CDM,61607WE,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL,16372.0,10641.8,1680.01,16372.0,35
CDM,61608WE,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL,18216.0,11840.4,1943.63,18216.0,35
CDM,61613WE,OBLTRJ CAROTID ARYSM ARTVEN CAROTID FISTULA DSJ,18012.0,11707.8,1894.98,18012.0,35
CDM,61615WE,RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL,14308.0,9300.2,1491.63,14308.0,35
CDM,61616WE,RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL,20566.0,13367.9,2005.36,20566.0,35
CDM,61618WE,SECONDARY RPR DURA CSF LEAK FREE TISSUE GRAFT,7476.0,4859.4,783.57,7476.0,35
CDM,61619WE,SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP,8840.0,5746.0,959.95,8840.0,35
CDM,61623WE,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,3980.0,2587.0,370.33,3980.0,35
CDM,61624WE,TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS,8853.0,5754.45,889.63,8853.0,35
CDM,61626WE,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,6640.0,4316.0,692.95,6640.0,35
CDM,61630WE,BALLON ANGIOPLASTY  INTRACRANIAL PERCUTANEOUS,8828.0,5738.2,1112.42,8828.0,31
CDM,61635WE,TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD,9712.0,6312.8,1211.3,9712.0,31
CDM,61645WE,PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL,6600.0,4290.0,634.67,6600.0,31
CDM,61650WE,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST,4000.0,2600.0,434.25,4000.0,31
CDM,61651WE,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL,1700.0,1105.0,176.18,1700.0,31
CDM,61680WE,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL,13020.0,8463.0,1649.39,13020.0,35
CDM,61682WE,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL,25364.0,16486.6,2468.21,25364.0,35
CDM,61684WE,INTRACRANIAL ARVEN MALFRMJ INFRATENTRL SMPL,16656.0,10826.4,1840.79,16656.0,35
CDM,61686WE,INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL,27000.0,17550.0,2575.69,27000.0,35
CDM,61692WE,INTRACRANIAL ARVEN MALFRMJ DURAL CMPL,21836.0,14193.4,2060.71,21836.0,35
CDM,61697WE,COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION,25360.0,16484.0,2456.04,25360.0,35
CDM,61698WE,CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ,27852.0,18103.8,2363.88,27852.0,35
CDM,61700WE,SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION,20248.0,13161.2,2122.57,20248.0,35
CDM,61702WE,SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ,24016.0,15610.4,2283.22,24016.0,35
CDM,61703WE,ICRA CRV APPL OCCLUDING CLAMP CRV CRTD ART,7520.0,4888.0,809.06,7520.0,35
CDM,61710WE,ARYSM VASC MALFRMJ IA EMBOLIZATION,12516.0,8135.4,1223.36,12516.0,35
CDM,61711WE,ANAST ARTL EXTRACRANIAL-INTRACRANIAL ARTERIES,15292.0,9939.8,1859.85,15292.0,35
CDM,61715WE,MRGFUS STEREOTACTIC ABLATION TARGET INTRACRANIAL,8801.0,5720.65,872.92,8801.0,14
CDM,61720WE,CRTJ LES STRTCTC BURR GLOBUS PALLIDUS/THALAMUS,7753.0,5039.45,907.49,7753.0,35
CDM,61736WE,LITT LES ICR SINGLE TRAJECTORY 1 SIMPLE LESION,7624.0,4955.6,675.3,7624.0,28
CDM,61737WE,LITT LES ICR MLT TRAJECTORIES MLT/CPLX LESIONS,9068.0,5894.2,804.94,9068.0,28
CDM,61750WE,STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES,7932.0,5155.8,821.46,7932.0,35
CDM,61751WE,STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR,7516.0,4885.4,1001.89,7516.0,35
CDM,61760WE,STRTCTC IMPLTJ ELTRD CEREBRUM SEIZURE MONITORING,8956.0,5821.4,990.86,8956.0,35
CDM,61781WE,STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL,1500.0,975.0,136.38,1500.0,35
CDM,61782WE,STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL,1399.0,909.35,111.23,1399.0,35
CDM,61783WE,STEREOTACTIC COMPUTER ASSISTED PX SPINAL,1500.0,975.0,112.6,1500.0,35
CDM,61790WE,CREATE LESION STRTCTC PRQ NEUROLYTIC GASSERIAN,4640.0,3016.0,618.27,4640.0,35
CDM,61791WE,CREATE LES STRTCTC PRQ NEUROLYTIC TRIGEMINAL TRC,6780.0,4407.0,595.9,6780.0,35
CDM,61796WE,STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES,5572.0,3621.8,572.24,5572.0,35
CDM,61797WE,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE,1392.0,904.8,157.41,1392.0,35
CDM,61798WE,STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES,7940.0,5161.0,674.61,7940.0,35
CDM,61799WE,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX,1924.0,1250.6,217.67,1924.0,35
CDM,61800005,MRA ABD W CONTR,3224.0,2095.6,285.23,2901.6,39
CDM,61800015,MRA ABD WO CONTR,3224.0,2095.6,285.23,2901.6,39
CDM,61800025,MRA ABD WO/W CONTR,3224.0,2095.6,285.23,2901.6,39
CDM,61800035,MRA CHEST W CONTRAST,7843.0,5097.95,285.23,7058.7,39
CDM,61800040,MRA SPINAL CANAL WO/W,3835.0,2492.75,285.23,3451.5,39
CDM,61800045,MRA CHEST WO CONTR,7843.0,5097.95,285.23,7058.7,39
CDM,61800055,MRA CHEST WO/W CONTR,7843.0,5097.95,285.23,7058.7,39
CDM,61800065,MRA PELV W CONTRL,7870.0,5115.5,285.23,7083.0,39
CDM,61800075,MRA PELV WO CONTRL,7870.0,5115.5,285.23,7083.0,39
CDM,61800080,MRA UPPER EXT WO CONT,5360.0,3484.0,285.23,4824.0,39
CDM,61800085,MRA PELV WO/W CONTR,7870.0,5115.5,285.23,7083.0,39
CDM,61800095,"MRA SPINAL CANAL, CONTENTS W/WO CONTRAST MATERIAL",3835.0,2492.75,285.23,3451.5,39
CDM,61800100,MRA CHEST W CON,7843.0,5097.95,285.23,7058.7,39
CDM,61800105,MRA W/CONTRAST SPINAL CANAL,3835.0,2492.75,285.23,3451.5,39
CDM,61800110,MRA CHEST WO,7843.0,5097.95,285.23,7058.7,39
CDM,61800115,MRA W/O CONTRAST SPINAL CANAL,3835.0,2492.75,285.23,3451.5,39
CDM,61800120,MRA CHEST WO/W,7843.0,5097.95,285.23,7058.7,39
CDM,61800125,MRA UPPER EXT W CONT,5360.0,3484.0,285.23,4824.0,39
CDM,61800130,MRA PELV W CONTR,7870.0,5115.5,285.23,7083.0,39
CDM,61800140,MRA PELV WO CONTR,7870.0,5115.5,285.23,7083.0,39
CDM,61800150,MRA PELV WO/W CONTR,7870.0,5115.5,285.23,7083.0,39
CDM,61800160,MRA ABD W CONT,3224.0,2095.6,285.23,2901.6,39
CDM,61800170,MRA ABD WO CONT,3224.0,2095.6,285.23,2901.6,39
CDM,61800180,MRA ABDOMEN WO/W CONT,3224.0,2095.6,285.23,2901.6,39
CDM,61800190,MRA UPPER EXT WO/W CONT,5360.0,3484.0,285.23,4824.0,39
CDM,61800WE,APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY,900.0,585.0,111.72,900.0,35
CDM,61850WE,TWIST/BURR HOLE IMPLTJ NSTIM ELTRD CORTICAL,5870.0,3815.5,618.61,5870.0,35
CDM,61863WE,STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD 1ST ARRAY,8284.0,5384.6,791.63,8284.0,35
CDM,61864WE,STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD EA ARRAY,1796.0,1167.4,217.79,1796.0,35
CDM,61867WE,STRTCTC IMPLTJ NSTIM ELTRD W/RECORD 1ST ARRAY,14533.0,9446.45,1164.96,14533.0,35
CDM,61868WE,STRTCTC IMPLTJ NSTIM ELTRD W/RECORD EA ARRAY,3480.0,2262.0,359.15,3480.0,35
CDM,61880WE,REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS,2780.0,1807.0,302.82,2780.0,35
CDM,61885WE,INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR,2662.0,1730.3,308.94,2662.0,35
CDM,61886WE,INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS,4369.0,2839.85,428.87,4369.0,35
CDM,61888WE,REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR,2092.0,1359.8,212.65,2092.0,35
CDM,61889WE,INSERTION SKULL-MNTD CRANIAL NSTIM PG/RECEIVER,11330.0,7364.5,925.73,11330.0,28
CDM,61891WE,REVJ/RPLCMT SKULL-MNTD CRANIAL NSTIM PG/RECEIVER,4950.0,3217.5,436.9,4950.0,28
CDM,61892WE,REMOVAL SKULL-MNTD CRANIAL NSTIM PG/RCVR W/CRNOP,6600.0,4290.0,600.59,6600.0,28
CDM,62005WE,ELVTN DEPRS SKL FX COMPOUND/COMMIND XDRL,7052.0,4583.8,738.47,7052.0,35
CDM,62010WE,ELVTN DEPRS SKL FX W/RPR DURA&/DBRDMT BRN,8572.0,5571.8,1041.31,8572.0,35
CDM,62100010,CATH DRNG,425.0,276.25,71.4,382.5,21
CDM,62100020,CATH NEPHROST,458.0,297.7,76.94,412.2,21
CDM,62100030,CATH PGTL,354.0,230.1,59.47,318.6,21
CDM,62100040,CATH TRACKER,1077.0,700.05,180.94,969.3,21
CDM,62100050,CATH TROCAR A,453.0,294.45,76.1,407.7,21
CDM,62100060,CONNSHLD LOCK,72.0,46.8,12.1,64.8,21
CDM,62100070,DRP XRAY CASS,56.0,36.4,9.41,50.4,21
CDM,62100080,GW AMPLATZ ST,229.0,148.85,38.47,206.1,21
CDM,62100090,GW VARBL STIF,234.0,152.1,39.31,210.6,21
CDM,62100100,INST BX GUN,114.0,74.1,19.15,102.6,21
CDM,62100110,KT ENTROKIT,464.0,301.6,77.95,417.6,21
CDM,62100120,KT INTRODUCER,185.0,120.25,31.08,166.5,21
CDM,62100130,KT NEPHRO STN,491.0,319.15,82.49,441.9,21
CDM,62100140,KT STEROTAC B,525.0,341.25,88.2,472.5,21
CDM,62100150,NDL ANY,312.0,202.8,52.42,280.8,21
CDM,62100160,NDL BX ANY,262.0,170.3,44.02,235.8,21
CDM,62100170,NDL VASC ACCE,2544.0,1653.6,427.39,2289.6,21
CDM,62100180,SHTH INTRO LN,148.0,96.2,24.86,133.2,21
CDM,62100190,SHTH PEELAWAY,245.0,159.25,41.16,220.5,21
CDM,62100200,TRY BX,314.0,204.1,52.75,282.6,21
CDM,62100210,TRY MYELOGRAM,168.0,109.2,28.22,151.2,21
CDM,62100WE,CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA,10353.0,6729.45,1166.19,10353.0,35
CDM,62120WE,RPR ENCEPHALOCELE SKULL VAULT W/CRANIOPLASTY,9836.0,6393.4,1155.11,9836.0,35
CDM,62121WE,CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE,10133.0,6586.45,1066.96,10133.0,35
CDM,62140WE,CRANIOPLASTY SKULL DEFECT </5 CM DIAMETER,5820.0,3783.0,722.99,5820.0,35
CDM,62141WE,CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER,6428.0,4178.2,843.13,6428.0,35
CDM,62142WE,RMVL BONE FLAP/PROSTHETIC PLATE SKULL,4732.0,3075.8,616.83,4732.0,35
CDM,62143WE,RPLCMT BONE FLAP/PROSTHETIC PLATE SKULL,5660.0,3679.0,607.74,5660.0,35
CDM,62146WE,CRANIOPLASTY W/AUTOGRAFT </ 5 CM DIAMETER,6912.0,4492.8,744.99,6912.0,35
CDM,62147WE,CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER,8268.0,5374.2,892.97,8268.0,35
CDM,62148WE,INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT,800.0,520.0,81.78,800.0,35
CDM,62160WE,NUNDSC ICRA PLMT/RPLCMT VENTR CATH SHUNT SYS,1200.0,780.0,118.01,1200.0,35
CDM,62161WE,NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS,8492.0,5519.8,840.29,8492.0,35
CDM,62164WE,NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY,11772.0,7651.8,1166.64,11772.0,35
CDM,62165WE,NUNDSC ICRA EXC PITUITRY TUM TRNSNSL/SPHENOID,9292.0,6039.8,913.27,9292.0,35
CDM,62180WE,VENTRICULO-CISTERNOSTOMY,9032.0,5870.8,870.0,9032.0,35
CDM,62190WE,CRTJ SHUNT SARACH/SDRL-ATR-JUG-AUR,4868.0,3164.2,563.8,4868.0,35
CDM,62192WE,CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH,5340.0,3471.0,694.58,5340.0,35
CDM,62194WE,RPLCMT/IRRG SUBARACHNOID/SUBDURAL CATHETER,2312.0,1502.8,242.3,2312.0,35
CDM,62200WE,"VENTRICULO-CISTERNOSTOMY,3RD VENT",7716.0,5015.4,949.97,7716.0,35
CDM,62201WE,VENTRICULOCISTERNOSTOMY 3RD VNTRC NEURONDSC,6416.0,4170.4,655.61,6416.0,35
CDM,62220WE,CREATE SHUNT; VENTRIC-ATR JUGUL AURICL,5640.0,3666.0,738.65,5640.0,35
CDM,62223WE,CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS,6182.0,4018.3,730.82,6182.0,35
CDM,62225WE,RPLCMT/IRRIGATION VENTRICULAR CATHETER,2724.0,1770.6,272.18,2724.0,35
CDM,62230WE,RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS,4572.0,2971.8,548.88,4572.0,35
CDM,62252WE,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,326.0,211.9,59.82,326.0,35
CDM,62256WE,RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT,2952.0,1918.8,353.73,2952.0,35
CDM,62258WE,RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT,6256.0,4066.4,780.1,6256.0,35
CDM,62263WE,PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS,2000.0,1300.0,151.23,1500.0,35
CDM,62264WE,PRQ LYSIS EPIDURAL ADHESIONS MULT SESSIONS 1 DAY,1768.0,1149.2,155.14,1326.0,35
CDM,62267WE,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,1200.0,780.0,102.19,900.0,35
CDM,62268WE,PERCUTANEOUS ASPIRATION SPINAL CORD CYST/SYRINX,1892.0,1229.8,197.07,1892.0,35
CDM,62269WE,BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE,2327.0,1512.55,195.91,2327.0,35
CDM,62270WE,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,537.0,349.05,29.92,402.75,35
CDM,62272WE,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,632.0,410.8,53.21,474.0,35
CDM,62273WE,INJECTION EPIDURAL BLOOD/CLOT PATCH,946.0,614.9,54.42,709.5,35
CDM,62280WE,INJX/INFUSION NEUROLYTIC SUBSTANCE SUBARACHNOID,1052.0,683.8,84.51,789.0,35
CDM,62281WE,INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC,1064.0,691.6,93.75,798.0,35
CDM,62282WE,INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL,1025.0,666.25,91.0,768.75,35
CDM,62284WE,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,616.0,400.4,40.76,462.0,35
CDM,62287WE,DCMPRN PX PERQ NUCLEUS PULPOSUS 1/MLT LVL LUMBAR,3612.0,2347.8,405.32,3612.0,35
CDM,62290WE,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,1200.0,780.0,77.09,900.0,35
CDM,62291WE,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,1164.0,756.6,122.28,873.0,35
CDM,62292WE,INJECTION PX CHEMONUCLEOLYSIS 1/MLT LUMBAR,3696.0,2402.4,427.83,3696.0,35
CDM,62300405,DRSG HDRCLD 30X9CM AQCEL PU,66.0,42.9,11.09,59.4,21
CDM,62302WE,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,916.0,595.4,93.39,687.0,31
CDM,62303WE,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,916.0,595.4,94.65,687.0,31
CDM,62304WE,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,900.0,585.0,91.81,675.0,31
CDM,62305WE,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,940.0,611.0,95.78,705.0,31
CDM,62320WE,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,792.0,514.8,78.13,594.0,31
CDM,62321WE,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,858.0,557.7,84.27,643.5,31
CDM,62322WE,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,682.0,443.3,67.21,511.5,31
CDM,62323WE,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,792.0,514.8,76.83,594.0,31
CDM,62324WE,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,832.0,540.8,71.86,624.0,31
CDM,62325WE,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,968.0,629.2,82.66,726.0,31
CDM,62326WE,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,783.0,508.95,70.3,587.25,31
CDM,62327WE,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,836.0,543.4,78.61,627.0,31
CDM,62328WE,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,692.0,449.8,69.52,519.0,31
CDM,62328WE-TC,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,5973.0,3882.45,2986.5,5973.0,12
CDM,62329WE,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,6785.0,4410.25,87.67,5088.75,31
CDM,62329WE-26,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,812.0,527.8,406.0,812.0,12
CDM,62329WE-TC,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,5973.0,3882.45,2986.5,5973.0,12
CDM,62330WE,DCMPRN PERQ PRTL RMVL LIGA FLAVM BI 1NTRSPC LMBR,3520.0,2288.0,503.41,3520.0,21
CDM,62331WE,DCMPRN PRQ PRT RMV LIGA FLAVM BI ADD NTRSPC LMBR,1870.0,1215.5,200.75,1870.0,21
CDM,62350WE,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM,2662.0,1730.3,290.23,2662.0,35
CDM,62351WE,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH W/LAM,4664.0,3031.6,445.14,4664.0,35
CDM,62355WE,RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH,1420.0,923.0,218.56,1420.0,35
CDM,62360WE,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS SUBQ RSVR,1732.0,1125.8,157.98,1732.0,35
CDM,62361WE,IMPLTJ/RPLCMT FS NON-PRGRBL PUMP,2000.0,1300.0,259.03,2000.0,35
CDM,62362WE,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP,2464.0,1601.6,299.75,2464.0,35
CDM,62365WE,RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS,1572.0,1021.8,232.6,1572.0,35
CDM,62367WE,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,211.0,137.15,12.17,158.25,32
CDM,62368WE,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,295.0,191.75,16.93,221.25,35
CDM,62369WE,ANAL SP INF PMP W/REPRG&FILL,295.0,191.75,17.1,221.25,35
CDM,62370WE,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR&REF PHYS,396.0,257.4,22.19,297.0,35
CDM,62380WE,NDSC DCMPRN SPINAL CORD 1 W/LAMOT NTRSPC LUMBAR,5916.0,3845.4,620.09,5916.0,16
CDM,62404455,"G160259, EARLY TAVR, NCT 03042104",30000.0,19500.0,5040.0,27000.0,21
CDM,62404805,"G140240,TENDYNE MITRAL VLV SYS, NCT03433274",30000.0,19500.0,5040.0,27000.0,21
CDM,62404875,G190020 CORDELLA PULM ART SENSOR,24500.0,15925.0,4116.0,22050.0,21
CDM,63001WE,LAM W/O FACETEC FORAMOT/DSC 1/2 VRT SGM CRV,7044.0,4578.6,892.18,7044.0,35
CDM,63003WE,LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC,7096.0,4612.4,898.72,7096.0,35
CDM,63005WE,LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR,6572.0,4271.8,844.0,6572.0,35
CDM,63011WE,LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL,6364.0,4136.6,659.82,6364.0,35
CDM,63012WE,LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR,6740.0,4381.0,866.76,6740.0,35
CDM,63015WE,LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL,8340.0,5421.0,1090.51,8340.0,35
CDM,63016WE,LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC,8812.0,5727.8,1083.44,8812.0,35
CDM,63017WE,LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR,6932.0,4505.8,914.77,6932.0,35
CDM,63020WE,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC,5964.0,3876.6,838.31,5964.0,35
CDM,63030WE,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR,4800.0,3120.0,688.29,4800.0,35
CDM,63032WE,LAMOT DCMPRN NRV RT RPR ANULR DFCT 1NTRSPC LMBR,1100.0,715.0,158.73,1100.0,21
CDM,63035WE,LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR,1544.0,1003.6,166.02,1544.0,35
CDM,63040WE,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL,8124.0,5280.6,1015.96,8124.0,35
CDM,63042WE,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR,7504.0,4877.6,954.38,7504.0,35
CDM,63043WE,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV,4346.0,2824.9,129.27,4346.0,17
CDM,63044WE,LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR,3744.0,2433.6,129.27,3744.0,17
CDM,63045WE,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM CERVICAL,7180.0,4667.0,951.35,7180.0,35
CDM,63046WE,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM THORACIC,7590.0,4933.5,920.08,7590.0,35
CDM,63047WE,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR,6763.0,4395.95,817.74,6763.0,35
CDM,63048WE,LAM FACETECTOMY&FORAMOT 1 VRT SGM EA ADDL SGM,1527.0,992.55,161.62,1527.0,35
CDM,63050WE,LAMOP CERVICAL W/DCMPRN SPI CORD 2/> VERT SEG,9684.0,6294.6,1031.44,9684.0,35
CDM,63051WE,LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ,11224.0,7295.6,1174.06,11224.0,35
CDM,63052WE,LAM FACETEC/FORAMOT DRG ARTHRD LUMBAR 1 VRT SGM,1700.0,1105.0,193.05,1700.0,28
CDM,63053WE,LAM FACETEC/FORAMOT DRG ARTHRD LMBR EA ADDL SGM,1512.0,982.8,144.36,1512.0,28
CDM,63055WE,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC,9420.0,6123.0,1218.88,9420.0,35
CDM,63056WE,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR,8744.0,5683.6,1124.67,8744.0,35
CDM,63057WE,TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR,2100.0,1365.0,225.82,2100.0,35
CDM,63064WE,COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG,10488.0,6817.2,1295.97,10488.0,35
CDM,63066WE,COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG,1304.0,847.6,156.76,1304.0,35
CDM,63075WE,DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC,7840.0,5096.0,998.88,7840.0,35
CDM,63076WE,DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC,1616.0,1050.4,187.15,1616.0,35
CDM,63077WE,DISCECTOMY ANT DCMPRN CORD THORACIC 1 NTRSPC,9152.0,5948.8,1076.49,9152.0,35
CDM,63078WE,DISCECTOMY ANT DCMPRN CORD THORACIC EA NTRSPC,1312.0,852.8,150.32,1312.0,35
CDM,63081WE,VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG,10440.0,6786.0,1325.14,10440.0,35
CDM,63082WE,VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG,1744.0,1133.6,204.0,1744.0,35
CDM,63085WE,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG,11788.0,7662.2,1447.08,11788.0,35
CDM,63087WE,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG,15012.0,9757.8,1703.49,15012.0,35
CDM,63088WE,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG,1728.0,1123.2,198.13,1728.0,35
CDM,63090WE,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG,12372.0,8041.8,1450.44,12372.0,35
CDM,63091WE,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG,1212.0,787.8,133.79,1212.0,35
CDM,63101WE,VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG,13640.0,8866.0,1455.9,13640.0,35
CDM,63102WE,VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG,15004.0,9752.6,1455.9,15004.0,35
CDM,63103WE,VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG,2121.0,1378.65,170.33,2121.0,35
CDM,63170WE,LAM W/MYELOTOMY CERVICAL/THORACIC/THORACOLUMBAR,8884.0,5774.6,1039.59,8884.0,35
CDM,63172WE,LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID,7904.0,5137.6,1010.6,7904.0,35
CDM,63173WE,LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL,9724.0,6320.6,1003.66,9724.0,35
CDM,63185WE,LAMINECTOMY W/RHIZOTOMY 1/2 SEGMENTS,7256.0,4716.4,819.76,7256.0,35
CDM,63190WE,LAMINECTOMY W/RHIZOTOMY > 2 SEGMENTS,7556.0,4911.4,940.62,7556.0,35
CDM,63200WE,LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR,9434.0,6132.1,855.96,9434.0,35
CDM,63251WE,LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC,17856.0,11606.4,1754.58,17856.0,35
CDM,63252WE,LAM EXC/OCCLUSION AVM SPI CORD THORACOLUMBAR,17852.0,11603.8,1801.73,17852.0,35
CDM,63265WE,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL,9528.0,6193.2,1163.62,9528.0,35
CDM,63266WE,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC,9872.0,6416.8,1246.83,9872.0,35
CDM,63267WE,LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR,7780.0,5057.0,1020.23,7780.0,35
CDM,63268WE,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL SACRAL,8008.0,5205.2,852.47,8008.0,35
CDM,63270WE,LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL,11920.0,7748.0,1229.16,11920.0,35
CDM,63271WE,LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC,11968.0,7779.2,1431.24,11968.0,35
CDM,63272WE,LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR,11000.0,7150.0,1302.74,11000.0,35
CDM,63273WE,LAM EXC ISPI LES OTH/THN NEO IDRL SACRAL,10588.0,6882.2,1135.51,10588.0,35
CDM,63275WE,LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL,10344.0,6723.6,1329.62,10344.0,35
CDM,63276WE,LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC,10276.0,6679.4,1297.81,10276.0,35
CDM,63277WE,LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR,8956.0,5821.4,1166.65,8956.0,35
CDM,63278WE,LAMINECTOMY BX/EXC ISPI NEO XDRL SACRAL,8848.0,5751.2,1154.67,8848.0,35
CDM,63280WE,LAM BX/EXC ISPI NEO IDRL XMED CERVICAL,12116.0,7875.4,1505.83,12116.0,35
CDM,63281WE,LAM BX/EXC ISPI NEO IDRL XMED THORACIC,11996.0,7797.4,1489.01,11996.0,35
CDM,63282WE,LAM BX/EXC ISPI NEO IDRL XMED LUMBAR,11260.0,7319.0,1356.86,11260.0,35
CDM,63283WE,LAM BX/EXC ISPI NEO IDRL SACRAL,10704.0,6957.6,1190.88,10704.0,35
CDM,63285WE,LAM BX/EXC ISPI NEO IDRL IMED CERVICAL,15220.0,9893.0,1644.58,15220.0,35
CDM,63286WE,LAM BX/EXC ISPI NEO IDRL IMED THORACIC,15048.0,9781.2,1731.35,15048.0,35
CDM,63287WE,LAM BX/EXC ISPI NEO IDRL IMED THORACOLMBR,16032.0,10420.8,1691.24,16032.0,35
CDM,63290WE,LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL,16328.0,10613.2,1736.78,16328.0,35
CDM,63300WE,VCRPEC LES 1 SGM XDRL CERVICAL,10720.0,6968.0,1111.15,10720.0,35
CDM,63301WE,VCRPEC LES 1 SGM XDRL THORACIC TTHRC,12628.0,8208.2,1260.28,12628.0,35
CDM,63302WE,VCRPEC LES 1 SEG XDRL THRC THORACOLMBR,12460.0,8099.0,1310.0,12460.0,35
CDM,63303WE,VCRPEC LES 1 SEG XDRL LMBR/SAC TRANSPRTL/RPR,13420.0,8723.0,1339.36,13420.0,35
CDM,63600030,RHO(D) IMMUNE GLOBULIN INJ,194.0,126.1,32.59,222.87,37
CDM,63600035,D5/0.9NS IV 500ML,32.63,21.21,1.02,32.63,31
CDM,63600045,D5/0.9NS IV 500ML,32.63,21.21,1.02,32.63,31
CDM,63600050,D5W 500ML,13.0,8.45,1.62,13.0,31
CDM,63600070,HEPARIN 1000UNIT/0.9NS 500ML,28.77,18.7,0.25,28.77,31
CDM,63600090,"OMNIPAQUE 350, 50 ML, PER ML",3.48,2.26,0.12,3.48,21
CDM,63600100,W PERMACOL I PER SQ CM,19.0,12.35,3.19,19.0,23
CDM,63600110,W PERMACOL II PER SQ CM,23.0,14.95,3.86,23.0,23
CDM,63600115,"HIB, PRP-T",47.0,30.55,7.9,47.0,29
CDM,63600120,W PERMACOL III PER SQ CM,26.0,16.9,4.37,26.0,23
CDM,63600130,W PERMACOL IV PER SQ CM,31.0,20.15,5.21,31.0,23
CDM,63600140,W PERMACOL V PER SQ CM,35.0,22.75,5.88,35.0,23
CDM,63600145,FLU VACCINE NO PRESERV 0.25 ML,74.7,48.56,12.55,74.7,36
CDM,63600150,W PERMACOL VI PER SQ CM,63.0,40.95,10.58,63.0,23
CDM,63600160,W IUD COPPER CONTRACEPTIVE,540.0,351.0,61.99,3252.38,29
CDM,63600165,IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE,69.7,45.31,11.71,69.7,36
CDM,63600175,FLUMIST VACC NSPR 0.2ML,62.9,40.89,10.57,62.9,36
CDM,63600185,FLU VACC PRSV FREE INC ANTIG,203.3,132.15,17.89,203.3,37
CDM,63600190,W GRFT TISSUE ALLODERM PER SQCM,67.0,43.55,16.75,198.19,27
CDM,63600200,W GRFT TISSUE ALLODERM PER SQCM,104.0,67.6,26.0,198.19,27
CDM,63600210,OMNIPAQUE 350 / 500 ML PER ML,3.48,2.26,0.12,3.48,21
CDM,63600220,W KIT REFILL LIORESAL INTRATHCL,50.0,32.5,12.95,502.19,47
CDM,63600230,ABOBOTULINUMTOXINA 5 UNITS,28.0,18.2,7.25,345.3,47
CDM,63600240,BOTULINUM TOX B INJ PER 100U,35.0,22.75,9.07,345.3,47
CDM,63600360,"ISOVUE 370, 100 ML, PER ML",3.48,2.26,0.12,3.48,21
CDM,63600370,"OMNIPAQUE 300, 50 ML, PER ML",3.48,2.26,0.12,3.48,21
CDM,63600385,TDAP VACCINE >7 IM,170.0,110.5,17.89,170.0,37
CDM,63600390,"OMNIPAQUE 350, 100 ML, PER ML",3.48,2.26,0.12,3.48,21
CDM,63600435,PNEUMOCOCCAL VACCINE 23V,423.0,274.95,17.89,423.0,37
CDM,63600455,"MENINGOCOCCAL VACCINE, IM",565.0,367.25,79.26,565.0,29
CDM,63600515,IMMUNIZATION HEPATITIS,258.0,167.7,17.89,258.0,37
CDM,63600560,"DEPO-MEDROL, 20 MG INJ",8.0,5.2,1.34,8.0,23
CDM,63600585,"INJ MULTIHANCE 20 ML, PER 1ML",16.27,10.58,1.64,16.27,21
CDM,63600605,"INJ EOVIST GADOXETATE DISODIUM, PER 1ML",49.24,32.01,8.27,49.24,21
CDM,63600625,GADAVIST GADOBUTROL INJ 0.1ML,2.99,1.94,0.31,2.99,21
CDM,63600650,"OMNIPAQUE 350, 150 ML, PER ML",3.48,2.26,0.12,3.48,21
CDM,63600670,"OMNIPAQUE 350, 100 ML, PER ML",3.48,2.26,0.12,3.48,21
CDM,63600700,DOBUTREX INJ PER 250 MG,29.0,18.85,4.87,29.0,31
CDM,63600745,"ISOVUE 300, 100 ML, PER ML",3.48,2.26,0.12,3.48,21
CDM,63600905,BOTULINUM TOXIN TYPE A/UNIT,26.0,16.9,5.69,345.3,47
CDM,63601040,TYSABRI 1 MG NATALIZUMAB,25.0,16.25,6.48,3407.66,47
CDM,63601070,ZOFRAN INJ PER 1 MG,20.0,13.0,0.09,20.0,31
CDM,63601165,REGADENOSON INJ 0.1 MG,441.0,286.65,5.09,441.0,31
CDM,63601275,STRL SALINE SOLN 500 ML=1 UNIT,13.0,8.45,1.17,13.0,31
CDM,63601295,"NRML SALINE SOLUTION, 250 CC",43.0,27.95,0.59,43.0,31
CDM,63601300,TRIAMCINOLONE ACET INJ 10 MG,36.0,23.4,0.97,36.0,31
CDM,63601365,ETONOGESTREL IMPLANT SYSTEM,1404.0,912.6,235.87,3494.49,29
CDM,63601400,VITAMIN B-12 INJ TO 1000 MCG,14.0,9.1,1.22,14.0,31
CDM,63601445,SYNVISC OR SYNVISC-ONE 1 MG,43.0,27.95,7.56,123.65,47
CDM,63601475,METHACHOLINE PER 1 MG,7.0,4.55,1.01,7.0,31
CDM,63601640,"5-FU, 500 MG",15.0,9.75,2.12,15.0,30
CDM,63601860,"INJ PERFLUTREN LIP MICROS, ML",444.0,288.6,40.03,444.0,24
CDM,63601955,HEP A/ADULT,308.0,200.2,17.89,308.0,37
CDM,63601965,IM ADULT HEPA-HEPB,472.0,306.8,79.26,472.0,29
CDM,63602155,HPV VIRUS VACCINE 9 VAL IM,1106.0,718.9,79.26,1106.0,29
CDM,63602165,FLU VACCINE 4 VALENT NASAL,57.0,37.05,9.58,57.0,30
CDM,63602185,FLU VAC NO PRSV 4 VAL 6-35 M,46.0,29.9,7.73,46.0,29
CDM,63602195,FLU VAC NO PRSV 4 VAL,70.0,45.5,11.76,70.0,30
CDM,63602215,"DOTAREM INJ 0.1ML, 20 ML",1.83,1.19,0.12,1.83,21
CDM,63602445,MENB RP W/OMV VACCINE IM,852.0,553.8,79.26,852.0,29
CDM,63602465,FLUZONE QUADRIVALENT MDV,67.0,43.55,11.26,67.0,30
CDM,63602485,DTAP-IPV-HIB-HEPB VACCINE IM,526.05,341.93,17.89,526.05,29
CDM,63602545,LEVONORGESTREL IU 52MG,1945.25,1264.41,273.36,3328.09,29
CDM,63602645,KENALOG 40MG/ML,36.0,23.4,0.97,36.0,31
CDM,63603225,CNTRST RAD OMPQ 240 100ML,3.48,2.26,0.35,3.48,21
CDM,63603305,KENALOG 40 MG /PER 1 CC,36.0,23.4,0.97,36.0,31
CDM,63603385,CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE,109.0,70.85,17.89,109.0,30
CDM,63603395,CCK DOSE,320.0,208.0,53.76,320.0,37
CDM,63604065,"OMNIPAQUE 350, 200ML, PER ML",3.48,2.26,0.12,3.48,21
CDM,63604075,"OMNIPAQUE 300, 75ML, PER ML",3.48,2.26,0.12,3.48,21
CDM,63604215,INFLUENZA VACCINE,74.7,48.56,12.55,74.7,36
CDM,63604335,FLUBLOK TRIVALENT,284.6,184.99,17.89,284.6,36
CDM,63604465,CONTR LOCM 300-399 MG 1 ML,3.48,2.26,0.12,3.48,21
CDM,63604605,IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE,69.7,45.31,11.71,69.7,36
CDM,63604645,HZV VACC RECOMBINANT IM NJX,777.0,505.05,79.26,777.0,29
CDM,63604705,"DOTAREM INJ 0.1 ML, 15 ML",1.83,1.19,0.12,1.83,21
CDM,63604715,"DOTAREM INJ 0.1 ML, 10 ML",1.83,1.19,0.12,1.83,21
CDM,63604735,OMNIPAQUE 240 / 50 ML,3.48,2.26,0.35,3.48,21
CDM,63604745,OMNIPAQUE 240 / 20 ML,3.48,2.26,0.35,3.48,21
CDM,63604755,OMNIPAQUE 300 / 500 ML,3.48,2.26,0.12,3.48,21
CDM,63604765,OMNIPAQUE 300 / 200 ML,3.48,2.26,0.12,3.48,21
CDM,63604775,OMNIPAQUE 300 / 150 ML,3.48,2.26,0.12,3.48,21
CDM,63604785,OMNIPAQUE 300 / 100 ML,3.48,2.26,0.12,3.48,21
CDM,63604795,VISIPAQUE 320 / 100 ML,3.48,2.26,0.12,3.48,21
CDM,63604905,OMNIPAQUE 300 / 10 ML PER ML,3.48,2.26,0.12,3.48,21
CDM,63604965,DOTAREM 10 MMOL SYRINGE 20ML,1.83,1.19,0.12,1.83,21
CDM,63604975,DOTAREM 7.5 MMOL SYRING 15ML,1.83,1.19,0.12,1.83,21
CDM,63605025,HEPB VACC 2 DOSE ADULT IM,562.0,365.3,17.89,562.0,37
CDM,63605055,FLUBLOK QUADRIVALENT PFS,233.0,151.45,17.89,233.0,30
CDM,63605065,OMNIPAQUE 300 150 ML,3.48,2.26,0.12,3.48,21
CDM,63605075,OMNIPAQUE 300 50 ML,3.48,2.26,0.58,3.48,23
CDM,63605085,OMNIPAQUE 240  50 ML,3.48,2.26,0.35,3.48,21
CDM,63605215,"INJECTION, DUROLANE, 1 MG",27.0,17.55,5.9,345.3,47
CDM,63605655,VISIPAQUE 320/150 ML,3.48,2.26,0.12,3.48,21
CDM,63605705,"EPICORD, PER SQUARE CM",205.0,133.25,51.25,223.53,28
CDM,63606375,PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677,1018.0,661.7,79.26,1018.0,37
CDM,63606385,HEP B VACC 3 AG 10 MCG 3 DOSE SCHED FOR IM USE,104.0,67.6,17.47,104.0,37
CDM,63606445,"MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)",617.0,401.05,79.26,617.0,29
CDM,63606495,TICK-BORNE ENCEPH VACC INACTIVATED 0.25ML IM USE,304.0,197.6,51.07,304.0,29
CDM,63606505,TICK-BORNE ENCEPH VACC INACTIVATED 0.5ML IM USE,304.0,197.6,51.07,304.0,29
CDM,63606785,DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE,102.0,66.3,17.14,102.0,29
CDM,63606795,"RSV VACCINE, ADJUVANTED (AREXVY)",363.0,235.95,17.89,363.0,29
CDM,63606805,"RSV VACCINE, BIVALENT (ABRYSVO)",1106.0,718.9,17.89,1106.0,29
CDM,63606885,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON) AGE 6 MO - 4 Y,140.0,91.0,17.89,140.0,30
CDM,63606895,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON)?AGE 5 YR - 11,278.0,180.7,17.89,278.0,37
CDM,63606905,SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE,532.7,346.26,17.89,532.7,37
CDM,63606975,RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE,2600.0,1690.0,436.8,2600.0,32
CDM,63606985,RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE,2600.0,1690.0,436.8,2600.0,32
CDM,63607015,BACLOFEN INJ 10 MG,750.0,487.5,160.09,750.0,47
CDM,63607035,HEPZATO KIT,1660.0,1079.0,343.08,2200.08,46
CDM,63607045,INJ METHYLPRED ACETATE 1 MG,1.29,0.84,0.12,1.29,38
CDM,63607055,JYNNEOS VACCINE (MPOX) 0.5 ML,785.7,510.71,0.01,785.7,39
CDM,63607075,"CHIKUNGUNYA VACCINE, LIVE",990.0,643.5,79.26,990.0,29
CDM,63607185,"INJ, GADOPICLENOL, 1 ML",4.0,2.6,0.67,4.61,21
CDM,63607255,SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE,465.4,302.51,17.89,465.4,37
CDM,63650WE,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,3146.0,2044.9,321.52,2359.5,35
CDM,63655WE,LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL,4805.0,3123.25,615.6,4805.0,35
CDM,63661WE,RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,2235.0,1452.75,159.29,1676.25,35
CDM,63662WE,RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR,4840.0,3146.0,414.73,4840.0,35
CDM,63663WE,REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR,3410.0,2216.5,217.97,2557.5,35
CDM,63664WE,REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR,5069.0,3294.85,431.5,5069.0,35
CDM,63685WE,INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ,2284.0,1484.6,262.47,2284.0,35
CDM,63688WE,REVJ/RMVL IMPL SPI NPG/RCVR DTCH CONNJ ELTRD RA,1914.0,1244.1,232.35,1914.0,35
CDM,63707WE,REPR DURAL/CSF LEAK,5060.0,3289.0,641.47,5060.0,35
CDM,63709WE,REPR DURAL/CSF LEAK W LAMINECTOMY,6260.0,4069.0,816.03,6260.0,35
CDM,63710WE,"DURAL GRAFT REPAIR,SPINE DEFECT",6160.0,4004.0,650.95,6160.0,35
CDM,63741WE,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM,3648.0,2371.2,478.2,3648.0,35
CDM,63744WE,RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT,3576.0,2324.4,439.38,3576.0,35
CDM,63746WE,RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT,2932.0,1905.8,318.03,2932.0,35
CDM,64400WE,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,330.0,214.5,24.49,247.5,35
CDM,64405WE,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,414.0,269.1,30.48,310.5,35
CDM,64408WE,INJECTION AA&/STRD VAGUS NERVE,330.0,214.5,42.06,247.5,35
CDM,64415WE,INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN,660.0,429.0,30.25,495.0,35
CDM,64416WE,INJECTION AA&/STRD BRACH PLEX CONT NFS CATH IMG,792.0,514.8,56.97,792.0,35
CDM,64417WE,INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN,576.0,374.4,29.26,432.0,35
CDM,64418WE,INJECTION AA&/STRD SUPRASCAPULAR NERVE,484.0,314.6,35.86,363.0,35
CDM,64420WE,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,475.0,308.75,28.44,356.25,35
CDM,64421WE,INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL,220.0,143.0,23.22,250.37,35
CDM,64425WE,INJECTION AA&/STRD ILIOINGUINAL IH NERVES,440.0,286.0,39.15,330.0,35
CDM,64430WE,INJECTION AA&/STRD PUDENDAL NERVE,440.0,286.0,32.37,330.0,35
CDM,64435WE,INJECTION AA&/STRD PARACERVICAL NERVE,330.0,214.5,28.83,247.5,35
CDM,64445WE,INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN,612.0,397.8,28.83,459.0,35
CDM,64446WE,INJECTION AA&/STRD SCIATIC NRV CONT NFS CATH IMG,770.0,500.5,52.68,770.0,35
CDM,64447WE,INJECTION AA&/STRD FEMORAL NERVE W/IMG GDN,590.0,383.5,25.32,442.5,35
CDM,64448WE,INJECTION AA&/STRD FEM NRV CONT NFS CATH IMG GDN,739.0,480.35,54.22,739.0,35
CDM,64449WE,INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH,559.0,363.35,49.79,559.0,35
CDM,64450WE,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,330.0,214.5,25.28,247.5,35
CDM,64451WE,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,669.0,434.85,61.22,501.75,31
CDM,64454WE,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,669.0,434.85,62.98,501.75,31
CDM,64455WE,NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES,330.0,214.5,24.58,247.5,35
CDM,64461WE,PVB THORACIC SINGLE INJECTION SITE W/IMG GID,770.0,500.5,66.73,577.5,31
CDM,64462WE,PVB THORACIC SECOND & ADDL INJ SITE W/IMG GID,484.0,314.6,41.9,363.0,31
CDM,64463WE,PVB THORACIC CONT CATHETER INFUSION W/IMG GID,836.0,543.4,65.57,627.0,31
CDM,64466WE,THORACIC FASCIAL PLANE BLOCK UNI INJECTION,660.0,429.0,47.22,495.0,25
CDM,64467WE,THORACIC FASCIAL PLANE BLOCK UNI CONT INFUSION,766.0,497.9,54.4,574.5,25
CDM,64468WE,THORACIC FASCIAL PLANE BLOCK BI INJECTION,735.0,477.75,52.48,551.25,25
CDM,64469WE,THORACIC FASCIAL PLANE BLOCK BI CONT INFUSION,805.0,523.25,57.02,611.19,25
CDM,64473WE,LOWER XTR FASCIAL PLANE BLOCK UNI INJECTION,590.0,383.5,42.18,442.5,25
CDM,64474WE,LOWER XTR FASCIAL PLANE BLOCK UNI CONT INFUSION,735.0,477.75,52.48,551.25,25
CDM,64479WE,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,1008.0,655.2,63.13,756.0,35
CDM,64480WE,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,528.0,343.2,32.3,396.0,35
CDM,64483WE,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,836.0,543.4,53.59,627.0,35
CDM,64484WE,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,440.0,286.0,39.69,330.0,35
CDM,64486WE,TAP BLOCK UNILATERAL BY INJECTION(S),528.0,343.2,48.52,396.0,31
CDM,64487WE,TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S),612.0,397.8,55.76,459.0,31
CDM,64488WE,TAP BLOCK BILATERAL BY INJECTION(S),616.0,400.4,60.25,462.0,31
CDM,64489WE,TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S),770.0,500.5,67.2,577.5,31
CDM,64490WE,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,801.0,520.65,50.96,600.75,35
CDM,64491WE,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,510.0,331.5,28.6,382.5,35
CDM,64492WE,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,510.0,331.5,28.94,382.5,35
CDM,64493WE,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,669.0,434.85,43.23,501.75,35
CDM,64494WE,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,440.0,286.0,24.66,330.0,35
CDM,64495WE,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,440.0,286.0,24.99,330.0,35
CDM,64505WE,INJECTION ANES AGENT SPHENOPALATINE GANGLION,598.0,388.7,50.3,448.5,35
CDM,64510WE,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,537.0,349.05,36.98,402.75,35
CDM,64517WE,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,968.0,629.2,60.82,726.0,35
CDM,64520WE,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,594.0,386.1,48.81,445.5,35
CDM,64530WE,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,695.0,451.75,45.37,521.25,35
CDM,64555WE,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,2304.0,1497.6,126.99,1728.0,35
CDM,64561WE,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,2394.0,1556.1,146.46,1795.5,35
CDM,64566WE,PERC TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,264.0,171.6,14.8,201.1,32
CDM,64567WE,PERQ ELEC NRV FIELD STIMJ CRANIAL NRV W/O IMPLTJ,660.0,429.0,71.28,660.0,21
CDM,64568WE,OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN,3600.0,2340.0,298.19,3600.0,35
CDM,64569WE,REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV,4400.0,2860.0,375.77,4400.0,35
CDM,64570WE,REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATOR,3640.0,2366.0,360.15,3640.0,35
CDM,64575WE,OPEN IMPLANTATION NEA PERIPHERAL NERVE,1768.0,1149.2,193.84,1768.0,35
CDM,64580WE,OPEN IMPLANTATION NEA NEUROMUSCULAR,1676.0,1089.4,208.59,1676.0,35
CDM,64581WE,OPEN IMPLANTATION NEA SACRAL NERVE,5368.0,3489.2,503.5,5368.0,35
CDM,64582WE,OPEN IMPLTJ HPGLSL NRV NSTIM RA PG&RESPIR SENSOR,5600.0,3640.0,642.26,5600.0,28
CDM,64585WE,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,844.0,548.6,69.37,633.0,35
CDM,64590WE,INS/RPLC PERPH SAC/GSTRC NPG/RCVR PCKT CRTJ&CONN,2244.0,1458.6,77.76,1683.0,35
CDM,64595WE,REV/RMV PRPH SAC/GSTRC NPG/RCV DTCH CONN ELTR RA,1516.0,985.4,61.31,1137.0,35
CDM,64596WE,INSJ/RPLCMT PERQ ELTRD RA PN W/INT NSTIM 1ST RA,2856.0,1856.4,1428.0,3966.56,13
CDM,64597WE,INSJ/RPLCMT PERQ ELTRD RA PN INT NSTIM EA ADD RA,2856.0,1856.4,1189.96,2856.0,13
CDM,64598WE,REVISION/REMOVAL NSTIM ELTRD ARRAY PN INT NSTIM,1047.0,680.55,464.74,1047.0,13
CDM,64600WE,DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH,1396.0,907.4,121.98,1047.0,35
CDM,64605WE,DSTRJ NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH,2260.0,1469.0,169.15,1695.0,35
CDM,64610WE,DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR,2880.0,1872.0,236.54,2160.0,35
CDM,64611WE,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS BI,412.0,267.8,54.08,309.0,35
CDM,64612WE,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL,620.0,403.0,79.26,465.0,35
CDM,64615WE,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,814.0,529.1,82.41,610.5,31
CDM,64616WE,CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA,673.0,437.45,82.35,504.75,31
CDM,64617WE,CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG,836.0,543.4,82.69,627.0,31
CDM,64620WE,DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE,1272.0,826.8,85.48,954.0,35
CDM,64624WE,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,1000.0,650.0,112.3,750.0,31
CDM,64625WE,RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN,1356.0,881.4,148.6,1017.0,31
CDM,64628WE,THERMAL DSTRJ INTRAOSSEOUS BVN 1ST 2 LMBR/SAC,2860.0,1859.0,340.05,2860.0,28
CDM,64629WE,THERMAL DSTRJ INTRAOSSEOUS BVN EA ADDL LMBR/SAC,1508.0,980.2,160.76,1508.0,28
CDM,64630WE,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,1342.0,872.3,104.78,1006.5,35
CDM,64633WE,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,1461.0,949.65,92.39,1095.75,35
CDM,64634WE,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,581.0,377.65,32.22,435.75,35
CDM,64635WE,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,1461.0,949.65,92.39,1095.75,35
CDM,64636WE,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,510.0,331.5,28.44,382.5,35
CDM,64640WE,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,871.0,566.15,83.64,653.25,35
CDM,64642WE,CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE,726.0,471.9,81.72,544.5,31
CDM,64643WE,CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,537.0,349.05,52.42,402.75,31
CDM,64644WE,CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES,801.0,520.65,89.19,600.75,31
CDM,64645WE,CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES,612.0,397.8,60.12,459.0,31
CDM,64646WE,CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES,792.0,514.8,84.18,594.0,31
CDM,64647WE,CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES,844.0,548.6,102.08,633.0,31
CDM,64650WE,CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,280.0,182.0,27.46,210.0,35
CDM,64653WE,CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY,352.0,228.8,33.55,264.0,35
CDM,64654WE,INITIAL OPEN IMPLANTATION BAT MODULATION SYSTEM,4840.0,3146.0,639.22,4840.0,21
CDM,64655WE,REVISION/RPLCMT BAT MODULATION SYSTEM LEAD ONLY,4972.0,3231.8,720.12,4972.0,21
CDM,64656WE,REVISION/RPLCMT BAT MODULATION SYSTEM PG ONLY,3524.0,2290.6,484.25,3524.0,21
CDM,64657WE,REMOVAL BAT MODULATION SYSTEM TOTAL SYSTEM,5337.0,3469.05,719.53,5337.0,21
CDM,64658WE,REMOVAL BAT MODULATION SYSTEM LEAD ONLY,3938.0,2559.7,541.23,3938.0,21
CDM,64659WE,REMOVAL BAT MODULATION SYSTEM PG ONLY,3621.0,2353.65,501.71,3621.0,21
CDM,64680WE,DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS,1175.0,763.75,77.59,881.25,35
CDM,64681WE,DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS,1512.0,982.8,108.33,1134.0,35
CDM,64702WE,NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT,2504.0,1627.6,248.87,2504.0,35
CDM,64704WE,NEUROPLASTY NERVE HAND/FOOT,1876.0,1219.4,240.13,1876.0,35
CDM,64708WE,NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC,2544.0,1653.6,348.35,2544.0,35
CDM,64712WE,NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV,3228.0,2098.2,432.93,3228.0,35
CDM,64713WE,NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS,4560.0,2964.0,542.17,4560.0,35
CDM,64714WE,NEURP MAJOR PRPH NRV OPN ARM/LEG LMBR PLEXUS,4220.0,2743.0,442.69,4220.0,35
CDM,64716WE,NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE,3076.0,1999.4,303.82,3076.0,35
CDM,64718WE,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW,2904.0,1887.6,340.03,2904.0,35
CDM,64719WE,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST,1988.0,1292.2,267.86,1988.0,35
CDM,64721WE,NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE,1988.0,1292.2,249.89,1491.0,35
CDM,64722WE,DECOMPRESSION UNSPECIFIED NERVE,1928.0,1253.2,265.1,1928.0,35
CDM,64726WE,DECOMPRESSION PLANTAR DIGITAL NERVE,1708.0,1110.2,156.62,1708.0,35
CDM,64727WE,INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE,1240.0,806.0,136.09,1240.0,35
CDM,64728WE,DCMPRN MEDIAN NRV AT CARPL TUNL PERQ BALO DILAT,1188.0,772.2,130.02,1188.0,21
CDM,64732WE,TRANSECTION/AVULSION SUPRAORBITAL NERVE,1956.0,1271.4,223.01,1956.0,35
CDM,64736WE,TRANSECT OR AVULSE; MENTAL NERVE,2092.0,1359.8,232.64,2092.0,35
CDM,64738WE,TRANSECTION/AVULSION INF ALVEOLAR NRV W/OSTEO,2544.0,1653.6,269.2,2544.0,35
CDM,64744WE,TRANSECTION/AVULSION GREATER OCCIPITAL NERVE,2288.0,1487.2,295.73,2288.0,35
CDM,64763WE,TRNSXJ/AVLSN OBTURAT NRV XPELV W/WO TENOTOMY,3326.0,2161.9,316.37,3326.0,35
CDM,64771WE,TRANSECTION/AVULSION OTH CRANIAL NRV XDRL,3260.0,2119.0,367.35,3260.0,35
CDM,64772WE,TRANSECTION/AVULSION OTH SPINAL NRV XDRL,3136.0,2038.4,376.54,3136.0,35
CDM,64774WE,EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE,2320.0,1508.0,217.72,2320.0,35
CDM,64776WE,EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT,2240.0,1456.0,215.48,2240.0,35
CDM,64778WE,"EXCISE DIGITAL NEUROMA,ADDNL DIGIT",1244.0,808.6,117.76,1244.0,35
CDM,64782WE,EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE,2744.0,1783.6,285.29,2744.0,35
CDM,64783WE,EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT,1484.0,964.6,152.77,1484.0,35
CDM,64784WE,EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC,4248.0,2761.2,424.75,4248.0,35
CDM,64786WE,EXCISE SCIATIC NERVE NEUROMA,6500.0,4225.0,757.14,6500.0,35
CDM,64787WE,IMPLANT NERVE END TO BONE/MUSC,1716.0,1115.4,179.49,1716.0,35
CDM,64788WE,EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV,2096.0,1362.4,222.37,2096.0,35
CDM,64790WE,EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV,4840.0,3146.0,505.08,4840.0,35
CDM,64792WE,EXC NEUROFIBROMA/NEUROLEMMOMA EXTNSV,6344.0,4123.6,656.0,6344.0,35
CDM,64795WE,BIOPSY OF NERVE,1204.0,782.6,143.9,1204.0,35
CDM,64804WE,"SYMPATHECTOMY,CERVICOTHORACIC",6364.0,4136.6,670.58,6364.0,35
CDM,64809WE,"SYMPATHECTOMY,THORACOLUMBAR",5884.0,3824.6,510.27,5884.0,35
CDM,64818WE,"SYMPATHECTOMY,LUMBAR",4536.0,2948.4,504.13,4536.0,35
CDM,64820WE,"SYMPATHECTOMY,DIGITAL ARTERIES",4296.0,2792.4,488.78,4296.0,35
CDM,64821WE,SYMPATHECTOMY RADIAL ARTERY,3732.0,2425.8,441.15,3732.0,35
CDM,64822WE,SYMPATHECTOMY ULNAR ARTERY,3732.0,2425.8,441.15,3732.0,35
CDM,64823WE,SYMPATHECTOMY SUPERFICIAL PALMAR ARCH,4376.0,2844.4,509.4,4376.0,35
CDM,64831WE,SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE,3664.0,2381.6,387.67,3664.0,35
CDM,64832WE,SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV,2260.0,1469.0,199.33,2260.0,35
CDM,64834WE,SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE,4324.0,2810.6,400.04,4324.0,35
CDM,64835WE,SUTURE 1 NERVE MEDIAN MOTOR THENAR,5161.0,3354.65,468.09,5161.0,35
CDM,64836WE,SUTURE 1 NERVE ULNAR MOTOR,4692.0,3049.8,487.93,4692.0,35
CDM,64837WE,SUTURE EACH ADDITIONAL NERVE HAND/FOOT,2500.0,1625.0,276.52,2500.0,35
CDM,64856WE,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS,6028.0,3918.2,608.47,6028.0,35
CDM,64857WE,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS,6328.0,4113.2,657.11,6328.0,35
CDM,64859WE,SUTURE EACH ADDITIONAL PERIPHERAL NERVE,1700.0,1105.0,187.92,1700.0,35
CDM,64861WE,SUTURE BRACHIAL PLEXUS,8356.0,5431.4,867.99,8356.0,35
CDM,64864WE,SUTURE FACIAL NERVE EXTRACRANIAL,5900.0,3835.0,558.36,5900.0,35
CDM,64865WE,SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT,6436.0,4183.4,732.95,6436.0,35
CDM,64866WE,ANAST FACIAL-SPINAL ACCESS,6732.0,4375.8,732.31,6732.0,35
CDM,64872WE,"REPR NERVE,SECONDARY/DELAY",796.0,517.4,88.09,796.0,35
CDM,64874WE,"REPR/TRANSPOSE NERVE,SECONADARY",1192.0,774.8,131.75,1192.0,35
CDM,64885WE,"NERVE GRAFT,HEAD/NECK,ONE,=<4CM",7040.0,4576.0,808.36,7040.0,35
CDM,64886WE,"NERVE GRAFT,HEAD/NECK,ONE,>4CM",8328.0,5413.2,958.08,8328.0,35
CDM,64890WE,"NERVE GRAFT,HAND/FOOT,ONE,=<4CM",6496.0,4222.4,744.98,6496.0,35
CDM,64891WE,"NERVE GRAFT,HAND/FOOT,ONE,>4CM",6940.0,4511.0,708.37,6940.0,35
CDM,64895WE,NRV GR MUL HND/FT TO 4 CM,8156.0,5301.4,880.53,8156.0,35
CDM,64896WE,NERVE GRAFT MULT STR HND/FT; > 4CM,8784.0,5709.6,996.85,8784.0,35
CDM,64897WE,"NERV GRFT,ARM/LEG,MULT,=<4CM",7752.0,5038.8,844.57,7752.0,35
CDM,64898WE,NERVE GRAFT MULTI STR ARM/LEG; > 4 CM,8388.0,5452.2,920.58,8388.0,35
CDM,64905WE,"NERVE PEDICLE XFER,FIRST STAGE",6044.0,3928.6,611.38,6044.0,35
CDM,64910WE,NERVE REPAIR W/CONDUIT EACH NERVE,4629.0,3008.85,66.81,4629.0,35
CDM,64912WE,NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND,4800.0,3120.0,77.04,4800.0,31
CDM,64913WE,NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND,1200.0,780.0,13.74,1200.0,31
CDM,64999AWE,"SI JOINT, RADIO REFEQUENCY (RF) ABLATION , SIMPLICITY III",104.0,67.6,52.0,104.0,12
CDM,64999BWE,TRIGEMINAL BALLOON COMPRESSION,1892.0,1229.8,946.0,1892.0,12
CDM,64999DISWE,DISC BIOPSY,1819.0,1182.35,909.5,1819.0,12
CDM,64999GANWE,GANGLION IMPAR SYMPATHETIC INJECTION,853.0,554.45,426.5,853.0,12
CDM,64999INFWE,INFERIORHYPOGASTRIC BLOCK,881.0,572.65,440.5,881.0,12
CDM,64999RVU24WE,GANGLION IMPAR BLOCK INJ,594.0,386.1,297.0,594.0,12
CDM,64999RVU35WE,SUBTEMP SKULLBASE MID & POST FOSSA TMR (61616),17474.0,11358.1,8737.0,17474.0,12
CDM,64999RVU36WE,PERCUTANEOUS GASSERIAN BALLOON DECOMPRESSION (COMP 64605),1855.0,1205.75,927.5,1855.0,12
CDM,64999RVU39WE,REMOVAL OF SEEG ELECTRODES,4340.0,2821.0,2170.0,4340.0,12
CDM,64999RVU44WE,NERVE WRAPPING (COMP CODE 15271),646.0,419.9,323.0,646.0,12
CDM,64999RVU45WE,"UNLIST PROC, NERVOUS SYSTEM COMPARED TO 64640",863.0,560.95,431.5,863.0,12
CDM,64999RVU4WE,ENDOS TRANSNASAL INTRACRANIAL BIOPSY (COMP CODE 61570),8526.0,5541.9,4263.0,8526.0,12
CDM,64999RVU51WE,"CHEMODENERVATION ECCRINE GLANDS, PALM/FOOT (COMP 64650)",281.0,182.65,140.5,281.0,12
CDM,64999RVU52WE,"INJ, ANESTHETIC AGENT; CERVICAL PLEXUS (COMP 64425)",578.0,375.7,289.0,578.0,12
CDM,64999RVU54WE,"UNLISTED PROC, INJECTION, ANESTHETIC AGENT, CERVICAL PLEXUS (COM",600.0,390.0,300.0,600.0,12
CDM,64999RVU57WE,QUTENZA APPLICATION (COMP 64632),272.0,176.8,136.0,272.0,12
CDM,64999RVU58WE,PECTO-INTERCOSTAL NERVE BLOCK (COMP 64450),300.0,195.0,150.0,300.0,12
CDM,64999RVU60WE,GANGLION OF IMPAR BLOCKADE UNDER FLUOROSCOPIC GUIDANCE (COMP COD,1080.0,702.0,540.0,1080.0,12
CDM,64999RVU69WE,PECS 1 & PECS 2 UNILAT CONTINUOUS INFUSION CATH (COMP CODE 64487,629.0,408.85,314.5,629.0,12
CDM,64999RVU6WE,MASSETER NRV TO FAC NRV ANASTOMOSIS (COMP 64865),6918.0,4496.7,3459.0,6918.0,12
CDM,64999RVU79WE,LIGATION CSF PROXIMAL SHUNT (COMP CODE 49428),2748.0,1786.2,1374.0,2748.0,12
CDM,64999RVU82WE,LARYNGEAL REINNERVATION USING CERVICAL NERVE BRANCHES (COMP CODE,6059.0,3938.35,3029.5,6059.0,12
CDM,64999RVU83WE,IMPAR GANGLION COCCYGEAL NEUROLYSIS (COMP CODE 64680),1175.0,763.75,587.5,1175.0,12
CDM,64999RVU84WE,SPINAL ACCESSORY NERVE BLOCK (COMP CODE 64405),414.0,269.1,207.0,414.0,12
CDM,64999RVU85WE,TRANSPALATAL APPROACH FOR REMOVAL OF FOREIGN BODY (61575),14624.0,9505.6,7312.0,14624.0,12
CDM,64999RVU8WE,ANTER CRANFAC RESECT W/ENDOS ASSIS (COMP CODE 61580),13756.0,8941.4,6878.0,13756.0,12
CDM,64999TIBWE,PERCUTANEOUS TIBIAL NERVE STIM PTNS,704.0,457.6,352.0,704.0,12
CDM,65091WE,EVISCERATION OCULAR CONTENTS W/O IMPLANT,2904.0,1887.6,370.95,2904.0,35
CDM,65093WE,EVISCERATION OCULAR CONTENTS W/IMPLANT,2816.0,1830.4,397.39,2816.0,35
CDM,65101WE,ENUCLEATION OF EYE W/O IMPLANT,3320.0,2158.0,415.39,3320.0,35
CDM,65103WE,ENUCLEATION EYE IMPLT MUSC X ATTACHED IMPLT,3536.0,2298.4,432.15,3536.0,35
CDM,65105WE,ENUCLEATION EYE IMPLT MUSC ATTACHED IMPLT,4369.0,2839.85,481.63,4369.0,35
CDM,65110WE,EXENTERATION ORBIT REMVL ORBITAL CONTENTS ONLY,6280.0,4082.0,773.94,6280.0,35
CDM,65112WE,EXENTERATION ORBIT RMVL ORBIT CONTENTS & BONE,7404.0,4812.6,750.36,7404.0,35
CDM,65114WE,EXNTJ ORBIT RMVL ORB CNTS W/MUSC/MYOQ FLAP,7860.0,5109.0,806.89,7860.0,35
CDM,65205WE,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,216.0,140.4,21.7,162.0,35
CDM,65210WE,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,268.0,174.2,27.94,201.0,35
CDM,65220WE,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,312.0,202.8,20.59,234.0,35
CDM,65222WE,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,370.0,240.5,31.39,277.5,35
CDM,65235WE,RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS,3604.0,2342.6,355.96,3604.0,35
CDM,65270WE,RPR LAC CJNC W/WO NONPERFOR LAC SCLERA DIR CLSR,780.0,507.0,69.9,585.0,35
CDM,65272WE,RPR LAC CJNC MOBLJ& REARGMT W/O HOSPITALIZATION,1848.0,1201.2,168.49,1386.0,35
CDM,65280WE,RPR LAC CORNEA&/SCLERA PERFOR X INVG UVEAL TIS,3640.0,2366.0,425.22,3640.0,35
CDM,65285WE,RPR LAC CORN&/SCLRA PERF W/REPOS/RESCJ UVEAL T,6144.0,3993.6,676.32,6144.0,35
CDM,65286WE,RPR LAC APPL TISSUE GLUE WOUND CORNEA&/SCLERA,2652.0,1723.8,236.22,1989.0,35
CDM,65400WE,EXCISION LESION CORNEA XCP PTERYGIUM,3000.0,1950.0,286.68,2250.0,35
CDM,65410WE,BIOPSY OF CORNEA,588.0,382.2,54.91,441.0,35
CDM,65420WE,EXCISION/TRANSPOSITION PTERYGIUM W/O GRAFT,1744.0,1133.6,180.49,1308.0,35
CDM,65426WE,EXCISION/TRANSPOSITION PTERYGIUM W/GRAFG,2420.0,1573.0,227.17,1815.0,35
CDM,65430WE,CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE,588.0,382.2,64.48,441.0,35
CDM,65435WE,RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION,368.0,239.2,48.19,276.0,35
CDM,65436WE,RMVL CORNEAL EPITHELIUM W/APPL CHELATING AGENT,1928.0,1253.2,175.56,1446.0,35
CDM,65450WE,DSTRJ LESION CRYOTHER PHOTO/THERMOCAUTZATION,1388.0,902.2,180.86,1041.0,35
CDM,65600WE,MULT PUNC ANTER CORNEA,1680.0,1092.0,161.42,1260.0,35
CDM,65730WE,KERATOPLASTY PENTRG EXCEPT APHAKIA/PSEUDOPHAKIA,7194.0,4676.1,782.87,7194.0,35
CDM,65750WE,KERATOPLASTY PENETRAING APHAKIA,6760.0,4394.0,825.5,6760.0,35
CDM,65755WE,KERATOPLASTY PENETRATING PSEUDOPHAKIA,6716.0,4365.4,822.67,6716.0,35
CDM,65756WE,KERATOPLASTY ENDOTHELIAL,7410.0,4816.5,755.17,7410.0,35
CDM,65757WE,BACKBENCH PREPJ CORNEAL ENDOTHELIAL ALLOGRAFT,1284.0,834.6,97.64,1284.0,14
CDM,65760WE,KERATOMILEUSIS,665.0,432.25,332.5,2348.46,13
CDM,65772WE,CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM,2036.0,1323.4,192.33,1527.0,35
CDM,65775WE,CRNL WEDGE RESCJ CORRJ INDUCED ASTIGMATISM,2764.0,1796.6,335.92,2764.0,35
CDM,65778WE,PLACE AMNIOTIC MEMBRA OCULAR SURFACE W/O SUTURES,336.0,218.4,37.09,1687.39,35
CDM,65780WE,OCULAR SURFACE RECONSTRUCTION AMNIOTIC MEMBRANE,2812.0,1827.8,449.88,2812.0,35
CDM,65782WE,OCCULAR SURFACE RECONSTRUCTION LIMBAL AUTOGRAFT,6172.0,4011.8,688.66,6172.0,35
CDM,65800WE,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,673.0,437.45,66.44,504.75,35
CDM,65815WE,PARACEN ANT CHAM RMVL BLOOD W/WO IRRIG&/AIR IN,2400.0,1560.0,226.36,1800.0,35
CDM,65850WE,TRABECULOTOMY AB EXTERNO,4556.0,2961.4,577.36,4556.0,35
CDM,65855WE,TRABECULOPLASTY BY LASER SURGERY,1320.0,858.0,179.03,990.0,35
CDM,65860WE,SEVERING ADHESIONS ANTERIOR SEGMENT LASER SPX,1436.0,933.4,148.39,1077.0,35
CDM,65865WE,SEVERING ADS ANT SEG INCAL TQ SPX GONIOSYNECHIAE,2308.0,1500.2,317.13,2308.0,35
CDM,65870WE,SEVERING ADS ANT SEG INCAL SPX ANT SYNECHIAE,2956.0,1921.4,328.1,2956.0,35
CDM,65875WE,SEVERING ADS ANT SEG INCAL SPX POST SYNECHIAE,3124.0,2030.6,345.1,3124.0,35
CDM,65900WE,RMVL EPITHELIAL DOWNGROWTH ANT CHAMBER EYE,5004.0,3252.6,535.66,5004.0,35
CDM,65920WE,RMVL IMPLANTED MATERIAL ANTERIO SEGMENT EYE,3996.0,2597.4,442.84,3996.0,35
CDM,65930WE,RMVL BLOOD CLOT ANTERIOR SEGMENT EYE,3356.0,2181.4,405.14,3356.0,35
CDM,66020WE,"INJECT ANTER CHMBR EYE,AIR/FLUID",656.0,426.4,62.14,492.0,35
CDM,66030WE,"INJECT ANTER CHMBR EYE,MEDICATN",520.0,338.0,52.77,390.0,35
CDM,66130WE,"REMOVE EYE LESION,SCLERA",3132.0,2035.8,268.6,2349.0,35
CDM,66160WE,FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT,5452.0,3543.8,548.59,5452.0,35
CDM,66170WE,FSTLJ SCLERA GLAUCOMA TRABECULECT AB EXTERNO,5576.0,3624.4,633.17,5576.0,35
CDM,66172WE,FSTLJ SCLERA GLC TRBEC AB EXTERNO SCARRING,5936.0,3858.4,718.9,5936.0,35
CDM,66174WE,TRLUML DILAT AQUEOUS O/F CAN WO RETENTION DEV/ST,3353.0,2179.45,504.17,3353.0,32
CDM,66175WE,TRLUML DILAT AQUEOUS O/F CAN W/RETENTION DEV/ST,3736.0,2428.4,553.99,3736.0,32
CDM,66179WE,AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT,5600.0,3640.0,703.05,5600.0,31
CDM,66180WE,AQUEOUS SHUNT EXTRAOC EQUAT PLATE RSVR W/GRAFT,6600.0,4290.0,792.76,6600.0,35
CDM,66183WE,INSERT ANTER DRAINAGE DEV W/O EXTRAOC RESERVOIR,5808.0,3775.2,762.89,5808.0,28
CDM,66184WE,REVJ SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT,3832.0,2490.8,489.83,3832.0,31
CDM,66185WE,REVJ AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/GRAFT,4232.0,2750.8,455.44,4232.0,35
CDM,66250WE,REVJ/RPR OPRATIVE WOUND ANTERIOR SEGMENT,2840.0,1846.0,264.65,2130.0,35
CDM,66600WE,IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES,4048.0,2631.2,473.92,4048.0,35
CDM,66625WE,IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX,2120.0,1378.0,296.94,2120.0,35
CDM,66635WE,IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX,2948.0,1916.2,351.98,2948.0,35
CDM,66680WE,REPAIR IRIS/CILIARY BODY,3188.0,2072.2,308.14,3188.0,35
CDM,66682WE,SUTURE IRIS CILIARY BODY SPX RETRIEVAL SUTURE,3496.0,2272.4,350.0,3496.0,35
CDM,66683WE,IMPLTJ IRIS PROSTHESIS W/SUTR FIXJ&RPR/RMVL IRIS,4695.0,3051.75,539.8,4695.0,25
CDM,66720WE,CILIARY BODY DESTRUCTION CRYOTHERAPY,1900.0,1235.0,241.97,1425.0,35
CDM,66761WE,IRIDOTOMY/IRIDECTOMY BY LASER,1320.0,858.0,172.34,990.0,35
CDM,66762WE,IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS,2152.0,1398.8,204.82,1614.0,35
CDM,66821WE,POST-CATARACT LASER SURGERY,1505.0,978.25,148.6,1128.75,35
CDM,66825WE,REPOSITIONING IO LENS PROSTHESIS REQ INC SPX,3604.0,2342.6,417.76,3604.0,35
CDM,66830WE,RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ,3788.0,2462.2,425.32,3788.0,35
CDM,66840WE,RMVL LENS MATERIAL ASPIR TQ 1/> STAGES,3672.0,2386.8,436.91,3672.0,35
CDM,66850WE,RMVL LENS MATERIAL PHACOFRAGMENTATION ASPIR,4220.0,2743.0,500.51,4220.0,35
CDM,66852WE,RMVL LENS MATERIAL PARS PLANA W/WO VITRECTOMY,4564.0,2966.6,549.26,4564.0,35
CDM,66920WE,RMVL LENS MATERIAL INTRACAPSULAR,4052.0,2633.8,485.93,4052.0,35
CDM,66982WE,XCAPSL CTRC RMVL INSJ IO LENS PROSTH CPLX WO ECP,4510.0,2931.5,564.01,4510.0,35
CDM,66983WE,ICAPSULAR CATARACT XTRJ INSJ IO LENS PRSTH 1 STG,4416.0,2870.4,459.85,4416.0,21
CDM,66984WE,XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP,3234.0,2102.1,411.84,3234.0,35
CDM,66985WE,INSJ IO LENS PROSTHESIS NOT W/CONCURRENT RMVL,4391.0,2854.15,455.72,4391.0,35
CDM,66986WE,EXCHANGE INTRAOCULAR LENS,4904.0,3187.6,633.81,4904.0,35
CDM,66999AWE,TECHNIS MULTIFOCAL IOL UPGRADE,2653.0,1724.45,357.5,2653.0,15
CDM,66999BWE,TORIC UPGRADE,1486.0,965.9,357.5,1486.0,15
CDM,66999CATWE,CATARACT EXT; EYEONICS IOL SYS,2383.0,1548.95,357.5,2383.0,15
CDM,66999CORWE,CORNEAL RELAXING INCISION,323.0,209.95,161.5,429.0,15
CDM,66999CRYWE,CUSTOM BASIC PRK/LASIK SURGERY,466.0,302.9,233.0,466.0,15
CDM,66999CWE,RESTOR IOL UPGRADE,2653.0,1724.45,357.5,2653.0,15
CDM,66999DWE,CRYSTALENS IOL UPGRADE,2653.0,1724.45,357.5,2653.0,15
CDM,66999INIWE,INTRALASE - INITIAL TREATMENT,410.0,266.5,205.0,429.0,15
CDM,66999INTWE,INTRALASE - RETREATMENT,410.0,266.5,205.0,429.0,15
CDM,66999KERWE,EPI-KERATOME - INITIAL TREATMENT,175.0,113.75,87.5,429.0,15
CDM,66999LASWE,RE-TREATMENT PRK/LASIK SURGERY CONVENTION,461.0,299.65,230.5,461.0,15
CDM,66999LIMWE,LIMBAL RELAXING INCISION,466.0,302.9,233.0,466.0,15
CDM,66999LRWE,LRI/NON-SURGICALLY INDUCED,468.0,304.2,234.0,468.0,15
CDM,66999PRKWE,RE-TREATMENT PRK/LASIK SURGERY CUSTOM,578.0,375.7,289.0,578.0,15
CDM,66999PTKWE,PTK,592.0,384.8,296.0,592.0,15
CDM,66999REFWE,PHOTO REFRACTIVE KERATECTOMY,2115.0,1374.75,357.5,2115.0,15
CDM,66999RESWE,RESTOR IOL UPGRADE; PRO FEE,1104.0,717.6,357.5,1104.0,15
CDM,66999SITWE,LASER IN SITU KERATOMILEUSIS; PER EYE,634.0,412.1,317.0,634.0,15
CDM,66999TECWE,TECNIS MULTIFOCAL,2098.0,1363.7,357.5,2098.0,15
CDM,66999TORWE,TORRIC LENS,380.0,247.0,190.0,429.0,15
CDM,66999UPGWE,CRYSTALENS UPGRADE; PRO FEE,1172.0,761.8,357.5,1172.0,15
CDM,67005WE,RMVL VITREOUS ANT APPR PARTIAL REMOVAL,2356.0,1531.4,304.68,2356.0,35
CDM,67010WE,RMVL VITREOUS ANT APPR SUBTOT RMVL MECH VITRECT,2824.0,1835.6,367.59,2824.0,35
CDM,67028WE,INTRAVITREAL NJX PHARMACOLOGIC AGT SPX,634.0,412.1,79.17,475.5,35
CDM,67031WE,SEVERING VITREOUS STRANS LASER 1/> STAGES,1788.0,1162.2,177.75,1341.0,35
CDM,67105WE,RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID PC,1356.0,881.4,224.69,1017.0,35
CDM,67145WE,"PROPHYLAXIS RETINA DETACH,PHOTOCOAG",1113.0,723.45,196.38,834.75,35
CDM,67208WE,DSTRJ LOCLZD LESION RETINA 1/> SESS CRTX DTHRM,3060.0,1989.0,348.0,2295.0,35
CDM,67210WE,DSTRJ LOCLZD LESION RETINA 1/> SESS PC,2544.0,1653.6,390.14,1908.0,35
CDM,67225WE,DSTRJ LESION CHOROID PDT 2ND EYE 1 SESSION,188.0,122.2,18.82,141.0,35
CDM,67227WE,DESTRUCTION RETINOPATHY CRYOTHERAPY DIATHERMY,1400.0,910.0,223.92,1050.0,35
CDM,67228WE,TREATMENT EXTENSIVE RETINOPATHY PHOTOCOAGULATION,1932.0,1255.8,257.11,1449.0,35
CDM,67255WE,SCLERAL REINFORCEMENT SPX W/GRAFT,3352.0,2178.8,504.47,3352.0,35
CDM,67345WE,CHEMODENERVATION EXTRAOCULAR MUSCLE,1324.0,860.6,122.34,993.0,35
CDM,67400WE,ORBITTMY W/O BN FLP EXP W W/O BX,4480.0,2912.0,546.17,4480.0,35
CDM,67405WE,ORBITTMY W/O BN FLP;W DRAINAGE,3680.0,2392.0,456.13,3680.0,35
CDM,67412WE,ORBITTMY W/O BN FLP W REM LESION,4120.0,2678.0,547.03,4120.0,35
CDM,67414WE,ORBITOTOMY W/O BONE FLAP W/RMVL BONE DCMPRN,7176.0,4664.4,711.6,7176.0,35
CDM,67415WE,FINE NEEDLE ASPIRATION ORBITAL CONTENTS,704.0,457.6,76.02,704.0,35
CDM,67445WE,ORBITOTOMY BONE FLAP/WINDOW LAT RMVL BONE DCMPRN,7648.0,4971.2,740.53,7648.0,35
CDM,67450WE,ORBITOTOMY BONE FLAP/WINDOW LAT EXPL W/WO BX,6164.0,4006.6,755.78,6164.0,35
CDM,67500WE,"RETROBULBAR INJECT,MEDICATN",472.0,306.8,38.19,354.0,35
CDM,67505WE,"RETROBULBAR INJECT,ALCOHOL",472.0,306.8,49.1,354.0,35
CDM,67515WE,INJECTION MEDICATION/OTHER SUBST TENON CAPSULE,330.0,214.5,34.68,247.5,35
CDM,67516WE,SUPRACHOROIDAL SPACE NJX PHARMACOLOGIC AGENT,673.0,437.45,68.82,504.75,31
CDM,67550WE,ORBITAL IMPLANT INSERTION,4708.0,3060.2,536.52,4708.0,35
CDM,67560WE,ORBITAL IMPLANT REMOVAL/REVISION,4872.0,3166.8,538.84,4872.0,35
CDM,67700WE,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,560.0,364.0,72.12,420.0,35
CDM,67710WE,SEVERING TARSORRHAPHY,428.0,278.2,61.39,321.0,35
CDM,67715WE,CANTHOTOMY SEPARATE PROCEDURE,508.0,330.2,51.61,381.0,35
CDM,67800WE,"EXCIS CHALAZION,SINGLE",564.0,366.6,48.94,423.0,35
CDM,67801WE,"EXCIS CHALAZION,MULT,SAME LID",764.0,496.6,71.16,573.0,35
CDM,67805WE,EXCISION CHALAZION MULTIPLE DIFFERENT LIDS,908.0,590.2,77.92,681.0,35
CDM,67808WE,EXC CHALAZION ANES REQ HOSPIZATION SINGLE/MULT,1840.0,1196.0,174.97,1840.0,35
CDM,67810WE,INCISIONAL BIOPSY EYELID SKIN & LID MARGIN,519.0,337.35,51.23,389.25,35
CDM,67820WE,CORRECTION TRICHIASIS EPILATION FORCEPS ONLY,141.0,91.65,14.87,105.75,35
CDM,67825WE,CORRECTION TRICHIASIS EPILATION OTH/THAN FORCEPS,629.0,408.85,58.91,471.75,35
CDM,67840WE,EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE,836.0,543.4,106.71,627.0,35
CDM,67850WE,DESTRUCTION LESION LID MARGIN </ 1 CM,696.0,452.4,81.32,522.0,35
CDM,67875WE,TEMP CLOSURE EYELID BY SUTURE,540.0,351.0,45.21,405.0,35
CDM,67880WE,CONSTJ INTERMARGIN ADHES/TARSORRH/CANTHORRHAPY,2024.0,1315.6,174.9,1518.0,35
CDM,67900WE,REPAIR BROW PTOSIS,3001.0,1950.65,240.65,2250.75,32
CDM,67902WE,RPR BLEPHAROPT FRONTALIS MUSC AUTOL FASCAL SLING,3928.0,2553.2,395.68,3928.0,35
CDM,67903WE,RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT INTERNAL,2604.0,1692.6,281.73,1953.0,35
CDM,67904WE,RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL,3507.0,2279.55,283.06,2630.25,35
CDM,67908WE,RPR BLPOS CONJUNCTIVO-TARSO-MUSC-LEVATOR RESCJ,2332.0,1515.8,233.63,1749.0,35
CDM,67909WE,REDUCTION OVERCORRECTION PTOSIS,2228.0,1448.2,231.85,1671.0,35
CDM,67912WE,CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD,2544.0,1653.6,231.94,1908.0,35
CDM,67914WE,"FIX ECTROPION,SUTURE",1500.0,975.0,156.0,1125.0,35
CDM,67916WE,"FIX ECTROPION,EXCIS TARSAL WEDGE",2192.0,1424.8,225.96,1644.0,35
CDM,67917WE,REPAIR ECTROPION EXTENSIVE,2372.0,1541.8,250.44,1779.0,35
CDM,67921WE,ENTROPION REPAIR/SUTURE,1388.0,902.2,147.78,1041.0,35
CDM,67923WE,"FIX ENTROPION,EXCIS TARSAL WEDGE",2411.0,1567.15,255.58,1808.25,35
CDM,67924WE,REPAIR OF ENTROPION; EXTENSIVE?,2372.0,1541.8,223.48,1779.0,35
CDM,67930WE,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK,1460.0,949.0,112.27,1095.0,35
CDM,67935WE,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK,2544.0,1653.6,209.59,1908.0,35
CDM,67938WE,"REMOVE EYELID FOREIGN BODY,EMBEDDED",552.0,358.8,55.89,414.0,35
CDM,67950WE,CANTHOPLASTY LATERAL,2636.0,1713.4,233.75,1977.0,35
CDM,67961WE,EXCISION & REPAIR EYELID < ONE-FOURTH LID MARGIN,2344.0,1523.6,225.65,1758.0,35
CDM,67966WE,EXCISION & REPAIR EYELID ONE-FOURTH LID MARGIN,3588.0,2332.2,310.84,2691.0,35
CDM,67971WE,RCNSTJ EYELID FULL THICKNESS </TWO-THIRDS 1 STG,4004.0,2602.6,531.49,4004.0,35
CDM,67974WE,"RECONSTRUC EYELID,TOT UPPER,1 STAGE",5240.0,3406.0,658.42,5240.0,35
CDM,67999RVU2WE,REMOVAL OF IMPLANT EYELID (COMP CODE 67938),552.0,358.8,143.6,552.0,15
CDM,67999RVU3WE,FACELIFT - ENDOSCOPIC,2760.0,1794.0,143.6,2760.0,15
CDM,67999RVU4WE,FOREHEAD LIFT - ENDOSCOPIC,3346.0,2174.9,143.6,3346.0,15
CDM,67999RVU5WE,"ORBICULARIS OCULI LATERAL MYECTOMY, UNILATERAL (COMP CODE 15823)",2996.0,1947.4,143.6,2996.0,15
CDM,68020WE,INCISION CONJUNCTIVA DRAINAGE OF CYST,568.0,369.2,52.6,426.0,35
CDM,68040WE,EXPRESS CONJUNC FOLLICLES,374.0,243.1,28.26,280.5,35
CDM,68100WE,BIOPSY OF CONJUNCTIVA,540.0,351.0,47.93,405.0,35
CDM,68110WE,EXCISION LESION CONJUNCTIVA </1 CM,728.0,473.2,70.02,546.0,35
CDM,68115WE,EXCISION LESION CONJUNCTIVA > 1 CM,964.0,626.6,86.96,723.0,35
CDM,68130WE,EXCISION LESION CONJUNCTIVA ADJACENT SCLERA,2040.0,1326.0,196.11,1530.0,35
CDM,68135WE,DESTRUCTION LESION CONJUNCTIVA,756.0,491.4,95.86,567.0,35
CDM,68200WE,SUBCONJUNCTIVAL INJECTN,196.0,127.4,25.37,147.0,35
CDM,68320WE,CONJUNCTIVOPLASTY W/GRF/XTNSV REARRANGEMENT,2922.0,1899.3,256.6,2191.5,35
CDM,68326WE,CJP RCNSTJ CUL-DE-SAC BUCCAL GRF/XTNSV REARRGMT,3368.0,2189.2,392.59,3368.0,35
CDM,68330WE,RPR SYMBLEPHARON CONJUNCTIVOPLASTY W/O GRAFT,2312.0,1502.8,218.13,1734.0,35
CDM,68340WE,RPR & DIV SYMBLEPHARON W/WO CONFORM/CONTACT LE,1988.0,1292.2,189.2,1491.0,35
CDM,68362WE,"CONJUNC FLAP,TOTAL",3444.0,2238.6,405.17,3444.0,35
CDM,68400WE,INCISION DRAINAGE LACRIMAL GLAND,696.0,452.4,61.81,522.0,35
CDM,68420WE,INCISION DRAINAGE LACRIMAL SAC,940.0,611.0,79.51,705.0,35
CDM,68440WE,SNIP INCISION LACRIMAL PUNCTUM,396.0,257.4,75.85,297.0,35
CDM,68510WE,BIOPSY LACRIMAL GLAND,1840.0,1196.0,145.29,1380.0,35
CDM,68530WE,RMVL FB/DACRYOLITH LACRIMAL PASSAGES,1480.0,962.0,120.17,1110.0,35
CDM,68720WE,DACRYOCYSTORHINOSTOMY,4382.0,2848.3,493.34,4382.0,35
CDM,68750WE,CONJUNCTIVORHINOSTOMY INSJ TUBE/STENT,4040.0,2626.0,481.91,4040.0,35
CDM,68760WE,CLSR LACRIMAL PUNCTUM THERMOCAUT LIG/LASER,712.0,462.8,68.88,534.0,35
CDM,68761WE,CLSR LACRIMAL PUNCTUM PLUG EACH,620.0,403.0,56.06,465.0,35
CDM,68801WE,DILATION LACRIMAL PUNCTUM W/WO IRRGATION,328.0,213.2,45.75,246.0,35
CDM,68810WE,PROBE NASOLACRIMAL DUCT W/WO IRRIGATION,678.0,440.7,86.65,508.5,35
CDM,68811WE,PROBE NASOLACRIMAL DUCT W/WO IRRIG REQ GEN ANES,766.0,497.9,101.85,766.0,35
CDM,68815WE,PROBE NASOLACRIMAL DUCT W/WO IRRG INSJ TUBE/STNT,1188.0,772.2,113.9,891.0,35
CDM,68840WE,PROBE LACRIMAL CANALICULI W/WO IRRIGATION,572.0,371.8,61.35,429.0,35
CDM,69000WE,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,660.0,429.0,60.33,495.0,35
CDM,69005WE,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,864.0,561.6,77.92,648.0,35
CDM,69020WE,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,612.0,397.8,70.2,459.0,35
CDM,69090RVU1WE,"EAR PIERCING, BOTH EARS W/EARRINGS",200.0,130.0,62.89,200.0,13
CDM,69090WE,EAR PIERCING,67.0,43.55,33.5,67.0,13
CDM,69100WE,BIOPSY EXTERNAL EAR,324.0,210.6,22.35,243.0,35
CDM,69105WE,BIOPSY EXTERNAL AUDITORY CANAL,374.0,243.1,30.25,280.5,35
CDM,69110WE,EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR,1412.0,917.8,160.77,1059.0,35
CDM,69120WE,EXCISION EXTERNAL EAR COMPLETE AMPUTATION,1656.0,1076.4,216.71,1656.0,35
CDM,69140WE,EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL,3256.0,2116.4,454.58,3256.0,35
CDM,69145WE,EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL,1080.0,702.0,126.08,810.0,35
CDM,69150WE,RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ,5988.0,3892.2,652.85,5988.0,35
CDM,69200WE,RMVL FB XTRNL AUDITORY CANAL W/O ANES,339.0,220.35,24.95,254.25,35
CDM,69205WE,RMVL FB XTRNL AUDITORY CANAL ANES,532.0,345.8,61.75,532.0,35
CDM,69209FAMWE,REMOVE IMPACTED EAR WAX UNI,16.0,10.4,8.0,30.65,31
CDM,69209WE,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,258.0,167.7,9.46,258.0,31
CDM,69210WE,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,268.0,174.2,15.95,201.0,35
CDM,69220WE,"DEBRID MASTOIDECTOM CAVITY,SIMP",332.0,215.8,24.78,249.0,35
CDM,69222WE,"DEBRIDE MASTOID CAVITY,COMPLEX",580.0,377.0,66.58,435.0,35
CDM,69300WE,OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ,2576.0,1674.4,227.17,1932.0,35
CDM,69310WE,RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX,4388.0,2852.2,574.39,4388.0,35
CDM,69320WE,RCNSTJ XTRNL AUD CANAL CONGENITAL ATRESIA 1 STG,6872.0,4466.8,851.77,6872.0,35
CDM,69399RVU1WE,REVISION OF OSSEOINTEGRATED BONE ANCHORED IMPANT ABUTMENT (COMP,3164.0,2056.6,234.46,3164.0,15
CDM,69399RVU2WE,ENDOSCOPIC EXTERNAL AUDITORY CANAL (COMP CODE 69200),339.0,220.35,169.5,339.0,15
CDM,69420WE,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ,552.0,358.8,58.36,414.0,35
CDM,69421WE,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES,783.0,508.95,111.89,783.0,35
CDM,69424WE,VENTILATING TUBE RMVL REQUIRING GENERAL ANES,340.0,221.0,33.65,255.0,35
CDM,69433WE,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,628.0,408.2,63.94,471.0,35
CDM,69436WE,TYMPANOSTOMY GENERAL ANESTHESIA,884.0,574.6,107.9,884.0,35
CDM,69440WE,MIDDLE EAR EXPL THRU POSTAUR/EAR CANAL INC,3084.0,2004.6,430.78,3084.0,35
CDM,69450WE,TYMPANOLYSIS TRANSCANAL,2276.0,1479.4,332.91,2276.0,35
CDM,69501WE,TRANSMASTOID ANTROTOMY,3684.0,2394.6,511.94,3684.0,35
CDM,69502WE,"MASTOIDECTOMY,COMPLETE",5024.0,3265.6,684.81,5024.0,35
CDM,69505WE,"MASTOIDECTOMY,MOD RADICAL",5268.0,3424.2,728.53,5268.0,35
CDM,69511WE,"MASTOIDECTOMY,RADICAL",5480.0,3562.0,756.45,5480.0,35
CDM,69530WE,PETROUS APICECTOMY RADICAL MASTOIDECTOMY,8152.0,5298.8,954.63,8152.0,35
CDM,69535WE,"RESECT TEMPORAL BONE,EXTERN APPRCH",14968.0,9729.2,1645.94,14968.0,35
CDM,69540WE,EXCISION AURAL POLYP,500.0,325.0,63.62,375.0,35
CDM,69550WE,EXCISION AURAL GLOMUS TUMOR TRANSCANAL,4460.0,2899.0,629.57,4460.0,35
CDM,69552WE,EXCISION AURAL GLOMUS TUMOR TRANSMASTOID,7924.0,5150.6,962.02,7924.0,35
CDM,69601WE,REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY,5380.0,3497.0,728.37,5380.0,35
CDM,69601WE-53,REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY,5380.0,3497.0,2690.0,5380.0,12
CDM,69602WE,REVJ MASTOIDECTOMY RSLTG MODF RAD MSTDC,5504.0,3577.6,758.96,5504.0,35
CDM,69603WE,REVJ MASTOIDECTOMY RSLTG RAD MASTOIDECTOMY,5680.0,3692.0,782.59,5680.0,35
CDM,69604WE,REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY,5680.0,3692.0,801.36,5680.0,35
CDM,69610WE,TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH,1967.0,1278.55,139.56,1475.25,35
CDM,69620WE,MYRINGOPLASTY,2653.0,1724.45,242.3,1989.75,35
CDM,69631WE,TYMPANOPLASTY W/O MASTOIDECT W/O OSSICLE RECNSTJ,4020.0,2613.0,563.27,4020.0,35
CDM,69632WE,TYMPNOPLSTY W/O MSTDC 1ST/REVJ W/OSICLE RECNSTJ,5184.0,3369.6,717.96,5184.0,35
CDM,69633WE,TYMPANOPLASTY W/O MASTOIDEC 1ST/REVJ PROSTH TORP,4924.0,3200.6,685.65,4924.0,35
CDM,69641WE,TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ,5156.0,3351.4,716.46,5156.0,35
CDM,69642WE,TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ,6824.0,4435.6,936.99,6824.0,35
CDM,69643WE,TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR,6860.0,4459.0,865.94,6860.0,35
CDM,69644WE,TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR,6892.0,4479.8,954.89,6892.0,35
CDM,69645WE,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/O OCR,6684.0,4344.6,920.41,6684.0,35
CDM,69646WE,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/OCR,7348.0,4776.2,1000.09,7348.0,35
CDM,69660WE,STAPEDECTOMY/STAPEDOTOMY,4812.0,3127.8,670.67,4812.0,35
CDM,69661WE,STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT,6368.0,4139.2,871.44,6368.0,35
CDM,69662WE,REVISION STAPEDECTOMY/STAPEDOTOMY,6240.0,4056.0,857.0,6240.0,35
CDM,69666WE,REPAIR OVAL WINDOW FISTULA,3956.0,2571.4,560.51,3956.0,35
CDM,69670WE,MASTOID OBLITERATION,4692.0,3049.8,588.7,4692.0,35
CDM,69705WE,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI,1200.0,780.0,128.76,4843.98,28
CDM,69706WE,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI,1708.0,1110.2,180.4,4993.5,28
CDM,69720WE,DCMPRN FACIAL NRV INTRATEMPORAL LAT GANGLION,5884.0,3824.6,811.78,5884.0,35
CDM,69728WE,RMVL ENTIRE OI IMPLT SKL MAG TC ATTCH ESP>=100,3400.0,2210.0,234.26,3400.0,31
CDM,69729WE,IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100,3988.0,2592.2,254.29,3988.0,31
CDM,69730WE,RPLCMT OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100,4100.0,2665.0,258.06,4100.0,31
CDM,69801WE,LABYRINTHOTOMY TRANSCANAL,906.0,588.9,96.2,679.5,35
CDM,69805WE,"ENDOLYMPH SAC OPERATN,NO SHUNT",5884.0,3824.6,732.62,5884.0,35
CDM,69806WE,ENDOLYMPH SAC OP W SHUNT,5052.0,3283.8,687.81,5052.0,35
CDM,69905WE,"EXCIS LABYRINTH,TRANSCANAL",4954.0,3220.1,636.69,4954.0,35
CDM,69910WE,EXCIS LABYRINTH W MASTOIDECTOMY,5564.0,3616.6,735.98,5564.0,35
CDM,69970WE,"REMOVE TUMOR,TEMPORAL BONE",12964.0,8426.6,1298.53,12964.0,35
CDM,69990WE,MICROSURG TQS REQ USE OPERATING MICROSCOPE,1384.0,899.6,125.3,1384.0,35
CDM,70030FBXWE,RADIOLOGICAL EXAM FOREIGN BODY,839.0,545.35,17.89,839.0,32
CDM,70030PROWE,"RAD EXAM,EYE,FOREIGN BODY",79.0,51.35,17.89,79.0,32
CDM,70030WE,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,839.0,545.35,17.89,839.0,32
CDM,70030WE-26,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,79.0,51.35,6.96,79.0,31
CDM,70030WE-TC,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,760.0,494.0,17.95,760.0,35
CDM,70100PROWE,XRAY MANDIBLE < 4 VIEWS,72.0,46.8,21.11,72.0,32
CDM,70100WE,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,832.0,540.8,21.11,832.0,32
CDM,70100WE-26,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,72.0,46.8,7.53,72.0,31
CDM,70100WE-TC,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,760.0,494.0,22.25,760.0,35
CDM,70100XRAWE,XRAY MANDIBLE < 4 VIEWS,832.0,540.8,21.11,832.0,32
CDM,70110PROWE,XRAY MANDIBLE COMPLETE,100.0,65.0,26.53,100.0,32
CDM,70110WE,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,1018.0,661.7,26.53,1018.0,32
CDM,70110WE-26,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,100.0,65.0,10.37,100.0,31
CDM,70110WE-TC,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,918.0,596.7,23.98,918.0,35
CDM,70110XRAWE,XRAY MANDIBLE COMPLETE,1018.0,661.7,26.53,1018.0,32
CDM,70120PROWE,"MASTOIDS,<3VIEWS PER SIDE",72.0,46.8,23.82,72.0,32
CDM,70120WE,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,990.0,643.5,23.82,990.0,32
CDM,70120WE-26,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,72.0,46.8,7.82,72.0,31
CDM,70120WE-TC,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,918.0,596.7,23.69,918.0,35
CDM,70120XRAWE,XRAY MASTOIDS < 3 VIEWS,990.0,643.5,23.82,990.0,32
CDM,70130PROWE,XRAY MASTOID COMPLETE,150.0,97.5,34.35,150.0,32
CDM,70130WE,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,1068.0,694.2,34.35,1068.0,32
CDM,70130WE-26,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,150.0,97.5,14.07,150.0,31
CDM,70130WE-TC,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,918.0,596.7,35.18,918.0,35
CDM,70130XRAWE,XRAY MASTOID COMPLETE,1068.0,694.2,34.35,1068.0,32
CDM,70134COMWE,XRAY INTERNAL AUDITORY COMP,4879.0,3171.35,32.99,4879.0,32
CDM,70134PROWE,"XRAY AUDITORY MEATI,CMPLT",150.0,97.5,32.99,150.0,32
CDM,70134WE,RADEX INTERNAL AUDITORY MEATI COMPLETE,4879.0,3171.35,32.99,4879.0,32
CDM,70134WE-26,RADEX INTERNAL AUDITORY MEATI COMPLETE,150.0,97.5,14.93,150.0,31
CDM,70134WE-TC,RADEX INTERNAL AUDITORY MEATI COMPLETE,4729.0,3073.85,33.46,4729.0,35
CDM,70140PROWE,XRAY FACIAL BONES < 3 VIEWS,76.0,49.4,24.07,76.0,32
CDM,70140TECWE,"XRAY FACIAL BONES ,3 VIEWS",760.0,494.0,24.07,760.0,32
CDM,70140WE,RADEX FACIAL BONES < 3 VIEWS,836.0,543.4,24.07,836.0,32
CDM,70140WE-26,RADEX FACIAL BONES < 3 VIEWS,76.0,49.4,8.39,76.0,31
CDM,70140WE-TC,RADEX FACIAL BONES < 3 VIEWS,760.0,494.0,17.95,760.0,35
CDM,70140XRBWE,XRAY FACIAL BONES < 3 VIEWS,836.0,543.4,24.07,836.0,32
CDM,70150COMWE,XRAY FACIAL BONES COMPLETE,1022.0,664.3,31.41,1022.0,32
CDM,70150PROWE,XRAY FACIAL BONES COMPLETE,104.0,67.6,31.41,104.0,32
CDM,70150WE,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,1022.0,664.3,31.41,1022.0,32
CDM,70150WE-26,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,104.0,67.6,10.65,104.0,31
CDM,70150WE-TC,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,918.0,596.7,26.28,918.0,35
CDM,70160COMWE,XRAY NASAL BONES COMPLETE,828.0,538.2,20.62,828.0,32
CDM,70160PROWE,XRAY NASAL BONES COMPLETE,68.0,44.2,20.62,68.0,32
CDM,70160WE,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,828.0,538.2,20.62,828.0,32
CDM,70160WE-26,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,68.0,44.2,7.25,68.0,31
CDM,70160WE-TC,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,760.0,494.0,21.68,760.0,35
CDM,70190WE,RADEX OPTIC FORAMINA,844.0,548.6,24.78,844.0,32
CDM,70190WE-26,RADEX OPTIC FORAMINA,84.0,54.6,8.95,84.0,31
CDM,70190WE-TC,RADEX OPTIC FORAMINA,760.0,494.0,22.25,760.0,35
CDM,70200PROWE,XRAY ORBITS COMPLETE,112.0,72.8,31.15,112.0,32
CDM,70200WE,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,1030.0,669.5,31.15,1030.0,32
CDM,70200WE-26,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,112.0,72.8,11.51,112.0,31
CDM,70200WE-TC,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,918.0,596.7,26.28,918.0,35
CDM,70200XRYWE,XRAY ORBITS COMPLETE,1030.0,669.5,31.15,1030.0,32
CDM,70210PARWE,XRAY SINUS PARANASAL <3VWS,828.0,538.2,23.3,828.0,32
CDM,70210PROWE,XRAY SINUS PARANASAL <3VWS,68.0,44.2,23.3,68.0,32
CDM,70210TECWE,XRAY SINUS PARANASAL <3VWS,760.0,494.0,23.3,760.0,32
CDM,70210WE,RADEX SINUSES PARANASAL <3 VIEWS,828.0,538.2,23.3,828.0,32
CDM,70210WE-26,RADEX SINUSES PARANASAL <3 VIEWS,68.0,44.2,7.25,68.0,31
CDM,70210WE-TC,RADEX SINUSES PARANASAL <3 VIEWS,760.0,494.0,19.67,760.0,35
CDM,70220PROWE,XRAY SINUS PARANASAL COMP,97.0,63.05,28.72,97.0,32
CDM,70220WE,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,857.0,557.05,28.72,857.0,32
CDM,70220WE-26,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,97.0,63.05,10.27,97.0,31
CDM,70220WE-TC,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,760.0,494.0,23.69,760.0,35
CDM,70220XRYWE,XRAY SINUS PARANASAL 3 VIEWS OR MORE,857.0,557.05,28.72,857.0,32
CDM,70240PROWE,XRAY SELLA TURCICA,76.0,49.4,18.66,76.0,32
CDM,70240WE,RADIOLOGIC EXAMINATION SELLA TURCICA,836.0,543.4,18.66,836.0,32
CDM,70240WE-26,RADIOLOGIC EXAMINATION SELLA TURCICA,76.0,49.4,8.1,76.0,31
CDM,70240WE-TC,RADIOLOGIC EXAMINATION SELLA TURCICA,760.0,494.0,17.95,760.0,35
CDM,70240XRYWE,XRAY SELLA TURCICA,836.0,543.4,18.66,836.0,32
CDM,70250PROWE,XRAY SKULL < 4 VIEWS,79.0,51.35,26.09,79.0,32
CDM,70250TECWE,XRAY SKULL < 4 VWS,918.0,596.7,26.09,918.0,32
CDM,70250WE,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,997.0,648.05,26.09,997.0,32
CDM,70250WE-26,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,79.0,51.35,8.65,79.0,31
CDM,70250WE-TC,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,918.0,596.7,21.97,918.0,35
CDM,70250XRYWE,XRAY SKULL < 4 VIEWS,997.0,648.05,26.09,997.0,32
CDM,70260PROWE,"XRAY SKULL,COMPLETE,MINIMUM 4 VIEWS",112.0,72.8,35.58,112.0,32
CDM,70260WE,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,1030.0,669.5,35.58,1030.0,32
CDM,70260WE-26,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,112.0,72.8,13.18,112.0,31
CDM,70260WE-TC,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,918.0,596.7,26.85,918.0,35
CDM,70260XRYWE,XRAY SKULL COMPLETE MIN 4VIEWS,1030.0,669.5,35.58,1030.0,32
CDM,70300WE,RADIOLOGIC EXAMINATION TEETH 1 VIEW,800.0,520.0,10.7,800.0,32
CDM,70300WE-26,RADIOLOGIC EXAMINATION TEETH 1 VIEW,40.0,26.0,4.98,40.0,31
CDM,70300WE-TC,RADIOLOGIC EXAMINATION TEETH 1 VIEW,760.0,494.0,7.89,760.0,35
CDM,70310WE,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,2155.0,1400.75,18.74,2155.0,32
CDM,70310WE-26,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,70.0,45.5,6.96,70.0,31
CDM,70310WE-TC,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,2085.0,1355.25,25.7,2085.0,35
CDM,70328PROWE,XRAY TMJ UNILATERAL,72.0,46.8,20.32,72.0,32
CDM,70328TMJWE,XRAY TMJ UNILATERAL,832.0,540.8,20.32,832.0,32
CDM,70328WE,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,832.0,540.8,20.32,832.0,32
CDM,70328WE-26,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,72.0,46.8,7.53,72.0,31
CDM,70328WE-TC,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,760.0,494.0,19.38,760.0,35
CDM,70330PROWE,XRAY TMJ BILATERAL,96.0,62.4,32.06,96.0,32
CDM,70330TMJWE,XRAY TMJ BILATERAL,856.0,556.4,32.06,856.0,32
CDM,70330WE,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,856.0,556.4,32.06,856.0,32
CDM,70330WE-26,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,96.0,62.4,10.38,96.0,31
CDM,70330WE-TC,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,760.0,494.0,31.73,760.0,35
CDM,70332WE,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,2301.0,1495.65,59.06,2301.0,32
CDM,70332WE-26,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,216.0,140.4,22.3,216.0,31
CDM,70332WE-TC,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,2085.0,1355.25,42.65,2085.0,35
CDM,70336MRIWE,MRI TM JOINT,2677.0,1740.05,249.3,2677.0,32
CDM,70336WE-198,MRI TEMPOROMANDIBULAR JOINT,592.0,384.8,249.3,592.0,32
CDM,70336WE-199,MRI TEMPOROMANDIBULAR JOINT,2677.0,1740.05,249.3,2677.0,32
CDM,70336WE-26,MRI TEMPOROMANDIBULAR JOINT,592.0,384.8,60.79,592.0,31
CDM,70336WE-TC,MRI TEMPOROMANDIBULAR JOINT,2085.0,1355.25,191.21,2085.0,35
CDM,70360PROWE,XRAY NECK SOFT TISSUE,79.0,51.35,17.04,79.0,32
CDM,70360WE,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,839.0,545.35,17.04,839.0,32
CDM,70360WE-26,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,79.0,51.35,6.96,79.0,31
CDM,70360WE-TC,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,760.0,494.0,16.51,760.0,35
CDM,70360XRYWE,XRAY NECK SOFT TISSUE,839.0,545.35,17.04,839.0,32
CDM,70380WE,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,828.0,538.2,24.61,828.0,32
CDM,70380WE-26,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,68.0,44.2,7.82,68.0,31
CDM,70380WE-TC,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,760.0,494.0,27.14,760.0,35
CDM,70390GRPWE,SIALOGRAPHY,2237.0,1454.05,62.53,2237.0,32
CDM,70390PROWE,SIALOGRAPHY,152.0,98.8,62.53,168.3,32
CDM,70390RADWE,"RADIOLOGIC EXAM, SALIVARY GLAND FOR CALC",2237.0,1454.05,62.53,2237.0,32
CDM,70390WE,SIALOGRAPHY RS&I,2237.0,1454.05,62.53,2237.0,32
CDM,70390WE-26,SIALOGRAPHY RS&I,152.0,98.8,16.05,152.0,31
CDM,70390WE-TC,SIALOGRAPHY RS&I,2085.0,1355.25,72.52,2085.0,35
CDM,70450CTBWE,CT HEAD/BRAIN WO CONTRAST,1292.0,839.8,95.92,1292.0,32
CDM,70450PROWE,CT HEAD/BRAIN WO CONTRAST,374.0,243.1,95.92,374.0,32
CDM,70450WE,CT HEAD/BRAIN W/O CONTRAST MATERIAL,1292.0,839.8,95.92,1292.0,32
CDM,70450WE-26,CT HEAD/BRAIN W/O CONTRAST MATERIAL,374.0,243.1,34.94,374.0,31
CDM,70450WE-TC,CT HEAD/BRAIN W/O CONTRAST MATERIAL,918.0,596.7,66.43,918.0,35
CDM,70460CTBWE,CT HEAD/BRAIN W CONTRAST,2032.0,1320.8,130.98,2032.0,32
CDM,70460PROWE,CT HEAD/BRAIN W CONTRAST,497.0,323.05,130.98,497.0,32
CDM,70460WE,CT HEAD/BRAIN W/CONTRAST MATERIAL,2032.0,1320.8,130.98,2032.0,32
CDM,70460WE-26,CT HEAD/BRAIN W/CONTRAST MATERIAL,497.0,323.05,46.45,497.0,31
CDM,70460WE-TC,CT HEAD/BRAIN W/CONTRAST MATERIAL,1535.0,997.75,95.09,1535.0,35
CDM,70470CTBWE,CT HEAD/BRAIN W/WO CONTRAST,2094.0,1361.1,154.47,2094.0,32
CDM,70470PROWE,CT HEAD/BRAIN W/WO CONTRAST,559.0,363.35,154.47,559.0,32
CDM,70470WE,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,2094.0,1361.1,154.47,2094.0,32
CDM,70470WE-26,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,559.0,363.35,52.7,559.0,31
CDM,70470WE-TC,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,1535.0,997.75,113.16,1535.0,35
CDM,70471WE,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,4174.0,2713.1,387.28,4174.0,21
CDM,70471WE-26,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,1100.0,715.0,123.29,1100.0,25
CDM,70471WE-TC,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,3074.0,1998.1,263.99,3074.0,29
CDM,70472WE,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,1874.0,1218.1,160.4,1874.0,21
CDM,70472WE-26,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,339.0,220.35,38.06,339.0,25
CDM,70472WE-TC,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,1535.0,997.75,122.34,1535.0,29
CDM,70473WE,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,1985.0,1290.25,247.47,1985.0,21
CDM,70473WE-26,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,440.0,286.0,49.45,440.0,25
CDM,70473WE-TC,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,1545.0,1004.25,198.02,1545.0,29
CDM,70480CTOWE,CT ORBITS SELLA WO CONT,1481.0,962.65,149.15,1481.0,32
CDM,70480PROWE,CT ORBITS SELLA W/O CONT,563.0,365.95,149.15,563.0,32
CDM,70480WE,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,1481.0,962.65,149.15,1481.0,32
CDM,70480WE-26,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,563.0,365.95,53.27,563.0,31
CDM,70480WE-TC,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,918.0,596.7,98.31,918.0,35
CDM,70481CTOWE,CT ORBITS SELLA W CONTRAST,2032.0,1320.8,168.6,2032.0,32
CDM,70481PROWE,CT ORBITS SELLA W CONTRAST,497.0,323.05,168.6,497.0,32
CDM,70481WE,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,2032.0,1320.8,168.6,2032.0,32
CDM,70481WE-26,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,497.0,323.05,52.65,497.0,31
CDM,70481WE-TC,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,1535.0,997.75,126.4,1535.0,35
CDM,70482CTOWE,CT ORBITS SELLA W/WO CONTRAST,2094.0,1361.1,196.64,2094.0,32
CDM,70482PROWE,CT ORBITS SELLA W/WO CONTRAST,559.0,363.35,196.64,559.0,32
CDM,70482WE,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,2094.0,1361.1,196.64,2094.0,32
CDM,70482WE-26,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,559.0,363.35,59.04,559.0,31
CDM,70482WE-TC,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,1535.0,997.75,149.32,1535.0,35
CDM,70486CTMWE,CT MAXILLOFACIAL WO CONT,1292.0,839.8,112.56,1292.0,32
CDM,70486PROWE,CT MAXILLOFACIAL WO CONT,374.0,243.1,112.56,374.0,32
CDM,70486WE,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,1292.0,839.8,112.56,1292.0,32
CDM,70486WE-26,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,374.0,243.1,40.11,374.0,31
CDM,70486WE-TC,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,918.0,596.7,87.09,918.0,35
CDM,70487CTMWE,CT MAXILLOFACIAL W CONTRAST,2032.0,1320.8,135.83,2032.0,32
CDM,70487PROWE,CT MAXILLOFACIAL W CONTRAST,497.0,323.05,135.83,497.0,32
CDM,70487WE,CT MAXILLOFACIAL W/CONTRAST MATERIAL,2032.0,1320.8,135.83,2032.0,32
CDM,70487WE-26,CT MAXILLOFACIAL W/CONTRAST MATERIAL,497.0,323.05,52.65,497.0,31
CDM,70487WE-TC,CT MAXILLOFACIAL W/CONTRAST MATERIAL,1535.0,997.75,98.64,1535.0,35
CDM,70488CTMWE,CT MAXILLOFACIAL W WO CONT,2094.0,1361.1,164.88,2094.0,32
CDM,70488PROWE,CT MAXILLOFACIAL W WO CONT,599.0,389.35,164.88,599.0,32
CDM,70488WE,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,2094.0,1361.1,164.88,2094.0,32
CDM,70488WE-26,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,559.0,363.35,58.81,559.0,31
CDM,70488WE-TC,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,1535.0,997.75,123.82,1535.0,35
CDM,70490CTNWE,CT SOFT TISSUE NECK WO CONT,1481.0,962.65,149.15,1481.0,32
CDM,70490PROWE,CT SOFT TISSUE NECK WO CONT,563.0,365.95,149.15,563.0,32
CDM,70490WE,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,1481.0,962.65,149.15,1481.0,32
CDM,70490WE-26,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,563.0,365.95,53.27,563.0,31
CDM,70490WE-TC,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,918.0,596.7,89.35,918.0,35
CDM,70491CTWWE,CT SOFT TISSUE NECK W CONT,2142.0,1392.3,182.87,2142.0,32
CDM,70491PROWE,CT SOFT TISSUE NECK W CONT,607.0,394.55,182.87,607.0,32
CDM,70491WE,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,2142.0,1392.3,182.87,2142.0,32
CDM,70491WE-26,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,607.0,394.55,56.96,607.0,31
CDM,70491WE-TC,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,1535.0,997.75,118.65,1535.0,35
CDM,70492CTNWE,CT SOFT TISS NECK W WO CONT,2248.0,1461.2,207.66,2248.0,32
CDM,70492PROWE,CT SOFT TISS NECK W WO CONT,713.0,463.45,207.66,713.0,32
CDM,70492WE,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,2248.0,1461.2,207.66,2248.0,32
CDM,70492WE-26,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,713.0,463.45,59.94,713.0,31
CDM,70492WE-TC,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,1535.0,997.75,144.15,1535.0,35
CDM,70496CTAWE,"CTA HEAD WWO C,W/3D",2305.0,1498.25,237.69,2305.0,32
CDM,70496PROWE,"CT ANGIOGRAPHY, HEAD",770.0,500.5,237.69,770.0,32
CDM,70496WE,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,2305.0,1498.25,237.69,2305.0,32
CDM,70496WE-26,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,770.0,500.5,72.73,770.0,31
CDM,70496WE-TC,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,1535.0,997.75,193.15,1535.0,35
CDM,70498CTAWE,"CTA NECK, W/WO C,W/3D",2305.0,1498.25,236.28,2305.0,32
CDM,70498PROWE,"CT ANGIOGRAPHY, NECK",770.0,500.5,236.28,770.0,32
CDM,70498WE,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,2305.0,1498.25,236.28,2305.0,32
CDM,70498WE-26,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,770.0,500.5,72.73,770.0,31
CDM,70498WE-TC,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,1535.0,997.75,192.83,1535.0,35
CDM,70540MRIWE,MRI ORBIT FACE NECK,2679.0,1741.35,212.13,2679.0,32
CDM,70540PROWE,MRI ORB FACE&NECK W/O CON,594.0,386.1,212.13,594.0,32
CDM,70540WE,MRI ORBIT FACE &/NECK W/O CONTRAST,2679.0,1741.35,212.13,2679.0,32
CDM,70540WE-26,MRI ORBIT FACE &/NECK W/O CONTRAST,594.0,386.1,55.96,594.0,31
CDM,70540WE-TC,MRI ORBIT FACE &/NECK W/O CONTRAST,2085.0,1355.25,161.26,2085.0,35
CDM,70542CONWE,"MRI ORBIT,FACE &/OR NECK W/CONTRAST",3728.0,2423.2,251.99,3728.0,32
CDM,70542PROWE,"MRI,ORBIT,FACE,NECK W/CON",648.0,421.2,251.99,648.0,32
CDM,70542WE,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,3728.0,2423.2,251.99,3728.0,32
CDM,70542WE-26,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,648.0,421.2,67.33,648.0,31
CDM,70542WE-TC,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,3080.0,2002.0,189.6,3080.0,35
CDM,70543CONWE,"MRI,ORBIT,FACE AND/OR NECK W/WO CONTRAST",3940.0,2561.0,318.62,3940.0,32
CDM,70543PROWE,"MRI,ORBT,FACE,NCK W/WO CN",860.0,559.0,318.62,860.0,32
CDM,70543WE,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,3940.0,2561.0,318.62,3940.0,32
CDM,70543WE-26,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,860.0,559.0,88.63,860.0,31
CDM,70543WE-TC,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,3080.0,2002.0,235.44,3080.0,35
CDM,70544MRIWE,"MRA, HEAD, W/O CONTRAST",2565.0,1667.25,201.09,2565.0,32
CDM,70544WE-200,"MRA, HEAD W/O CONTRAST",2565.0,1667.25,201.09,2565.0,32
CDM,70544WE-201,"MRA, HEAD W/O CONTRAST",480.0,312.0,201.09,547.99,32
CDM,70544WE-26,"MRA, HEAD W/O CONTRAST",480.0,312.0,49.86,480.0,31
CDM,70544WE-TC,"MRA, HEAD W/O CONTRAST",2085.0,1355.25,158.28,2085.0,35
CDM,70545MRIWE,"MRA, HEAD WITH CONTRAST",3560.0,2314.0,212.34,3560.0,32
CDM,70545PROWE,"MRA, HEAD; W/CONTRAST",480.0,312.0,212.34,538.99,32
CDM,70545WE,"MRA, HEAD, WITH CONTRAST",3560.0,2314.0,212.34,3560.0,32
CDM,70545WE-26,"MRA, HEAD, WITH CONTRAST",480.0,312.0,49.57,480.0,31
CDM,70545WE-TC,"MRA, HEAD, WITH CONTRAST",3080.0,2002.0,170.23,3080.0,35
CDM,70546MRAWE,"MRA,HEAD; W/WO CONTRAST",3731.0,2425.15,306.89,3731.0,32
CDM,70546PROWE,"MRA,HEAD; W/WO CONTRAST",651.0,423.15,306.89,841.98,32
CDM,70546WE,MRA; HEAD W & WO CONTRAST,3731.0,2425.15,306.89,3731.0,32
CDM,70546WE-26,MRA; HEAD W & WO CONTRAST,651.0,423.15,68.99,651.0,31
CDM,70546WE-TC,MRA; HEAD W & WO CONTRAST,3080.0,2002.0,257.96,3080.0,35
CDM,70547WE-202,"MRA, NECK; W/O CONTRAST",2613.0,1698.45,201.38,2613.0,32
CDM,70547WE-203,"MRA, NECK; W/O CONTRAST",528.0,343.2,201.38,547.27,32
CDM,70547WE-26,"MRA, NECK; W/O CONTRAST",528.0,343.2,49.86,528.0,31
CDM,70547WE-TC,"MRA, NECK; W/O CONTRAST",2085.0,1355.25,158.61,2085.0,35
CDM,70548WE-204,"MRA, NECK; W/CONTRAST",3680.0,2392.0,230.32,3680.0,32
CDM,70548WE-205,"MRA, NECK; W/CONTRAST",600.0,390.0,230.32,600.0,32
CDM,70548WE-26,"MRA, NECK; W/CONTRAST",600.0,390.0,49.86,600.0,31
CDM,70548WE-TC,"MRA, NECK; W/CONTRAST",3080.0,2002.0,174.75,3080.0,35
CDM,70549PROWE,"MRA, NECK; W/WO CONTRAST",720.0,468.0,342.72,843.61,32
CDM,70549WE,"MRA,NECK; W/WO CONTRAST",3800.0,2470.0,342.72,3800.0,32
CDM,70549WE-26,"MRA,NECK; W/WO CONTRAST",720.0,468.0,74.43,720.0,31
CDM,70549WE-TC,"MRA,NECK; W/WO CONTRAST",3080.0,2002.0,258.93,3080.0,35
CDM,70551CONWE,MRI BRAIN INCL BRAIN STEM W/O CONTRAST,2736.0,1778.4,189.4,2736.0,32
CDM,70551PROWE,MRI BRAIN WO CONTRAST,651.0,423.15,189.4,651.0,32
CDM,70551WE,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,2736.0,1778.4,189.4,2736.0,32
CDM,70551WE-26,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,651.0,423.15,61.08,651.0,31
CDM,70551WE-TC,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,2085.0,1355.25,126.4,2085.0,35
CDM,70552CONWE,MRI BRAIN INCL BRAIN STEM W/CONTRAST,3863.0,2510.95,257.12,3863.0,32
CDM,70552PROWE,MRI BRAIN W CONTRAST,783.0,508.95,257.12,783.0,32
CDM,70552WE,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,3863.0,2510.95,257.12,3863.0,32
CDM,70552WE-26,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,783.0,508.95,74.29,783.0,31
CDM,70552WE-TC,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,3080.0,2002.0,185.72,3080.0,35
CDM,70553MRIWE,MRI BRAIN INCL BRAIN STEM W/WO CON,4088.0,2657.2,303.75,4088.0,32
CDM,70553PROWE,MRI BRAIN W WO CONTRAST,1008.0,655.2,303.75,1008.0,32
CDM,70553WE,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,4088.0,2657.2,303.75,4088.0,32
CDM,70553WE-26,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,1008.0,655.2,98.01,1008.0,31
CDM,70553WE-TC,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,3080.0,2002.0,209.61,3080.0,35
CDM,70554WE,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,2512.0,1632.8,361.68,2512.0,32
CDM,70555WE,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,3101.0,2015.65,362.39,3101.0,14
CDM,70555WE-26,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,1016.0,660.4,110.24,1016.0,31
CDM,70555WE-TC,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,2085.0,1355.25,148.16,2085.0,21
CDM,71000010,PHASE II RECOVERY 1ST 30 MIN,611.0,397.15,102.65,549.9,21
CDM,71000020,PHASE II RECOVERY EA ADD 15 MI,188.0,122.2,31.58,169.2,21
CDM,71000060,PHASE I RECOVERY EA ADD 15 MIN,188.0,122.2,31.58,169.2,21
CDM,71000070,PHASE I RECOVERY 1ST 30 MIN,686.0,445.9,115.25,617.4,21
CDM,71000875,EXTENDED RECOVERY,2773.0,1802.45,465.86,2495.7,21
CDM,71000885,OP-POST IR/CATH/IMAGING RECOVERY,1823.0,1184.95,306.26,1640.7,21
CDM,71045WE,RADIOLOGIC EXAM CHEST SINGLE VIEW,839.0,545.35,14.23,839.0,28
CDM,71045WE-26,RADIOLOGIC EXAM CHEST SINGLE VIEW,79.0,51.35,8.65,79.0,31
CDM,71045WE-TC,RADIOLOGIC EXAM CHEST SINGLE VIEW,760.0,494.0,12.67,760.0,35
CDM,71046WE,RADIOLOGIC EXAM CHEST 2 VIEWS,857.0,557.05,21.72,857.0,28
CDM,71046WE-26,RADIOLOGIC EXAM CHEST 2 VIEWS,97.0,63.05,10.27,97.0,31
CDM,71046WE-TC,RADIOLOGIC EXAM CHEST 2 VIEWS,760.0,494.0,22.85,760.0,35
CDM,71047WE,RADIOLOGIC EXAM CHEST 3 VIEWS,879.0,571.35,27.74,879.0,28
CDM,71047WE-26,RADIOLOGIC EXAM CHEST 3 VIEWS,119.0,77.35,12.86,119.0,31
CDM,71047WE-TC,RADIOLOGIC EXAM CHEST 3 VIEWS,760.0,494.0,28.33,760.0,35
CDM,71048WE,RADIOLOGIC EXAM CHEST 4+ VIEWS,1054.0,685.1,29.8,1054.0,28
CDM,71048WE-26,RADIOLOGIC EXAM CHEST 4+ VIEWS,136.0,88.4,14.47,136.0,31
CDM,71048WE-TC,RADIOLOGIC EXAM CHEST 4+ VIEWS,918.0,596.7,29.96,918.0,35
CDM,71090WE,X-RAY & PACEMAKER INSERTION,134.0,87.1,67.0,134.0,12
CDM,71100PROWE,XRAY RIBS UNILATERAL 2 VIEW,88.0,57.2,23.43,88.0,32
CDM,71100WE,RADEX RIBS UNILATERAL 2 VIEWS,848.0,551.2,23.43,848.0,32
CDM,71100WE-26,RADEX RIBS UNILATERAL 2 VIEWS,88.0,57.2,9.24,88.0,31
CDM,71100WE-TC,RADEX RIBS UNILATERAL 2 VIEWS,760.0,494.0,19.1,760.0,35
CDM,71100XRYWE,XRAY RIBS UNILATERAL 2 VIEW,848.0,551.2,23.43,848.0,32
CDM,71101PROWE,XRAY UNI RIB W/CHEST 3VEW,108.0,70.2,27.75,108.0,32
CDM,71101RADWE,RAD EXAM RIB/CHEST MIN 3V,1026.0,666.9,27.75,1026.0,32
CDM,71101WE,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,1026.0,666.9,27.75,1026.0,32
CDM,71101WE-26,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,108.0,70.2,10.94,108.0,31
CDM,71101WE-TC,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,918.0,596.7,23.12,918.0,35
CDM,71110PROWE,XRAY RIBS BILATERAL 3 VIEW,128.0,83.2,31.85,128.0,32
CDM,71110TECWE,XRAY RIBS BILATERAL 3 VIEW,918.0,596.7,31.85,918.0,32
CDM,71110WE,RADEX RIBS BILATERAL 3 VIEWS,1046.0,679.9,31.85,1046.0,32
CDM,71110WE-26,RADEX RIBS BILATERAL 3 VIEWS,128.0,83.2,11.22,128.0,31
CDM,71110WE-TC,RADEX RIBS BILATERAL 3 VIEWS,918.0,596.7,23.98,918.0,35
CDM,71110XRYWE,XRAY RIBS BILATERAL 3 VIEW,1046.0,679.9,31.85,1046.0,32
CDM,71111PROWE,XRAY RIBS BILAT/CHEST 4 V,128.0,83.2,36.58,128.0,32
CDM,71111TECWE,XRAY RIBS/CHEST BILAT 3 VIEW,918.0,596.7,36.58,918.0,32
CDM,71111WE,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,1046.0,679.9,36.58,1046.0,32
CDM,71111WE-26,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,128.0,83.2,13.21,128.0,31
CDM,71111WE-TC,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,918.0,596.7,32.59,918.0,35
CDM,71111XRYWE,XRAY RIBS/CHEST BILAT 3 VIEW,1046.0,679.9,36.58,1046.0,32
CDM,71120PROWE,XRAY STERNUM 2 VIEW,88.0,57.2,25.13,88.0,32
CDM,71120WE,RADEX STERNUM MINIMUM 2 VIEWS,848.0,551.2,25.13,848.0,32
CDM,71120WE-26,RADEX STERNUM MINIMUM 2 VIEWS,88.0,57.2,8.38,88.0,31
CDM,71120WE-TC,RADEX STERNUM MINIMUM 2 VIEWS,760.0,494.0,19.1,760.0,35
CDM,71120XRYWE,XRAY STERNUM 2 VIEW,848.0,551.2,25.13,848.0,32
CDM,71130PROWE,XRAY STERNOCLAVICULAR 3 VW,97.0,63.05,27.32,97.0,32
CDM,71130WE,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,857.0,557.05,27.32,857.0,32
CDM,71130WE-26,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,97.0,63.05,9.24,97.0,31
CDM,71130WE-TC,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,760.0,494.0,23.12,760.0,35
CDM,71130XRYWE,XRAY STERNOCLAVICULAR 3 VW,857.0,557.05,27.32,857.0,32
CDM,71250PROWE,CT THORAX WO CONTRAST,475.0,308.75,124.66,475.0,32
CDM,71250THOWE,CT THORAX WO CONTRAST,1393.0,905.45,124.66,1393.0,32
CDM,71250WE,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,1393.0,905.45,124.66,1393.0,32
CDM,71250WE-26,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,475.0,308.75,42.48,475.0,31
CDM,71250WE-TC,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,918.0,596.7,81.92,918.0,35
CDM,71260PROWE,CT THORAX W CONTRAST,510.0,331.5,155.76,510.0,32
CDM,71260THOWE,CT THORAX W CONTRAST,2045.0,1329.25,155.76,2045.0,32
CDM,71260WE,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,2045.0,1329.25,155.76,2045.0,32
CDM,71260WE-26,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,510.0,331.5,51.56,510.0,31
CDM,71260WE-TC,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1535.0,997.75,111.55,1535.0,35
CDM,71270CTAWE,"CTA CHEST, W/WO CONTRAST",2085.0,1355.25,183.32,2085.0,32
CDM,71270PROWE,CT THORAS W WO CONTRAST,550.0,357.5,183.32,550.0,32
CDM,71270THOWE,CT THORAX W WO CONTRAST,2085.0,1355.25,183.32,2085.0,32
CDM,71270WE,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,2085.0,1355.25,183.32,2085.0,32
CDM,71270WE-26,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,550.0,357.5,56.96,550.0,31
CDM,71270WE-TC,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,1535.0,997.75,136.41,1535.0,35
CDM,71271WE,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,1393.0,905.45,105.66,1393.0,28
CDM,71271WE-26,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,475.0,308.75,50.39,475.0,31
CDM,71271WE-TC,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,918.0,596.7,86.69,918.0,35
CDM,71275PROWE,"CT ANGIOGRPHY,CHST,WWO CN",801.0,520.65,241.52,801.0,32
CDM,71275WE,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,2336.0,1518.4,241.52,2336.0,32
CDM,71275WE-26,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,801.0,520.65,79.69,801.0,31
CDM,71275WE-TC,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,1535.0,997.75,195.09,1535.0,35
CDM,71550MRIWE,MRI CHEST,3253.0,2114.45,287.55,3253.0,32
CDM,71550PROWE,MRI CHEST WO/CONTRAST,584.0,379.6,287.55,584.0,32
CDM,71550WE,MRI CHEST W/O CONTRAST MATERIAL,2669.0,1734.85,287.55,2669.0,32
CDM,71550WE-26,MRI CHEST W/O CONTRAST MATERIAL,584.0,379.6,60.22,584.0,31
CDM,71550WE-TC,MRI CHEST W/O CONTRAST MATERIAL,2085.0,1355.25,263.2,2085.0,35
CDM,71551PROWE,"MRI, CHEST; W/CONTRAST",692.0,449.8,346.0,692.0,32
CDM,71551WE,"MRI,CHEST; W/CONTRAST",7506.0,4878.9,360.88,7506.0,32
CDM,71551WE-26,"MRI,CHEST; W/CONTRAST",692.0,449.8,71.88,692.0,31
CDM,71551WE-TC,"MRI,CHEST; W/CONTRAST",6814.0,4429.1,288.7,6814.0,35
CDM,71552MRIWE,"MRI, CHEST; W/WO CONTRAST",3984.0,2589.6,454.25,3984.0,32
CDM,71552PROWE,"MRI,CHEST; W/WO CONTRAST",904.0,587.6,452.0,904.0,32
CDM,71552WE,MRI CHEST W/O & W/CONTRAST MATERIAL,3984.0,2589.6,454.25,3984.0,32
CDM,71552WE-26,MRI CHEST W/O & W/CONTRAST MATERIAL,904.0,587.6,93.47,904.0,31
CDM,71552WE-TC,MRI CHEST W/O & W/CONTRAST MATERIAL,3080.0,2002.0,358.36,3080.0,35
CDM,7155526WE-26-206,MR ANGIO CHEST (MRA),796.0,517.4,75.29,796.0,31
CDM,7155526WE-26-207,MRA CHEST W/O & W/CONTRAST MATERIAL,796.0,517.4,75.29,796.0,31
CDM,71555CWE,MRA CHEST W CONTRAST,8639.0,5615.35,318.89,8639.0,32
CDM,71555CWE-26,MRA CHEST W CONTRAST,796.0,517.4,75.29,796.0,31
CDM,71555CWE-TC,MRA CHEST W CONTRAST,7843.0,5097.95,246.66,7843.0,35
CDM,71555MRIWE,MRA CHEST W OR W/WO CONTRAST,8639.0,5615.35,318.89,8639.0,32
CDM,71555PROWE,MRA CHEST W(OR)WO/CONTRST,796.0,517.4,318.89,796.0,32
CDM,71555TCWE-TC-208,MR ANGIO CHEST (MRA),7843.0,5097.95,246.66,7843.0,35
CDM,71555TCWE-TC-209,MRA CHEST W/O & W/CONTRAST MATERIAL,7843.0,5097.95,246.66,7843.0,35
CDM,71555WE-210,MRA CHEST WITH OR W/O CONT,8639.0,5615.35,318.89,8639.0,32
CDM,71555WE-211,MR ANGIO CHEST (MRA),8639.0,5615.35,318.89,8639.0,32
CDM,71555WE-212,MRA CHEST W/O & W/CONTRAST MATERIAL,8639.0,5615.35,318.89,8639.0,32
CDM,71555WE-26,MRA CHEST WITH OR W/O CONT,796.0,517.4,75.29,796.0,31
CDM,71555WE-TC,MRA CHEST WITH OR W/O CONT,7843.0,5097.95,246.66,7843.0,35
CDM,72020PROWE,XRAY SPINE 1 VIEW,64.0,41.6,17.18,64.0,32
CDM,72020WE,RADEX SPINE 1 VIEW SPECIFY LEVEL,824.0,535.6,17.18,824.0,32
CDM,72020WE-26,RADEX SPINE 1 VIEW SPECIFY LEVEL,64.0,41.6,6.39,64.0,31
CDM,72020WE-TC,RADEX SPINE 1 VIEW SPECIFY LEVEL,760.0,494.0,14.21,760.0,35
CDM,72020XRYWE,XRAY SPINE 1 VIEW,824.0,535.6,17.18,824.0,32
CDM,72040PROWE,XRAY SPINE CERVICAL AP LAT,97.0,63.05,23.87,97.0,32
CDM,72040TECWE,XRAY SPINE CERVICAL AP LAT,760.0,494.0,23.87,760.0,32
CDM,72040WE,RADEX SPINE CERVICAL 2 OR 3 VIEWS,857.0,557.05,23.87,857.0,32
CDM,72040WE-26,RADEX SPINE CERVICAL 2 OR 3 VIEWS,97.0,63.05,10.09,97.0,31
CDM,72040WE-TC,RADEX SPINE CERVICAL 2 OR 3 VIEWS,760.0,494.0,24.55,760.0,35
CDM,72040XRYWE,"XRAY SPINE CERV APLAT 2,3VIEWS",857.0,557.05,23.87,857.0,32
CDM,72050PROWE,XRAY SPINE CERVICAL 4 VW,119.0,77.35,35.06,119.0,32
CDM,72050TECWE,XRAY SPINE 4 VIEW,918.0,596.7,35.06,918.0,32
CDM,72050WE,RADEX SPINE CERVICAL 4 OR 5 VIEWS,1037.0,674.05,35.06,1037.0,32
CDM,72050WE-26,RADEX SPINE CERVICAL 4 OR 5 VIEWS,119.0,77.35,12.86,119.0,31
CDM,72050WE-TC,RADEX SPINE CERVICAL 4 OR 5 VIEWS,918.0,596.7,32.88,918.0,35
CDM,72050XRYWE,XRAY SPINE 4 VIEW,1037.0,674.05,35.06,1037.0,32
CDM,72052PROWE,XRAY SPINE CERVICAL COMP,132.0,85.8,42.92,132.0,32
CDM,72052WE,RADEX SPINE CERVICAL 6 OR MORE VIEWS,1050.0,682.5,42.92,1050.0,32
CDM,72052WE-26,RADEX SPINE CERVICAL 6 OR MORE VIEWS,132.0,85.8,14.4,132.0,31
CDM,72052WE-TC,RADEX SPINE CERVICAL 6 OR MORE VIEWS,918.0,596.7,43.51,918.0,35
CDM,72052XRYWE,XRAY CERV OBL FLEX AND/OR EXTENSIONA,1050.0,682.5,42.92,1050.0,32
CDM,72070WE,RADEX SPINE THORACIC 2 VIEWS,1006.0,653.9,25.12,1006.0,32
CDM,72070WE-26,RADEX SPINE THORACIC 2 VIEWS,88.0,57.2,9.24,88.0,31
CDM,72070WE-TC,RADEX SPINE THORACIC 2 VIEWS,918.0,596.7,19.96,918.0,35
CDM,72072PROWE,XRAY THORACIC W/SWIM 3 V,101.0,65.65,27.45,101.0,32
CDM,72072TECWE,XRAY THORACIC SWIMMER VIEW,918.0,596.7,27.45,918.0,32
CDM,72072WE,RADEX SPINE THORACIC 3 VIEWS,1019.0,662.35,27.45,1019.0,32
CDM,72072WE-26,RADEX SPINE THORACIC 3 VIEWS,101.0,65.65,8.95,101.0,31
CDM,72072WE-TC,RADEX SPINE THORACIC 3 VIEWS,918.0,596.7,23.4,918.0,35
CDM,72072XRYWE,XRAY THORACIC SWIMMER VIEW,1019.0,662.35,27.45,1019.0,32
CDM,72074PROWE,XRAY THORACIC COMPLETE,110.0,71.5,32.16,110.0,32
CDM,72074TECWE,XRAY THORACIC COMPLETE,918.0,596.7,32.16,918.0,32
CDM,72074WE,RADEX SPINE THORACIC MINIMUM 4 VIEWS,1028.0,668.2,32.16,1028.0,32
CDM,72074WE-26,RADEX SPINE THORACIC MINIMUM 4 VIEWS,110.0,71.5,8.95,110.0,31
CDM,72074WE-TC,RADEX SPINE THORACIC MINIMUM 4 VIEWS,918.0,596.7,29.43,918.0,35
CDM,72074XRYWE,XRAY THOR MIN 4 VIEWS COMPLETE,1028.0,668.2,32.16,1028.0,32
CDM,72080PROWE,XRAY THORACOLUMBAR AP LAT,84.0,54.6,25.6,84.0,32
CDM,72080WE,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,844.0,548.6,25.6,844.0,32
CDM,72080WE-26,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,84.0,54.6,9.95,84.0,31
CDM,72080WE-TC,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,760.0,494.0,21.97,760.0,35
CDM,72080XRYWE,XRAY THORACOLUMBAR AP LAT,844.0,548.6,25.6,844.0,32
CDM,72081WE,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,874.0,568.1,27.83,874.0,28
CDM,72081WE-26,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,114.0,74.1,12.21,114.0,31
CDM,72081WE-TC,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,760.0,494.0,29.86,760.0,35
CDM,72082WE,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,1054.0,685.1,44.38,1054.0,28
CDM,72082WE-26,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,136.0,88.4,15.05,136.0,31
CDM,72082WE-TC,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,918.0,596.7,53.84,918.0,35
CDM,72083WE,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,1072.0,696.8,48.21,1072.0,28
CDM,72083WE-26,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,154.0,100.1,16.74,154.0,31
CDM,72083WE-TC,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,918.0,596.7,58.62,918.0,35
CDM,72084WE,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,1098.0,713.7,57.32,1098.0,28
CDM,72084WE-26,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,180.0,117.0,19.9,180.0,31
CDM,72084WE-TC,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,918.0,596.7,70.7,918.0,35
CDM,72100PROWE,XRAY LUMBOSACRAL AP LAT,97.0,63.05,25.6,97.0,32
CDM,72100TECWE,XRAY LUMBOSACRAL AP LAT,918.0,596.7,25.6,918.0,32
CDM,72100WE,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,1015.0,659.75,25.6,1015.0,32
CDM,72100WE-26,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,97.0,63.05,10.09,97.0,31
CDM,72100WE-TC,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,918.0,596.7,22.25,918.0,35
CDM,72100XRYWE,XRAY LUMBOSACRAL AP LAT,1015.0,659.75,25.6,1015.0,32
CDM,72110PROWE,XRAY LUMBOSACRAL COMP,114.0,74.1,35.54,114.0,32
CDM,72110TECWE,XRAY LUMBOSACRAL COMP,918.0,596.7,35.54,918.0,32
CDM,72110WE,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,1032.0,670.8,35.54,1032.0,32
CDM,72110WE-26,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,114.0,74.1,12.53,114.0,31
CDM,72110WE-TC,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,918.0,596.7,30.3,918.0,35
CDM,72110XRYWE,XRAY LUMBOSACRAL COMP,1032.0,670.8,35.54,1032.0,32
CDM,72114PROWE,XRAY LUMBOSAC BENDING,132.0,85.8,44.3,132.0,32
CDM,72114WE,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,1050.0,682.5,44.3,1050.0,32
CDM,72114WE-26,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,132.0,85.8,14.72,132.0,31
CDM,72114WE-TC,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,918.0,596.7,42.36,918.0,35
CDM,72114XRYWE,XRAY LUMBOSAC BENDING,1050.0,682.5,44.3,1050.0,32
CDM,72120PROWE,XRAY LUMBOSAC BEND COMPL,97.0,63.05,31.09,97.0,32
CDM,72120TECWE,XRAY LUMBOSAC BEND COMPL,918.0,596.7,31.09,918.0,32
CDM,72120WE,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,1015.0,659.75,31.09,1015.0,32
CDM,72120WE-26,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,97.0,63.05,10.38,97.0,31
CDM,72120WE-TC,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,918.0,596.7,28.0,918.0,35
CDM,72120XRYWE,CT CERV SPINE WO CONTRAST,1015.0,659.75,31.09,1015.0,32
CDM,72125CTSWE,CT CERV SPINE WO CONTRAST,1358.0,882.7,121.11,1358.0,32
CDM,72125PROWE,CT CERV SPINE WO CONTRAST,440.0,286.0,121.11,440.0,32
CDM,72125WE,CT CERVICAL SPINE W/O CONTRAST MATERIAL,1358.0,882.7,121.11,1358.0,32
CDM,72125WE-26,CT CERVICAL SPINE W/O CONTRAST MATERIAL,440.0,286.0,44.18,440.0,31
CDM,72125WE-TC,CT CERVICAL SPINE W/O CONTRAST MATERIAL,918.0,596.7,82.89,918.0,35
CDM,72126CTSWE,CT CERV SPINE WO CONTRAST,3568.0,2319.2,157.69,3568.0,32
CDM,72126PROWE,CT CERV SPINE W CONTRAST,488.0,317.2,157.69,488.0,32
CDM,72126WE,CT CERVICAL SPINE W/CONTRAST MATERIAL,3568.0,2319.2,157.69,3568.0,32
CDM,72126WE-26,CT CERVICAL SPINE W/CONTRAST MATERIAL,488.0,317.2,50.71,488.0,31
CDM,72126WE-TC,CT CERVICAL SPINE W/CONTRAST MATERIAL,3080.0,2002.0,110.9,3080.0,35
CDM,72127CTSWE,CT THORACIC SPINE WO CONTR,2043.0,1327.95,184.31,2043.0,32
CDM,72127PROWE,CT CERV SPINE W WO CONTR,508.0,330.2,184.31,508.0,32
CDM,72127WE,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,2043.0,1327.95,184.31,2043.0,32
CDM,72127WE-26,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,508.0,330.2,52.41,508.0,31
CDM,72127WE-TC,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,1535.0,997.75,136.08,1535.0,35
CDM,72128CTSWE,CT THORACIC SPINE W CONTR,1318.0,856.7,121.11,1318.0,32
CDM,72128PROWE,CT THORACIC SPINE WO CONTR,400.0,260.0,121.11,400.0,32
CDM,72128WE,CT THORACIC SPINE W/O CONTRAST MATERIAL,1318.0,856.7,121.11,1318.0,32
CDM,72128WE-26,CT THORACIC SPINE W/O CONTRAST MATERIAL,400.0,260.0,41.62,400.0,31
CDM,72128WE-TC,CT THORACIC SPINE W/O CONTRAST MATERIAL,918.0,596.7,82.57,918.0,35
CDM,72129CTSWE,CT THOR SPINE W WO CONTR,2023.0,1314.95,158.92,2023.0,32
CDM,72129PROWE,CT THORACIC SPINE W CONTR,488.0,317.2,158.92,488.0,32
CDM,72129WE,CT THORACIC SPINE W/CONTRAST MATERIAL,2023.0,1314.95,158.92,2023.0,32
CDM,72129WE-26,CT THORACIC SPINE W/CONTRAST MATERIAL,488.0,317.2,50.71,488.0,31
CDM,72129WE-TC,CT THORACIC SPINE W/CONTRAST MATERIAL,1535.0,997.75,112.19,1535.0,35
CDM,72130PROWE,CT THOR SPINE W WO CONTR,508.0,330.2,186.07,508.0,32
CDM,72130WE,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,2043.0,1327.95,186.07,2043.0,32
CDM,72130WE-26,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,508.0,330.2,52.7,508.0,31
CDM,72130WE-TC,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,1535.0,997.75,138.02,1535.0,35
CDM,72131CTSWE,CT LUMBAR SPINE WO CONTR,1358.0,882.7,120.52,1358.0,32
CDM,72131PROWE,CT LUMBAR SPINE WO CONTR,440.0,286.0,120.52,440.0,32
CDM,72131WE,CT LUMBAR SPINE W/O CONTRAST MATERIAL,1358.0,882.7,120.52,1358.0,32
CDM,72131WE-26,CT LUMBAR SPINE W/O CONTRAST MATERIAL,440.0,286.0,41.62,440.0,31
CDM,72131WE-TC,CT LUMBAR SPINE W/O CONTRAST MATERIAL,918.0,596.7,82.25,918.0,35
CDM,72132CTSWE,CT LUMBAR SPINE W CONTRAST,3617.0,2351.05,157.99,3617.0,32
CDM,72132PROWE,CT LUMBAR SPINE W CONTRAST,537.0,349.05,157.99,537.0,32
CDM,72132WE,CT LUMBAR SPINE W/CONTRAST MATERIAL,3617.0,2351.05,157.99,3617.0,32
CDM,72132WE-26,CT LUMBAR SPINE W/CONTRAST MATERIAL,537.0,349.05,50.71,537.0,31
CDM,72132WE-TC,CT LUMBAR SPINE W/CONTRAST MATERIAL,3080.0,2002.0,111.55,3080.0,35
CDM,72133CTSWE,CT LUMBAR SPINE W WO CONT,2094.0,1361.1,184.89,2094.0,32
CDM,72133PROWE,CT LUMBAR SPINE W WO CONT,559.0,363.35,184.89,559.0,32
CDM,72133WE,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,2094.0,1361.1,184.89,2094.0,32
CDM,72133WE-26,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,559.0,363.35,52.7,559.0,31
CDM,72133WE-TC,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,1535.0,997.75,136.41,1535.0,35
CDM,72141MRIWE,MRI CER SPINE CANAL WO CONT,2736.0,1778.4,179.08,2736.0,32
CDM,72141PROWE,MRI CER SPINE CANAL WO CONT,651.0,423.15,179.08,651.0,32
CDM,72141WE,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,2736.0,1778.4,179.08,2736.0,32
CDM,72141WE-26,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,651.0,423.15,66.76,651.0,31
CDM,72141WE-TC,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,2085.0,1355.25,120.26,2085.0,35
CDM,72142MRIWE,MRI CER SPINE CANAL W CONT,3863.0,2510.95,257.86,3863.0,32
CDM,72142PROWE,MRI CER SPINE CANAL W CONT,783.0,508.95,257.86,783.0,32
CDM,72142WE,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,3863.0,2510.95,257.86,3863.0,32
CDM,72142WE-26,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,783.0,508.95,79.97,783.0,31
CDM,72142WE-TC,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,3080.0,2002.0,189.27,3080.0,35
CDM,72146MRIWE,MRI THOR SPINE CANAL WO CO,2736.0,1778.4,179.08,2736.0,32
CDM,72146PROWE,MRI THOR SPINE CANAL WO CO,651.0,423.15,179.08,651.0,32
CDM,72146WE,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,2736.0,1778.4,179.08,2736.0,32
CDM,72146WE-26,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,651.0,423.15,66.76,651.0,31
CDM,72146WE-TC,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,2085.0,1355.25,120.59,2085.0,35
CDM,72147MRIWE,MRI THOR SPINE CANAL W CONT,3863.0,2510.95,255.45,3863.0,32
CDM,72147PROWE,MRI THORACIS SPINE W CONTRAST,783.0,508.95,255.45,783.0,32
CDM,72147WE,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,3863.0,2510.95,255.45,3863.0,32
CDM,72147WE-26,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,783.0,508.95,79.97,783.0,31
CDM,72147WE-TC,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,3080.0,2002.0,187.34,3080.0,35
CDM,72148MRIWE,MRI LUMB SPINE CANAL WO CO,2677.0,1740.05,178.94,2677.0,32
CDM,72148PROWE,MRI LUMB SPINE CANAL WO CO,592.0,384.8,178.94,592.0,32
CDM,72148WE,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,2677.0,1740.05,178.94,2677.0,32
CDM,72148WE-26,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,592.0,384.8,62.22,592.0,31
CDM,72148WE-TC,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,2085.0,1355.25,120.91,2085.0,35
CDM,72149MRIWE,MRI LUMB SPINE CANAL W CONT,3792.0,2464.8,254.01,3792.0,32
CDM,72149PROWE,MRI LUMB SPINE CANAL W CONT,712.0,462.8,254.01,712.0,32
CDM,72149WE,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,3792.0,2464.8,254.01,3792.0,32
CDM,72149WE-26,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,712.0,462.8,74.58,712.0,31
CDM,72149WE-TC,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,3080.0,2002.0,184.76,3080.0,35
CDM,72156MRIWE,MRI CERV SP W/WO CONTRAST,4088.0,2657.2,301.16,4088.0,32
CDM,72156PROWE,MRI SPINE CANAL W WO CONT,1008.0,655.2,301.16,1008.0,32
CDM,72156WE,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,4088.0,2657.2,301.16,4088.0,32
CDM,72156WE-26,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,1008.0,655.2,107.1,1008.0,31
CDM,72156WE-TC,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,3080.0,2002.0,210.26,3080.0,35
CDM,72157MRIWE,MRI THOR SPINE W WO CONTR,3996.0,2597.4,301.75,3996.0,32
CDM,72157PROWE,MRI THOR SPINE W WO CONTR,916.0,595.4,301.75,916.0,32
CDM,72157WE,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,3996.0,2597.4,301.75,3996.0,32
CDM,72157WE-26,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,916.0,595.4,107.1,916.0,31
CDM,72157WE-TC,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,3080.0,2002.0,210.9,3080.0,35
CDM,72158MRIWE,MRI LUMB SPINE W WO CONTR,3996.0,2597.4,300.57,3996.0,32
CDM,72158PROWE,MRI LMBR SPINE W WO CONTR,916.0,595.4,300.57,916.0,32
CDM,72158WE,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,3996.0,2597.4,300.57,3996.0,32
CDM,72158WE-26,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,916.0,595.4,99.15,916.0,31
CDM,72158WE-TC,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,3080.0,2002.0,209.61,3080.0,35
CDM,7215926WE,MR ANGIO SPINE (MRA),720.0,468.0,73.15,720.0,31
CDM,72159CWE,MRA WO/W CONTRAST SPINAL CANAL,4555.0,2960.75,323.75,4555.0,32
CDM,72159CWE-26,MRA WO/W CONTRAST SPINAL CANAL,720.0,468.0,73.15,720.0,31
CDM,72159CWE-TC,MRA WO/W CONTRAST SPINAL CANAL,3835.0,2492.75,254.41,3835.0,35
CDM,72159MRIWE,MRA SPINE W/WO CON ANY SITE W/3D,4555.0,2960.75,323.75,4555.0,32
CDM,72159PROWE,MRA SPINAL CANL W/WO CONT,720.0,468.0,323.75,720.0,32
CDM,72159TCWE,MR ANGIO SPINE (MRA),3835.0,2492.75,254.41,3835.0,35
CDM,72159WE-213,MRA SPINE WITH OR W/O CONT,4555.0,2960.75,323.75,4555.0,32
CDM,72159WE-214,MR ANGIO SPINE (MRA),4555.0,2960.75,323.75,4555.0,32
CDM,72159WE-26,MRA SPINE WITH OR W/O CONT,720.0,468.0,73.15,720.0,31
CDM,72159WE-TC,MRA SPINE WITH OR W/O CONT,3835.0,2492.75,254.41,3835.0,35
CDM,72170PROWE,XRAY PELVIS 1 OR 2 V,75.0,48.75,19.82,75.0,32
CDM,72170TECWE,XRAY PELVIC 1 OR 2 V,918.0,596.7,19.82,918.0,32
CDM,72170WE,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,993.0,645.45,19.82,993.0,32
CDM,72170WE-26,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,75.0,48.75,8.1,75.0,31
CDM,72170WE-TC,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,918.0,596.7,15.36,918.0,35
CDM,72170XRYWE,XRAY PELVIS 1 OR 2 V,993.0,645.45,19.82,993.0,32
CDM,72190PROWE,XRAY PELVIC COMPLETE,110.0,71.5,26.13,110.0,32
CDM,72190WE,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,1028.0,668.2,26.13,1028.0,32
CDM,72190WE-26,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,110.0,71.5,9.81,110.0,31
CDM,72190WE-TC,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,918.0,596.7,27.71,918.0,35
CDM,72190XRYWE,XRAY PELVIC COMPLETE,1028.0,668.2,26.13,1028.0,32
CDM,72191CTAWE,"CTA PELVIS W/WO C,INCL 3D",2259.0,1468.35,244.87,2259.0,32
CDM,72191PROWE,"CT ANGIOGRPHY,PELV WWO CN",724.0,470.6,244.87,724.0,32
CDM,72191WE,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,2259.0,1468.35,244.87,2259.0,32
CDM,72191WE-26,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,724.0,470.6,75.85,724.0,31
CDM,72191WE-TC,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,1535.0,997.75,210.95,1535.0,35
CDM,72192CTPWE,CT PELVIS WO CONTRAST,1354.0,880.1,117.19,1354.0,32
CDM,72192PROWE,CT PELVIS WO CONTRAST,436.0,283.4,117.19,436.0,32
CDM,72192WE,CT PELVIS W/O CONTRAST MATERIAL,1354.0,880.1,117.19,1354.0,32
CDM,72192WE-26,CT PELVIS W/O CONTRAST MATERIAL,436.0,283.4,44.74,436.0,31
CDM,72192WE-TC,CT PELVIS W/O CONTRAST MATERIAL,918.0,596.7,81.6,918.0,35
CDM,72193CTPWE,CT PELVIS W CONTRAST,2045.0,1329.25,181.38,2045.0,32
CDM,72193PROWE,CT PELVIS W CONTRAST,510.0,331.5,181.38,510.0,32
CDM,72193WE,CT PELVIS W/CONTRAST MATERIAL,2045.0,1329.25,181.38,2045.0,32
CDM,72193WE-26,CT PELVIS W/CONTRAST MATERIAL,510.0,331.5,48.44,510.0,31
CDM,72193WE-TC,CT PELVIS W/CONTRAST MATERIAL,1535.0,997.75,170.62,1535.0,35
CDM,72194CTPWE,CT PELVIS W WO CONTRAST,2072.0,1346.8,211.86,2072.0,32
CDM,72194PROWE,CT PELVIS W WO CONTRAST,537.0,349.05,211.86,537.0,32
CDM,72194WE,CT PELVIS W/O & W/CONTRAST MATERIAL,2072.0,1346.8,211.86,2072.0,32
CDM,72194WE-26,CT PELVIS W/O & W/CONTRAST MATERIAL,537.0,349.05,50.71,537.0,31
CDM,72194WE-TC,CT PELVIS W/O & W/CONTRAST MATERIAL,1535.0,997.75,191.28,1535.0,35
CDM,72195MRIWE,"MRI,PELVIS; WO CONTRAST",2727.0,1772.55,215.14,2727.0,32
CDM,72195PROWE,"MRI, PELVIS; WO CONTRAST",642.0,417.3,215.14,642.0,32
CDM,72195WE,MRI PELVIS W/O CONTRAST MATERIAL,2727.0,1772.55,215.14,2727.0,32
CDM,72195WE-26,MRI PELVIS W/O CONTRAST MATERIAL,642.0,417.3,61.37,642.0,31
CDM,72195WE-TC,MRI PELVIS W/O CONTRAST MATERIAL,2085.0,1355.25,158.03,2085.0,35
CDM,72196MRIWE,MRI PELVIS W/CONTRAST,3841.0,2496.65,252.69,3841.0,32
CDM,72196PROWE,MRI PELVIS W CONT,761.0,494.65,252.69,761.0,32
CDM,72196WE,MRI PELVIS W/CONTRAST MATERIAL,3841.0,2496.65,252.69,3841.0,32
CDM,72196WE-26,MRI PELVIS W/CONTRAST MATERIAL,761.0,494.65,72.16,761.0,31
CDM,72196WE-TC,MRI PELVIS W/CONTRAST MATERIAL,3080.0,2002.0,186.05,3080.0,35
CDM,72197MRIWE,"MRI,PELVIS; W/WO CONTRAST",4048.0,2631.2,317.3,4048.0,32
CDM,72197PROWE,"MRI,PELVIS; W/WO CONTRAST",968.0,629.2,317.3,968.0,32
CDM,72197WE,MRI PELVIS W/O & W/CONTRAST MATERIAL,4048.0,2631.2,317.3,4048.0,32
CDM,72197WE-26,MRI PELVIS W/O & W/CONTRAST MATERIAL,968.0,629.2,93.18,968.0,31
CDM,72197WE-TC,MRI PELVIS W/O & W/CONTRAST MATERIAL,3080.0,2002.0,230.92,3080.0,35
CDM,7219826WE,MRA PELVIS W/WO CONTRAST MATERIAL,792.0,514.8,74.43,792.0,31
CDM,72198BWE,MR ANGIO PELVIS(MRA),8662.0,5630.3,4331.0,8662.0,12
CDM,72198BWE-26,MR ANGIO PELVIS(MRA),792.0,514.8,396.0,792.0,12
CDM,72198BWE-TC,MR ANGIO PELVIS(MRA),7870.0,5115.5,518.75,7870.0,16
CDM,72198CWE,MRA PELV W CONTRL,8662.0,5630.3,316.11,8662.0,32
CDM,72198CWE-26,MRA PELV W CONTRL,792.0,514.8,74.43,792.0,31
CDM,72198CWE-TC,MRA PELV W CONTRL,7870.0,5115.5,251.83,7870.0,35
CDM,72198DWE,MRA PELV WO CONTRL,8662.0,5630.3,316.11,8662.0,32
CDM,72198DWE-26,MRA PELV WO CONTRL,792.0,514.8,74.43,792.0,31
CDM,72198DWE-TC,MRA PELV WO CONTRL,7870.0,5115.5,251.83,7870.0,35
CDM,72198MRAWE,MRA PELVIS W WO CONTRAST,8662.0,5630.3,316.11,8662.0,32
CDM,72198PROWE,MRA PELVIS W WO CONTRAST,792.0,514.8,316.11,792.0,32
CDM,72198TCWE,MRA PELVIS W/WO CONTRAST MATERIAL,7870.0,5115.5,251.83,7870.0,35
CDM,72198WE-215,MRA PELVIS WITH OR W/O CONT,8662.0,5630.3,316.11,8662.0,32
CDM,72198WE-216,MRA PELVIS W/WO CONTRAST MATERIAL,8662.0,5630.3,316.11,8662.0,32
CDM,72198WE-26,MRA PELVIS WITH OR W/O CONT,792.0,514.8,74.43,792.0,31
CDM,72198WE-TC,MRA PELVIS WITH OR W/O CONT,7870.0,5115.5,251.83,7870.0,35
CDM,72200135,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,15898.0,10333.7,443.28,14308.2,49
CDM,72200PROWE,SACROILIAC JOINTS <3VIEWS,75.0,48.75,20.62,75.0,32
CDM,72200WE,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,993.0,645.45,20.62,993.0,32
CDM,72200WE-26,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,75.0,48.75,7.25,75.0,31
CDM,72200WE-TC,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,918.0,596.7,18.81,918.0,35
CDM,72200XRYWE,XRAY SACROILIAC LESS THAN 3 VIEWS,993.0,645.45,20.62,993.0,32
CDM,72202PROWE,XRAY SACROILIAC 3 VIEW,101.0,65.65,24.07,101.0,32
CDM,72202TECWE,XRAY SACROILIAC 3 VIEW,918.0,596.7,24.07,918.0,32
CDM,72202WE,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,1019.0,662.35,24.07,1019.0,32
CDM,72202WE-26,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,101.0,65.65,7.81,101.0,31
CDM,72202WE-TC,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,918.0,596.7,22.25,918.0,35
CDM,72202XRYWE,XRAY SACROILIAC 3 VIEW,1019.0,662.35,24.07,1019.0,32
CDM,72220PROWE,XRAY SACRUM /COCCYX 2 VIEW,68.0,44.2,21.4,68.0,32
CDM,72220TECWE,XRAY SACRUM /COCCYX 2 VIEW,760.0,494.0,21.4,760.0,32
CDM,72220WE,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,828.0,538.2,21.4,828.0,32
CDM,72220WE-26,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,68.0,44.2,7.25,68.0,31
CDM,72220WE-TC,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,760.0,494.0,17.95,760.0,35
CDM,72220XRYWE,XRAY SACRUM /COCCYX 2 VIEW,828.0,538.2,21.4,828.0,32
CDM,72240WE,MYELOGRAPHY CERVICAL RS&I,7178.0,4665.7,84.13,7178.0,32
CDM,72240WE-26,MYELOGRAPHY CERVICAL RS&I,364.0,236.6,37.64,364.0,31
CDM,72240WE-TC,MYELOGRAPHY CERVICAL RS&I,6814.0,4429.1,66.1,6814.0,35
CDM,72255WE,MYELOGRAPHY THORACIC RS&I,7178.0,4665.7,83.51,7178.0,32
CDM,72255WE-26,MYELOGRAPHY THORACIC RS&I,364.0,236.6,37.5,364.0,31
CDM,72255WE-TC,MYELOGRAPHY THORACIC RS&I,6814.0,4429.1,61.59,6814.0,35
CDM,72265WE,MYELOGRAPY LUMBOSACRAL RS&I,7146.0,4644.9,78.57,7146.0,32
CDM,72265WE-26,MYELOGRAPY LUMBOSACRAL RS&I,332.0,215.8,34.38,332.0,31
CDM,72265WE-TC,MYELOGRAPY LUMBOSACRAL RS&I,6814.0,4429.1,66.43,6814.0,35
CDM,72270WE,MYELOGRAPY 2/MORE REGIONS RS&I,7346.0,4774.9,109.19,7346.0,32
CDM,72270WE-26,MYELOGRAPY 2/MORE REGIONS RS&I,532.0,345.8,55.26,532.0,31
CDM,72270WE-TC,MYELOGRAPY 2/MORE REGIONS RS&I,6814.0,4429.1,75.08,6814.0,35
CDM,72285WE,DISKOGRAPY CERVICAL/THORACIC RS&I,17307.0,11249.55,92.52,17307.0,32
CDM,72285WE-26,DISKOGRAPY CERVICAL/THORACIC RS&I,464.0,301.6,49.6,464.0,31
CDM,72285WE-TC,DISKOGRAPY CERVICAL/THORACIC RS&I,16843.0,10947.95,64.76,16843.0,35
CDM,72295WE,DISKOGRAPY LUMBAR RS&I,17175.0,11163.75,84.8,17175.0,32
CDM,72295WE-26,DISKOGRAPY LUMBAR RS&I,332.0,215.8,36.1,332.0,31
CDM,72295WE-TC,DISKOGRAPY LUMBAR RS&I,16843.0,10947.95,65.05,16843.0,35
CDM,73000010,EKG TRACING FOR INITIAL PREV,123.0,79.95,10.1,359.0,49
CDM,73000035,ECG ROUTINE ECG W/LEAST 12 LDS W/I&R,519.0,337.35,16.03,467.1,39
CDM,73000200,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,428.0,278.2,10.1,385.2,49
CDM,73000235,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,428.0,278.2,10.1,385.2,49
CDM,73000265,ASSTV ALG ECG RSK-BASED ASSMT RELATED CNCRT ECG,645.0,419.25,16.03,580.5,48
CDM,73000275,ASSTV ALG ECG RSK-BASED ASSMT RELATED PREV ECG,645.0,419.25,16.03,580.5,48
CDM,73000PROWE,XRAY CLAVICLE COMPLETE,64.0,41.6,20.17,64.0,32
CDM,73000TECWE,XRAY CLAVICLE COMPLETE,760.0,494.0,20.17,760.0,32
CDM,73000WE,RADEX CLAVICLE COMPLETE,824.0,535.6,20.17,824.0,32
CDM,73000WE-26,RADEX CLAVICLE COMPLETE,64.0,41.6,6.96,64.0,31
CDM,73000WE-TC,RADEX CLAVICLE COMPLETE,760.0,494.0,18.23,760.0,35
CDM,73000XRYWE,XRAY CLAVICLE COMPLETE,824.0,535.6,20.17,824.0,32
CDM,73010PROWE,XRAY SCAPULA COMPLETE,75.0,48.75,19.63,75.0,32
CDM,73010TECWE,XRAY SCAPULA COMPLETE,918.0,596.7,19.63,918.0,32
CDM,73010WE,RADEX SCAPULA COMPLETE,993.0,645.45,19.63,993.0,32
CDM,73010WE-26,RADEX SCAPULA COMPLETE,75.0,48.75,8.39,75.0,31
CDM,73010WE-TC,RADEX SCAPULA COMPLETE,918.0,596.7,15.1,918.0,35
CDM,73010XRAWE,XRAY SCAPULA COMPLETE,993.0,645.45,19.63,993.0,32
CDM,73020PROWE,XRAY SHOULDER 1 VIEW,66.0,42.9,17.72,66.0,32
CDM,73020TECWE,XRAY SHOULDER 1 VIEW,760.0,494.0,17.72,760.0,32
CDM,73020WE,RADEX SHOULDER 1 VIEW,826.0,536.9,17.72,826.0,32
CDM,73020WE-26,RADEX SHOULDER 1 VIEW,66.0,42.9,6.39,66.0,31
CDM,73020WE-TC,RADEX SHOULDER 1 VIEW,760.0,494.0,14.13,760.0,35
CDM,73020XRAWE,XRAY SHOULDER 1 VIEW,826.0,536.9,17.72,826.0,32
CDM,73030PROWE,XRAY SHOULDER COMPLETE,79.0,51.35,21.72,79.0,32
CDM,73030TECWE,XRAY SHOULDER COMPLETE,760.0,494.0,21.72,760.0,32
CDM,73030WE,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,839.0,545.35,21.72,839.0,32
CDM,73030WE-26,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,79.0,51.35,8.67,79.0,31
CDM,73030WE-TC,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,760.0,494.0,18.52,760.0,35
CDM,73030XRAWE,XRAY SHOULDER COMPLETE,839.0,545.35,21.72,839.0,32
CDM,73040WE,RADEX SHOULDER ARTHROGRAPHY RS&I,3318.0,2156.7,77.34,3318.0,32
CDM,73040WE-26,RADEX SHOULDER ARTHROGRAPHY RS&I,238.0,154.7,23.3,238.0,31
CDM,73040WE-TC,RADEX SHOULDER ARTHROGRAPHY RS&I,3080.0,2002.0,70.22,3080.0,35
CDM,73050PROWE,XRAY AC JOINTS BILATERAL,79.0,51.35,24.41,79.0,32
CDM,73050WE,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,839.0,545.35,24.41,839.0,32
CDM,73050WE-26,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,79.0,51.35,8.98,79.0,31
CDM,73050WE-TC,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,760.0,494.0,19.62,760.0,35
CDM,73050XRAWE,XRAY AC JOINTS BILATERAL,839.0,545.35,24.41,839.0,32
CDM,73060PROWE,XRAY HUMEROUS 2 VIEW,64.0,41.6,21.4,64.0,32
CDM,73060TECWE,XRAY HUMEROUS 2 VIEW,760.0,494.0,21.4,760.0,32
CDM,73060WE,RADEX HUMERUS MINIMUM 2 VIEWS,824.0,535.6,21.4,824.0,32
CDM,73060WE-26,RADEX HUMERUS MINIMUM 2 VIEWS,64.0,41.6,7.25,64.0,31
CDM,73060WE-TC,RADEX HUMERUS MINIMUM 2 VIEWS,760.0,494.0,18.23,760.0,35
CDM,73060XRAWE,XRAY HUMEROUS 2 VIEW,824.0,535.6,21.4,824.0,32
CDM,73070PROWE,XRAY ELBOW AP LAT,64.0,41.6,19.3,64.0,32
CDM,73070TECWE,XRAY ELBOW AP LAT,760.0,494.0,19.3,760.0,32
CDM,73070WE,RADEX ELBOW 2 VIEWS,824.0,535.6,19.3,824.0,32
CDM,73070WE-26,RADEX ELBOW 2 VIEWS,64.0,41.6,6.68,64.0,31
CDM,73070WE-TC,RADEX ELBOW 2 VIEWS,760.0,494.0,18.23,760.0,35
CDM,73070XRAWE,XRAY ELBOW AP LAT,824.0,535.6,19.3,824.0,32
CDM,73080PROWE,XRAY ELBOW COMPLETE,68.0,44.2,21.4,68.0,32
CDM,73080TECWE,XRAY ELBOW COMPLETE,760.0,494.0,21.4,760.0,32
CDM,73080WE,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,828.0,538.2,21.4,828.0,32
CDM,73080WE-26,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,68.0,44.2,7.25,68.0,31
CDM,73080WE-TC,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,760.0,494.0,22.25,760.0,35
CDM,73080XRAWE,XRAY ELBOW COMPLETE,828.0,538.2,21.4,828.0,32
CDM,73085WE,RADEX ELBOW ARTHROGRAPHY RS&I,3296.0,2142.4,77.41,3296.0,32
CDM,73085WE-26,RADEX ELBOW ARTHROGRAPHY RS&I,216.0,140.4,23.45,216.0,31
CDM,73085WE-TC,RADEX ELBOW ARTHROGRAPHY RS&I,3080.0,2002.0,63.9,3080.0,35
CDM,73090PROWE,XRAY FOREARM AP LAT,64.0,41.6,19.56,64.0,32
CDM,73090TECWE,XRAY FOREARM AP LAT,760.0,494.0,19.56,760.0,32
CDM,73090WE,RADEX FOREARM 2 VIEWS,824.0,535.6,19.56,824.0,32
CDM,73090WE-26,RADEX FOREARM 2 VIEWS,64.0,41.6,6.68,64.0,31
CDM,73090WE-TC,RADEX FOREARM 2 VIEWS,760.0,494.0,17.37,760.0,35
CDM,73090XRAWE,XRAY FOREARM AP LAT,824.0,535.6,19.56,824.0,32
CDM,73092PROWE,XRAY UPPER EXT INFANT,64.0,41.6,19.36,64.0,32
CDM,73092TECWE,XRAY UPPER EXT INFANT,918.0,596.7,19.36,918.0,32
CDM,73092WE,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,982.0,638.3,19.36,982.0,32
CDM,73092WE-26,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,64.0,41.6,6.68,64.0,31
CDM,73092WE-TC,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,918.0,596.7,17.66,918.0,35
CDM,73100010,XTRNL ECG & 48 HR RECORDING,926.0,601.9,26.48,833.4,49
CDM,73100030,XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS,268.0,174.2,12.09,474.0,49
CDM,73100035,XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS,660.0,429.0,23.85,594.0,49
CDM,73100125,EXTERNAL ECG REC>48HR<7D RECORDING,283.0,183.95,17.05,474.0,49
CDM,73100135,EXTERNAL ECG REC>7D<15D RECORDING,283.0,183.95,17.05,474.0,49
CDM,73100PROWE,XRAY WRIST AP LAT,64.0,41.6,19.36,64.0,32
CDM,73100TECWE,XRAY WRIST APLAT,760.0,494.0,19.36,760.0,32
CDM,73100WE,RADEX WRIST 2 VIEWS,824.0,535.6,19.36,824.0,32
CDM,73100WE-26,RADEX WRIST 2 VIEWS,64.0,41.6,8.01,64.0,31
CDM,73100WE-TC,RADEX WRIST 2 VIEWS,760.0,494.0,19.96,760.0,35
CDM,73100XRAWE,XRAY WRIST AP LAT,824.0,535.6,19.36,824.0,32
CDM,73110PROWE,XRAY WRIST COMPLETE,75.0,48.75,20.24,75.0,32
CDM,73110TECWE,XRAY WRIST COMPLETE,760.0,494.0,20.24,760.0,32
CDM,73110WE,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,835.0,542.75,20.24,835.0,32
CDM,73110WE-26,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,75.0,48.75,7.25,75.0,31
CDM,73110WE-TC,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,760.0,494.0,25.13,760.0,35
CDM,73110XRAWE,XRAY WRIST COMPLETE,835.0,542.75,20.24,835.0,32
CDM,73115WE,RADEX WRIST ARTHROGRAPHY RS&I,3296.0,2142.4,67.89,3296.0,32
CDM,73115WE-26,RADEX WRIST ARTHROGRAPHY RS&I,216.0,140.4,23.88,216.0,31
CDM,73115WE-TC,RADEX WRIST ARTHROGRAPHY RS&I,3080.0,2002.0,74.24,3080.0,35
CDM,73120PROWE,XRAY HAND 2 VIEW,64.0,41.6,18.78,64.0,32
CDM,73120TECWE,XRAY HAND 2 VIEW,918.0,596.7,18.78,918.0,32
CDM,73120WE,RADEX HAND 2 VIEWS,982.0,638.3,18.78,982.0,32
CDM,73120WE-26,RADEX HAND 2 VIEWS,64.0,41.6,6.96,64.0,31
CDM,73120WE-TC,RADEX HAND 2 VIEWS,918.0,596.7,17.37,918.0,35
CDM,73120XRAWE,XRAY HAND 2 VIEW,982.0,638.3,18.78,982.0,32
CDM,73130PROWE,XRAY HAND 3 VIEW,75.0,48.75,20.24,75.0,32
CDM,73130TECWE,XRAY HAND 3 VIEW,760.0,494.0,20.24,760.0,32
CDM,73130WE,RADEX HAND MINIMUM 3 VIEWS,835.0,542.75,20.24,835.0,32
CDM,73130WE-26,RADEX HAND MINIMUM 3 VIEWS,75.0,48.75,7.25,75.0,31
CDM,73130WE-TC,RADEX HAND MINIMUM 3 VIEWS,760.0,494.0,20.82,760.0,35
CDM,73130XRAWE,XRAY HAND 3 VIEW,835.0,542.75,20.24,835.0,32
CDM,73140PROWE,XRAY FINGERS 2 VIEW,52.0,33.8,18.41,56.16,32
CDM,73140TECWE,XRAY FINGERS 2 VIEW,760.0,494.0,18.41,760.0,32
CDM,73140WE,RADEX FINGR MINIMUM 2 VIEWS,812.0,527.8,18.41,812.0,32
CDM,73140WE-26,RADEX FINGR MINIMUM 2 VIEWS,52.0,33.8,5.83,52.0,31
CDM,73140WE-TC,RADEX FINGR MINIMUM 2 VIEWS,760.0,494.0,22.83,760.0,35
CDM,73140XRAWE,XRAY FINGERS 2 VIEW,812.0,527.8,18.41,812.0,32
CDM,73200005,TELEMETRY,362.0,235.3,16.03,474.0,40
CDM,73200PROWE,CT UPPER EXTREMITY WO CONT,440.0,286.0,137.17,440.0,32
CDM,73200WE,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,1358.0,882.7,137.17,1358.0,32
CDM,73200WE-26,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,440.0,286.0,42.48,440.0,31
CDM,73200WE-TC,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,918.0,596.7,113.16,918.0,35
CDM,73201PROWE,CT UPPER EXTRMT W CNTST,510.0,331.5,178.39,510.0,32
CDM,73201WE,CT UPPER EXTREMITY W/CONTRAST MATERIAL,3590.0,2333.5,178.39,3590.0,32
CDM,73201WE-26,CT UPPER EXTREMITY W/CONTRAST MATERIAL,510.0,331.5,48.44,510.0,31
CDM,73201WE-TC,CT UPPER EXTREMITY W/CONTRAST MATERIAL,3080.0,2002.0,144.15,3080.0,35
CDM,73202PROWE,CT ESTR UPPER L W/WO CONT,537.0,349.05,222.17,537.0,32
CDM,73202WE,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,2072.0,1346.8,222.17,2072.0,32
CDM,73202WE-26,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,537.0,349.05,50.71,537.0,31
CDM,73202WE-TC,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,1535.0,997.75,187.66,1535.0,35
CDM,73206CTAWE,"CTA UPPER EXTREMITY W/WO C,INCL 3D",2259.0,1468.35,247.22,2259.0,32
CDM,73206PROWE,"CT ANGIOGR,UP EXT W/WO CN",724.0,470.6,247.22,724.0,32
CDM,73206WE,CT ANGIOGRAPHY UPPER EXTREMITY,2259.0,1468.35,247.22,2259.0,32
CDM,73206WE-26,CT ANGIOGRAPHY UPPER EXTREMITY,724.0,470.6,74.43,724.0,31
CDM,73206WE-TC,CT ANGIOGRAPHY UPPER EXTREMITY,1535.0,997.75,210.95,1535.0,35
CDM,73218MRIWE,MRI UP EXTR NON-JOINT WO CONTRAST,2625.0,1706.25,281.72,2625.0,32
CDM,73218PROWE,"MRI,UP EXT-WO JNT-WO CON",540.0,351.0,270.0,540.0,32
CDM,73218WE,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,2625.0,1706.25,281.72,2625.0,32
CDM,73218WE-26,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,540.0,351.0,55.82,540.0,31
CDM,73218WE-TC,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,2085.0,1355.25,234.79,2085.0,35
CDM,73219MRIWE,"MRI,UP EXT-NON JOINT W/C",3728.0,2423.2,311.4,3728.0,32
CDM,73219PROWE,"MRI,UP EXT-WO JNT-W/CON",648.0,421.2,311.4,648.0,32
CDM,73219WE,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,3728.0,2423.2,311.4,3728.0,32
CDM,73219WE-26,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,648.0,421.2,67.61,648.0,31
CDM,73219WE-TC,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,3080.0,2002.0,250.93,3080.0,35
CDM,73220MRIWE,MRI UP EXT NONJOINT W/WO CONTRAST,3940.0,2561.0,341.11,3940.0,32
CDM,73220PROWE,MRI UPEST WO JNT W/WO CON,860.0,559.0,341.11,860.0,32
CDM,73220WE,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,3940.0,2561.0,341.11,3940.0,32
CDM,73220WE-26,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,860.0,559.0,89.21,860.0,31
CDM,73220WE-TC,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,3080.0,2002.0,303.8,3080.0,35
CDM,73221MRIWE,MRI UP EXTREM JOINT W/O CONTRAST,2625.0,1706.25,189.31,2625.0,32
CDM,73221PROWE,MRI UPPER EXT JNT WO CON,540.0,351.0,189.31,540.0,32
CDM,73221WE,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,2625.0,1706.25,189.31,2625.0,32
CDM,73221WE-26,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,540.0,351.0,57.39,540.0,31
CDM,73221WE-TC,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,2085.0,1355.25,139.24,2085.0,35
CDM,73222MRIWE,"MRI,UPPER EXT JOINT W/CONTRAST",7462.0,4850.3,293.68,7462.0,32
CDM,73222PROWE,"MRI,UPPER EXT JNT-W/CON",648.0,421.2,293.68,648.0,32
CDM,73222WE,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,7462.0,4850.3,293.68,7462.0,32
CDM,73222WE-26,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,648.0,421.2,67.61,648.0,31
CDM,73222WE-TC,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,6814.0,4429.1,231.89,6814.0,35
CDM,73223MRIWE,"MRI,UP EXT JNT-W/WO CON",3940.0,2561.0,364.13,3940.0,32
CDM,73223PROWE,"MRI,UP EXT JNT-W/WO CON",860.0,559.0,364.13,860.0,32
CDM,73223WE,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,3940.0,2561.0,364.13,3940.0,32
CDM,73223WE-26,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,860.0,559.0,89.21,860.0,31
CDM,73223WE-TC,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,3080.0,2002.0,279.99,3080.0,35
CDM,7322526WE,MR ANGIO UPPER EXTREM,692.0,449.8,70.02,692.0,31
CDM,73225CWE,MRA UPPER EXT WO CONT,6052.0,3933.8,320.62,6052.0,32
CDM,73225CWE-26,MRA UPPER EXT WO CONT,692.0,449.8,70.02,692.0,31
CDM,73225CWE-TC,MRA UPPER EXT WO CONT,5360.0,3484.0,244.08,5360.0,35
CDM,73225MRAWE,MRA UP EXT W AND/OR W/O CONTRAST,6052.0,3933.8,320.62,6052.0,32
CDM,73225PROWE,MRA UPPER EXT W/OR/WO CON,692.0,449.8,320.62,692.0,32
CDM,73225TCWE,MR ANGIO UPPER EXTREM,5360.0,3484.0,244.08,5360.0,35
CDM,73225WE-217,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,6052.0,3933.8,320.62,6052.0,32
CDM,73225WE-218,MR ANGIO UPPER EXTREM,6052.0,3933.8,320.62,6052.0,32
CDM,73225WE-26,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,692.0,449.8,70.02,692.0,31
CDM,73225WE-TC,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,5360.0,3484.0,244.08,5360.0,35
CDM,73501WE,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,839.0,545.35,21.38,839.0,28
CDM,73501WE-26,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,79.0,51.35,8.98,79.0,31
CDM,73501WE-TC,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,760.0,494.0,23.61,760.0,35
CDM,73502WE,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,857.0,557.05,29.45,857.0,28
CDM,73502WE-26,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,97.0,63.05,10.59,97.0,31
CDM,73502WE-TC,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,760.0,494.0,35.28,760.0,35
CDM,73503WE,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,1037.0,674.05,36.81,1037.0,28
CDM,73503WE-26,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,119.0,77.35,13.43,119.0,31
CDM,73503WE-TC,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,918.0,596.7,43.62,918.0,35
CDM,73521WE,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,1006.0,653.9,28.45,1006.0,28
CDM,73521WE-26,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,88.0,57.2,10.59,88.0,31
CDM,73521WE-TC,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,918.0,596.7,29.95,918.0,35
CDM,73522WE,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,1046.0,679.9,34.87,1046.0,28
CDM,73522WE-26,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,128.0,83.2,13.83,128.0,31
CDM,73522WE-TC,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,918.0,596.7,38.99,918.0,35
CDM,73523WE,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,1042.0,677.3,40.39,1042.0,28
CDM,73523WE-26,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,124.0,80.6,15.05,124.0,31
CDM,73523WE-TC,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,918.0,596.7,45.77,918.0,35
CDM,73525PROWE,ARTHROGRAPHY HIP,216.0,140.4,77.34,216.0,32
CDM,73525WE,RADEX HIP ARTHROGRAPHY RS&I,3296.0,2142.4,77.34,3296.0,32
CDM,73525WE-26,RADEX HIP ARTHROGRAPHY RS&I,216.0,140.4,24.16,216.0,31
CDM,73525WE-TC,RADEX HIP ARTHROGRAPHY RS&I,3080.0,2002.0,66.2,3080.0,35
CDM,73551WE,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,824.0,535.6,19.85,824.0,28
CDM,73551WE-26,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,64.0,41.6,8.01,64.0,31
CDM,73551WE-TC,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,760.0,494.0,21.23,760.0,35
CDM,73552WE,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,839.0,545.35,23.13,839.0,28
CDM,73552WE-26,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,79.0,51.35,8.65,79.0,31
CDM,73552WE-TC,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,760.0,494.0,26.4,760.0,35
CDM,73560PROWE,XRAY KNEE 1 OR 2 VIEWS,70.0,45.5,19.87,70.0,32
CDM,73560TECWE,XRAY KNEE 1 OR 2 VIEWS,760.0,494.0,19.87,760.0,32
CDM,73560WE,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,830.0,539.5,19.87,830.0,32
CDM,73560WE-26,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,70.0,45.5,8.01,70.0,31
CDM,73560WE-TC,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,760.0,494.0,19.1,760.0,35
CDM,73560XRAWE,XRAY KNEE 1 OR 2 VIEWS,830.0,539.5,19.87,830.0,32
CDM,73562PROWE,XRAY KNEE AP LAT OBLQ 3VWS,79.0,51.35,22.57,79.0,32
CDM,73562TECWE,XRAY KNEE AP LAT OBLQ 3VWS,760.0,494.0,22.57,760.0,32
CDM,73562WE,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,839.0,545.35,22.57,839.0,32
CDM,73562WE-26,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,79.0,51.35,8.67,79.0,31
CDM,73562WE-TC,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,760.0,494.0,23.98,760.0,35
CDM,73562XRAWE,XRAY KNEE AP LAT OBLQ 3VWS,839.0,545.35,22.57,839.0,32
CDM,73564PROWE,XRAY KNEE COMPLETE,97.0,63.05,25.38,97.0,32
CDM,73564WE,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,1015.0,659.75,25.38,1015.0,32
CDM,73564WE-26,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,97.0,63.05,10.38,97.0,31
CDM,73564WE-TC,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,918.0,596.7,27.71,918.0,35
CDM,73564XRAWE,XRAY KNEE COMPLETE,1015.0,659.75,25.38,1015.0,32
CDM,73565PROWE,XRAY KNEES STANDING,64.0,41.6,19.89,64.0,32
CDM,73565TECWE,XRAY KNEES STANDING,760.0,494.0,19.89,760.0,32
CDM,73565WE,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,824.0,535.6,19.89,824.0,32
CDM,73565WE-26,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,64.0,41.6,8.33,64.0,31
CDM,73565WE-TC,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,760.0,494.0,22.54,760.0,35
CDM,73565XRAWE,XRAY KNEES STANDING,824.0,535.6,19.89,824.0,32
CDM,73565XRYWE,X-RAY BILATERAL KNEES STANDING,824.0,535.6,19.89,824.0,32
CDM,73580WE,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,3340.0,2171.0,91.6,3340.0,32
CDM,73580WE-26,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,260.0,169.0,24.88,260.0,31
CDM,73580WE-TC,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,3080.0,2002.0,75.14,3080.0,35
CDM,73590PROWE,XRAY TIBIA/FIBULA AP LAT,64.0,41.6,19.82,64.0,32
CDM,73590TECWE,XRAY TINIA/FIBULA AP LAT,760.0,494.0,19.82,760.0,32
CDM,73590WE,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,824.0,535.6,19.82,824.0,32
CDM,73590WE-26,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,64.0,41.6,7.25,64.0,31
CDM,73590WE-TC,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,760.0,494.0,16.8,760.0,35
CDM,73590XRAWE,XRAY TIBIA/FIBULA AP LAT,824.0,535.6,19.82,824.0,32
CDM,73592PROWE,XRAY LOWER EXTREM INFANT,70.0,45.5,19.36,70.0,32
CDM,73592TECWE,XRAY LOWER EXTREM INFANT,760.0,494.0,19.36,760.0,32
CDM,73592WE,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,830.0,539.5,19.36,830.0,32
CDM,73592WE-26,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,70.0,45.5,6.96,70.0,31
CDM,73592WE-TC,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,760.0,494.0,21.11,760.0,35
CDM,73600PROWE,XRAY ANKLE AP LAT,64.0,41.6,19.36,64.0,32
CDM,73600TECWE,XRAY ANKLE AP LAT,760.0,494.0,19.36,760.0,32
CDM,73600WE,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,824.0,535.6,19.36,824.0,32
CDM,73600WE-26,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,64.0,41.6,6.96,64.0,31
CDM,73600WE-TC,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,760.0,494.0,18.23,760.0,35
CDM,73600XRAWE,XRAY ANKLE AP LAT,824.0,535.6,19.36,824.0,32
CDM,73610PROWE,XRAY ANKLE COMPLETE,75.0,48.75,20.24,75.0,32
CDM,73610TECWE,XRAY ANKLE COMPLETE,760.0,494.0,20.24,760.0,32
CDM,73610WE,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,835.0,542.75,20.24,835.0,32
CDM,73610WE-26,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,75.0,48.75,7.25,75.0,31
CDM,73610WE-TC,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,760.0,494.0,21.68,760.0,35
CDM,73610XRAWE,XRAY ANKLE COMPLETE,835.0,542.75,20.24,835.0,32
CDM,73615WE,RADEX ANKLE ARTHROGRAPHY RS&I,3296.0,2142.4,77.53,3296.0,32
CDM,73615WE-26,RADEX ANKLE ARTHROGRAPHY RS&I,216.0,140.4,24.16,216.0,31
CDM,73615WE-TC,RADEX ANKLE ARTHROGRAPHY RS&I,3080.0,2002.0,69.93,3080.0,35
CDM,73620PROWE,XRAY FOOT AP LAT,64.0,41.6,18.78,64.0,32
CDM,73620TECWE,XRAY FOOT AP LAT,760.0,494.0,18.78,760.0,32
CDM,73620WE,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,824.0,535.6,18.78,824.0,32
CDM,73620WE-26,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,64.0,41.6,6.39,64.0,31
CDM,73620WE-TC,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,760.0,494.0,17.37,760.0,35
CDM,73620XRAWE,XRAY FOOT AP LAT,824.0,535.6,18.78,824.0,32
CDM,73630PROWE,XRAY FOOT COMPLETE,75.0,48.75,20.24,75.0,32
CDM,73630TECWE,XRAY FOOT COMPLETE,760.0,494.0,20.24,760.0,32
CDM,73630WE,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,835.0,542.75,20.24,835.0,32
CDM,73630WE-26,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,75.0,48.75,6.96,75.0,31
CDM,73630WE-TC,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,760.0,494.0,20.53,760.0,35
CDM,73630XRAWE,XRAY FOOT COMPLETE,835.0,542.75,20.24,835.0,32
CDM,73650PROWE,XRAY CALCANEUS 2 VIEW,64.0,41.6,18.87,64.0,32
CDM,73650TECWE,XRAY CALCANEUS 2 VIEW,760.0,494.0,18.87,760.0,32
CDM,73650WE,RADEX CALCANEUS MINIMUM 2 VIEWS,824.0,535.6,18.87,824.0,32
CDM,73650WE-26,RADEX CALCANEUS MINIMUM 2 VIEWS,64.0,41.6,6.68,64.0,31
CDM,73650WE-TC,RADEX CALCANEUS MINIMUM 2 VIEWS,760.0,494.0,17.95,760.0,35
CDM,73650XRAWE,XRAY CALCANEUS 2 VIEW,824.0,535.6,18.87,824.0,32
CDM,73660PROWE,XRAY TOE(S) 2 VIEW,52.0,33.8,16.42,52.0,32
CDM,73660TECWE,XRAY TOE(S) 2 VIEW,760.0,494.0,16.42,760.0,32
CDM,73660WE,RADEX TOE MINIMUM 2 VIEWS,812.0,527.8,16.42,812.0,32
CDM,73660WE-26,RADEX TOE MINIMUM 2 VIEWS,52.0,33.8,5.54,52.0,31
CDM,73660WE-TC,RADEX TOE MINIMUM 2 VIEWS,760.0,494.0,20.53,760.0,35
CDM,73660XRAWE,XRAY TOE(S) 2 VIEW,812.0,527.8,16.42,812.0,32
CDM,73700PROWE,CT LOWER EXTREM WO CONTR,440.0,286.0,120.81,440.0,32
CDM,73700WE,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,1358.0,882.7,120.81,1358.0,32
CDM,73700WE-26,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,440.0,286.0,42.19,440.0,31
CDM,73700WE-TC,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,918.0,596.7,82.57,918.0,35
CDM,73701PROWE,CT LOWER EXTREM W CONTR,510.0,331.5,155.76,510.0,32
CDM,73701WE,CT LOWER EXTREMITY W/CONTRAST MATERIAL,2045.0,1329.25,155.76,2045.0,32
CDM,73701WE-26,CT LOWER EXTREMITY W/CONTRAST MATERIAL,510.0,331.5,48.44,510.0,31
CDM,73701WE-TC,CT LOWER EXTREMITY W/CONTRAST MATERIAL,1535.0,997.75,111.55,1535.0,35
CDM,73702PROWE,CT LOWER EXTREM W/WO CONT,537.0,349.05,182.06,537.0,32
CDM,73702WE,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,2072.0,1346.8,182.06,2072.0,32
CDM,73702WE-26,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,537.0,349.05,50.71,537.0,31
CDM,73702WE-TC,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,1535.0,997.75,137.37,1535.0,35
CDM,73706PROWE,"CT ANGIO LOW EXT,W/WO CON",760.0,494.0,247.22,760.0,32
CDM,73706WE,CT ANGIOGRAPHY LOWER EXTREMITY,2295.0,1491.75,247.22,2295.0,32
CDM,73706WE-26,CT ANGIOGRAPHY LOWER EXTREMITY,760.0,494.0,79.12,760.0,31
CDM,73706WE-TC,CT ANGIOGRAPHY LOWER EXTREMITY,1535.0,997.75,211.4,1535.0,35
CDM,73718MRIWE,"MRI,LOW EXT-NO JNT-WO CON",2679.0,1741.35,209.78,2679.0,32
CDM,73718PROWE,"MRI,LOW EXT-NO JNT-WO CON",594.0,386.1,209.78,594.0,32
CDM,73718WE,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,2679.0,1741.35,209.78,2679.0,32
CDM,73718WE-26,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,594.0,386.1,55.96,594.0,31
CDM,73718WE-TC,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,2085.0,1355.25,157.71,2085.0,35
CDM,73719MRIWE,"MRI,LOW EXT-NO JNT-W/CON",3793.0,2465.45,246.41,3793.0,32
CDM,73719PROWE,"MRI,LOW EXT-NO JNT-W/CON",713.0,463.45,246.41,713.0,32
CDM,73719WE,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,3793.0,2465.45,246.41,3793.0,32
CDM,73719WE-26,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,713.0,463.45,67.61,713.0,31
CDM,73719WE-TC,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,3080.0,2002.0,185.08,3080.0,35
CDM,73720MRIWE,MRI LOWER EXTREMITY NONJOINT W/WO C,4026.0,2616.9,317.45,4026.0,32
CDM,73720PROWE,MRI LOW EXT-NO JNT W/WO,946.0,614.9,317.45,946.0,32
CDM,73720WE,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,4026.0,2616.9,317.45,4026.0,32
CDM,73720WE-26,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,946.0,614.9,88.92,946.0,31
CDM,73720WE-TC,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,3080.0,2002.0,233.18,3080.0,35
CDM,73721MRIWE,MRI LOWER EXTREMITY JOINT W/O C,2679.0,1741.35,189.03,2679.0,32
CDM,73721PROWE,MRI ANY JOINT LOW EXTREMITY WO/CONTRAST,594.0,386.1,189.03,594.0,32
CDM,73721WE,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,2679.0,1741.35,189.03,2679.0,32
CDM,73721WE-26,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,594.0,386.1,57.39,594.0,31
CDM,73721WE-TC,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,2085.0,1355.25,138.92,2085.0,35
CDM,73722MRIWE,"MRI,LOW EXT JOINT W/CON",7527.0,4892.55,293.98,7527.0,32
CDM,73722PROWE,"MRI,LOW EXT JOINT W/CON",713.0,463.45,293.98,713.0,32
CDM,73722WE,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,7527.0,4892.55,293.98,7527.0,32
CDM,73722WE-26,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,713.0,463.45,68.33,713.0,31
CDM,73722WE-TC,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,6814.0,4429.1,233.5,6814.0,35
CDM,73723MRIWE,"MRI,LOW EXT JNT W&WO CN",4026.0,2616.9,362.96,4026.0,32
CDM,73723PROWE,"MRI,LOW EXT JNT W&WO CN",946.0,614.9,362.96,946.0,32
CDM,73723WE,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,4026.0,2616.9,362.96,4026.0,32
CDM,73723WE-26,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,946.0,614.9,88.92,946.0,31
CDM,73723WE-TC,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,3080.0,2002.0,279.02,3080.0,35
CDM,7372526WE-26-219,MR ANGIO LOWER EXTREM (MRA),728.0,473.2,75.28,728.0,31
CDM,7372526WE-26-220,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,728.0,473.2,75.28,728.0,31
CDM,73725CWE,MRA LWR EXT W CONTRL,8236.0,5353.4,313.82,8236.0,32
CDM,73725CWE-26,MRA LWR EXT W CONTRL,728.0,473.2,75.28,728.0,31
CDM,73725CWE-TC,MRA LWR EXT W CONTRL,7508.0,4880.2,249.89,7508.0,35
CDM,73725MRAWE,MRA LOWER EXTREMITY W WO,8236.0,5353.4,313.82,8236.0,32
CDM,73725PROWE,MRA LOWER EXTRM W W/O CNT,728.0,473.2,313.82,728.0,32
CDM,73725TCWE-TC-221,MR ANGIO LOWER EXTREM (MRA),7508.0,4880.2,249.89,7508.0,35
CDM,73725TCWE-TC-222,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,7508.0,4880.2,249.89,7508.0,35
CDM,73725WE-223,MRA LWR EXT WITH OR W/O CONT,8236.0,5353.4,313.82,8236.0,32
CDM,73725WE-224,MR ANGIO LOWER EXTREM (MRA),8236.0,5353.4,313.82,8236.0,32
CDM,73725WE-225,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,8236.0,5353.4,313.82,8236.0,32
CDM,73725WE-26,MRA LWR EXT WITH OR W/O CONT,728.0,473.2,75.28,728.0,31
CDM,73725WE-TC,MRA LWR EXT WITH OR W/O CONT,7508.0,4880.2,249.89,7508.0,35
CDM,74000000,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,8775.0,5703.75,453.85,7897.5,49
CDM,74000005,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,8775.0,5703.75,453.85,7897.5,49
CDM,74000010,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,4576.0,2974.4,453.85,4824.0,49
CDM,74000020,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1350.0,877.5,90.87,3288.0,49
CDM,74000030,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,8775.0,5703.75,453.85,7897.5,49
CDM,74000040,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,8775.0,5703.75,453.85,7897.5,49
CDM,74000045,ELECTROCORTICOGRAM SURGERY SPX,3389.0,2202.85,222.5,3050.1,39
CDM,74000050,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,2686.0,1745.9,225.48,2417.4,49
CDM,74000060,EEG EXTENDED MONITORING 61-119 MINUTES,2686.0,1745.9,225.48,2417.4,49
CDM,74000065,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,8775.0,5703.75,222.5,7897.5,49
CDM,74000070,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,2686.0,1745.9,222.5,2417.4,49
CDM,74000075,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,750.0,487.5,126.0,1863.0,39
CDM,74000080,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,2686.0,1745.9,222.5,2417.4,49
CDM,74000090,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,2686.0,1745.9,222.5,2417.4,49
CDM,74000100,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,4576.0,2974.4,222.5,4118.4,48
CDM,74000150,RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE,4576.0,2974.4,222.5,4118.4,49
CDM,74000160,EEG NONINTRACRANIAL SURGERY,1491.0,969.15,222.5,1863.0,39
CDM,74000180,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,8775.0,5703.75,222.5,7897.5,49
CDM,74000200,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,8775.0,5703.75,453.85,7897.5,49
CDM,74000210,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,8775.0,5703.75,453.85,7897.5,49
CDM,74000300,ELECTROCORTICOGRAM SURGERY SPX,3389.0,2202.85,222.5,3050.1,39
CDM,74000310,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,8775.0,5703.75,222.5,7897.5,49
CDM,74000315,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,750.0,487.5,126.0,1863.0,39
CDM,74000320,HOME SLEEP TEST/TYPE 3 PORTA,783.0,508.95,90.87,3288.0,48
CDM,74000395,ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS,321.0,208.65,23.85,1863.0,49
CDM,74000405,ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS,321.0,208.65,23.85,1863.0,49
CDM,74000425,EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,1350.0,877.5,157.05,1863.0,48
CDM,74000435,EEG W/O VIDEO BY TECH 2-12 HR UNMONITORED,2686.0,1745.9,222.5,2417.4,48
CDM,74000445,EEG W/O VIDEO BY TECH 2-12 HR INTERMITTENT MNTR,2686.0,1745.9,222.5,2417.4,48
CDM,74000455,EEG W/O VIDEO BY TECH 2-12HR CONTINUOUS R-T MNTR,2686.0,1745.9,222.5,2417.4,48
CDM,74000465,EEG W/O VID BY TECH EA INCR 12-26HR UNMONITORED,4576.0,2974.4,306.01,4118.4,48
CDM,74000475,EEG W/O VID BY TECH EA INCR 12-26 HR INTMT MNTR,4576.0,2974.4,306.01,4118.4,48
CDM,74000485,EEG W/O VID TECH EA INCR 12-26 HR CONT R-T MNTR,4576.0,2974.4,306.01,4118.4,48
CDM,74000495,VEEG BY TECH 2-12 HOURS UNMONITORED,2686.0,1745.9,222.5,2417.4,48
CDM,74000505,VEEG BY TECH 2-12 HR INTERMITTENT MONITORING,2686.0,1745.9,222.5,2417.4,48
CDM,74000515,VEEG BY TECH 2-12 HR CONTINUOUS R-T MONITORING,4576.0,2974.4,222.5,4118.4,48
CDM,74000525,VEEG BY TECH EA INCR 12-26 HR UNMONITORED,4576.0,2974.4,306.01,4118.4,48
CDM,74000535,VEEG BY TECH EA INCR 12-26 HR INTERMITTENT MNTR,4576.0,2974.4,306.01,4118.4,48
CDM,74000545,VEEG BY TECH EA INCR 12-26 HR CONT R-T MNTR,8775.0,5703.75,306.01,7897.5,48
CDM,74000615,ELEC ALYS IMPL S-SCLP CONT BI EEG SYS W/O PRGRMG,680.0,442.0,82.56,1863.0,41
CDM,74000625,ELEC ALYS IMPL S-SCLP CONT BI EEG SYS PRGRMG 1ST,486.0,315.9,82.56,1863.0,41
CDM,74000655,REM MNTR S-SCLP IMPL CONT BI EEG SYS FITG SET-UP,680.0,442.0,33.85,1863.0,41
CDM,74018WE,RADIOLOGIC EXAM ABDOMEN 1 VIEW,839.0,545.35,19.42,839.0,28
CDM,74018WE-26,RADIOLOGIC EXAM ABDOMEN 1 VIEW,79.0,51.35,8.65,79.0,31
CDM,74018WE-TC,RADIOLOGIC EXAM ABDOMEN 1 VIEW,760.0,494.0,20.91,760.0,35
CDM,74019WE,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,1019.0,662.35,23.71,1019.0,28
CDM,74019WE-26,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,101.0,65.65,10.92,101.0,31
CDM,74019WE-TC,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,918.0,596.7,25.43,918.0,35
CDM,74021WE,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,1037.0,674.05,27.77,1037.0,28
CDM,74021WE-26,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,119.0,77.35,12.53,119.0,31
CDM,74021WE-TC,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,918.0,596.7,29.3,918.0,35
CDM,74022PROWE,XRAY ACUTE ABDOMEN COMP W/CHEST,141.0,91.65,32.22,141.0,32
CDM,74022TECWE,XRAY ABDOMEN COM W CHEST,918.0,596.7,32.22,918.0,32
CDM,74022WE,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,1059.0,688.35,32.22,1059.0,32
CDM,74022WE-26,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,141.0,91.65,12.93,141.0,31
CDM,74022WE-TC,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,918.0,596.7,28.57,918.0,35
CDM,74022XRAWE,XRAY ABDOMEN COM W CHEST,1059.0,688.35,32.22,1059.0,32
CDM,74150PROWE,CT ABDOMEN WO CONTRAST,524.0,340.6,120.21,524.0,32
CDM,74150WE,CT ABDOMEN W/O CONTRAST,1442.0,937.3,120.21,1442.0,32
CDM,74150WE-26,CT ABDOMEN W/O CONTRAST,524.0,340.6,49.58,524.0,31
CDM,74150WE-TC,CT ABDOMEN W/O CONTRAST,918.0,596.7,80.31,918.0,35
CDM,74160PROWE,CT ABDOMEN W CONTRAST,559.0,363.35,185.12,559.0,32
CDM,74160WE,CT ABDOMEN W/CONTRAST,2094.0,1361.1,185.12,2094.0,32
CDM,74160WE-26,CT ABDOMEN W/CONTRAST,559.0,363.35,52.7,559.0,31
CDM,74160WE-TC,CT ABDOMEN W/CONTRAST,1535.0,997.75,169.33,1535.0,35
CDM,74170PROWE,CT ABDOMEN W WO CONTRAST,616.0,400.4,213.67,616.0,32
CDM,74170WE,CT ABDOMEN W & W/O CONTRAST,2151.0,1398.15,213.67,2151.0,32
CDM,74170WE-26,CT ABDOMEN W & W/O CONTRAST,616.0,400.4,58.24,616.0,31
CDM,74170WE-TC,CT ABDOMEN W & W/O CONTRAST,1535.0,997.75,191.93,1535.0,35
CDM,74174PROWE,CT ANGIO ABD&PELV W&WO CONTRAST,968.0,629.2,263.34,968.0,32
CDM,74174WE,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMGES,4048.0,2631.2,263.34,4048.0,32
CDM,74174WE-26,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMGES,968.0,629.2,90.04,968.0,31
CDM,74174WE-TC,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMGES,3080.0,2002.0,274.43,3080.0,35
CDM,74175PROWE,"CT ANGIO,ABDOMN W&WO CN",728.0,473.2,246.86,728.0,32
CDM,74175WE,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,2263.0,1470.95,246.86,2263.0,32
CDM,74175WE-26,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,728.0,473.2,79.26,728.0,31
CDM,74175WE-TC,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,1535.0,997.75,210.95,1535.0,35
CDM,74176PROWE,CT ABDOMEN & PELVIS W/O CONTRAST,766.0,497.9,121.99,766.0,32
CDM,74176WE,CT ABD & PELVIS W/O CONTRAST,2851.0,1853.15,121.99,2851.0,32
CDM,74176WE-26,CT ABD & PELVIS W/O CONTRAST,766.0,497.9,71.01,766.0,31
CDM,74176WE-TC,CT ABD & PELVIS W/O CONTRAST,2085.0,1355.25,101.86,2085.0,35
CDM,74177PROWE,CT ABDOMEN & PELVIS W/CONTRAST,801.0,520.65,175.85,801.0,32
CDM,74177WE,CT ABD & PELVIS W/CONTRAST,3881.0,2522.65,175.85,3881.0,32
CDM,74177WE-26,CT ABD & PELVIS W/CONTRAST,801.0,520.65,74.13,801.0,31
CDM,74177WE-TC,CT ABD & PELVIS W/CONTRAST,3080.0,2002.0,213.88,3080.0,35
CDM,74178PROWE,CT ABDOMEN & PELVIS WWO CONTRAST,804.0,522.6,208.69,804.0,32
CDM,74178WE,CT ABD & PELVIS W/WO CONTRST 1+ BODY REGNS,3884.0,2524.6,208.69,3884.0,32
CDM,74178WE-26,CT ABD & PELVIS W/WO CONTRST 1+ BODY REGNS,804.0,522.6,82.37,804.0,31
CDM,74178WE-TC,CT ABD & PELVIS W/WO CONTRST 1+ BODY REGNS,3080.0,2002.0,241.57,3080.0,35
CDM,74181MRIWE,MRI ABDOMEN W/O CONTRAST,2669.0,1734.85,184.59,2669.0,32
CDM,74181PROWE,MRI ABDOMEN WO CONTRAST,584.0,379.6,184.59,584.0,32
CDM,74181WE,"MRI, ABDOMEN (MRI)",2669.0,1734.85,184.59,2669.0,32
CDM,74181WE-26,"MRI, ABDOMEN (MRI)",584.0,379.6,60.51,584.0,31
CDM,74181WE-TC,"MRI, ABDOMEN (MRI)",2085.0,1355.25,126.4,2085.0,35
CDM,74182MRIWE,"MRI,ABDOMEN, W/CONTRAST",3841.0,2496.65,284.5,3841.0,32
CDM,74182PROWE,"MRI,ABDOMEN, W/CONTRAST",761.0,494.65,284.5,761.0,32
CDM,74182WE,MRI ABDOMEN W/CONTRAST MATERIAL,3841.0,2496.65,284.5,3841.0,32
CDM,74182WE-26,MRI ABDOMEN W/CONTRAST MATERIAL,761.0,494.65,71.88,761.0,31
CDM,74182WE-TC,MRI ABDOMEN W/CONTRAST MATERIAL,3080.0,2002.0,218.97,3080.0,35
CDM,74183MRIWE,"MRI,ABDOMEN,W&WO CONTRS",4048.0,2631.2,318.47,4048.0,32
CDM,74183PROWE,"MRI,ABDOMEN,W&WO CONTRS",968.0,629.2,318.47,968.0,32
CDM,74183WE,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,4048.0,2631.2,318.47,4048.0,32
CDM,74183WE-26,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,968.0,629.2,93.18,968.0,31
CDM,74183WE-TC,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,3080.0,2002.0,232.21,3080.0,35
CDM,7418526WE,MR ABDOMINAL AORTA ANGIOGRAM,720.0,468.0,74.43,720.0,31
CDM,74185CWE,MRA ABD W CONTR,3944.0,2563.6,315.52,3944.0,32
CDM,74185CWE-26,MRA ABD W CONTR,720.0,468.0,74.43,720.0,31
CDM,74185CWE-TC,MRA ABD W CONTR,3224.0,2095.6,250.54,3224.0,35
CDM,74185MRAWE,MRA ABDOMEN W WO CONTR,3944.0,2563.6,315.52,3944.0,32
CDM,74185PROWE,MRA ABDOMEN W OR WO CNRST,720.0,468.0,315.52,720.0,32
CDM,74185TCWE,MR ABDOMINAL AORTA ANGIOGRAM,3224.0,2095.6,250.54,3224.0,35
CDM,74185WE-226,MRA ABD WITH OR W/O CONT,3944.0,2563.6,315.52,3944.0,32
CDM,74185WE-227,MR ABDOMINAL AORTA ANGIOGRAM,3944.0,2563.6,315.52,3944.0,32
CDM,74185WE-26,MRA ABD WITH OR W/O CONT,720.0,468.0,74.43,720.0,31
CDM,74185WE-TC,MRA ABD WITH OR W/O CONT,3224.0,2095.6,250.54,3224.0,35
CDM,74210WE,RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY,1771.0,1151.15,48.99,1771.0,32
CDM,74210WE-26,RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY,236.0,153.4,14.63,236.0,31
CDM,74210WE-TC,RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY,1535.0,997.75,53.56,1535.0,35
CDM,74220PROWE,XRAY ESOPHAGUS,240.0,156.0,49.48,240.0,32
CDM,74220WE,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,1775.0,1153.75,49.48,1775.0,32
CDM,74220WE-26,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,240.0,156.0,19.18,240.0,31
CDM,74220WE-TC,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,1535.0,997.75,59.3,1535.0,35
CDM,74220XRAWE,XRAY ESOPHAGUS,1775.0,1153.75,49.48,1775.0,32
CDM,74221WE,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,1815.0,1179.75,82.34,1815.0,28
CDM,74221WE-26,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,280.0,182.0,33.0,280.0,31
CDM,74221WE-TC,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,1535.0,997.75,72.88,1535.0,35
CDM,74230PROWE,XRAY SWALLOWING FUNCTION,212.0,137.8,64.11,212.0,32
CDM,74230WE,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,1747.0,1135.55,64.11,1747.0,32
CDM,74230WE-26,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,212.0,137.8,22.02,212.0,31
CDM,74230WE-TC,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,1535.0,997.75,57.58,1535.0,35
CDM,74230XRAWE,XRAY SWALLOWING FUNCTION,1747.0,1135.55,64.11,1747.0,32
CDM,74235WE,RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,2057.0,1337.05,110.54,2057.0,14
CDM,74235WE-26,RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,524.0,340.6,55.56,524.0,31
CDM,74235WE-TC,RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,1533.0,996.45,103.17,1533.0,21
CDM,74240PROWE,"UPPER GI,WITHOUT KUB",320.0,208.0,66.16,320.0,32
CDM,74240WE,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,1855.0,1205.75,66.16,1855.0,32
CDM,74240WE-26,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,320.0,208.0,28.98,320.0,31
CDM,74240WE-TC,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,1535.0,997.75,69.93,1535.0,35
CDM,74240XRAWE,XRAY GI UPPER WO KUB,1855.0,1205.75,66.16,1855.0,32
CDM,74241PROWE,XRAY GI UPPER W KUB W/WO DELAYS,143.0,92.95,71.5,143.0,16
CDM,74241XRAWE,XRAY GI UPPER W KUB,938.0,609.7,103.37,938.0,16
CDM,74245PROWE,XRAY UGI SMALL BOWEL,170.0,110.5,85.0,193.3,16
CDM,74245XRAWE,XRAY UGI SMALL BOWEL,1080.0,702.0,154.1,1080.0,16
CDM,74246PROWE,"UPPER GI W/AIR,BARIUM WO KUB",360.0,234.0,71.07,360.0,32
CDM,74246WE,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,1895.0,1231.75,71.07,1895.0,32
CDM,74246WE-26,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,360.0,234.0,28.69,360.0,31
CDM,74246WE-TC,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,1535.0,997.75,82.28,1535.0,35
CDM,74246XRAWE,XRAY UGI SM BOWEL WO KUB,1895.0,1231.75,71.07,1895.0,32
CDM,74247PROWE,XRAY UGI W AIR W KUB,143.0,92.95,71.5,154.7,16
CDM,74247XRAWE,XRAY UGI SM BOWEL W KUB,938.0,609.7,123.32,938.0,16
CDM,74248WE,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,1274.0,828.1,62.8,1274.0,28
CDM,74248WE-26,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,280.0,182.0,33.0,280.0,31
CDM,74248WE-TC,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,994.0,646.1,47.06,994.0,35
CDM,74249PROWE,XRAY UGI W AIR & SM BOWEL,170.0,110.5,85.0,208.79,16
CDM,74249XRAWE,XRAY UGI SM BOWEL W BARIUM,1080.0,702.0,166.45,1080.0,16
CDM,74250PROWE,XRAY SMALL BOWEL MULTIPLE,324.0,210.6,61.81,324.0,32
CDM,74250WE,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,1859.0,1208.35,61.81,1859.0,32
CDM,74250WE-26,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,324.0,210.6,19.75,324.0,31
CDM,74250WE-TC,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,1535.0,997.75,73.95,1535.0,35
CDM,74250XRAWE,XRAY SMALL BOWEL MULTIPLE,1859.0,1208.35,61.81,1859.0,32
CDM,74251PROWE,XRAY SM BOWEL VIA ENT TUBE,468.0,304.2,189.53,526.34,32
CDM,74251WE,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,2003.0,1301.95,189.53,2003.0,32
CDM,74251WE-26,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,468.0,304.2,28.69,468.0,31
CDM,74251WE-TC,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,1535.0,997.75,201.23,1535.0,35
CDM,74251XRAWE,XRAY SM BOWEL VIA ENT TUBE,2003.0,1301.95,189.53,2003.0,32
CDM,74261PROWE,CT COLONOGRAPHY W/O DYE DIAG,1056.0,686.4,217.47,1056.0,32
CDM,74261WE,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,1974.0,1283.1,217.47,1974.0,32
CDM,74261WE-26,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,1056.0,686.4,97.43,1056.0,31
CDM,74261WE-TC,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,918.0,596.7,126.39,918.0,35
CDM,74262PROWE,CT COLONOGRAPHY W/WO DYE DX,1100.0,715.0,312.25,1100.0,32
CDM,74262WE,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,2635.0,1712.75,312.25,2635.0,32
CDM,74262WE-26,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,1100.0,715.0,103.69,1100.0,31
CDM,74262WE-TC,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,1535.0,997.75,210.89,1535.0,35
CDM,74263PROWE,CT COLONOGRAPHY W/DYE SCREENING,912.0,592.8,361.66,1073.6,29
CDM,74263WE,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,2997.0,1948.05,361.66,2997.0,29
CDM,74263WE-26,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,912.0,592.8,96.33,912.0,28
CDM,74263WE-TC,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,2085.0,1355.25,587.18,2085.0,32
CDM,74270PROWE,BARIUM ENEMA,416.0,270.4,77.76,416.0,32
CDM,74270WE,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,1951.0,1268.15,77.76,1951.0,32
CDM,74270WE-26,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,416.0,270.4,28.69,416.0,31
CDM,74270WE-TC,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,1535.0,997.75,99.35,1535.0,35
CDM,74270XRAWE,XRAY COLON BARIUM,1951.0,1268.15,77.76,1951.0,32
CDM,74280PROWE,XRAY COLON AIR CONTRAST,504.0,327.6,130.25,504.0,32
CDM,74280WE,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,2039.0,1325.35,130.25,2039.0,32
CDM,74280WE-26,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,504.0,327.6,40.77,504.0,31
CDM,74280WE-TC,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,1535.0,997.75,145.75,1535.0,35
CDM,74280XRAWE,XRAY COLON AIR CONTRAST,2039.0,1325.35,130.25,2039.0,32
CDM,74290WE,CHOLECYSTOGRAPHY ORAL CONTRST,1676.0,1089.4,43.57,1676.0,32
CDM,74290WE-26,CHOLECYSTOGRAPHY ORAL CONTRST,141.0,91.65,12.93,141.0,31
CDM,74290WE-TC,CHOLECYSTOGRAPHY ORAL CONTRST,1535.0,997.75,46.95,1535.0,35
CDM,74300WE,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,1502.0,976.3,65.92,1502.0,14
CDM,74300WE-26,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,126.0,81.9,13.11,126.0,31
CDM,74300WE-TC,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,1376.0,894.4,27.28,1376.0,21
CDM,74301WE,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,350.0,227.5,41.26,350.0,14
CDM,74301WE-26,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,82.0,53.3,9.52,82.0,31
CDM,74301WE-TC,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,268.0,174.2,19.48,268.0,21
CDM,74328WE,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,729.0,473.85,106.56,729.0,14
CDM,74328WE-26,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,184.0,119.6,22.48,184.0,31
CDM,74328WE-TC,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,545.0,354.25,60.19,545.0,21
CDM,74329WE,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,1165.0,757.25,106.56,1165.0,14
CDM,74329WE-26,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,219.0,142.35,22.8,219.0,31
CDM,74329WE-TC,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,946.0,614.9,48.43,946.0,21
CDM,74330WE,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,1419.0,922.35,111.81,1419.0,14
CDM,74330WE-26,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,260.0,169.0,26.36,260.0,31
CDM,74330WE-TC,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,1159.0,753.35,81.78,1159.0,21
CDM,74340WE,INTRO LONG GI TUBE W/FLUORO/FILMS,1001.0,650.65,87.24,1001.0,14
CDM,74340WE-26,INTRO LONG GI TUBE W/FLUORO/FILMS,211.0,137.15,22.73,211.0,31
CDM,74340WE-TC,INTRO LONG GI TUBE W/FLUORO/FILMS,790.0,513.5,85.16,790.0,21
CDM,74355WE,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,887.0,576.55,95.32,887.0,14
CDM,74355WE-26,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,353.0,229.45,33.68,353.0,31
CDM,74355WE-TC,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,534.0,347.1,103.53,534.0,21
CDM,74360WE,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,1329.0,863.85,75.51,1329.0,14
CDM,74360WE-26,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,211.0,137.15,24.74,211.0,31
CDM,74360WE-TC,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,1118.0,726.7,95.79,1118.0,21
CDM,74363WE,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,2465.0,1602.25,188.7,2465.0,14
CDM,74363WE-26,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,409.0,265.85,37.79,409.0,31
CDM,74363WE-TC,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,2056.0,1336.4,85.91,2056.0,21
CDM,74400WE,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,1751.0,1138.15,67.89,1751.0,32
CDM,74400WE-26,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,216.0,140.4,20.31,216.0,31
CDM,74400WE-TC,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,1535.0,997.75,76.82,1535.0,35
CDM,74410WE,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,1751.0,1138.15,71.08,1751.0,32
CDM,74410WE-26,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,216.0,140.4,20.6,216.0,31
CDM,74410WE-TC,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,1535.0,997.75,77.68,1535.0,35
CDM,74415WE,UROGRAPHY NFS DRIP &/BOLUS W/NEPHROTOMOGRAPHY,1751.0,1138.15,77.59,1751.0,32
CDM,74415WE-26,UROGRAPHY NFS DRIP &/BOLUS W/NEPHROTOMOGRAPHY,216.0,140.4,20.31,216.0,31
CDM,74415WE-TC,UROGRAPHY NFS DRIP &/BOLUS W/NEPHROTOMOGRAPHY,1535.0,997.75,98.08,1535.0,35
CDM,74420WE,UROGRAPHY RETROGRADE WITH/WO KUB,3288.0,2137.2,69.45,3288.0,28
CDM,74420WE-26,UROGRAPHY RETROGRADE WITH/WO KUB,208.0,135.2,15.49,208.0,31
CDM,74420WE-TC,UROGRAPHY RETROGRADE WITH/WO KUB,3080.0,2002.0,52.22,3080.0,35
CDM,74425PROWE,UROGRAPHY ANTEGRADE,204.0,132.6,102.0,204.0,28
CDM,74425UROWE,UROGRAPHY ANTEGRADE,3284.0,2134.6,110.23,3284.0,28
CDM,74425WE,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,3284.0,2134.6,110.23,3284.0,28
CDM,74425WE-26,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,204.0,132.6,15.2,204.0,31
CDM,74425WE-TC,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,3080.0,2002.0,51.59,3080.0,35
CDM,74430CYSWE,CYSTOGRAPHY 3 VIEW,3221.0,2093.65,30.12,3221.0,32
CDM,74430PROWE,CYSTOGRAPHY 3 VIEW,141.0,91.65,30.12,141.0,32
CDM,74430WE,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,3221.0,2093.65,30.12,3221.0,32
CDM,74430WE-26,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,141.0,91.65,12.93,141.0,31
CDM,74430WE-TC,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,3080.0,2002.0,25.75,3080.0,35
CDM,74445PROWE,CORPORA CAVERNOSOGRAPHY,502.0,326.3,137.21,502.0,14
CDM,74445WE,CORPORA CAVERNOSOGRAPY RS&I,1420.0,923.0,137.21,1420.0,14
CDM,74445WE-26,CORPORA CAVERNOSOGRAPY RS&I,502.0,326.3,49.44,502.0,31
CDM,74445WE-TC,CORPORA CAVERNOSOGRAPY RS&I,918.0,596.7,44.47,918.0,21
CDM,74450PROWE,URETHROCYSTOGRAPHY,132.0,85.8,66.0,324.44,14
CDM,74450UREWE,URETHROCYSTOGRAPHY,2217.0,1441.05,109.29,2217.0,14
CDM,74450WE,URETHROCYSTOGRAPHY RETROGRADE RS&I,2217.0,1441.05,109.29,2217.0,14
CDM,74450WE-26,URETHROCYSTOGRAPHY RETROGRADE RS&I,132.0,85.8,14.35,132.0,31
CDM,74450WE-TC,URETHROCYSTOGRAPHY RETROGRADE RS&I,2085.0,1355.25,57.63,2085.0,21
CDM,74455PROWE,URETHROCYSTOGRAPHY VOIDG,132.0,85.8,55.25,151.08,32
CDM,74455UREWE,URETHROCYSTOGRAPHY VOIDG,2217.0,1441.05,55.25,2217.0,32
CDM,74455WE,URETHROCYSTOGRAPHY VOIDING RS&I,2217.0,1441.05,55.25,2217.0,32
CDM,74455WE-26,URETHROCYSTOGRAPHY VOIDING RS&I,132.0,85.8,13.5,132.0,31
CDM,74455WE-TC,URETHROCYSTOGRAPHY VOIDING RS&I,2085.0,1355.25,62.75,2085.0,35
CDM,74470WE,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,4967.0,3228.55,86.69,4967.0,14
CDM,74470WE-26,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,238.0,154.7,22.73,238.0,31
CDM,74470WE-TC,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,4729.0,3073.85,49.44,4729.0,21
CDM,74485WE,DILATION URETERS/URETHRA RS&I,18001.0,11700.65,80.32,18001.0,32
CDM,74485WE-26,DILATION URETERS/URETHRA RS&I,332.0,215.8,22.3,332.0,31
CDM,74485WE-TC,DILATION URETERS/URETHRA RS&I,17669.0,11484.85,68.49,17669.0,35
CDM,74712WE,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,3285.0,2135.25,328.02,3285.0,28
CDM,74712WE-26,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,1200.0,780.0,141.71,1200.0,31
CDM,74712WE-TC,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,2085.0,1355.25,264.49,2085.0,35
CDM,74713WE,FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,3009.0,1955.85,158.34,3009.0,28
CDM,74713WE-26,FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,740.0,481.0,87.52,740.0,31
CDM,74713WE-TC,FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,2269.0,1474.85,110.65,2269.0,35
CDM,74740HYSWE,HYSTEROSALPINGOGRAPHY,2237.0,1454.05,49.44,2237.0,32
CDM,74740PROWE,HYSTEROSALPINGOGRAPHY,152.0,98.8,49.44,152.0,32
CDM,74740WE,HYSTEROSALPINGOGRAPHY RS&I,2237.0,1454.05,49.44,2237.0,32
CDM,74740WE-26,HYSTEROSALPINGOGRAPHY RS&I,152.0,98.8,15.48,152.0,31
CDM,74740WE-TC,HYSTEROSALPINGOGRAPHY RS&I,2085.0,1355.25,52.99,2085.0,35
CDM,74775PERWE,PERINEOGRAM/ VAGINOGRAM,2358.0,1532.7,119.44,2358.0,14
CDM,74775PROWE,PERINEOGRAM/VAGINOGRAM,273.0,177.45,119.44,342.61,14
CDM,74775WE,X-RAY PERINEOGRAM,2358.0,1532.7,119.44,2358.0,14
CDM,74775WE-26,X-RAY PERINEOGRAM,273.0,177.45,26.28,273.0,31
CDM,74775WE-TC,X-RAY PERINEOGRAM,2085.0,1355.25,57.63,2085.0,21
CDM,75000005,ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC,5391.0,3504.15,104.14,6317.0,49
CDM,75000010,SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX,6780.0,4407.0,203.53,7730.0,49
CDM,75000015,ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ,10908.0,7090.2,122.37,9817.2,49
CDM,75000050,COLSC FLX PROX SPLENIC FLXR ABLTJ LES,2636.0,1713.4,442.85,2372.4,21
CDM,75000090,SIGMOIDOSCOPY FLX NDSC US XM,5243.0,3407.95,149.29,6289.0,49
CDM,75000100,SIGMOIDOSCOPY FLX TNDSC STENT PLMT,7670.0,4985.5,1288.56,6903.0,21
CDM,75000110,SIGMOIDOSCOPY FLX ABLTJ LESION,2676.0,1739.4,449.57,2408.4,21
CDM,75000155,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,5391.0,3504.15,147.56,6317.0,49
CDM,75000195,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,5391.0,3504.15,165.65,6317.0,49
CDM,75000200,SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE,5243.0,3407.95,135.99,6289.0,49
CDM,75000210,SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,6780.0,4407.0,144.95,6289.0,49
CDM,75000240,ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,10908.0,7090.2,169.21,9817.2,49
CDM,75000250,ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE,10908.0,7090.2,191.63,9817.2,49
CDM,75000260,ESOPHSCPY W INS TUBE/STENT,8857.0,5757.05,1487.98,7971.3,21
CDM,75000275,EGD FLEXIBLE FOREIGN BODY REMOVAL,5391.0,3504.15,211.19,6317.0,49
CDM,75000280,ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,10908.0,7090.2,154.86,9817.2,49
CDM,75000310,ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM,10908.0,7090.2,187.4,9817.2,49
CDM,75000330,ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,10908.0,7090.2,161.81,9817.2,49
CDM,75000350,ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,10908.0,7090.2,123.65,9817.2,49
CDM,75000470,SGMDSC FLX DIRED SBMCSL NJX ANY SBST,5243.0,3407.95,81.15,6289.0,49
CDM,75000480,SIGMOIDOSCOPY FLX TNDSC BALO DILAT,6780.0,4407.0,94.76,7730.0,49
CDM,75000570,ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES,10908.0,7090.2,169.15,9817.2,49
CDM,75000610,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,5391.0,3504.15,89.14,7730.0,49
CDM,75000730,ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD,5391.0,3504.15,69.38,7730.0,49
CDM,75000760,NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE,5246.0,3409.9,107.7,6317.0,49
CDM,75000765,NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX,5243.0,3407.95,88.52,6317.0,49
CDM,75000775,NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE,5243.0,3407.95,107.7,6317.0,49
CDM,75000820,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,5243.0,3407.95,69.13,4718.7,49
CDM,75000830,SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,5243.0,3407.95,87.42,6289.0,49
CDM,75000840,SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,5243.0,3407.95,113.6,6289.0,49
CDM,75000845,BX ANORECTAL WALL ANAL APPROACH,15769.0,10249.85,379.65,36332.0,49
CDM,75000850,SIGMOIDOSCOPY FLX CONTROL BLEEDING,6780.0,4407.0,141.44,7730.0,49
CDM,75000855,PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX,5243.0,3407.95,58.83,4718.7,49
CDM,75000885,PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY,15769.0,10249.85,103.52,14192.1,49
CDM,75000925,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,5243.0,3407.95,69.13,4718.7,49
CDM,75000935,SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,5243.0,3407.95,87.42,6289.0,49
CDM,75001015,SIGMOIDOSCOPY FLX TNDSC BALO DILAT,6780.0,4407.0,94.76,7730.0,49
CDM,75001055,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,5243.0,3407.95,220.97,6317.0,49
CDM,75001095,COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,6780.0,4407.0,239.42,6317.0,49
CDM,75001105,COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST,6780.0,4407.0,239.42,6317.0,49
CDM,75001145,COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,6780.0,4407.0,302.84,6317.0,49
CDM,75001175,COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX,6780.0,4407.0,307.02,6317.0,49
CDM,75001235,PLACEMENT SETON,15769.0,10249.85,142.37,36332.0,49
CDM,75001245,REMOVAL ANAL SETON OTHER MARKER,6780.0,4407.0,105.61,6102.0,49
CDM,75001255,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,6780.0,4407.0,548.66,36332.0,49
CDM,75001275,I&D PERIANAL ABSCESS SUPERFICIAL,5243.0,3407.95,132.49,4718.7,49
CDM,75001325,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,5243.0,3407.95,255.2,4718.7,49
CDM,75001335,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,15769.0,10249.85,212.14,36332.0,49
CDM,75001345,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,15769.0,10249.85,399.8,36332.0,49
CDM,75001355,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,15769.0,10249.85,441.05,36332.0,49
CDM,75001375,SURG TX ANAL FISTULA INTERSPHINCTERIC,15769.0,10249.85,540.67,36332.0,49
CDM,75001435,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,741.0,481.65,51.37,3920.0,49
CDM,75001445,ANOSCOPY W/DILATION,6780.0,4407.0,80.3,7730.0,49
CDM,75001455,ANOSCOPY W/BX SINGLE/MULTIPLE,6780.0,4407.0,92.01,6102.0,49
CDM,75001485,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,5243.0,3407.95,97.54,7730.0,49
CDM,75001515,DSTRJ LESION ANUS SMPL ELTRDSICCATION,10518.0,6836.7,165.06,9466.2,49
CDM,75001535,DSTRJ LESION ANUS SIMPLE SURG EXCISION,15769.0,10249.85,168.76,14192.1,49
CDM,75001545,DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY,6073.0,3947.45,209.37,5465.7,49
CDM,75001685,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,3051.0,1983.15,181.25,2849.0,41
CDM,75001725,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,3051.0,1983.15,181.25,2745.9,41
CDM,75001755,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,1790.0,1163.5,181.25,1611.0,41
CDM,75001765,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,3051.0,1983.15,181.25,2745.9,41
CDM,75001795,BREATH HYDROGEN/METHANE TEST,900.0,585.0,32.49,810.0,41
CDM,75001885,"COLOSCPY, SCRN;  NOT HI RISK",4559.0,2963.35,221.16,6317.0,48
CDM,75001925,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,6780.0,4407.0,150.63,8370.0,49
CDM,75002265,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT,2295.0,1491.75,113.42,3920.0,49
CDM,75002295,FMT VIA COLONOSCOPY,4559.0,2963.35,84.54,4103.1,32
CDM,75002465,RMVL FECAL IMPACTION/FB SPX UNDER ANES,6780.0,4407.0,289.85,8370.0,49
CDM,75002605,LIVER ELASTOGRAPHY W/O IMAG W/I&R,900.0,585.0,47.19,810.0,49
CDM,75002625,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,5391.0,3504.15,181.25,4851.9,41
CDM,75003040,SCRN COLONOSCOPY ON HI RISK PT,4559.0,2963.35,220.97,6317.0,48
CDM,75003060,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,5243.0,3407.95,220.97,6317.0,49
CDM,75003070,COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,6780.0,4407.0,271.76,6317.0,49
CDM,75003080,COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,6780.0,4407.0,302.84,6317.0,49
CDM,75003090,COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,6780.0,4407.0,239.42,6317.0,49
CDM,75003100,COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD,6780.0,4407.0,307.88,6317.0,49
CDM,75003110,COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE,6780.0,4407.0,268.9,6317.0,49
CDM,75003120,COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX,5243.0,3407.95,187.03,6317.0,49
CDM,75003130,COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE,6780.0,4407.0,205.46,6317.0,49
CDM,75003140,COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT,6780.0,4407.0,252.83,6317.0,49
CDM,75003150,COLSC FLX PROX SPLENIC FLXR TNDSC STENT PLMT,7670.0,4985.5,1288.56,6903.0,21
CDM,75003160,COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST,6780.0,4407.0,239.42,6317.0,49
CDM,75003170,COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX,6780.0,4407.0,307.02,6317.0,49
CDM,75003180,COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL,6780.0,4407.0,361.08,6317.0,49
CDM,75003220,NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX,5243.0,3407.95,88.52,6317.0,49
CDM,75003230,ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING,10908.0,7090.2,456.41,9817.2,49
CDM,75003240,ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY,10908.0,7090.2,217.26,9817.2,49
CDM,75003250,ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING,10908.0,7090.2,285.58,9817.2,49
CDM,75003260,ENDOSCOPY UPPER SMALL INTESTINE,10908.0,7090.2,171.73,9817.2,49
CDM,75003270,ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE,10908.0,7090.2,354.73,9817.2,49
CDM,75003280,ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX,10908.0,7090.2,338.17,9817.2,49
CDM,75003290,ENTEROSCOPY > 2ND PRTN ABLTJ LESION,10908.0,7090.2,292.73,9817.2,49
CDM,75003300,ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY,10908.0,7090.2,189.53,9817.2,49
CDM,75003310,ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE,10908.0,7090.2,228.79,9817.2,49
CDM,75003330,ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE,10908.0,7090.2,243.93,9817.2,49
CDM,75003340,EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM,10908.0,7090.2,183.09,9817.2,49
CDM,75003350,EGD TRANSORAL CONTROL BLEEDING ANY METHOD,10908.0,7090.2,239.22,9817.2,49
CDM,75003360,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,10908.0,7090.2,238.21,9817.2,49
CDM,75003370,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,5391.0,3504.15,147.56,6317.0,49
CDM,75003380,EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS,5391.0,3504.15,198.8,6317.0,49
CDM,75003390,ENDOSCPY UP GI PRIMARY EXAM,2811.0,1827.15,472.25,2529.9,21
CDM,75003400,ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION,5391.0,3504.15,165.65,6317.0,49
CDM,75003410,EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY,10908.0,7090.2,312.4,9817.2,49
CDM,75003420,ENDOSCPY UP GI W ABLT,2924.0,1900.6,491.23,2631.6,21
CDM,75003430,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,5391.0,3504.15,165.65,6317.0,49
CDM,75003440,EGD DILATION GASTRIC/DUODENAL STRICTURE,10908.0,7090.2,209.68,9817.2,49
CDM,75003450,EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS,10908.0,7090.2,277.21,9817.2,49
CDM,75003460,ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS,10908.0,7090.2,233.66,9817.2,49
CDM,75003470,EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS,10908.0,7090.2,203.41,9817.2,49
CDM,75003480,EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,10908.0,7090.2,282.24,9817.2,49
CDM,75003490,EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,10908.0,7090.2,292.21,9817.2,49
CDM,75003500,EGD FLEXIBLE FOREIGN BODY REMOVAL,5391.0,3504.15,211.19,6317.0,49
CDM,75003510,EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH,10908.0,7090.2,233.48,9817.2,49
CDM,75003520,ENDOSCPY UP GI W STENT PLC,8857.0,5757.05,1487.98,7971.3,21
CDM,75003530,EGD DELIVER THERMAL ENERGY SPHNCTR/CARDIA GERD,21876.0,14219.4,276.88,19688.4,42
CDM,75003540,EGD INTRALUMINAL TUBE/CATHETER INSERTION,10908.0,7090.2,170.29,9817.2,49
CDM,75003550,EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM,10908.0,7090.2,269.37,9817.2,49
CDM,75003560,ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING,21876.0,14219.4,382.47,36332.0,49
CDM,75003570,ERCP W ABLT TUMOR,7561.0,4914.65,1270.25,6804.9,21
CDM,75003580,ERCP W/BIOPSY SINGLE/MULTIPLE,21876.0,14219.4,402.2,36332.0,49
CDM,75003590,ERCP W DIL DUCT,7561.0,4914.65,1270.25,6804.9,21
CDM,75003600,ERCP W INS NASO DRN TUBE,7561.0,4914.65,1270.25,6804.9,21
CDM,75003610,ERCP W INS TUBE/STENT DUCT,8857.0,5757.05,1487.98,7971.3,21
CDM,75003620,ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD,34229.0,22248.85,513.59,36332.0,49
CDM,75003640,ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT,21876.0,14219.4,432.01,36332.0,49
CDM,75003650,ERCP W RMVL FB CHG TUBE,8857.0,5757.05,1487.98,7971.3,21
CDM,75003660,ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,21876.0,14219.4,423.98,36332.0,49
CDM,75003670,ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC,5391.0,3504.15,104.14,6317.0,49
CDM,75003680,ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX,10908.0,7090.2,240.03,9817.2,49
CDM,75003710,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,5391.0,3504.15,181.25,4851.9,41
CDM,75003720,COLONOSCOPY STOMA W/TNDSC STENT PLMT,7670.0,4985.5,1288.56,6903.0,21
CDM,75003730,SCRN COLONOSCOPY PT NOT HI RISK,4559.0,2963.35,221.16,6317.0,48
CDM,75003740,COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS,6780.0,4407.0,238.17,6317.0,49
CDM,75003750,COLONOSCOPY STOMA CONTROL BLEEDING,6780.0,4407.0,274.62,6317.0,49
CDM,75003760,COLONOSCOPY STOMA W/RMVL FOREIGN BODY,5243.0,3407.95,251.08,6317.0,49
CDM,75003770,COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S),6780.0,4407.0,284.2,6317.0,49
CDM,75003780,ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC,6046.0,3929.9,140.31,36332.0,38
CDM,75003790,ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT,34229.0,22248.85,486.63,30806.1,42
CDM,75003800,EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST,34229.0,22248.85,465.52,30806.1,49
CDM,75003810,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,3051.0,1983.15,181.25,2745.9,41
CDM,75003820,ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS,10908.0,7090.2,160.08,9817.2,42
CDM,75003830,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,15769.0,10249.85,212.14,36332.0,49
CDM,75003840,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,15769.0,10249.85,399.8,36332.0,49
CDM,75003850,INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN,15769.0,10249.85,459.96,14192.1,49
CDM,75003860,INT HRHC BY LIGATION 2+ HROID W/O IMG GDN,15769.0,10249.85,498.98,36332.0,49
CDM,75003870,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,15769.0,10249.85,441.05,36332.0,49
CDM,75003880,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,5243.0,3407.95,255.2,4718.7,49
CDM,75003890,UNLISTED PROCEDURE INTESTINE,6439.0,4185.35,941.1,6317.0,48
CDM,75003900,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,6780.0,4407.0,150.63,8370.0,49
CDM,75003910,SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY,6780.0,4407.0,127.01,6289.0,49
CDM,75003920,ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY,10908.0,7090.2,228.94,9817.2,49
CDM,75003930,I&D PERIANAL ABSCESS SUPERFICIAL,5243.0,3407.95,132.49,4718.7,49
CDM,75003940,ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX,15769.0,10249.85,129.34,36332.0,49
CDM,75003950,PLACEMENT SETON,15769.0,10249.85,142.37,36332.0,49
CDM,75003960,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,741.0,481.65,51.37,3920.0,49
CDM,75003970,DUODENAL INTUBAT W/IMAG GUIDED MULTIPLE SPECIMEN,5391.0,3504.15,92.88,4851.9,49
CDM,75003990,ANOSCOPY W/BX SINGLE/MULTIPLE,6780.0,4407.0,92.01,6102.0,49
CDM,75004000,CHEMODENERVATION INTERNAL ANAL SPHINCTER,6780.0,4407.0,313.56,36332.0,49
CDM,75004010,I&D INTRAMURAL IM/ABSC TRANSANAL ANES,15769.0,10249.85,560.46,36332.0,49
CDM,75004020,DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL,6780.0,4407.0,212.24,36332.0,49
CDM,75004030,ANOSCOPY W/DILATION,6780.0,4407.0,80.3,7730.0,49
CDM,75004040,ESOPHSCPY W ABLT,5268.0,3424.2,885.02,4741.2,21
CDM,75004050,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,5391.0,3504.15,181.25,4851.9,41
CDM,75004060,FECAL MICROBIOTA PREP INSTIL,4559.0,2963.35,84.54,4103.1,32
CDM,75004070,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,1790.0,1163.5,82.59,1611.0,41
CDM,75004080,PROC GASTROENTERO UNLISTED (COMP 91110),485.0,315.25,125.62,521.0,40
CDM,75004100,UNLISTED PROCEDURE INTESTINE,2363.0,1535.95,664.0,6317.0,48
CDM,75004110,UNLISTED PROCEDURE ANUS,777.0,505.05,218.34,8370.0,48
CDM,75004120,UNLISTED PROCEDURE BILIARY TRACT,3151.0,2048.15,816.11,8370.0,48
CDM,75004130,ESOPHAGOSCOPY FLEXIBLE TRANSORAL MUCOSAL RESEXN,10908.0,7090.2,280.2,9817.2,49
CDM,75004140,ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT,34229.0,22248.85,226.8,30806.1,42
CDM,75004150,ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM,10908.0,7090.2,225.51,9817.2,49
CDM,75004160,ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION,21876.0,14219.4,235.25,19688.4,42
CDM,75004170,EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER,10908.0,7090.2,272.31,9817.2,49
CDM,75004180,EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER,10908.0,7090.2,312.59,9817.2,49
CDM,75004190,EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION,10908.0,7090.2,321.48,9817.2,49
CDM,75005000,EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION,34229.0,22248.85,259.72,30806.1,42
CDM,75005010,EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE,10908.0,7090.2,267.64,9817.2,49
CDM,75005020,ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT,34229.0,22248.85,548.63,30806.1,42
CDM,75005030,ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT,10908.0,7090.2,446.84,9817.2,42
CDM,75005040,ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE,34229.0,22248.85,571.5,30806.1,42
CDM,75005050,ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA,21876.0,14219.4,449.45,36332.0,49
CDM,75005060,ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE,21876.0,14219.4,513.07,36332.0,49
CDM,75005070,UNLISTED PROCEDURE ESOPHAGUS,2113.0,1373.45,593.75,13665.0,48
CDM,75005080,UNLISTED PROCEDURE STOMACH,2324.0,1510.6,653.04,7730.0,48
CDM,75005090,ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH,34015.0,22109.75,633.93,30613.5,42
CDM,75005100,ILEOSCOPY STOMA W/BALLOON DILATION,10908.0,7090.2,102.2,9817.2,49
CDM,75005110,ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT,10908.0,7090.2,183.26,9817.2,42
CDM,75005120,COLONOSCOPY STOMA ABLATION LESION,6780.0,4407.0,288.75,6317.0,49
CDM,75005130,COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT,34229.0,22248.85,311.04,30806.1,42
CDM,75005140,COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ,6780.0,4407.0,361.43,6317.0,49
CDM,75005150,COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION,6780.0,4407.0,204.91,6317.0,49
CDM,75005160,COLONOSCOPY STOMA W/BALLOON DILATION,6780.0,4407.0,219.2,6317.0,49
CDM,75005170,COLONOSCOPY STOMA W/ENDOSCOPIC ULTRASOUND EXAM,6780.0,4407.0,273.74,6317.0,49
CDM,75005180,COLONOSCOPY STOMA W/US GID NDL ASPIR/BX,6780.0,4407.0,327.59,6317.0,49
CDM,75005190,COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION,5243.0,3407.95,276.17,6317.0,49
CDM,75005200,SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES,6780.0,4407.0,192.18,7730.0,49
CDM,75005210,SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT,34229.0,22248.85,184.21,30806.1,42
CDM,75005220,SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION,15769.0,10249.85,236.79,14192.1,49
CDM,75005230,SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S),6780.0,4407.0,121.59,7730.0,49
CDM,75005240,COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES,6780.0,4407.0,322.23,6317.0,49
CDM,75005250,COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT,34229.0,22248.85,343.94,30806.1,42
CDM,75005260,COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION,15769.0,10249.85,395.05,14192.1,49
CDM,75005270,COLONOSCOPY FLEXIBLE WITH DECOMPRESSION,6780.0,4407.0,297.96,6317.0,49
CDM,75005280,COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S),6780.0,4407.0,280.48,6317.0,49
CDM,75005290,UNLISTED PROCEDURE COLON,2156.0,1401.4,605.04,2932.0,41
CDM,75005300,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT,741.0,481.65,113.42,3920.0,49
CDM,75005310,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX,6780.0,4407.0,151.08,6289.0,49
CDM,75005330,ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT,34229.0,22248.85,318.03,30806.1,42
CDM,75005340,ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM,10908.0,7090.2,140.73,9817.2,49
CDM,75005350,EGD PARTIAL/COMPL ESOPHAGOGASTRIC FUNDOPLASTY,59865.0,38912.25,509.9,53878.5,42
CDM,75005360,ESOPHAGOSCOPY RETROGRADE DILATE BALLOON/OTHER,10908.0,7090.2,302.96,9817.2,49
CDM,75005370,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,35879.0,23321.35,353.76,32291.1,42
CDM,75005380,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,35879.0,23321.35,355.15,32291.1,42
CDM,75005390,BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS,20293.0,13190.45,544.8,22573.24,42
CDM,75005400,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,20293.0,13190.45,422.92,18263.7,42
CDM,75005410,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,59865.0,38912.25,479.26,53878.5,42
CDM,75005420,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,10908.0,7090.2,285.64,9817.2,49
CDM,75005430,UNLISTED PROCEDURE RECTUM,1480.0,962.0,383.32,7730.0,48
CDM,75011405,EGD-PANCREATIC NECROSECTOMY HB,8303.0,5396.95,706.25,7472.7,41
CDM,75011995,GI TRACT IMAGING INTRALUMINAL ESOPHAGUS WI&R,5391.0,3504.15,181.25,4851.9,41
CDM,75012115,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,1399.0,909.35,46.01,4151.0,49
CDM,75012125,PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC,1399.0,909.35,106.78,4151.0,49
CDM,75012145,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,1399.0,909.35,46.01,4151.0,49
CDM,75012155,PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC,1399.0,909.35,106.78,4151.0,49
CDM,75012175,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC,5391.0,3504.15,93.54,6317.0,49
CDM,75012215,GI LEVEL 1 1ST 30 MIN,4243.0,2757.95,712.82,3818.7,21
CDM,75012225,GI LEVEL 2 1ST 30 MIN,5230.0,3399.5,878.64,4707.0,21
CDM,75012235,GI LEVEL 3 1ST 30 MIN,5894.0,3831.1,990.19,5304.6,21
CDM,75012245,GI LEVEL 4 1ST 30 MIN,6469.0,4204.85,1086.79,5822.1,21
CDM,75012255,GI LEVEL 5 1ST 30 MIN,7269.0,4724.85,1221.19,6542.1,21
CDM,75012265,GI LEVEL 1 EA ADD 30 MIN,3124.0,2030.6,524.83,2811.6,21
CDM,75012275,GI LEVEL 2 EA ADD 30 MIN,4104.0,2667.6,689.47,3693.6,21
CDM,75012285,GI LEVEL 3 EA ADD 30 MIN,4789.0,3112.85,804.55,4310.1,21
CDM,75012295,GI LEVEL 4 EA ADD 30 MIN,5371.0,3491.15,902.33,4833.9,21
CDM,75012305,GI LEVEL 5 EA ADD 30 MIN,6208.0,4035.2,1042.94,5587.2,21
CDM,75012415,I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON,15769.0,10249.85,621.91,36332.0,49
CDM,75012475,CHEMODENERVATION INTERNAL ANAL SPHINCTER,6780.0,4407.0,313.56,36332.0,49
CDM,75012665,UNLISTED LAP ESOPHAGUS,15181.0,9867.65,2220.45,15789.0,41
CDM,75012675,CLOSING FISTULA (COMP 43255),2956.0,1921.4,830.64,6317.0,48
CDM,75012685,EGD WITH VACCUM (97605 COMP) WOUND VAC ABDOMEN,245.0,159.25,68.85,13665.0,48
CDM,75012695,ENETROSC LOWER DEVICE (45380 COMP),3033.0,1971.45,852.27,6317.0,48
CDM,75012705,GI TRACT IMAGING INTRALUMINAL COLON I&R,5243.0,3407.95,181.25,4718.7,38
CDM,75012765,INSTLJ FECAL MICROBIOTA SSP RCT NMA LWR GI TRC,645.0,419.25,129.39,2932.0,34
CDM,75012895,RECTAL SENSATION TONE&COMPLIANCE STUDY,1903.0,1236.95,82.59,2849.0,31
CDM,75012905,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,2193.0,1425.45,82.59,2849.0,31
CDM,75557CARWE,"CARD MRI MORPH/FUNC W/O C,INCL 3D",3025.0,1966.25,257.23,3025.0,32
CDM,75557PROWE,"CARD MRI MORPH FUNC,W/O C",940.0,611.0,257.23,940.0,32
CDM,75557WE,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,3025.0,1966.25,257.23,3025.0,32
CDM,75557WE-26,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,940.0,611.0,97.74,940.0,31
CDM,75557WE-TC,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,2085.0,1355.25,166.43,2085.0,35
CDM,75561CARWE,"CARD MRI MORPH/FUNCTION W/WO C,INCL 3D",4224.0,2745.6,334.15,4224.0,32
CDM,75561PROWE,"CARD MRI W/W/O C MORPH,FUNC",1144.0,743.6,334.15,1144.0,32
CDM,75561WE,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,4224.0,2745.6,334.15,4224.0,32
CDM,75561WE-26,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,1144.0,743.6,107.83,1144.0,31
CDM,75561WE-TC,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,3080.0,2002.0,237.37,3080.0,35
CDM,75563WE,CARD MRI W/W/O CON W/STRESS IMAGE,8014.0,5209.1,393.87,8014.0,32
CDM,75563WE-26,CARD MRI W/W/O CON W/STRESS IMAGE,1200.0,780.0,125.75,1200.0,31
CDM,75563WE-TC,CARD MRI W/W/O CON W/STRESS IMAGE,6814.0,4429.1,278.7,6814.0,35
CDM,75565CARWE,CARD MRI VEL FLW MAP ADD ON,818.0,531.7,42.45,818.0,32
CDM,75565PROWE,CARD MRI VEL FLW MAP ADD ON,110.0,71.5,42.45,110.0,32
CDM,75565WE,CARDIAC MRI FOR VELOCITY FLOW MAPPING,818.0,531.7,42.45,818.0,32
CDM,75565WE-26,CARDIAC MRI FOR VELOCITY FLOW MAPPING,110.0,71.5,10.08,110.0,31
CDM,75565WE-TC,CARDIAC MRI FOR VELOCITY FLOW MAPPING,708.0,460.2,32.6,708.0,35
CDM,75571AWE,CT CALCIUM SCORING - SELF PAY,992.0,644.8,50.09,992.0,32
CDM,75571AWE-26,CT CALCIUM SCORING - SELF PAY,232.0,150.8,22.86,232.0,31
CDM,75571AWE-TC,CT CALCIUM SCORING - SELF PAY,760.0,494.0,72.81,760.0,35
CDM,75571PROWE,CT HEART W/O DYE W/COR CALCIUM,232.0,150.8,50.09,232.0,32
CDM,75571WE,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,992.0,644.8,50.09,992.0,32
CDM,75571WE-26,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,232.0,150.8,22.86,232.0,31
CDM,75571WE-TC,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,760.0,494.0,72.81,760.0,35
CDM,75572CTAWE,CTA HEART W/WO C W/STRXR MORPH,3780.0,2457.0,168.41,3780.0,32
CDM,75572PROWE,CCTA W/WO C W/STRXR MORPHOLOGY,700.0,455.0,168.41,700.0,32
CDM,75572WE,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,3780.0,2457.0,168.41,3780.0,32
CDM,75572WE-26,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,700.0,455.0,69.73,700.0,31
CDM,75572WE-TC,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,3080.0,2002.0,146.02,3080.0,35
CDM,75573CTAWE,CTA HRT W/STRXR MORPH CONGENTL,4100.0,2665.0,231.6,4100.0,32
CDM,75573PROWE,CTA  HEART W/WO C W/STXR MORPH CONGENTL,1020.0,663.0,231.6,1020.0,32
CDM,75573WE,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,4100.0,2665.0,231.6,4100.0,32
CDM,75573WE-26,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,1020.0,663.0,101.97,1020.0,31
CDM,75573WE-TC,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,3080.0,2002.0,186.3,3080.0,35
CDM,75574CTAWE,"CTA HRT W/ARTERY,STRX,MORPH IF DONE",4040.0,2626.0,283.81,4040.0,32
CDM,75574PROWE,"CTA HRT W/ARTERY,STRX,MORPH IF DONE",960.0,624.0,283.81,960.0,32
CDM,75574WE,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,4040.0,2626.0,283.81,4040.0,32
CDM,75574WE-26,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,960.0,624.0,96.0,960.0,31
CDM,75574WE-TC,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,3080.0,2002.0,209.86,3080.0,35
CDM,75577WE,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,8572.0,5571.8,1031.28,8572.0,21
CDM,75577WE-26,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,374.0,243.1,42.86,374.0,25
CDM,75577WE-TC,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,8198.0,5328.7,988.42,8198.0,29
CDM,75580WE,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,9105.0,5918.25,616.76,9105.0,28
CDM,75580WE-26,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,330.0,214.5,34.37,330.0,31
CDM,75580WE-TC,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,8775.0,5703.75,805.07,8775.0,35
CDM,75600WE,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,27344.0,17773.6,164.53,27344.0,32
CDM,75600WE-26,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,196.0,127.4,20.89,196.0,31
CDM,75600WE-TC,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,27148.0,17646.2,146.09,27148.0,35
CDM,75605WE,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,47126.0,30631.9,109.85,47126.0,32
CDM,75605WE-26,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,502.0,326.3,47.87,502.0,31
CDM,75605WE-TC,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,46624.0,30305.6,66.03,46624.0,35
CDM,75625WE,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,27724.0,18020.6,113.57,27724.0,32
CDM,75625WE-26,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,576.0,374.4,48.29,576.0,31
CDM,75625WE-TC,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,27148.0,17646.2,57.07,27148.0,35
CDM,75630WE,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,27948.0,18166.2,144.38,27948.0,32
CDM,75630WE-26,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,800.0,520.0,74.15,800.0,31
CDM,75630WE-TC,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,27148.0,17646.2,62.16,27148.0,35
CDM,75635CTAWE,CTA ABD AORTA FEMILIO RUNOFF,2495.0,1621.75,315.85,2495.0,32
CDM,75635PROWE,"CT ANGIO,ABD AORTA,ILIO",960.0,624.0,315.85,960.0,32
CDM,75635WE,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,2495.0,1621.75,315.85,2495.0,32
CDM,75635WE-26,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,960.0,624.0,99.44,960.0,31
CDM,75635WE-TC,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,1535.0,997.75,211.4,1535.0,35
CDM,75705WE,ANGIOGRAPHY SPINAL SELECTIVE RS&I,47496.0,30872.4,193.12,47496.0,32
CDM,75705WE-26,ANGIOGRAPHY SPINAL SELECTIVE RS&I,872.0,566.8,89.93,872.0,31
CDM,75705WE-TC,ANGIOGRAPHY SPINAL SELECTIVE RS&I,46624.0,30305.6,136.01,46624.0,35
CDM,75710WE,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,27848.0,18101.2,130.55,27848.0,32
CDM,75710WE-26,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,700.0,455.0,46.44,700.0,31
CDM,75710WE-TC,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,27148.0,17646.2,65.71,27148.0,35
CDM,75716WE,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,27936.0,18158.4,149.34,27936.0,32
CDM,75716WE-26,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,788.0,512.2,55.11,788.0,31
CDM,75716WE-TC,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,27148.0,17646.2,69.58,27148.0,35
CDM,75726WE,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,47444.0,30838.6,128.29,47444.0,32
CDM,75726WE-26,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,820.0,533.0,47.73,820.0,31
CDM,75726WE-TC,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,46624.0,30305.6,75.39,46624.0,35
CDM,75731WE,ANGIO ADRENAL UNILAT SELECT,27650.0,17972.5,130.31,27650.0,32
CDM,75731WE-26,ANGIO ADRENAL UNILAT SELECT,502.0,326.3,47.45,502.0,31
CDM,75731WE-TC,ANGIO ADRENAL UNILAT SELECT,27148.0,17646.2,98.24,27148.0,35
CDM,75733WE,ANGIO ADRENAL BILAT SELECT,27724.0,18020.6,148.1,27724.0,32
CDM,75733WE-26,ANGIO ADRENAL BILAT SELECT,576.0,374.4,54.56,576.0,31
CDM,75733WE-TC,ANGIO ADRENAL BILAT SELECT,27148.0,17646.2,110.11,27148.0,35
CDM,75736WE,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,47080.0,30602.0,129.57,47080.0,32
CDM,75736WE-26,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,456.0,296.4,46.44,456.0,31
CDM,75736WE-TC,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,46624.0,30305.6,91.14,46624.0,35
CDM,75741WE,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,27672.0,17986.8,119.39,27672.0,32
CDM,75741WE-26,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,524.0,340.6,54.26,524.0,31
CDM,75741WE-TC,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,27148.0,17646.2,68.29,27148.0,35
CDM,75743WE,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,27812.0,18077.8,135.75,27812.0,32
CDM,75743WE-26,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,664.0,431.6,69.03,664.0,31
CDM,75743WE-TC,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,27148.0,17646.2,69.58,27148.0,35
CDM,75746WE,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,27650.0,17972.5,122.33,27650.0,32
CDM,75746WE-26,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,502.0,326.3,47.59,502.0,31
CDM,75746WE-TC,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,27148.0,17646.2,81.2,27148.0,35
CDM,75756WE,ANGIOGRAPHY INTERNAL MAMMARY RS&I,27604.0,17942.6,137.91,27604.0,32
CDM,75756WE-26,ANGIOGRAPHY INTERNAL MAMMARY RS&I,456.0,296.4,54.57,456.0,31
CDM,75756WE-TC,ANGIOGRAPHY INTERNAL MAMMARY RS&I,27148.0,17646.2,105.34,27148.0,35
CDM,75774WE,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,5632.0,3660.8,74.05,5632.0,32
CDM,75774WE-26,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,404.0,262.6,15.2,404.0,31
CDM,75774WE-TC,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,5228.0,3398.2,49.0,5228.0,35
CDM,75801WE,LYMPHANGIOGRAM EXTREM UNILATER,5657.0,3677.05,168.59,5657.0,14
CDM,75801WE-26,LYMPHANGIOGRAM EXTREM UNILATER,324.0,210.6,39.79,324.0,31
CDM,75801WE-TC,LYMPHANGIOGRAM EXTREM UNILATER,5333.0,3466.45,213.81,5333.0,21
CDM,75803WE,LYMPHANGIO EXTREM BILAT,13914.0,9044.1,181.18,13914.0,14
CDM,75803WE-26,LYMPHANGIO EXTREM BILAT,515.0,334.75,50.29,515.0,31
CDM,75803WE-TC,LYMPHANGIO EXTREM BILAT,13399.0,8709.35,213.81,13399.0,21
CDM,75805WE,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,27472.0,17856.8,186.05,27472.0,14
CDM,75805WE-26,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,324.0,210.6,34.81,324.0,31
CDM,75805WE-TC,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,27148.0,17646.2,241.2,27148.0,21
CDM,75807WE,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,27616.0,17950.4,198.7,27616.0,14
CDM,75807WE-26,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,468.0,304.2,50.29,468.0,31
CDM,75807WE-TC,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,27148.0,17646.2,240.48,27148.0,21
CDM,75809WE,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,1125.0,731.25,60.44,1125.0,32
CDM,75809WE-26,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,207.0,134.55,20.03,207.0,31
CDM,75809WE-TC,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,918.0,596.7,56.74,918.0,35
CDM,75810WE,SPLENOPORTOGRAM,456.0,296.4,49.06,456.0,31
CDM,75820WE,VENOGRAPHY EXTREMITY UNILATERAL RS&I,13819.0,8982.35,73.1,13819.0,32
CDM,75820WE-26,VENOGRAPHY EXTREMITY UNILATERAL RS&I,420.0,273.0,29.26,420.0,31
CDM,75820WE-TC,VENOGRAPHY EXTREMITY UNILATERAL RS&I,13399.0,8709.35,56.42,13399.0,35
CDM,75822WE,VENOGRAPHY EXTREMITY BILATERAL RS&I,13991.0,9094.15,80.16,13991.0,32
CDM,75822WE-26,VENOGRAPHY EXTREMITY BILATERAL RS&I,592.0,384.8,44.17,592.0,31
CDM,75822WE-TC,VENOGRAPHY EXTREMITY BILATERAL RS&I,13399.0,8709.35,62.88,13399.0,35
CDM,75825WE,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,27650.0,17972.5,104.37,27650.0,32
CDM,75825WE-26,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,502.0,326.3,47.44,502.0,31
CDM,75825WE-TC,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,27148.0,17646.2,59.33,27148.0,35
CDM,75827WE,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,13855.0,9005.75,109.07,13855.0,32
CDM,75827WE-26,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,456.0,296.4,46.72,456.0,31
CDM,75827WE-TC,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,13399.0,8709.35,62.88,13399.0,35
CDM,75831WE,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,27604.0,17942.6,114.49,27604.0,32
CDM,75831WE-26,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,456.0,296.4,51.14,456.0,31
CDM,75831WE-TC,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,27148.0,17646.2,67.32,27148.0,35
CDM,75833WE,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,27744.0,18033.6,134.38,27744.0,32
CDM,75833WE-26,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,596.0,387.4,60.21,596.0,31
CDM,75833WE-TC,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,27148.0,17646.2,76.68,27148.0,35
CDM,75840WE,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,27604.0,17942.6,117.53,27604.0,32
CDM,75840WE-26,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,456.0,296.4,53.3,456.0,31
CDM,75840WE-TC,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,27148.0,17646.2,72.49,27148.0,35
CDM,75860WE,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,27604.0,17942.6,114.79,27604.0,32
CDM,75860WE-26,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,456.0,296.4,48.3,456.0,31
CDM,75860WE-TC,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,27148.0,17646.2,71.2,27148.0,35
CDM,75870WE,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,27650.0,17972.5,121.09,27650.0,32
CDM,75870WE-26,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,502.0,326.3,47.59,502.0,31
CDM,75870WE-TC,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,27148.0,17646.2,101.54,27148.0,35
CDM,75872WE,VENOGRAM EPIDURAL,5835.0,3792.75,120.79,5835.0,32
CDM,75872WE-26,VENOGRAM EPIDURAL,502.0,326.3,51.61,502.0,31
CDM,75872WE-TC,VENOGRAM EPIDURAL,5333.0,3466.45,72.49,5333.0,35
CDM,75880WE,VENOGRAM ORBITAL,5641.0,3666.65,75.63,5641.0,32
CDM,75880WE-26,VENOGRAM ORBITAL,308.0,200.2,28.98,308.0,31
CDM,75880WE-TC,VENOGRAM ORBITAL,5333.0,3466.45,72.49,5333.0,35
CDM,75885WE,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,27724.0,18020.6,124.74,27724.0,32
CDM,75885WE-26,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,576.0,374.4,59.66,576.0,31
CDM,75885WE-TC,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,27148.0,17646.2,70.87,27148.0,35
CDM,75887WE,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,27724.0,18020.6,126.5,27724.0,32
CDM,75887WE-26,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,576.0,374.4,58.09,576.0,31
CDM,75887WE-TC,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,27148.0,17646.2,70.87,27148.0,35
CDM,75889WE,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,27604.0,17942.6,112.64,27604.0,32
CDM,75889WE-26,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,456.0,296.4,47.3,456.0,31
CDM,75889WE-TC,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,27148.0,17646.2,70.55,27148.0,35
CDM,75891WE,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,27604.0,17942.6,113.18,27604.0,32
CDM,75891WE-26,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,456.0,296.4,47.3,456.0,31
CDM,75891WE-TC,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,27148.0,17646.2,70.87,27148.0,35
CDM,75893WE,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,46840.0,30446.0,93.13,46840.0,32
CDM,75893WE-26,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,216.0,140.4,21.45,216.0,31
CDM,75893WE-TC,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,46624.0,30305.6,78.3,46624.0,35
CDM,75894WE,TRANSCATHETER EMBOLIZATION ANY METH RS&I,4415.0,2869.75,335.01,4415.0,22
CDM,75894WE-26,TRANSCATHETER EMBOLIZATION ANY METH RS&I,524.0,340.6,57.67,524.0,31
CDM,75894WE-TC,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3891.0,2529.15,193.26,3891.0,29
CDM,75898WE,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,27808.0,18075.2,127.06,27808.0,22
CDM,75898WE-26,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,660.0,429.0,73.31,660.0,31
CDM,75898WE-TC,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,27148.0,17646.2,41.61,27148.0,29
CDM,75901WE,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,1096.0,712.4,102.84,1096.0,32
CDM,75901WE-26,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,196.0,127.4,20.31,196.0,31
CDM,75901WE-TC,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,900.0,585.0,128.81,900.0,35
CDM,75902WE,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,680.0,442.0,63.19,680.0,32
CDM,75902WE-26,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,156.0,101.4,16.76,156.0,31
CDM,75902WE-TC,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,524.0,340.6,50.11,524.0,35
CDM,75970WE,TRANSVASCULAR BIOPSY,4920.0,3198.0,326.59,4920.0,14
CDM,75970WE-26,TRANSVASCULAR BIOPSY,332.0,215.8,35.37,332.0,31
CDM,75970WE-TC,TRANSVASCULAR BIOPSY,4588.0,2982.2,424.72,4588.0,21
CDM,75984WE,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,1646.0,1069.9,76.48,1646.0,32
CDM,75984WE-26,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,332.0,215.8,29.83,332.0,31
CDM,75984WE-TC,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,1314.0,854.1,55.45,1314.0,35
CDM,75989PROWE,PERQ DRAIN W/PLCMT CATH,476.0,309.4,98.08,476.0,32
CDM,75989RADWE,RAD GUIDE PERC DRAINAGE,3135.0,2037.75,98.08,3135.0,32
CDM,75989WE,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,3135.0,2037.75,98.08,3135.0,32
CDM,75989WE-26,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,476.0,309.4,48.43,476.0,31
CDM,75989WE-TC,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2659.0,1728.35,54.48,2659.0,35
CDM,76000FLUWE,FLUOROSCOPY <1 HOUR,2205.0,1433.25,39.26,2205.0,32
CDM,76000PROWE,FLUOROSCOPY <1 HOUR,120.0,78.0,39.26,120.0,32
CDM,76000WE,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,2205.0,1433.25,39.26,2205.0,32
CDM,76000WE-26,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,120.0,78.0,7.25,120.0,31
CDM,76000WE-TC,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,2085.0,1355.25,27.37,2085.0,35
CDM,76010PROWE,"FOREIGN BDY,NOSE-RECT PED",72.0,46.8,20.93,72.0,32
CDM,76010WE,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,832.0,540.8,20.93,832.0,32
CDM,76010WE-26,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,72.0,46.8,7.53,72.0,31
CDM,76010WE-TC,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,760.0,494.0,15.94,760.0,35
CDM,76014WE,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,364.0,236.6,7.42,364.0,25
CDM,76014WE-26,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,153.0,99.45,76.5,153.0,12
CDM,76014WE-TC,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,211.0,137.15,105.5,211.0,12
CDM,76015WE,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,1145.0,744.25,35.76,1145.0,25
CDM,76015WE-26,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,716.0,465.4,358.0,716.0,12
CDM,76015WE-TC,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,429.0,278.85,214.5,429.0,12
CDM,76016WE,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,1024.0,665.6,50.48,1024.0,25
CDM,76016WE-26,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,264.0,171.6,27.9,264.0,28
CDM,76016WE-TC,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,760.0,494.0,44.4,760.0,32
CDM,76017WE,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,2419.0,1572.35,153.74,2419.0,25
CDM,76017WE-26,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,334.0,217.1,35.59,334.0,28
CDM,76017WE-TC,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,2085.0,1355.25,186.4,2085.0,32
CDM,76018WE,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,1121.0,728.65,78.71,1121.0,25
CDM,76018WE-26,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,330.0,214.5,34.69,330.0,28
CDM,76018WE-TC,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,791.0,514.15,77.73,791.0,32
CDM,76019WE,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,777.0,505.05,102.02,777.0,25
CDM,76019WE-26,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,264.0,171.6,28.08,264.0,28
CDM,76019WE-TC,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,513.0,333.45,118.72,513.0,32
CDM,76080WE,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,4945.0,3214.25,46.76,4945.0,32
CDM,76080WE-26,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,216.0,140.4,22.3,216.0,31
CDM,76080WE-TC,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,4729.0,3073.85,30.3,4729.0,35
CDM,76098WE,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,4853.0,3154.45,16.01,4853.0,32
CDM,76098WE-26,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,124.0,80.6,6.68,124.0,31
CDM,76098WE-TC,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,4729.0,3073.85,9.33,4729.0,35
CDM,76100010,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1861.0,1209.65,57.95,3920.0,35
CDM,76100030,THERAPEUTIC APHERESIS PLASMA PHERESIS,11783.0,7658.95,109.24,10604.7,46
CDM,76100040,THERAPEUTIC APHERESIS PLATELETS,3143.0,2042.95,123.09,7730.0,46
CDM,76100050,THERAPEUTIC APHERESIS RED BLOOD CELLS,11783.0,7658.95,121.22,10604.7,46
CDM,76100055,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,2298.0,1493.7,63.06,4151.0,46
CDM,76100060,THERAPEUTIC APHERESIS WHITE BLOOD CELLS,11783.0,7658.95,126.91,10604.7,46
CDM,76100070,UNLISTED VASC PROCEDURE,3785.0,2460.25,620.6,13665.0,44
CDM,76100075,ACNE SURGERY,745.0,484.25,58.43,3920.0,46
CDM,76100080,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,2384.0,1549.6,55.93,3920.0,46
CDM,76100085,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,745.0,484.25,98.33,4151.0,46
CDM,76100095,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1499.0,974.35,98.33,4151.0,46
CDM,76100100,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,2298.0,1493.7,33.94,2068.2,38
CDM,76100105,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,2639.0,1715.35,98.33,4151.0,46
CDM,76100110,THERAPEUTIC APHERESIS WHITE BLOOD CELLS,11783.0,7658.95,126.91,10604.7,46
CDM,76100115,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,2639.0,1715.35,213.06,4268.0,46
CDM,76100120,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN,188.0,122.2,31.58,169.2,22
CDM,76100125,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,1499.0,974.35,98.33,4151.0,46
CDM,76100130,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,5391.0,3504.15,92.62,4851.9,46
CDM,76100135,I&D HEMATOMA SEROMA/FLUID COLLECTION,6076.0,3949.4,147.52,5468.4,46
CDM,76100140,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,5391.0,3504.15,126.21,4851.9,46
CDM,76100145,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,10733.0,6976.45,219.77,13665.0,46
CDM,76100150,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,11779.0,7656.35,171.65,13665.0,46
CDM,76100160,INSJ NON-NDWELLG BLADDER CATHETER,741.0,481.65,30.28,3920.0,46
CDM,76100170,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,741.0,481.65,31.01,3920.0,46
CDM,76100180,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,900.0,585.0,53.02,3920.0,46
CDM,76100185,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,1499.0,974.35,73.55,4214.0,46
CDM,76100190,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,341.0,221.65,18.23,3920.0,46
CDM,76100195,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,6076.0,3949.4,269.11,6317.0,46
CDM,76100200,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,5973.0,3882.45,77.17,5375.7,46
CDM,76100210,INSERTION PICC W/O IMG GDN 5 YR/>,11165.0,7257.25,116.38,10048.5,46
CDM,76100215,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,745.0,484.25,19.58,3920.0,46
CDM,76100220,COMPLETE REPLACEMENT PICC RS&I,11165.0,7257.25,70.91,10048.5,46
CDM,76100225,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,745.0,484.25,36.39,3920.0,46
CDM,76100230,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,2384.0,1549.6,55.93,3920.0,46
CDM,76100240,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,926.0,601.9,44.56,3920.0,46
CDM,76100245,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10,423.0,274.95,17.95,3920.0,35
CDM,76100250,REMOVAL BREAST BALLOON CATHETER,3815.0,2479.75,816.59,13665.0,45
CDM,76100255,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,745.0,484.25,57.56,3920.0,46
CDM,76100260,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,1116.0,725.4,78.52,4151.0,46
CDM,76100265,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,745.0,484.25,66.8,3920.0,46
CDM,76100270,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,28385.0,18450.25,328.59,25546.5,46
CDM,76100275,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,745.0,484.25,46.34,3920.0,46
CDM,76100280,INSERTION VAGINAL RADIATION DEVICE,1749.0,1136.85,174.73,4214.0,46
CDM,76100285,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,745.0,484.25,71.99,3920.0,46
CDM,76100290,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,5391.0,3504.15,127.33,4851.9,46
CDM,76100295,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,745.0,484.25,50.37,3920.0,46
CDM,76100300,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,1156.0,751.4,74.4,4151.0,46
CDM,76100305,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,1499.0,974.35,83.03,4151.0,46
CDM,76100315,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM,1499.0,974.35,98.33,4151.0,46
CDM,76100320,CYSTOURETHROSCOPY,3838.0,2494.7,96.8,14866.0,46
CDM,76100325,EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<,2639.0,1715.35,100.13,4151.0,46
CDM,76100330,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM,10733.0,6976.45,316.96,36332.0,46
CDM,76100335,EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM,1499.0,974.35,121.13,4151.0,46
CDM,76100340,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,2639.0,1715.35,130.27,4151.0,46
CDM,76100345,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,2639.0,1715.35,130.58,4214.0,46
CDM,76100350,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM,2639.0,1715.35,155.65,4214.0,46
CDM,76100355,EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM,2639.0,1715.35,173.17,4214.0,46
CDM,76100360,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,2639.0,1715.35,169.34,4214.0,46
CDM,76100365,EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM,6076.0,3949.4,191.17,8370.0,46
CDM,76100370,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM,6076.0,3949.4,203.58,5468.4,46
CDM,76100375,EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM,6076.0,3949.4,289.89,8370.0,46
CDM,76100380,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM,6076.0,3949.4,258.41,6317.0,46
CDM,76100385,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,6076.0,3949.4,98.26,5468.4,46
CDM,76100390,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM,10733.0,6976.45,367.98,36332.0,46
CDM,76100395,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,2639.0,1715.35,126.84,4151.0,46
CDM,76100400,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,1116.0,725.4,73.27,4151.0,46
CDM,76100405,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,6076.0,3949.4,159.27,5468.4,46
CDM,76100410,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,3555.0,2310.75,132.14,4268.0,45
CDM,76100415,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM,6076.0,3949.4,182.86,5468.4,46
CDM,76100420,EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<,2639.0,1715.35,139.16,4214.0,46
CDM,76100425,EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,2639.0,1715.35,166.68,4214.0,46
CDM,76100430,EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM,1499.0,974.35,178.86,4268.0,46
CDM,76100435,EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM,2639.0,1715.35,214.49,4268.0,46
CDM,76100440,EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM,2639.0,1715.35,237.75,6317.0,46
CDM,76100445,EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM,6076.0,3949.4,360.23,8370.0,46
CDM,76100450,EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<,6076.0,3949.4,140.04,5468.4,46
CDM,76100455,EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM,2639.0,1715.35,167.93,4214.0,46
CDM,76100460,EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM,2639.0,1715.35,188.49,4268.0,46
CDM,76100465,EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM,6076.0,3949.4,233.54,5468.4,46
CDM,76100470,EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM,6076.0,3949.4,267.11,8370.0,46
CDM,76100475,EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM,10733.0,6976.45,332.58,36332.0,46
CDM,76100485,EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM,2639.0,1715.35,174.78,4268.0,46
CDM,76100490,EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM,2639.0,1715.35,202.5,4268.0,46
CDM,76100495,EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM,6076.0,3949.4,254.37,5468.4,46
CDM,76100500,EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM,6076.0,3949.4,315.94,8370.0,46
CDM,76100505,EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM,10733.0,6976.45,439.78,36332.0,46
CDM,76100510,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,223.0,144.95,9.69,3920.0,46
CDM,76100520,DEBRIDEMENT NAIL ANY METHOD 1-5,223.0,144.95,18.04,3920.0,46
CDM,76100525,DEBRIDEMENT NAIL ANY METHOD 6/>,223.0,144.95,30.5,3920.0,46
CDM,76100530,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,745.0,484.25,40.61,3920.0,46
CDM,76100535,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,670.0,435.5,21.5,3920.0,35
CDM,76100540,EVACUATION SUBUNGUAL HEMATOMA,484.0,314.6,40.61,3920.0,46
CDM,76100545,EXCISION NAIL MATRIX PERMANENT REMOVAL,1499.0,974.35,123.89,4214.0,46
CDM,76100550,BIOPSY NAIL UNIT SEPARATE PROCEDURE,2639.0,1715.35,76.03,4151.0,46
CDM,76100560,REPAIR NAIL BED,2295.0,1491.75,40.61,3920.0,45
CDM,76100570,WEDGE EXCISION SKIN NAIL FOLD,1499.0,974.35,40.61,3920.0,46
CDM,76100580,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,745.0,484.25,33.12,3920.0,46
CDM,76100585,INJECTION INTRALESIONAL >7 LESIONS,745.0,484.25,50.37,3920.0,46
CDM,76100605,SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<,745.0,484.25,58.35,3920.0,46
CDM,76100610,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,1143.0,742.95,199.45,1028.7,37
CDM,76100615,SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC,2295.0,1491.75,81.79,4151.0,45
CDM,76100625,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,2639.0,1715.35,108.67,4151.0,46
CDM,76100630,SUBCUTANEOUS HORMONE PELLET IMPLANTATION,1496.0,972.4,66.49,3920.0,46
CDM,76100635,INSERTION DRUG DELIVERY IMPLANT,484.0,314.6,72.99,3920.0,46
CDM,76100640,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,1496.0,972.4,84.79,3920.0,46
CDM,76100645,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,1496.0,972.4,98.33,3920.0,46
CDM,76100650,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,745.0,484.25,57.45,3920.0,46
CDM,76100655,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,745.0,484.25,75.39,3920.0,46
CDM,76100660,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,745.0,484.25,94.26,3920.0,46
CDM,76100670,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,745.0,484.25,71.21,3920.0,46
CDM,76100675,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,745.0,484.25,74.22,3920.0,46
CDM,76100680,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,1143.0,742.95,30.98,1028.7,38
CDM,76100685,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,1499.0,974.35,171.31,4214.0,46
CDM,76100690,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,1499.0,974.35,213.21,4214.0,46
CDM,76100695,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,1499.0,974.35,233.99,4214.0,46
CDM,76100700,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,1499.0,974.35,241.35,4214.0,46
CDM,76100710,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,1499.0,974.35,168.05,3920.0,46
CDM,76100715,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,1499.0,974.35,220.06,4214.0,46
CDM,76100720,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,2295.0,1491.75,241.35,4214.0,45
CDM,76100730,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,1499.0,974.35,192.62,4214.0,46
CDM,76100735,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1499.0,974.35,225.31,4214.0,46
CDM,76100740,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,1499.0,974.35,241.35,4214.0,46
CDM,76100750,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,2298.0,1493.7,33.94,2068.2,38
CDM,76100755,REPAIR COMPLEX TRUNK 1.1-2.5 CM,2295.0,1491.75,225.44,4268.0,45
CDM,76100760,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,393.0,255.45,66.02,4214.0,35
CDM,76100765,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,2295.0,1491.75,254.67,4214.0,45
CDM,76100770,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,2295.0,1491.75,254.67,4214.0,45
CDM,76100775,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,908.0,590.2,91.62,3920.0,35
CDM,76100780,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,1499.0,974.35,254.67,4214.0,46
CDM,76100785,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,2295.0,1491.75,254.67,4268.0,45
CDM,76100790,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,1449.0,941.85,139.37,4214.0,35
CDM,76100800,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,2295.0,1491.75,254.67,4268.0,45
CDM,76100805,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,2295.0,1491.75,254.67,4268.0,45
CDM,76100810,ADJACENT TISSUE TRANSFER/REARGMT TRUNK 10 SQCM/<,6860.0,4459.0,586.15,8370.0,46
CDM,76100815,ADJNT TIS TRANSFR/REARRANGE TRUNK 10.1-30.0 SQCM,6860.0,4459.0,759.51,8370.0,46
CDM,76100820,ADJT TIS TRNSFR/REARGMT SCALP/ARM/LEG 10 SQ CM/<,6860.0,4459.0,641.29,8370.0,46
CDM,76100825,ADJT/REARRGMT SCALP/ARM/LEG 10.1-30.0 SQ CM,6860.0,4459.0,799.09,8370.0,46
CDM,76100830,ADJT TIS TRNS/REARGMT F/C/C/M/N/A/G/H/F 10SQCM/<,6860.0,4459.0,705.68,8370.0,46
CDM,76100835,ADJT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0 SQ CM,6860.0,4459.0,851.33,8370.0,46
CDM,76100840,ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<,6860.0,4459.0,744.87,8370.0,46
CDM,76100845,ADJT TIS REARGMT EYE/NOSE/EAR/LIP 10.1-30.0 SQCM,6860.0,4459.0,910.44,8370.0,46
CDM,76100850,ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM,13729.0,8923.85,991.15,13665.0,46
CDM,76100855,ADJT TIS TRNSFR/REARGMT DEFEC EA ADDL 30 SQCM,4401.0,2860.65,243.21,13665.0,35
CDM,76100860,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,2298.0,1493.7,25.44,2068.2,38
CDM,76100865,PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT,2295.0,1491.75,306.91,4214.0,45
CDM,76100870,NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM,2298.0,1493.7,29.14,2068.2,38
CDM,76100880,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,745.0,484.25,98.33,4151.0,46
CDM,76100895,FTH/GFT FREE W/DIRECT CLOSURE S/A/L 20 CM/<,6860.0,4459.0,688.16,8370.0,46
CDM,76100905,FTH/GFT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F 20 CM/<,6860.0,4459.0,894.13,8370.0,46
CDM,76100915,FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<,6860.0,4459.0,944.7,8370.0,46
CDM,76100925,APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25,6860.0,4459.0,100.57,6174.0,46
CDM,76100930,APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC,6860.0,4459.0,20.02,6174.0,35
CDM,76100935,APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM,13729.0,8923.85,228.39,12356.1,46
CDM,76100940,APP SKN SUB GRFT T/A/L AREA>/=100SCM ADL 100SQCM,13729.0,8923.85,51.53,12356.1,35
CDM,76100945,SUB GRFT F/S/N/H/F/G/M/D <100SQ CM 1ST 25 SQ CM,6860.0,4459.0,115.43,6174.0,46
CDM,76100950,SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADDL25SQ CM,6860.0,4459.0,30.28,6174.0,35
CDM,76100WE,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,1150.0,747.5,61.98,1150.0,32
CDM,76100WE-26,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,232.0,150.8,26.58,232.0,31
CDM,76100WE-TC,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,918.0,596.7,59.25,918.0,35
CDM,76101005,FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL,6860.0,4459.0,734.91,13665.0,46
CDM,76101010,DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS,6860.0,4459.0,400.06,13665.0,46
CDM,76101020,FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY,6860.0,4459.0,963.73,8370.0,46
CDM,76101105,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,745.0,484.25,69.24,4151.0,46
CDM,76101110,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,745.0,484.25,115.89,4151.0,46
CDM,76101120,DESTRUCTION PREMALIGNANT LESION 1ST,745.0,484.25,62.34,3920.0,46
CDM,76101125,DESTRUCTION PREMALIGNANT LESION 2-14 EA,418.0,271.7,2.43,3920.0,35
CDM,76101130,DESTRUCTION PREMALIGNANT LESION 15/>,1499.0,974.35,98.33,4151.0,46
CDM,76101135,DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM,1499.0,974.35,309.15,4214.0,46
CDM,76101150,DESTRUCTION BENIGN LESIONS UP TO 14,745.0,484.25,82.82,3920.0,46
CDM,76101155,DESTRUCTION BENIGN LESIONS 15/>,745.0,484.25,96.29,4151.0,46
CDM,76101160,CHEMICAL CAUTERIZATION OF GRANULATION TISSUE,745.0,484.25,44.93,4151.0,46
CDM,76101170,DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,745.0,484.25,97.4,4151.0,46
CDM,76101175,DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM,745.0,484.25,98.33,4151.0,46
CDM,76101180,DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM,745.0,484.25,98.33,4151.0,46
CDM,76101185,DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM,1499.0,974.35,98.33,4151.0,46
CDM,76101195,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/>,745.0,484.25,98.33,4151.0,46
CDM,76101200,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM,745.0,484.25,98.33,4151.0,46
CDM,76101205,DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM,745.0,484.25,98.33,4151.0,46
CDM,76101215,DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM,1499.0,974.35,98.33,4214.0,46
CDM,76101240,DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM,745.0,484.25,98.33,4214.0,46
CDM,76101245,DESTRUCTION MAL LESION F/E/E/N/L/M 2.1-3.0CM,1499.0,974.35,98.33,4214.0,46
CDM,76101260,MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS,2295.0,1491.75,394.84,4268.0,45
CDM,76101265,MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE,978.0,635.7,164.3,4268.0,35
CDM,76101270,MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS,2295.0,1491.75,354.23,4268.0,45
CDM,76101275,MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE,978.0,635.7,164.3,4268.0,35
CDM,76101280,MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE,865.0,562.25,55.44,3920.0,35
CDM,76101295,PUNCTURE ASPIRATION CYST BREAST,2639.0,1715.35,50.26,4151.0,46
CDM,76101300,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,321.0,208.65,25.04,3920.0,35
CDM,76101305,BIOPSY BREAST OPEN INCISIONAL,14360.0,9334.0,270.59,12924.0,39
CDM,76101315,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,14360.0,9334.0,508.07,12924.0,39
CDM,76101340,BIOPSY MUSCLE DEEP,16456.0,10696.4,187.62,14810.4,46
CDM,76101345,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,9316.0,6055.4,68.63,8384.4,46
CDM,76101350,BIOPSY BONE TROCAR/NEEDLE DEEP,9316.0,6055.4,155.38,8384.4,46
CDM,76101360,INJECTION SINUS TRACT DIAGNOSTIC,1348.0,876.2,43.91,4151.0,35
CDM,76101370,INJECTION THERAPEUTIC CARPAL TUNNEL,1698.0,1103.7,64.98,3920.0,46
CDM,76101375,INJECTION ENZYME PALMAR FASCIAL CORD,1698.0,1103.7,75.43,3920.0,46
CDM,76101380,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,1698.0,1103.7,45.97,3920.0,46
CDM,76101385,INJECTION SINGLE TENDON ORIGIN/INSERTION,1698.0,1103.7,45.78,3920.0,46
CDM,76101390,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1698.0,1103.7,47.54,3920.0,46
CDM,76101395,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,1698.0,1103.7,54.21,3920.0,46
CDM,76101405,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,1698.0,1103.7,42.6,3920.0,46
CDM,76101415,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1698.0,1103.7,43.64,3920.0,46
CDM,76101420,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1698.0,1103.7,52.83,3920.0,46
CDM,76101425,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,1698.0,1103.7,48.88,3920.0,46
CDM,76101430,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,9316.0,6055.4,179.46,8384.4,46
CDM,76101435,REMOVAL IMPLANT DEEP,16456.0,10696.4,500.91,36332.0,46
CDM,76101440,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,4046.0,2629.9,106.11,4151.0,46
CDM,76101455,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM,9316.0,6055.4,321.7,8384.4,46
CDM,76101460,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>,9316.0,6055.4,404.25,8384.4,46
CDM,76101465,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>,16456.0,10696.4,607.54,14810.4,46
CDM,76101560,GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR,34015.0,22109.75,646.44,30613.5,39
CDM,76101610,BIOPSY SOFT TISSUE NECK/THORAX,9316.0,6055.4,183.07,8384.4,46
CDM,76101615,EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>,16456.0,10696.4,539.02,36332.0,46
CDM,76101620,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM,9316.0,6055.4,372.37,8384.4,46
CDM,76101635,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,9316.0,6055.4,438.66,8384.4,46
CDM,76101640,EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>,9316.0,6055.4,568.62,36332.0,46
CDM,76101645,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,9316.0,6055.4,411.84,8384.4,46
CDM,76101650,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>,16456.0,10696.4,536.09,36332.0,46
CDM,76101675,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>,9316.0,6055.4,508.6,36332.0,46
CDM,76101705,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,46
CDM,76101730,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,1379.0,896.35,240.79,4151.0,46
CDM,76101750,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>,16456.0,10696.4,489.82,36332.0,46
CDM,76101755,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,9316.0,6055.4,401.02,8384.4,46
CDM,76101830,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,9316.0,6055.4,386.07,8384.4,46
CDM,76101870,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,9203.0,5981.95,310.03,8282.7,46
CDM,76101895,DRAINAGE FINGER ABSCESS SIMPLE,1143.0,742.95,98.33,4151.0,46
CDM,76101920,MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD,1379.0,896.35,93.18,4268.0,46
CDM,76101990,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,1379.0,896.35,240.79,4151.0,46
CDM,76102020,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,910.0,591.5,79.74,3920.0,35
CDM,76102025,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,2410.0,1566.5,100.04,18285.0,36
CDM,76102070,EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM,9316.0,6055.4,387.68,36332.0,46
CDM,76102085,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,1379.0,896.35,240.79,4151.0,46
CDM,76102090,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,46
CDM,76102130,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1379.0,896.35,240.79,4151.0,46
CDM,76102140,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1379.0,896.35,240.79,4151.0,46
CDM,76102150,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1379.0,896.35,240.79,4151.0,46
CDM,76102160,CLTX PROX FIBULA/SHFT FX W/O MANJ,1379.0,896.35,240.79,4151.0,46
CDM,76102165,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1379.0,896.35,240.79,4151.0,46
CDM,76102170,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,1379.0,896.35,240.79,4151.0,46
CDM,76102175,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1379.0,896.35,240.79,4151.0,46
CDM,76102180,APPLICATION CAST ELBOW FINGER SHORT ARM,1528.0,993.2,74.39,4151.0,46
CDM,76102185,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1379.0,896.35,240.79,4151.0,46
CDM,76102200,REMOVAL FOREIGN BODY FOOT DEEP,9316.0,6055.4,383.66,8384.4,46
CDM,76102205,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,741.0,481.65,47.31,3920.0,46
CDM,76102220,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,46
CDM,76102225,CLOSED TX TALUS FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,46
CDM,76102230,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,1379.0,896.35,240.79,4151.0,46
CDM,76102235,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,1379.0,896.35,240.79,4151.0,46
CDM,76102240,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,1379.0,896.35,178.13,4151.0,46
CDM,76102250,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,1379.0,896.35,167.84,4151.0,46
CDM,76102255,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,1379.0,896.35,192.33,4151.0,46
CDM,76102265,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,1528.0,993.2,66.14,3920.0,46
CDM,76102280,APPLICATION RIGID TOTAL CONTACT LEG CAST,1528.0,993.2,114.84,4151.0,46
CDM,76102305,APPLICATION SHORT LEG SPLINT CALF FOOT,908.0,590.2,47.31,3920.0,46
CDM,76102315,STRAPPING ANKLE &/FOOT,908.0,590.2,22.01,3920.0,46
CDM,76102325,STRAPPING TOES,341.0,221.65,13.86,3920.0,46
CDM,76102335,STRAPPING UNNA BOOT,908.0,590.2,32.49,3920.0,46
CDM,76102345,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,908.0,590.2,33.94,3920.0,46
CDM,76102360,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,1335.0,867.75,112.01,4214.0,46
CDM,76102370,BIOPSY INTRANASAL,8518.0,5536.7,78.52,7666.2,46
CDM,76102375,EXCISION NASAL POLYP SIMPLE,8518.0,5536.7,152.19,7666.2,46
CDM,76102380,EXCISION/DESTRUCTION INTRANASAL LESION INT APPR,18648.0,12121.2,495.46,16783.2,46
CDM,76102390,INJECTION TURBINATE THERAPEUTIC,2929.0,1903.85,68.78,4151.0,45
CDM,76102400,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,741.0,481.65,112.01,3920.0,46
CDM,76102415,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,8518.0,5536.7,240.12,8370.0,46
CDM,76102420,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,741.0,481.65,67.25,3920.0,46
CDM,76102425,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,741.0,481.65,94.07,3920.0,46
CDM,76102430,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,741.0,481.65,112.01,3920.0,46
CDM,76102445,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,1116.0,725.4,73.27,4151.0,46
CDM,76102455,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,9916.0,6445.4,183.15,13665.0,46
CDM,76102475,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1335.0,867.75,181.19,4151.0,46
CDM,76102500,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,9916.0,6445.4,182.55,13665.0,46
CDM,76102510,LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE,21200.0,13780.0,283.43,19080.0,39
CDM,76102515,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,1116.0,725.4,78.52,4151.0,46
CDM,76102520,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,2233.0,1451.45,137.09,4214.0,46
CDM,76102530,TRACHEOBRNCHSC THRU EST TRACHS INC,2929.0,1903.85,134.12,6317.0,45
CDM,76102540,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,9916.0,6445.4,163.56,8924.4,46
CDM,76102550,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,9916.0,6445.4,164.87,8924.4,46
CDM,76102555,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,9916.0,6445.4,166.71,8924.4,46
CDM,76102560,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,9916.0,6445.4,194.29,8924.4,46
CDM,76102565,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,39804.0,25872.6,244.52,35823.6,39
CDM,76102570,BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION,2030.0,1319.5,119.08,3920.0,29
CDM,76102575,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,21200.0,13780.0,219.98,19080.0,46
CDM,76102580,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,21200.0,13780.0,233.07,19080.0,46
CDM,76102585,BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX,21200.0,13780.0,241.57,19080.0,39
CDM,76102595,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,1480.0,962.0,60.81,7730.0,35
CDM,76102600,BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE,1768.0,1149.2,78.73,7730.0,35
CDM,76102610,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,9916.0,6445.4,217.13,8924.4,46
CDM,76102635,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,20293.0,13190.45,247.1,18263.7,39
CDM,76102645,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,3555.0,2310.75,192.55,4151.0,45
CDM,76102650,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,3555.0,2310.75,109.61,4268.0,45
CDM,76102655,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,3555.0,2310.75,132.14,4268.0,45
CDM,76102660,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,10908.0,7090.2,152.72,9817.2,46
CDM,76102665,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,8933.0,5806.45,181.46,8039.7,46
CDM,76102700,INTRODUCTION NEEDLE/INTRACATHETER VEIN,308.0,200.2,44.56,3920.0,34
CDM,76102705,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,4444.0,2888.6,124.03,4151.0,45
CDM,76102720,INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK,2871.0,1866.15,399.63,3920.0,45
CDM,76102730,INJECTION SCLEROSANT SINGLE INCMPTNT VEIN,2871.0,1866.15,45.28,4151.0,46
CDM,76102740,INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS,2871.0,1866.15,90.0,4151.0,46
CDM,76102775,INSERTION PICC W/O IMG GDN 5 YR/>,11165.0,7257.25,116.38,10048.5,46
CDM,76102795,COMPLETE REPLACEMENT PICC RS&I,11165.0,7257.25,70.91,10048.5,46
CDM,76102805,RMVL TUN CVC W/O SUBQ PORT/PMP,4444.0,2888.6,164.43,6289.0,45
CDM,76102815,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,11165.0,7257.25,225.25,10048.5,46
CDM,76102825,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,926.0,601.9,44.56,3920.0,46
CDM,76102830,COLLECT BLOOD FROM CATHETER VENOUS NOS,926.0,601.9,44.56,3920.0,46
CDM,76102840,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,926.0,601.9,18.57,3920.0,46
CDM,76102885,DIAGNOSTIC BONE MARROW ASPIRATIONS,8101.0,5265.65,76.74,7290.9,46
CDM,76102890,DIAGNOSTIC BONE MARROW BIOPSIES,8101.0,5265.65,80.14,7290.9,46
CDM,76102900,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,8101.0,5265.65,102.26,7290.9,46
CDM,76102905,BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE,19146.0,12444.9,490.62,17231.4,39
CDM,76102915,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,2009.0,1305.85,38.23,3920.0,46
CDM,76102920,BIOPSY OF LIP,1335.0,867.75,77.24,4151.0,46
CDM,76102935,BIOPSY VESTIBULE MOUTH,2929.0,1903.85,106.52,4214.0,45
CDM,76102940,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR,18648.0,12121.2,149.85,16783.2,46
CDM,76102945,EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR,8518.0,5536.7,214.61,7666.2,46
CDM,76102965,INCISION LINGUAL FRENUM FRENOTOMY,8518.0,5536.7,134.98,7666.2,46
CDM,76102980,BIOPSY TONGUE ANTERIOR TWO-THIRDS,2929.0,1903.85,112.01,4214.0,45
CDM,76102990,BIOPSY FLOOR MOUTH,9316.0,6055.4,108.12,8384.4,46
CDM,76102995,EXCISION LESION TONGUE W/O CLOSURE,18648.0,12121.2,152.7,16783.2,46
CDM,76103000,EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS,18648.0,12121.2,291.98,16783.2,46
CDM,76103005,EXCISION LESION FLOOR MOUTH,18648.0,12121.2,259.83,16783.2,46
CDM,76103040,BIOPSY PALATE UVULA,8518.0,5536.7,130.01,7666.2,46
CDM,76103045,EXC LESION PALATE UVULA W/O CLOSURE,18648.0,12121.2,156.36,16783.2,46
CDM,76103060,SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL,18648.0,12121.2,191.96,16783.2,46
CDM,76103065,BIOPSY SALIVARY GLAND NEEDLE,4046.0,2629.9,62.36,4151.0,46
CDM,76103070,BIOPSY SALIVARY GLAND INCISIONAL,8518.0,5536.7,262.32,7666.2,39
CDM,76103075,DILATION SALIVARY DUCT,8518.0,5536.7,67.9,7666.2,46
CDM,76103080,I&D ABSCESS PERITONSILLAR,1335.0,867.75,112.01,4214.0,46
CDM,76103085,BIOPSY OROPHARYNX,8518.0,5536.7,135.22,7666.2,46
CDM,76103090,BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE,18648.0,12121.2,147.68,16783.2,46
CDM,76103095,EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD,18648.0,12121.2,190.76,16783.2,39
CDM,76103195,INCISION THROMBOSED HEMORRHOID EXTERNAL,1399.0,909.35,134.91,4151.0,46
CDM,76103210,DSTRJ LESION ANUS SIMPLE CRYOSURGERY,1143.0,742.95,158.39,4151.0,46
CDM,76103220,BIOPSY LIVER NEEDLE PERCUTANEOUS,9316.0,6055.4,104.99,8384.4,46
CDM,76103230,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,5391.0,3504.15,92.62,4851.9,46
CDM,76103235,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,5391.0,3504.15,127.33,4851.9,46
CDM,76103255,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,1390.0,903.5,36.13,4151.0,46
CDM,76103265,RENAL BIOPSY PRQ TROCAR/NEEDLE,9316.0,6055.4,151.39,8384.4,46
CDM,76103290,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,1249.0,811.85,82.94,4214.0,35
CDM,76103300,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,11779.0,7656.35,171.65,13665.0,46
CDM,76103305,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,1310.0,851.5,52.31,4151.0,35
CDM,76103310,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,1399.0,909.35,36.17,4151.0,46
CDM,76103315,INSJ NON-NDWELLG BLADDER CATHETER,741.0,481.65,30.28,3920.0,46
CDM,76103320,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,741.0,481.65,31.01,3920.0,46
CDM,76103325,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,900.0,585.0,53.02,3920.0,46
CDM,76103330,CHANGE CYSTOSTOMY TUBE SIMPLE,1399.0,909.35,53.02,4151.0,46
CDM,76103335,NDSC NJX IMPLT MATRL URT&/BLDR NCK,19831.0,12890.15,238.56,17847.9,39
CDM,76103340,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,3838.0,2494.7,52.54,4151.0,46
CDM,76103345,SIMPLE CYSTOMETROGRAM,1399.0,909.35,244.13,4214.0,46
CDM,76103350,BLADDER PRESSURE MEASUREMENT DURING FILLING,1399.0,909.35,244.13,4214.0,46
CDM,76103355,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,3838.0,2494.7,248.59,4214.0,49
CDM,76103360,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,3838.0,2494.7,248.59,4214.0,46
CDM,76103365,COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL,3838.0,2494.7,248.59,4214.0,46
CDM,76103370,COMPLEX UROFLOMETRY,1790.0,1163.5,19.94,3920.0,49
CDM,76103375,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,900.0,585.0,82.59,3920.0,49
CDM,76103380,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,1399.0,909.35,82.59,4151.0,46
CDM,76103390,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,341.0,221.65,18.23,3920.0,46
CDM,76103395,CYSTOURETHROSCOPY,3838.0,2494.7,96.8,14866.0,46
CDM,76103400,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,19831.0,12890.15,344.65,17847.9,46
CDM,76103405,CYSTO BLADDER W/URETERAL CATHETERIZATION,11779.0,7656.35,160.61,14866.0,39
CDM,76103410,CYSTOURETHROSCOPY WITH BIOPSY,11779.0,7656.35,171.08,10601.1,39
CDM,76103420,CYSTO W/REMOVAL OF LESIONS MINOR <0.5CM,19831.0,12890.15,243.17,17847.9,39
CDM,76103435,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,11779.0,7656.35,183.6,10601.1,46
CDM,76103440,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,11779.0,7656.35,202.5,10601.1,46
CDM,76103450,CYSTO W/SIMPLE REMOVAL STONE & STENT,11779.0,7656.35,182.3,10601.1,46
CDM,76103455,CYSTO W/COMPLEX REMOVAL STONE & STENT,11779.0,7656.35,330.02,10601.1,39
CDM,76103465,CYSTO W/INSERT URETERAL STENT,19831.0,12890.15,187.94,17847.9,39
CDM,76103470,CYSTO W/TX URETERAL STRICTURE,19831.0,12890.15,341.24,17847.9,39
CDM,76103520,DILAT URETHRAL STRIX DILATOR MALE 1ST,1399.0,909.35,53.02,3920.0,46
CDM,76103525,DILAT URETHRAL STRIX DILATOR MALE SBSQ,741.0,481.65,53.02,3920.0,46
CDM,76103530,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST,3838.0,2494.7,104.74,4151.0,46
CDM,76103535,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ,1399.0,909.35,86.73,4151.0,46
CDM,76103540,DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI,900.0,585.0,49.94,3920.0,46
CDM,76103545,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,741.0,481.65,48.63,3920.0,46
CDM,76103575,SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN,11779.0,7656.35,170.01,13665.0,46
CDM,76103585,DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION,10518.0,6836.7,111.04,9466.2,46
CDM,76103590,DSTRJ LESION PENIS SIMPLE CRYOSURGERY,1143.0,742.95,128.89,3920.0,46
CDM,76103610,BIOPSY PENIS SEPARATE PROCEDURE,9316.0,6055.4,138.09,8384.4,46
CDM,76103625,CIRCUMCISION AGE >28 DAYS,11779.0,7656.35,239.64,36332.0,46
CDM,76103635,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,1399.0,909.35,53.02,3920.0,46
CDM,76103645,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,1399.0,909.35,68.99,4214.0,46
CDM,76103660,PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED,4046.0,2629.9,53.02,4151.0,46
CDM,76103680,VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS,11779.0,7656.35,281.07,36332.0,46
CDM,76103710,I&D VULVA/PERINEAL ABSCESS,1749.0,1136.85,132.47,4151.0,46
CDM,76103715,I&D OF BARTHOLINS GLAND ABSCESS,1156.0,751.4,126.63,4151.0,46
CDM,76103725,DESTRUCTION LESIONS VULVA SIMPLE,10518.0,6836.7,152.72,9466.2,46
CDM,76103730,DESTRUCTION LESIONS VULVA EXTENSIVE,10518.0,6836.7,244.36,13665.0,46
CDM,76103735,BIOPSY VULVA/PERINEUM 1 LESION SPX,5006.0,3253.9,69.44,4505.4,46
CDM,76103740,BIOPSY VULVA/PERINEUM EACH ADDL LESION,980.0,637.0,34.34,3920.0,35
CDM,76103745,COLPOSCOPY VULVA,1156.0,751.4,99.88,4151.0,46
CDM,76103750,COLPOSCOPY VULVA W/BIOPSY,1749.0,1136.85,134.23,4151.0,46
CDM,76103755,DESTRUCTION VAGINAL LESIONS SIMPLE,18283.0,11883.95,135.4,16454.7,46
CDM,76103765,BIOPSY VAGINAL MUCOSA SIMPLE,5006.0,3253.9,77.73,4505.4,46
CDM,76103775,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,1156.0,751.4,54.7,3920.0,46
CDM,76103780,DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS,1156.0,751.4,55.92,3920.0,46
CDM,76103790,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,1749.0,1136.85,107.08,4151.0,46
CDM,76103795,COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX,5006.0,3253.9,144.56,4505.4,46
CDM,76103800,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,1156.0,751.4,107.75,4151.0,46
CDM,76103805,COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE,1749.0,1136.85,157.33,4151.0,46
CDM,76103810,COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX,1749.0,1136.85,128.55,4151.0,46
CDM,76103815,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,1749.0,1136.85,118.92,4151.0,46
CDM,76103820,COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX,18283.0,11883.95,188.17,16454.7,46
CDM,76103825,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,18283.0,11883.95,216.71,16454.7,46
CDM,76103830,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,5006.0,3253.9,88.91,4505.4,46
CDM,76103835,ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C,5006.0,3253.9,128.04,4505.4,46
CDM,76103840,CAUTERY CERVIX ELECTRO/THERMAL,18283.0,11883.95,133.79,16454.7,46
CDM,76103850,CONIZATION CERVIX W/WO D&C RPR ELTRD EXC,18283.0,11883.95,296.17,16454.7,46
CDM,76103860,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,1156.0,751.4,74.4,4151.0,46
CDM,76103865,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,559.0,363.35,47.59,4151.0,35
CDM,76103870,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,18283.0,11883.95,270.98,16454.7,46
CDM,76103875,INSERTION INTRAUTERINE DEVICE IUD,628.0,408.2,105.5,18285.0,35
CDM,76103880,REMOVAL INTRAUTERINE DEVICE IUD,1749.0,1136.85,78.23,3920.0,46
CDM,76103895,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,1039.0,675.35,67.55,36332.0,35
CDM,76103910,HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE,18283.0,11883.95,178.31,36332.0,46
CDM,76103915,HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C,18283.0,11883.95,272.4,36332.0,46
CDM,76103940,HYSTEROSCOPY ENDOMETRIAL ABLATION,28385.0,18450.25,289.61,25546.5,39
CDM,76104070,ASPIRATION AND/OR INJECTION THYROID CYST,3518.0,2286.7,58.07,4151.0,46
CDM,76104085,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,5973.0,3882.45,66.8,6289.0,46
CDM,76104090,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,2586.0,1680.9,21.15,3920.0,46
CDM,76104100,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,5973.0,3882.45,77.17,5375.7,46
CDM,76104105,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,5973.0,3882.45,112.86,5375.7,46
CDM,76104110,INJECTION EPIDURAL BLOOD/CLOT PATCH,5973.0,3882.45,139.83,6317.0,46
CDM,76104135,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,2629.0,1708.85,195.7,3920.0,35
CDM,76104185,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,2586.0,1680.9,29.6,3920.0,46
CDM,76104190,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,2586.0,1680.9,40.74,3920.0,46
CDM,76104195,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/REPRG&REFIL,2586.0,1680.9,41.1,4151.0,46
CDM,76104200,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR PHYS/QHP,2586.0,1680.9,54.99,4151.0,46
CDM,76104230,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,2546.0,1654.9,60.57,4151.0,46
CDM,76104240,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2546.0,1654.9,60.62,4151.0,46
CDM,76104265,INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN,7679.0,4991.35,92.64,6911.1,46
CDM,76104280,INJECTION AA&/STRD SUPRASCAPULAR NERVE,5973.0,3882.45,66.83,5375.7,46
CDM,76104285,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,5973.0,3882.45,71.65,5375.7,46
CDM,76104290,INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL,7679.0,4991.35,30.26,6911.1,46
CDM,76104295,INJECTION AA&/STRD ILIOINGUINAL IH NERVES,5973.0,3882.45,67.67,5375.7,46
CDM,76104300,INJECTION AA&/STRD PUDENDAL NERVE,7679.0,4991.35,66.22,6911.1,46
CDM,76104310,INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN,5973.0,3882.45,90.25,5375.7,46
CDM,76104320,INJECTION AA&/STRD FEMORAL NERVE W/IMG GDN,5973.0,3882.45,84.16,5375.7,46
CDM,76104335,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,5973.0,3882.45,51.82,5375.7,46
CDM,76104340,NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES,2546.0,1654.9,42.66,3920.0,46
CDM,76104345,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,7679.0,4991.35,157.7,6911.1,46
CDM,76104350,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,1701.0,1105.65,73.82,4268.0,35
CDM,76104355,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,7679.0,4991.35,133.87,6911.1,46
CDM,76104360,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,1853.0,1204.45,61.24,4268.0,35
CDM,76104365,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,7679.0,4991.35,126.8,6911.1,46
CDM,76104370,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,820.0,533.0,70.66,4214.0,35
CDM,76104375,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,820.0,533.0,71.38,4214.0,35
CDM,76104380,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,7679.0,4991.35,109.08,6911.1,46
CDM,76104385,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,2171.0,1411.15,61.24,4214.0,35
CDM,76104390,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,1575.0,1023.75,62.72,4214.0,35
CDM,76104395,INJECTION ANES AGENT SPHENOPALATINE GANGLION,2546.0,1654.9,122.46,4151.0,46
CDM,76104405,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,7679.0,4991.35,92.44,6911.1,46
CDM,76104415,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,7679.0,4991.35,101.9,6911.1,46
CDM,76104420,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,7679.0,4991.35,114.19,6911.1,46
CDM,76104430,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,30533.0,19846.45,363.56,27479.7,39
CDM,76104435,POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,2546.0,1654.9,36.17,4151.0,46
CDM,76104455,DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR,16843.0,10947.95,584.41,15158.7,46
CDM,76104460,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS,2546.0,1654.9,137.2,4151.0,46
CDM,76104465,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL,2546.0,1654.9,136.04,4151.0,46
CDM,76104480,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,2546.0,1654.9,146.31,3920.0,46
CDM,76104485,DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE,7679.0,4991.35,219.4,7730.0,46
CDM,76104510,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,7679.0,4991.35,236.24,6911.1,46
CDM,76104520,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,16843.0,10947.95,232.6,15158.7,46
CDM,76104525,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,1143.0,742.95,80.57,4214.0,35
CDM,76104530,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,16843.0,10947.95,233.15,15158.7,46
CDM,76104535,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,4084.0,2654.6,70.66,6317.0,35
CDM,76104540,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,7679.0,4991.35,147.37,6911.1,46
CDM,76104545,CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,2546.0,1654.9,44.87,4151.0,46
CDM,76104550,CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY,2546.0,1654.9,57.12,4151.0,46
CDM,76104555,DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS,7679.0,4991.35,195.15,7730.0,46
CDM,76104570,"UNLISTED PROCEDURE, NERVOUS",1679.0,1091.35,249.83,8550.0,45
CDM,76104645,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,13114.0,8524.1,98.22,11802.6,46
CDM,76104820,EXCISION CHALAZION MULTIPLE DIFFERENT LIDS,1719.0,1117.35,169.69,4214.0,46
CDM,76104825,INCISIONAL BIOPSY EYELID SKIN & LID MARGIN,1719.0,1117.35,75.72,4214.0,46
CDM,76104950,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,3518.0,2286.7,112.01,4151.0,46
CDM,76104965,BIOPSY EXTERNAL EAR,1161.0,754.65,51.62,4151.0,46
CDM,76104985,RMVL FB XTRNL AUDITORY CANAL W/O ANES,645.0,419.25,55.07,3920.0,40
CDM,76104990,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,298.0,193.7,37.27,3920.0,40
CDM,76104995,DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE,994.0,646.1,58.73,3920.0,46
CDM,76105000,DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX,2546.0,1654.9,164.38,4268.0,45
CDM,76105020,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,2546.0,1654.9,112.01,4214.0,45
CDM,76105025,TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH,7406.0,4813.9,327.98,6665.4,46
CDM,76105035,LABYRINTHOTOMY TRANSCANAL,7406.0,4813.9,142.93,6665.4,46
CDM,76105060,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,513.0,333.45,30.69,461.7,38
CDM,76105070,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,1143.0,742.95,44.41,2849.0,38
CDM,76105075,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,933.0,606.45,30.09,2849.0,28
CDM,76105080,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,1143.0,742.95,199.45,1028.7,37
CDM,76105085,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,1143.0,742.95,30.98,1028.7,38
CDM,76105130,"MEDICARE ONLY, REM IMP EAR WAX",153.0,99.45,25.7,3920.0,29
CDM,76105155,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,28385.0,18450.25,328.59,25546.5,49
CDM,76105165,INSERTION VAGINAL RADIATION DEVICE,1749.0,1136.85,174.73,4214.0,46
CDM,76105210,APPLICATION CAST SHOULDER HAND LONG ARM,1528.0,993.2,80.74,4151.0,46
CDM,76105220,APPLICATION LONG ARM SPLINT SHOULDER HAND,908.0,590.2,47.31,3920.0,46
CDM,76105230,APPLICATION FINGER SPLINT STATIC,741.0,481.65,34.13,3920.0,46
CDM,76105275,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,1528.0,993.2,70.57,4151.0,46
CDM,76105310,BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC,21200.0,13780.0,310.73,19080.0,39
CDM,76105320,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST,9916.0,6445.4,183.11,8924.4,46
CDM,76105360,CATHETER ASPIRATION NASOTRACHEAL SPX,1170.0,760.5,38.83,3920.0,46
CDM,76105370,SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR,18648.0,12121.2,384.83,16783.2,39
CDM,76105400,INJECTION SCLEROSING SOLUTION HEMORRHOIDS,5243.0,3407.95,260.89,4718.7,46
CDM,76105405,DSTRJ LESION ANUS SIMPLE CHEMICAL,2298.0,1493.7,168.33,4214.0,46
CDM,76105410,CYSTO W/REMOVAL OF TUMORS SMALL,19831.0,12890.15,295.05,17847.9,39
CDM,76105475,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,6076.0,3949.4,221.56,8370.0,46
CDM,76105505,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1499.0,974.35,98.33,4151.0,46
CDM,76105515,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,2295.0,1491.75,183.62,4214.0,45
CDM,76105525,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,745.0,484.25,28.24,3920.0,46
CDM,76105535,SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<,1499.0,974.35,38.18,3920.0,46
CDM,76105545,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,1499.0,974.35,79.34,4151.0,46
CDM,76105555,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,745.0,484.25,57.35,3920.0,46
CDM,76105565,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,13975.0,9083.75,182.44,12577.5,46
CDM,76105575,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,3286.0,2135.9,91.22,8370.0,35
CDM,76105585,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,1698.0,1103.7,54.67,3920.0,46
CDM,76105595,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,3983.0,2588.95,61.65,3920.0,46
CDM,76105605,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,1698.0,1103.7,68.5,3920.0,46
CDM,76105615,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,1379.0,896.35,240.79,4268.0,46
CDM,76105625,EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM,16456.0,10696.4,653.36,14810.4,46
CDM,76105645,EXC LESION TDN SHTH/JT CAPSL HAND/FNGR,9203.0,5981.95,398.06,8370.0,46
CDM,76105665,CLOSED TREATMENT COCCYGEAL FRACTURE,1379.0,896.35,240.79,4151.0,46
CDM,76105675,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1379.0,896.35,240.79,4151.0,46
CDM,76105705,DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF,2295.0,1491.75,34.69,3920.0,45
CDM,76105725,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,9916.0,6445.4,191.34,13665.0,46
CDM,76105765,LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES),9916.0,6445.4,136.89,13665.0,46
CDM,76105775,TRACHEOSTOMY PLANNED SEPARATE PROCEDURE,18648.0,12121.2,361.9,16783.2,39
CDM,76105795,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,2161.0,1404.65,30.28,4214.0,35
CDM,76105905,I&D PERIANAL ABSCESS SUPERFICIAL,5243.0,3407.95,132.49,4718.7,46
CDM,76105955,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,745.0,484.25,91.06,3920.0,46
CDM,76105985,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,18283.0,11883.95,650.73,16454.7,39
CDM,76106025,TAP BLOCK UNILATERAL BY INJECTION(S),1759.0,1143.35,69.04,3920.0,35
CDM,76106045,TAP BLOCK BILATERAL BY INJECTION(S),1759.0,1143.35,80.67,3920.0,35
CDM,76106065,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,1499.0,974.35,84.53,4151.0,46
CDM,76106075,INS/RPLC PERPH SAC/GSTRC NPG/RCVR PCKT CRTJ&CONN,34865.0,22662.25,354.22,46494.97,39
CDM,76106095,CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA,2546.0,1654.9,130.22,4151.0,46
CDM,76106105,CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG,5973.0,3882.45,123.85,5375.7,46
CDM,76106115,CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE,5973.0,3882.45,122.71,5375.7,46
CDM,76106125,CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,3458.0,2247.7,79.33,4151.0,35
CDM,76106135,CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES,5973.0,3882.45,132.99,5375.7,46
CDM,76106145,CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES,2786.0,1810.9,91.65,4151.0,35
CDM,76106155,CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES,5973.0,3882.45,133.47,5375.7,46
CDM,76106275,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,745.0,484.25,69.76,3920.0,46
CDM,76106285,REPAIR COMPLEX TRUNK 2.6-7.5 CM,2295.0,1491.75,254.67,4268.0,45
CDM,76106325,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>,16456.0,10696.4,509.36,36332.0,46
CDM,76106335,NJX RETROGRADE URETHROCSTOGRAPY,1669.0,1084.85,76.53,4268.0,35
CDM,76106355,NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,1995.0,1296.75,275.45,3920.0,44
CDM,76106365,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,2639.0,1715.35,163.62,4151.0,46
CDM,76106395,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,745.0,484.25,95.67,3920.0,46
CDM,76106405,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,2295.0,1491.75,227.32,4268.0,45
CDM,76106415,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,1499.0,974.35,241.35,3920.0,46
CDM,76106435,SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,6860.0,4459.0,835.0,13665.0,46
CDM,76106515,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,2639.0,1715.35,100.44,3920.0,46
CDM,76106545,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,9316.0,6055.4,181.29,8384.4,46
CDM,76106605,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,9316.0,6055.4,181.61,8384.4,46
CDM,76106705,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,9316.0,6055.4,235.47,8384.4,46
CDM,76106765,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>,16456.0,10696.4,495.87,36332.0,46
CDM,76106775,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,1379.0,896.35,240.79,4151.0,46
CDM,76106845,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,1335.0,867.75,41.35,4151.0,46
CDM,76106925,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,4501.0,2925.65,186.1,4050.9,35
CDM,76106945,VNPNXR 3 YEARS/> PHYS/QHP SKILL,278.0,180.7,11.13,3920.0,35
CDM,76106955,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,22623.0,14704.95,106.52,20360.7,46
CDM,76106965,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,4444.0,2888.6,41.1,6289.0,45
CDM,76106985,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM,34015.0,22109.75,397.21,30613.5,39
CDM,76107025,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,6780.0,4407.0,548.66,36332.0,46
CDM,76107035,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,9316.0,6055.4,144.38,8384.4,46
CDM,76107125,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,3518.0,2286.7,91.56,4151.0,46
CDM,76107185,CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES,5973.0,3882.45,149.49,5375.7,46
CDM,76107245,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,298.0,193.7,24.99,3920.0,40
CDM,76107275,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,4704.0,3057.6,130.58,4233.6,49
CDM,76108015,TUBE THORACOSTOMY INCLUDES WATER SEAL,8933.0,5806.45,191.38,8370.0,46
CDM,76108025,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM,6076.0,3949.4,210.67,8370.0,46
CDM,76108105,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,18656.0,12126.4,491.13,16790.4,39
CDM,76108165,TUBE THORACOSTOMY INCLUDES WATER SEAL,8933.0,5806.45,191.38,8370.0,46
CDM,76108235,LARYNGOSCOPY FLEXIBLE W/INJECTION AGMNTJ UNI,9916.0,6445.4,170.9,13665.0,46
CDM,76108265,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,5973.0,3882.45,118.99,6317.0,46
CDM,76108275,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,5973.0,3882.45,130.04,6317.0,46
CDM,76108285,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,7679.0,4991.35,101.28,6911.1,46
CDM,76108295,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,5973.0,3882.45,121.16,6317.0,46
CDM,76108305,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,7679.0,4991.35,119.23,6911.1,46
CDM,76108315,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,7679.0,4991.35,139.46,6911.1,46
CDM,76108325,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,7679.0,4991.35,113.52,7730.0,46
CDM,76108335,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,7679.0,4991.35,126.55,7730.0,46
CDM,76108445,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,9316.0,6055.4,104.99,8384.4,46
CDM,76108535,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ,2233.0,1451.45,177.21,7730.0,46
CDM,76108635,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,2758.0,1792.7,56.89,3920.0,35
CDM,76108645,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,3801.0,2470.65,129.05,3920.0,35
CDM,76108655,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,4880.0,3172.0,208.76,4392.0,35
CDM,76108665,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,3469.0,2254.85,178.77,3920.0,35
CDM,76108675,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,4031.0,2620.15,205.93,3920.0,35
CDM,76108715,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,9381.0,6097.65,256.22,8442.9,35
CDM,76108725,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,9548.0,6206.2,324.04,8593.2,35
CDM,76108735,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,10156.0,6601.4,395.53,9140.4,35
CDM,76108745,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,1238.0,804.7,61.88,3920.0,35
CDM,76108755,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,5016.0,3260.4,279.75,4514.4,35
CDM,76108765,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,5656.0,3676.4,297.53,5090.4,35
CDM,76108775,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,6836.0,4443.4,354.59,6152.4,35
CDM,76108785,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,1060.0,689.0,57.98,3920.0,35
CDM,76108795,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,1709.0,1110.85,287.11,3920.0,35
CDM,76108805,VEN CATHJ SLCTV ORGAN BLD SAMPLING,2075.0,1348.75,215.2,3920.0,35
CDM,76108815,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,38854.0,25255.1,437.08,34968.6,39
CDM,76108825,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,1514.0,984.1,42.88,4151.0,46
CDM,76108845,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,25485.0,16565.25,451.16,22936.5,39
CDM,76108855,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,63035.0,40972.75,508.93,56731.5,39
CDM,76108865,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,6924.0,4500.6,192.43,6231.6,28
CDM,76108885,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,37218.0,24191.7,469.64,33496.2,39
CDM,76108895,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,22623.0,14704.95,335.67,20360.7,39
CDM,76108905,TRANSCATHETER BIOPSY,38854.0,25255.1,260.94,34968.6,39
CDM,76108915,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,24600.0,15990.0,2126.0,22140.0,28
CDM,76108925,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,2295.0,1491.75,47.97,4151.0,46
CDM,76108945,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,20293.0,13190.45,387.96,18263.7,39
CDM,76108955,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,35879.0,23321.35,353.76,32291.1,39
CDM,76108965,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,35879.0,23321.35,355.15,32291.1,39
CDM,76108975,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,20293.0,13190.45,422.92,18263.7,39
CDM,76108985,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,59865.0,38912.25,479.26,53878.5,39
CDM,76109005,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,826.0,536.9,45.01,4214.0,35
CDM,76109015,RMV/RPLC INDW URET BI-S,11779.0,7656.35,304.33,10601.1,39
CDM,76109035,RMV ONLY INDW URET BI-S,11779.0,7656.35,275.36,10601.1,46
CDM,76109055,RMVL NFROS TUBE REQ FLUORO GUIDANCE,3838.0,2494.7,64.09,6289.0,46
CDM,76109135,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,188.0,122.2,10.95,169.2,22
CDM,76109275,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,608.0,395.2,89.99,3920.0,35
CDM,76109285,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,6814.0,4429.1,139.53,6132.6,46
CDM,76109295,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,6814.0,4429.1,145.43,6132.6,46
CDM,76109305,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,2546.0,1654.9,134.17,6317.0,46
CDM,76109315,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,9316.0,6055.4,100.15,8384.4,46
CDM,76109325,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,2639.0,1715.35,117.8,3920.0,46
CDM,76109335,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,6076.0,3949.4,117.05,5468.4,46
CDM,76109345,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,6076.0,3949.4,58.68,5468.4,35
CDM,76109355,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,6069.0,3944.85,186.04,5462.1,46
CDM,76109365,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,33548.0,21806.2,409.88,30193.2,39
CDM,76109375,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,33548.0,21806.2,531.35,30193.2,39
CDM,76109385,BIOPSY PLEURA PERCUTANEOUS NEEDLE,9316.0,6055.4,102.06,8384.4,46
CDM,76109865,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,2639.0,1715.35,59.26,3920.0,35
CDM,76109875,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,2639.0,1715.35,50.4,3920.0,35
CDM,76110345,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,6814.0,4429.1,141.59,6132.6,46
CDM,76110585,HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY,18283.0,11883.95,260.31,36332.0,46
CDM,76110625,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,2295.0,1491.75,241.35,4214.0,45
CDM,76110745,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,908.0,590.2,47.31,3920.0,46
CDM,76110785,NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE,16843.0,10947.95,542.3,15158.7,46
CDM,76110795,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,11779.0,7656.35,93.26,10601.1,46
CDM,76110885,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2546.0,1654.9,60.62,4151.0,46
CDM,76110925,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,926.0,601.9,44.56,3920.0,46
CDM,76110985,INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP,1085.0,705.25,105.9,976.5,22
CDM,76111075,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,3923.0,2549.95,297.94,18285.0,29
CDM,76111095,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,59484.0,38664.6,187.2,53535.6,39
CDM,76111115,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,11165.0,7257.25,115.4,10048.5,38
CDM,76111235,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,1974.0,1283.1,98.4,3920.0,35
CDM,76111335,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,14310.0,9301.5,87.17,12879.0,46
CDM,76111355,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,1143.0,742.95,199.45,1028.7,37
CDM,76111445,CT LUNG LOCALIZATION,1542.0,1002.3,399.38,1387.8,37
CDM,76111485,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,3838.0,2494.7,78.74,4214.0,46
CDM,76111495,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,22623.0,14704.95,444.55,20360.7,39
CDM,76111525,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,1499.0,974.35,169.35,4214.0,46
CDM,76111565,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,15898.0,10333.7,443.28,14308.2,46
CDM,76111655,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,9316.0,6055.4,831.56,8384.4,46
CDM,76111765,EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR,14310.0,9301.5,391.61,12879.0,46
CDM,76111855,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,22623.0,14704.95,396.78,20360.7,39
CDM,76111905,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,11779.0,7656.35,245.69,10601.1,46
CDM,76112055,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>,16456.0,10696.4,883.65,36332.0,46
CDM,76112085,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,41076.0,26699.4,595.96,36968.4,39
CDM,76112095,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,41076.0,26699.4,556.44,40475.0,39
CDM,76112105,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,13671.0,8886.15,251.77,40475.0,28
CDM,76112115,LYSIS VAGINAL ADHESIONS,18283.0,11883.95,201.93,16454.7,45
CDM,76112505,RMVL FECAL IMPACTION/FB SPX UNDER ANES,6780.0,4407.0,289.85,8370.0,46
CDM,76112515,ABLTJ PERC CRYOABLTJ IMG GDN LXTR/PERPH NERVE,9764.0,6346.6,835.73,8787.6,37
CDM,76112655,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,5391.0,3504.15,151.21,4851.9,46
CDM,76112745,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,4046.0,2629.9,86.76,4268.0,46
CDM,76112755,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,1178.0,765.7,59.99,4268.0,35
CDM,76112765,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,4046.0,2629.9,131.08,4268.0,46
CDM,76112775,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,1839.0,1195.35,92.56,4268.0,35
CDM,76112785,PUNCH BIOPSY SKIN SINGLE LESION,1499.0,974.35,52.3,4151.0,46
CDM,76112795,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,230.0,149.5,28.8,3920.0,35
CDM,76112805,TANGENTIAL BIOPSY SKIN SINGLE LESION,745.0,484.25,41.49,4151.0,46
CDM,76112815,TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,199.0,129.35,24.25,3920.0,35
CDM,76112845,INCISIONAL BIOPSY SKIN SINGLE LESION,2295.0,1491.75,63.47,4151.0,45
CDM,76112855,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,354.0,230.1,34.35,3920.0,35
CDM,76112865,BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID,19831.0,12890.15,276.02,17847.9,46
CDM,76112945,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,22623.0,14704.95,310.73,20360.7,39
CDM,76112985,TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE,10834.0,7042.1,405.91,18285.0,29
CDM,76113105,FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL,1271.0,826.15,49.68,4151.0,35
CDM,76113115,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,1399.0,909.35,46.01,4151.0,46
CDM,76113155,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,2639.0,1715.35,99.88,3259.0,39
CDM,76113165,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,771.0,501.15,50.78,2849.0,28
CDM,76113175,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,41076.0,26699.4,417.69,36968.4,39
CDM,76113185,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,951.0,618.15,59.24,3920.0,35
CDM,76113195,INJECTION ELBOW ARTHROGRAPHY,553.0,359.45,78.41,3920.0,35
CDM,76113205,INJECTION WRIST ARTHROGRAPHY,796.0,517.4,86.05,3920.0,35
CDM,76113215,NJX PX CNTRST KNE ARTHG CNTRST ENHNCD CT/MRI KNE,978.0,635.7,47.18,3920.0,35
CDM,76113225,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,20293.0,13190.45,84.32,18263.7,39
CDM,76113235,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,9316.0,6055.4,233.77,8550.0,46
CDM,76113245,EXCHNG ABSC/CST DRG CATH RAD GID SPX,10908.0,7090.2,85.11,9817.2,46
CDM,76113255,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,5391.0,3504.15,106.62,6289.0,46
CDM,76113265,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,4046.0,2629.9,113.54,6317.0,46
CDM,76113275,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,3838.0,2494.7,185.09,4214.0,46
CDM,76113315,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,6814.0,4429.1,141.41,6132.6,46
CDM,76113365,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1698.0,1103.7,52.83,3920.0,46
CDM,76113395,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,5391.0,3504.15,22.93,6289.0,46
CDM,76113405,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,11779.0,7656.35,119.32,10601.1,46
CDM,76113535,DRAINAGE SCROTAL WALL ABSCESS,9316.0,6055.4,208.95,8384.4,46
CDM,76113625,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,4172.0,2711.8,398.52,13665.0,46
CDM,76113765,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,141.0,91.65,17.96,3920.0,46
CDM,76113775,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,141.0,91.65,17.96,3920.0,46
CDM,76113845,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,11165.0,7257.25,270.56,10048.5,46
CDM,76113855,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,5973.0,3882.45,102.71,6317.0,46
CDM,76113865,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,5973.0,3882.45,125.3,6317.0,46
CDM,76113875,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,5973.0,3882.45,99.18,6317.0,46
CDM,76113885,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,5973.0,3882.45,100.09,5375.7,46
CDM,76113895,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,16843.0,10947.95,178.82,15158.7,46
CDM,76113965,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,19146.0,12444.9,816.59,17231.4,37
CDM,76113985,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,141.0,91.65,17.96,3920.0,46
CDM,76113995,EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,1350.0,877.5,157.05,1215.0,37
CDM,76114015,INSERTION PICC W/RS&I 5 YR/>,11165.0,7257.25,100.8,10048.5,46
CDM,76114025,CHANGE CYSTOSTOMY TUBE COMPLICATED,3838.0,2494.7,96.98,6289.0,46
CDM,76114065,CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY,315.0,204.75,44.56,18285.0,29
CDM,76114085,CHEMODENERVATION VAGINAL MUSCLE,354.0,230.1,99.47,8550.0,45
CDM,76114095,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM,16456.0,10696.4,791.51,14810.4,46
CDM,76114225,ASPIRATION & INJECTION TREATMENT BONE CYST,4046.0,2629.9,187.83,4214.0,46
CDM,76114245,EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM,16456.0,10696.4,624.58,36332.0,46
CDM,76114285,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,1111.0,722.15,44.56,999.9,38
CDM,76114295,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,614.0,399.1,20.57,552.6,38
CDM,76114305,THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG,1818.0,1181.7,30.69,1636.2,38
CDM,76114315,THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG,398.0,258.7,21.87,358.2,38
CDM,76114325,THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC,610.0,396.5,30.69,549.0,27
CDM,76114335,APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,398.0,258.7,26.03,2849.0,38
CDM,76114345,DRAINAGE ABSCESS PALATE UVULA,1335.0,867.75,112.01,4214.0,46
CDM,76114355,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,40980.0,26637.0,288.21,36882.0,39
CDM,76114385,REPAIR INTERMEDIATE S/A/T/E >30.0 CM,6860.0,4459.0,241.35,6174.0,46
CDM,76114395,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,5391.0,3504.15,79.18,6289.0,46
CDM,76114425,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,2295.0,1491.75,241.35,4214.0,45
CDM,76114435,INJECTION PROCEDURE LYMPHANGIOGRAPHY,4696.0,3052.4,98.49,4226.4,35
CDM,76114525,IRRIGATION CORPORA CAVERNOSA PRIAPISM,1399.0,909.35,53.02,4151.0,46
CDM,76114565,HYSTEROSCOPY REMOVAL LEIOMYOMATA,28385.0,18450.25,420.45,25546.5,39
CDM,76114605,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FING,908.0,590.2,19.57,3920.0,46
CDM,76114635,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,9316.0,6055.4,183.64,8384.4,46
CDM,76114755,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,18098.0,11763.7,262.69,36332.0,46
CDM,76114765,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,11165.0,7257.25,72.16,10048.5,46
CDM,76114815,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,18656.0,12126.4,310.03,16790.4,46
CDM,76114825,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM,9316.0,6055.4,322.18,8384.4,46
CDM,76114835,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,73984.0,48089.6,436.1,66585.6,39
CDM,76114845,PROC MUSSKL SYS UNLISTD,2797.0,1818.05,240.79,8370.0,45
CDM,76114855,ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION,33369.0,21689.85,531.7,30032.1,39
CDM,76114865,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,22623.0,14704.95,406.29,20360.7,39
CDM,76114875,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,22623.0,14704.95,377.73,20360.7,39
CDM,76114885,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,11165.0,7257.25,78.99,10048.5,46
CDM,76114895,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,22623.0,14704.95,220.17,20360.7,39
CDM,76114905,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,22623.0,14704.95,342.53,20360.7,39
CDM,76114925,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,38854.0,25255.1,148.67,34968.6,39
CDM,76114935,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,22974.0,14933.1,263.36,20676.6,39
CDM,76114945,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,22623.0,14704.95,415.85,20360.7,39
CDM,76114955,THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX,38854.0,25255.1,457.76,34968.6,46
CDM,76114965,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,22623.0,14704.95,276.29,36332.0,46
CDM,76114975,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,22623.0,14704.95,145.66,36332.0,46
CDM,76115025,INSJ INTRAPERITONEAL CATHETER W/IMG GUID,20293.0,13190.45,241.61,18263.7,39
CDM,76115045,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,11779.0,7656.35,101.0,10601.1,46
CDM,76115055,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,32064.0,20841.6,550.27,28857.6,39
CDM,76115065,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,19831.0,12890.15,243.79,17847.9,39
CDM,76115075,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,19831.0,12890.15,318.24,17847.9,39
CDM,76115085,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,19831.0,12890.15,408.35,17847.9,39
CDM,76115105,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,61270.0,39825.5,693.16,55143.0,39
CDM,76115115,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,65300.0,42445.0,994.94,58770.0,39
CDM,76115235,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,11165.0,7257.25,54.04,10048.5,46
CDM,76115265,CLTX POST HIP ARTHRP DISLC W/O ANES,1379.0,896.35,240.79,4151.0,46
CDM,76115435,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,1499.0,974.35,115.89,3920.0,46
CDM,76115495,PERITONSILAR ASPIRATION W/NEEDLE,583.0,378.95,163.82,7730.0,45
CDM,76115505,QUTENZA APPLICATION (COMP 64632),847.0,550.55,238.01,8550.0,45
CDM,76115525,PLACEMENT NEEDLE INTRAOSSEOUS INFUSION,2868.0,1864.2,76.83,4151.0,46
CDM,76115635,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,1156.0,751.4,136.27,4151.0,46
CDM,76115655,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,81510.0,52981.5,890.12,73359.0,39
CDM,76115665,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,129064.0,83891.6,859.26,116157.6,39
CDM,76115705,RPR NSL VLV COLLAPSE LW NRG SUBQ/SBMCSL RMDLG,34015.0,22109.75,171.41,30613.5,39
CDM,76115715,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,81510.0,52981.5,676.74,73359.0,39
CDM,76115725,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,81510.0,52981.5,1013.41,73359.0,39
CDM,76115825,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,22623.0,14704.95,112.14,20360.7,46
CDM,76115835,NPWT (WOUND VAT),1026.0,666.9,172.37,923.4,21
CDM,76115845,INCISION AND DRAINAGE,863.0,560.95,144.98,776.7,21
CDM,76115855,WOUND DEBRIDEMENT,1724.0,1120.6,289.63,1551.6,21
CDM,76115865,APHERESIS,4224.0,2745.6,709.63,3801.6,21
CDM,76116045,"UNLIST PROC, NERVOUS SYSTEM COMPARED TO 64640",3015.0,1959.75,249.83,8550.0,45
CDM,76116125,"OSTEOPATHIC MANIP,1-2 BODY REGN",95.0,61.75,17.96,85.5,38
CDM,76116135,MANUAL REDUCTION OF INGUINAL HERNIA (COMP CODE 49505),7003.0,4551.95,454.96,8370.0,45
CDM,76116245,SUPRACHOROIDAL SPACE NJX PHARMACOLOGIC AGENT,1908.0,1240.2,30.69,4151.0,46
CDM,76116275,FOREIGN BODY REMOVAL (TOOTH) AND I&D (COMP CODE 10061),770.0,500.5,199.43,8550.0,45
CDM,76116285,NASAL/SINUS NDSC DSTRJ RF ABLATION PST NSL NRV,34015.0,22109.75,180.49,30613.5,39
CDM,76116295,REMOVAL OF BREAST IMPLANT,14360.0,9334.0,646.88,12924.0,39
CDM,76116305,RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS,14360.0,9334.0,751.49,12924.0,39
CDM,76116325,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,22623.0,14704.95,394.12,20360.7,39
CDM,76116335,ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN,22623.0,14704.95,138.85,20360.7,39
CDM,76116345,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,6766.0,4397.9,283.81,18285.0,36
CDM,76116385,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,8518.0,5536.7,374.02,7666.2,46
CDM,76116395,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,1335.0,867.75,233.1,6317.0,46
CDM,76116405,INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR,38854.0,25255.1,389.35,34968.6,39
CDM,76116425,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN,1861.0,1209.65,129.78,3920.0,35
CDM,76116435,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ,5973.0,3882.45,134.7,6317.0,46
CDM,76116445,INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR,22623.0,14704.95,402.72,20360.7,39
CDM,76116455,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,59484.0,38664.6,193.69,53535.6,39
CDM,76116465,INSERTION PICC W/O IMG GDN < 5 YR,11165.0,7257.25,118.19,10048.5,46
CDM,76116475,INSERTION PICC W/RS&I < 5 YR,4444.0,2888.6,103.21,6317.0,45
CDM,76116485,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,2861.0,1859.65,93.33,2574.9,38
CDM,76116495,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,2861.0,1859.65,156.76,2574.9,38
CDM,76116505,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,6643.0,4317.95,332.3,18285.0,36
CDM,76116515,MAM STEREO BREAST BX FIRST LES,13975.0,9083.75,193.54,12577.5,46
CDM,76116525,CT GD DRAIN PERI/RETROPERI PER,9316.0,6055.4,233.77,8550.0,46
CDM,76116675,ASPIRATION OF SPERMATOCELE (COMP CODE 55000),2011.0,1307.15,244.13,8370.0,45
CDM,76116695,ABLTJ PERC CRYOABLTJ IMG GDN UXTR/PERPH NERVE,9764.0,6346.6,835.73,8787.6,37
CDM,76116745,PERIURETHRAL TPRNL ADJTBL BALO CNTNC DEV BI INSJ (COMP CODE 5344,23698.0,15403.7,2345.0,28169.71,38
CDM,76116755,PERIURETHRL TPRNL ADJTBL BALO CNTNC DEV UNI INSJ (COMP CODE 5344,23273.0,15127.45,1849.92,20945.7,38
CDM,76116765,PERIURETHRAL TPRNL ADJTBL BALO CNTNC DEV RMVL EA (COMP CODE 5344,21556.0,14011.4,1849.92,19400.4,38
CDM,76116775,PERIURETHRAL TPRNL ADJTBL BALO CNTNC DEV ADJMT (COMP CODE S2083),1399.0,909.35,244.13,4214.0,45
CDM,76116785,BEDSIDE PERIPHERAL NERVE BLOCK,761.0,494.65,127.85,684.9,21
CDM,76117065,CYSTO INSJ TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,41901.0,27235.65,198.05,37710.9,46
CDM,76117075,CATHJ RMVL TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,1399.0,909.35,53.02,4151.0,46
CDM,76117095,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR,1423.0,924.95,239.06,18285.0,29
CDM,76117105,INSTILL PHARM RENAL PELVIS,12940.0,8411.0,248.59,11646.0,37
CDM,76117175,VAGINAL LASER THERAPY - FEMILIFT (SELF PAY),531.0,345.15,98.33,477.9,37
CDM,76117185,ASPIRATION OF INTRAMUSCULAR HEMATOMA (COMP CODE 10160),1027.0,667.55,240.79,13665.0,45
CDM,76117255,"SIMP REPAIR FAC,EAR,EYE 12.6-20CM",1499.0,974.35,115.89,3920.0,46
CDM,76117265,DESTRUCTION LESION DENTOALVEOLAR STRUCTURES,8518.0,5536.7,1209.93,8370.0,45
CDM,76117275,DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM,18648.0,12121.2,164.47,16783.2,46
CDM,76117365,EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM,16456.0,10696.4,635.29,36332.0,46
CDM,76117375,BEDSIDE PROCEDURE 1ST 30 MIN,4243.0,2757.95,712.82,3818.7,21
CDM,76117385,BEDSIDE PROCEDURE EA ADDL 30 MIN,3124.0,2030.6,524.83,2811.6,21
CDM,76117405,TRANSCRV INSTLJ BIOD HYDROGEL MATRL INTRAUTERINE,1039.0,675.35,132.47,2849.0,27
CDM,76117415,DRG OF SKENE'S GLAND ABSCESS OR CYST,965.0,627.25,194.52,4441.51,46
CDM,76117435,BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED,20708.0,13460.2,182.66,18637.2,31
CDM,76117445,BX PROSTATE TRANSRECTAL US GID W/MRI FUS GDN 1ST,20708.0,13460.2,229.26,18637.2,31
CDM,76117455,BX PROSTATE TRANSPERINEAL ULTRASOUND-GUIDED,20708.0,13460.2,219.71,18637.2,31
CDM,76117465,BX PROSTATE TRANSPERINEAL US GID W/MRI FUS GDN 1,20708.0,13460.2,255.17,18637.2,31
CDM,76117475,BX PROSTATE TRANSRECTAL MRI-US GID TRGT LES 1ST,20708.0,13460.2,181.63,18637.2,31
CDM,76117485,BX PROSTATE TPRNL MRI-US GID TRGT LES 1ST,20708.0,13460.2,212.45,18637.2,31
CDM,76117495,BX PROSTATE IN-BORE CT/MRI BX ADDL TRGT LES 1ST,31498.0,20473.7,254.73,28348.2,31
CDM,76117505,BX PROSTATE IN-BORE CT/MRI TRGT LES ONLY 1ST,31498.0,20473.7,231.43,28348.2,31
CDM,76117515,BX PROSTATE EA ADDL MRI-US FUSION/IN-BORE CT/MRI,31498.0,20473.7,64.9,28348.2,28
CDM,76117525,INJECTION INTO BLADDER LESIONS (NON CHEMODENERVATION) (COMP CODE,11779.0,7656.35,244.13,10601.1,45
CDM,76120WE,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,1070.0,695.5,60.37,1070.0,32
CDM,76120WE-26,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,152.0,98.8,16.05,152.0,31
CDM,76120WE-TC,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,918.0,596.7,50.11,918.0,35
CDM,76140WE,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,2306.0,1498.9,1153.0,2306.0,12
CDM,76140WE-26,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,141.0,91.65,70.5,141.0,12
CDM,76140WE-TC,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,2165.0,1407.25,1082.5,2165.0,12
CDM,76200050,OBSERVATION PER HR NMN,114.0,74.1,19.15,8920.0,39
CDM,76200295,DIR ADMIT FOR HOSP OBV CARE,3065.0,1992.25,615.42,8920.0,43
CDM,76200545,OBSERVATION PER HR-SUBSEQUENT HOUR,111.0,72.15,18.65,8920.0,39
CDM,76201235,OBSERVATION PER HR-FIRST HOUR,1264.0,821.6,212.35,8920.0,39
CDM,76201265,OBSERVATION CARVE-OUT PER HR,165.0,107.25,27.72,8920.0,39
CDM,76201275,OBSERV CARVE OUT 60 MINUTES GRP 9,165.0,107.25,27.72,8920.0,39
CDM,76201315,OBSERV CARVE OUT 60 MINUTES GRP 1,165.0,107.25,27.72,8920.0,39
CDM,76201325,OBSERV CARVE OUT GRP 7,165.0,107.25,27.72,8920.0,39
CDM,76201335,OBSERV CARVE OUT GRP 8,165.0,107.25,27.72,8920.0,39
CDM,76201345,OBSERV CARVE OUT 60 MINUTES GRP 2,165.0,107.25,27.72,8920.0,39
CDM,76201355,OBSERV CARVE OUT 60 MINUTES GRP 3,165.0,107.25,27.72,8920.0,39
CDM,76201365,OBSERV CARVE OUT 60 MINUTES GRP 4,165.0,107.25,27.72,8920.0,39
CDM,76201375,OBSERV CARVE OUT 60 MINUTES GRP 5,165.0,107.25,27.72,8920.0,39
CDM,76201385,OBSERV CARVE OUT 60 MINUTES GRP 6,165.0,107.25,27.72,8920.0,39
CDM,76201395,OBSERV CARVE OUT 60 MINUTES GRP 10,165.0,107.25,27.72,8920.0,39
CDM,76376PROWE,3D RENDER W/O POSTPROCESS,88.0,57.2,18.56,88.0,32
CDM,76376WE,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,796.0,517.4,18.56,796.0,32
CDM,76376WE-26,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,88.0,57.2,8.38,88.0,31
CDM,76376WE-TC,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,708.0,460.2,16.07,708.0,35
CDM,76377PROWE,3D RENDER W/POSTPROCESS,316.0,205.4,55.39,316.0,32
CDM,76377WE,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,2111.0,1372.15,55.39,2111.0,32
CDM,76377WE-26,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,316.0,205.4,32.67,316.0,31
CDM,76377WE-TC,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1795.0,1166.75,41.17,1795.0,35
CDM,76380PROWE,CT LMTD OR LOC F/U STUDY,392.0,254.8,92.85,392.0,32
CDM,76380WE,CT LIMITED/LOCALIZED FOLLOW UP STUDY,1152.0,748.8,92.85,1152.0,32
CDM,76380WE-26,CT LIMITED/LOCALIZED FOLLOW UP STUDY,392.0,254.8,40.34,392.0,31
CDM,76380WE-TC,CT LIMITED/LOCALIZED FOLLOW UP STUDY,760.0,494.0,85.47,760.0,35
CDM,76390WE,MRI SPECTROSCOPY,1228.0,798.2,270.83,1228.0,18
CDM,76390WE-26,MRI SPECTROSCOPY,468.0,304.2,58.11,468.0,17
CDM,76390WE-TC,MRI SPECTROSCOPY,760.0,494.0,202.55,760.0,21
CDM,76391WE,MAGNETIC RESONANCE ELASTOGRAPHY,2569.0,1669.85,169.95,2569.0,28
CDM,76391WE-26,MAGNETIC RESONANCE ELASTOGRAPHY,484.0,314.6,51.36,484.0,31
CDM,76391WE-TC,MAGNETIC RESONANCE ELASTOGRAPHY,2085.0,1355.25,146.41,2085.0,35
CDM,76496RVU10WE,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),27604.0,17942.6,72.18,27604.0,13
CDM,76496RVU10WE-26,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),456.0,296.4,21.42,456.0,16
CDM,76496RVU10WE-TC,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),27148.0,17646.2,99.32,27148.0,20
CDM,76496RVU11WE,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),47496.0,30872.4,72.18,47496.0,13
CDM,76496RVU11WE-26,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),872.0,566.8,21.42,872.0,16
CDM,76496RVU11WE-TC,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),46624.0,30305.6,99.32,46624.0,20
CDM,76496RVU12WE,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",27650.0,17972.5,72.18,27650.0,13
CDM,76496RVU12WE-26,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",502.0,326.3,21.42,502.0,16
CDM,76496RVU12WE-TC,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",27148.0,17646.2,99.32,27148.0,20
CDM,76496RVU13WE,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),27604.0,17942.6,72.18,27604.0,13
CDM,76496RVU13WE-26,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),456.0,296.4,21.42,456.0,16
CDM,76496RVU13WE-TC,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),27148.0,17646.2,99.32,27148.0,20
CDM,76496RVU14WE,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),47496.0,30872.4,72.18,47496.0,13
CDM,76496RVU14WE-26,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),872.0,566.8,21.42,872.0,16
CDM,76496RVU14WE-TC,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),46624.0,30305.6,99.32,46624.0,20
CDM,76496RVU15WE,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),47496.0,30872.4,72.18,47496.0,13
CDM,76496RVU15WE-26,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),872.0,566.8,21.42,872.0,16
CDM,76496RVU15WE-TC,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),46624.0,30305.6,99.32,46624.0,20
CDM,76496RVU16WE,VENOGRAM SPLENIC VEIN (COMP CODE 75891),27604.0,17942.6,72.18,27604.0,13
CDM,76496RVU16WE-26,VENOGRAM SPLENIC VEIN (COMP CODE 75891),456.0,296.4,21.42,456.0,16
CDM,76496RVU16WE-TC,VENOGRAM SPLENIC VEIN (COMP CODE 75891),27148.0,17646.2,99.32,27148.0,20
CDM,76496RVU17WE,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),47496.0,30872.4,72.18,47496.0,13
CDM,76496RVU17WE-26,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),872.0,566.8,21.42,872.0,16
CDM,76496RVU17WE-TC,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),46624.0,30305.6,99.32,46624.0,20
CDM,76496RVU18WE,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),5632.0,3660.8,72.18,5632.0,13
CDM,76496RVU18WE-26,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),404.0,262.6,21.42,404.0,16
CDM,76496RVU18WE-TC,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),5228.0,3398.2,99.32,5228.0,20
CDM,76496RVU19WE,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),27604.0,17942.6,72.18,27604.0,13
CDM,76496RVU19WE-26,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),456.0,296.4,21.42,456.0,16
CDM,76496RVU19WE-TC,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),27148.0,17646.2,99.32,27148.0,20
CDM,76496RVU1WE,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),25232.0,16400.8,72.18,25232.0,13
CDM,76496RVU1WE-26,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),631.0,410.15,21.42,631.0,16
CDM,76496RVU1WE-TC,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),24601.0,15990.65,99.32,24601.0,20
CDM,76496RVU20WE,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),13819.0,8982.35,72.18,13819.0,13
CDM,76496RVU20WE-26,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),420.0,273.0,21.42,420.0,16
CDM,76496RVU20WE-TC,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),13399.0,8709.35,99.32,13399.0,20
CDM,76496RVU21WE,VENOGRAM CARDINAL VARIX (COMP CODE 75891),27604.0,17942.6,72.18,27604.0,13
CDM,76496RVU21WE-26,VENOGRAM CARDINAL VARIX (COMP CODE 75891),456.0,296.4,21.42,456.0,16
CDM,76496RVU21WE-TC,VENOGRAM CARDINAL VARIX (COMP CODE 75891),27148.0,17646.2,99.32,27148.0,20
CDM,76496RVU2WE,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),5205.0,3383.25,72.18,5205.0,13
CDM,76496RVU2WE-26,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),364.0,236.6,21.42,364.0,16
CDM,76496RVU2WE-TC,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),4841.0,3146.65,99.32,4841.0,20
CDM,76496RVU3WE,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),43197.0,28078.05,72.18,43197.0,13
CDM,76496RVU3WE-26,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),785.0,510.25,21.42,785.0,16
CDM,76496RVU3WE-TC,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),42412.0,27567.8,99.32,42412.0,20
CDM,76496RVU4WE,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),42823.0,27834.95,72.18,42823.0,13
CDM,76496RVU4WE-26,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),411.0,267.15,21.42,411.0,16
CDM,76496RVU4WE-TC,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),42412.0,27567.8,99.32,42412.0,20
CDM,76496RVU5WE,VENOGRAM AZYGOS VEIN (COMP CODE 75705),43197.0,28078.05,72.18,43197.0,13
CDM,76496RVU5WE-26,VENOGRAM AZYGOS VEIN (COMP CODE 75705),785.0,510.25,21.42,785.0,16
CDM,76496RVU5WE-TC,VENOGRAM AZYGOS VEIN (COMP CODE 75705),42412.0,27567.8,99.32,42412.0,20
CDM,76496RVU6WE,VENOGRAM GASTRIC VEIN (COMP CODE 75891),25012.0,16257.8,72.18,25012.0,13
CDM,76496RVU6WE-26,VENOGRAM GASTRIC VEIN (COMP CODE 75891),411.0,267.15,21.42,411.0,16
CDM,76496RVU6WE-TC,VENOGRAM GASTRIC VEIN (COMP CODE 75891),24601.0,15990.65,99.32,24601.0,20
CDM,76496RVU7WE,VENOGRAM GONADAL VEIN (COMP CODE 75831),25012.0,16257.8,72.18,25012.0,13
CDM,76496RVU7WE-26,VENOGRAM GONADAL VEIN (COMP CODE 75831),411.0,267.15,21.42,411.0,16
CDM,76496RVU7WE-TC,VENOGRAM GONADAL VEIN (COMP CODE 75831),24601.0,15990.65,99.32,24601.0,20
CDM,76496RVU8WE,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),25012.0,16257.8,72.18,25012.0,13
CDM,76496RVU8WE-26,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),411.0,267.15,21.42,411.0,16
CDM,76496RVU8WE-TC,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),24601.0,15990.65,99.32,24601.0,20
CDM,76496RVU9WE,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),27604.0,17942.6,72.18,27604.0,13
CDM,76496RVU9WE-26,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),456.0,296.4,21.42,456.0,16
CDM,76496RVU9WE-TC,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),27148.0,17646.2,99.32,27148.0,20
CDM,76496WE,"UNLISTED FLUOROSCOPIC PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL",677.0,440.05,72.18,677.0,13
CDM,76496WE-26,"UNLISTED FLUOROSCOPIC PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL",157.0,102.05,21.42,157.0,16
CDM,76496WE-TC,"UNLISTED FLUOROSCOPIC PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL",520.0,338.0,99.32,520.0,20
CDM,76497AWE,CT ABDOMEN SCREENING (COMP CODE 74176),134.0,87.1,67.0,134.0,13
CDM,76497AWE-26,CT ABDOMEN SCREENING (COMP CODE 74176),44.0,28.6,19.89,44.0,16
CDM,76497LWE,CT CHEST/LUNG SCREENING (COMP CODE G0297),234.0,152.1,117.0,234.0,13
CDM,76497LWE-26,CT CHEST/LUNG SCREENING (COMP CODE G0297),42.0,27.3,19.89,42.0,16
CDM,76497PROWE,CTA HEART FYNCTION EJECTION WALL MOTION,284.0,184.6,133.87,284.0,13
CDM,76497PWE,CT PELVIS SCREENING (COMP CODE 74176),130.0,84.5,65.0,133.87,13
CDM,76497PWE-26,CT PELVIS SCREENING (COMP CODE 74176),44.0,28.6,19.89,44.0,16
CDM,76497WBWE,LOW DOSE WHOLE BODY CT (COMP CODE 78813),13380.0,8697.0,133.87,13380.0,13
CDM,76497WBWE-26,LOW DOSE WHOLE BODY CT (COMP CODE 78813),800.0,520.0,19.89,800.0,16
CDM,76497WBWE-TC,LOW DOSE WHOLE BODY CT (COMP CODE 78813),12580.0,8177.0,96.98,12580.0,20
CDM,76497WE,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,550.0,357.5,133.87,550.0,13
CDM,76497WE-26,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,30.0,19.5,15.0,30.0,16
CDM,76497WE-TC,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,520.0,338.0,96.98,520.0,20
CDM,76498AWE,MRI GAMMA KNIFE LOCAL W CONT,3042.0,1977.3,69.93,3042.0,13
CDM,76498AWE-26,MRI GAMMA KNIFE LOCAL W CONT,587.0,381.55,17.21,587.0,16
CDM,76498AWE-TC,MRI GAMMA KNIFE LOCAL W CONT,2455.0,1595.75,84.3,2455.0,20
CDM,76498BWE,MRI BREAST LIMITED,406.0,263.9,69.93,406.0,13
CDM,76498BWE-26,MRI BREAST LIMITED,125.0,81.25,17.21,125.0,16
CDM,76498BWE-TC,MRI BREAST LIMITED,281.0,182.65,84.3,281.0,20
CDM,76498CWE,MRI CERVICAL LOCALIZATION W IVCON,3163.0,2055.95,69.93,3163.0,13
CDM,76498CWE-26,MRI CERVICAL LOCALIZATION W IVCON,591.0,384.15,17.21,591.0,16
CDM,76498CWE-TC,MRI CERVICAL LOCALIZATION W IVCON,2572.0,1671.8,84.3,2572.0,20
CDM,76498DWE,MRI BRAIN LOCALIZATION WO CONT,4443.0,2887.95,69.93,4443.0,13
CDM,76498DWE-26,MRI BRAIN LOCALIZATION WO CONT,2319.0,1507.35,17.21,2319.0,16
CDM,76498DWE-TC,MRI BRAIN LOCALIZATION WO CONT,2124.0,1380.6,84.3,2124.0,20
CDM,76498GWE,MRI BRAIN LOCALIZATION WWO CONT,3488.0,2267.2,69.93,3488.0,13
CDM,76498GWE-26,MRI BRAIN LOCALIZATION WWO CONT,916.0,595.4,17.21,916.0,16
CDM,76498GWE-TC,MRI BRAIN LOCALIZATION WWO CONT,2572.0,1671.8,84.3,2572.0,20
CDM,76498LWE,MRI LUMBAR LOCALIZATION W IVCON,3171.0,2061.15,69.93,3171.0,13
CDM,76498LWE-26,MRI LUMBAR LOCALIZATION W IVCON,599.0,389.35,17.21,599.0,16
CDM,76498LWE-TC,MRI LUMBAR LOCALIZATION W IVCON,2572.0,1671.8,84.3,2572.0,20
CDM,76498POM1WE,MRI PRE-OP MAPPING W/CONTRAST,1389.0,902.85,69.93,1389.0,13
CDM,76498POM1WE-26,MRI PRE-OP MAPPING W/CONTRAST,629.0,408.85,17.21,629.0,16
CDM,76498POM1WE-TC,MRI PRE-OP MAPPING W/CONTRAST,760.0,494.0,84.3,760.0,20
CDM,76498POM2WE,MRI PRE-OP MAPPING W/WO CNTRST,1595.0,1036.75,69.93,1595.0,13
CDM,76498POM2WE-26,MRI PRE-OP MAPPING W/WO CNTRST,835.0,542.75,17.21,835.0,16
CDM,76498POM2WE-TC,MRI PRE-OP MAPPING W/WO CNTRST,760.0,494.0,84.3,760.0,20
CDM,76498POMWE,MRI PRE-OP MAPPING W/O CONTRST,1283.0,833.95,69.93,1283.0,13
CDM,76498POMWE-26,MRI PRE-OP MAPPING W/O CONTRST,523.0,339.95,17.21,523.0,16
CDM,76498POMWE-TC,MRI PRE-OP MAPPING W/O CONTRST,760.0,494.0,84.3,760.0,20
CDM,76498PWE,MRI PROSTATE LIMITED WO IVCON,508.0,330.2,69.93,508.0,13
CDM,76498PWE-26,MRI PROSTATE LIMITED WO IVCON,70.0,45.5,17.21,70.0,16
CDM,76498PWE-TC,MRI PROSTATE LIMITED WO IVCON,438.0,284.7,84.3,438.0,20
CDM,76498RVU1WE,MRI BRAIN W/WO CONTRAST PC,3209.0,2085.85,69.93,3209.0,13
CDM,76498RVU1WE-26,MRI BRAIN W/WO CONTRAST PC,129.0,83.85,17.21,129.0,16
CDM,76498RVU1WE-TC,MRI BRAIN W/WO CONTRAST PC,3080.0,2002.0,84.3,3080.0,20
CDM,76498RVU2WE,MRI 3D CAD (COMP CODE 76377),1488.0,967.2,69.93,1488.0,13
CDM,76498RVU2WE-26,MRI 3D CAD (COMP CODE 76377),257.0,167.05,17.21,257.0,16
CDM,76498RVU2WE-TC,MRI 3D CAD (COMP CODE 76377),1231.0,800.15,84.3,1231.0,20
CDM,76498RVU3WE,WHOLE BODY MRI (COMP CODE 78816),13481.0,8762.65,69.93,13481.0,13
CDM,76498RVU3WE-26,WHOLE BODY MRI (COMP CODE 78816),901.0,585.65,17.21,901.0,16
CDM,76498RVU3WE-TC,WHOLE BODY MRI (COMP CODE 78816),12580.0,8177.0,84.3,12580.0,20
CDM,76498RVUWE,MMR BRAIN WITH PC,3667.0,2383.55,69.93,3667.0,13
CDM,76498RVUWE-26,MMR BRAIN WITH PC,587.0,381.55,17.21,587.0,16
CDM,76498RVUWE-TC,MMR BRAIN WITH PC,3080.0,2002.0,84.3,3080.0,20
CDM,76498TWE,MRI THORACIC LOCALIZATION W IVCON,3163.0,2055.95,69.93,3163.0,13
CDM,76498TWE-26,MRI THORACIC LOCALIZATION W IVCON,591.0,384.15,17.21,591.0,16
CDM,76498TWE-TC,MRI THORACIC LOCALIZATION W IVCON,2572.0,1671.8,84.3,2572.0,20
CDM,76499BDWE,BD WHOLE BODY COMPOSITION,981.0,637.65,490.5,981.0,12
CDM,76499BDWE-26,BD WHOLE BODY COMPOSITION,63.0,40.95,31.5,63.0,12
CDM,76499BDWE-TC,BD WHOLE BODY COMPOSITION,918.0,596.7,459.0,918.0,12
CDM,76499RVU1WE,3D RENDERING LIVER (DONOR) S&I,2894.0,1881.1,1447.0,2894.0,12
CDM,76499RVU1WE-26,3D RENDERING LIVER (DONOR) S&I,1099.0,714.35,549.5,1099.0,12
CDM,76499RVU1WE-TC,3D RENDERING LIVER (DONOR) S&I,1795.0,1166.75,897.5,1795.0,12
CDM,76499RVU2WE,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE (COMP TO 78445),3628.0,2358.2,1814.0,3628.0,12
CDM,76499RVU2WE-26,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE (COMP TO 78445),162.0,105.3,81.0,162.0,12
CDM,76499RVU2WE-TC,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE (COMP TO 78445),3466.0,2252.9,1733.0,3466.0,12
CDM,76499RVU3WE,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP (COMP CODE 7574",27180.0,17667.0,13590.0,27180.0,12
CDM,76499RVU3WE-26,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP (COMP CODE 7574",32.0,20.8,16.0,32.0,12
CDM,76499RVU3WE-TC,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP (COMP CODE 7574",27148.0,17646.2,13574.0,27148.0,12
CDM,76499RVU4WE,UNLISTED DXA BODY COMPOSITION STUDY (COMP CODE 77080),1003.0,651.95,501.5,1003.0,12
CDM,76499RVU4WE-26,UNLISTED DXA BODY COMPOSITION STUDY (COMP CODE 77080),85.0,55.25,42.5,85.0,12
CDM,76499RVU4WE-TC,UNLISTED DXA BODY COMPOSITION STUDY (COMP CODE 77080),918.0,596.7,459.0,918.0,12
CDM,76499RVU7WE,LYMPHANGIOGRAPHY OF FACE & NECK (COMP CODE 75803),13903.0,9036.95,6951.5,13903.0,12
CDM,76499RVU7WE-26,LYMPHANGIOGRAPHY OF FACE & NECK (COMP CODE 75803),504.0,327.6,252.0,504.0,12
CDM,76499RVU7WE-TC,LYMPHANGIOGRAPHY OF FACE & NECK (COMP CODE 75803),13399.0,8709.35,6699.5,13399.0,12
CDM,76499RVUWE,CT ABDOMEN W/O SCREENING,1442.0,937.3,721.0,1442.0,12
CDM,76499RVUWE-26,CT ABDOMEN W/O SCREENING,524.0,340.6,262.0,524.0,12
CDM,76499RVUWE-TC,CT ABDOMEN W/O SCREENING,918.0,596.7,459.0,918.0,12
CDM,76499WE,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,586.0,380.9,293.0,586.0,12
CDM,76499WE-26,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,66.0,42.9,33.0,66.0,12
CDM,76499WE-TC,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,520.0,338.0,260.0,520.0,12
CDM,76506WE,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,1170.0,760.5,62.7,1170.0,32
CDM,76506WE-26,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,252.0,163.8,26.42,252.0,31
CDM,76506WE-TC,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,918.0,596.7,77.08,918.0,35
CDM,76511WE,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,1200.0,780.0,54.9,1200.0,32
CDM,76511WE-26,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,282.0,183.3,34.19,282.0,31
CDM,76511WE-TC,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,918.0,596.7,20.91,918.0,35
CDM,76512WE,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,1164.0,756.6,43.67,1164.0,32
CDM,76512WE-26,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,246.0,159.9,29.34,246.0,31
CDM,76512WE-TC,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,918.0,596.7,17.36,918.0,35
CDM,76513WE,DX OPHTHALMIC US ANT SEGMENT IMMERSION UNI/BI,1182.0,768.3,64.29,1182.0,32
CDM,76513WE-26,DX OPHTHALMIC US ANT SEGMENT IMMERSION UNI/BI,264.0,171.6,28.86,264.0,31
CDM,76513WE-TC,DX OPHTHALMIC US ANT SEGMENT IMMERSION UNI/BI,918.0,596.7,41.25,918.0,35
CDM,76514WE,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,273.0,177.45,8.27,273.0,32
CDM,76514WE-26,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,62.0,40.3,7.68,62.0,31
CDM,76514WE-TC,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,211.0,137.15,3.8,211.0,35
CDM,76519OPHWE,OPHTHALMIC BIOMETRY,1134.0,737.1,51.05,1134.0,32
CDM,76519PROWE,OPHTHALMIC BIOMETRY W IOL POWER CALCULATI,216.0,140.4,51.05,216.0,32
CDM,76519WE,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,1134.0,737.1,51.05,1134.0,32
CDM,76519WE-26,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,216.0,140.4,26.03,216.0,31
CDM,76519WE-TC,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,918.0,596.7,37.05,918.0,35
CDM,76536ECHWE,ECHO HEAD NECK SOFT TISSUE,1164.0,756.6,59.89,1164.0,32
CDM,76536PROWE,ECHO HEAD NECK SOFT TISSUE,246.0,159.9,59.89,246.0,32
CDM,76536WE,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,1164.0,756.6,59.89,1164.0,32
CDM,76536WE-26,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,246.0,159.9,23.15,246.0,31
CDM,76536WE-TC,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,918.0,596.7,80.56,918.0,35
CDM,76604ECHWE,ECHO CHEST  B-SCAN,1154.0,750.1,51.82,1154.0,32
CDM,76604PROWE,ECHO CHEST  B-SCAN,236.0,153.4,51.82,236.0,32
CDM,76604WE,US CHEST REAL TIME W/IMAGE DOCUMENTATION,1154.0,750.1,51.82,1154.0,32
CDM,76604WE-26,US CHEST REAL TIME W/IMAGE DOCUMENTATION,236.0,153.4,22.58,236.0,31
CDM,76604WE-TC,US CHEST REAL TIME W/IMAGE DOCUMENTATION,918.0,596.7,30.27,918.0,35
CDM,76641WE,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,1239.0,805.35,76.93,1239.0,28
CDM,76641WE-26,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,321.0,208.65,34.62,321.0,31
CDM,76641WE-TC,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,918.0,596.7,65.46,918.0,35
CDM,76642WE,US BREAST UNI REAL TIME WITH IMAGE LIMITED,1059.0,688.35,63.36,1059.0,28
CDM,76642WE-26,US BREAST UNI REAL TIME WITH IMAGE LIMITED,299.0,194.35,32.36,299.0,31
CDM,76642WE-TC,US BREAST UNI REAL TIME WITH IMAGE LIMITED,760.0,494.0,50.93,760.0,35
CDM,76700ECHWE,ECHO ABDOMEN B-SCAN COMP,1274.0,828.1,84.07,1274.0,32
CDM,76700PROWE,ECHO ABDOMEN B-SCAN COMP,356.0,231.4,84.07,356.0,32
CDM,76700WE,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,1274.0,828.1,84.07,1274.0,32
CDM,76700WE-26,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,356.0,231.4,33.52,356.0,31
CDM,76700WE-TC,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,918.0,596.7,75.39,918.0,35
CDM,76705PROWE,ECHO ABDOMEN LIMITED,260.0,169.0,60.86,260.0,32
CDM,76705ULTWE,ULTRASOUND ABDOM LIMITED,1178.0,765.7,60.86,1178.0,32
CDM,76705WE,US ABDOMINAL REAL TIME W/IMAGE LIMITED,1178.0,765.7,60.86,1178.0,32
CDM,76705WE-26,US ABDOMINAL REAL TIME W/IMAGE LIMITED,260.0,169.0,24.29,260.0,31
CDM,76705WE-TC,US ABDOMINAL REAL TIME W/IMAGE LIMITED,918.0,596.7,57.39,918.0,35
CDM,76706WE,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,1138.0,739.7,67.75,1138.0,28
CDM,76706WE-26,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,220.0,143.0,25.64,220.0,31
CDM,76706WE-TC,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,918.0,596.7,77.73,918.0,35
CDM,76770ECHWE,ECHO RETROPERITONEAL COMP,1244.0,808.6,81.56,1244.0,32
CDM,76770PROWE,ECHO RETROPERITONEAL COMP,326.0,211.9,81.56,326.0,32
CDM,76770WE,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,1244.0,808.6,81.56,1244.0,32
CDM,76770WE-26,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,326.0,211.9,30.68,326.0,31
CDM,76770WE-TC,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,918.0,596.7,71.2,918.0,35
CDM,76775ECHWE,ECHO RETROPERITONEAL LTD,1150.0,747.5,47.11,1150.0,32
CDM,76775PROWE,ECHO RETROPERITONEAL LTD,232.0,150.8,47.11,232.0,32
CDM,76775WE,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,1150.0,747.5,47.11,1150.0,32
CDM,76775WE-26,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,232.0,150.8,24.01,232.0,31
CDM,76775WE-TC,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,918.0,596.7,32.53,918.0,35
CDM,76776WE,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,1222.0,794.3,100.3,1222.0,32
CDM,76776WE-26,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,304.0,197.6,31.25,304.0,31
CDM,76776WE-TC,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,918.0,596.7,100.95,918.0,35
CDM,76800WE,ULTRASOUND SPINAL CANAL & CONTENTS,1370.0,890.5,81.47,1370.0,32
CDM,76800WE-26,ULTRASOUND SPINAL CANAL & CONTENTS,452.0,293.8,45.73,452.0,31
CDM,76800WE-TC,ULTRASOUND SPINAL CANAL & CONTENTS,918.0,596.7,67.63,918.0,35
CDM,76801PROWE,"US,PREG UTERUS,<14 WEEKS",436.0,283.4,71.39,436.0,32
CDM,76801WE,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,1354.0,880.1,71.39,1354.0,32
CDM,76801WE-26,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,436.0,283.4,40.77,436.0,31
CDM,76801WE-TC,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,918.0,596.7,67.72,918.0,35
CDM,76802WE,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,1254.0,815.1,47.71,1254.0,32
CDM,76802WE-26,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,365.0,237.25,34.24,365.0,31
CDM,76802WE-TC,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,889.0,577.85,20.01,889.0,35
CDM,76805ECHWE,ECHO PREG UTERUS >/= 14 W,1314.0,854.1,94.64,1314.0,32
CDM,76805PROWE,ECHO PREG UTERUS >/= 14 W,396.0,257.4,94.64,396.0,32
CDM,76805WE,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,1314.0,854.1,94.64,1314.0,32
CDM,76805WE-26,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,396.0,257.4,40.77,396.0,31
CDM,76805WE-TC,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,918.0,596.7,84.75,918.0,35
CDM,76810PROWE,US PREG UTERUS EA ADD GES,392.0,254.8,69.44,392.0,32
CDM,76810WE,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,1281.0,832.65,69.44,1281.0,32
CDM,76810WE-26,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,392.0,254.8,40.49,392.0,31
CDM,76810WE-TC,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,889.0,577.85,39.31,889.0,35
CDM,76811WE,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,2845.0,1849.25,157.85,2845.0,32
CDM,76811WE-26,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,760.0,494.0,79.14,760.0,31
CDM,76811WE-TC,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,2085.0,1355.25,84.0,2085.0,35
CDM,76812WE,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,1530.0,994.5,99.39,1530.0,32
CDM,76812WE-26,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,712.0,462.8,74.03,712.0,31
CDM,76812WE-TC,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,818.0,531.7,102.51,818.0,35
CDM,76815ECHWE,ECHO PREG UTER LTD 1+,1204.0,782.6,60.45,1204.0,32
CDM,76815PROWE,ECHO PREG UTER LTD 1 +,286.0,185.9,60.45,286.0,32
CDM,76815WE,US PREGNANT UTERUS LIMITED 1/> FETUSES,1204.0,782.6,60.45,1204.0,32
CDM,76815WE-26,US PREGNANT UTERUS LIMITED 1/> FETUSES,286.0,185.9,26.28,286.0,31
CDM,76815WE-TC,US PREGNANT UTERUS LIMITED 1/> FETUSES,918.0,596.7,48.67,918.0,35
CDM,76816WE,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,1292.0,839.8,68.62,1292.0,32
CDM,76816WE-26,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,374.0,243.1,35.66,374.0,31
CDM,76816WE-TC,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,918.0,596.7,66.43,918.0,35
CDM,76817PROWE,"US,PREG UTERUS,TRANSVAGINAL",300.0,195.0,65.56,300.0,32
CDM,76817WE,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,1218.0,791.7,65.56,1218.0,32
CDM,76817WE-26,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,300.0,195.0,31.11,300.0,31
CDM,76817WE-TC,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,918.0,596.7,54.81,918.0,35
CDM,76818FETWE,FETAL BIOPHYSICAL PROFILE W/NON-STRESS,1338.0,869.7,73.41,1338.0,32
CDM,76818PROWE,FETAL BIOPHYS W/NON STRES,420.0,273.0,73.41,420.0,32
CDM,76818WE,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,1338.0,869.7,73.41,1338.0,32
CDM,76818WE-26,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,420.0,273.0,43.91,420.0,31
CDM,76818WE-TC,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,918.0,596.7,62.18,918.0,35
CDM,76819FETWE,FETAL BIOPHYSICAL PROFILE WO STRESS,1257.0,817.05,68.23,1257.0,32
CDM,76819PROWE,FETAL BIOPHYSICAL PROFILE WO STRESS,339.0,220.35,68.23,339.0,32
CDM,76819WE,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,1257.0,817.05,68.23,1257.0,32
CDM,76819WE-26,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,339.0,220.35,32.25,339.0,31
CDM,76819WE-TC,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,918.0,596.7,46.38,918.0,35
CDM,76825WE,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,5397.0,3508.05,186.9,5397.0,32
CDM,76825WE-26,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,668.0,434.2,68.76,668.0,31
CDM,76825WE-TC,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,4729.0,3073.85,120.19,4729.0,35
CDM,76826WE,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,2450.0,1592.5,110.34,2450.0,32
CDM,76826WE-26,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,365.0,237.25,34.52,365.0,31
CDM,76826WE-TC,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,2085.0,1355.25,76.82,2085.0,35
CDM,76827WE,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,1150.0,747.5,49.29,1150.0,32
CDM,76827WE-26,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,232.0,150.8,23.73,232.0,31
CDM,76827WE-TC,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,918.0,596.7,31.16,918.0,35
CDM,76828WE,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,1142.0,742.3,36.88,1142.0,32
CDM,76828WE-26,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,224.0,145.6,22.87,224.0,31
CDM,76828WE-TC,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,918.0,596.7,17.08,918.0,35
CDM,76830PROWE,ECHO TRANSVAGINAL NON-OB,304.0,197.6,67.93,304.0,32
CDM,76830ULTWE,ULTRASOUND TRANSVAGINAL,1222.0,794.3,67.93,1222.0,32
CDM,76830WE,US TRANSVAGINAL,1222.0,794.3,67.93,1222.0,32
CDM,76830WE-26,US TRANSVAGINAL,304.0,197.6,28.55,304.0,31
CDM,76830WE-TC,US TRANSVAGINAL,918.0,596.7,80.56,918.0,35
CDM,76831HYSWE,HYSTEROSONOGRAPHY,2373.0,1542.45,68.77,2373.0,32
CDM,76831PROWE,SALINE INFUSION SONOHYSTER W/WO DOPPLER,288.0,187.2,68.77,288.0,32
CDM,76831WE,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,2373.0,1542.45,68.77,2373.0,32
CDM,76831WE-26,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,288.0,187.2,30.26,288.0,31
CDM,76831WE-TC,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,2085.0,1355.25,77.98,2085.0,35
CDM,76856ECHWE,ECHO PELVIC NOT OBSTETRIC,1222.0,794.3,67.93,1222.0,32
CDM,76856PROWE,ECHO PELVIS NON OB COMP,304.0,197.6,67.93,304.0,32
CDM,76856WE,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,1222.0,794.3,67.93,1222.0,32
CDM,76856WE-26,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,304.0,197.6,28.27,304.0,31
CDM,76856WE-TC,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,918.0,596.7,70.55,918.0,35
CDM,76857BLAWE,BLADDER ULTRASOUND RESIDUAL,1118.0,726.7,38.73,1118.0,32
CDM,76857ECHWE,ECHO PELVIC NOT OB LTD,1118.0,726.7,38.73,1118.0,32
CDM,76857PROWE,ECHO PELVIC NOT OB FU,200.0,130.0,38.73,200.0,32
CDM,76857WE,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,1118.0,726.7,38.73,1118.0,32
CDM,76857WE-26,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,200.0,130.0,16.34,200.0,31
CDM,76857WE-TC,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,918.0,596.7,26.08,918.0,35
CDM,76870ECHWE,ECHO SCROTUM,1174.0,763.1,57.31,1174.0,32
CDM,76870PROWE,ECHO SCROTUM,256.0,166.4,57.31,256.0,32
CDM,76870WE,US SCROTUM & CONTENTS,1174.0,763.1,57.31,1174.0,32
CDM,76870WE-26,US SCROTUM & CONTENTS,256.0,166.4,26.7,256.0,31
CDM,76870WE-TC,US SCROTUM & CONTENTS,918.0,596.7,67.97,918.0,35
CDM,76872ECHWE,ECHO TRANSRECTAL,1194.0,776.1,89.5,1194.0,32
CDM,76872PROWE,"ULTRASOUND, TRANSRECTAL",276.0,179.4,89.5,292.51,32
CDM,76872TECWE,ECHO TRANSRECTAL,918.0,596.7,89.5,918.0,32
CDM,76872WE,"US, TRANSRECTAL",1194.0,776.1,89.5,1194.0,32
CDM,76872WE-26,"US, TRANSRECTAL",276.0,179.4,28.98,276.0,31
CDM,76872WE-TC,"US, TRANSRECTAL",918.0,596.7,88.89,918.0,35
CDM,76873PROWE,PROSTATE VOLUME STUDY BRACHYTHRPY,682.0,443.3,103.31,682.0,32
CDM,76873WE,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,1600.0,1040.0,103.31,1600.0,32
CDM,76873WE-26,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,682.0,443.3,64.78,682.0,31
CDM,76873WE-TC,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,918.0,596.7,84.87,918.0,35
CDM,76881PROWE,"ULTRASOUND EXT., NON-VASC COMPLETE",396.0,257.4,50.07,396.0,32
CDM,76881ULTWE,"ULTRASOUND EXT., NON-VASC COMPLETE",1314.0,854.1,50.07,1314.0,32
CDM,76881WE,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,1314.0,854.1,50.07,1314.0,32
CDM,76881WE-26,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,396.0,257.4,25.85,396.0,31
CDM,76881WE-TC,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,918.0,596.7,10.58,918.0,35
CDM,76882PROWE,"ULTRASOUND EXT., NON-VASC COMPLETE",304.0,197.6,27.46,304.0,32
CDM,76882ULTWE,"ULTRASOUND EXT., NON-VASC LIMITED",1222.0,794.3,27.46,1222.0,32
CDM,76882WE,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,1222.0,794.3,27.46,1222.0,32
CDM,76882WE-26,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,304.0,197.6,20.45,304.0,31
CDM,76882WE-TC,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,918.0,596.7,9.33,918.0,35
CDM,76936PROWE,US GUIDE AV FIST REPAIR,796.0,517.4,201.43,796.0,32
CDM,76936WE,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,3482.0,2263.3,201.43,3482.0,32
CDM,76936WE-26,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,796.0,517.4,86.22,796.0,31
CDM,76936WE-TC,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,2686.0,1745.9,160.22,2686.0,35
CDM,76937PROWE,US GUIDE FOR VASCULAR ACCESS,132.0,85.8,23.71,132.0,32
CDM,76937WE,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,465.0,302.25,23.71,465.0,32
CDM,76937WE-26,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,132.0,85.8,12.93,132.0,31
CDM,76937WE-TC,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,333.0,216.45,17.37,333.0,35
CDM,76940WE,US &MNTR PARENCHYMAL TISSUE ABLATION,1673.0,1087.45,111.86,1673.0,14
CDM,76940WE-26,US &MNTR PARENCHYMAL TISSUE ABLATION,800.0,520.0,90.79,800.0,31
CDM,76940WE-TC,US &MNTR PARENCHYMAL TISSUE ABLATION,873.0,567.45,68.51,873.0,21
CDM,76941WE,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,1441.0,936.65,88.52,1441.0,14
CDM,76941WE-26,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,536.0,348.4,56.96,536.0,31
CDM,76941WE-TC,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,905.0,588.25,60.13,905.0,21
CDM,76942PROWE,US GUIDANCE FOR NEEDLEBX,295.0,191.75,49.64,295.0,32
CDM,76942TECWE,US GUIDANCE FOR NEEDLE BX,1079.0,701.35,49.64,1079.0,32
CDM,76942WE,US GUIDANCE NEEDLE PLACEMENT IMG S&I,1374.0,893.1,49.64,1374.0,32
CDM,76942WE-26,US GUIDANCE NEEDLE PLACEMENT IMG S&I,295.0,191.75,28.13,295.0,31
CDM,76942WE-TC,US GUIDANCE NEEDLE PLACEMENT IMG S&I,1079.0,701.35,28.33,1079.0,35
CDM,76945WE,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,567.0,368.55,70.71,567.0,14
CDM,76945WE-26,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,268.0,174.2,28.99,268.0,31
CDM,76945WE-TC,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,299.0,194.35,33.83,299.0,21
CDM,76946WE,US GUIDANCE AMNIOCENTESIS IMG S&I,610.0,396.5,25.53,610.0,32
CDM,76946WE-26,US GUIDANCE AMNIOCENTESIS IMG S&I,152.0,98.8,15.77,152.0,31
CDM,76946WE-TC,US GUIDANCE AMNIOCENTESIS IMG S&I,458.0,297.7,14.21,458.0,35
CDM,76965PROWE,US GUIDANCE INTERSTITIAL RADIOELEMENT PLA,536.0,348.4,71.12,536.0,32
CDM,76965WE,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,2026.0,1316.9,71.12,2026.0,32
CDM,76965WE-26,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,536.0,348.4,56.54,536.0,31
CDM,76965WE-TC,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,1490.0,968.5,27.37,1490.0,35
CDM,76975WE,GI ENDOSCOPIC US S&I,324.0,210.6,68.43,356.71,14
CDM,76975WE-26,GI ENDOSCOPIC US S&I,324.0,210.6,37.24,324.0,31
CDM,76975WE-TC,GI ENDOSCOPIC US S&I,2085.0,1355.25,61.12,2085.0,21
CDM,76978WE,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,2183.0,1418.95,176.42,2183.0,28
CDM,76978WE-26,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,648.0,421.2,75.46,648.0,31
CDM,76978WE-TC,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,1535.0,997.75,99.14,1535.0,35
CDM,76979WE,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDLT LES,1298.0,843.7,110.05,1298.0,28
CDM,76979WE-26,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDLT LES,340.0,221.0,39.79,340.0,31
CDM,76979WE-TC,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDLT LES,958.0,622.7,68.95,958.0,35
CDM,76981WE,ULTRASOUND ELASTOGRAPHY PARENCHYMA,1178.0,765.7,77.81,1178.0,28
CDM,76981WE-26,ULTRASOUND ELASTOGRAPHY PARENCHYMA,260.0,169.0,28.23,260.0,31
CDM,76981WE-TC,ULTRASOUND ELASTOGRAPHY PARENCHYMA,918.0,596.7,75.39,918.0,35
CDM,76982WE,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,1154.0,750.1,69.78,1154.0,28
CDM,76982WE-26,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,236.0,153.4,27.9,236.0,31
CDM,76982WE-TC,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,918.0,596.7,62.55,918.0,35
CDM,76983WE,ULTRASOUND ELASTOGRAPHY EA ADDL TARGET LESION,1476.0,959.4,45.31,1476.0,28
CDM,76983WE-26,ULTRASOUND ELASTOGRAPHY EA ADDL TARGET LESION,188.0,122.2,22.8,188.0,31
CDM,76983WE-TC,ULTRASOUND ELASTOGRAPHY EA ADDL TARGET LESION,1288.0,837.2,35.44,1288.0,35
CDM,76988WE,DX NTRAOP EPCAR CAR US CHD PLMT MNPJ&IMG ACQUISJ,1582.0,1028.3,82.4,1582.0,13
CDM,76988WE-26,DX NTRAOP EPCAR CAR US CHD PLMT MNPJ&IMG ACQUISJ,528.0,343.2,62.43,528.0,31
CDM,76988WE-TC,DX NTRAOP EPCAR CAR US CHD PLMT MNPJ&IMG ACQUISJ,1054.0,685.1,0.01,1054.0,13
CDM,76998WE,INTRA OP ULTRASONIC GUIDANCE,1454.0,945.1,106.45,1454.0,14
CDM,76998WE-26,INTRA OP ULTRASONIC GUIDANCE,400.0,260.0,48.93,400.0,31
CDM,76998WE-TC,INTRA OP ULTRASONIC GUIDANCE,1054.0,685.1,103.53,1054.0,17
CDM,76999PROWE,US-SOFT TISSUE UNLISTED PROC,170.0,110.5,85.0,170.0,12
CDM,76999ULTWE,"ULTRASOUND, SOFT TISSUE BUTTOCKS",341.0,221.65,170.5,341.0,12
CDM,76999WE,UNLISTED US PROCEDURE,711.0,462.15,355.5,711.0,12
CDM,76999WE-26,UNLISTED US PROCEDURE,191.0,124.15,95.5,191.0,12
CDM,76999WE-TC,UNLISTED US PROCEDURE,520.0,338.0,260.0,520.0,12
CDM,77000000,SCREEN CERV/VAG & PELV/BREAST,463.0,300.95,32.46,416.7,32
CDM,77000035,VISIT TO DETERM LDCT ELIG,463.0,300.95,31.8,416.7,32
CDM,77000065,PAP SMEAR,123.0,79.95,9.95,110.7,38
CDM,77001000,HEP SCREEN HIGH RISK/OTHER,293.0,190.45,19.47,263.7,37
CDM,77001010,HEP SCREEN HIGH RISK/OTHER,294.0,191.1,19.47,264.6,37
CDM,77001PROWE,FLUOROGUIDE VEIN DEVICE,167.0,108.55,59.29,167.0,32
CDM,77001WE,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,1196.0,777.4,59.29,1196.0,32
CDM,77001WE-26,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,167.0,108.55,16.05,167.0,31
CDM,77001WE-TC,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,1029.0,668.85,76.76,1029.0,35
CDM,77002FLUWE,FLUORO GUIDE LOC FOR NEEDLE BX,1286.0,835.9,59.74,1286.0,32
CDM,77002PROWE,FLUORO LOCALZ NEEDLE BX,238.0,154.7,59.74,238.0,32
CDM,77002WE,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,1286.0,835.9,59.74,1286.0,32
CDM,77002WE-26,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,238.0,154.7,23.16,238.0,31
CDM,77002WE-TC,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,1048.0,681.2,43.22,1048.0,35
CDM,77003FLUWE,FLUOROGUIDE FOR SPINAL INJECTION,1509.0,980.85,52.92,1509.0,32
CDM,77003WE,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,1509.0,980.85,52.92,1509.0,32
CDM,77003WE-26,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,264.0,171.6,25.43,264.0,31
CDM,77003WE-TC,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,1245.0,809.25,29.43,1245.0,35
CDM,77011WE,CT GUIDANCE STEREOTACTIC LOCALIZATION,2393.0,1555.45,173.49,2393.0,32
CDM,77011WE-26,CT GUIDANCE STEREOTACTIC LOCALIZATION,484.0,314.6,50.58,484.0,31
CDM,77011WE-TC,CT GUIDANCE STEREOTACTIC LOCALIZATION,1909.0,1240.85,152.3,1909.0,35
CDM,77012WE,CT GUIDANCE NEEDLE PLACEMENT,3341.0,2171.65,99.61,3341.0,32
CDM,77012WE-26,CT GUIDANCE NEEDLE PLACEMENT,600.0,390.0,46.87,600.0,31
CDM,77012WE-TC,CT GUIDANCE NEEDLE PLACEMENT,2741.0,1781.65,55.77,2741.0,35
CDM,77013WE,CT GUIDANCE &MONITORING VISC TISS ABLATION,4837.0,3144.05,360.55,4837.0,14
CDM,77013WE-26,CT GUIDANCE &MONITORING VISC TISS ABLATION,1596.0,1037.4,171.17,1596.0,31
CDM,77013WE-TC,CT GUIDANCE &MONITORING VISC TISS ABLATION,3241.0,2106.65,379.6,3241.0,21
CDM,77014PROWE,CT SCAN FOR THERAPY GUIDE,366.0,237.9,95.91,366.0,23
CDM,77021WE,MRI GUIDANCE NEEDLE PLACEMENT RS&I,3166.0,2057.9,277.31,3166.0,32
CDM,77021WE-26,MRI GUIDANCE NEEDLE PLACEMENT RS&I,600.0,390.0,63.64,600.0,31
CDM,77021WE-TC,MRI GUIDANCE NEEDLE PLACEMENT RS&I,2566.0,1667.9,289.35,2566.0,35
CDM,77022WE,MRI GUIDANCE FOR PARENCHYMAL TISSUE ABLATION,3739.0,2430.35,389.67,3739.0,14
CDM,77022WE-26,MRI GUIDANCE FOR PARENCHYMAL TISSUE ABLATION,1696.0,1102.4,179.82,1696.0,31
CDM,77022WE-TC,MRI GUIDANCE FOR PARENCHYMAL TISSUE ABLATION,2043.0,1327.95,507.65,2043.0,21
CDM,77046WE,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,2723.0,1769.95,179.83,2723.0,28
CDM,77046WE-26,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,638.0,414.7,67.12,638.0,31
CDM,77046WE-TC,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,2085.0,1355.25,143.19,2085.0,35
CDM,77047WE,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,2789.0,1812.85,184.97,2789.0,28
CDM,77047WE-26,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,704.0,457.6,74.49,704.0,31
CDM,77047WE-TC,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,2085.0,1355.25,142.54,2085.0,35
CDM,77048WE,MRI BREAST WITHOUT&WITH CONTRAST W/CAD UNILATERAL,7053.0,4584.45,285.16,7053.0,28
CDM,77048WE-26,MRI BREAST WITHOUT&WITH CONTRAST W/CAD UNILATERAL,840.0,546.0,99.33,840.0,31
CDM,77048WE-TC,MRI BREAST WITHOUT&WITH CONTRAST W/CAD UNILATERAL,6213.0,4038.45,234.47,6213.0,35
CDM,77049AWE,MRI BREAST BILAT W CONTR,8400.0,5460.0,291.67,8400.0,28
CDM,77049AWE-26,MRI BREAST BILAT W CONTR,920.0,598.0,108.63,920.0,31
CDM,77049AWE-TC,MRI BREAST BILAT W CONTR,7480.0,4862.0,231.56,7480.0,35
CDM,77049BWE,MRI BREAST BILAT WO/W CONTR,8400.0,5460.0,291.67,8400.0,28
CDM,77049BWE-26,MRI BREAST BILAT WO/W CONTR,920.0,598.0,108.63,920.0,31
CDM,77049BWE-TC,MRI BREAST BILAT WO/W CONTR,7480.0,4862.0,231.56,7480.0,35
CDM,77049WE,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,8400.0,5460.0,291.67,8400.0,28
CDM,77049WE-26,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,920.0,598.0,108.63,920.0,31
CDM,77049WE-TC,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,7480.0,4862.0,231.56,7480.0,35
CDM,77053WE,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,2229.0,1448.85,41.01,2229.0,32
CDM,77053WE-26,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,144.0,93.6,14.34,144.0,31
CDM,77053WE-TC,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,2085.0,1355.25,35.76,2085.0,35
CDM,77054WE,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,2265.0,1472.25,61.45,2265.0,32
CDM,77054WE-26,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,180.0,117.0,18.89,180.0,31
CDM,77054WE-TC,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,2085.0,1355.25,47.06,2085.0,35
CDM,77061WE,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,199.0,129.35,99.5,199.0,13
CDM,77061WE-26,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,60.0,39.0,30.0,60.0,17
CDM,77061WE-TC,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,139.0,90.35,69.5,156.6,21
CDM,77062WE,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,246.0,159.9,123.0,246.0,13
CDM,77062WE-26,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,78.0,50.7,39.0,78.0,17
CDM,77062WE-TC,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,168.0,109.2,84.0,200.88,21
CDM,77063WE,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,415.0,269.75,38.86,415.0,28
CDM,77063WE-26,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,240.0,156.0,28.23,240.0,31
CDM,77063WE-TC,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,175.0,113.75,23.24,175.0,35
CDM,77065WE,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,1028.0,668.2,56.47,1028.0,28
CDM,77065WE-26,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,324.0,210.6,37.85,324.0,31
CDM,77065WE-TC,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,704.0,457.6,85.4,704.0,35
CDM,77066WE,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,1283.0,833.95,78.08,1283.0,28
CDM,77066WE-26,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,400.0,260.0,46.26,400.0,31
CDM,77066WE-TC,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,883.0,573.95,108.64,883.0,35
CDM,77067WE,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,1065.0,692.25,57.72,1065.0,28
CDM,77067WE-26,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,304.0,197.6,35.91,304.0,31
CDM,77067WE-TC,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,761.0,494.65,89.67,761.0,35
CDM,77071WE,MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS,940.0,611.0,27.12,940.0,32
CDM,77072WE-228,BONE AGE STUDIES,994.0,646.1,15.03,994.0,32
CDM,77072WE-229,BONE AGE STUDIES,76.0,49.4,15.03,76.0,32
CDM,77072WE-26,BONE AGE STUDIES,76.0,49.4,7.81,76.0,31
CDM,77072WE-TC,BONE AGE STUDIES,918.0,596.7,12.2,918.0,35
CDM,77073WE-230,BONE LENGTH STUDIES,1022.0,664.3,23.85,1022.0,32
CDM,77073WE-231,BONE LENGTH STUDIES,104.0,67.6,23.85,104.0,32
CDM,77073WE-26,BONE LENGTH STUDIES,104.0,67.6,12.79,104.0,31
CDM,77073WE-TC,BONE LENGTH STUDIES,918.0,596.7,21.11,918.0,35
CDM,77074BONWE,BONE SURVEY LIMITED,1112.0,722.8,46.13,1112.0,32
CDM,77074PROWE,BONE SURVEY LIMITED,194.0,126.1,46.13,194.0,32
CDM,77074WE,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,1112.0,722.8,46.13,1112.0,32
CDM,77074WE-26,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,194.0,126.1,18.89,194.0,31
CDM,77074WE-TC,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,918.0,596.7,41.21,918.0,35
CDM,77075BONWE,BONE SURVEY COMPLETE INFANT,1160.0,754.0,68.16,1160.0,32
CDM,77075PROWE,BONE SURVEY AXIAL & APPENDICULAR,242.0,157.3,68.16,242.0,32
CDM,77075WE,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,1160.0,754.0,68.16,1160.0,32
CDM,77075WE-26,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,242.0,157.3,22.59,242.0,31
CDM,77075WE-TC,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,918.0,596.7,67.06,918.0,35
CDM,77076WE,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,1198.0,778.7,65.64,1198.0,32
CDM,77076WE-26,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,280.0,182.0,29.26,280.0,31
CDM,77076WE-TC,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,918.0,596.7,63.61,918.0,35
CDM,77077JOIWE,"JOINT SURVEY,SINGLE VIEW",1050.0,682.5,29.22,1050.0,32
CDM,77077PROWE,"JOINT SURVEY,SINGLE VIEW",132.0,85.8,29.22,132.0,32
CDM,77077WE,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,1050.0,682.5,29.22,1050.0,32
CDM,77077WE-26,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,132.0,85.8,14.5,132.0,31
CDM,77077WE-TC,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,918.0,596.7,21.97,918.0,35
CDM,77080DUAWE,DUAL ENERGY XRAY ABSORP(DEXA)AXIAL SITE(S,1006.0,653.9,33.16,1006.0,32
CDM,77080PROWE,"DXA BONE DENSITY,AXIAL",88.0,57.2,33.16,88.0,32
CDM,77080WE,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,1006.0,653.9,33.16,1006.0,32
CDM,77080WE-26,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,88.0,57.2,8.38,88.0,31
CDM,77080WE-TC,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,918.0,596.7,29.3,918.0,35
CDM,77081DXAWE,"DXA BMD, PERIPHERAL",848.0,551.2,22.71,848.0,32
CDM,77081PROWE,DXA BONE DENSITY PERIPHER,88.0,57.2,22.71,88.0,32
CDM,77081WE,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,848.0,551.2,22.71,848.0,32
CDM,77081WE-26,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,88.0,57.2,9.24,88.0,31
CDM,77081WE-TC,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,760.0,494.0,15.36,760.0,35
CDM,77083WE,"RADIOGRAPH ABSORPTION,BONE",202.0,131.3,101.0,202.0,12
CDM,77084WE,BONE MARROW BLOOD SUPPLY,2789.0,1812.85,294.74,2789.0,32
CDM,77084WE-26,BONE MARROW BLOOD SUPPLY,704.0,457.6,66.76,704.0,31
CDM,77084WE-TC,BONE MARROW BLOOD SUPPLY,2085.0,1355.25,237.7,2085.0,35
CDM,77085WE,DXA BONE DENSITY STUDY AXIAL SKELETON,1050.0,682.5,38.17,1050.0,28
CDM,77085WE-26,DXA BONE DENSITY STUDY AXIAL SKELETON,132.0,85.8,13.83,132.0,31
CDM,77085WE-TC,DXA BONE DENSITY STUDY AXIAL SKELETON,918.0,596.7,39.24,918.0,35
CDM,77086WE,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,835.0,542.75,24.13,835.0,28
CDM,77086WE-26,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,75.0,48.75,8.01,75.0,31
CDM,77086WE-TC,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,760.0,494.0,25.75,760.0,35
CDM,77089WE,TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK,88.0,57.2,12.24,88.0,28
CDM,77091WE,TBS TECHNICAL CALCULATION ONLY,158.0,102.7,3.08,158.0,28
CDM,77092WE,TBS INTERPRETATION & REPORT FX RISK BY OTHER QHP,88.0,57.2,7.49,88.0,28
CDM,77100010,ADMIN VACCINE SNGL,268.0,174.2,25.75,241.2,41
CDM,77100030,ADMIN VACCINE EA ADD,80.0,52.0,13.44,72.0,31
CDM,77100040,ADMIN VACCINE FLU,268.0,174.2,25.75,241.2,41
CDM,77100045,ADMIN HEPATITIS B VACCINE,231.0,150.15,25.75,207.9,40
CDM,77100050,ADMIN VACCINE PNEUMONIA,268.0,174.2,25.75,241.2,41
CDM,77100055,IMMUNIZ INJ-FLU VACCINE ONLY,268.0,174.2,25.75,241.2,41
CDM,77100065,IMMUNIZ INJ-HEP B VACC ONLY,268.0,174.2,25.75,241.2,41
CDM,77100125,ADMIN FLU VACCINE,231.0,150.15,25.75,207.9,40
CDM,77100165,VFC IM ADMIN 1ST/ONLY THRU 18,21.25,13.81,3.57,44.0,31
CDM,77100355,ADM TOCILIZU COVID-19 1ST,2253.0,1464.45,44.0,2027.7,40
CDM,77100365,ADM TOCILIZU COVID-19 2ND,2253.0,1464.45,44.0,2027.7,40
CDM,77100585,RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE,36.0,23.4,9.32,154.31,41
CDM,77100625,ADMINISTRATION COVID VACCINE,358.0,232.7,25.75,322.2,40
CDM,77100705,"VFC ADMIN BEYFORTUS, W/COUNSELING",21.25,13.81,3.57,44.0,31
CDM,77100755,PEMIVIBART INFUSION (IV INFUSION FOR IMMUNE-COMPROMISED COVID-19,2250.0,1462.5,44.0,2025.0,40
CDM,77100765,IMM ADMN SARSCOV2 VACCINE EACH ADDL COMPONENT,358.0,232.7,25.75,322.2,30
CDM,77100775,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS 3<10 MIN,88.0,57.2,14.78,79.2,30
CDM,77100785,IMM CNSL PHYS/QHP IMM NOT ADMN SM DOS>10<20 MIN,88.0,57.2,14.78,79.2,30
CDM,77100795,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS>20 MIN,88.0,57.2,14.78,79.2,30
CDM,77261WE,THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE,572.0,371.8,53.42,572.0,32
CDM,77262WE,THERAPEUTIC RADIOLOGY TX PLANNING INTERMEDIATE,880.0,572.0,81.23,880.0,32
CDM,77263WE,THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX,1382.0,898.3,120.68,1382.0,32
CDM,77280WE,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,1453.0,944.45,130.85,1453.0,32
CDM,77280WE-26,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,308.0,200.2,29.12,308.0,31
CDM,77285WE,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,3620.0,2353.0,216.32,3620.0,32
CDM,77285WE-26,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,462.0,300.3,43.9,462.0,31
CDM,77290WE,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,3844.0,2498.6,283.66,3844.0,32
CDM,77290WE-26,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,686.0,445.9,64.92,686.0,31
CDM,77293WE,RESPIRATORY MOTION MANAGEMENT SIMULATION,4606.0,2993.9,291.68,4606.0,28
CDM,77293WE-26,RESPIRATORY MOTION MANAGEMENT SIMULATION,880.0,572.0,104.21,880.0,31
CDM,77293WE-TC,RESPIRATORY MOTION MANAGEMENT SIMULATION,3726.0,2421.9,288.38,3726.0,35
CDM,77295WE,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,13689.0,8897.85,346.96,13689.0,32
CDM,77295WE-26,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,1888.0,1227.2,191.22,1888.0,31
CDM,77299WE,UNLIS PX THER RADIOL CLINICAL TX PLANNING,348.0,226.2,174.0,348.0,12
CDM,77299WE-26,UNLIS PX THER RADIOL CLINICAL TX PLANNING,352.0,228.8,176.0,352.0,12
CDM,77300WE,BASIC RAD DOSIMETRY CALCULATION,1418.0,921.7,51.46,1418.0,32
CDM,77300WE-26,BASIC RAD DOSIMETRY CALCULATION,273.0,177.45,26.0,273.0,31
CDM,77301WE,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,15317.0,9956.05,1257.98,11487.75,32
CDM,77301WE-26,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,3516.0,2285.4,334.57,2637.0,31
CDM,77306WE,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,3774.0,2453.1,103.59,3774.0,28
CDM,77306WE-26,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,616.0,400.4,73.0,616.0,31
CDM,77307WE,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,4434.0,2882.1,202.42,4434.0,28
CDM,77307WE-26,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,1276.0,829.4,152.58,1276.0,31
CDM,77316WE,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,3718.0,2416.7,132.0,3718.0,28
CDM,77317WE,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,3890.0,2528.5,172.86,3890.0,28
CDM,77317WE-26,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,732.0,475.8,95.81,732.0,31
CDM,77318WE,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,4434.0,2882.1,249.79,4434.0,28
CDM,77321WE,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,3576.0,2324.4,70.75,3576.0,32
CDM,77321WE-26,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,418.0,271.7,39.49,418.0,31
CDM,77331WE,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,1528.0,993.2,46.79,1528.0,32
CDM,77331WE-26,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,383.0,248.95,36.37,383.0,31
CDM,77332WE,TX DEVICES DESIGN/CONSTR SIMPLE,1343.0,872.95,34.89,1343.0,32
CDM,77332WE-26,TX DEVICES DESIGN/CONSTR SIMPLE,198.0,128.7,22.59,198.0,31
CDM,77333WE,TX DEVICES DESIGN/CONSTR INTERMED,1475.0,958.75,46.29,1475.0,32
CDM,77333WE-26,TX DEVICES DESIGN/CONSTR INTERMED,330.0,214.5,34.95,330.0,31
CDM,77334WE,TX DEVICES DESIGN/CONSTR COMPLEX,3664.0,2381.6,113.01,3664.0,32
CDM,77334WE-26,TX DEVICES DESIGN/CONSTR COMPLEX,506.0,328.9,51.28,506.0,31
CDM,77336WE,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,1091.0,709.15,39.49,1091.0,32
CDM,77338WE,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,5046.0,3279.9,248.81,5046.0,32
CDM,77338WE-26,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,1888.0,1227.2,179.14,1888.0,31
CDM,77370WE,SPECIAL RADIATION PHYSICS CONSULT,2276.0,1479.4,94.93,2276.0,32
CDM,77372WE,RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR,6594.0,4286.1,618.9,6594.0,32
CDM,77373WE,STEREOTACTIC BODY RADIATION DELIVERY,14050.0,9132.5,883.97,14050.0,32
CDM,77387WE,GUIDANCE FOR LOC OF TARGET VOL RADIAJ TX DLVR,299.0,194.35,37.57,299.0,22
CDM,77402WE,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,1121.0,728.65,63.45,1121.0,26
CDM,77407WE,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,4236.0,2753.4,137.76,4236.0,26
CDM,77412WE,RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX,6068.0,3944.2,130.77,6068.0,26
CDM,77417WE,THERAPEUTIC RADIOLOGY PORT IMAGES(S),586.0,380.9,8.93,586.0,24
CDM,77427WE,RADIATION TREATMENT MANAGEMENT 5 TREATMENTS,1483.0,963.95,131.21,1483.0,32
CDM,77431WE,RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY,796.0,517.4,69.88,796.0,32
CDM,77432WE,STERETCTC RADIATION TX MANAGEMENT CRANIAL LESION,3485.0,2265.25,314.94,2613.75,32
CDM,77435WE,STEREOTACTIC BODY RADIATION MANAGEMENT,5223.0,3394.95,478.57,3917.25,32
CDM,77470WE,SPECIAL TREATMENT PROCEDURE,5882.0,3823.3,119.17,5882.0,32
CDM,77470WE-26,SPECIAL TREATMENT PROCEDURE,893.0,580.45,87.23,893.0,31
CDM,77600WE,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,576.0,374.4,248.05,792.18,32
CDM,77605WE,HYPERTHERMIA EXTERNAL GENERATED DEEP,6720.0,4368.0,488.7,6720.0,32
CDM,77620WE,HYPERTHERMIA INTRACAVITARY PROBES,624.0,405.6,63.64,624.0,31
CDM,77750WE,INFUSE RADIOACTIVE MATERIALS,2000.0,1300.0,214.99,2000.0,32
CDM,77750WE-26,INFUSE RADIOACTIVE MATERIALS,2000.0,1300.0,209.4,2000.0,31
CDM,77761WE,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,6529.0,4243.85,211.93,6529.0,32
CDM,77761WE-26,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,1540.0,1001.0,160.53,1540.0,31
CDM,77762PROWE,IP INTRACAVITARY BRACHY APP INTERMED PC,2534.0,1647.1,307.12,2534.0,32
CDM,77762WE,INTRACAVITARY RADIATION SOURCE APPLIC INTERMED,7523.0,4889.95,307.12,7523.0,32
CDM,77762WE-26,INTRACAVITARY RADIATION SOURCE APPLIC INTERMED,2534.0,1647.1,241.23,2534.0,31
CDM,77763PROWE,INTRACAVITY COMP,3464.0,2251.6,455.76,2598.0,32
CDM,77763WE,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,9448.0,6141.2,455.76,7086.0,32
CDM,77763WE-26,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,3464.0,2251.6,361.98,2598.0,31
CDM,77767WE,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,2689.0,1747.85,160.59,2689.0,28
CDM,77767WE-26,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,420.0,273.0,54.98,420.0,31
CDM,77767WE-TC,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,2269.0,1474.85,189.85,2269.0,35
CDM,77768WE,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,2829.0,1838.85,250.94,2829.0,28
CDM,77768WE-26,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,560.0,364.0,73.0,560.0,31
CDM,77768WE-TC,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,2269.0,1474.85,286.8,2269.0,35
CDM,77770WE,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,6764.0,4396.6,230.23,6764.0,28
CDM,77770WE-26,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,780.0,507.0,101.95,780.0,31
CDM,77770WE-TC,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,5984.0,3889.6,239.81,5984.0,35
CDM,77771WE,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,7504.0,4877.6,429.32,7504.0,28
CDM,77771WE-26,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,1520.0,988.0,199.55,1520.0,31
CDM,77771WE-TC,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,5984.0,3889.6,400.71,5984.0,35
CDM,77772WE,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,8144.0,5293.6,654.04,8144.0,28
CDM,77772WE-26,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,2160.0,1404.0,281.21,2160.0,31
CDM,77772WE-TC,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,5984.0,3889.6,615.02,5984.0,35
CDM,77778WE,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,9847.0,6400.55,565.04,7385.25,32
CDM,77778WE-26,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,3863.0,2510.95,460.39,2897.25,31
CDM,77789WE,SURFACE APPLIC LOW DOSE RATE RADIONUCLIDE SOURCE,502.0,326.3,64.11,502.0,32
CDM,77789WE-26,SURFACE APPLIC LOW DOSE RATE RADIONUCLIDE SOURCE,502.0,326.3,47.59,502.0,31
CDM,77790WE,SUPERVISION HANDLING LOADING RADIATION SOURCE,1647.0,1070.55,15.36,1647.0,32
CDM,77790WE-26,SUPERVISION HANDLING LOADING RADIATION SOURCE,446.0,289.9,43.18,446.0,16
CDM,78000045,"HOPD MNTL HLT, GRP",111.0,72.15,28.75,183.42,37
CDM,78000PROWE,THYROID UPTAKE SINGLE,45.0,29.25,22.5,79.15,16
CDM,78000THYWE,THYROID UPTAKE SINGLE,219.0,142.35,63.1,219.0,16
CDM,78001PROWE,"THYROID,UPTAKE,MULTIPLE DETERMINATIONS",56.0,36.4,28.0,101.07,16
CDM,78001THYWE,THYROID UPTAKE MULTIPLE,294.0,191.1,80.58,294.0,16
CDM,78006PROWE,THYROID IMAGE UPTAKE SING,113.0,73.45,56.5,261.62,16
CDM,78006THYWE,THYROID IMAGE UPTAKE SING,486.0,315.9,208.56,486.0,16
CDM,78007PROWE,THYROID IMAGING W/UPTAKE/MULTIPLE,143.0,92.95,71.5,248.64,16
CDM,78007THYWE,THYROID IMAGE UPTAKE MULT,551.0,358.15,198.22,551.0,16
CDM,78010PROWE,THYROID IMAGING,113.0,73.45,56.5,181.34,16
CDM,78010THYWE,THYROID IMAGING,329.0,213.85,144.57,329.0,16
CDM,78012WE,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,3542.0,2302.3,54.27,3542.0,28
CDM,78012WE-26,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,76.0,49.4,8.66,76.0,31
CDM,78012WE-TC,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,3466.0,2252.9,70.8,3466.0,35
CDM,78013WE,THYROID IMAGING WITH VASCULAR FLOW,3614.0,2349.1,136.87,3614.0,28
CDM,78013WE-26,THYROID IMAGING WITH VASCULAR FLOW,148.0,96.2,16.99,148.0,31
CDM,78013WE-TC,THYROID IMAGING WITH VASCULAR FLOW,3466.0,2252.9,147.56,3466.0,35
CDM,78014WE,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,3686.0,2395.9,158.75,3686.0,28
CDM,78014WE-26,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,220.0,143.0,22.81,220.0,31
CDM,78014WE-TC,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,3466.0,2252.9,185.65,3466.0,35
CDM,78015WE,THYROID CARCINOMA METASTASES IMG LMTD AREA,3734.0,2427.1,127.91,3734.0,32
CDM,78015WE-26,THYROID CARCINOMA METASTASES IMG LMTD AREA,268.0,174.2,27.27,268.0,31
CDM,78015WE-TC,THYROID CARCINOMA METASTASES IMG LMTD AREA,3466.0,2252.9,160.39,3466.0,35
CDM,78018WE,THYROID CARCINOMA METASTASES IMG WHOLE BODY,4987.0,3241.55,180.26,4987.0,32
CDM,78018WE-26,THYROID CARCINOMA METASTASES IMG WHOLE BODY,344.0,223.6,34.36,344.0,31
CDM,78018WE-TC,THYROID CARCINOMA METASTASES IMG WHOLE BODY,4643.0,3017.95,234.4,4643.0,35
CDM,78070WE,PARATHYROID PLANAR IMAGING,3786.0,2460.9,136.76,3786.0,32
CDM,78070WE-26,PARATHYROID PLANAR IMAGING,320.0,208.0,33.23,320.0,31
CDM,78070WE-TC,PARATHYROID PLANAR IMAGING,3466.0,2252.9,103.53,3466.0,35
CDM,78071WE,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,3946.0,2564.9,237.23,3946.0,28
CDM,78071WE-26,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,480.0,312.0,54.59,480.0,31
CDM,78071WE-TC,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,3466.0,2252.9,251.83,3466.0,35
CDM,78072WE,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,5283.0,3433.95,309.82,5283.0,28
CDM,78072WE-26,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,640.0,416.0,71.65,640.0,31
CDM,78072WE-TC,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,4643.0,3017.95,307.93,4643.0,35
CDM,78075WE,ADRENAL IMAGING CORTEX &/MEDULLA,11556.0,7511.4,248.43,11556.0,32
CDM,78075WE-26,ADRENAL IMAGING CORTEX &/MEDULLA,296.0,192.4,29.53,296.0,31
CDM,78075WE-TC,ADRENAL IMAGING CORTEX &/MEDULLA,11260.0,7319.0,336.88,11260.0,35
CDM,78102WE,"BONE MARROW IMAGING, LTD",3686.0,2395.9,99.36,3686.0,32
CDM,78102WE-26,"BONE MARROW IMAGING, LTD",220.0,143.0,22.3,220.0,31
CDM,78102WE-TC,"BONE MARROW IMAGING, LTD",3466.0,2252.9,122.48,3466.0,35
CDM,78103WE,"BONE MARROW IMAGING, MULT",3766.0,2447.9,114.18,3766.0,32
CDM,78103WE-26,"BONE MARROW IMAGING, MULT",300.0,195.0,28.71,300.0,31
CDM,78103WE-TC,"BONE MARROW IMAGING, MULT",3466.0,2252.9,135.94,3466.0,35
CDM,78104WE,"BONE MARROW IMAGING, BODY",3786.0,2460.9,140.57,3786.0,32
CDM,78104WE-26,"BONE MARROW IMAGING, BODY",320.0,208.0,32.38,320.0,31
CDM,78104WE-TC,"BONE MARROW IMAGING, BODY",3466.0,2252.9,181.07,3466.0,35
CDM,78122WE,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,4823.0,3134.95,77.34,4823.0,32
CDM,78122WE-26,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,180.0,117.0,17.18,180.0,31
CDM,78122WE-TC,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,4643.0,3017.95,70.5,4643.0,35
CDM,78140WE,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,3710.0,2411.5,97.69,3710.0,32
CDM,78140WE-26,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,244.0,158.6,23.53,244.0,31
CDM,78140WE-TC,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,3466.0,2252.9,83.64,3466.0,35
CDM,78185WE,SPLEEN IMAGING ONLY W/WO VASCULAR FLOW,3642.0,2367.3,123.05,3642.0,32
CDM,78185WE-26,SPLEEN IMAGING ONLY W/WO VASCULAR FLOW,176.0,114.4,15.77,176.0,31
CDM,78185WE-TC,SPLEEN IMAGING ONLY W/WO VASCULAR FLOW,3466.0,2252.9,133.68,3466.0,35
CDM,78195WE,LYMPHATICS & LYMPH NODES IMAGING,5123.0,3329.95,209.6,5123.0,32
CDM,78195WE-26,LYMPHATICS & LYMPH NODES IMAGING,480.0,312.0,49.28,480.0,31
CDM,78195WE-TC,LYMPHATICS & LYMPH NODES IMAGING,4643.0,3017.95,255.31,4643.0,35
CDM,78201WE,LIVER IMAGING STATIC ONLY,4837.0,3144.05,88.93,4837.0,32
CDM,78201WE-26,LIVER IMAGING STATIC ONLY,194.0,126.1,18.18,194.0,31
CDM,78201WE-TC,LIVER IMAGING STATIC ONLY,4643.0,3017.95,141.44,4643.0,35
CDM,78202WE,LIVER IMAGING W/VASCULAR FLOW,4847.0,3150.55,98.47,4847.0,32
CDM,78202WE-26,LIVER IMAGING W/VASCULAR FLOW,204.0,132.6,19.45,204.0,31
CDM,78202WE-TC,LIVER IMAGING W/VASCULAR FLOW,4643.0,3017.95,157.52,4643.0,35
CDM,78215WE,LIVER & SPLEEN IMAGING STATIC ONLY,3662.0,2380.3,97.49,3662.0,32
CDM,78215WE-26,LIVER & SPLEEN IMAGING STATIC ONLY,196.0,127.4,20.31,196.0,31
CDM,78215WE-TC,LIVER & SPLEEN IMAGING STATIC ONLY,3466.0,2252.9,146.89,3466.0,35
CDM,78216WE,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,3694.0,2401.1,95.61,3694.0,32
CDM,78216WE-26,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,228.0,148.2,22.86,228.0,31
CDM,78216WE-TC,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,3466.0,2252.9,84.86,3466.0,35
CDM,78226HEPWE,HEPATOBILIARY SYSTEM IMAGING,3762.0,2445.3,153.17,3762.0,32
CDM,78226PROWE,HEPATOBILIARY SYSTEM IMAGING,296.0,192.4,148.0,432.14,32
CDM,78226WE,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,3762.0,2445.3,153.17,3762.0,32
CDM,78226WE-26,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,296.0,192.4,29.82,296.0,31
CDM,78226WE-TC,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,3466.0,2252.9,247.99,3466.0,35
CDM,78227HEPWE,HEPATOBIL SYST IMAGE W/DRUG,5039.0,3275.35,209.46,5039.0,32
CDM,78227PROWE,HEPATOBIL SYST IMAGE W/DRUG,396.0,257.4,198.0,579.33,32
CDM,78227WE,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,5039.0,3275.35,209.46,5039.0,32
CDM,78227WE-26,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,396.0,257.4,35.78,396.0,31
CDM,78227WE-TC,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,4643.0,3017.95,338.2,4643.0,35
CDM,78232WE,SALIVARY GLAND FUNCTION STUDY,3673.0,2387.45,76.53,3673.0,32
CDM,78232WE-26,SALIVARY GLAND FUNCTION STUDY,207.0,134.55,17.74,207.0,31
CDM,78232WE-TC,SALIVARY GLAND FUNCTION STUDY,3466.0,2252.9,73.94,3466.0,35
CDM,78258WE,ESOPHAGEAL MOTILITY,3762.0,2445.3,106.06,3762.0,32
CDM,78258WE-26,ESOPHAGEAL MOTILITY,296.0,192.4,30.26,296.0,31
CDM,78258WE-TC,ESOPHAGEAL MOTILITY,3466.0,2252.9,159.18,3466.0,35
CDM,78262WE,GASTROESOPHAGEAL REFLUX STUDY,3738.0,2429.7,140.9,3738.0,32
CDM,78262WE-26,GASTROESOPHAGEAL REFLUX STUDY,272.0,176.8,26.84,272.0,31
CDM,78262WE-TC,GASTROESOPHAGEAL REFLUX STUDY,3466.0,2252.9,185.65,3466.0,35
CDM,78264WE-232,GASTRIC EMPTYING STUDY,3814.0,2479.1,153.86,3814.0,32
CDM,78264WE-233,GASTRIC EMPTYING STUDY,348.0,226.2,153.86,440.22,32
CDM,78264WE-26,GASTRIC EMPTYING STUDY,348.0,226.2,32.67,348.0,31
CDM,78264WE-TC,GASTRIC EMPTYING STUDY,3466.0,2252.9,216.97,3466.0,35
CDM,78265WE,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,3858.0,2507.7,277.74,3858.0,28
CDM,78265WE-26,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,392.0,254.8,44.64,392.0,31
CDM,78265WE-TC,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,3466.0,2252.9,299.21,3466.0,35
CDM,78266WE,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,5075.0,3298.75,329.26,5075.0,28
CDM,78266WE-26,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,432.0,280.8,47.55,432.0,31
CDM,78266WE-TC,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,4643.0,3017.95,339.17,4643.0,35
CDM,78278WE,ACUTE GI BLOOD LOSS IMAGING,3862.0,2510.3,169.15,3862.0,32
CDM,78278WE-26,ACUTE GI BLOOD LOSS IMAGING,396.0,257.4,40.48,396.0,31
CDM,78278WE-TC,ACUTE GI BLOOD LOSS IMAGING,3466.0,2252.9,259.5,3466.0,35
CDM,78290WE,INTESTINE IMAGING,3765.0,2447.25,195.55,3765.0,32
CDM,78290WE-26,INTESTINE IMAGING,299.0,194.35,28.12,299.0,31
CDM,78290WE-TC,INTESTINE IMAGING,3466.0,2252.9,256.6,3466.0,35
CDM,78291WE,PERITONEAL-VENOUS SHUNT PATENCY TEST,3818.0,2481.7,115.96,3818.0,32
CDM,78291WE-26,PERITONEAL-VENOUS SHUNT PATENCY TEST,352.0,228.8,35.93,352.0,31
CDM,78291WE-TC,PERITONEAL-VENOUS SHUNT PATENCY TEST,3466.0,2252.9,183.08,3466.0,35
CDM,78300WE,BONE &/JOINT IMAGING LIMITED AREA,3714.0,2414.1,123.41,3714.0,32
CDM,78300WE-26,BONE &/JOINT IMAGING LIMITED AREA,248.0,161.2,25.42,248.0,31
CDM,78300WE-TC,BONE &/JOINT IMAGING LIMITED AREA,3466.0,2252.9,127.94,3466.0,35
CDM,78305WE,BONE &/JOINT IMAGING MULTIPLE AREAS,3798.0,2468.7,130.65,3798.0,32
CDM,78305WE-26,BONE &/JOINT IMAGING MULTIPLE AREAS,332.0,215.8,33.8,332.0,31
CDM,78305WE-TC,BONE &/JOINT IMAGING MULTIPLE AREAS,3466.0,2252.9,168.72,3466.0,35
CDM,78306BONWE,BONE IMAGING WHOLE BODY,3844.0,2498.6,148.1,3844.0,32
CDM,78306PROWE,BONE IMAGING WHOLE BODY,378.0,245.7,148.1,392.28,32
CDM,78306WE,BONE &/JOINT IMAGING WHOLE BODY,3844.0,2498.6,148.1,3844.0,32
CDM,78306WE-26,BONE &/JOINT IMAGING WHOLE BODY,378.0,245.7,34.94,378.0,31
CDM,78306WE-TC,BONE &/JOINT IMAGING WHOLE BODY,3466.0,2252.9,182.79,3466.0,35
CDM,78315BONWE,BONE IMAGING THREE PHASE,3874.0,2518.1,167.52,3874.0,32
CDM,78315PROWE,BONE IMAGING THREE PHASE,408.0,265.2,167.52,461.81,32
CDM,78315WE,BONE &/JOINT IMAGING 3 PHASE STUDY,3874.0,2518.1,167.52,3874.0,32
CDM,78315WE-26,BONE &/JOINT IMAGING 3 PHASE STUDY,408.0,265.2,41.61,408.0,31
CDM,78315WE-TC,BONE &/JOINT IMAGING 3 PHASE STUDY,3466.0,2252.9,255.95,3466.0,35
CDM,78320BONWE,BONE IMAGING SPECT,1083.0,703.95,202.86,1083.0,16
CDM,78320PROWE,BONE IMAGING SPECT,226.0,146.9,113.0,254.46,16
CDM,78428WE,CARDIAC SHUNT DETECTION,3778.0,2455.7,123.98,3778.0,32
CDM,78428WE-26,CARDIAC SHUNT DETECTION,312.0,202.8,31.96,312.0,31
CDM,78428WE-TC,CARDIAC SHUNT DETECTION,3466.0,2252.9,130.81,3466.0,35
CDM,78429WE,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,13284.0,8634.6,2043.1,13284.0,13
CDM,78429WE-26,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,704.0,457.6,76.9,704.0,31
CDM,78429WE-TC,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,12580.0,8177.0,14.82,12580.0,21
CDM,78430WE,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,13248.0,8611.2,2038.07,13248.0,13
CDM,78430WE-26,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,668.0,434.2,72.45,668.0,31
CDM,78430WE-TC,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,12580.0,8177.0,14.82,12580.0,21
CDM,78431WE,MYOCRD IMG PET PRFUJ MLT STD RST & STRS CNCRNT CT,20170.0,13110.5,748.62,20170.0,14
CDM,78431WE-26,MYOCRD IMG PET PRFUJ MLT STD RST & STRS CNCRNT CT,760.0,494.0,84.98,760.0,31
CDM,78431WE-TC,MYOCRD IMG PET PRFUJ MLT STD RST & STRS CNCRNT CT,19410.0,12616.5,1488.0,19410.0,21
CDM,78432WE,MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER,16788.0,10912.2,2531.02,16788.0,13
CDM,78432WE-26,MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER,828.0,538.2,93.89,828.0,31
CDM,78432WE-TC,MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER,15960.0,10374.0,1488.0,15960.0,21
CDM,78433WE,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,17727.0,11522.55,2672.98,17727.0,13
CDM,78433WE-26,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,904.0,587.6,100.03,904.0,31
CDM,78433WE-TC,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,16823.0,10934.95,1488.0,16823.0,21
CDM,78434WE,AQMBF PET REST AND PHARMACOLOGIC STRESS,4263.0,2770.95,241.63,4263.0,13
CDM,78434WE-26,AQMBF PET REST AND PHARMACOLOGIC STRESS,252.0,163.8,28.3,252.0,31
CDM,78434WE-TC,AQMBF PET REST AND PHARMACOLOGIC STRESS,4011.0,2607.15,149.15,4011.0,21
CDM,78445WE,NONCARDIAC VASCULAR FLOW IMAGING,3682.0,2393.3,100.59,3682.0,32
CDM,78445WE-26,NONCARDIAC VASCULAR FLOW IMAGING,216.0,140.4,18.88,216.0,31
CDM,78445WE-TC,NONCARDIAC VASCULAR FLOW IMAGING,3466.0,2252.9,130.52,3466.0,35
CDM,78451MPIWE,MPI SPECT SING W/WALL MTN EJECTN FRCTN,11867.0,7713.55,202.07,11867.0,32
CDM,78451PROWE,HT MUSCLE IMAGE SPECT SINGLE,607.0,394.55,202.07,607.0,32
CDM,78451TECWE,MPI SPECT SNGL W/WALL MTN/EJECT FRCTN,11260.0,7319.0,202.07,11260.0,32
CDM,78451WE,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,11867.0,7713.55,202.07,11867.0,32
CDM,78451WE-26,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,607.0,394.55,55.24,607.0,31
CDM,78451WE-TC,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,11260.0,7319.0,236.33,11260.0,35
CDM,78452MPIWE,MPI SPECT MULT W/WALL MTN & EJECT FRCTN,11973.0,7782.45,279.71,11973.0,32
CDM,78452PROWE,HT MUSCLE IMAGE SPECT MULT PC,713.0,463.45,279.71,713.0,32
CDM,78452TECWE,MPI SPECT MULT W/WALL MTN & EJCTN FRCTN,11260.0,7319.0,279.71,11260.0,32
CDM,78452WE,MYOCARDIAL SPECT MULTIPLE STUDIES,11973.0,7782.45,279.71,11973.0,32
CDM,78452WE-26,MYOCARDIAL SPECT MULTIPLE STUDIES,713.0,463.45,64.62,713.0,31
CDM,78452WE-TC,MYOCARDIAL SPECT MULTIPLE STUDIES,11260.0,7319.0,337.8,11260.0,35
CDM,78453PROWE,HT MUSCLE IMAGE PLANAR SINGLE,400.0,260.0,180.05,400.0,32
CDM,78453WE,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,11660.0,7579.0,180.05,11660.0,32
CDM,78453WE-26,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,400.0,260.0,40.19,400.0,31
CDM,78453WE-TC,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,11260.0,7319.0,212.12,11260.0,35
CDM,78454PROWE,HT MUSC IMAGE PLANAR MULT,536.0,348.4,256.02,580.49,32
CDM,78454WE,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,11796.0,7667.4,256.02,11796.0,32
CDM,78454WE-26,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,536.0,348.4,53.25,536.0,31
CDM,78454WE-TC,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,11260.0,7319.0,318.83,11260.0,35
CDM,78456WE,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,11660.0,7579.0,148.5,11660.0,32
CDM,78456WE-26,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,400.0,260.0,41.92,400.0,31
CDM,78456WE-TC,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,11260.0,7319.0,228.84,11260.0,35
CDM,78457WE,VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL,4982.0,3238.3,101.34,4982.0,32
CDM,78457WE-26,VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL,339.0,220.35,31.53,339.0,31
CDM,78457WE-TC,VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL,4643.0,3017.95,117.54,4643.0,35
CDM,78458WE,VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL,3862.0,2510.3,142.79,3862.0,32
CDM,78458WE-26,VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL,396.0,257.4,35.06,396.0,31
CDM,78458WE-TC,VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL,3466.0,2252.9,128.51,3466.0,35
CDM,78459MYOWE,"MYOCARDIAL IMAGING, PET,METABOLIC EVAL",11968.0,7779.2,677.38,11968.0,14
CDM,78459PROWE,MYOCARDIAL IMAGING METABOLIC PET,708.0,460.2,354.0,1856.69,14
CDM,78459WE,MYOCRD IMG PET METAB EVAL SINGLE STUDY,11968.0,7779.2,677.38,11968.0,14
CDM,78459WE-26,MYOCRD IMG PET METAB EVAL SINGLE STUDY,708.0,460.2,61.92,708.0,31
CDM,78459WE-TC,MYOCRD IMG PET METAB EVAL SINGLE STUDY,11260.0,7319.0,1089.98,11260.0,21
CDM,78466MYOWE,MYOCARDIAL IMAGE INFARCT,3742.0,2432.3,97.64,3742.0,32
CDM,78466PROWE,"MYOCARD IMAG,INFARCT AVID",276.0,179.4,97.64,276.0,32
CDM,78466WE,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,3742.0,2432.3,97.64,3742.0,32
CDM,78466WE-26,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,276.0,179.4,28.55,276.0,31
CDM,78466WE-TC,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,3466.0,2252.9,123.06,3466.0,35
CDM,78468PROWE,NM CARD INFARCT PLANAR EJECT FRAC PASS 1,320.0,208.0,123.12,320.0,32
CDM,78468WE,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,4963.0,3225.95,123.12,4963.0,32
CDM,78468WE-26,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,320.0,208.0,33.39,320.0,31
CDM,78468WE-TC,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,4643.0,3017.95,140.78,4643.0,35
CDM,78469WE,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,5011.0,3257.15,167.6,5011.0,32
CDM,78469WE-26,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,368.0,239.2,37.93,368.0,31
CDM,78469WE-TC,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,4643.0,3017.95,157.24,4643.0,35
CDM,78472CARWE,CARDIAC BLOOD POOL SINGLE,3858.0,2507.7,177.52,3858.0,32
CDM,78472PROWE,"BLOOD POOL IMAGING,GATED,SGL STUDY (MUGA)",392.0,254.8,177.52,392.0,32
CDM,78472WE,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,3858.0,2507.7,177.52,3858.0,32
CDM,78472WE-26,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,392.0,254.8,40.34,392.0,31
CDM,78472WE-TC,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,3466.0,2252.9,157.24,3466.0,35
CDM,78473CARWE,CARDIAC BLOOD POOL MULT,4054.0,2635.1,231.4,4054.0,32
CDM,78473PROWE,CARDIAC BLOOD POOL MULT,588.0,382.2,231.4,588.0,32
CDM,78473WE,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,4054.0,2635.1,231.4,4054.0,32
CDM,78473WE-26,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,588.0,382.2,60.66,588.0,31
CDM,78473WE-TC,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,3466.0,2252.9,189.52,3466.0,35
CDM,78481CARWE,CARDIAC BLD POOL IMAGING,5035.0,3272.75,143.73,5035.0,32
CDM,78481PROWE,CARDIAC BLD POOL IMAG MULT,392.0,254.8,143.73,392.0,32
CDM,78481WE,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,5035.0,3272.75,143.73,5035.0,32
CDM,78481WE-26,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,392.0,254.8,40.78,392.0,31
CDM,78481WE-TC,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,4643.0,3017.95,113.41,4643.0,35
CDM,78483WE,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,5231.0,3400.15,192.47,5231.0,32
CDM,78483WE-26,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,588.0,382.2,61.24,588.0,31
CDM,78483WE-TC,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,4643.0,3017.95,146.59,4643.0,35
CDM,78491WE,MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS,13266.0,8622.9,532.68,13266.0,14
CDM,78491WE-26,MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS,686.0,445.9,62.78,686.0,31
CDM,78491WE-TC,MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS,12580.0,8177.0,869.03,12580.0,21
CDM,78492WE,MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS,13300.0,8645.0,545.2,13300.0,14
CDM,78492WE-26,MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS,720.0,468.0,79.27,720.0,31
CDM,78492WE-TC,MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS,12580.0,8177.0,1089.98,12580.0,21
CDM,78579LUNWE,LUNG VENTILATION IMAGING,3662.0,2380.3,109.39,3662.0,32
CDM,78579PROWE,LUNG VENTILATION IMAGING,196.0,127.4,98.0,250.95,32
CDM,78579WE,PULMONARY VENTILATION IMAGING,3662.0,2380.3,109.39,3662.0,32
CDM,78579WE-26,PULMONARY VENTILATION IMAGING,196.0,127.4,19.74,196.0,31
CDM,78579WE-TC,PULMONARY VENTILATION IMAGING,3466.0,2252.9,128.09,3466.0,35
CDM,78580PROWE,PULM PERFUSION PARTICULATE,296.0,192.4,120.94,316.16,32
CDM,78580PULWE,PULM PERFUSION PARTICULATE,3762.0,2445.3,120.94,3762.0,32
CDM,78580WE,PULMONARY PERFUSION IMAGING PARTICULATE,3762.0,2445.3,120.94,3762.0,32
CDM,78580WE-26,PULMONARY PERFUSION IMAGING PARTICULATE,296.0,192.4,29.97,296.0,31
CDM,78580WE-TC,PULMONARY PERFUSION IMAGING PARTICULATE,3466.0,2252.9,160.68,3466.0,35
CDM,78582LUNWE,LUNG VENTILATION&PERFUSION IMAGING,5071.0,3296.15,197.06,5071.0,32
CDM,78582PROWE,LUNG VENTILATION&PERFUSION IMAGING,428.0,278.2,197.06,442.18,32
CDM,78582WE,PULMONARY VENTILATION & PERFUSION IMAGING,5071.0,3296.15,197.06,5071.0,32
CDM,78582WE-26,PULMONARY VENTILATION & PERFUSION IMAGING,428.0,278.2,42.45,428.0,31
CDM,78582WE-TC,PULMONARY VENTILATION & PERFUSION IMAGING,4643.0,3017.95,229.61,4643.0,35
CDM,78597LUNWE,LUNG PERFUSION DIFFERENTIAL,3766.0,2447.9,93.86,3766.0,32
CDM,78597PROWE,LUNG PERFUSION DIFFERENTIAL,300.0,195.0,93.86,300.0,32
CDM,78597WE,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,3766.0,2447.9,93.86,3766.0,32
CDM,78597WE-26,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,300.0,195.0,28.96,300.0,31
CDM,78597WE-TC,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,3466.0,2252.9,137.28,3466.0,35
CDM,78598LUNWE,LUNG PERFUS&VENTILAT DIFFERENTIAL,4983.0,3238.95,140.99,4983.0,32
CDM,78598PROWE,LUNG PERFUS&VENTILAT DIFFERENTIAL,340.0,221.0,140.99,400.95,32
CDM,78598WE,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,4983.0,3238.95,140.99,4983.0,32
CDM,78598WE-26,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,340.0,221.0,33.08,340.0,31
CDM,78598WE-TC,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,4643.0,3017.95,222.43,4643.0,35
CDM,78601WE,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,3670.0,2385.5,111.39,3670.0,32
CDM,78601WE-26,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,204.0,132.6,20.88,204.0,31
CDM,78601WE-TC,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,3466.0,2252.9,163.55,3466.0,35
CDM,78606BRAWE,BRAIN IMAGE COMP W VAS FLOW,4899.0,3184.35,192.5,4899.0,32
CDM,78606PROWE,"BRAIN IMAGING, MIN 4 VWS; W/VASC FLOW",256.0,166.4,128.0,438.87,32
CDM,78606WE,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,4899.0,3184.35,192.5,4899.0,32
CDM,78606WE-26,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,256.0,166.4,25.42,256.0,31
CDM,78606WE-TC,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,4643.0,3017.95,258.21,4643.0,35
CDM,78608WE,BRAIN IMAGING PET METABOLIC EVALUATION,13180.0,8567.0,489.84,13180.0,14
CDM,78608WE-26,BRAIN IMAGING PET METABOLIC EVALUATION,600.0,390.0,61.49,600.0,31
CDM,78608WE-TC,BRAIN IMAGING PET METABOLIC EVALUATION,12580.0,8177.0,1089.98,12580.0,21
CDM,78610WE,"BRAIN IMAGING, VASC FLOW ONLY",4763.0,3095.95,101.91,4763.0,32
CDM,78610WE-26,"BRAIN IMAGING, VASC FLOW ONLY",120.0,78.0,12.36,120.0,31
CDM,78610WE-TC,"BRAIN IMAGING, VASC FLOW ONLY",4643.0,3017.95,140.58,4643.0,35
CDM,78630WE,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,4915.0,3194.75,161.99,4915.0,32
CDM,78630WE-26,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,272.0,176.8,27.7,272.0,31
CDM,78630WE-TC,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,4643.0,3017.95,262.73,4643.0,35
CDM,78645WE,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,4871.0,3166.15,188.79,4871.0,32
CDM,78645WE-26,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,228.0,148.2,23.15,228.0,31
CDM,78645WE-TC,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,4643.0,3017.95,254.31,4643.0,35
CDM,78650WE,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,11504.0,7477.6,187.09,11504.0,32
CDM,78650WE-26,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,244.0,158.6,23.53,244.0,31
CDM,78650WE-TC,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,11260.0,7319.0,212.69,11260.0,35
CDM,78700KIDWE,KIDNEY IMAGING STATIC,3646.0,2369.9,98.95,3646.0,32
CDM,78700PROWE,KIDNEY IMAGING STATIC,180.0,117.0,90.0,231.09,32
CDM,78700WE,KIDNEY IMAGING MORPHOLOGY,3646.0,2369.9,98.95,3646.0,32
CDM,78700WE-26,KIDNEY IMAGING MORPHOLOGY,180.0,117.0,18.89,180.0,31
CDM,78700WE-TC,KIDNEY IMAGING MORPHOLOGY,3466.0,2252.9,132.71,3466.0,35
CDM,78701KIDWE,KIDNEY W VASCULAR FLOW,3662.0,2380.3,114.23,3662.0,32
CDM,78701PROWE,KIDNEY W VASCULAR FLOW,196.0,127.4,98.0,302.86,32
CDM,78701WE,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,3662.0,2380.3,114.23,3662.0,32
CDM,78701WE-26,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,196.0,127.4,20.31,196.0,31
CDM,78701WE-TC,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,3466.0,2252.9,164.7,3466.0,35
CDM,78707WE,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,5027.0,3267.55,156.86,5027.0,32
CDM,78707WE-26,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,384.0,249.6,38.63,384.0,31
CDM,78707WE-TC,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,4643.0,3017.95,163.84,4643.0,35
CDM,78708WE,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,5127.0,3332.55,135.06,5127.0,32
CDM,78708WE-26,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,484.0,314.6,48.71,484.0,31
CDM,78708WE-TC,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,4643.0,3017.95,99.5,4643.0,35
CDM,78709WE,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,5207.0,3384.55,172.11,5207.0,32
CDM,78709WE-26,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,564.0,366.6,57.23,564.0,31
CDM,78709WE-TC,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,4643.0,3017.95,260.15,4643.0,35
CDM,78725WE,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,3618.0,2351.7,62.53,3618.0,32
CDM,78725WE-26,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,152.0,98.8,14.91,152.0,31
CDM,78725WE-TC,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,3466.0,2252.9,75.09,3466.0,35
CDM,78740WE,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,3694.0,2401.1,128.92,3694.0,32
CDM,78740WE-26,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,228.0,148.2,24.01,228.0,31
CDM,78740WE-TC,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,3466.0,2252.9,174.75,3466.0,35
CDM,78761WE,TESTICULAR IMAGING WITH VASCULAR FLOW,3750.0,2437.5,113.75,3750.0,32
CDM,78761WE-26,TESTICULAR IMAGING WITH VASCULAR FLOW,284.0,184.6,29.55,284.0,31
CDM,78761WE-TC,TESTICULAR IMAGING WITH VASCULAR FLOW,3466.0,2252.9,154.36,3466.0,35
CDM,78800WE,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,3722.0,2419.3,118.19,3722.0,32
CDM,78800WE-26,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,256.0,166.4,27.56,256.0,31
CDM,78800WE-TC,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,3466.0,2252.9,135.98,3466.0,35
CDM,78801WE,RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D,3787.0,2461.55,144.08,3787.0,32
CDM,78801WE-26,RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D,321.0,208.65,32.38,321.0,31
CDM,78801WE-TC,RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D,3466.0,2252.9,180.5,3466.0,35
CDM,78802WE,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,11612.0,7547.8,182.29,11612.0,32
CDM,78802WE-26,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,352.0,228.8,34.65,352.0,31
CDM,78802WE-TC,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,11260.0,7319.0,231.81,11260.0,35
CDM,78803WE,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,11740.0,7631.0,218.03,11740.0,32
CDM,78803WE-26,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,480.0,312.0,43.31,480.0,31
CDM,78803WE-TC,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,11260.0,7319.0,255.74,11260.0,35
CDM,78804WE,RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING,11704.0,7607.6,331.58,11704.0,32
CDM,78804WE-26,RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING,444.0,288.6,43.03,444.0,31
CDM,78804WE-TC,RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING,11260.0,7319.0,455.92,11260.0,35
CDM,78811PROWE,TUMOR IMAGING PET-LTD AREA-CHEST/HEAD/NEC,616.0,400.4,308.0,1854.46,14
CDM,78811WE,PET IMAGING LIMITED AREA CHEST HEAD/NECK,11876.0,7719.4,564.33,11876.0,14
CDM,78811WE-26,PET IMAGING LIMITED AREA CHEST HEAD/NECK,616.0,400.4,67.33,616.0,31
CDM,78811WE-TC,PET IMAGING LIMITED AREA CHEST HEAD/NECK,11260.0,7319.0,1089.98,11260.0,21
CDM,78812PROWE,TUMOR IMG PET SKULL BASE-MID HIGH NOS,772.0,501.8,386.0,2057.75,14
CDM,78812WE,PET IMAGING SKULL BASE TO MID-THIGH,13352.0,8678.8,697.72,13352.0,14
CDM,78812WE-26,PET IMAGING SKULL BASE TO MID-THIGH,772.0,501.8,81.24,772.0,31
CDM,78812WE-TC,PET IMAGING SKULL BASE TO MID-THIGH,12580.0,8177.0,1089.98,12580.0,21
CDM,78813PROWE,TUMOR IMGING PET FULL BODY ANY SITE NOS,800.0,520.0,400.0,2060.32,14
CDM,78813WE,PET IMAGE FULL BODY,13380.0,8697.0,721.64,13380.0,14
CDM,78813WE-26,PET IMAGE FULL BODY,800.0,520.0,85.23,800.0,31
CDM,78813WE-TC,PET IMAGE FULL BODY,12580.0,8177.0,1089.98,12580.0,21
CDM,78814PROWE,TUMOR IMAG PET W/CONCRNT CT; LTD AREA,880.0,572.0,440.0,2073.04,14
CDM,78814WE,PET IMAGING CT FOR ATTENUATION LIMITED AREA,13460.0,8749.0,790.05,13460.0,14
CDM,78814WE-26,PET IMAGING CT FOR ATTENUATION LIMITED AREA,880.0,572.0,93.46,880.0,31
CDM,78814WE-TC,PET IMAGING CT FOR ATTENUATION LIMITED AREA,12580.0,8177.0,1089.98,12580.0,21
CDM,78815PROWE,TUMOR IMG PET/CT SKULL-THIGH ANY SITE NOS,976.0,634.4,488.0,2087.89,14
CDM,78815WE,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,13556.0,8811.4,872.18,13556.0,14
CDM,78815WE-26,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,976.0,634.4,103.4,976.0,31
CDM,78815WE-TC,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,12580.0,8177.0,1089.98,12580.0,21
CDM,78816PROWE,TUMOR IMAG PET W/CONCURNT CT-WHOLE BODY,1000.0,650.0,500.0,2088.85,14
CDM,78816WE,PET IMAGING FOR CT ATTENUATION WHOLE BODY,13580.0,8827.0,892.66,13580.0,14
CDM,78816WE-26,PET IMAGING FOR CT ATTENUATION WHOLE BODY,1000.0,650.0,104.24,1000.0,31
CDM,78816WE-TC,PET IMAGING FOR CT ATTENUATION WHOLE BODY,12580.0,8177.0,1089.98,12580.0,21
CDM,78830WE,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,11856.0,7706.4,356.64,11856.0,28
CDM,78830WE-26,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,596.0,387.4,65.59,596.0,31
CDM,78830WE-TC,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,11260.0,7319.0,348.6,11260.0,35
CDM,78831WE,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,11988.0,7792.2,515.16,11988.0,28
CDM,78831WE-26,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,728.0,473.2,82.25,728.0,31
CDM,78831WE-TC,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,11260.0,7319.0,533.36,11260.0,35
CDM,78832WE,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,13428.0,8728.2,669.66,13428.0,28
CDM,78832WE-26,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,848.0,551.2,94.46,848.0,31
CDM,78832WE-TC,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,12580.0,8177.0,686.4,12580.0,35
CDM,78835WE,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,701.0,455.65,75.14,701.0,28
CDM,78835WE-26,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,188.0,122.2,20.87,188.0,31
CDM,78835WE-TC,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,513.0,333.45,65.46,513.0,35
CDM,78999RVU1WE,MRI FUSION TO PET (COMP CODE 76376),611.0,397.15,305.5,611.0,12
CDM,78999RVU1WE-26,MRI FUSION TO PET (COMP CODE 76376),87.0,56.55,43.5,87.0,12
CDM,78999RVU1WE-TC,MRI FUSION TO PET (COMP CODE 76376),524.0,340.6,262.0,524.0,12
CDM,79000010,LITHOTRIPSY ESWL UROLOGIC CTR,3005.0,1953.25,504.84,2704.5,21
CDM,79000020,LITHOTRIPSY ESWL FORTEC,2402.0,1561.3,403.54,2161.8,21
CDM,79005WE,RP THERAPY ORAL ADMINISTRATION,2653.0,1724.45,105.26,2653.0,32
CDM,79005WE-26,RP THERAPY ORAL ADMINISTRATION,720.0,468.0,72.57,720.0,31
CDM,79005WE-TC,RP THERAPY ORAL ADMINISTRATION,1933.0,1256.45,43.51,1933.0,35
CDM,79101WE,RP THERAPY INTRAVENOUS ADMINISTRATION,2717.0,1766.05,112.24,2717.0,32
CDM,79101WE-26,RP THERAPY INTRAVENOUS ADMINISTRATION,784.0,509.6,84.28,784.0,31
CDM,79101WE-TC,RP THERAPY INTRAVENOUS ADMINISTRATION,1933.0,1256.45,46.95,1933.0,35
CDM,79403WE,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,2833.0,1841.45,148.7,2833.0,32
CDM,79403WE-26,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,900.0,585.0,86.44,900.0,31
CDM,79403WE-TC,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,1933.0,1256.45,71.8,1933.0,35
CDM,79445WE,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,2893.0,1880.45,161.44,2893.0,14
CDM,79445WE-26,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,960.0,624.0,99.98,960.0,31
CDM,79445WE-TC,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,1933.0,1256.45,81.37,1933.0,21
CDM,80047WE,BASIC METABOLIC PANEL WITH CALCIUM IONIZED,226.0,146.9,5.77,226.0,17
CDM,80047WE-QW,BASIC METABOLIC PANEL WITH CALCIUM IONIZED,226.0,146.9,9.34,226.0,16
CDM,80048BSCWE,BSC METABLC PNL PROFESSIONAL FEE,39.0,25.35,3.55,39.0,17
CDM,80048WE,BASIC METABOLIC PANEL CALCIUM TOTAL,39.0,25.35,3.55,39.0,17
CDM,80050WE,GENERAL HEALTH PANEL,107.0,69.55,16.88,107.0,13
CDM,80051WE,ELECTROLYTE PANEL,35.0,22.75,2.94,35.0,17
CDM,80053WE,COMPREHENSIVE METABOLIC PANEL,36.0,23.4,4.44,36.0,17
CDM,80061CHDWE,CHD RISK PROFILE,113.0,73.45,5.62,113.0,17
CDM,80061LIPWE,LIPID PANEL,13.0,8.45,5.62,14.8,17
CDM,80061WE,LIPID PANEL,74.0,48.1,5.62,74.0,17
CDM,80069WE,RENAL FUNCT PNL,105.0,68.25,3.65,105.0,17
CDM,80076WE,HEPATIC FUNCTION PNL,24.0,15.6,3.43,24.0,17
CDM,80100000,CONTIN AV HEMOFILTRATION CAVH,3673.0,2387.45,105.79,3305.7,38
CDM,80100010,HEMO 1 EVAL IP,6035.0,3922.75,87.55,5431.5,38
CDM,80100020,CRRT DURING TRANSPLANT,3673.0,2387.45,105.79,3305.7,38
CDM,80150WE,DRUG SCREEN QUANTITATIVE AMIKACIN,15.0,9.75,6.33,16.65,17
CDM,80156WE,DRUG ASSAY CARBAMAZEPINE TOTAL,169.0,109.85,6.12,169.0,17
CDM,80158WE,DRUG ASSAY CYCLOSPORINE,261.0,169.65,7.58,261.0,17
CDM,80162WE,DRUG SCREEN QUANTITATIVE DIGOXIN TOTAL,143.0,92.95,5.58,143.0,17
CDM,80164WE,DRUG ASSAY VALPROIC DIPROPYLACETIC ACID TOTAL,119.0,77.35,5.69,119.0,17
CDM,80170WE,DRUG SCREEN QUANTITATIVE GENTAMICIN,175.0,113.75,6.88,175.0,17
CDM,80178WE,DRUG SCREEN QUANTITATIVE LITHIUM,86.0,55.9,2.78,86.0,17
CDM,80184WE,DRUG SCREEN QUANTITATIVE PHENOBARBITAL,60.0,39.0,6.43,60.0,17
CDM,80185WE,DRUG SCREEN QUANTITATIVE PHENYTOIN TOTAL,50.0,32.5,5.57,50.0,17
CDM,80192WE,DRUG SCREEN QUANTITATIVE PROCAINAMIDE METABOLITE,153.0,99.45,7.04,153.0,17
CDM,80194WE,DRUG SCREEN QUANTITATIVE QUINIDINE,112.0,72.8,6.13,112.0,17
CDM,80197WE,DRUG SCREEN QUANTITATIVE TACROLIMUS,170.0,110.5,5.77,170.0,17
CDM,80198WE,DRUG SCREEN QUANTITATIVE THEOPHYLLINE,151.0,98.15,5.94,151.0,17
CDM,80200WE,DRUG SCREEN QUANTITATIVE TOBRAMYCIN,15.0,9.75,6.77,17.81,17
CDM,80202WE,DRUG SCREEN QUANTITATIVE VANCOMYCIN,128.0,83.2,5.69,128.0,17
CDM,80400010,PERITON DIALYS CCPD,3673.0,2387.45,105.79,3305.7,38
CDM,80400020,ULTRAFILTRATION,3673.0,2387.45,105.79,3305.7,38
CDM,80400WE,ACTH STIMULATION PANEL ADRENAL INSUFFICIENCY,242.0,157.3,13.7,242.0,17
CDM,80900090,CONTIN RENAL RPLC,931.0,605.15,150.32,837.9,28
CDM,81000AWE,URINALYSIS,5.0,3.25,2.41,5.0,17
CDM,81000FAMWE,URINALYSIS NONAUTO W/SCOPE,5.0,3.25,2.41,5.0,17
CDM,81000WE,URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,19.0,12.35,2.41,19.0,17
CDM,81001URIWE,"URINALYSIS, AUTOMATED WITH MICROSCOPY",33.0,21.45,1.9,33.0,17
CDM,81001WE,URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY,32.0,20.8,1.9,32.0,17
CDM,81002AWE,URINALYSIS BY DIP  NO MICRO,5.0,3.25,2.09,5.0,17
CDM,81002URIWE,URINALYSIS W/OUT MICROSCOPY,33.0,21.45,2.09,33.0,17
CDM,81002WE,URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP,17.0,11.05,2.09,17.0,17
CDM,81003URIWE,"URINALYSIS,AUTOMATED, W/O MICROSCOPY",33.0,21.45,1.35,33.0,17
CDM,81003WE,URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY,7.0,4.55,1.35,7.0,17
CDM,81015WE,URINALYSIS MICROSCOPIC ONLY,41.0,26.65,1.83,41.0,17
CDM,81025AWE,URINE PREGNANCY TEST,10.0,6.5,5.0,10.0,17
CDM,81025WE,URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS,29.0,18.85,5.17,29.0,17
CDM,81100010,LIVER LIVE DONOR AQUISTION FEE,1528.0,993.2,256.7,1375.2,21
CDM,81100100,ACQUISITION KIDNEY LIVE DONOR,5000.0,3250.0,840.0,4500.0,21
CDM,81100110,LIVER LIVE DONOR AQUISTION FEE,3000.0,1950.0,504.0,2700.0,21
CDM,81200100,ACQUISITION FEE LIVER,176947.0,115015.55,29727.1,159252.3,21
CDM,81200110,ACQUISITION KIDNEY CADAVER,120122.0,78079.3,20180.5,108109.8,21
CDM,81200120,ACQUISITION FEE HEART,114523.0,74439.95,19239.86,103070.7,21
CDM,81500095,HEP B CORE AB TOTAL,64.0,41.6,5.23,57.6,37
CDM,81500135,HEP B SURFACE AG EIA,55.0,35.75,4.02,49.5,37
CDM,81900035,HEP B CORE AB TOTAL,52.0,33.8,5.23,46.8,37
CDM,81900075,HEP B SURFACE AG EIA,45.0,29.25,4.02,40.5,37
CDM,82000020,HEMODIALYSIS,6035.0,3922.75,87.55,5431.5,41
CDM,82009WE,KETONE BODIES SERUM QUALITATIVE,15.0,9.75,1.9,15.0,17
CDM,82040WE,ALBUMIN SERUM PLASMA/WHOLE BLOOD,40.0,26.0,2.08,40.0,17
CDM,82042WE,OTHER SOURCE ALBUMIN QUANTITATIVE EACH SPECIMEN,50.0,32.5,1.95,50.0,17
CDM,82043WE,URINE ALBUMIN QUANTITATIVE,15.0,9.75,1.95,15.0,17
CDM,82105WE,ALPHA-FETOPROTEIN SERUM,179.0,116.35,7.04,179.0,17
CDM,82140WE,ASSAY OF AMMONIA,133.0,86.45,6.12,133.0,17
CDM,82150AMYWE,AMYLASE UR TIME PROFESSIONAL FEE,13.0,8.45,2.72,13.0,17
CDM,82150WE,ASSAY OF AMYLASE,70.0,45.5,2.72,70.0,17
CDM,82247BILWE,BILRBN NB TOT PROFESSIONAL FEE,13.0,8.45,2.11,13.0,17
CDM,82247WE,BILIRUBIN TOTAL,44.0,28.6,2.11,44.0,17
CDM,82248WE,BILIRUBIN DIRECT,34.0,22.1,2.11,34.0,17
CDM,82270AWE,HEMO SLIDES/ OCULT BLD FECES 1-3,5.0,3.25,2.5,5.0,12
CDM,82270BLOWE,"BLOOD; OCCULT, FECES, X",22.0,14.3,2.63,22.0,17
CDM,82270FAMWE,OCCULT BLD FECES 1 DETER,5.0,3.25,2.5,5.0,17
CDM,82270WE,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER,11.0,7.15,2.63,11.0,17
CDM,82271WE,BLOOD OCCULT PEROXIDASE ACTV QUAL OTHER SOURCES,26.0,16.9,3.19,26.0,17
CDM,82272AWE,HEMO SLIDE/OCCULT BLOOD FECES 1-3 CARD,5.0,3.25,2.5,5.0,17
CDM,82272BLOWE,"BLOOD, OCCULT, SINGLE DRE DIAGNOSTIC",22.0,14.3,2.54,22.0,17
CDM,82272FAMWE,OCCULT BLD FECES 1-3 TESTS,5.0,3.25,2.5,5.0,17
CDM,82272WE,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC,11.0,7.15,2.54,11.0,17
CDM,82274HGBWE,HGB FECALIA,13.0,8.45,6.5,17.57,17
CDM,82274WE,BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3,52.0,33.8,9.55,52.0,17
CDM,82310WE,CALCIUM; TOTAL,34.0,22.1,2.17,34.0,17
CDM,82340CALWE,CALC URINE QUAN PROFESSIONAL FEE,13.0,8.45,2.53,13.0,17
CDM,82340WE,CALCIUM URINE QUANTITATIVE TIMED SPECIMEN,80.0,52.0,2.53,80.0,17
CDM,82374WE,CARBON DIOXIDE BICARBONATE,24.0,15.6,2.05,24.0,17
CDM,82435WE,CHLORIDE BLD,22.0,14.3,1.93,22.0,17
CDM,82436CHLWE,CHLORD 24HR URN PROFESSIONAL FEE,13.0,8.45,2.42,13.0,17
CDM,82436WE,CHLORIDE URINE,43.0,27.95,2.42,43.0,17
CDM,82438WE,CHLORIDE OTHER SOURCE,52.0,33.8,2.1,52.0,17
CDM,82465CHOWE,CHOLESTEROLTOT PROFESSIONAL FEE,13.0,8.45,1.83,13.0,17
CDM,82465WE,CHOLESTEROL SERUM/WHOLE BLOOD TOTAL,52.0,33.8,1.83,52.0,17
CDM,82533WE,CORTISOL; TOTAL,180.0,117.0,6.85,180.0,17
CDM,82550WE,CREATINE KINASE TOTAL,24.0,15.6,2.73,24.0,17
CDM,82553WE,CREATINE KINASE MB FRACTION ONLY,99.0,64.35,4.85,99.0,17
CDM,82565WE,CREATININE; BLOOD,28.0,18.2,2.15,28.0,17
CDM,82570CREWE,CREATIN 24HR UR PROFESSIONAL FEE,13.0,8.45,2.18,13.0,17
CDM,82575WE,CREATININE; CLEARANCE,111.0,72.15,3.97,111.0,17
CDM,82607WE,CYANOCOBALAMIN VITAMIN B-12,161.0,104.65,6.33,161.0,17
CDM,82728WE,ASSAY FERRITIN,146.0,94.9,5.72,146.0,17
CDM,82746WE,ASSAY OF FOLIC ACID SERUM,157.0,102.05,6.17,157.0,17
CDM,82784IGAWE,IG-A SERMAN,13.0,8.45,3.91,13.0,17
CDM,82784IGGWE,IG-G SERUM,13.0,8.45,3.91,13.0,17
CDM,82784IGMWE,IG-M SERUM,13.0,8.45,3.91,13.0,17
CDM,82785WE,"ASSAY, GAMMAGLOBULIN IGE",177.0,115.05,6.91,177.0,17
CDM,82803WE,BLOOD GASES ANY COMBINATION PH PCO2 PO2 CO2 HCO3,183.0,118.95,10.95,183.0,17
CDM,82805WE,GASES BLOOD PH DIRECT MEAS XCPT PULSE OXIMITRY,201.0,130.65,31.36,201.0,17
CDM,82900010,UNSCHEDULED DIALYS TX,3499.0,2274.35,565.8,3149.1,40
CDM,82945GLUWE,GLUCOSE BDY FLD PROFESSIONAL FEE,13.0,8.45,2.36,13.0,17
CDM,82947GLUWE,GLUCOSE QUANT PROFESSIONAL FEE,13.0,8.45,2.36,13.0,17
CDM,82947WE,GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP,20.0,13.0,2.36,20.0,17
CDM,82951WE,GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS,121.0,78.65,7.72,121.0,17
CDM,82952WE,GLUCOSE TOLERANCE EA ADDL BEYOND 3 SPECIMENS,46.0,29.9,2.35,46.0,17
CDM,82962GLUWE,GLUCOMETER-ACCUCHECK,13.0,8.45,1.97,13.0,17
CDM,82962WE,GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE,24.0,15.6,1.97,24.0,17
CDM,82977WE,ASSAY OF GLUTAMYLTRASE GAMMA,78.0,50.7,3.02,78.0,17
CDM,83000000,PERITONEAL DIALYSIS NON-CAPD,3673.0,2387.45,105.79,3305.7,41
CDM,83001WE,GONADOTROPIN FOLLICLE STIMULATING HORMONE,199.0,129.35,7.8,199.0,17
CDM,83002WE,GONADOTROPIN LUTEINIZING HORMONE,198.0,128.7,7.78,198.0,17
CDM,83013WE,HPYLORI BREATH ANAL UREASE ACT NON-RADACT ISTOPE,259.0,168.35,28.29,259.0,17
CDM,83014WE,HELICOBACTER PYLORI ; DRUG ADMINISTRATION,28.0,18.2,3.3,28.0,17
CDM,83036HEMWE,HEMOGLOBIN; GLYCOSYLATED,61.0,39.65,4.08,61.0,17
CDM,83036WE,HEMOGLOBIN GLYCOSYLATED A1C,37.0,24.05,4.08,37.0,17
CDM,83080WE,ASSAY OF B-HEXOSAMINIDASE EACH ASSAY,128.0,83.2,7.09,128.0,17
CDM,83090HOMWE,HOMOCYST QUAN,13.0,8.45,6.5,18.63,17
CDM,83090WE,ASSAY OF HOMOCYSTEINE,180.0,117.0,7.53,180.0,17
CDM,83518WE,IMMUNOASSAY ANALYTE QUAL/SEMIQUAL SINGLE STEP,33.0,21.45,5.78,33.0,17
CDM,83520WE,IMMUNOASSAY ANALYTE QUANTITATIVE NOS,26.0,16.9,7.25,26.0,17
CDM,83540WE,ASSAY OF IRON,70.0,45.5,2.72,70.0,17
CDM,83550WE,IRON BINDING CAPACITY,94.0,61.1,3.67,94.0,17
CDM,83605WE,ASSAY OF LACTATE,89.0,57.85,4.86,89.0,17
CDM,83615WE,LACTATE DEHYDROGENASE LDH,35.0,22.75,2.54,35.0,17
CDM,83690WE,ASSAY OF LIPASE,74.0,48.1,2.89,74.0,17
CDM,83704WE,LIPOPROTEIN BLOOD QUAN NUMBERS & SUBCLASSES,193.0,125.45,14.36,193.0,17
CDM,83718CHOWE,"CHOLESTEROL, HDL",56.0,36.4,3.44,56.0,17
CDM,83718WE,LIPOPROTEIN DIR MEAS HIGH DENSITY CHOLESTEROL,88.0,57.2,3.44,88.0,17
CDM,83721WE,LIPOPROTEIN DIRECT MEASUREMENT LDL CHOLESTEROL,37.0,24.05,4.41,37.0,17
CDM,83735MAGWE,MAGNESIUM URINE,13.0,8.45,2.81,13.0,17
CDM,83735WE,ASSAY OF MAGNESIUM,24.0,15.6,2.81,24.0,17
CDM,83880WE,NATRIURETIC PEPTIDE,319.0,207.35,16.49,319.0,17
CDM,83930WE,ASSAY OF OSMOLALITY BLOOD,94.0,61.1,2.78,94.0,17
CDM,83935WE,ASSAY OF OSMOLALITY URINE,96.0,62.4,2.86,96.0,17
CDM,83970WE,ASSAY OF PARATHORMONE,396.0,257.4,17.34,396.0,17
CDM,83986PHBWE,"PH, BODY FLUID EXCEPT BLOOD",33.0,21.45,2.15,33.0,17
CDM,83986PHFWE,PH BODY FLUID,13.0,8.45,2.15,13.0,17
CDM,83986WE,PH BODY FLUID NOT ELSEWHERE SPECIFIED,17.0,11.05,2.15,17.0,17
CDM,84000000,PERITONEAL DIALYSIS CAPD,3673.0,2387.45,105.79,3305.7,41
CDM,84075WE,ASSAY OF PHOSPHATASE ALKALINE,50.0,32.5,2.18,50.0,17
CDM,84100WE,ASSAY OF PHOSPHORUS INORGANIC,51.0,33.15,1.99,51.0,17
CDM,84105WE,ASSAY OF PHOSPHORUS INORGANIC URINE,57.0,37.05,2.43,57.0,17
CDM,84132WE,POTASSIUM SERUM PLASMA/WHOLE BLOOD,22.0,14.3,2.0,22.0,17
CDM,84133POTWE,POTASSIUM 24HR UR PROFESSIONAL FEE,13.0,8.45,1.99,13.0,17
CDM,84133WE,POTASSIUM URINE,52.0,33.8,1.99,52.0,17
CDM,84134WE,PREALBUMIN BLD,145.0,94.25,6.13,145.0,17
CDM,84153WE,ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL,51.0,33.15,7.72,51.0,17
CDM,84155WE,PROTEIN XCPT REFRACTOMETRY SERUM PLASMA/WHL BLD,31.0,20.15,1.54,31.0,17
CDM,84156PROWE,PROTEIN UR 24HRN PROFESSIONAL FEE,13.0,8.45,1.54,13.0,17
CDM,84156WE,PROTEIN TOTAL XCPT REFRACTOMETRY URINE,31.0,20.15,1.54,31.0,17
CDM,84157PROWE,PROT OTHR SOURC PROFESSIONAL FEE,13.0,8.45,1.68,13.0,17
CDM,84157WE,PROTEIN TOTAL XCPT REFRACTOMETRY OTH SRC,31.0,20.15,1.68,31.0,17
CDM,84165PROWE,PROTEIN ELECTROPHORETIC FRACTIONATION QUA,67.0,43.55,4.51,67.0,17
CDM,84165WE,PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM,160.0,104.0,4.51,160.0,17
CDM,84165WE-26,PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM,160.0,104.0,7.38,160.0,31
CDM,84295WE,SODIUM SERUM PLASMA OR WHOLE BLOOD,22.0,14.3,2.02,22.0,17
CDM,84300SODWE,SODIUM 24HR URIN PROFESSIONAL FEE,13.0,8.45,2.13,13.0,17
CDM,84300WE,ASSAY OF URINE SODIUM,58.0,37.7,2.13,58.0,17
CDM,84403WE,ASSAY OF TESTOSTERONE TOTAL,70.0,45.5,10.84,70.0,17
CDM,84436WE,"ASSAY, TOTAL THYROXINE",76.0,49.4,2.89,76.0,17
CDM,84439WE,ASSAY OF FREE THYROXINE,123.0,79.95,3.79,123.0,17
CDM,84443WE,ASSAY OF THYROID STIMULATING HORMONE TSH,59.0,38.35,7.06,59.0,17
CDM,84450WE,TRANSFERASE ASPARTATE AMINO AST SGOT,40.0,26.0,2.18,40.0,17
CDM,84460WE,TRANSFERASE ALANINE AMINO ALT SGPT,57.0,37.05,2.23,57.0,17
CDM,84478TRIWE,"TRIGLYCERIDES, BLOOD",35.0,22.75,2.41,35.0,17
CDM,84478WE,ASSAY OF TRIGLYCERIDES,62.0,40.3,2.41,62.0,17
CDM,84479WE,THYROID HORM UPTK/THYROID HORMONE BINDING RATIO,70.0,45.5,2.72,70.0,17
CDM,84480WE,ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3,210.0,136.5,5.96,210.0,17
CDM,84481WE,ASSAY OF TRIIODOTHYRONINE T3 FREE,210.0,136.5,7.11,210.0,17
CDM,84484WE,ASSAY OF TROPONIN QUANTITATIVE,141.0,91.65,5.24,141.0,17
CDM,84512WE,ASSAY OF TROPONIN QUALITATIVE,15.0,9.75,4.24,15.0,17
CDM,84520BLDWE,BLD UREA NTRG Q PROFESSIONAL FEE,13.0,8.45,1.66,13.0,17
CDM,84520UREWE,UREA NTRG POC PROFESSIONAL FEE,13.0,8.45,1.66,13.0,17
CDM,84520WE,ASSAY OF UREA NITROGEN QUANTITATIVE,20.0,13.0,1.66,20.0,17
CDM,84540UREWE,UREA NTRGN URIN PROFESSIONAL FEE,13.0,8.45,2.34,13.0,17
CDM,84540WE,ASSAY OF UREA NITROGEN URINE,40.0,26.0,2.34,40.0,17
CDM,84550WE,ASSAY OF BLOOD/URIC ACID,16.0,10.4,1.9,16.0,17
CDM,84560URIWE,URIC ACD UR 24H PROFESSIONAL FEE,13.0,8.45,2.13,13.0,17
CDM,84560WE,ASSAY OF URIC ACID OTHER SOURCE,51.0,33.15,2.13,51.0,17
CDM,84702WE,GONADOTROPIN CHORIONIC QUANTITATIVE,180.0,117.0,9.03,180.0,17
CDM,84703WE,GONADOTROPIN CHORIONIC QUALITATIVE,24.0,15.6,3.16,24.0,17
CDM,85000010,PERITONEAL DIALYSIS CCPD,3673.0,2387.45,105.79,3305.7,41
CDM,85002WE,BLEEDING TIME TEST,15.0,9.75,2.02,15.0,17
CDM,85007WE,BLOOD COUNT SMEAR MCRSCP W/MNL DIFRNTL WBC COUNT,15.0,9.75,1.6,15.0,17
CDM,85014WE,BLOOD COUNT HEMATOCRIT,34.0,22.1,1.42,34.0,17
CDM,85018WE,BLOOD COUNT HEMOGLOBIN,19.0,12.35,1.42,19.0,17
CDM,85025CBCWE,CBC / DIFF & PLATLT,48.0,31.2,3.26,48.0,17
CDM,85025WE,BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC,62.0,40.3,3.26,62.0,17
CDM,85027CBCWE,CBC WO DIFF PROFESSIONAL FEE,13.0,8.45,2.72,13.0,17
CDM,85027WE,BLOOD COUNT COMPLETE AUTOMATED,73.0,47.45,2.72,73.0,17
CDM,85032WE,BLOOD COUNT MANUAL CELL COUNT EACH,49.0,31.85,1.81,49.0,17
CDM,85044WE,BLOOD COUNT RETICULOCYTE AUTOMATED,15.0,9.75,1.81,15.0,17
CDM,85048WE,BLOOD COUNT LEUKOCYTE WBC AUTOMATED,40.0,26.0,1.07,40.0,17
CDM,85049WE,BLOOD COUNT PLATELET AUTOMATED,38.0,24.7,1.88,38.0,17
CDM,85060WE,BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT,194.0,126.1,10.11,194.0,31
CDM,85097WE,BONE MARROW SMEAR INTERPRETATION,405.0,263.25,20.24,303.75,31
CDM,85306WE,CLOTTING INHIBITORS PROTEIN S FREE,375.0,243.75,6.43,375.0,17
CDM,85307WE,ACTIVATED PROTEIN C APC RESISTANCE ASSAY,265.0,172.25,6.43,265.0,17
CDM,85347WE,COAGULATION TIME,50.0,32.5,1.8,50.0,17
CDM,85379WE,FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,199.0,129.35,4.28,199.0,17
CDM,85384WE,FIBRINOGEN ACTIVITY,51.0,33.15,4.08,51.0,17
CDM,85390WE,FIBRINOLYSINS/COAGULOPATHY SCREEN INTERP&REPOR,323.0,209.95,5.24,323.0,17
CDM,85396WE,COAGJ/FBRNLYS ASSAY WHOLE BLOOD ADDITIVE PER DAY,160.0,104.0,8.18,160.0,31
CDM,85460WE,HGB/RBCS FETAL FETOMATERNAL HEMRRG DIFRNTL LYSIS,83.0,53.95,3.25,83.0,17
CDM,85461WE,HGB/RBCS FETAL FETOMATERNAL HEMRRG ROSETTE,60.0,39.0,3.93,60.0,17
CDM,85576WE,PLATELET AGGREGATION IN VITRO EACH AGENT,160.0,104.0,10.46,160.0,17
CDM,85610PROWE,PROTHROMBIN TIME,33.0,21.45,2.57,33.0,17
CDM,85610WE,PROTHROMBIN TIME,32.0,20.8,2.57,32.0,17
CDM,85610WE-QW,PROTHROMBIN TIME,40.0,26.0,4.34,40.0,16
CDM,85652WE,SEDIMENTATION RATE RBC AUTOMATED,72.0,46.8,1.13,72.0,17
CDM,85660WE,SICKLING RBC REDUCTION,59.0,38.35,2.31,59.0,17
CDM,85670WE,THROMBIN TIME,69.0,44.85,2.42,69.0,17
CDM,85730WE,THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD,72.0,46.8,2.52,72.0,17
CDM,85810WE,VISCOSITY,126.0,81.9,4.9,126.0,17
CDM,86003WE,ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH,70.0,45.5,2.19,70.0,17
CDM,86036WE,ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,142.0,92.3,5.06,142.0,13
CDM,86077WE,BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REP,405.0,263.25,20.66,303.75,31
CDM,86078WE,BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT,405.0,263.25,202.5,405.0,12
CDM,86140WE,C-REACTIVE PROTEIN,123.0,79.95,2.18,123.0,17
CDM,86141WE,C-REACTIVE PROTEIN HIGH SENSITIVITY,57.0,37.05,5.44,57.0,17
CDM,86300WE,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 15-3,157.0,102.05,8.74,157.0,17
CDM,86301WE,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9,170.0,110.5,8.74,170.0,17
CDM,86304WE,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125,186.0,120.9,8.74,186.0,17
CDM,86308WE,HETEROPHILE ANTIBODIES SCREEN,24.0,15.6,3.11,24.0,17
CDM,86335WE,IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS,366.0,237.9,12.33,366.0,17
CDM,86335WE-26,IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS,163.0,105.95,7.38,163.0,31
CDM,86431WE,RHEUMATOID FACTOR QUANTITATIVE,79.0,51.35,2.38,79.0,17
CDM,86485WE,CANDIDA; SKIN TEST BO,48.0,31.2,8.32,48.0,13
CDM,86486WE,SKIN TEST UNLISTED ANTIGEN EACH,35.0,22.75,2.76,35.0,31
CDM,86490WE,COCCIDIOIDOMYCOSIS SKIN TEST,56.0,36.4,5.6,110.68,19
CDM,86580HISWE,HISTOPLASMOSIS SKIN TEST,45.0,29.25,6.34,45.0,31
CDM,86580SKIWE,SKIN TEST TB,45.0,29.25,6.34,45.0,31
CDM,86580WE,SKIN TEST TUBERCULOSIS INTRADERMAL,29.0,18.85,6.34,29.0,31
CDM,86592WE,SYPHILIS TEST NON-TREP QUAL,75.0,48.75,1.79,75.0,17
CDM,86593WE,SYPHILIS TEST QUANTITATIVE,75.0,48.75,1.85,75.0,17
CDM,86677WE,AB; HELICOBACTER PYLORI,57.0,37.05,7.08,57.0,17
CDM,86704WE,HEPATITIS B CORE ANTIBODY HBCAB TOTAL,155.0,100.75,5.06,155.0,17
CDM,86706HBSWE,HBS AB,13.0,8.45,4.51,13.0,17
CDM,86706WE,HEPATITIS B SURF ANTIBODY HBSAB,133.0,86.45,4.51,133.0,17
CDM,86735WE,ANTIBODY MUMPS,51.0,33.15,5.48,51.0,17
CDM,86768WE,ANTIBODY SALMONELLA,15.0,9.75,5.54,15.0,17
CDM,86850WE,ANTIBODY SCREEN RBC EACH SERUM TECHNIQUE,123.0,79.95,4.1,123.0,13
CDM,86860WE,ANTIBODY ELUTION RBC EACH ELUTION,15.0,9.75,7.5,15.0,13
CDM,86870WE,ANTIBODY ID RBC ANTIBODIES EA PANEL EA SERUM TQ,118.0,76.7,17.44,118.0,13
CDM,86880WE,ANTIHUMAN GLOBULIN DIRECT EACH ANTISERUM,166.0,107.9,2.26,166.0,17
CDM,86886CMBWE,CMBS INDIR -N PROFESSIONAL FEE,13.0,8.45,2.18,13.0,17
CDM,86886RBCWE,RBC AB TITER -N PROFESSIONAL FEE,13.0,8.45,2.18,13.0,17
CDM,86886WE,ANTIHUMAN GLOBULIN INDIRECT EACH ANTIBODY TITER,39.0,25.35,2.18,39.0,17
CDM,86900WE,BLOOD TYPING SEROLOGIC ABO,73.0,47.45,1.26,73.0,17
CDM,86901WE,BLOOD TYPING SEROLOGIC RH (D),63.0,40.95,1.26,63.0,17
CDM,86904WE,BLOOD TYPING ANTIGEN SCREEN PATIENT SERUM/UNIT,15.0,9.75,6.86,15.0,17
CDM,86920WE,COMPATIBILITY EACH UNIT IMMEDIATE SPIN TECHNIQUE,100.0,65.0,14.09,100.0,13
CDM,86922WE,COMPATIBILITY EACH UNIT ANTIGLOBULIN,210.0,136.5,15.07,210.0,13
CDM,86927WE,FRESH FROZEN PLASMA THAWING EACH UNIT,153.0,99.45,7.95,153.0,13
CDM,87040WE,CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES,193.0,125.45,4.33,193.0,17
CDM,87045WE,CUL BACT STOOL AEROBIC ISOL SALMONELLA&SHIGELL,155.0,100.75,3.96,155.0,17
CDM,87046WE,CUL BACT STOOL AEROBIC ADDL PATHOGENS&ID EA,117.0,76.05,3.96,117.0,17
CDM,87070CULWE,CULT FLD EX CSF,13.0,8.45,3.62,13.0,17
CDM,87070HELWE,HELI PYL CULT,13.0,8.45,3.62,13.0,17
CDM,87070WE,CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL,100.0,65.0,3.62,100.0,17
CDM,87075WE,CULTURE BACTERIAL ANY SOURCE ANAEROBIC ISO&ID,231.0,150.15,3.98,231.0,17
CDM,87076WE,CUL BACT ANAEROBIC ADDL METHS DEFINITIVE EA ISOL,87.0,56.55,3.39,87.0,17
CDM,87077CULWE,CULT AEROBIC ID PROFESSIONAL FEE,13.0,8.45,3.39,13.0,17
CDM,87077WE,CUL BACT AEROBIC ADDL METHS DEFINITIVE EA ISOL,29.0,18.85,3.39,29.0,17
CDM,87081CULWE,CULT BAC SCREEN PROFESSIONAL FEE,13.0,8.45,2.78,13.0,17
CDM,87081WE,CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ,79.0,51.35,2.78,79.0,17
CDM,87084AWE,RAPID FLU TESTING,20.0,13.0,9.52,20.0,17
CDM,87086WE,CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE,29.0,18.85,3.39,29.0,17
CDM,87158WE,CULTURE TYPING OTHER METHODS,168.0,109.2,3.25,168.0,17
CDM,87172WE,PIN WORM PREP,46.0,29.9,2.56,46.0,17
CDM,87177WE,OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID,98.0,63.7,3.74,98.0,17
CDM,87186WE,SUSCEPTIBLTY STDY ANTIMICRBIAL MICRO/AGAR DILUTJ,29.0,18.85,3.63,29.0,17
CDM,87205GRAWE,GRAM STAIN,13.0,8.45,1.79,13.0,17
CDM,87205WE,SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL,58.0,37.7,1.79,58.0,17
CDM,87207WE,"SMEAR, PARASITE SPECIAL STAIN",160.0,104.0,2.52,160.0,17
CDM,87210KOHWE,KOH PREP,13.0,8.45,3.49,13.0,17
CDM,87210WE,SMR PRIM SRC WET MOUNT NFCT AGT,31.0,20.15,3.49,31.0,17
CDM,87210WETWE,WET MNT W/SMP S PROFESSIONAL FEE,13.0,8.45,3.49,13.0,17
CDM,87220WE,TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT,29.0,18.85,2.56,29.0,17
CDM,87230WE,TOXIN/ANTITOXIN ASSAY TISSUE CULTURE,75.0,48.75,8.29,75.0,17
CDM,87251WE,OTHER VIRUSID,13.0,8.45,6.5,13.0,12
CDM,87252OTHWE,OTHR VIRUS CULT,13.0,8.45,6.5,28.8,17
CDM,87252PARWE,PARAINFLUENZA CULTURE,131.0,85.15,10.95,131.0,17
CDM,87252WE,VIRUS TISS CUL INOCULATION CYTOPATHIC EFFECT,15.0,9.75,7.5,28.8,17
CDM,87324WE,IAAD IA CLOSTRIDIUM DIFFICILE TOXIN,183.0,118.95,5.03,183.0,17
CDM,87328WE,IAAD IA CRYPTOSPORIDIUM,128.0,83.2,5.8,128.0,17
CDM,87329WE,IAAD IA GIARDIA,134.0,87.1,5.03,134.0,17
CDM,87340WE,IAAD IA HEPATITIS B SURFACE ANTIGEN,147.0,95.55,4.34,147.0,17
CDM,87400WE,IAAD IA INFLUENZA A/B EACH,38.0,24.7,5.93,38.0,17
CDM,87420WE,IAAD IA RESPIRATORY SYNCTIAL VIRUS,15.0,9.75,5.84,15.0,17
CDM,87425WE,IAAD IA ROTAVIRUS,128.0,83.2,5.03,128.0,17
CDM,87430WE,IAAD IA STREPTOCOCCUS GROUP A,43.0,27.95,7.06,43.0,17
CDM,87502WE,INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,214.0,139.1,40.24,214.0,17
CDM,87529WE,IADNA HERPES SOMPLX VIRUS AMPLIFIED PROBE TQ,157.0,102.05,14.74,157.0,17
CDM,87624WE,IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES,307.0,199.55,14.74,307.0,13
CDM,87635WE,IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ,150.0,97.5,30.79,150.0,13
CDM,87637WE,IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ,560.0,364.0,85.58,560.0,13
CDM,87651POCWE,STREP A (MOLECULAR),98.0,63.7,21.05,98.0,17
CDM,87802STRWE,STREP B IA DIR,13.0,8.45,5.35,13.25,17
CDM,87802WE,IAADIADOO STREPTOCOCCUS GROUP B,15.0,9.75,5.35,15.0,17
CDM,87803CDTWE,CDT A IA DIR PROFESSIONAL FEE,13.0,8.45,6.5,13.25,17
CDM,87803WE,IAADIADOO CLOSTRIDIUM DIFFICILE TOXIN A,15.0,9.75,6.72,15.0,17
CDM,87804AWE,INF A IA DIR,20.0,13.0,9.93,20.0,17
CDM,87804FAMWE,INFLUENZA ASSAY W/OPTIC,20.0,13.0,9.93,20.0,17
CDM,87804INFWE,INF A IA DIR,13.0,8.45,6.5,13.25,17
CDM,87804RAPWE,RAPID INFLUENZA TEST,77.0,50.05,9.93,77.0,17
CDM,87804WE,IAADIADOO INFLUENZA,108.0,70.2,9.93,108.0,17
CDM,87809AWE,ADENOVIRUS,20.0,13.0,9.14,20.0,17
CDM,87809FAMWE,ADENOVIRUS ASSAY W/OPTIC,20.0,13.0,9.14,20.0,17
CDM,87809WE,IAADIADOO ADENOVIRUS,92.0,59.8,9.14,92.0,17
CDM,87880AWE,STREP A ASSAY,20.0,13.0,9.92,20.0,17
CDM,87880FAMWE,STREP A ASSAY W/OPTIC,20.0,13.0,9.92,20.0,17
CDM,87880RAPWE,RAPID STREP A TEST,86.0,55.9,9.92,86.0,17
CDM,87880WE,IAADIADOO STREPTOCOCCUS GROUP A,47.0,30.55,9.92,47.0,17
CDM,87899WE,IAADIADOO NOT OTHERWISE SPECIFIED,15.0,9.75,6.75,15.0,17
CDM,87905WE,INFECTIOUS AGENT ENZYMATIC ACTV OTH/THN VIRUS,29.0,18.85,5.13,29.0,17
CDM,88104WE,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,241.0,156.65,45.73,241.0,31
CDM,88104WE-26,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,241.0,156.65,16.12,241.0,31
CDM,88106WE,CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ,174.0,113.1,43.13,174.0,31
CDM,88106WE-26,CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ,176.0,114.4,11.13,176.0,31
CDM,88108PROWE,"CYTOPATHOLOGY,BRONCHIAL WASH",190.0,123.5,41.39,190.0,31
CDM,88108WE,CYTP CONCENTRATION SMEARS & INTERPRETATION,461.0,299.65,41.39,461.0,31
CDM,88108WE-26,CYTP CONCENTRATION SMEARS & INTERPRETATION,190.0,123.5,13.13,190.0,31
CDM,88112WE,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,241.0,156.65,40.99,241.0,31
CDM,88112WE-26,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,241.0,156.65,16.12,241.0,31
CDM,88121WE,CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA,431.0,280.15,215.5,607.56,31
CDM,88141WE,CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN,112.0,72.8,14.51,112.0,31
CDM,88142WE,CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN,194.0,126.1,12.16,194.0,17
CDM,88150CYTWE,CYTO CERV/VAG PROFESSIONAL FEE,13.0,8.45,6.5,13.0,17
CDM,88150WE,CYTP SLIDES C/V MNL SCR UNDER PHYS,93.0,60.45,10.66,93.0,17
CDM,88155WE,CYTP SLIDES C/V DEFINITIVE HORMONAL EVAL,44.0,28.6,6.62,44.0,17
CDM,88160WE,CYTP SMRS ANY OTH SRC SCR&INTERPJ,216.0,140.4,47.16,216.0,31
CDM,88160WE-26,CYTP SMRS ANY OTH SRC SCR&INTERPJ,216.0,140.4,14.92,216.0,31
CDM,88161WE,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,138.0,89.7,48.31,138.0,31
CDM,88161WE-26,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,216.0,140.4,14.73,216.0,31
CDM,88162PROWE,"CYTOPATHOLOGY, EXTENSIVE",205.0,133.25,72.61,205.0,31
CDM,88162WE,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,327.0,212.55,72.61,327.0,31
CDM,88162WE-26,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,253.0,164.45,22.91,253.0,31
CDM,88172WE,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,297.0,193.05,33.62,297.0,31
CDM,88172WE-26,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,297.0,193.05,20.51,297.0,31
CDM,88173WE,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,598.0,388.7,100.89,598.0,31
CDM,88173WE-26,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,598.0,388.7,40.63,598.0,31
CDM,88177WE,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL,181.0,117.65,17.71,181.0,31
CDM,88182PROWE,"FLOW CYTORACTRY,EACH CELL",175.0,113.75,86.67,243.64,31
CDM,88182WE,FLOW CYTOMETRY CELL CYCLE/DNA ANALYSIS,215.0,139.75,86.67,243.64,31
CDM,88182WE-26,FLOW CYTOMETRY CELL CYCLE/DNA ANALYSIS,217.0,141.05,22.31,217.0,31
CDM,88187WE,FLOW CYTOMETRY INTERPRETATION 2-8 MARKE,319.0,207.35,21.42,319.0,31
CDM,88188WE,FLOW CYTOMETRY INTERP 9-15 MARKERS,528.0,343.2,37.05,528.0,31
CDM,88189WE,FLOW CYTOMETRY INTERP 16 OR MORE MARKERS,732.0,475.8,50.14,732.0,31
CDM,88300WE,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,35.0,22.75,10.08,35.0,31
CDM,88300WE-26,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,35.0,22.75,2.75,35.0,31
CDM,88302WE,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,56.0,36.4,20.24,59.36,31
CDM,88302WE-26,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,56.0,36.4,4.15,56.0,31
CDM,88304WE,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,95.0,61.75,26.03,95.0,31
CDM,88304WE-26,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,95.0,61.75,6.74,95.0,31
CDM,88305WE,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,323.0,209.95,43.19,323.0,31
CDM,88305WE-26,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,323.0,209.95,21.71,323.0,31
CDM,88307WE,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,684.0,444.6,173.36,684.0,31
CDM,88307WE-26,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,684.0,444.6,47.77,684.0,31
CDM,88309WE,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,1205.0,783.25,260.23,1205.0,31
CDM,88309WE-26,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,1205.0,783.25,84.2,1205.0,31
CDM,88311WE,DECALCIFICATION PROCEDURE,104.0,67.6,12.47,104.0,31
CDM,88311WE-26,DECALCIFICATION PROCEDURE,104.0,67.6,7.14,104.0,31
CDM,88312WE,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,233.0,151.45,67.7,233.0,31
CDM,88312WE-26,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,233.0,151.45,15.52,233.0,31
CDM,88313WE,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,104.0,67.6,49.95,120.71,31
CDM,88313WE-26,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,104.0,67.6,7.14,104.0,31
CDM,88314PROWE,SPECIAL STAINS HISTOCHEM,113.0,73.45,53.5,129.3,31
CDM,88314WE,SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU,194.0,126.1,53.5,194.0,31
CDM,88314WE-26,SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU,194.0,126.1,11.93,194.0,31
CDM,88319WE,SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS,228.0,148.2,82.21,228.0,31
CDM,88319WE-26,SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS,228.0,148.2,15.72,228.0,31
CDM,88321CWE,PATHOUT MICROSLIDE CONSULT,212.0,137.8,49.7,159.0,31
CDM,88321WE,CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE,701.0,455.65,49.7,525.75,31
CDM,88323WE,CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES,787.0,511.55,69.3,787.0,31
CDM,88323WE-26,CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES,787.0,511.55,51.41,787.0,31
CDM,88325WE,CONSLTJ COMPRE REVIEW REPRT REFERRED MATRL,1226.0,796.9,80.1,919.5,31
CDM,88329WE,PATHOLOGY CONSULTATION DURING SURGERY,289.0,187.85,21.17,216.75,31
CDM,88331WE,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,512.0,332.8,60.91,512.0,31
CDM,88331WE-26,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,512.0,332.8,36.04,512.0,31
CDM,88332WE,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,254.0,165.1,32.82,254.0,31
CDM,88332WE-26,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,254.0,165.1,17.72,254.0,31
CDM,88333WE,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,517.0,336.05,55.13,517.0,31
CDM,88333WE-26,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,517.0,336.05,35.84,517.0,31
CDM,88334WE,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,314.0,204.1,33.27,314.0,31
CDM,88334WE-26,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,314.0,204.1,21.71,314.0,31
CDM,88341WE,IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE,241.0,156.65,54.4,241.0,27
CDM,88342WE,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,302.0,196.3,63.72,302.0,31
CDM,88342WE-26,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,302.0,196.3,20.32,302.0,31
CDM,88344WE,IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE,332.0,215.8,103.79,332.0,27
CDM,88346WE,IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,319.0,207.35,87.22,319.0,31
CDM,88346WE-26,IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,319.0,207.35,20.92,319.0,31
CDM,88348WE,ELECTRON MICROSCOPY,650.0,422.5,291.38,746.31,31
CDM,88348WE-26,ELECTRON MICROSCOPY,650.0,422.5,44.82,650.0,31
CDM,88350WE,IMMUNOFLUORESCENCE PER SPEC ADD SINGL ANTB STAIN,254.0,165.1,16.92,254.0,31
CDM,88360WE,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,366.0,237.9,72.3,366.0,31
CDM,88361WE,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST,264.0,171.6,71.71,264.0,31
CDM,88361WE-26,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST,266.0,172.9,25.31,266.0,31
CDM,88362WE,NERVE TEASING PREPARATIONS,934.0,607.1,138.26,934.0,31
CDM,88362WE-26,NERVE TEASING PREPARATIONS,471.0,306.15,65.04,471.0,31
CDM,88364WE,IN SITU HYBRIDIZATION EA ADDL PROBE STAIN,302.0,196.3,19.72,302.0,31
CDM,88365WE,IN SITU HYBRIDIZATION 1ST PROBE STAIN,379.0,246.35,106.54,379.0,31
CDM,88365WE-26,IN SITU HYBRIDIZATION 1ST PROBE STAIN,379.0,246.35,24.91,379.0,31
CDM,88367WE,M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN,361.0,234.65,67.11,361.0,31
CDM,88367WE-26,M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN,371.0,241.15,19.32,371.0,31
CDM,88373WE,M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH,147.0,95.55,14.58,147.0,31
CDM,88374WE,M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR EACH MULTIPRB,244.0,158.6,24.51,244.0,31
CDM,88377WE,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB,603.0,391.95,37.09,603.0,31
CDM,88381WE,MICRODISSECTION PREP IDENTIFIED TARGET MANUAL,228.0,148.2,114.0,292.86,31
CDM,88900015,HEMO 1 EVAL OP,6035.0,3922.75,87.55,5431.5,38
CDM,88900025,CRRT - SINGLE EVALUATION,3673.0,2387.45,105.79,3305.7,38
CDM,89051WE,CELL COUNT MISC BODY FLUIDS W/DIFFERENTIAL COUNT,59.0,38.35,2.35,59.0,17
CDM,89055WE,LEUKOCYTE ASSMT FECAL QUAL/SEMIQUANTITATIVE,15.0,9.75,2.56,15.0,17
CDM,89060WE,CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,160.0,104.0,3.08,160.0,17
CDM,89190WE,NASAL SMEAR EOSINOPHILS,36.0,23.4,3.47,36.0,17
CDM,89220WE,SPUTUM OBTAINING SPEC AEROSOL INDUCED TX SPX,72.0,46.8,8.2,72.0,31
CDM,89300WE,SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER,185.0,120.25,5.9,185.0,17
CDM,89320SEMWE,SEMEN ANLYS CMP PROFESSIONAL FEE,13.0,8.45,6.5,13.31,17
CDM,89320WE,SEMEN ANAL VOL/COUNT/MOT,314.0,204.1,7.39,314.0,17
CDM,89321WE,SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM,50.0,32.5,5.06,50.0,17
CDM,90000005,PSYCHIATRIC DIAGNOSTIC EVALUATION,603.0,391.95,149.38,1819.0,41
CDM,90000010,PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES,603.0,391.95,149.38,1819.0,41
CDM,90000035,PSYCHOTHERAPY W/PATIENT 60 MINUTES,603.0,391.95,82.19,1819.0,41
CDM,90000040,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,603.0,391.95,82.19,1819.0,41
CDM,90000045,PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,746.0,484.9,82.19,1819.0,31
CDM,90000065,MULTIPLE FAMILY GROUP PSYCHOTHERAPY,603.0,391.95,42.65,1819.0,41
CDM,90000335,PRECUNEUS MAGNETIC STIMULATION TREATMENT PLNG,1168.0,759.2,82.59,1819.0,30
CDM,90000345,PRECUNEUS MAGNETIC STIMULATION TREATMENT DLVR,1168.0,759.2,196.22,1819.0,30
CDM,90103WE,PROSTATE SCREEN PROFESSIONAL FEE,13.0,8.45,6.5,13.0,12
CDM,90281WE,IMMUNE GLOBULIN IG HUMAN IM USE,220.0,143.0,97.93,220.0,13
CDM,90283WE,IMMUNE GLOBULIN IGIV HUMAN IV USE,261.0,169.65,74.37,261.0,13
CDM,90371WE,HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM,5650.0,3672.5,137.83,5650.0,13
CDM,90375WE,RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ,923.0,599.95,279.95,923.0,13
CDM,90380WE,RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE,2080.0,1352.0,595.06,2080.0,13
CDM,90381WE,RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE,2080.0,1352.0,556.13,2080.0,13
CDM,90460WE,IMADM THROUGH 18YR ANY ROUTE 1ST VAC/TOXOID,96.0,62.4,14.25,96.0,32
CDM,90461WE,IMADM THROUGH 18YR ANY ROUTE EA ADDL VAC/TOXOID,72.0,46.8,8.65,72.0,31
CDM,90471ADMWE,ADMINISTRATION FLU VACC,68.0,44.2,12.3,68.0,32
CDM,90471AWE,ADMIN FEE FOR 1 INJECTION,68.0,44.2,12.3,68.0,32
CDM,90471FAMWE,IMMUNIZATION ADMIN,68.0,44.2,12.3,68.0,32
CDM,90471WE,IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE,68.0,44.2,12.3,68.0,32
CDM,90472AWE,ADMIN FEE FOR 2 INJECTIONS OR MORE,60.0,39.0,9.36,60.0,32
CDM,90472FAMWE,IMMUNIZATION ADMIN EACH ADD,60.0,39.0,9.36,60.0,32
CDM,90472WE,IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE,60.0,39.0,9.36,60.0,32
CDM,90473WE,IM ADM INTRANSL/ORAL 1 VACCINE,68.0,44.2,12.3,68.0,32
CDM,90474WE,IM ADM INTRANSL/ORAL EA VACCINE,60.0,39.0,9.36,60.0,32
CDM,90480VFCWE,VFC ADMINISTRATION COVID VACCINE,21.25,13.81,10.63,44.78,13
CDM,90480WE,ADMINISTRATION COVID VACCINE (2023-2024),293.0,190.45,44.78,293.0,13
CDM,90481WE,IMM ADMN SARSCOV2 VACCINE EACH ADDL COMPONENT,358.0,232.7,179.0,358.0,12
CDM,90482WE,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS 3<10 MIN,106.0,68.9,18.87,106.0,13
CDM,90483WE,IMM CNSL PHYS/QHP IMM NOT ADMN SM DOS>10<20 MIN,220.0,143.0,38.87,220.0,13
CDM,90484WE,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS>20 MIN,330.0,214.5,58.29,330.0,13
CDM,90500010,FAM THERAPY W PATIENT DTOX,603.0,391.95,97.85,542.7,38
CDM,90589WE,CHIKUNGUNYA VIRUS VACCINE LIVE FOR IM USE,990.0,643.5,283.25,990.0,13
CDM,90619WE,"MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)",617.0,401.05,177.11,617.0,13
CDM,90620WE,MENB RECOMBINANT PROT W/OUT MEMBR VESIC VACC IM,852.0,553.8,237.13,852.0,13
CDM,90621WE,MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM,604.0,392.6,225.16,604.0,13
CDM,90625WE,CHOLERA VACCINE ADULT 1 DOSE LIVE FOR ORAL USE,734.0,477.1,300.25,734.0,13
CDM,90632AWE,HEPATITIS A VACCINE (PER DOSE),308.0,200.2,84.94,308.0,13
CDM,90632FAMWE,HEPA VACCINE ADULT IM,308.0,200.2,84.94,308.0,13
CDM,90632WE,HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE,308.0,200.2,84.94,308.0,13
CDM,90633WE,HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE,138.0,89.7,39.56,138.0,13
CDM,90634WE,HEPA VACCINE 3 DOSE SCHEDULE PED/ADOLESC IM USE,88.0,57.2,24.28,88.0,13
CDM,90636AWE,TWINRIX,472.0,306.8,132.43,472.0,13
CDM,90636FAMWE,HEP A / HEP B VACC ADULT IM,472.0,306.8,132.43,472.0,13
CDM,90636WE,HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM,472.0,306.8,132.43,472.0,13
CDM,90647WE,HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE,108.0,70.2,31.47,108.0,13
CDM,90648WE,HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE,47.0,30.55,13.91,47.0,13
CDM,90649AWE,VHPV 4 VACCINE 3 DOSE IM,442.0,287.3,164.98,442.0,13
CDM,90649WE,4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE,442.0,287.3,164.98,442.0,13
CDM,90651WE,9VHPV VACC 2/3 DOSE SCHED IM USE,1106.0,718.9,329.09,1106.0,13
CDM,90653WE,IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE,244.0,158.6,86.23,244.0,13
CDM,90656WE,IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE,74.7,48.56,21.07,74.7,13
CDM,90657WE,IIV3 VACCINE SPLIT VIRUS 0.25 ML DOSAGE IM USE,24.0,15.6,10.06,24.0,13
CDM,90658AWE,INFLUENZA VACCINE,24.0,15.6,12.0,24.0,13
CDM,90658WE,IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE,69.7,45.31,20.11,69.7,13
CDM,90660WE,LAIV3 VACCINE LIVE FOR INTRANASAL USE,62.9,40.89,25.44,62.9,13
CDM,90662AWE,HIGH DOSE FLU,98.0,63.7,49.0,98.0,13
CDM,90662FAMWE,IIV NO PRSV INCREASED AG IM,98.0,63.7,49.0,98.0,13
CDM,90662WE,IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM,203.3,132.15,86.23,203.3,13
CDM,90668AWE,IIV VACCINE PANDEMIC IM,22.0,14.3,11.0,22.0,12
CDM,90670AWE,PREVAR 13,814.0,529.1,257.99,814.0,13
CDM,90670BWE,PREVIA 13,814.0,529.1,257.99,814.0,13
CDM,90670FAMWE,PCV13 VACCINE IM,814.0,529.1,257.99,814.0,13
CDM,90670WE,PCV13 VACCINE FOR INTRAMUSCULAR USE,814.0,529.1,257.99,814.0,13
CDM,90672WE,LAIV4 VACCINE FOR INTRANASAL USE,57.0,37.05,27.79,57.0,13
CDM,90673WE,RIV3 VACCINE PRESERVATIVE FREE FOR IM USE,284.6,184.99,98.16,284.6,13
CDM,90675WE,"RABIES VACCINE, IM",1491.0,969.15,332.54,1491.0,13
CDM,90676WE,"RABIES VACCINE, ID",456.0,296.4,195.94,456.0,13
CDM,90677WE,PCV20 VACCINE FOR INTRAMUSCULAR USE,1018.0,661.7,298.49,1018.0,13
CDM,90678AWE,"RSV VACCINE, BIVALENT (ABRYSVO)",1106.0,718.9,319.07,1106.0,13
CDM,90678WE,RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE,1106.0,718.9,319.07,1106.0,13
CDM,90679WE,"RSV VACCINE, ADJUVANTED (AREXVY)",363.0,235.95,181.5,363.0,13
CDM,90682WE,RIV4 VACC RECOMBINANT DNA PRSRV ANTIBIO FREE IM,233.0,151.45,73.4,233.0,13
CDM,90685WE,IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE,34.0,22.1,17.0,34.0,13
CDM,90686WE,IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE,70.0,45.5,22.35,70.0,13
CDM,90688AWE,IIV4 VACCINE SPLT 0.5 ML IM,67.0,43.55,20.88,67.0,13
CDM,90688WE,IIV4 VACC SPLIT VIRUS 0.5 ML DOS FOR IM USE,67.0,43.55,20.88,67.0,13
CDM,90689WE,IIV4 VACC INACTIVATED PRSRV FR 0.25ML DOS IM USE,44.0,28.6,22.0,44.0,12
CDM,90690WE,"TYPHOID VACCINE, ORAL",115.0,74.75,57.5,117.28,13
CDM,90691AWE,TYPHOID VACCINE,441.0,286.65,161.6,441.0,13
CDM,90691FAMWE,TYPHOID VACCINE IM,441.0,286.65,161.6,441.0,13
CDM,90691WE,TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM,441.0,286.65,161.6,441.0,13
CDM,90697WE,DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR,526.05,341.93,167.44,526.05,13
CDM,90700AWE,DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE,102.0,66.3,30.56,102.0,13
CDM,90700WE,DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM,102.0,66.3,30.56,102.0,13
CDM,90702WE,DT VACCINE YOUNGER THAN 7 YRS FOR IM USE,222.0,144.3,66.09,222.0,13
CDM,90707AWE,MMR VACCINE SC,336.0,218.4,96.6,336.0,13
CDM,90707WE,MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ,336.0,218.4,96.6,336.0,13
CDM,90710WE,"MMR+VARICELLA,SQ-COMBINED VACCINE",992.0,644.8,289.17,992.0,13
CDM,90713WE,POLIOVIRUS VACCINE INACTIVATED SUBQ/IM,151.0,98.15,47.81,151.0,13
CDM,90714AWE,TETANUS & DIPHTHERIA,141.0,91.65,45.91,141.0,13
CDM,90714FAMWE,TD VACC NO PRESV 7 YRS+ IM,141.0,91.65,45.91,141.0,13
CDM,90714WE,TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE,141.0,91.65,45.91,141.0,13
CDM,90715AWE,TDAP / ADACEL,170.0,110.5,50.3,170.0,13
CDM,90715WE,TDAP VACCINE 7 YRS/> IM,170.0,110.5,50.3,170.0,13
CDM,90716WE,VAR VACCINE LIVE FOR SUBCUTANEOUS USE,657.0,427.05,192.12,657.0,13
CDM,90717WE,YELLOW FEVER VACCINE LIVE SUBQ,648.0,421.2,256.33,648.0,13
CDM,90732AWE,PNEUMOCOCCAL VACCINE,423.0,274.95,117.08,423.0,13
CDM,90732FAMWE,PPSV23 VACC 2 YRS+ SUBQ/IM,423.0,274.95,117.08,423.0,13
CDM,90732WE,PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE,423.0,274.95,117.08,423.0,13
CDM,90733WE,MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE,344.0,223.6,147.65,344.0,13
CDM,90734WE,MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE,565.0,367.25,166.75,565.0,13
CDM,90736AWE,ZOSTER,804.0,522.6,219.05,804.0,13
CDM,90736FAMWE,HZV VACC LIVE SUBQ,804.0,522.6,219.05,804.0,13
CDM,90736WE,ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE,804.0,522.6,219.05,804.0,13
CDM,90739WE,HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE,562.0,365.3,155.75,562.0,13
CDM,90743WE,HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM,139.0,90.35,69.5,139.0,13
CDM,90744WE,HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM,104.0,67.6,29.26,104.0,13
CDM,90746AWE,HEPATITIS B VACCINE (PER DOSE),258.0,167.7,72.23,258.0,13
CDM,90746FAMWE,HEPB VACCINE 3 DOSE ADULT IM,258.0,167.7,72.23,258.0,13
CDM,90746WE,HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE,258.0,167.7,72.23,258.0,13
CDM,90747WE,HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM,230.0,149.5,115.0,230.0,13
CDM,90748WE,HIB-HEPB VACCINE FOR INTRAMUSCULAR USE,132.0,85.8,50.47,132.0,13
CDM,90750FAMWE,HZV VACC RECOMBINANT IM,777.0,505.05,215.51,777.0,13
CDM,90750WE,HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX,777.0,505.05,215.51,777.0,13
CDM,90759WE,HEP B VACC 3 AG 10 MCG 3 DOSE SCHED FOR IM USE,104.0,67.6,52.0,104.0,13
CDM,90785WE,PSYCHOTHERAPY COMPLEX INTERACTIVE,145.0,94.25,5.91,145.0,31
CDM,90791WE,PSYCHIATRIC DIAGNOSTIC EVALUATION,1536.0,998.4,73.28,1152.0,31
CDM,90792WE,PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES,1664.0,1081.6,83.51,1248.0,31
CDM,90832WE,PSYCHOTHERAPY 30 MINUTES PATIENT,744.0,483.6,33.8,558.0,31
CDM,90833WE,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 30 MIN,656.0,426.4,35.01,492.0,31
CDM,90834WE,PSYCHOTHERAPY 45 MINUTES WITH PATIENT,980.0,637.0,46.96,735.0,31
CDM,90836WE,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN,832.0,540.8,45.08,624.0,31
CDM,90837WE,PSYCHOTHERAPY 60 MINUTES WITH PATIENT,1452.0,943.8,71.98,1089.0,31
CDM,90838WE,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 60 MIN,1096.0,712.4,73.06,822.0,31
CDM,90839WE,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINS,1509.0,980.85,92.44,1131.75,28
CDM,90840WE,PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,722.0,469.3,44.51,541.5,28
CDM,90846WE,FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS,1052.0,683.8,54.78,789.0,32
CDM,90847WE,FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS,1096.0,712.4,64.32,822.0,35
CDM,90849WE,MULTIPLE FAMILY GROUP PSYCHOTHERAPY,260.0,169.0,21.77,195.0,35
CDM,90853WE,GROUP PSYCHOTHERAPY,260.0,169.0,22.21,195.0,35
CDM,90863WE,PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY,192.0,124.8,19.14,192.0,17
CDM,90901WE,"BIOFEEDBACK TRAINING,ANY MODALITY",180.0,117.0,16.75,135.0,31
CDM,90912WE,BFB TRAING W/EMG &AMP;/MANOMETRY 1ST 15 MIN CNTCT,396.0,257.4,39.03,297.0,27
CDM,90913WE,BFB TRAING W/EMG&AMP;/MANOMETRY EA ADDL 15 MIN CNTCT,220.0,143.0,22.0,165.0,27
CDM,90935WE,HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION,651.0,423.15,52.72,651.0,35
CDM,90937WE,HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX,928.0,603.2,77.62,928.0,35
CDM,90945WE,DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL,686.0,445.9,57.33,686.0,35
CDM,90947WE,DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS,1008.0,655.2,91.19,1008.0,35
CDM,90951WE,ESRD RELATED SVC MONTHLY & <2 YR OLD 4/> VISITS,9568.0,6219.2,570.89,7176.0,35
CDM,90954WE,ESRD RELATED SVC MONTHLY 2-11 YR OLD 4/> VISITS,8344.0,5423.6,490.51,6258.0,35
CDM,90955WE,ESRD RELATED SVC MONTHLY 2-11 YR OLD 2/3 VISITS,4128.0,2683.2,277.32,3096.0,35
CDM,90956WE,ESRD RELATED SVC MONTHLY 2-11 YR OLD 1 VISIT,2656.0,1726.4,214.29,2656.0,35
CDM,90957WE,ESRD RELATED SVC MONTHLY 12-19 YR OLD 4/> VISITS,6184.0,4019.6,374.96,4638.0,35
CDM,90958WE,ESRD RELATED SVC MONTHLY 12-19 YR OLD 2/3 VISITS,3948.0,2566.2,243.94,2961.0,35
CDM,90959WE,ESRD RELATED SVC MONTHLY 12-19 YR OLD 1 VISIT,2476.0,1609.4,198.31,2476.0,35
CDM,90960WE,ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS,2708.0,1760.2,198.67,2708.0,35
CDM,90961WE,ESRD RELATED SVC MONTHLY 20/>YR OLD 2/3 VISITS,2208.0,1435.2,152.42,2208.0,35
CDM,90962WE,ESRD RELATED SVC MONTHLY 20&/>YR OLD 1 VISIT,1428.0,928.2,116.0,1428.0,35
CDM,90963WE,ESRD SVC HOME DIALYSIS FULL MONTH <2YR OLD,4836.0,3143.4,384.44,3627.0,35
CDM,90964WE,ESRD SVC HOME DIALYSIS FULL MONTH 2-11 YR OLD,4100.0,2665.0,321.24,3075.0,35
CDM,90965WE,ESRD SVC HOME DIALYSIS FULL MONTH 12-19 YR OLD,3920.0,2548.0,305.19,2940.0,35
CDM,90966WE,ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD,2208.0,1435.2,158.75,2208.0,35
CDM,90967WE,ESRD RELATED SVC <FULL MONTH <2 YR OLD,140.0,91.0,13.28,140.0,35
CDM,90968WE,ESRD RELATED SVC <FULL MONTH 2-11 YR OLD,136.0,88.4,8.39,136.0,35
CDM,90969WE,ESRD RELATED SVC <FULL MONTH 12-19 YR OLD,132.0,85.8,9.17,132.0,35
CDM,90970WE,ESRD RELATED SVC <FULL MONTH 20/>YR OLD,72.0,46.8,5.42,72.0,35
CDM,90989WE,DIALYSIS TRAINING PATIENT COMPLETED COURSE,2512.0,1632.8,744.16,2512.0,13
CDM,90993WE,DIALYSIS TRAINING PATIENT PER TRAINING SESSION,534.0,347.1,162.22,534.0,13
CDM,91010WE,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,563.0,365.95,117.42,563.0,35
CDM,91013ESOWE,ESOPHGL MOTIL W/STIM/PERFUS,79.0,51.35,12.83,79.0,35
CDM,91013WE,ESOPHGL MOTILITY STD W/I&R STIM/PERFUSION,79.0,51.35,12.83,79.0,35
CDM,91020GASWE,GASTRIC MOTILITY MANOMETRIC,576.0,374.4,138.9,576.0,35
CDM,91020PROWE,GASTRIC MOTILITY STUDIES,576.0,374.4,138.9,576.0,35
CDM,91020WE,GASTRIC MOTILITY MANOMETRIC STUDIES,576.0,374.4,138.9,576.0,35
CDM,91020WE-26,GASTRIC MOTILITY MANOMETRIC STUDIES,576.0,374.4,65.26,576.0,31
CDM,91030WE,ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,364.0,236.6,73.93,364.0,35
CDM,91034ACIWE,"ACID REFLUX TEST (PLACEMENT,RECORDING)",388.0,252.2,142.98,388.0,35
CDM,91034PROWE,GASTROESOPHAGEAL REFLUX TEST,388.0,252.2,142.98,388.0,35
CDM,91034WE,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,3439.0,2235.35,142.98,3439.0,35
CDM,91034WE-26,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,388.0,252.2,43.51,388.0,31
CDM,91035PROWE,GE REFLUX TEST W/TELEMETRY,700.0,455.0,334.73,794.15,35
CDM,91035WE,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,3751.0,2438.15,334.73,3751.0,35
CDM,91035WE-26,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,700.0,455.0,71.52,700.0,31
CDM,91037WE,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,388.0,252.2,126.39,388.0,35
CDM,91038WE,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,440.0,286.0,208.92,700.88,35
CDM,91040WE,ESOPHGL BALO DISTENSION DX STD W/PROVOCATION,388.0,252.2,194.0,898.23,35
CDM,91065BREWE,BREATH HYDROGEN TEST,988.0,642.2,44.72,988.0,35
CDM,91065PROWE,BREATH HYDROGEN TEST,88.0,57.2,44.0,129.13,35
CDM,91065TECWE,SMALL BOWEL TRANSIT TECH,900.0,585.0,44.72,900.0,35
CDM,91065WE,BREATH HYDROGEN/METHANE TEST,988.0,642.2,44.72,988.0,35
CDM,91065WE-26,BREATH HYDROGEN/METHANE TEST,88.0,57.2,8.96,88.0,31
CDM,91065WE-TC,BREATH HYDROGEN/METHANE TEST,900.0,585.0,54.48,900.0,35
CDM,91110CAPWE,CAPSULE ENDOSCOPY GI IMAGING INTRALUMINAL,6377.0,4145.05,533.37,6377.0,35
CDM,91110PROWE,GI TRACT CAPSULE ENDOSCOPY,986.0,640.9,493.0,1268.55,35
CDM,91110WE,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,6377.0,4145.05,533.37,6377.0,35
CDM,91110WE-26,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,986.0,640.9,108.17,986.0,31
CDM,91111WE,GI TRACT IMAGING INTRALUMINAL ESOPHAGUS WI&R,396.0,257.4,198.0,1517.24,35
CDM,91112WE,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,6315.0,4104.75,852.47,6315.0,31
CDM,91112WE-26,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,924.0,600.6,101.96,924.0,31
CDM,91113WE,GI TRACT IMAGING INTRALUMINAL COLON I&R,6207.0,4034.55,74.76,6207.0,31
CDM,91113WE-26,GI TRACT IMAGING INTRALUMINAL COLON I&R,964.0,626.6,116.83,964.0,31
CDM,91117WE,COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R,980.0,637.0,80.64,980.0,35
CDM,91120PROWE,"RECTAL SENSATION,TONE,COMPLIANCE TEST",350.0,227.5,175.0,724.88,26
CDM,91120RECWE,"RECTAL SENSATION,TONE,COMPLIANCE TEST",1966.0,1277.9,345.48,1966.0,26
CDM,91120TECWE,"RECTAL SENSATION, TONE, COMPLIANCE TEST",1616.0,1050.4,345.48,1616.0,26
CDM,91122PROWE,RECTAL MANOMETRY,638.0,414.7,141.47,638.0,26
CDM,91122RECWE,RECTAL MANOMETRY,2254.0,1465.1,141.47,2254.0,26
CDM,91122TECWE,RECTAL MANOMETRY,1616.0,1050.4,141.47,1616.0,26
CDM,91124WE,RECTAL SENSATION TONE&COMPLIANCE STUDY,3245.0,2109.25,786.97,3245.0,21
CDM,91124WE-26,RECTAL SENSATION TONE&COMPLIANCE STUDY,1342.0,872.3,170.09,1342.0,25
CDM,91124WE-TC,RECTAL SENSATION TONE&COMPLIANCE STUDY,1903.0,1236.95,616.88,1903.0,29
CDM,91125WE,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,3381.0,2197.65,357.0,3381.0,21
CDM,91125WE-26,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,1188.0,772.2,147.68,1188.0,25
CDM,91125WE-TC,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,2193.0,1425.45,209.32,2193.0,29
CDM,91132WE,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,208.0,135.2,104.0,759.07,32
CDM,91200WE,LIVER ELASTOGRAPHY W/O IMAG W/I&R,992.0,644.8,23.23,992.0,31
CDM,91200WE-26,LIVER ELASTOGRAPHY W/O IMAG W/I&R,92.0,59.8,10.27,92.0,31
CDM,91299AGIWE,AGILE PATENCY CAPSULE,205.0,133.25,102.5,205.0,15
CDM,91299WIRWE,WIRELESS CAPSULE ENDOSCOPY,2588.0,1682.2,148.83,2588.0,15
CDM,91318WE,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON) AGE 6 MO - 4 Y,140.0,91.0,65.55,140.0,13
CDM,91319WE,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON)?AGE 5 YR - 11,278.0,180.7,83.16,278.0,13
CDM,91320WE,SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE,532.7,346.26,169.84,532.7,13
CDM,91321WE,SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE,465.4,302.51,129.0,465.4,13
CDM,91400000,PSYCHOTHERAPY COMPLEX INTERACTIVE,191.0,124.15,17.76,171.9,28
CDM,91400025,PSYCHOTHERAPY W/PATIENT 30 MINUTES,603.0,391.95,74.14,542.7,38
CDM,91400035,PSYCHOTHERAPY W/PATIENT 45 MINUTES,603.0,391.95,82.19,542.7,38
CDM,91400045,PSYCHOTHERAPY W/PATIENT 60 MINUTES,603.0,391.95,82.19,542.7,38
CDM,91400105,PSYCHOTHERAPY W/PATIENT 30 MINUTES,603.0,391.95,74.14,542.7,38
CDM,91400115,PSYCHOTHERAPY W/PATIENT 45 MINUTES,603.0,391.95,82.19,542.7,38
CDM,91400125,PSYCHOTHERAPY W/PATIENT 60 MINUTES,603.0,391.95,82.19,542.7,38
CDM,91400225,ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN,531.0,345.15,82.77,477.9,37
CDM,91400235,ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN,924.0,600.6,82.77,831.6,37
CDM,91400295,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 1ST,444.0,288.6,74.59,399.6,27
CDM,91400305,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 2ND,444.0,288.6,74.59,399.6,27
CDM,91400315,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY STAFF,444.0,288.6,74.59,399.6,27
CDM,91500000,GROUP THERAPY,348.0,226.2,36.6,313.2,38
CDM,91500155,GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN,171.0,111.15,29.9,153.9,37
CDM,91500165,GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN,171.0,111.15,29.9,153.9,37
CDM,91600000,FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS,603.0,391.95,97.85,542.7,38
CDM,91600005,FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS,603.0,391.95,97.85,542.7,38
CDM,91600045,FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN,171.0,111.15,29.9,153.9,37
CDM,91600055,MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN,171.0,111.15,29.9,153.9,37
CDM,91700015,BIOFEEDBACK TRAINING ANY MODALITY,399.0,259.35,23.22,1819.0,41
CDM,91700045,BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT,334.0,217.1,52.06,1819.0,41
CDM,91700055,BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT,334.0,217.1,29.16,1819.0,41
CDM,91800015,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,395.0,256.75,66.36,1819.0,30
CDM,91800025,NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR,2686.0,1745.9,105.91,2417.4,41
CDM,91800055,BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,112.0,72.8,7.13,1819.0,41
CDM,91800075,DEVELOPMENTAL TST ADMIN PHYS/QHP 1ST HOUR,1350.0,877.5,134.37,1819.0,41
CDM,91800085,DEVELOPMENTAL TST ADMIN PHYS/QHP EA ADDL 30 MIN,378.0,245.7,63.5,1819.0,31
CDM,91800095,NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR,488.0,317.2,81.98,1819.0,31
CDM,91800105,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR,1168.0,759.2,145.9,1819.0,41
CDM,91800115,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR,488.0,317.2,81.98,1819.0,31
CDM,91800125,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR,1990.0,1293.5,145.16,1819.0,41
CDM,91800135,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR,488.0,317.2,81.98,1819.0,31
CDM,91800145,PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN,484.0,314.6,31.32,1819.0,41
CDM,91800155,PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN,488.0,317.2,24.83,1819.0,31
CDM,91800165,PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN,1496.0,972.4,55.74,1819.0,41
CDM,91800175,PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN,488.0,317.2,52.58,1819.0,31
CDM,91800185,PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT,91.0,59.15,3.16,1819.0,41
CDM,91800195,BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN,531.0,345.15,82.77,1819.0,40
CDM,91800205,BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN,531.0,345.15,82.77,1819.0,40
CDM,91800335,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,256.0,166.4,20.97,1819.0,41
CDM,91800345,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,256.0,166.4,20.97,1819.0,41
CDM,91800355,VIRTUAL BRIEF EMOTIONAL/BEHAV ASSMT,112.0,72.8,7.13,1819.0,41
CDM,92000005,COMPLEX UROFLOMETRY,1790.0,1163.5,19.94,3920.0,49
CDM,92000010,CHOLINESTERASE INHIBITOR CHALLENGE TEST,2686.0,1745.9,33.08,2417.4,41
CDM,92000025,VOID PRESSURE STUDIES INTRAABDOMINAL,1419.0,922.35,53.02,4151.0,35
CDM,92000040,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,2686.0,1745.9,82.59,2417.4,41
CDM,92000060,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,2686.0,1745.9,82.59,2417.4,41
CDM,92000080,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,8775.0,5703.75,82.59,7897.5,41
CDM,92000100,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,4576.0,2974.4,82.59,4118.4,41
CDM,92000120,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,513.0,333.45,45.31,839.0,41
CDM,92000130,ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING,1111.0,722.15,22.29,999.9,41
CDM,92000140,ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG,791.0,514.15,48.17,839.0,41
CDM,92000150,ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG,791.0,514.15,49.2,839.0,41
CDM,92000210,IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES,754.0,490.1,37.76,839.0,25
CDM,92000225,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,741.0,481.65,31.76,839.0,41
CDM,92000240,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB,4576.0,2974.4,82.59,4118.4,41
CDM,92000250,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI,8775.0,5703.75,82.59,7897.5,41
CDM,92000260,ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG,575.0,373.75,53.75,839.0,31
CDM,92000285,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,971.0,631.15,44.03,2849.0,41
CDM,92000295,AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY,926.0,601.9,33.85,839.0,41
CDM,92000330,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,1350.0,877.5,82.59,1215.0,41
CDM,92000335,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,1111.0,722.15,82.59,999.9,41
CDM,92000340,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,1111.0,722.15,82.59,999.9,41
CDM,92000345,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,2686.0,1745.9,82.59,2417.4,41
CDM,92000350,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2686.0,1745.9,82.59,2417.4,41
CDM,92000370,TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP,10620.0,6903.0,374.66,9558.0,30
CDM,92000425,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2686.0,1745.9,82.59,2417.4,41
CDM,92000535,AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R,926.0,601.9,8.62,839.0,41
CDM,92000775,ELEC ALYS IMPLT SMPL CN NPGT PRGRMG,321.0,208.65,37.43,839.0,41
CDM,92000785,ELEC ALYS IMPLT CPLX CN NPGT PRGRMG,791.0,514.15,59.34,839.0,41
CDM,92000805,ELEC ALYS IMPLT SMPL CN NPGT PRGRMG,321.0,208.65,37.43,839.0,41
CDM,92000815,ELEC ALYS IMPLT CPLX CN NPGT PRGRMG,791.0,514.15,59.34,839.0,41
CDM,92000825,ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN,791.0,514.15,58.37,839.0,41
CDM,92000835,ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN,449.0,291.85,51.41,839.0,31
CDM,92000845,ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG,513.0,333.45,21.15,839.0,41
CDM,92000855,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,321.0,208.65,21.15,839.0,41
CDM,92000855WE,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,321.0,208.65,17.59,240.75,32
CDM,92000915,IMG RETINA DETCJ/MNTR DS POC AUTO A/R UNI/BI,341.0,221.65,31.76,839.0,41
CDM,92000925,AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS,789.0,512.85,19.1,839.0,30
CDM,92000945,AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R,1558.0,1012.7,47.57,1402.2,41
CDM,92000955,AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT,1558.0,1012.7,47.57,1402.2,41
CDM,92001085,THER ACTIVATION IMPL PHRENIC NRV STIMULATOR SYS,791.0,514.15,21.15,839.0,41
CDM,92001095,INTERROG&PRGRMG IMPL PHRENIC NRV STIMULATOR SYS,791.0,514.15,21.15,839.0,41
CDM,92001105,INTERROG&PRGRMG IPNSS DURING POLYSOMNOGRAPHY,2586.0,1680.9,21.15,2327.4,41
CDM,92001115,INTERROGATION WITHOUT PROGRAMMING IPNSS,791.0,514.15,21.15,839.0,41
CDM,92001125,ELEC ALYS SMPL PRGRMG IINS SP/SAC NRV 1-3 PARAM,459.0,298.35,82.56,839.0,40
CDM,92001135,ELEC ALYS CPLX PRGRMG IINS SP/SAC NRV 4+PARAM,459.0,298.35,82.56,839.0,40
CDM,92001145,REM MULTI DAY CPLX UROFLOWMETRY SETUP&PT EDUCAJ,644.0,418.6,33.85,839.0,40
CDM,92001155,REM MULTI DAY CPLX UROFLOWMETRY DEV SPLY W/REPRT,783.0,508.95,21.15,839.0,40
CDM,92001185,RISK ASCVD TST ONCE PR 12 MO,149.0,96.85,11.31,839.0,41
CDM,92001285,ASCVD RSK MNG CLIN STF PR MO,463.0,300.95,11.31,839.0,41
CDM,92002WE,OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT,387.0,251.55,16.82,290.25,35
CDM,92004ANNWE,"ANNUAL EYE EXAM EXECUTIVE HEALTH, NEW PT",728.0,473.2,34.71,546.0,35
CDM,92004OPTWE,OPTHAMOLOGY VISIT NEW,728.0,473.2,34.71,546.0,35
CDM,92004WE,OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST,728.0,473.2,34.71,546.0,35
CDM,92009990,HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION,6035.0,3922.75,87.55,5431.5,38
CDM,92012WE,OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT,368.0,239.2,18.4,276.0,35
CDM,92014WE,OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>,568.0,369.2,32.99,426.0,35
CDM,92015WE,DETERMINATION REFRACTIVE STATE,65.0,42.25,14.55,48.75,24
CDM,92018WE,OPHTH XM&EVAL ANES W/WO MANJ GLOBE COMPL,1000.0,650.0,59.47,1000.0,35
CDM,92020WE,GONIOSCOPY SEPARATE PROCEDURE,163.0,105.95,11.12,122.25,35
CDM,92025WE,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,154.0,100.1,11.88,154.0,35
CDM,92060WE,SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX,276.0,179.4,21.69,276.0,35
CDM,92081WE,VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM,132.0,85.8,19.69,132.0,35
CDM,92082WE,VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM,176.0,114.4,25.64,176.0,35
CDM,92083TECWE,VISUAL FIELD EXTENDED TC,220.0,143.0,29.44,220.0,35
CDM,92083VISWE,VISUAL FIELD EXTENDED,220.0,143.0,29.44,220.0,35
CDM,92083WE,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,220.0,143.0,29.44,220.0,35
CDM,92083WE-TC,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,741.0,481.65,35.76,741.0,35
CDM,92100010,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,1738.0,1129.7,100.02,1564.2,49
CDM,92100020,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,764.0,496.6,66.35,1017.0,49
CDM,92100030,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,1738.0,1129.7,100.02,1564.2,49
CDM,92100040,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,764.0,496.6,66.35,1017.0,49
CDM,92100060,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,764.0,496.6,100.02,1017.0,49
CDM,92100070,TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX,764.0,496.6,66.35,1017.0,49
CDM,92100080,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,926.0,601.9,66.35,1017.0,49
CDM,92100090,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,1125.0,731.25,103.01,1017.0,49
CDM,92100100,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,1125.0,731.25,66.35,1017.0,49
CDM,92100110,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,1738.0,1129.7,100.02,1564.2,49
CDM,92100115,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,1738.0,1129.7,66.35,1564.2,49
CDM,92100120,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,764.0,496.6,66.35,1017.0,49
CDM,92100125,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,764.0,496.6,66.35,1017.0,49
CDM,92100130,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,1738.0,1129.7,66.35,1564.2,49
CDM,92100135,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,1738.0,1129.7,66.35,1564.2,49
CDM,92100140,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,764.0,496.6,66.35,1017.0,49
CDM,92100145,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,764.0,496.6,66.35,1017.0,49
CDM,92100150,DUP SCAN EXT VEIN BILAT,1738.0,1129.7,100.02,1564.2,49
CDM,92100160,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,764.0,496.6,66.35,1017.0,49
CDM,92100170,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1738.0,1129.7,100.02,1564.2,49
CDM,92100180,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,764.0,496.6,100.02,1017.0,49
CDM,92100190,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,1738.0,1129.7,100.02,1564.2,49
CDM,92100200,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,764.0,496.6,66.35,1017.0,49
CDM,92100205,US TEMPORAL ARTERIES (COMP CODE 93880),1577.0,1025.05,24.58,1419.3,48
CDM,92100210,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,764.0,496.6,100.02,1017.0,49
CDM,92100220,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,764.0,496.6,66.35,1017.0,49
CDM,92100230,DUPLEX SCAN HEMODIALYSIS ACCESS,764.0,496.6,66.35,1017.0,49
CDM,92100240,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1738.0,1129.7,100.02,1564.2,49
CDM,92100250,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,764.0,496.6,100.02,1017.0,49
CDM,92100WE,SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRES,268.0,174.2,12.64,201.0,35
CDM,92132WE,CPTRIZED OPH DX IMG ANTERIOR SEGMENT UNI/BI,128.0,83.2,14.23,128.0,35
CDM,92133WE,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI OPTIC NRV,136.0,88.4,17.43,136.0,35
CDM,92134WE,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA,141.0,91.65,17.43,141.0,35
CDM,92136WE,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,238.0,154.7,36.0,238.0,35
CDM,92137WE,CPTRIZD OPH DX IMG PST SGM UNI/BI RTA OCT ANGRPH,282.0,183.3,33.86,282.0,28
CDM,92145WE,CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI,40.0,26.0,13.1,40.0,28
CDM,92200010,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,1111.0,722.15,82.59,999.9,41
CDM,92200015,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,1350.0,877.5,82.59,1215.0,41
CDM,92200020,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,1111.0,722.15,82.59,999.9,41
CDM,92200025,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,94.0,61.1,15.79,395.0,31
CDM,92200035,NEEDLE EMG GUID W/CHEMODENERVATION,978.0,635.7,115.13,880.2,31
CDM,92200040,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,1350.0,877.5,82.59,1215.0,41
CDM,92200050,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,1350.0,877.5,82.59,1215.0,41
CDM,92200070,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,2686.0,1745.9,82.59,2417.4,41
CDM,92200090,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,2686.0,1745.9,82.59,2417.4,41
CDM,92200110,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,2686.0,1745.9,82.59,2417.4,41
CDM,92200120,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,1111.0,722.15,82.59,999.9,41
CDM,92200130,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,1350.0,877.5,82.59,1215.0,41
CDM,92200200,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,1350.0,877.5,82.59,1215.0,41
CDM,92200210,NERVE CONDUCTION STUDIES 1-2 STUDIES,1350.0,877.5,82.59,1215.0,41
CDM,92200220,NERVE CONDUCTION STUDIES 3-4 STUDIES,2686.0,1745.9,82.59,2417.4,41
CDM,92200230,NERVE CONDUCTION STUDIES 5-6 STUDIES,2686.0,1745.9,82.59,2417.4,41
CDM,92200240,NERVE CONDUCTION STUDIES 7-8 STUDIES,2686.0,1745.9,82.59,2417.4,41
CDM,92200250,NERVE CONDUCTION STUDIES 9-10 STUDIES,4576.0,2974.4,82.59,4118.4,41
CDM,92200260,NERVE CONDUCTION STUDIES 11-12 STUDIES,4576.0,2974.4,82.59,4118.4,41
CDM,92200270,NERVE CONDUCTION STUDIES 13/> STUDIES,4576.0,2974.4,82.59,4118.4,41
CDM,92200280,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,2686.0,1745.9,82.59,2417.4,41
CDM,92200290,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,1246.0,809.9,82.59,1121.4,31
CDM,92200300,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,1833.0,1191.45,82.59,1649.7,31
CDM,92200310,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,698.0,453.7,82.59,628.2,31
CDM,92201575,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,2686.0,1745.9,82.59,2417.4,41
CDM,92201585,IOM TRUNK OR HEAD SSEP,2686.0,1745.9,82.59,2417.4,41
CDM,92229WE,IMG RETINA DETCJ/MNTR DS POC AUTO A/R UNI/BI,341.0,221.65,27.91,341.0,31
CDM,92230WE,FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT,240.0,156.0,14.62,180.0,35
CDM,92235WE,FLUORESCEIN ANGRPH W/MULTIFRAME I&R UNI/BI,330.0,214.5,51.06,330.0,35
CDM,92250WE,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,176.0,114.4,28.09,176.0,35
CDM,92270WE,ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT,324.0,210.6,36.08,324.0,35
CDM,92283WE,COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV,68.0,44.2,16.07,79.29,35
CDM,92285WE,XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE,22.0,14.3,11.0,34.47,35
CDM,92286WE,ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY,176.0,114.4,29.62,176.0,35
CDM,92288WE,SCREENING DARK ADAPTATION MEASUREMENT W/I&R,75.0,48.75,31.91,75.0,13
CDM,92310CONWE,CONTACT LENS FIT SPECIAL,468.0,304.2,49.72,351.0,21
CDM,92310WE,RX&FITG C-LENS SUPVJ CRNL LENS OU XCPT APHK,468.0,304.2,49.72,351.0,21
CDM,92314WE,RX&FTG CONTACT CORNEAL LENS EYES XCPT APHAKIA,304.0,197.6,24.16,228.0,21
CDM,92316WE,RX CONTACT CORNEAL LENS APHAKIA BOTH EYES,299.0,194.35,25.78,224.25,32
CDM,92354WE,FITTING SPECTACLE MOUNTED LW VIS AID 1 ELMNT,128.0,83.2,12.88,128.0,21
CDM,92355WE,FITTING SPECTACLE MOUNTED LW VIS AID TLSCP,210.0,136.5,19.96,210.0,21
CDM,92400000,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,169.0,109.85,5.03,2205.87,41
CDM,92400015,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/I&R,91.0,59.15,4.17,323.0,41
CDM,92400020,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/I&R,165.0,107.25,8.52,323.0,41
CDM,92400025,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,163.0,105.95,1.58,323.0,41
CDM,92400060,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,1990.0,1293.5,25.14,1791.0,41
CDM,92400075,RAPID DESENSITIZATION PROCEDURE EACH HOUR,1496.0,972.4,25.14,1346.4,41
CDM,92499CORWE,CORNEAL TOPOGRAPHY,189.0,122.85,56.87,189.0,15
CDM,92499EXEWE,EXECUTIVE HEALTH TONOMERTY/IOP CHECK,107.0,69.55,53.5,107.0,15
CDM,92502WE,OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA,604.0,392.6,73.02,604.0,35
CDM,92504WE,BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE,79.0,51.35,3.89,59.25,35
CDM,92507WE,TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND,520.0,338.0,54.37,520.0,32
CDM,92508WE,TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV,132.0,85.8,18.95,132.0,32
CDM,92511WE,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,268.0,174.2,23.39,222.46,35
CDM,92512WE,NASAL FUNCTION STUDIES,220.0,143.0,13.32,165.0,35
CDM,92516WE,FACIAL NERVE FUNCTION STUDIES,172.0,111.8,18.71,129.0,35
CDM,92517WE,CERVICAL VEMP TESTING W/I&R,320.0,208.0,34.07,240.0,31
CDM,92518WE,OCULAR VEMP TESTING W/I&R,320.0,208.0,34.07,240.0,31
CDM,92519WE,CERVICAL & OCULAR VEMP TESTING W/I&R,480.0,312.0,51.0,360.0,31
CDM,92520WE,LARYNGEAL FUNCTION STUDY,300.0,195.0,19.07,225.0,35
CDM,92521WE,"EVALUATION OF SPEECH FLUENCY (EG, STUTTERING, CLUTTERING)",896.0,582.4,84.85,896.0,28
CDM,92522WE,EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE,768.0,499.2,69.05,768.0,28
CDM,92523WE,EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION,1536.0,998.4,143.21,1536.0,28
CDM,92524WE,BEHAVIORAL AND QUALITATIVE ANALYSIS OF VOICE AND RESONANCE,768.0,499.2,72.11,768.0,28
CDM,92526WE,TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING,536.0,348.4,52.4,536.0,35
CDM,92531WE,SPONTANEOUS NYSTAGMUS STUDY,150.0,97.5,6.24,150.0,16
CDM,92532WE,POSITIONAL NYSTAGMUS STUDY,215.0,139.75,6.24,215.0,16
CDM,92533WE,CALORIC VESTIBULAR TEST EACH IRRIGATION,258.0,167.7,15.9,258.0,16
CDM,92537WE,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,264.0,171.6,29.87,264.0,31
CDM,92538WE,CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL,132.0,85.8,16.85,132.0,31
CDM,92540WE,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRKG,626.0,406.9,59.35,626.0,35
CDM,92541WE,SPONTANEOUS NYSTAGMUS TEST,176.0,114.4,19.15,176.0,35
CDM,92542WE,POSITIONAL NYSTAGMUS TEST,211.0,137.15,21.96,211.0,35
CDM,92544WE,OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC,119.0,77.35,13.79,119.0,35
CDM,92545WE,OSCILLATING TRACKING TEST W/RECORDING,110.0,71.5,13.02,110.0,35
CDM,92546WE,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,128.0,83.2,44.71,231.22,35
CDM,92547WE,USE VERTICAL ELECTRODES,187.0,121.55,4.03,187.0,35
CDM,92548WE,CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT,268.0,174.2,35.75,268.0,35
CDM,92550WE,TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS,154.0,100.1,12.91,154.0,35
CDM,92551WE,SCREENING TEST PURE TONE AIR ONLY,62.0,40.3,6.64,62.0,21
CDM,92552WE,PURE TONE AUDIOMETRY AIR ONLY,127.0,82.55,12.75,127.0,35
CDM,92553WE,PURE TONE AUDIOMETRY AIR & BONE,166.0,107.9,19.17,166.0,35
CDM,92555WE,SPEECH AUDIOMETRY THRESHOLD,84.0,54.6,11.0,84.0,35
CDM,92556WE,SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ,147.0,95.55,16.78,147.0,35
CDM,92557WE,COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ,264.0,171.6,26.19,198.0,35
CDM,92562WE,LOUDNESS BALANCE BINAURAL/MONAURAL,104.0,67.6,11.83,104.0,32
CDM,92563WE,TONE DECAY,98.0,63.7,11.0,98.0,32
CDM,92565WE,PURE TONE STENGER,100.0,65.0,11.51,100.0,32
CDM,92567WE,TYMPANOMETRY,88.0,57.2,9.02,66.0,35
CDM,92568WE,ACOUSTIC REFLEX,116.0,75.4,11.0,87.0,35
CDM,92570WE,ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY,242.0,157.3,15.59,181.5,35
CDM,92577WE,SPEECH STENGER,144.0,93.6,15.07,144.0,32
CDM,92582WE,CONDITIONING PLAY AUDIOMETRY,168.0,109.2,20.79,168.0,35
CDM,92583WE,SELECT PICTURE AUDIOMETRY,181.0,117.65,25.98,181.0,32
CDM,92584WE,ELECTROCOCHLEOGRAPHY,440.0,286.0,60.17,440.0,32
CDM,92587WE,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,154.0,100.1,16.6,154.0,35
CDM,92588WE,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,242.0,157.3,25.53,242.0,35
CDM,92596WE,EAR PROTECTOR ATTEN MEASURES,121.0,78.65,36.61,133.85,31
CDM,92597EVAWE,EVAL OF PT PRESCIP OF VOICE PROTHESIS,504.0,327.6,69.95,504.0,32
CDM,92597WE,EVAL&/FITG VOICE PROSTC DEV SUPLMNT ORAL SPEEC,504.0,327.6,69.95,504.0,32
CDM,92607WE,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR,740.0,481.0,76.98,740.0,32
CDM,92608WE,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV EA 30 MIN,280.0,182.0,15.39,280.0,32
CDM,92609WE,THER SP-GENRATJ DEV PRGRMG&MODIFICAJ,600.0,390.0,41.79,600.0,32
CDM,92610WE,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,520.0,338.0,47.66,390.0,35
CDM,92611WE,MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,536.0,348.4,62.07,536.0,35
CDM,92612WE,FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC,508.0,330.2,42.16,381.0,35
CDM,92613WE,FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC I&R,312.0,202.8,31.37,312.0,31
CDM,92616WE,FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V REC,752.0,488.8,48.01,564.0,35
CDM,92617WE,FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V I&R,348.0,226.2,35.26,348.0,31
CDM,92625WE,TINNITUS ASSESSMENT,460.0,299.0,25.63,345.0,32
CDM,92628WE,EVALUATION HEARING AID CANDIDACY 1ST 30 MINUTES,100.0,65.0,50.0,100.0,12
CDM,92631WE,HEARING AID SELECTION SERVICES 1ST 30 MINUTES,100.0,65.0,50.0,100.0,12
CDM,92634WE,HEARING AID FITTING SERVICES 1ST 60 MINUTES,300.0,195.0,150.0,300.0,12
CDM,92636WE,HEARING AID POST-FITTING F-UP SVC 1ST 30 MINUTES,50.0,32.5,25.0,50.0,12
CDM,92637WE,HEARING AID POST-FITTING F-UP SVC EA ADDL 15 MIN,25.0,16.25,12.5,25.0,12
CDM,92642WE,HEARING ASSISTIVE DEVICE SUPPL TECH FITTING SVC,100.0,65.0,50.0,100.0,12
CDM,92650WE,AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS,110.0,71.5,22.58,110.0,20
CDM,92651WE,AEP HEARING STATUS DETER BROADBAND STIMULI I&R,400.0,260.0,60.51,400.0,31
CDM,92652WE,AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R,600.0,390.0,82.98,600.0,31
CDM,92653WE,AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT,420.0,273.0,62.04,420.0,31
CDM,92700EPLWE,EPLEY MANUVER,101.0,65.65,39.43,101.0,15
CDM,92700ESTWE,ESTABLISHED PT. MINIMUM SERVICE,45.0,29.25,22.5,47.32,15
CDM,92700FISWE,FISTULA,51.0,33.15,25.5,51.0,15
CDM,92700HAEWE,HAEARING AID CLEANING MON.,11.0,7.15,5.5,47.32,15
CDM,92700HEAWE,HEARING AID CLEANING BIR.,30.0,19.5,15.0,47.32,15
CDM,92700PIPWE,PIPB,30.0,19.5,15.0,47.32,15
CDM,92700REPWE,REPLACE BATTERY DOOR,5.0,3.25,2.5,47.32,15
CDM,92700SWIWE,SWIMPLUG,48.0,31.2,24.0,48.0,15
CDM,92900025,SANE EVAL,741.0,481.65,0.02,839.0,24
CDM,92900035,SANE EVAL,1023.0,664.95,171.86,920.7,24
CDM,92920WE,PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH,4334.0,2817.1,303.24,4334.0,31
CDM,92924WE,PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH,4696.0,3052.4,360.16,4696.0,31
CDM,92928WE,PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH,4822.0,3134.3,337.02,4822.0,31
CDM,92930WE,PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS,5280.0,3432.0,532.19,5280.0,21
CDM,92933WE,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,5408.0,3515.2,376.99,5408.0,31
CDM,92937WE,PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL,4818.0,3131.7,336.78,4818.0,31
CDM,92941WE,PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL,4924.0,3200.6,377.76,4924.0,31
CDM,92943WE,PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL,5416.0,3520.4,377.76,5416.0,31
CDM,92945WE,PERQ TRLUML REVSC CHRNC TOT OCCLS 1 ANTGRD&RTRGR,6600.0,4290.0,665.63,6600.0,21
CDM,92950WE,CARDIO-PULMONARY RESUSCITATION,1760.0,1144.0,88.61,1320.0,35
CDM,92953WE,TEMPORARY TRANSCUTANEOUS PACING,5.0,3.25,0.96,11.58,35
CDM,92960WE,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,880.0,572.0,53.02,660.0,35
CDM,92961WE,CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX,1736.0,1128.4,146.39,1736.0,35
CDM,92972WE,PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY,1307.0,849.55,104.37,1307.0,28
CDM,92973WE,PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY,1312.0,852.8,92.9,1312.0,35
CDM,92974WE,TCAT PLACEMENT RADJ DLVR DEV SBSQ C IV BRACHYTX,1200.0,780.0,114.05,1200.0,35
CDM,92978WE,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,7120.0,4628.0,185.68,7120.0,17
CDM,92978WE-26,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,792.0,514.8,78.16,792.0,31
CDM,92979WE,ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,5457.0,3547.05,114.24,5457.0,17
CDM,92979WE-26,ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,576.0,374.4,62.81,576.0,31
CDM,92986WE,PRQ BALLOON VALVULOPLASTY AORTIC VALVE,9040.0,5876.0,888.29,9040.0,35
CDM,92987WE,PRQ BALLOON VALVULOPLASTY MITRAL VALVE,9352.0,6078.8,916.71,9352.0,35
CDM,92997WE,PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL,4792.0,3114.8,473.63,4792.0,35
CDM,92998WE,PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL,2396.0,1557.4,238.22,2396.0,35
CDM,93000AWE,EKG PROF /TECH,75.0,48.75,10.98,75.0,35
CDM,93000FAMWE,ELECTROCARDIOGRAM COMPLETE,75.0,48.75,10.98,75.0,35
CDM,93000WE,ECG ROUTINE ECG W/LEAST 12 LDS W/I&R,75.0,48.75,10.98,75.0,35
CDM,93005WE,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,295.0,191.75,4.85,295.0,35
CDM,93010WE,ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY,75.0,48.75,6.13,75.0,35
CDM,93015WE,CV STRS TST XERS&/OR RX CONT ECG W/SI&R,330.0,214.5,55.92,330.0,35
CDM,93016WE,CV STRS TST XERS&/OR RX CONT ECG W/O I&R,198.0,128.7,15.83,198.0,35
CDM,93017WE,CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,517.0,336.05,30.88,517.0,32
CDM,93018WE,CV STRS TST XERS&/OR RX CONT ECG I&R ONLY,132.0,85.8,10.72,132.0,35
CDM,93024WE,ERGONOVINE PROVOCATION TST,3383.0,2198.95,86.55,3383.0,35
CDM,93024WE-26,ERGONOVINE PROVOCATION TST,515.0,334.75,48.88,515.0,31
CDM,93024WE-TC,ERGONOVINE PROVOCATION TST,2868.0,1864.2,47.82,2868.0,35
CDM,93025MICWE,MICROVOLT T-WAVE ASSESSMENT,1425.0,926.25,97.79,1425.0,35
CDM,93025PROWE,MICROVOLT T-WAVE ASSESS,300.0,195.0,97.79,300.0,35
CDM,93025WE,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,1425.0,926.25,97.79,1425.0,35
CDM,93025WE-26,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,300.0,195.0,31.69,300.0,31
CDM,93025WE-TC,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,1125.0,731.25,88.95,1125.0,35
CDM,93040WE,RHYTHM ECG 1-3 LEADS W/INTERPRETATION & REPORT,60.0,39.0,10.43,60.0,32
CDM,93041WE,RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R,72.0,46.8,3.88,72.0,32
CDM,93042WE,RHYTHM ECG 1-3 LEADS INTERPRETATION & REPRT ON,66.0,42.9,6.07,66.0,32
CDM,93050WE,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,244.0,158.6,12.51,244.0,31
CDM,93050WE-26,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,68.0,44.2,8.01,68.0,31
CDM,93050WE-TC,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,176.0,114.4,8.32,176.0,35
CDM,93145WE,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP WO,286.0,185.9,29.27,286.0,21
CDM,93146WE,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP W/,396.0,257.4,40.99,396.0,21
CDM,93150WE,THER ACTIVATION IMPL PHRENIC NRV STIMULATOR SYS,374.0,243.1,30.63,280.5,28
CDM,93151WE,INTERROG&PRGRMG IMPL PHRENIC NRV STIMULATOR SYS,352.0,228.8,28.93,264.0,28
CDM,93152WE,INTERROG&PRGRMG IPNSS DURING POLYSOMNOGRAPHY,801.0,520.65,67.45,600.75,28
CDM,93153WE,INTERROGATION WITHOUT PROGRAMMING IPNSS,189.0,122.85,15.58,141.75,28
CDM,93224WE,XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I,172.0,111.8,53.87,172.0,35
CDM,93225WE,XTRNL ECG & 48 HR RECORDING,357.0,232.05,10.71,357.0,35
CDM,93226WE,EXTERNAL ECG SCANNING ANALYSIS REPORT,750.0,487.5,20.28,750.0,35
CDM,93227WE,XTRNL ECG CONTINUOUS RHYTHM W/I&R UP TO 48 HRS,172.0,111.8,13.79,172.0,35
CDM,93228WE,XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS,211.0,137.15,19.15,211.0,35
CDM,93241WE,EXTERNAL ECG REC>48HR<7D SCAN ALYS REPORT R&I,220.0,143.0,65.25,449.4,31
CDM,93242WE,EXTERNAL ECG REC>48HR<7D RECORDING,328.0,213.2,6.99,328.0,31
CDM,93243WE,EXTERNAL ECG REC>48HR<7D SCANNING ALYS W/REPORT,370.0,240.5,136.96,387.95,31
CDM,93244WE,EXTERNAL ECG REC>48HR<7D REVIEW & INTERPRETATION,200.0,130.0,17.36,200.0,31
CDM,93245WE,EXTERNAL ECG REC>7D<15D SCAN ALYS REPORT R&I,220.0,143.0,65.25,472.52,31
CDM,93246WE,EXTERNAL ECG REC>7D<15D RECORDING,328.0,213.2,6.99,328.0,31
CDM,93247WE,EXTERNAL ECG REC>7D<15D SCANNING ALYS W/REPORT,370.0,240.5,142.05,407.0,31
CDM,93248WE,EXTERNAL ECG REC>7D<15D REVIEW & INTERPRETATION,242.0,157.3,19.15,242.0,31
CDM,93260WE,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,374.0,243.1,50.6,374.0,28
CDM,93261WE,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,326.0,211.9,46.14,326.0,28
CDM,93264WE,REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D,308.0,200.2,27.33,231.0,28
CDM,93268WE,XTRNL PT ACTIV ECG TRANSMIS W/R&I </30 DAYS,208.0,135.2,104.0,305.03,35
CDM,93270WE,XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS,537.0,349.05,6.13,537.0,35
CDM,93271WE,XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS,267.0,173.55,104.68,267.0,35
CDM,93272WE,XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS,208.0,135.2,18.13,208.0,35
CDM,93278PROWE,SIGNAL AVERAGED ECG W OR,100.0,65.0,25.25,100.0,32
CDM,93278SAEWE,SAECG,528.0,343.2,25.25,528.0,32
CDM,93278WE,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,528.0,343.2,25.25,528.0,32
CDM,93278WE-26,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,100.0,65.0,10.66,100.0,31
CDM,93278WE-TC,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,428.0,278.2,17.37,428.0,35
CDM,93279PPMWE,"PPM PROG, SINGLE LEAD",528.0,343.2,43.07,528.0,35
CDM,93279PROWE,PPM PROG SINGLE LEAD PRO COMP,260.0,169.0,43.07,260.0,35
CDM,93279WE,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,528.0,343.2,43.07,528.0,35
CDM,93279WE-26,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,260.0,169.0,27.71,260.0,31
CDM,93279WE-TC,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,268.0,174.2,15.36,268.0,35
CDM,93280PPMWE,PPM DEVICE PROG DUAL LEAD,576.0,374.4,50.2,576.0,35
CDM,93280WE,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,308.0,200.2,50.2,308.0,35
CDM,93280WE-26,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,308.0,200.2,32.83,308.0,31
CDM,93280WE-TC,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,268.0,174.2,17.37,268.0,35
CDM,93281PPMWE,PPM PROG MULTIPLE LEAD PRO,642.0,417.3,57.9,642.0,35
CDM,93281WE,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,374.0,243.1,57.9,374.0,35
CDM,93281WE-26,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,374.0,243.1,37.94,374.0,31
CDM,93281WE-TC,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,268.0,174.2,19.96,268.0,35
CDM,93282ICDWE,"ICD DEVICE PROG EVAL, SNGL",642.0,417.3,53.61,642.0,35
CDM,93282PROWE,"ICD DEVICE PROG EVAL, SNGL, PRO COMP",374.0,243.1,53.61,374.0,35
CDM,93282WE,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,642.0,417.3,53.61,642.0,35
CDM,93282WE-26,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,374.0,243.1,35.66,374.0,31
CDM,93282WE-TC,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,268.0,174.2,17.95,268.0,35
CDM,93283ICDWE,"ICD DEVICE PROGR EVAL, DUAL",774.0,503.1,68.84,774.0,35
CDM,93283PROWE,"ICD DEVICE PROGR EVAL, DUAL PRO COMP",506.0,328.9,68.84,506.0,35
CDM,93283WE,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,774.0,503.1,68.84,774.0,35
CDM,93283WE-26,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,506.0,328.9,48.31,506.0,31
CDM,93283WE-TC,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,268.0,174.2,20.53,268.0,35
CDM,93284ICDWE,"ICD DEVICE PROGR EVAL, MULTIPLE",818.0,531.7,76.27,818.0,35
CDM,93284PROWE,"ICD DEVICE PROGR EVAL, MULT PRO COMP",550.0,357.5,76.27,550.0,35
CDM,93284WE,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,818.0,531.7,76.27,818.0,35
CDM,93284WE-26,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,550.0,357.5,52.86,550.0,31
CDM,93284WE-TC,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,268.0,174.2,23.4,268.0,35
CDM,93285ILRWE,ILR DEVICE EVAL PROGR,476.0,309.4,35.33,476.0,35
CDM,93285PROWE,ILR DEVICE EVAL PROGR PRO COMP,208.0,135.2,35.33,208.0,35
CDM,93285WE,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,476.0,309.4,35.33,476.0,35
CDM,93285WE-26,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,208.0,135.2,21.74,208.0,31
CDM,93285WE-TC,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,268.0,174.2,13.93,268.0,35
CDM,93286PREWE,PRE-OP PM DEVICE EVAL,510.0,331.5,21.98,510.0,35
CDM,93286PROWE,PRE-OP PM DEVICE EVAL PRO COMP,132.0,85.8,21.98,132.0,35
CDM,93286WE,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,510.0,331.5,21.98,510.0,35
CDM,93286WE-26,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,132.0,85.8,12.07,132.0,31
CDM,93286WE-TC,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,378.0,245.7,9.9,378.0,35
CDM,93287PREWE,PRE-OP ICD DEVICE EVAL,622.0,404.3,29.09,622.0,35
CDM,93287PROWE,PRE-OP ICD DEVICE EVAL PRO COMP,198.0,128.7,29.09,198.0,35
CDM,93287WE,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,622.0,404.3,29.09,622.0,35
CDM,93287WE-26,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,198.0,128.7,18.04,198.0,31
CDM,93287WE-TC,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,424.0,275.6,11.05,424.0,35
CDM,93288PMDWE,PM DEVICE INTERROGATE IN PERSON,440.0,286.0,31.73,440.0,35
CDM,93288PROWE,PM DEVICE EVAL IN PERSON PRO FEE,172.0,111.8,31.73,172.0,35
CDM,93288WE,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,440.0,286.0,31.73,440.0,35
CDM,93288WE-26,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,172.0,111.8,18.05,172.0,31
CDM,93288WE-TC,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,268.0,174.2,14.21,268.0,35
CDM,93289ICDWE,ICD DEVICE INTERROGATE IN PERSON,598.0,388.7,54.13,598.0,35
CDM,93289PROWE,ICD DEVICE INTERROGATE,330.0,214.5,54.13,330.0,35
CDM,93289WE,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,598.0,388.7,54.13,598.0,35
CDM,93289WE-26,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,330.0,214.5,35.02,330.0,31
CDM,93289WE-TC,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,268.0,174.2,17.37,268.0,35
CDM,93290WE,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,457.0,297.05,25.37,457.0,35
CDM,93290WE-26,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,189.0,122.85,17.19,189.0,31
CDM,93290WE-TC,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,268.0,174.2,8.18,268.0,35
CDM,93291ILRWE,ILR DEV INTERROGATE IN PERSON,339.0,220.35,30.59,339.0,35
CDM,93291PROWE,ILR DEV INTERROGATE IN PERSON PRO,163.0,105.95,30.59,163.0,35
CDM,93291WE,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,339.0,220.35,30.59,339.0,35
CDM,93291WE-26,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,163.0,105.95,17.06,163.0,31
CDM,93291WE-TC,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,176.0,114.4,12.78,176.0,35
CDM,93294WE,REM INTERROG PM/LDLS PM <90 D PHYS/QHP,240.0,156.0,22.21,240.0,35
CDM,93295WE,INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB,326.0,211.9,27.32,326.0,35
CDM,93296WE,REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW,99.0,64.35,15.32,99.0,35
CDM,93297WE,REM INTERROG ICPMS <30 D PHYS/QHP,208.0,135.2,20.45,208.0,35
CDM,93297WE-26,REM INTERROG ICPMS <30 D PHYS/QHP,208.0,135.2,24.1,208.0,31
CDM,93297WE-TC,REM INTERROG ICPMS <30 D PHYS/QHP,268.0,174.2,34.79,268.0,35
CDM,93298WE,REM INTERROG SCRMS <30 D PHYS/QHP,208.0,135.2,22.6,208.0,35
CDM,93298WE-26,REM INTERROG SCRMS <30 D PHYS/QHP,208.0,135.2,24.1,208.0,31
CDM,93298WE-TC,REM INTERROG SCRMS <30 D PHYS/QHP,268.0,174.2,74.42,268.0,35
CDM,93303WE,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,4513.0,2933.45,161.84,4513.0,35
CDM,93303WE-26,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,572.0,371.8,54.28,572.0,31
CDM,93303WE-TC,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,3941.0,2561.65,121.34,3941.0,35
CDM,93304WE,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,330.0,214.5,87.89,330.0,35
CDM,93304WE-26,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,330.0,214.5,31.11,330.0,31
CDM,93304WE-TC,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,3941.0,2561.65,82.85,3941.0,35
CDM,93306PROWE,TTE W/DOPPLER COMPLETE PRO,642.0,417.3,148.34,642.0,35
CDM,93306TTEWE,"TTE W/DOPPLER, COMPLETE",4583.0,2978.95,148.34,4583.0,35
CDM,93306WE,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,4583.0,2978.95,148.34,4583.0,35
CDM,93306WE-26,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,642.0,417.3,54.56,642.0,31
CDM,93306WE-TC,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,3941.0,2561.65,123.1,3941.0,35
CDM,93307ECHWE,ECHO 2-D,2143.0,1392.95,97.57,2143.0,35
CDM,93307PROWE,ECHO INTERPRETATION ONLY,405.0,263.25,97.57,405.0,35
CDM,93307TECWE,ECHO COMPLETE TECHNICAL,1738.0,1129.7,97.57,1738.0,35
CDM,93307WE,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,2143.0,1392.95,97.57,2143.0,35
CDM,93307WE-26,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,405.0,263.25,38.79,405.0,31
CDM,93307WE-TC,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,1738.0,1129.7,73.09,1738.0,35
CDM,93308ECHWE,"ECHO, LIMITED STUDY",1971.0,1281.15,74.55,1971.0,35
CDM,93308PROWE,ECHO LIMITED PROF COMP,233.0,151.45,74.55,233.0,35
CDM,93308TECWE,"ECHO, LIMITED STUDY TC",1738.0,1129.7,74.55,1738.0,35
CDM,93308WE,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1971.0,1281.15,74.55,1971.0,35
CDM,93308WE-26,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,233.0,151.45,21.74,233.0,31
CDM,93308WE-TC,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1738.0,1129.7,64.19,1738.0,35
CDM,93312WE,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,4953.0,3219.45,177.96,4953.0,35
CDM,93312WE-26,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,1012.0,657.8,89.63,1012.0,31
CDM,93312WE-TC,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,3941.0,2561.65,125.03,3941.0,35
CDM,93313WE,ECHO R-T 2D W/PROBE PLACEMENT ONLY,114.0,74.1,8.48,114.0,35
CDM,93314ECHWE,ECHO IMAGE AQUISITION,3610.0,2346.5,152.67,3610.0,35
CDM,93314PROWE,ECHO IMAGE ACQUISTION,814.0,529.1,152.67,814.0,35
CDM,93314WE,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,3610.0,2346.5,152.67,3610.0,35
CDM,93314WE-26,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,814.0,529.1,51.14,814.0,31
CDM,93314WE-TC,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,2796.0,1817.4,131.49,2796.0,35
CDM,93315WE,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,5125.0,3331.25,199.8,5125.0,17
CDM,93315WE-26,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,1184.0,769.6,120.91,1184.0,31
CDM,93315WE-TC,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,3941.0,2561.65,236.43,3941.0,21
CDM,93317WE,ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT,1543.0,1002.95,160.43,1543.0,17
CDM,93317WE-26,ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT,810.0,526.5,80.54,810.0,31
CDM,93317WE-TC,ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT,733.0,476.45,107.02,733.0,21
CDM,93318WE,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,4887.0,3176.55,199.8,4887.0,17
CDM,93318WE-26,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,946.0,614.9,97.87,946.0,31
CDM,93318WE-TC,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,3941.0,2561.65,188.89,3941.0,21
CDM,93319WE,ECHO 3D IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,220.0,143.0,3.36,165.0,31
CDM,93320DOPWE,DOPPLER ECHO W DISPLAY,1833.0,1191.45,38.3,1833.0,35
CDM,93320PROWE,INTERPRETATION ONLY DOPPL,167.0,108.55,38.3,167.0,35
CDM,93320TECWE,DOPPLER ECHO COMPLTE TECH,1666.0,1082.9,38.3,1666.0,35
CDM,93320WE,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,1833.0,1191.45,38.3,1833.0,35
CDM,93320WE-26,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,167.0,108.55,15.77,167.0,31
CDM,93320WE-TC,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,1666.0,1082.9,30.01,1666.0,35
CDM,93321DOPWE,DOPPLER ECHO PULSE/CONT WAVE FU/LTD,816.0,530.4,18.89,816.0,35
CDM,93321PROWE,DOPPLER ECHO PULSED OR CO,66.0,42.9,18.89,66.0,35
CDM,93321WE,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,816.0,530.4,18.89,816.0,35
CDM,93321WE-26,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,66.0,42.9,6.39,66.0,31
CDM,93321WE-TC,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,750.0,487.5,16.51,750.0,35
CDM,93325DOPWE,DOPPLER COLOR FLOW ECHO,1364.0,886.6,17.06,1364.0,35
CDM,93325PROWE,DOPPLER COLOR FLOW,31.0,20.15,15.5,40.44,35
CDM,93325TECWE,DOPPL COLOR FLOW TECH,1333.0,866.45,17.06,1333.0,35
CDM,93325WE,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,1364.0,886.6,17.06,1364.0,35
CDM,93325WE-26,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,31.0,20.15,2.91,31.0,31
CDM,93325WE-TC,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,1333.0,866.45,19.05,1333.0,35
CDM,93350ECHWE,ECHO WO M-MODE RECORDING,4583.0,2978.95,98.28,4583.0,35
CDM,93350PROWE,"STRESS ECHO, MD INTERPT & REPORT",642.0,417.3,98.28,642.0,35
CDM,93350WE,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,4583.0,2978.95,98.28,4583.0,35
CDM,93350WE-26,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,642.0,417.3,61.53,642.0,31
CDM,93350WE-TC,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3941.0,2561.65,111.87,3941.0,35
CDM,93351WE,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,4711.0,3062.15,175.66,4711.0,35
CDM,93351WE-26,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,770.0,500.5,73.75,770.0,31
CDM,93351WE-TC,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,3941.0,2561.65,131.38,3941.0,35
CDM,93352WE,USE OF ECHO CONTRAST AGENT DURING STRESS ECHO,84.0,54.6,26.81,84.0,35
CDM,93355WE,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,2050.0,1332.5,168.51,2050.0,31
CDM,93356WE,MYOCRD STRAIN IMG SPECKLE TRCK ASSMT MYOCRD MECH,192.0,124.8,9.11,144.0,31
CDM,93356WE-26,MYOCRD STRAIN IMG SPECKLE TRCK ASSMT MYOCRD MECH,106.0,68.9,53.0,106.0,12
CDM,93451WE,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,24205.0,15733.25,443.83,24205.0,35
CDM,93451WE-26,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,1087.0,706.55,130.86,1087.0,31
CDM,93452WE,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,1980.0,1287.0,459.61,1980.0,35
CDM,93453WE,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,2636.0,1713.4,582.56,2636.0,35
CDM,93454WE,CATH PLMT & NJX CORONARY ART ANGIO IMG S&I,1998.0,1298.7,460.6,1998.0,35
CDM,93455WE,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,2328.0,1513.2,512.04,2328.0,35
CDM,93456WE,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,2596.0,1687.4,572.2,2596.0,35
CDM,93457WE,CATH PLMT R HRT/ARTS/GRFTS W/NJX&ANGIO IMG S&I,2922.0,1899.3,624.15,2922.0,35
CDM,93458WE,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,2464.0,1601.6,527.99,2464.0,35
CDM,93459WE,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,2794.0,1816.1,567.77,2794.0,35
CDM,93460WE,R & L HRT CATH WINJX HRT ART& L VENTR IMG,3124.0,2030.6,630.9,3124.0,35
CDM,93461WE,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,3454.0,2245.1,695.5,3454.0,35
CDM,93462WE,LEFT HEART CATH BY TRANSEPTAL PUNCTURE,1641.0,1066.65,101.42,1641.0,35
CDM,93463WE,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,880.0,572.0,54.33,880.0,35
CDM,93464WE,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASURE,720.0,468.0,134.6,720.0,35
CDM,93503WE,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,880.0,572.0,65.87,880.0,35
CDM,93505WE,ENDOMYOCARDIAL BIOPSY,24436.0,15883.4,327.28,24436.0,35
CDM,93505WE-26,ENDOMYOCARDIAL BIOPSY,1813.0,1178.45,212.48,1813.0,31
CDM,93531PROWE,RHC & RETROGR LHC CONGENITAL,1835.0,1192.75,917.5,1835.0,12
CDM,93531RHCWE,"RHC & RETROGR LHC, CONGENITAL",1835.0,1192.75,917.5,1835.0,12
CDM,93563WE,NJX SEL HRT ART CONGENITAL HRT CATH W/S&I,400.0,260.0,28.1,400.0,35
CDM,93564WE,NJX SEL HRT ART/GRFT CONGENITAL HRT CATH W/S&I,412.0,267.8,29.1,412.0,35
CDM,93565WE,NJX SEL L VENT/ATRIAL ANGIO HRT CATH W/S&I,220.0,143.0,22.35,220.0,35
CDM,93566WE,NJX SEL R VENT/ATRIAL ANGIO HRT CATH W/S&I,220.0,143.0,24.54,312.76,35
CDM,93567WE,NJX SUPRAVALV AORTOG HRT CATH W/S&I,308.0,200.2,25.16,261.39,35
CDM,93568WE,NJX DRG C-CATHJ NSLCTV P-ART ANGIOGRAPHY,387.0,251.55,23.02,290.25,35
CDM,93569WE,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY UNI,343.0,222.95,7.84,343.0,31
CDM,93571WE,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,6388.0,4152.2,82.96,6388.0,17
CDM,93571WE-26,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,607.0,394.55,74.45,607.0,31
CDM,93572WE,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,6378.0,4145.7,70.21,6378.0,17
CDM,93572WE-26,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,440.0,286.0,53.95,440.0,31
CDM,93573WE,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY BI,572.0,371.8,13.07,572.0,31
CDM,93574WE,NJX DRG C-CATHJ SLCTV PULM VEN ANGIOGRAPHY,634.0,412.1,14.51,634.0,31
CDM,93575WE,NJX DRG C-CATHJ SLCTV PULM ANGRPH MAPCA CHD EA,845.0,549.25,19.45,845.0,31
CDM,93580WE,PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT,7907.0,5139.55,667.69,7907.0,35
CDM,93581WE,PRQ TCAT CLSR CGEN VENTR SEPTAL DFCT W/IMPLT,9756.0,6341.4,893.35,9756.0,35
CDM,93582WE,PERCUTAN TRANSCATH CLOSURE PAT DUCT ARTERIOSUS,4924.0,3200.6,488.05,4924.0,31
CDM,93583WE,PERCUTANEOUS TRANSCATHETER SEPTAL REDUCTION THER,5500.0,3575.0,543.26,5500.0,31
CDM,93584WE,VENOGRAPHY CHD ANOMALOUS/PERSISTENT SVC NT DRG,528.0,343.2,42.18,528.0,31
CDM,93585WE,VENOGRAPHY CHD AZYGOS/HEMIAZYGOS VENOUS SYSTEM,497.0,323.05,39.76,497.0,31
CDM,93586WE,VENOGRAPHY CHD CORONARY SINUS,629.0,408.85,50.24,629.0,31
CDM,93587WE,VENOGRAPHY CHD VENOVENOUS COLTRL AT/ABOVE HRT,928.0,603.2,74.14,928.0,31
CDM,93588WE,VENOGRAPHY CHD VENOVENOUS COLLATERAL BELOW HEART,937.0,609.05,74.86,937.0,31
CDM,93590WE,PERQ TRANSCATH CLS PARAVALVR LEAK 1 MITRAL VALVE,8680.0,5642.0,800.19,8680.0,31
CDM,93591WE,PERQ TRANSCATH CLS PARAVALVR LEAK 1 AORTIC VALVE,7188.0,4672.2,663.33,7188.0,31
CDM,93592WE,PERQ TRANSCATH CLS PARAVALVR LEAK EACH OCCLS DEV,3200.0,2080.0,288.52,3200.0,31
CDM,93593WE,R HRT CATH CHD W/IMG CATH TRGT ZONE NML NT CONNJ,1596.0,1037.4,183.09,1596.0,31
CDM,93594WE,R HRT CATH CHD W/IMG CATH TRGT ZON ABNL NT CONNJ,2440.0,1586.0,280.61,2440.0,31
CDM,93595WE,L HRT CATH CHD IMG CATH TRGT ZON NML/ABNL NT CNJ,2541.0,1651.65,249.37,2541.0,31
CDM,93596WE,R&L HRT CATH CHD IMG CATH TRGT ZONE NML NT CONNJ,2736.0,1778.4,310.75,2736.0,31
CDM,93600WE,BUNDLE OF HIS RECORDING,26867.0,17463.55,137.29,26867.0,17
CDM,93600WE-26,BUNDLE OF HIS RECORDING,933.0,606.45,104.75,933.0,31
CDM,93600WE-TC,BUNDLE OF HIS RECORDING,25934.0,16857.1,78.89,25934.0,21
CDM,93602WE,INTRA-ATRIAL RECORDING,55473.0,36057.45,113.27,55473.0,17
CDM,93602WE-26,INTRA-ATRIAL RECORDING,933.0,606.45,104.75,933.0,31
CDM,93602WE-TC,INTRA-ATRIAL RECORDING,54540.0,35451.0,44.43,54540.0,21
CDM,93603WE,RIGHT VENTRICULAR RECORDING,9658.0,6277.7,129.37,9658.0,17
CDM,93603WE-26,RIGHT VENTRICULAR RECORDING,933.0,606.45,104.75,933.0,31
CDM,93603WE-TC,RIGHT VENTRICULAR RECORDING,8725.0,5671.25,67.52,8725.0,21
CDM,93609WE,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,9631.0,6260.15,269.3,9631.0,17
CDM,93609WE-26,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,2177.0,1415.05,248.59,2177.0,31
CDM,93609WE-TC,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,7454.0,4845.1,109.13,7454.0,21
CDM,93610WE,INTRA-ATRIAL PACING,55869.0,36314.85,154.97,55869.0,17
CDM,93610WE-26,INTRA-ATRIAL PACING,1329.0,863.85,149.37,1329.0,31
CDM,93610WE-TC,INTRA-ATRIAL PACING,54540.0,35451.0,55.04,54540.0,21
CDM,93612WE,INTRAVENTRICULAR PACING,55869.0,36314.85,162.39,55869.0,17
CDM,93612WE-26,INTRAVENTRICULAR PACING,1329.0,863.85,148.8,1329.0,31
CDM,93612WE-TC,INTRAVENTRICULAR PACING,54540.0,35451.0,65.02,54540.0,21
CDM,93613ADDWE,3-D INTRACARD MAP ADD ON,18770.0,12200.5,217.28,18770.0,35
CDM,93613PROWE,3-D INTRACARDIAC MAPPING - PROF COMP,2092.0,1359.8,217.28,2092.0,35
CDM,93613WE,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,2092.0,1359.8,217.28,2092.0,35
CDM,93615WE,ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS,9051.0,5883.15,32.0,9051.0,17
CDM,93615WE-26,ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS,326.0,211.9,35.02,326.0,31
CDM,93615WE-TC,ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS,8725.0,5671.25,11.63,8725.0,21
CDM,93616WE,ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG,9271.0,6026.15,55.36,9271.0,17
CDM,93616WE-26,ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG,546.0,354.9,56.28,546.0,31
CDM,93616WE-TC,ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG,8725.0,5671.25,12.8,8725.0,21
CDM,93618WE,INDUCTION ARRHYTHMIA ELECTRICAL PACING,10420.0,6773.0,250.33,10420.0,17
CDM,93618WE-26,INDUCTION ARRHYTHMIA ELECTRICAL PACING,1695.0,1101.75,211.35,1695.0,31
CDM,93618WE-TC,INDUCTION ARRHYTHMIA ELECTRICAL PACING,8725.0,5671.25,158.21,8725.0,21
CDM,93619WE,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,57540.0,37401.0,506.91,57540.0,17
CDM,93619WE-26,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,3000.0,1950.0,365.44,3000.0,31
CDM,93619WE-TC,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,54540.0,35451.0,307.88,54540.0,21
CDM,93620WE,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,59521.0,38688.65,800.64,44640.75,17
CDM,93620WE-26,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,4981.0,3237.65,577.07,3735.75,31
CDM,93620WE-TC,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,54540.0,35451.0,249.43,54540.0,21
CDM,93621WE,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,18895.0,12281.75,392.44,18895.0,17
CDM,93621WE-26,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,660.0,429.0,84.24,660.0,31
CDM,93621WE-TC,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,18235.0,11852.75,33.31,18235.0,21
CDM,93622WE,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,14456.0,9396.4,630.94,14456.0,17
CDM,93622WE-26,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,1313.0,853.45,153.93,1313.0,31
CDM,93622WE-TC,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,13143.0,8542.95,68.27,13143.0,21
CDM,93623WE,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,12511.0,8132.15,166.95,12511.0,17
CDM,93623WE-26,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,431.0,280.15,56.21,431.0,31
CDM,93623WE-TC,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,12080.0,7852.0,27.47,12080.0,21
CDM,93624WE,ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT,56542.0,36752.3,240.39,56542.0,17
CDM,93624WE-26,ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT,2002.0,1301.3,239.78,2002.0,31
CDM,93624WE-TC,ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT,54540.0,35451.0,79.96,54540.0,21
CDM,93631WE,INTRAOP EPICAR& ENDOCAR PACG& MAPG,3340.0,2171.0,424.15,11703.94,17
CDM,93631WE-26,INTRAOP EPICAR& ENDOCAR PACG& MAPG,3340.0,2171.0,371.55,3340.0,31
CDM,93631WE-TC,INTRAOP EPICAR& ENDOCAR PACG& MAPG,30129.0,19583.85,159.48,30129.0,21
CDM,93640WE,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,4995.0,3246.75,305.29,4995.0,17
CDM,93640WE-26,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,1434.0,932.1,174.54,1434.0,31
CDM,93640WE-TC,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,4436.0,2883.4,285.55,4436.0,21
CDM,93641WE,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,7418.0,4821.7,390.25,7418.0,17
CDM,93641WE-26,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,2495.0,1621.75,294.93,2495.0,31
CDM,93641WE-TC,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,4923.0,3199.95,285.55,4923.0,21
CDM,93642WE,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,10762.0,6995.3,249.96,10762.0,35
CDM,93642WE-26,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,2037.0,1324.05,206.33,2037.0,31
CDM,93642WE-TC,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,8725.0,5671.25,79.84,8725.0,35
CDM,93644WE,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,8554.0,5560.1,175.91,8554.0,28
CDM,93644WE-26,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,1338.0,869.7,136.81,1338.0,31
CDM,93644WE-TC,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,7216.0,4690.4,48.35,7216.0,35
CDM,93650WE,ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION,4096.0,2662.4,435.33,4096.0,35
CDM,93653WE,COMPRE EP EVAL ABLTJ 3D MAPG TX SVT,6600.0,4290.0,580.08,6600.0,31
CDM,93654WE,COMPRE EP EVAL ABLTJ 3D MAPG TX VT,7964.0,5176.6,752.7,7964.0,31
CDM,93655WE,ICAR CATHETER ABLATION ARRHYTHMIA ADD ON,2420.0,1573.0,229.28,2420.0,31
CDM,93656WE,COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION,7480.0,4862.0,707.76,7480.0,31
CDM,93657WE,ABLATE L/R ATRIAL FIBRIL W/ ISOLATED PULM VEIN,2420.0,1573.0,229.54,2420.0,31
CDM,93660PROWE,TILT TABLE EVALUATION,832.0,540.8,106.87,832.0,35
CDM,93660TILWE,TILT TABLE EVALUATION,4646.0,3019.9,106.87,4646.0,35
CDM,93660WE,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,4646.0,3019.9,106.87,4646.0,35
CDM,93660WE-26,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,832.0,540.8,79.72,832.0,31
CDM,93660WE-TC,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,3814.0,2479.1,53.85,3814.0,35
CDM,93662WE,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,9225.0,5996.25,214.53,9225.0,17
CDM,93662WE-26,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,634.0,412.1,67.59,634.0,31
CDM,93662WE-TC,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,8591.0,5584.15,28.3,8591.0,21
CDM,93668WE,PERIPHERAL ARTERIAL DISEASE REHAB PER SESSION,105.0,68.25,14.45,105.0,31
CDM,93701WE,BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS,187.0,121.55,20.05,187.0,35
CDM,93722WE,PLETHYSMOGRAPHY REPORT,53.0,34.45,26.5,53.0,12
CDM,93724WE,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,4302.0,2796.3,212.17,4302.0,35
CDM,93724WE-26,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,2147.0,1395.55,205.47,2147.0,31
CDM,93724WE-TC,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,2155.0,1400.75,31.45,2155.0,35
CDM,93750WE,INTERROGATION VAD IN PRSON W/PHYSICIAN ANALYSIS,330.0,214.5,19.24,247.5,35
CDM,93770WE,DERMINATION OF VENOUS PRESSUE,70.0,45.5,5.87,70.0,24
CDM,93784WE,AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R,167.0,108.55,35.23,167.0,34
CDM,93786WE,AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY,276.0,179.4,22.2,276.0,31
CDM,93788WE,AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R,136.0,88.4,5.74,136.0,31
CDM,93790WE,AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R,167.0,108.55,15.77,167.0,31
CDM,93792WE,PT/CAREGIVER TRAINJ FOR INITIATION HOME INR MNTR,535.0,347.75,40.36,535.0,28
CDM,93793WE,ANTICOAGULANT MGMT FOR PT TAKING WARFARIN,79.0,51.35,8.91,79.0,28
CDM,93797CARWE,CARDIAC REHAB PHASE IV,977.0,635.05,1.01,732.75,35
CDM,93797WE,OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR,72.0,46.8,1.01,54.0,35
CDM,93798CARWE,CARDIAC REHAB PHASE III SESSION,1017.0,661.05,9.63,762.75,35
CDM,93798WE,OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING,112.0,72.8,9.63,84.0,35
CDM,93799RVU5WE,AORTIC SCALLOP INTENTIONAL LACERATION (BASILICA) (COMP CODE 9298,9718.0,6316.7,329.82,9718.0,15
CDM,93799TRAWE,TRANS-SEPTAL PUNCTURE,1705.0,1108.25,329.82,1705.0,15
CDM,93880DUPWE,DUPLEX SCAN EXTRACRANIAL,2090.0,1358.5,127.76,2090.0,35
CDM,93880PROWE,DUPLEX SCAN EXTRACRANIAL,352.0,228.8,127.76,352.0,35
CDM,93880TECWE,DUPLEX SCAN EXTRACRANIAL,1738.0,1129.7,127.76,1738.0,35
CDM,93880WE,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,2090.0,1358.5,127.76,2090.0,35
CDM,93880WE-26,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,352.0,228.8,25.29,352.0,31
CDM,93880WE-TC,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,1738.0,1129.7,146.02,1738.0,35
CDM,93882DUPWE,DUPLEX SCAN EXTRACR UNI,964.0,626.6,90.73,964.0,35
CDM,93882PROWE,DUPLEX SCAN EXTRACR UNI,200.0,130.0,90.73,219.62,35
CDM,93882TECWE,TC CAROTID US UNILATERAL/LIMITED,764.0,496.6,90.73,764.0,35
CDM,93882WE,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,964.0,626.6,90.73,964.0,35
CDM,93882WE-26,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,200.0,130.0,17.47,200.0,31
CDM,93882WE-TC,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,764.0,496.6,97.02,764.0,35
CDM,93886PROWE,TRANSCRANIAL DOPPLER,360.0,234.0,152.06,478.96,35
CDM,93886TRAWE,TRANSCRANIAL DOPPLER COMPLETE,2098.0,1363.7,152.06,2098.0,35
CDM,93886WE,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,2098.0,1363.7,152.06,2098.0,35
CDM,93886WE-26,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,360.0,234.0,39.21,360.0,31
CDM,93886WE-TC,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,1738.0,1129.7,205.42,1738.0,35
CDM,93888PROWE,TRANSCRANIAL DOPPLER LTD,321.0,208.65,81.04,321.0,35
CDM,93888TRAWE,TRANSCRANIAL DPLR STDY OF INTRACRANIAL LM,1085.0,705.25,81.04,1085.0,35
CDM,93888WE,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,1085.0,705.25,81.04,1085.0,35
CDM,93888WE-26,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,321.0,208.65,26.43,321.0,31
CDM,93888WE-TC,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,764.0,496.6,120.43,764.0,35
CDM,93890PROWE,TCD VASOREACTIVITY STUDY,226.0,146.9,113.0,413.48,19
CDM,93890TCDWE,TCD VASOREACTIVITY STUDY,669.0,434.85,240.66,669.0,19
CDM,93892PROWE,TRANSCRANIAL DOPPLER; EMBOLI W/O INTRA BU,460.0,299.0,155.01,571.71,35
CDM,93892TRAWE,TRANSCRANIAL DOPPLER; EMBOLI W/O TNTR BUB,1224.0,795.6,155.01,1224.0,35
CDM,93892WE,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,1224.0,795.6,155.01,1224.0,35
CDM,93892WE-26,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,460.0,299.0,47.88,460.0,31
CDM,93892WE-TC,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,764.0,496.6,120.43,764.0,35
CDM,93893PROWE,TCD EMBOLI DECTION,460.0,299.0,192.33,703.68,35
CDM,93893TCDWE,TCD EMBOLI DECTION,1224.0,795.6,192.33,1224.0,35
CDM,93893WE,TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX,1224.0,795.6,192.33,1224.0,35
CDM,93893WE-26,TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX,460.0,299.0,48.16,460.0,31
CDM,93893WE-TC,TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX,764.0,496.6,120.38,764.0,35
CDM,93896WE,VASOREACTIVITY STUDY W/TCD ICR ARTERIES COMPLETE,356.0,231.4,40.11,356.0,28
CDM,93897WE,EMBOLI DETCJ W/O IV MBUBB NJX TCD ICR ART COMPL,321.0,208.65,36.56,321.0,28
CDM,93898WE,VEN-ARTL SHNT DETC IV MBUB NJX TCD ICR ART COMPL,374.0,243.1,42.95,374.0,28
CDM,93922DOPWE,DOPPLER UP/LOW EXT ART,1036.0,673.4,62.55,1036.0,35
CDM,93922PROWE,EXTR STUDY DOP WAVE SING,110.0,71.5,55.0,144.91,35
CDM,93922TECWE,TC DOPPLER UP/LOW EXT ART,926.0,601.9,62.55,926.0,35
CDM,93922WE,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,1036.0,673.4,62.55,1036.0,35
CDM,93922WE-26,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,110.0,71.5,10.08,110.0,31
CDM,93922WE-TC,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,926.0,601.9,68.29,926.0,35
CDM,93923EXTWE,EXTR STUDY DOP WAVE COMP,1323.0,859.95,98.36,1323.0,35
CDM,93923PROWE,EXTR STUDY DOP WAVE COMP,198.0,128.7,98.36,229.88,35
CDM,93923TECWE,EXTR STUDY DOP WV COMP,1125.0,731.25,98.36,1125.0,35
CDM,93923WE,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,1323.0,859.95,98.36,1323.0,35
CDM,93923WE-26,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,198.0,128.7,19.03,198.0,31
CDM,93923WE-TC,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,1125.0,731.25,105.99,1125.0,35
CDM,93924DOPWE,DOPPLER BILATERAL EXTREMITIES,1325.0,861.25,117.83,1325.0,35
CDM,93924PROWE,NONINVASIVE STUDY OF LOWER ARTERIED,200.0,130.0,100.0,281.28,35
CDM,93924TECWE,TC DOPPLER LOWER EXTS BIL,1125.0,731.25,117.83,1125.0,35
CDM,93924WE,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,1325.0,861.25,117.83,1325.0,35
CDM,93924WE-26,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,200.0,130.0,21.31,200.0,31
CDM,93924WE-TC,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,1125.0,731.25,132.14,1125.0,35
CDM,93925DUPWE,DUPLEX SCAN LOW EXT BIL,2058.0,1337.7,127.74,2058.0,35
CDM,93925PROWE,DUPLEX SCN LO EXT ART BIL,320.0,208.0,127.74,421.38,35
CDM,93925TECWE,TC LOWER EXT ART DUP BIL,1738.0,1129.7,127.74,1738.0,35
CDM,93925WE,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,2058.0,1337.7,127.74,2058.0,35
CDM,93925WE-26,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,320.0,208.0,24.15,320.0,31
CDM,93925WE-TC,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,1738.0,1129.7,194.04,1738.0,35
CDM,93926DUPWE,DUPLEX SCN LOW EXT ART UN,964.0,626.6,85.32,964.0,35
CDM,93926PROWE,DUPLEX LOW EXT UNI LTD,200.0,130.0,85.32,253.1,35
CDM,93926TECWE,TC DUP LOW EXT UNI LTD,764.0,496.6,85.32,764.0,35
CDM,93926WE,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,964.0,626.6,85.32,964.0,35
CDM,93926WE-26,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,200.0,130.0,16.9,200.0,31
CDM,93926WE-TC,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,764.0,496.6,116.32,764.0,35
CDM,93930DUPWE,DUPLEX SCAN UPPER EXTR BILATERAL,2058.0,1337.7,131.1,2058.0,35
CDM,93930PROWE,DUPLEX SCN UP EXT ART BIL,320.0,208.0,131.1,348.03,35
CDM,93930TECWE,TC DUP UPP EXT ART BIL,1738.0,1129.7,131.1,1738.0,35
CDM,93930WE,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,2058.0,1337.7,131.1,2058.0,35
CDM,93930WE-26,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,320.0,208.0,19.6,320.0,31
CDM,93930WE-TC,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,1738.0,1129.7,155.31,1738.0,35
CDM,93931DUPWE,DUP UPP EXT ART/GR UNILAT,964.0,626.6,87.13,964.0,35
CDM,93931PROWE,DUP UP EXT ART/GR UNILAT,200.0,130.0,87.13,217.44,35
CDM,93931WE,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,964.0,626.6,87.13,964.0,35
CDM,93931WE-26,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,200.0,130.0,13.21,200.0,31
CDM,93931WE-TC,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,764.0,496.6,96.7,764.0,35
CDM,93970DUPWE,DUPLEX EXT VEINS BILAT,2018.0,1311.7,141.19,2018.0,35
CDM,93970PROWE,DUPLEX EXT VEINS BILAT,280.0,182.0,140.0,328.08,35
CDM,93970TECWE,TC DUP EXT VEINS BIL,1738.0,1129.7,141.19,1738.0,35
CDM,93970VEIWE,"VEIN MAPPING, COMPLETE",2018.0,1311.7,141.19,2018.0,35
CDM,93970WE,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,2018.0,1311.7,141.19,2018.0,35
CDM,93970WE-26,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,280.0,182.0,29.12,280.0,31
CDM,93970WE-TC,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,1738.0,1129.7,148.28,1738.0,35
CDM,93971DUPWE,DUPLEX EXT VEIN UNI,962.0,625.3,89.79,962.0,35
CDM,93971PROWE,DUPLEX EXT VEIN UNILAT,198.0,128.7,89.79,208.45,35
CDM,93971TECWE,DUPLEX EXT VEIN UNI,764.0,496.6,89.79,764.0,35
CDM,93971VEIWE,VEIN MAPPING LIMITED F/U,962.0,625.3,89.79,962.0,35
CDM,93971WE,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,962.0,625.3,89.79,962.0,35
CDM,93971WE-26,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,198.0,128.7,19.03,198.0,31
CDM,93971WE-TC,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,764.0,496.6,94.76,764.0,35
CDM,93975DUPWE,DUPLEX SCAN VISCERAL COMPLETE,2248.0,1461.2,188.72,2248.0,35
CDM,93975PROWE,DUPLEX SCAN ARTERIAL INFL,510.0,331.5,188.72,510.0,35
CDM,93975TECWE,TC DUPLEX ARTERIAL INFLOW/OUTFLOW,1738.0,1129.7,188.72,1738.0,35
CDM,93975WE,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,2248.0,1461.2,188.72,2248.0,35
CDM,93975WE-26,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,510.0,331.5,54.37,510.0,31
CDM,93975WE-TC,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1738.0,1129.7,200.82,1738.0,35
CDM,93976DUPWE,DUPLEX SCAN VISCERAL LTD,1116.0,725.4,119.9,1116.0,35
CDM,93976PROWE,DUPLEX SCAN ARTERIAL FU,352.0,228.8,119.9,352.0,35
CDM,93976TECWE,TC DUPLEX ARTERIAL/ABD/PELVIC LIMITED,764.0,496.6,119.9,764.0,35
CDM,93976WE,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,1116.0,725.4,119.9,1116.0,35
CDM,93976WE-26,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,352.0,228.8,37.21,352.0,31
CDM,93976WE-TC,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,764.0,496.6,117.29,764.0,35
CDM,93978DUPWE,DUPLEX SCAN AORTA COMPLETE,2090.0,1358.5,126.34,2090.0,35
CDM,93978PROWE,DUPLEX SCAN AORTA IVC ILI,352.0,228.8,126.34,352.0,35
CDM,93978TECWE,"TC DUPLEX SCAN OF AORTA, IVC BYPASS GRAFT",1738.0,1129.7,126.34,1738.0,35
CDM,93978WE,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,2090.0,1358.5,126.34,2090.0,35
CDM,93978WE-26,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,352.0,228.8,27.98,352.0,31
CDM,93978WE-TC,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,1738.0,1129.7,137.62,1738.0,35
CDM,93979DUPWE,DUPLEX SCAN AORTA LTD UNILAT,984.0,639.6,88.71,984.0,35
CDM,93979PROWE,DUPLEX SCAN AORTA IVC UNI,220.0,143.0,88.71,220.0,35
CDM,93979TECWE,"TC DUPLEX AORTA,IVC,BYPASS GR UNILAT/LIMI",764.0,496.6,88.71,764.0,35
CDM,93979WE,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,984.0,639.6,88.71,984.0,35
CDM,93979WE-26,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,220.0,143.0,18.75,220.0,31
CDM,93979WE-TC,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,764.0,496.6,90.89,764.0,35
CDM,93980DUPWE,DUPLEX SCAN PENILE COMPLETE,1264.0,821.6,89.36,1264.0,35
CDM,93980PROWE,DUPLEX SCAN PENILE COMP,500.0,325.0,89.36,500.0,35
CDM,93980WE,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,1264.0,821.6,89.36,1264.0,35
CDM,93980WE-26,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,500.0,325.0,52.42,500.0,31
CDM,93980WE-TC,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,764.0,496.6,56.42,764.0,35
CDM,93981DUPWE,DUPLEX SCAN PENILE LTD,940.0,611.0,53.87,940.0,35
CDM,93981PROWE,DUP SCAN PENILE LTD,176.0,114.4,53.87,176.0,35
CDM,93981WE,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,940.0,611.0,53.87,940.0,35
CDM,93981WE-26,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,176.0,114.4,18.61,176.0,31
CDM,93981WE-TC,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,764.0,496.6,48.03,764.0,35
CDM,93985WE,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL BI STD,2058.0,1337.7,188.43,2058.0,31
CDM,93985WE-26,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL BI STD,320.0,208.0,39.78,320.0,31
CDM,93985WE-TC,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL BI STD,1738.0,1129.7,202.76,1738.0,35
CDM,93986WE,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL UNI STD,964.0,626.6,110.56,964.0,31
CDM,93986WE-26,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL UNI STD,200.0,130.0,23.48,200.0,31
CDM,93986WE-TC,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL UNI STD,764.0,496.6,118.58,764.0,35
CDM,93990DUPWE,DUP SCAN HEMODIALYSIS ACCESS,964.0,626.6,80.31,964.0,35
CDM,93990WE-234,DUPLEX SCAN HEMODIALYSIS ACCESS,964.0,626.6,80.31,964.0,35
CDM,93990WE-235,DUPLEX SCAN HEMODIALYSIS ACCESS,200.0,130.0,80.31,259.65,35
CDM,93990WE-26,DUPLEX SCAN HEMODIALYSIS ACCESS,200.0,130.0,11.08,200.0,31
CDM,93990WE-TC,DUPLEX SCAN HEMODIALYSIS ACCESS,764.0,496.6,118.9,764.0,35
CDM,93998RVU1WE,US TEMPORAL ARTERIES (COMP CODE 93880),345.0,224.25,172.5,345.0,12
CDM,93998WE,UNLISTED NONINVASIVE VASCULAR DIAGNOSTIC STUDY,127.0,82.55,63.5,127.0,12
CDM,94000070,IMMUNOTHERAPY 1 INJ,173.0,112.45,14.05,671.0,41
CDM,94000075,IMMUNOTHERAPY>=2 INJ,198.0,128.7,14.05,671.0,41
CDM,94000085,VENOM INSECT 1 VIAL,173.0,112.45,3.66,671.0,41
CDM,94000090,VENOM MULTIDOSE 2 VIAL,173.0,112.45,3.66,671.0,41
CDM,94000095,VENOM MULTIDOSE 3 VIAL,268.0,174.2,3.66,671.0,41
CDM,94000100,VENOM MULTIDOSE 4 VIAL,268.0,174.2,3.66,671.0,41
CDM,94000105,VENOM MULTIDOSE 5 VIAL,268.0,174.2,3.66,671.0,41
CDM,94000115,PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN,124.0,80.6,3.66,671.0,41
CDM,94000125,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,513.0,333.45,30.69,671.0,41
CDM,94000130,PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY,745.0,484.25,98.33,671.0,41
CDM,9400020,POLYSOMNGRAPHY -  W/CPAP,163.0,105.95,27.38,671.0,24
CDM,94000220,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,1111.0,722.15,44.56,999.9,41
CDM,94000455,PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP,745.0,484.25,98.33,671.0,41
CDM,94000535,MINI-BAL RT,450.0,292.5,38.83,671.0,40
CDM,94000545,TRACH ASPIRATION,432.0,280.8,38.83,671.0,40
CDM,94000585,REM THER MNTR DEV SPLY DATA COG BHV THER EA 30 D,140.0,91.0,33.85,671.0,40
CDM,94002WE,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,876.0,569.4,63.41,876.0,35
CDM,94003WE,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA,603.0,391.95,45.07,603.0,35
CDM,94010PROWE,SPIROMETRY,75.0,48.75,20.8,75.0,35
CDM,94010SPIWE,SPIROMETRY,975.0,633.75,20.8,975.0,35
CDM,94010TECWE,SPIROMETRY TC CHARGE,720.0,468.0,20.8,720.0,35
CDM,94010WE,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,975.0,633.75,20.8,975.0,35
CDM,94010WE-26,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,75.0,48.75,6.96,75.0,31
CDM,94010WE-TC,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,900.0,585.0,18.97,900.0,35
CDM,94016WE,PATIENT-INITIATED SPIROMETRIC PHYS/QHP R&I ONLY,208.0,135.2,15.15,208.0,35
CDM,94060BROWE,BRONCHOSPASM EVALULATION,1887.0,1226.55,29.87,1887.0,35
CDM,94060PROWE,BRONCHOSPASM EVAL,97.0,63.05,29.87,97.0,35
CDM,94060TECWE,BRONCHOSPASM TC CHARGE,1790.0,1163.5,29.87,1790.0,35
CDM,94060WE,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,1887.0,1226.55,29.87,1887.0,35
CDM,94060WE-26,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,97.0,63.05,9.95,97.0,31
CDM,94060WE-TC,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,1790.0,1163.5,28.33,1790.0,35
CDM,94070WE,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,2030.0,1319.5,48.51,2030.0,35
CDM,94070WE-26,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,240.0,156.0,24.28,240.0,31
CDM,94070WE-TC,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,1790.0,1163.5,27.42,1790.0,35
CDM,94150WE,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,928.0,603.2,12.0,928.0,24
CDM,94150WE-26,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,28.0,18.2,3.27,28.0,20
CDM,94150WE-TC,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,900.0,585.0,18.23,900.0,24
CDM,94200000,MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI,212.0,137.8,35.63,675.0,41
CDM,94200005,MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M,180.0,117.0,29.84,675.0,41
CDM,94200015,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,100.0,65.0,16.62,675.0,41
CDM,94200050,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,111.0,72.15,12.84,675.0,41
CDM,94200055,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,111.0,72.15,12.84,675.0,41
CDM,94200060,EDUCATION&TRAINING PT SELF-MGMT NQHP INDIV PT,158.0,102.7,26.54,675.0,30
CDM,94200080,EDUCATION,45.0,29.25,7.56,675.0,24
CDM,94200285,"NUTRITION THERAPY, INITIAL 15 MIN",212.0,137.8,35.63,675.0,41
CDM,94200295,"NUTRITION THERAPY, REASSES EA 15 MIN",180.0,117.0,29.84,675.0,41
CDM,94200605,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,100.0,65.0,16.62,675.0,41
CDM,94200MAXWE,MAXIMUM VOLUNTARY VENTILATION,361.0,234.65,11.49,361.0,35
CDM,94200TECWE,MAXIMUM BREATHING TC CHARGE,341.0,221.65,11.49,341.0,35
CDM,94200WE,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,361.0,234.65,11.49,361.0,35
CDM,94200WE-26,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,20.0,13.0,2.84,20.0,31
CDM,94200WE-TC,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,341.0,221.65,12.19,341.0,35
CDM,94201265,SUPPLY OF DIGITAL DEVICE,644.0,418.6,41.57,675.0,40
CDM,94201275,MONTHLY TX FOR DMHT 20MINS,644.0,418.6,23.85,675.0,41
CDM,94201285,ADD 20 M OF MONTHLY TX,323.0,209.95,23.85,675.0,31
CDM,94240WE,"LUNG VOLUMES, HELIUM DILUTION",47.0,30.55,23.5,47.0,12
CDM,94260WE,THORACIC GAS VOLUME,35.0,22.75,17.5,35.0,12
CDM,94300005,REHAB CARD PHASE I,905.0,588.25,10.95,814.5,41
CDM,94360WE,MEASURE AIRFLOW RESISTANCE,176.0,114.4,88.0,176.0,12
CDM,94450WE,BREATHING RESPONSE TO HYPOXIA,176.0,114.4,16.05,176.0,31
CDM,94452WE,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,877.0,570.05,37.14,877.0,32
CDM,94452WE-26,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,136.0,88.4,12.07,136.0,31
CDM,94452WE-TC,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,741.0,481.65,35.76,741.0,35
CDM,94453WE,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,917.0,596.05,50.23,917.0,32
CDM,94453WE-26,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,176.0,114.4,15.48,176.0,31
CDM,94453WE-TC,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,741.0,481.65,47.95,741.0,35
CDM,94617WE,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,1049.0,681.85,68.43,1049.0,31
CDM,94617WE-26,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,308.0,200.2,30.32,308.0,31
CDM,94617WE-TC,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,741.0,481.65,57.24,741.0,35
CDM,94618AWE,ADULT - SIX MINUTE WALK,593.0,385.45,25.37,593.0,31
CDM,94618BWE,ADULT - OXIMETRY WITH AMBULATION,593.0,385.45,25.37,593.0,31
CDM,94618BWE-26,ADULT - OXIMETRY WITH AMBULATION,192.0,124.8,21.51,192.0,31
CDM,94618CWE,OXYGEN TITRATION-TRANSPLANT,593.0,385.45,25.37,593.0,31
CDM,94618CWE-26,OXYGEN TITRATION-TRANSPLANT,192.0,124.8,21.51,192.0,31
CDM,94618WE,PULMONARY STRESS TESTING,192.0,124.8,25.37,192.0,31
CDM,94618WE-26,PULMONARY STRESS TESTING,192.0,124.8,21.51,192.0,31
CDM,94618WE-TC,PULMONARY STRESS TESTING,741.0,481.65,12.52,741.0,35
CDM,94619WE,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG,537.0,349.05,20.97,537.0,31
CDM,94619WE-26,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG,196.0,127.4,20.62,196.0,31
CDM,94619WE-TC,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG,341.0,221.65,43.43,341.0,35
CDM,94621WE,CARDIOPULMONARY EXERCISE TESTING,2358.0,1532.7,77.39,2358.0,35
CDM,94621WE-26,CARDIOPULMONARY EXERCISE TESTING,568.0,369.2,57.52,568.0,31
CDM,94621WE-TC,CARDIOPULMONARY EXERCISE TESTING,1790.0,1163.5,80.84,1790.0,35
CDM,94625WE,PHYS/QHP SVCS OP PULM REHAB WO CONT OXIMTRY MNTR,158.0,102.7,3.28,118.5,31
CDM,94626WE,PHYS/QHP SVCS OP PULM REHAB W/CONT OXIMTRY MNTR,246.0,159.9,19.85,184.5,31
CDM,94640WE,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,154.0,100.1,7.5,154.0,35
CDM,94642WE,PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH,359.0,233.35,57.66,359.0,13
CDM,94644WE,"CONTINUOUS INHALATION TX, 1ST HR",121.0,78.65,29.92,121.0,35
CDM,94660WE,CPAP VENTILATION CPAP INITIATION&MGMT,304.0,197.6,18.25,228.0,35
CDM,94664WE,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,124.0,80.6,9.36,124.0,35
CDM,94667WE,MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL,197.0,128.05,15.75,197.0,35
CDM,94669WE,MECHANICAL CHEST WALL OSCILLATION LUNG FUNCTION,360.0,234.0,17.13,360.0,28
CDM,94680WE,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,1004.0,652.6,38.61,1004.0,35
CDM,94680WE-26,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,104.0,67.6,10.65,104.0,31
CDM,94680WE-TC,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,900.0,585.0,39.56,900.0,35
CDM,94681WE,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,1878.0,1220.7,36.77,1878.0,35
CDM,94681WE-26,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,88.0,57.2,8.09,88.0,31
CDM,94681WE-TC,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,1790.0,1163.5,37.76,1790.0,35
CDM,94690WE,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,369.0,239.85,34.5,369.0,35
CDM,94690WE-26,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,28.0,18.2,3.27,28.0,31
CDM,94690WE-TC,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,341.0,221.65,40.92,341.0,35
CDM,94720WE,CARBON MONOXIDE DIFFUSING CAPACITY,282.0,183.3,141.0,282.0,12
CDM,94725WE,MEMBRANE DIFFUSION CAPACITY,487.0,316.55,243.5,487.0,12
CDM,94726WE,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,1904.0,1237.6,26.47,1904.0,35
CDM,94726WE-26,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,114.0,74.1,10.37,114.0,31
CDM,94726WE-TC,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,1790.0,1163.5,35.32,1790.0,35
CDM,94727WE,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&VOL,1014.0,659.1,21.2,1014.0,35
CDM,94727WE-26,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&VOL,114.0,74.1,10.37,114.0,31
CDM,94727WE-TC,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&VOL,900.0,585.0,25.41,900.0,35
CDM,94728WE,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,1004.0,652.6,19.24,1004.0,35
CDM,94728WE-26,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,104.0,67.6,10.37,104.0,31
CDM,94728WE-TC,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,900.0,585.0,25.41,900.0,35
CDM,94729WE,DIFFUSING CAPACITY,832.0,540.8,28.44,832.0,35
CDM,94729WE-26,DIFFUSING CAPACITY,76.0,49.4,6.96,76.0,31
CDM,94729WE-TC,DIFFUSING CAPACITY,756.0,491.4,38.34,756.0,35
CDM,94760WE,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,120.0,78.0,2.72,120.0,31
CDM,94761WE,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,198.0,128.7,4.12,198.0,31
CDM,94762WE,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,245.0,159.25,13.06,245.0,31
CDM,95004WE,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,169.0,109.85,2.81,169.0,35
CDM,95012WE,NITRIC OXIDE EXPIRED GAS DETERMINATION,71.0,46.15,11.56,71.0,32
CDM,95017WE,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/ I&R,28.0,18.2,3.16,21.0,31
CDM,95018WE,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/ I&R,165.0,107.25,5.38,123.75,31
CDM,95024WE,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,163.0,105.95,0.82,122.25,35
CDM,95027WE,INTRACUTANEOUS TESTS W/ALLERGENIC XTRCS AIRBORNE,5.0,3.25,2.5,9.11,35
CDM,95028WE,IC TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING,48.0,31.2,6.25,48.0,35
CDM,95044WE,PATCH TEST(S) SPECIFY NUMBER,408.0,265.2,3.83,408.0,35
CDM,95052WE,PHOTO PATCH TEST(S) SPECIFY NUM,52.0,33.8,4.34,52.0,35
CDM,95056WE,PHOTOSENSITIVITY TESTS,53.0,34.45,23.99,91.56,35
CDM,95070WE,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,527.0,342.55,26.44,527.0,35
CDM,95076WE,INGESTION CHALLENGE TEST INITIAL 120 MINUTES,660.0,429.0,53.82,495.0,31
CDM,95079WE,INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES,607.0,394.55,38.34,455.25,31
CDM,95100025,CARDIOPULMONARY EXERCISE TESTING W VO2 MAX AND SUBMAX,176.0,114.4,29.57,158.4,21
CDM,95115WE,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX,60.0,39.0,7.13,60.0,35
CDM,95117WE,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS,198.0,128.7,8.72,198.0,35
CDM,95120WE,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 1 NJX,39.0,25.35,19.5,39.0,13
CDM,95125WE,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 2/> NJX,40.0,26.0,20.0,40.0,13
CDM,95144WE,PREPJ& ANTIGEN PRV ALLERGEN IMMUNOTHERAPY 1 DO,24.0,15.6,2.35,18.0,35
CDM,95145WE,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT,24.0,15.6,2.35,30.99,35
CDM,95146WE,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 2 INSECT,24.0,15.6,2.35,54.79,35
CDM,95147WE,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 3 INSECT,24.0,15.6,2.35,49.33,35
CDM,95148WE,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 4 INSECT,24.0,15.6,2.35,73.63,35
CDM,95149WE,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 5 INSECT,24.0,15.6,2.35,98.42,35
CDM,95165WE,PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN,124.0,80.6,2.59,93.0,35
CDM,95170WE,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY WHL INSE,24.0,15.6,2.35,18.0,35
CDM,95180WE,RAPID DESENSITIZATION PROCEDURE EACH HOUR,804.0,522.6,58.56,603.0,35
CDM,95249WE,CONT GLUC MONITORING PATIENT PROVIDED EQUIPTMENT,297.0,193.05,41.17,297.0,28
CDM,95250WE,CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT,393.0,255.45,102.08,393.0,32
CDM,95251WE,CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,280.0,182.0,25.63,280.0,32
CDM,95708WE,EEG W/O VID BY TECH EA INCR 12-26HR UNMONITORED,1396.0,907.4,101.96,1396.0,17
CDM,95717WE,EEG PHYS/QHP 2-12 HR WITHOUT VIDEO,880.0,572.0,76.23,660.0,31
CDM,95718WE,EEG PHYS/QHP 2-12 HR WITH VEEG,1100.0,715.0,100.67,825.0,31
CDM,95719WE,EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR WO VID,1320.0,858.0,117.61,990.0,31
CDM,95720WE,EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR W/VEEG,1698.0,1103.7,154.55,1273.5,31
CDM,95721WE,EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/O VIDEO,1698.0,1103.7,154.79,1273.5,31
CDM,95723WE,EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/O VIDEO,2090.0,1358.5,191.9,1567.5,31
CDM,95725WE,EEG COMPLETE STD PHYS/QHP&GT;84 HR W/O VID,2376.0,1544.4,218.86,1782.0,31
CDM,95726WE,EEG COMPLETE STD PHYS/QHP&GT;84 HR W/VEEG,3335.0,2167.75,305.05,2501.25,31
CDM,95782WE,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,9919.0,6447.35,585.3,9919.0,31
CDM,95782WE-26,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,1144.0,743.6,118.45,1144.0,31
CDM,95782WE-TC,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,8775.0,5703.75,831.47,8775.0,35
CDM,95783WE,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,10020.0,6513.0,613.23,10020.0,31
CDM,95783WE-26,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,1245.0,809.25,129.05,1245.0,31
CDM,95783WE-TC,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,8775.0,5703.75,877.56,8775.0,35
CDM,95805WE,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,5104.0,3317.6,269.33,5104.0,35
CDM,95805WE-26,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,528.0,343.2,50.01,528.0,31
CDM,95805WE-TC,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,4576.0,2974.4,302.99,4576.0,35
CDM,95806WE,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1759.0,1143.35,66.29,1759.0,32
CDM,95806WE-26,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,409.0,265.85,42.45,409.0,31
CDM,95806WE-TC,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1350.0,877.5,51.83,1350.0,35
CDM,95807WE,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,5139.0,3340.35,239.38,5139.0,32
CDM,95807WE-26,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,563.0,365.95,52.42,563.0,31
CDM,95807WE-TC,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,4576.0,2974.4,348.09,4576.0,35
CDM,95808WE,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,9541.0,6201.65,325.64,9541.0,35
CDM,95808WE-26,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,766.0,497.9,73.75,766.0,31
CDM,95808WE-TC,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,8775.0,5703.75,401.13,8775.0,35
CDM,95810WE,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,9875.0,6418.75,342.25,9875.0,35
CDM,95810WE-26,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,1100.0,715.0,102.85,1100.0,31
CDM,95810WE-TC,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,8775.0,5703.75,458.19,8775.0,35
CDM,95811WE,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,9919.0,6447.35,374.94,9919.0,35
CDM,95811WE-26,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,1144.0,743.6,107.25,1144.0,31
CDM,95811WE-TC,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,8775.0,5703.75,491.07,8775.0,35
CDM,95812EEGWE,EEG UP TO 1 HOUR,3118.0,2026.7,168.99,3118.0,35
CDM,95812PROWE,EEG UP TO 1 HR PROF,432.0,280.8,168.99,611.68,35
CDM,95812TECWE,EEG UP TO 1 HR TECH,2686.0,1745.9,168.99,2686.0,35
CDM,95812WE,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,3118.0,2026.7,168.99,3118.0,35
CDM,95812WE-26,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,432.0,280.8,45.76,432.0,31
CDM,95812WE-TC,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,2686.0,1745.9,264.36,2686.0,35
CDM,95813EEGWE,EEG GREATER THAN 1 HOUR,3338.0,2169.7,209.1,3338.0,35
CDM,95813PROWE,EEG GREATER THAN 1 HR PC,652.0,423.8,209.1,773.62,35
CDM,95813TECWE,EEG GREATER THAN 1 HR TECH,2686.0,1745.9,209.1,2686.0,35
CDM,95813WE,EEG EXTENDED MONITORING 61-119 MINUTES,3338.0,2169.7,209.1,3338.0,35
CDM,95813WE-26,EEG EXTENDED MONITORING 61-119 MINUTES,652.0,423.8,73.18,652.0,31
CDM,95813WE-TC,EEG EXTENDED MONITORING 61-119 MINUTES,2686.0,1745.9,286.33,2686.0,35
CDM,95816EEGWE,EEG; AWAK/DROWSY SAME FACILITY,3161.0,2054.65,186.41,3161.0,35
CDM,95816PROWE,EEG; AWAKE/DROWSY PROF,475.0,308.75,186.41,688.93,35
CDM,95816TECWE,EEG; AWAKE/DROWSY TECH,2686.0,1745.9,186.41,2686.0,35
CDM,95816WE,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,3161.0,2054.65,186.41,3161.0,35
CDM,95816WE-26,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,475.0,308.75,46.18,475.0,31
CDM,95816WE-TC,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,2686.0,1745.9,238.8,2686.0,35
CDM,95819EEGWE,EEG W VENT/STIMULATION,3161.0,2054.65,218.79,3161.0,35
CDM,95819PROWE,EEG AWAKE/ASLEEP PROF,475.0,308.75,218.79,793.32,35
CDM,95819TECWE,EEG AWAKE/ASLEEP TECH,2686.0,1745.9,218.79,2686.0,35
CDM,95819WE,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,3161.0,2054.65,218.79,3161.0,35
CDM,95819WE-26,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,475.0,308.75,45.76,475.0,31
CDM,95819WE-TC,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,2686.0,1745.9,277.57,2686.0,35
CDM,95822WE,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,3161.0,2054.65,203.18,3161.0,35
CDM,95822WE-26,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,475.0,308.75,45.76,475.0,31
CDM,95822WE-TC,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,2686.0,1745.9,249.14,2686.0,35
CDM,95824WE,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,4872.0,3166.8,38.24,4872.0,14
CDM,95824WE-26,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,296.0,192.4,32.26,296.0,31
CDM,95824WE-TC,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,4576.0,2974.4,64.0,4576.0,21
CDM,95829WE,SURGERY ELECTROCORTICOGRAM,6117.0,3976.05,890.78,6117.0,35
CDM,95829WE-26,SURGERY ELECTROCORTICOGRAM,2728.0,1773.2,260.04,2728.0,31
CDM,95829WE-TC,SURGERY ELECTROCORTICOGRAM,3389.0,2202.85,1151.24,3389.0,35
CDM,95830EEGWE,EEG W/ELECTRODES,680.0,442.0,44.05,510.0,32
CDM,95830PROWE,INSERT ELECTRODES FOR EEG,680.0,442.0,44.05,510.0,32
CDM,95830WE,INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP,1765.0,1147.25,44.05,1323.75,32
CDM,95830WE-26,INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP,680.0,442.0,340.0,680.0,12
CDM,95836WE,ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS,792.0,514.8,80.43,792.0,31
CDM,95857WE,CHOLINESTERASE INHIBITOR CHALLENGE TEST,212.0,137.8,13.81,159.0,35
CDM,95860NEEWE,NEEDLE/EXTREMITY,1495.0,971.75,55.73,1495.0,35
CDM,95860PROWE,EMG 1 EXTREMITY,384.0,249.6,55.73,384.0,35
CDM,95860WE,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,1495.0,971.75,55.73,1495.0,35
CDM,95860WE-26,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,384.0,249.6,41.65,384.0,31
CDM,95860WE-TC,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,1111.0,722.15,39.49,1111.0,35
CDM,95861EMGWE,EMG NEEDLE 2 EXTREMITIES,1727.0,1122.55,82.39,1727.0,35
CDM,95861PROWE,EMG 2 EXTREMITIES,616.0,400.4,82.39,616.0,35
CDM,95861WE,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,1727.0,1122.55,82.39,1727.0,35
CDM,95861WE-26,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,616.0,400.4,66.38,616.0,31
CDM,95861WE-TC,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,1111.0,722.15,51.55,1111.0,35
CDM,95863EMGWE,EMG NEEDLE 3 EXTREMITIES,2098.0,1363.7,105.2,2098.0,35
CDM,95863PROWE,EMG 3 EXTREMETIES,748.0,486.2,105.2,748.0,35
CDM,95863WE,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,2098.0,1363.7,105.2,2098.0,35
CDM,95863WE-26,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,748.0,486.2,80.3,748.0,31
CDM,95863WE-TC,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,1350.0,877.5,62.46,1350.0,35
CDM,95864EMGWE,EMG NEEDLE 4 EXTREMITIES,2146.0,1394.9,128.6,2146.0,35
CDM,95864PROWE,EMG FOUR EXTREMITIES,796.0,517.4,128.6,796.0,35
CDM,95864WE,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,2146.0,1394.9,128.6,2146.0,35
CDM,95864WE-26,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,796.0,517.4,85.42,796.0,31
CDM,95864WE-TC,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,1350.0,877.5,69.07,1350.0,35
CDM,95865NEEWE,NEEDLE ELECTROMYOGRAPHY; LARYNX,1739.0,1130.35,74.96,1739.0,35
CDM,95865PROWE,NEEDLE ELECTROMYOGRAPHY; LARYNX PC,628.0,408.2,74.96,628.0,35
CDM,95865TECWE,NEEDLE ELECTROMYOGRAPHY; LARYNX TC,1111.0,722.15,74.96,1111.0,35
CDM,95865WE,NEEDLE ELECTROMYOGRAPHY LARYNX,1739.0,1130.35,74.96,1739.0,35
CDM,95865WE-26,NEEDLE ELECTROMYOGRAPHY LARYNX,628.0,408.2,67.66,628.0,31
CDM,95865WE-TC,NEEDLE ELECTROMYOGRAPHY LARYNX,1111.0,722.15,37.19,1111.0,35
CDM,95866NEEWE,NEEDLE ELECTROMYOGRAPHY; HEMIDIAPHRAGM,1850.0,1202.5,64.11,1850.0,35
CDM,95866PROWE,NEEDLE ELECTROMYOGRAPHY; HEMIDIAPHRAGM PC,500.0,325.0,64.11,500.0,35
CDM,95866TECWE,NEEDLE ELECTROMYOGRAPHY; HEMIDIAPHRAGM TC,1350.0,877.5,64.11,1350.0,35
CDM,95866WE,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,1850.0,1202.5,64.11,1850.0,35
CDM,95866WE-26,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,500.0,325.0,53.58,500.0,31
CDM,95866WE-TC,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,1350.0,877.5,40.64,1350.0,35
CDM,95867EMGWE,EMG CRANIAL NERVE UNILATERAL,3002.0,1951.3,53.1,3002.0,35
CDM,95867PROWE,EMG CRANIAL NERVE UNILAT,316.0,205.4,53.1,316.0,35
CDM,95867WE,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,3002.0,1951.3,53.1,3002.0,35
CDM,95867WE-26,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,316.0,205.4,33.68,316.0,31
CDM,95867WE-TC,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,2686.0,1745.9,43.79,2686.0,35
CDM,95868EMGWE,EMG CRANIAL MUSCLES BILAT,3158.0,2052.7,71.76,3158.0,35
CDM,95868PROWE,EMG CRANIAL MUSCLES BIL,472.0,306.8,71.76,472.0,35
CDM,95868WE,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,3158.0,2052.7,71.76,3158.0,35
CDM,95868WE-26,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,472.0,306.8,50.02,472.0,31
CDM,95868WE-TC,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,2686.0,1745.9,53.56,2686.0,35
CDM,95869EMGWE,EMG THORACIC,2834.0,1842.1,48.82,2834.0,35
CDM,95869PROWE,EMG THORACIC LTD,148.0,96.2,48.82,165.98,35
CDM,95869WE,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,2834.0,1842.1,48.82,2834.0,35
CDM,95869WE-26,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,148.0,96.2,15.49,148.0,31
CDM,95869WE-TC,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,2686.0,1745.9,42.07,2686.0,35
CDM,95870EMPWE,EMP OTHER THAN PARASPINAL,1259.0,818.35,42.25,1259.0,35
CDM,95870PROWE,EMG OTHER THAN PARASPINAL,148.0,96.2,42.25,148.0,35
CDM,95870WE,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,1259.0,818.35,42.25,1259.0,35
CDM,95870WE-26,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,148.0,96.2,15.78,148.0,31
CDM,95870WE-TC,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,1111.0,722.15,39.49,1111.0,35
CDM,95872WE,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,2502.0,1626.3,103.24,2502.0,35
CDM,95872WE-26,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,1152.0,748.8,121.49,1152.0,31
CDM,95872WE-TC,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,1350.0,877.5,35.18,1350.0,35
CDM,95873ELEWE,ELECTRICAL STIM GUIDE CHEMODENRVATION,257.0,167.05,37.32,257.0,35
CDM,95873PROWE,ELECTRICAL STIM GUIDE CHEMODENERVATION PC,163.0,105.95,37.32,163.0,35
CDM,95873TECWE,ELECTRICAL STIM GUIDE CHEMODENERVATION TC,94.0,61.1,37.32,122.34,35
CDM,95873WE,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,257.0,167.05,37.32,257.0,35
CDM,95873WE-26,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,163.0,105.95,16.64,163.0,31
CDM,95873WE-TC,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,94.0,61.1,39.77,94.0,35
CDM,95874NEEWE,NEEDLE EMG GUIDE CHEMODENERVATION,1141.0,741.65,39.29,1141.0,35
CDM,95874PROWE,NEEDLE EMG GUIDE CHEMODENERVATION PC,163.0,105.95,39.29,163.0,35
CDM,95874TECWE,NEEDLE EMG GUIDE CHEMODENERVATION TC,978.0,635.7,39.29,978.0,35
CDM,95874WE,NEEDLE EMG GUIDANCE FOR CHEMODENERVATION,1141.0,741.65,39.29,1141.0,35
CDM,95874WE-26,NEEDLE EMG GUIDANCE FOR CHEMODENERVATION,163.0,105.95,16.06,163.0,31
CDM,95874WE-TC,NEEDLE EMG GUIDANCE FOR CHEMODENERVATION,978.0,635.7,37.48,978.0,35
CDM,95875EMGWE,EMG ISCHEMIC LIMB,1790.0,1163.5,67.23,1790.0,32
CDM,95875PROWE,EMG ISCHEMIC LIMB,440.0,286.0,67.23,440.0,32
CDM,95875WE,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,1790.0,1163.5,67.23,1790.0,32
CDM,95875WE-26,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,440.0,286.0,47.04,440.0,31
CDM,95875WE-TC,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,1350.0,877.5,47.53,1350.0,35
CDM,95885WE,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,1386.0,900.9,31.56,1386.0,35
CDM,95885WE-26,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,140.0,91.0,14.92,140.0,31
CDM,95885WE-TC,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,1246.0,809.9,32.31,1246.0,35
CDM,95886WE,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,2211.0,1437.15,48.99,2211.0,35
CDM,95886WE-26,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,378.0,245.7,39.94,378.0,31
CDM,95886WE-TC,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,1833.0,1191.45,34.03,1833.0,35
CDM,95887WE,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,1010.0,656.5,42.25,1010.0,35
CDM,95887WE-26,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,312.0,202.8,31.27,312.0,31
CDM,95887WE-TC,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,698.0,453.7,34.6,698.0,35
CDM,95900NERWE,NERVE CONDUCT WO F WAVE,353.0,229.45,54.38,353.0,16
CDM,95900PROWE,NERVE CONDUCT WO F WAVE,91.0,59.15,45.5,91.0,16
CDM,95900TECWE,MOTOR NERVE COND W/O F-WAVE TC,266.0,172.9,54.38,266.0,16
CDM,95903MOTWE,MOTOR NERVE TEST W F WAVE,323.0,209.95,63.77,323.0,16
CDM,95903PROWE,MOTOR NERVE TEST W F WAVE,148.0,96.2,63.77,148.0,16
CDM,95903TECWE,MOTOR NERVE COND WITH F-WAVE,175.0,113.75,63.77,175.0,16
CDM,95904PROWE,SENSORY NERVE TEST EACH,91.0,59.15,45.5,91.0,16
CDM,95904SENWE,SENSORY NERVE TEST EACH,353.0,229.45,48.1,353.0,16
CDM,95904TECWE,SENSORY NERVE COND-TC,266.0,172.9,48.1,266.0,16
CDM,95907WE,NERVE CONDUCTION STUDIES 1-2 STUDIES,1790.0,1163.5,49.88,1790.0,31
CDM,95907WE-26,NERVE CONDUCTION STUDIES 1-2 STUDIES,440.0,286.0,51.1,440.0,31
CDM,95907WE-TC,NERVE CONDUCTION STUDIES 1-2 STUDIES,1350.0,877.5,35.76,1350.0,35
CDM,95908WE,NERVE CONDUCTION STUDIES 3-4 STUDIES,3236.0,2103.4,61.53,3236.0,31
CDM,95908WE-26,NERVE CONDUCTION STUDIES 3-4 STUDIES,550.0,357.5,63.38,550.0,31
CDM,95908WE-TC,NERVE CONDUCTION STUDIES 3-4 STUDIES,2686.0,1745.9,44.48,2686.0,35
CDM,95909WE,NERVE CONDUCTION STUDIES 5-6 STUDIES,3346.0,2174.9,73.78,3346.0,31
CDM,95909WE-26,NERVE CONDUCTION STUDIES 5-6 STUDIES,660.0,429.0,76.24,660.0,31
CDM,95909WE-TC,NERVE CONDUCTION STUDIES 5-6 STUDIES,2686.0,1745.9,53.51,2686.0,35
CDM,95910WE,NERVE CONDUCTION STUDIES 7-8 STUDIES,3566.0,2317.9,97.16,3566.0,31
CDM,95910WE-26,NERVE CONDUCTION STUDIES 7-8 STUDIES,880.0,572.0,101.63,880.0,31
CDM,95910WE-TC,NERVE CONDUCTION STUDIES 7-8 STUDIES,2686.0,1745.9,68.04,2686.0,35
CDM,95911WE,NERVE CONDUCTION STUDIES 9-10 STUDIES,5676.0,3689.4,117.59,5676.0,31
CDM,95911WE-26,NERVE CONDUCTION STUDIES 9-10 STUDIES,1100.0,715.0,127.27,1100.0,31
CDM,95911WE-TC,NERVE CONDUCTION STUDIES 9-10 STUDIES,4576.0,2974.4,76.76,4576.0,35
CDM,95912WE,NERVE CONDUCTION STUDIES 11-12 STUDIES,5896.0,3832.4,138.03,5896.0,31
CDM,95912WE-26,NERVE CONDUCTION STUDIES 11-12 STUDIES,1320.0,858.0,152.58,1320.0,31
CDM,95912WE-TC,NERVE CONDUCTION STUDIES 11-12 STUDIES,4576.0,2974.4,85.72,4576.0,35
CDM,95913WE,NERVE CONDUCTION STUDIES 13/> STUDIES,6142.0,3992.3,217.03,6142.0,31
CDM,95913WE-26,NERVE CONDUCTION STUDIES 13/> STUDIES,1566.0,1017.9,180.88,1566.0,31
CDM,95913WE-TC,NERVE CONDUCTION STUDIES 13/> STUDIES,4576.0,2974.4,97.99,4576.0,35
CDM,95919WE,QUANTITATIVE PUPILLOMETRY PHYS/QHP I&R UNI/BI,72.0,46.8,7.55,72.0,31
CDM,95919WE-26,QUANTITATIVE PUPILLOMETRY PHYS/QHP I&R UNI/BI,72.0,46.8,9.62,72.0,31
CDM,95919WE-TC,QUANTITATIVE PUPILLOMETRY PHYS/QHP I&R UNI/BI,1111.0,722.15,6.38,1111.0,35
CDM,95921AUTWE,AUTONOMIC NERVE TEST,1710.0,1111.5,43.4,1710.0,35
CDM,95921PROWE,AUTONOMIC NERVE TEST,360.0,234.0,43.4,360.0,35
CDM,95921TECWE,AUTONOMIC NERVE FUNCT-CARDIOVAGAL,1350.0,877.5,43.4,1350.0,35
CDM,95921WE,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,1710.0,1111.5,43.4,1710.0,35
CDM,95921WE-26,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,360.0,234.0,37.65,360.0,31
CDM,95921WE-TC,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,1350.0,877.5,33.46,1350.0,35
CDM,95922PROWE,VASOMOTOR TEST,384.0,249.6,49.48,384.0,35
CDM,95922TECWE,AUTONOMIC NERVE FUNCTION-VASOMOTOR,1111.0,722.15,49.48,1111.0,35
CDM,95922VASWE,VASOMOTOR TEST,1495.0,971.75,49.48,1495.0,35
CDM,95922WE,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,1495.0,971.75,49.48,1495.0,35
CDM,95922WE-26,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,384.0,249.6,40.21,384.0,31
CDM,95922WE-TC,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,1111.0,722.15,43.11,1111.0,35
CDM,95923PROWE,SUDOMOTOR TEST,360.0,234.0,61.65,360.0,32
CDM,95923SUDWE,SUDOMOTOR TEST,1471.0,956.15,61.65,1471.0,32
CDM,95923TECWE,AUTONOMIC NERVE FUNCTION-SUDOMOTOR,1111.0,722.15,61.65,1111.0,32
CDM,95923WE,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,1471.0,956.15,61.65,1471.0,32
CDM,95923WE-26,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,360.0,234.0,38.65,360.0,31
CDM,95923WE-TC,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,1111.0,722.15,71.92,1111.0,35
CDM,95924WE,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,3447.0,2240.55,77.89,3447.0,28
CDM,95924WE-26,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,761.0,494.65,83.78,761.0,31
CDM,95924WE-TC,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,2686.0,1745.9,61.19,2686.0,35
CDM,95925NERWE,NERVE STUDY CNS SHORT LACENCY,2902.0,1886.3,90.25,2902.0,35
CDM,95925PROWE,NERVE STDY CNS SHORT LAC,216.0,140.4,90.25,307.65,35
CDM,95925WE,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,2902.0,1886.3,90.25,2902.0,35
CDM,95925WE-26,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,216.0,140.4,22.59,216.0,31
CDM,95925WE-TC,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,2686.0,1745.9,117.89,2686.0,35
CDM,95926NERWE,NERVESTUDY LOWER LIMB LAT,2902.0,1886.3,78.08,2902.0,35
CDM,95926PROWE,NERVE STDY LOWER LIMB LAT,216.0,140.4,78.08,275.46,35
CDM,95926WE,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,2902.0,1886.3,78.08,2902.0,35
CDM,95926WE-26,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,216.0,140.4,23.16,216.0,31
CDM,95926WE-TC,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,2686.0,1745.9,111.48,2686.0,35
CDM,95927NERWE,NERVESRUDY TRUNK/HEAD LAT,2902.0,1886.3,73.48,2902.0,35
CDM,95927PROWE,NERVE STDY TRUNK/HEAD LAT,216.0,140.4,73.48,318.64,35
CDM,95927WE,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,2902.0,1886.3,73.48,2902.0,35
CDM,95927WE-26,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,216.0,140.4,22.59,216.0,31
CDM,95927WE-TC,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,2686.0,1745.9,115.31,2686.0,35
CDM,95928CENWE,"CENTRAL MOTOR EVOKED, UPPR LIMBS",9375.0,6093.75,115.89,9375.0,35
CDM,95928PROWE,"CENTRAL MOTOR EVOKED, UPPR LIMBS",600.0,390.0,115.89,600.0,35
CDM,95928WE,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,9375.0,6093.75,115.89,9375.0,35
CDM,95928WE-26,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,600.0,390.0,64.38,600.0,31
CDM,95928WE-TC,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,8775.0,5703.75,151.49,8775.0,35
CDM,95929CENWE,"CENTRAL MOTOR EVOKED, LOWER LIMBS",5176.0,3364.4,119.18,5176.0,35
CDM,95929PROWE,"CENTRAL MOTOR EVOKED, LOWER LIMBS",600.0,390.0,119.18,600.0,35
CDM,95929WE,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,5176.0,3364.4,119.18,5176.0,35
CDM,95929WE-26,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,600.0,390.0,64.38,600.0,31
CDM,95929WE-TC,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,4576.0,2974.4,154.94,4576.0,35
CDM,95930PROWE,VEP TEST CNS CHECK/FLASH,140.0,91.0,42.94,160.12,35
CDM,95930VEPWE,VEP TEST CNS CHECK/FLASH,2826.0,1836.9,42.94,2826.0,35
CDM,95930WE,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2826.0,1836.9,42.94,2826.0,35
CDM,95930WE-26,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,140.0,91.0,14.92,140.0,31
CDM,95930WE-TC,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2686.0,1745.9,46.74,2686.0,35
CDM,95933BLIWE,BLINK REFLEX TEST,749.0,486.85,43.99,749.0,32
CDM,95933PROWE,BLINK REFLEX,236.0,153.4,43.99,236.0,32
CDM,95933TECWE,BLINK REFLEX-ELECTRODIAGNOSTIC TEST,513.0,333.45,43.99,513.0,32
CDM,95933WE,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,749.0,486.85,43.99,749.0,32
CDM,95933WE-26,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,236.0,153.4,25.44,236.0,31
CDM,95933WE-TC,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,513.0,333.45,43.22,513.0,35
CDM,95934H RWE,H REFLEX AMP/LAT GAST/SOL,175.0,113.75,52.04,175.0,16
CDM,95934PROWE,H REFLEX AMP/LAT GAST/SOL,96.0,62.4,48.0,96.0,16
CDM,95936H RWE,H REFLEX AMP/LAT WO G/S,175.0,113.75,41.97,175.0,16
CDM,95936PROWE,H REFLEX AMP/LAT WO G/S,113.0,73.45,41.97,113.0,16
CDM,95937NEUWE,NEUROMUSC JUNCT TEST,1610.0,1046.5,52.44,1610.0,35
CDM,95937PROWE,NEUROMUSC JUNCT TEST,260.0,169.0,52.44,260.0,35
CDM,95937WE,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,1610.0,1046.5,52.44,1610.0,35
CDM,95937WE-26,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,260.0,169.0,28.14,260.0,31
CDM,95937WE-TC,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,1350.0,877.5,30.87,1350.0,35
CDM,95938WE,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMBS,4920.0,3198.0,177.2,4920.0,35
CDM,95938WE-26,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMBS,344.0,223.6,36.95,344.0,31
CDM,95938WE-TC,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMBS,4576.0,2974.4,213.24,4576.0,35
CDM,95939WE,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LIMB,900.0,585.0,267.78,974.15,35
CDM,95939WE-26,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LIMB,900.0,585.0,97.35,900.0,31
CDM,95939WE-TC,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LIMB,8775.0,5703.75,294.37,8775.0,35
CDM,95940WE,IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES,264.0,171.6,17.1,264.0,31
CDM,95941WE,IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR,1767.0,1148.55,65.13,1767.0,13
CDM,95941WE-QW,IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR,1767.0,1148.55,883.5,1767.0,12
CDM,95954WE,RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE,5654.0,3675.1,107.28,5654.0,35
CDM,95954WE-26,RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE,1078.0,700.7,99.85,1078.0,31
CDM,95954WE-TC,RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE,4576.0,2974.4,243.53,4576.0,35
CDM,95955WE,EEG NONINTRACRANIAL SURGERY,404.0,262.6,99.78,404.0,32
CDM,95955WE-26,EEG NONINTRACRANIAL SURGERY,404.0,262.6,42.91,404.0,31
CDM,95955WE-TC,EEG NONINTRACRANIAL SURGERY,1491.0,969.15,121.05,1491.0,35
CDM,95957WE,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,1138.0,739.7,126.9,1138.0,35
CDM,95957WE-26,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,792.0,514.8,84.69,792.0,31
CDM,95957WE-TC,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,346.0,224.9,173.0,347.41,35
CDM,95958WE,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,10471.0,6806.15,306.74,10471.0,35
CDM,95958WE-26,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,1696.0,1102.4,181.32,1696.0,31
CDM,95958WE-TC,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,8775.0,5703.75,238.36,8775.0,35
CDM,95961WE,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,9963.0,6475.95,158.3,9963.0,35
CDM,95961WE-26,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,1188.0,772.2,128.19,1188.0,31
CDM,95961WE-TC,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,8775.0,5703.75,101.24,8775.0,35
CDM,95962WE,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,2034.0,1322.1,141.48,2034.0,35
CDM,95962WE-26,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,1284.0,834.6,136.99,1284.0,31
CDM,95962WE-TC,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,750.0,487.5,63.04,750.0,35
CDM,95970WE,ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING,154.0,100.1,16.61,115.5,35
CDM,95971WE,ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG,343.0,222.95,19.24,257.25,35
CDM,95972WE,ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG,352.0,228.8,26.93,264.0,35
CDM,95976WE,ELEC ALYS IMPLT SMPL CN NPGT PRGRMG,321.0,208.65,28.85,240.75,31
CDM,95977WE,ELEC ALYS IMPLT CPLX CN NPGT PRGRMG,388.0,252.2,38.55,291.0,31
CDM,95980WE,ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG,320.0,208.0,22.03,320.0,32
CDM,95981WE,ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG,120.0,78.0,8.55,90.0,32
CDM,95982WE,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,260.0,169.0,17.59,195.0,32
CDM,95983WE,ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN,400.0,260.0,37.79,300.0,31
CDM,95984WE,ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN,352.0,228.8,32.94,264.0,31
CDM,95990WE,REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,217.0,141.05,44.22,217.0,35
CDM,95991WE,RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP,339.0,220.35,19.4,254.25,35
CDM,95992WE,CANALITH REPOSITIONING PROCEDURE,300.0,195.0,17.59,225.0,35
CDM,96000WE,COMPRE CPTR MTN ALYS VIDEO TAPING 3D KINEMATICS,720.0,468.0,59.85,720.0,32
CDM,96001WE,COMPRE CPTR MTN ALYS W/DYN PLNTR PRES MEAS WALKG,946.0,614.9,70.18,946.0,32
CDM,96002WE,DYN SURF EMG WALKG/FUNCJAL ACTV 1-12 MUSC,180.0,117.0,13.96,180.0,32
CDM,96003WE,DYN FINE WIRE EMG WALKG/FUNCJAL ACTV 1 MUSC,72.0,46.8,16.06,72.0,19
CDM,96004WE,PHYS/QHP R&I CPTR MTN ALYS WALK/FUNCJL ACTV REPR,856.0,556.4,75.43,856.0,32
CDM,96020WE,TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP,11992.0,7794.8,449.63,11992.0,13
CDM,96020WE-26,TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP,1372.0,891.8,147.89,1372.0,31
CDM,96041WE,MED GENETICS&GENETIC COUNSELING SVCS EACH 30 MIN,650.0,422.5,51.04,650.0,16
CDM,96105WE,ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR,700.0,455.0,47.51,700.0,35
CDM,96110WE,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,36.0,23.4,8.54,36.0,20
CDM,96112WE,DEVELOPMENTAL TST ADMIN PHYS/QHP 1ST HOUR,1024.0,665.6,33.2,768.0,31
CDM,96113WE,DEVELOPMENTAL TST ADMIN PHYS/QHP EA ADDL 30 MIN,464.0,301.6,17.56,348.0,31
CDM,96116WE,NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR,744.0,483.6,51.93,558.0,35
CDM,96121WE,NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR,752.0,488.8,47.79,564.0,28
CDM,96125WE,STANDARDIZED COGNITIVE PERFORMANCE TESTING,680.0,442.0,50.35,680.0,32
CDM,96127DABWE,DEPRESSION SCREENING AUTO BILLING,112.0,72.8,4.08,112.0,28
CDM,96127WE,BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,112.0,72.8,4.08,112.0,28
CDM,96130WE,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR,1126.0,731.9,48.23,844.5,31
CDM,96131WE,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR,862.0,560.3,48.23,646.5,31
CDM,96132WE,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR,1126.0,731.9,81.41,844.5,31
CDM,96133WE,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR,862.0,560.3,61.5,646.5,31
CDM,96136WE,PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN,242.0,157.3,17.41,181.5,31
CDM,96137WE,PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN,202.0,131.3,16.02,151.5,31
CDM,96138WE,PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN,788.0,512.2,33.82,788.0,27
CDM,96139WE,PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN,788.0,512.2,33.82,788.0,27
CDM,96146WE,PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT,203.0,131.95,1.53,203.0,28
CDM,96156WE,HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,920.0,598.0,87.9,690.0,27
CDM,96158WE,HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,636.0,413.4,60.41,477.0,27
CDM,96159WE,HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,220.0,143.0,20.49,165.0,27
CDM,96160WE,PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,46.0,29.9,2.54,46.0,28
CDM,96161WE,CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,2.54,89.0,28
CDM,96164WE,HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,92.0,59.8,9.63,69.0,27
CDM,96165WE,HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,44.0,28.6,4.03,33.0,27
CDM,96167WE,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,680.0,442.0,63.76,510.0,27
CDM,96168WE,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,240.0,156.0,23.11,180.0,27
CDM,96170WE,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,600.0,390.0,72.15,450.0,16
CDM,96171WE,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,216.0,140.4,25.96,162.0,16
CDM,96202WE,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING 1ST 60,172.0,111.8,17.76,129.0,27
CDM,96203WE,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING EA ADDL,48.0,31.2,5.32,48.0,27
CDM,96360WE,IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR,75.0,48.75,23.75,75.0,35
CDM,96361WE,IV INFUSION HYDRATION EACH ADDITIONAL HOUR,40.0,26.0,9.19,40.0,35
CDM,96365WE,IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR,92.0,59.8,45.7,110.39,35
CDM,96366WE,IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR,79.0,51.35,15.32,79.0,35
CDM,96367WE,IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR,84.0,54.6,20.94,84.0,35
CDM,96368WE,IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS,75.0,48.75,14.55,75.0,35
CDM,96372WE,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,614.0,399.1,10.98,614.0,35
CDM,96373WE,THERAPEUTIC PROPHYLACTIC/DX NJX INTRA-ARTERIAL,75.0,48.75,13.47,75.0,35
CDM,96374WE,THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG,79.0,51.35,26.81,79.0,35
CDM,96375WE,THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG,44.0,28.6,11.23,44.0,35
CDM,96377WE,APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,75.0,48.75,13.79,75.0,31
CDM,96401WE,"CHEMOTHER,NON-HORMONE ANTI-NEOPL, SUB-Q/IM",92.0,59.8,41.68,121.91,35
CDM,96402WE,CHEMOTHER HORMON ANTINEOPL SUB-Q/IM,84.0,54.6,26.66,84.0,35
CDM,96405WE,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7,229.0,148.85,22.33,171.75,35
CDM,96406WE,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL >7,352.0,228.8,33.72,264.0,35
CDM,96409WE,"CHEMOTHER, IV PUSH, SNGL DRUG",106.0,68.9,53.0,170.27,35
CDM,96411WE,"CHEMOTHER, IV PUSH,EA ADD DRUG",88.0,57.2,40.09,92.4,35
CDM,96413WE,"CHEMOTHER, IV INFUSION, 1 HR",123.0,79.95,61.5,219.88,35
CDM,96415WE,"CHEMOTHER, IV INFUSION, EA ADD HR",84.0,54.6,20.17,84.0,35
CDM,96416WE,CHEMOTHER PROLONG INFUSE W/PUMP,92.0,59.8,46.0,216.53,35
CDM,96417WE,"CHEMOTHER, IV INFUSE, EACH SEQU INFUS",92.0,59.8,46.0,108.49,35
CDM,96420WE,CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ,75.0,48.75,37.5,173.62,35
CDM,96422WE,CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS </1 HR,68.0,44.2,34.0,265.45,35
CDM,96423WE,CHEMOTHERAPY ADMN INTRAARTERIAL INFUSION EA HR,75.0,48.75,37.5,124.01,35
CDM,96425WE,CHEMOTX ADMN IA NFS >8 HR PRTBLE IMPLTBL PMP,75.0,48.75,37.5,286.98,35
CDM,96440WE,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,848.0,551.2,82.83,1662.94,35
CDM,96446WE,CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH,163.0,105.95,16.11,395.7,32
CDM,96450WE,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,612.0,397.8,48.3,459.0,35
CDM,96521WE,"REFILL/MAINT, PORTABLE PUMP",92.0,59.8,46.0,210.93,35
CDM,96522WE,REFILL/MAINT SYSTEMIC PUMP/RESVR,92.0,59.8,46.0,200.32,35
CDM,96523WE,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,18.0,11.7,9.0,42.36,35
CDM,96542WE,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,300.0,195.0,20.39,229.29,35
CDM,96547WE,INTRAOPERATIVE HIPEC PX FIRST 60 MINUTES,2612.0,1697.8,159.61,2612.0,27
CDM,96548WE,INTRAOPERATIVE HIPEC PX EACH ADDL 30 MINUTES,1200.0,780.0,79.81,1200.0,27
CDM,96567WE,PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY,441.0,286.65,70.52,441.0,32
CDM,96570WE,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX 30 MIN,440.0,286.0,48.58,440.0,32
CDM,96571WE,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX A 15 MIN,220.0,143.0,22.3,220.0,32
CDM,96573WE,PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP,211.0,137.15,105.5,393.65,28
CDM,96574WE,DEBRIDEMENT PRMLG HYPERKERATOTIC LES W/PDT,444.0,288.6,184.54,483.4,28
CDM,96900WE,ACTINOTHERAPY ULTRAVIOLET LIGHT,92.0,59.8,11.68,92.0,35
CDM,96910WE,PHOTOCHEMOTX TAR&UVB/PETROLATUM/UVB,134.0,87.1,57.53,206.48,35
CDM,96912WE,PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA,167.0,108.55,49.31,175.87,35
CDM,96920WE,EXCIMER LASER TX PSORIASIS TOT AREA <250 SQ CM,332.0,215.8,36.19,249.0,35
CDM,96921WE,EXCIMER LASER TX PSORIASIS 250-500 SQ CM,360.0,234.0,37.72,270.0,35
CDM,96922WE,EXCIMER LASER TX PSORIASIS >500 SQ CM,460.0,299.0,61.55,345.0,35
CDM,96999ABEWE,ABELLA ENLIGHTER,51.0,33.15,25.5,103.31,15
CDM,96999ACNWE,ACNE SPOT TREATMENT,31.0,20.15,15.5,103.31,15
CDM,96999ACUWE,ACUPUNCTURE CONSULTATION; NO TREATMENT,113.0,73.45,56.5,113.0,15
CDM,96999AHAWE,AHA MARINE FADE CREAM,68.0,44.2,34.0,103.31,15
CDM,96999ALPWE,ALPHA & BETA TONER 8 OZ,33.0,21.45,16.5,103.31,15
CDM,96999AQUWE,AQUA GUARD SUNBLOCK,18.0,11.7,9.0,103.31,15
CDM,96999AWE,VAGINAL LASER THERAPY - FEMILIFT (SELF PAY),531.0,345.15,86.09,531.0,15
CDM,96999BACWE,BACK/SHOULDER TREATMENT,86.0,55.9,43.0,103.31,15
CDM,96999BIOWE,BIOMEDICA ANTIBAC WASH 60 1OZ,31.0,20.15,15.5,103.31,15
CDM,96999BLEWE,BLENDER,91.0,59.15,45.5,103.31,15
CDM,96999BLUWE,BLUSH,29.0,18.85,14.5,103.31,15
CDM,96999BROWE,BRONZE BLAST,5.0,3.25,2.5,103.31,15
CDM,96999BRUWE,BRUSHES - HANDI,42.0,27.3,21.0,103.31,15
CDM,96999CAMWE,CAMMAGLOUGE MAKEUP,45.0,29.25,22.5,103.31,15
CDM,96999CHAWE,CHAMOMILE FACIAL CLEANSER,23.0,14.95,11.5,103.31,15
CDM,96999CHIWE,CHIN WAX,15.0,9.75,7.5,103.31,15
CDM,96999CIRWE,CIRCLE DELETE,32.0,20.8,16.0,103.31,15
CDM,96999CLEWE,CLEAR,96.0,62.4,48.0,103.31,15
CDM,96999CONWE,CONSULT W ACUPUNCTURE; IST OF 4 TREATMENT,431.0,280.15,86.09,431.0,15
CDM,96999CUSWE,CUSTOMIZED FACIAL-LYMPH MASSAGE 1 HR,91.0,59.15,45.5,103.31,15
CDM,96999D20WE,D20,19.0,12.35,9.5,103.31,15
CDM,96999DERWE,DERMAL REPAIR,113.0,73.45,56.5,113.0,15
CDM,96999EFFWE,EFFACLAR K ACNE TX FLUID 1OZ,19.0,12.35,9.5,103.31,15
CDM,96999EMPWE,EMPLOYEE BRONZE BLAST,4.0,2.6,2.0,103.31,15
CDM,96999ENZWE,ENZYMEPEEL,91.0,59.15,45.5,103.31,15
CDM,96999EURWE,EUROPEAN FACIAL,81.0,52.65,40.5,103.31,15
CDM,96999EXFWE,EXFODERM,63.0,40.95,31.5,103.31,15
CDM,96999EXPWE,EXPRESS FACIAL,51.0,33.15,25.5,103.31,15
CDM,96999EYEWE,EYE BROW WAX,12.0,7.8,6.0,103.31,15
CDM,96999FACWE,"FACIAL, OTHER",96.0,62.4,48.0,103.31,15
CDM,96999FOAWE,FOAMING CLEANSER,37.0,24.05,18.5,103.31,15
CDM,96999GENWE,GENTLE CLEANSER,37.0,24.05,18.5,103.31,15
CDM,96999GLYWE,GLYCOLIC PEEL,81.0,52.65,40.5,103.31,15
CDM,96999HEAWE,HEALTHY SKIN PROTECT SPF 35,43.0,27.95,21.5,103.31,15
CDM,96999HYDWE,HYDRATING EYE GEL,33.0,21.45,16.5,103.31,15
CDM,96999JESWE,JESSNER PEEL,189.0,122.85,86.09,189.0,15
CDM,96999LAVWE,LAVENDER CLEANSER 8.3 OZ,23.0,14.95,11.5,103.31,15
CDM,96999LIPWE,LIPID DROPS,36.0,23.4,18.0,103.31,15
CDM,96999MARWE,MARINE LIP & EYE THERAPY,43.0,27.95,21.5,103.31,15
CDM,96999MICWE,MICROPEEL,58.0,37.7,29.0,103.31,15
CDM,96999MITWE,MITTS,15.0,9.75,7.5,103.31,15
CDM,96999MULWE,MULTI - COMPLEX CREAM,63.0,40.95,31.5,103.31,15
CDM,96999PAPWE,PAPAYA MINT SCRUB,33.0,21.45,16.5,103.31,15
CDM,96999PERWE,"PERMANENT MAKEUP, AREOLA",278.0,180.7,86.09,278.0,15
CDM,96999PREWE,PRESSED POWDER,45.0,29.25,22.5,103.31,15
CDM,96999REPWE,REPLENISH SUNBLOCK SPF 36,37.0,24.05,18.5,103.31,15
CDM,96999RETWE,RETIN A 1.0,69.0,44.85,34.5,103.31,15
CDM,96999SALWE,SALICYLIC FACE & BODY WASH,23.0,14.95,11.5,103.31,15
CDM,96999SKIWE,SKIN CARE CONSULTATION,39.0,25.35,19.5,103.31,15
CDM,96999STAWE,STARTER KIT,358.0,232.7,86.09,358.0,15
CDM,96999SUNWE,SUNFADER,70.0,45.5,35.0,103.31,15
CDM,96999TANWE,TANNING,29.0,18.85,14.5,103.31,15
CDM,96999TEEWE,TEENAGE FACIAL,73.0,47.45,36.5,103.31,15
CDM,96999TNSWE,TNS RECOVERY COMPLEX,148.0,96.2,74.0,148.0,15
CDM,96999ULTWE,ULTRA FIRMING MARINE NECK & CHEST,69.0,44.85,34.5,103.31,15
CDM,96999UNDWE,UNDERARM WAX,15.0,9.75,7.5,103.31,15
CDM,96999UPLWE,UPLIFTING EYE SERUM,51.0,33.15,25.5,103.31,15
CDM,96999VITWE,VITAMIN C CREAM,63.0,40.95,31.5,103.31,15
CDM,96999WAXWE,WAXING,34.0,22.1,17.0,103.31,15
CDM,97010WE,APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS,24.0,15.6,5.0,24.0,20
CDM,97012WE,APPL MODALITY 1/> AREAS TRACTION MECHANICAL,100.0,65.0,12.81,100.0,32
CDM,97014WE,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,72.0,46.8,11.3,72.0,20
CDM,97016WE,APPL MODALITY 1/> AREAS VASOPNEUMATIC DEVICES,72.0,46.8,10.71,72.0,32
CDM,97018WE,APPL MODALITY 1/> AREAS PARAFFIN BATH,24.0,15.6,4.7,24.0,35
CDM,97022WE,APPLICATION MODALITY 1/> AREAS WHIRLPOOL,68.0,44.2,10.84,68.0,32
CDM,97032WE,APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN,100.0,65.0,11.68,100.0,32
CDM,97033WE,APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN,104.0,67.6,17.59,104.0,31
CDM,97034WE,APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN,84.0,54.6,9.69,84.0,32
CDM,97035WE,APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN,84.0,54.6,9.9,84.0,32
CDM,97110WE,"THERAPEUTIC EXERCISES RE, EA 15 MIN.",198.0,128.7,17.96,198.0,32
CDM,97112WE,THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA,220.0,143.0,18.5,220.0,32
CDM,97113WE,THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS,211.0,137.15,21.18,211.0,32
CDM,97116WE,THER PX 1/> AREAS EA 15 MIN GAIT TRAING W/STAIR,198.0,128.7,15.74,198.0,32
CDM,97124WE,THER PX 1/> AREAS EACH 15 MINUTES MASSAGE,140.0,91.0,14.2,140.0,32
CDM,97129WE,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,200.0,130.0,18.75,150.0,28
CDM,97130WE,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,192.0,124.8,18.49,192.0,28
CDM,97140WE,MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES,189.0,122.85,16.78,189.0,32
CDM,97150WE,THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS,116.0,75.4,14.03,116.0,32
CDM,97151WE,BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN,119.0,77.35,59.5,119.0,13
CDM,97152WE,BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN,293.0,190.45,73.12,293.0,13
CDM,97153WE,ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN,246.0,159.9,58.06,246.0,13
CDM,97154WE,GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN,181.0,117.65,8.26,181.0,13
CDM,97155WE,ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN,246.0,159.9,58.06,246.0,13
CDM,97156WE,FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN,98.0,63.7,49.0,98.0,13
CDM,97157WE,MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN,137.0,89.05,18.08,137.0,13
CDM,97158WE,GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN,75.0,48.75,9.54,75.0,13
CDM,97161WE,PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS,616.0,400.4,68.99,616.0,28
CDM,97162WE,PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS,616.0,400.4,68.99,616.0,28
CDM,97163WE,PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS,616.0,400.4,68.99,616.0,28
CDM,97164WE,PHYSICAL THERAPY RE-EVAL EST PLAN CARE 20 MINS,384.0,249.6,46.74,384.0,28
CDM,97165WE,OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS,616.0,400.4,66.98,616.0,28
CDM,97166WE,OCCUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS,616.0,400.4,66.98,616.0,28
CDM,97167WE,OCCUPATIONAL THERAPY EVAL HIGH COMPLEX 60 MINS,616.0,400.4,66.98,616.0,28
CDM,97168WE,OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS,384.0,249.6,44.12,384.0,28
CDM,97530WE,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,176.0,114.4,19.28,176.0,32
CDM,97533WE,SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES,192.0,124.8,23.36,192.0,32
CDM,97535WE,SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES,180.0,117.0,23.37,180.0,32
CDM,97537WE,COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN,192.0,124.8,21.26,192.0,32
CDM,97542WE,WHEELCHAIR MGMT EA 15 MIN,192.0,124.8,22.6,192.0,32
CDM,97550WE,CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,440.0,286.0,38.35,330.0,28
CDM,97551WE,CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,238.0,154.7,17.77,178.5,28
CDM,97552WE,GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,101.0,65.65,9.69,75.75,28
CDM,97597WE,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,308.0,200.2,10.82,231.0,35
CDM,97598WE,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,220.0,143.0,9.79,165.0,35
CDM,97602WE,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,144.0,93.6,22.56,144.0,16
CDM,97605WE,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,242.0,157.3,21.45,181.5,32
CDM,97606WE,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,264.0,171.6,23.47,198.0,32
CDM,97607WE,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,180.0,117.0,20.25,180.0,28
CDM,97608WE,NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM,202.0,131.3,24.04,202.0,28
CDM,97750WE,PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN,180.0,117.0,20.18,180.0,32
CDM,97760WE,ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS,200.0,130.0,31.24,200.0,32
CDM,97761WE,PROSTHETICS TRAINING INITIAL ENCTR EA 15 MINS,200.0,130.0,22.4,200.0,32
CDM,97763WE,ORTHOTICS/PROSTH MGMT &/TRAINJ SBSQ ENCTR 15 MIN,192.0,124.8,40.69,192.0,28
CDM,977994 NWE,4 NUTRITION CONSULTS 4 PERSONAL TRAINING,659.0,428.35,27.05,659.0,15
CDM,97799AFTWE,AFTER CARE REHAB PROGRAM,33.0,21.45,16.5,33.0,15
CDM,97799BASWE,BASEBALL SPECIFIC ADVANCE HOME TRAINING,68.0,44.2,27.05,68.0,15
CDM,97799CHAWE,CHAMPIONS GOLF PACKAGE,410.0,266.5,27.05,410.0,15
CDM,97799EXEWE,EXECUTIVE FITNESS EVALUATION,194.0,126.1,27.05,194.0,15
CDM,97799GOLWE,GOLF EVAL W/VIDEO ANALYSIS (MASTERS PKG),323.0,209.95,27.05,323.0,15
CDM,97799GROWE,"GROUP PRG INITIATION (PRE-POST-TESTS,HEP)",56.0,36.4,27.05,56.0,15
CDM,97799HOLWE,HOLE IN ONE PACKAGE,471.0,306.15,27.05,471.0,15
CDM,97799INDWE,INDIVIDUAL BASEBALL TRAINING,72.0,46.8,27.05,72.0,15
CDM,97799JUMWE,JUMP RIGHT GROUP TRAINING SESSIONS,30.0,19.5,15.0,32.46,15
CDM,97799MASWE,MASTERS GOLF PACKAGE,323.0,209.95,27.05,323.0,15
CDM,97799MATWE,MATCH PLAY PACKAGE,410.0,266.5,27.05,410.0,15
CDM,97799METWE,METABOLISM MEASURE INDIRECT CALORIMETRY,148.0,96.2,27.05,148.0,15
CDM,97799NUTWE,NUTRITION CONSULT&PERSONAL TRAIN SESSION,210.0,136.5,27.05,210.0,15
CDM,97799PERWE,PERSONAL TRAINING 6 SESSIONS,387.0,251.55,27.05,387.0,15
CDM,97799SPEWE,SPEECH & VOICE ENHNCMNT SESSION 2,175.0,113.75,27.05,175.0,15
CDM,97799SPOWE,SPORTS NUTRITION COMPREHENSIVE EVAL,148.0,96.2,27.05,148.0,15
CDM,97799SUPWE,SUPERVISED FITNESS PER MONTH,86.0,55.9,27.05,86.0,15
CDM,97799THRWE,THROW RIGHT INIT EVAL & VIDEO ANALYSIS,297.0,193.05,27.05,297.0,15
CDM,97799VIDWE,RE-VIDEO AND TRAINING,68.0,44.2,27.05,68.0,15
CDM,97802MEDWE,"MEDICAL NUTRITION, INDIVIDUAL,INT. 15 MIN",212.0,137.8,17.83,159.0,32
CDM,97802WE,MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI,212.0,137.8,17.83,159.0,32
CDM,97802WEIWE,WEIGHT LOSS NUTRITION VISIT,212.0,137.8,17.83,159.0,32
CDM,97803WE,MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M,180.0,117.0,15.26,135.0,32
CDM,97804MEDWE,"MEDICAL NUTRITION THERAPY,GROUP EACH 30MI",100.0,65.0,8.18,75.0,32
CDM,97804WE,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,100.0,65.0,8.18,75.0,32
CDM,97813WE,ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,76.0,49.4,27.85,59.03,32
CDM,97999BIOWE,BIOMEDIC 21-DAY INTENSIVE WRINKLE,165.0,107.25,82.5,165.0,12
CDM,97999CCFWE,CCF BENZOYL 2.5% SHAVE CREAM,16.0,10.4,8.0,16.0,12
CDM,97999COMWE,COMPLEX B HQ PLUS 2OZ 4%HQ AHA,56.0,36.4,28.0,56.0,12
CDM,97999DIRWE,DIROSEAL,45.0,29.25,22.5,45.0,12
CDM,97999ELTWE,ELTA MD UV DAILY SPF 40 PUMP 1.7 OZ,28.0,18.2,14.0,28.0,12
CDM,97999GLYWE,GLYTONE BODY LOTION,33.0,21.45,16.5,33.0,12
CDM,97999ILLWE,ILLUMINATING EYE SERUM,73.0,47.45,36.5,73.0,12
CDM,97999LIPWE,LIPIKAR BODY EMOLLIENT LOTION 6.8 OZ,20.0,13.0,10.0,20.0,12
CDM,97999NEOWE,NEOVA NIGHT THERAPY,65.0,42.25,32.5,65.0,12
CDM,97999POSWE,POST SURGERY,41.0,26.65,20.5,41.0,12
CDM,97999PREWE,PRE SURGERY PRO,101.0,65.65,50.5,101.0,12
CDM,97999RETWE,RETRINOL 0.1% CREAM,58.0,37.7,29.0,58.0,12
CDM,97999ROSWE,ROSALIAC ANTI-REDNESS MOISTURIZER,33.0,21.45,16.5,33.0,12
CDM,97999SLCWE,T1-SILC SHEER SPF 45 4OZ,56.0,36.4,28.0,56.0,12
CDM,97999SPFWE,T1-SIL GT SPF 60 4OZ,32.0,20.8,16.0,32.0,12
CDM,97999STRWE,STRIA,67.0,43.55,33.5,67.0,12
CDM,97999SUNWE,SUNSTICK SPF 15,9.0,5.85,4.5,9.0,12
CDM,97999THEWE,THERMAL SPRING WATER,12.0,7.8,6.0,12.0,12
CDM,97999TLTWE,TL TAN SUNLESS TANNING LOTION,31.0,20.15,15.5,31.0,12
CDM,97999TOLWE,TOLERINE FACIAL FLUID,22.0,14.3,11.0,22.0,12
CDM,97999VANWE,VANICREAM CLEANSING BAR,6.0,3.9,3.0,6.0,12
CDM,97999Z SWE,Z SILE SUNBLOCK SPF 30 3.5 OZ,32.0,20.8,16.0,32.0,12
CDM,9800098WE,STANDARD CL EVAL,55.0,35.75,27.5,117.56,21
CDM,98000WE,SYNCHRONOUS AUDIO-VIDEO VISIT NEW SF MDM 15 MIN,372.0,241.8,32.03,279.0,17
CDM,98001WE,SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?LOW MDM 30 MIN,640.0,416.0,55.31,480.0,17
CDM,98002WE,SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?MOD MDM 45 MIN,1040.0,676.0,89.74,780.0,17
CDM,9800303WE,VIDEO HEAD IMPULSE TEST (COMP CODE 92541),172.0,111.8,39.43,172.0,15
CDM,9800357WE,EGD/EUS GASTROJAJUNOSTOMY LAMS (COMP 43266 AND 43237),5000.0,3250.0,899.6,5000.0,15
CDM,98003WE,SYNCHRONOUS?AUDIO-VIDEO?VST NEW?HIGH MDM 60 MIN,1400.0,910.0,169.46,1050.0,16
CDM,9800441WE,MRI-TRUS FUSION-GUIDED PROSTRATE BIOPSY,1347.0,875.55,69.93,1347.0,13
CDM,9800442WE,"VIRTUAL INITIAL HOSPITAL CARE, E&M (30 MIN)",652.0,423.8,47.83,652.0,35
CDM,9800443WE,VIRTUAL 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES,1040.0,676.0,64.28,1040.0,35
CDM,9800444WE,1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES,1400.0,910.0,94.19,1400.0,35
CDM,9800445WE,VIRTUAL  SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES,400.0,260.0,18.41,400.0,35
CDM,9800446WE,VIRTUAL SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES,636.0,413.4,33.87,636.0,35
CDM,9800447WE,VIRTUAL SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES,960.0,624.0,48.66,960.0,35
CDM,9800449WE,IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES,600.0,390.0,37.22,600.0,24
CDM,9800450WE,VIRTUAL INPATIENT CONSULTATION SERVICES (45 MIN),880.0,572.0,54.42,880.0,24
CDM,9800451WE,IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES,1197.0,778.05,78.41,1197.0,24
CDM,9800452WE,IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES,1698.0,1103.7,94.85,1698.0,24
CDM,9800459WE,VIRTUAL VISIT PSYCH DIAGNOSTIC EVAL,1536.0,998.4,73.28,1152.0,31
CDM,9800460WE,VIRTUAL VISIT PSYTX PT&/FAMILY 30 MINS,744.0,483.6,33.8,558.0,31
CDM,9800461WE,VIRTUAL VISIT PSYTX PT&/FAMILY 45 MINS,980.0,637.0,46.96,735.0,31
CDM,9800462WE,VIRTUAL VISIT PSYTX PT&/FAMILY 60 MINS,1452.0,943.8,71.98,1089.0,31
CDM,9800463WE,VIRTUAL VISIT FAMILY PSYTX W/PATIENT,1096.0,712.4,64.32,822.0,35
CDM,9800464WE,VIRTUAL VISIT GROUP PSYCHOTHERAPY,260.0,169.0,22.21,195.0,35
CDM,9800476WE,OD EST ONLINE E&M LEVEL 1,79.0,51.35,5.59,59.25,35
CDM,9800477WE,OD EST ONLINE E&M LEVEL 2,280.0,182.0,17.42,210.0,35
CDM,9800478WE,OD EST ONLINE E&M LEVEL 3,520.0,338.0,32.05,390.0,35
CDM,9800479WE,OD EST ONLINE E&M LEVEL 4,768.0,499.2,47.02,576.0,35
CDM,9800480WE,OD EST ONLINE E&M LEVEL 5,1120.0,728.0,69.86,840.0,35
CDM,9800482WE,OD NEW ONLINE E&M LEVEL 2,372.0,241.8,23.51,279.0,35
CDM,9800483WE,OD NEW ONLINE E&M LEVEL 3,640.0,416.0,40.11,480.0,35
CDM,9800484WE,OD NEW ONLINE E&M LEVEL 4,1040.0,676.0,64.93,780.0,35
CDM,9800485WE,OD NEW ONLINE E&M LEVEL 5,1400.0,910.0,88.11,1050.0,35
CDM,9800489WE,"VIRTUAL VISIT MNT, INITIAL, EA. 15 MIN INCREMENT 97802",212.0,137.8,17.83,159.0,32
CDM,9800490WE,"SCLEROTHERAPY/VARICOSE VEINS, SINGLE VEIN",225.0,146.25,36.49,254.09,35
CDM,9800491WE,"SCHLEROTHERAPY/VARICOSE VEINS, MULTIPLE VEINS",500.0,325.0,55.05,375.0,35
CDM,9800492WE,SCLEROTHERAPY/SPIDER VEINS-SINGLE OR MULTIPLE INJECTIONS,350.0,227.5,31.27,350.0,15
CDM,9800495WE,LAYER CLOSURE OF EAR LOBES,415.0,269.75,81.21,430.78,35
CDM,9800496WE,LASER RESURFACING/PARTIAL FACE,650.0,422.5,325.0,845.79,34
CDM,9800497WE,LASER RESURFACING/OTHER THAN FACE,600.0,390.0,300.0,919.81,31
CDM,9800498WE,LASER CVP LESIONS,300.0,195.0,143.39,543.71,35
CDM,98004WE,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?SF MDM 10 MIN,280.0,182.0,23.98,210.0,17
CDM,9800502WE,TATTOO REMOVAL,300.0,195.0,150.0,695.01,31
CDM,9800503WE,MICRODERMABRASION,300.0,195.0,150.0,695.01,31
CDM,9800525WE,VIRTUAL VISIT DIAGNOSTIC EVAL W/MEDICAL  (PSYCHIATRISTS/MID LEVE,1664.0,1081.6,83.51,1248.0,31
CDM,9800528WE,PREP F/U 30 MIN (SELF PAY),60.0,39.0,27.05,60.0,15
CDM,9800530WE,PREP F/U 45 MIN (SELF PAY),80.0,52.0,27.05,80.0,15
CDM,9800531WE,PREP F/U 60 MIN (SELF PAY),100.0,65.0,27.05,100.0,15
CDM,98005WE,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?LOW MDM 20 MIN,520.0,338.0,44.61,390.0,17
CDM,9800635WE,JOINT VENTURE DIGITAL SECOND OPINION,500.0,325.0,250.0,500.0,12
CDM,9800675WE,"VIRTUAL VISIT MNT, RE ASSES, EA. 15 MIN INCREMENT 97803",180.0,117.0,15.26,135.0,32
CDM,9800676WE,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN,100.0,65.0,10.37,75.0,31
CDM,9800677WE,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN,200.0,130.0,20.72,150.0,31
CDM,9800678WE,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN,300.0,195.0,29.79,225.0,31
CDM,9800683WE,VV OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,475.0,308.75,32.22,356.25,24
CDM,9800684WE,VV OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,720.0,468.0,45.37,540.0,24
CDM,9800685WE,VV OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,1076.0,699.4,72.49,807.0,24
CDM,9800686WE,VV OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,1500.0,975.0,89.76,1125.0,24
CDM,9800687WE,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 5-10 MINUTES,65.0,42.25,9.89,48.75,28
CDM,9800688WE,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 11-20 MINUTES,80.0,52.0,20.31,60.0,28
CDM,9800689WE,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 21+ MINUTES,120.0,78.0,32.36,90.0,28
CDM,98006WE,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?MOD MDM 30 MIN,768.0,499.2,66.5,576.0,17
CDM,9800702WE,"VV MNT GROUP, EA. 30 MIN",100.0,65.0,8.18,75.0,32
CDM,9800748WE,VIRTUAL MGMT DIABETES SNGL 30 MIN,77.0,50.05,23.12,77.0,20
CDM,9800776WE,JV MULTIDISCIPLINARY BOARD REVIEW,700.0,455.0,350.0,700.0,12
CDM,98007WE,SYNCHRONOUS AUDIO-VIDEO VST EST HIGH MDM 40 MIN,1040.0,676.0,126.19,780.0,16
CDM,9800812WE,BARIATRIC NUTRITION INITIAL,342.0,222.3,171.0,342.0,12
CDM,9800813WE,NUTRITION PROBLEM FOCUSED,212.0,137.8,106.0,212.0,12
CDM,9800844WE,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,65.0,42.25,9.89,48.75,28
CDM,9800845WE,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,80.0,52.0,20.31,60.0,28
CDM,9800846WE,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,120.0,78.0,32.36,90.0,28
CDM,9800871WE,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,65.0,42.25,10.7,65.0,27
CDM,9800881WE,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,80.0,52.0,19.72,80.0,27
CDM,9800891WE,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,120.0,78.0,30.08,90.0,27
CDM,98008WE,SYNCHRONOUS AUDIO-ONLY VISIT NEW SF MDM 15 MIN,360.0,234.0,30.6,270.0,17
CDM,9800911WE,VV?PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN,356.0,231.4,28.53,356.0,17
CDM,9800912WE,VIRTUAL IP/OBS DISCHARGE =/<30 MIN,600.0,390.0,34.19,600.0,35
CDM,9800913WE,VIRTUAL IP/OBS DISCHARGE DAY > 30 MIN,860.0,559.0,49.97,860.0,35
CDM,9800917WE,VIRTUAL PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES,268.0,174.2,21.73,201.0,17
CDM,9800941WE,VV THERAPEUTIC EXERCISE PT (97110),198.0,128.7,17.96,198.0,32
CDM,9800942WE,VV NEUROMUSCULAR EDUCATION PT (97112),220.0,143.0,18.5,220.0,32
CDM,9800943WE,VV GAIT TRAINING THERAPY PT (97116),198.0,128.7,15.74,198.0,32
CDM,9800944WE,VV EVALUATION LOW COMPLEXITY PT (97161),616.0,400.4,68.99,616.0,28
CDM,9800945WE,VV EVALUATION MODERATE COMPLEXITY PT (97162),616.0,400.4,68.99,616.0,28
CDM,9800946WE,VV EVALUATION HIGH COMPLEXITY PT (97163),616.0,400.4,68.99,616.0,28
CDM,9800947WE,VV THERAPEUTIC ACTIVITIES PT (97530),176.0,114.4,19.28,176.0,32
CDM,9800948WE,VV SELF-CARE HOME MANAGEMENT PT (97535),180.0,117.0,23.37,180.0,32
CDM,9800949WE,VV THERAPEUTIC EXERCISE OT (97110),198.0,128.7,17.96,198.0,32
CDM,9800950WE,VV NEUROMUSCULAR EDUCATION OT (97112),220.0,143.0,18.5,220.0,32
CDM,9800951WE,VV EVALUATION LOW COMPLEXITY OT (97161),616.0,400.4,68.99,616.0,28
CDM,9800952WE,VV EVALUATION MODERATE COMPLEXITY OT (97162),616.0,400.4,68.99,616.0,28
CDM,9800953WE,VV EVALUATION HIGH COMPLEXITY OT (97163),616.0,400.4,68.99,616.0,28
CDM,9800954WE,VV SELF-CARE HOME MANAGEMENT OT (97535),180.0,117.0,23.37,180.0,32
CDM,9800955WE,VV SPEECH THERAPY (92507),520.0,338.0,54.37,520.0,32
CDM,9800956WE,VV FLUENCY EVALUATION (92521),896.0,582.4,84.85,896.0,28
CDM,9800957WE,VV SOUND PRODUCTION EVALUATION (92522),768.0,499.2,69.05,768.0,28
CDM,9800958WE,VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVALUATION (92523),1536.0,998.4,143.21,1536.0,28
CDM,9800959WE,VV VOICE EVALUATION (92524),768.0,499.2,72.11,768.0,28
CDM,9800980WE,JYNNEOS VACCINE (MPOX) 0.5 ML,785.7,510.71,247.34,785.7,13
CDM,9800981WE,VV HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,920.0,598.0,87.9,690.0,27
CDM,9800982WE,VV HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,636.0,413.4,60.41,477.0,27
CDM,9800983WE,VV HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,220.0,143.0,20.49,165.0,27
CDM,9800984WE,VV PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,46.0,29.9,2.54,46.0,28
CDM,9800985WE,VV CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,2.54,89.0,28
CDM,9800986WE,VV HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,92.0,59.8,9.63,69.0,27
CDM,9800987WE,VV HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,44.0,28.6,4.03,33.0,27
CDM,9800988WE,VV HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,680.0,442.0,63.76,510.0,27
CDM,9800989WE,VV HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,240.0,156.0,23.11,180.0,27
CDM,9800990WE,VV HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,600.0,390.0,72.15,450.0,16
CDM,9800991WE,VV HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,216.0,140.4,25.96,162.0,16
CDM,9800992WE,VV HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN (99234),800.0,520.0,61.98,800.0,35
CDM,9800993WE,VV HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN (99235),1296.0,842.4,80.1,1296.0,35
CDM,9800994WE,VV HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN (99236),1720.0,1118.0,100.61,1720.0,35
CDM,98009WE,SYNCHRONOUS AUDIO-ONLY VISIT NEW LOW MDM 30 MIN,620.0,403.0,53.15,465.0,17
CDM,9801018WE,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?SF MDM 15 MIN,372.0,241.8,32.03,279.0,17
CDM,9801019WE,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?LOW MDM 30 MIN,640.0,416.0,55.31,480.0,17
CDM,9801020WE,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?MOD MDM 45 MIN,1040.0,676.0,89.74,780.0,17
CDM,9801021WE,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VST NEW?HIGH MDM 60 MIN,1400.0,910.0,169.46,1050.0,16
CDM,9801022WE,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?SF MDM 10 MIN,280.0,182.0,23.98,210.0,17
CDM,9801023WE,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?LOW MDM 20 MIN,520.0,338.0,44.61,390.0,17
CDM,9801024WE,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?MOD MDM 30 MIN,768.0,499.2,66.5,576.0,17
CDM,9801025WE,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?HIGH MDM 40 MIN,1120.0,728.0,126.19,840.0,16
CDM,9801027WE,JELMYTO INSTILLATION VIA NEPHROSTOGRAM/URETEROGRAM,1160.0,754.0,128.34,870.0,31
CDM,9801028WE,"JELMYTO INSTILLATION , ANTEGRADE VIA EXISTING ACCESS",440.0,286.0,50.65,330.0,31
CDM,9801029WE,JELMYTO INSTILLATION W/O NEPHROSTOGRAM/URETEROGRAM,784.0,509.6,69.03,588.0,35
CDM,9801030WE,"JELMYTO INSTILLATION, RETROGRADE VIA CYSTOURETHROSCOPY",1043.0,677.95,63.29,782.25,35
CDM,98010WE,SYNCHRONOUS AUDIO-ONLY VISIT NEW MOD MDM 45 MIN,968.0,629.2,83.82,726.0,17
CDM,9801191WE,PRP WITH EXOMES,1435.0,932.75,717.5,1496.99,13
CDM,98011WE,SYNCHRONOUS AUDIO-ONLY VISIT NEW HIGH MDM 60 MIN,1280.0,832.0,154.49,960.0,16
CDM,98012WE,SYNCHRONOUS AUDIO-ONLY VISIT EST SF MDM 10 MIN,260.0,169.0,22.54,195.0,17
CDM,98013WE,SYNCHRONOUS AUDIO-ONLY VISIT EST LOW MDM 20 MIN,480.0,312.0,41.05,360.0,17
CDM,98014WE,SYNCHRONOUS AUDIO-ONLY VISIT EST MOD MDM 30 MIN,700.0,455.0,60.79,525.0,17
CDM,98015WE,SYNCHRONOUS AUDIO-ONLY VISIT EST HIGH MDM 40 MIN,1040.0,676.0,126.19,780.0,16
CDM,98016WE,BRIEF COMMUNICATION TECH-BSD SVC EST PT 5-10 MIN,132.0,85.8,10.67,99.0,25
CDM,98925WE,"OSTEOPATHIC MANIP,1-2 BODY REGN",202.0,131.3,11.34,151.5,35
CDM,98926WE,"OSTEOPATHIC MANIP,3-4 BODY REGN",312.0,202.8,16.93,234.0,35
CDM,98927WE,"OSTEOPATHIC MANIP,5-6 BODY REGN",422.0,274.3,22.35,316.5,35
CDM,98928WE,"OSTEOPATHIC MANIP,7-8 BODY REGN",532.0,345.8,28.27,399.0,35
CDM,98929WE,"OSTEOPATHIC MANIP,9-10 BODY REGN",642.0,417.3,34.03,481.5,35
CDM,98970WE,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 5-10 MIN,65.0,42.25,10.7,65.0,27
CDM,98971WE,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 11-20 MIN,80.0,52.0,19.72,80.0,27
CDM,98972WE,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 21+ MIN,120.0,78.0,30.08,90.0,27
CDM,98978WE,REM THER MNTR DEV SPLY DATA COG BHV THER EA 30 D,258.0,167.7,81.11,258.0,13
CDM,98979WE,RTM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,329.0,213.85,11.69,329.0,21
CDM,98985WE,RTM DEV SPLY DATA MUSCSKEL SYS 2-15 D IN 30D PD,59.0,38.35,29.5,89.39,21
CDM,98986WE,RTM DEV SPLY DATA CBT 2-15 DAYS IN 30 D PD,258.0,167.7,129.0,258.0,12
CDM,99000WE,HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB,39.0,25.35,2.34,39.0,13
CDM,99001WE,HANDLG&/OR CONVEY OF SPEC FOR TR FROM PT TO LAB,48.0,31.2,2.76,48.0,13
CDM,99050WE,SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS,143.0,92.95,7.95,143.0,17
CDM,99056WE,SVC TYPICAL PRV OFFICE PRV OUT OFFICE REQUEST PT,255.0,165.75,30.94,255.0,13
CDM,99058WE,SVC PRV EMER BASIS IN OFFICE DISRUPTING SVCS,211.0,137.15,37.88,211.0,13
CDM,99070ADVWE,ADVCD HYDRATING CMLX CRM - ALLERGAN,63.0,40.95,31.5,63.0,12
CDM,99070AFFWE,AFFIRM 1X,32.0,20.8,16.0,32.0,12
CDM,99070AHAWE,AHA ENHANCED GEL (15%),35.0,22.75,17.5,35.0,12
CDM,99070ALLWE,ALLYVN DRESSING,25.0,16.25,12.5,25.0,12
CDM,99070BATWE,BATTERIES,4.0,2.6,2.0,4.0,12
CDM,99070BBLWE,"BB,LEUKOCYTE FILTER RBC",33.0,21.45,16.5,33.0,12
CDM,99070BBWE,"BB,LEUKOCYTE FILTER,PLT",116.0,75.4,58.0,116.0,12
CDM,99070BICWE,BICROS ITE HEARING AID,1262.0,820.3,631.0,1262.0,12
CDM,99070BODWE,BODY ADHESIVE,6.0,3.9,3.0,6.0,12
CDM,99070BONWE,BONE CONDUCT HEARING AID,1133.0,736.45,566.5,1133.0,12
CDM,99070CALWE,CALCITEST,24.0,15.6,12.0,24.0,12
CDM,99070CAPWE,CAPTURE THE MAGIC,99.0,64.35,49.5,99.0,12
CDM,99070CONWE,CONSTRICTION BANDS,12.0,7.8,6.0,12.0,12
CDM,99070CORWE,CORS ITE HEARING AID,1230.0,799.5,615.0,1230.0,12
CDM,99070COTWE,COTY SPF 58 SUNBLOCK,32.0,20.8,16.0,32.0,12
CDM,99070CROWE,CROS BTE HEARING AID,1165.0,757.25,582.5,1165.0,12
CDM,99070DAIWE,DAILY LIP REJUVENATOR,8.0,5.2,4.0,8.0,12
CDM,99070DERWE,DERMAL REPAIR,93.0,60.45,46.5,93.0,12
CDM,99070DIAWE,DIAPHARGM,33.0,21.45,16.5,33.0,12
CDM,99070DUOWE,DUODERM 8 X 8,24.0,15.6,12.0,24.0,12
CDM,99070FACWE,FACIAL CLEANSER - ALLERGAN,37.0,24.05,18.5,37.0,12
CDM,99070FREWE,FREE & CLEAR CONDITIONER,9.0,5.85,4.5,9.0,12
CDM,99070GLYWE,GLYCOLIC CHEM PEEL KIT II ALLERGAN,128.0,83.2,64.0,128.0,12
CDM,99070HALWE,HALF SHELL HEARING AID,2200.0,1430.0,1100.0,2200.0,12
CDM,99070HELWE,HELIX HEARING AID MONAURA,2200.0,1430.0,1100.0,2200.0,12
CDM,99070MITWE,MITRAFLEX 4 X 4,8.0,5.2,4.0,8.0,12
CDM,99070MULWE,MULTICROS BTE,1165.0,757.25,582.5,1165.0,12
CDM,99070OLIWE,OLIGOSPERMIA CUP,61.0,39.65,30.5,61.0,12
CDM,99070OPTWE,OPTI CHAMBER,17.0,11.05,8.5,17.0,12
CDM,99070OVUWE,OVUSTICK,61.0,39.65,30.5,61.0,12
CDM,99070POSWE,POST PEEL NUTRICREAM,32.0,20.8,16.0,32.0,12
CDM,99070PRPWE,PRP KIT - SUPPLY,307.0,199.55,153.5,307.0,12
CDM,99070REJWE,REJUVENATING EYE CRM -ALLERGAN,67.0,43.55,33.5,67.0,12
CDM,99070ROBWE,ROBATHOL BATH OIL,8.0,5.2,4.0,8.0,12
CDM,99070SANWE,SANICREAM SUNSCREEN SPF 15,13.0,8.45,6.5,13.0,12
CDM,99070SKIWE,SKIN REJUVENATION LOTION I ALLERGAN,58.0,37.7,29.0,58.0,12
CDM,99070STOWE,STOCKING AIDE,39.0,25.35,19.5,39.0,12
CDM,99070SUPWE,SUPPORT HOSE; ULCER CARE,104.0,67.6,52.0,104.0,12
CDM,99070SURWE,SURGICAL SUPPLY KIT,128.0,83.2,64.0,128.0,12
CDM,99070TINWE,TINNITUS AID MASKER ITE B,2060.0,1339.0,1030.0,2060.0,12
CDM,99070TMSWE,TMS RECOVERY COMPLEX,160.0,104.0,80.0,160.0,12
CDM,99070TOTWE,TOTAL BLOCK SPF 60 SUNBLOCK,32.0,20.8,16.0,32.0,12
CDM,99070ULTWE,ULTRA SHEER MOISTURIZER,37.0,24.05,18.5,37.0,12
CDM,99070UPLWE,UPLIFTING EYE CREAM,44.0,28.6,22.0,44.0,12
CDM,99070VAGWE,VAGNIAL DILATOR,260.0,169.0,130.0,260.0,12
CDM,99070VANWE,VANICREAM SUNSCREEN SPF 35,13.0,8.45,6.5,13.0,12
CDM,99070VITWE,VITAMIN C COMPLEX,76.0,49.4,38.0,76.0,12
CDM,99070WE,SUPPLIES&MATERIALS ABOVE/BEYOND PROV BY PHYS/QHP,49.0,31.85,24.5,49.0,12
CDM,99071WE,EDUCATIONAL SUPPLIES PRV BY THE PHYS AT COST,16.0,10.4,8.0,16.0,12
CDM,99078CHOWE,CHOLESTEROL TRIG/HEART DZ 4 CLASS 1HOUR,222.0,144.3,42.75,222.0,13
CDM,99078GROWE,GROUP HEALTH EDUCATION,222.0,144.3,42.75,222.0,13
CDM,99078PHYWE,"PHYSICIAN EDUCATIONAL SRV, GROUP",222.0,144.3,42.75,222.0,13
CDM,99078WE,PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING,79.0,51.35,39.5,79.0,13
CDM,99078WEIWE,WEIGHT LOSS CLASSES (8),222.0,144.3,42.75,222.0,13
CDM,99080WE,SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG,129.0,83.85,64.5,129.0,12
CDM,99082WE,UNUSUAL PHYSICIAN TRAVEL,99.0,64.35,3.82,99.0,13
CDM,99100WE,ANESTHESIA EXTREME AGE PATIENT UNDER 1 YR/<,136.0,88.4,53.0,136.0,17
CDM,99116WE,ANES COMPLICJ UTILIZATION TOTAL BODY HYPOTHERMIA,133.0,86.45,53.0,133.0,17
CDM,99135WE,ANES COMPLICJ UTILIZATION CONTROLLED HYPOTENSION,136.0,88.4,53.0,136.0,17
CDM,99140WE,ANES COMPLICJ EMERGENCY CONDITIONS SPECIFY,137.0,89.05,53.0,137.0,17
CDM,99151WE,MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS,220.0,143.0,18.68,165.0,31
CDM,99152WE,MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,110.0,71.5,9.6,82.5,31
CDM,99153WE,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,110.0,71.5,8.19,110.0,31
CDM,99155WE,MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS,760.0,494.0,62.81,760.0,31
CDM,99156WE,MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS,660.0,429.0,56.17,660.0,31
CDM,99157WE,MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS,500.0,325.0,43.66,500.0,31
CDM,99195WE,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,368.0,239.2,49.48,368.0,35
CDM,99199GWE,NUTRITIONAL COUNSELING,94.0,61.1,47.0,94.0,12
CDM,99202FAMWE,NEW PATIENT VISIT LEVEL 2,372.0,241.8,23.51,279.0,35
CDM,99202LV2WE,OFFICE VISIT NEW LVL 2,372.0,241.8,23.51,279.0,35
CDM,99202NEWWE,OV NEW PATIENT LEVEL II,372.0,241.8,23.51,279.0,35
CDM,99202OFFWE,OFFC VISIT NEW EXPANDED,372.0,241.8,23.51,279.0,35
CDM,99202WE,OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES,372.0,241.8,23.51,279.0,35
CDM,99203FAMWE,NEW PATIENT VISIT LEVEL 3,640.0,416.0,40.11,480.0,35
CDM,99203LV3WE,OFFICE VISIT NEW  LVL 3,640.0,416.0,40.11,480.0,35
CDM,99203NEWWE,OV NEW PATIENT LEVEL III,640.0,416.0,40.11,480.0,35
CDM,99203WE,OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES,640.0,416.0,40.11,480.0,35
CDM,99204FAMWE,NEW PATIENT VISIT LEVEL 4,1040.0,676.0,64.93,780.0,35
CDM,99204NEWWE,OFFICE VISIT NEW  LVL 4,1040.0,676.0,64.93,780.0,35
CDM,99204WE,OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES,1040.0,676.0,64.93,780.0,35
CDM,99205FAMWE,NEW PATIENT VISIT LEVEL  5,1400.0,910.0,88.11,1050.0,35
CDM,99205LV5WE,OV NEW PATIENT LEVEL V,1400.0,910.0,88.11,1050.0,35
CDM,99205OFFWE,OFFICE VISIT NEW  LVL  5,1400.0,910.0,88.11,1050.0,35
CDM,99205WE,OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES,1400.0,910.0,88.11,1050.0,35
CDM,99211AWE,EST PATIENT VISIT LEVEL 1,79.0,51.35,5.59,59.25,35
CDM,99211ES1WE,OFFICE VISIT EST  LVL 1,79.0,51.35,5.59,59.25,35
CDM,99211OV 1WE,OV EST PATIENT LEVEL I,79.0,51.35,5.59,59.25,35
CDM,99211WE,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,79.0,51.35,5.59,59.25,35
CDM,99212AWE,EST PATIENT VISIT LEVEL 2,280.0,182.0,17.42,210.0,35
CDM,99212ES2WE,OFFICE VISIT EST LVL 2,280.0,182.0,17.42,210.0,35
CDM,99212WE,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN,280.0,182.0,17.42,210.0,35
CDM,99213AWE,EST PATIENT VISIT LEVEL 3,520.0,338.0,32.05,390.0,35
CDM,99213ESTWE,EST OFC VISIT BARIATRIC NUTRITIONAL,520.0,338.0,32.05,390.0,35
CDM,99213OV3WE,OFFICE VISIT LVL 3,520.0,338.0,32.05,390.0,35
CDM,99213WE,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN,520.0,338.0,32.05,390.0,35
CDM,99214AWE,EST PATIENT VISIT LEVEL 4,768.0,499.2,47.02,576.0,35
CDM,99214ES4WE,OFFICE VISIT EST LVL 4,768.0,499.2,47.02,576.0,35
CDM,99214OV4WE,OV EST PATIENT LEVEL IV,768.0,499.2,47.02,576.0,35
CDM,99214WE,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN,768.0,499.2,47.02,576.0,35
CDM,99215AWE,EST PATIENT VISIT LEVEL 5,1120.0,728.0,69.86,840.0,35
CDM,99215ES5WE,OFFICE VISIT EST LVL 5,1120.0,728.0,69.86,840.0,35
CDM,99215WE,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN,1120.0,728.0,69.86,840.0,35
CDM,992170BSWE,0BSERVATION CARE DISCHARGE,1009.0,655.85,59.73,1009.0,16
CDM,99217DISWE,DISCHARGE/OBSERVATION CARE MGMT,1009.0,655.85,59.73,1009.0,16
CDM,99221AIWE,"INITIAL HOSPITAL CARE, LEVEL I",652.0,423.8,47.83,652.0,35
CDM,99221WE,1ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES,652.0,423.8,47.83,652.0,35
CDM,99222WE,1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES,1040.0,676.0,64.28,1040.0,35
CDM,99231WE,SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES,400.0,260.0,18.41,400.0,35
CDM,99232WE,SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES,636.0,413.4,33.87,636.0,35
CDM,99233WE,SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES,960.0,624.0,48.66,960.0,35
CDM,99234WE,HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN,800.0,520.0,61.98,800.0,35
CDM,99235WE,HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN,1296.0,842.4,80.1,1296.0,35
CDM,99236WE,HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN,1720.0,1118.0,100.61,1720.0,35
CDM,99238WE,HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<,600.0,390.0,34.19,600.0,35
CDM,99239WE,HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN,860.0,559.0,49.97,860.0,35
CDM,99241LV1WE,OFFICE CONSULT LVL 1,175.0,113.75,27.99,175.0,16
CDM,99241OV1WE,OFFICE CONSULT LEVEL I,175.0,113.75,27.99,175.0,16
CDM,99242OFFWE,OFFICE CONSULT LEVEL II,475.0,308.75,32.22,356.25,24
CDM,99242WE,OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,475.0,308.75,32.22,356.25,24
CDM,99243LV3WE,OFFICE CONSULT LEVEL III,720.0,468.0,45.37,540.0,24
CDM,99243OFFWE,OFFICE CONSULT LVL 3,720.0,468.0,45.37,540.0,24
CDM,99243WE,OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,720.0,468.0,45.37,540.0,24
CDM,99244LV4WE,OFFICE CONSULT LEVEL IV,1076.0,699.4,72.49,807.0,24
CDM,99244OFFWE,OFFICE CONSULT LVL 4,1076.0,699.4,72.49,807.0,24
CDM,99244WE,OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,1076.0,699.4,72.49,807.0,24
CDM,99245INIWE,INITIAL COMP BARIATRIC NUTRITIONAL CONSUL,1500.0,975.0,89.76,1125.0,24
CDM,99245LV5WE,OFFICE CONSULT LVL 5,1500.0,975.0,89.76,1125.0,24
CDM,99245OFFWE,OFFICE CONSULT LEVEL V,1500.0,975.0,89.76,1125.0,24
CDM,99245WE,OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,1500.0,975.0,89.76,1125.0,24
CDM,99253WE,IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES,880.0,572.0,54.42,880.0,24
CDM,99281WE,EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP,110.0,71.5,11.7,110.0,35
CDM,99282WE,EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM,409.0,265.85,20.39,409.0,35
CDM,99283WE,EMERGENCY DEPARTMENT VISIT LOW MDM,704.0,457.6,35.8,704.0,35
CDM,99284WE,EMERGENCY DEPARTMENT VISIT MODERATE MDM,1206.0,783.9,59.76,1206.0,35
CDM,99285WE,EMERGENCY DEPARTMENT VISIT HIGH MDM,1760.0,1144.0,89.52,1760.0,35
CDM,99291WE,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,1980.0,1287.0,104.05,1485.0,35
CDM,99292WE,CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN,990.0,643.5,52.28,742.5,35
CDM,99304WE,INITIAL NURSING FACILITY CARE SF/LOW MDM 25 MIN,600.0,390.0,42.25,600.0,35
CDM,99305WE,INITIAL NURSING FACILITY CARE MOD MDM 35 MINUTES,1000.0,650.0,60.99,1000.0,35
CDM,99306WE,INITIAL NURSING FACILITY CARE HI MDM 50 MINUTES,1400.0,910.0,78.25,1400.0,35
CDM,99307WE,SBSQ NURSING FACILITY CARE SF MDM 10 MINUTES,280.0,182.0,20.71,280.0,35
CDM,99308WE,SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES,520.0,338.0,32.72,520.0,35
CDM,99309WE,SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES,768.0,499.2,43.07,768.0,35
CDM,99310WE,SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES,1120.0,728.0,63.45,1120.0,35
CDM,99315WE,NURSING FACILITY DSCHRG MGMT 30 MIN/< TOT TIME,600.0,390.0,34.36,600.0,35
CDM,99316WE,NURSING FACILITY DSCHRG MGMT 30 MIN+ TOT TIME,1000.0,650.0,49.15,1000.0,35
CDM,99341WE,HOME/RES VISIT NEW PATIENT SF MDM 15 MINUTES,440.0,286.0,37.53,440.0,35
CDM,99342WE,HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES,726.0,471.9,53.35,726.0,35
CDM,99344WE,HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES,1263.0,820.95,98.9,1263.0,35
CDM,99345WE,HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES,1707.0,1109.55,119.43,1707.0,35
CDM,99347WE,HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES,396.0,257.4,30.02,396.0,35
CDM,99348WE,HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES,660.0,429.0,44.95,660.0,35
CDM,99349WE,HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES,1074.0,698.1,66.62,1074.0,35
CDM,99350WE,HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES,1584.0,1029.6,96.77,1584.0,35
CDM,99358WE,PROLONGED E&M SERVICE-1ST HOUR,792.0,514.8,88.01,792.0,20
CDM,99359WE,"PROLONGED SERV,NO CONTCT,EA ADD 1/2",330.0,214.5,35.91,330.0,20
CDM,99360WE,"PHYSICIAN STANDBY SERV,EA 30 MIN",480.0,312.0,44.17,480.0,19
CDM,99366WE,TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN,328.0,213.2,34.81,246.0,20
CDM,99374WE,"HOME HEALTH CARE SUPERV,15-29 MIN",440.0,286.0,47.03,330.0,20
CDM,99375WE,CARE PLAN OVERSIGHT/30-60,692.0,449.8,76.04,519.0,20
CDM,99377WE,"HOSPICE CARE SUPERVISION,15-29 MIN",440.0,286.0,47.03,330.0,20
CDM,99378WE,"HOSPICE CARE SUPERVISION,30+ MIN",692.0,449.8,76.9,519.0,20
CDM,99379WE,"NURSING FAC CARE SUPERVN,15-29 MIN",440.0,286.0,47.03,330.0,20
CDM,99380WE,"NURSING FAC CARE SUPERVN,30+ MIN",692.0,449.8,74.03,519.0,20
CDM,99381WE,"PREVENTIVE VISIT,NEW,INFANT",600.0,390.0,39.58,450.0,27
CDM,99382WE,"PREVENTIVE VISIT,NEW,AGE 1-4",640.0,416.0,43.85,480.0,27
CDM,99383SCHWE,PREVENTATIVE 5-11 SCHOOL OR SPORT,680.0,442.0,40.19,510.0,27
CDM,99383VSTWE,PREVENTATIVE VST 5-11YR,680.0,442.0,40.19,510.0,27
CDM,99383WE,"PREVENTIVE VISIT,NEW,AGE5-11",680.0,442.0,40.19,510.0,27
CDM,99384NEWWE,PREV MED VST-NEW 12-17,800.0,520.0,48.5,600.0,27
CDM,99384SCHWE,PREVENTATIVE 12-17 SCHOOL OR SPORT,800.0,520.0,48.5,600.0,27
CDM,99384WE,WELLNESS EXAMS NEW 12-17 YRS,800.0,520.0,48.5,600.0,27
CDM,99385AWE,NEW PREVENTATIVE 99385A- (18YR-39YRS),768.0,499.2,46.52,576.0,27
CDM,99385BWE,NEW PREVENTATIVE MEDICINE 99385B- 18-39 YRS,768.0,499.2,46.52,576.0,27
CDM,99385FAMWE,NEW PREVENTATIVE 18 -39YRS,768.0,499.2,46.52,576.0,27
CDM,99385PREWE,PREVENTATIVE 18-39 SCHOOL OR SPORT,768.0,499.2,46.52,576.0,27
CDM,99385WE,WELLNESS EXAM NEW 18-39 YRS,768.0,499.2,46.52,576.0,27
CDM,99386AWE,NEW PREVENTATIVE 99386A- (40 - 64YRS),932.0,605.8,59.18,699.0,27
CDM,99386BWE,NEW PREVENTATIVE MEDICINE 99386B  40-64 YRS,932.0,605.8,59.18,699.0,27
CDM,99386FAMWE,NEW PREVENTATIVE 40 - 64YRS,932.0,605.8,59.18,699.0,27
CDM,99386PREWE,PREVENTIVE MED E&M VISIT- NEW PT 40-64 YR,932.0,605.8,59.18,699.0,27
CDM,99386WE,WELLNESS EXAMS NEW 40-64 YRS,932.0,605.8,59.18,699.0,27
CDM,99387AWE,NEW PREVENTATIVE 99385A- (65 & OVER),1000.0,650.0,63.58,750.0,27
CDM,99387BWE,NEW PREVENTATIVE MEDICINE 99387- 65 YRS & OVER,1000.0,650.0,63.58,750.0,27
CDM,99387FAMWE,NEW PREVENTATIVE 65+YRS,1000.0,650.0,63.58,750.0,27
CDM,99387PREWE,PREV MED INIT E&M NEW PT; 65 YRS/>,1000.0,650.0,63.58,750.0,27
CDM,99387WE,WELLNESS EXAMS NEW 65+ YRS,1000.0,650.0,63.58,750.0,27
CDM,99391WE,"PREVENTIVE VISIT,EST,INFANT",548.0,356.2,35.52,411.0,27
CDM,99392WE,"PREVENTIVE VISIT,EST,AGE 1-4",600.0,390.0,38.88,450.0,27
CDM,99393PREWE,PREVENTATIVE EST 5-11 SCHOOL OR SPORT,600.0,390.0,36.01,450.0,27
CDM,99393WE,"PREVENTIVE VISIT,EST,AGE5-11",600.0,390.0,36.01,450.0,27
CDM,99394PREWE,PREV MED-EST PT 12-17,680.0,442.0,40.76,510.0,27
CDM,99394WE,"PREVENTIVE VISIT,EST,12-17",680.0,442.0,40.76,510.0,27
CDM,99395AWE,ESTABLISHED PREVENTATIVE 99395A - 18-39YRS,700.0,455.0,41.92,525.0,27
CDM,99395BWE,ESTABLISHED PREVENTATIVE MEDICINE 99395B - 18-39YRS,700.0,455.0,41.92,525.0,27
CDM,99395EHPWE,EHPREV MED EST PT 18-39,700.0,455.0,41.92,525.0,27
CDM,99395FAMWE,EST PREVENTATIVE 18-39YRS,700.0,455.0,41.92,525.0,27
CDM,99395HOLWE,HOLLAND AMERICA EST 18-39,700.0,455.0,41.92,525.0,27
CDM,99395PREWE,PREV MED-EST PT 18-39,700.0,455.0,41.92,525.0,27
CDM,99395WE,WELLNESS EXAMS EST 18-39 YRS,700.0,455.0,41.92,525.0,27
CDM,99396AWE,ESTABLISHED PREVENTATIVE 99396 - 64YRS,760.0,494.0,46.03,570.0,27
CDM,99396BWE,ESTABLISHED PREVENTATIVE MEDICINE 99396B 40-64 YRS,760.0,494.0,46.03,570.0,27
CDM,99396FAMWE,EST PREVENTATIVE 40 - 64YRS,760.0,494.0,46.03,570.0,27
CDM,99396PREWE,PREVENTATIVE EST 40-64 SCHOOL OR SPORT,760.0,494.0,46.03,570.0,27
CDM,99396WE,WELLNESS EXAMS EST 40-64 YRS,760.0,494.0,46.03,570.0,27
CDM,99397AWE,ESTABLISHED PREVENTATIVE 99397A - 65 YRS & OVER,800.0,520.0,48.5,600.0,27
CDM,99397BWE,ESTABLISHED PREVENTATIVE MEDICINE 99397B 65 YRS & OLDER,800.0,520.0,48.5,600.0,27
CDM,99397FAMWE,EST PREVENTATIVE RE-EVAL 65+YRS,800.0,520.0,48.5,600.0,27
CDM,99397PREWE,PREVENTATIVE EST 65 > SCHOOL OR SPORT,800.0,520.0,48.5,600.0,27
CDM,99397WE,WELLNESS EXAMS EST 65+ YRS,800.0,520.0,48.5,600.0,27
CDM,99401WE,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN,192.0,124.8,17.81,144.0,24
CDM,99402PREWE,PREVENT MED COUNSEL 30 MIN,392.0,254.8,29.07,294.0,24
CDM,99402WE,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN,392.0,254.8,29.07,294.0,24
CDM,99403WE,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 MIN,584.0,379.6,43.19,438.0,21
CDM,99404WE,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN,780.0,507.0,59.39,585.0,21
CDM,99406WE,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,96.0,62.4,7.33,72.0,35
CDM,99407WE,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,200.0,130.0,20.94,150.0,35
CDM,99408WE,ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN,260.0,169.0,27.85,195.0,20
CDM,99415WE,PROLNG CLINCL STAFF SVC DURING O/P E/M 1ST HR,273.0,177.45,7.43,273.0,31
CDM,99416WE,PROLNG CLINCL STAFF SVC DURING O/P E/M EA 30 MIN,273.0,177.45,0.69,273.0,31
CDM,99417WE,PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES,268.0,174.2,21.73,201.0,17
CDM,99418WE,PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN,356.0,231.4,28.53,356.0,17
CDM,99421WE,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 5-10 MINUTES,65.0,42.25,9.89,48.75,28
CDM,99422WE,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 11-20 MINUTES,80.0,52.0,20.31,60.0,28
CDM,99423WE,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 21+ MINUTES,120.0,78.0,32.36,90.0,28
CDM,99424WE,PRINCIPAL CARE MGMT SVC 1ST 30 PHYS/QHP CAL MO,580.0,377.0,68.27,435.0,27
CDM,99425WE,PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO,400.0,260.0,46.32,300.0,27
CDM,99437WE,CHRONIC CARE MGMT SVC PHYS EA ADDL 30 MIN CAL MO,440.0,286.0,45.98,330.0,27
CDM,99439WE,CHRONIC CARE MANAGEMENT SERVICES EA ADDL 20 MIN,280.0,182.0,32.31,210.0,30
CDM,99445WE,REM MNTR PHYSIOL PARAM DEV SPLY W/REC 2-15 DAYS,37.0,24.05,18.5,90.53,21
CDM,99446WE,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN,154.0,100.1,13.07,154.0,28
CDM,99447WE,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN,280.0,182.0,25.84,280.0,28
CDM,99448WE,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN,420.0,273.0,39.37,420.0,28
CDM,99449WE,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 31/> MIN,560.0,364.0,52.09,560.0,28
CDM,99451WE,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5/> MIN,280.0,182.0,25.76,280.0,28
CDM,99452WE,NTRPROF PHONE/NTRNET/EHR REFERRAL SVC 30 MIN,280.0,182.0,24.16,280.0,28
CDM,99453WE,REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP,37.0,24.05,13.59,37.0,31
CDM,99454WE,REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D,118.0,76.7,33.96,118.0,31
CDM,99455WE,WORK RELATED/MED DBLT XM TREATING PHYS,193.0,125.45,96.5,193.0,12
CDM,99456MEDWE,"MED DISAB,EXAM OTHE THAN",918.0,596.7,459.0,918.0,12
CDM,99456WE,WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS,918.0,596.7,459.0,918.0,12
CDM,99456WORWE,WORK RELT/DISAB EX-NUT TX,918.0,596.7,459.0,918.0,12
CDM,99457WE,REMOTE PHYSIOLOGIC MONITORING 20 MIN+ PER MONTH,244.0,158.6,24.09,183.0,31
CDM,99458WE,REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO,244.0,158.6,27.66,183.0,31
CDM,99459WE,PELVIC EXAMINATION,53.0,34.45,15.42,53.0,31
CDM,99470WE,RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,136.0,88.4,14.0,136.0,21
CDM,99471WE,INITIAL PED CRITICAL CARE 29 DAYS THRU 24 MONTHS,7031.0,4570.15,565.82,7031.0,35
CDM,99474WE,SELF-MEAS BP 2 READG 1 MIN APART BID 30 DAY PD,72.0,46.8,6.39,54.0,31
CDM,99483WE,ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT,1690.0,1098.5,139.96,1267.5,28
CDM,99484WE,CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS,372.0,241.8,27.71,279.0,30
CDM,99487WE,COMPLX CHRON CARE COORD W/O PT VST 1ST HR PER MO,724.0,470.6,83.27,724.0,27
CDM,99489WE,COMPLX CHRON CARE COORD EA ADDL 30 MIN PER MONTH,400.0,260.0,45.98,400.0,27
CDM,99490WE,CHRONIC CARE MGMT SVCS STAFF 1ST 20 MIN CAL MO,400.0,260.0,38.09,300.0,30
CDM,99491WE,CHRONIC CARE MGMT SVC AT LEAST 30 MIN PER MONTH,600.0,390.0,68.39,600.0,27
CDM,99492WE,1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS,827.0,537.55,86.57,620.25,30
CDM,99493WE,SBSQ PSYCHIATRIC COLLAB CARE MGMT 1ST 60 MINS,902.0,586.3,91.86,676.5,30
CDM,99494WE,1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS,361.0,234.65,37.31,270.75,30
CDM,99495WE,TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE,1112.0,722.8,128.31,834.0,27
CDM,99496WE,TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE,1516.0,985.4,174.09,1137.0,27
CDM,99497WE,ADVANCE CARE PLANNING FIRST 30 MINS,600.0,390.0,53.12,600.0,28
CDM,99498WE,ADVANCE CARE PLANNING EA ADDL 30 MINS,560.0,364.0,50.26,560.0,28
CDM,9949907WE,SPORTS EXAM OR PHYSICAL,35.0,22.75,17.5,35.0,12
CDM,99499CEWE,COSMETIC ESTABLISHED,75.0,48.75,37.5,75.0,12
CDM,99499COSWE,COSMETIC CONSULT,122.0,79.3,61.0,122.0,12
CDM,99499DWE,COSMETIC ASSESSMENT,121.0,78.65,60.5,121.0,12
CDM,99499FOLWE,FOLLOW COSMETIC CONSULT,124.0,80.6,62.0,124.0,12
CDM,99499LASWE,LASIK EVALUATION,194.0,126.1,97.0,194.0,12
CDM,99499MARWE,MARITIME TELEPHONE CONSULT,297.0,193.05,148.5,297.0,12
CDM,99499NSAWE,NO SHOW APPOINTMENT HOLDING FEE VA ONLY,113.0,73.45,56.5,113.0,12
CDM,99499PILWE,PILOT EXAMINATION,124.0,80.6,62.0,124.0,12
CDM,A4215WE,STERILE NEEDLE,252.0,163.8,126.0,252.0,12
CDM,A4263WE,PERMANENT TEAR DUCT PLUG,68.0,44.2,10.63,68.0,13
CDM,A4264WE,PR INTRATUBAL OCCLUSION DEVICE,3891.0,2529.15,1945.5,3891.0,12
CDM,A4270WE,DISPOSABLE ENDOSCOPE SHEATH,135.0,87.75,67.5,135.0,12
CDM,A4310WE,INSERT TRAY W/O BAG/CATH,11.0,7.15,3.58,11.0,17
CDM,A4320WE,IRRIGATION TRAY,7.0,4.55,2.92,7.0,17
CDM,A4338WE,INDWELLING CATHETER LATEX,19.0,12.35,6.7,19.0,17
CDM,A4344WE,CATH INDW FOLEY 2 WAY SILICN,26.0,16.9,8.74,26.0,17
CDM,A4351FEMWE,FEMALE SELF-CATHETER,3.0,1.95,0.99,3.0,17
CDM,A4351STRWE,STRAIGHT ROBINSON,6.0,3.9,0.99,6.0,17
CDM,A4351WE,STRAIGHT TIP URINE CATHETER,3.0,1.95,0.99,3.0,17
CDM,A4352WE,COUDE TIP URINARY CATHETER,9.0,5.85,2.98,9.0,17
CDM,A4357WE,BEDSIDE DRAINAGE BAG,15.0,9.75,5.3,15.0,17
CDM,A4358WE,URINARY LEG BAG,13.0,8.45,3.62,13.0,17
CDM,A4362WE,SOLID SKIN BARRIER,9.0,5.85,1.86,9.0,17
CDM,A4371WE,SKIN BARRIER POWDER PER OZ,12.0,7.8,1.99,12.0,17
CDM,A4450WE,NON-WATERPROOF TAPE,4.0,2.6,0.06,4.0,13
CDM,A4452WE,WATERPROOF TAPE,4.0,2.6,0.21,4.0,13
CDM,A4550SUPWE,SUPPLY TRAY,118.0,76.7,7.84,118.0,13
CDM,A4550SURWE,SURGICAL TRAY,118.0,76.7,7.84,118.0,13
CDM,A4550WE,SURGICAL TRAYS,147.0,95.55,7.84,147.0,13
CDM,A4561WE,"PESSARY RUBBER, ANY TYPE",147.0,95.55,11.24,147.0,17
CDM,A4562WE,"PESSARY, NON RUBBER,ANY TYPE",147.0,95.55,27.94,147.0,17
CDM,A4564WE,"PESSARY, DISPOSABLE, ANY TYPE",76.0,49.4,38.0,76.0,12
CDM,A4565ARMWE,"ARM, ELEVATOR, EACH",60.0,39.0,4.2,60.0,13
CDM,A4565SLIWE,SLINGS AND SWATHE,24.0,15.6,4.2,24.0,13
CDM,A4580ARMWE,"PLASTER CAST; ARM, SHORT",60.0,39.0,30.0,60.0,12
CDM,A4580LEGWE,"PLASTER CAST; LEG, SHORT",60.0,39.0,30.0,60.0,12
CDM,A4580WE,CAST SUPPLIES (PLASTER),76.0,49.4,38.0,76.0,12
CDM,A4590FIBWE,"FIBERGLASS CAST; ARM, SHORT",128.0,83.2,10.36,128.0,13
CDM,A4590FILWE,"FIBERGLASS CAST; ARM, SHORT",63.0,40.95,10.36,63.0,13
CDM,A4590FISWE,"FIBERGLASS CAST; LEG, SHORT",70.0,45.5,10.36,70.0,13
CDM,A4595WE,TENS SUPPL 2 LEAD PER MONTH,103.0,66.95,5.01,103.0,17
CDM,A4614INCWE,INCENTIVE SPIROMETER,67.0,43.55,12.98,67.0,17
CDM,A4614PEAWE,PEAK FLOW METER,31.0,20.15,12.98,31.0,17
CDM,A4614SPAWE,SPACER,18.0,11.7,9.0,25.55,17
CDM,A4614WE,"PEAK EXPIR FLOW METER,HAND HELD",37.0,24.05,12.98,37.0,17
CDM,A4627WE,AEROCHAMBER SPACER WITH MASK,19.0,12.35,4.52,19.0,13
CDM,A4641AERWE,TC 99 DTPA AEROSOL PENTET,52.0,33.8,26.0,52.0,12
CDM,A4641DMSWE,TC-99 SUCCIMER DMSA 10MCI,215.0,139.75,107.5,215.0,12
CDM,A4641INDWE,INDIUM 111 DTPA INCLD DEL,656.0,426.4,328.0,656.0,12
CDM,A4641WE,RADIOISOTOPE I-131 HIPPURAN,825.0,536.25,412.5,825.0,12
CDM,A4648WE,IMPLANTABLE TISSUE MARKER,200.0,130.0,100.0,200.0,12
CDM,A4649CONWE,CONTOUR THREAD; 1 EACH,321.0,208.65,160.5,321.0,12
CDM,A4649MESWE,MESALT GAUZE RIBBON PER YARD,13.0,8.45,6.5,13.0,12
CDM,A4649SURWE,SURGICAL BRA,36.0,23.4,18.0,36.0,12
CDM,A5114WE,FOAM/FABRIC LEG STRAP,14.0,9.1,4.4,14.0,17
CDM,A6021COLWE,COLLAGEN PLUS WOUND DRESSING TO 16 SQ IN,47.0,30.55,11.48,47.0,17
CDM,A6021PROWE,PROMOGRAN PRISMA MATRIX UP TO 16 SQ IN,47.0,30.55,11.48,47.0,17
CDM,A6021WE,COLLAGEN DRESSING <=16 SQ IN,58.0,37.7,11.48,58.0,17
CDM,A6025WE,"SILICONE GEL SHEET, EACH",14.0,9.1,6.51,14.0,13
CDM,A6196ALGWE,ALGINATE DRESSING 4X4 EA.,22.0,14.3,4.02,22.0,17
CDM,A6196AQUWE,"AQUACEL, DRSG.4X4",24.0,15.6,4.02,24.0,17
CDM,A6196WE,"ALGINATE DRESS,<16 SQ IN, EACH",28.0,18.2,4.02,28.0,17
CDM,A6197WE,"ALGINATE DRESS,16-48 SQ IN,EACH",72.0,46.8,8.98,72.0,17
CDM,A6199WE,"ALGINATE DRESSING,FILLER,PER 6 IN",45.0,29.25,2.88,45.0,17
CDM,A6203WE,"COMPOSITE DRESS,<16 SQ IN,EACH",6.0,3.9,1.84,6.0,17
CDM,A6204ALLWE,ALLDRESS W/BORDER 6X6,8.0,5.2,3.4,8.0,17
CDM,A6204RESWE,RESTORE TRIACT 4X5 ABSORBENT DRESSING,13.0,8.45,3.4,13.0,17
CDM,A6204WE,"COMPOSITE DRESS,16-48 SQ IN,EACH",9.0,5.85,3.4,9.0,17
CDM,A6206WE,"CONTACT LAYER,<16 SQ IN, EACH",37.0,24.05,1.2,37.0,13
CDM,A6207NONWE,NON ADHERENT PAD-TELFA 3X4,16.0,10.4,4.01,16.0,17
CDM,A6207RESWE,RESTORE TRIACT 4X5 LAYER,16.0,10.4,4.01,16.0,17
CDM,A6207WE,"CONTACT LAYER,16-48 SQ IN, EACH",20.0,13.0,4.01,20.0,17
CDM,A6209FOAWE,FOAM DRESS W/O ADHESIVE 4X4,10.0,6.5,4.08,10.0,17
CDM,A6209HYDWE,HYDROFERA BLUE 4X4,16.0,10.4,4.08,16.0,17
CDM,A6209POLWE,POLYMEM FOAM DRESS W/O BORDER 4X4,48.0,31.2,4.08,48.0,17
CDM,A6209WE,"FOAM DRESS,<16 SQ IN,NO ADHESIVE,EA",12.0,7.8,4.08,12.0,17
CDM,A6210WE,"FOAM DRESS,16-48 SQ IN,NO ADHESIVE",86.0,55.9,10.88,86.0,17
CDM,A6212WE,"FOAM DRESS,<16 SQ IN,ADHESIVE,EACH",39.0,25.35,5.3,39.0,17
CDM,A6222IODWE,IODOFLEX 0.9% 1 1/4 X 2 1/4,5.0,3.25,1.16,5.0,17
CDM,A6222MESWE,MESALT GAUZE W/O BORDER 3X3,3.0,1.95,1.16,3.0,17
CDM,A6222WE,"GAUZE,IMPREG,<16 SQ IN,NO ADHESV,EA",3.0,1.95,1.16,3.0,17
CDM,A6223WE,"GAUZE,IMPREG,16-48 SQ IN,NO ADHSV,EA",6.0,3.9,1.32,6.0,17
CDM,A6224WE,"GAUZE,IMPREG,>48 SQ IN,NO ADHESV,EA",23.0,14.95,1.96,23.0,17
CDM,A6231WE,HYDROGEL DSG<=16 SQ IN,19.0,12.35,2.55,19.0,17
CDM,A6234DUOWE,DUODERM XTRA THIN 4 X 4,15.0,9.75,3.58,15.0,17
CDM,A6234WE,"HYDROCOLLOID,<16 SQ IN,NO ADHES,EA",6.0,3.9,3.0,7.02,17
CDM,A6237WE,"HYDROCOLLOID,<16 SQ IN,ADHESIVE,EA",19.0,12.35,4.32,19.0,17
CDM,A6248WE,"HYDROGEL,FILLER,GEL,PER FLUID OZ",26.0,16.9,8.87,26.0,17
CDM,A6250AHAWE,AHA OIL FREE LOTION SPF 15,21.0,13.65,0.03,21.0,13
CDM,A6250PERWE,PERLE,68.0,44.2,0.03,68.0,13
CDM,A6250PROWE,PROTECTIVE OINTMENT 8 OZ,34.0,22.1,0.03,34.0,13
CDM,A6253WE,"SPEC ABSORP,>48 SQ IN,NO ADHESV",26.0,16.9,3.46,26.0,17
CDM,A6260WE,"WOUND CLEANSERS, ANY TYPE, ANY SIZE",39.0,25.35,0.26,39.0,13
CDM,A6447WE,CONFORM BAND S W >=5?/YD,2.0,1.3,0.37,2.0,17
CDM,A6449ELAWE,ELASTIC BANDAGE >3 <5 IN PER YD,6.0,3.9,0.96,6.0,17
CDM,A6449PROWE,PROFORE BANDAGE LAYER 3 PER YD,6.0,3.9,0.96,6.0,17
CDM,A6449WE,LT COMPRES BAND >=3? <5?/YD,7.0,4.55,0.96,7.0,17
CDM,A6452WE,HIGH COMPRES BAND W>=3?<5?YD,24.0,15.6,3.22,24.0,17
CDM,A6454WE,SELF-ADHER BAND W>=3? <5?/YD,2.0,1.3,0.43,2.0,17
CDM,A6456WE,ZINC PASTE BAND W >=3?<5?/YD,3.0,1.95,0.68,3.0,17
CDM,A6457WE,TUBULAR DRESSING,2.0,1.3,0.62,2.0,17
CDM,A92701STWE,1ST STEP OTS INSOLES 3/4 LGTH W 7-8,58.0,37.7,29.0,58.0,12
CDM,A9270ACNWE,ACNE TREATMENT KIT,34.0,22.1,17.0,34.0,12
CDM,A9270AFTWE,AFTERCARE ENV PROTECTOR SPF 30,29.0,18.85,14.5,29.0,12
CDM,A9270BODWE,BODY WASH,15.0,9.75,7.5,15.0,12
CDM,A9270BRAWE,"BRA, CHAMPION",48.0,31.2,24.0,48.0,12
CDM,A9270FACWE,FACIAL CLEANSER II,34.0,22.1,17.0,34.0,12
CDM,A9270GLYWE,GLYCARE CLEANSING GEL,34.0,22.1,17.0,34.0,12
CDM,A9270HANWE,HAND AND BODY CREAM,39.0,25.35,19.5,39.0,12
CDM,A9270KERWE,KERATOSIS PILARIS KIT,39.0,25.35,19.5,39.0,12
CDM,A9270KITWE,SINUS RINSE;KIT,12.0,7.8,6.0,12.0,12
CDM,A9270MALWE,MALLETT SPLINT,5.0,3.25,2.5,5.0,12
CDM,A9270MILWE,MILD GEL FACIAL WASH,15.0,9.75,7.5,15.0,12
CDM,A9270NORWE,NORMAL SKIN REGIMEN KIT,132.0,85.8,66.0,132.0,12
CDM,A9270ROYWE,ROYCE MEDICAL FORM FIT BACK SUPPORT,67.0,43.55,33.5,67.0,12
CDM,A9270SENWE,SENSITIVE SKIN REGIMEN KIT,48.0,31.2,24.0,48.0,12
CDM,A9270SINWE,SINUS RINSE; KIT,4.0,2.6,2.0,4.0,12
CDM,A9270SPFWE,SPF 20 SUN PROTECTOR,29.0,18.85,14.5,29.0,12
CDM,A9270THEWE,THER PUTTY,28.0,18.2,14.0,28.0,12
CDM,A9270TOTWE,TOTAL DAILY PROTECTOR SPF 15,21.0,13.65,10.5,21.0,12
CDM,A9270TXWE,TX OF SPEECH/SWALLOWING DYSFUNCTION N/C,205.0,133.25,102.5,205.0,12
CDM,A9270ULTWE,ULTRA HEEL & ELBOW CREAM,34.0,22.1,17.0,34.0,12
CDM,A9500TC9WE,"TC99M,SESTAMIBI, CARDIOLITE PER DOSE",189.0,122.85,94.5,450.58,14
CDM,A9500WE,"SUPPLY TECHNICIUM SESTAMIBI,PER DOSE",73.0,47.45,36.5,450.58,14
CDM,A9502WE,SUPPLY TECHNICIUM TETROFOSMIN / DOSE,68.0,44.2,34.0,91.68,14
CDM,A9503WE,"SUPPLY TECHNETIUM MEDRONATE,TO 30 MC",62.0,40.3,13.0,62.0,14
CDM,A9513WE,"LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MILLICURIE",117172.0,76161.8,335.22,117172.0,13
CDM,A9537WE,TC99M MEBROFENIN,68.0,44.2,34.0,68.0,14
CDM,A9538WE,"TECHNETIUM TC-99M PYROPHOSPHATE, DIAGNOSTIC",130.0,84.5,64.05,130.0,14
CDM,A9547WE,IN111 OXYQUINOLINE,5533.0,3596.45,2104.98,5533.0,14
CDM,A9548WE,IN111 PENTETATE,4970.0,3230.5,885.5,4970.0,13
CDM,A9552WE,F18 FDG,250.0,162.5,125.0,359.05,13
CDM,A9560WE,TC99M LABELED RBC,385.0,250.25,100.0,385.0,13
CDM,A9562WE,TC99M MERTIATIDE,625.0,406.25,312.5,883.24,13
CDM,A9573WE,"INJ, GADOPICLENOL, 1 ML",4.0,2.6,2.0,4.0,13
CDM,A9575BWE,15 ML DOTAREM INJ 0.1ML,2.0,1.3,0.1,2.0,14
CDM,A9575CWE,10 ML DOTAREM INJ 0.1ML,2.0,1.3,0.1,2.0,14
CDM,A9575WE,20 ML DOTAREM INJ 0.1 ML,2.0,1.3,0.1,2.0,14
CDM,A9577AWE,"INJ MULTIHANCE 10ML, MR CONTRAST",37.0,24.05,1.8,37.0,13
CDM,A9577BWE,"INJ MULTIHANCE 15ML, MR CONTRAST",37.0,24.05,1.8,37.0,13
CDM,A9577CWE,INJ MULTIHANCE PER 1 ML,17.0,11.05,1.8,17.0,13
CDM,A9577WE,INJ MULTIHANCE PER 1 ML,11.0,7.15,1.8,11.0,13
CDM,A9579DWE,GAD-BASE MR CONTRAST NOS PER 1 ML,3.0,1.95,1.46,3.0,13
CDM,A9579WE,INJ OPTIMARK 20ML,57.0,37.05,1.46,57.0,13
CDM,A9581WE,INJ EOVIST GADOXETATE DISODIUM PER ML,84.0,54.6,14.75,84.0,13
CDM,A9582WE,PR IODINE I-123 IOBENGUANE,9698.0,6303.7,4849.0,9698.0,13
CDM,A9584WE,IODINE I-123 IOFLUPANE,4620.0,3003.0,2310.0,4620.0,13
CDM,A9586WE,FLORBETAPIR F18,6292.0,4089.8,2857.4,6292.0,13
CDM,A9587WE,GALLIUM GA-68,154.0,100.1,60.67,154.0,13
CDM,A9591WE,FLUOROESTRADIOL F 18 DIAGNOSTIC 1 MCI,1562.0,1015.3,781.0,1562.0,13
CDM,A9606WE,RADIUM RA223 DICHLORIDE THER,337.0,219.05,168.5,337.0,13
CDM,A9607WE,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC",477.0,310.05,238.5,477.0,13
CDM,A9608WE,"FLOTUFOLASTAT F18, DIAGNOSTIC, 1 MILLICURIE",1230.0,799.5,615.0,1230.0,13
CDM,A9700PERWE,PERFLEXANE LIPID MICROSPHERES,358.0,232.7,74.81,358.0,13
CDM,A9700WE,ECHOCARDIOGRAPHY CONTRAST,450.0,292.5,74.81,450.0,13
CDM,C1717WE,"BRACHYTX SOURCE, HDR IR-192",972.0,631.8,486.0,972.0,12
CDM,C1747WE,AMBU DISPOSABLE SCOPE,250.0,162.5,125.0,250.0,12
CDM,C7568WE,COR ANGIO W/FLOW RESRV,3045.0,1979.25,1522.5,3045.0,12
CDM,C7569WE,PTCA W/ IVUS OR OCT,5702.0,3706.3,2851.0,5702.0,12
CDM,C7570WE,COR ANGIO W/FFR & 3D MAP,2605.0,1693.25,1302.5,2605.0,12
CDM,C7571WE,PCTA W/ COR LITHOTRIP,6129.0,3983.85,3064.5,6129.0,12
CDM,C9809WE,GEN 2 SMART TIP 190,525.0,341.25,262.5,525.0,12
CDM,C9810WE,COLD THERAPY NON-OPIOID DEV,261.0,169.65,130.5,261.0,12
CDM,C9817WE,CRYPNM CMPRS NONOPIOID DEV,261.0,169.65,130.5,261.0,12
CDM,COSANES105WE,COSMETIC ANES 1 HOUR 45 MINUTES,1351.0,878.15,675.5,1351.0,12
CDM,COSANES120WE,COSMETIC ANES 2 HOURS,1448.0,941.2,724.0,1448.0,12
CDM,COSANES135WE,COSMETIC ANES 2 HOURS 15 MINUTES,1544.0,1003.6,772.0,1544.0,12
CDM,COSANES150WE,COSMETIC ANES 2 HOURS 30 MINUTES,1641.0,1066.65,820.5,1641.0,12
CDM,COSANES165WE,COSMETIC ANES 2 HOURS 45 MINUTES,1737.0,1129.05,868.5,1737.0,12
CDM,COSANES180WE,COSMETIC ANES 3 HOURS,1834.0,1192.1,917.0,1834.0,12
CDM,COSANES195WE,COSMETIC ANES 3 HOURS 15 MINUTES,1930.0,1254.5,965.0,1930.0,12
CDM,COSANES210WE,COSMETIC ANES 3 HOURS 30 MINUTES,2027.0,1317.55,1013.5,2027.0,12
CDM,COSANES225WE,COSMETIC ANES 3 HOURS 45 MINUTES,2123.0,1379.95,1061.5,2123.0,12
CDM,COSANES240WE,COSMETIC ANES 4 HOURS,2220.0,1443.0,1110.0,2220.0,12
CDM,COSANES255WE,COSMETIC ANES 4 HOURS 15 MINUTES,2316.0,1505.4,1158.0,2316.0,12
CDM,COSANES270WE,COSMETIC ANES 4 HOURS 30 MINUTES,2413.0,1568.45,1206.5,2413.0,12
CDM,COSANES285WE,COSMETIC ANES 4 HOURS 45 MINUTES,2509.0,1630.85,1254.5,2509.0,12
CDM,COSANES300WE,COSMETIC ANES 5 HOURS,2606.0,1693.9,1303.0,2606.0,12
CDM,COSANES30WE,COSMETIC ANES 30 MINUTES,579.0,376.35,289.5,579.0,12
CDM,COSANES315WE,COSMETIC ANES 5 HOURS 15 MINUTES,2702.0,1756.3,1351.0,2702.0,12
CDM,COSANES330WE,COSMETIC ANES 5 HOURS 30 MINUTES,2799.0,1819.35,1399.5,2799.0,12
CDM,COSANES345WE,COSMETIC ANES 5 HOURS 45 MINUTES,2895.0,1881.75,1447.5,2895.0,12
CDM,COSANES360WE,COSMETIC ANES 6 HOURS,2992.0,1944.8,1496.0,2992.0,12
CDM,COSANES375WE,COSMETIC ANES 6 HOURS 15 MINUTES,3088.0,2007.2,1544.0,3088.0,12
CDM,COSANES390WE,COSMETIC ANES 6 HOURS 30 MINUTES,3185.0,2070.25,1592.5,3185.0,12
CDM,COSANES405WE,COSMETIC ANES 6 HOURS 45 MINUTES,3281.0,2132.65,1640.5,3281.0,12
CDM,COSANES420WE,COSMETIC ANES 7 HOURS,3378.0,2195.7,1689.0,3378.0,12
CDM,COSANES435WE,COSMETIC ANES 7 HOURS 15 MINUTES,3472.0,2256.8,1736.0,3472.0,12
CDM,COSANES450WE,COSMETIC ANES 7 HOURS 30 MINUTES,3571.0,2321.15,1785.5,3571.0,12
CDM,COSANES45WE,COSMETIC ANES 45 MINUTES,772.0,501.8,386.0,772.0,12
CDM,COSANES465WE,COSMETIC ANES 7 HOURS 45 MINUTES,3667.0,2383.55,1833.5,3667.0,12
CDM,COSANES480WE,COSMETIC ANES 8 HOURS,3764.0,2446.6,1882.0,3764.0,12
CDM,COSANES495WE,COSMETIC ANES 8 HOURS 15 MINUTES,3860.0,2509.0,1930.0,3860.0,12
CDM,COSANES510WE,COSMETIC ANES 8 HOURS 30 MINUTES,3957.0,2572.05,1978.5,3957.0,12
CDM,COSANES525WE,COSMETIC ANES 8 HOURS 45 MINUTES,4053.0,2634.45,2026.5,4053.0,12
CDM,COSANES540WE,COSMETIC ANES 9 HOURS,4150.0,2697.5,2075.0,4150.0,12
CDM,COSANES555WE,COSMETIC ANES 9 HOURS 15 MINUTES,4247.0,2760.55,2123.5,4247.0,12
CDM,COSANES570WE,COSMETIC ANES 9 HOURS 30 MINUTES,4343.0,2822.95,2171.5,4343.0,12
CDM,COSANES585WE,COSMETIC ANES 9 HOURS 45 MINUTES,4440.0,2886.0,2220.0,4440.0,12
CDM,COSANES600WE,COSMETIC ANES 10 HOURS,4536.0,2948.4,2268.0,4536.0,12
CDM,COSANES60WE,COSMETIC ANES 1 HOUR,1062.0,690.3,531.0,1062.0,12
CDM,COSANES75WE,COSMETIC ANES 1 HOUR 15 MINUTES,1158.0,752.7,579.0,1158.0,12
CDM,COSANES90WE,COSMETIC ANES 1 HOUR 30 MINUTES,1258.0,817.7,629.0,1258.0,12
CDM,COSNANES100WE,NON CCF PHYSICIANS COSMETIC CASES,1351.0,878.15,675.5,1351.0,12
CDM,COSOR105,COSMETIC OR 1 HOUR 45 MINUTES,1783.0,1158.95,299.54,1604.7,21
CDM,COSOR120,COSMETIC OR 2 HOURS,1908.55,1240.56,320.64,1717.7,21
CDM,COSOR135,COSMETIC OR 2 HOURS 15 MINUTES,2033.0,1321.45,341.54,1829.7,21
CDM,COSOR150,COSMETIC OR 2 HOURS 30 MINUTES,2157.85,1402.6,362.52,1942.07,21
CDM,COSOR165,COSMETIC OR 2 HOURS 45 MINUTES,2282.5,1483.63,383.46,2054.25,21
CDM,COSOR180,COSMETIC OR 3 HOURS,2407.15,1564.65,404.4,2166.44,21
CDM,COSOR195,COSMETIC OR 3 HOURS 15 MINUTES,2531.8,1645.67,425.34,2278.62,21
CDM,COSOR210,COSMETIC OR 3 HOURS 30 MINUTES,2656.45,1726.69,446.28,2390.81,21
CDM,COSOR225,COSMETIC OR 3 HOURS 45 MINUTES,2781.1,1807.72,467.22,2502.99,21
CDM,COSOR240,COSMETIC OR 4 HOURS,2905.75,1888.74,488.17,2615.18,21
CDM,COSOR255,COSMETIC OR 4 HOURS 15 MINUTES,3030.4,1969.76,509.11,2727.36,21
CDM,COSOR270,COSMETIC OR 4 HOURS 30 MINUTES,3155.05,2050.78,530.05,2839.55,21
CDM,COSOR285,COSMETIC OR 4 HOURS 45 MINUTES,3279.7,2131.81,550.99,2951.73,21
CDM,COSOR300,COSMETIC OR 5 HOURS,3404.34,2212.82,571.93,3063.91,21
CDM,COSOR315,COSMETIC OR 5 HOURS 15 MINUTES,4526.19,2942.02,760.4,4073.57,21
CDM,COSOR330,COSMETIC OR 5 HOURS 30 MINUTES - 9 HOURS 30 MINUTES,5648.03,3671.22,948.87,5083.23,21
CDM,COSOR60,COSMETIC OR 1 HOUR,1409.95,916.47,236.87,1268.96,21
CDM,COSOR75,COSMETIC OR 1 HOUR 15 MINUTES,1534.0,997.1,257.71,1380.6,21
CDM,COSOR90,COSMETIC OR 1 HOUR 30 MINUTES,1659.25,1078.51,278.75,1493.33,21
CDM,CPETVO2WE,CARDIOPULMONARY EXERCISE TESTING W VO2 MAX AND SUBMAX,150.0,97.5,75.0,150.0,12
CDM,D1110WE,PROPHYLAXIS - ADULT,143.0,92.95,68.82,143.0,13
CDM,D2150WE,"AMALGAM - TWO SURFACES, PRIMARY OR PERMANENT",274.0,178.1,96.74,274.0,13
CDM,D9210WE,LOCAL ANESTHESIA NOT IN CONJUNCTION WITH OPERATIVE OR SURGICAL P,285.0,185.25,30.37,285.0,13
CDM,E0114CRUWE,CRUTCHES ALUMINUM PAIR,58.0,37.7,22.73,58.0,13
CDM,E0747WE,"OSTEOGENESIS STIMULATOR,NOT SPINAL",5913.0,3843.45,2137.31,5913.0,13
CDM,E1399TESWE,TEST STIMULATION LEAD INTERSTIM,706.0,458.9,353.0,706.0,12
CDM,E1399WALWE,WALKER BRACE,297.0,193.05,148.5,297.0,12
CDM,G0008WE,ADMIN FLU VIRUS VACCINE,68.0,44.2,12.3,68.0,32
CDM,G0009WE,MEDICAR PT ADMIN.PNEUMOCCAL VIR,43.0,27.95,21.5,43.0,13
CDM,G0010WE,HEPATITIS B ADMINIS,99.0,64.35,33.58,99.0,13
CDM,G0101ESTWE,EST PATIENT SCREENING,198.0,128.7,20.49,198.0,35
CDM,G0101PELWE,PELVIC AND CLINICAL BREAST EXAM,198.0,128.7,20.49,198.0,35
CDM,G0101WE,"CERV/VAG CANC SCRN,PELV/BREAST EXAM",198.0,128.7,20.49,198.0,35
CDM,G0102WE,PROSTATE CA SCREENING; DRE,79.0,51.35,7.53,79.0,31
CDM,G0104WE,SCREENING SIGMOIDOSCOPY,370.0,240.5,55.82,370.0,31
CDM,G0105WE,"COLONOSCOPY, SCREENING, HIGH RISK",1434.0,932.1,177.19,1434.0,31
CDM,G0106WE,"COLOREC CANC SCRN,SIGMOIDOSCOPY+BE",542.0,352.3,185.66,542.0,19
CDM,G0106WE-26,"COLOREC CANC SCRN,SIGMOIDOSCOPY+BE",542.0,352.3,39.91,542.0,19
CDM,G0108DIAWE,DIABETES OP SELF MANAGEMENT INDIV PER 30,396.0,257.4,40.12,396.0,32
CDM,G0108WE,"DIAB OUTPT TRAINING INDIV, PER SESSN",396.0,257.4,40.12,396.0,32
CDM,G0109WE,"DIAB TRAIN SERV, GROUP SESSN,INDIVID",110.0,71.5,11.12,110.0,32
CDM,G0117WE,GLAUCOMA SCRN HGH RISK DIREC,198.0,128.7,43.88,198.0,31
CDM,G0121SCRWE,SCREENING COLONSCOPY NOT HIGH RISK,1434.0,932.1,177.8,1434.0,31
CDM,G0121WE,COLONOSCOPY SCRN NOT HIGH RISK,1434.0,932.1,177.8,1434.0,31
CDM,G0124WE,"SCR CYTOPATH,CERV/VAG, PHYS INTERPRE",114.0,74.1,14.51,114.0,31
CDM,G0127WE,"TRIMMING DYSTROPHIC NAILS,ANY NUMBER",75.0,48.75,6.67,75.0,34
CDM,G0136WE,"ADMINISTRATION OF A STANDARDIZED, EVIDENCE-BASED SOCIAL DETERMIN",79.0,51.35,8.35,79.0,27
CDM,G0168WE,WOUND CLOSURE BY ADHESIVE,136.0,88.4,15.15,136.0,31
CDM,G0179WE,MD RECERTIFICATION HHA PT,198.0,128.7,34.69,198.0,31
CDM,G0180WE,MD CERTIFICATION HHA PATIENT,295.0,191.75,44.79,295.0,31
CDM,G0181WE,HOME HEALTH CARE SUPERVISION,761.0,494.65,89.11,761.0,31
CDM,G0235WE,PET NOT OTHERWISE SPECIFIED,643.0,417.95,321.5,643.0,12
CDM,G0235WE-26,PET NOT OTHERWISE SPECIFIED,643.0,417.95,321.5,643.0,12
CDM,G0237WE,THERAPEUTIC PROCD STRG ENDUR,113.0,73.45,8.76,113.0,31
CDM,G0238WE,"OTH RESP PROC, INDIV",119.0,77.35,9.33,119.0,31
CDM,G0239WE,"OTH RESP PROC, GROUP",72.0,46.8,10.77,72.0,31
CDM,G0245WE,INITIAL FOOT EXAM PT LOPS,387.0,251.55,35.93,387.0,34
CDM,G0246WE,FOLLOWUP EVAL OF FOOT PT LOP,198.0,128.7,18.02,198.0,34
CDM,G0247WE,ROUTINE FOOTCARE PT W LOPS,220.0,143.0,19.7,220.0,34
CDM,G0248WE,DEMONSTRATE USE HOME INR MON,1322.0,859.3,97.52,1322.0,31
CDM,G0250HOMWE,"HOME MONITORING, PT/INR",79.0,51.35,7.82,79.0,31
CDM,G0250MDWE,MD REVIEW HME INR TEST; PER 4 TEST,35.0,22.75,7.82,35.0,31
CDM,G0250WE,MD REVIEW INTERPRET OF TEST,79.0,51.35,7.82,79.0,31
CDM,G0260WE,INJ FOR SACROILIAC JT ANESTH,1387.0,901.55,693.5,1387.0,12
CDM,G0268WE,REMOVAL OF IMPACTED WAX MD,268.0,174.2,27.44,268.0,31
CDM,G0269WE,OCCLUSIVE DEVICE IN VEIN ART,75.0,48.75,37.5,75.0,12
CDM,G0270MEDWE,MEDICAL NUTRITION REASSEMENT PER 15MIN,198.0,128.7,22.51,198.0,31
CDM,G0270WE,MEDICAL NUTRITION THERAPY; REASSESSMENT,198.0,128.7,22.51,198.0,31
CDM,G0271MEDWE,MED NUT TX REASSESS GR/15,110.0,71.5,12.38,110.0,31
CDM,G0271WE,GROUP MNT 2 OR MORE 30 MINS,110.0,71.5,12.38,110.0,31
CDM,G0278WE,"ILIAC ART ANGIO,CARDIAC CATH",110.0,71.5,10.66,110.0,31
CDM,G0279WE,"TOMOSYNTHESIS, MAMMO",373.0,242.45,40.39,373.0,28
CDM,G0279WE-26,"TOMOSYNTHESIS, MAMMO",264.0,171.6,28.23,264.0,31
CDM,G0279WE-TC,"TOMOSYNTHESIS, MAMMO",109.0,70.85,12.92,109.0,35
CDM,G0281WE,ELEC STIM UNATTEND FOR PRESS,79.0,51.35,11.26,79.0,31
CDM,G0283WE,ELEC STIM OTHER THAN WOUND,79.0,51.35,11.26,79.0,31
CDM,G0288WE,"RECON, CTA FOR SURG PLAN",1554.0,1010.1,46.94,1554.0,31
CDM,G0289WE,"ARTHRO, LOOSE BODY + CHONDRO",651.0,423.15,64.85,651.0,34
CDM,G0296WE,VISIT TO DETERM LDCT ELIG,229.0,148.85,20.01,229.0,28
CDM,G0316WE,PROLONG INPT EVAL ADD15 M,268.0,174.2,22.13,268.0,28
CDM,G0317WE,PROLONG NURSIN FAC EVAL 15M,244.0,158.6,22.13,244.0,28
CDM,G0318WE,PROLONG HOME EVAL ADD 15M,244.0,158.6,21.67,244.0,28
CDM,G0341WE,PERCUTANEOUS ISLET CELLTRANS,3071.0,1996.15,276.67,3071.0,31
CDM,G0343WE,LAPAROTOMY ISLET CELL TRANSP,9219.0,5992.35,966.22,9219.0,31
CDM,G0372WE,MD SERVICE REQUIRED FOR PMD,75.0,48.75,7.25,75.0,31
CDM,G0398WE,HOME SLEEP TEST/TYPE 2 PORTA,573.0,372.45,234.07,573.0,13
CDM,G0399WE,HOME SLEEP TEST/TYPE 3 PORTA,1489.0,967.85,163.08,1489.0,13
CDM,G0399WE-26,HOME SLEEP TEST/TYPE 3 PORTA,706.0,458.9,74.7,706.0,17
CDM,G0400WE,HOME SLEEP TEST/TYPE 4 PORTA,616.0,400.4,168.17,616.0,13
CDM,G0402WE,INITIAL PREVENTIVE EXAM,1144.0,743.6,105.17,1144.0,31
CDM,G0403WE,EKG FOR INITIAL PREVENT EXAM,75.0,48.75,14.39,75.0,31
CDM,G0404WE,EKG TRACING FOR INITIAL PREV,279.0,181.35,6.38,279.0,31
CDM,G0405WE,EKG INTERPRET & REPORT PREVE,75.0,48.75,6.96,75.0,31
CDM,G0406WE,TELEHEALTH FOLLOW-UP INPT CONSULTATION 15 MINS,334.0,217.1,29.39,334.0,32
CDM,G0407WE,TELEHEALTH FOLLOW-UP INPT CONSULTATION 25 MINS,612.0,397.8,54.17,612.0,32
CDM,G0408WE,TELEHEALTH FOLLOW-UP INPT CONSULTATION 35 MINS,880.0,572.0,77.91,880.0,32
CDM,G0415WE,OPEN TX POST PELVIC FXCTURE,9209.0,5985.85,1211.27,9209.0,31
CDM,G0416WE,SAT BIOPSY PROSTATE 1-20 SPC,1440.0,936.0,218.9,1440.0,31
CDM,G0420WE,ED SVC CKD IND PER SESSION,933.0,606.45,89.94,933.0,31
CDM,G0421WE,ED SVC CKD GRP PER SESSION,220.0,143.0,20.88,220.0,31
CDM,G0425WE,PR INPT TELEHEALTH CONSULT 30M,845.0,549.25,75.31,845.0,32
CDM,G0426WE,PR INPT TELEHEALTH CONSULT 50M,1148.0,746.2,102.22,1148.0,32
CDM,G0427WE,PR INPT TELEHEALTH CON 70/>M,1698.0,1103.7,151.62,1698.0,32
CDM,G0438AWE,ANNUAL WELLNESS,1040.0,676.0,141.07,1040.0,31
CDM,G0438BWE,NEW PREVENTATIVE MEDICINE G0438- ANNUAL WELLNESS,1040.0,676.0,141.07,1040.0,31
CDM,G0438FAMWE,NEW PREVENTIVE ANNUAL WELLNESS,1040.0,676.0,141.07,1040.0,31
CDM,G0438WE,"PPPS, INITIAL VISIT",1040.0,676.0,141.07,1040.0,31
CDM,G0439AWE,ANNUAL WELLNESS SUBSEQUENT G0439A,768.0,499.2,93.4,768.0,31
CDM,G0439BWE,ANNUAL WELLNESS SUBSEQUENT G0439B,768.0,499.2,384.0,768.0,12
CDM,G0439FAMWE,"ANNUAL WELLNESS PPPS, SUBSEQ VISIT",768.0,499.2,93.4,768.0,31
CDM,G0439WE,"PPPS, SUBSEQ VISIT",768.0,499.2,93.4,768.0,31
CDM,G0444WE,DEPRESSION SCREEN ANNUAL,79.0,51.35,7.82,79.0,31
CDM,G0447WE,BEHAVIOR COUNSEL OBESITY 15M,264.0,171.6,19.75,264.0,31
CDM,G0452WE,MOLECULAR PATHOLOGY INTERPR,372.0,241.8,47.69,372.0,27
CDM,G0455WE,FECAL MICROBIOTA PREP INSTILL,590.0,383.5,65.73,590.0,27
CDM,G0459WE,INPATIENT TELEHEALTH PHARMACOLOGIC MANAGEMENT,418.0,271.7,41.65,418.0,27
CDM,G0498WE,CHEMO EXTEND IV INFUSION W/PUMP,1530.0,994.5,299.94,1530.0,13
CDM,G0500WE,MOD SEDAT ENDO SERVICE >5YRS,44.0,28.6,6.2,44.0,27
CDM,G0508WE,CRIT CARE TELEHEA CONSULT 60,1760.0,1144.0,195.9,1760.0,27
CDM,G0537WE,RISK ASCVD TST ONCE PR 12 MO,79.0,51.35,6.39,79.0,25
CDM,G0538WE,ASCVD RSK MNG CLIN STF PR MO,79.0,51.35,6.39,79.0,25
CDM,G0545WE,INFECTIOUS DISEASE CONFIRMED/SUSPECTED INHERENT TO INPATIENT OR,392.0,254.8,31.54,392.0,25
CDM,G0552WE,SUPPLY OF DIGITAL DEVICE,248.0,161.2,124.0,248.0,13
CDM,G0553WE,MONTHLY TX FOR DMHT 20MINS,273.0,177.45,27.05,273.0,24
CDM,G0554WE,ADD 20 M OF MONTHLY TX,268.0,174.2,26.38,268.0,24
CDM,G0556WE,ADV PRIM CARE MGMT LVL 1,110.0,71.5,8.79,110.0,25
CDM,G0557WE,ADV PRIM CARE MGMT LVL 2,339.0,220.35,26.56,339.0,25
CDM,G0558WE,ADV PRIM CARE MGMT LVL 3,735.0,477.75,58.63,735.0,25
CDM,G0559WE,POST-OP FOLLOW-UP PROVIDED BY A DIFFERENT PRACTICE FROM THE SURG,70.0,45.5,6.42,70.0,25
CDM,G0571WE,INTRAOP NERVE CRYOABLATION,598.0,388.7,64.93,598.0,21
CDM,G2058WE,"CHRONIC CARE MANAGEMENT SERVICES, EACH ADDITIONAL 20 MINUTES",159.0,103.35,79.5,159.0,12
CDM,G2211WE,VISIT CPLX INHERENT E&M ASSOC WITH MED CARE SRVC,145.0,94.25,15.01,145.0,27
CDM,G2212WE,PROLONG OUTPT/OFFICE VIS,268.0,174.2,21.53,268.0,28
CDM,G2213WE,INITIAT MED ASSIST TX IN ER,572.0,371.8,58.61,572.0,27
CDM,J0120WE,TETRACYCLIN INJECTION,29.0,18.85,14.5,29.0,13
CDM,J0129WE,ABATACEPT INJECTION,97.0,63.05,44.77,97.0,14
CDM,J0180WE,AGALSIDASE BETA INJECTION,594.0,386.1,230.32,594.0,14
CDM,J0207WE,"AMIFOSTINE,500 MG",1516.0,985.4,758.0,1516.0,14
CDM,J0270WE,INJECT ALLPPROSTADIL PER 1.25 MCG,13.0,8.45,6.5,13.0,14
CDM,J0278WE,AMIKACIN SULFATE INJECTION,13.0,8.45,0.62,13.0,14
CDM,J0280WE,AMINOPHYLLIN,36.0,23.4,10.41,36.0,14
CDM,J0285WE,"INJEC,AMPHOTERICIN B,50 MG",85.0,55.25,42.5,85.0,14
CDM,J0287WE,AMPHOTERICIN B LIPID COMPLEX,40.0,26.0,10.5,40.0,14
CDM,J0290AMPWE,AMPICILLIN 500 MG,6.0,3.9,0.59,6.0,14
CDM,J0290WE,AMPICILLIN 500 MG INJ,8.0,5.2,0.59,8.0,14
CDM,J0295WE,AMPICILLIN SODIUM PER 1.5 GM,51.0,33.15,1.33,51.0,14
CDM,J0330WE,SUCCINYCHOLINE CHLORIDE INJ,13.0,8.45,0.85,13.0,14
CDM,J0360WE,HYDRALAZINE HCL INJECTION,12.0,7.8,4.39,12.0,14
CDM,J0461WE,ATROPINE SULFATE INJECTION,24.0,15.6,0.1,24.0,14
CDM,J0475WE,BACLOFEN 10 MG INJECTION,750.0,487.5,181.47,750.0,14
CDM,J0476WE,"INJECT,BACLOFEN,50 MCG INTRATHECAL",420.0,273.0,59.51,420.0,14
CDM,J0490WE,BELIMUMAB INJECTION,146.0,94.9,57.16,146.0,14
CDM,J0500WE,DICYCLOMINE INJECTION,55.0,35.75,11.33,55.0,14
CDM,J0561WE,PENICILLIN G BENZATHINE INJ,9.0,5.85,4.5,36.15,14
CDM,J0585ADLWE,BOTULINUM TOXIN ADD'L SITE,213.0,138.45,6.51,213.0,14
CDM,J0585AWE,BOTOX PER UNIT,14.0,9.1,6.51,14.0,14
CDM,J0585BOTWE,BOTOX PER UNIT,13.0,8.45,6.5,13.0,14
CDM,J0585DYSWE,"DYSPORT, PLASTIC FF",414.0,269.1,6.51,414.0,14
CDM,J0585WE,BOTULINUM TOXIN A PER 1 UNIT,26.0,16.9,6.51,26.0,14
CDM,J0586DYSWE,"DYSPORT, PLASTIC FF",418.0,271.7,8.8,418.0,14
CDM,J0586NORVU1WE,DYSPORT 5 UNITS (SP),23.35,15.18,8.8,23.35,14
CDM,J0586NORVUWE,BOTULINUM TOXIN A PER 1 UNIT,23.0,14.95,8.8,23.0,14
CDM,J0586WE,ABOBOTULINUMTOXINA,28.0,18.2,8.8,28.0,14
CDM,J0587WE,BOTULINUM TOXIN TYPE B,35.0,22.75,13.29,35.0,14
CDM,J0588AWE,XEOMIN PER UNIT,9.96,6.47,4.98,9.96,14
CDM,J0588WE,INCOBOTULINUMTOXIN A,15.0,9.75,5.25,15.0,14
CDM,J0637WE,CASPOFUNGIN ACETATE,121.0,78.65,3.82,121.0,14
CDM,J0640WE,LEUCOVORIN CALCIUM INJECTION,135.0,87.75,3.84,135.0,14
CDM,J0690WE,CEFAZOLIN SODIUM INJECTION,8.0,5.2,0.83,8.0,14
CDM,J0692WE,CEFEPIME HCL FOR INJECTION,37.0,24.05,0.87,37.0,14
CDM,J0694WE,CEFOXITIN SODIUM INJECTION,65.0,42.25,4.74,65.0,14
CDM,J0696CEFWE,"CEFTRIAXONE, PER 250 MG",2.0,1.3,0.46,2.0,14
CDM,J0696ROCWE,ROCEPHIN 250 MG,44.0,28.6,0.46,44.0,14
CDM,J0696WE,CEFTRIAXONE SODIUM INJECTION,2.0,1.3,0.46,2.0,14
CDM,J0698WE,CEFOTAXIME SODIUM INJECTION,45.0,29.25,9.8,45.0,14
CDM,J0702WE,BETAMETHASONE ACET&SOD PHOSP,15.0,9.75,6.91,15.0,14
CDM,J0713WE,"INJECTION, CEFTAZIDIME, PER 500 MG",23.0,14.95,1.47,23.0,14
CDM,J0717WE,CERTOLIZUMAB PEGOL INJ 1MG,25.0,16.25,3.87,25.0,14
CDM,J0725APLWE,APL CHORIONIC GONADOTROPIN 1000 U,10.0,6.5,5.0,17.42,14
CDM,J0725APRWE,APRESOLINE UP TO 20 MG,13.0,8.45,6.5,17.42,14
CDM,J0725WE,CHORIONIC GONADOTROPIN/1000U,15.0,9.75,7.5,17.42,14
CDM,J0735WE,"CLONIDINE HCL,1 MG",209.0,135.85,17.23,209.0,14
CDM,J0740WE,"CIDOFOVIR,375 MG",3249.0,2111.85,524.48,3249.0,14
CDM,J0743WE,CILASTATIN SODIUM INJECTION,80.0,52.0,7.1,80.0,14
CDM,J0744WE,CIPROFLOXACIN IV,29.0,18.85,2.0,29.0,14
CDM,J0745WE,INJ CODEINE PHOSPHATE /30 MG,15.0,9.75,1.52,15.0,13
CDM,J0775WE,"COLLAGENASE, CLOST HIST INJ",120.0,78.0,60.0,120.0,14
CDM,J0780WE,PROCHLORPERAZINE INJECTION,20.0,13.0,2.52,20.0,14
CDM,J0800WE,CORTICOTROPIN INJECTION,52.0,33.8,26.0,52.0,12
CDM,J0834WE,COSYNTROPIN CORTROSYN INJ,193.0,125.45,20.65,193.0,14
CDM,J0850WE,"INJECTION, CYTOMEGALOVIRUS IMMUNE GLOBULIN INTRAVENOUS (HUMAN),",4997.0,3248.05,1808.33,4997.0,14
CDM,J0878WE,DAPTOMYCIN INJECTION,17.0,11.05,0.03,17.0,14
CDM,J0881WE,"DARBEPOETIN ALFA, NON-ESRD",9.0,5.85,3.02,9.0,14
CDM,J0882WE,"DARBEPOETIN ALFA, ESRD USE",9.0,5.85,3.02,9.0,14
CDM,J0885WE,"EPOETIN ALFA, NON-ESRD",56.0,36.4,7.74,56.0,14
CDM,J0894DECWE,DECITABINE 50 MG,6806.0,4423.9,0.65,6806.0,14
CDM,J0894DEPWE,DECITABINE PER 1 MG,113.0,73.45,0.65,113.0,14
CDM,J0895WE,DEFEROXAMINE MESYLATE INJ,50.0,32.5,8.47,50.0,14
CDM,J0897WE,DENOSUMAB INJECTION,107.2,69.68,29.46,107.2,14
CDM,J1020WE,METHYLPREDNISOLONE 20 MG INJ,9.0,5.85,4.5,9.0,12
CDM,J1040WE,METHYLPREDNISOLONE 80 MG INJ,39.0,25.35,19.5,39.0,12
CDM,J1100DEXWE,DEXAMETHASONE 1 MG INJ,6.0,3.9,0.11,6.0,14
CDM,J1110WE,DEHYDROERGOTAMINE INJECTION,51.0,33.15,25.5,64.57,14
CDM,J1160WE,DIGOXIN INJECTION,15.0,9.75,7.5,15.0,14
CDM,J1190WE,DEXRAZOXANE HCL INJECTION 250 MG,642.0,417.3,58.01,642.0,14
CDM,J1200WE,DIPHENHYDRAMINE HCL INJECTIO,15.0,9.75,0.71,15.0,14
CDM,J1212WE,DIMETHYL SULFOXIDE 50% 50 ML,157.0,102.05,78.5,847.53,14
CDM,J1250WE,"DOBUTAMINE HCL,PER 250 MG",37.0,24.05,8.02,37.0,14
CDM,J1260WE,"INJECTION, DOLASETRON MESYLATE, 1 MG",44.0,28.6,6.31,44.0,14
CDM,J1335WE,ERTAPENEM INJECTION,75.0,48.75,9.16,75.0,14
CDM,J1364WE,ERYTHRO LACTOBIONATE /500 MG,44.0,28.6,20.16,44.0,14
CDM,J1410WE,INJ ESTROGEN CONJUGATE 25 MG,215.0,139.75,107.5,443.16,14
CDM,J1438WE,ETANERCEPT INJECTION,673.0,437.45,336.5,1096.38,14
CDM,J1442WE,"INJ, FILGRASTIM G-CSF 1MCG",2.0,1.3,1.0,2.0,14
CDM,J1450WE,DIFLUCAN PER 200 MG,35.0,22.75,4.48,35.0,14
CDM,J1453WE,FOSAPREPITANT INJECTION,9.0,5.85,0.11,9.0,14
CDM,J1561WE,IMMUNE GLOBULIN INJECTION,128.0,83.2,49.08,128.0,14
CDM,J1566WE,"IMMUNE GLOBULIN, POWDER",79.0,51.35,39.5,89.24,14
CDM,J1569WE,GAMMAGARD LIQUID INJECTION,108.0,70.2,47.29,108.0,14
CDM,J1570GANWE,GANCICLOVIR SODIUM 500 MG,205.0,133.25,33.52,205.0,14
CDM,J1580INJWE,GENTAMICIN TO 80 MG INJ,44.0,28.6,2.17,44.0,14
CDM,J1610WE,GLUCAGON HYDROCHLORIDE/1 MG,172.0,111.8,86.0,186.49,14
CDM,J1626WE,"GRANISETRON HCL, 100 MCG",69.0,44.85,0.15,69.0,14
CDM,J1630WE,HALOPERIDOL INJECTION,29.0,18.85,0.73,29.0,14
CDM,J1642WE,HEPARIN SODIUM PER 10 U,2.0,1.3,0.02,2.0,14
CDM,J1650WE,"ENOXAPARIN SODIUM, 30 MG",20.0,13.0,0.53,20.0,14
CDM,J1652WE,FONDAPARINUX SODIUM,386.0,250.9,0.88,386.0,14
CDM,J1670WE,TETANUS IMMUNE GLOBULIN INJ,394.0,256.1,197.0,665.76,14
CDM,J1720WE,HYDROCORTISONE SODIUM SUCC I,23.0,14.95,11.5,24.95,14
CDM,J1730WE,DIAZOXIDE INJECTION,459.0,298.35,115.96,459.0,14
CDM,J1740WE,IBANDRONATE SODIUM INJECTION,617.0,401.05,13.14,617.0,14
CDM,J1745WE,INFLIXIMAB INJECTION,285.0,185.25,32.42,285.0,14
CDM,J1750WE,IRON DEXTRAN INJECTION,146.0,94.9,18.08,146.0,14
CDM,J1756WE,IRON SUCROSE INJECTION PER 1 MG,2.0,1.3,0.27,2.0,14
CDM,J1786WE,IMUGLUCERASE INJECTION,252.0,163.8,43.23,252.0,14
CDM,J1790WE,DROPERIDOL INJECTION,19.0,12.35,7.18,19.0,14
CDM,J1800WE,PROPRANOLOL INJECTION,65.0,42.25,9.74,65.0,14
CDM,J1815INJWE,"INJECTION, INSULIN, PER 5 UNITS",12.0,7.8,0.22,12.0,14
CDM,J1815INSWE,"INJECTION, INSULIN, PER 5 UNITS",5.0,3.25,0.22,5.0,14
CDM,J1815WE,INSULIN INJECTION,107.0,69.55,0.22,107.0,14
CDM,J1885WE,KETOROLAC TROMETHAMINE INJ,19.0,12.35,0.33,19.0,14
CDM,J1941WE,"INJ, FUROSCIX, 20 MG",882.8,573.82,245.15,882.8,14
CDM,J1950DEPWE,DEPO LUPRON 11.25MG,1516.0,985.4,758.0,1995.29,14
CDM,J1950LUPWE,LUPRON DEPOT PER 3.75 MG,1516.0,985.4,758.0,1995.29,14
CDM,J1950WE,LEUPROLIDE ACETATE /3.75 MG,1909.0,1240.85,954.5,1995.29,14
CDM,J1956LEOWE,"LEVOFLOXACIN, 250MG",32.0,20.8,2.16,32.0,14
CDM,J1956LEVWE,"LEVOFLOXACIN, 250MG",54.0,35.1,2.16,54.0,14
CDM,J2020WE,LINEZOLID INJECTION,121.0,78.65,2.74,121.0,14
CDM,J2060WE,LORAZEPAM INJECTION,35.0,22.75,1.41,35.0,14
CDM,J2175INJWE,MEPERIDINE 50 MG TUBEX INJ,12.0,7.8,6.0,12.0,14
CDM,J2175WE,MEPERIDINE HYDROCHL /100 MG,14.0,9.1,7.0,14.0,14
CDM,J2182WE,"INJECTION, MEPOLIZUMAB, 1MG",133.0,86.45,31.89,133.0,14
CDM,J2185WE,MEROPENEM,25.0,16.25,0.38,25.0,14
CDM,J2248WE,MICAFUNGIN SODIUM INJECTION,7.0,4.55,0.25,7.0,14
CDM,J2250WE,"MIDAZOLAM HCI, PER 1 MG",6.0,3.9,0.14,6.0,14
CDM,J2260WE,INJ MILRINONE LACTATE / 5 ML,186.0,120.9,1.35,186.0,14
CDM,J2270WE,MORPHINE SULFATE INJECTION,14.0,9.1,3.04,14.0,14
CDM,J2278PRIWE,"PRIALT, PER 1 MCG",21.0,13.65,10.5,21.0,14
CDM,J2278WE,ZICONOTIDE INJECTION,26.0,16.9,10.57,26.0,14
CDM,J2278ZICWE,ZICONOTIDE INJ 1 MCG,13.0,8.45,6.5,13.0,14
CDM,J2280WE,"INJ, MOXIFLOXACIN 100 MG",13.0,8.45,6.5,13.0,14
CDM,J2300WE,"NALBUPHINE HCL, PER 10 MG",14.0,9.1,3.45,14.0,14
CDM,J2323WE,NATALIZUMAB INJECTION,25.0,16.25,12.5,27.73,14
CDM,J2353WE,"OCTREOTIDE INJECTION, DEPOT",264.0,171.6,132.0,264.0,14
CDM,J2356WE,"INJ TEZEPELUMAB-EKKO, 1MG",14387.0,9351.55,17.82,14387.0,14
CDM,J2357WE,OMALIZUMAB INJECTION,73.0,47.45,36.5,73.0,14
CDM,J2360WE,ORPHENADRINE INJ TO 60 MG,21.0,13.65,6.39,21.0,14
CDM,J2370WE,PHENYLEPHRINE HCL INJECTION,19.0,12.35,9.5,19.0,12
CDM,J2405WE,ONDANSETRON HCL INJECTION,20.0,13.0,0.09,20.0,14
CDM,J2425WE,PALIFERMIN INJECTION,72.0,46.8,36.0,72.0,14
CDM,J2430WE,PAMIDRONATE DISODIUM /30 MG,1307.0,849.55,11.29,1307.0,14
CDM,J2440WE,PAPAVERIN HCL INJECTION,37.0,24.05,18.5,40.32,14
CDM,J2469WE,PALONOSETRON HCL,40.0,26.0,0.35,40.0,14
CDM,J2540WE,PENICILLIN G POTASSIUM INJ,2.0,1.3,0.78,2.0,14
CDM,J2543WE,PIPERACILLIN/TAZOBACTAM INJ,12.0,7.8,1.09,12.0,14
CDM,J2545PENWE,PENTAM 300 MG,96.0,62.4,48.0,100.8,14
CDM,J2545TAMWE,PENTAM 300 MG,291.0,189.15,90.0,291.0,14
CDM,J2545WE,PENTAMIDINE ISETHIONTE/300MG,275.0,178.75,90.0,275.0,14
CDM,J2550INJWE,PHENERGAN 50 MG INJ,12.0,7.8,3.97,12.0,14
CDM,J2550WE,PROMETHAZINE HCL INJECTION,14.0,9.1,3.97,14.0,14
CDM,J2597WE,"DESMOPRESSIN ACETATE,PER 4 MCG",15.0,9.75,3.41,15.0,14
CDM,J2675WE,INJ PROGESTERONE PER 50 MG,19.0,12.35,0.72,19.0,14
CDM,J2690WE,PROCAINAMIDE HCL INJECTION,43.0,27.95,21.5,389.74,14
CDM,J2710PROWE,PROSTIGMIN UP TO 0.5 MG,21.0,13.65,0.7,21.0,14
CDM,J2710WE,NEOSTIGMINE METHYLSLFTE INJ,26.0,16.9,0.7,26.0,14
CDM,J2720WE,INJ PROTAMINE SULFATE/10 MG,3.0,1.95,1.5,3.0,14
CDM,J2760WE,PHENTOLAINE MESYLATE INJ,121.0,78.65,60.5,475.73,14
CDM,J2765WE,METOCLOPRAMIDE HCL INJECTION,15.0,9.75,1.08,15.0,14
CDM,J2770WE,QUINUPRISTIN/DALFOPRISTIN,386.0,250.9,193.0,501.05,14
CDM,J2780RANWE,RANITIDINE HCL (ZANTAC) 25MG INJ,5.0,3.25,2.5,5.0,12
CDM,J2780WE,RANITIDINE HYDROCHLORIDE ING,6.0,3.9,3.0,6.0,12
CDM,J2780ZANWE,ZANTAC 50 MG INJ,44.0,28.6,22.0,44.0,12
CDM,J2783WE,RASBURICASE,469.0,304.85,234.5,469.0,14
CDM,J2785WE,REGADENOSON INJECTION,172.0,111.8,2.68,172.0,14
CDM,J2790WE,RHO D IMMUNE GLOBULIN INJ,1533.0,996.45,80.53,1533.0,14
CDM,J2820WE,SARGRAMOSTIM INJECTION,206.0,133.9,61.75,206.0,14
CDM,J2916WE,NA FERRIC GLUCONATE COMPLEX,34.0,22.1,2.21,34.0,14
CDM,J2919WE,"INJ, METHYLPRED SOD SUCC",3.05,1.98,0.26,3.05,14
CDM,J2920WE,METHYLPREDNISOLONE INJECTION,15.0,9.75,7.5,15.0,12
CDM,J2997WE,ALTEPLASE RECOMBINANT,142.0,92.3,71.0,142.0,14
CDM,J3000WE,STREPTOMYCIN INJECTION,19.0,12.35,9.5,38.33,14
CDM,J3010WE,FENTANYL CITRATE INJECTION,17.0,11.05,1.19,17.0,14
CDM,J3030WE,SUMATRIPTAN SUCCINATE / 6 MG,108.0,70.2,25.0,108.0,14
CDM,J3105WE,TERBUTALINE SULFATE INJ,15.0,9.75,2.47,15.0,14
CDM,J3230WE,CHLORPROMAZINE HCL INJECTION,23.0,14.95,11.5,26.88,14
CDM,J3240WE,THYROTROPIN INJECTION,2068.0,1344.2,1034.0,2404.52,14
CDM,J3243WE,TIGECYCLINE INJECTION,20.0,13.0,0.56,20.0,14
CDM,J3250WE,TRIMETHOBENZAMIDE HCL INJ,15.0,9.75,7.5,65.15,14
CDM,J3260NEBWE,NEBCIN UP TO 80 MG,20.0,13.0,2.07,20.0,14
CDM,J3260TOBWE,TOBRAMYCIN SULFATE UP TO 80MG,20.0,13.0,2.07,20.0,14
CDM,J3260WE,TOBRAMYCIN SULFATE INJECTION,25.0,16.25,2.07,25.0,14
CDM,J3262WE,TOCILIZUMAB INJECTION,29.0,18.85,5.61,29.0,14
CDM,J3300WE,TRIAMCINOLONE A INJ PRS-FREE,12.0,7.8,6.0,27.71,14
CDM,J3301AWE,KENALOG 10MG,300.0,195.0,0.74,300.0,14
CDM,J3301KENWE,KENALOG PER 10MG/10MG VIAL,13.0,8.45,0.74,13.0,14
CDM,J3301VIAWE,KENALOG PER 10 MG 40MG VIAL,29.0,18.85,0.74,29.0,14
CDM,J3301WE,KENALOG PER 10MG,36.0,23.4,0.74,36.0,14
CDM,J3315WE,TRIPTORELIN PAMOATE,617.0,401.05,308.5,617.0,14
CDM,J3357WE,USTEKINUMAB INJECTION,442.0,287.3,221.0,442.0,14
CDM,J3360WE,DIAZEPAM INJECTION,17.0,11.05,6.69,17.0,14
CDM,J3410WE,HYDROXYZINE HCL INJECTION,3.0,1.95,1.5,14.71,14
CDM,J3411WE,THIAMINE HCL 100 MG,4.0,2.6,1.81,4.0,14
CDM,J3420AWE,B12 INJECTION IM PER 1000 MCG,2.0,1.3,0.64,2.0,14
CDM,J3420FAMWE,VITAMIN B12 INJECTION,2.0,1.3,0.64,2.0,14
CDM,J3420WE,ADMIN VITAMIN B12 INJ,14.0,9.1,0.64,14.0,14
CDM,J3430WE,VITAMIN K PHYTONADIONE INJ,17.0,11.05,2.81,17.0,14
CDM,J3470AWE,HYALURONIDASE,2.0,1.3,1.0,35.99,14
CDM,J3470WE,HYALURONIDASE INJECTION,76.0,49.4,31.81,76.0,14
CDM,J3475WE,"MAGNESIUM SULPHATE, PER 500 MG",6.0,3.9,0.41,6.0,14
CDM,J3480WE,"POTASSIUM CHLORIDE, PER 2 MEQ",2.0,1.3,0.12,2.0,14
CDM,J3490ACTWE,"ACTEMRA, PER 200 MG",1803.0,1171.95,901.5,1803.0,12
CDM,J3490ALLWE,ALLOPURINOL 300 MG PO,16.0,10.4,8.0,16.0,12
CDM,J3490ARGWE,ARGININE 30GM,51.0,33.15,25.5,51.0,12
CDM,J3490ASCWE,ASCLERA 1% 1CC,46.0,29.9,23.0,46.0,12
CDM,J3490AWE,BELOTERO 1.0CC,600.0,390.0,300.0,600.0,12
CDM,J3490AZAWE,AZACTAM/AZTREONAM 500MG,101.0,65.65,50.5,101.0,12
CDM,J3490AZEWE,AZERRA (OFATUMUMAB) 100MG,750.0,487.5,375.0,750.0,12
CDM,J3490BWE,KYBELLA  2CC PER VILE,845.0,549.25,422.5,845.0,12
CDM,J3490CALWE,CALCIUM CHLORIDE INJ,18.0,11.7,9.0,18.0,12
CDM,J3490CANWE,CANDIDA ANTIGEN PER .1 ML,37.0,24.05,18.5,37.0,12
CDM,J3490CARWE,CARDIZEM 2.5MG/5ML,5.0,3.25,2.5,5.0,12
CDM,J3490CLIWE,CLINDAMYCIN 600 MG INJ,124.0,80.6,62.0,124.0,12
CDM,J3490CWE,PRE-PEN (BENZYPENICILLOYL POLYLYSINE),536.0,348.4,268.0,536.0,12
CDM,J3490D5WWE,D5W 100 CC,10.0,6.5,5.0,10.0,12
CDM,J3490DEXWE,DEXTROSE 50% 50 ML INJ,49.0,31.85,24.5,49.0,12
CDM,J3490DIPWE,DIPRIVAN AMP 10 MG/20ML NDC 00310030022,36.0,23.4,18.0,36.0,12
CDM,J3490DORWE,DORIPENEM 500 MG,148.0,96.2,74.0,148.0,12
CDM,J3490DYCWE,DYCLONE (DYCLONINE) 1% 15 ML TOPICAL,24.0,15.6,12.0,24.0,12
CDM,J3490EMEWE,"EMEND, PER 115 MG IV",957.0,622.05,478.5,957.0,12
CDM,J3490EPHWE,EPHEDRINE 50 MG INJ,13.0,8.45,6.5,13.0,12
CDM,J3490EPIWE,EPINEPHRINE 1/10000 1MG/10ML,39.0,25.35,19.5,39.0,12
CDM,J3490ERTWE,ERTAPENEM SODIUM(INVANZ) 1GRAM,75.0,48.75,37.5,75.0,12
CDM,J3490ESOWE,ESOMPERAZOLE SODIUM PER 20 MG,107.0,69.55,53.5,107.0,12
CDM,J3490FERWE,FERAHEME INJ IV PER 1 MG,2.0,1.3,1.0,2.0,12
CDM,J3490FLAWE,FLAGYL 500 MG IV,18.0,11.7,9.0,18.0,12
CDM,J3490FOLWE,FOLOTYN (PRALATREXATE) PER 20 MG,16472.0,10706.8,8236.0,16472.0,12
CDM,J3490HALWE,HALAVEN 1 MG/2ML,4279.0,2781.35,2139.5,4279.0,12
CDM,J3490HESWE,HESPAN 500 ML,101.0,65.65,50.5,101.0,12
CDM,J3490HURWE,HURRICAINE 1/8 OZ,4.0,2.6,2.0,4.0,12
CDM,J3490HYSWE,HYSKON 100 ML,40.0,26.0,20.0,40.0,12
CDM,J3490INDWE,INDIGO CARMINE 5 ML INJ,18.0,11.7,9.0,18.0,12
CDM,J3490JEVWE,JEVTANA (CABAZITAXEL) INJ. PER 60 MG,41481.0,26962.65,20740.5,41481.0,12
CDM,J3490JUVWE,JUVADERM,642.0,417.3,321.0,642.0,12
CDM,J3490KRYWE,"KRYSTEXXA, 8 MG",7556.0,4911.4,3778.0,7556.0,12
CDM,J3490LABWE,LABETALOL 5 MG/ML,2.0,1.3,1.0,2.0,12
CDM,J3490LEVWE,LEVOPHED 4 ML INJ,16.0,10.4,8.0,16.0,12
CDM,J3490LEXWE,LEXISCAN 0.1 MG,137.0,89.05,68.5,137.0,12
CDM,J3490LIDWE,LIDOCAINE 4% TOPICAL SOLUTION,24.0,15.6,12.0,24.0,12
CDM,J3490LOPWE,LOPRESSOR 5 MG/5 ML INJ,40.0,26.0,20.0,40.0,12
CDM,J3490MESWE,MESTINON 10 MG INJ,15.0,9.75,7.5,15.0,12
CDM,J3490METWE,METHOTREXATE 25 MG VIAL,34.0,22.1,17.0,34.0,12
CDM,J3490MIFWE,MIFEPREX TABLETS 600MG DOSE,615.0,399.75,307.5,615.0,12
CDM,J3490MVIWE,MVI W/ VITAMIN K 1 MG/ML,39.0,25.35,19.5,39.0,12
CDM,J3490NARWE,NARCAN PER 1 MG INJ,18.0,11.7,9.0,18.0,12
CDM,J3490NEXWE,"NEXIUM, PER 40 MG",23.0,14.95,11.5,23.0,12
CDM,J3490NITWE,NITROLINGUAL PUMPSPRAY 4.9 GM,284.0,184.6,142.0,284.0,12
CDM,J3490NORWE,NOROMDYNE 5MG IV INFUSION,96.0,62.4,48.0,96.0,12
CDM,J3490NS1WE,NS 100 CC,7.0,4.55,3.5,7.0,12
CDM,J3490NSWE,NS 100 CC,8.0,5.2,4.0,8.0,12
CDM,J3490PEGWE,PEGFILGRASTIM 6MG SYRINGE,9100.0,5915.0,4550.0,9100.0,12
CDM,J3490PERWE,"PERLANE, EACH ADDTL SITE BILL W 3349855",507.0,329.55,253.5,507.0,12
CDM,J3490PITWE,PITRESSIN 10 U AMP INJ,15.0,9.75,7.5,15.0,12
CDM,J3490RESWE,"RESTYLANE, 0.5 CC",428.0,278.2,214.0,428.0,12
CDM,J3490SANWE,SANDOSTATIN OCTREOTIDE ACETATE PER 100 MC,13.0,8.45,6.5,13.0,12
CDM,J3490SECWE,SECRETIN VIAL 75U,528.0,343.2,264.0,528.0,12
CDM,J3490SODWE,SODIUM BICARBONATE 8.4% 50 ML,5.0,3.25,2.5,5.0,12
CDM,J3490SYNWE,SYNTHROID INJECTION PER 200 MCG,98.0,63.7,49.0,98.0,12
CDM,J3490TENWE,TENSILON INJ,14.0,9.1,7.0,14.0,12
CDM,J3490TESWE,TESTOSTERONE PELLET 75 MG,206.0,133.9,103.0,206.0,12
CDM,J3490THIWE,THIAMINE 100 MG INJ,2.0,1.3,1.0,2.0,12
CDM,J3490VALWE,VALPROATE 100 MG,48.0,31.2,24.0,48.0,12
CDM,J3490VASWE,VASOPRESSIN INJECTION 20 UNITS,23.0,14.95,11.5,23.0,12
CDM,J3490VERWE,VERAPAMIL 5 MG INJECTION,14.0,9.1,7.0,14.0,12
CDM,J3490XGEWE,"XGEVA (DENOSUMAB), PER 120 MG",8308.0,5400.2,4154.0,8308.0,12
CDM,J3490XOLWE,XOLAIR 150 MG,1080.0,702.0,540.0,1080.0,12
CDM,J3490YERWE,YERVOY (IPILIMUMAB),100682.0,65443.3,50341.0,100682.0,12
CDM,J3490ZOVWE,ZOVIRAX ACYLOVIR 500 MG,86.0,55.9,43.0,86.0,12
CDM,J3590AMEWE,AMEVIVE 15MG IM,2502.0,1626.3,1251.0,2502.0,12
CDM,J3590BWE,JUVADERM VOLBELLA 0.55CC SYRINGE,400.0,260.0,200.0,400.0,12
CDM,J3590CWE,JUVADERM VOLBELLA 1CC SYRINGE,725.0,471.25,362.5,725.0,12
CDM,J3590DWE,JUVADERM VOLUMA,800.0,520.0,400.0,800.0,12
CDM,J3590EWE,JUVADERMVOLLURE,700.0,455.0,350.0,700.0,12
CDM,J3590FWE,JUVEDERM ULTRA XC  .55CC,455.0,295.75,227.5,455.0,12
CDM,J3590GWE,JUVEDERM ULTRA  XC 1CC,600.0,390.0,300.0,600.0,12
CDM,J3590HWE,JUVEDERM ULTRA PLUS,600.0,390.0,300.0,600.0,12
CDM,J3590IWE,RENUVA HYDRADTED 1.5 SYRINGE,1125.0,731.25,562.5,1125.0,12
CDM,J3590JWE,RENUVA HYDRADTED 3.0 SYRINGE,2250.0,1462.5,1125.0,2250.0,12
CDM,J3590KWE,RESTYLANE  .5CC,400.0,260.0,200.0,400.0,12
CDM,J3590LWE,RESTYLANE 1CC SYRINGE,600.0,390.0,300.0,600.0,12
CDM,J3590MWE,RESTYLANE DEFYNE,700.0,455.0,350.0,700.0,12
CDM,J3590NWE,RESTYLANE KYSSE 1CC SYRINGE,700.0,455.0,350.0,700.0,12
CDM,J3590OWE,RESTYLANE LYFT,600.0,390.0,300.0,600.0,12
CDM,J3590PROWE,PROLIA DENOSUMAB PER 60 MG,2710.0,1761.5,1355.0,2710.0,12
CDM,J3590PWE,RESTYLANE REFYNE,700.0,455.0,350.0,700.0,12
CDM,J3590QWE,RESTYLANE SILK,600.0,390.0,300.0,600.0,12
CDM,J3590RWE,RHA 2 (REVANCE),600.0,390.0,300.0,600.0,12
CDM,J3590STEWE,"STELARA (USTEKINUMAB), PER 45 MG",15778.0,10255.7,7889.0,15778.0,12
CDM,J3590SWE,RHA 3 (REVANCE),600.0,390.0,300.0,600.0,12
CDM,J3590TWE,RHA 4 (REVANCE),600.0,390.0,300.0,600.0,12
CDM,J3590UWE,JUVEDERM ULTRA PLUS .55CC,455.0,295.75,227.5,455.0,12
CDM,J3590VWE,RESTYLANE CONTOUR,700.0,455.0,350.0,700.0,12
CDM,J3590WE,UNCLASSIFIED BIOLOGICS,3413.0,2218.45,1706.5,3413.0,12
CDM,J3590WWE,JUVADERM VOLUX XC 1CC,800.0,520.0,400.0,800.0,12
CDM,J3590XWE,RESTYLANE EYELIGHT .5,400.0,260.0,200.0,400.0,12
CDM,J3590YWE,RESTYLANE EYELIGHT 1CC,900.0,585.0,450.0,900.0,12
CDM,J3590ZWE,JUV?DERM SKINVIVE,325.0,211.25,162.5,325.0,12
CDM,J7030WE,NORMAL SALINE SOLUTION INFUS,40.0,26.0,1.99,40.0,14
CDM,J7040WE,NORMAL SALINE SOLUTION INFUS,13.0,8.45,1.29,13.0,14
CDM,J7042WE,5% DEXTROSE/NORMAL SALINE,43.0,27.95,1.31,43.0,14
CDM,J7050WE,NORMAL SALINE SOLUTION INFUS,43.0,27.95,0.66,43.0,14
CDM,J7060D5WWE,D5W 500 CC,33.0,21.45,1.75,33.0,14
CDM,J7060WE,5% DEXTROSE/WATER,41.0,26.65,1.75,41.0,14
CDM,J7070WE,D5W INFUSION,51.0,33.15,2.94,51.0,14
CDM,J7120D5LWE,D5LR 500 CC,39.0,25.35,2.38,39.0,14
CDM,J7120WE,RINGERS LACTATE INFUSION,48.0,31.2,2.38,48.0,14
CDM,J7189WE,FACTOR VIIA,3.0,1.95,1.5,3.0,14
CDM,J7192WE,FACTOR VIII RECOMBINANT,3.0,1.95,1.5,3.0,14
CDM,J7296WE,"LEVONORGESTREL-RELEASING INTR CONTRACEPTIVE  (KYLEENA), 19.5 MG",3312.0,2152.8,1214.63,3312.0,14
CDM,J7298WE,LEVONORGESTREL IU 52MG 5 YR,614.0,399.1,307.0,1360.39,14
CDM,J7300WE,INTRAUT COPPER CONTRACEPTIVE,802.0,521.3,401.0,1329.44,14
CDM,J7301WE,SKYLA,1012.0,657.8,506.0,1132.75,14
CDM,J7307WE,ETONOGESTREL IMPLANT SYSTEM,1404.0,912.6,702.0,1428.4,14
CDM,J7308WE,AMINOLEVULINIC ACID HCL TOP,1062.0,690.3,389.83,1062.0,14
CDM,J7321WE,HYALGAN/SUPARTZ INJ PER DOSE,373.0,242.45,72.97,373.0,14
CDM,J7323WE,EUFLEXXA INJ PER DOSE,407.0,264.55,105.46,407.0,14
CDM,J7324WE,ORTHOVISC INJ PER DOSE,630.0,409.5,111.26,630.0,14
CDM,J7325SYNWE,SYNVISC ONE,34.0,22.1,7.56,34.0,14
CDM,J7325WE,SYNVISC OR SYNVISC-ONE,43.0,27.95,7.56,43.0,14
CDM,J7326WE,GEL-ONE PER DOSE,1802.0,1171.3,528.05,1802.0,14
CDM,J7327WE,MONOVISC INJ PER DOSE,2969.0,1929.85,564.77,2969.0,14
CDM,J7611WE,ALBUTEROL CONCENTRATED FORM,2.0,1.3,0.26,2.0,14
CDM,J7612WE,LEVALBUTEROL CONCENTRATED,13.0,8.45,0.38,13.0,14
CDM,J7613WE,ALBUTEROL UNIT DOSE,3.0,1.95,0.07,3.0,14
CDM,J7614WE,LEVALBUTEROL UNIT DOSE,7.0,4.55,0.08,7.0,14
CDM,J7620WE,ALBUTEROL SULFATE .O83% INH,3.0,1.95,0.2,3.0,14
CDM,J7674WE,"METHACHOLINE CHLORIDE, NEB",5.88,3.82,1.9,5.88,14
CDM,J8490WE,REGLAN 10 MG TAB,3.0,1.95,1.5,3.0,12
CDM,J8499ATIWE,ATIVAN 0.5 MG TAB,2.0,1.3,1.0,2.0,12
CDM,J8499COMWE,COMPAZINE 10 MG TABS,2.0,1.3,1.0,2.0,12
CDM,J8499KAYWE,KAYEXALATE 15 GM (SPSS),11.0,7.15,5.5,11.0,12
CDM,J8499PERWE,PERCOCET 5 MG,2.0,1.3,1.0,2.0,12
CDM,J8499ZANWE,ZANTAC 150 MG TAB,4.0,2.6,2.0,4.0,12
CDM,J8501WE,ORAL APREPITANT,51.0,33.15,2.77,51.0,14
CDM,J8521WE,"CAPECITABINE, ORAL, 500 MG",62.0,40.3,31.0,62.0,12
CDM,J8540WE,ORAL DEXAMETHASONE,37.0,24.05,0.01,37.0,14
CDM,J8999CEEWE,CEENU(LOMUSTINER) 100MG CAPS,58.0,37.7,29.0,58.0,12
CDM,J8999LEUWE,LEUCOVORIN CALCIUM ORAL 25 MG,36.0,23.4,18.0,36.0,12
CDM,J9000WE,DOXORUBIC HCL 10 MG VL CHEMO,172.0,111.8,2.78,172.0,14
CDM,J9015WE,"ALDESLEUKIN, PER SINGLE USE VIAL",2613.0,1698.45,1306.5,6605.4,14
CDM,J9017WE,ARSENIC TRIOXIDE,65.0,42.25,7.39,65.0,14
CDM,J9025WE,AZACITIDINE INJECTION,28.0,18.2,0.46,28.0,14
CDM,J9033WE,"INJ, BENDAMUSTINE HCL, 1MG",121.0,78.65,2.05,121.0,14
CDM,J9035WE,BEVACIZUMAB INJECTION,252.0,163.8,73.63,252.0,14
CDM,J9040WE,BLEOMYCIN SULFATE INJECTION,1129.0,733.85,23.02,1129.0,14
CDM,J9041WE,BORTEZOMIB INJECTION,59.0,38.35,2.68,59.0,14
CDM,J9043WE,CABAZITAXEL INJECTION,845.0,549.25,230.8,845.0,14
CDM,J9045WE,CARBOPLATIN INJECTION,536.0,348.4,2.93,536.0,14
CDM,J9050WE,CARMUS BISCHL NITRO INJ,399.0,259.35,199.5,399.0,14
CDM,J9055WE,CETUXIMAB INJECTION,108.0,70.2,54.0,108.0,14
CDM,J9060WE,CISPLATIN 10 MG INJECTION,166.0,107.9,2.11,166.0,14
CDM,J9065WE,INJ CLADRIBINE PER 1 MG,208.0,135.2,7.42,208.0,14
CDM,J9070CYCWE,"CYCLOPHOSPHAMIDE, PER 100 MG",44.0,28.6,22.0,44.0,12
CDM,J9070CYTWE,"CYTOXAN, PER 100 MG",44.0,28.6,22.0,44.0,12
CDM,J9070WE,CYCLOPHOSPHAMIDE 100 MG INJ,55.0,35.75,27.5,55.0,12
CDM,J9100WE,CYTARABINE HCL 100 MG INJ,34.0,22.1,0.84,34.0,14
CDM,J9130WE,DACARBAZINE 10 MG INJ,47.0,30.55,4.12,47.0,14
CDM,J9150WE,DAUNORUBICIN HCL INJECTION,315.0,204.75,26.33,315.0,14
CDM,J9155WE,DEGARELIX INJECTION,55.0,35.75,4.45,55.0,14
CDM,J9160WE,"DENILEUKIN DIFTITOX, 300 MCG",3885.0,2525.25,1942.5,3885.0,12
CDM,J9171DOCWE,DOCETAXEL (TAXOTERE) PER 1 MG,100.0,65.0,0.65,100.0,14
CDM,J9171INJWE,DOCETAXEL INJECTION,1213.0,788.45,0.65,1213.0,14
CDM,J9171WE,DOCETAXEL INJECTION,125.0,81.25,0.65,125.0,14
CDM,J9178WE,"INJ, EPIRUBICIN HCL, 2 MG",84.0,54.6,1.97,84.0,14
CDM,J9179WE,ERIBULIN MESYLATE INJECTION,537.0,349.05,72.61,537.0,14
CDM,J9181WE,ETOPOSIDE 10 MG INJ,47.0,30.55,1.04,47.0,14
CDM,J9185WE,FLUDARABINE PHOSPHATE INJ,1002.0,651.3,81.41,1002.0,14
CDM,J9190FLUWE,FLUOROURACIL 500 MG,7.0,4.55,1.94,7.0,14
CDM,J9190MGWE,5-FU 500 MG VIALS,13.0,8.45,1.94,13.0,14
CDM,J9190WE,FLUOROURACIL INJECTION,15.0,9.75,1.94,15.0,14
CDM,J9201WE,"GEMCITABINE HCL, 200 MG",415.0,269.75,3.59,415.0,14
CDM,J9202WE,GOSERELIN ACETATE IMPLANT,1734.0,1127.1,777.5,1734.0,14
CDM,J9206WE,"IRINOTECAN, 20 MG",658.0,427.7,1.79,658.0,14
CDM,J9207WE,IXABEPILONE INJECTION,422.0,274.3,139.98,422.0,14
CDM,J9208WE,IFOSFOMIDE INJECTION,609.0,395.85,24.84,609.0,14
CDM,J9209WE,MESNA INJECTION,135.0,87.75,1.7,135.0,14
CDM,J9213WE,INTERFERON ALFA-2A INJ,135.0,87.75,40.53,135.0,14
CDM,J9214WE,INTERFERON ALFA-2B INJ,47.0,30.55,23.5,47.0,14
CDM,J9217ELIWE,ELIGARD 7.5MG,437.0,284.05,170.78,437.0,14
CDM,J9217LUPWE,LUPRON DEPOT 7.5 MG,1383.0,898.95,170.78,1383.0,14
CDM,J9217WE,LEUPROLIDE ACETATE SUSPNSION,551.0,358.15,170.78,551.0,14
CDM,J9218WE,LEUPROLIDE ACETATE INJECTION,579.0,376.35,50.4,579.0,14
CDM,J9219WE,LEUPROLIDE ACETATE IMPLANT,20962.0,13625.3,4318.56,20962.0,14
CDM,J9225WE,HISTRELIN IMPLANT,21298.0,13843.7,4873.86,21298.0,14
CDM,J9245WE,"INJ MELPHALAN HYDROCHL, NOT OTHERWISE SPEC, 50 MG",8136.0,5288.4,86.94,8136.0,14
CDM,J9260WE,METHOTREXATE SODIUM INJ,19.0,12.35,2.58,19.0,14
CDM,J9263WE,OXALIPLATIN,24.0,15.6,0.05,24.0,14
CDM,J9264WE,PACLITAXEL PROTEIN BOUND,19.0,12.35,8.18,19.0,14
CDM,J9266WE,"PEGASPARGASE, PER SINGLE DOSE VIAL",5123.0,3329.95,2561.5,32153.3,14
CDM,J9268WE,PENTOSTATIN INJECTION,6414.0,4169.1,2537.1,6414.0,14
CDM,J9280WE,MITOMYCIN 5 MG INJ,487.0,316.55,26.1,487.0,14
CDM,J9293WE,MITOXANTRONE HYDROCHL / 5 MG,945.0,614.25,30.88,945.0,14
CDM,J9302WE,OFATUMUMAB INJECTION,277.0,180.05,60.34,277.0,14
CDM,J9303WE,PANITUMUMAB INJECTION,551.0,358.15,173.67,551.0,14
CDM,J9305WE,"INJECTION, PEMETREXED, NOT OTHERWISE SPECIFIED, 10 MG",86.0,55.9,3.59,86.0,14
CDM,J9320WE,STREPTOZOCIN INJECTION,454.0,295.1,227.0,1397.76,14
CDM,J9325WE,INJ TALIMOGENE LAHERPAREPVEC,233.0,151.45,73.94,233.0,14
CDM,J9330WE,TEMSIROLIMUS INJECTION,309.0,200.85,20.32,309.0,14
CDM,J9351WE,TOPOTECAN INJECTION,178.0,115.7,1.25,178.0,14
CDM,J9355WE,"TRASTUZUMAB, 10 MG",386.0,250.9,73.48,386.0,14
CDM,J9357WE,"VALRUBICIN, 200 MG",2052.0,1333.8,1026.0,2052.0,14
CDM,J9360WE,VINBLASTINE SULFATE INJ,13.0,8.45,5.18,13.0,14
CDM,J9370WE,VINCRISTINE SULFATE 1 MG INJ,121.0,78.65,8.15,121.0,14
CDM,J9390WE,"INJECTION, VINORELBINE TARTRATE, 10 MG",488.0,317.2,5.44,488.0,14
CDM,J9395WE,"INJECTION, FULVESTRANT",243.0,157.95,5.72,243.0,14
CDM,J9600WE,"PORFIMER SODIUM, 75 MG",16943.0,11012.95,8471.5,25076.89,14
CDM,J9999ABRWE,ABRAXANE 100 MG,1669.0,1084.85,834.5,1669.0,12
CDM,J9999AVAWE,AVASTIN 100 MG,1375.0,893.75,687.5,1375.0,12
CDM,J9999BREWE,BRENTUXIMAB (VEDOTIN) 50 MG,18878.0,12270.7,9439.0,18878.0,12
CDM,J9999HERWE,HERCEPTIN 440 MG,3945.0,2564.25,1972.5,3945.0,12
CDM,J9999PLEWE,PLENAXIS/ABARELIX 100MG NDC#68158-0149-51,1847.0,1200.55,923.5,1847.0,12
CDM,J9999VELWE,VELCADE 3.5 MG,2273.0,1477.45,1136.5,2273.0,12
CDM,L1810DELWE,DELUXE HINGED KNEE SUPPORT,170.0,110.5,57.29,170.0,17
CDM,L1810WE,KO ELASTIC W/JOINTS,215.0,139.75,57.29,215.0,17
CDM,L1810WRPWE,"KNEE ORTHOSIS, NEOPRENE WRAP",107.0,69.55,53.5,112.75,17
CDM,L1830KNEWE,KNEE IMMOBILIZER,101.0,65.65,29.2,101.0,17
CDM,L1830WE,"KO IMMOBILIZER, CANVAS LONGITUDE",128.0,83.2,29.2,128.0,17
CDM,L1830XLGWE,KNEE IMMOBILIZER X-LARGE,38.0,24.7,19.0,93.94,17
CDM,L1902ANKWE,ANKLE BRACE / FOOT ANKLE ORTHOSIS,91.0,59.15,36.15,91.0,17
CDM,L1902ASOWE,ASO ANKLE STABILIZER ANKLE/FOOT ARTHROSIS,200.0,130.0,36.15,200.0,17
CDM,L1902WE,"ASO ANKLE GAUNTLET, CUSTOM FITTED",116.0,75.4,36.15,116.0,17
CDM,L1906WE,AFO MULTILIGAMENTUS ANKLE SUPPORT,193.0,125.45,60.48,193.0,17
CDM,L3020WE,FOOT INSERT REMOVABLE LONG/MT SPPT,543.0,352.95,93.88,543.0,17
CDM,L3040WE,FOOT ARCH SUPPORT REMV LONG,64.0,41.6,22.27,64.0,17
CDM,L3260WE,AMBULATORY SURGICAL BOOT EAC,19.0,12.35,4.92,19.0,13
CDM,L3650WE,SHOULDER ORTHOSIS,80.0,52.0,25.78,80.0,17
CDM,L3702WE,EO W/O JOINTS CF,34.0,22.1,17.0,244.73,17
CDM,L3710WE,ELBOW ORTHOSIS WITH METAL JOINTS,535.0,347.75,62.44,535.0,17
CDM,L3807LRGWE,SPLINT WRIST/HAND RT LRG,282.0,183.3,107.69,282.0,17
CDM,L3807MEDWE,SPLINT WRIST FOREARM MED,282.0,183.3,107.69,282.0,17
CDM,L3807SMLWE,SPLINT WRIST FOREARM SML,282.0,183.3,107.69,282.0,17
CDM,L3807SPIWE,"SPLINT, THUMB SPICA",30.0,19.5,15.0,211.93,17
CDM,L3807SRTWE,SPLINT WRIST SMALL RIGHT,282.0,183.3,107.69,282.0,17
CDM,L3807WE,WHFO W INFLATABLE AIRCHAMBER,355.0,230.75,107.69,355.0,17
CDM,L3807WRTWE,SPLINT WRIST LARGE,282.0,183.3,107.69,282.0,17
CDM,L3908WE,WHFO WRIST EXTENSION CONTROL,63.0,40.95,25.8,63.0,17
CDM,L3923BBLWE,SPLINT BASEBALL,37.0,24.05,18.5,73.72,17
CDM,L3923FGRWE,SPLINT FINGER VELCRO,37.0,24.05,18.5,73.72,17
CDM,L3923PRGWE,SPLINT 4 PRONG,37.0,24.05,18.5,73.72,17
CDM,L3923THUWE,SPLINT THUMB,37.0,24.05,18.5,73.72,17
CDM,L3923WE,HFO W/O JOINTS PF,46.0,29.9,23.0,73.72,17
CDM,L3980WE,"UPPER LIMB FX ORTHOSIS, HUMERAL",422.0,274.3,133.13,422.0,17
CDM,L3982COLWE,COLLUM SPLINT,431.0,280.15,164.48,431.0,17
CDM,L3982UNIWE,UNIVERSAL FOREARM SML,431.0,280.15,164.48,431.0,17
CDM,L3982WE,"UPPER LIMB FX ORTHOSIS, RADIUS/ULNA",543.0,352.95,164.48,543.0,17
CDM,L3999AIRWE,AIRCAST PNEUMATIC ARM BAN,96.0,62.4,48.0,96.0,12
CDM,L3999WE,UNLISTED UPPER LIMB ORTHOSIS PROCS,110.0,71.5,55.0,110.0,12
CDM,L4210WE,"REPAIR OF ORTHOTIC DEVICE, MINOR",122.0,79.3,61.0,122.0,12
CDM,L4350WE,PNEUMATIC ANKLE CNTRL SPLINT,142.0,92.3,46.27,142.0,17
CDM,L4360WE,PNEUMATIC WALKING SPLINT,407.0,264.55,129.46,407.0,17
CDM,L8002WE,BRST PRSTH BRA & BILAT FORM,100.0,65.0,50.0,153.96,17
CDM,L850701WE,PROVOX NID,158.0,102.7,19.86,158.0,17
CDM,L850702WE,LOW PRESSURE,194.0,126.1,19.86,194.0,17
CDM,L850901WE,PROVOX 2,443.0,287.95,51.78,443.0,17
CDM,L850902WE,VEGA,410.0,266.5,51.78,410.0,17
CDM,L850903WE,XTRA SEAL,482.0,313.3,51.78,482.0,17
CDM,L850904WE,CLASSIC,395.0,256.75,51.78,395.0,17
CDM,L850905WE,ADVANTAGE,533.0,346.45,51.78,533.0,17
CDM,L850906WE,DUAL VALVE,618.0,401.7,51.78,618.0,17
CDM,L8509WE,TRACH-ESOPH VOICE PROS MD IN,546.0,354.9,51.78,546.0,17
CDM,L8603WE,COLLAGEN IMPLNT URIN TRCT 2.5CC,688.0,447.2,205.62,688.0,20
CDM,L8605WE,INJ BULKING AGENT ANAL CANAL,4330.0,2814.5,339.59,4330.0,13
CDM,L8606BULWE,SYNTHETIC IMPLNT URINARY 1ML,2974.0,1933.1,107.93,2974.0,20
CDM,L8606INJWE,INJ BULKING AGENT SYNTHETIC PER 1ML,534.0,347.1,107.93,534.0,20
CDM,L8606MACWE,MACROPLASTIQUE 1ML,1443.0,937.95,107.93,1443.0,20
CDM,L8606WE,SYNTHETIC IMPLNT URINARY 1ML,1817.0,1181.05,107.93,1817.0,20
CDM,L8680WE,IMPLANT NEUROSTIM ELECTRODE,464.0,301.6,92.09,464.0,17
CDM,M0249WE,ADM TOCILIZU COVID-19 1ST,361.0,234.65,180.5,806.51,13
CDM,M0250WE,ADM TOCILIZU COVID-19 2ND,361.0,234.65,180.5,806.51,13
CDM,M1072WE,"ROM RAD THERAPY ANAL, PC",11472.0,7456.8,5736.0,11472.0,12
CDM,M1073WE,"ROM RAD THERAPY ANAL, TC",67428.0,43828.2,33714.0,67428.0,12
CDM,M1074WE,"ROM RAD THERAPY BLADDER, PC",10304.0,6697.6,5152.0,10304.0,12
CDM,M1075WE,"ROM RAD THERAPY BLADDER, TC",54154.0,35200.1,27077.0,54154.0,12
CDM,M1076WE,"ROM RAD THER BONE METS, PC",5342.0,3472.3,2671.0,5342.0,12
CDM,M1077WE,"ROM RAD THER BONE METS, TC",24248.0,15761.2,12124.0,24248.0,12
CDM,M1078WE,"ROM RAD THER BRAIN METS, PC",6097.0,3963.05,3048.5,6097.0,12
CDM,M1079WE,"ROM RAD THER BRAIN METS, TC",38984.0,25339.6,19492.0,38984.0,12
CDM,M1080WE,"ROM RAD THERAPY BREAST, PC",7614.0,4949.1,3807.0,7614.0,12
CDM,M1081WE,"ROM RAD THERAPY BREAST, TC",39712.0,25812.8,19856.0,39712.0,12
CDM,M1082WE,"ROM RAD THERAPY CERVICAL, PC",11224.0,7295.6,5612.0,11224.0,12
CDM,M1083WE,"ROM RAD THERAPY CERVICAL, TC",54252.0,35263.8,27126.0,54252.0,12
CDM,M1084WE,"ROM RAD THERAPY CNS, PC",9452.0,6143.8,4726.0,9452.0,12
CDM,M1085WE,"ROM RAD THERAPY CNS, TC",59412.0,38617.8,29706.0,59412.0,12
CDM,M1086WE,"ROM RAD THER COLORECTAL, PC",9269.0,6024.85,4634.5,9269.0,12
CDM,M1087WE,"ROM RAD THER COLORECTAL, TC",48679.0,31641.35,24339.5,48679.0,12
CDM,M1088WE,"ROM RAD THER HEAD/NECK, PC",11487.0,7466.55,5743.5,11487.0,12
CDM,M1089WE,"ROM RAD THER HEAD/NECK, TC",70144.0,45593.6,35072.0,70144.0,12
CDM,M1094WE,"ROM RAD THERAPY LUNG, PC",8246.0,5359.9,4123.0,8246.0,12
CDM,M1095WE,"ROM RAD THERAPY LUNG, TC",48030.0,31219.5,24015.0,48030.0,12
CDM,M1096WE,"ROM RAD THERAPY LYMPHOMA, PC",6373.0,4142.45,3186.5,6373.0,12
CDM,M1097WE,"ROM RAD THERAPY LYMPHOMA, TC",31717.0,20616.05,15858.5,31717.0,12
CDM,M1098WE,"ROM RAD THERAPY PANCREAS, PC",9168.0,5959.2,4584.0,9168.0,12
CDM,M1099WE,"ROM RAD THERAPY PANCREAS, TC",54386.0,35350.9,27193.0,54386.0,12
CDM,M1100WE,"ROM RAD THERAPY PROSTATE, PC",12493.0,8120.45,6246.5,12493.0,12
CDM,M1101WE,"ROM RAD THERAPY PROSTATE, TC",81221.0,52793.65,40610.5,81221.0,12
CDM,M1102WE,"ROM RAD THERAPY GI, PC",9858.0,6407.7,4929.0,9858.0,12
CDM,M1103WE,"ROM RAD THERAPY GI, TC",58634.0,38112.1,29317.0,58634.0,12
CDM,M1104WE,"ROM RAD THERAPY UTERUS, PC",10120.0,6578.0,5060.0,10120.0,12
CDM,M1105WE,"ROM RAD THERAPY UTERUS, TC",56879.0,36971.35,28439.5,56879.0,12
CDM,P9047WE,"ALBUMIN (HUMAN), 25%, 50ML",336.0,218.4,53.08,336.0,14
CDM,P9612WE,"CATH COLL SPEC,1 PT,ALL PLACES SERVC",17.0,11.05,2.34,17.0,17
CDM,PKG54405WE,PENILE IMPLANT,42000.0,27300.0,547.09,42000.0,32
CDM,PKG90867WE,REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M,485.0,315.25,90.36,485.0,18
CDM,PKG90868WE,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,485.0,315.25,18.79,485.0,18
CDM,PKG90869WE,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN,515.0,334.75,75.5,515.0,18
CDM,PKGFETALINJWE,FETAL INJECTION,1500.0,975.0,750.0,1500.0,12
CDM,PKGICGWE,ICG PACKAGE,3434.0,2232.1,1717.0,3434.0,12
CDM,PKGTERMCONSULTWE,PREGNANCY TERMINATION CONSULT,950.0,617.5,475.0,950.0,12
CDM,Q0091FAMWE,OBTAINING SCREEN PAP SMEAR,163.0,105.95,16.34,163.0,31
CDM,Q0091WE,PAP SMEAR,163.0,105.95,16.34,163.0,31
CDM,Q0112WE,POTASSIUM HYDROXIDE PREPS,20.0,13.0,3.5,20.0,20
CDM,Q0138WE,"FERUMOXYTOL, NON-ESRD",2.0,1.3,0.36,2.0,13
CDM,Q0139WE,"FERUMOXYTOL, ESRD USE",2.0,1.3,0.36,2.0,13
CDM,Q0166WE,"GRANISETRON HYDROCHLORIDE,1MG,ORAL",135.0,87.75,3.0,135.0,13
CDM,Q0180WE,"DOLASETRON MESYLATE,100 MG,ORAL",201.0,130.65,60.32,201.0,14
CDM,Q0478AWE,"VAD CABLE,PWR MODULE,DC INPUT,2230",381.0,247.65,87.12,381.0,17
CDM,Q0479AWE,VAD MODULE POWER HEARTMATE,13245.0,8609.25,5681.31,13245.0,17
CDM,Q0479WE,POWER MODULE,13068.0,8494.2,5681.31,13068.0,17
CDM,Q0481AWE,"VAD POCKET CTRL,HEARTMATE,106762",14857.0,9657.05,6889.43,14857.0,17
CDM,Q0481WE,POCKET CONTROLLER INCL EMERGENCY BACK-UP-BATTERY,8985.0,5840.25,4492.5,13558.79,17
CDM,Q0495AWE,VAD CHARGER BATTERY UNIVERSAL,12225.0,7946.25,1980.46,12225.0,17
CDM,Q0495WE,UNIVERSAL BATTERY CHARGER (UBC),11761.0,7644.65,1980.46,11761.0,17
CDM,Q0497AWE,VAD BATTERY CLIP SET 14V LI-ION,934.0,607.1,221.94,934.0,17
CDM,Q0497WE,14V BATTERY CLIPS (SET OF 2),1760.0,1144.0,221.94,1760.0,17
CDM,Q0498AWE,"VAD HOLSTR,GOGEAR HM, ALL SZ 1042XX",671.0,436.15,243.53,671.0,17
CDM,Q0498BWE,"VAD VEST,HOLSTER,14V,ALL SZ",838.0,544.7,243.53,838.0,17
CDM,Q0498DWE,LVAD BATTERY HOLSTER,593.0,385.45,243.53,593.0,17
CDM,Q0498WE,"LVAD HOLSTER VEST (SM, MED, LG)",717.0,466.05,243.53,717.0,17
CDM,Q0499AWE,"VAD BELT,MODULAR,14V,10422X,ALL SZ",585.0,380.25,79.13,585.0,17
CDM,Q0499BWE,"LVAD CONSOLIDATED BAG (RIGHT, LEFT)",488.0,317.2,79.13,488.0,17
CDM,Q0501AWE,LVAD SHOWER BAG,675.0,438.75,242.13,675.0,17
CDM,Q0503WE,BATTERY FOR PNEUMATIC VENTRICULAR ASSIST DEVICE,1089.0,707.85,544.5,1213.38,17
CDM,Q0506AWE,14V BATTERIES (SET OF 4),3375.0,2193.75,404.96,3375.0,17
CDM,Q0506BWE,"VAD BTTRY BCKUP,PKT CNTRL,HM 106128",870.0,565.5,404.96,870.0,17
CDM,Q0506WE,BACKUP BATTERY (11V) (FOR CONTROLLER),908.0,590.2,404.96,908.0,17
CDM,Q0508AWE,"VAD CABLE, PATIENT POWR MODULE,14V",2335.0,1517.75,1167.5,2335.0,12
CDM,Q0508BWE,LVAD STABILIZATION BELT,175.0,113.75,87.5,175.0,12
CDM,Q0508CWE,LVAD TRAVEL BAG,240.0,156.0,120.0,240.0,12
CDM,Q0508DWE,POWER MODULE CABLE,1688.0,1097.2,844.0,1688.0,12
CDM,Q0508EWE,"DRIVELINE MANGEMENT SYSTEM (E.G., DRESSINGS)",22.0,14.3,11.0,22.0,12
CDM,Q0515WE,SERMORELIN ACETATE INJECTION,24.0,15.6,1.61,24.0,14
CDM,Q2004WE,BLADDER CALCULI IRRIG SOL,86.0,55.9,43.0,108.8,14
CDM,Q2026AWE,RADIESSE 0.8CC PER EA. SYRINGE,600.0,390.0,300.0,600.0,12
CDM,Q2026BWE,RADIESSE 1.5CC EA. SYRINGE,800.0,520.0,400.0,800.0,12
CDM,Q2028AWE,SCULPTRA .5MG,800.0,520.0,0.67,800.0,14
CDM,Q2037WE,"PR FLUVIRIN VACC, 3 YRS & >, IM",24.0,15.6,12.0,24.0,13
CDM,Q2038WE,"PR FLUZONE VACC, 3 YRS & >, IM",72.0,46.8,36.0,72.0,13
CDM,Q2039WE,"NOS FLU VACC, 3 YRS & >, IM",44.0,28.6,22.0,44.0,13
CDM,Q2043WE,SIPULEUCEL-T AUTO CD54+,168610.0,109596.5,54404.11,168610.0,13
CDM,Q3031WE,COLLAGEN SKIN TEST,79.0,51.35,39.5,79.0,12
CDM,Q4005WE,CAST SUP LONG ARM ADULT PLST,37.0,24.05,4.56,37.0,17
CDM,Q4006WE,CAST SUP LONG ARM ADULT FBRG,116.0,75.4,10.29,116.0,17
CDM,Q4009WE,CAST SUP SHT ARM ADULT PLSTR,95.0,61.75,3.05,95.0,17
CDM,Q4010WE,CAST SUP SHT ARM ADULT FBRGL,80.0,52.0,6.86,80.0,17
CDM,Q4017WE,CAST SUP LNG ARM SPLINT PLST,108.0,70.2,3.21,108.0,17
CDM,Q4018WE,CAST SUP LNG ARM SPLINT FBRG,41.0,26.65,5.12,41.0,17
CDM,Q4021WE,CAST SUP SHT ARM SPLINT PLST,51.0,33.15,2.38,51.0,17
CDM,Q4022WE,CAST SUP SHT ARM SPLINT FBRG,36.0,23.4,4.28,36.0,17
CDM,Q4029WE,CAST SUP LONG LEG PLASTER,79.0,51.35,10.17,79.0,17
CDM,Q4030WE,CAST SUP LONG LEG FIBERGLASS,230.0,149.5,26.79,230.0,17
CDM,Q4033WE,CAST SUP LNG LEG CYLINDER PL,75.0,48.75,9.49,75.0,17
CDM,Q4034WE,CAST SUP LNG LEG CYLINDER FB,186.0,120.9,23.62,186.0,17
CDM,Q4038WE,CAST SUP SHRT LEG FIBERGLASS,74.0,48.1,14.51,74.0,17
CDM,Q4041WE,CAST SUP LNG LEG SPLNT PLSTR,55.0,35.75,7.04,55.0,17
CDM,Q4042WE,CAST SUP LNG LEG SPLNT FBRGL,95.0,61.75,12.03,95.0,17
CDM,Q4045WE,CAST SUP SHT LEG SPLNT PLSTR,35.0,22.75,4.09,35.0,17
CDM,Q4046WE,CAST SUP SHT LEG SPLNT FBRGL,52.0,33.8,6.57,52.0,17
CDM,Q4051SPLWE,SPLINT PADDING PER INCH,10.0,6.5,5.0,10.0,12
CDM,Q4051STOWE,STOCKINETTE PER FT,5.0,3.25,2.5,5.0,12
CDM,Q4051WE,SPLINT SUPPLIES MISC,12.0,7.8,6.0,12.0,12
CDM,Q4081WE,"EPOETIN ALFA, 100 UNITS ESRD",9.0,5.85,0.77,9.0,14
CDM,Q4118WE,PR MATRISTEM MICROMATRIX,6.0,3.9,3.0,6.0,13
CDM,Q5104WE,"INJECTION, RENFLEXIS",345.0,224.25,27.75,345.0,14
CDM,Q5106WE,INJ RETACRIT NON-ESRD USE (RETACRIT),51.0,33.15,7.57,51.0,14
CDM,Q5108WE,"INJECTION, FULPHILA",19113.0,12423.45,98.87,19113.0,14
CDM,Q9956WE,"INJ OCTAFLUOROPROPANE MIC,ML",142.0,92.3,40.21,142.0,14
CDM,Q9957WE,"INJ PERFLUTREN LIP MICROS,ML",459.0,298.35,40.21,459.0,14
CDM,Q9966WE,"LOCM 200-299MG/ML IODINE,1ML",8.0,5.2,0.4,8.0,13
CDM,Q9967AWE,OMNIPAQUE 300 (100 ML),3.0,1.95,0.15,3.0,13
CDM,Q9967BWE,OMNIPAQUE 300 (150 ML),3.0,1.95,0.15,3.0,13
CDM,Q9967CWE,OMNIPAQUE 350 (150 ML),3.0,1.95,0.15,3.0,13
CDM,S0028WE,"INJECTION, FAMOTIDINE, 20 MG",7.0,4.55,3.5,7.0,12
CDM,S0039WE,"INJECTION, SULFAMETHOXAZOLE, 10 ML",23.0,14.95,11.5,23.0,12
CDM,S0073WE,"INJECTION, AZTREONAM, 500 MG",128.0,83.2,64.0,128.0,12
CDM,S0189WE,TESTOSTERONE PELLET 75 MG,259.0,168.35,129.5,259.0,12
CDM,S0610WE,"GYN EXAM, NEW PT., ANNUAL",373.0,242.45,186.5,373.0,12
CDM,S0612WE,"GYN EXAM, EST PT., ANNUAL",303.0,196.95,151.5,303.0,12
CDM,S0800WE,LASER IN SITU KERATOMILEUSIS,3529.0,2293.85,1764.5,3529.0,12
CDM,S2067WE,"BREAST ""STACKED"" DIEP/GAP",21109.0,13720.85,10554.5,21109.0,12
CDM,S2068WE,BREAST DIEP FLAP RECONSTRUCT,21547.0,14005.55,10773.5,21547.0,12
CDM,S2083WE,ADJUSTMENT GASTRIC BAND,72.0,46.8,36.0,72.0,12
CDM,S2325WE,HIP CORE DECOMPRESSION,2516.0,1635.4,1258.0,2516.0,12
CDM,S2900WE,ROBOTIC SURGICAL SYSTEM,526.0,341.9,263.0,526.0,12
CDM,S5010WE,5% DEXTROSE AND 0.45% SALINE,23.0,14.95,9.32,23.0,13
CDM,S9460WE,DM CGM-DIAGNOSTIC,279.0,181.35,139.5,279.0,12
CDM,S9465WE,DM MGMT X20 DIETICIAN VISIT,279.0,181.35,139.5,279.0,12
CDM,U0001WE-236,COVID19,150.0,97.5,21.55,150.0,13
CDM,U0001WE-237,COVID19,150.0,97.5,15.09,150.0,13
CDM,V2520WE,CONTACT LENS HYDROPHILIC,36.0,23.4,18.0,96.23,17
CDM,V2632PAYWE,CRYSTALENS IOL; UPGRADE INSURANCE PAYERS,1058.0,687.7,55.81,1058.0,13
CDM,V2632SELWE,CRYSTALENS ACCOMMODATING IOL SELF PAY,1172.0,761.8,55.81,1172.0,13
CDM,V2718WE,FRESNEL PRISM PRESS-ON LENS,44.0,28.6,13.39,44.0,17
CDM,V5010WE,ASSESSMENT FOR HEARING AID,122.0,79.3,61.0,122.0,13
CDM,V5050ITEWE,ITE HEARING AID MOAURAL,2037.0,1324.05,1018.5,2037.0,13
CDM,V5050MONWE,REAL-EAR MONAURAL,2037.0,1324.05,1018.5,2037.0,13
CDM,V5050TRIWE,TRITON I.Q.3004B;BTE-MONAURAL,2037.0,1324.05,1018.5,2037.0,13
CDM,V5050WE,HEARING AID MONAURAL IN-THE-EAR,2565.0,1667.25,1040.65,2565.0,13
CDM,V5100WE,BODY-WORN BILAT HEARING AID,2565.0,1667.25,1282.5,2565.0,13
CDM,V5130BINWE,REAL-EAR BINAURAL,1907.0,1239.55,953.5,1907.0,13
CDM,V5130ITEWE,ITE HEARING AID BINAURAL,1907.0,1239.55,953.5,1907.0,13
CDM,V5130WE,HEARING AID BINAURAL IN-THE-EAR,2400.0,1560.0,1200.0,2400.0,13
CDM,V5140BTEWE,BTE HEARING AID BINAURAL,3945.0,2564.25,1884.38,3945.0,13
CDM,V5140TRIWE,TRITON I.Q.2004B;BTE-BINAURAL,3945.0,2564.25,1884.38,3945.0,13
CDM,V5140WE,"HEARING AID BINAURAL, BEHIND-EAR",4968.0,3229.2,1884.38,4968.0,13
CDM,V5254WE,"HEARING ID, DIGIT, MON, CIC",643.0,417.95,321.5,2500.0,13
CDM,V5255WE,"HEARING AID, DIGIT, MON, ITC",643.0,417.95,321.5,2500.0,13
CDM,V5256WE,"HEARING AID, DIGIT, MON, ITE",643.0,417.95,321.5,2500.0,13
CDM,V5257WE,"HEARING AID, DIGIT, MON, BTE",643.0,417.95,321.5,2500.0,13
CDM,V5258WE,"HEARING AID, DIGIT, BIN, CIC",1867.0,1213.55,933.5,5000.0,13
CDM,V5259WE,"HEARING AID, DIGIT, BIN, ITC",1867.0,1213.55,933.5,5000.0,13
CDM,V5260WE,"HEARING AID, DIGIT, BIN, ITE",1867.0,1213.55,933.5,5000.0,13
CDM,V5261WE,"HEARING AID, DIGIT, BIN, BTE",1867.0,1213.55,933.5,5000.0,13
CDM,V5267AIRWE,AIR BLOWER,113.0,73.45,56.5,113.0,12
CDM,V5267DRIWE,DRI-AID KIT,113.0,73.45,56.5,113.0,12
CDM,V5267VOIWE,VOICE MIC,113.0,73.45,56.5,113.0,12
CDM,V5299ADVWE,ADVANCED PROGAM AID REPAIR/1YR,323.0,209.95,161.5,323.0,12
CDM,V5299AIDWE,IN THRE CANAL HEARING AID,1114.0,724.1,557.0,1114.0,12
CDM,V5299COIWE,T-COIL,56.0,36.4,28.0,56.0,12
CDM,V5299COMWE,COMPLETELY-IN-CANAL;MONAURAL,1877.0,1220.05,938.5,1877.0,12
CDM,V5299DIGWE,DIGITAL AID REPAIR/12MTHS REPAIR,353.0,229.45,176.5,353.0,12
CDM,V5299EARWE,EARGENE,11.0,7.15,5.5,11.0,12
CDM,V5299MINWE,MINI CANAL HEARING AID,2353.0,1529.45,1176.5,2353.0,12
CDM,V5299MUSWE,MUSICIAN EAR PLUG,72.0,46.8,36.0,72.0,12
CDM,V5299REPWE,REPLACE TUBING,11.0,7.15,5.5,11.0,12
CDM,V5299WE,"HEARING AID, OTHER:",55.0,35.75,27.5,55.0,12
CDM,W9759WE,"FAMILY PLANNING,ANNUAL,1ST OV-MCAID",116.0,75.4,58.0,116.0,12
CDM,W9850WE,"MCAID, F/U, COUNSELING FAM PLANNING",69.0,44.85,34.5,69.0,12
CDM,W9851WE,"MCAID, FAM PLANNING,RX REFILL,SUPPLIES",36.0,23.4,18.0,36.0,12
CDM,WP99212WE,WORK PERMIT PHYSICAL,30.0,19.5,15.0,67.22,35
CPT,AUTOTANIP,Cornea - IP,,,24629.0,24629.0,1
CPT,AUTOTANOP,Cornea - OP,,,18192.0,18192.0,1
CPT,INTESTONLYA,Intestine Only-Adult,,,485000.0,485000.0,1
CPT,INTESTONLYP,Intestine Only-Pediatric,,,540500.0,540500.0,1
CPT,KIDPANC,Kidney/Pancreas - Adult & Pediatric,,,238302.0,238302.0,1
HCPCS,0001A,Adm sarscov2 30mcg/0.3ml 1st,,,25.75,32.53,6
HCPCS,0001F,HEART FAILURE COMPOSITE,,,0.01,0.01,1
HCPCS,0001F0,HEART FAILURE COMPOSITE,,,0.01,0.01,1
HCPCS,0001U,RBC DNA HEA 35 AG 11 BLD GRP,,,622.08,1203.12,15
HCPCS,0001U,Rbc dna hea 35 ag 11 bld grp,,,325.19,410.76,6
HCPCS,0001U0,RBC DNA HEA 35 AG 11 BLD GRP,,,622.08,622.08,1
HCPCS,0002A,Adm sarscov2 30mcg/0.3ml 2nd,,,25.75,32.53,6
HCPCS,0002M,LIVER DIS 10 ASSAYS W/ASH,,,434.94,841.18,15
HCPCS,0002M,Liver dis 10 assays w/ash,,,170.1,214.86,6
HCPCS,0002M0,LIVER DIS 10 ASSAYS W/ASH,,,434.94,434.94,1
HCPCS,0002U,ONC CLRCT 3 UR METAB ALG PLP,,,21.6,41.78,15
HCPCS,0002U,Onc clrct 3 ur metab alg plp,,,5.78,7.3,6
HCPCS,0002U0,ONC CLRCT 3 UR METAB ALG PLP,,,21.6,21.6,1
HCPCS,0003A,Adm sarscov2 30mcg/0.3ml 3rd,,,25.75,32.53,6
HCPCS,0003M,LIVER DIS 10 ASSAYS W/NASH,,,434.94,841.18,15
HCPCS,0003M,Liver dis 10 assays w/nash,,,170.1,214.86,6
HCPCS,0003M0,LIVER DIS 10 ASSAYS W/NASH,,,434.94,434.94,1
HCPCS,0003U,ONC OVAR 5 PRTN SER ALG SCOR,,,820.8,1587.45,15
HCPCS,0003U,Onc ovar 5 prtn ser alg scor,,,325.19,410.76,6
HCPCS,0003U0,ONC OVAR 5 PRTN SER ALG SCOR,,,820.8,820.8,1
HCPCS,0004A,Adm sarscov2 30mcg/0.3ml bst,,,25.75,32.53,6
HCPCS,0004M,SCOLIOSIS DNA ALYS,,,68.26,132.01,15
HCPCS,0004M,Scoliosis dna alys,,,22.32,28.19,6
HCPCS,0004M0,SCOLIOSIS DNA ALYS,,,68.26,68.26,1
HCPCS,0005F,OSTEOARTHRITIS COMPOSITE,,,0.01,0.01,1
HCPCS,0005F0,OSTEOARTHRITIS COMPOSITE,,,0.01,0.01,1
HCPCS,0005U,ONCO PRST8 3 GENE UR ALG,,,656.64,1269.96,15
HCPCS,0005U,Onco prst8 3 gene ur alg,,,325.19,410.76,6
HCPCS,0005U0,ONCO PRST8 3 GENE UR ALG,,,656.64,656.64,1
HCPCS,0006M,ONC HEP GENE RISK CLASSIFIER,,,129.6,250.65,15
HCPCS,0006M,Onc hep gene risk classifier,,,76.88,97.12,6
HCPCS,0006M0,ONC HEP GENE RISK CLASSIFIER,,,129.6,129.6,1
HCPCS,0007M,ONC GASTRO 51 GENE NOMOGRAM,,,324.0,626.63,15
HCPCS,0007M,Onc gastro 51 gene nomogram,,,170.1,214.86,6
HCPCS,0007M0,ONC GASTRO 51 GENE NOMOGRAM,,,324.0,324.0,1
HCPCS,0007U,RX TEST PRSMV UR W/DEF CONF,,,98.86,191.21,15
HCPCS,0007U,Rx test prsmv ur w/def conf,,,33.04,41.74,6
HCPCS,0007U0,RX TEST PRSMV UR W/DEF CONF,,,98.86,98.86,1
HCPCS,0008U,HPYLORI DETCJ ABX RSTNC DNA,,,516.6,999.11,15
HCPCS,0008U,Hpylori detcj abx rstnc dna,,,170.1,214.86,6
HCPCS,0008U0,HPYLORI DETCJ ABX RSTNC DNA,,,516.6,516.6,1
HCPCS,0009U,ONC BRST CA ERBB2 AMP/NONAMP,,,92.45,178.8,15
HCPCS,0009U,Onc brst ca erbb2 amp/nonamp,,,22.32,28.19,6
HCPCS,0009U0,ONC BRST CA ERBB2 AMP/NONAMP,,,92.45,92.45,1
HCPCS,00100,Anes px salivary gland w/bx,,,13.94,17.6,6
HCPCS,00102,Anes px plstc rpr cleft lip,,,13.94,17.6,6
HCPCS,00103,Anes rcnstv px eyelid,,,13.94,17.6,6
HCPCS,00104,Anes electroconvulsive ther,,,13.94,17.6,6
HCPCS,0010U,NFCT DS STRN TYP WHL GEN SEQ,,,369.15,713.95,15
HCPCS,0010U,Nfct ds strn typ whl gen seq,,,170.1,214.86,6
HCPCS,0010U0,NFCT DS STRN TYP WHL GEN SEQ,,,369.15,369.15,1
HCPCS,0011A,Adm sarscov2 100mcg/0.5ml1st,,,25.75,32.53,6
HCPCS,0011M,ONC PRST8 CA MRNA 12 GEN ALG,,,656.64,1269.96,15
HCPCS,0011M,Onc prst8 ca mrna 12 gen alg,,,325.19,410.76,6
HCPCS,0011M0,ONC PRST8 CA MRNA 12 GEN ALG,,,656.64,656.64,1
HCPCS,0011U,RX MNTR LC-MS/MS ORAL FLUID,,,98.86,191.21,15
HCPCS,0011U,Rx mntr lc-ms/ms oral fluid,,,33.04,41.74,6
HCPCS,0011U0,RX MNTR LC-MS/MS ORAL FLUID,,,98.86,98.86,1
HCPCS,00120,Anes px ear w/bx nos,,,13.94,17.6,6
HCPCS,00124,Anes px ear otoscopy,,,13.94,17.6,6
HCPCS,00126,Anes px ear tympanotomy,,,13.94,17.6,6
HCPCS,0012A,Adm sarscov2 100mcg/0.5ml2nd,,,25.75,32.53,6
HCPCS,0012F,CAP BACTERIAL ASSESS,,,0.01,0.01,1
HCPCS,0012F0,CAP BACTERIAL ASSESS,,,0.01,0.01,1
HCPCS,0012M,ONC MRNA 5 GEN RSK URTHL CA,,,656.64,1269.96,15
HCPCS,0012M,Onc mrna 5 gen rsk urthl ca,,,325.19,410.76,6
HCPCS,0012M0,ONC MRNA 5 GEN RSK URTHL CA,,,656.64,656.64,1
HCPCS,0012U,Germln do gene reargmt detcj,,,1109.84,1401.9,6
HCPCS,0013A,Adm sarscov2 100mcg/0.5ml3rd,,,25.75,32.53,6
HCPCS,0013M,ONC MRNA 5 GEN RECR URTHL CA,,,656.64,1269.96,15
HCPCS,0013M,Onc mrna 5 gen recr urthl ca,,,325.19,410.76,6
HCPCS,0013M0,ONC MRNA 5 GEN RECR URTHL CA,,,656.64,656.64,1
HCPCS,0013U,Onc sld org neo gene reargmt,,,1109.84,1401.9,6
HCPCS,00140,Anes procedures on eye nos,,,13.94,17.6,6
HCPCS,00142,Anes px on eye lens surgery,,,13.94,17.6,6
HCPCS,00144,Anes px eye corneal trnspl,,,13.94,17.6,6
HCPCS,00145,Anes px eye vitreortnl surg,,,13.94,17.6,6
HCPCS,00147,Anes px on eye iridectomy,,,13.94,17.6,6
HCPCS,00148,Anes px eye ophthalmoscopy,,,13.94,17.6,6
HCPCS,0014A,Fee covid-19 vac 2 res,,,25.75,32.53,6
HCPCS,0014F,COMP PREOP ASSESS CAT SURG,,,0.01,0.01,1
HCPCS,0014F0,COMP PREOP ASSESS CAT SURG,,,0.01,0.01,1
HCPCS,0014M,Liver ds alys 3 bmrk srm alg,,,76.88,97.12,6
HCPCS,0014U,Hem hmtlmf neo gene reargmt,,,1109.84,1401.9,6
HCPCS,0015F,MELAN FOLLOW-UP COMPLETE,,,0.01,0.01,1
HCPCS,0015F0,MELAN FOLLOW-UP COMPLETE,,,0.01,0.01,1
HCPCS,0015M,ADRNL CORTCL TUM BCHM ASY 25,,,1127.84,2181.27,15
HCPCS,0015M,Adrnl cortcl tum bchm asy 25,,,22.32,28.19,6
HCPCS,0015M0,ADRNL CORTCL TUM BCHM ASY 25,,,1127.84,1127.84,1
HCPCS,00160,Anes px nose&sinus nos,,,13.94,17.6,6
HCPCS,00162,Anes px nose&sinus rad surg,,,13.94,17.6,6
HCPCS,00164,Anes px nose&sins bx sft tis,,,13.94,17.6,6
HCPCS,0016M,ONC BLADDER MRNA 219 GEN ALG,,,3015.04,5831.17,15
HCPCS,0016M,Onc bladder mrna 219 gen alg,,,22.32,28.19,6
HCPCS,0016M0,ONC BLADDER MRNA 219 GEN ALG,,,3015.04,3015.04,1
HCPCS,0016U,ONC HMTLMF NEO RNA BCR/ABL1,,,141.66,273.98,15
HCPCS,0016U,Onc hmtlmf neo rna bcr/abl1,,,76.88,97.12,6
HCPCS,0016U0,ONC HMTLMF NEO RNA BCR/ABL1,,,141.66,141.66,1
HCPCS,00170,Anes intraoral px nos,,,13.94,17.6,6
HCPCS,00172,Anes ntroral px rpr clft pal,,,13.94,17.6,6
HCPCS,00174,Anes ntrorl exc rtrphrng tum,,,13.94,17.6,6
HCPCS,00176,Anes intraoral px rad surg,,,13.94,17.6,6
HCPCS,0017M,ONC DLBCL MRNA 20 GENES ALG,,,2168.82,4194.56,15
HCPCS,0017M,Onc dlbcl mrna 20 genes alg,,,1109.84,1401.9,6
HCPCS,0017M0,ONC DLBCL MRNA 20 GENES ALG,,,2168.82,2168.82,1
HCPCS,0017U,ONC HMTLMF NEO JAK2 MUT DNA,,,79.2,153.16,15
HCPCS,0017U,Onc hmtlmf neo jak2 mut dna,,,22.32,28.19,6
HCPCS,0017U0,ONC HMTLMF NEO JAK2 MUT DNA,,,79.2,79.2,1
HCPCS,0018M,TRNSPLJ RNL MEAS CD154+CLL,,,553.59,1070.66,15
HCPCS,0018M,Trnsplj rnl meas cd154+cll,,,81.35,102.76,6
HCPCS,0018M0,TRNSPLJ RNL MEAS CD154+CLL,,,553.59,553.59,1
HCPCS,0018U,ONC THYR 10 MICRORNA SEQ ALG,,,2593.8,5016.49,15
HCPCS,0018U,Onc thyr 10 microrna seq alg,,,1109.84,1401.9,6
HCPCS,0018U0,ONC THYR 10 MICRORNA SEQ ALG,,,2593.8,2593.8,1
HCPCS,00190,Anes px facial b1/skull nos,,,13.94,17.6,6
HCPCS,00192,Anes px fcl b1/skl rad surg,,,13.94,17.6,6
HCPCS,0019M,CV DS PLASMA ALYS PRTN BMRK,,,615.51,1190.42,15
HCPCS,0019M,Cv ds plasma alys prtn bmrk,,,22.32,28.19,6
HCPCS,0019M0,CV DS PLASMA ALYS PRTN BMRK,,,615.51,615.51,1
HCPCS,0019U,ONC RNA TISS PREDICT ALG,,,3175.2,6140.93,15
HCPCS,0019U,Onc rna tiss predict alg,,,1109.84,1401.9,6
HCPCS,0019U0,ONC RNA TISS PREDICT ALG,,,3175.2,3175.2,1
HCPCS,0020M,ONC CNS ALYS 30000 DNA LOCI,,,2500.0,2750.0,4
HCPCS,0020M,Onc cns alys 30000 dna loci,,,22.32,28.19,6
HCPCS,00210,Anes intracranial px nos,,,13.94,17.6,6
HCPCS,00211,Anes icr px crnec/crnot hmtm,,,13.94,17.6,6
HCPCS,00212,Anes icr px subdural taps,,,13.94,17.6,6
HCPCS,00214,Anes icr px burr holes,,,13.94,17.6,6
HCPCS,00215,Anes icr px crnop/elvtn fx,,,13.94,17.6,6
HCPCS,00216,Anes icr px vascular px,,,13.94,17.6,6
HCPCS,00218,Anes icr px in sitting pos,,,13.94,17.6,6
HCPCS,0021A,Adm sarscov2 5x1010vp/.5ml 1,,,25.75,32.53,6
HCPCS,0021U,ONC PRST8 DETCJ 8 AUTOANTB,,,656.64,1269.96,15
HCPCS,0021U,Onc prst8 detcj 8 autoantb,,,325.19,410.76,6
HCPCS,0021U0,ONC PRST8 DETCJ 8 AUTOANTB,,,656.64,656.64,1
HCPCS,00220,Anes icr px csf shunting px,,,13.94,17.6,6
HCPCS,00222,Anes icr px ecoag icr nrv,,,13.94,17.6,6
HCPCS,0022A,Adm sarscov2 5x1010vp/.5ml 2,,,25.75,32.53,6
HCPCS,0022U,TGSAP NSM LUNG NEO DNA&RNA23,,,1684.8,3258.45,15
HCPCS,0022U,Tgsap nsm lung neo dna&rna23,,,170.1,214.86,6
HCPCS,0022U0,TGSAP NSM LUNG NEO DNA&RNA23,,,1684.8,1684.8,1
HCPCS,0023A,Fee covid-19 vac 3 booster,,,25.75,32.53,6
HCPCS,0023U,ONC AML DNA DETCJ/NONDETCJ,,,214.71,415.26,15
HCPCS,0023U,Onc aml dna detcj/nondetcj,,,76.88,97.12,6
HCPCS,0023U0,ONC AML DNA DETCJ/NONDETCJ,,,214.71,214.71,1
HCPCS,0024A,Fee covid-19 vac 3 res,,,25.75,32.53,6
HCPCS,0024U,GLYCA NUC MR SPECTRSC QUAN,,,29.54,57.13,15
HCPCS,0024U,Glyca nuc mr spectrsc quan,,,13.39,16.91,6
HCPCS,0024U0,GLYCA NUC MR SPECTRSC QUAN,,,29.54,29.54,1
HCPCS,0025U,TENOFOVIR LIQ CHROM UR QUAN,,,98.86,191.21,15
HCPCS,0025U,Tenofovir liq chrom ur quan,,,33.04,41.74,6
HCPCS,0025U0,TENOFOVIR LIQ CHROM UR QUAN,,,98.86,98.86,1
HCPCS,0026U,ONC THYR DNA&MRNA 112 GENES,,,3110.4,6015.6,15
HCPCS,0026U,Onc thyr dna&mrna 112 genes,,,1109.84,1401.9,6
HCPCS,0026U0,ONC THYR DNA&MRNA 112 GENES,,,3110.4,3110.4,1
HCPCS,0027U,JAK2 GENE TRGT SEQ ALYS,,,105.33,203.71,15
HCPCS,0027U,Jak2 gene trgt seq alys,,,22.32,28.19,6
HCPCS,0027U0,JAK2 GENE TRGT SEQ ALYS,,,105.33,105.33,1
HCPCS,0029U,RX METAB ADVRS TRGT SEQ ALYS,,,641.33,1240.33,15
HCPCS,0029U,Rx metab advrs trgt seq alys,,,325.19,410.76,6
HCPCS,0029U0,RX METAB ADVRS TRGT SEQ ALYS,,,641.33,641.33,1
HCPCS,00300,Anes all px integ h/n/ptrunk,,,13.94,17.6,6
HCPCS,0030U,RX METAB WARF TRGT SEQ ALYS,,,115.88,224.13,15
HCPCS,0030U,Rx metab warf trgt seq alys,,,76.88,97.12,6
HCPCS,0030U0,RX METAB WARF TRGT SEQ ALYS,,,115.88,115.88,1
HCPCS,0031A,Adm sarscov2 vac ad26 .5ml,,,25.75,32.53,6
HCPCS,0031U,CYP1A2 GENE,,,151.04,292.11,15
HCPCS,0031U,Cyp1a2 gene,,,76.88,97.12,6
HCPCS,0031U0,CYP1A2 GENE,,,151.04,151.04,1
HCPCS,00320,Anes all px neck nos 1yr/>,,,13.94,17.6,6
HCPCS,00322,Anes all px nck ndl bx thyr,,,13.94,17.6,6
HCPCS,00326,Anes all px larynx&trach<1yr,,,13.94,17.6,6
HCPCS,0032A,Fee covid-19 vac 4 dose 2,,,25.75,32.53,6
HCPCS,0032U,COMT GENE,,,151.04,292.11,15
HCPCS,0032U,Comt gene,,,76.88,97.12,6
HCPCS,0032U0,COMT GENE,,,151.04,151.04,1
HCPCS,0033A,Fee covid-19 vac 4 booster,,,25.75,32.53,6
HCPCS,0033U,HTR2A HTR2C GENES,,,302.08,584.22,11
HCPCS,0033U,Htr2a htr2c genes,,,76.88,97.12,6
HCPCS,0033U0,HTR2A HTR2C GENES,,,302.08,302.08,1
HCPCS,0034A,Adm sarscov2 vac ad26 .5ml b,,,25.75,32.53,6
HCPCS,0034U,TPMT NUDT15 GENES,,,402.78,778.97,15
HCPCS,0034U,Tpmt nudt15 genes,,,170.1,214.86,6
HCPCS,0034U0,TPMT NUDT15 GENES,,,402.78,402.78,1
HCPCS,00350,Anes px major vsl neck nos,,,13.94,17.6,6
HCPCS,00352,Anes px maj vsl nck smpl lig,,,13.94,17.6,6
HCPCS,0035U,CJD NEURO CSF QUAL,674.0,438.1,168.5,674.0,37
HCPCS,0035U,NEURO CSF PRION PRTN QUAL,,,467.41,467.41,1
HCPCS,0035U0,NEURO CSF PRION PRTN QUAL,,,467.41,467.41,1
HCPCS,0036U,XOME TUM & NML SPEC SEQ ALYS,,,4129.92,7987.38,15
HCPCS,0036U,Xome tum & nml spec seq alys,,,1109.84,1401.9,6
HCPCS,0036U0,XOME TUM & NML SPEC SEQ ALYS,,,4129.92,4129.92,1
HCPCS,0037U,TRGT GEN SEQ DNA 324 GENES,,,3024.0,5848.5,15
HCPCS,0037U,Trgt gen seq dna 324 genes,,,1109.84,1401.9,6
HCPCS,0037U0,TRGT GEN SEQ DNA 324 GENES,,,3024.0,3024.0,1
HCPCS,0038U,VITAMIN D SRM MICROSAMP QUAN,,,25.57,49.46,15
HCPCS,0038U,Vitamin d srm microsamp quan,,,13.39,16.91,6
HCPCS,0038U0,VITAMIN D SRM MICROSAMP QUAN,,,25.57,25.57,1
HCPCS,0039U,DNA ANTB 2STRAND HI AVIDITY,,,11.87,22.96,15
HCPCS,0039U,Dna antb 2strand hi avidity,,,5.23,6.6,6
HCPCS,0039U0,DNA ANTB 2STRAND HI AVIDITY,,,11.87,11.87,1
HCPCS,00400,Anes integumentary sys nos,,,13.94,17.6,6
HCPCS,00402,Anes integ sys rcnstv breast,,,13.94,17.6,6
HCPCS,00404,Anes integ sys rad/modf brst,,,13.94,17.6,6
HCPCS,00406,Anes integ sys rad brst dsj,,,13.94,17.6,6
HCPCS,0040U,BCR/ABL1 GENE MAJOR BP QUAN,,,354.15,684.94,15
HCPCS,0040U,Bcr/abl1 gene major bp quan,,,170.1,214.86,6
HCPCS,0040U0,BCR/ABL1 GENE MAJOR BP QUAN,,,354.15,354.15,1
HCPCS,00410,Anes integ sys conv arrhyt,,,13.94,17.6,6
HCPCS,0041A,Adm sarscov2 5mcg/0.5ml 1st,,,25.75,32.53,6
HCPCS,0041U,B BRGDRFERI ANTB 5 PRTN IGM,,,14.87,28.76,15
HCPCS,0041U,B brgdrferi antb 5 prtn igm,,,5.23,6.6,6
HCPCS,0041U0,B BRGDRFERI ANTB 5 PRTN IGM,,,14.87,14.87,1
HCPCS,0042A,Adm sarscov2 5mcg/0.5ml 2nd,,,25.75,32.53,6
HCPCS,0042T,Ct perfusion w/contrast cbf,,,196.56,248.28,6
HCPCS,0042U,B BRGDRFERI ANTB 12 PRTN IGG,,,14.87,28.76,15
HCPCS,0042U,B brgdrferi antb 12 prtn igg,,,5.23,6.6,6
HCPCS,0042U0,B BRGDRFERI ANTB 12 PRTN IGG,,,14.87,14.87,1
HCPCS,0043A,Fee covid-19 vac 5 booster,,,25.75,32.53,6
HCPCS,0043U,TBRF B GRP ANTB 4 PRTN IGM,,,12.84,24.83,15
HCPCS,0043U,Tbrf b grp antb 4 prtn igm,,,5.23,6.6,6
HCPCS,0043U0,TBRF B GRP ANTB 4 PRTN IGM,,,12.84,12.84,1
HCPCS,0044A,Adm sarscov2 5mcg/0.5ml bst,,,25.75,32.53,6
HCPCS,0044U,TBRF B GRP ANTB 4 PRTN IGG,,,12.84,24.83,15
HCPCS,0044U,Tbrf b grp antb 4 prtn igg,,,5.23,6.6,6
HCPCS,0044U0,TBRF B GRP ANTB 4 PRTN IGG,,,12.84,12.84,1
HCPCS,00450,Anes px clav&scapula nos,,,13.94,17.6,6
HCPCS,00454,Anes px clav&scapula bx clav,,,13.94,17.6,6
HCPCS,0045U,ONC BRST DUX CARC IS 12 GENE,,,3346.27,6471.78,15
HCPCS,0045U,Onc brst dux carc is 12 gene,,,1109.84,1401.9,6
HCPCS,0045U0,ONC BRST DUX CARC IS 12 GENE,,,3346.27,3346.27,1
HCPCS,0046U,FLT3 GENE ITD VARIANTS QUAN,,,352.02,352.02,1
HCPCS,0046U,FLT3 ITD MRD ASSAY,2852.0,1853.8,170.1,2566.8,37
HCPCS,0046U0,FLT3 GENE ITD VARIANTS QUAN,,,352.02,352.02,1
HCPCS,00470,Anes partial rib rescj nos,,,13.94,17.6,6
HCPCS,00472,Anes prtl rib rescj thoracop,,,13.94,17.6,6
HCPCS,00474,Anes prtl rib rescj rad px,,,13.94,17.6,6
HCPCS,0047U,ONC PRST8 MRNA 17 GENE ALG,,,3346.27,6471.78,15
HCPCS,0047U,Onc prst8 mrna 17 gene alg,,,1109.84,1401.9,6
HCPCS,0047U0,ONC PRST8 MRNA 17 GENE ALG,,,3346.27,3346.27,1
HCPCS,0048U,ONC SLD ORG NEO DNA 468 GENE,,,2522.53,4878.65,15
HCPCS,0048U,Onc sld org neo dna 468 gene,,,1109.84,1401.9,6
HCPCS,0048U0,ONC SLD ORG NEO DNA 468 GENE,,,2522.53,2522.53,1
HCPCS,0049U,NPM1 GENE ANALYSIS QUAN,,,352.02,680.82,15
HCPCS,0049U,Npm1 gene analysis quan,,,170.1,214.86,6
HCPCS,0049U0,NPM1 GENE ANALYSIS QUAN,,,352.02,352.02,1
HCPCS,00500,Anes all px on esophagus,,,13.94,17.6,6
HCPCS,0050U,TRGT GEN SEQ DNA 194 GENES,,,2519.94,4873.64,15
HCPCS,0050U,Trgt gen seq dna 194 genes,,,1109.84,1401.9,6
HCPCS,0050U0,TRGT GEN SEQ DNA 194 GENES,,,2519.94,2519.94,1
HCPCS,0051A,Adm sarscv2 30mcg trs-sucr 1,,,25.75,32.53,6
HCPCS,0051U,RX MNTR LC-MS/MS UR/BLD 31,,,213.34,412.6,15
HCPCS,0051U,Rx mntr lc-ms/ms ur/bld 31,,,74.65,94.3,6
HCPCS,0051U0,RX MNTR LC-MS/MS UR/BLD 31,,,213.34,213.34,1
HCPCS,00520,Anes closed chest px nos,,,13.94,17.6,6
HCPCS,00522,Anes clsd ch px ndl bx pleur,,,13.94,17.6,6
HCPCS,00524,Anes clsd ch px pneumocents,,,13.94,17.6,6
HCPCS,00528,Anes clsd ch mediast&thrc wo,,,13.94,17.6,6
HCPCS,00529,Anes clsd ch mediast&thrc w/,,,13.94,17.6,6
HCPCS,0052A,Adm sarscv2 30mcg trs-sucr 2,,,25.75,32.53,6
HCPCS,0052U,LPOPRTN BLD W/5 MAJ CLASSES,,,29.26,56.58,15
HCPCS,0052U,Lpoprtn bld w/5 maj classes,,,13.39,16.91,6
HCPCS,0052U0,LPOPRTN BLD W/5 MAJ CLASSES,,,29.26,29.26,1
HCPCS,00530,Anes perm transvns pm insj,,,13.94,17.6,6
HCPCS,00532,Anes access ctr venous crcj,,,13.94,17.6,6
HCPCS,00534,Anes insertion/rplcmt cvdfb,,,13.94,17.6,6
HCPCS,00537,Anes cardiac ep procedures,,,13.94,17.6,6
HCPCS,00539,Anes tracheobronchial rcnstj,,,13.94,17.6,6
HCPCS,0053A,Adm sarscv2 30mcg trs-sucr 3,,,25.75,32.53,6
HCPCS,0053U,Onc prst8 ca fish alys 4 gen,,,1109.84,1401.9,6
HCPCS,00540,Anes thoracotomy px nos,,,13.94,17.6,6
HCPCS,00541,Anes thrcm px 1 lung vntj,,,13.94,17.6,6
HCPCS,00542,Anes thrcm px decortication,,,13.94,17.6,6
HCPCS,00546,Anes thrcm px pulm rescj,,,13.94,17.6,6
HCPCS,00548,Anes thrcm px trach&bronchi,,,13.94,17.6,6
HCPCS,0054A,Adm sarscv2 30mcg trs-sucr b,,,25.75,32.53,6
HCPCS,0054T,BONE SRGRY CMPTR FLUOR IMAGE,,,177.15,177.15,1
HCPCS,0054T0,BONE SRGRY CMPTR FLUOR IMAGE,,,177.15,177.15,1
HCPCS,0054U,RX MNTR 14+ DRUGS & SBSTS,,,171.71,332.09,15
HCPCS,0054U,Rx mntr 14+ drugs & sbsts,,,74.65,94.3,6
HCPCS,0054U0,RX MNTR 14+ DRUGS & SBSTS,,,171.71,171.71,1
HCPCS,00550,Anes for sternal debridement,,,13.94,17.6,6
HCPCS,0055T,BONE SRGRY CMPTR CT/MRI IMAG,,,221.16,221.16,1
HCPCS,0055T,CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI,730.0,474.5,53.0,730.0,18
HCPCS,0055T0,BONE SRGRY CMPTR CT/MRI IMAG,,,221.16,221.16,1
HCPCS,0055U,CARD HRT TRNSPL 96 DNA SEQ,,,2799.36,5414.04,15
HCPCS,0055U,Card hrt trnspl 96 dna seq,,,1109.84,1401.9,6
HCPCS,0055U0,CARD HRT TRNSPL 96 DNA SEQ,,,2799.36,2799.36,1
HCPCS,00560,Anes px heart w/o pump oxtj,,,13.94,17.6,6
HCPCS,00561,Anes px heart w/pump<1 yr,,,13.94,17.6,6
HCPCS,00562,Anes px hrt w/pump age 1yr+,,,13.94,17.6,6
HCPCS,00563,Anes px heart w/pmp crc arst,,,13.94,17.6,6
HCPCS,00566,Anes direct cabg w/o pump,,,13.94,17.6,6
HCPCS,00567,Anes direct cabg w/pump,,,13.94,17.6,6
HCPCS,0056U,Hem aml dna gene reargmt,,,1109.84,1401.9,6
HCPCS,00580,Anes heart/lung transplant,,,13.94,17.6,6
HCPCS,0058T,Cryopreservation ovary tiss,,,59.1,74.65,6
HCPCS,0058U,ONC MERKEL CLL CARC SRM QUAN,,,279.04,539.67,15
HCPCS,0058U,Onc merkel cll carc srm quan,,,76.88,97.12,6
HCPCS,0058U0,ONC MERKEL CLL CARC SRM QUAN,,,279.04,279.04,1
HCPCS,0059U,ONC MERKEL CLL CARC SRM +/-,,,279.04,539.67,15
HCPCS,0059U,Onc merkel cll carc srm +/-,,,76.88,97.12,6
HCPCS,0059U0,ONC MERKEL CLL CARC SRM +/-,,,279.04,279.04,1
HCPCS,00600,Anes px crv spine&cord nos,,,13.94,17.6,6
HCPCS,00604,Anes px crv spn&cord sitting,,,13.94,17.6,6
HCPCS,0060U,TWN ZYG GEN SEQ ALYS CHRMS2,,,655.82,1268.37,15
HCPCS,0060U,Twn zyg gen seq alys chrms2,,,325.19,410.76,6
HCPCS,0060U0,TWN ZYG GEN SEQ ALYS CHRMS2,,,655.82,655.82,1
HCPCS,0061A,Fee covid-19 vac 7 dose 1,,,25.75,32.53,6
HCPCS,0061U,TC MEAS 5 BMRK SFDI M-S ALYS,,,21.69,41.94,15
HCPCS,0061U,Tc meas 5 bmrk sfdi m-s alys,,,20.85,26.34,6
HCPCS,0061U0,TC MEAS 5 BMRK SFDI M-S ALYS,,,21.69,21.69,1
HCPCS,00620,Anes px thrc spine&cord nos,,,13.94,17.6,6
HCPCS,00625,Anes thrc spine wo 1lng vent,,,13.94,17.6,6
HCPCS,00626,Anes thrc spine w/1 lng vent,,,13.94,17.6,6
HCPCS,0062A,Fee covid-19 vac 7 dose 2,,,25.75,32.53,6
HCPCS,0062U,AI SLE IGG&IGM ALYS 80 BMRK,,,328.95,636.18,15
HCPCS,0062U,Ai sle igg&igm alys 80 bmrk,,,170.1,214.86,6
HCPCS,0062U0,AI SLE IGG&IGM ALYS 80 BMRK,,,328.95,328.95,1
HCPCS,00630,Anes px lumbar region nos,,,13.94,17.6,6
HCPCS,00632,Anes px lumbar sympathectomy,,,13.94,17.6,6
HCPCS,00635,Anes dx/ther lumbar pnxr,,,13.94,17.6,6
HCPCS,0063A,Fee covid-19 vac 7 booster,,,25.75,32.53,6
HCPCS,0063U,NEURO AUTISM 32 AMINES ALG,,,648.0,1253.25,15
HCPCS,0063U,Neuro autism 32 amines alg,,,325.19,410.76,6
HCPCS,0063U0,NEURO AUTISM 32 AMINES ALG,,,648.0,648.0,1
HCPCS,00640,Anes spine manipulation,,,13.94,17.6,6
HCPCS,0064A,Adm sarscov2 50mcg/0.25mlbst,,,25.75,32.53,6
HCPCS,0064U,ANTB TP TOTAL&RPR IA QUAL,,,27.06,52.35,15
HCPCS,0064U,Antb tp total&rpr ia qual,,,19.47,24.59,6
HCPCS,0064U0,ANTB TP TOTAL&RPR IA QUAL,,,27.06,27.06,1
HCPCS,0065U,SYFLS TST NONTREPONEMAL ANTB,,,15.63,30.23,15
HCPCS,0065U,Syfls tst nontreponemal antb,,,5.23,6.6,6
HCPCS,0065U0,SYFLS TST NONTREPONEMAL ANTB,,,15.63,15.63,1
HCPCS,0066U,PAMG-1 IA CERVICO-VAG FLUID,,,23.58,25.55,3
HCPCS,0066U,Pamg-1 ia cervico-vag fluid,,,5.78,7.3,6
HCPCS,00670,Anes xtnsv sp&spi cord px,,,13.94,17.6,6
HCPCS,0067U,ONC BRST IMHCHEM PRFL 4 BMRK,,,1639.01,3169.89,15
HCPCS,0067U,Onc brst imhchem prfl 4 bmrk,,,1109.84,1401.9,6
HCPCS,0067U0,ONC BRST IMHCHEM PRFL 4 BMRK,,,1639.01,1639.01,1
HCPCS,0068U,CANDIDA SPECIES PNL AMP PRB,,,123.23,238.33,15
HCPCS,0068U,Candida species pnl amp prb,,,92.55,116.9,6
HCPCS,0068U0,CANDIDA SPECIES PNL AMP PRB,,,123.23,123.23,1
HCPCS,0069U,ONC CLRCT MICRORNA MIR-31-3P,,,328.32,634.98,15
HCPCS,0069U,Onc clrct microrna mir-31-3p,,,170.1,214.86,6
HCPCS,0069U0,ONC CLRCT MICRORNA MIR-31-3P,,,328.32,328.32,1
HCPCS,00700,Anes px upr ant abd wall nos,,,13.94,17.6,6
HCPCS,00702,Anes upr ant abd wall lvr bx,,,13.94,17.6,6
HCPCS,0070U,CYP2D6 GEN COM&SLCT RAR VRNT,,,584.39,1130.21,15
HCPCS,0070U,Cyp2d6 gen com&slct rar vrnt,,,325.19,410.76,6
HCPCS,0070U0,CYP2D6 GEN COM&SLCT RAR VRNT,,,584.39,584.39,1
HCPCS,0071A,Adm sarscv2 10mcg trs-sucr 1,,,25.75,32.53,6
HCPCS,0071T,US LEIOMYOMATA ABLATE <200,,,1082.94,6893.74,15
HCPCS,0071T,Us leiomyomata ablate <200,,,2575.55,3253.32,6
HCPCS,0071T0,US LEIOMYOMATA ABLATE <200,,,1082.94,1082.94,1
HCPCS,0071U,CYP2D6 FULL GENE SEQUENCE,,,518.4,1002.6,15
HCPCS,0071U,Cyp2d6 full gene sequence,,,170.1,214.86,6
HCPCS,0071U0,CYP2D6 FULL GENE SEQUENCE,,,518.4,518.4,1
HCPCS,0072A,Adm sarscv2 10mcg trs-sucr 2,,,25.75,32.53,6
HCPCS,0072T,FCSD US ABLTJ LEIOMYOM>=200,,,593.14,6893.74,15
HCPCS,0072T,Fcsd us abltj leiomyom>=200,,,2575.55,3253.32,6
HCPCS,0072T0,FCSD US ABLTJ LEIOMYOM>=200,,,593.14,593.14,1
HCPCS,0072U,CYP2D6 GEN CYP2D6-2D7 HYBRID,,,389.59,753.47,15
HCPCS,0072U,Cyp2d6 gen cyp2d6-2d7 hybrid,,,170.1,214.86,6
HCPCS,0072U0,CYP2D6 GEN CYP2D6-2D7 HYBRID,,,389.59,389.59,1
HCPCS,00730,Anes px upper pst abdl wall,,,13.94,17.6,6
HCPCS,00731,Anes upr gi ndsc px nos,,,13.94,17.6,6
HCPCS,00732,Anes upr gi ndsc px ercp,,,13.94,17.6,6
HCPCS,0073A,Adm sarscv2 10mcg trs-sucr 3,,,25.75,32.53,6
HCPCS,0073U,CYP2D6 GEN CYP2D7-2D6 HYBRID,,,389.59,753.47,15
HCPCS,0073U,Cyp2d6 gen cyp2d7-2d6 hybrid,,,170.1,214.86,6
HCPCS,0073U0,CYP2D6 GEN CYP2D7-2D6 HYBRID,,,389.59,389.59,1
HCPCS,0074A,Adm sarscv2 10mcg trs-sucr b,,,25.75,32.53,6
HCPCS,0074U,CYP2D6 NONDUPLICATED GENE,,,389.59,753.47,15
HCPCS,0074U,Cyp2d6 nonduplicated gene,,,170.1,214.86,6
HCPCS,0074U0,CYP2D6 NONDUPLICATED GENE,,,389.59,389.59,1
HCPCS,00750,Anes hrna rpr upr abd nos,,,13.94,17.6,6
HCPCS,00752,Anes hrna rpr lmbr&vnt&/dehs,,,13.94,17.6,6
HCPCS,00754,Anes hrna rpr omphalocele,,,13.94,17.6,6
HCPCS,00756,Anes hrna rpr diphrg hrna,,,13.94,17.6,6
HCPCS,0075T,PERQ STENT/CHEST VERT ART,,,766.58,766.58,2
HCPCS,0075T,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,7707.0,5009.549999999999,53.0,10364.4,48
HCPCS,0075T0,PERQ STENT/CHEST VERT ART,,,766.58,766.58,1
HCPCS,0075TTC,PERQ STENT/CHEST VERT ART,,,766.58,766.58,1
HCPCS,0075U,CYP2D6 5' GENE DUP/MLT,,,389.59,753.47,15
HCPCS,0075U,Cyp2d6 5' gene dup/mlt,,,170.1,214.86,6
HCPCS,0075U0,CYP2D6 5' GENE DUP/MLT,,,389.59,389.59,1
HCPCS,0076T,S&I STENT/CHEST VERT ART,,,481.54,481.54,2
HCPCS,0076T,S&i stent/chest vert art,,,6649.91,8399.88,6
HCPCS,0076T,TCAT PLMT XTRC VRT CRTD STENT RS&IPRQ EA VSL,2228.0,1448.2,53.0,2228.0,18
HCPCS,0076T0,S&I STENT/CHEST VERT ART,,,481.54,481.54,1
HCPCS,0076TTC,S&I STENT/CHEST VERT ART,,,481.54,481.54,1
HCPCS,0076U,CYP2D6 3' GENE DUP/MLT,,,389.59,753.47,15
HCPCS,0076U,Cyp2d6 3' gene dup/mlt,,,170.1,214.86,6
HCPCS,0076U0,CYP2D6 3' GENE DUP/MLT,,,389.59,389.59,1
HCPCS,00770,Anes px maj abd blood vessel,,,13.94,17.6,6
HCPCS,0077U,IG PARAPROTEIN QUAL BLD/UR,,,37.52,72.57,15
HCPCS,0077U,Ig paraprotein qual bld/ur,,,19.47,24.59,6
HCPCS,0077U0,IG PARAPROTEIN QUAL BLD/UR,,,37.52,37.52,1
HCPCS,0078U,PAIN MGT OPI USE GNOTYP PNL,,,695.3,753.47,3
HCPCS,0078U,Pain mgt opi use gnotyp pnl,,,170.1,214.86,6
HCPCS,00790,Anes iper upr abd nos,,,13.94,17.6,6
HCPCS,00792,Anes iper upr abd prtl hptc,,,13.94,17.6,6
HCPCS,00794,Anes iper upr abd pncrtect,,,13.94,17.6,6
HCPCS,00796,Anes iper upr abd lvr trnspl,,,13.94,17.6,6
HCPCS,00797,Anes iper upr abd gstr px mo,,,13.94,17.6,6
HCPCS,0079U,CMPRTV DNA ALYS MLT SNPS,,,196.56,196.56,2
HCPCS,0079U,Cmprtv dna alys mlt snps,,,22.32,28.19,6
HCPCS,0079U0,CMPRTV DNA ALYS MLT SNPS,,,196.56,196.56,1
HCPCS,0079UTC,CMPRTV DNA ALYS MLT SNPS,,,196.56,196.56,1
HCPCS,00800,Anes px lwr ant abdl wal nos,,,13.94,17.6,6
HCPCS,00802,Anes px lwr abdl wal pannic,,,13.94,17.6,6
HCPCS,0080U,ONC LNG 5 CLIN RSK FACTR ALG,,,3041.28,5881.92,15
HCPCS,0080U,Onc lng 5 clin rsk factr alg,,,1109.84,1401.9,6
HCPCS,0080U0,ONC LNG 5 CLIN RSK FACTR ALG,,,3041.28,3041.28,1
HCPCS,00811,Anes lwr intst ndsc nos,,,13.94,17.6,6
HCPCS,00812,Anes lwr intst scr colsc,,,13.94,17.6,6
HCPCS,00813,Anes upr lwr gi ndsc px,,,13.94,17.6,6
HCPCS,0081A,Adm sarscv2 3mcg trs-sucr 1,,,25.75,32.53,6
HCPCS,00820,Anes px lwr post abdl wall,,,13.94,17.6,6
HCPCS,0082A,Adm sarscv2 3mcg trs-sucr 2,,,25.75,32.53,6
HCPCS,0082U,RX TEST DEF 90+ RX/SBSTS UR,,,213.34,412.6,15
HCPCS,0082U,Rx test def 90+ rx/sbsts ur,,,74.65,94.3,6
HCPCS,0082U0,RX TEST DEF 90+ RX/SBSTS UR,,,213.34,213.34,1
HCPCS,00830,Anes hernia rpr lwr abd nos,,,13.94,17.6,6
HCPCS,00832,Anes hernia repair vnt&incal,,,13.94,17.6,6
HCPCS,00834,Anes hernia repair<1 yr age,,,13.94,17.6,6
HCPCS,00836,Anes hrna rpr<37wk brth<50,,,13.94,17.6,6
HCPCS,0083A,Adm sarscv2 3mcg trs-sucr 3,,,25.75,32.53,6
HCPCS,0083U,ONC RSPSE CHEMO CNTRST TOMOG,,,144.59,279.64,15
HCPCS,0083U,Onc rspse chemo cntrst tomog,,,101.52,128.23,6
HCPCS,0083U0,ONC RSPSE CHEMO CNTRST TOMOG,,,144.59,144.59,1
HCPCS,00840,Anes iper px lower abd nos,,,13.94,17.6,6
HCPCS,00842,Anes iper px amniocentesis,,,13.94,17.6,6
HCPCS,00844,Anes iper px abdmnprnl rescj,,,13.94,17.6,6
HCPCS,00846,Anes iper px rad hystrectomy,,,13.94,17.6,6
HCPCS,00848,Anes iper px pel exentration,,,13.94,17.6,6
HCPCS,0084A,Fee covid-19 vac 9 res,,,25.75,32.53,6
HCPCS,0084U,RBC DNA GNOTYP 10 BLD GROUPS,,,622.08,1203.12,15
HCPCS,0084U,Rbc dna gnotyp 10 bld groups,,,325.19,410.76,6
HCPCS,0084U0,RBC DNA GNOTYP 10 BLD GROUPS,,,622.08,622.08,1
HCPCS,00851,Anes iper px tubal ligation,,,13.94,17.6,6
HCPCS,0085T,Breath test heart reject,,,2.59,3.28,6
HCPCS,00860,Anes xtrprtl px lwr abd nos,,,13.94,17.6,6
HCPCS,00862,Anes xtrprtl lwr abd rnl px,,,13.94,17.6,6
HCPCS,00864,Anes xtrprt lwr abd tot cstc,,,13.94,17.6,6
HCPCS,00865,Anes xtrprt lwr abd prst8ect,,,13.94,17.6,6
HCPCS,00866,Anes xtrprt lw abd adrnlctmy,,,13.94,17.6,6
HCPCS,00868,Anes xtrprtl px rnl transpl,,,13.94,17.6,6
HCPCS,0086U,NFCT DS BACT&FNG ORG ID 6+,,,172.8,334.2,15
HCPCS,0086U,Nfct ds bact&fng org id 6+,,,92.55,116.9,6
HCPCS,0086U0,NFCT DS BACT&FNG ORG ID 6+,,,172.8,172.8,1
HCPCS,00870,Anes xtrprtl cystolithotomy,,,13.94,17.6,6
HCPCS,00872,Anes lithotrp esw water bath,,,13.94,17.6,6
HCPCS,00873,Anes lithotrp esw wo wtr bth,,,13.94,17.6,6
HCPCS,0087U,CRD HRT TRNSPL MRNA 1283 GEN,,,2729.74,5279.39,15
HCPCS,0087U,Crd hrt trnspl mrna 1283 gen,,,1109.84,1401.9,6
HCPCS,0087U0,CRD HRT TRNSPL MRNA 1283 GEN,,,2729.74,2729.74,1
HCPCS,00880,Anes maj lwr abd vessel nos,,,13.94,17.6,6
HCPCS,00882,Anes maj lwr adb vsl ivc lig,,,13.94,17.6,6
HCPCS,0088U,TRNSPLJ KDN ALGRFT REJ 1494,,,2729.74,5279.39,15
HCPCS,0088U,Trnsplj kdn algrft rej 1494,,,1109.84,1401.9,6
HCPCS,0088U0,TRNSPLJ KDN ALGRFT REJ 1494,,,2729.74,2729.74,1
HCPCS,0089U,ONC MLNMA PRAME & LINC00518,,,656.64,1269.96,15
HCPCS,0089U,Onc mlnma prame & linc00518,,,325.19,410.76,6
HCPCS,0089U0,ONC MLNMA PRAME & LINC00518,,,656.64,656.64,1
HCPCS,00902,Anes anorectal px,,,13.94,17.6,6
HCPCS,00904,Anes radical perineal px,,,13.94,17.6,6
HCPCS,00906,Anes vulvectomy,,,13.94,17.6,6
HCPCS,00908,Anes perineal prostatectomy,,,13.94,17.6,6
HCPCS,0090U,ONC CUTAN MLNMA MRNA 23 GENE,,,1684.8,3258.45,15
HCPCS,0090U,Onc cutan mlnma mrna 23 gene,,,1109.84,1401.9,6
HCPCS,0090U0,ONC CUTAN MLNMA MRNA 23 GENE,,,1684.8,1684.8,1
HCPCS,00910,Anes transurethral px nos,,,13.94,17.6,6
HCPCS,00912,Anes trurl px rescj bldr tum,,,13.94,17.6,6
HCPCS,00914,Anes trurl px rescj prst8,,,13.94,17.6,6
HCPCS,00916,Anes trurl px rescj bleeding,,,13.94,17.6,6
HCPCS,00918,Anes trurl px urtrl cal rmvl,,,13.94,17.6,6
HCPCS,0091A,Adm sarscov2 50 mcg/.5 ml1st,,,25.75,32.53,6
HCPCS,0091U,Onc clrct scr whl bld alg,,,19.47,24.59,6
HCPCS,00920,Anes px male genitalia nos,,,13.94,17.6,6
HCPCS,00921,Anes px male genitalia vasec,,,13.94,17.6,6
HCPCS,00922,Anes px male gent sem ves,,,13.94,17.6,6
HCPCS,00924,Anes male gent undscnd tstis,,,13.94,17.6,6
HCPCS,00926,Anes male gent rad orch ing,,,13.94,17.6,6
HCPCS,00928,Anes male gent rad orch abd,,,13.94,17.6,6
HCPCS,0092A,Adm sarscov2 50 mcg/.5 ml2nd,,,25.75,32.53,6
HCPCS,0092T,ARTIFIC DISC ADDL,21441.0,13936.65,53.0,21441.0,17
HCPCS,0092U,ONC LNG 3 PRTN BMRK PLSM ALG,,,2149.63,4157.45,15
HCPCS,0092U,Onc lng 3 prtn bmrk plsm alg,,,1109.84,1401.9,6
HCPCS,0092U0,ONC LNG 3 PRTN BMRK PLSM ALG,,,2149.63,2149.63,1
HCPCS,00930,Anes px male gent orchiopexy,,,13.94,17.6,6
HCPCS,00932,Anes male gent compl amp pns,,,13.94,17.6,6
HCPCS,00934,Anes rad amp penis ingun lym,,,13.94,17.6,6
HCPCS,00936,Anes rad amp pns ingun&ilac,,,13.94,17.6,6
HCPCS,00938,Anes insj penile prosthesis,,,13.94,17.6,6
HCPCS,0093A,Adm sarscov2 50 mcg/.5 ml3rd,,,25.75,32.53,6
HCPCS,0093U,RX MNTR 65 COM DRUGS URINE,,,53.69,103.84,15
HCPCS,0093U,Rx mntr 65 com drugs urine,,,33.04,41.74,6
HCPCS,0093U0,RX MNTR 65 COM DRUGS URINE,,,53.69,53.69,1
HCPCS,00940,Anes vaginal px nos,,,13.94,17.6,6
HCPCS,00942,Anes vag px clptmy vgnc clpr,,,13.94,17.6,6
HCPCS,00944,Anes vag px vag hysterectomy,,,13.94,17.6,6
HCPCS,00948,Anes vag px crv cerclage,,,13.94,17.6,6
HCPCS,0094A,Adm sarscov2 50 mcg/.5 mlbst,,,25.75,32.53,6
HCPCS,0094U,GENOME RAPID SEQUENCE ALYS,,,6551.02,12669.86,15
HCPCS,0094U,Genome rapid sequence alys,,,1109.84,1401.9,6
HCPCS,0094U0,GENOME RAPID SEQUENCE ALYS,,,6551.02,6551.02,1
HCPCS,00950,Anes vag px culdoscopy,,,13.94,17.6,6
HCPCS,00952,Anes vag px hystsc&/hsg,,,13.94,17.6,6
HCPCS,0095T,RMVL ARTIFIC DISC ADDL CRVCL,,,1115.53,1115.53,1
HCPCS,0095T,RMVL TOT DISC ARTHRP ANT APPR CRV EA NTRSPC,16896.0,10982.4,53.0,16896.0,18
HCPCS,0095T,Rmvl artific disc addl crvcl,,,9774.46,12346.69,6
HCPCS,0095T0,RMVL ARTIFIC DISC ADDL CRVCL,,,1115.53,1115.53,1
HCPCS,0095U,EE 2 PRTN BMRK MBP ELISA EST,,,666.99,1289.98,15
HCPCS,0095U,Ee 2 prtn bmrk elisa est,,,325.19,410.76,6
HCPCS,0095U0,EE 2 PRTN BMRK MBP ELISA EST,,,666.99,666.99,1
HCPCS,0096U,HPV HI RISK TYPES MALE URINE,,,30.32,58.64,15
HCPCS,0096U,Hpv hi risk types male urine,,,25.65,32.4,6
HCPCS,0096U0,HPV HI RISK TYPES MALE URINE,,,30.32,30.32,1
HCPCS,0097U,Gi pathogen 22 targets,,,92.55,116.9,6
HCPCS,0098T,REV ARTIFIC DISC ADDL,,,784.46,784.46,1
HCPCS,0098T,REVJ TOT DISC ARTHRP ANT APPR CRV EA NTRSPC,11653.0,7574.45,53.0,11653.0,18
HCPCS,0098T,Rev artific disc addl,,,9774.46,12346.69,6
HCPCS,0098T0,REV ARTIFIC DISC ADDL,,,784.46,784.46,1
HCPCS,0098U,Respir pathogen 14 targets,,,92.55,116.9,6
HCPCS,0099U,Respir pathogen 20 targets,,,92.55,116.9,6
HCPCS,0100T,PROSTH RETINA RECEIVE&GEN,,,1885.45,1885.45,1
HCPCS,0100T,Prosth retina receive&gen,,,1810.58,2287.04,6
HCPCS,0100T0,PROSTH RETINA RECEIVE&GEN,,,1885.45,1885.45,1
HCPCS,0100U,Respir pathogen 21 targets,,,92.55,116.9,6
HCPCS,0101A,Fee covid-19 vac 11 dose 1,,,25.75,32.53,6
HCPCS,0101T,ESW MUSCSKEL SYS NOS,,,189.95,520.1,15
HCPCS,0101T,"EXTRACORP SHOCKWV TX,HI ENRG",190.0,123.5,53.0,548.14,18
HCPCS,0101T,Esw muscskel sys nos,,,310.03,391.62,6
HCPCS,0101T0,ESW MUSCSKEL SYS NOS,,,189.95,189.95,1
HCPCS,0101U,HERED COLON CA DO 15 GENES,,,1506.77,2914.14,15
HCPCS,0101U,Hered colon ca do 15 genes,,,1109.84,1401.9,6
HCPCS,0101U0,HERED COLON CA DO 15 GENES,,,1506.77,1506.77,1
HCPCS,0102A,Fee covid-19 vac 11 dose 2,,,25.75,32.53,6
HCPCS,0102T,ESW PHY ANES LAT HMRL EPCNDL,,,320.3,7034.85,15
HCPCS,0102T,Esw phy anes lat hmrl epcndl,,,2951.94,3728.76,6
HCPCS,0102T0,ESW PHY ANES LAT HMRL EPCNDL,,,320.3,320.3,1
HCPCS,0102U,HERED BRST CA RLTD DO 17 GEN,,,1126.61,2178.9,15
HCPCS,0102U,Hered brst ca rltd do 17 gen,,,1109.84,1401.9,6
HCPCS,0102U0,HERED BRST CA RLTD DO 17 GEN,,,1126.61,1126.61,1
HCPCS,0103A,Fee covid-19 vac 11 booster,,,25.75,32.53,6
HCPCS,0103U,HERED OVA CA PNL 24 GENES,,,1506.77,2914.14,15
HCPCS,0103U,Hered ova ca pnl 24 genes,,,1109.84,1401.9,6
HCPCS,0103U0,HERED OVA CA PNL 24 GENES,,,1506.77,1506.77,1
HCPCS,0104A,Adm sarscov2 5mcg/.5ml as03b,,,25.75,32.53,6
HCPCS,0105U,NEPH CKD MULT ECLIA TUM NEC,,,820.8,1587.45,15
HCPCS,0105U,Neph ckd mult eclia tum nec,,,325.19,410.76,6
HCPCS,0105U0,NEPH CKD MULT ECLIA TUM NEC,,,820.8,820.8,1
HCPCS,0106T,TOUCH QUANT SENSORY TEST,,,39.0,85.1,15
HCPCS,0106T,Touch quant sensory test,,,82.59,104.33,6
HCPCS,0106T0,TOUCH QUANT SENSORY TEST,,,40.0,40.0,1
HCPCS,0106U,GSTR EMPTG 7 TIMED BRTH SPEC,,,755.56,1461.27,15
HCPCS,0106U,Gstr emptg 7 timed brth spec,,,325.19,410.76,6
HCPCS,0106U0,GSTR EMPTG 7 TIMED BRTH SPEC,,,755.56,755.56,1
HCPCS,0107T,VIBRATE QUANT SENSORY TEST,,,28.48,85.1,15
HCPCS,0107T,Vibrate quant sensory test,,,82.59,104.33,6
HCPCS,0107T0,VIBRATE QUANT SENSORY TEST,,,28.48,28.48,1
HCPCS,0107U,C DIFF TOX AG DETCJ IA STOOL,,,13.82,26.74,15
HCPCS,0107U,C diff tox ag detcj ia stool,,,4.02,5.08,6
HCPCS,0107U0,C DIFF TOX AG DETCJ IA STOOL,,,13.82,13.82,1
HCPCS,0108T,COOL QUANT SENSORY TEST,,,28.48,128.79,15
HCPCS,0108T,Cool quant sensory test,,,82.59,104.33,6
HCPCS,0108T0,COOL QUANT SENSORY TEST,,,28.48,28.48,1
HCPCS,0108U,GI BARRETT ESOPH 9 PRTN BMRK,,,4276.8,8271.45,15
HCPCS,0108U,Gi barrett esoph 9 prtn bmrk,,,1109.84,1401.9,6
HCPCS,0108U0,GI BARRETT ESOPH 9 PRTN BMRK,,,4276.8,4276.8,1
HCPCS,0109T,HEAT QUANT SENSORY TEST,,,28.48,85.1,15
HCPCS,0109T,Heat quant sensory test,,,82.59,104.33,6
HCPCS,0109T0,HEAT QUANT SENSORY TEST,,,28.48,28.48,1
HCPCS,0109U,ID ASPERGILLUS DNA 4 SPECIES,,,123.23,238.33,15
HCPCS,0109U,Id aspergillus dna 4 species,,,92.55,116.9,6
HCPCS,0109U0,ID ASPERGILLUS DNA 4 SPECIES,,,123.23,123.23,1
HCPCS,0110T,NOS QUANT SENSORY TEST,,,40.0,279.48,15
HCPCS,0110T,Nos quant sensory test,,,82.59,104.33,6
HCPCS,0110T0,NOS QUANT SENSORY TEST,,,40.0,40.0,1
HCPCS,0110U,RX MNTR 1+ORAL ONC RX&SBSTS,,,23.43,45.3,15
HCPCS,0110U,Rx mntr 1+oral onc rx&sbsts,,,6.62,8.36,6
HCPCS,0110U0,RX MNTR 1+ORAL ONC RX&SBSTS,,,23.43,23.43,1
HCPCS,01112,Anes bone marrow aspir&/bx,,,13.94,17.6,6
HCPCS,0111A,Adm sarscov2 25mcg/0.25ml1st,,,25.75,32.53,6
HCPCS,0111T,Rbc membranes fatty acids,,,16.61,20.98,6
HCPCS,0111U,ONC COLON CA KRAS&NRAS ALYS,,,589.5,1140.11,15
HCPCS,0111U,Onc colon ca kras&nras alys,,,325.19,410.76,6
HCPCS,0111U0,ONC COLON CA KRAS&NRAS ALYS,,,589.5,589.5,1
HCPCS,01120,Anes px on bony pelvis,,,13.94,17.6,6
HCPCS,0112A,Adm sarscov2 25mcg/0.25ml2nd,,,25.75,32.53,6
HCPCS,0112U,IADI 16S&18S RRNA GENES,,,307.69,595.09,15
HCPCS,0112U,Iadi 16s&18s rrna genes,,,92.55,116.9,6
HCPCS,0112U0,IADI 16S&18S RRNA GENES,,,307.69,307.69,1
HCPCS,01130,Anes body cast appl/revj,,,13.94,17.6,6
HCPCS,0113A,Adm sarscov2 25mcg/0.25ml3rd,,,25.75,32.53,6
HCPCS,0113U,ONC PRST8 PCA3&TMPRSS2-ERG,,,656.64,1269.96,15
HCPCS,0113U,Onc prst8 pca3&tmprss2-erg,,,325.19,410.76,6
HCPCS,0113U0,ONC PRST8 PCA3&TMPRSS2-ERG,,,656.64,656.64,1
HCPCS,01140,Anes ntrplvabdmnl amputation,,,13.94,17.6,6
HCPCS,0114U,GI BARRETTS ESOPH VIM&CCNA1,,,1674.44,3238.41,15
HCPCS,0114U,Gi barretts esoph vim&ccna1,,,1109.84,1401.9,6
HCPCS,0114U0,GI BARRETTS ESOPH VIM&CCNA1,,,1674.44,1674.44,1
HCPCS,01150,Anes rad px tumor of pelvis,,,13.94,17.6,6
HCPCS,0115U,RESPIR IADNA 18 VIRAL&2 BACT,,,237.9,460.11,15
HCPCS,0115U,Respir iadna 18 viral&2 bact,,,76.88,97.12,6
HCPCS,0115U0,RESPIR IADNA 18 VIRAL&2 BACT,,,237.9,237.9,1
HCPCS,01160,Anes clsd px symph pub/si jt,,,13.94,17.6,6
HCPCS,0116U,RX MNTR NZM IA 35+ORAL FLU,,,213.34,412.6,15
HCPCS,0116U,Rx mntr nzm ia 35+oral flu,,,74.65,94.3,6
HCPCS,0116U0,RX MNTR NZM IA 35+ORAL FLU,,,213.34,213.34,1
HCPCS,01170,Anes opn px symph pub/si jt,,,13.94,17.6,6
HCPCS,01173,Anes opn rpr fx disrpj plvs,,,13.94,17.6,6
HCPCS,0117U,PAIN MGMT 11 ENDOGENOUS ANAL,,,726.32,1404.73,15
HCPCS,0117U,Pain mgmt 11 endogenous anal,,,325.19,410.76,6
HCPCS,0117U0,PAIN MGMT 11 ENDOGENOUS ANAL,,,726.32,726.32,1
HCPCS,0118U,TRNSPLJ DON-DRV CLL-FR DNA,,,2378.81,4600.68,15
HCPCS,0118U,Trnsplj don-drv cll-fr dna,,,1109.84,1401.9,6
HCPCS,0118U0,TRNSPLJ DON-DRV CLL-FR DNA,,,2378.81,2378.81,1
HCPCS,0119U,CRD CERAMIDES LIQ CHROM PLSM,,,72.37,139.96,15
HCPCS,0119U,Crd ceramides liq chrom plsm,,,32.49,41.04,6
HCPCS,0119U0,CRD CERAMIDES LIQ CHROM PLSM,,,72.37,72.37,1
HCPCS,01200,Anes all closed px hip joint,,,13.94,17.6,6
HCPCS,01202,Anes arthroscopic px hip jt,,,13.94,17.6,6
HCPCS,0120U,ONC B CLL LYMPHM MRNA 58 GEN,,,2168.82,4194.56,15
HCPCS,0120U,Onc b cll lymphm mrna 58 gen,,,1109.84,1401.9,6
HCPCS,0120U0,ONC B CLL LYMPHM MRNA 58 GEN,,,2168.82,2168.82,1
HCPCS,01210,Anes open px hip joint nos,,,13.94,17.6,6
HCPCS,01212,Anes open px hip jt disrtcj,,,13.94,17.6,6
HCPCS,01214,Anes open px tot hip arthrp,,,13.94,17.6,6
HCPCS,01215,Anes opn revj tot hip arthrp,,,13.94,17.6,6
HCPCS,0121A,Adm sarscv2 bvl 30mcg/.3ml 1,,,25.75,32.53,6
HCPCS,0121U,SC DIS VCAM-1 WHOLE BLOOD,,,439.95,850.87,15
HCPCS,0121U,Sc dis vcam-1 whole blood,,,170.1,214.86,6
HCPCS,0121U0,SC DIS VCAM-1 WHOLE BLOOD,,,439.95,439.95,1
HCPCS,01220,Anes clsd px upper 2/3 femur,,,13.94,17.6,6
HCPCS,0122U,SC DIS P-SELECTIN WHL BLOOD,,,454.66,879.33,15
HCPCS,0122U,Sc dis p-selectin whl blood,,,170.1,214.86,6
HCPCS,0122U0,SC DIS P-SELECTIN WHL BLOOD,,,454.66,454.66,1
HCPCS,01230,Anes opn upper 2/3 femur nos,,,13.94,17.6,6
HCPCS,01232,Anes opn px upr 2/3 fem amp,,,13.94,17.6,6
HCPCS,01234,Anes opn upr 2/3 fem rad res,,,13.94,17.6,6
HCPCS,0123U,MCHNL FRAGILITY RBC PRFLG,,,308.99,597.6,15
HCPCS,0123U,Mchnl fragility rbc prflg,,,170.1,214.86,6
HCPCS,0123U0,MCHNL FRAGILITY RBC PRFLG,,,308.99,308.99,1
HCPCS,0124A,Adm sarscv2 bvl 30mcg/.3ml a,,,25.75,32.53,6
HCPCS,01250,Anes all px nrv musc upr leg,,,13.94,17.6,6
HCPCS,01260,Anes all px veins upper leg,,,13.94,17.6,6
HCPCS,0126T,Chd risk imt study,,,66.35,83.81,6
HCPCS,01270,Anes px arteries upr leg nos,,,13.94,17.6,6
HCPCS,01272,Anes px art femoral art lig,,,13.94,17.6,6
HCPCS,01274,Anes px art fem art emblc,,,13.94,17.6,6
HCPCS,0129U,HERED BRST CA RLTD DO PANEL,,,1126.61,2178.9,15
HCPCS,0129U,Hered brst ca rltd do panel,,,1109.84,1401.9,6
HCPCS,0129U0,HERED BRST CA RLTD DO PANEL,,,1126.61,1126.61,1
HCPCS,0130U,HERED COLON CA DO MRNA PNL,,,505.35,977.37,15
HCPCS,0130U,Hered colon ca do mrna pnl,,,170.1,214.86,6
HCPCS,0130U0,HERED COLON CA DO MRNA PNL,,,505.35,505.35,1
HCPCS,0131U,HERED BRST CA RLTD DO PNL 13,,,613.44,1186.41,11
HCPCS,0131U,Hered brst ca rltd do pnl 13,,,325.19,410.76,6
HCPCS,0131U0,HERED BRST CA RLTD DO PNL 13,,,613.44,613.44,1
HCPCS,01320,Anes all px nrv msc kne&/pop,,,13.94,17.6,6
HCPCS,0132U,HERED OVA CA RLTD DO PNL 17,,,640.77,1239.28,11
HCPCS,0132U,Hered ova ca rltd do pnl 17,,,325.19,410.76,6
HCPCS,0132U0,HERED OVA CA RLTD DO PNL 17,,,640.77,640.77,1
HCPCS,0133U,HERED PRST8 CA RLTD DO 11,,,596.41,1153.47,15
HCPCS,0133U,Hered prst8 ca rltd do 11,,,325.19,410.76,6
HCPCS,0133U0,HERED PRST8 CA RLTD DO 11,,,596.41,596.41,1
HCPCS,01340,Anes clsd px lower 1/3 femur,,,13.94,17.6,6
HCPCS,0134A,Adm sarscv2 bvl 50mcg/.5ml a,,,25.75,32.53,6
HCPCS,0134U,HERED PAN CA MRNA PNL 18 GEN,,,646.61,1250.56,15
HCPCS,0134U,Hered pan ca mrna pnl 18 gen,,,325.19,410.76,6
HCPCS,0134U0,HERED PAN CA MRNA PNL 18 GEN,,,646.61,646.61,1
HCPCS,0135U,HERED GYN CA MRNA PNL 12 GEN,,,605.29,1170.64,11
HCPCS,0135U,Hered gyn ca mrna pnl 12 gen,,,325.19,410.76,6
HCPCS,0135U0,HERED GYN CA MRNA PNL 12 GEN,,,605.29,605.29,1
HCPCS,01360,Anes open px lower 1/3 femur,,,13.94,17.6,6
HCPCS,0136U,ATM MRNA SEQ ALYS,,,352.02,680.82,15
HCPCS,0136U,Atm mrna seq alys,,,170.1,214.86,6
HCPCS,0136U0,ATM MRNA SEQ ALYS,,,352.02,352.02,1
HCPCS,0137U,PALB2 MRNA SEQ ALYS,,,244.4,472.69,15
HCPCS,0137U,Palb2 mrna seq alys,,,76.88,97.12,6
HCPCS,0137U0,PALB2 MRNA SEQ ALYS,,,244.4,244.4,1
HCPCS,01380,Anes all clsd px knee joint,,,13.94,17.6,6
HCPCS,01382,Anes dx arthrs px knee jt,,,13.94,17.6,6
HCPCS,0138U,BRCA1 BRCA2 MRNA SEQ ALYS,,,404.63,782.58,15
HCPCS,0138U,Brca1 brca2 mrna seq alys,,,170.1,214.86,6
HCPCS,0138U0,BRCA1 BRCA2 MRNA SEQ ALYS,,,404.63,404.63,1
HCPCS,01390,Anes cls px upr tib fib&/pat,,,13.94,17.6,6
HCPCS,01392,Anes opn px upr tib fib&/pat,,,13.94,17.6,6
HCPCS,0139U,Neuro austm meas 6 c metablt,,,22.32,28.19,6
HCPCS,01400,Anes opn/arthrs knee jt nos,,,13.94,17.6,6
HCPCS,01402,Anes opn/arth tot kne arthrp,,,13.94,17.6,6
HCPCS,01404,Anes opn/arthrs disrtcj knee,,,13.94,17.6,6
HCPCS,0140U,NFCT DS FUNGI DNA 15 TRGT,,,135.43,261.93,15
HCPCS,0140U,Nfct ds fungi dna 15 trgt,,,25.65,32.4,6
HCPCS,0140U0,NFCT DS FUNGI DNA 15 TRGT,,,135.43,135.43,1
HCPCS,0141A,Adm srscv2 bvl 25mcg/.25ml 1,,,25.75,32.53,6
HCPCS,0141U,NFCT DS BACT&FNG GRAM POS,,,135.43,261.93,15
HCPCS,0141U,Nfct ds bact&fng gram pos,,,92.55,116.9,6
HCPCS,0141U0,NFCT DS BACT&FNG GRAM POS,,,135.43,135.43,1
HCPCS,01420,Anes cst appl rmv/rpr kne jt,,,13.94,17.6,6
HCPCS,0142A,Adm srscv2 bvl 25mcg/.25ml 2,,,25.75,32.53,6
HCPCS,0142U,NFCT DS BACT&FNG GRAM NEG,,,135.43,261.93,15
HCPCS,0142U,Nfct ds bact&fng gram neg,,,92.55,116.9,6
HCPCS,0142U0,NFCT DS BACT&FNG GRAM NEG,,,135.43,135.43,1
HCPCS,01430,Anes px veins knee&pop nos,,,13.94,17.6,6
HCPCS,01432,Anes px vn knee&pop av fstl,,,13.94,17.6,6
HCPCS,0143U,Drug assay 120+ rx/metablt,,,74.65,94.3,6
HCPCS,01440,Anes px art knee&pop nos,,,13.94,17.6,6
HCPCS,01442,Anes px art knee&pop teaec,,,13.94,17.6,6
HCPCS,01444,Anes px art knee&pop exc&grf,,,13.94,17.6,6
HCPCS,0144A,Adm srscv2 bvl 25mcg/.25ml a,,,25.75,32.53,6
HCPCS,0144U,Drug assay 160+ rx/metablt,,,74.65,94.3,6
HCPCS,0145U,Drug assay 65+ rx/metablt,,,33.04,41.74,6
HCPCS,01462,Anes clsd px lower l/a/f,,,13.94,17.6,6
HCPCS,01464,Anes arthrs px ankle&/foot,,,13.94,17.6,6
HCPCS,0146U,Drug assay 80+ rx/metablt,,,33.04,41.74,6
HCPCS,01470,Anes px nrv msc lw l/a/f nos,,,13.94,17.6,6
HCPCS,01472,Anes rpr rpt achilles tendon,,,13.94,17.6,6
HCPCS,01474,Anes gastrocnemius recession,,,13.94,17.6,6
HCPCS,0147U,Drug assay 85+ rx/metablt,,,33.04,41.74,6
HCPCS,01480,Anes open px lower l/a/f nos,,,13.94,17.6,6
HCPCS,01482,Anes opn lwr l/a/f rad rescj,,,13.94,17.6,6
HCPCS,01484,Anes opn lw l/a/f oste/ostpl,,,13.94,17.6,6
HCPCS,01486,Anes open total ankle rplcmt,,,13.94,17.6,6
HCPCS,0148U,Drug assay 100+ rx/metablt,,,33.04,41.74,6
HCPCS,01490,Anes lwr leg cst app rmv/rpr,,,13.94,17.6,6
HCPCS,0149U,Drug assay 60+ rx/metablt,,,33.04,41.74,6
HCPCS,01500,Anes px art lower leg nos,,,13.94,17.6,6
HCPCS,01502,Anes px art lower leg emblc,,,13.94,17.6,6
HCPCS,0150U,Drug assay 120+ rx/metablt,,,33.04,41.74,6
HCPCS,0151A,Adm sarscv2 bvl 10mcg/.2ml 1,,,25.75,32.53,6
HCPCS,0151U,Nfct bct/vir resp nfctj 33,,,92.55,116.9,6
HCPCS,01520,Anes px veins lower leg nos,,,13.94,17.6,6
HCPCS,01522,Anes px vn lwr leg ven thrmb,,,13.94,17.6,6
HCPCS,0152U,MICROBIAL CELL-FREE DNA BY NGS,13778.0,8955.7,1109.84,12400.2,37
HCPCS,0152U,NFCT DS DNA UNTRGT NGNRJ SEQ,,,1837.04,1837.04,1
HCPCS,0152U0,NFCT DS DNA UNTRGT NGNRJ SEQ,,,1837.04,1837.04,1
HCPCS,0153U,ONC BREAST MRNA 101 GENES,,,2729.74,5279.39,15
HCPCS,0153U,Onc breast mrna 101 genes,,,170.1,214.86,6
HCPCS,0153U0,ONC BREAST MRNA 101 GENES,,,2729.74,2729.74,1
HCPCS,0154A,Adm sarscv2 bvl 10mcg/.2ml a,,,25.75,32.53,6
HCPCS,0154U,ONC URTHL CA RNA FGFR3 GENE,,,416.57,805.66,15
HCPCS,0154U,Onc urthl ca rna fgfr3 gene,,,170.1,214.86,6
HCPCS,0154U0,ONC URTHL CA RNA FGFR3 GENE,,,416.57,416.57,1
HCPCS,0155U,ONC BRST CA DNA PIK3CA GENE,,,237.45,459.24,15
HCPCS,0155U,Onc brst ca dna pik3ca gene,,,76.88,97.12,6
HCPCS,0155U0,ONC BRST CA DNA PIK3CA GENE,,,237.45,237.45,1
HCPCS,0156U,COPY NUMBER SEQUENCE ALYS,,,1503.36,2907.54,15
HCPCS,0156U,Copy number sequence alys,,,22.32,28.19,6
HCPCS,0156U0,COPY NUMBER SEQUENCE ALYS,,,1503.36,1503.36,1
HCPCS,0157U,APC MRNA SEQ ALYS,,,244.4,472.69,15
HCPCS,0157U,Apc mrna seq alys,,,170.1,214.86,6
HCPCS,0157U0,APC MRNA SEQ ALYS,,,244.4,244.4,1
HCPCS,0158U,MLH1 MRNA SEQ ALYS,,,244.4,472.69,15
HCPCS,0158U,Mlh1 mrna seq alys,,,22.32,28.19,6
HCPCS,0158U0,MLH1 MRNA SEQ ALYS,,,244.4,244.4,1
HCPCS,0159U,MSH2 MRNA SEQ ALYS,,,244.4,472.69,15
HCPCS,0159U,Msh2 mrna seq alys,,,22.32,28.19,6
HCPCS,0159U0,MSH2 MRNA SEQ ALYS,,,244.4,244.4,1
HCPCS,0160U,MSH6 MRNA SEQ ALYS,,,244.4,472.69,15
HCPCS,0160U,Msh6 mrna seq alys,,,22.32,28.19,6
HCPCS,0160U0,MSH6 MRNA SEQ ALYS,,,244.4,244.4,1
HCPCS,01610,Anes all px nrv musc sho&ax,,,13.94,17.6,6
HCPCS,0161U,PMS2 MRNA SEQ ALYS,,,244.4,472.69,15
HCPCS,0161U,Pms2 mrna seq alys,,,170.1,214.86,6
HCPCS,0161U0,PMS2 MRNA SEQ ALYS,,,244.4,244.4,1
HCPCS,01620,Anes clsd px shoulder joint,,,13.94,17.6,6
HCPCS,01622,Anes dx arthr px shoulder jt,,,13.94,17.6,6
HCPCS,0162U,HERED COLON CA TRGT MRNA PNL,,,420.37,813.01,15
HCPCS,0162U,Hered colon ca trgt mrna pnl,,,170.1,214.86,6
HCPCS,0162U0,HERED COLON CA TRGT MRNA PNL,,,420.37,420.37,1
HCPCS,01630,Anes opn/arthr px sho jt nos,,,13.94,17.6,6
HCPCS,01634,Anes open/arthrs sho disrtcj,,,13.94,17.6,6
HCPCS,01636,Anes open/arthr ntrthrc amp,,,13.94,17.6,6
HCPCS,01638,Anes opn/arthr tot sho rplcm,,,13.94,17.6,6
HCPCS,0163T,Tot disc arthrp ea addl lmbr,,,9774.46,12346.69,6
HCPCS,0163U,ONC CLRCT SCR 3 PRTN ALG,,,337.61,652.94,4
HCPCS,0163U,Onc clrct scr 3 prtn alg,,,22.32,28.19,6
HCPCS,0163U0,ONC CLRCT SCR 3 PRTN ALG,,,337.61,337.61,1
HCPCS,0164A,Adm srscv2 bvl 10mcg/0.2ml a,,,25.75,32.53,6
HCPCS,0164T,REMOVE LUMB ARTIF DISC ADDL,,,755.71,755.71,1
HCPCS,0164T,Remove lumb artif disc addl,,,9774.46,12346.69,6
HCPCS,0164T0,REMOVE LUMB ARTIF DISC ADDL,,,755.71,755.71,1
HCPCS,0164U,GI IBS IA ANTI-CDTB&VINCULIN,,,96.79,187.19,15
HCPCS,0164U,Gi ibs ia anti-cdtb&vinculin,,,76.88,97.12,6
HCPCS,0164U0,GI IBS IA ANTI-CDTB&VINCULIN,,,96.79,96.79,1
HCPCS,01650,Anes art sho&ax nos,,,13.94,17.6,6
HCPCS,01652,Anes art sho&ax ax-brch arsm,,,13.94,17.6,6
HCPCS,01654,Anes art sho&ax bypass grf,,,13.94,17.6,6
HCPCS,01656,Anes art sho&ax ax-fem bpg,,,13.94,17.6,6
HCPCS,0165T,REVISE LUMB ARTIF DISC ADDL,,,722.75,722.75,1
HCPCS,0165T,Revise lumb artif disc addl,,,9774.46,12346.69,6
HCPCS,0165T0,REVISE LUMB ARTIF DISC ADDL,,,722.75,722.75,1
HCPCS,0165U,PEANUT ALLG ASMT EPI PRB ALL,,,400.69,774.94,15
HCPCS,0165U,Peanut allg asmt epi,,,19.47,24.59,6
HCPCS,0165U0,PEANUT ALLG ASMT EPI PRB ALL,,,400.69,400.69,1
HCPCS,0166U,LIVER DS 10 BIOCHEM ASY SRM,,,434.94,841.18,15
HCPCS,0166U,Liver ds 10 biochem asy srm,,,170.1,214.86,6
HCPCS,0166U0,LIVER DS 10 BIOCHEM ASY SRM,,,434.94,434.94,1
HCPCS,01670,Anes all px vn shoulder&ax,,,13.94,17.6,6
HCPCS,0167U,Chornc gonadotropin hcg ia,,,6.33,7.99,6
HCPCS,01680,Anes sho cast appl rmvl/rpr,,,13.94,17.6,6
HCPCS,0168U,Ftl aneuploidy dna seq alys,,,325.19,410.76,6
HCPCS,0169U,NUDT15&TPMT GENE COM VRNT,,,402.78,778.97,15
HCPCS,0169U,Nudt15&tpmt gene com vrnt,,,170.1,214.86,6
HCPCS,0169U0,NUDT15&TPMT GENE COM VRNT,,,402.78,402.78,1
HCPCS,0170U,NEURO ASD RNA NEXT GEN SEQ,,,1684.8,3258.45,15
HCPCS,0170U,Neuro asd rna next gen seq,,,1109.84,1401.9,6
HCPCS,0170U0,NEURO ASD RNA NEXT GEN SEQ,,,1684.8,1684.8,1
HCPCS,01710,Anes px nrv musc upr a&e nos,,,13.94,17.6,6
HCPCS,01712,Anes px nrv msc upr a&e tnot,,,13.94,17.6,6
HCPCS,01714,Anes nrv msc upr a&e tnplsty,,,13.94,17.6,6
HCPCS,01716,Anes nrv msc upr a&e tndsis,,,13.94,17.6,6
HCPCS,0171A,Adm sarscv2 bvl 3mcg/0.2ml 1,,,25.75,32.53,6
HCPCS,0171U,TRGT GEN SEQ ALYS PNL DNA 23,,,1312.47,2538.35,15
HCPCS,0171U,Trgt gen seq alys pnl dna 23,,,170.1,214.86,6
HCPCS,0171U0,TRGT GEN SEQ ALYS PNL DNA 23,,,1312.47,1312.47,1
HCPCS,0172A,Adm sarscv2 bvl 3mcg/0.2ml 2,,,25.75,32.53,6
HCPCS,0172U,ONC SLD TUM ALYS BRCA1 BRCA2,,,2617.92,5063.13,15
HCPCS,0172U,Onc sld tum alys brca1 brca2,,,1109.84,1401.9,6
HCPCS,0172U0,ONC SLD TUM ALYS BRCA1 BRCA2,,,2617.92,2617.92,1
HCPCS,01730,Anes clsd px humerus&elbow,,,13.94,17.6,6
HCPCS,01732,Anes dx arthrs px elbow jt,,,13.94,17.6,6
HCPCS,0173A,Adm sarscv2 bvl 3mcg/0.2ml 3,,,25.75,32.53,6
HCPCS,0173U,PSYC GEN ALYS PANEL 14 GENES,,,402.78,778.97,15
HCPCS,0173U,Psyc gen alys panel 14 genes,,,22.32,28.19,6
HCPCS,0173U0,PSYC GEN ALYS PANEL 14 GENES,,,402.78,402.78,1
HCPCS,01740,Anes opn/arthrs px elbw nos,,,13.94,17.6,6
HCPCS,01742,Anes opn/arthrs elbw osteot,,,13.94,17.6,6
HCPCS,01744,Anes opn/arthrs elbw rpr hum,,,13.94,17.6,6
HCPCS,0174A,Adm sarscv2 bvl 3mcg/0.2ml a,,,25.75,32.53,6
HCPCS,0174T,CAD CXR WITH INTERP,,,33.48,33.48,1
HCPCS,0174T0,CAD CXR WITH INTERP,,,33.48,33.48,1
HCPCS,0174U,ONC SOLID TUMOR 30 PRTN TRGT,,,1127.84,2181.27,15
HCPCS,0174U,Onc solid tumor 30 prtn trgt,,,22.32,28.19,6
HCPCS,0174U0,ONC SOLID TUMOR 30 PRTN TRGT,,,1127.84,1127.84,1
HCPCS,01756,Anes opn/arthrs elbw rad px,,,13.94,17.6,6
HCPCS,01758,Anes opn/arthrs elbw exc cst,,,13.94,17.6,6
HCPCS,0175T,CAD CXR REMOTE,,,16.08,16.08,1
HCPCS,0175T0,CAD CXR REMOTE,,,16.08,16.08,1
HCPCS,0175U,PSYC GEN ALYS PANEL 15 GENES,,,1154.38,2232.61,15
HCPCS,0175U,Psyc gen alys panel 15 genes,,,1109.84,1401.9,6
HCPCS,0175U0,PSYC GEN ALYS PANEL 15 GENES,,,1154.38,1154.38,1
HCPCS,01760,Anes opn/arthr elb tot rplct,,,13.94,17.6,6
HCPCS,0176U,CDTB&VINCULIN IGG ANTB IA,,,55.46,107.26,15
HCPCS,0176U,Cdtb&vinculin igg antb ia,,,19.47,24.59,6
HCPCS,0176U0,CDTB&VINCULIN IGG ANTB IA,,,55.46,55.46,1
HCPCS,01770,Anes px art upr arm&elbw nos,,,13.94,17.6,6
HCPCS,01772,Anes art upr arm&elbw emblc,,,13.94,17.6,6
HCPCS,0177U,ONC BRST CA DNA PIK3CA 11,,,237.45,459.24,15
HCPCS,0177U,Onc brst ca dna pik3ca 11,,,76.88,97.12,6
HCPCS,0177U0,ONC BRST CA DNA PIK3CA 11,,,237.45,237.45,1
HCPCS,01780,Anes px vn upr arm&elbw nos,,,13.94,17.6,6
HCPCS,01782,Anes vn upr arm&elbw phlbrpy,,,13.94,17.6,6
HCPCS,0178U,PEANUT ALLG ASMT EPI CLIN RX,,,397.32,768.43,15
HCPCS,0178U,Peanut allg asmt epi clin rx,,,5.23,6.6,6
HCPCS,0178U0,PEANUT ALLG ASMT EPI CLIN RX,,,397.32,397.32,1
HCPCS,0179U,ONC NONSM CLL LNG CA ALYS 23,,,1678.94,3247.1,15
HCPCS,0179U,Onc nonsm cll lng ca alys 23,,,22.32,28.19,6
HCPCS,0179U0,ONC NONSM CLL LNG CA ALYS 23,,,1678.94,1678.94,1
HCPCS,0180U,ABO GNOTYP ABO 7 EXONS,,,237.45,459.24,15
HCPCS,0180U,Abo gnotyp abo 7 exons,,,22.32,28.19,6
HCPCS,0180U0,ABO GNOTYP ABO 7 EXONS,,,237.45,237.45,1
HCPCS,01810,Anes px nrv musc f/arm wrst,,,13.94,17.6,6
HCPCS,0181U,CO GNOTYP AQP1 EXON 1,,,160.01,309.47,15
HCPCS,0181U,Co gnotyp aqp1 exon 1,,,76.88,97.12,6
HCPCS,0181U0,CO GNOTYP AQP1 EXON 1,,,160.01,160.01,1
HCPCS,01820,Anes clsd px rds u/w/h bones,,,13.94,17.6,6
HCPCS,01829,Anes dx arthroscopic px wrst,,,13.94,17.6,6
HCPCS,0182U,CROM GNOTYP CD55 EXONS 1-10,,,260.37,503.56,15
HCPCS,0182U,Crom gnotyp cd55 exons 1-10,,,76.88,97.12,6
HCPCS,0182U0,CROM GNOTYP CD55 EXONS 1-10,,,260.37,260.37,1
HCPCS,01830,Anes arthr/ndsc wrst/hnd nos,,,13.94,17.6,6
HCPCS,01832,Anes arthr/ndsc tot wrst rpl,,,13.94,17.6,6
HCPCS,0183U,DI GNOTYP SLC4A1 EXON 19,,,160.01,309.47,15
HCPCS,0183U,Di gnotyp slc4a1 exon 19,,,76.88,97.12,6
HCPCS,0183U0,DI GNOTYP SLC4A1 EXON 19,,,160.01,160.01,1
HCPCS,01840,Anes art f/arm wrst&hnd nos,,,13.94,17.6,6
HCPCS,01842,Anes art farm wrst&hnd emblc,,,13.94,17.6,6
HCPCS,01844,Anes vasc shunt/shunt revj,,,13.94,17.6,6
HCPCS,0184T,EXC RECTAL TUMOR ENDOSCOPIC,,,916.23,12906.67,15
HCPCS,0184T,Exc rectal tumor endoscopic,,,1410.62,1781.83,6
HCPCS,0184T,RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC,7239.0,4705.35,53.0,7239.0,18
HCPCS,0184T0,EXC RECTAL TUMOR ENDOSCOPIC,,,916.23,916.23,1
HCPCS,0184U,DO GNOTYP ART4 EXON 2,,,160.01,309.47,15
HCPCS,0184U,Do gnotyp art4 exon 2,,,76.88,97.12,6
HCPCS,0184U0,DO GNOTYP ART4 EXON 2,,,160.01,160.01,1
HCPCS,01850,Anes vein f/arm wrst&hnd nos,,,13.94,17.6,6
HCPCS,01852,Anes px vn f/arm phlbrrhaphy,,,13.94,17.6,6
HCPCS,0185U,FUT1 GNOTYP FUT1 EXON 4,,,160.01,309.47,15
HCPCS,0185U,Fut1 gnotyp fut1 exon 4,,,76.88,97.12,6
HCPCS,0185U0,FUT1 GNOTYP FUT1 EXON 4,,,160.01,160.01,1
HCPCS,01860,Anes forearm wrist/hand cast,,,13.94,17.6,6
HCPCS,0186U,FUT2 GNOTYP FUT2 EXON 2,,,160.01,309.47,15
HCPCS,0186U,Fut2 gnotyp fut2 exon 2,,,76.88,97.12,6
HCPCS,0186U0,FUT2 GNOTYP FUT2 EXON 2,,,160.01,160.01,1
HCPCS,0187U,FY GNOTYP ACKR1 EXONS 1-2,,,237.45,459.24,15
HCPCS,0187U,Fy gnotyp ackr1 exons 1-2,,,76.88,97.12,6
HCPCS,0187U0,FY GNOTYP ACKR1 EXONS 1-2,,,237.45,237.45,1
HCPCS,0188U,GE GNOTYP GYPC EXONS 1-4,,,237.45,459.24,15
HCPCS,0188U,Ge gnotyp gypc exons 1-4,,,76.88,97.12,6
HCPCS,0188U0,GE GNOTYP GYPC EXONS 1-4,,,237.45,237.45,1
HCPCS,0189U,GYPA GNOTYP NTRNS 1 5 EXON 2,,,237.45,459.24,15
HCPCS,0189U,Gypa gnotyp ntrns 1 5 exon 2,,,76.88,97.12,6
HCPCS,0189U0,GYPA GNOTYP NTRNS 1 5 EXON 2,,,237.45,237.45,1
HCPCS,0190U,GYPB GNOTYP NTRNS 1 5 SEUX 3,,,237.45,459.24,15
HCPCS,0190U,Gypb gnotyp ntrns 1 5 seux 3,,,76.88,97.12,6
HCPCS,0190U0,GYPB GNOTYP NTRNS 1 5 SEUX 3,,,237.45,237.45,1
HCPCS,01916,Anes dx arteriography/vngrph,,,13.94,17.6,6
HCPCS,0191T,Insert ant segment drain int,,,2069.78,2614.46,6
HCPCS,0191U,IN GNOTYP CD44 EXONS 2 3 6,,,237.45,459.24,15
HCPCS,0191U,In gnotyp cd44 exons 2 3 6,,,76.88,97.12,6
HCPCS,0191U0,IN GNOTYP CD44 EXONS 2 3 6,,,237.45,237.45,1
HCPCS,01920,Anes cardiac catheterization,,,13.94,17.6,6
HCPCS,01922,Anes n-invas img/radj ther,,,13.94,17.6,6
HCPCS,01924,Anes ther ivntl rad artl nos,,,13.94,17.6,6
HCPCS,01925,Anes ivntl rad artl crtd/c,,,13.94,17.6,6
HCPCS,01926,Anes ivntl rad icr icar/aort,,,13.94,17.6,6
HCPCS,0192U,JK GNOTYP SLC14A1 EXON 9,,,237.45,459.24,15
HCPCS,0192U,Jk gnotyp slc14a1 exon 9,,,76.88,97.12,6
HCPCS,0192U0,JK GNOTYP SLC14A1 EXON 9,,,237.45,237.45,1
HCPCS,01930,Anes ther ivntl rad ven nos,,,13.94,17.6,6
HCPCS,01931,Anes ivnt rad ntrhpt/prt crc,,,13.94,17.6,6
HCPCS,01932,Anes th ivnt rad ntrthrc/jug,,,13.94,17.6,6
HCPCS,01933,Anes ther ivntl rad px icr,,,13.94,17.6,6
HCPCS,01935,Anesth perc img dx sp proc,,,13.94,17.6,6
HCPCS,01936,Anesth perc img tx sp proc,,,13.94,17.6,6
HCPCS,01937,Anes drg/aspir crv/thrc,,,13.94,17.6,6
HCPCS,01938,Anes drg/aspir lmbr/sac,,,13.94,17.6,6
HCPCS,01939,Anes nulyt agt crv/thrc,,,13.94,17.6,6
HCPCS,0193U,JR GNOTYP ABCG2 EXONS 2-26,,,244.4,472.69,15
HCPCS,0193U,Jr gnotyp abcg2 exons 2-26,,,76.88,97.12,6
HCPCS,0193U0,JR GNOTYP ABCG2 EXONS 2-26,,,244.4,244.4,1
HCPCS,01940,Anes nulyt agt lmbr/sac,,,13.94,17.6,6
HCPCS,01941,Anes neuromd/ntrvrt crv/thrc,,,13.94,17.6,6
HCPCS,01942,Anes neuromd/ntrvrt lmbr/sac,,,13.94,17.6,6
HCPCS,0194U,KEL GNOTYP KEL EXON 8,,,160.01,309.47,15
HCPCS,0194U,Kel gnotyp kel exon 8,,,76.88,97.12,6
HCPCS,0194U0,KEL GNOTYP KEL EXON 8,,,160.01,160.01,1
HCPCS,01951,Anes 2&3 burn less 4 % tbsa,,,13.94,17.6,6
HCPCS,01952,Anes 2&3 burn 4-9% tbsa,,,13.94,17.6,6
HCPCS,01953,Anes 2&3 burn ea add 9% tbsa,,,13.94,17.6,6
HCPCS,01958,Anes xtrnl cephalic version,,,13.94,17.6,6
HCPCS,0195U,KLF1 TARGETED SEQUENCING,,,324.22,627.04,15
HCPCS,0195U,Klf1 targeted sequencing,,,170.1,214.86,6
HCPCS,0195U0,KLF1 TARGETED SEQUENCING,,,324.22,324.22,1
HCPCS,01960,Anes vaginal delivery only,,,13.94,17.6,6
HCPCS,01961,Anes cesarean delivery only,,,13.94,17.6,6
HCPCS,01962,Anes urgent hysterectomy,,,13.94,17.6,6
HCPCS,01963,Anes cesarean hysterectomy,,,13.94,17.6,6
HCPCS,01965,Anes incompl/missed ab px,,,13.94,17.6,6
HCPCS,01966,Anes induced abortion px,,,13.94,17.6,6
HCPCS,01967,Neuraxl lbr anes vag dlvr,,,13.94,17.6,6
HCPCS,01968,Anes/analg cs dlvr neuraxial,,,13.94,17.6,6
HCPCS,01969,Anes c hyst flwg neuraxial,,,13.94,17.6,6
HCPCS,0196U,LU GNOTYP BCAM EXON 3,,,160.01,309.47,15
HCPCS,0196U,Lu gnotyp bcam exon 3,,,76.88,97.12,6
HCPCS,0196U0,LU GNOTYP BCAM EXON 3,,,160.01,160.01,1
HCPCS,0197U,LW GNOTYP ICAM4 EXON 1,,,160.01,309.47,15
HCPCS,0197U,Lw gnotyp icam4 exon 1,,,76.88,97.12,6
HCPCS,0197U0,LW GNOTYP ICAM4 EXON 1,,,160.01,160.01,1
HCPCS,0198T,OCULAR BLOOD FLOW MEASURE,,,87.12,279.48,15
HCPCS,0198T,Ocular blood flow measure,,,45.31,57.23,6
HCPCS,0198T0,OCULAR BLOOD FLOW MEASURE,,,87.12,87.12,1
HCPCS,0198U,RHD&RHCE GNTYP RHD1-10&RHCE5,,,244.4,472.69,15
HCPCS,0198U,Rhd&rhce gntyp rhd1-10&rhce5,,,76.88,97.12,6
HCPCS,0198U0,RHD&RHCE GNTYP RHD1-10&RHCE5,,,244.4,244.4,1
HCPCS,01990,Physiol support hrvg organs,,,13.94,17.6,6
HCPCS,01991,Anes dx/ther nrv blk&inj oth,,,13.94,17.6,6
HCPCS,01992,Anes dx/ther nrv blk&inj prn,,,13.94,17.6,6
HCPCS,01996,DAILY HOSP MGMT EDRL/SARACH CONT DRUG ADMN,395.0,256.75,53.0,395.0,18
HCPCS,01996,DAILY ROUNDS; EPIDURAL,193.0,125.45,53.0,193.0,18
HCPCS,01996,Dly hosp mgmt edrl rx admin,,,13.94,17.6,6
HCPCS,01999,Unlisted anes procedure,,,13.94,17.6,6
HCPCS,0199U,SC GNOTYP ERMAP EXONS 4 12,,,237.45,459.24,15
HCPCS,0199U,Sc gnotyp ermap exons 4 12,,,76.88,97.12,6
HCPCS,0199U0,SC GNOTYP ERMAP EXONS 4 12,,,237.45,237.45,1
HCPCS,0200T,PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL,15070.0,9795.5,3094.77,21261.6,53
HCPCS,0200T,PERQ SACRAL AUGMT UNILAT INJ,,,2037.3,2037.3,1
HCPCS,0200T0,PERQ SACRAL AUGMT UNILAT INJ,,,2037.3,2037.3,1
HCPCS,0200U,XK GNOTYP XK EXONS 1-3,,,237.45,459.24,15
HCPCS,0200U,Xk gnotyp xk exons 1-3,,,76.88,97.12,6
HCPCS,0200U0,XK GNOTYP XK EXONS 1-3,,,237.45,237.45,1
HCPCS,0201T,PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS,24275.0,15778.75,3094.77,32147.1,53
HCPCS,0201T,PERQ SACRAL AUGMT BILAT INJ,,,2082.0,2082.0,1
HCPCS,0201T0,PERQ SACRAL AUGMT BILAT INJ,,,2082.0,2082.0,1
HCPCS,0201U,YT GNOTYP ACHE EXON 2,,,160.01,309.47,15
HCPCS,0201U,Yt gnotyp ache exon 2,,,76.88,97.12,6
HCPCS,0201U0,YT GNOTYP ACHE EXON 2,,,160.01,160.01,1
HCPCS,0202T,POST VERT ARTHRPLST 1 LUMBAR,,,2252.57,14747.88,5
HCPCS,0202T,Post vert arthrplst 1 lumbar,,,3094.77,3909.18,6
HCPCS,0202T0,POST VERT ARTHRPLST 1 LUMBAR,,,2252.57,2252.57,1
HCPCS,0202U,"FILM ARRAY, RESPIRATORY 22 TARGETS",1144.0,743.6,170.1,1029.6,37
HCPCS,0202U,NFCT DS 22 TRGT SARS-COV-2,,,450.12,450.12,1
HCPCS,0202U0,NFCT DS 22 TRGT SARS-COV-2,,,450.12,450.12,1
HCPCS,0203U,AI IBD MRNA XPRSN PRFL 17,,,656.64,1269.96,15
HCPCS,0203U,Ai ibd mrna xprsn prfl 17,,,325.19,410.76,6
HCPCS,0203U0,AI IBD MRNA XPRSN PRFL 17,,,656.64,656.64,1
HCPCS,0204U,Onc thyr mrna xprsn alys 593,,,1109.84,1401.9,6
HCPCS,0205U,OPH AMD ALYS 3 GENE VARIANTS,,,40.61,78.54,15
HCPCS,0205U,Oph amd alys 3 gene variants,,,22.32,28.19,6
HCPCS,0205U0,OPH AMD ALYS 3 GENE VARIANTS,,,40.61,40.61,1
HCPCS,0206U,NEURO ALZHEIMER CELL AGGREGJ,,,1914.11,3701.93,15
HCPCS,0206U,Neuro alzheimer cell aggregj,,,22.32,28.19,6
HCPCS,0206U0,NEURO ALZHEIMER CELL AGGREGJ,,,1914.11,1914.11,1
HCPCS,0207T,CLEAR EYELID GLAND W/HEAT,,,89.86,279.48,15
HCPCS,0207T,Clear eyelid gland w/heat,,,45.31,57.23,6
HCPCS,0207T0,CLEAR EYELID GLAND W/HEAT,,,89.86,89.86,1
HCPCS,0207U,NEURO ALZHEIMER QUAN IMAGING,,,441.68,854.22,4
HCPCS,0207U,Neuro alzheimer quan imaging,,,76.88,97.12,6
HCPCS,0207U0,NEURO ALZHEIMER QUAN IMAGING,,,441.68,441.68,1
HCPCS,0208T,AUDIOMETRY AIR ONLY,,,29.07,85.1,15
HCPCS,0208T,Audiometry air only,,,19.1,24.12,6
HCPCS,0208T0,AUDIOMETRY AIR ONLY,,,29.07,29.07,1
HCPCS,0208U,Onc mtc mrna xprsn alys 108,,,170.1,214.86,6
HCPCS,0209T,AUDIOMETRY AIR & BONE,,,37.88,85.1,15
HCPCS,0209T,Audiometry air & bone,,,19.1,24.12,6
HCPCS,0209T0,AUDIOMETRY AIR & BONE,,,37.88,37.88,1
HCPCS,0209U,CYTOG CONST ALYS INTERROG,,,680.1,1315.33,15
HCPCS,0209U,Cytog const alys interrog,,,22.32,28.19,6
HCPCS,0209U0,CYTOG CONST ALYS INTERROG,,,680.1,680.1,1
HCPCS,0210T,SPEECH AUDIOMETRY THRESHOLD,,,22.79,85.1,15
HCPCS,0210T,Speech audiometry threshold,,,19.1,24.12,6
HCPCS,0210T0,SPEECH AUDIOMETRY THRESHOLD,,,22.79,22.79,1
HCPCS,0210U,SYPHILIS TST ANTB IA QUAN,,,16.09,31.13,15
HCPCS,0210U,Syphilis tst antb ia quan,,,5.23,6.6,6
HCPCS,0210U0,SYPHILIS TST ANTB IA QUAN,,,16.09,16.09,1
HCPCS,0211T,SPEECH AUDIOM THRESH & RECOG,,,34.73,85.1,15
HCPCS,0211T,Speech audiom thresh & recog,,,19.1,24.12,6
HCPCS,0211T0,SPEECH AUDIOM THRESH & RECOG,,,34.73,34.73,1
HCPCS,0211U,ONC PAN-TUM DNA&RNA GNRJ SEQ,,,7305.12,7305.12,1
HCPCS,0211U,ONC PAN-TUMOR DNA&RNA NEXT-GENERATION SEQUENCING-CARIS,58339.0,37920.35,1109.84,52505.1,30
HCPCS,0211U0,ONC PAN-TUM DNA&RNA GNRJ SEQ,,,7305.12,7305.12,1
HCPCS,0212T,COMPRE AUDIOMETRY EVALUATION,,,33.03,339.23,15
HCPCS,0212T,Compre audiometry evaluation,,,19.1,24.12,6
HCPCS,0212T0,COMPRE AUDIOMETRY EVALUATION,,,33.03,33.03,1
HCPCS,0212U,RARE DS GEN DNA ALYS PROBAND,,,4730.57,9149.06,15
HCPCS,0212U,Rare ds gen dna alys proband,,,22.32,28.19,6
HCPCS,0212U0,RARE DS GEN DNA ALYS PROBAND,,,4730.57,4730.57,1
HCPCS,0213T,NJX PARAVERT W/US CER/THOR,,,218.74,1930.3,15
HCPCS,0213T,Njx paravert w/us cer/thor,,,459.05,579.85,6
HCPCS,0213T0,NJX PARAVERT W/US CER/THOR,,,218.74,218.74,1
HCPCS,0213U,RARE DS GEN DNA ALYS EA COMP,,,2341.4,4528.33,15
HCPCS,0213U,Rare ds gen dna alys ea comp,,,22.32,28.19,6
HCPCS,0213U0,RARE DS GEN DNA ALYS EA COMP,,,2341.4,2341.4,1
HCPCS,0214T,NJX PARAVERT W/US CER/THOR,,,109.21,109.21,1
HCPCS,0214T,Njx paravert w/us cer/thor,,,459.05,579.85,6
HCPCS,0214T0,NJX PARAVERT W/US CER/THOR,,,109.21,109.21,1
HCPCS,0214U,RARE DS XOM DNA ALYS PROBAND,,,4514.05,8730.31,15
HCPCS,0214U,Rare ds xom dna alys proband,,,1109.84,1401.9,6
HCPCS,0214U0,RARE DS XOM DNA ALYS PROBAND,,,4514.05,4514.05,1
HCPCS,0215T,NJX PARAVERT W/US CER/THOR,,,109.89,109.89,1
HCPCS,0215T,Njx paravert w/us cer/thor,,,459.05,579.85,6
HCPCS,0215T0,NJX PARAVERT W/US CER/THOR,,,109.89,109.89,1
HCPCS,0215U,RARE DS XOM DNA ALYS EA COMP,,,2224.5,4302.24,15
HCPCS,0215U,Rare ds xom dna alys ea comp,,,1109.84,1401.9,6
HCPCS,0215U0,RARE DS XOM DNA ALYS EA COMP,,,2224.5,2224.5,1
HCPCS,0216T,NJX PARAVERT W/US LUMB/SAC,,,197.24,1930.3,15
HCPCS,0216T,Njx paravert w/us lumb/sac,,,459.05,579.85,6
HCPCS,0216T0,NJX PARAVERT W/US LUMB/SAC,,,197.24,197.24,1
HCPCS,0216U,NEURO INH ATAXIA DNA 12 COM,,,1327.99,2568.36,15
HCPCS,0216U,Neuro inh ataxia dna 12 com,,,22.32,28.19,6
HCPCS,0216U0,NEURO INH ATAXIA DNA 12 COM,,,1327.99,1327.99,1
HCPCS,0217T,NJX PARAVERT W/US LUMB/SAC,,,97.06,97.06,1
HCPCS,0217T,Njx paravert w/us lumb/sac,,,459.05,579.85,6
HCPCS,0217T0,NJX PARAVERT W/US LUMB/SAC,,,97.06,97.06,1
HCPCS,0217U,NEURO INH ATAXIA DNA 51 GENE,,,1899.37,3673.44,15
HCPCS,0217U,Neuro inh ataxia dna 51 gene,,,22.32,28.19,6
HCPCS,0217U0,NEURO INH ATAXIA DNA 51 GENE,,,1899.37,1899.37,1
HCPCS,0218T,NJX PARAVERT W/US LUMB/SAC,,,100.86,100.86,1
HCPCS,0218T,Njx paravert w/us lumb/sac,,,459.05,579.85,6
HCPCS,0218T0,NJX PARAVERT W/US LUMB/SAC,,,100.86,100.86,1
HCPCS,0218U,NEURO MUSC DYS DMD SEQ ALYS,,,1969.06,3808.21,15
HCPCS,0218U,Neuro musc dys dmd seq alys,,,1109.84,1401.9,6
HCPCS,0218U0,NEURO MUSC DYS DMD SEQ ALYS,,,1969.06,1969.06,1
HCPCS,0219T,PLMT POST FACET IMPLT CERV,,,1167.52,14747.88,5
HCPCS,0219T,Plmt post facet implt cerv,,,9774.46,12346.69,6
HCPCS,0219T0,PLMT POST FACET IMPLT CERV,,,1167.52,1167.52,1
HCPCS,0219U,NFCT AGT HIV GNRJ SEQ ALYS,,,626.4,1211.48,15
HCPCS,0219U,Nfct agt hiv gnrj seq alys,,,19.47,24.59,6
HCPCS,0219U0,NFCT AGT HIV GNRJ SEQ ALYS,,,626.4,626.4,1
HCPCS,0220T,PLMT POST FACET IMPLT THOR,,,1440.68,14747.88,5
HCPCS,0220T,Plmt post facet implt thor,,,6141.85,7758.12,6
HCPCS,0220T0,PLMT POST FACET IMPLT THOR,,,1440.68,1440.68,1
HCPCS,0220U,ONC BRST CA AI ASSMT 12 FEAT,,,610.2,1180.14,15
HCPCS,0220U,Onc brst ca ai assmt 12 feat,,,11.52,14.56,6
HCPCS,0220U0,ONC BRST CA AI ASSMT 12 FEAT,,,610.2,610.2,1
HCPCS,0221T,PLMT POST FACET IMPLT LUMB,,,1382.78,15488.78,15
HCPCS,0221T,Plmt post facet implt lumb,,,3094.77,3909.18,6
HCPCS,0221T0,PLMT POST FACET IMPLT LUMB,,,1382.78,1382.78,1
HCPCS,0221U,ABO GNOTYP NEXT GNRJ SEQ ABO,,,237.45,459.24,15
HCPCS,0221U,Abo gnotyp next gnrj seq abo,,,22.32,28.19,6
HCPCS,0221U0,ABO GNOTYP NEXT GNRJ SEQ ABO,,,237.45,237.45,1
HCPCS,0222T,PLMT POST FACET IMPLT ADDL,,,402.13,402.13,1
HCPCS,0222T,Plmt post facet implt addl,,,3094.77,3909.18,6
HCPCS,0222T0,PLMT POST FACET IMPLT ADDL,,,402.13,402.13,1
HCPCS,0222U,RHD&RHCE GNTYP NEXT GNRJ SEQ,,,244.4,472.69,15
HCPCS,0222U,Rhd&rhce gntyp next gnrj seq,,,22.32,28.19,6
HCPCS,0222U0,RHD&RHCE GNTYP NEXT GNRJ SEQ,,,244.4,244.4,1
HCPCS,0223U,NFCT DS 22 TRGT SARS-COV-2,,,416.78,696.44,15
HCPCS,0223U,Nfct ds 22 trgt sars-cov-2,,,92.55,116.9,6
HCPCS,0223U0,NFCT DS 22 TRGT SARS-COV-2,,,450.12,450.12,1
HCPCS,0224U,ANTIBODY SARS-COV-2 TITER(S),,,45.5,91.0,18
HCPCS,0224U,Antibody sars-cov-2 titer(s),,,25.65,32.4,6
HCPCS,0224U0,ANTIBODY SARS-COV-2 TITER(S),,,45.5,45.5,1
HCPCS,0225U,NFCT DS DNA&RNA 21 SARSCOV2,,,416.78,696.44,15
HCPCS,0225U,Nfct ds dna&rna 21 sarscov2,,,92.55,116.9,6
HCPCS,0225U0,NFCT DS DNA&RNA 21 SARSCOV2,,,450.12,450.12,1
HCPCS,0226U,SVNT SARSCOV2 ELISA PLSM SRM,,,42.28,91.32,18
HCPCS,0226U,Svnt sarscov2 elisa plsm srm,,,19.47,24.59,6
HCPCS,0226U0,SVNT SARSCOV2 ELISA PLSM SRM,,,45.66,45.66,1
HCPCS,0227U,RX ASY PRSMV 30+RX/METABLT,,,53.69,103.84,15
HCPCS,0227U,Rx asy prsmv 30+rx/metablt,,,33.04,41.74,6
HCPCS,0227U0,RX ASY PRSMV 30+RX/METABLT,,,53.69,53.69,1
HCPCS,0228T,Njx tfrml eprl w/us cer/thor,,,459.05,579.85,6
HCPCS,0228U,ONC PRST8 MA MOLEC PRFL ALG,,,149.49,289.13,15
HCPCS,0228U,Onc prst8 ma molec prfl alg,,,170.1,214.86,6
HCPCS,0228U0,ONC PRST8 MA MOLEC PRFL ALG,,,149.49,149.49,1
HCPCS,0229T,Njx tfrml eprl w/us cer/thor,,,459.05,579.85,6
HCPCS,0229U,BCAT1&IKZF1 PRMTR MTHLN ALYS,,,331.78,641.66,15
HCPCS,0229U,Bcat1&ikzf1 prmtr mthyln aly,,,170.1,214.86,6
HCPCS,0229U0,BCAT1&IKZF1 PRMTR MTHLN ALYS,,,331.78,331.78,1
HCPCS,0230T,Njx tfrml eprl w/us lumb/sac,,,459.05,579.85,6
HCPCS,0230U,AR FULL SEQUENCE ANALYSIS,,,260.37,503.56,15
HCPCS,0230U,Ar full sequence analysis,,,76.88,97.12,6
HCPCS,0230U0,AR FULL SEQUENCE ANALYSIS,,,260.37,260.37,1
HCPCS,0231T,Njx tfrml eprl w/us lumb/sac,,,459.05,579.85,6
HCPCS,0231U,CACNA1A FULL GENE ANALYSIS,,,731.18,1414.12,15
HCPCS,0231U,Cacna1a full gene analysis,,,325.19,410.76,6
HCPCS,0231U0,CACNA1A FULL GENE ANALYSIS,,,731.18,731.18,1
HCPCS,0232T,NJX PLATELET PLASMA,,,385.13,385.13,1
HCPCS,0232T,NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,1465.0,952.25,275.45,3920.0,57
HCPCS,0232T,PB NJX PLTLT RICH PLASMA ADDTL SAME DAY,876.0,569.4,438.0,1496.99,13
HCPCS,0232T,PRP WITH EXOMES,1435.0,932.75,717.5,1496.99,13
HCPCS,0232T0,NJX PLATELET PLASMA,,,385.13,385.13,1
HCPCS,0232U,CSTB FULL GENE ANALYSIS,,,237.45,459.24,15
HCPCS,0232U,Cstb full gene analysis,,,76.88,97.12,6
HCPCS,0232U0,CSTB FULL GENE ANALYSIS,,,237.45,237.45,1
HCPCS,0233U,FXN GENE ANALYSIS,,,237.45,459.24,15
HCPCS,0233U,Fxn gene analysis,,,76.88,97.12,6
HCPCS,0233U0,FXN GENE ANALYSIS,,,237.45,237.45,1
HCPCS,0234T,"TP ATHERECTOMY,PERC; RENAL ARTERY",5111.0,3322.15,2555.5,15995.68,13
HCPCS,0234T,TRLUML PERIP ATHRC RENAL ART,5111.0,3322.15,2555.5,15995.68,14
HCPCS,0234T,TRLUML PERIPHERAL ATHERECTOMY RENAL ARTERY EA,17499.5,11374.675000000001,2555.5,26899.2,53
HCPCS,0234T0,TRLUML PERIP ATHRC RENAL ART,,,5351.65,5351.65,1
HCPCS,0234U,MECP2 FULL GENE ANALYSIS,,,456.08,882.07,15
HCPCS,0234U,Mecp2 full gene analysis,,,170.1,214.86,6
HCPCS,0234U0,MECP2 FULL GENE ANALYSIS,,,456.08,456.08,1
HCPCS,0235T,"TP ATHERECTOMY,PERC; VISCERAL ARTERY",5131.0,3335.15,2565.5,15995.68,13
HCPCS,0235T,TRLUML PERIP ATHRC VISCERAL,5131.0,3335.15,2565.5,15995.68,14
HCPCS,0235T,TRLUML PERIPHERAL ATHERECTOMY VISCERAL ARTERY EA,12944.5,8413.925000000001,1940.0,18682.2,43
HCPCS,0235T0,TRLUML PERIP ATHRC VISCERAL,,,6546.54,6546.54,1
HCPCS,0235U,PTEN FULL GENE ANALYSIS,,,518.4,1002.6,15
HCPCS,0235U,Pten full gene analysis,,,170.1,214.86,6
HCPCS,0235U0,PTEN FULL GENE ANALYSIS,,,518.4,518.4,1
HCPCS,0236T,"TP ATHERECTOMY,PERC; ABDOMINAL AORTA",4455.0,2895.75,2227.5,16285.51,13
HCPCS,0236T,TRLUML PERIP ATHRC ABD AORTA,4455.0,2895.75,2227.5,16285.51,14
HCPCS,0236T,TRLUML PERIPH ATHRC W/RS&I ABDOM AORTA,30579.0,19876.35,2227.5,51032.7,53
HCPCS,0236T0,TRLUML PERIP ATHRC ABD AORTA,,,6095.22,6095.22,1
HCPCS,0236U,SMN1&SMN2 FULL GENE ANALYSIS,,,520.73,1007.11,15
HCPCS,0236U,Smn1&smn2 full gene analysis,,,325.19,410.76,6
HCPCS,0236U0,SMN1&SMN2 FULL GENE ANALYSIS,,,520.73,520.73,1
HCPCS,0237T,"TP ATHERECTOMY,PERC; BRACHIOCEPHALIC",5843.0,3797.95,2921.5,16285.51,13
HCPCS,0237T,TRLUML PERIP ATHRC BRCHIOCPH,5843.0,3797.95,2921.5,16285.51,14
HCPCS,0237T,TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL,15611.5,10147.475,2921.5,24588.22,53
HCPCS,0237T0,TRLUML PERIP ATHRC BRCHIOCPH,,,9442.16,9442.16,1
HCPCS,0237U,CAR ION CHNLPTHY GEN SEQ PNL,,,505.35,977.37,15
HCPCS,0237U,Car ion chnlpthy gen seq pnl,,,170.1,214.86,6
HCPCS,0237U0,CAR ION CHNLPTHY GEN SEQ PNL,,,505.35,505.35,1
HCPCS,0238T,TRLUML PERIP ATHRC ILIAC ART,,,10812.83,10812.83,1
HCPCS,0238T,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,26139.5,16990.675,2149.5,43182.0,93
HCPCS,0238T0,TRLUML PERIP ATHRC ILIAC ART,,,10812.83,10812.83,1
HCPCS,0238U,ONC LNCH SYN GEN DNA SEQ ALY,,,505.35,977.37,15
HCPCS,0238U,Onc lnch syn gen dna seq aly,,,170.1,214.86,6
HCPCS,0238U0,ONC LNCH SYN GEN DNA SEQ ALY,,,505.35,505.35,1
HCPCS,0239U,TRGT GEN SEQ ALYS PNL 311+,,,3024.0,5848.5,15
HCPCS,0239U,Trgt gen seq alys pnl 311+,,,1109.84,1401.9,6
HCPCS,0239U0,TRGT GEN SEQ ALYS PNL 311+,,,3024.0,3024.0,1
HCPCS,0240U,NFCT DS VIR RESP RNA 3 TRGT,,,142.63,308.08,16
HCPCS,0240U,Nfct ds vir resp rna 3 trgt,,,25.65,32.4,6
HCPCS,0240UQW,NFCT DS VIR RESP RNA 3 TRGT,,,219.94,238.33,3
HCPCS,0241U,NFCT DS VIR RESP RNA 4 TRGT,,,142.63,308.08,16
HCPCS,0241U,Nfct ds vir resp rna 4 trgt,,,25.65,32.4,6
HCPCS,0241UQW,NFCT DS VIR RESP RNA 4 TRGT,,,219.94,238.33,3
HCPCS,0242U,TRGT GEN SEQ ALYS PNL 55-74,,,4320.0,8355.0,15
HCPCS,0242U,Trgt gen seq alys pnl 55-74,,,1109.84,1401.9,6
HCPCS,0242U0,TRGT GEN SEQ ALYS PNL 55-74,,,4320.0,4320.0,1
HCPCS,0243U,OB PE BIOCHEM ASSAY PGF ALG,,,55.65,107.63,15
HCPCS,0243U,Ob pe biochem assay pgf alg,,,22.32,28.19,6
HCPCS,0243U0,OB PE BIOCHEM ASSAY PGF ALG,,,55.65,55.65,1
HCPCS,0244U,ONC SOLID ORGN DNA 257 GENES,,,3024.0,5848.5,15
HCPCS,0244U,Onc solid orgn dna 257 genes,,,170.1,214.86,6
HCPCS,0244U0,ONC SOLID ORGN DNA 257 GENES,,,3024.0,3024.0,1
HCPCS,0245U,ONC THYR MUT ALYS 10 GEN&37,,,1093.89,2115.6,15
HCPCS,0245U,Onc thyr mut alys 10 gen&37,,,170.1,214.86,6
HCPCS,0245U0,ONC THYR MUT ALYS 10 GEN&37,,,1093.89,1093.89,1
HCPCS,0246U,RBC DNA GNOTYP 16 BLD GROUPS,,,622.08,1203.12,15
HCPCS,0246U,Rbc dna gnotyp 16 bld groups,,,325.19,410.76,6
HCPCS,0246U0,RBC DNA GNOTYP 16 BLD GROUPS,,,622.08,622.08,1
HCPCS,0247U,OB PRTRM BRTH IBP4 SHBG MEAS,,,648.0,1253.25,15
HCPCS,0247U,Ob prtrm brth ibp4 shbg meas,,,5.78,7.3,6
HCPCS,0247U0,OB PRTRM BRTH IBP4 SHBG MEAS,,,648.0,648.0,1
HCPCS,0248U,ONC SPHRD CELL CUL 12 RX PNL,,,2621.26,5069.58,15
HCPCS,0248U,Onc sphrd cell cul 12 rx pnl,,,170.1,214.86,6
HCPCS,0248U0,ONC SPHRD CELL CUL 12 RX PNL,,,2621.26,2621.26,1
HCPCS,0249U,ONC BRST ALYS 32 PHSPRTN ALG,,,1917.32,3708.17,15
HCPCS,0249U,Onc brst alys 32 phsprtn alg,,,170.1,214.86,6
HCPCS,0249U0,ONC BRST ALYS 32 PHSPRTN ALG,,,1917.32,1917.32,1
HCPCS,0250U,ONC SLD ORG NEO DNA 505 GENE,,,2522.53,4878.65,15
HCPCS,0250U,Onc sld org neo dna 505 gene,,,1109.84,1401.9,6
HCPCS,0250U0,ONC SLD ORG NEO DNA 505 GENE,,,2522.53,2522.53,1
HCPCS,0251U,HEPCIDIN-25 ELISA SERUM/PLSM,,,14.93,28.86,15
HCPCS,0251U,Hepcidin-25 elisa serum/plsm,,,5.78,7.3,6
HCPCS,0251U0,HEPCIDIN-25 ELISA SERUM/PLSM,,,14.93,14.93,1
HCPCS,0252U,FTL ANEUPLOIDY STR ALYS DNA,,,655.82,1268.37,15
HCPCS,0252U,Ftl aneuploidy str alys dna,,,170.1,214.86,6
HCPCS,0252U0,FTL ANEUPLOIDY STR ALYS DNA,,,655.82,655.82,1
HCPCS,0253T,INSERT AQUEOUS DRAIN DEVICE,,,1010.17,8722.22,16
HCPCS,0253T,Insert aqueous drain device,,,2069.78,2614.46,6
HCPCS,0253T0,INSERT AQUEOUS DRAIN DEVICE,,,1010.17,1010.17,1
HCPCS,0253TTC,INSERT AQUEOUS DRAIN DEVICE,,,1010.17,1010.17,1
HCPCS,0253U,RPRDTVE MED RNA GEN PRFL 238,,,2729.74,5279.39,15
HCPCS,0253U,Rprdtve med rna gen prfl 238,,,170.1,214.86,6
HCPCS,0253U0,RPRDTVE MED RNA GEN PRFL 238,,,2729.74,2729.74,1
HCPCS,0254U,REPRDTVE MED ALYS 24 CHRMSM,,,655.82,1268.37,15
HCPCS,0254U,Reprdtve med alys 24 chrmsm,,,170.1,214.86,6
HCPCS,0254U0,REPRDTVE MED ALYS 24 CHRMSM,,,655.82,655.82,1
HCPCS,0255U,ANDROLOGY INFERTILITY ASSMT,,,27.3,52.8,15
HCPCS,0255U,Andrology infertility assmt,,,59.1,74.65,6
HCPCS,0255U0,ANDROLOGY INFERTILITY ASSMT,,,27.3,27.3,1
HCPCS,0256U,TMA/TMAO PRFL LCMS/MS UR ALG,,,138.2,267.28,15
HCPCS,0256U,Tma/tmao prfl lcms/ms ur alg,,,22.32,28.19,6
HCPCS,0256U0,TMA/TMAO PRFL LCMS/MS UR ALG,,,138.2,138.2,1
HCPCS,0257U,VLCAD LEUK NZM ACTV WHL BLD,,,615.58,1190.54,15
HCPCS,0257U,Vlcad leuk nzm actv whl bld,,,5.78,7.3,6
HCPCS,0257U0,VLCAD LEUK NZM ACTV WHL BLD,,,615.58,615.58,1
HCPCS,0258U,AI PSOR MRNA 50-100 GEN ALG,,,3175.2,6140.93,15
HCPCS,0258U,Ai psor mrna 50-100 gen alg,,,22.32,28.19,6
HCPCS,0258U0,AI PSOR MRNA 50-100 GEN ALG,,,3175.2,3175.2,1
HCPCS,0259U,NEPH CKD NUC MRS MEAS GFR,,,45.54,88.08,15
HCPCS,0259U,Neph ckd nuc mrs meas gfr,,,13.39,16.91,6
HCPCS,0259U0,NEPH CKD NUC MRS MEAS GFR,,,45.54,45.54,1
HCPCS,0260U,RARE DS ID OPT GENOME MAPG,,,1091.69,2111.36,15
HCPCS,0260U,Rare ds id opt genome mapg,,,22.32,28.19,6
HCPCS,0260U0,RARE DS ID OPT GENOME MAPG,,,1091.69,1091.69,1
HCPCS,0261U,ONC CLRCT CA IMG ALYS W/AI,,,2171.45,4199.64,15
HCPCS,0261U,Onc clrct ca img alys w/ai,,,22.32,28.19,6
HCPCS,0261U0,ONC CLRCT CA IMG ALYS W/AI,,,2171.45,2171.45,1
HCPCS,0262U,ONC SLD TUM RT-PCR 7 GEN,,,2764.8,5347.2,15
HCPCS,0262U,Onc sld tum rt-pcr 7 gen,,,22.32,28.19,6
HCPCS,0262U0,ONC SLD TUM RT-PCR 7 GEN,,,2764.8,2764.8,1
HCPCS,0263T,AUTO BONE MARRW CELL RX COMPLT BONE MARRW HARVST,3196.0,2077.4,119.49,3196.0,13
HCPCS,0263T,IM B1 MRW CEL THER CMPL,,,61.02,10158.22,15
HCPCS,0263T,Im b1 mrw cel ther cmpl,,,2646.54,3343.0,6
HCPCS,0263T0,IM B1 MRW CEL THER CMPL,,,61.02,61.02,1
HCPCS,0263U,NEURO ASD MEAS 16 C METBLT,,,648.0,1253.25,15
HCPCS,0263U,Neuro asd meas 16 c metblt,,,325.19,410.76,6
HCPCS,0263U0,NEURO ASD MEAS 16 C METBLT,,,648.0,648.0,1
HCPCS,0264T,IM B1 MRW CEL THER XCL HRVST,,,170.92,10158.22,15
HCPCS,0264T,Im b1 mrw cel ther xcl hrvst,,,2646.54,3343.0,6
HCPCS,0264T0,IM B1 MRW CEL THER XCL HRVST,,,170.92,170.92,1
HCPCS,0264U,RARE DS ID OPT GENOME MAPG,,,1091.69,2111.36,15
HCPCS,0264U,Rare ds id opt genome mapg,,,22.32,28.19,6
HCPCS,0264U0,RARE DS ID OPT GENOME MAPG,,,1091.69,1091.69,1
HCPCS,0265T,IM B1 MRW CEL THER HRVST ONL,,,289.44,10158.22,15
HCPCS,0265T,Im b1 mrw cel ther hrvst onl,,,2646.54,3343.0,6
HCPCS,0265T0,IM B1 MRW CEL THER HRVST ONL,,,289.44,289.44,1
HCPCS,0265U,RAR DO WHL GN&MTCDRL DNA ALS,,,4731.09,9150.06,15
HCPCS,0265U,Rar do whl gn&mtcdrl dna als,,,22.32,28.19,6
HCPCS,0265U0,RAR DO WHL GN&MTCDRL DNA ALS,,,4731.09,4731.09,1
HCPCS,0266T,IMPLT/RPL CRTD SNS DEV TOTAL,,,45170.6,97568.5,10
HCPCS,0266T,Implt/rpl crtd sns dev total,,,11520.56,14552.29,6
HCPCS,0266U,UNXPL CNST HRTBL DO GN XPRSN,,,2764.8,5347.2,15
HCPCS,0266U,Unxpl cnst hrtbl do gn xprsn,,,22.32,28.19,6
HCPCS,0266U0,UNXPL CNST HRTBL DO GN XPRSN,,,2764.8,2764.8,1
HCPCS,0267T,IMPLT/RPL CRTD SNS DEV LEAD,,,3452.01,7456.34,10
HCPCS,0267T,Implt/rpl crtd sns dev lead,,,1950.92,2464.32,6
HCPCS,0267U,RARE DO ID OPT GEN MAPG&SEQ,,,5822.78,11261.42,15
HCPCS,0267U,Rare do id opt gen mapg&seq,,,22.32,28.19,6
HCPCS,0267U0,RARE DO ID OPT GEN MAPG&SEQ,,,5822.78,5822.78,1
HCPCS,0268T,IMPLT/RPL CRTD SNS DEV GEN,,,30588.78,66071.77,10
HCPCS,0268T,Implt/rpl crtd sns dev gen,,,11520.56,14552.29,6
HCPCS,0268U,HEM AHUS GEN SEQ ALYS 15 GEN,,,525.46,1016.25,15
HCPCS,0268U,Hem ahus gen seq alys 15 gen,,,22.32,28.19,6
HCPCS,0268U0,HEM AHUS GEN SEQ ALYS 15 GEN,,,525.46,525.46,1
HCPCS,0269T,REV/REMVL CRTD SNS DEV TOTAL,,,6428.28,13885.08,10
HCPCS,0269T,Rev/remvl crtd sns dev total,,,1950.92,2464.32,6
HCPCS,0269U,HEM AUT DM CGEN TRMBCTPNA 22,,,525.46,1016.25,15
HCPCS,0269U,Hem aut dm cgen trmbctpna 22,,,22.32,28.19,6
HCPCS,0269U0,HEM AUT DM CGEN TRMBCTPNA 22,,,525.46,525.46,1
HCPCS,0270T,REV/REMVL CRTD SNS DEV LEAD,,,3452.01,7456.34,10
HCPCS,0270T,Rev/remvl crtd sns dev lead,,,1950.92,2464.32,6
HCPCS,0270U,HEM CGEN COAGJ DO 20 GENES,,,525.46,1016.25,15
HCPCS,0270U,Hem cgen coagj do 20 genes,,,22.32,28.19,6
HCPCS,0270U0,HEM CGEN COAGJ DO 20 GENES,,,525.46,525.46,1
HCPCS,0271T,REV/REMVL CRTD SNS DEV GEN,,,3452.01,7456.34,10
HCPCS,0271T,Rev/remvl crtd sns dev gen,,,1950.92,2464.32,6
HCPCS,0271U,HEM CGEN NEUTROPENIA 24 GEN,,,525.46,1016.25,15
HCPCS,0271U,Hem cgen neutropenia 24 gen,,,22.32,28.19,6
HCPCS,0271U0,HEM CGEN NEUTROPENIA 24 GEN,,,525.46,525.46,1
HCPCS,0272T,INTERROGATE CRTD SNS DEV,,,157.05,339.23,10
HCPCS,0272T,Interrogate crtd sns dev,,,21.15,26.71,6
HCPCS,0272U,HEM GENETIC BLD DO 60 GENES,,,525.46,1016.25,15
HCPCS,0272U,Hem genetic bld do 60 genes,,,22.32,28.19,6
HCPCS,0272U0,HEM GENETIC BLD DO 60 GENES,,,525.46,525.46,1
HCPCS,0273T,INTERROGATE CRTD SNS W/PGRMG,,,157.05,339.23,10
HCPCS,0273T,Interrogate crtd sns w/pgrmg,,,21.15,26.71,6
HCPCS,0273U,HEM GEN HYPRFIBRNLYSIS 9 GEN,,,525.46,1016.25,15
HCPCS,0273U,Hem gen hyprfibrnlysis 8 gen,,,22.32,28.19,6
HCPCS,0273U0,HEM GEN HYPRFIBRNLYSIS 9 GEN,,,525.46,525.46,1
HCPCS,0274T,PRQ LAMOT/LAM DCMPR CRV/THRC,,,968.9,15488.78,15
HCPCS,0274T,Prq lamot/lam dcmpr crv/thrc,,,3094.77,3909.18,6
HCPCS,0274T0,PRQ LAMOT/LAM DCMPR CRV/THRC,,,968.9,968.9,1
HCPCS,0274U,HEM GEN PLTLT DO 62 GENES,,,525.46,1016.25,15
HCPCS,0274U,Hem gen pltlt do 62 genes,,,22.32,28.19,6
HCPCS,0274U0,HEM GEN PLTLT DO 62 GENES,,,525.46,525.46,1
HCPCS,0275T,PERQ LAMOT/LAM LUMBAR,,,7170.73,15488.78,10
HCPCS,0275T,Perq lamot/lam lumbar,,,3094.77,3909.18,6
HCPCS,0275U,HEM HEPRN NDUC TRMBCTPNA SRM,,,15.88,30.7,15
HCPCS,0275U,Hem heprn nduc trmbctpna srm,,,2.12,2.68,6
HCPCS,0275U0,HEM HEPRN NDUC TRMBCTPNA SRM,,,15.88,15.88,1
HCPCS,0276U,HEM INH THROMBOCYTOPENIA 42,,,2115.56,4091.54,15
HCPCS,0276U,Hem inh thrombocytopenia 42,,,22.32,28.19,6
HCPCS,0276U0,HEM INH THROMBOCYTOPENIA 42,,,2115.56,2115.56,1
HCPCS,0277U,HEM GEN PLTLT FUNCJ DO 40,,,525.46,1016.25,15
HCPCS,0277U,Hem gen pltlt funcj do 40,,,22.32,28.19,6
HCPCS,0277U0,HEM GEN PLTLT FUNCJ DO 40,,,525.46,525.46,1
HCPCS,0278T,TEMPR,,,17.3,339.23,15
HCPCS,0278T,Tempr,,,82.59,104.33,6
HCPCS,0278T0,TEMPR,,,17.3,17.3,1
HCPCS,0278U,HEM GEN THROMBOSIS 14 GENES,,,525.46,1016.25,15
HCPCS,0278U,Hem gen thrombosis 14 genes,,,22.32,28.19,6
HCPCS,0278U0,HEM GEN THROMBOSIS 14 GENES,,,525.46,525.46,1
HCPCS,0279U,HEM VW FACTOR&CLGN III BNDG,,,9.96,19.27,15
HCPCS,0279U,Hem vw factor&clgn iii bndg,,,2.12,2.68,6
HCPCS,0279U0,HEM VW FACTOR&CLGN III BNDG,,,9.96,9.96,1
HCPCS,0280U,HEM VW FACTOR&CLGN IV BNDG,,,14.93,28.86,15
HCPCS,0280U,Hem vw factor&clgn iv bndg,,,2.12,2.68,6
HCPCS,0280U0,HEM VW FACTOR&CLGN IV BNDG,,,14.93,14.93,1
HCPCS,0281U,HEM VWD PROPEPTIDE AG LVL,,,14.93,28.86,15
HCPCS,0281U,Hem vwd propeptide ag lvl,,,2.12,2.68,6
HCPCS,0281U0,HEM VWD PROPEPTIDE AG LVL,,,14.93,14.93,1
HCPCS,0282U,RBC DNA GNTYP 12 BLD GRP GEN,,,622.08,622.08,1
HCPCS,0282U,RED CELL GENOTYPING,1800.0,1170.0,325.19,1620.0,37
HCPCS,0282U0,RBC DNA GNTYP 12 BLD GRP GEN,,,622.08,622.08,1
HCPCS,0283U,VW FACTOR TYPE 2B EVAL PLSM,,,15.9,30.75,15
HCPCS,0283U,Vw factor type 2b eval plsm,,,2.12,2.68,6
HCPCS,0283U0,VW FACTOR TYPE 2B EVAL PLSM,,,15.9,15.9,1
HCPCS,0284U,VW FACTOR TYPE 2N EVAL PLSM,,,14.93,28.86,15
HCPCS,0284U,Vw factor type 2n eval plsm,,,2.12,2.68,6
HCPCS,0284U0,VW FACTOR TYPE 2N EVAL PLSM,,,14.93,14.93,1
HCPCS,0285U,ONC DS PROG&RSPSE MNTR RADJ,,,383.02,740.77,15
HCPCS,0285U,Onc ds prog&rspse mntr radj,,,22.32,28.19,6
HCPCS,0285U0,ONC DS PROG&RSPSE MNTR RADJ,,,383.02,383.02,1
HCPCS,0286U,CEP72 NUDT15&TPMT GENE ALYS,,,115.88,224.13,15
HCPCS,0286U,Cep72 nudt15&tpmt gene alys,,,76.88,97.12,6
HCPCS,0286U0,CEP72 NUDT15&TPMT GENE ALYS,,,115.88,115.88,1
HCPCS,0287U,ONC THYR DNA&MRNA 112 GENES,,,3110.4,6015.6,15
HCPCS,0287U,Onc thyr dna&mrna 112 genes,,,1109.84,1401.9,6
HCPCS,0287U0,ONC THYR DNA&MRNA 112 GENES,,,3110.4,3110.4,1
HCPCS,0288U,ONC LUNG MRNA QUAN PCR 11&3,,,3346.27,6471.78,15
HCPCS,0288U,Onc lung mrna quan pcr 11&3,,,1109.84,1401.9,6
HCPCS,0288U0,ONC LUNG MRNA QUAN PCR 11&3,,,3346.27,3346.27,1
HCPCS,0289U,NEURO ALZHEIMER MRNA 24 GEN,,,656.64,1269.96,15
HCPCS,0289U,Neuro alzheimer mrna 24 gen,,,325.19,410.76,6
HCPCS,0289U0,NEURO ALZHEIMER MRNA 24 GEN,,,656.64,656.64,1
HCPCS,0290T,Laser inc for pkp/lkp recip,,,2010.76,2539.91,6
HCPCS,0290U,PAIN MGMT MRNA GEN XPRSN 36,,,656.64,1269.96,15
HCPCS,0290U,Pain mgmt mrna gen xprsn 36,,,325.19,410.76,6
HCPCS,0290U0,PAIN MGMT MRNA GEN XPRSN 36,,,656.64,656.64,1
HCPCS,0291U,PSYC MOOD DO MRNA 144 GENES,,,1516.32,2932.61,15
HCPCS,0291U,Psyc mood do mrna 144 genes,,,1109.84,1401.9,6
HCPCS,0291U0,PSYC MOOD DO MRNA 144 GENES,,,1516.32,1516.32,1
HCPCS,0292U,PSYC STRS DO MRNA 72 GENES,,,1516.32,2932.61,15
HCPCS,0292U,Psyc strs do mrna 72 genes,,,1109.84,1401.9,6
HCPCS,0292U0,PSYC STRS DO MRNA 72 GENES,,,1516.32,1516.32,1
HCPCS,0293U,PSYC SUICIDAL IDEA MRNA 54,,,656.64,1269.96,15
HCPCS,0293U,Psyc suicidal idea mrna 54,,,325.19,410.76,6
HCPCS,0293U0,PSYC SUICIDAL IDEA MRNA 54,,,656.64,656.64,1
HCPCS,0294U,LNGVTY&MRTLTY RSK MRNA 18GEN,,,656.64,1269.96,4
HCPCS,0294U,Lngvty&mrtlty rsk mrna 18gen,,,325.19,410.76,6
HCPCS,0294U0,LNGVTY&MRTLTY RSK MRNA 18GEN,,,656.64,656.64,1
HCPCS,0295T,Ext ecg complete,,,33.85,42.76,6
HCPCS,0295U,ONC BRST DUX CARC 7 PROTEINS,,,4695.84,9081.89,15
HCPCS,0295U,Onc brst dux carc 7 proteins,,,1109.84,1401.9,6
HCPCS,0295U0,ONC BRST DUX CARC 7 PROTEINS,,,4695.84,4695.84,1
HCPCS,0296T,Ext ecg recording,,,33.85,42.76,6
HCPCS,0296U,ONC ORL&/OROP CA 20 MLC FEAT,,,1684.8,3258.45,15
HCPCS,0296U,Onc orl&/orop ca 20 mlc feat,,,1109.84,1401.9,6
HCPCS,0296U0,ONC ORL&/OROP CA 20 MLC FEAT,,,1684.8,1684.8,1
HCPCS,0297T,Ext ecg scan w/report,,,33.85,42.76,6
HCPCS,0297U,ONC PAN TUM WHL GEN SEQ DNA,,,2522.53,4878.65,15
HCPCS,0297U,Onc pan tum whl gen seq dna,,,1109.84,1401.9,6
HCPCS,0297U0,ONC PAN TUM WHL GEN SEQ DNA,,,2522.53,2522.53,1
HCPCS,0298T,Ext ecg review and interp,,,33.85,42.76,6
HCPCS,0298U,ONC PAN TUM WHL TRNS SEQ RNA,,,2522.53,4878.65,15
HCPCS,0298U,Onc pan tum whl trns seq rna,,,1109.84,1401.9,6
HCPCS,0298U0,ONC PAN TUM WHL TRNS SEQ RNA,,,2522.53,2522.53,1
HCPCS,0299U,ONC PAN TUM WHL GEN OPT MAPG,,,1609.83,3113.44,15
HCPCS,0299U,Onc pan tum whl gen opt mapg,,,22.32,28.19,6
HCPCS,0299U0,ONC PAN TUM WHL GEN OPT MAPG,,,1609.83,1609.83,1
HCPCS,0300U,ONC PAN TUM WHL GEN SEQ&OPT,,,3614.22,6990.01,15
HCPCS,0300U,Onc pan tum whl gen seq&opt,,,22.32,28.19,6
HCPCS,0300U0,ONC PAN TUM WHL GEN SEQ&OPT,,,3614.22,3614.22,1
HCPCS,0301U,IADNA BARTONELLA DDPCR,,,226.99,439.01,15
HCPCS,0301U,Iadna bartonella ddpcr,,,25.65,32.4,6
HCPCS,0301U0,IADNA BARTONELLA DDPCR,,,226.99,226.99,1
HCPCS,0302U,IADNA BRTNLA DDPCR FLWG LIQ,,,312.23,603.85,15
HCPCS,0302U,Iadna brtnla ddpcr flwg liq,,,25.65,32.4,6
HCPCS,0302U0,IADNA BRTNLA DDPCR FLWG LIQ,,,312.23,312.23,1
HCPCS,0303U,HEM RBC ADS WHL BLD HYPOXIC,,,1902.2,3678.91,15
HCPCS,0303U,Hem rbc ads whl bld hypoxic,,,2.81,3.55,6
HCPCS,0303U0,HEM RBC ADS WHL BLD HYPOXIC,,,1902.2,1902.2,1
HCPCS,0304U,HEM RBC ADS WHL BLD NORMOXIC,,,1793.49,3468.66,15
HCPCS,0304U,Hem rbc ads whl bld normoxic,,,2.81,3.55,6
HCPCS,0304U0,HEM RBC ADS WHL BLD NORMOXIC,,,1793.49,1793.49,1
HCPCS,0305U,HEM RBC FNCLTY&DFRM SHR STRS,,,572.46,1107.17,15
HCPCS,0305U,Hem rbc fnclty&dfrm shr strs,,,2.81,3.55,6
HCPCS,0305U0,HEM RBC FNCLTY&DFRM SHR STRS,,,572.46,572.46,1
HCPCS,0306U,ONC MRD NXT-GNRJ ALYS 1ST,,,3350.98,6480.89,15
HCPCS,0306U,Onc mrd nxt-gnrj alys 1st,,,22.32,28.19,6
HCPCS,0306U0,ONC MRD NXT-GNRJ ALYS 1ST,,,3350.98,3350.98,1
HCPCS,0307U,ONC MRD NXT-GNRJ ALYS SBSQ,,,686.44,1327.59,15
HCPCS,0307U,Onc mrd nxt-gnrj alys sbsq,,,22.32,28.19,6
HCPCS,0307U0,ONC MRD NXT-GNRJ ALYS SBSQ,,,686.44,686.44,1
HCPCS,0308T,INSJ OCULAR TELESCOPE PROSTH,,,1538.11,35593.55,15
HCPCS,0308T,Insj ocular telescope prosth,,,2069.78,2614.46,6
HCPCS,0308T0,INSJ OCULAR TELESCOPE PROSTH,,,1538.11,1538.11,1
HCPCS,0308U,CRD CAD ALYS 3 PRTN 3 PARAM,,,337.61,652.94,15
HCPCS,0308U,Crd cad alys 3 prtn 3 param,,,22.32,28.19,6
HCPCS,0308U0,CRD CAD ALYS 3 PRTN 3 PARAM,,,337.61,337.61,1
HCPCS,0309U,CRD CV DS ALY 4 PRTN PLM ALG,,,337.61,652.94,15
HCPCS,0309U,Crd cv ds aly 4 prtn plm alg,,,22.32,28.19,6
HCPCS,0309U0,CRD CV DS ALY 4 PRTN PLM ALG,,,337.61,337.61,1
HCPCS,0310U,PED VSCLTS KD ALYS 3 BMRKS,,,337.61,652.94,15
HCPCS,0310U,Ped vsclts kd alys 3 bmrks,,,22.32,28.19,6
HCPCS,0310U0,PED VSCLTS KD ALYS 3 BMRKS,,,337.61,337.61,1
HCPCS,0311U,NFCT DS BCT QUAN ANTMCRB SC,,,6.98,13.5,15
HCPCS,0311U,Nfct ds bct quan antmcrb sc,,,4.02,5.08,6
HCPCS,0311U0,NFCT DS BCT QUAN ANTMCRB SC,,,6.98,6.98,1
HCPCS,0312T,Laps impltj nstim vagus,,,11520.56,14552.29,6
HCPCS,0312U,AI DS SLE ALYS 8 IGG AUTOANT,,,726.32,1404.73,15
HCPCS,0312U,Ai ds sle alys 8 igg autoant,,,325.19,410.76,6
HCPCS,0312U0,AI DS SLE ALYS 8 IGG AUTOANT,,,726.32,726.32,1
HCPCS,0313T,Laps rmvl nstim array vagus,,,1950.92,2464.32,6
HCPCS,0313U,ONC PNCRS DNA&MRNA SEQ 74,,,3110.4,6015.6,15
HCPCS,0313U,Onc pncrs dna&mrna seq 74,,,1109.84,1401.9,6
HCPCS,0313U0,ONC PNCRS DNA&MRNA SEQ 74,,,3110.4,3110.4,1
HCPCS,0314T,Laps rmvl vgl arry&pls gen,,,1950.92,2464.32,6
HCPCS,0314U,ONC CUTAN MLNMA MRNA 35 GENE,,,1684.8,3258.45,15
HCPCS,0314U,Onc cutan mlnma mrna 35 gene,,,1109.84,1401.9,6
HCPCS,0314U0,ONC CUTAN MLNMA MRNA 35 GENE,,,1684.8,1684.8,1
HCPCS,0315T,Rmvl vagus nerve pls gen,,,1950.92,2464.32,6
HCPCS,0315U,ONC CUTAN SQ CLL CA MRNA 40,,,7344.0,14203.5,15
HCPCS,0315U,Onc cutan sq cll ca mrna 40,,,1109.84,1401.9,6
HCPCS,0315U0,ONC CUTAN SQ CLL CA MRNA 40,,,7344.0,7344.0,1
HCPCS,0316T,Replc vagus nerve pls gen,,,11520.56,14552.29,6
HCPCS,0316U,B BRGDRFERI LYME DS OSPA EVL,,,16.12,31.18,15
HCPCS,0316U,B brgdrferi lyme ds ospa evl,,,4.02,5.08,6
HCPCS,0316U0,B BRGDRFERI LYME DS OSPA EVL,,,16.12,16.12,1
HCPCS,0317T,Elec alys vagus nrv pls gen,,,21.15,26.71,6
HCPCS,0317U,ONC LUNG CA 4-PRB FISH ASSAY,,,1753.92,3392.13,15
HCPCS,0317U,Onc lung ca 4-prb fish assay,,,1109.84,1401.9,6
HCPCS,0317U0,ONC LUNG CA 4-PRB FISH ASSAY,,,1753.92,1753.92,1
HCPCS,0318U,PED WHL GEN MTHYLTN ALYS 50+,,,1529.69,2958.47,15
HCPCS,0318U,Ped whl gen mthyltn alys 50+,,,22.32,28.19,6
HCPCS,0318U0,PED WHL GEN MTHYLTN ALYS 50+,,,1529.69,1529.69,1
HCPCS,0319U,NEPH RNA PRETRNSPL PERPH BLD,,,2289.6,4428.15,15
HCPCS,0319U,Neph rna pretrnspl perph bld,,,22.32,28.19,6
HCPCS,0319U0,NEPH RNA PRETRNSPL PERPH BLD,,,2289.6,2289.6,1
HCPCS,0320U,NEPH RNA PSTTRNSPL PERPH BLD,,,2289.6,4428.15,15
HCPCS,0320U,Neph rna psttrnspl perph bld,,,22.32,28.19,6
HCPCS,0320U0,NEPH RNA PSTTRNSPL PERPH BLD,,,2289.6,2289.6,1
HCPCS,0321U,IADNA GU PTHGN 20BCT&FNG ORG,,,548.5,1060.82,15
HCPCS,0321U,Iadna gu pthgn 20bct&fng org,,,170.1,214.86,6
HCPCS,0321U0,IADNA GU PTHGN 20BCT&FNG ORG,,,548.5,548.5,1
HCPCS,0322U,NEURO ASD MEAS 14 ACYL CARN,,,648.0,1253.25,15
HCPCS,0322U,Neuro asd meas 14 acyl carn,,,325.19,410.76,6
HCPCS,0322U0,NEURO ASD MEAS 14 ACYL CARN,,,648.0,648.0,1
HCPCS,0323U,IADNA CNS PTHGN NEXT GEN SEQ,,,1837.04,3552.88,15
HCPCS,0323U,Iadna cns pthgn next gen seq,,,1109.84,1401.9,6
HCPCS,0323U0,IADNA CNS PTHGN NEXT GEN SEQ,,,1837.04,1837.04,1
HCPCS,0324U,Onc ovar sphrd cell 4 rx pnl,,,1109.84,1401.9,6
HCPCS,0325U,Onc ovar sphrd cell parp,,,1109.84,1401.9,6
HCPCS,0326U,TRGT GEN SEQ ALYS PNL 83+,,,4320.0,8355.0,15
HCPCS,0326U,Trgt gen seq alys pnl 83+,,,22.32,28.19,6
HCPCS,0326U0,TRGT GEN SEQ ALYS PNL 83+,,,4320.0,4320.0,1
HCPCS,0327U,FTL ANEUPLOIDY TRSMY DNA SEQ,,,686.88,1328.45,15
HCPCS,0327U,Ftl aneuploidy trsmy dna seq,,,325.19,410.76,6
HCPCS,0327U0,FTL ANEUPLOIDY TRSMY DNA SEQ,,,686.88,686.88,1
HCPCS,0328U,DRUG ASSAY 120+ RX&METABLT,,,98.86,191.21,15
HCPCS,0328U,Drug assay 120+ rx&metablt,,,33.04,41.74,6
HCPCS,0328U0,DRUG ASSAY 120+ RX&METABLT,,,98.86,98.86,1
HCPCS,0329T,MNTR IO PRESS 24HRS/> UNI/BI,,,416.01,416.01,1
HCPCS,0329T,Mntr io press 24hrs/> uni/bi,,,45.31,57.23,6
HCPCS,0329T0,MNTR IO PRESS 24HRS/> UNI/BI,,,416.01,416.01,1
HCPCS,0329U,ONC NEO XOME&TRNS SEQ ALYS,,,2970.41,5744.86,15
HCPCS,0329U,Onc neo xome&trns seq alys,,,22.32,28.19,6
HCPCS,0329U0,ONC NEO XOME&TRNS SEQ ALYS,,,2970.41,2970.41,1
HCPCS,0330T,TEAR FILM IMG UNI/BI W/I&R,,,37.83,85.1,15
HCPCS,0330T0,TEAR FILM IMG UNI/BI W/I&R,,,37.83,37.83,1
HCPCS,0330U,IADNA VAG PTHGN PANEL 27 ORG,,,360.09,696.44,15
HCPCS,0330U,Iadna vag pthgn panel 27 org,,,25.65,32.4,6
HCPCS,0330U0,IADNA VAG PTHGN PANEL 27 ORG,,,360.09,360.09,1
HCPCS,0331T,HEART SYMP IMAGE PLNR,,,174.34,174.34,1
HCPCS,0331T,MYOCRD SYMPATHETIC INNERVAJ IMG PLNR QUAL&QUANT,6528.0,4243.2,533.79,5875.2,45
HCPCS,0331T0,HEART SYMP IMAGE PLNR,,,174.34,174.34,1
HCPCS,0331U,ONC HL NEO OPT GEN MAPPING,,,1609.83,3113.44,15
HCPCS,0331U,Onc hl neo opt gen mapping,,,22.32,28.19,6
HCPCS,0331U0,ONC HL NEO OPT GEN MAPPING,,,1609.83,1609.83,1
HCPCS,0332T,HEART SYMP IMAGE PLNR SPECT,,,300.51,300.51,1
HCPCS,0332T,MYOCRD SYMP INNERVAJ IMG PLNR QUAL&QUANT W/SPECT,6528.0,4243.2,533.79,5875.2,45
HCPCS,0332T0,HEART SYMP IMAGE PLNR SPECT,,,300.51,300.51,1
HCPCS,0332U,ONC PAN TUM GEN PRFLG 8 DNA,,,986.74,1908.38,15
HCPCS,0332U,Onc pan tum gen prflg 8 dna,,,22.32,28.19,6
HCPCS,0332U0,ONC PAN TUM GEN PRFLG 8 DNA,,,986.74,986.74,1
HCPCS,0333T,VISUAL EP SCR ACUITY AUTO,,,67.79,67.79,1
HCPCS,0333T,Visual ep scr acuity auto,,,82.59,104.33,6
HCPCS,0333T0,VISUAL EP SCR ACUITY AUTO,,,67.79,67.79,1
HCPCS,0333U,ONC LVR SURVEILANC HCC CFDNA,,,572.25,1106.74,15
HCPCS,0333U,Onc lvr surveilanc hcc cfdna,,,22.32,28.19,6
HCPCS,0333U0,ONC LVR SURVEILANC HCC CFDNA,,,572.25,572.25,1
HCPCS,0334U,ONC SLD ORGN TGSA DNA 84/+,,,3024.0,5848.5,15
HCPCS,0334U,Onc sld orgn tgsa dna 84/+,,,1109.84,1401.9,6
HCPCS,0334U0,ONC SLD ORGN TGSA DNA 84/+,,,3024.0,3024.0,1
HCPCS,0335T,INSJ SINUS TARSI IMPLANT,,,563.65,15488.78,15
HCPCS,0335T,Insj sinus tarsi implant,,,1342.37,1695.62,6
HCPCS,0335T0,INSJ SINUS TARSI IMPLANT,,,563.65,563.65,1
HCPCS,0335U,RARE DS WHL GEN SEQ FETAL,,,4514.05,8730.31,15
HCPCS,0335U,Rare ds whl gen seq feta,,,1109.84,1401.9,6
HCPCS,0335U0,RARE DS WHL GEN SEQ FETAL,,,4514.05,4514.05,1
HCPCS,0336U,RARE DS WHL GEN SEQ BLD/SLV,,,2224.5,4302.24,15
HCPCS,0336U,Rare ds whl gen seq bld/slv,,,1109.84,1401.9,6
HCPCS,0336U0,RARE DS WHL GEN SEQ BLD/SLV,,,2224.5,2224.5,1
HCPCS,0337U,ONC PLSM CELL DO&MYELOMA ID,,,2103.84,4068.89,15
HCPCS,0337U,Onc plsm cell do&myeloma id,,,22.32,28.19,6
HCPCS,0337U0,ONC PLSM CELL DO&MYELOMA ID,,,2103.84,2103.84,1
HCPCS,0338T,TRANSCATHETER RENAL SYMPATH DENERVATION UNILAT,28508.0,18530.2,1190.0,25657.2,48
HCPCS,0338T,TRNSCTH RENAL SYMP DENRV UNL,,,1122.82,1122.82,1
HCPCS,0338T0,TRNSCTH RENAL SYMP DENRV UNL,,,1122.82,1122.82,1
HCPCS,0338U,ONC SLD TUM CRCG TUM CL SLCT,,,2103.84,4068.89,15
HCPCS,0338U,Onc sld tum crcg tum cl slct,,,22.32,28.19,6
HCPCS,0338U0,ONC SLD TUM CRCG TUM CL SLCT,,,2103.84,2103.84,1
HCPCS,0339T,TRANSCATH RENAL SYMP DENERV BILAT,8704.0,5657.6,3310.85,8704.0,13
HCPCS,0339T,TRANSCATHETER RENAL SYMPATH DENERVATION BILAT,16224.0,10545.6,1190.0,14601.6,48
HCPCS,0339T,TRNSCTH RENAL SYMP DENRV BIL,,,1359.26,1359.26,1
HCPCS,0339T0,TRNSCTH RENAL SYMP DENRV BIL,,,1359.26,1359.26,1
HCPCS,0339U,ONC PRST8 MRNA HOXC6 & DLX1,,,656.64,1269.96,15
HCPCS,0339U,Onc prst8 mrna hoxc6 & dlx1,,,325.19,410.76,6
HCPCS,0339U0,ONC PRST8 MRNA HOXC6 & DLX1,,,656.64,656.64,1
HCPCS,0340T,ABLATE PULM TUMORS W/PLEURA/CHEST WALL EXTSN,6528.0,4243.2,1096.7,5875.2,21
HCPCS,0340U,ONC PAN CA ALYS MRD PLASMA,,,3101.76,6550.32,15
HCPCS,0340U,Onc pan ca alys mrd plasma,,,22.32,28.19,6
HCPCS,0340U0,ONC PAN CA ALYS MRD PLASMA,,,3101.76,3101.76,1
HCPCS,0341U,FTL ANEUP DNA SEQ CMPR ALYS,,,1641.77,3175.23,15
HCPCS,0341U,Ftl aneup dna seq cmpr alys,,,22.32,28.19,6
HCPCS,0341U0,FTL ANEUP DNA SEQ CMPR ALYS,,,1641.77,1641.77,1
HCPCS,0342T,THXP APHERESIS W/HDL DELIP,,,262.06,10158.22,15
HCPCS,0342T,Thxp apheresis w/hdl delip,,,2646.54,3343.0,6
HCPCS,0342T0,THXP APHERESIS W/HDL DELIP,,,262.06,262.06,1
HCPCS,0342U,ONC PNCRTC CA MULT IA ECLIA,,,775.01,1498.89,4
HCPCS,0342U,Onc pncrtc ca mult ia eclia,,,325.19,410.76,6
HCPCS,0342U0,ONC PNCRTC CA MULT IA ECLIA,,,775.01,775.01,1
HCPCS,0343U,ONC PRST8 XOM ALY 442 SNCRNA,,,656.64,1269.96,15
HCPCS,0343U,Onc prst8 xom aly 442 sncrna,,,325.19,410.76,6
HCPCS,0343U0,ONC PRST8 XOM ALY 442 SNCRNA,,,656.64,656.64,1
HCPCS,0344U,HEP NAFLD SEMIQ EVL 28 LIPID,,,684.44,1323.72,15
HCPCS,0344U,Hep nafld semiq evl 28 lipid,,,22.32,28.19,6
HCPCS,0344U0,HEP NAFLD SEMIQ EVL 28 LIPID,,,684.44,684.44,1
HCPCS,0345T,TRANSCATH MTRAL VLVE REPAIR,,,1922.55,1922.55,1
HCPCS,0345T,Transcath mtral vlve repair,,,8538.66,10785.67,6
HCPCS,0345T0,TRANSCATH MTRAL VLVE REPAIR,,,1922.55,1922.55,1
HCPCS,0345U,PSYC GENOM ALYS PNL 15 GEN,,,1154.38,2232.61,15
HCPCS,0345U,Psyc genom alys pnl 15 gen,,,1109.84,1401.9,6
HCPCS,0345U0,PSYC GENOM ALYS PNL 15 GEN,,,1154.38,1154.38,1
HCPCS,0346U,Beta amyl ab40&ab42 lc-ms/ms,,,5.78,7.3,6
HCPCS,0347T,INS BONE DEVICE FOR RSA,,,59.62,147.68,15
HCPCS,0347T,Ins bone device for rsa,,,114.29,144.36,6
HCPCS,0347T0,INS BONE DEVICE FOR RSA,,,147.68,147.68,1
HCPCS,0347U,RX METAB/PCX DNA 16 GEN ALYS,,,1154.38,2232.61,15
HCPCS,0347U,Rx metab/pcx dna 16 gen alys,,,1109.84,1401.9,6
HCPCS,0347U0,RX METAB/PCX DNA 16 GEN ALYS,,,1154.38,1154.38,1
HCPCS,0348T,RSA SPINE EXAM,,,31.81,252.18,18
HCPCS,0348T,Rsa spine exam,,,33.81,42.71,6
HCPCS,0348T0,RSA SPINE EXAM,,,31.81,31.81,1
HCPCS,0348U,RX METAB/PCX DNA 25 GEN ALYS,,,641.33,1240.33,15
HCPCS,0348U,Rx metab/pcx dna 25 gen alys,,,325.19,410.76,6
HCPCS,0348U0,RX METAB/PCX DNA 25 GEN ALYS,,,641.33,641.33,1
HCPCS,0349T,RSA UPPER EXTR EXAM,,,33.48,252.18,18
HCPCS,0349T,Rsa upper extr exam,,,33.81,42.71,6
HCPCS,0349T0,RSA UPPER EXTR EXAM,,,33.48,33.48,1
HCPCS,0349U,RX METAB/PCX DNA 27GEN RX IA,,,641.33,1240.33,15
HCPCS,0349U,Rx metab/pcx dna 27gen rx ia,,,325.19,410.76,6
HCPCS,0349U0,RX METAB/PCX DNA 27GEN RX IA,,,641.33,641.33,1
HCPCS,0350T,RSA LOWER EXTR EXAM,,,34.5,190.91,18
HCPCS,0350T,Rsa lower extr exam,,,33.81,42.71,6
HCPCS,0350T0,RSA LOWER EXTR EXAM,,,34.5,34.5,1
HCPCS,0350U,RX METAB/PCX DNA 27 GEN ALYS,,,1154.38,2232.61,15
HCPCS,0350U,Rx metab/pcx dna 27 gen alys,,,1109.84,1401.9,6
HCPCS,0350U0,RX METAB/PCX DNA 27 GEN ALYS,,,1154.38,1154.38,1
HCPCS,0351T,INTRAOP OCT BRST/NODE SPEC,,,167.34,167.34,1
HCPCS,0351T0,INTRAOP OCT BRST/NODE SPEC,,,167.34,167.34,1
HCPCS,0351U,NFCT DS BCT/VIRAL TRAIL IP10,,,225.07,435.3,15
HCPCS,0351U,Nfct ds bct/viral trail ip10,,,22.32,28.19,6
HCPCS,0351U0,NFCT DS BCT/VIRAL TRAIL IP10,,,225.07,225.07,1
HCPCS,0352T,OCT BRST/NODE I&R PER SPEC,,,42.84,2185.7,4
HCPCS,0352T0,OCT BRST/NODE I&R PER SPEC,,,42.84,42.84,1
HCPCS,0352U,Nfct ds bv&vaginitis amp prb,,,25.65,32.4,6
HCPCS,0353T,INTRAOP OCT BREAST CAVITY,,,103.4,103.4,1
HCPCS,0353T0,INTRAOP OCT BREAST CAVITY,,,103.4,103.4,1
HCPCS,0353U,Iadna chlmyd&gonorr amp prb,,,4.02,5.08,6
HCPCS,0354T,OCT BREAST SURG CAVITY I&R,,,42.84,2185.7,4
HCPCS,0354T0,OCT BREAST SURG CAVITY I&R,,,42.84,42.84,1
HCPCS,0354U,Hpv hi rsk qual mrna e6/e7,,,25.65,32.4,6
HCPCS,0355T,Gi tract capsule endoscopy,,,181.25,228.95,6
HCPCS,0355U,APOL1 RISK VARIANTS,,,118.37,228.93,15
HCPCS,0355U,Apol1 risk variants,,,22.32,28.19,6
HCPCS,0355U0,APOL1 RISK VARIANTS,,,118.37,118.37,1
HCPCS,0356T,Insrt drug device for iop,,,45.31,57.23,6
HCPCS,0356U,ONC OROP/ANAL 17 DNA DDPCR,,,1555.2,3007.8,15
HCPCS,0356U,Onc orop/anal 17 dna ddpcr,,,22.32,28.19,6
HCPCS,0356U0,ONC OROP/ANAL 17 DNA DDPCR,,,1555.2,1555.2,1
HCPCS,0357U,Onc mlnma ai quan alys 142,,,76.88,97.12,6
HCPCS,0358T,BIA WHOLE BODY,,,24.58,53.1,15
HCPCS,0358T,BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R,67.0,43.55,33.5,67.0,13
HCPCS,0358T,Bia whole body,,,33.85,42.76,6
HCPCS,0358T0,BIA WHOLE BODY,,,27.46,27.46,1
HCPCS,0358U,NEURO ALYS ß-AMYL 1-42&1-40,,,225.07,435.3,15
HCPCS,0358U,Neuro alys b-amyl 1-42&1-40,,,76.88,97.12,6
HCPCS,0358U0,NEURO ALYS ß-AMYL 1-42&1-40,,,225.07,225.07,1
HCPCS,0359U,ONC PRST8 CA ALYS ALL PSA,,,656.64,1269.96,15
HCPCS,0359U,Onc prst8 ca alys all psa,,,5.78,7.3,6
HCPCS,0359U0,ONC PRST8 CA ALYS ALL PSA,,,656.64,656.64,1
HCPCS,0360U,ONC LUNG ELISA 7 AUTOANT ALG,,,726.32,1308.28,15
HCPCS,0360U,Onc lung elisa 7 autoant alg,,,22.32,28.19,6
HCPCS,0360U0,ONC LUNG ELISA 7 AUTOANT ALG,,,726.32,726.32,1
HCPCS,0361U,NEURFLMNT LT CHN DIG IA QUAN,,,100.42,194.22,11
HCPCS,0361U,Neurflmnt lt chn dig ia quan,,,4.02,5.08,6
HCPCS,0361U0,NEURFLMNT LT CHN DIG IA QUAN,,,100.42,100.42,1
HCPCS,0362T,BHV ID SUPRT ASSMT EA 15 MIN,,,29.9,105.76,15
HCPCS,0362T,Bhv id suprt assmt ea 15 min,,,149.38,188.69,6
HCPCS,0362T0,BHV ID SUPRT ASSMT EA 15 MIN,,,105.76,105.76,1
HCPCS,0362U,ONC PAP THYR CA RNA 82&10,,,3110.4,6015.6,15
HCPCS,0362U,Onc pap thyr ca rna 82&10,,,22.32,28.19,6
HCPCS,0362U0,ONC PAP THYR CA RNA 82&10,,,3110.4,3110.4,1
HCPCS,0363U,ONC URTHL MRNA 5 GEN ALG,,,656.64,1269.96,15
HCPCS,0363U,Onc urthl mrna 5 gen alg,,,22.32,28.19,6
HCPCS,0363U0,ONC URTHL MRNA 5 GEN ALG,,,656.64,656.64,1
HCPCS,0364U,ONC HL NEO GEN SEQ ALYS ALG,,,1734.26,3354.11,15
HCPCS,0364U,Onc hl neo gen seq alys alg,,,22.32,28.19,6
HCPCS,0364U0,ONC HL NEO GEN SEQ ALYS ALG,,,1734.26,1734.26,1
HCPCS,0365U,ONC BLDR 10 UR HRBR URTHL CA,,,775.01,1498.89,15
HCPCS,0365U,Onc bldr 10 ur hrbr urthl ca,,,22.32,28.19,6
HCPCS,0365U0,ONC BLDR 10 UR HRBR URTHL CA,,,775.01,775.01,1
HCPCS,0366U,ONC BLDR 10 PRB RECR BLDR CA,,,775.01,1498.89,15
HCPCS,0366U,Onc bldr 10 prb recr bldr ca,,,22.32,28.19,6
HCPCS,0366U0,ONC BLDR 10 PRB RECR BLDR CA,,,775.01,775.01,1
HCPCS,0367U,ONC BLDR 10 FLWG TRURL RESCJ,,,779.48,1507.54,15
HCPCS,0367U,Onc bldr 10 flwg trurl rescj,,,22.32,28.19,6
HCPCS,0367U0,ONC BLDR 10 FLWG TRURL RESCJ,,,779.48,779.48,1
HCPCS,0368U,ONC CLRCT CA MUT&MTHYLTN MRK,,,360.09,696.44,4
HCPCS,0368U,Onc clrct ca mut&mthyltn mrk,,,22.32,28.19,6
HCPCS,0368U0,ONC CLRCT CA MUT&MTHYLTN MRK,,,360.09,360.09,1
HCPCS,0369U,IADNA GI PTHGN 31 ORG&21 ARG,,,416.78,696.44,10
HCPCS,0369U,Iadna gi pthgn 31 org&21 arg,,,92.55,116.9,6
HCPCS,0370U,IADNA SURG WND PTHGN 34&21,,,416.78,696.44,10
HCPCS,0370U,Iadna surg wnd pthgn 34&21,,,92.55,116.9,6
HCPCS,0371U,IADNA GU PTHGN SEMIQ DNA16&1,,,360.09,696.44,15
HCPCS,0371U,Iadna gu pthgn semiq dna16&1,,,92.55,116.9,6
HCPCS,0371U0,IADNA GU PTHGN SEMIQ DNA16&1,,,360.09,360.09,1
HCPCS,0372U,NFCT DS GU PTHGN ARG DETCJ,,,360.09,696.44,15
HCPCS,0372U,Nfct ds gu pthgn arg detcj,,,25.65,32.4,6
HCPCS,0372U0,NFCT DS GU PTHGN ARG DETCJ,,,360.09,360.09,1
HCPCS,0373T,ADAPT BHV TX EA 15 MIN,,,5.44,64.59,15
HCPCS,0373T,Adapt bhv tx ea 15 min,,,149.38,188.69,6
HCPCS,0373T0,ADAPT BHV TX EA 15 MIN,,,5.44,5.44,1
HCPCS,0373U,IADNA RSP TR NFCT 17 8 13&16,,,416.78,696.44,10
HCPCS,0373U,Iadna rsp tr nfct 17 8 13&16,,,25.65,32.4,6
HCPCS,0374U,IADNA GU PTHGN 21 ORG&21ARG,,,416.78,696.44,10
HCPCS,0374U,Iadna gu pthgn 21 org&21arg,,,92.55,116.9,6
HCPCS,0375U,ONC OVRN BCHM ASY 7 PRTN ALG,,,775.01,1498.89,15
HCPCS,0375U,Onc ovrn bchm asy 7 prtn alg,,,22.32,28.19,6
HCPCS,0375U0,ONC OVRN BCHM ASY 7 PRTN ALG,,,775.01,775.01,1
HCPCS,0376T,Insert ant segment drain int,,,2069.78,2614.46,6
HCPCS,0376U,ONC PRST8 CA IMG ALYS 128,,,610.2,1180.14,15
HCPCS,0376U,Onc prst8 ca img alys 128,,,22.32,28.19,6
HCPCS,0376U0,ONC PRST8 CA IMG ALYS 128,,,610.2,610.2,1
HCPCS,0377U,CV DS QUAN ADVSRM/PLSM LPRTN,,,41.1,79.51,15
HCPCS,0377U,Cv ds quan advsrm/plsm lprtn,,,22.32,28.19,6
HCPCS,0377U0,CV DS QUAN ADVSRM/PLSM LPRTN,,,41.1,41.1,1
HCPCS,0378T,VISUAL FIELD ASSMNT REV/RPRT,,,30.18,30.18,1
HCPCS,0378T,Visual field assmnt rev/rprt,,,23.85,30.13,6
HCPCS,0378T0,VISUAL FIELD ASSMNT REV/RPRT,,,30.18,30.18,1
HCPCS,0378U,RFC1 REPEAT XPNSJ VRNT ALYS,,,118.37,228.93,15
HCPCS,0378U,Rfc1 repeat xpnsj vrnt alys,,,22.32,28.19,6
HCPCS,0378U0,RFC1 REPEAT XPNSJ VRNT ALYS,,,118.37,118.37,1
HCPCS,0379T,VIS FIELD ASSMNT TECH SUPPT,,,39.0,545.86,15
HCPCS,0379T,Vis field assmnt tech suppt,,,23.85,30.13,6
HCPCS,0379T0,VIS FIELD ASSMNT TECH SUPPT,,,545.86,545.86,1
HCPCS,0379U,TGSAP SL OR NEO DNA523&RNA55,,,2841.27,5495.1,15
HCPCS,0379U,Tgsap sl or neo dna523&rna55,,,22.32,28.19,6
HCPCS,0379U0,TGSAP SL OR NEO DNA523&RNA55,,,2841.27,2841.27,1
HCPCS,0380U,Rx metb advrs trgt sq aly 20,,,22.32,28.19,6
HCPCS,0381T,Ext h rate epi sz 14 days,,,33.85,42.76,6
HCPCS,0381U,MAPLE SYRUP UR DS MNTR QUAN,,,38.12,73.72,15
HCPCS,0381U,Maple syrup ur ds mntr quan,,,22.32,28.19,6
HCPCS,0381U0,MAPLE SYRUP UR DS MNTR QUAN,,,38.12,38.12,1
HCPCS,0382T,Ext h rate sz 14 day ri only,,,33.85,42.76,6
HCPCS,0382U,HYPRPHENYLALNINMIA MNTR QUAN,,,44.61,86.29,15
HCPCS,0382U,Hyprphenylalninmia mntr quan,,,22.32,28.19,6
HCPCS,0382U0,HYPRPHENYLALNINMIA MNTR QUAN,,,44.61,44.61,1
HCPCS,0383T,Ext h rate sz up to 30 days,,,23.85,30.13,6
HCPCS,0383U,TYROSINEMIA TYP I MNTR QUAN,,,44.97,86.98,15
HCPCS,0383U,Tyrosinemia typ i mntr quan,,,22.32,28.19,6
HCPCS,0383U0,TYROSINEMIA TYP I MNTR QUAN,,,44.97,44.97,1
HCPCS,0384T,Ex h rate sz 30 day ri only,,,23.85,30.13,6
HCPCS,0384U,NEPH CKD RSK HI STG KDN DS,,,648.0,1253.25,15
HCPCS,0384U,Neph ckd rsk hi stg kdn ds,,,22.32,28.19,6
HCPCS,0384U0,NEPH CKD RSK HI STG KDN DS,,,648.0,648.0,1
HCPCS,0385T,Ex h rate for sz ovr 30 day,,,23.85,30.13,6
HCPCS,0385U,NEPH CKD ALG RSK DBTC KDN DS,,,337.61,652.94,15
HCPCS,0385U,Neph ckd alg rsk dbtc kdn ds,,,22.32,28.19,6
HCPCS,0385U0,NEPH CKD ALG RSK DBTC KDN DS,,,337.61,337.61,1
HCPCS,0386T,Ex h rate sz 30+ day ri only,,,23.85,30.13,6
HCPCS,0386U,Gi barrett esoph mthyltn aly,,,22.32,28.19,6
HCPCS,0387U,ONC MLNMA AMBRA1&AMLO,,,819.5,1584.94,15
HCPCS,0387U,Onc mlnma ambra1&amlo,,,22.32,28.19,6
HCPCS,0387U0,ONC MLNMA AMBRA1&AMLO,,,819.5,819.5,1
HCPCS,0388U,ONC NONSM CLL LNG CA 37 GEN,,,3024.0,5848.5,15
HCPCS,0388U,Onc nonsm cll lng ca 37 gen,,,22.32,28.19,6
HCPCS,0388U0,ONC NONSM CLL LNG CA 37 GEN,,,3024.0,3024.0,1
HCPCS,0389U,PED FBRL KD IFI27&MCEMP1 RNA,,,60.65,117.3,15
HCPCS,0389U,Ped fbrl kd ifi27&mcemp1 rna,,,22.32,28.19,6
HCPCS,0389U0,PED FBRL KD IFI27&MCEMP1 RNA,,,60.65,60.65,1
HCPCS,0390U,OB PE KDR ENG&RBP4 IA ALG,,,55.65,107.63,15
HCPCS,0390U,Ob pe kdr eng&rbp4 ia alg,,,22.32,28.19,6
HCPCS,0390U0,OB PE KDR ENG&RBP4 IA ALG,,,55.65,55.65,1
HCPCS,0391U,ONC SLD TUM DNA&RNA 437 GEN,,,3110.4,6015.6,15
HCPCS,0391U,Onc sld tum dna&rna 437 gen,,,22.32,28.19,6
HCPCS,0391U0,ONC SLD TUM DNA&RNA 437 GEN,,,3110.4,3110.4,1
HCPCS,0392U,RX METAB GEN-RX IA 16 GENES,,,1154.38,2232.61,15
HCPCS,0392U,Rx metab genrx ia 16 genes,,,22.32,28.19,6
HCPCS,0392U0,RX METAB GEN-RX IA 16 GENES,,,1154.38,1154.38,1
HCPCS,0393U,NEU PRKSN MSFL a-SYNCLN PRTN,,,467.41,903.99,15
HCPCS,0393U,Neu prksn msfl a-syncln prtn,,,22.32,28.19,6
HCPCS,0393U0,NEU PRKSN MSFL a-SYNCLN PRTN,,,467.41,467.41,1
HCPCS,0394T,HDR ELCTRNC SKN SURF BRCHYTX,,,263.97,570.18,10
HCPCS,0394T,Hdr elctrnc skn surf brchytx,,,107.19,135.4,6
HCPCS,0394U,PFAS 16 PFAS COMPND LC MS/MS,,,171.71,332.09,15
HCPCS,0394U,Pfas 16 pfas compnd lc ms/ms,,,5.78,7.3,6
HCPCS,0394U0,PFAS 16 PFAS COMPND LC MS/MS,,,171.71,171.71,1
HCPCS,0395T,HDR ELCTR NTRST/NTRCV BRCHTX,,,643.22,1504.29,15
HCPCS,0395T,Hdr elctr ntrst/ntrcv brchtx,,,280.79,354.68,6
HCPCS,0395T0,HDR ELCTR NTRST/NTRCV BRCHTX,,,643.22,643.22,1
HCPCS,0395U,ONC LNG MULTIOMICS PLSM ALG,,,689.0,1332.54,15
HCPCS,0395U,Onc lng multiomics plsm alg,,,22.32,28.19,6
HCPCS,0395U0,ONC LNG MULTIOMICS PLSM ALG,,,689.0,689.0,1
HCPCS,0396T,Intraop kinetic balnce sensr,,,1992.02,2516.23,6
HCPCS,0396U,Ob preimpltj tst 300000 dna,,,22.32,28.19,6
HCPCS,0397T,ERCP W/OPTICAL ENDOMICROSCPY,,,48.19,48.19,1
HCPCS,0397T,Ercp w/optical endomicroscpy,,,2720.71,3436.69,6
HCPCS,0397T0,ERCP W/OPTICAL ENDOMICROSCPY,,,48.19,48.19,1
HCPCS,0397U,Onc nonsm cll lng ca 109,,,22.32,28.19,6
HCPCS,0398T,Mrgfus strtctc les abltj,,,3699.03,4672.46,6
HCPCS,0398U,GI BARET ESPH DNA MTHYLN ALY,,,1516.32,2932.61,15
HCPCS,0398U,Gi baret esph dna mthyln aly,,,22.32,28.19,6
HCPCS,0398U0,GI BARET ESPH DNA MTHYLN ALY,,,1516.32,1516.32,1
HCPCS,0399U,NEURO CERE FOLATE DEFNCY SRM,,,259.2,501.3,15
HCPCS,0399U,Neuro cere folate defncy srm,,,22.32,28.19,6
HCPCS,0399U0,NEURO CERE FOLATE DEFNCY SRM,,,259.2,259.2,1
HCPCS,0400T,Mltispectrl digital les alys,,,20.85,26.34,6
HCPCS,0400U,OB XPND CAR SCR 145 GENES,,,1258.74,2434.45,4
HCPCS,0400U,Ob xpnd car scr 145 genes,,,22.32,28.19,6
HCPCS,0400U0,OB XPND CAR SCR 145 GENES,,,1258.74,1258.74,1
HCPCS,0401T,Mltispectrl digital les alys,,,20.85,26.34,6
HCPCS,0401U,CRD C HRT DS 9 GEN 12 VRNTS,,,423.08,818.26,15
HCPCS,0401U,Crd c hrt ds 9 gen 12 vrnts,,,22.32,28.19,6
HCPCS,0401U0,CRD C HRT DS 9 GEN 12 VRNTS,,,423.08,423.08,1
HCPCS,0402T,COLGN CRS-LINK CRN&PACHYMTRY,,,294.24,5058.24,15
HCPCS,0402T,Colgn crs-link crn&pachymtry,,,351.76,444.32,6
HCPCS,0402T0,COLGN CRS-LINK CRN&PACHYMTRY,,,294.24,294.24,1
HCPCS,0402U,NFCT AGT STI MULT AMP PRB TQ,,,123.23,238.33,15
HCPCS,0402U,Nfct agt sti mult amp prb tq,,,4.02,5.08,6
HCPCS,0402U0,NFCT AGT STI MULT AMP PRB TQ,,,123.23,123.23,1
HCPCS,0403T,DIABETES PREV STANDARD CURR,,,33.92,33.92,2
HCPCS,0403T,Diabetes prev standard curr,,,25.5,32.21,6
HCPCS,0403T0,DIABETES PREV STANDARD CURR,,,33.92,33.92,1
HCPCS,0403TTC,DIABETES PREV STANDARD CURR,,,33.92,33.92,1
HCPCS,0403U,ONC PRST8 MRNA 18 GEN 1ST UR,,,656.64,1269.96,15
HCPCS,0403U,Onc prst8 mrna 18 gen 1st ur,,,22.32,28.19,6
HCPCS,0403U0,ONC PRST8 MRNA 18 GEN 1ST UR,,,656.64,656.64,1
HCPCS,0404T,Trnscrv uterin fibroid abltj,,,3616.15,4567.76,6
HCPCS,0404U,ONC BRST SEMIQ MEAS THYM KN,,,279.04,539.67,15
HCPCS,0404U,Onc brst semiq meas thym kn,,,22.32,28.19,6
HCPCS,0404U0,ONC BRST SEMIQ MEAS THYM KN,,,279.04,279.04,1
HCPCS,0405U,ONC PNCRTC 59 MTHLTN BLK MRK,,,1529.69,2958.47,15
HCPCS,0405U,Onc pncrtc 59 mthltn blk mrk,,,22.32,28.19,6
HCPCS,0405U0,ONC PNCRTC 59 MTHLTN BLK MRK,,,1529.69,1529.69,1
HCPCS,0406U,ONC LUNG FLOW CYTMTRY 5 MRK,,,656.64,1269.96,15
HCPCS,0406U,Onc lung flow cytmtry 5 mrk,,,22.32,28.19,6
HCPCS,0406U0,ONC LUNG FLOW CYTMTRY 5 MRK,,,656.64,656.64,1
HCPCS,0407U,NEPH DBTC CKD MULT ECLIA ALG,,,820.8,1587.45,15
HCPCS,0407U,Neph dbtc ckd mult eclia alg,,,22.32,28.19,6
HCPCS,0407U0,NEPH DBTC CKD MULT ECLIA ALG,,,820.8,820.8,1
HCPCS,0408T,INSJ/RPLC CAR MODULJ SYS PLS GEN TRANSVNS ELTRD,20696.0,13452.4,1036.3,70939.0,61
HCPCS,0408T,INSJ/RPLC CARDIAC MODULJ SYS,,,858.32,858.32,2
HCPCS,0408T0,INSJ/RPLC CARDIAC MODULJ SYS,,,858.32,858.32,1
HCPCS,0408TTC,INSJ/RPLC CARDIAC MODULJ SYS,,,858.32,858.32,1
HCPCS,0408U,IAAD BLK AC WV BSNSR SARSCV2,,,12.2,23.61,15
HCPCS,0408U,Iaad blk ac wv bsnsr sarscv2,,,25.65,32.4,6
HCPCS,0408U0,IAAD BLK AC WV BSNSR SARSCV2,,,12.2,12.2,1
HCPCS,0409T,INSJ/RPLC CAR MODULJ PLS GN,,,383.75,48667.04,16
HCPCS,0409T,INSJ/RPLC CARDIAC MODULJ SYS PLS GENERATOR ONLY,2334.0,1517.1,713.42,2334.0,13
HCPCS,0409T,Insj/rplc car modulj pls gn,,,13248.3,16734.7,6
HCPCS,0409T0,INSJ/RPLC CAR MODULJ PLS GN,,,383.75,383.75,1
HCPCS,0409TTC,INSJ/RPLC CAR MODULJ PLS GN,,,383.75,383.75,1
HCPCS,0409U,ONC SLD TUM DNA 80 & RNA 36,,,2522.53,4878.65,15
HCPCS,0409U,Onc sld tum dna 80 & rna 36,,,22.32,28.19,6
HCPCS,0409U0,ONC SLD TUM DNA 80 & RNA 36,,,2522.53,2522.53,1
HCPCS,0410T,INSJ/RPLC CAR MODULJ ATR ELT,,,392.74,17943.69,16
HCPCS,0410T,INSJ/RPLC CARDIAC MODULJ SYS ATR ELECTRODE ONLY,2460.0,1599.0,740.34,2460.0,13
HCPCS,0410T,Insj/rplc car modulj atr elt,,,916.39,1157.54,6
HCPCS,0410T0,INSJ/RPLC CAR MODULJ ATR ELT,,,392.74,392.74,1
HCPCS,0410TTC,INSJ/RPLC CAR MODULJ ATR ELT,,,392.74,392.74,1
HCPCS,0410U,ONC PNCRTC DNA WHL GN SEQ 5-,,,1002.24,1938.36,15
HCPCS,0410U,Onc pncrtc dna whl gn seq 5-,,,22.32,28.19,6
HCPCS,0410U0,ONC PNCRTC DNA WHL GN SEQ 5-,,,1002.24,1002.24,1
HCPCS,0411T,INSJ/RPLC CAR MODULJ SYS VENTR ELECTRODE ONLY,2460.0,1599.0,740.34,2460.0,13
HCPCS,0411T,INSJ/RPLC CAR MODULJ VNT ELT,,,392.74,17943.69,16
HCPCS,0411T,Insj/rplc car modulj vnt elt,,,916.39,1157.54,6
HCPCS,0411T0,INSJ/RPLC CAR MODULJ VNT ELT,,,392.74,392.74,1
HCPCS,0411TTC,INSJ/RPLC CAR MODULJ VNT ELT,,,392.74,392.74,1
HCPCS,0411U,PSYC GENOM ALYS PNL 15 GEN,,,1154.38,2232.61,15
HCPCS,0411U,Psyc genom alys pnl 15 gen,,,1109.84,1401.9,6
HCPCS,0411U0,PSYC GENOM ALYS PNL 15 GEN,,,1154.38,1154.38,1
HCPCS,0412T,REMOVAL CARDIAC MODULJ SYS PLS GENERATOR ONLY,1436.0,933.4,462.69,1436.0,13
HCPCS,0412T,RMVL CARDIAC MODULJ PLS GEN,,,268.3,7890.6,16
HCPCS,0412T,Rmvl cardiac modulj pls gen,,,4041.02,5104.45,6
HCPCS,0412T0,RMVL CARDIAC MODULJ PLS GEN,,,268.3,268.3,1
HCPCS,0412TTC,RMVL CARDIAC MODULJ PLS GEN,,,268.3,268.3,1
HCPCS,0412U,BETA AMYLOID Aß42/40 IMPRCIP,,,648.0,1253.25,15
HCPCS,0412U,Beta amyloid ab42/40 imprcip,,,5.78,7.3,6
HCPCS,0412U0,BETA AMYLOID Aß42/40 IMPRCIP,,,648.0,648.0,1
HCPCS,0413T,REMOVAL CARDIAC MODULJ SYS TRANSVENOUS ELECTRODE,10935.5,7108.075,916.39,37851.0,61
HCPCS,0413T,RMVL CAR MODULJ TRANVNS ELT,,,498.83,498.83,2
HCPCS,0413T0,RMVL CAR MODULJ TRANVNS ELT,,,498.83,498.83,1
HCPCS,0413TTC,RMVL CAR MODULJ TRANVNS ELT,,,498.83,498.83,1
HCPCS,0413U,ONC HL NEO OPT GEN MAPG DNA,,,1091.69,2111.36,15
HCPCS,0413U,Onc hl neo opt gen mapg dna,,,22.32,28.19,6
HCPCS,0413U0,ONC HL NEO OPT GEN MAPG DNA,,,1091.69,1091.69,1
HCPCS,0414T,(2017) RMVL & RPL CARDIAC MODULJ SYS PLS GENERATOR ONLY,2330.0,1514.5,744.62,2330.0,13
HCPCS,0414T,RMVL & RPL CAR MODULJ PLS GN,,,384.79,48667.04,16
HCPCS,0414T,Rmvl & rpl car modulj pls gn,,,13248.3,16734.7,6
HCPCS,0414T0,RMVL & RPL CAR MODULJ PLS GN,,,384.79,384.79,1
HCPCS,0414TTC,RMVL & RPL CAR MODULJ PLS GN,,,384.79,384.79,1
HCPCS,0414U,ONC LNG AUG ALG ALY WHL SLD8,,,610.2,1180.14,15
HCPCS,0414U,Onc lng aug alg aly whl sld8,,,22.32,28.19,6
HCPCS,0414U0,ONC LNG AUG ALG ALY WHL SLD8,,,610.2,610.2,1
HCPCS,0415T,(2017) REPOS CARDIAC MODULJ TRANSVENOUS ELECTRODE,2071.0,1346.15,621.65,2071.0,13
HCPCS,0415T,REPOS CAR MODULJ TRANVNS ELT,,,337.63,1340.49,16
HCPCS,0415T,Repos car modulj tranvns elt,,,916.39,1157.54,6
HCPCS,0415T0,REPOS CAR MODULJ TRANVNS ELT,,,337.63,337.63,1
HCPCS,0415TTC,REPOS CAR MODULJ TRANVNS ELT,,,337.63,337.63,1
HCPCS,0415U,CV DS ACS BLD ALG 5 YR SCORE,,,337.61,652.94,15
HCPCS,0415U,Cv ds acs bld alg 5 yr score,,,22.32,28.19,6
HCPCS,0415U0,CV DS ACS BLD ALG 5 YR SCORE,,,337.61,337.61,1
HCPCS,0416T,RELOC SKIN POCKET CARDIAC MODULJ PULSE GENERATOR,2121.0,1378.65,683.62,2121.0,13
HCPCS,0416T,RELOC SKIN POCKET PLS GEN,,,364.67,3966.07,16
HCPCS,0416T,Reloc skin pocket pls gen,,,916.39,1157.54,6
HCPCS,0416T0,RELOC SKIN POCKET PLS GEN,,,364.67,364.67,1
HCPCS,0416TTC,RELOC SKIN POCKET PLS GEN,,,364.67,364.67,1
HCPCS,0416U,Iadna gu pthgn 20bct&fng org,,,22.32,28.19,6
HCPCS,0417T,PRGRMG DEVICE EVALUATION CARDIAC MODULJ SYSTEM,872.0,566.8,143.87,872.0,13
HCPCS,0417T,PRGRMG EVAL CARDIAC MODULJ,,,37.43,84.08,16
HCPCS,0417T,Prgrmg eval cardiac modulj,,,21.15,26.71,6
HCPCS,0417T0,PRGRMG EVAL CARDIAC MODULJ,,,84.08,84.08,1
HCPCS,0417TTC,PRGRMG EVAL CARDIAC MODULJ,,,84.08,84.08,1
HCPCS,0417U,RARE DS ALYS 335 NUC GENES,,,2455.94,4749.87,15
HCPCS,0417U,Rare ds alys 335 nuc genes,,,22.32,28.19,6
HCPCS,0417U0,RARE DS ALYS 335 NUC GENES,,,2455.94,2455.94,1
HCPCS,0418T,INTERRO DEVICE EVALUATION CARDIAC MODULJ SYSTEM,390.0,253.5,96.36,390.0,13
HCPCS,0418T,INTERRO EVAL CARDIAC MODULJ,,,37.43,80.85,16
HCPCS,0418T,Interro eval cardiac modulj,,,21.15,26.71,6
HCPCS,0418T0,INTERRO EVAL CARDIAC MODULJ,,,58.32,58.32,1
HCPCS,0418TTC,INTERRO EVAL CARDIAC MODULJ,,,58.32,58.32,1
HCPCS,0418U,ONC BRST AUG ALG ALY WHL SL8,,,610.2,1180.14,15
HCPCS,0418U,Onc brst aug alg aly whl sl8,,,11.52,14.56,6
HCPCS,0418U0,ONC BRST AUG ALG ALY WHL SL8,,,610.2,610.2,1
HCPCS,0419T,DSTRJ NEUROFIBROMA XTNSV,,,310.25,1327.2,16
HCPCS,0419T,Dstrj neurofibroma xtnsv,,,98.33,124.2,6
HCPCS,0419T0,DSTRJ NEUROFIBROMA XTNSV,,,310.25,310.25,1
HCPCS,0419TTC,DSTRJ NEUROFIBROMA XTNSV,,,310.25,310.25,1
HCPCS,0419U,NRPSYC GEN SEQ VRNT ALY 13,,,1154.38,2232.61,15
HCPCS,0419U,Nrpsyc gen seq vrnt aly 13,,,22.32,28.19,6
HCPCS,0419U0,NRPSYC GEN SEQ VRNT ALY 13,,,1154.38,1154.38,1
HCPCS,0420T,DSTRJ NEUROFIBROMA XTNSV,,,586.21,1327.2,15
HCPCS,0420T,Dstrj neurofibroma xtnsv,,,98.33,124.2,6
HCPCS,0420T0,DSTRJ NEUROFIBROMA XTNSV,,,586.21,586.21,1
HCPCS,0420U,ONC URTHL MRNA XPRSN 6 SNP,,,1328.32,1461.15,4
HCPCS,0420U,Onc urthl mrna xprsn 6 snp,,,22.32,28.19,6
HCPCS,0421T,WATERJET PROSTATE ABLTJ CMPL,,,9282.1,20049.35,10
HCPCS,0421T,Waterjet prostate abltj cmpl,,,2889.05,3649.33,6
HCPCS,0421U,ONC CLRCT SCR SGL AMP 8 RNA,,,439.67,850.32,4
HCPCS,0421U,Onc clrct scr sgl amp 8 rna,,,22.32,28.19,6
HCPCS,0421U0,ONC CLRCT SCR SGL AMP 8 RNA,,,439.67,439.67,1
HCPCS,0422T,TACTILE BREAST IMG UNI/BI,,,88.38,190.91,18
HCPCS,0422T,Tactile breast img uni/bi,,,27.88,35.22,6
HCPCS,0422T0,TACTILE BREAST IMG UNI/BI,,,108.09,108.09,1
HCPCS,0422U,ONC PAN SOLID TUM ALYS DNA,,,1943.21,2137.53,4
HCPCS,0422U,Onc pan solid tum alys dna,,,22.32,28.19,6
HCPCS,0423T,Assay secretory type ii pla2,,,13.39,16.91,6
HCPCS,0423U,PSYC GENOMIC ALYS PNL 26 GEN,,,360.09,696.44,15
HCPCS,0423U,Psyc genomic alys pnl 26 gen,,,22.32,28.19,6
HCPCS,0423U0,PSYC GENOMIC ALYS PNL 26 GEN,,,360.09,360.09,1
HCPCS,0424T,Insj/rplc nstim apnea compl,,,11520.56,14552.29,6
HCPCS,0424U,ONC PRST8 XOM ALYS 53 SNCRNA,,,656.64,1269.96,15
HCPCS,0424U,Onc prst8 xom alys 53 sncrna,,,22.32,28.19,6
HCPCS,0424U0,ONC PRST8 XOM ALYS 53 SNCRNA,,,656.64,656.64,1
HCPCS,0425T,Insj/rplc nstim apnea sen ld,,,3699.03,4672.46,6
HCPCS,0425U,GENOM RPD SEQ ALYS EA CMPRTR,,,4094.39,4503.83,4
HCPCS,0425U,Genom rpd seq alys ea cmprtr,,,22.32,28.19,6
HCPCS,0426T,Insj/rplc nstim apnea stm ld,,,3699.03,4672.46,6
HCPCS,0426U,GENOME ULTRA-RAPID SEQ ALYS,,,7582.2,8340.42,4
HCPCS,0426U,Genome ultra-rapid seq alys,,,22.32,28.19,6
HCPCS,0427T,Insj/rplc nstim apnea pls gn,,,11520.56,14552.29,6
HCPCS,0427U,MONOCYTE DSTRBJ WDTH WHL BLD,,,3.87,7.49,15
HCPCS,0427U,Monocyte dstrbj wdth whl bld,,,2.81,3.55,6
HCPCS,0427U0,MONOCYTE DSTRBJ WDTH WHL BLD,,,3.87,3.87,1
HCPCS,0428T,Rmvl nstim apnea pls gen,,,1950.92,2464.32,6
HCPCS,0428U,Onc brst ctdna alys 56/> gen,,,22.32,28.19,6
HCPCS,0429T,Rmvl nstim apnea sen ld,,,1950.92,2464.32,6
HCPCS,0429U,HPV OROP SWAB 14 HI-RISK TYP,,,30.32,58.64,15
HCPCS,0429U,Hpv orop swab 14 hi-risk typ,,,25.65,32.4,6
HCPCS,0429U0,HPV OROP SWAB 14 HI-RISK TYP,,,30.32,30.32,1
HCPCS,0430T,Rmvl nstim apnea stimj ld,,,1950.92,2464.32,6
HCPCS,0430U,GI MALABS AAT CALPRO PNCRTC,,,53.17,102.83,15
HCPCS,0430U,Gi malabs aat calpro pncrtc,,,5.78,7.3,6
HCPCS,0430U0,GI MALABS AAT CALPRO PNCRTC,,,53.17,53.17,1
HCPCS,0431T,Rmvl/rplc nstim apnea pls gn,,,11520.56,14552.29,6
HCPCS,0431U,GLY RCPTR ALPHA1 IGG SRM/CSF,,,31.6,31.6,1
HCPCS,0431U,SPSDEV GLYCINE RECEPTOR ALPHA1 IGG,700.0,455.0,5.78,630.0,37
HCPCS,0431U0,GLY RCPTR ALPHA1 IGG SRM/CSF,,,31.6,31.6,1
HCPCS,0432T,Repos nstim apnea stimj ld,,,1950.92,2464.32,6
HCPCS,0432U,KLHL11 ANTB SR/CSF ASY QUAL,,,31.6,61.11,15
HCPCS,0432U,Klhl11 antb sr/csf asy qual,,,5.78,7.3,6
HCPCS,0432U0,KLHL11 ANTB SR/CSF ASY QUAL,,,31.6,31.6,1
HCPCS,0433T,Repos nstim apnea sensing ld,,,1950.92,2464.32,6
HCPCS,0433U,ONC PRST8 5 DNA REG MRK PCR,,,656.64,1269.96,15
HCPCS,0433U,Onc prst8 5 dna reg mrk pcr,,,22.32,28.19,6
HCPCS,0433U0,ONC PRST8 5 DNA REG MRK PCR,,,656.64,656.64,1
HCPCS,0434T,Interro eval npgs apnea,,,21.15,26.71,6
HCPCS,0434U,RX METAB ADVRS VRNT ALYS 25,,,360.09,696.44,15
HCPCS,0434U,Rx metab advrs vrnt alys 25,,,22.32,28.19,6
HCPCS,0434U0,RX METAB ADVRS VRNT ALYS 25,,,360.09,360.09,1
HCPCS,0435T,Prgrmg eval npgs apnea 1 ses,,,21.15,26.71,6
HCPCS,0435U,ONC CHEMO RX CYTOX CSC 14 RX,,,2621.26,5069.58,15
HCPCS,0435U,Onc chemo rx cytox csc 14 rx,,,5.81,7.34,6
HCPCS,0435U0,ONC CHEMO RX CYTOX CSC 14 RX,,,2621.26,2621.26,1
HCPCS,0436T,Prgrmg eval npgs apnea study,,,21.15,26.71,6
HCPCS,0436U,ONC LNG PLSM ALYS 388 PRTN,,,1504.24,1654.66,4
HCPCS,0436U,Onc lng plsm alys 388 prtn,,,22.32,28.19,6
HCPCS,0437T,IMPLTJ NONBIOL/SYNTH IMPLT FASC RNFCMT ABDL WALL,2128.0,1383.2,428.28,2128.0,13
HCPCS,0437T,IMPLTJ SYNTH RNFCMT ABDL WAL,,,274.55,274.55,1
HCPCS,0437T,Impltj synth rnfcmt abdl wal,,,2419.02,3055.61,6
HCPCS,0437T0,IMPLTJ SYNTH RNFCMT ABDL WAL,,,274.55,274.55,1
HCPCS,0437U,PSYC ANXIETY DO MRNA 15 BMRK,,,656.64,1269.96,15
HCPCS,0437U,Psyc anxiety do mrna 15 bmrk,,,22.32,28.19,6
HCPCS,0437U0,PSYC ANXIETY DO MRNA 15 BMRK,,,656.64,656.64,1
HCPCS,0438U,RX METAB ADVRS VRNT ALYS 33,,,360.09,696.44,15
HCPCS,0438U,Rx metab advrs vrnt alys 33,,,22.32,28.19,6
HCPCS,0438U0,RX METAB ADVRS VRNT ALYS 33,,,360.09,360.09,1
HCPCS,0439T,MYOCARDIAL PERFUSION ECHO ISCHM/VIABILITY ASSMT,652.0,423.8,127.04,652.0,13
HCPCS,0439T,MYOCRD CONTRAST PRFUJ ECHO,,,95.61,95.61,1
HCPCS,0439T,Myocrd contrast prfuj echo,,,284.16,358.94,6
HCPCS,0439T0,MYOCRD CONTRAST PRFUJ ECHO,,,95.61,95.61,1
HCPCS,0439U,CRD CHD DNA ALYS 5 SNP 3 DNA,,,854.0,939.4,4
HCPCS,0439U,Crd chd dna alys 5 snp 3 dna,,,22.32,28.19,6
HCPCS,0440T,ABLTJ PERC CRYOABLTJ IMG GDN UXTR/PERPH NERVE,5373.5,3492.775,471.55,8787.6,50
HCPCS,0440T,ABLTJ PERC UXTR/PERPH NRV,,,229.14,229.14,1
HCPCS,0440T0,ABLTJ PERC UXTR/PERPH NRV,,,229.14,229.14,1
HCPCS,0440U,CRD CHD DNA ALYS 10 SNP 6DNA,,,854.0,939.4,4
HCPCS,0440U,Crd chd dna alys 10 snp 6dna,,,22.32,28.19,6
HCPCS,0441T,ABLTJ PERC CRYOABLTJ IMG GDN LXTR/PERPH NERVE,5435.5,3533.0750000000003,471.55,8787.6,50
HCPCS,0441T,ABLTJ PERC LXTR/PERPH NRV,,,229.14,229.14,1
HCPCS,0441T0,ABLTJ PERC LXTR/PERPH NRV,,,229.14,229.14,1
HCPCS,0441U,NFCT DS BCT FNGL/VIRAL SEMIQ,,,444.08,488.49,4
HCPCS,0441U,Nfct ds bct fngl/viral semiq,,,22.32,28.19,6
HCPCS,0442T,ABLTJ PERC CRYOABLTJ IMG GDN NRV PLEX/TRNCL NRV,1517.0,986.05,471.55,1517.0,13
HCPCS,0442T,ABLTJ PERC PLEX/TRNCL NRV,,,245.42,13885.08,15
HCPCS,0442T,Abltj perc plex/trncl nrv,,,3157.38,3988.27,6
HCPCS,0442T0,ABLTJ PERC PLEX/TRNCL NRV,,,245.42,245.42,1
HCPCS,0442U,NFCT DS RESPIR NFCTJ MXA&CRP,,,35.75,69.15,15
HCPCS,0442U,Nfct ds respir nfctj mxa&crp,,,22.32,28.19,6
HCPCS,0442U0,NFCT DS RESPIR NFCTJ MXA&CRP,,,35.75,35.75,1
HCPCS,0443T,R-T SPCTRL ALYS PRST8 TISS,,,20.12,20.12,1
HCPCS,0443T,R-t spctrl alys prst8 tiss,,,19.72,24.91,6
HCPCS,0443T0,R-T SPCTRL ALYS PRST8 TISS,,,20.12,20.12,1
HCPCS,0443U,NEURFLMNT LT CHN ULTRSENS IA,,,116.23,127.85,4
HCPCS,0443U,Neurflmnt lt chn ultrsens ia,,,4.02,5.08,6
HCPCS,0444T,1ST PLMT DRUG ELUT OC INS,,,162.06,162.06,1
HCPCS,0444T,1st plmt drug elut oc ins,,,30.69,38.77,6
HCPCS,0444T0,1ST PLMT DRUG ELUT OC INS,,,162.06,162.06,1
HCPCS,0444U,ONC SLD ORGN NEO TGSAP 361,,,2522.53,4878.65,15
HCPCS,0444U,Onc sld orgn neo tgsap 361,,,22.32,28.19,6
HCPCS,0444U0,ONC SLD ORGN NEO TGSAP 361,,,2522.53,2522.53,1
HCPCS,0445T,SBSQT PLMT DRUG ELUT OC INS,,,281.08,281.08,1
HCPCS,0445T,Sbsqt plmt drug elut oc ins,,,30.69,38.77,6
HCPCS,0445T0,SBSQT PLMT DRUG ELUT OC INS,,,281.08,281.08,1
HCPCS,0445U,ABETA42 & PTAU181 ECLIA CSF,,,225.07,435.3,15
HCPCS,0445U,Abeta42 & ptau181 eclia csf,,,22.32,28.19,6
HCPCS,0445U0,ABETA42 & PTAU181 ECLIA CSF,,,225.07,225.07,1
HCPCS,0446T,INSJ IMPLTBL GLUCOSE SENSOR,,,58.98,4779.07,15
HCPCS,0446T,Insj impltbl glucose sensor,,,254.67,321.68,6
HCPCS,0446T0,INSJ IMPLTBL GLUCOSE SENSOR,,,58.98,58.98,1
HCPCS,0446U,AI DS SLE ALYS 10 CYTOKINE,,,726.32,1404.73,15
HCPCS,0446U,Ai ds sle alys 10 cytokine,,,22.32,28.19,6
HCPCS,0446U0,AI DS SLE ALYS 10 CYTOKINE,,,726.32,726.32,1
HCPCS,0447T,RMVL IMPLTBL GLUCOSE SENSOR,,,69.15,430.81,15
HCPCS,0447T,Rmvl impltbl glucose sensor,,,98.33,124.2,6
HCPCS,0447T0,RMVL IMPLTBL GLUCOSE SENSOR,,,69.15,69.15,1
HCPCS,0447U,AI DS SLE ALYS 11 CYTOKINE,,,726.32,1404.73,15
HCPCS,0447U,Ai ds sle alys 11 cytokine,,,22.32,28.19,6
HCPCS,0447U0,AI DS SLE ALYS 11 CYTOKINE,,,726.32,726.32,1
HCPCS,0448T,REMVL INSJ IMPLTBL GLUC SENS,,,98.3,4779.07,15
HCPCS,0448T,Remvl insj impltbl gluc sens,,,254.67,321.68,6
HCPCS,0448T0,REMVL INSJ IMPLTBL GLUC SENS,,,98.3,98.3,1
HCPCS,0448U,Onc lng&cln ca dna qual ngs,,,22.32,28.19,6
HCPCS,0449T,INSJ AQUEOUS DRAIN DEV 1ST,,,827.46,11187.1,15
HCPCS,0449T,Insj aqueous drain dev 1st,,,2069.78,2614.46,6
HCPCS,0449T0,INSJ AQUEOUS DRAIN DEV 1ST,,,827.46,827.46,1
HCPCS,0449U,CAR SCR SEV INH COND 5 GENES,,,1576.69,3049.37,4
HCPCS,0449U,Car scr sev inh cond 5 genes,,,22.32,28.19,6
HCPCS,0449U0,CAR SCR SEV INH COND 5 GENES,,,1576.69,1576.69,1
HCPCS,0450T,INSJ AQUEOUS DRAIN DEV EACH,,,349.09,349.09,1
HCPCS,0450T,Insj aqueous drain dev each,,,2069.78,2614.46,6
HCPCS,0450T0,INSJ AQUEOUS DRAIN DEV EACH,,,349.09,349.09,1
HCPCS,0450U,ONC MM LC-MS/MS MONOC P-PRTN,,,43.43,72.57,10
HCPCS,0450U,Onc mm lc-ms/ms monoc p-prtn,,,22.32,28.19,6
HCPCS,0451T,Insj/rplcmt aortic ventr sys,,,18442.86,23296.25,6
HCPCS,0451U,ONC MM LC-MS/MS PEP ION QUAN,,,43.43,72.57,10
HCPCS,0451U,Onc mm lc-ms/ms pep ion quan,,,22.32,28.19,6
HCPCS,0452T,Insj/rplcmt dev vasc seal,,,18442.86,23296.25,6
HCPCS,0452U,ONC BLDR MTHYL PENK LTE-QMSP,,,165.89,320.83,15
HCPCS,0452U,Onc bldr mthyl penk lte-qmsp,,,22.32,28.19,6
HCPCS,0452U0,ONC BLDR MTHYL PENK LTE-QMSP,,,165.89,165.89,1
HCPCS,0453T,Insj/rplcmt mech-elec ntrfce,,,18442.86,23296.25,6
HCPCS,0453U,ONC CLRCT CA CFDNA QPCR ASY,,,165.89,320.83,15
HCPCS,0453U,Onc clrct ca cfdna qpcr asy,,,22.32,28.19,6
HCPCS,0453U0,ONC CLRCT CA CFDNA QPCR ASY,,,165.89,165.89,1
HCPCS,0454T,Insj/rplcmt subq electrode,,,18442.86,23296.25,6
HCPCS,0454U,RARE DS ID OPT GENOME MAPG,,,1091.69,2111.36,15
HCPCS,0454U,Rare ds id opt genome mapg,,,22.32,28.19,6
HCPCS,0454U0,RARE DS ID OPT GENOME MAPG,,,1091.69,1091.69,1
HCPCS,0455T,Remvl aortic ventr cmpl sys,,,4041.02,5104.45,6
HCPCS,0455U,NFCT AGT STI MULT AMP PRB UR,,,123.23,238.33,15
HCPCS,0455U,Nfct agt sti mult amp prb ur,,,4.02,5.08,6
HCPCS,0455U0,NFCT AGT STI MULT AMP PRB UR,,,123.23,123.23,1
HCPCS,0456T,Remvl aortic dev vasc seal,,,4041.02,5104.45,6
HCPCS,0456U,Ai ra ngs 19 genes anti-ccp,,,22.32,28.19,6
HCPCS,0457T,Remvl mech-elec skin ntrfce,,,4041.02,5104.45,6
HCPCS,0457U,PFAS 9 CMPND LC-MS/MS PLS/SR,,,171.71,332.09,15
HCPCS,0457U,Pfas 9 cmpnd lcms/ms pls/sr,,,5.78,7.3,6
HCPCS,0457U0,PFAS 9 CMPND LC-MS/MS PLS/SR,,,171.71,171.71,1
HCPCS,0458T,Remvl subq electrode,,,916.39,1157.54,6
HCPCS,0458U,ONC BRST CA S100 A8&A9 ELISA,,,225.07,435.3,15
HCPCS,0458U,Onc brst ca s100 a8&a9 elisa,,,22.32,28.19,6
HCPCS,0458U0,ONC BRST CA S100 A8&A9 ELISA,,,225.07,225.07,1
HCPCS,0459T,Relocaj rplcmt aortic ventr,,,18442.86,23296.25,6
HCPCS,0459U,ABETA42 & TTAU ECLIA CSF,,,225.07,435.3,15
HCPCS,0459U,Abeta42 & ttau eclia csf,,,22.32,28.19,6
HCPCS,0459U0,ABETA42 & TTAU ECLIA CSF,,,225.07,225.07,1
HCPCS,0460T,Repos aortic ventr dev eltrd,,,916.39,1157.54,6
HCPCS,0460U,ONC WHL BLD/BUCC RTPCR 24GEN,,,917.08,1008.79,4
HCPCS,0460U,Onc whl bld/bucc rtpcr 24gen,,,22.32,28.19,6
HCPCS,0461T,Repos aortic contrpulsj dev,,,4041.02,5104.45,6
HCPCS,0461U,ONC RXGENOM ALYS RTPCR 24GEN,,,917.08,1008.79,4
HCPCS,0461U,Onc rxgenom alys rtpcr 24gen,,,22.32,28.19,6
HCPCS,0462T,Prgrmg eval aortic ventr sys,,,21.15,26.71,6
HCPCS,0462U,MELATONIN LVL TST SLP STD7/9,,,14.93,28.86,15
HCPCS,0462U,Melatonin lvl tst slp std7/9,,,22.32,28.19,6
HCPCS,0462U0,MELATONIN LVL TST SLP STD7/9,,,14.93,14.93,1
HCPCS,0463T,Interrog aortic ventr sys,,,21.15,26.71,6
HCPCS,0463U,ONC CRVX MRNA GENXPRSN 14BMK,,,760.0,836.0,4
HCPCS,0463U,Onc crvx mrna genxprsn 14bmk,,,22.32,28.19,6
HCPCS,0464T,VISUAL EP TEST FOR GLAUCOMA,,,72.59,339.23,16
HCPCS,0464T,Visual ep test for glaucoma,,,45.31,57.23,6
HCPCS,0464T0,VISUAL EP TEST FOR GLAUCOMA,,,72.59,72.59,1
HCPCS,0464TTC,VISUAL EP TEST FOR GLAUCOMA,,,72.59,72.59,1
HCPCS,0464U,ONC CLRCT SCR QRTSA DNA MRK,,,511.42,989.1,8
HCPCS,0464U,Onc clrct scr qrtsa dna mrk,,,22.32,28.19,6
HCPCS,0464U0,ONC CLRCT SCR QRTSA DNA MRK,,,511.42,511.42,1
HCPCS,0465T,Supchrdl njx rx w/o supply,,,30.69,38.77,6
HCPCS,0465U,ONC URTHL CARC DNA QMSP 2GEN,,,1674.44,3238.41,15
HCPCS,0465U,Onc urthl carc dna qmsp 2gen,,,22.32,28.19,6
HCPCS,0465U0,ONC URTHL CARC DNA QMSP 2GEN,,,1674.44,1674.44,1
HCPCS,0466T,Insj ch wal respir eltrd/ra,,,11520.56,14552.29,6
HCPCS,0466U,CRD CAD DNA GWAS 564856 SNP,,,345.43,379.97,4
HCPCS,0466U,Crd cad dna gwas 564856 snp,,,22.32,28.19,6
HCPCS,0467T,Revj/rplmnt ch respir eltrd,,,1950.92,2464.32,6
HCPCS,0467U,ONC BLDR DNA NGS 60GEN&ANEUP,,,1312.47,2538.35,15
HCPCS,0467U,Onc bldr dna ngs 60gen&aneup,,,22.32,28.19,6
HCPCS,0467U0,ONC BLDR DNA NGS 60GEN&ANEUP,,,1312.47,1312.47,1
HCPCS,0468T,Rmvl ch wal respir eltrd/ra,,,1950.92,2464.32,6
HCPCS,0468U,HEP NASH MIR-34A5P A2M YKL40,,,217.47,420.59,15
HCPCS,0468U,Hep nash mir34a5p a2m ykl40,,,22.32,28.19,6
HCPCS,0468U0,HEP NASH MIR-34A5P A2M YKL40,,,217.47,217.47,1
HCPCS,0469T,RTA POLARIZE SCAN OC SCR BI,,,27.0,27.0,2
HCPCS,0469T,Rta polarize scan oc scr bi,,,31.76,40.12,6
HCPCS,0469T0,RTA POLARIZE SCAN OC SCR BI,,,27.0,27.0,1
HCPCS,0469TTC,RTA POLARIZE SCAN OC SCR BI,,,27.0,27.0,1
HCPCS,0469U,RARE DS WHL GEN SEQ FTL SAMP,,,1035.02,2001.76,15
HCPCS,0469U,Rare ds whl gen seq ftl samp,,,22.32,28.19,6
HCPCS,0469U0,RARE DS WHL GEN SEQ FTL SAMP,,,1035.02,1035.02,1
HCPCS,0470T,Oct skn img acquisj i&r 1st,,,137.74,173.99,6
HCPCS,0470U,ONC OROP DETCJ MRD 8 DNA HPV,,,597.91,657.7,4
HCPCS,0470U,Onc orop detcj mrd 8 dna hpv,,,22.32,28.19,6
HCPCS,0471T,Oct skn img acquisj i&r addl,,,137.74,173.99,6
HCPCS,0471U,ONC CLRC CA 35 VRN KRAS&NRAS,,,656.64,1269.96,15
HCPCS,0471U,Onc clrc ca 35 vrn kras&nras,,,22.32,28.19,6
HCPCS,0471U0,ONC CLRC CA 35 VRN KRAS&NRAS,,,656.64,656.64,1
HCPCS,0472T,PRGRMG IO RTA ELTRD RA,,,65.11,650.25,16
HCPCS,0472T,Prgrmg io rta eltrd ra,,,21.15,26.71,6
HCPCS,0472T0,PRGRMG IO RTA ELTRD RA,,,65.11,65.11,1
HCPCS,0472TTC,PRGRMG IO RTA ELTRD RA,,,65.11,65.11,1
HCPCS,0472U,CA VI PSP&SP1 ANTB SJÖGREN,,,27.9,30.69,4
HCPCS,0472U,Ca vi psp&sp1 antb sjogren,,,22.32,28.19,6
HCPCS,0473T,REPRGRMG IO RTA ELTRD RA,,,59.66,199.02,16
HCPCS,0473T,Reprgrmg io rta eltrd ra,,,21.15,26.71,6
HCPCS,0473T0,REPRGRMG IO RTA ELTRD RA,,,59.66,59.66,1
HCPCS,0473TTC,REPRGRMG IO RTA ELTRD RA,,,59.66,59.66,1
HCPCS,0473U,ONC SLD TUM BLD/SLV 648 GENE,,,3888.0,7519.5,15
HCPCS,0473U,Onc sld tum bld/slv 648 gene,,,22.32,28.19,6
HCPCS,0473U0,ONC SLD TUM BLD/SLV 648 GENE,,,3888.0,3888.0,1
HCPCS,0474T,INSJ ANT SEG AQUEOUS DRG DEV W/IO RSVR,5757.0,3742.05,1588.44,5757.0,13
HCPCS,0474T,INSJ AQUEOUS DRG DEV IO RSVR,,,404.2,404.2,2
HCPCS,0474T,Insj aqueous drg dev io rsvr,,,2069.78,2614.46,6
HCPCS,0474T0,INSJ AQUEOUS DRG DEV IO RSVR,,,404.2,404.2,1
HCPCS,0474TTC,INSJ AQUEOUS DRG DEV IO RSVR,,,404.2,404.2,1
HCPCS,0474U,HERED PAN CA GSAP 88GENE NGS,,,1126.61,2178.9,15
HCPCS,0474U,Hered pan ca gsap 88gene ngs,,,22.32,28.19,6
HCPCS,0474U0,HERED PAN CA GSAP 88GENE NGS,,,1126.61,1126.61,1
HCPCS,0475T,Rec ftl car sgl 3 ch i&r,,,16.03,20.24,6
HCPCS,0475U,HERED PRST8 CA GSAP 23 GENES,,,1126.61,2178.9,15
HCPCS,0475U,Hered prst8 ca gsap 23 genes,,,22.32,28.19,6
HCPCS,0475U0,HERED PRST8 CA GSAP 23 GENES,,,1126.61,1126.61,1
HCPCS,0476T,Rec ftl car sgl elec tr data,,,16.03,20.24,6
HCPCS,0476U,RX METAB PSYC 14GEN&CYP2D6,,,360.09,696.44,15
HCPCS,0476U,Rx metab psyc 14gen&cyp2d6,,,325.19,410.76,6
HCPCS,0476U0,RX METAB PSYC 14GEN&CYP2D6,,,360.09,360.09,1
HCPCS,0477T,Rec ftl car sgl xrtj alys,,,16.03,20.24,6
HCPCS,0477U,RX METAB PSY 14&CYP2D6 GN-RX,,,360.09,696.44,15
HCPCS,0477U,Rx metab psy 14&cyp2d6 gn-rx,,,325.19,410.76,6
HCPCS,0477U0,RX METAB PSY 14&CYP2D6 GN-RX,,,360.09,360.09,1
HCPCS,0478T,Rec ftl car 3 ch rev i&r,,,16.03,20.24,6
HCPCS,0478U,ONC NSCLC DNA&RNA DPCR 9GENS,,,552.99,608.29,4
HCPCS,0478U,Onc nsclc dna&rna dpcr 9gens,,,22.32,28.19,6
HCPCS,0479T,FXJL ABL LSR 1ST 100 SQ CM,,,272.8,1327.2,15
HCPCS,0479T,Fxjl abl lsr 1st 100 sq cm,,,241.35,304.86,6
HCPCS,0479T0,FXJL ABL LSR 1ST 100 SQ CM,,,272.8,272.8,1
HCPCS,0479U,TAU PHOSPHORYLATED PTAU217,,,14.93,28.86,15
HCPCS,0479U,Tau phosphorylated ptau217,,,22.32,28.19,6
HCPCS,0479U0,TAU PHOSPHORYLATED PTAU217,,,14.93,14.93,1
HCPCS,0480T,FXJL ABL LSR EA ADDL 100SQCM,,,100.18,100.18,1
HCPCS,0480T,Fxjl abl lsr ea addl 100sqcm,,,241.35,304.86,6
HCPCS,0480T0,FXJL ABL LSR EA ADDL 100SQCM,,,100.18,100.18,1
HCPCS,0480U,NFCT DS CSF METAG NGS ALYS,,,1837.04,3552.88,15
HCPCS,0480U,Nfct ds csf metag ngs alys,,,22.32,28.19,6
HCPCS,0480U0,NFCT DS CSF METAG NGS ALYS,,,1837.04,1837.04,1
HCPCS,0481T,NJX AUTOL WBC CONCENTRATE,,,290.85,865.18,15
HCPCS,0481T,Njx autol wbc concentrate,,,275.45,347.94,6
HCPCS,0481T0,NJX AUTOL WBC CONCENTRATE,,,290.85,290.85,1
HCPCS,0481U,IDH1 IDH2&TERT PROMOTER NGS,,,582.54,1126.66,15
HCPCS,0481U,Idh1 idh2&tert promoter ngs,,,22.32,28.19,6
HCPCS,0481U0,IDH1 IDH2&TERT PROMOTER NGS,,,582.54,582.54,1
HCPCS,0482U,OB PE BIOCHEM ASY SFLT1&PLGF,,,111.3,215.26,15
HCPCS,0482U,Ob pe biochem asy sflt1&plgf,,,22.32,28.19,6
HCPCS,0482U0,OB PE BIOCHEM ASY SFLT1&PLGF,,,111.3,111.3,1
HCPCS,0483T,TMVI PERCUTANEOUS APPROACH,,,1497.54,1497.54,1
HCPCS,0483T,TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH,15216.0,9890.4,1940.0,16924.5,43
HCPCS,0483T0,TMVI PERCUTANEOUS APPROACH,,,1497.54,1497.54,1
HCPCS,0483U,NFCT DS NG GYRA S91F PT MUT,,,35.09,38.6,4
HCPCS,0483U,Nfct ds ng gyra s91f pt mut,,,4.02,5.08,6
HCPCS,0484T,TMVI TRANSTHORACIC EXPOSURE,,,1861.52,1861.52,1
HCPCS,0484T,TMVI W/PROSTHETIC VALVE TRANSTHORACIC EXPOSURE,22684.0,14744.599999999999,1940.0,26564.0,43
HCPCS,0484T0,TMVI TRANSTHORACIC EXPOSURE,,,1861.52,1861.52,1
HCPCS,0484U,NFCT DS MGEN 23S RRNA PT MUT,,,35.09,38.6,4
HCPCS,0484U,Nfct ds mgen 23s rrna pt mut,,,4.02,5.08,6
HCPCS,0485T,OCT MID EAR I&R UNILATERAL,,,10.2,85.1,16
HCPCS,0485T,Oct mid ear i&r unilateral,,,19.1,24.12,6
HCPCS,0485T0,OCT MID EAR I&R UNILATERAL,,,10.2,10.2,1
HCPCS,0485TTC,OCT MID EAR I&R UNILATERAL,,,10.2,10.2,1
HCPCS,0485U,ONC SOL TUM CFDNA&RNA NGS GM,,,3649.48,4014.43,4
HCPCS,0485U,Onc sol tum cfdna&rna ngs gm,,,22.32,28.19,6
HCPCS,0486T,OCT MID EAR I&R BILATERAL,,,26.9,85.1,16
HCPCS,0486T,Oct mid ear i&r bilateral,,,19.1,24.12,6
HCPCS,0486T0,OCT MID EAR I&R BILATERAL,,,26.9,26.9,1
HCPCS,0486TTC,OCT MID EAR I&R BILATERAL,,,26.9,26.9,1
HCPCS,0486U,ONC PAN SOL TUM NGS CFCTDNA,,,1644.25,1808.68,4
HCPCS,0486U,Onc pan sol tum ngs cfctdna,,,22.32,28.19,6
HCPCS,0487T,Trvg biomchn mapg w/reprt,,,66.35,83.81,6
HCPCS,0487U,ONC SOL TUM CFCDNA TGSAP 84,,,2522.53,4878.65,15
HCPCS,0487U,Onc sol tum cfcdna tgsap 84,,,22.32,28.19,6
HCPCS,0487U0,ONC SOL TUM CFCDNA TGSAP 84,,,2522.53,2522.53,1
HCPCS,0488T,DIABETES PREV ONLINE/ELEC,,,58.32,58.32,1
HCPCS,0488T,Diabetes prev online/elec,,,34.32,43.36,6
HCPCS,0488T0,DIABETES PREV ONLINE/ELEC,,,58.32,58.32,1
HCPCS,0488U,OB FETAL AG NIPT CFDNA ALYS,,,655.82,1268.37,4
HCPCS,0488U,Ob fetal ag nipt cfdna alys,,,22.32,28.19,6
HCPCS,0488U0,OB FETAL AG NIPT CFDNA ALYS,,,655.82,655.82,1
HCPCS,0489T,REGN CELL TX SCLDR HANDS,,,176.09,176.09,1
HCPCS,0489T,Regn cell tx scldr hands,,,275.45,347.94,6
HCPCS,0489T0,REGN CELL TX SCLDR HANDS,,,176.09,176.09,1
HCPCS,0489U,Ob sgnipt cfdna seq alys 1+,,,22.32,28.19,6
HCPCS,0490T,REGN CELL TX SCLDR H MLT INJ,,,577.18,577.18,1
HCPCS,0490T,Regn cell tx scldr h mlt inj,,,275.45,347.94,6
HCPCS,0490T0,REGN CELL TX SCLDR H MLT INJ,,,577.18,577.18,1
HCPCS,0490U,ONC CUTAN/UVEAL MLNMA CD146,,,2103.84,4068.89,15
HCPCS,0490U,Onc cutan/uveal mlnma cd146,,,22.32,28.19,6
HCPCS,0490U0,ONC CUTAN/UVEAL MLNMA CD146,,,2103.84,2103.84,1
HCPCS,0491T,Abl lsr opn wnd 1st 20 sqcm,,,241.35,304.86,6
HCPCS,0491U,ONC SOL TUM CTC SLCT ER PRTN,,,2103.84,4068.89,15
HCPCS,0491U,Onc sol tum ctc slct er prtn,,,22.32,28.19,6
HCPCS,0491U0,ONC SOL TUM CTC SLCT ER PRTN,,,2103.84,2103.84,1
HCPCS,0492T,Abl lsr opn wnd addl 20 sqcm,,,241.35,304.86,6
HCPCS,0492U,ONC SOL TUM CTC SLCTN PD-L1,,,2103.84,4068.89,15
HCPCS,0492U,Onc sol tum ctc slctn pd-l1,,,22.32,28.19,6
HCPCS,0492U0,ONC SOL TUM CTC SLCTN PD-L1,,,2103.84,2103.84,1
HCPCS,0493U,TRNSPL MED QUAN DD-CFDNA NGS,,,2378.81,4600.68,15
HCPCS,0493U,Trnspl med quan dd-cfdna ngs,,,1109.84,1401.9,6
HCPCS,0493U0,TRNSPL MED QUAN DD-CFDNA NGS,,,2378.81,2378.81,1
HCPCS,0494T,PREP & CANNULJ CDVR DON LUNG,,,331.39,331.39,1
HCPCS,0494T,Prep & cannulj cdvr don lung,,,3411.14,4308.8,6
HCPCS,0494T0,PREP & CANNULJ CDVR DON LUNG,,,331.39,331.39,1
HCPCS,0494U,RBC AG FTL RHD GENE ALYS NGS,,,655.82,1268.37,15
HCPCS,0494U,Rbc ag ftl rhd gene alys ngs,,,22.32,28.19,6
HCPCS,0494U0,RBC AG FTL RHD GENE ALYS NGS,,,655.82,655.82,1
HCPCS,0495T,MNTR CDVR DON LNG 1ST 2 HRS,,,335.92,335.92,1
HCPCS,0495T,Mntr cdvr don lng 1st 2 hrs,,,3411.14,4308.8,6
HCPCS,0495T0,MNTR CDVR DON LNG 1ST 2 HRS,,,335.92,335.92,1
HCPCS,0495U,ONC PRST8 ALYS CRCG PLSM PRT,,,656.64,1269.96,15
HCPCS,0495U,Onc prst8 alys crcg plsm prt,,,22.32,28.19,6
HCPCS,0495U0,ONC PRST8 ALYS CRCG PLSM PRT,,,656.64,656.64,1
HCPCS,0496T,MNTR CDVR DON LNG EA ADDL HR,,,263.12,263.12,1
HCPCS,0496T,Mntr cdvr don lng ea addl hr,,,3411.14,4308.8,6
HCPCS,0496T0,MNTR CDVR DON LNG EA ADDL HR,,,263.12,263.12,1
HCPCS,0496U,ONC CLRCT CFDNA 8/7 GENES,,,485.86,534.45,4
HCPCS,0496U,Onc clrct cfdna 8/7 genes,,,76.88,97.12,6
HCPCS,0497T,Xtrnl pt act ecg in-off conn,,,16.03,20.24,6
HCPCS,0497U,ONC PRST8 MRNA RT-PCR 6GENES,,,3346.27,6471.78,15
HCPCS,0497U,Onc prst8 mrna rt-pcr 6genes,,,22.32,28.19,6
HCPCS,0497U0,ONC PRST8 MRNA RT-PCR 6GENES,,,3346.27,3346.27,1
HCPCS,0498T,Xtrnl pt act ecg r&i pr 30 d,,,16.03,20.24,6
HCPCS,0498U,ONC CLRCT NGS MUT DETC 43GEN,,,1345.31,1479.84,4
HCPCS,0498U,Onc clrct ngs mut detc 43gen,,,22.32,28.19,6
HCPCS,0499T,Cysto f/urtl strix/stenosis,,,1849.92,2336.74,6
HCPCS,0499U,ONC CLRCT&LNG DNA NGS 8GENES,,,516.6,999.11,15
HCPCS,0499U,Onc clrct&lng dna ngs 8genes,,,22.32,28.19,6
HCPCS,0499U0,ONC CLRCT&LNG DNA NGS 8GENES,,,516.6,516.6,1
HCPCS,0500F,INITIAL PRENATAL CARE VISIT,,,0.01,0.01,1
HCPCS,0500F0,INITIAL PRENATAL CARE VISIT,,,0.01,0.01,1
HCPCS,0500T,Hpv 5+ hi risk hpv types,,,4.02,5.08,6
HCPCS,0500U,AUTOINFLAM DS VEXAS SYND DNA,,,151.55,293.09,15
HCPCS,0500U,Autoinflam ds vexas synd dna,,,22.32,28.19,6
HCPCS,0500U0,AUTOINFLAM DS VEXAS SYND DNA,,,151.55,151.55,1
HCPCS,0501F,PRENATAL FLOW SHEET,,,0.01,0.01,1
HCPCS,0501F0,PRENATAL FLOW SHEET,,,0.01,0.01,1
HCPCS,0501T,Cor ffr derived cor cta data,,,242.66,306.52,6
HCPCS,0501U,Onc clrc bld quan meas cfdna,,,22.32,28.19,6
HCPCS,0502F,SUBSEQUENT PRENATAL CARE,,,0.01,0.01,1
HCPCS,0502F0,SUBSEQUENT PRENATAL CARE,,,0.01,0.01,1
HCPCS,0502U,HPV E6/E7 MRK HI-RSK TYP CRV,,,30.32,58.64,15
HCPCS,0502U,Hpv e6/e7 mrk hi-rsk typ crv,,,22.32,28.19,6
HCPCS,0502U0,HPV E6/E7 MRK HI-RSK TYP CRV,,,30.32,30.32,1
HCPCS,0503F,POSTPARTUM CARE VISIT,,,0.01,0.01,1
HCPCS,0503F0,POSTPARTUM CARE VISIT,,,0.01,0.01,1
HCPCS,0503T,Cor ffr alys gnrj ffr mdl,,,242.66,306.52,6
HCPCS,0503U,NEURO ALZ DS ßAMYL&TAU PRTN,,,648.0,1253.25,15
HCPCS,0503U,Neuro alz ds bamyl&tau prtn,,,22.32,28.19,6
HCPCS,0503U0,NEURO ALZ DS ßAMYL&TAU PRTN,,,648.0,648.0,1
HCPCS,0504U,NFCT DS UTI ID 17 PATH ORGS,,,360.09,696.44,15
HCPCS,0504U,Nfct ds uti id 17 path orgs,,,92.55,116.9,6
HCPCS,0504U0,NFCT DS UTI ID 17 PATH ORGS,,,360.09,360.09,1
HCPCS,0505F,HEMODIALYSIS PLAN DOCD,,,0.01,0.01,1
HCPCS,0505F0,HEMODIALYSIS PLAN DOCD,,,0.01,0.01,1
HCPCS,0505T,EV FEMPOP ARTL REVSC,,,6407.21,6407.21,1
HCPCS,0505T,EV FEMPOP ARTL REVSC TCAT PLMT IV ST GRF & CLSR,58971.0,38331.15,3686.0,53073.9,40
HCPCS,0505T0,EV FEMPOP ARTL REVSC,,,6407.21,6407.21,1
HCPCS,0505U,NFCT DS VAG INFCTJ ID 32ORGS,,,587.33,1135.9,15
HCPCS,0505U,Nfct ds vag infctj id 32orgs,,,4.02,5.08,6
HCPCS,0505U0,NFCT DS VAG INFCTJ ID 32ORGS,,,587.33,587.33,1
HCPCS,0506T,MAC PGMT OPT DNS MEAS HFP,,,54.63,128.79,16
HCPCS,0506T,Mac pgmt opt dns meas hfp,,,31.76,40.12,6
HCPCS,0506T0,MAC PGMT OPT DNS MEAS HFP,,,54.63,54.63,1
HCPCS,0506TTC,MAC PGMT OPT DNS MEAS HFP,,,54.63,54.63,1
HCPCS,0506U,GI BARRETTS ESOPHGL CELL 89,,,1674.44,3238.41,15
HCPCS,0506U,Gi barretts esophgl cell 89,,,22.32,28.19,6
HCPCS,0506U0,GI BARRETTS ESOPHGL CELL 89,,,1674.44,1674.44,1
HCPCS,0507F,PERITON DIALYSIS PLAN DOCD,,,0.01,0.01,1
HCPCS,0507F0,PERITON DIALYSIS PLAN DOCD,,,0.01,0.01,1
HCPCS,0507T,NEAR IFR 2IMG MIBMN GLND I&R,,,23.76,128.79,16
HCPCS,0507T,Near ifr 2img mibmn glnd i&r,,,31.76,40.12,6
HCPCS,0507T0,NEAR IFR 2IMG MIBMN GLND I&R,,,23.76,23.76,1
HCPCS,0507TTC,NEAR IFR 2IMG MIBMN GLND I&R,,,23.76,23.76,1
HCPCS,0507U,ONC OVR DNA WHOLE GEN W/5HMC,,,1002.24,1938.36,15
HCPCS,0507U,Onc ovr dna whole gen w/5hmc,,,22.32,28.19,6
HCPCS,0507U0,ONC OVR DNA WHOLE GEN W/5HMC,,,1002.24,1002.24,1
HCPCS,0508T,Pls echo us b1 dns meas tib,,,44.5,56.21,6
HCPCS,0508U,Trnsplj med dd-cfdna 40 snps,,,22.32,28.19,6
HCPCS,0509F,URINE INCON PLAN DOCD,,,0.01,0.01,1
HCPCS,0509F0,URINE INCON PLAN DOCD,,,0.01,0.01,1
HCPCS,0509T,PATTERN ERG W/I&R,,,54.41,675.17,16
HCPCS,0509T,Pattern erg w/i&r,,,45.31,57.23,6
HCPCS,0509T0,PATTERN ERG W/I&R,,,54.41,54.41,1
HCPCS,0509TTC,PATTERN ERG W/I&R,,,54.41,54.41,1
HCPCS,0509U,Trnsplj med dd-cfdna<12 snps,,,22.32,28.19,6
HCPCS,0510T,REMOVAL OF SINUS TARSI IMPLANT,16223.0,10544.95,1342.37,14600.7,40
HCPCS,0510T,RMVL SINUS TARSI IMPLANT,,,547.01,547.01,1
HCPCS,0510T0,RMVL SINUS TARSI IMPLANT,,,547.01,547.01,1
HCPCS,0510U,ONC PNCRTC CA ALG ALYS 16GEN,,,473.91,521.3,4
HCPCS,0510U,Onc pncrtc ca alg alys 16gen,,,22.32,28.19,6
HCPCS,0511T,REMOVAL AND REINSERTION OF SINUS TARSI IMPLANT,18213.0,11838.45,3342.0,16391.7,40
HCPCS,0511T,RMVL&RINSJ SINUS TARSI IMPLT,,,532.8,532.8,1
HCPCS,0511T0,RMVL&RINSJ SINUS TARSI IMPLT,,,532.8,532.8,1
HCPCS,0511U,ONC SOL TUM 3DMICROENVIR 36+,,,2621.26,5069.58,15
HCPCS,0511U,Onc sol tum 3dmicroenvir 36+,,,22.32,28.19,6
HCPCS,0511U0,ONC SOL TUM 3DMICROENVIR 36+,,,2621.26,2621.26,1
HCPCS,0512T,ESW INTEG WND HLG 1ST WND,,,191.88,430.81,15
HCPCS,0512T,Esw integ wnd hlg 1st wnd,,,241.35,304.86,6
HCPCS,0512T0,ESW INTEG WND HLG 1ST WND,,,191.88,191.88,1
HCPCS,0512U,ONC PRST8 ALYS DGTZ IMG MSI,,,610.2,1180.14,15
HCPCS,0512U,Onc prst8 alys dgtz img msi,,,22.32,28.19,6
HCPCS,0512U0,ONC PRST8 ALYS DGTZ IMG MSI,,,610.2,610.2,1
HCPCS,0513F,ELEV BP PLAN OF CARE DOCD,,,0.01,0.01,1
HCPCS,0513F0,ELEV BP PLAN OF CARE DOCD,,,0.01,0.01,1
HCPCS,0513T,ESW INTEG WND HLG EA ADDL,,,47.8,47.8,1
HCPCS,0513T,Esw integ wnd hlg ea addl,,,241.35,304.86,6
HCPCS,0513T0,ESW INTEG WND HLG EA ADDL,,,47.8,47.8,1
HCPCS,0513U,ONC PRST8 ALG ALYS MSI&HRD,,,610.2,1180.14,15
HCPCS,0513U,Onc prst8 alg alys msi&hrd,,,22.32,28.19,6
HCPCS,0513U0,ONC PRST8 ALG ALYS MSI&HRD,,,610.2,610.2,1
HCPCS,0514F,CARE PLAN HGB DOCD ESA PT,,,0.01,0.01,1
HCPCS,0514F0,CARE PLAN HGB DOCD ESA PT,,,0.01,0.01,1
HCPCS,0514T,Intraop vis axis id pt fixj,,,45.31,57.23,6
HCPCS,0514U,GI IBD IA QUAN DETER ADL LVL,,,33.33,64.45,15
HCPCS,0514U,Gi ibd ia quan deter adl lvl,,,5.81,7.34,6
HCPCS,0514U0,GI IBD IA QUAN DETER ADL LVL,,,33.33,33.33,1
HCPCS,0515T,INSERTION WRLS CAR STIMULATOR LV PACG COMPL SYS,24003.5,15602.275000000001,1036.3,70939.0,53
HCPCS,0515T,INSJ WCS LV COMPL SYS,,,539.73,539.73,1
HCPCS,0515T0,INSJ WCS LV COMPL SYS,,,539.73,539.73,1
HCPCS,0515U,GI IBD IA QUAN DETER IFX LVL,,,33.33,64.45,15
HCPCS,0515U,Gi ibd ia quan deter ifx lvl,,,5.81,7.34,6
HCPCS,0515U0,GI IBD IA QUAN DETER IFX LVL,,,33.33,33.33,1
HCPCS,0516F,ANEMIA PLAN OF CARE DOCD,,,0.01,0.01,1
HCPCS,0516F0,ANEMIA PLAN OF CARE DOCD,,,0.01,0.01,1
HCPCS,0516T,INSERTION WRLS CAR STIMULATOR LV PACG ELTRD ONLY,16620.5,10803.325,916.39,22690.56,53
HCPCS,0516T,INSJ WCS LV ELTRD ONLY,,,452.06,452.06,1
HCPCS,0516T0,INSJ WCS LV ELTRD ONLY,,,452.06,452.06,1
HCPCS,0516U,RX METAB RXGENOMIC GNOTYP 40,,,360.09,696.44,15
HCPCS,0516U,Rx metab rxgenomic gnotyp 40,,,22.32,28.19,6
HCPCS,0516U0,RX METAB RXGENOMIC GNOTYP 40,,,360.09,360.09,1
HCPCS,0517F,GLAUCOMA PLAN OF CARE DOCD,,,0.01,0.01,1
HCPCS,0517F0,GLAUCOMA PLAN OF CARE DOCD,,,0.01,0.01,1
HCPCS,0517T,INSERTION WRLS CAR STIMULATOR LV PACG BTH COMPNT,13358.0,8682.7,676.84,22690.56,53
HCPCS,0517T,INSJ WCS LV BOTH COMPNT PG,,,379.58,379.58,1
HCPCS,0517T0,INSJ WCS LV BOTH COMPNT PG,,,379.58,379.58,1
HCPCS,0517U,THER RX MNTR 80+ PSYACTIV RX,,,213.34,412.6,15
HCPCS,0517U,Ther rx mntr 80+ psyactiv rx,,,5.81,7.34,6
HCPCS,0517U0,THER RX MNTR 80+ PSYACTIV RX,,,213.34,213.34,1
HCPCS,0518F,FALL PLAN OF CARE DOCD,,,0.01,0.01,1
HCPCS,0518F0,FALL PLAN OF CARE DOCD,,,0.01,0.01,1
HCPCS,0518T,REMOVAL PG WCS LV PACG BATTERY COMPONENT ONLY,10362.5,6735.625,462.69,16376.4,53
HCPCS,0518T,RMVL PG WCS LV BATTERY ONLY,,,258.94,258.94,1
HCPCS,0518T0,RMVL PG WCS LV BATTERY ONLY,,,258.94,258.94,1
HCPCS,0518U,THER RX MNTR 90+ PN&MTL HLTH,,,213.34,412.6,15
HCPCS,0518U,Ther rx mntr 90+ pn&mtl hlth,,,5.81,7.34,6
HCPCS,0518U0,THER RX MNTR 90+ PN&MTL HLTH,,,213.34,213.34,1
HCPCS,0519F,PLAND CHEMO DOCD B/4 TXMNT,,,0.01,0.01,1
HCPCS,0519F0,PLAND CHEMO DOCD B/4 TXMNT,,,0.01,0.01,1
HCPCS,0519T,REMOVAL&RPLCMT PG WCS LV PACG BOTH COMPONENTS,27427.5,17827.875,678.7,47093.4,53
HCPCS,0519T,RMV&RPLCMT PG WCS LV BOTH,,,654.11,654.11,1
HCPCS,0519T0,RMV&RPLCMT PG WCS LV BOTH,,,654.11,654.11,1
HCPCS,0519U,THER RX MNTR MEDS P/D/A 110+,,,213.34,412.6,15
HCPCS,0519U,Ther rx mntr meds p/d/a 110+,,,5.81,7.34,6
HCPCS,0519U0,THER RX MNTR MEDS P/D/A 110+,,,213.34,213.34,1
HCPCS,0520F,RAD DOS LIMTS B/4 3D RAD,,,0.01,0.01,1
HCPCS,0520F0,RAD DOS LIMTS B/4 3D RAD,,,0.01,0.01,1
HCPCS,0520T,RMV&RPLCMT PG WCS LV BATTERY,,,492.59,492.59,1
HCPCS,0520T,RMVL&RPLCMT PG WCS LV PACG BATTERY COMPNT ONLY,12679.5,8241.675,956.21,70939.0,53
HCPCS,0520T0,RMV&RPLCMT PG WCS LV BATTERY,,,492.59,492.59,1
HCPCS,0520U,THER RX MNTR 200+ RX/SBSTS,,,213.34,412.6,15
HCPCS,0520U,Ther rx mntr 200+ rx/sbsts,,,5.81,7.34,6
HCPCS,0520U0,THER RX MNTR 200+ RX/SBSTS,,,213.34,213.34,1
HCPCS,0521F,PLAN OF CARE 4 PAIN DOCD,,,0.01,0.01,1
HCPCS,0521F0,PLAN OF CARE 4 PAIN DOCD,,,0.01,0.01,1
HCPCS,0521T,INTERROG DEV EVAL WCS IP,,,26.67,26.67,2
HCPCS,0521T,INTERROG DEV EVAL WRLS CAR STIMULATOR IN PERSON,215.5,140.075,21.15,2693.0,61
HCPCS,0521T0,INTERROG DEV EVAL WCS IP,,,26.67,26.67,1
HCPCS,0521TTC,INTERROG DEV EVAL WCS IP,,,26.67,26.67,1
HCPCS,0521U,RF IGA&IGM CCP ANTB SR-A IA,,,51.8,56.98,4
HCPCS,0521U,Rf iga&igm ccp antb sr-a ia,,,22.32,28.19,6
HCPCS,0522T,PRGRMG DEV EVAL WCS IP,,,29.94,29.94,2
HCPCS,0522T,PRGRMG DEVICE EVAL WRLS CAR STIMULATOR IN PERSON,294.5,191.425,21.15,2693.0,61
HCPCS,0522T0,PRGRMG DEV EVAL WCS IP,,,29.94,29.94,1
HCPCS,0522TTC,PRGRMG DEV EVAL WCS IP,,,29.94,29.94,1
HCPCS,0522U,CA VI PSP&SP1 ANTB CL SEMIQL,,,260.5,286.55,4
HCPCS,0522U,Ca vi psp&sp1 antb cl semiql,,,22.32,28.19,6
HCPCS,0523T,NTRAPX C FFR W/3D FUNCJL MAP,,,113.24,113.24,1
HCPCS,0523T0,NTRAPX C FFR W/3D FUNCJL MAP,,,113.24,113.24,1
HCPCS,0523U,ONC SOLTUM DNA NGS SNV 22GEN,,,1352.09,1487.3,4
HCPCS,0523U,Onc soltum dna ngs snv 22gen,,,22.32,28.19,6
HCPCS,0524T,EV CATH DIR CHEM ABLTJ W/IMG,,,1680.92,6824.3,15
HCPCS,0524T,Ev cath dir chem abltj w/img,,,1583.18,1999.8,6
HCPCS,0524T0,EV CATH DIR CHEM ABLTJ W/IMG,,,1680.92,1680.92,1
HCPCS,0524U,OB PE SFLT-1/PLGF IA SRM/PLS,,,128.82,141.7,4
HCPCS,0524U,Ob pe sflt-1/plgf ia srm/pls,,,22.32,28.19,6
HCPCS,0525F,INITIAL VISIT FOR EPISODE,,,0.01,0.01,1
HCPCS,0525F0,INITIAL VISIT FOR EPISODE,,,0.01,0.01,1
HCPCS,0525T,INSERTION/REPLACEMENT COMPLETE IIMS,18738.0,12179.7,4706.22,41349.42,40
HCPCS,0525T,INSJ/RPLCMT COMPL IIMS,,,449.27,449.27,1
HCPCS,0525T0,INSJ/RPLCMT COMPL IIMS,,,449.27,449.27,1
HCPCS,0525U,ONC SPHRD CELL CUL 11-RX PNL,,,3033.86,3337.25,4
HCPCS,0525U,Onc sphrd cell cul 11-rx pnl,,,22.32,28.19,6
HCPCS,0526F,SUBS VISIT FOR EPISODE,,,0.01,0.01,1
HCPCS,0526F0,SUBS VISIT FOR EPISODE,,,0.01,0.01,1
HCPCS,0526T,INSERTION/REPLACEMENT IIMS ELECTRODE ONLY,13548.0,8806.2,916.39,20773.0,40
HCPCS,0526T,INSJ/RPLCMT IIMS ELTRD ONLY,,,385.13,385.13,1
HCPCS,0526T0,INSJ/RPLCMT IIMS ELTRD ONLY,,,385.13,385.13,1
HCPCS,0526U,Nefro rnl trnspl quan cxcl10,,,22.32,28.19,6
HCPCS,0527T,INSERTION/REPLACEMENT IIMS IMPLANTABLE MNTR ONLY,41380.0,26897.0,3686.0,37242.0,40
HCPCS,0527T,INSJ/RPLCMT IIMS IMPLT MNTR,,,363.99,363.99,1
HCPCS,0527T0,INSJ/RPLCMT IIMS IMPLT MNTR,,,363.99,363.99,1
HCPCS,0527U,HSV 1&2 VZV AMP PRB TQ PTHGN,,,142.63,156.89,4
HCPCS,0527U,Hsv 1&2 vzv amp prb tq pthgn,,,4.02,5.08,6
HCPCS,0528F,RCMND FLW-UP 10 YRS DOCD,,,0.01,0.01,1
HCPCS,0528F0,RCMND FLW-UP 10 YRS DOCD,,,0.01,0.01,1
HCPCS,0528T,PRGRMG DEV EVAL IIMS IP,,,45.41,45.41,2
HCPCS,0528T,PRGRMG DEVICE EVAL IIMS IN PERSON,186.0,120.9,21.15,2693.0,48
HCPCS,0528T0,PRGRMG DEV EVAL IIMS IP,,,45.41,45.41,1
HCPCS,0528TTC,PRGRMG DEV EVAL IIMS IP,,,45.41,45.41,1
HCPCS,0528U,LRT IAD 18BCT/8VIR&7ARG RNA,,,634.84,698.32,4
HCPCS,0528U,Lrt iad 18bct/8vir&7arg rna,,,4.02,5.08,6
HCPCS,0529F,INTRVL 3/>YR PTS CLNSCP DOCD,,,0.01,0.01,1
HCPCS,0529F0,INTRVL 3/>YR PTS CLNSCP DOCD,,,0.01,0.01,1
HCPCS,0529T,INTERROG DEV EVAL IIMS IP,,,32.93,32.93,2
HCPCS,0529T,INTERROGATION DEVICE EVAL IIMS IN PERSON,186.0,120.9,21.15,2693.0,48
HCPCS,0529T0,INTERROG DEV EVAL IIMS IP,,,32.93,32.93,1
HCPCS,0529TTC,INTERROG DEV EVAL IIMS IP,,,32.93,32.93,1
HCPCS,0529U,Hem vte snp f2&f5 gen leiden,,,22.32,28.19,6
HCPCS,0530T,REMOVAL COMPLETE IIMS,,,660.03,660.03,1
HCPCS,0530T,REMOVAL COMPLETE IIMS INCL IMG S&I,18196.0,11827.4,3342.0,16376.4,40
HCPCS,0530T0,REMOVAL COMPLETE IIMS,,,660.03,660.03,1
HCPCS,0530U,ONC PAN-SOL TUM CTDNA 77 GEN,,,2919.6,3211.56,4
HCPCS,0530U,Onc pan-sol tum ctdna 77 gen,,,22.32,28.19,6
HCPCS,0531T,REMOVAL IIMS ELECTRODE ONLY,,,498.83,498.83,1
HCPCS,0531T,REMOVAL IIMS ELECTRODE ONLY INCL IMG S&I,18196.0,11827.4,916.39,16376.4,40
HCPCS,0531T0,REMOVAL IIMS ELECTRODE ONLY,,,498.83,498.83,1
HCPCS,0531U,Nfct ds afb&inv fng 673orgs,,,22.32,28.19,6
HCPCS,0532T,REMOVAL IIMS IMPLANTABLE MNTR ONLY INCL IMG S&I,18196.0,11827.4,3342.0,16376.4,40
HCPCS,0532T,REMOVAL IIMS IMPLT MNTR ONLY,,,351.15,351.15,1
HCPCS,0532T0,REMOVAL IIMS IMPLT MNTR ONLY,,,351.15,351.15,1
HCPCS,0532U,RARE DS WHLGEN&MITOCHDRL DNA,,,5031.2,5534.32,4
HCPCS,0532U,Rare ds whlgen&mitochdrl dna,,,22.32,28.19,6
HCPCS,0533T,Cont rec mvmt do 6-10 days,,,33.85,42.76,6
HCPCS,0533U,RX METAB ADVRS GNOTYP 16GENS,,,416.78,458.46,4
HCPCS,0533U,Rx metab advrs gnotyp 16gens,,,22.32,28.19,6
HCPCS,0534T,Cont rec mvmt do setup&train,,,41.57,52.51,6
HCPCS,0534U,Onc prst8 mirna snp 32 vrnt,,,22.32,28.19,6
HCPCS,0535F,DYSPNEA MNGMNT PLAN DOCD,,,0.01,0.01,1
HCPCS,0535F0,DYSPNEA MNGMNT PLAN DOCD,,,0.01,0.01,1
HCPCS,0535T,Cont rec mvmt do reprt cnfig,,,33.85,42.76,6
HCPCS,0535U,PFAS LC-MS/MS PLSM/SRM QUAN,,,62.14,68.35,4
HCPCS,0535U,Pfas lc-ms/ms plsm/srm quan,,,5.78,7.3,6
HCPCS,0536T,Cont rec mvmt do dl w/i&r,,,33.85,42.76,6
HCPCS,0536U,RBCAG FTL RHD PCR ALYS EXON4,,,192.0,211.2,4
HCPCS,0536U,Rbcag ftl rhd pcr alys exon4,,,22.32,28.19,6
HCPCS,0537T,Bld drv t lymphcyt car-t cll,,,532.47,672.59,6
HCPCS,0537U,ONC CLRCT CA CFDNA >2500 DMR,,,1291.68,1644.5,5
HCPCS,0537U,Onc clrct ca cfdna >2500 dmr,,,22.32,28.19,6
HCPCS,0537U0,ONC CLRCT CA CFDNA >2500 DMR,,,1291.68,1291.68,1
HCPCS,0538T,Bld drv t lymphcyt prep trns,,,532.47,672.59,6
HCPCS,0538U,ONC SOL TUM NGTS FFPE 600GEN,,,2989.55,3288.51,4
HCPCS,0538U,Onc sol tum ngts ffpe 600gen,,,22.32,28.19,6
HCPCS,0539T,Receipt&prep car-t cll admn,,,532.47,672.59,6
HCPCS,0539U,ONC SOL TUMOR CFCTDNA 152GEN,,,3288.51,3617.36,4
HCPCS,0539U,Onc sol tumor cfctdna 152gen,,,22.32,28.19,6
HCPCS,0540F,GLUCO MNGMNT PLAN DOCD,,,0.01,0.01,1
HCPCS,0540F0,GLUCO MNGMNT PLAN DOCD,,,0.01,0.01,1
HCPCS,0540T,Car-t cll admn autologous,,,532.47,672.59,6
HCPCS,0540U,TRNSPLJ MED QUAN DD-CFDNA,,,2753.25,3028.58,4
HCPCS,0540U,Trnsplj med quan dd-cfdna,,,22.32,28.19,6
HCPCS,0541T,MYOCARDIAL IMAGING MCG,,,328.19,1150.43,15
HCPCS,0541T,Myocardial imaging mcg,,,145.46,183.74,6
HCPCS,0541T0,MYOCARDIAL IMAGING MCG,,,328.19,328.19,1
HCPCS,0541U,Cv ds hdl rct cec lc-ms/ms 5,,,22.32,28.19,6
HCPCS,0542T,MYOCARDIAL IMAGING MCG I&R,,,15.96,15.96,1
HCPCS,0542T,Myocardial imaging mcg i&r,,,145.46,183.74,6
HCPCS,0542T0,MYOCARDIAL IMAGING MCG I&R,,,15.96,15.96,1
HCPCS,0542U,Nefro renal trnspl ur nmr 84,,,22.32,28.19,6
HCPCS,0543T,TA MV RPR W/ARTIF CHORD TEND,,,1610.92,1610.92,1
HCPCS,0543T,Ta mv rpr w/artif chord tend,,,8538.66,10785.67,6
HCPCS,0543T0,TA MV RPR W/ARTIF CHORD TEND,,,1610.92,1610.92,1
HCPCS,0543U,ONC SOL TUM NGS DNA 517 GENS,,,2989.55,3288.51,4
HCPCS,0543U,Onc sol tum ngs dna 517 gens,,,22.32,28.19,6
HCPCS,0544T,TCAT MV ANNULUS RCNSTJ,,,1612.29,1612.29,1
HCPCS,0544T,Tcat mv annulus rcnstj,,,8538.66,10785.67,6
HCPCS,0544T0,TCAT MV ANNULUS RCNSTJ,,,1612.29,1612.29,1
HCPCS,0544U,Nefro trnsp mntr 48vrnt dpcr,,,22.32,28.19,6
HCPCS,0545F,FOLLOW UP CARE PLAN MDD DOCD,,,0.01,0.01,1
HCPCS,0545F0,FOLLOW UP CARE PLAN MDD DOCD,,,0.01,0.01,1
HCPCS,0545T,TCAT TV ANNULUS RCNSTJ,,,2233.69,2233.69,1
HCPCS,0545T,Tcat tv annulus rcnstj,,,8538.66,10785.67,6
HCPCS,0545T0,TCAT TV ANNULUS RCNSTJ,,,2233.69,2233.69,1
HCPCS,0545U,ACHR ANTB ID IMFLUOR LIVECLL,,,37.73,41.5,4
HCPCS,0545U,Achr antb id imfluor livecll,,,5.23,6.6,6
HCPCS,0546T,RF SPECTRSC NTRAOP MRGN ASMT,,,95.61,95.61,1
HCPCS,0546T0,RF SPECTRSC NTRAOP MRGN ASMT,,,95.61,95.61,1
HCPCS,0546U,LDNS LRP4 ANTB IMFLR LIVECLL,,,37.73,41.5,4
HCPCS,0546U,Ldns lrp4 antb imflr livecll,,,5.23,6.6,6
HCPCS,0547T,B1 MATRL QUAL TST MCRIND TIB,,,139.36,591.95,4
HCPCS,0547T,B1 matrl qual tst mcrind tib,,,44.5,56.21,6
HCPCS,0547T0,B1 MATRL QUAL TST MCRIND TIB,,,139.36,139.36,1
HCPCS,0547U,NEURFLMNT LT CHN CLEIA PLSM,,,116.23,127.85,4
HCPCS,0547U,Neurflmnt lt chn cleia plsm,,,4.02,5.08,6
HCPCS,0548T,Tprnl balo cntnc dev bi,,,3664.3,4628.59,6
HCPCS,0548U,GFAP CLEIA PLASMA,,,116.23,127.85,4
HCPCS,0548U,Gfap cleia plasma,,,4.02,5.08,6
HCPCS,0549T,Tprnl balo cntnc dev uni,,,1849.92,2336.74,6
HCPCS,0549U,ONC URTHL DNA MTHYLTD RT PCR,,,760.0,836.0,4
HCPCS,0549U,Onc urthl dna mthyltd rt pcr,,,22.32,28.19,6
HCPCS,0550F,CYTOPATH REPORT NONGYN SPCMN,,,0.01,0.01,1
HCPCS,0550F0,CYTOPATH REPORT NONGYN SPCMN,,,0.01,0.01,1
HCPCS,0550T,Tprnl balo cntnc dev rmvl ea,,,1849.92,2336.74,6
HCPCS,0550U,Onc prst8 elisa tot&free psa,,,5.78,7.3,6
HCPCS,0551F,CYTOPATH REPORT NON ROUTINE,,,0.01,0.01,1
HCPCS,0551F0,CYTOPATH REPORT NON ROUTINE,,,0.01,0.01,1
HCPCS,0551T,Tprnl balo cntnc dev adjmt,,,248.59,314.0,6
HCPCS,0551U,Tp ptau217 ult dgt prtn detj,,,22.32,28.19,6
HCPCS,0552T,LOW-LEVEL LASER THERAPY,,,6.78,6.78,1
HCPCS,0552T,Low-level laser therapy,,,17.96,22.69,6
HCPCS,0552T0,LOW-LEVEL LASER THERAPY,,,6.78,6.78,1
HCPCS,0552U,Repr med pga gdo te bx locus,,,22.32,28.19,6
HCPCS,0553T,Perq tcat iliac anast implt,,,6649.91,8399.88,6
HCPCS,0553U,REPR MED PGA EMBRY TE STRUX,,,759.05,834.96,4
HCPCS,0553U,Repr med pga embry te strux,,,22.32,28.19,6
HCPCS,0554T,B1 STR & FX RSK ANALYSIS,,,41.34,87.71,4
HCPCS,0554T,B1 str & fx rsk analysis,,,44.5,56.21,6
HCPCS,0554T0,B1 STR & FX RSK ANALYSIS,,,41.34,41.34,1
HCPCS,0554U,REPR MED PGA 24CHRM TE BX QC,,,759.05,834.96,4
HCPCS,0554U,Repr med pga 24chrm te bx qc,,,22.32,28.19,6
HCPCS,0555F,SYMPTOM MGMNT PLAN CARE DOCD,,,0.01,0.01,1
HCPCS,0555F0,SYMPTOM MGMNT PLAN CARE DOCD,,,0.01,0.01,1
HCPCS,0555T,B1 STR&FX RSK TRANSMIS DATA,,,10.52,53.1,18
HCPCS,0555T0,B1 STR&FX RSK TRANSMIS DATA,,,10.52,10.52,1
HCPCS,0555U,REPR MED PGA EMBRYONIC TE QC,,,759.05,834.96,4
HCPCS,0555U,Repr med pga embryonic te qc,,,22.32,28.19,6
HCPCS,0556F,PLAN CARE LIPID CONTROL DOCD,,,0.01,0.01,1
HCPCS,0556F0,PLAN CARE LIPID CONTROL DOCD,,,0.01,0.01,1
HCPCS,0556T,B1 STR & FX RSK ASSESSMENT,,,31.51,524.34,18
HCPCS,0556T,B1 str & fx rsk assessment,,,44.5,56.21,6
HCPCS,0556T0,B1 STR & FX RSK ASSESSMENT,,,31.51,31.51,1
HCPCS,0556U,NFCT DS P-S DNA&RNA 12 TRGTS,,,142.63,156.89,4
HCPCS,0556U,Nfct ds p-s dna&rna 12 trgts,,,22.32,28.19,6
HCPCS,0557F,PLAN CAREMNG ANGNL SYMPTDOCD,,,0.01,0.01,1
HCPCS,0557F0,PLAN CAREMNG ANGNL SYMPTDOCD,,,0.01,0.01,1
HCPCS,0557T,B1 STR & FX RSK I&R,,,10.52,21.92,4
HCPCS,0557T0,B1 STR & FX RSK I&R,,,10.52,10.52,1
HCPCS,0557U,NFCT DS BV DNA MRK VAG FLUID,,,262.99,289.29,4
HCPCS,0557U,Nfct ds bv dna mrk vag fluid,,,22.32,28.19,6
HCPCS,0558T,CT SCAN F/BIOMCHN CT ALYS,,,88.38,242.81,19
HCPCS,0558T,Ct scan f/biomchn ct alys,,,137.74,173.99,6
HCPCS,0558T0,CT SCAN F/BIOMCHN CT ALYS,,,242.81,242.81,1
HCPCS,0558TTC,CT SCAN F/BIOMCHN CT ALYS,,,242.81,242.81,1
HCPCS,0558U,ONC CLRCT ELISA BF7 AG SERUM,,,20.81,22.89,4
HCPCS,0558U,Onc clrct elisa bf7 ag serum,,,22.32,28.19,6
HCPCS,0559T,ANTMC MDL 3D PRINT 1ST CMPNT,,,15.61,152.83,18
HCPCS,0559T0,ANTMC MDL 3D PRINT 1ST CMPNT,,,15.61,15.61,1
HCPCS,0559U,ONC BRS QUAN ELISA BF9AG SRM,,,20.81,22.89,4
HCPCS,0559U,Onc brs quan elisa bf9ag srm,,,22.32,28.19,6
HCPCS,0560T,ANTMC MDL 3D PRINT EA ADDL,,,5.44,5.44,1
HCPCS,0560T0,ANTMC MDL 3D PRINT EA ADDL,,,5.44,5.44,1
HCPCS,0560U,ONC MRD GSA CFDNA BASELINE,,,3878.45,4266.3,4
HCPCS,0560U,Onc mrd gsa cfdna baseline,,,22.32,28.19,6
HCPCS,0561T,ANTMC GUIDE 3D PRINT 1ST GD,,,59.62,152.83,18
HCPCS,0561T0,ANTMC GUIDE 3D PRINT 1ST GD,,,73.93,73.93,1
HCPCS,0561U,ONC MRD GSA CFDNA SUBSEQUENT,,,794.49,873.94,4
HCPCS,0561U,Onc mrd gsa cfdna subsequent,,,22.32,28.19,6
HCPCS,0562T,ANTMC GUIDE 3D PRINT EA ADDL,,,19.66,19.66,1
HCPCS,0562T0,ANTMC GUIDE 3D PRINT EA ADDL,,,19.66,19.66,1
HCPCS,0562U,ONC SOL TUM TGSA 33GENS SNVS,,,597.91,657.7,4
HCPCS,0562U,Onc sol tum tgsa 33gens snvs,,,22.32,28.19,6
HCPCS,0563T,EVAC MEIBOMIAN GLND HEAT BI,,,26.45,128.79,15
HCPCS,0563T,Evac meibomian glnd heat bi,,,45.31,57.23,6
HCPCS,0563T0,EVAC MEIBOMIAN GLND HEAT BI,,,26.45,26.45,1
HCPCS,0563U,NFCT DS PTHGN-SNA 11VIR&4BCT,,,416.78,458.46,4
HCPCS,0563U,Nfct ds pthgn-sna 11vir&4bct,,,22.32,28.19,6
HCPCS,0564T,Onc chemo rx cytotox csc 14,,,5.81,7.34,6
HCPCS,0564U,NFCT DS PTHGN-SNA 10VIR&4BCT,,,416.78,458.46,4
HCPCS,0564U,Nfct ds pthgn-sna 10vir&4bct,,,22.32,28.19,6
HCPCS,0565T,AUTOL CELL IMPLT ADPS HRVG,,,469.39,469.39,1
HCPCS,0565T,Autol cell implt adps hrvg,,,114.29,144.36,6
HCPCS,0565T0,AUTOL CELL IMPLT ADPS HRVG,,,469.39,469.39,1
HCPCS,0565U,ONC HCC NGS DETC 6626EPIGALT,,,1160.0,1276.0,4
HCPCS,0565U,Onc hcc ngs detc 6626epigalt,,,22.32,28.19,6
HCPCS,0566T,AUTOL CELL IMPLT ADPS NJX,,,95.0,95.0,1
HCPCS,0566T,Autol cell implt adps njx,,,151.21,191.0,6
HCPCS,0566T0,AUTOL CELL IMPLT ADPS NJX,,,95.0,95.0,1
HCPCS,0566U,ONC LNG QPCR-BSD ALYS 13DMRS,,,416.78,458.46,4
HCPCS,0566U,Onc lng qpcr-bsd alys 13dmrs,,,22.32,28.19,6
HCPCS,0567T,Perm flp tube occls w/implt,,,1486.15,1877.24,6
HCPCS,0567U,RARE DS WHL GEN SEQ SRS&LRS,,,5031.2,5534.32,4
HCPCS,0567U,Rare ds whl gen seq srs&lrs,,,22.32,28.19,6
HCPCS,0568T,Intro mix saline&air f/ssg,,,136.83,172.84,6
HCPCS,0568U,NEUROL DEMENTIA BAMYL PTAU,,,897.0,986.7,4
HCPCS,0568U,Neurol dementia bamyl ptau,,,22.32,28.19,6
HCPCS,0569T,TTVR PERCUTANEOUS APPROACH INITIAL PROSTHESIS,15087.0,9806.55,1940.0,17006.4,43
HCPCS,0569T,TTVR PERQ APPR 1ST PROSTH,,,1365.12,1365.12,1
HCPCS,0569T0,TTVR PERQ APPR 1ST PROSTH,,,1365.12,1365.12,1
HCPCS,0569U,Onc sol tum ngs tmm>20000dmr,,,22.32,28.19,6
HCPCS,0570T,TTVR PERCUTANEOUS APPROACH EACH ADDL PROSTHESIS,10560.5,6864.325,853.03,11278.0,43
HCPCS,0570T,TTVR PERQ EA ADDL PROSTH,,,458.25,458.25,1
HCPCS,0570T0,TTVR PERQ EA ADDL PROSTH,,,458.25,458.25,1
HCPCS,0570U,NEUROL TBI ALYS GFAP&UCH-L1,,,260.5,286.55,4
HCPCS,0570U,Neurol tbi alys gfap&uch-l1,,,22.32,28.19,6
HCPCS,0571T,INSJ/RPLCMT ICDS SS ELTRD,,,763.32,69514.79,15
HCPCS,0571T,INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE,9806.0,6373.9,1119.88,9806.0,13
HCPCS,0571T,Insj/rplcmt icds ss eltrd,,,13248.3,16734.7,6
HCPCS,0571T0,INSJ/RPLCMT ICDS SS ELTRD,,,763.32,763.32,1
HCPCS,0571U,ONC SOL TUM DNA80&RNA10G NGS,,,2919.6,3211.56,4
HCPCS,0571U,Onc sol tum dna80&rna10g ngs,,,22.32,28.19,6
HCPCS,0572T,INSERTION SS DFB ELECTRODE,,,492.59,17943.69,15
HCPCS,0572T,INSJ SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,2484.0,1614.6,913.6,2484.0,13
HCPCS,0572T,Insertion ss dfb electrode,,,916.39,1157.54,6
HCPCS,0572T0,INSERTION SS DFB ELECTRODE,,,492.59,492.59,1
HCPCS,0572U,Onc prst8 httl qfish whl bld,,,22.32,28.19,6
HCPCS,0573T,REMOVAL SS DFB ELECTRODE,,,365.36,7890.6,15
HCPCS,0573T,RMVL SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,10278.0,6680.7,694.36,10278.0,13
HCPCS,0573T,Removal ss dfb electrode,,,916.39,1157.54,6
HCPCS,0573T0,REMOVAL SS DFB ELECTRODE,,,365.36,365.36,1
HCPCS,0573U,Onc pancreas 3bmrk pclf alg,,,22.32,28.19,6
HCPCS,0574T,REPOS PREV IMPL SS IMPLTBL DFB PACING ELTRD,2835.0,1842.75,808.21,2835.0,13
HCPCS,0574T,REPOS PREV SS IMPL DFB ELTRD,,,433.31,7890.6,15
HCPCS,0574T,Repos prev ss impl dfb eltrd,,,916.39,1157.54,6
HCPCS,0574T0,REPOS PREV SS IMPL DFB ELTRD,,,433.31,433.31,1
HCPCS,0574U,Mtb cfp-10 serum/plsm lc-ms,,,25.65,32.4,6
HCPCS,0575F,HIV RNA PLAN CARE DOCD,,,0.01,0.01,1
HCPCS,0575F0,HIV RNA PLAN CARE DOCD,,,0.01,0.01,1
HCPCS,0575T,PRGRMG DEV EVAL ICDS SS IP,,,37.43,80.85,15
HCPCS,0575T,Prgrmg dev eval icds ss ip,,,21.15,26.71,6
HCPCS,0575T0,PRGRMG DEV EVAL ICDS SS IP,,,74.94,74.94,1
HCPCS,0575U,TRNSPLJ MED LAR RTPCR 4GENES,,,380.0,418.0,4
HCPCS,0575U,Trnsplj med lar rtpcr 4genes,,,22.32,28.19,6
HCPCS,0576T,INTERROG DEV EVAL ICDS SS IP,,,37.43,80.85,15
HCPCS,0576T,INTERROGATION DEV EVAL ICDS W/SS ELTRD IN PERSON,402.0,261.3,96.36,402.0,13
HCPCS,0576T,Interrog dev eval icds ss ip,,,21.15,26.71,6
HCPCS,0576T0,INTERROG DEV EVAL ICDS SS IP,,,66.13,66.13,1
HCPCS,0576U,TRNSPLJ MED LAR QUAN DDCFDNA,,,3240.0,3564.0,4
HCPCS,0576U,Trnsplj med lar quan ddcfdna,,,22.32,28.19,6
HCPCS,0577T,ELECTROPHYSIOLOGIC EVAL ICDS W/SS ELECTRODE,2414.0,1569.1,327.98,2414.0,13
HCPCS,0577T,EPHYS EVAL ICDS SS,,,225.14,2632.13,15
HCPCS,0577T,Ephys eval icds ss,,,4038.75,5101.58,6
HCPCS,0577T0,EPHYS EVAL ICDS SS,,,225.14,225.14,1
HCPCS,0577U,ONC OVR SERUM ALYS 39 GPS,,,246.92,271.61,4
HCPCS,0577U,Onc ovr serum alys 39 gps,,,22.32,28.19,6
HCPCS,0578T,REM INTERROG DEV EVAL SS LD ICDS & UP TO 90D PHY/QHP,662.0,430.3,51.25,662.0,13
HCPCS,0578T,REM INTERROG DEV ICDS PHYS,,,37.29,37.29,1
HCPCS,0578T,Rem interrog dev icds phys,,,21.15,26.71,6
HCPCS,0578T0,REM INTERROG DEV ICDS PHYS,,,37.29,37.29,1
HCPCS,0578U,ONC CUTAN MLN RNA QPCR 10GEN,,,3873.0,4260.3,4
HCPCS,0578U,Onc cutan mln rna qpcr 10gen,,,22.32,28.19,6
HCPCS,0579T,REM INTERROG DEV EVAL SS LD ICDS & UP TO 90D TECH,643.0,417.95,36.8,643.0,13
HCPCS,0579T,REM INTERROG DEV ICDS TECH,,,24.42,80.85,15
HCPCS,0579T,Rem interrog dev icds tech,,,21.15,26.71,6
HCPCS,0579T0,REM INTERROG DEV ICDS TECH,,,24.42,24.42,1
HCPCS,0579U,NFRO DBTC CKD ELISA APOA4,,,390.75,429.83,4
HCPCS,0579U,Nfro dbtc ckd elisa apoa4,,,22.32,28.19,6
HCPCS,0580F,MULTIDISCIPLINARY CARE PLAN,,,0.01,0.01,1
HCPCS,0580F0,MULTIDISCIPLINARY CARE PLAN,,,0.01,0.01,1
HCPCS,0580T,RMVL SS IMPL DFB PG ONLY,,,226.03,7890.6,15
HCPCS,0580T,RMVL SUBSTERNAL IMPLTBL DFB PULSE GENERATOR ONLY,1407.0,914.55,427.73,1407.0,13
HCPCS,0580T,Rmvl ss impl dfb pg only,,,916.39,1157.54,6
HCPCS,0580T0,RMVL SS IMPL DFB PG ONLY,,,226.03,226.03,1
HCPCS,0580U,BBRGDRFERI LD ANTB DETCJ 31,,,17.21,18.93,4
HCPCS,0580U,Bbrgdrferi ld antb detcj 31,,,5.23,6.6,6
HCPCS,0581F,PT TRNSFRD FROM ANESTH TO CC,,,0.01,0.01,1
HCPCS,0581F0,PT TRNSFRD FROM ANESTH TO CC,,,0.01,0.01,1
HCPCS,0581T,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,10443.0,6787.95,816.59,26432.0,141
HCPCS,0581T,ABLTJ MAL BRST TUM PERQ CRTX,,,1944.73,1944.73,1
HCPCS,0581T0,ABLTJ MAL BRST TUM PERQ CRTX,,,1944.73,1944.73,1
HCPCS,0581U,TRNSPL MED ANTB NOHLA 39TRGT,,,325.8,358.38,4
HCPCS,0581U,Trnspl med antb nohla 39trgt,,,28.87,36.47,6
HCPCS,0582F,NO TRNSFR FROM ANESTH TO CC,,,0.01,0.01,1
HCPCS,0582F0,NO TRNSFR FROM ANESTH TO CC,,,0.01,0.01,1
HCPCS,0582T,TRURL ABLTJ MAL PRST8 TISS,,,1525.63,15155.41,5
HCPCS,0582T,Trurl abltj mal prst8 tiss,,,2889.05,3649.33,6
HCPCS,0582T0,TRURL ABLTJ MAL PRST8 TISS,,,1525.63,1525.63,1
HCPCS,0582U,RARE DS RPD WHLGEN DNA VRNTS,,,7582.2,8340.42,4
HCPCS,0582U,Rare ds rpd whlgen dna vrnts,,,22.32,28.19,6
HCPCS,0583F,TRANSFER CARE CHECKLIST USED,,,0.01,0.01,1
HCPCS,0583F0,TRANSFER CARE CHECKLIST USED,,,0.01,0.01,1
HCPCS,0583T,TMPST AUTO TUBE DLVR SYS,,,201.41,3211.66,15
HCPCS,0583T,TYMPANOSTOMY AUTOMATED TUBE DELIVERY SYSTEM,1949.0,1266.85,130.98,1949.0,21
HCPCS,0583T,Tmpst auto tube dlvr sys,,,839.72,1060.7,6
HCPCS,0583T0,TMPST AUTO TUBE DLVR SYS,,,201.41,201.41,1
HCPCS,0583U,RARE DS RPD WHLGEN CMPTR DNA,,,3791.1,4170.21,4
HCPCS,0583U,Rare ds rpd whlgen cmptr dna,,,22.32,28.19,6
HCPCS,0584F,NO TRANSFERCARE CHKLIST USED,,,0.01,0.01,1
HCPCS,0584F0,NO TRANSFERCARE CHKLIST USED,,,0.01,0.01,1
HCPCS,0584T,PERQ ISLET CELL TRANSPLANT,,,289.8,289.8,1
HCPCS,0584T,Perq islet cell transplant,,,3427.97,4330.07,6
HCPCS,0584T0,PERQ ISLET CELL TRANSPLANT,,,289.8,289.8,1
HCPCS,0584U,NEURO CSF PRION PRTN QUAL,,,540.99,595.09,4
HCPCS,0584U,Neuro csf prion prtn qual,,,22.32,28.19,6
HCPCS,0585T,LAPS ISLET CELL TRANSPLANT,,,424.66,424.66,1
HCPCS,0585T,Laps islet cell transplant,,,3427.97,4330.07,6
HCPCS,0585T0,LAPS ISLET CELL TRANSPLANT,,,424.66,424.66,1
HCPCS,0585U,TGSAP SO NEO CFDNA 521 GENES,,,2919.6,3211.56,4
HCPCS,0585U,Tgsap so neo cfdna 521 genes,,,22.32,28.19,6
HCPCS,0586T,OPEN ISLET CELL TRANSPLANT,,,453.07,453.07,1
HCPCS,0586T,Open islet cell transplant,,,3427.97,4330.07,6
HCPCS,0586T0,OPEN ISLET CELL TRANSPLANT,,,453.07,453.07,1
HCPCS,0586U,ONC MRNA GEN XPRSN 216 GENES,,,2919.6,3211.56,4
HCPCS,0586U,Onc mrna gen xprsn 216 genes,,,22.32,28.19,6
HCPCS,0587T,PERQ IMPLTJ/RPLCMT ISDNS BLDR DYSF PTN,3473.0,2257.45,856.04,3473.0,13
HCPCS,0587T,PERQ IMPLTJ/RPLCMT ISDNS PTN,,,404.56,14229.45,15
HCPCS,0587T,Perq impltj/rplcmt isdns ptn,,,248.59,314.0,6
HCPCS,0587T0,PERQ IMPLTJ/RPLCMT ISDNS PTN,,,404.56,404.56,1
HCPCS,0587U,THER RX MNTR 60-150RX&METABL,,,114.43,125.87,4
HCPCS,0587U,Ther rx mntr 60150rx&metabl,,,5.81,7.34,6
HCPCS,0588T,REVISION/REMOVAL ISDNS PTN,,,339.74,7456.34,15
HCPCS,0588T,REVJ/ OR RMVL PERQ ISDNS BLDR DYSF PTN,2800.0,1820.0,703.69,2800.0,13
HCPCS,0588T,Revision/removal isdns ptn,,,248.59,314.0,6
HCPCS,0588T0,REVISION/REMOVAL ISDNS PTN,,,339.74,339.74,1
HCPCS,0588U,NFCT DS BCT/VIR 32GENES MRNA,,,760.0,836.0,4
HCPCS,0588U,Nfct ds bct/vir 32genes mrna,,,22.32,28.19,6
HCPCS,0589T,ELEC ALYS SMPL PRGRMG IINS,,,50.17,199.02,15
HCPCS,0589T,ELEC ALYS SMPL PRGRMG IINS BLDR DYSF PTN 1-3,351.0,228.15,84.97,351.0,13
HCPCS,0589T,Elec alys smpl prgrmg iins,,,82.56,104.28,6
HCPCS,0589T0,ELEC ALYS SMPL PRGRMG IINS,,,50.17,50.17,1
HCPCS,0589U,PFAS24CMPND HI-PERF LC-MS/MS,,,198.74,218.61,4
HCPCS,0589U,Pfas24cmpnd hiperf lc-ms/ms,,,5.78,7.3,6
HCPCS,0590T,ELEC ALYS CPLX PRGRMG IINS,,,57.3,199.02,15
HCPCS,0590T,ELEC ALYS CPLX PRGRMG IINS BLDR DYSF PTN 4+,654.0,425.1,100.18,654.0,13
HCPCS,0590T,Elec alys cplx prgrmg iins,,,82.56,104.28,6
HCPCS,0590T0,ELEC ALYS CPLX PRGRMG IINS,,,57.3,57.3,1
HCPCS,0590U,Nfct ds bct&fngl dna 44 orgs,,,92.55,116.9,6
HCPCS,0591T,HEALTH &AMP; WELL-BEING COACHING F2F INDIV 1ST ASSMT,195.0,126.75,80.24,195.0,13
HCPCS,0591T,HLTH&WB COACHING INDIV 1ST,,,45.78,45.78,1
HCPCS,0591T,Hlth&wb coaching indiv 1st,,,41.57,52.51,6
HCPCS,0591T0,HLTH&WB COACHING INDIV 1ST,,,45.78,45.78,1
HCPCS,0591U,ONC PRST8 CA 3PRTNS PLSM SRM,,,760.0,836.0,4
HCPCS,0591U,Onc prst8 ca 3prtns plsm srm,,,22.32,28.19,6
HCPCS,0592T,HEALTH &AMP; WELL-BEING COACHING F2F INDIV F-UP SESS,195.0,126.75,80.24,195.0,13
HCPCS,0592T,HLTH&WB COACHING INDIV F-UP,,,45.78,45.78,1
HCPCS,0592T,Hlth&wb coaching indiv f-up,,,41.57,52.51,6
HCPCS,0592T0,HLTH&WB COACHING INDIV F-UP,,,45.78,45.78,1
HCPCS,0592U,ONC HL NEO DNA TGS 417 GENES,,,2919.6,3211.56,4
HCPCS,0592U,Onc hl neo dna tgs 417 genes,,,22.32,28.19,6
HCPCS,0593T,HEALTH &AMP; WELL-BEING COACHING FACE TO FACE GROUP,42.0,27.3,17.78,42.0,13
HCPCS,0593T,HLTH&WB COACHING GROUP,,,10.15,10.15,1
HCPCS,0593T,Hlth&wb coaching group,,,25.5,32.21,6
HCPCS,0593T0,HLTH&WB COACHING GROUP,,,10.15,10.15,1
HCPCS,0593U,NFCT DS GU PTHGN DNA 46TRGT,,,634.84,698.32,4
HCPCS,0593U,Nfct ds gu pthgn dna 46trgt,,,92.55,116.9,6
HCPCS,0594T,OSTEOT HUM XTRNL LNGTH DEV,,,1240.33,15488.78,15
HCPCS,0594T,Osteot hum xtrnl lngth dev,,,2951.94,3728.76,6
HCPCS,0594T0,OSTEOT HUM XTRNL LNGTH DEV,,,1240.33,1240.33,1
HCPCS,0594U,Nfct ds sepsis pncrtc spc,,,92.55,116.9,6
HCPCS,0595U,NFCT DS TFP VCTRBRN&ZOONOTIC,,,262.99,289.29,4
HCPCS,0595U,Nfct ds tfp vctrbrn&zoonotic,,,92.55,116.9,6
HCPCS,0596T,TEMP FML IU VLV-PMP 1ST INSJ,,,669.99,1447.18,15
HCPCS,0596T,Temp fml iu vlv-pmp 1st insj,,,248.59,314.0,6
HCPCS,0596T0,TEMP FML IU VLV-PMP 1ST INSJ,,,685.32,685.32,1
HCPCS,0596U,Neuro alzds plsm 3dstnct isp,,,5.78,7.3,6
HCPCS,0597T,TEMP FML IU VALVE-PMP RPLCMT,,,241.62,1447.18,15
HCPCS,0597T,Temp fml iu valve-pmp rplcmt,,,248.59,314.0,6
HCPCS,0597T0,TEMP FML IU VALVE-PMP RPLCMT,,,241.62,241.62,1
HCPCS,0597U,Onc breast rna xprsn 329gens,,,22.32,28.19,6
HCPCS,0598T,R-T FLUOR WOUND IMG 1ST SITE,,,61.38,675.17,18
HCPCS,0598T0,R-T FLUOR WOUND IMG 1ST SITE,,,61.38,61.38,1
HCPCS,0598U,GI IBS IGG ANTB 18FOOD ITEMS,,,300.0,330.0,4
HCPCS,0598U,Gi ibs igg antb 18food items,,,22.32,28.19,6
HCPCS,0599T,R-T FLUOR WOUND IMG EA ADDL,,,39.32,39.32,1
HCPCS,0599T0,R-T FLUOR WOUND IMG EA ADDL,,,39.32,39.32,1
HCPCS,0599U,ONC PNCRTC CA MULT IA SERUM,,,897.0,986.7,4
HCPCS,0599U,Onc pncrtc ca mult ia serum,,,22.32,28.19,6
HCPCS,0600T,ABLT IRE 1+ O/T LV/PRST8 PRQ,,,3151.77,22573.24,15
HCPCS,0600T,Ablt ire 1+ o/t lv/prst8 prq,,,2290.02,2892.66,6
HCPCS,0600T0,ABLT IRE 1+ O/T LV/PRST8 PRQ,,,3151.77,3151.77,1
HCPCS,0600U,Nfct ds wnd infctj 65orgs&30,,,4.02,5.08,6
HCPCS,0601T,ABLTJ IRE 1+TUMORS OPEN,,,1560.3,22573.24,15
HCPCS,0601T,Abltj ire 1+tumors open,,,2290.02,2892.66,6
HCPCS,0601T0,ABLTJ IRE 1+TUMORS OPEN,,,1560.3,1560.3,1
HCPCS,0601U,Nfct ds pji alys 11 bmrks ia,,,22.32,28.19,6
HCPCS,0602T,TRANSDERMAL GFR MEASUREMENTS,,,195.98,452.99,4
HCPCS,0602T,Transdermal gfr measurements,,,5.78,7.3,6
HCPCS,0602T0,TRANSDERMAL GFR MEASUREMENTS,,,195.98,195.98,1
HCPCS,0602U,Endocrin dm ins gen mthyltn,,,22.32,28.19,6
HCPCS,0603T,TRANSDERMAL GFR MONITORING,,,493.67,1143.09,4
HCPCS,0603T,Transdermal gfr monitoring,,,5.78,7.3,6
HCPCS,0603T0,TRANSDERMAL GFR MONITORING,,,493.67,493.67,1
HCPCS,0603U,Rx asy prsmv 77rx/metablt ur,,,6.62,8.36,6
HCPCS,0604T,REM OCT RTA DEV SETUP&EDUCAJ,,,19.66,260.84,4
HCPCS,0604T,Rem oct rta dev setup&educaj,,,31.76,40.12,6
HCPCS,0604T0,REM OCT RTA DEV SETUP&EDUCAJ,,,19.66,19.66,1
HCPCS,0604U,All&immunology crae 4bk pep,,,5.78,7.3,6
HCPCS,0605T,REM OCT RTA TECHL SPRT MIN 8,,,47.48,81.56,4
HCPCS,0605T,Rem oct rta techl sprt min 8,,,31.76,40.12,6
HCPCS,0605T0,REM OCT RTA TECHL SPRT MIN 8,,,47.48,47.48,1
HCPCS,0605U,All&immunology hat tpsab1,,,22.32,28.19,6
HCPCS,0606T,REM OCT RTA PHYS/QHP EA 30D,,,51.18,65.16,4
HCPCS,0606T0,REM OCT RTA PHYS/QHP EA 30D,,,51.18,51.18,1
HCPCS,0606U,Hem red cll memb do rbc oge,,,2.81,3.55,6
HCPCS,0607T,REM MNTR PULM FLU MNTR SETUP,,,19.66,19.66,1
HCPCS,0607T,Rem mntr pulm flu mntr setup,,,33.85,42.76,6
HCPCS,0607T0,REM MNTR PULM FLU MNTR SETUP,,,19.66,19.66,1
HCPCS,0607U,Reprdtve med ema rtpcr 31bct,,,22.32,28.19,6
HCPCS,0608T,REM MNTR PULM FLU MNTR ALYS,,,845.94,845.94,1
HCPCS,0608T,Rem mntr pulm flu mntr alys,,,33.85,42.76,6
HCPCS,0608T0,REM MNTR PULM FLU MNTR ALYS,,,845.94,845.94,1
HCPCS,0608U,Reprdtve med ema rtpcr 10bct,,,22.32,28.19,6
HCPCS,0609T,MRS DISC PAIN ACQUISJ DATA,,,193.76,524.09,18
HCPCS,0609T,Mrs disc pain acquisj data,,,145.46,183.74,6
HCPCS,0609T0,MRS DISC PAIN ACQUISJ DATA,,,193.76,193.76,1
HCPCS,0609U,Onc prostate ia tot&free psa,,,5.78,7.3,6
HCPCS,0610T,MRS DISC PAIN TRANSMIS DATA,,,164.66,386.26,4
HCPCS,0610T,Mrs disc pain transmis data,,,33.85,42.76,6
HCPCS,0610T0,MRS DISC PAIN TRANSMIS DATA,,,164.66,164.66,1
HCPCS,0610U,Nfct ds antmcr sc phenotypic,,,4.02,5.08,6
HCPCS,0611T,MRS DISC PAIN ALG ALYS DATA,,,37.83,524.09,18
HCPCS,0611T,Mrs disc pain alg alys data,,,33.85,42.76,6
HCPCS,0611T0,MRS DISC PAIN ALG ALYS DATA,,,37.83,37.83,1
HCPCS,0611U,Onc lvr alys >1000 mr cfdna,,,22.32,28.19,6
HCPCS,0612T,MRS DISCOGENIC PAIN I&R,,,36.16,63.59,4
HCPCS,0612T0,MRS DISCOGENIC PAIN I&R,,,36.16,36.16,1
HCPCS,0612U,Onc lvr alys >1000 mr cfdna,,,22.32,28.19,6
HCPCS,0613T,PERQ TCAT INTRATRL SEPTL SHT,,,1279.15,1279.15,1
HCPCS,0613T,Perq tcat intratrl septl sht,,,8538.66,10785.67,6
HCPCS,0613T0,PERQ TCAT INTRATRL SEPTL SHT,,,1279.15,1279.15,1
HCPCS,0613U,Onc uc dna mthyltn&mut 6bmrk,,,22.32,28.19,6
HCPCS,0614T,RMVL&RPLCMT SS IMPL DFB PG,,,384.11,48667.04,15
HCPCS,0614T,Rmvl&rplcmt ss impl dfb pg,,,13248.3,16734.7,6
HCPCS,0614T0,RMVL&RPLCMT SS IMPL DFB PG,,,384.11,384.11,1
HCPCS,0614U,Iem pmd alys 4 nzm cplx page,,,13.39,16.91,6
HCPCS,0615T,AUTO ALYS BINOCULAR EYE MVMT,,,71.9,279.48,15
HCPCS,0615T,Auto alys binocular eye mvmt,,,45.31,57.23,6
HCPCS,0615T0,AUTO ALYS BINOCULAR EYE MVMT,,,71.9,71.9,1
HCPCS,0615U,Bbrgdrferi ld antb detcj 26,,,5.23,6.6,6
HCPCS,0616T,Insertion of iris prosthesis,,,599.44,757.19,6
HCPCS,0616U,Neurol dementia alys >30000,,,22.32,28.19,6
HCPCS,0617T,Insj iris prosth w/rmvl&insj,,,2069.78,2614.46,6
HCPCS,0617U,Cv ascvd dna alys >20000,,,22.32,28.19,6
HCPCS,0618T,Insj iris prosth sec io lens,,,2069.78,2614.46,6
HCPCS,0618U,Psyc bd dna mthyl alys>10000,,,22.32,28.19,6
HCPCS,0619T,CYSTO W/PRST8 COMMISSUROTOMY,,,9282.1,20049.35,10
HCPCS,0619T,Cysto w/prst8 commissurotomy,,,2889.05,3649.33,6
HCPCS,0619U,Pulm copd dna alys >18000,,,22.32,28.19,6
HCPCS,0620T,ENDOVASCULAR VENOUS ARTERIALIZATION TIBL/PRNL VN,12104.0,7867.6,2675.85,12104.0,13
HCPCS,0620T,EVASC VEN ARTLZ TIBL/PRNL VN,,,1437.57,75886.85,15
HCPCS,0620T,Evasc ven artlz tibl/prnl vn,,,6649.91,8399.88,6
HCPCS,0620T0,EVASC VEN ARTLZ TIBL/PRNL VN,,,1437.57,1437.57,1
HCPCS,0620U,Onc hcc dna mthyln alys>5000,,,22.32,28.19,6
HCPCS,0621T,TRABECULOSTOMY INTERNO LASER,,,254.78,8722.22,15
HCPCS,0621T,Trabeculostomy interno laser,,,599.44,757.19,6
HCPCS,0621T0,TRABECULOSTOMY INTERNO LASER,,,254.78,254.78,1
HCPCS,0621U,Nfct ds lb dna alys>10000,,,22.32,28.19,6
HCPCS,0622T,TRABECULOSTOMY INT LSR W/SCP,,,349.44,349.44,1
HCPCS,0622T,Trabeculostomy int lsr w/scp,,,599.44,757.19,6
HCPCS,0622T0,TRABECULOSTOMY INT LSR W/SCP,,,349.44,349.44,1
HCPCS,0622U,Psyc mdd dna alys >20000,,,22.32,28.19,6
HCPCS,0623T,Auto quantification c plaque,,,137.74,173.99,6
HCPCS,0623U,Ai ms dna mthyl alys >5000,,,22.32,28.19,6
HCPCS,0624U,Hep nash dna mthyl alys 5000,,,22.32,28.19,6
HCPCS,0625T,AUTO QUAN C PLAQ CPTR ALYS,,,954.09,2060.84,10
HCPCS,0625U,Endocrinol op dna alys>5000,,,22.32,28.19,6
HCPCS,0626U,Neurol pd dna alys >20000,,,22.32,28.19,6
HCPCS,0627T,PERQ NJX ALGC FLUOR LMBR 1ST,,,264.49,27897.39,15
HCPCS,0627T,Perq njx algc fluor lmbr 1st,,,3094.77,3909.18,6
HCPCS,0627T0,PERQ NJX ALGC FLUOR LMBR 1ST,,,264.49,264.49,1
HCPCS,0627U,Psyc scz dna alys >15000,,,22.32,28.19,6
HCPCS,0628T,PERQ NJX ALGC FLUOR LMBR EA,,,78.68,78.68,1
HCPCS,0628T,Perq njx algc fluor lmbr ea,,,3094.77,3909.18,6
HCPCS,0628T0,PERQ NJX ALGC FLUOR LMBR EA,,,78.68,78.68,1
HCPCS,0628U,Nfro kdn ds genetic cond 449,,,22.32,28.19,6
HCPCS,0629T,PERQ NJX ALGC CT LMBR 1ST,,,262.06,27897.39,15
HCPCS,0629T,Perq njx algc ct lmbr 1st,,,3094.77,3909.18,6
HCPCS,0629T0,PERQ NJX ALGC CT LMBR 1ST,,,262.06,262.06,1
HCPCS,0629U,Nfct ds tb dna aly 1trgt pcr,,,22.32,28.19,6
HCPCS,0630T,PERQ NJX ALGC CT LMBR EA,,,78.68,78.68,1
HCPCS,0630T,Perq njx algc ct lmbr ea,,,3094.77,3909.18,6
HCPCS,0630T0,PERQ NJX ALGC CT LMBR EA,,,78.68,78.68,1
HCPCS,0630U,Onc brst mrna gen prflg 80,,,22.32,28.19,6
HCPCS,0631T,TC VIS LIT HYPERSPECTRAL IMG,,,24.58,53.1,10
HCPCS,0632T,PERQ TCAT US ABLTJ NRV P-ART,,,612.53,38933.13,15
HCPCS,0632T,Perq tcat us abltj nrv p-art,,,5298.24,6692.51,6
HCPCS,0632T0,PERQ TCAT US ABLTJ NRV P-ART,,,612.53,612.53,1
HCPCS,0633T,CT BREAST W/3D UNI C-,,,106.74,245.18,19
HCPCS,0633T,Ct breast w/3d uni c-,,,64.08,80.94,6
HCPCS,0633T0,CT BREAST W/3D UNI C-,,,110.08,110.08,1
HCPCS,0633TTC,CT BREAST W/3D UNI C-,,,110.08,110.08,1
HCPCS,0634T,CT BREAST W/3D UNI C+,,,178.69,401.74,19
HCPCS,0634T,Ct breast w/3d uni c+,,,64.08,80.94,6
HCPCS,0634T0,CT BREAST W/3D UNI C+,,,184.02,184.02,1
HCPCS,0634TTC,CT BREAST W/3D UNI C+,,,184.02,184.02,1
HCPCS,0635T,CT BREAST W/3D UNI C-/C+,,,178.69,401.74,19
HCPCS,0635T,Ct breast w/3d uni c-/c+,,,64.08,80.94,6
HCPCS,0635T0,CT BREAST W/3D UNI C-/C+,,,184.02,184.02,1
HCPCS,0635TTC,CT BREAST W/3D UNI C-/C+,,,184.02,184.02,1
HCPCS,0636T,CT BREAST W/3D BI C-,,,242.63,524.09,19
HCPCS,0636T,Ct breast w/3d bi c-,,,196.56,248.28,6
HCPCS,0636T0,CT BREAST W/3D BI C-,,,245.24,245.24,1
HCPCS,0636TTC,CT BREAST W/3D BI C-,,,245.24,245.24,1
HCPCS,0637T,CT BREAST W/3D BI C+,,,358.48,828.27,19
HCPCS,0637T,Ct breast w/3d bi c+,,,196.56,248.28,6
HCPCS,0637T0,CT BREAST W/3D BI C+,,,384.86,384.86,1
HCPCS,0637TTC,CT BREAST W/3D BI C+,,,384.86,384.86,1
HCPCS,0638T,CT BREAST W/3D BI C-/C+,,,358.48,828.27,19
HCPCS,0638T,Ct breast w/3d bi c-/c+,,,196.56,248.28,6
HCPCS,0638T0,CT BREAST W/3D BI C-/C+,,,384.86,384.86,1
HCPCS,0638TTC,CT BREAST W/3D BI C-/C+,,,384.86,384.86,1
HCPCS,0639T,WRLS SKN SNR ANISOTROPY MEAS,,,81.72,189.2,4
HCPCS,0639T,Wrls skn snr anisotropy meas,,,33.85,42.76,6
HCPCS,0639T0,WRLS SKN SNR ANISOTROPY MEAS,,,81.72,81.72,1
HCPCS,0640T,NCNTC IFR SPCTRSC O/T PAD 1,,,13.19,85.1,16
HCPCS,0640T0,NCNTC IFR SPCTRSC O/T PAD 1,,,13.19,13.19,1
HCPCS,0640TTC,NCNTC IFR SPCTRSC O/T PAD 1,,,13.19,13.19,1
HCPCS,0643T,Tcat l ventr rstrj dev implt,,,8538.66,10785.67,6
HCPCS,0644T,TCAT RMVL/DBLK ICAR MAS PERQ,,,1648.7,1648.7,1
HCPCS,0644T,TCAT RMVL/DEBULK ICAR MASS SUCTION DEVICE PERQ,16433.0,10681.45,2179.0,37851.0,61
HCPCS,0644T0,TCAT RMVL/DBLK ICAR MAS PERQ,,,1648.7,1648.7,1
HCPCS,0645T,TCAT IMPLTJ C SINS RDCTJ DEV,,,1172.37,38933.13,15
HCPCS,0645T,Tcat impltj c sins rdctj dev,,,5298.24,6692.51,6
HCPCS,0645T0,TCAT IMPLTJ C SINS RDCTJ DEV,,,1172.37,1172.37,1
HCPCS,0646T,"TRANSCATHETER TRICUSPID VALVE REPAIR,PERCUTANEOUS APPROACH; INIT",21259.0,13818.35,1940.0,37851.0,38
HCPCS,0646T,TTVI/RPLCMT PROSTC VLV PERQ W/R HRT CATH&ANGRPH,16980.0,11037.0,3626.06,16980.0,13
HCPCS,0646T,TTVI/RPLCMT W/PRSTC VLV PERQ,,,1594.95,1594.95,1
HCPCS,0646T0,TTVI/RPLCMT W/PRSTC VLV PERQ,,,1594.95,1594.95,1
HCPCS,0647T,INSJ GTUBE PERQ MAG GASTRPXY,,,962.3,4112.99,15
HCPCS,0647T,Insj gtube perq mag gastrpxy,,,181.25,228.95,6
HCPCS,0647T0,INSJ GTUBE PERQ MAG GASTRPXY,,,962.3,962.3,1
HCPCS,0648T,QUAN MR TIS WO MRI 1ORGN,,,517.79,2060.84,19
HCPCS,0648T,Quan mr tis wo mri 1orgn,,,145.46,183.74,6
HCPCS,0648T0,QUAN MR TIS WO MRI 1ORGN,,,950.8,950.8,1
HCPCS,0648TTC,QUAN MR TIS WO MRI 1ORGN,,,950.8,950.8,1
HCPCS,0649T,QUAN MR ALYS TISS COMPOSITION W/MRI,2529.0,1643.85,145.46,4277.7,50
HCPCS,0649T,QUAN MR TISS W/MRI 1ORGN,,,950.8,950.8,2
HCPCS,0649T0,QUAN MR TISS W/MRI 1ORGN,,,950.8,950.8,1
HCPCS,0649TTC,QUAN MR TISS W/MRI 1ORGN,,,950.8,950.8,1
HCPCS,0650T,PRGRMG DEV EVAL SCRMS REMOTE,,,21.71,80.85,16
HCPCS,0650T,Prgrmg dev eval scrms remote,,,21.15,26.71,6
HCPCS,0650T0,PRGRMG DEV EVAL SCRMS REMOTE,,,21.71,21.71,1
HCPCS,0650TTC,PRGRMG DEV EVAL SCRMS REMOTE,,,21.71,21.71,1
HCPCS,0651T,MAG CTRLD CAPSULE ENDOSCOPY,,,261.41,2032.78,15
HCPCS,0651T,Mag ctrld capsule endoscopy,,,181.25,228.95,6
HCPCS,0651T0,MAG CTRLD CAPSULE ENDOSCOPY,,,261.41,261.41,1
HCPCS,0652T,EGD FLX TRANSNASAL DX BR/WA,,,317.53,4112.99,15
HCPCS,0652T,Egd flx transnasal dx br/wa,,,616.53,778.78,6
HCPCS,0652T0,EGD FLX TRANSNASAL DX BR/WA,,,317.53,317.53,1
HCPCS,0653T,EGD FLX TRANSNASAL BX 1/MLT,,,408.0,4112.99,15
HCPCS,0653T,Egd flx transnasal bx 1/mlt,,,616.53,778.78,6
HCPCS,0653T0,EGD FLX TRANSNASAL BX 1/MLT,,,408.0,408.0,1
HCPCS,0654T,EGD FLEXIBLE TRANSNASAL W/INSJ INTRAL TUBE/CATH,1055.0,685.75,276.4,1055.0,13
HCPCS,0654T,EGD FLX TRANSNASAL TUBE/CATH,,,151.48,8248.85,15
HCPCS,0654T,Egd flx transnasal tube/cath,,,616.53,778.78,6
HCPCS,0654T0,EGD FLX TRANSNASAL TUBE/CATH,,,151.48,151.48,1
HCPCS,0655T,TPRNL FOCAL ABLTJ MAL PRST8,,,1629.26,11022.13,15
HCPCS,0655T,Tprnl focal abltj mal prst8,,,2889.05,3649.33,6
HCPCS,0655T0,TPRNL FOCAL ABLTJ MAL PRST8,,,1629.26,1629.26,1
HCPCS,0656T,ANT LMBR VRT BDY TETH <7 SEG,,,2333.66,20141.22,5
HCPCS,0656T,Ant lmbr vrt bdy teth <7 seg,,,9774.46,12346.69,6
HCPCS,0656T0,ANT LMBR VRT BDY TETH <7 SEG,,,2333.66,2333.66,1
HCPCS,0657T,ANT LMBR VRT BDY TETH 8+ SEG,,,2411.33,20141.22,5
HCPCS,0657T,Ant lmbr vrt bdy teth 8+ seg,,,9774.46,12346.69,6
HCPCS,0657T0,ANT LMBR VRT BDY TETH 8+ SEG,,,2411.33,2411.33,1
HCPCS,0658T,ELEC IMPD SPECTRSC 1+SKN LES,,,26.45,128.79,18
HCPCS,0658T,Elec impd spectrsc 1+skn les,,,20.85,26.34,6
HCPCS,0658T0,ELEC IMPD SPECTRSC 1+SKN LES,,,26.45,26.45,1
HCPCS,0659T,TCAT INTRA-C NFS SUPERSAT O2,,,2013.63,2013.63,1
HCPCS,0659T,Tcat intra-c nfs supersat o2,,,5298.24,6692.51,6
HCPCS,0659T0,TCAT INTRA-C NFS SUPERSAT O2,,,2013.63,2013.63,1
HCPCS,0660T,IMPLT ANT SGM IO NBIO RX SYS,,,828.15,8722.22,15
HCPCS,0660T,Implt ant sgm io nbio rx sys,,,169.69,214.34,6
HCPCS,0660T0,IMPLT ANT SGM IO NBIO RX SYS,,,828.15,828.15,1
HCPCS,0661T,RMVL&RIMPLTJ ANT SGM IMPLT,,,4038.07,8722.22,14
HCPCS,0661T,Rmvl&rimpltj ant sgm implt,,,169.69,214.34,6
HCPCS,0662T,SCALP COOL 1ST MEAS&CALBRJ,,,1757.12,3795.37,10
HCPCS,0662T,Scalp cool 1st meas&calbrj,,,20.85,26.34,6
HCPCS,0663T,Scalp cool plmt mntr rmvl,,,20.85,26.34,6
HCPCS,0664T,Don hysterectomy open cdvr,,,3411.14,4308.8,6
HCPCS,0665T,Don hysterectomy open liv,,,2575.55,3253.32,6
HCPCS,0666T,Don hysterectomy laps liv,,,2575.55,3253.32,6
HCPCS,0667T,Don hysterectomy rcp uter,,,3411.14,4308.8,6
HCPCS,0668T,Bkbench prep don uter algrft,,,3411.14,4308.8,6
HCPCS,0669T,Bkbench rcnstj don uter ven,,,3411.14,4308.8,6
HCPCS,0670T,Bkbench rcnstj don uter artl,,,3411.14,4308.8,6
HCPCS,0671T,INSJ ANT SGM AQ DRG DEV 1+,,,799.41,11187.1,15
HCPCS,0671T,Insj ant sgm aq drg dev 1+,,,599.44,757.19,6
HCPCS,0671T0,INSJ ANT SGM AQ DRG DEV 1+,,,799.41,799.41,1
HCPCS,0672T,Ndovag cryg rf remdl tiss,,,53.02,66.97,6
HCPCS,0673T,ABLTJ B9 THYR NDUL PERQ LASR,,,1626.36,3512.95,15
HCPCS,0673T,Abltj b9 thyr ndul perq lasr,,,839.72,1060.7,6
HCPCS,0673T0,ABLTJ B9 THYR NDUL PERQ LASR,,,2906.34,2906.34,1
HCPCS,0674T,LAPS INSJ NW/RPCMT PRM ISDSS,,,30588.78,66071.77,14
HCPCS,0674T,Laps insj nw/rpcmt prm isdss,,,3699.03,4672.46,6
HCPCS,0675T,LAPS INSJ NW/RPCMT ISDSS 1LD,,,11636.08,27037.69,14
HCPCS,0675T,Laps insj nw/rpcmt isdss 1ld,,,1950.92,2464.32,6
HCPCS,0676T,Laps insj nw/rpcmt isdss ea,,,1950.92,2464.32,6
HCPCS,0677T,LAPS REPOS LEAD ISDSS 1ST LD,,,10450.57,22573.24,14
HCPCS,0677T,Laps repos lead isdss 1st ld,,,1950.92,2464.32,6
HCPCS,0678T,Laps repos lead isdss ea add,,,1950.92,2464.32,6
HCPCS,0679T,LAPS RMVL LEAD ISDSS,,,10450.57,22573.24,14
HCPCS,0679T,Laps rmvl lead isdss,,,1950.92,2464.32,6
HCPCS,0680T,INSJ/RPLCMT PG ONLY ISDSS,,,20259.13,46494.97,14
HCPCS,0680T,Insj/rplcmt pg only isdss,,,3699.03,4672.46,6
HCPCS,0681T,RLCJ PULSE GEN ONLY ISDSS,,,3452.01,7456.34,14
HCPCS,0681T,Rlcj pulse gen only isdss,,,1950.92,2464.32,6
HCPCS,0682T,REMOVAL PULSE GEN ONLY ISDSS,,,3452.01,7456.34,14
HCPCS,0682T,Removal pulse gen only isdss,,,1950.92,2464.32,6
HCPCS,0683T,PRGRMG DEV EVAL ISDSS IP,,,37.43,80.85,14
HCPCS,0683T,Prgrmg dev eval isdss ip,,,21.15,26.71,6
HCPCS,0684T,Peri-px dev eval isdss ip,,,21.15,26.71,6
HCPCS,0685T,INTERROG DEV EVAL ISDSS IP,,,37.43,80.85,14
HCPCS,0685T,Interrog dev eval isdss ip,,,21.15,26.71,6
HCPCS,0686T,HISTOTRIPSY MAL HEPATCEL TIS,,,3977.36,37943.97,18
HCPCS,0686T,Histotripsy mal hepatcel tis,,,181.25,228.95,6
HCPCS,0686T0,HISTOTRIPSY MAL HEPATCEL TIS,,,3977.36,3977.36,1
HCPCS,0687T,Tx amblyopia dev setup 1st,,,45.31,57.23,6
HCPCS,0688T,Tx amblyopia assmt w/report,,,23.85,30.13,6
HCPCS,0689T,QUAN US TIS CHARAC W/O DX US,,,86.51,190.91,19
HCPCS,0689T,Quan us tis charac w/o dx us,,,66.35,83.81,6
HCPCS,0689T0,QUAN US TIS CHARAC W/O DX US,,,86.51,86.51,1
HCPCS,0689TTC,QUAN US TIS CHARAC W/O DX US,,,86.51,86.51,1
HCPCS,0690T,QUAN US TIS CHARAC W/DX US,,,44.3,44.3,2
HCPCS,0690T,Quan us tis charac w/dx us,,,66.35,83.81,6
HCPCS,0690T0,QUAN US TIS CHARAC W/DX US,,,44.3,44.3,1
HCPCS,0690TTC,QUAN US TIS CHARAC W/DX US,,,44.3,44.3,1
HCPCS,0691T,AUTO ALYS XST CT STD VRT FX,,,8.51,19.06,5
HCPCS,0691T,Auto alys xst ct std vrt fx,,,44.5,56.21,6
HCPCS,0691T0,AUTO ALYS XST CT STD VRT FX,,,8.51,8.51,1
HCPCS,0691TTC,AUTO ALYS XST CT STD VRT FX,,,8.51,8.51,1
HCPCS,0692T,THERAPEUTIC ULTRAFILTRATION,,,277.33,3554.23,15
HCPCS,0692T,Therapeutic ultrafiltration,,,166.76,210.65,6
HCPCS,0692T0,THERAPEUTIC ULTRAFILTRATION,,,277.33,277.33,1
HCPCS,0693T,COMPRE FUL BDY 3D MTN ALYS,,,95.29,788.63,18
HCPCS,0693T,Compre ful bdy 3d mtn alys,,,82.59,104.33,6
HCPCS,0693T0,COMPRE FUL BDY 3D MTN ALYS,,,95.29,95.29,1
HCPCS,0694T,3D VOL IMG&RCNSTJ BRST/AX,,,33.83,33.83,2
HCPCS,0694T0,3D VOL IMG&RCNSTJ BRST/AX,,,33.83,33.83,1
HCPCS,0694TTC,3D VOL IMG&RCNSTJ BRST/AX,,,33.83,33.83,1
HCPCS,0695T,BDY SRF MPG PM/CVDFB TM IMPL,,,160.03,160.03,1
HCPCS,0695T,Bdy srf mpg pm/cvdfb tm impl,,,16.03,20.24,6
HCPCS,0695T0,BDY SRF MPG PM/CVDFB TM IMPL,,,160.03,160.03,1
HCPCS,0696T,BDY SURF MAPG PM/CVDFB F/UP,,,37.43,80.85,15
HCPCS,0696T,Bdy surf mapg pm/cvdfb f/up,,,16.03,20.24,6
HCPCS,0696T0,BDY SURF MAPG PM/CVDFB F/UP,,,42.74,42.74,1
HCPCS,0697T,QUAN MR TIS WO MRI MLT ORGN,,,528.75,2060.84,17
HCPCS,0697T,Quan mr tis wo mri mlt orgn,,,145.46,183.74,6
HCPCS,0698T,QUAN MR TISS W/MRI MLT ORGN,,,88.6,2060.84,16
HCPCS,0698T,Quan mr tiss w/mri mlt orgn,,,145.46,183.74,6
HCPCS,0698T0,QUAN MR TISS W/MRI MLT ORGN,,,88.6,88.6,1
HCPCS,0698TTC,QUAN MR TISS W/MRI MLT ORGN,,,88.6,88.6,1
HCPCS,0699T,NJX PST CHMBR EYE MEDICATION,,,118.0,4945.0,15
HCPCS,0699T,Njx pst chmbr eye medication,,,624.8,789.22,6
HCPCS,0699T0,NJX PST CHMBR EYE MEDICATION,,,118.0,118.0,1
HCPCS,0700T,MOLEC FLUOR IMG SUS NEV 1ST,,,36.57,80.06,5
HCPCS,0700T,Molec fluor img sus nev 1st,,,20.85,26.34,6
HCPCS,0700T0,MOLEC FLUOR IMG SUS NEV 1ST,,,36.57,36.57,1
HCPCS,0700TTC,MOLEC FLUOR IMG SUS NEV 1ST,,,36.57,36.57,1
HCPCS,0701T,MOLEC FLUOR IMG SUS NEV EA,,,10.9,23.65,5
HCPCS,0701T,Molec fluor img sus nev ea,,,20.85,26.34,6
HCPCS,0701T0,MOLEC FLUOR IMG SUS NEV EA,,,10.9,10.9,1
HCPCS,0701TTC,MOLEC FLUOR IMG SUS NEV EA,,,10.9,10.9,1
HCPCS,0702T,Rem ther mntr ol tech sprt,,,23.85,30.13,6
HCPCS,0703T,Rem ther mntr ol cog bhv,,,23.85,30.13,6
HCPCS,0704T,REM TX AMBLYOPIA SETUP&EDU,,,271.08,271.08,1
HCPCS,0704T,Rem tx amblyopia setup&edu,,,45.31,57.23,6
HCPCS,0704T0,REM TX AMBLYOPIA SETUP&EDU,,,271.08,271.08,1
HCPCS,0705T,REM TX AMBLYOPIA TECH SPRT,,,14.04,14.04,1
HCPCS,0705T,Rem tx amblyopia tech sprt,,,23.85,30.13,6
HCPCS,0705T0,REM TX AMBLYOPIA TECH SPRT,,,14.04,14.04,1
HCPCS,0706T,REM TX AMBLYOPIA I&R PHY/QHP,,,87.48,87.48,1
HCPCS,0706T,Rem tx amblyopia i&r phy/qhp,,,23.85,30.13,6
HCPCS,0706T0,REM TX AMBLYOPIA I&R PHY/QHP,,,87.48,87.48,1
HCPCS,0707T,NJX B1 SUB MTRL SBCHDRL DFCT,,,366.42,7034.85,15
HCPCS,0707T,NJX BONE SUB MATRL INTO SUBCHONDRAL BONE DEFECT,966.0,627.9,483.0,966.0,13
HCPCS,0707T,Njx b1 sub mtrl sbchdrl dfct,,,151.21,191.0,6
HCPCS,0707T0,NJX B1 SUB MTRL SBCHDRL DFCT,,,366.42,366.42,1
HCPCS,0708T,ID CA IMMNTX PREP & 1ST NJX,,,86.11,86.11,1
HCPCS,0708T,Id ca immntx prep & 1st njx,,,166.76,210.65,6
HCPCS,0708T0,ID CA IMMNTX PREP & 1ST NJX,,,86.11,86.11,1
HCPCS,0709T,ID CA IMMNTX EACH ADDL NJX,,,26.11,26.11,1
HCPCS,0709T,Id ca immntx each addl njx,,,166.76,210.65,6
HCPCS,0709T0,ID CA IMMNTX EACH ADDL NJX,,,26.11,26.11,1
HCPCS,0710T,N-invas artl plaq alys,,,137.74,173.99,6
HCPCS,0712T,N-NVS ARTL PLAQ ALYS QUAN,,,88.38,248.03,14
HCPCS,0712T,N-nvs artl plaq alys quan,,,137.74,173.99,6
HCPCS,0714T,TPLA B9 PRST8 HYPRPLSA<50ML,,,1355.31,11022.13,15
HCPCS,0714T,Tpla b9 prst8 hyprplsa<50ml,,,2889.05,3649.33,6
HCPCS,0714T0,TPLA B9 PRST8 HYPRPLSA<50ML,,,1355.31,1355.31,1
HCPCS,0715T,Perq trluml coronry lithotrp,,,5298.24,6692.51,6
HCPCS,0716T,CAR ACOUS WAVFRM REC CAD RSK,,,59.62,922.35,15
HCPCS,0716T,Car acous wavfrm rec cad rsk,,,16.03,20.24,6
HCPCS,0716T0,CAR ACOUS WAVFRM REC CAD RSK,,,922.35,922.35,1
HCPCS,0717T,ADRC THER PRTL RC TEAR,,,3674.81,7937.59,14
HCPCS,0717T,Adrc ther prtl rc tear,,,114.29,144.36,6
HCPCS,0718T,ADRC THER PRTL RC TEAR NJX,,,3674.81,7937.59,14
HCPCS,0718T,Adrc ther prtl rc tear njx,,,151.21,191.0,6
HCPCS,0719T,Pst vrt jt rplcmt lmbr 1 sgm,,,3094.77,3909.18,6
HCPCS,0720T,PRQ ELC NRV STIM CN WO IMPLT,,,1021.24,2205.87,10
HCPCS,0720T,Prq elc nrv stim cn wo implt,,,82.59,104.33,6
HCPCS,0721T,QUAN CT TISS CHARAC W/O CT,,,652.96,1463.63,17
HCPCS,0721T,Quan ct tiss charac w/o ct,,,64.08,80.94,6
HCPCS,0722T,QUAN CT TISS CHARAC W/CT,,,652.96,1410.39,14
HCPCS,0722T,Quan ct tiss charac w/ct,,,64.08,80.94,6
HCPCS,0723T,QMRCP W/O DX MRI SM ANAT SES,,,954.09,2138.63,18
HCPCS,0723T,Qmrcp w/o dx mri sm anat ses,,,145.46,183.74,6
HCPCS,0723T0,QMRCP W/O DX MRI SM ANAT SES,,,1297.08,1297.08,1
HCPCS,0724T,QMRCP W/DX MRI SAME ANATOMY,2412.5,1568.125,36.0,4277.7,58
HCPCS,0724T0,QMRCP W/DX MRI SAME ANATOMY,,,1143.95,1143.95,1
HCPCS,0725T,Vestibular dev impltj uni,,,2719.4,3435.04,6
HCPCS,0726T,Rmvl implt vstibular dev uni,,,2132.36,2693.51,6
HCPCS,0727T,Rmvl&rplcmt implt vstblr dev,,,2719.4,3435.04,6
HCPCS,0728T,Dx alys vstblr implt uni 1st,,,21.15,26.71,6
HCPCS,0729T,Dx alys vstblr implt uni sbq,,,21.15,26.71,6
HCPCS,0730T,TRABECULOTOMY LSR W/OCT GDN,,,270.73,270.73,1
HCPCS,0730T,Trabeculotomy lsr w/oct gdn,,,2069.78,2614.46,6
HCPCS,0730T0,TRABECULOTOMY LSR W/OCT GDN,,,270.73,270.73,1
HCPCS,0731T,AUGMNT AI-BASED FCL PHNT A/R,,,59.62,128.79,14
HCPCS,0732T,Immntx admn electroporatn im,,,30.69,38.77,6
HCPCS,0733T,REM R-T MTN NREHAB THER SPLY,,,351.82,759.94,14
HCPCS,0733T,Rem r-t mtn nrehab ther sply,,,23.85,30.13,6
HCPCS,0734T,Rem r-t mtn nrehab tx mgmt,,,33.85,42.76,6
HCPCS,0735T,Prep tum cav iort prim crnot,,,2513.55,3175.01,6
HCPCS,0736T,COLONIC LAVAGE 35+L WATER,,,134.37,339.23,15
HCPCS,0736T0,COLONIC LAVAGE 35+L WATER,,,136.08,136.08,1
HCPCS,0737T,XENOGRAFT IMPLTJ ARTCLR SURF,,,70.2,27897.39,15
HCPCS,0737T,Xenograft impltj artclr surf,,,1311.27,1656.34,6
HCPCS,0737T0,XENOGRAFT IMPLTJ ARTCLR SURF,,,70.2,70.2,1
HCPCS,0738T,TX PLN MAG FLD ABLTJ PRST8,,,67.93,67.93,1
HCPCS,0738T,Tx pln mag fld abltj prst8,,,71.21,89.95,6
HCPCS,0738T0,TX PLN MAG FLD ABLTJ PRST8,,,67.93,67.93,1
HCPCS,0739T,ABLTJ MAL PRST8 MAG FLD NDCT,,,1558.14,1558.14,1
HCPCS,0739T,Abltj mal prst8 mag fld ndct,,,2889.05,3649.33,6
HCPCS,0739T0,ABLTJ MAL PRST8 MAG FLD NDCT,,,1558.14,1558.14,1
HCPCS,0740T,REM AUTON ALG INSULIN DOSE 1ST SETUP& PT EDUCAJ,297.0,193.05,34.96,297.0,13
HCPCS,0740T,REM AUTON ALG NSLN CAL SETUP,,,19.66,128.79,15
HCPCS,0740T,Rem auton alg nsln cal setup,,,41.57,52.51,6
HCPCS,0740T0,REM AUTON ALG NSLN CAL SETUP,,,19.66,19.66,1
HCPCS,0741T,REM AUTON ALG NSLN DATA COLL,,,37.43,80.85,15
HCPCS,0741T,REM AUTON ALG NSLN DOS CAL SW DATA COLL TRANSMIS,465.0,302.25,81.11,465.0,13
HCPCS,0741T,Rem auton alg nsln data coll,,,23.85,30.13,6
HCPCS,0741T0,REM AUTON ALG NSLN DATA COLL,,,47.8,47.8,1
HCPCS,0742T,AQMBF SPECT W/EXERCISE/RX STRESS & REST,585.0,380.25,119.21,585.0,13
HCPCS,0742T,AQMBF SPECT XERS/STRS & REST,,,70.91,70.91,2
HCPCS,0742T,Aqmbf spect xers/strs & rest,,,533.79,674.26,6
HCPCS,0742T0,AQMBF SPECT XERS/STRS & REST,,,70.91,70.91,1
HCPCS,0742TTC,AQMBF SPECT XERS/STRS & REST,,,70.91,70.91,1
HCPCS,0743T,B1 STR & FX RSK VRT FX ASSMT,,,41.64,543.87,19
HCPCS,0743T,B1 str & fx rsk vrt fx assmt,,,44.5,56.21,6
HCPCS,0743T,BONE STRENGTH & FRACTURE RSK CNCRNT VRT FX ASSMT,96.0,62.4,48.0,96.0,13
HCPCS,0743T0,B1 STR & FX RSK VRT FX ASSMT,,,41.64,41.64,1
HCPCS,0743TTC,B1 STR & FX RSK VRT FX ASSMT,,,41.64,41.64,1
HCPCS,0744T,INSERTION BIOPROSTHETIC VALVE OPEN FEMORAL VEIN,7136.0,4638.4,1830.51,7136.0,13
HCPCS,0744T,INSJ BIOPROSTC VLV FEM VN,,,933.55,11720.45,15
HCPCS,0744T,Insj bioprostc vlv fem vn,,,2357.43,2977.81,6
HCPCS,0744T0,INSJ BIOPROSTC VLV FEM VN,,,933.55,933.55,1
HCPCS,0745T,CAR ABLT RAD ARR N-INVAS LOC,,,240.93,240.93,1
HCPCS,0745T,CAR FCL ABLTJ RADJ ARRHYT N-INVAS LOCLZJ & MAPG,40618.0,26401.7,480.69,62082.9,51
HCPCS,0745T0,CAR ABLT RAD ARR N-INVAS LOC,,,240.93,240.93,1
HCPCS,0746T,CAR ABLT RAD ARR CNV LOC MAP,,,215.84,215.84,1
HCPCS,0746T,CAR FCL ABLTJ RADJ ARRHYT CONV LOCLZJ & MAPG,40618.0,26401.7,423.41,62082.9,51
HCPCS,0746T0,CAR ABLT RAD ARR CNV LOC MAP,,,215.84,215.84,1
HCPCS,0747T,CAR ABLT RAD ARRHYT DLVR RAD,,,955.09,955.09,1
HCPCS,0747T,CAR FCL ABLTJ RADJ ARRHYT DLVR RADJ THER,40618.0,26401.7,1190.0,62082.9,51
HCPCS,0747T0,CAR ABLT RAD ARRHYT DLVR RAD,,,955.09,955.09,1
HCPCS,0748T,NJX STEM CLL PRDCT PERIANAL PERIFISTULAR SFT TIS,997.0,648.05,362.77,997.0,13
HCPCS,0748T,NJX STM CL PRDCT ANL SFT TIS,,,186.83,186.83,1
HCPCS,0748T,Njx stm cl prdct anl sft tis,,,901.17,1138.32,6
HCPCS,0748T0,NJX STM CL PRDCT ANL SFT TIS,,,186.83,186.83,1
HCPCS,0749T,B1 str&fx rsk assmt dxr-bmd,,,44.5,56.21,6
HCPCS,0750T,B1 str&fx rsk asmt dxrbmd1vw,,,44.5,56.21,6
HCPCS,0751T,Dgtz gls mcrscp sld level ii,,,19.72,24.91,6
HCPCS,0752T,Dgtz gls mcrscp sld lvl iii,,,19.72,24.91,6
HCPCS,0753T,Dgtz gls mcrscp sld level iv,,,19.72,24.91,6
HCPCS,0754T,Dgtz gls mcrscp sld level v,,,94.71,119.63,6
HCPCS,0755T,Dgtz gls mcrscp sld level vi,,,94.71,119.63,6
HCPCS,0756T,Dgtz gls mcrscp sld spc grpi,,,19.72,24.91,6
HCPCS,0757T,Dgtz gls mcrscp sl spc grpii,,,19.72,24.91,6
HCPCS,0758T,Dgtz gls mcrscp sl spc hchem,,,94.71,119.63,6
HCPCS,0759T,Dgtz gls mcrscp sl sp grpiii,,,94.71,119.63,6
HCPCS,0760T,Dgtz gls mcrscp sl imm 1st,,,94.71,119.63,6
HCPCS,0761T,Dgtz gls mcrscp sl imm ea 1,,,94.71,119.63,6
HCPCS,0762T,Dgtz gls mcrscp sl imm ea m,,,94.71,119.63,6
HCPCS,0763T,Dgtz gls mcrscp mphmtrc alys,,,94.71,119.63,6
HCPCS,0764T,ASSTV ALG ECG RSK ASMT CNCRT,,,4.06,4.06,1
HCPCS,0764T,ASSTV ALG ECG RSK-BASED ASSMT RELATED CNCRT ECG,471.5,306.475,7.6,580.5,61
HCPCS,0764T0,ASSTV ALG ECG RSK ASMT CNCRT,,,4.06,4.06,1
HCPCS,0765T,ASSTV ALG ECG RSK ASMT PREV,,,7.8,7.8,1
HCPCS,0765T,ASSTV ALG ECG RSK-BASED ASSMT RELATED PREV ECG,471.5,306.475,14.1,580.5,61
HCPCS,0765T0,ASSTV ALG ECG RSK ASMT PREV,,,7.8,7.8,1
HCPCS,0766T,TC MAG STIMJ FCSD LW FRQ EMGNT PLS PN 1ST NERVE,308.0,200.2,154.0,308.0,12
HCPCS,0766T,TC MAG STIMJ PN 1ST NERVE,,,225.48,675.17,14
HCPCS,0766T,Tc mag stimj pn 1st nerve,,,82.59,104.33,6
HCPCS,0767T,TC MAG STIMJ FCSD LW FRQ EMGNT PLS PN EA ADD NRV,308.0,200.2,154.0,308.0,12
HCPCS,0767T,Tc mag stimj pn ea addl nrv,,,82.59,104.33,6
HCPCS,0768T,Tc mag stimj pn sbsq tx 1nrv,,,82.59,104.33,6
HCPCS,0769T,Tc mag stimj pn sbsq tx ea,,,82.59,104.33,6
HCPCS,0770T,VR TECHNOLOGY ASSIST THERAPY,,,461.94,461.94,1
HCPCS,0770T0,VR TECHNOLOGY ASSIST THERAPY,,,461.94,461.94,1
HCPCS,0771T,VR PX DISSOC SVC SM PHY 1ST,,,26.45,26.45,1
HCPCS,0771T0,VR PX DISSOC SVC SM PHY 1ST,,,26.45,26.45,1
HCPCS,0772T,VR PX DISSOC SVC SM PHY EA,,,26.45,26.45,1
HCPCS,0772T0,VR PX DISSOC SVC SM PHY EA,,,26.45,26.45,1
HCPCS,0773T,VR PX DISSOC SVC OTH PHY 1ST,,,22.38,22.38,1
HCPCS,0773T0,VR PX DISSOC SVC OTH PHY 1ST,,,22.38,22.38,1
HCPCS,0774T,VR PX DISSOC SVC OTH PHY EA,,,22.38,22.38,1
HCPCS,0774T0,VR PX DISSOC SVC OTH PHY EA,,,22.38,22.38,1
HCPCS,0775T,Arthrd si jt prq iartic impl,,,9774.46,12346.69,6
HCPCS,0776T,THERAPEUTIC INDUCTION OF INTRA-BRAIN HYPOTHERMIA,1906.0,1238.9,953.0,1906.0,12
HCPCS,0777T,R-T PRESSURE SENSING EPIDURAL GUIDANCE SYSTEM,993.0,645.45,43.46,993.0,13
HCPCS,0777T,R-T PRS SENSING EDRL GDN SYS,,,15.41,15.41,2
HCPCS,0777T,R-t prs sensing edrl gdn sys,,,459.05,579.85,6
HCPCS,0777T0,R-T PRS SENSING EDRL GDN SYS,,,15.41,15.41,1
HCPCS,0777TTC,R-T PRS SENSING EDRL GDN SYS,,,15.41,15.41,1
HCPCS,0778T,SMMG CNCRNT APPL IMU SNR,,,134.37,339.23,17
HCPCS,0778T,SMMG CNCRNT APPL IMU SNR MEAS ROM POST GAIT MUSC,174.0,113.1,87.0,174.0,12
HCPCS,0779T,GI MYOELECTRICAL ACTIVITY STUDY STMCH-COLON I&R,69.0,44.85,34.5,746.7,13
HCPCS,0779T,GI MYOELECTRICAL ACTV STUDY,,,145.79,1150.43,16
HCPCS,0779T,Gi myoelectrical actv study,,,82.59,104.33,6
HCPCS,0779T0,GI MYOELECTRICAL ACTV STUDY,,,145.79,145.79,1
HCPCS,0779TTC,GI MYOELECTRICAL ACTV STUDY,,,145.79,145.79,1
HCPCS,0780T,INSTLJ FECAL MICROBIOTA SSP,,,23.93,23.93,1
HCPCS,0780T,INSTLJ FECAL MICROBIOTA SSP RCT NMA LWR GI TRC,624.0,405.6,43.78,2932.0,47
HCPCS,0780T0,INSTLJ FECAL MICROBIOTA SSP,,,23.93,23.93,1
HCPCS,0781T,BRNCHSC RF DSTRJ PULM NRV BI MAINSTEM BRONCHI,1177.0,765.05,588.5,1177.0,12
HCPCS,0781T,Brnchsc rf dstrj pulm nrv bi,,,1152.77,1456.13,6
HCPCS,0782T,BRNCHSC RF DSTRJ PULM NRV UNI MAINSTEM BRONCHUS,1177.0,765.05,588.5,1177.0,12
HCPCS,0782T,Brnchsc rf dstrj plm nrv uni,,,1152.77,1456.13,6
HCPCS,0783T,TC AURICULAR NSTIMJ SETUP CALIBRATION &PT EDUCAJ,174.0,113.1,24.86,174.0,13
HCPCS,0783T,TC AURICULR NEUROSTIMULATION,,,13.89,339.23,15
HCPCS,0783T,Tc auriculr neurostimulation,,,33.85,42.76,6
HCPCS,0783T0,TC AURICULR NEUROSTIMULATION,,,13.89,13.89,1
HCPCS,0784T,INS/RPLMT ELTRD RA SPI NSTIM,,,2140.24,2140.24,1
HCPCS,0784T,INSJ/RPLCMT PERQ ELTRD RA SPI W/INTEGRATED NSTIM,32948.5,21416.525,1773.0,56115.9,53
HCPCS,0784T0,INS/RPLMT ELTRD RA SPI NSTIM,,,2140.24,2140.24,1
HCPCS,0785T,REVJ/RMVL NEA SPI W/NSTIM,,,246.48,246.48,1
HCPCS,0785T,REVJ/RMVL NSTIM ELTRD RA SPI W/INTEGRATED NSTIM,9884.5,6424.925,464.74,15475.5,53
HCPCS,0785T0,REVJ/RMVL NEA SPI W/NSTIM,,,246.48,246.48,1
HCPCS,0786T,INSJ/RPLCMT PERQ ELTRD RA SAC W/INTEGRATED NSTIM,33796.0,21967.4,1348.5,58405.5,46
HCPCS,0786T,INSJ/RPLCMT PRQ RA SAC NSTIM,,,743.56,743.56,1
HCPCS,0786T0,INSJ/RPLCMT PRQ RA SAC NSTIM,,,743.56,743.56,1
HCPCS,0787T,REVJ/RMVL NEA SAC W/NSTIM,,,246.48,246.48,1
HCPCS,0787T,REVJ/RMVL NSTIM ELTRD RA SAC W/INTEGRATED NSTIM,9121.0,5928.65,464.74,15475.5,53
HCPCS,0787T0,REVJ/RMVL NEA SAC W/NSTIM,,,246.48,246.48,1
HCPCS,0788T,ELEC ALY SMP IINS SP/SAC NRV,,,19.07,19.07,1
HCPCS,0788T,ELEC ALYS SMPL PRGRMG IINS SP/SAC NRV 1-3 PARAM,423.5,275.275,33.17,839.0,53
HCPCS,0788T0,ELEC ALY SMP IINS SP/SAC NRV,,,19.07,19.07,1
HCPCS,0789T,ELEC ALY CPX IINS SP/SAC NRV,,,27.04,27.04,1
HCPCS,0789T,ELEC ALYS CPLX PRGRMG IINS SP/SAC NRV 4+PARAM,428.0,278.20000000000005,49.77,839.0,53
HCPCS,0789T0,ELEC ALY CPX IINS SP/SAC NRV,,,27.04,27.04,1
HCPCS,0790T,REVJ RPLCMT/RMVL VRT TETHRG,,,1958.26,20141.22,5
HCPCS,0790T,Revj rplcmt/rmvl vrt tethrg,,,9774.46,12346.69,6
HCPCS,0790T0,REVJ RPLCMT/RMVL VRT TETHRG,,,1958.26,1958.26,1
HCPCS,0791T,MOTR COG VR GAIT TRAIN EA 15,,,9.36,9.36,1
HCPCS,0791T,Motr cog vr gait train ea 15,,,17.96,22.69,6
HCPCS,0791T0,MOTR COG VR GAIT TRAIN EA 15,,,9.36,9.36,1
HCPCS,0792T,Appl slvr diamn fluoride 38%,,,81.86,103.4,6
HCPCS,0793T,PRQ TCAT THRM ABLT NRV P-ART,,,583.42,38933.13,15
HCPCS,0793T,Prq tcat thrm ablt nrv p-art,,,5298.24,6692.51,6
HCPCS,0793T0,PRQ TCAT THRM ABLT NRV P-ART,,,583.42,583.42,1
HCPCS,0794T,PT SPEC ALG RX-ONC TX OPTION,,,59.62,134.84,15
HCPCS,0794T,Pt spec alg rx-onc tx option,,,22.32,28.19,6
HCPCS,0794T0,PT SPEC ALG RX-ONC TX OPTION,,,134.84,134.84,1
HCPCS,0795T,TCAT INS 2CHMBR LDLS PM CMPL,,,467.19,467.19,1
HCPCS,0795T,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,20041.5,13026.975,1190.0,41349.42,61
HCPCS,0795T0,TCAT INS 2CHMBR LDLS PM CMPL,,,467.19,467.19,1
HCPCS,0796T,TCAT INS 2CHMBR LDLS PM RA,,,467.19,41349.42,15
HCPCS,0796T,Tcat ins 2chmbr ldls pm ra,,,4706.22,5944.7,6
HCPCS,0796T0,TCAT INS 2CHMBR LDLS PM RA,,,467.19,467.19,1
HCPCS,0797T,TCAT INS 2CHMBR LDLS PM RV,,,477.15,41349.42,15
HCPCS,0797T,Tcat ins 2chmbr ldls pm rv,,,4706.22,5944.7,6
HCPCS,0797T0,TCAT INS 2CHMBR LDLS PM RV,,,477.15,477.15,1
HCPCS,0798T,TCAT RMV 2CHMBR LDLS PM CMPL,,,490.95,6824.3,15
HCPCS,0798T,Tcat rmv 2chmbr ldls pm cmpl,,,4041.02,5104.45,6
HCPCS,0798T0,TCAT RMV 2CHMBR LDLS PM CMPL,,,490.95,490.95,1
HCPCS,0799T,TCAT RMVL 2CHMBR LDLS PM RA,,,490.95,6824.3,15
HCPCS,0799T,Tcat rmvl 2chmbr ldls pm ra,,,4706.22,5944.7,6
HCPCS,0799T0,TCAT RMVL 2CHMBR LDLS PM RA,,,490.95,490.95,1
HCPCS,0800T,TCAT RMVL 2CHMBR LDLS PM RV,,,503.76,6824.3,15
HCPCS,0800T,Tcat rmvl 2chmbr ldls pm rv,,,4706.22,5944.7,6
HCPCS,0800T0,TCAT RMVL 2CHMBR LDLS PM RV,,,503.76,503.76,1
HCPCS,0801T,TCAT RMV&RPL 2CHMBR LDLS PM,,,981.88,41349.42,15
HCPCS,0801T,Tcat rmv&rpl 2chmbr ldls pm,,,4706.22,5944.7,6
HCPCS,0801T0,TCAT RMV&RPL 2CHMBR LDLS PM,,,981.88,981.88,1
HCPCS,0802T,TCAT RMV&RPL2CHMB LDLS PM RA,,,491.28,41349.42,15
HCPCS,0802T,Tcat rmv&rpl2chmb ldls pm ra,,,4706.22,5944.7,6
HCPCS,0802T0,TCAT RMV&RPL2CHMB LDLS PM RA,,,491.28,491.28,1
HCPCS,0803T,TCAT RMV&RPL2CHMB LDLS PM RV,,,491.28,41349.42,15
HCPCS,0803T,Tcat rmv&rpl2chmb ldls pm rv,,,4706.22,5944.7,6
HCPCS,0803T0,TCAT RMV&RPL2CHMB LDLS PM RV,,,491.28,491.28,1
HCPCS,0804T,PRGRMG EVL LDLS PM 2CHMBR IP,,,37.43,80.85,14
HCPCS,0804T,PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH REVIEW AND REPORT,246.0,159.9,35.41,246.0,17
HCPCS,0804T,Prgrmg evl ldls pm 2chmbr ip,,,21.15,26.71,6
HCPCS,0805T,TCAT S&IVC PRSTC VL IMPL PRQ,,,2984.7,2984.7,1
HCPCS,0805T,Tcat s&ivc prstc vl impl prq,,,8538.66,10785.67,6
HCPCS,0805T0,TCAT S&IVC PRSTC VL IMPL PRQ,,,2984.7,2984.7,1
HCPCS,0806T,TCAT S&IVC PRSTC VL IMPL OPN,,,3979.24,3979.24,1
HCPCS,0806T,Tcat s&ivc prstc vl impl opn,,,8538.66,10785.67,6
HCPCS,0806T0,TCAT S&IVC PRSTC VL IMPL OPN,,,3979.24,3979.24,1
HCPCS,0807T,PULM TISS VNTJ ALYS PREV CT,,,27.1,675.17,19
HCPCS,0807T,Pulm tiss vntj alys prev ct,,,64.08,80.94,6
HCPCS,0807T0,PULM TISS VNTJ ALYS PREV CT,,,27.1,27.1,1
HCPCS,0807TTC,PULM TISS VNTJ ALYS PREV CT,,,27.1,27.1,1
HCPCS,0808T,PULM TISS VNTJ ALYS W/CT,,,27.1,675.17,19
HCPCS,0808T,Pulm tiss vntj alys w/ct,,,64.08,80.94,6
HCPCS,0808T0,PULM TISS VNTJ ALYS W/CT,,,27.1,27.1,1
HCPCS,0808TTC,PULM TISS VNTJ ALYS W/CT,,,27.1,27.1,1
HCPCS,0809T,Arthrd si jt prq tfx&implt,,,6850.38,8653.12,6
HCPCS,0810T,SUBRTA NJX RX AGT W/VTRC,,,1148.81,9215.78,15
HCPCS,0810T,Subrta njx rx agt w/vtrc,,,1959.49,2475.14,6
HCPCS,0810T0,SUBRTA NJX RX AGT W/VTRC,,,1148.81,1148.81,1
HCPCS,0811T,REM MLT DAY UROFLOW SETUP,,,20.54,20.54,1
HCPCS,0811T,REM MULTI DAY CPLX UROFLOWMETRY SETUP&PT EDUCAJ,364.0,236.60000000000002,33.85,839.0,53
HCPCS,0811T0,REM MLT DAY UROFLOW SETUP,,,20.54,20.54,1
HCPCS,0812T,REM MULTI DAY CPLX UROFLOWMETRY DEV SPLY W/REPRT,433.5,281.775,21.15,839.0,52
HCPCS,0813T,EGD VOL ADJMT BARIATRIC BALO,,,941.1,2618.97,15
HCPCS,0813T,Egd vol adjmt bariatric balo,,,181.25,228.95,6
HCPCS,0813T0,EGD VOL ADJMT BARIATRIC BALO,,,2618.97,2618.97,1
HCPCS,0814T,PRQ NJX BIOD OSTEO MATRL FEM,,,471.1,471.1,1
HCPCS,0814T,Prq njx biod osteo matrl fem,,,2390.81,3019.97,6
HCPCS,0814T0,PRQ NJX BIOD OSTEO MATRL FEM,,,471.1,471.1,1
HCPCS,0815T,Us rems b1 dns hips plvs/spi,,,44.5,56.21,6
HCPCS,0816T,OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBQ,2856.0,1856.4,250.15,2856.0,13
HCPCS,0816T,OPN INSJ/RPLCMT INS PTN SUBQ,,,127.92,46494.97,15
HCPCS,0816T,Opn insj/rplcmt ins ptn subq,,,11520.56,14552.29,6
HCPCS,0816T0,OPN INSJ/RPLCMT INS PTN SUBQ,,,127.92,127.92,1
HCPCS,0817T,OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBF,2192.0,1424.8,1096.0,4841.13,13
HCPCS,0817T,OPN INSJ/RPLCMT INS PTN SUBF,,,20259.13,46494.97,14
HCPCS,0817T,Opn insj/rplcmt ins ptn subf,,,11520.56,14552.29,6
HCPCS,0818T,REVJ/RMVL INS PTN SUBQ,,,473.1,7456.34,15
HCPCS,0818T,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBCUTANEOUS,2529.0,1643.85,715.37,2529.0,13
HCPCS,0818T,Revj/rmvl ins ptn subq,,,1950.92,2464.32,6
HCPCS,0818T0,REVJ/RMVL INS PTN SUBQ,,,473.1,473.1,1
HCPCS,0819T,REVJ/RMVL INS PTN SUBF,,,3452.01,7456.34,14
HCPCS,0819T,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBFASCIAL,2529.0,1643.85,1264.5,2529.0,12
HCPCS,0819T,Revj/rmvl ins ptn subf,,,1950.92,2464.32,6
HCPCS,0820T,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 1ST,1083.0,703.95,74.59,1722.0,40
HCPCS,0820T,MNTR PSYCHDLC MED 1STPHY/QHP,,,150.11,150.11,1
HCPCS,0820T0,MNTR PSYCHDLC MED 1STPHY/QHP,,,150.11,150.11,1
HCPCS,0821T,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 2ND,1083.0,703.95,74.59,1722.0,40
HCPCS,0821T,MNTR PSYCHDLC MED 2NDPHY/QHP,,,150.11,150.11,1
HCPCS,0821T0,MNTR PSYCHDLC MED 2NDPHY/QHP,,,150.11,150.11,1
HCPCS,0822T,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY STAFF,1083.0,703.95,74.59,1722.0,40
HCPCS,0822T,MNTR PSYCHDLC MED CLN STAFF,,,127.56,127.56,1
HCPCS,0822T0,MNTR PSYCHDLC MED CLN STAFF,,,127.56,127.56,1
HCPCS,0823T,TCAT INS 1CHMBR LDLS PM RA,,,467.19,467.19,1
HCPCS,0823T,TCAT INSJ PERM 1CHMBR LDLS PACEMAKER R ATRIAL,16147.5,10495.875,1190.0,41349.42,61
HCPCS,0823T0,TCAT INS 1CHMBR LDLS PM RA,,,467.19,467.19,1
HCPCS,0824T,TCAT RMV 1CHMBR LDLS PM RA,,,757.27,757.27,1
HCPCS,0824T,TCAT RMVL PERM 1CHMBR LDLS PACEMAKER R ATRIAL,8647.5,5620.875,778.5,14164.2,61
HCPCS,0824T0,TCAT RMV 1CHMBR LDLS PM RA,,,757.27,757.27,1
HCPCS,0825T,TCAT RMV&RPL1CHMB LDLS PM RA,,,981.88,981.88,1
HCPCS,0825T,TCAT RMVL&RPLCMT PERM 1CHMBR LDLS PM R ATRIAL,15515.5,10085.075,1190.0,41349.42,61
HCPCS,0825T0,TCAT RMV&RPL1CHMB LDLS PM RA,,,981.88,981.88,1
HCPCS,0826T,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,323.0,209.95,21.15,2693.0,95
HCPCS,0827T,Dgtz gls mcrscp cytp smears,,,11.52,14.56,6
HCPCS,0828T,Dgtz gls mcrscp cytp smpl fl,,,11.52,14.56,6
HCPCS,0829T,Dgtz gls mcrscp cytp conctrj,,,11.52,14.56,6
HCPCS,0830T,Dgtz gls mcrscp cytp slctv,,,11.52,14.56,6
HCPCS,0831T,Dgtz gls mcrscp cytp c/v,,,9.95,12.56,6
HCPCS,0832T,Dgtz gls mcrscp cytp oth scr,,,11.52,14.56,6
HCPCS,0833T,Dgtz gls mcrscp cytp oth prp,,,11.52,14.56,6
HCPCS,0834T,Dgtz gls mcrscp cytp oth xtn,,,11.52,14.56,6
HCPCS,0835T,Dgtz gls mcrscp fna 1st ea,,,101.52,128.23,6
HCPCS,0836T,Dgtz gls mcrscp fna ea addl,,,101.52,128.23,6
HCPCS,0837T,Dgtz gls mcrscp fna i&r,,,11.52,14.56,6
HCPCS,0838T,Dgtz gls mcrscp cslt sld els,,,56.79,71.74,6
HCPCS,0839T,Dgtz gls mcrscp cslt mat prp,,,56.79,71.74,6
HCPCS,0840T,Dgtz gls mcrscp cslt compre,,,56.79,71.74,6
HCPCS,0841T,Dgtz gls mcrscp pth cslt 1st,,,56.79,71.74,6
HCPCS,0842T,Dgtz gls mcrscp pth cslt ea,,,56.79,71.74,6
HCPCS,0843T,Dgtz gls mcrscp cslt cyt 1st,,,56.79,71.74,6
HCPCS,0844T,Dgtz gls mcrscp cslt cyt ea,,,56.79,71.74,6
HCPCS,0845T,Dgtz gls mcrscp imfluor 1st,,,19.72,24.91,6
HCPCS,0846T,Dgtz gls mcrscp imfluor ea,,,19.72,24.91,6
HCPCS,0847T,Dgtz gls mcrscp xm arch tiss,,,11.52,14.56,6
HCPCS,0848T,Dgtz gls mcrscp ish 1st,,,94.71,119.63,6
HCPCS,0849T,Dgtz gls mcrscp ish ea adl 1,,,19.72,24.91,6
HCPCS,0850T,Dgtz gls mcrscp ish ea mult,,,94.71,119.63,6
HCPCS,0851T,Dgtz gls mcrscp mphmtrc 1st,,,94.71,119.63,6
HCPCS,0852T,Dgtz gls mcrscp mphmtrc ea 1,,,19.72,24.91,6
HCPCS,0853T,Dgtz gls mcrscp mphmtrc ea m,,,94.71,119.63,6
HCPCS,0854T,Dgtz gls mcrscp bld smr prph,,,2.81,3.55,6
HCPCS,0855T,Dgtz gls mcrscp b1 marow smr,,,325.19,410.76,6
HCPCS,0856T,Dgtz gls mcrscp electron mic,,,94.71,119.63,6
HCPCS,0857T,OPTO-ACOUSTIC IMG BREAST UNI,,,20.04,20.04,2
HCPCS,0857T,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,531.0,345.15,10.42,893.0,99
HCPCS,0857T0,OPTO-ACOUSTIC IMG BREAST UNI,,,20.04,20.04,1
HCPCS,0857TTC,OPTO-ACOUSTIC IMG BREAST UNI,,,20.04,20.04,1
HCPCS,0858T,Ext trnscranl mag stimj meas,,,292.32,369.25,6
HCPCS,0859T,NCNTC IFR SPCTRSC O/T PAD EA,,,17.01,17.01,2
HCPCS,0859T0,NCNTC IFR SPCTRSC O/T PAD EA,,,17.01,17.01,1
HCPCS,0859TTC,NCNTC IFR SPCTRSC O/T PAD EA,,,17.01,17.01,1
HCPCS,0861T,RMVL PG WCS LV BOTH COMPNT,,,3653.06,7890.6,14
HCPCS,0861T,Rmvl pg wcs lv both compnt,,,4041.02,5104.45,6
HCPCS,0862T,RLCJ PG WCS LV BATTERY ONLY,,,1836.14,3966.07,14
HCPCS,0862T,Rlcj pg wcs lv battery only,,,916.39,1157.54,6
HCPCS,0863T,RLCJ PG WCS LV TRNSMTR ONLY,,,1836.14,3966.07,14
HCPCS,0863T,Rlcj pg wcs lv trnsmtr only,,,916.39,1157.54,6
HCPCS,0864T,LOW INTENSITY ESWT CORPUS CAVERNOSUM LOW ENERGY,1216.0,790.4,53.02,2849.0,48
HCPCS,0864T,LOW NTSTY ESWT CORPUS CVRNSM,,,318.92,318.92,1
HCPCS,0864T0,LOW NTSTY ESWT CORPUS CVRNSM,,,318.92,318.92,1
HCPCS,0865T,QUAN MRI ALYS BRN W/O DX MRI,,,242.63,525.31,17
HCPCS,0865T,Quan mri alys brn w/o dx mri,,,145.46,183.74,6
HCPCS,0866T,QUAN MRI ALYS BRAIN WITH DIAGNOSTIC MRI,1209.0,785.85,53.52,1479.0,51
HCPCS,0866T,QUAN MRI ALYS BRN W/DX MRI,,,139.83,139.83,2
HCPCS,0866T,QUANTITATIVE MRI ANALYSIS OF THE BRAIN,1209.0,785.85,145.46,2109.0,48
HCPCS,0866T0,QUAN MRI ALYS BRN W/DX MRI,,,139.83,139.83,1
HCPCS,0866TTC,QUAN MRI ALYS BRN W/DX MRI,,,139.83,139.83,1
HCPCS,0867T,TPLA B9 PRST8 HYPRPLSA>=50ML,,,1694.38,11022.13,15
HCPCS,0867T,Tpla b9 prst8 hyprplsa>=50ml,,,2889.05,3649.33,6
HCPCS,0867T0,TPLA B9 PRST8 HYPRPLSA>=50ML,,,1694.38,1694.38,1
HCPCS,0868T,HI-RES GASTRIC EP MAPPING,,,389.68,1150.43,14
HCPCS,0868T,Hi-res gastric ep mapping,,,181.25,228.95,6
HCPCS,0869T,NJX B1 SUB MATRL B1&/SFT TISSUE HW FIXJ AGMNTJ,1118.0,726.7,559.0,1118.0,13
HCPCS,0869T,NJX B1 SUB MTRL HW FIXJ AUG,,,362.64,7034.85,15
HCPCS,0869T,Njx b1 sub mtrl hw fixj aug,,,151.21,191.0,6
HCPCS,0869T0,NJX B1 SUB MTRL HW FIXJ AUG,,,362.64,362.64,1
HCPCS,0870T,IMP SUBQ PRTL ASCTS PMP SYS,,,35775.41,39352.95,4
HCPCS,0870T,Imp subq prtl ascts pmp sys,,,3427.97,4330.07,6
HCPCS,0871T,RPLCMT SUBQ PRTL ASCITES PMP,,,28109.36,30920.3,4
HCPCS,0871T,Rplcmt subq prtl ascites pmp,,,2290.02,2892.66,6
HCPCS,0872T,RPLCMT NDWLLG BLDR&PRTL CATH,,,3738.94,4112.83,4
HCPCS,0872T,Rplcmt ndwllg bldr&prtl cath,,,2290.02,2892.66,6
HCPCS,0873T,REVJ SUBQ PRTL ASCT PMP SYS,,,3738.94,4112.83,4
HCPCS,0873T,Revj subq prtl asct pmp sys,,,2290.02,2892.66,6
HCPCS,0874T,RMVL PERTL ASCITES PMP SYS,,,3738.94,4112.83,4
HCPCS,0874T,Rmvl pertl ascites pmp sys,,,2290.02,2892.66,6
HCPCS,0875T,PRGRM SUBQ PRTL ASCT PMP SYS,,,38.97,42.87,4
HCPCS,0875T,Prgrm subq prtl asct pmp sys,,,21.15,26.71,6
HCPCS,0876T,Duplex scan hemo fstl lmtd,,,66.35,83.81,6
HCPCS,0877T,AUGMNT ALYS CH CT ILD W/O CT,,,652.96,1410.39,14
HCPCS,0877T,Augmnt alys ch ct ild w/o ct,,,64.08,80.94,6
HCPCS,0878T,AUGMNT ALYS CH CT ILD W/CT,,,652.96,1410.39,14
HCPCS,0878T,Augmnt alys ch ct ild w/ct,,,64.08,80.94,6
HCPCS,0881T,CRYOTHERAPY ORAL CAVITY,,,400.55,865.18,14
HCPCS,0882T,Intraop ther estim pn ue 1st,,,835.73,1055.66,6
HCPCS,0883T,Intraop ther estim pn ue ea,,,835.73,1055.66,6
HCPCS,0884T,ESPHGSC FLX 1ST TNDSC DILAT,,,1006.13,12906.67,15
HCPCS,0884T,Esphgsc flx 1st tndsc dilat,,,1333.44,1684.34,6
HCPCS,0884T0,ESPHGSC FLX 1ST TNDSC DILAT,,,1006.13,1006.13,1
HCPCS,0885T,COLSC FLX 1ST TNDSC DILAT,,,661.31,12906.67,15
HCPCS,0885T,Colsc flx 1st tndsc dilat,,,1275.65,1611.35,6
HCPCS,0885T0,COLSC FLX 1ST TNDSC DILAT,,,661.31,661.31,1
HCPCS,0886T,SGMDSC FLX 1ST TNDSC DILAT,,,551.21,12906.67,15
HCPCS,0886T,Sgmdsc flx 1st tndsc dilat,,,1275.65,1611.35,6
HCPCS,0886T0,SGMDSC FLX 1ST TNDSC DILAT,,,551.21,551.21,1
HCPCS,0887T,End-tidal ctrl inhaled anes,,,13.94,17.6,6
HCPCS,0888T,HISTOTRIPSY MAL RENAL TISSUE,,,17566.65,39376.13,17
HCPCS,0888T,Histotripsy mal renal tissue,,,4333.98,5474.5,6
HCPCS,0889T,PRSNLZ TRGT DVL ARHFCMRIGTBS,,,954.09,2060.84,14
HCPCS,0889T,Prsnlz trgt dvl arhfcmrigtbs,,,292.32,369.25,6
HCPCS,0890T,ARHFCMRIGTBS 1ST TX DAY,,,3764.68,8131.7,14
HCPCS,0890T,Arhfcmrigtbs 1st tx day,,,292.32,369.25,6
HCPCS,0891T,ARHFCMRIGTBS SBSQ TX DAY,,,3764.68,8131.7,14
HCPCS,0891T,Arhfcmrigtbs sbsq tx day,,,292.32,369.25,6
HCPCS,0892T,ARHFCMRIGTBS SBSQ PER TX DAY,,,3764.68,8131.7,14
HCPCS,0892T,Arhfcmrigtbs sbsq per tx day,,,292.32,369.25,6
HCPCS,0893T,N-INVAS ASSMT BLD OXYGNATION,,,59.62,152.83,14
HCPCS,0894T,CANNULATION LIVER ALLOGRAFT,,,45.8,45.8,1
HCPCS,0894T,CANNULJ LVR ALGRFT PREPJ CONNJ NRMTHRMC PRFU DEV,6094.0,3961.1,92.37,6094.0,13
HCPCS,0894T,Cannulation liver allograft,,,3411.14,4308.8,6
HCPCS,0894T0,CANNULATION LIVER ALLOGRAFT,,,45.8,45.8,1
HCPCS,0895T,CONNJ LVR ALGRFT NRMTHRMC PRFUJ DEV 1ST 4 HOURS,3924.0,2550.6,52.13,3924.0,13
HCPCS,0895T,CONNJ LVR ALGRFT PRFU DEV 1,,,28.29,28.29,1
HCPCS,0895T,Connj lvr algrft prfu dev 1,,,3411.14,4308.8,6
HCPCS,0895T0,CONNJ LVR ALGRFT PRFU DEV 1,,,28.29,28.29,1
HCPCS,0896T,CONNJ LVR ALGRFT NRMTHRMC PRFUJ DEV EA ADDL HOUR,1666.0,1082.9,13.04,1666.0,13
HCPCS,0896T,CONNJ LVR ALGRFT PRFU DEV EA,,,7.08,7.08,1
HCPCS,0896T,Connj lvr algrft prfu dev ea,,,3411.14,4308.8,6
HCPCS,0896T0,CONNJ LVR ALGRFT PRFU DEV EA,,,7.08,7.08,1
HCPCS,0897T,N-INVAS AUGMNT ARRHYT ALYS,,,896.76,2205.87,14
HCPCS,0898T,N-INVAS PRST8 CANCER EST MAP,,,896.76,2205.87,14
HCPCS,0899T,N-invas deter aqmbf aug cmr,,,145.46,183.74,6
HCPCS,0900T,N-invas est aqmbf asstv cmr,,,145.46,183.74,6
HCPCS,0901T,Plmt bone marrow smplg port,,,136.83,172.84,6
HCPCS,0902T,QTC NTRVL AUGMNT ALG ALY ECG,,,129.39,279.48,14
HCPCS,0902T,Qtc ntrvl augmnt alg aly ecg,,,16.03,20.24,6
HCPCS,0903T,Ecg alg 12 lead reduced i&r,,,16.03,20.24,6
HCPCS,0904T,ECG ALG 12 LD RDCD TRCG ONLY,,,59.62,128.79,14
HCPCS,0904T,Ecg alg 12 ld rdcd trcg only,,,16.03,20.24,6
HCPCS,0905T,Ecg alg 12 ld rdcd i&r only,,,16.03,20.24,6
HCPCS,0906T,COMS THER 1ST APPL<=50 SQ CM,,,199.45,430.81,14
HCPCS,0906T,Coms ther 1st appl<=50 sq cm,,,115.89,146.39,6
HCPCS,0907T,Coms ther ea addl<=50 sq cm,,,115.89,146.39,6
HCPCS,0908T,OPEN IMPLTJ INT NEUROSTIMULATION SYS VAGUS NERVE,4180.0,2717.0,2090.0,4180.0,12
HCPCS,0908T,OPN IMP INT NSTM SYS VGS NRV,,,32224.05,35446.45,4
HCPCS,0908T,Opn imp int nstm sys vgs nrv,,,3699.03,4672.46,6
HCPCS,0909T,REPLACEMENT INT NEUROSTIMULATION SYS VAGUS NERVE,5108.0,3320.2,2554.0,5108.0,12
HCPCS,0909T,RPLCMT INT NSTIM SYS VGS NRV,,,32224.05,35446.45,4
HCPCS,0909T,Rplcmt int nstim sys vgs nrv,,,3699.03,4672.46,6
HCPCS,0910T,REMOVAL INT NEUROSTIMULATION SYS VAGUS NERVE,4226.0,2746.9,2113.0,4226.0,12
HCPCS,0910T,RMVL INT NSTIM SYS VAGUS NRV,,,3650.91,4016.0,4
HCPCS,0910T,Rmvl int nstim sys vagus nrv,,,1950.92,2464.32,6
HCPCS,0911T,ELEC ALY NSTM SYS VGS NRV WO,,,61.6,67.76,4
HCPCS,0911T,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/O PRGRMG,163.0,105.95,81.5,163.0,12
HCPCS,0911T,Elec aly nstm sys vgs nrv wo,,,82.56,104.28,6
HCPCS,0912T,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/SMPL PRGRMG,363.0,235.95,181.5,363.0,12
HCPCS,0912T,ELEC ALYS NSTIM SYS VGS SMPL,,,99.28,109.21,4
HCPCS,0912T,Elec alys nstim sys vgs smpl,,,82.56,104.28,6
HCPCS,0913T,PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART,2708.0,1760.2,955.89,2708.0,13
HCPCS,0913T,PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART PERQ TCAT THER,28508.0,18530.2,3519.0,37851.0,45
HCPCS,0914T,PERQ TCAT THER RX DLVR NTRAC RX BALO SEPARATE,9183.0,5968.950000000001,1354.0,37851.0,47
HCPCS,0915T,INSJ PERM CCM-D SYS PG&DUAL TRANSVNS ELTRDS/LDS,5227.0,3397.55,2613.5,5227.0,12
HCPCS,0915T,INSJ PERM CCM-D SYS PG&ELTRD,,,32182.77,69514.79,14
HCPCS,0915T,Insj perm ccm-d sys pg&eltrd,,,13248.3,16734.7,6
HCPCS,0916T,INSERTION PERM CCM-D SYSTEM PULSE GENERATOR ONLY,2334.0,1517.1,1167.0,2334.0,12
HCPCS,0916T,INSJ PERM CCM-D SYS PG ONLY,,,22531.04,48667.04,14
HCPCS,0916T,Insj perm ccm-d sys pg only,,,13248.3,16734.7,6
HCPCS,0917T,INSJ PERM CCM-D SYS 1 LEAD,,,8307.26,17943.69,14
HCPCS,0917T,INSJ PERM CCM-D SYS 1 TRANSVNS LEAD ONLY,2460.0,1599.0,1230.0,2460.0,12
HCPCS,0917T,Insj perm ccm-d sys 1 lead,,,916.39,1157.54,6
HCPCS,0918T,INSJ PERM CCM-D SYS DUAL LD,,,8307.26,17943.69,14
HCPCS,0918T,INSJ PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,2460.0,1599.0,1230.0,2460.0,12
HCPCS,0918T,Insj perm ccm-d sys dual ld,,,916.39,1157.54,6
HCPCS,0919T,REMOVAL PERM CCM-D SYSTEM PULSE GENERATOR ONLY,1436.0,933.4,718.0,1436.0,12
HCPCS,0919T,RMVL PERM CCM-D SYS PG ONLY,,,3653.06,7890.6,14
HCPCS,0919T,Rmvl perm ccm-d sys pg only,,,4041.02,5104.45,6
HCPCS,0920T,RMVL PERM CCM-D SYS 1 PAC LD,,,3653.06,7890.6,14
HCPCS,0920T,RMVL PERM CCM-D SYS 1 TRANSVNS PACING LEAD ONLY,3675.0,2388.75,1837.5,3675.0,12
HCPCS,0920T,Rmvl perm ccm-d sys 1 pac ld,,,916.39,1157.54,6
HCPCS,0921T,RMVL PERM CCM-D SYS 1 DFB LD,,,3653.06,7890.6,14
HCPCS,0921T,RMVL PERM CCM-D SYS 1 TRANSVNS DFB LEAD ONLY,3675.0,2388.75,1837.5,3675.0,12
HCPCS,0921T,Rmvl perm ccm-d sys 1 dfb ld,,,916.39,1157.54,6
HCPCS,0922T,RMVL PERM CCM-D SYS DUAL LD,,,3653.06,7890.6,14
HCPCS,0922T,RMVL PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,3675.0,2388.75,1837.5,3675.0,12
HCPCS,0922T,Rmvl perm ccm-d sys dual ld,,,916.39,1157.54,6
HCPCS,0923T,RMVL&RPLCMT PERM CCM-D PG,,,22531.04,48667.04,14
HCPCS,0923T,RMVL&RPLCMT PERMANENT CCM-D PULSE GENERATOR ONLY,2330.0,1514.5,1165.0,2330.0,12
HCPCS,0923T,Rmvl&rplcmt perm ccm-d pg,,,13248.3,16734.7,6
HCPCS,0924T,REPOSITIONING PREV IMPL CCM-D TRANSVNS ELTRD/LD,2071.0,1346.15,1035.5,2071.0,12
HCPCS,0924T,RPOS PRV CCM-D TRNSVNS ELTRD,,,620.6,1340.49,14
HCPCS,0924T,Rpos prv ccm-d trnsvns eltrd,,,916.39,1157.54,6
HCPCS,0925T,RELOCATION SKIN POCKET IMPLANTED CCM-D PG,2926.0,1901.9,1463.0,2926.0,12
HCPCS,0925T,RLCJ SKIN POCKET CCM-D PG,,,1836.14,3966.07,14
HCPCS,0925T,Rlcj skin pocket ccm-d pg,,,916.39,1157.54,6
HCPCS,0926T,PRGRMG DEV EVAL CCM-D IP,,,37.43,80.85,14
HCPCS,0926T,PROGRAMMING DEVICE EVAL IMPL CCM-D SYS IN PERSON,872.0,566.8,436.0,872.0,12
HCPCS,0926T,Prgrmg dev eval ccm-d ip,,,21.15,26.71,6
HCPCS,0927T,INTERROG DEV EVAL CCM-D IP,,,37.43,80.85,14
HCPCS,0927T,INTERROG DEV EVAL IMPL CCM-D SYSTEM IN PERSON,390.0,253.5,195.0,390.0,12
HCPCS,0927T,Interrog dev eval ccm-d ip,,,21.15,26.71,6
HCPCS,0928T,REMOTE INTERROG DEV EVAL CCM-D SYS <90D PHYS/QHP,279.0,181.35,139.5,279.0,12
HCPCS,0928T,Rem interrog dev ccm-d phys,,,21.15,26.71,6
HCPCS,0929T,REM INTERROG DEV CCM-D TECH,,,37.43,80.85,14
HCPCS,0929T,Rem interrog dev ccm-d tech,,,21.15,26.71,6
HCPCS,0930T,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS AT 1ST IMPL,5227.0,3397.55,2613.5,5227.0,12
HCPCS,0930T,EPHYS EVAL CCM-D LD 1ST IMPL,,,1218.58,2632.13,14
HCPCS,0930T,Ephys eval ccm-d ld 1st impl,,,4038.75,5101.58,6
HCPCS,0931T,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS SEPARATE,5227.0,3397.55,2613.5,5227.0,12
HCPCS,0931T,EPHYS EVAL CCM-D LD SEPARATE,,,1218.58,2632.13,14
HCPCS,0931T,Ephys eval ccm-d ld separate,,,4038.75,5101.58,6
HCPCS,0932T,N-INVS DET HRT FAIL AUG ECHO,,,301.04,650.25,14
HCPCS,0932T,N-invs det hrt fail aug echo,,,82.56,104.28,6
HCPCS,0933T,TCAT IMPL WRLS L ATR PRS SNR,,,3228.57,6973.71,14
HCPCS,0933T,TCAT IMPLT WRLS L ATR PRS SNR L-T L ATR PRS MNTR,2786.0,1810.9,1393.0,2786.0,12
HCPCS,0933T,Tcat impl wrls l atr prs snr,,,1513.2,1911.41,6
HCPCS,0934T,REMOTE MNTR WIRELESS L ATRIAL PRESSURE SNR<30 D,325.0,211.25,162.5,325.0,12
HCPCS,0934T,Rem mntr wrls l atr prs snr,,,23.85,30.13,6
HCPCS,0935T,CYSTO W/RNL PEL SYMPATHETIC DNRVTJ RF ABLTJ BI,3715.0,2414.75,1857.5,3715.0,12
HCPCS,0935T,Cysto w/rnl pel symp dnrvtj,,,918.04,1159.63,6
HCPCS,0936T,PHOTOBIOMODULATION THERAPY RETINA SINGLE SESSION,28.0,18.2,14.0,1086.71,13
HCPCS,0936T,Photobiomodulation ther rta,,,169.69,214.34,6
HCPCS,0937T,XTRNL ECG REC>15D<30D REC SCAN ALYS RVW&INTERPJ,256.0,166.4,128.0,256.0,12
HCPCS,0937T,Xtrnl ecg rec>15d<30d,,,33.85,42.76,6
HCPCS,0938T,Xtrnl ecg rec>15d<30d rec,,,33.85,42.76,6
HCPCS,0939T,Xtrnl ecg rec>15d<30d scan,,,33.85,42.76,6
HCPCS,0940T,XTRNL ECG REC>15D<30D REVIEW&INTERPJ PHYS/QHP,256.0,166.4,128.0,256.0,12
HCPCS,0940T,Xtrnl ecg rec>15d<30d r&i,,,33.85,42.76,6
HCPCS,0941T,CYSTO FLX INSJ&XPNSJ PROSTATIC URTL SCAFFOLD,762.0,495.3,381.0,762.0,12
HCPCS,0941T,Cysto flx ins&xpns urtl scaf,,,1043.57,1318.19,6
HCPCS,0942T,CYSTO FLX RMVL&RPLCMT PROSTATIC URTL SCAFFOLD,1306.0,848.9,653.0,1306.0,12
HCPCS,0942T,Cysto flx rmv&rplc urtl scaf,,,1043.57,1318.19,6
HCPCS,0943T,CYSTO FLX REMOVAL PROSTATIC URETHRAL SCAFFOLD,1306.0,848.9,653.0,1306.0,12
HCPCS,0943T,Cysto flx rmvl urtl scaffold,,,1043.57,1318.19,6
HCPCS,0944T,3D CNTR SIMULA TRGT LVR LES,,,242.63,543.87,17
HCPCS,0946T,ORTHO IMPL MVMT ALYS PAIR CT,,,106.74,239.27,17
HCPCS,0946T,Ortho impl mvmt alys pair ct,,,64.08,80.94,6
HCPCS,0947T,Mrgfus strtctc bl-br disrpj,,,3699.03,4672.46,6
HCPCS,0948T,Rem interrog dev ccm phys,,,21.15,26.71,6
HCPCS,0949T,REM INTERROG DEV CCM TECH,,,38.97,42.87,4
HCPCS,0949T,Rem interrog dev ccm tech,,,21.15,26.71,6
HCPCS,0950T,ABLTJ B9 PRST8 TISSUE HIFU,,,9885.63,10874.19,4
HCPCS,0950T,Abltj b9 prst8 tissue hifu,,,2889.05,3649.33,6
HCPCS,0950T,PR ABLTJ B9 PRST8 TISSUE TRANSRECTAL HIFU W/US GDN,7092.0,4609.8,3546.0,7092.0,12
HCPCS,0951T,Tot impl amei 1st plmt,,,14455.15,18259.14,6
HCPCS,0952T,Tot impl amei rev/rplc mstdc,,,14455.15,18259.14,6
HCPCS,0953T,Tot impl amei rev/rplc w/o,,,2132.36,2693.51,6
HCPCS,0954T,Tot impl amei rplc snd proc,,,1634.08,2064.1,6
HCPCS,0955T,Tot impl amei removal,,,1634.08,2064.1,6
HCPCS,0956T,PRT CRN CH CR&TUN ELT S-SCLP,,,28335.49,31169.04,4
HCPCS,0956T,Prt crn ch cr&tun elt s-sclp,,,11520.56,14552.29,6
HCPCS,0957T,REV S-SCLP ELTR RA RCVR&TLMT,,,1679.19,1847.11,4
HCPCS,0957T,Rev s-sclp eltr ra rcvr&tlmt,,,1950.92,2464.32,6
HCPCS,0958T,RMV S-SCLP ELTR RA RCVR&TLMT,,,3416.88,3758.57,4
HCPCS,0958T,Rmv s-sclp eltr ra rcvr&tlmt,,,1950.92,2464.32,6
HCPCS,0959T,RMV/RPLC MAGNET COIL ASSEM,,,1724.73,1897.2,4
HCPCS,0959T,Rmv/rplc magnet coil assem,,,1950.92,2464.32,6
HCPCS,0960T,RPL S-SCLP ELTR RA RCVR&TLMT,,,28335.49,31169.04,4
HCPCS,0960T,Rpl s-sclp eltr ra rcvr&tlmt,,,11520.56,14552.29,6
HCPCS,0961T,Shortwave ifr radiation img,,,94.71,119.63,6
HCPCS,0962T,ASSTV ALG ALYS ACOUS&ECG REC,,,138.94,152.83,4
HCPCS,0962T,Asstv alg alys acous&ecg rec,,,33.85,42.76,6
HCPCS,0963T,ANOSC SBMCSL NJX BULKING AGT,,,1249.63,1374.59,4
HCPCS,0963T,Anosc sbmcsl njx bulking agt,,,1275.65,1611.35,6
HCPCS,0964T,I&CUST PREP JAW XPNSJ 1ARCH,,,3462.26,3808.49,4
HCPCS,0964T,I&cust prep jaw xpnsj 1arch,,,1105.23,1396.08,6
HCPCS,0965T,I&CST PRP JW XPN DL ARCH NON,,,3462.26,3808.49,4
HCPCS,0965T,I&cst prp jw xpn dl arch non,,,1829.98,2311.55,6
HCPCS,0966T,I&CST PRP JW XPN DL ARCH FXD,,,3462.26,3808.49,4
HCPCS,0966T,I&cst prp jw xpn dl arch fxd,,,1829.98,2311.55,6
HCPCS,0967T,TRANAL INS TMP CLRC ANST DEV,,,1249.63,1374.59,4
HCPCS,0967T,Tranal ins tmp clrc anst dev,,,2480.69,3133.5,6
HCPCS,0968T,Insj/rplcmt epcrnl nstim sys,,,11520.56,14552.29,6
HCPCS,0969T,Removal epicranial nstim sys,,,1950.92,2464.32,6
HCPCS,0970T,ABLT B9 BRST TUM PERQ LSR EA,,,4088.81,4497.69,4
HCPCS,0970T,Ablt b9 brst tum perq lsr ea,,,816.59,1031.48,6
HCPCS,0971T,ABLT MAL BRST TUM PQ LSR UNI,,,4088.81,4497.69,4
HCPCS,0971T,Ablt mal brst tum pq lsr uni,,,816.59,1031.48,6
HCPCS,0973T,SLCTV NZMTC DBRDMT T/A/L 1ST,,,424.52,466.97,4
HCPCS,0973T,Slctv nzmtc dbrdmt t/a/l 1st,,,613.49,774.94,6
HCPCS,0974T,Slctv nzmtc dbrdmt t/a/l ea,,,241.35,304.86,6
HCPCS,0975T,SLCTV NZMTC DBRDMT S/N/HF 1,,,424.52,466.97,4
HCPCS,0975T,Slctv nzmtc dbrdmt s/n/hf 1,,,613.49,774.94,6
HCPCS,0976T,Slctv nzmtc dbrdmt s/n/hf ea,,,241.35,304.86,6
HCPCS,0977T,UPR GI BLD DETCJ SNR CAPSULE,,,947.15,1041.86,4
HCPCS,0977T,Upr gi bld detcj snr capsule,,,181.25,228.95,6
HCPCS,0981T,TCAT IMPL WRLS IVC SNR,,,19143.34,21057.68,4
HCPCS,0981T,Tcat impl wrls ivc snr,,,4706.22,5944.7,6
HCPCS,0982T,REM MNTR IMPL IVC SNR SET-UP,,,139.03,152.93,4
HCPCS,0982T,Rem mntr impl ivc snr set-up,,,33.85,42.76,6
HCPCS,0983T,REM MNTR IMPL IVC SNR PHYS,,,38.97,42.87,4
HCPCS,0983T,Rem mntr impl ivc snr phys,,,23.85,30.13,6
HCPCS,0988T,OPEN INSJ/RPLCMT INT NSTIMJ SYS PTN SUBQ&SUBF,2192.0,1424.8,1096.0,2192.0,12
HCPCS,0988T,Opn ins/rplc ins ptn sbq&sbf,,,11520.56,14552.29,6
HCPCS,0989T,REVJ/RMVL INS PTN SUBQ&SUBF,,,3650.91,4016.0,4
HCPCS,0989T,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBQ&SUBF,2529.0,1643.85,1264.5,2529.0,12
HCPCS,0989T,Revj/rmvl ins ptn subq&subf,,,1950.92,2464.32,6
HCPCS,0990T,TRANSCRV INSTLJ BIOD HYDROGEL MATRL INTRAUTERINE,713.0,463.45000000000005,132.47,2849.0,39
HCPCS,0991T,CYSTO LO-NRG LITHOTRP&ACOUS ACTUATED MICROSPHERE,3200.0,2080.0,1600.0,3200.0,12
HCPCS,0991T,CYSTO LO-NRG LITHTRP&MCRSPHR,,,9885.63,10874.19,4
HCPCS,0991T,Cysto lo-nrg lithtrp&mcrsphr,,,1770.94,2236.98,6
HCPCS,0992T,N-INVAS ASSMT CAR RSK W/O CT,,,249.17,274.08,4
HCPCS,0992T,N-invas assmt car rsk w/o ct,,,64.08,80.94,6
HCPCS,0993T,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,1219.0,792.35,64.08,1746.0,74
HCPCS,0994T,Evasc dlvr a-wal stbl rx prq,,,8579.14,10836.8,6
HCPCS,0995T,Evasc dlvr a-wal stbl rx opn,,,5148.42,6503.27,6
HCPCS,0996T,INS&SCLR FIX CAPS BAG PROSTH,,,2410.01,2651.01,4
HCPCS,0996T,Ins&sclr fix caps bag prosth,,,1056.74,1334.83,6
HCPCS,0997T,PRECUNEUS MAGNETIC STIMULATION TREATMENT PLNG,876.0,569.4000000000001,82.59,1819.0,42
HCPCS,0998T,PRECUNEUS MAGNETIC STIMULATION TREATMENT DLVR,876.0,569.4000000000001,196.22,1819.0,42
HCPCS,0999T,Autol musc cell therapy hrvg,,,974.47,1230.91,6
HCPCS,1,ANNUAL WELLNESS SUBSEQUENT G0439B,768.0,499.2,384.0,768.0,12
HCPCS,10004,FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL,795.5,517.075,33.48,26432.0,104
HCPCS,10004,FNA BX W/O IMG GDN EA ADDL,,,40.85,40.85,1
HCPCS,100040,FNA BX W/O IMG GDN EA ADDL,,,40.85,40.85,1
HCPCS,10005,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,2344.0,1523.6000000000001,35.67,26432.0,224
HCPCS,10005,FNA BX W/US GDN 1ST LES,,,68.5,68.5,1
HCPCS,100050,FNA BX W/US GDN 1ST LES,,,68.5,68.5,1
HCPCS,10006,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,809.0,525.85,26.62,26432.0,142
HCPCS,10006,FNA BX W/US GDN EA ADDL,,,46.89,46.89,1
HCPCS,100060,FNA BX W/US GDN EA ADDL,,,46.89,46.89,1
HCPCS,10007,FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION,4046.0,2629.9,109.5,26432.0,98
HCPCS,10007,FINE NEEDLE ASPIRATION BX W/FLUORO GDN 1ST LESION,724.0,470.6,43.89,543.0,31
HCPCS,10007,FNA BX W/FLUOR GDN 1ST LES,,,84.2,84.2,1
HCPCS,100070,FNA BX W/FLUOR GDN 1ST LES,,,84.2,84.2,1
HCPCS,10008,FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL,689.0,447.85,17.52,26432.0,107
HCPCS,10008,FNA BX W/FLUOR GDN EA ADDL,,,48.79,48.79,1
HCPCS,100080,FNA BX W/FLUOR GDN EA ADDL,,,48.79,48.79,1
HCPCS,10009,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,2475.0,1608.75,58.42,26432.0,224
HCPCS,10009,FNA BX W/CT GDN 1ST LES,,,101.7,101.7,1
HCPCS,100090,FNA BX W/CT GDN 1ST LES,,,101.7,101.7,1
HCPCS,1000F,TOBACCO USE ASSESSED,,,0.01,0.01,1
HCPCS,1000F0,TOBACCO USE ASSESSED,,,0.01,0.01,1
HCPCS,1000T,Autol musc cell therapy admn,,,970.74,1226.2,6
HCPCS,10010,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,1249.5,812.175,38.3,26432.0,142
HCPCS,10010,FNA BX W/CT GDN EA ADDL,,,68.36,68.36,1
HCPCS,100100,FNA BX W/CT GDN EA ADDL,,,68.36,68.36,1
HCPCS,10011,FINE NEEDLE ASPIRATION BX W/MR GDN 1ST LESION,2626.0,1706.9,96.76,26432.0,112
HCPCS,10011,FNA BX W/MR GDN 1ST LES,,,323.55,323.55,1
HCPCS,100110,FNA BX W/MR GDN 1ST LES,,,323.55,323.55,1
HCPCS,10012,FINE NEEDLE ASPIRATION BX W/MR GDN EA ADDL,1212.5,788.125,96.76,26432.0,90
HCPCS,10012,FNA BX W/MR GDN EA ADDL,,,172.85,172.85,1
HCPCS,100120,FNA BX W/MR GDN EA ADDL,,,172.85,172.85,1
HCPCS,1001T,Autol musc cell therapy njx,,,901.17,1138.32,6
HCPCS,10021,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,1375.5,894.075,47.28,4151.0,228
HCPCS,10021,FNA BX W/O IMG GDN 1ST LES,,,51.56,51.56,1
HCPCS,100210,FNA BX W/O IMG GDN 1ST LES,,,51.56,51.56,1
HCPCS,10022,FINE NEEDLE ASPIRATION WITH IMAGING GUIDANCE,890.0,578.5,149.52,801.0,42
HCPCS,1002F,ASSESS ANGINAL SYMPTOM/LEVEL,,,0.01,0.01,1
HCPCS,1002F0,ASSESS ANGINAL SYMPTOM/LEVEL,,,0.01,0.01,1
HCPCS,1002T,AIR DISPLACMNT PLETHYSMOGRAP,,,30.2,33.22,4
HCPCS,1002T,Air displacmnt plethysmograp,,,33.85,42.76,6
HCPCS,10030,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,1869.5,1215.175,113.46,4151.0,273
HCPCS,10030,IMG GID FLU COLL DRG SFT TIS,,,126.17,126.17,1
HCPCS,100300,IMG GID FLU COLL DRG SFT TIS,,,126.17,126.17,1
HCPCS,10035,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,1659.5,1078.675,66.63,3259.0,322
HCPCS,10035,PLMT SFT TISS LOCLZJ DEV 1ST,,,78.38,78.38,1
HCPCS,100350,PLMT SFT TISS LOCLZJ DEV 1ST,,,78.38,78.38,1
HCPCS,10036,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,555.5,361.075,33.57,2849.0,245
HCPCS,10036,PLMT SFT TISS LOCLZJ DEV EA,,,39.69,39.69,1
HCPCS,100360,PLMT SFT TISS LOCLZJ DEV EA,,,39.69,39.69,1
HCPCS,1003F,LEVEL OF ACTIVITY ASSESS,,,0.01,0.01,1
HCPCS,1003F0,LEVEL OF ACTIVITY ASSESS,,,0.01,0.01,1
HCPCS,1003T,ARTHRP 1ST CRP/MTCRPL PROSTC,,,13407.17,14747.88,4
HCPCS,1003T,Arthrp 1st crp/mtcrpl prostc,,,2190.3,2766.7,6
HCPCS,10040,ACNE SURGERY,572.5,372.125,44.93,3920.0,81
HCPCS,10040,EXTRACTION,,,48.71,48.71,1
HCPCS,10040,MILIA EXTRACTION 1-5,250.0,162.5,44.93,187.5,35
HCPCS,10040,MILIA EXTRACTION EACH ADDTL 10,100.0,65.0,44.93,145.23,35
HCPCS,100400,EXTRACTION,,,48.71,48.71,1
HCPCS,1004F,CLIN SYMP VOL OVRLD ASSESS,,,0.01,0.01,1
HCPCS,1004F0,CLIN SYMP VOL OVRLD ASSESS,,,0.01,0.01,1
HCPCS,1004T,ELEC ALYS IMPL S-SCLP CONT BI EEG SYS W/O PRGRMG,680.0,442.0,82.56,1863.0,41
HCPCS,1005F,ASTHMA SYMPTOMS EVALUATE,,,0.01,0.01,1
HCPCS,1005F0,ASTHMA SYMPTOMS EVALUATE,,,0.01,0.01,1
HCPCS,1005T,ELEC ALYS IMPL S-SCLP CONT BI EEG SYS PRGRMG 1ST,486.0,315.9,82.56,1863.0,41
HCPCS,10060,I&D ABSCESS SIMPLE/SINGLE,,,98.94,98.94,1
HCPCS,10060,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,641.0,416.65,56.76,4151.0,372
HCPCS,100600,I&D ABSCESS SIMPLE/SINGLE,,,98.94,98.94,1
HCPCS,10061,I&D ABSCESS COMP/MULTIPLE,,,172.21,172.21,1
HCPCS,10061,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1288.5,837.5250000000001,88.77,4151.0,179
HCPCS,100610,I&D ABSCESS COMP/MULTIPLE,,,172.21,172.21,1
HCPCS,1006F,OSTEOARTHRITIS ASSESS,,,0.01,0.01,1
HCPCS,1006F0,OSTEOARTHRITIS ASSESS,,,0.01,0.01,1
HCPCS,1006T,Elec alys s-scl eeg prgrm ea,,,82.56,104.28,6
HCPCS,1007F,ANTI-INFLM/ANLGSC OTC ASSESS,,,0.01,0.01,1
HCPCS,1007F0,ANTI-INFLM/ANLGSC OTC ASSESS,,,0.01,0.01,1
HCPCS,1007T,Eeg impl s-sclp eeg w/o vid,,,222.5,281.05,6
HCPCS,10080,I&D PILONIDAL CYST SIMPLE,,,98.03,98.03,1
HCPCS,10080,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,1588.0,1032.2,50.8,4151.0,179
HCPCS,100800,I&D PILONIDAL CYST SIMPLE,,,98.03,98.03,1
HCPCS,10081,I&D PILONIDAL CYST COMP,,,160.86,160.86,1
HCPCS,10081,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,1869.5,1215.175,83.01,4268.0,179
HCPCS,100810,I&D PILONIDAL CYST COMP,,,160.86,160.86,1
HCPCS,1008F,GI/RENAL RISK ASSESS,,,0.01,0.01,1
HCPCS,1008F0,GI/RENAL RISK ASSESS,,,0.01,0.01,1
HCPCS,1008T,REM MNTR S-SCLP IMPL CONT BI EEG SYS FITG SET-UP,680.0,442.0,33.85,1863.0,41
HCPCS,1009T,Rem mntr s-sclp cont eeg sys,,,23.85,30.13,6
HCPCS,1010F,SEVERITY ANGINA BY ACTVTY,,,0.01,0.01,1
HCPCS,1010F0,SEVERITY ANGINA BY ACTVTY,,,0.01,0.01,1
HCPCS,1010T,CPTR OPH ALYS MONOC EYE MVMT,,,138.94,152.83,4
HCPCS,1010T,Cptr oph alys monoc eye mvmt,,,31.76,40.12,6
HCPCS,1011F,ANGINA PRESENT,,,0.01,0.01,1
HCPCS,1011F0,ANGINA PRESENT,,,0.01,0.01,1
HCPCS,1011T,Pbm therapy of oral cavity,,,112.01,141.49,6
HCPCS,10120,INC&RMVL FB SUBQ TISS SMPL,,,98.13,98.13,1
HCPCS,10120,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,1018.0,661.7,49.97,4151.0,179
HCPCS,101200,INC&RMVL FB SUBQ TISS SMPL,,,98.13,98.13,1
HCPCS,10121,INC&RMVL FB SUBQ TISS COMP,,,172.17,172.17,1
HCPCS,10121,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,3641.0,2366.65,88.93,8370.0,179
HCPCS,101210,INC&RMVL FB SUBQ TISS COMP,,,172.17,172.17,1
HCPCS,1012F,ANGINA ABSENT,,,0.01,0.01,1
HCPCS,1012F0,ANGINA ABSENT,,,0.01,0.01,1
HCPCS,1012T,MTRZ AB NTRNO TRPH SCL/TR MW,,,4316.45,4748.09,4
HCPCS,1012T,Mtrz ab ntrno trph scl/tr mw,,,2069.78,2614.46,6
HCPCS,1013T,LAP SRG IMP/RPL ESO NEA&PG/R,,,20259.13,22285.04,4
HCPCS,1013T,Lap srg imp/rpl eso nea&pg/r,,,11520.56,14552.29,6
HCPCS,10140,I&D HEMATOMA SEROMA/FLUID COLLECTION,3385.5,2200.575,57.04,5468.4,326
HCPCS,10140,I&D HMTMA SEROMA/FLUID COLLJ,,,110.6,110.6,1
HCPCS,101400,I&D HMTMA SEROMA/FLUID COLLJ,,,110.6,110.6,1
HCPCS,1014T,LAP RV/RMV ESO SPH NSTM ELTR,,,11636.08,12799.69,4
HCPCS,1014T,Lap rv/rmv eso sph nstm eltr,,,1950.92,2464.32,6
HCPCS,1015F,COPD SYMPTOMS ASSESS,,,0.01,0.01,1
HCPCS,1015F0,COPD SYMPTOMS ASSESS,,,0.01,0.01,1
HCPCS,1015T,REV/RMV LW ESOPH SPHNC NPG/R,,,3650.91,4016.0,4
HCPCS,1015T,Rev/rmv lw esoph sphnc npg/r,,,1950.92,2464.32,6
HCPCS,10160,PNXR ASPIR ABSC HMTMA BULLA,,,90.01,90.01,1
HCPCS,10160,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,999.5,649.675,45.87,4151.0,375
HCPCS,101600,PNXR ASPIR ABSC HMTMA BULLA,,,90.01,90.01,1
HCPCS,1016T,Elec alys npgs esoph intraop,,,82.56,104.28,6
HCPCS,1017T,ELEC ALY NPGS ESOPH SBSQ W/O,,,61.6,67.76,4
HCPCS,1017T,Elec aly npgs esoph sbsq w/o,,,21.15,26.71,6
HCPCS,10180,I&D COMPLEX PO WOUND INFCTJ,,,167.51,167.51,1
HCPCS,10180,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,5826.5,3787.225,86.47,13665.0,179
HCPCS,101800,I&D COMPLEX PO WOUND INFCTJ,,,167.51,167.51,1
HCPCS,1018F,ASSESS DYSPNEA NOT PRESENT,,,0.01,0.01,1
HCPCS,1018F0,ASSESS DYSPNEA NOT PRESENT,,,0.01,0.01,1
HCPCS,1018T,ELEC ALYS NPGS ESOPH SBSQ W/,,,38.97,42.87,4
HCPCS,1018T,Elec alys npgs esoph sbsq w/,,,21.15,26.71,6
HCPCS,1019F,ASSESS DYSPNEA PRESENT,,,0.01,0.01,1
HCPCS,1019F0,ASSESS DYSPNEA PRESENT,,,0.01,0.01,1
HCPCS,1019T,LYMPHOVENOUS BYPASS PER XTR,,,6934.19,7627.61,4
HCPCS,1019T,Lymphovenous bypass per xtr,,,1977.31,2497.66,6
HCPCS,1020T,RAMAN SPECTROSCOPY 1+SKN LES,,,61.6,135.61,7
HCPCS,1020T,Raman spectroscopy 1+skn les,,,20.85,26.34,6
HCPCS,1021T,ACTIVE THRC IRRIGATION SPX,,,655.08,720.59,4
HCPCS,1021T,Active thrc irrigation spx,,,599.03,756.67,6
HCPCS,1022F,PNEUMO IMM STATUS ASSESS,,,0.01,0.01,1
HCPCS,1022F0,PNEUMO IMM STATUS ASSESS,,,0.01,0.01,1
HCPCS,1025T,ALT ELEC FLD DOS&DLV SIM MDL,,,140.36,154.4,4
HCPCS,1025T,Alt elec fld dos&dlv sim mdl,,,71.21,89.95,6
HCPCS,1026F,CO-MORBID CONDITION ASSESS,,,0.01,0.01,1
HCPCS,1026F0,CO-MORBID CONDITION ASSESS,,,0.01,0.01,1
HCPCS,1030F,INFLUENZA IMM STATUS ASSESS,,,0.01,0.01,1
HCPCS,1030F0,INFLUENZA IMM STATUS ASSESS,,,0.01,0.01,1
HCPCS,1031F,SMOKING & 2ND HAND ASSESSED,,,0.01,0.01,1
HCPCS,1031F0,SMOKING & 2ND HAND ASSESSED,,,0.01,0.01,1
HCPCS,1032F,SMOKER/EXPOSED 2ND HND SMOKE,,,0.01,0.01,1
HCPCS,1032F0,SMOKER/EXPOSED 2ND HND SMOKE,,,0.01,0.01,1
HCPCS,1033F,TOBACCO NONSMOKER NOR 2NDHND,,,0.01,0.01,1
HCPCS,1033F0,TOBACCO NONSMOKER NOR 2NDHND,,,0.01,0.01,1
HCPCS,1034F,CURRENT TOBACCO SMOKER,,,0.01,0.01,1
HCPCS,1034F0,CURRENT TOBACCO SMOKER,,,0.01,0.01,1
HCPCS,1035F,SMOKELESS TOBACCO USER,,,0.01,0.01,1
HCPCS,1035F0,SMOKELESS TOBACCO USER,,,0.01,0.01,1
HCPCS,1036F,TOBACCO NON-USER,,,0.01,0.01,1
HCPCS,1036F0,TOBACCO NON-USER,,,0.01,0.01,1
HCPCS,1038F,PERSISTENT ASTHMA,,,0.01,0.01,1
HCPCS,1038F0,PERSISTENT ASTHMA,,,0.01,0.01,1
HCPCS,1039F,INTERMITTENT ASTHMA,,,0.01,0.01,1
HCPCS,1039F0,INTERMITTENT ASTHMA,,,0.01,0.01,1
HCPCS,1040F,DSM-5 INFO MDD DOCD,,,0.01,0.01,1
HCPCS,1040F0,DSM-5 INFO MDD DOCD,,,0.01,0.01,1
HCPCS,1050F,HISTORY OF MOLE CHANGES,,,0.01,0.01,1
HCPCS,1050F0,HISTORY OF MOLE CHANGES,,,0.01,0.01,1
HCPCS,1052F,TYPE LOCATION ACTIVITYASSESS,,,0.01,0.01,1
HCPCS,1052F0,TYPE LOCATION ACTIVITYASSESS,,,0.01,0.01,1
HCPCS,1055F,VISUAL FUNCT STATUS ASSESS,,,0.01,0.01,1
HCPCS,1055F0,VISUAL FUNCT STATUS ASSESS,,,0.01,0.01,1
HCPCS,1060F,DOC PERM/CONT/PAROX ATR FIB,,,0.01,0.01,1
HCPCS,1060F0,DOC PERM/CONT/PAROX ATR FIB,,,0.01,0.01,1
HCPCS,1061F,DOC LACK PERM&CONT&PAROX FIB,,,0.01,0.01,1
HCPCS,1061F0,DOC LACK PERM&CONT&PAROX FIB,,,0.01,0.01,1
HCPCS,1065F,ISCHM STROKE SYMP LT3 HRSB/4,,,0.01,0.01,1
HCPCS,1065F0,ISCHM STROKE SYMP LT3 HRSB/4,,,0.01,0.01,1
HCPCS,1066F,ISCHM STROKE SX ONSET>=3HR,,,0.01,0.01,1
HCPCS,1066F0,ISCHM STROKE SX ONSET>=3HR,,,0.01,0.01,1
HCPCS,1070F,ALARM SYMP ASSESSED-ABSENT,,,0.01,0.01,1
HCPCS,1070F0,ALARM SYMP ASSESSED-ABSENT,,,0.01,0.01,1
HCPCS,1071F,ALARM SYMP ASSESSED-1+ PRSNT,,,0.01,0.01,1
HCPCS,1071F0,ALARM SYMP ASSESSED-1+ PRSNT,,,0.01,0.01,1
HCPCS,1090F,PRES/ABSN URINE INCON ASSESS,,,0.01,0.01,1
HCPCS,1090F0,PRES/ABSN URINE INCON ASSESS,,,0.01,0.01,1
HCPCS,1091F,URINE INCON CHARACTERIZED,,,0.01,0.01,1
HCPCS,1091F0,URINE INCON CHARACTERIZED,,,0.01,0.01,1
HCPCS,11000,DBRDMT ECZ/INFECTED SKIN<10%,,,26.09,26.09,1
HCPCS,11000,DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF,1267.5,823.875,19.69,3920.0,80
HCPCS,110000,DBRDMT ECZ/INFECTED SKIN<10%,,,26.09,26.09,1
HCPCS,11001,DBRDMT ECZ/INFCT SKN EA ADDL,,,13.95,13.95,1
HCPCS,11001,DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF,120.0,78.0,9.99,90.0,35
HCPCS,11001,Dbrdmt ecz/infct skn ea addl,,,241.35,304.86,6
HCPCS,110010,DBRDMT ECZ/INFCT SKN EA ADDL,,,13.95,13.95,1
HCPCS,11004,DBRDMT SKIN XTRNL GENT&PER,,,535.68,535.68,1
HCPCS,11004,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR,2871.5,1866.475,239.06,18285.0,64
HCPCS,110040,DBRDMT SKIN XTRNL GENT&PER,,,535.68,535.68,1
HCPCS,11005,DBRDMT SKIN ABDOMINAL WALL,,,730.98,730.98,1
HCPCS,11005,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL,5696.0,3702.4,564.21,5696.0,35
HCPCS,11005,Dbrdmt skin abdominal wall,,,613.49,774.94,6
HCPCS,110050,DBRDMT SKIN ABDOMINAL WALL,,,730.98,730.98,1
HCPCS,11006,DBRDMT SKIN XTRNL GENT PER,,,660.78,660.78,1
HCPCS,11006,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL,5240.0,3406.0,521.96,5240.0,35
HCPCS,11006,Dbrdmt skin xtrnl gent per,,,613.49,774.94,6
HCPCS,110060,DBRDMT SKIN XTRNL GENT PER,,,660.78,660.78,1
HCPCS,11008,REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION,2000.0,1300.0,202.25,2000.0,35
HCPCS,11008,RMV PRSTC MTRL/MESH ABD WALL,,,257.42,257.42,1
HCPCS,11008,Rmv prstc mtrl/mesh abd wall,,,613.49,774.94,6
HCPCS,110080,RMV PRSTC MTRL/MESH ABD WALL,,,257.42,257.42,1
HCPCS,1100F,PTFALLS ASSESS-DOCD GE2>/YR,,,0.01,0.01,1
HCPCS,1100F0,PTFALLS ASSESS-DOCD GE2>/YR,,,0.01,0.01,1
HCPCS,11010,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,2241.5,1456.975,133.65,4268.0,133
HCPCS,11010,DEBRIDE SKIN AT FX SITE,,,258.45,258.45,1
HCPCS,110100,DEBRIDE SKIN AT FX SITE,,,258.45,258.45,1
HCPCS,11011,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,2406.5,1564.225,143.51,4268.0,84
HCPCS,11011,DEBRIDE SKIN MUSC AT FX SITE,,,279.8,279.8,1
HCPCS,110110,DEBRIDE SKIN MUSC AT FX SITE,,,279.8,279.8,1
HCPCS,11012,DBRDMT FX&/DISLC SUBQ T/M/F BONE,6878.0,4470.7,201.2,9659.7,133
HCPCS,11012,DEB SKIN BONE AT FX SITE,,,390.57,390.57,1
HCPCS,110120,DEB SKIN BONE AT FX SITE,,,390.57,390.57,1
HCPCS,1101F,PT FALLS ASSESS-DOCD LE1/YR,,,0.01,0.01,1
HCPCS,1101F0,PT FALLS ASSESS-DOCD LE1/YR,,,0.01,0.01,1
HCPCS,11042,DBRDMT SUBQ TIS 1ST 20SQCM/<,,,56.78,56.78,1
HCPCS,11042,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,971.5,631.475,28.94,4214.0,228
HCPCS,110420,DBRDMT SUBQ TIS 1ST 20SQCM/<,,,56.78,56.78,1
HCPCS,11043,DBRDMT MUSC&/FSCA 1ST 20/<,,,144.35,144.35,1
HCPCS,11043,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,1741.5,1131.975,74.14,4214.0,176
HCPCS,110430,DBRDMT MUSC&/FSCA 1ST 20/<,,,144.35,144.35,1
HCPCS,11044,DBRDMT BONE 1ST 20 SQ CM/<,,,212.49,212.49,1
HCPCS,11044,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,3940.0,2561.0,110.39,6317.0,179
HCPCS,110440,DBRDMT BONE 1ST 20 SQ CM/<,,,212.49,212.49,1
HCPCS,11045,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,1180.5,767.325,12.66,4214.0,108
HCPCS,11045,DBRDMT SUBQ TISS EACH ADDL,,,23.86,23.86,1
HCPCS,110450,DBRDMT SUBQ TISS EACH ADDL,,,23.86,23.86,1
HCPCS,11046,DBRDMT MUSC&/FSCA EA ADDL,,,51.76,51.76,1
HCPCS,11046,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,1738.5,1130.025,26.8,4214.0,73
HCPCS,110460,DBRDMT MUSC&/FSCA EA ADDL,,,51.76,51.76,1
HCPCS,11047,DBRDMT BONE EACH ADDL,,,91.45,91.45,1
HCPCS,11047,DEBRIDEMENT BONE EA ADDL 20 SQ CM/<,720.0,468.0,46.85,540.0,35
HCPCS,11047,Dbrdmt bone each addl,,,613.49,774.94,6
HCPCS,110470,DBRDMT BONE EACH ADDL,,,91.45,91.45,1
HCPCS,11055,PARING/CUTG B9 HYPRKER LES 1,,,14.69,14.69,1
HCPCS,11055,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,449.5,292.175,9.33,3920.0,130
HCPCS,110550,PARING/CUTG B9 HYPRKER LES 1,,,14.69,14.69,1
HCPCS,11056,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,482.5,313.625,15.63,3920.0,81
HCPCS,11056,PARNG/CUTG B9 HYPRKR LES 2-4,,,20.76,20.76,1
HCPCS,110560,PARNG/CUTG B9 HYPRKR LES 2-4,,,20.76,20.76,1
HCPCS,11057,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,515.5,335.075,20.36,3920.0,81
HCPCS,11057,PARNG/CUTG B9 HYPRKR LES >4,,,27.12,27.12,1
HCPCS,110570,PARNG/CUTG B9 HYPRKR LES >4,,,27.12,27.12,1
HCPCS,11102,TANGENTIAL BIOPSY SKIN SINGLE LESION,517.5,336.375,24.24,26432.0,175
HCPCS,11102,TANGNTL BX SKIN SINGLE LES,,,35.19,35.19,1
HCPCS,111020,TANGNTL BX SKIN SINGLE LES,,,35.19,35.19,1
HCPCS,11103,TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,183.0,118.94999999999999,14.54,26432.0,142
HCPCS,11103,TANGNTL BX SKIN EA SEP/ADDL,,,20.41,20.41,1
HCPCS,111030,TANGNTL BX SKIN EA SEP/ADDL,,,20.41,20.41,1
HCPCS,11104,PUNCH BIOPSY SKIN SINGLE LESION,932.0,605.8,29.54,26432.0,224
HCPCS,11104,PUNCH BX SKIN SINGLE LESION,,,43.76,43.76,1
HCPCS,111040,PUNCH BX SKIN SINGLE LESION,,,43.76,43.76,1
HCPCS,11105,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,214.0,139.1,12.33,26432.0,142
HCPCS,11105,PUNCH BX SKIN EA SEP/ADDL,,,23.93,23.93,1
HCPCS,111050,PUNCH BX SKIN EA SEP/ADDL,,,23.93,23.93,1
HCPCS,11106,INCAL BX SKN SINGLE LES,,,52.94,52.94,1
HCPCS,11106,INCISIONAL BIOPSY SKIN SINGLE LESION,2295.0,1491.75,63.47,26432.0,141
HCPCS,11106,INCISIONAL BIOSPY SKIN SINGLE LESION,404.0,262.6,36.84,303.0,31
HCPCS,111060,INCAL BX SKN SINGLE LES,,,52.94,52.94,1
HCPCS,11107,INCAL BX SKN EA SEP/ADDL,,,28.65,28.65,1
HCPCS,11107,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,285.0,185.25,22.9,26432.0,142
HCPCS,111070,INCAL BX SKN EA SEP/ADDL,,,28.65,28.65,1
HCPCS,1110F,PT LFT INPT FAC W/IN 60 DAYS,,,0.01,0.01,1
HCPCS,1110F0,PT LFT INPT FAC W/IN 60 DAYS,,,0.01,0.01,1
HCPCS,1111F,DSCHRG MED/CURRENT MED MERGE,,,0.01,0.01,1
HCPCS,1111F0,DSCHRG MED/CURRENT MED MERGE,,,0.01,0.01,1
HCPCS,1116F,AURIC/PERI PAIN ASSESSED,,,0.01,0.01,1
HCPCS,1116F0,AURIC/PERI PAIN ASSESSED,,,0.01,0.01,1
HCPCS,1118F,GERD SYMPS ASSESSED 12 MONTH,,,0.01,0.01,1
HCPCS,1118F0,GERD SYMPS ASSESSED 12 MONTH,,,0.01,0.01,1
HCPCS,1119F,INIT EVAL FOR CONDITION,,,0.01,0.01,1
HCPCS,1119F0,INIT EVAL FOR CONDITION,,,0.01,0.01,1
HCPCS,11200,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,553.0,359.45,41.82,3920.0,179
HCPCS,11200,RMVL SKIN TAGS UP TO&INC 15,,,70.8,70.8,1
HCPCS,11200,SKIN TAG REMOVAL 1 - 15,250.0,162.5,41.82,187.5,35
HCPCS,112000,RMVL SKIN TAGS UP TO&INC 15,,,70.8,70.8,1
HCPCS,11201,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10,275.5,179.075,9.94,3920.0,70
HCPCS,11201,RMVL SKIN TAGS EA ADDL 10,,,15.1,15.1,1
HCPCS,11201,SKIN TAG REMOVAL EA ADDL 10,100.0,65.0,9.94,75.0,35
HCPCS,112010,RMVL SKIN TAGS EA ADDL 10,,,15.1,15.1,1
HCPCS,1121F,SUBS EVAL FOR CONDITION,,,0.01,0.01,1
HCPCS,1121F0,SUBS EVAL FOR CONDITION,,,0.01,0.01,1
HCPCS,1123F,ACP DISCUSS/DSCN MKR DOCD,,,0.01,0.01,1
HCPCS,1123F0,ACP DISCUSS/DSCN MKR DOCD,,,0.01,0.01,1
HCPCS,1124F,ACP DISCUSS-NO DSCNMKR DOCD,,,0.01,0.01,1
HCPCS,1124F0,ACP DISCUSS-NO DSCNMKR DOCD,,,0.01,0.01,1
HCPCS,1125F,AMNT PAIN NOTED PAIN PRSNT,,,0.01,0.01,1
HCPCS,1125F0,AMNT PAIN NOTED PAIN PRSNT,,,0.01,0.01,1
HCPCS,1126F,AMNT PAIN NOTED NONE PRSNT,,,0.01,0.01,1
HCPCS,1126F0,AMNT PAIN NOTED NONE PRSNT,,,0.01,0.01,1
HCPCS,1127F,NEW EPISODE FOR CONDITION,,,0.01,0.01,1
HCPCS,1127F0,NEW EPISODE FOR CONDITION,,,0.01,0.01,1
HCPCS,1128F,SUBS EPISODE FOR CONDITION,,,0.01,0.01,1
HCPCS,1128F0,SUBS EPISODE FOR CONDITION,,,0.01,0.01,1
HCPCS,11300,SHAVE SKIN LESION 0.5 CM/<,,,31.77,31.77,1
HCPCS,11300,SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<,881.5,572.975,26.03,3920.0,81
HCPCS,113000,SHAVE SKIN LESION 0.5 CM/<,,,31.77,31.77,1
HCPCS,11301,SHAVE SKIN LESION 0.6-1.0 CM,,,47.79,47.79,1
HCPCS,11301,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,570.5,370.825,32.99,3920.0,81
HCPCS,113010,SHAVE SKIN LESION 0.6-1.0 CM,,,47.79,47.79,1
HCPCS,11302,SHAVE SKIN LESION 1.1-2.0 CM,,,55.63,55.63,1
HCPCS,11302,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,603.5,392.275,40.49,3920.0,81
HCPCS,113020,SHAVE SKIN LESION 1.1-2.0 CM,,,55.63,55.63,1
HCPCS,11303,SHAVE SKIN LESION >2.0 CM,,,66.34,66.34,1
HCPCS,11303,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,1024.5,665.925,52.31,4151.0,81
HCPCS,113030,SHAVE SKIN LESION >2.0 CM,,,66.34,66.34,1
HCPCS,11305,SHAVE SKIN LESION 0.5 CM/<,,,35.29,35.29,1
HCPCS,11305,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,548.5,356.525,28.27,3920.0,130
HCPCS,113050,SHAVE SKIN LESION 0.5 CM/<,,,35.29,35.29,1
HCPCS,11306,SHAVE SKIN LESION 0.6-1.0 CM,,,45.86,45.86,1
HCPCS,11306,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,583.5,379.275,36.76,3920.0,81
HCPCS,113060,SHAVE SKIN LESION 0.6-1.0 CM,,,45.86,45.86,1
HCPCS,11307,SHAVE SKIN LESION 1.1-2.0 CM,,,58.46,58.46,1
HCPCS,11307,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,636.5,413.725,43.04,3920.0,130
HCPCS,113070,SHAVE SKIN LESION 1.1-2.0 CM,,,58.46,58.46,1
HCPCS,11308,SHAVE SKIN LESION >2.0 CM,,,65.73,65.73,1
HCPCS,11308,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,1070.5,695.825,56.15,4151.0,81
HCPCS,113080,SHAVE SKIN LESION >2.0 CM,,,65.73,65.73,1
HCPCS,1130F,BK PAIN & FXN ASSESSED,,,0.01,0.01,1
HCPCS,1130F0,BK PAIN & FXN ASSESSED,,,0.01,0.01,1
HCPCS,11310,SHAVE SKIN LESION 0.5 CM/<,,,42.45,42.45,1
HCPCS,11310,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,548.5,356.525,35.72,3920.0,81
HCPCS,113100,SHAVE SKIN LESION 0.5 CM/<,,,42.45,42.45,1
HCPCS,11311,SHAVE SKIN LESION 0.6-1.0 CM,,,58.47,58.47,1
HCPCS,11311,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,614.5,399.425,38.56,3920.0,81
HCPCS,113110,SHAVE SKIN LESION 0.6-1.0 CM,,,58.47,58.47,1
HCPCS,11312,SHAVE SKIN LESION 1.1-2.0 CM,,,69.14,69.14,1
HCPCS,11312,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,1035.5,673.075,47.01,4151.0,81
HCPCS,113120,SHAVE SKIN LESION 1.1-2.0 CM,,,69.14,69.14,1
HCPCS,11313,SHAVE SKIN LESION >2.0 CM,,,89.6,89.6,1
HCPCS,11313,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM,1119.0,727.35,63.17,4151.0,81
HCPCS,113130,SHAVE SKIN LESION >2.0 CM,,,89.6,89.6,1
HCPCS,1134F,EPSD BK PAIN FOR 6 WKS/<,,,0.01,0.01,1
HCPCS,1134F0,EPSD BK PAIN FOR 6 WKS/<,,,0.01,0.01,1
HCPCS,1135F,EPSD BK PAIN FOR >6 WKS,,,0.01,0.01,1
HCPCS,1135F0,EPSD BK PAIN FOR >6 WKS,,,0.01,0.01,1
HCPCS,1136F,EPSD BK PAIN FOR 12 WKS/<,,,0.01,0.01,1
HCPCS,1136F0,EPSD BK PAIN FOR 12 WKS/<,,,0.01,0.01,1
HCPCS,1137F,EPSD BK PAIN FOR >12 WKS,,,0.01,0.01,1
HCPCS,1137F0,EPSD BK PAIN FOR >12 WKS,,,0.01,0.01,1
HCPCS,11400,EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<,2639.0,1715.35,100.13,4151.0,95
HCPCS,11400,EXC TR-EXT B9+MARG 0.5 CM<,,,78.22,78.22,1
HCPCS,11400,"REM LESION TRUNK, ARM, LEG <0.5CM",115.0,74.75,44.86,176.96,35
HCPCS,11400,"REM LESION TRUNK,ARM, LEG <0.5 CM",360.0,234.0,44.86,270.0,35
HCPCS,114000,EXC TR-EXT B9+MARG 0.5 CM<,,,78.22,78.22,1
HCPCS,11401,EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM,1499.0,974.35,121.13,4151.0,95
HCPCS,11401,EXC TR-EXT B9+MARG 0.6-1 CM,,,98.34,98.34,1
HCPCS,11401,"REM LESION TRUNK, ARM, LEG 0.6-1.0CM",130.0,84.5,55.7,213.15,35
HCPCS,11401,"REM LESION TRUNK,ARM,LEG 0.6 -1.0CM",563.0,365.95,55.7,422.25,35
HCPCS,114010,EXC TR-EXT B9+MARG 0.6-1 CM,,,98.34,98.34,1
HCPCS,11402,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,2639.0,1715.35,130.58,4214.0,144
HCPCS,11402,EXC TR-EXT B9+MARG 1.1-2 CM,,,107.79,107.79,1
HCPCS,11402,"REM LESIO TRUNK, ARM, LEG 1.1-2.0CM",145.0,94.25,56.72,237.57,35
HCPCS,11402,"REM LESIO TRUNK,ARM,LEG 1.1 -2.0CM",638.0,414.7,56.72,478.5,35
HCPCS,114020,EXC TR-EXT B9+MARG 1.1-2 CM,,,107.79,107.79,1
HCPCS,11403,EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM,2639.0,1715.35,173.17,4214.0,95
HCPCS,11403,EXC TR-EXT B9+MARG 2.1-3CM,,,139.59,139.59,1
HCPCS,11403,"REM LESIO TRUNK, ARM, LEG 2.1-3.0CM",180.0,117.0,71.51,297.48,35
HCPCS,11403,"REM LESIO TRUNK,ARM,LEG 2.1-3.0CM",810.0,526.5,71.51,607.5,35
HCPCS,114030,EXC TR-EXT B9+MARG 2.1-3CM,,,139.59,139.59,1
HCPCS,11404,EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM,6076.0,3949.4,191.17,8370.0,46
HCPCS,11404,EXC TR-EXT B9+MARG 3.1-4 CM,,,153.95,153.95,1
HCPCS,11404,"REM LESIO TRUNK, ARM, LEG 3.0-4.0CM",205.0,133.25,79.23,329.68,35
HCPCS,11404,"REM LESIO TRUNK,ARM,LEG 3.0-4.0CM",928.0,603.2,79.23,696.0,35
HCPCS,114040,EXC TR-EXT B9+MARG 3.1-4 CM,,,153.95,153.95,1
HCPCS,11406,EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM,6076.0,3949.4,289.89,8370.0,46
HCPCS,11406,EXC TR-EXT B9+MARG >4.0 CM,,,233.52,233.52,1
HCPCS,11406,"REM LESION TRUNK, ARM, LEG >4.0CM",340.0,221.0,120.17,503.34,35
HCPCS,11406,"REM LESION TRUNK,ARM,LEG > 4.0CM",1549.0,1006.85,120.17,1161.75,35
HCPCS,114060,EXC TR-EXT B9+MARG >4.0 CM,,,233.52,233.52,1
HCPCS,11420,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,6076.0,3949.4,98.26,5468.4,95
HCPCS,11420,EXC H-F-NK-SP B9+MARG 0.5/<,,,76.46,76.46,1
HCPCS,11420,"REM LESION NEC, HAND, SCAL <0.5CM",115.0,74.75,44.32,173.96,35
HCPCS,11420,"REM LESION NEC,HAND,SCAL<0.5CM",453.0,294.45,44.32,339.75,35
HCPCS,114200,EXC H-F-NK-SP B9+MARG 0.5/<,,,76.46,76.46,1
HCPCS,11421,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,2639.0,1715.35,126.84,4151.0,46
HCPCS,11421,EXC H-F-NK-SP B9+MARG 0.6-1,,,101.88,101.88,1
HCPCS,11421,"REM LESION NEC, HND, SCAL 0.6-1.0CM",150.0,97.5,55.06,224.63,35
HCPCS,11421,"REM LESION NEC,HND,SCAL 0.6-1.0CM",647.0,420.55,55.06,485.25,35
HCPCS,114210,EXC H-F-NK-SP B9+MARG 0.6-1,,,101.88,101.88,1
HCPCS,11422,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,6076.0,3949.4,159.27,5468.4,46
HCPCS,11422,EXC H-F-NK-SP B9+MARG 1.1-2,,,126.52,126.52,1
HCPCS,11422,"REM LESION NEC, HND, SCAL, FEET, GENITALIA 1.1-2.0CM",175.0,113.75,65.27,268.13,35
HCPCS,11422,"REM LESION NEC,HND,SCAL,FEET,GENITALIA 1.1-2.0CM",739.0,480.35,65.27,554.25,35
HCPCS,114220,EXC H-F-NK-SP B9+MARG 1.1-2,,,126.52,126.52,1
HCPCS,11423,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM,6076.0,3949.4,182.86,5468.4,46
HCPCS,11423,EXC H-F-NK-SP B9+MARG 2.1-3,,,146.72,146.72,1
HCPCS,11423,"REM LESION NEC, HND, SCAL 2.1-3.0CM",230.0,149.5,74.96,311.33,35
HCPCS,11423,"REM LESION NEC,HND,SCAL 2.1-3.0CM",906.0,588.9,74.96,679.5,35
HCPCS,114230,EXC H-F-NK-SP B9+MARG 2.1-3,,,146.72,146.72,1
HCPCS,11424,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM,6076.0,3949.4,210.67,8370.0,46
HCPCS,11424,EXC H-F-NK-SP B9+MARG 3.1-4,,,169.54,169.54,1
HCPCS,11424,"REM LESION NEC, HND, SCAL 3.1-4.0CM",240.0,156.0,85.82,361.5,35
HCPCS,11424,"REM LESION NEC,HND,SCAL 3.1-4.0CM",1091.0,709.15,85.82,818.25,35
HCPCS,114240,EXC H-F-NK-SP B9+MARG 3.1-4,,,169.54,169.54,1
HCPCS,11426,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM,10733.0,6976.45,316.96,36332.0,46
HCPCS,11426,EXC H-F-NK-SP B9+MARG >4 CM,,,251.83,251.83,1
HCPCS,11426,"REM LESION NECK, HAND, SCAL >4.0CM",400.0,260.0,131.51,537.77,35
HCPCS,11426,"REM LESION NECK,HAND,SCAL >4.0CM",1800.0,1170.0,131.51,1350.0,35
HCPCS,114260,EXC H-F-NK-SP B9+MARG >4 CM,,,251.83,251.83,1
HCPCS,11440,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,2639.0,1715.35,130.27,4151.0,46
HCPCS,11440,EXC FACE-MM B9+MARG 0.5 CM/<,,,98.96,98.96,1
HCPCS,11440,"REM LESION FACE, EAR, EYEL <5MM",115.0,74.75,52.42,209.13,35
HCPCS,11440,"REM LESION FACE,EAR,EYEL <5MM",462.0,300.3,52.42,346.5,35
HCPCS,114400,EXC FACE-MM B9+MARG 0.5 CM/<,,,98.96,98.96,1
HCPCS,11441,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM,2639.0,1715.35,155.65,4214.0,46
HCPCS,11441,EXC FACE-MM B9+MARG 0.6-1 CM,,,123.98,123.98,1
HCPCS,11441,"REM LESION FACE, EAR, EYE 0.6-1CM",155.0,100.75,64.0,263.23,35
HCPCS,11441,"REM LESION FACE,EAR,EYE 0.6-1CM",673.0,437.45,64.0,504.75,35
HCPCS,114410,EXC FACE-MM B9+MARG 0.6-1 CM,,,123.98,123.98,1
HCPCS,11442,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,2639.0,1715.35,169.34,4214.0,95
HCPCS,11442,EXC FACE-MM B9+MARG 1.1-2 CM,,,136.91,136.91,1
HCPCS,11442,"REM LESION FACE, EAR, EYE 1.1-2CM",175.0,113.75,70.52,290.99,35
HCPCS,11442,"REM LESION FACE,EAR,EYE 1.1-2 CM",779.0,506.35,70.52,584.25,35
HCPCS,114420,EXC FACE-MM B9+MARG 1.1-2 CM,,,136.91,136.91,1
HCPCS,11443,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM,6076.0,3949.4,203.58,5468.4,46
HCPCS,11443,EXC FACE-MM B9+MARG 2.1-3 CM,,,167.17,167.17,1
HCPCS,11443,"REM LESION FACE, EAR, EYE 2.1-3CM",230.0,149.5,86.98,355.28,35
HCPCS,11443,"REM LESION FACE,EAR,EYE 2.1-3 CM",1030.0,669.5,86.98,772.5,35
HCPCS,114430,EXC FACE-MM B9+MARG 2.1-3 CM,,,167.17,167.17,1
HCPCS,11444,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM,6076.0,3949.4,258.41,6317.0,46
HCPCS,11444,EXC FACE-MM B9+MARG 3.1-4 CM,,,211.06,211.06,1
HCPCS,11444,"REM LESION FACE, EAR, EYE 3.1-4CM",305.0,198.25,108.98,448.6,35
HCPCS,11444,"REM LESION FACE,EAR,EYE 3.1-4 CM",1404.0,912.6,108.98,1053.0,35
HCPCS,114440,EXC FACE-MM B9+MARG 3.1-4 CM,,,211.06,211.06,1
HCPCS,11446,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM,10733.0,6976.45,367.98,36332.0,46
HCPCS,11446,EXC FACE-MM B9+MARG >4 CM,,,297.41,297.41,1
HCPCS,11446,"REM LESION FACE, EAR, EYE >4CM",460.0,299.0,154.36,632.7,35
HCPCS,11446,"REM LESION FACE,EAR,EYE >4CM",2112.0,1372.8,154.36,1584.0,35
HCPCS,114460,EXC FACE-MM B9+MARG >4 CM,,,297.41,297.41,1
HCPCS,11450,EXC SKN HDRDNT AX SMPL/NTRM,,,246.23,6205.4,15
HCPCS,11450,EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR,1288.0,837.2,127.89,966.0,35
HCPCS,11450,Exc skn hdrdnt ax smpl/ntrm,,,1113.47,1406.48,6
HCPCS,114500,EXC SKN HDRDNT AX SMPL/NTRM,,,246.23,246.23,1
HCPCS,11451,EXC SKN HDRDNT AX COMPLEX,,,311.85,6205.4,15
HCPCS,11451,EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR,1772.0,1151.8,160.93,1329.0,35
HCPCS,11451,Exc skn hdrdnt ax complex,,,1113.47,1406.48,6
HCPCS,114510,EXC SKN HDRDNT AX COMPLEX,,,311.85,311.85,1
HCPCS,11462,EXC SKN HDRDNT ING SMPL/NTRM,,,234.17,6205.4,15
HCPCS,11462,EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR,1200.0,780.0,124.59,900.0,35
HCPCS,11462,Exc skn hdrdnt ing smpl/ntrm,,,1113.47,1406.48,6
HCPCS,114620,EXC SKN HDRDNT ING SMPL/NTRM,,,234.17,234.17,1
HCPCS,11463,EXC SKN HDRDNT ING COMPLEX,,,313.17,6205.4,15
HCPCS,11463,EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR,1772.0,1151.8,162.57,1329.0,35
HCPCS,11463,Exc skn hdrdnt ing complex,,,1113.47,1406.48,6
HCPCS,114630,EXC SKN HDRDNT ING COMPLEX,,,313.17,313.17,1
HCPCS,11470,EXC SKN H/P/P/U SMPL/NTRM,,,269.7,6205.4,15
HCPCS,11470,EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR,1496.0,972.4,139.23,1122.0,35
HCPCS,11470,Exc skn h/p/p/u smpl/ntrm,,,1113.47,1406.48,6
HCPCS,114700,EXC SKN H/P/P/U SMPL/NTRM,,,269.7,269.7,1
HCPCS,11471,EXC SKN H/P/P/U COMPLEX,,,330.71,6205.4,15
HCPCS,11471,EXCISION H/P/P/U COMPLEX REPAIR,1956.0,1271.4,171.45,1467.0,35
HCPCS,11471,Exc skn h/p/p/u complex,,,1113.47,1406.48,6
HCPCS,114710,EXC SKN H/P/P/U COMPLEX,,,330.71,330.71,1
HCPCS,1150F,DOC PT RSK DEATH W/IN 1YR,,,0.01,0.01,1
HCPCS,1150F0,DOC PT RSK DEATH W/IN 1YR,,,0.01,0.01,1
HCPCS,1151F,DOC NO PT RSK DEATH W/IN 1YR,,,0.01,0.01,1
HCPCS,1151F0,DOC NO PT RSK DEATH W/IN 1YR,,,0.01,0.01,1
HCPCS,1152F,DOC ADVNCD DIS COMFORT 1ST,,,0.01,0.01,1
HCPCS,1152F0,DOC ADVNCD DIS COMFORT 1ST,,,0.01,0.01,1
HCPCS,1153F,DOC ADVNCD DIS CMFRT NOT 1ST,,,0.01,0.01,1
HCPCS,1153F0,DOC ADVNCD DIS CMFRT NOT 1ST,,,0.01,0.01,1
HCPCS,1157F,ADVNC CARE PLAN IN RCRD,,,0.01,0.01,1
HCPCS,1157F0,ADVNC CARE PLAN IN RCRD,,,0.01,0.01,1
HCPCS,1158F,ADVNC CARE PLAN TLK DOCD,,,0.01,0.01,1
HCPCS,1158F0,ADVNC CARE PLAN TLK DOCD,,,0.01,0.01,1
HCPCS,1159F,MED LIST DOCD IN RCRD,,,0.01,0.01,1
HCPCS,1159F0,MED LIST DOCD IN RCRD,,,0.01,0.01,1
HCPCS,11600,EXC TR-EXT MAL+MARG 0.5 CM/<,,,114.04,114.04,1
HCPCS,11600,EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<,2639.0,1715.35,139.16,4214.0,46
HCPCS,11600,MAL REM LESION 0.5 CM OR LESS,717.0,466.05,64.32,537.75,35
HCPCS,116000,EXC TR-EXT MAL+MARG 0.5 CM/<,,,114.04,114.04,1
HCPCS,11601,EXC TR-EXT MAL+MARG 0.6-1 CM,,,138.11,138.11,1
HCPCS,11601,EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,2639.0,1715.35,166.68,4214.0,46
HCPCS,11601,"MAL LESION TRUNK,ARM,LEG 0.6-1.0CM",911.0,592.15,75.53,683.25,35
HCPCS,116010,EXC TR-EXT MAL+MARG 0.6-1 CM,,,138.11,138.11,1
HCPCS,11602,EXC TR-EXT MAL+MARG 1.1-2 CM,,,149.89,149.89,1
HCPCS,11602,EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM,1499.0,974.35,178.86,4268.0,46
HCPCS,11602,"MAL LESION TRUNK,ARM,LEG 1.1-2.0 CM",999.0,649.35,81.39,749.25,35
HCPCS,116020,EXC TR-EXT MAL+MARG 1.1-2 CM,,,149.89,149.89,1
HCPCS,11603,EXC TR-EXT MAL+MARG 2.1-3 CM,,,179.54,179.54,1
HCPCS,11603,EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM,2639.0,1715.35,214.49,4268.0,46
HCPCS,11603,"MAL LESION TRUNK,ARM,LEG 2.1-3.0 CM",1241.0,806.65,100.83,930.75,35
HCPCS,116030,EXC TR-EXT MAL+MARG 2.1-3 CM,,,179.54,179.54,1
HCPCS,11604,EXC TR-EXT MAL+MARG 3.1-4 CM,,,197.95,197.95,1
HCPCS,11604,EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM,2639.0,1715.35,237.75,6317.0,46
HCPCS,11604,"MAL LESION TRUNK,ARM,LEG 3.1-4.0 CM",1395.0,906.75,105.21,1046.25,35
HCPCS,116040,EXC TR-EXT MAL+MARG 3.1-4 CM,,,197.95,197.95,1
HCPCS,11606,EXC TR-EXT MAL+MARG >4 CM,,,296.73,296.73,1
HCPCS,11606,EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM,4142.5,2692.625,153.21,8370.0,81
HCPCS,116060,EXC TR-EXT MAL+MARG >4 CM,,,296.73,296.73,1
HCPCS,1160F,RVW MEDS BY RX/DR IN RCRD,,,0.01,0.01,1
HCPCS,1160F0,RVW MEDS BY RX/DR IN RCRD,,,0.01,0.01,1
HCPCS,11620,EXC H-F-NK-SP MAL+MARG 0.5/<,,,114.99,114.99,1
HCPCS,11620,EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<,6076.0,3949.4,140.04,5468.4,46
HCPCS,11620,"MAL LESION TRUNK,ARM,LEG<0.5CM",656.0,426.4,65.36,492.0,35
HCPCS,116200,EXC H-F-NK-SP MAL+MARG 0.5/<,,,114.99,114.99,1
HCPCS,11621,EXC S/N/H/F/G MAL+MRG 0.6-1,,,138.77,138.77,1
HCPCS,11621,EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM,2639.0,1715.35,167.93,4214.0,46
HCPCS,11621,"MAL LESION NECK,HAND,SCAL 0.6-1CM",832.0,540.8,76.03,624.0,35
HCPCS,116210,EXC S/N/H/F/G MAL+MRG 0.6-1,,,138.77,138.77,1
HCPCS,11622,EXC S/N/H/F/G MAL+MRG 1.1-2,,,157.53,157.53,1
HCPCS,11622,EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM,2639.0,1715.35,188.49,4268.0,46
HCPCS,11622,"MAL LESION NECK,HAND,SCAL 1.1-2CM",964.0,626.6,88.91,723.0,35
HCPCS,116220,EXC S/N/H/F/G MAL+MRG 1.1-2,,,157.53,157.53,1
HCPCS,11623,EXC S/N/H/F/G MAL+MRG 2.1-3,,,194.76,194.76,1
HCPCS,11623,EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM,6076.0,3949.4,233.54,5468.4,46
HCPCS,11623,"MAL LESION NECK,HAND,SCAL 2.1-3CM",1244.0,808.6,114.34,933.0,35
HCPCS,116230,EXC S/N/H/F/G MAL+MRG 2.1-3,,,194.76,194.76,1
HCPCS,11624,EXC S/N/H/F/G MAL+MRG 3.1-4,,,222.05,222.05,1
HCPCS,11624,EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM,6076.0,3949.4,267.11,8370.0,46
HCPCS,11624,"MAL LESION NECK,HAND,SCAL 3.1-4CM",1448.0,941.2,127.19,1086.0,35
HCPCS,116240,EXC S/N/H/F/G MAL+MRG 3.1-4,,,222.05,222.05,1
HCPCS,11626,EXC S/N/H/F/G MAL+MRG >4 CM,,,272.46,272.46,1
HCPCS,11626,EXC SKIN MALIG >4CM REMAINDR BODY,1844.0,1198.6,153.34,1383.0,35
HCPCS,11626,EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM,10733.0,6976.45,332.58,36332.0,46
HCPCS,116260,EXC S/N/H/F/G MAL+MRG >4 CM,,,272.46,272.46,1
HCPCS,11640,EXC F/E/E/N/L MAL+MRG 0.5CM<,,,117.94,1525.5,15
HCPCS,11640,Exc f/e/e/n/l mal+mrg 0.5cm<,,,254.67,321.68,6
HCPCS,11640,"MAL LESION FACE,EAR,EYEL <5MM",668.0,434.2,68.68,501.0,35
HCPCS,116400,EXC F/E/E/N/L MAL+MRG 0.5CM<,,,117.94,117.94,1
HCPCS,11641,EXC F/E/E/N/L MAL+MRG 0.6-1,,,144.68,144.68,1
HCPCS,11641,EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM,2639.0,1715.35,174.78,4268.0,95
HCPCS,11641,"MAL LESION FACE,EAR,EYEL 0.6-1CM",868.0,564.2,107.5,651.0,35
HCPCS,116410,EXC F/E/E/N/L MAL+MRG 0.6-1,,,144.68,144.68,1
HCPCS,11642,EXC F/E/E/N/L MAL+MRG 1.1-2,,,169.53,169.53,1
HCPCS,11642,EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM,2639.0,1715.35,202.5,4268.0,46
HCPCS,11642,"MAL LESION FACE,EAR,EYEL 1.1-2CM",1048.0,681.2,109.83,786.0,35
HCPCS,116420,EXC F/E/E/N/L MAL+MRG 1.1-2,,,169.53,169.53,1
HCPCS,11643,EXC F/E/E/N/L MAL+MRG 2.1-3,,,211.81,211.81,1
HCPCS,11643,EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM,6076.0,3949.4,254.37,5468.4,46
HCPCS,11643,"MAL LESION FACE,EAR,EYEL 2.1-3CM",1368.0,889.2,126.69,1026.0,35
HCPCS,116430,EXC F/E/E/N/L MAL+MRG 2.1-3,,,211.81,211.81,1
HCPCS,11644,EXC F/E/E/N/L MAL+MRG 3.1-4,,,262.84,262.84,1
HCPCS,11644,EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM,6076.0,3949.4,315.94,8370.0,46
HCPCS,11644,"MAL LESION FACE,EAR,EYEL 3.1-4CM",1736.0,1128.4,156.97,1302.0,35
HCPCS,116440,EXC F/E/E/N/L MAL+MRG 3.1-4,,,262.84,262.84,1
HCPCS,11646,EXC F/E/E/N/L MAL+MRG >4 CM,,,364.14,364.14,1
HCPCS,11646,EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM,10733.0,6976.45,439.78,36332.0,46
HCPCS,11646,"MAL LESION FACE,EAR,EYEL >4.0CM",2504.0,1627.6,201.96,1878.0,35
HCPCS,116460,EXC F/E/E/N/L MAL+MRG >4 CM,,,364.14,364.14,1
HCPCS,1170F,FXNL STATUS ASSESSED,,,0.01,0.01,1
HCPCS,1170F0,FXNL STATUS ASSESSED,,,0.01,0.01,1
HCPCS,11719,TRIM NAIL(S) ANY NUMBER,,,7.32,7.32,1
HCPCS,11719,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,149.0,96.85,6.67,3920.0,129
HCPCS,117190,TRIM NAIL(S) ANY NUMBER,,,7.32,7.32,1
HCPCS,11720,DEBRIDE NAIL 1-5,,,14.02,14.02,1
HCPCS,11720,DEBRIDEMENT NAIL ANY METHOD 1-5,223.0,144.95,18.04,3920.0,144
HCPCS,11720,"DEBRIDEMENT OF NAIL(S), 1-5",141.0,91.65,7.07,105.75,35
HCPCS,117200,DEBRIDE NAIL 1-5,,,14.02,14.02,1
HCPCS,11721,DEBRIDE NAIL 6 OR MORE,,,23.34,23.34,1
HCPCS,11721,DEBRIDEMENT NAIL ANY METHOD 6/>,223.0,144.95,30.5,3920.0,46
HCPCS,11721,"DEBRIDEMENT OF NAILS, 6 OR MORE",238.0,154.7,14.16,178.5,35
HCPCS,117210,DEBRIDE NAIL 6 OR MORE,,,23.34,23.34,1
HCPCS,11730,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,603.5,392.275,25.81,3920.0,179
HCPCS,11730,AVULSION NAIL PLATE SIMPLE 1,,,52.79,52.79,1
HCPCS,117300,AVULSION NAIL PLATE SIMPLE 1,,,52.79,52.79,1
HCPCS,11732,AVLSN NAIL PLATE SIMPLE EACH,,,16.66,16.66,1
HCPCS,11732,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,411.0,267.15,15.22,3920.0,146
HCPCS,117320,AVLSN NAIL PLATE SIMPLE EACH,,,16.66,16.66,1
HCPCS,11740,EVAC. SUBUNGUAL HEMATOMA,148.0,96.2,15.12,111.0,35
HCPCS,11740,EVACUATION SUBUNGUAL HEMATOMA,484.0,314.6,40.61,3920.0,144
HCPCS,11740,EVACUATION SUBUNGUAL HMTMA,,,31.1,31.1,1
HCPCS,117400,EVACUATION SUBUNGUAL HMTMA,,,31.1,31.1,1
HCPCS,11750,EXCISION NAIL MATRIX PERMANENT REMOVAL,1097.0,713.05,68.22,4214.0,179
HCPCS,11750,EXCISION NAIL&NAIL MATRIX,,,99.49,99.49,1
HCPCS,117500,EXCISION NAIL&NAIL MATRIX,,,99.49,99.49,1
HCPCS,11755,BIOPSY NAIL UNIT,,,59.58,59.58,1
HCPCS,11755,BIOPSY NAIL UNIT SEPARATE PROCEDURE,1569.5,1020.175,47.92,4151.0,81
HCPCS,117550,BIOPSY NAIL UNIT,,,59.58,59.58,1
HCPCS,1175F,FUNCTION STAT ASSESSED RVWD,,,0.01,0.01,1
HCPCS,1175F0,FUNCTION STAT ASSESSED RVWD,,,0.01,0.01,1
HCPCS,11760,REPAIR NAIL BED,2295.0,1491.75,40.61,3920.0,141
HCPCS,11760,REPAIR OF NAIL BED,,,106.97,106.97,1
HCPCS,11760,"REPAIR OF NAIL BED, SIMPLE",652.0,423.8,53.75,489.0,35
HCPCS,117600,REPAIR OF NAIL BED,,,106.97,106.97,1
HCPCS,11762,RECONSTRUC OF NAIL BED W GRAFT,1176.0,764.4,105.19,882.0,35
HCPCS,11762,RECONSTRUCTION OF NAIL BED,,,182.91,3966.07,15
HCPCS,11762,Reconstruction of nail bed,,,740.34,935.16,6
HCPCS,117620,RECONSTRUCTION OF NAIL BED,,,182.91,182.91,1
HCPCS,11765,WEDGE EXCISION SKIN NAIL FOLD,993.5,645.775,40.61,3920.0,179
HCPCS,11765,WEDGE EXCISION SKN NAIL FOLD,,,90.28,90.28,1
HCPCS,117650,WEDGE EXCISION SKN NAIL FOLD,,,90.28,90.28,1
HCPCS,11770,EXC PILONIDAL CYST SIMPLE,,,175.09,175.09,1
HCPCS,11770,EXCISION PILONIDAL CYST/SINUS SIMPLE,5951.5,3868.475,107.2,36332.0,133
HCPCS,117700,EXC PILONIDAL CYST SIMPLE,,,175.09,175.09,1
HCPCS,11771,EXC PILONIDAL CYST XTNSV,,,424.53,28770.0,17
HCPCS,11771,EXCISION PILONIDAL CYST/SINUS EXTENSIVE,2680.0,1742.0,220.9,2010.0,35
HCPCS,11771,Exc pilonidal cyst xtnsv,,,1113.47,1406.48,6
HCPCS,117710,EXC PILONIDAL CYST XTNSV,,,424.53,424.53,1
HCPCS,11772,EXC PILONIDAL CYST COMP,,,543.84,6205.4,17
HCPCS,11772,EXCISION PILONIDAL CYST/SINUS COMPLICATED,3234.0,2102.1,285.04,2425.5,35
HCPCS,11772,Exc pilonidal cyst comp,,,1113.47,1406.48,6
HCPCS,117720,EXC PILONIDAL CYST COMP,,,543.84,543.84,1
HCPCS,1180F,THROMBOEMB RISK ASSESSED,,,0.01,0.01,1
HCPCS,1180F0,THROMBOEMB RISK ASSESSED,,,0.01,0.01,1
HCPCS,1181F,NEUROPSYCHIA SYMPTS ASSESSED,,,0.01,0.01,1
HCPCS,1181F0,NEUROPSYCHIA SYMPTS ASSESSED,,,0.01,0.01,1
HCPCS,1182F,NEUROPSYCHI SYMPT 1+PRESENT,,,0.01,0.01,1
HCPCS,1182F0,NEUROPSYCHI SYMPT 1+PRESENT,,,0.01,0.01,1
HCPCS,1183F,NEUROPSYCHIATRIC SYMP ABSENT,,,0.01,0.01,1
HCPCS,1183F0,NEUROPSYCHIATRIC SYMP ABSENT,,,0.01,0.01,1
HCPCS,11900,INJECT SKIN LESIONS </W 7,,,27.97,27.97,1
HCPCS,11900,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,487.0,316.55,18.77,3920.0,130
HCPCS,119000,INJECT SKIN LESIONS </W 7,,,27.97,27.97,1
HCPCS,11901,INJECT SKIN LESIONS >7,,,42.41,42.41,1
HCPCS,11901,INJECTION INTRALESIONAL >7 LESIONS,548.5,356.525,31.49,3920.0,81
HCPCS,119010,INJECT SKIN LESIONS >7,,,42.41,42.41,1
HCPCS,11920,CORRECT SKIN COLOR 6.0 CM/<,,,106.34,1327.2,15
HCPCS,11920,Correct skin color 6.0 cm/<,,,254.67,321.68,6
HCPCS,11920,TATTOOING INCL MICROPIGMENTATION 6.0 CM/<,644.0,418.6,102.72,483.0,35
HCPCS,119200,CORRECT SKIN COLOR 6.0 CM/<,,,106.34,106.34,1
HCPCS,11921,CORRECT SKN COLOR 6.1-20.0CM,,,122.19,1327.2,15
HCPCS,11921,Correct skn color 6.1-20.0cm,,,254.67,321.68,6
HCPCS,11921,TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM,772.0,501.8,120.37,579.0,35
HCPCS,119210,CORRECT SKN COLOR 6.1-20.0CM,,,122.19,122.19,1
HCPCS,11922,CORRECT SKIN COLOR EA 20.0CM,,,27.12,27.12,1
HCPCS,11922,Correct skin color ea 20.0cm,,,254.67,321.68,6
HCPCS,11922,TATTOOING INCL MICROPIGMENTATION EA 20.0 CM,196.0,127.4,26.18,147.0,35
HCPCS,119220,CORRECT SKIN COLOR EA 20.0CM,,,27.12,27.12,1
HCPCS,11950,SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<,540.5,351.325,34.35,3920.0,78
HCPCS,11950,SUBQ NJX FILLING MATRL 1CC/<,,,48.74,48.74,1
HCPCS,119500,SUBQ NJX FILLING MATRL 1CC/<,,,48.74,48.74,1
HCPCS,11951,SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC,1385.5,900.575,45.59,4151.0,77
HCPCS,11951,SUBQ NJX FIL MATRL 1.1-5.0CC,,,68.26,68.26,1
HCPCS,119510,SUBQ NJX FIL MATRL 1.1-5.0CC,,,68.26,68.26,1
HCPCS,11952,FAT INJECTION - FACE 5.1-10CC,568.0,369.2,67.77,426.0,32
HCPCS,11952,FAT INJECTION - TRUNK 5.1-10CC,574.0,373.1,67.77,430.5,32
HCPCS,11952,INJECTION COLLAGEN 5.1-10.0 CC,592.0,384.8,67.77,444.0,32
HCPCS,11952,LIP AUGMENTATION W/FILLING MAT 5.1-10CC,568.0,369.2,67.77,426.0,32
HCPCS,11952,SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC,676.0,439.4,67.77,507.0,32
HCPCS,11952,SUBQ NJX FIL MATRL 5.1-10CC,,,95.99,1327.2,15
HCPCS,11952,Subq njx fil matrl 5.1-10cc,,,254.67,321.68,6
HCPCS,119520,SUBQ NJX FIL MATRL 5.1-10CC,,,95.99,95.99,1
HCPCS,11954,SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC,740.0,481.0,87.2,555.0,32
HCPCS,11954,SUBQ NJX FIL MATRL>10.0 CC,,,104.82,1327.2,15
HCPCS,11954,Subq njx fil matrl>10.0 cc,,,740.34,935.16,6
HCPCS,119540,SUBQ NJX FIL MATRL>10.0 CC,,,104.82,104.82,1
HCPCS,11960,INSERT TISSUE EXPANDER(S),,,942.72,7937.59,15
HCPCS,11960,INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ,4596.0,2987.4,521.21,4596.0,35
HCPCS,11960,Insert tissue expander(s),,,1113.47,1406.48,6
HCPCS,119600,INSERT TISSUE EXPANDER(S),,,942.72,942.72,1
HCPCS,11970,REPLACEMENT TISSUE EXPANDER W/PERMANENT IMPLANT,3296.0,2142.4,342.35,3296.0,35
HCPCS,11970,RPLCMT TISS XPNDR PERM IMPLT,,,526.67,15488.78,18
HCPCS,11970,Rplcmt tiss xpndr perm implt,,,2132.55,2693.75,6
HCPCS,119700,RPLCMT TISS XPNDR PERM IMPLT,,,526.67,526.67,1
HCPCS,11971,REMOVAL TISSUE EXPANDER W/O INSERTION IMPLANT,2808.0,1825.2,266.95,2106.0,35
HCPCS,11971,RMVL TIS XPNDR WO INSJ IMPLT,,,517.3,6205.4,15
HCPCS,11971,Rmvl tis xpndr wo insj implt,,,816.59,1031.48,6
HCPCS,119710,RMVL TIS XPNDR WO INSJ IMPLT,,,517.3,517.3,1
HCPCS,11976,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,1675.5,1089.075,49.45,4151.0,81
HCPCS,11976,REMOVE CONTRACEPTIVE CAPSULE,,,87.96,87.96,1
HCPCS,119760,REMOVE CONTRACEPTIVE CAPSULE,,,87.96,87.96,1
HCPCS,11980,IMPLANT HORMONE PELLET(S),,,52.39,52.39,1
HCPCS,11980,SUBCUTANEOUS HORMONE PELLET IMPLANT,440.0,286.0,52.6,330.0,32
HCPCS,11980,SUBCUTANEOUS HORMONE PELLET IMPLANTATION,1496.0,972.4,66.49,3920.0,46
HCPCS,119800,IMPLANT HORMONE PELLET(S),,,52.39,52.39,1
HCPCS,11981,INSERT DRUG IMPLANT DEVICE,502.0,326.3,35.54,376.5,35
HCPCS,11981,INSERTION DRUG DELIVERY IMPLANT,484.0,314.6,72.99,3920.0,46
HCPCS,11981,INSERTION DRUG DLVR IMPLANT,,,59.23,59.23,1
HCPCS,119810,INSERTION DRUG DLVR IMPLANT,,,59.23,59.23,1
HCPCS,11982,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,1043.0,677.95,47.03,3920.0,130
HCPCS,11982,REMOVE DRUG IMPLANT DEVICE,,,69.07,69.07,1
HCPCS,119820,REMOVE DRUG IMPLANT DEVICE,,,69.07,69.07,1
HCPCS,11983,REMOVE/INSERT DRUG IMPLANT,,,97.63,97.63,1
HCPCS,11983,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,1168.0,759.2,98.33,3920.0,81
HCPCS,119830,REMOVE/INSERT DRUG IMPLANT,,,97.63,97.63,1
HCPCS,12001,RPR S/N/AX/GEN/TRNK 2.5CM/<,,,42.55,42.55,1
HCPCS,12001,"SIMP REPAIR SCALP,NECK,TRK <2.5CM",370.0,240.5,29.32,277.5,35
HCPCS,12001,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,745.0,484.25,57.45,3920.0,144
HCPCS,120010,RPR S/N/AX/GEN/TRNK 2.5CM/<,,,42.55,42.55,1
HCPCS,12002,RPR S/N/AX/GEN/TRNK2.6-7.5CM,,,56.03,56.03,1
HCPCS,12002,"SIMP REPAIR SCALP,NECK,TRK 2.6-7.5CM",502.0,326.3,37.14,376.5,35
HCPCS,12002,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,745.0,484.25,75.39,3920.0,144
HCPCS,120020,RPR S/N/AX/GEN/TRNK2.6-7.5CM,,,56.03,56.03,1
HCPCS,12004,RPR S/N/AX/GEN/TRK7.6-12.5CM,,,70.14,70.14,1
HCPCS,12004,"SIMP REPAIR SCALP,NECK,TRK 7.6-12.5CM",634.0,412.1,37.35,475.5,35
HCPCS,12004,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,745.0,484.25,94.26,3920.0,144
HCPCS,120040,RPR S/N/AX/GEN/TRK7.6-12.5CM,,,70.14,70.14,1
HCPCS,12005,RPR S/N/A/GEN/TRK12.6-20.0CM,,,90.67,90.67,1
HCPCS,12005,"SIMP REPAIR SCALP,NECK,TRK 12.6-20CM",867.0,563.55,64.56,650.25,35
HCPCS,12005,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,1499.0,974.35,115.89,3920.0,98
HCPCS,120050,RPR S/N/A/GEN/TRK12.6-20.0CM,,,90.67,90.67,1
HCPCS,12006,REPR SUPERF WND BODY 20.1-30,1052.0,683.8,83.57,789.0,35
HCPCS,12006,RPR S/N/A/GEN/TRK20.1-30.0CM,,,110.72,110.72,1
HCPCS,12006,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,1499.0,974.35,115.89,3920.0,98
HCPCS,120060,RPR S/N/A/GEN/TRK20.1-30.0CM,,,110.72,110.72,1
HCPCS,12007,REPR SUPERF WND BODY >30CM,1276.0,829.4,96.87,957.0,35
HCPCS,12007,RPR S/N/AX/GEN/TRNK >30.0 CM,,,137.39,137.39,1
HCPCS,12007,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,745.0,484.25,115.89,3920.0,98
HCPCS,120070,RPR S/N/AX/GEN/TRNK >30.0 CM,,,137.39,137.39,1
HCPCS,1200F,SEIZURE TYPE& FREQU DOCD,,,0.01,0.01,1
HCPCS,1200F0,SEIZURE TYPE& FREQU DOCD,,,0.01,0.01,1
HCPCS,12011,RPR F/E/E/N/L/M 2.5 CM/<,,,52.84,52.84,1
HCPCS,12011,"SIMP REPAIR FACE,EAR,EYE <2.5CM",471.0,306.15,32.99,353.25,35
HCPCS,12011,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,745.0,484.25,71.21,3920.0,144
HCPCS,120110,RPR F/E/E/N/L/M 2.5 CM/<,,,52.84,52.84,1
HCPCS,12013,RPR F/E/E/N/L/M 2.6-5.0 CM,,,55.46,55.46,1
HCPCS,12013,"SIMP REPAIR FACE,EAR,EYE 2.6-5CM",537.0,349.05,39.71,402.75,35
HCPCS,12013,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,745.0,484.25,74.22,3920.0,144
HCPCS,120130,RPR F/E/E/N/L/M 2.6-5.0 CM,,,55.46,55.46,1
HCPCS,12014,RPR F/E/E/N/L/M 5.1-7.5 CM,,,71.81,71.81,1
HCPCS,12014,"SIMP REPAIR FACE,EAR,EYE 5.1-7.5CM",691.0,449.15,51.38,518.25,35
HCPCS,12014,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,745.0,484.25,95.67,3920.0,144
HCPCS,120140,RPR F/E/E/N/L/M 5.1-7.5 CM,,,71.81,71.81,1
HCPCS,12015,RPR F/E/E/N/L/M 7.6-12.5 CM,,,90.1,90.1,1
HCPCS,12015,"SIMP REPAIR FAC,EAR,EYE 7.6-12.5CM",871.0,566.15,68.19,653.25,35
HCPCS,12015,SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM,745.0,484.25,115.89,3920.0,98
HCPCS,120150,RPR F/E/E/N/L/M 7.6-12.5 CM,,,90.1,90.1,1
HCPCS,12016,RPR FE/E/EN/L/M 12.6-20.0 CM,,,122.15,122.15,1
HCPCS,12016,"SIMP REPAIR FAC,EAR,EYE 12.6-20CM",1339.0,870.35,93.49,3920.0,81
HCPCS,12016,SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM,1499.0,974.35,115.89,3920.0,98
HCPCS,120160,RPR FE/E/EN/L/M 12.6-20.0 CM,,,122.15,122.15,1
HCPCS,12017,RPR FE/E/EN/L/M 20.1-30.0 CM,,,147.47,147.47,1
HCPCS,12017,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,1499.0,974.35,115.89,3920.0,144
HCPCS,120170,RPR FE/E/EN/L/M 20.1-30.0 CM,,,147.47,147.47,1
HCPCS,12018,RPR F/E/E/N/L/M >30.0 CM,,,166.11,166.11,1
HCPCS,12018,SIMPLE REPAIR F/E/E/N/L/M >30.0 CM,745.0,484.25,115.89,4214.0,98
HCPCS,120180,RPR F/E/E/N/L/M >30.0 CM,,,166.11,166.11,1
HCPCS,12020,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,1735.0,1127.75,90.74,4268.0,173
HCPCS,12020,TX SUPFC WND DEHSN SMPL CLSR,,,176.18,176.18,1
HCPCS,120200,TX SUPFC WND DEHSN SMPL CLSR,,,176.18,176.18,1
HCPCS,12021,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,1165.5,757.575,68.22,4214.0,225
HCPCS,12021,TX SUPFC WND DEHSN W/PACKING,,,131.94,131.94,1
HCPCS,120210,TX SUPFC WND DEHSN W/PACKING,,,131.94,131.94,1
HCPCS,12031,"INT REPAIR SCALP,AXL,TRUNK <2.5CM",880.0,572.0,85.37,660.0,35
HCPCS,12031,INTMD RPR S/A/T/EXT 2.5 CM/<,,,140.56,140.56,1
HCPCS,12031,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,1499.0,974.35,171.31,4214.0,144
HCPCS,120310,INTMD RPR S/A/T/EXT 2.5 CM/<,,,140.56,140.56,1
HCPCS,12032,"INT REPAIR SCALP,AXL,TRUNK 2.6-7.5CM",1109.0,720.85,90.74,831.75,35
HCPCS,12032,INTMD RPR S/A/T/EXT 2.6-7.5,,,176.42,176.42,1
HCPCS,12032,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,1499.0,974.35,213.21,4214.0,144
HCPCS,120320,INTMD RPR S/A/T/EXT 2.6-7.5,,,176.42,176.42,1
HCPCS,12034,"INT REPAIR SCALP,AXL,TRUNK 7.6-12.5CM",1307.0,849.55,98.63,980.25,35
HCPCS,12034,INTMD RPR S/TR/EXT 7.6-12.5,,,191.41,191.41,1
HCPCS,12034,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,1499.0,974.35,233.99,4214.0,144
HCPCS,120340,INTMD RPR S/TR/EXT 7.6-12.5,,,191.41,191.41,1
HCPCS,12035,"INT REPAIR SCALP,AXL,TRUNK 12.6-20CM",1540.0,1001.0,116.55,1155.0,35
HCPCS,12035,INTMD RPR S/A/T/EXT 12.6-20,,,225.97,225.97,1
HCPCS,12035,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,1499.0,974.35,241.35,4214.0,144
HCPCS,120350,INTMD RPR S/A/T/EXT 12.6-20,,,225.97,225.97,1
HCPCS,12036,INTMD RPR S/A/T/EXT 20.1-30,,,265.31,265.31,1
HCPCS,12036,"LAYR CLOS WND TRUNK,ARM,LEG 20.1-30",1861.0,1209.65,137.43,1395.75,35
HCPCS,12036,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,2295.0,1491.75,241.35,4214.0,141
HCPCS,120360,INTMD RPR S/A/T/EXT 20.1-30,,,265.31,265.31,1
HCPCS,12037,INTMD RPR S/TR/EXT >30.0 CM,,,308.62,308.62,1
HCPCS,12037,"LAYR CLOS WND TRUNK,ARM,LEG >30CM",2200.0,1430.0,159.13,1650.0,35
HCPCS,12037,REPAIR INTERMEDIATE S/A/T/E >30.0 CM,6860.0,4459.0,241.35,6174.0,144
HCPCS,120370,INTMD RPR S/TR/EXT >30.0 CM,,,308.62,308.62,1
HCPCS,12041,INT REPAIR NECK/HANDS/FEET/XTRNL GENT <2.5CM,924.0,600.6,69.21,693.0,35
HCPCS,12041,INTMD RPR N-HF/GENIT 2.5CM/<,,,135.29,135.29,1
HCPCS,12041,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,1499.0,974.35,168.05,3920.0,144
HCPCS,120410,INTMD RPR N-HF/GENIT 2.5CM/<,,,135.29,135.29,1
HCPCS,12042,"INT REPAIR NECK,HANDS,FEET, GENIT, 2.6-7.5 CM",1228.0,798.2,93.86,921.0,35
HCPCS,12042,INTMD RPR N-HF/GENIT2.6-7.5,,,182.07,182.07,1
HCPCS,12042,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,1499.0,974.35,220.06,4214.0,144
HCPCS,120420,INTMD RPR N-HF/GENIT2.6-7.5,,,182.07,182.07,1
HCPCS,12044,"INT REPAIR SCALP,NEC,TRK 7.6-12.5CM",1404.0,912.6,102.57,1053.0,35
HCPCS,12044,INTMD RPR N-HF/GENIT7.6-12.5,,,200.2,200.2,1
HCPCS,12044,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,2295.0,1491.75,241.35,4214.0,141
HCPCS,120440,INTMD RPR N-HF/GENIT7.6-12.5,,,200.2,200.2,1
HCPCS,12045,"INT REPAIR SCALP,NEC,TRK 12.6-20CM",1650.0,1072.5,131.18,1237.5,35
HCPCS,12045,INTMD RPR N-HF/GENIT12.6-20,,,255.81,255.81,1
HCPCS,12045,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,2295.0,1491.75,241.35,4214.0,141
HCPCS,120450,INTMD RPR N-HF/GENIT12.6-20,,,255.81,255.81,1
HCPCS,12046,INTMD RPR N-HF/GENIT20.1-30,,,299.18,299.18,1
HCPCS,12046,LAYR CLOS WND REST BODY 20.1-30,1892.0,1229.8,155.51,1419.0,35
HCPCS,12046,RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,2295.0,1491.75,241.35,4214.0,96
HCPCS,120460,INTMD RPR N-HF/GENIT20.1-30,,,299.18,299.18,1
HCPCS,12047,INTMD RPR N-HF/GENIT >30.0CM,,,332.31,332.31,1
HCPCS,12047,LAYR CLOS WND REST BODY >30CM,2178.0,1415.7,172.77,1633.5,35
HCPCS,12047,REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,6860.0,4459.0,241.35,6174.0,98
HCPCS,120470,INTMD RPR N-HF/GENIT >30.0CM,,,332.31,332.31,1
HCPCS,12051,"INT REPAIR FACE,EAR,EYE <2.5CM",1025.0,666.25,81.21,768.75,35
HCPCS,12051,INTMD RPR FACE/MM 2.5 CM/<,,,157.67,157.67,1
HCPCS,12051,LAYER CLOSURE OF EAR LOBES,415.0,269.75,81.21,430.78,35
HCPCS,12051,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,1499.0,974.35,192.62,4214.0,144
HCPCS,120510,INTMD RPR FACE/MM 2.5 CM/<,,,157.67,157.67,1
HCPCS,12052,"INT REPAIR FACE,EAR,EYE 2.6-5CM",1263.0,820.95,95.5,947.25,35
HCPCS,12052,INTMD RPR FACE/MM 2.6-5.0 CM,,,185.62,185.62,1
HCPCS,12052,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1499.0,974.35,225.31,4214.0,144
HCPCS,120520,INTMD RPR FACE/MM 2.6-5.0 CM,,,185.62,185.62,1
HCPCS,12053,"INT REPAIR FACE,EAR,EYE 5.1-7.5CM",1395.0,906.75,102.9,1046.25,35
HCPCS,12053,INTMD RPR FACE/MM 5.1-7.5 CM,,,200.53,200.53,1
HCPCS,12053,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,1499.0,974.35,241.35,4214.0,144
HCPCS,120530,INTMD RPR FACE/MM 5.1-7.5 CM,,,200.53,200.53,1
HCPCS,12054,"INT REPAIR FAC,EAR,EYE 7.6-12.5CM",1540.0,1001.0,105.37,1155.0,35
HCPCS,12054,INTMD RPR FACE/MM 7.6-12.5CM,,,206.38,206.38,1
HCPCS,12054,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,1499.0,974.35,241.35,3920.0,144
HCPCS,120540,INTMD RPR FACE/MM 7.6-12.5CM,,,206.38,206.38,1
HCPCS,12055,"INT REPAIR FAC,EAR,EYE 12.6-20CM",1980.0,1287.0,144.16,1485.0,35
HCPCS,12055,INTMD RPR FACE/MM 12.6-20 CM,,,282.92,282.92,1
HCPCS,12055,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,1499.0,974.35,241.35,4214.0,98
HCPCS,120550,INTMD RPR FACE/MM 12.6-20 CM,,,282.92,282.92,1
HCPCS,12056,INTMD RPR FACE/MM 20.1-30.0,,,358.69,358.69,1
HCPCS,12056,"LAYR CLOS WND FACE,FACIAL 20.1-30",2332.0,1515.8,186.08,1749.0,35
HCPCS,12056,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM,1499.0,974.35,241.35,4214.0,98
HCPCS,120560,INTMD RPR FACE/MM 20.1-30.0,,,358.69,358.69,1
HCPCS,12057,INTMD RPR FACE/MM >30.0 CM,,,392.21,392.21,1
HCPCS,12057,"LAYR CLOS WND FACE,FACIAL >30CM",2640.0,1716.0,202.84,1980.0,35
HCPCS,12057,REPAIR INTERMEDIATE F/E/E/N/L&/MUC >30.0 CM,1499.0,974.35,241.35,4214.0,98
HCPCS,120570,INTMD RPR FACE/MM >30.0 CM,,,392.21,392.21,1
HCPCS,1205F,EPI ETIOL SYND RVWD AND DOCD,,,0.01,0.01,1
HCPCS,1205F0,EPI ETIOL SYND RVWD AND DOCD,,,0.01,0.01,1
HCPCS,1220F,PT SCREENED FOR DEPRESSION,,,0.01,0.01,1
HCPCS,1220F0,PT SCREENED FOR DEPRESSION,,,0.01,0.01,1
HCPCS,13100,CMPLX RPR TRUNK 1.1-2.5 CM,,,186.41,186.41,1
HCPCS,13100,REPAIR COMPLEX TRUNK 1.1-2.5 CM,2295.0,1491.75,225.44,4268.0,141
HCPCS,13100,REPR CMPL WND TRUNK 1.1-2.5CM,1200.0,780.0,96.17,900.0,35
HCPCS,131000,CMPLX RPR TRUNK 1.1-2.5 CM,,,186.41,186.41,1
HCPCS,13101,CMPLX RPR TRUNK 2.6-7.5 CM,,,228.68,228.68,1
HCPCS,13101,REPAIR COMPLEX TRUNK 2.6-7.5 CM,2295.0,1491.75,254.67,4268.0,141
HCPCS,13101,REPR CMPL WND TRUNK 2.6-7.5CM,1400.0,910.0,119.18,1050.0,35
HCPCS,131010,CMPLX RPR TRUNK 2.6-7.5 CM,,,228.68,228.68,1
HCPCS,13102,CMPLX RPR TRUNK ADDL 5CM/<,,,67.14,67.14,1
HCPCS,13102,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,444.5,288.92499999999995,34.86,4214.0,146
HCPCS,131020,CMPLX RPR TRUNK ADDL 5CM/<,,,67.14,67.14,1
HCPCS,13120,CMPLX RPR S/A/L 1.1-2.5 CM,,,214.55,214.55,1
HCPCS,13120,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,2295.0,1491.75,254.67,4214.0,141
HCPCS,13120,"REPR CMPL WND SCALP,EXTR 1.1-2.5",1292.0,839.8,112.11,969.0,35
HCPCS,131200,CMPLX RPR S/A/L 1.1-2.5 CM,,,214.55,214.55,1
HCPCS,13121,CMPLX RPR S/A/L 2.6-7.5 CM,,,239.75,239.75,1
HCPCS,13121,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,2295.0,1491.75,254.67,4214.0,141
HCPCS,13121,"REPR CMPL WND SCALP,EXTR 2.6-7.5",1600.0,1040.0,123.29,1200.0,35
HCPCS,131210,CMPLX RPR S/A/L 2.6-7.5 CM,,,239.75,239.75,1
HCPCS,13122,CMPLX RPR S/A/L ADDL 5 CM/>,,,77.23,77.23,1
HCPCS,13122,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,742.0,482.3,39.67,3920.0,146
HCPCS,131220,CMPLX RPR S/A/L ADDL 5 CM/>,,,77.23,77.23,1
HCPCS,13131,CMPLX RPR F/C/C/M/N/AX/G/H/F,,,225.08,225.08,1
HCPCS,13131,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,1499.0,974.35,254.67,4214.0,144
HCPCS,13131,"REPR CMPL WND HEAD,FAC,HAND 1.1-2.5",1492.0,969.8,116.05,1119.0,35
HCPCS,131310,CMPLX RPR F/C/C/M/N/AX/G/H/F,,,225.08,225.08,1
HCPCS,13132,CMPLX RPR F/C/C/M/N/AX/G/H/F,,,281.22,281.22,1
HCPCS,13132,REP COMP 2.6-7.5CM FACE,2115.0,1374.75,145.15,1586.25,35
HCPCS,13132,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,2295.0,1491.75,254.67,4268.0,141
HCPCS,13132,"REPR CMPL WND HEAD,FAC,HAND 2.6-7.5",2103.0,1366.95,145.15,1577.25,35
HCPCS,13132,SCAR REVISION,2353.0,1529.45,145.15,1764.75,35
HCPCS,131320,CMPLX RPR F/C/C/M/N/AX/G/H/F,,,281.22,281.22,1
HCPCS,13133,CMPLX RPR F/C/C/M/N/AX/G/H/F,,,117.1,117.1,1
HCPCS,13133,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,1206.5,784.225,62.93,4214.0,146
HCPCS,131330,CMPLX RPR F/C/C/M/N/AX/G/H/F,,,117.1,117.1,1
HCPCS,13151,CMPLX RPR E/N/E/L 1.1-2.5 CM,,,258.69,258.69,1
HCPCS,13151,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,2295.0,1491.75,254.67,4268.0,141
HCPCS,13151,"REPR CMPL WND LID,NOS,EAR 1.1-2.5",1736.0,1128.4,133.65,1302.0,35
HCPCS,131510,CMPLX RPR E/N/E/L 1.1-2.5 CM,,,258.69,258.69,1
HCPCS,13152,CMPLX RPR E/N/E/L 2.6-7.5 CM,,,312.15,312.15,1
HCPCS,13152,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,2295.0,1491.75,254.67,4268.0,141
HCPCS,13152,"REPR CMPL WND LID,NOS,EAR 2.5-7.5",2136.0,1388.4,160.93,1602.0,35
HCPCS,131520,CMPLX RPR E/N/E/L 2.6-7.5 CM,,,312.15,312.15,1
HCPCS,13153,CMPLX RPR E/N/E/L ADDL 5CM/<,,,127.69,127.69,1
HCPCS,13153,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,853.0,554.45,67.89,4214.0,111
HCPCS,131530,CMPLX RPR E/N/E/L ADDL 5CM/<,,,127.69,127.69,1
HCPCS,13160,SEC CLSR SURG WND/DEHSN XTN,,,747.01,6830.0,16
HCPCS,13160,SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC,4816.0,3130.4,426.56,4816.0,35
HCPCS,13160,Sec clsr surg wnd/dehsn xtn,,,613.49,774.94,6
HCPCS,131600,SEC CLSR SURG WND/DEHSN XTN,,,747.01,747.01,1
HCPCS,14000,ADJACENT TISSUE TRANSFER/REARGMT TRUNK 10 SQCM/<,6860.0,4459.0,586.15,8370.0,46
HCPCS,14000,TIS TRNFR TRUNK 10 SQ CM/<,,,470.88,470.88,1
HCPCS,14000,TISSUE REARRAN TRUNK DEF <10SCM,2548.0,1656.2,242.63,1911.0,35
HCPCS,140000,TIS TRNFR TRUNK 10 SQ CM/<,,,470.88,470.88,1
HCPCS,14001,ADJNT TIS TRANSFR/REARRANGE TRUNK 10.1-30.0 SQCM,6860.0,4459.0,759.51,8370.0,46
HCPCS,14001,TIS TRNFR TRUNK 10.1-30SQCM,,,611.29,611.29,1
HCPCS,14001,TISSUE REARRAN TRUNK  10.1-30SCM,3512.0,2282.8,315.29,2634.0,35
HCPCS,140010,TIS TRNFR TRUNK 10.1-30SQCM,,,611.29,611.29,1
HCPCS,1400F,PRKNS DIAG RVIEWED,,,0.01,0.01,1
HCPCS,1400F0,PRKNS DIAG RVIEWED,,,0.01,0.01,1
HCPCS,14020,ADJT TIS TRNSFR/REARGMT SCALP/ARM/LEG 10 SQ CM/<,6860.0,4459.0,641.29,8370.0,46
HCPCS,14020,TIS TRNFR S/A/L 10 SQ CM/<,,,527.8,527.8,1
HCPCS,14020,"TISSUE REARRA SCALP,EXTRE LT 10SCM",2888.0,1877.2,271.72,2166.0,35
HCPCS,140200,TIS TRNFR S/A/L 10 SQ CM/<,,,527.8,527.8,1
HCPCS,14021,"ADJ TISS XFER SCALP,EXTREM 10.1-30",3888.0,2527.2,340.43,2916.0,35
HCPCS,14021,ADJT/REARRGMT SCALP/ARM/LEG 10.1-30.0 SQ CM,6860.0,4459.0,799.09,8370.0,46
HCPCS,14021,TIS TRNFR S/A/L 10.1-30 SQCM,,,660.31,660.31,1
HCPCS,140210,TIS TRNFR S/A/L 10.1-30 SQCM,,,660.31,660.31,1
HCPCS,14040,ADJT TIS TRNS/REARGMT F/C/C/M/N/A/G/H/F 10SQCM/<,6860.0,4459.0,705.68,8370.0,46
HCPCS,14040,TIS TRNFR F/C/C/M/N/A/G/H/F,,,581.27,581.27,1
HCPCS,14040,"TISSUE REARR MOUTH,FORE  <10SCM",3440.0,2236.0,299.01,2580.0,35
HCPCS,140400,TIS TRNFR F/C/C/M/N/A/G/H/F,,,581.27,581.27,1
HCPCS,14041,ADJT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0 SQ CM,6860.0,4459.0,851.33,8370.0,46
HCPCS,14041,TIS TRNFR F/C/C/M/N/A/G/H/F,,,709.7,709.7,1
HCPCS,14041,"TISSUE REARR MOUTH,FORE 10.1-30SCM",4332.0,2815.8,365.23,3249.0,35
HCPCS,140410,TIS TRNFR F/C/C/M/N/A/G/H/F,,,709.7,709.7,1
HCPCS,14060,ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<,6860.0,4459.0,744.87,8370.0,46
HCPCS,14060,TIS TRNFR E/N/E/L 10 SQ CM/<,,,619.12,619.12,1
HCPCS,14060,"TISSUE REARR LIP,EAR,EYE GT 10 SCM",4061.0,2639.65,323.71,3045.75,35
HCPCS,140600,TIS TRNFR E/N/E/L 10 SQ CM/<,,,619.12,619.12,1
HCPCS,14061,ADJT TIS REARGMT EYE/NOSE/EAR/LIP 10.1-30.0 SQCM,6860.0,4459.0,910.44,8370.0,46
HCPCS,14061,TIS TRNFR E/N/E/L10.1-30SQCM,,,761.79,761.79,1
HCPCS,14061,"TISSUE REARR LIP,EAR,EYE 10.1-30SCM",5051.0,3283.15,423.29,3788.25,35
HCPCS,140610,TIS TRNFR E/N/E/L10.1-30SQCM,,,761.79,761.79,1
HCPCS,14301,ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM,13729.0,8923.85,991.15,13665.0,46
HCPCS,14301,ATT/R ANY AREA DEFECT 30.1-60SQCM,5060.0,3289.0,418.67,3795.0,35
HCPCS,14301,TIS TRNFR ANY 30.1-60 SQ CM,,,812.37,812.37,1
HCPCS,143010,TIS TRNFR ANY 30.1-60 SQ CM,,,812.37,812.37,1
HCPCS,14302,ADJT TIS TRNSFR/REARGMT DEFEC EA ADDL 30 SQCM,4401.0,2860.65,243.21,13665.0,35
HCPCS,14302,ATT/R ANY AREA DEFECT EA ADDL 30SQCM OR PART,1641.0,1066.65,127.4,1641.0,35
HCPCS,14302,TIS TRNFR ADDL 30 SQ CM,,,202.07,202.07,1
HCPCS,143020,TIS TRNFR ADDL 30 SQ CM,,,202.07,202.07,1
HCPCS,14350,FILLETED FINGER/TOE FLAP,,,634.38,3966.07,15
HCPCS,14350,FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE,4420.0,2873.0,426.11,4420.0,35
HCPCS,14350,Filleted finger/toe flap,,,1181.56,1492.5,6
HCPCS,143500,FILLETED FINGER/TOE FLAP,,,634.38,634.38,1
HCPCS,1450F,SYMPTOMS IMPROVED/CONSIST,,,0.01,0.01,1
HCPCS,1450F0,SYMPTOMS IMPROVED/CONSIST,,,0.01,0.01,1
HCPCS,1451F,SYMPT SHOW CLIN IMPORT DROP,,,0.01,0.01,1
HCPCS,1451F0,SYMPT SHOW CLIN IMPORT DROP,,,0.01,0.01,1
HCPCS,1460F,QUAL CARD DIAG PRIOR 12 MONS,,,0.01,0.01,1
HCPCS,1460F0,QUAL CARD DIAG PRIOR 12 MONS,,,0.01,0.01,1
HCPCS,1461F,NO QUAL CARD DIAG PRIOR12MON,,,0.01,0.01,1
HCPCS,1461F0,NO QUAL CARD DIAG PRIOR12MON,,,0.01,0.01,1
HCPCS,1490F,DEM SEVERITY CLASSIFIED MILD,,,0.01,0.01,1
HCPCS,1490F0,DEM SEVERITY CLASSIFIED MILD,,,0.01,0.01,1
HCPCS,1491F,DEM SEVERITY CLASSIFIED MOD,,,0.01,0.01,1
HCPCS,1491F0,DEM SEVERITY CLASSIFIED MOD,,,0.01,0.01,1
HCPCS,1493F,DEM SEVERITY CLASS SEVERE,,,0.01,0.01,1
HCPCS,1493F0,DEM SEVERITY CLASS SEVERE,,,0.01,0.01,1
HCPCS,1494F,COGNIT ASSESSED AND REVIEWED,,,0.01,0.01,1
HCPCS,1494F0,COGNIT ASSESSED AND REVIEWED,,,0.01,0.01,1
HCPCS,15002,PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT,1606.0,1043.9,106.03,1204.5,35
HCPCS,15002,WOUND PREP TRK/ARM/LEG,,,205.59,3966.07,16
HCPCS,15002,Wound prep trk/arm/leg,,,613.49,774.94,6
HCPCS,150020,WOUND PREP TRK/ARM/LEG,,,205.59,205.59,1
HCPCS,15003,PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT,320.0,208.0,22.03,240.0,35
HCPCS,15003,WOUND PREP ADDL 100 CM,,,42.51,42.51,1
HCPCS,15003,Wound prep addl 100 cm,,,241.35,304.86,6
HCPCS,150030,WOUND PREP ADDL 100 CM,,,42.51,42.51,1
HCPCS,15004,PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT,2063.5,1341.275,126.08,4214.0,80
HCPCS,15004,WOUND PREP F/N/HF/G,,,242.89,242.89,1
HCPCS,150040,WOUND PREP F/N/HF/G,,,242.89,242.89,1
HCPCS,15005,PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT,640.0,416.0,44.05,480.0,35
HCPCS,15005,WND PREP F/N/HF/G ADDL CM,,,84.32,84.32,1
HCPCS,15005,Wnd prep f/n/hf/g addl cm,,,241.35,304.86,6
HCPCS,150050,WND PREP F/N/HF/G ADDL CM,,,84.32,84.32,1
HCPCS,1500F,SYMPTOM&SIGN SYMM POLYNEURO,,,0.01,0.01,1
HCPCS,1500F0,SYMPTOM&SIGN SYMM POLYNEURO,,,0.01,0.01,1
HCPCS,15011,HRV SKIN FOR SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,929.0,603.85,149.74,929.0,13
HCPCS,15011,HRV SKN CLL SSP AGRFT 1ST 25,,,1836.14,3966.07,14
HCPCS,15011,Hrv skn cll ssp agrft 1st 25,,,1181.56,1492.5,6
HCPCS,15012,HRV SKIN FOR SKIN CELL SSP AGRFT EA ADDL 25 SQCM,929.0,603.85,70.29,929.0,13
HCPCS,15012,Hrv skn cll ssp agrft ea add,,,1181.56,1492.5,6
HCPCS,15013,PREPARATION SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,1696.0,1102.4,166.45,1696.0,13
HCPCS,15013,PREPJ SKN CLL SSP AGRFT 1ST,,,6274.13,13552.11,14
HCPCS,15013,Prepj skn cll ssp agrft 1st,,,115.89,146.39,6
HCPCS,15014,PREPARATION SKIN CELL SSP AGRFT EA ADDL 25 SQ CM,1696.0,1102.4,166.45,1696.0,13
HCPCS,15014,Prepj skn cll ssp agrft ea,,,115.89,146.39,6
HCPCS,15015,APP SKN CL SSP AGRFT T/A/L 1,,,1836.14,3966.07,14
HCPCS,15015,APPL SKIN CELL SSP AGRFT T/A/L 1ST 480 SQ CM/<,697.0,453.05,348.5,1500.53,13
HCPCS,15015,App skn cl ssp agrft t/a/l 1,,,1181.56,1492.5,6
HCPCS,15016,APPL SKIN CELL SSP AGRFT T/A/L EA ADDL 480 SQ CM,697.0,453.05,255.19,697.0,13
HCPCS,15016,App skn cl ssp agrf t/a/l ea,,,1181.56,1492.5,6
HCPCS,15017,APP SKN CLL SSP F/N/G/HF 1ST,,,1836.14,3966.07,14
HCPCS,15017,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT 1ST 480,850.0,552.5,425.0,1728.6,13
HCPCS,15017,App skn cll ssp f/n/g/hf 1st,,,1181.56,1492.5,6
HCPCS,15018,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT EA ADDL,850.0,552.5,352.44,850.0,13
HCPCS,15018,App skn cll ssp f/n/g/hf ea,,,1181.56,1492.5,6
HCPCS,1501F,NOT INITIAL EVAL FOR COND,,,0.01,0.01,1
HCPCS,1501F0,NOT INITIAL EVAL FOR COND,,,0.01,0.01,1
HCPCS,1502F,PT QUERIED PAIN FXN W/ INSTR,,,0.01,0.01,1
HCPCS,1502F0,PT QUERIED PAIN FXN W/ INSTR,,,0.01,0.01,1
HCPCS,1503F,PT QUERIED SYMP RESP INSUFF,,,0.01,0.01,1
HCPCS,1503F0,PT QUERIED SYMP RESP INSUFF,,,0.01,0.01,1
HCPCS,15040,HARVEST CULTURED SKIN GRAFT,,,117.54,3966.07,15
HCPCS,15040,HARVEST SKIN TISSUE CLTR SKIN AGRFT 100 CM/<,800.0,520.0,59.84,600.0,32
HCPCS,15040,Harvest cultured skin graft,,,1181.56,1492.5,6
HCPCS,150400,HARVEST CULTURED SKIN GRAFT,,,117.54,117.54,1
HCPCS,1504F,PT HAS RESP INSUFFICIENCY,,,0.01,0.01,1
HCPCS,1504F0,PT HAS RESP INSUFFICIENCY,,,0.01,0.01,1
HCPCS,15050,PINCH GRAFT 1/MLT SM ULCER TIP/OTH AREA 2CM,2228.0,1448.2,224.71,1671.0,35
HCPCS,15050,PINCH GRAFT UP TO 2 CM DIAM,,,426.2,1327.2,15
HCPCS,15050,Pinch graft up to 2 cm diam,,,254.67,321.68,6
HCPCS,150500,PINCH GRAFT UP TO 2 CM DIAM,,,426.2,426.2,1
HCPCS,1505F,PT HAS NO RESP INSUFFICIENCY,,,0.01,0.01,1
HCPCS,1505F0,PT HAS NO RESP INSUFFICIENCY,,,0.01,0.01,1
HCPCS,15100,SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,5410.0,3516.5,347.66,13665.0,81
HCPCS,15100,SPLT AGRFT T/A/L 1ST 100SQCM,,,670.15,670.15,1
HCPCS,151000,SPLT AGRFT T/A/L 1ST 100SQCM,,,670.15,670.15,1
HCPCS,15101,SPLIT AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,688.0,447.2,54.42,516.0,35
HCPCS,15101,SPLT AGRFT T/A/L EA ADDL 100,,,103.72,103.72,1
HCPCS,15101,Splt agrft t/a/l ea addl 100,,,1181.56,1492.5,6
HCPCS,151010,SPLT AGRFT T/A/L EA ADDL 100,,,103.72,103.72,1
HCPCS,15110,EPIDRM AGRFT T/A/L 1ST 100,,,673.02,3966.07,15
HCPCS,15110,Epidrm agrft t/a/l 1st 100,,,1181.56,1492.5,6
HCPCS,151100,EPIDRM AGRFT T/A/L 1ST 100,,,673.02,673.02,1
HCPCS,15111,EPIDRM AGRFT T/A/L EA ADDL,,,96.0,96.0,1
HCPCS,15111,Epidrm agrft t/a/l ea addl,,,1181.56,1492.5,6
HCPCS,151110,EPIDRM AGRFT T/A/L EA ADDL,,,96.0,96.0,1
HCPCS,15115,EPDRM AGRFT F/S/N/H/F/G/M 1,,,655.4,3966.07,15
HCPCS,15115,EPI AUTOGRFT FACE/NCK/HND/FT/GEN <100SQCM,4963.0,3225.95,393.65,3722.25,35
HCPCS,15115,Epdrm agrft f/s/n/h/f/g/m 1,,,1181.56,1492.5,6
HCPCS,151150,EPDRM AGRFT F/S/N/H/F/G/M 1,,,655.4,655.4,1
HCPCS,15116,EPDRM AGRFT F/S/N/H/F/G/M EA,,,130.52,130.52,1
HCPCS,15116,Epdrm agrft f/s/n/h/f/g/m ea,,,1181.56,1492.5,6
HCPCS,151160,EPDRM AGRFT F/S/N/H/F/G/M EA,,,130.52,130.52,1
HCPCS,15120,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/</1 %,4060.0,2639.0,333.7,3045.0,35
HCPCS,15120,SPLT AGRFT F/S/N/H/F/G/M 1ST,,,646.86,7937.59,15
HCPCS,15120,Splt agrft f/s/n/h/f/g/m 1st,,,1181.56,1492.5,6
HCPCS,151200,SPLT AGRFT F/S/N/H/F/G/M 1ST,,,646.86,646.86,1
HCPCS,15121,SPLIT AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA 1 %,800.0,520.0,78.19,600.0,35
HCPCS,15121,SPLT AGRFT F/S/N/H/F/G/M EA,,,122.88,122.88,1
HCPCS,15121,Splt agrft f/s/n/h/f/g/m ea,,,1181.56,1492.5,6
HCPCS,151210,SPLT AGRFT F/S/N/H/F/G/M EA,,,122.88,122.88,1
HCPCS,15130,"DERM AUTOGRFT, TRNK/ARM/LEG <100SQCM",3012.0,1957.8,328.5,2259.0,35
HCPCS,15130,DRM AGRFT T/A/L 1ST 100 SQCM,,,556.85,3966.07,15
HCPCS,15130,Drm agrft t/a/l 1st 100 sqcm,,,1181.56,1492.5,6
HCPCS,151300,DRM AGRFT T/A/L 1ST 100 SQCM,,,556.85,556.85,1
HCPCS,15131,"DERM AUTOGRFT TRNK/ARM/LEG, EA 100SQCM",600.0,390.0,51.16,450.0,35
HCPCS,15131,DRM AGRFT T/A/L EA ADDL,,,83.49,83.49,1
HCPCS,15131,Drm agrft t/a/l ea addl,,,1181.56,1492.5,6
HCPCS,151310,DRM AGRFT T/A/L EA ADDL,,,83.49,83.49,1
HCPCS,15135,DERM AUTOGRAFT FACE/NCK/HND/FT/GEN <100SQCM,4412.0,2867.8,430.11,3309.0,35
HCPCS,15135,DRM AGRFT F/S/N/H/F/G/M 1ST,,,707.94,7937.59,15
HCPCS,15135,Drm agrft f/s/n/h/f/g/m 1st,,,1181.56,1492.5,6
HCPCS,151350,DRM AGRFT F/S/N/H/F/G/M 1ST,,,707.94,707.94,1
HCPCS,15136,"DERM AUTOGRAFT FACE/NCK/HND/FT/GEN, EA 100SQCM",600.0,390.0,64.36,450.0,35
HCPCS,15136,DRM AGRFT F/S/N/H/F/G/M EA,,,83.49,83.49,1
HCPCS,15136,Drm agrft f/s/n/h/f/g/m ea,,,1181.56,1492.5,6
HCPCS,151360,DRM AGRFT F/S/N/H/F/G/M EA,,,83.49,83.49,1
HCPCS,15150,CLTR SKIN AUTOGRAFT T/A/L 1ST 25 CM/<,3756.0,2441.4,425.39,2817.0,35
HCPCS,15150,TIS CLTR SKN AGRFT T/A/L 1ST,,,603.96,3966.07,15
HCPCS,15150,Tis cltr skn agrft t/a/l 1st,,,1181.56,1492.5,6
HCPCS,151500,TIS CLTR SKN AGRFT T/A/L 1ST,,,603.96,603.96,1
HCPCS,15151,CLTR SKIN AGRFT T/A/L ADDL 1 CM-75 CM,800.0,520.0,82.8,600.0,35
HCPCS,15151,TIS CLTR SKN AGRFT T/A/L ADD,,,103.27,103.27,1
HCPCS,15151,Tis cltr skn agrft t/a/l add,,,1181.56,1492.5,6
HCPCS,151510,TIS CLTR SKN AGRFT T/A/L ADD,,,103.27,103.27,1
HCPCS,15152,CLTR SKIN AGRFT T/A/L EA 100 CM/EA 1%BODY AREA,1000.0,650.0,87.82,750.0,35
HCPCS,15152,TIS CLTR SKN AGRFT T/A/L EA,,,130.98,130.98,1
HCPCS,15152,Tis cltr skn agrft t/a/l ea,,,1181.56,1492.5,6
HCPCS,151520,TIS CLTR SKN AGRFT T/A/L EA,,,130.98,130.98,1
HCPCS,15155,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT 1ST 25CM/<,4056.0,2636.4,448.55,3042.0,35
HCPCS,15155,TIS CLTR AGRFT F/S/N/H/F/G 1,,,680.89,7937.59,15
HCPCS,15155,Tis cltr agrft f/s/n/h/f/g 1,,,1181.56,1492.5,6
HCPCS,151550,TIS CLTR AGRFT F/S/N/H/F/G 1,,,680.89,680.89,1
HCPCS,15156,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT ADDL 1-75CM,1100.0,715.0,93.0,825.0,35
HCPCS,15156,TIS CLT AGRFT F/S/N/H/F/G AD,,,142.47,142.47,1
HCPCS,15156,Tis clt agrft f/s/n/h/f/g ad,,,1181.56,1492.5,6
HCPCS,151560,TIS CLT AGRFT F/S/N/H/F/G AD,,,142.47,142.47,1
HCPCS,15157,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT EA 100 EA,1200.0,780.0,120.01,900.0,35
HCPCS,15157,TIS CLT AGRFT F/S/N/H/F/G EA,,,155.23,155.23,1
HCPCS,15157,Tis clt agrft f/s/n/h/f/g ea,,,1181.56,1492.5,6
HCPCS,151570,TIS CLT AGRFT F/S/N/H/F/G EA,,,155.23,155.23,1
HCPCS,15200,FTH/GFT FR TRNK 20 SQ CM/<,,,629.75,3966.07,15
HCPCS,15200,FULL GRAFT PROC TRUNK <20 SQCM,3660.0,2379.0,325.15,2745.0,35
HCPCS,15200,Fth/gft fr trnk 20 sq cm/<,,,1181.56,1492.5,6
HCPCS,152000,FTH/GFT FR TRNK 20 SQ CM/<,,,629.75,629.75,1
HCPCS,15201,FTH/GFT FR TRNK EACH ADDL,,,71.7,71.7,1
HCPCS,15201,FULL GRAFT PROC TRUNK ADD 20 SQCM,581.0,377.65,51.18,435.75,35
HCPCS,15201,Fth/gft fr trnk each addl,,,1181.56,1492.5,6
HCPCS,152010,FTH/GFT FR TRNK EACH ADDL,,,71.7,71.7,1
HCPCS,15220,FTH/GFT FR S/A/L 20 SQ CM/<,,,568.58,568.58,1
HCPCS,15220,FTH/GFT FREE W/DIRECT CLOSURE S/A/L 20 CM/<,6860.0,4459.0,688.16,8370.0,46
HCPCS,15220,"FULL THICKNESS GRAFT SCALP, ARMS LEGS 20 SQ CM OR LESS",3236.0,2103.4,293.09,2427.0,35
HCPCS,152200,FTH/GFT FR S/A/L 20 SQ CM/<,,,568.58,568.58,1
HCPCS,15221,FTH/GFT FR S/A/L EACH ADDL,,,64.68,64.68,1
HCPCS,15221,"FULL GRAFT PROC SCALP,ARM ADD 20SQCM",476.0,309.4,46.86,357.0,35
HCPCS,15221,Fth/gft fr s/a/l each addl,,,1181.56,1492.5,6
HCPCS,152210,FTH/GFT FR S/A/L EACH ADDL,,,64.68,64.68,1
HCPCS,15240,FTH/GFT F/C/C/M/N/AX/G/H/F20,,,740.72,740.72,1
HCPCS,15240,FTH/GFT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F 20 CM/<,6860.0,4459.0,894.13,8370.0,46
HCPCS,15240,SKIN GRAFT HAND <20 SQ CM,4164.0,2706.6,382.02,3123.0,35
HCPCS,152400,FTH/GFT F/C/C/M/N/AX/G/H/F20,,,740.72,740.72,1
HCPCS,15241,FTH/GFT F/C/C/M/N/A/G/H/F EA,,,100.31,100.31,1
HCPCS,15241,Fth/gft f/c/c/m/n/a/g/h/f ea,,,1181.56,1492.5,6
HCPCS,15241,SKIN GRAFT HAND ADD'L 20 SCM,818.0,531.7,72.96,613.5,35
HCPCS,152410,FTH/GFT F/C/C/M/N/A/G/H/F EA,,,100.31,100.31,1
HCPCS,15260,FTH/GFT FR N/E/E/L 20 SQCM/<,,,786.22,786.22,1
HCPCS,15260,FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<,6860.0,4459.0,944.7,8370.0,46
HCPCS,15260,SKIN GRAFT NOSE <20 SQ CM,4656.0,3026.4,405.19,3492.0,35
HCPCS,152600,FTH/GFT FR N/E/E/L 20 SQCM/<,,,786.22,786.22,1
HCPCS,15261,FTH/GFT FR N/E/E/L EACH ADDL,,,126.22,126.22,1
HCPCS,15261,Fth/gft fr n/e/e/l each addl,,,1181.56,1492.5,6
HCPCS,15261,SKIN GRAFT NOSE ADD'L 20SCM,892.0,579.8,101.94,669.0,35
HCPCS,152610,FTH/GFT FR N/E/E/L EACH ADDL,,,126.22,126.22,1
HCPCS,15271,APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25,6860.0,4459.0,100.57,6174.0,46
HCPCS,15271,APP SKN SUB GRFT T/A/L AREA/<100SCM /<1ST 25 SCM,660.0,429.0,41.56,495.0,35
HCPCS,15271,SKIN SUB GRAFT TRNK/ARM/LEG,,,78.87,78.87,1
HCPCS,152710,SKIN SUB GRAFT TRNK/ARM/LEG,,,78.87,78.87,1
HCPCS,15272,APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC,6860.0,4459.0,20.02,6174.0,35
HCPCS,15272,APP SKN SUB GRFT T/A/L AREA/<100SCM EA ADL 25SCM,145.0,94.25,8.55,108.75,35
HCPCS,15272,SKIN SUB GRAFT T/A/L ADD-ON,,,15.89,15.89,1
HCPCS,152720,SKIN SUB GRAFT T/A/L ADD-ON,,,15.89,15.89,1
HCPCS,15273,APP SKN SUB GRFT T/A/L AREA/>100SCM 1ST 100SCM,1400.0,910.0,95.67,1050.0,35
HCPCS,15273,APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM,13729.0,8923.85,228.39,12356.1,46
HCPCS,15273,SKIN SUB GRFT T/ARM/LG CHILD,,,183.57,183.57,1
HCPCS,152730,SKIN SUB GRFT T/ARM/LG CHILD,,,183.57,183.57,1
HCPCS,15274,APP SKN SUB GRFT T/A/L AREA/>100SCM ADL 100SCM,320.0,208.0,22.03,240.0,35
HCPCS,15274,APP SKN SUB GRFT T/A/L AREA>/=100SCM ADL 100SQCM,13729.0,8923.85,51.53,12356.1,35
HCPCS,15274,SKN SUB GRFT T/A/L CHILD ADD,,,41.88,41.88,1
HCPCS,152740,SKN SUB GRFT T/A/L CHILD ADD,,,41.88,41.88,1
HCPCS,15275,SKIN SUB GRAFT FACE/NK/HF/G,,,87.66,87.66,1
HCPCS,15275,SUB GRFT F/S/N/H/F/G/M/D /<100SCM /<1ST 25 SCM,732.0,475.8,45.04,549.0,35
HCPCS,15275,SUB GRFT F/S/N/H/F/G/M/D <100SQ CM 1ST 25 SQ CM,6860.0,4459.0,115.43,6174.0,46
HCPCS,152750,SKIN SUB GRAFT FACE/NK/HF/G,,,87.66,87.66,1
HCPCS,15276,SKIN SUB GRAFT F/N/HF/G ADDL,,,23.53,23.53,1
HCPCS,15276,SUB GRFT F/S/N/H/F/G/M/D /<100SCM EA ADL 25SCM,200.0,130.0,12.33,150.0,35
HCPCS,15276,SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADDL25SQ CM,6860.0,4459.0,30.28,6174.0,35
HCPCS,152760,SKIN SUB GRAFT F/N/HF/G ADDL,,,23.53,23.53,1
HCPCS,15277,SKN SUB GRFT F/N/HF/G CHILD,,,209.2,3966.07,15
HCPCS,15277,SUB GRFT F/S/N/H/F/G/M/D />100SCM 1ST 100SCM,1600.0,1040.0,108.98,1200.0,35
HCPCS,15277,Skn sub grft f/n/hf/g child,,,1181.56,1492.5,6
HCPCS,152770,SKN SUB GRFT F/N/HF/G CHILD,,,209.2,209.2,1
HCPCS,15278,SKN SUB GRFT F/N/HF/G CH ADD,,,52.3,52.3,1
HCPCS,15278,SUB GRFT F/S/N/H/F/G/M/D />100SCM ADL 100SCM,400.0,260.0,27.46,300.0,35
HCPCS,15278,Skn sub grft f/n/hf/g ch add,,,1181.56,1492.5,6
HCPCS,152780,SKN SUB GRFT F/N/HF/G CH ADD,,,52.3,52.3,1
HCPCS,15570,FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK,4084.0,2654.6,355.4,3063.0,35
HCPCS,15570,SKIN PEDICLE FLAP TRUNK,,,682.78,3966.07,15
HCPCS,15570,Skin pedicle flap trunk,,,1181.56,1492.5,6
HCPCS,155700,SKIN PEDICLE FLAP TRUNK,,,682.78,682.78,1
HCPCS,15572,FRMJ DIRECT/TUBE PEDICLE W/WO TR SCALP ARMS/LEGS,4048.0,2631.2,354.41,3036.0,35
HCPCS,15572,SKIN PEDICLE FLAP ARMS/LEGS,,,689.09,7937.59,15
HCPCS,15572,Skin pedicle flap arms/legs,,,1181.56,1492.5,6
HCPCS,155720,SKIN PEDICLE FLAP ARMS/LEGS,,,689.09,689.09,1
HCPCS,15574,FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F,4280.0,2782.0,357.52,3210.0,35
HCPCS,15574,PEDCLE FH/CH/CH/M/N/AX/G/H/F,,,692.65,3966.07,15
HCPCS,15574,Pedcle fh/ch/ch/m/n/ax/g/h/f,,,1181.56,1492.5,6
HCPCS,155740,PEDCLE FH/CH/CH/M/N/AX/G/H/F,,,692.65,692.65,1
HCPCS,15576,FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL,5304.0,3447.6,313.8,13665.0,81
HCPCS,15576,PEDICLE E/N/E/L/NTRORAL,,,603.95,603.95,1
HCPCS,155760,PEDICLE E/N/E/L/NTRORAL,,,603.95,603.95,1
HCPCS,15600,DELAY FLAP TRUNK,,,196.78,7937.59,16
HCPCS,15600,DELAY/SECTN FLAP TRUNK,804.0,522.6,103.46,603.0,35
HCPCS,15600,Delay flap trunk,,,1181.56,1492.5,6
HCPCS,156000,DELAY FLAP TRUNK,,,196.78,196.78,1
HCPCS,15610,DELAY FLAP ARMS/LEGS,,,227.16,3966.07,15
HCPCS,15610,"DELAY/SECTN FLAP SCALP,ARM,LEG",1008.0,655.2,124.99,756.0,35
HCPCS,15610,Delay flap arms/legs,,,1181.56,1492.5,6
HCPCS,156100,DELAY FLAP ARMS/LEGS,,,227.16,227.16,1
HCPCS,15620,DELAY FLAP F/C/C/N/AX/G/H/F,,,304.05,3966.07,15
HCPCS,15620,"DELAY/SECTN FLAP FACE,GENIT,HAND,FT",1500.0,975.0,157.8,1125.0,35
HCPCS,15620,Delay flap f/c/c/n/ax/g/h/f,,,1181.56,1492.5,6
HCPCS,156200,DELAY FLAP F/C/C/N/AX/G/H/F,,,304.05,304.05,1
HCPCS,15630,DELAY FLAP EYE/NOS/EAR/LIP,,,319.92,319.92,1
HCPCS,15630,DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS,6860.0,4459.0,400.06,13665.0,46
HCPCS,15630,"DELAY/SECTN FLAP LID,NOS,EAR,LIP",1632.0,1060.8,165.37,1224.0,35
HCPCS,156300,DELAY FLAP EYE/NOS/EAR/LIP,,,319.92,319.92,1
HCPCS,15650,TRANSFER SKIN PEDICLE FLAP,1908.0,1240.2,184.27,3966.07,50
HCPCS,15650,Transfer skin pedicle flap,,,1181.56,1492.5,6
HCPCS,156500,TRANSFER SKIN PEDICLE FLAP,,,376.86,376.86,1
HCPCS,15730,MDFC FLAP W/PRSRV VASC PEDCL,,,852.38,7937.59,15
HCPCS,15730,MIDFACE FLAP W/PRESERVATION OF VASCULAR PEDICLES,5400.0,3510.0,694.19,4050.0,31
HCPCS,15730,Mdfc flap w/prsrv vasc pedcl,,,1181.56,1492.5,6
HCPCS,157300,MDFC FLAP W/PRSRV VASC PEDCL,,,852.38,852.38,1
HCPCS,15731,FOREHEAD FLAP W/VASC PEDICLE,5752.0,3738.8,497.71,7937.59,50
HCPCS,15731,Forehead flap w/vasc pedicle,,,1181.56,1492.5,6
HCPCS,157310,FOREHEAD FLAP W/VASC PEDICLE,,,931.93,931.93,1
HCPCS,15733,MUSC MYOQ/FSCQ FLAP HEAD&NECK W/NAMED VASC PEDCL,6272.0,4076.8,792.27,6272.0,31
HCPCS,15733,MUSC MYOQ/FSCQ FLP H&N PEDCL,,,964.59,7937.59,15
HCPCS,15733,Musc myoq/fscq flp h&n pedcl,,,1181.56,1492.5,6
HCPCS,157330,MUSC MYOQ/FSCQ FLP H&N PEDCL,,,964.59,964.59,1
HCPCS,15734,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK,9200.0,5980.0,731.65,6900.0,35
HCPCS,15734,MUSCLE-SKIN GRAFT TRUNK,,,1412.6,7937.59,17
HCPCS,15734,Muscle-skin graft trunk,,,1181.56,1492.5,6
HCPCS,157340,MUSCLE-SKIN GRAFT TRUNK,,,1412.6,1412.6,1
HCPCS,15736,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR,6816.0,4430.4,636.53,5112.0,35
HCPCS,15736,MUSCLE-SKIN GRAFT ARM,,,1140.19,3966.07,15
HCPCS,15736,Muscle-skin graft arm,,,1181.56,1492.5,6
HCPCS,157360,MUSCLE-SKIN GRAFT ARM,,,1140.19,1140.19,1
HCPCS,15738,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR,8378.0,5445.7,619.55,6283.5,35
HCPCS,15738,MUSCLE-SKIN GRAFT LEG,,,1189.14,7937.59,15
HCPCS,15738,Muscle-skin graft leg,,,1181.56,1492.5,6
HCPCS,157380,MUSCLE-SKIN GRAFT LEG,,,1189.14,1189.14,1
HCPCS,15740,FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY,5790.0,3763.5,408.43,8370.0,81
HCPCS,15740,ISLAND PEDICLE FLAP GRAFT,,,786.9,786.9,1
HCPCS,157400,ISLAND PEDICLE FLAP GRAFT,,,786.9,786.9,1
HCPCS,15750,NEUROVASCULAR PEDICLE FLAP,,,875.74,7937.59,15
HCPCS,15750,NEUROVASCULAR PEDICLE GRAFT,5184.0,3369.6,621.15,5184.0,35
HCPCS,15750,Neurovascular pedicle flap,,,1181.56,1492.5,6
HCPCS,157500,NEUROVASCULAR PEDICLE FLAP,,,875.74,875.74,1
HCPCS,15756,FREE MUSC FLAP W MICROVASC ANAST,14776.0,9604.4,1745.42,14776.0,35
HCPCS,15756,FREE MYO/SKIN FLAP MICROVASC,,,2141.29,2141.29,1
HCPCS,15756,Free myo/skin flap microvasc,,,1181.56,1492.5,6
HCPCS,157560,FREE MYO/SKIN FLAP MICROVASC,,,2141.29,2141.29,1
HCPCS,15757,FREE SKIN FLAP MICROVASC,,,2127.76,2127.76,1
HCPCS,15757,FREE SKIN FLAP W MICROVASC ANAST,16346.0,10624.9,1665.45,16346.0,35
HCPCS,15757,Free skin flap microvasc,,,1181.56,1492.5,6
HCPCS,157570,FREE SKIN FLAP MICROVASC,,,2127.76,2127.76,1
HCPCS,15758,FREE FASCIAL FLAP MICROVASC,,,2118.52,2118.52,1
HCPCS,15758,FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS,14760.0,9594.0,1662.43,14760.0,35
HCPCS,15758,Free fascial flap microvasc,,,1181.56,1492.5,6
HCPCS,157580,FREE FASCIAL FLAP MICROVASC,,,2118.52,2118.52,1
HCPCS,15760,COMPOSITE SKIN GRAFT,,,651.91,3966.07,15
HCPCS,15760,Composite skin graft,,,1181.56,1492.5,6
HCPCS,15760,GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA,3944.0,2563.6,337.31,2958.0,35
HCPCS,157600,COMPOSITE SKIN GRAFT,,,651.91,651.91,1
HCPCS,15769,FAT INJECTIONS FOR BUTTOCK AUGMENT (BBL) - MODERATE,1500.0,975.0,366.08,1500.0,31
HCPCS,15769,GRAFTING OF AUTOLOGOUS SOFT TISS BY DIRECT EXC,2672.0,1736.8,366.08,2672.0,31
HCPCS,15769,GRFG AUTOL SOFT TISS DIR EXC,,,451.02,7937.59,16
HCPCS,15769,Grfg autol soft tiss dir exc,,,1181.56,1492.5,6
HCPCS,157690,GRFG AUTOL SOFT TISS DIR EXC,,,451.02,451.02,1
HCPCS,15770,DERMA-FAT-FASCIA GRAFT,,,630.18,7937.59,15
HCPCS,15770,Derma-fat-fascia graft,,,1181.56,1492.5,6
HCPCS,15770,"GRAFT,DERMA-FAT-FASCIA",3942.0,2562.3,396.28,3942.0,35
HCPCS,157700,DERMA-FAT-FASCIA GRAFT,,,630.18,630.18,1
HCPCS,15771,GRAFTING OF AUTOLOGOUS FAT BY LIPO 50 CC OR LESS,2961.0,1924.65,363.72,2220.75,28
HCPCS,15771,GRFG AUTOL FAT LIPO 50 CC/<,,,479.42,7937.59,19
HCPCS,15771,Grfg autol fat lipo 50 cc/<,,,1181.56,1492.5,6
HCPCS,157710,GRFG AUTOL FAT LIPO 50 CC/<,,,479.42,479.42,1
HCPCS,15772,GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 50 CC,1100.0,715.0,108.98,825.0,28
HCPCS,15772,GRFG AUTOL FAT LIPO EA ADDL,,,139.01,390.0,2
HCPCS,15772,Grfg autol fat lipo ea addl,,,1181.56,1492.5,6
HCPCS,157720,GRFG AUTOL FAT LIPO EA ADDL,,,139.01,139.01,1
HCPCS,15773,FAT INJECTION FACE/NECK INC REVOLVE - MODERATE,990.0,643.5,386.07,1007.52,28
HCPCS,15773,GRAFTING OF AUTOLOGOUS FAT BY LIPO 25 CC OR LESS,2732.0,1775.8,386.07,2049.0,28
HCPCS,15773,GRFG AUTOL FAT LIPO 25 CC/<,,,469.67,3966.07,15
HCPCS,15773,Grfg autol fat lipo 25 cc/<,,,1181.56,1492.5,6
HCPCS,157730,GRFG AUTOL FAT LIPO 25 CC/<,,,469.67,469.67,1
HCPCS,15774,GFRG AUTOL FAT LIPO EA ADDL,,,134.24,134.24,1
HCPCS,15774,GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 25 CC,964.0,626.6,104.67,723.0,28
HCPCS,15774,Gfrg autol fat lipo ea addl,,,1181.56,1492.5,6
HCPCS,157740,GFRG AUTOL FAT LIPO EA ADDL,,,134.24,134.24,1
HCPCS,15775,HAIR TRNSPL 1-15 PUNCH GRFTS,,,238.57,866.25,15
HCPCS,15775,HAIR XPLANT PUNCH GRFT 1-15,1580.0,1027.0,182.13,1185.0,31
HCPCS,15775,Hair trnspl 1-15 punch grfts,,,254.67,321.68,6
HCPCS,157750,HAIR TRNSPL 1-15 PUNCH GRFTS,,,238.57,238.57,1
HCPCS,15776,HAIR TRNSPL >15 PUNCH GRAFTS,,,327.47,866.25,15
HCPCS,15776,HAIR XPLANT PUNCH GRFT >15,2212.0,1437.8,251.64,1659.0,31
HCPCS,15776,Hair trnspl >15 punch grafts,,,254.67,321.68,6
HCPCS,157760,HAIR TRNSPL >15 PUNCH GRAFTS,,,327.47,327.47,1
HCPCS,15777,ACELLULAR DERM MATRIX IMPLT,,,201.07,6627.0,4
HCPCS,15777,Acellular derm matrix implt,,,1181.56,1492.5,6
HCPCS,15777,IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT,1460.0,949.0,104.22,1460.0,35
HCPCS,157770,ACELLULAR DERM MATRIX IMPLT,,,201.07,201.07,1
HCPCS,15778,IMPL ABSRB MESH/PRSTH DLYD CLSR DFCT INFCTJ/TRMA,2820.0,1833.0,82.15,2820.0,31
HCPCS,15778,IMPL ABSRB MSH/PRSTH DLY CLS,,,365.37,365.37,1
HCPCS,15778,Impl absrb msh/prsth dly cls,,,1181.56,1492.5,6
HCPCS,157780,IMPL ABSRB MSH/PRSTH DLY CLS,,,365.37,365.37,1
HCPCS,15780,COMBINATION DERMABRASION FACE,3060.0,1989.0,548.92,2295.0,31
HCPCS,15780,COMBINATION DERMABRASION- ADD-ON IN ASC,3639.0,2365.35,548.92,2729.25,31
HCPCS,15780,DERMABRASION TOTAL FACE,3639.0,2365.35,548.92,6205.4,46
HCPCS,15780,Dermabrasion total face,,,683.14,862.91,6
HCPCS,157800,DERMABRASION TOTAL FACE,,,616.23,616.23,1
HCPCS,15781,DERMABRASION SEGMENTAL FACE,,,396.26,1525.5,15
HCPCS,15781,DERMABRASION; PERIORBITAL BY LASER,1411.0,917.15,375.79,1058.25,34
HCPCS,15781,DERMABRASION;NOSE BY LASER,1411.0,917.15,375.79,1058.25,34
HCPCS,15781,Dermabrasion segmental face,,,683.14,862.91,6
HCPCS,15781,LASER RESURFACING/PARTIAL FACE,650.0,422.5,325.0,845.79,34
HCPCS,15781,PERIORBITAL DERMABRASION,1524.0,990.6,375.79,1143.0,34
HCPCS,15781,PERIORBITAL DERMABRASION - ADD-ON IN ASC,1876.0,1219.4,375.79,1407.0,34
HCPCS,157810,DERMABRASION SEGMENTAL FACE,,,396.26,396.26,1
HCPCS,15782,DERMABRAS RX SKIN REGIONAL,1954.0,1270.1,335.68,1465.5,31
HCPCS,15782,DERMABRASION OTHER THAN FACE,,,342.96,6205.4,15
HCPCS,15782,Dermabrasion other than face,,,683.14,862.91,6
HCPCS,15782,LASER RESURFACING/OTHER THAN FACE,600.0,390.0,300.0,919.81,31
HCPCS,157820,DERMABRASION OTHER THAN FACE,,,342.96,342.96,1
HCPCS,15783,DERMABRAS RX SKIN SUPERFICIAL,1940.0,1261.0,322.09,1455.0,31
HCPCS,15783,DERMABRASION SUPRFL ANY SITE,,,329.86,866.25,15
HCPCS,15783,Dermabrasion suprfl any site,,,683.14,862.91,6
HCPCS,15783,MICRODERMABRASION,300.0,195.0,150.0,695.01,31
HCPCS,15783,TATTOO REMOVAL,300.0,195.0,150.0,695.01,31
HCPCS,157830,DERMABRASION SUPRFL ANY SITE,,,329.86,329.86,1
HCPCS,15786,ABRAS SINGLE LESION,832.0,540.8,89.68,624.0,32
HCPCS,15786,ABRASION LESION SINGLE,,,125.98,430.81,15
HCPCS,15786,Abrasion lesion single,,,98.33,124.2,6
HCPCS,157860,ABRASION LESION SINGLE,,,125.98,125.98,1
HCPCS,15787,ABRASION LESIONS ADD-ON,,,15.48,15.48,1
HCPCS,15787,"ABRASION, EACH ADDN 4 OR LESS",145.0,94.25,10.56,108.75,32
HCPCS,15787,Abrasion lesions add-on,,,98.33,124.2,6
HCPCS,15787,"SCAR REVISION, ABRASION EA ADDL 4 LESIONS OR LESS",150.0,97.5,10.56,112.5,32
HCPCS,157870,ABRASION LESIONS ADD-ON,,,15.48,15.48,1
HCPCS,15788,"CHEM PEEL, FACE, EPIDERM",836.0,543.4,204.24,652.77,31
HCPCS,15788,CHEMICAL PEEL FACIAL EPIDERMA,1933.0,1256.45,204.24,1449.75,31
HCPCS,15788,CHEMICAL PEEL FACIAL EPIDRM,,,199.74,866.25,15
HCPCS,15788,CHEMICAL PEEL; EPIDERAL-PERIORAL,2844.0,1848.6,204.24,2133.0,31
HCPCS,15788,Chemical peel facial epidrm,,,98.33,124.2,6
HCPCS,15788,FACE PEEL EPDIERMAL FACE,2844.0,1848.6,204.24,2133.0,31
HCPCS,15788,GLYCOLIC TRADITIONAL,100.0,65.0,50.0,652.77,31
HCPCS,15788,PERIORBITAL FACE CHEMICAL PEEL IN OFFICE,1024.0,665.6,204.24,768.0,31
HCPCS,15788,PERIORBITAL FACE CHEMICAL PEEL-ADD ASC,1252.0,813.8,204.24,939.0,31
HCPCS,157880,CHEMICAL PEEL FACIAL EPIDRM,,,199.74,199.74,1
HCPCS,15789,"CHEM PEEL, FACE, DERMAL",1964.0,1276.6,366.68,1473.0,31
HCPCS,15789,CHEMICAL PEEL FACIAL DERMAL,,,380.71,1327.2,15
HCPCS,15789,"CHEMICAL PEEL, FACIAL: DERMAL EA. AREA",250.0,162.5,125.0,805.26,31
HCPCS,15789,"CHEMICAL PEEL, FACIAL: DERMAL, FULL FACE",700.0,455.0,350.0,805.26,31
HCPCS,15789,Chemical peel facial dermal,,,98.33,124.2,6
HCPCS,157890,CHEMICAL PEEL FACIAL DERMAL,,,380.71,380.71,1
HCPCS,15792,CHEM PEEL NONFACIAL EPIDRM,,,193.77,1327.2,15
HCPCS,15792,"CHEM PEEL, NONFACIAL EPIDERM",744.0,483.6,200.34,614.21,31
HCPCS,15792,CHEMICAL PEEL EPIDERMA INITIAL,853.0,554.45,200.34,639.75,31
HCPCS,15792,CHEMICAL PEEL EPIDERMAL,1933.0,1256.45,200.34,1449.75,31
HCPCS,15792,"CHEMICAL PEEL, TCA-NON-FACIAL",250.0,162.5,125.0,614.21,31
HCPCS,15792,Chem peel nonfacial epidrm,,,98.33,124.2,6
HCPCS,157920,CHEM PEEL NONFACIAL EPIDRM,,,193.77,193.77,1
HCPCS,15793,"CHEM PEEL, NONFACIAL DERMAL",1584.0,1029.6,316.01,1188.0,31
HCPCS,15793,CHEMICAL PEEL NONFACIAL DRM,,,330.87,866.25,15
HCPCS,15793,Chemical peel nonfacial drm,,,98.33,124.2,6
HCPCS,15793,"NON FACIAL, DERMAL (TCA)",250.0,162.5,125.0,703.51,31
HCPCS,157930,CHEMICAL PEEL NONFACIAL DRM,,,330.87,330.87,1
HCPCS,15819,CERVICOPLASTY   (REMOVAL EXCESS NECK SKIN),3000.0,1950.0,667.52,3000.0,19
HCPCS,15819,NECKLIFT,10006.0,6503.9,667.52,10006.0,19
HCPCS,15819,"PLASTIC SURGERY NECK OR UTERUS, CERVICOPL",2501.0,1625.65,667.52,2501.0,19
HCPCS,15819,Plastic surgery neck,,,1113.47,1406.48,6
HCPCS,15820,BLEPHAROPLASTY LOWER EYELID,,,476.28,3966.07,15
HCPCS,15820,BLEPHAROPLASTY LOWER LID,2759.0,1793.35,442.48,2069.25,34
HCPCS,15820,Blepharoplasty lower eyelid,,,1113.47,1406.48,6
HCPCS,158200,BLEPHAROPLASTY LOWER EYELID,,,476.28,476.28,1
HCPCS,15821,BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD,3010.0,1956.5,479.47,2257.5,31
HCPCS,15821,BLEPHARP LWR EYELID FAT PAD,,,508.86,3966.07,15
HCPCS,15821,Blepharp lwr eyelid fat pad,,,1113.47,1406.48,6
HCPCS,158210,BLEPHARP LWR EYELID FAT PAD,,,508.86,508.86,1
HCPCS,15822,BLEPHAROPLASTY UPPER EYELID,2033.0,1321.45,340.33,3966.07,49
HCPCS,15822,Blepharoplasty upper eyelid,,,1113.47,1406.48,6
HCPCS,158220,BLEPHAROPLASTY UPPER EYELID,,,368.78,368.78,1
HCPCS,15823,BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN,2996.0,1947.4,338.73,2247.0,35
HCPCS,15823,BLEPHARP UPR EYELID XCSV SKN,,,508.87,3966.07,16
HCPCS,15823,Blepharp upr eyelid xcsv skn,,,1113.47,1406.48,6
HCPCS,158230,BLEPHARP UPR EYELID XCSV SKN,,,508.87,508.87,1
HCPCS,15824,RHYTIDECTOMY FOREHEAD,4486.0,2915.9,1052.33,4486.0,28
HCPCS,15824,Rhytidectomy forehead,,,1113.47,1406.48,6
HCPCS,158240,RHYTIDECTOMY FOREHEAD,,,1052.33,1052.33,1
HCPCS,15825,RHYTDCT NCK PLTYSML TGHTG,,,1184.0,7937.59,15
HCPCS,15825,RHYTIDECTOMY (EXC. NECK),3412.0,2217.8,1706.0,3412.0,13
HCPCS,15825,RHYTIDECTOMY NECK W PFLAP,3184.0,2069.6,1592.0,3184.0,13
HCPCS,15825,RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING,5845.0,3799.25,2573.86,5845.0,13
HCPCS,15825,Rhytdct nck pltysml tghtg,,,1113.47,1406.48,6
HCPCS,158250,RHYTDCT NCK PLTYSML TGHTG,,,1184.0,1184.0,1
HCPCS,15826,RHYTIDECTOMY GLABELLAR FROWN LINES,6105.0,3968.25,1858.08,6105.0,13
HCPCS,15826,RHYTIDECTOMY GLBLR FRN LINES,,,854.84,7937.59,15
HCPCS,15826,Rhytidectomy glblr frn lines,,,1113.47,1406.48,6
HCPCS,158260,RHYTIDECTOMY GLBLR FRN LINES,,,854.84,854.84,1
HCPCS,15828,MINI-FACELIFT DONE IN OFFICE,8301.0,5395.65,4150.5,8301.0,13
HCPCS,15828,RHYTIDECTOMY CHEEK CHIN & NECK,8610.0,5596.5,4305.0,8610.0,25
HCPCS,15828,RHYTIDECTOMY CHEEK CHN & NCK,,,2236.33,7937.59,15
HCPCS,15828,RHYTIDECTOMY CHK CHN NECK,3184.0,2069.6,1592.0,4861.32,13
HCPCS,15828,Rhytidectomy cheek chn & nck,,,1113.47,1406.48,6
HCPCS,158280,RHYTIDECTOMY CHEEK CHN & NCK,,,2236.33,2236.33,1
HCPCS,15829,RHYTIDECTOMY SMAS FLAP,9126.0,5931.9,2499.02,9126.0,28
HCPCS,15829,Rhytidectomy smas flap,,,1113.47,1406.48,6
HCPCS,158290,RHYTIDECTOMY SMAS FLAP,,,2499.02,2499.02,1
HCPCS,15830,EXC EXCESSIVE SKIN ABDOMEN,,,1099.86,14139.6,17
HCPCS,15830,EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY,6844.0,4448.6,658.15,6844.0,35
HCPCS,15830,Exc excessive skin abdomen,,,1113.47,1406.48,6
HCPCS,158300,EXC EXCESSIVE SKIN ABDOMEN,,,1099.86,1099.86,1
HCPCS,15832,EXC EXCESSIVE SKIN THIGH,,,864.0,6205.4,15
HCPCS,15832,EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH,5654.0,3675.1,719.5,5654.0,34
HCPCS,15832,Exc excessive skin thigh,,,1113.47,1406.48,6
HCPCS,158320,EXC EXCESSIVE SKIN THIGH,,,864.0,864.0,1
HCPCS,15833,EXC EXCESSIVE SKIN LEG,,,820.82,6205.4,15
HCPCS,15833,EXCISION EXCESSIVE SKIN & SUBQ TISSUE LEG,5236.0,3403.4,671.06,5236.0,34
HCPCS,15833,Exc excessive skin leg,,,1113.47,1406.48,6
HCPCS,158330,EXC EXCESSIVE SKIN LEG,,,820.82,820.82,1
HCPCS,15834,EXC EXCESSIVE SKIN HIP,,,835.61,6205.4,15
HCPCS,15834,EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP,4868.0,3164.2,693.21,4868.0,34
HCPCS,15834,Exc excessive skin hip,,,1113.47,1406.48,6
HCPCS,158340,EXC EXCESSIVE SKIN HIP,,,835.61,835.61,1
HCPCS,15835,EXC EXCESSIVE SKIN BUTTOCK,,,871.87,6205.4,15
HCPCS,15835,EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK,5196.0,3377.4,722.31,5196.0,34
HCPCS,15835,Exc excessive skin buttock,,,1113.47,1406.48,6
HCPCS,158350,EXC EXCESSIVE SKIN BUTTOCK,,,871.87,871.87,1
HCPCS,15836,EXC EXCESSIVE SKIN ARM,,,745.71,6205.4,15
HCPCS,15836,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM,4668.0,3034.2,618.91,4668.0,34
HCPCS,15836,Exc excessive skin arm,,,1113.47,1406.48,6
HCPCS,158360,EXC EXCESSIVE SKIN ARM,,,745.71,745.71,1
HCPCS,15837,EXC EXCESSIVE SKIN &SUBQ TISSUE FOREARM/HAND,3820.0,2483.0,625.95,2865.0,34
HCPCS,15837,EXC EXCSV SKIN FOREARM/HAND,,,670.2,6205.4,15
HCPCS,15837,Exc excsv skin forearm/hand,,,1113.47,1406.48,6
HCPCS,158370,EXC EXCSV SKIN FOREARM/HAND,,,670.2,670.2,1
HCPCS,15838,EXC EXCSV SKIN & SUBQ TISSUE SUBMENTAL FAT PAD,3300.0,2145.0,496.11,3300.0,34
HCPCS,15838,EXC EXCSV SUBMENTAL FAT PAD,,,606.9,6205.4,15
HCPCS,15838,Exc excsv submental fat pad,,,1113.47,1406.48,6
HCPCS,158380,EXC EXCSV SUBMENTAL FAT PAD,,,606.9,606.9,1
HCPCS,15839,EXC EXCESSIVE SKN OTHER AREA,,,693.99,6205.4,15
HCPCS,15839,EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA,4200.0,2730.0,505.56,3150.0,35
HCPCS,15839,Exc excessive skn other area,,,1113.47,1406.48,6
HCPCS,158390,EXC EXCESSIVE SKN OTHER AREA,,,693.99,693.99,1
HCPCS,15840,"GRAFT FACE N PALSY,FREE FASCIA",5996.0,3897.4,736.07,5996.0,35
HCPCS,15840,NERVE PALSY FASCIAL GRAFT,,,947.8,7937.59,15
HCPCS,15840,Nerve palsy fascial graft,,,1181.56,1492.5,6
HCPCS,158400,NERVE PALSY FASCIAL GRAFT,,,947.8,947.8,1
HCPCS,15841,"GRAFT FACE N PALSY,FREE MUSCLE",10396.0,6757.4,1027.85,10396.0,35
HCPCS,15841,NERVE PALSY MUSCLE GRAFT,,,1664.55,7937.59,15
HCPCS,15841,Nerve palsy muscle graft,,,1181.56,1492.5,6
HCPCS,158410,NERVE PALSY MUSCLE GRAFT,,,1664.55,1664.55,1
HCPCS,15842,GRF FACIAL NRV PALYSS FR MUSCLE FLAP MICROSURG,16404.0,10662.6,1733.29,16404.0,35
HCPCS,15842,NERVE PALSY MICROSURG GRAFT,,,1836.14,3966.07,15
HCPCS,15842,Nerve palsy microsurg graft,,,1181.56,1492.5,6
HCPCS,158420,NERVE PALSY MICROSURG GRAFT,,,2524.18,2524.18,1
HCPCS,15845,GRF FACIAL NERVE PARALYSIS REGIONAL MUSCLE TR,5728.0,3723.2,703.5,5728.0,35
HCPCS,15845,SKIN AND MUSCLE REPAIR FACE,,,993.16,7937.59,15
HCPCS,15845,Skin and muscle repair face,,,1181.56,1492.5,6
HCPCS,158450,SKIN AND MUSCLE REPAIR FACE,,,993.16,993.16,1
HCPCS,15847,ABDOMINOPLASTY ADD-ON  (INCL FLEUR DE LIS),1000.0,650.0,321.43,1000.0,17
HCPCS,15847,EXC SKIN ABD ADD-ON,,,460.5,460.5,1
HCPCS,15847,EXC SKIN ABD ADD-ON SPECIAL,3525.0,2291.25,321.43,3525.0,17
HCPCS,15847,"EXCISE EXCESS SKIN TISSUE,ABDOMEN, ADD-ON",5828.0,3788.2,321.43,5828.0,17
HCPCS,15847,EXCISION EXCESS SKN ABD,2115.0,1374.75,321.43,2115.0,17
HCPCS,15847,Exc skin abd add-on,,,1113.47,1406.48,6
HCPCS,15847,MUSCLE TIGHTENING,3525.0,2291.25,321.43,3525.0,17
HCPCS,158470,EXC SKIN ABD ADD-ON,,,460.5,460.5,1
HCPCS,15850,Remove sutures same surgeon,,,740.34,935.16,6
HCPCS,15851,REMOVAL SUTR/STAPLE REQ ANES,,,61.12,3966.07,15
HCPCS,15851,REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA,440.0,286.0,32.35,330.0,35
HCPCS,15851,Removal sutr/staple req anes,,,740.34,935.16,6
HCPCS,158510,REMOVAL SUTR/STAPLE REQ ANES,,,61.12,61.12,1
HCPCS,15852,DRESSING CHANGE NOT FOR BURN,,,42.23,42.23,1
HCPCS,15852,DRESSING CHANGE UNDER ANESTHESIA,779.5,506.675,33.96,3920.0,83
HCPCS,158520,DRESSING CHANGE NOT FOR BURN,,,42.23,42.23,1
HCPCS,15853,REMOVAL SUTR/STAPL XREQ ANES,,,10.36,10.36,1
HCPCS,15853,REMOVAL SUTURES OR STAPLES NOT REQUIRING ANESTHESIA,364.0,236.6,7.83,364.0,31
HCPCS,158530,REMOVAL SUTR/STAPL XREQ ANES,,,10.36,10.36,1
HCPCS,15854,REMOVAL SUTR&STAPL XREQ ANES,,,14.22,14.22,1
HCPCS,158540,REMOVAL SUTR&STAPL XREQ ANES,,,14.22,14.22,1
HCPCS,15860,IV NJX TST VASC FLO FLAP/GRF,,,100.22,2129.0,18
HCPCS,15860,Iv njx tst vasc flo flap/grf,,,223.78,282.67,6
HCPCS,15860,TEST FOR BLOOD FLOW IN GRAFT,780.0,507.0,81.45,780.0,35
HCPCS,158600,IV NJX TST VASC FLO FLAP/GRF,,,100.22,100.22,1
HCPCS,15865,REMOVAL SUTURES & STAPLES NOT REQUIRING ANESTHESIA,337.0,219.05,168.5,337.0,12
HCPCS,15876,"SUCT ASSIS LIPECTOMY,HEAD/NECK",2456.0,1596.4,82.87,2456.0,16
HCPCS,15876,SUCTION LIPECTOMY HEAD&NECK,,,392.31,7937.59,15
HCPCS,15876,Suction lipectomy head&neck,,,1113.47,1406.48,6
HCPCS,158760,SUCTION LIPECTOMY HEAD&NECK,,,392.31,392.31,1
HCPCS,15877,"SUCT ASSIS LIPECTOMY,TRUNK",4640.0,3016.0,474.61,4640.0,13
HCPCS,15877,SUCTION LIPECTOMY TRUNK,,,557.73,7937.59,15
HCPCS,15877,Suction lipectomy trunk,,,1113.47,1406.48,6
HCPCS,158770,SUCTION LIPECTOMY TRUNK,,,557.73,557.73,1
HCPCS,15878,"SUCT ASSIS LIPECTOMY,UP EXTREM",4777.0,3105.05,474.61,4777.0,13
HCPCS,15878,SUCTION LIPECTOMY UPR EXTREM,,,1603.93,3966.07,15
HCPCS,15878,Suction lipectomy upr extrem,,,1113.47,1406.48,6
HCPCS,158780,SUCTION LIPECTOMY UPR EXTREM,,,1603.93,1603.93,1
HCPCS,15879,"SUCT ASSIS LIPECTOMY,LOW EXTREM",4640.0,3016.0,474.61,4640.0,13
HCPCS,15879,SUCTION LIPECTOMY LWR EXTREM,,,1488.09,7937.59,15
HCPCS,15879,Suction lipectomy lwr extrem,,,1113.47,1406.48,6
HCPCS,158790,SUCTION LIPECTOMY LWR EXTREM,,,1488.09,1488.09,1
HCPCS,15920,EXC COCCYGL PR ULC PRIM SUTR,,,592.84,6205.4,15
HCPCS,15920,Exc coccygl pr ulc prim sutr,,,613.49,774.94,6
HCPCS,159200,EXC COCCYGL PR ULC PRIM SUTR,,,592.84,592.84,1
HCPCS,15922,EXC COCCYGL PR ULC FLAP CLSR,,,745.44,7937.59,15
HCPCS,15922,Exc coccygl pr ulc flap clsr,,,613.49,774.94,6
HCPCS,159220,EXC COCCYGL PR ULC FLAP CLSR,,,745.44,745.44,1
HCPCS,15931,EXC SACRAL PR ULC PRIM SUTR,,,664.75,6205.4,15
HCPCS,15931,EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE,4028.0,2618.2,350.14,4028.0,35
HCPCS,15931,Exc sacral pr ulc prim sutr,,,613.49,774.94,6
HCPCS,159310,EXC SACRAL PR ULC PRIM SUTR,,,664.75,664.75,1
HCPCS,15933,EXC SAC PR ULC PRIM STR OSTC,,,819.78,6205.4,15
HCPCS,15933,EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY,4708.0,3060.2,491.27,4708.0,35
HCPCS,15933,Exc sac pr ulc prim str ostc,,,613.49,774.94,6
HCPCS,159330,EXC SAC PR ULC PRIM STR OSTC,,,819.78,819.78,1
HCPCS,15934,EXC SACRAL PR ULC SKN FLAP,,,922.45,7937.59,15
HCPCS,15934,EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR,5472.0,3556.8,553.41,5472.0,35
HCPCS,15934,Exc sacral pr ulc skn flap,,,613.49,774.94,6
HCPCS,159340,EXC SACRAL PR ULC SKN FLAP,,,922.45,922.45,1
HCPCS,15935,EXC SAC PR ULC SKN FLP OSTC,,,1080.58,7937.59,15
HCPCS,15935,Exc sac pr ulc skn flp ostc,,,613.49,774.94,6
HCPCS,159350,EXC SAC PR ULC SKN FLP OSTC,,,1080.58,1080.58,1
HCPCS,15936,EXC SAC PR ULC PREP MUS FLAP,,,845.33,3966.07,15
HCPCS,15936,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR,5264.0,3421.6,615.7,5264.0,35
HCPCS,15936,Exc sac pr ulc prep mus flap,,,613.49,774.94,6
HCPCS,159360,EXC SAC PR ULC PREP MUS FLAP,,,845.33,845.33,1
HCPCS,15937,EXC SAC PR ULC PREP MUS OSTC,,,973.89,3966.07,15
HCPCS,15937,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC,6056.0,3936.4,747.01,6056.0,35
HCPCS,15937,Exc sac pr ulc prep mus ostc,,,613.49,774.94,6
HCPCS,159370,EXC SAC PR ULC PREP MUS OSTC,,,973.89,973.89,1
HCPCS,15940,EXC ISCHIAL PR ULC PRIM SUTR,,,668.33,6205.4,15
HCPCS,15940,EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE,4080.0,2652.0,364.14,4080.0,35
HCPCS,15940,Exc ischial pr ulc prim sutr,,,613.49,774.94,6
HCPCS,159400,EXC ISCHIAL PR ULC PRIM SUTR,,,668.33,668.33,1
HCPCS,15941,EXC ISCH PR ULC PRM SUT OSTC,,,868.81,6205.4,15
HCPCS,15941,Exc isch pr ulc prm sut ostc,,,613.49,774.94,6
HCPCS,159410,EXC ISCH PR ULC PRM SUT OSTC,,,868.81,868.81,1
HCPCS,15944,EXC ISCH PR ULC SKN FLP CLSR,,,873.72,7937.59,15
HCPCS,15944,EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE,4976.0,3234.4,564.69,4976.0,35
HCPCS,15944,Exc isch pr ulc skn flp clsr,,,613.49,774.94,6
HCPCS,159440,EXC ISCH PR ULC SKN FLP CLSR,,,873.72,873.72,1
HCPCS,15945,EXC ISCH PR ULC SKN FLP OSTC,,,954.53,3966.07,15
HCPCS,15945,Exc isch pr ulc skn flp ostc,,,613.49,774.94,6
HCPCS,159450,EXC ISCH PR ULC SKN FLP OSTC,,,954.53,954.53,1
HCPCS,15946,EXC ISCH PR ULC PREP MUS FLP,,,1513.34,3966.07,15
HCPCS,15946,EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN,9648.0,6271.2,1028.28,9648.0,35
HCPCS,15946,Exc isch pr ulc prep mus flp,,,613.49,774.94,6
HCPCS,159460,EXC ISCH PR ULC PREP MUS FLP,,,1513.34,1513.34,1
HCPCS,15950,EXC TRCHNTR PR ULC PRIM SUTR,,,595.23,3512.95,15
HCPCS,15950,EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR,3212.0,2087.8,310.02,3212.0,35
HCPCS,15950,Exc trchntr pr ulc prim sutr,,,613.49,774.94,6
HCPCS,159500,EXC TRCHNTR PR ULC PRIM SUTR,,,595.23,595.23,1
HCPCS,15951,EXC TRCHNTR PR ULC OSTC,,,839.7,6205.4,15
HCPCS,15951,Exc trchntr pr ulc ostc,,,613.49,774.94,6
HCPCS,159510,EXC TRCHNTR PR ULC OSTC,,,839.7,839.7,1
HCPCS,15952,EXC TRCHNTR PR ULC FLP CLSR,,,857.35,3966.07,15
HCPCS,15952,EXC TROCHANTERIC PR ULCER W/SKIN FLAP CLOSURE,4924.0,3200.6,505.48,4924.0,35
HCPCS,15952,Exc trchntr pr ulc flp clsr,,,613.49,774.94,6
HCPCS,159520,EXC TRCHNTR PR ULC FLP CLSR,,,857.35,857.35,1
HCPCS,15953,EXC TRCHNTR PR ULC FLP OSTC,,,944.13,7937.59,15
HCPCS,15953,Exc trchntr pr ulc flp ostc,,,613.49,774.94,6
HCPCS,159530,EXC TRCHNTR PR ULC FLP OSTC,,,944.13,944.13,1
HCPCS,15956,EXC TRCHNTR PR ULC PREP FLAP,,,1114.38,3966.07,15
HCPCS,15956,EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN,6716.0,4365.4,869.9,6716.0,35
HCPCS,15956,Exc trchntr pr ulc prep flap,,,613.49,774.94,6
HCPCS,159560,EXC TRCHNTR PR ULC PREP FLAP,,,1114.38,1114.38,1
HCPCS,15958,EXC TRCHNTR PR ULC PREP OSTC,,,1101.75,7937.59,15
HCPCS,15958,EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC,6700.0,4355.0,876.55,6700.0,35
HCPCS,15958,Exc trchntr pr ulc prep ostc,,,613.49,774.94,6
HCPCS,159580,EXC TRCHNTR PR ULC PREP OSTC,,,1101.75,1101.75,1
HCPCS,15999,UNLISTED PX EXC PRESSURE ULC,,,706.25,1525.5,14
HCPCS,15999,Unlisted px exc pressure ulc,,,115.89,146.39,6
HCPCS,16000,INITIAL TREATMENT OF BURN(S),,,43.2,43.2,1
HCPCS,16000,INITIAL TX 1ST DEGREE BURN LOCAL TX,745.0,484.25,56.54,3920.0,98
HCPCS,16000,"INITIAL TX, FIRST DEGREE BURN, LOCAL TREATMENT",356.0,231.4,23.13,267.0,32
HCPCS,160000,INITIAL TREATMENT OF BURN(S),,,43.2,43.2,1
HCPCS,16020,DRESS/DEBRID P-THICK BURN S,,,52.03,52.03,1
HCPCS,16020,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,528.5,343.525,31.19,4151.0,179
HCPCS,160200,DRESS/DEBRID P-THICK BURN S,,,52.03,52.03,1
HCPCS,16025,DRESS/DEBRID P-THICK BURN M,,,104.61,104.61,1
HCPCS,16025,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,720.5,468.325,62.63,4151.0,179
HCPCS,160250,DRESS/DEBRID P-THICK BURN M,,,104.61,104.61,1
HCPCS,16030,DRESS/DEBRID P-THICK BURN L,,,124.08,124.08,1
HCPCS,16030,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,1165.5,757.575,63.62,4151.0,133
HCPCS,160300,DRESS/DEBRID P-THICK BURN L,,,124.08,124.08,1
HCPCS,16035,ESCHAROTOMY 1ST INCISION,,,184.98,866.25,15
HCPCS,16035,ESCHAROTOMY; INIT INC,1496.0,972.4,149.36,1496.0,35
HCPCS,16035,Escharotomy 1st incision,,,241.35,304.86,6
HCPCS,160350,ESCHAROTOMY 1ST INCISION,,,184.98,184.98,1
HCPCS,16036,ESCHAROTOMY EA ADDL INCISION,,,77.84,77.84,1
HCPCS,16036,ESCHAROTOMY; ADDL INCISION,660.0,429.0,61.87,660.0,35
HCPCS,16036,Escharotomy ea addl incision,,,241.35,304.86,6
HCPCS,160360,ESCHAROTOMY EA ADDL INCISION,,,77.84,77.84,1
HCPCS,17000,DESTRUCT PREMALG LESION,,,50.92,50.92,1
HCPCS,17000,DESTRUCTION PREMALIGNANT LESION 1ST,745.0,484.25,62.34,3920.0,144
HCPCS,17000,"DESTRUCTION, 1ST LESION",268.0,174.2,26.47,201.0,35
HCPCS,170000,DESTRUCT PREMALG LESION,,,50.92,50.92,1
HCPCS,17003,"DESTRUC BENIGN/PREMAL,2-14 LESIONS",18.0,11.7,1.68,13.5,35
HCPCS,17003,DESTRUCT PREMALG LES 2-14,,,1.88,1.88,1
HCPCS,17003,DESTRUCTION PREMALIGNANT LESION 2-14 EA,418.0,271.7,2.43,3920.0,35
HCPCS,170030,DESTRUCT PREMALG LES 2-14,,,1.88,1.88,1
HCPCS,17004,DESTROY PREMAL LESIONS 15/>,,,91.49,91.49,1
HCPCS,17004,"DESTRUC BENIGN/PREMAL,>15 LESIONS",603.0,391.95,84.08,452.25,35
HCPCS,17004,DESTRUCTION PREMALIGNANT LESION 15/>,1499.0,974.35,98.33,4151.0,46
HCPCS,170040,DESTROY PREMAL LESIONS 15/>,,,91.49,91.49,1
HCPCS,17106,DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM,1561.5,1014.9749999999999,143.39,4214.0,81
HCPCS,17106,DSTR CUT VSC PRLF LES<10SQCM,,,257.27,257.27,1
HCPCS,17106,LASER CVP LESIONS,300.0,195.0,143.39,543.71,35
HCPCS,171060,DSTR CUT VSC PRLF LES<10SQCM,,,257.27,257.27,1
HCPCS,17107,"DESTR,CUTAN VASC LESION 10-50SCM",2108.0,1370.2,266.63,1581.0,35
HCPCS,17107,DSTR CUT VSC PRLF LES10-50SQ,,,334.52,1327.2,15
HCPCS,17107,Dstr cut vsc prlf les10-50sq,,,683.14,862.91,6
HCPCS,17107,"LASER, DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM",650.0,422.5,266.63,705.87,35
HCPCS,171070,DSTR CUT VSC PRLF LES10-50SQ,,,334.52,334.52,1
HCPCS,17108,DESTRUC CUT/VASC >50 SQ CM,3296.0,2142.4,347.01,2472.0,35
HCPCS,17108,DSTR CUT VSC PRLF LES>50SQCM,,,493.12,3966.07,15
HCPCS,17108,Dstr cut vsc prlf les>50sqcm,,,683.14,862.91,6
HCPCS,17108,"LASER, DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM",1100.0,715.0,347.01,1047.94,35
HCPCS,171080,DSTR CUT VSC PRLF LES>50SQCM,,,493.12,493.12,1
HCPCS,17110,DESTRUCTION B9 LES UP TO 14,,,63.31,63.31,1
HCPCS,17110,DESTRUCTION BENIGN LESIONS UP TO 14,526.5,342.225,34.32,3920.0,81
HCPCS,17110,KERATOSES DESTRUCTION UP TO 14,200.0,130.0,34.32,156.23,35
HCPCS,171100,DESTRUCTION B9 LES UP TO 14,,,63.31,63.31,1
HCPCS,17111,"DESTRUC FLAT WARTS, 15 OR MORE",427.0,277.55,42.27,320.25,35
HCPCS,17111,DESTRUCTION B9 LESIONS 15/>,,,77.18,77.18,1
HCPCS,17111,DESTRUCTION BENIGN LESIONS 15/>,745.0,484.25,96.29,4151.0,46
HCPCS,17111,KERATOSES DESTRUCTION 15 OR MORE,250.0,162.5,42.27,187.5,35
HCPCS,171110,DESTRUCTION B9 LESIONS 15/>,,,77.18,77.18,1
HCPCS,17250,CHEM CAUT OF GRANLTJ TISSUE,,,35.07,35.07,1
HCPCS,17250,CHEM CAUTER GRANULAR TISSUE,220.0,143.0,19.39,165.0,35
HCPCS,17250,CHEMICAL CAUTERIZATION OF GRANULATION TISSUE,745.0,484.25,44.93,4151.0,144
HCPCS,172500,CHEM CAUT OF GRANLTJ TISSUE,,,35.07,35.07,1
HCPCS,17260,"DESTR MALIG TRUNK,EXTREM <0.5 CM",422.0,274.3,47.67,316.5,35
HCPCS,17260,DSTRJ MAL LES T/A/L 0.5 CM/<,,,65.65,430.81,15
HCPCS,17260,Dstrj mal les t/a/l 0.5 cm/<,,,98.33,124.2,6
HCPCS,172600,DSTRJ MAL LES T/A/L 0.5 CM/<,,,65.65,65.65,1
HCPCS,17261,"DESTR MALIG TRUNK,EXTREM 0.6-1 CM",537.0,349.05,41.26,402.75,35
HCPCS,17261,DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,745.0,484.25,97.4,4151.0,46
HCPCS,17261,DSTRJ MAL LES T/A/L .6-1.0CM,,,81.25,81.25,1
HCPCS,172610,DSTRJ MAL LES T/A/L .6-1.0CM,,,81.25,81.25,1
HCPCS,17262,"DESTR MALIG TRUNK,EXTREM 1.1-2 CM",717.0,466.05,65.92,537.75,35
HCPCS,17262,DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM,745.0,484.25,98.33,4151.0,46
HCPCS,17262,DSTRJ MAL LES T/A/L 1.1-2.0,,,102.93,102.93,1
HCPCS,172620,DSTRJ MAL LES T/A/L 1.1-2.0,,,102.93,102.93,1
HCPCS,17263,"DESTR MALIG TRUNK,EXTREM 2.1-3 CM",810.0,526.5,78.16,607.5,35
HCPCS,17263,DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM,745.0,484.25,98.33,4151.0,46
HCPCS,17263,DSTRJ MAL LES T/A/L 2.1-3.0,,,113.93,113.93,1
HCPCS,172630,DSTRJ MAL LES T/A/L 2.1-3.0,,,113.93,113.93,1
HCPCS,17264,"DESTR MALIG TRUNK,EXTREM 3.1-4 CM",876.0,569.4,89.25,657.0,35
HCPCS,17264,DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM,1499.0,974.35,98.33,4151.0,46
HCPCS,17264,DSTRJ MAL LES T/A/L 3.1-4.0,,,121.81,121.81,1
HCPCS,172640,DSTRJ MAL LES T/A/L 3.1-4.0,,,121.81,121.81,1
HCPCS,17266,"DESTR MALIG TRUNK,EXTREM >4.0 CM",1052.0,683.8,94.53,789.0,35
HCPCS,17266,DSTRJ MAL LES T/A/L >4.0 CM,,,142.87,866.25,15
HCPCS,17266,Dstrj mal les t/a/l >4.0 cm,,,98.33,124.2,6
HCPCS,172660,DSTRJ MAL LES T/A/L >4.0 CM,,,142.87,142.87,1
HCPCS,17270,"DESTR MALIG SCAL,NCK,HAND <0.5 CM",548.0,356.2,50.8,411.0,35
HCPCS,17270,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/>,745.0,484.25,98.33,4151.0,46
HCPCS,17270,DSTR MAL LES S/N/H/F/G .5 /<,,,89.13,89.13,1
HCPCS,172700,DSTR MAL LES S/N/H/F/G .5 /<,,,89.13,89.13,1
HCPCS,17271,"DESTR MALIG SCAL,NCK,HAND 0.6-1 CM",616.0,400.4,62.0,462.0,35
HCPCS,17271,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM,745.0,484.25,98.33,4151.0,46
HCPCS,17271,DSTR MAL LES S/N/H/F/G 0.6-1,,,97.91,97.91,1
HCPCS,172710,DSTR MAL LES S/N/H/F/G 0.6-1,,,97.91,97.91,1
HCPCS,17272,"DESTR MALIG SCAL,NCK,HAND 1.1-2 CM",728.0,473.2,76.28,546.0,35
HCPCS,17272,DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM,745.0,484.25,98.33,4151.0,46
HCPCS,17272,DSTR MAL LES S/N/H/F/G 1.1-2,,,112.99,112.99,1
HCPCS,172720,DSTR MAL LES S/N/H/F/G 1.1-2,,,112.99,112.99,1
HCPCS,17273,"DESTR MALIG SCAL,NCK,HAND 2.1-3 CM",840.0,546.0,90.71,630.0,35
HCPCS,17273,DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM,1499.0,974.35,98.33,4214.0,46
HCPCS,17273,DSTR MAL LES S/N/H/F/G 2.1-3,,,127.76,127.76,1
HCPCS,172730,DSTR MAL LES S/N/H/F/G 2.1-3,,,127.76,127.76,1
HCPCS,17274,"DESTR MALIG SCAL,NCK,HAND 3.1-4 CM",1056.0,686.4,110.66,792.0,35
HCPCS,17274,DSTR MAL LES S/N/H/F/G 3.1-4,,,156.05,866.25,15
HCPCS,17274,Dstr mal les s/n/h/f/g 3.1-4,,,98.33,124.2,6
HCPCS,172740,DSTR MAL LES S/N/H/F/G 3.1-4,,,156.05,156.05,1
HCPCS,17276,"DESTR MALIG SCAL,NCK,HAND >4 CM",1300.0,845.0,131.43,975.0,35
HCPCS,17276,DSTR MAL LES S/N/H/F/G >4.0,,,188.48,866.25,15
HCPCS,17276,Dstr mal les s/n/h/f/g >4.0,,,98.33,124.2,6
HCPCS,172760,DSTR MAL LES S/N/H/F/G >4.0,,,188.48,188.48,1
HCPCS,17280,DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<,488.0,317.2,55.21,366.0,35
HCPCS,17280,DSTR MAL LS F/E/E/N/L/M .5/<,,,80.96,430.81,15
HCPCS,17280,Dstr mal ls f/e/e/n/l/m .5/<,,,98.33,124.2,6
HCPCS,172800,DSTR MAL LS F/E/E/N/L/M .5/<,,,80.96,80.96,1
HCPCS,17281,"DESTR MALIG FACE,NOSE,LIP 0.6-1 CM",708.0,460.2,73.45,531.0,35
HCPCS,17281,DSTR MAL LS F/E/E/N/L/M .6-1,,,110.19,430.81,15
HCPCS,17281,Dstr mal ls f/e/e/n/l/m .6-1,,,98.33,124.2,6
HCPCS,172810,DSTR MAL LS F/E/E/N/L/M .6-1,,,110.19,110.19,1
HCPCS,17282,"DESTR MALIG FACE,NOSE,LIP 1.1-2 CM",836.0,543.4,88.86,627.0,35
HCPCS,17282,DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM,745.0,484.25,98.33,4214.0,46
HCPCS,17282,DSTR MAL LS F/E/E/N/L/M1.1-2,,,127.15,127.15,1
HCPCS,172820,DSTR MAL LS F/E/E/N/L/M1.1-2,,,127.15,127.15,1
HCPCS,17283,"DESTR MALIG FACE,NOSE,LIP 2.1-3 CM",1076.0,699.4,109.19,807.0,35
HCPCS,17283,DESTRUCTION MAL LESION F/E/E/N/L/M 2.1-3.0CM,1499.0,974.35,98.33,4214.0,46
HCPCS,17283,DSTR MAL LS F/E/E/N/L/M2.1-3,,,159.21,159.21,1
HCPCS,172830,DSTR MAL LS F/E/E/N/L/M2.1-3,,,159.21,159.21,1
HCPCS,17284,"DESTR MALIG FACE,NOSE,LIP 3.1-4 CM",1280.0,832.0,131.02,960.0,35
HCPCS,17284,DSTR MAL LS F/E/E/N/L/M3.1-4,,,185.35,1327.2,15
HCPCS,17284,Dstr mal ls f/e/e/n/l/m3.1-4,,,98.33,124.2,6
HCPCS,172840,DSTR MAL LS F/E/E/N/L/M3.1-4,,,185.35,185.35,1
HCPCS,17286,"DESTR MALIG FACE,NOSE,LIP >4CM",1792.0,1164.8,173.85,1344.0,35
HCPCS,17286,DSTR MAL LS F/E/E/N/L/M>4.0,,,252.04,1327.2,15
HCPCS,17286,Dstr mal ls f/e/e/n/l/m>4.0,,,98.33,124.2,6
HCPCS,172860,DSTR MAL LS F/E/E/N/L/M>4.0,,,252.04,252.04,1
HCPCS,17311,MOHS 1 STAGE H/N/HF/G,,,330.47,330.47,1
HCPCS,17311,MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS,2387.5,1551.875,191.61,4268.0,80
HCPCS,173110,MOHS 1 STAGE H/N/HF/G,,,330.47,330.47,1
HCPCS,17312,MOHS ADDL STAGE,,,175.95,175.95,1
HCPCS,17312,MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE,1149.0,746.85,103.58,4268.0,70
HCPCS,173120,MOHS ADDL STAGE,,,175.95,175.95,1
HCPCS,17313,MOHS 1 STAGE T/A/L,,,296.56,296.56,1
HCPCS,17313,MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS,2259.5,1468.675,171.86,4268.0,80
HCPCS,173130,MOHS 1 STAGE T/A/L,,,296.56,296.56,1
HCPCS,17314,MOHS ADDL STAGE T/A/L,,,163.06,163.06,1
HCPCS,17314,MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE,1162.0,755.3,96.24,4268.0,70
HCPCS,173140,MOHS ADDL STAGE T/A/L,,,163.06,163.06,1
HCPCS,17315,MOHS SURG ADDL BLOCK,,,46.48,46.48,1
HCPCS,17315,MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE,624.0,405.6,34.38,3920.0,70
HCPCS,173150,MOHS SURG ADDL BLOCK,,,46.48,46.48,1
HCPCS,17340,CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE,308.0,200.2,30.89,231.0,35
HCPCS,17340,CRYOTHERAPY FOR ACNE,,,45.9,128.79,15
HCPCS,17340,Cryotherapy for acne,,,98.33,124.2,6
HCPCS,173400,CRYOTHERAPY FOR ACNE,,,45.9,45.9,1
HCPCS,17360,CHEMICAL EXFOLIATION ACNE,584.0,379.6,62.02,438.0,47
HCPCS,17360,Chemical exfoliation acne,,,98.33,124.2,6
HCPCS,173600,CHEMICAL EXFOLIATION ACNE,,,87.07,87.07,1
HCPCS,17380,ELECTROLYSIS EPILATION EA 30,,,73.95,1327.2,15
HCPCS,17380,Electrolysis epilation ea 30,,,98.33,124.2,6
HCPCS,173800,ELECTROLYSIS EPILATION EA 30,,,73.95,73.95,1
HCPCS,17999,ABDOMINOPLASY W/ FLEUR-DE-LIS W/O PANNICULECTOMY(COMP CODE 15830,7992.0,5194.8,172.09,7992.0,15
HCPCS,17999,ACNE TREATMENT 3TX,636.0,413.4,172.09,636.0,15
HCPCS,17999,ARMS - ARMS COMPLETE,552.0,358.8,172.09,552.0,15
HCPCS,17999,ARMS - HANDS,183.0,118.95,91.5,206.51,15
HCPCS,17999,ARMS - UNDERARMS,399.0,259.35,172.09,399.0,15
HCPCS,17999,BACK AND SHOULDERS,636.0,413.4,172.09,636.0,15
HCPCS,17999,BIKINI- STANDARD,212.0,137.8,106.0,212.0,15
HCPCS,17999,BILATERAL EAR LOBE REPAIR,743.0,482.95,172.09,743.0,15
HCPCS,17999,CERVICOPLASTY (REMOVAL EXCESS NECK SKIN),990.0,643.5,172.09,990.0,15
HCPCS,17999,CONTACT RADIOFREQUENCY (COMP CODE 15781),400.0,260.0,172.09,400.0,15
HCPCS,17999,"CONTOUR THREAD FACE LIFT, 1ST HOUR",849.0,551.85,172.09,849.0,15
HCPCS,17999,CONTOUR THREAD LIFT - BROW ** ASC,2840.0,1846.0,172.09,2840.0,15
HCPCS,17999,CONTOUR THREAD LIFT - BROW ** IN OFFICE,2017.0,1311.05,172.09,2017.0,15
HCPCS,17999,CONTOUR THREAD LIFT - MID-FACE ** ASC,4166.0,2707.9,172.09,4166.0,15
HCPCS,17999,CONTOUR THREAD LIFT - NECK ** ASC,2840.0,1846.0,172.09,2840.0,15
HCPCS,17999,CONTOUR THREAD LIFT-MID-FACE*IN OFFICE,3077.0,2000.05,172.09,3077.0,15
HCPCS,17999,CONTOUR THREAD LIFT-NECK* IN OFFICE,2017.0,1311.05,172.09,2017.0,15
HCPCS,17999,CONTOUR THREAD PROCEDURE; ECH ADDTL 15MIN,212.0,137.8,106.0,212.0,15
HCPCS,17999,COOLSCULPTING CYCLES 1 (COMP 15877),750.0,487.5,172.09,750.0,15
HCPCS,17999,COOLSCULPTING CYCLES 10 (COMP 15877),5000.0,3250.0,172.09,5000.0,15
HCPCS,17999,COOLSCULPTING CYCLES 11 (COMP 15877),5500.0,3575.0,172.09,5500.0,15
HCPCS,17999,COOLSCULPTING CYCLES 12 (COMP 15877),6000.0,3900.0,172.09,6000.0,15
HCPCS,17999,COOLSCULPTING CYCLES 13 (COMP 15877),6500.0,4225.0,172.09,6500.0,15
HCPCS,17999,COOLSCULPTING CYCLES 14 (COMP 15877),7000.0,4550.0,172.09,7000.0,15
HCPCS,17999,COOLSCULPTING CYCLES 15 (COMP 15877),7500.0,4875.0,172.09,7500.0,15
HCPCS,17999,COOLSCULPTING CYCLES 2 (COMP 15877),1500.0,975.0,172.09,1500.0,15
HCPCS,17999,COOLSCULPTING CYCLES 3 (COMP 15877),2250.0,1462.5,172.09,2250.0,15
HCPCS,17999,COOLSCULPTING CYCLES 4 (COMP 15877),3000.0,1950.0,172.09,3000.0,15
HCPCS,17999,COOLSCULPTING CYCLES 5 (COMP 15877),3200.0,2080.0,172.09,3200.0,15
HCPCS,17999,COOLSCULPTING CYCLES 6 (COMP 15877),3800.0,2470.0,172.09,3800.0,15
HCPCS,17999,COOLSCULPTING CYCLES 7 (COMP 15877),4200.0,2730.0,172.09,4200.0,15
HCPCS,17999,COOLSCULPTING CYCLES 8 (COMP 15877),4500.0,2925.0,172.09,4500.0,15
HCPCS,17999,COOLSCULPTING CYCLES 9 (COMP 15877),4800.0,3120.0,172.09,4800.0,15
HCPCS,17999,COOLSCULPTING CYCLES ADV + 1 (COMP 15877),1500.0,975.0,172.09,1500.0,15
HCPCS,17999,COOLSCULPTING CYCLES ADV + 2 (COMP 15877),2700.0,1755.0,172.09,2700.0,15
HCPCS,17999,COOLSCULPTING CYCLES ADV + 3 (COMP 15877),3800.0,2470.0,172.09,3800.0,15
HCPCS,17999,COOLSCULPTING CYCLES ADV + 4 (COMP 15877),4500.0,2925.0,172.09,4500.0,15
HCPCS,17999,COOLSCULPTING CYCLES ADV + 5 (COMP 15877),5000.0,3250.0,172.09,5000.0,15
HCPCS,17999,COOLSCULPTING CYCLES ADV + 6 (COMP 15877),6000.0,3900.0,172.09,6000.0,15
HCPCS,17999,COOLSCULPTING CYCLES ADV + 7 (COMP 15877),7000.0,4550.0,172.09,7000.0,15
HCPCS,17999,COSMETIC CONSULT,121.0,78.65,60.5,206.51,15
HCPCS,17999,COSMETIC CONSULT/FEE,121.0,78.65,60.5,206.51,15
HCPCS,17999,CRYOABLATION ABDOMINAL WALL MASS (COMP CODE 20983),19504.5,12677.925,98.33,33128.1,63
HCPCS,17999,CRYOABLATION OF SUBCUTANEOOUS MASS (COMP CODE 20983),21914.0,14244.1,98.33,36968.4,63
HCPCS,17999,ELECTROHYDROLIC SHOCKWAVE ENERGY LEVEL 3 LARGE (COMP CODE 15780),2200.0,1430.0,172.09,2200.0,15
HCPCS,17999,EXTRACTIONS,75.0,48.75,37.5,206.51,15
HCPCS,17999,FACE - CHIN,265.0,172.25,132.5,265.0,15
HCPCS,17999,FACE - FULL BEARD,424.0,275.6,172.09,424.0,15
HCPCS,17999,FACE - NECK/FRONT OR BACK,399.0,259.35,172.09,399.0,15
HCPCS,17999,FACE - UPPER LIP,199.0,129.35,99.5,206.51,15
HCPCS,17999,FACIAL REJUVENATION,2335.0,1517.75,172.09,2335.0,15
HCPCS,17999,FAT PAD BIOPSY (COMP CODE 20200),4950.0,3217.5,98.33,8384.4,63
HCPCS,17999,FEET,183.0,118.95,91.5,206.51,15
HCPCS,17999,FUNGUS TREATMENT PACKAGE,265.0,172.25,132.5,265.0,15
HCPCS,17999,FUNGUS TREATMENT TOE,106.0,68.9,53.0,206.51,15
HCPCS,17999,"GLYCOLIC WASH, ONLY",91.0,59.15,45.5,206.51,15
HCPCS,17999,IMPLANTATION OF BIO IMPLANT FOR SOFT TISSUE REINF; OTHER AREAS (,1460.0,949.0,172.09,1460.0,15
HCPCS,17999,LASER ACNE TREATMENT,240.0,156.0,120.0,240.0,15
HCPCS,17999,LASER COMPLETE LEGS 7TX,4245.0,2759.25,172.09,4245.0,15
HCPCS,17999,LASER DESTRUCT. PIGMENTED LESIONS/15 MIN,371.0,241.15,172.09,371.0,15
HCPCS,17999,LASER FRACT ABLAT SINGLE-USE LARGE (COMP CODE 15780),5000.0,3250.0,172.09,5000.0,15
HCPCS,17999,LASER FRACT ABLAT SINGLE-USE MEDIUM (COMP CODE 15780),3000.0,1950.0,172.09,3000.0,15
HCPCS,17999,LASER FRACT ABLAT SINGLE-USE SMALL (COMP CODE 15781),1500.0,975.0,172.09,1500.0,15
HCPCS,17999,LASER FRACT ABLATIVE FULL FACE SUPERFICIAL /PARTIAL AGGRESSIVE (,900.0,585.0,172.09,900.0,15
HCPCS,17999,LASER FRACT ABLATIVE LARGE  (COMP CODE 15780),3500.0,2275.0,172.09,3500.0,15
HCPCS,17999,LASER FRACT ABLATIVE MEDIUM (COMP CODE 15780),2000.0,1300.0,172.09,2000.0,15
HCPCS,17999,LASER FRACT ABLATIVE SMALL (COMP CODIE 15781),900.0,585.0,172.09,900.0,15
HCPCS,17999,LASER FRACT NON-ABLAT SINGLE-USE LARGE (COMP CODE 15780),1100.0,715.0,172.09,1100.0,15
HCPCS,17999,LASER FRACT NON-ABLAT SINGLE-USE MEDIUM (COMP CODE 15780),800.0,520.0,172.09,800.0,15
HCPCS,17999,LASER FRACT NON-ABLAT SINGLE-USE SMALL (COMP CODE 15781),500.0,325.0,172.09,500.0,15
HCPCS,17999,LASER FRACT NON-ABLATIVE FULL FACE & NECK (COMP 15780),1000.0,650.0,172.09,1000.0,15
HCPCS,17999,LASER FRACT NON-ABLATIVE FULL FACE (COMP 15780),800.0,520.0,172.09,800.0,15
HCPCS,17999,LASER FRACT NON-ABLATIVE SPOT/PARTIAL FACE (COMP 15781),300.0,195.0,150.0,300.0,15
HCPCS,17999,LASER HAIR REMOVAL - COMPLEX,750.0,487.5,172.09,750.0,15
HCPCS,17999,LASER HAIR REMOVAL - SIMPLE,275.0,178.75,137.5,275.0,15
HCPCS,17999,LASER HAIR REMOVAL -THIGHS,414.0,269.1,172.09,414.0,15
HCPCS,17999,LASER HAIR REMOVAL BUTTOCKS,663.0,430.95,132.5,1061.0,30
HCPCS,17999,LASER HAIR REMOVAL CHEEKS (BOTH),365.0,237.25,172.09,365.0,15
HCPCS,17999,LASER HAIR REMOVAL EYEBROW (CENTER),106.0,68.9,53.0,206.51,15
HCPCS,17999,LASER HAIR REMOVAL SHOULDERS ONLY,265.0,172.25,132.5,265.0,15
HCPCS,17999,"LASER HAIR REMOVAL, MODERATE",500.0,325.0,172.09,500.0,15
HCPCS,17999,LASER HAIR REMOVAL- EARS,200.0,130.0,100.0,206.51,15
HCPCS,17999,LASER HAIR RMVL ABDOMEN-FEMALE,306.0,198.9,153.0,306.0,15
HCPCS,17999,LASER HAIR RMVL ABDOMEN-MALE,371.0,241.15,172.09,371.0,15
HCPCS,17999,LASER HAIR RMVL BIKINI ALL,250.0,162.5,125.0,250.0,15
HCPCS,17999,LASER HAIR RMVL CHEST-MALE,371.0,241.15,172.09,371.0,15
HCPCS,17999,LASER HAIR RMVL FACE & NECK PKG,565.0,367.25,172.09,565.0,15
HCPCS,17999,LASER HAIR RMVL LEGS COMPLETE,759.0,493.35,172.09,759.0,15
HCPCS,17999,LASER HAIR RMVL UPPER ARMS,265.0,172.25,132.5,265.0,15
HCPCS,17999,LASER HAIR RMVL-FOREARMS,399.0,259.35,172.09,399.0,15
HCPCS,17999,LASER NECK FRONT OR BACK,1273.0,827.45,172.09,1273.0,15
HCPCS,17999,LASER PACKAGE BEARD 4 TX,1354.0,880.1,172.09,1354.0,15
HCPCS,17999,LASER PACKAGE CHEEKS BOTH,1167.0,758.55,172.09,1167.0,15
HCPCS,17999,LASER PACKAGE CHIN 4 TX,849.0,551.85,172.09,849.0,15
HCPCS,17999,LASER PACKAGE EARS 4 TX,636.0,413.4,172.09,636.0,15
HCPCS,17999,LASER PACKAGE EYEBROW 4TX,399.0,259.35,172.09,399.0,15
HCPCS,17999,LASER PACKAGE HANDS 4TX,583.0,378.95,172.09,583.0,15
HCPCS,17999,LASER PACKAGE LIP 4 TX,636.0,413.4,172.09,636.0,15
HCPCS,17999,LASER PKG AREOLA ONLY 4TX,530.0,344.5,172.09,530.0,15
HCPCS,17999,LASER PKG AXILLAE 5TX,1592.0,1034.8,172.09,1592.0,15
HCPCS,17999,LASER PKG BACK & SHOUDLERS 5TX,2547.0,1655.55,172.09,2547.0,15
HCPCS,17999,LASER PKG BIKINI ALL 4TX,796.0,517.4,172.09,796.0,15
HCPCS,17999,LASER PKG COMPLETE ARMS-5TX,2123.0,1379.95,172.09,2123.0,15
HCPCS,17999,LASER PKG FACE/NECK 4 TX,1804.0,1172.6,172.09,1804.0,15
HCPCS,17999,LASER PKG FEET W/TOES 4TX,583.0,378.95,172.09,583.0,15
HCPCS,17999,LASER PKG FEMAL ABDOMEN 5 TX,1220.0,793.0,172.09,1220.0,15
HCPCS,17999,LASER PKG FEMALE CHEST 5X,1061.0,689.65,172.09,1061.0,15
HCPCS,17999,LASER PKG FOREARMS 5TX,1592.0,1034.8,172.09,1592.0,15
HCPCS,17999,LASER PKG LEGS KNEE DOWN 7TX,2971.0,1931.15,172.09,2971.0,15
HCPCS,17999,LASER PKG LEGS THIGHS 7TX,2308.0,1500.2,172.09,2308.0,15
HCPCS,17999,LASER PKG MALE ABDOMEN 5TX,1486.0,965.9,172.09,1486.0,15
HCPCS,17999,LASER PKG MALE CHEST 5TX,1486.0,965.9,172.09,1486.0,15
HCPCS,17999,LASER PKG PIGMENTED 3 TX,1008.0,655.2,172.09,1008.0,15
HCPCS,17999,LASER PKG PSORIASIS 6TX,1273.0,827.45,172.09,1273.0,15
HCPCS,17999,LASER PKG SIDEBURNS 4 TX,636.0,413.4,172.09,636.0,15
HCPCS,17999,LASER PKG TOES ONLY 4TX,399.0,259.35,172.09,399.0,15
HCPCS,17999,LASER PKG VASCULAR LSNS 3,1008.0,655.2,172.09,1008.0,15
HCPCS,17999,LASER TX PSORIASISPER 15 MINUTES,240.0,156.0,120.0,240.0,15
HCPCS,17999,LASER TX VASCULAR LESIONS/15 MINUTES,371.0,241.15,172.09,371.0,15
HCPCS,17999,LASER VASC & PIGM LESIONS FACE & NECK/LARGE (COMP 15781),800.0,520.0,172.09,800.0,15
HCPCS,17999,LASER VASC & PIGM LESIONS FULL FACE/MEDIUM (COMP 15780),600.0,390.0,172.09,600.0,15
HCPCS,17999,LASER VASC & PIGM LESIONS SMALL (COMP CODE 15781),400.0,260.0,172.09,400.0,15
HCPCS,17999,LEGS ( KNEE DOWN),530.0,344.5,172.09,530.0,15
HCPCS,17999,MICRO-CORING SMALL (COMP CODE 15781),2000.0,1300.0,172.09,2000.0,15
HCPCS,17999,"MICRO-CORING, MEDIUM (COMP CODE 15781)",3000.0,1950.0,172.09,3000.0,15
HCPCS,17999,"MICROFOCUSED ULTRASOUND, FULL FACE & SUBMENTUM (COMP CODE 15780)",3500.0,2275.0,172.09,3500.0,15
HCPCS,17999,"MICROFOCUSED ULTRASOUND, LOWER FACE & SUBMENTUM (COMP CODE 15781",2500.0,1625.0,172.09,2500.0,15
HCPCS,17999,"MICROFOCUSED ULTRASOUND, UPPER FACE (COMP CODE 15781)",1500.0,975.0,172.09,1500.0,15
HCPCS,17999,"MICROFOCUSED ULTRASOUND,NECK (COMP CODE 15782)",1800.0,1170.0,172.09,1800.0,15
HCPCS,17999,MICRONEEDLING LARGE (COMP CODE 15780),800.0,520.0,172.09,800.0,15
HCPCS,17999,MICRONEEDLING MEDIUM  (COMP CODE 15780),500.0,325.0,172.09,500.0,15
HCPCS,17999,MICRONEEDLING SMALL (COMP CODE 15781),250.0,162.5,125.0,250.0,15
HCPCS,17999,MICROPEEL FACIALSUBCUTANEOUS TX,91.0,59.15,45.5,206.51,15
HCPCS,17999,"MICROPEEL, FACIAL INTITIAL TX",187.0,121.55,93.5,206.51,15
HCPCS,17999,"MICROPEEL, NON-FACIAL INITIAL TX",187.0,121.55,93.5,206.51,15
HCPCS,17999,"MICROPEEL, NONFACE SUBSEQUENT TX",187.0,121.55,93.5,206.51,15
HCPCS,17999,"NON INVASIVE RADIOFREQUENCY, LARGE (COMP CODE 15780)",2800.0,1820.0,172.09,2800.0,15
HCPCS,17999,"NON INVASIVE RADIOFREQUENCY, MEDIUM (COMP CODE 15781)",2500.0,1625.0,172.09,2500.0,15
HCPCS,17999,"NON INVASIVE RADIOFREQUENCY, SMALL (COMP CODE 15781)",1100.0,715.0,172.09,1100.0,15
HCPCS,17999,PRP & MICRONEEDLING LARGE (COMP CODE 15780 + 0232T),1300.0,845.0,172.09,1300.0,15
HCPCS,17999,PRP & MICRONEEDLING MEDIUM (COMP CODE 15780 + 0232T),1100.0,715.0,172.09,1100.0,15
HCPCS,17999,PRP & MICRONEEDLING SMALL (COMP CODE 15781 + 0232T),600.0,390.0,172.09,600.0,15
HCPCS,17999,RADIOFREQUENCY ABLATION SUBCUTANEOUS MASS  (COMP CODE 20982),38396.0,24957.399999999998,98.33,66585.6,63
HCPCS,17999,"RADIOFREQUENCY MICRONEEDLING, LARGE (COMP CODE 15780)",1200.0,780.0,172.09,1200.0,15
HCPCS,17999,"RADIOFREQUENCY MICRONEEDLING, MEDIUM (COMP CODE 15781)",900.0,585.0,172.09,900.0,15
HCPCS,17999,"RADIOFREQUENCY MICRONEEDLING, SMALL (COMP CODE 15781)",800.0,520.0,172.09,800.0,15
HCPCS,17999,"RADIOFREQUENCY MICRONEEDLING, XLARGE (COMP CODE 15781)",1600.0,1040.0,172.09,1600.0,15
HCPCS,17999,STERNOHYOID/OMOHYOID ROTNAL MSCLE FLAP RPR ESOPHAGL INJRY (COMP,9200.0,5980.0,172.09,9200.0,15
HCPCS,17999,SUBDERMAL RADIOFREQUENCY ABDOMEN (5X8 AREA) OR UPPER BACK (COMP,1875.0,1218.75,172.09,1875.0,15
HCPCS,17999,"SUBDERMAL RADIOFREQUENCY, KNEES, BOTH (COMP 15780)",1250.0,812.5,172.09,1250.0,15
HCPCS,17999,"SUBDERMAL RADIOFREQUENCY, LOWER FACE & NECK SCULPTING (COMP 1578",4375.0,2843.75,172.09,4375.0,15
HCPCS,17999,"SUBDERMAL RADIOFREQUENCY, POSTERIOR ARMS, BOTH (COMP 15782)",3125.0,2031.25,172.09,3125.0,15
HCPCS,17999,TEST SPOT,121.0,78.65,60.5,206.51,15
HCPCS,17999,UNILATERAL EAR LOBE REPAIR,424.0,275.6,172.09,424.0,15
HCPCS,17999,"UNLIST PROC, SKIN, MUCOUS MEMBRANE & SUBCUT TISSUE COMP TO 15777",1205.0,783.25,172.09,1205.0,15
HCPCS,17999,UNLISTED PROC SKIN MM & SQ TISS,369.0,239.85,98.33,7730.0,96
HCPCS,17999,WOUND ELECTROCAUTERIZATION/CONTROL OF BLEEDING (COMP 20103),1923.0,1249.95,172.09,1923.0,15
HCPCS,19000,PUNCTURE ASPIR CYST BREAST,,,39.7,39.7,1
HCPCS,19000,PUNCTURE ASPIRATION CYST BREAST,1487.5,966.875,27.88,4151.0,228
HCPCS,190000,PUNCTURE ASPIR CYST BREAST,,,39.7,39.7,1
HCPCS,19001,PUNCTURE ASPIR CYST BRST EA,,,19.68,19.68,1
HCPCS,19001,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,244.5,158.925,15.4,3920.0,146
HCPCS,190010,PUNCTURE ASPIR CYST BRST EA,,,19.68,19.68,1
HCPCS,19020,MASTOTOMY EXPL DRG ABSC DP,,,295.32,295.32,1
HCPCS,19020,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,4172.0,2711.8,153.04,13665.0,130
HCPCS,190200,MASTOTOMY EXPL DRG ABSC DP,,,295.32,295.32,1
HCPCS,19030,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,610.0,396.5,36.17,3920.0,146
HCPCS,19030,NJX PX ONLY MAM DUCTO/GLCTO,,,70.73,70.73,1
HCPCS,190300,NJX PX ONLY MAM DUCTO/GLCTO,,,70.73,70.73,1
HCPCS,19081,BX BREAST 1ST LESION STRTCTC,,,151.97,151.97,1
HCPCS,19081,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,7711.5,5012.475,134.95,12577.5,178
HCPCS,19081,MAM STEREO BREAST BX FIRST LES,13975.0,9083.75,193.54,12577.5,46
HCPCS,190810,BX BREAST 1ST LESION STRTCTC,,,151.97,151.97,1
HCPCS,19082,BX BREAST ADD LESION STRTCTC,,,76.16,76.16,1
HCPCS,19082,BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID,1957.0,1272.05,63.88,8370.0,107
HCPCS,190820,BX BREAST ADD LESION STRTCTC,,,76.16,76.16,1
HCPCS,19083,BX BREAST 1ST LESION US IMAG,,,143.76,143.76,1
HCPCS,19083,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,7669.5,4985.175,126.35,12577.5,224
HCPCS,190830,BX BREAST 1ST LESION US IMAG,,,143.76,143.76,1
HCPCS,19084,BX BREAST ADD LESION US IMAG,,,71.71,71.71,1
HCPCS,19084,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,1984.0,1289.6000000000001,60.0,8370.0,142
HCPCS,190840,BX BREAST ADD LESION US IMAG,,,71.71,71.71,1
HCPCS,19085,BX BREAST 1ST LESION MR IMAG,,,166.83,166.83,1
HCPCS,19085,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,7788.5,5062.525,147.43,12577.5,224
HCPCS,190850,BX BREAST 1ST LESION MR IMAG,,,166.83,166.83,1
HCPCS,19086,BX BREAST ADD LESION MR IMAG,,,83.1,83.1,1
HCPCS,19086,BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID,1965.0,1277.25,64.74,8370.0,107
HCPCS,190860,BX BREAST ADD LESION MR IMAG,,,83.1,83.1,1
HCPCS,19100,BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX,508.0,330.2,38.37,381.0,35
HCPCS,19100,BX BREAST PERCUT W/O IMAGE,,,65.6,3512.95,15
HCPCS,19100,Bx breast percut w/o image,,,816.59,1031.48,6
HCPCS,191000,BX BREAST PERCUT W/O IMAGE,,,65.6,65.6,1
HCPCS,19101,BIOPSY BREAST OPEN INCISIONAL,7826.0,5086.9,109.81,12924.0,74
HCPCS,19101,BIOPSY OF BREAST OPEN,,,211.09,211.09,1
HCPCS,191010,BIOPSY OF BREAST OPEN,,,211.09,211.09,1
HCPCS,19102,BX BREAST PERC NDL CORE W/IMAGE,1143.0,742.95,87.8,1143.0,16
HCPCS,19102,"BX-BREAST,PERC,NEEDLE CORE,IMAGE GUIDED",1058.0,687.7,87.8,1058.0,16
HCPCS,19103,"BREAST BX,PERC,VACUUM ASSISTED,IMAGE GUID",2353.0,1529.45,165.09,2353.0,16
HCPCS,19103,BX BRST PERC VAC ASSIST W/IMAGE,3503.0,2276.95,165.09,3503.0,16
HCPCS,19105,ABLTJ CRYOSURGICAL W/US GID EA FIBROADENOMA,1476.0,959.4,126.83,4124.29,32
HCPCS,19105,CRYOSURG ABLATE FA EACH,,,199.18,8302.51,15
HCPCS,19105,Cryosurg ablate fa each,,,816.59,1031.48,6
HCPCS,191050,CRYOSURG ABLATE FA EACH,,,199.18,199.18,1
HCPCS,19110,NIPPLE EXPLORATION,1776.0,1154.4,172.61,8302.51,50
HCPCS,19110,Nipple exploration,,,816.59,1031.48,6
HCPCS,191100,NIPPLE EXPLORATION,,,332.67,332.67,1
HCPCS,19112,EXCISE BREAST DUCT FISTULA,,,304.29,8302.51,15
HCPCS,19112,EXCISION LACTIFEROUS DUCT FISTULA,1524.0,990.6,158.3,1143.0,35
HCPCS,19112,Excise breast duct fistula,,,816.59,1031.48,6
HCPCS,191120,EXCISE BREAST DUCT FISTULA,,,304.29,304.29,1
HCPCS,19120,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,8364.0,5436.6,204.33,12924.0,74
HCPCS,19120,REMOVAL OF BREAST LESION,,,396.01,396.01,1
HCPCS,191200,REMOVAL OF BREAST LESION,,,396.01,396.01,1
HCPCS,19125,EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES,2944.0,1913.6,226.68,2208.0,35
HCPCS,19125,EXCISION BREAST LESION,,,438.6,8302.51,20
HCPCS,19125,Excision breast lesion,,,816.59,1031.48,6
HCPCS,191250,EXCISION BREAST LESION,,,438.6,438.6,1
HCPCS,19126,EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL,1172.0,761.8,118.48,1172.0,35
HCPCS,19126,EXCISION ADDL BREAST LESION,,,151.96,390.0,2
HCPCS,19126,Excision addl breast lesion,,,816.59,1031.48,6
HCPCS,191260,EXCISION ADDL BREAST LESION,,,151.96,151.96,1
HCPCS,19281,PERQ DEVICE BREAST 1ST IMAG,,,91.66,91.66,1
HCPCS,19281,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,3438.0,2234.7,74.81,5468.4,224
HCPCS,192810,PERQ DEVICE BREAST 1ST IMAG,,,91.66,91.66,1
HCPCS,19282,PERQ DEVICE BREAST EA IMAG,,,45.98,45.98,1
HCPCS,19282,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,3258.0,2117.7,37.31,5468.4,104
HCPCS,192820,PERQ DEVICE BREAST EA IMAG,,,45.98,45.98,1
HCPCS,19283,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,1759.5,1143.675,75.53,3920.0,224
HCPCS,19283,PERQ DEV BREAST 1ST STRTCTC,,,92.65,92.65,1
HCPCS,192830,PERQ DEV BREAST 1ST STRTCTC,,,92.65,92.65,1
HCPCS,19284,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,1539.5,1000.675,37.55,3920.0,142
HCPCS,19284,PERQ DEV BREAST ADD STRTCTC,,,46.35,46.35,1
HCPCS,192840,PERQ DEV BREAST ADD STRTCTC,,,46.35,46.35,1
HCPCS,19285,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,1693.5,1100.7749999999999,64.05,3920.0,224
HCPCS,19285,PERQ DEV BREAST 1ST US IMAG,,,78.38,78.38,1
HCPCS,192850,PERQ DEV BREAST 1ST US IMAG,,,78.38,78.38,1
HCPCS,19286,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,1506.5,979.2249999999999,32.24,3920.0,142
HCPCS,19286,PERQ DEV BREAST ADD US IMAG,,,39.36,39.36,1
HCPCS,192860,PERQ DEV BREAST ADD US IMAG,,,39.36,39.36,1
HCPCS,19287,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,1829.5,1189.175,105.15,3920.0,178
HCPCS,19287,PERQ DEV BREAST 1ST MR GUIDE,,,117.02,117.02,1
HCPCS,192870,PERQ DEV BREAST 1ST MR GUIDE,,,117.02,117.02,1
HCPCS,19288,PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID,1575.5,1024.075,45.91,3920.0,107
HCPCS,19288,PERQ DEV BREAST ADD MR GUIDE,,,58.35,58.35,1
HCPCS,192880,PERQ DEV BREAST ADD MR GUIDE,,,58.35,58.35,1
HCPCS,19290,PREOP PLACEMENT NEEDLE LOC 1ST,648.0,421.2,54.84,648.0,16
HCPCS,19291,PREOP PLACEMENT NEEDLE EA AD,297.0,193.05,26.85,297.0,16
HCPCS,19291,PREOP PLACEMENT NEEDLE EA ADD''L,648.0,421.2,26.85,648.0,16
HCPCS,19294,PREP TUMOR CAVITY IORT W/PARTIAL MASTECTOMY,1200.0,780.0,125.62,1200.0,31
HCPCS,19294,PREPJ TUM CAV IORT PRTL MAST,,,155.74,155.74,1
HCPCS,19294,Prepj tum cav iort prtl mast,,,4624.58,5841.58,6
HCPCS,192940,PREPJ TUM CAV IORT PRTL MAST,,,155.74,155.74,1
HCPCS,19295,IMG GUID PL METAL LOC CLIP PERC BRST,437.0,284.05,77.11,437.0,16
HCPCS,19296,PLACE PO BREAST CATH FOR RAD,,,199.11,20747.28,15
HCPCS,19296,PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST,1452.0,943.8,157.67,6465.26,35
HCPCS,19296,Place po breast cath for rad,,,2132.55,2693.75,6
HCPCS,192960,PLACE PO BREAST CATH FOR RAD,,,199.11,199.11,1
HCPCS,19297,PLACE BREAST CATH FOR RAD,,,88.85,88.85,1
HCPCS,19297,PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST,688.0,447.2,70.59,688.0,35
HCPCS,19297,Place breast cath for rad,,,4624.58,5841.58,6
HCPCS,192970,PLACE BREAST CATH FOR RAD,,,88.85,88.85,1
HCPCS,19298,PLACE BREAST RAD TUBE/CATHS,,,296.88,15830.27,15
HCPCS,19298,PLMT RADTHX BRACHYTX BRST FOLLOWING PRTL MAST,2300.0,1495.0,228.29,1745.21,35
HCPCS,19298,Place breast rad tube/caths,,,2132.55,2693.75,6
HCPCS,192980,PLACE BREAST RAD TUBE/CATHS,,,296.88,296.88,1
HCPCS,19300,MASTECTOMY FOR GYNECOMASTIA,2124.0,1380.6,217.76,8302.51,51
HCPCS,19300,Mastectomy for gynecomastia,,,816.59,1031.48,6
HCPCS,193000,MASTECTOMY FOR GYNECOMASTIA,,,405.43,405.43,1
HCPCS,19301,"MASTECTOMY, PARTIAL",4052.0,2633.8,324.49,4052.0,35
HCPCS,19301,PARTIAL MASTECTOMY,,,626.72,8302.51,19
HCPCS,19301,Partial mastectomy,,,2132.55,2693.75,6
HCPCS,193010,PARTIAL MASTECTOMY,,,626.72,626.72,1
HCPCS,19302,"MASTECTOMY,PARTIAL,  WITH AXILLARY LYMPHADENECTOMY",5596.0,3637.4,480.32,5596.0,35
HCPCS,19302,P-MASTECTOMY W/LN REMOVAL,,,860.72,14139.6,15
HCPCS,19302,P-mastectomy w/ln removal,,,2132.55,2693.75,6
HCPCS,193020,P-MASTECTOMY W/LN REMOVAL,,,860.72,860.72,1
HCPCS,19303,MAST SIMPLE COMPLETE,,,909.34,14139.6,18
HCPCS,19303,"MASTECTOMY, SIMPLE, COMPLETE",6000.0,3900.0,525.09,6000.0,35
HCPCS,19303,Mast simple complete,,,2132.55,2693.75,6
HCPCS,193030,MAST SIMPLE COMPLETE,,,909.34,909.34,1
HCPCS,19305,MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES,6984.0,4539.6,600.85,6984.0,35
HCPCS,19305,MAST RADICAL,,,1088.39,1088.39,1
HCPCS,19305,Mast radical,,,4624.58,5841.58,6
HCPCS,193050,MAST RADICAL,,,1088.39,1088.39,1
HCPCS,19306,MAST RAD URBAN TYPE,,,1155.31,1155.31,1
HCPCS,19306,MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES,7252.0,4713.8,627.76,7252.0,35
HCPCS,19306,Mast rad urban type,,,4624.58,5841.58,6
HCPCS,193060,MAST RAD URBAN TYPE,,,1155.31,1155.31,1
HCPCS,19307,MAST MOD RAD,,,1117.63,14139.6,15
HCPCS,19307,MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN,7196.0,4677.4,634.09,7196.0,35
HCPCS,19307,Mast mod rad,,,4624.58,5841.58,6
HCPCS,193070,MAST MOD RAD,,,1117.63,1117.63,1
HCPCS,19316,MASTOPEXY,4880.0,3172.0,436.64,14139.6,51
HCPCS,19316,Mastopexy,,,2132.55,2693.75,6
HCPCS,193160,MASTOPEXY,,,743.83,743.83,1
HCPCS,19318,BREAST REDUCTION,,,1025.7,14139.6,19
HCPCS,19318,BREAST REDUCTION FEMALE - MODERATE,1820.0,1183.0,727.46,2211.49,35
HCPCS,19318,Breast reduction,,,4624.58,5841.58,6
HCPCS,19318,REDUCTION OF LARGE BREAST,7053.0,4584.45,727.46,7053.0,35
HCPCS,193180,BREAST REDUCTION,,,1025.7,1025.7,1
HCPCS,19324,Enlarge breast,,,816.59,1031.48,6
HCPCS,19325,BREAST AUG (GEL) - MODERATE,2500.0,1625.0,353.02,2500.0,35
HCPCS,19325,BREAST AUGMENTATION W/IMPLT,,,576.42,20747.28,16
HCPCS,19325,BREAST AUGMENTATION WITH IMPLANT,3573.0,2322.45,353.02,3573.0,35
HCPCS,19325,Breast augmentation w/implt,,,2132.55,2693.75,6
HCPCS,193250,BREAST AUGMENTATION W/IMPLT,,,576.42,576.42,1
HCPCS,19328,REMOVAL OF BREAST IMPLANT,8668.0,5634.2,269.58,12924.0,74
HCPCS,19328,RMVL INTACT BREAST IMPLANT,,,519.57,519.57,1
HCPCS,193280,RMVL INTACT BREAST IMPLANT,,,519.57,519.57,1
HCPCS,19330,RMVL RUPTURED BREAST IMPLANT,,,606.27,606.27,1
HCPCS,19330,RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS,8980.0,5837.0,328.12,12924.0,74
HCPCS,193300,RMVL RUPTURED BREAST IMPLANT,,,606.27,606.27,1
HCPCS,19340,INSERTION BREAST IMPLANT SAME DAY OF MASTECTOMY,4192.0,2724.8,455.2,4192.0,35
HCPCS,19340,INSJ BREAST IMPLT SM D MAST,,,712.42,14139.6,15
HCPCS,19340,Insj breast implt sm d mast,,,2132.55,2693.75,6
HCPCS,193400,INSJ BREAST IMPLT SM D MAST,,,712.42,712.42,1
HCPCS,19342,INSJ/RPLCMT BREAST IMPLANT SEP DAY MASTECTOMY,4611.0,2997.15,562.26,4611.0,35
HCPCS,19342,INSJ/RPLCMT BRST IMPLT SEP D,,,713.76,20747.28,17
HCPCS,19342,Insj/rplcmt brst implt sep d,,,2132.55,2693.75,6
HCPCS,193420,INSJ/RPLCMT BRST IMPLT SEP D,,,713.76,713.76,1
HCPCS,19350,NIPPLE/AREOLA RECONSTRUCTION,4008.0,2605.2,434.27,8302.51,50
HCPCS,19350,Nipple/areola reconstruction,,,2132.55,2693.75,6
HCPCS,193500,NIPPLE/AREOLA RECONSTRUCTION,,,631.01,631.01,1
HCPCS,19355,CORRECT INVERTED NIPPLE(S),3408.0,2215.2,376.96,8302.51,47
HCPCS,19355,Correct inverted nipple(s),,,2132.55,2693.75,6
HCPCS,19355,INVERTED NIPPPLE CORRECTION,1600.0,1040.0,376.96,1245.93,32
HCPCS,193550,CORRECT INVERTED NIPPLE(S),,,578.69,578.69,1
HCPCS,19357,BREAST RECONSTRUC W TISS EXPANDR,6530.0,4244.5,833.32,6530.0,35
HCPCS,19357,TISS XPNDR PLMT BRST RCNSTJ,,,1082.74,37722.49,18
HCPCS,19357,Tiss xpndr plmt brst rcnstj,,,4624.58,5841.58,6
HCPCS,193570,TISS XPNDR PLMT BRST RCNSTJ,,,1082.74,1082.74,1
HCPCS,19361,BREAST RECONSTRUC W LAT DORSI FLAP,9344.0,6073.6,1048.12,9344.0,35
HCPCS,19361,BRST RCNSTJ LATSMS DRSI FLAP,,,1460.41,1460.41,1
HCPCS,19361,Brst rcnstj latsms drsi flap,,,4624.58,5841.58,6
HCPCS,193610,BRST RCNSTJ LATSMS DRSI FLAP,,,1460.41,1460.41,1
HCPCS,19364,BREAST RECONSTRUC W FREE FLAP,18735.0,12177.75,1499.62,18735.0,35
HCPCS,19364,BRST RCNSTJ FREE FLAP,,,2548.59,2548.59,1
HCPCS,19364,Brst rcnstj free flap,,,4624.58,5841.58,6
HCPCS,193640,BRST RCNSTJ FREE FLAP,,,2548.59,2548.59,1
HCPCS,19366,Breast reconstruction,,,4624.58,5841.58,6
HCPCS,19367,BREAST RECONSTRUCTION SINGLE PEDICLED TRAM FLAP,10720.0,6968.0,1233.95,10720.0,35
HCPCS,19367,BRST RCNSTJ 1 PDCL TRAM FLAP,,,1658.64,1658.64,1
HCPCS,19367,Brst rcnstj 1 pdcl tram flap,,,4624.58,5841.58,6
HCPCS,193670,BRST RCNSTJ 1 PDCL TRAM FLAP,,,1658.64,1658.64,1
HCPCS,19368,BREAST RECONSTRUCTION 1PEDICLED TRAM FLAP ANAST,13560.0,8814.0,1361.8,13560.0,35
HCPCS,19368,BRST RCNSTJ 1PDCL TRAM ANAST,,,2032.7,2032.7,1
HCPCS,19368,Brst rcnstj 1pdcl tram anast,,,4624.58,5841.58,6
HCPCS,193680,BRST RCNSTJ 1PDCL TRAM ANAST,,,2032.7,2032.7,1
HCPCS,19369,BREAST RECONSTRUCTION BIPEDICLED TRAM FLAP,12524.0,8140.6,1292.17,12524.0,35
HCPCS,19369,BRST RCNSTJ 2 PDCL TRAM FLAP,,,1888.35,1888.35,1
HCPCS,19369,Brst rcnstj 2 pdcl tram flap,,,4624.58,5841.58,6
HCPCS,193690,BRST RCNSTJ 2 PDCL TRAM FLAP,,,1888.35,1888.35,1
HCPCS,19370,REVISION PERI-IMPLANT CAPSULE BREAST,4035.0,2622.75,388.57,4035.0,35
HCPCS,19370,REVJ PERI-IMPLT CAPSULE BRST,,,630.04,9115.0,19
HCPCS,19370,Revj peri-implt capsule brst,,,2132.55,2693.75,6
HCPCS,193700,REVJ PERI-IMPLT CAPSULE BRST,,,630.04,630.04,1
HCPCS,19371,PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE,4391.0,2854.15,469.75,4391.0,35
HCPCS,19371,PERI-IMPLT CAPSLC BRST COMPL,,,667.74,8302.51,18
HCPCS,19371,Peri-implt capslc brst compl,,,2132.55,2693.75,6
HCPCS,193710,PERI-IMPLT CAPSLC BRST COMPL,,,667.74,667.74,1
HCPCS,19380,REVISE BREAST RECONSTRUCTION,4915.0,3194.75,422.97,4915.0,35
HCPCS,19380,REVJ RECONSTRUCTED BREAST,,,756.93,14139.6,19
HCPCS,19380,Revj reconstructed breast,,,2132.55,2693.75,6
HCPCS,193800,REVJ RECONSTRUCTED BREAST,,,756.93,756.93,1
HCPCS,19396,DESIGN CUSTOM BREAST IMPLANT,,,133.69,8302.51,15
HCPCS,19396,Design custom breast implant,,,816.59,1031.48,6
HCPCS,19396,PREPARATION MOULAGE CUSTOM BREAST IMPLANT,955.0,620.75,126.95,716.25,32
HCPCS,193960,DESIGN CUSTOM BREAST IMPLANT,,,133.69,133.69,1
HCPCS,19499,DEEP INFERIOR EPIGASTRIC PERFORATOR,9055.0,5885.75,324.44,9055.0,15
HCPCS,19499,ENDOSCOPIC MASTECTOMY (COMP CODE 19303),6000.0,3900.0,324.44,6000.0,15
HCPCS,19499,REMOVAL BREAST BALLOON CATHETER,3815.0,2479.75,816.59,13665.0,45
HCPCS,19499,"THERMAGE, ABDOMEN",2388.0,1552.2,324.44,2388.0,15
HCPCS,19499,"THERMAGE, ANTERIOR THIGHS",3070.0,1995.5,324.44,3070.0,15
HCPCS,19499,"THERMAGE, ARMS",3070.0,1995.5,324.44,3070.0,15
HCPCS,19499,"THERMAGE, BUTTOCKS & UPPER THIGHS",3070.0,1995.5,324.44,3070.0,15
HCPCS,19499,"THERMAGE, EYES",1762.0,1145.3,324.44,1762.0,15
HCPCS,19499,"THERMAGE, FULL FACE & NECK",1933.0,1256.45,324.44,1933.0,15
HCPCS,19499,"THERMAGE, FULL FACE , NECK & EYES",2614.0,1699.1,324.44,2614.0,15
HCPCS,19499,"THERMAGE, INNER THIGHS",2388.0,1552.2,324.44,2388.0,15
HCPCS,19499,"THERMAGE, KNEES",2047.0,1330.55,324.44,2047.0,15
HCPCS,19499,"THERMAGE, PARTIAL FACE & UPPER NECK",1592.0,1034.8,324.44,1592.0,15
HCPCS,2000F,BLOOD PRESSURE MEASURE,,,0.01,0.01,1
HCPCS,2000F0,BLOOD PRESSURE MEASURE,,,0.01,0.01,1
HCPCS,2001F,WEIGHT RECORD,,,0.01,0.01,1
HCPCS,2001F0,WEIGHT RECORD,,,0.01,0.01,1
HCPCS,2002F,CLIN SIGN VOL OVRLD ASSESS,,,0.01,0.01,1
HCPCS,2002F0,CLIN SIGN VOL OVRLD ASSESS,,,0.01,0.01,1
HCPCS,2004F,INITIAL EXAM INVOLVED JOINTS,,,0.01,0.01,1
HCPCS,2004F0,INITIAL EXAM INVOLVED JOINTS,,,0.01,0.01,1
HCPCS,20100,EXPL PENTRG WOUND NECK,,,511.18,1104.14,15
HCPCS,20100,EXPLORATION PENETRATING WOUND SPX NECK,4152.0,2698.8,414.61,4152.0,35
HCPCS,20100,Expl pentrg wound neck,,,613.49,774.94,6
HCPCS,201000,EXPL PENTRG WOUND NECK,,,632.09,632.09,1
HCPCS,20101,EXPL PENTRG WOUND CHEST,,,220.31,220.31,1
HCPCS,20101,EXPLORATION PENETRATING WOUND SPX CHEST,5905.0,3838.25,103.4,13665.0,133
HCPCS,201010,EXPL PENTRG WOUND CHEST,,,220.31,220.31,1
HCPCS,20102,EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK,1592.0,1034.8,127.63,1194.0,35
HCPCS,20102,EXPL PENTRG WND ABD/FLNK/BK,,,269.5,3966.07,15
HCPCS,20102,Expl pentrg wnd abd/flnk/bk,,,613.49,774.94,6
HCPCS,201020,EXPL PENTRG WND ABD/FLNK/BK,,,269.5,269.5,1
HCPCS,20103,EXPL PENTRG WOUND EXTREMITY,,,361.56,361.56,1
HCPCS,20103,EXPLORATION PENETRATING WOUND SPX EXTREMITY,5726.0,3721.8999999999996,167.67,8384.4,133
HCPCS,201030,EXPL PENTRG WOUND EXTREMITY,,,361.56,361.56,1
HCPCS,2010F,VITAL SIGNS RECORDED,,,0.01,0.01,1
HCPCS,2010F0,VITAL SIGNS RECORDED,,,0.01,0.01,1
HCPCS,2014F,MENTAL STATUS ASSESS,,,0.01,0.01,1
HCPCS,2014F0,MENTAL STATUS ASSESS,,,0.01,0.01,1
HCPCS,20150,EXCISION EPIPHYSEAL BAR,,,1052.22,7034.85,15
HCPCS,20150,Excision epiphyseal bar,,,1112.95,1405.84,6
HCPCS,201500,EXCISION EPIPHYSEAL BAR,,,1052.22,1052.22,1
HCPCS,2015F,ASTHMA IMPAIRMENT ASSESSED,,,0.01,0.01,1
HCPCS,2015F0,ASTHMA IMPAIRMENT ASSESSED,,,0.01,0.01,1
HCPCS,2016F,ASTHMA RISK ASSESSED,,,0.01,0.01,1
HCPCS,2016F0,ASTHMA RISK ASSESSED,,,0.01,0.01,1
HCPCS,2018F,HYDRATION STATUS ASSESS,,,0.01,0.01,1
HCPCS,2018F0,HYDRATION STATUS ASSESS,,,0.01,0.01,1
HCPCS,2019F,DILATED MACUL EXAM DONE,,,0.01,0.01,1
HCPCS,2019F0,DILATED MACUL EXAM DONE,,,0.01,0.01,1
HCPCS,20200,BIOPSY MUSCLE SUPERFICIAL,584.0,379.6,58.27,438.0,35
HCPCS,20200,MUSCLE BIOPSY SUPERFICIAL,,,99.96,3512.95,15
HCPCS,20200,Muscle biopsy superficial,,,1112.95,1405.84,6
HCPCS,202000,MUSCLE BIOPSY SUPERFICIAL,,,99.96,99.96,1
HCPCS,20205,BIOPSY MUSCLE DEEP,16456.0,10696.4,187.62,14810.4,46
HCPCS,20205,DEEP MUSCLE BIOPSY,940.0,611.0,77.94,705.0,36
HCPCS,202050,DEEP MUSCLE BIOPSY,,,163.04,163.04,1
HCPCS,20206,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,4856.0,3156.3999999999996,41.71,8384.4,277
HCPCS,20206,BIOPSY MUSCLE PERQ NEEDLE,,,58.96,58.96,1
HCPCS,202060,BIOPSY MUSCLE PERQ NEEDLE,,,58.96,58.96,1
HCPCS,2020F,DILATED FUNDUS EVAL DONE,,,0.01,0.01,1
HCPCS,2020F0,DILATED FUNDUS EVAL DONE,,,0.01,0.01,1
HCPCS,2021F,DILAT MACULAR EXAM DONE,,,0.01,0.01,1
HCPCS,2021F0,DILAT MACULAR EXAM DONE,,,0.01,0.01,1
HCPCS,20220,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,9316.0,6055.4,104.99,8384.4,193
HCPCS,20220,BONE BIOPSY TROCAR/NDL SUPFC,,,90.15,90.15,1
HCPCS,20220,"BONE BIOPSY,TROCAR/NEEDLE SUPERF",660.0,429.0,41.75,495.0,35
HCPCS,202200,BONE BIOPSY TROCAR/NDL SUPFC,,,90.15,90.15,1
HCPCS,20225,BIOPSY BONE TROCAR/NEEDLE DEEP,9316.0,6055.4,155.38,8384.4,242
HCPCS,20225,BONE BIOPSY TROCAR/NDL DEEP,,,133.71,133.71,1
HCPCS,20225,"BONE BIOPSY,TROCAR/NEEDLE DEEP",980.0,637.0,80.3,949.75,35
HCPCS,202250,BONE BIOPSY TROCAR/NDL DEEP,,,133.71,133.71,1
HCPCS,2022F,DILAT RTA XM EVC RTNOPTHY,,,0.01,0.01,1
HCPCS,2022F0,DILAT RTA XM EVC RTNOPTHY,,,0.01,0.01,1
HCPCS,2023F,DILAT RTA XM W/O RTNOPTHY,,,0.01,0.01,1
HCPCS,2023F0,DILAT RTA XM W/O RTNOPTHY,,,0.01,0.01,1
HCPCS,20240,BIOPSY BONE OPEN SUPERFICIAL,1148.0,746.2,107.24,1148.0,35
HCPCS,20240,BONE BIOPSY OPEN SUPERFICIAL,,,146.57,6205.4,15
HCPCS,20240,Bone biopsy open superficial,,,1112.95,1405.84,6
HCPCS,202400,BONE BIOPSY OPEN SUPERFICIAL,,,146.57,146.57,1
HCPCS,20245,BIOPSY BONE OPEN DEEP,2640.0,1716.0,262.47,2640.0,35
HCPCS,20245,BONE BIOPSY OPEN DEEP,,,359.5,6205.4,15
HCPCS,20245,Bone biopsy open deep,,,1112.95,1405.84,6
HCPCS,202450,BONE BIOPSY OPEN DEEP,,,359.5,359.5,1
HCPCS,2024F,7 FLD RTA PHOTO EVC RTNOPTHY,,,0.01,0.01,1
HCPCS,2024F0,7 FLD RTA PHOTO EVC RTNOPTHY,,,0.01,0.01,1
HCPCS,20250,BIOPSY VERTEBRAL BODY OPEN THORACIC,2076.0,1349.4,269.87,2076.0,35
HCPCS,20250,BIOPSY VRT BDY OPEN THORACIC,,,410.82,7034.85,15
HCPCS,20250,Biopsy vrt bdy open thoracic,,,3094.77,3909.18,6
HCPCS,202500,BIOPSY VRT BDY OPEN THORACIC,,,410.82,410.82,1
HCPCS,20251,BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL,2288.0,1487.2,307.14,2288.0,35
HCPCS,20251,BIOPSY VRT BDY OPEN LMBR/CRV,,,439.59,15488.78,15
HCPCS,20251,Biopsy vrt bdy open lmbr/crv,,,3094.77,3909.18,6
HCPCS,202510,BIOPSY VRT BDY OPEN LMBR/CRV,,,439.59,439.59,1
HCPCS,2025F,7 FLD RTA PHOTO W/O RTNOPTHY,,,0.01,0.01,1
HCPCS,2025F0,7 FLD RTA PHOTO W/O RTNOPTHY,,,0.01,0.01,1
HCPCS,2026F,EYE IMG VALID EVC RTNOPTHY,,,0.01,0.01,1
HCPCS,2026F0,EYE IMG VALID EVC RTNOPTHY,,,0.01,0.01,1
HCPCS,2027F,OPTIC NERVE HEAD EVAL DONE,,,0.01,0.01,1
HCPCS,2027F0,OPTIC NERVE HEAD EVAL DONE,,,0.01,0.01,1
HCPCS,2028F,FOOT EXAM PERFORMED,,,0.01,0.01,1
HCPCS,2028F0,FOOT EXAM PERFORMED,,,0.01,0.01,1
HCPCS,2029F,COMPLETE PHYS SKIN EXAM DONE,,,0.01,0.01,1
HCPCS,2029F0,COMPLETE PHYS SKIN EXAM DONE,,,0.01,0.01,1
HCPCS,2030F,H2O STAT DOCD NORMAL,,,0.01,0.01,1
HCPCS,2030F0,H2O STAT DOCD NORMAL,,,0.01,0.01,1
HCPCS,2031F,H2O STAT DOCD DEHYDRATED,,,0.01,0.01,1
HCPCS,2031F0,H2O STAT DOCD DEHYDRATED,,,0.01,0.01,1
HCPCS,2033F,EYE IMG VALID W/O RTNOPTHY,,,0.01,0.01,1
HCPCS,2033F0,EYE IMG VALID W/O RTNOPTHY,,,0.01,0.01,1
HCPCS,2035F,TYMP MEMB MOTION EXAMD,,,0.01,0.01,1
HCPCS,2035F0,TYMP MEMB MOTION EXAMD,,,0.01,0.01,1
HCPCS,2040F,BK PN XM ON INIT VISIT DATE,,,0.01,0.01,1
HCPCS,2040F0,BK PN XM ON INIT VISIT DATE,,,0.01,0.01,1
HCPCS,2044F,DOC MNTL TST B/4 BK TRXMNT,,,0.01,0.01,1
HCPCS,2044F0,DOC MNTL TST B/4 BK TRXMNT,,,0.01,0.01,1
HCPCS,20500,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,4515.0,2934.75,64.03,7666.2,133
HCPCS,20500,NJX SINUS TRACT THERAPEUTIC,,,92.86,92.86,1
HCPCS,205000,NJX SINUS TRACT THERAPEUTIC,,,92.86,92.86,1
HCPCS,20501,INJECTION SINUS TRACT DIAGNOSTIC,826.0,536.9,27.93,4151.0,184
HCPCS,20501,NJX SINUS TRACT DIAGNOSTIC,,,37.78,37.78,1
HCPCS,205010,NJX SINUS TRACT DIAGNOSTIC,,,37.78,37.78,1
HCPCS,2050F,WOUND CHAR SIZE ETC DOCD,,,0.01,0.01,1
HCPCS,2050F0,WOUND CHAR SIZE ETC DOCD,,,0.01,0.01,1
HCPCS,20520,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,5038.0,3274.7,85.78,8384.4,179
HCPCS,20520,RMVL FB MUSC/TDN SIMPLE,,,153.75,153.75,1
HCPCS,205200,RMVL FB MUSC/TDN SIMPLE,,,153.75,153.75,1
HCPCS,20525,RMVL FB MUSC/TDN DEEP/COMP,,,258.22,6205.4,15
HCPCS,20525,RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,1416.0,920.4,120.0,1062.0,35
HCPCS,20525,Rmvl fb musc/tdn deep/comp,,,1112.95,1405.84,6
HCPCS,205250,RMVL FB MUSC/TDN DEEP/COMP,,,258.22,258.22,1
HCPCS,20526,INJECTION THERAPEUTIC CARPAL TUNNEL,1056.0,686.4000000000001,33.26,3920.0,130
HCPCS,20526,THER INJECTION CARP TUNNEL,,,59.43,59.43,1
HCPCS,205260,THER INJECTION CARP TUNNEL,,,59.43,59.43,1
HCPCS,20527,INJECTION ENZYME PALMAR FASCIAL CORD,1049.0,681.85,31.73,3920.0,81
HCPCS,20527,NJX NZM PALMAR FASCIAL CORD,,,68.55,68.55,1
HCPCS,205270,NJX NZM PALMAR FASCIAL CORD,,,68.55,68.55,1
HCPCS,20550,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,1014.0,659.1,31.07,3920.0,228
HCPCS,20550,NJX 1 TENDON SHEATH/LIGAMENT,,,40.82,40.82,1
HCPCS,205500,NJX 1 TENDON SHEATH/LIGAMENT,,,40.82,40.82,1
HCPCS,20551,INJECTION SINGLE TENDON ORIGIN/INSERTION,1014.0,659.1,32.02,3920.0,228
HCPCS,20551,NJX 1 TENDON ORIGIN/INSJ,,,40.46,40.46,1
HCPCS,205510,NJX 1 TENDON ORIGIN/INSJ,,,40.46,40.46,1
HCPCS,20552,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1698.0,1103.7,47.54,3920.0,193
HCPCS,20552,NJX 1/MLT TRIGGER POINT 1/2,,,38.49,38.49,1
HCPCS,20552,TRIGGER POINT INJECTION MULTI 1-2 MUSCLE GR,290.0,188.5,26.7,217.5,35
HCPCS,205520,NJX 1/MLT TRIGGER POINT 1/2,,,38.49,38.49,1
HCPCS,20553,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,1698.0,1103.7,54.21,3920.0,193
HCPCS,20553,NJX 1/MLT TRIGGER POINTS 3/>,,,43.73,43.73,1
HCPCS,20553,TRIGGER POINT INJECTION MULTI 3+ MUSCLE GRP,330.0,214.5,32.19,247.5,35
HCPCS,205530,NJX 1/MLT TRIGGER POINTS 3/>,,,43.73,43.73,1
HCPCS,20555,PLACE NDL MUSC/TIS FOR RT,,,348.76,7034.85,15
HCPCS,20555,Place ndl musc/tis for rt,,,1112.95,1405.84,6
HCPCS,205550,PLACE NDL MUSC/TIS FOR RT,,,348.76,348.76,1
HCPCS,20560,NDL INSJ W/O NJX 1 OR 2 MUSC,,,15.48,15.48,1
HCPCS,20560,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,141.0,91.65,11.25,26432.0,248
HCPCS,205600,NDL INSJ W/O NJX 1 OR 2 MUSC,,,15.48,15.48,1
HCPCS,20561,NDL INSJ W/O NJX 3+ MUSC,,,23.24,23.24,1
HCPCS,20561,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,176.0,114.4,16.97,26432.0,343
HCPCS,205610,NDL INSJ W/O NJX 3+ MUSC,,,23.24,23.24,1
HCPCS,20600,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,994.0,646.1,24.35,3920.0,277
HCPCS,20600,DRAIN/INJ JOINT/BURSA W/O US,,,37.55,37.55,1
HCPCS,206000,DRAIN/INJ JOINT/BURSA W/O US,,,37.55,37.55,1
HCPCS,20604,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,1045.0,679.25,34.35,3920.0,175
HCPCS,20604,DRAIN/INJ JOINT/BURSA W/US,,,47.82,47.82,1
HCPCS,206040,DRAIN/INJ JOINT/BURSA W/US,,,47.82,47.82,1
HCPCS,20605,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,998.5,649.025,34.49,3920.0,277
HCPCS,20605,DRAIN/INJ JOINT/BURSA W/O US,,,38.6,38.6,1
HCPCS,206050,DRAIN/INJ JOINT/BURSA W/O US,,,38.6,38.6,1
HCPCS,20606,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,2211.5,1437.475,38.85,3920.0,224
HCPCS,20606,DRAIN/INJ JOINT/BURSA W/US,,,54.53,54.53,1
HCPCS,206060,DRAIN/INJ JOINT/BURSA W/US,,,54.53,54.53,1
HCPCS,2060F,PT INTRVWD ON/BEFORE DX MDD,,,0.01,0.01,1
HCPCS,2060F0,PT INTRVWD ON/BEFORE DX MDD,,,0.01,0.01,1
HCPCS,20610,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1023.0,664.95,28.34,3920.0,372
HCPCS,20610,DRAIN/INJ JOINT/BURSA W/O US,,,47.64,47.64,1
HCPCS,206100,DRAIN/INJ JOINT/BURSA W/O US,,,47.64,47.64,1
HCPCS,20611,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,1091.0,709.1500000000001,45.64,3920.0,224
HCPCS,20611,DRAIN/INJ JOINT/BURSA W/US,,,61.82,61.82,1
HCPCS,206110,DRAIN/INJ JOINT/BURSA W/US,,,61.82,61.82,1
HCPCS,20612,ASPIRATE/INJ GANGLION CYST,,,42.96,42.96,1
HCPCS,20612,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,1003.0,651.95,29.91,3920.0,228
HCPCS,206120,ASPIRATE/INJ GANGLION CYST,,,42.96,42.96,1
HCPCS,20615,ASPIRATION & INJECTION TREATMENT BONE CYST,2489.0,1617.85,77.43,4214.0,130
HCPCS,20615,TREATMENT OF BONE CYST,,,169.33,169.33,1
HCPCS,206150,TREATMENT OF BONE CYST,,,169.33,169.33,1
HCPCS,20650,INSERT AND REMOVE BONE PIN,,,174.64,174.64,1
HCPCS,20650,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,9784.0,6359.599999999999,78.25,16790.4,119
HCPCS,206500,INSERT AND REMOVE BONE PIN,,,174.64,174.64,1
HCPCS,20660,APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX,1600.0,1040.0,117.04,1600.0,35
HCPCS,20660,APPLY REM FIXATION DEVICE,,,254.22,3469.95,15
HCPCS,20660,Apply rem fixation device,,,1450.73,1832.5,6
HCPCS,206600,APPLY REM FIXATION DEVICE,,,254.22,254.22,1
HCPCS,20661,APPLICATION HALO CRANIAL,,,550.96,1847.11,5
HCPCS,20661,APPLICATION HALO CRANIAL INCLUDING REMOVAL,2104.0,1367.6,249.53,2104.0,35
HCPCS,20661,Application halo cranial,,,1450.73,1832.5,6
HCPCS,206610,APPLICATION HALO CRANIAL,,,550.96,550.96,1
HCPCS,20662,APPLICATION HALO PELVIC,,,547.55,3469.95,15
HCPCS,20662,Application halo pelvic,,,1450.73,1832.5,6
HCPCS,206620,APPLICATION HALO PELVIC,,,547.55,547.55,1
HCPCS,20663,APPLICATION HALO FEMORAL,,,505.4,7034.85,15
HCPCS,20663,Application halo femoral,,,1450.73,1832.5,6
HCPCS,206630,APPLICATION HALO FEMORAL,,,505.4,505.4,1
HCPCS,20664,APPL HALO CRANIAL 6+PINS,,,942.33,1847.11,5
HCPCS,20664,Appl halo cranial 6+pins,,,1450.73,1832.5,6
HCPCS,206640,APPL HALO CRANIAL 6+PINS,,,942.33,942.33,1
HCPCS,20665,REMOVAL TONG/HALO APPLIED BY ANOTHER INDIVIDUAL,544.0,353.6,69.57,408.0,35
HCPCS,20665,RMVL TONGS/HALO ANTHR INDIV,,,101.12,865.18,15
HCPCS,20665,Rmvl tongs/halo anthr indiv,,,114.29,144.36,6
HCPCS,206650,RMVL TONGS/HALO ANTHR INDIV,,,101.12,101.12,1
HCPCS,20670,REMOVAL IMPLANT SUPERFICIAL,,,150.36,150.36,1
HCPCS,20670,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,5052.0,3283.7999999999997,73.65,8384.4,179
HCPCS,206700,REMOVAL IMPLANT SUPERFICIAL,,,150.36,150.36,1
HCPCS,20680,REMOVAL DEEP IMPLANT,2622.0,1704.3,203.67,1966.5,35
HCPCS,20680,REMOVAL IMPLANT DEEP,16456.0,10696.4,500.91,36332.0,46
HCPCS,20680,REMOVAL OF IMPLANT DEEP,,,439.98,439.98,1
HCPCS,206800,REMOVAL OF IMPLANT DEEP,,,439.98,439.98,1
HCPCS,20690,APPL UNIPLN UNI EXT FIXJ SYS,,,626.46,15488.78,15
HCPCS,20690,APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM,3512.0,2282.8,290.62,3512.0,35
HCPCS,20690,Appl unipln uni ext fixj sys,,,1450.73,1832.5,6
HCPCS,206900,APPL UNIPLN UNI EXT FIXJ SYS,,,626.46,626.46,1
HCPCS,20692,APPL MLTPLN UNI EXT FIXJ SYS,,,1181.16,27897.39,15
HCPCS,20692,APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM,6508.0,4230.2,544.59,6508.0,35
HCPCS,20692,Appl mltpln uni ext fixj sys,,,1450.73,1832.5,6
HCPCS,206920,APPL MLTPLN UNI EXT FIXJ SYS,,,1181.16,1181.16,1
HCPCS,20693,ADJMT/REVJ EXT FIXJ SYS ANES,,,468.62,15488.78,15
HCPCS,20693,ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES,2424.0,1575.6,253.73,2424.0,35
HCPCS,20693,Adjmt/revj ext fixj sys anes,,,1450.73,1832.5,6
HCPCS,206930,ADJMT/REVJ EXT FIXJ SYS ANES,,,468.62,468.62,1
HCPCS,20694,REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES,1712.0,1112.8,165.53,1284.0,35
HCPCS,20694,RMVL EXT FIXJ SYS UNDER ANES,,,358.38,3469.95,15
HCPCS,20694,Rmvl ext fixj sys under anes,,,1450.73,1832.5,6
HCPCS,206940,RMVL EXT FIXJ SYS UNDER ANES,,,358.38,358.38,1
HCPCS,20696,APP MLTPLN UNI XTRNL FIX 1ST,,,1218.79,39872.66,15
HCPCS,20696,App mltpln uni xtrnl fix 1st,,,1450.73,1832.5,6
HCPCS,206960,APP MLTPLN UNI XTRNL FIX 1ST,,,1218.79,1218.79,1
HCPCS,20697,APP MLTPLN UNI XTRNL FIX XCH,,,1606.46,3469.95,15
HCPCS,20697,App mltpln uni xtrnl fix xch,,,1450.73,1832.5,6
HCPCS,20697,XTRNL FIXJ W/STRTCTC ADJUSTMENT EXCHANGE STRUT,8468.0,5504.2,928.75,8468.0,35
HCPCS,206970,APP MLTPLN UNI XTRNL FIX XCH,,,1739.2,1739.2,1
HCPCS,20700,MANUAL PREP AND INSERTION DEEP DRUG DELIVERY DEV,600.0,390.0,64.09,600.0,31
HCPCS,20700,MNL PREP&INSJ DP RX DLVR DEV,,,88.6,88.6,1
HCPCS,207000,MNL PREP&INSJ DP RX DLVR DEV,,,88.6,88.6,1
HCPCS,20701,REMOVAL DEEP DRUG DELIVERY DEVICE,497.0,323.05,48.75,497.0,31
HCPCS,20701,RMVL DEEP RX DELIVERY DEVICE,,,67.13,67.13,1
HCPCS,207010,RMVL DEEP RX DELIVERY DEVICE,,,67.13,67.13,1
HCPCS,20702,MANUAL PREP&AMP;INSJ INTRAMEDULLARY DRUG DLVR DEVICE,1000.0,650.0,108.84,1000.0,31
HCPCS,20702,MNL PREP&INSJ IMED RX DEV,,,149.01,149.01,1
HCPCS,207020,MNL PREP&INSJ IMED RX DEV,,,149.01,149.01,1
HCPCS,20703,REMOVAL INTRAMEDULLARY DRUG DELIVERY DEVICE,720.0,468.0,77.96,720.0,31
HCPCS,20703,RMVL IMED RX DELIVERY DEVICE,,,108.91,108.91,1
HCPCS,207030,RMVL IMED RX DELIVERY DEVICE,,,108.91,108.91,1
HCPCS,20704,MANUAL PREP&AMP;INSJ I-ARTIC DRUG DELIVERY DEVICE,1040.0,676.0,113.39,1040.0,31
HCPCS,20704,MNL PREP&INSJ I-ARTIC RX DEV,,,156.66,156.66,1
HCPCS,207040,MNL PREP&INSJ I-ARTIC RX DEV,,,156.66,156.66,1
HCPCS,20705,REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE,860.0,559.0,93.26,860.0,31
HCPCS,20705,RMVL I-ARTIC RX DELIVERY DEV,,,129.61,129.61,1
HCPCS,207050,RMVL I-ARTIC RX DELIVERY DEV,,,129.61,129.61,1
HCPCS,20802,REPLANTATION ARM COMPLETE,,,2867.17,20141.22,5
HCPCS,20802,Replantation arm complete,,,5924.91,7484.1,6
HCPCS,208020,REPLANTATION ARM COMPLETE,,,2867.17,2867.17,1
HCPCS,20805,REPLANT FOREARM COMPLETE,,,3406.87,20141.22,5
HCPCS,20805,Replant forearm complete,,,3488.43,4406.44,6
HCPCS,208050,REPLANT FOREARM COMPLETE,,,3406.87,3406.87,1
HCPCS,20808,REPLANTATION HAND COMPLETE,,,4112.05,20141.22,5
HCPCS,20808,Replantation hand complete,,,1326.89,1676.08,6
HCPCS,208080,REPLANTATION HAND COMPLETE,,,4112.05,4112.05,1
HCPCS,20816,REPLANTATION DIGIT COMPLETE,,,1679.19,2146.71,5
HCPCS,20816,RPLJ DGT EXCEPT THMB MTCARPHLNGL JT COMPL AMP,14058.0,9137.7,1552.33,14058.0,35
HCPCS,20816,Replantation digit complete,,,1326.89,1676.08,6
HCPCS,208160,REPLANTATION DIGIT COMPLETE,,,2146.71,2146.71,1
HCPCS,20822,REPLANTATION DIGIT COMPLETE,,,1606.46,3469.95,15
HCPCS,20822,RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP,11730.0,7624.5,1361.69,11730.0,35
HCPCS,20822,Replantation digit complete,,,1326.89,1676.08,6
HCPCS,208220,REPLANTATION DIGIT COMPLETE,,,1853.13,1853.13,1
HCPCS,20824,REPLANTATION THUMB COMPLETE,,,1679.19,2150.64,5
HCPCS,20824,Replantation thumb complete,,,1326.89,1676.08,6
HCPCS,208240,REPLANTATION THUMB COMPLETE,,,2150.64,2150.64,1
HCPCS,20827,REPLANTATION THUMB COMPLETE,,,1679.19,1902.68,5
HCPCS,20827,RPLJ THUMB DISTAL TIP MP JOINT COMPL AMPUTATION,10992.0,7144.8,1396.52,10992.0,35
HCPCS,20827,Replantation thumb complete,,,1326.89,1676.08,6
HCPCS,208270,REPLANTATION THUMB COMPLETE,,,1902.68,1902.68,1
HCPCS,20838,REPLANTATION FOOT COMPLETE,,,2908.18,20141.22,5
HCPCS,20838,Replantation foot complete,,,3613.7,4564.67,6
HCPCS,208380,REPLANTATION FOOT COMPLETE,,,2908.18,2908.18,1
HCPCS,20900,BONE GRAFT ANY DONOR AREA MINOR/SMALL,1200.0,780.0,126.39,900.0,35
HCPCS,20900,REMOVAL OF BONE FOR GRAFT,,,188.32,15488.78,15
HCPCS,20900,Removal of bone for graft,,,1181.56,1492.5,6
HCPCS,209000,REMOVAL OF BONE FOR GRAFT,,,188.32,188.32,1
HCPCS,20902,BONE GRAFT ANY DONOR AREA MAJOR/LARGE,1832.0,1190.8,210.13,1832.0,35
HCPCS,20902,REMOVAL OF BONE FOR GRAFT,,,287.59,15488.78,15
HCPCS,20902,Removal of bone for graft,,,1181.56,1492.5,6
HCPCS,209020,REMOVAL OF BONE FOR GRAFT,,,287.59,287.59,1
HCPCS,20910,CARTILAGE GRAFT COSTOCHONDRAL,2212.0,1437.8,233.12,2212.0,35
HCPCS,20910,REMOVE CARTILAGE FOR GRAFT,,,499.31,1327.2,15
HCPCS,20910,Remove cartilage for graft,,,1181.56,1492.5,6
HCPCS,209100,REMOVE CARTILAGE FOR GRAFT,,,499.31,499.31,1
HCPCS,20912,CARTILAGE GRAFT NASAL SEPTUM,2616.0,1700.4,305.51,2616.0,35
HCPCS,20912,REMOVE CARTILAGE FOR GRAFT,,,504.26,7937.59,15
HCPCS,20912,Remove cartilage for graft,,,1181.56,1492.5,6
HCPCS,209120,REMOVE CARTILAGE FOR GRAFT,,,504.26,504.26,1
HCPCS,20920,FASCIA LATA GRAFT BY STRIPPER,2204.0,1432.6,253.37,2204.0,35
HCPCS,20920,REMOVAL OF FASCIA FOR GRAFT,,,418.4,3966.07,15
HCPCS,20920,Removal of fascia for graft,,,1181.56,1492.5,6
HCPCS,209200,REMOVAL OF FASCIA FOR GRAFT,,,418.4,418.4,1
HCPCS,20922,FASCIA LATA GRAFT INCISION & AREA EXPOSURE,2772.0,1801.8,237.37,2079.0,35
HCPCS,20922,REMOVAL OF FASCIA FOR GRAFT,,,523.93,3966.07,15
HCPCS,20922,Removal of fascia for graft,,,1181.56,1492.5,6
HCPCS,209220,REMOVAL OF FASCIA FOR GRAFT,,,523.93,523.93,1
HCPCS,20924,REMOVAL OF TENDON FOR GRAFT,,,528.55,15488.78,15
HCPCS,20924,Removal of tendon for graft,,,1181.56,1492.5,6
HCPCS,20924,TENDON GRAFT FROM A DISTANCE,2672.0,1736.8,329.05,2672.0,35
HCPCS,209240,REMOVAL OF TENDON FOR GRAFT,,,528.55,528.55,1
HCPCS,20930,ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED,767.0,498.55,237.21,767.0,13
HCPCS,20930,SP BONE ALGRFT MORSEL ADD-ON,,,121.32,3102.0,3
HCPCS,20930,Sp bone algrft morsel add-on,,,6141.85,7758.12,6
HCPCS,209300,SP BONE ALGRFT MORSEL ADD-ON,,,121.32,121.32,1
HCPCS,20931,ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL,724.0,470.6,85.02,724.0,35
HCPCS,20931,SP BONE ALGRFT STRUCT ADD-ON,,,116.46,116.46,1
HCPCS,20931,Sp bone algrft struct add-on,,,6141.85,7758.12,6
HCPCS,209310,SP BONE ALGRFT STRUCT ADD-ON,,,116.46,116.46,1
HCPCS,20932,OSTEOART ALGRFT W/SURF & B1,,,788.03,788.03,1
HCPCS,20932,OSTEOARTIUCLAR ALLOGRAFT W/ARTICULAR SURF & BONE,5204.0,3382.6,550.41,5204.0,31
HCPCS,20932,Osteoart algrft w/surf & b1,,,1181.56,1492.5,6
HCPCS,209320,OSTEOART ALGRFT W/SURF & B1,,,788.03,788.03,1
HCPCS,20933,HEMICORTICAL INTERCALARY ALLOGRAFT PARTIAL,4776.0,3104.4,504.84,4776.0,31
HCPCS,20933,HEMICRT INTRCLRY ALGRFT PRTL,,,722.68,722.68,1
HCPCS,20933,Hemicrt intrclry algrft prtl,,,1181.56,1492.5,6
HCPCS,209330,HEMICRT INTRCLRY ALGRFT PRTL,,,722.68,722.68,1
HCPCS,20934,INTERCALARY ALGRFT COMPL,,,787.34,787.34,1
HCPCS,20934,INTERCALARY ALLOGRAFT COMPLETE,5200.0,3380.0,550.14,5200.0,31
HCPCS,20934,Intercalary algrft compl,,,1181.56,1492.5,6
HCPCS,209340,INTERCALARY ALGRFT COMPL,,,787.34,787.34,1
HCPCS,20936,AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION,1089.0,707.85,253.79,1089.0,13
HCPCS,20936,SP BONE AGRFT LOCAL ADD-ON,,,129.65,4107.0,3
HCPCS,20936,Sp bone agrft local add-on,,,6141.85,7758.12,6
HCPCS,209360,SP BONE AGRFT LOCAL ADD-ON,,,129.65,129.65,1
HCPCS,20937,AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION,1116.0,725.4,128.17,1116.0,35
HCPCS,20937,SP BONE AGRFT MORSEL ADD-ON,,,175.53,175.53,1
HCPCS,20937,Sp bone agrft morsel add-on,,,6141.85,7758.12,6
HCPCS,209370,SP BONE AGRFT MORSEL ADD-ON,,,175.53,175.53,1
HCPCS,20938,AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC,1208.0,785.2,140.17,1208.0,35
HCPCS,20938,SP BONE AGRFT STRUCT ADD-ON,,,193.76,193.76,1
HCPCS,20938,Sp bone agrft struct add-on,,,6141.85,7758.12,6
HCPCS,209380,SP BONE AGRFT STRUCT ADD-ON,,,193.76,193.76,1
HCPCS,20939,BONE MARROW ASPIR BONE GRFG,,,73.32,73.32,1
HCPCS,20939,BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY,757.0,492.05,51.45,7758.12,69
HCPCS,209390,BONE MARROW ASPIR BONE GRFG,,,73.32,73.32,1
HCPCS,20950,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,2275.0,1478.75,44.96,4151.0,130
HCPCS,20950,MNTR INTRSTITIAL FLUID PRESS,,,92.11,92.11,1
HCPCS,209500,MNTR INTRSTITIAL FLUID PRESS,,,92.11,92.11,1
HCPCS,20955,BONE GRAFT MICROVASCULAR ANASTOMOSIS FIBULA,17714.0,11514.1,1871.78,17714.0,35
HCPCS,20955,FIBULA BONE GRAFT MICROVASC,,,2547.61,8335.26,5
HCPCS,20955,Fibula bone graft microvasc,,,4645.92,5868.53,6
HCPCS,209550,FIBULA BONE GRAFT MICROVASC,,,2547.61,2547.61,1
HCPCS,20956,ILIAC BONE GRAFT MICROVASC,,,2757.39,8335.26,5
HCPCS,20956,Iliac bone graft microvasc,,,2390.81,3019.97,6
HCPCS,209560,ILIAC BONE GRAFT MICROVASC,,,2757.39,2757.39,1
HCPCS,20957,MT BONE GRAFT MICROVASC,,,2872.05,8335.26,5
HCPCS,20957,Mt bone graft microvasc,,,3613.7,4564.67,6
HCPCS,209570,MT BONE GRAFT MICROVASC,,,2872.05,2872.05,1
HCPCS,20962,BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR,15684.0,10194.6,1895.78,15684.0,35
HCPCS,20962,OTHER BONE GRAFT MICROVASC,,,2785.31,8335.26,5
HCPCS,20962,Other bone graft microvasc,,,4645.92,5868.53,6
HCPCS,209620,OTHER BONE GRAFT MICROVASC,,,2785.31,2785.31,1
HCPCS,20969,BONE/SKIN GRAFT MICROVASC,,,2832.2,8335.26,5
HCPCS,20969,Bone/skin graft microvasc,,,4645.92,5868.53,6
HCPCS,20969,FREE OSTQ FLAP W/MVASC ANAST METAR/GREAT TOE,18172.0,11811.8,2076.55,18172.0,35
HCPCS,209690,BONE/SKIN GRAFT MICROVASC,,,2832.2,2832.2,1
HCPCS,20970,BONE/SKIN GRAFT ILIAC CREST,,,2975.09,8335.26,5
HCPCS,20970,Bone/skin graft iliac crest,,,2390.81,3019.97,6
HCPCS,209700,BONE/SKIN GRAFT ILIAC CREST,,,2975.09,2975.09,1
HCPCS,20972,BONE/SKIN GRAFT METATARSAL,,,2966.63,15488.78,15
HCPCS,20972,Bone/skin graft metatarsal,,,3613.7,4564.67,6
HCPCS,209720,BONE/SKIN GRAFT METATARSAL,,,2966.63,2966.63,1
HCPCS,20973,BONE/SKIN GRAFT GREAT TOE,,,3134.28,15488.78,15
HCPCS,20973,Bone/skin graft great toe,,,3613.7,4564.67,6
HCPCS,209730,BONE/SKIN GRAFT GREAT TOE,,,3134.28,3134.28,1
HCPCS,20974,ELECTRICAL STIMULATION BONE HEALING NONINVASIVE,248.0,161.2,33.78,186.0,35
HCPCS,20974,ESTIM AID BONE HEALG N-INVAS,,,53.13,125.68,22
HCPCS,20974,Estim aid bone healg n-invas,,,114.29,144.36,6
HCPCS,209740,ESTIM AID BONE HEALG N-INVAS,,,53.13,53.13,1
HCPCS,20975,ELECTRICAL STIMULATION BONE HEALING INVASIVE,1040.0,676.0,132.23,1040.0,35
HCPCS,20975,ESTIM AID BONE HEALG INVASIV,,,184.55,184.55,1
HCPCS,20975,Estim aid bone healg invasiv,,,1112.95,1405.84,6
HCPCS,209750,ESTIM AID BONE HEALG INVASIV,,,184.55,184.55,1
HCPCS,20979,LOW INTENSITY US STIMJ BONE HEALING NONINVASIVE,248.0,161.2,24.59,186.0,32
HCPCS,20979,LW NTSTY US STIMJ BONE HEALG,,,24.58,53.1,15
HCPCS,20979,Lw ntsty us stimj bone healg,,,114.29,144.36,6
HCPCS,209790,LW NTSTY US STIMJ BONE HEALG,,,33.49,33.49,1
HCPCS,20982,ABLATE BONE TUMOR(S) PERQ,,,381.56,381.56,1
HCPCS,20982,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,38396.0,24957.399999999998,283.87,66585.6,158
HCPCS,209820,ABLATE BONE TUMOR(S) PERQ,,,381.56,381.56,1
HCPCS,20983,ABLATE BONE TUMOR(S) PERQ,,,354.91,354.91,1
HCPCS,20983,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,21914.0,14244.1,302.31,36968.4,196
HCPCS,209830,ABLATE BONE TUMOR(S) PERQ,,,354.91,354.91,1
HCPCS,20985,CPTR-ASST DIR MS PX,,,151.06,151.06,1
HCPCS,20985,CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS,1000.0,650.0,92.55,1000.0,35
HCPCS,209850,CPTR-ASST DIR MS PX,,,151.06,151.06,1
HCPCS,20999,BONE MARROW ASPIRATE CONCENTRATE 2 JOINTS,4900.0,3185.0,285.32,4900.0,15
HCPCS,20999,BONE MARROW ASPIRATION AND INJECTION,3900.0,2535.0,285.32,3900.0,15
HCPCS,20999,CRYOABLATION OF SOFT TISSUE  MASS (COMP CODE 20983),21914.0,14244.1,240.79,36968.4,63
HCPCS,20999,LIPOGEMS 2 JOINT,5400.0,3510.0,285.32,5400.0,15
HCPCS,20999,LIPOGEMS ? AUTOLOGOUS ADIPOSE TISSUE HARVESTING/INJECTION,3500.0,2275.0,285.32,3500.0,15
HCPCS,20999,PROC MUSSKL SYS UNLISTD,2797.0,1818.05,240.79,8370.0,93
HCPCS,20999,RADIOFREQUENCY ABLATION SOFT TISSUE MASS (COMP CODE 20982),38396.0,24957.399999999998,240.79,66585.6,63
HCPCS,20999,RFA MSK TUMOR (COMP CODE 20982),38396.0,24957.399999999998,240.79,66585.6,63
HCPCS,20999,SHOCK WAVE THERAPY,190.0,123.5,95.0,342.38,15
HCPCS,21010,ARTHROTOMY TEMPOROMANDIBULAR JOINT,4416.0,2870.4,506.34,4416.0,35
HCPCS,21010,INCISION OF JAW JOINT,,,767.76,7031.51,15
HCPCS,21010,Incision of jaw joint,,,1664.64,2102.7,6
HCPCS,210100,INCISION OF JAW JOINT,,,767.76,767.76,1
HCPCS,21011,EXC FACE LES SC <2 CM,,,270.86,270.86,1
HCPCS,21011,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ < 2CM,1196.0,777.4,125.91,897.0,35
HCPCS,21011,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM,9316.0,6055.4,321.7,8384.4,46
HCPCS,210110,EXC FACE LES SC <2 CM,,,270.86,270.86,1
HCPCS,21012,EXC FACE LES SBQ 2 CM/>,,,355.23,355.23,1
HCPCS,21012,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>,9316.0,6055.4,404.25,8384.4,46
HCPCS,21012,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2+CM,1780.0,1157.0,182.86,1780.0,35
HCPCS,210120,EXC FACE LES SBQ 2 CM/>,,,355.23,355.23,1
HCPCS,21013,EXC FACE TUM DEEP < 2 CM,,,420.13,4989.0,16
HCPCS,21013,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL < 2CM,2168.0,1409.2,195.45,1626.0,35
HCPCS,21013,Exc face tum deep < 2 cm,,,1112.95,1405.84,6
HCPCS,210130,EXC FACE TUM DEEP < 2 CM,,,420.13,420.13,1
HCPCS,21014,EXC FACE TUM DEEP 2 CM/>,,,545.54,545.54,1
HCPCS,21014,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>,16456.0,10696.4,607.54,14810.4,46
HCPCS,21014,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2+CM,2852.0,1853.8,282.87,2852.0,35
HCPCS,210140,EXC FACE TUM DEEP 2 CM/>,,,545.54,545.54,1
HCPCS,21015,RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM,3956.0,2571.4,340.27,3956.0,35
HCPCS,21015,RESECT FACE/SCALP TUM < 2 CM,,,727.96,6205.4,15
HCPCS,21015,Resect face/scalp tum < 2 cm,,,1112.95,1405.84,6
HCPCS,210150,RESECT FACE/SCALP TUM < 2 CM,,,727.96,727.96,1
HCPCS,21016,RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2+CM,6104.0,3967.6,572.67,6104.0,35
HCPCS,21016,RESECT FACE/SCALP TUM 2 CM/>,,,1053.85,6205.4,15
HCPCS,21016,Resect face/scalp tum 2 cm/>,,,1112.95,1405.84,6
HCPCS,210160,RESECT FACE/SCALP TUM 2 CM/>,,,1053.85,1053.85,1
HCPCS,21025,EXCISION BONE MANDIBLE,4012.0,2607.8,394.78,3009.0,35
HCPCS,21025,EXCISION OF BONE LOWER JAW,,,688.28,12826.13,15
HCPCS,21025,Excision of bone lower jaw,,,1664.64,2102.7,6
HCPCS,210250,EXCISION OF BONE LOWER JAW,,,688.28,688.28,1
HCPCS,21026,EXCISION OF FACIAL BONE(S),2280.0,1482.0,206.96,12826.13,50
HCPCS,21026,Excision of facial bone(s),,,1664.64,2102.7,6
HCPCS,210260,EXCISION OF FACIAL BONE(S),,,443.64,443.64,1
HCPCS,21029,CONTOUR OF FACE BONE LESION,,,650.82,7031.51,15
HCPCS,21029,Contour of face bone lesion,,,1664.64,2102.7,6
HCPCS,21029,REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE,3356.0,2181.4,319.07,2517.0,35
HCPCS,210290,CONTOUR OF FACE BONE LESION,,,650.82,650.82,1
HCPCS,21030,EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG,1964.0,1276.6,199.38,1473.0,35
HCPCS,21030,EXCISE MAX/ZYGOMA B9 TUMOR,,,372.84,12826.13,15
HCPCS,21030,Excise max/zygoma b9 tumor,,,1664.64,2102.7,6
HCPCS,210300,EXCISE MAX/ZYGOMA B9 TUMOR,,,372.84,372.84,1
HCPCS,21031,EXCISION TORUS MANDIBULARIS,1320.0,858.0,132.97,990.0,35
HCPCS,21031,REMOVE EXOSTOSIS MANDIBLE,,,280.61,7031.51,15
HCPCS,21031,Remove exostosis mandible,,,1664.64,2102.7,6
HCPCS,210310,REMOVE EXOSTOSIS MANDIBLE,,,280.61,280.61,1
HCPCS,21032,EXCISION MAXILLARY TORUS PALATINUS,1336.0,868.4,134.79,1002.0,35
HCPCS,21032,REMOVE EXOSTOSIS MAXILLA,,,269.32,7031.51,15
HCPCS,21032,Remove exostosis maxilla,,,1664.64,2102.7,6
HCPCS,210320,REMOVE EXOSTOSIS MAXILLA,,,269.32,269.32,1
HCPCS,21034,EXCISE MAX/ZYGOMA MAL TUMOR,,,1172.88,12826.13,15
HCPCS,21034,EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA,7647.0,4970.55,548.05,5735.25,35
HCPCS,21034,Excise max/zygoma mal tumor,,,3243.49,4097.04,6
HCPCS,210340,EXCISE MAX/ZYGOMA MAL TUMOR,,,1172.88,1172.88,1
HCPCS,21040,EXCISE MANDIBLE LESION,,,374.14,7031.51,15
HCPCS,21040,EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT,1964.0,1276.6,176.71,1473.0,35
HCPCS,21040,Excise mandible lesion,,,1664.64,2102.7,6
HCPCS,210400,EXCISE MANDIBLE LESION,,,374.14,374.14,1
HCPCS,21044,EXCISION MALIGNANT TUMOR MANDIBLE,5120.0,3328.0,568.17,5120.0,35
HCPCS,21044,REMOVAL OF JAW BONE LESION,,,898.78,12826.13,15
HCPCS,21044,Removal of jaw bone lesion,,,3243.49,4097.04,6
HCPCS,210440,REMOVAL OF JAW BONE LESION,,,898.78,898.78,1
HCPCS,21045,EXCISION MALIGNANT TUMOR MANDIBLE RADICAL,7348.0,4776.2,789.69,7348.0,35
HCPCS,21045,EXTENSIVE JAW SURGERY,,,1249.34,6800.15,5
HCPCS,21045,Extensive jaw surgery,,,3243.49,4097.04,6
HCPCS,210450,EXTENSIVE JAW SURGERY,,,1249.34,1249.34,1
HCPCS,21046,EXC BENIGN TUMOR/CYST MNDBL INTRA-ORAL OSTEOT,5684.0,3694.6,612.05,5684.0,35
HCPCS,21046,REMOVE MANDIBLE CYST COMPLEX,,,1020.41,12826.13,15
HCPCS,21046,Remove mandible cyst complex,,,3243.49,4097.04,6
HCPCS,210460,REMOVE MANDIBLE CYST COMPLEX,,,1020.41,1020.41,1
HCPCS,21047,EXC B9 TUM/CST MNDBL XTR-ORAL OSTEOT&PRTL MNDB,8028.0,5218.2,758.52,8028.0,35
HCPCS,21047,EXCISE LWR JAW CYST W/REPAIR,,,1260.59,12826.13,15
HCPCS,21047,Excise lwr jaw cyst w/repair,,,3243.49,4097.04,6
HCPCS,210470,EXCISE LWR JAW CYST W/REPAIR,,,1260.59,1260.59,1
HCPCS,21048,EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT,5884.0,3824.6,629.9,5884.0,35
HCPCS,21048,REMOVE MAXILLA CYST COMPLEX,,,1030.69,12826.13,15
HCPCS,21048,Remove maxilla cyst complex,,,3243.49,4097.04,6
HCPCS,210480,REMOVE MAXILLA CYST COMPLEX,,,1030.69,1030.69,1
HCPCS,21049,EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC,7728.0,5023.2,718.66,7728.0,35
HCPCS,21049,EXCIS UPPR JAW CYST W/REPAIR,,,1199.02,12826.13,15
HCPCS,21049,Excis uppr jaw cyst w/repair,,,3243.49,4097.04,6
HCPCS,210490,EXCIS UPPR JAW CYST W/REPAIR,,,1199.02,1199.02,1
HCPCS,21050,REMOVAL OF JAW JOINT,,,889.92,12826.13,15
HCPCS,21050,Removal of jaw joint,,,3243.49,4097.04,6
HCPCS,210500,REMOVAL OF JAW JOINT,,,889.92,889.92,1
HCPCS,21060,MENISCECTOMY PRTL/COMPL TEMPOROMANDIBULAR JT SPX,4428.0,2878.2,540.19,4428.0,35
HCPCS,21060,REMOVE JAW JOINT CARTILAGE,,,808.14,12826.13,15
HCPCS,21060,Remove jaw joint cartilage,,,3243.49,4097.04,6
HCPCS,210600,REMOVE JAW JOINT CARTILAGE,,,808.14,808.14,1
HCPCS,21070,CORONOIDECTOMY SEPARATE PROCEDURE,3448.0,2241.2,402.08,3448.0,35
HCPCS,21070,REMOVE CORONOID PROCESS,,,637.64,12826.13,15
HCPCS,21070,Remove coronoid process,,,3243.49,4097.04,6
HCPCS,210700,REMOVE CORONOID PROCESS,,,637.64,637.64,1
HCPCS,21073,MNPJ OF TMJ W/ANESTH,,,248.89,3211.66,15
HCPCS,21073,Mnpj of tmj w/anesth,,,632.74,799.25,6
HCPCS,210730,MNPJ OF TMJ W/ANESTH,,,248.89,248.89,1
HCPCS,21076,IMPRES&PREP SURG OBT PROSTH,,,738.77,3211.66,15
HCPCS,21076,Impres&prep surg obt prosth,,,1105.23,1396.08,6
HCPCS,210760,IMPRES&PREP SURG OBT PROSTH,,,738.77,738.77,1
HCPCS,21077,IMPRES&PREP ORBITAL PROSTH,,,1819.93,12826.13,15
HCPCS,21077,Impres&prep orbital prosth,,,1829.98,2311.55,6
HCPCS,210770,IMPRES&PREP ORBITAL PROSTH,,,1819.93,1819.93,1
HCPCS,21079,IMPRES&PREP INTRM OBT PROSTH,,,1222.23,7031.51,15
HCPCS,21079,Impres&prep intrm obt prosth,,,1105.23,1396.08,6
HCPCS,210790,IMPRES&PREP INTRM OBT PROSTH,,,1222.23,1222.23,1
HCPCS,21080,IMPRES&PREP DEF OBT PROSTH,,,1378.57,7031.51,15
HCPCS,21080,Impres&prep def obt prosth,,,1105.23,1396.08,6
HCPCS,210800,IMPRES&PREP DEF OBT PROSTH,,,1378.57,1378.57,1
HCPCS,21081,IMPRES&PREP MNDBL RES PROSTH,,,1265.24,12826.13,15
HCPCS,21081,Impres&prep mndbl res prosth,,,1829.98,2311.55,6
HCPCS,210810,IMPRES&PREP MNDBL RES PROSTH,,,1265.24,1265.24,1
HCPCS,21082,IMPRES&PREP PALTL AUG PROSTH,,,1166.14,7031.51,15
HCPCS,21082,Impres&prep paltl aug prosth,,,1829.98,2311.55,6
HCPCS,210820,IMPRES&PREP PALTL AUG PROSTH,,,1166.14,1166.14,1
HCPCS,21083,IMPRES&PREP PALTL LFT PROSTH,,,1077.84,7031.51,15
HCPCS,21083,Impres&prep paltl lft prosth,,,1105.23,1396.08,6
HCPCS,210830,IMPRES&PREP PALTL LFT PROSTH,,,1077.84,1077.84,1
HCPCS,21084,IMPRES&PREP SP AID PROSTH,,,1247.7,7031.51,15
HCPCS,21084,Impres&prep sp aid prosth,,,1105.23,1396.08,6
HCPCS,210840,IMPRES&PREP SP AID PROSTH,,,1247.7,1247.7,1
HCPCS,21085,IMPRES&PREP ORAL SURG SPLINT,,,233.1,506.29,15
HCPCS,21085,IMPRESSION & PREPARATION ORAL SURGICAL SPLINT,3596.0,2337.4,306.37,2697.0,35
HCPCS,21085,Impres&prep oral surg splint,,,1105.23,1396.08,6
HCPCS,210850,IMPRES&PREP ORAL SURG SPLINT,,,506.29,506.29,1
HCPCS,21086,IMPRES&PREP AURICULAR PROSTH,,,1341.18,7031.51,15
HCPCS,21086,Impres&prep auricular prosth,,,1829.98,2311.55,6
HCPCS,210860,IMPRES&PREP AURICULAR PROSTH,,,1341.18,1341.18,1
HCPCS,21087,IMPRES&PREP NASAL PROSTH,,,1341.18,12826.13,15
HCPCS,21087,IMPRESSION & PREPARATION NASAL PROSTHESIS,9952.0,6468.8,824.5,7464.0,35
HCPCS,21087,Impres&prep nasal prosth,,,1829.98,2311.55,6
HCPCS,210870,IMPRES&PREP NASAL PROSTH,,,1341.18,1341.18,1
HCPCS,21088,IMPRES&PREP FACIAL PROSTH,,,3255.33,7031.51,15
HCPCS,21088,Impres&prep facial prosth,,,1105.23,1396.08,6
HCPCS,210880,IMPRES&PREP FACIAL PROSTH,,,3567.75,3567.75,1
HCPCS,21089,UNLISTED MAXLFCL PROSTH PX,,,233.1,503.49,14
HCPCS,21089,Unlisted maxlfcl prosth px,,,1105.23,1396.08,6
HCPCS,21100,MAXILLOFACIAL FIXATION,,,368.19,12826.13,15
HCPCS,21100,Maxillofacial fixation,,,1450.73,1832.5,6
HCPCS,211000,MAXILLOFACIAL FIXATION,,,368.19,368.19,1
HCPCS,21110,APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,5457.0,3547.05,518.84,7666.2,84
HCPCS,21110,INTERDENTAL FIXATION,,,720.0,720.0,1
HCPCS,211100,INTERDENTAL FIXATION,,,720.0,720.0,1
HCPCS,21116,INJECTION JAW JOINT X-RAY,,,46.17,46.17,1
HCPCS,21116,INJECTION TEMPOROMANDIBULAR JOINT ARTHROGRAPHY,324.0,210.6,29.53,270.51,35
HCPCS,21116,Injection jaw joint x-ray,,,223.78,282.67,6
HCPCS,211160,INJECTION JAW JOINT X-RAY,,,46.17,46.17,1
HCPCS,21120,GENIOPLASTY AUGMENTATION,2040.0,1326.0,185.01,12826.13,47
HCPCS,21120,Genioplasty augmentation,,,3243.49,4097.04,6
HCPCS,211200,GENIOPLASTY AUGMENTATION,,,521.9,521.9,1
HCPCS,21121,GENIOP SLDG OSTEOT 1,,,549.02,7031.51,15
HCPCS,21121,GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE,3436.0,2233.4,269.04,2577.0,35
HCPCS,21121,Geniop sldg osteot 1,,,1664.64,2102.7,6
HCPCS,211210,GENIOP SLDG OSTEOT 1,,,549.02,549.02,1
HCPCS,21122,GENIOP SLDG OSTEOT 2/>,,,772.16,12826.13,15
HCPCS,21122,GENIOPLASTY 2/> SLIDING OSTEOTOMIES,3484.0,2264.6,390.02,3484.0,32
HCPCS,21122,Geniop sldg osteot 2/>,,,3243.49,4097.04,6
HCPCS,211220,GENIOP SLDG OSTEOT 2/>,,,772.16,772.16,1
HCPCS,21123,GENIOP SLDG AUGMENTATION,,,869.4,7031.51,15
HCPCS,21123,Geniop sldg augmentation,,,1664.64,2102.7,6
HCPCS,211230,GENIOP SLDG AUGMENTATION,,,869.4,869.4,1
HCPCS,21125,AGMNTJ MNDBLR BODY/ANGLE PROSTHETIC MATERIAL,4320.0,2808.0,385.99,5743.04,35
HCPCS,21125,AUGMENTATION MNDBLR PROSTC,,,694.55,12826.13,15
HCPCS,21125,Augmentation mndblr prostc,,,3243.49,4097.04,6
HCPCS,211250,AUGMENTATION MNDBLR PROSTC,,,694.55,694.55,1
HCPCS,21127,AGMNTJ MNDBLR BDY/ANGL W/GRF ONLAY/INTERPOSAL,4976.0,3234.4,491.75,7932.76,35
HCPCS,21127,AUGMENTATION MNDBLR B1 GRF,,,804.54,12826.13,15
HCPCS,21127,Augmentation mndblr b1 grf,,,3243.49,4097.04,6
HCPCS,211270,AUGMENTATION MNDBLR B1 GRF,,,804.54,804.54,1
HCPCS,21137,RDCTJ FOREHEAD CNTRG ONLY,,,781.51,7031.51,15
HCPCS,21137,REDUCTION FOREHEAD; CONTOURING ONLY,4096.0,2662.4,457.33,4096.0,35
HCPCS,21137,Rdctj forehead cntrg only,,,3243.49,4097.04,6
HCPCS,211370,RDCTJ FOREHEAD CNTRG ONLY,,,781.51,781.51,1
HCPCS,21138,RDCTJ FOREHEAD CNTRG&PROSTC,,,951.9,12826.13,15
HCPCS,21138,Rdctj forehead cntrg&prostc,,,3243.49,4097.04,6
HCPCS,211380,RDCTJ FOREHEAD CNTRG&PROSTC,,,951.9,951.9,1
HCPCS,21139,RDCTJ FOREHEAD CNTRG&SETBACK,,,1131.16,12826.13,15
HCPCS,21139,Rdctj forehead cntrg&setback,,,3243.49,4097.04,6
HCPCS,211390,RDCTJ FOREHEAD CNTRG&SETBACK,,,1131.16,1131.16,1
HCPCS,21141,RCNSTJ MIDFACE LEFORT I 1PC,,,1373.28,12826.13,15
HCPCS,21141,"RECONST FACE,LEFORT I,1 PIECE",7828.0,5088.2,853.43,7828.0,35
HCPCS,21141,Rcnstj midface lefort i 1pc,,,3243.49,4097.04,6
HCPCS,211410,RCNSTJ MIDFACE LEFORT I 1PC,,,1373.28,1373.28,1
HCPCS,21142,RCNSTJ MIDFACE LEFORT I 2PCS,,,1409.96,12826.13,15
HCPCS,21142,Rcnstj midface lefort i 2pcs,,,3243.49,4097.04,6
HCPCS,211420,RCNSTJ MIDFACE LEFORT I 2PCS,,,1409.96,1409.96,1
HCPCS,21143,RCNSTJ MDFACE LEFORT I 3/>PC,,,1453.71,12826.13,15
HCPCS,21143,Rcnstj mdface lefort i 3/>pc,,,3243.49,4097.04,6
HCPCS,211430,RCNSTJ MDFACE LEFORT I 3/>PC,,,1453.71,1453.71,1
HCPCS,21145,RCNSTJ MDFC LEFORT I 1 W/GRF,,,1599.46,6800.15,5
HCPCS,21145,Rcnstj mdfc lefort i 1 w/grf,,,3243.49,4097.04,6
HCPCS,211450,RCNSTJ MDFC LEFORT I 1 W/GRF,,,1599.46,1599.46,1
HCPCS,21146,RCNSTJ MDFC LEFORT I 2 W/GRF,,,1670.05,6800.15,5
HCPCS,21146,Rcnstj mdfc lefort i 2 w/grf,,,3243.49,4097.04,6
HCPCS,211460,RCNSTJ MDFC LEFORT I 2 W/GRF,,,1670.05,1670.05,1
HCPCS,21147,RCNSTJ MDFC LEFORT I 3/>GRF,,,1757.75,6800.15,5
HCPCS,21147,Rcnstj mdfc lefort i 3/>grf,,,3243.49,4097.04,6
HCPCS,211470,RCNSTJ MDFC LEFORT I 3/>GRF,,,1757.75,1757.75,1
HCPCS,21150,RCNSTJ MDFC LEFRTII ANT NTRU,,,1712.94,12826.13,15
HCPCS,21150,Rcnstj mdfc lefrtii ant ntru,,,3243.49,4097.04,6
HCPCS,211500,RCNSTJ MDFC LEFRTII ANT NTRU,,,1712.94,1712.94,1
HCPCS,21151,RCNSTJ MDFC LEFRTII W/B1 GRF,,,1886.5,6800.15,5
HCPCS,21151,Rcnstj mdfc lefrtii w/b1 grf,,,3243.49,4097.04,6
HCPCS,211510,RCNSTJ MDFC LEFRTII W/B1 GRF,,,1886.5,1886.5,1
HCPCS,21154,RCNSTJ MDFC LEFORT III W/O I,,,2030.8,6800.15,5
HCPCS,21154,Rcnstj mdfc lefort iii w/o i,,,3243.49,4097.04,6
HCPCS,211540,RCNSTJ MDFC LEFORT III W/O I,,,2030.8,2030.8,1
HCPCS,21155,RCNSTJ MDFC LEFORT III W/I,,,2254.26,6800.15,5
HCPCS,21155,Rcnstj mdfc lefort iii w/i,,,3243.49,4097.04,6
HCPCS,211550,RCNSTJ MDFC LEFORT III W/I,,,2254.26,2254.26,1
HCPCS,21159,RCNST MDFC LFRTIII ADVM WO I,,,2702.51,6800.15,5
HCPCS,21159,Rcnst mdfc lfrtiii advm wo i,,,3243.49,4097.04,6
HCPCS,211590,RCNST MDFC LFRTIII ADVM WO I,,,2702.51,2702.51,1
HCPCS,21160,RCNST MDFC LFRTIII ADVM W/I,,,2931.91,6800.15,5
HCPCS,21160,Rcnst mdfc lfrtiii advm w/i,,,3243.49,4097.04,6
HCPCS,211600,RCNST MDFC LFRTIII ADVM W/I,,,2931.91,2931.91,1
HCPCS,21172,RCNST SUPR-LAT ORB RM&LW FHD,,,2249.28,12826.13,15
HCPCS,21172,Rcnst supr-lat orb rm&lw fhd,,,3243.49,4097.04,6
HCPCS,211720,RCNST SUPR-LAT ORB RM&LW FHD,,,2249.28,2249.28,1
HCPCS,21175,RCNST BFRNT SP ORB RM&LW FHD,,,2296.46,12826.13,15
HCPCS,21175,Rcnst bfrnt sp orb rm&lw fhd,,,3243.49,4097.04,6
HCPCS,211750,RCNST BFRNT SP ORB RM&LW FHD,,,2296.46,2296.46,1
HCPCS,21179,RCNSTJ FOREHEAD WITH GRAFTS,,,1580.69,6800.15,5
HCPCS,21179,Rcnstj forehead with grafts,,,3243.49,4097.04,6
HCPCS,211790,RCNSTJ FOREHEAD WITH GRAFTS,,,1580.69,1580.69,1
HCPCS,21180,RCNSTJ FOREHEAD W/AUTOGRAFT,,,1765.27,6800.15,5
HCPCS,21180,Rcnstj forehead w/autograft,,,3243.49,4097.04,6
HCPCS,211800,RCNSTJ FOREHEAD W/AUTOGRAFT,,,1765.27,1765.27,1
HCPCS,21181,RCNST CNTRG B9 TUM CRNL XTRC,,,771.53,12826.13,15
HCPCS,21181,Rcnst cntrg b9 tum crnl xtrc,,,1664.64,2102.7,6
HCPCS,211810,RCNST CNTRG B9 TUM CRNL XTRC,,,771.53,771.53,1
HCPCS,21182,RCNSTJ ORBIT/FHD/NASETHMD EXCBONE TUM GRF<40SQCM,13032.0,8470.8,1519.79,13032.0,35
HCPCS,21182,RECONSTRUCT CRANIAL BONE,,,2200.22,6800.15,5
HCPCS,21182,Reconstruct cranial bone,,,3243.49,4097.04,6
HCPCS,211820,RECONSTRUCT CRANIAL BONE,,,2200.22,2200.22,1
HCPCS,21183,RECONSTRUCT CRANIAL BONE,,,2393.86,6800.15,5
HCPCS,21183,Reconstruct cranial bone,,,3243.49,4097.04,6
HCPCS,211830,RECONSTRUCT CRANIAL BONE,,,2393.86,2393.86,1
HCPCS,21184,RECONSTRUCT CRANIAL BONE,,,2575.59,6800.15,5
HCPCS,21184,Reconstruct cranial bone,,,3243.49,4097.04,6
HCPCS,211840,RECONSTRUCT CRANIAL BONE,,,2575.59,2575.59,1
HCPCS,21188,RECONSTRUCTION OF MIDFACE,,,1625.4,6800.15,5
HCPCS,21188,Reconstruction of midface,,,1664.64,2102.7,6
HCPCS,211880,RECONSTRUCTION OF MIDFACE,,,1625.4,1625.4,1
HCPCS,21193,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/O GRF,7560.0,4914.0,786.03,7560.0,35
HCPCS,21193,RECONST LWR JAW W/O GRAFT,,,1270.9,12826.13,15
HCPCS,21193,Reconst lwr jaw w/o graft,,,1664.64,2102.7,6
HCPCS,211930,RECONST LWR JAW W/O GRAFT,,,1270.9,1270.9,1
HCPCS,21194,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/GRAFT,8728.0,5673.2,919.61,8728.0,35
HCPCS,21194,RECONST LWR JAW W/GRAFT,,,1468.89,12826.13,15
HCPCS,21194,Reconst lwr jaw w/graft,,,3243.49,4097.04,6
HCPCS,211940,RECONST LWR JAW W/GRAFT,,,1468.89,1468.89,1
HCPCS,21195,RECONST LWR JAW W/O FIXATION,,,1378.06,12826.13,15
HCPCS,21195,Reconst lwr jaw w/o fixation,,,3243.49,4097.04,6
HCPCS,211950,RECONST LWR JAW W/O FIXATION,,,1378.06,1378.06,1
HCPCS,21196,RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI,8332.0,5415.8,876.58,8332.0,35
HCPCS,21196,RECONST LWR JAW W/FIXATION,,,1473.18,12826.13,15
HCPCS,21196,Reconst lwr jaw w/fixation,,,3243.49,4097.04,6
HCPCS,211960,RECONST LWR JAW W/FIXATION,,,1473.18,1473.18,1
HCPCS,21198,OSTEOTOMY MANDIBLE SEGMENTAL,6284.0,4084.6,766.95,6284.0,35
HCPCS,21198,RECONSTR LWR JAW SEGMENT,,,1047.63,12826.13,15
HCPCS,21198,Reconstr lwr jaw segment,,,3243.49,4097.04,6
HCPCS,211980,RECONSTR LWR JAW SEGMENT,,,1047.63,1047.63,1
HCPCS,21199,RECONSTR LWR JAW W/ADVANCE,,,1053.76,12826.13,15
HCPCS,21199,Reconstr lwr jaw w/advance,,,1664.64,2102.7,6
HCPCS,211990,RECONSTR LWR JAW W/ADVANCE,,,1053.76,1053.76,1
HCPCS,21206,RECONSTRUCT UPPER JAW BONE,,,1006.41,12826.13,15
HCPCS,21206,Reconstruct upper jaw bone,,,3243.49,4097.04,6
HCPCS,212060,RECONSTRUCT UPPER JAW BONE,,,1006.41,1006.41,1
HCPCS,21208,AUGMENTATION OF FACIAL BONES,,,764.96,12826.13,15
HCPCS,21208,Augmentation of facial bones,,,3243.49,4097.04,6
HCPCS,21208,OSTEOPLASTY FACIAL BONES AUGMENTATION,4568.0,2969.2,559.74,3528.05,35
HCPCS,212080,AUGMENTATION OF FACIAL BONES,,,764.96,764.96,1
HCPCS,21209,OSTEOPLASTY FACIAL BONES REDUCTION,3128.0,2033.2,300.66,2346.0,32
HCPCS,21209,REDUCTION OF FACIAL BONES,,,625.05,12826.13,15
HCPCS,21209,Reduction of facial bones,,,3243.49,4097.04,6
HCPCS,212090,REDUCTION OF FACIAL BONES,,,625.05,625.05,1
HCPCS,21210,CHEECK IMPLANT W BONE GRAFT,2000.0,1300.0,564.41,4239.08,35
HCPCS,21210,FACE BONE GRAFT,,,787.24,12826.13,15
HCPCS,21210,Face bone graft,,,3243.49,4097.04,6
HCPCS,21210,GRAFT BONE NASAL/MAXILLARY/MALAR AREAS,5144.0,3343.6,564.41,4239.08,35
HCPCS,212100,FACE BONE GRAFT,,,787.24,787.24,1
HCPCS,21215,GRAFT BONE MANDIBLE,4892.0,3179.8,593.06,7524.39,35
HCPCS,21215,LOWER JAW BONE GRAFT,,,818.34,12826.13,15
HCPCS,21215,Lower jaw bone graft,,,3243.49,4097.04,6
HCPCS,212150,LOWER JAW BONE GRAFT,,,818.34,818.34,1
HCPCS,21230,GRAFT RIB CRTLG AUTOGENOUS FACE/CHIN/NOSE/EAR,4468.0,2904.2,554.36,4468.0,35
HCPCS,21230,RIB CARTILAGE GRAFT,,,780.25,12826.13,15
HCPCS,21230,Rib cartilage graft,,,3243.49,4097.04,6
HCPCS,212300,RIB CARTILAGE GRAFT,,,780.25,780.25,1
HCPCS,21235,EAR CARTILAGE GRAFT,,,593.28,593.28,1
HCPCS,21235,GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR,18507.5,12029.875,285.07,30613.5,74
HCPCS,212350,EAR CARTILAGE GRAFT,,,593.28,593.28,1
HCPCS,21240,ARTHRP TEMPOROMANDIBULAR JOINT W/WO AUTOGRAFT,6428.0,4178.2,780.79,6428.0,35
HCPCS,21240,RECONSTRUCTION OF JAW JOINT,,,1083.39,12826.13,15
HCPCS,21240,Reconstruction of jaw joint,,,3243.49,4097.04,6
HCPCS,212400,RECONSTRUCTION OF JAW JOINT,,,1083.39,1083.39,1
HCPCS,21242,ARTHROPLASTY TEMPOROMANDIBULAR JT W/ALLOGRAFT,5836.0,3793.4,693.82,5836.0,35
HCPCS,21242,RECONSTRUCTION OF JAW JOINT,,,1044.01,12826.13,15
HCPCS,21242,Reconstruction of jaw joint,,,3243.49,4097.04,6
HCPCS,212420,RECONSTRUCTION OF JAW JOINT,,,1044.01,1044.01,1
HCPCS,21243,ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT,9812.0,6377.8,893.91,9812.0,35
HCPCS,21243,RECONSTRUCTION OF JAW JOINT,,,1728.68,39872.66,15
HCPCS,21243,Reconstruction of jaw joint,,,5660.06,7149.55,6
HCPCS,212430,RECONSTRUCTION OF JAW JOINT,,,1728.68,1728.68,1
HCPCS,21244,RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE,5448.0,3541.2,668.97,5448.0,35
HCPCS,21244,RECONSTRUCTION OF LOWER JAW,,,1041.25,12826.13,15
HCPCS,21244,Reconstruction of lower jaw,,,3243.49,4097.04,6
HCPCS,212440,RECONSTRUCTION OF LOWER JAW,,,1041.25,1041.25,1
HCPCS,21245,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT PARTIAL,5248.0,3411.2,446.29,3936.0,35
HCPCS,21245,RECONSTRUCTION OF JAW,,,974.1,12826.13,15
HCPCS,21245,Reconstruction of jaw,,,3243.49,4097.04,6
HCPCS,212450,RECONSTRUCTION OF JAW,,,974.1,974.1,1
HCPCS,21246,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT COMPLETE,828.0,538.2,414.0,1660.36,35
HCPCS,21246,RECONSTRUCTION OF JAW,,,877.74,12826.13,15
HCPCS,21246,Reconstruction of jaw,,,3243.49,4097.04,6
HCPCS,212460,RECONSTRUCTION OF JAW,,,877.74,877.74,1
HCPCS,21247,RECONSTRUCT LOWER JAW BONE,,,1631.18,6800.15,5
HCPCS,21247,Reconstruct lower jaw bone,,,3243.49,4097.04,6
HCPCS,212470,RECONSTRUCT LOWER JAW BONE,,,1631.18,1631.18,1
HCPCS,21248,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL,5096.0,3312.4,454.77,3822.0,35
HCPCS,21248,RECONSTRUCTION OF JAW,,,823.75,12826.13,15
HCPCS,21248,Reconstruction of jaw,,,3243.49,4097.04,6
HCPCS,212480,RECONSTRUCTION OF JAW,,,823.75,823.75,1
HCPCS,21249,RECONSTRUCTION OF JAW,,,1153.49,12826.13,15
HCPCS,21249,Reconstruction of jaw,,,3243.49,4097.04,6
HCPCS,212490,RECONSTRUCTION OF JAW,,,1153.49,1153.49,1
HCPCS,21255,RCNSTJ ZYGMTC ARCH/GLENOID FOSSA W/BONE CARTLG,7384.0,4799.6,916.99,7384.0,35
HCPCS,21255,RECONSTRUCT LOWER JAW BONE,,,1372.47,12826.13,15
HCPCS,21255,Reconstruct lower jaw bone,,,3243.49,4097.04,6
HCPCS,212550,RECONSTRUCT LOWER JAW BONE,,,1372.47,1372.47,1
HCPCS,21256,RECONSTRUCTION OF ORBIT,,,1290.49,12826.13,15
HCPCS,21256,RECONSTRUCTION ORBIT W/OSTEOTOMIES & BONE GRAFTS,7770.0,5050.5,865.93,7770.0,35
HCPCS,21256,Reconstruction of orbit,,,3243.49,4097.04,6
HCPCS,212560,RECONSTRUCTION OF ORBIT,,,1290.49,1290.49,1
HCPCS,21260,REVISE EYE SOCKETS,,,1414.25,12826.13,15
HCPCS,21260,Revise eye sockets,,,3243.49,4097.04,6
HCPCS,212600,REVISE EYE SOCKETS,,,1414.25,1414.25,1
HCPCS,21261,REVISE EYE SOCKETS,,,2512.39,12826.13,15
HCPCS,21261,Revise eye sockets,,,3243.49,4097.04,6
HCPCS,212610,REVISE EYE SOCKETS,,,2512.39,2512.39,1
HCPCS,21263,REVISE EYE SOCKETS,,,2322.59,12826.13,15
HCPCS,21263,Revise eye sockets,,,3243.49,4097.04,6
HCPCS,212630,REVISE EYE SOCKETS,,,2322.59,2322.59,1
HCPCS,21267,ORBITAL REPOSITIONING W/BONE GRAFTS EXTRACRANIAL,8276.0,5379.4,956.64,8276.0,35
HCPCS,21267,REVISE EYE SOCKETS,,,1652.7,12826.13,15
HCPCS,21267,Revise eye sockets,,,1664.64,2102.7,6
HCPCS,212670,REVISE EYE SOCKETS,,,1652.7,1652.7,1
HCPCS,21268,ORBITAL REPOSITIONING W/BONE GRAFTS ICRA & XTRC,10828.0,7038.2,1129.15,10828.0,35
HCPCS,21268,REVISE EYE SOCKETS,,,2078.18,6800.15,5
HCPCS,21268,Revise eye sockets,,,3243.49,4097.04,6
HCPCS,212680,REVISE EYE SOCKETS,,,2078.18,2078.18,1
HCPCS,21270,AUGMENTATION CHEEK BONE,,,779.18,12826.13,15
HCPCS,21270,Augmentation cheek bone,,,3243.49,4097.04,6
HCPCS,21270,CHEECK IMPLANT W/O BONE GRAFT,2000.0,1300.0,390.96,1758.46,35
HCPCS,21270,MALAR AUGMENTATION PROSTHETIC MATERIAL,4252.0,2763.8,390.96,3189.0,35
HCPCS,212700,AUGMENTATION CHEEK BONE,,,779.18,779.18,1
HCPCS,21275,REVISION ORBITOFACIAL BONES,,,878.04,12826.13,15
HCPCS,21275,Revision orbitofacial bones,,,1664.64,2102.7,6
HCPCS,21275,SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ,4704.0,3057.6,580.63,4704.0,35
HCPCS,212750,REVISION ORBITOFACIAL BONES,,,878.04,878.04,1
HCPCS,21280,MEDIAL CANTHOPEXY,,,605.75,7031.51,15
HCPCS,21280,Medial canthopexy,,,1810.58,2287.04,6
HCPCS,212800,MEDIAL CANTHOPEXY,,,605.75,605.75,1
HCPCS,21282,CANTHOPEXY,1538.0,999.7,227.48,1538.0,32
HCPCS,21282,CANTHOPEXY ;LATERAL,1708.0,1110.2,227.48,1708.0,32
HCPCS,21282,LATERAL CANTHOPEXY,,,410.96,7031.51,15
HCPCS,21282,Lateral canthopexy,,,1810.58,2287.04,6
HCPCS,212820,LATERAL CANTHOPEXY,,,410.96,410.96,1
HCPCS,21295,REVISION OF JAW MUSCLE/BONE,,,204.1,3211.66,15
HCPCS,21295,Revision of jaw muscle/bone,,,1664.64,2102.7,6
HCPCS,212950,REVISION OF JAW MUSCLE/BONE,,,204.1,204.1,1
HCPCS,21296,REVISION OF JAW MUSCLE/BONE,,,423.17,7031.51,15
HCPCS,21296,Revision of jaw muscle/bone,,,1664.64,2102.7,6
HCPCS,212960,REVISION OF JAW MUSCLE/BONE,,,423.17,423.17,1
HCPCS,21299,COMPLEX SCULPTING & CARVING OF CADAVERIC RIB EAR CARTILAGE FRAME,4022.0,2614.3,610.73,4022.0,15
HCPCS,21299,"TRANS-OSTEAL PLATING FOR MANDIBLE RECONSTRUCTION, INTRAORAL, WIT",4904.0,3187.6,610.73,4904.0,15
HCPCS,21299,TRANSCER EXCIS STYLOID PROCESS LIGAMENT (COMP 61605),14005.0,9103.25,610.73,14005.0,15
HCPCS,21299,UNLISTED CRANFCL&MAXLFCL PX,,,233.1,503.49,14
HCPCS,21299,Unlisted cranfcl&maxlfcl px,,,1664.64,2102.7,6
HCPCS,21310,CLOSED TREATMENT NASAL FRACTURE W/O MANIPULATION,519.0,337.35,87.19,1764.0,30
HCPCS,21315,CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION,4470.0,2905.5,57.2,8370.0,133
HCPCS,21315,CLSD TX NSL FX MNPJ WO STBLJ,,,62.4,62.4,1
HCPCS,213150,CLSD TX NSL FX MNPJ WO STBLJ,,,62.4,62.4,1
HCPCS,21320,CLOSED TX NASAL BONE FX W/MNPJ W/STABILIZATION,700.0,455.0,52.74,525.0,35
HCPCS,21320,CLSD TX NSL FX W/MNPJ&STABLJ,,,99.48,7031.51,15
HCPCS,21320,Clsd tx nsl fx w/mnpj&stablj,,,310.03,391.62,6
HCPCS,213200,CLSD TX NSL FX W/MNPJ&STABLJ,,,99.48,99.48,1
HCPCS,21325,OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED,1672.0,1086.8,262.63,1672.0,35
HCPCS,21325,OPEN TX NOSE FX UNCOMPLICATD,,,456.51,7031.51,15
HCPCS,21325,Open tx nose fx uncomplicatd,,,1664.64,2102.7,6
HCPCS,213250,OPEN TX NOSE FX UNCOMPLICATD,,,456.51,456.51,1
HCPCS,21330,OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI,2316.0,1505.4,322.15,2316.0,35
HCPCS,21330,OPEN TX NOSE FX W/SKELE FIXJ,,,551.51,12826.13,15
HCPCS,21330,Open tx nose fx w/skele fixj,,,1664.64,2102.7,6
HCPCS,213300,OPEN TX NOSE FX W/SKELE FIXJ,,,551.51,551.51,1
HCPCS,21335,OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM,3608.0,2345.2,499.63,3608.0,35
HCPCS,21335,OPEN TX NOSE & SEPTAL FX,,,743.56,7031.51,15
HCPCS,21335,Open tx nose & septal fx,,,1664.64,2102.7,6
HCPCS,213350,OPEN TX NOSE & SEPTAL FX,,,743.56,743.56,1
HCPCS,21336,OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION,2708.0,1760.2,342.18,2708.0,35
HCPCS,21336,OPEN TX SEPTAL FX W/WO STABJ,,,655.81,7034.85,15
HCPCS,21336,Open tx septal fx w/wo stabj,,,3366.74,4252.73,6
HCPCS,213360,OPEN TX SEPTAL FX W/WO STABJ,,,655.81,655.81,1
HCPCS,21337,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,10002.0,6501.3,145.97,16783.2,130
HCPCS,21337,CLOSED TX SEPTAL&NOSE FX,,,312.47,312.47,1
HCPCS,213370,CLOSED TX SEPTAL&NOSE FX,,,312.47,312.47,1
HCPCS,21338,OPEN NASOETHMOID FX W/O FIXJ,,,689.33,12826.13,15
HCPCS,21338,OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION,2748.0,1786.2,430.1,2748.0,35
HCPCS,21338,Open nasoethmoid fx w/o fixj,,,3243.49,4097.04,6
HCPCS,213380,OPEN NASOETHMOID FX W/O FIXJ,,,689.33,689.33,1
HCPCS,21339,OPEN NASOETHMOID FX W/ FIXJ,,,780.99,12826.13,15
HCPCS,21339,Open nasoethmoid fx w/ fixj,,,3243.49,4097.04,6
HCPCS,213390,OPEN NASOETHMOID FX W/ FIXJ,,,780.99,780.99,1
HCPCS,21340,PERCUTANEOUS TX NASOETHMOID COMPLEX FRACTURE,4596.0,2987.4,514.61,4596.0,35
HCPCS,21340,PERQ TX NASOETHMOID FX,,,788.84,7031.51,15
HCPCS,21340,Perq tx nasoethmoid fx,,,1664.64,2102.7,6
HCPCS,213400,PERQ TX NASOETHMOID FX,,,788.84,788.84,1
HCPCS,21343,OPEN TX DEPRESSED FRONTAL SINUS FRACTURE,5728.0,3723.2,632.74,5728.0,35
HCPCS,21343,OPEN TX DPRSD FRONT SINUS FX,,,1127.91,6800.15,5
HCPCS,21343,Open tx dprsd front sinus fx,,,1664.64,2102.7,6
HCPCS,213430,OPEN TX DPRSD FRONT SINUS FX,,,1127.91,1127.91,1
HCPCS,21344,OPEN TX COMPL FRONT SINUS FX,,,1453.13,6800.15,5
HCPCS,21344,OPEN TX COMPLICATED FRONTAL SINUS FRACTURE,8628.0,5608.2,821.87,8628.0,35
HCPCS,21344,Open tx compl front sinus fx,,,3243.49,4097.04,6
HCPCS,213440,OPEN TX COMPL FRONT SINUS FX,,,1453.13,1453.13,1
HCPCS,21345,CLOSED TX NOSE/JAW FX,,,670.14,3211.66,15
HCPCS,21345,Closed tx nose/jaw fx,,,310.03,391.62,6
HCPCS,213450,CLOSED TX NOSE/JAW FX,,,670.14,670.14,1
HCPCS,21346,OPN TX NASOMAX FX W/FIXJ,,,1050.4,12826.13,15
HCPCS,21346,OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG & FXJ,4580.0,2977.0,546.41,4580.0,35
HCPCS,21346,Opn tx nasomax fx w/fixj,,,3243.49,4097.04,6
HCPCS,213460,OPN TX NASOMAX FX W/FIXJ,,,1050.4,1050.4,1
HCPCS,21347,OPN TX NASOMAX FX MULTPLE,,,1073.8,12826.13,15
HCPCS,21347,Opn tx nasomax fx multple,,,3243.49,4097.04,6
HCPCS,213470,OPN TX NASOMAX FX MULTPLE,,,1073.8,1073.8,1
HCPCS,21348,OPN TX NASOMAX FX W/GRAFT,,,1146.1,6800.15,5
HCPCS,21348,Opn tx nasomax fx w/graft,,,3243.49,4097.04,6
HCPCS,213480,OPN TX NASOMAX FX W/GRAFT,,,1146.1,1146.1,1
HCPCS,21355,PERQ TX MALAR FRACTURE,,,343.57,7031.51,15
HCPCS,21355,Perq tx malar fracture,,,1664.64,2102.7,6
HCPCS,213550,PERQ TX MALAR FRACTURE,,,343.57,343.57,1
HCPCS,21356,OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE,1932.0,1255.8,196.93,1449.0,35
HCPCS,21356,OPN TX DPRSD ZYGOMATIC ARCH,,,418.96,12826.13,15
HCPCS,21356,Opn tx dprsd zygomatic arch,,,1664.64,2102.7,6
HCPCS,213560,OPN TX DPRSD ZYGOMATIC ARCH,,,418.96,418.96,1
HCPCS,21360,OPEN TX DEPRESSED MALAR FRACTURE,2876.0,1869.4,374.61,2876.0,35
HCPCS,21360,OPN TX DPRSD MALAR FRACTURE,,,549.37,12826.13,15
HCPCS,21360,Opn tx dprsd malar fracture,,,1664.64,2102.7,6
HCPCS,213600,OPN TX DPRSD MALAR FRACTURE,,,549.37,549.37,1
HCPCS,21365,OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG,6708.0,4360.2,741.74,6708.0,35
HCPCS,21365,OPN TX COMPLX MALAR FX,,,1125.66,12826.13,15
HCPCS,21365,Opn tx complx malar fx,,,3243.49,4097.04,6
HCPCS,213650,OPN TX COMPLX MALAR FX,,,1125.66,1125.66,1
HCPCS,21366,OPEN TX COMP FRACTURE MALAR AREA W/BONE GRAFT,7440.0,4836.0,817.5,7440.0,35
HCPCS,21366,OPN TX COMPLX MALAR W/GRFT,,,1328.3,12826.13,15
HCPCS,21366,Opn tx complx malar w/grft,,,3243.49,4097.04,6
HCPCS,213660,OPN TX COMPLX MALAR W/GRFT,,,1328.3,1328.3,1
HCPCS,21385,OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL,3828.0,2488.2,501.73,3828.0,35
HCPCS,21385,OPN TX ORBIT FX TRANSANTRAL,,,760.83,12826.13,15
HCPCS,21385,Opn tx orbit fx transantral,,,3243.49,4097.04,6
HCPCS,213850,OPN TX ORBIT FX TRANSANTRAL,,,760.83,760.83,1
HCPCS,21386,OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL,3828.0,2488.2,501.85,3828.0,35
HCPCS,21386,OPN TX ORBIT FX PERIORBITAL,,,721.19,12826.13,15
HCPCS,21386,Opn tx orbit fx periorbital,,,3243.49,4097.04,6
HCPCS,213860,OPN TX ORBIT FX PERIORBITAL,,,721.19,721.19,1
HCPCS,21387,OPN TX ORBIT FX COMBINED,,,794.43,12826.13,15
HCPCS,21387,Opn tx orbit fx combined,,,3243.49,4097.04,6
HCPCS,213870,OPN TX ORBIT FX COMBINED,,,794.43,794.43,1
HCPCS,21390,OPN TX ORBIT PERIORBTL IMPLT,,,833.21,12826.13,15
HCPCS,21390,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC,4492.0,2919.8,580.67,4492.0,35
HCPCS,21390,Opn tx orbit periorbtl implt,,,3243.49,4097.04,6
HCPCS,213900,OPN TX ORBIT PERIORBTL IMPLT,,,833.21,833.21,1
HCPCS,21395,OPN TX ORBIT PERIORBT W/GRFT,,,1048.98,12826.13,15
HCPCS,21395,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/BONE GRF,5880.0,3822.0,621.12,5880.0,35
HCPCS,21395,Opn tx orbit periorbt w/grft,,,3243.49,4097.04,6
HCPCS,213950,OPN TX ORBIT PERIORBT W/GRFT,,,1048.98,1048.98,1
HCPCS,21400,CLOSED TX ORBIT W/O MANIPULJ,,,175.63,175.63,1
HCPCS,21400,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,1764.5,1146.925,80.22,6317.0,80
HCPCS,214000,CLOSED TX ORBIT W/O MANIPULJ,,,175.63,175.63,1
HCPCS,21401,CLOSED TX ORBIT W/MANIPULJ,,,342.92,3211.66,15
HCPCS,21401,Closed tx orbit w/manipulj,,,310.03,391.62,6
HCPCS,214010,CLOSED TX ORBIT W/MANIPULJ,,,342.92,342.92,1
HCPCS,21406,OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT,2968.0,1929.2,348.03,2968.0,35
HCPCS,21406,OPN TX ORBIT FX W/O IMPLANT,,,607.14,12826.13,15
HCPCS,21406,Opn tx orbit fx w/o implant,,,3243.49,4097.04,6
HCPCS,214060,OPN TX ORBIT FX W/O IMPLANT,,,607.14,607.14,1
HCPCS,21407,OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT,3608.0,2345.2,436.19,3608.0,35
HCPCS,21407,OPN TX ORBIT FX W/IMPLANT,,,666.69,12826.13,15
HCPCS,21407,Opn tx orbit fx w/implant,,,1664.64,2102.7,6
HCPCS,214070,OPN TX ORBIT FX W/IMPLANT,,,666.69,666.69,1
HCPCS,21408,OPEN TX FX ORBIT EXCEPT BLOWOUT W/BONE GRAFT,5112.0,3322.8,573.69,5112.0,35
HCPCS,21408,OPN TX ORBIT FX W/BONE GRFT,,,939.41,12826.13,15
HCPCS,21408,Opn tx orbit fx w/bone grft,,,1664.64,2102.7,6
HCPCS,214080,OPN TX ORBIT FX W/BONE GRFT,,,939.41,939.41,1
HCPCS,21421,CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT,10528.0,6843.200000000001,266.47,16783.2,77
HCPCS,21421,CLTX PALATAL/MAX FX WIRE FIX,,,557.24,557.24,1
HCPCS,214210,CLTX PALATAL/MAX FX WIRE FIX,,,557.24,557.24,1
HCPCS,21422,OPEN TREATMENT PALATAL/MAXILLARY FRACTURE,3492.0,2269.8,471.76,3492.0,35
HCPCS,21422,OPTX PALATAL/MAX FRACTURE,,,647.32,12826.13,15
HCPCS,21422,Optx palatal/max fracture,,,3243.49,4097.04,6
HCPCS,214220,OPTX PALATAL/MAX FRACTURE,,,647.32,647.32,1
HCPCS,21423,OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR,4340.0,2821.0,541.37,4340.0,35
HCPCS,21423,OPTX PALATAL/MAX FX COMP,,,827.92,6800.15,5
HCPCS,21423,Optx palatal/max fx comp,,,3243.49,4097.04,6
HCPCS,214230,OPTX PALATAL/MAX FX COMP,,,827.92,827.92,1
HCPCS,21431,CLTX CRANIOFACIAL SEPARATION,,,708.85,6800.15,5
HCPCS,21431,Cltx craniofacial separation,,,3243.49,4097.04,6
HCPCS,214310,CLTX CRANIOFACIAL SEPARATION,,,708.85,708.85,1
HCPCS,21432,OPTX CRANFCL SEP W/WIRING,,,736.89,6800.15,5
HCPCS,21432,Optx cranfcl sep w/wiring,,,3243.49,4097.04,6
HCPCS,214320,OPTX CRANFCL SEP W/WIRING,,,736.89,736.89,1
HCPCS,21433,OPTX CRANFCL SEP COMP MLT,,,1803.85,6800.15,5
HCPCS,21433,Optx cranfcl sep comp mlt,,,3243.49,4097.04,6
HCPCS,214330,OPTX CRANFCL SEP COMP MLT,,,1803.85,1803.85,1
HCPCS,21435,OPTX CRNFC SEP COMP INT&/XTR,,,1463.97,6800.15,5
HCPCS,21435,Optx crnfc sep comp int&/xtr,,,3243.49,4097.04,6
HCPCS,214350,OPTX CRNFC SEP COMP INT&/XTR,,,1463.97,1463.97,1
HCPCS,21436,OPTX CRNFCL SEP COMP MLT INT,,,2119.04,6800.15,5
HCPCS,21436,Optx crnfcl sep comp mlt int,,,3243.49,4097.04,6
HCPCS,214360,OPTX CRNFCL SEP COMP MLT INT,,,2119.04,2119.04,1
HCPCS,21440,CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,10012.0,6507.8,273.86,16783.2,84
HCPCS,21440,CLTX MNDBLR/MAX ALV RIDGE FX,,,609.64,609.64,1
HCPCS,214400,CLTX MNDBLR/MAX ALV RIDGE FX,,,609.64,609.64,1
HCPCS,21445,OPTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,2504.0,1627.6,319.72,1878.0,35
HCPCS,21445,OPTX MNDBLR/MAX ALV RIDGE FX,,,641.35,12826.13,15
HCPCS,21445,Optx mndblr/max alv ridge fx,,,3243.49,4097.04,6
HCPCS,214450,OPTX MNDBLR/MAX ALV RIDGE FX,,,641.35,641.35,1
HCPCS,21450,CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,1484.0,964.6,238.36,1159.34,32
HCPCS,21450,CLOSED TX OF MANDIBULAR FRACTURE W/O MANIPULATION,2929.0,1903.85,310.03,4214.0,48
HCPCS,21450,CLTX MNDBLR FX W/O MNPJ,,,485.72,485.72,1
HCPCS,214500,CLTX MNDBLR FX W/O MNPJ,,,485.72,485.72,1
HCPCS,21451,CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION,2260.0,1469.0,317.91,1695.0,35
HCPCS,21451,CLTX MNDBLR FX W/MNPJ,,,649.92,3211.66,15
HCPCS,21451,Cltx mndblr fx w/mnpj,,,310.03,391.62,6
HCPCS,214510,CLTX MNDBLR FX W/MNPJ,,,649.92,649.92,1
HCPCS,21452,PERQ TX MNDBLR FX XTRNL FIXJ,,,458.73,12826.13,15
HCPCS,21452,Perq tx mndblr fx xtrnl fixj,,,3243.49,4097.04,6
HCPCS,214520,PERQ TX MNDBLR FX XTRNL FIXJ,,,458.73,458.73,1
HCPCS,21453,CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,2656.0,1726.4,462.07,1992.0,35
HCPCS,21453,CLTX MNDBLR FX NTRDNTL FIXJ,,,939.97,12826.13,15
HCPCS,21453,Cltx mndblr fx ntrdntl fixj,,,3243.49,4097.04,6
HCPCS,214530,CLTX MNDBLR FX NTRDNTL FIXJ,,,939.97,939.97,1
HCPCS,21454,OPEN TX MANDIBULAR FX W/EXTERNAL FIXATION,2944.0,1913.6,359.2,2944.0,35
HCPCS,21454,OPTX MNDBLR FX XTRNL FIXJ,,,508.43,12826.13,15
HCPCS,21454,Optx mndblr fx xtrnl fixj,,,3243.49,4097.04,6
HCPCS,214540,OPTX MNDBLR FX XTRNL FIXJ,,,508.43,508.43,1
HCPCS,21455,CLSD MANIP TX INTDEN FIX MAND FX,2656.0,1726.4,1328.0,2656.0,12
HCPCS,21461,OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION,3724.0,2420.6,520.92,3932.09,35
HCPCS,21461,OPTX MNDBLR FX WO NTRDNTL,,,1080.85,12826.13,15
HCPCS,21461,Optx mndblr fx wo ntrdntl,,,3243.49,4097.04,6
HCPCS,214610,OPTX MNDBLR FX WO NTRDNTL,,,1080.85,1080.85,1
HCPCS,21462,OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION,4404.0,2862.6,580.59,4188.31,35
HCPCS,21462,OPTX MNDBLR FX W/NTRDNTL,,,1181.27,12826.13,15
HCPCS,21462,Optx mndblr fx w/ntrdntl,,,3243.49,4097.04,6
HCPCS,214620,OPTX MNDBLR FX W/NTRDNTL,,,1181.27,1181.27,1
HCPCS,21465,OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE,5248.0,3411.2,547.87,5248.0,35
HCPCS,21465,OPTX MNDBLR CNDYLR FX,,,831.23,12826.13,15
HCPCS,21465,Optx mndblr cndylr fx,,,3243.49,4097.04,6
HCPCS,214650,OPTX MNDBLR CNDYLR FX,,,831.23,831.23,1
HCPCS,21470,OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION,7016.0,4560.4,833.11,7016.0,35
HCPCS,21470,OPTX COMPLICATED MNDBLR FX,,,1212.18,12826.13,15
HCPCS,21470,Optx complicated mndblr fx,,,3243.49,4097.04,6
HCPCS,214700,OPTX COMPLICATED MNDBLR FX,,,1212.18,1212.18,1
HCPCS,21480,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,823.5,535.275,19.48,3920.0,133
HCPCS,21480,CLTX TMPRMAND DISLC 1ST/SBSQ,,,32.94,32.94,1
HCPCS,214800,CLTX TMPRMAND DISLC 1ST/SBSQ,,,32.94,32.94,1
HCPCS,21485,CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ,1908.0,1240.2,395.17,1499.21,35
HCPCS,21485,CLTX TMPRMAND DISLC COMP,,,786.03,3211.66,15
HCPCS,21485,Cltx tmprmand dislc comp,,,632.74,799.25,6
HCPCS,214850,CLTX TMPRMAND DISLC COMP,,,786.03,786.03,1
HCPCS,21490,OPEN TREATMENT TEMPOROMANDIBULAR DISLOCATION,5180.0,3367.0,498.32,5180.0,35
HCPCS,21490,OPTX TMPRMAND DISLOCATION,,,819.51,7031.51,15
HCPCS,21490,Optx tmprmand dislocation,,,1664.64,2102.7,6
HCPCS,214900,OPTX TMPRMAND DISLOCATION,,,819.51,819.51,1
HCPCS,21497,INTERDENTAL WIRG OTH/THN FX,,,594.5,594.5,1
HCPCS,21497,INTERDENTAL WIRING OTHER THAN FRACTURE,5187.0,3371.55,453.26,8370.0,84
HCPCS,214970,INTERDENTAL WIRG OTH/THN FX,,,594.5,594.5,1
HCPCS,21499,UNLISTED MUSCSKEL PX HEAD,,,233.1,503.49,14
HCPCS,21499,Unlisted muscskel px head,,,1664.64,2102.7,6
HCPCS,21501,I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX,1592.0,1034.8,162.74,1194.0,35
HCPCS,21501,I&D DP ABSC/HMTMA SFT TS NCK,,,352.03,6205.4,17
HCPCS,21501,I&d dp absc/hmtma sft ts nck,,,1419.15,1792.61,6
HCPCS,215010,I&D DP ABSC/HMTMA SFT TS NCK,,,352.03,352.03,1
HCPCS,21502,I&D DP ABS/HMTM NCK RIB OSTC,,,533.68,7034.85,15
HCPCS,21502,I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RI,3020.0,1963.0,336.44,3020.0,35
HCPCS,21502,I&d dp abs/hmtm nck rib ostc,,,1419.15,1792.61,6
HCPCS,215020,I&D DP ABS/HMTM NCK RIB OSTC,,,533.68,533.68,1
HCPCS,21510,INC DEEP OPNG B1 CRTX THORAX,,,474.58,3758.57,5
HCPCS,21510,Inc deep opng b1 crtx thorax,,,1419.15,1792.61,6
HCPCS,215100,INC DEEP OPNG B1 CRTX THORAX,,,474.58,474.58,1
HCPCS,21550,BIOPSY OF NECK/CHEST,,,162.04,162.04,1
HCPCS,21550,BIOPSY SOFT TISSUE NECK/CHEST,844.0,548.6,75.62,633.0,35
HCPCS,21550,BIOPSY SOFT TISSUE NECK/THORAX,9316.0,6055.4,183.07,8384.4,193
HCPCS,215500,BIOPSY OF NECK/CHEST,,,162.04,162.04,1
HCPCS,21552,EXC NECK LES SC 3 CM/>,,,471.5,471.5,1
HCPCS,21552,EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>,16456.0,10696.4,539.02,36332.0,46
HCPCS,21552,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ 3+CM,2596.0,1687.4,246.31,2596.0,35
HCPCS,215520,EXC NECK LES SC 3 CM/>,,,471.5,471.5,1
HCPCS,21554,EXC NECK TUM DEEP 5 CM/>,,,769.89,14834.0,18
HCPCS,21554,EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5+CM,4452.0,2893.8,405.21,4452.0,35
HCPCS,21554,Exc neck tum deep 5 cm/>,,,1419.15,1792.61,6
HCPCS,215540,EXC NECK TUM DEEP 5 CM/>,,,769.89,769.89,1
HCPCS,21555,EXC NECK LES SC < 3 CM,,,322.12,322.12,1
HCPCS,21555,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM,5450.0,3542.5,149.92,8384.4,81
HCPCS,215550,EXC NECK LES SC < 3 CM,,,322.12,322.12,1
HCPCS,21556,EXC NECK TUM DEEP < 5 CM,,,556.42,556.42,1
HCPCS,21556,EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM,9760.0,6344.0,259.72,36332.0,81
HCPCS,215560,EXC NECK TUM DEEP < 5 CM,,,556.42,556.42,1
HCPCS,21557,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM,5900.0,3835.0,477.16,5900.0,35
HCPCS,21557,RESECT NECK THORAX TUMOR<5CM,,,1006.95,6205.4,15
HCPCS,21557,Resect neck thorax tumor<5cm,,,1419.15,1792.61,6
HCPCS,215570,RESECT NECK THORAX TUMOR<5CM,,,1006.95,1006.95,1
HCPCS,21558,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5+CM,8632.0,5610.8,762.3,8632.0,35
HCPCS,21558,RESECT NECK TUMOR 5 CM/>,,,1407.62,28770.0,16
HCPCS,21558,Resect neck tumor 5 cm/>,,,3296.96,4164.58,6
HCPCS,215580,RESECT NECK TUMOR 5 CM/>,,,1407.62,1407.62,1
HCPCS,21600,EXCISION RIB PARTIAL,2904.0,1887.6,343.43,2904.0,35
HCPCS,21600,PARTIAL REMOVAL OF RIB,,,593.25,15488.78,15
HCPCS,21600,Partial removal of rib,,,1419.15,1792.61,6
HCPCS,216000,PARTIAL REMOVAL OF RIB,,,593.25,593.25,1
HCPCS,21601,EXC CHEST WALL TUMOR W/RIBS,,,1205.09,6205.4,15
HCPCS,21601,EXCISION CHEST WALL TUMOR INCLUDING RIBS,7112.0,4622.8,880.1,7112.0,31
HCPCS,21601,Exc chest wall tumor w/ribs,,,1419.15,1792.61,6
HCPCS,216010,EXC CHEST WALL TUMOR W/RIBS,,,1205.09,1205.09,1
HCPCS,21602,EXC CH WAL TUM W/O LYMPHADEC,,,1597.58,8335.26,5
HCPCS,21602,EXCISION CH WAL TUM W/RIB W/O MEDSTNL LYMPHADEC,8876.0,5769.4,1186.24,8876.0,31
HCPCS,21602,Exc ch wal tum w/o lymphadec,,,3296.96,4164.58,6
HCPCS,216020,EXC CH WAL TUM W/O LYMPHADEC,,,1597.58,1597.58,1
HCPCS,21603,EXC CH WAL TUM W/LYMPHADEC,,,1755.14,8335.26,5
HCPCS,21603,EXCISION CH WAL TUM W/RIB W/MEDSTNL LYMPHADEC,10068.0,6544.2,1286.32,10068.0,31
HCPCS,21603,Exc ch wal tum w/lymphadec,,,3296.96,4164.58,6
HCPCS,216030,EXC CH WAL TUM W/LYMPHADEC,,,1755.14,1755.14,1
HCPCS,21610,COSTOTRANSVERSECTOMY,,,1287.47,7034.85,15
HCPCS,21610,COSTOTRANSVERSECTOMY SEPARATE PROCEDURE,6364.0,4136.6,589.14,6364.0,35
HCPCS,21610,Costotransversectomy,,,3094.77,3909.18,6
HCPCS,216100,COSTOTRANSVERSECTOMY,,,1287.47,1287.47,1
HCPCS,21615,EXCISION 1ST &/CERVICAL RIB,4180.0,2717.0,479.75,8335.26,40
HCPCS,21615,Excision 1st &/cervical rib,,,3296.96,4164.58,6
HCPCS,216150,EXCISION 1ST &/CERVICAL RIB,,,655.93,655.93,1
HCPCS,21616,EXC 1ST&/CRV RIB W/SYMPTH,,,752.72,8335.26,5
HCPCS,21616,Exc 1st&/crv rib w/sympth,,,3296.96,4164.58,6
HCPCS,216160,EXC 1ST&/CRV RIB W/SYMPTH,,,752.72,752.72,1
HCPCS,21620,OSTECTOMY STERNUM PARTIAL,2912.0,1892.8,372.93,3758.57,40
HCPCS,21620,Ostectomy sternum partial,,,1419.15,1792.61,6
HCPCS,216200,OSTECTOMY STERNUM PARTIAL,,,527.34,527.34,1
HCPCS,21627,STERNAL DEBRIDEMENT,2920.0,1898.0,352.83,3758.57,40
HCPCS,21627,Sternal debridement,,,1419.15,1792.61,6
HCPCS,216270,STERNAL DEBRIDEMENT,,,572.46,572.46,1
HCPCS,21630,RADICAL RESECTION STERNUM,,,1368.31,8335.26,5
HCPCS,21630,RADICAL RESECTN STERNUM,7672.0,4986.8,858.69,7672.0,35
HCPCS,21630,Radical resection sternum,,,3296.96,4164.58,6
HCPCS,216300,RADICAL RESECTION STERNUM,,,1368.31,1368.31,1
HCPCS,21632,Extensive sternum surgery,,,3296.96,4164.58,6
HCPCS,21685,HYOID MYOTOMY & SUSPENSION,,,1028.03,12826.13,15
HCPCS,21685,HYOID MYOTOMY AND SUSPENSION,6104.0,3967.6,627.41,6104.0,35
HCPCS,21685,Hyoid myotomy & suspension,,,3243.49,4097.04,6
HCPCS,216850,HYOID MYOTOMY & SUSPENSION,,,1028.03,1028.03,1
HCPCS,21700,DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB,2524.0,1640.6,272.43,2524.0,35
HCPCS,21700,REVISION OF NECK MUSCLE,,,375.21,15488.78,15
HCPCS,21700,Revision of neck muscle,,,3094.77,3909.18,6
HCPCS,217000,REVISION OF NECK MUSCLE,,,375.21,375.21,1
HCPCS,21705,DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB,3968.0,2579.2,406.22,3968.0,35
HCPCS,21705,REVISION OF NECK MUSCLE/RIB,,,561.63,8335.26,5
HCPCS,21705,Revision of neck muscle/rib,,,3094.77,3909.18,6
HCPCS,217050,REVISION OF NECK MUSCLE/RIB,,,561.63,561.63,1
HCPCS,21720,REVISION OF NECK MUSCLE,,,564.56,7034.85,15
HCPCS,21720,Revision of neck muscle,,,1419.15,1792.61,6
HCPCS,217200,REVISION OF NECK MUSCLE,,,564.56,564.56,1
HCPCS,21725,REVISION OF NECK MUSCLE,,,571.24,1525.5,15
HCPCS,21725,Revision of neck muscle,,,3094.77,3909.18,6
HCPCS,217250,REVISION OF NECK MUSCLE,,,571.24,571.24,1
HCPCS,21740,RECONSTRUCTION OF STERNUM,,,1077.11,8335.26,5
HCPCS,21740,REPAIR PECTUS EXCAVATUM/CARINATUM OPEN,7028.0,4568.2,730.99,7028.0,35
HCPCS,21740,Reconstruction of sternum,,,3296.96,4164.58,6
HCPCS,217400,RECONSTRUCTION OF STERNUM,,,1077.11,1077.11,1
HCPCS,21742,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/O THRSC,9670.0,6285.5,538.35,9670.0,17
HCPCS,21742,REPAIR STERN/NUSS W/O SCOPE,,,1263.21,7034.85,15
HCPCS,21742,Repair stern/nuss w/o scope,,,1419.15,1792.61,6
HCPCS,217420,REPAIR STERN/NUSS W/O SCOPE,,,1263.21,1263.21,1
HCPCS,21743,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC,10772.0,7001.8,538.35,10772.0,17
HCPCS,21743,REPAIR STERNUM/NUSS W/SCOPE,,,1662.22,7034.85,15
HCPCS,21743,Repair sternum/nuss w/scope,,,1419.15,1792.61,6
HCPCS,217430,REPAIR STERNUM/NUSS W/SCOPE,,,1662.22,1662.22,1
HCPCS,21750,CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX,4560.0,2964.0,518.31,4560.0,35
HCPCS,21750,REPAIR OF STERNUM SEPARATION,,,709.6,8335.26,5
HCPCS,21750,Repair of sternum separation,,,3296.96,4164.58,6
HCPCS,217500,REPAIR OF STERNUM SEPARATION,,,709.6,709.6,1
HCPCS,21800,CLOSED TX RIB FRACTURE UNCOMPLICATED EACH,724.0,470.6,121.63,1764.0,24
HCPCS,21811,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS,4316.0,2805.4,426.25,4316.0,31
HCPCS,21811,OPTX OF RIB FX W/FIXJ SCOPE,,,624.22,15488.78,15
HCPCS,21811,Optx of rib fx w/fixj scope,,,3366.74,4252.73,6
HCPCS,218110,OPTX OF RIB FX W/FIXJ SCOPE,,,624.22,624.22,1
HCPCS,21812,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS,5200.0,3380.0,510.09,5200.0,31
HCPCS,21812,TREATMENT OF RIB FRACTURE,,,753.07,15488.78,15
HCPCS,21812,Treatment of rib fracture,,,3366.74,4252.73,6
HCPCS,218120,TREATMENT OF RIB FRACTURE,,,753.07,753.07,1
HCPCS,21813,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS,7044.0,4578.6,696.36,7044.0,31
HCPCS,21813,TREATMENT OF RIB FRACTURE,,,1032.49,3469.95,15
HCPCS,21813,Treatment of rib fracture,,,3366.74,4252.73,6
HCPCS,218130,TREATMENT OF RIB FRACTURE,,,1032.49,1032.49,1
HCPCS,21820,CLOSED TREATMENT STERNUM FRACTURE,1379.0,896.35,226.8,4151.0,49
HCPCS,21820,TREAT STERNUM FRACTURE,,,156.6,156.6,1
HCPCS,218200,TREAT STERNUM FRACTURE,,,156.6,156.6,1
HCPCS,21825,OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION,3104.0,2017.6,402.73,3104.0,35
HCPCS,21825,TREAT STERNUM FRACTURE,,,579.1,8335.26,5
HCPCS,21825,Treat sternum fracture,,,3366.74,4252.73,6
HCPCS,218250,TREAT STERNUM FRACTURE,,,579.1,579.1,1
HCPCS,21899,UNLISTED PX NECK/THORAX,,,233.1,503.49,14
HCPCS,21899,Unlisted px neck/thorax,,,1419.15,1792.61,6
HCPCS,21920,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,5080.0,3302.0,83.07,8384.4,81
HCPCS,21920,BIOPSY SOFT TISSUE OF BACK,,,161.15,161.15,1
HCPCS,219200,BIOPSY SOFT TISSUE OF BACK,,,161.15,161.15,1
HCPCS,21925,BIOPSY SOFT TISSUE BACK/FLANK DEEP,1852.0,1203.8,184.27,1389.0,35
HCPCS,21925,BIOPSY SOFT TISSUE OF BACK,,,397.04,3512.95,15
HCPCS,21925,Biopsy soft tissue of back,,,1112.95,1405.84,6
HCPCS,219250,BIOPSY SOFT TISSUE OF BACK,,,397.04,397.04,1
HCPCS,21930,EXC BACK LES SC < 3 CM,,,384.08,384.08,1
HCPCS,21930,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,5646.0,3669.8999999999996,177.86,8384.4,81
HCPCS,219300,EXC BACK LES SC < 3 CM,,,384.08,384.08,1
HCPCS,21931,EXC BACK LES SC 3 CM/>,,,495.58,495.58,1
HCPCS,21931,EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>,9316.0,6055.4,568.62,36332.0,46
HCPCS,21931,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ 3+CM,2752.0,1788.8,258.34,2752.0,35
HCPCS,219310,EXC BACK LES SC 3 CM/>,,,495.58,495.58,1
HCPCS,21932,EXC BACK TUM DEEP < 5 CM,,,697.49,697.49,1
HCPCS,21932,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM,10192.0,6624.799999999999,371.55,14810.4,81
HCPCS,219320,EXC BACK TUM DEEP < 5 CM,,,697.49,697.49,1
HCPCS,21933,EXC BACK TUM DEEP 5 CM/>,,,777.12,777.12,1
HCPCS,21933,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>,16456.0,10696.4,883.65,36332.0,46
HCPCS,21933,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM,4452.0,2893.8,410.54,4452.0,35
HCPCS,219330,EXC BACK TUM DEEP 5 CM/>,,,777.12,777.12,1
HCPCS,21935,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM,6288.0,4087.2,690.71,6288.0,35
HCPCS,21935,RESECT BACK TUM < 5 CM,,,1074.69,6205.4,15
HCPCS,21935,Resect back tum < 5 cm,,,1112.95,1405.84,6
HCPCS,219350,RESECT BACK TUM < 5 CM,,,1074.69,1074.69,1
HCPCS,21936,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5+CM,9020.0,5863.0,795.72,9020.0,35
HCPCS,21936,RESECT BACK TUM 5 CM/>,,,1488.79,6205.4,16
HCPCS,21936,Resect back tum 5 cm/>,,,1112.95,1405.84,6
HCPCS,219360,RESECT BACK TUM 5 CM/>,,,1488.79,1488.79,1
HCPCS,22010,I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR,5100.0,3315.0,569.72,5100.0,35
HCPCS,22010,I&D P-SPINE C/T/CERV-THOR,,,1026.04,8335.26,5
HCPCS,22010,I&d p-spine c/t/cerv-thor,,,6141.85,7758.12,6
HCPCS,220100,I&D P-SPINE C/T/CERV-THOR,,,1026.04,1026.04,1
HCPCS,22015,I&D ABSCESS P-SPINE L/S/LS,,,1000.35,8335.26,5
HCPCS,22015,I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC,5056.0,3286.4,564.84,5056.0,35
HCPCS,22015,I&d abscess p-spine l/s/ls,,,6141.85,7758.12,6
HCPCS,220150,I&D ABSCESS P-SPINE L/S/LS,,,1000.35,1000.35,1
HCPCS,22100,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV,4400.0,2860.0,473.54,4400.0,35
HCPCS,22100,REMOVE PART OF NECK VERTEBRA,,,1003.99,15488.78,15
HCPCS,22100,Remove part of neck vertebra,,,3094.77,3909.18,6
HCPCS,221000,REMOVE PART OF NECK VERTEBRA,,,1003.99,1003.99,1
HCPCS,22101,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC,4432.0,2880.8,490.3,4432.0,35
HCPCS,22101,REMOVE PART THORAX VERTEBRA,,,925.46,15488.78,15
HCPCS,22101,Remove part thorax vertebra,,,3094.77,3909.18,6
HCPCS,221010,REMOVE PART THORAX VERTEBRA,,,925.46,925.46,1
HCPCS,22102,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR,4432.0,2880.8,430.34,4432.0,35
HCPCS,22102,REMOVE PART LUMBAR VERTEBRA,,,810.25,15488.78,15
HCPCS,22102,Remove part lumbar vertebra,,,3094.77,3909.18,6
HCPCS,221020,REMOVE PART LUMBAR VERTEBRA,,,810.25,810.25,1
HCPCS,22103,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA,936.0,608.4,101.87,936.0,35
HCPCS,22103,REMOVE EXTRA SPINE SEGMENT,,,141.36,141.36,1
HCPCS,22103,Remove extra spine segment,,,3094.77,3909.18,6
HCPCS,221030,REMOVE EXTRA SPINE SEGMENT,,,141.36,141.36,1
HCPCS,22110,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV,5600.0,3640.0,617.98,5600.0,35
HCPCS,22110,REMOVE PART OF NECK VERTEBRA,,,1121.84,8335.26,5
HCPCS,22110,Remove part of neck vertebra,,,6141.85,7758.12,6
HCPCS,221100,REMOVE PART OF NECK VERTEBRA,,,1121.84,1121.84,1
HCPCS,22112,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM THRC,5628.0,3658.2,594.5,5628.0,35
HCPCS,22112,REMOVE PART THORAX VERTEBRA,,,1210.73,8335.26,5
HCPCS,22112,Remove part thorax vertebra,,,6141.85,7758.12,6
HCPCS,221120,REMOVE PART THORAX VERTEBRA,,,1210.73,1210.73,1
HCPCS,22114,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR,5628.0,3658.2,568.01,5628.0,35
HCPCS,22114,REMOVE PART LUMBAR VERTEBRA,,,1210.73,8335.26,5
HCPCS,22114,Remove part lumbar vertebra,,,6141.85,7758.12,6
HCPCS,221140,REMOVE PART LUMBAR VERTEBRA,,,1210.73,1210.73,1
HCPCS,22116,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA,928.0,603.2,109.28,928.0,35
HCPCS,22116,REMOVE EXTRA SPINE SEGMENT,,,148.6,148.6,1
HCPCS,22116,Remove extra spine segment,,,6141.85,7758.12,6
HCPCS,221160,REMOVE EXTRA SPINE SEGMENT,,,148.6,148.6,1
HCPCS,22206,INCIS SPINE 3 COLUMN THORAC,,,2596.29,8335.26,5
HCPCS,22206,Incis spine 3 column thorac,,,3094.77,3909.18,6
HCPCS,22206,OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC,14872.0,9666.8,1417.76,14872.0,35
HCPCS,222060,INCIS SPINE 3 COLUMN THORAC,,,2596.29,2596.29,1
HCPCS,22207,INCIS SPINE 3 COLUMN LUMBAR,,,2538.05,8335.26,5
HCPCS,22207,Incis spine 3 column lumbar,,,3094.77,3909.18,6
HCPCS,22207,OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR,14672.0,9536.8,1399.31,14672.0,35
HCPCS,222070,INCIS SPINE 3 COLUMN LUMBAR,,,2538.05,2538.05,1
HCPCS,22208,INCIS SPINE 3 COLUMN ADL SEG,,,622.34,622.34,1
HCPCS,22208,Incis spine 3 column adl seg,,,3094.77,3909.18,6
HCPCS,22208,OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM,3864.0,2511.6,361.12,3864.0,35
HCPCS,222080,INCIS SPINE 3 COLUMN ADL SEG,,,622.34,622.34,1
HCPCS,22210,INCIS 1 VERTEBRAL SEG CERV,,,1892.94,8335.26,5
HCPCS,22210,Incis 1 vertebral seg cerv,,,3094.77,3909.18,6
HCPCS,22210,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV,10152.0,6598.8,1039.12,10152.0,35
HCPCS,222100,INCIS 1 VERTEBRAL SEG CERV,,,1892.94,1892.94,1
HCPCS,22212,INCIS 1 VERTEBRAL SEG THORAC,,,1597.95,8335.26,5
HCPCS,22212,Incis 1 vertebral seg thorac,,,3094.77,3909.18,6
HCPCS,22212,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC,8396.0,5457.4,991.32,8396.0,35
HCPCS,222120,INCIS 1 VERTEBRAL SEG THORAC,,,1597.95,1597.95,1
HCPCS,22214,INCIS 1 VERTEBRAL SEG LUMBAR,,,1598.59,8335.26,5
HCPCS,22214,Incis 1 vertebral seg lumbar,,,3094.77,3909.18,6
HCPCS,22214,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR,8408.0,5465.2,947.29,8408.0,35
HCPCS,222140,INCIS 1 VERTEBRAL SEG LUMBAR,,,1598.59,1598.59,1
HCPCS,22216,INCIS ADDL SPINE SEGMENT,,,381.05,381.05,1
HCPCS,22216,Incis addl spine segment,,,6141.85,7758.12,6
HCPCS,22216,OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM,2653.0,1724.45,278.3,2653.0,35
HCPCS,222160,INCIS ADDL SPINE SEGMENT,,,381.05,381.05,1
HCPCS,22220,OSTEOT DSC ANT 1 VRT SGM CRV,,,1710.09,8335.26,5
HCPCS,22220,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM CRV,9176.0,5964.4,1027.17,9176.0,35
HCPCS,22220,Osteot dsc ant 1 vrt sgm crv,,,3094.77,3909.18,6
HCPCS,222200,OSTEOT DSC ANT 1 VRT SGM CRV,,,1710.09,1710.09,1
HCPCS,22222,OSTEOT DSC ANT 1VRT SGM THRC,,,1878.11,8335.26,5
HCPCS,22222,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM THRC,9236.0,6003.4,921.7,9236.0,35
HCPCS,22222,Osteot dsc ant 1vrt sgm thrc,,,3094.77,3909.18,6
HCPCS,222220,OSTEOT DSC ANT 1VRT SGM THRC,,,1878.11,1878.11,1
HCPCS,22224,OSTEOT DSC ANT 1VRT SGM LMBR,,,1665.28,8335.26,5
HCPCS,22224,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM LUMBAR,9236.0,6003.4,995.41,9236.0,35
HCPCS,22224,Osteot dsc ant 1vrt sgm lmbr,,,3094.77,3909.18,6
HCPCS,222240,OSTEOT DSC ANT 1VRT SGM LMBR,,,1665.28,1665.28,1
HCPCS,22226,OSTEOT DSC ANT 1VRT SGM EA,,,377.05,377.05,1
HCPCS,22226,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM EA ADDL,2412.0,1567.8,276.01,2412.0,35
HCPCS,22226,Osteot dsc ant 1vrt sgm ea,,,3094.77,3909.18,6
HCPCS,222260,OSTEOT DSC ANT 1VRT SGM EA,,,377.05,377.05,1
HCPCS,22310,CLOSED TX VERT FX W/O MANJ,,,312.44,312.44,1
HCPCS,22310,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,1379.5,896.675,145.31,4268.0,130
HCPCS,223100,CLOSED TX VERT FX W/O MANJ,,,312.44,312.44,1
HCPCS,22315,CLOSED TX VERT FX W/MANJ,,,819.29,7034.85,15
HCPCS,22315,CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ,4044.0,2628.6,376.11,3033.0,35
HCPCS,22315,Closed tx vert fx w/manj,,,310.03,391.62,6
HCPCS,223150,CLOSED TX VERT FX W/MANJ,,,819.29,819.29,1
HCPCS,22318,OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT,9088.0,5907.2,1070.47,9088.0,35
HCPCS,22318,TREAT ODONTOID FX W/O GRAFT,,,1763.91,14747.88,5
HCPCS,22318,Treat odontoid fx w/o graft,,,6141.85,7758.12,6
HCPCS,223180,TREAT ODONTOID FX W/O GRAFT,,,1763.91,1763.91,1
HCPCS,22319,TREAT ODONTOID FX W/GRAFT,,,1958.18,14747.88,5
HCPCS,22319,Treat odontoid fx w/graft,,,6141.85,7758.12,6
HCPCS,223190,TREAT ODONTOID FX W/GRAFT,,,1958.18,1958.18,1
HCPCS,22325,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM,7948.0,5166.2,747.69,7948.0,35
HCPCS,22325,TREAT SPINE FRACTURE,,,1565.6,14747.88,5
HCPCS,22325,Treat spine fracture,,,6141.85,7758.12,6
HCPCS,223250,TREAT SPINE FRACTURE,,,1565.6,1565.6,1
HCPCS,22326,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR,8336.0,5418.4,968.6,8336.0,35
HCPCS,22326,TREAT NECK SPINE FRACTURE,,,1605.66,14747.88,5
HCPCS,22326,Treat neck spine fracture,,,6141.85,7758.12,6
HCPCS,223260,TREAT NECK SPINE FRACTURE,,,1605.66,1605.66,1
HCPCS,22327,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH,8308.0,5400.2,947.33,8308.0,35
HCPCS,22327,TREAT THORAX SPINE FRACTURE,,,1632.44,14747.88,5
HCPCS,22327,Treat thorax spine fracture,,,6141.85,7758.12,6
HCPCS,223270,TREAT THORAX SPINE FRACTURE,,,1632.44,1632.44,1
HCPCS,22328,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA,1840.0,1196.0,216.77,1840.0,35
HCPCS,22328,TREAT EACH ADD SPINE FX,,,297.32,297.32,1
HCPCS,22328,Treat each add spine fx,,,6141.85,7758.12,6
HCPCS,223280,TREAT EACH ADD SPINE FX,,,297.32,297.32,1
HCPCS,22505,MANIPULATION OF SPINE,,,136.62,3469.95,15
HCPCS,22505,Manipulation of spine,,,632.74,799.25,6
HCPCS,225050,MANIPULATION OF SPINE,,,136.62,136.62,1
HCPCS,22510,PERQ CERVICOTHORACIC INJECT,,,450.51,450.51,1
HCPCS,22510,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,3160.0,2054.0,336.9,16790.4,157
HCPCS,225100,PERQ CERVICOTHORACIC INJECT,,,450.51,450.51,1
HCPCS,22511,PERQ LUMBOSACRAL INJECTION,,,423.78,423.78,1
HCPCS,22511,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,10794.0,7016.099999999999,315.56,16790.4,115
HCPCS,225110,PERQ LUMBOSACRAL INJECTION,,,423.78,423.78,1
HCPCS,22512,VERTEBROPLASTY ADDL INJECT,,,216.72,216.72,1
HCPCS,22512,VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,3613.0,2348.45,154.14,5063.4,93
HCPCS,225120,VERTEBROPLASTY ADDL INJECT,,,216.72,216.72,1
HCPCS,22513,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,22268.0,14474.2,383.26,36968.4,154
HCPCS,22513,PERQ VERTEBRAL AUGMENTATION,,,532.97,532.97,1
HCPCS,225130,PERQ VERTEBRAL AUGMENTATION,,,532.97,532.97,1
HCPCS,22514,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,22136.0,14388.400000000001,358.0,40475.0,154
HCPCS,22514,PERQ VERTEBRAL AUGMENTATION,,,496.55,496.55,1
HCPCS,225140,PERQ VERTEBRAL AUGMENTATION,,,496.55,496.55,1
HCPCS,22515,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,7715.5,5015.075,160.65,40475.0,121
HCPCS,22515,PERQ VERTEBRAL AUGMENTATION,,,227.55,227.55,1
HCPCS,225150,PERQ VERTEBRAL AUGMENTATION,,,227.55,227.55,1
HCPCS,22520,PERCUTANEOUS VERTEBROPLSTY THORACIC W/WO BONE BX,5334.0,3467.1,896.11,4800.6,42
HCPCS,22521,PERCUTANEOUS VERTEBROPLASTY LUMBAR W/WO BNE BX,5334.0,3467.1,896.11,4800.6,42
HCPCS,22522,PERCUTANEOUS VERTEBROPLASTY EA ADDL THRC/LMBR,3469.0,2254.85,582.79,3122.1,42
HCPCS,22523,PERCUTANEOUS VERTEBRAL AUGMENTATION THORACIC,11928.0,7753.2,2003.9,10735.2,42
HCPCS,22524,PERCUTANEOUS VERTEBRAL AUGMENTATION LUMBAR,11928.0,7753.2,2003.9,10735.2,42
HCPCS,22525,PERQ VERTEBRAL AUGMENTATION EA ADDL THRC/LMBR,11928.0,7753.2,2003.9,10735.2,42
HCPCS,22526,IDET SINGLE LEVEL,,,341.6,341.6,1
HCPCS,22526,Idet single level,,,3094.77,3909.18,6
HCPCS,22526,"PERC INTRADISC ELECTRO ANNULOPLASTY, SINGLE LEVEL",2340.0,1521.0,249.46,4265.33,21
HCPCS,225260,IDET SINGLE LEVEL,,,341.6,341.6,1
HCPCS,22527,IDET 1 OR MORE LEVELS,,,159.08,159.08,1
HCPCS,22527,Idet 1 or more levels,,,3094.77,3909.18,6
HCPCS,22527,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL,1212.0,787.8,112.46,3547.46,21
HCPCS,225270,IDET 1 OR MORE LEVELS,,,159.08,159.08,1
HCPCS,22532,ARTHRD LAT XTRCVTRY TQ THRC,,,1899.75,14747.88,5
HCPCS,22532,ARTHRODESIS LATERAL EXTRACAVITARY THORACIC,10396.0,6757.4,1105.0,10396.0,35
HCPCS,22532,Arthrd lat xtrcvtry tq thrc,,,9774.46,12346.69,6
HCPCS,225320,ARTHRD LAT XTRCVTRY TQ THRC,,,1899.75,1899.75,1
HCPCS,22533,ARTHRD LAT XTRCVTRY TQ LMBR,,,1750.94,20141.22,5
HCPCS,22533,ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR,9916.0,6445.4,1031.41,9916.0,35
HCPCS,22533,Arthrd lat xtrcvtry tq lmbr,,,9774.46,12346.69,6
HCPCS,225330,ARTHRD LAT XTRCVTRY TQ LMBR,,,1750.94,1750.94,1
HCPCS,22534,ARTHRD LAT XTRCVTRY TQ EA AD,,,379.79,379.79,1
HCPCS,22534,ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR,2396.0,1557.4,261.27,2396.0,35
HCPCS,22534,Arthrd lat xtrcvtry tq ea ad,,,9774.46,12346.69,6
HCPCS,225340,ARTHRD LAT XTRCVTRY TQ EA AD,,,379.79,379.79,1
HCPCS,22548,ARTHRD ANT TORAL/XORAL C1-C2,,,2098.82,14747.88,5
HCPCS,22548,Arthrd ant toral/xoral c1-c2,,,9774.46,12346.69,6
HCPCS,225480,ARTHRD ANT TORAL/XORAL C1-C2,,,2098.82,2098.82,1
HCPCS,22551,ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2,11000.0,7150.0,1133.74,11000.0,35
HCPCS,22551,ARTHRD ANT NTRBDY CERVICAL,,,1803.2,27897.39,16
HCPCS,22551,Arthrd ant ntrbdy cervical,,,6141.85,7758.12,6
HCPCS,225510,ARTHRD ANT NTRBDY CERVICAL,,,1803.2,1803.2,1
HCPCS,22552,ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC,2600.0,1690.0,264.8,2600.0,35
HCPCS,22552,ARTHRD ANT NTRBD CERVICAL EA,,,418.24,418.24,1
HCPCS,22552,Arthrd ant ntrbd cervical ea,,,6141.85,7758.12,6
HCPCS,225520,ARTHRD ANT NTRBD CERVICAL EA,,,418.24,418.24,1
HCPCS,22554,ARTHRD ANT INTERBODY MIN DSC CRV BELOW C2,7784.0,5059.6,980.16,7784.0,35
HCPCS,22554,ARTHRD ANT NTRBD MIN DSC CRV,,,1338.01,27897.39,15
HCPCS,22554,Arthrd ant ntrbd min dsc crv,,,6141.85,7758.12,6
HCPCS,225540,ARTHRD ANT NTRBD MIN DSC CRV,,,1338.01,1338.01,1
HCPCS,22556,ARTHRD ANT INTERBODY MIN DSC THORACIC,9880.0,6422.0,1210.15,9880.0,35
HCPCS,22556,ARTHRD ANT NTRBD MIN DSC THC,,,1785.3,20141.22,5
HCPCS,22556,Arthrd ant ntrbd min dsc thc,,,9774.46,12346.69,6
HCPCS,225560,ARTHRD ANT NTRBD MIN DSC THC,,,1785.3,1785.3,1
HCPCS,22558,ARTHRD ANT INTERBODY MIN DSC LUMBAR,10353.0,6729.45,1138.55,10353.0,35
HCPCS,22558,ARTHRD ANT NTRBD MIN DSC LUM,,,1612.06,31169.04,5
HCPCS,22558,Arthrd ant ntrbd min dsc lum,,,6141.85,7758.12,6
HCPCS,225580,ARTHRD ANT NTRBD MIN DSC LUM,,,1612.06,1612.06,1
HCPCS,22585,ARTHRD ANT NTRBD MIN DSC EA,,,342.12,342.12,1
HCPCS,22585,ARTHRD ANT NTRBD MIN DSC EA ADDL INTERSPACE,2429.0,1578.85,248.18,2429.0,35
HCPCS,22585,Arthrd ant ntrbd min dsc ea,,,6141.85,7758.12,6
HCPCS,225850,ARTHRD ANT NTRBD MIN DSC EA,,,342.12,342.12,1
HCPCS,22586,ARTHRD PRE-SAC NTRBDY L5-S1,,,2171.28,20141.22,5
HCPCS,22586,ARTHRODESIS PRESACRAL INTRBDY W/INSTRUMENT L5/S1,11248.0,7311.2,1090.77,11248.0,31
HCPCS,22586,Arthrd pre-sac ntrbdy l5-s1,,,6141.85,7758.12,6
HCPCS,225860,ARTHRD PRE-SAC NTRBDY L5-S1,,,2171.28,2171.28,1
HCPCS,22590,ARTHRD PST TQ CRANIOCERVICAL,,,1691.45,14747.88,5
HCPCS,22590,ARTHRODESIS POSTERIOR CRANIOCERVICAL,8704.0,5657.6,1120.27,8704.0,35
HCPCS,22590,Arthrd pst tq craniocervical,,,9774.46,12346.69,6
HCPCS,225900,ARTHRD PST TQ CRANIOCERVICAL,,,1691.45,1691.45,1
HCPCS,22595,ARTHRD PST TQ ATLAS-AXIS,,,1616.13,14747.88,5
HCPCS,22595,ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2,8256.0,5366.4,1091.13,8256.0,35
HCPCS,22595,Arthrd pst tq atlas-axis,,,9774.46,12346.69,6
HCPCS,225950,ARTHRD PST TQ ATLAS-AXIS,,,1616.13,1616.13,1
HCPCS,22600,ARTHRD PST TQ 1NTRSPC CRV,,,1382.72,20141.22,5
HCPCS,22600,ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT,6960.0,4524.0,913.86,6960.0,35
HCPCS,22600,Arthrd pst tq 1ntrspc crv,,,6141.85,7758.12,6
HCPCS,226000,ARTHRD PST TQ 1NTRSPC CRV,,,1382.72,1382.72,1
HCPCS,22610,ARTHRD PST TQ 1NTRSPC THRC,,,1357.84,20141.22,5
HCPCS,22610,ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC,7603.0,4941.95,897.42,7603.0,35
HCPCS,22610,Arthrd pst tq 1ntrspc thrc,,,9774.46,12346.69,6
HCPCS,226100,ARTHRD PST TQ 1NTRSPC THRC,,,1357.84,1357.84,1
HCPCS,22612,ARTHRD PST TQ 1NTRSPC LUMBAR,,,1670.01,39872.66,15
HCPCS,22612,ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR,10353.0,6729.45,1113.94,10353.0,35
HCPCS,22612,Arthrd pst tq 1ntrspc lumbar,,,6141.85,7758.12,6
HCPCS,226120,ARTHRD PST TQ 1NTRSPC LUMBAR,,,1670.01,1670.01,1
HCPCS,22614,ARTHRD PST TQ 1NTRSPC EA ADD,,,412.88,412.88,1
HCPCS,22614,ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC,2829.0,1838.85,300.26,2829.0,35
HCPCS,22614,Arthrd pst tq 1ntrspc ea add,,,6141.85,7758.12,6
HCPCS,226140,ARTHRD PST TQ 1NTRSPC EA ADD,,,412.88,412.88,1
HCPCS,22630,ARTHRD PST TQ 1NTRSPC LUM,,,1657.43,39872.66,15
HCPCS,22630,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR,9720.0,6318.0,1064.7,9720.0,35
HCPCS,22630,Arthrd pst tq 1ntrspc lum,,,6141.85,7758.12,6
HCPCS,226300,ARTHRD PST TQ 1NTRSPC LUM,,,1657.43,1657.43,1
HCPCS,22632,ARTHRD PST TQ 1NTRSPC LM EA,,,339.83,339.83,1
HCPCS,22632,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC EA ADDL,2297.0,1493.05,246.13,2297.0,35
HCPCS,22632,Arthrd pst tq 1ntrspc lm ea,,,6141.85,7758.12,6
HCPCS,226320,ARTHRD PST TQ 1NTRSPC LM EA,,,339.83,339.83,1
HCPCS,22633,ARTHRD CMBN 1NTRSPC LUMBAR,,,1913.95,39872.66,16
HCPCS,22633,ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR,11792.0,7664.8,902.28,11792.0,35
HCPCS,22633,Arthrd cmbn 1ntrspc lumbar,,,9774.46,12346.69,6
HCPCS,226330,ARTHRD CMBN 1NTRSPC LUMBAR,,,1913.95,1913.95,1
HCPCS,22634,ARTHRD CMBN 1NTRSPC EA ADDL,,,511.35,511.35,1
HCPCS,22634,ARTHRODESIS CMBN TQ 1NTRSPC EACH ADDITIONAL,3502.0,2276.3,240.65,3502.0,35
HCPCS,22634,Arthrd cmbn 1ntrspc ea addl,,,6141.85,7758.12,6
HCPCS,226340,ARTHRD CMBN 1NTRSPC EA ADDL,,,511.35,511.35,1
HCPCS,22800,ARTHRD PST DFRM<6 VRT SGM,,,1442.71,20141.22,5
HCPCS,22800,ARTHRODESIS POSTERIOR SPINAL DFRM <6 VRT SGM,8580.0,5577.0,1029.28,8580.0,35
HCPCS,22800,Arthrd pst dfrm<6 vrt sgm,,,9774.46,12346.69,6
HCPCS,228000,ARTHRD PST DFRM<6 VRT SGM,,,1442.71,1442.71,1
HCPCS,22802,ARTHRD PST DFRM 7-12 VRT SGM,,,2236.27,20141.22,5
HCPCS,22802,ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SGM,14128.0,9183.2,1584.59,14128.0,35
HCPCS,22802,Arthrd pst dfrm 7-12 vrt sgm,,,9774.46,12346.69,6
HCPCS,228020,ARTHRD PST DFRM 7-12 VRT SGM,,,2236.27,2236.27,1
HCPCS,22804,ARTHRD PST DFRM 13+ VRT SGM,,,2566.92,20141.22,5
HCPCS,22804,ARTHRODESIS POSTERIOR SPINAL DFRM 13+ VRT SGM,16500.0,10725.0,1740.02,16500.0,35
HCPCS,22804,Arthrd pst dfrm 13+ vrt sgm,,,9774.46,12346.69,6
HCPCS,228040,ARTHRD PST DFRM 13+ VRT SGM,,,2566.92,2566.92,1
HCPCS,22808,ARTHRD ANT DFRM 2-3 VRT SGM,,,1935.33,20141.22,5
HCPCS,22808,ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SGM,11004.0,7152.6,1219.38,11004.0,35
HCPCS,22808,Arthrd ant dfrm 2-3 vrt sgm,,,9774.46,12346.69,6
HCPCS,228080,ARTHRD ANT DFRM 2-3 VRT SGM,,,1935.33,1935.33,1
HCPCS,22810,ARTHRD ANT DFRM 4-7 VRT SGM,,,2101.93,20141.22,5
HCPCS,22810,ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SGM,12600.0,8190.0,1332.35,12600.0,35
HCPCS,22810,Arthrd ant dfrm 4-7 vrt sgm,,,9774.46,12346.69,6
HCPCS,228100,ARTHRD ANT DFRM 4-7 VRT SGM,,,2101.93,2101.93,1
HCPCS,22812,ARTHRD ANT DFRM 8+ VRT SGM,,,2302.53,20141.22,5
HCPCS,22812,Arthrd ant dfrm 8+ vrt sgm,,,9774.46,12346.69,6
HCPCS,228120,ARTHRD ANT DFRM 8+ VRT SGM,,,2302.53,2302.53,1
HCPCS,22818,KYPHECTOMY 1-2 SEGMENTS,,,2250.47,20141.22,5
HCPCS,22818,"KYPHECTOMY, 1-2 SEGMENTS",13732.0,8925.8,1598.68,13732.0,35
HCPCS,22818,Kyphectomy 1-2 segments,,,9774.46,12346.69,6
HCPCS,228180,KYPHECTOMY 1-2 SEGMENTS,,,2250.47,2250.47,1
HCPCS,22819,KYPHECTOMY 3 OR MORE,,,2589.85,20141.22,5
HCPCS,22819,"KYPHECTOMY, 3 & MORE SEGMENT",15752.0,10238.8,1647.8,15752.0,35
HCPCS,22819,Kyphectomy 3 or more,,,9774.46,12346.69,6
HCPCS,228190,KYPHECTOMY 3 OR MORE,,,2589.85,2589.85,1
HCPCS,22830,EXPLORATION OF SPINAL FUSION,4937.0,3209.05,620.83,8335.26,40
HCPCS,22830,Exploration of spinal fusion,,,3094.77,3909.18,6
HCPCS,228300,EXPLORATION OF SPINAL FUSION,,,870.16,870.16,1
HCPCS,22836,ANT THORACIC VRT BODY TETHERING <7 VRT SEGMENTS,14080.0,9152.0,1245.23,14080.0,28
HCPCS,22836,ANT THRC VRT BODY TETHRG <7,,,1798.9,20141.22,5
HCPCS,22836,Ant thrc vrt body tethrg <7,,,9774.46,12346.69,6
HCPCS,228360,ANT THRC VRT BODY TETHRG <7,,,1798.9,1798.9,1
HCPCS,22837,ANT THORACIC VRT BODY TETHERING 8+ VRT SEGMENTS,15620.0,10153.0,1372.16,15620.0,28
HCPCS,22837,ANT THRC VRT BODY TETHRG 8+,,,1982.26,20141.22,5
HCPCS,22837,Ant thrc vrt body tethrg 8+,,,9774.46,12346.69,6
HCPCS,228370,ANT THRC VRT BODY TETHRG 8+,,,1982.26,1982.26,1
HCPCS,22838,REV RPLC/RMV THRC VRT TETHRG,,,2008.69,20141.22,5
HCPCS,22838,REVJ RPLCMT/RMVL THORACIC VRT BODY TETHERING,15840.0,10296.0,1390.46,15840.0,28
HCPCS,22838,Rev rplc/rmv thrc vrt tethrg,,,9774.46,12346.69,6
HCPCS,228380,REV RPLC/RMV THRC VRT TETHRG,,,2008.69,2008.69,1
HCPCS,22840,INSERT SPINE FIXATION DEVICE,,,797.12,797.12,1
HCPCS,22840,Insert spine fixation device,,,9774.46,12346.69,6
HCPCS,22840,POSTERIOR NON-SEGMENTAL INSTRUMENTATION,5509.0,3580.85,445.37,5509.0,35
HCPCS,228400,INSERT SPINE FIXATION DEVICE,,,797.12,797.12,1
HCPCS,22841,INSERT SPINE FIXATION DEVICE,,,406.94,406.94,1
HCPCS,22841,INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS,2427.0,1577.55,796.01,2427.0,13
HCPCS,22841,Insert spine fixation device,,,6141.85,7758.12,6
HCPCS,228410,INSERT SPINE FIXATION DEVICE,,,406.94,406.94,1
HCPCS,22842,INSERT SPINE FIXATION DEVICE,,,804.83,804.83,1
HCPCS,22842,Insert spine fixation device,,,6141.85,7758.12,6
HCPCS,22842,POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG,5526.0,3591.9,445.63,5526.0,35
HCPCS,228420,INSERT SPINE FIXATION DEVICE,,,804.83,804.83,1
HCPCS,22843,INSERT SPINE FIXATION DEVICE,,,862.01,862.01,1
HCPCS,22843,Insert spine fixation device,,,6141.85,7758.12,6
HCPCS,22843,POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG,5914.0,3844.1,555.77,5914.0,35
HCPCS,228430,INSERT SPINE FIXATION DEVICE,,,862.01,862.01,1
HCPCS,22844,INSERT SPINE FIXATION DEVICE,,,1034.35,1034.35,1
HCPCS,22844,Insert spine fixation device,,,6141.85,7758.12,6
HCPCS,22844,POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SE,7225.0,4696.25,679.14,7225.0,35
HCPCS,228440,INSERT SPINE FIXATION DEVICE,,,1034.35,1034.35,1
HCPCS,22845,ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS,5254.0,3415.1,426.84,5254.0,35
HCPCS,22845,INSERT SPINE FIXATION DEVICE,,,766.57,766.57,1
HCPCS,22845,Insert spine fixation device,,,6141.85,7758.12,6
HCPCS,228450,INSERT SPINE FIXATION DEVICE,,,766.57,766.57,1
HCPCS,22846,ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS,5456.0,3546.4,513.16,5456.0,35
HCPCS,22846,INSERT SPINE FIXATION DEVICE,,,798.02,798.02,1
HCPCS,22846,Insert spine fixation device,,,9774.46,12346.69,6
HCPCS,228460,INSERT SPINE FIXATION DEVICE,,,798.02,798.02,1
HCPCS,22847,ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS,6063.0,3940.95,570.17,6063.0,35
HCPCS,22847,INSERT SPINE FIXATION DEVICE,,,833.68,833.68,1
HCPCS,22847,Insert spine fixation device,,,9774.46,12346.69,6
HCPCS,228470,INSERT SPINE FIXATION DEVICE,,,833.68,833.68,1
HCPCS,22848,INSERT PELV FIXATION DEVICE,,,378.54,378.54,1
HCPCS,22848,Insert pelv fixation device,,,3094.77,3909.18,6
HCPCS,22848,PELVIC FIXATION OTHER THAN SACRUM,2636.0,1713.4,275.5,2636.0,35
HCPCS,228480,INSERT PELV FIXATION DEVICE,,,378.54,378.54,1
HCPCS,22849,REINSERT SPINAL FIXATION,,,1381.33,14747.88,5
HCPCS,22849,REINSERTION SPINAL FIXATION DEVICE,8435.0,5482.75,781.47,8435.0,35
HCPCS,22849,Reinsert spinal fixation,,,6141.85,7758.12,6
HCPCS,228490,REINSERT SPINAL FIXATION,,,1381.33,1381.33,1
HCPCS,22850,REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION,3928.0,2553.2,508.9,3928.0,35
HCPCS,22850,REMOVE SPINE FIXATION DEVICE,,,777.42,8335.26,5
HCPCS,22850,Remove spine fixation device,,,3094.77,3909.18,6
HCPCS,228500,REMOVE SPINE FIXATION DEVICE,,,777.42,777.42,1
HCPCS,22852,REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION,3748.0,2436.2,509.05,3748.0,35
HCPCS,22852,REMOVE SPINE FIXATION DEVICE,,,749.2,11329.0,6
HCPCS,22852,Remove spine fixation device,,,3094.77,3909.18,6
HCPCS,228520,REMOVE SPINE FIXATION DEVICE,,,749.2,749.2,1
HCPCS,22853,INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD,1870.0,1215.5,197.62,1870.0,31
HCPCS,22853,INSJ BIOMECHANICAL DEVICE,,,271.65,271.65,1
HCPCS,22853,Insj biomechanical device,,,6141.85,7758.12,6
HCPCS,228530,INSJ BIOMECHANICAL DEVICE,,,271.65,271.65,1
HCPCS,22854,INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD,2420.0,1573.0,257.37,2420.0,31
HCPCS,22854,INSJ BIOMECHANICAL DEVICE,,,354.11,354.11,1
HCPCS,22854,Insj biomechanical device,,,9774.46,12346.69,6
HCPCS,228540,INSJ BIOMECHANICAL DEVICE,,,354.11,354.11,1
HCPCS,22855,REMOVAL ANTERIOR INSTRMJ,,,1173.58,8335.26,5
HCPCS,22855,REMOVAL ANTERIOR INSTRUMENTATION,6978.0,4535.7,601.44,6978.0,35
HCPCS,22855,Removal anterior instrmj,,,3094.77,3909.18,6
HCPCS,228550,REMOVAL ANTERIOR INSTRMJ,,,1173.58,1173.58,1
HCPCS,22856,TOT DISC ARTHRP 1NTRSPC CRV,,,1718.66,39872.66,15
HCPCS,22856,TOTAL DISC ARTHRP ANT DSC 1 INTERSPACE CERVICAL,10582.0,6878.3,554.94,10582.0,35
HCPCS,22856,Tot disc arthrp 1ntrspc crv,,,9774.46,12346.69,6
HCPCS,228560,TOT DISC ARTHRP 1NTRSPC CRV,,,1718.66,1718.66,1
HCPCS,22857,TOT DISC ARTHRP 1NTRSPC LMBR,,,1828.21,20141.22,5
HCPCS,22857,Tot disc arthrp 1ntrspc lmbr,,,6141.85,7758.12,6
HCPCS,228570,TOT DISC ARTHRP 1NTRSPC LMBR,,,1828.21,1828.21,1
HCPCS,22858,TOT DISC ARTHRP 2ND LVL CRV,,,532.88,532.88,1
HCPCS,22858,TOT DISC ARTHRP ANT APPR DISC 2ND LEVEL CERVICAL,3360.0,2184.0,388.86,3360.0,31
HCPCS,22858,Tot disc arthrp 2nd lvl crv,,,9774.46,12346.69,6
HCPCS,228580,TOT DISC ARTHRP 2ND LVL CRV,,,532.88,532.88,1
HCPCS,22859,INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD,2420.0,1573.0,257.11,2420.0,31
HCPCS,22859,INSJ BIOMECHANICAL DEVICE,,,351.43,351.43,1
HCPCS,22859,Insj biomechanical device,,,6141.85,7758.12,6
HCPCS,228590,INSJ BIOMECHANICAL DEVICE,,,351.43,351.43,1
HCPCS,22860,TOT DISC ARTHRP 2NTRSPC LMBR,,,360.83,360.83,1
HCPCS,22860,TOTAL DISC ARTHRP ANT SECOND INTERSPACE LUMBAR,2752.0,1788.8,316.09,2752.0,30
HCPCS,22860,Tot disc arthrp 2ntrspc lmbr,,,6141.85,7758.12,6
HCPCS,228600,TOT DISC ARTHRP 2NTRSPC LMBR,,,360.83,360.83,1
HCPCS,22861,REV RPLCM ARTHRP 1NTRSPC CRV,,,2476.31,20141.22,5
HCPCS,22861,Rev rplcm arthrp 1ntrspc crv,,,6141.85,7758.12,6
HCPCS,228610,REV RPLCM ARTHRP 1NTRSPC CRV,,,2476.31,2476.31,1
HCPCS,22862,REV RPLCM RTHRP 1NTRSPC LMBR,,,2474.3,20141.22,5
HCPCS,22862,REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC LMBR,13052.0,8483.8,1851.15,13052.0,31
HCPCS,22862,Rev rplcm rthrp 1ntrspc lmbr,,,6141.85,7758.12,6
HCPCS,228620,REV RPLCM RTHRP 1NTRSPC LMBR,,,2474.3,2474.3,1
HCPCS,22864,RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE CERVICAL,11760.0,7644.0,1382.07,11760.0,32
HCPCS,22864,RMVL TOT ARTHRP 1NTRSPC CRV,,,2210.45,8335.26,5
HCPCS,22864,Rmvl tot arthrp 1ntrspc crv,,,6141.85,7758.12,6
HCPCS,228640,RMVL TOT ARTHRP 1NTRSPC CRV,,,2210.45,2210.45,1
HCPCS,22865,RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE LUMBAR,12700.0,8255.0,1815.84,12700.0,31
HCPCS,22865,RMVL TOT ARTHRP 1NTRSPC LMBR,,,2414.47,8335.26,5
HCPCS,22865,Rmvl tot arthrp 1ntrspc lmbr,,,6141.85,7758.12,6
HCPCS,228650,RMVL TOT ARTHRP 1NTRSPC LMBR,,,2414.47,2414.47,1
HCPCS,22867,INSJ STABLJ DEV W/DCMPRN,,,1132.08,39872.66,15
HCPCS,22867,INSJ STABLJ DEV W/DCMPRN LUMBAR SINGLE LEVEL,6000.0,3900.0,792.21,6000.0,28
HCPCS,22867,Insj stablj dev w/dcmprn,,,9774.46,12346.69,6
HCPCS,228670,INSJ STABLJ DEV W/DCMPRN,,,1132.08,1132.08,1
HCPCS,22868,INSJ STABLJ DEV W/DCMPRN,,,255.9,255.9,1
HCPCS,22868,INSJ STABLJ DEV W/DCMPRN LUMBAR SECOND LEVEL,1600.0,1040.0,190.42,1600.0,28
HCPCS,22868,Insj stablj dev w/dcmprn,,,9774.46,12346.69,6
HCPCS,228680,INSJ STABLJ DEV W/DCMPRN,,,255.9,255.9,1
HCPCS,22869,INSJ STABLJ DEV W/O DCMPRN,,,451.66,27897.39,15
HCPCS,22869,INSJ STABLJ DEV W/O DCMPRN LUMBAR SINGLE LEVEL,2812.0,1827.8,413.16,2812.0,28
HCPCS,22869,Insj stablj dev w/o dcmprn,,,6141.85,7758.12,6
HCPCS,228690,INSJ STABLJ DEV W/O DCMPRN,,,451.66,451.66,1
HCPCS,22870,INSJ STABLJ DEV W/O DCMPRN,,,122.8,122.8,1
HCPCS,22870,INSJ STABLJ DEV W/O DCMPRN LUMBAR SECOND LEVEL,936.0,608.4,107.3,936.0,28
HCPCS,22870,Insj stablj dev w/o dcmprn,,,6141.85,7758.12,6
HCPCS,228700,INSJ STABLJ DEV W/O DCMPRN,,,122.8,122.8,1
HCPCS,22899,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC THORACIC (COMP CODE 226,10649.0,6921.85,831.19,10649.0,15
HCPCS,22899,CHARITE - ARTIFICIAL DISC,20672.0,13436.8,831.19,20672.0,15
HCPCS,22899,IMAGE GUIDED VERTEBRAL BODY FIDUCIAL MARKER PLCMNT (COMP CODE 22,9750.5,6337.825,240.79,14990.4,56
HCPCS,22899,KYPHOPLASTY LUMBAR - 1ST VERTEBRAL BODY,8221.0,5343.65,831.19,8221.0,15
HCPCS,22899,KYPHOPLASTY THORACIC -1ST VERTEBRAL BODY,8460.0,5499.0,831.19,8460.0,15
HCPCS,22899,"KYPHOPLASTY THORACIC, EA ADD VB",7517.0,4886.05,831.19,7517.0,15
HCPCS,22899,"KYPHOPLASTY, LUMBAR EACH ADD VB",7278.0,4730.7,831.19,7278.0,15
HCPCS,22899,LUMBAR INTERVERTEBRAL DISC BIOPSY,819.0,532.35,409.5,997.43,15
HCPCS,22899,"OPEN VERTEBRAE AUGMENTATION (KYPHOPLASTY), INCLUDING CAVITY CREA",3115.0,2024.75,831.19,3115.0,15
HCPCS,22899,REMOVAL OF AN INTRASPINOUS SPACER (COMP CODE 22867),6450.0,4192.5,831.19,6450.0,15
HCPCS,22899,TOTAL DISC ARTHRP ANT CERVICAL 3 OR MORE LVL (COMP CODE 22858),3025.0,1966.25,831.19,3025.0,15
HCPCS,22899,UNLISTED PROCEDURE SPINE,2233.0,1451.45,240.79,3909.18,41
HCPCS,22899,UNLISTED SPINE SURGERY OR PROCEDURE,661.0,429.65,330.5,997.43,15
HCPCS,22899,VIDEO ASSISTED THORACOSCOPIC SPINAL SURG,1648.0,1071.2,824.0,1648.0,15
HCPCS,22900,EXC ABDL TUM DEEP < 5 CM,,,596.85,6205.4,16
HCPCS,22900,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM,3328.0,2163.2,277.14,3328.0,35
HCPCS,22900,Exc abdl tum deep < 5 cm,,,1112.95,1405.84,6
HCPCS,229000,EXC ABDL TUM DEEP < 5 CM,,,596.85,596.85,1
HCPCS,22901,EXC ABDL TUM DEEP 5 CM/>,,,702.85,6205.4,15
HCPCS,22901,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5+CM,4044.0,2628.6,366.47,4044.0,35
HCPCS,22901,Exc abdl tum deep 5 cm/>,,,1112.95,1405.84,6
HCPCS,229010,EXC ABDL TUM DEEP 5 CM/>,,,702.85,702.85,1
HCPCS,22902,EXC ABD LES SC < 3 CM,,,351.54,351.54,1
HCPCS,22902,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,5542.0,3602.2999999999997,163.56,8384.4,81
HCPCS,229020,EXC ABD LES SC < 3 CM,,,351.54,351.54,1
HCPCS,22903,EXC ABD LES SC 3 CM/>,,,464.51,464.51,1
HCPCS,22903,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>,16456.0,10696.4,536.09,36332.0,46
HCPCS,22903,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3+CM,2556.0,1661.4,240.87,2556.0,35
HCPCS,229030,EXC ABD LES SC 3 CM/>,,,464.51,464.51,1
HCPCS,22904,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM,6676.0,4339.4,576.36,6676.0,35
HCPCS,22904,RADICAL RESECT ABD TUMOR<5CM,,,1103.45,6205.4,15
HCPCS,22904,Radical resect abd tumor<5cm,,,1112.95,1405.84,6
HCPCS,229040,RADICAL RESECT ABD TUMOR<5CM,,,1103.45,1103.45,1
HCPCS,22905,RAD RESECT ABD TUMOR 5 CM/>,,,1399.97,6205.4,15
HCPCS,22905,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5+CM,8632.0,5610.8,746.87,8632.0,35
HCPCS,22905,Rad resect abd tumor 5 cm/>,,,1112.95,1405.84,6
HCPCS,229050,RAD RESECT ABD TUMOR 5 CM/>,,,1399.97,1399.97,1
HCPCS,22999,EXPLORATORY OF ABDOMEN (COMP CODE 20102),1592.0,1034.8,538.14,1592.0,15
HCPCS,22999,I&D ABDOMINAL WALL HEMATOMA (COMP CODE 26990),3180.0,2067.0,538.14,3180.0,15
HCPCS,22999,REMOVAL OF MESH ABD WALL (COMP 20680),2563.0,1665.95,538.14,2563.0,15
HCPCS,22999,UNLISTED PX ABDOMEN MUSCSKEL,,,240.79,520.1,14
HCPCS,22999,Unlisted px abdomen muscskel,,,310.03,391.62,6
HCPCS,23000,REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN,1792.0,1164.8,180.82,1344.0,35
HCPCS,23000,RMVL SBDLTD CLCREOUS DEP OPN,,,376.19,6205.4,15
HCPCS,23000,Rmvl sbdltd clcreous dep opn,,,1112.95,1405.84,6
HCPCS,230000,RMVL SBDLTD CLCREOUS DEP OPN,,,376.19,376.19,1
HCPCS,23020,CAPSULAR CONTRACTURE RELEASE,3744.0,2433.6,451.43,7034.85,50
HCPCS,23020,Capsular contracture release,,,2951.94,3728.76,6
HCPCS,230200,CAPSULAR CONTRACTURE RELEASE,,,725.97,725.97,1
HCPCS,23030,I&D SHOULDER DEEP ABSC/HMTMA,,,267.33,6205.4,15
HCPCS,23030,I&D SHOULDER DEEP ABSCESS/HEMATOMA,1388.0,902.2,124.76,1041.0,35
HCPCS,23030,I&d shoulder deep absc/hmtma,,,1112.95,1405.84,6
HCPCS,230300,I&D SHOULDER DEEP ABSC/HMTMA,,,267.33,267.33,1
HCPCS,23031,I&D SHOULDER INFECTED BURSA,1116.0,725.4,107.02,6205.4,50
HCPCS,23031,I&d shoulder infected bursa,,,1112.95,1405.84,6
HCPCS,230310,I&D SHOULDER INFECTED BURSA,,,233.15,233.15,1
HCPCS,23035,INCISION BONE CORTEX SHO,,,712.47,3469.95,15
HCPCS,23035,Incision bone cortex sho,,,2951.94,3728.76,6
HCPCS,230350,INCISION BONE CORTEX SHO,,,712.47,712.47,1
HCPCS,23040,ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB,4290.0,2788.5,514.14,4290.0,35
HCPCS,23040,ARTHRT GH JT EXPL/DRG/RMV FB,,,754.05,7034.85,15
HCPCS,23040,Arthrt gh jt expl/drg/rmv fb,,,2951.94,3728.76,6
HCPCS,230400,ARTHRT GH JT EXPL/DRG/RMV FB,,,754.05,754.05,1
HCPCS,23044,ARTHRT AC SC JT EXP/RMVL FB,,,595.6,7034.85,15
HCPCS,23044,ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB,3036.0,1973.4,398.28,3036.0,35
HCPCS,23044,Arthrt ac sc jt exp/rmvl fb,,,2951.94,3728.76,6
HCPCS,230440,ARTHRT AC SC JT EXP/RMVL FB,,,595.6,595.6,1
HCPCS,23065,BIOPSY SHOULDER TISSUES,,,167.08,3512.95,15
HCPCS,23065,BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL,920.0,598.0,77.92,690.0,35
HCPCS,23065,Biopsy shoulder tissues,,,1112.95,1405.84,6
HCPCS,230650,BIOPSY SHOULDER TISSUES,,,167.08,167.08,1
HCPCS,23066,BIOPSY SHOULDER TISSUES,,,387.18,6205.4,15
HCPCS,23066,BIOPSY SOFT TISSUE SHOULDER DEEP,1720.0,1118.0,178.35,1290.0,35
HCPCS,23066,Biopsy shoulder tissues,,,1112.95,1405.84,6
HCPCS,230660,BIOPSY SHOULDER TISSUES,,,387.18,387.18,1
HCPCS,23071,EXC SHOULDER LES SC 3 CM/>,,,442.86,442.86,1
HCPCS,23071,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>,9316.0,6055.4,508.6,36332.0,46
HCPCS,23071,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3+CM,2364.0,1536.6,228.98,2364.0,35
HCPCS,230710,EXC SHOULDER LES SC 3 CM/>,,,442.86,442.86,1
HCPCS,23073,EXC SHOULDER TUM DEEP 5 CM/>,,,733.42,6205.4,15
HCPCS,23073,EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5+CM,4052.0,2633.8,380.44,4052.0,35
HCPCS,23073,Exc shoulder tum deep 5 cm/>,,,1112.95,1405.84,6
HCPCS,230730,EXC SHOULDER TUM DEEP 5 CM/>,,,733.42,733.42,1
HCPCS,23075,EXC SHOULDER LES SC < 3 CM,,,346.28,3512.95,15
HCPCS,23075,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM,1684.0,1094.6,161.26,1263.0,35
HCPCS,23075,Exc shoulder les sc < 3 cm,,,1112.95,1405.84,6
HCPCS,230750,EXC SHOULDER LES SC < 3 CM,,,346.28,346.28,1
HCPCS,23076,EXC SHOULDER TUM DEEP < 5 CM,,,571.62,571.62,1
HCPCS,23076,EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM,9710.0,6311.5,319.87,14810.4,81
HCPCS,230760,EXC SHOULDER TUM DEEP < 5 CM,,,571.62,571.62,1
HCPCS,23077,RAD RESCJ TUM SHOULDER<5 CM,,,1190.18,6205.4,15
HCPCS,23077,RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM,7064.0,4591.6,662.03,7064.0,35
HCPCS,23077,Rad rescj tum shoulder<5 cm,,,2951.94,3728.76,6
HCPCS,230770,RAD RESCJ TUM SHOULDER<5 CM,,,1190.18,1190.18,1
HCPCS,23078,RAD RESCJ TUM SHOULDER 5CM/>,,,1507.6,6205.4,15
HCPCS,23078,RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5+CM,9020.0,5863.0,777.39,9020.0,35
HCPCS,23078,Rad rescj tum shoulder 5cm/>,,,2951.94,3728.76,6
HCPCS,230780,RAD RESCJ TUM SHOULDER 5CM/>,,,1507.6,1507.6,1
HCPCS,23100,ARTHROTOMY GLENHUMRL JT W/BX,,,534.07,7034.85,15
HCPCS,23100,ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY,2480.0,1612.0,358.09,2480.0,35
HCPCS,23100,Arthrotomy glenhumrl jt w/bx,,,2951.94,3728.76,6
HCPCS,231000,ARTHROTOMY GLENHUMRL JT W/BX,,,534.07,534.07,1
HCPCS,23101,ARTHRT ACRMCLV/STRNCLAV JT,,,483.71,7034.85,15
HCPCS,23101,ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG,2288.0,1487.2,333.39,2288.0,35
HCPCS,23101,Arthrt acrmclv/strnclav jt,,,2951.94,3728.76,6
HCPCS,231010,ARTHRT ACRMCLV/STRNCLAV JT,,,483.71,483.71,1
HCPCS,23105,ARTHROTOMY GLENOHUMERAL JT,,,675.62,15488.78,15
HCPCS,23105,ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY,3392.0,2204.8,480.38,3392.0,35
HCPCS,23105,Arthrotomy glenohumeral jt,,,2951.94,3728.76,6
HCPCS,231050,ARTHROTOMY GLENOHUMERAL JT,,,675.62,675.62,1
HCPCS,23106,ARTHROTOMY STRNCLAV JOINT,,,529.83,7034.85,15
HCPCS,23106,ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX,2452.0,1593.8,306.61,2452.0,35
HCPCS,23106,Arthrotomy strnclav joint,,,2951.94,3728.76,6
HCPCS,231060,ARTHROTOMY STRNCLAV JOINT,,,529.83,529.83,1
HCPCS,23107,ARTHRT GLENHUMRL JT W/EXPL,,,700.13,15488.78,15
HCPCS,23107,ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB,3548.0,2306.2,498.35,3548.0,35
HCPCS,23107,Arthrt glenhumrl jt w/expl,,,2951.94,3728.76,6
HCPCS,231070,ARTHRT GLENHUMRL JT W/EXPL,,,700.13,700.13,1
HCPCS,23120,CLAVICULECTOMY PARTIAL,3252.0,2113.8,339.74,7034.85,50
HCPCS,23120,Claviculectomy partial,,,2951.94,3728.76,6
HCPCS,231200,CLAVICULECTOMY PARTIAL,,,619.78,619.78,1
HCPCS,23125,CLAVICULECTOMY TOTAL,4242.0,2757.3,490.29,7034.85,50
HCPCS,23125,Claviculectomy total,,,2951.94,3728.76,6
HCPCS,231250,CLAVICULECTOMY TOTAL,,,748.02,748.02,1
HCPCS,23130,ACROMP/ACROMIONECTOMY PRTL,,,650.49,7034.85,15
HCPCS,23130,Acromp/acromionectomy prtl,,,2951.94,3728.76,6
HCPCS,23130,PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE,3419.0,2222.35,409.84,3419.0,35
HCPCS,231300,ACROMP/ACROMIONECTOMY PRTL,,,650.49,650.49,1
HCPCS,23140,EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA,2848.0,1851.2,314.28,2848.0,35
HCPCS,23140,REMOVAL OF BONE LESION,,,586.04,7034.85,15
HCPCS,23140,Removal of bone lesion,,,2951.94,3728.76,6
HCPCS,231400,REMOVAL OF BONE LESION,,,586.04,586.04,1
HCPCS,23145,REMOVAL OF BONE LESION,,,732.86,7034.85,15
HCPCS,23145,Removal of bone lesion,,,2951.94,3728.76,6
HCPCS,231450,REMOVAL OF BONE LESION,,,732.86,732.86,1
HCPCS,23146,REMOVAL OF BONE LESION,,,657.74,15488.78,15
HCPCS,23146,Removal of bone lesion,,,2951.94,3728.76,6
HCPCS,231460,REMOVAL OF BONE LESION,,,657.74,657.74,1
HCPCS,23150,EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS,3564.0,2316.6,421.34,3564.0,35
HCPCS,23150,REMOVAL OF HUMERUS LESION,,,703.02,7034.85,15
HCPCS,23150,Removal of humerus lesion,,,2951.94,3728.76,6
HCPCS,231500,REMOVAL OF HUMERUS LESION,,,703.02,703.02,1
HCPCS,23155,REMOVAL OF HUMERUS LESION,,,838.74,15488.78,15
HCPCS,23155,Removal of humerus lesion,,,2951.94,3728.76,6
HCPCS,231550,REMOVAL OF HUMERUS LESION,,,838.74,838.74,1
HCPCS,23156,REMOVAL OF HUMERUS LESION,,,715.29,15488.78,15
HCPCS,23156,Removal of humerus lesion,,,2951.94,3728.76,6
HCPCS,231560,REMOVAL OF HUMERUS LESION,,,715.29,715.29,1
HCPCS,23170,SEQUESTRECTOMY CLAVICLE,,,595.91,7034.85,15
HCPCS,23170,Sequestrectomy clavicle,,,2951.94,3728.76,6
HCPCS,231700,SEQUESTRECTOMY CLAVICLE,,,595.91,595.91,1
HCPCS,23172,SEQUESTRECTOMY SCAPULA,,,601.88,7034.85,15
HCPCS,23172,Sequestrectomy scapula,,,2951.94,3728.76,6
HCPCS,231720,SEQUESTRECTOMY SCAPULA,,,601.88,601.88,1
HCPCS,23174,SQSTRCTMY HUMRL HEAD SRG NCK,,,804.33,15488.78,15
HCPCS,23174,Sqstrctmy humrl head srg nck,,,2951.94,3728.76,6
HCPCS,231740,SQSTRCTMY HUMRL HEAD SRG NCK,,,804.33,804.33,1
HCPCS,23180,PARTIAL EXCISION BONE CLAVICLE,3596.0,2337.4,393.04,3596.0,35
HCPCS,23180,PRTL EXCISION BONE CLAVICLE,,,696.01,15488.78,15
HCPCS,23180,Prtl excision bone clavicle,,,2951.94,3728.76,6
HCPCS,231800,PRTL EXCISION BONE CLAVICLE,,,696.01,696.01,1
HCPCS,23182,PARTIAL EXCISION BONE SCAPULA,3444.0,2238.6,441.42,3444.0,35
HCPCS,23182,PRTL EXCISION BONE SCAPULA,,,707.03,15488.78,15
HCPCS,23182,Prtl excision bone scapula,,,2951.94,3728.76,6
HCPCS,231820,PRTL EXCISION BONE SCAPULA,,,707.03,707.03,1
HCPCS,23184,PARTIAL EXCISION BONE PROXIMAL HUMERUS,3960.0,2574.0,532.41,3960.0,35
HCPCS,23184,PRTL EXCISION BONE PROX HUM,,,779.73,15488.78,15
HCPCS,23184,Prtl excision bone prox hum,,,2951.94,3728.76,6
HCPCS,231840,PRTL EXCISION BONE PROX HUM,,,779.73,779.73,1
HCPCS,23190,OSTECTOMY SCAPULA PARTIAL,2988.0,1942.2,371.38,7034.85,50
HCPCS,23190,Ostectomy scapula partial,,,2951.94,3728.76,6
HCPCS,231900,OSTECTOMY SCAPULA PARTIAL,,,606.74,606.74,1
HCPCS,23195,RESECTION HUMERAL HEAD,,,786.56,15488.78,15
HCPCS,23195,Resection humeral head,,,2951.94,3728.76,6
HCPCS,231950,RESECTION HUMERAL HEAD,,,786.56,786.56,1
HCPCS,23200,RADICAL RESCJ TUMOR CLAVICLE,,,1575.13,8335.26,5
HCPCS,23200,Radical rescj tumor clavicle,,,2951.94,3728.76,6
HCPCS,232000,RADICAL RESCJ TUMOR CLAVICLE,,,1575.13,1575.13,1
HCPCS,23210,RADICAL RESCJ TUMOR SCAPULA,,,1848.5,8335.26,5
HCPCS,23210,Radical rescj tumor scapula,,,2951.94,3728.76,6
HCPCS,232100,RADICAL RESCJ TUMOR SCAPULA,,,1848.5,1848.5,1
HCPCS,23220,RADICAL RESCJ TUMOR PROX HUM,,,2023.76,8335.26,5
HCPCS,23220,RADICAL RESECTION BONE TUMOR PROXIMAL HUMERUS,12084.0,7854.6,942.72,12084.0,35
HCPCS,23220,Radical rescj tumor prox hum,,,2951.94,3728.76,6
HCPCS,232200,RADICAL RESCJ TUMOR PROX HUM,,,2023.76,2023.76,1
HCPCS,23330,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,9316.0,6055.4,213.46,8384.4,98
HCPCS,23330,REMOVE SHOULDER FOREIGN BODY,,,175.14,175.14,1
HCPCS,233300,REMOVE SHOULDER FOREIGN BODY,,,175.14,175.14,1
HCPCS,23333,REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM,2400.0,1560.0,344.25,2400.0,31
HCPCS,23333,REMOVE SHOULDER FB DEEP,,,499.15,6205.4,15
HCPCS,23333,Remove shoulder fb deep,,,1112.95,1405.84,6
HCPCS,233330,REMOVE SHOULDER FB DEEP,,,499.15,499.15,1
HCPCS,23334,PROSTHESIS REMOVAL HUMERAL/GLENOID COMPONENT,6200.0,4030.0,777.84,6200.0,31
HCPCS,23334,SHOULDER PROSTHESIS REMOVAL,,,1109.71,8335.26,15
HCPCS,23334,Shoulder prosthesis removal,,,2951.94,3728.76,6
HCPCS,233340,SHOULDER PROSTHESIS REMOVAL,,,1109.71,1109.71,1
HCPCS,23335,PROSTHESIS REMOVAL HUMERAL AND GLENOID COMPONENT,7600.0,4940.0,929.01,7600.0,31
HCPCS,23335,SHOULDER PROSTHESIS REMOVAL,,,1327.38,8335.26,5
HCPCS,23335,Shoulder prosthesis removal,,,2951.94,3728.76,6
HCPCS,233350,SHOULDER PROSTHESIS REMOVAL,,,1327.38,1327.38,1
HCPCS,23350,INJECTION FOR SHOULDER X-RAY,,,51.79,51.79,1
HCPCS,23350,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,675.5,439.075,24.01,3920.0,146
HCPCS,233500,INJECTION FOR SHOULDER X-RAY,,,51.79,51.79,1
HCPCS,23395,MUSCLE TRANSFER SHOULDER/ARM,,,1345.06,15488.78,15
HCPCS,23395,MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE,7416.0,4820.4,746.28,7416.0,35
HCPCS,23395,Muscle transfer shoulder/arm,,,2951.94,3728.76,6
HCPCS,233950,MUSCLE TRANSFER SHOULDER/ARM,,,1345.06,1345.06,1
HCPCS,23397,MUSCLE TRANSFERS,,,1197.12,15488.78,15
HCPCS,23397,Muscle transfers,,,2951.94,3728.76,6
HCPCS,233970,MUSCLE TRANSFERS,,,1197.12,1197.12,1
HCPCS,23400,FIXATION OF SHOULDER BLADE,,,1021.06,15488.78,15
HCPCS,23400,Fixation of shoulder blade,,,2951.94,3728.76,6
HCPCS,234000,FIXATION OF SHOULDER BLADE,,,1021.06,1021.06,1
HCPCS,23405,INCISION OF TENDON & MUSCLE,,,646.89,15488.78,15
HCPCS,23405,Incision of tendon & muscle,,,2951.94,3728.76,6
HCPCS,23405,TENOTOMY SHOULDER AREA 1 TENDON,3416.0,2220.4,431.98,3416.0,35
HCPCS,234050,INCISION OF TENDON & MUSCLE,,,646.89,646.89,1
HCPCS,23406,INCISE TENDON(S) & MUSCLE(S),,,767.37,15488.78,15
HCPCS,23406,Incise tendon(s) & muscle(s),,,2951.94,3728.76,6
HCPCS,23406,TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION,4404.0,2862.6,558.59,4404.0,35
HCPCS,234060,INCISE TENDON(S) & MUSCLE(S),,,767.37,767.37,1
HCPCS,23410,OPEN REPAIR OF ROTATOR CUFF ACUTE,4556.0,2961.4,611.2,4556.0,35
HCPCS,23410,REPAIR ROTATOR CUFF ACUTE,,,860.63,15488.78,15
HCPCS,23410,Repair rotator cuff acute,,,2951.94,3728.76,6
HCPCS,234100,REPAIR ROTATOR CUFF ACUTE,,,860.63,860.63,1
HCPCS,23412,OPEN REPAIR OF ROTATOR CUFF CHRONIC,4772.0,3101.8,665.12,4772.0,35
HCPCS,23412,REPAIR ROTATOR CUFF CHRONIC,,,894.99,15488.78,15
HCPCS,23412,Repair rotator cuff chronic,,,2951.94,3728.76,6
HCPCS,234120,REPAIR ROTATOR CUFF CHRONIC,,,894.99,894.99,1
HCPCS,23415,CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY,3692.0,2399.8,430.45,3692.0,35
HCPCS,23415,RELEASE OF SHOULDER LIGAMENT,,,734.02,15488.78,15
HCPCS,23415,Release of shoulder ligament,,,2951.94,3728.76,6
HCPCS,234150,RELEASE OF SHOULDER LIGAMENT,,,734.02,734.02,1
HCPCS,23420,RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC,5416.0,3520.4,721.16,5416.0,35
HCPCS,23420,REPAIR OF SHOULDER,,,1022.57,15488.78,15
HCPCS,23420,Repair of shoulder,,,2951.94,3728.76,6
HCPCS,234200,REPAIR OF SHOULDER,,,1022.57,1022.57,1
HCPCS,23430,REPAIR BICEPS TENDON,,,782.51,15488.78,15
HCPCS,23430,Repair biceps tendon,,,2951.94,3728.76,6
HCPCS,23430,TENODESIS LONG TENDON BICEPS,4068.0,2644.2,486.29,4068.0,35
HCPCS,234300,REPAIR BICEPS TENDON,,,782.51,782.51,1
HCPCS,23440,REMOVE/TRANSPLANT TENDON,,,797.2,15488.78,15
HCPCS,23440,RESECTION/TRANSPLANTATION LONG TENDON BICEPS,4256.0,2766.4,497.82,4256.0,35
HCPCS,23440,Remove/transplant tendon,,,2951.94,3728.76,6
HCPCS,234400,REMOVE/TRANSPLANT TENDON,,,797.2,797.2,1
HCPCS,23450,CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON,5480.0,3562.0,710.92,5480.0,35
HCPCS,23450,REPAIR SHOULDER CAPSULE,,,993.16,15488.78,15
HCPCS,23450,Repair shoulder capsule,,,2951.94,3728.76,6
HCPCS,234500,REPAIR SHOULDER CAPSULE,,,993.16,993.16,1
HCPCS,23455,CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR,5868.0,3814.2,755.25,5868.0,35
HCPCS,23455,REPAIR SHOULDER CAPSULE,,,1035.59,15488.78,15
HCPCS,23455,Repair shoulder capsule,,,2951.94,3728.76,6
HCPCS,234550,REPAIR SHOULDER CAPSULE,,,1035.59,1035.59,1
HCPCS,23460,CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK,6961.0,4524.65,798.9,6961.0,35
HCPCS,23460,REPAIR SHOULDER CAPSULE,,,1144.1,15488.78,15
HCPCS,23460,Repair shoulder capsule,,,2951.94,3728.76,6
HCPCS,234600,REPAIR SHOULDER CAPSULE,,,1144.1,1144.1,1
HCPCS,23462,CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR,6288.0,4087.2,782.14,6288.0,35
HCPCS,23462,REPAIR SHOULDER CAPSULE,,,1120.45,15488.78,15
HCPCS,23462,Repair shoulder capsule,,,2951.94,3728.76,6
HCPCS,234620,REPAIR SHOULDER CAPSULE,,,1120.45,1120.45,1
HCPCS,23465,CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK,6520.0,4238.0,814.53,6520.0,35
HCPCS,23465,REPAIR SHOULDER CAPSULE,,,1173.26,15488.78,15
HCPCS,23465,Repair shoulder capsule,,,2951.94,3728.76,6
HCPCS,234650,REPAIR SHOULDER CAPSULE,,,1173.26,1173.26,1
HCPCS,23466,CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS,6952.0,4518.8,805.58,6952.0,35
HCPCS,23466,REPAIR SHOULDER CAPSULE,,,1177.18,15488.78,15
HCPCS,23466,Repair shoulder capsule,,,2951.94,3728.76,6
HCPCS,234660,REPAIR SHOULDER CAPSULE,,,1177.18,1177.18,1
HCPCS,23470,ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY,7156.0,4651.4,913.82,7156.0,35
HCPCS,23470,RECONSTRUCT SHOULDER JOINT,,,1255.12,27897.39,15
HCPCS,23470,Reconstruct shoulder joint,,,5660.06,7149.55,6
HCPCS,234700,RECONSTRUCT SHOULDER JOINT,,,1255.12,1255.12,1
HCPCS,23472,ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER,9737.0,6329.05,992.84,9737.0,35
HCPCS,23472,RECONSTRUCT SHOULDER JOINT,,,1512.39,39872.66,16
HCPCS,23472,Reconstruct shoulder joint,,,5660.06,7149.55,6
HCPCS,234720,RECONSTRUCT SHOULDER JOINT,,,1512.39,1512.39,1
HCPCS,23473,REVIS RECONST SHOULDER JOINT,,,1683.12,27897.39,15
HCPCS,23473,REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT,10000.0,6500.0,1137.24,10000.0,31
HCPCS,23473,Revis reconst shoulder joint,,,5660.06,7149.55,6
HCPCS,234730,REVIS RECONST SHOULDER JOINT,,,1683.12,1683.12,1
HCPCS,23474,REVIS RECONST SHOULDER JOINT,,,1817.64,14747.88,5
HCPCS,23474,REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT,10884.0,7074.6,1229.51,10884.0,31
HCPCS,23474,Revis reconst shoulder joint,,,5660.06,7149.55,6
HCPCS,234740,REVIS RECONST SHOULDER JOINT,,,1817.64,1817.64,1
HCPCS,23480,OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION,4616.0,3000.4,500.53,4616.0,35
HCPCS,23480,REVISION OF COLLAR BONE,,,862.49,15488.78,15
HCPCS,23480,Revision of collar bone,,,2951.94,3728.76,6
HCPCS,234800,REVISION OF COLLAR BONE,,,862.49,862.49,1
HCPCS,23485,OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL,5564.0,3616.6,682.53,5564.0,35
HCPCS,23485,REVISION OF COLLAR BONE,,,1001.69,27897.39,15
HCPCS,23485,Revision of collar bone,,,5924.91,7484.1,6
HCPCS,234850,REVISION OF COLLAR BONE,,,1001.69,1001.69,1
HCPCS,23490,REINFORCE CLAVICLE,,,904.67,15488.78,15
HCPCS,23490,Reinforce clavicle,,,2951.94,3728.76,6
HCPCS,234900,REINFORCE CLAVICLE,,,904.67,904.67,1
HCPCS,23491,PROPH TX W/WO METHYLMETHACRYLATE PROX HUMERUS,5816.0,3780.4,734.92,5816.0,35
HCPCS,23491,REINFORCE SHOULDER BONES,,,1066.07,27897.39,15
HCPCS,23491,Reinforce shoulder bones,,,2951.94,3728.76,6
HCPCS,234910,REINFORCE SHOULDER BONES,,,1066.07,1066.07,1
HCPCS,23500,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,1175.5,764.075,102.77,4151.0,133
HCPCS,23500,CLTX CLAVICULAR FX W/O MNPJ,,,244.16,244.16,1
HCPCS,235000,CLTX CLAVICULAR FX W/O MNPJ,,,244.16,244.16,1
HCPCS,23505,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,5367.5,3488.875,175.15,8550.0,133
HCPCS,23505,CLTX CLAVICULAR FX W/MNPJ,,,357.22,357.22,1
HCPCS,235050,CLTX CLAVICULAR FX W/MNPJ,,,357.22,357.22,1
HCPCS,23515,OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION,3876.0,2519.4,394.62,3876.0,35
HCPCS,23515,OPTX CLAVICULAR FX W/INT FIX,,,757.7,15488.78,15
HCPCS,23515,Optx clavicular fx w/int fix,,,3366.74,4252.73,6
HCPCS,235150,OPTX CLAVICULAR FX W/INT FIX,,,757.7,757.7,1
HCPCS,23520,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,9203.0,5981.95,310.03,8282.7,98
HCPCS,23520,CLTX STRNCLAV DISLC W/O MNPJ,,,255.02,255.02,1
HCPCS,235200,CLTX STRNCLAV DISLC W/O MNPJ,,,255.02,255.02,1
HCPCS,23525,CLTX STRNCLAV DISLC W/MNPJ,,,240.79,520.1,15
HCPCS,23525,Cltx strnclav dislc w/mnpj,,,310.03,391.62,6
HCPCS,235250,CLTX STRNCLAV DISLC W/MNPJ,,,386.62,386.62,1
HCPCS,23530,OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC,2992.0,1944.8,376.82,2992.0,35
HCPCS,23530,OPTX STRNCLAV DISLC AQT/CHRN,,,607.1,15488.78,15
HCPCS,23530,Optx strnclav dislc aqt/chrn,,,3366.74,4252.73,6
HCPCS,235300,OPTX STRNCLAV DISLC AQT/CHRN,,,607.1,607.1,1
HCPCS,23532,OPTX STRCLV DSLC AQ/CHRN GRF,,,660.51,15488.78,15
HCPCS,23532,Optx strclv dslc aq/chrn grf,,,3366.74,4252.73,6
HCPCS,235320,OPTX STRCLV DSLC AQ/CHRN GRF,,,660.51,660.51,1
HCPCS,23540,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,1161.5,754.975,116.38,4151.0,130
HCPCS,23540,CLTX ACROMCLAV DISLC WO MNPJ,,,252.95,252.95,1
HCPCS,235400,CLTX ACROMCLAV DISLC WO MNPJ,,,252.95,252.95,1
HCPCS,23545,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,1375.5,894.075,156.16,4268.0,133
HCPCS,23545,CLTX ACROMCLAV DISLC W/MNPJ,,,345.99,345.99,1
HCPCS,235450,CLTX ACROMCLAV DISLC W/MNPJ,,,345.99,345.99,1
HCPCS,23550,OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC,3036.0,1973.4,417.38,3036.0,35
HCPCS,23550,OPTX ACROMCLV DISLC AQT/CHRN,,,603.06,15488.78,15
HCPCS,23550,Optx acromclv dislc aqt/chrn,,,3366.74,4252.73,6
HCPCS,235500,OPTX ACROMCLV DISLC AQT/CHRN,,,603.06,603.06,1
HCPCS,23552,OPTX ACRCLV DSLC AQ/CHRN GRF,,,683.86,15488.78,15
HCPCS,23552,OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,3528.0,2293.2,433.23,3528.0,35
HCPCS,23552,Optx acrclv dslc aq/chrn grf,,,3366.74,4252.73,6
HCPCS,235520,OPTX ACRCLV DSLC AQ/CHRN GRF,,,683.86,683.86,1
HCPCS,23570,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,1161.5,754.975,116.22,4151.0,130
HCPCS,23570,CLTX SCAPULAR FX W/O MNPJ,,,259.18,259.18,1
HCPCS,235700,CLTX SCAPULAR FX W/O MNPJ,,,259.18,259.18,1
HCPCS,23575,CLTX SCAP FX W/MNPJ +-TRACTJ,,,404.51,404.51,1
HCPCS,23575,CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION,5447.5,3540.875,187.72,8282.7,84
HCPCS,235750,CLTX SCAP FX W/MNPJ +-TRACTJ,,,404.51,404.51,1
HCPCS,23585,OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD,5692.0,3699.8,477.85,5692.0,35
HCPCS,23585,OPTX SCAPULAR FX W/INT FIXJ,,,1023.96,15488.78,15
HCPCS,23585,Optx scapular fx w/int fixj,,,3366.74,4252.73,6
HCPCS,235850,OPTX SCAPULAR FX W/INT FIXJ,,,1023.96,1023.96,1
HCPCS,23600,CLTX PROX HUMRL FX W/O MNPJ,,,336.74,336.74,1
HCPCS,23600,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,1289.5,838.175,165.17,4151.0,133
HCPCS,236000,CLTX PROX HUMRL FX W/O MNPJ,,,336.74,336.74,1
HCPCS,23605,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,5613.5,3648.7749999999996,254.07,8550.0,133
HCPCS,23605,CLTX PRX HMRL FX MNPJ+-TRACT,,,455.07,455.07,1
HCPCS,236050,CLTX PRX HMRL FX MNPJ+-TRACT,,,455.07,455.07,1
HCPCS,23615,OPEN TREATMENT PROXIMAL HUMERAL FRACTURE,4920.0,3198.0,536.65,4920.0,35
HCPCS,23615,OPTX PROX HUMRL FX W/INT FIX,,,927.59,27897.39,16
HCPCS,23615,Optx prox humrl fx w/int fix,,,3366.74,4252.73,6
HCPCS,236150,OPTX PROX HUMRL FX W/INT FIX,,,927.59,927.59,1
HCPCS,23616,OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT,7348.0,4776.2,957.21,7348.0,35
HCPCS,23616,OPTX PRX HMRL FX FIX RPR RPL,,,1296.46,39872.66,15
HCPCS,23616,Optx prx hmrl fx fix rpr rpl,,,3366.74,4252.73,6
HCPCS,236160,OPTX PRX HMRL FX FIX RPR RPL,,,1296.46,1296.46,1
HCPCS,23620,CLTX GR HMRL TBRS FX WO MNPJ,,,277.27,277.27,1
HCPCS,23620,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,1199.5,779.675,153.02,4151.0,84
HCPCS,236200,CLTX GR HMRL TBRS FX WO MNPJ,,,277.27,277.27,1
HCPCS,23625,CLTX GR HMRL TBRS FX W/MNPJ,,,377.44,377.44,1
HCPCS,23625,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,5421.5,3523.975,193.56,8550.0,84
HCPCS,236250,CLTX GR HMRL TBRS FX W/MNPJ,,,377.44,377.44,1
HCPCS,23630,OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE,4228.0,2748.2,422.39,4228.0,35
HCPCS,23630,OPTX GR HMRL TBRS FX INT FIX,,,821.28,15488.78,15
HCPCS,23630,Optx gr hmrl tbrs fx int fix,,,3366.74,4252.73,6
HCPCS,236300,OPTX GR HMRL TBRS FX INT FIX,,,821.28,821.28,1
HCPCS,23650,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,1466.0,952.9000000000001,149.91,4151.0,179
HCPCS,23650,CLTX SHO DSLC W/MNPJ WO ANES,,,322.36,322.36,1
HCPCS,236500,CLTX SHO DSLC W/MNPJ WO ANES,,,322.36,322.36,1
HCPCS,23655,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,5648.5,3671.5249999999996,205.54,8370.0,133
HCPCS,23655,CLTX SHO DSLC W/MNPJ W/ANES,,,432.15,432.15,1
HCPCS,236550,CLTX SHO DSLC W/MNPJ W/ANES,,,432.15,432.15,1
HCPCS,23660,OPEN RX ACUTE SHLDR DISLOC,3064.0,1991.6,426.18,3064.0,35
HCPCS,23660,OPTX ACUTE SHOULDER DISLC,,,616.85,15488.78,15
HCPCS,23660,Optx acute shoulder dislc,,,3366.74,4252.73,6
HCPCS,236600,OPTX ACUTE SHOULDER DISLC,,,616.85,616.85,1
HCPCS,23665,CLTX SHO DSLC FX GR HMRL TBR,,,427.24,427.24,1
HCPCS,23665,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,5533.5,3596.7749999999996,216.36,8282.7,133
HCPCS,236650,CLTX SHO DSLC FX GR HMRL TBR,,,427.24,427.24,1
HCPCS,23670,OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX,4912.0,3192.8,461.38,4912.0,35
HCPCS,23670,OPTX SHO DISLC FX,,,917.13,15488.78,15
HCPCS,23670,Optx sho dislc fx,,,3366.74,4252.73,6
HCPCS,236700,OPTX SHO DISLC FX,,,917.13,917.13,1
HCPCS,23675,CLTX SHO DISLC NECK FX MNPJ,,,533.97,533.97,1
HCPCS,23675,CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ,5855.5,3806.075,246.57,8282.7,84
HCPCS,236750,CLTX SHO DISLC NECK FX MNPJ,,,533.97,533.97,1
HCPCS,23680,OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE,5260.0,3419.0,576.38,5260.0,35
HCPCS,23680,OPTX SHO DISLC NECK FX FIXJ,,,967.05,27897.39,15
HCPCS,23680,Optx sho dislc neck fx fixj,,,3366.74,4252.73,6
HCPCS,236800,OPTX SHO DISLC NECK FX FIXJ,,,967.05,967.05,1
HCPCS,23700,MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS,1028.0,668.2,152.21,1028.0,35
HCPCS,23700,MNPJ ANES SHO JT FIXJ APRATS,,,205.61,3469.95,15
HCPCS,23700,Mnpj anes sho jt fixj aprats,,,632.74,799.25,6
HCPCS,237000,MNPJ ANES SHO JT FIXJ APRATS,,,205.61,205.61,1
HCPCS,23800,ARTHRODESIS GLENOHUMERAL JT,,,1078.03,15488.78,15
HCPCS,23800,Arthrodesis glenohumeral jt,,,2951.94,3728.76,6
HCPCS,238000,ARTHRODESIS GLENOHUMERAL JT,,,1078.03,1078.03,1
HCPCS,23802,ARTHRD GLENOHUMERAL JT W/GRF,,,1344.7,27897.39,15
HCPCS,23802,Arthrd glenohumeral jt w/grf,,,5924.91,7484.1,6
HCPCS,238020,ARTHRD GLENOHUMERAL JT W/GRF,,,1344.7,1344.7,1
HCPCS,23900,INTERTHORACOSCPLR AMPUTATION,,,1450.45,14747.88,5
HCPCS,23900,Interthoracoscplr amputation,,,5924.91,7484.1,6
HCPCS,239000,INTERTHORACOSCPLR AMPUTATION,,,1450.45,1450.45,1
HCPCS,23920,DISARTICULATION SHOULDER,6492.0,4219.8,775.19,14747.88,40
HCPCS,23920,Disarticulation shoulder,,,5924.91,7484.1,6
HCPCS,239200,DISARTICULATION SHOULDER,,,1178.24,1178.24,1
HCPCS,23921,DISARTICULATION SHO SEC CLSR,,,497.47,3966.07,15
HCPCS,23921,Disarticulation sho sec clsr,,,1112.95,1405.84,6
HCPCS,239210,DISARTICULATION SHO SEC CLSR,,,497.47,497.47,1
HCPCS,23929,REPAIR PECTORALIS MAJOR MUSCLE (COMP 29828),5264.0,3421.6,371.14,5264.0,15
HCPCS,23929,SHOULDER AUGMENTATION W/CEMENT (COMP CODE 22513),22268.0,14474.2,240.79,36968.4,56
HCPCS,23930,I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA,1196.0,777.4,105.2,897.0,35
HCPCS,23930,I&D UPR A/E DP ABSC/HMTMA,,,226.2,6205.4,15
HCPCS,23930,I&d upr a/e dp absc/hmtma,,,1112.95,1405.84,6
HCPCS,239300,I&D UPR A/E DP ABSC/HMTMA,,,226.2,226.2,1
HCPCS,23931,I&D UPR A/E BURSA,,,168.56,168.56,1
HCPCS,23931,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,5026.0,3266.8999999999996,78.25,13665.0,133
HCPCS,239310,I&D UPR A/E BURSA,,,168.56,168.56,1
HCPCS,23935,INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW,2552.0,1658.8,324.4,2552.0,35
HCPCS,23935,INC DP OPN B1 CRTX HUM/ELBW,,,541.48,7034.85,15
HCPCS,23935,Inc dp opn b1 crtx hum/elbw,,,3488.43,4406.44,6
HCPCS,239350,INC DP OPN B1 CRTX HUM/ELBW,,,541.48,541.48,1
HCPCS,24000,ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB,2432.0,1580.8,341.42,2432.0,35
HCPCS,24000,ARTHRT ELBW EXPL DRG/RMVL FB,,,505.26,7034.85,15
HCPCS,24000,Arthrt elbw expl drg/rmvl fb,,,1074.6,1357.39,6
HCPCS,240000,ARTHRT ELBW EXPL DRG/RMVL FB,,,505.26,505.26,1
HCPCS,24006,ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX,4286.0,2785.9,451.2,4286.0,35
HCPCS,24006,ARTHRT ELBW CAPSL EXC RLS,,,751.51,7034.85,15
HCPCS,24006,Arthrt elbw capsl exc rls,,,1074.6,1357.39,6
HCPCS,240060,ARTHRT ELBW CAPSL EXC RLS,,,751.51,751.51,1
HCPCS,24065,BIOPSY ARM/ELBOW SOFT TISSUE,,,169.68,3512.95,15
HCPCS,24065,"BX ARM/ELBOW SOFT TISSUE,SUPERFICIAL",852.0,553.8,85.4,639.0,35
HCPCS,24065,Biopsy arm/elbow soft tissue,,,1112.95,1405.84,6
HCPCS,240650,BIOPSY ARM/ELBOW SOFT TISSUE,,,169.68,169.68,1
HCPCS,24066,BIOPSY ARM/ELBOW SOFT TISSUE,,,444.97,6205.4,15
HCPCS,24066,"BX ARM/ELBOW SOFT TISSUE,DEEP",2140.0,1391.0,205.31,1605.0,35
HCPCS,24066,Biopsy arm/elbow soft tissue,,,1112.95,1405.84,6
HCPCS,240660,BIOPSY ARM/ELBOW SOFT TISSUE,,,444.97,444.97,1
HCPCS,24071,EXC ARM/ELBOW LES SC 3 CM/>,,,427.39,427.39,1
HCPCS,24071,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3+CM,2280.0,1482.0,222.13,2280.0,35
HCPCS,24071,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>,16456.0,10696.4,489.82,36332.0,46
HCPCS,240710,EXC ARM/ELBOW LES SC 3 CM/>,,,427.39,427.39,1
HCPCS,24073,EX ARM/ELBOW TUM DEEP 5 CM/>,,,729.35,6205.4,16
HCPCS,24073,EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM,4052.0,2633.8,381.98,4052.0,35
HCPCS,24073,Ex arm/elbow tum deep 5 cm/>,,,1074.6,1357.39,6
HCPCS,240730,EX ARM/ELBOW TUM DEEP 5 CM/>,,,729.35,729.35,1
HCPCS,24075,EXC ARM/ELBOW LES SC < 3 CM,,,346.66,346.66,1
HCPCS,24075,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,5591.0,3634.1499999999996,161.59,8384.4,81
HCPCS,240750,EXC ARM/ELBOW LES SC < 3 CM,,,346.66,346.66,1
HCPCS,24076,EX ARM/ELBOW TUM DEEP < 5 CM,,,575.48,6205.4,15
HCPCS,24076,EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM,3260.0,2119.0,283.86,3260.0,35
HCPCS,24076,Ex arm/elbow tum deep < 5 cm,,,1112.95,1405.84,6
HCPCS,240760,EX ARM/ELBOW TUM DEEP < 5 CM,,,575.48,575.48,1
HCPCS,24077,RAD RESCJ TUM TISS A/E <5CM,,,1080.49,6205.4,15
HCPCS,24077,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM,6288.0,4087.2,600.53,6288.0,35
HCPCS,24077,Rad rescj tum tiss a/e <5cm,,,2951.94,3728.76,6
HCPCS,240770,RAD RESCJ TUM TISS A/E <5CM,,,1080.49,1080.49,1
HCPCS,24079,RAD RESCJ TUM TISS A/E 5 CM+,,,1392.85,17782.0,16
HCPCS,24079,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5+CM,8244.0,5358.6,716.36,8244.0,35
HCPCS,24079,Rad rescj tum tiss a/e 5 cm+,,,2951.94,3728.76,6
HCPCS,240790,RAD RESCJ TUM TISS A/E 5 CM+,,,1392.85,1392.85,1
HCPCS,24100,ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY,2231.0,1450.15,254.55,2231.0,35
HCPCS,24100,ARTHRT ELBW SYNOVIAL BX ONLY,,,444.34,7034.85,15
HCPCS,24100,Arthrt elbw synovial bx only,,,1074.6,1357.39,6
HCPCS,241000,ARTHRT ELBW SYNOVIAL BX ONLY,,,444.34,444.34,1
HCPCS,24101,ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB,2520.0,1638.0,357.04,2520.0,35
HCPCS,24101,ARTHRT ELBW JT EXPL BX RMVL,,,530.57,7034.85,15
HCPCS,24101,Arthrt elbw jt expl bx rmvl,,,1074.6,1357.39,6
HCPCS,241010,ARTHRT ELBW JT EXPL BX RMVL,,,530.57,530.57,1
HCPCS,24102,ARTHROTOMY ELBOW W/SYNOVECTOMY,3304.0,2147.6,461.93,3304.0,35
HCPCS,24102,ARTHRT ELBOW W/SYNOVECTOMY,,,650.47,7034.85,15
HCPCS,24102,Arthrt elbow w/synovectomy,,,1074.6,1357.39,6
HCPCS,241020,ARTHRT ELBOW W/SYNOVECTOMY,,,650.47,650.47,1
HCPCS,24105,EXCISION OLECRANON BURSA,1512.0,982.8,206.39,7034.85,50
HCPCS,24105,Excision olecranon bursa,,,1074.6,1357.39,6
HCPCS,241050,EXCISION OLECRANON BURSA,,,379.58,379.58,1
HCPCS,24110,EXC/CURTG B1 CST/B9 TUM HUM,,,622.9,7034.85,15
HCPCS,24110,EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS,3032.0,1970.8,417.04,3032.0,35
HCPCS,24110,Exc/curtg b1 cst/b9 tum hum,,,2951.94,3728.76,6
HCPCS,241100,EXC/CURTG B1 CST/B9 TUM HUM,,,622.9,622.9,1
HCPCS,24115,EXC/CRTG B1 CST/TUM HUM AGRF,,,776.8,15488.78,15
HCPCS,24115,Exc/crtg b1 cst/tum hum agrf,,,2951.94,3728.76,6
HCPCS,241150,EXC/CRTG B1 CST/TUM HUM AGRF,,,776.8,776.8,1
HCPCS,24116,EXC/CRTG B1 CST/TUM HUM ALGR,,,904.69,15488.78,15
HCPCS,24116,EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT,4892.0,3179.8,591.95,4892.0,35
HCPCS,24116,Exc/crtg b1 cst/tum hum algr,,,2951.94,3728.76,6
HCPCS,241160,EXC/CRTG B1 CST/TUM HUM ALGR,,,904.69,904.69,1
HCPCS,24120,EXC/CRTG B1 CST/B9 TUM RDS,,,561.91,7034.85,15
HCPCS,24120,EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN,2728.0,1773.2,347.11,2728.0,35
HCPCS,24120,Exc/crtg b1 cst/b9 tum rds,,,1074.6,1357.39,6
HCPCS,241200,EXC/CRTG B1 CST/B9 TUM RDS,,,561.91,561.91,1
HCPCS,24125,EXC/CRTG B1 CST/TUM RDS AGRF,,,656.99,7034.85,15
HCPCS,24125,Exc/crtg b1 cst/tum rds agrf,,,1074.6,1357.39,6
HCPCS,241250,EXC/CRTG B1 CST/TUM RDS AGRF,,,656.99,656.99,1
HCPCS,24126,EXC/CRTG B1 CST/TUM RDS ALGR,,,685.78,15488.78,15
HCPCS,24126,EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/ALGRT,3448.0,2241.2,401.59,3448.0,35
HCPCS,24126,Exc/crtg b1 cst/tum rds algr,,,3488.43,4406.44,6
HCPCS,241260,EXC/CRTG B1 CST/TUM RDS ALGR,,,685.78,685.78,1
HCPCS,24130,EXCISION RADIAL HEAD,2568.0,1669.2,353.24,7034.85,50
HCPCS,24130,Excision radial head,,,3488.43,4406.44,6
HCPCS,241300,EXCISION RADIAL HEAD,,,538.49,538.49,1
HCPCS,24134,SEQUESTRECTOMY SHFT/DSTL HUM,,,787.04,15488.78,15
HCPCS,24134,Sequestrectomy shft/dstl hum,,,2951.94,3728.76,6
HCPCS,241340,SEQUESTRECTOMY SHFT/DSTL HUM,,,787.04,787.04,1
HCPCS,24136,SEQUESTRECTOMY RADIAL H/N,,,666.84,7034.85,15
HCPCS,24136,Sequestrectomy radial h/n,,,1074.6,1357.39,6
HCPCS,241360,SEQUESTRECTOMY RADIAL H/N,,,666.84,666.84,1
HCPCS,24138,SEQUESTRECTOMY OLECRN PROCES,,,723.25,15488.78,15
HCPCS,24138,"SEQUESTRECTOMY,OLECRANNON PROCESS",3740.0,2431.0,399.14,3740.0,35
HCPCS,24138,Sequestrectomy olecrn proces,,,3488.43,4406.44,6
HCPCS,241380,SEQUESTRECTOMY OLECRN PROCES,,,723.25,723.25,1
HCPCS,24140,PARTIAL EXC BONE HUMERUS,,,739.71,7034.85,15
HCPCS,24140,PARTIAL REMOVAL HUMERUS,3820.0,2483.0,523.86,3820.0,35
HCPCS,24140,Partial exc bone humerus,,,2951.94,3728.76,6
HCPCS,241400,PARTIAL EXC BONE HUMERUS,,,739.71,739.71,1
HCPCS,24145,PARTIAL REMOVAL RADIAL HEAD/NECK,3124.0,2030.6,403.2,3124.0,35
HCPCS,24145,PRTL EXC BONE RADIAL H/N,,,627.13,15488.78,15
HCPCS,24145,Prtl exc bone radial h/n,,,3488.43,4406.44,6
HCPCS,241450,PRTL EXC BONE RADIAL H/N,,,627.13,627.13,1
HCPCS,24147,PARTIAL REMOVAL OLECRANNON PROCESS,3136.0,2038.4,406.36,3136.0,35
HCPCS,24147,PRTL EXC BONE OLECRN PROCESS,,,660.29,7034.85,15
HCPCS,24147,Prtl exc bone olecrn process,,,1074.6,1357.39,6
HCPCS,241470,PRTL EXC BONE OLECRN PROCESS,,,660.29,660.29,1
HCPCS,24149,RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT,7137.0,4639.05,720.11,7137.0,35
HCPCS,24149,RADICAL RESECTION OF ELBOW,,,1237.71,15488.78,15
HCPCS,24149,Radical resection of elbow,,,3488.43,4406.44,6
HCPCS,241490,RADICAL RESECTION OF ELBOW,,,1237.71,1237.71,1
HCPCS,24150,RAD RESCJ TUM DSTL/SHFT HUM,,,1616.91,15488.78,15
HCPCS,24150,RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS,9384.0,6099.6,751.71,9384.0,35
HCPCS,24150,Rad rescj tum dstl/shft hum,,,2951.94,3728.76,6
HCPCS,241500,RAD RESCJ TUM DSTL/SHFT HUM,,,1616.91,1616.91,1
HCPCS,24152,RAD RESECTION TUM RADIAL H/N,,,1407.18,15488.78,15
HCPCS,24152,Rad resection tum radial h/n,,,3488.43,4406.44,6
HCPCS,241520,RAD RESECTION TUM RADIAL H/N,,,1407.18,1407.18,1
HCPCS,24155,RESECTION OF ELBOW JOINT,,,895.56,7034.85,15
HCPCS,24155,Resection of elbow joint,,,1074.6,1357.39,6
HCPCS,241550,RESECTION OF ELBOW JOINT,,,895.56,895.56,1
HCPCS,24160,PROSTHESIS REMOVAL HUMERAL AND ULNAR COMPONENTS,7452.0,4843.8,526.73,7452.0,35
HCPCS,24160,RMVL PROSTHHUMRL&ULNAR CMPNT,,,1317.06,7034.85,15
HCPCS,24160,Rmvl prosthhumrl&ulnar cmpnt,,,1074.6,1357.39,6
HCPCS,241600,RMVL PROSTHHUMRL&ULNAR CMPNT,,,1317.06,1317.06,1
HCPCS,24164,PROSTHESIS REMOVAL RADIAL HEAD,4000.0,2600.0,354.57,4000.0,35
HCPCS,24164,REMOVAL PROSTH RADIAL HEAD,,,763.19,7034.85,15
HCPCS,24164,Removal prosth radial head,,,1074.6,1357.39,6
HCPCS,241640,REMOVAL PROSTH RADIAL HEAD,,,763.19,763.19,1
HCPCS,24200,RMVL FB UPPER ARM/ELBW SUBQ,,,148.07,148.07,1
HCPCS,24200,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,5020.0,3263.0,69.05,8384.4,133
HCPCS,242000,RMVL FB UPPER ARM/ELBW SUBQ,,,148.07,148.07,1
HCPCS,24201,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,9168.0,5959.2,179.5,14810.4,133
HCPCS,24201,RMVL FB UPPER ARM/ELBW DEEP,,,421.15,421.15,1
HCPCS,242010,RMVL FB UPPER ARM/ELBW DEEP,,,421.15,421.15,1
HCPCS,24220,INJECTION ELBOW ARTHROGRAPHY,553.0,359.45,78.41,3920.0,111
HCPCS,24220,INJECTION FOR ELBOW ARTHROGRAM,524.0,340.6,41.62,393.0,35
HCPCS,24220,INJECTION PX FOR ELBOW ARTHG,,,68.96,68.96,1
HCPCS,242200,INJECTION PX FOR ELBOW ARTHG,,,68.96,68.96,1
HCPCS,24300,MANIPULATION ELBOW W/ANESTH,1616.0,1050.4,253.49,1616.0,35
HCPCS,24300,MNPJ ELBOW UNDER ANES,,,461.3,3469.95,15
HCPCS,24300,Mnpj elbow under anes,,,632.74,799.25,6
HCPCS,243000,MNPJ ELBOW UNDER ANES,,,461.3,461.3,1
HCPCS,24301,MUSC/TDN TRANSFER UPR A/E 1,,,789.79,15488.78,15
HCPCS,24301,MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE,4152.0,2698.8,493.99,4152.0,35
HCPCS,24301,Musc/tdn transfer upr a/e 1,,,3488.43,4406.44,6
HCPCS,243010,MUSC/TDN TRANSFER UPR A/E 1,,,789.79,789.79,1
HCPCS,24305,"ARM/ELBOW TENDON LENGTHEN,SINGLE,EA",3048.0,1981.2,315.0,3048.0,35
HCPCS,24305,TENDON LNGTH UPR A/E EA TDN,,,611.09,7034.85,15
HCPCS,24305,Tendon lngth upr a/e ea tdn,,,1074.6,1357.39,6
HCPCS,243050,TENDON LNGTH UPR A/E EA TDN,,,611.09,611.09,1
HCPCS,24310,"TENOTOMY,ELBOW-SHLDR,SINGL,EACH",2448.0,1591.2,263.06,2448.0,35
HCPCS,24310,TNOT OPN ELBW TO SHO EA TDN,,,500.67,7034.85,15
HCPCS,24310,Tnot opn elbw to sho ea tdn,,,2951.94,3728.76,6
HCPCS,243100,TNOT OPN ELBW TO SHO EA TDN,,,500.67,500.67,1
HCPCS,24320,TENOPLASTY ELBOW TO SHO 1,,,821.05,15488.78,15
HCPCS,24320,Tenoplasty elbow to sho 1,,,2951.94,3728.76,6
HCPCS,243200,TENOPLASTY ELBOW TO SHO 1,,,821.05,821.05,1
HCPCS,24330,FLEXOR-PLASTY ELBOW,,,756.44,15488.78,15
HCPCS,24330,"FLEXORPLASTY,ELBOW",4308.0,2800.2,474.09,4308.0,35
HCPCS,24330,Flexor-plasty elbow,,,3488.43,4406.44,6
HCPCS,243300,FLEXOR-PLASTY ELBOW,,,756.44,756.44,1
HCPCS,24331,FLEXOR-PLASTY ELBW W/ADVMNT,,,826.34,15488.78,15
HCPCS,24331,Flexor-plasty elbw w/advmnt,,,1074.6,1357.39,6
HCPCS,243310,FLEXOR-PLASTY ELBW W/ADVMNT,,,826.34,826.34,1
HCPCS,24332,TENOLYSIS TRICEPS,,,649.16,7034.85,15
HCPCS,24332,"TENOLYSIS, TRICEPS",3164.0,2056.6,352.88,3164.0,35
HCPCS,24332,Tenolysis triceps,,,2951.94,3728.76,6
HCPCS,243320,TENOLYSIS TRICEPS,,,649.16,649.16,1
HCPCS,24340,TENODESIS BICEPS TDN AT ELBW,,,629.35,15488.78,15
HCPCS,24340,TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE,3232.0,2100.8,407.76,3232.0,35
HCPCS,24340,Tenodesis biceps tdn at elbw,,,2951.94,3728.76,6
HCPCS,243400,TENODESIS BICEPS TDN AT ELBW,,,629.35,629.35,1
HCPCS,24341,REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA,3796.0,2467.4,406.96,3796.0,35
HCPCS,24341,RPR TDN/MUSC UPR A/E EACH,,,787.82,15488.78,15
HCPCS,24341,Rpr tdn/musc upr a/e each,,,2951.94,3728.76,6
HCPCS,243410,RPR TDN/MUSC UPR A/E EACH,,,787.82,787.82,1
HCPCS,24342,REPAIR OF RUPTURED TENDON,,,814.02,15488.78,16
HCPCS,24342,RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF,4344.0,2823.6,567.58,4344.0,35
HCPCS,24342,Repair of ruptured tendon,,,2951.94,3728.76,6
HCPCS,243420,REPAIR OF RUPTURED TENDON,,,814.02,814.02,1
HCPCS,24343,REPAIR LATERAL COLLATERAL LIGAMENT ELBOW,3664.0,2381.6,465.0,3664.0,35
HCPCS,24343,REPR ELBOW LAT LIGMNT W/TISS,,,751.45,7034.85,15
HCPCS,24343,Repr elbow lat ligmnt w/tiss,,,1074.6,1357.39,6
HCPCS,243430,REPR ELBOW LAT LIGMNT W/TISS,,,751.45,751.45,1
HCPCS,24344,RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT,6084.0,3954.6,703.04,6084.0,35
HCPCS,24344,RECONSTRUCT ELBOW LAT LIGMNT,,,1159.3,15488.78,15
HCPCS,24344,Reconstruct elbow lat ligmnt,,,3488.43,4406.44,6
HCPCS,243440,RECONSTRUCT ELBOW LAT LIGMNT,,,1159.3,1159.3,1
HCPCS,24345,REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW,3664.0,2381.6,465.0,3664.0,35
HCPCS,24345,REPR ELBW MED LIGMNT W/TISSU,,,748.22,15488.78,15
HCPCS,24345,Repr elbw med ligmnt w/tissu,,,3488.43,4406.44,6
HCPCS,243450,REPR ELBW MED LIGMNT W/TISSU,,,748.22,748.22,1
HCPCS,24346,RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF,6084.0,3954.6,703.04,6084.0,35
HCPCS,24346,RECONSTRUCT ELBOW MED LIGMNT,,,1159.3,27897.39,15
HCPCS,24346,Reconstruct elbow med ligmnt,,,3488.43,4406.44,6
HCPCS,243460,RECONSTRUCT ELBOW MED LIGMNT,,,1159.3,1159.3,1
HCPCS,24357,REPAIR ELBOW PERC,,,437.07,437.07,1
HCPCS,24357,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,10416.0,6770.4,264.85,16790.4,116
HCPCS,243570,REPAIR ELBOW PERC,,,437.07,437.07,1
HCPCS,24358,REPAIR ELBOW W/DEB OPEN,,,558.51,7034.85,15
HCPCS,24358,Repair elbow w/deb open,,,1074.6,1357.39,6
HCPCS,24358,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN,2664.0,1731.6,311.35,2664.0,35
HCPCS,243580,REPAIR ELBOW W/DEB OPEN,,,558.51,558.51,1
HCPCS,24359,REPAIR ELBOW DEB/ATTCH OPEN,,,699.29,7034.85,15
HCPCS,24359,Repair elbow deb/attch open,,,1074.6,1357.39,6
HCPCS,24359,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR,3592.0,2334.8,383.41,3592.0,35
HCPCS,243590,REPAIR ELBOW DEB/ATTCH OPEN,,,699.29,699.29,1
HCPCS,24360,"ARTHROPLASTY,ELBOW,W MEMBRANE",5575.0,3623.75,694.33,5575.0,35
HCPCS,24360,RECONSTRUCT ELBOW JOINT,,,948.75,15488.78,15
HCPCS,24360,Reconstruct elbow joint,,,2190.3,2766.7,6
HCPCS,243600,RECONSTRUCT ELBOW JOINT,,,948.75,948.75,1
HCPCS,24361,ARTHROPLASTY ELBOW W/DISTAL HUMRL PROSTC RPLCMT,6340.0,4121.0,716.43,6340.0,35
HCPCS,24361,RECONSTRUCT ELBOW JOINT,,,1057.34,39872.66,15
HCPCS,24361,Reconstruct elbow joint,,,5660.06,7149.55,6
HCPCS,243610,RECONSTRUCT ELBOW JOINT,,,1057.34,1057.34,1
HCPCS,24362,RECONSTRUCT ELBOW JOINT,,,1113.24,27897.39,15
HCPCS,24362,Reconstruct elbow joint,,,5660.06,7149.55,6
HCPCS,243620,RECONSTRUCT ELBOW JOINT,,,1113.24,1113.24,1
HCPCS,24363,ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM,8800.0,5720.0,1046.05,8800.0,35
HCPCS,24363,REPLACE ELBOW JOINT,,,1517.73,39872.66,15
HCPCS,24363,Replace elbow joint,,,5660.06,7149.55,6
HCPCS,243630,REPLACE ELBOW JOINT,,,1517.73,1517.73,1
HCPCS,24365,ARTHROPLASTY RADIAL HEAD,3448.0,2241.2,432.7,3448.0,35
HCPCS,24365,RECONSTRUCT HEAD OF RADIUS,,,675.63,27897.39,15
HCPCS,24365,Reconstruct head of radius,,,5660.06,7149.55,6
HCPCS,243650,RECONSTRUCT HEAD OF RADIUS,,,675.63,675.63,1
HCPCS,24366,ARTHROPLASTY RADIAL HEAD W/IMPLANT,3744.0,2433.6,517.39,3744.0,35
HCPCS,24366,RECONSTRUCT HEAD OF RADIUS,,,715.83,27897.39,15
HCPCS,24366,Reconstruct head of radius,,,5660.06,7149.55,6
HCPCS,243660,RECONSTRUCT HEAD OF RADIUS,,,715.83,715.83,1
HCPCS,24370,REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT,9420.0,6123.0,1072.9,9420.0,31
HCPCS,24370,REVISE RECONST ELBOW JOINT,,,1608.25,27897.39,15
HCPCS,24370,Revise reconst elbow joint,,,5660.06,7149.55,6
HCPCS,243700,REVISE RECONST ELBOW JOINT,,,1608.25,1608.25,1
HCPCS,24371,REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT,11000.0,7150.0,1237.37,11000.0,31
HCPCS,24371,REVISE RECONST ELBOW JOINT,,,1849.94,39872.66,15
HCPCS,24371,Revise reconst elbow joint,,,5660.06,7149.55,6
HCPCS,243710,REVISE RECONST ELBOW JOINT,,,1849.94,1849.94,1
HCPCS,24400,OSTEOT HUMERUS W/WO INT FIXJ,,,869.37,15488.78,15
HCPCS,24400,OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION,4985.0,3240.25,546.03,4985.0,35
HCPCS,24400,Osteot humerus w/wo int fixj,,,2951.94,3728.76,6
HCPCS,244000,OSTEOT HUMERUS W/WO INT FIXJ,,,869.37,869.37,1
HCPCS,24410,MLT OSTEOT RLGNM IMED RD HUM,,,1110.39,27897.39,15
HCPCS,24410,Mlt osteot rlgnm imed rd hum,,,2951.94,3728.76,6
HCPCS,244100,MLT OSTEOT RLGNM IMED RD HUM,,,1110.39,1110.39,1
HCPCS,24420,OSTEOPLASTY HUMERUS,5492.0,3569.8,716.55,15488.78,50
HCPCS,24420,Osteoplasty humerus,,,2951.94,3728.76,6
HCPCS,244200,OSTEOPLASTY HUMERUS,,,1111.2,1111.2,1
HCPCS,24430,REPAIR NON/MALUNION HUMERUS W/O GRAFT,6100.0,3965.0,728.2,6100.0,35
HCPCS,24430,RPR NON/MAL HUMERUS WO GRAFT,,,1107.29,27897.39,15
HCPCS,24430,Rpr non/mal humerus wo graft,,,5924.91,7484.1,6
HCPCS,244300,RPR NON/MAL HUMERUS WO GRAFT,,,1107.29,1107.29,1
HCPCS,24435,REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT,5996.0,3897.4,761.28,5996.0,35
HCPCS,24435,RPR NON/MAL HUM WITH AGRFT,,,1133.56,27897.39,15
HCPCS,24435,Rpr non/mal hum with agrft,,,5924.91,7484.1,6
HCPCS,244350,RPR NON/MAL HUM WITH AGRFT,,,1133.56,1133.56,1
HCPCS,24470,HEMIEPIPHYSEAL ARREST,,,708.32,7034.85,15
HCPCS,24470,Hemiepiphyseal arrest,,,1074.6,1357.39,6
HCPCS,244700,HEMIEPIPHYSEAL ARREST,,,708.32,708.32,1
HCPCS,24495,DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL,3364.0,2186.6,398.3,3364.0,35
HCPCS,24495,DECOMPRESSION FASCT FOREARM,,,947.87,15488.78,15
HCPCS,24495,Decompression fasct forearm,,,3488.43,4406.44,6
HCPCS,244950,DECOMPRESSION FASCT FOREARM,,,947.87,947.87,1
HCPCS,24498,PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT,4912.0,3192.8,612.84,4912.0,35
HCPCS,24498,PROPH TX W/WO MTHYLMTHCRYLT,,,911.33,27897.39,15
HCPCS,24498,Proph tx w/wo mthylmthcrylt,,,2951.94,3728.76,6
HCPCS,244980,PROPH TX W/WO MTHYLMTHCRYLT,,,911.33,911.33,1
HCPCS,24500,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,1439.5,935.675,165.21,4151.0,133
HCPCS,24500,CLTX HUMRL SHFT FX W/O MNPJ,,,357.17,357.17,1
HCPCS,245000,CLTX HUMRL SHFT FX W/O MNPJ,,,357.17,357.17,1
HCPCS,24505,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,5679.5,3691.675,270.29,8282.7,133
HCPCS,24505,CLTX HUMRL SHFT FX W/MNPJ,,,481.7,481.7,1
HCPCS,245050,CLTX HUMRL SHFT FX W/MNPJ,,,481.7,481.7,1
HCPCS,24515,OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE,4848.0,3151.2,582.7,4848.0,35
HCPCS,24515,OPTX HUMRL SHFT FX PLATE/SCR,,,924.59,27897.39,15
HCPCS,24515,Optx humrl shft fx plate/scr,,,3366.74,4252.73,6
HCPCS,245150,OPTX HUMRL SHFT FX PLATE/SCR,,,924.59,924.59,1
HCPCS,24516,TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE,4876.0,3169.4,587.39,4876.0,35
HCPCS,24516,TX HUMRL SHAFT FX IMED IMPLT,,,902.34,27897.39,15
HCPCS,24516,Tx humrl shaft fx imed implt,,,3366.74,4252.73,6
HCPCS,245160,TX HUMRL SHAFT FX IMED IMPLT,,,902.34,902.34,1
HCPCS,24530,CLTX SPRCNDYLR HUMERAL FX WO,,,374.99,374.99,1
HCPCS,24530,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,1427.5,927.875,173.58,4151.0,133
HCPCS,245300,CLTX SPRCNDYLR HUMERAL FX WO,,,374.99,374.99,1
HCPCS,24535,CLTX SPRCNDYLR HUMERAL FX W/,,,608.19,608.19,1
HCPCS,24535,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,6023.5,3915.2749999999996,279.94,8282.7,133
HCPCS,245350,CLTX SPRCNDYLR HUMERAL FX W/,,,608.19,608.19,1
HCPCS,24538,PRQ SKEL FIX SPRCNDLR HUM FX,,,827.78,15488.78,15
HCPCS,24538,PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX,4299.0,2794.35,483.51,4299.0,35
HCPCS,24538,Prq skel fix sprcndlr hum fx,,,3366.74,4252.73,6
HCPCS,245380,PRQ SKEL FIX SPRCNDLR HUM FX,,,827.78,827.78,1
HCPCS,24545,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN,5260.0,3419.0,555.53,5260.0,35
HCPCS,24545,OPTX HUM FX WO NTRCNDYLR XTN,,,975.3,27897.39,15
HCPCS,24545,Optx hum fx wo ntrcndylr xtn,,,3366.74,4252.73,6
HCPCS,245450,OPTX HUM FX WO NTRCNDYLR XTN,,,975.3,975.3,1
HCPCS,24546,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN,5964.0,3876.6,708.42,5964.0,35
HCPCS,24546,OPTX HUM FX W/NTRCNDYLR XTN,,,1088.18,27897.39,15
HCPCS,24546,Optx hum fx w/ntrcndylr xtn,,,3366.74,4252.73,6
HCPCS,245460,OPTX HUM FX W/NTRCNDYLR XTN,,,1088.18,1088.18,1
HCPCS,24560,CLTX HUM EPCNDYLR FX WO MNPJ,,,314.74,314.74,1
HCPCS,24560,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1285.5,835.575,145.97,4151.0,133
HCPCS,245600,CLTX HUM EPCNDYLR FX WO MNPJ,,,314.74,314.74,1
HCPCS,24565,CLTX HUM EPCNDYLR FX W/MNPJ,,,526.2,526.2,1
HCPCS,24565,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ,5757.5,3742.375,247.25,8282.7,84
HCPCS,245650,CLTX HUM EPCNDYLR FX W/MNPJ,,,526.2,526.2,1
HCPCS,24566,PRQ SKEL FIX EPCNDYLR HUM FX,,,758.32,3469.95,15
HCPCS,24566,Prq skel fix epcndylr hum fx,,,3366.74,4252.73,6
HCPCS,245660,PRQ SKEL FIX EPCNDYLR HUM FX,,,758.32,758.32,1
HCPCS,24575,OPEN TX HUMERAL EPICONDYLAR FRACTURE,3884.0,2524.6,502.82,3884.0,35
HCPCS,24575,OPTX HUMERAL EPCNDYLR FX,,,771.18,27897.39,15
HCPCS,24575,Optx humeral epcndylr fx,,,3366.74,4252.73,6
HCPCS,245750,OPTX HUMERAL EPCNDYLR FX,,,771.18,771.18,1
HCPCS,24576,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,1362.5,885.625,155.01,4151.0,133
HCPCS,24576,CLTX HUMRL CNDYLR FX WO MNPJ,,,335.06,335.06,1
HCPCS,245760,CLTX HUMRL CNDYLR FX WO MNPJ,,,335.06,335.06,1
HCPCS,24577,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,5923.5,3850.2749999999996,268.95,8282.7,133
HCPCS,24577,CLTX HUMRL CNDYLR FX W/MNPJ,,,539.51,539.51,1
HCPCS,245770,CLTX HUMRL CNDYLR FX W/MNPJ,,,539.51,539.51,1
HCPCS,24579,OPEN TREATMENT HUMERAL CONDYLAR FRACTURE,4576.0,2974.4,553.48,4576.0,35
HCPCS,24579,OPTX HUMRL CNDYLR FRACTURE,,,877.45,27897.39,15
HCPCS,24579,Optx humrl cndylr fracture,,,3366.74,4252.73,6
HCPCS,245790,OPTX HUMRL CNDYLR FRACTURE,,,877.45,877.45,1
HCPCS,24582,PRQ SKEL FIX HUMRL CNDYLR FX,,,858.09,15488.78,15
HCPCS,24582,Prq skel fix humrl cndylr fx,,,3366.74,4252.73,6
HCPCS,245820,PRQ SKEL FIX HUMRL CNDYLR FX,,,858.09,858.09,1
HCPCS,24586,OPTX PARTCLR FX&/DISLC ELBOW,,,1139.56,27897.39,15
HCPCS,24586,OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO,6312.0,4102.8,796.0,6312.0,35
HCPCS,24586,Optx partclr fx&/dislc elbow,,,3366.74,4252.73,6
HCPCS,245860,OPTX PARTCLR FX&/DISLC ELBOW,,,1139.56,1139.56,1
HCPCS,24587,OPTX PARTCLR FX&/DSLC ELBW W,,,1142.37,27897.39,15
HCPCS,24587,OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR,6316.0,4105.4,769.35,6316.0,35
HCPCS,24587,Optx partclr fx&/dslc elbw w,,,3366.74,4252.73,6
HCPCS,245870,OPTX PARTCLR FX&/DSLC ELBW W,,,1142.37,1142.37,1
HCPCS,24600,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,1563.5,1016.2750000000001,167.67,4151.0,133
HCPCS,24600,TX CLSD ELBOW DISLC W/O ANES,,,367.1,367.1,1
HCPCS,246000,TX CLSD ELBOW DISLC W/O ANES,,,367.1,367.1,1
HCPCS,24605,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,5729.5,3724.175,243.1,8370.0,133
HCPCS,24605,TX CLSD ELBOW DISLC REQ ANES,,,505.88,505.88,1
HCPCS,246050,TX CLSD ELBOW DISLC REQ ANES,,,505.88,505.88,1
HCPCS,24615,OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION,3932.0,2555.8,502.02,3932.0,35
HCPCS,24615,OPTX AQT/CHRNC ELBOW DISLC,,,751.08,15488.78,15
HCPCS,24615,Optx aqt/chrnc elbow dislc,,,3366.74,4252.73,6
HCPCS,246150,OPTX AQT/CHRNC ELBOW DISLC,,,751.08,751.08,1
HCPCS,24620,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,6045.5,3929.575,301.72,8550.0,133
HCPCS,24620,CLTX MONTEGGIA FX DISLC ELBW,,,622.14,622.14,1
HCPCS,246200,CLTX MONTEGGIA FX DISLC ELBW,,,622.14,622.14,1
HCPCS,24635,OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW,3520.0,2288.0,533.37,3520.0,35
HCPCS,24635,OPTX MONTEGGIA FX DISLC ELBW,,,710.78,15488.78,15
HCPCS,24635,Optx monteggia fx dislc elbw,,,3366.74,4252.73,6
HCPCS,246350,OPTX MONTEGGIA FX DISLC ELBW,,,710.78,710.78,1
HCPCS,24640,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,964.5,626.925,43.12,4151.0,133
HCPCS,24640,CLTX RDL HEAD SUBLXTJ NRSEMD,,,83.66,83.66,1
HCPCS,246400,CLTX RDL HEAD SUBLXTJ NRSEMD,,,83.66,83.66,1
HCPCS,24650,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1197.5,778.375,123.74,4151.0,133
HCPCS,24650,CLTX RDL HEAD/NCK FX WO MNPJ,,,262.86,262.86,1
HCPCS,246500,CLTX RDL HEAD/NCK FX WO MNPJ,,,262.86,262.86,1
HCPCS,24655,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,5618.0,3651.7,206.36,8282.7,133
HCPCS,24655,CLTX RDL HEAD/NCK FX W/MNPJ,,,433.58,433.58,1
HCPCS,246550,CLTX RDL HEAD/NCK FX W/MNPJ,,,433.58,433.58,1
HCPCS,24665,OPEN TX RADIAL HEAD/NECK FRACTURE,3344.0,2173.6,423.56,3344.0,35
HCPCS,24665,OPTX RADIAL HEAD/NECK FX,,,691.58,15488.78,15
HCPCS,24665,Optx radial head/neck fx,,,3366.74,4252.73,6
HCPCS,246650,OPTX RADIAL HEAD/NECK FX,,,691.58,691.58,1
HCPCS,24666,OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC,3944.0,2563.6,535.86,3944.0,35
HCPCS,24666,OPTX RADIAL HEAD/NCK FX RPLC,,,770.16,27897.39,15
HCPCS,24666,Optx radial head/nck fx rplc,,,3366.74,4252.73,6
HCPCS,246660,OPTX RADIAL HEAD/NCK FX RPLC,,,770.16,770.16,1
HCPCS,24670,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,1227.5,797.875,133.02,4151.0,133
HCPCS,24670,CLTX ULNAR FX PROX W/O MNPJ,,,286.04,286.04,1
HCPCS,246700,CLTX ULNAR FX PROX W/O MNPJ,,,286.04,286.04,1
HCPCS,24675,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,5583.5,3629.2749999999996,231.69,8282.7,133
HCPCS,24675,CLTX ULNAR FX PROX W/MNPJ,,,444.83,444.83,1
HCPCS,246750,CLTX ULNAR FX PROX W/MNPJ,,,444.83,444.83,1
HCPCS,24685,OPEN TREATMENT ULNAR FRACTURE PROXIMAL END,3348.0,2176.2,472.26,3348.0,35
HCPCS,24685,OPTX ULNAR FX PROX END W/FIX,,,688.14,15488.78,16
HCPCS,24685,Optx ulnar fx prox end w/fix,,,3366.74,4252.73,6
HCPCS,246850,OPTX ULNAR FX PROX END W/FIX,,,688.14,688.14,1
HCPCS,24800,ARTHRODESIS ELBW JOINT LOCAL,,,876.72,15488.78,15
HCPCS,24800,Arthrodesis elbw joint local,,,3488.43,4406.44,6
HCPCS,248000,ARTHRODESIS ELBW JOINT LOCAL,,,876.72,876.72,1
HCPCS,24802,ARTHRD ELBOW JT AUTOG GRAFT,,,1052.05,27897.39,15
HCPCS,24802,Arthrd elbow jt autog graft,,,3488.43,4406.44,6
HCPCS,248020,ARTHRD ELBOW JT AUTOG GRAFT,,,1052.05,1052.05,1
HCPCS,24900,AMPUTATION OF UPPER ARM,,,777.87,14747.88,5
HCPCS,24900,Amputation of upper arm,,,5924.91,7484.1,6
HCPCS,249000,AMPUTATION OF UPPER ARM,,,777.87,777.87,1
HCPCS,24920,AMPUTATE ARM-HUMER; OP CIRCULAR,4052.0,2633.8,464.96,4052.0,35
HCPCS,24920,AMPUTATION OF UPPER ARM,,,771.6,14747.88,5
HCPCS,24920,Amputation of upper arm,,,5924.91,7484.1,6
HCPCS,249200,AMPUTATION OF UPPER ARM,,,771.6,771.6,1
HCPCS,24925,AMPUTATION FOLLOW-UP SURGERY,,,600.5,7034.85,15
HCPCS,24925,"AMPUTATN ARM,THRU HUMER,SECOND CL",2920.0,1898.0,366.68,2920.0,35
HCPCS,24925,Amputation follow-up surgery,,,2951.94,3728.76,6
HCPCS,249250,AMPUTATION FOLLOW-UP SURGERY,,,600.5,600.5,1
HCPCS,24930,AMPUTATION FOLLOW-UP SURGERY,,,813.75,8335.26,5
HCPCS,24930,Amputation follow-up surgery,,,5924.91,7484.1,6
HCPCS,249300,AMPUTATION FOLLOW-UP SURGERY,,,813.75,813.75,1
HCPCS,24931,AMPUTATE UPPER ARM & IMPLANT,,,977.42,14747.88,5
HCPCS,24931,Amputate upper arm & implant,,,5924.91,7484.1,6
HCPCS,249310,AMPUTATE UPPER ARM & IMPLANT,,,977.42,977.42,1
HCPCS,24935,REVISION OF AMPUTATION,,,1277.04,15488.78,15
HCPCS,24935,Revision of amputation,,,2951.94,3728.76,6
HCPCS,249350,REVISION OF AMPUTATION,,,1277.04,1277.04,1
HCPCS,24940,REVISION OF UPPER ARM,,,1144.64,14747.88,5
HCPCS,24940,Revision of upper arm,,,2951.94,3728.76,6
HCPCS,249400,REVISION OF UPPER ARM,,,1144.64,1144.64,1
HCPCS,24999,UNLISTED PX HUMERUS/ELBOW,,,240.79,520.1,14
HCPCS,24999,Unlisted px humerus/elbow,,,310.03,391.62,6
HCPCS,25000,INCISION EXTENSOR TENDON SHEATH WRIST,1420.0,923.0,218.07,1420.0,35
HCPCS,25000,INCISION OF TENDON SHEATH,,,364.12,3469.95,15
HCPCS,25000,Incision of tendon sheath,,,1074.6,1357.39,6
HCPCS,250000,INCISION OF TENDON SHEATH,,,364.12,364.12,1
HCPCS,25001,INCISE FLEXOR CARPI RADIALIS,,,366.7,7034.85,15
HCPCS,25001,INCISE FLX TENDN SHEATH WRST,1516.0,985.4,212.05,1516.0,35
HCPCS,25001,Incise flexor carpi radialis,,,815.24,1029.78,6
HCPCS,250010,INCISE FLEXOR CARPI RADIALIS,,,366.7,366.7,1
HCPCS,25020,DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT,2424.0,1575.6,370.35,2424.0,35
HCPCS,25020,DECOMPRESS FOREARM 1 SPACE,,,758.52,3469.95,15
HCPCS,25020,Decompress forearm 1 space,,,1074.6,1357.39,6
HCPCS,250200,DECOMPRESS FOREARM 1 SPACE,,,758.52,758.52,1
HCPCS,25023,DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT,5532.0,3595.8,651.93,5532.0,35
HCPCS,25023,DECOMPRESS FOREARM 1 SPACE,,,1352.2,7034.85,15
HCPCS,25023,Decompress forearm 1 space,,,1074.6,1357.39,6
HCPCS,250230,DECOMPRESS FOREARM 1 SPACE,,,1352.2,1352.2,1
HCPCS,25024,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB,4316.0,2805.4,494.24,4316.0,35
HCPCS,25024,DECOMPRESS FOREARM 2 SPACES,,,819.91,7034.85,15
HCPCS,25024,Decompress forearm 2 spaces,,,1074.6,1357.39,6
HCPCS,250240,DECOMPRESS FOREARM 2 SPACES,,,819.91,819.91,1
HCPCS,25025,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT,7176.0,4664.4,799.99,7176.0,35
HCPCS,25025,DECOMPRESS FOREARM 2 SPACES,,,1286.72,3469.95,15
HCPCS,25025,Decompress forearm 2 spaces,,,1074.6,1357.39,6
HCPCS,250250,DECOMPRESS FOREARM 2 SPACES,,,1286.72,1286.72,1
HCPCS,25028,I&D F/ARM&/WRST DP ABSC/HMTM,,,709.8,7034.85,15
HCPCS,25028,I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA,2156.0,1401.4,347.66,2156.0,35
HCPCS,25028,I&d f/arm&/wrst dp absc/hmtm,,,1074.6,1357.39,6
HCPCS,250280,I&D F/ARM&/WRST DP ABSC/HMTM,,,709.8,709.8,1
HCPCS,25031,I&D FOREARM&/WRIST BURSA,,,389.21,3469.95,15
HCPCS,25031,I&d forearm&/wrist bursa,,,1074.6,1357.39,6
HCPCS,25031,INCISION & DRAINAGE FOREARM&/WRIST BURSA,1704.0,1107.6,253.87,1704.0,35
HCPCS,250310,I&D FOREARM&/WRIST BURSA,,,389.21,389.21,1
HCPCS,25035,INC DP BONE CRTX F/ARM&/WRST,,,621.91,15488.78,15
HCPCS,25035,INCISION DEEP BONE CORTEX FOREARM&/WRIST,3060.0,1989.0,443.69,3060.0,35
HCPCS,25035,Inc dp bone crtx f/arm&/wrst,,,3488.43,4406.44,6
HCPCS,250350,INC DP BONE CRTX F/ARM&/WRST,,,621.91,621.91,1
HCPCS,25040,ARTHRT RDCRPL/MIDCARPL JT,,,589.13,7034.85,15
HCPCS,25040,ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB,3000.0,1950.0,366.11,3000.0,35
HCPCS,25040,Arthrt rdcrpl/midcarpl jt,,,1074.6,1357.39,6
HCPCS,250400,ARTHRT RDCRPL/MIDCARPL JT,,,589.13,589.13,1
HCPCS,25065,BIOPSY FOREARM SOFT TISSUES,,,164.4,3512.95,15
HCPCS,25065,BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL,816.0,530.4,85.0,612.0,35
HCPCS,25065,Biopsy forearm soft tissues,,,1074.6,1357.39,6
HCPCS,250650,BIOPSY FOREARM SOFT TISSUES,,,164.4,164.4,1
HCPCS,25066,BIOPSY FOREARM SOFT TISSUES,,,386.69,6205.4,15
HCPCS,25066,BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP,1708.0,1110.2,240.31,1708.0,35
HCPCS,25066,Biopsy forearm soft tissues,,,1074.6,1357.39,6
HCPCS,250660,BIOPSY FOREARM SOFT TISSUES,,,386.69,386.69,1
HCPCS,25071,EXC FOREARM LES SC 3 CM/>,,,447.29,3512.95,15
HCPCS,25071,EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3+CM,2364.0,1536.6,232.42,2364.0,35
HCPCS,25071,Exc forearm les sc 3 cm/>,,,1074.6,1357.39,6
HCPCS,250710,EXC FOREARM LES SC 3 CM/>,,,447.29,447.29,1
HCPCS,25073,EXC FOREARM TUM DEEP 3 CM/>,,,564.08,564.08,1
HCPCS,25073,EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM,9654.0,6275.099999999999,288.52,36332.0,81
HCPCS,250730,EXC FOREARM TUM DEEP 3 CM/>,,,564.08,564.08,1
HCPCS,25075,EXC FOREARM LES SC < 3 CM,,,332.19,332.19,1
HCPCS,25075,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,5450.0,3542.5,154.52,8384.4,81
HCPCS,250750,EXC FOREARM LES SC < 3 CM,,,332.19,332.19,1
HCPCS,25076,EXC FOREARM TUM DEEP < 3 CM,,,546.08,3512.95,15
HCPCS,25076,EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM,2696.0,1752.4,305.62,2696.0,35
HCPCS,25076,Exc forearm tum deep < 3 cm,,,1074.6,1357.39,6
HCPCS,250760,EXC FOREARM TUM DEEP < 3 CM,,,546.08,546.08,1
HCPCS,25077,RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM,5172.0,3361.8,533.13,5172.0,35
HCPCS,25077,RESECT FOREARM/WRIST TUM<3CM,,,906.18,6205.4,15
HCPCS,25077,Resect forearm/wrist tum<3cm,,,3488.43,4406.44,6
HCPCS,250770,RESECT FOREARM/WRIST TUM<3CM,,,906.18,906.18,1
HCPCS,25078,RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3+CM,7076.0,4599.4,624.85,7076.0,35
HCPCS,25078,RESECT FORARM/WRIST TUM 3CM>,,,1225.53,6205.4,15
HCPCS,25078,Resect forarm/wrist tum 3cm>,,,3488.43,4406.44,6
HCPCS,250780,RESECT FORARM/WRIST TUM 3CM>,,,1225.53,1225.53,1
HCPCS,25085,CAPSULOTOMY WRIST,2256.0,1466.4,306.24,2256.0,35
HCPCS,25085,INCISION OF WRIST CAPSULE,,,474.04,7034.85,15
HCPCS,25085,Incision of wrist capsule,,,1074.6,1357.39,6
HCPCS,250850,INCISION OF WRIST CAPSULE,,,474.04,474.04,1
HCPCS,25100,ARTHROTOMY WRIST JOINT WITH BIOPSY,1608.0,1045.2,240.17,1608.0,35
HCPCS,25100,BIOPSY OF WRIST JOINT,,,369.85,7034.85,15
HCPCS,25100,Biopsy of wrist joint,,,1074.6,1357.39,6
HCPCS,251000,BIOPSY OF WRIST JOINT,,,369.85,369.85,1
HCPCS,25101,ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB,1932.0,1255.8,283.83,1932.0,35
HCPCS,25101,EXPLORE/TREAT WRIST JOINT,,,429.01,7034.85,15
HCPCS,25101,Explore/treat wrist joint,,,1074.6,1357.39,6
HCPCS,251010,EXPLORE/TREAT WRIST JOINT,,,429.01,429.01,1
HCPCS,25105,ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY,2408.0,1565.2,356.98,2408.0,35
HCPCS,25105,REMOVE WRIST JOINT LINING,,,513.97,7034.85,15
HCPCS,25105,Remove wrist joint lining,,,1074.6,1357.39,6
HCPCS,251050,REMOVE WRIST JOINT LINING,,,513.97,513.97,1
HCPCS,25107,ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE,3080.0,2002.0,345.6,3080.0,35
HCPCS,25107,REMOVE WRIST JOINT CARTILAGE,,,650.6,7034.85,15
HCPCS,25107,Remove wrist joint cartilage,,,1074.6,1357.39,6
HCPCS,251070,REMOVE WRIST JOINT CARTILAGE,,,650.6,650.6,1
HCPCS,25109,EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA,2776.0,1804.4,286.06,2776.0,35
HCPCS,25109,EXCISE TENDON FOREARM/WRIST,,,565.35,7034.85,15
HCPCS,25109,Excise tendon forearm/wrist,,,1074.6,1357.39,6
HCPCS,251090,EXCISE TENDON FOREARM/WRIST,,,565.35,565.35,1
HCPCS,25110,"EXCIS TENDON SHEATH LESN,WRIST/FORE",1616.0,1050.4,234.27,1616.0,35
HCPCS,25110,REMOVE WRIST TENDON LESION,,,365.43,3469.95,15
HCPCS,25110,Remove wrist tendon lesion,,,1074.6,1357.39,6
HCPCS,251100,REMOVE WRIST TENDON LESION,,,365.43,365.43,1
HCPCS,25111,EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY,1412.0,917.8,194.78,1412.0,35
HCPCS,25111,REMOVE WRIST TENDON LESION,,,343.09,5678.0,16
HCPCS,25111,Remove wrist tendon lesion,,,815.24,1029.78,6
HCPCS,251110,REMOVE WRIST TENDON LESION,,,343.09,343.09,1
HCPCS,25112,EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT,1868.0,1214.2,241.68,1868.0,35
HCPCS,25112,REREMOVE WRIST TENDON LESION,,,413.21,3469.95,15
HCPCS,25112,Reremove wrist tendon lesion,,,815.24,1029.78,6
HCPCS,251120,REREMOVE WRIST TENDON LESION,,,413.21,413.21,1
HCPCS,25115,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS,4036.0,2623.4,507.7,4036.0,35
HCPCS,25115,REMOVE WRIST/FOREARM LESION,,,795.85,3469.95,15
HCPCS,25115,Remove wrist/forearm lesion,,,1074.6,1357.39,6
HCPCS,251150,REMOVE WRIST/FOREARM LESION,,,795.85,795.85,1
HCPCS,25116,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS,3024.0,1965.6,444.46,3024.0,35
HCPCS,25116,REMOVE WRIST/FOREARM LESION,,,636.68,7034.85,15
HCPCS,25116,Remove wrist/forearm lesion,,,1074.6,1357.39,6
HCPCS,251160,REMOVE WRIST/FOREARM LESION,,,636.68,636.68,1
HCPCS,25118,EXCISE WRIST TENDON SHEATH,,,404.62,3469.95,15
HCPCS,25118,Excise wrist tendon sheath,,,1074.6,1357.39,6
HCPCS,25118,SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT,1804.0,1172.6,270.09,1804.0,35
HCPCS,251180,EXCISE WRIST TENDON SHEATH,,,404.62,404.62,1
HCPCS,25119,PARTIAL REMOVAL OF ULNA,,,530.17,7034.85,15
HCPCS,25119,Partial removal of ulna,,,1074.6,1357.39,6
HCPCS,25119,SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA,2484.0,1614.6,374.54,2484.0,35
HCPCS,251190,PARTIAL REMOVAL OF ULNA,,,530.17,530.17,1
HCPCS,25120,EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA,2508.0,1630.2,382.12,2508.0,35
HCPCS,25120,REMOVAL OF FOREARM LESION,,,529.41,7034.85,15
HCPCS,25120,Removal of forearm lesion,,,1074.6,1357.39,6
HCPCS,251200,REMOVAL OF FOREARM LESION,,,529.41,529.41,1
HCPCS,25125,REMOVE/GRAFT FOREARM LESION,,,628.52,3469.95,15
HCPCS,25125,Remove/graft forearm lesion,,,1074.6,1357.39,6
HCPCS,251250,REMOVE/GRAFT FOREARM LESION,,,628.52,628.52,1
HCPCS,25126,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT,3096.0,2012.4,442.1,3096.0,35
HCPCS,25126,REMOVE/GRAFT FOREARM LESION,,,633.09,7034.85,15
HCPCS,25126,Remove/graft forearm lesion,,,1074.6,1357.39,6
HCPCS,251260,REMOVE/GRAFT FOREARM LESION,,,633.09,633.09,1
HCPCS,25130,EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES,2172.0,1411.8,275.84,2172.0,35
HCPCS,25130,REMOVAL OF WRIST LESION,,,476.11,7034.85,15
HCPCS,25130,Removal of wrist lesion,,,1074.6,1357.39,6
HCPCS,251300,REMOVAL OF WRIST LESION,,,476.11,476.11,1
HCPCS,25135,EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT,2832.0,1840.8,354.65,2832.0,35
HCPCS,25135,REMOVE & GRAFT WRIST LESION,,,592.75,15488.78,15
HCPCS,25135,Remove & graft wrist lesion,,,1074.6,1357.39,6
HCPCS,251350,REMOVE & GRAFT WRIST LESION,,,592.75,592.75,1
HCPCS,25136,EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT,2456.0,1596.4,306.0,2456.0,35
HCPCS,25136,REMOVE & GRAFT WRIST LESION,,,525.6,15488.78,15
HCPCS,25136,Remove & graft wrist lesion,,,1326.89,1676.08,6
HCPCS,251360,REMOVE & GRAFT WRIST LESION,,,525.6,525.6,1
HCPCS,25145,REMOVE FOREARM BONE LESION,,,550.53,7034.85,15
HCPCS,25145,Remove forearm bone lesion,,,3488.43,4406.44,6
HCPCS,25145,"SEQUESTRECTOMY,FOREARM/WRIST",2616.0,1700.4,387.82,2616.0,35
HCPCS,251450,REMOVE FOREARM BONE LESION,,,550.53,550.53,1
HCPCS,25150,"PART REMOVAL BONE,ULNA",2952.0,1918.8,399.26,2952.0,35
HCPCS,25150,PARTIAL REMOVAL OF ULNA,,,597.54,7034.85,15
HCPCS,25150,Partial removal of ulna,,,1074.6,1357.39,6
HCPCS,251500,PARTIAL REMOVAL OF ULNA,,,597.54,597.54,1
HCPCS,25151,"PART REMOVAL BONE,RADIUS",3072.0,1996.8,427.38,3072.0,35
HCPCS,25151,PARTIAL REMOVAL OF RADIUS,,,615.9,7034.85,15
HCPCS,25151,Partial removal of radius,,,1074.6,1357.39,6
HCPCS,251510,PARTIAL REMOVAL OF RADIUS,,,615.9,615.9,1
HCPCS,25170,RADICAL RESECTION TUMOR RADIUS OR ULNA,8884.0,5774.6,714.88,8884.0,35
HCPCS,25170,RESECT RADIUS/ULNAR TUMOR,,,1536.78,15488.78,15
HCPCS,25170,Resect radius/ulnar tumor,,,3488.43,4406.44,6
HCPCS,251700,RESECT RADIUS/ULNAR TUMOR,,,1536.78,1536.78,1
HCPCS,25210,CARPECTOMY 1 BONE,2448.0,1591.2,311.97,2448.0,35
HCPCS,25210,REMOVAL OF WRIST BONE,,,520.56,7034.85,15
HCPCS,25210,Removal of wrist bone,,,815.24,1029.78,6
HCPCS,252100,REMOVAL OF WRIST BONE,,,520.56,520.56,1
HCPCS,25215,CARPECTOMY ALL BONES PROXIMAL ROW,3256.0,2116.4,469.94,3256.0,35
HCPCS,25215,REMOVAL OF WRIST BONES,,,652.77,7034.85,15
HCPCS,25215,Removal of wrist bones,,,1326.89,1676.08,6
HCPCS,252150,REMOVAL OF WRIST BONES,,,652.77,652.77,1
HCPCS,25230,PARTIAL REMOVAL OF RADIUS,,,457.57,7034.85,15
HCPCS,25230,Partial removal of radius,,,1074.6,1357.39,6
HCPCS,25230,RADICAL STYLOIDECTOMY SEPARATE PROCEDURE,2148.0,1396.2,305.5,2148.0,35
HCPCS,252300,PARTIAL REMOVAL OF RADIUS,,,457.57,457.57,1
HCPCS,25240,"EXCIS DISTAL ULNA,PART/COMPLETE",2124.0,1380.6,311.07,2124.0,35
HCPCS,25240,PARTIAL REMOVAL OF ULNA,,,454.76,7034.85,15
HCPCS,25240,Partial removal of ulna,,,1074.6,1357.39,6
HCPCS,252400,PARTIAL REMOVAL OF ULNA,,,454.76,454.76,1
HCPCS,25246,INJECTION FOR WRIST ARTHROGRAM,580.0,377.0,44.74,435.0,35
HCPCS,25246,INJECTION FOR WRIST X-RAY,,,76.04,76.04,1
HCPCS,25246,INJECTION WRIST ARTHROGRAPHY,796.0,517.4,86.05,3920.0,111
HCPCS,252460,INJECTION FOR WRIST X-RAY,,,76.04,76.04,1
HCPCS,25248,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,5663.5,3681.2749999999996,291.94,13665.0,133
HCPCS,25248,REMOVE FOREARM FOREIGN BODY,,,448.41,448.41,1
HCPCS,252480,REMOVE FOREARM FOREIGN BODY,,,448.41,448.41,1
HCPCS,25250,REMOVAL OF WRIST PROSTHESIS,,,563.57,3469.95,15
HCPCS,25250,REMOVAL WRIST PROSTHESIS SEPARATE PROCEDURE,2708.0,1760.2,334.62,2708.0,35
HCPCS,25250,Removal of wrist prosthesis,,,1074.6,1357.39,6
HCPCS,252500,REMOVAL OF WRIST PROSTHESIS,,,563.57,563.57,1
HCPCS,25251,REMOVAL OF WRIST PROSTHESIS,,,758.22,7034.85,15
HCPCS,25251,REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST,3928.0,2553.2,514.24,3928.0,35
HCPCS,25251,Removal of wrist prosthesis,,,1074.6,1357.39,6
HCPCS,252510,REMOVAL OF WRIST PROSTHESIS,,,758.22,758.22,1
HCPCS,25259,MANIPULATE WRIST W/ANESTHES,1616.0,1050.4,250.51,3469.95,47
HCPCS,25259,Manipulate wrist w/anesthes,,,632.74,799.25,6
HCPCS,252590,MANIPULATE WRIST W/ANESTHES,,,453.72,453.72,1
HCPCS,25260,REPAIR FOREARM TENDON/MUSCLE,,,667.85,667.85,1
HCPCS,25260,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,10936.0,7108.4,447.52,16790.4,119
HCPCS,252600,REPAIR FOREARM TENDON/MUSCLE,,,667.85,667.85,1
HCPCS,25263,REPAIR FOREARM TENDON/MUSCLE,,,668.37,15488.78,15
HCPCS,25263,Repair forearm tendon/muscle,,,1074.6,1357.39,6
HCPCS,252630,REPAIR FOREARM TENDON/MUSCLE,,,668.37,668.37,1
HCPCS,25265,REPAIR FOREARM TENDON/MUSCLE,,,793.44,7034.85,15
HCPCS,25265,RPR TDN/MUSC FLXR F/ARM&/WRISTSEC FR GRF EA,4040.0,2626.0,542.07,4040.0,35
HCPCS,25265,Repair forearm tendon/muscle,,,1074.6,1357.39,6
HCPCS,252650,REPAIR FOREARM TENDON/MUSCLE,,,793.44,793.44,1
HCPCS,25270,REPAIR FOREARM TENDON/MUSCLE,,,521.51,7034.85,15
HCPCS,25270,RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN,2468.0,1604.2,377.33,2468.0,35
HCPCS,25270,Repair forearm tendon/muscle,,,1074.6,1357.39,6
HCPCS,252700,REPAIR FOREARM TENDON/MUSCLE,,,521.51,521.51,1
HCPCS,25272,REPAIR FOREARM TENDON/MUSCLE,,,591.32,7034.85,15
HCPCS,25272,RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU,2884.0,1874.6,416.76,2884.0,35
HCPCS,25272,Repair forearm tendon/muscle,,,1074.6,1357.39,6
HCPCS,252720,REPAIR FOREARM TENDON/MUSCLE,,,591.32,591.32,1
HCPCS,25274,REPAIR FOREARM TENDON/MUSCLE,,,699.7,7034.85,15
HCPCS,25274,RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN,3576.0,2324.4,474.92,3576.0,35
HCPCS,25274,Repair forearm tendon/muscle,,,1074.6,1357.39,6
HCPCS,252740,REPAIR FOREARM TENDON/MUSCLE,,,699.7,699.7,1
HCPCS,25275,REPAIR FOREARM TENDON SHEATH,,,707.89,7034.85,15
HCPCS,25275,RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT,3584.0,2329.6,448.74,3584.0,35
HCPCS,25275,Repair forearm tendon sheath,,,1074.6,1357.39,6
HCPCS,252750,REPAIR FOREARM TENDON SHEATH,,,707.89,707.89,1
HCPCS,25280,LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN,2956.0,1921.4,417.82,2956.0,35
HCPCS,25280,REVISE WRIST/FOREARM TENDON,,,597.03,7034.85,15
HCPCS,25280,Revise wrist/forearm tendon,,,1074.6,1357.39,6
HCPCS,252800,REVISE WRIST/FOREARM TENDON,,,597.03,597.03,1
HCPCS,25290,INCISE WRIST/FOREARM TENDON,,,460.75,7034.85,15
HCPCS,25290,Incise wrist/forearm tendon,,,1074.6,1357.39,6
HCPCS,25290,TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,2172.0,1411.8,345.96,2172.0,35
HCPCS,252900,INCISE WRIST/FOREARM TENDON,,,460.75,460.75,1
HCPCS,25295,RELEASE WRIST/FOREARM TENDON,,,555.67,7034.85,15
HCPCS,25295,Release wrist/forearm tendon,,,1074.6,1357.39,6
HCPCS,25295,TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,2688.0,1747.2,393.15,2688.0,35
HCPCS,252950,RELEASE WRIST/FOREARM TENDON,,,555.67,555.67,1
HCPCS,25300,FUSION OF TENDONS AT WRIST,,,727.03,7034.85,15
HCPCS,25300,Fusion of tendons at wrist,,,3488.43,4406.44,6
HCPCS,25300,TENODESIS WRIST FLEXORS FINGERS,3608.0,2345.2,459.28,3608.0,35
HCPCS,253000,FUSION OF TENDONS AT WRIST,,,727.03,727.03,1
HCPCS,25301,FUSION OF TENDONS AT WRIST,,,678.19,7034.85,15
HCPCS,25301,Fusion of tendons at wrist,,,1074.6,1357.39,6
HCPCS,25301,TENODESIS WRIST EXTENSORS FINGERS,3436.0,2233.4,426.64,3436.0,35
HCPCS,253010,FUSION OF TENDONS AT WRIST,,,678.19,678.19,1
HCPCS,25310,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN,3960.0,2574.0,460.39,3960.0,35
HCPCS,25310,TRANSPLANT FOREARM TENDON,,,654.46,7034.85,15
HCPCS,25310,Transplant forearm tendon,,,1074.6,1357.39,6
HCPCS,253100,TRANSPLANT FOREARM TENDON,,,654.46,654.46,1
HCPCS,25312,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR,4321.0,2808.65,516.79,4321.0,35
HCPCS,25312,TRANSPLANT FOREARM TENDON,,,754.9,7034.85,15
HCPCS,25312,Transplant forearm tendon,,,1074.6,1357.39,6
HCPCS,253120,TRANSPLANT FOREARM TENDON,,,754.9,754.9,1
HCPCS,25315,FLEXOR ORIGIN SLIDE FOREARM &/WRIST,4272.0,2776.8,541.35,4272.0,35
HCPCS,25315,REVISE PALSY HAND TENDON(S),,,810.56,15488.78,15
HCPCS,25315,Revise palsy hand tendon(s),,,1326.89,1676.08,6
HCPCS,253150,REVISE PALSY HAND TENDON(S),,,810.56,810.56,1
HCPCS,25316,FLEXOR ORIGIN SLIDE F/ARM&/WRST TENDON TRANSFE,5676.0,3689.4,655.43,5676.0,35
HCPCS,25316,REVISE PALSY HAND TENDON(S),,,963.13,15488.78,15
HCPCS,25316,Revise palsy hand tendon(s),,,1326.89,1676.08,6
HCPCS,253160,REVISE PALSY HAND TENDON(S),,,963.13,963.13,1
HCPCS,25320,CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS,5100.0,3315.0,542.31,5100.0,35
HCPCS,25320,REPAIR/REVISE WRIST JOINT,,,1038.19,15488.78,15
HCPCS,25320,Repair/revise wrist joint,,,3488.43,4406.44,6
HCPCS,253200,REPAIR/REVISE WRIST JOINT,,,1038.19,1038.19,1
HCPCS,25332,ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ,4696.0,3052.4,591.38,4696.0,35
HCPCS,25332,REVISE WRIST JOINT,,,888.02,7034.85,15
HCPCS,25332,Revise wrist joint,,,2190.3,2766.7,6
HCPCS,253320,REVISE WRIST JOINT,,,888.02,888.02,1
HCPCS,25335,CENTRALIZATION WRIST ON ULNA,,,991.95,7034.85,15
HCPCS,25335,CENTRALIZATION WRST ULNA,5356.0,3481.4,669.0,5356.0,35
HCPCS,25335,Centralization wrist on ulna,,,1074.6,1357.39,6
HCPCS,253350,CENTRALIZATION WRIST ON ULNA,,,991.95,991.95,1
HCPCS,25337,RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ,4692.0,3049.8,534.51,4692.0,35
HCPCS,25337,RECONSTRUCT ULNA/RADIOULNAR,,,932.1,15488.78,15
HCPCS,25337,Reconstruct ulna/radioulnar,,,3488.43,4406.44,6
HCPCS,253370,RECONSTRUCT ULNA/RADIOULNAR,,,932.1,932.1,1
HCPCS,25350,"OSTEOTOMY RADIUS,DISTAL THIRD",3636.0,2363.4,488.93,3636.0,35
HCPCS,25350,REVISION OF RADIUS,,,709.99,15488.78,15
HCPCS,25350,Revision of radius,,,3488.43,4406.44,6
HCPCS,253500,REVISION OF RADIUS,,,709.99,709.99,1
HCPCS,25355,REVISION OF RADIUS,,,805.65,7034.85,15
HCPCS,25355,Revision of radius,,,1074.6,1357.39,6
HCPCS,253550,REVISION OF RADIUS,,,805.65,805.65,1
HCPCS,25360,OSTEOTOMY ULNA,3496.0,2272.4,475.11,3496.0,35
HCPCS,25360,REVISION OF ULNA,,,691.51,15488.78,15
HCPCS,25360,Revision of ulna,,,3488.43,4406.44,6
HCPCS,253600,REVISION OF ULNA,,,691.51,691.51,1
HCPCS,25365,OSTEOTOMY RADIUS/ULNA,5164.0,3356.6,646.2,5164.0,35
HCPCS,25365,REVISE RADIUS & ULNA,,,963.82,27897.39,15
HCPCS,25365,Revise radius & ulna,,,3488.43,4406.44,6
HCPCS,253650,REVISE RADIUS & ULNA,,,963.82,963.82,1
HCPCS,25370,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS/ULNA,5640.0,3666.0,653.1,5640.0,35
HCPCS,25370,REVISE RADIUS OR ULNA,,,1062.26,7034.85,15
HCPCS,25370,Revise radius or ulna,,,1074.6,1357.39,6
HCPCS,253700,REVISE RADIUS OR ULNA,,,1062.26,1062.26,1
HCPCS,25375,REVISE RADIUS & ULNA,,,1001.76,7034.85,15
HCPCS,25375,Revise radius & ulna,,,1074.6,1357.39,6
HCPCS,253750,REVISE RADIUS & ULNA,,,1001.76,1001.76,1
HCPCS,25390,OSTEOPLASTY RADIUS/ULNA SHORTENING,4280.0,2782.0,560.33,4280.0,35
HCPCS,25390,SHORTEN RADIUS OR ULNA,,,808.2,15488.78,15
HCPCS,25390,Shorten radius or ulna,,,3488.43,4406.44,6
HCPCS,253900,SHORTEN RADIUS OR ULNA,,,808.2,808.2,1
HCPCS,25391,LENGTHEN RADIUS OR ULNA,,,1045.66,27897.39,15
HCPCS,25391,Lengthen radius or ulna,,,3488.43,4406.44,6
HCPCS,25391,OSTEOPLASTY RADIUS/ULNA LENGTHENING W/AUTOGRAFT,5712.0,3712.8,708.06,5712.0,35
HCPCS,253910,LENGTHEN RADIUS OR ULNA,,,1045.66,1045.66,1
HCPCS,25392,OSTEOPLASTY RADIUS & ULNA SHORTENING,5832.0,3790.8,737.27,5832.0,35
HCPCS,25392,SHORTEN RADIUS & ULNA,,,1063.91,15488.78,15
HCPCS,25392,Shorten radius & ulna,,,3488.43,4406.44,6
HCPCS,253920,SHORTEN RADIUS & ULNA,,,1063.91,1063.91,1
HCPCS,25393,LENGTHEN RADIUS & ULNA,,,1184.84,15488.78,15
HCPCS,25393,Lengthen radius & ulna,,,3488.43,4406.44,6
HCPCS,253930,LENGTHEN RADIUS & ULNA,,,1184.84,1184.84,1
HCPCS,25394,"OSTEOPLSTY CARPAL, SHORTNING",4340.0,2821.0,523.49,4340.0,35
HCPCS,25394,REPAIR CARPAL BONE SHORTEN,,,825.93,7034.85,15
HCPCS,25394,Repair carpal bone shorten,,,1326.89,1676.08,6
HCPCS,253940,REPAIR CARPAL BONE SHORTEN,,,825.93,825.93,1
HCPCS,25400,REPAIR RADIUS OR ULNA,,,843.13,15488.78,15
HCPCS,25400,RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT,4512.0,2932.8,596.78,4512.0,35
HCPCS,25400,Repair radius or ulna,,,3488.43,4406.44,6
HCPCS,254000,REPAIR RADIUS OR ULNA,,,843.13,843.13,1
HCPCS,25405,REPAIR/GRAFT RADIUS OR ULNA,,,1087.12,15488.78,15
HCPCS,25405,RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT,6004.0,3902.6,764.85,6004.0,35
HCPCS,25405,Repair/graft radius or ulna,,,3488.43,4406.44,6
HCPCS,254050,REPAIR/GRAFT RADIUS OR ULNA,,,1087.12,1087.12,1
HCPCS,25415,REPAIR RADIUS & ULNA,,,1016.5,15488.78,15
HCPCS,25415,RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF,5520.0,3588.0,705.44,5520.0,35
HCPCS,25415,Repair radius & ulna,,,3488.43,4406.44,6
HCPCS,254150,REPAIR RADIUS & ULNA,,,1016.5,1016.5,1
HCPCS,25420,REPAIR/GRAFT RADIUS & ULNA,,,1223.45,15488.78,15
HCPCS,25420,RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT,6816.0,4430.4,871.7,6816.0,35
HCPCS,25420,Repair/graft radius & ulna,,,3488.43,4406.44,6
HCPCS,254200,REPAIR/GRAFT RADIUS & ULNA,,,1223.45,1223.45,1
HCPCS,25425,FIX DEFECT RAD OR ULNA W AUTOGRFT,5488.0,3567.2,685.41,5488.0,35
HCPCS,25425,REPAIR/GRAFT RADIUS OR ULNA,,,1011.94,15488.78,15
HCPCS,25425,Repair/graft radius or ulna,,,3488.43,4406.44,6
HCPCS,254250,REPAIR/GRAFT RADIUS OR ULNA,,,1011.94,1011.94,1
HCPCS,25426,REPAIR/GRAFT RADIUS & ULNA,,,1178.13,7034.85,15
HCPCS,25426,Repair/graft radius & ulna,,,3488.43,4406.44,6
HCPCS,254260,REPAIR/GRAFT RADIUS & ULNA,,,1178.13,1178.13,1
HCPCS,25430,VASC GRAFT INTO CARPAL BONE,,,770.84,7034.85,15
HCPCS,25430,VASC PEDICL INTO CARPAL BONE,3884.0,2524.6,462.01,3884.0,35
HCPCS,25430,Vasc graft into carpal bone,,,1326.89,1676.08,6
HCPCS,254300,VASC GRAFT INTO CARPAL BONE,,,770.84,770.84,1
HCPCS,25431,REP NONUNION CARPAL BONE EA,4356.0,2831.4,457.96,4356.0,35
HCPCS,25431,REPAIR NONUNION CARPAL BONE,,,829.38,15488.78,15
HCPCS,25431,Repair nonunion carpal bone,,,3366.74,4252.73,6
HCPCS,254310,REPAIR NONUNION CARPAL BONE,,,829.38,829.38,1
HCPCS,25440,REPAIR NONU SCPHD CARPL B1,,,808.51,15488.78,15
HCPCS,25440,RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC,4272.0,2776.8,541.71,4272.0,35
HCPCS,25440,Repair nonu scphd carpl b1,,,3488.43,4406.44,6
HCPCS,254400,REPAIR NONU SCPHD CARPL B1,,,808.51,808.51,1
HCPCS,25441,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS,5316.0,3455.4,651.72,5316.0,35
HCPCS,25441,ARTHRP W/PROSTC DSTL RDS,,,985.65,27897.39,15
HCPCS,25441,Arthrp w/prostc dstl rds,,,5660.06,7149.55,6
HCPCS,254410,ARTHRP W/PROSTC DSTL RDS,,,985.65,985.65,1
HCPCS,25442,ARTHRP W/PROSTC DSTL ULNA,,,849.85,39872.66,15
HCPCS,25442,Arthrp w/prostc dstl ulna,,,5660.06,7149.55,6
HCPCS,254420,ARTHRP W/PROSTC DSTL ULNA,,,849.85,849.85,1
HCPCS,25443,ARTHRP PROSTC DSTL SCPH CRPL,,,826.83,15488.78,15
HCPCS,25443,Arthrp prostc dstl scph crpl,,,2190.3,2766.7,6
HCPCS,254430,ARTHRP PROSTC DSTL SCPH CRPL,,,826.83,826.83,1
HCPCS,25444,ARTHRP W/PROSTC LUNATE,,,864.17,27897.39,15
HCPCS,25444,Arthrp w/prostc lunate,,,5660.06,7149.55,6
HCPCS,254440,ARTHRP W/PROSTC LUNATE,,,864.17,864.17,1
HCPCS,25445,ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM,3952.0,2568.8,534.17,3952.0,35
HCPCS,25445,ARTHRP W/PROSTC TRAPEZIUM,,,758.13,15488.78,15
HCPCS,25445,Arthrp w/prostc trapezium,,,2190.3,2766.7,6
HCPCS,254450,ARTHRP W/PROSTC TRAPEZIUM,,,758.13,758.13,1
HCPCS,25446,ARTHRP W/PROSTC DST RDS&CRPS,,,1228.79,39872.66,15
HCPCS,25446,ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS,6920.0,4498.0,900.16,6920.0,35
HCPCS,25446,Arthrp w/prostc dst rds&crps,,,5660.06,7149.55,6
HCPCS,254460,ARTHRP W/PROSTC DST RDS&CRPS,,,1228.79,1228.79,1
HCPCS,25447,ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION,4200.0,2730.0,554.13,4200.0,35
HCPCS,25447,ARTHRP NTRCRP/CRP/MTCR NTRPS,,,874.15,7034.85,15
HCPCS,25447,Arthrp ntrcrp/crp/mtcr ntrps,,,2190.3,2766.7,6
HCPCS,254470,ARTHRP NTRCRP/CRP/MTCR NTRPS,,,874.15,874.15,1
HCPCS,25448,ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION,5214.0,3389.1,635.47,5214.0,28
HCPCS,25448,ARTHRP NTRCRPL/CRP/MTCRP SSP,,,910.08,7034.85,15
HCPCS,25448,Arthrp ntrcrpl/crp/mtcrp ssp,,,2190.3,2766.7,6
HCPCS,254480,ARTHRP NTRCRPL/CRP/MTCRP SSP,,,910.08,910.08,1
HCPCS,25449,REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT,5976.0,3884.4,639.74,5976.0,35
HCPCS,25449,REVJ ARTHRP WRIST JOINT,,,1082.89,15488.78,15
HCPCS,25449,Revj arthrp wrist joint,,,2190.3,2766.7,6
HCPCS,254490,REVJ ARTHRP WRIST JOINT,,,1082.89,1082.89,1
HCPCS,25450,EPIPHYSL ARRST DSTL RDS/ULNA,,,651.74,7034.85,15
HCPCS,25450,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U,3224.0,2095.6,406.14,3224.0,35
HCPCS,25450,Epiphysl arrst dstl rds/ulna,,,1074.6,1357.39,6
HCPCS,254500,EPIPHYSL ARRST DSTL RDS/ULNA,,,651.74,651.74,1
HCPCS,25455,EPIPHYSL ARRST DSTL RDS&ULNA,,,769.2,7034.85,15
HCPCS,25455,Epiphysl arrst dstl rds&ulna,,,1074.6,1357.39,6
HCPCS,254550,EPIPHYSL ARRST DSTL RDS&ULNA,,,769.2,769.2,1
HCPCS,25490,PROPHYLACTIC TX RADIUS,,,757.52,15488.78,15
HCPCS,25490,Prophylactic tx radius,,,3488.43,4406.44,6
HCPCS,254900,PROPHYLACTIC TX RADIUS,,,757.52,757.52,1
HCPCS,25491,PROPHYLACTIC TX ULNA,,,778.91,27897.39,15
HCPCS,25491,Prophylactic tx ulna,,,3488.43,4406.44,6
HCPCS,254910,PROPHYLACTIC TX ULNA,,,778.91,778.91,1
HCPCS,25492,PROPHYLACTIC TX RADIUS&ULNA,,,952.97,7034.85,15
HCPCS,25492,Prophylactic tx radius&ulna,,,1074.6,1357.39,6
HCPCS,254920,PROPHYLACTIC TX RADIUS&ULNA,,,952.97,952.97,1
HCPCS,25500,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,1209.5,786.175,131.01,4151.0,133
HCPCS,25500,CLTX RDL SHFT FX W/O MNPJ,,,276.12,276.12,1
HCPCS,255000,CLTX RDL SHFT FX W/O MNPJ,,,276.12,276.12,1
HCPCS,25505,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,5691.5,3699.475,242.73,8282.7,182
HCPCS,25505,CLTX RDL SHFT FX W/MNPJ,,,491.71,491.71,1
HCPCS,255050,CLTX RDL SHFT FX W/MNPJ,,,491.71,491.71,1
HCPCS,25515,OPEN TREATMENT RADIAL SHAFT FRACTURE,3520.0,2288.0,458.63,3520.0,35
HCPCS,25515,OPTX RADIAL SHAFT FRACTURE,,,706.85,15488.78,15
HCPCS,25515,Optx radial shaft fracture,,,3366.74,4252.73,6
HCPCS,255150,OPTX RADIAL SHAFT FRACTURE,,,706.85,706.85,1
HCPCS,25520,CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,2600.0,1690.0,336.22,1950.0,35
HCPCS,25520,CLTX RDL SHFT FX&DISLC,,,578.2,3469.95,15
HCPCS,25520,Cltx rdl shft fx&dislc,,,310.03,391.62,6
HCPCS,255200,CLTX RDL SHFT FX&DISLC,,,578.2,578.2,1
HCPCS,25525,OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE,4220.0,2743.0,606.37,4220.0,35
HCPCS,25525,OPTX RDL SHFT FX&CLTX RAD/UL,,,831.61,15488.78,15
HCPCS,25525,Optx rdl shft fx&cltx rad/ul,,,3366.74,4252.73,6
HCPCS,255250,OPTX RDL SHFT FX&CLTX RAD/UL,,,831.61,831.61,1
HCPCS,25526,OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE,5260.0,3419.0,706.61,5260.0,35
HCPCS,25526,OPTX RDL SHFT FX&DSTL RAD/UL,,,1005.37,15488.78,15
HCPCS,25526,Optx rdl shft fx&dstl rad/ul,,,3366.74,4252.73,6
HCPCS,255260,OPTX RDL SHFT FX&DSTL RAD/UL,,,1005.37,1005.37,1
HCPCS,25530,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,1137.5,739.375,124.3,4151.0,133
HCPCS,25530,CLTX ULNAR SHFT FX W/O MNPJ,,,259.6,259.6,1
HCPCS,255300,CLTX ULNAR SHFT FX W/O MNPJ,,,259.6,259.6,1
HCPCS,25535,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,1761.5,1144.975,238.72,4151.0,133
HCPCS,25535,CLTX ULNAR SHFT FX W/MNPJ,,,486.91,486.91,1
HCPCS,255350,CLTX ULNAR SHFT FX W/MNPJ,,,486.91,486.91,1
HCPCS,25545,OPEN TREATMENT OF ULNAR SHAFT FRACTURE,3176.0,2064.4,455.79,3176.0,35
HCPCS,25545,OPTX ULNAR SHFT FX INT FIXJ,,,658.44,15488.78,15
HCPCS,25545,Optx ulnar shft fx int fixj,,,3366.74,4252.73,6
HCPCS,255450,OPTX ULNAR SHFT FX INT FIXJ,,,658.44,658.44,1
HCPCS,25560,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,1207.5,784.875,130.0,4151.0,133
HCPCS,25560,CLTX RDL&ULN SHFT FX WO MNPJ,,,277.44,277.44,1
HCPCS,255600,CLTX RDL&ULN SHFT FX WO MNPJ,,,277.44,277.44,1
HCPCS,25565,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,5771.5,3751.475,272.84,8282.7,133
HCPCS,25565,CLTX RDL&ULN SHFT FX W/MNPJ,,,495.97,495.97,1
HCPCS,255650,CLTX RDL&ULN SHFT FX W/MNPJ,,,495.97,495.97,1
HCPCS,25574,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA,3520.0,2288.0,414.47,3520.0,35
HCPCS,25574,OPTX RDL&ULN SHFT FX RDS/ULN,,,711.2,15488.78,15
HCPCS,25574,Optx rdl&uln shft fx rds/uln,,,3366.74,4252.73,6
HCPCS,255740,OPTX RDL&ULN SHFT FX RDS/ULN,,,711.2,711.2,1
HCPCS,25575,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA,4916.0,3195.4,573.52,4916.0,35
HCPCS,25575,OPTX RDL&ULN SHFT FX RDS&ULN,,,950.11,15488.78,15
HCPCS,25575,Optx rdl&uln shft fx rds&uln,,,3366.74,4252.73,6
HCPCS,255750,OPTX RDL&ULN SHFT FX RDS&ULN,,,950.11,950.11,1
HCPCS,25600,CLTX DST RDL FX/EPHYS SEP WO,,,344.67,344.67,1
HCPCS,25600,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,1245.5,809.575,162.98,4151.0,133
HCPCS,256000,CLTX DST RDL FX/EPHYS SEP WO,,,344.67,344.67,1
HCPCS,25605,CLTX DST RDL FX/EPHYS SEP W/,,,543.73,543.73,1
HCPCS,25605,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,5851.5,3803.475,262.13,8282.7,179
HCPCS,256050,CLTX DST RDL FX/EPHYS SEP W/,,,543.73,543.73,1
HCPCS,25606,PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP,3324.0,2160.6,370.95,3324.0,35
HCPCS,25606,PERQ SKEL FIXJ DSTL RDL FX,,,704.7,7034.85,15
HCPCS,25606,Perq skel fixj dstl rdl fx,,,3366.74,4252.73,6
HCPCS,256060,PERQ SKEL FIXJ DSTL RDL FX,,,704.7,704.7,1
HCPCS,25607,"OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR",4206.0,2733.9,392.58,4206.0,35
HCPCS,25607,OPTX DST RD XARTC FX/EPI SEP,,,778.96,15488.78,15
HCPCS,25607,Optx dst rd xartc fx/epi sep,,,3366.74,4252.73,6
HCPCS,256070,OPTX DST RD XARTC FX/EPI SEP,,,778.96,778.96,1
HCPCS,25608,"OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 2 FRAG",4871.0,3166.15,450.02,4871.0,35
HCPCS,25608,OPTX DST RD XART FX/EPI SEP2,,,871.29,15488.78,15
HCPCS,25608,Optx dst rd xart fx/epi sep2,,,3366.74,4252.73,6
HCPCS,256080,OPTX DST RD XART FX/EPI SEP2,,,871.29,871.29,1
HCPCS,25609,"OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 3+ FRAG",6327.0,4112.55,574.84,6327.0,35
HCPCS,25609,OPTX DST RD XART FX/EP SEP3+,,,1104.27,15488.78,19
HCPCS,25609,Optx dst rd xart fx/ep sep3+,,,3366.74,4252.73,6
HCPCS,256090,OPTX DST RD XART FX/EP SEP3+,,,1104.27,1104.27,1
HCPCS,25622,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,1247.5,810.875,140.54,4151.0,133
HCPCS,25622,CLTX CARPL SCPHD FX W/O MNPJ,,,303.39,303.39,1
HCPCS,256220,CLTX CARPL SCPHD FX W/O MNPJ,,,303.39,303.39,1
HCPCS,25624,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,5555.5,3611.075,227.31,8282.7,182
HCPCS,25624,CLTX CARPL SCPHD FX W/MNPJ,,,473.54,473.54,1
HCPCS,256240,CLTX CARPL SCPHD FX W/MNPJ,,,473.54,473.54,1
HCPCS,25628,OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE,3868.0,2514.2,432.36,3868.0,35
HCPCS,25628,OPTX CARPL SCPHD FX INT FIXJ,,,756.45,15488.78,15
HCPCS,25628,Optx carpl scphd fx int fixj,,,3366.74,4252.73,6
HCPCS,256280,OPTX CARPL SCPHD FX INT FIXJ,,,756.45,756.45,1
HCPCS,25630,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1356.0,881.4000000000001,141.8,4151.0,133
HCPCS,25630,CLTX CARPL FX W/O MNPJ EA B1,,,304.05,304.05,1
HCPCS,256300,CLTX CARPL FX W/O MNPJ EA B1,,,304.05,304.05,1
HCPCS,25635,CLTX CARPAL BONE FX W/MANJ EACH BONE,5615.5,3650.075,209.1,8282.7,133
HCPCS,25635,CLTX CARPL FX W/MNPJ EA B1,,,450.62,450.62,1
HCPCS,256350,CLTX CARPL FX W/MNPJ EA B1,,,450.62,450.62,1
HCPCS,25645,OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA,2968.0,1929.2,385.44,2968.0,35
HCPCS,25645,OPTX CRPL FX OTH/THN SCPH EA,,,603.27,7034.85,15
HCPCS,25645,Optx crpl fx oth/thn scph ea,,,3366.74,4252.73,6
HCPCS,256450,OPTX CRPL FX OTH/THN SCPH EA,,,603.27,603.27,1
HCPCS,25650,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1335.5,868.075,164.16,4151.0,182
HCPCS,25650,CLTX ULNAR STYLOID FRACTURE,,,326.85,326.85,1
HCPCS,256500,CLTX ULNAR STYLOID FRACTURE,,,326.85,326.85,1
HCPCS,25651,PERQ SKEL FIX ULNAR STYLD FX,,,518.49,7034.85,15
HCPCS,25651,PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE,2328.0,1513.2,274.6,2328.0,35
HCPCS,25651,Perq skel fix ulnar styld fx,,,3366.74,4252.73,6
HCPCS,256510,PERQ SKEL FIX ULNAR STYLD FX,,,518.49,518.49,1
HCPCS,25652,OPEN TREATMENT ULNAR STYLOID FRACTURE,3224.0,2095.6,404.86,3224.0,35
HCPCS,25652,OPTX ULNAR STYLOID FRACTURE,,,657.0,15488.78,15
HCPCS,25652,Optx ulnar styloid fracture,,,3366.74,4252.73,6
HCPCS,256520,OPTX ULNAR STYLOID FRACTURE,,,657.0,657.0,1
HCPCS,25660,CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ,1685.5,1095.575,221.26,4151.0,84
HCPCS,25660,CLTX RDCRPL/NTRCRPL DISLC 1+,,,476.71,476.71,1
HCPCS,256600,CLTX RDCRPL/NTRCRPL DISLC 1+,,,476.71,476.71,1
HCPCS,25670,OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES,3236.0,2103.4,415.3,3236.0,35
HCPCS,25670,OPTX RDCRPL/NTRCRPL DISLC 1+,,,640.71,15488.78,15
HCPCS,25670,Optx rdcrpl/ntrcrpl dislc 1+,,,3366.74,4252.73,6
HCPCS,256700,OPTX RDCRPL/NTRCRPL DISLC 1+,,,640.71,640.71,1
HCPCS,25671,PERQ SKEL FIX RAD/ULN DISLC,,,565.59,7034.85,15
HCPCS,25671,PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION,2584.0,1679.6,333.92,2584.0,35
HCPCS,25671,Perq skel fix rad/uln dislc,,,3366.74,4252.73,6
HCPCS,256710,PERQ SKEL FIX RAD/ULN DISLC,,,565.59,565.59,1
HCPCS,25675,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ,1667.5,1083.875,200.71,4151.0,84
HCPCS,25675,CLTX DSTL RAD/ULN DISLC MNPJ,,,441.02,441.02,1
HCPCS,256750,CLTX DSTL RAD/ULN DISLC MNPJ,,,441.02,441.02,1
HCPCS,25676,OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC,3316.0,2155.4,424.09,3316.0,35
HCPCS,25676,OPTX RAD/ULN DISLC AQT/CHRNC,,,664.89,15488.78,15
HCPCS,25676,Optx rad/uln dislc aqt/chrnc,,,3366.74,4252.73,6
HCPCS,256760,OPTX RAD/ULN DISLC AQT/CHRNC,,,664.89,664.89,1
HCPCS,25680,CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ,2492.0,1619.8,261.2,2492.0,35
HCPCS,25680,CLTX TRNS-SCPHPRLNR FX MNPJ,,,240.79,561.68,15
HCPCS,25680,Cltx trns-scphprlnr fx mnpj,,,310.03,391.62,6
HCPCS,256800,CLTX TRNS-SCPHPRLNR FX MNPJ,,,561.68,561.68,1
HCPCS,25685,OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC,4036.0,2623.4,509.05,4036.0,35
HCPCS,25685,OPTX TRNS-SCPHPRLNR FX DISLC,,,774.69,15488.78,15
HCPCS,25685,Optx trns-scphprlnr fx dislc,,,3366.74,4252.73,6
HCPCS,256850,OPTX TRNS-SCPHPRLNR FX DISLC,,,774.69,774.69,1
HCPCS,25690,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,5745.5,3734.575,289.63,8550.0,84
HCPCS,25690,CLTX LUNATE DISLC W/MNPJ,,,522.03,522.03,1
HCPCS,256900,CLTX LUNATE DISLC W/MNPJ,,,522.03,522.03,1
HCPCS,25695,OPEN TREATMENT LUNATE DISLOCATION,3404.0,2212.6,427.16,3404.0,35
HCPCS,25695,OPTX LUNATE DISLOCATION,,,669.29,15488.78,15
HCPCS,25695,Optx lunate dislocation,,,3366.74,4252.73,6
HCPCS,256950,OPTX LUNATE DISLOCATION,,,669.29,669.29,1
HCPCS,25800,ARTHRD WRIST COMPLETE WO GRF,,,768.6,15488.78,15
HCPCS,25800,ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT,4431.0,2880.15,562.58,4431.0,35
HCPCS,25800,Arthrd wrist complete wo grf,,,3488.43,4406.44,6
HCPCS,258000,ARTHRD WRIST COMPLETE WO GRF,,,768.6,768.6,1
HCPCS,25805,ARTHRD WRIST W/SLIDING GRAFT,,,891.43,15488.78,15
HCPCS,25805,ARTHRODESIS WRIST W/SLIDING GRAFT,4692.0,3049.8,647.01,4692.0,35
HCPCS,25805,Arthrd wrist w/sliding graft,,,3488.43,4406.44,6
HCPCS,258050,ARTHRD WRIST W/SLIDING GRAFT,,,891.43,891.43,1
HCPCS,25810,ARTHRD WRST ILIAC/OTH AGRFT,,,910.81,27897.39,15
HCPCS,25810,ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT,4780.0,3107.0,609.55,4780.0,35
HCPCS,25810,Arthrd wrst iliac/oth agrft,,,3488.43,4406.44,6
HCPCS,258100,ARTHRD WRST ILIAC/OTH AGRFT,,,910.81,910.81,1
HCPCS,25820,ARTHRD WRIST LMTD W/O B1 GRF,,,679.07,15488.78,15
HCPCS,25820,ARTHRODESIS WRIST LIMITED W/O BONE GRAFT,3056.0,1986.4,439.7,3056.0,35
HCPCS,25820,Arthrd wrist lmtd w/o b1 grf,,,1326.89,1676.08,6
HCPCS,258200,ARTHRD WRIST LMTD W/O B1 GRF,,,679.07,679.07,1
HCPCS,25825,ARTHRD WRIST WITH AUTOGRAFT,,,829.59,15488.78,15
HCPCS,25825,ARTHRODESIS WRIST LIMITED W/AUTOGRAFT,3876.0,2519.4,544.34,3876.0,35
HCPCS,25825,Arthrd wrist with autograft,,,1326.89,1676.08,6
HCPCS,258250,ARTHRD WRIST WITH AUTOGRAFT,,,829.59,829.59,1
HCPCS,25830,ARTHRD DST RAD/UL JT SGM RSC,,,1067.12,15488.78,15
HCPCS,25830,ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE,4352.0,2828.8,549.01,4352.0,35
HCPCS,25830,Arthrd dst rad/ul jt sgm rsc,,,3488.43,4406.44,6
HCPCS,258300,ARTHRD DST RAD/UL JT SGM RSC,,,1067.12,1067.12,1
HCPCS,25900,AMPUTATION FOREARM THROUGH RADIUS & ULNA,3844.0,2498.6,471.7,3844.0,35
HCPCS,25900,AMPUTATION OF FOREARM,,,754.03,8335.26,5
HCPCS,25900,Amputation of forearm,,,3488.43,4406.44,6
HCPCS,259000,AMPUTATION OF FOREARM,,,754.03,754.03,1
HCPCS,25905,AMP FOREARM THRU RADIUS & ULNA OPEN CIRCULAR,3836.0,2493.4,481.5,3836.0,35
HCPCS,25905,AMPUTATION OF FOREARM,,,739.63,8335.26,5
HCPCS,25905,Amputation of forearm,,,5924.91,7484.1,6
HCPCS,259050,AMPUTATION OF FOREARM,,,739.63,739.63,1
HCPCS,25907,AMPUTATION FOLLOW-UP SURGERY,,,648.59,7034.85,15
HCPCS,25907,Amputation follow-up surgery,,,1074.6,1357.39,6
HCPCS,259070,AMPUTATION FOLLOW-UP SURGERY,,,648.59,648.59,1
HCPCS,25909,AMPUTATION FOLLOW-UP SURGERY,,,721.68,15488.78,15
HCPCS,25909,Amputation follow-up surgery,,,3488.43,4406.44,6
HCPCS,259090,AMPUTATION FOLLOW-UP SURGERY,,,721.68,721.68,1
HCPCS,25915,AMPUTATION OF FOREARM,,,1224.4,8335.26,5
HCPCS,25915,Amputation of forearm,,,5924.91,7484.1,6
HCPCS,259150,AMPUTATION OF FOREARM,,,1224.4,1224.4,1
HCPCS,25920,AMPUTATE HAND AT WRIST,,,764.4,3758.57,5
HCPCS,25920,Amputate hand at wrist,,,3488.43,4406.44,6
HCPCS,259200,AMPUTATE HAND AT WRIST,,,764.4,764.4,1
HCPCS,25922,AMPUTATE HAND AT WRIST,,,676.92,3469.95,15
HCPCS,25922,Amputate hand at wrist,,,1074.6,1357.39,6
HCPCS,259220,AMPUTATE HAND AT WRIST,,,676.92,676.92,1
HCPCS,25924,AMPUTATION FOLLOW-UP SURGERY,,,746.82,3758.57,5
HCPCS,25924,Amputation follow-up surgery,,,3488.43,4406.44,6
HCPCS,259240,AMPUTATION FOLLOW-UP SURGERY,,,746.82,746.82,1
HCPCS,25927,AMPUTATION OF HAND,,,894.7,3758.57,5
HCPCS,25927,AMPUTATION TRANSMETACARPAL,3636.0,2363.4,445.93,3636.0,35
HCPCS,25927,Amputation of hand,,,1326.89,1676.08,6
HCPCS,259270,AMPUTATION OF HAND,,,894.7,894.7,1
HCPCS,25929,AMPUTATION FOLLOW-UP SURGERY,,,631.75,3966.07,15
HCPCS,25929,Amputation follow-up surgery,,,815.24,1029.78,6
HCPCS,25929,TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ,3128.0,2033.2,328.28,3128.0,35
HCPCS,259290,AMPUTATION FOLLOW-UP SURGERY,,,631.75,631.75,1
HCPCS,25931,AMPUTATION FOLLOW-UP SURGERY,,,827.22,7034.85,15
HCPCS,25931,Amputation follow-up surgery,,,1074.6,1357.39,6
HCPCS,259310,AMPUTATION FOLLOW-UP SURGERY,,,827.22,827.22,1
HCPCS,25999,DECOMPRESSION OF THE DISTAL RADIUS (COMP CODE 25035),2755.0,1790.75,468.68,2755.0,15
HCPCS,25999,RESURFACING OF THE CAPITATE (COMP CODE 25444),4911.0,3192.15,468.68,4911.0,15
HCPCS,25999,UNLISTED PROCEDURE FOREARM OR WRIST,592.0,384.8,166.35,2093.0,82
HCPCS,26010,DRAIN FINGER ABSCESS SIMPLE,700.0,455.0,68.71,525.0,35
HCPCS,26010,DRAINAGE FINGER ABSCESS SIMPLE,1143.0,742.95,98.33,4151.0,144
HCPCS,26010,DRAINAGE OF FINGER ABSCESS,,,147.1,147.1,1
HCPCS,260100,DRAINAGE OF FINGER ABSCESS,,,147.1,147.1,1
HCPCS,26011,DRAIN FINGER ABSCESS COMPL,986.0,640.9,90.57,739.5,35
HCPCS,26011,DRAINAGE FINGER ABSCESS COMPLICATED,9316.0,6055.4,232.56,8384.4,98
HCPCS,26011,DRAINAGE OF FINGER ABSCESS,,,193.35,193.35,1
HCPCS,260110,DRAINAGE OF FINGER ABSCESS,,,193.35,193.35,1
HCPCS,26020,DRAIN HAND TENDON SHEATH,2736.0,1778.4,272.71,2736.0,36
HCPCS,26020,DRAINAGE TENDON SHEATH DIGIT&/PALM EACH,18656.0,12126.4,673.26,16790.4,49
HCPCS,260200,DRAIN HAND TENDON SHEATH,,,584.72,584.72,1
HCPCS,26025,DRAINAGE OF PALM BURSA,,,441.2,7034.85,15
HCPCS,26025,"DRAINAGE PALM BURSA,SINGLE",2032.0,1320.8,281.52,2032.0,35
HCPCS,26025,Drainage of palm bursa,,,815.24,1029.78,6
HCPCS,260250,DRAINAGE OF PALM BURSA,,,441.2,441.2,1
HCPCS,26030,DRAINAGE OF PALM BURSAS,,,517.88,7034.85,15
HCPCS,26030,"DRAINAGE PALM BURSA,MULTIP/COMPLX",2500.0,1625.0,354.27,2500.0,35
HCPCS,26030,Drainage of palm bursas,,,815.24,1029.78,6
HCPCS,260300,DRAINAGE OF PALM BURSAS,,,517.88,517.88,1
HCPCS,26034,INCIS DEEP FINGR/HAND BONE LESN,2652.0,1723.8,310.01,2652.0,35
HCPCS,26034,TREAT HAND BONE LESION,,,579.57,3469.95,15
HCPCS,26034,Treat hand bone lesion,,,815.24,1029.78,6
HCPCS,260340,TREAT HAND BONE LESION,,,579.57,579.57,1
HCPCS,26035,DECOMPRESS FINGERS/HAND,,,904.72,7034.85,15
HCPCS,26035,"DECOMPRESS FINGERS/HAND,INJECT INJ",4548.0,2956.2,427.28,4548.0,35
HCPCS,26035,Decompress fingers/hand,,,1326.89,1676.08,6
HCPCS,260350,DECOMPRESS FINGERS/HAND,,,904.72,904.72,1
HCPCS,26037,DECOMPRESS FASCIOTOMY FINGR/HAND,3028.0,1968.2,399.57,3028.0,35
HCPCS,26037,DECOMPRESS FINGERS/HAND,,,591.69,7034.85,15
HCPCS,26037,Decompress fingers/hand,,,1326.89,1676.08,6
HCPCS,260370,DECOMPRESS FINGERS/HAND,,,591.69,591.69,1
HCPCS,26040,FASCIOTOMY PALMAR PERCUTANEOUS,1384.0,899.6,189.28,1384.0,35
HCPCS,26040,RELEASE PALM CONTRACTURE,,,333.53,3469.95,15
HCPCS,26040,Release palm contracture,,,815.24,1029.78,6
HCPCS,260400,RELEASE PALM CONTRACTURE,,,333.53,333.53,1
HCPCS,26045,FASCIOTOMY PALMAR OPEN PARTIAL,2292.0,1489.8,320.63,2292.0,35
HCPCS,26045,RELEASE PALM CONTRACTURE,,,498.51,7034.85,15
HCPCS,26045,Release palm contracture,,,815.24,1029.78,6
HCPCS,260450,RELEASE PALM CONTRACTURE,,,498.51,498.51,1
HCPCS,26055,INCISE FINGER TENDON SHEATH,1368.0,889.2,142.85,3469.95,51
HCPCS,26055,Incise finger tendon sheath,,,815.24,1029.78,6
HCPCS,260550,INCISE FINGER TENDON SHEATH,,,306.64,306.64,1
HCPCS,26060,INCISION OF FINGER TENDON,,,269.21,3469.95,15
HCPCS,26060,Incision of finger tendon,,,815.24,1029.78,6
HCPCS,26060,TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT,1164.0,756.6,139.89,1164.0,35
HCPCS,260600,INCISION OF FINGER TENDON,,,269.21,269.21,1
HCPCS,26070,ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT,1524.0,990.6,191.71,1524.0,35
HCPCS,26070,EXPLORE/TREAT HAND JOINT,,,341.46,3469.95,15
HCPCS,26070,Explore/treat hand joint,,,815.24,1029.78,6
HCPCS,260700,EXPLORE/TREAT HAND JOINT,,,341.46,341.46,1
HCPCS,26075,ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA,1564.0,1016.6,230.0,1564.0,35
HCPCS,26075,EXPLORE/TREAT FINGER JOINT,,,357.35,7034.85,15
HCPCS,26075,Explore/treat finger joint,,,815.24,1029.78,6
HCPCS,260750,EXPLORE/TREAT FINGER JOINT,,,357.35,357.35,1
HCPCS,26080,ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA,5495.5,3572.075,218.51,8370.0,84
HCPCS,26080,EXPLORE/TREAT FINGER JOINT,,,420.54,420.54,1
HCPCS,260800,EXPLORE/TREAT FINGER JOINT,,,420.54,420.54,1
HCPCS,26100,ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH,1516.0,985.4,203.29,1516.0,35
HCPCS,26100,BIOPSY HAND JOINT LINING,,,359.1,7034.85,15
HCPCS,26100,Biopsy hand joint lining,,,815.24,1029.78,6
HCPCS,261000,BIOPSY HAND JOINT LINING,,,359.1,359.1,1
HCPCS,26105,ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH,1532.0,995.8,246.86,1532.0,35
HCPCS,26105,BIOPSY FINGER JOINT LINING,,,361.2,7034.85,15
HCPCS,26105,Biopsy finger joint lining,,,815.24,1029.78,6
HCPCS,261050,BIOPSY FINGER JOINT LINING,,,361.2,361.2,1
HCPCS,26110,ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH,1460.0,949.0,200.86,1460.0,35
HCPCS,26110,BIOPSY FINGER JOINT LINING,,,343.57,3469.95,15
HCPCS,26110,Biopsy finger joint lining,,,815.24,1029.78,6
HCPCS,261100,BIOPSY FINGER JOINT LINING,,,343.57,343.57,1
HCPCS,26111,EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5+CM,2168.0,1409.2,223.99,2168.0,35
HCPCS,26111,EXC HAND LES SC 1.5 CM/>,,,438.21,3512.95,15
HCPCS,26111,Exc hand les sc 1.5 cm/>,,,815.24,1029.78,6
HCPCS,261110,EXC HAND LES SC 1.5 CM/>,,,438.21,438.21,1
HCPCS,26113,EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5+CM,2852.0,1853.8,294.58,2852.0,35
HCPCS,26113,EXC HAND TUM DEEP 1.5 CM/>,,,575.95,5038.0,16
HCPCS,26113,Exc hand tum deep 1.5 cm/>,,,815.24,1029.78,6
HCPCS,261130,EXC HAND TUM DEEP 1.5 CM/>,,,575.95,575.95,1
HCPCS,26115,EXC HAND LES SC < 1.5 CM,,,350.02,3512.95,15
HCPCS,26115,EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM,1584.0,1029.6,161.92,1188.0,35
HCPCS,26115,Exc hand les sc < 1.5 cm,,,815.24,1029.78,6
HCPCS,261150,EXC HAND LES SC < 1.5 CM,,,350.02,350.02,1
HCPCS,26116,EXC HAND TUM DEEP < 1.5 CM,,,552.74,3512.95,15
HCPCS,26116,EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM,2696.0,1752.4,280.41,2696.0,35
HCPCS,26116,Exc hand tum deep < 1.5 cm,,,815.24,1029.78,6
HCPCS,261160,EXC HAND TUM DEEP < 1.5 CM,,,552.74,552.74,1
HCPCS,26117,RAD RESECT HAND TUMOR < 3 CM,,,781.38,6205.4,15
HCPCS,26117,RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM,4052.0,2633.8,412.85,4052.0,35
HCPCS,26117,Rad resect hand tumor < 3 cm,,,1326.89,1676.08,6
HCPCS,261170,RAD RESECT HAND TUMOR < 3 CM,,,781.38,781.38,1
HCPCS,26118,RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>,5924.0,3850.6,581.72,5924.0,35
HCPCS,26118,RAD RESECT HAND TUMOR 3 CM/>,,,1098.86,6205.4,15
HCPCS,26118,Rad resect hand tumor 3 cm/>,,,1326.89,1676.08,6
HCPCS,261180,RAD RESECT HAND TUMOR 3 CM/>,,,1098.86,1098.86,1
HCPCS,26121,FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT,3092.0,2009.8,445.69,3092.0,35
HCPCS,26121,RELEASE PALM CONTRACTURE,,,631.55,7034.85,15
HCPCS,26121,Release palm contracture,,,1326.89,1676.08,6
HCPCS,261210,RELEASE PALM CONTRACTURE,,,631.55,631.55,1
HCPCS,26123,FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR,4352.0,2828.8,533.28,4352.0,35
HCPCS,26123,RELEASE PALM CONTRACTURE,,,880.26,7034.85,15
HCPCS,26123,Release palm contracture,,,1326.89,1676.08,6
HCPCS,261230,RELEASE PALM CONTRACTURE,,,880.26,880.26,1
HCPCS,26125,FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR,1840.0,1196.0,196.97,1840.0,35
HCPCS,26125,RELEASE PALM CONTRACTURE,,,280.54,280.54,1
HCPCS,26125,Release palm contracture,,,1326.89,1676.08,6
HCPCS,261250,RELEASE PALM CONTRACTURE,,,280.54,280.54,1
HCPCS,26130,REMOVE WRIST JOINT LINING,,,495.61,7034.85,15
HCPCS,26130,Remove wrist joint lining,,,815.24,1029.78,6
HCPCS,26130,SYNOVECTOMY CARPOMETACARPAL JOINT,2236.0,1453.4,323.14,2236.0,35
HCPCS,261300,REMOVE WRIST JOINT LINING,,,495.61,495.61,1
HCPCS,26135,REVISE FINGER JOINT EACH,,,583.49,7034.85,15
HCPCS,26135,Revise finger joint each,,,1326.89,1676.08,6
HCPCS,26135,SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD,2852.0,1853.8,363.73,2852.0,35
HCPCS,261350,REVISE FINGER JOINT EACH,,,583.49,583.49,1
HCPCS,26140,REVISE FINGER JOINT EACH,,,536.09,3469.95,15
HCPCS,26140,Revise finger joint each,,,815.24,1029.78,6
HCPCS,26140,SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT,2536.0,1648.4,324.79,2536.0,35
HCPCS,261400,REVISE FINGER JOINT EACH,,,536.09,536.09,1
HCPCS,26145,SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN,2596.0,1687.4,339.68,2596.0,35
HCPCS,26145,TENDON EXCISION PALM/FINGER,,,544.28,3469.95,15
HCPCS,26145,Tendon excision palm/finger,,,1326.89,1676.08,6
HCPCS,261450,TENDON EXCISION PALM/FINGER,,,544.28,544.28,1
HCPCS,26160,EXC LESION TDN SHTH/JT CAPSL HAND/FNGR,5387.0,3501.5499999999997,154.68,8370.0,81
HCPCS,26160,REMOVE TENDON SHEATH LESION,,,333.4,333.4,1
HCPCS,261600,REMOVE TENDON SHEATH LESION,,,333.4,333.4,1
HCPCS,26170,EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH,1964.0,1276.6,232.02,1964.0,35
HCPCS,26170,REMOVAL OF PALM TENDON EACH,,,431.09,3469.95,15
HCPCS,26170,Removal of palm tendon each,,,815.24,1029.78,6
HCPCS,261700,REMOVAL OF PALM TENDON EACH,,,431.09,431.09,1
HCPCS,26180,EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH,2140.0,1391.0,272.52,2140.0,35
HCPCS,26180,REMOVAL OF FINGER TENDON,,,474.82,3469.95,15
HCPCS,26180,Removal of finger tendon,,,815.24,1029.78,6
HCPCS,261800,REMOVAL OF FINGER TENDON,,,474.82,474.82,1
HCPCS,26185,REMOVE FINGER BONE,,,587.76,3469.95,15
HCPCS,26185,Remove finger bone,,,815.24,1029.78,6
HCPCS,26185,"SESAMOIDECTOMY, THUMB/FINGER",2608.0,1695.2,273.15,2608.0,35
HCPCS,261850,REMOVE FINGER BONE,,,587.76,587.76,1
HCPCS,26200,EXCISION/CURETTAGE CYST/TUMOR METACARPAL,2260.0,1469.0,307.24,2260.0,35
HCPCS,26200,REMOVE HAND BONE LESION,,,476.09,3469.95,15
HCPCS,26200,Remove hand bone lesion,,,815.24,1029.78,6
HCPCS,262000,REMOVE HAND BONE LESION,,,476.09,476.09,1
HCPCS,26205,EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT,3172.0,2061.8,422.39,3172.0,35
HCPCS,26205,REMOVE/GRAFT BONE LESION,,,638.09,15488.78,15
HCPCS,26205,Remove/graft bone lesion,,,1326.89,1676.08,6
HCPCS,262050,REMOVE/GRAFT BONE LESION,,,638.09,638.09,1
HCPCS,26210,EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER,2128.0,1383.2,279.85,2128.0,35
HCPCS,26210,REMOVAL OF FINGER LESION,,,472.76,3469.95,15
HCPCS,26210,Removal of finger lesion,,,815.24,1029.78,6
HCPCS,262100,REMOVAL OF FINGER LESION,,,472.76,472.76,1
HCPCS,26215,EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT,2908.0,1890.2,382.19,2908.0,35
HCPCS,26215,REMOVE/GRAFT FINGER LESION,,,598.76,7034.85,15
HCPCS,26215,Remove/graft finger lesion,,,1326.89,1676.08,6
HCPCS,262150,REMOVE/GRAFT FINGER LESION,,,598.76,598.76,1
HCPCS,26230,"PART REMV BONE,METACARPAL",2588.0,1682.2,321.31,2588.0,35
HCPCS,26230,PARTIAL REMOVAL OF HAND BONE,,,527.52,7034.85,15
HCPCS,26230,Partial removal of hand bone,,,1326.89,1676.08,6
HCPCS,262300,PARTIAL REMOVAL OF HAND BONE,,,527.52,527.52,1
HCPCS,26235,"PART REMV BONE,PROX/MID PHALANX",2532.0,1645.8,315.19,2532.0,35
HCPCS,26235,PARTIAL REMOVAL FINGER BONE,,,520.39,3469.95,15
HCPCS,26235,Partial removal finger bone,,,1326.89,1676.08,6
HCPCS,262350,PARTIAL REMOVAL FINGER BONE,,,520.39,520.39,1
HCPCS,26236,"PART REMV BONE,DISTAL PHALANX",2184.0,1419.6,278.75,2184.0,35
HCPCS,26236,PARTIAL REMOVAL FINGER BONE,,,466.55,3469.95,15
HCPCS,26236,Partial removal finger bone,,,815.24,1029.78,6
HCPCS,262360,PARTIAL REMOVAL FINGER BONE,,,466.55,466.55,1
HCPCS,26250,EXTENSIVE HAND SURGERY,,,1118.05,7034.85,15
HCPCS,26250,Extensive hand surgery,,,815.24,1029.78,6
HCPCS,26250,RADICAL RESECTION TUMOR METACARPAL,6084.0,3954.6,519.11,6084.0,35
HCPCS,262500,EXTENSIVE HAND SURGERY,,,1118.05,1118.05,1
HCPCS,26260,RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER,4464.0,2901.6,394.79,4464.0,35
HCPCS,26260,RESECT PROX FINGER TUMOR,,,837.67,7034.85,15
HCPCS,26260,Resect prox finger tumor,,,1326.89,1676.08,6
HCPCS,262600,RESECT PROX FINGER TUMOR,,,837.67,837.67,1
HCPCS,26262,RADICAL RESECTION TUMOR DISTAL PHALANX FINGER,3316.0,2155.4,305.69,3316.0,35
HCPCS,26262,RESECT DISTAL FINGER TUMOR,,,664.48,3469.95,15
HCPCS,26262,Resect distal finger tumor,,,815.24,1029.78,6
HCPCS,262620,RESECT DISTAL FINGER TUMOR,,,664.48,664.48,1
HCPCS,26320,REMOVAL OF IMPLANT FROM HAND,,,368.19,3512.95,15
HCPCS,26320,REMOVAL OF IMPLANT FROM HAND/FINGR,1640.0,1066.0,230.58,1640.0,35
HCPCS,26320,Removal of implant from hand,,,815.24,1029.78,6
HCPCS,263200,REMOVAL OF IMPLANT FROM HAND,,,368.19,368.19,1
HCPCS,26340,MANIPULATE FINGER W/ANESTH,,,373.14,3469.95,15
HCPCS,26340,MANIPULATION FINGER JOINT UNDER ANES EACH JOINT,1120.0,728.0,190.92,1120.0,32
HCPCS,26340,Manipulate finger w/anesth,,,632.74,799.25,6
HCPCS,263400,MANIPULATE FINGER W/ANESTH,,,373.14,373.14,1
HCPCS,26341,MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD,871.5,566.475,38.3,4268.0,81
HCPCS,26341,MANIPULAT PALM CORD POST INJ,,,81.6,81.6,1
HCPCS,263410,MANIPULAT PALM CORD POST INJ,,,81.6,81.6,1
HCPCS,26350,REPAIR FINGER/HAND TENDON,,,769.23,769.23,1
HCPCS,26350,RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON,10570.0,6870.5,426.48,16790.4,77
HCPCS,263500,REPAIR FINGER/HAND TENDON,,,769.23,769.23,1
HCPCS,26352,REPAIR/GRAFT HAND TENDON,,,859.0,15488.78,15
HCPCS,26352,RPR/ADVMNT FLXR TDN N/Z/2 W/FR GRAFT EA TENDON,3148.0,2046.2,479.92,3148.0,35
HCPCS,26352,Repair/graft hand tendon,,,1326.89,1676.08,6
HCPCS,263520,REPAIR/GRAFT HAND TENDON,,,859.0,859.0,1
HCPCS,26356,REPAIR FINGER/HAND TENDON,,,832.65,7034.85,15
HCPCS,26356,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,3824.0,2485.6,599.58,3824.0,35
HCPCS,26356,Repair finger/hand tendon,,,1326.89,1676.08,6
HCPCS,263560,REPAIR FINGER/HAND TENDON,,,832.65,832.65,1
HCPCS,26357,REPAIR FINGER/HAND TENDON,,,934.3,7034.85,15
HCPCS,26357,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,4400.0,2860.0,508.15,4400.0,35
HCPCS,26357,Repair finger/hand tendon,,,1326.89,1676.08,6
HCPCS,263570,REPAIR FINGER/HAND TENDON,,,934.3,934.3,1
HCPCS,26358,REPAIR/GRAFT HAND TENDON,,,1031.3,15488.78,15
HCPCS,26358,Repair/graft hand tendon,,,1326.89,1676.08,6
HCPCS,263580,REPAIR/GRAFT HAND TENDON,,,1031.3,1031.3,1
HCPCS,26370,REPAIR FINGER/HAND TENDON,,,808.44,7034.85,15
HCPCS,26370,RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN,2912.0,1892.8,461.12,2912.0,35
HCPCS,26370,Repair finger/hand tendon,,,1326.89,1676.08,6
HCPCS,263700,REPAIR FINGER/HAND TENDON,,,808.44,808.44,1
HCPCS,26372,REPAIR/GRAFT HAND TENDON,,,946.44,15488.78,15
HCPCS,26372,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA,3604.0,2342.6,530.34,3604.0,35
HCPCS,26372,Repair/graft hand tendon,,,1326.89,1676.08,6
HCPCS,263720,REPAIR/GRAFT HAND TENDON,,,946.44,946.44,1
HCPCS,26373,REPAIR FINGER/HAND TENDON,,,909.89,7034.85,15
HCPCS,26373,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA,3364.0,2186.6,504.86,3364.0,35
HCPCS,26373,Repair finger/hand tendon,,,1326.89,1676.08,6
HCPCS,263730,REPAIR FINGER/HAND TENDON,,,909.89,909.89,1
HCPCS,26390,EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F,3772.0,2451.8,503.15,3772.0,35
HCPCS,26390,REVISE HAND/FINGER TENDON,,,911.21,15488.78,15
HCPCS,26390,Revise hand/finger tendon,,,1326.89,1676.08,6
HCPCS,263900,REVISE HAND/FINGER TENDON,,,911.21,911.21,1
HCPCS,26392,REPAIR/GRAFT HAND TENDON,,,1037.43,15488.78,15
HCPCS,26392,RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD,4200.0,2730.0,570.37,4200.0,35
HCPCS,26392,Repair/graft hand tendon,,,1326.89,1676.08,6
HCPCS,263920,REPAIR/GRAFT HAND TENDON,,,1037.43,1037.43,1
HCPCS,26410,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,5555.5,3611.075,341.25,8370.0,133
HCPCS,26410,REPAIR HAND TENDON,,,618.97,618.97,1
HCPCS,264100,REPAIR HAND TENDON,,,618.97,618.97,1
HCPCS,26412,REPAIR EXTENSOR TENDON HAND W/GRAFT EACH,2592.0,1684.8,407.21,2592.0,35
HCPCS,26412,REPAIR/GRAFT HAND TENDON,,,738.83,7034.85,15
HCPCS,26412,Repair/graft hand tendon,,,1326.89,1676.08,6
HCPCS,264120,REPAIR/GRAFT HAND TENDON,,,738.83,738.83,1
HCPCS,26415,EXC XTNSR TDN W/IMPLTJ SYNTH ROD DLYD GRF H/F EA,3404.0,2212.6,440.3,3404.0,35
HCPCS,26415,EXCISION HAND/FINGER TENDON,,,880.86,7034.85,15
HCPCS,26415,Excision hand/finger tendon,,,1326.89,1676.08,6
HCPCS,264150,EXCISION HAND/FINGER TENDON,,,880.86,880.86,1
HCPCS,26416,GRAFT HAND OR FINGER TENDON,,,954.66,7034.85,15
HCPCS,26416,Graft hand or finger tendon,,,1326.89,1676.08,6
HCPCS,264160,GRAFT HAND OR FINGER TENDON,,,954.66,954.66,1
HCPCS,26418,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,5495.5,3572.075,341.36,8370.0,133
HCPCS,26418,REPAIR FINGER TENDON,,,641.65,641.65,1
HCPCS,264180,REPAIR FINGER TENDON,,,641.65,641.65,1
HCPCS,26420,REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH,2776.0,1804.4,425.47,2776.0,35
HCPCS,26420,REPAIR/GRAFT FINGER TENDON,,,767.51,7034.85,15
HCPCS,26420,Repair/graft finger tendon,,,1326.89,1676.08,6
HCPCS,264200,REPAIR/GRAFT FINGER TENDON,,,767.51,767.51,1
HCPCS,26426,REPAIR FINGER/HAND TENDON,,,531.53,7034.85,15
HCPCS,26426,RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR,2528.0,1643.2,382.76,2528.0,35
HCPCS,26426,Repair finger/hand tendon,,,1326.89,1676.08,6
HCPCS,264260,REPAIR FINGER/HAND TENDON,,,531.53,531.53,1
HCPCS,26428,REPAIR/GRAFT FINGER TENDON,,,823.62,7034.85,15
HCPCS,26428,Repair/graft finger tendon,,,1326.89,1676.08,6
HCPCS,264280,REPAIR/GRAFT FINGER TENDON,,,823.62,823.62,1
HCPCS,26432,CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING,1664.0,1081.6,295.45,1664.0,35
HCPCS,26432,REPAIR FINGER TENDON,,,559.42,3469.95,15
HCPCS,26432,Repair finger tendon,,,815.24,1029.78,6
HCPCS,264320,REPAIR FINGER TENDON,,,559.42,559.42,1
HCPCS,26433,REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF,1880.0,1222.0,318.05,1880.0,35
HCPCS,26433,REPAIR FINGER TENDON,,,589.14,7034.85,15
HCPCS,26433,Repair finger tendon,,,815.24,1029.78,6
HCPCS,264330,REPAIR FINGER TENDON,,,589.14,589.14,1
HCPCS,26434,REPAIR EXTENSOR TENDON DISTAL INSERTION W/GRAFT,2504.0,1627.6,370.87,2504.0,35
HCPCS,26434,REPAIR/GRAFT FINGER TENDON,,,719.36,7034.85,15
HCPCS,26434,Repair/graft finger tendon,,,1326.89,1676.08,6
HCPCS,264340,REPAIR/GRAFT FINGER TENDON,,,719.36,719.36,1
HCPCS,26437,REALIGNMENT EXTENSOR TENDON HAND EACH TENDON,2396.0,1557.4,364.14,2396.0,35
HCPCS,26437,REALIGNMENT OF TENDONS,,,689.01,7034.85,15
HCPCS,26437,Realignment of tendons,,,815.24,1029.78,6
HCPCS,264370,REALIGNMENT OF TENDONS,,,689.01,689.01,1
HCPCS,26440,RELEASE PALM/FINGER TENDON,,,668.57,3469.95,15
HCPCS,26440,Release palm/finger tendon,,,815.24,1029.78,6
HCPCS,26440,TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON,2064.0,1341.6,377.8,2064.0,35
HCPCS,264400,RELEASE PALM/FINGER TENDON,,,668.57,668.57,1
HCPCS,26442,RELEASE PALM & FINGER TENDON,,,1024.05,7034.85,15
HCPCS,26442,Release palm & finger tendon,,,1326.89,1676.08,6
HCPCS,26442,TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO,4290.0,2788.5,534.85,4290.0,35
HCPCS,264420,RELEASE PALM & FINGER TENDON,,,1024.05,1024.05,1
HCPCS,26445,RELEASE HAND/FINGER TENDON,,,619.84,7034.85,15
HCPCS,26445,Release hand/finger tendon,,,815.24,1029.78,6
HCPCS,26445,TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH,1780.0,1157.0,354.74,1780.0,35
HCPCS,264450,RELEASE HAND/FINGER TENDON,,,619.84,619.84,1
HCPCS,26449,RELEASE FOREARM/HAND TENDON,,,735.46,7034.85,15
HCPCS,26449,Release forearm/hand tendon,,,815.24,1029.78,6
HCPCS,26449,TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA,3436.0,2233.4,503.76,3436.0,35
HCPCS,264490,RELEASE FOREARM/HAND TENDON,,,735.46,735.46,1
HCPCS,26450,INCISION OF PALM TENDON,,,479.37,7034.85,15
HCPCS,26450,Incision of palm tendon,,,815.24,1029.78,6
HCPCS,26450,"TENOTOMY PALM FLEX,SINGLE,OPEN,EACH",1516.0,985.4,232.24,1516.0,35
HCPCS,264500,INCISION OF PALM TENDON,,,479.37,479.37,1
HCPCS,26455,INCISION OF FINGER TENDON,,,476.32,3469.95,15
HCPCS,26455,Incision of finger tendon,,,815.24,1029.78,6
HCPCS,26455,"TENOTOMY FINGR FLEX,SINGLE,OPEN,EACH",1504.0,977.6,230.28,1504.0,35
HCPCS,264550,INCISION OF FINGER TENDON,,,476.32,476.32,1
HCPCS,26460,INCISE HAND/FINGER TENDON,,,466.03,3469.95,15
HCPCS,26460,Incise hand/finger tendon,,,815.24,1029.78,6
HCPCS,26460,"TENOTOMY HAND EXTEN,SINGLE,OPEN,EACH",1432.0,930.8,225.37,1432.0,35
HCPCS,264600,INCISE HAND/FINGER TENDON,,,466.03,466.03,1
HCPCS,26471,FUSION OF FINGER TENDONS,,,682.13,7034.85,15
HCPCS,26471,Fusion of finger tendons,,,815.24,1029.78,6
HCPCS,26471,TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH,2360.0,1534.0,356.59,2360.0,35
HCPCS,264710,FUSION OF FINGER TENDONS,,,682.13,682.13,1
HCPCS,26474,FUSION OF FINGER TENDONS,,,673.37,3469.95,15
HCPCS,26474,Fusion of finger tendons,,,815.24,1029.78,6
HCPCS,26474,TENODESIS DISTAL JOINT EACH,2196.0,1427.4,347.07,2196.0,35
HCPCS,264740,FUSION OF FINGER TENDONS,,,673.37,673.37,1
HCPCS,26476,TENDON LENGTHENING,,,664.93,7034.85,15
HCPCS,26476,"TENDON LENGTHENING,EXTEN,HAND/FINGR",2140.0,1391.0,336.94,2140.0,35
HCPCS,26476,Tendon lengthening,,,815.24,1029.78,6
HCPCS,264760,TENDON LENGTHENING,,,664.93,664.93,1
HCPCS,26477,TENDON SHORTENING,,,649.29,7034.85,15
HCPCS,26477,"TENDON SHORTENING,EXTEN,HAND/FINGR",2128.0,1383.2,339.46,2128.0,35
HCPCS,26477,Tendon shortening,,,815.24,1029.78,6
HCPCS,264770,TENDON SHORTENING,,,649.29,649.29,1
HCPCS,26478,LENGTHENING OF HAND TENDON,,,680.05,7034.85,15
HCPCS,26478,Lengthening of hand tendon,,,815.24,1029.78,6
HCPCS,26478,"TENDON LENGTHENING,FLEX,HAND/FINGR",2388.0,1552.2,367.71,2388.0,35
HCPCS,264780,LENGTHENING OF HAND TENDON,,,680.05,680.05,1
HCPCS,26479,SHORTENING OF HAND TENDON,,,698.64,7034.85,15
HCPCS,26479,Shortening of hand tendon,,,815.24,1029.78,6
HCPCS,26479,"TENDON SHORTENING,FLEX,HAND/FINGR",2364.0,1536.6,345.71,2364.0,35
HCPCS,264790,SHORTENING OF HAND TENDON,,,698.64,698.64,1
HCPCS,26480,TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN,3600.0,2340.0,449.92,3600.0,35
HCPCS,26480,TRANSPLANT HAND TENDON,,,809.5,7034.85,15
HCPCS,26480,Transplant hand tendon,,,1326.89,1676.08,6
HCPCS,264800,TRANSPLANT HAND TENDON,,,809.5,809.5,1
HCPCS,26483,TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT,3392.0,2204.8,506.9,3392.0,35
HCPCS,26483,TRANSPLANT/GRAFT HAND TENDON,,,900.78,7034.85,15
HCPCS,26483,Transplant/graft hand tendon,,,1326.89,1676.08,6
HCPCS,264830,TRANSPLANT/GRAFT HAND TENDON,,,900.78,900.78,1
HCPCS,26485,TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH,3156.0,2051.4,480.38,3156.0,35
HCPCS,26485,TRANSPLANT PALM TENDON,,,863.7,7034.85,15
HCPCS,26485,Transplant palm tendon,,,1326.89,1676.08,6
HCPCS,264850,TRANSPLANT PALM TENDON,,,863.7,863.7,1
HCPCS,26489,TRANSPLANT/GRAFT PALM TENDON,,,998.46,7034.85,15
HCPCS,26489,Transplant/graft palm tendon,,,1326.89,1676.08,6
HCPCS,264890,TRANSPLANT/GRAFT PALM TENDON,,,998.46,998.46,1
HCPCS,26490,OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN,3440.0,2236.0,474.75,3440.0,35
HCPCS,26490,REVISE THUMB TENDON,,,870.06,7034.85,15
HCPCS,26490,Revise thumb tendon,,,1326.89,1676.08,6
HCPCS,264900,REVISE THUMB TENDON,,,870.06,870.06,1
HCPCS,26492,OPPONENSPLASTY TDN TR W/GRF EA TDN,3936.0,2558.4,533.81,3936.0,35
HCPCS,26492,TENDON TRANSFER WITH GRAFT,,,963.31,7034.85,15
HCPCS,26492,Tendon transfer with graft,,,1326.89,1676.08,6
HCPCS,264920,TENDON TRANSFER WITH GRAFT,,,963.31,963.31,1
HCPCS,26494,HAND TENDON/MUSCLE TRANSFER,,,873.94,7034.85,15
HCPCS,26494,Hand tendon/muscle transfer,,,1326.89,1676.08,6
HCPCS,264940,HAND TENDON/MUSCLE TRANSFER,,,873.94,873.94,1
HCPCS,26496,OPPONENSPLASTY OTHER METHODS,3912.0,2542.8,529.42,3912.0,35
HCPCS,26496,REVISE THUMB TENDON,,,942.12,7034.85,15
HCPCS,26496,Revise thumb tendon,,,1326.89,1676.08,6
HCPCS,264960,REVISE THUMB TENDON,,,942.12,942.12,1
HCPCS,26497,FINGER TENDON TRANSFER,,,940.69,7034.85,15
HCPCS,26497,Finger tendon transfer,,,1326.89,1676.08,6
HCPCS,26497,TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR,3904.0,2537.6,526.83,3904.0,35
HCPCS,264970,FINGER TENDON TRANSFER,,,940.69,940.69,1
HCPCS,26498,FINGER TENDON TRANSFER,,,1227.48,7034.85,15
HCPCS,26498,Finger tendon transfer,,,1326.89,1676.08,6
HCPCS,26498,TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS,5684.0,3694.6,744.84,5684.0,35
HCPCS,264980,FINGER TENDON TRANSFER,,,1227.48,1227.48,1
HCPCS,26499,CORRECTION CLAW FINGER OTHER,,,904.5,7034.85,15
HCPCS,26499,CORRECTION CLAW FINGER OTHER METHODS,3668.0,2384.2,491.29,3668.0,35
HCPCS,26499,Correction claw finger other,,,1326.89,1676.08,6
HCPCS,264990,CORRECTION CLAW FINGER OTHER,,,904.5,904.5,1
HCPCS,26500,HAND TENDON RECONSTRUCTION,,,711.27,15488.78,15
HCPCS,26500,Hand tendon reconstruction,,,1326.89,1676.08,6
HCPCS,26500,RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX,2452.0,1593.8,365.6,2452.0,35
HCPCS,265000,HAND TENDON RECONSTRUCTION,,,711.27,711.27,1
HCPCS,26502,HAND TENDON RECONSTRUCTION,,,783.32,7034.85,15
HCPCS,26502,Hand tendon reconstruction,,,1326.89,1676.08,6
HCPCS,26502,RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX,2924.0,1900.6,406.94,2924.0,35
HCPCS,265020,HAND TENDON RECONSTRUCTION,,,783.32,783.32,1
HCPCS,26508,RELEASE THENAR MUSCLE,2472.0,1606.8,371.86,2472.0,35
HCPCS,26508,RELEASE THUMB CONTRACTURE,,,700.14,7034.85,15
HCPCS,26508,Release thumb contracture,,,815.24,1029.78,6
HCPCS,265080,RELEASE THUMB CONTRACTURE,,,700.14,700.14,1
HCPCS,26510,CROSS INTRINSIC TRANSFER EACH TENDON,2240.0,1456.0,349.57,2240.0,35
HCPCS,26510,THUMB TENDON TRANSFER,,,661.63,7034.85,15
HCPCS,26510,Thumb tendon transfer,,,1326.89,1676.08,6
HCPCS,265100,THUMB TENDON TRANSFER,,,661.63,661.63,1
HCPCS,26516,CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT,2928.0,1903.2,408.83,2928.0,35
HCPCS,26516,FUSION OF KNUCKLE JOINT,,,770.02,7034.85,15
HCPCS,26516,Fusion of knuckle joint,,,815.24,1029.78,6
HCPCS,265160,FUSION OF KNUCKLE JOINT,,,770.02,770.02,1
HCPCS,26517,CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS,3632.0,2360.8,486.94,3632.0,35
HCPCS,26517,FUSION OF KNUCKLE JOINTS,,,899.22,7034.85,15
HCPCS,26517,Fusion of knuckle joints,,,815.24,1029.78,6
HCPCS,265170,FUSION OF KNUCKLE JOINTS,,,899.22,899.22,1
HCPCS,26518,FUSION OF KNUCKLE JOINTS,,,910.81,15488.78,15
HCPCS,26518,Fusion of knuckle joints,,,1326.89,1676.08,6
HCPCS,265180,FUSION OF KNUCKLE JOINTS,,,910.81,910.81,1
HCPCS,26520,CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH,2188.0,1422.2,394.09,2188.0,35
HCPCS,26520,RELEASE KNUCKLE CONTRACTURE,,,700.98,7034.85,15
HCPCS,26520,Release knuckle contracture,,,815.24,1029.78,6
HCPCS,265200,RELEASE KNUCKLE CONTRACTURE,,,700.98,700.98,1
HCPCS,26525,CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH,2200.0,1430.0,396.47,2200.0,35
HCPCS,26525,RELEASE FINGER CONTRACTURE,,,705.1,3469.95,15
HCPCS,26525,Release finger contracture,,,815.24,1029.78,6
HCPCS,265250,RELEASE FINGER CONTRACTURE,,,705.1,705.1,1
HCPCS,26530,ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH,2752.0,1788.8,364.52,2752.0,35
HCPCS,26530,REVISE KNUCKLE JOINT,,,571.67,15488.78,15
HCPCS,26530,Revise knuckle joint,,,2190.3,2766.7,6
HCPCS,265300,REVISE KNUCKLE JOINT,,,571.67,571.67,1
HCPCS,26531,ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT,3252.0,2113.8,450.7,3252.0,35
HCPCS,26531,REVISE KNUCKLE WITH IMPLANT,,,664.82,15488.78,15
HCPCS,26531,Revise knuckle with implant,,,2190.3,2766.7,6
HCPCS,265310,REVISE KNUCKLE WITH IMPLANT,,,664.82,664.82,1
HCPCS,26535,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,10410.0,6766.5,292.77,16790.4,77
HCPCS,26535,REVISE FINGER JOINT,,,462.43,462.43,1
HCPCS,265350,REVISE FINGER JOINT,,,462.43,462.43,1
HCPCS,26536,ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA,2624.0,1705.6,413.73,2624.0,35
HCPCS,26536,REVISE/IMPLANT FINGER JOINT,,,772.77,15488.78,15
HCPCS,26536,Revise/implant finger joint,,,2190.3,2766.7,6
HCPCS,265360,REVISE/IMPLANT FINGER JOINT,,,772.77,772.77,1
HCPCS,26540,REPAIR HAND JOINT,,,723.54,7034.85,15
HCPCS,26540,RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT,2640.0,1716.0,391.74,2640.0,35
HCPCS,26540,Repair hand joint,,,815.24,1029.78,6
HCPCS,265400,REPAIR HAND JOINT,,,723.54,723.54,1
HCPCS,26541,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF,3524.0,2290.6,510.99,3524.0,35
HCPCS,26541,REPAIR HAND JOINT WITH GRAFT,,,867.06,7034.85,15
HCPCS,26541,Repair hand joint with graft,,,1326.89,1676.08,6
HCPCS,265410,REPAIR HAND JOINT WITH GRAFT,,,867.06,867.06,1
HCPCS,26542,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS,2780.0,1807.0,396.01,2780.0,35
HCPCS,26542,REPAIR HAND JOINT WITH GRAFT,,,747.44,7034.85,15
HCPCS,26542,Repair hand joint with graft,,,1326.89,1676.08,6
HCPCS,265420,REPAIR HAND JOINT WITH GRAFT,,,747.44,747.44,1
HCPCS,26545,RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT,2844.0,1848.6,402.59,2844.0,35
HCPCS,26545,RECONSTRUCT FINGER JOINT,,,760.89,7034.85,15
HCPCS,26545,Reconstruct finger joint,,,1326.89,1676.08,6
HCPCS,265450,RECONSTRUCT FINGER JOINT,,,760.89,760.89,1
HCPCS,26546,REPAIR NONUNION HAND,,,1075.95,15488.78,15
HCPCS,26546,RPR NON-UNION MTCRPL/PHALANX,4332.0,2815.8,545.7,4332.0,35
HCPCS,26546,Repair nonunion hand,,,1326.89,1676.08,6
HCPCS,265460,REPAIR NONUNION HAND,,,1075.95,1075.95,1
HCPCS,26548,RECONSTRUCT FINGER JOINT,,,829.32,7034.85,15
HCPCS,26548,RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL,3288.0,2137.2,442.52,3288.0,35
HCPCS,26548,Reconstruct finger joint,,,1326.89,1676.08,6
HCPCS,265480,RECONSTRUCT FINGER JOINT,,,829.32,829.32,1
HCPCS,26550,POLLICIZATION DIGIT,,,1720.3,7034.85,15
HCPCS,26550,POLLICIZATION OF DIGIT,8672.0,5636.8,1157.16,8672.0,35
HCPCS,26550,Pollicization digit,,,1326.89,1676.08,6
HCPCS,265500,POLLICIZATION DIGIT,,,1720.3,1720.3,1
HCPCS,26551,GREAT TOE-HAND TRANSFER,,,3435.97,8335.26,5
HCPCS,26551,Great toe-hand transfer,,,3613.7,4564.67,6
HCPCS,265510,GREAT TOE-HAND TRANSFER,,,3435.97,3435.97,1
HCPCS,26553,SINGLE TRANSFER TOE-HAND,,,3413.09,8335.26,5
HCPCS,26553,Single transfer toe-hand,,,3613.7,4564.67,6
HCPCS,265530,SINGLE TRANSFER TOE-HAND,,,3413.09,3413.09,1
HCPCS,26554,DOUBLE TRANSFER TOE-HAND,,,3975.34,8335.26,5
HCPCS,26554,Double transfer toe-hand,,,3613.7,4564.67,6
HCPCS,265540,DOUBLE TRANSFER TOE-HAND,,,3975.34,3975.34,1
HCPCS,26555,POSITIONAL CHANGE OF FINGER,,,1442.39,15488.78,15
HCPCS,26555,Positional change of finger,,,1326.89,1676.08,6
HCPCS,265550,POSITIONAL CHANGE OF FINGER,,,1442.39,1442.39,1
HCPCS,26556,TOE JOINT TRANSFER,,,3549.57,8335.26,5
HCPCS,26556,Toe joint transfer,,,3613.7,4564.67,6
HCPCS,265560,TOE JOINT TRANSFER,,,3549.57,3549.57,1
HCPCS,26560,REPAIR OF WEB FINGER,,,657.46,3469.95,15
HCPCS,26560,Repair of web finger,,,1326.89,1676.08,6
HCPCS,265600,REPAIR OF WEB FINGER,,,657.46,657.46,1
HCPCS,26561,REPAIR OF WEB FINGER,,,1021.82,7034.85,15
HCPCS,26561,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT,4440.0,2886.0,585.71,4440.0,35
HCPCS,26561,Repair of web finger,,,1326.89,1676.08,6
HCPCS,265610,REPAIR OF WEB FINGER,,,1021.82,1021.82,1
HCPCS,26562,REPAIR OF WEB FINGER,,,1433.88,7034.85,15
HCPCS,26562,Repair of web finger,,,1326.89,1676.08,6
HCPCS,265620,REPAIR OF WEB FINGER,,,1433.88,1433.88,1
HCPCS,26565,CORRECT METACARPAL FLAW,,,735.89,7034.85,15
HCPCS,26565,Correct metacarpal flaw,,,1326.89,1676.08,6
HCPCS,26565,OSTEOTOMY METACARPAL EACH,2764.0,1796.6,393.4,2764.0,35
HCPCS,265650,CORRECT METACARPAL FLAW,,,735.89,735.89,1
HCPCS,26567,CORRECT FINGER DEFORMITY,,,744.75,7034.85,15
HCPCS,26567,Correct finger deformity,,,1326.89,1676.08,6
HCPCS,26567,OSTEOTOMY PHALANX FINGER EACH,2796.0,1817.4,396.28,2796.0,35
HCPCS,265670,CORRECT FINGER DEFORMITY,,,744.75,744.75,1
HCPCS,26568,LENGTHEN METACARPAL/FINGER,,,962.23,15488.78,15
HCPCS,26568,Lengthen metacarpal/finger,,,1326.89,1676.08,6
HCPCS,26568,OSTEOPLASTY LENGTHENING METACARPAL/PHALANX,3708.0,2410.2,518.24,3708.0,35
HCPCS,265680,LENGTHEN METACARPAL/FINGER,,,962.23,962.23,1
HCPCS,26580,REPAIR CLEFT HAND,,,1606.95,7034.85,15
HCPCS,26580,Repair cleft hand,,,1326.89,1676.08,6
HCPCS,265800,REPAIR CLEFT HAND,,,1606.95,1606.95,1
HCPCS,26587,RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE,5800.0,3770.0,542.43,5800.0,35
HCPCS,26587,RECONSTRUCT EXTRA FINGER,,,1095.7,7034.85,15
HCPCS,26587,Reconstruct extra finger,,,1326.89,1676.08,6
HCPCS,265870,RECONSTRUCT EXTRA FINGER,,,1095.7,1095.7,1
HCPCS,26590,REPAIR FINGER DEFORMITY,,,1493.42,3469.95,15
HCPCS,26590,Repair finger deformity,,,1326.89,1676.08,6
HCPCS,265900,REPAIR FINGER DEFORMITY,,,1493.42,1493.42,1
HCPCS,26591,REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE,1487.0,966.55,264.02,1487.0,35
HCPCS,26591,REPAIR MUSCLES OF HAND,,,501.85,7034.85,15
HCPCS,26591,Repair muscles of hand,,,1326.89,1676.08,6
HCPCS,265910,REPAIR MUSCLES OF HAND,,,501.85,501.85,1
HCPCS,26593,RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE,2200.0,1430.0,344.76,2200.0,35
HCPCS,26593,RELEASE MUSCLES OF HAND,,,665.06,7034.85,15
HCPCS,26593,Release muscles of hand,,,815.24,1029.78,6
HCPCS,265930,RELEASE MUSCLES OF HAND,,,665.06,665.06,1
HCPCS,26596,EXCISION CONSTRICTING TISSUE,,,852.0,7034.85,15
HCPCS,26596,Excision constricting tissue,,,1326.89,1676.08,6
HCPCS,265960,EXCISION CONSTRICTING TISSUE,,,852.0,852.0,1
HCPCS,26600,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,1261.5,819.975,141.7,4151.0,133
HCPCS,26600,TREAT METACARPAL FRACTURE,,,305.92,305.92,1
HCPCS,266000,TREAT METACARPAL FRACTURE,,,305.92,305.92,1
HCPCS,26605,CLTX METACARPAL FX W/MANIPULATION EACH BONE,1356.0,881.4000000000001,151.13,4151.0,133
HCPCS,26605,TREAT METACARPAL FRACTURE,,,317.2,317.2,1
HCPCS,266050,TREAT METACARPAL FRACTURE,,,317.2,317.2,1
HCPCS,26607,CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE,2192.0,1424.8,264.01,2192.0,35
HCPCS,26607,TREAT METACARPAL FRACTURE,,,532.84,7034.85,15
HCPCS,26607,Treat metacarpal fracture,,,310.03,391.62,6
HCPCS,266070,TREAT METACARPAL FRACTURE,,,532.84,532.84,1
HCPCS,26608,PRQ SKELETAL FIXJ METACARPAL FX EACH BONE,2220.0,1443.0,262.0,2220.0,35
HCPCS,26608,TREAT METACARPAL FRACTURE,,,508.56,7034.85,15
HCPCS,26608,Treat metacarpal fracture,,,3366.74,4252.73,6
HCPCS,266080,TREAT METACARPAL FRACTURE,,,508.56,508.56,1
HCPCS,26615,OPEN TX METACARPAL FRACTURE SINGLE EA BONE,2828.0,1838.2,289.25,2828.0,35
HCPCS,26615,TREAT METACARPAL FRACTURE,,,605.94,7034.85,15
HCPCS,26615,Treat metacarpal fracture,,,3366.74,4252.73,6
HCPCS,266150,TREAT METACARPAL FRACTURE,,,605.94,605.94,1
HCPCS,26641,CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,1515.5,985.075,189.2,4151.0,84
HCPCS,26641,TREAT THUMB DISLOCATION,,,407.38,407.38,1
HCPCS,266410,TREAT THUMB DISLOCATION,,,407.38,407.38,1
HCPCS,26645,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,5517.5,3586.375,195.45,8282.7,182
HCPCS,26645,TREAT THUMB FRACTURE,,,421.33,421.33,1
HCPCS,266450,TREAT THUMB FRACTURE,,,421.33,421.33,1
HCPCS,26650,PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB,2140.0,1391.0,282.47,2140.0,35
HCPCS,26650,TREAT THUMB FRACTURE,,,507.37,7034.85,15
HCPCS,26650,Treat thumb fracture,,,3366.74,4252.73,6
HCPCS,266500,TREAT THUMB FRACTURE,,,507.37,507.37,1
HCPCS,26665,OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB,3176.0,2064.4,390.99,3176.0,35
HCPCS,26665,TREAT THUMB FRACTURE,,,658.88,7034.85,15
HCPCS,26665,Treat thumb fracture,,,3366.74,4252.73,6
HCPCS,266650,TREAT THUMB FRACTURE,,,658.88,658.88,1
HCPCS,26670,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,1455.5,946.075,154.68,4151.0,182
HCPCS,26670,TREAT HAND DISLOCATION,,,336.59,336.59,1
HCPCS,266700,TREAT HAND DISLOCATION,,,336.59,336.59,1
HCPCS,26675,CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES,1932.0,1255.8,208.6,1449.0,35
HCPCS,26675,TREAT HAND DISLOCATION,,,449.91,3469.95,15
HCPCS,26675,Treat hand dislocation,,,632.74,799.25,6
HCPCS,266750,TREAT HAND DISLOCATION,,,449.91,449.91,1
HCPCS,26676,PIN HAND DISLOCATION,,,537.75,7034.85,15
HCPCS,26676,PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT,2296.0,1492.4,295.27,2296.0,35
HCPCS,26676,Pin hand dislocation,,,3366.74,4252.73,6
HCPCS,266760,PIN HAND DISLOCATION,,,537.75,537.75,1
HCPCS,26685,OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB,2828.0,1838.2,360.15,2828.0,35
HCPCS,26685,TREAT HAND DISLOCATION,,,606.02,7034.85,15
HCPCS,26685,Treat hand dislocation,,,3366.74,4252.73,6
HCPCS,266850,TREAT HAND DISLOCATION,,,606.02,606.02,1
HCPCS,26686,OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ,3268.0,2124.2,397.52,3268.0,35
HCPCS,26686,TREAT HAND DISLOCATION,,,656.43,7034.85,15
HCPCS,26686,Treat hand dislocation,,,3366.74,4252.73,6
HCPCS,266860,TREAT HAND DISLOCATION,,,656.43,656.43,1
HCPCS,26700,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,1455.5,946.075,154.02,4151.0,133
HCPCS,26700,TREAT KNUCKLE DISLOCATION,,,336.55,336.55,1
HCPCS,267000,TREAT KNUCKLE DISLOCATION,,,336.55,336.55,1
HCPCS,26705,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES,1752.0,1138.8,190.03,1314.0,35
HCPCS,26705,TREAT KNUCKLE DISLOCATION,,,422.47,3469.95,16
HCPCS,26705,Treat knuckle dislocation,,,632.74,799.25,6
HCPCS,267050,TREAT KNUCKLE DISLOCATION,,,422.47,422.47,1
HCPCS,26706,PIN KNUCKLE DISLOCATION,,,472.33,7034.85,15
HCPCS,26706,PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ,2124.0,1380.6,271.08,2124.0,35
HCPCS,26706,Pin knuckle dislocation,,,3366.74,4252.73,6
HCPCS,267060,PIN KNUCKLE DISLOCATION,,,472.33,472.33,1
HCPCS,26715,OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION,2812.0,1827.8,283.61,2812.0,35
HCPCS,26715,TREAT KNUCKLE DISLOCATION,,,603.85,7034.85,15
HCPCS,26715,Treat knuckle dislocation,,,3366.74,4252.73,6
HCPCS,267150,TREAT KNUCKLE DISLOCATION,,,603.85,603.85,1
HCPCS,26720,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,1076.5,699.725,93.04,4151.0,133
HCPCS,26720,TREAT FINGER FRACTURE EACH,,,202.69,202.69,1
HCPCS,267200,TREAT FINGER FRACTURE EACH,,,202.69,202.69,1
HCPCS,26725,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,1455.0,945.75,150.58,4151.0,133
HCPCS,26725,TREAT FINGER FRACTURE EACH,,,326.28,326.28,1
HCPCS,267250,TREAT FINGER FRACTURE EACH,,,326.28,326.28,1
HCPCS,26727,PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T,2168.0,1409.2,253.17,2168.0,35
HCPCS,26727,TREAT FINGER FRACTURE EACH,,,501.09,7034.85,15
HCPCS,26727,Treat finger fracture each,,,3366.74,4252.73,6
HCPCS,267270,TREAT FINGER FRACTURE EACH,,,501.09,501.09,1
HCPCS,26735,OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA,2968.0,1929.2,291.28,2968.0,35
HCPCS,26735,TREAT FINGER FRACTURE EACH,,,626.73,7034.85,15
HCPCS,26735,Treat finger fracture each,,,3366.74,4252.73,6
HCPCS,267350,TREAT FINGER FRACTURE EACH,,,626.73,626.73,1
HCPCS,26740,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,1103.5,717.2750000000001,108.98,4151.0,133
HCPCS,26740,TREAT FINGER FRACTURE EACH,,,235.62,235.62,1
HCPCS,267400,TREAT FINGER FRACTURE EACH,,,235.62,235.62,1
HCPCS,26742,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,5399.5,3509.675,171.57,8282.7,133
HCPCS,26742,TREAT FINGER FRACTURE EACH,,,358.11,358.11,1
HCPCS,267420,TREAT FINGER FRACTURE EACH,,,358.11,358.11,1
HCPCS,26746,OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,11288.0,7337.2,363.12,16790.4,77
HCPCS,26746,TREAT FINGER FRACTURE EACH,,,779.27,779.27,1
HCPCS,267460,TREAT FINGER FRACTURE EACH,,,779.27,779.27,1
HCPCS,26750,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,1049.5,682.175,92.55,4151.0,133
HCPCS,26750,TREAT FINGER FRACTURE EACH,,,203.8,203.8,1
HCPCS,267500,TREAT FINGER FRACTURE EACH,,,203.8,203.8,1
HCPCS,26755,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,1335.5,868.075,135.95,4151.0,179
HCPCS,26755,TREAT FINGER FRACTURE EACH,,,293.81,293.81,1
HCPCS,267550,TREAT FINGER FRACTURE EACH,,,293.81,293.81,1
HCPCS,26756,PIN FINGER FRACTURE EACH,,,447.55,7034.85,15
HCPCS,26756,PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA,1832.0,1190.8,223.15,1832.0,35
HCPCS,26756,Pin finger fracture each,,,3366.74,4252.73,6
HCPCS,267560,PIN FINGER FRACTURE EACH,,,447.55,447.55,1
HCPCS,26765,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,10500.0,6825.0,246.24,16790.4,119
HCPCS,26765,TREAT FINGER FRACTURE EACH,,,530.69,530.69,1
HCPCS,267650,TREAT FINGER FRACTURE EACH,,,530.69,530.69,1
HCPCS,26770,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1319.5,857.675,128.54,4151.0,133
HCPCS,26770,TREAT FINGER DISLOCATION,,,282.99,282.99,1
HCPCS,267700,TREAT FINGER DISLOCATION,,,282.99,282.99,1
HCPCS,26775,CLTX IPHAL JT DISLC W/MANJ REQ ANES,1544.0,1003.6,174.25,4268.0,84
HCPCS,26775,TREAT FINGER DISLOCATION,,,378.93,378.93,1
HCPCS,267750,TREAT FINGER DISLOCATION,,,378.93,378.93,1
HCPCS,26776,PIN FINGER DISLOCATION,,,474.43,7034.85,15
HCPCS,26776,PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ,1996.0,1297.4,238.14,1996.0,35
HCPCS,26776,Pin finger dislocation,,,3366.74,4252.73,6
HCPCS,267760,PIN FINGER DISLOCATION,,,474.43,474.43,1
HCPCS,26785,OPEN TX INTERPHALANGEAL JOINT DISLOCATION,10648.0,6921.2,267.78,16790.4,119
HCPCS,26785,TREAT FINGER DISLOCATION,,,576.54,576.54,1
HCPCS,267850,TREAT FINGER DISLOCATION,,,576.54,576.54,1
HCPCS,26820,THUMB FUSION WITH GRAFT,,,860.93,15488.78,15
HCPCS,26820,Thumb fusion with graft,,,1326.89,1676.08,6
HCPCS,268200,THUMB FUSION WITH GRAFT,,,860.93,860.93,1
HCPCS,26841,ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ,2940.0,1911.0,429.0,2940.0,35
HCPCS,26841,FUSION OF THUMB,,,802.43,15488.78,15
HCPCS,26841,Fusion of thumb,,,1326.89,1676.08,6
HCPCS,268410,FUSION OF THUMB,,,802.43,802.43,1
HCPCS,26842,ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT,3396.0,2207.4,492.58,3396.0,35
HCPCS,26842,THUMB FUSION WITH GRAFT,,,863.4,15488.78,15
HCPCS,26842,Thumb fusion with graft,,,1326.89,1676.08,6
HCPCS,268420,THUMB FUSION WITH GRAFT,,,863.4,863.4,1
HCPCS,26843,ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH,3112.0,2022.8,424.39,3112.0,35
HCPCS,26843,FUSION OF HAND JOINT,,,811.38,15488.78,15
HCPCS,26843,Fusion of hand joint,,,815.24,1029.78,6
HCPCS,268430,FUSION OF HAND JOINT,,,811.38,811.38,1
HCPCS,26844,ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT,3592.0,2334.8,480.97,3592.0,35
HCPCS,26844,FUSION/GRAFT OF HAND JOINT,,,893.24,15488.78,15
HCPCS,26844,Fusion/graft of hand joint,,,1326.89,1676.08,6
HCPCS,268440,FUSION/GRAFT OF HAND JOINT,,,893.24,893.24,1
HCPCS,26850,ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ,2856.0,1856.4,404.34,2856.0,35
HCPCS,26850,FUSION OF KNUCKLE,,,760.37,15488.78,15
HCPCS,26850,Fusion of knuckle,,,1326.89,1676.08,6
HCPCS,268500,FUSION OF KNUCKLE,,,760.37,760.37,1
HCPCS,26852,ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT,3484.0,2264.6,455.26,3484.0,35
HCPCS,26852,FUSION OF KNUCKLE WITH GRAFT,,,865.3,15488.78,15
HCPCS,26852,Fusion of knuckle with graft,,,1326.89,1676.08,6
HCPCS,268520,FUSION OF KNUCKLE WITH GRAFT,,,865.3,865.3,1
HCPCS,26860,ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ,1952.0,1268.8,330.75,1952.0,35
HCPCS,26860,FUSION OF FINGER JOINT,,,631.15,7034.85,15
HCPCS,26860,Fusion of finger joint,,,815.24,1029.78,6
HCPCS,268600,FUSION OF FINGER JOINT,,,631.15,631.15,1
HCPCS,26861,ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT,696.0,452.4,77.87,696.0,35
HCPCS,26861,FUSION OF FINGER JNT ADD-ON,,,106.25,106.25,1
HCPCS,26861,Fusion of finger jnt add-on,,,815.24,1029.78,6
HCPCS,268610,FUSION OF FINGER JNT ADD-ON,,,106.25,106.25,1
HCPCS,26862,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT,3024.0,1965.6,418.04,3024.0,35
HCPCS,26862,FUSION/GRAFT OF FINGER JOINT,,,794.53,7034.85,15
HCPCS,26862,Fusion/graft of finger joint,,,815.24,1029.78,6
HCPCS,268620,FUSION/GRAFT OF FINGER JOINT,,,794.53,794.53,1
HCPCS,26863,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT,1556.0,1011.4,173.37,1556.0,35
HCPCS,26863,FUSE/GRAFT ADDED JOINT,,,237.09,237.09,1
HCPCS,26863,Fuse/graft added joint,,,815.24,1029.78,6
HCPCS,268630,FUSE/GRAFT ADDED JOINT,,,237.09,237.09,1
HCPCS,26910,AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER,3116.0,2025.4,404.21,3116.0,35
HCPCS,26910,AMPUTATE METACARPAL BONE,,,789.77,7034.85,15
HCPCS,26910,Amputate metacarpal bone,,,1326.89,1676.08,6
HCPCS,269100,AMPUTATE METACARPAL BONE,,,789.77,789.77,1
HCPCS,26951,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,10536.0,6848.4,347.99,16790.4,133
HCPCS,26951,AMPUTATION OF FINGER/THUMB,,,725.46,725.46,1
HCPCS,269510,AMPUTATION OF FINGER/THUMB,,,725.46,725.46,1
HCPCS,26952,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,10624.0,6905.599999999999,378.18,16790.4,133
HCPCS,26952,AMPUTATION OF FINGER/THUMB,,,707.35,707.35,1
HCPCS,269520,AMPUTATION OF FINGER/THUMB,,,707.35,707.35,1
HCPCS,26989,"INJECTION/EXTENSION, XIAFLEX",250.0,162.5,125.0,416.29,15
HCPCS,26989,UNLISTED PROCEDURE HANDS OR FINGERS,651.0,423.15,182.93,13665.0,96
HCPCS,26990,DRAINAGE OF PELVIS LESION,,,710.13,7034.85,15
HCPCS,26990,Drainage of pelvis lesion,,,2390.81,3019.97,6
HCPCS,26990,I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA,3180.0,2067.0,336.0,3180.0,35
HCPCS,269900,DRAINAGE OF PELVIS LESION,,,710.13,710.13,1
HCPCS,26991,DRAINAGE OF PELVIS BURSA,,,555.15,3469.95,15
HCPCS,26991,Drainage of pelvis bursa,,,1112.95,1405.84,6
HCPCS,26991,I&D PELVIS/HIP JOINT AREA INFECTED BURSA,2824.0,1835.6,256.43,2118.0,35
HCPCS,269910,DRAINAGE OF PELVIS BURSA,,,555.15,555.15,1
HCPCS,26992,DRAINAGE OF BONE LESION,,,1057.13,3758.57,5
HCPCS,26992,Drainage of bone lesion,,,2390.81,3019.97,6
HCPCS,26992,INCISION BONE CORTEX PELVIS&/HIP JOINT,5392.0,3504.8,591.0,5392.0,35
HCPCS,269920,DRAINAGE OF BONE LESION,,,1057.13,1057.13,1
HCPCS,27000,TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX,2296.0,1492.4,244.82,2296.0,35
HCPCS,27000,TENOTOMY ADDUCTOR HIP PERQ,,,409.71,3469.95,15
HCPCS,27000,Tenotomy adductor hip perq,,,2390.81,3019.97,6
HCPCS,270000,TENOTOMY ADDUCTOR HIP PERQ,,,409.71,409.71,1
HCPCS,27001,TENOTOMY ADDUCTOR HIP OPEN,2856.0,1856.4,295.37,7034.85,50
HCPCS,27001,Tenotomy adductor hip open,,,2390.81,3019.97,6
HCPCS,270010,TENOTOMY ADDUCTOR HIP OPEN,,,568.7,568.7,1
HCPCS,27003,TNOT ADDUCTR SUBQ OPN NEURCT,,,631.72,15488.78,15
HCPCS,27003,Tnot adductr subq opn neurct,,,2390.81,3019.97,6
HCPCS,270030,TNOT ADDUCTR SUBQ OPN NEURCT,,,631.72,631.72,1
HCPCS,27005,TENOTOMY HIP FLEXOR OPEN,,,757.58,3758.57,5
HCPCS,27005,TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE,4028.0,2618.2,401.26,4028.0,35
HCPCS,27005,Tenotomy hip flexor open,,,2390.81,3019.97,6
HCPCS,270050,TENOTOMY HIP FLEXOR OPEN,,,757.58,757.58,1
HCPCS,27006,TENOTOMY ABDUCTOR&/XTNSR HIP,,,749.6,7034.85,15
HCPCS,27006,TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX,4044.0,2628.6,412.62,4044.0,35
HCPCS,27006,Tenotomy abductor&/xtnsr hip,,,2390.81,3019.97,6
HCPCS,270060,TENOTOMY ABDUCTOR&/XTNSR HIP,,,749.6,749.6,1
HCPCS,27025,FASCIOTOMY HIP/THIGH ANY TYP,,,973.73,3758.57,5
HCPCS,27025,FASCIOTOMY HIP/THIGH ANY TYPE,5156.0,3351.4,485.07,5156.0,35
HCPCS,27025,Fasciotomy hip/thigh any typ,,,2390.81,3019.97,6
HCPCS,270250,FASCIOTOMY HIP/THIGH ANY TYP,,,973.73,973.73,1
HCPCS,27027,DCMPRN FASCT PEL COMPARTMENT,,,930.68,15488.78,15
HCPCS,27027,DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI,5216.0,3390.4,624.25,5216.0,35
HCPCS,27027,Dcmprn fasct pel compartment,,,2390.81,3019.97,6
HCPCS,270270,DCMPRN FASCT PEL COMPARTMENT,,,930.68,930.68,1
HCPCS,27030,ARTHROTOMY HIP W/DRAINAGE,5460.0,3549.0,669.23,8335.26,40
HCPCS,27030,Arthrotomy hip w/drainage,,,2390.81,3019.97,6
HCPCS,270300,ARTHROTOMY HIP W/DRAINAGE,,,982.76,982.76,1
HCPCS,27033,ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY,5644.0,3668.6,680.25,5644.0,35
HCPCS,27033,ARTHRT HIP EXPL/RMV LOOSE/FB,,,1019.3,15488.78,15
HCPCS,27033,Arthrt hip expl/rmv loose/fb,,,2390.81,3019.97,6
HCPCS,270330,ARTHRT HIP EXPL/RMV LOOSE/FB,,,1019.3,1019.3,1
HCPCS,27035,DENERVATION OF HIP JOINT,,,1169.59,7034.85,15
HCPCS,27035,Denervation of hip joint,,,2390.81,3019.97,6
HCPCS,270350,DENERVATION OF HIP JOINT,,,1169.59,1169.59,1
HCPCS,27036,CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC,5752.0,3738.8,668.93,5752.0,35
HCPCS,27036,CAPSULECTOMY/CAPSULOTOMY HIP,,,1068.29,8335.26,5
HCPCS,27036,Capsulectomy/capsulotomy hip,,,2390.81,3019.97,6
HCPCS,270360,CAPSULECTOMY/CAPSULOTOMY HIP,,,1068.29,1068.29,1
HCPCS,27040,BIOPSY OF SOFT TISSUES,,,207.54,207.54,1
HCPCS,27040,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,5242.0,3407.2999999999997,96.0,8384.4,130
HCPCS,270400,BIOPSY OF SOFT TISSUES,,,207.54,207.54,1
HCPCS,27041,BIOPSY OF SOFT TISSUES,,,744.22,744.22,1
HCPCS,27041,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,6694.0,4351.1,370.69,8384.4,130
HCPCS,270410,BIOPSY OF SOFT TISSUES,,,744.22,744.22,1
HCPCS,27043,EXC HIP PELVIS LES SC 3 CM/>,,,495.3,6205.4,15
HCPCS,27043,EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3+CM,2752.0,1788.8,257.95,2752.0,35
HCPCS,27043,Exc hip pelvis les sc 3 cm/>,,,1112.95,1405.84,6
HCPCS,270430,EXC HIP PELVIS LES SC 3 CM/>,,,495.3,495.3,1
HCPCS,27045,EXC HIP/PELV TUM DEEP 5 CM/>,,,771.81,6205.4,15
HCPCS,27045,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5+CM,4452.0,2893.8,410.61,4452.0,35
HCPCS,27045,Exc hip/pelv tum deep 5 cm/>,,,1112.95,1405.84,6
HCPCS,270450,EXC HIP/PELV TUM DEEP 5 CM/>,,,771.81,771.81,1
HCPCS,27047,EXC HIP/PELVIS LES SC < 3 CM,,,381.3,6205.4,16
HCPCS,27047,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM,2174.0,1413.1,203.72,1630.5,35
HCPCS,27047,Exc hip/pelvis les sc < 3 cm,,,1112.95,1405.84,6
HCPCS,270470,EXC HIP/PELVIS LES SC < 3 CM,,,381.3,381.3,1
HCPCS,27048,EXC HIP/PELV TUM DEEP < 5 CM,,,645.27,6205.4,15
HCPCS,27048,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM,3540.0,2301.0,301.36,3540.0,35
HCPCS,27048,Exc hip/pelv tum deep < 5 cm,,,1112.95,1405.84,6
HCPCS,270480,EXC HIP/PELV TUM DEEP < 5 CM,,,645.27,645.27,1
HCPCS,27049,RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM,8620.0,5603.0,626.85,8620.0,35
HCPCS,27049,RESECT HIP/PELV TUM < 5 CM,,,1492.79,6205.4,15
HCPCS,27049,Resect hip/pelv tum < 5 cm,,,2390.81,3019.97,6
HCPCS,270490,RESECT HIP/PELV TUM < 5 CM,,,1492.79,1492.79,1
HCPCS,27050,BIOPSY OF SACROILIAC JOINT,,,428.2,3469.95,15
HCPCS,27050,Biopsy of sacroiliac joint,,,2390.81,3019.97,6
HCPCS,270500,BIOPSY OF SACROILIAC JOINT,,,428.2,428.2,1
HCPCS,27052,BIOPSY OF HIP JOINT,,,610.47,3469.95,15
HCPCS,27052,Biopsy of hip joint,,,2390.81,3019.97,6
HCPCS,270520,BIOPSY OF HIP JOINT,,,610.47,610.47,1
HCPCS,27054,ARTHROTOMY W/SYNOVECTOMY HIP JOINT,3684.0,2394.6,510.5,3684.0,35
HCPCS,27054,REMOVAL OF HIP JOINT LINING,,,724.17,3758.57,5
HCPCS,27054,Removal of hip joint lining,,,2390.81,3019.97,6
HCPCS,270540,REMOVAL OF HIP JOINT LINING,,,724.17,724.17,1
HCPCS,27057,BUTTOCK FASCIOTOMY W/DBRDMT,,,1057.45,3469.95,15
HCPCS,27057,Buttock fasciotomy w/dbrdmt,,,2390.81,3019.97,6
HCPCS,270570,BUTTOCK FASCIOTOMY W/DBRDMT,,,1057.45,1057.45,1
HCPCS,27059,RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5+CM,11740.0,7631.0,1010.51,11740.0,35
HCPCS,27059,RESECT HIP/PELV TUM 5 CM/>,,,1902.14,6205.4,15
HCPCS,27059,Resect hip/pelv tum 5 cm/>,,,2390.81,3019.97,6
HCPCS,270590,RESECT HIP/PELV TUM 5 CM/>,,,1902.14,1902.14,1
HCPCS,27060,EXCISION ISCHIAL BURSA,2348.0,1526.2,254.7,2348.0,35
HCPCS,27060,REMOVAL OF ISCHIAL BURSA,,,492.15,15488.78,15
HCPCS,27060,Removal of ischial bursa,,,2390.81,3019.97,6
HCPCS,270600,REMOVAL OF ISCHIAL BURSA,,,492.15,492.15,1
HCPCS,27062,EXCISION TROCHANTERIC BURSA/CALCIFICATION,2300.0,1495.0,274.32,2300.0,35
HCPCS,27062,REMOVE FEMUR LESION/BURSA,,,478.72,7034.85,15
HCPCS,27062,Remove femur lesion/bursa,,,2390.81,3019.97,6
HCPCS,270620,REMOVE FEMUR LESION/BURSA,,,478.72,478.72,1
HCPCS,27065,REMOVE HIP BONE LES SUPER,,,550.39,15488.78,15
HCPCS,27065,Remove hip bone les super,,,2390.81,3019.97,6
HCPCS,270650,REMOVE HIP BONE LES SUPER,,,550.39,550.39,1
HCPCS,27066,EXCISION BONE CYST/BENIGN TUMOR DEEP,4480.0,2912.0,515.24,4480.0,35
HCPCS,27066,REMOVE HIP BONE LES DEEP,,,856.66,7034.85,15
HCPCS,27066,Remove hip bone les deep,,,2390.81,3019.97,6
HCPCS,270660,REMOVE HIP BONE LES DEEP,,,856.66,856.66,1
HCPCS,27067,REMOVE/GRAFT HIP BONE LESION,,,1086.8,15488.78,15
HCPCS,27067,Remove/graft hip bone lesion,,,2390.81,3019.97,6
HCPCS,270670,REMOVE/GRAFT HIP BONE LESION,,,1086.8,1086.8,1
HCPCS,27070,PART REMOVE HIP BONE SUPER,,,923.68,3758.57,5
HCPCS,27070,PARTIAL EXCISION SUPERFICIAL PELVIS,4624.0,3005.6,535.64,4624.0,35
HCPCS,27070,Part remove hip bone super,,,2390.81,3019.97,6
HCPCS,270700,PART REMOVE HIP BONE SUPER,,,923.68,923.68,1
HCPCS,27071,PART REMOVAL HIP BONE DEEP,,,1014.4,3758.57,5
HCPCS,27071,PARTIAL EXCISION DEEP PELVIS,5452.0,3543.8,593.66,5452.0,35
HCPCS,27071,Part removal hip bone deep,,,2390.81,3019.97,6
HCPCS,270710,PART REMOVAL HIP BONE DEEP,,,1014.4,1014.4,1
HCPCS,27075,RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL,13084.0,8504.6,1267.16,13084.0,35
HCPCS,27075,RESECT HIP TUMOR,,,2177.31,8335.26,5
HCPCS,27075,Resect hip tumor,,,2390.81,3019.97,6
HCPCS,270750,RESECT HIP TUMOR,,,2177.31,2177.31,1
HCPCS,27076,RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC,16084.0,10454.6,1223.15,16084.0,35
HCPCS,27076,RESECT HIP TUM INCL ACETABUL,,,2631.25,8335.26,5
HCPCS,27076,Resect hip tum incl acetabul,,,2390.81,3019.97,6
HCPCS,270760,RESECT HIP TUM INCL ACETABUL,,,2631.25,2631.25,1
HCPCS,27077,RESECT HIP TUM W/INNOM BONE,,,2934.86,8335.26,5
HCPCS,27077,Resect hip tum w/innom bone,,,6850.38,8653.12,6
HCPCS,270770,RESECT HIP TUM W/INNOM BONE,,,2934.86,2934.86,1
HCPCS,27078,RSECT HIP TUM INCL FEMUR,,,2147.1,8335.26,5
HCPCS,27078,Rsect hip tum incl femur,,,2390.81,3019.97,6
HCPCS,270780,RSECT HIP TUM INCL FEMUR,,,2147.1,2147.1,1
HCPCS,27080,COCCYGECTOMY PRIMARY,2756.0,1791.4,313.88,2756.0,35
HCPCS,27080,REMOVAL OF TAIL BONE,,,536.35,7034.85,15
HCPCS,27080,Removal of tail bone,,,2390.81,3019.97,6
HCPCS,270800,REMOVAL OF TAIL BONE,,,536.35,536.35,1
HCPCS,27086,REMOVE HIP FOREIGN BODY,,,176.57,176.57,1
HCPCS,27086,RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS,8612.0,5597.8,88.83,14810.4,133
HCPCS,270860,REMOVE HIP FOREIGN BODY,,,176.57,176.57,1
HCPCS,27087,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,11094.0,7211.1,351.19,16790.4,133
HCPCS,27087,REMOVE HIP FOREIGN BODY,,,648.98,648.98,1
HCPCS,270870,REMOVE HIP FOREIGN BODY,,,648.98,648.98,1
HCPCS,27090,REMOVAL OF HIP PROSTHESIS,4676.0,3039.4,560.55,8335.26,40
HCPCS,27090,Removal of hip prosthesis,,,2390.81,3019.97,6
HCPCS,270900,REMOVAL OF HIP PROSTHESIS,,,870.83,870.83,1
HCPCS,27091,REMOVAL OF HIP PROSTHESIS,,,1666.69,14747.88,5
HCPCS,27091,RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA,9740.0,6331.0,1123.43,9740.0,35
HCPCS,27091,Removal of hip prosthesis,,,2390.81,3019.97,6
HCPCS,270910,REMOVAL OF HIP PROSTHESIS,,,1666.69,1666.69,1
HCPCS,27093,INJECTION FOR HIP X-RAY,,,70.64,70.64,1
HCPCS,27093,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,715.0,464.75,48.66,3920.0,146
HCPCS,270930,INJECTION FOR HIP X-RAY,,,70.64,70.64,1
HCPCS,27095,INJECTION FOR HIP X-RAY,,,85.35,85.35,1
HCPCS,27095,INJECTION HIP ARTHROGRAPHY W/ANESTHESIA,845.5,549.575,54.58,3920.0,73
HCPCS,270950,INJECTION FOR HIP X-RAY,,,85.35,85.35,1
HCPCS,27096,INJECT SACROILIAC JOINT,,,86.25,86.25,1
HCPCS,27096,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,1530.5,994.825,59.25,18285.0,149
HCPCS,270960,INJECT SACROILIAC JOINT,,,86.25,86.25,1
HCPCS,27097,REVISION OF HIP TENDON,,,719.22,7034.85,15
HCPCS,27097,Revision of hip tendon,,,2390.81,3019.97,6
HCPCS,270970,REVISION OF HIP TENDON,,,719.22,719.22,1
HCPCS,27098,ADDUCTOR TRANSFER TO ISCHIUM,4101.0,2665.65,458.19,4101.0,35
HCPCS,27098,TRANSFER TENDON TO PELVIS,,,731.86,7034.85,15
HCPCS,27098,Transfer tendon to pelvis,,,2390.81,3019.97,6
HCPCS,270980,TRANSFER TENDON TO PELVIS,,,731.86,731.86,1
HCPCS,27100,TR XTRNL OBLQ MUSC TRCHNTR W/FSCAL/TDN XTN GRF,4540.0,2951.0,533.69,4540.0,35
HCPCS,27100,TRANSFER OF ABDOMINAL MUSCLE,,,872.51,15488.78,15
HCPCS,27100,Transfer of abdominal muscle,,,2390.81,3019.97,6
HCPCS,271000,TRANSFER OF ABDOMINAL MUSCLE,,,872.51,872.51,1
HCPCS,27105,TR PARASPI MUSC HIP FASC/TDN XTN GRF,5298.0,3443.7,512.05,5298.0,35
HCPCS,27105,TRANSFER OF SPINAL MUSCLE,,,914.68,7034.85,15
HCPCS,27105,Transfer of spinal muscle,,,2390.81,3019.97,6
HCPCS,271050,TRANSFER OF SPINAL MUSCLE,,,914.68,914.68,1
HCPCS,27110,TRANSFER OF ILIOPSOAS MUSCLE,,,1019.02,15488.78,15
HCPCS,27110,Transfer of iliopsoas muscle,,,2390.81,3019.97,6
HCPCS,271100,TRANSFER OF ILIOPSOAS MUSCLE,,,1019.02,1019.02,1
HCPCS,27111,TRANSFER OF ILIOPSOAS MUSCLE,,,948.77,7034.85,15
HCPCS,27111,Transfer of iliopsoas muscle,,,2390.81,3019.97,6
HCPCS,271110,TRANSFER OF ILIOPSOAS MUSCLE,,,948.77,948.77,1
HCPCS,27120,ACETABULOPLASTY,7700.0,5005.0,967.46,7700.0,35
HCPCS,27120,RECONSTRUCTION OF HIP SOCKET,,,1360.55,14747.88,5
HCPCS,27120,Reconstruction of hip socket,,,2390.81,3019.97,6
HCPCS,271200,RECONSTRUCTION OF HIP SOCKET,,,1360.55,1360.55,1
HCPCS,27122,ACETABULOPLASTY RESECTION FEMORAL HEAD,6436.0,4183.4,813.38,6436.0,35
HCPCS,27122,RECONSTRUCTION OF HIP SOCKET,,,1156.97,8335.26,5
HCPCS,27122,Reconstruction of hip socket,,,2390.81,3019.97,6
HCPCS,271220,RECONSTRUCTION OF HIP SOCKET,,,1156.97,1156.97,1
HCPCS,27125,HEMIARTHROPLASTY HIP PARTIAL,6656.0,4326.4,839.02,6656.0,35
HCPCS,27125,PARTIAL HIP REPLACEMENT,,,1185.98,14747.88,5
HCPCS,27125,Partial hip replacement,,,2190.3,2766.7,6
HCPCS,271250,PARTIAL HIP REPLACEMENT,,,1185.98,1185.98,1
HCPCS,27130,ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT,8624.0,5605.6,993.98,8624.0,35
HCPCS,27130,TOTAL HIP ARTHROPLASTY,,,1345.55,27897.39,19
HCPCS,27130,Total hip arthroplasty,,,5660.06,7149.55,6
HCPCS,271300,TOTAL HIP ARTHROPLASTY,,,1345.55,1345.55,1
HCPCS,27132,CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT,11304.0,7347.6,1261.35,11304.0,35
HCPCS,27132,TOTAL HIP ARTHROPLASTY,,,1748.14,14747.88,5
HCPCS,27132,Total hip arthroplasty,,,5660.06,7149.55,6
HCPCS,271320,TOTAL HIP ARTHROPLASTY,,,1748.14,1748.14,1
HCPCS,27134,REVISE HIP JOINT REPLACEMENT,,,1992.36,14747.88,5
HCPCS,27134,REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT,13323.0,8659.95,1467.09,13323.0,35
HCPCS,27134,Revise hip joint replacement,,,5660.06,7149.55,6
HCPCS,271340,REVISE HIP JOINT REPLACEMENT,,,1992.36,1992.36,1
HCPCS,27137,REVISE HIP JOINT REPLACEMENT,,,1533.83,14747.88,5
HCPCS,27137,REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT,9988.0,6492.2,1132.11,9988.0,35
HCPCS,27137,Revise hip joint replacement,,,5660.06,7149.55,6
HCPCS,271370,REVISE HIP JOINT REPLACEMENT,,,1533.83,1533.83,1
HCPCS,27138,REVISE HIP JOINT REPLACEMENT,,,1593.25,14747.88,5
HCPCS,27138,REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT,10428.0,6778.2,1175.77,10428.0,35
HCPCS,27138,Revise hip joint replacement,,,5660.06,7149.55,6
HCPCS,271380,REVISE HIP JOINT REPLACEMENT,,,1593.25,1593.25,1
HCPCS,27140,OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX,5112.0,3322.8,635.83,5112.0,35
HCPCS,27140,TRANSPLANT FEMUR RIDGE,,,941.99,8335.26,5
HCPCS,27140,Transplant femur ridge,,,2390.81,3019.97,6
HCPCS,271400,TRANSPLANT FEMUR RIDGE,,,941.99,941.99,1
HCPCS,27146,INCISION OF HIP BONE,,,1340.19,8335.26,5
HCPCS,27146,Incision of hip bone,,,2390.81,3019.97,6
HCPCS,27146,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE,7568.0,4919.2,762.57,7568.0,35
HCPCS,271460,INCISION OF HIP BONE,,,1340.19,1340.19,1
HCPCS,27147,REVISION OF HIP BONE,,,1531.66,8335.26,5
HCPCS,27147,Revision of hip bone,,,2390.81,3019.97,6
HCPCS,271470,REVISION OF HIP BONE,,,1531.66,1531.66,1
HCPCS,27151,INCISION OF HIP BONES,,,1654.97,8335.26,5
HCPCS,27151,Incision of hip bones,,,2390.81,3019.97,6
HCPCS,27151,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT,9648.0,6271.2,1095.52,9648.0,35
HCPCS,271510,INCISION OF HIP BONES,,,1654.97,1654.97,1
HCPCS,27156,REVISION OF HIP BONES,,,1783.23,8335.26,5
HCPCS,27156,Revision of hip bones,,,2390.81,3019.97,6
HCPCS,271560,REVISION OF HIP BONES,,,1783.23,1783.23,1
HCPCS,27158,OSTEOTOMY PELVIS BILAT,9258.0,6017.7,948.05,9258.0,35
HCPCS,27158,REVISION OF PELVIS,,,1465.17,8335.26,5
HCPCS,27158,Revision of pelvis,,,2390.81,3019.97,6
HCPCS,271580,REVISION OF PELVIS,,,1465.17,1465.17,1
HCPCS,27161,INCISION OF NECK OF FEMUR,,,1278.7,8335.26,5
HCPCS,27161,Incision of neck of femur,,,2390.81,3019.97,6
HCPCS,27161,OSTEOTOMY FEMORAL NECK SEPARATE PROCEDURE,7156.0,4651.4,846.88,7156.0,35
HCPCS,271610,INCISION OF NECK OF FEMUR,,,1278.7,1278.7,1
HCPCS,27165,INCISION/FIXATION OF FEMUR,,,1436.3,8335.26,5
HCPCS,27165,Incision/fixation of femur,,,2390.81,3019.97,6
HCPCS,27165,OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL,8116.0,5275.4,933.46,8116.0,35
HCPCS,271650,INCISION/FIXATION OF FEMUR,,,1436.3,1436.3,1
HCPCS,27170,B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA,7044.0,4578.6,875.0,7044.0,35
HCPCS,27170,REPAIR/GRAFT FEMUR HEAD/NECK,,,1226.21,8335.26,5
HCPCS,27170,Repair/graft femur head/neck,,,2390.81,3019.97,6
HCPCS,271700,REPAIR/GRAFT FEMUR HEAD/NECK,,,1226.21,1226.21,1
HCPCS,27175,TREAT SLIPPED EPIPHYSIS,,,701.69,3758.57,5
HCPCS,27175,Treat slipped epiphysis,,,3366.74,4252.73,6
HCPCS,271750,TREAT SLIPPED EPIPHYSIS,,,701.69,701.69,1
HCPCS,27176,TREAT SLIPPED EPIPHYSIS,,,968.11,3758.57,5
HCPCS,27176,Treat slipped epiphysis,,,2390.81,3019.97,6
HCPCS,271760,TREAT SLIPPED EPIPHYSIS,,,968.11,968.11,1
HCPCS,27177,TREAT SLIPPED EPIPHYSIS,,,1170.12,3758.57,5
HCPCS,27177,Treat slipped epiphysis,,,2390.81,3019.97,6
HCPCS,271770,TREAT SLIPPED EPIPHYSIS,,,1170.12,1170.12,1
HCPCS,27178,TREAT SLIPPED EPIPHYSIS,,,968.11,3758.57,5
HCPCS,27178,Treat slipped epiphysis,,,3366.74,4252.73,6
HCPCS,271780,TREAT SLIPPED EPIPHYSIS,,,968.11,968.11,1
HCPCS,27179,REVISE HEAD/NECK OF FEMUR,,,1026.71,15488.78,15
HCPCS,27179,Revise head/neck of femur,,,2390.81,3019.97,6
HCPCS,271790,REVISE HEAD/NECK OF FEMUR,,,1026.71,1026.71,1
HCPCS,27181,TREAT SLIPPED EPIPHYSIS,,,1175.08,8335.26,5
HCPCS,27181,Treat slipped epiphysis,,,3366.74,4252.73,6
HCPCS,271810,TREAT SLIPPED EPIPHYSIS,,,1175.08,1175.08,1
HCPCS,27185,REVISION OF FEMUR EPIPHYSIS,,,756.44,3758.57,5
HCPCS,27185,Revision of femur epiphysis,,,2390.81,3019.97,6
HCPCS,271850,REVISION OF FEMUR EPIPHYSIS,,,756.44,756.44,1
HCPCS,27187,PROPH TX N/P/PLTWR W/WO MMA FEM NCK & PROX FEMUR,5692.0,3699.8,738.6,5692.0,35
HCPCS,27187,REINFORCE HIP BONES,,,1045.03,8335.26,5
HCPCS,27187,Reinforce hip bones,,,2390.81,3019.97,6
HCPCS,271870,REINFORCE HIP BONES,,,1045.03,1045.03,1
HCPCS,27197,CLSD TX PELVIC RING FX,,,138.56,138.56,1
HCPCS,27197,CLSD TX PELVIC RING FX W/O MANIPULATION,1026.0,666.9,92.15,4214.0,80
HCPCS,271970,CLSD TX PELVIC RING FX,,,138.56,138.56,1
HCPCS,27198,CLSD TX PELVIC RING FX,,,330.19,330.19,1
HCPCS,27198,CLSD TX PELVIC RING FX W/MANIPULATION W/ANES,1734.5,1127.425,237.4,4214.0,80
HCPCS,271980,CLSD TX PELVIC RING FX,,,330.19,330.19,1
HCPCS,27200,CLOSED TREATMENT COCCYGEAL FRACTURE,1073.5,697.775,93.04,4151.0,127
HCPCS,27200,TREAT TAIL BONE FRACTURE,,,203.66,203.66,1
HCPCS,272000,TREAT TAIL BONE FRACTURE,,,203.66,203.66,1
HCPCS,27202,TREAT TAIL BONE FRACTURE,,,556.36,7034.85,15
HCPCS,27202,Treat tail bone fracture,,,3366.74,4252.73,6
HCPCS,272020,TREAT TAIL BONE FRACTURE,,,556.36,556.36,1
HCPCS,27215,TREAT PELVIC FRACTURE(S),,,633.3,633.3,1
HCPCS,27215,Treat pelvic fracture(s),,,3366.74,4252.73,6
HCPCS,272150,TREAT PELVIC FRACTURE(S),,,633.3,633.3,1
HCPCS,27216,TREAT PELVIC RING FRACTURE,,,936.42,936.42,1
HCPCS,27216,Treat pelvic ring fracture,,,3366.74,4252.73,6
HCPCS,272160,TREAT PELVIC RING FRACTURE,,,936.42,936.42,1
HCPCS,27217,OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR,6446.0,4189.9,645.72,6446.0,24
HCPCS,27217,TREAT PELVIC RING FRACTURE,,,880.12,880.12,1
HCPCS,27217,Treat pelvic ring fracture,,,3366.74,4252.73,6
HCPCS,272170,TREAT PELVIC RING FRACTURE,,,880.12,880.12,1
HCPCS,27218,OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD,8372.0,5441.8,885.72,8372.0,24
HCPCS,27218,TREAT PELVIC RING FRACTURE,,,1209.25,1209.25,1
HCPCS,27218,Treat pelvic ring fracture,,,3366.74,4252.73,6
HCPCS,272180,TREAT PELVIC RING FRACTURE,,,1209.25,1209.25,1
HCPCS,27220,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,1899.5,1234.675,240.79,4151.0,84
HCPCS,27220,TREAT HIP SOCKET FRACTURE,,,436.24,436.24,1
HCPCS,272200,TREAT HIP SOCKET FRACTURE,,,436.24,436.24,1
HCPCS,27222,CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ,5644.0,3668.6,536.37,5644.0,35
HCPCS,27222,TREAT HIP SOCKET FRACTURE,,,257.59,1028.47,5
HCPCS,27222,Treat hip socket fracture,,,310.03,391.62,6
HCPCS,272220,TREAT HIP SOCKET FRACTURE,,,1028.47,1028.47,1
HCPCS,27226,OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ,6228.0,4048.2,795.16,6228.0,35
HCPCS,27226,TREAT HIP WALL FRACTURE,,,1109.96,8335.26,5
HCPCS,27226,Treat hip wall fracture,,,3366.74,4252.73,6
HCPCS,272260,TREAT HIP WALL FRACTURE,,,1109.96,1109.96,1
HCPCS,27227,OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT,10164.0,6606.6,1121.7,10164.0,35
HCPCS,27227,TREAT HIP FRACTURE(S),,,1727.99,8335.26,5
HCPCS,27227,Treat hip fracture(s),,,3366.74,4252.73,6
HCPCS,272270,TREAT HIP FRACTURE(S),,,1727.99,1727.99,1
HCPCS,27228,OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT,11732.0,7625.8,1203.96,11732.0,35
HCPCS,27228,TREAT HIP FRACTURE(S),,,1964.63,8335.26,5
HCPCS,27228,Treat hip fracture(s),,,3366.74,4252.73,6
HCPCS,272280,TREAT HIP FRACTURE(S),,,1964.63,1964.63,1
HCPCS,27230,CLTX FEM FX PROX END NCK W/O MANJ,1851.5,1203.475,240.79,4151.0,84
HCPCS,27230,TREAT THIGH FRACTURE,,,506.31,506.31,1
HCPCS,272300,TREAT THIGH FRACTURE,,,506.31,506.31,1
HCPCS,27232,CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ,5389.5,3503.175,310.03,18285.0,119
HCPCS,27232,TREAT THIGH FRACTURE,,,767.19,767.19,1
HCPCS,272320,TREAT THIGH FRACTURE,,,767.19,767.19,1
HCPCS,27235,PRQ SKEL FIXJ FEMORAL FX PROX END NECK,5200.0,3380.0,668.57,5200.0,35
HCPCS,27235,TREAT THIGH FRACTURE,,,951.53,15488.78,15
HCPCS,27235,Treat thigh fracture,,,3366.74,4252.73,6
HCPCS,272350,TREAT THIGH FRACTURE,,,951.53,951.53,1
HCPCS,27236,OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT,7044.0,4578.6,874.43,7044.0,35
HCPCS,27236,TREAT THIGH FRACTURE,,,1250.83,8335.26,5
HCPCS,27236,Treat thigh fracture,,,3366.74,4252.73,6
HCPCS,272360,TREAT THIGH FRACTURE,,,1250.83,1250.83,1
HCPCS,27238,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,5751.5,3738.475,287.85,8282.7,84
HCPCS,27238,TREAT THIGH FRACTURE,,,494.9,494.9,1
HCPCS,272380,TREAT THIGH FRACTURE,,,494.9,494.9,1
HCPCS,27240,CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ,3899.5,2534.675,310.03,18285.0,77
HCPCS,27240,TREAT THIGH FRACTURE,,,1000.39,1000.39,1
HCPCS,272400,TREAT THIGH FRACTURE,,,1000.39,1000.39,1
HCPCS,27244,TREAT THIGH FRACTURE,,,1286.27,8335.26,5
HCPCS,27244,TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT,7272.0,4726.8,869.94,7272.0,35
HCPCS,27244,Treat thigh fracture,,,2390.81,3019.97,6
HCPCS,272440,TREAT THIGH FRACTURE,,,1286.27,1286.27,1
HCPCS,27245,TREAT THIGH FRACTURE,,,1284.54,8335.26,5
HCPCS,27245,TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW,7272.0,4726.8,949.87,7272.0,35
HCPCS,27245,Treat thigh fracture,,,2390.81,3019.97,6
HCPCS,272450,TREAT THIGH FRACTURE,,,1284.54,1284.54,1
HCPCS,27246,CLTX GREATER TROCHANTERIC FX W/O MANJ,1655.5,1076.075,240.79,4268.0,84
HCPCS,27246,TREAT THIGH FRACTURE,,,410.18,410.18,1
HCPCS,272460,TREAT THIGH FRACTURE,,,410.18,410.18,1
HCPCS,27248,OPEN TREATMENT GREATER TROCHANTERIC FRACTURE,4312.0,2802.8,575.04,4312.0,35
HCPCS,27248,TREAT THIGH FRACTURE,,,782.4,8335.26,5
HCPCS,27248,Treat thigh fracture,,,3366.74,4252.73,6
HCPCS,272480,TREAT THIGH FRACTURE,,,782.4,782.4,1
HCPCS,27250,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,1530.0,994.5,137.62,4151.0,133
HCPCS,27250,TREAT HIP DISLOCATION,,,191.56,191.56,1
HCPCS,272500,TREAT HIP DISLOCATION,,,191.56,191.56,1
HCPCS,27252,CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA,7028.0,4568.2,413.27,8370.0,133
HCPCS,27252,TREAT HIP DISLOCATION,,,788.65,788.65,1
HCPCS,272520,TREAT HIP DISLOCATION,,,788.65,788.65,1
HCPCS,27253,OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ,5432.0,3530.8,699.36,5432.0,35
HCPCS,27253,TREAT HIP DISLOCATION,,,985.81,3758.57,5
HCPCS,27253,Treat hip dislocation,,,3366.74,4252.73,6
HCPCS,272530,TREAT HIP DISLOCATION,,,985.81,985.81,1
HCPCS,27254,TREAT HIP DISLOCATION,,,1332.44,8335.26,5
HCPCS,27254,Treat hip dislocation,,,2390.81,3019.97,6
HCPCS,272540,TREAT HIP DISLOCATION,,,1332.44,1332.44,1
HCPCS,27256,TREAT HIP DISLOCATION,,,255.83,255.83,1
HCPCS,27256,TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES,1379.0,896.35,240.79,4151.0,98
HCPCS,272560,TREAT HIP DISLOCATION,,,255.83,255.83,1
HCPCS,27257,TREAT HIP DISLOCATION,,,379.81,379.81,1
HCPCS,27257,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES,9203.0,5981.95,420.39,8370.0,98
HCPCS,272570,TREAT HIP DISLOCATION,,,379.81,379.81,1
HCPCS,27258,TREAT HIP DISLOCATION,,,1165.91,3758.57,5
HCPCS,27258,Treat hip dislocation,,,2390.81,3019.97,6
HCPCS,272580,TREAT HIP DISLOCATION,,,1165.91,1165.91,1
HCPCS,27259,TREAT HIP DISLOCATION,,,1615.4,3758.57,5
HCPCS,27259,Treat hip dislocation,,,2390.81,3019.97,6
HCPCS,272590,TREAT HIP DISLOCATION,,,1615.4,1615.4,1
HCPCS,27265,CLTX POST HIP ARTHRP DISLC W/O ANES,1737.5,1129.375,240.07,4151.0,176
HCPCS,27265,TREAT HIP DISLOCATION,,,444.12,444.12,1
HCPCS,272650,TREAT HIP DISLOCATION,,,444.12,444.12,1
HCPCS,27266,CLTX POST HIP ARTHRP DISLC REQ ANES,8271.0,5376.15,336.27,8370.0,231
HCPCS,27266,TREAT HIP DISLOCATION,,,614.51,614.51,1
HCPCS,272660,TREAT HIP DISLOCATION,,,614.51,614.51,1
HCPCS,27267,CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ,18656.0,12126.4,310.03,16790.4,49
HCPCS,27267,CLTX THIGH FX,,,467.96,467.96,1
HCPCS,272670,CLTX THIGH FX,,,467.96,467.96,1
HCPCS,27268,CLTX THIGH FX W/MNPJ,,,574.91,1847.11,5
HCPCS,27268,Cltx thigh fx w/mnpj,,,310.03,391.62,6
HCPCS,272680,CLTX THIGH FX W/MNPJ,,,574.91,574.91,1
HCPCS,27269,OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD,7556.0,4911.4,733.57,7556.0,35
HCPCS,27269,OPTX THIGH FX,,,1299.11,8335.26,5
HCPCS,27269,Optx thigh fx,,,3366.74,4252.73,6
HCPCS,272690,OPTX THIGH FX,,,1299.11,1299.11,1
HCPCS,27275,MANIPULATION HIP JOINT W ANESTHESIA,928.0,603.2,120.01,928.0,35
HCPCS,27275,MANIPULATION OF HIP JOINT,,,193.08,3469.95,15
HCPCS,27275,Manipulation of hip joint,,,632.74,799.25,6
HCPCS,272750,MANIPULATION OF HIP JOINT,,,193.08,193.08,1
HCPCS,27278,ARTHRD SI JT PLMT IARTIC DEV,,,488.15,39872.66,15
HCPCS,27278,ARTHRD SI JT PRQ W/PLMT IARTIC IMPLT WO TFXJ DEV,3458.0,2247.7,337.91,23061.26,28
HCPCS,27278,Arthrd si jt plmt iartic dev,,,9774.46,12346.69,6
HCPCS,272780,ARTHRD SI JT PLMT IARTIC DEV,,,488.15,488.15,1
HCPCS,27279,ARTHRD SI JT PLMT TARTCLR DV,,,840.73,39872.66,15
HCPCS,27279,ARTHRODESIS SI JOINT PERCUTANEOUS/MIN INVASIVE,4852.0,3153.8,443.93,4852.0,31
HCPCS,27279,Arthrd si jt plmt tartclr dv,,,6850.38,8653.12,6
HCPCS,272790,ARTHRD SI JT PLMT TARTCLR DV,,,840.73,840.73,1
HCPCS,27280,ARTHR SI JT OPN B1GRF INSTRM,,,1437.59,20141.22,5
HCPCS,27280,ARTHRODESIS SI JT OPN W/OBTAINING B1 GRF INSTRMJ,8000.0,5200.0,664.59,8000.0,35
HCPCS,27280,Arthr si jt opn b1grf instrm,,,6850.38,8653.12,6
HCPCS,272800,ARTHR SI JT OPN B1GRF INSTRM,,,1437.59,1437.59,1
HCPCS,27282,ARTHRODESIS SYMPHYSIS PUBIS,,,903.09,3758.57,5
HCPCS,27282,Arthrodesis symphysis pubis,,,6850.38,8653.12,6
HCPCS,272820,ARTHRODESIS SYMPHYSIS PUBIS,,,903.09,903.09,1
HCPCS,27284,ARTHRODESIS HIP JOINT,,,1678.59,14747.88,5
HCPCS,27284,Arthrodesis hip joint,,,6850.38,8653.12,6
HCPCS,272840,ARTHRODESIS HIP JOINT,,,1678.59,1678.59,1
HCPCS,27286,ARTHRD HIP JT SBTRCHC OSTEOT,,,1718.94,14747.88,5
HCPCS,27286,Arthrd hip jt sbtrchc osteot,,,6850.38,8653.12,6
HCPCS,272860,ARTHRD HIP JT SBTRCHC OSTEOT,,,1718.94,1718.94,1
HCPCS,27290,AMPUTATION OF LEG AT HIP,,,1699.68,20141.22,5
HCPCS,27290,Amputation of leg at hip,,,6850.38,8653.12,6
HCPCS,272900,AMPUTATION OF LEG AT HIP,,,1699.68,1699.68,1
HCPCS,27295,AMPUTATION OF LEG AT HIP,,,1323.54,20141.22,5
HCPCS,27295,Amputation of leg at hip,,,6850.38,8653.12,6
HCPCS,27295,DISARTICULATION OF HIP,7864.0,5111.6,949.47,7864.0,35
HCPCS,272950,AMPUTATION OF LEG AT HIP,,,1323.54,1323.54,1
HCPCS,27299,ABDUCTOR ANCHOR RECONSTRUCTION (COMP CODE 27100),4880.0,3172.0,509.75,4880.0,15
HCPCS,27299,CT GUIDED ACETABULOPLASTY (COMP CODE 22511),9647.5,6270.875,240.79,14990.4,63
HCPCS,27299,GLUTEUS MEDIUS/MINIMUS REPAIR (COMP CODE 27385),2458.0,1597.7,509.75,2458.0,15
HCPCS,27299,OPEN PX TO RPR ABDUCTOR MUSCULATURE TO TUMOR PROSTHESIS (COMP CO,4101.0,2665.65,509.75,4101.0,15
HCPCS,27299,POSTERIOR CAPSULAR RECONSTRUCTION (COMP CODE 27100),4540.0,2951.0,509.75,4540.0,15
HCPCS,27299,SUTURE OF ABDUCTOR TENDON (COMP CODE 27385),2980.0,1937.0,509.75,2980.0,15
HCPCS,27299,"UNLIST PROC, PELVIS OR HIP JOINT COMPARED TO 27000",2420.0,1573.0,509.75,2420.0,15
HCPCS,27299,UNLISTED PROC; OPEN TREATMENT TOTAL HIP REPLACEMENT DISLOCATION,2501.0,1625.65,509.75,2501.0,15
HCPCS,27301,DRAIN THIGH/KNEE LESION,,,535.37,535.37,1
HCPCS,27301,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,9584.0,6229.599999999999,248.22,14810.4,133
HCPCS,273010,DRAIN THIGH/KNEE LESION,,,535.37,535.37,1
HCPCS,27303,DRAINAGE OF BONE LESION,,,675.0,3758.57,5
HCPCS,27303,Drainage of bone lesion,,,1992.02,2516.23,6
HCPCS,27303,INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE,3452.0,2243.8,423.13,3452.0,35
HCPCS,273030,DRAINAGE OF BONE LESION,,,675.0,675.0,1
HCPCS,27305,"FASCIOTOMY,ILIOTIBIAL,OPEN",2472.0,1606.8,285.77,2472.0,35
HCPCS,27305,INCISE THIGH TENDON & FASCIA,,,509.27,7034.85,15
HCPCS,27305,Incise thigh tendon & fascia,,,2390.81,3019.97,6
HCPCS,273050,INCISE THIGH TENDON & FASCIA,,,509.27,509.27,1
HCPCS,27306,INCISION OF THIGH TENDON,,,360.55,7034.85,15
HCPCS,27306,Incision of thigh tendon,,,2390.81,3019.97,6
HCPCS,27306,TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX,1896.0,1232.4,210.14,1896.0,35
HCPCS,273060,INCISION OF THIGH TENDON,,,360.55,360.55,1
HCPCS,27307,INCISION OF THIGH TENDONS,,,429.29,7034.85,15
HCPCS,27307,Incision of thigh tendons,,,2390.81,3019.97,6
HCPCS,27307,TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON,2424.0,1575.6,258.87,2424.0,35
HCPCS,273070,INCISION OF THIGH TENDONS,,,429.29,429.29,1
HCPCS,27310,ARTHRT KNE W/EXPL DRG/RMVL FB,4000.0,2600.0,517.64,4000.0,35
HCPCS,27310,EXPLORATION OF KNEE JOINT,,,770.96,7034.85,15
HCPCS,27310,Exploration of knee joint,,,1992.02,2516.23,6
HCPCS,273100,EXPLORATION OF KNEE JOINT,,,770.96,770.96,1
HCPCS,27323,BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL,932.0,605.8,84.33,699.0,35
HCPCS,27323,BIOPSY THIGH SOFT TISSUES,,,182.24,3512.95,15
HCPCS,27323,Biopsy thigh soft tissues,,,1112.95,1405.84,6
HCPCS,273230,BIOPSY THIGH SOFT TISSUES,,,182.24,182.24,1
HCPCS,27324,BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP,2016.0,1310.4,220.23,2016.0,35
HCPCS,27324,BIOPSY THIGH SOFT TISSUES,,,432.24,6205.4,15
HCPCS,27324,Biopsy thigh soft tissues,,,1112.95,1405.84,6
HCPCS,273240,BIOPSY THIGH SOFT TISSUES,,,432.24,432.24,1
HCPCS,27325,NEURECTOMY HAMSTRING,,,595.18,4233.93,15
HCPCS,27325,Neurectomy hamstring,,,2390.81,3019.97,6
HCPCS,273250,NEURECTOMY HAMSTRING,,,595.18,595.18,1
HCPCS,27326,NEURECTOMY POPLITEAL,,,550.88,4233.93,15
HCPCS,27326,Neurectomy popliteal,,,1992.02,2516.23,6
HCPCS,273260,NEURECTOMY POPLITEAL,,,550.88,550.88,1
HCPCS,27327,EXC THIGH/KNEE LES SC < 3 CM,,,331.55,331.55,1
HCPCS,27327,EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM,5450.0,3542.5,154.19,36332.0,81
HCPCS,273270,EXC THIGH/KNEE LES SC < 3 CM,,,331.55,331.55,1
HCPCS,27328,EXC THIGH/KNEE TUM DEEP <5CM,,,657.3,6205.4,15
HCPCS,27328,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM,3540.0,2301.0,304.76,3540.0,35
HCPCS,27328,Exc thigh/knee tum deep <5cm,,,1112.95,1405.84,6
HCPCS,273280,EXC THIGH/KNEE TUM DEEP <5CM,,,657.3,657.3,1
HCPCS,27329,RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM,6288.0,4087.2,713.3,6288.0,35
HCPCS,27329,RESECT THIGH/KNEE TUM < 5 CM,,,1093.77,6205.4,15
HCPCS,27329,Resect thigh/knee tum < 5 cm,,,1992.02,2516.23,6
HCPCS,273290,RESECT THIGH/KNEE TUM < 5 CM,,,1093.77,1093.77,1
HCPCS,27330,ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY,2044.0,1328.6,295.43,2044.0,35
HCPCS,27330,BIOPSY KNEE JOINT LINING,,,446.81,7034.85,15
HCPCS,27330,Biopsy knee joint lining,,,1992.02,2516.23,6
HCPCS,273300,BIOPSY KNEE JOINT LINING,,,446.81,446.81,1
HCPCS,27331,ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB,2408.0,1565.2,351.89,2408.0,35
HCPCS,27331,EXPLORE/TREAT KNEE JOINT,,,503.15,7034.85,15
HCPCS,27331,Explore/treat knee joint,,,1992.02,2516.23,6
HCPCS,273310,EXPLORE/TREAT KNEE JOINT,,,503.15,503.15,1
HCPCS,27332,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT,3384.0,2199.6,476.59,3384.0,35
HCPCS,27332,REMOVAL OF KNEE CARTILAGE,,,680.17,7034.85,15
HCPCS,27332,Removal of knee cartilage,,,1992.02,2516.23,6
HCPCS,273320,REMOVAL OF KNEE CARTILAGE,,,680.17,680.17,1
HCPCS,27333,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL&LAT,3020.0,1963.0,419.1,3020.0,35
HCPCS,27333,REMOVAL OF KNEE CARTILAGE,,,621.5,7034.85,15
HCPCS,27333,Removal of knee cartilage,,,1992.02,2516.23,6
HCPCS,273330,REMOVAL OF KNEE CARTILAGE,,,621.5,621.5,1
HCPCS,27334,ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR,3676.0,2389.4,503.98,3676.0,35
HCPCS,27334,REMOVE KNEE JOINT LINING,,,722.42,7034.85,15
HCPCS,27334,Remove knee joint lining,,,1992.02,2516.23,6
HCPCS,273340,REMOVE KNEE JOINT LINING,,,722.42,722.42,1
HCPCS,27335,ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA,4220.0,2743.0,577.66,4220.0,35
HCPCS,27335,REMOVE KNEE JOINT LINING,,,806.37,15488.78,15
HCPCS,27335,Remove knee joint lining,,,4645.92,5868.53,6
HCPCS,273350,REMOVE KNEE JOINT LINING,,,806.37,806.37,1
HCPCS,27337,EXC THIGH/KNEE LES SC 3 CM/>,,,442.21,442.21,1
HCPCS,27337,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>,16456.0,10696.4,509.36,36332.0,46
HCPCS,27337,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3+CM,2364.0,1536.6,229.55,2364.0,35
HCPCS,273370,EXC THIGH/KNEE LES SC 3 CM/>,,,442.21,442.21,1
HCPCS,27339,EXC THIGH/KNEE TUM DEP 5CM/>,,,795.64,6205.4,15
HCPCS,27339,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM,4452.0,2893.8,414.62,4452.0,35
HCPCS,27339,Exc thigh/knee tum dep 5cm/>,,,1112.95,1405.84,6
HCPCS,273390,EXC THIGH/KNEE TUM DEP 5CM/>,,,795.64,795.64,1
HCPCS,27340,EXCISION PREPATELLAR BURSA,1728.0,1123.2,227.52,1728.0,35
HCPCS,27340,REMOVAL OF KNEECAP BURSA,,,395.95,7034.85,15
HCPCS,27340,Removal of kneecap bursa,,,1992.02,2516.23,6
HCPCS,273400,REMOVAL OF KNEECAP BURSA,,,395.95,395.95,1
HCPCS,27345,EXCISION SYNOVIAL CYST POPLITEAL SPACE,2436.0,1583.4,323.47,2436.0,35
HCPCS,27345,REMOVAL OF KNEE CYST,,,512.83,7034.85,15
HCPCS,27345,Removal of knee cyst,,,1992.02,2516.23,6
HCPCS,273450,REMOVAL OF KNEE CYST,,,512.83,512.83,1
HCPCS,27347,EXCISION LESION MENISCUS/CAPSULE KNEE,2692.0,1749.8,269.58,2692.0,35
HCPCS,27347,REMOVE KNEE CYST,,,556.01,7034.85,15
HCPCS,27347,Remove knee cyst,,,1992.02,2516.23,6
HCPCS,273470,REMOVE KNEE CYST,,,556.01,556.01,1
HCPCS,27350,PATELLECTOMY/HEMIPATELLECTOMY,3464.0,2251.6,470.0,3464.0,35
HCPCS,27350,REMOVAL OF KNEECAP,,,689.05,15488.78,15
HCPCS,27350,Removal of kneecap,,,1992.02,2516.23,6
HCPCS,273500,REMOVAL OF KNEECAP,,,689.05,689.05,1
HCPCS,27355,EXCISION/CURETTAGE CYST/TUMOR FEMUR,3200.0,2080.0,426.14,3200.0,35
HCPCS,27355,REMOVE FEMUR LESION,,,640.32,7034.85,15
HCPCS,27355,Remove femur lesion,,,2390.81,3019.97,6
HCPCS,273550,REMOVE FEMUR LESION,,,640.32,640.32,1
HCPCS,27356,REMOVE FEMUR LESION/GRAFT,,,779.28,27897.39,15
HCPCS,27356,Remove femur lesion/graft,,,2390.81,3019.97,6
HCPCS,273560,REMOVE FEMUR LESION/GRAFT,,,779.28,779.28,1
HCPCS,27357,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT,4464.0,2901.6,537.81,4464.0,35
HCPCS,27357,REMOVE FEMUR LESION/GRAFT,,,859.94,15488.78,15
HCPCS,27357,Remove femur lesion/graft,,,2390.81,3019.97,6
HCPCS,273570,REMOVE FEMUR LESION/GRAFT,,,859.94,859.94,1
HCPCS,27358,EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION,1892.0,1229.8,209.37,1892.0,35
HCPCS,27358,REMOVE FEMUR LESION/FIXATION,,,286.35,286.35,1
HCPCS,27358,Remove femur lesion/fixation,,,2390.81,3019.97,6
HCPCS,273580,REMOVE FEMUR LESION/FIXATION,,,286.35,286.35,1
HCPCS,27360,PARTIAL REMOVAL LEG BONE(S),,,943.61,7034.85,15
HCPCS,27360,PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA,4584.0,2979.6,563.83,4584.0,35
HCPCS,27360,Partial removal leg bone(s),,,1992.02,2516.23,6
HCPCS,273600,PARTIAL REMOVAL LEG BONE(S),,,943.61,943.61,1
HCPCS,27364,RAD RESECTION TUMOR SOFT TISSUE THIGH/KNEE 5+CM,9796.0,6367.4,868.73,9796.0,35
HCPCS,27364,RESECT THIGH/KNEE TUM 5 CM/>,,,1640.49,6205.4,16
HCPCS,27364,Resect thigh/knee tum 5 cm/>,,,1992.02,2516.23,6
HCPCS,273640,RESECT THIGH/KNEE TUM 5 CM/>,,,1640.49,1640.49,1
HCPCS,27365,"RAD RESEC TUMOR,FEMUR OR KNEE",12884.0,8374.6,997.29,12884.0,35
HCPCS,27365,RESECT FEMUR/KNEE TUMOR,,,2146.59,3758.57,5
HCPCS,27365,Resect femur/knee tumor,,,2390.81,3019.97,6
HCPCS,273650,RESECT FEMUR/KNEE TUMOR,,,2146.59,2146.59,1
HCPCS,27369,NJX CNTRST KNE ARTHG/CT/MRI,,,41.83,41.83,1
HCPCS,27369,NJX PX CNTRST KNE ARTHG CNTRST ENHNCD CT/MRI KNE,978.0,635.7,47.18,3920.0,111
HCPCS,27369,NJX PX CNTRST KNE ARTHG CONTRST ENHNCD CT/MRI KNE,308.0,200.2,31.35,259.0,31
HCPCS,273690,NJX CNTRST KNE ARTHG/CT/MRI,,,41.83,41.83,1
HCPCS,27370,INJECTION KNEE ARTHROGRAPHY,547.0,355.55,91.9,492.3,21
HCPCS,27372,REMOVAL FOREIGN BODY DEEP THIGH/KNEE,16456.0,10696.4,490.04,36332.0,98
HCPCS,27372,REMOVAL OF FOREIGN BODY,,,420.77,420.77,1
HCPCS,27372,"REMV FOREIGN BODY,KNEE/THIGH,DEEP",2084.0,1354.6,196.93,1563.0,35
HCPCS,273720,REMOVAL OF FOREIGN BODY,,,420.77,420.77,1
HCPCS,27380,REPAIR OF KNEECAP TENDON,,,652.4,15488.78,15
HCPCS,27380,Repair of kneecap tendon,,,1992.02,2516.23,6
HCPCS,27380,SUTURE INFRAPATELLAR TENDON PRIMARY,2980.0,1937.0,415.12,2980.0,35
HCPCS,273800,REPAIR OF KNEECAP TENDON,,,652.4,652.4,1
HCPCS,27381,REPAIR/GRAFT KNEECAP TENDON,,,859.77,15488.78,15
HCPCS,27381,Repair/graft kneecap tendon,,,4645.92,5868.53,6
HCPCS,27381,SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF,4304.0,2797.6,585.28,4304.0,35
HCPCS,273810,REPAIR/GRAFT KNEECAP TENDON,,,859.77,859.77,1
HCPCS,27385,REPAIR OF THIGH MUSCLE,,,635.1,15488.78,15
HCPCS,27385,Repair of thigh muscle,,,2390.81,3019.97,6
HCPCS,27385,SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY,3049.0,1981.85,448.71,3049.0,35
HCPCS,273850,REPAIR OF THIGH MUSCLE,,,635.1,635.1,1
HCPCS,27386,REPAIR/GRAFT OF THIGH MUSCLE,,,896.92,15488.78,15
HCPCS,27386,Repair/graft of thigh muscle,,,2390.81,3019.97,6
HCPCS,27386,SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ,4452.0,2893.8,606.26,4452.0,35
HCPCS,273860,REPAIR/GRAFT OF THIGH MUSCLE,,,896.92,896.92,1
HCPCS,27390,INCISION OF THIGH TENDON,,,476.05,7034.85,15
HCPCS,27390,Incision of thigh tendon,,,2390.81,3019.97,6
HCPCS,27390,TENOTOMY OPEN HAMSTRING KNEE HIP SINGLE TENDON,2212.0,1437.8,278.03,2212.0,35
HCPCS,273900,INCISION OF THIGH TENDON,,,476.05,476.05,1
HCPCS,27391,INCISION OF THIGH TENDONS,,,610.36,7034.85,15
HCPCS,27391,Incision of thigh tendons,,,2390.81,3019.97,6
HCPCS,27391,TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG,2996.0,1947.4,357.72,2996.0,35
HCPCS,273910,INCISION OF THIGH TENDONS,,,610.36,610.36,1
HCPCS,27392,INCISION OF THIGH TENDONS,,,751.59,7034.85,15
HCPCS,27392,Incision of thigh tendons,,,2390.81,3019.97,6
HCPCS,273920,INCISION OF THIGH TENDONS,,,751.59,751.59,1
HCPCS,27393,"LENGTHEN HAMSTR TENDON,SINGLE",2900.0,1885.0,342.11,2900.0,35
HCPCS,27393,LENGTHENING OF THIGH TENDON,,,528.77,15488.78,15
HCPCS,27393,Lengthening of thigh tendon,,,2390.81,3019.97,6
HCPCS,273930,LENGTHENING OF THIGH TENDON,,,528.77,528.77,1
HCPCS,27394,"LENGTHEN HAMSTR TENDON,MULTI,ONE LEG",3868.0,2514.2,406.74,3868.0,35
HCPCS,27394,LENGTHENING OF THIGH TENDONS,,,690.38,15488.78,15
HCPCS,27394,Lengthening of thigh tendons,,,2390.81,3019.97,6
HCPCS,273940,LENGTHENING OF THIGH TENDONS,,,690.38,690.38,1
HCPCS,27395,LENGTHENING OF THIGH TENDONS,,,927.33,7034.85,15
HCPCS,27395,Lengthening of thigh tendons,,,2390.81,3019.97,6
HCPCS,273950,LENGTHENING OF THIGH TENDONS,,,927.33,927.33,1
HCPCS,27396,TRANSPLANT OF THIGH TENDON,,,651.78,15488.78,15
HCPCS,27396,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR 1 TENDON,3260.0,2119.0,419.28,3260.0,35
HCPCS,27396,Transplant of thigh tendon,,,2390.81,3019.97,6
HCPCS,273960,TRANSPLANT OF THIGH TENDON,,,651.78,651.78,1
HCPCS,27397,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN,5064.0,3291.6,559.71,5064.0,35
HCPCS,27397,TRANSPLANTS OF THIGH TENDONS,,,961.82,15488.78,15
HCPCS,27397,Transplants of thigh tendons,,,2390.81,3019.97,6
HCPCS,273970,TRANSPLANTS OF THIGH TENDONS,,,961.82,961.82,1
HCPCS,27400,REVISE THIGH MUSCLES/TENDONS,,,732.6,15488.78,15
HCPCS,27400,Revise thigh muscles/tendons,,,2390.81,3019.97,6
HCPCS,274000,REVISE THIGH MUSCLES/TENDONS,,,732.6,732.6,1
HCPCS,27403,ARTHROTOMY W/MENISCUS REPAIR KNEE,3448.0,2241.2,467.35,3448.0,35
HCPCS,27403,REPAIR OF KNEE CARTILAGE,,,679.84,15488.78,15
HCPCS,27403,Repair of knee cartilage,,,1992.02,2516.23,6
HCPCS,274030,REPAIR OF KNEE CARTILAGE,,,679.84,679.84,1
HCPCS,27405,REPAIR OF KNEE LIGAMENT,,,712.03,15488.78,15
HCPCS,27405,RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL,3632.0,2360.8,499.03,3632.0,35
HCPCS,27405,Repair of knee ligament,,,4645.92,5868.53,6
HCPCS,274050,REPAIR OF KNEE LIGAMENT,,,712.03,712.03,1
HCPCS,27407,REPAIR OF KNEE LIGAMENT,,,838.05,15488.78,15
HCPCS,27407,REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT,4340.0,2821.0,525.99,4340.0,35
HCPCS,27407,Repair of knee ligament,,,4645.92,5868.53,6
HCPCS,274070,REPAIR OF KNEE LIGAMENT,,,838.05,838.05,1
HCPCS,27409,REPAIR OF KNEE LIGAMENTS,,,1015.14,15488.78,15
HCPCS,27409,RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE,5484.0,3564.6,734.69,5484.0,35
HCPCS,27409,Repair of knee ligaments,,,4645.92,5868.53,6
HCPCS,274090,REPAIR OF KNEE LIGAMENTS,,,1015.14,1015.14,1
HCPCS,27412,AUTOCHONDROCYTE IMPLANT KNEE,,,1725.03,15488.78,15
HCPCS,27412,AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE,9896.0,6432.4,1172.07,9896.0,35
HCPCS,27412,Autochondrocyte implant knee,,,3407.88,4304.69,6
HCPCS,274120,AUTOCHONDROCYTE IMPLANT KNEE,,,1725.03,1725.03,1
HCPCS,27415,OSTEOCHONDRAL KNEE ALLOGRAFT,8000.0,5200.0,977.86,27897.39,50
HCPCS,27415,Osteochondral knee allograft,,,3407.88,4304.69,6
HCPCS,274150,OSTEOCHONDRAL KNEE ALLOGRAFT,,,1438.0,1438.0,1
HCPCS,27416,OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY,5664.0,3681.6,575.2,5664.0,32
HCPCS,27416,OSTEOCHONDRAL KNEE AUTOGRAFT,,,1029.13,15488.78,15
HCPCS,27416,Osteochondral knee autograft,,,4645.92,5868.53,6
HCPCS,274160,OSTEOCHONDRAL KNEE AUTOGRAFT,,,1029.13,1029.13,1
HCPCS,27418,ANTERIOR TIBIAL TUBERCLEPLASTY,4640.0,3016.0,616.49,4640.0,35
HCPCS,27418,REPAIR DEGENERATED KNEECAP,,,863.16,15488.78,15
HCPCS,27418,Repair degenerated kneecap,,,4645.92,5868.53,6
HCPCS,274180,REPAIR DEGENERATED KNEECAP,,,863.16,863.16,1
HCPCS,27420,RCNSTJ DISLOCATING PATELLA,4104.0,2667.6,559.14,4104.0,35
HCPCS,27420,REVISION OF UNSTABLE KNEECAP,,,789.5,15488.78,15
HCPCS,27420,Revision of unstable kneecap,,,4645.92,5868.53,6
HCPCS,274200,REVISION OF UNSTABLE KNEECAP,,,789.5,789.5,1
HCPCS,27422,RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL,4084.0,2654.6,558.4,4084.0,35
HCPCS,27422,REVISION OF UNSTABLE KNEECAP,,,780.56,15488.78,15
HCPCS,27422,Revision of unstable kneecap,,,4645.92,5868.53,6
HCPCS,274220,REVISION OF UNSTABLE KNEECAP,,,780.56,780.56,1
HCPCS,27424,REVISION/REMOVAL OF KNEECAP,,,788.09,15488.78,15
HCPCS,27424,Revision/removal of kneecap,,,4645.92,5868.53,6
HCPCS,274240,REVISION/REMOVAL OF KNEECAP,,,788.09,788.09,1
HCPCS,27425,LAT RETINACULAR RELEASE OPEN,,,479.31,7034.85,15
HCPCS,27425,LATERAL RETINACULAR RELEASE OPEN,2156.0,1401.4,309.04,2156.0,35
HCPCS,27425,Lat retinacular release open,,,1992.02,2516.23,6
HCPCS,274250,LAT RETINACULAR RELEASE OPEN,,,479.31,479.31,1
HCPCS,27427,LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR,3916.0,2545.4,544.61,3916.0,35
HCPCS,27427,RECONSTRUCTION KNEE,,,745.48,15488.78,15
HCPCS,27427,Reconstruction knee,,,4645.92,5868.53,6
HCPCS,274270,RECONSTRUCTION KNEE,,,745.48,745.48,1
HCPCS,27428,LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR,6232.0,4050.8,761.17,6232.0,35
HCPCS,27428,RECONSTRUCTION KNEE,,,1172.22,27897.39,15
HCPCS,27428,Reconstruction knee,,,4645.92,5868.53,6
HCPCS,274280,RECONSTRUCTION KNEE,,,1172.22,1172.22,1
HCPCS,27429,LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR,7016.0,4560.4,733.17,7016.0,35
HCPCS,27429,RECONSTRUCTION KNEE,,,1321.12,27897.39,15
HCPCS,27429,Reconstruction knee,,,4645.92,5868.53,6
HCPCS,274290,RECONSTRUCTION KNEE,,,1321.12,1321.12,1
HCPCS,27430,QUADRICEPSPLASTY,4064.0,2641.6,519.1,4064.0,35
HCPCS,27430,REVISION OF THIGH MUSCLES,,,781.48,15488.78,15
HCPCS,27430,Revision of thigh muscles,,,2390.81,3019.97,6
HCPCS,274300,REVISION OF THIGH MUSCLES,,,781.48,781.48,1
HCPCS,27435,CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE,4352.0,2828.8,459.11,4352.0,35
HCPCS,27435,INCISION OF KNEE JOINT,,,848.21,7034.85,15
HCPCS,27435,Incision of knee joint,,,1992.02,2516.23,6
HCPCS,274350,INCISION OF KNEE JOINT,,,848.21,848.21,1
HCPCS,27437,ARTHROPLASTY PATELLA W/O PROSTHESIS,3572.0,2321.8,490.31,3572.0,35
HCPCS,27437,REVISE KNEECAP,,,696.82,15488.78,15
HCPCS,27437,Revise kneecap,,,2190.3,2766.7,6
HCPCS,274370,REVISE KNEECAP,,,696.82,696.82,1
HCPCS,27438,ARTHROPLASTY PATELLA W/PROSTHESIS,4756.0,3091.4,640.4,4756.0,35
HCPCS,27438,REVISE KNEECAP WITH IMPLANT,,,883.76,27897.39,15
HCPCS,27438,Revise kneecap with implant,,,5660.06,7149.55,6
HCPCS,274380,REVISE KNEECAP WITH IMPLANT,,,883.76,883.76,1
HCPCS,27440,REVISION OF KNEE JOINT,,,839.04,27897.39,15
HCPCS,27440,Revision of knee joint,,,5660.06,7149.55,6
HCPCS,274400,REVISION OF KNEE JOINT,,,839.04,839.04,1
HCPCS,27441,REVISION OF KNEE JOINT,,,866.1,27897.39,15
HCPCS,27441,Revision of knee joint,,,5660.06,7149.55,6
HCPCS,274410,REVISION OF KNEE JOINT,,,866.1,866.1,1
HCPCS,27442,REVISION OF KNEE JOINT,,,912.55,27897.39,15
HCPCS,27442,Revision of knee joint,,,5660.06,7149.55,6
HCPCS,274420,REVISION OF KNEE JOINT,,,912.55,912.55,1
HCPCS,27443,ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL,5020.0,3263.0,605.57,5020.0,35
HCPCS,27443,REVISION OF KNEE JOINT,,,858.71,27897.39,15
HCPCS,27443,Revision of knee joint,,,5660.06,7149.55,6
HCPCS,274430,REVISION OF KNEE JOINT,,,858.71,858.71,1
HCPCS,27445,Revision of knee joint,,,5660.06,7149.55,6
HCPCS,27446,ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT,6852.0,4453.8,873.2,6852.0,35
HCPCS,27446,REVISION OF KNEE JOINT,,,1203.06,27897.39,15
HCPCS,27446,Revision of knee joint,,,5660.06,7149.55,6
HCPCS,274460,REVISION OF KNEE JOINT,,,1203.06,1203.06,1
HCPCS,27447,ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS,7840.0,5096.0,992.7,7840.0,35
HCPCS,27447,TOTAL KNEE ARTHROPLASTY,,,1343.5,27897.39,20
HCPCS,27447,Total knee arthroplasty,,,5660.06,7149.55,6
HCPCS,274470,TOTAL KNEE ARTHROPLASTY,,,1343.5,1343.5,1
HCPCS,27448,INCISION OF THIGH,,,870.3,8335.26,5
HCPCS,27448,Incision of thigh,,,2390.81,3019.97,6
HCPCS,27448,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/O FIXATION,4640.0,3016.0,605.76,4640.0,35
HCPCS,274480,INCISION OF THIGH,,,870.3,870.3,1
HCPCS,27450,INCISION OF THIGH,,,1058.73,8335.26,5
HCPCS,27450,Incision of thigh,,,2390.81,3019.97,6
HCPCS,27450,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION,5844.0,3798.6,743.23,5844.0,35
HCPCS,274500,INCISION OF THIGH,,,1058.73,1058.73,1
HCPCS,27454,OSTEOT MLT W/RELIGNMT IMED ROD FEM SHFT,7668.0,4984.2,902.35,7668.0,35
HCPCS,27454,REALIGNMENT OF THIGH BONE,,,1355.66,8335.26,5
HCPCS,27454,Realignment of thigh bone,,,2390.81,3019.97,6
HCPCS,274540,REALIGNMENT OF THIGH BONE,,,1355.66,1355.66,1
HCPCS,27455,OSTEOT PROX TIBIA FIB EXC/OSTEOT BEFORE EPIPHYSL,5344.0,3473.6,679.9,5344.0,35
HCPCS,27455,REALIGNMENT OF KNEE,,,1007.21,8335.26,5
HCPCS,27455,Realignment of knee,,,4645.92,5868.53,6
HCPCS,274550,REALIGNMENT OF KNEE,,,1007.21,1007.21,1
HCPCS,27457,OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL,5612.0,3647.8,720.39,5612.0,35
HCPCS,27457,REALIGNMENT OF KNEE,,,991.42,8335.26,5
HCPCS,27457,Realignment of knee,,,4645.92,5868.53,6
HCPCS,274570,REALIGNMENT OF KNEE,,,991.42,991.42,1
HCPCS,27458,OSTEOT FEMUR IMED LNGTH DEV,,,1808.55,8335.26,5
HCPCS,27458,OSTEOT FEMUR UNI INSJ XTRNL CTRLD IMED LNGTH DEV,11726.0,7621.9,1888.03,11726.0,21
HCPCS,27458,Osteot femur imed lngth dev,,,2390.81,3019.97,6
HCPCS,274580,OSTEOT FEMUR IMED LNGTH DEV,,,1808.55,1808.55,1
HCPCS,27465,SHORTENING OF THIGH BONE,,,1307.46,8335.26,5
HCPCS,27465,Shortening of thigh bone,,,2390.81,3019.97,6
HCPCS,274650,SHORTENING OF THIGH BONE,,,1307.46,1307.46,1
HCPCS,27466,LENGTHENING OF THIGH BONE,,,1242.12,8335.26,5
HCPCS,27466,Lengthening of thigh bone,,,2390.81,3019.97,6
HCPCS,274660,LENGTHENING OF THIGH BONE,,,1242.12,1242.12,1
HCPCS,27468,Shorten/lengthen thighs,,,2390.81,3019.97,6
HCPCS,27470,REPAIR OF THIGH,,,1238.22,8335.26,5
HCPCS,27470,RPR NON/MAL FEMUR DSTL H/N W/O GRF,6856.0,4456.4,886.21,6856.0,35
HCPCS,27470,Repair of thigh,,,2390.81,3019.97,6
HCPCS,274700,REPAIR OF THIGH,,,1238.22,1238.22,1
HCPCS,27472,REPAIR/GRAFT OF THIGH,,,1325.57,8335.26,5
HCPCS,27472,RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE,8237.0,5354.05,954.04,8237.0,35
HCPCS,27472,Repair/graft of thigh,,,2390.81,3019.97,6
HCPCS,274720,REPAIR/GRAFT OF THIGH,,,1325.57,1325.57,1
HCPCS,27475,ARREST EPIPHYSEAL DISTAL FEMUR,41076.0,26699.4,785.71,36968.4,84
HCPCS,27475,SURGERY TO STOP LEG GROWTH,,,698.82,698.82,1
HCPCS,274750,SURGERY TO STOP LEG GROWTH,,,698.82,698.82,1
HCPCS,27477,SURGERY TO STOP LEG GROWTH,,,772.29,15488.78,15
HCPCS,27477,Surgery to stop leg growth,,,1992.02,2516.23,6
HCPCS,274770,SURGERY TO STOP LEG GROWTH,,,772.29,772.29,1
HCPCS,27479,SURGERY TO STOP LEG GROWTH,,,964.8,15488.78,15
HCPCS,27479,Surgery to stop leg growth,,,4645.92,5868.53,6
HCPCS,274790,SURGERY TO STOP LEG GROWTH,,,964.8,964.8,1
HCPCS,27485,SURGERY TO STOP LEG GROWTH,,,707.5,15488.78,15
HCPCS,27485,Surgery to stop leg growth,,,1992.02,2516.23,6
HCPCS,274850,SURGERY TO STOP LEG GROWTH,,,707.5,707.5,1
HCPCS,27486,REVISE/REPLACE KNEE JOINT,,,1469.97,14747.88,5
HCPCS,27486,REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT,8448.0,5491.2,1045.89,8448.0,35
HCPCS,27486,Revise/replace knee joint,,,5660.06,7149.55,6
HCPCS,274860,REVISE/REPLACE KNEE JOINT,,,1469.97,1469.97,1
HCPCS,27487,REVISE/REPLACE KNEE JOINT,,,1834.24,20141.22,5
HCPCS,27487,REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE,10844.0,7048.6,1353.22,10844.0,35
HCPCS,27487,Revise/replace knee joint,,,5660.06,7149.55,6
HCPCS,274870,REVISE/REPLACE KNEE JOINT,,,1834.24,1834.24,1
HCPCS,27488,REMOVAL OF KNEE PROSTHESIS,,,1258.06,14747.88,5
HCPCS,27488,RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER,7040.0,4576.0,860.05,7040.0,35
HCPCS,27488,Removal of knee prosthesis,,,4645.92,5868.53,6
HCPCS,274880,REMOVAL OF KNEE PROSTHESIS,,,1258.06,1258.06,1
HCPCS,27495,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE FEMUR,6616.0,4300.4,842.09,6616.0,35
HCPCS,27495,REINFORCE THIGH,,,1184.64,8335.26,5
HCPCS,27495,Reinforce thigh,,,2390.81,3019.97,6
HCPCS,274950,REINFORCE THIGH,,,1184.64,1184.64,1
HCPCS,27496,DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT,2712.0,1762.8,294.32,2712.0,35
HCPCS,27496,DECOMPRESSION OF THIGH/KNEE,,,578.71,7034.85,15
HCPCS,27496,Decompression of thigh/knee,,,2390.81,3019.97,6
HCPCS,274960,DECOMPRESSION OF THIGH/KNEE,,,578.71,578.71,1
HCPCS,27497,DCMPRN FASCT THIGH&/KNEE DBRDMT MUSCLE&/NERVE,3116.0,2025.4,352.48,3116.0,35
HCPCS,27497,DECOMPRESSION OF THIGH/KNEE,,,612.33,7034.85,15
HCPCS,27497,Decompression of thigh/knee,,,1992.02,2516.23,6
HCPCS,274970,DECOMPRESSION OF THIGH/KNEE,,,612.33,612.33,1
HCPCS,27498,DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS,3464.0,2251.6,397.4,3464.0,35
HCPCS,27498,DECOMPRESSION OF THIGH/KNEE,,,692.17,3469.95,15
HCPCS,27498,Decompression of thigh/knee,,,1992.02,2516.23,6
HCPCS,274980,DECOMPRESSION OF THIGH/KNEE,,,692.17,692.17,1
HCPCS,27499,DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE,3772.0,2451.8,448.08,3772.0,35
HCPCS,27499,DECOMPRESSION OF THIGH/KNEE,,,739.27,15488.78,15
HCPCS,27499,Decompression of thigh/knee,,,1992.02,2516.23,6
HCPCS,274990,DECOMPRESSION OF THIGH/KNEE,,,739.27,739.27,1
HCPCS,27500,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,1949.5,1267.175,240.79,4268.0,84
HCPCS,27500,TREATMENT OF THIGH FRACTURE,,,508.56,508.56,1
HCPCS,275000,TREATMENT OF THIGH FRACTURE,,,508.56,508.56,1
HCPCS,27501,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,1979.5,1286.675,240.79,4151.0,84
HCPCS,27501,TREATMENT OF THIGH FRACTURE,,,525.83,525.83,1
HCPCS,275010,TREATMENT OF THIGH FRACTURE,,,525.83,525.83,1
HCPCS,27502,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,6873.5,4467.775,310.03,8550.0,133
HCPCS,27502,TREATMENT OF THIGH FRACTURE,,,794.97,794.97,1
HCPCS,275020,TREATMENT OF THIGH FRACTURE,,,794.97,794.97,1
HCPCS,27503,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,6855.5,4456.075,310.03,8282.7,133
HCPCS,27503,TREATMENT OF THIGH FRACTURE,,,840.96,840.96,1
HCPCS,275030,TREATMENT OF THIGH FRACTURE,,,840.96,840.96,1
HCPCS,27506,OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW,7860.0,5109.0,901.78,7860.0,35
HCPCS,27506,TREATMENT OF THIGH FRACTURE,,,1401.68,8335.26,5
HCPCS,27506,Treatment of thigh fracture,,,2390.81,3019.97,6
HCPCS,275060,TREATMENT OF THIGH FRACTURE,,,1401.68,1401.68,1
HCPCS,27507,OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,5792.0,3764.8,751.16,5792.0,35
HCPCS,27507,TREATMENT OF THIGH FRACTURE,,,1014.28,8335.26,5
HCPCS,27507,Treatment of thigh fracture,,,3366.74,4252.73,6
HCPCS,275070,TREATMENT OF THIGH FRACTURE,,,1014.28,1014.28,1
HCPCS,27508,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,1929.5,1254.175,240.79,4151.0,179
HCPCS,27508,TREATMENT OF THIGH FRACTURE,,,527.4,527.4,1
HCPCS,275080,TREATMENT OF THIGH FRACTURE,,,527.4,527.4,1
HCPCS,27509,PRQ SKELETAL FIXJ FEMORAL FX DISTAL END,3256.0,2116.4,353.93,3256.0,35
HCPCS,27509,TREATMENT OF THIGH FRACTURE,,,706.92,15488.78,15
HCPCS,27509,Treatment of thigh fracture,,,3366.74,4252.73,6
HCPCS,275090,TREATMENT OF THIGH FRACTURE,,,706.92,706.92,1
HCPCS,27510,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,6561.5,4264.975,310.03,8282.7,133
HCPCS,27510,TREATMENT OF THIGH FRACTURE,,,720.12,720.12,1
HCPCS,275100,TREATMENT OF THIGH FRACTURE,,,720.12,720.12,1
HCPCS,27511,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN,6648.0,4321.2,742.08,6648.0,35
HCPCS,27511,TREATMENT OF THIGH FRACTURE,,,1044.14,14747.88,5
HCPCS,27511,Treatment of thigh fracture,,,3366.74,4252.73,6
HCPCS,275110,TREATMENT OF THIGH FRACTURE,,,1044.14,1044.14,1
HCPCS,27513,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN,8470.0,5505.5,923.26,8470.0,35
HCPCS,27513,TREATMENT OF THIGH FRACTURE,,,1293.6,14747.88,5
HCPCS,27513,Treatment of thigh fracture,,,3366.74,4252.73,6
HCPCS,275130,TREATMENT OF THIGH FRACTURE,,,1293.6,1293.6,1
HCPCS,27514,OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE,5840.0,3796.0,748.61,5840.0,35
HCPCS,27514,TREATMENT OF THIGH FRACTURE,,,1012.13,14747.88,5
HCPCS,27514,Treatment of thigh fracture,,,3366.74,4252.73,6
HCPCS,275140,TREATMENT OF THIGH FRACTURE,,,1012.13,1012.13,1
HCPCS,27516,TREAT THIGH FX GROWTH PLATE,,,240.79,520.1,15
HCPCS,27516,Treat thigh fx growth plate,,,310.03,391.62,6
HCPCS,275160,TREAT THIGH FX GROWTH PLATE,,,514.61,514.61,1
HCPCS,27517,TREAT THIGH FX GROWTH PLATE,,,727.12,3469.95,15
HCPCS,27517,Treat thigh fx growth plate,,,310.03,391.62,6
HCPCS,275170,TREAT THIGH FX GROWTH PLATE,,,727.12,727.12,1
HCPCS,27519,TREAT THIGH FX GROWTH PLATE,,,933.72,8335.26,5
HCPCS,27519,Treat thigh fx growth plate,,,2390.81,3019.97,6
HCPCS,275190,TREAT THIGH FX GROWTH PLATE,,,933.72,933.72,1
HCPCS,27520,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1297.5,843.375,164.71,4151.0,179
HCPCS,27520,TREAT KNEECAP FRACTURE,,,320.87,320.87,1
HCPCS,275200,TREAT KNEECAP FRACTURE,,,320.87,320.87,1
HCPCS,27524,OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR,4148.0,2696.2,547.7,4148.0,35
HCPCS,27524,TREAT KNEECAP FRACTURE,,,792.1,15488.78,16
HCPCS,27524,Treat kneecap fracture,,,3366.74,4252.73,6
HCPCS,275240,TREAT KNEECAP FRACTURE,,,792.1,792.1,1
HCPCS,27530,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1272.5,827.125,194.92,4151.0,133
HCPCS,27530,TREAT KNEE FRACTURE,,,307.49,307.49,1
HCPCS,275300,TREAT KNEE FRACTURE,,,307.49,307.49,1
HCPCS,27532,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,10989.0,7142.85,310.03,16790.4,179
HCPCS,27532,TREAT KNEE FRACTURE,,,613.27,613.27,1
HCPCS,275320,TREAT KNEE FRACTURE,,,613.27,613.27,1
HCPCS,27535,OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR,5364.0,3486.6,637.25,5364.0,35
HCPCS,27535,TREAT KNEE FRACTURE,,,940.51,8335.26,5
HCPCS,27535,Treat knee fracture,,,3366.74,4252.73,6
HCPCS,275350,TREAT KNEE FRACTURE,,,940.51,940.51,1
HCPCS,27536,OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ,6956.0,4521.4,743.76,6956.0,35
HCPCS,27536,TREAT KNEE FRACTURE,,,1245.09,8335.26,5
HCPCS,27536,Treat knee fracture,,,3366.74,4252.73,6
HCPCS,275360,TREAT KNEE FRACTURE,,,1245.09,1245.09,1
HCPCS,27538,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,1379.0,896.35,240.79,4151.0,49
HCPCS,27538,TREAT KNEE FRACTURE(S),,,477.07,477.07,1
HCPCS,275380,TREAT KNEE FRACTURE(S),,,477.07,477.07,1
HCPCS,27540,OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE,4520.0,2938.0,619.42,4520.0,35
HCPCS,27540,TREAT KNEE FRACTURE,,,854.86,8335.26,5
HCPCS,27540,Treat knee fracture,,,3366.74,4252.73,6
HCPCS,275400,TREAT KNEE FRACTURE,,,854.86,854.86,1
HCPCS,27550,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,1885.5,1225.575,233.42,4151.0,133
HCPCS,27550,TREAT KNEE DISLOCATION,,,499.75,499.75,1
HCPCS,275500,TREAT KNEE DISLOCATION,,,499.75,499.75,1
HCPCS,27552,CLOSED TX KNEE DISLOCATION W/ANESTHESIA,3272.0,2126.8,336.59,3272.0,35
HCPCS,27552,TREAT KNEE DISLOCATION,,,669.19,3469.95,15
HCPCS,27552,Treat knee dislocation,,,632.74,799.25,6
HCPCS,275520,TREAT KNEE DISLOCATION,,,669.19,669.19,1
HCPCS,27556,OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR,5200.0,3380.0,679.16,5200.0,35
HCPCS,27556,TREAT KNEE DISLOCATION,,,919.0,8335.26,5
HCPCS,27556,Treat knee dislocation,,,4645.92,5868.53,6
HCPCS,275560,TREAT KNEE DISLOCATION,,,919.0,919.0,1
HCPCS,27557,OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR,6996.0,4547.4,807.85,6996.0,35
HCPCS,27557,TREAT KNEE DISLOCATION,,,1094.67,8335.26,5
HCPCS,27557,Treat knee dislocation,,,4645.92,5868.53,6
HCPCS,275570,TREAT KNEE DISLOCATION,,,1094.67,1094.67,1
HCPCS,27558,TREAT KNEE DISLOCATION,,,1245.0,8335.26,5
HCPCS,27558,Treat knee dislocation,,,4645.92,5868.53,6
HCPCS,275580,TREAT KNEE DISLOCATION,,,1245.0,1245.0,1
HCPCS,27560,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,1487.5,966.875,166.35,4151.0,133
HCPCS,27560,TREAT KNEECAP DISLOCATION,,,364.83,364.83,1
HCPCS,275600,TREAT KNEECAP DISLOCATION,,,364.83,364.83,1
HCPCS,27562,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,1885.5,1225.575,240.79,8370.0,133
HCPCS,27562,TREAT KNEECAP DISLOCATION,,,519.07,519.07,1
HCPCS,275620,TREAT KNEECAP DISLOCATION,,,519.07,519.07,1
HCPCS,27566,OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY,5084.0,3304.6,617.83,5084.0,35
HCPCS,27566,TREAT KNEECAP DISLOCATION,,,938.44,15488.78,15
HCPCS,27566,Treat kneecap dislocation,,,3366.74,4252.73,6
HCPCS,275660,TREAT KNEECAP DISLOCATION,,,938.44,938.44,1
HCPCS,27570,FIXATION OF KNEE JOINT,,,161.28,3469.95,16
HCPCS,27570,Fixation of knee joint,,,632.74,799.25,6
HCPCS,27570,MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,716.0,465.4,101.53,716.0,35
HCPCS,275700,FIXATION OF KNEE JOINT,,,161.28,161.28,1
HCPCS,27580,ARTHRODESIS KNEE ANY TECHNIQUE,8440.0,5486.0,894.11,8440.0,35
HCPCS,27580,FUSION OF KNEE,,,1544.05,14747.88,5
HCPCS,27580,Fusion of knee,,,4645.92,5868.53,6
HCPCS,275800,FUSION OF KNEE,,,1544.05,1544.05,1
HCPCS,27590,AMPUTATE LEG AT THIGH,,,825.12,3758.57,5
HCPCS,27590,AMPUTATION THIGH THROUGH FEMUR ANY LEVEL,5927.0,3852.55,585.22,5927.0,35
HCPCS,27590,Amputate leg at thigh,,,2390.81,3019.97,6
HCPCS,275900,AMPUTATE LEG AT THIGH,,,825.12,825.12,1
HCPCS,27591,AMPUTATE LEG AT THIGH,,,1011.51,3758.57,5
HCPCS,27591,Amputate leg at thigh,,,2390.81,3019.97,6
HCPCS,275910,AMPUTATE LEG AT THIGH,,,1011.51,1011.51,1
HCPCS,27592,AMPUTATE LEG AT THIGH,,,703.93,3758.57,5
HCPCS,27592,AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR,4392.0,2854.8,506.95,4392.0,35
HCPCS,27592,Amputate leg at thigh,,,2390.81,3019.97,6
HCPCS,275920,AMPUTATE LEG AT THIGH,,,703.93,703.93,1
HCPCS,27594,AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION,2916.0,1895.4,303.57,2916.0,35
HCPCS,27594,AMPUTATION FOLLOW-UP SURGERY,,,529.21,7034.85,15
HCPCS,27594,Amputation follow-up surgery,,,2390.81,3019.97,6
HCPCS,275940,AMPUTATION FOLLOW-UP SURGERY,,,529.21,529.21,1
HCPCS,27596,AMPUTATION FOLLOW-UP SURGERY,,,746.32,3758.57,5
HCPCS,27596,AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION,4516.0,2935.4,504.81,4516.0,35
HCPCS,27596,Amputation follow-up surgery,,,2390.81,3019.97,6
HCPCS,275960,AMPUTATION FOLLOW-UP SURGERY,,,746.32,746.32,1
HCPCS,27598,AMPUTATE LOWER LEG AT KNEE,,,728.42,3758.57,5
HCPCS,27598,Amputate lower leg at knee,,,4645.92,5868.53,6
HCPCS,27598,DISARTICULATION KNEE,4488.0,2917.2,535.67,4488.0,35
HCPCS,275980,AMPUTATE LOWER LEG AT KNEE,,,728.42,728.42,1
HCPCS,27599,"ALLOGRAFT STRUT, FEMUR (COMP CODE 27472)",8050.0,5232.5,355.42,8050.0,15
HCPCS,27599,"ARTHROPLASTY FEMORAL/FEMUR/PATELLA, KNEE (COMP CODE 27446)",7365.0,4787.25,355.42,7365.0,15
HCPCS,27599,MANIPULATION KNEE JOINT NOT UNDER GENERAL ANESTHESIA (COMP CODE,769.0,499.85,355.42,769.0,15
HCPCS,27599,OPEN REPAIR OF MEDIAL RETINACULUM (COMP CODE 27424),4096.0,2662.4,355.42,4096.0,15
HCPCS,27599,PERCUTANEOUS ULTRASOUND GUIDED TENOTOMY OF LEFT KNEE (COMP TO 24,2632.0,1710.8,355.42,2632.0,15
HCPCS,27599,STAGE 1 OSSEOINTEGRATION (COMP CODE 27495),7112.0,4622.8,355.42,7112.0,15
HCPCS,27599,UNLISTED PX FEMUR/KNEE,,,240.79,520.1,14
HCPCS,27599,Unlisted px femur/knee,,,310.03,391.62,6
HCPCS,27600,DECOMPRESS ANT/LAT LEG CMPART,2412.0,1567.8,258.3,2412.0,35
HCPCS,27600,DECOMPRESSION OF LOWER LEG,,,419.71,7034.85,15
HCPCS,27600,Decompression of lower leg,,,1992.02,2516.23,6
HCPCS,276000,DECOMPRESSION OF LOWER LEG,,,419.71,419.71,1
HCPCS,27601,DECOMPRESS POST LEG COMPARTMT,2420.0,1573.0,259.02,2420.0,35
HCPCS,27601,DECOMPRESSION OF LOWER LEG,,,463.81,7034.85,15
HCPCS,27601,Decompression of lower leg,,,1992.02,2516.23,6
HCPCS,276010,DECOMPRESSION OF LOWER LEG,,,463.81,463.81,1
HCPCS,27602,DECOMPRESS ANT/LAT+POST LEG CMPART,3128.0,2033.2,321.21,3128.0,35
HCPCS,27602,DECOMPRESSION OF LOWER LEG,,,500.86,7034.85,15
HCPCS,27602,Decompression of lower leg,,,1992.02,2516.23,6
HCPCS,276020,DECOMPRESSION OF LOWER LEG,,,500.86,500.86,1
HCPCS,27603,DRAIN LOWER LEG LESION,,,408.01,6205.4,15
HCPCS,27603,Drain lower leg lesion,,,1112.95,1405.84,6
HCPCS,27603,INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA,2092.0,1359.8,192.0,1569.0,35
HCPCS,276030,DRAIN LOWER LEG LESION,,,408.01,408.01,1
HCPCS,27604,DRAIN LOWER LEG BURSA,,,338.76,7034.85,15
HCPCS,27604,Drain lower leg bursa,,,1992.02,2516.23,6
HCPCS,27604,INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA,1836.0,1193.4,156.32,1377.0,35
HCPCS,276040,DRAIN LOWER LEG BURSA,,,338.76,338.76,1
HCPCS,27605,INCISION OF ACHILLES TENDON,,,191.4,3469.95,15
HCPCS,27605,Incision of achilles tendon,,,1342.37,1695.62,6
HCPCS,27605,TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES,1168.0,759.2,88.44,876.0,35
HCPCS,276050,INCISION OF ACHILLES TENDON,,,191.4,191.4,1
HCPCS,27606,INCISION OF ACHILLES TENDON,,,282.73,7034.85,15
HCPCS,27606,Incision of achilles tendon,,,1992.02,2516.23,6
HCPCS,27606,TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES,1672.0,1086.8,187.18,1672.0,35
HCPCS,276060,INCISION OF ACHILLES TENDON,,,282.73,282.73,1
HCPCS,27607,INCISION LEG/ANKLE,3448.0,2241.2,412.82,3448.0,35
HCPCS,27607,TREAT LOWER LEG BONE LESION,,,629.09,7034.85,15
HCPCS,27607,Treat lower leg bone lesion,,,1992.02,2516.23,6
HCPCS,276070,TREAT LOWER LEG BONE LESION,,,629.09,629.09,1
HCPCS,27610,ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB,3652.0,2373.8,440.56,3652.0,35
HCPCS,27610,EXPLORE/TREAT ANKLE JOINT,,,677.62,7034.85,15
HCPCS,27610,Explore/treat ankle joint,,,1992.02,2516.23,6
HCPCS,276100,EXPLORE/TREAT ANKLE JOINT,,,677.62,677.62,1
HCPCS,27612,ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH,3260.0,2119.0,417.82,3260.0,35
HCPCS,27612,EXPLORATION OF ANKLE JOINT,,,600.45,7034.85,15
HCPCS,27612,Exploration of ankle joint,,,1992.02,2516.23,6
HCPCS,276120,EXPLORATION OF ANKLE JOINT,,,600.45,600.45,1
HCPCS,27613,BIOPSY LOWER LEG SOFT TISSUE,,,168.66,3512.95,15
HCPCS,27613,BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL,888.0,577.2,77.76,666.0,35
HCPCS,27613,Biopsy lower leg soft tissue,,,1112.95,1405.84,6
HCPCS,276130,BIOPSY LOWER LEG SOFT TISSUE,,,168.66,168.66,1
HCPCS,27614,BIOPSY LOWER LEG SOFT TISSUE,,,436.36,6205.4,15
HCPCS,27614,BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP,2320.0,1508.0,201.2,1740.0,35
HCPCS,27614,Biopsy lower leg soft tissue,,,1112.95,1405.84,6
HCPCS,276140,BIOPSY LOWER LEG SOFT TISSUE,,,436.36,436.36,1
HCPCS,27615,RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM,6288.0,4087.2,593.24,6288.0,35
HCPCS,27615,RESECT LEG/ANKLE TUM < 5 CM,,,1065.33,6205.4,15
HCPCS,27615,Resect leg/ankle tum < 5 cm,,,1112.95,1405.84,6
HCPCS,276150,RESECT LEG/ANKLE TUM < 5 CM,,,1065.33,1065.33,1
HCPCS,27616,RESECT LEG/ANKLE TUM 5 CM/>,,,1322.51,6205.4,15
HCPCS,27616,Resect leg/ankle tum 5 cm/>,,,1112.95,1405.84,6
HCPCS,276160,RESECT LEG/ANKLE TUM 5 CM/>,,,1322.51,1322.51,1
HCPCS,27618,EXC LEG/ANKLE TUM < 3 CM,,,321.25,3512.95,15
HCPCS,27618,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM,1584.0,1029.6,149.59,1188.0,35
HCPCS,27618,Exc leg/ankle tum < 3 cm,,,1112.95,1405.84,6
HCPCS,276180,EXC LEG/ANKLE TUM < 3 CM,,,321.25,321.25,1
HCPCS,27619,EXC LEG/ANKLE TUM DEEP <5 CM,,,495.34,6205.4,15
HCPCS,27619,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM,2764.0,1796.6,352.81,2764.0,35
HCPCS,27619,Exc leg/ankle tum deep <5 cm,,,1112.95,1405.84,6
HCPCS,276190,EXC LEG/ANKLE TUM DEEP <5 CM,,,495.34,495.34,1
HCPCS,27620,ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB,2460.0,1599.0,334.69,2460.0,35
HCPCS,27620,EXPLORE/TREAT ANKLE JOINT,,,470.52,7034.85,15
HCPCS,27620,Explore/treat ankle joint,,,1992.02,2516.23,6
HCPCS,276200,EXPLORE/TREAT ANKLE JOINT,,,470.52,470.52,1
HCPCS,27625,ARTHROTOMY W/SYNOVECTOMY ANKLE,3396.0,2207.4,441.74,3396.0,35
HCPCS,27625,REMOVE ANKLE JOINT LINING,,,601.86,7034.85,15
HCPCS,27625,Remove ankle joint lining,,,1992.02,2516.23,6
HCPCS,276250,REMOVE ANKLE JOINT LINING,,,601.86,601.86,1
HCPCS,27626,REMOVE ANKLE JOINT LINING,,,650.91,7034.85,15
HCPCS,27626,Remove ankle joint lining,,,1992.02,2516.23,6
HCPCS,276260,REMOVE ANKLE JOINT LINING,,,650.91,650.91,1
HCPCS,27630,EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK,1976.0,1284.4,174.9,1482.0,35
HCPCS,27630,REMOVAL OF TENDON LESION,,,375.25,7034.85,15
HCPCS,27630,Removal of tendon lesion,,,1992.02,2516.23,6
HCPCS,276300,REMOVAL OF TENDON LESION,,,375.25,375.25,1
HCPCS,27632,EXC LEG/ANKLE LES SC 3 CM/>,,,430.09,430.09,1
HCPCS,27632,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>,16456.0,10696.4,495.87,36332.0,46
HCPCS,27632,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3+CM,2364.0,1536.6,226.5,2364.0,35
HCPCS,276320,EXC LEG/ANKLE LES SC 3 CM/>,,,430.09,430.09,1
HCPCS,27634,EXC LEG/ANKLE TUM DEP 5 CM/>,,,707.25,6205.4,15
HCPCS,27634,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5+CM,4052.0,2633.8,369.64,4052.0,35
HCPCS,27634,Exc leg/ankle tum dep 5 cm/>,,,1992.02,2516.23,6
HCPCS,276340,EXC LEG/ANKLE TUM DEP 5 CM/>,,,707.25,707.25,1
HCPCS,27635,EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA,3212.0,2087.8,441.62,3212.0,35
HCPCS,27635,REMOVE LOWER LEG BONE LESION,,,608.67,7034.85,15
HCPCS,27635,Remove lower leg bone lesion,,,1992.02,2516.23,6
HCPCS,276350,REMOVE LOWER LEG BONE LESION,,,608.67,608.67,1
HCPCS,27637,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT,4124.0,2680.6,515.92,4124.0,35
HCPCS,27637,REMOVE/GRAFT LEG BONE LESION,,,784.33,15488.78,15
HCPCS,27637,Remove/graft leg bone lesion,,,4645.92,5868.53,6
HCPCS,276370,REMOVE/GRAFT LEG BONE LESION,,,784.33,784.33,1
HCPCS,27638,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT,4396.0,2857.4,553.85,4396.0,35
HCPCS,27638,REMOVE/GRAFT LEG BONE LESION,,,780.06,15488.78,15
HCPCS,27638,Remove/graft leg bone lesion,,,4645.92,5868.53,6
HCPCS,276380,REMOVE/GRAFT LEG BONE LESION,,,780.06,780.06,1
HCPCS,27640,PARTIAL EXCISION BONE TIBIA,4896.0,3182.4,610.25,4896.0,35
HCPCS,27640,PARTIAL REMOVAL OF TIBIA,,,872.91,7034.85,15
HCPCS,27640,Partial removal of tibia,,,4645.92,5868.53,6
HCPCS,276400,PARTIAL REMOVAL OF TIBIA,,,872.91,872.91,1
HCPCS,27641,PARTIAL EXCISION BONE FIBULA,3936.0,2558.4,485.15,3936.0,35
HCPCS,27641,PARTIAL REMOVAL OF FIBULA,,,685.62,7034.85,15
HCPCS,27641,Partial removal of fibula,,,1992.02,2516.23,6
HCPCS,276410,PARTIAL REMOVAL OF FIBULA,,,685.62,685.62,1
HCPCS,27645,"RAD RESEC TUMOR,TIBIA",10884.0,7074.6,858.89,10884.0,35
HCPCS,27645,RESECT TIBIA TUMOR,,,1848.5,3758.57,5
HCPCS,27645,Resect tibia tumor,,,4645.92,5868.53,6
HCPCS,276450,RESECT TIBIA TUMOR,,,1848.5,1848.5,1
HCPCS,27646,"RAD RESEC TUMOR,FIBULA",9284.0,6034.6,746.45,9284.0,35
HCPCS,27646,RESECT FIBULA TUMOR,,,1605.7,3758.57,5
HCPCS,27646,Resect fibula tumor,,,4645.92,5868.53,6
HCPCS,276460,RESECT FIBULA TUMOR,,,1605.7,1605.7,1
HCPCS,27647,RADICAL RESECTION OF TUMOR TALUS OR CALCANEUS,8104.0,5267.6,598.92,8104.0,35
HCPCS,27647,RESECT TALUS/CALCANEUS TUM,,,1047.17,7034.85,15
HCPCS,27647,Resect talus/calcaneus tum,,,4645.92,5868.53,6
HCPCS,276470,RESECT TALUS/CALCANEUS TUM,,,1047.17,1047.17,1
HCPCS,27648,INJECTION ANKLE ARTHROGRAPHY,599.0,389.35,36.47,3920.0,111
HCPCS,27648,INJECTION FOR ANKLE X-RAY,,,53.79,53.79,1
HCPCS,276480,INJECTION FOR ANKLE X-RAY,,,53.79,53.79,1
HCPCS,27650,REPAIR ACHILLES TENDON,,,688.79,15488.78,15
HCPCS,27650,REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON,3684.0,2394.6,484.59,3684.0,35
HCPCS,27650,Repair achilles tendon,,,1992.02,2516.23,6
HCPCS,276500,REPAIR ACHILLES TENDON,,,688.79,688.79,1
HCPCS,27652,REPAIR/GRAFT ACHILLES TENDON,,,706.08,15488.78,15
HCPCS,27652,RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT,4312.0,2802.8,518.82,4312.0,35
HCPCS,27652,Repair/graft achilles tendon,,,4645.92,5868.53,6
HCPCS,276520,REPAIR/GRAFT ACHILLES TENDON,,,706.08,706.08,1
HCPCS,27654,REPAIR OF ACHILLES TENDON,,,750.95,15488.78,15
HCPCS,27654,REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT,4212.0,2737.8,536.24,4212.0,35
HCPCS,27654,Repair of achilles tendon,,,4645.92,5868.53,6
HCPCS,276540,REPAIR OF ACHILLES TENDON,,,750.95,750.95,1
HCPCS,27656,REPAIR FASCIAL DEFECT LEG,1884.0,1224.6,171.94,1413.0,35
HCPCS,27656,REPAIR LEG FASCIA DEFECT,,,357.78,7034.85,15
HCPCS,27656,Repair leg fascia defect,,,2390.81,3019.97,6
HCPCS,276560,REPAIR LEG FASCIA DEFECT,,,357.78,357.78,1
HCPCS,27658,REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH,2048.0,1331.2,264.86,2048.0,35
HCPCS,27658,REPAIR OF LEG TENDON EACH,,,387.71,7034.85,15
HCPCS,27658,Repair of leg tendon each,,,1992.02,2516.23,6
HCPCS,276580,REPAIR OF LEG TENDON EACH,,,387.71,387.71,1
HCPCS,27659,REPAIR OF LEG TENDON EACH,,,496.91,15488.78,15
HCPCS,27659,RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH,2840.0,1846.0,350.88,2840.0,35
HCPCS,27659,Repair of leg tendon each,,,4645.92,5868.53,6
HCPCS,276590,REPAIR OF LEG TENDON EACH,,,496.91,496.91,1
HCPCS,27664,REPAIR OF LEG TENDON EACH,,,379.95,15488.78,15
HCPCS,27664,RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH,1892.0,1229.8,242.98,1892.0,35
HCPCS,27664,Repair of leg tendon each,,,1992.02,2516.23,6
HCPCS,276640,REPAIR OF LEG TENDON EACH,,,379.95,379.95,1
HCPCS,27665,REPAIR OF LEG TENDON EACH,,,444.91,15488.78,15
HCPCS,27665,Repair of leg tendon each,,,4645.92,5868.53,6
HCPCS,276650,REPAIR OF LEG TENDON EACH,,,444.91,444.91,1
HCPCS,27675,REPAIR LOWER LEG TENDONS,,,520.98,7034.85,15
HCPCS,27675,RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY,2940.0,1911.0,377.18,2940.0,35
HCPCS,27675,Repair lower leg tendons,,,1992.02,2516.23,6
HCPCS,276750,REPAIR LOWER LEG TENDONS,,,520.98,520.98,1
HCPCS,27676,REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT,3492.0,2269.8,435.46,3492.0,35
HCPCS,27676,REPAIR LOWER LEG TENDONS,,,640.22,15488.78,15
HCPCS,27676,Repair lower leg tendons,,,4645.92,5868.53,6
HCPCS,276760,REPAIR LOWER LEG TENDONS,,,640.22,640.22,1
HCPCS,27680,RELEASE OF LOWER LEG TENDON,,,441.88,7034.85,15
HCPCS,27680,Release of lower leg tendon,,,1992.02,2516.23,6
HCPCS,27680,TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH,2352.0,1528.8,281.22,2352.0,35
HCPCS,276800,RELEASE OF LOWER LEG TENDON,,,441.88,441.88,1
HCPCS,27681,RELEASE OF LOWER LEG TENDONS,,,533.31,7034.85,15
HCPCS,27681,Release of lower leg tendons,,,1992.02,2516.23,6
HCPCS,27681,TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN,2820.0,1833.0,356.45,2820.0,35
HCPCS,276810,RELEASE OF LOWER LEG TENDONS,,,533.31,533.31,1
HCPCS,27685,"LENGTH/SHORT LEG/ANKL TENDON,SINGLE",2676.0,1739.4,226.02,2007.0,35
HCPCS,27685,REVISION OF LOWER LEG TENDON,,,489.56,7034.85,15
HCPCS,27685,Revision of lower leg tendon,,,1992.02,2516.23,6
HCPCS,276850,REVISION OF LOWER LEG TENDON,,,489.56,489.56,1
HCPCS,27686,REVISE LOWER LEG TENDONS,,,559.31,7034.85,15
HCPCS,27686,Revise lower leg tendons,,,1992.02,2516.23,6
HCPCS,276860,REVISE LOWER LEG TENDONS,,,559.31,559.31,1
HCPCS,27687,GASTROCNEMIUS RECESSION,2564.0,1666.6,325.76,2564.0,35
HCPCS,27687,REVISION OF CALF TENDON,,,476.97,7034.85,15
HCPCS,27687,Revision of calf tendon,,,1992.02,2516.23,6
HCPCS,276870,REVISION OF CALF TENDON,,,476.97,476.97,1
HCPCS,27690,REVISE LOWER LEG TENDON,,,668.53,15488.78,15
HCPCS,27690,Revise lower leg tendon,,,4645.92,5868.53,6
HCPCS,27690,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC,3668.0,2384.2,424.77,3668.0,35
HCPCS,276900,REVISE LOWER LEG TENDON,,,668.53,668.53,1
HCPCS,27691,REVISE LOWER LEG TENDON,,,778.79,15488.78,15
HCPCS,27691,Revise lower leg tendon,,,4645.92,5868.53,6
HCPCS,27691,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP,4196.0,2727.4,496.6,4196.0,35
HCPCS,276910,REVISE LOWER LEG TENDON,,,778.79,778.79,1
HCPCS,27692,REVISE ADDITIONAL LEG TENDON,,,106.66,106.66,1
HCPCS,27692,Revise additional leg tendon,,,4645.92,5868.53,6
HCPCS,27692,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN,748.0,486.2,78.38,748.0,35
HCPCS,276920,REVISE ADDITIONAL LEG TENDON,,,106.66,106.66,1
HCPCS,27695,REPAIR OF ANKLE LIGAMENT,,,510.47,15488.78,15
HCPCS,27695,RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL,2680.0,1742.0,365.96,2680.0,35
HCPCS,27695,Repair of ankle ligament,,,4645.92,5868.53,6
HCPCS,276950,REPAIR OF ANKLE LIGAMENT,,,510.47,510.47,1
HCPCS,27696,REPAIR OF ANKLE LIGAMENTS,,,576.31,15488.78,15
HCPCS,27696,RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS,3432.0,2230.8,405.77,3432.0,35
HCPCS,27696,Repair of ankle ligaments,,,4645.92,5868.53,6
HCPCS,276960,REPAIR OF ANKLE LIGAMENTS,,,576.31,576.31,1
HCPCS,27698,REPAIR OF ANKLE LIGAMENT,,,669.71,15488.78,15
HCPCS,27698,REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL,3844.0,2498.6,497.37,3844.0,35
HCPCS,27698,Repair of ankle ligament,,,4645.92,5868.53,6
HCPCS,276980,REPAIR OF ANKLE LIGAMENT,,,669.71,669.71,1
HCPCS,27700,ARTHROPLASTY ANKLE JOINT,3864.0,2511.6,445.28,3864.0,35
HCPCS,27700,REVISION OF ANKLE JOINT,,,748.74,15488.78,15
HCPCS,27700,Revision of ankle joint,,,2190.3,2766.7,6
HCPCS,277000,REVISION OF ANKLE JOINT,,,748.74,748.74,1
HCPCS,27702,ARTHROPLASTY ANKLE W/IMPLANT,5768.0,3749.2,746.57,5768.0,35
HCPCS,27702,RECONSTRUCT ANKLE JOINT,,,1008.81,39872.66,15
HCPCS,27702,Reconstruct ankle joint,,,5660.06,7149.55,6
HCPCS,277020,RECONSTRUCT ANKLE JOINT,,,1008.81,1008.81,1
HCPCS,27703,ARTHROPLASTY ANKLE REVISION TOTAL ANKLE,6776.0,4404.4,793.14,6776.0,35
HCPCS,27703,RECONSTRUCTION ANKLE JOINT,,,1164.01,20141.22,5
HCPCS,27703,Reconstruction ankle joint,,,5660.06,7149.55,6
HCPCS,277030,RECONSTRUCTION ANKLE JOINT,,,1164.01,1164.01,1
HCPCS,27704,REMOVAL OF ANKLE IMPLANT,3124.0,2030.6,372.92,7034.85,50
HCPCS,27704,Removal of ankle implant,,,1992.02,2516.23,6
HCPCS,277040,REMOVAL OF ANKLE IMPLANT,,,594.93,594.93,1
HCPCS,27705,OSTEOTOMY TIBIA,4344.0,2823.6,577.88,15488.78,50
HCPCS,27705,Osteotomy tibia,,,4645.92,5868.53,6
HCPCS,277050,OSTEOTOMY TIBIA,,,786.88,786.88,1
HCPCS,27707,OSTEOTOMY FIBULA,1912.0,1242.8,263.6,7034.85,50
HCPCS,27707,Osteotomy fibula,,,4645.92,5868.53,6
HCPCS,277070,OSTEOTOMY FIBULA,,,425.26,425.26,1
HCPCS,27709,OSTEOTOMY TIBIA & FIBULA,6992.0,4544.8,579.54,27897.39,50
HCPCS,27709,Osteotomy tibia & fibula,,,4645.92,5868.53,6
HCPCS,277090,OSTEOTOMY TIBIA & FIBULA,,,1201.47,1201.47,1
HCPCS,27712,OSTEOT MLT RELIGNMT IMED ROD,,,1156.42,14747.88,5
HCPCS,27712,Osteot mlt relignmt imed rod,,,4645.92,5868.53,6
HCPCS,277120,OSTEOT MLT RELIGNMT IMED ROD,,,1156.42,1156.42,1
HCPCS,27713,OSTEOT TIBIA IMED LNGTH DEV,,,1835.09,8335.26,5
HCPCS,27713,OSTEOT TIBIA UNI INSJ XTRNL CTRLD IMED LNGTH DEV,12320.0,8008.0,1912.09,12320.0,21
HCPCS,27713,Osteot tibia imed lngth dev,,,4645.92,5868.53,6
HCPCS,277130,OSTEOT TIBIA IMED LNGTH DEV,,,1835.09,1835.09,1
HCPCS,27715,OSTEOPLASTY TIBIA & FIBULA LENGTHENING/SHORTENIN,6200.0,4030.0,740.56,6200.0,35
HCPCS,27715,OSTPL TIBFIB LNGTH/SHRT,,,1124.8,14747.88,5
HCPCS,27715,Ostpl tibfib lngth/shrt,,,4645.92,5868.53,6
HCPCS,277150,OSTPL TIBFIB LNGTH/SHRT,,,1124.8,1124.8,1
HCPCS,27720,REPAIR NONUNION/MALUNION TIBIA W/O GRAFT,4944.0,3213.6,647.92,4944.0,35
HCPCS,27720,REPAIR OF TIBIA,,,915.35,15488.78,15
HCPCS,27720,Repair of tibia,,,3366.74,4252.73,6
HCPCS,277200,REPAIR OF TIBIA,,,915.35,915.35,1
HCPCS,27722,REPAIR/GRAFT OF TIBIA,,,939.97,15488.78,15
HCPCS,27722,Repair/graft of tibia,,,3366.74,4252.73,6
HCPCS,277220,REPAIR/GRAFT OF TIBIA,,,939.97,939.97,1
HCPCS,27724,REPAIR/GRAFT OF TIBIA,,,1315.08,8335.26,5
HCPCS,27724,RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT,7724.0,5020.6,836.5,7724.0,35
HCPCS,27724,Repair/graft of tibia,,,3366.74,4252.73,6
HCPCS,277240,REPAIR/GRAFT OF TIBIA,,,1315.08,1315.08,1
HCPCS,27725,REPAIR OF LOWER LEG,,,1275.09,8335.26,5
HCPCS,27725,Repair of lower leg,,,4645.92,5868.53,6
HCPCS,277250,REPAIR OF LOWER LEG,,,1275.09,1275.09,1
HCPCS,27726,REPAIR FIBULA NONUNION,,,1002.76,15488.78,15
HCPCS,27726,REPAIR FIBULA NONUNION/MALUNION W/INT FIXATION,5736.0,3728.4,537.94,5736.0,35
HCPCS,27726,Repair fibula nonunion,,,3366.74,4252.73,6
HCPCS,277260,REPAIR FIBULA NONUNION,,,1002.76,1002.76,1
HCPCS,27727,REPAIR OF LOWER LEG,,,1089.94,3758.57,5
HCPCS,27727,Repair of lower leg,,,4645.92,5868.53,6
HCPCS,277270,REPAIR OF LOWER LEG,,,1089.94,1089.94,1
HCPCS,27730,REPAIR OF TIBIA EPIPHYSIS,,,620.47,7034.85,15
HCPCS,27730,Repair of tibia epiphysis,,,1992.02,2516.23,6
HCPCS,277300,REPAIR OF TIBIA EPIPHYSIS,,,620.47,620.47,1
HCPCS,27732,REPAIR OF FIBULA EPIPHYSIS,,,479.01,7034.85,15
HCPCS,27732,Repair of fibula epiphysis,,,1992.02,2516.23,6
HCPCS,277320,REPAIR OF FIBULA EPIPHYSIS,,,479.01,479.01,1
HCPCS,27734,ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA,3532.0,2295.8,440.61,3532.0,35
HCPCS,27734,REPAIR LOWER LEG EPIPHYSES,,,693.18,7034.85,15
HCPCS,27734,Repair lower leg epiphyses,,,1992.02,2516.23,6
HCPCS,277340,REPAIR LOWER LEG EPIPHYSES,,,693.18,693.18,1
HCPCS,27740,ARREST EPIPHYSEAL ANY METHOD TIBIA & FIBULA,3844.0,2498.6,456.19,3844.0,35
HCPCS,27740,REPAIR OF LEG EPIPHYSES,,,745.91,7034.85,15
HCPCS,27740,Repair of leg epiphyses,,,1992.02,2516.23,6
HCPCS,277400,REPAIR OF LEG EPIPHYSES,,,745.91,745.91,1
HCPCS,27742,REPAIR OF LEG EPIPHYSES,,,817.89,7034.85,15
HCPCS,27742,Repair of leg epiphyses,,,1992.02,2516.23,6
HCPCS,277420,REPAIR OF LEG EPIPHYSES,,,817.89,817.89,1
HCPCS,27745,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA,4196.0,2727.4,527.71,4196.0,35
HCPCS,27745,REINFORCE TIBIA,,,782.92,15488.78,16
HCPCS,27745,Reinforce tibia,,,4645.92,5868.53,6
HCPCS,277450,REINFORCE TIBIA,,,782.92,782.92,1
HCPCS,27750,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1363.5,886.2750000000001,177.09,4151.0,179
HCPCS,27750,TREATMENT OF TIBIA FRACTURE,,,344.51,344.51,1
HCPCS,277500,TREATMENT OF TIBIA FRACTURE,,,344.51,344.51,1
HCPCS,27752,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,5855.5,3806.075,247.32,8550.0,133
HCPCS,27752,TREATMENT OF TIBIA FRACTURE,,,520.26,520.26,1
HCPCS,277520,TREATMENT OF TIBIA FRACTURE,,,520.26,520.26,1
HCPCS,27756,PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE,2980.0,1937.0,412.8,2980.0,35
HCPCS,27756,TREATMENT OF TIBIA FRACTURE,,,608.2,15488.78,15
HCPCS,27756,Treatment of tibia fracture,,,3366.74,4252.73,6
HCPCS,277560,TREATMENT OF TIBIA FRACTURE,,,608.2,608.2,1
HCPCS,27758,OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,5016.0,3260.4,667.21,5016.0,35
HCPCS,27758,TREATMENT OF TIBIA FRACTURE,,,941.2,27897.39,15
HCPCS,27758,Treatment of tibia fracture,,,3366.74,4252.73,6
HCPCS,277580,TREATMENT OF TIBIA FRACTURE,,,941.2,941.2,1
HCPCS,27759,TREATMENT OF TIBIA FRACTURE,,,1045.92,27897.39,16
HCPCS,27759,TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA,5780.0,3757.0,746.29,5780.0,35
HCPCS,27759,Treatment of tibia fracture,,,3366.74,4252.73,6
HCPCS,277590,TREATMENT OF TIBIA FRACTURE,,,1045.92,1045.92,1
HCPCS,27760,CLTX MEDIAL ANKLE FX,,,327.83,327.83,1
HCPCS,27760,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1331.5,865.475,151.89,4151.0,179
HCPCS,277600,CLTX MEDIAL ANKLE FX,,,327.83,327.83,1
HCPCS,27762,CLTX MED ANKLE FX W/MNPJ,,,469.83,469.83,1
HCPCS,27762,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,5695.5,3702.075,234.3,8550.0,133
HCPCS,277620,CLTX MED ANKLE FX W/MNPJ,,,469.83,469.83,1
HCPCS,27766,OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE,3156.0,2051.4,443.6,3156.0,35
HCPCS,27766,OPTX MEDIAL ANKLE FX,,,635.05,15488.78,16
HCPCS,27766,Optx medial ankle fx,,,3366.74,4252.73,6
HCPCS,277660,OPTX MEDIAL ANKLE FX,,,635.05,635.05,1
HCPCS,27767,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1217.5,791.375,143.17,4151.0,130
HCPCS,27767,CLTX POST ANKLE FX,,,307.27,307.27,1
HCPCS,277670,CLTX POST ANKLE FX,,,307.27,307.27,1
HCPCS,27768,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,5629.5,3659.175,235.1,8282.7,133
HCPCS,27768,CLTX POST ANKLE FX W/MNPJ,,,475.76,475.76,1
HCPCS,277680,CLTX POST ANKLE FX W/MNPJ,,,475.76,475.76,1
HCPCS,27769,OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE,4056.0,2636.4,407.07,4056.0,35
HCPCS,27769,OPTX POST ANKLE FX,,,763.29,15488.78,15
HCPCS,27769,Optx post ankle fx,,,3366.74,4252.73,6
HCPCS,277690,OPTX POST ANKLE FX,,,763.29,763.29,1
HCPCS,27780,CLTX PROX FIBULA/SHFT FX W/O MANJ,1255.5,816.075,141.21,4151.0,179
HCPCS,27780,TREATMENT OF FIBULA FRACTURE,,,303.57,303.57,1
HCPCS,277800,TREATMENT OF FIBULA FRACTURE,,,303.57,303.57,1
HCPCS,27781,CLTX PROX FIBULA/SHFT FX W/MANJ,5519.5,3587.675,208.36,8550.0,133
HCPCS,27781,TREATMENT OF FIBULA FRACTURE,,,429.42,429.42,1
HCPCS,277810,TREATMENT OF FIBULA FRACTURE,,,429.42,429.42,1
HCPCS,27784,OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE,3868.0,2514.2,356.92,3868.0,35
HCPCS,27784,TREATMENT OF FIBULA FRACTURE,,,751.89,15488.78,15
HCPCS,27784,Treatment of fibula fracture,,,3366.74,4252.73,6
HCPCS,277840,TREATMENT OF FIBULA FRACTURE,,,751.89,751.89,1
HCPCS,27786,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1293.5,840.7750000000001,142.68,4151.0,228
HCPCS,27786,TREATMENT OF ANKLE FRACTURE,,,305.8,305.8,1
HCPCS,277860,TREATMENT OF ANKLE FRACTURE,,,305.8,305.8,1
HCPCS,27788,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,1617.5,1051.375,215.45,4151.0,179
HCPCS,27788,TREATMENT OF ANKLE FRACTURE,,,410.21,410.21,1
HCPCS,277880,TREATMENT OF ANKLE FRACTURE,,,410.21,410.21,1
HCPCS,27792,OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS,3500.0,2275.0,411.62,3500.0,35
HCPCS,27792,TREATMENT OF ANKLE FRACTURE,,,677.68,15488.78,15
HCPCS,27792,Treatment of ankle fracture,,,3366.74,4252.73,6
HCPCS,277920,TREATMENT OF ANKLE FRACTURE,,,677.68,677.68,1
HCPCS,27808,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1295.5,842.075,151.39,4151.0,179
HCPCS,27808,TREATMENT OF ANKLE FRACTURE,,,325.62,325.62,1
HCPCS,278080,TREATMENT OF ANKLE FRACTURE,,,325.62,325.62,1
HCPCS,27810,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,5665.5,3682.575,260.51,8282.7,133
HCPCS,27810,TREATMENT OF ANKLE FRACTURE,,,456.45,456.45,1
HCPCS,278100,TREATMENT OF ANKLE FRACTURE,,,456.45,456.45,1
HCPCS,27814,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE,4248.0,2761.2,565.31,4248.0,35
HCPCS,27814,TREATMENT OF ANKLE FRACTURE,,,802.42,15488.78,15
HCPCS,27814,Treatment of ankle fracture,,,3366.74,4252.73,6
HCPCS,278140,TREATMENT OF ANKLE FRACTURE,,,802.42,802.42,1
HCPCS,27816,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1365.0,887.25,181.7,4151.0,179
HCPCS,27816,TREATMENT OF ANKLE FRACTURE,,,314.04,314.04,1
HCPCS,278160,TREATMENT OF ANKLE FRACTURE,,,314.04,314.04,1
HCPCS,27818,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,5853.5,3804.7749999999996,304.85,8282.7,133
HCPCS,27818,TREATMENT OF ANKLE FRACTURE,,,469.74,469.74,1
HCPCS,278180,TREATMENT OF ANKLE FRACTURE,,,469.74,469.74,1
HCPCS,27822,OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP,4484.0,2914.6,615.53,4484.0,35
HCPCS,27822,TREATMENT OF ANKLE FRACTURE,,,912.49,15488.78,15
HCPCS,27822,Treatment of ankle fracture,,,3366.74,4252.73,6
HCPCS,278220,TREATMENT OF ANKLE FRACTURE,,,912.49,912.49,1
HCPCS,27823,OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP,5264.0,3421.6,754.57,5264.0,35
HCPCS,27823,TREATMENT OF ANKLE FRACTURE,,,1029.55,15488.78,15
HCPCS,27823,Treatment of ankle fracture,,,3366.74,4252.73,6
HCPCS,278230,TREATMENT OF ANKLE FRACTURE,,,1029.55,1029.55,1
HCPCS,27824,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1351.5,878.475,187.19,4151.0,179
HCPCS,27824,TREAT LOWER LEG FRACTURE,,,324.72,324.72,1
HCPCS,278240,TREAT LOWER LEG FRACTURE,,,324.72,324.72,1
HCPCS,27825,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,5939.5,3860.675,310.03,8550.0,133
HCPCS,27825,TREAT LOWER LEG FRACTURE,,,522.72,522.72,1
HCPCS,278250,TREAT LOWER LEG FRACTURE,,,522.72,522.72,1
HCPCS,27826,OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA,4440.0,2886.0,551.86,4440.0,35
HCPCS,27826,TREAT LOWER LEG FRACTURE,,,891.89,15488.78,15
HCPCS,27826,Treat lower leg fracture,,,3366.74,4252.73,6
HCPCS,278260,TREAT LOWER LEG FRACTURE,,,891.89,891.89,1
HCPCS,27827,OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY,5916.0,3845.4,688.58,5916.0,35
HCPCS,27827,TREAT LOWER LEG FRACTURE,,,1169.97,27897.39,16
HCPCS,27827,Treat lower leg fracture,,,3366.74,4252.73,6
HCPCS,278270,TREAT LOWER LEG FRACTURE,,,1169.97,1169.97,1
HCPCS,27828,OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA,7372.0,4791.8,797.39,7372.0,35
HCPCS,27828,TREAT LOWER LEG FRACTURE,,,1386.51,27897.39,15
HCPCS,27828,Treat lower leg fracture,,,3366.74,4252.73,6
HCPCS,278280,TREAT LOWER LEG FRACTURE,,,1386.51,1386.51,1
HCPCS,27829,OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION,3520.0,2288.0,366.17,3520.0,35
HCPCS,27829,TREAT LOWER LEG JOINT,,,738.84,15488.78,15
HCPCS,27829,Treat lower leg joint,,,3366.74,4252.73,6
HCPCS,278290,TREAT LOWER LEG JOINT,,,738.84,738.84,1
HCPCS,27830,CLTX PROX TIBFIB JT DISLC W/O ANES,1379.0,896.35,240.79,4151.0,49
HCPCS,27830,TREAT LOWER LEG DISLOCATION,,,383.36,383.36,1
HCPCS,278300,TREAT LOWER LEG DISLOCATION,,,383.36,383.36,1
HCPCS,27831,TREAT LOWER LEG DISLOCATION,,,433.73,7034.85,15
HCPCS,27831,Treat lower leg dislocation,,,310.03,391.62,6
HCPCS,278310,TREAT LOWER LEG DISLOCATION,,,433.73,433.73,1
HCPCS,27832,TREAT LOWER LEG DISLOCATION,,,797.64,15488.78,15
HCPCS,27832,Treat lower leg dislocation,,,3366.74,4252.73,6
HCPCS,278320,TREAT LOWER LEG DISLOCATION,,,797.64,797.64,1
HCPCS,27840,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,1643.5,1068.275,188.39,4151.0,179
HCPCS,27840,TREAT ANKLE DISLOCATION,,,412.53,412.53,1
HCPCS,278400,TREAT ANKLE DISLOCATION,,,412.53,412.53,1
HCPCS,27842,CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ,2584.0,1679.6,258.48,2584.0,35
HCPCS,27842,TREAT ANKLE DISLOCATION,,,520.97,3469.95,15
HCPCS,27842,Treat ankle dislocation,,,632.74,799.25,6
HCPCS,278420,TREAT ANKLE DISLOCATION,,,520.97,520.97,1
HCPCS,27846,OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ,4112.0,2672.8,502.13,4112.0,35
HCPCS,27846,TREAT ANKLE DISLOCATION,,,764.76,15488.78,15
HCPCS,27846,Treat ankle dislocation,,,3366.74,4252.73,6
HCPCS,278460,TREAT ANKLE DISLOCATION,,,764.76,764.76,1
HCPCS,27848,OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ,4672.0,3036.8,592.15,4672.0,35
HCPCS,27848,TREAT ANKLE DISLOCATION,,,829.25,15488.78,15
HCPCS,27848,Treat ankle dislocation,,,3366.74,4252.73,6
HCPCS,278480,TREAT ANKLE DISLOCATION,,,829.25,829.25,1
HCPCS,27860,FIXATION OF ANKLE JOINT,,,171.21,7034.85,15
HCPCS,27860,Fixation of ankle joint,,,632.74,799.25,6
HCPCS,27860,MANIPULATION ANKLE UNDER GENERAL ANESTHESIA,956.0,621.4,109.32,956.0,35
HCPCS,278600,FIXATION OF ANKLE JOINT,,,171.21,171.21,1
HCPCS,27870,ARTHRODESIS ANKLE OPEN,6164.0,4006.6,744.35,6164.0,35
HCPCS,27870,FUSION OF ANKLE JOINT OPEN,,,1057.67,27897.39,15
HCPCS,27870,Fusion of ankle joint open,,,4645.92,5868.53,6
HCPCS,278700,FUSION OF ANKLE JOINT OPEN,,,1057.67,1057.67,1
HCPCS,27871,ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL,3816.0,2480.4,472.78,3816.0,35
HCPCS,27871,FUSION OF TIBIOFIBULAR JOINT,,,725.66,27897.39,15
HCPCS,27871,Fusion of tibiofibular joint,,,4645.92,5868.53,6
HCPCS,278710,FUSION OF TIBIOFIBULAR JOINT,,,725.66,725.66,1
HCPCS,27880,AMPUTATION LOW LEG THRU TIB/FIB,6148.0,3996.2,559.65,6148.0,35
HCPCS,27880,AMPUTATION OF LOWER LEG,,,944.27,8335.26,5
HCPCS,27880,Amputation of lower leg,,,4645.92,5868.53,6
HCPCS,278800,AMPUTATION OF LOWER LEG,,,944.27,944.27,1
HCPCS,27881,AMP LEG THRU TIBFIB W/IMMT FITG TQ W/1ST CST,5388.0,3502.2,635.76,5388.0,35
HCPCS,27881,AMPUTATION OF LOWER LEG,,,882.39,3758.57,5
HCPCS,27881,Amputation of lower leg,,,4645.92,5868.53,6
HCPCS,278810,AMPUTATION OF LOWER LEG,,,882.39,882.39,1
HCPCS,27882,AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR,3916.0,2545.4,439.12,3916.0,35
HCPCS,27882,AMPUTATION OF LOWER LEG,,,621.09,3758.57,5
HCPCS,27882,Amputation of lower leg,,,4645.92,5868.53,6
HCPCS,278820,AMPUTATION OF LOWER LEG,,,621.09,621.09,1
HCPCS,27884,AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV,3504.0,2277.6,336.6,3504.0,35
HCPCS,27884,AMPUTATION FOLLOW-UP SURGERY,,,606.52,7034.85,15
HCPCS,27884,Amputation follow-up surgery,,,1992.02,2516.23,6
HCPCS,278840,AMPUTATION FOLLOW-UP SURGERY,,,606.52,606.52,1
HCPCS,27886,AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION,4008.0,2605.2,461.19,4008.0,35
HCPCS,27886,AMPUTATION FOLLOW-UP SURGERY,,,679.94,3758.57,5
HCPCS,27886,Amputation follow-up surgery,,,1992.02,2516.23,6
HCPCS,278860,AMPUTATION FOLLOW-UP SURGERY,,,679.94,679.94,1
HCPCS,27888,AMPUTATION OF FOOT AT ANKLE,,,605.19,3758.57,5
HCPCS,27888,Amputation of foot at ankle,,,4645.92,5868.53,6
HCPCS,278880,AMPUTATION OF FOOT AT ANKLE,,,605.19,605.19,1
HCPCS,27889,ANKLE DISARTICULATION,,,673.09,15488.78,15
HCPCS,27889,Ankle disarticulation,,,4645.92,5868.53,6
HCPCS,278890,ANKLE DISARTICULATION,,,673.09,673.09,1
HCPCS,27892,DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE,3176.0,2064.4,298.02,3176.0,35
HCPCS,27892,DECOMPRESSION OF LEG,,,563.32,7034.85,15
HCPCS,27892,Decompression of leg,,,2390.81,3019.97,6
HCPCS,278920,DECOMPRESSION OF LEG,,,563.32,563.32,1
HCPCS,27893,DECOMPRESSION OF LEG,,,646.51,15488.78,15
HCPCS,27893,Decompression of leg,,,2390.81,3019.97,6
HCPCS,278930,DECOMPRESSION OF LEG,,,646.51,646.51,1
HCPCS,27894,DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS,5068.0,3294.2,451.77,5068.0,35
HCPCS,27894,DECOMPRESSION OF LEG,,,855.24,7034.85,15
HCPCS,27894,Decompression of leg,,,2390.81,3019.97,6
HCPCS,278940,DECOMPRESSION OF LEG,,,855.24,855.24,1
HCPCS,27899,ASPIRATION OF INTRAMUSCULAR HEMATOMA (COMP CODE 10160),739.0,480.34999999999997,225.5,13665.0,60
HCPCS,27899,"EXCISION OF ACCESSORY SOLEUS MUSCLE, LEG OR ANKLE AREA (COMP COD",2972.0,1931.8,340.23,2972.0,15
HCPCS,27899,REPAIR/SUTURE MUSCLE LOWER LEG (COMP CODE 27658),1844.0,1198.6,340.23,1844.0,15
HCPCS,27899,UNLISTED PROCEDURE LEG OR ANKLE,651.0,423.15,182.93,13665.0,96
HCPCS,27899,"WIRE NEEDLE LOC, FB, LEG/ANKLE UNLISTED",1114.0,724.1,340.23,1114.0,15
HCPCS,28001,DRAINAGE OF BURSA OF FOOT,,,100.81,3512.95,15
HCPCS,28001,Drainage of bursa of foot,,,1342.37,1695.62,6
HCPCS,28001,INCIS/DRAINAGE BURSA OF FOOT,800.0,520.0,73.04,600.0,35
HCPCS,280010,DRAINAGE OF BURSA OF FOOT,,,100.81,100.81,1
HCPCS,28002,I&D BELOW FASCIA FOOT 1 BURSAL SPACE,1116.0,725.4,125.22,837.0,35
HCPCS,28002,TREATMENT OF FOOT INFECTION,,,147.25,3469.95,15
HCPCS,28002,Treatment of foot infection,,,1342.37,1695.62,6
HCPCS,280020,TREATMENT OF FOOT INFECTION,,,147.25,147.25,1
HCPCS,28003,I&D BELOW FASCIA FOOT MULTIPLE AREAS,2112.0,1372.8,236.95,1584.0,35
HCPCS,28003,TREATMENT OF FOOT INFECTION,,,271.9,7034.85,15
HCPCS,28003,Treatment of foot infection,,,1112.95,1405.84,6
HCPCS,280030,TREATMENT OF FOOT INFECTION,,,271.9,271.9,1
HCPCS,28005,INCISION BONE CORTEX FOOT,3776.0,2454.4,364.27,3776.0,35
HCPCS,28005,TREAT FOOT BONE LESION,,,598.49,7034.85,15
HCPCS,28005,Treat foot bone lesion,,,3613.7,4564.67,6
HCPCS,280050,TREAT FOOT BONE LESION,,,598.49,598.49,1
HCPCS,28008,FASCIOTOMY FOOT&/TOE,1836.0,1193.4,142.19,1377.0,35
HCPCS,28008,INCISION OF FOOT FASCIA,,,308.3,7034.85,15
HCPCS,28008,Incision of foot fascia,,,1342.37,1695.62,6
HCPCS,280080,INCISION OF FOOT FASCIA,,,308.3,308.3,1
HCPCS,28010,INCISION OF TOE TENDON,,,217.59,3469.95,15
HCPCS,28010,Incision of toe tendon,,,1342.37,1695.62,6
HCPCS,28010,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,1188.0,772.2,149.95,891.0,35
HCPCS,280100,INCISION OF TOE TENDON,,,217.59,217.59,1
HCPCS,28011,INCISION OF TOE TENDONS,,,292.81,3469.95,15
HCPCS,28011,Incision of toe tendons,,,1342.37,1695.62,6
HCPCS,280110,INCISION OF TOE TENDONS,,,292.81,292.81,1
HCPCS,28020,ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT,2060.0,1339.0,236.87,1545.0,35
HCPCS,28020,EXPLORATION OF FOOT JOINT,,,382.3,7034.85,15
HCPCS,28020,Exploration of foot joint,,,1342.37,1695.62,6
HCPCS,280200,EXPLORATION OF FOOT JOINT,,,382.3,382.3,1
HCPCS,28022,ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT,1924.0,1250.6,157.98,1443.0,35
HCPCS,28022,EXPLORATION OF FOOT JOINT,,,342.98,7034.85,15
HCPCS,28022,Exploration of foot joint,,,1342.37,1695.62,6
HCPCS,280220,EXPLORATION OF FOOT JOINT,,,342.98,342.98,1
HCPCS,28024,ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT,1808.0,1175.2,146.79,1356.0,35
HCPCS,28024,EXPLORATION OF TOE JOINT,,,322.7,3469.95,15
HCPCS,28024,Exploration of toe joint,,,1342.37,1695.62,6
HCPCS,280240,EXPLORATION OF TOE JOINT,,,322.7,322.7,1
HCPCS,28035,DECOMPRESSION OF TIBIA NERVE,,,375.55,4233.93,15
HCPCS,28035,Decompression of tibia nerve,,,1992.02,2516.23,6
HCPCS,28035,RELEASE TARSAL TUNNEL,2092.0,1359.8,190.64,1569.0,35
HCPCS,280350,DECOMPRESSION OF TIBIA NERVE,,,375.55,375.55,1
HCPCS,28039,EXC FOOT/TOE TUM SC 1.5 CM/>,,,355.06,6205.4,15
HCPCS,28039,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ 1.5+CM,2168.0,1409.2,168.33,1626.0,35
HCPCS,28039,Exc foot/toe tum sc 1.5 cm/>,,,1342.37,1695.62,6
HCPCS,280390,EXC FOOT/TOE TUM SC 1.5 CM/>,,,355.06,355.06,1
HCPCS,28041,EXC FOOT/TOE TUM DEP 1.5CM/>,,,472.93,6205.4,15
HCPCS,28041,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5+CM,2852.0,1853.8,243.82,2852.0,35
HCPCS,28041,Exc foot/toe tum dep 1.5cm/>,,,1342.37,1695.62,6
HCPCS,280410,EXC FOOT/TOE TUM DEP 1.5CM/>,,,472.93,472.93,1
HCPCS,28043,EXC FOOT/TOE TUM SC < 1.5 CM,,,273.45,273.45,1
HCPCS,28043,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM,5450.0,3542.5,125.43,8384.4,81
HCPCS,280430,EXC FOOT/TOE TUM SC < 1.5 CM,,,273.45,273.45,1
HCPCS,28045,EXC FOOT/TOE TUM DEEP <1.5CM,,,363.6,6205.4,15
HCPCS,28045,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM,2180.0,1417.0,166.69,1635.0,35
HCPCS,28045,Exc foot/toe tum deep <1.5cm,,,1342.37,1695.62,6
HCPCS,280450,EXC FOOT/TOE TUM DEEP <1.5CM,,,363.6,363.6,1
HCPCS,28046,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM,4952.0,3218.8,439.76,4952.0,35
HCPCS,28046,RESECT FOOT/TOE TUMOR < 3 CM,,,734.43,6205.4,15
HCPCS,28046,Resect foot/toe tumor < 3 cm,,,3613.7,4564.67,6
HCPCS,280460,RESECT FOOT/TOE TUMOR < 3 CM,,,734.43,734.43,1
HCPCS,28047,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3+CM,6980.0,4537.0,515.74,6980.0,35
HCPCS,28047,RESECT FOOT/TOE TUMOR 3 CM/>,,,1086.79,6205.4,15
HCPCS,28047,Resect foot/toe tumor 3 cm/>,,,3613.7,4564.67,6
HCPCS,280470,RESECT FOOT/TOE TUMOR 3 CM/>,,,1086.79,1086.79,1
HCPCS,28050,BIOPSY OF FOOT JOINT LINING,,,292.32,7034.85,15
HCPCS,28050,Biopsy of foot joint lining,,,1342.37,1695.62,6
HCPCS,280500,BIOPSY OF FOOT JOINT LINING,,,292.32,292.32,1
HCPCS,28052,BIOPSY OF FOOT JOINT LINING,,,268.22,7034.85,15
HCPCS,28052,Biopsy of foot joint lining,,,1342.37,1695.62,6
HCPCS,280520,BIOPSY OF FOOT JOINT LINING,,,268.22,268.22,1
HCPCS,28054,BIOPSY OF TOE JOINT LINING,,,244.81,7034.85,15
HCPCS,28054,Biopsy of toe joint lining,,,1342.37,1695.62,6
HCPCS,280540,BIOPSY OF TOE JOINT LINING,,,244.81,244.81,1
HCPCS,28055,NEURECTOMY FOOT,,,408.5,4233.93,15
HCPCS,28055,Neurectomy foot,,,3613.7,4564.67,6
HCPCS,280550,NEURECTOMY FOOT,,,408.5,408.5,1
HCPCS,28060,FASCIECTOMY PLANTAR FASCIA PARTIAL SPX,2160.0,1404.0,174.73,1620.0,35
HCPCS,28060,PARTIAL REMOVAL FOOT FASCIA,,,377.46,7034.85,15
HCPCS,28060,Partial removal foot fascia,,,1342.37,1695.62,6
HCPCS,280600,PARTIAL REMOVAL FOOT FASCIA,,,377.46,377.46,1
HCPCS,28062,REMOVAL OF FOOT FASCIA,,,424.3,7034.85,15
HCPCS,28062,Removal of foot fascia,,,1342.37,1695.62,6
HCPCS,280620,REMOVAL OF FOOT FASCIA,,,424.3,424.3,1
HCPCS,28070,REMOVAL OF FOOT JOINT LINING,,,359.09,15488.78,15
HCPCS,28070,Removal of foot joint lining,,,1342.37,1695.62,6
HCPCS,280700,REMOVAL OF FOOT JOINT LINING,,,359.09,359.09,1
HCPCS,28072,REMOVAL OF FOOT JOINT LINING,,,340.72,7034.85,15
HCPCS,28072,Removal of foot joint lining,,,1342.37,1695.62,6
HCPCS,28072,SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH,1888.0,1227.2,157.15,1416.0,35
HCPCS,280720,REMOVAL OF FOOT JOINT LINING,,,340.72,340.72,1
HCPCS,28080,EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH,1944.0,1263.6,181.97,1458.0,35
HCPCS,28080,REMOVAL OF FOOT LESION,,,394.09,3469.95,15
HCPCS,28080,Removal of foot lesion,,,1342.37,1695.62,6
HCPCS,280800,REMOVAL OF FOOT LESION,,,394.09,394.09,1
HCPCS,28086,EXCISE FOOT TENDON SHEATH,,,366.37,7034.85,15
HCPCS,28086,Excise foot tendon sheath,,,1342.37,1695.62,6
HCPCS,28086,"SYNOVECTOMY FLEX TENDN SHEATH,FOOT",1968.0,1279.2,172.77,1476.0,35
HCPCS,280860,EXCISE FOOT TENDON SHEATH,,,366.37,366.37,1
HCPCS,28088,EXCISE FOOT TENDON SHEATH,,,307.3,7034.85,15
HCPCS,28088,Excise foot tendon sheath,,,1342.37,1695.62,6
HCPCS,28088,"SYNOVECTOMY EXTEN TENDN SHEATH,FOOT",1592.0,1034.8,139.23,1194.0,35
HCPCS,280880,EXCISE FOOT TENDON SHEATH,,,307.3,307.3,1
HCPCS,28090,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT,1820.0,1183.0,148.44,1365.0,35
HCPCS,28090,REMOVAL OF FOOT LESION,,,323.17,3469.95,15
HCPCS,28090,Removal of foot lesion,,,1342.37,1695.62,6
HCPCS,280900,REMOVAL OF FOOT LESION,,,323.17,323.17,1
HCPCS,28092,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA,1512.0,982.8,130.03,1134.0,35
HCPCS,28092,REMOVAL OF TOE LESIONS,,,284.98,3469.95,15
HCPCS,28092,Removal of toe lesions,,,1342.37,1695.62,6
HCPCS,280920,REMOVAL OF TOE LESIONS,,,284.98,284.98,1
HCPCS,28100,EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS,2332.0,1515.8,203.99,1749.0,35
HCPCS,28100,REMOVAL OF ANKLE/HEEL LESION,,,437.21,7034.85,16
HCPCS,28100,Removal of ankle/heel lesion,,,3613.7,4564.67,6
HCPCS,281000,REMOVAL OF ANKLE/HEEL LESION,,,437.21,437.21,1
HCPCS,28102,REMOVE/GRAFT FOOT LESION,,,643.29,15488.78,15
HCPCS,28102,Remove/graft foot lesion,,,3613.7,4564.67,6
HCPCS,281020,REMOVE/GRAFT FOOT LESION,,,643.29,643.29,1
HCPCS,28103,EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT,2668.0,1734.2,300.77,2668.0,35
HCPCS,28103,REMOVE/GRAFT FOOT LESION,,,406.48,15488.78,15
HCPCS,28103,Remove/graft foot lesion,,,3613.7,4564.67,6
HCPCS,281030,REMOVE/GRAFT FOOT LESION,,,406.48,406.48,1
HCPCS,28104,EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL,2104.0,1367.6,170.63,1578.0,35
HCPCS,28104,REMOVAL OF FOOT LESION,,,371.62,7034.85,15
HCPCS,28104,Removal of foot lesion,,,1342.37,1695.62,6
HCPCS,281040,REMOVAL OF FOOT LESION,,,371.62,371.62,1
HCPCS,28106,REMOVE/GRAFT FOOT LESION,,,446.91,15488.78,15
HCPCS,28106,Remove/graft foot lesion,,,3613.7,4564.67,6
HCPCS,281060,REMOVE/GRAFT FOOT LESION,,,446.91,446.91,1
HCPCS,28107,REMOVE/GRAFT FOOT LESION,,,362.88,15488.78,15
HCPCS,28107,Remove/graft foot lesion,,,3613.7,4564.67,6
HCPCS,281070,REMOVE/GRAFT FOOT LESION,,,362.88,362.88,1
HCPCS,28108,EXC/CURTG CST/B9 TUM PHALANGES FOOT,1720.0,1118.0,138.9,1290.0,35
HCPCS,28108,REMOVAL OF TOE LESIONS,,,302.09,3469.95,15
HCPCS,28108,Removal of toe lesions,,,1342.37,1695.62,6
HCPCS,281080,REMOVAL OF TOE LESIONS,,,302.09,302.09,1
HCPCS,28110,OSTECTOMY PRTL 5TH METAR HEAD SPX,1688.0,1097.2,140.38,1266.0,35
HCPCS,28110,PART REMOVAL OF METATARSAL,,,307.24,7034.85,15
HCPCS,28110,Part removal of metatarsal,,,3613.7,4564.67,6
HCPCS,281100,PART REMOVAL OF METATARSAL,,,307.24,307.24,1
HCPCS,28111,OSTECTOMY COMPLETE 1ST METATARSAL HEAD,2060.0,1339.0,158.68,1545.0,35
HCPCS,28111,PART REMOVAL OF METATARSAL,,,334.48,7034.85,15
HCPCS,28111,Part removal of metatarsal,,,1342.37,1695.62,6
HCPCS,281110,PART REMOVAL OF METATARSAL,,,334.48,334.48,1
HCPCS,28112,OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4,1852.0,1203.8,151.23,1389.0,35
HCPCS,28112,PART REMOVAL OF METATARSAL,,,327.81,7034.85,15
HCPCS,28112,Part removal of metatarsal,,,1342.37,1695.62,6
HCPCS,281120,PART REMOVAL OF METATARSAL,,,327.81,327.81,1
HCPCS,28113,OSTECTOMY COMPLETE 5TH METATARSAL HEAD,2444.0,1588.6,205.15,1833.0,35
HCPCS,28113,PART REMOVAL OF METATARSAL,,,445.61,7034.85,15
HCPCS,28113,Part removal of metatarsal,,,1342.37,1695.62,6
HCPCS,281130,PART REMOVAL OF METATARSAL,,,445.61,445.61,1
HCPCS,28114,OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC,4800.0,3120.0,405.69,3600.0,35
HCPCS,28114,REMOVAL OF METATARSAL HEADS,,,874.47,7034.85,15
HCPCS,28114,Removal of metatarsal heads,,,3613.7,4564.67,6
HCPCS,281140,REMOVAL OF METATARSAL HEADS,,,874.47,874.47,1
HCPCS,28116,OSTECTOMY TARSAL COALITION,3656.0,2376.4,283.06,2742.0,35
HCPCS,28116,REVISION OF FOOT,,,610.71,7034.85,15
HCPCS,28116,Revision of foot,,,1342.37,1695.62,6
HCPCS,281160,REVISION OF FOOT,,,610.71,610.71,1
HCPCS,28118,OSTECTOMY CALCANEUS,2452.0,1593.8,204.16,1839.0,35
HCPCS,28118,REMOVAL OF HEEL BONE,,,443.08,7034.85,15
HCPCS,28118,Removal of heel bone,,,1342.37,1695.62,6
HCPCS,281180,REMOVAL OF HEEL BONE,,,443.08,443.08,1
HCPCS,28119,OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS,2224.0,1445.6,175.89,1668.0,35
HCPCS,28119,REMOVAL OF HEEL SPUR,,,382.19,7034.85,15
HCPCS,28119,Removal of heel spur,,,1342.37,1695.62,6
HCPCS,281190,REMOVAL OF HEEL SPUR,,,382.19,382.19,1
HCPCS,28120,PART REMOVAL OF ANKLE/HEEL,,,519.19,7034.85,15
HCPCS,28120,PARTIAL EXCISION BONE TALUS/CALCANEUS,2924.0,1900.6,241.15,2193.0,35
HCPCS,28120,Part removal of ankle/heel,,,1342.37,1695.62,6
HCPCS,281200,PART REMOVAL OF ANKLE/HEEL,,,519.19,519.19,1
HCPCS,28122,PARTIAL REMOVAL OF FOOT BONE,,,460.41,7034.85,15
HCPCS,28122,PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS,2704.0,1757.6,249.72,2028.0,35
HCPCS,28122,Partial removal of foot bone,,,3613.7,4564.67,6
HCPCS,281220,PARTIAL REMOVAL OF FOOT BONE,,,460.41,460.41,1
HCPCS,28124,PARTIAL REMOVAL OF TOE,,,350.07,7034.85,15
HCPCS,28124,PARTICAL EXCISION BONE PHALANX TOE,2000.0,1300.0,160.6,1500.0,35
HCPCS,28124,Partial removal of toe,,,1342.37,1695.62,6
HCPCS,281240,PARTIAL REMOVAL OF TOE,,,350.07,350.07,1
HCPCS,28126,PARTIAL REMOVAL OF TOE,,,262.68,7034.85,15
HCPCS,28126,Partial removal of toe,,,1342.37,1695.62,6
HCPCS,28126,RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH,1456.0,946.4,119.51,1092.0,35
HCPCS,281260,PARTIAL REMOVAL OF TOE,,,262.68,262.68,1
HCPCS,28130,REMOVAL OF ANKLE BONE,,,648.39,15488.78,15
HCPCS,28130,Removal of ankle bone,,,3613.7,4564.67,6
HCPCS,281300,REMOVAL OF ANKLE BONE,,,648.39,648.39,1
HCPCS,28140,METATARSECTOMY,2856.0,1856.4,208.44,2142.0,35
HCPCS,28140,REMOVAL OF METATARSAL,,,447.44,7034.85,15
HCPCS,28140,Removal of metatarsal,,,1342.37,1695.62,6
HCPCS,281400,REMOVAL OF METATARSAL,,,447.44,447.44,1
HCPCS,28150,PHALANGECTOMY TOE EACH TOE,1692.0,1099.8,133.97,1269.0,35
HCPCS,28150,REMOVAL OF TOE,,,292.78,7034.85,15
HCPCS,28150,Removal of toe,,,1342.37,1695.62,6
HCPCS,281500,REMOVAL OF TOE,,,292.78,292.78,1
HCPCS,28153,PARTIAL REMOVAL OF TOE,,,276.03,7034.85,15
HCPCS,28153,Partial removal of toe,,,1342.37,1695.62,6
HCPCS,28153,RESECTION CONDYLE DISTAL END PHALANX EACH TOE,1520.0,988.0,127.73,1140.0,35
HCPCS,281530,PARTIAL REMOVAL OF TOE,,,276.03,276.03,1
HCPCS,28160,HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE,1552.0,1008.8,129.2,1164.0,35
HCPCS,28160,PARTIAL REMOVAL OF TOE,,,279.32,7034.85,15
HCPCS,28160,Partial removal of toe,,,1342.37,1695.62,6
HCPCS,281600,PARTIAL REMOVAL OF TOE,,,279.32,279.32,1
HCPCS,28171,RESECT TARSAL TUMOR,,,1160.6,7034.85,15
HCPCS,28171,Resect tarsal tumor,,,3613.7,4564.67,6
HCPCS,281710,RESECT TARSAL TUMOR,,,1160.6,1160.6,1
HCPCS,28173,RESECT METATARSAL TUMOR,,,762.64,7034.85,15
HCPCS,28173,Resect metatarsal tumor,,,3613.7,4564.67,6
HCPCS,281730,RESECT METATARSAL TUMOR,,,762.64,762.64,1
HCPCS,28175,RADICAL RESECTION TUMOR PHALANX OR TOE,3316.0,2155.4,317.94,3316.0,35
HCPCS,28175,RESECT PHALANX OF TOE TUMOR,,,492.51,3469.95,15
HCPCS,28175,Resect phalanx of toe tumor,,,1342.37,1695.62,6
HCPCS,281750,RESECT PHALANX OF TOE TUMOR,,,492.51,492.51,1
HCPCS,28190,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,4046.0,2629.9,165.58,4268.0,98
HCPCS,28190,REMOVAL OF FOOT FOREIGN BODY,,,138.32,138.32,1
HCPCS,28190,"REMV FOOT FOREIGN BODY,SUBCUTANEOUS",884.0,574.6,70.46,663.0,35
HCPCS,281900,REMOVAL OF FOOT FOREIGN BODY,,,138.32,138.32,1
HCPCS,28192,REMOVAL FOREIGN BODY FOOT DEEP,9316.0,6055.4,383.66,8384.4,193
HCPCS,28192,REMOVAL OF FOOT FOREIGN BODY,,,324.48,324.48,1
HCPCS,28192,"REMV FOOT FOREIGN BODY,DEEP",1912.0,1242.8,149.92,1434.0,35
HCPCS,281920,REMOVAL OF FOOT FOREIGN BODY,,,324.48,324.48,1
HCPCS,28193,REMOVAL FOREIGN BODY FOOT COMPLICATED,9316.0,6055.4,450.76,8384.4,98
HCPCS,28193,REMOVAL OF FOOT FOREIGN BODY,,,382.73,382.73,1
HCPCS,28193,"REMV FOOT FOREIGN BODY,COMPLEX",2360.0,1534.0,176.71,1770.0,35
HCPCS,281930,REMOVAL OF FOOT FOREIGN BODY,,,382.73,382.73,1
HCPCS,28200,REPAIR OF FOOT TENDON,,,342.1,7034.85,15
HCPCS,28200,RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON,1896.0,1232.4,158.63,1422.0,35
HCPCS,28200,Repair of foot tendon,,,1342.37,1695.62,6
HCPCS,282000,REPAIR OF FOOT TENDON,,,342.1,342.1,1
HCPCS,28202,REPAIR/GRAFT OF FOOT TENDON,,,449.44,15488.78,15
HCPCS,28202,Repair/graft of foot tendon,,,3613.7,4564.67,6
HCPCS,282020,REPAIR/GRAFT OF FOOT TENDON,,,449.44,449.44,1
HCPCS,28208,REPAIR OF FOOT TENDON,,,336.12,7034.85,15
HCPCS,28208,REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON,1804.0,1172.6,154.68,1353.0,35
HCPCS,28208,Repair of foot tendon,,,1342.37,1695.62,6
HCPCS,282080,REPAIR OF FOOT TENDON,,,336.12,336.12,1
HCPCS,28210,REPAIR/GRAFT OF FOOT TENDON,,,444.71,15488.78,15
HCPCS,28210,Repair/graft of foot tendon,,,3613.7,4564.67,6
HCPCS,282100,REPAIR/GRAFT OF FOOT TENDON,,,444.71,444.71,1
HCPCS,28220,RELEASE OF FOOT TENDON,,,320.19,3469.95,15
HCPCS,28220,Release of foot tendon,,,1342.37,1695.62,6
HCPCS,28220,TENOLYSIS FLEXOR FOOT SINGLE TENDON,1868.0,1214.2,146.96,1401.0,35
HCPCS,282200,RELEASE OF FOOT TENDON,,,320.19,320.19,1
HCPCS,28222,RELEASE OF FOOT TENDONS,,,388.7,7034.85,15
HCPCS,28222,Release of foot tendons,,,1342.37,1695.62,6
HCPCS,28222,TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS,2304.0,1497.6,191.24,1728.0,35
HCPCS,282220,RELEASE OF FOOT TENDONS,,,388.7,388.7,1
HCPCS,28225,RELEASE OF FOOT TENDON,,,277.17,7034.85,15
HCPCS,28225,Release of foot tendon,,,1342.37,1695.62,6
HCPCS,28225,TENOLYSIS EXTENSOR FOOT SINGLE TENDON,1512.0,982.8,127.73,1134.0,35
HCPCS,282250,RELEASE OF FOOT TENDON,,,277.17,277.17,1
HCPCS,28226,RELEASE OF FOOT TENDONS,,,419.41,7034.85,15
HCPCS,28226,Release of foot tendons,,,1342.37,1695.62,6
HCPCS,28226,TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON,1868.0,1214.2,194.79,1401.0,35
HCPCS,282260,RELEASE OF FOOT TENDONS,,,419.41,419.41,1
HCPCS,28230,INCISION OF FOOT TENDON(S),,,298.44,3469.95,15
HCPCS,28230,Incision of foot tendon(s),,,1342.37,1695.62,6
HCPCS,28230,TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX,1744.0,1133.6,136.93,1308.0,35
HCPCS,282300,INCISION OF FOOT TENDON(S),,,298.44,298.44,1
HCPCS,28232,INCISION OF TOE TENDON,,,252.37,3469.95,15
HCPCS,28232,Incision of toe tendon,,,1342.37,1695.62,6
HCPCS,28232,TX OPEN TENDON FLEXOR TOE 1 TENDON SPX,1404.0,912.6,116.05,1053.0,35
HCPCS,282320,INCISION OF TOE TENDON,,,252.37,252.37,1
HCPCS,28234,INCISION OF FOOT TENDON,,,281.46,3469.95,16
HCPCS,28234,Incision of foot tendon,,,1342.37,1695.62,6
HCPCS,28234,TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON,1416.0,920.4,128.88,1062.0,35
HCPCS,282340,INCISION OF FOOT TENDON,,,281.46,281.46,1
HCPCS,28238,RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR,3184.0,2069.6,250.25,2388.0,35
HCPCS,28238,REVISION OF FOOT TENDON,,,513.84,15488.78,15
HCPCS,28238,Revision of foot tendon,,,3613.7,4564.67,6
HCPCS,282380,REVISION OF FOOT TENDON,,,513.84,513.84,1
HCPCS,28240,RELEASE OF BIG TOE,,,307.75,7034.85,15
HCPCS,28240,Release of big toe,,,1342.37,1695.62,6
HCPCS,28240,TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC,1792.0,1164.8,141.7,1344.0,35
HCPCS,282400,RELEASE OF BIG TOE,,,307.75,307.75,1
HCPCS,28250,DIVISN PLANTAR FASCIA/MUSCLE,2424.0,1575.6,196.43,1818.0,35
HCPCS,28250,REVISION OF FOOT FASCIA,,,432.42,7034.85,15
HCPCS,28250,Revision of foot fascia,,,1342.37,1695.62,6
HCPCS,282500,REVISION OF FOOT FASCIA,,,432.42,432.42,1
HCPCS,28260,RELEASE OF MIDFOOT JOINT,,,567.46,7034.85,15
HCPCS,28260,Release of midfoot joint,,,3613.7,4564.67,6
HCPCS,282600,RELEASE OF MIDFOOT JOINT,,,567.46,567.46,1
HCPCS,28261,REVISION OF FOOT TENDON,,,885.06,3469.95,15
HCPCS,28261,Revision of foot tendon,,,3613.7,4564.67,6
HCPCS,282610,REVISION OF FOOT TENDON,,,885.06,885.06,1
HCPCS,28262,CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH,7572.0,4921.8,548.21,5679.0,35
HCPCS,28262,REVISION OF FOOT AND ANKLE,,,1161.78,15488.78,15
HCPCS,28262,Revision of foot and ankle,,,3613.7,4564.67,6
HCPCS,282620,REVISION OF FOOT AND ANKLE,,,1161.78,1161.78,1
HCPCS,28264,RELEASE OF MIDFOOT JOINT,,,703.36,3469.95,15
HCPCS,28264,Release of midfoot joint,,,3613.7,4564.67,6
HCPCS,282640,RELEASE OF MIDFOOT JOINT,,,703.36,703.36,1
HCPCS,28270,CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX,1972.0,1281.8,161.09,1479.0,35
HCPCS,28270,RELEASE OF FOOT CONTRACTURE,,,349.69,7034.85,16
HCPCS,28270,Release of foot contracture,,,1342.37,1695.62,6
HCPCS,282700,RELEASE OF FOOT CONTRACTURE,,,349.69,349.69,1
HCPCS,28272,CAPSULOTOMY IPHAL JOINT EACH JOINT SPX,1568.0,1019.2,120.82,1176.0,35
HCPCS,28272,RELEASE OF TOE JOINT EACH,,,263.19,3469.95,15
HCPCS,28272,Release of toe joint each,,,1342.37,1695.62,6
HCPCS,282720,RELEASE OF TOE JOINT EACH,,,263.19,263.19,1
HCPCS,28280,FUSION OF TOES,,,361.39,7034.85,15
HCPCS,28280,Fusion of toes,,,1342.37,1695.62,6
HCPCS,28280,SYNDACTYLIZATION TOES,2132.0,1385.8,168.16,1599.0,35
HCPCS,282800,FUSION OF TOES,,,361.39,361.39,1
HCPCS,28285,CORRECTION HAMMERTOE,2473.0,1607.45,185.42,1854.75,35
HCPCS,28285,REPAIR OF HAMMERTOE,,,404.74,7034.85,16
HCPCS,28285,Repair of hammertoe,,,1342.37,1695.62,6
HCPCS,282850,REPAIR OF HAMMERTOE,,,404.74,404.74,1
HCPCS,28286,CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE,1880.0,1222.0,143.17,1410.0,35
HCPCS,28286,REPAIR OF HAMMERTOE,,,312.21,7034.85,15
HCPCS,28286,Repair of hammertoe,,,1342.37,1695.62,6
HCPCS,282860,REPAIR OF HAMMERTOE,,,312.21,312.21,1
HCPCS,28288,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,2408.0,1565.2,209.91,1806.0,35
HCPCS,28288,PARTIAL REMOVAL OF FOOT BONE,,,454.8,7034.85,16
HCPCS,28288,Partial removal of foot bone,,,1342.37,1695.62,6
HCPCS,282880,PARTIAL REMOVAL OF FOOT BONE,,,454.8,454.8,1
HCPCS,28289,CORRJ HALUX RIGDUS W/O IMPLT,,,483.44,7034.85,15
HCPCS,28289,Corrj halux rigdus w/o implt,,,3613.7,4564.67,6
HCPCS,28289,HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/O IMPLT,2760.0,1794.0,221.75,2070.0,35
HCPCS,282890,CORRJ HALUX RIGDUS W/O IMPLT,,,483.44,483.44,1
HCPCS,28291,CORRJ HALUX RIGDUS W/IMPLT,,,504.41,15488.78,15
HCPCS,28291,Corrj halux rigdus w/implt,,,3613.7,4564.67,6
HCPCS,28291,HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/IMPLT,3524.0,2290.6,366.15,2643.0,31
HCPCS,282910,CORRJ HALUX RIGDUS W/IMPLT,,,504.41,504.41,1
HCPCS,28292,COR HLX VLGS RSC PRX PHLX BS,,,509.14,7034.85,15
HCPCS,28292,CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE,2976.0,1934.4,238.31,2232.0,35
HCPCS,28292,Cor hlx vlgs rsc prx phlx bs,,,3613.7,4564.67,6
HCPCS,282920,COR HLX VLGS RSC PRX PHLX BS,,,509.14,509.14,1
HCPCS,28295,COR HLX VLGS PRX MTAR OSTEOT,,,629.87,7034.85,15
HCPCS,28295,CORRJ HLX VLGS BNCTY SESMDC PROX METAR OSTEOT,3428.0,2228.2,427.22,2571.0,31
HCPCS,28295,Cor hlx vlgs prx mtar osteot,,,3613.7,4564.67,6
HCPCS,282950,COR HLX VLGS PRX MTAR OSTEOT,,,629.87,629.87,1
HCPCS,28296,COR HLX VLGS DSTL MTAR OSTEO,,,538.39,7034.85,15
HCPCS,28296,CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT,3300.0,2145.0,298.59,2475.0,35
HCPCS,28296,Cor hlx vlgs dstl mtar osteo,,,3613.7,4564.67,6
HCPCS,282960,COR HLX VLGS DSTL MTAR OSTEO,,,538.39,538.39,1
HCPCS,28297,COR HLX VLGS JT ARTHRD,,,630.42,27897.39,15
HCPCS,28297,CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS,3716.0,2415.4,297.81,2787.0,35
HCPCS,28297,Cor hlx vlgs jt arthrd,,,3613.7,4564.67,6
HCPCS,282970,COR HLX VLGS JT ARTHRD,,,630.42,630.42,1
HCPCS,28298,COR HLX VLGS PRX PHLX OSTEOT,,,532.62,15488.78,15
HCPCS,28298,CORRJ HLX VLGS BNCTY SESMDC PROX PHLX OSTEOT,3100.0,2015.0,270.86,2325.0,35
HCPCS,28298,Cor hlx vlgs prx phlx osteot,,,3613.7,4564.67,6
HCPCS,282980,COR HLX VLGS PRX PHLX OSTEOT,,,532.62,532.62,1
HCPCS,28299,COR HLX VLGS DOUBLE OSTEOT,,,624.3,15488.78,16
HCPCS,28299,CORRJ HLX VLGS BNCTY SESMDC W/DOUBLE OSTEOTOMY,3716.0,2415.4,314.16,2787.0,35
HCPCS,28299,Cor hlx vlgs double osteot,,,3613.7,4564.67,6
HCPCS,282990,COR HLX VLGS DOUBLE OSTEOT,,,624.3,624.3,1
HCPCS,28300,INCISION OF HEEL BONE,,,683.16,15488.78,15
HCPCS,28300,Incision of heel bone,,,3613.7,4564.67,6
HCPCS,28300,OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION,3892.0,2529.8,467.04,3892.0,35
HCPCS,283000,INCISION OF HEEL BONE,,,683.16,683.16,1
HCPCS,28302,INCISION OF ANKLE BONE,,,753.29,15488.78,15
HCPCS,28302,Incision of ankle bone,,,3613.7,4564.67,6
HCPCS,283020,INCISION OF ANKLE BONE,,,753.29,753.29,1
HCPCS,28304,INCISION OF MIDFOOT BONES,,,644.67,15488.78,15
HCPCS,28304,Incision of midfoot bones,,,3613.7,4564.67,6
HCPCS,28304,OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS,4140.0,2691.0,296.88,3105.0,35
HCPCS,283040,INCISION OF MIDFOOT BONES,,,644.67,644.67,1
HCPCS,28305,INCISE/GRAFT MIDFOOT BONES,,,709.07,15488.78,15
HCPCS,28305,Incise/graft midfoot bones,,,3613.7,4564.67,6
HCPCS,28305,OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT,4308.0,2800.2,522.9,4308.0,35
HCPCS,283050,INCISE/GRAFT MIDFOOT BONES,,,709.07,709.07,1
HCPCS,28306,INCISION OF METATARSAL,,,427.55,15488.78,15
HCPCS,28306,Incision of metatarsal,,,1342.37,1695.62,6
HCPCS,28306,OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR,2400.0,1560.0,195.28,1800.0,35
HCPCS,283060,INCISION OF METATARSAL,,,427.55,427.55,1
HCPCS,28307,INCISION OF METATARSAL,,,543.81,15488.78,15
HCPCS,28307,Incision of metatarsal,,,3613.7,4564.67,6
HCPCS,283070,INCISION OF METATARSAL,,,543.81,543.81,1
HCPCS,28308,INCISION OF METATARSAL,,,406.27,7034.85,16
HCPCS,28308,Incision of metatarsal,,,1342.37,1695.62,6
HCPCS,28308,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA,2192.0,1424.8,186.41,1644.0,35
HCPCS,283080,INCISION OF METATARSAL,,,406.27,406.27,1
HCPCS,28309,INCISION OF METATARSALS,,,950.41,15488.78,15
HCPCS,28309,Incision of metatarsals,,,3613.7,4564.67,6
HCPCS,28309,OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT,5664.0,3681.6,497.52,5664.0,35
HCPCS,283090,INCISION OF METATARSALS,,,950.41,950.41,1
HCPCS,28310,OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE,2228.0,1448.2,174.73,1671.0,35
HCPCS,28310,REVISION OF BIG TOE,,,381.82,15488.78,15
HCPCS,28310,Revision of big toe,,,1342.37,1695.62,6
HCPCS,283100,REVISION OF BIG TOE,,,381.82,381.82,1
HCPCS,28312,REVISION OF TOE,,,360.96,7034.85,15
HCPCS,28312,Revision of toe,,,1342.37,1695.62,6
HCPCS,283120,REVISION OF TOE,,,360.96,360.96,1
HCPCS,28313,RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY,2266.0,1472.9,173.92,1699.5,35
HCPCS,28313,REPAIR DEFORMITY OF TOE,,,379.16,7034.85,15
HCPCS,28313,Repair deformity of toe,,,1342.37,1695.62,6
HCPCS,283130,REPAIR DEFORMITY OF TOE,,,379.16,379.16,1
HCPCS,28315,REMOVAL OF SESAMOID BONE,,,341.49,7034.85,15
HCPCS,28315,Removal of sesamoid bone,,,1342.37,1695.62,6
HCPCS,28315,SESAMOIDECTOMY FIRST TOE SPX,2000.0,1300.0,158.14,1500.0,35
HCPCS,283150,REMOVAL OF SESAMOID BONE,,,341.49,341.49,1
HCPCS,28320,REPAIR NONUNION/MALUNION TARSAL BONES,3748.0,2436.2,455.44,3748.0,35
HCPCS,28320,REPAIR OF FOOT BONES,,,648.04,27897.39,15
HCPCS,28320,Repair of foot bones,,,3613.7,4564.67,6
HCPCS,283200,REPAIR OF FOOT BONES,,,648.04,648.04,1
HCPCS,28322,REPAIR OF METATARSALS,,,607.17,15488.78,15
HCPCS,28322,RPR NON/MALUNION METARSAL W/WO BONE GRAFT,3412.0,2217.8,280.11,2559.0,35
HCPCS,28322,Repair of metatarsals,,,3613.7,4564.67,6
HCPCS,283220,REPAIR OF METATARSALS,,,607.17,607.17,1
HCPCS,28340,RESECT ENLARGED TOE TISSUE,,,428.82,7034.85,15
HCPCS,28340,Resect enlarged toe tissue,,,1342.37,1695.62,6
HCPCS,283400,RESECT ENLARGED TOE TISSUE,,,428.82,428.82,1
HCPCS,28341,RESECT ENLARGED TOE,,,510.4,7034.85,15
HCPCS,28341,Resect enlarged toe,,,3613.7,4564.67,6
HCPCS,283410,RESECT ENLARGED TOE,,,510.4,510.4,1
HCPCS,28344,RECONSTRUCTION TOE POLYDACTYLY,1936.0,1258.4,134.14,1452.0,35
HCPCS,28344,REPAIR EXTRA TOE(S),,,292.69,7034.85,15
HCPCS,28344,Repair extra toe(s),,,1342.37,1695.62,6
HCPCS,283440,REPAIR EXTRA TOE(S),,,292.69,292.69,1
HCPCS,28345,RCNSTJ TOE SYNDACTYLY W/WO SKIN GRAFT EACH WEB,2436.0,1583.4,187.18,1827.0,35
HCPCS,28345,REPAIR WEBBED TOE(S),,,379.89,3469.95,15
HCPCS,28345,Repair webbed toe(s),,,1342.37,1695.62,6
HCPCS,283450,REPAIR WEBBED TOE(S),,,379.89,379.89,1
HCPCS,28360,RECONSTRUCT CLEFT FOOT,,,1150.83,15488.78,15
HCPCS,28360,Reconstruct cleft foot,,,3613.7,4564.67,6
HCPCS,283600,RECONSTRUCT CLEFT FOOT,,,1150.83,1150.83,1
HCPCS,28400,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,1151.5,748.475,134.51,4151.0,179
HCPCS,28400,CLTX CALCANEAL FX W/O MNPJ,,,243.14,243.14,1
HCPCS,284000,CLTX CALCANEAL FX W/O MNPJ,,,243.14,243.14,1
HCPCS,28405,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,1637.5,1064.375,219.53,8550.0,84
HCPCS,28405,CLTX CALCANEAL FX W/MNPJ,,,430.81,430.81,1
HCPCS,284050,CLTX CALCANEAL FX W/MNPJ,,,430.81,430.81,1
HCPCS,28406,PRQ SKEL FIX CLCNL FX W/MNPJ,,,618.72,15488.78,15
HCPCS,28406,PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ,2624.0,1705.6,350.18,2624.0,35
HCPCS,28406,Prq skel fix clcnl fx w/mnpj,,,3366.74,4252.73,6
HCPCS,284060,PRQ SKEL FIX CLCNL FX W/MNPJ,,,618.72,618.72,1
HCPCS,28415,OPEN TREATMENT CALCANEAL FRACTURE,6476.0,4209.4,697.85,6476.0,35
HCPCS,28415,OPTX CALCANEAL FRACTURE,,,1172.83,15488.78,16
HCPCS,28415,Optx calcaneal fracture,,,3366.74,4252.73,6
HCPCS,284150,OPTX CALCANEAL FRACTURE,,,1172.83,1172.83,1
HCPCS,28420,OPTX CALCANEAL FX W/BONE GRF,,,1355.72,27897.39,15
HCPCS,28420,Optx calcaneal fx w/bone grf,,,3366.74,4252.73,6
HCPCS,284200,OPTX CALCANEAL FX W/BONE GRF,,,1355.72,1355.72,1
HCPCS,28430,CLOSED TX TALUS FRACTURE W/O MANIPULATION,1133.5,736.7750000000001,125.21,4151.0,179
HCPCS,28430,CLTX TALUS FRACTURE W/O MNPJ,,,223.2,223.2,1
HCPCS,284300,CLTX TALUS FRACTURE W/O MNPJ,,,223.2,223.2,1
HCPCS,28435,CLOSED TX TALUS FRACTURE W/MANIPULATION,5309.5,3451.1749999999997,161.42,8282.7,133
HCPCS,28435,CLTX TALUS FRACTURE W/MNPJ,,,348.59,348.59,1
HCPCS,284350,CLTX TALUS FRACTURE W/MNPJ,,,348.59,348.59,1
HCPCS,28436,PRQ SKEL FIX TALUS FX W/MNPJ,,,519.32,519.32,1
HCPCS,28436,PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ,22391.0,14554.15,651.49,20151.9,42
HCPCS,284360,PRQ SKEL FIX TALUS FX W/MNPJ,,,519.32,519.32,1
HCPCS,28445,OPEN TREATMENT TALUS FRACTURE,6304.0,4097.6,631.66,6304.0,35
HCPCS,28445,OPTX TALUS FRACTURE,,,1100.52,15488.78,15
HCPCS,28445,Optx talus fracture,,,3366.74,4252.73,6
HCPCS,284450,OPTX TALUS FRACTURE,,,1100.52,1100.52,1
HCPCS,28446,OPEN OSTEOCHONDRAL AUTOGRAFT TALUS,7084.0,4604.6,703.22,7084.0,32
HCPCS,28446,OPN OSTEOCHONDRL AGRFT TALUS,,,1283.85,15488.78,15
HCPCS,28446,Opn osteochondrl agrft talus,,,3613.7,4564.67,6
HCPCS,284460,OPN OSTEOCHONDRL AGRFT TALUS,,,1283.85,1283.85,1
HCPCS,28450,TX TARSAL B1 FX W/O MNPJ EA,,,202.22,202.22,1
HCPCS,28450,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,1136.0,738.4000000000001,99.49,4151.0,179
HCPCS,284500,TX TARSAL B1 FX W/O MNPJ EA,,,202.22,202.22,1
HCPCS,28455,TX TARSAL B1 FX W/MNPJ EACH,,,241.37,241.37,1
HCPCS,28455,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,5314.5,3454.4249999999997,141.08,8282.7,133
HCPCS,284550,TX TARSAL B1 FX W/MNPJ EACH,,,241.37,241.37,1
HCPCS,28456,PRQ SKEL FIX TARSL FX W/MNPJ,,,385.05,15488.78,15
HCPCS,28456,PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ,1144.0,743.6,183.28,1144.0,35
HCPCS,28456,Prq skel fix tarsl fx w/mnpj,,,3366.74,4252.73,6
HCPCS,284560,PRQ SKEL FIX TARSL FX W/MNPJ,,,385.05,385.05,1
HCPCS,28465,OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA,3520.0,2288.0,379.13,3520.0,35
HCPCS,28465,OPTX TARSAL BONE FX EACH,,,671.85,15488.78,15
HCPCS,28465,Optx tarsal bone fx each,,,3366.74,4252.73,6
HCPCS,284650,OPTX TARSAL BONE FX EACH,,,671.85,671.85,1
HCPCS,28470,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,1136.0,738.4000000000001,110.79,4151.0,179
HCPCS,28470,CLTX METATARSAL FX WO MNP EA,,,216.71,216.71,1
HCPCS,284700,CLTX METATARSAL FX WO MNP EA,,,216.71,216.71,1
HCPCS,28475,CLTX METAR FX W/MANJ,1291.5,839.475,134.68,4151.0,133
HCPCS,28475,CLTX METATARSAL FX W/MNPJ EA,,,243.13,243.13,1
HCPCS,284750,CLTX METATARSAL FX W/MNPJ EA,,,243.13,243.13,1
HCPCS,28476,PRQ SKEL FIX METAR FX W/MNPJ,,,402.03,7034.85,15
HCPCS,28476,PRQ SKEL FIXJ METAR FX W/MANJ,1440.0,936.0,196.26,1440.0,35
HCPCS,28476,Prq skel fix metar fx w/mnpj,,,3366.74,4252.73,6
HCPCS,284760,PRQ SKEL FIX METAR FX W/MNPJ,,,402.03,402.03,1
HCPCS,28485,OPEN TREATMENT METATARSAL FRACTURE EACH,2976.0,1934.4,310.93,2976.0,35
HCPCS,28485,OPTX METATARSAL FX EACH,,,589.45,15488.78,15
HCPCS,28485,Optx metatarsal fx each,,,3366.74,4252.73,6
HCPCS,284850,OPTX METATARSAL FX EACH,,,589.45,589.45,1
HCPCS,28490,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,923.5,600.275,60.66,4151.0,179
HCPCS,28490,TREAT BIG TOE FRACTURE,,,131.19,131.19,1
HCPCS,284900,TREAT BIG TOE FRACTURE,,,131.19,131.19,1
HCPCS,28495,CLTX FX GRT TOE PHLX/PHLG W/MANJ,1025.5,666.575,72.49,4151.0,133
HCPCS,28495,TREAT BIG TOE FRACTURE,,,157.52,157.52,1
HCPCS,284950,TREAT BIG TOE FRACTURE,,,157.52,157.52,1
HCPCS,28496,PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ,992.0,644.8,133.89,825.12,35
HCPCS,28496,TREAT BIG TOE FRACTURE,,,286.22,7034.85,15
HCPCS,28496,Treat big toe fracture,,,3366.74,4252.73,6
HCPCS,284960,TREAT BIG TOE FRACTURE,,,286.22,286.22,1
HCPCS,28505,OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES,2976.0,1934.4,241.97,2232.0,35
HCPCS,28505,TREAT BIG TOE FRACTURE,,,520.74,7034.85,15
HCPCS,28505,Treat big toe fracture,,,3366.74,4252.73,6
HCPCS,285050,TREAT BIG TOE FRACTURE,,,520.74,520.74,1
HCPCS,28510,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,923.5,600.275,57.86,4151.0,179
HCPCS,28510,TREATMENT OF TOE FRACTURE,,,127.17,127.17,1
HCPCS,285100,TREATMENT OF TOE FRACTURE,,,127.17,127.17,1
HCPCS,28515,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,1001.5,650.975,69.37,4151.0,179
HCPCS,28515,TREATMENT OF TOE FRACTURE,,,151.48,151.48,1
HCPCS,285150,TREATMENT OF TOE FRACTURE,,,151.48,151.48,1
HCPCS,28525,OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE,2248.0,1461.2,196.6,1686.0,35
HCPCS,28525,TREAT TOE FRACTURE,,,426.79,7034.85,15
HCPCS,28525,Treat toe fracture,,,3366.74,4252.73,6
HCPCS,285250,TREAT TOE FRACTURE,,,426.79,426.79,1
HCPCS,28530,CLOSED TREATMENT SESAMOID FRACTURE,911.5,592.475,53.27,4151.0,133
HCPCS,28530,TREAT SESAMOID BONE FRACTURE,,,107.57,107.57,1
HCPCS,285300,TREAT SESAMOID BONE FRACTURE,,,107.57,107.57,1
HCPCS,28531,OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION,1028.0,668.2,124.56,771.0,35
HCPCS,28531,TREAT SESAMOID BONE FRACTURE,,,189.89,15488.78,15
HCPCS,28531,Treat sesamoid bone fracture,,,3366.74,4252.73,6
HCPCS,285310,TREAT SESAMOID BONE FRACTURE,,,189.89,189.89,1
HCPCS,28540,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES,1379.0,896.35,223.94,4151.0,49
HCPCS,28540,TREAT FOOT DISLOCATION,,,185.59,185.59,1
HCPCS,285400,TREAT FOOT DISLOCATION,,,185.59,185.59,1
HCPCS,28545,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES,1040.0,676.0,133.15,780.0,35
HCPCS,28545,TREAT FOOT DISLOCATION,,,287.06,7034.85,15
HCPCS,28545,Treat foot dislocation,,,632.74,799.25,6
HCPCS,285450,TREAT FOOT DISLOCATION,,,287.06,287.06,1
HCPCS,28546,TREAT FOOT DISLOCATION,,,370.32,3469.95,15
HCPCS,28546,Treat foot dislocation,,,3366.74,4252.73,6
HCPCS,285460,TREAT FOOT DISLOCATION,,,370.32,370.32,1
HCPCS,28555,OPEN TREATMENT TARSAL BONE DISLOCATION,3860.0,2509.0,320.22,2895.0,35
HCPCS,28555,REPAIR FOOT DISLOCATION,,,695.64,15488.78,15
HCPCS,28555,Repair foot dislocation,,,3366.74,4252.73,6
HCPCS,285550,REPAIR FOOT DISLOCATION,,,695.64,695.64,1
HCPCS,28570,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,1041.5,676.975,96.33,4151.0,133
HCPCS,28570,TREAT FOOT DISLOCATION,,,209.33,209.33,1
HCPCS,285700,TREAT FOOT DISLOCATION,,,209.33,209.33,1
HCPCS,28575,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,10026.0,6516.9,166.85,16790.4,133
HCPCS,28575,TREAT FOOT DISLOCATION,,,359.52,359.52,1
HCPCS,285750,TREAT FOOT DISLOCATION,,,359.52,359.52,1
HCPCS,28576,PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ,1840.0,1196.0,204.27,1840.0,35
HCPCS,28576,TREAT FOOT DISLOCATION,,,410.58,15488.78,15
HCPCS,28576,Treat foot dislocation,,,3366.74,4252.73,6
HCPCS,285760,TREAT FOOT DISLOCATION,,,410.58,410.58,1
HCPCS,28585,OPEN TREATMENT TALOTARSAL JOINT DISLOCATION,4452.0,2893.8,338.3,3339.0,35
HCPCS,28585,REPAIR FOOT DISLOCATION,,,742.77,15488.78,15
HCPCS,28585,Repair foot dislocation,,,3366.74,4252.73,6
HCPCS,285850,REPAIR FOOT DISLOCATION,,,742.77,742.77,1
HCPCS,28600,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,1379.0,896.35,206.85,4151.0,98
HCPCS,28600,TREAT FOOT DISLOCATION,,,169.28,169.28,1
HCPCS,286000,TREAT FOOT DISLOCATION,,,169.28,169.28,1
HCPCS,28605,CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES,1156.0,751.4,149.75,867.0,35
HCPCS,28605,TREAT FOOT DISLOCATION,,,240.79,520.1,15
HCPCS,28605,Treat foot dislocation,,,632.74,799.25,6
HCPCS,286050,TREAT FOOT DISLOCATION,,,322.96,322.96,1
HCPCS,28606,TREAT FOOT DISLOCATION,,,413.2,7034.85,15
HCPCS,28606,Treat foot dislocation,,,3366.74,4252.73,6
HCPCS,286060,TREAT FOOT DISLOCATION,,,413.2,413.2,1
HCPCS,28615,OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION,4280.0,2782.0,403.55,4280.0,35
HCPCS,28615,REPAIR FOOT DISLOCATION,,,865.36,15488.78,15
HCPCS,28615,Repair foot dislocation,,,3366.74,4252.73,6
HCPCS,286150,REPAIR FOOT DISLOCATION,,,865.36,865.36,1
HCPCS,28630,CLTX METATARSOPHLNGL JT DISLC W/O ANES,1039.5,675.675,53.59,4151.0,179
HCPCS,28630,TREAT TOE DISLOCATION,,,117.16,117.16,1
HCPCS,286300,TREAT TOE DISLOCATION,,,117.16,117.16,1
HCPCS,28635,CLTX METATARSOPHLNGL JT DISLC REQ ANES,784.0,509.6,64.28,588.0,35
HCPCS,28635,TREAT TOE DISLOCATION,,,137.21,3469.95,15
HCPCS,28635,Treat toe dislocation,,,632.74,799.25,6
HCPCS,286350,TREAT TOE DISLOCATION,,,137.21,137.21,1
HCPCS,28636,PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ,1108.0,720.2,96.82,831.0,35
HCPCS,28636,TREAT TOE DISLOCATION,,,234.03,7034.85,15
HCPCS,28636,Treat toe dislocation,,,3366.74,4252.73,6
HCPCS,286360,TREAT TOE DISLOCATION,,,234.03,234.03,1
HCPCS,28645,OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION,2976.0,1934.4,234.9,2232.0,35
HCPCS,28645,REPAIR TOE DISLOCATION,,,511.3,7034.85,15
HCPCS,28645,Repair toe dislocation,,,3366.74,4252.73,6
HCPCS,286450,REPAIR TOE DISLOCATION,,,511.3,511.3,1
HCPCS,28660,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,945.5,614.575,45.21,4151.0,130
HCPCS,28660,TREAT TOE DISLOCATION,,,99.47,99.47,1
HCPCS,286600,TREAT TOE DISLOCATION,,,99.47,99.47,1
HCPCS,28665,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,1158.0,752.7,67.32,8370.0,84
HCPCS,28665,TREAT TOE DISLOCATION,,,132.9,132.9,1
HCPCS,286650,TREAT TOE DISLOCATION,,,132.9,132.9,1
HCPCS,28666,TREAT TOE DISLOCATION,,,183.02,7034.85,15
HCPCS,28666,Treat toe dislocation,,,3366.74,4252.73,6
HCPCS,286660,TREAT TOE DISLOCATION,,,183.02,183.02,1
HCPCS,28675,OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION,2248.0,1461.2,199.56,1686.0,35
HCPCS,28675,REPAIR OF TOE DISLOCATION,,,433.61,7034.85,15
HCPCS,28675,Repair of toe dislocation,,,3366.74,4252.73,6
HCPCS,286750,REPAIR OF TOE DISLOCATION,,,433.61,433.61,1
HCPCS,28705,ARTHRODESIS PANTALAR,8132.0,5285.8,812.85,39872.66,50
HCPCS,28705,Arthrodesis pantalar,,,3613.7,4564.67,6
HCPCS,287050,ARTHRODESIS PANTALAR,,,1281.26,1281.26,1
HCPCS,28715,ARTHRODESIS TRIPLE,5368.0,3489.2,690.83,27897.39,50
HCPCS,28715,Arthrodesis triple,,,3613.7,4564.67,6
HCPCS,287150,ARTHRODESIS TRIPLE,,,982.82,982.82,1
HCPCS,28725,ARTHRODESIS SUBTALAR,4488.0,2917.2,575.03,27897.39,50
HCPCS,28725,Arthrodesis subtalar,,,3613.7,4564.67,6
HCPCS,287250,ARTHRODESIS SUBTALAR,,,815.58,815.58,1
HCPCS,28730,ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS,4280.0,2782.0,542.47,4280.0,35
HCPCS,28730,FUSION OF FOOT BONES,,,759.48,27897.39,15
HCPCS,28730,Fusion of foot bones,,,3613.7,4564.67,6
HCPCS,287300,FUSION OF FOOT BONES,,,759.48,759.48,1
HCPCS,28735,ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT,4892.0,3179.8,557.27,4892.0,35
HCPCS,28735,FUSION OF FOOT BONES,,,814.16,27897.39,15
HCPCS,28735,Fusion of foot bones,,,3613.7,4564.67,6
HCPCS,287350,FUSION OF FOOT BONES,,,814.16,814.16,1
HCPCS,28737,ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR,4412.0,2867.8,501.39,4412.0,35
HCPCS,28737,REVISION OF FOOT BONES,,,726.08,27897.39,15
HCPCS,28737,Revision of foot bones,,,3613.7,4564.67,6
HCPCS,287370,REVISION OF FOOT BONES,,,726.08,726.08,1
HCPCS,28740,ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT,3716.0,2415.4,299.83,2787.0,35
HCPCS,28740,FUSION OF FOOT BONES,,,646.1,15488.78,15
HCPCS,28740,Fusion of foot bones,,,3613.7,4564.67,6
HCPCS,287400,FUSION OF FOOT BONES,,,646.1,646.1,1
HCPCS,28750,ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT,3428.0,2228.2,281.1,2571.0,35
HCPCS,28750,FUSION OF BIG TOE JOINT,,,603.35,15488.78,15
HCPCS,28750,Fusion of big toe joint,,,3613.7,4564.67,6
HCPCS,287500,FUSION OF BIG TOE JOINT,,,603.35,603.35,1
HCPCS,28755,ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT,1952.0,1268.8,162.08,1464.0,35
HCPCS,28755,FUSION OF BIG TOE JOINT,,,350.54,15488.78,15
HCPCS,28755,Fusion of big toe joint,,,1342.37,1695.62,6
HCPCS,287550,FUSION OF BIG TOE JOINT,,,350.54,350.54,1
HCPCS,28760,ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK,3656.0,2376.4,274.68,2742.0,35
HCPCS,28760,FUSION OF BIG TOE JOINT,,,600.77,15488.78,15
HCPCS,28760,Fusion of big toe joint,,,3613.7,4564.67,6
HCPCS,287600,FUSION OF BIG TOE JOINT,,,600.77,600.77,1
HCPCS,28800,"AMPUTATION FOOT,MIDTARSAL-CHOPART",3516.0,2285.4,392.81,3516.0,35
HCPCS,28800,AMPUTATION OF MIDFOOT,,,552.55,3758.57,5
HCPCS,28800,Amputation of midfoot,,,3613.7,4564.67,6
HCPCS,288000,AMPUTATION OF MIDFOOT,,,552.55,552.55,1
HCPCS,28805,"AMPUTATION FOOT,TRANSMETATARSAL",5084.0,3304.6,408.31,5084.0,35
HCPCS,28805,AMPUTATION THRU METATARSAL,,,740.98,7034.85,15
HCPCS,28805,Amputation thru metatarsal,,,3613.7,4564.67,6
HCPCS,288050,AMPUTATION THRU METATARSAL,,,740.98,740.98,1
HCPCS,28810,"AMPUTATION METATARSAL+TOE,SINGLE",2656.0,1726.4,288.51,2656.0,35
HCPCS,28810,AMPUTATION TOE & METATARSAL,,,442.83,7034.85,15
HCPCS,28810,Amputation toe & metatarsal,,,3613.7,4564.67,6
HCPCS,288100,AMPUTATION TOE & METATARSAL,,,442.83,442.83,1
HCPCS,28820,AMPUTATION OF TOE,,,186.61,7034.85,15
HCPCS,28820,AMPUTATION TOE METATARSOPHALANGEAL JOINT,1544.0,1003.6,133.97,1158.0,35
HCPCS,28820,Amputation of toe,,,1342.37,1695.62,6
HCPCS,288200,AMPUTATION OF TOE,,,186.61,186.61,1
HCPCS,28825,AMPUTATION TOE INTERPHALANGEAL JOINT,1500.0,975.0,131.1,1125.0,35
HCPCS,28825,PARTIAL AMPUTATION OF TOE,,,181.99,7034.85,15
HCPCS,28825,Partial amputation of toe,,,1342.37,1695.62,6
HCPCS,288250,PARTIAL AMPUTATION OF TOE,,,181.99,181.99,1
HCPCS,28890,HI ENRGY ESWT PLANTAR FASCIA,,,233.76,3469.95,15
HCPCS,28890,Hi enrgy eswt plantar fascia,,,1342.37,1695.62,6
HCPCS,288900,HI ENRGY ESWT PLANTAR FASCIA,,,233.76,233.76,1
HCPCS,28899,COMPLETE REMOVAL OF TARSAL BONE (COMP CODE 28130),4085.0,2655.25,323.14,4085.0,15
HCPCS,28899,PERINEURAL TARSAL TUNNEL INJECTION (COMP CODE 64450),3151.0,2048.15,165.0,36332.0,63
HCPCS,28899,REPAIR LIGAMENT FOOT (COMP CODE 27695),2413.0,1568.45,323.14,2413.0,15
HCPCS,28899,SUBTALAR JOINT?ARTHROEREISIS (COMP CODE 28725),4040.0,2626.0,323.14,4040.0,15
HCPCS,28899,TALUS DECOMPRESSION W/DRILLING (COMP CODE 28005),1836.0,1193.4,323.14,1836.0,15
HCPCS,28899,UNLISTED PLANTAR PLATE REPAIR 2ND METATARSOPHALANGEAL JOINT OF L,1700.0,1105.0,323.14,1700.0,15
HCPCS,29000,APPL HALO TYPE BODY CAST,,,209.47,575.82,15
HCPCS,29000,Appl halo type body cast,,,114.84,145.06,6
HCPCS,290000,APPL HALO TYPE BODY CAST,,,209.47,209.47,1
HCPCS,29010,APPL RISSER JACKET BODY ONLY,,,166.95,575.82,15
HCPCS,29010,Appl risser jacket body only,,,114.84,145.06,6
HCPCS,290100,APPL RISSER JACKET BODY ONLY,,,166.95,166.95,1
HCPCS,29015,APPL RISSR JACKET BDY W/HEAD,,,188.03,575.82,15
HCPCS,29015,Appl rissr jacket bdy w/head,,,114.84,145.06,6
HCPCS,290150,APPL RISSR JACKET BDY W/HEAD,,,188.03,188.03,1
HCPCS,29035,APPL BODY CAST SHO TO HIPS,,,149.75,575.82,15
HCPCS,29035,Appl body cast sho to hips,,,114.84,145.06,6
HCPCS,290350,APPL BODY CAST SHO TO HIPS,,,149.75,149.75,1
HCPCS,29040,APPL BDY CST SHO TO HIP HEAD,,,180.36,575.82,15
HCPCS,29040,Appl bdy cst sho to hip head,,,114.84,145.06,6
HCPCS,290400,APPL BDY CST SHO TO HIP HEAD,,,180.36,180.36,1
HCPCS,29044,APPL BDY CST SHO TO HIP 1THI,,,158.39,342.11,15
HCPCS,29044,Appl bdy cst sho to hip 1thi,,,114.84,145.06,6
HCPCS,290440,APPL BDY CST SHO TO HIP 1THI,,,174.06,174.06,1
HCPCS,29046,APPL BDY CST SHO TO HIP B TH,,,195.56,575.82,15
HCPCS,29046,Appl bdy cst sho to hip b th,,,114.84,145.06,6
HCPCS,290460,APPL BDY CST SHO TO HIP B TH,,,195.56,195.56,1
HCPCS,29049,APPL CAST FIGURE-OF-EIGHT,,,72.74,575.82,15
HCPCS,29049,Appl cast figure-of-eight,,,114.84,145.06,6
HCPCS,290490,APPL CAST FIGURE-OF-EIGHT,,,72.74,72.74,1
HCPCS,29055,APPL CAST SHOULDER SPICA,,,143.56,575.82,15
HCPCS,29055,"APPLY SHOULDER CAST,SPICA",712.0,462.8,52.72,534.0,35
HCPCS,29055,Appl cast shoulder spica,,,114.84,145.06,6
HCPCS,290550,APPL CAST SHOULDER SPICA,,,143.56,143.56,1
HCPCS,29058,APPL CAST PLASTER VELPEAU,,,97.69,575.82,15
HCPCS,29058,"APPLY SHOULDER CAST,PLASTR VELPEAU",712.0,462.8,53.41,534.0,35
HCPCS,29058,Appl cast plaster velpeau,,,114.84,145.06,6
HCPCS,290580,APPL CAST PLASTER VELPEAU,,,97.69,97.69,1
HCPCS,29065,APPL CST SHO TO HAND LNG ARM,,,71.0,71.0,1
HCPCS,29065,APPLICATION CAST SHOULDER HAND LONG ARM,938.0,609.7,51.62,4151.0,179
HCPCS,290650,APPL CST SHO TO HAND LNG ARM,,,71.0,71.0,1
HCPCS,29075,APPL CST ELBW FNGR SHORT ARM,,,65.02,65.02,1
HCPCS,29075,APPLICATION CAST ELBOW FINGER SHORT ARM,918.0,596.7,47.03,4151.0,179
HCPCS,290750,APPL CST ELBW FNGR SHORT ARM,,,65.02,65.02,1
HCPCS,29085,APPL CAST HAND&LWR FOREARM,,,70.3,70.3,1
HCPCS,29085,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,628.0,408.20000000000005,50.76,3920.0,133
HCPCS,290850,APPL CAST HAND&LWR FOREARM,,,70.3,70.3,1
HCPCS,29086,APPLICATION CAST FINGER,,,51.09,342.11,15
HCPCS,29086,APPLICATION FINGER CAST,248.0,161.2,38.41,186.0,32
HCPCS,29086,Application cast finger,,,114.84,145.06,6
HCPCS,290860,APPLICATION CAST FINGER,,,51.09,51.09,1
HCPCS,29105,APPLICATION LONG ARM SPLINT,,,44.2,44.2,1
HCPCS,29105,APPLICATION LONG ARM SPLINT SHOULDER HAND,614.0,399.1,40.11,3920.0,179
HCPCS,291050,APPLICATION LONG ARM SPLINT,,,44.2,44.2,1
HCPCS,29125,APPL SHORT ARM SPLINT STATIC,,,41.95,41.95,1
HCPCS,29125,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,480.5,312.325,29.87,3920.0,228
HCPCS,291250,APPL SHORT ARM SPLINT STATIC,,,41.95,41.95,1
HCPCS,29126,APPL SHORT ARM SPLINT DYN,,,51.41,51.41,1
HCPCS,29126,APPLICATION SHORT ARM SPLINT DYNAMIC,741.0,481.65,47.31,3920.0,98
HCPCS,29126,"APPLY FOREARM SPLINT,DYNAMIC",299.0,194.35,23.67,224.25,35
HCPCS,291260,APPL SHORT ARM SPLINT DYN,,,51.41,51.41,1
HCPCS,29130,APPL FINGER SPLINT STATIC,,,30.49,30.49,1
HCPCS,29130,APPLICATION FINGER SPLINT STATIC,480.5,312.325,22.02,3920.0,228
HCPCS,291300,APPL FINGER SPLINT STATIC,,,30.49,30.49,1
HCPCS,29131,APPL FINGER SPLINT DYNAMIC,,,36.21,36.21,1
HCPCS,29131,APPLICATION FINGER SPLINT DYNAMIC,341.0,221.65,40.74,3920.0,98
HCPCS,29131,"APPLY FINGER SPLINT,DYNAMIC",242.0,157.3,16.61,181.5,35
HCPCS,291310,APPL FINGER SPLINT DYNAMIC,,,36.21,36.21,1
HCPCS,29200,STRAPPING THORAX,908.0,590.2,19.02,3920.0,99
HCPCS,292000,STRAPPING THORAX,,,19.02,19.02,1
HCPCS,29240,STRAPPING OF SHOULDER,,,18.69,18.69,1
HCPCS,29240,STRAPPING SHOULDER,456.5,296.72499999999997,15.74,3920.0,182
HCPCS,292400,STRAPPING OF SHOULDER,,,18.69,18.69,1
HCPCS,29260,STRAPPING ELBOW/WRIST,341.0,221.65,22.56,3920.0,98
HCPCS,29260,STRAPPING OF ELBOW OR WRIST,,,19.72,19.72,1
HCPCS,292600,STRAPPING OF ELBOW OR WRIST,,,19.72,19.72,1
HCPCS,29280,STRAPPING HAND/FINGER,341.0,221.65,23.67,3920.0,98
HCPCS,29280,STRAPPING OF HAND OR FINGER,,,21.11,21.11,1
HCPCS,292800,STRAPPING OF HAND OR FINGER,,,21.11,21.11,1
HCPCS,29305,APPL HIP SPICA CAST 1 LEG,,,164.84,575.82,15
HCPCS,29305,Appl hip spica cast 1 leg,,,114.84,145.06,6
HCPCS,293050,APPL HIP SPICA CAST 1 LEG,,,164.84,164.84,1
HCPCS,29325,APPL HIP SPICA CAST1&1/2,,,184.7,575.82,15
HCPCS,29325,Appl hip spica cast1&1/2,,,114.84,145.06,6
HCPCS,293250,APPL HIP SPICA CAST1&1/2,,,184.7,184.7,1
HCPCS,29345,APPLICATION LONG LEG CAST THIGH-TOE,1044.0,678.6,48.65,4151.0,133
HCPCS,29345,APPLICATION OF LONG LEG CAST,,,103.22,103.22,1
HCPCS,293450,APPLICATION OF LONG LEG CAST,,,103.22,103.22,1
HCPCS,29355,APPL LONG LEG CAST WALKER,,,111.01,575.82,15
HCPCS,29355,APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE,612.0,397.8,53.78,459.0,35
HCPCS,29355,Appl long leg cast walker,,,114.84,145.06,6
HCPCS,293550,APPL LONG LEG CAST WALKER,,,111.01,111.01,1
HCPCS,29358,APPL LONG LEG CAST BRACE,,,107.75,575.82,15
HCPCS,29358,Appl long leg cast brace,,,114.84,145.06,6
HCPCS,293580,APPL LONG LEG CAST BRACE,,,107.75,107.75,1
HCPCS,29365,APPL CYLINDER CAST,,,91.62,575.82,15
HCPCS,29365,APPLICATION CYLINDER CAST THIGH ANKLE,472.0,306.8,66.97,354.0,35
HCPCS,29365,Appl cylinder cast,,,114.84,145.06,6
HCPCS,293650,APPL CYLINDER CAST,,,91.62,91.62,1
HCPCS,29405,APPL SHORT LEG CAST,,,61.1,61.1,1
HCPCS,29405,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,924.0,600.6,45.23,4151.0,179
HCPCS,294050,APPL SHORT LEG CAST,,,61.1,61.1,1
HCPCS,29425,APPL SHORT LEG CAST WALKING,,,56.39,56.39,1
HCPCS,29425,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,924.0,600.6,42.92,3920.0,179
HCPCS,294250,APPL SHORT LEG CAST WALKING,,,56.39,56.39,1
HCPCS,29435,APPL PATLLR TDN BEARING CAST,,,90.31,90.31,1
HCPCS,29435,APPLICATION PATELLAR TENDON BEARING CAST,1000.0,650.0,46.9,4151.0,133
HCPCS,294350,APPL PATLLR TDN BEARING CAST,,,90.31,90.31,1
HCPCS,29440,ADDING WALKER TO PREV CAST,,,29.55,342.11,15
HCPCS,29440,Adding walker to prev cast,,,114.84,145.06,6
HCPCS,294400,ADDING WALKER TO PREV CAST,,,29.55,29.55,1
HCPCS,29445,APPL RIGID TOT CNTC LEG CAST,,,103.18,103.18,1
HCPCS,29445,APPLICATION RIGID TOTAL CONTACT LEG CAST,1120.0,728.0,76.3,4151.0,179
HCPCS,294450,APPL RIGID TOT CNTC LEG CAST,,,103.18,103.18,1
HCPCS,29450,APPLICATION CLUBFOOT CAST,,,118.03,342.11,15
HCPCS,29450,Application clubfoot cast,,,114.84,145.06,6
HCPCS,294500,APPLICATION CLUBFOOT CAST,,,118.03,118.03,1
HCPCS,29505,APPLICATION LONG LEG SPLINT,,,54.48,54.48,1
HCPCS,29505,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,606.0,393.90000000000003,37.96,3920.0,228
HCPCS,295050,APPLICATION LONG LEG SPLINT,,,54.48,54.48,1
HCPCS,29515,APPLICATION SHORT LEG SPLINT,,,51.95,51.95,1
HCPCS,29515,APPLICATION SHORT LEG SPLINT CALF FOOT,614.5,399.425,37.99,3920.0,228
HCPCS,295150,APPLICATION SHORT LEG SPLINT,,,51.95,51.95,1
HCPCS,29520,STRAPPING OF HIP,,,19.02,279.48,15
HCPCS,29520,Strapping of hip,,,47.31,59.76,6
HCPCS,295200,STRAPPING OF HIP,,,19.02,19.02,1
HCPCS,29530,STRAPPING KNEE,456.5,296.72499999999997,15.74,3920.0,133
HCPCS,29530,STRAPPING OF KNEE,,,18.69,18.69,1
HCPCS,295300,STRAPPING OF KNEE,,,18.69,18.69,1
HCPCS,29540,STRAPPING ANKLE &/FOOT,540.0,351.0,13.12,3920.0,180
HCPCS,295400,STRAPPING ANKLE &/FOOT,,,18.08,18.08,1
HCPCS,29550,STRAPPING OF TOES,110.0,71.5,10.29,82.5,36
HCPCS,29550,STRAPPING TOES,341.0,221.65,13.86,3920.0,144
HCPCS,295500,STRAPPING OF TOES,,,11.7,11.7,1
HCPCS,29580,STRAPPING UNNA BOOT,575.0,373.75,20.6,3920.0,180
HCPCS,295800,STRAPPING UNNA BOOT,,,27.62,27.62,1
HCPCS,29581,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,586.0,380.90000000000003,10.66,3920.0,81
HCPCS,29581,APPL MULTLAYER CMPRN SYS LEG,,,27.83,27.83,1
HCPCS,295810,APPL MULTLAYER CMPRN SYS LEG,,,27.83,27.83,1
HCPCS,29584,APPL MLTLAY CMPRN SYS UP ARM,,,16.23,16.23,1
HCPCS,29584,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FING,908.0,590.2,19.57,3920.0,46
HCPCS,295840,APPL MLTLAY CMPRN SYS UP ARM,,,16.23,16.23,1
HCPCS,29700,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,878.0,570.7,15.95,3920.0,179
HCPCS,29700,RMVL/BIVLV GAUNTLET BOOT/CST,,,34.69,34.69,1
HCPCS,297000,RMVL/BIVLV GAUNTLET BOOT/CST,,,34.69,34.69,1
HCPCS,29705,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,916.0,595.4,21.54,3920.0,179
HCPCS,29705,RMVL/BIVLV FULL ARM/LEG CAST,,,46.52,46.52,1
HCPCS,297050,RMVL/BIVLV FULL ARM/LEG CAST,,,46.52,46.52,1
HCPCS,29710,RMVL/BIVLV SHO/HIP SPICA,,,86.04,575.82,15
HCPCS,29710,Rmvl/bivlv sho/hip spica,,,114.84,145.06,6
HCPCS,297100,RMVL/BIVLV SHO/HIP SPICA,,,86.04,86.04,1
HCPCS,29720,REPAIR SPICA BODY CST/JACKET,,,45.69,342.11,15
HCPCS,29720,Repair spica body cst/jacket,,,114.84,145.06,6
HCPCS,297200,REPAIR SPICA BODY CST/JACKET,,,45.69,45.69,1
HCPCS,29730,WINDOWING CAST,300.0,195.0,21.38,225.0,32
HCPCS,29730,WINDOWING OF CAST,,,46.86,342.11,15
HCPCS,29730,Windowing of cast,,,114.84,145.06,6
HCPCS,297300,WINDOWING OF CAST,,,46.86,46.86,1
HCPCS,29740,WEDGING CAST EXCEPT CLUBFOOT CASTS,448.0,291.2,33.54,336.0,32
HCPCS,29740,WEDGING OF CAST,,,72.06,575.82,15
HCPCS,29740,Wedging of cast,,,114.84,145.06,6
HCPCS,297400,WEDGING OF CAST,,,72.06,72.06,1
HCPCS,29750,WEDGING OF CLUBFOOT CAST,,,80.46,575.82,15
HCPCS,29750,Wedging of clubfoot cast,,,114.84,145.06,6
HCPCS,297500,WEDGING OF CLUBFOOT CAST,,,80.46,80.46,1
HCPCS,29799,UNLISTED PROCEDURE CASTING OR STRAPPING,307.0,199.55,47.31,1974.0,82
HCPCS,29800,JAW ARTHROSCOPY/SURGERY,,,559.01,7034.85,15
HCPCS,29800,Jaw arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298000,JAW ARTHROSCOPY/SURGERY,,,559.01,559.01,1
HCPCS,29804,JAW ARTHROSCOPY/SURGERY,,,617.67,7034.85,15
HCPCS,29804,Jaw arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298040,JAW ARTHROSCOPY/SURGERY,,,617.67,617.67,1
HCPCS,29805,DIAGNOSTIC ARTHROSCOPY SHOULDER +- SYNOVIAL BX,2412.0,1567.8,261.6,2412.0,35
HCPCS,29805,SHO ARTHRS DX +- SYNOVIAL BX,,,491.5,7034.85,15
HCPCS,29805,Sho arthrs dx +- synovial bx,,,1311.27,1656.34,6
HCPCS,298050,SHO ARTHRS DX +- SYNOVIAL BX,,,491.5,491.5,1
HCPCS,29806,SHO ARTHRS SRG CAPSULORRAPHY,,,1110.37,15488.78,15
HCPCS,29806,SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY,6056.0,3936.4,726.33,6056.0,35
HCPCS,29806,Sho arthrs srg capsulorraphy,,,3407.88,4304.69,6
HCPCS,298060,SHO ARTHRS SRG CAPSULORRAPHY,,,1110.37,1110.37,1
HCPCS,29807,SHO ARTHRS SRG RPR SLAP LES,,,1083.91,15488.78,15
HCPCS,29807,SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION,5868.0,3814.2,706.83,5868.0,35
HCPCS,29807,Sho arthrs srg rpr slap les,,,3407.88,4304.69,6
HCPCS,298070,SHO ARTHRS SRG RPR SLAP LES,,,1083.91,1083.91,1
HCPCS,29819,SHO ARTHRS SRG RMVL LOOSE/FB,,,616.94,7034.85,15
HCPCS,29819,SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB,3116.0,2025.4,449.86,3116.0,35
HCPCS,29819,Sho arthrs srg rmvl loose/fb,,,1311.27,1656.34,6
HCPCS,298190,SHO ARTHRS SRG RMVL LOOSE/FB,,,616.94,616.94,1
HCPCS,29820,SHO ARTHRS SRG PRTL SYNVCT,,,560.71,15488.78,15
HCPCS,29820,SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY,2884.0,1874.6,402.41,2884.0,35
HCPCS,29820,Sho arthrs srg prtl synvct,,,1311.27,1656.34,6
HCPCS,298200,SHO ARTHRS SRG PRTL SYNVCT,,,560.71,560.71,1
HCPCS,29821,SHO ARTHRS SRG COMPL SYNVCT,,,622.59,7034.85,15
HCPCS,29821,SURGICAL ARTHROSCOPY SHOULDER COMPL SYNOVECTOMY,3156.0,2051.4,442.88,3156.0,35
HCPCS,29821,Sho arthrs srg compl synvct,,,3407.88,4304.69,6
HCPCS,298210,SHO ARTHRS SRG COMPL SYNVCT,,,622.59,622.59,1
HCPCS,29822,SHO ARTHRS SRG LMTD DBRDMT,,,569.02,7034.85,15
HCPCS,29822,SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2,3093.0,2010.45,420.16,3093.0,35
HCPCS,29822,Sho arthrs srg lmtd dbrdmt,,,1311.27,1656.34,6
HCPCS,298220,SHO ARTHRS SRG LMTD DBRDMT,,,569.02,569.02,1
HCPCS,29823,SHO ARTHRS SRG XTNSV DBRDMT,,,623.25,7034.85,15
HCPCS,29823,SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+,3511.0,2282.15,463.92,3511.0,35
HCPCS,29823,Sho arthrs srg xtnsv dbrdmt,,,1311.27,1656.34,6
HCPCS,298230,SHO ARTHRS SRG XTNSV DBRDMT,,,623.25,623.25,1
HCPCS,29824,SHO ARTHRS SRG DSTL CLAVICLC,,,710.83,7034.85,15
HCPCS,29824,SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC,3592.0,2334.8,441.97,3592.0,35
HCPCS,29824,Sho arthrs srg dstl claviclc,,,1311.27,1656.34,6
HCPCS,298240,SHO ARTHRS SRG DSTL CLAVICLC,,,710.83,710.83,1
HCPCS,29825,SHO ARTHRS SRG LSS&RESCJ ADS,,,615.54,7034.85,15
HCPCS,29825,SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS,3116.0,2025.4,434.73,3116.0,35
HCPCS,29825,Sho arthrs srg lss&rescj ads,,,1311.27,1656.34,6
HCPCS,298250,SHO ARTHRS SRG LSS&RESCJ ADS,,,615.54,615.54,1
HCPCS,29826,SHO ARTHRS SRG DECOMPRESSION,,,179.17,390.0,2
HCPCS,29826,SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS,1320.0,858.0,131.49,1320.0,35
HCPCS,29826,Sho arthrs srg decompression,,,1311.27,1656.34,6
HCPCS,298260,SHO ARTHRS SRG DECOMPRESSION,,,179.17,179.17,1
HCPCS,29827,SHO ARTHRS SRG RT8TR CUF RPR,,,1119.9,15488.78,16
HCPCS,29827,SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR,6236.0,4053.4,720.99,6236.0,35
HCPCS,29827,Sho arthrs srg rt8tr cuf rpr,,,3407.88,4304.69,6
HCPCS,298270,SHO ARTHRS SRG RT8TR CUF RPR,,,1119.9,1119.9,1
HCPCS,29828,SHO ARTHRS SRG BICP TENODSIS,,,960.99,15488.78,15
HCPCS,29828,SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS,5790.0,3763.5,543.77,5790.0,35
HCPCS,29828,Sho arthrs srg bicp tenodsis,,,3407.88,4304.69,6
HCPCS,298280,SHO ARTHRS SRG BICP TENODSIS,,,960.99,960.99,1
HCPCS,29830,ARTHROSCOPY ELBOW DIAG W/WO SYNOVIAL BIOPSY SPX,2352.0,1528.8,303.43,2352.0,35
HCPCS,29830,ELBOW ARTHROSCOPY,,,479.77,7034.85,15
HCPCS,29830,Elbow arthroscopy,,,1311.27,1656.34,6
HCPCS,298300,ELBOW ARTHROSCOPY,,,479.77,479.77,1
HCPCS,29834,ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB,2568.0,1669.2,334.54,2568.0,35
HCPCS,29834,ELBOW ARTHROSCOPY/SURGERY,,,516.96,7034.85,15
HCPCS,29834,Elbow arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298340,ELBOW ARTHROSCOPY/SURGERY,,,516.96,516.96,1
HCPCS,29835,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL,2648.0,1721.2,343.84,2648.0,35
HCPCS,29835,ELBOW ARTHROSCOPY/SURGERY,,,536.75,7034.85,15
HCPCS,29835,Elbow arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298350,ELBOW ARTHROSCOPY/SURGERY,,,536.75,536.75,1
HCPCS,29836,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE,3088.0,2007.2,400.19,3088.0,35
HCPCS,29836,ELBOW ARTHROSCOPY/SURGERY,,,614.47,15488.78,15
HCPCS,29836,Elbow arthroscopy/surgery,,,3407.88,4304.69,6
HCPCS,298360,ELBOW ARTHROSCOPY/SURGERY,,,614.47,614.47,1
HCPCS,29837,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED,2804.0,1822.6,365.67,2804.0,35
HCPCS,29837,ELBOW ARTHROSCOPY/SURGERY,,,552.45,7034.85,15
HCPCS,29837,Elbow arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298370,ELBOW ARTHROSCOPY/SURGERY,,,552.45,552.45,1
HCPCS,29838,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE,3152.0,2048.8,403.17,3152.0,35
HCPCS,29838,ELBOW ARTHROSCOPY/SURGERY,,,625.78,7034.85,15
HCPCS,29838,Elbow arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298380,ELBOW ARTHROSCOPY/SURGERY,,,625.78,625.78,1
HCPCS,29840,ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX,2272.0,1476.8,262.68,2272.0,35
HCPCS,29840,WRIST ARTHROSCOPY,,,473.76,7034.85,15
HCPCS,29840,Wrist arthroscopy,,,1311.27,1656.34,6
HCPCS,298400,WRIST ARTHROSCOPY,,,473.76,473.76,1
HCPCS,29843,ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE,2460.0,1599.0,330.38,2460.0,35
HCPCS,29843,WRIST ARTHROSCOPY/SURGERY,,,512.91,7034.85,15
HCPCS,29843,Wrist arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298430,WRIST ARTHROSCOPY/SURGERY,,,512.91,512.91,1
HCPCS,29844,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL,2604.0,1692.6,342.43,2604.0,35
HCPCS,29844,WRIST ARTHROSCOPY/SURGERY,,,525.06,7034.85,15
HCPCS,29844,Wrist arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298440,WRIST ARTHROSCOPY/SURGERY,,,525.06,525.06,1
HCPCS,29845,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE,3076.0,1999.4,413.25,3076.0,35
HCPCS,29845,WRIST ARTHROSCOPY/SURGERY,,,616.77,7034.85,15
HCPCS,29845,Wrist arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298450,WRIST ARTHROSCOPY/SURGERY,,,616.77,616.77,1
HCPCS,29846,ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT,2756.0,1791.4,405.85,2756.0,35
HCPCS,29846,WRIST ARTHROSCOPY/SURGERY,,,549.8,7034.85,15
HCPCS,29846,Wrist arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298460,WRIST ARTHROSCOPY/SURGERY,,,549.8,549.8,1
HCPCS,29847,WRIST ARTHROSCOPY/SURGERY,,,573.67,15488.78,15
HCPCS,29847,Wrist arthroscopy/surgery,,,3407.88,4304.69,6
HCPCS,298470,WRIST ARTHROSCOPY/SURGERY,,,573.67,573.67,1
HCPCS,29848,NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM,2556.0,1661.4,263.12,2556.0,35
HCPCS,29848,WRIST ENDOSCOPY/SURGERY,,,539.37,3469.95,15
HCPCS,29848,Wrist endoscopy/surgery,,,1311.27,1656.34,6
HCPCS,298480,WRIST ENDOSCOPY/SURGERY,,,539.37,539.37,1
HCPCS,29850,ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ,3308.0,2150.2,465.1,3308.0,35
HCPCS,29850,KNEE ARTHROSCOPY/SURGERY,,,657.21,3469.95,15
HCPCS,29850,Knee arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298500,KNEE ARTHROSCOPY/SURGERY,,,657.21,657.21,1
HCPCS,29851,ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ,5304.0,3447.6,654.54,5304.0,35
HCPCS,29851,KNEE ARTHROSCOPY/SURGERY,,,976.01,3469.95,15
HCPCS,29851,Knee arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298510,KNEE ARTHROSCOPY/SURGERY,,,976.01,976.01,1
HCPCS,29855,ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR,4304.0,2797.6,573.5,4304.0,35
HCPCS,29855,TIBIAL ARTHROSCOPY/SURGERY,,,818.75,15488.78,15
HCPCS,29855,Tibial arthroscopy/surgery,,,3407.88,4304.69,6
HCPCS,298550,TIBIAL ARTHROSCOPY/SURGERY,,,818.75,818.75,1
HCPCS,29856,ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR,5712.0,3712.8,703.4,5712.0,35
HCPCS,29856,TIBIAL ARTHROSCOPY/SURGERY,,,1041.4,27897.39,15
HCPCS,29856,Tibial arthroscopy/surgery,,,3407.88,4304.69,6
HCPCS,298560,TIBIAL ARTHROSCOPY/SURGERY,,,1041.4,1041.4,1
HCPCS,29860,ARTHROSCOPY HIP DIAGNOSTIC W/WO SYNOVIAL BYP SPX,3600.0,2340.0,360.72,3600.0,35
HCPCS,29860,HIP ARTHROSCOPY DX,,,688.87,15488.78,15
HCPCS,29860,Hip arthroscopy dx,,,3407.88,4304.69,6
HCPCS,298600,HIP ARTHROSCOPY DX,,,688.87,688.87,1
HCPCS,29861,ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB,4040.0,2626.0,506.35,4040.0,35
HCPCS,29861,HIP ARTHRO W/FB REMOVAL,,,750.47,15488.78,15
HCPCS,29861,Hip arthro w/fb removal,,,1311.27,1656.34,6
HCPCS,298610,HIP ARTHRO W/FB REMOVAL,,,750.47,750.47,1
HCPCS,29862,ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG,4468.0,2904.2,554.81,4468.0,35
HCPCS,29862,HIP ARTHR0 W/DEBRIDEMENT,,,855.4,15488.78,15
HCPCS,29862,Hip arthr0 w/debridement,,,3407.88,4304.69,6
HCPCS,298620,HIP ARTHR0 W/DEBRIDEMENT,,,855.4,855.4,1
HCPCS,29863,ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY,4915.0,3194.75,517.24,4915.0,35
HCPCS,29863,HIP ARTHR0 W/SYNOVECTOMY,,,854.71,7034.85,15
HCPCS,29863,Hip arthr0 w/synovectomy,,,1311.27,1656.34,6
HCPCS,298630,HIP ARTHR0 W/SYNOVECTOMY,,,854.71,854.71,1
HCPCS,29866,ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST,5868.0,3814.2,761.25,5868.0,35
HCPCS,29866,AUTGRFT IMPLNT KNEE W/SCOPE,,,1103.95,15488.78,15
HCPCS,29866,Autgrft implnt knee w/scope,,,3407.88,4304.69,6
HCPCS,298660,AUTGRFT IMPLNT KNEE W/SCOPE,,,1103.95,1103.95,1
HCPCS,29867,ALLGRFT IMPLNT KNEE W/SCOPE,,,1340.3,27897.39,15
HCPCS,29867,ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT,7356.0,4781.4,909.82,7356.0,35
HCPCS,29867,Allgrft implnt knee w/scope,,,3407.88,4304.69,6
HCPCS,298670,ALLGRFT IMPLNT KNEE W/SCOPE,,,1340.3,1340.3,1
HCPCS,29868,ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT,10040.0,6526.0,1235.3,10040.0,35
HCPCS,29868,MENISCAL TRNSPL KNEE W/SCPE,,,1747.17,15488.78,15
HCPCS,29868,Meniscal trnspl knee w/scpe,,,3407.88,4304.69,6
HCPCS,298680,MENISCAL TRNSPL KNEE W/SCPE,,,1747.17,1747.17,1
HCPCS,29870,ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX,2284.0,1484.6,199.23,1713.0,35
HCPCS,29870,ARTHRS KNEE DX W/WO SYN BX,,,431.82,7034.85,15
HCPCS,29870,Arthrs knee dx w/wo syn bx,,,1311.27,1656.34,6
HCPCS,298700,ARTHRS KNEE DX W/WO SYN BX,,,431.82,431.82,1
HCPCS,29871,ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE,2944.0,1913.6,364.85,2944.0,35
HCPCS,29871,ARTHRS KNEE SURG FOR INFCTJ,,,542.17,7034.85,15
HCPCS,29871,Arthrs knee surg for infctj,,,1311.27,1656.34,6
HCPCS,298710,ARTHRS KNEE SURG FOR INFCTJ,,,542.17,542.17,1
HCPCS,29873,ARTHRS KNEE SURG W/LAT RLS,,,563.92,7034.85,15
HCPCS,29873,ARTHRS KNEE W LAT RELEASE,2746.0,1784.9,331.77,2746.0,35
HCPCS,29873,Arthrs knee surg w/lat rls,,,1311.27,1656.34,6
HCPCS,298730,ARTHRS KNEE SURG W/LAT RLS,,,563.92,563.92,1
HCPCS,29874,ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY,3164.0,2056.6,409.38,3164.0,35
HCPCS,29874,ARTHRS KNEE SURG RMV LOOS/FB,,,566.48,7034.85,15
HCPCS,29874,Arthrs knee surg rmv loos/fb,,,1311.27,1656.34,6
HCPCS,298740,ARTHRS KNEE SURG RMV LOOS/FB,,,566.48,566.48,1
HCPCS,29875,ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX,2838.0,1844.7,374.38,2838.0,35
HCPCS,29875,ARTHRS KNEE SURG SYNVCT LMTD,,,522.51,7034.85,15
HCPCS,29875,Arthrs knee surg synvct lmtd,,,1311.27,1656.34,6
HCPCS,298750,ARTHRS KNEE SURG SYNVCT LMTD,,,522.51,522.51,1
HCPCS,29876,ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS,3548.0,2306.2,465.96,3548.0,35
HCPCS,29876,ARTHRS KNEE SURG SYNVCT MAJ,,,686.25,7034.85,15
HCPCS,29876,Arthrs knee surg synvct maj,,,1311.27,1656.34,6
HCPCS,298760,ARTHRS KNEE SURG SYNVCT MAJ,,,686.25,686.25,1
HCPCS,29877,ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG,3652.0,2373.8,431.99,3652.0,35
HCPCS,29877,ARTHRS KNEE SURG DBRDMT/SHVG,,,652.5,7034.85,15
HCPCS,29877,Arthrs knee surg dbrdmt/shvg,,,1311.27,1656.34,6
HCPCS,298770,ARTHRS KNEE SURG DBRDMT/SHVG,,,652.5,652.5,1
HCPCS,29879,ARTHRS KNE SRG ABRASJ ARTHRP,,,695.65,7034.85,15
HCPCS,29879,ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX,3596.0,2337.4,474.73,3596.0,35
HCPCS,29879,Arthrs kne srg abrasj arthrp,,,1311.27,1656.34,6
HCPCS,298790,ARTHRS KNE SRG ABRASJ ARTHRP,,,695.65,695.65,1
HCPCS,29880,ARTHRS KNE SRG MNISECTMY M&L,,,590.84,7034.85,15
HCPCS,29880,ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING,3252.0,2113.8,440.69,3252.0,35
HCPCS,29880,Arthrs kne srg mnisectmy m&l,,,1311.27,1656.34,6
HCPCS,298800,ARTHRS KNE SRG MNISECTMY M&L,,,590.84,590.84,1
HCPCS,29881,ARTHRS KNE SRG MNISECTMY M/L,,,569.02,7034.85,16
HCPCS,29881,ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG,3093.0,2010.45,424.86,3093.0,35
HCPCS,29881,Arthrs kne srg mnisectmy m/l,,,1311.27,1656.34,6
HCPCS,298810,ARTHRS KNE SRG MNISECTMY M/L,,,569.02,569.02,1
HCPCS,29882,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL,4224.0,2745.6,499.72,4224.0,35
HCPCS,29882,ARTHRS KNE SRG MNISC RPR M/L,,,723.37,7034.85,15
HCPCS,29882,Arthrs kne srg mnisc rpr m/l,,,1311.27,1656.34,6
HCPCS,298820,ARTHRS KNE SRG MNISC RPR M/L,,,723.37,723.37,1
HCPCS,29883,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL,4708.0,3060.2,560.59,4708.0,35
HCPCS,29883,ARTHRS KNE SRG MNISC RPR M&L,,,885.34,7034.85,15
HCPCS,29883,Arthrs kne srg mnisc rpr m&l,,,1311.27,1656.34,6
HCPCS,298830,ARTHRS KNE SRG MNISC RPR M&L,,,885.34,885.34,1
HCPCS,29884,ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX,3312.0,2152.8,428.21,3312.0,35
HCPCS,29884,ARTHRS KNEE SURG LYSIS ADS,,,651.46,7034.85,15
HCPCS,29884,Arthrs knee surg lysis ads,,,1311.27,1656.34,6
HCPCS,298840,ARTHRS KNEE SURG LYSIS ADS,,,651.46,651.46,1
HCPCS,29885,ARTHRS KNE SRG DRLG OST DISS,,,795.19,15488.78,15
HCPCS,29885,ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG,4084.0,2654.6,477.57,4084.0,35
HCPCS,29885,Arthrs kne srg drlg ost diss,,,3407.88,4304.69,6
HCPCS,298850,ARTHRS KNE SRG DRLG OST DISS,,,795.19,795.19,1
HCPCS,29886,ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION,3736.0,2428.4,399.06,3736.0,35
HCPCS,29886,ARTHRS KNEE SURG DRLG OD LES,,,670.16,7034.85,15
HCPCS,29886,Arthrs knee surg drlg od les,,,1311.27,1656.34,6
HCPCS,298860,ARTHRS KNEE SURG DRLG OD LES,,,670.16,670.16,1
HCPCS,29887,ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ,4064.0,2641.6,518.13,4064.0,35
HCPCS,29887,ARTHRS KNEE SRG DRLG OD FIXJ,,,792.37,15488.78,15
HCPCS,29887,Arthrs knee srg drlg od fixj,,,3407.88,4304.69,6
HCPCS,298870,ARTHRS KNEE SRG DRLG OD FIXJ,,,792.37,792.37,1
HCPCS,29888,ARTHRS AID ACL RPR/AGMNTJ,,,1021.43,15488.78,15
HCPCS,29888,ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,6292.0,4089.8,755.76,6292.0,35
HCPCS,29888,Arthrs aid acl rpr/agmntj,,,3407.88,4304.69,6
HCPCS,298880,ARTHRS AID ACL RPR/AGMNTJ,,,1021.43,1021.43,1
HCPCS,29889,ARTHRS AID PCL RPR/AGMNTJ,,,1284.58,27897.39,15
HCPCS,29889,ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,6964.0,4526.6,666.81,6964.0,35
HCPCS,29889,Arthrs aid pcl rpr/agmntj,,,3407.88,4304.69,6
HCPCS,298890,ARTHRS AID PCL RPR/AGMNTJ,,,1284.58,1284.58,1
HCPCS,29891,ARTHR ANK OSTCHN DF TAL&/TIB,,,707.3,7034.85,15
HCPCS,29891,ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT,3868.0,2514.2,477.72,3868.0,35
HCPCS,29891,Arthr ank ostchn df tal&/tib,,,1311.27,1656.34,6
HCPCS,298910,ARTHR ANK OSTCHN DF TAL&/TIB,,,707.3,707.3,1
HCPCS,29892,ARTHRS AID RPR OD LES/TIB FX,,,674.04,15488.78,15
HCPCS,29892,Arthrs aid rpr od les/tib fx,,,3407.88,4304.69,6
HCPCS,298920,ARTHRS AID RPR OD LES/TIB FX,,,674.04,674.04,1
HCPCS,29893,ENDOSCOPIC PLANTR FASCIOTOMY,,,457.84,7034.85,15
HCPCS,29893,Endoscopic plantr fasciotomy,,,1342.37,1695.62,6
HCPCS,298930,ENDOSCOPIC PLANTR FASCIOTOMY,,,457.84,457.84,1
HCPCS,29894,ANKLE ARTHROSCOPY/SURGERY,,,529.87,7034.85,15
HCPCS,29894,ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY,2940.0,1911.0,394.99,2940.0,35
HCPCS,29894,Ankle arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298940,ANKLE ARTHROSCOPY/SURGERY,,,529.87,529.87,1
HCPCS,29895,ANKLE ARTHROSCOPY/SURGERY,,,486.78,7034.85,15
HCPCS,29895,ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL,2852.0,1853.8,358.22,2852.0,35
HCPCS,29895,Ankle arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298950,ANKLE ARTHROSCOPY/SURGERY,,,486.78,486.78,1
HCPCS,29897,ANKLE ARTHROSCOPY/SURGERY,,,520.47,7034.85,15
HCPCS,29897,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED,2928.0,1903.2,384.26,2928.0,35
HCPCS,29897,Ankle arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298970,ANKLE ARTHROSCOPY/SURGERY,,,520.47,520.47,1
HCPCS,29898,ANKLE ARTHROSCOPY/SURGERY,,,588.06,7034.85,15
HCPCS,29898,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE,3736.0,2428.4,436.35,3736.0,35
HCPCS,29898,Ankle arthroscopy/surgery,,,1311.27,1656.34,6
HCPCS,298980,ANKLE ARTHROSCOPY/SURGERY,,,588.06,588.06,1
HCPCS,29899,ANKLE ARTHROSCOPY/SURGERY,,,1054.37,15488.78,15
HCPCS,29899,ARTHRS ANKLE W ARTHRODESIS,6164.0,4006.6,662.51,6164.0,35
HCPCS,29899,Ankle arthroscopy/surgery,,,3407.88,4304.69,6
HCPCS,298990,ANKLE ARTHROSCOPY/SURGERY,,,1054.37,1054.37,1
HCPCS,29900,ARTHROSCOPY METACARPOPHALANGEAL SYNOVIAL BIOPSY,2587.0,1681.55,298.41,2587.0,35
HCPCS,29900,MCP JOINT ARTHROSCOPY DX,,,530.82,7034.85,15
HCPCS,29900,Mcp joint arthroscopy dx,,,1311.27,1656.34,6
HCPCS,299000,MCP JOINT ARTHROSCOPY DX,,,530.82,530.82,1
HCPCS,29901,ARTHRS METACARPOPHALANGEAL JOINT DEBRIDEMENT,2900.0,1885.0,345.56,2900.0,35
HCPCS,29901,MCP JOINT ARTHROSCOPY SURG,,,569.41,7034.85,15
HCPCS,29901,Mcp joint arthroscopy surg,,,1311.27,1656.34,6
HCPCS,299010,MCP JOINT ARTHROSCOPY SURG,,,569.41,569.41,1
HCPCS,29902,ARTHRS MTCARPHLNGL JT W/RDCTJ UR COLTRL LIGM,3150.0,2047.5,371.02,3150.0,35
HCPCS,29902,MCP JOINT ARTHROSCOPY SURG,,,604.23,3469.95,15
HCPCS,29902,Mcp joint arthroscopy surg,,,1311.27,1656.34,6
HCPCS,299020,MCP JOINT ARTHROSCOPY SURG,,,604.23,604.23,1
HCPCS,29904,SUBTALAR ARTHRO W/FB RMVL,,,673.1,7034.85,15
HCPCS,29904,Subtalar arthro w/fb rmvl,,,1311.27,1656.34,6
HCPCS,299040,SUBTALAR ARTHRO W/FB RMVL,,,673.1,673.1,1
HCPCS,29905,SUBTALAR ARTHRO W/EXC,,,540.86,15488.78,15
HCPCS,29905,Subtalar arthro w/exc,,,1311.27,1656.34,6
HCPCS,299050,SUBTALAR ARTHRO W/EXC,,,540.86,540.86,1
HCPCS,29906,SUBTALAR ARTHRO W/DEB,,,685.59,7034.85,15
HCPCS,29906,Subtalar arthro w/deb,,,1311.27,1656.34,6
HCPCS,299060,SUBTALAR ARTHRO W/DEB,,,685.59,685.59,1
HCPCS,29907,SUBTALAR ARTHRO W/FUSION,,,921.48,27897.39,15
HCPCS,29907,Subtalar arthro w/fusion,,,3407.88,4304.69,6
HCPCS,299070,SUBTALAR ARTHRO W/FUSION,,,921.48,921.48,1
HCPCS,29914,ARTHROSCOPY HIP W/FEMOROPLASTY,6455.0,4195.75,604.0,6455.0,35
HCPCS,29914,HIP ARTHRO W/FEMOROPLASTY,,,1041.17,15488.78,15
HCPCS,29914,Hip arthro w/femoroplasty,,,3407.88,4304.69,6
HCPCS,299140,HIP ARTHRO W/FEMOROPLASTY,,,1041.17,1041.17,1
HCPCS,29915,ARTHROSCOPY HIP W/ACETABULOPLASTY,6000.0,3900.0,615.29,6000.0,35
HCPCS,29915,HIP ARTHRO ACETABULOPLASTY,,,1067.28,15488.78,15
HCPCS,29915,Hip arthro acetabuloplasty,,,3407.88,4304.69,6
HCPCS,299150,HIP ARTHRO ACETABULOPLASTY,,,1067.28,1067.28,1
HCPCS,29916,ARTHROSCOPY HIP W/LABRAL REPAIR,6000.0,3900.0,615.29,6000.0,35
HCPCS,29916,HIP ARTHRO W/LABRAL REPAIR,,,1062.89,15488.78,15
HCPCS,29916,Hip arthro w/labral repair,,,3407.88,4304.69,6
HCPCS,299160,HIP ARTHRO W/LABRAL REPAIR,,,1062.89,1062.89,1
HCPCS,29999,ARTHROSCOPIC AC JOINT RECONSTRUCTION (COMP CODE 23462),6288.0,4087.2,467.7,6288.0,15
HCPCS,29999,ARTHROSCOPIC BONE EXCISION WITH GRAFTING (COMP CODE 27360),4584.0,2979.6,467.7,4584.0,15
HCPCS,29999,ARTHROSCOPIC CORACOPLASTY SHOULDER (COMP CODE 23182),3444.0,2238.6,467.7,3444.0,15
HCPCS,29999,ARTHROSCOPIC EXCISION OF MENISCAL CYST OF THE KNEE (COMP CODE 29,2838.0,1844.7,467.7,2838.0,15
HCPCS,29999,ARTHROSCOPIC REMOVAL OF IMPLANT (COMP CODE 20680),2622.0,1704.3,467.7,2622.0,15
HCPCS,29999,ARTHROSCOPIC REMPLISSAGE REPAIR (COMP CODE 29827),5613.0,3648.45,467.7,5613.0,15
HCPCS,29999,ARTHROSCOPIC TENOTOMY (COMP CODE 23405),3416.0,2220.4,467.7,3416.0,15
HCPCS,29999,ARTHROSCOPICALLY AIDED CARPAL DECOMPRESSION/BONE DRILLING (COMP,3060.0,1989.0,467.7,3060.0,15
HCPCS,29999,ARTHROSCOPY SHOULDER - BALLOON SPACER IMPLANTATION (COMP CODE 29,3432.0,2230.8,467.7,3432.0,15
HCPCS,29999,ENDOSCOPIC ILIOPSOAS TENDON RELEASE (COMP CODE 29862),4468.0,2904.2,467.7,4468.0,15
HCPCS,29999,ILIOPSOAS TENDON RELEASE; SCOPE (COMP 27306),1896.0,1232.4,467.7,1896.0,15
HCPCS,29999,TENOTOMY OF HIP FLEXORS (COMP CODE 27005),4330.0,2814.5,467.7,4330.0,15
HCPCS,29999,UNLISTED PX ARTHROSCOPY,,,240.79,520.1,14
HCPCS,29999,Unlisted px arthroscopy,,,1311.27,1656.34,6
HCPCS,30000,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,963.5,626.275,60.7,4214.0,130
HCPCS,30000,DRAINAGE OF NOSE LESION,,,128.41,128.41,1
HCPCS,300000,DRAINAGE OF NOSE LESION,,,128.41,128.41,1
HCPCS,30020,"DRAIN ABSCESS/HEMATOMA,NASAL SEPTUM",592.0,384.8,62.19,444.0,35
HCPCS,30020,DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,2929.0,1903.85,142.7,4214.0,96
HCPCS,30020,DRAINAGE OF NOSE LESION,,,130.09,130.09,1
HCPCS,300200,DRAINAGE OF NOSE LESION,,,130.09,130.09,1
HCPCS,3006F,CXR DOC REV,,,0.01,0.01,1
HCPCS,3006F0,CXR DOC REV,,,0.01,0.01,1
HCPCS,3008F,BODY MASS INDEX DOCD,,,0.01,0.01,1
HCPCS,3008F0,BODY MASS INDEX DOCD,,,0.01,0.01,1
HCPCS,30100,BIOPSY INTRANASAL,8518.0,5536.7,78.52,7666.2,46
HCPCS,30100,"BIOPSY,INTRANASAL",376.0,244.4,46.1,282.0,35
HCPCS,30100,INTRANASAL BIOPSY,,,72.47,72.47,1
HCPCS,301000,INTRANASAL BIOPSY,,,72.47,72.47,1
HCPCS,30110,EXCISION NASAL POLYP SIMPLE,8518.0,5536.7,152.19,7666.2,46
HCPCS,30110,"EXCISION NOSE POLYP(S),SIMPLE",672.0,436.8,84.04,504.0,35
HCPCS,30110,REMOVAL OF NOSE POLYP(S),,,141.18,141.18,1
HCPCS,301100,REMOVAL OF NOSE POLYP(S),,,141.18,141.18,1
HCPCS,30115,"EXCISION NOSE POLYP(S),EXTENSIVE",1776.0,1154.4,231.78,1776.0,35
HCPCS,30115,REMOVAL OF NOSE POLYP(S),,,488.71,7031.51,15
HCPCS,30115,Removal of nose polyp(s),,,839.72,1060.7,6
HCPCS,301150,REMOVAL OF NOSE POLYP(S),,,488.71,488.71,1
HCPCS,30117,"EXCIS INTRANASAL LESN,INTERN APPRCH",1564.0,1016.6,168.64,1366.21,35
HCPCS,30117,EXCISION/DESTRUCTION INTRANASAL LESION INT APPR,18648.0,12121.2,495.46,16783.2,46
HCPCS,30117,REMOVAL OF INTRANASAL LESION,,,432.84,432.84,1
HCPCS,301170,REMOVAL OF INTRANASAL LESION,,,432.84,432.84,1
HCPCS,30118,"EXCIS INTRANASAL LESN,EXT APPRCH",3100.0,2015.0,478.45,3100.0,35
HCPCS,30118,REMOVAL OF INTRANASAL LESION,,,746.66,7031.51,15
HCPCS,30118,Removal of intranasal lesion,,,1634.08,2064.1,6
HCPCS,301180,REMOVAL OF INTRANASAL LESION,,,746.66,746.66,1
HCPCS,3011F,LIPID PANEL DOC REV,,,0.01,0.01,1
HCPCS,3011F0,LIPID PANEL DOC REV,,,0.01,0.01,1
HCPCS,30120,EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA,2156.0,1401.4,214.57,1617.0,35
HCPCS,30120,REVISION OF NOSE,,,444.71,7031.51,15
HCPCS,30120,Revision of nose,,,1634.08,2064.1,6
HCPCS,301200,REVISION OF NOSE,,,444.71,444.71,1
HCPCS,30124,EXCISION DERMOID CYST NOSE SIMPLE SUBCUTANEOUS,1280.0,832.0,149.43,1280.0,35
HCPCS,30124,REMOVAL OF NOSE LESION,,,321.51,3211.66,15
HCPCS,30124,Removal of nose lesion,,,839.72,1060.7,6
HCPCS,301240,REMOVAL OF NOSE LESION,,,321.51,321.51,1
HCPCS,30125,EXC DERMOID CYST NOSE COMPLEX UNDER BONE/CRTLG,2920.0,1898.0,351.48,2920.0,35
HCPCS,30125,REMOVAL OF NOSE LESION,,,690.42,12826.13,15
HCPCS,30125,Removal of nose lesion,,,839.72,1060.7,6
HCPCS,301250,REMOVAL OF NOSE LESION,,,690.42,690.42,1
HCPCS,30130,EXCISE INFERIOR TURBINATE,,,434.43,7031.51,15
HCPCS,30130,EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE,1527.0,992.55,207.28,1527.0,35
HCPCS,30130,Excise inferior turbinate,,,1664.64,2102.7,6
HCPCS,301300,EXCISE INFERIOR TURBINATE,,,434.43,434.43,1
HCPCS,30140,RESECT INFERIOR TURBINATE,,,189.77,7031.51,16
HCPCS,30140,Resect inferior turbinate,,,1664.64,2102.7,6
HCPCS,30140,SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL,1320.0,858.0,166.27,1320.0,35
HCPCS,301400,RESECT INFERIOR TURBINATE,,,189.77,189.77,1
HCPCS,3014F,SCREEN MAMMO DOC REV,,,0.01,0.01,1
HCPCS,3014F0,SCREEN MAMMO DOC REV,,,0.01,0.01,1
HCPCS,30150,RHINECTOMY PARTIAL,3820.0,2483.0,464.36,12826.13,50
HCPCS,30150,Rhinectomy partial,,,3243.49,4097.04,6
HCPCS,301500,RHINECTOMY PARTIAL,,,845.01,845.01,1
HCPCS,3015F,CERV CANCER SCREEN DOCD,,,0.01,0.01,1
HCPCS,3015F0,CERV CANCER SCREEN DOCD,,,0.01,0.01,1
HCPCS,30160,RHINECTOMY TOTAL,3996.0,2597.4,542.36,12826.13,50
HCPCS,30160,Rhinectomy total,,,3243.49,4097.04,6
HCPCS,301600,RHINECTOMY TOTAL,,,862.26,862.26,1
HCPCS,3016F,PT SCRND UNHLTHY OH USE,,,0.01,0.01,1
HCPCS,3016F0,PT SCRND UNHLTHY OH USE,,,0.01,0.01,1
HCPCS,3017F,COLORECTAL CA SCREEN DOC REV,,,0.01,0.01,1
HCPCS,3017F0,COLORECTAL CA SCREEN DOC REV,,,0.01,0.01,1
HCPCS,3018F,PRE-PRXD RSK ET AL DOCD,,,0.01,0.01,1
HCPCS,3018F0,PRE-PRXD RSK ET AL DOCD,,,0.01,0.01,1
HCPCS,3019F,LVEF ASSESS PLANPOST DSCHRGE,,,0.01,0.01,1
HCPCS,3019F0,LVEF ASSESS PLANPOST DSCHRGE,,,0.01,0.01,1
HCPCS,30200,INJECTION TREATMENT OF NOSE,,,63.17,63.17,1
HCPCS,30200,INJECTION TURBINATE THERAPEUTIC,1620.5,1053.325,28.44,4151.0,80
HCPCS,302000,INJECTION TREATMENT OF NOSE,,,63.17,63.17,1
HCPCS,3020F,LVF ASSESS,,,0.01,0.01,1
HCPCS,3020F0,LVF ASSESS,,,0.01,0.01,1
HCPCS,30210,DISPLACEMENT THERAPY PROETZ TYPE,452.0,293.8,49.97,339.0,35
HCPCS,30210,NASAL SINUS THERAPY,,,108.58,3211.66,15
HCPCS,30210,Nasal sinus therapy,,,112.01,141.49,6
HCPCS,302100,NASAL SINUS THERAPY,,,108.58,108.58,1
HCPCS,3021F,LVEF MOD/SEVER DEPRS SYST,,,0.01,0.01,1
HCPCS,3021F0,LVEF MOD/SEVER DEPRS SYST,,,0.01,0.01,1
HCPCS,30220,INSERT NASAL SEPTAL BUTTON,,,136.17,3211.66,15
HCPCS,30220,INSERTION NASAL SEPTAL PROSTHESIS BUTTON,636.0,413.4,85.7,477.0,35
HCPCS,30220,Insert nasal septal button,,,839.72,1060.7,6
HCPCS,302200,INSERT NASAL SEPTAL BUTTON,,,136.17,136.17,1
HCPCS,3022F,LVEF >=40% SYSTOLIC,,,0.01,0.01,1
HCPCS,3022F0,LVEF >=40% SYSTOLIC,,,0.01,0.01,1
HCPCS,3023F,SPIROM DOC REV,,,0.01,0.01,1
HCPCS,3023F0,SPIROM DOC REV,,,0.01,0.01,1
HCPCS,3025F,SPIROM FEV/FVC <70% W/COPD,,,0.01,0.01,1
HCPCS,3025F0,SPIROM FEV/FVC <70% W/COPD,,,0.01,0.01,1
HCPCS,3027F,SPIROM FEV/FVC>=70%/W/OCOPD,,,0.01,0.01,1
HCPCS,3027F0,SPIROM FEV/FVC>=70%/W/OCOPD,,,0.01,0.01,1
HCPCS,3028F,O2 SATURATION DOC REV,,,0.01,0.01,1
HCPCS,3028F0,O2 SATURATION DOC REV,,,0.01,0.01,1
HCPCS,30300,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,610.5,396.825,60.82,3920.0,179
HCPCS,30300,REMOVE NASAL FOREIGN BODY,,,128.54,128.54,1
HCPCS,303000,REMOVE NASAL FOREIGN BODY,,,128.54,128.54,1
HCPCS,30310,REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES,9726.0,6321.900000000001,107.62,16783.2,84
HCPCS,30310,REMOVE NASAL FOREIGN BODY,,,218.31,218.31,1
HCPCS,303100,REMOVE NASAL FOREIGN BODY,,,218.31,218.31,1
HCPCS,30320,REMOVE NASAL FOREIGN BODY,,,512.25,3211.66,15
HCPCS,30320,Remove nasal foreign body,,,839.72,1060.7,6
HCPCS,303200,REMOVE NASAL FOREIGN BODY,,,512.25,512.25,1
HCPCS,3035F,O2 SATURATION<=88%/PAO<=55,,,0.01,0.01,1
HCPCS,3035F0,O2 SATURATION<=88%/PAO<=55,,,0.01,0.01,1
HCPCS,3037F,O2 SATURATION >88%/PAO>55 HG,,,0.01,0.01,1
HCPCS,3037F0,O2 SATURATION >88%/PAO>55 HG,,,0.01,0.01,1
HCPCS,3038F,PULM FX W/IN 12 MON B/4 SURG,,,0.01,0.01,1
HCPCS,3038F0,PULM FX W/IN 12 MON B/4 SURG,,,0.01,0.01,1
HCPCS,30400,RECONSTRUCTION OF NOSE,,,1281.79,12826.13,15
HCPCS,30400,RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI,4778.0,3105.7,611.82,4778.0,32
HCPCS,30400,Reconstruction of nose,,,1664.64,2102.7,6
HCPCS,304000,RECONSTRUCTION OF NOSE,,,1281.79,1281.79,1
HCPCS,3040F,FEV <40% PREDICTED VALUE,,,0.01,0.01,1
HCPCS,3040F0,FEV <40% PREDICTED VALUE,,,0.01,0.01,1
HCPCS,30410,RECONSTRUCTION OF NOSE,,,1480.37,12826.13,15
HCPCS,30410,RHINP PRIM COMPLETE XTRNL PARTS,5600.0,3640.0,702.56,5600.0,32
HCPCS,30410,Reconstruction of nose,,,3243.49,4097.04,6
HCPCS,304100,RECONSTRUCTION OF NOSE,,,1480.37,1480.37,1
HCPCS,30420,RECONSTRUCTION OF NOSE,,,1529.52,12826.13,15
HCPCS,30420,RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR,6760.0,4394.0,605.89,6760.0,35
HCPCS,30420,Reconstruction of nose,,,3243.49,4097.04,6
HCPCS,304200,RECONSTRUCTION OF NOSE,,,1529.52,1529.52,1
HCPCS,3042F,FEV >=40% PREDICTED VALUE,,,0.01,0.01,1
HCPCS,3042F0,FEV >=40% PREDICTED VALUE,,,0.01,0.01,1
HCPCS,30430,REVISION OF NOSE,,,1116.04,12826.13,15
HCPCS,30430,RHINOPLASTY SECONDARY MINOR REVISION,3296.0,2142.4,535.88,3296.0,32
HCPCS,30430,Revision of nose,,,1634.08,2064.1,6
HCPCS,304300,REVISION OF NOSE,,,1116.04,1116.04,1
HCPCS,30435,REVISION OF NOSE,,,1399.6,12826.13,15
HCPCS,30435,RHINOPLASTY SECONDARY INTERMEDIATE REVISION,5601.0,3640.65,666.8,5601.0,32
HCPCS,30435,Revision of nose,,,3243.49,4097.04,6
HCPCS,304350,REVISION OF NOSE,,,1399.6,1399.6,1
HCPCS,3044F,HG A1C LEVEL LT 7.0%,,,0.01,0.01,1
HCPCS,3044F0,HG A1C LEVEL LT 7.0%,,,0.01,0.01,1
HCPCS,30450,REVISION OF NOSE,,,1838.22,12826.13,15
HCPCS,30450,RHINOPLASTY SECONDARY MAJOR REVISION,7864.0,5111.6,872.74,7864.0,32
HCPCS,30450,Revision of nose,,,3243.49,4097.04,6
HCPCS,304500,REVISION OF NOSE,,,1838.22,1838.22,1
HCPCS,30460,REVISION OF NOSE,,,875.65,12826.13,15
HCPCS,30460,RHINP DFRM W/COLUM LNGTH TIP ONLY,4128.0,2683.2,498.73,4128.0,35
HCPCS,30460,Revision of nose,,,3243.49,4097.04,6
HCPCS,304600,REVISION OF NOSE,,,875.65,875.65,1
HCPCS,30462,REVISION OF NOSE,,,1683.44,12826.13,15
HCPCS,30462,RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT,8112.0,5272.8,966.62,8112.0,35
HCPCS,30462,Revision of nose,,,3243.49,4097.04,6
HCPCS,304620,REVISION OF NOSE,,,1683.44,1683.44,1
HCPCS,30465,NASAL VESTIBUL STENOS REPAIR,4944.0,3213.6,599.06,4944.0,35
HCPCS,30465,REPAIR NASAL STENOSIS,,,1084.06,12826.13,15
HCPCS,30465,Repair nasal stenosis,,,1634.08,2064.1,6
HCPCS,304650,REPAIR NASAL STENOSIS,,,1084.06,1084.06,1
HCPCS,30468,RPR NSL VLV COLLAPSE W/IMPLT,,,179.96,12826.13,15
HCPCS,30468,Rpr nsl vlv collapse w/implt,,,2132.36,2693.51,6
HCPCS,304680,RPR NSL VLV COLLAPSE W/IMPLT,,,179.96,179.96,1
HCPCS,30469,RPR NSL VLV COLLAPSE LW NRG SUBQ/SBMCSL RMDLG,17495.5,11372.075,109.38,30613.5,70
HCPCS,30469,RPR NSL VLV COLLAPSE W/RMDLG,,,160.24,160.24,1
HCPCS,304690,RPR NSL VLV COLLAPSE W/RMDLG,,,160.24,160.24,1
HCPCS,3046F,HEMOGLOBIN A1C LEVEL >9.0%,,,0.01,0.01,1
HCPCS,3046F0,HEMOGLOBIN A1C LEVEL >9.0%,,,0.01,0.01,1
HCPCS,3048F,LDL-C <100 MG/DL,,,0.01,0.01,1
HCPCS,3048F0,LDL-C <100 MG/DL,,,0.01,0.01,1
HCPCS,3049F,LDL-C 100-129 MG/DL,,,0.01,0.01,1
HCPCS,3049F0,LDL-C 100-129 MG/DL,,,0.01,0.01,1
HCPCS,3050F,LDL-C >= 130 MG/DL,,,0.01,0.01,1
HCPCS,3050F0,LDL-C >= 130 MG/DL,,,0.01,0.01,1
HCPCS,3051F,HG A1C>EQUAL 7.0%<8.0%,,,0.01,0.01,1
HCPCS,3051F0,HG A1C>EQUAL 7.0%<8.0%,,,0.01,0.01,1
HCPCS,30520,REPAIR OF NASAL SEPTUM,,,710.01,7031.51,18
HCPCS,30520,Repair of nasal septum,,,1664.64,2102.7,6
HCPCS,30520,SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF,2804.0,1822.6,333.86,2804.0,35
HCPCS,305200,REPAIR OF NASAL SEPTUM,,,710.01,710.01,1
HCPCS,3052F,HG A1C>EQUAL 8.0%<EQUAL 9.0%,,,0.01,0.01,1
HCPCS,3052F0,HG A1C>EQUAL 8.0%<EQUAL 9.0%,,,0.01,0.01,1
HCPCS,30540,RPR CHOANAL ATRESIA NTRANASL,,,778.04,12826.13,15
HCPCS,30540,Rpr choanal atresia ntranasl,,,2132.36,2693.51,6
HCPCS,305400,RPR CHOANAL ATRESIA NTRANASL,,,778.04,778.04,1
HCPCS,30545,RPR CHOANAL ATRESIA TRSNPLTN,,,1056.68,12826.13,15
HCPCS,30545,Rpr choanal atresia trsnpltn,,,1833.3,2315.75,6
HCPCS,305450,RPR CHOANAL ATRESIA TRSNPLTN,,,1056.68,1056.68,1
HCPCS,3055F,LVEF LESS THAN/EQUAL TO 35%,,,0.01,0.01,1
HCPCS,3055F0,LVEF LESS THAN/EQUAL TO 35%,,,0.01,0.01,1
HCPCS,30560,LYSIS INTRANASAL SYNECHIA,524.0,340.6,74.3,1104.14,50
HCPCS,30560,Lysis intranasal synechia,,,839.72,1060.7,6
HCPCS,305600,LYSIS INTRANASAL SYNECHIA,,,158.17,158.17,1
HCPCS,3056F,LVEF GREATER THAN 35%,,,0.01,0.01,1
HCPCS,3056F0,LVEF GREATER THAN 35%,,,0.01,0.01,1
HCPCS,30580,REPAIR FISTULA OROMAXILLARY,2752.0,1788.8,223.39,2064.0,35
HCPCS,30580,REPAIR UPPER JAW FISTULA,,,488.05,12826.13,15
HCPCS,30580,Repair upper jaw fistula,,,2132.36,2693.51,6
HCPCS,305800,REPAIR UPPER JAW FISTULA,,,488.05,488.05,1
HCPCS,30600,REPAIR FISTULA ORONASAL,2464.0,1601.6,185.42,1848.0,35
HCPCS,30600,REPAIR MOUTH/NOSE FISTULA,,,408.92,12826.13,15
HCPCS,30600,Repair mouth/nose fistula,,,2132.36,2693.51,6
HCPCS,306000,REPAIR MOUTH/NOSE FISTULA,,,408.92,408.92,1
HCPCS,3060F,POS MICROALBUMINURIA REV,,,0.01,0.01,1
HCPCS,3060F0,POS MICROALBUMINURIA REV,,,0.01,0.01,1
HCPCS,3061F,NEG MICROALBUMINURIA REV,,,0.01,0.01,1
HCPCS,3061F0,NEG MICROALBUMINURIA REV,,,0.01,0.01,1
HCPCS,30620,INTRANASAL RECONSTRUCTION,,,706.28,12826.13,15
HCPCS,30620,Intranasal reconstruction,,,2132.36,2693.51,6
HCPCS,30620,SEPTAL/OTHER INTRANASAL DERMATOPLASTY,2464.0,1601.6,345.73,2464.0,35
HCPCS,306200,INTRANASAL RECONSTRUCTION,,,706.28,706.28,1
HCPCS,3062F,POS MACROALBUMINURIA REV,,,0.01,0.01,1
HCPCS,3062F0,POS MACROALBUMINURIA REV,,,0.01,0.01,1
HCPCS,30630,REPAIR NASAL SEPTAL PERFORATIONS,2916.0,1895.4,364.39,2916.0,35
HCPCS,30630,REPAIR NASAL SEPTUM DEFECT,,,704.81,7031.51,15
HCPCS,30630,Repair nasal septum defect,,,2132.36,2693.51,6
HCPCS,306300,REPAIR NASAL SEPTUM DEFECT,,,704.81,704.81,1
HCPCS,3066F,NEPHROPATHY DOC TX,,,0.01,0.01,1
HCPCS,3066F0,NEPHROPATHY DOC TX,,,0.01,0.01,1
HCPCS,3072F,LOW RISK FOR RETINOPATHY,,,0.01,0.01,1
HCPCS,3072F0,LOW RISK FOR RETINOPATHY,,,0.01,0.01,1
HCPCS,3073F,PRE-SURG EYE MEASURES DOCD,,,0.01,0.01,1
HCPCS,3073F0,PRE-SURG EYE MEASURES DOCD,,,0.01,0.01,1
HCPCS,3074F,SYST BP LT 130 MM HG,,,0.01,0.01,1
HCPCS,3074F0,SYST BP LT 130 MM HG,,,0.01,0.01,1
HCPCS,3075F,SYST BP GE 130 - 139MM HG,,,0.01,0.01,1
HCPCS,3075F0,SYST BP GE 130 - 139MM HG,,,0.01,0.01,1
HCPCS,3077F,SYST BP >= 140 MM HG,,,0.01,0.01,1
HCPCS,3077F0,SYST BP >= 140 MM HG,,,0.01,0.01,1
HCPCS,3078F,DIAST BP <80 MM HG,,,0.01,0.01,1
HCPCS,3078F0,DIAST BP <80 MM HG,,,0.01,0.01,1
HCPCS,3079F,DIAST BP 80-89 MM HG,,,0.01,0.01,1
HCPCS,3079F0,DIAST BP 80-89 MM HG,,,0.01,0.01,1
HCPCS,30801,ABLATE INF TURBINATE SUPERF,,,158.14,3211.66,15
HCPCS,30801,ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC,456.0,296.4,75.78,357.25,35
HCPCS,30801,Ablate inf turbinate superf,,,839.72,1060.7,6
HCPCS,308010,ABLATE INF TURBINATE SUPERF,,,158.14,158.14,1
HCPCS,30802,ABLATE INF TURBINATE SUBMUC,,,212.58,212.58,1
HCPCS,30802,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,4675.0,3038.75,100.43,8370.0,81
HCPCS,308020,ABLATE INF TURBINATE SUBMUC,,,212.58,212.58,1
HCPCS,3080F,DIAST BP >= 90 MM HG,,,0.01,0.01,1
HCPCS,3080F0,DIAST BP >= 90 MM HG,,,0.01,0.01,1
HCPCS,3082F,KT/V <1.2,,,0.01,0.01,1
HCPCS,3082F0,KT/V <1.2,,,0.01,0.01,1
HCPCS,3083F,KT/V =/> 1.2 & <1.7,,,0.01,0.01,1
HCPCS,3083F0,KT/V =/> 1.2 & <1.7,,,0.01,0.01,1
HCPCS,3084F,KT/V >= 1.7,,,0.01,0.01,1
HCPCS,3084F0,KT/V >= 1.7,,,0.01,0.01,1
HCPCS,3085F,SUICIDE RISK ASSESSED,,,0.01,0.01,1
HCPCS,3085F0,SUICIDE RISK ASSESSED,,,0.01,0.01,1
HCPCS,3088F,MDD MILD,,,0.01,0.01,1
HCPCS,3088F0,MDD MILD,,,0.01,0.01,1
HCPCS,3089F,MDD MODERATE,,,0.01,0.01,1
HCPCS,3089F0,MDD MODERATE,,,0.01,0.01,1
HCPCS,30901,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,590.5,383.825,27.46,3920.0,179
HCPCS,30901,CONTROL OF NOSEBLEED,,,60.9,60.9,1
HCPCS,309010,CONTROL OF NOSEBLEED,,,60.9,60.9,1
HCPCS,30903,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,709.5,461.17499999999995,56.13,3920.0,179
HCPCS,30903,CONTROL OF NOSEBLEED,,,83.02,83.02,1
HCPCS,309030,CONTROL OF NOSEBLEED,,,83.02,83.02,1
HCPCS,30905,CONTROL OF NOSEBLEED,,,113.56,113.56,1
HCPCS,30905,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,804.0,522.5999999999999,71.05,3920.0,179
HCPCS,309050,CONTROL OF NOSEBLEED,,,113.56,113.56,1
HCPCS,30906,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,1206.5,784.225,65.75,3920.0,133
HCPCS,30906,REPEAT CONTROL OF NOSEBLEED,,,142.07,142.07,1
HCPCS,309060,REPEAT CONTROL OF NOSEBLEED,,,142.07,142.07,1
HCPCS,3090F,MDD SEVERE W/O PSYCH,,,0.01,0.01,1
HCPCS,3090F0,MDD SEVERE W/O PSYCH,,,0.01,0.01,1
HCPCS,30915,LIGATION ARTERIES ETHMOIDAL,2976.0,1934.4,337.18,2976.0,35
HCPCS,30915,LIGATION NASAL SINUS ARTERY,,,639.2,6824.3,15
HCPCS,30915,Ligation nasal sinus artery,,,1320.48,1667.98,6
HCPCS,309150,LIGATION NASAL SINUS ARTERY,,,639.2,639.2,1
HCPCS,3091F,MDD SEVERE W/PSYCH,,,0.01,0.01,1
HCPCS,3091F0,MDD SEVERE W/PSYCH,,,0.01,0.01,1
HCPCS,30920,LIGATION ARTERIES INT MAXILLARY TRANSANTRAL,4902.0,3186.3,522.48,4902.0,35
HCPCS,30920,LIGATION UPPER JAW ARTERY,,,923.52,6824.3,15
HCPCS,30920,Ligation upper jaw artery,,,1320.48,1667.98,6
HCPCS,309200,LIGATION UPPER JAW ARTERY,,,923.52,923.52,1
HCPCS,3092F,MDD IN REMISSION,,,0.01,0.01,1
HCPCS,3092F0,MDD IN REMISSION,,,0.01,0.01,1
HCPCS,30930,FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC,524.0,340.6,62.6,524.0,35
HCPCS,30930,THER FX NASAL INF TURBINATE,,,125.05,7031.51,19
HCPCS,30930,Ther fx nasal inf turbinate,,,1664.64,2102.7,6
HCPCS,309300,THER FX NASAL INF TURBINATE,,,125.05,125.05,1
HCPCS,3093F,DOC NEW DIAG 1ST/ADDL MDD,,,0.01,0.01,1
HCPCS,3093F0,DOC NEW DIAG 1ST/ADDL MDD,,,0.01,0.01,1
HCPCS,3095F,CENTRAL DEXA RESULTS DOCD,,,0.01,0.01,1
HCPCS,3095F0,CENTRAL DEXA RESULTS DOCD,,,0.01,0.01,1
HCPCS,3096F,CENTRAL DEXA ORDERED,,,0.01,0.01,1
HCPCS,3096F0,CENTRAL DEXA ORDERED,,,0.01,0.01,1
HCPCS,30999,UNLISTED PROC; NASAL SURG PROC (COMP TO 30465),4079.0,2651.35,311.77,4079.0,15
HCPCS,30999,UNLISTED PROCEDURE NOSE,425.0,276.25,119.43,7730.0,96
HCPCS,31000,IRRIGATION MAXILLARY SINUS,,,116.59,503.49,15
HCPCS,31000,Irrigation maxillary sinus,,,839.72,1060.7,6
HCPCS,31000,LAVAGE CANNULATION MAXILLARY SINUS,480.0,312.0,53.1,360.0,35
HCPCS,310000,IRRIGATION MAXILLARY SINUS,,,116.59,116.59,1
HCPCS,31002,IRRIGATION SPHENOID SINUS,,,198.08,3211.66,15
HCPCS,31002,Irrigation sphenoid sinus,,,112.01,141.49,6
HCPCS,310020,IRRIGATION SPHENOID SINUS,,,198.08,198.08,1
HCPCS,3100F,IMAGE TEST REF CAROT DIAM,,,0.01,0.01,1
HCPCS,3100F0,IMAGE TEST REF CAROT DIAM,,,0.01,0.01,1
HCPCS,31020,EXPLORATION MAXILLARY SINUS,,,356.0,7031.51,15
HCPCS,31020,Exploration maxillary sinus,,,839.72,1060.7,6
HCPCS,31020,SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL,1228.0,798.2,182.96,921.0,35
HCPCS,310200,EXPLORATION MAXILLARY SINUS,,,356.0,356.0,1
HCPCS,31030,EXPLORATION MAXILLARY SINUS,,,540.58,12826.13,15
HCPCS,31030,Exploration maxillary sinus,,,2132.36,2693.51,6
HCPCS,31030,SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS,2404.0,1562.6,251.34,1803.0,35
HCPCS,310300,EXPLORATION MAXILLARY SINUS,,,540.58,540.58,1
HCPCS,31032,EXPLORE SINUS REMOVE POLYPS,,,625.87,12826.13,15
HCPCS,31032,Explore sinus remove polyps,,,2132.36,2693.51,6
HCPCS,31032,SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS,2676.0,1739.4,371.71,2676.0,35
HCPCS,310320,EXPLORE SINUS REMOVE POLYPS,,,625.87,625.87,1
HCPCS,31040,EXPLORATION BEHIND UPPER JAW,,,851.89,12826.13,15
HCPCS,31040,Exploration behind upper jaw,,,3243.49,4097.04,6
HCPCS,31040,PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH,4299.0,2794.35,460.05,4299.0,35
HCPCS,310400,EXPLORATION BEHIND UPPER JAW,,,851.89,851.89,1
HCPCS,31050,EXPLORATION SPHENOID SINUS,,,543.49,12826.13,15
HCPCS,31050,Exploration sphenoid sinus,,,2132.36,2693.51,6
HCPCS,31050,SINUSOTOMY SPHENOID W/WO BIOPSY,2148.0,1396.2,296.66,2148.0,35
HCPCS,310500,EXPLORATION SPHENOID SINUS,,,543.49,543.49,1
HCPCS,31051,SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP,2900.0,1885.0,396.25,2900.0,35
HCPCS,31051,SPHENOID SINUS SURGERY,,,729.3,12826.13,15
HCPCS,31051,Sphenoid sinus surgery,,,2132.36,2693.51,6
HCPCS,310510,SPHENOID SINUS SURGERY,,,729.3,729.3,1
HCPCS,31070,EXPLORATION OF FRONTAL SINUS,,,498.23,12826.13,15
HCPCS,31070,Exploration of frontal sinus,,,2132.36,2693.51,6
HCPCS,31070,SINUSOTOMY FRONTAL EXTERNAL SIMPLE,1760.0,1144.0,244.44,1760.0,32
HCPCS,310700,EXPLORATION OF FRONTAL SINUS,,,498.23,498.23,1
HCPCS,31075,EXPLORATION OF FRONTAL SINUS,,,872.69,12826.13,15
HCPCS,31075,Exploration of frontal sinus,,,2132.36,2693.51,6
HCPCS,31075,SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL,3804.0,2472.6,509.05,3804.0,35
HCPCS,310750,EXPLORATION OF FRONTAL SINUS,,,872.69,872.69,1
HCPCS,31080,REMOVAL OF FRONTAL SINUS,,,1148.9,12826.13,15
HCPCS,31080,Removal of frontal sinus,,,2719.4,3435.04,6
HCPCS,310800,REMOVAL OF FRONTAL SINUS,,,1148.9,1148.9,1
HCPCS,31081,REMOVAL OF FRONTAL SINUS,,,1233.13,12826.13,15
HCPCS,31081,Removal of frontal sinus,,,3243.49,4097.04,6
HCPCS,31081,SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC,5676.0,3689.4,639.94,5676.0,35
HCPCS,310810,REMOVAL OF FRONTAL SINUS,,,1233.13,1233.13,1
HCPCS,31084,REMOVAL OF FRONTAL SINUS,,,1277.19,12826.13,15
HCPCS,31084,Removal of frontal sinus,,,2132.36,2693.51,6
HCPCS,310840,REMOVAL OF FRONTAL SINUS,,,1277.19,1277.19,1
HCPCS,31085,REMOVAL OF FRONTAL SINUS,,,1316.6,12826.13,15
HCPCS,31085,Removal of frontal sinus,,,2719.4,3435.04,6
HCPCS,31085,SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC,6256.0,4066.4,777.63,6256.0,35
HCPCS,310850,REMOVAL OF FRONTAL SINUS,,,1316.6,1316.6,1
HCPCS,31086,REMOVAL OF FRONTAL SINUS,,,1242.79,12826.13,15
HCPCS,31086,Removal of frontal sinus,,,2719.4,3435.04,6
HCPCS,31086,SINUSOT FRNT NONOBLIT W/OSTPL FLAP BROW INC,5744.0,3733.6,604.63,5744.0,35
HCPCS,310860,REMOVAL OF FRONTAL SINUS,,,1242.79,1242.79,1
HCPCS,31087,REMOVAL OF FRONTAL SINUS,,,1186.87,12826.13,15
HCPCS,31087,Removal of frontal sinus,,,2132.36,2693.51,6
HCPCS,31087,SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC,5828.0,3788.2,635.43,5828.0,35
HCPCS,310870,REMOVAL OF FRONTAL SINUS,,,1186.87,1186.87,1
HCPCS,31090,EXPLORATION OF SINUSES,,,1161.51,12826.13,15
HCPCS,31090,Exploration of sinuses,,,2132.36,2693.51,6
HCPCS,310900,EXPLORATION OF SINUSES,,,1161.51,1161.51,1
HCPCS,3110F,PRES/ABSN HMRHG/LESION DOCD,,,0.01,0.01,1
HCPCS,3110F0,PRES/ABSN HMRHG/LESION DOCD,,,0.01,0.01,1
HCPCS,3111F,CT/MRI BRAIN DONE W/IN 24HRS,,,0.01,0.01,1
HCPCS,3111F0,CT/MRI BRAIN DONE W/IN 24HRS,,,0.01,0.01,1
HCPCS,3112F,CT/MRI BRAIN DONE 24 HRS,,,0.01,0.01,1
HCPCS,3112F0,CT/MRI BRAIN DONE 24 HRS,,,0.01,0.01,1
HCPCS,3115F,QUANT RESULTS ACTIVITY &SYMP,,,0.01,0.01,1
HCPCS,3115F0,QUANT RESULTS ACTIVITY &SYMP,,,0.01,0.01,1
HCPCS,3117F,HF ASSESSMENT TOOL COMPLETED,,,0.01,0.01,1
HCPCS,3117F0,HF ASSESSMENT TOOL COMPLETED,,,0.01,0.01,1
HCPCS,3118F,NY HEART ASSOC CLASS DOCD,,,0.01,0.01,1
HCPCS,3118F0,NY HEART ASSOC CLASS DOCD,,,0.01,0.01,1
HCPCS,3119F,NO EVAL ACTIVITY CLIN SYMP,,,0.01,0.01,1
HCPCS,3119F0,NO EVAL ACTIVITY CLIN SYMP,,,0.01,0.01,1
HCPCS,31200,ETHMOIDECTOMY INTRANASAL ANTERIOR,2056.0,1336.4,307.89,2056.0,35
HCPCS,31200,REMOVAL OF ETHMOID SINUS,,,650.16,12826.13,15
HCPCS,31200,Removal of ethmoid sinus,,,2132.36,2693.51,6
HCPCS,312000,REMOVAL OF ETHMOID SINUS,,,650.16,650.16,1
HCPCS,31201,ETHMOIDECTOMY INTRANASAL TOTAL,3440.0,2236.0,417.38,3440.0,35
HCPCS,31201,REMOVAL OF ETHMOID SINUS,,,820.37,3211.66,15
HCPCS,31201,Removal of ethmoid sinus,,,1634.08,2064.1,6
HCPCS,312010,REMOVAL OF ETHMOID SINUS,,,820.37,820.37,1
HCPCS,31205,ETHMOIDECTOMY EXTRANASAL TOTAL,4232.0,2750.8,494.54,4232.0,35
HCPCS,31205,REMOVAL OF ETHMOID SINUS,,,985.26,7031.51,15
HCPCS,31205,Removal of ethmoid sinus,,,1634.08,2064.1,6
HCPCS,312050,REMOVAL OF ETHMOID SINUS,,,985.26,985.26,1
HCPCS,3120F,12-LEAD ECG PERFORMED,,,0.01,0.01,1
HCPCS,3120F0,12-LEAD ECG PERFORMED,,,0.01,0.01,1
HCPCS,31225,MAXILLECTOMY W/O ORBITAL EXENTERATION,10680.0,6942.0,1034.63,10680.0,35
HCPCS,31225,REMOVAL OF UPPER JAW,,,1910.76,1910.76,1
HCPCS,31225,Removal of upper jaw,,,3243.49,4097.04,6
HCPCS,312250,REMOVAL OF UPPER JAW,,,1910.76,1910.76,1
HCPCS,31230,MAXILLECTOMY W/ORBITAL EXENTERATION,12328.0,8013.2,1170.17,12328.0,35
HCPCS,31230,REMOVAL OF UPPER JAW,,,2135.71,2135.71,1
HCPCS,31230,Removal of upper jaw,,,3243.49,4097.04,6
HCPCS,312300,REMOVAL OF UPPER JAW,,,2135.71,2135.71,1
HCPCS,31231,"NASAL ENDOS,DIAG,UNI/ BILATERAL",484.0,314.6,30.74,363.0,35
HCPCS,31231,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,1116.0,725.4,73.27,4151.0,141
HCPCS,31231,NASAL ENDOSCOPY DX,,,68.77,68.77,1
HCPCS,312310,NASAL ENDOSCOPY DX,,,68.77,68.77,1
HCPCS,31233,"NASAL/SINUS ENDOS,DIAG W/ MAX SI",872.0,566.8,65.09,654.0,35
HCPCS,31233,NSL/SINS NDSC DX MAX SINUSC,,,144.17,841.92,15
HCPCS,31233,Nsl/sins ndsc dx max sinusc,,,357.79,451.94,6
HCPCS,312330,NSL/SINS NDSC DX MAX SINUSC,,,144.17,144.17,1
HCPCS,31235,"NASAL/SPHENOID SINUS ENDOSCOPY,DX",1162.0,755.3,76.44,871.5,35
HCPCS,31235,NSL/SINS NDSC DX SPHN SINUSC,,,169.95,3738.94,15
HCPCS,31235,Nsl/sins ndsc dx sphn sinusc,,,1193.97,1508.17,6
HCPCS,312350,NSL/SINS NDSC DX SPHN SINUSC,,,169.95,169.95,1
HCPCS,31237,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,5530.0,3594.5,79.51,13665.0,130
HCPCS,31237,NSL/SINS NDSC SURG BX POLYPC,,,170.2,170.2,1
HCPCS,312370,NSL/SINS NDSC SURG BX POLYPC,,,170.2,170.2,1
HCPCS,31238,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,5561.0,3614.6499999999996,90.1,13665.0,130
HCPCS,31238,NSL/SINS NDSC SRG NSL HEMRRG,,,178.09,178.09,1
HCPCS,312380,NSL/SINS NDSC SRG NSL HEMRRG,,,178.09,178.09,1
HCPCS,31239,NASAL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY,3978.0,2585.7,458.45,3978.0,35
HCPCS,31239,NSL/SINUS ENDOSCOPY SURG DCR,,,641.34,7993.92,15
HCPCS,31239,Nsl/sinus endoscopy surg dcr,,,1193.97,1508.17,6
HCPCS,312390,NSL/SINUS ENDOSCOPY SURG DCR,,,641.34,641.34,1
HCPCS,31240,NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION,1148.0,746.2,122.3,1148.0,35
HCPCS,31240,NSL/SNS NDSC CNCH BULL RESCJ,,,169.23,5038.0,16
HCPCS,31240,Nsl/sns ndsc cnch bull rescj,,,357.79,451.94,6
HCPCS,312400,NSL/SNS NDSC CNCH BULL RESCJ,,,169.23,169.23,1
HCPCS,31241,NASAL/SINUS NDSC W/LIG SPHENOPALATINE ARTERY,3520.0,2288.0,338.56,3520.0,31
HCPCS,31241,NSL/SNS NDSC LIG SPHNPTN ART,,,474.78,3738.94,15
HCPCS,31241,Nsl/sns ndsc lig sphnptn art,,,1193.97,1508.17,6
HCPCS,312410,NSL/SNS NDSC LIG SPHNPTN ART,,,474.78,474.78,1
HCPCS,31242,NASAL/SINUS NDSC DSTRJ RF ABLATION PST NSL NRV,17601.5,11440.975,114.2,30613.5,67
HCPCS,31242,NSL/SINUS NDSC RF ABLTJ PNN,,,168.27,168.27,1
HCPCS,312420,NSL/SINUS NDSC RF ABLTJ PNN,,,168.27,168.27,1
HCPCS,31243,NASAL/SINUS NDSC DSTRJ CRYOABLATION PST NSL NRV,1188.0,772.2,114.2,3958.55,28
HCPCS,31243,NSL/SINUS NDSC CRYOABLTJ PNN,,,168.27,12826.13,15
HCPCS,31243,Nsl/sinus ndsc cryoabltj pnn,,,2132.36,2693.51,6
HCPCS,312430,NSL/SINUS NDSC CRYOABLTJ PNN,,,168.27,168.27,1
HCPCS,31253,NASAL/SINUS NDSC TOT W/FRNT SINS EXPL TISS RMVL,3960.0,2574.0,380.94,3960.0,31
HCPCS,31253,NSL/SINS NDSC TOTAL,,,532.31,15009.06,16
HCPCS,31253,Nsl/sins ndsc total,,,2719.4,3435.04,6
HCPCS,312530,NSL/SINS NDSC TOTAL,,,532.31,532.31,1
HCPCS,31254,NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY,1879.0,1221.35,223.66,1879.0,35
HCPCS,31254,NSL/SINS NDSC W/PRTL ETHMDCT,,,258.85,15009.06,16
HCPCS,31254,Nsl/sins ndsc w/prtl ethmdct,,,1634.08,2064.1,6
HCPCS,312540,NSL/SINS NDSC W/PRTL ETHMDCT,,,258.85,258.85,1
HCPCS,31255,NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY,2530.0,1644.5,246.64,2530.0,35
HCPCS,31255,NSL/SINS NDSC W/TOT ETHMDCT,,,344.17,15009.06,15
HCPCS,31255,Nsl/sins ndsc w/tot ethmdct,,,2719.4,3435.04,6
HCPCS,312550,NSL/SINS NDSC W/TOT ETHMDCT,,,344.17,344.17,1
HCPCS,31256,EXPLORATION MAXILLARY SINUS,,,191.51,7993.92,15
HCPCS,31256,Exploration maxillary sinus,,,1634.08,2064.1,6
HCPCS,31256,NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY,1368.0,889.2,138.64,1368.0,35
HCPCS,312560,EXPLORATION MAXILLARY SINUS,,,191.51,191.51,1
HCPCS,31257,NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY,3520.0,2288.0,339.84,3520.0,31
HCPCS,31257,NSL/SINS NDSC TOT W/SPHENDT,,,475.02,15009.06,15
HCPCS,31257,Nsl/sins ndsc tot w/sphendt,,,2719.4,3435.04,6
HCPCS,312570,NSL/SINS NDSC TOT W/SPHENDT,,,475.02,475.02,1
HCPCS,31259,NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL,3731.0,2425.15,359.75,3731.0,31
HCPCS,31259,NSL/SINS NDSC SPHN TISS RMVL,,,501.87,15009.06,15
HCPCS,31259,Nsl/sins ndsc sphn tiss rmvl,,,2719.4,3435.04,6
HCPCS,312590,NSL/SINS NDSC SPHN TISS RMVL,,,501.87,501.87,1
HCPCS,31267,ENDOSCOPY MAXILLARY SINUS,,,282.94,15009.06,17
HCPCS,31267,Endoscopy maxillary sinus,,,357.79,451.94,6
HCPCS,31267,NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS,2059.0,1338.35,202.47,2059.0,35
HCPCS,312670,ENDOSCOPY MAXILLARY SINUS,,,282.94,282.94,1
HCPCS,3126F,ESOPH BX RPRT W/DYSPL INFO,,,0.01,0.01,1
HCPCS,3126F0,ESOPH BX RPRT W/DYSPL INFO,,,0.01,0.01,1
HCPCS,31276,NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS,2970.0,1930.5,288.52,2970.0,35
HCPCS,31276,NSL/SINS NDSC FRNT TISS RMVL,,,402.95,15009.06,16
HCPCS,31276,Nsl/sins ndsc frnt tiss rmvl,,,357.79,451.94,6
HCPCS,312760,NSL/SINS NDSC FRNT TISS RMVL,,,402.95,402.95,1
HCPCS,31287,NASAL/SINUS ENDOSCOPY SURG,,,214.1,15009.06,15
HCPCS,31287,NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY,1540.0,1001.0,153.96,1540.0,35
HCPCS,31287,Nasal/sinus endoscopy surg,,,357.79,451.94,6
HCPCS,312870,NASAL/SINUS ENDOSCOPY SURG,,,214.1,214.1,1
HCPCS,31288,NASAL/SINUS ENDOSCOPY SURG,,,249.24,15009.06,15
HCPCS,31288,NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS,1640.0,1066.0,178.98,1640.0,35
HCPCS,31288,Nasal/sinus endoscopy surg,,,357.79,451.94,6
HCPCS,312880,NASAL/SINUS ENDOSCOPY SURG,,,249.24,249.24,1
HCPCS,31290,NASAL/SINUS ENDOSCOPY SURG,,,1217.3,1217.3,1
HCPCS,31290,NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID,7444.0,4838.6,841.03,7444.0,35
HCPCS,31290,Nasal/sinus endoscopy surg,,,1193.97,1508.17,6
HCPCS,312900,NASAL/SINUS ENDOSCOPY SURG,,,1217.3,1217.3,1
HCPCS,31291,NASAL/SINUS ENDOSCOPY SURG,,,1307.21,1307.21,1
HCPCS,31291,NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID,7824.0,5085.6,883.5,7824.0,35
HCPCS,31291,Nasal/sinus endoscopy surg,,,1193.97,1508.17,6
HCPCS,312910,NASAL/SINUS ENDOSCOPY SURG,,,1307.21,1307.21,1
HCPCS,31292,NASAL/SINUS NDSC SURG MEDIAL/INF ORB WALL DCMPRN,6996.0,4547.4,738.83,6996.0,35
HCPCS,31292,NSL/SINS NDSC MED/INF DCMPRN,,,1053.29,15009.06,15
HCPCS,31292,Nsl/sins ndsc med/inf dcmprn,,,1193.97,1508.17,6
HCPCS,312920,NSL/SINS NDSC MED/INF DCMPRN,,,1053.29,1053.29,1
HCPCS,31293,NASAL/SINUS NDSC SURG MEDIAL&INF ORB WALL DCMPRN,6988.0,4542.2,808.41,6988.0,35
HCPCS,31293,NSL/SINS NDSC MED&INF DCMPRN,,,1144.76,15009.06,15
HCPCS,31293,Nsl/sins ndsc med&inf dcmprn,,,1193.97,1508.17,6
HCPCS,312930,NSL/SINS NDSC MED&INF DCMPRN,,,1144.76,1144.76,1
HCPCS,31294,NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN,8124.0,5280.6,923.88,8124.0,35
HCPCS,31294,NSL/SINS NDSC SURG ON DCMPRN,,,1308.15,15009.06,15
HCPCS,31294,Nsl/sins ndsc surg on dcmprn,,,1193.97,1508.17,6
HCPCS,312940,NSL/SINS NDSC SURG ON DCMPRN,,,1308.15,1308.15,1
HCPCS,31295,NSL/SINS NDSC SURG MAX SINS,,,167.9,15009.06,15
HCPCS,31295,NSL/SINUS NDSC SURG W/DILAT MAXILLARY SINUS,1080.0,702.0,80.2,3172.88,32
HCPCS,31295,Nsl/sins ndsc surg max sins,,,1193.97,1508.17,6
HCPCS,312950,NSL/SINS NDSC SURG MAX SINS,,,167.9,167.9,1
HCPCS,31296,NSL/SINS NDSC SURG FRNT SINS,,,190.8,15009.06,15
HCPCS,31296,NSL/SINUS NDSC SURG W/DILAT FRONTAL SINUS,1364.0,886.6,165.21,3219.26,32
HCPCS,31296,Nsl/sins ndsc surg frnt sins,,,357.79,451.94,6
HCPCS,312960,NSL/SINS NDSC SURG FRNT SINS,,,190.8,190.8,1
HCPCS,31297,NSL/SINS NDSC SURG SPHN SINS,,,153.22,15009.06,15
HCPCS,31297,NSL/SINUS NDSC SURG W/DILAT SPHENOID SINUS,976.0,634.4,134.38,3158.7,32
HCPCS,31297,Nsl/sins ndsc surg sphn sins,,,357.79,451.94,6
HCPCS,312970,NSL/SINS NDSC SURG SPHN SINS,,,153.22,153.22,1
HCPCS,31298,NASAL/SINUS NDSC SURG W/DILATION FRNT&SPHN SINUS,1800.0,1170.0,194.43,5967.54,28
HCPCS,31298,NSL/SINS NDSC SURG FRNT&SPHN,,,272.53,15009.06,15
HCPCS,31298,Nsl/sins ndsc surg frnt&sphn,,,357.79,451.94,6
HCPCS,312980,NSL/SINS NDSC SURG FRNT&SPHN,,,272.53,272.53,1
HCPCS,31299,MAXILLECTOMY; WITHOUT ORBITAL EXENTERATION (COMP 31225),9613.0,6248.45,344.78,9613.0,15
HCPCS,31299,UNLISTED PX ACCESSORY SINUS,,,233.1,503.49,14
HCPCS,31299,Unlisted px accessory sinus,,,839.72,1060.7,6
HCPCS,31300,LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY,6364.0,4136.6,731.1,6364.0,35
HCPCS,31300,REMOVAL OF LARYNX LESION,,,1318.99,7031.51,15
HCPCS,31300,Removal of larynx lesion,,,1634.08,2064.1,6
HCPCS,313000,REMOVAL OF LARYNX LESION,,,1318.99,1318.99,1
HCPCS,3130F,UPPER GI ENDOSCOPY PERFORMED,,,0.01,0.01,1
HCPCS,3130F0,UPPER GI ENDOSCOPY PERFORMED,,,0.01,0.01,1
HCPCS,3132F,DOC REF UPPER GI ENDOSCOPY,,,0.01,0.01,1
HCPCS,3132F0,DOC REF UPPER GI ENDOSCOPY,,,0.01,0.01,1
HCPCS,31360,LARYNGECTOMY TOTAL W/O RADICAL NECK DISSECTION,11964.0,7776.6,1004.36,11964.0,35
HCPCS,31360,REMOVAL OF LARYNX,,,2177.24,2177.24,1
HCPCS,31360,Removal of larynx,,,2719.4,3435.04,6
HCPCS,313600,REMOVAL OF LARYNX,,,2177.24,2177.24,1
HCPCS,31365,LARYNGECTOMY TOTAL W/RADICAL NECK DISSECTION,15524.0,10090.6,1366.41,15524.0,35
HCPCS,31365,REMOVAL OF LARYNX,,,2690.92,2690.92,1
HCPCS,31365,Removal of larynx,,,2719.4,3435.04,6
HCPCS,313650,REMOVAL OF LARYNX,,,2690.92,2690.92,1
HCPCS,31367,LARYNGECTOMY STOT SUPRAGLOTTIC W/O RAD NECK DSJ,12228.0,7948.2,1112.0,12228.0,35
HCPCS,31367,PARTIAL REMOVAL OF LARYNX,,,2296.74,2296.74,1
HCPCS,31367,Partial removal of larynx,,,2719.4,3435.04,6
HCPCS,313670,PARTIAL REMOVAL OF LARYNX,,,2296.74,2296.74,1
HCPCS,31368,LARYNGECTOMY STOT SUPRAGLOTTIC W/RAD NCK DSJ,13676.0,8889.4,1477.51,13676.0,35
HCPCS,31368,PARTIAL REMOVAL OF LARYNX,,,2540.08,2540.08,1
HCPCS,31368,Partial removal of larynx,,,2719.4,3435.04,6
HCPCS,313680,PARTIAL REMOVAL OF LARYNX,,,2540.08,2540.08,1
HCPCS,31370,PARTIAL LARYNGECTOMY HEMILARYGECTOMY HORIZONTAL,11028.0,7168.2,1073.66,11028.0,35
HCPCS,31370,PARTIAL REMOVAL OF LARYNX,,,2151.4,2151.4,1
HCPCS,31370,Partial removal of larynx,,,2719.4,3435.04,6
HCPCS,313700,PARTIAL REMOVAL OF LARYNX,,,2151.4,2151.4,1
HCPCS,31375,PARTIAL LARYNGECTOMY HEMILARYNG LATEROVERTICAL,10428.0,6778.2,991.75,10428.0,35
HCPCS,31375,PARTIAL REMOVAL OF LARYNX,,,2044.97,2044.97,1
HCPCS,31375,Partial removal of larynx,,,2719.4,3435.04,6
HCPCS,313750,PARTIAL REMOVAL OF LARYNX,,,2044.97,2044.97,1
HCPCS,31380,PARTIAL LARYNGECTOMY HEMILARYNG ANTEROVERTICAL,10228.0,6648.2,1042.27,10228.0,35
HCPCS,31380,PARTIAL REMOVAL OF LARYNX,,,2016.3,2016.3,1
HCPCS,31380,Partial removal of larynx,,,2719.4,3435.04,6
HCPCS,313800,PARTIAL REMOVAL OF LARYNX,,,2016.3,2016.3,1
HCPCS,31382,PARTIAL LARYNG HEMILARYNG ANTERO-LATERO-VERTICAL,11428.0,7428.2,1065.4,11428.0,35
HCPCS,31382,PARTIAL REMOVAL OF LARYNX,,,2209.45,2209.45,1
HCPCS,31382,Partial removal of larynx,,,2719.4,3435.04,6
HCPCS,313820,PARTIAL REMOVAL OF LARYNX,,,2209.45,2209.45,1
HCPCS,31390,PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/O RCNSTJ,17004.0,11052.6,1515.66,17004.0,35
HCPCS,31390,REMOVAL OF LARYNX & PHARYNX,,,2966.89,2966.89,1
HCPCS,31390,Removal of larynx & pharynx,,,2719.4,3435.04,6
HCPCS,313900,REMOVAL OF LARYNX & PHARYNX,,,2966.89,2966.89,1
HCPCS,31395,PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/RCNSTJ,17520.0,11388.0,1775.57,17520.0,35
HCPCS,31395,RECONSTRUCT LARYNX & PHARYNX,,,3109.24,3109.24,1
HCPCS,31395,Reconstruct larynx & pharynx,,,2719.4,3435.04,6
HCPCS,313950,RECONSTRUCT LARYNX & PHARYNX,,,3109.24,3109.24,1
HCPCS,31400,REVISION OF LARYNX,,,1063.96,12826.13,15
HCPCS,31400,Revision of larynx,,,2719.4,3435.04,6
HCPCS,314000,REVISION OF LARYNX,,,1063.96,1063.96,1
HCPCS,3140F,UPPER GI ENDO SHOWS BARRTTS,,,0.01,0.01,1
HCPCS,3140F0,UPPER GI ENDO SHOWS BARRTTS,,,0.01,0.01,1
HCPCS,3141F,UPPER GI ENDO NOT BARRTTS,,,0.01,0.01,1
HCPCS,3141F0,UPPER GI ENDO NOT BARRTTS,,,0.01,0.01,1
HCPCS,31420,EPIGLOTTIDECTOMY,,,882.93,12826.13,15
HCPCS,31420,Epiglottidectomy,,,2719.4,3435.04,6
HCPCS,314200,EPIGLOTTIDECTOMY,,,882.93,882.93,1
HCPCS,3142F,BARIUM SWALLOW TEST ORDERED,,,0.01,0.01,1
HCPCS,3142F0,BARIUM SWALLOW TEST ORDERED,,,0.01,0.01,1
HCPCS,31500,INSERT EMERGENCY AIRWAY,,,151.02,151.02,1
HCPCS,31500,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1267.5,823.875,89.91,4151.0,326
HCPCS,315000,INSERT EMERGENCY AIRWAY,,,151.02,151.02,1
HCPCS,31502,CHANGE OF WINDPIPE AIRWAY,,,37.27,37.27,1
HCPCS,31502,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,797.5,518.375,25.93,4151.0,228
HCPCS,315020,CHANGE OF WINDPIPE AIRWAY,,,37.27,37.27,1
HCPCS,31505,DIAGNOSTIC LARYNGOSCOPY,,,52.12,52.12,1
HCPCS,31505,LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,1116.0,725.4,57.56,3920.0,98
HCPCS,31505,"LARYNGOSCOPY,INDIRECT,DIAGNOSTIC",244.0,158.6,23.67,183.0,35
HCPCS,315050,DIAGNOSTIC LARYNGOSCOPY,,,52.12,52.12,1
HCPCS,3150F,FORCEPS ESOPH BIOPSY DONE,,,0.01,0.01,1
HCPCS,3150F0,FORCEPS ESOPH BIOPSY DONE,,,0.01,0.01,1
HCPCS,31510,LARYNGOSCOPY WITH BIOPSY,,,128.74,7993.92,15
HCPCS,31510,"LARYNGOSCOPY,INDIRECT WITH BIOPSY",768.0,499.2,57.86,576.0,35
HCPCS,31510,Laryngoscopy with biopsy,,,1193.97,1508.17,6
HCPCS,315100,LARYNGOSCOPY WITH BIOPSY,,,128.74,128.74,1
HCPCS,31511,LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY,1116.0,725.4,112.01,4151.0,98
HCPCS,31511,"LARYNGOSCOPY,INDIRECT+REMV FOR.BODY",864.0,561.6,63.78,648.0,35
HCPCS,31511,REMOVE FOREIGN BODY LARYNX,,,143.11,143.11,1
HCPCS,315110,REMOVE FOREIGN BODY LARYNX,,,143.11,143.11,1
HCPCS,31512,"LARYNGOSCOPY,INDIRECT+REMV LESN",911.0,592.15,61.98,683.25,35
HCPCS,31512,REMOVAL OF LARYNX LESION,,,137.71,7993.92,15
HCPCS,31512,Removal of larynx lesion,,,1193.97,1508.17,6
HCPCS,315120,REMOVAL OF LARYNX LESION,,,137.71,137.71,1
HCPCS,31513,INJECTION INTO VOCAL CORD,,,139.53,841.92,15
HCPCS,31513,Injection into vocal cord,,,357.79,451.94,6
HCPCS,31513,LARYNGOSCOPY INDIRECT W/VOCAL CORD INJECTION,840.0,546.0,100.6,840.0,35
HCPCS,315130,INJECTION INTO VOCAL CORD,,,139.53,139.53,1
HCPCS,31515,LARYNGOSCOPY FOR ASPIRATION,,,117.86,117.86,1
HCPCS,31515,LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION,1476.5,959.725,53.75,13665.0,84
HCPCS,315150,LARYNGOSCOPY FOR ASPIRATION,,,117.86,117.86,1
HCPCS,31520,DX LARYNGOSCOPY NEWBORN,,,166.4,841.92,15
HCPCS,31520,Dx laryngoscopy newborn,,,357.79,451.94,6
HCPCS,315200,DX LARYNGOSCOPY NEWBORN,,,166.4,166.4,1
HCPCS,31525,DX LARYNGOSCOPY EXCL NB,,,170.34,170.34,1
HCPCS,31525,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,5484.0,3564.6,77.09,13665.0,130
HCPCS,315250,DX LARYNGOSCOPY EXCL NB,,,170.34,170.34,1
HCPCS,31526,DX LARYNGOSCOPY W/OPER SCOPE,,,166.76,3738.94,15
HCPCS,31526,Dx laryngoscopy w/oper scope,,,357.79,451.94,6
HCPCS,31526,LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE,1028.0,668.2,120.77,1028.0,35
HCPCS,315260,DX LARYNGOSCOPY W/OPER SCOPE,,,166.76,166.76,1
HCPCS,31527,LARYNGOSCOPY FOR TREATMENT,,,206.86,7993.92,15
HCPCS,31527,LARYNGOSCOPY W/WO TRACHEOSCOPY INSERT OBTURATOR,1439.0,935.35,149.62,1439.0,35
HCPCS,31527,Laryngoscopy for treatment,,,1193.97,1508.17,6
HCPCS,315270,LARYNGOSCOPY FOR TREATMENT,,,206.86,206.86,1
HCPCS,31528,LARYNGOSCOPY AND DILATION,,,153.28,7993.92,15
HCPCS,31528,LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN,948.0,616.2,110.81,948.0,35
HCPCS,31528,Laryngoscopy and dilation,,,1193.97,1508.17,6
HCPCS,315280,LARYNGOSCOPY AND DILATION,,,153.28,153.28,1
HCPCS,31529,LARYNGOSCOPY AND DILATION,,,171.17,7993.92,16
HCPCS,31529,LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ,1072.0,696.8,123.32,1072.0,35
HCPCS,31529,Laryngoscopy and dilation,,,1193.97,1508.17,6
HCPCS,315290,LARYNGOSCOPY AND DILATION,,,171.17,171.17,1
HCPCS,31530,LARYNGOSCOPY W/FB REMOVAL,,,211.41,211.41,1
HCPCS,31530,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,5634.0,3662.1,152.17,13665.0,84
HCPCS,315300,LARYNGOSCOPY W/FB REMOVAL,,,211.41,211.41,1
HCPCS,31531,LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE,1432.0,930.8,161.11,1432.0,35
HCPCS,31531,LARYNGOSCOPY W/FB & OP SCOPE,,,224.09,7993.92,15
HCPCS,31531,Laryngoscopy w/fb & op scope,,,1193.97,1508.17,6
HCPCS,315310,LARYNGOSCOPY W/FB & OP SCOPE,,,224.09,224.09,1
HCPCS,31535,LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY,1264.0,821.6,145.28,1264.0,35
HCPCS,31535,LARYNGOSCOPY W/BIOPSY,,,200.78,7993.92,15
HCPCS,31535,Laryngoscopy w/biopsy,,,1193.97,1508.17,6
HCPCS,315350,LARYNGOSCOPY W/BIOPSY,,,200.78,200.78,1
HCPCS,31536,LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE,1420.0,923.0,160.6,1420.0,35
HCPCS,31536,LARYNGOSCOPY W/BX & OP SCOPE,,,222.99,7993.92,17
HCPCS,31536,Laryngoscopy w/bx & op scope,,,1193.97,1508.17,6
HCPCS,315360,LARYNGOSCOPY W/BX & OP SCOPE,,,222.99,222.99,1
HCPCS,31540,LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT,11424.0,7425.6,184.34,19080.0,84
HCPCS,31540,LARYNGOSCOPY W/EXC OF TUMOR,,,255.98,255.98,1
HCPCS,315400,LARYNGOSCOPY W/EXC OF TUMOR,,,255.98,255.98,1
HCPCS,31541,LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP,1808.0,1175.2,200.68,1808.0,35
HCPCS,31541,LARYNSCOP W/TUMR EXC + SCOPE,,,279.28,10738.0,18
HCPCS,31541,Larynscop w/tumr exc + scope,,,1193.97,1508.17,6
HCPCS,315410,LARYNSCOP W/TUMR EXC + SCOPE,,,279.28,279.28,1
HCPCS,31545,LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP,2772.0,1801.8,267.86,2772.0,35
HCPCS,31545,REMOVE VC LESION W/SCOPE,,,384.12,7993.92,15
HCPCS,31545,Remove vc lesion w/scope,,,1193.97,1508.17,6
HCPCS,315450,REMOVE VC LESION W/SCOPE,,,384.12,384.12,1
HCPCS,31546,LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD GRAFT,4281.0,2782.65,394.79,4281.0,35
HCPCS,31546,REMOVE VC LESION SCOPE/GRAFT,,,582.67,15009.06,15
HCPCS,31546,Remove vc lesion scope/graft,,,1193.97,1508.17,6
HCPCS,315460,REMOVE VC LESION SCOPE/GRAFT,,,582.67,582.67,1
HCPCS,31551,LARYNGOPLASTY LARYNGEAL STEN,,,1634.91,12826.13,15
HCPCS,31551,LARYNGOPLASTY LARYNGEAL STEN W/O STENT < 12 YRS,8600.0,5590.0,1128.28,8600.0,31
HCPCS,31551,Laryngoplasty laryngeal sten,,,2719.4,3435.04,6
HCPCS,315510,LARYNGOPLASTY LARYNGEAL STEN,,,1634.91,1634.91,1
HCPCS,31552,LARYNGOPLASTY LARYNGEAL STEN,,,1577.11,12826.13,15
HCPCS,31552,LARYNGOPLASTY LARYNGEAL STEN W/O STENT 12 YRS >,8200.0,5330.0,1137.44,8200.0,31
HCPCS,31552,Laryngoplasty laryngeal sten,,,2132.36,2693.51,6
HCPCS,315520,LARYNGOPLASTY LARYNGEAL STEN,,,1577.11,1577.11,1
HCPCS,31553,LARYNGOPLASTY LARYNGEAL STEN,,,1774.83,12826.13,15
HCPCS,31553,LARYNGOPLASTY LARYNGEAL STEN W/STENT < 12 YRS,8800.0,5720.0,1239.25,8800.0,31
HCPCS,31553,Laryngoplasty laryngeal sten,,,2719.4,3435.04,6
HCPCS,315530,LARYNGOPLASTY LARYNGEAL STEN,,,1774.83,1774.83,1
HCPCS,31554,LARYNGOPLASTY LARYNGEAL STEN,,,1775.5,12826.13,15
HCPCS,31554,Laryngoplasty laryngeal sten,,,2132.36,2693.51,6
HCPCS,315540,LARYNGOPLASTY LARYNGEAL STEN,,,1775.5,1775.5,1
HCPCS,3155F,CYTOGEN TEST MARROW B/4 TX,,,0.01,0.01,1
HCPCS,3155F0,CYTOGEN TEST MARROW B/4 TX,,,0.01,0.01,1
HCPCS,31560,LARYNGOSCOP W/ARYTENOIDECTOM,,,331.32,15009.06,15
HCPCS,31560,LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY,2398.0,1558.7,238.22,2398.0,35
HCPCS,31560,Laryngoscop w/arytenoidectom,,,1193.97,1508.17,6
HCPCS,315600,LARYNGOSCOP W/ARYTENOIDECTOM,,,331.32,331.32,1
HCPCS,31561,LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE,2396.0,1557.4,259.66,2396.0,35
HCPCS,31561,LARYNSCOP REMVE CART + SCOP,,,362.51,15009.06,15
HCPCS,31561,Larynscop remve cart + scop,,,1193.97,1508.17,6
HCPCS,315610,LARYNSCOP REMVE CART + SCOP,,,362.51,362.51,1
HCPCS,31570,LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC,1544.0,1003.6,124.57,1158.0,35
HCPCS,31570,LARYNGOSCOPE W/VC INJ,,,243.49,7993.92,15
HCPCS,31570,Laryngoscope w/vc inj,,,1193.97,1508.17,6
HCPCS,315700,LARYNGOSCOPE W/VC INJ,,,243.49,243.49,1
HCPCS,31571,LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE,11452.0,7443.8,190.22,19080.0,74
HCPCS,31571,LARYNGOSCOP W/VC INJ + SCOPE,,,264.21,264.21,1
HCPCS,315710,LARYNGOSCOP W/VC INJ + SCOPE,,,264.21,264.21,1
HCPCS,31572,LARGSC W/LASER DSTRJ LES,,,191.81,191.81,1
HCPCS,31572,LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI,11262.0,7320.3,138.13,19080.0,73
HCPCS,315720,LARGSC W/LASER DSTRJ LES,,,191.81,191.81,1
HCPCS,31573,LARGSC W/THER INJECTION,,,158.16,158.16,1
HCPCS,31573,LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,5444.0,3538.6,113.88,13665.0,80
HCPCS,315730,LARGSC W/THER INJECTION,,,158.16,158.16,1
HCPCS,31574,LARGSC W/NJX AUGMENTATION,,,158.87,158.87,1
HCPCS,31574,LARYNGOSCOPY FLEXIBLE W/INJECTION AGMNTJ UNI,5444.0,3538.6,113.88,13665.0,126
HCPCS,315740,LARGSC W/NJX AUGMENTATION,,,158.87,158.87,1
HCPCS,31575,DIAGNOSTIC LARYNGOSCOPY,,,72.51,72.51,1
HCPCS,31575,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,765.0,497.25,41.66,4151.0,225
HCPCS,315750,DIAGNOSTIC LARYNGOSCOPY,,,72.51,72.51,1
HCPCS,31576,LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES),5336.0,3468.3999999999996,57.04,13665.0,130
HCPCS,31576,LARYNGOSCOPY WITH BIOPSY,,,126.96,126.96,1
HCPCS,315760,LARYNGOSCOPY WITH BIOPSY,,,126.96,126.96,1
HCPCS,31577,LARGSC W/RMVL FOREIGN BDY(S),,,141.91,141.91,1
HCPCS,31577,LARYNGOSCOPY FLX RMVL FOREIGN BODY(S),1598.5,1039.025,70.62,4268.0,84
HCPCS,315770,LARGSC W/RMVL FOREIGN BDY(S),,,141.91,141.91,1
HCPCS,31578,LARGSC W/REMOVAL LESION,,,158.87,158.87,1
HCPCS,31578,LARYNGOSCOPY FLEXIBLE RMVL LESION(S) NON-LASER,11086.0,7205.9,72.43,19080.0,77
HCPCS,315780,LARGSC W/REMOVAL LESION,,,158.87,158.87,1
HCPCS,31579,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,1530.0,994.5,69.36,4214.0,228
HCPCS,31579,LARYNGOSCOPY TELESCOPIC,,,126.85,126.85,1
HCPCS,315790,LARYNGOSCOPY TELESCOPIC,,,126.85,126.85,1
HCPCS,31580,LARYNGOPLASTY LARYN WEB W/KEEL STENT INSERTION,5840.0,3796.0,730.65,5840.0,35
HCPCS,31580,LARYNGOPLASTY LARYNGEAL WEB,,,1347.65,12826.13,15
HCPCS,31580,Laryngoplasty laryngeal web,,,2132.36,2693.51,6
HCPCS,315800,LARYNGOPLASTY LARYNGEAL WEB,,,1347.65,1347.65,1
HCPCS,31584,LARYNGOPLASTY FX RDCTJ FIXJ,,,1486.95,12826.13,15
HCPCS,31584,LARYNGOPLASTY W/OPEN REDUCTION FRACTURE W/TRACHS,7032.0,4570.8,901.1,7032.0,35
HCPCS,31584,Laryngoplasty fx rdctj fixj,,,2132.36,2693.51,6
HCPCS,315840,LARYNGOPLASTY FX RDCTJ FIXJ,,,1486.95,1486.95,1
HCPCS,31587,LARYNGOPLASTY CRICOID SPLIT,,,1275.07,12826.13,15
HCPCS,31587,Laryngoplasty cricoid split,,,2719.4,3435.04,6
HCPCS,315870,LARYNGOPLASTY CRICOID SPLIT,,,1275.07,1275.07,1
HCPCS,31590,REINNERVATE LARYNX,,,963.17,12826.13,15
HCPCS,31590,Reinnervate larynx,,,2719.4,3435.04,6
HCPCS,315900,REINNERVATE LARYNX,,,963.17,963.17,1
HCPCS,31591,LARYNGOPLASTY MEDIALIZATION,,,1161.94,12826.13,15
HCPCS,31591,LARYNGOPLASTY MEDIALIZATION UNLIATERAL,5424.0,3525.6,820.91,5424.0,31
HCPCS,31591,Laryngoplasty medialization,,,2132.36,2693.51,6
HCPCS,315910,LARYNGOPLASTY MEDIALIZATION,,,1161.94,1161.94,1
HCPCS,31592,CRICOTRACHEAL RESECTION,10000.0,6500.0,1272.71,12826.13,46
HCPCS,31592,Cricotracheal resection,,,3296.96,4164.58,6
HCPCS,315920,CRICOTRACHEAL RESECTION,,,1837.65,1837.65,1
HCPCS,31599,DIRECT LARYNGOSCOPY WITH LYSIS LARYNGEAL STENOSIS (COMP 31541),1630.0,1059.5,815.0,1772.22,15
HCPCS,31599,ESOPHAGOSCOPY WITH ESOPHAGEAL STENT (COMP CODE 43212),1360.0,884.0,680.0,1772.22,15
HCPCS,31599,MICRODRCT LARYN W VOCAL CORDOTOMY (COMP CODE 31541),1836.0,1193.4,918.0,1836.0,15
HCPCS,31599,UNLISTED ENDOSCOPIC LARYNGOPLASTY WITH PLACEMENT OF POSTERIOR CR,7741.0,5031.65,1476.85,7741.0,15
HCPCS,31599,UNLISTED PROCEDURE LARYNX,,,233.1,4188.0,15
HCPCS,31599,Unlisted procedure larynx,,,839.72,1060.7,6
HCPCS,31600,PLANNED TRACHEOSTOMY,,,325.97,325.97,1
HCPCS,31600,TRACHEOSTOMY PLANNED SEPARATE PROCEDURE,18648.0,12121.2,361.9,16783.2,39
HCPCS,31600,"TRACHEOSTOMY, PLANNED",2446.0,1589.9,226.21,2446.0,35
HCPCS,316000,PLANNED TRACHEOSTOMY,,,325.97,325.97,1
HCPCS,31601,PLANNED TRACHEOSTOMY<2 YRS,,,479.36,12826.13,15
HCPCS,31601,Planned tracheostomy<2 yrs,,,1454.91,1837.78,6
HCPCS,316010,PLANNED TRACHEOSTOMY<2 YRS,,,479.36,479.36,1
HCPCS,31603,EMER TRACHEOSTOMY TTRACH,,,342.28,342.28,1
HCPCS,31603,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,5459.0,3548.35,193.33,7666.2,179
HCPCS,316030,EMER TRACHEOSTOMY TTRACH,,,342.28,342.28,1
HCPCS,31605,EMER TRACHEOSTOMY CTHYR MEM,,,353.73,353.73,1
HCPCS,31605,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,1957.5,1272.375,161.42,6317.0,179
HCPCS,316050,EMER TRACHEOSTOMY CTHYR MEM,,,353.73,353.73,1
HCPCS,3160F,DOC FE+ STORES B/4 EPO THX,,,0.01,0.01,1
HCPCS,3160F0,DOC FE+ STORES B/4 EPO THX,,,0.01,0.01,1
HCPCS,31610,TRACHEOSTOMY FENEST SKIN FLP,,,1009.82,12826.13,15
HCPCS,31610,TRACHEOSTOMY FENESTRATION W/SKIN FLAPS,4800.0,3120.0,471.28,4800.0,35
HCPCS,31610,Tracheostomy fenest skin flp,,,1454.91,1837.78,6
HCPCS,316100,TRACHEOSTOMY FENEST SKIN FLP,,,1009.82,1009.82,1
HCPCS,31611,CONSTJ TRACHEOESOPHGL FSTL&INSJ SP PROSTH,2400.0,1560.0,357.13,2400.0,35
HCPCS,31611,CONSTJ TRACHESOPHGL FSTL,,,565.12,7031.51,15
HCPCS,31611,Constj trachesophgl fstl,,,1454.91,1837.78,6
HCPCS,316110,CONSTJ TRACHESOPHGL FSTL,,,565.12,565.12,1
HCPCS,31612,PERQ TRCHL PNXR TTRACH ASPIR,,,51.36,7031.51,15
HCPCS,31612,Perq trchl pnxr ttrach aspir,,,599.03,756.67,6
HCPCS,31612,TRACHEAL PNXR PRQ W/TRANSTRACHEAL ASPIR&/NJX,400.0,260.0,23.18,300.0,35
HCPCS,316120,PERQ TRCHL PNXR TTRACH ASPIR,,,51.36,51.36,1
HCPCS,31613,TRACHEOSTOMA REVJ SIMPLE,,,446.41,7031.51,15
HCPCS,31613,TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION,1884.0,1224.6,229.34,1884.0,35
HCPCS,31613,Tracheostoma revj simple,,,1454.91,1837.78,6
HCPCS,316130,TRACHEOSTOMA REVJ SIMPLE,,,446.41,446.41,1
HCPCS,31614,TRACHEOSTOMA REVJ COMPLEX,,,751.63,12826.13,15
HCPCS,31614,TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION,3452.0,2243.8,397.49,3452.0,35
HCPCS,31614,Tracheostoma revj complex,,,1454.91,1837.78,6
HCPCS,316140,TRACHEOSTOMA REVJ COMPLEX,,,751.63,751.63,1
HCPCS,31615,TRACHEOBRNCHSC THRU EST TRACHS INC,1869.5,1215.175,70.64,6317.0,224
HCPCS,31615,TRCHEOBRNCHSC EST TRACHS INC,,,122.71,122.71,1
HCPCS,316150,TRCHEOBRNCHSC EST TRACHS INC,,,122.71,122.71,1
HCPCS,31620,ENDOBRNCL US BRONCHOSCOPIC DX/THER IVNTJ,355.0,230.75,59.64,319.5,21
HCPCS,31622,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,5514.5,3584.4249999999997,63.29,8924.4,228
HCPCS,31622,DX BRONCHOSCOPE/WASH,,,139.92,139.92,1
HCPCS,316220,DX BRONCHOSCOPE/WASH,,,139.92,139.92,1
HCPCS,31623,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,5536.5,3598.725,63.62,8924.4,179
HCPCS,31623,DX BRONCHOSCOPE/BRUSH,,,138.89,138.89,1
HCPCS,316230,DX BRONCHOSCOPE/BRUSH,,,138.89,138.89,1
HCPCS,31624,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,5536.5,3598.725,64.28,8924.4,179
HCPCS,31624,DX BRONCHOSCOPE/LAVAGE,,,140.61,140.61,1
HCPCS,316240,DX BRONCHOSCOPE/LAVAGE,,,140.61,140.61,1
HCPCS,31625,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,5642.0,3667.2999999999997,75.13,8924.4,179
HCPCS,31625,BRONCHOSCOPY W/BIOPSY(S),,,164.49,164.49,1
HCPCS,316250,BRONCHOSCOPY W/BIOPSY(S),,,164.49,164.49,1
HCPCS,31626,BRONCHOSCOPY W/MARKERS,,,207.9,207.9,1
HCPCS,31626,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,20684.0,13444.599999999999,94.35,35823.6,116
HCPCS,316260,BRONCHOSCOPY W/MARKERS,,,207.9,207.9,1
HCPCS,31627,BRNCHSC W/CPTR-ASST IMAGE-GUIDED NAVIGATION,800.0,520.0,46.36,2178.82,35
HCPCS,31627,BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION,2030.0,1319.5,119.08,3920.0,61
HCPCS,31627,NAVIGATIONAL BRONCHOSCOPY,,,101.67,101.67,1
HCPCS,316270,NAVIGATIONAL BRONCHOSCOPY,,,101.67,101.67,1
HCPCS,31628,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,11381.0,7397.65,84.33,19080.0,179
HCPCS,31628,BRONCHOSCOPY/LUNG BX EACH,,,185.01,185.01,1
HCPCS,316280,BRONCHOSCOPY/LUNG BX EACH,,,185.01,185.01,1
HCPCS,31629,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,11425.0,7426.25,121.93,19080.0,130
HCPCS,31629,BRONCHOSCOPY/NEEDLE BX EACH,,,196.58,196.58,1
HCPCS,316290,BRONCHOSCOPY/NEEDLE BX EACH,,,196.58,196.58,1
HCPCS,31630,BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX,11362.0,7385.3,149.36,19080.0,116
HCPCS,31630,BRONCHOSCOPY DILATE/FX REPR,,,208.92,208.92,1
HCPCS,316300,BRONCHOSCOPY DILATE/FX REPR,,,208.92,208.92,1
HCPCS,31631,BRONCHOSCOPY DILATE W/STENT,,,238.03,238.03,1
HCPCS,31631,BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT,20774.0,13503.099999999999,170.3,35823.6,77
HCPCS,316310,BRONCHOSCOPY DILATE W/STENT,,,238.03,238.03,1
HCPCS,31632,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,946.0,614.9,28.37,7730.0,108
HCPCS,31632,BRONCHOSCOPY/LUNG BX ADDL,,,51.54,51.54,1
HCPCS,316320,BRONCHOSCOPY/LUNG BX ADDL,,,51.54,51.54,1
HCPCS,31633,BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE,1148.0,746.2,36.64,7730.0,108
HCPCS,31633,BRONCHOSCOPY/NEEDLE BX ADDL,,,66.36,66.36,1
HCPCS,316330,BRONCHOSCOPY/NEEDLE BX ADDL,,,66.36,66.36,1
HCPCS,31634,BRONCH W/BALLOON OCCLUSION,,,197.96,197.96,1
HCPCS,31634,BRONCHOSCOPY BALLOON OCCLUSION,20652.0,13423.8,91.89,35823.6,81
HCPCS,316340,BRONCH W/BALLOON OCCLUSION,,,197.96,197.96,1
HCPCS,31635,BRONCHOSCOPY W/FB REMOVAL,,,184.91,184.91,1
HCPCS,31635,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,5710.5,3711.825,84.16,8924.4,179
HCPCS,316350,BRONCHOSCOPY W/FB REMOVAL,,,184.91,184.91,1
HCPCS,31636,BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,20762.0,13495.3,163.41,35823.6,77
HCPCS,31636,BRONCHOSCOPY BRONCH STENTS,,,227.88,227.88,1
HCPCS,316360,BRONCHOSCOPY BRONCH STENTS,,,227.88,227.88,1
HCPCS,31637,BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED,632.0,410.8,56.94,632.0,35
HCPCS,31637,BRONCHOSCOPY STENT ADD-ON,,,79.98,79.98,1
HCPCS,31637,Bronchoscopy stent add-on,,,2523.58,3187.68,6
HCPCS,316370,BRONCHOSCOPY STENT ADD-ON,,,79.98,79.98,1
HCPCS,31638,BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,20878.0,13570.699999999999,184.85,35823.6,77
HCPCS,31638,BRONCHOSCOPY REVISE STENT,,,258.68,258.68,1
HCPCS,316380,BRONCHOSCOPY REVISE STENT,,,258.68,258.68,1
HCPCS,31640,BRONCHOSCOPY W/EXCISION TUMOR,11586.0,7530.9,184.85,19080.0,77
HCPCS,31640,BRONCHOSCOPY W/TUMOR EXCISE,,,260.18,260.18,1
HCPCS,316400,BRONCHOSCOPY W/TUMOR EXCISE,,,260.18,260.18,1
HCPCS,31641,BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC,11604.0,7542.6,189.45,19080.0,116
HCPCS,31641,BRONCHOSCOPY TREAT BLOCKAGE,,,267.29,267.29,1
HCPCS,316410,BRONCHOSCOPY TREAT BLOCKAGE,,,267.29,267.29,1
HCPCS,31643,BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL,1396.0,907.4,119.01,1396.0,35
HCPCS,31643,DIAG BRONCHOSCOPE/CATHETER,,,178.29,3738.94,15
HCPCS,31643,Diag bronchoscope/catheter,,,1152.77,1456.13,6
HCPCS,316430,DIAG BRONCHOSCOPE/CATHETER,,,178.29,178.29,1
HCPCS,31645,BRNCHSC W/THER ASPIR 1ST,,,155.01,155.01,1
HCPCS,31645,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST,5591.5,3634.475,70.36,8924.4,81
HCPCS,316450,BRNCHSC W/THER ASPIR 1ST,,,155.01,155.01,1
HCPCS,31646,BRNCHSC W/THER ASPIR SBSQ,,,149.58,149.58,1
HCPCS,31646,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ,1728.0,1123.2,68.06,7730.0,81
HCPCS,316460,BRNCHSC W/THER ASPIR SBSQ,,,149.58,149.58,1
HCPCS,31647,BRNCHSC OCCLUSION&INSERT BRONCH VALVE INIT LOBE,20732.0,13475.8,149.75,35823.6,77
HCPCS,31647,BRONCHIAL VALVE INIT INSERT,,,216.01,216.01,1
HCPCS,316470,BRONCHIAL VALVE INIT INSERT,,,216.01,216.01,1
HCPCS,31648,BRNCHSC REMOVAL BRONCHIAL VALVE INITIAL,11390.0,7403.5,155.63,19080.0,77
HCPCS,31648,BRONCHIAL VALVE REMOV INIT,,,208.34,208.34,1
HCPCS,316480,BRONCHIAL VALVE REMOV INIT,,,208.34,208.34,1
HCPCS,31649,BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL,5246.0,3409.8999999999996,48.61,8924.4,77
HCPCS,31649,BRONCHIAL VALVE REMOV ADDL,,,70.33,70.33,1
HCPCS,316490,BRONCHIAL VALVE REMOV ADDL,,,70.33,70.33,1
HCPCS,31651,BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE,2370.0,1540.5,54.21,13665.0,66
HCPCS,31651,BRONCHIAL VALVE ADDL INSERT,,,79.98,79.98,1
HCPCS,316510,BRONCHIAL VALVE ADDL INSERT,,,79.98,79.98,1
HCPCS,31652,BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX,11581.0,7527.65,180.12,19080.0,80
HCPCS,31652,BRONCH EBUS SAMPLNG 1/2 NODE,,,231.9,231.9,1
HCPCS,316520,BRONCH EBUS SAMPLNG 1/2 NODE,,,231.9,231.9,1
HCPCS,31653,BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX,11691.0,7599.15,198.84,19080.0,80
HCPCS,31653,BRONCH EBUS SAMPLNG 3/> NODE,,,257.19,257.19,1
HCPCS,316530,BRONCH EBUS SAMPLNG 3/> NODE,,,257.19,257.19,1
HCPCS,31654,BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES,1390.5,903.825,52.14,7730.0,69
HCPCS,31654,BRONCH EBUS IVNTJ PERPH LES,,,70.62,70.62,1
HCPCS,316540,BRONCH EBUS IVNTJ PERPH LES,,,70.62,70.62,1
HCPCS,31660,BRONCH THERMOPLSTY 1 LOBE,,,199.89,199.89,1
HCPCS,31660,BRONCHOSCOPIC THERMOPLASTY ONE LOBE,20702.0,13456.3,149.79,35823.6,77
HCPCS,316600,BRONCH THERMOPLSTY 1 LOBE,,,199.89,199.89,1
HCPCS,31661,BRONCH THERMOPLSTY 2/> LOBES,,,211.15,211.15,1
HCPCS,31661,BRONCHOSCOPIC THERMOPLASTY 2/> LOBES,20752.0,13488.8,158.49,35823.6,77
HCPCS,316610,BRONCH THERMOPLSTY 2/> LOBES,,,211.15,211.15,1
HCPCS,3170F,BASELIN FLO CYTOMETRY B/4 TX,,,0.01,0.01,1
HCPCS,3170F0,BASELIN FLO CYTOMETRY B/4 TX,,,0.01,0.01,1
HCPCS,31717,BRONCHIAL BRUSH BIOPSY,,,111.91,841.92,15
HCPCS,31717,Bronchial brush biopsy,,,2523.58,3187.68,6
HCPCS,317170,BRONCHIAL BRUSH BIOPSY,,,111.91,111.91,1
HCPCS,31720,CATHETER ASPIRATION NASOTRACHEAL SPX,1170.0,760.5,38.83,3920.0,144
HCPCS,31720,"CATHETER ASPIRATN,NASOTRACH",424.0,275.6,40.6,424.0,35
HCPCS,31720,CLEARANCE OF AIRWAYS,,,51.59,51.59,1
HCPCS,317200,CLEARANCE OF AIRWAYS,,,51.59,51.59,1
HCPCS,31725,CLEARANCE OF AIRWAYS,,,83.71,83.71,1
HCPCS,31725,Clearance of airways,,,357.79,451.94,6
HCPCS,317250,CLEARANCE OF AIRWAYS,,,83.71,83.71,1
HCPCS,31730,INTRO WINDPIPE WIRE/TUBE,,,158.54,3738.94,15
HCPCS,31730,Intro windpipe wire/tube,,,1454.91,1837.78,6
HCPCS,317300,INTRO WINDPIPE WIRE/TUBE,,,158.54,158.54,1
HCPCS,31750,TRACHEOPLASTY CERVICAL,6772.0,4401.8,697.49,12826.13,50
HCPCS,31750,Tracheoplasty cervical,,,1454.91,1837.78,6
HCPCS,317500,TRACHEOPLASTY CERVICAL,,,1415.86,1415.86,1
HCPCS,31755,TRACHEOPLASTY TRACHEOPHARYNGEAL FSTLJ EA STG,7718.0,5016.7,886.55,7718.0,35
HCPCS,31755,TRACHPLSTY TRCHPHRYNGL FSTLJ,,,1806.81,12826.13,15
HCPCS,31755,Trachplsty trchphryngl fstlj,,,1454.91,1837.78,6
HCPCS,317550,TRACHPLSTY TRCHPHRYNGL FSTLJ,,,1806.81,1806.81,1
HCPCS,31760,TRACHEOPLASTY INTRATHORACIC,,,1464.53,1464.53,1
HCPCS,31760,Tracheoplasty intrathoracic,,,3296.96,4164.58,6
HCPCS,317600,TRACHEOPLASTY INTRATHORACIC,,,1464.53,1464.53,1
HCPCS,31766,CARINAL RECONSTRUCTION,,,1889.86,1889.86,1
HCPCS,31766,Carinal reconstruction,,,3296.96,4164.58,6
HCPCS,317660,CARINAL RECONSTRUCTION,,,1889.86,1889.86,1
HCPCS,31770,REPAIR/GRAFT OF BRONCHUS,,,1413.67,1413.67,1
HCPCS,31770,Repair/graft of bronchus,,,3296.96,4164.58,6
HCPCS,317700,REPAIR/GRAFT OF BRONCHUS,,,1413.67,1413.67,1
HCPCS,31775,RECONSTRUCT BRONCHUS,,,1488.79,1488.79,1
HCPCS,31775,Reconstruct bronchus,,,3296.96,4164.58,6
HCPCS,317750,RECONSTRUCT BRONCHUS,,,1488.79,1488.79,1
HCPCS,31780,EXCISION TRACHEAL STENOSIS&ANASTOMOSIS CERVICA,7936.0,5158.4,902.15,7936.0,35
HCPCS,31780,RECONSTRUCT WINDPIPE,,,1279.58,1279.58,1
HCPCS,31780,Reconstruct windpipe,,,1454.91,1837.78,6
HCPCS,317800,RECONSTRUCT WINDPIPE,,,1279.58,1279.58,1
HCPCS,31781,EXC TRACHEAL STENOSIS&ANAST CERVICOTHORACIC,9940.0,6461.0,1071.33,9940.0,35
HCPCS,31781,RECONSTRUCT WINDPIPE,,,1536.42,1536.42,1
HCPCS,31781,Reconstruct windpipe,,,3296.96,4164.58,6
HCPCS,317810,RECONSTRUCT WINDPIPE,,,1536.42,1536.42,1
HCPCS,31785,EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL,7340.0,4771.0,760.83,7340.0,35
HCPCS,31785,REMOVE WINDPIPE LESION,,,1148.21,12826.13,15
HCPCS,31785,Remove windpipe lesion,,,1454.91,1837.78,6
HCPCS,317850,REMOVE WINDPIPE LESION,,,1148.21,1148.21,1
HCPCS,31786,REMOVE WINDPIPE LESION,,,1534.49,1534.49,1
HCPCS,31786,Remove windpipe lesion,,,3296.96,4164.58,6
HCPCS,317860,REMOVE WINDPIPE LESION,,,1534.49,1534.49,1
HCPCS,31800,REPAIR OF WINDPIPE INJURY,,,743.32,743.32,1
HCPCS,31800,Repair of windpipe injury,,,1454.91,1837.78,6
HCPCS,31800,SUTURE TRACHEAL WOUND/INJURY CERVICAL,3272.0,2126.8,373.43,3272.0,35
HCPCS,318000,REPAIR OF WINDPIPE INJURY,,,743.32,743.32,1
HCPCS,31805,REPAIR OF WINDPIPE INJURY,,,872.09,872.09,1
HCPCS,31805,Repair of windpipe injury,,,1419.15,1792.61,6
HCPCS,31805,SUTURE TRACHEAL WOUND/INJURY INTRATHORACIC,5368.0,3489.2,608.66,5368.0,35
HCPCS,318050,REPAIR OF WINDPIPE INJURY,,,872.09,872.09,1
HCPCS,31820,CLOSURE OF WINDPIPE LESION,,,354.42,354.42,1
HCPCS,31820,SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR,10252.0,6663.8,161.92,16783.2,74
HCPCS,318200,CLOSURE OF WINDPIPE LESION,,,354.42,354.42,1
HCPCS,31825,REPAIR OF WINDPIPE DEFECT,,,518.89,7031.51,15
HCPCS,31825,Repair of windpipe defect,,,1454.91,1837.78,6
HCPCS,31825,SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR,2828.0,1838.2,236.22,2121.0,35
HCPCS,318250,REPAIR OF WINDPIPE DEFECT,,,518.89,518.89,1
HCPCS,31830,REVISE TRACHEOSTOMY SCAR,1848.0,1201.2,179.01,1386.0,35
HCPCS,31830,REVISE WINDPIPE SCAR,,,390.59,7031.51,15
HCPCS,31830,Revise windpipe scar,,,1454.91,1837.78,6
HCPCS,318300,REVISE WINDPIPE SCAR,,,390.59,390.59,1
HCPCS,31899,BRONCHIAL THERMOPL INITIAL,1802.0,1171.3,288.87,1802.0,15
HCPCS,31899,BRONCHIAL THERMOPL SUBSEQUENT,1802.0,1171.3,288.87,1802.0,15
HCPCS,31899,PLC OF ENDOBRONCHIAL BLOCKER,1008.0,655.2,194.87,2849.0,41
HCPCS,31899,UNLISTED PROC; TRACHEOSTOMY TUBE EXCHANGE FOLLOWING ESTABLISHED,260.0,169.0,130.0,346.64,15
HCPCS,31899,UNLISTED PROCEDURE TRACHEA BRONCHI,2553.0,1659.45,194.87,2297.7,82
HCPCS,3200F,BARIUM SWALLOW TEST NOT REQ,,,0.01,0.01,1
HCPCS,3200F0,BARIUM SWALLOW TEST NOT REQ,,,0.01,0.01,1
HCPCS,32035,THORACOSTOMY W/RIB RESECTION,,,781.54,781.54,1
HCPCS,32035,"THORACOSTOMY,RIB RESECT,EMPYEMA",4516.0,2935.4,427.72,4516.0,35
HCPCS,32035,Thoracostomy w/rib resection,,,3296.96,4164.58,6
HCPCS,320350,THORACOSTOMY W/RIB RESECTION,,,781.54,781.54,1
HCPCS,32036,THORACOSTOMY W/FLAP DRAINAGE,,,842.1,842.1,1
HCPCS,32036,"THORACOSTOMY,OPEN DRAIN/EMPYEMA",4920.0,3198.0,470.68,4920.0,35
HCPCS,32036,Thoracostomy w/flap drainage,,,3296.96,4164.58,6
HCPCS,320360,THORACOSTOMY W/FLAP DRAINAGE,,,842.1,842.1,1
HCPCS,32096,OPEN WEDGE/BX LUNG INFILTR,,,852.16,852.16,1
HCPCS,32096,Open wedge/bx lung infiltr,,,1419.15,1792.61,6
HCPCS,32096,THORACTOMY W/DX BX LUNG INFILTRATE UNILATERAL,5500.0,3575.0,386.62,5500.0,35
HCPCS,320960,OPEN WEDGE/BX LUNG INFILTR,,,852.16,852.16,1
HCPCS,32097,OPEN WEDGE/BX LUNG NODULE,,,853.49,853.49,1
HCPCS,32097,Open wedge/bx lung nodule,,,3296.96,4164.58,6
HCPCS,32097,THORACTOMY W/DX BX LUNG NODULE/MASS UNILATERAL,5500.0,3575.0,387.45,5500.0,35
HCPCS,320970,OPEN WEDGE/BX LUNG NODULE,,,853.49,853.49,1
HCPCS,32098,OPEN BIOPSY OF LUNG PLEURA,,,806.59,806.59,1
HCPCS,32098,Open biopsy of lung pleura,,,3296.96,4164.58,6
HCPCS,32098,THORACOTOMY W/BIOPSY OF PLEURA,5164.0,3356.6,367.06,5164.0,35
HCPCS,320980,OPEN BIOPSY OF LUNG PLEURA,,,806.59,806.59,1
HCPCS,32100,EXPLORATION OF CHEST,,,863.58,863.58,1
HCPCS,32100,THORACOTOMY WITH EXPLORATION,4319.0,2807.35,527.18,18285.0,99
HCPCS,321000,EXPLORATION OF CHEST,,,863.58,863.58,1
HCPCS,3210F,GRP A STREP TEST PERFORMED,,,0.01,0.01,1
HCPCS,3210F0,GRP A STREP TEST PERFORMED,,,0.01,0.01,1
HCPCS,32110,EXPLORE/REPAIR CHEST,,,1573.04,1573.04,1
HCPCS,32110,THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR,11623.5,7555.275,806.66,18285.0,99
HCPCS,321100,EXPLORE/REPAIR CHEST,,,1573.04,1573.04,1
HCPCS,32120,RE-EXPLORATION OF CHEST,,,929.12,929.12,1
HCPCS,32120,Re-exploration of chest,,,3296.96,4164.58,6
HCPCS,32120,"THORACOTOMY,POSTOP COMPLICATNS",5756.0,3741.4,588.46,5756.0,35
HCPCS,321200,RE-EXPLORATION OF CHEST,,,929.12,929.12,1
HCPCS,32124,EXPLORE CHEST FREE ADHESIONS,,,981.66,981.66,1
HCPCS,32124,Explore chest free adhesions,,,1419.15,1792.61,6
HCPCS,32124,THORACOTOMY OPN INTRAPLEURAL PNEUMONOLYSIS,6180.0,4017.0,659.18,6180.0,35
HCPCS,321240,EXPLORE CHEST FREE ADHESIONS,,,981.66,981.66,1
HCPCS,32140,REMOVAL OF LUNG LESION(S),,,1055.22,1055.22,1
HCPCS,32140,Removal of lung lesion(s),,,1419.15,1792.61,6
HCPCS,32140,"THORACOTOMY,CYST REMOVAL",6664.0,4331.6,726.66,6664.0,35
HCPCS,321400,REMOVAL OF LUNG LESION(S),,,1055.22,1055.22,1
HCPCS,32141,REMOVE/TREAT LUNG LESIONS,,,1618.51,1618.51,1
HCPCS,32141,Remove/treat lung lesions,,,3296.96,4164.58,6
HCPCS,32141,THORACOTOMY W/RESECTION BULLAE,10872.0,7066.8,771.3,10872.0,35
HCPCS,321410,REMOVE/TREAT LUNG LESIONS,,,1618.51,1618.51,1
HCPCS,32150,REMOVAL OF LUNG LESION(S),,,1082.58,1082.58,1
HCPCS,32150,Removal of lung lesion(s),,,3296.96,4164.58,6
HCPCS,32150,THORCOM W/RMVL INTRAPLEURAL FB/FIBRIN DEP,6728.0,4373.2,684.29,6728.0,35
HCPCS,321500,REMOVAL OF LUNG LESION(S),,,1082.58,1082.58,1
HCPCS,32151,REMOVE LUNG FOREIGN BODY,,,1070.82,1070.82,1
HCPCS,32151,Remove lung foreign body,,,1419.15,1792.61,6
HCPCS,321510,REMOVE LUNG FOREIGN BODY,,,1070.82,1070.82,1
HCPCS,3215F,PT IMMUNITY TO HEP A DOCD,,,0.01,0.01,1
HCPCS,3215F0,PT IMMUNITY TO HEP A DOCD,,,0.01,0.01,1
HCPCS,32160,OPEN CHEST HEART MASSAGE,,,849.07,849.07,1
HCPCS,32160,THORACOTOMY W/CARDIAC MASSAGE,6308.0,4100.2,513.13,18285.0,99
HCPCS,321600,OPEN CHEST HEART MASSAGE,,,849.07,849.07,1
HCPCS,3216F,PT IMMUNITY TO HEP B DOCD,,,0.01,0.01,1
HCPCS,3216F0,PT IMMUNITY TO HEP B DOCD,,,0.01,0.01,1
HCPCS,3218F,RNA TSTNG HEP C DOCD DONE,,,0.01,0.01,1
HCPCS,3218F0,RNA TSTNG HEP C DOCD DONE,,,0.01,0.01,1
HCPCS,32200,DRAIN OPEN LUNG LESION,,,1213.67,1213.67,1
HCPCS,32200,Drain open lung lesion,,,3296.96,4164.58,6
HCPCS,32200,PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST,7472.0,4856.8,617.4,7472.0,35
HCPCS,322000,DRAIN OPEN LUNG LESION,,,1213.67,1213.67,1
HCPCS,3220F,HEP C QUANT RNA TSTNG DOCD,,,0.01,0.01,1
HCPCS,3220F0,HEP C QUANT RNA TSTNG DOCD,,,0.01,0.01,1
HCPCS,32215,TREAT CHEST LINING,,,855.06,855.06,1
HCPCS,32215,Treat chest lining,,,1419.15,1792.61,6
HCPCS,322150,TREAT CHEST LINING,,,855.06,855.06,1
HCPCS,32220,DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE,10660.0,6929.0,971.04,10660.0,35
HCPCS,32220,RELEASE OF LUNG,,,1700.07,1700.07,1
HCPCS,32220,Release of lung,,,3296.96,4164.58,6
HCPCS,322200,RELEASE OF LUNG,,,1700.07,1700.07,1
HCPCS,32225,DECORTICATION PULMONARY PARTIAL SEPARATE PROC,6700.0,4355.0,731.2,6700.0,35
HCPCS,32225,PARTIAL RELEASE OF LUNG,,,1058.89,1058.89,1
HCPCS,32225,Partial release of lung,,,1419.15,1792.61,6
HCPCS,322250,PARTIAL RELEASE OF LUNG,,,1058.89,1058.89,1
HCPCS,3230F,NOTE HRING TST W/IN 6 MON,,,0.01,0.01,1
HCPCS,3230F0,NOTE HRING TST W/IN 6 MON,,,0.01,0.01,1
HCPCS,32310,PLEURECTOMY PARIETAL SEPARATE PROCEDURE,6112.0,3972.8,669.52,6112.0,35
HCPCS,32310,REMOVAL OF CHEST LINING,,,978.38,978.38,1
HCPCS,32310,Removal of chest lining,,,1419.15,1792.61,6
HCPCS,323100,REMOVAL OF CHEST LINING,,,978.38,978.38,1
HCPCS,32320,DECORTICATION & PARIETAL PLEURECTOMY,10900.0,7085.0,1059.89,10900.0,35
HCPCS,32320,FREE/REMOVE CHEST LINING,,,1707.29,1707.29,1
HCPCS,32320,Free/remove chest lining,,,3296.96,4164.58,6
HCPCS,323200,FREE/REMOVE CHEST LINING,,,1707.29,1707.29,1
HCPCS,32400,BIOPSY PLEURA PERCUTANEOUS NEEDLE,5010.0,3256.5,40.76,8384.4,277
HCPCS,32400,NEEDLE BIOPSY CHEST LINING,,,88.73,88.73,1
HCPCS,324000,NEEDLE BIOPSY CHEST LINING,,,88.73,88.73,1
HCPCS,32405,BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE,1782.0,1158.3,299.38,1603.8,81
HCPCS,32408,CORE NDL BX LNG/MED PERQ,,,160.8,160.8,1
HCPCS,32408,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,5357.5,3482.375,111.91,8384.4,175
HCPCS,324080,CORE NDL BX LNG/MED PERQ,,,160.8,160.8,1
HCPCS,32440,REMOVAL OF LUNG PNEUMONECTOMY,10912.0,7092.8,1083.93,10912.0,35
HCPCS,32440,REMOVE LUNG PNEUMONECTOMY,,,1669.04,1669.04,1
HCPCS,32440,Remove lung pneumonectomy,,,3296.96,4164.58,6
HCPCS,324400,REMOVE LUNG PNEUMONECTOMY,,,1669.04,1669.04,1
HCPCS,32442,SLEEVE PNEUMONECTOMY,,,3247.73,3247.73,1
HCPCS,32442,Sleeve pneumonectomy,,,3296.96,4164.58,6
HCPCS,324420,SLEEVE PNEUMONECTOMY,,,3247.73,3247.73,1
HCPCS,32445,REMOVAL LUNG PNEUMONECTOMY EXTRAPLEURAL,25536.0,16598.4,1723.7,25536.0,35
HCPCS,32445,REMOVAL OF LUNG EXTRAPLEURAL,,,3753.96,3753.96,1
HCPCS,32445,Removal of lung extrapleural,,,3296.96,4164.58,6
HCPCS,324450,REMOVAL OF LUNG EXTRAPLEURAL,,,3753.96,3753.96,1
HCPCS,32480,PARTIAL REMOVAL OF LUNG,,,1573.5,1573.5,1
HCPCS,32480,Partial removal of lung,,,3296.96,4164.58,6
HCPCS,32480,RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT,10328.0,6713.2,956.15,10328.0,35
HCPCS,324800,PARTIAL REMOVAL OF LUNG,,,1573.5,1573.5,1
HCPCS,32482,BILOBECTOMY,,,1681.2,1681.2,1
HCPCS,32482,Bilobectomy,,,3296.96,4164.58,6
HCPCS,32482,RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC,10976.0,7134.4,1002.7,10976.0,35
HCPCS,324820,BILOBECTOMY,,,1681.2,1681.2,1
HCPCS,32484,RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY,10152.0,6598.8,1031.02,10152.0,35
HCPCS,32484,SEGMENTECTOMY,,,1524.88,1524.88,1
HCPCS,32484,Segmentectomy,,,3296.96,4164.58,6
HCPCS,324840,SEGMENTECTOMY,,,1524.88,1524.88,1
HCPCS,32486,SLEEVE LOBECTOMY,,,2490.54,2490.54,1
HCPCS,32486,Sleeve lobectomy,,,3296.96,4164.58,6
HCPCS,324860,SLEEVE LOBECTOMY,,,2490.54,2490.54,1
HCPCS,32488,COMPLETION PNEUMONECTOMY,,,2543.73,2543.73,1
HCPCS,32488,Completion pneumonectomy,,,3296.96,4164.58,6
HCPCS,32488,RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC,17196.0,11177.4,1258.76,17196.0,35
HCPCS,324880,COMPLETION PNEUMONECTOMY,,,2543.73,2543.73,1
HCPCS,32491,LUNG VOLUME REDUCTION,,,1567.75,1567.75,1
HCPCS,32491,Lung volume reduction,,,3296.96,4164.58,6
HCPCS,32491,RMVL LUNG OTH/THN PNUMEC RESXN-PLCTJ EMPHY LUNG,10096.0,6562.4,1350.23,10096.0,31
HCPCS,324910,LUNG VOLUME REDUCTION,,,1567.75,1567.75,1
HCPCS,32501,REPAIR BRONCHUS ADD-ON,,,259.03,259.03,1
HCPCS,32501,RESCJ&BRONCHOPLASTY PFRMD TM LOBEC/SGMECTOMY,1872.0,1216.8,182.3,1872.0,35
HCPCS,32501,Repair bronchus add-on,,,3296.96,4164.58,6
HCPCS,325010,REPAIR BRONCHUS ADD-ON,,,259.03,259.03,1
HCPCS,32503,RESECT APICAL LUNG TUMOR,,,1909.17,1909.17,1
HCPCS,32503,Resect apical lung tumor,,,3296.96,4164.58,6
HCPCS,325030,RESECT APICAL LUNG TUMOR,,,1909.17,1909.17,1
HCPCS,32504,RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ,14616.0,9500.4,1498.05,14616.0,35
HCPCS,32504,RESECT APICAL LUNG TUM/CHEST,,,2175.83,2175.83,1
HCPCS,32504,Resect apical lung tum/chest,,,3296.96,4164.58,6
HCPCS,325040,RESECT APICAL LUNG TUM/CHEST,,,2175.83,2175.83,1
HCPCS,32505,THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL,6300.0,4095.0,450.57,6300.0,35
HCPCS,32505,WEDGE RESECT OF LUNG INITIAL,,,990.88,990.88,1
HCPCS,32505,Wedge resect of lung initial,,,3296.96,4164.58,6
HCPCS,325050,WEDGE RESECT OF LUNG INITIAL,,,990.88,990.88,1
HCPCS,32506,THORACOTOMY W/THERAP WEDGE RESEXN ADDL IPSILATRL,1200.0,780.0,75.45,1200.0,35
HCPCS,32506,WEDGE RESECT OF LUNG ADD-ON,,,166.06,166.06,1
HCPCS,32506,Wedge resect of lung add-on,,,3296.96,4164.58,6
HCPCS,325060,WEDGE RESECT OF LUNG ADD-ON,,,166.06,166.06,1
HCPCS,32507,THORACOTOMY W/DX WEDGE RESEXN &ANTOM LUNG RESEXN,1200.0,780.0,75.45,1200.0,35
HCPCS,32507,WEDGE RESECT OF LUNG DIAG,,,165.73,165.73,1
HCPCS,32507,Wedge resect of lung diag,,,3296.96,4164.58,6
HCPCS,325070,WEDGE RESECT OF LUNG DIAG,,,165.73,165.73,1
HCPCS,3250F,NONPRIM LOC ANAT BX SITE TUM,,,0.01,0.01,1
HCPCS,3250F0,NONPRIM LOC ANAT BX SITE TUM,,,0.01,0.01,1
HCPCS,32540,EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY,12140.0,7891.0,879.35,12140.0,35
HCPCS,32540,REMOVAL OF LUNG LESION,,,1839.07,1839.07,1
HCPCS,32540,Removal of lung lesion,,,3296.96,4164.58,6
HCPCS,325400,REMOVAL OF LUNG LESION,,,1839.07,1839.07,1
HCPCS,32550,INSERT PLEURAL CATH,,,215.64,215.64,1
HCPCS,32550,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,10930.5,7104.825000000001,150.83,18263.7,158
HCPCS,325500,INSERT PLEURAL CATH,,,215.64,215.64,1
HCPCS,32551,INSERTION OF CHEST TUBE,921.0,598.65,112.77,921.0,36
HCPCS,32551,THORACOSTOMY W/ OR W/O WATER SEAL,819.0,532.35,112.77,819.0,35
HCPCS,32551,TUBE THORACOSTOMY INCLUDES WATER SEAL,5074.5,3298.4249999999997,112.77,8370.0,421
HCPCS,325510,INSERTION OF CHEST TUBE,,,165.63,165.63,1
HCPCS,32552,REMOVAL CATHETER,948.0,616.2,75.94,711.0,35
HCPCS,32552,REMOVE LUNG CATHETER,,,165.59,165.59,1
HCPCS,32552,REMOVE TUNNELED PLEURAL CATH,815.0,529.75,75.94,611.25,35
HCPCS,32552,RMVL NDWELLG TUN PLEURAL CATH W/CUFF,1012.0,657.8,75.94,759.0,35
HCPCS,32552,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,3555.0,2310.75,192.55,4151.0,237
HCPCS,325520,REMOVE LUNG CATHETER,,,165.59,165.59,1
HCPCS,32553,INS MARK THOR FOR RT PERQ,,,184.57,184.57,1
HCPCS,32553,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,4715.0,3064.75,118.56,7730.0,231
HCPCS,325530,INS MARK THOR FOR RT PERQ,,,184.57,184.57,1
HCPCS,32554,ASPIRATE PLEURA W/O IMAGING,,,94.07,94.07,1
HCPCS,32554,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,2178.0,1415.7,49.14,4268.0,268
HCPCS,325540,ASPIRATE PLEURA W/O IMAGING,,,94.07,94.07,1
HCPCS,32555,ASPIRATE PLEURA W/ IMAGING,,,115.29,115.29,1
HCPCS,32555,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,2277.0,1480.05,61.53,4268.0,457
HCPCS,325550,ASPIRATE PLEURA W/ IMAGING,,,115.29,115.29,1
HCPCS,32556,INSERT CATH PLEURA W/O IMAGE,,,132.08,132.08,1
HCPCS,32556,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,6004.0,3902.6,67.5,9817.2,224
HCPCS,325560,INSERT CATH PLEURA W/O IMAGE,,,132.08,132.08,1
HCPCS,32557,INSERT CATH PLEURA W/ IMAGE,,,157.55,157.55,1
HCPCS,32557,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,5153.0,3349.45,92.73,8039.7,175
HCPCS,325570,INSERT CATH PLEURA W/ IMAGE,,,157.55,157.55,1
HCPCS,32560,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,2085.5,1355.575,37.15,6289.0,131
HCPCS,32560,TREAT PLEURODESIS W/AGENT,,,80.92,80.92,1
HCPCS,325600,TREAT PLEURODESIS W/AGENT,,,80.92,80.92,1
HCPCS,32561,INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY,556.0,361.4,32.88,417.0,35
HCPCS,32561,LYSE CHEST FIBRIN INIT DAY,,,71.4,1340.49,15
HCPCS,32561,Lyse chest fibrin init day,,,599.03,756.67,6
HCPCS,325610,LYSE CHEST FIBRIN INIT DAY,,,71.4,71.4,1
HCPCS,32562,INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY,496.0,322.4,28.77,372.0,35
HCPCS,32562,LYSE CHEST FIBRIN SUBQ DAY,,,63.81,1340.49,15
HCPCS,32562,Lyse chest fibrin subq day,,,599.03,756.67,6
HCPCS,325620,LYSE CHEST FIBRIN SUBQ DAY,,,63.81,63.81,1
HCPCS,32601,THORACOSCOPY DIAGNOSTIC,,,327.51,12649.85,15
HCPCS,32601,THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX,2200.0,1430.0,233.11,2200.0,35
HCPCS,32601,Thoracoscopy diagnostic,,,3296.96,4164.58,6
HCPCS,326010,THORACOSCOPY DIAGNOSTIC,,,327.51,327.51,1
HCPCS,32604,THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX,3508.0,2280.2,336.21,3508.0,35
HCPCS,32604,THORACOSCOPY WBX SAC,,,509.68,22573.24,15
HCPCS,32604,Thoracoscopy wbx sac,,,1419.15,1792.61,6
HCPCS,326040,THORACOSCOPY WBX SAC,,,509.68,509.68,1
HCPCS,32606,THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX,3356.0,2181.4,342.94,3356.0,35
HCPCS,32606,THORACOSCOPY W/BX MED SPACE,,,490.58,12649.85,15
HCPCS,32606,Thoracoscopy w/bx med space,,,3296.96,4164.58,6
HCPCS,326060,THORACOSCOPY W/BX MED SPACE,,,490.58,490.58,1
HCPCS,32607,THORACOSCOPY W/BX INFILTRATE,,,326.85,22573.24,15
HCPCS,32607,THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL,2200.0,1430.0,148.28,2200.0,35
HCPCS,32607,Thoracoscopy w/bx infiltrate,,,3296.96,4164.58,6
HCPCS,326070,THORACOSCOPY W/BX INFILTRATE,,,326.85,326.85,1
HCPCS,32608,THORACOSCOPY W/BX NODULE,,,402.31,22573.24,15
HCPCS,32608,THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL,2736.0,1778.4,182.47,2736.0,35
HCPCS,32608,Thoracoscopy w/bx nodule,,,3296.96,4164.58,6
HCPCS,326080,THORACOSCOPY W/BX NODULE,,,402.31,402.31,1
HCPCS,32609,THORACOSCOPY W/BX PLEURA,,,271.59,12649.85,15
HCPCS,32609,THORACOSCOPY WITH BIOPSYIES OF PLEURA,1832.0,1190.8,123.29,1832.0,35
HCPCS,32609,Thoracoscopy w/bx pleura,,,1419.15,1792.61,6
HCPCS,326090,THORACOSCOPY W/BX PLEURA,,,271.59,271.59,1
HCPCS,3260F,PT CAT/PN CAT/HIST GRD DOCD,,,0.01,0.01,1
HCPCS,3260F0,PT CAT/PN CAT/HIST GRD DOCD,,,0.01,0.01,1
HCPCS,32650,THORACOSCOPY SURG W PLEURODESIS,4332.0,2815.8,492.96,4332.0,35
HCPCS,32650,THORACOSCOPY W/PLEURODESIS,,,711.33,711.33,1
HCPCS,32650,Thoracoscopy w/pleurodesis,,,3296.96,4164.58,6
HCPCS,326500,THORACOSCOPY W/PLEURODESIS,,,711.33,711.33,1
HCPCS,32651,THORACOSCOPY REMOVE CORTEX,4869.0,3164.85,684.73,4869.0,36
HCPCS,32651,THORACOSCOPY SURG PART PULM DECORT,7512.0,4882.8,684.73,7512.0,35
HCPCS,32651,THORACOSCOPY W PART PULMONAY DECORTICATIO,4935.0,3207.75,684.73,4935.0,35
HCPCS,32651,Thoracoscopy remove cortex,,,3296.96,4164.58,6
HCPCS,326510,THORACOSCOPY REMOVE CORTEX,,,1165.09,1165.09,1
HCPCS,32652,THORACOSCOPY REM TOTL CORTEX,,,1768.24,1768.24,1
HCPCS,32652,THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS,11652.0,7573.8,948.89,11652.0,35
HCPCS,32652,Thoracoscopy rem totl cortex,,,3296.96,4164.58,6
HCPCS,326520,THORACOSCOPY REM TOTL CORTEX,,,1768.24,1768.24,1
HCPCS,32653,THORACOSCOPY REMOV FB/FIBRIN,,,1125.21,1125.21,1
HCPCS,32653,THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT,7268.0,4724.2,651.99,7268.0,35
HCPCS,32653,Thoracoscopy remov fb/fibrin,,,1419.15,1792.61,6
HCPCS,326530,THORACOSCOPY REMOV FB/FIBRIN,,,1125.21,1125.21,1
HCPCS,32654,THORACOSCOPY CONTRL BLEEDING,,,1257.67,1257.67,1
HCPCS,32654,THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE,8208.0,5335.2,669.1,8208.0,35
HCPCS,32654,Thoracoscopy contrl bleeding,,,3296.96,4164.58,6
HCPCS,326540,THORACOSCOPY CONTRL BLEEDING,,,1257.67,1257.67,1
HCPCS,32655,THORACOSCOPY RESECT BULLAE,,,1018.17,1018.17,1
HCPCS,32655,THORACOSCOPY W/RESECTION BULLAE W/WO PLEURAL PX,6468.0,4204.2,701.08,6468.0,35
HCPCS,32655,Thoracoscopy resect bullae,,,3296.96,4164.58,6
HCPCS,326550,THORACOSCOPY RESECT BULLAE,,,1018.17,1018.17,1
HCPCS,32656,THORACOSCOPY SURG PART PLEURECTOMY,5304.0,3447.6,613.03,5304.0,35
HCPCS,32656,THORACOSCOPY W/PLEURECTOMY,,,854.79,854.79,1
HCPCS,32656,Thoracoscopy w/pleurectomy,,,1419.15,1792.61,6
HCPCS,326560,THORACOSCOPY W/PLEURECTOMY,,,854.79,854.79,1
HCPCS,32658,THORACOSCOPY W/RMVL CLOT/FB FROM PERICARDIAL SAC,4684.0,3044.6,545.37,4684.0,35
HCPCS,32658,THORACOSCOPY W/SAC FB REMOVE,,,760.98,760.98,1
HCPCS,32658,Thoracoscopy w/sac fb remove,,,3296.96,4164.58,6
HCPCS,326580,THORACOSCOPY W/SAC FB REMOVE,,,760.98,760.98,1
HCPCS,32659,THORACOSCOPY W/SAC DRAINAGE,,,781.53,781.53,1
HCPCS,32659,THRSC CRTJ PRCRD WINDOW/PRTL RESCJ PRCRD SAC,4776.0,3104.4,560.18,4776.0,35
HCPCS,32659,Thoracoscopy w/sac drainage,,,3296.96,4164.58,6
HCPCS,326590,THORACOSCOPY W/SAC DRAINAGE,,,781.53,781.53,1
HCPCS,3265F,RNA TSTNG HEPC VIR ORD/DOCD,,,0.01,0.01,1
HCPCS,3265F0,RNA TSTNG HEPC VIR ORD/DOCD,,,0.01,0.01,1
HCPCS,32660,THORACOSCOPY SURG TOTL PERICARDIECTM,6185.0,4020.25,3092.5,6185.0,12
HCPCS,32661,THORACOSCOPY W/EXC PERICARDIAL CYST TUMOR/MASS,5332.0,3465.8,598.69,5332.0,35
HCPCS,32661,THORACOSCOPY W/PERICARD EXC,,,850.65,850.65,1
HCPCS,32661,Thoracoscopy w/pericard exc,,,3296.96,4164.58,6
HCPCS,326610,THORACOSCOPY W/PERICARD EXC,,,850.65,850.65,1
HCPCS,32662,THORACOSCOPY W/EXC MEDIASTINAL CYST TUMOR/MASS,5996.0,3897.4,680.44,5996.0,35
HCPCS,32662,THORACOSCOPY W/MEDIAST EXC,,,951.69,951.69,1
HCPCS,32662,Thoracoscopy w/mediast exc,,,3296.96,4164.58,6
HCPCS,326620,THORACOSCOPY W/MEDIAST EXC,,,951.69,951.69,1
HCPCS,32663,THORACOSCOPY W/LOBECTOMY,,,1486.81,1486.81,1
HCPCS,32663,THORACOSCOPY W/LOBECTOMY SINGLE LOBE,9856.0,6406.4,970.13,9856.0,35
HCPCS,32663,Thoracoscopy w/lobectomy,,,3296.96,4164.58,6
HCPCS,326630,THORACOSCOPY W/LOBECTOMY,,,1486.81,1486.81,1
HCPCS,32664,THORACOSCOPY W/ TH NRV EXC,,,903.23,903.23,1
HCPCS,32664,THORACOSCOPY W/THORACIC SYMPATHECTOMY,6283.0,4083.95,645.2,6283.0,35
HCPCS,32664,Thoracoscopy w/ th nrv exc,,,3296.96,4164.58,6
HCPCS,326640,THORACOSCOPY W/ TH NRV EXC,,,903.23,903.23,1
HCPCS,32665,THORACOSCOP W/ESOPH MUSC EXC,,,1310.0,1310.0,1
HCPCS,32665,THORACOSCOPY W/ESOPHAGOMYOTOMY HELLER TYPE,8612.0,5597.8,812.88,8612.0,35
HCPCS,32665,Thoracoscop w/esoph musc exc,,,3296.96,4164.58,6
HCPCS,326650,THORACOSCOP W/ESOPH MUSC EXC,,,1310.0,1310.0,1
HCPCS,32666,THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT,5800.0,3770.0,420.81,5800.0,35
HCPCS,32666,THORACOSCOPY W/WEDGE RESECT,,,925.79,925.79,1
HCPCS,32666,Thoracoscopy w/wedge resect,,,3296.96,4164.58,6
HCPCS,326660,THORACOSCOPY W/WEDGE RESECT,,,925.79,925.79,1
HCPCS,32667,THORACOSCOPY W/THERA WEDGE RESEXN ADDL IPSILATRL,1200.0,780.0,75.62,1200.0,35
HCPCS,32667,THORACOSCOPY W/W RESECT ADDL,,,166.44,166.44,1
HCPCS,32667,Thoracoscopy w/w resect addl,,,3296.96,4164.58,6
HCPCS,326670,THORACOSCOPY W/W RESECT ADDL,,,166.44,166.44,1
HCPCS,32668,THORACOSCOPY W/DX WEDGE RESEXN ANATO LUNG RESEXN,1200.0,780.0,75.78,1200.0,35
HCPCS,32668,THORACOSCOPY W/W RESECT DIAG,,,166.44,166.44,1
HCPCS,32668,Thoracoscopy w/w resect diag,,,3296.96,4164.58,6
HCPCS,326680,THORACOSCOPY W/W RESECT DIAG,,,166.44,166.44,1
HCPCS,32669,THORACOSCOPY REMOVE SEGMENT,,,1427.24,1427.24,1
HCPCS,32669,THORACOSCOPY W/SEGMENTECTOMY,9412.0,6117.8,648.15,9412.0,35
HCPCS,32669,Thoracoscopy remove segment,,,3296.96,4164.58,6
HCPCS,326690,THORACOSCOPY REMOVE SEGMENT,,,1427.24,1427.24,1
HCPCS,3266F,HEPC GN TSTNG DOCD B/4TXMNT,,,0.01,0.01,1
HCPCS,3266F0,HEPC GN TSTNG DOCD B/4TXMNT,,,0.01,0.01,1
HCPCS,32670,THORACOSCOPY BILOBECTOMY,,,1701.13,1701.13,1
HCPCS,32670,THORACOSCOPY W/BILOBECTOMY,11408.0,7415.2,774.39,11408.0,35
HCPCS,32670,Thoracoscopy bilobectomy,,,3296.96,4164.58,6
HCPCS,326700,THORACOSCOPY BILOBECTOMY,,,1701.13,1701.13,1
HCPCS,32671,THORACOSCOPY PNEUMONECTOMY,,,1884.93,1884.93,1
HCPCS,32671,THORACOSCOPY W/PNEUMONECTOMY,12768.0,8299.2,854.77,12768.0,35
HCPCS,32671,Thoracoscopy pneumonectomy,,,3296.96,4164.58,6
HCPCS,326710,THORACOSCOPY PNEUMONECTOMY,,,1884.93,1884.93,1
HCPCS,32672,THORACOSCOPY FOR LVRS,,,1614.45,1614.45,1
HCPCS,32672,THORACOSCOPY W/RESEXN-PLICAJ EMPHYSEMA LUNG UNIL,10800.0,7020.0,733.3,10800.0,35
HCPCS,32672,Thoracoscopy for lvrs,,,3296.96,4164.58,6
HCPCS,326720,THORACOSCOPY FOR LVRS,,,1614.45,1614.45,1
HCPCS,32673,THORACOSCOPY RESEXN THYMUS UNI/BILATERAL,8452.0,5493.8,586.83,8452.0,35
HCPCS,32673,THORACOSCOPY W/THYMUS RESECT,,,1292.78,1292.78,1
HCPCS,32673,Thoracoscopy w/thymus resect,,,3296.96,4164.58,6
HCPCS,326730,THORACOSCOPY W/THYMUS RESECT,,,1292.78,1292.78,1
HCPCS,32674,THORACOSCOPY LYMPH NODE EXC,,,228.84,228.84,1
HCPCS,32674,THORCOSCPY W/MEDIASTINL &REGIONL LYMPHADENECTOMY,1648.0,1071.2,103.56,1648.0,35
HCPCS,326740,THORACOSCOPY LYMPH NODE EXC,,,228.84,228.84,1
HCPCS,3267F,PATH RPRT W/ PT PN CAT ET AL,,,0.01,0.01,1
HCPCS,3267F0,PATH RPRT W/ PT PN CAT ET AL,,,0.01,0.01,1
HCPCS,3268F,PSA/T/GLSC DOCD B/4 TXMNT,,,0.01,0.01,1
HCPCS,3268F0,PSA/T/GLSC DOCD B/4 TXMNT,,,0.01,0.01,1
HCPCS,3269F,BONE SCN B/4 TXMNT/AFTR DX,,,0.01,0.01,1
HCPCS,3269F0,BONE SCN B/4 TXMNT/AFTR DX,,,0.01,0.01,1
HCPCS,32701,THORAX STEREO RAD TARGETW/TX,,,222.96,222.96,1
HCPCS,32701,THORAX STEREOTACTIC RADIATION TARGET W/TX COURSE,1672.0,1086.8,158.67,1672.0,28
HCPCS,327010,THORAX STEREO RAD TARGETW/TX,,,222.96,222.96,1
HCPCS,3270F,NO BONE SCN B/4 TXMNT/AFTRDX,,,0.01,0.01,1
HCPCS,3270F0,NO BONE SCN B/4 TXMNT/AFTRDX,,,0.01,0.01,1
HCPCS,3271F,LOW RISK PROSTATE CANCER,,,0.01,0.01,1
HCPCS,3271F0,LOW RISK PROSTATE CANCER,,,0.01,0.01,1
HCPCS,3272F,MED RISK PROSTATE CANCER,,,0.01,0.01,1
HCPCS,3272F0,MED RISK PROSTATE CANCER,,,0.01,0.01,1
HCPCS,3273F,HIGH RISK PROSTATE CANCER,,,0.01,0.01,1
HCPCS,3273F0,HIGH RISK PROSTATE CANCER,,,0.01,0.01,1
HCPCS,3274F,PROST CNCR RSK NOT LW/MD/HGH,,,0.01,0.01,1
HCPCS,3274F0,PROST CNCR RSK NOT LW/MD/HGH,,,0.01,0.01,1
HCPCS,3278F,SERUM LVLS CA/IPTH/LPD ORD,,,0.01,0.01,1
HCPCS,3278F0,SERUM LVLS CA/IPTH/LPD ORD,,,0.01,0.01,1
HCPCS,3279F,HGB LVL >= 13 G/DL,,,0.01,0.01,1
HCPCS,3279F0,HGB LVL >= 13 G/DL,,,0.01,0.01,1
HCPCS,32800,REPAIR LUNG HERNIA,,,1003.0,1003.0,1
HCPCS,32800,REPAIR LUNG HERNIA THROUGH CHEST WALL,6284.0,4084.6,619.52,6284.0,35
HCPCS,32800,Repair lung hernia,,,3296.96,4164.58,6
HCPCS,328000,REPAIR LUNG HERNIA,,,1003.0,1003.0,1
HCPCS,3280F,HGB LVL 11-12.9 G/DL,,,0.01,0.01,1
HCPCS,3280F0,HGB LVL 11-12.9 G/DL,,,0.01,0.01,1
HCPCS,32810,CLOSE CHEST AFTER DRAINAGE,,,960.62,960.62,1
HCPCS,32810,Close chest after drainage,,,3296.96,4164.58,6
HCPCS,328100,CLOSE CHEST AFTER DRAINAGE,,,960.62,960.62,1
HCPCS,32815,CLOSE BRONCHIAL FISTULA,,,2978.54,2978.54,1
HCPCS,32815,Close bronchial fistula,,,3296.96,4164.58,6
HCPCS,32815,OPEN CLOSURE MAJOR BRONCHIAL FISTULA,20012.0,13007.8,1361.86,20012.0,35
HCPCS,328150,CLOSE BRONCHIAL FISTULA,,,2978.54,2978.54,1
HCPCS,3281F,HGB LVL <11 G/DL,,,0.01,0.01,1
HCPCS,3281F0,HGB LVL <11 G/DL,,,0.01,0.01,1
HCPCS,32820,MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC,9004.0,5852.6,1053.15,9004.0,35
HCPCS,32820,RECONSTRUCT INJURED CHEST,,,1418.54,1418.54,1
HCPCS,32820,Reconstruct injured chest,,,3296.96,4164.58,6
HCPCS,328200,RECONSTRUCT INJURED CHEST,,,1418.54,1418.54,1
HCPCS,3284F,IOP RED >=15% PRE-NTRV LVL,,,0.01,0.01,1
HCPCS,3284F0,IOP RED >=15% PRE-NTRV LVL,,,0.01,0.01,1
HCPCS,32850,DONOR PNEUMONECTOMY,,,5361.62,5361.62,1
HCPCS,32850,Donor pneumonectomy,,,7770.52,9815.39,6
HCPCS,328500,DONOR PNEUMONECTOMY,,,5361.62,5361.62,1
HCPCS,32851,LUNG TRANSPLANT SINGLE,,,3480.46,3480.46,1
HCPCS,32851,Lung transplant single,,,3411.14,4308.8,6
HCPCS,328510,LUNG TRANSPLANT SINGLE,,,3480.46,3480.46,1
HCPCS,32852,LUNG TRANSPLANT WITH BYPASS,,,3746.82,3746.82,1
HCPCS,32852,Lung transplant with bypass,,,7770.52,9815.39,6
HCPCS,328520,LUNG TRANSPLANT WITH BYPASS,,,3746.82,3746.82,1
HCPCS,32853,LUNG TRANSPLANT DOUBLE,,,4866.89,4866.89,1
HCPCS,32853,Lung transplant double,,,3411.14,4308.8,6
HCPCS,328530,LUNG TRANSPLANT DOUBLE,,,4866.89,4866.89,1
HCPCS,32854,LUNG TRANSPLANT WITH BYPASS,,,5154.45,5154.45,1
HCPCS,32854,Lung transplant with bypass,,,7770.52,9815.39,6
HCPCS,328540,LUNG TRANSPLANT WITH BYPASS,,,5154.45,5154.45,1
HCPCS,32855,PREPARE DONOR LUNG SINGLE,,,315.39,315.39,1
HCPCS,32855,Prepare donor lung single,,,3411.14,4308.8,6
HCPCS,328550,PREPARE DONOR LUNG SINGLE,,,315.39,315.39,1
HCPCS,32856,PREPARE DONOR LUNG DOUBLE,,,388.25,388.25,1
HCPCS,32856,Prepare donor lung double,,,3411.14,4308.8,6
HCPCS,328560,PREPARE DONOR LUNG DOUBLE,,,388.25,388.25,1
HCPCS,3285F,IOP DOWN <15% OF PRE-SVC LVL,,,0.01,0.01,1
HCPCS,3285F0,IOP DOWN <15% OF PRE-SVC LVL,,,0.01,0.01,1
HCPCS,3288F,FALL RISK ASSESSMENT DOCD,,,0.01,0.01,1
HCPCS,3288F0,FALL RISK ASSESSMENT DOCD,,,0.01,0.01,1
HCPCS,32900,REMOVAL OF RIB(S),,,1449.65,1449.65,1
HCPCS,32900,RESECTION RIBS EXTRAPLEURAL ALL STAGES,9524.0,6190.6,811.61,9524.0,35
HCPCS,32900,Removal of rib(s),,,3296.96,4164.58,6
HCPCS,329000,REMOVAL OF RIB(S),,,1449.65,1449.65,1
HCPCS,32905,REVISE & REPAIR CHEST WALL,,,1420.6,1420.6,1
HCPCS,32905,Revise & repair chest wall,,,3296.96,4164.58,6
HCPCS,32905,THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL,9316.0,6055.4,936.81,9316.0,35
HCPCS,329050,REVISE & REPAIR CHEST WALL,,,1420.6,1420.6,1
HCPCS,32906,REVISE & REPAIR CHEST WALL,,,1753.3,1753.3,1
HCPCS,32906,Revise & repair chest wall,,,3296.96,4164.58,6
HCPCS,329060,REVISE & REPAIR CHEST WALL,,,1753.3,1753.3,1
HCPCS,3290F,PT=D(RH)- AND UNSENSITIZED,,,0.01,0.01,1
HCPCS,3290F0,PT=D(RH)- AND UNSENSITIZED,,,0.01,0.01,1
HCPCS,3291F,PT=D(RH)+ OR SENSITIZED,,,0.01,0.01,1
HCPCS,3291F0,PT=D(RH)+ OR SENSITIZED,,,0.01,0.01,1
HCPCS,3292F,HIV TSTNG ASKED/DOCD/REVWD,,,0.01,0.01,1
HCPCS,3292F0,HIV TSTNG ASKED/DOCD/REVWD,,,0.01,0.01,1
HCPCS,3293F,ABO RH BLOOD TYPING DOCD,,,0.01,0.01,1
HCPCS,3293F0,ABO RH BLOOD TYPING DOCD,,,0.01,0.01,1
HCPCS,32940,PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX,8536.0,5548.4,843.93,8536.0,35
HCPCS,32940,REVISION OF LUNG,,,1312.49,1312.49,1
HCPCS,32940,Revision of lung,,,3296.96,4164.58,6
HCPCS,329400,REVISION OF LUNG,,,1312.49,1312.49,1
HCPCS,3294F,GRP B STREP SCREENING DOCD,,,0.01,0.01,1
HCPCS,3294F0,GRP B STREP SCREENING DOCD,,,0.01,0.01,1
HCPCS,32960,THERAPEUTIC PNEUMOTHORAX,,,95.87,1340.49,15
HCPCS,32960,Therapeutic pneumothorax,,,599.03,756.67,6
HCPCS,329600,THERAPEUTIC PNEUMOTHORAX,,,95.87,95.87,1
HCPCS,32994,ABLATE PULM TUMOR PERQ CRYBL,,,460.4,460.4,1
HCPCS,32994,ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION,18490.5,12018.824999999999,372.71,30032.1,154
HCPCS,329940,ABLATE PULM TUMOR PERQ CRYBL,,,460.4,460.4,1
HCPCS,32997,TOTAL LUNG LAVAGE,,,356.45,356.45,1
HCPCS,32997,TOTAL LUNG LAVAGE (UNILATERAL),2924.0,1900.6,238.31,2924.0,35
HCPCS,32997,Total lung lavage,,,2523.58,3187.68,6
HCPCS,329970,TOTAL LUNG LAVAGE,,,356.45,356.45,1
HCPCS,32998,ABLATE PULM TUMOR PERQ RF,,,461.07,461.07,1
HCPCS,32998,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,33548.0,21806.2,211.38,30193.2,212
HCPCS,329980,ABLATE PULM TUMOR PERQ RF,,,461.07,461.07,1
HCPCS,32999,CT LUNG LOCALIZATION,1542.0,1002.3,399.38,1387.8,37
HCPCS,32999,GUIDE WIRE LOCALIZATION FOR LUNG,648.0,421.2,324.0,754.84,15
HCPCS,32999,IMAGE GUIDED CHEST TUBE EXCHANGE REPOSITION (COMP CODE 49423),5210.0,3386.5,314.0,8812.8,55
HCPCS,32999,IMAGE GUIDED LUNG LOCALIZATION (COMP CODE 32553),4715.0,3064.75,599.03,7081.2,55
HCPCS,32999,UNLISTED FLUORESCENCE BRONCHOSCOPY,2115.0,1374.75,629.03,2115.0,15
HCPCS,32999,UNLISTED PROC LUNG/PLEURA,1542.0,1002.3,399.38,1754.0,40
HCPCS,32999,UNLISTED PROCEDURE LUNGS AND PLEURA,1151.0,748.15,298.11,1754.0,80
HCPCS,32999,UNLISTED RADIO FREQUENCY ABLATION LUNG,2115.0,1374.75,629.03,2115.0,15
HCPCS,3300F,AJCC STAGE DOCD B/4 THXPY,,,0.01,0.01,1
HCPCS,3300F0,AJCC STAGE DOCD B/4 THXPY,,,0.01,0.01,1
HCPCS,33016,PERICARDIOCENTESIS W/IMAGING,,,277.4,277.4,1
HCPCS,33016,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,6462.5,4200.625,175.92,37851.0,322
HCPCS,330160,PERICARDIOCENTESIS W/IMAGING,,,277.4,277.4,1
HCPCS,33017,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,4399.5,2859.6749999999997,185.11,37851.0,223
HCPCS,33017,PRCRD DRG 6YR+ W/O CGEN CAR,,,292.73,292.73,1
HCPCS,330170,PRCRD DRG 6YR+ W/O CGEN CAR,,,292.73,292.73,1
HCPCS,33018,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,4401.5,2860.975,217.28,37851.0,223
HCPCS,33018,PRCRD DRG 0-5YR OR W/ANOMLY,,,342.13,342.13,1
HCPCS,330180,PRCRD DRG 0-5YR OR W/ANOMLY,,,342.13,342.13,1
HCPCS,33019,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,4265.5,2772.575,157.02,37851.0,148
HCPCS,33019,PERQ PRCRD DRG INSJ CATH CT,,,247.86,247.86,1
HCPCS,330190,PERQ PRCRD DRG INSJ CATH CT,,,247.86,247.86,1
HCPCS,3301F,CANCER STAGE DOCD METAST,,,0.01,0.01,1
HCPCS,3301F0,CANCER STAGE DOCD METAST,,,0.01,0.01,1
HCPCS,33020,INCISION OF HEART SAC,,,978.88,978.88,1
HCPCS,33020,PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY,6747.0,4385.55,628.86,18285.0,99
HCPCS,330200,INCISION OF HEART SAC,,,978.88,978.88,1
HCPCS,33025,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,8466.5,5503.225,585.46,18285.0,99
HCPCS,33025,INCISION OF HEART SAC,,,915.63,915.63,1
HCPCS,330250,INCISION OF HEART SAC,,,915.63,915.63,1
HCPCS,33030,PARTIAL REMOVAL OF HEART SAC,,,2374.55,2374.55,1
HCPCS,33030,PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS,14400.0,9360.0,1070.49,14400.0,35
HCPCS,33030,Partial removal of heart sac,,,7099.16,8967.36,6
HCPCS,330300,PARTIAL REMOVAL OF HEART SAC,,,2374.55,2374.55,1
HCPCS,33031,PARTIAL REMOVAL OF HEART SAC,,,2934.64,2934.64,1
HCPCS,33031,PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS,18000.0,11700.0,1193.56,18000.0,35
HCPCS,33031,Partial removal of heart sac,,,7099.16,8967.36,6
HCPCS,330310,PARTIAL REMOVAL OF HEART SAC,,,2934.64,2934.64,1
HCPCS,33050,RESECT HEART SAC LESION,,,1198.08,1198.08,1
HCPCS,33050,RESECTION PERICARDIAL CYST/TUMOR,6788.0,4412.2,656.15,6788.0,35
HCPCS,33050,Resect heart sac lesion,,,7099.16,8967.36,6
HCPCS,330500,RESECT HEART SAC LESION,,,1198.08,1198.08,1
HCPCS,33120,EXC ICAR TUM RESC W/CARD BYP,,,2481.02,2481.02,1
HCPCS,33120,EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP,15380.0,9997.0,1375.89,15380.0,35
HCPCS,33120,Exc icar tum resc w/card byp,,,7099.16,8967.36,6
HCPCS,331200,EXC ICAR TUM RESC W/CARD BYP,,,2481.02,2481.02,1
HCPCS,33130,RESCJ EXTERNAL CARDIAC TUMOR,,,1616.27,1616.27,1
HCPCS,33130,Rescj external cardiac tumor,,,7099.16,8967.36,6
HCPCS,331300,RESCJ EXTERNAL CARDIAC TUMOR,,,1616.27,1616.27,1
HCPCS,33140,HEART REVASCULARIZE (TMR),,,1840.19,1840.19,1
HCPCS,33140,Heart revascularize (tmr),,,7099.16,8967.36,6
HCPCS,33140,TRANSMYOCARDIAL LASER REVASCULAR THORACOTOMY SPX,11336.0,7368.4,910.44,11336.0,35
HCPCS,331400,HEART REVASCULARIZE (TMR),,,1840.19,1840.19,1
HCPCS,33141,HEART TMR W/OTHER PROCEDURE,,,156.48,156.48,1
HCPCS,33141,TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX,1016.0,660.4,99.07,1016.0,35
HCPCS,331410,HEART TMR W/OTHER PROCEDURE,,,156.48,156.48,1
HCPCS,3315F,ER+ OR PR+ BREAST CANCER,,,0.01,0.01,1
HCPCS,3315F0,ER+ OR PR+ BREAST CANCER,,,0.01,0.01,1
HCPCS,3316F,ER- OR PR- BREAST CANCER,,,0.01,0.01,1
HCPCS,3316F0,ER- OR PR- BREAST CANCER,,,0.01,0.01,1
HCPCS,3317F,PATH RPT MALIG CANCER DOCD,,,0.01,0.01,1
HCPCS,3317F0,PATH RPT MALIG CANCER DOCD,,,0.01,0.01,1
HCPCS,3318F,PATH RPT MALIG CANCER DOCD,,,0.01,0.01,1
HCPCS,3318F0,PATH RPT MALIG CANCER DOCD,,,0.01,0.01,1
HCPCS,3319F,X-RAY/CT/ULTRSND ET AL ORD,,,0.01,0.01,1
HCPCS,3319F0,X-RAY/CT/ULTRSND ET AL ORD,,,0.01,0.01,1
HCPCS,33202,INSERT EPICARD ELTRD OPEN,,,915.63,915.63,1
HCPCS,33202,"INSERT EPICARDIAL ELECTRODE, OPEN",5808.0,3775.2,463.58,5808.0,35
HCPCS,33202,Insert epicard eltrd open,,,7099.16,8967.36,6
HCPCS,332020,INSERT EPICARD ELTRD OPEN,,,915.63,915.63,1
HCPCS,33203,INSERT EPICARD ELTRD ENDO,5588.0,3632.2,475.12,5588.0,36
HCPCS,33203,Insert epicard eltrd endo,,,4706.22,5944.7,6
HCPCS,332030,INSERT EPICARD ELTRD ENDO,,,963.2,963.2,1
HCPCS,33206,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,18379.0,11946.35,343.92,30254.4,119
HCPCS,33206,INSERT HEART PM ATRIAL,,,534.77,534.77,1
HCPCS,332060,INSERT HEART PM ATRIAL,,,534.77,534.77,1
HCPCS,33207,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,18909.5,12291.175,361.79,31229.1,119
HCPCS,33207,INSERT HEART PM VENTRICULAR,,,563.36,563.36,1
HCPCS,332070,INSERT HEART PM VENTRICULAR,,,563.36,563.36,1
HCPCS,33208,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,17733.5,11526.775,390.65,39131.0,168
HCPCS,33208,INSRT HEART PM ATRIAL & VENT,,,610.1,610.1,1
HCPCS,332080,INSRT HEART PM ATRIAL & VENT,,,610.1,610.1,1
HCPCS,3320F,NO XRAY/CT/ ET AL ORDD,,,0.01,0.01,1
HCPCS,3320F0,NO XRAY/CT/ ET AL ORDD,,,0.01,0.01,1
HCPCS,33210,INSERT ELECTRD/PM CATH SNGL,,,190.5,190.5,1
HCPCS,33210,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,30413.0,19768.45,121.02,53535.6,200
HCPCS,332100,INSERT ELECTRD/PM CATH SNGL,,,190.5,190.5,1
HCPCS,33211,INSERT CARD ELECTRODES DUAL,,,199.24,199.24,1
HCPCS,33211,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,30370.0,19740.5,125.62,53535.6,158
HCPCS,332110,INSERT CARD ELECTRODES DUAL,,,199.24,199.24,1
HCPCS,33212,INS PM PLS GEN W/EXIST SINGLE LEAD,15212.5,9888.125,245.62,25578.9,77
HCPCS,33212,INSERT PULSE GEN SNGL LEAD,,,380.58,380.58,1
HCPCS,332120,INSERT PULSE GEN SNGL LEAD,,,380.58,380.58,1
HCPCS,33213,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,17401.0,11310.65,255.58,29421.0,119
HCPCS,33213,INSERT PULSE GEN DUAL LEADS,,,398.67,398.67,1
HCPCS,332130,INSERT PULSE GEN DUAL LEADS,,,398.67,398.67,1
HCPCS,33214,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,17633.5,11461.775000000001,362.31,39131.0,119
HCPCS,33214,UPGRADE OF PACEMAKER SYSTEM,,,563.74,563.74,1
HCPCS,332140,UPGRADE OF PACEMAKER SYSTEM,,,563.74,563.74,1
HCPCS,33215,REPOSITION PACING-DEFIB LEAD,,,365.97,365.97,1
HCPCS,33215,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,12295.5,7992.075000000001,207.55,37851.0,182
HCPCS,332150,REPOSITION PACING-DEFIB LEAD,,,365.97,365.97,1
HCPCS,33216,INSERT 1 ELECTRODE PM-DEFIB,,,436.8,436.8,1
HCPCS,33216,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,20322.0,13209.300000000001,278.02,34556.4,119
HCPCS,332160,INSERT 1 ELECTRODE PM-DEFIB,,,436.8,436.8,1
HCPCS,33217,INSERT 2 ELECTRODE PM-DEFIB,,,433.71,433.71,1
HCPCS,33217,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,17862.5,11610.625,277.19,30140.1,119
HCPCS,332170,INSERT 2 ELECTRODE PM-DEFIB,,,433.71,433.71,1
HCPCS,33218,REPAIR LEAD PACE-DEFIB ONE,,,457.94,457.94,1
HCPCS,33218,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,14243.0,9257.95,270.43,36332.0,133
HCPCS,332180,REPAIR LEAD PACE-DEFIB ONE,,,457.94,457.94,1
HCPCS,3321F,AJCC CNCR 0/IA MELAN DOCD,,,0.01,0.01,1
HCPCS,3321F0,AJCC CNCR 0/IA MELAN DOCD,,,0.01,0.01,1
HCPCS,33220,REPAIR LEAD PACE-DEFIB DUAL,,,448.73,448.73,1
HCPCS,33220,RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB,14259.0,9268.35,274.73,36332.0,84
HCPCS,332200,REPAIR LEAD PACE-DEFIB DUAL,,,448.73,448.73,1
HCPCS,33221,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,29258.0,19017.7,175.89,50666.4,119
HCPCS,33221,INSERT PULSE GEN MULT LEADS,,,420.76,420.76,1
HCPCS,332210,INSERT PULSE GEN MULT LEADS,,,420.76,420.76,1
HCPCS,33222,RELOCATION OF SKIN POCKET FOR PACEMAKER,7544.0,4903.6,260.94,11833.2,133
HCPCS,33222,RELOCATION POCKET PACEMAKER,,,403.37,403.37,1
HCPCS,332220,RELOCATION POCKET PACEMAKER,,,403.37,403.37,1
HCPCS,33223,RELOCATE POCKET FOR DEFIB,,,481.63,481.63,1
HCPCS,33223,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,7834.0,5092.1,309.45,11833.2,133
HCPCS,332230,RELOCATE POCKET FOR DEFIB,,,481.63,481.63,1
HCPCS,33224,INSERT PACING LEAD & CONNECT,,,602.89,602.89,1
HCPCS,33224,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,20252.0,13163.800000000001,336.17,39131.0,119
HCPCS,332240,INSERT PACING LEAD & CONNECT,,,602.89,602.89,1
HCPCS,33225,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,12050.0,7832.5,298.12,39131.0,97
HCPCS,33225,L VENTRIC PACING LEAD ADD-ON,,,544.24,544.24,1
HCPCS,332250,L VENTRIC PACING LEAD ADD-ON,,,544.24,544.24,1
HCPCS,33226,REPOSITION L VENTRIC LEAD,,,577.43,577.43,1
HCPCS,33226,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,13047.5,8480.875,323.75,36332.0,133
HCPCS,332260,REPOSITION L VENTRIC LEAD,,,577.43,577.43,1
HCPCS,33227,REMOVE&REPLACE PM GEN SINGL,,,399.68,399.68,1
HCPCS,33227,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,14484.5,9414.925,165.37,37851.0,168
HCPCS,332270,REMOVE&REPLACE PM GEN SINGL,,,399.68,399.68,1
HCPCS,33228,REMV&REPLC PM GEN DUAL LEAD,,,417.34,417.34,1
HCPCS,33228,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,17814.0,11579.1,173.09,37851.0,168
HCPCS,332280,REMV&REPLC PM GEN DUAL LEAD,,,417.34,417.34,1
HCPCS,33229,REMV&REPLC PM GEN MULT LEADS,,,438.79,438.79,1
HCPCS,33229,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,28010.5,18206.825,182.79,48334.5,168
HCPCS,332290,REMV&REPLC PM GEN MULT LEADS,,,438.79,438.79,1
HCPCS,3322F,MELANOMAAJCC STAGE 0 OR IA,,,0.01,0.01,1
HCPCS,3322F0,MELANOMAAJCC STAGE 0 OR IA,,,0.01,0.01,1
HCPCS,33230,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS,53369.0,34689.85,428.95,70939.0,84
HCPCS,33230,INSRT PULSE GEN W/DUAL LEADS,,,441.7,441.7,1
HCPCS,332300,INSRT PULSE GEN W/DUAL LEADS,,,441.7,441.7,1
HCPCS,33231,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS,81923.0,53249.95,456.32,76175.0,84
HCPCS,33231,INSRT PULSE GEN W/MULT LEADS,,,472.34,472.34,1
HCPCS,332310,INSRT PULSE GEN W/MULT LEADS,,,472.34,472.34,1
HCPCS,33233,REMOVAL OF PM GENERATOR,,,273.42,273.42,1
HCPCS,33233,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,30370.0,19740.5,159.0,53535.6,133
HCPCS,332330,REMOVAL OF PM GENERATOR,,,273.42,273.42,1
HCPCS,33234,REMOVAL OF PACEMAKER SYSTEM,,,569.75,569.75,1
HCPCS,33234,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,14611.0,9497.15,295.6,37851.0,182
HCPCS,332340,REMOVAL OF PACEMAKER SYSTEM,,,569.75,569.75,1
HCPCS,33235,REMOVAL PACEMAKER ELECTRODE,,,748.21,748.21,1
HCPCS,33235,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,15059.0,9788.35,365.88,37851.0,182
HCPCS,332350,REMOVAL PACEMAKER ELECTRODE,,,748.21,748.21,1
HCPCS,33236,REMOVE ELECTRODE/THORACOTOMY,,,927.23,927.23,1
HCPCS,33236,RMVL PRM EPICAR PM&ELTRDS THORCOM 1 LEAD SYS,5092.0,3309.8,473.81,5092.0,35
HCPCS,33236,Remove electrode/thoracotomy,,,7099.16,8967.36,6
HCPCS,332360,REMOVE ELECTRODE/THORACOTOMY,,,927.23,927.23,1
HCPCS,33237,REMOVE ELECTRODE/THORACOTOMY,,,995.77,995.77,1
HCPCS,33237,RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SY,5536.0,3598.4,629.15,5536.0,35
HCPCS,33237,Remove electrode/thoracotomy,,,7099.16,8967.36,6
HCPCS,332370,REMOVE ELECTRODE/THORACOTOMY,,,995.77,995.77,1
HCPCS,33238,REMOVE ELECTRODE/THORACOTOMY,,,1125.61,1125.61,1
HCPCS,33238,RMVL PRM TRANSVENOUS ELECTRODE THORACOTOMY,6160.0,4004.0,705.18,6160.0,35
HCPCS,33238,Remove electrode/thoracotomy,,,7099.16,8967.36,6
HCPCS,332380,REMOVE ELECTRODE/THORACOTOMY,,,1125.61,1125.61,1
HCPCS,3323F,CLIN NODE STGNG DOCDB/4 SURG,,,0.01,0.01,1
HCPCS,3323F0,CLIN NODE STGNG DOCDB/4 SURG,,,0.01,0.01,1
HCPCS,33240,INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD,32410.0,21066.5,272.18,76175.0,119
HCPCS,33240,INSRT PULSE GEN W/SINGL LEAD,,,434.02,434.02,1
HCPCS,332400,INSRT PULSE GEN W/SINGL LEAD,,,434.02,434.02,1
HCPCS,33241,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,13687.0,8896.550000000001,157.74,36332.0,133
HCPCS,33241,REMOVE PULSE GENERATOR,,,252.42,252.42,1
HCPCS,332410,REMOVE PULSE GENERATOR,,,252.42,252.42,1
HCPCS,33243,REMOVE ELTRD/THORACOTOMY,,,1632.03,1632.03,1
HCPCS,33243,RMVL 1/DUAL CHAMBER DEFIB ELECTRODE BY THORACOM,11260.5,7319.325000000001,874.13,37851.0,74
HCPCS,332430,REMOVE ELTRD/THORACOTOMY,,,1632.03,1632.03,1
HCPCS,33244,REMOVE ELCTRD TRANSVENOUSLY,,,1015.75,1015.75,1
HCPCS,33244,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,15827.0,10287.550000000001,496.3,36332.0,133
HCPCS,332440,REMOVE ELCTRD TRANSVENOUSLY,,,1015.75,1015.75,1
HCPCS,33249,INSJ/RPLCMT DEFIB W/LEAD(S),,,1073.9,1073.9,1
HCPCS,33249,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,38310.0,24901.5,687.33,76175.0,119
HCPCS,332490,INSJ/RPLCMT DEFIB W/LEAD(S),,,1073.9,1073.9,1
HCPCS,3324F,MRI CT SCAN ORD RVWD RQSTD,,,0.01,0.01,1
HCPCS,3324F0,MRI CT SCAN ORD RVWD RQSTD,,,0.01,0.01,1
HCPCS,33250,ABLATE HEART DYSRHYTHM FOCUS,,,1721.7,1721.7,1
HCPCS,33250,Ablate heart dysrhythm focus,,,7099.16,8967.36,6
HCPCS,332500,ABLATE HEART DYSRHYTHM FOCUS,,,1721.7,1721.7,1
HCPCS,33251,ABLATE HEART DYSRHYTHM FOCUS,,,1936.03,1936.03,1
HCPCS,33251,ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/BYPASS,11568.0,7519.2,1113.44,11568.0,35
HCPCS,33251,Ablate heart dysrhythm focus,,,7099.16,8967.36,6
HCPCS,332510,ABLATE HEART DYSRHYTHM FOCUS,,,1936.03,1936.03,1
HCPCS,33254,ABLATE ATRIA LMTD,,,1616.36,1616.36,1
HCPCS,33254,ABLATION & RECONSTRUCTION ATRIA LIMITED,9484.0,6164.6,811.6,9484.0,35
HCPCS,33254,Ablate atria lmtd,,,7099.16,8967.36,6
HCPCS,332540,ABLATE ATRIA LMTD,,,1616.36,1616.36,1
HCPCS,33255,ABLATE ATRIA W/O BYPASS EXT,,,1921.53,1921.53,1
HCPCS,33255,Ablate atria w/o bypass ext,,,7099.16,8967.36,6
HCPCS,332550,ABLATE ATRIA W/O BYPASS EXT,,,1921.53,1921.53,1
HCPCS,33256,ABLATE ATRIA W/BYPASS EXTEN,,,2277.5,2277.5,1
HCPCS,33256,ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS,13960.0,9074.0,1169.81,13960.0,35
HCPCS,33256,Ablate atria w/bypass exten,,,7099.16,8967.36,6
HCPCS,332560,ABLATE ATRIA W/BYPASS EXTEN,,,2277.5,2277.5,1
HCPCS,33257,ABLATE ATRIA LMTD ADD-ON,,,690.67,690.67,1
HCPCS,33257,ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE,3852.0,2503.8,368.7,3852.0,35
HCPCS,332570,ABLATE ATRIA LMTD ADD-ON,,,690.67,690.67,1
HCPCS,33258,ABLATE ATRIA X10SV ADD-ON,,,768.18,768.18,1
HCPCS,33258,ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTENSIV W/O BYP,4400.0,2860.0,417.14,4400.0,35
HCPCS,332580,ABLATE ATRIA X10SV ADD-ON,,,768.18,768.18,1
HCPCS,33259,ABLATE ATRIA W/BYPASS ADD-ON,,,1004.02,1004.02,1
HCPCS,33259,ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS,5656.0,3676.4,549.23,5656.0,35
HCPCS,332590,ABLATE ATRIA W/BYPASS ADD-ON,,,1004.02,1004.02,1
HCPCS,3325F,PREOP ASSES 4 CATARACT SURG,,,0.01,0.01,1
HCPCS,3325F0,PREOP ASSES 4 CATARACT SURG,,,0.01,0.01,1
HCPCS,33261,ABLATE HEART DYSRHYTHM FOCUS,,,1904.5,1904.5,1
HCPCS,33261,Ablate heart dysrhythm focus,,,7099.16,8967.36,6
HCPCS,332610,ABLATE HEART DYSRHYTHM FOCUS,,,1904.5,1904.5,1
HCPCS,33262,REM PAC CVDFB PLSE GEN &REPL PLSE GEN SNGL LEAD,2324.0,1510.6,182.13,2324.0,35
HCPCS,33262,RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD,52578.0,34175.7,422.44,76175.0,133
HCPCS,33262,RMVL& REPLC PULSE GEN 1 LEAD,,,438.11,438.11,1
HCPCS,332620,RMVL& REPLC PULSE GEN 1 LEAD,,,438.11,438.11,1
HCPCS,33263,REM PAC CVDFB PLSE GEN &REPL PLSE GEN DUAL LEAD,2432.0,1580.8,189.36,2432.0,35
HCPCS,33263,RMVL & RPLCMT DFB GEN 2 LEAD,,,455.5,455.5,1
HCPCS,33263,RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD,50610.0,32896.5,439.54,70939.0,84
HCPCS,332630,RMVL & RPLCMT DFB GEN 2 LEAD,,,455.5,455.5,1
HCPCS,33264,REM PAC CVDFB PLS GEN &REPL PLSE GEN MULTI LEAD,2540.0,1651.0,197.26,2540.0,35
HCPCS,33264,RMVL & RPLCMT DFB GEN MLT LD,,,475.14,475.14,1
HCPCS,33264,RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD,65906.0,42838.9,456.66,76175.0,84
HCPCS,332640,RMVL & RPLCMT DFB GEN MLT LD,,,475.14,475.14,1
HCPCS,33265,ABLATE ATRIA LMTD ENDO,,,1615.14,1615.14,1
HCPCS,33265,Ablate atria lmtd endo,,,7099.16,8967.36,6
HCPCS,33265,NDSC ABLATION & RCNSTJ ATRIA LIMITED W/O BYPAS,9484.0,6164.6,811.6,9484.0,35
HCPCS,332650,ABLATE ATRIA LMTD ENDO,,,1615.14,1615.14,1
HCPCS,33266,ABLATE ATRIA X10SV ENDO,,,2183.93,2183.93,1
HCPCS,33266,Ablate atria x10sv endo,,,7099.16,8967.36,6
HCPCS,33266,NDSC ABLATION & RCNSTJ ATRIA EXTEN W/O BYPASS,13216.0,8590.4,1112.82,13216.0,35
HCPCS,332660,ABLATE ATRIA X10SV ENDO,,,2183.93,2183.93,1
HCPCS,33267,EXCL LAA OPEN ANY METHOD,,,1239.22,1239.22,1
HCPCS,33267,EXCLUSION LEFT ATRIAL APPENDAGE OPEN ANY METHOD,7400.0,4810.0,81.91,7400.0,31
HCPCS,33267,Excl laa open any method,,,7099.16,8967.36,6
HCPCS,332670,EXCL LAA OPEN ANY METHOD,,,1239.22,1239.22,1
HCPCS,33268,EXCL LAA OPN OTH PX ANY METH,,,153.58,153.58,1
HCPCS,33268,EXCLUSION LAA OPEN TM STRNT/THRCM ANY METHOD,1000.0,650.0,10.23,1000.0,31
HCPCS,33268,Excl laa opn oth px any meth,,,7099.16,8967.36,6
HCPCS,332680,EXCL LAA OPN OTH PX ANY METH,,,153.58,153.58,1
HCPCS,33269,EXCL LAA THRSCP ANY METHOD,,,984.18,984.18,1
HCPCS,33269,EXCLUSION L ATR APPENDAGE THORACOSCOPIC ANY METH,5724.0,3720.6,59.46,5724.0,31
HCPCS,33269,Excl laa thrscp any method,,,8538.66,10785.67,6
HCPCS,332690,EXCL LAA THRSCP ANY METHOD,,,984.18,984.18,1
HCPCS,33270,INS/REP SUBQ DEFIBRILLATOR,,,659.53,659.53,1
HCPCS,33270,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,34644.5,22518.925,422.82,76175.0,115
HCPCS,332700,INS/REP SUBQ DEFIBRILLATOR,,,659.53,659.53,1
HCPCS,33271,INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,13825.0,8986.25,344.18,76175.0,115
HCPCS,33271,INSJ SUBQ IMPLTBL DFB ELCTRD,,,537.38,537.38,1
HCPCS,332710,INSJ SUBQ IMPLTBL DFB ELCTRD,,,537.38,537.38,1
HCPCS,33272,RMVL OF SUBQ DEFIBRILLATOR,,,409.04,409.04,1
HCPCS,33272,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,14271.5,9276.475,264.01,76175.0,164
HCPCS,332720,RMVL OF SUBQ DEFIBRILLATOR,,,409.04,409.04,1
HCPCS,33273,REPOS PREV IMPLTBL SUBQ DFB,,,475.19,475.19,1
HCPCS,33273,REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB,14379.0,9346.35,297.21,36332.0,80
HCPCS,332730,REPOS PREV IMPLTBL SUBQ DFB,,,475.19,475.19,1
HCPCS,33274,TCAT INSJ/RPL PERM LDLS PM,,,562.99,562.99,1
HCPCS,33274,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,25471.0,16556.15,360.26,46695.0,164
HCPCS,332740,TCAT INSJ/RPL PERM LDLS PM,,,562.99,562.99,1
HCPCS,33275,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,13029.5,8469.175000000001,380.94,20360.7,164
HCPCS,33275,TCAT RMVL PERM LDLS PM W/IMG,,,596.84,596.84,1
HCPCS,332750,TCAT RMVL PERM LDLS PM W/IMG,,,596.84,596.84,1
HCPCS,33276,INSJ PHRNC NRV STIM SYS,,,682.03,97568.5,15
HCPCS,33276,Insj phrnc nrv stim sys,,,11520.56,14552.29,6
HCPCS,332760,INSJ PHRNC NRV STIM SYS,,,682.03,682.03,1
HCPCS,33277,INSJ PHRNC NRV STIM TRANSVNS,,,359.09,359.09,1
HCPCS,33277,Insj phrnc nrv stim transvns,,,1950.92,2464.32,6
HCPCS,332770,INSJ PHRNC NRV STIM TRANSVNS,,,359.09,359.09,1
HCPCS,33278,RMVL PHRNC NRV STIM SYS,,,679.47,7456.34,15
HCPCS,33278,Rmvl phrnc nrv stim sys,,,1950.92,2464.32,6
HCPCS,332780,RMVL PHRNC NRV STIM SYS,,,679.47,679.47,1
HCPCS,33279,RMVL PHRNC NRV STIM TRANSVNS,,,408.72,7456.34,15
HCPCS,33279,Rmvl phrnc nrv stim transvns,,,1950.92,2464.32,6
HCPCS,332790,RMVL PHRNC NRV STIM TRANSVNS,,,408.72,408.72,1
HCPCS,33280,RMVL PHRNC NRV STIM PG ONLY,,,243.0,7456.34,15
HCPCS,33280,Rmvl phrnc nrv stim pg only,,,1950.92,2464.32,6
HCPCS,332800,RMVL PHRNC NRV STIM PG ONLY,,,243.0,243.0,1
HCPCS,33281,REPOSG PHRNC NRV STIM TRNSVN,,,442.84,7456.34,15
HCPCS,33281,Reposg phrnc nrv stim trnsvn,,,1950.92,2464.32,6
HCPCS,332810,REPOSG PHRNC NRV STIM TRNSVN,,,442.84,442.84,1
HCPCS,33282,IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER,7244.0,4708.6,1216.99,6519.6,21
HCPCS,33284,RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER,2217.0,1441.05,372.46,1995.3,21
HCPCS,33285,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,9443.5,6138.275000000001,69.4,20773.0,206
HCPCS,33285,INSJ SUBQ CAR RHYTHM MNTR,,,103.28,103.28,1
HCPCS,332850,INSJ SUBQ CAR RHYTHM MNTR,,,103.28,103.28,1
HCPCS,33286,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,2829.0,1838.85,68.05,6317.0,227
HCPCS,33286,RMVL SUBQ CAR RHYTHM MNTR,,,101.26,101.26,1
HCPCS,332860,RMVL SUBQ CAR RHYTHM MNTR,,,101.26,101.26,1
HCPCS,33287,RMV&RPLCMT PHRNC NRV STIM PG,,,456.14,66071.77,15
HCPCS,33287,Rmv&rplcmt phrnc nrv stim pg,,,11520.56,14552.29,6
HCPCS,332870,RMV&RPLCMT PHRNC NRV STIM PG,,,456.14,456.14,1
HCPCS,33288,RMV&RPLCMT PHRNC NRV STIM LD,,,603.87,27037.69,15
HCPCS,33288,Rmv&rplcmt phrnc nrv stim ld,,,3699.03,4672.46,6
HCPCS,332880,RMV&RPLCMT PHRNC NRV STIM LD,,,603.87,603.87,1
HCPCS,33289,TCAT IMPL WRLS P-ART PRS SNR,,,394.16,394.16,1
HCPCS,33289,TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR,25341.5,16471.975,255.58,61637.3,77
HCPCS,332890,TCAT IMPL WRLS P-ART PRS SNR,,,394.16,394.16,1
HCPCS,3328F,PRFRMNC DOCD 2 WKS B/4 SURG,,,0.01,0.01,1
HCPCS,3328F0,PRFRMNC DOCD 2 WKS B/4 SURG,,,0.01,0.01,1
HCPCS,33300,REPAIR CARDIAC WOUND W/O BYPASS,20678.5,13441.025000000001,853.0,21032.1,99
HCPCS,33300,REPAIR OF HEART WOUND,,,2899.11,2899.11,1
HCPCS,333000,REPAIR OF HEART WOUND,,,2899.11,2899.11,1
HCPCS,33305,REPAIR CARDIAC WOUND W/CARDIOPULMONARY BYPASS,30772.0,20001.8,1969.6,30772.0,35
HCPCS,33305,REPAIR OF HEART WOUND,,,4860.4,4860.4,1
HCPCS,33305,Repair of heart wound,,,7099.16,8967.36,6
HCPCS,333050,REPAIR OF HEART WOUND,,,4860.4,4860.4,1
HCPCS,3330F,IMAGING STUDY ORDERED (BKP),,,0.01,0.01,1
HCPCS,3330F0,IMAGING STUDY ORDERED (BKP),,,0.01,0.01,1
HCPCS,33310,CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP,8136.0,5288.4,830.89,8136.0,35
HCPCS,33310,EXPLORATORY HEART SURGERY,,,1382.7,1382.7,1
HCPCS,33310,Exploratory heart surgery,,,7099.16,8967.36,6
HCPCS,333100,EXPLORATORY HEART SURGERY,,,1382.7,1382.7,1
HCPCS,33315,CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP,14000.0,9100.0,1039.72,14000.0,35
HCPCS,33315,EXPLORATORY HEART SURGERY,,,2275.46,2275.46,1
HCPCS,33315,Exploratory heart surgery,,,7099.16,8967.36,6
HCPCS,333150,EXPLORATORY HEART SURGERY,,,2275.46,2275.46,1
HCPCS,3331F,BK IMAGING TST NOT ORDERED,,,0.01,0.01,1
HCPCS,3331F0,BK IMAGING TST NOT ORDERED,,,0.01,0.01,1
HCPCS,33320,REPAIR MAJOR BLOOD VESSEL(S),,,1271.42,1271.42,1
HCPCS,33320,Repair major blood vessel(s),,,5148.42,6503.27,6
HCPCS,33320,SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP,7416.0,4820.4,810.65,7416.0,35
HCPCS,333200,REPAIR MAJOR BLOOD VESSEL(S),,,1271.42,1271.42,1
HCPCS,33321,REPAIR MAJOR VESSEL,,,1404.8,1404.8,1
HCPCS,33321,Repair major vessel,,,5148.42,6503.27,6
HCPCS,33321,SUTR RPR AORTA/GREAT VESSEL W/SHUNT BYPASS,8324.0,5410.6,864.15,8324.0,35
HCPCS,333210,REPAIR MAJOR VESSEL,,,1404.8,1404.8,1
HCPCS,33322,REPAIR MAJOR BLOOD VESSEL(S),,,1659.45,1659.45,1
HCPCS,33322,Repair major blood vessel(s),,,5148.42,6503.27,6
HCPCS,33322,SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS,9768.0,6349.2,1049.38,9768.0,35
HCPCS,333220,REPAIR MAJOR BLOOD VESSEL(S),,,1659.45,1659.45,1
HCPCS,33330,INSERT MAJOR VESSEL GRAFT,,,1684.38,1684.38,1
HCPCS,33330,Insert major vessel graft,,,5148.42,6503.27,6
HCPCS,333300,INSERT MAJOR VESSEL GRAFT,,,1684.38,1684.38,1
HCPCS,33335,INSERT MAJOR VESSEL GRAFT,,,2207.78,2207.78,1
HCPCS,33335,Insert major vessel graft,,,5148.42,6503.27,6
HCPCS,333350,INSERT MAJOR VESSEL GRAFT,,,2207.78,2207.78,1
HCPCS,33340,PERQ CLSR TCAT L ATR APNDGE,,,919.77,919.77,1
HCPCS,33340,PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT,11242.5,7307.625,619.52,18285.0,92
HCPCS,333400,PERQ CLSR TCAT L ATR APNDGE,,,919.77,919.77,1
HCPCS,33361,REPLACE AORTIC VALVE PERQ,,,1430.6,1430.6,1
HCPCS,33361,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,14391.5,9354.475,906.66,18285.0,95
HCPCS,333610,REPLACE AORTIC VALVE PERQ,,,1430.6,1430.6,1
HCPCS,33362,REPLACE AORTIC VALVE OPEN,,,1559.38,1559.38,1
HCPCS,33362,REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH,9816.0,6380.4,989.38,9816.0,31
HCPCS,33362,TAVR OPEN FEMORAL APPROACH,35547.0,23105.55,1545.24,31992.3,32
HCPCS,333620,REPLACE AORTIC VALVE OPEN,,,1559.38,1559.38,1
HCPCS,33363,REPLACE AORTIC VALVE OPEN,,,1618.53,1618.53,1
HCPCS,33363,REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH,19197.0,12478.050000000001,1024.62,37851.0,70
HCPCS,333630,REPLACE AORTIC VALVE OPEN,,,1618.53,1618.53,1
HCPCS,33364,REPLACE AORTIC VALVE OPEN,,,1613.74,1613.74,1
HCPCS,33364,REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPROACH,10388.0,6752.2,1022.06,10388.0,31
HCPCS,33364,Replace aortic valve open,,,8538.66,10785.67,6
HCPCS,333640,REPLACE AORTIC VALVE OPEN,,,1613.74,1613.74,1
HCPCS,33365,REPLACE AORTIC VALVE OPEN,,,1685.87,1685.87,1
HCPCS,33365,REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH,10636.0,6913.4,1067.26,10636.0,31
HCPCS,33365,TAVR TRANSAORTIC APPROACH,51028.0,33168.2,1674.78,45925.2,32
HCPCS,333650,REPLACE AORTIC VALVE OPEN,,,1685.87,1685.87,1
HCPCS,33366,TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE,25074.0,16298.099999999999,1177.3,33510.6,63
HCPCS,33366,TRCATH REPLACE AORTIC VALVE,,,1855.43,1855.43,1
HCPCS,333660,TRCATH REPLACE AORTIC VALVE,,,1855.43,1855.43,1
HCPCS,33367,REPLACE AORTIC VALVE W/BYP,,,721.25,721.25,1
HCPCS,33367,REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH,4752.0,3088.8,446.03,4752.0,31
HCPCS,33367,Replace aortic valve w/byp,,,8538.66,10785.67,6
HCPCS,333670,REPLACE AORTIC VALVE W/BYP,,,721.25,721.25,1
HCPCS,33368,REPLACE AORTIC VALVE W/BYP,,,874.1,874.1,1
HCPCS,33368,REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH,5756.0,3741.4,525.67,5756.0,31
HCPCS,33368,Replace aortic valve w/byp,,,8538.66,10785.67,6
HCPCS,333680,REPLACE AORTIC VALVE W/BYP,,,874.1,874.1,1
HCPCS,33369,REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH,7600.0,4940.0,693.84,7600.0,31
HCPCS,33369,REPLACE AORTIC VALVE W/BYP,,,1153.84,1153.84,1
HCPCS,33369,Replace aortic valve w/byp,,,8538.66,10785.67,6
HCPCS,333690,REPLACE AORTIC VALVE W/BYP,,,1153.84,1153.84,1
HCPCS,33370,TCAT PLMT&RMVL CEPD PERQ,,,157.58,157.58,1
HCPCS,33370,TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,2459.0,1598.35,10.38,37851.0,101
HCPCS,333700,TCAT PLMT&RMVL CEPD PERQ,,,157.58,157.58,1
HCPCS,33390,VALVULOPLASTY AORTIC VALVE,,,2277.6,2277.6,1
HCPCS,33390,VALVULOPLASTY AORTIC VALVE OPEN CARD BYP SIMPLE,14000.0,9100.0,1451.01,14000.0,31
HCPCS,33390,Valvuloplasty aortic valve,,,7099.16,8967.36,6
HCPCS,333900,VALVULOPLASTY AORTIC VALVE,,,2277.6,2277.6,1
HCPCS,33391,(2017) VALVULOPLASTY AORTIC VALVE OPEN CARD BYP COMPLEX,16600.0,10790.0,1719.61,16600.0,31
HCPCS,33391,VALVULOPLASTY AORTIC VALVE,,,2699.85,2699.85,1
HCPCS,33391,Valvuloplasty aortic valve,,,7099.16,8967.36,6
HCPCS,333910,VALVULOPLASTY AORTIC VALVE,,,2699.85,2699.85,1
HCPCS,33404,PREPARE HEART-AORTA CONDUIT,,,2067.23,2067.23,1
HCPCS,33404,Prepare heart-aorta conduit,,,7099.16,8967.36,6
HCPCS,334040,PREPARE HEART-AORTA CONDUIT,,,2067.23,2067.23,1
HCPCS,33405,REPLACEMENT AORTIC VALVE OPN,,,2692.87,2692.87,1
HCPCS,33405,RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT,18181.0,11817.65,1664.33,18181.0,35
HCPCS,33405,Replacement aortic valve opn,,,7099.16,8967.36,6
HCPCS,334050,REPLACEMENT AORTIC VALVE OPN,,,2692.87,2692.87,1
HCPCS,33406,REPLACEMENT AORTIC VALVE OPN,,,3423.87,3423.87,1
HCPCS,33406,RPLCMT AORTIC VALVE OPN ALLOGRAFT VALVE FREEHAND,21072.0,13696.8,1862.82,21072.0,35
HCPCS,33406,Replacement aortic valve opn,,,7099.16,8967.36,6
HCPCS,334060,REPLACEMENT AORTIC VALVE OPN,,,3423.87,3423.87,1
HCPCS,3340F,MAMMO ASSESS INC XRAY DOCD,,,0.01,0.01,1
HCPCS,3340F0,MAMMO ASSESS INC XRAY DOCD,,,0.01,0.01,1
HCPCS,33410,REPLACEMENT AORTIC VALVE OPN,,,3013.69,3013.69,1
HCPCS,33410,RPLCMT AORTIC VALVE OPN W/STENTLESS TISSUE VALVE,20420.0,13273.0,1602.69,20420.0,35
HCPCS,33410,Replacement aortic valve opn,,,7099.16,8967.36,6
HCPCS,334100,REPLACEMENT AORTIC VALVE OPN,,,3013.69,3013.69,1
HCPCS,33411,REPLACEMENT OF AORTIC VALVE,,,3974.42,3974.42,1
HCPCS,33411,RPLCMT AORTIC VALVE ANNULUS ENLGMENT NONC SINUS,24828.0,16138.2,1874.09,24828.0,35
HCPCS,33411,Replacement of aortic valve,,,7099.16,8967.36,6
HCPCS,334110,REPLACEMENT OF AORTIC VALVE,,,3974.42,3974.42,1
HCPCS,33412,REPLACEMENT AORTIC VALVE KONNO PROCEDURE,23600.0,15340.0,1977.93,23600.0,35
HCPCS,33412,REPLACEMENT OF AORTIC VALVE,,,3716.23,3716.23,1
HCPCS,33412,Replacement of aortic valve,,,7099.16,8967.36,6
HCPCS,334120,REPLACEMENT OF AORTIC VALVE,,,3716.23,3716.23,1
HCPCS,33413,REPLACEMENT AORTIC&PULMON VALVES ROSS PROCEDUR,23948.0,15566.2,2025.93,23948.0,35
HCPCS,33413,REPLACEMENT OF AORTIC VALVE,,,3806.33,3806.33,1
HCPCS,33413,Replacement of aortic valve,,,7099.16,8967.36,6
HCPCS,334130,REPLACEMENT OF AORTIC VALVE,,,3806.33,3806.33,1
HCPCS,33414,REPAIR OF AORTIC VALVE,,,2552.42,2552.42,1
HCPCS,33414,Repair of aortic valve,,,7099.16,8967.36,6
HCPCS,334140,REPAIR OF AORTIC VALVE,,,2552.42,2552.42,1
HCPCS,33415,RESECTION/INCISION SUBVALVULAR TISSUE,14908.0,9690.2,1527.86,14908.0,35
HCPCS,33415,REVISION SUBVALVULAR TISSUE,,,2406.07,2406.07,1
HCPCS,33415,Revision subvalvular tissue,,,7099.16,8967.36,6
HCPCS,334150,REVISION SUBVALVULAR TISSUE,,,2406.07,2406.07,1
HCPCS,33416,REVISE VENTRICLE MUSCLE,,,2400.46,2400.46,1
HCPCS,33416,Revise ventricle muscle,,,7099.16,8967.36,6
HCPCS,33416,VENTRICULOMYOTOMY-MYECTOMY,14624.0,9505.6,1525.7,14624.0,35
HCPCS,334160,REVISE VENTRICLE MUSCLE,,,2400.46,2400.46,1
HCPCS,33417,AORTOPLASTY SUPRAVALVULAR STENOSIS,11732.0,7625.8,1263.35,11732.0,35
HCPCS,33417,REPAIR OF AORTIC VALVE,,,1985.12,1985.12,1
HCPCS,33417,Repair of aortic valve,,,7099.16,8967.36,6
HCPCS,334170,REPAIR OF AORTIC VALVE,,,1985.12,1985.12,1
HCPCS,33418,REPAIR TCAT MITRAL VALVE,,,2127.57,2127.57,1
HCPCS,33418,TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS,17724.5,11520.925,1322.27,44585.0,106
HCPCS,334180,REPAIR TCAT MITRAL VALVE,,,2127.57,2127.57,1
HCPCS,33419,REPAIR TCAT MITRAL VALVE,,,500.19,500.19,1
HCPCS,33419,TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS,6666.0,4332.9,390.0,44585.0,67
HCPCS,334190,REPAIR TCAT MITRAL VALVE,,,500.19,500.19,1
HCPCS,3341F,MAMMO ASSESS NEGATIVE DOCD,,,0.01,0.01,1
HCPCS,3341F0,MAMMO ASSESS NEGATIVE DOCD,,,0.01,0.01,1
HCPCS,33420,REVISION OF MITRAL VALVE,,,1715.6,1715.6,1
HCPCS,33420,Revision of mitral valve,,,7099.16,8967.36,6
HCPCS,334200,REVISION OF MITRAL VALVE,,,1715.6,1715.6,1
HCPCS,33422,REVISION OF MITRAL VALVE,,,1966.6,1966.6,1
HCPCS,33422,Revision of mitral valve,,,7099.16,8967.36,6
HCPCS,33422,VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS,11892.0,7729.8,1254.41,11892.0,35
HCPCS,334220,REVISION OF MITRAL VALVE,,,1966.6,1966.6,1
HCPCS,33425,REPAIR OF MITRAL VALVE,,,3237.65,3237.65,1
HCPCS,33425,Repair of mitral valve,,,7099.16,8967.36,6
HCPCS,33425,VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS,19984.0,12989.6,1547.5,19984.0,35
HCPCS,334250,REPAIR OF MITRAL VALVE,,,3237.65,3237.65,1
HCPCS,33426,REPAIR OF MITRAL VALVE,,,2826.42,2826.42,1
HCPCS,33426,Repair of mitral valve,,,7099.16,8967.36,6
HCPCS,33426,VLVP MITRAL VALVE W/CARD BYP W/PROSTC RING,17312.0,11252.8,1721.57,17312.0,35
HCPCS,334260,REPAIR OF MITRAL VALVE,,,2826.42,2826.42,1
HCPCS,33427,REPAIR OF MITRAL VALVE,,,2891.32,2891.32,1
HCPCS,33427,Repair of mitral valve,,,7099.16,8967.36,6
HCPCS,33427,VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING,17932.0,11655.8,1782.37,17932.0,35
HCPCS,334270,REPAIR OF MITRAL VALVE,,,2891.32,2891.32,1
HCPCS,3342F,MAMMO ASSESS BENGN DOCD,,,0.01,0.01,1
HCPCS,3342F0,MAMMO ASSESS BENGN DOCD,,,0.01,0.01,1
HCPCS,33430,REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP,20372.0,13241.8,1795.9,20372.0,35
HCPCS,33430,REPLACEMENT OF MITRAL VALVE,,,3322.13,3322.13,1
HCPCS,33430,Replacement of mitral valve,,,7099.16,8967.36,6
HCPCS,334300,REPLACEMENT OF MITRAL VALVE,,,3322.13,3322.13,1
HCPCS,3343F,MAMMO PROBABLY BENGN DOCD,,,0.01,0.01,1
HCPCS,3343F0,MAMMO PROBABLY BENGN DOCD,,,0.01,0.01,1
HCPCS,33440,RPLCMT A-VALVE TLCJ AUTOL PV,,,4019.07,4019.07,1
HCPCS,33440,RPLCMT AORTIC VALVE BY TLCJ AUTOL PULM VALVE,25600.0,16640.0,2548.65,25600.0,31
HCPCS,33440,Rplcmt a-valve tlcj autol pv,,,7099.16,8967.36,6
HCPCS,334400,RPLCMT A-VALVE TLCJ AUTOL PV,,,4019.07,4019.07,1
HCPCS,3344F,MAMMO ASSESS SUSP DOCD,,,0.01,0.01,1
HCPCS,3344F0,MAMMO ASSESS SUSP DOCD,,,0.01,0.01,1
HCPCS,3345F,MAMMO ASSESS HGHLYMALIG DOC,,,0.01,0.01,1
HCPCS,3345F0,MAMMO ASSESS HGHLYMALIG DOC,,,0.01,0.01,1
HCPCS,33460,REVISION OF TRICUSPID VALVE,,,2834.76,2834.76,1
HCPCS,33460,Revision of tricuspid valve,,,7099.16,8967.36,6
HCPCS,33460,VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP,17880.0,11622.0,1361.77,17880.0,35
HCPCS,334600,REVISION OF TRICUSPID VALVE,,,2834.76,2834.76,1
HCPCS,33463,VALVULOPLAS TRICUS NO RING INSERT,22832.0,14840.8,1555.74,22832.0,35
HCPCS,33463,VALVULOPLASTY TRICUSPID,,,3645.02,3645.02,1
HCPCS,33463,Valvuloplasty tricuspid,,,7099.16,8967.36,6
HCPCS,334630,VALVULOPLASTY TRICUSPID,,,3645.02,3645.02,1
HCPCS,33464,VALVULOPLAS TRICUS W RING INSERT,17848.0,11601.2,1573.41,17848.0,35
HCPCS,33464,VALVULOPLASTY TRICUSPID,,,2889.24,2889.24,1
HCPCS,33464,Valvuloplasty tricuspid,,,7099.16,8967.36,6
HCPCS,334640,VALVULOPLASTY TRICUSPID,,,2889.24,2889.24,1
HCPCS,33465,REPLACE TRICUSPID VALVE,,,3265.51,3265.51,1
HCPCS,33465,REPLACEMENT TRICUSPID VALVE W/CARD BYPASS,20288.0,13187.2,1648.35,20288.0,35
HCPCS,33465,Replace tricuspid valve,,,7099.16,8967.36,6
HCPCS,334650,REPLACE TRICUSPID VALVE,,,3265.51,3265.51,1
HCPCS,33468,REVISION OF TRICUSPID VALVE,,,2911.37,2911.37,1
HCPCS,33468,Revision of tricuspid valve,,,7099.16,8967.36,6
HCPCS,334680,REVISION OF TRICUSPID VALVE,,,2911.37,2911.37,1
HCPCS,33470,Revision of pulmonary valve,,,7099.16,8967.36,6
HCPCS,33471,Vlvt pv clsd hrt via p-art,,,7099.16,8967.36,6
HCPCS,33474,REVISION OF PULMONARY VALVE,,,2590.23,2590.23,1
HCPCS,33474,Revision of pulmonary valve,,,7099.16,8967.36,6
HCPCS,334740,REVISION OF PULMONARY VALVE,,,2590.23,2590.23,1
HCPCS,33475,REPLACEMENT PULMONARY VALVE,,,2750.6,2750.6,1
HCPCS,33475,"REPLACEMENT, PULMONARY VALVE",16960.0,11024.0,1627.2,16960.0,35
HCPCS,33475,Replacement pulmonary valve,,,7099.16,8967.36,6
HCPCS,334750,REPLACEMENT PULMONARY VALVE,,,2750.6,2750.6,1
HCPCS,33476,REVISION OF HEART CHAMBER,,,1813.24,1813.24,1
HCPCS,33476,Revision of heart chamber,,,7099.16,8967.36,6
HCPCS,334760,REVISION OF HEART CHAMBER,,,1813.24,1813.24,1
HCPCS,33477,IMPLANT TCAT PULM VLV PERQ,,,1545.43,1545.43,1
HCPCS,33477,TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH,16384.5,10649.925,974.32,20492.1,63
HCPCS,334770,IMPLANT TCAT PULM VLV PERQ,,,1545.43,1545.43,1
HCPCS,33478,OUTFLOW TRACT AGMNTJ W/WO COMMISSUR/INFUND RESCJ,11016.0,7160.4,1193.39,11016.0,35
HCPCS,33478,REVISION OF HEART CHAMBER,,,1872.4,1872.4,1
HCPCS,33478,Revision of heart chamber,,,7099.16,8967.36,6
HCPCS,334780,REVISION OF HEART CHAMBER,,,1872.4,1872.4,1
HCPCS,33496,REPAIR PROSTH VALVE CLOT,,,1967.9,1967.9,1
HCPCS,33496,RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS,11936.0,7758.4,1254.41,11936.0,35
HCPCS,33496,Repair prosth valve clot,,,7099.16,8967.36,6
HCPCS,334960,REPAIR PROSTH VALVE CLOT,,,1967.9,1967.9,1
HCPCS,33500,REPAIR HEART VESSEL FISTULA,,,1845.37,1845.37,1
HCPCS,33500,Repair heart vessel fistula,,,7099.16,8967.36,6
HCPCS,335000,REPAIR HEART VESSEL FISTULA,,,1845.37,1845.37,1
HCPCS,33501,REPAIR HEART VESSEL FISTULA,,,1319.78,1319.78,1
HCPCS,33501,Repair heart vessel fistula,,,7099.16,8967.36,6
HCPCS,335010,REPAIR HEART VESSEL FISTULA,,,1319.78,1319.78,1
HCPCS,33502,CORONARY ARTERY CORRECTION,,,1521.73,1521.73,1
HCPCS,33502,Coronary artery correction,,,9690.96,12241.21,6
HCPCS,33502,RPR ANOM CORONARY ART PULM ART ORIGIN LIGATION,8740.0,5681.0,937.41,8740.0,35
HCPCS,335020,CORONARY ARTERY CORRECTION,,,1521.73,1521.73,1
HCPCS,33503,CORONARY ARTERY GRAFT,,,1580.95,1580.95,1
HCPCS,33503,Coronary artery graft,,,9690.96,12241.21,6
HCPCS,33503,RPR ANOM CORONARY ARTERY PULM ART ORIGIN GRAFT,9004.0,5852.6,926.89,9004.0,35
HCPCS,335030,CORONARY ARTERY GRAFT,,,1580.95,1580.95,1
HCPCS,33504,CORONARY ARTERY GRAFT,,,1745.44,1745.44,1
HCPCS,33504,Coronary artery graft,,,9690.96,12241.21,6
HCPCS,33504,RPR ANOM CORONARY ART PULM ART ORIGIN GRF W/BYP,10184.0,6619.6,1113.47,10184.0,35
HCPCS,335040,CORONARY ARTERY GRAFT,,,1745.44,1745.44,1
HCPCS,33505,REPAIR ARTERY W/TUNNEL,,,2446.87,2446.87,1
HCPCS,33505,RPR ANOM CORON ART W/CONSTJ INTRAPULM ART TUNNEL,15360.0,9984.0,1107.57,15360.0,35
HCPCS,33505,Repair artery w/tunnel,,,9690.96,12241.21,6
HCPCS,335050,REPAIR ARTERY W/TUNNEL,,,2446.87,2446.87,1
HCPCS,33506,REPAIR ARTERY TRANSLOCATION,,,2438.19,2438.19,1
HCPCS,33506,RPR ANOM CORONARY ART FROM PULM ART TO AORTA,15140.0,9841.0,1487.07,15140.0,35
HCPCS,33506,Repair artery translocation,,,9690.96,12241.21,6
HCPCS,335060,REPAIR ARTERY TRANSLOCATION,,,2438.19,2438.19,1
HCPCS,33507,REPAIR ART INTRAMURAL,,,2044.77,2044.77,1
HCPCS,33507,RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ,12560.0,8164.0,1264.47,12560.0,35
HCPCS,33507,Repair art intramural,,,9690.96,12241.21,6
HCPCS,335070,REPAIR ART INTRAMURAL,,,2044.77,2044.77,1
HCPCS,33508,ENDOSCOPIC VEIN HARVEST,,,19.03,19.03,1
HCPCS,33508,Endoscopic vein harvest,,,9690.96,12241.21,6
HCPCS,33508,NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG,124.0,80.6,11.39,124.0,35
HCPCS,335080,ENDOSCOPIC VEIN HARVEST,,,19.03,19.03,1
HCPCS,33509,NDSC HRV UXTR ART 1 SGM CAB,,,204.68,204.68,1
HCPCS,33509,Ndsc hrv uxtr art 1 sgm cab,,,9690.96,12241.21,6
HCPCS,335090,NDSC HRV UXTR ART 1 SGM CAB,,,204.68,204.68,1
HCPCS,3350F,MAMMO BX PROVEN MALIG DOCD,,,0.01,0.01,1
HCPCS,3350F0,MAMMO BX PROVEN MALIG DOCD,,,0.01,0.01,1
HCPCS,33510,CABG VEIN SINGLE,,,2292.97,2292.97,1
HCPCS,33510,CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT,13992.0,9094.8,1441.52,13992.0,35
HCPCS,33510,Cabg vein single,,,9690.96,12241.21,6
HCPCS,335100,CABG VEIN SINGLE,,,2292.97,2292.97,1
HCPCS,33511,CABG VEIN TWO,,,2518.2,2518.2,1
HCPCS,33511,CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS,15380.0,9997.0,1571.34,15380.0,35
HCPCS,33511,Cabg vein two,,,9690.96,12241.21,6
HCPCS,335110,CABG VEIN TWO,,,2518.2,2518.2,1
HCPCS,33512,CABG VEIN THREE,,,2869.72,2869.72,1
HCPCS,33512,CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS,17592.0,11434.8,1700.56,17592.0,35
HCPCS,33512,Cabg vein three,,,9690.96,12241.21,6
HCPCS,335120,CABG VEIN THREE,,,2869.72,2869.72,1
HCPCS,33513,CABG VEIN FOUR,,,2932.25,2932.25,1
HCPCS,33513,CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS,18148.0,11796.2,1832.09,18148.0,35
HCPCS,33513,Cabg vein four,,,9690.96,12241.21,6
HCPCS,335130,CABG VEIN FOUR,,,2932.25,2932.25,1
HCPCS,33514,CABG VEIN FIVE,,,3082.85,3082.85,1
HCPCS,33514,CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS,19232.0,12500.8,1898.85,19232.0,35
HCPCS,33514,Cabg vein five,,,9690.96,12241.21,6
HCPCS,335140,CABG VEIN FIVE,,,3082.85,3082.85,1
HCPCS,33516,CABG VEIN SIX OR MORE,,,3190.61,3190.61,1
HCPCS,33516,CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT,19904.0,12937.6,1978.98,19904.0,35
HCPCS,33516,Cabg vein six or more,,,9690.96,12241.21,6
HCPCS,335160,CABG VEIN SIX OR MORE,,,3190.61,3190.61,1
HCPCS,33517,CABG ARTERY-VEIN SINGLE,,,222.12,222.12,1
HCPCS,33517,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN,1588.0,1032.2,132.06,1588.0,35
HCPCS,33517,Cabg artery-vein single,,,9690.96,12241.21,6
HCPCS,335170,CABG ARTERY-VEIN SINGLE,,,222.12,222.12,1
HCPCS,33518,CABG ARTERY-VEIN TWO,,,486.41,486.41,1
HCPCS,33518,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN,3489.0,2267.85,249.33,3489.0,35
HCPCS,33518,Cabg artery-vein two,,,9690.96,12241.21,6
HCPCS,335180,CABG ARTERY-VEIN TWO,,,486.41,486.41,1
HCPCS,33519,CABG ARTERY-VEIN THREE,,,643.71,643.71,1
HCPCS,33519,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN,4616.0,3000.4,365.89,4616.0,35
HCPCS,33519,Cabg artery-vein three,,,9690.96,12241.21,6
HCPCS,335190,CABG ARTERY-VEIN THREE,,,643.71,643.71,1
HCPCS,3351F,NEG SCRN DEP SYMP BY DEPTOOL,,,0.01,0.01,1
HCPCS,3351F0,NEG SCRN DEP SYMP BY DEPTOOL,,,0.01,0.01,1
HCPCS,33521,CABG ARTERY-VEIN FOUR,,,771.42,771.42,1
HCPCS,33521,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN,5540.0,3601.0,483.5,5540.0,35
HCPCS,33521,Cabg artery-vein four,,,9690.96,12241.21,6
HCPCS,335210,CABG ARTERY-VEIN FOUR,,,771.42,771.42,1
HCPCS,33522,CABG ARTERY-VEIN FIVE,,,867.14,867.14,1
HCPCS,33522,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN,6222.0,4044.3,547.67,6222.0,35
HCPCS,33522,Cabg artery-vein five,,,9690.96,12241.21,6
HCPCS,335220,CABG ARTERY-VEIN FIVE,,,867.14,867.14,1
HCPCS,33523,CABG ART-VEIN SIX OR MORE,,,975.88,975.88,1
HCPCS,33523,CORONARY ARTERY BYP W/VEIN &ARTERY GRAFT 6 VEIN,7075.0,4598.75,616.61,7075.0,35
HCPCS,33523,Cabg art-vein six or more,,,9690.96,12241.21,6
HCPCS,335230,CABG ART-VEIN SIX OR MORE,,,975.88,975.88,1
HCPCS,3352F,NO SIG DEP SYMP BY DEP TOOL,,,0.01,0.01,1
HCPCS,3352F0,NO SIG DEP SYMP BY DEP TOOL,,,0.01,0.01,1
HCPCS,33530,CORONARY ARTERY BYPASS/REOP,,,620.99,620.99,1
HCPCS,33530,Coronary artery bypass/reop,,,9690.96,12241.21,6
HCPCS,33530,ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ,4052.0,2633.8,286.76,4052.0,35
HCPCS,335300,CORONARY ARTERY BYPASS/REOP,,,620.99,620.99,1
HCPCS,33533,CABG ARTERIAL SINGLE,,,2220.45,2220.45,1
HCPCS,33533,CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT,14850.0,9652.5,1412.2,14850.0,35
HCPCS,33533,Cabg arterial single,,,9690.96,12241.21,6
HCPCS,335330,CABG ARTERIAL SINGLE,,,2220.45,2220.45,1
HCPCS,33534,CABG ARTERIAL TWO,,,2608.58,2608.58,1
HCPCS,33534,"CABG, ARTERIAL, TWO",17547.0,11405.55,1658.84,17547.0,35
HCPCS,33534,Cabg arterial two,,,9690.96,12241.21,6
HCPCS,335340,CABG ARTERIAL TWO,,,2608.58,2608.58,1
HCPCS,33535,CABG ARTERIAL THREE,,,2899.77,2899.77,1
HCPCS,33535,"CABG, ARTERIAL, THREE",19690.0,12798.5,1396.22,19690.0,35
HCPCS,33535,Cabg arterial three,,,9690.96,12241.21,6
HCPCS,335350,CABG ARTERIAL THREE,,,2899.77,2899.77,1
HCPCS,33536,CABG ARTERIAL FOUR OR MORE,,,3125.4,3125.4,1
HCPCS,33536,"CABG, ARTERIAL, FOUR+",21309.0,13850.85,1984.89,21309.0,35
HCPCS,33536,Cabg arterial four or more,,,9690.96,12241.21,6
HCPCS,335360,CABG ARTERIAL FOUR OR MORE,,,3125.4,3125.4,1
HCPCS,3353F,MILD-MOD DEP SYMP BY DEPTOOL,,,0.01,0.01,1
HCPCS,3353F0,MILD-MOD DEP SYMP BY DEPTOOL,,,0.01,0.01,1
HCPCS,33542,MYOCARD RESECTN,19284.0,12534.6,1636.82,19284.0,35
HCPCS,33542,REMOVAL OF HEART LESION,,,3110.07,3110.07,1
HCPCS,33542,Removal of heart lesion,,,7099.16,8967.36,6
HCPCS,335420,REMOVAL OF HEART LESION,,,3110.07,3110.07,1
HCPCS,33545,REPAIR OF HEART DAMAGE,,,3622.53,3622.53,1
HCPCS,33545,RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT,22824.0,14835.6,1976.8,22824.0,35
HCPCS,33545,Repair of heart damage,,,7099.16,8967.36,6
HCPCS,335450,REPAIR OF HEART DAMAGE,,,3622.53,3622.53,1
HCPCS,33548,RESTORE/REMODEL VENTRICLE,,,3484.57,3484.57,1
HCPCS,33548,Restore/remodel ventricle,,,7099.16,8967.36,6
HCPCS,33548,SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD,21656.0,14076.4,1661.79,21656.0,35
HCPCS,335480,RESTORE/REMODEL VENTRICLE,,,3484.57,3484.57,1
HCPCS,3354F,CLIN SIG DEP SYM BY DEP TOOL,,,0.01,0.01,1
HCPCS,3354F0,CLIN SIG DEP SYM BY DEP TOOL,,,0.01,0.01,1
HCPCS,33572,CORONARY ENDARTERCOMY OPEN ANY METHOD,1776.0,1154.4,171.83,1776.0,35
HCPCS,33572,OPEN CORONARY ENDARTERECTOMY,,,273.62,273.62,1
HCPCS,33572,Open coronary endarterectomy,,,9690.96,12241.21,6
HCPCS,335720,OPEN CORONARY ENDARTERECTOMY,,,273.62,273.62,1
HCPCS,33600,CLOSURE OF VALVE,,,2045.52,2045.52,1
HCPCS,33600,Closure of valve,,,7099.16,8967.36,6
HCPCS,336000,CLOSURE OF VALVE,,,2045.52,2045.52,1
HCPCS,33602,CLOSURE OF VALVE,,,1985.53,1985.53,1
HCPCS,33602,CLOSURE SEMILUNAR VALVE AORTIC/PULM SUTURE/PATCH,11906.0,7738.9,1263.86,11906.0,35
HCPCS,33602,Closure of valve,,,7099.16,8967.36,6
HCPCS,336020,CLOSURE OF VALVE,,,1985.53,1985.53,1
HCPCS,33606,ANASTOMOSIS/ARTERY-AORTA,,,2114.85,2114.85,1
HCPCS,33606,Anastomosis/artery-aorta,,,7099.16,8967.36,6
HCPCS,336060,ANASTOMOSIS/ARTERY-AORTA,,,2114.85,2114.85,1
HCPCS,33608,REPAIR ANOMALY W/CONDUIT,,,2141.59,2141.59,1
HCPCS,33608,Repair anomaly w/conduit,,,7099.16,8967.36,6
HCPCS,336080,REPAIR ANOMALY W/CONDUIT,,,2141.59,2141.59,1
HCPCS,33610,REPAIR BY ENLARGEMENT,,,2111.98,2111.98,1
HCPCS,33610,Repair by enlargement,,,7099.16,8967.36,6
HCPCS,336100,REPAIR BY ENLARGEMENT,,,2111.98,2111.98,1
HCPCS,33611,REPAIR DOUBLE VENTRICLE,,,2316.83,2316.83,1
HCPCS,33611,Repair double ventricle,,,7099.16,8967.36,6
HCPCS,336110,REPAIR DOUBLE VENTRICLE,,,2316.83,2316.83,1
HCPCS,33612,REPAIR DOUBLE VENTRICLE,,,2379.27,2379.27,1
HCPCS,33612,Repair double ventricle,,,7099.16,8967.36,6
HCPCS,336120,REPAIR DOUBLE VENTRICLE,,,2379.27,2379.27,1
HCPCS,33615,REPAIR MODIFIED FONTAN,,,2374.78,2374.78,1
HCPCS,33615,RPR CAR ANOMAL CLSR SEPTL DFCT SMPL FONTAN PX,14356.0,9331.4,1508.46,14356.0,35
HCPCS,33615,Repair modified fontan,,,7099.16,8967.36,6
HCPCS,336150,REPAIR MODIFIED FONTAN,,,2374.78,2374.78,1
HCPCS,33617,REPAIR SINGLE VENTRICLE,,,2572.65,2572.65,1
HCPCS,33617,Repair single ventricle,,,7099.16,8967.36,6
HCPCS,336170,REPAIR SINGLE VENTRICLE,,,2572.65,2572.65,1
HCPCS,33619,REPAIR SINGLE VENTRICLE,,,3263.22,3263.22,1
HCPCS,33619,Repair single ventricle,,,7099.16,8967.36,6
HCPCS,336190,REPAIR SINGLE VENTRICLE,,,3263.22,3263.22,1
HCPCS,33620,APPLICATION RIGHT & LEFT PULMONARY ARTERY BANDS,13200.0,8580.0,1242.66,13200.0,35
HCPCS,33620,APPLY R&L PULM ART BANDS,,,1958.87,1958.87,1
HCPCS,33620,Apply r&l pulm art bands,,,7099.16,8967.36,6
HCPCS,336200,APPLY R&L PULM ART BANDS,,,1958.87,1958.87,1
HCPCS,33621,TRANSTHOR CATH FOR STENT,,,1104.96,1104.96,1
HCPCS,33621,TRANSTHORACIC CATHETER INSERTION FOR STENT PLMT,6472.0,4206.8,667.85,6472.0,35
HCPCS,33621,Transthor cath for stent,,,7099.16,8967.36,6
HCPCS,336210,TRANSTHOR CATH FOR STENT,,,1104.96,1104.96,1
HCPCS,33622,RECONSTRUCTION COMPLEX CARDIAC ANOMALY,25600.0,16640.0,2496.3,25600.0,35
HCPCS,33622,REDO COMPL CARDIAC ANOMALY,,,4072.43,4072.43,1
HCPCS,33622,Redo compl cardiac anomaly,,,7099.16,8967.36,6
HCPCS,336220,REDO COMPL CARDIAC ANOMALY,,,4072.43,4072.43,1
HCPCS,33641,REPAIR HEART SEPTUM DEFECT,,,1947.88,1947.88,1
HCPCS,33641,REPR ASD W BYPASS,11832.0,7690.8,1236.79,11832.0,35
HCPCS,33641,Repair heart septum defect,,,7099.16,8967.36,6
HCPCS,336410,REPAIR HEART SEPTUM DEFECT,,,1947.88,1947.88,1
HCPCS,33645,DIR/PTCH CLS SINUS VENOSUS W/WO ANOM PUL VEN DRG,12520.0,8138.0,1305.98,12520.0,35
HCPCS,33645,REVISION OF HEART VEINS,,,2057.0,2057.0,1
HCPCS,33645,Revision of heart veins,,,7099.16,8967.36,6
HCPCS,336450,REVISION OF HEART VEINS,,,2057.0,2057.0,1
HCPCS,33647,REPAIR HEART SEPTUM DEFECTS,,,2157.9,2157.9,1
HCPCS,33647,RPR ATRIAL & VENTRIC SEPTAL DFCT DIR/PATCH CLS,14520.0,9438.0,1369.3,14520.0,35
HCPCS,33647,Repair heart septum defects,,,7099.16,8967.36,6
HCPCS,336470,REPAIR HEART SEPTUM DEFECTS,,,2157.9,2157.9,1
HCPCS,33660,REPAIR OF HEART DEFECTS,,,2086.1,2086.1,1
HCPCS,33660,RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR,14005.0,9103.25,1324.11,14005.0,35
HCPCS,33660,Repair of heart defects,,,7099.16,8967.36,6
HCPCS,336600,REPAIR OF HEART DEFECTS,,,2086.1,2086.1,1
HCPCS,33665,REPAIR OF HEART DEFECTS,,,2272.65,2272.65,1
HCPCS,33665,Repair of heart defects,,,7099.16,8967.36,6
HCPCS,336650,REPAIR OF HEART DEFECTS,,,2272.65,2272.65,1
HCPCS,33670,REPAIR OF HEART CHAMBERS,,,2341.52,2341.52,1
HCPCS,33670,Repair of heart chambers,,,7099.16,8967.36,6
HCPCS,336700,REPAIR OF HEART CHAMBERS,,,2341.52,2341.52,1
HCPCS,33675,CLOSE MULT VSD,,,2341.12,2341.12,1
HCPCS,33675,Close mult vsd,,,7099.16,8967.36,6
HCPCS,336750,CLOSE MULT VSD,,,2341.12,2341.12,1
HCPCS,33676,CLOSE MULT VSD W/RESECTION,,,2403.56,2403.56,1
HCPCS,33676,Close mult vsd w/resection,,,7099.16,8967.36,6
HCPCS,336760,CLOSE MULT VSD W/RESECTION,,,2403.56,2403.56,1
HCPCS,33677,CL MULT VSD W/REM PUL BAND,,,2496.01,2496.01,1
HCPCS,33677,Cl mult vsd w/rem pul band,,,7099.16,8967.36,6
HCPCS,336770,CL MULT VSD W/REM PUL BAND,,,2496.01,2496.01,1
HCPCS,33681,CLOSURE 1 VSD W/WO PATCH,,,2192.72,2192.72,1
HCPCS,33681,CLSR 1 VENTRICULAR SEPTAL DEFECT W/WO PATCH,14230.0,9249.5,1396.37,14230.0,35
HCPCS,33681,Closure 1 vsd w/wo patch,,,7099.16,8967.36,6
HCPCS,336810,CLOSURE 1 VSD W/WO PATCH,,,2192.72,2192.72,1
HCPCS,33684,CLSR 1 VSD W/WO PATCH W/VLVT,,,2242.63,2242.63,1
HCPCS,33684,Clsr 1 vsd w/wo patch w/vlvt,,,7099.16,8967.36,6
HCPCS,336840,CLSR 1 VSD W/WO PATCH W/VLVT,,,2242.63,2242.63,1
HCPCS,33688,CLSR 1VSD W/WO PTCH RMVL BND,,,2235.56,2235.56,1
HCPCS,33688,Clsr 1vsd w/wo ptch rmvl bnd,,,7099.16,8967.36,6
HCPCS,336880,CLSR 1VSD W/WO PTCH RMVL BND,,,2235.56,2235.56,1
HCPCS,33690,BANDING PULMONARY ARTERY,,,1430.82,1430.82,1
HCPCS,33690,Banding pulmonary artery,,,7099.16,8967.36,6
HCPCS,336900,BANDING PULMONARY ARTERY,,,1430.82,1430.82,1
HCPCS,33692,COMP RPR TOF WO PULM ATRESIA,,,2321.94,2321.94,1
HCPCS,33692,Comp rpr tof wo pulm atresia,,,7099.16,8967.36,6
HCPCS,336920,COMP RPR TOF WO PULM ATRESIA,,,2321.94,2321.94,1
HCPCS,33694,CMP RPR TOF WO PLM ATRS PTCH,,,2316.83,2316.83,1
HCPCS,33694,Cmp rpr tof wo plm atrs ptch,,,7099.16,8967.36,6
HCPCS,336940,CMP RPR TOF WO PLM ATRS PTCH,,,2316.83,2316.83,1
HCPCS,33697,COMPL RPR TOF W/PULM ATRESIA,,,2440.93,2440.93,1
HCPCS,33697,Compl rpr tof w/pulm atresia,,,7099.16,8967.36,6
HCPCS,336970,COMPL RPR TOF W/PULM ATRESIA,,,2440.93,2440.93,1
HCPCS,33702,REPAIR OF HEART DEFECTS,,,1840.38,1840.38,1
HCPCS,33702,Repair of heart defects,,,7099.16,8967.36,6
HCPCS,337020,REPAIR OF HEART DEFECTS,,,1840.38,1840.38,1
HCPCS,3370F,AJCC BRST CNCR STAGE 0 DOCD,,,0.01,0.01,1
HCPCS,3370F0,AJCC BRST CNCR STAGE 0 DOCD,,,0.01,0.01,1
HCPCS,33710,REPAIR OF HEART DEFECTS,,,2435.62,2435.62,1
HCPCS,33710,Repair of heart defects,,,7099.16,8967.36,6
HCPCS,337100,REPAIR OF HEART DEFECTS,,,2435.62,2435.62,1
HCPCS,33720,REPAIR OF HEART DEFECT,,,1841.58,1841.58,1
HCPCS,33720,RPR SINUS VALSALVA ANEURYSM,10904.0,7087.6,1172.96,10904.0,35
HCPCS,33720,Repair of heart defect,,,7099.16,8967.36,6
HCPCS,337200,REPAIR OF HEART DEFECT,,,1841.58,1841.58,1
HCPCS,33722,Repair of heart defect,,,7099.16,8967.36,6
HCPCS,33724,REPAIR ISOLATED PARTIAL PULM VENOUS RETURN,11052.0,7183.8,927.85,11052.0,35
HCPCS,33724,REPAIR VENOUS ANOMALY,,,1826.53,1826.53,1
HCPCS,33724,Repair venous anomaly,,,7099.16,8967.36,6
HCPCS,337240,REPAIR VENOUS ANOMALY,,,1826.53,1826.53,1
HCPCS,33726,REPAIR PUL VENOUS STENOSIS,,,2413.29,2413.29,1
HCPCS,33726,Repair pul venous stenosis,,,7099.16,8967.36,6
HCPCS,337260,REPAIR PUL VENOUS STENOSIS,,,2413.29,2413.29,1
HCPCS,3372F,AJCC BRST CNCR STAGE 1 DOCD,,,0.01,0.01,1
HCPCS,3372F0,AJCC BRST CNCR STAGE 1 DOCD,,,0.01,0.01,1
HCPCS,33730,REPAIR HEART-VEIN DEFECT(S),,,2385.0,2385.0,1
HCPCS,33730,Repair heart-vein defect(s),,,7099.16,8967.36,6
HCPCS,337300,REPAIR HEART-VEIN DEFECT(S),,,2385.0,2385.0,1
HCPCS,33732,REPAIR HEART-VEIN DEFECT,,,1961.99,1961.99,1
HCPCS,33732,Repair heart-vein defect,,,7099.16,8967.36,6
HCPCS,337320,REPAIR HEART-VEIN DEFECT,,,1961.99,1961.99,1
HCPCS,33735,REVISION OF HEART CHAMBER,,,1544.37,1544.37,1
HCPCS,33735,Revision of heart chamber,,,7099.16,8967.36,6
HCPCS,337350,REVISION OF HEART CHAMBER,,,1544.37,1544.37,1
HCPCS,33736,REVISION OF HEART CHAMBER,,,1675.3,1675.3,1
HCPCS,33736,Revision of heart chamber,,,7099.16,8967.36,6
HCPCS,337360,REVISION OF HEART CHAMBER,,,1675.3,1675.3,1
HCPCS,33737,Revision of heart chamber,,,7099.16,8967.36,6
HCPCS,33741,TAS CONGENITAL CAR ANOMAL,,,888.24,888.24,1
HCPCS,33741,TAS CONGENITAL CARDIAC ANOMALIES ANY METHOD,5600.0,3640.0,562.22,5600.0,31
HCPCS,33741,Tas congenital car anomal,,,8538.66,10785.67,6
HCPCS,337410,TAS CONGENITAL CAR ANOMAL,,,888.24,888.24,1
HCPCS,33745,TIS CGEN CAR ANOMAL 1ST SHNT,,,1269.1,1269.1,1
HCPCS,33745,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL 1ST SHUNT,8000.0,5200.0,800.26,8000.0,31
HCPCS,33745,Tis cgen car anomal 1st shnt,,,8538.66,10785.67,6
HCPCS,337450,TIS CGEN CAR ANOMAL 1ST SHNT,,,1269.1,1269.1,1
HCPCS,33746,TIS CGEN CAR ANOMAL EA ADDL,,,507.32,507.32,1
HCPCS,33746,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL EA ADDL,3200.0,2080.0,299.64,3200.0,31
HCPCS,33746,Tis cgen car anomal ea addl,,,8538.66,10785.67,6
HCPCS,337460,TIS CGEN CAR ANOMAL EA ADDL,,,507.32,507.32,1
HCPCS,3374F,AJCC BRST CNCR STAGE 1 DOCD,,,0.01,0.01,1
HCPCS,3374F0,AJCC BRST CNCR STAGE 1 DOCD,,,0.01,0.01,1
HCPCS,33750,SHUNT SUBCLAVIAN TO PULM ART,,,1501.14,1501.14,1
HCPCS,33750,Shunt subclavian to pulm art,,,5148.42,6503.27,6
HCPCS,337500,SHUNT SUBCLAVIAN TO PULM ART,,,1501.14,1501.14,1
HCPCS,33755,SHUNT AS-AORT TO PULM ART,,,1569.1,1569.1,1
HCPCS,33755,Shunt as-aort to pulm art,,,5148.42,6503.27,6
HCPCS,337550,SHUNT AS-AORT TO PULM ART,,,1569.1,1569.1,1
HCPCS,33762,SHUNT DESC AORTA TO PULM ART,,,1525.05,1525.05,1
HCPCS,33762,Shunt desc aorta to pulm art,,,5148.42,6503.27,6
HCPCS,337620,SHUNT DESC AORTA TO PULM ART,,,1525.05,1525.05,1
HCPCS,33764,SHUNT CENTRAL W/PROSTC GRAFT,,,1569.1,1569.1,1
HCPCS,33764,Shunt central w/prostc graft,,,5148.42,6503.27,6
HCPCS,337640,SHUNT CENTRAL W/PROSTC GRAFT,,,1569.1,1569.1,1
HCPCS,33766,SHUNT SUPR V/C P-ART 1 LUNG,,,1584.24,1584.24,1
HCPCS,33766,Shunt supr v/c p-art 1 lung,,,5148.42,6503.27,6
HCPCS,337660,SHUNT SUPR V/C P-ART 1 LUNG,,,1584.24,1584.24,1
HCPCS,33767,SHUNT SUPR V/C P-ART BTH LNG,,,1691.27,1691.27,1
HCPCS,33767,Shunt supr v/c p-art bth lng,,,5148.42,6503.27,6
HCPCS,337670,SHUNT SUPR V/C P-ART BTH LNG,,,1691.27,1691.27,1
HCPCS,33768,ANAST CAVOPULM SEC SUP V/C,,,493.83,493.83,1
HCPCS,33768,Anast cavopulm sec sup v/c,,,7099.16,8967.36,6
HCPCS,337680,ANAST CAVOPULM SEC SUP V/C,,,493.83,493.83,1
HCPCS,3376F,AJCC BRSTCNCR STAGE 2 DOCD,,,0.01,0.01,1
HCPCS,3376F0,AJCC BRSTCNCR STAGE 2 DOCD,,,0.01,0.01,1
HCPCS,33770,RPR TGA W/O SURG ENLGMNT VSD,,,2512.78,2512.78,1
HCPCS,33770,Rpr tga w/o surg enlgmnt vsd,,,7099.16,8967.36,6
HCPCS,337700,RPR TGA W/O SURG ENLGMNT VSD,,,2512.78,2512.78,1
HCPCS,33771,RPR TGA W/SURG ENLGMNT VSD,,,2584.74,2584.74,1
HCPCS,33771,Rpr tga w/surg enlgmnt vsd,,,7099.16,8967.36,6
HCPCS,337710,RPR TGA W/SURG ENLGMNT VSD,,,2584.74,2584.74,1
HCPCS,33774,RPR TGA ATRIAL BAFFLE PX,,,2141.21,2141.21,1
HCPCS,33774,Rpr tga atrial baffle px,,,7099.16,8967.36,6
HCPCS,337740,RPR TGA ATRIAL BAFFLE PX,,,2141.21,2141.21,1
HCPCS,33775,RPR TGA ATR BFL RMVL PLM BND,,,2204.43,2204.43,1
HCPCS,33775,Rpr tga atr bfl rmvl plm bnd,,,7099.16,8967.36,6
HCPCS,337750,RPR TGA ATR BFL RMVL PLM BND,,,2204.43,2204.43,1
HCPCS,33776,RPR TGA ATR BFL CLSR VSD,,,2331.88,2331.88,1
HCPCS,33776,Rpr tga atr bfl clsr vsd,,,7099.16,8967.36,6
HCPCS,337760,RPR TGA ATR BFL CLSR VSD,,,2331.88,2331.88,1
HCPCS,33777,RPR TGA BFL RPR SBPULM OBSTR,,,2248.0,2248.0,1
HCPCS,33777,Rpr tga bfl rpr sbpulm obstr,,,7099.16,8967.36,6
HCPCS,337770,RPR TGA BFL RPR SBPULM OBSTR,,,2248.0,2248.0,1
HCPCS,33778,RPR TGA AORTIC PULM ART RCNS,,,2794.13,2794.13,1
HCPCS,33778,Rpr tga aortic pulm art rcns,,,5148.42,6503.27,6
HCPCS,337780,RPR TGA AORTIC PULM ART RCNS,,,2794.13,2794.13,1
HCPCS,33779,RPR TGA RCNSTJ RMVL PLM BND,,,2758.99,2758.99,1
HCPCS,33779,Rpr tga rcnstj rmvl plm bnd,,,5148.42,6503.27,6
HCPCS,337790,RPR TGA RCNSTJ RMVL PLM BND,,,2758.99,2758.99,1
HCPCS,33780,RPR TGA RCNSTJ CLSR VSD,,,2811.14,2811.14,1
HCPCS,33780,Rpr tga rcnstj clsr vsd,,,5148.42,6503.27,6
HCPCS,337800,RPR TGA RCNSTJ CLSR VSD,,,2811.14,2811.14,1
HCPCS,33781,RPR TGA RCNSTJ RPR SBPL OBST,,,2743.61,2743.61,1
HCPCS,33781,Rpr tga rcnstj rpr sbpl obst,,,5148.42,6503.27,6
HCPCS,337810,RPR TGA RCNSTJ RPR SBPL OBST,,,2743.61,2743.61,1
HCPCS,33782,NIKAIDOH PROC,,,3829.49,3829.49,1
HCPCS,33782,Nikaidoh proc,,,7099.16,8967.36,6
HCPCS,337820,NIKAIDOH PROC,,,3829.49,3829.49,1
HCPCS,33783,NIKAIDOH PROC W/OSTIA IMPLT,,,4139.33,4139.33,1
HCPCS,33783,Nikaidoh proc w/ostia implt,,,7099.16,8967.36,6
HCPCS,337830,NIKAIDOH PROC W/OSTIA IMPLT,,,4139.33,4139.33,1
HCPCS,33786,REPAIR ARTERIAL TRUNK,,,2704.64,2704.64,1
HCPCS,33786,Repair arterial trunk,,,7099.16,8967.36,6
HCPCS,337860,REPAIR ARTERIAL TRUNK,,,2704.64,2704.64,1
HCPCS,33788,REVISION OF PULMONARY ARTERY,,,1822.2,1822.2,1
HCPCS,33788,Revision of pulmonary artery,,,7099.16,8967.36,6
HCPCS,337880,REVISION OF PULMONARY ARTERY,,,1822.2,1822.2,1
HCPCS,3378F,AJCC BRSTCNCR STAGE 3 DOCD,,,0.01,0.01,1
HCPCS,3378F0,AJCC BRSTCNCR STAGE 3 DOCD,,,0.01,0.01,1
HCPCS,33800,AORTIC SUSPENSION,,,1173.1,1173.1,1
HCPCS,33800,Aortic suspension,,,5148.42,6503.27,6
HCPCS,338000,AORTIC SUSPENSION,,,1173.1,1173.1,1
HCPCS,33802,DIVISION ABERRANT VESSEL,,,1293.42,1293.42,1
HCPCS,33802,Division aberrant vessel,,,5148.42,6503.27,6
HCPCS,338020,DIVISION ABERRANT VESSEL,,,1293.42,1293.42,1
HCPCS,33803,DIV ABERRANT VSL W/REANAST,,,1368.93,1368.93,1
HCPCS,33803,Div aberrant vsl w/reanast,,,5148.42,6503.27,6
HCPCS,338030,DIV ABERRANT VSL W/REANAST,,,1368.93,1368.93,1
HCPCS,3380F,AJCC BRSTCNCR STAGE 4 DOCD,,,0.01,0.01,1
HCPCS,3380F0,AJCC BRSTCNCR STAGE 4 DOCD,,,0.01,0.01,1
HCPCS,33813,OBLTRJ AORTOPULMONARY SEPTAL DEFECT W/O BYPASS,7830.0,5089.5,1153.06,7830.0,19
HCPCS,33813,Repair septal defect,,,5148.42,6503.27,6
HCPCS,33814,OBLTRJ A-PULM SEP DEF W/BYP,,,1814.37,1814.37,1
HCPCS,33814,OBLTRJ AORTOPULMONARY SEPTAL DFCT W/CARD BYPASS,10628.0,6908.2,1156.36,10628.0,35
HCPCS,33814,Obltrj a-pulm sep def w/byp,,,5148.42,6503.27,6
HCPCS,338140,OBLTRJ A-PULM SEP DEF W/BYP,,,1814.37,1814.37,1
HCPCS,33820,REPAIR PATENT DUCTUS ARTERIOSUS LIGATION,6676.0,4339.4,735.08,6676.0,35
HCPCS,33820,REPAIR PDA BY LIGATION,,,1151.53,1151.53,1
HCPCS,33820,Repair pda by ligation,,,5148.42,6503.27,6
HCPCS,338200,REPAIR PDA BY LIGATION,,,1151.53,1151.53,1
HCPCS,33822,REPAIR PDA DIV<18 YEARS,,,1214.37,1214.37,1
HCPCS,33822,Repair pda div<18 years,,,5148.42,6503.27,6
HCPCS,338220,REPAIR PDA DIV<18 YEARS,,,1214.37,1214.37,1
HCPCS,33824,REPAIR PDA DIV 18 YRS&OLDER,,,1406.62,1406.62,1
HCPCS,33824,Repair pda div 18 yrs&older,,,5148.42,6503.27,6
HCPCS,338240,REPAIR PDA DIV 18 YRS&OLDER,,,1406.62,1406.62,1
HCPCS,3382F,AJCC CLN CNCR STAGE 0 DOCD,,,0.01,0.01,1
HCPCS,3382F0,AJCC CLN CNCR STAGE 0 DOCD,,,0.01,0.01,1
HCPCS,33840,EXC COA W/DIRECT ANASTOMOSIS,,,1475.5,1475.5,1
HCPCS,33840,Exc coa w/direct anastomosis,,,5148.42,6503.27,6
HCPCS,338400,EXC COA W/DIRECT ANASTOMOSIS,,,1475.5,1475.5,1
HCPCS,33845,EXCISION COA W/GRAFT,,,1589.37,1589.37,1
HCPCS,33845,EXCISION COARCTATION AORTA W/WO PDA W/GRAFT,9172.0,5961.8,1014.91,9172.0,35
HCPCS,33845,Excision coa w/graft,,,5148.42,6503.27,6
HCPCS,338450,EXCISION COA W/GRAFT,,,1589.37,1589.37,1
HCPCS,3384F,AJCC CLN CNCR STAGE 1 DOCD,,,0.01,0.01,1
HCPCS,3384F0,AJCC CLN CNCR STAGE 1 DOCD,,,0.01,0.01,1
HCPCS,33851,EXC COA RPR L SUBCL ART/PRST,,,1515.64,1515.64,1
HCPCS,33851,EXC COARCJ AORTA W/L SUBCLAV ART/PROSTC GUSSET,8792.0,5714.8,967.42,8792.0,35
HCPCS,33851,Exc coa rpr l subcl art/prst,,,5148.42,6503.27,6
HCPCS,338510,EXC COA RPR L SUBCL ART/PRST,,,1515.64,1515.64,1
HCPCS,33852,RPR HYPOPL A-ARCH WO BYP,,,1666.07,1666.07,1
HCPCS,33852,Rpr hypopl a-arch wo byp,,,5148.42,6503.27,6
HCPCS,338520,RPR HYPOPL A-ARCH WO BYP,,,1666.07,1666.07,1
HCPCS,33853,RPR HYPOPL A-ARCH W/BYP,,,2180.9,2180.9,1
HCPCS,33853,Rpr hypopl a-arch w/byp,,,5148.42,6503.27,6
HCPCS,338530,RPR HYPOPL A-ARCH W/BYP,,,2180.9,2180.9,1
HCPCS,33858,AS-AORT GRF F/AORTIC DSJ,,,4020.38,4020.38,1
HCPCS,33858,AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION,22996.5,14947.725,1940.0,25360.0,63
HCPCS,338580,AS-AORT GRF F/AORTIC DSJ,,,4020.38,4020.38,1
HCPCS,33859,AS-AORT GRF F/DS OTH/THN DSJ,,,2887.77,2887.77,1
HCPCS,33859,AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ,18052.0,11733.8,1831.95,18052.0,31
HCPCS,33859,As-aort grf f/ds oth/thn dsj,,,5148.42,6503.27,6
HCPCS,338590,AS-AORT GRF F/DS OTH/THN DSJ,,,2887.77,2887.77,1
HCPCS,33863,AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT,23516.0,15285.4,1947.56,23516.0,35
HCPCS,33863,ASCENDING AORTIC GRAFT,,,3726.42,3726.42,1
HCPCS,33863,Ascending aortic graft,,,5148.42,6503.27,6
HCPCS,338630,ASCENDING AORTIC GRAFT,,,3726.42,3726.42,1
HCPCS,33864,ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL,24032.0,15620.8,2000.23,24032.0,35
HCPCS,33864,ASCENDING AORTIC GRAFT,,,3806.36,3806.36,1
HCPCS,33864,Ascending aortic graft,,,5148.42,6503.27,6
HCPCS,338640,ASCENDING AORTIC GRAFT,,,3806.36,3806.36,1
HCPCS,33866,AORTIC HEMIARCH GRAFT,,,1089.59,1089.59,1
HCPCS,33866,AORTIC HEMIARCH GRAFT W/ISOL & CTRL ARCH VESSELS,7810.0,5076.5,688.87,7810.0,31
HCPCS,33866,Aortic hemiarch graft,,,5148.42,6503.27,6
HCPCS,338660,AORTIC HEMIARCH GRAFT,,,1089.59,1089.59,1
HCPCS,3386F,AJCC CLN CNCR STAGE 2 DOCD,,,0.01,0.01,1
HCPCS,3386F0,AJCC CLN CNCR STAGE 2 DOCD,,,0.01,0.01,1
HCPCS,33871,TRANSVRS A-ARCH GRF HYPTHRM,,,3857.77,3857.77,1
HCPCS,33871,TRANSVRS A-ARCH GRF W/CARD BYP PRFD HYPOTHERMIA,24352.0,15828.8,2441.92,24352.0,31
HCPCS,33871,Transvrs a-arch grf hypthrm,,,5148.42,6503.27,6
HCPCS,338710,TRANSVRS A-ARCH GRF HYPTHRM,,,3857.77,3857.77,1
HCPCS,33875,DESCENDING THORACIC AORTA GRAFT W/WO BYPASS,20288.0,13187.2,1756.61,20288.0,35
HCPCS,33875,THORACIC AORTIC GRAFT,,,3253.29,3253.29,1
HCPCS,33875,Thoracic aortic graft,,,5148.42,6503.27,6
HCPCS,338750,THORACIC AORTIC GRAFT,,,3253.29,3253.29,1
HCPCS,33877,RPR THORACOABDOMINAL AORTIC ANEURYS W/WO BYPASS,27612.0,17947.8,2375.33,27612.0,35
HCPCS,33877,THORACOABDOMINAL GRAFT,,,4279.64,4279.64,1
HCPCS,33877,Thoracoabdominal graft,,,5148.42,6503.27,6
HCPCS,338770,THORACOABDOMINAL GRAFT,,,4279.64,4279.64,1
HCPCS,33880,EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH,14785.5,9610.575,1306.7,18285.0,67
HCPCS,33880,EVASC RPR TA NDGFT COV LSA,,,2119.01,2119.01,1
HCPCS,338800,EVASC RPR TA NDGFT COV LSA,,,2119.01,2119.01,1
HCPCS,33881,EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN,11832.0,7690.8,1121.84,11832.0,35
HCPCS,33881,EVASC RPR TA NDGFT XCOV LSA,,,1819.66,1819.66,1
HCPCS,33881,Evasc rpr ta ndgft xcov lsa,,,8579.14,10836.8,6
HCPCS,338810,EVASC RPR TA NDGFT XCOV LSA,,,1819.66,1819.66,1
HCPCS,33882,EVASC RPR TA DPLMNT BRNCHD NDGFT MULTIPIECE SYS,15400.0,10010.0,1994.81,15400.0,21
HCPCS,33882,EVASC RPR TA DPLMT MLTPC SYS,,,2138.4,2138.4,1
HCPCS,33882,Evasc rpr ta dplmt mltpc sys,,,8579.14,10836.8,6
HCPCS,338820,EVASC RPR TA DPLMT MLTPC SYS,,,2138.4,2138.4,1
HCPCS,33883,DELAYED PLMT PROX XTN PROSTH,,,1318.58,1318.58,1
HCPCS,33883,Delayed plmt prox xtn prosth,,,8579.14,10836.8,6
HCPCS,33883,PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN,8436.0,5483.4,829.27,8436.0,35
HCPCS,338830,DELAYED PLMT PROX XTN PROSTH,,,1318.58,1318.58,1
HCPCS,33884,Endovasc prosth taa add-on,,,8579.14,10836.8,6
HCPCS,33886,DELAYED PLMT DSTL XTN PROSTH,,,1138.2,1138.2,1
HCPCS,33886,Delayed plmt dstl xtn prosth,,,8579.14,10836.8,6
HCPCS,33886,PLMT DSTL XTN PROSTH DLYD AFTER EVASC RPR DTA,7236.0,4703.4,715.6,7236.0,35
HCPCS,338860,DELAYED PLMT DSTL XTN PROSTH,,,1138.2,1138.2,1
HCPCS,33889,Artery transpose/endovas taa,,,5148.42,6503.27,6
HCPCS,3388F,AJCC CLN CNCR STAGE 3 DOCD,,,0.01,0.01,1
HCPCS,3388F0,AJCC CLN CNCR STAGE 3 DOCD,,,0.01,0.01,1
HCPCS,33891,Car-car bp grft/endovas taa,,,3216.6,4063.07,6
HCPCS,33894,EVASC ST RPR COARCJ THRC/AA ACRS MAJ SIDE BRNCH,6399.0,4159.35,1075.03,37851.0,39
HCPCS,33894,EVASC ST RPR THRC/AA ACRS BR,,,1159.66,1159.66,1
HCPCS,338940,EVASC ST RPR THRC/AA ACRS BR,,,1159.66,1159.66,1
HCPCS,33895,EVASC ST RPR COARCJ THRC/AA XCRSG MAJ SIDE BRNCH,28474.0,18508.1,892.74,37851.0,39
HCPCS,33895,EVASC ST RPR THRC/AA X CRSG,,,922.97,922.97,1
HCPCS,338950,EVASC ST RPR THRC/AA X CRSG,,,922.97,922.97,1
HCPCS,33897,PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECR COA,8410.0,5466.5,663.5,37851.0,39
HCPCS,33897,PERQ TRLUML ANGP NT/RECR COA,,,685.84,685.84,1
HCPCS,338970,PERQ TRLUML ANGP NT/RECR COA,,,685.84,685.84,1
HCPCS,33900,PERQ P-ART REVSC 1 NM NT UNI,,,683.75,683.75,1
HCPCS,33900,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,42961.0,27924.65,113.21,73359.0,154
HCPCS,339000,PERQ P-ART REVSC 1 NM NT UNI,,,683.75,683.75,1
HCPCS,33901,PERQ P-ART REVSC 1 NM NT BI,,,898.66,898.66,1
HCPCS,33901,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,43655.0,28375.75,148.92,73359.0,154
HCPCS,339010,PERQ P-ART REVSC 1 NM NT BI,,,898.66,898.66,1
HCPCS,33902,PERQ P-ART REVSC 1 ABNOR UNI,,,867.59,867.59,1
HCPCS,33902,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,67332.0,43765.8,143.68,116157.6,154
HCPCS,339020,PERQ P-ART REVSC 1 ABNOR UNI,,,867.59,867.59,1
HCPCS,33903,PERQ P-ART REVSC 1 ABNOR BI,,,1022.37,1022.37,1
HCPCS,33903,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,44055.0,28635.75,169.52,73359.0,154
HCPCS,339030,PERQ P-ART REVSC 1 ABNOR BI,,,1022.37,1022.37,1
HCPCS,33904,PERQ P-ART REVSC EACH ADDL,,,343.53,343.53,1
HCPCS,33904,PERQ P-ART REVSC ST EA ADDL VSL/SEP LES NM/ABNL,2212.0,1437.8,56.89,2212.0,31
HCPCS,33904,Perq p-art revsc each addl,,,5298.24,6692.51,6
HCPCS,339040,PERQ P-ART REVSC EACH ADDL,,,343.53,343.53,1
HCPCS,3390F,AJCC CLN CNCR STAGE 4 DOCD,,,0.01,0.01,1
HCPCS,3390F0,AJCC CLN CNCR STAGE 4 DOCD,,,0.01,0.01,1
HCPCS,33910,PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS,19284.0,12534.6,1268.35,19284.0,35
HCPCS,33910,REMOVE LUNG ARTERY EMBOLI,,,3089.07,3089.07,1
HCPCS,33910,Remove lung artery emboli,,,5148.42,6503.27,6
HCPCS,339100,REMOVE LUNG ARTERY EMBOLI,,,3089.07,3089.07,1
HCPCS,33915,PULMONARY ARTERY EMBOLECTOMY W/O CARD BYPASS,9980.0,6487.0,929.63,9980.0,35
HCPCS,33915,REMOVE LUNG ARTERY EMBOLI,,,1625.94,1625.94,1
HCPCS,33915,Remove lung artery emboli,,,5148.42,6503.27,6
HCPCS,339150,REMOVE LUNG ARTERY EMBOLI,,,1625.94,1625.94,1
HCPCS,33916,PULMONARY ENDARTERCOMY W/WO EMBOLECTOMY W/BYPASS,31200.0,20280.0,2011.02,31200.0,35
HCPCS,33916,SURGERY OF GREAT VESSEL,,,4936.98,4936.98,1
HCPCS,33916,Surgery of great vessel,,,5148.42,6503.27,6
HCPCS,339160,SURGERY OF GREAT VESSEL,,,4936.98,4936.98,1
HCPCS,33917,REPAIR PULMONARY ARTERY,,,1735.7,1735.7,1
HCPCS,33917,RPR PULMONARY ART STENOSIS RCNSTJ W/PATCH/GRAFT,10120.0,6578.0,1106.32,10120.0,35
HCPCS,33917,Repair pulmonary artery,,,5148.42,6503.27,6
HCPCS,339170,REPAIR PULMONARY ARTERY,,,1735.7,1735.7,1
HCPCS,33920,REPAIR PULMONARY ATRESIA,,,2150.26,2150.26,1
HCPCS,33920,Repair pulmonary atresia,,,7099.16,8967.36,6
HCPCS,339200,REPAIR PULMONARY ATRESIA,,,2150.26,2150.26,1
HCPCS,33922,TRANSECT PULMONARY ARTERY,,,1654.72,1654.72,1
HCPCS,33922,TRANSECTION PULMONARY ARTERY W/CARD BYPASS,9688.0,6297.2,1053.98,9688.0,35
HCPCS,33922,Transect pulmonary artery,,,5148.42,6503.27,6
HCPCS,339220,TRANSECT PULMONARY ARTERY,,,1654.72,1654.72,1
HCPCS,33924,LIG&TKDN SYSIC-TO-PULM ART SHUNT W/CGEN HEART,2196.0,1427.4,213.96,2196.0,35
HCPCS,33924,REMOVE PULMONARY SHUNT,,,338.16,338.16,1
HCPCS,33924,Remove pulmonary shunt,,,7099.16,8967.36,6
HCPCS,339240,REMOVE PULMONARY SHUNT,,,338.16,338.16,1
HCPCS,33925,RPR PUL ART UNIFOCAL W/O CPB,,,2038.72,2038.72,1
HCPCS,33925,Rpr pul art unifocal w/o cpb,,,5148.42,6503.27,6
HCPCS,339250,RPR PUL ART UNIFOCAL W/O CPB,,,2038.72,2038.72,1
HCPCS,33926,REPR PUL ART UNIFOCAL W/CPB,,,2868.76,2868.76,1
HCPCS,33926,Repr pul art unifocal w/cpb,,,5148.42,6503.27,6
HCPCS,339260,REPR PUL ART UNIFOCAL W/CPB,,,2868.76,2868.76,1
HCPCS,33927,IMPLTJ TOT RPLCMT HRT SYS,,,3024.7,3024.7,1
HCPCS,33927,IMPLTJ TOTAL RPLCMT HEART SYS W/RCP CARDIECTOMY,19600.0,12740.0,1977.58,19600.0,28
HCPCS,33927,Impltj tot rplcmt hrt sys,,,7099.16,8967.36,6
HCPCS,339270,IMPLTJ TOT RPLCMT HRT SYS,,,3024.7,3024.7,1
HCPCS,33928,REMOVAL & RPLCMT TOTAL RPLCMT HEART SYS,20031.0,13020.15,6835.08,20031.0,13
HCPCS,33928,RMVL & RPLCMT TOT HRT SYS,,,3469.36,3469.36,1
HCPCS,33928,Rmvl & rplcmt tot hrt sys,,,7099.16,8967.36,6
HCPCS,339280,RMVL & RPLCMT TOT HRT SYS,,,3469.36,3469.36,1
HCPCS,33929,REMOVAL TOTAL RPLCMT HEART SYS FOR HEART TRNSPL,27438.0,17834.7,2558.01,27438.0,13
HCPCS,33929,RMVL RPLCMT HRT SYS F/TRNSPL,,,1775.55,1775.55,1
HCPCS,33929,Rmvl rplcmt hrt sys f/trnspl,,,7099.16,8967.36,6
HCPCS,339290,RMVL RPLCMT HRT SYS F/TRNSPL,,,1775.55,1775.55,1
HCPCS,33930,REMOVAL OF DONOR HEART/LUNG,,,2068.5,2068.5,1
HCPCS,33930,Removal of donor heart/lung,,,3411.14,4308.8,6
HCPCS,339300,REMOVAL OF DONOR HEART/LUNG,,,2068.5,2068.5,1
HCPCS,33933,PREPARE DONOR HEART/LUNG,,,502.65,502.65,1
HCPCS,33933,Prepare donor heart/lung,,,3411.14,4308.8,6
HCPCS,339330,PREPARE DONOR HEART/LUNG,,,502.65,502.65,1
HCPCS,33935,TRANSPLANTATION HEART/LUNG,,,5820.72,5820.72,1
HCPCS,33935,Transplantation heart/lung,,,3411.14,4308.8,6
HCPCS,339350,TRANSPLANTATION HEART/LUNG,,,5820.72,5820.72,1
HCPCS,33940,REMOVAL OF DONOR HEART,,,1944.0,1944.0,1
HCPCS,33940,Removal of donor heart,,,3411.14,4308.8,6
HCPCS,339400,REMOVAL OF DONOR HEART,,,1944.0,1944.0,1
HCPCS,33944,BKBENCH PREPJ CADAVER DONOR HEART ALLOGRAFT,6741.0,4381.65,114.02,6741.0,14
HCPCS,33944,PREPARE DONOR HEART,,,392.42,392.42,1
HCPCS,33944,Prepare donor heart,,,3411.14,4308.8,6
HCPCS,339440,PREPARE DONOR HEART,,,392.42,392.42,1
HCPCS,33945,HEART TRANSPLANT W/WO REC CARDIECTOMY,35800.0,23270.0,2456.48,35800.0,35
HCPCS,33945,TRANSPLANTATION OF HEART,,,5763.03,5763.03,1
HCPCS,33945,Transplantation of heart,,,3411.14,4308.8,6
HCPCS,339450,TRANSPLANTATION OF HEART,,,5763.03,5763.03,1
HCPCS,33946,ECMO/ECLS INITIATION VENO-VENOUS,2879.5,1871.675,232.35,18285.0,63
HCPCS,33946,ECMO/ECLS INITIATION VENOUS,,,366.97,366.97,1
HCPCS,339460,ECMO/ECLS INITIATION VENOUS,,,366.97,366.97,1
HCPCS,33947,ECMO/ECLS INITIATION ARTERY,,,406.24,406.24,1
HCPCS,33947,ECMO/ECLS INITIATION VENO-ARTERIAL,3181.5,2067.975,257.62,18285.0,63
HCPCS,339470,ECMO/ECLS INITIATION ARTERY,,,406.24,406.24,1
HCPCS,33948,ECMO/ECLS DAILY MANAGEMENT EACH DAY VENO-VENOUS,2081.0,1352.65,179.75,2081.0,31
HCPCS,33948,ECMO/ECLS DAILY MGMT-VENOUS,,,281.48,281.48,1
HCPCS,33948,Ecmo/ecls daily mgmt-venous,,,4792.23,6053.34,6
HCPCS,339480,ECMO/ECLS DAILY MGMT-VENOUS,,,281.48,281.48,1
HCPCS,33949,ECMO/ECLS DAILY MANAGEMENT EA DAY VENO-ARTERIAL,1840.0,1196.0,175.41,1840.0,31
HCPCS,33949,ECMO/ECLS DAILY MGMT ARTERY,,,275.09,275.09,1
HCPCS,33949,Ecmo/ecls daily mgmt artery,,,4792.23,6053.34,6
HCPCS,339490,ECMO/ECLS DAILY MGMT ARTERY,,,275.09,275.09,1
HCPCS,3394F,QUANT HER2 IHC EVAL BRST CX,,,0.01,0.01,1
HCPCS,3394F0,QUANT HER2 IHC EVAL BRST CX,,,0.01,0.01,1
HCPCS,33951,ECMO/ECLS INSJ PRPH CANNULA,,,498.68,498.68,1
HCPCS,33951,Ecmo/ecls insj prph cannula,,,4792.23,6053.34,6
HCPCS,339510,ECMO/ECLS INSJ PRPH CANNULA,,,498.68,498.68,1
HCPCS,33952,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ,3300.5,2145.325,306.0,18285.0,63
HCPCS,33952,ECMO/ECLS INSJ PRPH CANNULA,,,505.62,505.62,1
HCPCS,339520,ECMO/ECLS INSJ PRPH CANNULA,,,505.62,505.62,1
HCPCS,33953,ECMO/ECLS INSJ PRPH CANNULA,,,557.1,557.1,1
HCPCS,33953,Ecmo/ecls insj prph cannula,,,4792.23,6053.34,6
HCPCS,339530,ECMO/ECLS INSJ PRPH CANNULA,,,557.1,557.1,1
HCPCS,33954,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER OPEN,3644.0,2368.6,340.77,3644.0,31
HCPCS,33954,ECMO/ECLS INSJ PRPH CANNULA,,,563.79,563.79,1
HCPCS,33954,Ecmo/ecls insj prph cannula,,,4792.23,6053.34,6
HCPCS,339540,ECMO/ECLS INSJ PRPH CANNULA,,,563.79,563.79,1
HCPCS,33955,ECMO/ECLS INSJ CTR CANNULA,,,975.91,975.91,1
HCPCS,33955,Ecmo/ecls insj ctr cannula,,,4792.23,6053.34,6
HCPCS,339550,ECMO/ECLS INSJ CTR CANNULA,,,975.91,975.91,1
HCPCS,33956,ECMO/ECLS INSJ CTR CANNULA,,,990.95,990.95,1
HCPCS,33956,ECMO/ECLS INSJ OF CENTRAL CANNULA 6 YRS & OLDER,6400.0,4160.0,624.52,6400.0,31
HCPCS,33956,Ecmo/ecls insj ctr cannula,,,4792.23,6053.34,6
HCPCS,339560,ECMO/ECLS INSJ CTR CANNULA,,,990.95,990.95,1
HCPCS,33957,ECMO/ECLS REPOS PERPH CNULA,,,216.93,216.93,1
HCPCS,33957,Ecmo/ecls repos perph cnula,,,4792.23,6053.34,6
HCPCS,339570,ECMO/ECLS REPOS PERPH CNULA,,,216.93,216.93,1
HCPCS,33958,ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER,1404.0,912.6,137.88,1404.0,31
HCPCS,33958,ECMO/ECLS REPOS PERPH CNULA,,,216.93,216.93,1
HCPCS,33958,Ecmo/ecls repos perph cnula,,,4792.23,6053.34,6
HCPCS,339580,ECMO/ECLS REPOS PERPH CNULA,,,216.93,216.93,1
HCPCS,33959,ECMO/ECLS REPOS PERPH CNULA,,,276.56,276.56,1
HCPCS,33959,Ecmo/ecls repos perph cnula,,,4792.23,6053.34,6
HCPCS,339590,ECMO/ECLS REPOS PERPH CNULA,,,276.56,276.56,1
HCPCS,3395F,QUANT NONHER2 IHC BRST CX,,,0.01,0.01,1
HCPCS,3395F0,QUANT NONHER2 IHC BRST CX,,,0.01,0.01,1
HCPCS,33962,ECMO/ECLS REPOS PERPH CANNULA OPEN 6 YRS & OLDER,1788.0,1162.2,174.9,1788.0,31
HCPCS,33962,ECMO/ECLS REPOS PERPH CNULA,,,276.56,276.56,1
HCPCS,33962,Ecmo/ecls repos perph cnula,,,4792.23,6053.34,6
HCPCS,339620,ECMO/ECLS REPOS PERPH CNULA,,,276.56,276.56,1
HCPCS,33963,ECMO/ECLS REPOS PERPH CNULA,,,550.63,550.63,1
HCPCS,33963,Ecmo/ecls repos perph cnula,,,4792.23,6053.34,6
HCPCS,339630,ECMO/ECLS REPOS PERPH CNULA,,,550.63,550.63,1
HCPCS,33964,ECMO/ECLS ECLS REPOS CENTRAL CNULA 6YRS & OLDER,3800.0,2470.0,367.16,3800.0,31
HCPCS,33964,ECMO/ECLS REPOS PERPH CNULA,,,581.43,581.43,1
HCPCS,33964,Ecmo/ecls repos perph cnula,,,4792.23,6053.34,6
HCPCS,339640,ECMO/ECLS REPOS PERPH CNULA,,,581.43,581.43,1
HCPCS,33965,ECMO/ECLS RMVL PERPH CANNULA,,,216.93,216.93,1
HCPCS,33965,Ecmo/ecls rmvl perph cannula,,,4792.23,6053.34,6
HCPCS,339650,ECMO/ECLS RMVL PERPH CANNULA,,,216.93,216.93,1
HCPCS,33966,ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER,2261.0,1469.65,177.45,18285.0,63
HCPCS,33966,ECMO/ECLS RMVL PRPH CANNULA,,,280.72,280.72,1
HCPCS,339660,ECMO/ECLS RMVL PRPH CANNULA,,,280.72,280.72,1
HCPCS,33967,INSERT I-AORT PERCUT DEVICE,,,305.83,305.83,1
HCPCS,33967,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,2929.5,1904.175,188.21,46695.0,167
HCPCS,339670,INSERT I-AORT PERCUT DEVICE,,,305.83,305.83,1
HCPCS,33968,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,995.0,646.75,25.53,46695.0,138
HCPCS,33968,REMOVE AORTIC ASSIST DEVICE,,,39.99,39.99,1
HCPCS,339680,REMOVE AORTIC ASSIST DEVICE,,,39.99,39.99,1
HCPCS,33969,ECMO/ECLS RMVL PERPH CANNULA,,,321.16,321.16,1
HCPCS,33969,Ecmo/ecls rmvl perph cannula,,,4792.23,6053.34,6
HCPCS,339690,ECMO/ECLS RMVL PERPH CANNULA,,,321.16,321.16,1
HCPCS,33970,AORTIC CIRCULATION ASSIST,,,417.54,417.54,1
HCPCS,33970,Aortic circulation assist,,,5148.42,6503.27,6
HCPCS,33970,INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN,2696.0,1752.4,264.26,2696.0,35
HCPCS,339700,AORTIC CIRCULATION ASSIST,,,417.54,417.54,1
HCPCS,33971,AORTIC CIRCULATION ASSIST,,,839.51,839.51,1
HCPCS,33971,Aortic circulation assist,,,5148.42,6503.27,6
HCPCS,33971,RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF,4796.0,3117.4,397.66,4796.0,35
HCPCS,339710,AORTIC CIRCULATION ASSIST,,,839.51,839.51,1
HCPCS,33973,INSERT BALLOON DEVICE,,,591.49,591.49,1
HCPCS,33973,INSJ I-AORT BALO ASSIST DEV VIA ASCENDING AORTA,3900.0,2535.0,374.31,3900.0,35
HCPCS,33973,Insert balloon device,,,5148.42,6503.27,6
HCPCS,339730,INSERT BALLOON DEVICE,,,591.49,591.49,1
HCPCS,33974,REMOVE INTRA-AORTIC BALLOON,,,1054.53,1054.53,1
HCPCS,33974,Remove intra-aortic balloon,,,5148.42,6503.27,6
HCPCS,339740,REMOVE INTRA-AORTIC BALLOON,,,1054.53,1054.53,1
HCPCS,33975,IMPLANT VENTRICULAR DEVICE,,,1546.03,1546.03,1
HCPCS,33975,INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE,10000.0,6500.0,978.66,10000.0,35
HCPCS,33975,Implant ventricular device,,,18442.86,23296.25,6
HCPCS,339750,IMPLANT VENTRICULAR DEVICE,,,1546.03,1546.03,1
HCPCS,33976,IMPLANT VENTRICULAR DEVICE,,,1867.83,1867.83,1
HCPCS,33976,INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR,12300.0,7995.0,1169.06,12300.0,35
HCPCS,33976,Implant ventricular device,,,18442.86,23296.25,6
HCPCS,339760,IMPLANT VENTRICULAR DEVICE,,,1867.83,1867.83,1
HCPCS,33977,REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE,8344.0,5423.6,845.12,8344.0,35
HCPCS,33977,REMOVE VENTRICULAR DEVICE,,,1329.59,1329.59,1
HCPCS,33977,Remove ventricular device,,,4041.02,5104.45,6
HCPCS,339770,REMOVE VENTRICULAR DEVICE,,,1329.59,1329.59,1
HCPCS,33978,REMOVAL VENTR ASSIST DEVICE XTRCORP BIVENTR,10000.0,6500.0,958.74,10000.0,35
HCPCS,33978,REMOVE VENTRICULAR DEVICE,,,1568.68,1568.68,1
HCPCS,33978,Remove ventricular device,,,4041.02,5104.45,6
HCPCS,339780,REMOVE VENTRICULAR DEVICE,,,1568.68,1568.68,1
HCPCS,33979,INSERT INTRACORPOREAL DEVICE,,,2304.71,2304.71,1
HCPCS,33979,INSJ VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC,15000.0,9750.0,1453.56,15000.0,35
HCPCS,33979,Insert intracorporeal device,,,18442.86,23296.25,6
HCPCS,339790,INSERT INTRACORPOREAL DEVICE,,,2304.71,2304.71,1
HCPCS,33980,REMOVE INTRACORPOREAL DEVICE,,,2113.03,2113.03,1
HCPCS,33980,RMVL VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC,13400.0,8710.0,1711.52,13400.0,32
HCPCS,33980,Remove intracorporeal device,,,4041.02,5104.45,6
HCPCS,339800,REMOVE INTRACORPOREAL DEVICE,,,2113.03,2113.03,1
HCPCS,33981,REPLACE VAD PUMP EXT,,,977.91,977.91,1
HCPCS,33981,REPLACE XTRA CORP VAD BIVENTRICLE PUMP,6444.0,4188.6,529.06,6444.0,35
HCPCS,33981,Replace vad pump ext,,,18442.86,23296.25,6
HCPCS,339810,REPLACE VAD PUMP EXT,,,977.91,977.91,1
HCPCS,33982,PLCMT VAD PMP IMPLTBL ICORP 1 VENTR W/O BYPASS,15144.0,9843.6,619.36,15144.0,35
HCPCS,33982,REPLACE VAD INTRA W/O BP,,,2299.64,2299.64,1
HCPCS,33982,Replace vad intra w/o bp,,,18442.86,23296.25,6
HCPCS,339820,REPLACE VAD INTRA W/O BP,,,2299.64,2299.64,1
HCPCS,33983,REPLACE VAD INTRA W/BP,,,2706.3,2706.3,1
HCPCS,33983,RPLCMT VAD PMP IMPLTBL ICORP 1 VNTR W/BYPASS,17816.0,11580.4,810.23,17816.0,35
HCPCS,33983,Replace vad intra w/bp,,,18442.86,23296.25,6
HCPCS,339830,REPLACE VAD INTRA W/BP,,,2706.3,2706.3,1
HCPCS,33984,ECMO/ECLS RMVL PRPH CANNULA,,,336.36,336.36,1
HCPCS,33984,ECMO/ECLS RMVL PRPH CANNULA OPEN 6 YRS & OLDER,2184.0,1419.6,212.69,2184.0,31
HCPCS,33984,Ecmo/ecls rmvl prph cannula,,,4792.23,6053.34,6
HCPCS,339840,ECMO/ECLS RMVL PRPH CANNULA,,,336.36,336.36,1
HCPCS,33985,ECMO/ECLS RMVL CTR CANNULA,,,604.53,604.53,1
HCPCS,33985,Ecmo/ecls rmvl ctr cannula,,,4792.23,6053.34,6
HCPCS,339850,ECMO/ECLS RMVL CTR CANNULA,,,604.53,604.53,1
HCPCS,33986,ECMO/ECLS RMVL CTR CANNULA,,,620.46,620.46,1
HCPCS,33986,ECMO/ECLS RMVL OF CENTRAL CANNULA 6 YRS & OLDER,4000.0,2600.0,393.45,4000.0,31
HCPCS,33986,Ecmo/ecls rmvl ctr cannula,,,4792.23,6053.34,6
HCPCS,339860,ECMO/ECLS RMVL CTR CANNULA,,,620.46,620.46,1
HCPCS,33987,ARTERY EXPOS/GRAFT ARTERY,,,245.69,245.69,1
HCPCS,33987,ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS,1616.0,1050.4,154.73,1616.0,31
HCPCS,33987,Artery expos/graft artery,,,4792.23,6053.34,6
HCPCS,339870,ARTERY EXPOS/GRAFT ARTERY,,,245.69,245.69,1
HCPCS,33988,INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS,6000.0,3900.0,572.23,6000.0,31
HCPCS,33988,INSERTION OF LEFT HEART VENT,,,915.11,915.11,1
HCPCS,33988,Insertion of left heart vent,,,4792.23,6053.34,6
HCPCS,339880,INSERTION OF LEFT HEART VENT,,,915.11,915.11,1
HCPCS,33989,REMOVAL OF LEFT HEART VENT,,,581.43,581.43,1
HCPCS,33989,RMVL LEFT HEART VENT BY THORACIC INCIS ECMO/ECLS,3800.0,2470.0,367.16,3800.0,31
HCPCS,33989,Removal of left heart vent,,,4792.23,6053.34,6
HCPCS,339890,REMOVAL OF LEFT HEART VENT,,,581.43,581.43,1
HCPCS,33990,INSJ PERQ VAD L HRT ARTERIAL,,,426.21,426.21,1
HCPCS,33990,INSJ PERQ VAD W/IMAGING ARTERY ACCESS ONLY,2970.0,1930.5,269.62,2970.0,31
HCPCS,33990,INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY,9876.0,6419.4,414.73,37851.0,103
HCPCS,339900,INSJ PERQ VAD L HRT ARTERIAL,,,426.21,426.21,1
HCPCS,33991,INSJ PERQ VAD L HRT ARTL&VEN,,,536.77,536.77,1
HCPCS,33991,INSJ PERQ VAD TRNSPTAL W/IMAGE ART&VENOUS ACCESS,3890.0,2528.5,339.07,3890.0,31
HCPCS,33991,INSJ PERQ VAD W/RS&I L HRT ARTERIAL&VEN ACCESS,11880.0,7722.0,548.73,37851.0,39
HCPCS,339910,INSJ PERQ VAD L HRT ARTL&VEN,,,536.77,536.77,1
HCPCS,33992,REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ,3495.0,2271.75,140.68,18285.0,95
HCPCS,33992,RMVL PERQ LEFT HEART VAD,,,222.35,222.35,1
HCPCS,339920,RMVL PERQ LEFT HEART VAD,,,222.35,222.35,1
HCPCS,33993,REPOSG PERQ R/L HRT VAD,,,196.06,196.06,1
HCPCS,33993,REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ,2425.0,1576.25,124.08,18285.0,95
HCPCS,339930,REPOSG PERQ R/L HRT VAD,,,196.06,196.06,1
HCPCS,33995,INSJ PERQ VAD R HRT VENOUS,,,419.52,419.52,1
HCPCS,33995,INSJ PERQ VAD W/RS&I R HEART VENOUS ACCESS ONLY,6140.0,3991.0,265.03,23296.25,63
HCPCS,339950,INSJ PERQ VAD R HRT VENOUS,,,419.52,419.52,1
HCPCS,33997,REMOVAL PERQ R HEART VAD VENOUS CANNULA SEP INSJ,1200.0,780.0,115.11,1200.0,31
HCPCS,33997,RMVL PERQ RIGHT HEART VAD,,,190.67,190.67,1
HCPCS,33997,Rmvl perq right heart vad,,,4041.02,5104.45,6
HCPCS,339970,RMVL PERQ RIGHT HEART VAD,,,190.67,190.67,1
HCPCS,33999,IABP REPOSITION (COMP CODE 33993),3343.0,2172.95,620.6,37851.0,48
HCPCS,33999,LOOP REVISION,4905.0,3188.25,620.6,4414.5,40
HCPCS,33999,MODIFIED MAZE PROCEDURE,3991.0,2594.15,1302.32,3991.0,15
HCPCS,33999,OPEN CAROTID TAVR (COMP CODE 33362),32914.0,21394.1,620.6,29622.6,40
HCPCS,33999,REPLACE TRICUSPID VALVE PERQ,13191.0,8574.15,620.6,11871.9,40
HCPCS,33999,SUBCLAVIAN TRANS-CAROTID TAVR,21984.0,14289.6,620.6,37851.0,48
HCPCS,33999,UNLISTED CARDIAC SURGERY,5158.0,3352.7,620.6,4642.2,40
HCPCS,34001,REMOVAL OF ARTERY CLOT,,,1089.15,1089.15,1
HCPCS,34001,Removal of artery clot,,,2940.84,3714.74,6
HCPCS,340010,REMOVAL OF ARTERY CLOT,,,1089.15,1089.15,1
HCPCS,34051,EMBLC/THRMBC INNOMINATE SUBCLAVIAN ARTERY,6796.0,4417.4,652.53,6796.0,35
HCPCS,34051,REMOVAL OF ARTERY CLOT,,,1175.52,1175.52,1
HCPCS,34051,Removal of artery clot,,,8579.14,10836.8,6
HCPCS,340510,REMOVAL OF ARTERY CLOT,,,1175.52,1175.52,1
HCPCS,34101,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,21612.5,14048.125,448.6,34967.7,77
HCPCS,34101,REMOVAL OF ARTERY CLOT,,,706.8,706.8,1
HCPCS,341010,REMOVAL OF ARTERY CLOT,,,706.8,706.8,1
HCPCS,34111,EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC,4372.0,2841.8,419.51,4372.0,35
HCPCS,34111,REMOVAL OF ARM ARTERY CLOT,,,706.05,11720.45,15
HCPCS,34111,Removal of arm artery clot,,,2357.43,2977.81,6
HCPCS,341110,REMOVAL OF ARM ARTERY CLOT,,,706.05,706.05,1
HCPCS,34151,EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART,10608.0,6895.2,828.06,10608.0,35
HCPCS,34151,REMOVAL OF ARTERY CLOT,,,1651.62,1651.62,1
HCPCS,34151,Removal of artery clot,,,5148.42,6503.27,6
HCPCS,341510,REMOVAL OF ARTERY CLOT,,,1651.62,1651.62,1
HCPCS,34201,EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART,7792.0,5064.8,548.73,7792.0,35
HCPCS,34201,"EMBO/THROM FEM/POP, AORTAILIAC ART",38853.0,25254.45,1215.71,34967.7,42
HCPCS,34201,REMOVAL OF ARTERY CLOT,,,1212.67,1212.67,1
HCPCS,342010,REMOVAL OF ARTERY CLOT,,,1212.67,1212.67,1
HCPCS,34203,EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC,7144.0,4643.6,575.86,7144.0,35
HCPCS,34203,EMBO/THROM POP/TIBIO/PERONEAL ART,38853.0,25254.45,1128.06,34967.7,42
HCPCS,34203,REMOVAL OF LEG ARTERY CLOT,,,1125.57,1125.57,1
HCPCS,342030,REMOVAL OF LEG ARTERY CLOT,,,1125.57,1125.57,1
HCPCS,34401,REMOVAL OF VEIN CLOT,,,1770.36,1770.36,1
HCPCS,34401,Removal of vein clot,,,5148.42,6503.27,6
HCPCS,34401,THRMBC DIR/W/CATH VENA CAVA ILIAC VEIN ABDL INC,10608.0,6895.2,826.3,10608.0,35
HCPCS,344010,REMOVAL OF VEIN CLOT,,,1770.36,1770.36,1
HCPCS,34421,REMOVAL OF VEIN CLOT,,,827.82,6824.3,15
HCPCS,34421,Removal of vein clot,,,2357.43,2977.81,6
HCPCS,34421,THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN LEG INC,5348.0,3476.2,471.29,5348.0,35
HCPCS,344210,REMOVAL OF VEIN CLOT,,,827.82,827.82,1
HCPCS,34451,REMOVAL OF VEIN CLOT,,,1710.68,1710.68,1
HCPCS,34451,Removal of vein clot,,,5148.42,6503.27,6
HCPCS,344510,REMOVAL OF VEIN CLOT,,,1710.68,1710.68,1
HCPCS,34471,REMOVAL OF VEIN CLOT,,,620.6,1340.49,15
HCPCS,34471,Removal of vein clot,,,2357.43,2977.81,6
HCPCS,344710,REMOVAL OF VEIN CLOT,,,1285.31,1285.31,1
HCPCS,34490,REMOVAL OF VEIN CLOT,,,685.07,6824.3,15
HCPCS,34490,Removal of vein clot,,,2357.43,2977.81,6
HCPCS,34490,THRMBC DIR/W/CATH AXILL&SUBCLAVIAN VEIN ARM IN,4364.0,2836.6,401.0,4364.0,35
HCPCS,344900,REMOVAL OF VEIN CLOT,,,685.07,685.07,1
HCPCS,34501,REPAIR VALVE FEMORAL VEIN,,,1065.47,11720.45,15
HCPCS,34501,Repair valve femoral vein,,,2357.43,2977.81,6
HCPCS,345010,REPAIR VALVE FEMORAL VEIN,,,1065.47,1065.47,1
HCPCS,34502,RECONSTRUCT VENA CAVA,,,1836.71,1836.71,1
HCPCS,34502,RECONSTRUCTION VENA CAVA ANY METHOD,11228.0,7298.2,1166.07,11228.0,35
HCPCS,34502,Reconstruct vena cava,,,5148.42,6503.27,6
HCPCS,345020,RECONSTRUCT VENA CAVA,,,1836.71,1836.71,1
HCPCS,3450F,DYSPNEA SCRND NO-MILD DYSP,,,0.01,0.01,1
HCPCS,3450F0,DYSPNEA SCRND NO-MILD DYSP,,,0.01,0.01,1
HCPCS,34510,TRANSPOSITION OF VEIN VALVE,,,1216.33,11720.45,15
HCPCS,34510,Transposition of vein valve,,,2357.43,2977.81,6
HCPCS,34510,VENOUS VALVE TRANSPOSITION ANY VEIN DONOR,7964.0,5176.6,642.6,7964.0,35
HCPCS,345100,TRANSPOSITION OF VEIN VALVE,,,1216.33,1216.33,1
HCPCS,3451F,DYSPNEA SCRND MOD-HIGH DYSP,,,0.01,0.01,1
HCPCS,3451F0,DYSPNEA SCRND MOD-HIGH DYSP,,,0.01,0.01,1
HCPCS,34520,CROSS-OVER VEIN GRAFT,,,1177.58,11720.45,15
HCPCS,34520,CROSS-OVER VEIN GRAFT VENOUS SYSTEM,7672.0,4986.8,592.05,7672.0,35
HCPCS,34520,Cross-over vein graft,,,2357.43,2977.81,6
HCPCS,345200,CROSS-OVER VEIN GRAFT,,,1177.58,1177.58,1
HCPCS,3452F,DYSPNEA NOT SCREENED,,,0.01,0.01,1
HCPCS,3452F0,DYSPNEA NOT SCREENED,,,0.01,0.01,1
HCPCS,34530,LEG VEIN FUSION,,,1120.36,6824.3,15
HCPCS,34530,Leg vein fusion,,,2357.43,2977.81,6
HCPCS,345300,LEG VEIN FUSION,,,1120.36,1120.36,1
HCPCS,3455F,TB SCR PFRMD&INTERPD 6 MO,,,0.01,0.01,1
HCPCS,3455F0,TB SCR PFRMD&INTERPD 6 MO,,,0.01,0.01,1
HCPCS,34701,EVASC RPR A-AO NDGFT,,,1463.29,1463.29,1
HCPCS,34701,EVASC RPR DPLMNT AORTO-AORTIC NDGFT,23350.0,15177.5,925.55,33494.4,63
HCPCS,347010,EVASC RPR A-AO NDGFT,,,1463.29,1463.29,1
HCPCS,34702,EVASC RPR A-AO NDGFT RPT,,,2189.1,2189.1,1
HCPCS,34702,EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT,11248.5,7311.525,1341.98,18285.0,63
HCPCS,347020,EVASC RPR A-AO NDGFT RPT,,,2189.1,2189.1,1
HCPCS,34703,EVASC RPR A-UNILAC NDGFT,,,1626.43,1626.43,1
HCPCS,34703,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT,15202.0,9881.3,1025.64,18285.0,63
HCPCS,347030,EVASC RPR A-UNILAC NDGFT,,,1626.43,1626.43,1
HCPCS,34704,EVASC RPR A-UNILAC NDGFT RPT,,,2714.87,2714.87,1
HCPCS,34704,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT RPT,18898.0,12283.7,1704.03,18285.0,63
HCPCS,347040,EVASC RPR A-UNILAC NDGFT RPT,,,2714.87,2714.87,1
HCPCS,34705,EVAC RPR A-BIILIAC NDGFT,,,1808.94,1808.94,1
HCPCS,34705,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT,38065.0,24742.25,1139.77,34259.4,95
HCPCS,347050,EVAC RPR A-BIILIAC NDGFT,,,1808.94,1808.94,1
HCPCS,34706,EVASC RPR A-BIILIAC RPT,,,2700.67,2700.67,1
HCPCS,34706,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT,18898.0,12283.7,1701.74,18285.0,63
HCPCS,347060,EVASC RPR A-BIILIAC RPT,,,2700.67,2700.67,1
HCPCS,34707,EVASC RPR DPLMNT ILIO-ILIAC NDGFT,14354.5,9330.425,869.63,18285.0,63
HCPCS,34707,EVASC RPR ILIO-ILIAC NDGFT,,,1374.75,1374.75,1
HCPCS,347070,EVASC RPR ILIO-ILIAC NDGFT,,,1374.75,1374.75,1
HCPCS,34708,EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT,17198.0,11178.7,1359.86,18285.0,63
HCPCS,34708,EVASC RPR ILIO-ILIAC RPT,,,2163.84,2163.84,1
HCPCS,347080,EVASC RPR ILIO-ILIAC RPT,,,2163.84,2163.84,1
HCPCS,34709,PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR,7714.0,5014.1,240.0,18285.0,63
HCPCS,34709,PLMT XTN PROSTH EVASC RPR,,,382.15,382.15,1
HCPCS,347090,PLMT XTN PROSTH EVASC RPR,,,382.15,382.15,1
HCPCS,3470F,RA DISEASE ACTIVITY LOW,,,0.01,0.01,1
HCPCS,3470F0,RA DISEASE ACTIVITY LOW,,,0.01,0.01,1
HCPCS,34710,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL,9414.0,6119.1,595.93,18285.0,63
HCPCS,34710,DLYD PLMT XTN PROSTH 1ST VSL,,,942.8,942.8,1
HCPCS,347100,DLYD PLMT XTN PROSTH 1ST VSL,,,942.8,942.8,1
HCPCS,34711,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL,7614.0,4949.1,219.83,18285.0,63
HCPCS,34711,DLYD PLMT XTN PROSTH EA ADDL,,,349.57,349.57,1
HCPCS,347110,DLYD PLMT XTN PROSTH EA ADDL,,,349.57,349.57,1
HCPCS,34712,TCAT DLVR ENHNCD FIXJ DEV,,,774.92,774.92,1
HCPCS,34712,TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I,8814.0,5729.1,490.99,18285.0,63
HCPCS,347120,TCAT DLVR ENHNCD FIXJ DEV,,,774.92,774.92,1
HCPCS,34713,PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT,6525.0,4241.25,91.92,10845.0,62
HCPCS,34713,PERQ ACCESS & CLSR FEM ART,,,146.16,146.16,1
HCPCS,347130,PERQ ACCESS & CLSR FEM ART,,,146.16,146.16,1
HCPCS,34714,OPN FEM ART EXPOS CNDT CRTJ,,,319.33,319.33,1
HCPCS,34714,OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH,12713.0,8263.45,201.45,20993.4,56
HCPCS,347140,OPN FEM ART EXPOS CNDT CRTJ,,,319.33,319.33,1
HCPCS,34715,OPN AX/SUBCLA ART EXPOS,,,354.53,354.53,1
HCPCS,34715,OPN AX/SUBCLA ART EXPOS DLVR EVASC PROSTH UNI,2400.0,1560.0,222.39,2400.0,31
HCPCS,34715,Opn ax/subcla art expos,,,2357.43,2977.81,6
HCPCS,347150,OPN AX/SUBCLA ART EXPOS,,,354.53,354.53,1
HCPCS,34716,OPN AX/SUBCLA ART EXPOS CNDT,,,440.67,440.67,1
HCPCS,34716,OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ,2876.0,1869.4,278.81,2876.0,31
HCPCS,347160,OPN AX/SUBCLA ART EXPOS CNDT,,,440.67,440.67,1
HCPCS,34717,EVASC RPR A-ILIAC NDGFT,,,525.84,525.84,1
HCPCS,34717,EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI,23621.0,15353.65,329.37,38953.8,63
HCPCS,347170,EVASC RPR A-ILIAC NDGFT,,,525.84,525.84,1
HCPCS,34718,EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI,24968.5,16229.525,923.76,35439.3,63
HCPCS,34718,EVASC RPR N/A A-ILIAC NDGFT,,,1467.71,1467.71,1
HCPCS,347180,EVASC RPR N/A A-ILIAC NDGFT,,,1467.71,1467.71,1
HCPCS,3471F,RA DISEASE ACTIVITY MOD,,,0.01,0.01,1
HCPCS,3471F0,RA DISEASE ACTIVITY MOD,,,0.01,0.01,1
HCPCS,3472F,RA DISEASE ACTIVITY HIGH,,,0.01,0.01,1
HCPCS,3472F0,RA DISEASE ACTIVITY HIGH,,,0.01,0.01,1
HCPCS,3475F,DISEASE PROGN RA POOR DOCD,,,0.01,0.01,1
HCPCS,3475F0,DISEASE PROGN RA POOR DOCD,,,0.01,0.01,1
HCPCS,3476F,DISEASE PROGN RA GOOD DOCD,,,0.01,0.01,1
HCPCS,3476F0,DISEASE PROGN RA GOOD DOCD,,,0.01,0.01,1
HCPCS,34808,ENDOVAS ILIAC A DEVICE ADDON,,,240.83,240.83,1
HCPCS,34808,EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE,17538.5,11400.025,150.9,30086.1,67
HCPCS,348080,ENDOVAS ILIAC A DEVICE ADDON,,,240.83,240.83,1
HCPCS,34812,OPN FEM ART EXPOS,,,244.61,244.61,1
HCPCS,34812,OPN FEM ART EXPOS DLVR EVASC PROSTH UNI,12488.5,8117.525,153.45,20992.5,67
HCPCS,348120,OPN FEM ART EXPOS,,,244.61,244.61,1
HCPCS,34813,FEMORAL ENDOVAS GRAFT ADD-ON,,,279.17,279.17,1
HCPCS,34813,Femoral endovas graft add-on,,,8579.14,10836.8,6
HCPCS,34813,PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR,1916.0,1245.4,174.9,1916.0,35
HCPCS,348130,FEMORAL ENDOVAS GRAFT ADD-ON,,,279.17,279.17,1
HCPCS,34820,OPN ILIAC ART EXPOS,,,400.82,400.82,1
HCPCS,34820,OPN ILIAC ART EXPOS PROSTH/ILIAC OCCLS EVASC UNI,2800.0,1820.0,251.49,2800.0,35
HCPCS,34820,Opn iliac art expos,,,8579.14,10836.8,6
HCPCS,348200,OPN ILIAC ART EXPOS,,,400.82,400.82,1
HCPCS,34830,OPEN AORTIC TUBE PROSTH REPR,,,2098.99,2098.99,1
HCPCS,34830,Open aortic tube prosth repr,,,5148.42,6503.27,6
HCPCS,348300,OPEN AORTIC TUBE PROSTH REPR,,,2098.99,2098.99,1
HCPCS,34831,OPEN AORTOILIAC PROSTH REPR,,,2292.81,2292.81,1
HCPCS,34831,OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH,15192.0,9874.8,1430.55,15192.0,35
HCPCS,34831,Open aortoiliac prosth repr,,,5148.42,6503.27,6
HCPCS,348310,OPEN AORTOILIAC PROSTH REPR,,,2292.81,2292.81,1
HCPCS,34832,OPEN AORTOFEMOR PROSTH REPR,,,2256.96,2256.96,1
HCPCS,34832,Open aortofemor prosth repr,,,5148.42,6503.27,6
HCPCS,348320,OPEN AORTOFEMOR PROSTH REPR,,,2256.96,2256.96,1
HCPCS,34833,OPN ILAC ART EXPOS CNDT CRTJ,,,467.78,467.78,1
HCPCS,34833,OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP,3264.0,2121.6,293.11,3264.0,35
HCPCS,348330,OPN ILAC ART EXPOS CNDT CRTJ,,,467.78,467.78,1
HCPCS,34834,OPN BRACH ART EXPOS,,,153.73,153.73,1
HCPCS,34834,"OPN BRACH ART EXPOS PROS, UNLAT",24733.0,16076.45,154.98,22259.7,32
HCPCS,34834,OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI,1166.0,757.9,96.26,1166.0,35
HCPCS,348340,OPN BRACH ART EXPOS,,,153.73,153.73,1
HCPCS,34839,PLNNING PT SPEC FENEST GRAFT,,,291.34,291.34,1
HCPCS,348390,PLNNING PT SPEC FENEST GRAFT,,,291.34,291.34,1
HCPCS,34841,ENDOVASC VISC AORTA 1 GRAFT,,,1792.96,1792.96,1
HCPCS,34841,ENDOVASC VISCER AORTA REPAIR FENEST 1 ENDOGRAFT,12429.0,8078.85,923.01,12429.0,14
HCPCS,34841,Endovasc visc aorta 1 graft,,,8579.14,10836.8,6
HCPCS,348410,ENDOVASC VISC AORTA 1 GRAFT,,,1792.96,1792.96,1
HCPCS,34842,ENDOVASC VISC AORTA 2 GRAFT,,,1962.88,1962.88,1
HCPCS,34842,Endovasc visc aorta 2 graft,,,8579.14,10836.8,6
HCPCS,348420,ENDOVASC VISC AORTA 2 GRAFT,,,1962.88,1962.88,1
HCPCS,34843,ENDOVASC VISC AORTA 3 GRAFT,,,2154.17,2154.17,1
HCPCS,34843,Endovasc visc aorta 3 graft,,,8579.14,10836.8,6
HCPCS,348430,ENDOVASC VISC AORTA 3 GRAFT,,,2154.17,2154.17,1
HCPCS,34844,ENDOVASC VISC AORTA 4 GRAFT,,,2383.78,2383.78,1
HCPCS,34844,Endovasc visc aorta 4 graft,,,8579.14,10836.8,6
HCPCS,348440,ENDOVASC VISC AORTA 4 GRAFT,,,2383.78,2383.78,1
HCPCS,34845,VISC & INFRAREN ABD 1 PROSTH,39377.0,25595.05,1940.0,35439.3,32
HCPCS,348450,VISC & INFRAREN ABD 1 PROSTH,,,2183.38,2183.38,1
HCPCS,34846,VISC & INFRAREN ABD 2 PROSTH,43282.0,28133.3,1940.0,38953.8,32
HCPCS,348460,VISC & INFRAREN ABD 2 PROSTH,,,2456.48,2456.48,1
HCPCS,34847,VISC & INFRAREN ABD 3 PROSTH,47188.0,30672.2,1940.0,42469.2,32
HCPCS,348470,VISC & INFRAREN ABD 3 PROSTH,,,2616.53,2616.53,1
HCPCS,34848,VISC & INFRAREN ABD 4+ PROST,,,2808.97,2808.97,1
HCPCS,34848,VISC & INFRAREN ABD 4+ PROSTH,51094.0,33211.1,1940.0,45984.6,31
HCPCS,34848,VISCER AND INFRARENAL ABDOM AORTA 4+ PROSTHESIS,11885.0,7725.25,3771.56,11885.0,13
HCPCS,348480,VISC & INFRAREN ABD 4+ PROST,,,2808.97,2808.97,1
HCPCS,3490F,HISTORY AIDS-DEFINING COND,,,0.01,0.01,1
HCPCS,3490F0,HISTORY AIDS-DEFINING COND,,,0.01,0.01,1
HCPCS,3491F,HIV UNSURE BABY OF HIV+MOMS,,,0.01,0.01,1
HCPCS,3491F0,HIV UNSURE BABY OF HIV+MOMS,,,0.01,0.01,1
HCPCS,3492F,HISTORY CD4+ CELL COUNT <350,,,0.01,0.01,1
HCPCS,3492F0,HISTORY CD4+ CELL COUNT <350,,,0.01,0.01,1
HCPCS,3493F,NO HIST CD4+ CELL COUNT <350,,,0.01,0.01,1
HCPCS,3493F0,NO HIST CD4+ CELL COUNT <350,,,0.01,0.01,1
HCPCS,3494F,CD4+CELL COUNT <200CELLS/MM3,,,0.01,0.01,1
HCPCS,3494F0,CD4+CELL COUNT <200CELLS/MM3,,,0.01,0.01,1
HCPCS,3495F,CD4+CELL CNT 200-499 CELLS,,,0.01,0.01,1
HCPCS,3495F0,CD4+CELL CNT 200-499 CELLS,,,0.01,0.01,1
HCPCS,3496F,CD4+ CELL COUNT >= 500 CELLS,,,0.01,0.01,1
HCPCS,3496F0,CD4+ CELL COUNT >= 500 CELLS,,,0.01,0.01,1
HCPCS,3497F,CD4+ CELL PERCENTAGE <15%,,,0.01,0.01,1
HCPCS,3497F0,CD4+ CELL PERCENTAGE <15%,,,0.01,0.01,1
HCPCS,3498F,CD4+ CELL >=15% (HIV),,,0.01,0.01,1
HCPCS,3498F0,CD4+ CELL >=15% (HIV),,,0.01,0.01,1
HCPCS,35001,DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY,8324.0,5410.6,832.1,8324.0,35
HCPCS,35001,REPAIR DEFECT OF ARTERY,,,1331.59,1331.59,1
HCPCS,35001,Repair defect of artery,,,2940.84,3714.74,6
HCPCS,350010,REPAIR DEFECT OF ARTERY,,,1331.59,1331.59,1
HCPCS,35002,REPAIR ARTERY RUPTURE NECK,,,1355.43,1355.43,1
HCPCS,35002,Repair artery rupture neck,,,2940.84,3714.74,6
HCPCS,350020,REPAIR ARTERY RUPTURE NECK,,,1355.43,1355.43,1
HCPCS,35005,REPAIR DEFECT OF ARTERY,,,1186.01,1186.01,1
HCPCS,35005,Repair defect of artery,,,2940.84,3714.74,6
HCPCS,350050,REPAIR DEFECT OF ARTERY,,,1186.01,1186.01,1
HCPCS,3500F,CD4+CELL CNT/% DOCD AS DONE,,,0.01,0.01,1
HCPCS,3500F0,CD4+CELL CNT/% DOCD AS DONE,,,0.01,0.01,1
HCPCS,35011,DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION,7432.0,4830.8,651.22,7432.0,35
HCPCS,35011,REPAIR DEFECT OF ARTERY,,,1199.16,11720.45,15
HCPCS,35011,Repair defect of artery,,,2357.43,2977.81,6
HCPCS,350110,REPAIR DEFECT OF ARTERY,,,1199.16,1199.16,1
HCPCS,35013,DIR RPR RUPTD ANEURYSM AXIL-BRACHIAL ARM INCIS,9292.0,6039.8,856.34,9292.0,35
HCPCS,35013,REPAIR ARTERY RUPTURE ARM,,,1504.6,1504.6,1
HCPCS,35013,Repair artery rupture arm,,,2357.43,2977.81,6
HCPCS,350130,REPAIR ARTERY RUPTURE ARM,,,1504.6,1504.6,1
HCPCS,35021,DIR RPR ANEURYSM INNOMINATE/SUBCLAVIAN ARTERY,8868.0,5764.2,951.33,8868.0,35
HCPCS,35021,REPAIR DEFECT OF ARTERY,,,1490.18,1490.18,1
HCPCS,35021,Repair defect of artery,,,5148.42,6503.27,6
HCPCS,350210,REPAIR DEFECT OF ARTERY,,,1490.18,1490.18,1
HCPCS,35022,REPAIR ARTERY RUPTURE CHEST,,,1705.47,1705.47,1
HCPCS,35022,Repair artery rupture chest,,,5148.42,6503.27,6
HCPCS,350220,REPAIR ARTERY RUPTURE CHEST,,,1705.47,1705.47,1
HCPCS,3502F,HIV RNA VRL LD <LMTS QUANTIF,,,0.01,0.01,1
HCPCS,3502F0,HIV RNA VRL LD <LMTS QUANTIF,,,0.01,0.01,1
HCPCS,3503F,HIV RNA VRL LDNOT<LMTS QUNTF,,,0.01,0.01,1
HCPCS,3503F0,HIV RNA VRL LDNOT<LMTS QUNTF,,,0.01,0.01,1
HCPCS,35045,DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY,7204.0,4682.6,627.37,7204.0,35
HCPCS,35045,REPAIR DEFECT OF ARM ARTERY,,,1151.25,11720.45,15
HCPCS,35045,Repair defect of arm artery,,,2357.43,2977.81,6
HCPCS,350450,REPAIR DEFECT OF ARM ARTERY,,,1151.25,1151.25,1
HCPCS,35081,DIR RPR ANEURYSM ABDOMINAL AORTA,13412.0,8717.8,1258.7,13412.0,35
HCPCS,35081,REPAIR DEFECT OF ARTERY,,,2055.77,2055.77,1
HCPCS,35081,Repair defect of artery,,,5148.42,6503.27,6
HCPCS,350810,REPAIR DEFECT OF ARTERY,,,2055.77,2055.77,1
HCPCS,35082,DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA,16836.0,10943.4,1593.11,16836.0,35
HCPCS,35082,REPAIR ARTERY RUPTURE AORTA,,,2567.22,2567.22,1
HCPCS,35082,Repair artery rupture aorta,,,5148.42,6503.27,6
HCPCS,350820,REPAIR ARTERY RUPTURE AORTA,,,2567.22,2567.22,1
HCPCS,35091,DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS,14140.0,9191.0,1332.03,14140.0,35
HCPCS,35091,REPAIR DEFECT OF ARTERY,,,2115.75,2115.75,1
HCPCS,35091,Repair defect of artery,,,5148.42,6503.27,6
HCPCS,350910,REPAIR DEFECT OF ARTERY,,,2115.75,2115.75,1
HCPCS,35092,DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS,20388.0,13252.2,1736.42,20388.0,35
HCPCS,35092,REPAIR ARTERY RUPTURE AORTA,,,3084.24,3084.24,1
HCPCS,35092,Repair artery rupture aorta,,,5148.42,6503.27,6
HCPCS,350920,REPAIR ARTERY RUPTURE AORTA,,,3084.24,3084.24,1
HCPCS,35102,DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS,14612.0,9497.8,1405.56,14612.0,35
HCPCS,35102,REPAIR DEFECT OF ARTERY,,,2235.48,2235.48,1
HCPCS,35102,Repair defect of artery,,,5148.42,6503.27,6
HCPCS,351020,REPAIR DEFECT OF ARTERY,,,2235.48,2235.48,1
HCPCS,35103,DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS,17448.0,11341.2,1594.93,17448.0,35
HCPCS,35103,REPAIR ARTERY RUPTURE AORTA,,,2634.84,2634.84,1
HCPCS,35103,Repair artery rupture aorta,,,5148.42,6503.27,6
HCPCS,351030,REPAIR ARTERY RUPTURE AORTA,,,2634.84,2634.84,1
HCPCS,3510F,DOC TB SCRNG-RSLTS INTERPD,,,0.01,0.01,1
HCPCS,3510F0,DOC TB SCRNG-RSLTS INTERPD,,,0.01,0.01,1
HCPCS,35111,DIR RPR ANEURYSM SPLENIC ARTERY,10512.0,6832.8,908.3,10512.0,35
HCPCS,35111,REPAIR DEFECT OF ARTERY,,,1582.47,1582.47,1
HCPCS,35111,Repair defect of artery,,,5148.42,6503.27,6
HCPCS,351110,REPAIR DEFECT OF ARTERY,,,1582.47,1582.47,1
HCPCS,35112,DIR RPR RUPTD ANEURYSM SPLENIC ARTERY,13028.0,8468.2,948.78,13028.0,35
HCPCS,35112,REPAIR ARTERY RUPTURE SPLEEN,,,1945.88,1945.88,1
HCPCS,35112,Repair artery rupture spleen,,,5148.42,6503.27,6
HCPCS,351120,REPAIR ARTERY RUPTURE SPLEEN,,,1945.88,1945.88,1
HCPCS,3511F,CHLMYD/GONRH TSTS DOCD DONE,,,0.01,0.01,1
HCPCS,3511F0,CHLMYD/GONRH TSTS DOCD DONE,,,0.01,0.01,1
HCPCS,35121,DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC,12608.0,8195.2,1149.76,12608.0,35
HCPCS,35121,REPAIR DEFECT OF ARTERY,,,1882.13,1882.13,1
HCPCS,35121,Repair defect of artery,,,5148.42,6503.27,6
HCPCS,351210,REPAIR DEFECT OF ARTERY,,,1882.13,1882.13,1
HCPCS,35122,DIR RPR RUPTD ANEURSM HEPATIC/CELIAC/RENAL/MESEN,15156.0,9851.4,1398.15,15156.0,35
HCPCS,35122,REPAIR ARTERY RUPTURE BELLY,,,2252.06,2252.06,1
HCPCS,35122,Repair artery rupture belly,,,5148.42,6503.27,6
HCPCS,351220,REPAIR ARTERY RUPTURE BELLY,,,2252.06,2252.06,1
HCPCS,3512F,SYPH SCRNG DOCD AS DONE,,,0.01,0.01,1
HCPCS,3512F0,SYPH SCRNG DOCD AS DONE,,,0.01,0.01,1
HCPCS,35131,DIR RPR ANEURYSM & GRAFT ILIAC ARTERY,10560.0,6864.0,923.39,10560.0,35
HCPCS,35131,REPAIR DEFECT OF ARTERY,,,1640.46,1640.46,1
HCPCS,35131,Repair defect of artery,,,5148.42,6503.27,6
HCPCS,351310,REPAIR DEFECT OF ARTERY,,,1640.46,1640.46,1
HCPCS,35132,REPAIR ARTERY RUPTURE GROIN,,,1945.88,1945.88,1
HCPCS,35132,Repair artery rupture groin,,,5148.42,6503.27,6
HCPCS,351320,REPAIR ARTERY RUPTURE GROIN,,,1945.88,1945.88,1
HCPCS,3513F,HEP B SCRNG DOCD AS DONE,,,0.01,0.01,1
HCPCS,3513F0,HEP B SCRNG DOCD AS DONE,,,0.01,0.01,1
HCPCS,35141,DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY,8364.0,5436.6,775.6,8364.0,35
HCPCS,35141,REPAIR DEFECT OF ARTERY,,,1296.97,1296.97,1
HCPCS,35141,Repair defect of artery,,,2357.43,2977.81,6
HCPCS,351410,REPAIR DEFECT OF ARTERY,,,1296.97,1296.97,1
HCPCS,35142,DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART,10064.0,6541.6,849.56,10064.0,35
HCPCS,35142,REPAIR ARTERY RUPTURE THIGH,,,1566.11,1566.11,1
HCPCS,35142,Repair artery rupture thigh,,,2357.43,2977.81,6
HCPCS,351420,REPAIR ARTERY RUPTURE THIGH,,,1566.11,1566.11,1
HCPCS,3514F,HEP C SCRNG DOCD AS DONE,,,0.01,0.01,1
HCPCS,3514F0,HEP C SCRNG DOCD AS DONE,,,0.01,0.01,1
HCPCS,35151,DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY,9488.0,6167.2,865.15,9488.0,35
HCPCS,35151,REPAIR DEFECT OF ARTERY,,,1474.41,1474.41,1
HCPCS,35151,Repair defect of artery,,,2357.43,2977.81,6
HCPCS,351510,REPAIR DEFECT OF ARTERY,,,1474.41,1474.41,1
HCPCS,35152,DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY,11064.0,7191.6,868.79,11064.0,35
HCPCS,35152,REPAIR RUPTD POPLITEAL ART,,,1663.78,1663.78,1
HCPCS,35152,Repair ruptd popliteal art,,,2357.43,2977.81,6
HCPCS,351520,REPAIR RUPTD POPLITEAL ART,,,1663.78,1663.78,1
HCPCS,3515F,PT HAS DOCD IMMUN TO HEP C,,,0.01,0.01,1
HCPCS,3515F0,PT HAS DOCD IMMUN TO HEP C,,,0.01,0.01,1
HCPCS,3517F,HBV ASSESS&RESULTS INTRP 1YR,,,0.01,0.01,1
HCPCS,3517F0,HBV ASSESS&RESULTS INTRP 1YR,,,0.01,0.01,1
HCPCS,35180,RPR CGEN AV FISTULA HEAD&NCK,,,934.79,3368.11,15
HCPCS,35180,Rpr cgen av fistula head&nck,,,1320.48,1667.98,6
HCPCS,351800,RPR CGEN AV FISTULA HEAD&NCK,,,934.79,934.79,1
HCPCS,35182,RPR CGEN AV FISTULA THRX&ABD,,,2130.31,2130.31,1
HCPCS,35182,Rpr cgen av fistula thrx&abd,,,5148.42,6503.27,6
HCPCS,351820,RPR CGEN AV FISTULA THRX&ABD,,,2130.31,2130.31,1
HCPCS,35184,RPR CGEN AV FISTULA XTR,,,1148.6,6824.3,15
HCPCS,35184,Rpr cgen av fistula xtr,,,1320.48,1667.98,6
HCPCS,351840,RPR CGEN AV FISTULA XTR,,,1148.6,1148.6,1
HCPCS,35188,RPR ACQ AV FISTULA HEAD&NECK,,,1563.74,11720.45,15
HCPCS,35188,RPR/TRAUMATIC AV FISTULA HEAD & NECK,7200.0,4680.0,583.91,7200.0,35
HCPCS,35188,Rpr acq av fistula head&neck,,,1320.48,1667.98,6
HCPCS,351880,RPR ACQ AV FISTULA HEAD&NECK,,,1563.74,1563.74,1
HCPCS,35189,RPR ACQ AV FISTULA THRX&ABD,,,1798.12,1798.12,1
HCPCS,35189,Rpr acq av fistula thrx&abd,,,5148.42,6503.27,6
HCPCS,351890,RPR ACQ AV FISTULA THRX&ABD,,,1798.12,1798.12,1
HCPCS,35190,REPAIR ACQ AV FISTULA XTR,,,897.81,11720.45,15
HCPCS,35190,RPR/TRAUMATIC AV FISTULA EXTREMITIES,5368.0,3489.2,568.35,5368.0,35
HCPCS,35190,Repair acq av fistula xtr,,,1320.48,1667.98,6
HCPCS,351900,REPAIR ACQ AV FISTULA XTR,,,897.81,897.81,1
HCPCS,35201,REPAIR BLOOD VESSEL DIR NECK,,,1109.24,1109.24,1
HCPCS,35201,REPAIR BLOOD VESSEL DIRECT NECK,22813.0,14828.449999999999,555.58,34968.6,77
HCPCS,352010,REPAIR BLOOD VESSEL DIR NECK,,,1109.24,1109.24,1
HCPCS,35206,REPAIR BLOOD VESSEL DIR UXTR,,,939.5,939.5,1
HCPCS,35206,REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY,5536.0,3598.4,519.16,5536.0,35
HCPCS,35206,REPAIR BLOOD VESSEL UPPER EXT,22623.0,14704.95,940.87,20360.7,42
HCPCS,352060,REPAIR BLOOD VESSEL DIR UXTR,,,939.5,939.5,1
HCPCS,35207,REPAIR BLOOD VESSEL DIRECT HAND FINGER,13499.5,8774.675000000001,571.85,20360.7,77
HCPCS,35207,RPR BLD VSL DIR HAND FINGER,,,899.69,899.69,1
HCPCS,352070,RPR BLD VSL DIR HAND FINGER,,,899.69,899.69,1
HCPCS,3520F,CDIFFICILE TESTING PERFORMED,,,0.01,0.01,1
HCPCS,3520F0,CDIFFICILE TESTING PERFORMED,,,0.01,0.01,1
HCPCS,35211,RPR BLVSL DIR NTRATHRC W/BYP,,,1653.39,1653.39,1
HCPCS,35211,Rpr blvsl dir ntrathrc w/byp,,,5148.42,6503.27,6
HCPCS,352110,RPR BLVSL DIR NTRATHRC W/BYP,,,1653.39,1653.39,1
HCPCS,35216,RPR BLOOD VESSEL DIRECT INTRATHORACIC W/O BYPASS,14644.0,9518.6,1017.74,14644.0,35
HCPCS,35216,RPR BLVSL DIR NTRTHRC WO BYP,,,2497.22,2497.22,1
HCPCS,35216,Rpr blvsl dir ntrthrc wo byp,,,5148.42,6503.27,6
HCPCS,352160,RPR BLVSL DIR NTRTHRC WO BYP,,,2497.22,2497.22,1
HCPCS,35221,RPR BLD VSL DIR INTRA-ABDL,,,1754.19,1754.19,1
HCPCS,35221,RPR BLOOD VESSEL DIRECT INTRA-ABDOMINAL,10648.0,6921.2,817.74,10648.0,35
HCPCS,35221,Rpr bld vsl dir intra-abdl,,,5148.42,6503.27,6
HCPCS,352210,RPR BLD VSL DIR INTRA-ABDL,,,1754.19,1754.19,1
HCPCS,35226,REPAIR BLOOD VESSEL DIR LXTR,,,983.53,983.53,1
HCPCS,35226,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,5589.0,3632.85,512.54,6317.0,133
HCPCS,352260,REPAIR BLOOD VESSEL DIR LXTR,,,983.53,983.53,1
HCPCS,35231,REPAIR BLOOD VESSEL W/VEIN GRAFT NECK,8464.0,5501.6,688.92,8464.0,35
HCPCS,35231,REPAIR BLVSL VN GRF NECK,,,1479.51,6824.3,15
HCPCS,35231,Repair blvsl vn grf neck,,,1320.48,1667.98,6
HCPCS,352310,REPAIR BLVSL VN GRF NECK,,,1479.51,1479.51,1
HCPCS,35236,REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY,7208.0,4685.2,596.43,7208.0,35
HCPCS,35236,REPAIR BLVSL VN GRF UXTR,,,1186.15,11720.45,15
HCPCS,35236,Repair blvsl vn grf uxtr,,,1320.48,1667.98,6
HCPCS,352360,REPAIR BLVSL VN GRF UXTR,,,1186.15,1186.15,1
HCPCS,35241,RPR BLVSL VN GRF NTRTHRC W/B,,,1698.16,1698.16,1
HCPCS,35241,Rpr blvsl vn grf ntrthrc w/b,,,5148.42,6503.27,6
HCPCS,352410,RPR BLVSL VN GRF NTRTHRC W/B,,,1698.16,1698.16,1
HCPCS,35246,RPR BLVSL VN GRF NTRTHRC W/O,,,1848.23,1848.23,1
HCPCS,35246,Rpr blvsl vn grf ntrthrc w/o,,,5148.42,6503.27,6
HCPCS,352460,RPR BLVSL VN GRF NTRTHRC W/O,,,1848.23,1848.23,1
HCPCS,35251,REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL,12764.0,8296.6,978.48,12764.0,35
HCPCS,35251,RPR BLVSL VN GRF INTRA-ABDL,,,2069.12,2069.12,1
HCPCS,35251,Rpr blvsl vn grf intra-abdl,,,5148.42,6503.27,6
HCPCS,352510,RPR BLVSL VN GRF INTRA-ABDL,,,2069.12,2069.12,1
HCPCS,35256,REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY,7624.0,4955.6,633.61,7624.0,35
HCPCS,35256,REPAIR BLVSL VN GRF LXTR,,,1201.08,11720.45,15
HCPCS,35256,Repair blvsl vn grf lxtr,,,2357.43,2977.81,6
HCPCS,352560,REPAIR BLVSL VN GRF LXTR,,,1201.08,1201.08,1
HCPCS,35261,REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK,7584.0,4929.6,649.7,7584.0,35
HCPCS,35261,RPR BLVSL GRF OTH/THN VN NCK,,,1167.57,6824.3,15
HCPCS,35261,Rpr blvsl grf oth/thn vn nck,,,2357.43,2977.81,6
HCPCS,352610,RPR BLVSL GRF OTH/THN VN NCK,,,1167.57,1167.57,1
HCPCS,35266,RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY,6332.0,4115.8,579.56,6332.0,35
HCPCS,35266,RPR BLVSL GRF OTH/TH VN UXTR,,,1027.51,11720.45,15
HCPCS,35266,Rpr blvsl grf oth/th vn uxtr,,,1320.48,1667.98,6
HCPCS,352660,RPR BLVSL GRF OTH/TH VN UXTR,,,1027.51,1027.51,1
HCPCS,35271,RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP,9832.0,6390.8,1006.84,9832.0,35
HCPCS,35271,RPR BLVS GR OT/TH VN NTRTH W,,,1644.88,1644.88,1
HCPCS,35271,Rpr blvs gr ot/th vn ntrth w,,,5148.42,6503.27,6
HCPCS,352710,RPR BLVS GR OT/TH VN NTRTH W,,,1644.88,1644.88,1
HCPCS,35276,RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/O BYP,6108.0,3970.2,1026.14,18285.0,32
HCPCS,35276,RPR BLVS GR OT/T VN NTRTH WO,,,1724.76,1724.76,1
HCPCS,352760,RPR BLVS GR OT/T VN NTRTH WO,,,1724.76,1724.76,1
HCPCS,35281,RPR BLVSL GR OT/TH VN NTR-AB,,,1924.92,1924.92,1
HCPCS,35281,RPR BLVSL W/GRFT OTHER/THAN VEIN INTRA-ABDOMINAL,12024.0,7815.6,934.72,12024.0,35
HCPCS,35281,Rpr blvsl gr ot/th vn ntr-ab,,,5148.42,6503.27,6
HCPCS,352810,RPR BLVSL GR OT/TH VN NTR-AB,,,1924.92,1924.92,1
HCPCS,35286,RPR BLVSL GRF OTH/TH VN LXTR,,,1099.49,11720.45,15
HCPCS,35286,RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY,6876.0,4469.4,632.68,6876.0,35
HCPCS,35286,Rpr blvsl grf oth/th vn lxtr,,,3216.6,4063.07,6
HCPCS,352860,RPR BLVSL GRF OTH/TH VN LXTR,,,1099.49,1099.49,1
HCPCS,35301,RECHANNELING OF ARTERY,,,1339.75,1339.75,1
HCPCS,35301,Rechanneling of artery,,,2940.84,3714.74,6
HCPCS,35301,TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC,8464.0,5501.6,845.63,8464.0,35
HCPCS,353010,RECHANNELING OF ARTERY,,,1339.75,1339.75,1
HCPCS,35302,RECHANNELING OF ARTERY,,,1326.28,1326.28,1
HCPCS,35302,TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY,20639.5,13415.675,692.66,29465.1,67
HCPCS,353020,RECHANNELING OF ARTERY,,,1326.28,1326.28,1
HCPCS,35303,RECHANNELING OF ARTERY,,,1455.0,1455.0,1
HCPCS,35303,Rechanneling of artery,,,2357.43,2977.81,6
HCPCS,35303,TEAEC W/GRAFT POPLITEAL ARTERY,9440.0,6136.0,761.41,9440.0,35
HCPCS,353030,RECHANNELING OF ARTERY,,,1455.0,1455.0,1
HCPCS,35304,RECHANNELING OF ARTERY,,,1514.88,1514.88,1
HCPCS,35304,Rechanneling of artery,,,2357.43,2977.81,6
HCPCS,35304,TEAEC W/GRAFT TIBIOPERONEAL TRUNK ARTERY,9840.0,6396.0,792.39,9840.0,35
HCPCS,353040,RECHANNELING OF ARTERY,,,1514.88,1514.88,1
HCPCS,35305,RECHANNELING OF ARTERY,,,1456.96,1456.96,1
HCPCS,35305,Rechanneling of artery,,,2357.43,2977.81,6
HCPCS,35305,TEAEC W/GRAFT TIBIAL/PERONEAL ART 1ST VESSEL,9440.0,6136.0,761.41,9440.0,35
HCPCS,353050,RECHANNELING OF ARTERY,,,1456.96,1456.96,1
HCPCS,35306,RECHANNELING OF ARTERY,,,529.44,529.44,1
HCPCS,35306,Rechanneling of artery,,,2357.43,2977.81,6
HCPCS,353060,RECHANNELING OF ARTERY,,,529.44,529.44,1
HCPCS,35311,RECHANNELING OF ARTERY,,,1837.71,1837.71,1
HCPCS,35311,Rechanneling of artery,,,5148.42,6503.27,6
HCPCS,353110,RECHANNELING OF ARTERY,,,1837.71,1837.71,1
HCPCS,35321,RECHANNELING OF ARTERY,,,1066.04,11720.45,15
HCPCS,35321,Rechanneling of artery,,,2357.43,2977.81,6
HCPCS,35321,TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL,6636.0,4313.4,659.78,6636.0,35
HCPCS,353210,RECHANNELING OF ARTERY,,,1066.04,1066.04,1
HCPCS,35331,RECHANNELING OF ARTERY,,,1726.17,1726.17,1
HCPCS,35331,Rechanneling of artery,,,5148.42,6503.27,6
HCPCS,35331,TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA,11088.0,7207.2,1001.41,11088.0,35
HCPCS,353310,RECHANNELING OF ARTERY,,,1726.17,1726.17,1
HCPCS,35341,RECHANNELING OF ARTERY,,,1645.01,1645.01,1
HCPCS,35341,Rechanneling of artery,,,5148.42,6503.27,6
HCPCS,35341,TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL,10484.0,6814.6,1030.49,10484.0,35
HCPCS,353410,RECHANNELING OF ARTERY,,,1645.01,1645.01,1
HCPCS,35351,RECHANNELING OF ARTERY,,,1525.69,1525.69,1
HCPCS,35351,Rechanneling of artery,,,5148.42,6503.27,6
HCPCS,35351,TEAEC W/WO PATCH GRAFT ILIAC,9844.0,6398.6,944.42,9844.0,35
HCPCS,353510,RECHANNELING OF ARTERY,,,1525.69,1525.69,1
HCPCS,35355,RECHANNELING OF ARTERY,,,1221.18,1221.18,1
HCPCS,35355,TEAEC W/WO PATCH GRAFT ILIOFEMORAL,8133.5,5286.775,769.8,18285.0,67
HCPCS,353550,RECHANNELING OF ARTERY,,,1221.18,1221.18,1
HCPCS,35361,RECHANNELING OF ARTERY,,,1813.23,1813.23,1
HCPCS,35361,Rechanneling of artery,,,5148.42,6503.27,6
HCPCS,35361,TEAEC W/WO PATCH GRAFT COMBINED AORTOILIAC,12096.0,7862.4,1140.79,12096.0,35
HCPCS,353610,RECHANNELING OF ARTERY,,,1813.23,1813.23,1
HCPCS,35363,RECHANNELING OF ARTERY,,,1933.25,1933.25,1
HCPCS,35363,Rechanneling of artery,,,5148.42,6503.27,6
HCPCS,353630,RECHANNELING OF ARTERY,,,1933.25,1933.25,1
HCPCS,35371,RECHANNELING OF ARTERY,,,966.01,966.01,1
HCPCS,35371,Rechanneling of artery,,,2357.43,2977.81,6
HCPCS,35371,TEAEC W/WO PATCH GRAFT COMMON FEMORAL,6124.0,3980.6,609.97,6124.0,35
HCPCS,353710,RECHANNELING OF ARTERY,,,966.01,966.01,1
HCPCS,35372,RECHANNELING OF ARTERY,,,1158.58,6391.96,5
HCPCS,35372,Rechanneling of artery,,,2357.43,2977.81,6
HCPCS,35372,TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL,7432.0,4830.8,665.05,7432.0,35
HCPCS,353720,RECHANNELING OF ARTERY,,,1158.58,1158.58,1
HCPCS,35390,REOPERATION CAROTID ADD-ON,,,188.41,188.41,1
HCPCS,35390,ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO,1276.0,829.4,118.98,1276.0,35
HCPCS,35390,Reoperation carotid add-on,,,2940.84,3714.74,6
HCPCS,353900,REOPERATION CAROTID ADD-ON,,,188.41,188.41,1
HCPCS,35400,ANGIOSCOPY,,,175.56,175.56,1
HCPCS,35400,ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS THER IVNTJ,1200.0,780.0,107.49,1200.0,35
HCPCS,35400,Angioscopy,,,136.83,172.84,6
HCPCS,354000,ANGIOSCOPY,,,175.56,175.56,1
HCPCS,35500,HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX,2576.0,1674.4,231.1,2576.0,35
HCPCS,35500,HARVEST VEIN FOR BYPASS,,,377.87,377.87,1
HCPCS,35500,Harvest vein for bypass,,,3216.6,4063.07,6
HCPCS,355000,HARVEST VEIN FOR BYPASS,,,377.87,377.87,1
HCPCS,35501,ART BYP GRFT IPSILAT CAROTID,,,1737.41,1737.41,1
HCPCS,35501,Art byp grft ipsilat carotid,,,2940.84,3714.74,6
HCPCS,35501,BYPASS W/VEIN COMMON-IPSILATERAL CAROTID,11636.0,7563.4,1011.07,11636.0,35
HCPCS,355010,ART BYP GRFT IPSILAT CAROTID,,,1737.41,1737.41,1
HCPCS,35506,ART BYP GRFT SUBCLAV-CAROTID,,,1516.53,1516.53,1
HCPCS,35506,Art byp grft subclav-carotid,,,2940.84,3714.74,6
HCPCS,35506,BYPASS W/VEIN CAROTID-SUBCLV/SUBCLAVIAN CAROTID,10132.0,6585.8,955.42,10132.0,35
HCPCS,355060,ART BYP GRFT SUBCLAV-CAROTID,,,1516.53,1516.53,1
HCPCS,35508,ART BYP GRFT CAROTID-VERTBRL,,,1581.9,1581.9,1
HCPCS,35508,Art byp grft carotid-vertbrl,,,2940.84,3714.74,6
HCPCS,355080,ART BYP GRFT CAROTID-VERTBRL,,,1581.9,1581.9,1
HCPCS,35509,ART BYP GRFT CONTRAL CAROTID,,,1679.71,1679.71,1
HCPCS,35509,Art byp grft contral carotid,,,2940.84,3714.74,6
HCPCS,35509,BYPASS W/VEIN CAROTID-CONTRALATERAL CAROTID,11236.0,7303.4,980.38,11236.0,35
HCPCS,355090,ART BYP GRFT CONTRAL CAROTID,,,1679.71,1679.71,1
HCPCS,3550F,LOW RSK THROMBOEMBOLISM,,,0.01,0.01,1
HCPCS,3550F0,LOW RSK THROMBOEMBOLISM,,,0.01,0.01,1
HCPCS,35510,ART BYP GRFT CAROTID-BRCHIAL,,,1464.21,1464.21,1
HCPCS,35510,Art byp grft carotid-brchial,,,2940.84,3714.74,6
HCPCS,355100,ART BYP GRFT CAROTID-BRCHIAL,,,1464.21,1464.21,1
HCPCS,35511,ART BYP GRFT SUBCLAV-SUBCLAV,,,1333.99,1333.99,1
HCPCS,35511,Art byp grft subclav-subclav,,,5148.42,6503.27,6
HCPCS,355110,ART BYP GRFT SUBCLAV-SUBCLAV,,,1333.99,1333.99,1
HCPCS,35512,ART BYP GRFT SUBCLAV-BRCHIAL,,,1435.64,1435.64,1
HCPCS,35512,Art byp grft subclav-brchial,,,3216.6,4063.07,6
HCPCS,355120,ART BYP GRFT SUBCLAV-BRCHIAL,,,1435.64,1435.64,1
HCPCS,35515,ART BYP GRFT SUBCLAV-VERTBRL,,,1581.9,1581.9,1
HCPCS,35515,Art byp grft subclav-vertbrl,,,5148.42,6503.27,6
HCPCS,355150,ART BYP GRFT SUBCLAV-VERTBRL,,,1581.9,1581.9,1
HCPCS,35516,ART BYP GRFT SUBCLAV-AXILARY,,,1452.85,1452.85,1
HCPCS,35516,Art byp grft subclav-axilary,,,3216.6,4063.07,6
HCPCS,355160,ART BYP GRFT SUBCLAV-AXILARY,,,1452.85,1452.85,1
HCPCS,35518,ART BYP GRFT AXILLARY-AXILRY,,,1359.71,1359.71,1
HCPCS,35518,Art byp grft axillary-axilry,,,3216.6,4063.07,6
HCPCS,35518,BYPASS W/VEIN AXILLARY-AXILLARY,9966.0,6477.9,852.42,9966.0,35
HCPCS,355180,ART BYP GRFT AXILLARY-AXILRY,,,1359.71,1359.71,1
HCPCS,3551F,INTRMED RSK THROMBOEMBOLISM,,,0.01,0.01,1
HCPCS,3551F0,INTRMED RSK THROMBOEMBOLISM,,,0.01,0.01,1
HCPCS,35521,ART BYP GRFT AXILL-FEMORAL,,,1462.16,1462.16,1
HCPCS,35521,Art byp grft axill-femoral,,,5148.42,6503.27,6
HCPCS,35521,BYPASS W/VEIN AXILLARY-FEMORAL,10617.0,6901.05,847.93,10617.0,35
HCPCS,355210,ART BYP GRFT AXILL-FEMORAL,,,1462.16,1462.16,1
HCPCS,35522,ART BYP GRFT AXILL-BRACHIAL,,,1392.37,1392.37,1
HCPCS,35522,Art byp grft axill-brachial,,,3216.6,4063.07,6
HCPCS,35522,BYPASS W/VEIN AXILLARY-BRACHIAL,9260.0,6019.0,857.93,9260.0,35
HCPCS,355220,ART BYP GRFT AXILL-BRACHIAL,,,1392.37,1392.37,1
HCPCS,35523,ART BYP GRFT BRCHL-ULNR-RDL,,,1464.03,1464.03,1
HCPCS,35523,Art byp grft brchl-ulnr-rdl,,,3216.6,4063.07,6
HCPCS,35523,BYPASS W/VEIN BRACHIAL-ULNAR/-RADIAL,9652.0,6273.8,812.25,9652.0,35
HCPCS,355230,ART BYP GRFT BRCHL-ULNR-RDL,,,1464.03,1464.03,1
HCPCS,35525,ART BYP GRFT BRACHIAL-BRCHL,,,1344.77,1344.77,1
HCPCS,35525,Art byp grft brachial-brchl,,,3216.6,4063.07,6
HCPCS,35525,BYPASS W/VEIN BRACHIAL-BRACHIAL,8676.0,5639.4,819.29,8676.0,35
HCPCS,355250,ART BYP GRFT BRACHIAL-BRCHL,,,1344.77,1344.77,1
HCPCS,35526,ART BYP GRFT AOR/CAROT/INNOM,,,2045.31,2045.31,1
HCPCS,35526,Art byp grft aor/carot/innom,,,5148.42,6503.27,6
HCPCS,355260,ART BYP GRFT AOR/CAROT/INNOM,,,2045.31,2045.31,1
HCPCS,3552F,HGH RISK FOR THROMBOEMBOLISM,,,0.01,0.01,1
HCPCS,3552F0,HGH RISK FOR THROMBOEMBOLISM,,,0.01,0.01,1
HCPCS,35531,ART BYP GRFT AORCEL/AORMESEN,,,2322.27,2322.27,1
HCPCS,35531,Art byp grft aorcel/aormesen,,,5148.42,6503.27,6
HCPCS,35531,BYPASS W/VEIN AORTOCELIAC/AORTOMESENTERIC,15644.0,10168.6,1223.14,15644.0,35
HCPCS,355310,ART BYP GRFT AORCEL/AORMESEN,,,2322.27,2322.27,1
HCPCS,35533,ART BYP GRFT AXILL/FEM/FEM,,,1794.87,1794.87,1
HCPCS,35533,Art byp grft axill/fem/fem,,,2357.43,2977.81,6
HCPCS,35533,BYPASS W/VEIN AXILLARY-FEMORAL-FEMORAL,11968.0,7779.2,1106.49,11968.0,35
HCPCS,355330,ART BYP GRFT AXILL/FEM/FEM,,,1794.87,1794.87,1
HCPCS,35535,ART BYP GRFT HEPATORENAL,,,2266.29,2266.29,1
HCPCS,35535,Art byp grft hepatorenal,,,5148.42,6503.27,6
HCPCS,355350,ART BYP GRFT HEPATORENAL,,,2266.29,2266.29,1
HCPCS,35536,ART BYP GRFT SPLENORENAL,,,2012.0,2012.0,1
HCPCS,35536,Art byp grft splenorenal,,,5148.42,6503.27,6
HCPCS,35536,BYPASS W/VEIN SPLENORENAL,13492.0,8769.8,1181.35,13492.0,35
HCPCS,355360,ART BYP GRFT SPLENORENAL,,,2012.0,2012.0,1
HCPCS,35537,ART BYP GRFT AORTOILIAC,,,2482.61,2482.61,1
HCPCS,35537,Art byp grft aortoiliac,,,5148.42,6503.27,6
HCPCS,355370,ART BYP GRFT AORTOILIAC,,,2482.61,2482.61,1
HCPCS,35538,ART BYP GRFT AORTOBI-ILIAC,,,2780.62,2780.62,1
HCPCS,35538,Art byp grft aortobi-iliac,,,5148.42,6503.27,6
HCPCS,355380,ART BYP GRFT AORTOBI-ILIAC,,,2780.62,2780.62,1
HCPCS,35539,ART BYP GRFT AORTOFEMORAL,,,2609.93,2609.93,1
HCPCS,35539,Art byp grft aortofemoral,,,5148.42,6503.27,6
HCPCS,35539,"VEIN BYPASS GRAFT,AORTOFEMORAL",17644.0,11468.6,1407.25,17644.0,35
HCPCS,355390,ART BYP GRFT AORTOFEMORAL,,,2609.93,2609.93,1
HCPCS,35540,ART BYP GRFT AORTBIFEMORAL,,,2908.76,2908.76,1
HCPCS,35540,Art byp grft aortbifemoral,,,5148.42,6503.27,6
HCPCS,35540,"VEIN BYPASS GRAFT,AORTOBIFEMORAL",19732.0,12825.8,1569.4,19732.0,35
HCPCS,355400,ART BYP GRFT AORTBIFEMORAL,,,2908.76,2908.76,1
HCPCS,35556,ART BYP GRFT FEM-POPLITEAL,,,1652.54,1652.54,1
HCPCS,35556,Art byp grft fem-popliteal,,,3216.6,4063.07,6
HCPCS,35556,BYPASS W/VEIN FEMORAL-POPLITEAL,10700.0,6955.0,1028.55,10700.0,35
HCPCS,355560,ART BYP GRFT FEM-POPLITEAL,,,1652.54,1652.54,1
HCPCS,35558,ART BYP GRFT FEM-FEMORAL,,,1468.31,1468.31,1
HCPCS,35558,Art byp grft fem-femoral,,,3216.6,4063.07,6
HCPCS,35558,BYPASS W/VEIN FEMORAL-FEMORAL,9252.0,6013.8,784.57,9252.0,35
HCPCS,355580,ART BYP GRFT FEM-FEMORAL,,,1468.31,1468.31,1
HCPCS,3555F,PT INR MEASUREMENT PERFORMED,,,0.01,0.01,1
HCPCS,3555F0,PT INR MEASUREMENT PERFORMED,,,0.01,0.01,1
HCPCS,35560,ART BYP GRFT AORTORENAL,,,2029.97,2029.97,1
HCPCS,35560,Art byp grft aortorenal,,,5148.42,6503.27,6
HCPCS,35560,BYPASS W/VEIN AORTORENAL,13612.0,8847.8,1111.6,13612.0,35
HCPCS,355600,ART BYP GRFT AORTORENAL,,,2029.97,2029.97,1
HCPCS,35563,ART BYP GRFT ILIOILIAC,,,1576.47,1576.47,1
HCPCS,35563,Art byp grft ilioiliac,,,5148.42,6503.27,6
HCPCS,355630,ART BYP GRFT ILIOILIAC,,,1576.47,1576.47,1
HCPCS,35565,ART BYP GRFT ILIOFEMORAL,,,1557.06,1557.06,1
HCPCS,35565,Art byp grft iliofemoral,,,5148.42,6503.27,6
HCPCS,35565,BYPASS W/VEIN ILIOFEMORAL,10052.0,6533.8,848.09,10052.0,35
HCPCS,355650,ART BYP GRFT ILIOFEMORAL,,,1557.06,1557.06,1
HCPCS,35566,ART BYP FEM-ANT-POST TIB/PRL,,,1972.73,1972.73,1
HCPCS,35566,Art byp fem-ant-post tib/prl,,,3216.6,4063.07,6
HCPCS,35566,BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL,12940.0,8411.0,1223.08,12940.0,35
HCPCS,355660,ART BYP FEM-ANT-POST TIB/PRL,,,1972.73,1972.73,1
HCPCS,35570,ART BYP TIBIAL-TIB/PERONEAL,,,1754.89,1754.89,1
HCPCS,35570,Art byp tibial-tib/peroneal,,,3216.6,4063.07,6
HCPCS,355700,ART BYP TIBIAL-TIB/PERONEAL,,,1754.89,1754.89,1
HCPCS,35571,ART BYP POP-TIBL-PRL-OTHER,,,1570.81,1570.81,1
HCPCS,35571,Art byp pop-tibl-prl-other,,,3216.6,4063.07,6
HCPCS,35571,BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL,11229.0,7298.85,967.17,11229.0,35
HCPCS,355710,ART BYP POP-TIBL-PRL-OTHER,,,1570.81,1570.81,1
HCPCS,35572,HARVEST FEMOROPOPLITEAL VEIN,,,406.92,406.92,1
HCPCS,35572,HARVEST FEMPOP VEIN 1 SGM VASC RCNSTJ PX,2724.0,1770.6,252.83,2724.0,35
HCPCS,35572,Harvest femoropopliteal vein,,,3216.6,4063.07,6
HCPCS,355720,HARVEST FEMOROPOPLITEAL VEIN,,,406.92,406.92,1
HCPCS,35583,IN-SITU VEIN BYPASS FEMORAL-POPLITEAL,11100.0,7215.0,1078.23,11100.0,35
HCPCS,35583,VEIN BYP GRFT FEM-POPLITEAL,,,1710.6,1710.6,1
HCPCS,35583,Vein byp grft fem-popliteal,,,3216.6,4063.07,6
HCPCS,355830,VEIN BYP GRFT FEM-POPLITEAL,,,1710.6,1710.6,1
HCPCS,35585,IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART,12940.0,8411.0,1248.28,12940.0,35
HCPCS,35585,VEIN BYP FEM-TIBIAL PERONEAL,,,1981.79,1981.79,1
HCPCS,35585,Vein byp fem-tibial peroneal,,,3216.6,4063.07,6
HCPCS,355850,VEIN BYP FEM-TIBIAL PERONEAL,,,1981.79,1981.79,1
HCPCS,35587,IN-SITU VEIN BYP POP-TIBL PRONEAL,10484.0,6814.6,999.34,10484.0,35
HCPCS,35587,VEIN BYP POP-TIBL PERONEAL,,,1586.23,1586.23,1
HCPCS,35587,Vein byp pop-tibl peroneal,,,3216.6,4063.07,6
HCPCS,355870,VEIN BYP POP-TIBL PERONEAL,,,1586.23,1586.23,1
HCPCS,35600,OPEN HARVEST UPPER EXTREMITY ART 1 SEGMENT CAB,1580.0,1027.0,139.15,1580.0,35
HCPCS,35600,OPEN HRV UXTR ART 1 SGM CAB,,,220.5,220.5,1
HCPCS,35600,Open hrv uxtr art 1 sgm cab,,,9690.96,12241.21,6
HCPCS,356000,OPEN HRV UXTR ART 1 SGM CAB,,,220.5,220.5,1
HCPCS,35601,BPG COM CRTD-IPSI INT CRTD,,,1663.34,1663.34,1
HCPCS,35601,BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID,10836.0,7043.4,949.73,10836.0,35
HCPCS,35601,Bpg com crtd-ipsi int crtd,,,2940.84,3714.74,6
HCPCS,356010,BPG COM CRTD-IPSI INT CRTD,,,1663.34,1663.34,1
HCPCS,35602,BPG CRTD-CLAT CRTD,,,1406.88,1406.88,1
HCPCS,35602,BPG OTH/THN VEIN CAROTID-CONTRALATERAL CAROTID,10353.0,6729.45,1325.39,10353.0,21
HCPCS,35602,Bpg crtd-clat crtd,,,2940.84,3714.74,6
HCPCS,356020,BPG CRTD-CLAT CRTD,,,1406.88,1406.88,1
HCPCS,35606,ART BYPASS CAROTID-SUBCLAVIAN,35547.0,23105.55,1397.3,31992.3,32
HCPCS,35606,BPG CAROTID-SUBCLAVIAN,,,1396.0,1396.0,1
HCPCS,35606,BYP OTH/THN VEIN CAROTID-SUBCLAVIAN,8984.0,5839.6,879.34,8984.0,35
HCPCS,356060,BPG CAROTID-SUBCLAVIAN,,,1396.0,1396.0,1
HCPCS,35612,BPG SUBCLAVIAN-SUBCLAVIAN,,,1245.05,1245.05,1
HCPCS,35612,BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN,7019.0,4562.35,785.38,18285.0,67
HCPCS,356120,BPG SUBCLAVIAN-SUBCLAVIAN,,,1245.05,1245.05,1
HCPCS,35616,BPG SUBCLAVIAN-AXILLARY,,,1311.95,1311.95,1
HCPCS,35616,BYP OTH/THN VEIN SUBCLAVIAN-AXILLARY,8728.0,5673.2,818.93,8728.0,35
HCPCS,35616,Bpg subclavian-axillary,,,3216.6,4063.07,6
HCPCS,356160,BPG SUBCLAVIAN-AXILLARY,,,1311.95,1311.95,1
HCPCS,35621,BPG AXILLARY-FEMORAL,,,1301.19,1301.19,1
HCPCS,35621,BYP OTH/THN VEIN AXILLARY-FEMORAL,8412.0,5467.8,819.59,8412.0,35
HCPCS,35621,Bpg axillary-femoral,,,3216.6,4063.07,6
HCPCS,356210,BPG AXILLARY-FEMORAL,,,1301.19,1301.19,1
HCPCS,35623,BPG AXILLARY-POP/-TIBIAL,,,1564.61,1564.61,1
HCPCS,35623,BYP OTH/THN VEIN AXILLARY-POPLITEAL/-TIBIAL,10368.0,6739.2,813.82,10368.0,35
HCPCS,35623,Bpg axillary-pop/-tibial,,,3216.6,4063.07,6
HCPCS,356230,BPG AXILLARY-POP/-TIBIAL,,,1564.61,1564.61,1
HCPCS,35626,BPG AOR-SUBCLA/INNOM/CAROTID,,,1878.98,1878.98,1
HCPCS,35626,BYPASS NOT VEIN AORTOSUBCLA/CAROTID/INNOMINATE,11656.0,7576.4,1180.63,11656.0,35
HCPCS,35626,Bpg aor-subcla/innom/carotid,,,5148.42,6503.27,6
HCPCS,356260,BPG AOR-SUBCLA/INNOM/CAROTID,,,1878.98,1878.98,1
HCPCS,35631,BPG AOR-CELIAC-MSN-RENAL,,,2200.18,2200.18,1
HCPCS,35631,BYP OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL,14412.0,9367.8,1142.15,14412.0,35
HCPCS,35631,Bpg aor-celiac-msn-renal,,,5148.42,6503.27,6
HCPCS,356310,BPG AOR-CELIAC-MSN-RENAL,,,2200.18,2200.18,1
HCPCS,35632,BPG ILIO-CELIAC,,,2151.17,2151.17,1
HCPCS,35632,Bpg ilio-celiac,,,5148.42,6503.27,6
HCPCS,356320,BPG ILIO-CELIAC,,,2151.17,2151.17,1
HCPCS,35633,BPG ILIO-MESENTERIC,,,2356.89,2356.89,1
HCPCS,35633,BYPASS GRAFT W/OTHER THAN VEIN ILIO-MESENTERIC,15644.0,10168.6,1478.58,15644.0,35
HCPCS,35633,Bpg ilio-mesenteric,,,5148.42,6503.27,6
HCPCS,356330,BPG ILIO-MESENTERIC,,,2356.89,2356.89,1
HCPCS,35634,BPG ILIORENAL,,,2105.06,2105.06,1
HCPCS,35634,Bpg iliorenal,,,5148.42,6503.27,6
HCPCS,356340,BPG ILIORENAL,,,2105.06,2105.06,1
HCPCS,35636,BPG SPLENORENAL,,,1898.95,1898.95,1
HCPCS,35636,BYP OTH/THN VEIN SPLENORENAL,12700.0,8255.0,935.23,12700.0,35
HCPCS,35636,Bpg splenorenal,,,5148.42,6503.27,6
HCPCS,356360,BPG SPLENORENAL,,,1898.95,1898.95,1
HCPCS,35637,BPG AORTOILIAC,,,1974.37,1974.37,1
HCPCS,35637,Bpg aortoiliac,,,5148.42,6503.27,6
HCPCS,356370,BPG AORTOILIAC,,,1974.37,1974.37,1
HCPCS,35638,BPG AORTOBI-ILIAC,,,2059.01,2059.01,1
HCPCS,35638,"BYPASS GRAFT OTHR,AORTOBI-ILIAC",13440.0,8736.0,1082.52,13440.0,35
HCPCS,35638,Bpg aortobi-iliac,,,5148.42,6503.27,6
HCPCS,356380,BPG AORTOBI-ILIAC,,,2059.01,2059.01,1
HCPCS,35642,BPG CAROTID-VERTEBRAL,,,1176.02,1176.02,1
HCPCS,35642,BYP OTH/THN VEIN CAROTID-VERTEBRAL,20633.0,13411.45,1185.76,18569.7,32
HCPCS,356420,BPG CAROTID-VERTEBRAL,,,1176.02,1176.02,1
HCPCS,35645,BPG SUBCLAVIAN-VERTEBRAL,,,1128.07,1128.07,1
HCPCS,35645,Bpg subclavian-vertebral,,,5148.42,6503.27,6
HCPCS,356450,BPG SUBCLAVIAN-VERTEBRAL,,,1128.07,1128.07,1
HCPCS,35646,BPG AORTOBIFEMORAL,,,2023.47,2023.47,1
HCPCS,35646,BYP OTH/THN VEIN AORTOBIFEMORAL,13192.0,8574.8,1257.31,13192.0,35
HCPCS,35646,Bpg aortobifemoral,,,5148.42,6503.27,6
HCPCS,356460,BPG AORTOBIFEMORAL,,,2023.47,2023.47,1
HCPCS,35647,BPG AORTOFEMORAL,,,1839.33,1839.33,1
HCPCS,35647,BYP OTH/THN VEIN AORTOFEMORAL,11892.0,7729.8,1132.55,11892.0,35
HCPCS,35647,Bpg aortofemoral,,,3216.6,4063.07,6
HCPCS,356470,BPG AORTOFEMORAL,,,1839.33,1839.33,1
HCPCS,35650,BPG AXILLARY-AXILLARY,,,1216.43,1216.43,1
HCPCS,35650,BYP OTH/THN VEIN AXILLARY-AXILLARY,8064.0,5241.6,766.48,8064.0,35
HCPCS,35650,Bpg axillary-axillary,,,3216.6,4063.07,6
HCPCS,356500,BPG AXILLARY-AXILLARY,,,1216.43,1216.43,1
HCPCS,35654,BPG AXILLARY-FEMORAL-FEMORAL,,,1618.54,1618.54,1
HCPCS,35654,BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL,10512.0,6832.8,991.88,10512.0,35
HCPCS,35654,Bpg axillary-femoral-femoral,,,5148.42,6503.27,6
HCPCS,356540,BPG AXILLARY-FEMORAL-FEMORAL,,,1618.54,1618.54,1
HCPCS,35656,BPG FEMORAL-POPLITEAL,,,1272.41,1272.41,1
HCPCS,35656,BYP OTH/THN VEIN FEMORAL-POPLITEAL,8188.0,5322.2,801.72,8188.0,35
HCPCS,35656,Bpg femoral-popliteal,,,3216.6,4063.07,6
HCPCS,356560,BPG FEMORAL-POPLITEAL,,,1272.41,1272.41,1
HCPCS,35661,ART BYP FEMORAL-FEMORAL,26455.0,17195.75,1285.35,23809.5,32
HCPCS,35661,BPG FEMORAL-FEMORAL,,,1283.35,1283.35,1
HCPCS,35661,BYP OTH/THN VEIN FEMORAL-FEMORAL,8140.0,5291.0,741.57,8140.0,35
HCPCS,356610,BPG FEMORAL-FEMORAL,,,1283.35,1283.35,1
HCPCS,35663,BPG ILIOILIAC,,,1451.15,1451.15,1
HCPCS,35663,BYP OTH/THN VEIN ILIOILIAC,9572.0,6221.8,806.59,9572.0,35
HCPCS,35663,Bpg ilioiliac,,,5148.42,6503.27,6
HCPCS,356630,BPG ILIOILIAC,,,1451.15,1451.15,1
HCPCS,35665,BPG ILIOFEMORAL,,,1392.53,1392.53,1
HCPCS,35665,BYP OTH/THN VEIN ILIOFEMORAL,8940.0,5811.0,863.22,8940.0,35
HCPCS,35665,Bpg iliofemoral,,,3216.6,4063.07,6
HCPCS,356650,BPG ILIOFEMORAL,,,1392.53,1392.53,1
HCPCS,35666,BPG FEM-ANT TIB PST TIB/PRNL,,,1523.64,1523.64,1
HCPCS,35666,BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL,9464.0,6151.6,961.55,9464.0,35
HCPCS,35666,Bpg fem-ant tib pst tib/prnl,,,3216.6,4063.07,6
HCPCS,356660,BPG FEM-ANT TIB PST TIB/PRNL,,,1523.64,1523.64,1
HCPCS,35671,BPG POP-TIBL/-PRNL ARTERY,,,1341.07,1341.07,1
HCPCS,35671,BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART,8308.0,5400.2,838.7,8308.0,35
HCPCS,35671,Bpg pop-tibl/-prnl artery,,,3216.6,4063.07,6
HCPCS,356710,BPG POP-TIBL/-PRNL ARTERY,,,1341.07,1341.07,1
HCPCS,35681,BYPASS COMPOSITE GRAFT PROSTHETIC & VEIN,640.0,416.0,59.24,640.0,35
HCPCS,35681,COMPOSITE BYP GRFT PROS&VEIN,,,94.82,94.82,1
HCPCS,35681,Composite byp grft pros&vein,,,3216.6,4063.07,6
HCPCS,356810,COMPOSITE BYP GRFT PROS&VEIN,,,94.82,94.82,1
HCPCS,35682,BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS,2876.0,1869.4,262.22,2876.0,35
HCPCS,35682,COMPOSITE BYP GRFT 2 VEINS,,,419.31,419.31,1
HCPCS,35682,Composite byp grft 2 veins,,,3216.6,4063.07,6
HCPCS,356820,COMPOSITE BYP GRFT 2 VEINS,,,419.31,419.31,1
HCPCS,35683,BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATION,3396.0,2207.4,301.43,3396.0,35
HCPCS,35683,COMPOSITE BYP GRFT 3/> SEGMT,,,486.56,486.56,1
HCPCS,35683,Composite byp grft 3/> segmt,,,3216.6,4063.07,6
HCPCS,356830,COMPOSITE BYP GRFT 3/> SEGMT,,,486.56,486.56,1
HCPCS,35685,BYPASS GRAFT PATENCY/PATCH,,,235.27,235.27,1
HCPCS,35685,Bypass graft patency/patch,,,3216.6,4063.07,6
HCPCS,35685,PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT,1616.0,1050.4,147.83,1616.0,35
HCPCS,356850,BYPASS GRAFT PATENCY/PATCH,,,235.27,235.27,1
HCPCS,35686,BYPASS GRAFT/AV FIST PATENCY,,,191.02,191.02,1
HCPCS,35686,Bypass graft/av fist patency,,,3216.6,4063.07,6
HCPCS,35686,CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO,1336.0,868.4,120.0,1336.0,35
HCPCS,356860,BYPASS GRAFT/AV FIST PATENCY,,,191.02,191.02,1
HCPCS,35691,ART TRNSPOSJ VERTBRL CAROTID,,,1126.45,1126.45,1
HCPCS,35691,Art trnsposj vertbrl carotid,,,2940.84,3714.74,6
HCPCS,35691,TRPOS&/RIMPLTJ VERTEBRAL CAROTID ART,7364.0,4786.6,710.57,7364.0,35
HCPCS,356910,ART TRNSPOSJ VERTBRL CAROTID,,,1126.45,1126.45,1
HCPCS,35693,ART TRNSPOSJ SUBCLAVIAN,,,996.14,996.14,1
HCPCS,35693,Art trnsposj subclavian,,,5148.42,6503.27,6
HCPCS,356930,ART TRNSPOSJ SUBCLAVIAN,,,996.14,996.14,1
HCPCS,35694,ART TRNSPOSJ SUBCLAV CAROTID,,,1176.65,1176.65,1
HCPCS,35694,Art trnsposj subclav carotid,,,2940.84,3714.74,6
HCPCS,35694,TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART,7712.0,5012.8,742.48,7712.0,35
HCPCS,356940,ART TRNSPOSJ SUBCLAV CAROTID,,,1176.65,1176.65,1
HCPCS,35695,ART TRNSPOSJ CAROTID SUBCLAV,,,1221.13,1221.13,1
HCPCS,35695,Art trnsposj carotid subclav,,,2940.84,3714.74,6
HCPCS,35695,TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART,8024.0,5215.6,743.63,8024.0,35
HCPCS,356950,ART TRNSPOSJ CAROTID SUBCLAV,,,1221.13,1221.13,1
HCPCS,35697,REIMPLANT ARTERY EACH,,,174.06,174.06,1
HCPCS,35697,RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART,1200.0,780.0,107.89,1200.0,35
HCPCS,35697,Reimplant artery each,,,2357.43,2977.81,6
HCPCS,356970,REIMPLANT ARTERY EACH,,,174.06,174.06,1
HCPCS,35700,REOPERATION BYPASS GRAFT,,,180.06,180.06,1
HCPCS,35700,ROPRTJ > 1 MO AFTER ORIGINAL OPRATION,1232.0,800.8,113.11,1232.0,35
HCPCS,35700,Reoperation bypass graft,,,2357.43,2977.81,6
HCPCS,357000,REOPERATION BYPASS GRAFT,,,180.06,180.06,1
HCPCS,35701,EXPL N/FLWD SURG NECK ART,,,519.54,519.54,1
HCPCS,35701,EXPLORATION N/FLWD SURG NECK ARTERY,3300.0,2145.0,314.59,3300.0,35
HCPCS,35701,Expl n/flwd surg neck art,,,2940.84,3714.74,6
HCPCS,357010,EXPL N/FLWD SURG NECK ART,,,519.54,519.54,1
HCPCS,35702,EXPL N/FLWD SURG UXTR ART,,,486.09,486.09,1
HCPCS,35702,EXPLORATION N/FLWD SURG UPPER EXTREMITY ARTERY,2848.0,1851.2,310.99,2848.0,31
HCPCS,35702,Expl n/flwd surg uxtr art,,,2357.43,2977.81,6
HCPCS,357020,EXPL N/FLWD SURG UXTR ART,,,486.09,486.09,1
HCPCS,35703,EXPL N/FLWD SURG LXTR ART,,,493.3,493.3,1
HCPCS,35703,EXPLORATION N/FLWD SURG LOWER EXTREMITY ARTERY,3000.0,1950.0,315.58,3000.0,31
HCPCS,35703,Expl n/flwd surg lxtr art,,,2357.43,2977.81,6
HCPCS,357030,EXPL N/FLWD SURG LXTR ART,,,493.3,493.3,1
HCPCS,3570F,RPRT BONE SCINT XREF W XRAY,,,0.01,0.01,1
HCPCS,3570F0,RPRT BONE SCINT XREF W XRAY,,,0.01,0.01,1
HCPCS,3572F,PT CONSID POSS RISK FX,,,0.01,0.01,1
HCPCS,3572F0,PT CONSID POSS RISK FX,,,0.01,0.01,1
HCPCS,3573F,PT NOT CONSID POSS RISK FX,,,0.01,0.01,1
HCPCS,3573F0,PT NOT CONSID POSS RISK FX,,,0.01,0.01,1
HCPCS,35800,EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK,4800.0,3120.0,353.58,4800.0,35
HCPCS,35800,EXPLORE NECK VESSELS,,,871.64,6391.96,6
HCPCS,35800,Explore neck vessels,,,2357.43,2977.81,6
HCPCS,358000,EXPLORE NECK VESSELS,,,871.64,871.64,1
HCPCS,35820,EXPL PO HEMRRG THROMBOSIS/INFCTJ CH,14756.0,9591.4,977.76,14756.0,35
HCPCS,35820,EXPLORE CHEST VESSELS,,,2389.27,2389.27,1
HCPCS,35820,Explore chest vessels,,,2357.43,2977.81,6
HCPCS,358200,EXPLORE CHEST VESSELS,,,2389.27,2389.27,1
HCPCS,35840,EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD,8300.0,5395.0,587.66,8300.0,35
HCPCS,35840,EXPLORE ABDOMINAL VESSELS,,,1452.45,1452.45,1
HCPCS,35840,Explore abdominal vessels,,,8579.14,10836.8,6
HCPCS,358400,EXPLORE ABDOMINAL VESSELS,,,1452.45,1452.45,1
HCPCS,35860,EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR,6100.0,3965.0,405.53,6100.0,35
HCPCS,35860,EXPLORE LIMB VESSELS,,,1000.16,6824.3,15
HCPCS,35860,Explore limb vessels,,,2357.43,2977.81,6
HCPCS,358600,EXPLORE LIMB VESSELS,,,1000.16,1000.16,1
HCPCS,35870,REPAIR VESSEL GRAFT DEFECT,,,1485.62,1485.62,1
HCPCS,35870,Repair vessel graft defect,,,5148.42,6503.27,6
HCPCS,358700,REPAIR VESSEL GRAFT DEFECT,,,1485.62,1485.62,1
HCPCS,35875,REMOVAL OF CLOT IN GRAFT,,,700.88,700.88,1
HCPCS,35875,THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL,21571.0,14021.15,443.24,34968.6,77
HCPCS,358750,REMOVAL OF CLOT IN GRAFT,,,700.88,700.88,1
HCPCS,35876,REMOVAL OF CLOT IN GRAFT,,,1117.75,11720.45,15
HCPCS,35876,Removal of clot in graft,,,2357.43,2977.81,6
HCPCS,35876,THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF,7128.0,4633.2,672.0,7128.0,35
HCPCS,358760,REMOVAL OF CLOT IN GRAFT,,,1117.75,1117.75,1
HCPCS,35879,REVISE GRAFT W/VEIN,,,1092.91,11720.45,15
HCPCS,35879,REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP,6964.0,4526.6,675.66,6964.0,35
HCPCS,35879,Revise graft w/vein,,,3216.6,4063.07,6
HCPCS,358790,REVISE GRAFT W/VEIN,,,1092.91,1092.91,1
HCPCS,35881,REVISE GRAFT W/VEIN,,,1220.96,11720.45,15
HCPCS,35881,REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS,7740.0,5031.0,741.67,7740.0,35
HCPCS,35881,Revise graft w/vein,,,3216.6,4063.07,6
HCPCS,358810,REVISE GRAFT W/VEIN,,,1220.96,1220.96,1
HCPCS,35883,REVJ FEM ANAST BPG GRN OPN W/NONAUTOG PATCH GRF,9260.0,6019.0,776.1,9260.0,35
HCPCS,35883,REVJ FEM ANAST NONAUTOG GRF,,,1419.9,11720.45,15
HCPCS,35883,Revj fem anast nonautog grf,,,3216.6,4063.07,6
HCPCS,358830,REVJ FEM ANAST NONAUTOG GRF,,,1419.9,1419.9,1
HCPCS,35884,"REVISE FEMORAL GRAFT, AUTOGENOUS GRAFT",9860.0,6409.0,824.28,9860.0,35
HCPCS,35884,REVJ FEM ANAST AUTOG VN GRF,,,1475.54,11720.45,15
HCPCS,35884,Revj fem anast autog vn grf,,,3216.6,4063.07,6
HCPCS,358840,REVJ FEM ANAST AUTOG VN GRF,,,1475.54,1475.54,1
HCPCS,35901,EXCISION GRAFT NECK,,,566.29,566.29,1
HCPCS,35901,"EXCISION, INFEC GRAFT, NECK",3352.0,2178.8,360.77,3352.0,35
HCPCS,35901,Excision graft neck,,,2357.43,2977.81,6
HCPCS,359010,EXCISION GRAFT NECK,,,566.29,566.29,1
HCPCS,35903,EXCISION GRAFT EXTREMITY,,,667.83,667.83,1
HCPCS,35903,EXCISION INFECTED GRAFT EXTREMITY,22623.0,14704.95,665.39,20360.7,42
HCPCS,35903,"EXCISION, INFEC GRAFT, EXTREMITY",3812.0,2477.8,423.84,3812.0,35
HCPCS,359030,EXCISION GRAFT EXTREMITY,,,667.83,667.83,1
HCPCS,35905,EXCISION GRAFT THORAX,,,2000.57,2000.57,1
HCPCS,35905,"EXCISION, INFEC GRAFT, THORAX",13408.0,8715.2,1044.11,13408.0,35
HCPCS,35905,Excision graft thorax,,,5148.42,6503.27,6
HCPCS,359050,EXCISION GRAFT THORAX,,,2000.57,2000.57,1
HCPCS,35907,EXCISION GRAFT ABDOMEN,,,2268.73,2268.73,1
HCPCS,35907,"EXCISION, INFEC GRAFT, ABDOMEN",14908.0,9690.2,1149.42,14908.0,35
HCPCS,35907,Excision graft abdomen,,,5148.42,6503.27,6
HCPCS,359070,EXCISION GRAFT ABDOMEN,,,2268.73,2268.73,1
HCPCS,36000,INTRODUCTION NEEDLE/INTRACATHETER VEIN,190.0,123.5,6.97,3920.0,169
HCPCS,36000,PLACE NEEDLE IN VEIN,,,10.83,10.83,1
HCPCS,360000,PLACE NEEDLE IN VEIN,,,10.83,10.83,1
HCPCS,36002,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,2614.0,1699.1,55.12,4151.0,272
HCPCS,36002,PSEUDOANEURYSM INJECTION TRT,,,122.95,122.95,1
HCPCS,360020,PSEUDOANEURYSM INJECTION TRT,,,122.95,122.95,1
HCPCS,36005,INJECTION EXT VENOGRAPHY,,,56.16,56.16,1
HCPCS,36005,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,836.0,543.4,33.48,3920.0,158
HCPCS,360050,INJECTION EXT VENOGRAPHY,,,56.16,56.16,1
HCPCS,36010,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,3801.0,2470.65,129.05,3920.0,111
HCPCS,36010,INTRO. OF CATH SUP/INF VENA CAVA,872.0,566.8,82.95,914.77,35
HCPCS,36010,PLACE CATHETER IN VEIN,,,128.3,128.3,1
HCPCS,360100,PLACE CATHETER IN VEIN,,,128.3,128.3,1
HCPCS,36011,PLACE CATHETER IN VEIN,,,183.93,183.93,1
HCPCS,36011,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,2878.5,1871.025,113.62,4050.9,146
HCPCS,360110,PLACE CATHETER IN VEIN,,,183.93,183.93,1
HCPCS,36012,PLACE CATHETER IN VEIN,,,204.95,204.95,1
HCPCS,36012,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,3142.0,2042.3,125.34,4392.0,146
HCPCS,360120,PLACE CATHETER IN VEIN,,,204.95,204.95,1
HCPCS,36013,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,2343.0,1522.9499999999998,89.8,3920.0,111
HCPCS,36013,PLACE CATHETER IN ARTERY,,,147.96,147.96,1
HCPCS,360130,PLACE CATHETER IN ARTERY,,,147.96,147.96,1
HCPCS,36014,PLACE CATHETER IN ARTERY,,,178.07,178.07,1
HCPCS,36014,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,2399.0,1559.35,110.79,3920.0,146
HCPCS,360140,PLACE CATHETER IN ARTERY,,,178.07,178.07,1
HCPCS,36015,PLACE CATHETER IN ARTERY,,,201.31,201.31,1
HCPCS,36015,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,2717.5,1766.375,126.81,3920.0,146
HCPCS,360150,PLACE CATHETER IN ARTERY,,,201.31,201.31,1
HCPCS,36100,ESTABLISH ACCESS TO ARTERY,,,180.81,180.81,1
HCPCS,36100,INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY,1332.0,865.8,105.48,3920.0,73
HCPCS,361000,ESTABLISH ACCESS TO ARTERY,,,180.81,180.81,1
HCPCS,36140,INTRO NDL ICATH UPR/LXTR ART,,,105.29,105.29,1
HCPCS,36140,INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY,2637.5,1714.375,68.26,4113.9,111
HCPCS,361400,INTRO NDL ICATH UPR/LXTR ART,,,105.29,105.29,1
HCPCS,36160,ESTABLISH ACCESS TO AORTA,,,144.98,144.98,1
HCPCS,36160,INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR,1232.5,801.125,93.96,3920.0,73
HCPCS,361600,ESTABLISH ACCESS TO AORTA,,,144.98,144.98,1
HCPCS,36200,INTRODUCTION CATHETER AORTA,2476.0,1609.4,103.17,3920.0,111
HCPCS,36200,PLACE CATHETER IN AORTA,,,165.11,165.11,1
HCPCS,362000,PLACE CATHETER IN AORTA,,,165.11,165.11,1
HCPCS,36215,PLACE CATHETER IN ARTERY,,,250.06,250.06,1
HCPCS,36215,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,5608.0,3645.2,157.75,8442.9,146
HCPCS,362150,PLACE CATHETER IN ARTERY,,,250.06,250.06,1
HCPCS,36216,PLACE CATHETER IN ARTERY,,,322.24,322.24,1
HCPCS,36216,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,5828.0,3788.2,168.17,8593.2,146
HCPCS,362160,PLACE CATHETER IN ARTERY,,,322.24,322.24,1
HCPCS,36217,PLACE CATHETER IN ARTERY,,,395.39,395.39,1
HCPCS,36217,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,6336.0,4118.4,214.3,9140.4,146
HCPCS,362170,PLACE CATHETER IN ARTERY,,,395.39,395.39,1
HCPCS,36218,PLACE CATHETER IN ARTERY,,,62.23,62.23,1
HCPCS,36218,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,821.0,533.6500000000001,36.76,3920.0,146
HCPCS,362180,PLACE CATHETER IN ARTERY,,,62.23,62.23,1
HCPCS,36221,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,12095.5,7862.075000000001,121.1,20360.7,115
HCPCS,36221,PLACE CATH THORACIC AORTA,,,237.11,237.11,1
HCPCS,362210,PLACE CATH THORACIC AORTA,,,237.11,237.11,1
HCPCS,36222,PLACE CATH CAROTID/INOM ART,,,340.12,340.12,1
HCPCS,36222,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,4646.0,3019.9,162.76,20360.7,253
HCPCS,362220,PLACE CATH CAROTID/INOM ART,,,340.12,340.12,1
HCPCS,36223,PLACE CATH CAROTID/INOM ART,,,392.45,392.45,1
HCPCS,36223,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,5060.0,3289.0,175.98,34968.6,253
HCPCS,362230,PLACE CATH CAROTID/INOM ART,,,392.45,392.45,1
HCPCS,36224,PLACE CATH CAROTD ART,,,440.43,440.43,1
HCPCS,36224,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,5500.0,3575.0,191.26,34968.6,253
HCPCS,362240,PLACE CATH CAROTD ART,,,440.43,440.43,1
HCPCS,36225,PLACE CATH SUBCLAVIAN ART,,,389.42,389.42,1
HCPCS,36225,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,5060.0,3289.0,175.23,20360.7,292
HCPCS,362250,PLACE CATH SUBCLAVIAN ART,,,389.42,389.42,1
HCPCS,36226,PLACE CATH VERTEBRAL ART,,,437.67,437.67,1
HCPCS,36226,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,5500.0,3575.0,191.6,34968.6,253
HCPCS,362260,PLACE CATH VERTEBRAL ART,,,437.67,437.67,1
HCPCS,36227,PLACE CATH XTRNL CAROTID,,,144.44,144.44,1
HCPCS,36227,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,1840.0,1196.0,60.49,7274.7,136
HCPCS,362270,PLACE CATH XTRNL CAROTID,,,144.44,144.44,1
HCPCS,36228,PLACE CATH INTRACRANIAL ART,,,297.84,297.84,1
HCPCS,36228,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,3400.0,2210.0,123.22,6577.2,136
HCPCS,362280,PLACE CATH INTRACRANIAL ART,,,297.84,297.84,1
HCPCS,36245,INS CATH ABD/L-EXT ART 1ST,,,277.98,277.98,1
HCPCS,36245,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,3438.0,2234.7,155.62,4514.4,146
HCPCS,362450,INS CATH ABD/L-EXT ART 1ST,,,277.98,277.98,1
HCPCS,36246,INS CATH ABD/L-EXT ART 2ND,,,299.05,299.05,1
HCPCS,36246,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,3832.0,2490.8,170.2,37851.0,185
HCPCS,362460,INS CATH ABD/L-EXT ART 2ND,,,299.05,299.05,1
HCPCS,36247,INS CATH ABD/L-EXT ART 3RD,,,351.63,351.63,1
HCPCS,36247,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,4747.0,3085.5499999999997,200.23,6152.4,146
HCPCS,362470,INS CATH ABD/L-EXT ART 3RD,,,351.63,351.63,1
HCPCS,36248,INS CATH ABD/L-EXT ART ADDL,,,56.56,56.56,1
HCPCS,36248,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,732.0,475.8,34.97,3920.0,146
HCPCS,362480,INS CATH ABD/L-EXT ART ADDL,,,56.56,56.56,1
HCPCS,36251,INS CATH REN ART 1ST UNILAT,,,301.73,301.73,1
HCPCS,36251,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,22623.0,14704.95,303.79,20360.7,147
HCPCS,36251,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UNI,2244.0,1458.6,217.14,2595.99,35
HCPCS,362510,INS CATH REN ART 1ST UNILAT,,,301.73,301.73,1
HCPCS,36252,INS CATH REN ART 1ST BILAT,,,421.45,421.45,1
HCPCS,36252,INS CATH RENAL ART 1ST BILAT,1287.0,836.55,282.59,2832.5,35
HCPCS,36252,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,22623.0,14704.95,411.79,20360.7,147
HCPCS,36252,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BILAT,2966.0,1927.9,282.59,2832.5,35
HCPCS,36252,THORACSCOPY REM TOTAL CORTEX,5357.0,3482.05,282.59,4017.75,35
HCPCS,362520,INS CATH REN ART 1ST BILAT,,,421.45,421.45,1
HCPCS,36253,INS CATH REN ART 2ND+ UNILAT,,,415.22,415.22,1
HCPCS,36253,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,38854.0,25255.1,425.5,34968.6,147
HCPCS,36253,SUPSLCTV CATH 2ND+ORD RENL&ACCES ARTERY/S&I UNI,3212.0,2087.8,301.55,4104.79,35
HCPCS,362530,INS CATH REN ART 2ND+ UNILAT,,,415.22,415.22,1
HCPCS,36254,INS CATH REN ART 2ND+ BILAT,,,491.42,491.42,1
HCPCS,36254,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,22623.0,14704.95,482.17,20360.7,147
HCPCS,36254,SUPSLCTV CATH 2ND+ORD RENL&ACCES ARTER/S&I BILAT,3160.0,2054.0,325.39,4026.28,35
HCPCS,362540,INS CATH REN ART 2ND+ BILAT,,,491.42,491.42,1
HCPCS,36260,INSERTION OF INFUSION PUMP,,,787.77,11720.45,15
HCPCS,36260,INSJ IMPLANTABLE INTRA-ARTERIAL INFUSION PUM,3964.0,2576.6,448.88,3964.0,35
HCPCS,36260,Insertion of infusion pump,,,4706.22,5944.7,6
HCPCS,362600,INSERTION OF INFUSION PUMP,,,787.77,787.77,1
HCPCS,36261,REVIS IMPLANT INTRA-ART INFUS PUMP,2252.0,1463.8,216.32,2252.0,35
HCPCS,36261,REVISION OF INFUSION PUMP,,,493.42,7890.6,15
HCPCS,36261,Revision of infusion pump,,,916.39,1157.54,6
HCPCS,362610,REVISION OF INFUSION PUMP,,,493.42,493.42,1
HCPCS,36262,REMOV IMPLANT INTRA-ART INFUS PUMP,1644.0,1068.6,160.69,1644.0,35
HCPCS,36262,REMOVAL OF INFUSION PUMP,,,376.53,7890.6,15
HCPCS,36262,Removal of infusion pump,,,916.39,1157.54,6
HCPCS,362620,REMOVAL OF INFUSION PUMP,,,376.53,376.53,1
HCPCS,36299,DIRECT PUNCTURE JUGULAR VEIN (COMP CODE 36005),1481.5,962.9749999999999,139.8,2298.6,45
HCPCS,36299,INJECTION FOR EGD W/ ECHO TIP (COMP CODE 36481),2893.0,1880.45,139.8,2893.0,15
HCPCS,36299,INJECTION HEPATIC ARTERY INFUSION PUMP (COMP CODE 36598),905.0,588.25,139.8,1362.6,45
HCPCS,36299,"UNLISTED PROCEDURE, VASCULAR INJECTION",463.0,300.95,77.78,521.0,30
HCPCS,36400,"VENIPUNC <3 Y/O,FEM,JUG,SAG SINUS",152.0,98.8,10.52,114.0,32
HCPCS,36400,VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN,198.0,128.7,2.52,3920.0,76
HCPCS,36400,VNPNXR<3YRS PHY/QHP FEM/JUG,,,22.08,22.08,1
HCPCS,364000,VNPNXR<3YRS PHY/QHP FEM/JUG,,,22.08,22.08,1
HCPCS,36405,VNPNXR <3 YEARS PHYS/QHP SKILL SCALP VEIN,161.0,104.65,2.52,3920.0,76
HCPCS,36405,VNPNXR<3YRS PHY/QHP SCALP VN,,,17.66,17.66,1
HCPCS,364050,VNPNXR<3YRS PHY/QHP SCALP VN,,,17.66,17.66,1
HCPCS,36406,VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN,161.0,104.65,2.52,3920.0,76
HCPCS,36406,VNPNXR<3YRS PHY/QHP OTHER VN,,,10.41,10.41,1
HCPCS,364060,VNPNXR<3YRS PHY/QHP OTHER VN,,,10.41,10.41,1
HCPCS,36410,VNPNXR 3 YEARS/> PHYS/QHP SKILL,178.5,116.02499999999999,7.12,3920.0,216
HCPCS,36410,VNPNXR 3YR/> PHY/QHP DX/THER,,,10.83,10.83,1
HCPCS,364100,VNPNXR 3YR/> PHY/QHP DX/THER,,,10.83,10.83,1
HCPCS,36415,COLL VENOUS BLD VENIPUNCTURE,,,7.62,7.62,1
HCPCS,36415,COLLECTION VENOUS BLOOD VENIPUNCTURE,28.5,18.525,2.34,18285.0,65
HCPCS,36415,ROUTINE VENIPUNCTURE,28.5,18.525,2.34,261.0,62
HCPCS,36415,VENIPUNCTURE,20.0,13.0,2.52,261.0,45
HCPCS,36415,VENIPUNCTURE (LAB DRAW),37.0,24.05,2.34,37.0,17
HCPCS,364150,COLL VENOUS BLD VENIPUNCTURE,,,7.62,7.62,1
HCPCS,36416,CAPILLARY STICK (POINT OF CARE),60.0,39.0,2.52,261.0,35
HCPCS,36416,COLL CAP BLOOD SPECIMEN,60.0,39.0,2.52,261.0,35
HCPCS,36416,COLLECTION CAPILLARY BLOOD,31.0,20.15,3.45,31.0,14
HCPCS,36416,COLLECTION CAPILLARY BLOOD SPECIMEN,60.0,39.0,2.52,3920.0,37
HCPCS,36416,COLLJ CAPILLARY BLOOD SPEC,,,7.07,7.07,1
HCPCS,364160,COLLJ CAPILLARY BLOOD SPEC,,,7.07,7.07,1
HCPCS,36420,VENIPUNCTURE CUTDOWN < 1 YR,,,57.42,57.42,1
HCPCS,36420,VENIPUNCTURE CUTDOWN UNDER AGE 1 YR,926.0,601.9,44.56,3920.0,98
HCPCS,364200,VENIPUNCTURE CUTDOWN < 1 YR,,,57.42,57.42,1
HCPCS,36425,VENIPUNCTURE CUTDOWN 1 YR/>,,,47.0,47.0,1
HCPCS,36425,VENIPUNCTURE CUTDOWN AGE 1 YR/>,2868.0,1864.2,44.56,3920.0,98
HCPCS,36425,VENOUS CUTDOWN >1 Y/O,304.0,197.6,27.7,304.0,35
HCPCS,364250,VENIPUNCTURE CUTDOWN 1 YR/>,,,47.0,47.0,1
HCPCS,36430,BLOOD TRANSFUSION 1 HOUR,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 10 HRS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 11 HRS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 12 HRS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 13 HRS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 14 HRS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 15 HRS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 16 HRS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 2 HOURS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 3 HOURS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 4 HOURS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 5 HOURS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 6 HOURS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 7 HOURS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 8 HOURS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,BLOOD TRANSFUSION 9 HOURS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,TRANSFUSION BLD/BLD COMPNT,,,47.56,47.56,1
HCPCS,36430,TRANSFUSION BLOOD OR BLOOD COMPONENTS,3143.0,2042.95,69.51,3920.0,49
HCPCS,36430,TRANSFUSION BLOOD/BLOOD COMPONENTS,2100.0,1365.0,27.55,3920.0,84
HCPCS,36430,TXFUS BLOOD/BLOOD COMPONENT,3143.0,2042.95,69.51,3920.0,49
HCPCS,364300,TRANSFUSION BLD/BLD COMPNT,,,47.56,47.56,1
HCPCS,36440,BLD PUSH TFUJ 2 YR/<,,,59.37,947.88,15
HCPCS,36440,Bld push tfuj 2 yr/<,,,275.45,347.94,6
HCPCS,364400,BLD PUSH TFUJ 2 YR/<,,,59.37,59.37,1
HCPCS,36450,BLD EXCHANGE TRUJ NEWBORN,,,201.77,947.88,15
HCPCS,36450,Bld exchange truj newborn,,,275.45,347.94,6
HCPCS,364500,BLD EXCHANGE TRUJ NEWBORN,,,201.77,201.77,1
HCPCS,36455,BLD EXCHANGE TRUJ OTH THN NB,,,149.58,947.88,15
HCPCS,36455,Bld exchange truj oth thn nb,,,275.45,347.94,6
HCPCS,364550,BLD EXCHANGE TRUJ OTH THN NB,,,149.58,149.58,1
HCPCS,36456,PRTL EXCHANGE TRANSFUSE BLOOD/PLSM/CRYST NEWBORN,880.0,572.0,82.42,880.0,28
HCPCS,36456,PRTL EXCHANGE TRANSFUSE NB,,,115.15,947.88,15
HCPCS,36456,Prtl exchange transfuse nb,,,275.45,347.94,6
HCPCS,364560,PRTL EXCHANGE TRANSFUSE NB,,,115.15,115.15,1
HCPCS,36460,INTRAUTERINE TRANSFUSION FTL,,,411.98,947.88,15
HCPCS,36460,Intrauterine transfusion ftl,,,275.45,347.94,6
HCPCS,364600,INTRAUTERINE TRANSFUSION FTL,,,411.98,411.98,1
HCPCS,36465,NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN,940.0,611.0,92.65,2633.48,31
HCPCS,36465,NJX NONCMPND SCLRSNT 1 VEIN,,,141.18,3966.07,15
HCPCS,36465,Njx noncmpnd sclrsnt 1 vein,,,399.63,504.79,6
HCPCS,364650,NJX NONCMPND SCLRSNT 1 VEIN,,,141.18,141.18,1
HCPCS,36466,NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS,1200.0,780.0,117.83,2754.26,31
HCPCS,36466,NJX NONCMPND SCLRSNT MLT VN,,,180.04,3966.07,15
HCPCS,36466,Njx noncmpnd sclrsnt mlt vn,,,399.63,504.79,6
HCPCS,364660,NJX NONCMPND SCLRSNT MLT VN,,,180.04,180.04,1
HCPCS,36468,INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK,1564.0,1016.6,31.27,3920.0,60
HCPCS,36468,NJX SCLRSNT SPIDER VEINS,,,81.27,81.27,1
HCPCS,36468,SCLEROTHERAPY/SPIDER VEINS-SINGLE OR MULTIPLE INJECTIONS,350.0,227.5,31.27,350.0,15
HCPCS,364680,NJX SCLRSNT SPIDER VEINS,,,81.27,81.27,1
HCPCS,36470,"INJ SCLEROSING SOLUTION, SINGLE VEIN",2871.0,1866.15,45.28,4151.0,49
HCPCS,36470,INJECTION SCLEROSANT SINGLE INCMPTNT VEIN,1585.5,1030.575,36.49,4151.0,130
HCPCS,36470,NJX SCLRSNT 1 INCMPTNT VEIN,,,45.31,45.31,1
HCPCS,36470,"SCLEROTHERAPY/VARICOSE VEINS, SINGLE VEIN",225.0,146.25,36.49,254.09,35
HCPCS,364700,NJX SCLRSNT 1 INCMPTNT VEIN,,,45.31,45.31,1
HCPCS,36471,COSMETIC SCHLEROTHERAPY MLT VNS LEV 1,189.0,122.85,55.05,298.43,35
HCPCS,36471,COSMETIC SCHLEROTHERAPY MLT VNS LEV 2,375.0,243.75,55.05,298.43,35
HCPCS,36471,COSMETIC SCHLEROTHERAPY MLT VNS LEV 3,590.0,383.5,55.05,442.5,35
HCPCS,36471,INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS,1765.5,1147.575,55.05,4151.0,81
HCPCS,36471,NJX SCLRSNT MLT INCMPTNT VN,,,90.23,90.23,1
HCPCS,36471,"SCHLEROTHERAPY/VARICOSE VEINS, MULTIPLE VEINS",500.0,325.0,55.05,375.0,35
HCPCS,36471,SCLEROTHERAP MULTIPLE VEINS,819.0,532.35,55.05,614.25,35
HCPCS,364710,NJX SCLRSNT MLT INCMPTNT VN,,,90.23,90.23,1
HCPCS,36473,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM 1ST VEIN,1400.0,910.0,134.51,2477.91,28
HCPCS,36473,ENDOVENOUS MCHNCHEM 1ST VEIN,,,215.09,6824.3,15
HCPCS,36473,Endovenous mchnchem 1st vein,,,1583.18,1999.8,6
HCPCS,364730,ENDOVENOUS MCHNCHEM 1ST VEIN,,,215.09,215.09,1
HCPCS,36474,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM SBSQ VEINS,700.0,455.0,67.38,525.0,28
HCPCS,36474,ENDOVENOUS MCHNCHEM ADD-ON,,,105.16,105.16,1
HCPCS,36474,Endovenous mchnchem add-on,,,1583.18,1999.8,6
HCPCS,364740,ENDOVENOUS MCHNCHEM ADD-ON,,,105.16,105.16,1
HCPCS,36475,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN,12371.5,8041.475,257.61,20360.7,77
HCPCS,36475,ENDOVENOUS RF 1ST VEIN,,,329.37,329.37,1
HCPCS,364750,ENDOVENOUS RF 1ST VEIN,,,329.37,329.37,1
HCPCS,36476,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS,7670.0,4985.5,119.96,12852.0,66
HCPCS,36476,ENDOVENOUS RF VEIN ADD-ON,,,158.08,158.08,1
HCPCS,364760,ENDOVENOUS RF VEIN ADD-ON,,,158.08,158.08,1
HCPCS,36478,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,12477.5,8110.375,266.63,20360.7,77
HCPCS,36478,ENDOVENOUS LASER 1ST VEIN,,,329.08,329.08,1
HCPCS,364780,ENDOVENOUS LASER 1ST VEIN,,,329.08,329.08,1
HCPCS,36479,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,7723.0,5019.95,118.83,12852.0,66
HCPCS,36479,ENDOVENOUS LASER VEIN ADDON,,,161.02,161.02,1
HCPCS,364790,ENDOVENOUS LASER VEIN ADDON,,,161.02,161.02,1
HCPCS,36481,INSERTION OF CATHETER VEIN,,,381.82,381.82,1
HCPCS,36481,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,2200.5,1430.3249999999998,241.07,3920.0,146
HCPCS,364810,INSERTION OF CATHETER VEIN,,,381.82,381.82,1
HCPCS,36482,ENDOVEN ABLTI THER CHEM ADHESIVE 1ST VEIN,20127.0,13082.55,137.38,34968.6,70
HCPCS,36482,ENDOVEN THER CHEM ADHES 1ST,,,212.75,212.75,1
HCPCS,364820,ENDOVEN THER CHEM ADHES 1ST,,,212.75,212.75,1
HCPCS,36483,ENDOVEN ABLTI THER CHEM ADHESIVE SBSQ VEIN,2812.0,1827.8,68.54,4431.6,66
HCPCS,36483,ENDOVEN THER CHEM ADHES SBSQ,,,105.03,105.03,1
HCPCS,364830,ENDOVEN THER CHEM ADHES SBSQ,,,105.03,105.03,1
HCPCS,36500,INSERTION OF CATHETER VEIN,,,215.16,215.16,1
HCPCS,36500,VEN CATHJ SLCTV ORGAN BLD SAMPLING,1739.5,1130.675,104.0,3920.0,146
HCPCS,365000,INSERTION OF CATHETER VEIN,,,215.16,215.16,1
HCPCS,3650F,EEG ORDERED RVWD REQSTD,,,0.01,0.01,1
HCPCS,3650F0,EEG ORDERED RVWD REQSTD,,,0.01,0.01,1
HCPCS,36510,CATHJ UMBILICAL VEIN DX/THER NB,298.5,194.02499999999998,26.48,3920.0,73
HCPCS,36510,INSERTION OF CATHETER VEIN,,,63.0,63.0,1
HCPCS,365100,INSERTION OF CATHETER VEIN,,,63.0,63.0,1
HCPCS,36511,APHERESIS WBC,,,130.41,130.41,1
HCPCS,36511,THERAPEUTIC APHERESIS WHITE BLOOD CELLS,11783.0,7658.95,126.91,10604.7,92
HCPCS,36511,THR APHERESIS WHITE BLD CELL,880.0,572.0,63.15,880.0,35
HCPCS,365110,APHERESIS WBC,,,130.41,130.41,1
HCPCS,36512,APHERESIS RBC,,,124.38,124.38,1
HCPCS,36512,THERAPEUTIC APHERESIS RED BLOOD CELLS,11783.0,7658.95,121.22,10604.7,46
HCPCS,365120,APHERESIS RBC,,,124.38,124.38,1
HCPCS,36513,APHERESIS PLATELETS,,,125.11,125.11,1
HCPCS,36513,THERAPEUTIC APHERESIS PLATELETS,3143.0,2042.95,123.09,7730.0,46
HCPCS,365130,APHERESIS PLATELETS,,,125.11,125.11,1
HCPCS,36514,APHERESIS PLASMA,,,110.03,110.03,1
HCPCS,36514,THERAPEUTIC APHERESIS PLASMA,796.0,517.4,49.22,883.95,35
HCPCS,36514,THERAPEUTIC APHERESIS PLASMA PHERESIS,11783.0,7658.95,109.24,10604.7,46
HCPCS,365140,APHERESIS PLASMA,,,110.03,110.03,1
HCPCS,36516,APHERESIS IMMUNOADS SLCTV,,,102.07,10158.22,15
HCPCS,36516,Apheresis immunoads slctv,,,2646.54,3343.0,6
HCPCS,365160,APHERESIS IMMUNOADS SLCTV,,,102.07,102.07,1
HCPCS,36522,PHOTOPHERESIS,,,112.27,10158.22,15
HCPCS,36522,Photopheresis,,,2646.54,3343.0,6
HCPCS,365220,PHOTOPHERESIS,,,112.27,112.27,1
HCPCS,36555,INSERT NON-TUNNEL CV CATH,,,100.43,100.43,1
HCPCS,36555,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,22623.0,14704.95,112.14,20360.7,144
HCPCS,365550,INSERT NON-TUNNEL CV CATH,,,100.43,100.43,1
HCPCS,36556,INSERT NON-TUNNEL CV CATH,,,100.5,100.5,1
HCPCS,36556,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,11696.5,7602.725,46.28,37851.0,375
HCPCS,365560,INSERT NON-TUNNEL CV CATH,,,100.5,100.5,1
HCPCS,36557,INSERT TUNNELED CV CATH,,,382.51,382.51,1
HCPCS,36557,INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR,38854.0,25255.1,389.35,34968.6,39
HCPCS,365570,INSERT TUNNELED CV CATH,,,382.51,382.51,1
HCPCS,36558,INSERT TUNNELED CV CATH,,,304.82,304.82,1
HCPCS,36558,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,12321.5,8008.975,187.6,20360.7,326
HCPCS,365580,INSERT TUNNELED CV CATH,,,304.82,304.82,1
HCPCS,36560,INSERT TUNNELED CV CATH,,,458.03,6824.3,15
HCPCS,36560,Insert tunneled cv cath,,,1311.96,1657.21,6
HCPCS,365600,INSERT TUNNELED CV CATH,,,458.03,458.03,1
HCPCS,36561,INSERT TUNNELED CV CATH,,,392.18,392.18,1
HCPCS,36561,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,12585.5,8180.575000000001,228.07,20360.7,158
HCPCS,365610,INSERT TUNNELED CV CATH,,,392.18,392.18,1
HCPCS,36563,INSERT TUNNELED CV CATH,,,428.24,428.24,1
HCPCS,36563,INSJ TUNNELED CTR VAD W/SUBQ PUMP,38854.0,25255.1,438.02,34968.6,42
HCPCS,365630,INSERT TUNNELED CV CATH,,,428.24,428.24,1
HCPCS,36565,INSERT TUNNELED CV CATH,,,399.98,399.98,1
HCPCS,36565,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,12585.5,8180.575000000001,227.16,20360.7,158
HCPCS,365650,INSERT TUNNELED CV CATH,,,399.98,399.98,1
HCPCS,36566,INSERT TUNNELED CV CATH,,,422.44,422.44,1
HCPCS,36566,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,20811.0,13527.15,239.0,34968.6,116
HCPCS,365660,INSERT TUNNELED CV CATH,,,422.44,422.44,1
HCPCS,36568,INSERTION PICC W/O IMG GDN < 5 YR,11165.0,7257.25,118.19,10048.5,46
HCPCS,36568,INSJ PICC <5 YR W/O IMAGING,,,109.75,109.75,1
HCPCS,365680,INSJ PICC <5 YR W/O IMAGING,,,109.75,109.75,1
HCPCS,36569,INSERTION PICC W/O IMG GDN 5 YR/>,11040.0,7176.0,63.51,10048.5,323
HCPCS,36569,INSJ PICC 5 YR+ W/O IMAGING,,,112.55,112.55,1
HCPCS,365690,INSJ PICC 5 YR+ W/O IMAGING,,,112.55,112.55,1
HCPCS,36570,INSERT PICVAD CATH,,,397.05,397.05,1
HCPCS,36570,INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR,22623.0,14704.95,402.72,20360.7,39
HCPCS,365700,INSERT PICVAD CATH,,,397.05,397.05,1
HCPCS,36571,INSERT PICVAD CATH,,,370.72,370.72,1
HCPCS,36571,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,12431.5,8080.475,206.82,20360.7,158
HCPCS,365710,INSERT PICVAD CATH,,,370.72,370.72,1
HCPCS,36572,INSERTION PICC W/RS&I < 5 YR,4444.0,2888.6,103.21,6317.0,141
HCPCS,36572,INSERTION PICC W/RS&I < 5YR,801.0,520.65,71.08,693.82,31
HCPCS,36572,INSJ PICC RS&I <5 YR,,,96.65,96.65,1
HCPCS,365720,INSJ PICC RS&I <5 YR,,,96.65,96.65,1
HCPCS,36573,INSERTION PICC W/RS&I 5 YR >,748.0,486.2,65.84,654.16,31
HCPCS,36573,INSERTION PICC W/RS&I 5 YR/>,11165.0,7257.25,100.8,10048.5,144
HCPCS,36573,INSJ PICC RS&I 5 YR+,,,98.15,98.15,1
HCPCS,365730,INSJ PICC RS&I 5 YR+,,,98.15,98.15,1
HCPCS,36575,REPAIR TUNNELED CV CATH,,,39.39,39.39,1
HCPCS,36575,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,2356.0,1531.3999999999999,27.25,6289.0,272
HCPCS,365750,REPAIR TUNNELED CV CATH,,,39.39,39.39,1
HCPCS,36576,REPAIR TUNNELED CV CATH,,,216.49,216.49,1
HCPCS,36576,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,6180.5,4017.325,89.42,10048.5,231
HCPCS,365760,REPAIR TUNNELED CV CATH,,,216.49,216.49,1
HCPCS,36578,REPLACE TUNNELED CV CATH,,,240.81,240.81,1
HCPCS,36578,RPLCMT CATH CTR VAD SUBQ PORT/PMP,11969.5,7780.175,98.31,20360.7,203
HCPCS,365780,REPLACE TUNNELED CV CATH,,,240.81,240.81,1
HCPCS,36580,REPLACE CVAD CATH,,,76.94,76.94,1
HCPCS,36580,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,5870.5,3815.825,47.07,10048.5,326
HCPCS,365800,REPLACE CVAD CATH,,,76.94,76.94,1
HCPCS,36581,REPLACE TUNNELED CV CATH,,,214.75,214.75,1
HCPCS,36581,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,11957.5,7772.375,134.83,20360.7,242
HCPCS,365810,REPLACE TUNNELED CV CATH,,,214.75,214.75,1
HCPCS,36582,REPLACE TUNNELED CV CATH,,,339.11,339.11,1
HCPCS,36582,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,12309.5,8001.175,192.52,20360.7,158
HCPCS,365820,REPLACE TUNNELED CV CATH,,,339.11,339.11,1
HCPCS,36583,REPLACE TUNNELED CV CATH,,,392.22,392.22,1
HCPCS,36583,RPLCMT COMPL TUN CTR VAD W/SUBQ PMP,20536.0,13348.4,205.6,34968.6,77
HCPCS,365830,REPLACE TUNNELED CV CATH,,,392.22,392.22,1
HCPCS,36584,COMPL RPLCMT PICC RS&I,,,68.82,68.82,1
HCPCS,36584,COMPLETE REPLACEMENT PICC RS&I,5822.5,3784.625,43.66,10048.5,323
HCPCS,365840,COMPL RPLCMT PICC RS&I,,,68.82,68.82,1
HCPCS,36585,REPLACE PICVAD CATH,,,328.21,328.21,1
HCPCS,36585,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,12229.5,7949.175,181.51,20360.7,119
HCPCS,365850,REPLACE PICVAD CATH,,,328.21,328.21,1
HCPCS,36589,REMOVAL TUNNELED CV CATH,,,160.48,160.48,1
HCPCS,36589,RMVL TUN CVC W/O SUBQ PORT/PMP,2723.5,1770.275,86.25,37851.0,273
HCPCS,365890,REMOVAL TUNNELED CV CATH,,,160.48,160.48,1
HCPCS,36590,REMOVAL TUNNELED CV CATH,,,223.84,223.84,1
HCPCS,36590,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,6264.5,4071.925,104.56,10048.5,277
HCPCS,365900,REMOVAL TUNNELED CV CATH,,,223.84,223.84,1
HCPCS,36591,BLOOD DRAW VENOUS ACCESS DEV,926.0,601.9,44.56,3920.0,46
HCPCS,36591,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,481.0,312.65,13.08,3920.0,268
HCPCS,36591,DRAW BLOOD OFF VENOUS DEVICE,,,31.04,31.04,1
HCPCS,365910,DRAW BLOOD OFF VENOUS DEVICE,,,31.04,31.04,1
HCPCS,36592,COLL BLOOD OFF PICC VENOUS,926.0,601.9,44.56,3920.0,46
HCPCS,36592,COLLECT BLOOD FROM CATHETER VENOUS NOS,492.5,320.125,16.16,3920.0,176
HCPCS,36592,COLLECT BLOOD FROM PICC,,,33.65,33.65,1
HCPCS,365920,COLLECT BLOOD FROM PICC,,,33.65,33.65,1
HCPCS,36593,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,1448.0,941.1999999999999,24.57,3920.0,274
HCPCS,36593,DECLOT VASCULAR DEVICE,,,38.93,38.93,1
HCPCS,365930,DECLOT VASCULAR DEVICE,,,38.93,38.93,1
HCPCS,36595,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,12029.5,7819.175,129.36,20360.7,119
HCPCS,36595,MECH REMOV TUNNELED CV CATH,,,212.71,212.71,1
HCPCS,365950,MECH REMOV TUNNELED CV CATH,,,212.71,212.71,1
HCPCS,36596,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,5732.5,3726.125,31.55,10048.5,179
HCPCS,36596,MECH REMOV TUNNELED CV CATH,,,52.94,52.94,1
HCPCS,365960,MECH REMOV TUNNELED CV CATH,,,52.94,52.94,1
HCPCS,36597,REPOSITION VENOUS CATHETER,,,70.87,70.87,1
HCPCS,36597,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,5824.5,3785.925,28.6,10048.5,179
HCPCS,365970,REPOSITION VENOUS CATHETER,,,70.87,70.87,1
HCPCS,36598,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,905.0,588.25,26.46,4151.0,179
HCPCS,36598,INJ W/FLUOR EVAL CV DEVICE,,,41.88,41.88,1
HCPCS,365980,INJ W/FLUOR EVAL CV DEVICE,,,41.88,41.88,1
HCPCS,36600,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,527.0,342.55,7.56,3920.0,228
HCPCS,36600,WITHDRAWAL OF ARTERIAL BLOOD,,,17.69,17.69,1
HCPCS,366000,WITHDRAWAL OF ARTERIAL BLOOD,,,17.69,17.69,1
HCPCS,36620,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1150.5,747.825,32.94,3920.0,222
HCPCS,36620,INSERTION CATHETER ARTERY,,,52.64,52.64,1
HCPCS,366200,INSERTION CATHETER ARTERY,,,52.64,52.64,1
HCPCS,36625,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN,1352.5,879.125,78.86,3920.0,70
HCPCS,36625,INSERTION CATHETER ARTERY,,,125.09,125.09,1
HCPCS,366250,INSERTION CATHETER ARTERY,,,125.09,125.09,1
HCPCS,36640,ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN,22623.0,14704.95,138.85,20360.7,39
HCPCS,36640,INSERTION CATHETER ARTERY,,,139.14,139.14,1
HCPCS,366400,INSERTION CATHETER ARTERY,,,139.14,139.14,1
HCPCS,36660,CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY,315.0,204.75,44.56,18285.0,29
HCPCS,36660,INSERTION CATHETER ARTERY,,,80.65,80.65,1
HCPCS,366600,INSERTION CATHETER ARTERY,,,80.65,80.65,1
HCPCS,36680,INSERT NEEDLE BONE CAVITY,,,71.56,71.56,1
HCPCS,36680,PLACEMENT NEEDLE INTRAOSSEOUS INFUSION,2868.0,1864.2,76.83,4151.0,144
HCPCS,36680,PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION,528.0,343.2,45.45,528.0,35
HCPCS,366800,INSERT NEEDLE BONE CAVITY,,,71.56,71.56,1
HCPCS,36800,INSERTION OF CANNULA,,,143.23,143.23,1
HCPCS,36800,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,19961.5,12974.974999999999,90.9,34968.6,74
HCPCS,368000,INSERTION OF CANNULA,,,143.23,143.23,1
HCPCS,36810,INSERTION OF CANNULA,,,247.6,6824.3,15
HCPCS,36810,INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL,1584.0,1029.6,145.79,1584.0,35
HCPCS,36810,Insertion of cannula,,,1311.96,1657.21,6
HCPCS,368100,INSERTION OF CANNULA,,,247.6,247.6,1
HCPCS,36815,INSERTION OF CANNULA,,,160.98,11720.45,15
HCPCS,36815,INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR,1048.0,681.2,101.87,1048.0,35
HCPCS,36815,Insertion of cannula,,,1311.96,1657.21,6
HCPCS,368150,INSERTION OF CANNULA,,,160.98,160.98,1
HCPCS,36818,ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS,4956.0,3221.4,513.3,4956.0,35
HCPCS,36818,AV FUSE UPPR ARM CEPHALIC,,,816.87,11720.45,15
HCPCS,36818,Av fuse uppr arm cephalic,,,2199.26,2778.01,6
HCPCS,368180,AV FUSE UPPR ARM CEPHALIC,,,816.87,816.87,1
HCPCS,36819,ARTVEN ANAST OPN UPR ARM BASLILIC VEN TRANS,38854.0,25255.1,863.44,34968.6,42
HCPCS,36819,ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS,5316.0,3455.4,547.16,5316.0,35
HCPCS,36819,AV FUSE UPPR ARM BASILIC,,,865.88,865.88,1
HCPCS,368190,AV FUSE UPPR ARM BASILIC,,,865.88,865.88,1
HCPCS,36820,ARVEN ANAST OPN F/ARM VEIN TRPOS,5228.0,3398.2,548.18,5228.0,35
HCPCS,36820,AV FUSION/FOREARM VEIN,,,860.58,11720.45,15
HCPCS,36820,Av fusion/forearm vein,,,2199.26,2778.01,6
HCPCS,368200,AV FUSION/FOREARM VEIN,,,860.58,860.58,1
HCPCS,36821,ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT,4760.0,3094.0,435.06,4760.0,35
HCPCS,36821,AV FUSION DIRECT ANY SITE,,,782.01,6824.3,15
HCPCS,36821,Av fusion direct any site,,,2199.26,2778.01,6
HCPCS,368210,AV FUSION DIRECT ANY SITE,,,782.01,782.01,1
HCPCS,36822,INSERT CANNULA PROLONG CP INSUFF,2362.0,1535.3,351.08,2362.0,16
HCPCS,36823,INSERTION OF CANNULA(S),,,1684.57,1684.57,1
HCPCS,36823,Insertion of cannula(s),,,2357.43,2977.81,6
HCPCS,368230,INSERTION OF CANNULA(S),,,1684.57,1684.57,1
HCPCS,36825,ARTERY-VEIN AUTOGRAFT,,,940.01,11720.45,15
HCPCS,36825,Artery-vein autograft,,,2199.26,2778.01,6
HCPCS,36825,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF,5668.0,3684.2,514.51,5668.0,35
HCPCS,368250,ARTERY-VEIN AUTOGRAFT,,,940.01,940.01,1
HCPCS,36830,ARTERY-VEIN NONAUTOGRAFT,,,789.77,15651.0,16
HCPCS,36830,Artery-vein nonautograft,,,2199.26,2778.01,6
HCPCS,36830,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF,4812.0,3127.8,501.2,4812.0,35
HCPCS,368300,ARTERY-VEIN NONAUTOGRAFT,,,789.77,789.77,1
HCPCS,36831,OPEN THROMBECT AV FISTULA,,,731.05,11720.45,15
HCPCS,36831,Open thrombect av fistula,,,2199.26,2778.01,6
HCPCS,36831,THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF,4400.0,2860.0,297.2,4400.0,35
HCPCS,368310,OPEN THROMBECT AV FISTULA,,,731.05,731.05,1
HCPCS,36832,AV FISTULA REVISION OPEN,,,895.92,895.92,1
HCPCS,36832,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,22127.0,14382.55,462.73,34968.6,77
HCPCS,368320,AV FISTULA REVISION OPEN,,,895.92,895.92,1
HCPCS,36833,AV FISTULA REVISION,,,956.12,956.12,1
HCPCS,36833,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,22327.0,14512.55,390.56,34968.6,77
HCPCS,368330,AV FISTULA REVISION,,,956.12,956.12,1
HCPCS,36835,INSERTION THOMAS SHUNT,,,574.6,6824.3,15
HCPCS,36835,Insertion thomas shunt,,,2199.26,2778.01,6
HCPCS,368350,INSERTION THOMAS SHUNT,,,574.6,574.6,1
HCPCS,36836,PERQ AV FISTULA CREATION UXTR SINGLE ACCESS,65972.0,42881.8,257.0,116157.6,112
HCPCS,36836,PRQ AV FSTL CRTJ UXTR 1 ACS,,,419.61,419.61,1
HCPCS,368360,PRQ AV FSTL CRTJ UXTR 1 ACS,,,419.61,419.61,1
HCPCS,36837,PERQ AV FISTULA CREATION UXTR SEP ACCESS SITES,66392.0,43154.8,336.06,116157.6,112
HCPCS,36837,PRQ AV FSTL CRT UXTR SEP ACS,,,542.94,542.94,1
HCPCS,368370,PRQ AV FSTL CRT UXTR SEP ACS,,,542.94,542.94,1
HCPCS,36838,DIST REVAS LIGATION HEMO,,,1353.14,11720.45,15
HCPCS,36838,DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS,8676.0,5639.4,841.63,8676.0,35
HCPCS,36838,Dist revas ligation hemo,,,2199.26,2778.01,6
HCPCS,368380,DIST REVAS LIGATION HEMO,,,1353.14,1353.14,1
HCPCS,36860,EXTERNAL CANNULA DECLOTTING,,,131.6,131.6,1
HCPCS,36860,XTRNL CANNULA DECLTNG SPX W/O BALO CATH,11165.0,7257.25,128.64,10048.5,98
HCPCS,368600,EXTERNAL CANNULA DECLOTTING,,,131.6,131.6,1
HCPCS,36861,CANNULA DECLOTTING,,,165.1,165.1,1
HCPCS,36861,XTRNL CANNULA DECLTNG SPX W/BALO CATH,38854.0,25255.1,162.32,34968.6,84
HCPCS,368610,CANNULA DECLOTTING,,,165.1,165.1,1
HCPCS,36901,INTRO CATH DIALYSIS CIRCUIT,,,197.75,197.75,1
HCPCS,36901,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I,6254.5,4065.425,118.39,10048.5,129
HCPCS,369010,INTRO CATH DIALYSIS CIRCUIT,,,197.75,197.75,1
HCPCS,36902,INTRO CATH DIALYSIS CIRCUIT,,,282.19,282.19,1
HCPCS,36902,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,21456.0,13946.4,176.42,36882.0,154
HCPCS,369020,INTRO CATH DIALYSIS CIRCUIT,,,282.19,282.19,1
HCPCS,36903,INTRO CATH DIALYSIS CIRCUIT,,,371.57,371.57,1
HCPCS,36903,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT,21427.5,13927.875,230.04,36269.1,115
HCPCS,369030,INTRO CATH DIALYSIS CIRCUIT,,,371.57,371.57,1
HCPCS,36904,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH,21990.0,14293.5,264.89,36882.0,115
HCPCS,36904,THRMBC/NFS DIALYSIS CIRCUIT,,,433.2,433.2,1
HCPCS,369040,THRMBC/NFS DIALYSIS CIRCUIT,,,433.2,433.2,1
HCPCS,36905,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP,42555.0,27660.75,332.5,73359.0,115
HCPCS,36905,THRMBC/NFS DIALYSIS CIRCUIT,,,519.54,519.54,1
HCPCS,369050,THRMBC/NFS DIALYSIS CIRCUIT,,,519.54,519.54,1
HCPCS,36906,PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT,35324.5,22960.925,388.04,59832.9,115
HCPCS,36906,THRMBC/NFS DIALYSIS CIRCUIT,,,600.37,600.37,1
HCPCS,369060,THRMBC/NFS DIALYSIS CIRCUIT,,,600.37,600.37,1
HCPCS,36907,(2017) TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,1200.0,780.0,101.69,1206.75,31
HCPCS,36907,BALO ANGIOP CTR DIALYSIS SEG,,,171.87,171.87,1
HCPCS,36907,TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,20284.0,13184.6,175.85,18255.6,62
HCPCS,369070,BALO ANGIOP CTR DIALYSIS SEG,,,171.87,171.87,1
HCPCS,36908,STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR,16104.0,10467.6,152.43,27457.2,93
HCPCS,36908,STENT PLMT CTR DIALYSIS SEG,,,244.19,244.19,1
HCPCS,369080,STENT PLMT CTR DIALYSIS SEG,,,244.19,244.19,1
HCPCS,36909,DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I,15055.5,9786.075,144.66,25616.7,93
HCPCS,36909,DIALYSIS CIRCUIT EMBOLJ,,,236.79,236.79,1
HCPCS,369090,DIALYSIS CIRCUIT EMBOLJ,,,236.79,236.79,1
HCPCS,3700F,PSYCH DISORDERS ASSESSED,,,0.01,0.01,1
HCPCS,3700F0,PSYCH DISORDERS ASSESSED,,,0.01,0.01,1
HCPCS,37140,REVISION OF CIRCULATION,,,2784.94,2784.94,1
HCPCS,37140,Revision of circulation,,,5148.42,6503.27,6
HCPCS,37140,VENOUS ANASTOMOSIS OPEN PORTOCAVAL,16000.0,10400.0,1136.03,16000.0,35
HCPCS,371400,REVISION OF CIRCULATION,,,2784.94,2784.94,1
HCPCS,37145,REVISION OF CIRCULATION,,,2583.84,2583.84,1
HCPCS,37145,Revision of circulation,,,2357.43,2977.81,6
HCPCS,371450,REVISION OF CIRCULATION,,,2583.84,2583.84,1
HCPCS,37160,REVISION OF CIRCULATION,,,2653.7,2653.7,1
HCPCS,37160,Revision of circulation,,,5148.42,6503.27,6
HCPCS,37160,VENOUS ANASTOMOSIS OPEN CAVAL-MESENTERIC,15200.0,9880.0,1082.28,15200.0,35
HCPCS,371600,REVISION OF CIRCULATION,,,2653.7,2653.7,1
HCPCS,37180,REVISION OF CIRCULATION,,,2550.75,2550.75,1
HCPCS,37180,Revision of circulation,,,5148.42,6503.27,6
HCPCS,371800,REVISION OF CIRCULATION,,,2550.75,2550.75,1
HCPCS,37181,SPLICE SPLEEN/KIDNEY VEINS,,,2784.94,2784.94,1
HCPCS,37181,Splice spleen/kidney veins,,,5148.42,6503.27,6
HCPCS,37181,VENOUS ANASTOMOSIS OPEN SPLENORENAL DISTAL,16000.0,10400.0,1106.92,16000.0,35
HCPCS,371810,SPLICE SPLEEN/KIDNEY VEINS,,,2784.94,2784.94,1
HCPCS,37182,INSERT HEPATIC SHUNT (TIPS),,,952.95,952.95,1
HCPCS,37182,INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT,14101.0,9165.65,597.44,21057.68,105
HCPCS,371820,INSERT HEPATIC SHUNT (TIPS),,,952.95,952.95,1
HCPCS,37183,REVISION TIPS,,,437.32,437.32,1
HCPCS,37183,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,14290.5,9288.825,231.76,22936.5,158
HCPCS,371830,REVISION TIPS,,,437.32,437.32,1
HCPCS,37184,PRIM ART M-THRMBC 1ST VSL,,,507.09,507.09,1
HCPCS,37184,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,33367.5,21688.875,315.59,56731.5,158
HCPCS,371840,PRIM ART M-THRMBC 1ST VSL,,,507.09,507.09,1
HCPCS,37185,PRIM ART M-THRMBC SBSQ VSL,,,192.09,192.09,1
HCPCS,37185,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,4183.5,2719.275,116.26,6231.6,125
HCPCS,371850,PRIM ART M-THRMBC SBSQ VSL,,,192.09,192.09,1
HCPCS,37186,SEC ART THROMBECTOMY ADD-ON,,,288.08,288.08,1
HCPCS,37186,SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL,5477.0,3560.05,178.83,8399.88,66
HCPCS,371860,SEC ART THROMBECTOMY ADD-ON,,,288.08,288.08,1
HCPCS,37187,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,20320.5,13208.325,288.8,33496.2,158
HCPCS,37187,VENOUS MECH THROMBECTOMY,,,462.23,462.23,1
HCPCS,371870,VENOUS MECH THROMBECTOMY,,,462.23,462.23,1
HCPCS,37188,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,12512.5,8133.125,204.43,20360.7,158
HCPCS,37188,VEN MECHNL THRMBC REPEAT TX,,,330.54,330.54,1
HCPCS,371880,VEN MECHNL THRMBC REPEAT TX,,,330.54,330.54,1
HCPCS,37191,INS ENDOVAS VENA CAVA FILTR,,,259.11,259.11,1
HCPCS,37191,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,12468.0,8104.2,184.18,20676.6,158
HCPCS,371910,INS ENDOVAS VENA CAVA FILTR,,,259.11,259.11,1
HCPCS,37192,REDO ENDOVAS VENA CAVA FILTR,,,409.87,409.87,1
HCPCS,37192,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,12731.5,8275.475,283.65,20360.7,119
HCPCS,371920,REDO ENDOVAS VENA CAVA FILTR,,,409.87,409.87,1
HCPCS,37193,REM ENDOVAS VENA CAVA FILTER,,,407.92,407.92,1
HCPCS,37193,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,12731.5,8275.475,284.13,20360.7,158
HCPCS,371930,REM ENDOVAS VENA CAVA FILTER,,,407.92,407.92,1
HCPCS,37195,THROMBOLYSIS CEREBRAL IV INFUSION,2229.5,1449.175,118.18,4268.0,113
HCPCS,37195,THROMBOLYTIC THERAPY STROKE,,,969.81,969.81,1
HCPCS,371950,THROMBOLYTIC THERAPY STROKE,,,969.81,969.81,1
HCPCS,37197,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,12640.5,8216.325,167.98,37851.0,206
HCPCS,37197,REMOVE INTRVAS FOREIGN BODY,,,354.14,354.14,1
HCPCS,371970,REMOVE INTRVAS FOREIGN BODY,,,354.14,354.14,1
HCPCS,37200,TRANSCATHETER BIOPSY,38854.0,25255.1,251.55,34968.6,124
HCPCS,37200,TRANSVASCULAR BIOPSY,1820.0,1183.0,161.37,1820.0,35
HCPCS,372000,TRANSCATHETER BIOPSY,,,251.55,251.55,1
HCPCS,37202,TCAT THER INFUSION OTH/THN THROMBOLYSIS ANY TYPE,1969.0,1279.85,330.79,1772.1,21
HCPCS,3720F,COGNIT IMPAIRMENT ASSESSED,,,0.01,0.01,1
HCPCS,3720F0,COGNIT IMPAIRMENT ASSESSED,,,0.01,0.01,1
HCPCS,37211,THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX,38854.0,25255.1,457.76,34968.6,144
HCPCS,37211,THROMBOLYSIS ARTERIAL INFUSION W/IMAGING INIT TX,3100.0,2015.0,286.43,3100.0,31
HCPCS,37211,THROMBOLYTIC ART THERAPY,,,456.76,456.76,1
HCPCS,372110,THROMBOLYTIC ART THERAPY,,,456.76,456.76,1
HCPCS,37212,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,12673.5,8237.775,252.52,20360.7,178
HCPCS,37212,THROMBOLYTIC VENOUS THERAPY,,,397.75,397.75,1
HCPCS,372120,THROMBOLYTIC VENOUS THERAPY,,,397.75,397.75,1
HCPCS,37213,THROMBLYTIC ART/VEN THERAPY,,,272.28,272.28,1
HCPCS,37213,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,12261.5,7969.975,168.51,36332.0,175
HCPCS,372130,THROMBLYTIC ART/VEN THERAPY,,,272.28,272.28,1
HCPCS,37214,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,22623.0,14704.95,145.66,36332.0,144
HCPCS,37214,CESSATION THROMBOLYTIC THRPY W/CATHETER REMOVAL,1096.0,712.4,91.66,1096.0,31
HCPCS,37214,CESSJ THERAPY CATH REMOVAL,,,143.88,143.88,1
HCPCS,372140,CESSJ THERAPY CATH REMOVAL,,,143.88,143.88,1
HCPCS,37215,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,17322.5,11259.625,740.7,24151.5,99
HCPCS,37215,TRANSCATH STENT CCA W/EPS,,,1171.89,1171.89,1
HCPCS,372150,TRANSCATH STENT CCA W/EPS,,,1171.89,1171.89,1
HCPCS,37216,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,15896.0,10332.4,747.59,22140.0,113
HCPCS,37216,TRANSCATH STENT CCA W/O EPS,,,1164.2,1164.2,1
HCPCS,372160,TRANSCATH STENT CCA W/O EPS,,,1164.2,1164.2,1
HCPCS,37217,STENT PLACEMT RETRO CAROTID,,,1278.31,1278.31,1
HCPCS,37217,Stent placemt retro carotid,,,8216.69,10378.98,6
HCPCS,37217,TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE,8152.0,5298.8,811.93,8152.0,31
HCPCS,372170,STENT PLACEMT RETRO CAROTID,,,1278.31,1278.31,1
HCPCS,37218,STENT PLACEMT ANTE CAROTID,,,978.81,978.81,1
HCPCS,37218,TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE,12817.0,8331.05,623.76,44585.0,109
HCPCS,372180,STENT PLACEMT ANTE CAROTID,,,978.81,978.81,1
HCPCS,37220,REVASCULARIZATION ILIAC ARTERY ANGIOP 1ST VSL,36761.0,23894.65,2345.0,33084.9,38
HCPCS,37221,REVSC OPN/PRQ ILIAC ART W/STNT PLMT & ANGIOPLSTY,45051.0,29283.15,2345.0,40545.9,38
HCPCS,37222,REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL,9336.0,6068.4,1568.45,15651.0,30
HCPCS,37223,REVSC OPN/PRQ ILIAC ART W/STNT & ANGIOP IPSILATL,8241.0,5356.65,1384.49,15651.0,30
HCPCS,37224,FEM/POPL REVAS W/TLA,17752.0,11538.8,224.51,13314.0,26
HCPCS,37224,"REVASC, FEM/POP ARTERY(S), UNILAT W/PTA",1623.0,1054.95,224.51,6958.3,26
HCPCS,37224,REVSC OPN/PRG FEM/POP W/ANGIOPLASTY UNI,26097.0,16963.05,2345.0,23487.3,38
HCPCS,37225,REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIOP SM VSL,57312.0,37252.8,2345.0,51580.8,38
HCPCS,37226,REVSC OPN/PRQ FEM/POP W/STNT/ANGIOP SM VSL,57312.0,37252.8,2345.0,51580.8,38
HCPCS,37227,REVSC OPN/PRQ FEM/POP W/STNT/ATHRC/ANGIOP SM VSL,57312.0,37252.8,2345.0,51580.8,38
HCPCS,37228,"REVASC, TIB, PER ARTERY, UNILAT, W/PTA",1984.0,1289.6,274.85,9885.22,26
HCPCS,37228,REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI,45051.0,29283.15,2345.0,40545.9,38
HCPCS,37228,TIB/PER REVASC W/TLA,25229.0,16398.85,274.85,18921.75,26
HCPCS,37229,REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP SM VSL,57312.0,37252.8,2345.0,51580.8,38
HCPCS,37230,REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP SM VSL,57312.0,37252.8,2345.0,51580.8,38
HCPCS,37231,REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP SM VSL,57312.0,37252.8,2345.0,51580.8,38
HCPCS,37232,REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI EA VSL,7772.0,5051.8,1305.7,15651.0,30
HCPCS,37233,REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP UNI EA VSL,61559.0,40013.35,1810.0,55403.1,30
HCPCS,37234,REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP UNI EA VSL,29772.0,19351.8,1810.0,26794.8,30
HCPCS,37235,REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP EA VSL,29771.0,19351.15,1810.0,26793.9,30
HCPCS,37236,OPEN/PERQ PLACE STENT 1ST,,,520.86,520.86,1
HCPCS,37236,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,26790.0,17413.5,347.06,45072.0,227
HCPCS,372360,OPEN/PERQ PLACE STENT 1ST,,,520.86,520.86,1
HCPCS,37237,OPEN/PERQ PLACE STENT EA ADD,,,249.92,249.92,1
HCPCS,37237,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL,9626.5,6257.225,162.49,44585.0,109
HCPCS,372370,OPEN/PERQ PLACE STENT EA ADD,,,249.92,249.92,1
HCPCS,37238,OPEN/PERQ PLACE STENT SAME,,,361.81,361.81,1
HCPCS,37238,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,24413.0,15868.45,243.1,44585.0,178
HCPCS,372380,OPEN/PERQ PLACE STENT SAME,,,361.81,361.81,1
HCPCS,37239,OPEN/PERQ PLACE STENT EA ADD,,,177.31,177.31,1
HCPCS,37239,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,9298.5,6044.025,113.42,44585.0,109
HCPCS,372390,OPEN/PERQ PLACE STENT EA ADD,,,177.31,177.31,1
HCPCS,37241,VASC EMBOLIZE/OCCLUDE VENOUS,,,502.45,502.45,1
HCPCS,37241,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,42680.0,27742.0,332.04,73359.0,115
HCPCS,372410,VASC EMBOLIZE/OCCLUDE VENOUS,,,502.45,502.45,1
HCPCS,37242,VASC EMBOLIZE/OCCLUDE ARTERY,,,560.17,560.17,1
HCPCS,37242,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,38823.0,25234.95,370.79,66000.6,164
HCPCS,372420,VASC EMBOLIZE/OCCLUDE ARTERY,,,560.17,560.17,1
HCPCS,37243,VASC EMBOLIZE/OCCLUDE ORGAN,,,656.06,656.06,1
HCPCS,37243,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,43338.0,28169.7,442.11,73359.0,115
HCPCS,372430,VASC EMBOLIZE/OCCLUDE ORGAN,,,656.06,656.06,1
HCPCS,37244,VASC EMBOLIZE/OCCLUDE BLEED,,,773.39,773.39,1
HCPCS,37244,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,31541.5,20501.975,515.72,51329.7,115
HCPCS,372440,VASC EMBOLIZE/OCCLUDE BLEED,,,773.39,773.39,1
HCPCS,37246,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,22030.0,14319.5,275.96,36882.0,115
HCPCS,37246,TRLUML BALO ANGIOP 1ST ART,,,410.67,410.67,1
HCPCS,372460,TRLUML BALO ANGIOP 1ST ART,,,410.67,410.67,1
HCPCS,37247,TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART,5274.0,3428.1,136.85,8107.2,93
HCPCS,37247,TRLUML BALO ANGIOP ADDL ART,,,204.71,204.71,1
HCPCS,372470,TRLUML BALO ANGIOP ADDL ART,,,204.71,204.71,1
HCPCS,37248,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN,21810.0,14176.5,237.29,36882.0,115
HCPCS,37248,TRLUML BALO ANGIOP 1ST VEIN,,,349.39,349.39,1
HCPCS,372480,TRLUML BALO ANGIOP 1ST VEIN,,,349.39,349.39,1
HCPCS,37249,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN,4031.0,2620.15,116.44,6079.5,93
HCPCS,37249,TRLUML BALO ANGIOP ADDL VEIN,,,171.78,171.78,1
HCPCS,372490,TRLUML BALO ANGIOP ADDL VEIN,,,171.78,171.78,1
HCPCS,37250,IV US NON-C VSL DX EVAL&/THER IVNTJ 1ST VSL,703.0,456.95,118.1,632.7,21
HCPCS,37252,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,4669.0,3034.85,72.32,7691.4,95
HCPCS,37252,INTRVASC US NONCORONARY 1ST,,,105.02,105.02,1
HCPCS,372520,INTRVASC US NONCORONARY 1ST,,,105.02,105.02,1
HCPCS,37253,INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL,3236.5,2103.725,57.88,5255.1,95
HCPCS,37253,INTRVASC US NONCORONARY ADDL,,,83.52,83.52,1
HCPCS,372530,INTRVASC US NONCORONARY ADDL,,,83.52,83.52,1
HCPCS,37254,REVSC EVASC IVT ANGIO SF 1ST,,,410.13,410.13,1
HCPCS,37254,REVSC EVASC IVT ANGIOP UNI SF LES 1ST VSL,22503.0,14626.949999999999,384.19,37851.0,60
HCPCS,372540,REVSC EVASC IVT ANGIO SF 1ST,,,410.13,410.13,1
HCPCS,37255,REVSC EVASC IVT ANGIO SF EA,,,166.32,166.32,1
HCPCS,37255,REVSC EVASC IVT ANGIOP UNI SF LES EA ADDL VSL,21557.0,14012.05,156.03,37851.0,57
HCPCS,372550,REVSC EVASC IVT ANGIO SF EA,,,166.32,166.32,1
HCPCS,37256,REVSC EVASC IVT ANGIO CPLX 1,,,601.31,601.31,1
HCPCS,37256,REVSC EVASC IVT ANGIOP UNI CPLX LES 1ST VSL,23262.0,15120.3,563.17,37851.0,60
HCPCS,372560,REVSC EVASC IVT ANGIO CPLX 1,,,601.31,601.31,1
HCPCS,37257,REVSC EVASC IVT ANGIOP UNI CPLX LES EA ADDL VSL,21753.0,14139.449999999999,202.05,37851.0,57
HCPCS,37257,REVSC EVSC IVT ANGIO CPLX EA,,,215.37,215.37,1
HCPCS,372570,REVSC EVSC IVT ANGIO CPLX EA,,,215.37,215.37,1
HCPCS,37258,REVSC EVASC IVT ST PLMT UNI SF LES 1ST VSL,44310.5,28801.825,460.34,76293.9,60
HCPCS,37258,REVSC EVASC IVT STENT SF 1ST,,,490.4,490.4,1
HCPCS,372580,REVSC EVASC IVT STENT SF 1ST,,,490.4,490.4,1
HCPCS,37259,REVSC EVASC IVT ST PLMT UNI SF LES EA ADDL VSL,43265.5,28122.575,209.05,76293.9,57
HCPCS,37259,REVSC EVASC IVT STENT SF EA,,,222.02,222.02,1
HCPCS,372590,REVSC EVASC IVT STENT SF EA,,,222.02,222.02,1
HCPCS,3725F,SCREEN DEPRESSION PERFORMED,,,0.01,0.01,1
HCPCS,3725F0,SCREEN DEPRESSION PERFORMED,,,0.01,0.01,1
HCPCS,37260,REVSC EVASC IVT ST CPLX 1ST,,,708.99,708.99,1
HCPCS,37260,REVSC EVASC IVT ST PLMT UNI CPLX LES 1ST VSL,45177.5,29365.375,665.36,76293.9,60
HCPCS,372600,REVSC EVASC IVT ST CPLX 1ST,,,708.99,708.99,1
HCPCS,37261,REVSC EVASC IVT ST CPLX EA,,,235.9,235.9,1
HCPCS,37261,REVSC EVASC IVT ST PLMT UNI CPLX LES EA ADDL VSL,43320.5,28158.325,222.1,76293.9,57
HCPCS,372610,REVSC EVASC IVT ST CPLX EA,,,235.9,235.9,1
HCPCS,37262,INTRAVASCULAR LITHOTRIPSY IVT WITHIN SAME ARTERY,1320.0,858.0,153.1,1320.0,21
HCPCS,37262,IV LITHOTRP IVT W/IN SM ART,,,165.89,165.89,1
HCPCS,37262,Iv lithotrp ivt w/in sm art,,,2417.66,3053.89,6
HCPCS,372620,IV LITHOTRP IVT W/IN SM ART,,,165.89,165.89,1
HCPCS,37263,REVSC EVASC FPVT ANGIO SF 1,,,435.11,435.11,1
HCPCS,37263,REVSC EVASC FPVT ANGIOP UNI SF LES 1ST VSL,22602.0,14691.3,407.94,37851.0,60
HCPCS,372630,REVSC EVASC FPVT ANGIO SF 1,,,435.11,435.11,1
HCPCS,37264,REVSC EVASC FPVT ANGIO SF EA,,,166.65,166.65,1
HCPCS,37264,REVSC EVASC FPVT ANGIOP UNI SF LES EA ADDL VSL,21557.0,14012.05,156.11,37851.0,57
HCPCS,372640,REVSC EVASC FPVT ANGIO SF EA,,,166.65,166.65,1
HCPCS,37265,REVSC EVASC FPVT ANGIOP UNI CPLX LES 1ST VSL,23207.0,15084.55,551.94,37851.0,60
HCPCS,37265,REVSC EVSC FPVT ANGIO CPLX 1,,,588.66,588.66,1
HCPCS,372650,REVSC EVSC FPVT ANGIO CPLX 1,,,588.66,588.66,1
HCPCS,37266,REVSC EVASC FPVT ANGIOP UNI CPLX LES EA ADDL VSL,21777.0,14155.05,207.71,37851.0,57
HCPCS,37266,RVSC EVSC FPVT ANGIO CPLX EA,,,221.82,221.82,1
HCPCS,372660,RVSC EVSC FPVT ANGIO CPLX EA,,,221.82,221.82,1
HCPCS,37267,REVSC EVASC FPVT ST PLMT UNI SF LES 1ST VSL,44310.5,28801.825,460.68,76293.9,60
HCPCS,37267,REVSC EVSC FPVT STENT SF 1ST,,,490.76,490.76,1
HCPCS,372670,REVSC EVSC FPVT STENT SF 1ST,,,490.76,490.76,1
HCPCS,37268,REVSC EVASC FPVT ST PLMT UNI SF LES EA ADDL VSL,43206.0,28083.9,194.86,76293.9,57
HCPCS,37268,REVSC EVASC FPVT STENT SF EA,,,207.55,207.55,1
HCPCS,372680,REVSC EVASC FPVT STENT SF EA,,,207.55,207.55,1
HCPCS,37269,REVSC EVASC FPVT ST CPLX 1ST,,,824.98,824.98,1
HCPCS,37269,REVSC EVASC FPVT ST PLMT UNI CPLX LES 1ST VSL,45630.5,29659.825,774.64,76293.9,60
HCPCS,372690,REVSC EVASC FPVT ST CPLX 1ST,,,824.98,824.98,1
HCPCS,37270,REVSC EVASC FPVT ST CPLX EA,,,278.64,278.64,1
HCPCS,37270,REVSC EVASC FPVT ST PLMT UNI CPLX LES EA ADD VSL,43485.5,28265.575,261.75,76293.9,57
HCPCS,372700,REVSC EVASC FPVT ST CPLX EA,,,278.64,278.64,1
HCPCS,37271,REVSC EVASC FPVT ATHRC UNI SF LES 1ST VSL,69286.5,45036.225,468.37,121151.7,60
HCPCS,37271,REVSC EVSC FPVT ATHRC SF 1ST,,,502.58,502.58,1
HCPCS,372710,REVSC EVSC FPVT ATHRC SF 1ST,,,502.58,502.58,1
HCPCS,37272,REVSC EVASC FPVT ATHRC UNI SF LES EA ADDL VSL,68186.5,44321.225,206.65,121151.7,57
HCPCS,37272,REVSC EVSC FPVT ATHRC SF EA,,,221.66,221.66,1
HCPCS,372720,REVSC EVSC FPVT ATHRC SF EA,,,221.66,221.66,1
HCPCS,37273,REVSC EVASC FPVT ATHRC UNI CPLX LES 1ST VSL,70085.0,45555.25,656.04,121151.7,60
HCPCS,37273,REVSC EVSC FPVT ATHRC CPLX 1,,,703.83,703.83,1
HCPCS,372730,REVSC EVSC FPVT ATHRC CPLX 1,,,703.83,703.83,1
HCPCS,37274,REVSC EVASC FPVT ATHRC UNI CPLX LES EA ADDL VSL,68516.5,44535.725,284.77,121151.7,57
HCPCS,37274,RVSC EVSC FPVT ATHRC CPLX EA,,,305.33,305.33,1
HCPCS,372740,RVSC EVSC FPVT ATHRC CPLX EA,,,305.33,305.33,1
HCPCS,37275,REVSC EVASC FPVT ST ATHRC UNI SF LES 1ST VSL,69726.5,45322.225,572.58,121151.7,60
HCPCS,37275,RVSC EVSC FPVT ST ATHRC SF 1,,,612.72,612.72,1
HCPCS,372750,RVSC EVSC FPVT ST ATHRC SF 1,,,612.72,612.72,1
HCPCS,37276,REVSC EVASC FPVT ST ATHRC UNI SF LES EA ADDL VSL,68241.5,44356.975,220.5,121151.7,57
HCPCS,37276,RVSC EVSC FPVT ST ATHR SF EA,,,235.67,235.67,1
HCPCS,372760,RVSC EVSC FPVT ST ATHR SF EA,,,235.67,235.67,1
HCPCS,37277,REVSC EVASC FPVT ST ATHRC UNI CPLX LES 1ST VSL,70606.5,45894.225,778.47,121151.7,60
HCPCS,37277,RVSC EVSC FPVT ST ATHR CPX 1,,,833.3,833.3,1
HCPCS,372770,RVSC EVSC FPVT ST ATHR CPX 1,,,833.3,833.3,1
HCPCS,37278,REVSC EVSC FPVT ST ATHRC UNI CPLX LES EA ADD VSL,68626.5,44607.225,309.18,121151.7,57
HCPCS,37278,RVSC EVSC FPVT ST ATH CPX EA,,,331.24,331.24,1
HCPCS,372780,RVSC EVSC FPVT ST ATH CPX EA,,,331.24,331.24,1
HCPCS,37279,INTRAVASCULAR LITHOTRIPSY FPVT W/IN SAME ARTERY,1760.0,1144.0,204.85,1760.0,21
HCPCS,37279,IV LITHOTRP FPVT W/IN SM ART,,,221.72,221.72,1
HCPCS,37279,Iv lithotrp fpvt w/in sm art,,,2417.66,3053.89,6
HCPCS,372790,IV LITHOTRP FPVT W/IN SM ART,,,221.72,221.72,1
HCPCS,37280,REVSC EVASC TPVT ANGIOP UNI SF LES 1ST VSL,44541.5,28951.975000000002,513.02,76293.9,60
HCPCS,37280,REVSC EVSC TPVT ANGIO SF 1ST,,,547.19,547.19,1
HCPCS,372800,REVSC EVSC TPVT ANGIO SF 1ST,,,547.19,547.19,1
HCPCS,37281,REVSC EVASC TPVT ANGIOP UNI SF LES EA ADDL VSL,43045.5,27979.575,153.34,76293.9,57
HCPCS,37281,REVSC EVSC TPVT ANGIO SF EA,,,164.62,164.62,1
HCPCS,372810,REVSC EVSC TPVT ANGIO SF EA,,,164.62,164.62,1
HCPCS,37282,REVSC EVASC TPVT ANGIOP UNI CPLX LES 1ST VSL,45093.5,29310.775,643.62,76293.9,60
HCPCS,37282,RVSC EVSC TPVT ANGIO CPLX 1,,,686.51,686.51,1
HCPCS,372820,RVSC EVSC TPVT ANGIO CPLX 1,,,686.51,686.51,1
HCPCS,37283,REVSC EVASC TPVT ANGIOP UNI CPLX LES EA ADDL VSL,43322.5,28159.625,218.68,76293.9,57
HCPCS,37283,RVSC EVSC TPVT ANGIO CPLX EA,,,234.47,234.47,1
HCPCS,372830,RVSC EVSC TPVT ANGIO CPLX EA,,,234.47,234.47,1
HCPCS,37284,REVSC EVASC TPVT ST PLMT UNI SF LES 1ST VSL,69506.5,45179.225,526.95,121151.7,60
HCPCS,37284,REVSC EVASC TPVT ST SF 1ST,,,563.64,563.64,1
HCPCS,372840,REVSC EVASC TPVT ST SF 1ST,,,563.64,563.64,1
HCPCS,37285,REVSC EVASC TPVT ST PLMT UNI SF LES EA ADDL VSL,68041.5,44226.975,173.08,121151.7,57
HCPCS,37285,REVSC EVASC TPVT ST SF EA,,,186.01,186.01,1
HCPCS,372850,REVSC EVASC TPVT ST SF EA,,,186.01,186.01,1
HCPCS,37286,REVSC EVASC TPVT ST CPLX 1ST,,,755.87,755.87,1
HCPCS,37286,REVSC EVASC TPVT ST PLMT UNI CPLX LES 1ST VSL,70267.5,45673.875,706.14,121151.7,60
HCPCS,372860,REVSC EVASC TPVT ST CPLX 1ST,,,755.87,755.87,1
HCPCS,37287,REVSC EVASC TPVT ST CPLX EA,,,279.83,279.83,1
HCPCS,37287,REVSC EVASC TPVT ST PLMT UNI CPLX LES EA ADD VSL,68406.5,44464.225,260.97,121151.7,57
HCPCS,372870,REVSC EVASC TPVT ST CPLX EA,,,279.83,279.83,1
HCPCS,37288,REVSC EVASC TPVT ATHRC UNI SF LES 1ST VSL,70276.5,45679.725,690.47,121151.7,60
HCPCS,37288,REVSC EVSC TPVT ATHRC SF 1ST,,,744.6,744.6,1
HCPCS,372880,REVSC EVSC TPVT ATHRC SF 1ST,,,744.6,744.6,1
HCPCS,37289,REVSC EVASC TPVT ATHRC UNI SF LES EA ADDL VSL,68351.5,44428.475,243.53,121151.7,57
HCPCS,37289,REVSC EVSC TPVT ATHRC SF EA,,,262.35,262.35,1
HCPCS,372890,REVSC EVSC TPVT ATHRC SF EA,,,262.35,262.35,1
HCPCS,37290,REVSC EVASC TPVT ATHRC UNI CPLX LES 1ST VSL,71046.5,46180.225,868.85,121151.7,60
HCPCS,37290,REVSC EVSC TPVT ATHRC CPLX 1,,,936.86,936.86,1
HCPCS,372900,REVSC EVSC TPVT ATHRC CPLX 1,,,936.86,936.86,1
HCPCS,37291,REVSC EVASC TPVT ATHRC UNI CPLX LES EA ADDL VSL,68736.5,44678.725,331.4,121151.7,57
HCPCS,37291,REVSC EVSC TPVT ATHR CPLX EA,,,357.8,357.8,1
HCPCS,372910,REVSC EVSC TPVT ATHR CPLX EA,,,357.8,357.8,1
HCPCS,37292,REVSC EVASC TPVT ST ATHRC UNI SF LES 1ST VSL,70606.5,45894.225,765.88,121151.7,60
HCPCS,37292,RVSC EVSC TPVT ST ATHRC SF 1,,,828.85,828.85,1
HCPCS,372920,RVSC EVSC TPVT ST ATHRC SF 1,,,828.85,828.85,1
HCPCS,37293,REVSC EVASC TPVT ST ATHRC UNI SF LES EA ADDL VSL,68736.5,44678.725,336.92,121151.7,57
HCPCS,37293,RVSC EVSC TPVT ST ATHR SF EA,,,364.14,364.14,1
HCPCS,372930,RVSC EVSC TPVT ST ATHR SF EA,,,364.14,364.14,1
HCPCS,37294,REVSC EVASC TPVT ST ATHRC UNI CPLX LES 1ST VSL,71266.5,46323.225,918.22,121151.7,60
HCPCS,37294,RVSC EVSC TPVT ST ATHR CPX 1,,,993.64,993.64,1
HCPCS,372940,RVSC EVSC TPVT ST ATHR CPX 1,,,993.64,993.64,1
HCPCS,37295,REVSC EVSC TPVT ST ATHRC UNI CPLX LES EA ADD VSL,69101.5,44915.975,425.56,121151.7,57
HCPCS,37295,RVSC EVSC TPVT ST ATH CPX EA,,,459.05,459.05,1
HCPCS,372950,RVSC EVSC TPVT ST ATH CPX EA,,,459.05,459.05,1
HCPCS,37296,REVSC EVASC IMVT ANGIO SF 1,,,612.95,612.95,1
HCPCS,37296,REVSC EVASC IMVT ANGIOP UNI SF LES 1ST VSL,44805.5,29123.575,574.18,76293.9,60
HCPCS,372960,REVSC EVASC IMVT ANGIO SF 1,,,612.95,612.95,1
HCPCS,37297,REVSC EVASC IMVT ANGIO SF EA,,,219.75,219.75,1
HCPCS,37297,REVSC EVASC IMVT ANGIOP UNI SF LES EA ADDL VSL,43265.5,28122.575,204.68,76293.9,57
HCPCS,372970,REVSC EVASC IMVT ANGIO SF EA,,,219.75,219.75,1
HCPCS,37298,REVSC EVASC IMVT ANGIOP UNI CPLX LES 1ST VSL,45399.5,29509.675,705.17,76293.9,60
HCPCS,37298,REVSC EVSC IMVT ANGIO CPLX 1,,,756.27,756.27,1
HCPCS,372980,REVSC EVSC IMVT ANGIO CPLX 1,,,756.27,756.27,1
HCPCS,37299,REVSC EVASC IMVT ANGIOP UNI CPLX LES EA ADDL VSL,43485.5,28265.575,254.2,76293.9,57
HCPCS,37299,REVSC EVSC IMVT ANGIO CPX EA,,,273.63,273.63,1
HCPCS,372990,REVSC EVSC IMVT ANGIO CPX EA,,,273.63,273.63,1
HCPCS,37500,ENDOSCOPY LIGATE PERF VEINS,,,5426.13,11720.45,10
HCPCS,37500,Endoscopy ligate perf veins,,,2357.43,2977.81,6
HCPCS,37501,ENDOSCOPIC HARVEST ARTERY IN BREAST RECON,1058.0,687.7,421.06,1058.0,16
HCPCS,37501,UNLISTED VASC ENDOSCOPY PX,,,620.6,1340.49,14
HCPCS,3750F,PTNOTRCVNGSTEROID>=10MG/DAY,,,0.01,0.01,1
HCPCS,3750F0,PTNOTRCVNGSTEROID>=10MG/DAY,,,0.01,0.01,1
HCPCS,3751F,ELECTRODIAG POLYNEURO 6 MN,,,0.01,0.01,1
HCPCS,3751F0,ELECTRODIAG POLYNEURO 6 MN,,,0.01,0.01,1
HCPCS,3752F,NO ELECTRODIAG POLYNEURO 6MN,,,0.01,0.01,1
HCPCS,3752F0,NO ELECTRODIAG POLYNEURO 6MN,,,0.01,0.01,1
HCPCS,3753F,PT HAS SYMP&SIGNS NEUROPATHY,,,0.01,0.01,1
HCPCS,3753F0,PT HAS SYMP&SIGNS NEUROPATHY,,,0.01,0.01,1
HCPCS,3754F,SCREENING TESTS DM DONE,,,0.01,0.01,1
HCPCS,3754F0,SCREENING TESTS DM DONE,,,0.01,0.01,1
HCPCS,3755F,COG&BEHAV IMPRMNT SCRNG DONE,,,0.01,0.01,1
HCPCS,3755F0,COG&BEHAV IMPRMNT SCRNG DONE,,,0.01,0.01,1
HCPCS,37565,LIGATION INT JUGULAR VEIN,,,867.47,6824.3,15
HCPCS,37565,LIGATION INTERNAL JUGULAR VEIN,4820.0,3133.0,389.55,4820.0,35
HCPCS,37565,Ligation int jugular vein,,,1320.48,1667.98,6
HCPCS,375650,LIGATION INT JUGULAR VEIN,,,867.47,867.47,1
HCPCS,3756F,PT W/PSEUDOBULB AFFECT/ALS,,,0.01,0.01,1
HCPCS,3756F0,PT W/PSEUDOBULB AFFECT/ALS,,,0.01,0.01,1
HCPCS,3757F,PT W/O PSEUDOBULBAFFECT/ALS,,,0.01,0.01,1
HCPCS,3757F0,PT W/O PSEUDOBULBAFFECT/ALS,,,0.01,0.01,1
HCPCS,3758F,PT REF PULM FX TEST/PEAKFLOW,,,0.01,0.01,1
HCPCS,3758F0,PT REF PULM FX TEST/PEAKFLOW,,,0.01,0.01,1
HCPCS,3759F,PT SCRN DYSPHAG/WT LOSS/NUTR,,,0.01,0.01,1
HCPCS,3759F0,PT SCRN DYSPHAG/WT LOSS/NUTR,,,0.01,0.01,1
HCPCS,37600,LIGATION EXTERNAL CAROTID ARTERY,4968.0,3229.2,413.39,4968.0,35
HCPCS,37600,LIGATION XTRNL CAROTID ART,,,890.42,6824.3,15
HCPCS,37600,Ligation xtrnl carotid art,,,2940.84,3714.74,6
HCPCS,376000,LIGATION XTRNL CAROTID ART,,,890.42,890.42,1
HCPCS,37605,LIGATION INT/COM CAROTID ART,,,880.45,6824.3,15
HCPCS,37605,LIGATION INTERNAL/COMMON CAROTID ARTERY,5712.0,3712.8,472.16,5712.0,35
HCPCS,37605,Ligation int/com carotid art,,,2940.84,3714.74,6
HCPCS,376050,LIGATION INT/COM CAROTID ART,,,880.45,880.45,1
HCPCS,37606,LIG INT/COM CAROTID ART OCCL,,,886.06,6824.3,15
HCPCS,37606,Lig int/com carotid art occl,,,2940.84,3714.74,6
HCPCS,376060,LIG INT/COM CAROTID ART OCCL,,,886.06,886.06,1
HCPCS,37607,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,12561.5,8164.975,254.97,20360.7,116
HCPCS,37607,LIG/BANDING ANGIOACS AV FSTL,,,443.61,443.61,1
HCPCS,376070,LIG/BANDING ANGIOACS AV FSTL,,,443.61,443.61,1
HCPCS,37609,LIGATION/BIOPSY TEMPORAL ARTERY,6432.5,4181.125,99.46,10480.5,133
HCPCS,37609,LIGATION/BX TEMPORAL ARTERY,,,242.45,242.45,1
HCPCS,376090,LIGATION/BX TEMPORAL ARTERY,,,242.45,242.45,1
HCPCS,3760F,PT W/DYSPHAG/WT LOSS/NUTR,,,0.01,0.01,1
HCPCS,3760F0,PT W/DYSPHAG/WT LOSS/NUTR,,,0.01,0.01,1
HCPCS,37615,LIGATION MAJOR ARTERY NECK,3120.0,2028.0,309.41,6824.3,50
HCPCS,37615,Ligation major artery neck,,,1320.48,1667.98,6
HCPCS,376150,LIGATION MAJOR ARTERY NECK,,,613.0,613.0,1
HCPCS,37616,LIGATION MAJOR ARTERY CHEST,7588.0,4932.2,606.42,7588.0,36
HCPCS,37616,Ligation major artery chest,,,5148.42,6503.27,6
HCPCS,376160,LIGATION MAJOR ARTERY CHEST,,,1343.1,1343.1,1
HCPCS,37617,LIGATION MAJOR ARTERY ABD,,,1581.8,6391.96,5
HCPCS,37617,LIGATION MAJOR ARTERY ABDOMEN,9516.0,6185.4,735.95,9516.0,35
HCPCS,37617,Ligation major artery abd,,,5148.42,6503.27,6
HCPCS,376170,LIGATION MAJOR ARTERY ABD,,,1581.8,1581.8,1
HCPCS,37618,LIGATION MAJOR ARTERY EXTREMITY,2412.0,1567.8,267.65,2412.0,35
HCPCS,37618,LIGATION MAJOR ARTERY XTR,,,467.14,467.14,1
HCPCS,37618,Ligation major artery xtr,,,1320.48,1667.98,6
HCPCS,376180,LIGATION MAJOR ARTERY XTR,,,467.14,467.14,1
HCPCS,37619,LIGATION OF INF VENA CAVA,,,2071.26,11720.45,15
HCPCS,37619,LIGATION OF INFERIOR VENA CAVA,12000.0,7800.0,845.07,12000.0,35
HCPCS,37619,Ligation of inf vena cava,,,2357.43,2977.81,6
HCPCS,376190,LIGATION OF INF VENA CAVA,,,2071.26,2071.26,1
HCPCS,3761F,PT W/O DYSPHAG/WT LOSS/NUTR,,,0.01,0.01,1
HCPCS,3761F0,PT W/O DYSPHAG/WT LOSS/NUTR,,,0.01,0.01,1
HCPCS,3762F,PATIENT IS DYSARTHRIC,,,0.01,0.01,1
HCPCS,3762F0,PATIENT IS DYSARTHRIC,,,0.01,0.01,1
HCPCS,3763F,PATIENT IS NOT DYSARTHRIC,,,0.01,0.01,1
HCPCS,3763F0,PATIENT IS NOT DYSARTHRIC,,,0.01,0.01,1
HCPCS,37650,LIGATION OF FEMORAL VEIN,3396.0,2207.4,290.07,6824.3,50
HCPCS,37650,Ligation of femoral vein,,,1320.48,1667.98,6
HCPCS,376500,LIGATION OF FEMORAL VEIN,,,547.8,547.8,1
HCPCS,37660,LIGATION COMMON ILIAC VEIN,,,1577.97,1577.97,1
HCPCS,37660,LIGATION OF COMMON ILIAC VEIN,8912.0,5792.8,693.39,8912.0,35
HCPCS,37660,Ligation common iliac vein,,,5148.42,6503.27,6
HCPCS,376600,LIGATION COMMON ILIAC VEIN,,,1577.97,1577.97,1
HCPCS,37700,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ,1528.0,993.2,186.39,1528.0,35
HCPCS,37700,LIGATION&DIV LONG SAPH VEIN,,,289.74,6824.3,15
HCPCS,37700,Ligation&div long saph vein,,,1583.18,1999.8,6
HCPCS,377000,LIGATION&DIV LONG SAPH VEIN,,,289.74,289.74,1
HCPCS,37718,LIG DIV&STRPG SHORT SAPH VN,,,468.28,6824.3,15
HCPCS,37718,LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN,2852.0,1853.8,289.32,2852.0,35
HCPCS,37718,Lig div&strpg short saph vn,,,1583.18,1999.8,6
HCPCS,377180,LIG DIV&STRPG SHORT SAPH VN,,,468.28,468.28,1
HCPCS,37722,LIG DIV&STRPG LONG SAPH VEIN,,,548.8,6824.3,15
HCPCS,37722,LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW,3590.0,2333.5,345.08,3590.0,35
HCPCS,37722,Lig div&strpg long saph vein,,,1583.18,1999.8,6
HCPCS,377220,LIG DIV&STRPG LONG SAPH VEIN,,,548.8,548.8,1
HCPCS,37735,LIG&DIV&COMPL STRPG SAPH VN,,,694.36,6824.3,15
HCPCS,37735,Lig&div&compl strpg saph vn,,,1583.18,1999.8,6
HCPCS,377350,LIG&DIV&COMPL STRPG SAPH VN,,,694.36,694.36,1
HCPCS,3775F,ADENOMA DETECTED SCREENING,,,0.01,0.01,1
HCPCS,3775F0,ADENOMA DETECTED SCREENING,,,0.01,0.01,1
HCPCS,37760,LIG PRFRATR VEIN SUBFSCAL RAD INCL SKN GRF 1 LEG,4312.0,2802.8,435.33,4312.0,35
HCPCS,37760,LIG PRFRATR VN RADICAL 1 LEG,,,687.43,6824.3,15
HCPCS,37760,Lig prfratr vn radical 1 leg,,,1583.18,1999.8,6
HCPCS,377600,LIG PRFRATR VN RADICAL 1 LEG,,,687.43,687.43,1
HCPCS,37761,LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG,3652.0,2373.8,325.0,3652.0,35
HCPCS,37761,LIGATE LEG VEINS OPEN,,,638.04,6824.3,15
HCPCS,37761,Ligate leg veins open,,,1583.18,1999.8,6
HCPCS,377610,LIGATE LEG VEINS OPEN,,,638.04,638.04,1
HCPCS,37765,STAB PHLEB VEINS XTR 10-20,,,320.9,6824.3,16
HCPCS,37765,STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS,2112.0,1372.8,262.02,1584.0,35
HCPCS,37765,Stab phleb veins xtr 10-20,,,1583.18,1999.8,6
HCPCS,377650,STAB PHLEB VEINS XTR 10-20,,,320.9,320.9,1
HCPCS,37766,PHLEB VEINS - EXTREM 20+,,,393.78,6824.3,18
HCPCS,37766,Phleb veins - extrem 20+,,,1583.18,1999.8,6
HCPCS,37766,STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS,2640.0,1716.0,320.87,1980.0,35
HCPCS,377660,PHLEB VEINS - EXTREM 20+,,,393.78,393.78,1
HCPCS,3776F,ADENOMA NOT DETECT SCREENING,,,0.01,0.01,1
HCPCS,3776F0,ADENOMA NOT DETECT SCREENING,,,0.01,0.01,1
HCPCS,37780,LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX,1572.0,1021.8,159.93,1572.0,35
HCPCS,37780,REVISION OF LEG VEIN,,,280.96,6824.3,15
HCPCS,37780,Revision of leg vein,,,1583.18,1999.8,6
HCPCS,377800,REVISION OF LEG VEIN,,,280.96,280.96,1
HCPCS,37785,LIGATE/DIVIDE/EXCISE VEIN,,,302.19,6824.3,15
HCPCS,37785,LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG,1729.0,1123.85,124.44,1296.75,35
HCPCS,37785,Ligate/divide/excise vein,,,1583.18,1999.8,6
HCPCS,377850,LIGATE/DIVIDE/EXCISE VEIN,,,302.19,302.19,1
HCPCS,37788,REVASCULARIZATION PENIS,,,1499.35,1499.35,1
HCPCS,37788,Revascularization penis,,,1932.48,2441.03,6
HCPCS,377880,REVASCULARIZATION PENIS,,,1499.35,1499.35,1
HCPCS,37790,PENILE VENOUS OCCLUSION,,,578.82,7477.94,15
HCPCS,37790,Penile venous occlusion,,,1256.84,1587.59,6
HCPCS,377900,PENILE VENOUS OCCLUSION,,,578.82,578.82,1
HCPCS,37799,AORTIC ARTERIAL JUMP GRAFT (COMP CODE 47147),2521.0,1638.65,1260.5,2561.04,15
HCPCS,37799,BILAT MIDDLE MENINGEAL ARTERY LIDOCAINE INFUSION (COMP CODE 6165,6250.5,4062.825,620.6,13665.0,62
HCPCS,37799,CREATION OF MESORENAL SHUNT (SUP MESENTERIC VEIN TO RENAL VEIN),14401.0,9360.65,2134.2,14401.0,15
HCPCS,37799,CRYOABLATION AVM (COMP CODE 20983),21914.0,14244.1,620.6,36968.4,62
HCPCS,37799,DISRUPTION-FIBRIN SHEATH W/BALLOON,4310.0,2801.5,620.6,13665.0,47
HCPCS,37799,ENDOVENOUS RF ABLATION SAPHENOUS VEIN,4697.0,3053.05,2134.2,4697.0,15
HCPCS,37799,EXCISION /LIGATION ABDOMINAL VEINS (COMP CODE 35221),9584.0,6229.6,2134.2,9584.0,15
HCPCS,37799,EXCISION OF VEIN (COMP CODE 35206),3121.0,2028.65,1560.5,3121.0,15
HCPCS,37799,"EXPLORATION OF VEIN, NOT FOLLOWED BY SURGICAL REPAIR (COMP CODE",2848.0,1851.2,1424.0,2848.0,15
HCPCS,37799,FIBRIN SHEATH DISRUPTION W/BALLOON (COMP CODE 36595),12029.5,7819.175,620.6,20360.7,62
HCPCS,37799,INSERTION OF ENDOVASCULAR IVC FLOW REGULATOR DEVICE (COMP CODE 3,35343.0,22972.95,620.6,37851.0,48
HCPCS,37799,OCCLUSION OF VASC DEVICE,2729.0,1773.85,620.6,13665.0,47
HCPCS,37799,PERCUTANEOUS HEPATIC PERFUSION DELIVERY OF INTRA-ARTERIAL HIGH D,1150.5,747.825,220.0,13665.0,62
HCPCS,37799,PERCUTANEOUS SCLEROTHERAPY EXTREMITY,4230.0,2749.5,2115.0,4230.0,15
HCPCS,37799,PORTAL/HEPATIC VEIN THROMBECTOMY (COMP CODE 34401),10608.0,6895.2,2134.2,10608.0,15
HCPCS,37799,SCLEROTHERAPY VENOUS MALFORMATION,699.0,454.35,349.5,2561.04,15
HCPCS,37799,SELECTIVE EXTERNAL CAROTID ANGIOGRAPHY (COMP CODE 36227),4501.5,2925.975,460.0,13665.0,62
HCPCS,37799,STAB INCISION UNDER 10 (COMP CODE 37765),1920.0,1248.0,960.0,2561.04,15
HCPCS,37799,STAB PHLEB VARICOSE LESS THAN 10,2662.0,1730.3,1331.0,2662.0,15
HCPCS,37799,"UNLISTED PROCEDURE, VASCULAR SURGERY",2218.0,1441.7,1109.0,2561.04,15
HCPCS,37799,"UNLISTED PROCEDURE, VASCULAR SURGERY (COMPARISON CODE 37765)",2420.0,1573.0,1210.0,2561.04,15
HCPCS,37799,UNLISTED VASC PROCEDURE,3043.5,1978.275,620.6,13665.0,138
HCPCS,37799,VENOUS SINUS TEST BALLOON OCCLUSION (COMP CODE 61623),32625.0,21206.25,620.6,55143.0,62
HCPCS,37799,VESSEL EXPLORATION AND REMOVAL OF FOREIGN OBJECT,22623.0,14704.95,620.6,37851.0,48
HCPCS,38100,REMOVAL OF SPLEEN TOTAL,,,1223.55,1223.55,1
HCPCS,38100,Removal of spleen total,,,2290.02,2892.66,6
HCPCS,38100,SPLENECTOMY TOTAL SEPARATE PROCEDURE,7820.0,5083.0,584.12,7820.0,35
HCPCS,381000,REMOVAL OF SPLEEN TOTAL,,,1223.55,1223.55,1
HCPCS,38101,REMOVAL OF SPLEEN PARTIAL,,,1239.57,1239.57,1
HCPCS,38101,Removal of spleen partial,,,2290.02,2892.66,6
HCPCS,381010,REMOVAL OF SPLEEN PARTIAL,,,1239.57,1239.57,1
HCPCS,38102,REMOVAL OF SPLEEN TOTAL,,,278.08,278.08,1
HCPCS,38102,Removal of spleen total,,,2290.02,2892.66,6
HCPCS,38102,SPLENC TOT EN BLOC EXTNSV DS CONJUNCT W/OTH PX,1916.0,1245.4,197.94,1916.0,35
HCPCS,381020,REMOVAL OF SPLEEN TOTAL,,,278.08,278.08,1
HCPCS,38115,REPAIR OF RUPTURED SPLEEN,,,1375.5,1375.5,1
HCPCS,38115,RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT,8752.0,5688.8,635.84,8752.0,35
HCPCS,38115,Repair of ruptured spleen,,,2290.02,2892.66,6
HCPCS,381150,REPAIR OF RUPTURED SPLEEN,,,1375.5,1375.5,1
HCPCS,38120,LAPAROSCOPIC SPLENECTOMY,4697.0,3053.05,657.59,4697.0,35
HCPCS,38120,LAPAROSCOPIC SPLENECTOMY- NAPLES,4697.0,3053.05,657.59,4697.0,35
HCPCS,38120,LAPAROSCOPY SPLENECTOMY,,,1127.38,22573.24,15
HCPCS,38120,"LAPAROSCOPY, SURGICAL, SPLENECTOMY",6828.0,4438.2,657.59,6828.0,35
HCPCS,38120,Laparoscopy splenectomy,,,2290.02,2892.66,6
HCPCS,381200,LAPAROSCOPY SPLENECTOMY,,,1127.38,1127.38,1
HCPCS,38129,UNLISTED LAPS PX SPLEEN,,,5856.41,12649.85,14
HCPCS,38129,Unlisted laps px spleen,,,2290.02,2892.66,6
HCPCS,38200,INJECTION FOR SPLEEN X-RAY,,,135.95,135.95,1
HCPCS,38200,INJECTION PROCEDURE SPLENOPORTOGRAPY,2672.0,1736.8,98.04,3920.0,111
HCPCS,382000,INJECTION FOR SPLEEN X-RAY,,,135.95,135.95,1
HCPCS,38204,BL DONOR SEARCH MANAGEMENT,,,106.29,106.29,1
HCPCS,382040,BL DONOR SEARCH MANAGEMENT,,,106.29,106.29,1
HCPCS,38205,HARVEST ALLOGENEIC STEM CELL,,,87.65,87.65,1
HCPCS,38205,Harvest allogeneic stem cell,,,974.47,1230.91,6
HCPCS,382050,HARVEST ALLOGENEIC STEM CELL,,,87.65,87.65,1
HCPCS,38206,HARVEST AUTO STEM CELLS,,,86.0,3554.23,15
HCPCS,38206,Harvest auto stem cells,,,974.47,1230.91,6
HCPCS,382060,HARVEST AUTO STEM CELLS,,,86.0,86.0,1
HCPCS,38207,CRYOPRESERVE STEM CELLS,,,47.27,47.27,1
HCPCS,38207,CRYOPRSRV/STRGE HEMATOPOIE CELL,2186.0,1420.9,438.83,4214.0,45
HCPCS,382070,CRYOPRESERVE STEM CELLS,,,47.27,47.27,1
HCPCS,38208,THAW PRESERVED STEM CELLS,,,29.86,947.88,15
HCPCS,38208,Thaw preserved stem cells,,,974.47,1230.91,6
HCPCS,382080,THAW PRESERVED STEM CELLS,,,29.86,29.86,1
HCPCS,38209,WASH HARVEST STEM CELLS,,,12.44,947.88,15
HCPCS,38209,Wash harvest stem cells,,,974.47,1230.91,6
HCPCS,382090,WASH HARVEST STEM CELLS,,,12.44,12.44,1
HCPCS,38210,T-CELL DEPLETION OF HARVEST,,,83.18,947.88,15
HCPCS,38210,T-cell depletion of harvest,,,974.47,1230.91,6
HCPCS,382100,T-CELL DEPLETION OF HARVEST,,,83.18,83.18,1
HCPCS,38211,TUMOR CELL DEPLETE OF HARVST,,,75.38,947.88,15
HCPCS,38211,Tumor cell deplete of harvst,,,974.47,1230.91,6
HCPCS,382110,TUMOR CELL DEPLETE OF HARVST,,,75.38,75.38,1
HCPCS,38212,RBC DEPLETION OF HARVEST,,,49.79,947.88,15
HCPCS,38212,Rbc depletion of harvest,,,275.45,347.94,6
HCPCS,382120,RBC DEPLETION OF HARVEST,,,49.79,49.79,1
HCPCS,38213,PLATELET DEPLETE OF HARVEST,,,12.44,947.88,15
HCPCS,38213,Platelet deplete of harvest,,,974.47,1230.91,6
HCPCS,382130,PLATELET DEPLETE OF HARVEST,,,12.44,12.44,1
HCPCS,38214,VOLUME DEPLETE OF HARVEST,,,42.67,947.88,15
HCPCS,38214,Volume deplete of harvest,,,974.47,1230.91,6
HCPCS,382140,VOLUME DEPLETE OF HARVEST,,,42.67,42.67,1
HCPCS,38215,HARVEST STEM CELL CONCENTRTE,,,49.79,947.88,15
HCPCS,38215,Harvest stem cell concentrte,,,974.47,1230.91,6
HCPCS,382150,HARVEST STEM CELL CONCENTRTE,,,49.79,49.79,1
HCPCS,38220,DIAGNOSTIC BONE MARROW ASPIRATIONS,4290.5,2788.825,40.26,7290.9,179
HCPCS,38220,DX BONE MARROW ASPIRATIONS,,,70.15,70.15,1
HCPCS,382200,DX BONE MARROW ASPIRATIONS,,,70.15,70.15,1
HCPCS,38221,DIAGNOSTIC BONE MARROW BIOPSIES,4306.5,2799.225,34.03,7290.9,228
HCPCS,38221,DX BONE MARROW BIOPSIES,,,73.39,73.39,1
HCPCS,382210,DX BONE MARROW BIOPSIES,,,73.39,73.39,1
HCPCS,38222,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,7472.0,4856.8,59.32,12879.0,175
HCPCS,38222,DX BONE MARROW BX & ASPIR,,,78.62,78.62,1
HCPCS,382220,DX BONE MARROW BX & ASPIR,,,78.62,78.62,1
HCPCS,38225,CAR-T HRV BLD-DRV T LYMPHCYT,,,100.17,100.17,1
HCPCS,38225,Car-t hrv bld-drv t lymphcyt,,,532.47,672.59,6
HCPCS,382250,CAR-T HRV BLD-DRV T LYMPHCYT,,,100.17,100.17,1
HCPCS,38226,CAR-T PREP T LYMPHCYT F/TRNS,,,40.39,40.39,1
HCPCS,38226,Car-t prep t lymphcyt f/trns,,,532.47,672.59,6
HCPCS,382260,CAR-T PREP T LYMPHCYT F/TRNS,,,40.39,40.39,1
HCPCS,38227,CAR-T RECEIPT&PREPJ ADMN,,,40.74,40.74,1
HCPCS,38227,Car-t receipt&prepj admn,,,532.47,672.59,6
HCPCS,382270,CAR-T RECEIPT&PREPJ ADMN,,,40.74,40.74,1
HCPCS,38228,CAR-T ADMN AUTOLOGOUS,,,179.68,719.16,15
HCPCS,38228,Car-t admn autologous,,,532.47,672.59,6
HCPCS,382280,CAR-T ADMN AUTOLOGOUS,,,179.68,179.68,1
HCPCS,38230,BONE MARROW HARVEST ALLOGEN,,,214.34,3554.23,15
HCPCS,38230,BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC,1400.0,910.0,159.97,1400.0,32
HCPCS,38230,Bone marrow harvest allogen,,,974.47,1230.91,6
HCPCS,382300,BONE MARROW HARVEST ALLOGEN,,,214.34,214.34,1
HCPCS,38232,BONE MARROW HARVEST AUTOLOG,,,199.14,10158.22,15
HCPCS,38232,BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS,1400.0,910.0,95.5,1400.0,35
HCPCS,38232,Bone marrow harvest autolog,,,974.47,1230.91,6
HCPCS,382320,BONE MARROW HARVEST AUTOLOG,,,199.14,199.14,1
HCPCS,38240,TRANSPLT ALLO HCT/DONOR,,,250.92,128230.32,15
HCPCS,38240,Transplt allo hct/donor,,,2646.54,3343.0,6
HCPCS,382400,TRANSPLT ALLO HCT/DONOR,,,250.92,250.92,1
HCPCS,38241,TRANSPLT AUTOL HCT/DONOR,,,185.57,3554.23,15
HCPCS,38241,Transplt autol hct/donor,,,974.47,1230.91,6
HCPCS,382410,TRANSPLT AUTOL HCT/DONOR,,,185.57,185.57,1
HCPCS,38242,TRANSPLT ALLO LYMPHOCYTES,,,131.16,3554.23,15
HCPCS,38242,Transplt allo lymphocytes,,,974.47,1230.91,6
HCPCS,382420,TRANSPLT ALLO LYMPHOCYTES,,,131.16,131.16,1
HCPCS,38243,TRANSPLJ HEMATOPOIETIC BOOST,,,128.9,3554.23,15
HCPCS,38243,Transplj hematopoietic boost,,,974.47,1230.91,6
HCPCS,382430,TRANSPLJ HEMATOPOIETIC BOOST,,,128.9,128.9,1
HCPCS,38300,DRAINAGE LYMPH NODE LESION,,,220.67,220.67,1
HCPCS,38300,DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL,7627.0,4957.55,102.9,12879.0,84
HCPCS,383000,DRAINAGE LYMPH NODE LESION,,,220.67,220.67,1
HCPCS,38305,DRAINAGE LYMPH NODE LESION,,,525.39,6205.4,15
HCPCS,38305,DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV,2672.0,1736.8,242.79,2672.0,35
HCPCS,38305,Drainage lymph node lesion,,,1977.31,2497.66,6
HCPCS,383050,DRAINAGE LYMPH NODE LESION,,,525.39,525.39,1
HCPCS,38308,INCISION OF LYMPH CHANNELS,,,498.9,8302.51,15
HCPCS,38308,Incision of lymph channels,,,1977.31,2497.66,6
HCPCS,38308,LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS,2724.0,1770.6,233.9,2724.0,35
HCPCS,383080,INCISION OF LYMPH CHANNELS,,,498.9,498.9,1
HCPCS,38380,SUTR&/LIG THORACIC DUCT CERVICAL APPROACH,3384.0,2199.6,334.27,3384.0,35
HCPCS,38380,THORACIC DUCT PROCEDURE,,,611.02,611.02,1
HCPCS,38380,Thoracic duct procedure,,,1977.31,2497.66,6
HCPCS,383800,THORACIC DUCT PROCEDURE,,,611.02,611.02,1
HCPCS,38381,SUTR&/LIG THORACIC DUCT THORACIC APPROACH,5352.0,3478.8,581.91,5352.0,35
HCPCS,38381,THORACIC DUCT PROCEDURE,,,850.99,850.99,1
HCPCS,38381,Thoracic duct procedure,,,3296.96,4164.58,6
HCPCS,383810,THORACIC DUCT PROCEDURE,,,850.99,850.99,1
HCPCS,38382,THORACIC DUCT PROCEDURE,,,722.19,722.19,1
HCPCS,38382,Thoracic duct procedure,,,2290.02,2892.66,6
HCPCS,383820,THORACIC DUCT PROCEDURE,,,722.19,722.19,1
HCPCS,38500,BIOPSY/REMOVAL LYMPH NODES,,,270.94,8302.51,16
HCPCS,38500,BX/EXC LYMPH NODE OPEN SUPERFICIAL,1516.0,985.4,125.1,1137.0,35
HCPCS,38500,Biopsy/removal lymph nodes,,,1977.31,2497.66,6
HCPCS,385000,BIOPSY/REMOVAL LYMPH NODES,,,270.94,270.94,1
HCPCS,38505,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,4368.5,2839.5249999999996,41.1,7290.9,277
HCPCS,38505,NEEDLE BIOPSY LYMPH NODES,,,89.53,89.53,1
HCPCS,385050,NEEDLE BIOPSY LYMPH NODES,,,89.53,89.53,1
HCPCS,38510,BIOPSY/REMOVAL LYMPH NODES,,,443.62,443.62,1
HCPCS,38510,BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE,10921.0,7098.65,204.16,17231.4,74
HCPCS,385100,BIOPSY/REMOVAL LYMPH NODES,,,443.62,443.62,1
HCPCS,38520,BIOPSY/REMOVAL LYMPH NODES,,,496.01,8302.51,15
HCPCS,38520,BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD,2812.0,1827.8,243.94,2812.0,35
HCPCS,38520,Biopsy/removal lymph nodes,,,1977.31,2497.66,6
HCPCS,385200,BIOPSY/REMOVAL LYMPH NODES,,,496.01,496.01,1
HCPCS,38525,BIOPSY/REMOVAL LYMPH NODES,,,469.17,8302.51,17
HCPCS,38525,BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE,2572.0,1671.8,217.47,2572.0,35
HCPCS,38525,Biopsy/removal lymph nodes,,,1977.31,2497.66,6
HCPCS,385250,BIOPSY/REMOVAL LYMPH NODES,,,469.17,469.17,1
HCPCS,38530,BIOPSY/REMOVAL LYMPH NODES,,,599.3,8302.51,15
HCPCS,38530,BX/EXC LYMPH NODE OPEN INT MAMMARY NODE,3336.0,2168.4,284.43,3336.0,35
HCPCS,38530,Biopsy/removal lymph nodes,,,1977.31,2497.66,6
HCPCS,385300,BIOPSY/REMOVAL LYMPH NODES,,,599.3,599.3,1
HCPCS,38531,OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES,2696.0,1752.4,334.83,2696.0,31
HCPCS,38531,OPEN BX/EXC INGUINOFEM NODES,,,476.17,8302.51,17
HCPCS,38531,Open bx/exc inguinofem nodes,,,1977.31,2497.66,6
HCPCS,385310,OPEN BX/EXC INGUINOFEM NODES,,,476.17,476.17,1
HCPCS,38542,DISSECTION DEEP JUGULAR NODE,3180.0,2067.0,283.44,3180.0,35
HCPCS,38542,EXPLORE DEEP NODE(S) NECK,,,554.82,12649.85,15
HCPCS,38542,Explore deep node(s) neck,,,1977.31,2497.66,6
HCPCS,385420,EXPLORE DEEP NODE(S) NECK,,,554.82,554.82,1
HCPCS,38550,EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ,2844.0,1848.6,272.13,2844.0,35
HCPCS,38550,REMOVAL NECK/ARMPIT LESION,,,554.67,8302.51,15
HCPCS,38550,Removal neck/armpit lesion,,,1977.31,2497.66,6
HCPCS,385500,REMOVAL NECK/ARMPIT LESION,,,554.67,554.67,1
HCPCS,38555,EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ,6236.0,4053.4,597.95,6236.0,35
HCPCS,38555,REMOVAL NECK/ARMPIT LESION,,,1090.59,14139.6,15
HCPCS,38555,Removal neck/armpit lesion,,,1977.31,2497.66,6
HCPCS,385550,REMOVAL NECK/ARMPIT LESION,,,1090.59,1090.59,1
HCPCS,38562,LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC,4424.0,2875.6,474.0,4424.0,35
HCPCS,38562,REMOVAL PELVIC LYMPH NODES,,,748.42,9388.83,5
HCPCS,38562,Removal pelvic lymph nodes,,,2290.02,2892.66,6
HCPCS,385620,REMOVAL PELVIC LYMPH NODES,,,748.42,748.42,1
HCPCS,38564,LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC,4552.0,2958.8,497.13,4552.0,35
HCPCS,38564,REMOVAL ABDOMEN LYMPH NODES,,,744.3,744.3,1
HCPCS,38564,Removal abdomen lymph nodes,,,2290.02,2892.66,6
HCPCS,385640,REMOVAL ABDOMEN LYMPH NODES,,,744.3,744.3,1
HCPCS,38570,LAPAROSCOPY LYMPH NODE BIOP,,,547.74,12649.85,19
HCPCS,38570,LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT,3736.0,2428.4,377.26,3736.0,35
HCPCS,38570,Laparoscopy lymph node biop,,,2290.02,2892.66,6
HCPCS,385700,LAPAROSCOPY LYMPH NODE BIOP,,,547.74,547.74,1
HCPCS,38571,LAPAROSCOPY LYMPHADENECTOMY,,,699.65,22573.24,20
HCPCS,38571,LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY,5280.0,3432.0,507.84,5280.0,35
HCPCS,38571,Laparoscopy lymphadenectomy,,,2290.02,2892.66,6
HCPCS,385710,LAPAROSCOPY LYMPHADENECTOMY,,,699.65,699.65,1
HCPCS,38572,LAPAROSCOPY LYMPHADENECTOMY,,,951.78,22573.24,15
HCPCS,38572,LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1,6240.0,4056.0,660.12,6240.0,35
HCPCS,38572,Laparoscopy lymphadenectomy,,,2290.02,2892.66,6
HCPCS,385720,LAPAROSCOPY LYMPHADENECTOMY,,,951.78,951.78,1
HCPCS,38573,LAPS PELVIC LYMPHADEC,,,1248.07,22573.24,15
HCPCS,38573,LAPS W/BI TOT PEL LMPHADEC & OMNTC LYMPH BX,8000.0,5200.0,891.03,8000.0,31
HCPCS,38573,Laps pelvic lymphadec,,,2290.02,2892.66,6
HCPCS,385730,LAPS PELVIC LYMPHADEC,,,1248.07,1248.07,1
HCPCS,38589,LAP ROBOTIC RETROPERITONEAL LYMPHADENECTOMY COMP 38780,7016.0,4560.4,334.22,7016.0,15
HCPCS,38589,"UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM (COMPARISON COD",3650.0,2372.5,334.22,3650.0,15
HCPCS,38589,UNLISTED LAPS PX LYMPHTC SYS,,,5856.41,12649.85,14
HCPCS,38589,UNLISTED PROC; LAP INGUINAL LYMPH NODE DISSECTION (COMPARED TO 3,5448.0,3541.2,334.22,5448.0,15
HCPCS,38589,Unlisted laps px lymphtc sys,,,2290.02,2892.66,6
HCPCS,38700,REMOVAL OF LYMPH NODES NECK,,,852.67,14139.6,15
HCPCS,38700,Removal of lymph nodes neck,,,1977.31,2497.66,6
HCPCS,38700,SUPRAHYOID LYMPHADENECTOMY,5124.0,3330.6,502.83,5124.0,35
HCPCS,387000,REMOVAL OF LYMPH NODES NECK,,,852.67,852.67,1
HCPCS,38720,CERVICAL LYMPHADENECTOMY,8780.0,5707.0,793.73,8780.0,35
HCPCS,38720,REMOVAL OF LYMPH NODES NECK,,,1424.17,14139.6,15
HCPCS,38720,Removal of lymph nodes neck,,,1977.31,2497.66,6
HCPCS,387200,REMOVAL OF LYMPH NODES NECK,,,1424.17,1424.17,1
HCPCS,38724,CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ,9580.0,6227.0,806.35,9580.0,35
HCPCS,38724,REMOVAL OF LYMPH NODES NECK,,,1536.14,1536.14,1
HCPCS,38724,Removal of lymph nodes neck,,,1977.31,2497.66,6
HCPCS,387240,REMOVAL OF LYMPH NODES NECK,,,1536.14,1536.14,1
HCPCS,38740,AXILLARY LYMPHADENECTOMY SUPERFICIAL,4280.0,2782.0,349.51,4280.0,35
HCPCS,38740,REMOVE ARMPIT LYMPH NODES,,,747.72,12649.85,15
HCPCS,38740,Remove armpit lymph nodes,,,1113.47,1406.48,6
HCPCS,387400,REMOVE ARMPIT LYMPH NODES,,,747.72,747.72,1
HCPCS,38745,AXILLARY LYMPHADENECTOMY COMPLETE,5548.0,3606.2,465.42,5548.0,35
HCPCS,38745,REMOVE ARMPIT LYMPH NODES,,,940.79,12649.85,16
HCPCS,38745,Remove armpit lymph nodes,,,1113.47,1406.48,6
HCPCS,387450,REMOVE ARMPIT LYMPH NODES,,,940.79,940.79,1
HCPCS,38746,REMOVE THORACIC LYMPH NODES,,,225.85,225.85,1
HCPCS,38746,THORCOM THRC W/MEDSTNL & REGIONAL LMPHADEC,1648.0,1071.2,160.85,1648.0,35
HCPCS,387460,REMOVE THORACIC LYMPH NODES,,,225.85,225.85,1
HCPCS,38747,ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC,1952.0,1268.8,202.47,1952.0,35
HCPCS,38747,REMOVE ABDOMINAL LYMPH NODES,,,283.02,283.02,1
HCPCS,38747,Remove abdominal lymph nodes,,,2290.02,2892.66,6
HCPCS,387470,REMOVE ABDOMINAL LYMPH NODES,,,283.02,283.02,1
HCPCS,38760,INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX,5448.0,3541.2,441.6,5448.0,35
HCPCS,38760,REMOVE GROIN LYMPH NODES,,,889.13,14139.6,15
HCPCS,38760,Remove groin lymph nodes,,,1977.31,2497.66,6
HCPCS,387600,REMOVE GROIN LYMPH NODES,,,889.13,889.13,1
HCPCS,38765,INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC,8764.0,5696.6,778.59,8764.0,35
HCPCS,38765,REMOVE GROIN LYMPH NODES,,,1389.51,1389.51,1
HCPCS,38765,Remove groin lymph nodes,,,1977.31,2497.66,6
HCPCS,387650,REMOVE GROIN LYMPH NODES,,,1389.51,1389.51,1
HCPCS,38770,PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR,5624.0,3655.6,619.16,5624.0,35
HCPCS,38770,REMOVE PELVIS LYMPH NODES,,,854.71,854.71,1
HCPCS,38770,Remove pelvis lymph nodes,,,2290.02,2892.66,6
HCPCS,387700,REMOVE PELVIS LYMPH NODES,,,854.71,854.71,1
HCPCS,38780,REMOVE ABDOMEN LYMPH NODES,,,1115.75,1115.75,1
HCPCS,38780,RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL,7080.0,4602.0,813.46,7080.0,35
HCPCS,38780,Remove abdomen lymph nodes,,,2290.02,2892.66,6
HCPCS,387800,REMOVE ABDOMEN LYMPH NODES,,,1115.75,1115.75,1
HCPCS,38790,INJECT FOR LYMPHATIC X-RAY,,,85.76,85.76,1
HCPCS,38790,INJECTION PROCEDURE LYMPHANGIOGRAPHY,2632.0,1710.8,63.07,4226.4,146
HCPCS,387900,INJECT FOR LYMPHATIC X-RAY,,,85.76,85.76,1
HCPCS,38792,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,1134.5,737.425,21.5,3920.0,176
HCPCS,38792,RA TRACER ID OF SENTINL NODE,,,33.88,33.88,1
HCPCS,387920,RA TRACER ID OF SENTINL NODE,,,33.88,33.88,1
HCPCS,38794,ACCESS THORACIC LYMPH DUCT,,,293.68,293.68,1
HCPCS,38794,CANNULATION THORACIC DUCT,8934.0,5807.1,341.56,8040.6,38
HCPCS,387940,ACCESS THORACIC LYMPH DUCT,,,293.68,293.68,1
HCPCS,38900,INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION,1000.0,650.0,70.13,1000.0,35
HCPCS,38900,IO MAP OF SENT LYMPH NODE,478.0,310.7,70.13,4979.0,40
HCPCS,38900,Io map of sent lymph node,,,223.78,282.67,6
HCPCS,389000,IO MAP OF SENT LYMPH NODE,,,145.98,145.98,1
HCPCS,38999,"LVA/LVB MICROSURGERY - THERAPEUTIC (COMP 35206, 38308, 69990)",10367.0,6738.55,624.86,10367.0,15
HCPCS,38999,LYMPH NODE NEEDLE LOCALIZATION,2178.0,1415.7,624.86,2178.0,15
HCPCS,38999,UNLISTD PX HEMIC/LYMPHTC SYS,,,438.83,947.88,14
HCPCS,38999,UNLISTED MAGTRACE INJECTION ADMINISTRATION (COMP CODE 38900),1000.0,650.0,500.0,1000.0,15
HCPCS,38999,Unlistd px hemic/lymphtc sys,,,1977.31,2497.66,6
HCPCS,39000,EXPLORATION OF CHEST,,,548.96,548.96,1
HCPCS,39000,Exploration of chest,,,1419.15,1792.61,6
HCPCS,39000,MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR,3028.0,1968.2,354.26,3028.0,35
HCPCS,390000,EXPLORATION OF CHEST,,,548.96,548.96,1
HCPCS,39010,EXPLORATION OF CHEST,,,857.81,857.81,1
HCPCS,39010,Exploration of chest,,,3296.96,4164.58,6
HCPCS,39010,MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR,5276.0,3429.4,602.57,5276.0,35
HCPCS,390100,EXPLORATION OF CHEST,,,857.81,857.81,1
HCPCS,39200,RESECT MEDIASTINAL CYST,,,945.95,945.95,1
HCPCS,39200,RESECTION OF MEDIASTINAL CYST,6036.0,3923.4,660.03,6036.0,35
HCPCS,39200,Resect mediastinal cyst,,,3296.96,4164.58,6
HCPCS,392000,RESECT MEDIASTINAL CYST,,,945.95,945.95,1
HCPCS,39220,RESECT MEDIASTINAL TUMOR,,,1233.64,1233.64,1
HCPCS,39220,RESECTION MEDIASTINAL TUMOR,7820.0,5083.0,840.27,7820.0,35
HCPCS,39220,Resect mediastinal tumor,,,3296.96,4164.58,6
HCPCS,392200,RESECT MEDIASTINAL TUMOR,,,1233.64,1233.64,1
HCPCS,39401,MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY,2176.0,1414.4,234.39,2176.0,31
HCPCS,39401,MEDIASTINOSCPY W/MEDSTNL BX,,,334.28,12649.85,15
HCPCS,39401,Mediastinoscpy w/medstnl bx,,,1419.15,1792.61,6
HCPCS,394010,MEDIASTINOSCPY W/MEDSTNL BX,,,334.28,334.28,1
HCPCS,39402,MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES,2900.0,1885.0,305.62,2900.0,31
HCPCS,39402,MEDIASTINOSCPY W/LMPH NOD BX,,,437.14,12649.85,15
HCPCS,39402,Mediastinoscpy w/lmph nod bx,,,1419.15,1792.61,6
HCPCS,394020,MEDIASTINOSCPY W/LMPH NOD BX,,,437.14,437.14,1
HCPCS,39499,Unlisted px mediastinum,,,599.03,756.67,6
HCPCS,39501,REPAIR DIAPHRAGM LACERATION,,,932.06,932.06,1
HCPCS,39501,REPAIR LACERATION DIAPHRAGM ANY APPROACH,5592.0,3634.8,651.31,5592.0,35
HCPCS,39501,Repair diaphragm laceration,,,4108.4,5189.56,6
HCPCS,395010,REPAIR DIAPHRAGM LACERATION,,,932.06,932.06,1
HCPCS,39503,REPAIR OF DIAPHRAGM HERNIA,,,6309.76,6309.76,1
HCPCS,39503,Repair of diaphragm hernia,,,4108.4,5189.56,6
HCPCS,395030,REPAIR OF DIAPHRAGM HERNIA,,,6309.76,6309.76,1
HCPCS,39540,REPAIR OF DIAPHRAGM HERNIA,,,948.55,948.55,1
HCPCS,39540,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT,5828.0,3788.2,657.72,5828.0,35
HCPCS,39540,Repair of diaphragm hernia,,,4108.4,5189.56,6
HCPCS,395400,REPAIR OF DIAPHRAGM HERNIA,,,948.55,948.55,1
HCPCS,39541,REPAIR OF DIAPHRAGM HERNIA,,,1019.68,1019.68,1
HCPCS,39541,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC,6300.0,4095.0,718.74,6300.0,35
HCPCS,39541,Repair of diaphragm hernia,,,4108.4,5189.56,6
HCPCS,395410,REPAIR OF DIAPHRAGM HERNIA,,,1019.68,1019.68,1
HCPCS,39545,IMBRICATION DIAPHRAGM EVENTRATION,5868.0,3814.2,588.37,5868.0,35
HCPCS,39545,REVISION OF DIAPHRAGM,,,973.64,973.64,1
HCPCS,39545,Revision of diaphragm,,,4108.4,5189.56,6
HCPCS,395450,REVISION OF DIAPHRAGM,,,973.64,973.64,1
HCPCS,39560,RESCJ DIAPHRAGM W/SIMPLE REPAIR,5224.0,3395.6,587.28,5224.0,35
HCPCS,39560,RESECT DIAPHRAGM SIMPLE,,,875.9,875.9,1
HCPCS,39560,Resect diaphragm simple,,,4108.4,5189.56,6
HCPCS,395600,RESECT DIAPHRAGM SIMPLE,,,875.9,875.9,1
HCPCS,39561,RESCJ DIAPHRAGM W/COMPLEX REPAIR,7996.0,5197.4,807.22,7996.0,35
HCPCS,39561,RESECT DIAPHRAGM COMPLEX,,,1367.09,1367.09,1
HCPCS,39561,Resect diaphragm complex,,,4108.4,5189.56,6
HCPCS,395610,RESECT DIAPHRAGM COMPLEX,,,1367.09,1367.09,1
HCPCS,39599,LAP OR ROBOTIC REPAIR OF DIAPHRAGMATIC HERNIA; CHRONIC (COMP COD,5671.0,3686.15,1183.3,5671.0,15
HCPCS,39599,UNLISTED PROC; LAP DIAPHRAGM RESECTION (COMP TO 39560),5224.0,3395.6,1183.3,5224.0,15
HCPCS,39599,UNLISTED THORACOSCOPIC REPAIR CONGENITAL DIAPHRAGMATIC HERNIA-NE,43564.0,28316.6,1183.3,43564.0,15
HCPCS,39599,Unlisted px diaphragm,,,4108.4,5189.56,6
HCPCS,39599,VATS PLICATION OF DIAPHRAGM (COMP CODE 39545),4841.0,3146.65,1183.3,4841.0,15
HCPCS,4000F,TOBACCO USE TXMNT COUNSELING,,,0.01,0.01,1
HCPCS,4000F0,TOBACCO USE TXMNT COUNSELING,,,0.01,0.01,1
HCPCS,4001F,TOBACCO USE TXMNT PHARMACOL,,,0.01,0.01,1
HCPCS,4001F0,TOBACCO USE TXMNT PHARMACOL,,,0.01,0.01,1
HCPCS,4003F,PT ED WRITE/ORAL PTS W/ HF,,,0.01,0.01,1
HCPCS,4003F0,PT ED WRITE/ORAL PTS W/ HF,,,0.01,0.01,1
HCPCS,4004F,PT TOBACCO SCREEN RCVD TLK,,,0.01,0.01,1
HCPCS,4004F0,PT TOBACCO SCREEN RCVD TLK,,,0.01,0.01,1
HCPCS,4005F,PHARM THX FOR OP RXD,,,0.01,0.01,1
HCPCS,4005F0,PHARM THX FOR OP RXD,,,0.01,0.01,1
HCPCS,4008F,BETA-BLOCKER THERAPY RXD/TKN,,,0.01,0.01,1
HCPCS,4008F0,BETA-BLOCKER THERAPY RXD/TKN,,,0.01,0.01,1
HCPCS,4010F,ACE/ARB THERAPY RXD/TAKEN,,,0.01,0.01,1
HCPCS,4010F0,ACE/ARB THERAPY RXD/TAKEN,,,0.01,0.01,1
HCPCS,4011F,ORAL ANTIPLATELET THERAPY RX,,,0.01,0.01,1
HCPCS,4011F0,ORAL ANTIPLATELET THERAPY RX,,,0.01,0.01,1
HCPCS,4012F,WARFARIN THERAPY RX,,,0.01,0.01,1
HCPCS,4012F0,WARFARIN THERAPY RX,,,0.01,0.01,1
HCPCS,4013F,STATIN THERAPY/CURRENTLY TKN,,,0.01,0.01,1
HCPCS,4013F0,STATIN THERAPY/CURRENTLY TKN,,,0.01,0.01,1
HCPCS,4014F,WRITTEN DISCHARGE INSTR PRVD,,,0.01,0.01,1
HCPCS,4014F0,WRITTEN DISCHARGE INSTR PRVD,,,0.01,0.01,1
HCPCS,4015F,PERSIST ASTHMA MEDICINE CTRL,,,0.01,0.01,1
HCPCS,4015F0,PERSIST ASTHMA MEDICINE CTRL,,,0.01,0.01,1
HCPCS,4016F,ANTI-INFLM/ANLGSC AGENT RX,,,0.01,0.01,1
HCPCS,4016F0,ANTI-INFLM/ANLGSC AGENT RX,,,0.01,0.01,1
HCPCS,4017F,GI PROPHYLAXIS FOR NSAID RX,,,0.01,0.01,1
HCPCS,4017F0,GI PROPHYLAXIS FOR NSAID RX,,,0.01,0.01,1
HCPCS,4018F,THERAPY EXERCISE JOINT RX,,,0.01,0.01,1
HCPCS,4018F0,THERAPY EXERCISE JOINT RX,,,0.01,0.01,1
HCPCS,4019F,DOC RECPT COUNSL VIT D/CALC+,,,0.01,0.01,1
HCPCS,4019F0,DOC RECPT COUNSL VIT D/CALC+,,,0.01,0.01,1
HCPCS,4025F,INHALED BRONCHODILATOR RX,,,0.01,0.01,1
HCPCS,4025F0,INHALED BRONCHODILATOR RX,,,0.01,0.01,1
HCPCS,4030F,OXYGEN THERAPY RX,,,0.01,0.01,1
HCPCS,4030F0,OXYGEN THERAPY RX,,,0.01,0.01,1
HCPCS,4033F,PULMONARY REHAB REC,,,0.01,0.01,1
HCPCS,4033F0,PULMONARY REHAB REC,,,0.01,0.01,1
HCPCS,4035F,INFLUENZA IMM REC,,,0.01,0.01,1
HCPCS,4035F0,INFLUENZA IMM REC,,,0.01,0.01,1
HCPCS,4037F,INFLUENZA IMM ORDER/ADMIN,,,0.01,0.01,1
HCPCS,4037F0,INFLUENZA IMM ORDER/ADMIN,,,0.01,0.01,1
HCPCS,4040F,PNEUMOC VAC/ADMIN/RCVD,,,0.01,0.01,1
HCPCS,4040F0,PNEUMOC VAC/ADMIN/RCVD,,,0.01,0.01,1
HCPCS,4041F,DOC ORDER CEFAZOLIN/CEFUROX,,,0.01,0.01,1
HCPCS,4041F0,DOC ORDER CEFAZOLIN/CEFUROX,,,0.01,0.01,1
HCPCS,4042F,DOC ANTIBIO NOT GIVEN,,,0.01,0.01,1
HCPCS,4042F0,DOC ANTIBIO NOT GIVEN,,,0.01,0.01,1
HCPCS,4043F,DOC ORDER GIVEN STOP ANTIBIO,,,0.01,0.01,1
HCPCS,4043F0,DOC ORDER GIVEN STOP ANTIBIO,,,0.01,0.01,1
HCPCS,4044F,DOC ORDER GIVEN VTE PROPHYLX,,,0.01,0.01,1
HCPCS,4044F0,DOC ORDER GIVEN VTE PROPHYLX,,,0.01,0.01,1
HCPCS,4045F,EMPIRIC ANTIBIOTIC RX,,,0.01,0.01,1
HCPCS,4045F0,EMPIRIC ANTIBIOTIC RX,,,0.01,0.01,1
HCPCS,4046F,DOC ANTIBIO GIVEN B/4 SURG,,,0.01,0.01,1
HCPCS,4046F0,DOC ANTIBIO GIVEN B/4 SURG,,,0.01,0.01,1
HCPCS,4047F,DOC ANTIBIO GIVEN B/4 SURG,,,0.01,0.01,1
HCPCS,4047F0,DOC ANTIBIO GIVEN B/4 SURG,,,0.01,0.01,1
HCPCS,4048F,DOC ANTIBIO GIVEN B/4 SURG,,,0.01,0.01,1
HCPCS,4048F0,DOC ANTIBIO GIVEN B/4 SURG,,,0.01,0.01,1
HCPCS,40490,BIOPSY OF LIP,911.5,592.475,59.81,4151.0,82
HCPCS,404900,BIOPSY OF LIP,,,73.38,73.38,1
HCPCS,4049F,DOC ORDER GIVEN STOP ANTIBIO,,,0.01,0.01,1
HCPCS,4049F0,DOC ORDER GIVEN STOP ANTIBIO,,,0.01,0.01,1
HCPCS,40500,PARTIAL EXCISION OF LIP,,,392.37,7031.51,15
HCPCS,40500,Partial excision of lip,,,839.72,1060.7,6
HCPCS,40500,VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT,1788.0,1162.2,250.73,1341.0,35
HCPCS,405000,PARTIAL EXCISION OF LIP,,,392.37,392.37,1
HCPCS,4050F,HT CARE PLAN DOC,,,0.01,0.01,1
HCPCS,4050F0,HT CARE PLAN DOC,,,0.01,0.01,1
HCPCS,40510,EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR,1928.0,1253.2,260.04,1446.0,35
HCPCS,40510,PARTIAL EXCISION OF LIP,,,371.88,7031.51,15
HCPCS,40510,Partial excision of lip,,,1634.08,2064.1,6
HCPCS,405100,PARTIAL EXCISION OF LIP,,,371.88,371.88,1
HCPCS,4051F,REFERRED FOR AN AV FISTULA,,,0.01,0.01,1
HCPCS,4051F0,REFERRED FOR AN AV FISTULA,,,0.01,0.01,1
HCPCS,40520,EXC LIP V-EXC W/PRIM DIR LINR CLSR,1916.0,1245.4,259.09,1437.0,35
HCPCS,40520,PARTIAL EXCISION OF LIP,,,379.64,7031.51,15
HCPCS,40520,Partial excision of lip,,,839.72,1060.7,6
HCPCS,405200,PARTIAL EXCISION OF LIP,,,379.64,379.64,1
HCPCS,40525,EXC LIP FULL THKNS RCNSTJ W/LOCAL FLAP,3088.0,2007.2,416.66,3088.0,35
HCPCS,40525,RECONSTRUCT LIP WITH FLAP,,,587.91,7031.51,15
HCPCS,40525,Reconstruct lip with flap,,,1634.08,2064.1,6
HCPCS,405250,RECONSTRUCT LIP WITH FLAP,,,587.91,587.91,1
HCPCS,40527,EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP,3728.0,2423.2,486.65,3728.0,35
HCPCS,40527,RECONSTRUCT LIP WITH FLAP,,,671.21,12826.13,15
HCPCS,40527,Reconstruct lip with flap,,,2132.36,2693.51,6
HCPCS,405270,RECONSTRUCT LIP WITH FLAP,,,671.21,671.21,1
HCPCS,4052F,HEMODIALYSIS VIA AV FISTULA,,,0.01,0.01,1
HCPCS,4052F0,HEMODIALYSIS VIA AV FISTULA,,,0.01,0.01,1
HCPCS,40530,PARTIAL REMOVAL OF LIP,,,432.29,7031.51,15
HCPCS,40530,Partial removal of lip,,,1634.08,2064.1,6
HCPCS,40530,RESCJ LIP > ONE-FOURTH W/O RCNSTJ,2216.0,1440.4,285.39,1662.0,35
HCPCS,405300,PARTIAL REMOVAL OF LIP,,,432.29,432.29,1
HCPCS,4053F,HEMODIALYSIS VIA AV GRAFT,,,0.01,0.01,1
HCPCS,4053F0,HEMODIALYSIS VIA AV GRAFT,,,0.01,0.01,1
HCPCS,4054F,HEMODIALYSIS VIA CATHETER,,,0.01,0.01,1
HCPCS,4054F0,HEMODIALYSIS VIA CATHETER,,,0.01,0.01,1
HCPCS,4055F,PT RCVNG PERITON DIALYSIS,,,0.01,0.01,1
HCPCS,4055F0,PT RCVNG PERITON DIALYSIS,,,0.01,0.01,1
HCPCS,4056F,APPROP ORAL REHYD RECOMMD,,,0.01,0.01,1
HCPCS,4056F0,APPROP ORAL REHYD RECOMMD,,,0.01,0.01,1
HCPCS,4058F,PED GASTRO ED GIVEN CAREGVR,,,0.01,0.01,1
HCPCS,4058F0,PED GASTRO ED GIVEN CAREGVR,,,0.01,0.01,1
HCPCS,4060F,PSYCH SVCS PROVIDED,,,0.01,0.01,1
HCPCS,4060F0,PSYCH SVCS PROVIDED,,,0.01,0.01,1
HCPCS,4062F,PT REFERRAL PSYCH DOCD,,,0.01,0.01,1
HCPCS,4062F0,PT REFERRAL PSYCH DOCD,,,0.01,0.01,1
HCPCS,4063F,ANTIDEPRES RXTHXPY NOT RXD,,,0.01,0.01,1
HCPCS,4063F0,ANTIDEPRES RXTHXPY NOT RXD,,,0.01,0.01,1
HCPCS,4064F,ANTIDEPRESSANT RX,,,0.01,0.01,1
HCPCS,4064F0,ANTIDEPRESSANT RX,,,0.01,0.01,1
HCPCS,40650,RPR LIP FTH VERMILION ONLY,,,337.01,337.01,1
HCPCS,40650,RPR LIP FULL THICKNESS VERMILION ONLY,2220.5,1443.3249999999998,112.01,6317.0,131
HCPCS,406500,RPR LIP FTH VERMILION ONLY,,,337.01,337.01,1
HCPCS,40652,RPR LIP FTH<HALF VER HEIGHT,,,384.03,384.03,1
HCPCS,40652,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,2350.5,1527.8249999999998,112.01,6317.0,179
HCPCS,406520,RPR LIP FTH<HALF VER HEIGHT,,,384.03,384.03,1
HCPCS,40654,RPR LIP FTH>1HALF VER HT/CPX,,,453.34,453.34,1
HCPCS,40654,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,5355.0,3480.75,308.84,7666.2,133
HCPCS,406540,RPR LIP FTH>1HALF VER HT/CPX,,,453.34,453.34,1
HCPCS,4065F,ANTIPSYCHOTIC RX,,,0.01,0.01,1
HCPCS,4065F0,ANTIPSYCHOTIC RX,,,0.01,0.01,1
HCPCS,4066F,ECT PROVIDED,,,0.01,0.01,1
HCPCS,4066F0,ECT PROVIDED,,,0.01,0.01,1
HCPCS,4067F,PT REFERRAL FOR ECT DOCD,,,0.01,0.01,1
HCPCS,4067F0,PT REFERRAL FOR ECT DOCD,,,0.01,0.01,1
HCPCS,4069F,VTE PROPHYLAXIS RCVD,,,0.01,0.01,1
HCPCS,4069F0,VTE PROPHYLAXIS RCVD,,,0.01,0.01,1
HCPCS,40700,REPAIR CLEFT LIP/NASAL,,,1069.83,12826.13,15
HCPCS,40700,Repair cleft lip/nasal,,,1833.3,2315.75,6
HCPCS,407000,REPAIR CLEFT LIP/NASAL,,,1069.83,1069.83,1
HCPCS,40701,REPAIR CLEFT LIP/NASAL,,,1263.43,12826.13,15
HCPCS,40701,Repair cleft lip/nasal,,,1833.3,2315.75,6
HCPCS,407010,REPAIR CLEFT LIP/NASAL,,,1263.43,1263.43,1
HCPCS,40702,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 2 STGS,5708.0,3710.2,601.53,5708.0,35
HCPCS,40702,REPAIR CLEFT LIP/NASAL,,,1061.23,12826.13,15
HCPCS,40702,Repair cleft lip/nasal,,,1833.3,2315.75,6
HCPCS,407020,REPAIR CLEFT LIP/NASAL,,,1061.23,1061.23,1
HCPCS,4070F,DVT PROPHYLX RECVD DAY 2,,,0.01,0.01,1
HCPCS,4070F0,DVT PROPHYLX RECVD DAY 2,,,0.01,0.01,1
HCPCS,40720,REPAIR CLEFT LIP/NASAL,,,1089.06,7031.51,15
HCPCS,40720,Repair cleft lip/nasal,,,1833.3,2315.75,6
HCPCS,407200,REPAIR CLEFT LIP/NASAL,,,1089.06,1089.06,1
HCPCS,4073F,ORAL ANTIPLAT THX RX DISCHRG,,,0.01,0.01,1
HCPCS,4073F0,ORAL ANTIPLAT THX RX DISCHRG,,,0.01,0.01,1
HCPCS,4075F,ANTICOAG THX RX AT DISCHRG,,,0.01,0.01,1
HCPCS,4075F0,ANTICOAG THX RX AT DISCHRG,,,0.01,0.01,1
HCPCS,40761,PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP,6336.0,4118.4,673.69,6336.0,35
HCPCS,40761,REPAIR CLEFT LIP/NASAL,,,1144.72,12826.13,15
HCPCS,40761,Repair cleft lip/nasal,,,1833.3,2315.75,6
HCPCS,407610,REPAIR CLEFT LIP/NASAL,,,1144.72,1144.72,1
HCPCS,4077F,DOC T-PA ADMIN CONSIDERED,,,0.01,0.01,1
HCPCS,4077F0,DOC T-PA ADMIN CONSIDERED,,,0.01,0.01,1
HCPCS,40799,FOREIGN BODY REMOVAL (TOOTH) AND I&D (COMP CODE 10061),770.0,500.5,199.43,8550.0,45
HCPCS,40799,"UNLISTED PROCEDURE, LIPS",592.0,384.8,166.35,8550.0,48
HCPCS,4079F,DOC REHAB SVCS CONSIDERED,,,0.01,0.01,1
HCPCS,4079F0,DOC REHAB SVCS CONSIDERED,,,0.01,0.01,1
HCPCS,40800,DRAINAGE OF MOUTH LESION,,,124.19,124.19,1
HCPCS,40800,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,2269.0,1474.8500000000001,81.46,4151.0,133
HCPCS,408000,DRAINAGE OF MOUTH LESION,,,124.19,124.19,1
HCPCS,40801,DRAINAGE OF MOUTH LESION,,,209.56,209.56,1
HCPCS,40801,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,1990.5,1293.8249999999998,148.76,6317.0,131
HCPCS,408010,DRAINAGE OF MOUTH LESION,,,209.56,209.56,1
HCPCS,40804,REMOVAL FOREIGN BODY MOUTH,,,119.83,119.83,1
HCPCS,40804,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,2955.5,1921.075,91.52,4851.9,179
HCPCS,408040,REMOVAL FOREIGN BODY MOUTH,,,119.83,119.83,1
HCPCS,40805,REMOVAL FOREIGN BODY MOUTH,,,208.7,208.7,1
HCPCS,40805,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,2022.5,1314.625,140.95,6289.0,131
HCPCS,408050,REMOVAL FOREIGN BODY MOUTH,,,208.7,208.7,1
HCPCS,40806,INCISION LABIAL FRENUM FRENOTOMY,124.0,80.6,20.06,170.91,32
HCPCS,40806,INCISION OF LIP FOLD,,,30.96,1104.14,15
HCPCS,40806,Incision of lip fold,,,839.72,1060.7,6
HCPCS,408060,INCISION OF LIP FOLD,,,30.96,30.96,1
HCPCS,40808,BIOPSY OF MOUTH LESION,,,93.87,93.87,1
HCPCS,40808,BIOPSY VESTIBULE MOUTH,2929.0,1903.85,106.52,4214.0,45
HCPCS,40808,"BIOPSY, MOUTH, VESTIBULE",420.0,273.0,78.99,315.0,35
HCPCS,408080,BIOPSY OF MOUTH LESION,,,93.87,93.87,1
HCPCS,40810,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR,9596.0,6237.400000000001,72.63,16783.2,81
HCPCS,40810,EXCISION OF MOUTH LESION,,,128.8,128.8,1
HCPCS,408100,EXCISION OF MOUTH LESION,,,128.8,128.8,1
HCPCS,40812,EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR,4733.0,3076.45,106.84,7666.2,81
HCPCS,40812,EXCISE/REPAIR MOUTH LESION,,,191.96,191.96,1
HCPCS,408120,EXCISE/REPAIR MOUTH LESION,,,191.96,191.96,1
HCPCS,40814,EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR,1408.0,915.2,179.43,1056.0,35
HCPCS,40814,EXCISE/REPAIR MOUTH LESION,,,297.9,7031.51,15
HCPCS,40814,Excise/repair mouth lesion,,,1928.02,2435.39,6
HCPCS,408140,EXCISE/REPAIR MOUTH LESION,,,297.9,297.9,1
HCPCS,40816,EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC,1508.0,980.2,197.15,1131.0,35
HCPCS,40816,EXCISION OF MOUTH LESION,,,320.74,7031.51,15
HCPCS,40816,Excision of mouth lesion,,,1928.02,2435.39,6
HCPCS,408160,EXCISION OF MOUTH LESION,,,320.74,320.74,1
HCPCS,40818,EXC MUCOSA VESTIBULE MOUTH AS DON GRF,1132.0,735.8,142.98,849.0,35
HCPCS,40818,EXCISE ORAL MUCOSA FOR GRAFT,,,277.71,1104.14,15
HCPCS,40818,Excise oral mucosa for graft,,,1209.93,1528.33,6
HCPCS,408180,EXCISE ORAL MUCOSA FOR GRAFT,,,277.71,277.71,1
HCPCS,40819,EXC FRENUM LABIAL/BUCCAL,1004.0,652.6,121.68,753.0,35
HCPCS,40819,EXCISE LIP OR CHEEK FOLD,,,210.04,3211.66,15
HCPCS,40819,Excise lip or cheek fold,,,839.72,1060.7,6
HCPCS,408190,EXCISE LIP OR CHEEK FOLD,,,210.04,210.04,1
HCPCS,40820,DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS,536.0,348.4,82.75,424.12,35
HCPCS,40820,TREATMENT OF MOUTH LESION,,,172.37,7031.51,15
HCPCS,40820,Treatment of mouth lesion,,,1209.93,1528.33,6
HCPCS,408200,TREATMENT OF MOUTH LESION,,,172.37,172.37,1
HCPCS,40830,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,1031.5,670.475,84.27,4214.0,133
HCPCS,40830,REPAIR MOUTH LACERATION,,,152.86,152.86,1
HCPCS,408300,REPAIR MOUTH LACERATION,,,152.86,152.86,1
HCPCS,40831,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,1978.5,1286.025,120.7,6317.0,131
HCPCS,40831,REPAIR MOUTH LACERATION,,,211.12,211.12,1
HCPCS,408310,REPAIR MOUTH LACERATION,,,211.12,211.12,1
HCPCS,40840,RECONSTRUCTION OF MOUTH,,,673.51,12826.13,15
HCPCS,40840,Reconstruction of mouth,,,1928.02,2435.39,6
HCPCS,40840,VESTIBULOPLASTY ANTERIOR,3660.0,2379.0,398.82,2745.0,35
HCPCS,408400,RECONSTRUCTION OF MOUTH,,,673.51,673.51,1
HCPCS,40842,RECONSTRUCTION OF MOUTH,,,719.57,12826.13,15
HCPCS,40842,Reconstruction of mouth,,,1928.02,2435.39,6
HCPCS,40842,VESTIBULOPLASTY POSTERIOR UNILATERAL,3660.0,2379.0,398.76,2745.0,35
HCPCS,408420,RECONSTRUCTION OF MOUTH,,,719.57,719.57,1
HCPCS,40843,RECONSTRUCTION OF MOUTH,,,926.2,12826.13,15
HCPCS,40843,Reconstruction of mouth,,,1928.02,2435.39,6
HCPCS,408430,RECONSTRUCTION OF MOUTH,,,926.2,926.2,1
HCPCS,40844,RECONSTRUCTION OF MOUTH,,,1251.31,12826.13,15
HCPCS,40844,Reconstruction of mouth,,,1928.02,2435.39,6
HCPCS,408440,RECONSTRUCTION OF MOUTH,,,1251.31,1251.31,1
HCPCS,40845,RECONSTRUCTION OF MOUTH,,,1285.74,12826.13,15
HCPCS,40845,Reconstruction of mouth,,,1928.02,2435.39,6
HCPCS,40845,VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG,7744.0,5033.6,938.96,5808.0,35
HCPCS,408450,RECONSTRUCTION OF MOUTH,,,1285.74,1285.74,1
HCPCS,4084F,ASPIRIN RECVD W/IN 24 HRS,,,0.01,0.01,1
HCPCS,4084F0,ASPIRIN RECVD W/IN 24 HRS,,,0.01,0.01,1
HCPCS,4086F,ASPIRIN/CLOPIDOGREL RXD,,,0.01,0.01,1
HCPCS,4086F0,ASPIRIN/CLOPIDOGREL RXD,,,0.01,0.01,1
HCPCS,40899,TRANSORAL MYECTOMY OF DEPRESSOR ANGULI ORIS MUSCLE (COMP CODE 21,2168.0,1409.2,194.57,2168.0,15
HCPCS,40899,UNLISTED PX VESTIBULE MOUTH,,,233.1,503.49,14
HCPCS,40899,Unlisted px vestibule mouth,,,844.88,1067.22,6
HCPCS,4090F,PT RCVNG EPO THXPY,,,0.01,0.01,1
HCPCS,4090F0,PT RCVNG EPO THXPY,,,0.01,0.01,1
HCPCS,4095F,PT NOT RCVNG EPO THXPY,,,0.01,0.01,1
HCPCS,4095F0,PT NOT RCVNG EPO THXPY,,,0.01,0.01,1
HCPCS,41000,DRAINAGE OF MOUTH LESION,,,109.98,109.98,1
HCPCS,41000,INTRAORAL I&D TONGUE/FLOOR LINGUAL,1734.5,1127.425,93.73,4214.0,83
HCPCS,410000,DRAINAGE OF MOUTH LESION,,,109.98,109.98,1
HCPCS,41005,DRAINAGE OF MOUTH LESION,,,121.82,121.82,1
HCPCS,41005,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,929.5,604.175,90.8,4214.0,84
HCPCS,410050,DRAINAGE OF MOUTH LESION,,,121.82,121.82,1
HCPCS,41006,DRAINAGE OF MOUTH LESION,,,244.59,3211.66,15
HCPCS,41006,Drainage of mouth lesion,,,839.72,1060.7,6
HCPCS,410060,DRAINAGE OF MOUTH LESION,,,244.59,244.59,1
HCPCS,41007,DRAINAGE OF MOUTH LESION,,,234.32,234.32,1
HCPCS,41007,INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE,8518.0,5536.7,266.76,8370.0,49
HCPCS,410070,DRAINAGE OF MOUTH LESION,,,234.32,234.32,1
HCPCS,41008,DRAINAGE OF MOUTH LESION,,,272.73,272.73,1
HCPCS,41008,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,10016.0,6510.400000000001,181.73,16783.2,84
HCPCS,410080,DRAINAGE OF MOUTH LESION,,,272.73,272.73,1
HCPCS,41009,DRAINAGE OF MOUTH LESION,,,301.36,301.36,1
HCPCS,41009,INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE,2280.5,1482.3249999999998,183.81,4214.0,83
HCPCS,410090,DRAINAGE OF MOUTH LESION,,,301.36,301.36,1
HCPCS,4100F,BIPHOS THXPY VEIN ORD/RECVD,,,0.01,0.01,1
HCPCS,4100F0,BIPHOS THXPY VEIN ORD/RECVD,,,0.01,0.01,1
HCPCS,41010,INCISION LINGUAL FRENUM FRENOTOMY,4481.0,2912.65,56.15,7666.2,81
HCPCS,41010,INCISION OF TONGUE FOLD,,,115.58,115.58,1
HCPCS,410100,INCISION OF TONGUE FOLD,,,115.58,115.58,1
HCPCS,41015,DRAINAGE OF MOUTH LESION,,,315.09,1104.14,15
HCPCS,41015,Drainage of mouth lesion,,,844.88,1067.22,6
HCPCS,410150,DRAINAGE OF MOUTH LESION,,,315.09,315.09,1
HCPCS,41016,DRAINAGE OF MOUTH LESION,,,361.86,361.86,1
HCPCS,41016,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT,17845.5,11599.575,217.27,30613.5,84
HCPCS,410160,DRAINAGE OF MOUTH LESION,,,361.86,361.86,1
HCPCS,41017,DRAINAGE OF MOUTH LESION,,,359.77,359.77,1
HCPCS,41017,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB,10162.0,6605.3,185.5,16783.2,84
HCPCS,410170,DRAINAGE OF MOUTH LESION,,,359.77,359.77,1
HCPCS,41018,DRAINAGE OF MOUTH LESION,,,420.88,3211.66,15
HCPCS,41018,Drainage of mouth lesion,,,1209.93,1528.33,6
HCPCS,41018,XTRORAL I&D FLOOR MASTICATOR SPACE,2088.0,1357.2,240.64,1566.0,35
HCPCS,410180,DRAINAGE OF MOUTH LESION,,,420.88,420.88,1
HCPCS,41019,PLACE NEEDLES H&N FOR RT,,,518.42,12826.13,15
HCPCS,41019,Place needles h&n for rt,,,2719.4,3435.04,6
HCPCS,410190,PLACE NEEDLES H&N FOR RT,,,518.42,518.42,1
HCPCS,41100,BIOPSY OF TONGUE,,,113.72,113.72,1
HCPCS,41100,BIOPSY TONGUE ANTERIOR 2/3,568.0,369.2,72.4,426.0,35
HCPCS,41100,BIOPSY TONGUE ANTERIOR TWO-THIRDS,2929.0,1903.85,112.01,4214.0,45
HCPCS,411000,BIOPSY OF TONGUE,,,113.72,113.72,1
HCPCS,41105,BIOPSY OF TONGUE,,,116.89,7031.51,15
HCPCS,41105,"BIOPSY TONGUE,POSTER 1/3",588.0,382.2,71.49,441.0,35
HCPCS,41105,Biopsy of tongue,,,839.72,1060.7,6
HCPCS,411050,BIOPSY OF TONGUE,,,116.89,116.89,1
HCPCS,41108,BIOPSY FLOOR MOUTH,9316.0,6055.4,108.12,8384.4,46
HCPCS,41108,BIOPSY OF FLOOR OF MOUTH,,,96.47,96.47,1
HCPCS,41108,"BIOPSY, MOUTH, FLOOR",484.0,314.6,56.84,363.0,35
HCPCS,411080,BIOPSY OF FLOOR OF MOUTH,,,96.47,96.47,1
HCPCS,4110F,INT MAM ART USED FOR CABG,,,0.01,0.01,1
HCPCS,4110F0,INT MAM ART USED FOR CABG,,,0.01,0.01,1
HCPCS,41110,EXCISION LESION TONGUE W/O CLOSURE,9636.0,6263.400000000001,95.06,16783.2,81
HCPCS,41110,EXCISION OF TONGUE LESION,,,137.37,137.37,1
HCPCS,411100,EXCISION OF TONGUE LESION,,,137.37,137.37,1
HCPCS,41112,EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS,9890.0,6428.5,140.15,16783.2,81
HCPCS,41112,EXCISION OF TONGUE LESION,,,255.71,255.71,1
HCPCS,411120,EXCISION OF TONGUE LESION,,,255.71,255.71,1
HCPCS,41113,EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD,1316.0,855.4,175.48,987.0,35
HCPCS,41113,EXCISION OF TONGUE LESION,,,278.06,7031.51,15
HCPCS,41113,Excision of tongue lesion,,,839.72,1060.7,6
HCPCS,411130,EXCISION OF TONGUE LESION,,,278.06,278.06,1
HCPCS,41114,EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP,3528.0,2293.2,398.84,3528.0,35
HCPCS,41114,EXCISION OF TONGUE LESION,,,660.2,7031.51,15
HCPCS,41114,Excision of tongue lesion,,,1634.08,2064.1,6
HCPCS,411140,EXCISION OF TONGUE LESION,,,660.2,660.2,1
HCPCS,41115,EXCISION OF LINGUAL FRENUM (FRENECTOMY),716.0,465.4,97.13,537.0,35
HCPCS,41115,EXCISION OF TONGUE FOLD,,,154.61,3211.66,15
HCPCS,41115,Excision of tongue fold,,,839.72,1060.7,6
HCPCS,411150,EXCISION OF TONGUE FOLD,,,154.61,154.61,1
HCPCS,41116,EXCISION LESION FLOOR MOUTH,9828.0,6388.200000000001,134.57,16783.2,81
HCPCS,41116,EXCISION OF MOUTH LESION,,,228.21,228.21,1
HCPCS,411160,EXCISION OF MOUTH LESION,,,228.21,228.21,1
HCPCS,41120,GLOSSECTOMY <ONE-HALF TONGUE,4902.0,3186.3,553.45,4902.0,35
HCPCS,41120,PARTIAL REMOVAL OF TONGUE,,,1102.62,12826.13,15
HCPCS,41120,Partial removal of tongue,,,2132.36,2693.51,6
HCPCS,411200,PARTIAL REMOVAL OF TONGUE,,,1102.62,1102.62,1
HCPCS,41130,GLOSSECTOMY HEMIGLOSSECTOMY,6296.0,4092.4,671.58,6296.0,35
HCPCS,41130,PARTIAL REMOVAL OF TONGUE,,,1371.69,1371.69,1
HCPCS,41130,Partial removal of tongue,,,2132.36,2693.51,6
HCPCS,411300,PARTIAL REMOVAL OF TONGUE,,,1371.69,1371.69,1
HCPCS,41135,GLOSSECTOMY PRTL W/UNI RADICAL NECK DSJ,12056.0,7836.4,1125.3,12056.0,35
HCPCS,41135,TONGUE AND NECK SURGERY,,,2276.88,2276.88,1
HCPCS,41135,Tongue and neck surgery,,,2719.4,3435.04,6
HCPCS,411350,TONGUE AND NECK SURGERY,,,2276.88,2276.88,1
HCPCS,41140,GLSSC COMPL/TOT W/WOTRACHS W/O RAD NECK DSJ,11660.0,7579.0,1195.93,11660.0,35
HCPCS,41140,REMOVAL OF TONGUE,,,2288.21,2288.21,1
HCPCS,41140,Removal of tongue,,,2719.4,3435.04,6
HCPCS,411400,REMOVAL OF TONGUE,,,2288.21,2288.21,1
HCPCS,41145,GLSSC COMPL/TOT W/WO TRACHS W/UNI RAD NECK DSJ,15172.0,9861.8,1448.61,15172.0,35
HCPCS,41145,TONGUE REMOVAL NECK SURGERY,,,2885.86,2885.86,1
HCPCS,41145,Tongue removal neck surgery,,,2719.4,3435.04,6
HCPCS,411450,TONGUE REMOVAL NECK SURGERY,,,2885.86,2885.86,1
HCPCS,41150,GLSSC COMPOSIT W/RESCJ FLOOR & MANDIBULAR RESCJ,11944.0,7763.6,1150.34,11944.0,35
HCPCS,41150,TONGUE MOUTH JAW SURGERY,,,2307.6,2307.6,1
HCPCS,41150,Tongue mouth jaw surgery,,,2719.4,3435.04,6
HCPCS,411500,TONGUE MOUTH JAW SURGERY,,,2307.6,2307.6,1
HCPCS,41153,GLSSC COMPOSIT RESCJ FLOOR SUPRAHYOID NCK DSJ,13436.0,8733.4,1283.53,13436.0,35
HCPCS,41153,TONGUE MOUTH NECK SURGERY,,,2514.62,2514.62,1
HCPCS,41153,Tongue mouth neck surgery,,,2719.4,3435.04,6
HCPCS,411530,TONGUE MOUTH NECK SURGERY,,,2514.62,2514.62,1
HCPCS,41155,GLSSC COMPOSIT RESCJ FLR MNDBLR RESCJ & RAD NECK,17720.0,11518.0,1514.82,17720.0,35
HCPCS,41155,TONGUE JAW & NECK SURGERY,,,3142.28,3142.28,1
HCPCS,41155,Tongue jaw & neck surgery,,,2719.4,3435.04,6
HCPCS,411550,TONGUE JAW & NECK SURGERY,,,3142.28,3142.28,1
HCPCS,4115F,BETA BLCKR ADMIN W/IN 24 HRS,,,0.01,0.01,1
HCPCS,4115F0,BETA BLCKR ADMIN W/IN 24 HRS,,,0.01,0.01,1
HCPCS,4120F,ANTIBIOT RXD/GIVEN,,,0.01,0.01,1
HCPCS,4120F0,ANTIBIOT RXD/GIVEN,,,0.01,0.01,1
HCPCS,4124F,ANTIBIOT NOT RXD/GIVEN,,,0.01,0.01,1
HCPCS,4124F0,ANTIBIOT NOT RXD/GIVEN,,,0.01,0.01,1
HCPCS,41250,"REPAIR TONGUE LACER,<2.5CM",784.0,509.6,85.93,588.0,35
HCPCS,41250,REPAIR TONGUE LACERATION,,,163.1,163.1,1
HCPCS,41250,RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG,2295.0,1491.75,112.01,3920.0,98
HCPCS,412500,REPAIR TONGUE LACERATION,,,163.1,163.1,1
HCPCS,41251,REPAIR TONGUE LACERATION,,,194.83,194.83,1
HCPCS,41251,RPR LAC 2.5 CM/< PST ONE-THIRD TONGUE,1335.0,867.75,112.01,4214.0,98
HCPCS,412510,REPAIR TONGUE LACERATION,,,194.83,194.83,1
HCPCS,41252,"REPAIR TONGUE LACER,2.6CM+/COMPLX",1208.0,785.2,146.15,906.0,35
HCPCS,41252,REPAIR TONGUE LACERATION,,,222.22,222.22,1
HCPCS,41252,RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX,1335.0,867.75,112.01,6317.0,98
HCPCS,412520,REPAIR TONGUE LACERATION,,,222.22,222.22,1
HCPCS,4130F,TOPICAL PREP RX AOE,,,0.01,0.01,1
HCPCS,4130F0,TOPICAL PREP RX AOE,,,0.01,0.01,1
HCPCS,4131F,SYST ANTIMICROBIAL THX RX,,,0.01,0.01,1
HCPCS,4131F0,SYST ANTIMICROBIAL THX RX,,,0.01,0.01,1
HCPCS,4132F,NO SYST ANTIMICROBIAL THX RX,,,0.01,0.01,1
HCPCS,4132F0,NO SYST ANTIMICROBIAL THX RX,,,0.01,0.01,1
HCPCS,4133F,ANTIHIST/DECONG RX/RECOM,,,0.01,0.01,1
HCPCS,4133F0,ANTIHIST/DECONG RX/RECOM,,,0.01,0.01,1
HCPCS,4134F,NO ANTIHIST/DECONG RX/RECOM,,,0.01,0.01,1
HCPCS,4134F0,NO ANTIHIST/DECONG RX/RECOM,,,0.01,0.01,1
HCPCS,4135F,SYSTEMIC CORTICOSTEROIDS RX,,,0.01,0.01,1
HCPCS,4135F0,SYSTEMIC CORTICOSTEROIDS RX,,,0.01,0.01,1
HCPCS,4136F,SYST CORTICOSTEROIDS NOT RX,,,0.01,0.01,1
HCPCS,4136F0,SYST CORTICOSTEROIDS NOT RX,,,0.01,0.01,1
HCPCS,4140F,INHALED CORTICOSTEROIDS RXD,,,0.01,0.01,1
HCPCS,4140F0,INHALED CORTICOSTEROIDS RXD,,,0.01,0.01,1
HCPCS,4142F,CORTICOSTER SPARNG THRPY RXD,,,0.01,0.01,1
HCPCS,4142F0,CORTICOSTER SPARNG THRPY RXD,,,0.01,0.01,1
HCPCS,4144F,ALT LONG-TERM CNTRL MED RXD,,,0.01,0.01,1
HCPCS,4144F0,ALT LONG-TERM CNTRL MED RXD,,,0.01,0.01,1
HCPCS,4145F,2+ ANTI-HYPRTNSV AGENTS TKN,,,0.01,0.01,1
HCPCS,4145F0,2+ ANTI-HYPRTNSV AGENTS TKN,,,0.01,0.01,1
HCPCS,4148F,HEP A VAC INJXN ADMIN/RECVD,,,0.01,0.01,1
HCPCS,4148F0,HEP A VAC INJXN ADMIN/RECVD,,,0.01,0.01,1
HCPCS,4149F,HEP B VAC INJXN ADMIN/RECVD,,,0.01,0.01,1
HCPCS,4149F0,HEP B VAC INJXN ADMIN/RECVD,,,0.01,0.01,1
HCPCS,4150F,PT RECVNG ANTIVIR TXMNT HEPC,,,0.01,0.01,1
HCPCS,4150F0,PT RECVNG ANTIVIR TXMNT HEPC,,,0.01,0.01,1
HCPCS,41510,TONGUE TO LIP SURGERY,,,470.35,7031.51,15
HCPCS,41510,Tongue to lip surgery,,,839.72,1060.7,6
HCPCS,415100,TONGUE TO LIP SURGERY,,,470.35,470.35,1
HCPCS,41512,TONGUE SUSPENSION,,,695.74,12826.13,15
HCPCS,41512,Tongue suspension,,,2719.4,3435.04,6
HCPCS,415120,TONGUE SUSPENSION,,,695.74,695.74,1
HCPCS,4151F,PT NOT RECVNG ANTIV HEP C,,,0.01,0.01,1
HCPCS,4151F0,PT NOT RECVNG ANTIV HEP C,,,0.01,0.01,1
HCPCS,41520,FRENOPLASTY SURG REVJ FRENUM EG W/Z-PLASTY,1132.0,735.8,148.16,849.0,35
HCPCS,41520,RECONSTRUCTION TONGUE FOLD,,,265.25,7031.51,15
HCPCS,41520,Reconstruction tongue fold,,,2132.36,2693.51,6
HCPCS,415200,RECONSTRUCTION TONGUE FOLD,,,265.25,265.25,1
HCPCS,41530,SUBMUCOSAL ABLTJ TONGUE RF 1/> SITES PR SESSION,1400.0,910.0,355.35,5025.8,32
HCPCS,41530,TONGUE BASE VOL REDUCTION,,,392.4,7031.51,15
HCPCS,41530,Tongue base vol reduction,,,1634.08,2064.1,6
HCPCS,415300,TONGUE BASE VOL REDUCTION,,,392.4,392.4,1
HCPCS,4153F,COMBO PEGINTF/RIB RX,,,0.01,0.01,1
HCPCS,4153F0,COMBO PEGINTF/RIB RX,,,0.01,0.01,1
HCPCS,4155F,HEP A VAC SERIES PREV RECVD,,,0.01,0.01,1
HCPCS,4155F0,HEP A VAC SERIES PREV RECVD,,,0.01,0.01,1
HCPCS,4157F,HEP B VAC SERIES PREV RECVD,,,0.01,0.01,1
HCPCS,4157F0,HEP B VAC SERIES PREV RECVD,,,0.01,0.01,1
HCPCS,4158F,PT EDU RE ALCOH DRNKNG DONE,,,0.01,0.01,1
HCPCS,4158F0,PT EDU RE ALCOH DRNKNG DONE,,,0.01,0.01,1
HCPCS,41599,LASER DESTRUCTION/TONGUE LESION (COMP 41110),624.0,405.6,249.67,624.0,15
HCPCS,41599,RADIOFREQUENCY ABLATION TONGUE,2582.0,1678.3,249.67,2582.0,15
HCPCS,41599,UNLISTED PX TONGUE FLR MOUTH,,,233.1,503.49,14
HCPCS,41599,Unlisted px tongue flr mouth,,,839.72,1060.7,6
HCPCS,4159F,CONTRCP TALK B/4 ANTIV TXMNT,,,0.01,0.01,1
HCPCS,4159F0,CONTRCP TALK B/4 ANTIV TXMNT,,,0.01,0.01,1
HCPCS,4163F,PT COUNS 4 TXMNT OPT PROST,,,0.01,0.01,1
HCPCS,4163F0,PT COUNS 4 TXMNT OPT PROST,,,0.01,0.01,1
HCPCS,4164F,ADJV HRMNL THXPY RXD,,,0.01,0.01,1
HCPCS,4164F0,ADJV HRMNL THXPY RXD,,,0.01,0.01,1
HCPCS,4165F,3D-CRT/IMRT RECEIVED,,,0.01,0.01,1
HCPCS,4165F0,3D-CRT/IMRT RECEIVED,,,0.01,0.01,1
HCPCS,4167F,HD BED TILTED 1ST DAY VENT,,,0.01,0.01,1
HCPCS,4167F0,HD BED TILTED 1ST DAY VENT,,,0.01,0.01,1
HCPCS,4168F,PT CARE ICU&VENT W/IN 24HRS,,,0.01,0.01,1
HCPCS,4168F0,PT CARE ICU&VENT W/IN 24HRS,,,0.01,0.01,1
HCPCS,4169F,NO PT CARE ICU/VENT IN 24HRS,,,0.01,0.01,1
HCPCS,4169F0,NO PT CARE ICU/VENT IN 24HRS,,,0.01,0.01,1
HCPCS,4171F,PT RCVNG ESA THXPY,,,0.01,0.01,1
HCPCS,4171F0,PT RCVNG ESA THXPY,,,0.01,0.01,1
HCPCS,4172F,PT NOT RCVNG ESA THXPY,,,0.01,0.01,1
HCPCS,4172F0,PT NOT RCVNG ESA THXPY,,,0.01,0.01,1
HCPCS,4174F,COUNS POTENT GLAUC IMPCT,,,0.01,0.01,1
HCPCS,4174F0,COUNS POTENT GLAUC IMPCT,,,0.01,0.01,1
HCPCS,4175F,VIS 20/40/> W/IN 90 DAYS,,,0.01,0.01,1
HCPCS,4175F0,VIS 20/40/> W/IN 90 DAYS,,,0.01,0.01,1
HCPCS,4176F,TALK RE UV LIGHT PT/CRGVR,,,0.01,0.01,1
HCPCS,4176F0,TALK RE UV LIGHT PT/CRGVR,,,0.01,0.01,1
HCPCS,4177F,TALK PT/CRGVR RE AREDS PREV,,,0.01,0.01,1
HCPCS,4177F0,TALK PT/CRGVR RE AREDS PREV,,,0.01,0.01,1
HCPCS,4178F,ANTID GLBLN RCVD W/IN 26WKS,,,0.01,0.01,1
HCPCS,4178F0,ANTID GLBLN RCVD W/IN 26WKS,,,0.01,0.01,1
HCPCS,4179F,TAMOXIFEN/AI PRESCRIBED,,,0.01,0.01,1
HCPCS,4179F0,TAMOXIFEN/AI PRESCRIBED,,,0.01,0.01,1
HCPCS,41800,DRAINAGE OF GUM LESION,,,160.8,160.8,1
HCPCS,41800,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,624.5,405.92499999999995,74.63,4151.0,133
HCPCS,418000,DRAINAGE OF GUM LESION,,,160.8,160.8,1
HCPCS,41805,REMOVAL FOREIGN BODY GUM,,,200.76,200.76,1
HCPCS,41805,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,4527.0,2942.5499999999997,96.99,7666.2,84
HCPCS,418050,REMOVAL FOREIGN BODY GUM,,,200.76,200.76,1
HCPCS,41806,REMOVAL FOREIGN BODY JAWBONE,,,287.33,3211.66,15
HCPCS,41806,Removal foreign body jawbone,,,1209.93,1528.33,6
HCPCS,418060,REMOVAL FOREIGN BODY JAWBONE,,,287.33,287.33,1
HCPCS,4180F,ADJV THXPYRXD/RCVD COLON CA,,,0.01,0.01,1
HCPCS,4180F0,ADJV THXPYRXD/RCVD COLON CA,,,0.01,0.01,1
HCPCS,4181F,CONFORMAL RADN THXPY RCVD,,,0.01,0.01,1
HCPCS,4181F0,CONFORMAL RADN THXPY RCVD,,,0.01,0.01,1
HCPCS,41820,EXCISION GUM EACH QUADRANT,,,261.65,7031.51,15
HCPCS,41820,Excision gum each quadrant,,,662.16,836.41,6
HCPCS,418200,EXCISION GUM EACH QUADRANT,,,261.65,261.65,1
HCPCS,41821,EXCISION OF GUM FLAP,,,58.7,3211.66,15
HCPCS,41821,Excision of gum flap,,,166.94,210.88,6
HCPCS,41821,OPRCULECTOMY EXC PRICORONAL TISSUE,282.0,183.3,80.62,282.0,16
HCPCS,418210,EXCISION OF GUM FLAP,,,58.7,58.7,1
HCPCS,41822,EXCISION OF GUM LESION,,,212.94,3211.66,15
HCPCS,41822,Excision of gum lesion,,,1209.93,1528.33,6
HCPCS,418220,EXCISION OF GUM LESION,,,212.94,212.94,1
HCPCS,41823,EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS,1508.0,980.2,207.04,1131.0,35
HCPCS,41823,EXCISION OF GUM LESION,,,386.91,12826.13,15
HCPCS,41823,Excision of gum lesion,,,1928.02,2435.39,6
HCPCS,418230,EXCISION OF GUM LESION,,,386.91,386.91,1
HCPCS,41825,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/O RPR,564.0,366.6,77.95,423.0,35
HCPCS,41825,EXCISION OF GUM LESION,,,127.92,7031.51,15
HCPCS,41825,Excision of gum lesion,,,1209.93,1528.33,6
HCPCS,418250,EXCISION OF GUM LESION,,,127.92,127.92,1
HCPCS,41826,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/SMPL RPR,1060.0,689.0,117.92,795.0,35
HCPCS,41826,EXCISION OF GUM LESION,,,204.69,7031.51,15
HCPCS,41826,Excision of gum lesion,,,1928.02,2435.39,6
HCPCS,418260,EXCISION OF GUM LESION,,,204.69,204.69,1
HCPCS,41827,EXC LESION/TUMOR DENTALVEOLAR STRUX W/CMPLX RPR,1685.0,1095.25,188.99,1263.75,35
HCPCS,41827,EXCISION OF GUM LESION,,,304.34,12826.13,15
HCPCS,41827,Excision of gum lesion,,,1928.02,2435.39,6
HCPCS,418270,EXCISION OF GUM LESION,,,304.34,304.34,1
HCPCS,41828,EXCISION OF GUM LESION,,,235.95,3211.66,15
HCPCS,41828,Excision of gum lesion,,,1928.02,2435.39,6
HCPCS,418280,EXCISION OF GUM LESION,,,235.95,235.95,1
HCPCS,4182F,NO CONFORMAL RADN THXPY,,,0.01,0.01,1
HCPCS,4182F0,NO CONFORMAL RADN THXPY,,,0.01,0.01,1
HCPCS,41830,ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY,1380.0,897.0,244.47,1035.0,34
HCPCS,41830,REMOVAL OF GUM TISSUE,,,329.77,7031.51,15
HCPCS,41830,Removal of gum tissue,,,1209.93,1528.33,6
HCPCS,418300,REMOVAL OF GUM TISSUE,,,329.77,329.77,1
HCPCS,41850,DESTRUCTION LESION DENTOALVEOLAR STRUCTURES,4571.5,2971.475,17.04,8370.0,61
HCPCS,41850,TREATMENT OF GUM LESION,,,130.47,130.47,1
HCPCS,418500,TREATMENT OF GUM LESION,,,130.47,130.47,1
HCPCS,4185F,CONTINUOUS PPI OR H2RA RCVD,,,0.01,0.01,1
HCPCS,4185F0,CONTINUOUS PPI OR H2RA RCVD,,,0.01,0.01,1
HCPCS,4186F,NO CONT PPI OR H2RA RCVD,,,0.01,0.01,1
HCPCS,4186F0,NO CONT PPI OR H2RA RCVD,,,0.01,0.01,1
HCPCS,41870,PERIODONTAL MUCOSAL GRAFTING,,,327.07,3211.66,15
HCPCS,41870,Periodontal mucosal grafting,,,662.16,836.41,6
HCPCS,418700,PERIODONTAL MUCOSAL GRAFTING,,,327.07,327.07,1
HCPCS,41872,GINGIVOPLASTY EACH QUADRANT,,,320.28,7031.51,15
HCPCS,41872,GINGIVOPLASTY EACH QUADRANT SPECIFY,1204.0,782.6,256.96,903.0,34
HCPCS,41872,Gingivoplasty each quadrant,,,662.16,836.41,6
HCPCS,418720,GINGIVOPLASTY EACH QUADRANT,,,320.28,320.28,1
HCPCS,41874,ALVEOLOPLASTY EACH QUADRANT,,,257.18,7031.51,15
HCPCS,41874,ALVEOLOPLASTY EACH QUADRANT SPECIFY,1404.0,912.6,219.76,1053.0,34
HCPCS,41874,Alveoloplasty each quadrant,,,1928.02,2435.39,6
HCPCS,418740,ALVEOLOPLASTY EACH QUADRANT,,,257.18,257.18,1
HCPCS,4187F,ANTI RHEUM DRUGTHXPYRXD/GVN,,,0.01,0.01,1
HCPCS,4187F0,ANTI RHEUM DRUGTHXPYRXD/GVN,,,0.01,0.01,1
HCPCS,4188F,APPROP ACE/ARB TSTNG DONE,,,0.01,0.01,1
HCPCS,4188F0,APPROP ACE/ARB TSTNG DONE,,,0.01,0.01,1
HCPCS,41899,SCLEROTHERAPY TO THE ORAL CAVITY (COMP CODE 36470),300.0,195.0,150.0,300.0,15
HCPCS,41899,UNLISTED PX DENTALVLR STRUX,,,233.1,503.49,14
HCPCS,41899,Unlisted px dentalvlr strux,,,844.88,1067.22,6
HCPCS,4189F,APPROP DIGOXIN TSTNG DONE,,,0.01,0.01,1
HCPCS,4189F0,APPROP DIGOXIN TSTNG DONE,,,0.01,0.01,1
HCPCS,4190F,APPROP DIURETIC TSTNG DONE,,,0.01,0.01,1
HCPCS,4190F0,APPROP DIURETIC TSTNG DONE,,,0.01,0.01,1
HCPCS,4191F,APPROP ANTICONVULS TSTNG,,,0.01,0.01,1
HCPCS,4191F0,APPROP ANTICONVULS TSTNG,,,0.01,0.01,1
HCPCS,4192F,PT NOT RCVNG GLUCOCO THXPY,,,0.01,0.01,1
HCPCS,4192F0,PT NOT RCVNG GLUCOCO THXPY,,,0.01,0.01,1
HCPCS,4193F,PT RCV <10MG DAILY PREDNISO,,,0.01,0.01,1
HCPCS,4193F0,PT RCV <10MG DAILY PREDNISO,,,0.01,0.01,1
HCPCS,4194F,PT RCV >=10MG DAILY PREDNISO,,,0.01,0.01,1
HCPCS,4194F0,PT RCV >=10MG DAILY PREDNISO,,,0.01,0.01,1
HCPCS,4195F,PT RCVNG ANTI-RHEUM THXPY RA,,,0.01,0.01,1
HCPCS,4195F0,PT RCVNG ANTI-RHEUM THXPY RA,,,0.01,0.01,1
HCPCS,4196F,PTNOT RCVNG ANTI-RHM THXPYRA,,,0.01,0.01,1
HCPCS,4196F0,PTNOT RCVNG ANTI-RHM THXPYRA,,,0.01,0.01,1
HCPCS,42000,DRAINAGE ABSCESS PALATE UVULA,1335.0,867.75,112.01,4214.0,144
HCPCS,42000,DRAINAGE MOUTH ROOF LESION,,,115.6,115.6,1
HCPCS,420000,DRAINAGE MOUTH ROOF LESION,,,115.6,115.6,1
HCPCS,4200F,EXTERNAL BEAM TO PROST ONLY,,,0.01,0.01,1
HCPCS,4200F0,EXTERNAL BEAM TO PROST ONLY,,,0.01,0.01,1
HCPCS,4201F,EXTRNL BEAM OTHER THAN PROST,,,0.01,0.01,1
HCPCS,4201F0,EXTRNL BEAM OTHER THAN PROST,,,0.01,0.01,1
HCPCS,42100,BIOPSY PALATE UVULA,4558.0,2962.7,62.69,7666.2,81
HCPCS,42100,BIOPSY ROOF OF MOUTH,,,116.49,116.49,1
HCPCS,421000,BIOPSY ROOF OF MOUTH,,,116.49,116.49,1
HCPCS,42104,EXC LESION PALATE UVULA W/O CLOSURE,9662.0,6280.3,90.22,16783.2,81
HCPCS,42104,EXCISION LESION MOUTH ROOF,,,142.84,142.84,1
HCPCS,421040,EXCISION LESION MOUTH ROOF,,,142.84,142.84,1
HCPCS,42106,EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE,860.0,559.0,115.76,645.0,35
HCPCS,42106,EXCISION LESION MOUTH ROOF,,,169.44,7031.51,15
HCPCS,42106,Excision lesion mouth roof,,,1634.08,2064.1,6
HCPCS,421060,EXCISION LESION MOUTH ROOF,,,169.44,169.44,1
HCPCS,42107,EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE,1824.0,1185.6,243.12,1368.0,35
HCPCS,42107,EXCISION LESION MOUTH ROOF,,,342.53,12826.13,15
HCPCS,42107,Excision lesion mouth roof,,,1634.08,2064.1,6
HCPCS,421070,EXCISION LESION MOUTH ROOF,,,342.53,342.53,1
HCPCS,4210F,ACE/ARB THXPY FOR MOS/>,,,0.01,0.01,1
HCPCS,4210F0,ACE/ARB THXPY FOR MOS/>,,,0.01,0.01,1
HCPCS,42120,REMOVE PALATE/LESION,,,1050.92,12826.13,15
HCPCS,42120,RESCJ PALATE/EXTENSIVE RESCJ LESION,4744.0,3083.6,498.0,4744.0,35
HCPCS,42120,Remove palate/lesion,,,1928.02,2435.39,6
HCPCS,421200,REMOVE PALATE/LESION,,,1050.92,1050.92,1
HCPCS,42140,EXCISION OF UVULA,,,171.98,7031.51,15
HCPCS,42140,Excision of uvula,,,1634.08,2064.1,6
HCPCS,42140,UVULECTOMY EXCISION UVULA,680.0,442.0,89.21,510.0,35
HCPCS,421400,EXCISION OF UVULA,,,171.98,171.98,1
HCPCS,42145,PALATOPHARYNGOPLASTY,3349.5,2177.175,459.6,3639.0,70
HCPCS,42145,PALATOPHAYNGOPLASTY,3912.0,2542.8,459.6,3912.0,35
HCPCS,42145,REPAIR PALATE PHARYNX/UVULA,,,732.87,12826.13,15
HCPCS,42145,Repair palate pharynx/uvula,,,1833.3,2315.75,6
HCPCS,421450,REPAIR PALATE PHARYNX/UVULA,,,732.87,732.87,1
HCPCS,42160,DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM,9694.0,6301.1,94.1,16783.2,81
HCPCS,42160,TREATMENT MOUTH ROOF LESION,,,149.08,149.08,1
HCPCS,421600,TREATMENT MOUTH ROOF LESION,,,149.08,149.08,1
HCPCS,42180,REPAIR LAC PALATE<2 CM,,,199.39,199.39,1
HCPCS,42180,REPAIR LACERATION PALATE </2 CM,2929.0,1903.85,215.93,4214.0,96
HCPCS,42180,REPAIR PALATE LACER <2CM,1020.0,663.0,129.54,765.0,35
HCPCS,421800,REPAIR LAC PALATE<2 CM,,,199.39,199.39,1
HCPCS,42182,REPAIR LACERATION PALATE >2 CM/COMPLEX,34015.0,22109.75,296.75,30613.5,84
HCPCS,42182,REPAIR PALATE,,,275.7,275.7,1
HCPCS,421820,REPAIR PALATE,,,275.7,275.7,1
HCPCS,42200,PALATOP CL PALATE SOFT&/HARD PALATE ONLY,5012.0,3257.8,514.99,5012.0,35
HCPCS,42200,RECONSTRUCT CLEFT PALATE,,,981.24,12826.13,15
HCPCS,42200,Reconstruct cleft palate,,,1833.3,2315.75,6
HCPCS,422000,RECONSTRUCT CLEFT PALATE,,,981.24,981.24,1
HCPCS,42205,PALATOPLASTY W/CLSR ALVEOLAR RIDGE SOFT TISSUE,5464.0,3551.6,512.79,5464.0,35
HCPCS,42205,RECONSTRUCT CLEFT PALATE,,,1023.0,7031.51,15
HCPCS,42205,Reconstruct cleft palate,,,1833.3,2315.75,6
HCPCS,422050,RECONSTRUCT CLEFT PALATE,,,1023.0,1023.0,1
HCPCS,4220F,DIGOXIN THXPY FOR 6 MOS/>,,,0.01,0.01,1
HCPCS,4220F0,DIGOXIN THXPY FOR 6 MOS/>,,,0.01,0.01,1
HCPCS,42210,PALATOP CLSR ALVEOLAR RIDGE GRF ALVEOLAR RIDGE,6012.0,3907.8,685.42,6012.0,35
HCPCS,42210,RECONSTRUCT CLEFT PALATE,,,1140.79,12826.13,15
HCPCS,42210,Reconstruct cleft palate,,,1833.3,2315.75,6
HCPCS,422100,RECONSTRUCT CLEFT PALATE,,,1140.79,1140.79,1
HCPCS,42215,PALATOPLASTY CLEFT PALATE MAJOR REVJ,3596.0,2337.4,447.54,3596.0,35
HCPCS,42215,RECONSTRUCT CLEFT PALATE,,,743.3,12826.13,15
HCPCS,42215,Reconstruct cleft palate,,,1833.3,2315.75,6
HCPCS,422150,RECONSTRUCT CLEFT PALATE,,,743.3,743.3,1
HCPCS,4221F,DIURETIC THXPY FOR 6 MOS/>,,,0.01,0.01,1
HCPCS,4221F0,DIURETIC THXPY FOR 6 MOS/>,,,0.01,0.01,1
HCPCS,42220,PALATOPLASTY CLEFT PALATE SEC LNGTH PX,2864.0,1861.6,341.8,2864.0,35
HCPCS,42220,RECONSTRUCT CLEFT PALATE,,,611.87,12826.13,15
HCPCS,42220,Reconstruct cleft palate,,,1833.3,2315.75,6
HCPCS,422200,RECONSTRUCT CLEFT PALATE,,,611.87,611.87,1
HCPCS,42225,PALATOP CL PALATE ATTACHMENT PHARYNGEAL FLAP,3908.0,2540.2,551.18,3908.0,35
HCPCS,42225,RECONSTRUCT CLEFT PALATE,,,1024.7,12826.13,15
HCPCS,42225,Reconstruct cleft palate,,,1833.3,2315.75,6
HCPCS,422250,RECONSTRUCT CLEFT PALATE,,,1024.7,1024.7,1
HCPCS,42226,LENGTHENING OF PALATE,,,951.56,12826.13,15
HCPCS,42226,LENGTHENING PALATE+PHARY FLAP,4140.0,2691.0,525.14,4140.0,35
HCPCS,42226,Lengthening of palate,,,1833.3,2315.75,6
HCPCS,422260,LENGTHENING OF PALATE,,,951.56,951.56,1
HCPCS,42227,LENGTHENING OF PALATE,,,887.64,12826.13,15
HCPCS,42227,LENGTHENING PALATE+ISLAND FLAP,3960.0,2574.0,520.1,3960.0,35
HCPCS,42227,Lengthening of palate,,,1833.3,2315.75,6
HCPCS,422270,LENGTHENING OF PALATE,,,887.64,887.64,1
HCPCS,42235,REPAIR ANTER PALATE W VOMER FLAP,3204.0,2082.6,420.37,3204.0,35
HCPCS,42235,REPAIR PALATE,,,778.71,12826.13,15
HCPCS,42235,Repair palate,,,1833.3,2315.75,6
HCPCS,422350,REPAIR PALATE,,,778.71,778.71,1
HCPCS,42260,REPAIR NOSE TO LIP FISTULA,,,716.87,12826.13,15
HCPCS,42260,Repair nose to lip fistula,,,2132.36,2693.51,6
HCPCS,422600,REPAIR NOSE TO LIP FISTULA,,,716.87,716.87,1
HCPCS,42280,PREPARATION PALATE MOLD,,,114.8,1104.14,15
HCPCS,42280,Preparation palate mold,,,1105.23,1396.08,6
HCPCS,422800,PREPARATION PALATE MOLD,,,114.8,114.8,1
HCPCS,42281,INSERTION PALATE PROSTHESIS,,,169.04,12826.13,15
HCPCS,42281,Insertion palate prosthesis,,,1928.02,2435.39,6
HCPCS,422810,INSERTION PALATE PROSTHESIS,,,169.04,169.04,1
HCPCS,42299,LASER ASSISTED UVULOPALATOPLASTY,4697.0,3053.05,259.15,4697.0,15
HCPCS,42299,UNLISTED PROCEDURE PALATE UVULA,425.0,276.25,119.43,8370.0,96
HCPCS,42300,"DRAIN ABSCESS PAROTID,SIMPLE",792.0,514.8,116.52,594.0,35
HCPCS,42300,DRAINAGE OF SALIVARY GLAND,,,166.1,3211.66,15
HCPCS,42300,Drainage of salivary gland,,,844.88,1067.22,6
HCPCS,423000,DRAINAGE OF SALIVARY GLAND,,,166.1,166.1,1
HCPCS,42305,"DRAIN ABSCESS PAROTID,COMPLIC",2524.0,1640.6,237.84,2524.0,35
HCPCS,42305,DRAINAGE OF SALIVARY GLAND,,,463.33,7031.51,15
HCPCS,42305,Drainage of salivary gland,,,1634.08,2064.1,6
HCPCS,423050,DRAINAGE OF SALIVARY GLAND,,,463.33,463.33,1
HCPCS,4230F,ANTICONV THXPY FOR 6 MOS/>,,,0.01,0.01,1
HCPCS,4230F0,ANTICONV THXPY FOR 6 MOS/>,,,0.01,0.01,1
HCPCS,42310,"DRAIN ABSC-SUBMAX,SUBLING-INTRAORAL",644.0,418.6,100.56,483.0,35
HCPCS,42310,DRAINAGE OF SALIVARY GLAND,,,141.98,1104.14,15
HCPCS,42310,Drainage of salivary gland,,,844.88,1067.22,6
HCPCS,423100,DRAINAGE OF SALIVARY GLAND,,,141.98,141.98,1
HCPCS,42320,DRAIN ABSC-SUBMAX-EXTERNAL,960.0,624.0,133.85,720.0,35
HCPCS,42320,DRAINAGE OF SALIVARY GLAND,,,190.79,1104.14,15
HCPCS,42320,Drainage of salivary gland,,,844.88,1067.22,6
HCPCS,423200,DRAINAGE OF SALIVARY GLAND,,,190.79,190.79,1
HCPCS,42330,REMOVAL OF SALIVARY STONE,,,176.17,176.17,1
HCPCS,42330,SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL,9776.0,6354.400000000001,95.16,16783.2,81
HCPCS,423300,REMOVAL OF SALIVARY STONE,,,176.17,176.17,1
HCPCS,42335,REMOVAL OF SALIVARY STONE,,,280.18,7031.51,15
HCPCS,42335,Removal of salivary stone,,,1209.93,1528.33,6
HCPCS,42335,SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL,1364.0,886.6,158.72,1023.0,35
HCPCS,423350,REMOVAL OF SALIVARY STONE,,,280.18,280.18,1
HCPCS,42340,REMOVAL OF SALIVARY STONE,,,368.25,7031.51,15
HCPCS,42340,Removal of salivary stone,,,1209.93,1528.33,6
HCPCS,42340,SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL,1888.0,1227.2,236.37,1416.0,35
HCPCS,423400,REMOVAL OF SALIVARY STONE,,,368.25,368.25,1
HCPCS,42400,BIOPSY OF SALIVARY GLAND,,,55.68,55.68,1
HCPCS,42400,BIOPSY SALIVARY GLAND NEEDLE,4046.0,2629.9,62.36,4151.0,144
HCPCS,42400,"BIOPSY SALIVARY GLAND,NEEDLE",343.0,222.95,45.49,257.25,35
HCPCS,424000,BIOPSY OF SALIVARY GLAND,,,55.68,55.68,1
HCPCS,42405,BIOPSY OF SALIVARY GLAND,,,242.17,242.17,1
HCPCS,42405,BIOPSY SALIVARY GLAND INCISIONAL,4927.0,3202.5499999999997,137.01,7666.2,74
HCPCS,424050,BIOPSY OF SALIVARY GLAND,,,242.17,242.17,1
HCPCS,42408,EXC SUBLINGUAL SALIVARY CYST RANULA,1864.0,1211.6,212.69,1398.0,35
HCPCS,42408,EXCISION OF SALIVARY CYST,,,367.74,7031.51,15
HCPCS,42408,Excision of salivary cyst,,,1209.93,1528.33,6
HCPCS,424080,EXCISION OF SALIVARY CYST,,,367.74,367.74,1
HCPCS,42409,DRAINAGE OF SALIVARY CYST,,,247.22,7031.51,15
HCPCS,42409,Drainage of salivary cyst,,,1209.93,1528.33,6
HCPCS,42409,MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA,1164.0,756.6,151.23,873.0,35
HCPCS,424090,DRAINAGE OF SALIVARY CYST,,,247.22,247.22,1
HCPCS,4240F,INSTR XRCZ BACK PAIN 12 WKS,,,0.01,0.01,1
HCPCS,4240F0,INSTR XRCZ BACK PAIN 12 WKS,,,0.01,0.01,1
HCPCS,42410,EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ,3828.0,2488.2,428.03,3828.0,35
HCPCS,42410,EXCISE PAROTID GLAND/LESION,,,674.42,12826.13,15
HCPCS,42410,Excise parotid gland/lesion,,,2132.36,2693.51,6
HCPCS,424100,EXCISE PAROTID GLAND/LESION,,,674.42,674.42,1
HCPCS,42415,EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR,6864.0,4461.6,802.61,6864.0,35
HCPCS,42415,EXCISE PAROTID GLAND/LESION,,,1133.15,12826.13,15
HCPCS,42415,Excise parotid gland/lesion,,,2719.4,3435.04,6
HCPCS,424150,EXCISE PAROTID GLAND/LESION,,,1133.15,1133.15,1
HCPCS,42420,EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR,7812.0,5077.8,885.17,7812.0,35
HCPCS,42420,EXCISE PAROTID GLAND/LESION,,,1268.25,12826.13,15
HCPCS,42420,Excise parotid gland/lesion,,,2719.4,3435.04,6
HCPCS,424200,EXCISE PAROTID GLAND/LESION,,,1268.25,1268.25,1
HCPCS,42425,EXCISE PAROTID GLAND/LESION,,,898.39,12826.13,15
HCPCS,42425,EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL,5368.0,3489.2,621.95,5368.0,35
HCPCS,42425,Excise parotid gland/lesion,,,2719.4,3435.04,6
HCPCS,424250,EXCISE PAROTID GLAND/LESION,,,898.39,898.39,1
HCPCS,42426,EXC PRTD TUM/PRTD GLND TOT W/UNI RAD NCK DSJ,9064.0,5891.6,1039.17,9064.0,35
HCPCS,42426,EXCISE PAROTID GLAND/LESION,,,1443.71,1443.71,1
HCPCS,42426,Excise parotid gland/lesion,,,2719.4,3435.04,6
HCPCS,424260,EXCISE PAROTID GLAND/LESION,,,1443.71,1443.71,1
HCPCS,4242F,SPRVSD XRCZ BACK PN >12 WKS,,,0.01,0.01,1
HCPCS,4242F0,SPRVSD XRCZ BACK PN >12 WKS,,,0.01,0.01,1
HCPCS,42440,EXCISE SUBMAXILLARY GLAND,,,445.4,12826.13,16
HCPCS,42440,EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND,2702.0,1756.3,322.47,2702.0,35
HCPCS,42440,Excise submaxillary gland,,,2132.36,2693.51,6
HCPCS,424400,EXCISE SUBMAXILLARY GLAND,,,445.4,445.4,1
HCPCS,42450,EXCISE SUBLINGUAL GLAND,,,387.78,12826.13,15
HCPCS,42450,EXCISION SUBLINGUAL GLAND,1896.0,1232.4,218.6,1422.0,35
HCPCS,42450,Excise sublingual gland,,,2132.36,2693.51,6
HCPCS,424500,EXCISE SUBLINGUAL GLAND,,,387.78,387.78,1
HCPCS,4245F,PT INSTR NRML ACTIVITIES,,,0.01,0.01,1
HCPCS,4245F0,PT INSTR NRML ACTIVITIES,,,0.01,0.01,1
HCPCS,4248F,PT INSTR NO BD REST 4 DAYS/>,,,0.01,0.01,1
HCPCS,4248F0,PT INSTR NO BD REST 4 DAYS/>,,,0.01,0.01,1
HCPCS,42500,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM,17891.5,11629.475,237.52,30613.5,74
HCPCS,42500,REPAIR SALIVARY DUCT,,,366.92,366.92,1
HCPCS,425000,REPAIR SALIVARY DUCT,,,366.92,366.92,1
HCPCS,42505,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP,2528.0,1643.2,341.88,1896.0,35
HCPCS,42505,REPAIR SALIVARY DUCT,,,489.03,12826.13,15
HCPCS,42505,Repair salivary duct,,,1928.02,2435.39,6
HCPCS,425050,REPAIR SALIVARY DUCT,,,489.03,489.03,1
HCPCS,42507,PAROTID DUCT DIVERSION,,,524.93,12826.13,15
HCPCS,42507,Parotid duct diversion,,,2132.36,2693.51,6
HCPCS,425070,PAROTID DUCT DIVERSION,,,524.93,524.93,1
HCPCS,42509,PAROTID DUCT DIVERSION,,,869.82,12826.13,15
HCPCS,42509,Parotid duct diversion,,,2719.4,3435.04,6
HCPCS,425090,PAROTID DUCT DIVERSION,,,869.82,869.82,1
HCPCS,4250F,WRMNG 4 SURG NORMOTHERMIA,,,0.01,0.01,1
HCPCS,4250F0,WRMNG 4 SURG NORMOTHERMIA,,,0.01,0.01,1
HCPCS,42510,PAROTID DUCT DIVERSION,,,646.38,7031.51,15
HCPCS,42510,Parotid duct diversion,,,2132.36,2693.51,6
HCPCS,425100,PAROTID DUCT DIVERSION,,,646.38,646.38,1
HCPCS,42550,INJECTION FOR SALIVARY X-RAY,,,64.7,64.7,1
HCPCS,42550,INJECTION PROCEDURE SIALOGRAPHY,373.5,242.775,41.5,36332.0,73
HCPCS,425500,INJECTION FOR SALIVARY X-RAY,,,64.7,64.7,1
HCPCS,4255F,ANESTH 60 MIN/> AS DOCD,,,0.01,0.01,1
HCPCS,4255F0,ANESTH 60 MIN/> AS DOCD,,,0.01,0.01,1
HCPCS,4256F,ANESTHE <60 MIN AS DOCD,,,0.01,0.01,1
HCPCS,4256F0,ANESTHE <60 MIN AS DOCD,,,0.01,0.01,1
HCPCS,42600,CLOSURE OF SALIVARY FISTULA,,,380.8,7031.51,15
HCPCS,42600,Closure of salivary fistula,,,2132.36,2693.51,6
HCPCS,426000,CLOSURE OF SALIVARY FISTULA,,,380.8,380.8,1
HCPCS,4260F,WOUND SRFC CULTURETECH USED,,,0.01,0.01,1
HCPCS,4260F0,WOUND SRFC CULTURETECH USED,,,0.01,0.01,1
HCPCS,4261F,TECH OTHER THAN SURFC CULTR,,,0.01,0.01,1
HCPCS,4261F0,TECH OTHER THAN SURFC CULTR,,,0.01,0.01,1
HCPCS,42650,DILATION OF SALIVARY DUCT,308.0,200.2,48.41,231.0,36
HCPCS,42650,DILATION SALIVARY DUCT,8518.0,5536.7,67.9,7666.2,46
HCPCS,426500,DILATION OF SALIVARY DUCT,,,62.47,62.47,1
HCPCS,4265F,WET-DRY DRESSINGS RX RECMD,,,0.01,0.01,1
HCPCS,4265F0,WET-DRY DRESSINGS RX RECMD,,,0.01,0.01,1
HCPCS,42660,DILAT&CATHJ SALIVARY DUCT W/WO INJECTION,452.0,293.8,63.22,339.0,35
HCPCS,42660,DILATION OF SALIVARY DUCT,,,91.75,1104.14,15
HCPCS,42660,Dilation of salivary duct,,,1209.93,1528.33,6
HCPCS,426600,DILATION OF SALIVARY DUCT,,,91.75,91.75,1
HCPCS,42665,LIGATION OF SALIVARY DUCT,,,231.48,7031.51,15
HCPCS,42665,LIGATION SALIVARY DUCT INTRAORAL,1052.0,683.8,129.52,789.0,35
HCPCS,42665,Ligation of salivary duct,,,844.88,1067.22,6
HCPCS,426650,LIGATION OF SALIVARY DUCT,,,231.48,231.48,1
HCPCS,4266F,NO WET-DRY DRSSINGS RX RECMD,,,0.01,0.01,1
HCPCS,4266F0,NO WET-DRY DRSSINGS RX RECMD,,,0.01,0.01,1
HCPCS,4267F,COMPRSSION THXPY PRESCRIBED,,,0.01,0.01,1
HCPCS,4267F0,COMPRSSION THXPY PRESCRIBED,,,0.01,0.01,1
HCPCS,4268F,PT ED RE COMP THXPY RCVD,,,0.01,0.01,1
HCPCS,4268F0,PT ED RE COMP THXPY RCVD,,,0.01,0.01,1
HCPCS,42699,SIALOENDOSCOPY W SALIVARY DUCT STONE EXTRACTION (COMP 31255),2473.0,1607.45,217.79,2473.0,15
HCPCS,42699,UNLISTED PX SALIVRY GLND/DUX,,,233.1,503.49,14
HCPCS,42699,UNLISTED SALIVARY GLAND OR DUCTS ENDOSCOP,1137.0,739.05,217.79,1137.0,15
HCPCS,42699,Unlisted px salivry glnd/dux,,,844.88,1067.22,6
HCPCS,4269F,APPROPOS MTHD OFFLOADING RXD,,,0.01,0.01,1
HCPCS,4269F0,APPROPOS MTHD OFFLOADING RXD,,,0.01,0.01,1
HCPCS,42700,"I & D ABSCESS, PERITONSILLAR",668.0,434.2,103.53,501.0,35
HCPCS,42700,I&D ABSCESS PERITONSILLAR,1335.0,867.75,112.01,4214.0,145
HCPCS,427000,I&D ABSCESS PERITONSILLAR,,,144.2,144.2,1
HCPCS,4270F,PT RCVNG ANTI R-VIRAL THXPY,,,0.01,0.01,1
HCPCS,4270F0,PT RCVNG ANTI R-VIRAL THXPY,,,0.01,0.01,1
HCPCS,4271F,PT RCVNG ANTI R-VIRAL THXPY,,,0.01,0.01,1
HCPCS,4271F0,PT RCVNG ANTI R-VIRAL THXPY,,,0.01,0.01,1
HCPCS,42720,I&D ABSC PHRNGL NTRAORL APPR,,,412.17,7031.51,15
HCPCS,42720,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL,2524.0,1640.6,214.04,1893.0,35
HCPCS,42720,I&d absc phrngl ntraorl appr,,,839.72,1060.7,6
HCPCS,427200,I&D ABSC PHRNGL NTRAORL APPR,,,412.17,412.17,1
HCPCS,42725,I&D ABSC PHRNGL XTRNL APPR,,,853.37,12826.13,15
HCPCS,42725,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR,4964.0,3226.6,436.31,4964.0,35
HCPCS,42725,I&d absc phrngl xtrnl appr,,,839.72,1060.7,6
HCPCS,427250,I&D ABSC PHRNGL XTRNL APPR,,,853.37,853.37,1
HCPCS,4274F,FLU IMMUNO ADMIND RCVD,,,0.01,0.01,1
HCPCS,4274F0,FLU IMMUNO ADMIND RCVD,,,0.01,0.01,1
HCPCS,4276F,POTENT ANTIVIR THXPY RXD,,,0.01,0.01,1
HCPCS,4276F0,POTENT ANTIVIR THXPY RXD,,,0.01,0.01,1
HCPCS,4279F,PCP PROPHYLAXIS RXD,,,0.01,0.01,1
HCPCS,4279F0,PCP PROPHYLAXIS RXD,,,0.01,0.01,1
HCPCS,42800,BIOPSY OF THROAT,,,124.23,124.23,1
HCPCS,42800,BIOPSY OROPHARYNX,4547.0,2955.5499999999997,63.68,7666.2,179
HCPCS,428000,BIOPSY OF THROAT,,,124.23,124.23,1
HCPCS,42804,BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE,18648.0,12121.2,147.68,16783.2,46
HCPCS,42804,"BIOPSY NASOPHARYNX,SIMPLE",516.0,335.4,69.88,387.0,35
HCPCS,42804,BIOPSY OF UPPER NOSE/THROAT,,,130.0,130.0,1
HCPCS,428040,BIOPSY OF UPPER NOSE/THROAT,,,130.0,130.0,1
HCPCS,42806,BIOPSY OF UPPER NOSE/THROAT,,,150.03,150.03,1
HCPCS,42806,BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION,9650.0,6272.5,87.94,16783.2,77
HCPCS,428060,BIOPSY OF UPPER NOSE/THROAT,,,150.03,150.03,1
HCPCS,42808,EXCISE PHARYNX LESION,,,177.22,177.22,1
HCPCS,42808,EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD,9794.0,6366.1,127.93,16783.2,74
HCPCS,428080,EXCISE PHARYNX LESION,,,177.22,177.22,1
HCPCS,42809,REMOVAL FOREIGN BODY PHARYNX,2295.0,1491.75,112.01,3920.0,98
HCPCS,42809,REMOVE PHARYNX FOREIGN BODY,744.0,483.6,78.52,558.0,36
HCPCS,428090,REMOVE PHARYNX FOREIGN BODY,,,135.69,135.69,1
HCPCS,4280F,PCP PROPHYLAX RXD 3MON LOW %,,,0.01,0.01,1
HCPCS,4280F0,PCP PROPHYLAX RXD 3MON LOW %,,,0.01,0.01,1
HCPCS,42810,EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS,1352.0,878.8,164.16,1014.0,35
HCPCS,42810,EXCISION OF NECK CYST,,,300.51,7031.51,15
HCPCS,42810,Excision of neck cyst,,,839.72,1060.7,6
HCPCS,428100,EXCISION OF NECK CYST,,,300.51,300.51,1
HCPCS,42815,EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX,2924.0,1900.6,408.65,2924.0,35
HCPCS,42815,EXCISION OF NECK CYST,,,573.0,12826.13,15
HCPCS,42815,Excision of neck cyst,,,2132.36,2693.51,6
HCPCS,428150,EXCISION OF NECK CYST,,,573.0,573.0,1
HCPCS,42820,REMOVE TONSILS AND ADENOIDS,,,312.14,12826.13,15
HCPCS,42820,Remove tonsils and adenoids,,,1292.16,1632.2,6
HCPCS,42820,TONSILLECTOMY & ADENOIDECTOMY <AGE 12,1688.0,1097.2,185.09,1688.0,35
HCPCS,428200,REMOVE TONSILS AND ADENOIDS,,,312.14,312.14,1
HCPCS,42821,REMOVE TONSILS AND ADENOIDS,,,325.72,7031.51,15
HCPCS,42821,Remove tonsils and adenoids,,,1292.16,1632.2,6
HCPCS,42821,TONSILLECTOMY & ADENOIDECTOMY AGE 12/>,1744.0,1133.6,224.65,1744.0,35
HCPCS,428210,REMOVE TONSILS AND ADENOIDS,,,325.72,325.72,1
HCPCS,42825,REMOVAL OF TONSILS,,,286.62,12826.13,15
HCPCS,42825,Removal of tonsils,,,1292.16,1632.2,6
HCPCS,42825,TONSILLECTOMY PRIMARY/SECONDARY <AGE 12,1404.0,912.6,170.32,1404.0,35
HCPCS,428250,REMOVAL OF TONSILS,,,286.62,286.62,1
HCPCS,42826,REMOVAL OF TONSILS,,,273.39,7031.51,16
HCPCS,42826,Removal of tonsils,,,1292.16,1632.2,6
HCPCS,42826,TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>,1380.0,897.0,193.48,1380.0,35
HCPCS,428260,REMOVAL OF TONSILS,,,273.39,273.39,1
HCPCS,42830,ADENOIDECTOMY PRIMARY <AGE 12,1060.0,689.0,125.84,1060.0,35
HCPCS,42830,REMOVAL OF ADENOIDS,,,227.2,7031.51,15
HCPCS,42830,Removal of adenoids,,,1292.16,1632.2,6
HCPCS,428300,REMOVAL OF ADENOIDS,,,227.2,227.2,1
HCPCS,42831,ADENOIDECTOMY PRIMARY AGE 12/>,1124.0,730.6,139.77,1124.0,35
HCPCS,42831,REMOVAL OF ADENOIDS,,,246.47,7031.51,16
HCPCS,42831,Removal of adenoids,,,1292.16,1632.2,6
HCPCS,428310,REMOVAL OF ADENOIDS,,,246.47,246.47,1
HCPCS,42835,REMOVAL OF ADENOIDS,,,211.78,7031.51,15
HCPCS,42835,Removal of adenoids,,,1292.16,1632.2,6
HCPCS,428350,REMOVAL OF ADENOIDS,,,211.78,211.78,1
HCPCS,42836,ADENOIDECTOMY SECONDARY AGE 12/>,1304.0,847.6,166.27,1304.0,35
HCPCS,42836,REMOVAL OF ADENOIDS,,,262.29,7031.51,15
HCPCS,42836,Removal of adenoids,,,1292.16,1632.2,6
HCPCS,428360,REMOVAL OF ADENOIDS,,,262.29,262.29,1
HCPCS,42842,EXTENSIVE SURGERY OF THROAT,,,1061.92,12826.13,15
HCPCS,42842,Extensive surgery of throat,,,1292.16,1632.2,6
HCPCS,42842,RADICAL RESECTION TONSIL W/O CLOSURE,4892.0,3179.8,495.77,4892.0,35
HCPCS,428420,EXTENSIVE SURGERY OF THROAT,,,1061.92,1061.92,1
HCPCS,42844,EXTENSIVE SURGERY OF THROAT,,,1448.14,12826.13,15
HCPCS,42844,Extensive surgery of throat,,,1292.16,1632.2,6
HCPCS,42844,RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP,7112.0,4622.8,716.65,7112.0,35
HCPCS,428440,EXTENSIVE SURGERY OF THROAT,,,1448.14,1448.14,1
HCPCS,42845,EXTENSIVE SURGERY OF THROAT,,,2326.54,2326.54,1
HCPCS,42845,Extensive surgery of throat,,,1292.16,1632.2,6
HCPCS,42845,RADICAL RESCJ TONSIL CLOSURE W/OTHER FLAP,13024.0,8465.6,1173.88,13024.0,35
HCPCS,428450,EXTENSIVE SURGERY OF THROAT,,,2326.54,2326.54,1
HCPCS,42860,EXCISION OF TONSIL TAGS,920.0,598.0,117.33,7031.51,50
HCPCS,42860,Excision of tonsil tags,,,1292.16,1632.2,6
HCPCS,428600,EXCISION OF TONSIL TAGS,,,207.12,207.12,1
HCPCS,42870,EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX,2208.0,1435.2,299.08,2208.0,35
HCPCS,42870,EXCISION OF LINGUAL TONSIL,,,613.88,12826.13,15
HCPCS,42870,Excision of lingual tonsil,,,1292.16,1632.2,6
HCPCS,428700,EXCISION OF LINGUAL TONSIL,,,613.88,613.88,1
HCPCS,42890,LIMITED PHARYNGECTOMY,7652.0,4973.8,707.83,12826.13,50
HCPCS,42890,Limited pharyngectomy,,,2132.36,2693.51,6
HCPCS,428900,LIMITED PHARYNGECTOMY,,,1492.84,1492.84,1
HCPCS,42892,RESCJ LAT PHRNGL WALL/PYRIFORM SINUS DIR CLSR,10412.0,6767.8,919.7,10412.0,35
HCPCS,42892,REVISION OF PHARYNGEAL WALLS,,,1964.0,12826.13,15
HCPCS,42892,Revision of pharyngeal walls,,,2132.36,2693.51,6
HCPCS,428920,REVISION OF PHARYNGEAL WALLS,,,1964.0,1964.0,1
HCPCS,42894,RESCJ PHRNGL WALL CLSR W/FLP OR FLP W/MVASC ANAS,13568.0,8819.2,1189.48,13568.0,35
HCPCS,42894,REVISION OF PHARYNGEAL WALLS,,,2493.64,2493.64,1
HCPCS,42894,Revision of pharyngeal walls,,,2719.4,3435.04,6
HCPCS,428940,REVISION OF PHARYNGEAL WALLS,,,2493.64,2493.64,1
HCPCS,42900,REPAIR THROAT WOUND,,,354.77,3211.66,15
HCPCS,42900,Repair throat wound,,,839.72,1060.7,6
HCPCS,42900,SUTURE PHARYNX WOUND/INJURY,2116.0,1375.4,245.26,2116.0,35
HCPCS,429000,REPAIR THROAT WOUND,,,354.77,354.77,1
HCPCS,4290F,PT SCRNED FOR INJ DRUG USE,,,0.01,0.01,1
HCPCS,4290F0,PT SCRNED FOR INJ DRUG USE,,,0.01,0.01,1
HCPCS,4293F,PT SCRND HGH-RISK SEX BEHAV,,,0.01,0.01,1
HCPCS,4293F0,PT SCRND HGH-RISK SEX BEHAV,,,0.01,0.01,1
HCPCS,42950,PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX,3308.0,2150.2,454.94,3308.0,35
HCPCS,42950,RECONSTRUCTION OF THROAT,,,832.85,12826.13,15
HCPCS,42950,Reconstruction of throat,,,2132.36,2693.51,6
HCPCS,429500,RECONSTRUCTION OF THROAT,,,832.85,832.85,1
HCPCS,42953,PHARYNGOESOPHAGEAL REPAIR,3780.0,2457.0,553.5,3780.0,35
HCPCS,42953,REPAIR THROAT ESOPHAGUS,,,996.74,996.74,1
HCPCS,42953,Repair throat esophagus,,,839.72,1060.7,6
HCPCS,429530,REPAIR THROAT ESOPHAGUS,,,996.74,996.74,1
HCPCS,42955,SURGICAL OPENING OF THROAT,,,793.75,3211.66,15
HCPCS,42955,Surgical opening of throat,,,839.72,1060.7,6
HCPCS,429550,SURGICAL OPENING OF THROAT,,,793.75,793.75,1
HCPCS,42960,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,1940.5,1261.3249999999998,99.04,3920.0,131
HCPCS,42960,CONTROL THROAT BLEEDING,,,172.07,172.07,1
HCPCS,429600,CONTROL THROAT BLEEDING,,,172.07,172.07,1
HCPCS,42961,CONTROL THROAT BLEEDING,,,447.55,447.55,1
HCPCS,42961,CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ,2308.0,1500.2,226.77,2308.0,35
HCPCS,42961,Control throat bleeding,,,839.72,1060.7,6
HCPCS,429610,CONTROL THROAT BLEEDING,,,447.55,447.55,1
HCPCS,42962,CONTROL THROAT BLEEDING,,,552.16,7031.51,15
HCPCS,42962,CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,3256.0,2116.4,354.67,3256.0,35
HCPCS,42962,Control throat bleeding,,,839.72,1060.7,6
HCPCS,429620,CONTROL THROAT BLEEDING,,,552.16,552.16,1
HCPCS,42970,CONTROL NOSE/THROAT BLEEDING,,,439.37,439.37,1
HCPCS,42970,CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS,1335.0,867.75,112.01,3920.0,98
HCPCS,429700,CONTROL NOSE/THROAT BLEEDING,,,439.37,439.37,1
HCPCS,42971,CONTROL NOSE/THROAT BLEEDING,,,484.54,484.54,1
HCPCS,42971,Control nose/throat bleeding,,,1634.08,2064.1,6
HCPCS,429710,CONTROL NOSE/THROAT BLEEDING,,,484.54,484.54,1
HCPCS,42972,CONTROL NOSE/THROAT BLEEDING,,,542.22,7031.51,15
HCPCS,42972,CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,3036.0,1973.4,327.07,3036.0,35
HCPCS,42972,Control nose/throat bleeding,,,839.72,1060.7,6
HCPCS,429720,CONTROL NOSE/THROAT BLEEDING,,,542.22,542.22,1
HCPCS,42975,DISE DYN EVAL SLEEP DISORDERED BREATHING FLX DX,695.0,451.75,82.78,695.0,28
HCPCS,42975,DISE EVAL SLP DO BRTH FLX DX,,,103.4,3738.94,21
HCPCS,42975,Dise eval slp do brth flx dx,,,112.01,141.49,6
HCPCS,429750,DISE EVAL SLP DO BRTH FLX DX,,,103.4,103.4,1
HCPCS,42999,NASOPHARYNGOSOCOPY W/BX NASOPHARYNX (COMP CODE 31237),1040.0,676.0,239.34,1040.0,15
HCPCS,42999,PERITONSILAR ASPIRATION W/NEEDLE,583.0,378.95,163.82,7730.0,45
HCPCS,4300F,PT RCVNG WARF THXPY,,,0.01,0.01,1
HCPCS,4300F0,PT RCVNG WARF THXPY,,,0.01,0.01,1
HCPCS,4301F,PT NOT RCVNG WARF THXPY,,,0.01,0.01,1
HCPCS,4301F0,PT NOT RCVNG WARF THXPY,,,0.01,0.01,1
HCPCS,43020,INCISION OF ESOPHAGUS,,,607.92,3211.66,15
HCPCS,43020,Incision of esophagus,,,839.72,1060.7,6
HCPCS,430200,INCISION OF ESOPHAGUS,,,607.92,607.92,1
HCPCS,43030,CRICOPHARYNGEAL MYOTOMY,,,561.1,12826.13,15
HCPCS,43030,CRICOPHAYNGEAL MYOTOMY,3196.0,2077.4,406.22,3196.0,35
HCPCS,43030,Cricopharyngeal myotomy,,,2132.36,2693.51,6
HCPCS,430300,CRICOPHARYNGEAL MYOTOMY,,,561.1,561.1,1
HCPCS,43045,ESOPHAGOTOMY THORACIC APPR W/RMVL FB,8752.0,5688.8,852.64,8752.0,35
HCPCS,43045,ESOPHAGOTOMY THRC RMVL FB,,,1391.76,1391.76,1
HCPCS,43045,Esophagotomy thrc rmvl fb,,,3296.96,4164.58,6
HCPCS,430450,ESOPHAGOTOMY THRC RMVL FB,,,1391.76,1391.76,1
HCPCS,4305F,PT ED RE FT CARE INSPCT RCVD,,,0.01,0.01,1
HCPCS,4305F0,PT ED RE FT CARE INSPCT RCVD,,,0.01,0.01,1
HCPCS,4306F,PT TLK PSYCH & RX OPD ADDIC,,,0.01,0.01,1
HCPCS,4306F0,PT TLK PSYCH & RX OPD ADDIC,,,0.01,0.01,1
HCPCS,43100,EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR,3864.0,2511.6,437.17,3864.0,35
HCPCS,43100,EXCISION OF ESOPHAGUS LESION,,,680.94,680.94,1
HCPCS,43100,Excision of esophagus lesion,,,2220.45,2804.78,6
HCPCS,431000,EXCISION OF ESOPHAGUS LESION,,,680.94,680.94,1
HCPCS,43101,EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR,6828.0,4438.2,709.36,6828.0,35
HCPCS,43101,EXCISION OF ESOPHAGUS LESION,,,1074.01,1074.01,1
HCPCS,43101,Excision of esophagus lesion,,,2220.45,2804.78,6
HCPCS,431010,EXCISION OF ESOPHAGUS LESION,,,1074.01,1074.01,1
HCPCS,43107,REMOVAL OF ESOPHAGUS,,,3172.85,3172.85,1
HCPCS,43107,Removal of esophagus,,,2324.53,2936.24,6
HCPCS,43107,TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY,20820.0,13533.0,1439.96,20820.0,35
HCPCS,431070,REMOVAL OF ESOPHAGUS,,,3172.85,3172.85,1
HCPCS,43108,REMOVAL OF ESOPHAGUS,,,4729.99,4729.99,1
HCPCS,43108,Removal of esophagus,,,2324.53,2936.24,6
HCPCS,43108,TOT ESOPHG W/O THORCOM COLON NTRPSTJ/INT RCNSTJ,33148.0,21546.2,2035.28,33148.0,35
HCPCS,431080,REMOVAL OF ESOPHAGUS,,,4729.99,4729.99,1
HCPCS,43112,ESPHG TOT W/THRCM,,,3682.07,3682.07,1
HCPCS,43112,Esphg tot w/thrcm,,,2324.53,2936.24,6
HCPCS,43112,TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY,24800.0,16120.0,1678.16,24800.0,35
HCPCS,431120,ESPHG TOT W/THRCM,,,3682.07,3682.07,1
HCPCS,43113,REMOVAL OF ESOPHAGUS,,,4624.48,4624.48,1
HCPCS,43113,Removal of esophagus,,,2324.53,2936.24,6
HCPCS,431130,REMOVAL OF ESOPHAGUS,,,4624.48,4624.48,1
HCPCS,43116,PARTIAL REMOVAL OF ESOPHAGUS,,,5288.65,5288.65,1
HCPCS,43116,PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF,37196.0,24177.4,2398.96,37196.0,35
HCPCS,43116,Partial removal of esophagus,,,2324.53,2936.24,6
HCPCS,431160,PARTIAL REMOVAL OF ESOPHAGUS,,,5288.65,5288.65,1
HCPCS,43117,PARTIAL REMOVAL OF ESOPHAGUS,,,3469.31,3469.31,1
HCPCS,43117,PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY,23000.0,14950.0,1574.1,23000.0,35
HCPCS,43117,Partial removal of esophagus,,,2324.53,2936.24,6
HCPCS,431170,PARTIAL REMOVAL OF ESOPHAGUS,,,3469.31,3469.31,1
HCPCS,43118,PARTIAL REMOVAL OF ESOPHAGUS,,,3858.24,3858.24,1
HCPCS,43118,Partial removal of esophagus,,,2324.53,2936.24,6
HCPCS,431180,PARTIAL REMOVAL OF ESOPHAGUS,,,3858.24,3858.24,1
HCPCS,43121,PARTIAL REMOVAL OF ESOPHAGUS,,,3043.97,3043.97,1
HCPCS,43121,PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY,20572.0,13371.8,1444.04,20572.0,35
HCPCS,43121,Partial removal of esophagus,,,2324.53,2936.24,6
HCPCS,431210,PARTIAL REMOVAL OF ESOPHAGUS,,,3043.97,3043.97,1
HCPCS,43122,PARTIAL REMOVAL OF ESOPHAGUS,,,2746.16,2746.16,1
HCPCS,43122,PRTL ESOPHG THORACOABD W/WO PROXGASTREC/PYLOROPL,17672.0,11486.8,1374.79,17672.0,35
HCPCS,43122,Partial removal of esophagus,,,2324.53,2936.24,6
HCPCS,431220,PARTIAL REMOVAL OF ESOPHAGUS,,,2746.16,2746.16,1
HCPCS,43123,PARTIAL REMOVAL OF ESOPHAGUS,,,4793.21,4793.21,1
HCPCS,43123,PRTL ESPHG THORACOABDL/ABDL APPR NTRPSTJ/RCNSTJ,33248.0,21611.2,2173.59,33248.0,35
HCPCS,43123,Partial removal of esophagus,,,2324.53,2936.24,6
HCPCS,431230,PARTIAL REMOVAL OF ESOPHAGUS,,,4793.21,4793.21,1
HCPCS,43124,REMOVAL OF ESOPHAGUS,,,4053.13,4053.13,1
HCPCS,43124,Removal of esophagus,,,2324.53,2936.24,6
HCPCS,43124,TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY,27636.0,17963.4,1838.1,27636.0,35
HCPCS,431240,REMOVAL OF ESOPHAGUS,,,4053.13,4053.13,1
HCPCS,43130,DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR,5513.0,3583.45,581.91,5513.0,35
HCPCS,43130,REMOVAL OF ESOPHAGUS POUCH,,,849.79,12826.13,15
HCPCS,43130,Removal of esophagus pouch,,,2324.53,2936.24,6
HCPCS,431300,REMOVAL OF ESOPHAGUS POUCH,,,849.79,849.79,1
HCPCS,43135,DIVERTICULECTOMY HYPOPHARYNX/ESOPH THRC APPR,10468.0,6804.2,764.85,10468.0,35
HCPCS,43135,REMOVAL OF ESOPHAGUS POUCH,,,1567.51,1567.51,1
HCPCS,43135,Removal of esophagus pouch,,,2324.53,2936.24,6
HCPCS,431350,REMOVAL OF ESOPHAGUS POUCH,,,1567.51,1567.51,1
HCPCS,43180,ESOPHAGOSCOPY RIGID TRNSO,,,584.95,584.95,1
HCPCS,43180,ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH,18813.5,12228.775,403.81,30613.5,73
HCPCS,431800,ESOPHAGOSCOPY RIGID TRNSO,,,584.95,584.95,1
HCPCS,43191,ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH,996.0,647.4,96.43,996.0,31
HCPCS,43191,ESOPHAGOSCOPY RIGID TRNSO DX,,,165.5,4112.99,15
HCPCS,43191,Esophagoscopy rigid trnso dx,,,1333.44,1684.34,6
HCPCS,431910,ESOPHAGOSCOPY RIGID TRNSO DX,,,165.5,165.5,1
HCPCS,43192,ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL,1116.0,725.4,115.17,1116.0,31
HCPCS,43192,ESOPHAGOSCP RIG TRNSO INJECT,,,180.98,4112.99,16
HCPCS,43192,Esophagoscp rig trnso inject,,,1333.44,1684.34,6
HCPCS,431920,ESOPHAGOSCP RIG TRNSO INJECT,,,180.98,180.98,1
HCPCS,43193,ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY,1116.0,725.4,130.73,1116.0,31
HCPCS,43193,ESOPHAGOSCP RIG TRNSO BIOPSY,,,180.31,4112.99,15
HCPCS,43193,Esophagoscp rig trnso biopsy,,,1333.44,1684.34,6
HCPCS,431930,ESOPHAGOSCP RIG TRNSO BIOPSY,,,180.31,180.31,1
HCPCS,43194,ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY,1404.0,912.6,125.41,1404.0,31
HCPCS,43194,ESOPHAGOSCP RIG TRNSO REM FB,,,203.71,4112.99,15
HCPCS,43194,Esophagoscp rig trnso rem fb,,,1333.44,1684.34,6
HCPCS,431940,ESOPHAGOSCP RIG TRNSO REM FB,,,203.71,203.71,1
HCPCS,43195,ESOPHAGOSCOPY RIGID BALLOON,,,197.1,8248.85,17
HCPCS,43195,ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION,1228.0,798.2,137.67,1228.0,31
HCPCS,43195,Esophagoscopy rigid balloon,,,2495.61,3152.35,6
HCPCS,431950,ESOPHAGOSCOPY RIGID BALLOON,,,197.1,197.1,1
HCPCS,43196,ESOPHAGOSCOPY RIG TRANSORAL GUIDE WIRE DILATION,1324.0,860.6,144.14,1324.0,31
HCPCS,43196,ESOPHAGOSCP GUIDE WIRE DILAT,,,208.57,4112.99,16
HCPCS,43196,Esophagoscp guide wire dilat,,,1333.44,1684.34,6
HCPCS,431960,ESOPHAGOSCP GUIDE WIRE DILAT,,,208.57,208.57,1
HCPCS,43197,ESOPHAGOSCOPY FLEX DX BRUSH,,,87.54,87.54,1
HCPCS,43197,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC,2999.5,1949.675,61.73,6317.0,80
HCPCS,431970,ESOPHAGOSCOPY FLEX DX BRUSH,,,87.54,87.54,1
HCPCS,43198,ESOPHAGOSC FLEX TRNSN BIOPSY,,,104.27,2032.78,15
HCPCS,43198,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL WITH BIOPSY,728.0,473.2,73.54,546.0,31
HCPCS,43198,Esophagosc flex trnsn biopsy,,,616.53,778.78,6
HCPCS,431980,ESOPHAGOSC FLEX TRNSN BIOPSY,,,104.27,104.27,1
HCPCS,43200,ESOPHAGOSCOPY FLEXIBLE BRUSH,,,93.14,93.14,1
HCPCS,43200,ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC,3008.0,1955.2,83.13,6317.0,133
HCPCS,432000,ESOPHAGOSCOPY FLEXIBLE BRUSH,,,93.14,93.14,1
HCPCS,43201,ESOPH SCOPE W/SUBMUCOUS INJ,,,109.58,109.58,1
HCPCS,43201,ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ,5798.0,3768.7,98.99,9817.2,84
HCPCS,432010,ESOPH SCOPE W/SUBMUCOUS INJ,,,109.58,109.58,1
HCPCS,43202,ESOPHAGOSCOPY FLEX BIOPSY,,,108.86,108.86,1
HCPCS,43202,ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,5798.0,3768.7,92.57,9817.2,84
HCPCS,432020,ESOPHAGOSCOPY FLEX BIOPSY,,,108.86,108.86,1
HCPCS,43204,ESOPH SCOPE W/SCLEROSIS INJ,,,142.11,142.11,1
HCPCS,43204,ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,5920.0,3848.0,102.64,9817.2,84
HCPCS,432040,ESOPH SCOPE W/SCLEROSIS INJ,,,142.11,142.11,1
HCPCS,43205,ESOPHAGUS ENDOSCOPY/LIGATION,,,148.56,148.56,1
HCPCS,43205,ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES,10908.0,7090.2,169.15,9817.2,49
HCPCS,432050,ESOPHAGUS ENDOSCOPY/LIGATION,,,148.56,148.56,1
HCPCS,43206,ESOPH OPTICAL ENDOMICROSCOPY,,,139.59,4112.99,15
HCPCS,43206,Esoph optical endomicroscopy,,,1333.44,1684.34,6
HCPCS,432060,ESOPH OPTICAL ENDOMICROSCOPY,,,139.59,139.59,1
HCPCS,4320F,PT TALK PSYCHSOC&RX OH DPND,,,0.01,0.01,1
HCPCS,4320F0,PT TALK PSYCHSOC&RX OH DPND,,,0.01,0.01,1
HCPCS,43210,EGD ESOPHAGOGASTRC FNDOPLSTY,,,456.07,456.07,1
HCPCS,43210,EGD PARTIAL/COMPL ESOPHAGOGASTRIC FUNDOPLASTY,31482.5,20463.625,326.05,53878.5,73
HCPCS,432100,EGD ESOPHAGOGASTRC FNDOPLSTY,,,456.07,456.07,1
HCPCS,43211,ESOPHAGOSCOP MUCOSAL RESECT,,,247.07,247.07,1
HCPCS,43211,ESOPHAGOSCOPY FLEXIBLE TRANSORAL MUCOSAL RESEXN,6294.0,4091.1,169.85,9817.2,80
HCPCS,432110,ESOPHAGOSCOP MUCOSAL RESECT,,,247.07,247.07,1
HCPCS,43212,ESOPHAGOSCOP STENT PLACEMENT,,,199.96,199.96,1
HCPCS,43212,ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT,17794.5,11566.425,142.33,30806.1,73
HCPCS,432120,ESOPHAGOSCOP STENT PLACEMENT,,,199.96,199.96,1
HCPCS,43213,ESOPHAGOSCOPY RETRO BALLOON,,,274.98,274.98,1
HCPCS,43213,ESOPHAGOSCOPY RETROGRADE DILATE BALLOON/OTHER,6380.0,4147.0,200.0,9817.2,80
HCPCS,432130,ESOPHAGOSCOPY RETRO BALLOON,,,274.98,274.98,1
HCPCS,43214,ESOPHAGOSC DILATE BALLOON 30,,,205.5,205.5,1
HCPCS,43214,ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM,6134.0,3987.1,144.61,9817.2,80
HCPCS,432140,ESOPHAGOSC DILATE BALLOON 30,,,205.5,205.5,1
HCPCS,43215,ESOPHAGOSCOPY FLEX REMOVE FB,,,149.63,149.63,1
HCPCS,43215,ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,5942.0,3862.2999999999997,125.41,9817.2,84
HCPCS,432150,ESOPHAGOSCOPY FLEX REMOVE FB,,,149.63,149.63,1
HCPCS,43216,ESOPHAGOSCOPY LESION REMOVAL,,,140.67,140.67,1
HCPCS,43216,ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS,5914.0,3844.1,121.67,9817.2,77
HCPCS,432160,ESOPHAGOSCOPY LESION REMOVAL,,,140.67,140.67,1
HCPCS,43217,ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE,6014.0,3909.1,144.99,9817.2,84
HCPCS,43217,ESOPHAGOSCOPY SNARE LES REMV,,,168.62,168.62,1
HCPCS,432170,ESOPHAGOSCOPY SNARE LES REMV,,,168.62,168.62,1
HCPCS,43220,ESOPHAGOSCOPY BALLOON <30MM,,,124.65,124.65,1
HCPCS,43220,ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM,5854.0,3805.1,102.94,9817.2,84
HCPCS,432200,ESOPHAGOSCOPY BALLOON <30MM,,,124.65,124.65,1
HCPCS,43226,ESOPH ENDOSCOPY DILATION,,,138.2,138.2,1
HCPCS,43226,ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,5902.0,3836.2999999999997,114.83,9817.2,84
HCPCS,432260,ESOPH ENDOSCOPY DILATION,,,138.2,138.2,1
HCPCS,43227,ESOPHAGOSCOPY CONTROL BLEED,,,174.11,4112.99,15
HCPCS,43227,ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL,1156.0,751.4,153.78,867.0,35
HCPCS,43227,Esophagoscopy control bleed,,,616.53,778.78,6
HCPCS,432270,ESOPHAGOSCOPY CONTROL BLEED,,,174.11,174.11,1
HCPCS,43229,ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION,11636.0,7563.4,152.86,19688.4,73
HCPCS,43229,ESOPHAGOSCOPY LESION ABLATE,,,207.45,207.45,1
HCPCS,432290,ESOPHAGOSCOPY LESION ABLATE,,,207.45,207.45,1
HCPCS,4322F,CRGVR PROV W/ ED ADDL RSRCS,,,0.01,0.01,1
HCPCS,4322F0,CRGVR PROV W/ ED ADDL RSRCS,,,0.01,0.01,1
HCPCS,43231,ESOPHAGOSCOP ULTRASOUND EXAM,,,165.53,165.53,1
HCPCS,43231,ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM,6014.0,3909.1,117.7,9817.2,84
HCPCS,432310,ESOPHAGOSCOP ULTRASOUND EXAM,,,165.53,165.53,1
HCPCS,43232,ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX,6172.0,4011.7999999999997,149.62,9817.2,84
HCPCS,43232,ESOPHAGOSCOPY W/US NEEDLE BX,,,209.64,209.64,1
HCPCS,432320,ESOPHAGOSCOPY W/US NEEDLE BX,,,209.64,209.64,1
HCPCS,43233,EGD BALLOON DIL ESOPH30 MM/>,,,242.25,242.25,1
HCPCS,43233,EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER,6268.0,4074.2,171.67,9817.2,80
HCPCS,432330,EGD BALLOON DIL ESOPH30 MM/>,,,242.25,242.25,1
HCPCS,43235,EGD DIAGNOSTIC BRUSH WASH,,,129.24,129.24,1
HCPCS,43235,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,3113.5,2023.775,118.03,6317.0,182
HCPCS,432350,EGD DIAGNOSTIC BRUSH WASH,,,129.24,129.24,1
HCPCS,43236,ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION,3221.5,2093.975,132.0,6317.0,84
HCPCS,43236,UPPR GI SCOPE W/SUBMUC INJ,,,146.1,146.1,1
HCPCS,432360,UPPR GI SCOPE W/SUBMUC INJ,,,146.1,146.1,1
HCPCS,43237,ENDOSCOPIC US EXAM ESOPH,,,205.87,205.87,1
HCPCS,43237,ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS,6217.5,4041.375,142.94,9817.2,84
HCPCS,432370,ENDOSCOPIC US EXAM ESOPH,,,205.87,205.87,1
HCPCS,43238,EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS,6369.0,4139.85,175.66,9817.2,84
HCPCS,43238,EGD US FINE NEEDLE BX/ASPIR,,,244.22,244.22,1
HCPCS,432380,EGD US FINE NEEDLE BX/ASPIR,,,244.22,244.22,1
HCPCS,43239,EGD BIOPSY SINGLE/MULTIPLE,,,146.1,146.1,1
HCPCS,43239,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,3221.5,2093.975,132.0,6317.0,231
HCPCS,432390,EGD BIOPSY SINGLE/MULTIPLE,,,146.1,146.1,1
HCPCS,43240,EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST,18687.5,12146.875,290.04,30806.1,84
HCPCS,43240,EGD W/TRANSMURAL DRAIN CYST,,,412.65,412.65,1
HCPCS,432400,EGD W/TRANSMURAL DRAIN CYST,,,412.65,412.65,1
HCPCS,43241,EGD INTRALUMINAL TUBE/CATHETER INSERTION,6002.0,3901.2999999999997,108.0,9817.2,84
HCPCS,43241,EGD TUBE/CATH INSERTION,,,150.24,150.24,1
HCPCS,432410,EGD TUBE/CATH INSERTION,,,150.24,150.24,1
HCPCS,43242,EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY,6494.5,4221.425,197.88,9817.2,84
HCPCS,43242,EGD US FINE NEEDLE BX/ASPIR,,,276.46,276.46,1
HCPCS,432420,EGD US FINE NEEDLE BX/ASPIR,,,276.46,276.46,1
HCPCS,43243,EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,6393.5,4155.775,179.75,9817.2,84
HCPCS,43243,EGD INJECTION VARICES,,,250.66,250.66,1
HCPCS,432430,EGD INJECTION VARICES,,,250.66,250.66,1
HCPCS,43244,EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,6422.0,4174.3,184.6,9817.2,84
HCPCS,43244,EGD VARICES LIGATION,,,257.83,257.83,1
HCPCS,432440,EGD VARICES LIGATION,,,257.83,257.83,1
HCPCS,43245,EGD DILATE STRICTURE,,,185.39,185.39,1
HCPCS,43245,EGD DILATION GASTRIC/DUODENAL STRICTURE,6131.5,3985.475,131.93,9817.2,84
HCPCS,432450,EGD DILATE STRICTURE,,,185.39,185.39,1
HCPCS,43246,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,6237.0,4054.0499999999997,151.66,9817.2,84
HCPCS,43246,EGD PLACE GASTROSTOMY TUBE,,,211.84,211.84,1
HCPCS,432460,EGD PLACE GASTROSTOMY TUBE,,,211.84,211.84,1
HCPCS,43247,EGD FLEXIBLE FOREIGN BODY REMOVAL,3379.5,2196.675,163.66,6317.0,182
HCPCS,43247,EGD REMOVE FOREIGN BODY,,,186.32,186.32,1
HCPCS,432470,EGD REMOVE FOREIGN BODY,,,186.32,186.32,1
HCPCS,43248,EGD GUIDE WIRE INSERTION,,,175.13,175.13,1
HCPCS,43248,EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS,3335.5,2168.075,154.19,6317.0,84
HCPCS,432480,EGD GUIDE WIRE INSERTION,,,175.13,175.13,1
HCPCS,43249,EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM,6041.5,3926.975,138.33,9817.2,84
HCPCS,43249,ESOPH EGD DILATION <30 MM,,,161.9,161.9,1
HCPCS,432490,ESOPH EGD DILATION <30 MM,,,161.9,161.9,1
HCPCS,4324F,PT QUERIED PRKNS COMPLIC,,,0.01,0.01,1
HCPCS,4324F0,PT QUERIED PRKNS COMPLIC,,,0.01,0.01,1
HCPCS,43250,EGD CAUTERY TUMOR POLYP,,,179.65,179.65,1
HCPCS,43250,EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS,6107.5,3969.875,153.15,9817.2,84
HCPCS,432500,EGD CAUTERY TUMOR POLYP,,,179.65,179.65,1
HCPCS,43251,EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH,6217.5,4041.375,177.97,9817.2,84
HCPCS,43251,EGD REMOVE LESION SNARE,,,206.29,206.29,1
HCPCS,432510,EGD REMOVE LESION SNARE,,,206.29,206.29,1
HCPCS,43252,EGD FLEX TRANSORAL W/OPTICAL ENDOMICROSCOPY,1302.0,846.3,135.19,976.5,28
HCPCS,43252,EGD OPTICAL ENDOMICROSCOPY,,,177.29,4112.99,15
HCPCS,43252,Egd optical endomicroscopy,,,2495.61,3152.35,6
HCPCS,432520,EGD OPTICAL ENDOMICROSCOPY,,,177.29,177.29,1
HCPCS,43253,EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER,6494.5,4221.425,198.13,9817.2,80
HCPCS,43253,EGD US TRANSMURAL INJXN/MARK,,,276.12,276.12,1
HCPCS,432530,EGD US TRANSMURAL INJXN/MARK,,,276.12,276.12,1
HCPCS,43254,EGD ENDO MUCOSAL RESECTION,,,284.02,284.02,1
HCPCS,43254,EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION,6525.5,4241.575,203.75,9817.2,80
HCPCS,432540,EGD ENDO MUCOSAL RESECTION,,,284.02,284.02,1
HCPCS,43255,EGD CONTROL BLEEDING ANY,,,210.55,210.55,1
HCPCS,43255,EGD TRANSORAL CONTROL BLEEDING ANY METHOD,10908.0,7090.2,239.22,9817.2,49
HCPCS,43255,"EGD WITH CONTROL OF BLEED,",1566.0,1017.9,186.44,1174.5,35
HCPCS,432550,EGD CONTROL BLEEDING ANY,,,210.55,210.55,1
HCPCS,43257,EGD DELIVER THERMAL ENERGY SPHNCTR/CARDIA GERD,21876.0,14219.4,276.88,19688.4,42
HCPCS,43257,EGD W/THRML TXMNT GERD,,,247.1,247.1,1
HCPCS,432570,EGD W/THRML TXMNT GERD,,,247.1,247.1,1
HCPCS,43259,EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM,6262.0,4070.3,170.81,9817.2,84
HCPCS,43259,EGD US EXAM DUODENUM/JEJUNUM,,,237.39,237.39,1
HCPCS,432590,EGD US EXAM DUODENUM/JEJUNUM,,,237.39,237.39,1
HCPCS,4325F,MED TXMNT OPTIONS RVWD W/PT,,,0.01,0.01,1
HCPCS,4325F0,MED TXMNT OPTIONS RVWD W/PT,,,0.01,0.01,1
HCPCS,43260,ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING,12108.0,7870.2,242.81,36332.0,84
HCPCS,43260,ERCP W/SPECIMEN COLLECTION,,,339.58,339.58,1
HCPCS,432600,ERCP W/SPECIMEN COLLECTION,,,339.58,339.58,1
HCPCS,43261,ENDO CHOLANGIOPANCREATOGRAPH,,,356.44,356.44,1
HCPCS,43261,ERCP W/BIOPSY SINGLE/MULTIPLE,12168.0,7909.2,254.56,36332.0,84
HCPCS,432610,ENDO CHOLANGIOPANCREATOGRAPH,,,356.44,356.44,1
HCPCS,43262,ENDO CHOLANGIOPANCREATOGRAPH,,,375.38,375.38,1
HCPCS,43262,ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,12238.0,7954.7,268.6,36332.0,84
HCPCS,432620,ENDO CHOLANGIOPANCREATOGRAPH,,,375.38,375.38,1
HCPCS,43263,ERCP SPHINCTER PRESSURE MEAS,,,376.09,4112.99,15
HCPCS,43263,ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI,2600.0,1690.0,269.11,2600.0,35
HCPCS,43263,Ercp sphincter pressure meas,,,1642.89,2075.23,6
HCPCS,432630,ERCP SPHINCTER PRESSURE MEAS,,,376.09,376.09,1
HCPCS,43264,ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT,12396.5,8057.724999999999,274.22,36332.0,84
HCPCS,43264,ERCP REMOVE DUCT CALCULI,,,382.9,382.9,1
HCPCS,432640,ERCP REMOVE DUCT CALCULI,,,382.9,382.9,1
HCPCS,43265,ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD,18859.0,12258.349999999999,325.03,36332.0,84
HCPCS,43265,ERCP LITHOTRIPSY CALCULI,,,455.67,455.67,1
HCPCS,432650,ERCP LITHOTRIPSY CALCULI,,,455.67,455.67,1
HCPCS,43266,EGD ENDOSCOPIC STENT PLACE,,,229.59,229.59,1
HCPCS,43266,EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION,17898.5,11634.025,164.43,30806.1,73
HCPCS,432660,EGD ENDOSCOPIC STENT PLACE,,,229.59,229.59,1
HCPCS,4326F,PT ASKED RE SYMP AUTO DYSFXN,,,0.01,0.01,1
HCPCS,4326F0,PT ASKED RE SYMP AUTO DYSFXN,,,0.01,0.01,1
HCPCS,43270,EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE,6256.0,4066.3999999999996,179.77,9817.2,80
HCPCS,43270,EGD LESION ABLATION,,,236.0,236.0,1
HCPCS,432700,EGD LESION ABLATION,,,236.0,236.0,1
HCPCS,43273,ENDOSCOPIC PANCREATOSCOPY,,,125.4,125.4,1
HCPCS,43273,ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC,3471.0,2256.15,89.62,36332.0,73
HCPCS,432730,ENDOSCOPIC PANCREATOSCOPY,,,125.4,125.4,1
HCPCS,43274,ERCP DUCT STENT PLACEMENT,,,486.9,486.9,1
HCPCS,43274,ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT,18980.0,12337.0,347.75,30806.1,73
HCPCS,432740,ERCP DUCT STENT PLACEMENT,,,486.9,486.9,1
HCPCS,43275,ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT,6963.0,4525.95,283.15,9817.2,73
HCPCS,43275,ERCP REMOVE FORGN BODY DUCT,,,395.82,395.82,1
HCPCS,432750,ERCP REMOVE FORGN BODY DUCT,,,395.82,395.82,1
HCPCS,43276,ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE,19059.5,12388.675,361.79,30806.1,73
HCPCS,43276,ERCP STENT EXCHANGE W/DILATE,,,506.95,506.95,1
HCPCS,432760,ERCP STENT EXCHANGE W/DILATE,,,506.95,506.95,1
HCPCS,43277,ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA,12318.0,8006.7,284.69,36332.0,80
HCPCS,43277,ERCP EA DUCT/AMPULLA DILATE,,,397.95,397.95,1
HCPCS,432770,ERCP EA DUCT/AMPULLA DILATE,,,397.95,397.95,1
HCPCS,43278,ERCP LESION ABLATE W/DILATE,,,455.68,455.68,1
HCPCS,43278,ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE,12522.0,8139.299999999999,325.54,36332.0,80
HCPCS,432780,ERCP LESION ABLATE W/DILATE,,,455.68,455.68,1
HCPCS,43279,LAP MYOTOMY HELLER,,,1378.89,1378.89,1
HCPCS,43279,LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED,8840.0,5746.0,917.86,8840.0,35
HCPCS,43279,Lap myotomy heller,,,3143.0,3970.1,6
HCPCS,432790,LAP MYOTOMY HELLER,,,1378.89,1378.89,1
HCPCS,43280,LAPAROSCOPY FUNDOPLASTY,,,1159.11,22573.24,15
HCPCS,43280,LAPS SURG ESOPG/GSTR FUNDOPLASTY,7240.0,4706.0,795.62,7240.0,35
HCPCS,43280,Laparoscopy fundoplasty,,,3143.0,3970.1,6
HCPCS,432800,LAPAROSCOPY FUNDOPLASTY,,,1159.11,1159.11,1
HCPCS,43281,LAP PARAESOPHAG HERN REPAIR,,,1651.55,22573.24,18
HCPCS,43281,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH,10640.0,6916.0,877.14,10640.0,35
HCPCS,43281,Lap paraesophag hern repair,,,4108.4,5189.56,6
HCPCS,432810,LAP PARAESOPHAG HERN REPAIR,,,1651.55,1651.55,1
HCPCS,43282,LAP PARAESOPH HER RPR W/MESH,,,1860.74,22573.24,15
HCPCS,43282,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH,12040.0,7826.0,987.04,12040.0,35
HCPCS,43282,Lap paraesoph her rpr w/mesh,,,4108.4,5189.56,6
HCPCS,432820,LAP PARAESOPH HER RPR W/MESH,,,1860.74,1860.74,1
HCPCS,43283,LAP ESOPH LENGTHENING,,,168.94,168.94,1
HCPCS,43283,LAPS ESOPHAGEAL LENGTHENING ADDL,1298.0,843.7,101.25,1298.0,35
HCPCS,43283,Lap esoph lengthening,,,4108.4,5189.56,6
HCPCS,432830,LAP ESOPH LENGTHENING,,,168.94,168.94,1
HCPCS,43284,LAPS ESOPHGL SPHNCTR AGMNTJ,,,702.16,22573.24,15
HCPCS,43284,Laps esophgl sphnctr agmntj,,,3143.0,3970.1,6
HCPCS,432840,LAPS ESOPHGL SPHNCTR AGMNTJ,,,702.16,702.16,1
HCPCS,43285,REMOVAL ESOPHAGEAL SPHINCTER AGMNTJ DEVICE,4188.0,2722.2,504.88,4188.0,28
HCPCS,43285,RMVL ESOPHGL SPHNCTR DEV,,,722.06,12649.85,15
HCPCS,43285,Rmvl esophgl sphnctr dev,,,3143.0,3970.1,6
HCPCS,432850,RMVL ESOPHGL SPHNCTR DEV,,,722.06,722.06,1
HCPCS,43286,ESOPHAGECTOMY TOTAL NEAR TOTAL W/LAPS MOBLJ,22000.0,14300.0,2419.45,22000.0,31
HCPCS,43286,ESPHG TOT W/LAPS MOBLJ,,,3382.88,3382.88,1
HCPCS,43286,Esphg tot w/laps moblj,,,2324.53,2936.24,6
HCPCS,432860,ESPHG TOT W/LAPS MOBLJ,,,3382.88,3382.88,1
HCPCS,43287,ESOPHAGECTOMY DISTAL 2/3 W/LAPAROSCOPIC MOBLJ,25200.0,16380.0,2688.31,25200.0,31
HCPCS,43287,ESPHG DSTL 2/3 W/LAPS MOBLJ,,,3786.63,3786.63,1
HCPCS,43287,Esphg dstl 2/3 w/laps moblj,,,2324.53,2936.24,6
HCPCS,432870,ESPHG DSTL 2/3 W/LAPS MOBLJ,,,3786.63,3786.63,1
HCPCS,43288,ESOPHAGECTOMY TOTAL NEAR TOTAL W/THRSC MOBLJ,26568.0,17269.2,2838.19,26568.0,31
HCPCS,43288,ESPHG THRSC MOBLJ,,,3992.8,3992.8,1
HCPCS,43288,Esphg thrsc moblj,,,2324.53,2936.24,6
HCPCS,432880,ESPHG THRSC MOBLJ,,,3992.8,3992.8,1
HCPCS,43289,LIG/STAPLING G-ESOP JUNCT PRE-ESOPHGL PRF8J (COMP CODE 43405),9892.0,6429.8,1494.7,9892.0,15
HCPCS,43289,UNLISTED LAP ESOPHAGUS,15181.0,9867.65,2220.45,15789.0,41
HCPCS,43289,"UNLISTED LAP RESECTION, ESOPHAGEAL DUPLICATION CYST (COMP CODE 4",7340.0,4771.0,1494.7,7340.0,15
HCPCS,43289,UNLISTED LAPAROSCOPIC PROCEDURE ESOPHAGUS,17952.0,11668.8,1494.7,17952.0,15
HCPCS,4328F,PT ASKED RE SLEEP DISTURB,,,0.01,0.01,1
HCPCS,4328F0,PT ASKED RE SLEEP DISTURB,,,0.01,0.01,1
HCPCS,43290,EGD FLX TRNSORL DPLMNT BALO,,,192.96,4112.99,15
HCPCS,43290,EGD FLX TRNSORL W/DPLMNT NTRGSTR BARIATRIC BALO,1244.0,808.6,132.01,4711.11,28
HCPCS,43290,Egd flx trnsorl dplmnt balo,,,616.53,778.78,6
HCPCS,432900,EGD FLX TRNSORL DPLMNT BALO,,,192.96,192.96,1
HCPCS,43291,EGD FLX TRNSORL RMVL BALO,,,169.14,2032.78,15
HCPCS,43291,EGD FLX TRNSORL W/RMVL NTRGSTR BARIATRIC BALO,1120.0,728.0,115.48,840.0,28
HCPCS,43291,Egd flx trnsorl rmvl balo,,,616.53,778.78,6
HCPCS,432910,EGD FLX TRNSORL RMVL BALO,,,169.14,169.14,1
HCPCS,43300,ESPHGP CRV APPR W/O RPR TRACHEOESOPHGL FSTL,3732.0,2425.8,485.63,3732.0,35
HCPCS,43300,REPAIR OF ESOPHAGUS,,,669.58,669.58,1
HCPCS,43300,Repair of esophagus,,,2220.45,2804.78,6
HCPCS,433000,REPAIR OF ESOPHAGUS,,,669.58,669.58,1
HCPCS,43305,ESPHGP CRV APPR W/RPR TRACHEOESOPHGL FSTL,7240.0,4706.0,818.54,7240.0,35
HCPCS,43305,REPAIR ESOPHAGUS AND FISTULA,,,1171.27,1171.27,1
HCPCS,43305,Repair esophagus and fistula,,,2324.53,2936.24,6
HCPCS,433050,REPAIR ESOPHAGUS AND FISTULA,,,1171.27,1171.27,1
HCPCS,4330F,CNSLNG EPI SPEC SFTY ISSUES,,,0.01,0.01,1
HCPCS,4330F0,CNSLNG EPI SPEC SFTY ISSUES,,,0.01,0.01,1
HCPCS,43310,ESPHGP THRC APPR W/O RPR TRACHEOESOPHGL FSTL,10504.0,6827.6,1108.57,10504.0,35
HCPCS,43310,REPAIR OF ESOPHAGUS,,,1580.93,1580.93,1
HCPCS,43310,Repair of esophagus,,,3143.0,3970.1,6
HCPCS,433100,REPAIR OF ESOPHAGUS,,,1580.93,1580.93,1
HCPCS,43312,ESPHGP THRC APPR W/RPR TRACHEOESOPHGL FSTL,11700.0,7605.0,1190.7,11700.0,35
HCPCS,43312,REPAIR ESOPHAGUS AND FISTULA,,,1693.3,1693.3,1
HCPCS,43312,Repair esophagus and fistula,,,3143.0,3970.1,6
HCPCS,433120,REPAIR ESOPHAGUS AND FISTULA,,,1693.3,1693.3,1
HCPCS,43313,ESOPHAGOPLASTY CONGENITAL,,,3117.73,3117.73,1
HCPCS,43313,ESPHGP CGEN DFCT THRC APPR W/O RPR FSTL,19380.0,12597.0,1914.93,19380.0,35
HCPCS,43313,Esophagoplasty congenital,,,3143.0,3970.1,6
HCPCS,433130,ESOPHAGOPLASTY CONGENITAL,,,3117.73,3117.73,1
HCPCS,43314,ESPHGP CGEN DFCT THRC APPR W/RPR FSTL,21372.0,13891.8,2103.7,21372.0,35
HCPCS,43314,TRACHEO-ESOPHAGOPLASTY CONG,,,3342.44,3342.44,1
HCPCS,43314,Tracheo-esophagoplasty cong,,,3143.0,3970.1,6
HCPCS,433140,TRACHEO-ESOPHAGOPLASTY CONG,,,3342.44,3342.44,1
HCPCS,43320,EGST W/WO VAGOTOMY&PYLOROPLASTY TABDL/TTHRC AP,9324.0,6060.6,755.51,9324.0,35
HCPCS,43320,FUSE ESOPHAGUS & STOMACH,,,1503.67,1503.67,1
HCPCS,43320,Fuse esophagus & stomach,,,2324.53,2936.24,6
HCPCS,433200,FUSE ESOPHAGUS & STOMACH,,,1503.67,1503.67,1
HCPCS,43325,ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH,9040.0,5876.0,761.55,9040.0,35
HCPCS,43325,REVISE ESOPHAGUS & STOMACH,,,1461.37,1461.37,1
HCPCS,43325,Revise esophagus & stomach,,,3143.0,3970.1,6
HCPCS,433250,REVISE ESOPHAGUS & STOMACH,,,1461.37,1461.37,1
HCPCS,43327,ESOPG/GSTR FUNDOPLASTY W/LAPT,5340.0,3471.0,410.22,5340.0,35
HCPCS,43327,ESOPH FUNDOPLASTY LAP,,,876.86,876.86,1
HCPCS,43327,Esoph fundoplasty lap,,,3143.0,3970.1,6
HCPCS,433270,ESOPH FUNDOPLASTY LAP,,,876.86,876.86,1
HCPCS,43328,ESOPG/GSTR FUNDOPLASTY W/THORCOM,7964.0,5176.6,606.04,7964.0,35
HCPCS,43328,ESOPH FUNDOPLASTY THOR,,,1197.02,1197.02,1
HCPCS,43328,Esoph fundoplasty thor,,,3143.0,3970.1,6
HCPCS,433280,ESOPH FUNDOPLASTY THOR,,,1197.02,1197.02,1
HCPCS,43330,ESOPHAGOMYOTOMY ABDOMINAL,,,1437.88,1437.88,1
HCPCS,43330,ESOPHAGOMYOTOMY HELLER TYPE ABDOMINAL APPROACH,8876.0,5769.4,751.16,8876.0,35
HCPCS,43330,Esophagomyotomy abdominal,,,3143.0,3970.1,6
HCPCS,433300,ESOPHAGOMYOTOMY ABDOMINAL,,,1437.88,1437.88,1
HCPCS,43331,ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH,9224.0,5995.6,827.15,9224.0,35
HCPCS,43331,ESOPHAGOMYOTOMY THORACIC,,,1429.27,1429.27,1
HCPCS,43331,Esophagomyotomy thoracic,,,3143.0,3970.1,6
HCPCS,433310,ESOPHAGOMYOTOMY THORACIC,,,1429.27,1429.27,1
HCPCS,43332,RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH,7848.0,5101.2,588.05,7848.0,35
HCPCS,43332,TRANSAB ESOPH HIAT HERN RPR,,,1233.93,1233.93,1
HCPCS,43332,Transab esoph hiat hern rpr,,,4108.4,5189.56,6
HCPCS,433320,TRANSAB ESOPH HIAT HERN RPR,,,1233.93,1233.93,1
HCPCS,43333,LAPT RPR PARAESOPH HIATAL HERNIA W/ MESH,8584.0,5579.6,638.63,8584.0,35
HCPCS,43333,TRANSAB ESOPH HIAT HERN RPR,,,1351.66,1351.66,1
HCPCS,43333,Transab esoph hiat hern rpr,,,4108.4,5189.56,6
HCPCS,433330,TRANSAB ESOPH HIAT HERN RPR,,,1351.66,1351.66,1
HCPCS,43334,RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH,8848.0,5751.2,646.29,8848.0,35
HCPCS,43334,TRANSTHOR DIAPHRAG HERN RPR,,,1322.97,1322.97,1
HCPCS,43334,Transthor diaphrag hern rpr,,,4108.4,5189.56,6
HCPCS,433340,TRANSTHOR DIAPHRAG HERN RPR,,,1322.97,1322.97,1
HCPCS,43335,RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH,9588.0,6232.2,696.41,9588.0,35
HCPCS,43335,TRANSTHOR DIAPHRAG HERN RPR,,,1422.33,1422.33,1
HCPCS,43335,Transthor diaphrag hern rpr,,,4108.4,5189.56,6
HCPCS,433350,TRANSTHOR DIAPHRAG HERN RPR,,,1422.33,1422.33,1
HCPCS,43336,RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH,10324.0,6710.6,764.14,10324.0,35
HCPCS,43336,THORABD DIAPHR HERN REPAIR,,,1543.84,1543.84,1
HCPCS,43336,Thorabd diaphr hern repair,,,4108.4,5189.56,6
HCPCS,433360,THORABD DIAPHR HERN REPAIR,,,1543.84,1543.84,1
HCPCS,43337,RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/MESH,11060.0,7189.0,833.35,11060.0,35
HCPCS,43337,THORABD DIAPHR HERN REPAIR,,,1645.06,1645.06,1
HCPCS,43337,Thorabd diaphr hern repair,,,4108.4,5189.56,6
HCPCS,433370,THORABD DIAPHR HERN REPAIR,,,1645.06,1645.06,1
HCPCS,43338,ESOPH LENGTHENING,,,121.87,121.87,1
HCPCS,43338,ESOPHAGUS LENGTHENING,884.0,574.6,67.71,884.0,35
HCPCS,43338,Esoph lengthening,,,3143.0,3970.1,6
HCPCS,433380,ESOPH LENGTHENING,,,121.87,121.87,1
HCPCS,43340,ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT ABDL APPR,9196.0,5977.4,777.93,9196.0,35
HCPCS,43340,FUSE ESOPHAGUS & INTESTINE,,,1485.23,1485.23,1
HCPCS,43340,Fuse esophagus & intestine,,,2220.45,2804.78,6
HCPCS,433400,FUSE ESOPHAGUS & INTESTINE,,,1485.23,1485.23,1
HCPCS,43341,ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT THRC APPR,9692.0,6299.8,731.24,9692.0,35
HCPCS,43341,FUSE ESOPHAGUS & INTESTINE,,,1494.94,1494.94,1
HCPCS,43341,Fuse esophagus & intestine,,,2220.45,2804.78,6
HCPCS,433410,FUSE ESOPHAGUS & INTESTINE,,,1494.94,1494.94,1
HCPCS,43351,SURGICAL OPENING ESOPHAGUS,,,1408.19,1408.19,1
HCPCS,43351,Surgical opening esophagus,,,2220.45,2804.78,6
HCPCS,433510,SURGICAL OPENING ESOPHAGUS,,,1408.19,1408.19,1
HCPCS,43352,ESOPHAGOSTOMY FSTLJ ESOPH XTRNL CRV APPR,7124.0,4630.6,584.31,7124.0,35
HCPCS,43352,SURGICAL OPENING ESOPHAGUS,,,1139.4,1139.4,1
HCPCS,43352,Surgical opening esophagus,,,2324.53,2936.24,6
HCPCS,433520,SURGICAL OPENING ESOPHAGUS,,,1139.4,1139.4,1
HCPCS,43360,GASTROINTESTINAL REPAIR,,,2399.25,2399.25,1
HCPCS,43360,GI RCNSTJ PREV ESPHG/EXCLUSION W/STOMACH,16044.0,10428.6,1352.03,16044.0,35
HCPCS,43360,Gastrointestinal repair,,,2324.53,2936.24,6
HCPCS,433600,GASTROINTESTINAL REPAIR,,,2399.25,2399.25,1
HCPCS,43361,GASTROINTESTINAL REPAIR,,,2899.36,2899.36,1
HCPCS,43361,GI RCNSTJ PREV ESPHG/EXCLUSION W/COLON SM INT,18272.0,11876.8,1554.17,18272.0,35
HCPCS,43361,Gastrointestinal repair,,,2324.53,2936.24,6
HCPCS,433610,GASTROINTESTINAL REPAIR,,,2899.36,2899.36,1
HCPCS,43400,LIGATE ESOPHAGUS VEINS,,,1638.39,1638.39,1
HCPCS,43400,Ligate esophagus veins,,,2324.53,2936.24,6
HCPCS,434000,LIGATE ESOPHAGUS VEINS,,,1638.39,1638.39,1
HCPCS,43405,LIG/STAPLING G-ESOP JUNCT PRE-ESOPHGL PRF8J,9892.0,6429.8,821.71,9892.0,35
HCPCS,43405,LIGATE/STAPLE ESOPHAGUS,,,1555.9,1555.9,1
HCPCS,43405,Ligate/staple esophagus,,,2220.45,2804.78,6
HCPCS,434050,LIGATE/STAPLE ESOPHAGUS,,,1555.9,1555.9,1
HCPCS,4340F,CNSLNG CHLDBRNG WOMEN EPI,,,0.01,0.01,1
HCPCS,4340F0,CNSLNG CHLDBRNG WOMEN EPI,,,0.01,0.01,1
HCPCS,43410,REPAIR ESOPHAGUS WOUND,,,1104.84,1104.84,1
HCPCS,43410,Repair esophagus wound,,,2324.53,2936.24,6
HCPCS,43410,SUTR ESOPHGL WND/INJ CRV APPR,6564.0,4266.6,543.71,6564.0,35
HCPCS,434100,REPAIR ESOPHAGUS WOUND,,,1104.84,1104.84,1
HCPCS,43415,REPAIR ESOPHAGUS WOUND,,,2752.89,2752.89,1
HCPCS,43415,Repair esophagus wound,,,2324.53,2936.24,6
HCPCS,43415,SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR,17952.0,11668.8,1238.93,17952.0,35
HCPCS,434150,REPAIR ESOPHAGUS WOUND,,,2752.89,2752.89,1
HCPCS,43420,CLSR ESOPHAGOSTOMY/FSTL CRV APPR,6712.0,4362.8,525.34,6712.0,35
HCPCS,43420,REPAIR ESOPHAGUS OPENING,,,1088.56,7031.51,15
HCPCS,43420,Repair esophagus opening,,,2324.53,2936.24,6
HCPCS,434200,REPAIR ESOPHAGUS OPENING,,,1088.56,1088.56,1
HCPCS,43425,CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR,10016.0,6510.4,787.38,10016.0,35
HCPCS,43425,REPAIR ESOPHAGUS OPENING,,,1538.81,1538.81,1
HCPCS,43425,Repair esophagus opening,,,2220.45,2804.78,6
HCPCS,434250,REPAIR ESOPHAGUS OPENING,,,1538.81,1538.81,1
HCPCS,43450,DILATE ESOPHAGUS 1/MULT PASS,,,84.07,2032.78,15
HCPCS,43450,DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS,563.0,365.95,71.64,422.25,35
HCPCS,43450,Dilate esophagus 1/mult pass,,,181.25,228.95,6
HCPCS,434500,DILATE ESOPHAGUS 1/MULT PASS,,,84.07,84.07,1
HCPCS,43453,DILATE ESOPHAGUS,,,91.64,4112.99,15
HCPCS,43453,DILATION ESOPHAGUS GUIDE WIRE,564.0,366.6,71.34,1626.52,35
HCPCS,43453,Dilate esophagus,,,181.25,228.95,6
HCPCS,434530,DILATE ESOPHAGUS,,,91.64,91.64,1
HCPCS,43460,ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE,1516.0,985.4,121.44,1516.0,32
HCPCS,43460,PRESSURE TREATMENT ESOPHAGUS,,,223.46,223.46,1
HCPCS,43460,Pressure treatment esophagus,,,2220.45,2804.78,6
HCPCS,434600,PRESSURE TREATMENT ESOPHAGUS,,,223.46,223.46,1
HCPCS,43496,FREE JEJUNUM FLAP MICROVASC,,,2223.34,2223.34,1
HCPCS,43496,"FREE JEJUNUM XFER,MICROVASC ANAST",5238.0,3404.7,1254.58,5238.0,14
HCPCS,43496,Free jejunum flap microvasc,,,2220.45,2804.78,6
HCPCS,434960,FREE JEJUNUM FLAP MICROVASC,,,2223.34,2223.34,1
HCPCS,43497,TRANSORAL LOWER ESOPHAGEAL MYOTOMY,5316.0,3455.4,584.02,5316.0,28
HCPCS,43497,TRANSORL LWR ESOPHGL MYOTOMY,,,836.58,12906.67,15
HCPCS,43497,Transorl lwr esophgl myotomy,,,2220.45,2804.78,6
HCPCS,434970,TRANSORL LWR ESOPHGL MYOTOMY,,,836.58,836.58,1
HCPCS,43499,EGD REPAIR ESOPHAGEAL PERFORATION W/HEMOCLIPS (COMP 43235),836.0,543.4,418.0,836.0,15
HCPCS,43499,EGD WITH VACCUM (97605 COMP) WOUND VAC ABDOMEN,245.0,159.25,68.85,13665.0,48
HCPCS,43499,ENDOSCOPIC SUBMUCOSAL DISSECTION OF  ESOPHAGUS - (COMP CODE 4304,8752.0,5688.8,611.56,8752.0,15
HCPCS,43499,"ENDOVAC, ESOPH; EGD (COMP 43235, 97605)",990.0,643.5,495.0,990.0,15
HCPCS,43499,"ENDOVAC, ESOPH; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,567.0,1134.0,15
HCPCS,43499,"ENDOVAC, ESOPH; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,611.56,2092.0,15
HCPCS,43499,ESD ESOPHAGUS (COMP 43211),1680.0,1092.0,611.56,1680.0,15
HCPCS,43499,PERORAL ENDOSCOPIC MYOTOMY,5731.0,3725.15,611.56,5731.0,15
HCPCS,43499,THORACOSCOPY W/ LIGATION OF TRACHEOESOPH FISTULA & REP OF ESOPHA,19235.0,12502.75,611.56,19235.0,15
HCPCS,43499,UNLISTED MIN INVASIVE FOKER - ANASTOMOSIS (COMP CODE 43313),19380.0,12597.0,611.56,19380.0,15
HCPCS,43499,UNLISTED MIN INVASIVE FOKER - STRETCHING (COMP CODE 43425),10016.0,6510.4,611.56,10016.0,15
HCPCS,43499,UNLISTED PROC; ORAL ENDOSCOPIC MYOTOMY (COMP TO 43279),9503.0,6176.95,611.56,9503.0,15
HCPCS,43499,UNLISTED PROCEDURE ESOPHAGUS,2113.0,1373.45,593.75,13665.0,48
HCPCS,43499,ZENKERS DIVERTICULOPEXY,3883.0,2523.95,611.56,3883.0,15
HCPCS,43500,GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL,5116.0,3325.4,397.59,5116.0,35
HCPCS,43500,SURGICAL OPENING OF STOMACH,,,847.07,847.07,1
HCPCS,43500,Surgical opening of stomach,,,2220.45,2804.78,6
HCPCS,435000,SURGICAL OPENING OF STOMACH,,,847.07,847.07,1
HCPCS,43501,GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER,9040.0,5876.0,691.08,9040.0,35
HCPCS,43501,SURGICAL REPAIR OF STOMACH,,,1454.78,1454.78,1
HCPCS,43501,Surgical repair of stomach,,,2324.53,2936.24,6
HCPCS,435010,SURGICAL REPAIR OF STOMACH,,,1454.78,1454.78,1
HCPCS,43502,GASTROTOMY W/SUTR RPR PRE-ESOPG/GASTRIC LAC,10002.0,6501.3,786.82,10002.0,35
HCPCS,43502,SURGICAL REPAIR OF STOMACH,,,1642.44,1642.44,1
HCPCS,43502,Surgical repair of stomach,,,2324.53,2936.24,6
HCPCS,435020,SURGICAL REPAIR OF STOMACH,,,1642.44,1642.44,1
HCPCS,4350F,CNSLNG PROVIDED SYMP MNGMNT,,,0.01,0.01,1
HCPCS,4350F0,CNSLNG PROVIDED SYMP MNGMNT,,,0.01,0.01,1
HCPCS,43510,SURGICAL OPENING OF STOMACH,,,941.1,2032.78,15
HCPCS,43510,Surgical opening of stomach,,,2324.53,2936.24,6
HCPCS,435100,SURGICAL OPENING OF STOMACH,,,1022.89,1022.89,1
HCPCS,43520,INCISION OF PYLORIC MUSCLE,,,743.36,743.36,1
HCPCS,43520,Incision of pyloric muscle,,,2220.45,2804.78,6
HCPCS,435200,INCISION OF PYLORIC MUSCLE,,,743.36,743.36,1
HCPCS,43605,BIOPSY OF STOMACH,,,899.54,899.54,1
HCPCS,43605,"BIOPSY OF STOMACH,BY LAPAROTOMY",5488.0,3567.2,425.4,5488.0,35
HCPCS,43605,Biopsy of stomach,,,2220.45,2804.78,6
HCPCS,436050,BIOPSY OF STOMACH,,,899.54,899.54,1
HCPCS,43610,EXC LOCAL ULCER/BENIGN TUMOR STOMACH,6536.0,4248.4,523.61,6536.0,35
HCPCS,43610,EXCISION OF STOMACH LESION,,,1052.06,1052.06,1
HCPCS,43610,Excision of stomach lesion,,,2220.45,2804.78,6
HCPCS,436100,EXCISION OF STOMACH LESION,,,1052.06,1052.06,1
HCPCS,43611,EXC LOCAL MALIGNANT TUMOR STOMACH,8152.0,5298.8,624.58,8152.0,35
HCPCS,43611,EXCISION OF STOMACH LESION,,,1321.4,1321.4,1
HCPCS,43611,Excision of stomach lesion,,,2324.53,2936.24,6
HCPCS,436110,EXCISION OF STOMACH LESION,,,1321.4,1321.4,1
HCPCS,43620,GSTRCT TOT W/ESOPHAGOENTEROSTOMY,13616.0,8850.4,1024.27,13616.0,35
HCPCS,43620,REMOVAL OF STOMACH,,,2132.34,2132.34,1
HCPCS,43620,Removal of stomach,,,2324.53,2936.24,6
HCPCS,436200,REMOVAL OF STOMACH,,,2132.34,2132.34,1
HCPCS,43621,GSTRCT TOT W/ROUX-EN-Y RCNSTJ,15812.0,10277.8,1148.14,15812.0,35
HCPCS,43621,REMOVAL OF STOMACH,,,2444.32,2444.32,1
HCPCS,43621,Removal of stomach,,,2324.53,2936.24,6
HCPCS,436210,REMOVAL OF STOMACH,,,2444.32,2444.32,1
HCPCS,43622,GSTRCT TOT W/FRMJ INTSTINAL POUCH ANY TYPE,16012.0,10407.8,1174.39,16012.0,35
HCPCS,43622,REMOVAL OF STOMACH,,,2484.58,2484.58,1
HCPCS,43622,Removal of stomach,,,2324.53,2936.24,6
HCPCS,436220,REMOVAL OF STOMACH,,,2484.58,2484.58,1
HCPCS,43631,GSTRCT PRTL DSTL W/GASTRODUODENOSTOMY,9804.0,6372.6,869.0,9804.0,35
HCPCS,43631,REMOVAL OF STOMACH PARTIAL,,,1559.35,1559.35,1
HCPCS,43631,Removal of stomach partial,,,2324.53,2936.24,6
HCPCS,436310,REMOVAL OF STOMACH PARTIAL,,,1559.35,1559.35,1
HCPCS,43632,GSTRCT PRTL DSTL W/GASTROJEJUNOSTOMY,14056.0,9136.4,994.83,14056.0,35
HCPCS,43632,REMOVAL OF STOMACH PARTIAL,,,2188.61,2188.61,1
HCPCS,43632,Removal of stomach partial,,,2324.53,2936.24,6
HCPCS,436320,REMOVAL OF STOMACH PARTIAL,,,2188.61,2188.61,1
HCPCS,43633,GSTRCT PRTL DSTL W/ROUX-EN-Y RCNSTJ,13256.0,8616.4,945.75,13256.0,35
HCPCS,43633,REMOVAL OF STOMACH PARTIAL,,,2070.18,2070.18,1
HCPCS,43633,Removal of stomach partial,,,2324.53,2936.24,6
HCPCS,436330,REMOVAL OF STOMACH PARTIAL,,,2070.18,2070.18,1
HCPCS,43634,GSTRCT PRTL DSTL W/FRMJ INTSTINAL POUCH,14656.0,9526.4,1142.38,14656.0,35
HCPCS,43634,REMOVAL OF STOMACH PARTIAL,,,2285.52,2285.52,1
HCPCS,43634,Removal of stomach partial,,,2324.53,2936.24,6
HCPCS,436340,REMOVAL OF STOMACH PARTIAL,,,2285.52,2285.52,1
HCPCS,43635,REMOVAL OF STOMACH PARTIAL,,,120.63,120.63,1
HCPCS,43635,Removal of stomach partial,,,2324.53,2936.24,6
HCPCS,43635,VAGOTOMY PFRMD W/PRTL DSTL GSTRCT,824.0,535.6,85.35,824.0,35
HCPCS,436350,REMOVAL OF STOMACH PARTIAL,,,120.63,120.63,1
HCPCS,43640,VAGOTOMY & PYLORUS REPAIR,,,1282.65,1282.65,1
HCPCS,43640,VGTMY W/PYLORPLSTY W/WO GASTROST TRUNCAL/SLCTV,7824.0,5085.6,679.51,7824.0,35
HCPCS,43640,Vagotomy & pylorus repair,,,2220.45,2804.78,6
HCPCS,436400,VAGOTOMY & PYLORUS REPAIR,,,1282.65,1282.65,1
HCPCS,43641,VAGOTOMY & PYLORUS REPAIR,,,1297.43,1297.43,1
HCPCS,43641,Vagotomy & pylorus repair,,,2220.45,2804.78,6
HCPCS,436410,VAGOTOMY & PYLORUS REPAIR,,,1297.43,1297.43,1
HCPCS,43644,LAP GASTRIC BYPASS/ROUX-EN-Y,,,1869.84,1869.84,1
HCPCS,43644,LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM,12936.0,8408.4,975.58,12936.0,35
HCPCS,43644,Lap gastric bypass/roux-en-y,,,3143.0,3970.1,6
HCPCS,436440,LAP GASTRIC BYPASS/ROUX-EN-Y,,,1869.84,1869.84,1
HCPCS,43645,LAP GASTR BYPASS INCL SMLL I,,,1987.06,1987.06,1
HCPCS,43645,LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ,12612.0,8197.8,1043.12,12612.0,35
HCPCS,43645,Lap gastr bypass incl smll i,,,3143.0,3970.1,6
HCPCS,436450,LAP GASTR BYPASS INCL SMLL I,,,1987.06,1987.06,1
HCPCS,43647,LAP IMPL ELECTRODE ANTRUM,,,645.3,27037.69,17
HCPCS,43647,LAP IMPLANT/ REPLACE GASTRIC NEUROSTIM ANTRUM,1499.0,974.35,166.16,1835.37,17
HCPCS,43647,Lap impl electrode antrum,,,2290.02,2892.66,6
HCPCS,436470,LAP IMPL ELECTRODE ANTRUM,,,645.3,645.3,1
HCPCS,43648,LAP REVISE/REMOVE GASTRIC NEUROSTIM ANTRUM,1543.0,1002.95,166.16,1835.37,14
HCPCS,43648,LAP REVISE/REMV ELTRD ANTRUM,,,613.13,22573.24,15
HCPCS,43648,Lap revise/remv eltrd antrum,,,2290.02,2892.66,6
HCPCS,436480,LAP REVISE/REMV ELTRD ANTRUM,,,613.13,613.13,1
HCPCS,43651,LAPAROSCOPY VAGUS NERVE,,,708.18,12649.85,15
HCPCS,43651,LAPS SURG TRNSXJ VAGUS NRV TRUNCAL,4052.0,2633.8,417.72,4052.0,35
HCPCS,43651,Laparoscopy vagus nerve,,,2290.02,2892.66,6
HCPCS,436510,LAPAROSCOPY VAGUS NERVE,,,708.18,708.18,1
HCPCS,43652,LAPAROSCOPY VAGUS NERVE,,,825.61,12649.85,15
HCPCS,43652,LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV,4852.0,3153.8,504.36,4852.0,35
HCPCS,43652,Laparoscopy vagus nerve,,,2290.02,2892.66,6
HCPCS,436520,LAPAROSCOPY VAGUS NERVE,,,825.61,825.61,1
HCPCS,43653,LAPAROSCOPY GASTROSTOMY,,,621.18,12649.85,16
HCPCS,43653,LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX,3392.0,2204.8,375.34,3392.0,35
HCPCS,43653,Laparoscopy gastrostomy,,,2324.53,2936.24,6
HCPCS,436530,LAPAROSCOPY GASTROSTOMY,,,621.18,621.18,1
HCPCS,43659,ESO/GASTRECTOMY W RY ESO/JEJUNOSTOMY,14637.0,9514.05,757.54,14637.0,15
HCPCS,43659,GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ (COMP CODE 4384,12112.0,7872.8,757.54,12112.0,15
HCPCS,43659,LAP DUODENAL SWITCH PROCEDURE (COMP 43845),10659.0,6928.35,757.54,10659.0,15
HCPCS,43659,LAP EXC. OF GASTRIC TUMOR (COMP 43610),5113.0,3323.45,757.54,5113.0,15
HCPCS,43659,LAP GASTRIC BYPASS W/SMALL BOWEL RECONSTR,6572.0,4271.8,757.54,6572.0,15
HCPCS,43659,LAP GASTRIC REST PROCEDURE (LAP BAND),4469.0,2904.85,757.54,4469.0,15
HCPCS,43659,LAP GASTROTOMY (COMP 43500),4605.0,2993.25,757.54,4605.0,15
HCPCS,43659,LAP PARTIAL GASTRECTOMY (COMP CODE 43611),8152.0,5298.8,757.54,8152.0,15
HCPCS,43659,LAP PARTIAL GASTRECTOMY W RNY RECONSTRUC (COMP 43633),13256.0,8616.4,757.54,13256.0,15
HCPCS,43659,LAP REPAIR GASTRIC FISTULA (COMP 43880),10872.0,7066.8,757.54,10872.0,15
HCPCS,43659,LAP REVISION GASTRIC PROCEDURE,6572.0,4271.8,757.54,6572.0,15
HCPCS,43659,LAP REVISION GASTROJEJUNOSTOMY (COMP 43860),6423.0,4174.95,757.54,6423.0,15
HCPCS,43659,LAP TOTAL GASTRECTOMY W/RESECTION OF THE GASTROJEJUNOSTOMY (COMP,13616.0,8850.4,757.54,13616.0,15
HCPCS,43659,"LAP, GASTROJEJUNOSTOMY (COMP 43820)",6115.0,3974.75,757.54,6115.0,15
HCPCS,43659,LAP. OVERSEW GASTR ULCER,9132.0,5935.8,757.54,9132.0,15
HCPCS,43659,LAPAROSCOPIC EXCISION MALIGNANT TUMOR OF STOMACH (COMP 43611),6181.0,4017.65,757.54,6181.0,15
HCPCS,43659,LAPAROSCOPIC EXCISION ULCER OR BENIGN TUMOR STOMACH (COMP CODE 4,5113.0,3323.45,757.54,5113.0,15
HCPCS,43659,LAPAROSCOPIC GASTRIC BYPASS,9393.0,6105.45,757.54,9393.0,15
HCPCS,43659,LAPAROSCOPIC GASTRIC BYPASS SURGERY,7517.0,4886.05,757.54,7517.0,15
HCPCS,43659,"LAPAROSCOPIC GASTROJEJUNOSTOMY, WITHOUT VAGOTOMY (COMP 43820)",9012.0,5857.8,757.54,9012.0,15
HCPCS,43659,LAPAROSCOPIC GASTROPEXY (COMP CODE 43338),950.0,617.5,475.0,950.0,15
HCPCS,43659,LAPAROSCOPIC GASTROPLASTY,9871.0,6416.15,757.54,9871.0,15
HCPCS,43659,LAPAROSCOPIC PARTIAL GASTRECTOMY FOR EXCISION OF GASTROCUTANEOUS,8713.0,5663.45,757.54,8713.0,15
HCPCS,43659,LAPAROSCOPIC PYLOROMYOTOMY (COMP 43800),3728.0,2423.2,757.54,3728.0,15
HCPCS,43659,LAPAROSCOPIC PYLOROMYOTOMY (COMP CODE 43520),4854.0,3155.1,757.54,4854.0,15
HCPCS,43659,LAPAROSCOPIC PYLOROPLASTY,4484.0,2914.6,757.54,4484.0,15
HCPCS,43659,LAPAROSCOPIC REMOVAL GASTRIC BANDING,2353.0,1529.45,757.54,2353.0,15
HCPCS,43659,LAPAROSCOPIC REVISION GASTROJEJUNAL ANASTOMOSIS W/EXCISION GASTR,8328.0,5413.2,757.54,8328.0,15
HCPCS,43659,LAPAROSCOPIC TOTAL GASTRECTOMY W/ROUX-EN Y ANASTOMOSIS (COMPARIS,15812.0,10277.8,757.54,15812.0,15
HCPCS,43659,"UNLIST LAP PROC, STOMACH COMPARED TO 43633",13256.0,8616.4,757.54,13256.0,15
HCPCS,43659,"UNLIST LAP PROC, STOMACH COMPARED TO 43820",6324.0,4110.6,757.54,6324.0,15
HCPCS,43659,UNLIST. LAP.GASTRIC PLICATION,5640.0,3666.0,757.54,5640.0,15
HCPCS,43659,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH (COMP CODE 43843),9120.0,5928.0,757.54,9120.0,15
HCPCS,43659,UNLISTED LAPAROSCOPIC PYLOROPLASTY (COMPARED TO 43800),6172.0,4011.8,757.54,6172.0,15
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH",3775.0,2453.75,757.54,3775.0,15
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43611)",6181.0,4017.65,757.54,6181.0,15
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43631)",9804.0,6372.6,757.54,9804.0,15
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43840)",6454.0,4195.1,757.54,6454.0,15
HCPCS,43659,UNLISTED LAPS PX STOMACH,,,5856.41,12649.85,15
HCPCS,43659,"UNLISTED PROC, LAP DISTAL GASTRECTOMY W/GASTROJEJUNOSTOMY (COMP",14056.0,9136.4,757.54,14056.0,15
HCPCS,43659,UNLISTED PROC; LAPARSCOPIC REVISION ROUX-EN-Y GASTRIC BYPASS GAS,9681.0,6292.65,757.54,9681.0,15
HCPCS,43659,Unlisted laps px stomach,,,2220.45,2804.78,6
HCPCS,43752,NASAL/OROGASTRIC W/TUBE PLMT,,,42.51,42.51,1
HCPCS,43752,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1325.5,861.575,30.38,4151.0,276
HCPCS,437520,NASAL/OROGASTRIC W/TUBE PLMT,,,42.51,42.51,1
HCPCS,43753,GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE,1790.0,1163.5,27.52,3920.0,86
HCPCS,43753,GASTRIC TUBE PLMT W/ASPIR & LAVAGE,180.0,117.0,10.69,180.0,35
HCPCS,43753,TX GASTRO INTUB W/ASP,,,23.21,23.21,1
HCPCS,437530,TX GASTRO INTUB W/ASP,,,23.21,23.21,1
HCPCS,43754,DX GASTR INTUB W/ASP SPEC,,,40.0,675.17,15
HCPCS,43754,GASTRIC TUBE DX PLMT W/ASPIR 1 SPECIMEN,180.0,117.0,27.36,218.44,35
HCPCS,437540,DX GASTR INTUB W/ASP SPEC,,,40.0,40.0,1
HCPCS,43755,DX GASTR INTUB W/ASP SPECS,,,63.02,339.23,15
HCPCS,43755,Dx gastr intub w/asp specs,,,181.25,228.95,6
HCPCS,43755,GASTRIC TUBE DX PLMT W/ASPIR MULT SPECIMENS,376.0,244.4,46.51,282.0,35
HCPCS,437550,DX GASTR INTUB W/ASP SPECS,,,63.02,63.02,1
HCPCS,43756,DUODENAL TUBE DX PLMT W/IMG GID 1 SPECIMEN,339.0,220.35,44.31,344.82,35
HCPCS,43756,DX DUOD INTUB W/ASP SPEC,,,53.7,2032.78,15
HCPCS,43756,Dx duod intub w/asp spec,,,181.25,228.95,6
HCPCS,437560,DX DUOD INTUB W/ASP SPEC,,,53.7,53.7,1
HCPCS,43757,DUODENAL INTUBAT W/IMAG GUIDED MULTIPLE SPECIMEN,5391.0,3504.15,92.88,4851.9,49
HCPCS,43757,DUODENAL TUBE DX PLMT W/IMG GID MULT SPECIMEN,504.0,327.6,67.2,493.55,35
HCPCS,43757,DX DUOD INTUB W/ASP SPECS,,,81.28,81.28,1
HCPCS,437570,DX DUOD INTUB W/ASP SPECS,,,81.28,81.28,1
HCPCS,43760,CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GDNCE,703.0,456.95,118.1,632.7,21
HCPCS,43761,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,1141.5,741.975,78.32,6317.0,182
HCPCS,43761,REPOSITION GASTROSTOMY TUBE,,,111.39,111.39,1
HCPCS,437610,REPOSITION GASTROSTOMY TUBE,,,111.39,111.39,1
HCPCS,43762,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,864.5,561.925,29.35,4151.0,224
HCPCS,43762,RPLC GTUBE NO REVJ TRC,,,40.15,40.15,1
HCPCS,437620,RPLC GTUBE NO REVJ TRC,,,40.15,40.15,1
HCPCS,43763,PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC,981.5,637.975,64.22,4151.0,178
HCPCS,43763,RPLC GTUBE REVJ GSTRST TRC,,,93.0,93.0,1
HCPCS,437630,RPLC GTUBE REVJ GSTRST TRC,,,93.0,93.0,1
HCPCS,43770,LAP PLACE GASTR ADJ DEVICE,,,1211.21,22573.24,15
HCPCS,43770,LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE,7200.0,4680.0,624.95,7200.0,35
HCPCS,43770,Lap place gastr adj device,,,3143.0,3970.1,6
HCPCS,437700,LAP PLACE GASTR ADJ DEVICE,,,1211.21,1211.21,1
HCPCS,43771,LAP REVISE GASTR ADJ DEVICE,,,1375.24,1375.24,1
HCPCS,43771,LAPS GASTRIC RESTRICTIVE PX REVISION DEVICE,8316.0,5405.4,654.76,8316.0,35
HCPCS,43771,Lap revise gastr adj device,,,3143.0,3970.1,6
HCPCS,437710,LAP REVISE GASTR ADJ DEVICE,,,1375.24,1375.24,1
HCPCS,43772,LAP RMVL GASTR ADJ DEVICE,,,1023.58,8248.85,15
HCPCS,43772,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE,6280.0,4082.0,492.56,6280.0,35
HCPCS,43772,Lap rmvl gastr adj device,,,3143.0,3970.1,6
HCPCS,437720,LAP RMVL GASTR ADJ DEVICE,,,1023.58,1023.58,1
HCPCS,43773,LAP REPLACE GASTR ADJ DEVICE,,,1375.24,12649.85,15
HCPCS,43773,LAPS GASTRIC RESTRICTIVE PX REMOVE&RPLCMT DEVICE,8316.0,5405.4,654.44,8316.0,35
HCPCS,43773,Lap replace gastr adj device,,,3143.0,3970.1,6
HCPCS,437730,LAP REPLACE GASTR ADJ DEVICE,,,1375.24,1375.24,1
HCPCS,43774,LAP RMVL GASTR ADJ ALL PARTS,,,1034.85,18376.0,16
HCPCS,43774,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT,6304.0,4097.6,495.56,6304.0,35
HCPCS,43774,Lap rmvl gastr adj all parts,,,3143.0,3970.1,6
HCPCS,437740,LAP RMVL GASTR ADJ ALL PARTS,,,1034.85,1034.85,1
HCPCS,43775,LAP SLEEVE GASTRECTOMY,,,1193.17,1193.17,1
HCPCS,43775,LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY,8967.0,5828.55,667.38,8967.0,35
HCPCS,43775,Lap sleeve gastrectomy,,,2220.45,2804.78,6
HCPCS,437750,LAP SLEEVE GASTRECTOMY,,,1193.17,1193.17,1
HCPCS,43800,PYLOROPLASTY,6172.0,4011.8,477.64,6172.0,36
HCPCS,43800,Pyloroplasty,,,2220.45,2804.78,6
HCPCS,438000,PYLOROPLASTY,,,1001.45,1001.45,1
HCPCS,43810,GASTRODUODENOSTOMY,6752.0,4388.8,516.31,6752.0,36
HCPCS,43810,Gastroduodenostomy,,,2220.45,2804.78,6
HCPCS,438100,GASTRODUODENOSTOMY,,,1095.39,1095.39,1
HCPCS,43820,GASTROJEJUNOSTOMY W/O VAGOTOMY,9012.0,5857.8,658.83,9012.0,35
HCPCS,43820,GASTROJEJUNOSTOMY WO VAGOTMY,,,1447.47,1447.47,1
HCPCS,43820,Gastrojejunostomy wo vagotmy,,,2324.53,2936.24,6
HCPCS,438200,GASTROJEJUNOSTOMY WO VAGOTMY,,,1447.47,1447.47,1
HCPCS,43825,GASTROJEJUNOSTOMY W/VAGOTOMY,,,1411.97,1411.97,1
HCPCS,43825,GASTROJEJUNOSTOMY+VAGOTOMY,8704.0,5657.6,693.06,8704.0,35
HCPCS,43825,Gastrojejunostomy w/vagotomy,,,2220.45,2804.78,6
HCPCS,438250,GASTROJEJUNOSTOMY W/VAGOTOMY,,,1411.97,1411.97,1
HCPCS,43830,GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX,4340.0,2821.0,358.44,4340.0,35
HCPCS,43830,GSTRST OPEN WO CONSTJ TUBE,,,755.22,4112.99,15
HCPCS,43830,Gstrst open wo constj tube,,,2220.45,2804.78,6
HCPCS,438300,GSTRST OPEN WO CONSTJ TUBE,,,755.22,755.22,1
HCPCS,43831,GASTROSTOMY OPEN NEONATAL,,,653.8,2032.78,15
HCPCS,43831,Gastrostomy open neonatal,,,2220.45,2804.78,6
HCPCS,438310,GASTROSTOMY OPEN NEONATAL,,,653.8,653.8,1
HCPCS,43832,GASTROSTOMY OPN W/CONSTJ GSTR TUBE,6936.0,4508.4,541.73,6936.0,35
HCPCS,43832,GSTRST OPEN W/CONSTJ TUBE,,,1127.04,1127.04,1
HCPCS,43832,Gstrst open w/constj tube,,,2324.53,2936.24,6
HCPCS,438320,GSTRST OPEN W/CONSTJ TUBE,,,1127.04,1127.04,1
HCPCS,43840,GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ,9132.0,5935.8,666.56,9132.0,35
HCPCS,43840,GSTRRPHY SUTR DUOL/GSTR ULCR,,,1462.84,4428.81,5
HCPCS,43840,Gstrrphy sutr duol/gstr ulcr,,,2324.53,2936.24,6
HCPCS,438400,GSTRRPHY SUTR DUOL/GSTR ULCR,,,1462.84,1462.84,1
HCPCS,43842,GASTRIC RSTCV W/O BYP VERTICAL-BANDED GASTROPLY,8412.0,5467.8,739.44,8412.0,24
HCPCS,43842,GSTR RSTCV PX V-BANDED GSTP,,,1230.8,1230.8,1
HCPCS,43842,Gstr rstcv px v-banded gstp,,,3143.0,3970.1,6
HCPCS,438420,GSTR RSTCV PX V-BANDED GSTP,,,1230.8,1230.8,1
HCPCS,43843,GSTR RSTCV OTH/THN V-BAND,,,1382.78,1382.78,1
HCPCS,43843,GSTR RSTCV W/O BYP OTH/THN VER-BANDED GSTP,8484.0,5514.6,983.13,8484.0,35
HCPCS,43843,Gstr rstcv oth/thn v-band,,,3143.0,3970.1,6
HCPCS,438430,GSTR RSTCV OTH/THN V-BAND,,,1382.78,1382.78,1
HCPCS,43845,GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM,13320.0,8658.0,1100.12,13320.0,32
HCPCS,43845,GASTROPLASTY DUODENAL SWITCH,,,2108.83,2108.83,1
HCPCS,43845,Gastroplasty duodenal switch,,,3143.0,3970.1,6
HCPCS,438450,GASTROPLASTY DUODENAL SWITCH,,,2108.83,2108.83,1
HCPCS,43846,GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<,10964.0,7126.6,916.31,10964.0,35
HCPCS,43846,GSTR RSTCV PX SHRT ROUX-EN-Y,,,1777.68,1777.68,1
HCPCS,43846,Gstr rstcv px shrt roux-en-y,,,3143.0,3970.1,6
HCPCS,438460,GSTR RSTCV PX SHRT ROUX-EN-Y,,,1777.68,1777.68,1
HCPCS,43847,GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ,12112.0,7872.8,1385.41,12112.0,35
HCPCS,43847,GSTR RSTCV PX SM INT RCNSTJ,,,1945.65,1945.65,1
HCPCS,43847,Gstr rstcv px sm int rcnstj,,,3143.0,3970.1,6
HCPCS,438470,GSTR RSTCV PX SM INT RCNSTJ,,,1945.65,1945.65,1
HCPCS,43848,REVISION OPEN GASTRIC RESTRICTIVE PX NOT DEVICE,13100.0,8515.0,1478.46,13100.0,35
HCPCS,43848,REVJ OPEN GSTR RSTCV PX,,,2084.12,2084.12,1
HCPCS,43848,Revj open gstr rstcv px,,,3143.0,3970.1,6
HCPCS,438480,REVJ OPEN GSTR RSTCV PX,,,2084.12,2084.12,1
HCPCS,43850,Revise stomach-bowel fusion,,,2220.45,2804.78,6
HCPCS,43855,Revise stomach-bowel fusion,,,2220.45,2804.78,6
HCPCS,43860,REVJ GSTR/JJ ANAST W/O VGTMY,,,1758.93,18285.0,2
HCPCS,43860,REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY,11156.0,7251.4,853.05,11156.0,35
HCPCS,43860,Revj gstr/jj anast w/o vgtmy,,,2324.53,2936.24,6
HCPCS,438600,REVJ GSTR/JJ ANAST W/O VGTMY,,,1758.93,1758.93,1
HCPCS,43865,REVJ GSTR/JJ ANAST W/RCNSTJ W/VGTMY,11620.0,7553.0,936.1,11620.0,35
HCPCS,43865,REVJ GSTR/JJ ANAST W/VGTMY,,,1840.08,1840.08,1
HCPCS,43865,Revj gstr/jj anast w/vgtmy,,,2324.53,2936.24,6
HCPCS,438650,REVJ GSTR/JJ ANAST W/VGTMY,,,1840.08,1840.08,1
HCPCS,43870,CLOSURE GASTROSTOMY SURGICAL,,,762.43,8248.85,15
HCPCS,43870,"CLOSURE OF GASTROSTOMY,SURGICAL",4576.0,2974.4,357.76,4576.0,35
HCPCS,43870,Closure gastrostomy surgical,,,2220.45,2804.78,6
HCPCS,438700,CLOSURE GASTROSTOMY SURGICAL,,,762.43,762.43,1
HCPCS,43880,CLOSURE GASTROCOLIC FISTULA,10872.0,7066.8,829.81,10872.0,36
HCPCS,43880,Closure gastrocolic fistula,,,2324.53,2936.24,6
HCPCS,438800,CLOSURE GASTROCOLIC FISTULA,,,1729.13,1729.13,1
HCPCS,43881,IMPL/RPLCMT GSTR NSTIM ELTRD,,,754.55,754.55,1
HCPCS,43881,Impl/rplcmt gstr nstim eltrd,,,2324.53,2936.24,6
HCPCS,438810,IMPL/RPLCMT GSTR NSTIM ELTRD,,,754.55,754.55,1
HCPCS,43882,REV/RMVL GSTR NSTIM ELTRD,,,852.14,852.14,1
HCPCS,43882,REVISION/RMVL GASTRIC NSTIM ELTRDE ANTRUM OPEN,1772.0,1151.8,334.01,1835.37,14
HCPCS,43882,Rev/rmvl gstr nstim eltrd,,,2220.45,2804.78,6
HCPCS,438820,REV/RMVL GSTR NSTIM ELTRD,,,852.14,852.14,1
HCPCS,43886,GSTR RSTCV PX OPN REVJ PORT,,,394.71,7937.59,15
HCPCS,43886,GSTR RSTCV PX OPN REVJ SUBQ PORT COMPONENT ONLY,1856.0,1206.4,287.24,1856.0,35
HCPCS,43886,Gstr rstcv px opn revj port,,,2220.45,2804.78,6
HCPCS,438860,GSTR RSTCV PX OPN REVJ PORT,,,394.71,394.71,1
HCPCS,43887,GSTR RSTCV PX OPN RMVL PORT,,,357.22,3966.07,15
HCPCS,43887,GSTR RSTCV PX OPN RMVL SUBQ PORT COMPONENT ONLY,1728.0,1123.2,236.48,1728.0,35
HCPCS,43887,Gstr rstcv px opn rmvl port,,,2220.45,2804.78,6
HCPCS,438870,GSTR RSTCV PX OPN RMVL PORT,,,357.22,357.22,1
HCPCS,43888,GSTR RSTCV OPN RMVL & RPLCMT SUBQ PORT,2576.0,1674.4,330.56,2576.0,35
HCPCS,43888,GSTR RSTCV PX OPN RMVL&RPLC,,,499.42,7937.59,15
HCPCS,43888,Gstr rstcv px opn rmvl&rplc,,,3143.0,3970.1,6
HCPCS,438880,GSTR RSTCV PX OPN RMVL&RPLC,,,499.42,499.42,1
HCPCS,43889,GSTR RSTCV PX TRNSORL ESG,,,771.1,12210.56,5
HCPCS,43889,Gstr rstcv px trnsorl esg,,,3143.0,3970.1,6
HCPCS,438890,GSTR RSTCV PX TRNSORL ESG,,,771.1,771.1,1
HCPCS,43999,CENTRAL GASTRECTOMY WITH GASTROGASTROSTOMY (COMP 43631),8824.0,5735.6,899.6,8824.0,15
HCPCS,43999,EGD W SUTURE OF GASTROCUTANEOUS FISTULA (COMP 43255),1531.0,995.15,765.5,1531.0,15
HCPCS,43999,EGD W/ GASTRO/GASTRIC FISTULA REPAIR (COMP CODE 44650),10048.0,6531.2,899.6,10048.0,15
HCPCS,43999,EGD W/ SUTURE REPAIR OF STOMACH (COMP CODE 43840),9816.0,6380.4,899.6,9816.0,15
HCPCS,43999,EGD/EUS GASTROJAJUNOSTOMY LAMS (COMP 43266 AND 43237),5000.0,3250.0,899.6,5000.0,15
HCPCS,43999,ENDOSCOPIC PYLOROMYOTOMY (COMP 43520),4700.0,3055.0,899.6,4700.0,15
HCPCS,43999,ENDOSCOPIC SUBMUCOSAL DISSECTION OF STOMACH - (COMP CODE 43611),8152.0,5298.8,899.6,8152.0,15
HCPCS,43999,ENDOSCOPIC WOUND VAC PLACEMENT (COMP CODE 43235 & 97605),567.0,368.55,283.5,1079.52,15
HCPCS,43999,"ENDOVAC, STOMACH; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,567.0,1134.0,15
HCPCS,43999,"ENDOVAC, STOMACH; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,899.6,2092.0,15
HCPCS,43999,ESD STOMACH (COMP 43254),1948.0,1266.2,899.6,1948.0,15
HCPCS,43999,EXC GASTROCUTANEOUS FISTULA (COMP 44640),10406.0,6763.9,899.6,10406.0,15
HCPCS,43999,GASTRIC BANDING ADJUSTMENTS,294.5,191.425,133.0,1079.52,30
HCPCS,43999,IMAGE GUIDED REPOSITION G-TUBE (COMP CODE 43761),1141.5,741.975,393.12,7730.0,63
HCPCS,43999,"LAP, REVISION NISSEN FUNDOPLASTY (COMP 43280)",7240.0,4706.0,899.6,7240.0,15
HCPCS,43999,"LIGATION OF GASTRIC VARIED, OPEN (COMP CODE 43244)",1893.0,1230.45,899.6,1893.0,15
HCPCS,43999,OPEN GASTRIC BAND REMOVAL (COMP CODE 43774),6776.0,4404.4,899.6,6776.0,15
HCPCS,43999,PARTIAL GASTRECTOMY (COMP CODE 43610),2880.0,1872.0,899.6,2880.0,15
HCPCS,43999,"PARTIAL GATRECTOMY, PROXIMAL (COMP 43610)",7026.0,4566.9,899.6,7026.0,15
HCPCS,43999,SLEEVE GASTRECTOMY TO SINGLE ANASTOMOSIS DUODENAL SWITCH (SADIS),13320.0,8658.0,899.6,13320.0,15
HCPCS,43999,TRANS ORAL GASTRIC OUTLET REDUCTION TORE (COMP CODE 43771),8939.0,5810.35,899.6,8939.0,15
HCPCS,43999,TRANSNASAL EGD W/REMOVAL OF FOREIGN BODY (COMP 43247),1368.0,889.2,684.0,1368.0,15
HCPCS,43999,UNLISTED PROCEDURE STOMACH,1611.0,1047.15,252.34,7730.0,192
HCPCS,43999,"UNLISTED PROCEDURE, STOMACH (COMPARISON CODE 43880)",11687.0,7596.55,899.6,11687.0,15
HCPCS,44005,ENTEROLSS FRING INTSTINAL ADHESION SPX,7384.0,4799.6,572.87,7384.0,35
HCPCS,44005,FREEING OF BOWEL ADHESION,,,1173.0,1173.0,1
HCPCS,44005,Freeing of bowel adhesion,,,2480.69,3133.5,6
HCPCS,440050,FREEING OF BOWEL ADHESION,,,1173.0,1173.0,1
HCPCS,4400F,REHAB THXPY OPTIONS W/PT,,,0.01,0.01,1
HCPCS,4400F0,REHAB THXPY OPTIONS W/PT,,,0.01,0.01,1
HCPCS,44010,"DUODENOTOMY FOR EXPLOR,BX,FB REMOV",5704.0,3707.6,457.7,5704.0,35
HCPCS,44010,INCISION OF SMALL BOWEL,,,908.51,908.51,1
HCPCS,44010,Incision of small bowel,,,1250.66,1579.78,6
HCPCS,440100,INCISION OF SMALL BOWEL,,,908.51,908.51,1
HCPCS,44015,INSERT NEEDLE CATH BOWEL,,,151.38,151.38,1
HCPCS,44015,TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD,934.5,607.425,107.24,18285.0,67
HCPCS,440150,INSERT NEEDLE CATH BOWEL,,,151.38,151.38,1
HCPCS,44020,ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL,6488.0,4217.2,536.11,6488.0,35
HCPCS,44020,EXPLORE SMALL INTESTINE,,,1046.15,1046.15,1
HCPCS,44020,Explore small intestine,,,2480.69,3133.5,6
HCPCS,440200,EXPLORE SMALL INTESTINE,,,1046.15,1046.15,1
HCPCS,44021,DECOMPRESS SMALL BOWEL,,,1043.72,1043.72,1
HCPCS,44021,Decompress small bowel,,,1250.66,1579.78,6
HCPCS,44021,ENTEROTOMY SM INT OTH/THN DUO DCMPRN,6524.0,4240.6,520.58,6524.0,35
HCPCS,440210,DECOMPRESS SMALL BOWEL,,,1043.72,1043.72,1
HCPCS,44025,COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL,6604.0,4292.6,539.95,6604.0,35
HCPCS,44025,INCISION OF LARGE BOWEL,,,1054.93,1054.93,1
HCPCS,44025,Incision of large bowel,,,1250.66,1579.78,6
HCPCS,440250,INCISION OF LARGE BOWEL,,,1054.93,1054.93,1
HCPCS,44050,RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT,6208.0,4035.2,519.89,6208.0,35
HCPCS,44050,REDUCE BOWEL OBSTRUCTION,,,1007.11,1007.11,1
HCPCS,44050,Reduce bowel obstruction,,,2480.69,3133.5,6
HCPCS,440500,REDUCE BOWEL OBSTRUCTION,,,1007.11,1007.11,1
HCPCS,44055,CORRECT MALROTATION OF BOWEL,,,1601.24,1601.24,1
HCPCS,44055,CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS,10252.0,6663.8,768.02,10252.0,35
HCPCS,44055,Correct malrotation of bowel,,,2480.69,3133.5,6
HCPCS,440550,CORRECT MALROTATION OF BOWEL,,,1601.24,1601.24,1
HCPCS,44100,BIOPSY OF BOWEL,,,112.86,2032.78,15
HCPCS,44100,BX INTESTINE CAPSULE TUBE PRORAL 1/> SPECIMENS,884.0,574.6,80.17,884.0,35
HCPCS,44100,Biopsy of bowel,,,605.04,764.26,6
HCPCS,441000,BIOPSY OF BOWEL,,,112.86,112.86,1
HCPCS,44110,EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM,5616.0,3650.4,480.28,5616.0,35
HCPCS,44110,EXCISE INTESTINE LESION(S),,,912.32,912.32,1
HCPCS,44110,Excise intestine lesion(s),,,1250.66,1579.78,6
HCPCS,441100,EXCISE INTESTINE LESION(S),,,912.32,912.32,1
HCPCS,44111,EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE,6608.0,4295.2,594.83,6608.0,35
HCPCS,44111,EXCISION OF BOWEL LESION(S),,,1049.14,1049.14,1
HCPCS,44111,Excision of bowel lesion(s),,,1250.66,1579.78,6
HCPCS,441110,EXCISION OF BOWEL LESION(S),,,1049.14,1049.14,1
HCPCS,44120,ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST,8328.0,5413.2,649.6,8328.0,35
HCPCS,44120,REMOVAL OF SMALL INTESTINE,,,1312.91,1312.91,1
HCPCS,44120,Removal of small intestine,,,2480.69,3133.5,6
HCPCS,441200,REMOVAL OF SMALL INTESTINE,,,1312.91,1312.91,1
HCPCS,44121,ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA,1776.0,1154.4,183.07,1776.0,35
HCPCS,44121,REMOVAL OF SMALL INTESTINE,,,258.13,258.13,1
HCPCS,44121,Removal of small intestine,,,2480.69,3133.5,6
HCPCS,441210,REMOVAL OF SMALL INTESTINE,,,258.13,258.13,1
HCPCS,44125,ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY,8813.0,5728.45,693.92,8813.0,35
HCPCS,44125,REMOVAL OF SMALL INTESTINE,,,1261.8,1261.8,1
HCPCS,44125,Removal of small intestine,,,2480.69,3133.5,6
HCPCS,441250,REMOVAL OF SMALL INTESTINE,,,1261.8,1261.8,1
HCPCS,44126,ENTERECTOMY W/O TAPER CONG,,,2653.91,2653.91,1
HCPCS,44126,ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING,16892.0,10979.8,1420.16,16892.0,35
HCPCS,44126,Enterectomy w/o taper cong,,,2480.69,3133.5,6
HCPCS,441260,ENTERECTOMY W/O TAPER CONG,,,2653.91,2653.91,1
HCPCS,44127,ENTERECTOMY W/TAPER CONG,,,3065.7,3065.7,1
HCPCS,44127,ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING,19720.0,12818.0,1633.29,19720.0,35
HCPCS,44127,Enterectomy w/taper cong,,,2480.69,3133.5,6
HCPCS,441270,ENTERECTOMY W/TAPER CONG,,,3065.7,3065.7,1
HCPCS,44128,ENTERECTOMY CONG ADD-ON,,,260.87,260.87,1
HCPCS,44128,ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS,1776.0,1154.4,176.3,1776.0,35
HCPCS,44128,Enterectomy cong add-on,,,2480.69,3133.5,6
HCPCS,441280,ENTERECTOMY CONG ADD-ON,,,260.87,260.87,1
HCPCS,44130,BOWEL TO BOWEL FUSION,,,1412.6,1412.6,1
HCPCS,44130,Bowel to bowel fusion,,,1250.66,1579.78,6
HCPCS,44130,ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX,8844.0,5748.6,643.71,8844.0,35
HCPCS,441300,BOWEL TO BOWEL FUSION,,,1412.6,1412.6,1
HCPCS,44132,ENTERECTOMY CADAVER DONOR,,,3742.41,3742.41,1
HCPCS,44132,Enterectomy cadaver donor,,,3411.14,4308.8,6
HCPCS,441320,ENTERECTOMY CADAVER DONOR,,,3742.41,3742.41,1
HCPCS,44133,ENTERECTOMY LIVE DONOR,,,6575.3,6575.3,1
HCPCS,44133,Enterectomy live donor,,,3411.14,4308.8,6
HCPCS,441330,ENTERECTOMY LIVE DONOR,,,6575.3,6575.3,1
HCPCS,44135,INTESTINE TRANSPLNT CADAVER,,,704.47,704.47,1
HCPCS,44135,Intestine transplnt cadaver,,,3411.14,4308.8,6
HCPCS,441350,INTESTINE TRANSPLNT CADAVER,,,704.47,704.47,1
HCPCS,44136,INTESTINE TRANSPLANT LIVE,,,8152.93,8152.93,1
HCPCS,44136,Intestine transplant live,,,3411.14,4308.8,6
HCPCS,441360,INTESTINE TRANSPLANT LIVE,,,8152.93,8152.93,1
HCPCS,44137,REMOVE INTESTINAL ALLOGRAFT,,,1250.64,1250.64,1
HCPCS,44137,Remove intestinal allograft,,,3411.14,4308.8,6
HCPCS,441370,REMOVE INTESTINAL ALLOGRAFT,,,1250.64,1250.64,1
HCPCS,44139,MOBILIZATION OF COLON,,,128.44,128.44,1
HCPCS,44139,MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT,892.0,579.8,91.41,892.0,35
HCPCS,44139,Mobilization of colon,,,2480.69,3133.5,6
HCPCS,441390,MOBILIZATION OF COLON,,,128.44,128.44,1
HCPCS,44140,COLECTOMY PARTIAL W ANASTOM,6339.0,4120.35,805.51,6572.0,70
HCPCS,44140,COLECTOMY PARTIAL W/ANASTOMOSIS,9036.0,5873.4,805.51,9036.0,35
HCPCS,44140,PARTIAL REMOVAL OF COLON,,,1439.91,1439.91,1
HCPCS,44140,Partial removal of colon,,,1250.66,1579.78,6
HCPCS,441400,PARTIAL REMOVAL OF COLON,,,1439.91,1439.91,1
HCPCS,44141,COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY,11964.0,7776.6,888.31,11964.0,35
HCPCS,44141,PARTIAL REMOVAL OF COLON,,,1938.93,1938.93,1
HCPCS,44141,Partial removal of colon,,,2480.69,3133.5,6
HCPCS,441410,PARTIAL REMOVAL OF COLON,,,1938.93,1938.93,1
HCPCS,44143,COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT,11116.0,7225.4,880.35,11116.0,35
HCPCS,44143,PARTIAL REMOVAL OF COLON,,,1768.24,1768.24,1
HCPCS,44143,Partial removal of colon,,,2480.69,3133.5,6
HCPCS,441430,PARTIAL REMOVAL OF COLON,,,1768.24,1768.24,1
HCPCS,44144,COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA,11964.0,7776.6,878.54,11964.0,35
HCPCS,44144,PARTIAL REMOVAL OF COLON,,,1887.82,1887.82,1
HCPCS,44144,Partial removal of colon,,,1250.66,1579.78,6
HCPCS,441440,PARTIAL REMOVAL OF COLON,,,1887.82,1887.82,1
HCPCS,44145,COLECTOMY PRTL W/COLOPROCTOSTOMY,11432.0,7430.8,990.73,11432.0,35
HCPCS,44145,COLECTOMY W COLOPROCTOSTOMY,7284.0,4734.6,990.73,7517.0,70
HCPCS,44145,PARTIAL REMOVAL OF COLON,,,1764.94,1764.94,1
HCPCS,44145,Partial removal of colon,,,2480.69,3133.5,6
HCPCS,441450,PARTIAL REMOVAL OF COLON,,,1764.94,1764.94,1
HCPCS,44146,COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY,14120.0,9178.0,1074.59,14120.0,35
HCPCS,44146,COLECTOMY W COLOSTOMY,8510.5,5531.825000000001,1074.59,9039.0,70
HCPCS,44146,PARTIAL REMOVAL OF COLON,,,2240.08,2240.08,1
HCPCS,44146,Partial removal of colon,,,2480.69,3133.5,6
HCPCS,441460,PARTIAL REMOVAL OF COLON,,,2240.08,2240.08,1
HCPCS,44147,COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH,13476.0,8759.4,941.74,13476.0,35
HCPCS,44147,PARTIAL REMOVAL OF COLON,,,2070.23,2070.23,1
HCPCS,44147,Partial removal of colon,,,1250.66,1579.78,6
HCPCS,441470,PARTIAL REMOVAL OF COLON,,,2070.23,2070.23,1
HCPCS,44150,COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS,12072.0,7846.8,983.56,12072.0,35
HCPCS,44150,REMOVAL OF COLON,,,1975.29,1975.29,1
HCPCS,44150,Removal of colon,,,2480.69,3133.5,6
HCPCS,441500,REMOVAL OF COLON,,,1975.29,1975.29,1
HCPCS,44151,COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST,13968.0,9079.2,1072.05,13968.0,35
HCPCS,44151,REMOVAL OF COLON/ILEOSTOMY,,,2301.94,2301.94,1
HCPCS,44151,Removal of colon/ileostomy,,,2480.69,3133.5,6
HCPCS,441510,REMOVAL OF COLON/ILEOSTOMY,,,2301.94,2301.94,1
HCPCS,44155,COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY,13768.0,8949.2,1122.73,13768.0,35
HCPCS,44155,REMOVAL OF COLON/ILEOSTOMY,,,2202.6,2202.6,1
HCPCS,44155,Removal of colon/ileostomy,,,2480.69,3133.5,6
HCPCS,441550,REMOVAL OF COLON/ILEOSTOMY,,,2202.6,2202.6,1
HCPCS,44156,COLECTOMY TOT ABDL W/PROCTECTOMY W/CONTNT ILEOST,14968.0,9729.2,1107.17,14968.0,35
HCPCS,44156,REMOVAL OF COLON/ILEOSTOMY,,,2460.95,2460.95,1
HCPCS,44156,Removal of colon/ileostomy,,,2480.69,3133.5,6
HCPCS,441560,REMOVAL OF COLON/ILEOSTOMY,,,2460.95,2460.95,1
HCPCS,44157,COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST,14280.0,9282.0,1212.32,14280.0,35
HCPCS,44157,COLECTOMY W/ILEOANAL ANAST,,,2340.79,2340.79,1
HCPCS,44157,Colectomy w/ileoanal anast,,,2480.69,3133.5,6
HCPCS,441570,COLECTOMY W/ILEOANAL ANAST,,,2340.79,2340.79,1
HCPCS,44158,COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR,14680.0,9542.0,1243.99,14680.0,35
HCPCS,44158,COLECTOMY W/NEO-RECTUM POUCH,,,2399.72,2399.72,1
HCPCS,44158,Colectomy w/neo-rectum pouch,,,2480.69,3133.5,6
HCPCS,441580,COLECTOMY W/NEO-RECTUM POUCH,,,2399.72,2399.72,1
HCPCS,44160,COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS,8356.0,5431.4,763.42,8356.0,35
HCPCS,44160,REMOVAL OF COLON,,,1331.58,1331.58,1
HCPCS,44160,Removal of colon,,,1250.66,1579.78,6
HCPCS,441600,REMOVAL OF COLON,,,1331.58,1331.58,1
HCPCS,44180,LAP ENTEROLYSIS,,,989.24,12649.85,16
HCPCS,44180,LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE,6108.0,3970.2,597.06,6108.0,35
HCPCS,44180,Lap enterolysis,,,2480.69,3133.5,6
HCPCS,441800,LAP ENTEROLYSIS,,,989.24,989.24,1
HCPCS,44186,LAP JEJUNOSTOMY,,,700.93,12649.85,15
HCPCS,44186,LAPAROSCOPY SURGICAL JEJUNOSTOMY,4152.0,2698.8,419.24,4152.0,35
HCPCS,44186,Lap jejunostomy,,,2480.69,3133.5,6
HCPCS,441860,LAP JEJUNOSTOMY,,,700.93,700.93,1
HCPCS,44187,LAP ILEO/JEJUNO-STOMY,,,1160.22,1160.22,1
HCPCS,44187,LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE,6960.0,4524.0,692.05,6960.0,35
HCPCS,44187,Lap ileo/jejuno-stomy,,,1250.66,1579.78,6
HCPCS,441870,LAP ILEO/JEJUNO-STOMY,,,1160.22,1160.22,1
HCPCS,44188,LAP COLOSTOMY,,,1293.86,1293.86,1
HCPCS,44188,LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY,7740.0,5031.0,759.44,7740.0,35
HCPCS,44188,Lap colostomy,,,2480.69,3133.5,6
HCPCS,441880,LAP COLOSTOMY,,,1293.86,1293.86,1
HCPCS,44202,LAP ENTERECTOMY,,,1487.46,1487.46,1
HCPCS,44202,LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA,9356.0,6081.4,954.14,9356.0,35
HCPCS,44202,Lap enterectomy,,,2480.69,3133.5,6
HCPCS,442020,LAP ENTERECTOMY,,,1487.46,1487.46,1
HCPCS,44203,LAP RESECT S/INTESTINE ADDL,,,257.04,257.04,1
HCPCS,44203,LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS,1776.0,1154.4,171.7,1776.0,35
HCPCS,44203,Lap resect s/intestine addl,,,2480.69,3133.5,6
HCPCS,442030,LAP RESECT S/INTESTINE ADDL,,,257.04,257.04,1
HCPCS,44204,LAPARO PARTIAL COLECTOMY,,,1641.85,1641.85,1
HCPCS,44204,LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS,10568.0,6869.2,985.77,10568.0,35
HCPCS,44204,Laparo partial colectomy,,,2480.69,3133.5,6
HCPCS,442040,LAPARO PARTIAL COLECTOMY,,,1641.85,1641.85,1
HCPCS,44205,LAP COLECTOMY PART W/ILEUM,,,1424.55,1424.55,1
HCPCS,44205,LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM,10098.0,6563.7,873.12,10098.0,35
HCPCS,44205,Lap colectomy part w/ileum,,,1250.66,1579.78,6
HCPCS,442050,LAP COLECTOMY PART W/ILEUM,,,1424.55,1424.55,1
HCPCS,44206,LAP PART COLECTOMY W/STOMA,,,1859.62,1859.62,1
HCPCS,44206,LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM,11916.0,7745.4,1014.46,11916.0,35
HCPCS,44206,Lap part colectomy w/stoma,,,2480.69,3133.5,6
HCPCS,442060,LAP PART COLECTOMY W/STOMA,,,1859.62,1859.62,1
HCPCS,44207,L COLECTOMY/COLOPROCTOSTOMY,,,1931.25,1931.25,1
HCPCS,44207,L colectomy/coloproctostomy,,,2480.69,3133.5,6
HCPCS,44207,LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST,14045.0,9129.25,1110.74,14045.0,35
HCPCS,442070,L COLECTOMY/COLOPROCTOSTOMY,,,1931.25,1931.25,1
HCPCS,44208,L COLECTOMY/COLOPROCTOSTOMY,,,2099.56,2099.56,1
HCPCS,44208,L colectomy/coloproctostomy,,,2480.69,3133.5,6
HCPCS,44208,LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST,14956.0,9721.4,1200.53,14956.0,35
HCPCS,442080,L COLECTOMY/COLOPROCTOSTOMY,,,2099.56,2099.56,1
HCPCS,44210,LAPARO TOTAL PROCTOCOLECTOMY,,,1882.01,1882.01,1
HCPCS,44210,LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS,12036.0,7823.4,1062.59,12036.0,35
HCPCS,44210,Laparo total proctocolectomy,,,2480.69,3133.5,6
HCPCS,442100,LAPARO TOTAL PROCTOCOLECTOMY,,,1882.01,1882.01,1
HCPCS,44211,LAP COLECTOMY W/PROCTECTOMY,,,2238.12,2238.12,1
HCPCS,44211,LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS,14832.0,9640.8,1319.57,14832.0,35
HCPCS,44211,Lap colectomy w/proctectomy,,,2480.69,3133.5,6
HCPCS,442110,LAP COLECTOMY W/PROCTECTOMY,,,2238.12,2238.12,1
HCPCS,44212,LAPARO TOTAL PROCTOCOLECTOMY,,,2147.72,2147.72,1
HCPCS,44212,LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY,13832.0,8990.8,1232.88,13832.0,35
HCPCS,44212,Laparo total proctocolectomy,,,2480.69,3133.5,6
HCPCS,442120,LAPARO TOTAL PROCTOCOLECTOMY,,,2147.72,2147.72,1
HCPCS,44213,LAP MOBIL SPLENIC FL ADD-ON,,,198.67,198.67,1
HCPCS,44213,LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY,1400.0,910.0,137.22,1400.0,35
HCPCS,44213,Lap mobil splenic fl add-on,,,2480.69,3133.5,6
HCPCS,442130,LAP MOBIL SPLENIC FL ADD-ON,,,198.67,198.67,1
HCPCS,44227,LAP CLOSE ENTEROSTOMY,,,1770.62,1770.62,1
HCPCS,44227,LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS,11448.0,7441.2,1075.29,11448.0,35
HCPCS,44227,Lap close enterostomy,,,2480.69,3133.5,6
HCPCS,442270,LAP CLOSE ENTEROSTOMY,,,1770.62,1770.62,1
HCPCS,44238,LAP CLOSURE OF ILEOSIGMOID FISTULA (COMP 44650),10048.0,6531.2,855.0,10048.0,16
HCPCS,44238,LAP COLECTOMY W/REMOVAL OF TI; NO ANASTOMOSIS W/ STOMA (COMP 442,10725.0,6971.25,855.0,10725.0,16
HCPCS,44238,LAP EXCISION OF CECUM W/O ANASTOMOSIS (COMP 44110),6037.0,3924.05,855.0,6037.0,16
HCPCS,44238,LAP EXCISION OF LARGE BOWEL LESION(S) (COMP 44110),5616.0,3650.4,855.0,5616.0,16
HCPCS,44238,LAP EXCISION SM BOWEL LESION,4739.0,3080.35,855.0,4739.0,16
HCPCS,44238,LAP GRAHAM PATCH INTESTINE (COMP 43840),8219.0,5342.35,855.0,8219.0,16
HCPCS,44238,"LAP REDUCE VOLVULUS,INTUSS,INTERNAL HERNIA (COMP 44050)",6674.0,4338.1,855.0,6674.0,16
HCPCS,44238,LAP REPAIR ENTEROCUTANEOUS FISTULA (COMP 44640),9680.0,6292.0,855.0,9680.0,16
HCPCS,44238,LAP REVISION COLOSTOMY W/RPR PARACOLOSTOMY HERNIA (COMP 44346),5035.0,3272.75,855.0,5035.0,16
HCPCS,44238,LAP REVISION OF ILEAL POUCH W/ RESECTION (COMP 46712),13123.0,8529.95,855.0,13123.0,16
HCPCS,44238,"LAP SUTURE OF LG INTESTINE, SINGLE/MULT (COMP 44604)",7264.0,4721.6,855.0,7264.0,16
HCPCS,44238,"LAP SUTURE OF SM INTESTINE, SINGLE (COMP 44602)",4495.0,2921.75,855.0,4495.0,16
HCPCS,44238,LAP/MALROTATION OF BOWEL,8044.0,5228.6,855.0,8044.0,16
HCPCS,44238,LAPAROSCOPIC BRAUN ENTEROENTEROSTOMY (COMP 44130),9507.0,6179.55,855.0,9507.0,16
HCPCS,44238,LAPAROSCOPIC CECOPEXY (COMP CODE 44680),6466.0,4202.9,855.0,6466.0,16
HCPCS,44238,LAPAROSCOPIC ENTEROENTEROSTOMY,5243.0,3407.95,855.0,5243.0,16
HCPCS,44238,LAPAROSCOPIC EXCISION SMALL BOWEL LESION/S (COMP 44110),6037.0,3924.05,855.0,6037.0,16
HCPCS,44238,LAPAROSCOPIC ILEOCOLOSTOMY PEXY (COMP 44312),3395.0,2206.75,855.0,3395.0,16
HCPCS,44238,LAPAROSCOPIC PARTIAL COLECTOMY WITHOUT ANASTOMOSIS (COMP CODE 44,11360.0,7384.0,855.0,11360.0,16
HCPCS,44238,LAPAROSCOPIC REMOVAL OF FOREIGN BODY; SMALL INTESTINE (COMP 4402,5840.0,3796.0,855.0,5840.0,16
HCPCS,44238,LAPAROSCOPIC STRICTUROPLASTY (COMP 44615),6538.0,4249.7,855.0,6538.0,16
HCPCS,44238,LAPARSCOPIC CLOSURE ENTEROCOLIC FISTULA (COMP 44650),10940.0,7111.0,855.0,10940.0,16
HCPCS,44238,LX EXCISION OF MECKEL'S DIVERTICULUM (COMP CODE 44800),4820.0,3133.0,855.0,4820.0,16
HCPCS,44238,"LX PROCTOSIGMOID, CAA, ILEOSTOMY",7104.0,4617.6,855.0,7104.0,16
HCPCS,44238,LX TAKEDOWN OF COLOVESICLE FIST W/RESECT (COMP CODE 44661),7924.0,5150.6,855.0,7924.0,16
HCPCS,44238,SUTURE OF MESENTERY (SEPARATE PROCEDURE) (COMP CODE 44850),4845.0,3149.25,855.0,4845.0,16
HCPCS,44238,"UNLIST LAP PROC, INTEST (EXC RECTUM) COMPARED TO 44050",4945.5,3214.575,855.0,5181.0,32
HCPCS,44238,"UNLIST LAP PROC, INTESTINE (EXCEPT RECTUM) (COMP CODE 44144)",9461.0,6149.65,855.0,9461.0,16
HCPCS,44238,UNLISTED LAP LADDS PROCEDURE (COMP CODE 44055),9227.0,5997.55,855.0,9227.0,16
HCPCS,44238,UNLISTED LAPAROSCOPIC COMPLETION PROCTECTOMY WITH ILEOANAL POUCH,13288.0,8637.2,855.0,13288.0,16
HCPCS,44238,"UNLISTED LAPAROSCOPIC PROCEDURE, INTESTINE (EXCEPT RECTUM)  (COM",6037.5,3924.375,855.0,7103.0,32
HCPCS,44238,UNLISTED LAPAROSCOPY PX INTESTINE XCP RECTUM,4308.0,2800.2,855.0,4308.0,16
HCPCS,44238,UNLISTED LAPS PX INTESTINE,,,5856.41,12649.85,15
HCPCS,44238,"UNLISTED PROC, LAP REPAIR OF DUODENAL PERFORATION (COMP TO 44602",9988.0,6492.2,855.0,9988.0,16
HCPCS,44238,UNLISTED PROC; LAP REVISION OF ILEOSTOMY; COMPLICATED (COMP TO 4,7198.0,4678.7,855.0,7198.0,16
HCPCS,44238,Unlisted laps px intestine,,,1250.66,1579.78,6
HCPCS,44300,OPEN BOWEL TO SKIN,,,905.26,2204.26,5
HCPCS,44300,Open bowel to skin,,,1250.66,1579.78,6
HCPCS,44300,PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN,5500.0,3575.0,430.1,5500.0,35
HCPCS,443000,OPEN BOWEL TO SKIN,,,905.26,905.26,1
HCPCS,44310,ILEOST/JEJUNO UNUSUAL PX,3764.0,2446.6,544.64,3764.0,35
HCPCS,44310,ILEOSTOMY OR JEJUNOSTOMY,4469.0,2904.85,544.64,4469.0,35
HCPCS,44310,ILEOSTOMY/JEJUNOSTOMY,,,1113.37,1113.37,1
HCPCS,44310,"ILEOSTOMY/JEJUNOSTOMY,NONTUBE",7740.0,5031.0,544.64,7740.0,35
HCPCS,44310,Ileostomy/jejunostomy,,,1250.66,1579.78,6
HCPCS,443100,ILEOSTOMY/JEJUNOSTOMY,,,1113.37,1113.37,1
HCPCS,44312,REVISION OF ILEOSTOMY,,,640.05,7937.59,16
HCPCS,44312,REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX,3772.0,2451.8,298.46,3772.0,35
HCPCS,44312,Revision of ileostomy,,,1250.66,1579.78,6
HCPCS,443120,REVISION OF ILEOSTOMY,,,640.05,640.05,1
HCPCS,44314,REVISION OF ILEOSTOMY,,,1074.24,4070.7,5
HCPCS,44314,REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX,6696.0,4352.4,517.43,6696.0,35
HCPCS,44314,Revision of ileostomy,,,1250.66,1579.78,6
HCPCS,443140,REVISION OF ILEOSTOMY,,,1074.24,1074.24,1
HCPCS,44316,CONTINENT ILEOSTOMY KOCK PROCEDURE SPX,9436.0,6133.4,715.56,9436.0,35
HCPCS,44316,DEVISE BOWEL POUCH,,,1522.61,1522.61,1
HCPCS,44316,Devise bowel pouch,,,1250.66,1579.78,6
HCPCS,443160,DEVISE BOWEL POUCH,,,1522.61,1522.61,1
HCPCS,44320,COLOSTOMY,,,1285.97,1285.97,1
HCPCS,44320,COLOSTOMY/SKIN LEVEL CECOSTOMY,7964.0,5176.6,614.1,7964.0,35
HCPCS,44320,Colostomy,,,2480.69,3133.5,6
HCPCS,443200,COLOSTOMY,,,1285.97,1285.97,1
HCPCS,44322,COLOSTOMY WITH BIOPSIES,,,1068.35,1068.35,1
HCPCS,44322,COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX,5328.0,3463.2,589.15,5328.0,35
HCPCS,44322,Colostomy with biopsies,,,1250.66,1579.78,6
HCPCS,443220,COLOSTOMY WITH BIOPSIES,,,1068.35,1068.35,1
HCPCS,44340,REVISION OF COLOSTOMY,,,674.35,7937.59,15
HCPCS,44340,REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX,3712.0,2412.8,306.57,3712.0,35
HCPCS,44340,Revision of colostomy,,,1250.66,1579.78,6
HCPCS,443400,REVISION OF COLOSTOMY,,,674.35,674.35,1
HCPCS,44345,REVISION OF COLOSTOMY,,,1124.37,4070.7,5
HCPCS,44345,REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX,6888.0,4477.2,537.01,6888.0,35
HCPCS,44345,Revision of colostomy,,,1250.66,1579.78,6
HCPCS,443450,REVISION OF COLOSTOMY,,,1124.37,1124.37,1
HCPCS,44346,REVISION OF COLOSTOMY,,,1265.82,4070.7,5
HCPCS,44346,REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX,7852.0,5103.8,600.93,7852.0,35
HCPCS,44346,Revision of colostomy,,,2480.69,3133.5,6
HCPCS,443460,REVISION OF COLOSTOMY,,,1265.82,1265.82,1
HCPCS,44360,ENDOSCOPY UPPER SMALL INTESTINE,5952.0,3868.7999999999997,107.94,9817.2,84
HCPCS,44360,SMALL BOWEL ENDOSCOPY,,,151.45,151.45,1
HCPCS,443600,SMALL BOWEL ENDOSCOPY,,,151.45,151.45,1
HCPCS,44361,ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY,6008.0,3905.2,120.0,9817.2,84
HCPCS,44361,SMALL BOWEL ENDOSCOPY/BIOPSY,,,166.86,166.86,1
HCPCS,443610,SMALL BOWEL ENDOSCOPY/BIOPSY,,,166.86,166.86,1
HCPCS,44363,ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY,6132.0,3985.7999999999997,144.51,9817.2,84
HCPCS,44363,SMALL BOWEL ENDOSCOPY,,,201.59,201.59,1
HCPCS,443630,SMALL BOWEL ENDOSCOPY,,,201.59,201.59,1
HCPCS,44364,ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE,6180.0,4017.0,154.22,9817.2,84
HCPCS,44364,SMALL BOWEL ENDOSCOPY,,,214.83,214.83,1
HCPCS,443640,SMALL BOWEL ENDOSCOPY,,,214.83,214.83,1
HCPCS,44365,ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY,6096.0,3962.4,137.62,9817.2,84
HCPCS,44365,SMALL BOWEL ENDOSCOPY,,,191.95,191.95,1
HCPCS,443650,SMALL BOWEL ENDOSCOPY,,,191.95,191.95,1
HCPCS,44366,ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING,6314.0,4104.1,180.77,9817.2,84
HCPCS,44366,SMALL BOWEL ENDOSCOPY,,,252.07,252.07,1
HCPCS,443660,SMALL BOWEL ENDOSCOPY,,,252.07,252.07,1
HCPCS,44369,ENTEROSCOPY > 2ND PRTN ABLTJ LESION,6336.0,4118.4,185.11,9817.2,84
HCPCS,44369,SMALL BOWEL ENDOSCOPY,,,258.2,258.2,1
HCPCS,443690,SMALL BOWEL ENDOSCOPY,,,258.2,258.2,1
HCPCS,44370,ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT,18052.5,11734.125,172.02,30806.1,119
HCPCS,44370,SMALL BOWEL ENDOSCOPY/STENT,,,280.67,280.67,1
HCPCS,443700,SMALL BOWEL ENDOSCOPY/STENT,,,280.67,280.67,1
HCPCS,44372,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,6314.0,4104.1,181.28,9817.2,84
HCPCS,44372,SMALL BOWEL ENDOSCOPY,,,252.39,252.39,1
HCPCS,443720,SMALL BOWEL ENDOSCOPY,,,252.39,252.39,1
HCPCS,44373,ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE,6132.0,3985.7999999999997,144.19,9817.2,84
HCPCS,44373,SMALL BOWEL ENDOSCOPY,,,201.4,201.4,1
HCPCS,443730,SMALL BOWEL ENDOSCOPY,,,201.4,201.4,1
HCPCS,44376,ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX,6484.0,4214.6,214.22,9817.2,84
HCPCS,44376,SMALL BOWEL ENDOSCOPY,,,298.34,298.34,1
HCPCS,443760,SMALL BOWEL ENDOSCOPY,,,298.34,298.34,1
HCPCS,44377,ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE,6538.0,4249.7,224.69,9817.2,84
HCPCS,44377,SMALL BOWEL ENDOSCOPY/BIOPSY,,,314.95,314.95,1
HCPCS,443770,SMALL BOWEL ENDOSCOPY/BIOPSY,,,314.95,314.95,1
HCPCS,44378,ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING,6858.0,4457.7,289.28,9817.2,84
HCPCS,44378,SMALL BOWEL ENDOSCOPY,,,404.4,404.4,1
HCPCS,443780,SMALL BOWEL ENDOSCOPY,,,404.4,404.4,1
HCPCS,44379,ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT,18586.5,12081.224999999999,267.68,30806.1,77
HCPCS,44379,S BOWEL ENDOSCOPE W/STENT,,,430.83,430.83,1
HCPCS,443790,S BOWEL ENDOSCOPE W/STENT,,,430.83,430.83,1
HCPCS,44380,ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD,2869.5,1865.175,44.39,7730.0,84
HCPCS,44380,SMALL BOWEL ENDOSCOPY BR/WA,,,60.46,60.46,1
HCPCS,443800,SMALL BOWEL ENDOSCOPY BR/WA,,,60.46,60.46,1
HCPCS,44381,ILEOSCOPY STOMA W/BALLOON DILATION,5730.0,3724.5,64.39,9817.2,79
HCPCS,44381,SMALL BOWEL ENDOSCOPY BR/WA,,,89.49,89.49,1
HCPCS,443810,SMALL BOWEL ENDOSCOPY BR/WA,,,89.49,89.49,1
HCPCS,44382,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,2929.5,1904.175,53.41,7730.0,84
HCPCS,44382,SMALL BOWEL ENDOSCOPY,,,77.99,77.99,1
HCPCS,443820,SMALL BOWEL ENDOSCOPY,,,77.99,77.99,1
HCPCS,44384,ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT,6024.0,3915.6,64.58,9817.2,72
HCPCS,44384,SMALL BOWEL ENDOSCOPY,,,161.19,161.19,1
HCPCS,443840,SMALL BOWEL ENDOSCOPY,,,161.19,161.19,1
HCPCS,44385,ENDOSCOPY OF BOWEL POUCH,,,77.17,77.17,1
HCPCS,44385,NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX,2885.5,1875.5749999999998,70.02,6317.0,133
HCPCS,443850,ENDOSCOPY OF BOWEL POUCH,,,77.17,77.17,1
HCPCS,44386,ENDOSCOPY BOWEL POUCH/BIOP,,,94.27,94.27,1
HCPCS,44386,NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE,5243.0,3407.95,86.14,6317.0,133
HCPCS,443860,ENDOSCOPY BOWEL POUCH/BIOP,,,94.27,94.27,1
HCPCS,44388,COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX,3165.5,2057.575,75.29,6317.0,84
HCPCS,44388,COLONOSCOPY THRU STOMA SPX,,,82.88,165.05,2
HCPCS,443880,COLONOSCOPY THRU STOMA SPX,,,165.05,165.05,1
HCPCS,4438853,COLONOSCOPY THRU STOMA SPX,,,82.88,82.88,1
HCPCS,44389,COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE,4054.5,2635.425,150.52,6317.0,84
HCPCS,44389,COLONOSCOPY WITH BIOPSY,,,181.02,181.02,1
HCPCS,443890,COLONOSCOPY WITH BIOPSY,,,181.02,181.02,1
HCPCS,44390,COLONOSCOPY FOR FOREIGN BODY,,,221.29,221.29,1
HCPCS,44390,COLONOSCOPY STOMA W/RMVL FOREIGN BODY,3369.5,2190.1749999999997,170.37,6317.0,84
HCPCS,443900,COLONOSCOPY FOR FOREIGN BODY,,,221.29,221.29,1
HCPCS,44391,COLONOSCOPY FOR BLEEDING,,,242.89,242.89,1
HCPCS,44391,COLONOSCOPY STOMA CONTROL BLEEDING,4214.0,2739.1,205.29,6317.0,84
HCPCS,443910,COLONOSCOPY FOR BLEEDING,,,242.89,242.89,1
HCPCS,44392,COLONOSCOPY & POLYPECTOMY,,,211.64,211.64,1
HCPCS,44392,COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS,4096.0,2662.4,178.14,6317.0,84
HCPCS,443920,COLONOSCOPY & POLYPECTOMY,,,211.64,211.64,1
HCPCS,44394,COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE,4196.0,2727.4,209.63,6317.0,84
HCPCS,44394,COLONOSCOPY W/SNARE,,,237.72,237.72,1
HCPCS,443940,COLONOSCOPY W/SNARE,,,237.72,237.72,1
HCPCS,44397,COLONOSCOPY STOMA W/TNDSC STENT PLMT,7670.0,4985.5,1288.56,6903.0,21
HCPCS,44401,COLONOSCOPY STOMA ABLATION LESION,4258.0,2767.7,199.26,6317.0,80
HCPCS,44401,COLONOSCOPY WITH ABLATION,,,254.97,254.97,1
HCPCS,444010,COLONOSCOPY WITH ABLATION,,,254.97,254.97,1
HCPCS,44402,COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT,18054.5,11735.425,196.86,30806.1,73
HCPCS,44402,COLONOSCOPY W/STENT PLCMT,,,275.02,275.02,1
HCPCS,444020,COLONOSCOPY W/STENT PLCMT,,,275.02,275.02,1
HCPCS,44403,COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ,4490.0,2918.5,228.77,6317.0,79
HCPCS,44403,COLONOSCOPY W/RESECTION,,,320.22,320.22,1
HCPCS,444030,COLONOSCOPY W/RESECTION,,,320.22,320.22,1
HCPCS,44404,COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION,3994.0,2596.1,164.86,6317.0,79
HCPCS,44404,COLONOSCOPY W/INJECTION,,,181.02,181.02,1
HCPCS,444040,COLONOSCOPY W/INJECTION,,,181.02,181.02,1
HCPCS,44405,COLONOSCOPY STOMA W/BALLOON DILATION,4036.0,2623.4,173.83,6317.0,79
HCPCS,44405,COLONOSCOPY W/DILATION,,,193.01,193.01,1
HCPCS,444050,COLONOSCOPY W/DILATION,,,193.01,193.01,1
HCPCS,44406,COLONOSCOPY STOMA W/ENDOSCOPIC ULTRASOUND EXAM,4210.0,2736.5,173.37,6317.0,79
HCPCS,44406,COLONOSCOPY W/ULTRASOUND,,,241.35,241.35,1
HCPCS,444060,COLONOSCOPY W/ULTRASOUND,,,241.35,241.35,1
HCPCS,44407,COLONOSCOPY STOMA W/US GID NDL ASPIR/BX,4382.0,2848.3,207.58,6317.0,79
HCPCS,44407,COLONOSCOPY W/NDL ASPIR/BX,,,289.38,289.38,1
HCPCS,444070,COLONOSCOPY W/NDL ASPIR/BX,,,289.38,289.38,1
HCPCS,44408,COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION,3449.5,2242.175,168.09,6317.0,80
HCPCS,44408,COLONOSCOPY W/DECOMPRESSION,,,243.49,243.49,1
HCPCS,444080,COLONOSCOPY W/DECOMPRESSION,,,243.49,243.49,1
HCPCS,44500,INTRO GASTROINTESTINAL TUBE,,,20.16,20.16,1
HCPCS,44500,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,2781.5,1807.9750000000001,14.55,6289.0,228
HCPCS,445000,INTRO GASTROINTESTINAL TUBE,,,20.16,20.16,1
HCPCS,4450F,SELF-CARE ED PROVIDED TO PT,,,0.01,0.01,1
HCPCS,4450F0,SELF-CARE ED PROVIDED TO PT,,,0.01,0.01,1
HCPCS,44602,ENTERORRHAPHY SINGLE PERFORATION,9888.0,6427.2,691.14,9888.0,35
HCPCS,44602,SUTURE SMALL INTESTINE,,,1510.73,4428.81,5
HCPCS,44602,Suture small intestine,,,2480.69,3133.5,6
HCPCS,446020,SUTURE SMALL INTESTINE,,,1510.73,1510.73,1
HCPCS,44603,ENTERORRHAPHY MULTIPLE PERFORATIONS,11264.0,7321.6,788.37,11264.0,35
HCPCS,44603,SUTURE SMALL INTESTINE,,,1733.49,1733.49,1
HCPCS,44603,Suture small intestine,,,1250.66,1579.78,6
HCPCS,446030,SUTURE SMALL INTESTINE,,,1733.49,1733.49,1
HCPCS,44604,SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY,7264.0,4721.6,606.28,7264.0,35
HCPCS,44604,SUTURE LARGE INTESTINE,,,1131.34,1131.34,1
HCPCS,44604,Suture large intestine,,,2480.69,3133.5,6
HCPCS,446040,SUTURE LARGE INTESTINE,,,1131.34,1131.34,1
HCPCS,44605,REPAIR OF BOWEL LESION,,,1379.69,1379.69,1
HCPCS,44605,Repair of bowel lesion,,,1250.66,1579.78,6
HCPCS,44605,SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY,8832.0,5740.8,679.15,8832.0,35
HCPCS,446050,REPAIR OF BOWEL LESION,,,1379.69,1379.69,1
HCPCS,44615,INTESTINAL STRICTUROPLASTY,,,1144.24,1144.24,1
HCPCS,44615,INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ,7264.0,4721.6,579.1,7264.0,35
HCPCS,44615,Intestinal stricturoplasty,,,2480.69,3133.5,6
HCPCS,446150,INTESTINAL STRICTUROPLASTY,,,1144.24,1144.24,1
HCPCS,44620,CLOSURE ENTEROSTOMY LG/SMALL INTESTINE,6349.0,4126.85,461.5,6349.0,35
HCPCS,44620,REPAIR BOWEL OPENING,,,924.71,924.71,1
HCPCS,44620,Repair bowel opening,,,1250.66,1579.78,6
HCPCS,446200,REPAIR BOWEL OPENING,,,924.71,924.71,1
HCPCS,44625,CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT,6912.0,4492.8,621.66,6912.0,35
HCPCS,44625,REPAIR BOWEL OPENING,,,1080.15,1080.15,1
HCPCS,44625,Repair bowel opening,,,1250.66,1579.78,6
HCPCS,446250,REPAIR BOWEL OPENING,,,1080.15,1080.15,1
HCPCS,44626,CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS,11160.0,7254.0,922.26,11160.0,35
HCPCS,44626,REPAIR BOWEL OPENING,,,1702.27,1702.27,1
HCPCS,44626,Repair bowel opening,,,2480.69,3133.5,6
HCPCS,446260,REPAIR BOWEL OPENING,,,1702.27,1702.27,1
HCPCS,44640,CLOSURE INTESTINAL CUTANEOUS FISTULA,9680.0,6292.0,731.72,9680.0,35
HCPCS,44640,REPAIR BOWEL-SKIN FISTULA,,,1494.58,1494.58,1
HCPCS,44640,Repair bowel-skin fistula,,,2480.69,3133.5,6
HCPCS,446400,REPAIR BOWEL-SKIN FISTULA,,,1494.58,1494.58,1
HCPCS,44650,CLSR ENTEROENTERIC/ENTEROCOLIC FSTL,10048.0,6531.2,760.16,10048.0,35
HCPCS,44650,REPAIR BOWEL FISTULA,,,1540.77,1540.77,1
HCPCS,44650,Repair bowel fistula,,,1250.66,1579.78,6
HCPCS,446500,REPAIR BOWEL FISTULA,,,1540.77,1540.77,1
HCPCS,44660,CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ,9564.0,6216.6,716.97,9564.0,35
HCPCS,44660,LAP CLOSURE OF ENTEROVESICAL FISTULA W/O RESECTION (COMP 44660),10281.0,6682.65,716.97,10281.0,35
HCPCS,44660,REPAIR BOWEL-BLADDER FISTULA,,,1435.78,1435.78,1
HCPCS,44660,Repair bowel-bladder fistula,,,1250.66,1579.78,6
HCPCS,446600,REPAIR BOWEL-BLADDER FISTULA,,,1435.78,1435.78,1
HCPCS,44661,CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ,10940.0,7111.0,822.93,10940.0,35
HCPCS,44661,REPAIR BOWEL-BLADDER FISTULA,,,1648.67,1648.67,1
HCPCS,44661,Repair bowel-bladder fistula,,,1250.66,1579.78,6
HCPCS,446610,REPAIR BOWEL-BLADDER FISTULA,,,1648.67,1648.67,1
HCPCS,44680,INTESTINAL PLICATION SEPARATE PROCEDURE,7184.0,4669.6,639.25,7184.0,35
HCPCS,44680,SURGICAL REVISION INTESTINE,,,1158.58,1158.58,1
HCPCS,44680,Surgical revision intestine,,,1250.66,1579.78,6
HCPCS,446800,SURGICAL REVISION INTESTINE,,,1158.58,1158.58,1
HCPCS,44700,EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS,6992.0,4544.8,696.14,6992.0,35
HCPCS,44700,SUSPEND BOWEL W/PROSTHESIS,,,1070.46,1070.46,1
HCPCS,44700,Suspend bowel w/prosthesis,,,1250.66,1579.78,6
HCPCS,447000,SUSPEND BOWEL W/PROSTHESIS,,,1070.46,1070.46,1
HCPCS,44701,INTRAOP COLON LAVAGE ADD-ON,,,181.69,181.69,1
HCPCS,44701,INTRAOPERATIVE COLONIC LAVAGE,1240.0,806.0,110.5,1240.0,35
HCPCS,44701,Intraop colon lavage add-on,,,2480.69,3133.5,6
HCPCS,447010,INTRAOP COLON LAVAGE ADD-ON,,,181.69,181.69,1
HCPCS,44705,PREPARE FECAL MICROBIOTA,,,76.13,76.13,1
HCPCS,44705,PREPARE FECAL MICROBIOTA FOR INSTILLATION,568.0,369.2,73.17,568.0,17
HCPCS,44705,Prepare fecal microbiota,,,181.25,228.95,6
HCPCS,447050,PREPARE FECAL MICROBIOTA,,,76.13,76.13,1
HCPCS,4470F,ICD COUNSELING PROVIDED,,,0.01,0.01,1
HCPCS,4470F0,ICD COUNSELING PROVIDED,,,0.01,0.01,1
HCPCS,44715,PREPARE DONOR INTESTINE,,,385.77,385.77,1
HCPCS,44715,Prepare donor intestine,,,3411.14,4308.8,6
HCPCS,447150,PREPARE DONOR INTESTINE,,,385.77,385.77,1
HCPCS,44720,PREP DONOR INTESTINE/VENOUS,,,292.97,292.97,1
HCPCS,44720,Prep donor intestine/venous,,,3411.14,4308.8,6
HCPCS,447200,PREP DONOR INTESTINE/VENOUS,,,292.97,292.97,1
HCPCS,44721,PREP DONOR INTESTINE/ARTERY,,,410.01,410.01,1
HCPCS,44721,Prep donor intestine/artery,,,3411.14,4308.8,6
HCPCS,447210,PREP DONOR INTESTINE/ARTERY,,,410.01,410.01,1
HCPCS,44799,BAE W/ENDOSCOPIC MUCOSAL RESECTION (COMP CODE 43254),1948.0,1266.2,147.38,1948.0,15
HCPCS,44799,CLOSING FISTULA (COMP 43255),2956.0,1921.4,830.64,6317.0,48
HCPCS,44799,CORRECTION OF GUT MALROTATION (EG. KAREEM'S PROCEDURE) - (COMP C,11020.0,7163.0,147.38,11020.0,15
HCPCS,44799,EGD THROUGH ARTIFICIAL STOMA (COMP 44369),1588.0,1032.2,147.38,1588.0,15
HCPCS,44799,EGD W/ CLIPPING OF INTESTINAL FISTULA (COMP 43255),1566.0,1017.9,147.38,1566.0,15
HCPCS,44799,ENDOSCOPIC SUBMUCOSAL DISSECTION OF SMALL INSTESTINE - (COMP COD,9356.0,6081.4,147.38,9356.0,15
HCPCS,44799,"ENDOVAC, SMALL INT; EGD (COMP 43235, 97605)",990.0,643.5,147.38,990.0,15
HCPCS,44799,"ENDOVAC, SMALL INT; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,147.38,1134.0,15
HCPCS,44799,"ENDOVAC, SMALL INT; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,147.38,2092.0,15
HCPCS,44799,"ENDOVAC, SMALL INT; POUCHOSCOPY (COMP 44385, 97605)",2203.0,1431.95,147.38,2203.0,15
HCPCS,44799,ENETROSC LOWER DEVICE (45380 COMP),3033.0,1971.45,852.27,6317.0,48
HCPCS,44799,ENTEROSCOPY W/DILATION (COMP CODE 43249),1148.0,746.2,147.38,1148.0,15
HCPCS,44799,ENTEROSCOPY W/SUBMUCOSAL INJECTION (COMP CODE 43236),2016.0,1310.4,147.38,2016.0,15
HCPCS,44799,ESD SMALL INTESTINE (COMP 44364),1452.0,943.8,147.38,1452.0,15
HCPCS,44799,ILEOSCOPY W/ CONTROL OF BLEEDING THROUGH THE STOMA (COMP 44378),3018.0,1961.7,147.38,3018.0,15
HCPCS,44799,"LOWER BAE, RETROGRADE, W/O FLUORO (COMP 45378)",1304.0,847.6,147.38,1304.0,15
HCPCS,44799,PERC JEJUNOSTOMY TUBE CHANGE,353.0,229.45,147.38,353.0,15
HCPCS,44799,POUCHOSCOPY W/ STENT PLACEMENT (COMP 44402),1693.0,1100.45,147.38,1693.0,15
HCPCS,44799,POUCHOSCOPY W/DECOMPRESSION (COMP 45393),2059.0,1338.35,147.38,2059.0,15
HCPCS,44799,POUCHOSCOPY W/INJECTION (COMP 44386),646.0,419.9,147.38,646.0,15
HCPCS,44799,POUCHOSCOPY W/SNARE (COMP 44386),1887.0,1226.55,147.38,1887.0,15
HCPCS,44799,POUCHOSCOPY W/STRICTUROTOMY/FISTULOTOMY (COMP 44386),600.0,390.0,147.38,600.0,15
HCPCS,44799,POUCHOSCOPY WITH DILATION (COMP 44386),600.0,390.0,147.38,600.0,15
HCPCS,44799,REPAIR DUODENAL FISTULA (COMP 44650),10801.0,7020.65,147.38,10801.0,15
HCPCS,44799,RETROGRADE ENTEROSCOPY SUBMUCOSAL INJECTION (COMP 45381),1308.0,850.2,147.38,1308.0,15
HCPCS,44799,RETROGRADE ENTEROSCOPY W/CONTROL OF BLEEDING (COMP 44378),2346.0,1524.9,147.38,2346.0,15
HCPCS,44799,RETROGRADE ENTEROSCOPY W/DILATION (COMP 45386),1659.0,1078.35,147.38,1659.0,15
HCPCS,44799,RETROGRADE SMALL INTESTINE ENTEROSCOPY W/BIOPSY (COMP 44377),2168.0,1409.2,147.38,2168.0,15
HCPCS,44799,REVISION JEJUNOJEJUNOSTOMY,2016.0,1310.4,147.38,2016.0,15
HCPCS,44799,REVISION OF ANASTOMOSIS (COMP 44125),8813.0,5728.45,147.38,8813.0,15
HCPCS,44799,REVISION OF JEJUNOSTOMY (COMP 44314),6696.0,4352.4,147.38,6696.0,15
HCPCS,44799,SMALL INTESTINE MYRIAD COLLAGEN MATRIX IMPLANT (COMP 15777),1315.0,854.75,147.38,1315.0,15
HCPCS,44799,UNLISTED PROCEDURE INTESTINE,4401.0,2860.65,664.0,6317.0,96
HCPCS,44799,"UNLISTED PROCEDURE, SMALL INTESTINE (COMPARISON CODE 15860)",780.0,507.0,147.38,780.0,15
HCPCS,44799,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 43236",2016.0,1310.4,147.38,2016.0,15
HCPCS,44799,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 44394",1732.0,1125.8,147.38,1732.0,15
HCPCS,44800,EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT,4820.0,3133.0,452.19,4820.0,35
HCPCS,44800,EXCISION OF BOWEL POUCH,,,834.67,834.67,1
HCPCS,44800,Excision of bowel pouch,,,1250.66,1579.78,6
HCPCS,448000,EXCISION OF BOWEL POUCH,,,834.67,834.67,1
HCPCS,4480F,PT RCVNG ACE/ARB B-BLOCKERTX,,,0.01,0.01,1
HCPCS,4480F0,PT RCVNG ACE/ARB B-BLOCKERTX,,,0.01,0.01,1
HCPCS,4481F,PT RCVNG ACE/ARB BLKER <3MOS,,,0.01,0.01,1
HCPCS,4481F0,PT RCVNG ACE/ARB BLKER <3MOS,,,0.01,0.01,1
HCPCS,44820,EXCISION LESION MESENTERY SEPARATE PROCEDURE,5492.0,3569.8,440.8,5492.0,35
HCPCS,44820,EXCISION OF MESENTERY LESION,,,917.17,917.17,1
HCPCS,44820,Excision of mesentery lesion,,,1250.66,1579.78,6
HCPCS,448200,EXCISION OF MESENTERY LESION,,,917.17,917.17,1
HCPCS,44850,REPAIR OF MESENTERY,,,804.29,804.29,1
HCPCS,44850,Repair of mesentery,,,1250.66,1579.78,6
HCPCS,44850,SUTURE MESENTERY SEPARATE PROCEDURE,4844.0,3148.6,416.35,4844.0,35
HCPCS,448500,REPAIR OF MESENTERY,,,804.29,804.29,1
HCPCS,44899,"UNLISTED PROCEDURE, MECKEL'S DIVERTICULUM AND THE MESENTERY (COM",5492.0,3569.8,576.65,5492.0,15
HCPCS,44899,Unlisted px meckel's dvrtclm,,,1250.66,1579.78,6
HCPCS,44900,I&D APPENDIX ABSCESS OPEN,,,844.18,844.18,1
HCPCS,44900,I&d appendix abscess open,,,1250.66,1579.78,6
HCPCS,44900,INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN,5028.0,3268.2,386.13,5028.0,35
HCPCS,449000,I&D APPENDIX ABSCESS OPEN,,,844.18,844.18,1
HCPCS,44950,APPENDECTOMY,4240.0,2756.0,352.33,13528.81,50
HCPCS,44950,Appendectomy,,,2480.69,3133.5,6
HCPCS,449500,APPENDECTOMY,,,691.68,691.68,1
HCPCS,44955,APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX,612.0,397.8,63.58,612.0,35
HCPCS,44955,APPENDECTOMY ADD-ON,,,89.36,89.36,1
HCPCS,44955,Appendectomy add-on,,,2290.02,2892.66,6
HCPCS,449550,APPENDECTOMY ADD-ON,,,89.36,89.36,1
HCPCS,44960,APPENDEC RPTD APPENDIX ABSC/PRITONITIS,5800.0,3770.0,456.57,5800.0,35
HCPCS,44960,APPENDECTOMY,,,943.81,943.81,1
HCPCS,44960,Appendectomy,,,2480.69,3133.5,6
HCPCS,449600,APPENDECTOMY,,,943.81,943.81,1
HCPCS,44970,LAPAROSCOPIC APPENDECTOMY,3780.0,2457.0,352.33,3780.0,35
HCPCS,44970,LAPAROSCOPY APPENDECTOMY,,,648.63,12649.85,19
HCPCS,44970,Laparoscopy appendectomy,,,2480.69,3133.5,6
HCPCS,449700,LAPAROSCOPY APPENDECTOMY,,,648.63,648.63,1
HCPCS,44979,LAP APPENDECTOMY AT TIME OTHER SURGERY (COMP CODE 44955),612.0,397.8,306.0,612.0,15
HCPCS,44979,UNLISTED LAPS PX APPENDIX,,,5856.41,12649.85,14
HCPCS,44979,UNLISTED PROC; LAP DRAINAGE OF APPENDICEAL ABSCESS W/DEBRIDEMENT,5405.0,3513.25,430.18,5405.0,15
HCPCS,44979,Unlisted laps px appendix,,,1250.66,1579.78,6
HCPCS,45000,DRAINAGE OF PELVIC ABSCESS,,,458.41,458.41,1
HCPCS,45000,TRANSRECTAL DRAINAGE OF PELVIC ABSCESS,4650.0,3022.5,209.42,36332.0,84
HCPCS,450000,DRAINAGE OF PELVIC ABSCESS,,,458.41,458.41,1
HCPCS,45005,DRAINAGE OF RECTAL ABSCESS,,,175.9,175.9,1
HCPCS,45005,I&D SUBMUCOSAL ABSCESS RECTUM,4056.0,2636.4,101.98,36332.0,182
HCPCS,450050,DRAINAGE OF RECTAL ABSCESS,,,175.9,175.9,1
HCPCS,4500F,REF TO OUTPT CARD REHAB PROG,,,0.01,0.01,1
HCPCS,4500F0,REF TO OUTPT CARD REHAB PROG,,,0.01,0.01,1
HCPCS,45020,DRAINAGE OF RECTAL ABSCESS,,,607.42,607.42,1
HCPCS,45020,I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC,5102.0,3316.3,280.92,8370.0,133
HCPCS,450200,DRAINAGE OF RECTAL ABSCESS,,,607.42,607.42,1
HCPCS,45100,BIOPSY OF RECTUM,,,323.21,323.21,1
HCPCS,45100,BX ANORECTAL WALL ANAL APPROACH,8692.5,5650.125,163.62,36332.0,84
HCPCS,451000,BIOPSY OF RECTUM,,,323.21,323.21,1
HCPCS,45108,ANORECTAL MYOMECTOMY,2048.0,1331.2,217.64,5945.95,50
HCPCS,45108,Anorectal myomectomy,,,1410.62,1781.83,6
HCPCS,451080,ANORECTAL MYOMECTOMY,,,402.06,402.06,1
HCPCS,4510F,PREV CARDREHAB QUALCARDEVENT,,,0.01,0.01,1
HCPCS,4510F0,PREV CARDREHAB QUALCARDEVENT,,,0.01,0.01,1
HCPCS,45110,PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST,12304.0,7997.6,1084.23,12304.0,35
HCPCS,45110,REMOVAL OF RECTUM,,,1931.97,1931.97,1
HCPCS,45110,Removal of rectum,,,1410.62,1781.83,6
HCPCS,451100,REMOVAL OF RECTUM,,,1931.97,1931.97,1
HCPCS,45111,PARTIAL REMOVAL OF RECTUM,,,1162.38,1162.38,1
HCPCS,45111,PRCTECT PRTL RESCJ RECTUM TABDL APPR,7204.0,4682.6,768.02,7204.0,35
HCPCS,45111,Partial removal of rectum,,,1410.62,1781.83,6
HCPCS,451110,PARTIAL REMOVAL OF RECTUM,,,1162.38,1162.38,1
HCPCS,45112,PRCTECT CMBN ABDOMINOPRNL PULL-THRU PX,13272.0,8626.8,1137.83,13272.0,35
HCPCS,45112,REMOVAL OF RECTUM,,,1926.66,1926.66,1
HCPCS,45112,Removal of rectum,,,1410.62,1781.83,6
HCPCS,451120,REMOVAL OF RECTUM,,,1926.66,1926.66,1
HCPCS,45113,PARTIAL PROCTECTOMY,,,1977.23,1977.23,1
HCPCS,45113,PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR,13288.0,8637.2,1135.51,13288.0,35
HCPCS,45113,Partial proctectomy,,,1410.62,1781.83,6
HCPCS,451130,PARTIAL PROCTECTOMY,,,1977.23,1977.23,1
HCPCS,45114,PARTIAL REMOVAL OF RECTUM,,,1953.24,1953.24,1
HCPCS,45114,PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH,12316.0,8005.4,1045.53,12316.0,35
HCPCS,45114,Partial removal of rectum,,,1410.62,1781.83,6
HCPCS,451140,PARTIAL REMOVAL OF RECTUM,,,1953.24,1953.24,1
HCPCS,45116,PARTIAL REMOVAL OF RECTUM,,,1640.95,1640.95,1
HCPCS,45116,PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY,11088.0,7207.2,865.3,11088.0,35
HCPCS,45116,Partial removal of rectum,,,1410.62,1781.83,6
HCPCS,451160,PARTIAL REMOVAL OF RECTUM,,,1640.95,1640.95,1
HCPCS,45119,PRCTECT CMBN PULL-THRU W/RSVR W/NTRSTM,13392.0,8704.8,1144.82,13392.0,35
HCPCS,45119,REMOVE RECTUM W/RESERVOIR,,,1992.0,1992.0,1
HCPCS,45119,Remove rectum w/reservoir,,,1410.62,1781.83,6
HCPCS,451190,REMOVE RECTUM W/RESERVOIR,,,1992.0,1992.0,1
HCPCS,45120,PRCTECT COMPL W/PULL-THRU PX & ANASTOMOSIS,10560.0,6864.0,1110.84,10560.0,35
HCPCS,45120,REMOVAL OF RECTUM,,,1720.35,1720.35,1
HCPCS,45120,Removal of rectum,,,1410.62,1781.83,6
HCPCS,451200,REMOVAL OF RECTUM,,,1720.35,1720.35,1
HCPCS,45121,PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS,11632.0,7560.8,1035.77,11632.0,35
HCPCS,45121,REMOVAL OF RECTUM AND COLON,,,1878.64,1878.64,1
HCPCS,45121,Removal of rectum and colon,,,1410.62,1781.83,6
HCPCS,451210,REMOVAL OF RECTUM AND COLON,,,1878.64,1878.64,1
HCPCS,45123,PARTIAL PROCTECTOMY,,,1185.61,1185.61,1
HCPCS,45123,PRCTECT PRTL W/O ANAST PRNL APPR,7544.0,4903.6,700.64,7544.0,35
HCPCS,45123,Partial proctectomy,,,1410.62,1781.83,6
HCPCS,451230,PARTIAL PROCTECTOMY,,,1185.61,1185.61,1
HCPCS,45126,PELVIC EXENTERATION,,,2922.03,2922.03,1
HCPCS,45126,PELVIC EXENTERATION COLORECTAL MALIGNANCY,19640.0,12766.0,1488.81,19640.0,35
HCPCS,45126,Pelvic exenteration,,,2290.02,2892.66,6
HCPCS,451260,PELVIC EXENTERATION,,,2922.03,2922.03,1
HCPCS,45130,EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH,7400.0,4810.0,618.81,7400.0,35
HCPCS,45130,EXCISION OF RECTAL PROLAPSE,,,1155.58,1155.58,1
HCPCS,45130,Excision of rectal prolapse,,,1410.62,1781.83,6
HCPCS,451300,EXCISION OF RECTAL PROLAPSE,,,1155.58,1155.58,1
HCPCS,45135,EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH,8944.0,5813.6,866.19,8944.0,35
HCPCS,45135,EXCISION OF RECTAL PROLAPSE,,,1377.67,1377.67,1
HCPCS,45135,Excision of rectal prolapse,,,1410.62,1781.83,6
HCPCS,451350,EXCISION OF RECTAL PROLAPSE,,,1377.67,1377.67,1
HCPCS,45136,EXC ILEOANAL RESVR W/ILEOSTMY,12328.0,8013.2,1110.88,12328.0,35
HCPCS,45136,EXCISE ILEOANAL RESERVIOR,,,1890.51,1890.51,1
HCPCS,45136,Excise ileoanal reservior,,,1410.62,1781.83,6
HCPCS,451360,EXCISE ILEOANAL RESERVIOR,,,1890.51,1890.51,1
HCPCS,45150,DIVISION STRICTURE RECTUM,2340.0,1521.0,254.08,2340.0,35
HCPCS,45150,EXCISION OF RECTAL STRICTURE,,,455.11,2556.44,15
HCPCS,45150,Excision of rectal stricture,,,1410.62,1781.83,6
HCPCS,451500,EXCISION OF RECTAL STRICTURE,,,455.11,455.11,1
HCPCS,45160,EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL,6532.0,4245.8,558.48,6532.0,35
HCPCS,45160,EXCISION OF RECTAL LESION,,,1104.28,5945.95,15
HCPCS,45160,Excision of rectal lesion,,,1410.62,1781.83,6
HCPCS,451600,EXCISION OF RECTAL LESION,,,1104.28,1104.28,1
HCPCS,45171,EXC RCT TUM NOT INCL MUSCULARIS PROPRIA,3252.0,2113.8,324.87,3252.0,35
HCPCS,45171,EXC RECT TUM TRANSANAL PART,,,654.48,5945.95,16
HCPCS,45171,Exc rect tum transanal part,,,1410.62,1781.83,6
HCPCS,451710,EXC RECT TUM TRANSANAL PART,,,654.48,654.48,1
HCPCS,45172,EXC RCT TUM INCL MUSCULARIS PROPRIA,4852.0,3153.8,448.69,4852.0,35
HCPCS,45172,EXC RECT TUM TRANSANAL FULL,,,876.0,5945.95,15
HCPCS,45172,Exc rect tum transanal full,,,1410.62,1781.83,6
HCPCS,451720,EXC RECT TUM TRANSANAL FULL,,,876.0,876.0,1
HCPCS,45190,DESTRUCTION RECTAL TUMOR,,,741.59,5945.95,15
HCPCS,45190,DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH,4168.0,2709.2,363.57,4168.0,35
HCPCS,45190,Destruction rectal tumor,,,1410.62,1781.83,6
HCPCS,451900,DESTRUCTION RECTAL TUMOR,,,741.59,741.59,1
HCPCS,4525F,NEUROPSYCHIA INTERVEN ORDER,,,0.01,0.01,1
HCPCS,4525F0,NEUROPSYCHIA INTERVEN ORDER,,,0.01,0.01,1
HCPCS,4526F,NEUROPSYCHIA INTERVEN RCVD,,,0.01,0.01,1
HCPCS,4526F0,NEUROPSYCHIA INTERVEN RCVD,,,0.01,0.01,1
HCPCS,45300,PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX,2781.5,1807.975,41.06,4718.7,84
HCPCS,45300,PROCTOSIGMOIDOSCOPY DX,,,51.3,51.3,1
HCPCS,453000,PROCTOSIGMOIDOSCOPY DX,,,51.3,51.3,1
HCPCS,45303,PROCTOSGMDSC RIGID W/DILATION,560.0,364.0,40.94,1609.5,35
HCPCS,45303,PROCTOSIGMOIDOSCOPY DILATE,,,91.16,2556.44,15
HCPCS,45303,Proctosigmoidoscopy dilate,,,1275.65,1611.35,6
HCPCS,453030,PROCTOSIGMOIDOSCOPY DILATE,,,91.16,91.16,1
HCPCS,45305,PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE,460.0,299.0,53.71,345.0,35
HCPCS,45305,PROCTOSIGMOIDOSCOPY W/BX,,,77.47,2556.44,15
HCPCS,45305,Proctosigmoidoscopy w/bx,,,605.04,764.26,6
HCPCS,453050,PROCTOSIGMOIDOSCOPY W/BX,,,77.47,77.47,1
HCPCS,45307,PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY,640.0,416.0,53.43,480.0,35
HCPCS,45307,PROCTOSIGMOIDOSCOPY FB,,,107.57,5945.95,15
HCPCS,45307,Proctosigmoidoscopy fb,,,605.04,764.26,6
HCPCS,453070,PROCTOSIGMOIDOSCOPY FB,,,107.57,107.57,1
HCPCS,45308,PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY,8144.5,5293.925,47.51,14192.1,84
HCPCS,45308,PROCTOSIGMOIDOSCOPY REMOVAL,,,90.61,90.61,1
HCPCS,453080,PROCTOSIGMOIDOSCOPY REMOVAL,,,90.61,90.61,1
HCPCS,45309,PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ,560.0,364.0,81.82,420.0,35
HCPCS,45309,PROCTOSIGMOIDOSCOPY REMOVAL,,,96.04,2556.44,15
HCPCS,45309,Proctosigmoidoscopy removal,,,605.04,764.26,6
HCPCS,453090,PROCTOSIGMOIDOSCOPY REMOVAL,,,96.04,96.04,1
HCPCS,45315,PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE,680.0,442.0,75.67,510.0,35
HCPCS,45315,PROCTOSIGMOIDOSCOPY REMOVAL,,,113.37,2556.44,15
HCPCS,45315,Proctosigmoidoscopy removal,,,605.04,764.26,6
HCPCS,453150,PROCTOSIGMOIDOSCOPY REMOVAL,,,113.37,113.37,1
HCPCS,45317,PROCTOSGMDSC RIGID CONTROL BLEEDING,760.0,494.0,103.41,570.0,35
HCPCS,45317,PROCTOSIGMOIDOSCOPY BLEED,,,118.12,2556.44,15
HCPCS,45317,Proctosigmoidoscopy bleed,,,1275.65,1611.35,6
HCPCS,453170,PROCTOSIGMOIDOSCOPY BLEED,,,118.12,118.12,1
HCPCS,45320,PROCTOSGMDSC RIGID ABLATION LESION,672.0,436.8,80.86,504.0,35
HCPCS,45320,PROCTOSIGMOIDOSCOPY ABLATE,,,112.26,5945.95,15
HCPCS,45320,Proctosigmoidoscopy ablate,,,1275.65,1611.35,6
HCPCS,453200,PROCTOSIGMOIDOSCOPY ABLATE,,,112.26,112.26,1
HCPCS,45321,PROCTOSGMDSC RIGID DCMPRN VOLVULUS,660.0,429.0,64.89,660.0,35
HCPCS,45321,PROCTOSIGMOIDOSCOPY VOLVUL,,,110.82,5945.95,15
HCPCS,45321,Proctosigmoidoscopy volvul,,,1275.65,1611.35,6
HCPCS,453210,PROCTOSIGMOIDOSCOPY VOLVUL,,,110.82,110.82,1
HCPCS,45327,PROCTOSIGMOIDOSCOPY W/STENT,,,125.27,12906.67,15
HCPCS,45327,Proctosigmoidoscopy w/stent,,,1275.65,1611.35,6
HCPCS,453270,PROCTOSIGMOIDOSCOPY W/STENT,,,125.27,125.27,1
HCPCS,45330,DIAGNOSTIC SIGMOIDOSCOPY,,,59.73,59.73,1
HCPCS,45330,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,2806.5,1824.225,49.8,4718.7,133
HCPCS,453300,DIAGNOSTIC SIGMOIDOSCOPY,,,59.73,59.73,1
HCPCS,45331,SIGMOIDOSCOPY AND BIOPSY,,,76.22,76.22,1
HCPCS,45331,SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,2872.5,1867.125,60.33,6289.0,133
HCPCS,453310,SIGMOIDOSCOPY AND BIOPSY,,,76.22,76.22,1
HCPCS,45332,SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY,3777.0,2455.05,92.42,6289.0,84
HCPCS,45332,SIGMOIDOSCOPY W/FB REMOVAL,,,111.38,111.38,1
HCPCS,453320,SIGMOIDOSCOPY W/FB REMOVAL,,,111.38,111.38,1
HCPCS,45333,SIGMOIDOSCOPY & POLYPECTOMY,,,99.67,99.67,1
HCPCS,45333,SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,2962.5,1925.625,88.34,6289.0,84
HCPCS,453330,SIGMOIDOSCOPY & POLYPECTOMY,,,99.67,99.67,1
HCPCS,45334,SIGMOIDOSCOPY FLX CONTROL BLEEDING,3830.0,2489.5,112.81,7730.0,84
HCPCS,45334,SIGMOIDOSCOPY FOR BLEEDING,,,123.85,123.85,1
HCPCS,453340,SIGMOIDOSCOPY FOR BLEEDING,,,123.85,123.85,1
HCPCS,45335,SGMDSC FLX DIRED SBMCSL NJX ANY SBST,2850.5,1852.8249999999998,63.45,6289.0,84
HCPCS,45335,SIGMOIDOSCOPY W/SUBMUC INJ,,,70.5,70.5,1
HCPCS,453350,SIGMOIDOSCOPY W/SUBMUC INJ,,,70.5,70.5,1
HCPCS,45337,SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE,3083.5,2004.2749999999999,86.55,6289.0,84
HCPCS,45337,SIGMOIDOSCOPY & DECOMPRESS,,,120.97,120.97,1
HCPCS,453370,SIGMOIDOSCOPY & DECOMPRESS,,,120.97,120.97,1
HCPCS,45338,SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,3841.0,2496.65,114.83,6289.0,84
HCPCS,45338,SIGMOIDOSCOPY W/TUMR REMOVE,,,126.78,126.78,1
HCPCS,453380,SIGMOIDOSCOPY W/TUMR REMOVE,,,126.78,126.78,1
HCPCS,45339,SIGMOIDOSCOPY FLX ABLTJ LESION,2676.0,1739.4,449.57,2408.4,21
HCPCS,45340,SIG W/TNDSC BALLOON DILATION,,,82.72,82.72,1
HCPCS,45340,SIGMOIDOSCOPY FLX TNDSC BALO DILAT,3665.0,2382.25,75.29,7730.0,133
HCPCS,453400,SIG W/TNDSC BALLOON DILATION,,,82.72,82.72,1
HCPCS,45341,SIGMOIDOSCOPY FLX NDSC US XM,3088.0,2007.1999999999998,93.96,6289.0,84
HCPCS,45341,SIGMOIDOSCOPY W/ULTRASOUND,,,130.64,130.64,1
HCPCS,453410,SIGMOIDOSCOPY W/ULTRASOUND,,,130.64,130.64,1
HCPCS,45342,SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX,4045.5,2629.575,128.68,7730.0,84
HCPCS,45342,SIGMOIDOSCOPY W/US GUIDE BX,,,179.88,179.88,1
HCPCS,453420,SIGMOIDOSCOPY W/US GUIDE BX,,,179.88,179.88,1
HCPCS,45345,SIGMOIDOSCOPY FLX TNDSC STENT PLMT,7670.0,4985.5,1288.56,6903.0,21
HCPCS,45346,SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES,4008.0,2605.2,133.83,7730.0,80
HCPCS,45346,SIGMOIDOSCOPY W/ABLATION,,,169.08,169.08,1
HCPCS,453460,SIGMOIDOSCOPY W/ABLATION,,,169.08,169.08,1
HCPCS,45347,SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT,34229.0,22248.85,184.21,30806.1,42
HCPCS,45347,SIGMOIDOSCOPY W/PLACEMENT OF STENT,1197.0,778.05,116.43,1197.0,31
HCPCS,45347,SIGMOIDOSCOPY W/PLCMT STENT,,,162.35,162.35,1
HCPCS,453470,SIGMOIDOSCOPY W/PLCMT STENT,,,162.35,162.35,1
HCPCS,45349,SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION,8659.0,5628.35,135.43,14192.1,79
HCPCS,45349,SIGMOIDOSCOPY W/RESECTION,,,208.41,208.41,1
HCPCS,453490,SIGMOIDOSCOPY W/RESECTION,,,208.41,208.41,1
HCPCS,45350,SGMDSC W/BAND LIGATION,,,106.73,106.73,1
HCPCS,45350,SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S),3759.5,2443.675,98.4,7730.0,79
HCPCS,453500,SGMDSC W/BAND LIGATION,,,106.73,106.73,1
HCPCS,45378,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,3338.5,2170.025,55.82,6317.0,167
HCPCS,45378,COLONOSCPY FLX DX,1648.0,1071.2,88.77,1236.0,35
HCPCS,45378,COLONOSCPY FLX DX DISCONT,592.0,384.8,88.77,657.34,35
HCPCS,45378,DIAGNOSTIC COLONOSCOPY,,,97.46,194.58,2
HCPCS,453780,DIAGNOSTIC COLONOSCOPY,,,194.58,194.58,1
HCPCS,4537853,DIAGNOSTIC COLONOSCOPY,,,97.46,97.46,1
HCPCS,45379,COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S),4331.5,2815.475,220.88,6317.0,84
HCPCS,45379,COLONOSCOPY W/FB REMOVAL,,,251.14,251.14,1
HCPCS,453790,COLONOSCOPY W/FB REMOVAL,,,251.14,251.14,1
HCPCS,45380,COLONOSCOPY AND BIOPSY,,,211.35,211.35,1
HCPCS,45380,COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,4173.0,2712.45,190.59,6317.0,133
HCPCS,453800,COLONOSCOPY AND BIOPSY,,,211.35,211.35,1
HCPCS,45381,COLONOSCOPY SUBMUCOUS NJX,,,211.01,211.01,1
HCPCS,45381,COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST,4173.0,2712.45,190.59,6317.0,133
HCPCS,453810,COLONOSCOPY SUBMUCOUS NJX,,,211.01,211.01,1
HCPCS,45382,COLONOSCOPY W/CONTROL BLEED,,,272.22,272.22,1
HCPCS,45382,COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD,4322.0,2809.3,242.25,6317.0,84
HCPCS,453820,COLONOSCOPY W/CONTROL BLEED,,,272.22,272.22,1
HCPCS,45383,COLSC FLX PROX SPLENIC FLXR ABLTJ LES,2636.0,1713.4,442.85,2372.4,21
HCPCS,45384,COLONOSCOPY W/LESION REMOVAL,,,241.21,241.21,1
HCPCS,45384,COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,4204.0,2732.6,220.27,6317.0,84
HCPCS,453840,COLONOSCOPY W/LESION REMOVAL,,,241.21,241.21,1
HCPCS,45385,COLONOSCOPY W/LESION REMOVAL,,,267.63,267.63,1
HCPCS,45385,COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,4395.5,2857.075,239.15,6317.0,133
HCPCS,453850,COLONOSCOPY W/LESION REMOVAL,,,267.63,267.63,1
HCPCS,45386,COLONOSCOPY W/BALLOON DILAT,,,223.24,223.24,1
HCPCS,45386,COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT,4219.5,2742.675,200.9,6317.0,84
HCPCS,453860,COLONOSCOPY W/BALLOON DILAT,,,223.24,223.24,1
HCPCS,45387,COLSC FLX PROX SPLENIC FLXR TNDSC STENT PLMT,7670.0,4985.5,1288.56,6903.0,21
HCPCS,45388,COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES,4463.5,2901.275,93.68,6317.0,80
HCPCS,45388,COLONOSCOPY W/ABLATION,,,284.99,284.99,1
HCPCS,453880,COLONOSCOPY W/ABLATION,,,284.99,284.99,1
HCPCS,45389,COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT,18162.5,11805.625,218.05,30806.1,73
HCPCS,45389,COLONOSCOPY W/STENT PLCMT,,,304.87,304.87,1
HCPCS,453890,COLONOSCOPY W/STENT PLCMT,,,304.87,304.87,1
HCPCS,45390,COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION,9092.5,5910.125,250.22,14192.1,80
HCPCS,45390,COLONOSCOPY W/RESECTION,,,349.97,349.97,1
HCPCS,453900,COLONOSCOPY W/RESECTION,,,349.97,349.97,1
HCPCS,45391,COLONOSCOPY W/ENDOSCOPE US,,,271.11,271.11,1
HCPCS,45391,COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX,4318.0,2806.7,194.3,6317.0,133
HCPCS,453910,COLONOSCOPY W/ENDOSCOPE US,,,271.11,271.11,1
HCPCS,45392,COLONOSCOPY W/ENDOSCOPIC FNB,,,320.22,320.22,1
HCPCS,45392,COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL,4490.0,2918.5,229.03,6317.0,84
HCPCS,453920,COLONOSCOPY W/ENDOSCOPIC FNB,,,320.22,320.22,1
HCPCS,45393,COLONOSCOPY FLEXIBLE WITH DECOMPRESSION,4419.5,2872.675,189.45,6317.0,80
HCPCS,45393,COLONOSCOPY W/DECOMPRESSION,,,265.54,265.54,1
HCPCS,453930,COLONOSCOPY W/DECOMPRESSION,,,265.54,265.54,1
HCPCS,45395,LAP REMOVAL OF RECTUM,,,2078.59,2078.59,1
HCPCS,45395,LAPS PROCTECTOMY ABDOMINOPERINEAL W/COLOSTOMY,13200.0,8580.0,1267.19,13200.0,35
HCPCS,45395,Lap removal of rectum,,,1410.62,1781.83,6
HCPCS,453950,LAP REMOVAL OF RECTUM,,,2078.59,2078.59,1
HCPCS,45397,LAP REMOVE RECTUM W/POUCH,,,2249.67,2249.67,1
HCPCS,45397,LAPS PROCTECTOMY COMBINED PULL-THRU W/RESERVOIR,14600.0,9490.0,1377.88,14600.0,35
HCPCS,45397,Lap remove rectum w/pouch,,,1410.62,1781.83,6
HCPCS,453970,LAP REMOVE RECTUM W/POUCH,,,2249.67,2249.67,1
HCPCS,45398,COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S),4230.0,2749.5,183.11,6317.0,80
HCPCS,45398,COLONOSCOPY W/BAND LIGATION,,,248.69,248.69,1
HCPCS,453980,COLONOSCOPY W/BAND LIGATION,,,248.69,248.69,1
HCPCS,45399,DILATION OF COLOSTOMY (COMP 57800),308.0,200.2,154.0,878.18,15
HCPCS,45399,EDOSCOPIC STRICTUROTOMY (COMP 46700),4218.0,2741.7,731.82,4218.0,15
HCPCS,45399,ENDOSCOPIC DEFECT CLOSURE (COMP CODE 44604),7808.0,5075.2,731.82,7808.0,15
HCPCS,45399,ENDOSCOPIC SUBMUCOSAL DISSECTION OF COLON - (COMP CODE 44204),10568.0,6869.2,731.82,10568.0,15
HCPCS,45399,"ENDOVAC, COLON; COLONOSCOPY (COMP 45378, 97605)",1639.0,1065.35,731.82,1639.0,15
HCPCS,45399,"ENDOVAC, COLON; COLONOSCOPY VIA STOMA (COMP 45388, 97605)",2336.0,1518.4,731.82,2336.0,15
HCPCS,45399,"ENDOVAC, COLON; FLEX-SIG (COMP 45330, 97605)",599.0,389.35,299.5,878.18,15
HCPCS,45399,ESD COLON (COMP 45390),2416.0,1570.4,731.82,2416.0,15
HCPCS,45399,OPEN RESECTION OF CECUM W/O ANASTOMOSIS (COMP 44110),5055.0,3285.75,731.82,5055.0,15
HCPCS,45399,SERIAL TRANVERSE COLOPLASTY (COMP 44604),6538.0,4249.7,731.82,6538.0,15
HCPCS,45399,UNLISTED PROCEDURE COLON,2156.0,1401.4,605.04,2932.0,41
HCPCS,45400,LAPAROSCOPIC PROC,,,1206.24,1206.24,1
HCPCS,45400,LAPAROSCOPY PROCTOPEXY PROLAPSE,7776.0,5054.4,740.5,7776.0,35
HCPCS,45400,Laparoscopic proc,,,1410.62,1781.83,6
HCPCS,454000,LAPAROSCOPIC PROC,,,1206.24,1206.24,1
HCPCS,45402,LAP PROCTOPEXY W/SIG RESECT,,,1616.8,1616.8,1
HCPCS,45402,LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ,10604.0,6892.6,1004.65,10604.0,35
HCPCS,45402,Lap proctopexy w/sig resect,,,1410.62,1781.83,6
HCPCS,454020,LAP PROCTOPEXY W/SIG RESECT,,,1616.8,1616.8,1
HCPCS,4540F,DISEASE MODIF PHARMACOTHXPY,,,0.01,0.01,1
HCPCS,4540F0,DISEASE MODIF PHARMACOTHXPY,,,0.01,0.01,1
HCPCS,4541F,PT OFFERED TX FOR PSEUDOBULB,,,0.01,0.01,1
HCPCS,4541F0,PT OFFERED TX FOR PSEUDOBULB,,,0.01,0.01,1
HCPCS,45499,LAP COMPLETE PROCTECTOMY W/WO COLOANAL ANASTOMOSIS (COMP 45112),14267.0,9273.55,892.83,14267.0,15
HCPCS,45499,LAP EXCISION  RETRORECTAL MASS/TUMOR (COMP 45172),6239.0,4055.35,892.83,6239.0,15
HCPCS,45499,LAP PARTIAL PROCTECTOMY (COMP 45111),7744.0,5033.6,892.83,7744.0,15
HCPCS,45499,LAPAROSCOPE PROC RECTUM,,,5856.41,12649.85,14
HCPCS,45499,LAPAROSCOPIC ABDOMINAL PERINEAL EXCISION OF ILEAL J POUCH (COMP,12328.0,8013.2,892.83,12328.0,15
HCPCS,45499,LX COMP. PROC. IPAA +-ILEOSTOMY (COMP CODE 44211),14832.0,9640.8,892.83,14832.0,15
HCPCS,45499,Laparoscope proc rectum,,,901.17,1138.32,6
HCPCS,45499,UNLISTED LAP SWENSON PROCEDURE (COMP CODE 45120),10560.0,6864.0,892.83,10560.0,15
HCPCS,45500,PROCTOPLASTY STENOSIS,3092.0,2009.8,357.31,3092.0,35
HCPCS,45500,REPAIR OF RECTUM,,,609.42,5945.95,15
HCPCS,45500,Repair of rectum,,,1410.62,1781.83,6
HCPCS,455000,REPAIR OF RECTUM,,,609.42,609.42,1
HCPCS,45505,PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE,3344.0,2173.6,325.59,3344.0,35
HCPCS,45505,REPAIR OF RECTUM,,,640.18,5945.95,15
HCPCS,45505,Repair of rectum,,,1410.62,1781.83,6
HCPCS,455050,REPAIR OF RECTUM,,,640.18,640.18,1
HCPCS,4550F,NONINVAS RESP SUPPORT TALK,,,0.01,0.01,1
HCPCS,4550F0,NONINVAS RESP SUPPORT TALK,,,0.01,0.01,1
HCPCS,4551F,NUTRITIONAL SUPPORT OFFERED,,,0.01,0.01,1
HCPCS,4551F0,NUTRITIONAL SUPPORT OFFERED,,,0.01,0.01,1
HCPCS,45520,PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE,220.0,143.0,34.34,264.32,35
HCPCS,45520,TREATMENT OF RECTAL PROLAPSE,,,42.87,1976.74,15
HCPCS,45520,Treatment of rectal prolapse,,,901.17,1138.32,6
HCPCS,455200,TREATMENT OF RECTAL PROLAPSE,,,42.87,42.87,1
HCPCS,4552F,PT REF FOR SPEECH LANG PATH,,,0.01,0.01,1
HCPCS,4552F0,PT REF FOR SPEECH LANG PATH,,,0.01,0.01,1
HCPCS,4553F,PT ASST RE END LIFE ISSUES,,,0.01,0.01,1
HCPCS,4553F0,PT ASST RE END LIFE ISSUES,,,0.01,0.01,1
HCPCS,45540,CORRECT RECTAL PROLAPSE,,,1119.16,1119.16,1
HCPCS,45540,Correct rectal prolapse,,,1410.62,1781.83,6
HCPCS,45540,PROCTOPEXY ABDOMINAL APPROACH,7248.0,4711.2,616.73,7248.0,35
HCPCS,455400,CORRECT RECTAL PROLAPSE,,,1119.16,1119.16,1
HCPCS,45541,CORRECT RECTAL PROLAPSE,,,1000.17,6040.0,16
HCPCS,45541,Correct rectal prolapse,,,1410.62,1781.83,6
HCPCS,45541,PROCTOPEXY PERINEAL APPROACH,5940.0,3861.0,555.44,5940.0,35
HCPCS,455410,CORRECT RECTAL PROLAPSE,,,1000.17,1000.17,1
HCPCS,4554F,PT RECVD INHAL ANESTHETIC,,,0.01,0.01,1
HCPCS,4554F0,PT RECVD INHAL ANESTHETIC,,,0.01,0.01,1
HCPCS,45550,PROCTOPEXY W/SIGMOID RESCJ ABDL APPR,9920.0,6448.0,802.37,9920.0,35
HCPCS,45550,REPAIR RECTUM/REMOVE SIGMOID,,,1546.16,1546.16,1
HCPCS,45550,Repair rectum/remove sigmoid,,,1410.62,1781.83,6
HCPCS,455500,REPAIR RECTUM/REMOVE SIGMOID,,,1546.16,1546.16,1
HCPCS,4555F,PT RECVD NO INHAL ANESTHIC,,,0.01,0.01,1
HCPCS,4555F0,PT RECVD NO INHAL ANESTHIC,,,0.01,0.01,1
HCPCS,45560,REPAIR OF RECTOCELE,,,739.65,5945.95,15
HCPCS,45560,REPAIR RECTOCELE SEPARATE PROCEDURE,4600.0,2990.0,367.28,4600.0,35
HCPCS,45560,Repair of rectocele,,,1410.62,1781.83,6
HCPCS,455600,REPAIR OF RECTOCELE,,,739.65,739.65,1
HCPCS,45562,EXPL RPR & PRESACRAL DRG RECTAL INJURY,7192.0,4674.8,557.87,7192.0,35
HCPCS,45562,EXPLORATION/REPAIR OF RECTUM,,,1252.56,1252.56,1
HCPCS,45562,Exploration/repair of rectum,,,1410.62,1781.83,6
HCPCS,455620,EXPLORATION/REPAIR OF RECTUM,,,1252.56,1252.56,1
HCPCS,45563,EXPL RPR & PRESACRAL DRG RECTAL INJ W/COLOSTOMY,10552.0,6858.8,845.16,10552.0,35
HCPCS,45563,EXPLORATION/REPAIR OF RECTUM,,,1776.07,1776.07,1
HCPCS,45563,Exploration/repair of rectum,,,1410.62,1781.83,6
HCPCS,455630,EXPLORATION/REPAIR OF RECTUM,,,1776.07,1776.07,1
HCPCS,4556F,PT W/3+ POST-OP NAUSEA&VOM,,,0.01,0.01,1
HCPCS,4556F0,PT W/3+ POST-OP NAUSEA&VOM,,,0.01,0.01,1
HCPCS,4557F,PT W/O 3+ POST-OPNAUSEA&VOM,,,0.01,0.01,1
HCPCS,4557F0,PT W/O 3+ POST-OPNAUSEA&VOM,,,0.01,0.01,1
HCPCS,4558F,PT RECVD 2 RX ANTI-EMET AGT,,,0.01,0.01,1
HCPCS,4558F0,PT RECVD 2 RX ANTI-EMET AGT,,,0.01,0.01,1
HCPCS,4559F,1 BODYTEMP >=35.5CW/IN 30MIN,,,0.01,0.01,1
HCPCS,4559F0,1 BODYTEMP >=35.5CW/IN 30MIN,,,0.01,0.01,1
HCPCS,4560F,ANESTH W/O GEN/NEURAX ANESTH,,,0.01,0.01,1
HCPCS,4560F0,ANESTH W/O GEN/NEURAX ANESTH,,,0.01,0.01,1
HCPCS,4561F,PT W/ CORONARY ARTERY STENT,,,0.01,0.01,1
HCPCS,4561F0,PT W/ CORONARY ARTERY STENT,,,0.01,0.01,1
HCPCS,4562F,PT W/O CORONARY ARTERY STENT,,,0.01,0.01,1
HCPCS,4562F0,PT W/O CORONARY ARTERY STENT,,,0.01,0.01,1
HCPCS,4563F,PT RECVD ASPIRIN W/IN 24 HRS,,,0.01,0.01,1
HCPCS,4563F0,PT RECVD ASPIRIN W/IN 24 HRS,,,0.01,0.01,1
HCPCS,45800,CLOSURE RECTOVESICAL FISTULA,8124.0,5280.6,632.99,8124.0,35
HCPCS,45800,REPAIR RECT/BLADDER FISTULA,,,1364.07,1364.07,1
HCPCS,45800,Repair rect/bladder fistula,,,1410.62,1781.83,6
HCPCS,458000,REPAIR RECT/BLADDER FISTULA,,,1364.07,1364.07,1
HCPCS,45805,CLSR RECTOVESICAL FISTULA W/COLOSTOMY,9328.0,6063.2,774.41,9328.0,35
HCPCS,45805,REPAIR FISTULA W/COLOSTOMY,,,1573.19,1573.19,1
HCPCS,45805,Repair fistula w/colostomy,,,1410.62,1781.83,6
HCPCS,458050,REPAIR FISTULA W/COLOSTOMY,,,1573.19,1573.19,1
HCPCS,45820,CLOSURE RECTOURETHRAL FISTULA,8148.0,5296.2,627.28,8148.0,35
HCPCS,45820,REPAIR RECTOURETHRAL FISTULA,,,1367.7,1367.7,1
HCPCS,45820,Repair rectourethral fistula,,,1410.62,1781.83,6
HCPCS,458200,REPAIR RECTOURETHRAL FISTULA,,,1367.7,1367.7,1
HCPCS,45825,CLOSURE RECTOURETHRAL FISTULA W/COLOSTOMY,9668.0,6284.2,718.67,9668.0,35
HCPCS,45825,REPAIR FISTULA W/COLOSTOMY,,,1646.38,1646.38,1
HCPCS,45825,Repair fistula w/colostomy,,,1410.62,1781.83,6
HCPCS,458250,REPAIR FISTULA W/COLOSTOMY,,,1646.38,1646.38,1
HCPCS,45900,RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE,1196.0,777.4,104.55,1196.0,35
HCPCS,45900,REDUCTION OF RECTAL PROLAPSE,,,227.62,1976.74,15
HCPCS,45900,Reduction of rectal prolapse,,,901.17,1138.32,6
HCPCS,459000,REDUCTION OF RECTAL PROLAPSE,,,227.62,227.62,1
HCPCS,45905,DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL,3860.0,2509.0,110.71,36332.0,84
HCPCS,45905,DILATION OF ANAL SPHINCTER,,,181.26,181.26,1
HCPCS,459050,DILATION OF ANAL SPHINCTER,,,181.26,181.26,1
HCPCS,45910,DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL,3960.0,2574.0,131.56,36332.0,84
HCPCS,45910,DILATION OF RECTAL NARROWING,,,205.87,205.87,1
HCPCS,459100,DILATION OF RECTAL NARROWING,,,205.87,205.87,1
HCPCS,45915,REMOVE RECTAL OBSTRUCTION,,,243.26,243.26,1
HCPCS,45915,RMVL FECAL IMPACTION/FB SPX UNDER ANES,4028.0,2618.2,175.82,8370.0,179
HCPCS,459150,REMOVE RECTAL OBSTRUCTION,,,243.26,243.26,1
HCPCS,45990,ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX,8244.5,5358.925,73.07,36332.0,84
HCPCS,45990,SURG DX EXAM ANORECTAL,,,112.87,112.87,1
HCPCS,459900,SURG DX EXAM ANORECTAL,,,112.87,112.87,1
HCPCS,45999,"ENDOVAC, RECTUM; COLONOSCOPY (COMP 45378, 97605)",1639.0,1065.35,682.21,1639.0,15
HCPCS,45999,"ENDOVAC, RECTUM; COLONOSCOPY VIA STOMA (COMP 44388, 97605)",1217.0,791.05,608.5,1217.0,15
HCPCS,45999,"ENDOVAC, RECTUM; FLEX-SIG (COMP 45330, 97605)",599.0,389.35,299.5,818.65,15
HCPCS,45999,ESD RECTUM (COMP 45390),1212.0,787.8,606.0,1212.0,15
HCPCS,45999,"OPEN REPAIR OF RECTAL FISTULA WO ANASTOMOSIS, TRANS-PERINEAL APP",6484.0,4214.6,682.21,6484.0,15
HCPCS,45999,REV ILEOANAL RES W/W/O ST (COMP 45113),14000.0,9100.0,682.21,14000.0,15
HCPCS,45999,REVISION/REDO POUCH AP APPROACH W/W/O STOMA (COMP 46712),13123.0,8529.95,682.21,13123.0,15
HCPCS,45999,TRANSANAL RPR COLOANAL ANASTOMOSIS (COMP 45505),3344.0,2173.6,682.21,3344.0,15
HCPCS,45999,UNLISTED PROCEDURE RECTUM,1419.0,922.35,381.6,7730.0,144
HCPCS,46020,PLACEMENT OF SETON,818.0,531.7,112.43,613.5,36
HCPCS,46020,PLACEMENT SETON,15769.0,10249.85,142.37,36332.0,98
HCPCS,460200,PLACEMENT OF SETON,,,124.56,124.56,1
HCPCS,46030,REMOVAL ANAL SETON OTH MRK,,,92.43,92.43,1
HCPCS,46030,REMOVAL ANAL SETON OTHER MARKER,3686.0,2395.9,49.51,6102.0,84
HCPCS,460300,REMOVAL ANAL SETON OTH MRK,,,92.43,92.43,1
HCPCS,46040,I&D ISCHIORCT&/PERIRCT ABSC,,,453.7,453.7,1
HCPCS,46040,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,4464.0,2901.6,209.26,36332.0,277
HCPCS,460400,I&D ISCHIORCT&/PERIRCT ABSC,,,453.7,453.7,1
HCPCS,46045,I&D ABSC TRANAL UNDER ANES,,,469.16,469.16,1
HCPCS,46045,I&D INTRAMURAL IM/ABSC TRANSANAL ANES,9058.5,5888.025000000001,216.32,36332.0,84
HCPCS,460450,I&D ABSC TRANAL UNDER ANES,,,469.16,469.16,1
HCPCS,46050,I&D PERIANAL ABSCESS SUPERFICIAL,5243.0,3407.95,132.49,4718.7,291
HCPCS,46050,I&D PERIANAL ABSCESS SUPFC,,,107.68,107.68,1
HCPCS,46050,"I/D PERIANAL ABSCESS, SUPERFICIAL",546.0,354.9,72.98,409.5,35
HCPCS,460500,I&D PERIANAL ABSCESS SUPFC,,,107.68,107.68,1
HCPCS,46060,I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON,9158.5,5953.025000000001,297.01,36332.0,84
HCPCS,46060,I&D ISCHIORECTAL/NTRMRL ABSC,,,517.85,517.85,1
HCPCS,460600,I&D ISCHIORECTAL/NTRMRL ABSC,,,517.85,517.85,1
HCPCS,46070,INCISION ANAL SEPTUM INFANT,,,286.92,5945.95,15
HCPCS,46070,"INCISION OF ANAL SEPTUM, INFANT",1228.0,798.2,134.8,1228.0,35
HCPCS,46070,Incision anal septum infant,,,901.17,1138.32,6
HCPCS,460700,INCISION ANAL SEPTUM INFANT,,,286.92,286.92,1
HCPCS,46080,SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX,1008.0,655.2,121.36,756.0,35
HCPCS,46080,SPHNCTROTMY ANAL DIV SPHNCTR,,,169.1,5945.95,16
HCPCS,46080,Sphnctrotmy anal div sphnctr,,,901.17,1138.32,6
HCPCS,460800,SPHNCTROTMY ANAL DIV SPHNCTR,,,169.1,169.1,1
HCPCS,46083,INC THROMBOSED HROID XTRNL,,,117.18,117.18,1
HCPCS,46083,INCISION THROMBOSED HEMORRHOID EXTERNAL,989.5,643.175,60.85,4151.0,179
HCPCS,460830,INC THROMBOSED HROID XTRNL,,,117.18,117.18,1
HCPCS,46200,FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED,1436.0,933.4,184.71,1077.0,35
HCPCS,46200,REMOVAL OF ANAL FISSURE,,,357.19,14834.0,17
HCPCS,46200,Removal of anal fissure,,,901.17,1138.32,6
HCPCS,462000,REMOVAL OF ANAL FISSURE,,,357.19,357.19,1
HCPCS,46220,EXCISE ANAL EXT TAG/PAPILLA,,,129.54,129.54,1
HCPCS,46220,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,3712.0,2412.8,61.73,8370.0,133
HCPCS,462200,EXCISE ANAL EXT TAG/PAPILLA,,,129.54,129.54,1
HCPCS,46221,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,3093.5,2010.7749999999999,113.84,4718.7,133
HCPCS,46221,LIGATION OF HEMORRHOID(S),,,203.02,203.02,1
HCPCS,462210,LIGATION OF HEMORRHOID(S),,,203.02,203.02,1
HCPCS,46230,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,8408.5,5465.525000000001,102.83,36332.0,133
HCPCS,46230,REMOVAL OF ANAL TAGS,,,185.7,185.7,1
HCPCS,462300,REMOVAL OF ANAL TAGS,,,185.7,185.7,1
HCPCS,46250,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,8734.5,5677.425,210.25,36332.0,133
HCPCS,46250,REMOVE EXT HEM GROUPS 2+,,,339.24,339.24,1
HCPCS,462500,REMOVE EXT HEM GROUPS 2+,,,339.24,339.24,1
HCPCS,46255,HEMORRHOIDECTOMY (COMP CODE 46255),2132.0,1385.8,272.69,1599.0,35
HCPCS,46255,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,8876.5,5769.725,272.69,36332.0,133
HCPCS,46255,REMOVE INT/EXT HEM 1 GROUP,,,378.46,378.46,1
HCPCS,462550,REMOVE INT/EXT HEM 1 GROUP,,,378.46,378.46,1
HCPCS,46257,HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO,2304.0,1497.6,308.68,2304.0,35
HCPCS,46257,REMOVE IN/EX HEM GRP & FISS,,,442.53,5945.95,15
HCPCS,46257,Remove in/ex hem grp & fiss,,,1410.62,1781.83,6
HCPCS,462570,REMOVE IN/EX HEM GRP & FISS,,,442.53,442.53,1
HCPCS,46258,HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY,2564.0,1666.6,335.7,2564.0,35
HCPCS,46258,REMOVE IN/EX HEM GRP W/FISTU,,,517.03,5945.95,15
HCPCS,46258,Remove in/ex hem grp w/fistu,,,1410.62,1781.83,6
HCPCS,462580,REMOVE IN/EX HEM GRP W/FISTU,,,517.03,517.03,1
HCPCS,46260,HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO,2692.0,1749.8,362.4,2692.0,35
HCPCS,46260,REMOVE IN/EX HEM GROUPS 2+,,,514.31,5945.95,18
HCPCS,46260,Remove in/ex hem groups 2+,,,1410.62,1781.83,6
HCPCS,462600,REMOVE IN/EX HEM GROUPS 2+,,,514.31,514.31,1
HCPCS,46261,HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU,3104.0,2017.6,397.84,3104.0,35
HCPCS,46261,REMOVE IN/EX HEM GRPS & FISS,,,569.94,5945.95,15
HCPCS,46261,Remove in/ex hem grps & fiss,,,1410.62,1781.83,6
HCPCS,462610,REMOVE IN/EX HEM GRPS & FISS,,,569.94,569.94,1
HCPCS,46262,HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY,3164.0,2056.6,415.47,3164.0,35
HCPCS,46262,REMOVE IN/EX HEM GRPS W/FIST,,,627.19,5945.95,15
HCPCS,46262,Remove in/ex hem grps w/fist,,,1410.62,1781.83,6
HCPCS,462620,REMOVE IN/EX HEM GRPS W/FIST,,,627.19,627.19,1
HCPCS,46270,REMOVE ANAL FIST SUBQ,,,426.32,426.32,1
HCPCS,46270,SURG TX ANAL FISTULA SUBQ,8868.5,5764.525000000001,196.76,36332.0,84
HCPCS,462700,REMOVE ANAL FIST SUBQ,,,426.32,426.32,1
HCPCS,46275,REMOVE ANAL FIST INTER,,,449.25,449.25,1
HCPCS,46275,SURG TX ANAL FISTULA INTERSPHINCTERIC,8968.5,5829.525000000001,233.23,36332.0,84
HCPCS,462750,REMOVE ANAL FIST INTER,,,449.25,449.25,1
HCPCS,46280,REMOVE ANAL FIST COMPLEX,,,511.29,28770.0,17
HCPCS,46280,Remove anal fist complex,,,1410.62,1781.83,6
HCPCS,46280,TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON,2556.0,1661.4,322.11,2556.0,35
HCPCS,462800,REMOVE ANAL FIST COMPLEX,,,511.29,511.29,1
HCPCS,46285,REMOVE ANAL FIST 2 STAGE,,,450.67,28770.0,17
HCPCS,46285,Remove anal fist 2 stage,,,901.17,1138.32,6
HCPCS,46285,SURG TX ANAL FISTULA 2ND STAGE,2168.0,1409.2,206.96,1626.0,35
HCPCS,462850,REMOVE ANAL FIST 2 STAGE,,,450.67,450.67,1
HCPCS,46288,CLSR ANAL FSTL W/RCT ADVMNT FLAP,3124.0,2030.6,295.97,3124.0,35
HCPCS,46288,REPAIR ANAL FISTULA,,,595.41,17782.0,17
HCPCS,46288,Repair anal fistula,,,1410.62,1781.83,6
HCPCS,462880,REPAIR ANAL FISTULA,,,595.41,595.41,1
HCPCS,46320,EXC THROMBOSED HEMORRHOID XTRNL,3718.0,2416.7,70.67,6102.0,182
HCPCS,46320,REMOVAL OF HEMORRHOID CLOT,,,121.23,121.23,1
HCPCS,463200,REMOVAL OF HEMORRHOID CLOT,,,121.23,121.23,1
HCPCS,46500,INJECTION INTO HEMORRHOID(S),,,191.92,191.92,1
HCPCS,46500,INJECTION SCLEROSING SOLUTION HEMORRHOIDS,2969.5,1930.175,91.23,4718.7,81
HCPCS,465000,INJECTION INTO HEMORRHOID(S),,,191.92,191.92,1
HCPCS,46505,CHEMODENERVATION ANAL MUSC,,,265.01,265.01,1
HCPCS,46505,CHEMODENERVATION INTERNAL ANAL SPHINCTER,4026.0,2616.9,158.06,36332.0,133
HCPCS,465050,CHEMODENERVATION ANAL MUSC,,,265.01,265.01,1
HCPCS,46600,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,491.5,319.475,34.77,3920.0,231
HCPCS,46600,DIAGNOSTIC ANOSCOPY SPX,,,43.62,43.62,1
HCPCS,466000,DIAGNOSTIC ANOSCOPY SPX,,,43.62,43.62,1
HCPCS,46601,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT,741.0,481.65,69.86,3920.0,128
HCPCS,46601,DIAGNOSTIC ANOSCOPY,,,99.74,99.74,1
HCPCS,466010,DIAGNOSTIC ANOSCOPY,,,99.74,99.74,1
HCPCS,46604,ANOSCOPY AND DILATION,,,70.31,70.31,1
HCPCS,46604,ANOSCOPY W/DILATION,3596.0,2337.4,47.6,7730.0,133
HCPCS,466040,ANOSCOPY AND DILATION,,,70.31,70.31,1
HCPCS,46606,ANOSCOPY AND BIOPSY,,,80.35,80.35,1
HCPCS,46606,ANOSCOPY W/BX SINGLE/MULTIPLE,3654.0,2375.1,36.5,6102.0,133
HCPCS,466060,ANOSCOPY AND BIOPSY,,,80.35,80.35,1
HCPCS,46607,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX,3874.0,2518.1,95.22,6289.0,79
HCPCS,46607,DIAGNOSTIC ANOSCOPY & BIOPSY,,,132.88,132.88,1
HCPCS,466070,DIAGNOSTIC ANOSCOPY & BIOPSY,,,132.88,132.88,1
HCPCS,46608,ANOSCOPY REMOVE FOR BODY,,,90.61,90.61,1
HCPCS,46608,ANOSCOPY W/RMVL FOREIGN BODY,6011.5,3907.475,103.52,6289.0,98
HCPCS,46608,"ANOSCOPY,REMOVE FOREIGN BODY",520.0,338.0,68.67,403.88,35
HCPCS,466080,ANOSCOPY REMOVE FOR BODY,,,90.61,90.61,1
HCPCS,46610,ANOSCOPY REMOVE LESION,,,85.43,5945.95,15
HCPCS,46610,ANOSCOPY W/RMVL LESION CAUTERY,512.0,332.8,58.94,384.0,35
HCPCS,46610,Anoscopy remove lesion,,,1275.65,1611.35,6
HCPCS,466100,ANOSCOPY REMOVE LESION,,,85.43,85.43,1
HCPCS,46611,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,2881.5,1872.975,72.16,7730.0,84
HCPCS,46611,ANOSCOPY,,,85.64,85.64,1
HCPCS,466110,ANOSCOPY,,,85.64,85.64,1
HCPCS,46612,ANOSC RMVL MULT TUMORS CAUTERY/SNARE,600.0,390.0,83.53,467.0,35
HCPCS,46612,ANOSCOPY REMOVE LESIONS,,,102.18,5945.95,15
HCPCS,46612,Anoscopy remove lesions,,,1275.65,1611.35,6
HCPCS,466120,ANOSCOPY REMOVE LESIONS,,,102.18,102.18,1
HCPCS,46614,ANOSCOPY CONTROL BLEEDING,,,68.45,2556.44,16
HCPCS,46614,"ANOSCOPY,CONTROL BLEEDING",400.0,260.0,56.38,300.0,35
HCPCS,46614,Anoscopy control bleeding,,,605.04,764.26,6
HCPCS,466140,ANOSCOPY CONTROL BLEEDING,,,68.45,68.45,1
HCPCS,46615,ANOSCOPY,,,96.37,5945.95,15
HCPCS,46615,"ANOSCOPY,ABLATE LESION",600.0,390.0,82.96,450.0,35
HCPCS,46615,Anoscopy,,,1275.65,1611.35,6
HCPCS,466150,ANOSCOPY,,,96.37,96.37,1
HCPCS,46700,ANOPLASTY PLASTIC OPERATION STRICTURE ADULT,3924.0,2550.6,358.49,3924.0,35
HCPCS,46700,REPAIR OF ANAL STRICTURE,,,695.71,5945.95,15
HCPCS,46700,Repair of anal stricture,,,1410.62,1781.83,6
HCPCS,467000,REPAIR OF ANAL STRICTURE,,,695.71,695.71,1
HCPCS,46705,ANOPLASTY PLASTIC OPERATION STRICTURE INFANT,2972.0,1931.8,302.01,2972.0,35
HCPCS,46705,REPAIR OF ANAL STRICTURE,,,610.34,610.34,1
HCPCS,46705,Repair of anal stricture,,,1410.62,1781.83,6
HCPCS,467050,REPAIR OF ANAL STRICTURE,,,610.34,610.34,1
HCPCS,46706,REPAIR ANAL FISTULA W/FIBRIN GLUE,976.0,634.4,95.49,976.0,35
HCPCS,46706,REPR OF ANAL FISTULA W/GLUE,,,192.8,5945.95,15
HCPCS,46706,Repr of anal fistula w/glue,,,901.17,1138.32,6
HCPCS,467060,REPR OF ANAL FISTULA W/GLUE,,,192.8,192.8,1
HCPCS,46707,REPAIR ANORECTAL FIST W/PLUG,,,537.97,5945.95,15
HCPCS,46707,RPR ANORECTAL FISTULA W/ PLUG,2556.0,1661.4,249.53,2556.0,35
HCPCS,46707,Repair anorectal fist w/plug,,,901.17,1138.32,6
HCPCS,467070,REPAIR ANORECTAL FIST W/PLUG,,,537.97,537.97,1
HCPCS,46710,REPR PER/VAG POUCH SNGL PROC,,,1190.71,1190.71,1
HCPCS,46710,RPR ILEOANAL POUCH FSTL/POUCH ADVMNT TPRNL APPR,6856.0,4456.4,634.1,6856.0,35
HCPCS,46710,Repr per/vag pouch sngl proc,,,1410.62,1781.83,6
HCPCS,467100,REPR PER/VAG POUCH SNGL PROC,,,1190.71,1190.71,1
HCPCS,46712,REPR PER/VAG POUCH DBL PROC,,,2376.54,2376.54,1
HCPCS,46712,RPR ILEOANAL POUCH FSTL/POUCH ADVMNT CMBN APPR,14580.0,9477.0,1397.64,14580.0,35
HCPCS,46712,Repr per/vag pouch dbl proc,,,1410.62,1781.83,6
HCPCS,467120,REPR PER/VAG POUCH DBL PROC,,,2376.54,2376.54,1
HCPCS,46715,REP PERF ANOPER FISTU,,,594.18,594.18,1
HCPCS,46715,Rep perf anoper fistu,,,1410.62,1781.83,6
HCPCS,467150,REP PERF ANOPER FISTU,,,594.18,594.18,1
HCPCS,46716,REP PERF ANOPER/VESTIB FISTU,,,1322.08,1322.08,1
HCPCS,46716,RPR LW IMPERFORATE ANUS W/TRPOS FISTULA,7016.0,4560.4,607.22,7016.0,35
HCPCS,46716,Rep perf anoper/vestib fistu,,,1410.62,1781.83,6
HCPCS,467160,REP PERF ANOPER/VESTIB FISTU,,,1322.08,1322.08,1
HCPCS,46730,CONSTRUCTION OF ABSENT ANUS,,,2132.33,2132.33,1
HCPCS,46730,Construction of absent anus,,,1410.62,1781.83,6
HCPCS,46730,RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR,12260.0,7969.0,976.25,12260.0,35
HCPCS,467300,CONSTRUCTION OF ABSENT ANUS,,,2132.33,2132.33,1
HCPCS,46735,CONSTRUCTION OF ABSENT ANUS,,,2455.34,2455.34,1
HCPCS,46735,Construction of absent anus,,,1410.62,1781.83,6
HCPCS,467350,CONSTRUCTION OF ABSENT ANUS,,,2455.34,2455.34,1
HCPCS,46740,CONSTRUCTION OF ABSENT ANUS,,,2327.46,2327.46,1
HCPCS,46740,Construction of absent anus,,,1410.62,1781.83,6
HCPCS,467400,CONSTRUCTION OF ABSENT ANUS,,,2327.46,2327.46,1
HCPCS,46742,REPAIR OF IMPERFORATED ANUS,,,2690.52,2690.52,1
HCPCS,46742,Repair of imperforated anus,,,1410.62,1781.83,6
HCPCS,467420,REPAIR OF IMPERFORATED ANUS,,,2690.52,2690.52,1
HCPCS,46744,REPAIR OF CLOACAL ANOMALY,,,3796.75,3796.75,1
HCPCS,46744,Repair of cloacal anomaly,,,1410.62,1781.83,6
HCPCS,467440,REPAIR OF CLOACAL ANOMALY,,,3796.75,3796.75,1
HCPCS,46746,REPAIR OF CLOACAL ANOMALY,,,4182.88,4182.88,1
HCPCS,46746,Repair of cloacal anomaly,,,1410.62,1781.83,6
HCPCS,467460,REPAIR OF CLOACAL ANOMALY,,,4182.88,4182.88,1
HCPCS,46748,REPAIR OF CLOACAL ANOMALY,,,4533.66,4533.66,1
HCPCS,46748,Repair of cloacal anomaly,,,1410.62,1781.83,6
HCPCS,467480,REPAIR OF CLOACAL ANOMALY,,,4533.66,4533.66,1
HCPCS,46750,REPAIR OF ANAL SPHINCTER,,,799.9,5945.95,15
HCPCS,46750,Repair of anal sphincter,,,1410.62,1781.83,6
HCPCS,46750,SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT,4860.0,3159.0,383.76,4860.0,35
HCPCS,467500,REPAIR OF ANAL SPHINCTER,,,799.9,799.9,1
HCPCS,46751,REPAIR OF ANAL SPHINCTER,,,716.14,716.14,1
HCPCS,46751,Repair of anal sphincter,,,1410.62,1781.83,6
HCPCS,467510,REPAIR OF ANAL SPHINCTER,,,716.14,716.14,1
HCPCS,46753,GRAFT THIERSCH RCT INCONTINENCE &/PROLAPSE,3556.0,2311.4,309.01,3556.0,35
HCPCS,46753,RECONSTRUCTION OF ANUS,,,664.24,5945.95,15
HCPCS,46753,Reconstruction of anus,,,1410.62,1781.83,6
HCPCS,467530,RECONSTRUCTION OF ANUS,,,664.24,664.24,1
HCPCS,46754,REMOVAL OF SUTURE FROM ANUS,,,256.48,5945.95,15
HCPCS,46754,RMVL THIERSCH WIRE/SUTURE ANAL CANAL,1204.0,782.6,116.71,903.0,35
HCPCS,46754,Removal of suture from anus,,,901.17,1138.32,6
HCPCS,467540,REMOVAL OF SUTURE FROM ANUS,,,256.48,256.48,1
HCPCS,46760,REPAIR OF ANAL SPHINCTER,,,1171.57,5945.95,15
HCPCS,46760,Repair of anal sphincter,,,1410.62,1781.83,6
HCPCS,46760,SPHINCTEROPLASTY ANAL MUSCLE TRANSPLANT,6980.0,4537.0,516.06,6980.0,35
HCPCS,46760,SPINCTEROPLASTY ANAL,4582.0,2978.3,516.06,4582.0,35
HCPCS,467600,REPAIR OF ANAL SPHINCTER,,,1171.57,1171.57,1
HCPCS,46761,REPAIR OF ANAL SPHINCTER,,,975.54,5945.95,15
HCPCS,46761,Repair of anal sphincter,,,1410.62,1781.83,6
HCPCS,46761,SPHNCTROP ANAL LEVATOR MUSC IMBRCJ,6116.0,3975.4,459.32,6116.0,35
HCPCS,467610,REPAIR OF ANAL SPHINCTER,,,975.54,975.54,1
HCPCS,46900,DESTRUCTION ANAL LESION(S),,,146.03,146.03,1
HCPCS,46900,DSTRJ LESION ANUS SIMPLE CHEMICAL,1531.0,995.1500000000001,119.69,4214.0,81
HCPCS,469000,DESTRUCTION ANAL LESION(S),,,146.03,146.03,1
HCPCS,46910,DESTRUCTION ANAL LESION(S),,,144.3,144.3,1
HCPCS,46910,DSTRJ LESION ANUS SMPL ELTRDSICCATION,5641.0,3666.65,99.49,9466.2,84
HCPCS,469100,DESTRUCTION ANAL LESION(S),,,144.3,144.3,1
HCPCS,46916,CRYOSURGERY ANAL LESION(S),,,150.2,150.2,1
HCPCS,46916,DSTRJ LESION ANUS SIMPLE CRYOSURGERY,953.5,619.7750000000001,75.13,4151.0,81
HCPCS,469160,CRYOSURGERY ANAL LESION(S),,,150.2,150.2,1
HCPCS,46917,DSTRJ LESION ANUS SIMPLE LASER SURG,764.0,496.6,106.44,753.63,35
HCPCS,46917,LASER SURGERY ANAL LESIONS,,,137.86,5945.95,15
HCPCS,46917,Laser surgery anal lesions,,,901.17,1138.32,6
HCPCS,469170,LASER SURGERY ANAL LESIONS,,,137.86,137.86,1
HCPCS,46922,DSTRJ LESION ANUS SIMPLE SURG EXCISION,8266.5,5373.225,95.87,14192.1,84
HCPCS,46922,EXCISION OF ANAL LESION(S),,,147.15,147.15,1
HCPCS,469220,EXCISION OF ANAL LESION(S),,,147.15,147.15,1
HCPCS,46924,DESTRUCTION ANAL LESION(S),,,193.49,5945.95,15
HCPCS,46924,DSTRJ LESION ANUS EXTENSIVE,1124.0,730.6,139.05,901.85,35
HCPCS,46924,Destruction anal lesion(s),,,901.17,1138.32,6
HCPCS,469240,DESTRUCTION ANAL LESION(S),,,193.49,193.49,1
HCPCS,46930,DESTROY INTERNAL HEMORRHOIDS,,,159.28,159.28,1
HCPCS,46930,DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY,3358.5,2183.025,129.31,5465.7,84
HCPCS,469300,DESTROY INTERNAL HEMORRHOIDS,,,159.28,159.28,1
HCPCS,46940,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST,940.0,611.0,99.24,705.0,35
HCPCS,46940,TREATMENT OF ANAL FISSURE,,,154.84,5945.95,15
HCPCS,46940,Treatment of anal fissure,,,901.17,1138.32,6
HCPCS,469400,TREATMENT OF ANAL FISSURE,,,154.84,154.84,1
HCPCS,46942,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ,828.0,538.2,89.73,621.0,35
HCPCS,46942,TREATMENT OF ANAL FISSURE,,,139.05,1976.74,15
HCPCS,46942,Treatment of anal fissure,,,901.17,1138.32,6
HCPCS,469420,TREATMENT OF ANAL FISSURE,,,139.05,139.05,1
HCPCS,46945,INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN,8622.5,5604.625,167.01,14192.1,84
HCPCS,46945,INT HRHC LIG 1 HROID W/O IMG,,,358.23,358.23,1
HCPCS,469450,INT HRHC LIG 1 HROID W/O IMG,,,358.23,358.23,1
HCPCS,46946,INT HRHC BY LIGATION 2+ HROID W/O IMG GDN,8784.5,5709.925,188.21,36332.0,84
HCPCS,46946,INT HRHC LIG 2+HROID W/O IMG,,,401.36,401.36,1
HCPCS,469460,INT HRHC LIG 2+HROID W/O IMG,,,401.36,401.36,1
HCPCS,46947,HEMORRHOIDOPEXY BY STAPLING,2228.0,1448.2,240.14,5945.95,50
HCPCS,46947,Hemorrhoidopexy by stapling,,,1410.62,1781.83,6
HCPCS,469470,HEMORRHOIDOPEXY BY STAPLING,,,417.16,417.16,1
HCPCS,46948,INT HRHC TRANAL DARTLZJ 2+,,,470.74,5945.95,15
HCPCS,46948,INT HRHC TRANSANAL HROID DARTLZJ 2+ W/US GDN,2228.0,1448.2,334.7,2228.0,31
HCPCS,46948,Int hrhc tranal dartlzj 2+,,,1410.62,1781.83,6
HCPCS,469480,INT HRHC TRANAL DARTLZJ 2+,,,470.74,470.74,1
HCPCS,46999,ANAL BIOPSY (COMP 45100),236.0,153.4,118.0,262.82,15
HCPCS,46999,"ANOSCOPY W/SUBMUCOSAL INJECTION, ANY SUBSTANCE (COMP 45381)",1566.0,1017.9,219.02,1566.0,15
HCPCS,46999,EXPLANATION OF ARTIFICIAL BOWEL SPHINCTER (COMP 53446),3968.0,2579.2,219.02,3968.0,15
HCPCS,46999,"HEMORRHOIDECTOMY, EXTERNAL, SINGLE COLUMN (COMP 46255)",1786.0,1160.9,219.02,1786.0,15
HCPCS,46999,"HEMORROIDECTOMY, EXTERNAL, SINGLE (COMP CODE 46220)",2147.0,1395.55,219.02,2147.0,15
HCPCS,46999,LAP ASSISTED CLOACA REPAIR (COMP 46748),27852.0,18103.8,219.02,27852.0,15
HCPCS,46999,POST OP CONTROL OF BLEEDING,781.0,507.65,219.02,781.0,15
HCPCS,46999,POST OP CONTROL OF BLEEDING ANUS (COMP 46945),1586.0,1030.9,219.02,1586.0,15
HCPCS,46999,POST OP CONTROL OF BLEEDING-ANUS (COMP CODE 46614),361.0,234.65,180.5,361.0,15
HCPCS,46999,"REPAIR, CLOSURE OF ANAL FISTULA-OTHER THAN GLUE (COMP 46706)",1049.0,681.85,219.02,1049.0,15
HCPCS,46999,SUBMUCOSAL ANAL INJECTION FOR INFLAMMATION/PAIN (COMP CODE 46505,1367.0,888.55,219.02,1367.0,15
HCPCS,46999,"UNLIST PROC, ANUS COMPARED TO 45100",1737.0,1129.05,219.02,1737.0,15
HCPCS,46999,"UNLIST PROC, ANUS COMPARED TO 46947",2395.0,1556.75,219.02,2395.0,15
HCPCS,46999,"UNLISTED PROC; TRANSANAL HEMORRHOIDAL DEARTERIALIZATION, SINGLE",1838.0,1194.7,219.02,1838.0,15
HCPCS,46999,UNLISTED PROCEDURE ANUS,777.0,505.05,218.34,8370.0,48
HCPCS,46999,"UNLISTED PROCEDURE, ANUS",777.0,505.05,218.34,8370.0,48
HCPCS,47000,BIOPSY LIVER NEEDLE PERCUTANEOUS,4988.0,3242.2,81.7,8384.4,326
HCPCS,47000,NEEDLE BIOPSY OF LIVER PERQ,,,92.33,92.33,1
HCPCS,470000,NEEDLE BIOPSY OF LIVER PERQ,,,92.33,92.33,1
HCPCS,47001,BX LVR NDL DONE PURPOSE TM OTH MAJOR PX,993.5,645.775,79.41,13665.0,73
HCPCS,47001,NDL BIOPSY LVR TM OTH MAJ PX,,,110.86,110.86,1
HCPCS,470010,NDL BIOPSY LVR TM OTH MAJ PX,,,110.86,110.86,1
HCPCS,47010,HEPATOT OPN DRG ABSC/CST 1/2,,,1301.66,1301.66,1
HCPCS,47010,HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES,5110.0,3321.5,413.28,18285.0,74
HCPCS,470100,HEPATOT OPN DRG ABSC/CST 1/2,,,1301.66,1301.66,1
HCPCS,47015,LAPT ASPIR&/NJX HEP PRST CST,,,1250.46,1250.46,1
HCPCS,47015,LAPT W/ASPIR &/NJX HEPATC PARASITIC CYST/ABSCESS,7400.0,4810.0,574.92,7400.0,35
HCPCS,47015,Lapt aspir&/njx hep prst cst,,,3427.97,4330.07,6
HCPCS,470150,LAPT ASPIR&/NJX HEP PRST CST,,,1250.46,1250.46,1
HCPCS,47100,WEDGE BIOPSY OF LIVER,5164.0,3356.6,423.37,5164.0,36
HCPCS,47100,Wedge biopsy of liver,,,3427.97,4330.07,6
HCPCS,471000,WEDGE BIOPSY OF LIVER,,,911.3,911.3,1
HCPCS,47120,HEPATECTOMY RESCJ PARTIAL LOBECTOMY,15604.0,10142.6,1208.51,15604.0,35
HCPCS,47120,PARTIAL REMOVAL OF LIVER,,,2505.98,2505.98,1
HCPCS,47120,Partial removal of liver,,,3427.97,4330.07,6
HCPCS,471200,PARTIAL REMOVAL OF LIVER,,,2505.98,2505.98,1
HCPCS,47122,EXTENSIVE REMOVAL OF LIVER,,,3667.53,3667.53,1
HCPCS,47122,Extensive removal of liver,,,3427.97,4330.07,6
HCPCS,47122,HEPATECTOMY RESCJ TRISEGMENTECTOMY,23792.0,15464.8,1808.17,23792.0,35
HCPCS,471220,EXTENSIVE REMOVAL OF LIVER,,,3667.53,3667.53,1
HCPCS,47125,HEPATECTOMY RESCJ TOTAL LEFT LOBECTOMY,21216.0,13790.4,1620.69,21216.0,35
HCPCS,47125,PARTIAL REMOVAL OF LIVER,,,3302.88,3302.88,1
HCPCS,47125,Partial removal of liver,,,3427.97,4330.07,6
HCPCS,471250,PARTIAL REMOVAL OF LIVER,,,3302.88,3302.88,1
HCPCS,47130,HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY,22876.0,14869.4,1744.35,22876.0,35
HCPCS,47130,PARTIAL REMOVAL OF LIVER,,,3545.07,3545.07,1
HCPCS,47130,Partial removal of liver,,,3427.97,4330.07,6
HCPCS,471300,PARTIAL REMOVAL OF LIVER,,,3545.07,3545.07,1
HCPCS,47133,REMOVAL OF DONOR LIVER,,,6920.06,6920.06,1
HCPCS,47133,Removal of donor liver,,,3411.14,4308.8,6
HCPCS,471330,REMOVAL OF DONOR LIVER,,,6920.06,6920.06,1
HCPCS,47135,LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE,39600.0,25740.0,3324.44,39600.0,35
HCPCS,47135,TRANSPLANTATION OF LIVER,,,5791.85,5791.85,1
HCPCS,47135,Transplantation of liver,,,3411.14,4308.8,6
HCPCS,471350,TRANSPLANTATION OF LIVER,,,5791.85,5791.85,1
HCPCS,47140,DONOR HEPATECTOMY LIVING DONOR SEG II & III,23760.0,15444.0,2011.14,23760.0,32
HCPCS,47140,PARTIAL REMOVAL DONOR LIVER,,,3837.88,3837.88,1
HCPCS,47140,Partial removal donor liver,,,3411.14,4308.8,6
HCPCS,471400,PARTIAL REMOVAL DONOR LIVER,,,3837.88,3837.88,1
HCPCS,47141,DONOR HEPATECTOMY LIVING DONOR SEG II III & IV,28600.0,18590.0,2430.2,28600.0,32
HCPCS,47141,PARTIAL REMOVAL DONOR LIVER,,,4586.46,4586.46,1
HCPCS,47141,Partial removal donor liver,,,3411.14,4308.8,6
HCPCS,471410,PARTIAL REMOVAL DONOR LIVER,,,4586.46,4586.46,1
HCPCS,47142,DONOR HEPATECTOMY LIVING DONOR SEG V VI VII &VI,31776.0,20654.4,2809.29,31776.0,32
HCPCS,47142,PARTIAL REMOVAL DONOR LIVER,,,5051.34,5051.34,1
HCPCS,47142,Partial removal donor liver,,,3411.14,4308.8,6
HCPCS,471420,PARTIAL REMOVAL DONOR LIVER,,,5051.34,5051.34,1
HCPCS,47143,BKBENCH PREP CADAVER DONOR,2673.0,1737.45,161.3,2673.0,14
HCPCS,47143,PREP DONOR LIVER WHOLE,,,385.77,385.77,1
HCPCS,47143,Prep donor liver whole,,,3411.14,4308.8,6
HCPCS,471430,PREP DONOR LIVER WHOLE,,,385.77,385.77,1
HCPCS,47144,PREP DONOR LIVER 3-SEGMENT,,,517.31,517.31,1
HCPCS,47144,Prep donor liver 3-segment,,,3411.14,4308.8,6
HCPCS,471440,PREP DONOR LIVER 3-SEGMENT,,,517.31,517.31,1
HCPCS,47145,PREP DONOR LIVER LOBE SPLIT,,,533.54,533.54,1
HCPCS,47145,Prep donor liver lobe split,,,3411.14,4308.8,6
HCPCS,471450,PREP DONOR LIVER LOBE SPLIT,,,533.54,533.54,1
HCPCS,47146,BKBENCH RCNSTJ LVR GRF VENOUS ANAST EA,2400.0,1560.0,247.51,2400.0,32
HCPCS,47146,PREP DONOR LIVER/VENOUS,,,350.75,350.75,1
HCPCS,47146,Prep donor liver/venous,,,3411.14,4308.8,6
HCPCS,471460,PREP DONOR LIVER/VENOUS,,,350.75,350.75,1
HCPCS,47147,BKBENCH RCNSTJ LVR GRF ARTL ANAST EA,2800.0,1820.0,288.9,2800.0,32
HCPCS,47147,PREP DONOR LIVER/ARTERIAL,,,409.55,409.55,1
HCPCS,47147,Prep donor liver/arterial,,,3411.14,4308.8,6
HCPCS,471470,PREP DONOR LIVER/ARTERIAL,,,409.55,409.55,1
HCPCS,47300,MARSUPIALIZE LIVER CYST/ABSCESS,7256.0,4716.4,566.05,7256.0,35
HCPCS,47300,SURGERY FOR LIVER LESION,,,1220.37,1220.37,1
HCPCS,47300,Surgery for liver lesion,,,3427.97,4330.07,6
HCPCS,473000,SURGERY FOR LIVER LESION,,,1220.37,1220.37,1
HCPCS,47350,MGMT LVR HEMRRG SMPL SUTR LVR WND/INJ,8996.0,5847.4,700.44,8996.0,35
HCPCS,47350,REPAIR LIVER WOUND,,,1462.26,1462.26,1
HCPCS,47350,Repair liver wound,,,1461.38,1845.95,6
HCPCS,473500,REPAIR LIVER WOUND,,,1462.26,1462.26,1
HCPCS,47360,MGMT LVR HEMRRG CPLX SUTR WND/INJ,12524.0,8140.6,953.64,12524.0,35
HCPCS,47360,REPAIR LIVER WOUND,,,2012.31,2012.31,1
HCPCS,47360,Repair liver wound,,,1461.38,1845.95,6
HCPCS,473600,REPAIR LIVER WOUND,,,2012.31,2012.31,1
HCPCS,47361,MGMT LVR HEMRRG EXPL WND DBRDMT COAGJ/SUTR,21040.0,13676.0,1581.4,21040.0,35
HCPCS,47361,REPAIR LIVER WOUND,,,3225.24,3225.24,1
HCPCS,47361,Repair liver wound,,,3427.97,4330.07,6
HCPCS,473610,REPAIR LIVER WOUND,,,3225.24,3225.24,1
HCPCS,47362,REPAIR LIVER WOUND,,,1556.8,1556.8,1
HCPCS,47362,Repair liver wound,,,1461.38,1845.95,6
HCPCS,473620,REPAIR LIVER WOUND,,,1556.8,1556.8,1
HCPCS,47370,LAPARO ABLATE LIVER TUMOR RF,,,1349.35,22573.24,16
HCPCS,47370,LAPS SURG ABLTJ 1/> LVR TUM RF,8320.0,5408.0,687.33,8320.0,35
HCPCS,47370,Laparo ablate liver tumor rf,,,3427.97,4330.07,6
HCPCS,473700,LAPARO ABLATE LIVER TUMOR RF,,,1349.35,1349.35,1
HCPCS,47371,LAPARO ABLATE LIVER CRYOSURG,,,1355.27,22573.24,15
HCPCS,47371,LAPS SURG ABLTJ 1 > LVR TUM CRYOSURG,8320.0,5408.0,650.93,8320.0,35
HCPCS,47371,Laparo ablate liver cryosurg,,,3427.97,4330.07,6
HCPCS,473710,LAPARO ABLATE LIVER CRYOSURG,,,1355.27,1355.27,1
HCPCS,47379,LAP EXCISION LIVER CYST (COMP 47010),8342.0,5422.3,848.68,8342.0,15
HCPCS,47379,LAP LT LOBECTOMY LIVER (COMP 47125),22807.0,14824.55,848.68,22807.0,15
HCPCS,47379,LAP MARSUPIALIZATION HEPATIC CYST (COMP CODE 47300),7800.0,5070.0,848.68,7800.0,15
HCPCS,47379,LAPAROSCOPIC LIVER BIOPSY (COMP 47001),760.0,494.0,380.0,1018.42,15
HCPCS,47379,LAPAROSCOPIC PARTIAL HEPATIC LOBECTOMY W/ PARTIAL HEPATIC LOBECT,15604.0,10142.6,848.68,15604.0,15
HCPCS,47379,LAPAROSCOPIC POSTOPERATIVE LIVER HEMORRHAGE(COMP CODE 47361),22618.0,14701.7,848.68,22618.0,15
HCPCS,47379,LAPRO DONOR HEPATECTOMY LIVING DONOR LT SEG II & III (47140),25542.0,16602.3,848.68,25542.0,15
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47000)",660.0,429.0,330.0,1018.42,15
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47001)",817.0,531.05,408.5,1018.42,15
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47010)",5919.0,3847.35,848.68,5919.0,15
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47100)",4438.0,2884.7,848.68,4438.0,15
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47120)",11828.0,7688.2,848.68,11828.0,15
HCPCS,47379,UNLISTED LAPS PX LIVER,,,5856.41,14834.0,16
HCPCS,47379,Unlisted laps px liver,,,1461.38,1845.95,6
HCPCS,47380,ABLTJ OPN 1/> LVR TUM RF,9824.0,6385.6,807.3,9824.0,35
HCPCS,47380,OPEN ABLATE LIVER TUMOR RF,,,1555.88,1555.88,1
HCPCS,47380,Open ablate liver tumor rf,,,3427.97,4330.07,6
HCPCS,473800,OPEN ABLATE LIVER TUMOR RF,,,1555.88,1555.88,1
HCPCS,47381,ABLTJ OPN 1/> LVR TUM CRYOSURG,9651.0,6273.15,798.09,9651.0,35
HCPCS,47381,OPEN ABLATE LIVER TUMOR CRYO,,,1594.06,1594.06,1
HCPCS,47381,Open ablate liver tumor cryo,,,1461.38,1845.95,6
HCPCS,473810,OPEN ABLATE LIVER TUMOR CRYO,,,1594.06,1594.06,1
HCPCS,47382,ABLTJ 1/> LVR TUM PRQ RF,19768.0,12849.2,480.42,30193.2,161
HCPCS,47382,PERCUT ABLATE LIVER RF,,,774.49,774.49,1
HCPCS,473820,PERCUT ABLATE LIVER RF,,,774.49,774.49,1
HCPCS,47383,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,31708.5,20610.525,367.57,53878.5,157
HCPCS,47383,PERQ ABLTJ LVR CRYOABLATION,,,471.1,471.1,1
HCPCS,473830,PERQ ABLTJ LVR CRYOABLATION,,,471.1,471.1,1
HCPCS,47384,ABLATION IRE LIVER 1+ TUMORS W/IMG GDN PERQ,32745.0,21284.25,457.63,56200.5,52
HCPCS,47384,ABLTJ IRE LIVER 1+ TUM PERQ,,,460.67,460.67,1
HCPCS,473840,ABLTJ IRE LIVER 1+ TUM PERQ,,,460.67,460.67,1
HCPCS,47399,DESTRUCTION/FULGURATION LIVER LESION(S) (COMP 44005),6718.0,4366.7,1135.87,6718.0,15
HCPCS,47399,FLUSHING OF LIVER IN SITU (COMP 47146),2400.0,1560.0,1135.87,2400.0,15
HCPCS,47399,UNLISTED PROCEDURE LIVER,,,706.25,2169.0,15
HCPCS,47399,Unlisted procedure liver,,,1461.38,1845.95,6
HCPCS,47400,INCISION OF LIVER DUCT,,,2309.34,2309.34,1
HCPCS,47400,Incision of liver duct,,,1461.38,1845.95,6
HCPCS,474000,INCISION OF LIVER DUCT,,,2309.34,2309.34,1
HCPCS,47420,CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP,9693.0,6300.45,716.16,9693.0,35
HCPCS,47420,INCISION OF BILE DUCT,,,1438.24,1438.24,1
HCPCS,47420,Incision of bile duct,,,3427.97,4330.07,6
HCPCS,474200,INCISION OF BILE DUCT,,,1438.24,1438.24,1
HCPCS,47425,CHOLEDOCHOT/OST W/SPHNCTROTOMY/SPHNCTROP,8924.0,5800.6,772.45,8924.0,35
HCPCS,47425,INCISION OF BILE DUCT,,,1468.8,1468.8,1
HCPCS,47425,Incision of bile duct,,,2279.67,2879.58,6
HCPCS,474250,INCISION OF BILE DUCT,,,1468.8,1468.8,1
HCPCS,47460,INCISE BILE DUCT SPHINCTER,,,1363.69,1363.69,1
HCPCS,47460,Incise bile duct sphincter,,,1461.38,1845.95,6
HCPCS,47460,TRANSDUOL SPHINCTEROT/PLASTY W/WO RMVL CALCULUS,8208.0,5335.2,752.59,8208.0,35
HCPCS,474600,INCISE BILE DUCT SPHINCTER,,,1363.69,1363.69,1
HCPCS,47480,CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX,5300.0,3445.0,458.08,5300.0,35
HCPCS,47480,INCISION OF GALLBLADDER,,,938.0,938.0,1
HCPCS,47480,Incision of gallbladder,,,3427.97,4330.07,6
HCPCS,474800,INCISION OF GALLBLADDER,,,938.0,938.0,1
HCPCS,47490,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,11193.5,7275.775000000001,252.01,18263.7,158
HCPCS,47490,INCISION OF GALLBLADDER,,,344.68,344.68,1
HCPCS,474900,INCISION OF GALLBLADDER,,,344.68,344.68,1
HCPCS,47500,INJECTION PX PRQ TRANSHEPATIC CHOLANGIOGRAPHY,1125.0,731.25,189.0,1012.5,21
HCPCS,47505,INJ PX CHOLANGIOGRAPHY VIA CATHETER/T-TUBE,703.0,456.95,118.1,632.7,42
HCPCS,47510,INTRO PRQ TRANSHEPATC CATH BILIARY DRG,3775.0,2453.75,634.2,3397.5,21
HCPCS,47511,INTRODUCJ PERCUT TRANSHEPATC STENT BILIARY DRG,5238.0,3404.7,879.98,4714.2,21
HCPCS,47525,CHANGE PERCUTANEOUS BILIARY DRAINAGE CATHETER,3095.0,2011.75,519.96,2785.5,21
HCPCS,47530,REVISION &/REINSERTION TRANSHEPATC TUBE,3095.0,2011.75,519.96,2785.5,21
HCPCS,47531,INJECTION FOR CHOLANGIOGRAM,,,73.65,73.65,1
HCPCS,47531,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,10432.5,6781.125,66.09,18263.7,154
HCPCS,475310,INJECTION FOR CHOLANGIOGRAM,,,73.65,73.65,1
HCPCS,47532,INJECTION FOR CHOLANGIOGRAM,,,221.09,221.09,1
HCPCS,47532,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,11081.5,7202.975,166.87,18263.7,115
HCPCS,475320,INJECTION FOR CHOLANGIOGRAM,,,221.09,221.09,1
HCPCS,47533,PLMT BILIARY DRAINAGE CATH,,,275.24,275.24,1
HCPCS,47533,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,11330.0,7364.5,236.84,18263.7,115
HCPCS,475330,PLMT BILIARY DRAINAGE CATH,,,275.24,275.24,1
HCPCS,47534,PLMT BILIARY DRAINAGE CATH,,,385.35,385.35,1
HCPCS,47534,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,11818.5,7682.025000000001,314.1,18263.7,115
HCPCS,475340,PLMT BILIARY DRAINAGE CATH,,,385.35,385.35,1
HCPCS,47535,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,11015.5,7160.075000000001,180.21,18263.7,115
HCPCS,47535,CONVERSION EXT BIL DRG CATH,,,204.42,204.42,1
HCPCS,475350,CONVERSION EXT BIL DRG CATH,,,204.42,204.42,1
HCPCS,47536,EXCHANGE BILIARY DRG CATH,,,137.67,137.67,1
HCPCS,47536,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,10720.5,6968.325000000001,113.94,18263.7,115
HCPCS,475360,EXCHANGE BILIARY DRG CATH,,,137.67,137.67,1
HCPCS,47537,REMOVAL BILIARY DRG CATH,,,100.72,100.72,1
HCPCS,47537,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,3100.5,2015.325,76.82,6289.0,129
HCPCS,475370,REMOVAL BILIARY DRG CATH,,,100.72,100.72,1
HCPCS,47538,PERQ PLMT BILE DUCT STENT,,,244.86,244.86,1
HCPCS,47538,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,17819.0,11582.35,217.05,30193.2,115
HCPCS,475380,PERQ PLMT BILE DUCT STENT,,,244.86,244.86,1
HCPCS,47539,PERQ PLMT BILE DUCT STENT,,,445.33,445.33,1
HCPCS,47539,PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH,18524.0,12040.6,343.93,30193.2,115
HCPCS,475390,PERQ PLMT BILE DUCT STENT,,,445.33,445.33,1
HCPCS,47540,PERQ PLMT BILE DUCT STENT,,,458.69,458.69,1
HCPCS,47540,PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH,18580.0,12077.0,405.0,30193.2,115
HCPCS,475400,PERQ PLMT BILE DUCT STENT,,,458.69,458.69,1
HCPCS,47541,PLMT ACCESS BIL TREE SM BWL,,,350.62,350.62,1
HCPCS,47541,PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW,19289.5,12538.175,229.62,32291.1,115
HCPCS,475410,PLMT ACCESS BIL TREE SM BWL,,,350.62,350.62,1
HCPCS,47542,BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT,3150.5,2047.825,103.52,4644.9,93
HCPCS,47542,DILATE BILIARY DUCT/AMPULLA,,,141.93,141.93,1
HCPCS,475420,DILATE BILIARY DUCT/AMPULLA,,,141.93,141.93,1
HCPCS,47543,ENDOLUMINAL BX BILIARY TREE,,,149.81,149.81,1
HCPCS,47543,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH 1/MLT,4763.0,3095.95,172.84,4330.07,62
HCPCS,47543,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH SNG/MLT,1200.0,780.0,130.6,2211.23,31
HCPCS,475430,ENDOLUMINAL BX BILIARY TREE,,,149.81,149.81,1
HCPCS,47544,REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I,3634.5,2362.425,145.51,5243.4,93
HCPCS,47544,REMOVAL DUCT GLBLDR CALCULI,,,163.6,163.6,1
HCPCS,475440,REMOVAL DUCT GLBLDR CALCULI,,,163.6,163.6,1
HCPCS,47550,BILE DUCT ENDOSCOPY ADD-ON,,,175.1,175.1,1
HCPCS,47550,BILIARY NDSC INTRAOPERATIVE,1208.0,785.2,123.65,1208.0,35
HCPCS,47550,Bile duct endoscopy add-on,,,2720.71,3436.69,6
HCPCS,475500,BILE DUCT ENDOSCOPY ADD-ON,,,175.1,175.1,1
HCPCS,47552,BILIARY ENDO PERQ DX W/SPECI,,,294.92,294.92,1
HCPCS,47552,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,19145.5,12444.574999999999,200.46,32291.1,200
HCPCS,475520,BILIARY ENDO PERQ DX W/SPECI,,,294.92,294.92,1
HCPCS,47553,BILIARY ENDOSCOPY THRU SKIN,,,296.44,296.44,1
HCPCS,47553,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,19207.5,12484.875,210.9,32291.1,200
HCPCS,475530,BILIARY ENDOSCOPY THRU SKIN,,,296.44,296.44,1
HCPCS,47554,BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS,11956.5,7771.725,329.19,22573.24,119
HCPCS,47554,BILIARY ENDOSCOPY THRU SKIN,,,474.17,474.17,1
HCPCS,475540,BILIARY ENDOSCOPY THRU SKIN,,,474.17,474.17,1
HCPCS,47555,BILIARY ENDOSCOPY THRU SKIN,,,353.21,353.21,1
HCPCS,47555,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,11656.5,7576.725,250.22,18263.7,200
HCPCS,475550,BILIARY ENDOSCOPY THRU SKIN,,,353.21,353.21,1
HCPCS,47556,BILIARY ENDOSCOPY THRU SKIN,,,400.15,400.15,1
HCPCS,47556,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,31642.5,20567.625,280.42,53878.5,200
HCPCS,475560,BILIARY ENDOSCOPY THRU SKIN,,,400.15,400.15,1
HCPCS,47562,LAPAROSCOPIC CHOLECYSTECTOMY,,,711.43,12649.85,20
HCPCS,47562,LAPAROSCOPY SURG CHOLECYSTECTOMY,4188.0,2722.2,489.9,4188.0,35
HCPCS,47562,Laparoscopic cholecystectomy,,,2279.67,2879.58,6
HCPCS,475620,LAPAROSCOPIC CHOLECYSTECTOMY,,,711.43,711.43,1
HCPCS,47563,LAPARO CHOLECYSTECTOMY/GRAPH,,,773.6,12649.85,19
HCPCS,47563,LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,4588.0,2982.2,550.01,4588.0,35
HCPCS,47563,Laparo cholecystectomy/graph,,,2279.67,2879.58,6
HCPCS,475630,LAPARO CHOLECYSTECTOMY/GRAPH,,,773.6,773.6,1
HCPCS,47564,LAPARO CHOLECYSTECTOMY/EXPLR,,,1203.25,22573.24,15
HCPCS,47564,LAPS SURG CHOLECSTC W/EXPL COMMON DUCT,7200.0,4680.0,639.65,7200.0,35
HCPCS,47564,Laparo cholecystectomy/explr,,,2279.67,2879.58,6
HCPCS,475640,LAPARO CHOLECYSTECTOMY/EXPLR,,,1203.25,1203.25,1
HCPCS,47570,LAPARO CHOLECYSTOENTEROSTOMY,,,836.14,836.14,1
HCPCS,47570,LAPAROSCOPY SURG CHOLECYSTOENETEROSTOMY,5024.0,3265.6,586.67,5024.0,35
HCPCS,47570,Laparo cholecystoenterostomy,,,2279.67,2879.58,6
HCPCS,475700,LAPARO CHOLECYSTOENTEROSTOMY,,,836.14,836.14,1
HCPCS,47579,LAPAROSCOPIC CHOLECYSTOSTOMY TUBE PLACEMENT (COMP CODE 47480),5300.0,3445.0,611.77,5300.0,15
HCPCS,47579,"UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT (COMPARISON CODE 4",14924.0,9700.6,611.77,14924.0,15
HCPCS,47579,UNLISTED LAPS PX BILIARY TRC,,,5856.41,12649.85,14
HCPCS,47579,"UNLISTED PROC, LAP COMMON BILE DUCT EXPLORATION (COMP CODE 47420",9473.0,6157.45,611.77,9473.0,15
HCPCS,47579,UNLISTED PROC; LAP REPAIR OF COMMON BILE DUCT INJURY. (COMP TO 4,9649.0,6271.85,611.77,9649.0,15
HCPCS,47579,Unlisted laps px biliary trc,,,1461.38,1845.95,6
HCPCS,47600,CHOLECYSTECTOMY,6992.0,4544.8,528.61,6992.0,36
HCPCS,47600,Cholecystectomy,,,3427.97,4330.07,6
HCPCS,476000,CHOLECYSTECTOMY,,,1151.13,1151.13,1
HCPCS,47605,CHOLECYSTECTOMY W/CHOLANG,,,1212.53,1212.53,1
HCPCS,47605,CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,7392.0,4804.8,558.32,7392.0,35
HCPCS,47605,Cholecystectomy w/cholang,,,3427.97,4330.07,6
HCPCS,476050,CHOLECYSTECTOMY W/CHOLANG,,,1212.53,1212.53,1
HCPCS,47610,CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT,8368.0,5439.2,687.84,8368.0,35
HCPCS,47610,REMOVAL OF GALLBLADDER,,,1343.53,1343.53,1
HCPCS,47610,Removal of gallbladder,,,3427.97,4330.07,6
HCPCS,476100,REMOVAL OF GALLBLADDER,,,1343.53,1343.53,1
HCPCS,47612,CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY,8484.0,5514.6,807.26,8484.0,35
HCPCS,47612,REMOVAL OF GALLBLADDER,,,1369.75,1369.75,1
HCPCS,47612,Removal of gallbladder,,,2279.67,2879.58,6
HCPCS,476120,REMOVAL OF GALLBLADDER,,,1369.75,1369.75,1
HCPCS,47620,CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP,9228.0,5998.2,740.41,9228.0,35
HCPCS,47620,REMOVAL OF GALLBLADDER,,,1479.23,1479.23,1
HCPCS,47620,Removal of gallbladder,,,2279.67,2879.58,6
HCPCS,476200,REMOVAL OF GALLBLADDER,,,1479.23,1479.23,1
HCPCS,47630,BILIARY DUCT STONE XTRJ PRQ VIA BASKET/SNARE,3775.0,2453.75,634.2,3397.5,21
HCPCS,47700,EXPLOR CONG ATRESIA BILE DUCTS,6600.0,4290.0,622.2,6600.0,35
HCPCS,47700,EXPLORATION OF BILE DUCTS,,,1137.84,1137.84,1
HCPCS,47700,Exploration of bile ducts,,,1461.38,1845.95,6
HCPCS,477000,EXPLORATION OF BILE DUCTS,,,1137.84,1137.84,1
HCPCS,47701,BILE DUCT REVISION,,,1865.4,1865.4,1
HCPCS,47701,Bile duct revision,,,1461.38,1845.95,6
HCPCS,477010,BILE DUCT REVISION,,,1865.4,1865.4,1
HCPCS,47711,EXC BILE DUX TUM W/WO PRIM RPR XTRHEPATC,10360.0,6734.0,855.25,10360.0,35
HCPCS,47711,EXCISION OF BILE DUCT TUMOR,,,1674.4,1674.4,1
HCPCS,47711,Excision of bile duct tumor,,,1461.38,1845.95,6
HCPCS,477110,EXCISION OF BILE DUCT TUMOR,,,1674.4,1674.4,1
HCPCS,47712,EXC BILE DUX TUM W/WO PRIM RPR INTRAHEPATC,13488.0,8767.2,1030.05,13488.0,35
HCPCS,47712,EXCISION OF BILE DUCT TUMOR,,,2144.26,2144.26,1
HCPCS,47712,Excision of bile duct tumor,,,1461.38,1845.95,6
HCPCS,477120,EXCISION OF BILE DUCT TUMOR,,,2144.26,2144.26,1
HCPCS,47715,EXCISION OF BILE DUCT CYST,,,1430.06,1430.06,1
HCPCS,47715,EXCISION OF CHOLEDOCHAL CYST,8620.0,5603.0,670.52,8620.0,35
HCPCS,47715,Excision of bile duct cyst,,,1461.38,1845.95,6
HCPCS,477150,EXCISION OF BILE DUCT CYST,,,1430.06,1430.06,1
HCPCS,47720,FUSE GALLBLADDER & BOWEL,,,1241.07,1241.07,1
HCPCS,47720,Fuse gallbladder & bowel,,,2279.67,2879.58,6
HCPCS,477200,FUSE GALLBLADDER & BOWEL,,,1241.07,1241.07,1
HCPCS,47721,CHOLECYSTOENTEROSTOMY+GASTROENTERO,8635.0,5612.75,712.75,8635.0,35
HCPCS,47721,FUSE UPPER GI STRUCTURES,,,1456.09,1456.09,1
HCPCS,47721,Fuse upper gi structures,,,2279.67,2879.58,6
HCPCS,477210,FUSE UPPER GI STRUCTURES,,,1456.09,1456.09,1
HCPCS,47740,CHOLECYSTOENTEROSTOMY+ROUX-EN-Y,8492.0,5519.8,701.98,8492.0,35
HCPCS,47740,FUSE GALLBLADDER & BOWEL,,,1411.29,1411.29,1
HCPCS,47740,Fuse gallbladder & bowel,,,2279.67,2879.58,6
HCPCS,477400,FUSE GALLBLADDER & BOWEL,,,1411.29,1411.29,1
HCPCS,47741,FUSE GALLBLADDER & BOWEL,,,1586.1,1586.1,1
HCPCS,47741,Fuse gallbladder & bowel,,,2279.67,2879.58,6
HCPCS,477410,FUSE GALLBLADDER & BOWEL,,,1586.1,1586.1,1
HCPCS,47760,ANAST EXTRAHEP DUCT TO GI TRACT,15328.0,9963.2,1101.68,15328.0,35
HCPCS,47760,FUSE BILE DUCTS AND BOWEL,,,2419.36,2419.36,1
HCPCS,47760,Fuse bile ducts and bowel,,,3427.97,4330.07,6
HCPCS,477600,FUSE BILE DUCTS AND BOWEL,,,2419.36,2419.36,1
HCPCS,47765,ANAST INTRAHEP DUCT TO GI TRACT,20876.0,13569.4,1486.16,20876.0,35
HCPCS,47765,FUSE LIVER DUCTS & BOWEL,,,3255.16,3255.16,1
HCPCS,47765,Fuse liver ducts & bowel,,,3427.97,4330.07,6
HCPCS,477650,FUSE LIVER DUCTS & BOWEL,,,3255.16,3255.16,1
HCPCS,47780,"ANAST,ROUX-EN-Y,EXTRAHEP TO GI TRCT",16928.0,11003.2,1209.5,16928.0,35
HCPCS,47780,FUSE BILE DUCTS AND BOWEL,,,2660.58,2660.58,1
HCPCS,47780,Fuse bile ducts and bowel,,,3427.97,4330.07,6
HCPCS,477800,FUSE BILE DUCTS AND BOWEL,,,2660.58,2660.58,1
HCPCS,47785,"ANAST,ROUX-EN-Y,INTRAHEP TO GI TRCT",22476.0,14609.4,1576.56,22476.0,35
HCPCS,47785,FUSE BILE DUCTS AND BOWEL,,,3477.0,3477.0,1
HCPCS,47785,Fuse bile ducts and bowel,,,3427.97,4330.07,6
HCPCS,477850,FUSE BILE DUCTS AND BOWEL,,,3477.0,3477.0,1
HCPCS,47799,UNLISTED-JEJUN TUBE CHANGE,1069.0,694.85,534.5,1069.0,12
HCPCS,47800,RCNSTJ PLSTC BILIARY DUCTS W/END-TO-END ANAST,10468.0,6804.2,883.47,10468.0,35
HCPCS,47800,RECONSTRUCTION OF BILE DUCTS,,,1668.76,1668.76,1
HCPCS,47800,Reconstruction of bile ducts,,,1461.38,1845.95,6
HCPCS,478000,RECONSTRUCTION OF BILE DUCTS,,,1668.76,1668.76,1
HCPCS,47801,PLACEMENT BILE DUCT SUPPORT,,,1198.1,1198.1,1
HCPCS,47801,PLACEMENT CHOLEDOCHAL STENT,4750.0,3087.5,413.28,18285.0,67
HCPCS,478010,PLACEMENT BILE DUCT SUPPORT,,,1198.1,1198.1,1
HCPCS,47802,Fuse liver duct & intestine,,,1461.38,1845.95,6
HCPCS,47900,SUTURE BILE DUCT INJURY,,,1482.05,1482.05,1
HCPCS,47900,SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY,8976.0,5834.4,801.13,8976.0,35
HCPCS,47900,Suture bile duct injury,,,1461.38,1845.95,6
HCPCS,479000,SUTURE BILE DUCT INJURY,,,1482.05,1482.05,1
HCPCS,47999,BILE DUCT RECONSTRUCTION (COMP CODE 47760),16477.0,10710.05,763.14,16477.0,15
HCPCS,47999,ERCP W/ SUBMUCOSAL INJECTION (TATTOOING) (COMP 43236),1028.0,668.2,514.0,1028.0,15
HCPCS,47999,ERCP W/CONTROL OF BLEED (COMP CODE 44378),3019.0,1962.35,763.14,3019.0,15
HCPCS,47999,"FOREIGN BODY RETRIEVAL, BILIARY TRACT",1051.0,683.15,525.5,1051.0,15
HCPCS,47999,RF ABLATION BILIARY TRACT (COMP CODE 47556),28021.0,18213.649999999998,763.14,47666.7,63
HCPCS,47999,UNLISTED PROCEDURE BILIARY TRACT,3151.0,2048.15,816.11,8370.0,48
HCPCS,47999,"UNLISTED PROCEDURE, BILIARY TRACT (COMPARISON CODE 47900)",9649.0,6271.85,763.14,9649.0,15
HCPCS,48000,DRAINAGE OF ABDOMEN,,,2023.51,2023.51,1
HCPCS,48000,Drainage of abdomen,,,3427.97,4330.07,6
HCPCS,48000,PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS,12780.0,8307.0,965.16,12780.0,35
HCPCS,480000,DRAINAGE OF ABDOMEN,,,2023.51,2023.51,1
HCPCS,48001,PLACE DRAIN PERIPANCREATIC W/CHOLECYSTOSTOMY,15876.0,10319.4,1196.82,15876.0,35
HCPCS,48001,PLACEMENT OF DRAIN PANCREAS,,,2478.39,2478.39,1
HCPCS,48001,Placement of drain pancreas,,,3427.97,4330.07,6
HCPCS,480010,PLACEMENT OF DRAIN PANCREAS,,,2478.39,2478.39,1
HCPCS,48020,REMOVAL OF PANCREATIC STONE,7636.0,4963.4,589.45,7636.0,36
HCPCS,48020,Removal of pancreatic stone,,,1461.38,1845.95,6
HCPCS,480200,REMOVAL OF PANCREATIC STONE,,,1268.84,1268.84,1
HCPCS,48100,BIOPSY OF PANCREAS OPEN,,,959.48,959.48,1
HCPCS,48100,Biopsy of pancreas open,,,3427.97,4330.07,6
HCPCS,48100,OPEN BIOPSY OF PANCREAS,5784.0,3759.6,448.46,5784.0,35
HCPCS,481000,BIOPSY OF PANCREAS OPEN,,,959.48,959.48,1
HCPCS,48102,BIOPSY PANCREA PERCUTANEOUS NEEDLE,5598.0,3638.7,199.06,8384.4,231
HCPCS,48102,NEEDLE BIOPSY PANCREAS,,,248.28,248.28,1
HCPCS,481020,NEEDLE BIOPSY PANCREAS,,,248.28,248.28,1
HCPCS,48105,RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS,19704.0,12807.6,1559.0,19704.0,35
HCPCS,48105,RESECT/DEBRIDE PANCREAS,,,3019.01,3019.01,1
HCPCS,48105,Resect/debride pancreas,,,3427.97,4330.07,6
HCPCS,481050,RESECT/DEBRIDE PANCREAS,,,3019.01,3019.01,1
HCPCS,48120,EXCISION OF PANCREAS LESION,7364.0,4786.6,654.19,7364.0,35
HCPCS,48120,REMOVAL OF PANCREAS LESION,,,1198.63,1198.63,1
HCPCS,48120,Removal of pancreas lesion,,,3427.97,4330.07,6
HCPCS,481200,REMOVAL OF PANCREAS LESION,,,1198.63,1198.63,1
HCPCS,48140,PARTIAL REMOVAL OF PANCREAS,,,1684.56,1684.56,1
HCPCS,48140,PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY,10528.0,6843.2,924.31,10528.0,35
HCPCS,48140,Partial removal of pancreas,,,3427.97,4330.07,6
HCPCS,481400,PARTIAL REMOVAL OF PANCREAS,,,1684.56,1684.56,1
HCPCS,48145,PARTIAL REMOVAL OF PANCREAS,,,1756.2,1756.2,1
HCPCS,48145,PNCRTECT DSTL STOT W/PNCRTCOJEJUNOSTOMY,10956.0,7121.4,1008.81,10956.0,35
HCPCS,48145,Partial removal of pancreas,,,3427.97,4330.07,6
HCPCS,481450,PARTIAL REMOVAL OF PANCREAS,,,1756.2,1756.2,1
HCPCS,48146,PANCREATECTOMY,,,2021.55,2021.55,1
HCPCS,48146,Pancreatectomy,,,3427.97,4330.07,6
HCPCS,481460,PANCREATECTOMY,,,2021.55,2021.55,1
HCPCS,48148,EXCISION AMPULLA VATER,8156.0,5301.4,656.84,8156.0,35
HCPCS,48148,REMOVAL OF PANCREATIC DUCT,,,1345.04,1345.04,1
HCPCS,48148,Removal of pancreatic duct,,,1461.38,1845.95,6
HCPCS,481480,REMOVAL OF PANCREATIC DUCT,,,1345.04,1345.04,1
HCPCS,48150,PARTIAL REMOVAL OF PANCREAS,,,3345.12,3345.12,1
HCPCS,48150,PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY,21136.0,13738.4,1806.07,21136.0,35
HCPCS,48150,Partial removal of pancreas,,,3427.97,4330.07,6
HCPCS,481500,PARTIAL REMOVAL OF PANCREAS,,,3345.12,3345.12,1
HCPCS,48152,PANCREATECTOMY,,,3096.89,3096.89,1
HCPCS,48152,PNCRTECT WHIPPLE W/O PANCREATOJEJUNOSTOMY,19460.0,12649.0,1705.88,19460.0,35
HCPCS,48152,Pancreatectomy,,,3427.97,4330.07,6
HCPCS,481520,PANCREATECTOMY,,,3096.89,3096.89,1
HCPCS,48153,PANCREATECTOMY,,,3332.73,3332.73,1
HCPCS,48153,PNCRTECT W/PANCREATOJEJUNOSTOMY,21116.0,13725.4,1802.7,21116.0,35
HCPCS,48153,Pancreatectomy,,,3427.97,4330.07,6
HCPCS,481530,PANCREATECTOMY,,,3332.73,3332.73,1
HCPCS,48154,PANCREATECTOMY,,,3110.61,3110.61,1
HCPCS,48154,PNCRTECT PROX STOT W/O PANCREATOJEJUNOSTOMY,19552.0,12708.8,1706.36,19552.0,35
HCPCS,48154,Pancreatectomy,,,3427.97,4330.07,6
HCPCS,481540,PANCREATECTOMY,,,3110.61,3110.61,1
HCPCS,48155,PANCREATECTOMY TOTAL,11780.0,7657.0,1158.04,11780.0,35
HCPCS,48155,REMOVAL OF PANCREAS,,,1950.53,1950.53,1
HCPCS,48155,Removal of pancreas,,,3427.97,4330.07,6
HCPCS,481550,REMOVAL OF PANCREAS,,,1950.53,1950.53,1
HCPCS,48160,PANCREAS REMOVAL/TRANSPLANT,,,3303.57,3303.57,1
HCPCS,48160,PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS,13636.0,8863.4,6336.68,13636.0,13
HCPCS,48160,Pancreas removal/transplant,,,3427.97,4330.07,6
HCPCS,481600,PANCREAS REMOVAL/TRANSPLANT,,,3303.57,3303.57,1
HCPCS,48400,INJECTION INTRAOP ADD-ON,,,114.12,114.12,1
HCPCS,48400,INJECTION INTRAOPERATIVE PANCREATOGRAPHY,858.0,557.7,78.67,858.0,35
HCPCS,48400,Injection intraop add-on,,,223.78,282.67,6
HCPCS,484000,INJECTION INTRAOP ADD-ON,,,114.12,114.12,1
HCPCS,48500,SURGERY OF PANCREATIC CYST,,,1234.62,1234.62,1
HCPCS,48500,Surgery of pancreatic cyst,,,1461.38,1845.95,6
HCPCS,485000,SURGERY OF PANCREATIC CYST,,,1234.62,1234.62,1
HCPCS,48510,DRAIN PANCREATIC PSEUDOCYST,,,1177.56,1177.56,1
HCPCS,48510,Drain pancreatic pseudocyst,,,3427.97,4330.07,6
HCPCS,48510,EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN,6876.0,4469.4,560.72,6876.0,35
HCPCS,485100,DRAIN PANCREATIC PSEUDOCYST,,,1177.56,1177.56,1
HCPCS,48520,FUSE PANCREAS CYST AND BOWEL,,,1183.47,1183.47,1
HCPCS,48520,Fuse pancreas cyst and bowel,,,1461.38,1845.95,6
HCPCS,48520,INT ANAST PANCREATIC CYST GI TRACT DIRECT,7260.0,4719.0,686.58,7260.0,35
HCPCS,485200,FUSE PANCREAS CYST AND BOWEL,,,1183.47,1183.47,1
HCPCS,48540,FUSE PANCREAS CYST AND BOWEL,,,1406.39,1406.39,1
HCPCS,48540,Fuse pancreas cyst and bowel,,,1461.38,1845.95,6
HCPCS,48540,INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y,8776.0,5704.4,823.57,8776.0,35
HCPCS,485400,FUSE PANCREAS CYST AND BOWEL,,,1406.39,1406.39,1
HCPCS,48545,PANCREATORRHAPHY,,,1448.74,1448.74,1
HCPCS,48545,PANCREATORRHAPHY INJURY,8892.0,5779.8,672.43,8892.0,35
HCPCS,48545,Pancreatorrhaphy,,,1461.38,1845.95,6
HCPCS,485450,PANCREATORRHAPHY,,,1448.74,1448.74,1
HCPCS,48547,DUODENAL EXCLUSION,,,1926.7,1926.7,1
HCPCS,48547,Duodenal exclusion,,,1461.38,1845.95,6
HCPCS,485470,DUODENAL EXCLUSION,,,1926.7,1926.7,1
HCPCS,48548,FUSE PANCREAS AND BOWEL,,,1797.75,1797.75,1
HCPCS,48548,Fuse pancreas and bowel,,,1461.38,1845.95,6
HCPCS,48548,PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST,11236.0,7303.4,908.16,11236.0,35
HCPCS,485480,FUSE PANCREAS AND BOWEL,,,1797.75,1797.75,1
HCPCS,48550,DONOR PANCREATECTOMY,,,5992.68,5992.68,1
HCPCS,48550,Donor pancreatectomy,,,3411.14,4308.8,6
HCPCS,485500,DONOR PANCREATECTOMY,,,5992.68,5992.68,1
HCPCS,48551,PREP DONOR PANCREAS,,,265.91,265.91,1
HCPCS,48551,Prep donor pancreas,,,3411.14,4308.8,6
HCPCS,485510,PREP DONOR PANCREAS,,,265.91,265.91,1
HCPCS,48552,PREP DONOR PANCREAS/VENOUS,,,252.55,252.55,1
HCPCS,48552,Prep donor pancreas/venous,,,3411.14,4308.8,6
HCPCS,485520,PREP DONOR PANCREAS/VENOUS,,,252.55,252.55,1
HCPCS,48554,TRANSPL ALLOGRAFT PANCREAS,,,2809.1,2809.1,1
HCPCS,48554,Transpl allograft pancreas,,,3411.14,4308.8,6
HCPCS,485540,TRANSPL ALLOGRAFT PANCREAS,,,2809.1,2809.1,1
HCPCS,48556,REMOVAL ALLOGRAFT PANCREAS,,,1384.06,1384.06,1
HCPCS,48556,Removal allograft pancreas,,,1461.38,1845.95,6
HCPCS,485560,REMOVAL ALLOGRAFT PANCREAS,,,1384.06,1384.06,1
HCPCS,48999,EGD-PANCREATIC NECROSECTOMY HB,8303.0,5396.95,706.25,7472.7,41
HCPCS,48999,EGD-PSEUDOCYST NECROSECTOMY (COMP 48105),19704.0,12807.6,1120.55,19704.0,15
HCPCS,48999,LAP ENUCLEATION PANCREAS LESION (COMP 48120),6075.0,3948.75,1120.55,6075.0,15
HCPCS,48999,LAP PANCREAS DEBRIDEMENT (COMP 48105),16256.0,10566.4,1120.55,16256.0,15
HCPCS,48999,LAP REMOVAL PANCREAS W/OR W/O SPLENECTOM (COMP CODE 48140),10528.0,6843.2,1120.55,10528.0,15
HCPCS,48999,LAPAROSCOPIC PYLORUS PRESERVING PANCREATICODUODENECTOMY (COMP CO,22699.0,14754.35,1120.55,22699.0,15
HCPCS,48999,LAPAROSCOPIC WHIPPLE,21776.0,14154.4,1120.55,21776.0,15
HCPCS,48999,PANCREAS STONE SHOCK WAVE LITHOTRIPSY (COMP 50590),4201.0,2730.65,1120.55,4201.0,15
HCPCS,48999,UNLISTED LAP DEBRIDEMENT OF PANCREATIC CYST (COMP CODE 48105),15817.0,10281.05,1120.55,15817.0,15
HCPCS,48999,UNLISTED PROC; DUNKING PANCREATIC JEJUNAL ANASTOMOSIS (COMP CODE,6180.0,4017.0,1120.55,6180.0,15
HCPCS,48999,UNLISTED PROC; ENDOSCOPIC DEBRIDEMENT OF PANCREATIC PSEUDOCYST (,2860.0,1859.0,1120.55,2860.0,15
HCPCS,49000,EXPLORATION OF ABDOMEN,,,825.8,825.8,1
HCPCS,49000,EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX,3489.5,2268.175,329.78,18285.0,74
HCPCS,490000,EXPLORATION OF ABDOMEN,,,825.8,825.8,1
HCPCS,49002,REOPENING OF ABDOMEN,,,1120.11,1120.11,1
HCPCS,49002,REOPENING RECENT LAPAROTOMY,7052.0,4583.8,510.57,7052.0,35
HCPCS,49002,Reopening of abdomen,,,2290.02,2892.66,6
HCPCS,490020,REOPENING OF ABDOMEN,,,1120.11,1120.11,1
HCPCS,49010,EXPL RETROPERITONEUM W/WO BX SPX,6424.0,4175.6,522.95,6424.0,35
HCPCS,49010,EXPLORATION BEHIND ABDOMEN,,,991.53,7436.52,5
HCPCS,49010,Exploration behind abdomen,,,2290.02,2892.66,6
HCPCS,490100,EXPLORATION BEHIND ABDOMEN,,,991.53,991.53,1
HCPCS,49013,PREPERITONEAL PEL PACK F/HEMRRG ASSOC PEL TRMA,3340.0,2171.0,341.8,3340.0,31
HCPCS,49013,PRPERTL PEL PACK HEMRRG TRMA,,,489.86,489.86,1
HCPCS,49013,Prpertl pel pack hemrrg trma,,,2290.02,2892.66,6
HCPCS,490130,PRPERTL PEL PACK HEMRRG TRMA,,,489.86,489.86,1
HCPCS,49014,REEXPL PEL WND W/RMVL PREPERITONEAL PEL PACKING,2692.0,1749.8,282.19,2692.0,31
HCPCS,49014,REEXPLORATION PELVIC WOUND,,,406.81,406.81,1
HCPCS,49014,Reexploration pelvic wound,,,2290.02,2892.66,6
HCPCS,490140,REEXPLORATION PELVIC WOUND,,,406.81,406.81,1
HCPCS,49020,DRAINAGE ABDOM ABSCESS OPEN,,,1711.69,1711.69,1
HCPCS,49020,DRAINAGE PERITON ABSCESS/LOCAL PERITONITIS OPEN,2627.0,1707.55,441.34,18285.0,32
HCPCS,49020,DRG PERITONEAL ABSCESS/LOCAL PERITONITIS OPEN,10668.0,6934.2,815.84,10668.0,35
HCPCS,490200,DRAINAGE ABDOM ABSCESS OPEN,,,1711.69,1711.69,1
HCPCS,49040,DRAIN OPEN ABDOM ABSCESS,,,1077.48,1077.48,1
HCPCS,49040,DRAINAGE SUBDIAPHRAGMATIC/SUBPHREN ABSCESS OPEN,4534.0,2947.1,413.28,18285.0,67
HCPCS,490400,DRAIN OPEN ABDOM ABSCESS,,,1077.48,1077.48,1
HCPCS,49060,DRAIN OPEN RETROPERI ABSCESS,,,1175.27,1175.27,1
HCPCS,49060,DRAINAGE OF RETROPERITONEAL ABSCESS OPEN,4936.0,3208.4,413.28,18285.0,67
HCPCS,490600,DRAIN OPEN RETROPERI ABSCESS,,,1175.27,1175.27,1
HCPCS,49062,DRAIN TO PERITONEAL CAVITY,,,828.33,828.33,1
HCPCS,49062,DRG XTRAPERITONEAL LYMPHOCELE PERITON CAVITY OPN,4888.0,3177.2,511.91,4888.0,35
HCPCS,49062,Drain to peritoneal cavity,,,2290.02,2892.66,6
HCPCS,490620,DRAIN TO PERITONEAL CAVITY,,,828.33,828.33,1
HCPCS,49082,ABD PARACENTESIS,,,77.72,77.72,1
HCPCS,49082,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,2968.5,1929.525,46.97,4851.9,274
HCPCS,490820,ABD PARACENTESIS,,,77.72,77.72,1
HCPCS,49083,ABD PARACENTESIS W/IMAGING,,,111.65,111.65,1
HCPCS,49083,ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE,880.0,572.0,84.22,660.0,35
HCPCS,49083,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,5391.0,3504.15,127.33,4851.9,386
HCPCS,490830,ABD PARACENTESIS W/IMAGING,,,111.65,111.65,1
HCPCS,49084,PERITONEAL LAVAGE,,,114.44,114.44,1
HCPCS,49084,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,3135.5,2038.075,51.95,4851.9,179
HCPCS,490840,PERITONEAL LAVAGE,,,114.44,114.44,1
HCPCS,49180,BIOPSY ABDOMINAL MASS,,,87.25,87.25,1
HCPCS,49180,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,9316.0,6055.4,100.15,8384.4,242
HCPCS,49180,BX ABDL/RPR MASS PRQ NDL,761.0,494.65,74.44,570.75,35
HCPCS,491800,BIOPSY ABDOMINAL MASS,,,87.25,87.25,1
HCPCS,49185,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,5128.0,3333.2,94.97,8384.4,175
HCPCS,49185,SCLEROTX FLUID COLLECTION,,,125.46,125.46,1
HCPCS,491850,SCLEROTX FLUID COLLECTION,,,125.46,125.46,1
HCPCS,49186,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5 CM OR LESS,9680.0,6292.0,936.76,9680.0,28
HCPCS,49186,OPN EXC/DSTR NTRA-ABD 5 CM/<,,,1371.12,1371.12,1
HCPCS,49186,Opn exc/dstr ntra-abd 5 cm/<,,,2290.02,2892.66,6
HCPCS,491860,OPN EXC/DSTR NTRA-ABD 5 CM/<,,,1371.12,1371.12,1
HCPCS,49187,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5.1-10 CM,12606.0,8193.9,1200.07,12606.0,28
HCPCS,49187,OPN EXC/DSTR NTRA-ABD 5.1-10,,,1756.81,1756.81,1
HCPCS,49187,Opn exc/dstr ntra-abd 5.1-10,,,2290.02,2892.66,6
HCPCS,491870,OPN EXC/DSTR NTRA-ABD 5.1-10,,,1756.81,1756.81,1
HCPCS,49188,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 10.1-20 CM,14960.0,9724.0,1433.45,14960.0,28
HCPCS,49188,OPN EXC/DST NTRA-ABD 10.1-20,,,2098.34,2098.34,1
HCPCS,49188,Opn exc/dst ntra-abd 10.1-20,,,2290.02,2892.66,6
HCPCS,491880,OPN EXC/DST NTRA-ABD 10.1-20,,,2098.34,2098.34,1
HCPCS,49189,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 20.1-30 CM,17600.0,11440.0,1668.68,17600.0,28
HCPCS,49189,OPN EXC/DST NTRA-ABD 20.1-30,,,2442.94,2442.94,1
HCPCS,49189,Opn exc/dst ntra-abd 20.1-30,,,2290.02,2892.66,6
HCPCS,491890,OPN EXC/DST NTRA-ABD 20.1-30,,,2442.94,2442.94,1
HCPCS,49190,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CYST >30 CM,22000.0,14300.0,2057.98,22000.0,28
HCPCS,49190,OPN EXC/DSTR NTRA-ABD >30 CM,,,3013.26,3013.26,1
HCPCS,49190,Opn exc/dstr ntra-abd >30 cm,,,2290.02,2892.66,6
HCPCS,491900,OPN EXC/DSTR NTRA-ABD >30 CM,,,3013.26,3013.26,1
HCPCS,49203,Exc abd tum 5 cm or less,,,2290.02,2892.66,6
HCPCS,49204,Exc abd tum over 5 cm,,,2290.02,2892.66,6
HCPCS,49205,Exc abd tum over 10 cm,,,2290.02,2892.66,6
HCPCS,49215,EXCISE PRESACRAL/SACRAL TUMOR,15124.0,9830.6,1154.26,15124.0,35
HCPCS,49215,EXCISE SACRAL SPINE TUMOR,,,2379.64,2379.64,1
HCPCS,49215,Excise sacral spine tumor,,,1410.62,1781.83,6
HCPCS,492150,EXCISE SACRAL SPINE TUMOR,,,2379.64,2379.64,1
HCPCS,49220,Multiple surgery abdomen,,,2290.02,2892.66,6
HCPCS,49250,EXCISION OF UMBILICUS,,,638.72,7651.58,15
HCPCS,49250,Excision of umbilicus,,,2376.39,3001.75,6
HCPCS,49250,UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX,3604.0,2342.6,353.93,3604.0,35
HCPCS,492500,EXCISION OF UMBILICUS,,,638.72,638.72,1
HCPCS,49255,OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX,5024.0,3265.6,403.11,5024.0,35
HCPCS,49255,REMOVAL OF OMENTUM,,,850.93,7436.52,5
HCPCS,49255,Removal of omentum,,,2290.02,2892.66,6
HCPCS,492550,REMOVAL OF OMENTUM,,,850.93,850.93,1
HCPCS,49320,DIAG LAPARO SEPARATE PROC,,,354.28,12649.85,16
HCPCS,49320,Diag laparo separate proc,,,2290.02,2892.66,6
HCPCS,49320,LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX,2262.0,1470.3,245.54,2262.0,35
HCPCS,493200,DIAG LAPARO SEPARATE PROC,,,354.28,354.28,1
HCPCS,49321,L'SCOPE W/BIOPSY SINGLE/MULTIPLE,2176.0,1414.4,258.5,2176.0,35
HCPCS,49321,LAPAROSCOPY BIOPSY,,,370.3,12649.85,19
HCPCS,49321,Laparoscopy biopsy,,,2290.02,2892.66,6
HCPCS,493210,LAPAROSCOPY BIOPSY,,,370.3,370.3,1
HCPCS,49322,L'SCOPE CAVITY/CYST SINGLE/MULTIPLE,2404.0,1562.6,275.69,2404.0,35
HCPCS,49322,LAPAROSCOPY ASPIRATION,,,403.32,12649.85,15
HCPCS,49322,Laparoscopy aspiration,,,2290.02,2892.66,6
HCPCS,493220,LAPAROSCOPY ASPIRATION,,,403.32,403.32,1
HCPCS,49323,L'SCOPE W/DRNG  LYMPHOCELE TO PERIT,4092.0,2659.8,420.98,4092.0,35
HCPCS,49323,LAPARO DRAIN LYMPHOCELE,,,686.83,12649.85,15
HCPCS,49323,Laparo drain lymphocele,,,2290.02,2892.66,6
HCPCS,493230,LAPARO DRAIN LYMPHOCELE,,,686.83,686.83,1
HCPCS,49324,LAP INSERT TUNNEL IP CATH,,,416.25,12649.85,16
HCPCS,49324,LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER,2528.0,1643.2,215.74,2528.0,35
HCPCS,49324,Lap insert tunnel ip cath,,,2290.02,2892.66,6
HCPCS,493240,LAP INSERT TUNNEL IP CATH,,,416.25,416.25,1
HCPCS,49325,LAP REVISION PERM IP CATH,,,444.18,12649.85,15
HCPCS,49325,LAPS W/REVISION INTRAPERITONEAL CATHETER,2728.0,1773.2,232.47,2728.0,35
HCPCS,49325,Lap revision perm ip cath,,,2290.02,2892.66,6
HCPCS,493250,LAP REVISION PERM IP CATH,,,444.18,444.18,1
HCPCS,49326,LAP W/OMENTOPEXY ADD-ON,,,202.14,202.14,1
HCPCS,49326,LAPAROSCOPY W/OMENTOPEXY,1400.0,910.0,107.41,1400.0,35
HCPCS,49326,Lap w/omentopexy add-on,,,2290.02,2892.66,6
HCPCS,493260,LAP W/OMENTOPEXY ADD-ON,,,202.14,202.14,1
HCPCS,49327,LAP INS DEVICE FOR RT,,,139.44,139.44,1
HCPCS,49327,LAPS W/INSERTION NTRSTL DEV W/IMG GID 1+,952.0,618.8,60.78,952.0,35
HCPCS,493270,LAP INS DEVICE FOR RT,,,139.44,139.44,1
HCPCS,49329,LAP DRAINAGE OF ABD ABSCESS (COMP 49020),3987.0,2591.55,252.02,3987.0,15
HCPCS,49329,"LAP EXCISION ABD, PERITONEUM, OMENTUM 10.1-20CM (COMP 49188)",14620.0,9503.0,252.02,14620.0,15
HCPCS,49329,"LAP EXCISION ABD, PERITONEUM, OMENTUM 20.1-30CM (COMP 49189)",17200.0,11180.0,252.02,17200.0,15
HCPCS,49329,"LAP EXCISION ABD, PERITONEUM, OMENTUM 5CM OR LESS (COMP 49186)",9460.0,6149.0,252.02,9460.0,15
HCPCS,49329,"LAP EXCISION ABD, PERITONEUM, OMENTUM GREATER THAN 30CM (COMP 49",21500.0,13975.0,252.02,21500.0,15
HCPCS,49329,LAP EXCISION OF A PRESACRAL SINUS(FISTULA) TRACT/ABSCESS (COMP 4,15124.0,9830.6,252.02,15124.0,15
HCPCS,49329,LAP EXPLORATION FOR POST OP HEMORRHAGE,3851.0,2503.15,252.02,3851.0,15
HCPCS,49329,"LAP LYSIS ADHESIONS,PERITONEAL (COMP CODE 44180)",5013.0,3258.45,252.02,5013.0,15
HCPCS,49329,LAP RELEASE MEDIAN ARCUATE LIGAMENT (COMP 49320),2056.0,1336.4,252.02,2056.0,15
HCPCS,49329,"LAP,EXCISION ABD, PERITONEUM, OMENTUM 5.1-10CM (COMP 49187)",12320.0,8008.0,252.02,12320.0,15
HCPCS,49329,LAPAROPSCOPIC URACHAL CYST EXCISION (COMP CODE 39545),5868.0,3814.2,252.02,5868.0,15
HCPCS,49329,LAPAROSCOPIC EVACUATION HEMATOMA (COMP 49002),1967.0,1278.55,252.02,1967.0,15
HCPCS,49329,LAPAROSCOPIC EXCISION OMENTUM (49255),5024.0,3265.6,252.02,5024.0,15
HCPCS,49329,LAPAROSCOPIC RELEASE OF MEDIAN ARCUATE LIGAMENT (MALS PROC) (COM,7783.0,5058.95,252.02,7783.0,15
HCPCS,49329,LAPROSCOPIC OMENTAL FLAP INTRA-ABDOMINAL (COMP CODE 49905),968.0,629.2,252.02,968.0,15
HCPCS,49329,LX EXCISION OF RETROPERITONEAL TUMOR (COMP 49203),8655.0,5625.75,252.02,8655.0,15
HCPCS,49329,POST OP LAP EXPLOR & CONTROL HEMORRHAGE ABD (COMP TO 35840),8923.0,5799.95,252.02,8923.0,15
HCPCS,49329,"UNLISTED LAP REMOVAL FOREIGN BODY , ABD (COMP CODE 49402)",4739.0,3080.35,252.02,4739.0,15
HCPCS,49329,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",6538.0,4249.7,252.02,10452.0,90
HCPCS,49329,"UNLISTED LAPAROSCOPY, ABDOMEN, PERITONEUM AND OMENTUM (COMP CODE",2728.0,1773.2,252.02,2728.0,15
HCPCS,49329,UNLSTD LAPS PX ABD PERTM&OMN,,,5856.41,12649.85,16
HCPCS,49329,Unlstd laps px abd pertm&omn,,,2290.02,2892.66,6
HCPCS,49400,AIR INJECTION INTO ABDOMEN,,,95.27,95.27,1
HCPCS,49400,INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX,406.0,263.9,68.21,4214.0,76
HCPCS,494000,AIR INJECTION INTO ABDOMEN,,,95.27,95.27,1
HCPCS,49402,REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY,5636.0,3663.4,467.2,5636.0,35
HCPCS,49402,REMOVE FOREIGN BODY ADBOMEN,,,919.19,7651.58,15
HCPCS,49402,Remove foreign body adbomen,,,2290.02,2892.66,6
HCPCS,494020,REMOVE FOREIGN BODY ADBOMEN,,,919.19,919.19,1
HCPCS,49405,IMAGE CATH FLUID COLXN VISC,,,204.26,204.26,1
HCPCS,49405,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,5458.0,3547.7,157.0,8550.0,273
HCPCS,494050,IMAGE CATH FLUID COLXN VISC,,,204.26,204.26,1
HCPCS,49406,CT GD DRAIN PERI/RETROPERI PER,9316.0,6055.4,233.77,8550.0,46
HCPCS,49406,IMAGE CATH FLUID PERI/RETRO,,,204.26,204.26,1
HCPCS,49406,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,5538.0,3599.7,157.23,8550.0,227
HCPCS,494060,IMAGE CATH FLUID PERI/RETRO,,,204.26,204.26,1
HCPCS,49407,IMAGE CATH FLUID TRNS/VGNL,,,216.79,216.79,1
HCPCS,49407,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,5508.0,3580.2,167.42,8384.4,227
HCPCS,494070,IMAGE CATH FLUID TRNS/VGNL,,,216.79,216.79,1
HCPCS,49411,INS MARK ABD/PEL FOR RT PERQ,,,194.9,194.9,1
HCPCS,49411,INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT,4648.0,3021.2,111.82,7730.0,182
HCPCS,494110,INS MARK ABD/PEL FOR RT PERQ,,,194.9,194.9,1
HCPCS,49412,INS DEVICE FOR RT GUIDE OPEN,,,88.15,88.15,1
HCPCS,49412,PLMT INTRSTL DEV OPN W/IMG GID 1+,600.0,390.0,45.54,600.0,35
HCPCS,494120,INS DEVICE FOR RT GUIDE OPEN,,,88.15,88.15,1
HCPCS,49418,INSERT TUN IP CATH PERC,,,210.28,210.28,1
HCPCS,49418,INSJ INTRAPERITONEAL CATHETER W/IMG GID,1584.0,1029.6,187.9,2375.72,35
HCPCS,49418,INSJ INTRAPERITONEAL CATHETER W/IMG GUID,20293.0,13190.45,241.61,18263.7,123
HCPCS,494180,INSERT TUN IP CATH PERC,,,210.28,210.28,1
HCPCS,49419,INSERT TUN IP CATH W/PORT,,,446.9,11720.45,15
HCPCS,49419,INSERTION TUNNEL INTRAPERITONEAL CATH SUBQ PORT,2832.0,1840.8,276.65,2832.0,35
HCPCS,49419,Insert tun ip cath w/port,,,2290.02,2892.66,6
HCPCS,494190,INSERT TUN IP CATH W/PORT,,,446.9,446.9,1
HCPCS,49421,INS TUN IP CATH FOR DIAL OPN,,,243.08,243.08,1
HCPCS,49421,INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN,10988.5,7142.525000000001,172.6,18263.7,77
HCPCS,494210,INS TUN IP CATH FOR DIAL OPN,,,243.08,243.08,1
HCPCS,49422,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,9929.0,6453.85,168.26,36332.0,228
HCPCS,49422,REMOVE TUNNELED IP CATH,,,237.11,237.11,1
HCPCS,494220,REMOVE TUNNELED IP CATH,,,237.11,237.11,1
HCPCS,49423,EXCHANGE DRAINAGE CATHETER,,,74.29,74.29,1
HCPCS,49423,EXCHNG ABSC/CST DRG CATH RAD GID SPX,5775.0,3753.75,63.08,9817.2,277
HCPCS,494230,EXCHANGE DRAINAGE CATHETER,,,74.29,74.29,1
HCPCS,49424,ASSESS CYST CONTRAST INJECT,,,39.25,39.25,1
HCPCS,49424,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,565.0,367.25,33.68,4214.0,184
HCPCS,494240,ASSESS CYST CONTRAST INJECT,,,39.25,39.25,1
HCPCS,49425,INSERT ABDOMEN-VENOUS DRAIN,,,840.35,840.35,1
HCPCS,49425,INSERTION PERITONEAL-VENOUS SHUNT,9759.5,6343.674999999999,512.25,18285.0,67
HCPCS,494250,INSERT ABDOMEN-VENOUS DRAIN,,,840.35,840.35,1
HCPCS,49426,REVIS PERITONEAL-VENOUS SHUNT,4164.0,2706.6,412.6,4164.0,35
HCPCS,49426,REVISE ABDOMEN-VENOUS SHUNT,,,721.76,7651.58,15
HCPCS,49426,Revise abdomen-venous shunt,,,2290.02,2892.66,6
HCPCS,494260,REVISE ABDOMEN-VENOUS SHUNT,,,721.76,721.76,1
HCPCS,49427,INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT,674.5,438.42499999999995,29.87,4214.0,73
HCPCS,49427,INJECTION ABDOMINAL SHUNT,,,41.48,41.48,1
HCPCS,494270,INJECTION ABDOMINAL SHUNT,,,41.48,41.48,1
HCPCS,49428,LIGATION OF ABD-VENOUS SHUNT,2748.0,1786.2,223.43,2748.0,35
HCPCS,49428,LIGATION OF SHUNT,,,463.57,463.57,1
HCPCS,49428,Ligation of shunt,,,2290.02,2892.66,6
HCPCS,494280,LIGATION OF SHUNT,,,463.57,463.57,1
HCPCS,49429,REMOVAL OF SHUNT,,,492.11,492.11,1
HCPCS,49429,RMVL PERITONEAL-VENOUS SHUNT,10537.0,6849.05,298.65,36332.0,84
HCPCS,494290,REMOVAL OF SHUNT,,,492.11,492.11,1
HCPCS,49435,INSERT SUBQ EXTEN TO IP CATH,,,126.44,126.44,1
HCPCS,49435,Insert subq exten to ip cath,,,454.96,574.68,6
HCPCS,494350,INSERT SUBQ EXTEN TO IP CATH,,,126.44,126.44,1
HCPCS,49436,EMBEDDED IP CATH EXIT-SITE,,,199.37,4112.99,15
HCPCS,49436,Embedded ip cath exit-site,,,454.96,574.68,6
HCPCS,494360,EMBEDDED IP CATH EXIT-SITE,,,199.37,199.37,1
HCPCS,49440,INSERT GASTROSTOMY TUBE PERCUTANEOUS,6318.5,4107.025,181.25,9817.2,133
HCPCS,49440,PLACE GASTROSTOMY TUBE PERC,,,212.76,212.76,1
HCPCS,494400,PLACE GASTROSTOMY TUBE PERC,,,212.76,212.76,1
HCPCS,49441,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,6358.0,4132.7,181.25,9817.2,133
HCPCS,49441,PLACE DUOD/JEJ TUBE PERC,,,253.79,253.79,1
HCPCS,494410,PLACE DUOD/JEJ TUBE PERC,,,253.79,253.79,1
HCPCS,49442,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,4140.0,2691.0,180.78,36332.0,133
HCPCS,49442,PLACE CECOSTOMY TUBE PERC,,,216.15,216.15,1
HCPCS,494420,PLACE CECOSTOMY TUBE PERC,,,216.15,216.15,1
HCPCS,49446,CHANGE G-TUBE TO G-J PERC,,,153.77,153.77,1
HCPCS,49446,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,6066.0,3942.9,136.57,9817.2,133
HCPCS,494460,CHANGE G-TUBE TO G-J PERC,,,153.77,153.77,1
HCPCS,49450,REPLACE G/C TUBE PERC,,,68.91,68.91,1
HCPCS,49450,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,2967.5,1928.875,57.96,6289.0,179
HCPCS,494500,REPLACE G/C TUBE PERC,,,68.91,68.91,1
HCPCS,49451,REPLACE DUOD/JEJ TUBE PERC,,,93.09,93.09,1
HCPCS,49451,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,3063.5,1991.275,80.41,6289.0,228
HCPCS,494510,REPLACE DUOD/JEJ TUBE PERC,,,93.09,93.09,1
HCPCS,49452,REPLACE G-J TUBE PERC,,,143.29,143.29,1
HCPCS,49452,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,3267.5,2123.875,123.16,6289.0,133
HCPCS,494520,REPLACE G-J TUBE PERC,,,143.29,143.29,1
HCPCS,49460,FIX G/COLON TUBE W/DEVICE,,,53.49,53.49,1
HCPCS,49460,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,2887.5,1876.875,41.51,6289.0,133
HCPCS,494600,FIX G/COLON TUBE W/DEVICE,,,53.49,53.49,1
HCPCS,49465,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,819.0,532.35,26.28,4151.0,228
HCPCS,49465,FLUORO EXAM OF G/COLON TUBE,,,32.02,32.02,1
HCPCS,494650,FLUORO EXAM OF G/COLON TUBE,,,32.02,32.02,1
HCPCS,49491,RPR HERN PREEMIE REDUC,,,860.38,12649.85,15
HCPCS,49491,Rpr hern preemie reduc,,,2376.39,3001.75,6
HCPCS,494910,RPR HERN PREEMIE REDUC,,,860.38,860.38,1
HCPCS,49492,RPR ING HERN PREMIE BLOCKED,,,1034.55,7651.58,15
HCPCS,49492,Rpr ing hern premie blocked,,,2376.39,3001.75,6
HCPCS,494920,RPR ING HERN PREMIE BLOCKED,,,1034.55,1034.55,1
HCPCS,49495,RPR ING HERNIA BABY REDUC,,,440.91,7651.58,15
HCPCS,49495,Rpr ing hernia baby reduc,,,2376.39,3001.75,6
HCPCS,494950,RPR ING HERNIA BABY REDUC,,,440.91,440.91,1
HCPCS,49496,RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER,3768.0,2449.2,384.17,3768.0,35
HCPCS,49496,RPR ING HERNIA BABY BLOCKED,,,663.92,7651.58,15
HCPCS,49496,Rpr ing hernia baby blocked,,,2376.39,3001.75,6
HCPCS,494960,RPR ING HERNIA BABY BLOCKED,,,663.92,663.92,1
HCPCS,49500,RPR ING HERNIA INIT REDUCE,,,448.07,13528.81,15
HCPCS,49500,Rpr ing hernia init reduce,,,2376.39,3001.75,6
HCPCS,495000,RPR ING HERNIA INIT REDUCE,,,448.07,448.07,1
HCPCS,49501,RPR ING HERNIA INIT BLOCKED,,,654.29,7651.58,15
HCPCS,49501,Rpr ing hernia init blocked,,,2376.39,3001.75,6
HCPCS,495010,RPR ING HERNIA INIT BLOCKED,,,654.29,654.29,1
HCPCS,49505,PRP I/HERN INIT REDUC >5 YR,,,563.45,7651.58,17
HCPCS,49505,Prp i/hern init reduc >5 yr,,,2376.39,3001.75,6
HCPCS,49505,RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE,3184.0,2069.6,298.01,3184.0,35
HCPCS,495050,PRP I/HERN INIT REDUC >5 YR,,,563.45,563.45,1
HCPCS,49507,PRP I/HERN INIT BLOCK >5 YR,,,633.48,7651.58,15
HCPCS,49507,Prp i/hern init block >5 yr,,,2376.39,3001.75,6
HCPCS,49507,RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED,3636.0,2363.4,364.74,3636.0,35
HCPCS,495070,PRP I/HERN INIT BLOCK >5 YR,,,633.48,633.48,1
HCPCS,49520,REREPAIR ING HERNIA REDUCE,,,683.32,7651.58,15
HCPCS,49520,RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE,3996.0,2597.4,367.48,3996.0,35
HCPCS,49520,Rerepair ing hernia reduce,,,2376.39,3001.75,6
HCPCS,495200,REREPAIR ING HERNIA REDUCE,,,683.32,683.32,1
HCPCS,49521,REREPAIR ING HERNIA BLOCKED,,,772.59,13528.81,15
HCPCS,49521,RPR RECRT INGUN HERNIA ANY AGE INCARCERATED,4592.0,2984.8,418.51,4592.0,35
HCPCS,49521,Rerepair ing hernia blocked,,,2376.39,3001.75,6
HCPCS,495210,REREPAIR ING HERNIA BLOCKED,,,772.59,772.59,1
HCPCS,49525,REPAIR ING HERNIA SLIDING,,,618.42,7651.58,15
HCPCS,49525,RPR INGUN HERNIA SLIDING ANY AGE,3572.0,2321.8,348.86,3572.0,35
HCPCS,49525,Repair ing hernia sliding,,,2376.39,3001.75,6
HCPCS,495250,REPAIR ING HERNIA SLIDING,,,618.42,618.42,1
HCPCS,49540,REPAIR LUMBAR HERNIA,4296.0,2792.4,385.22,12649.85,50
HCPCS,49540,Repair lumbar hernia,,,2419.02,3055.61,6
HCPCS,495400,REPAIR LUMBAR HERNIA,,,723.58,723.58,1
HCPCS,49550,RPR 1ST FEM HRNA ANY AGE REDUCIBLE,3596.0,2337.4,325.53,3596.0,35
HCPCS,49550,RPR REM HERNIA INIT REDUCE,,,623.05,7651.58,15
HCPCS,49550,Rpr rem hernia init reduce,,,2376.39,3001.75,6
HCPCS,495500,RPR REM HERNIA INIT REDUCE,,,623.05,623.05,1
HCPCS,49553,RPR 1ST FEM HERNIA ANY AGE INCARCERATED,3968.0,2579.2,347.3,3968.0,35
HCPCS,49553,RPR FEM HERNIA INIT BLOCKED,,,681.52,7651.58,15
HCPCS,49553,Rpr fem hernia init blocked,,,2376.39,3001.75,6
HCPCS,495530,RPR FEM HERNIA INIT BLOCKED,,,681.52,681.52,1
HCPCS,49555,REREPAIR FEM HERNIA REDUCE,,,652.08,7651.58,15
HCPCS,49555,RPR RECRT FEM HERNIA REDUCIBLE,3756.0,2441.4,373.63,3756.0,35
HCPCS,49555,Rerepair fem hernia reduce,,,2376.39,3001.75,6
HCPCS,495550,REREPAIR FEM HERNIA REDUCE,,,652.08,652.08,1
HCPCS,49557,REREPAIR FEM HERNIA BLOCKED,,,779.19,7651.58,15
HCPCS,49557,RPR RECRT FEM HRNA INCARCERATED,4648.0,3021.2,423.54,4648.0,35
HCPCS,49557,Rerepair fem hernia blocked,,,2376.39,3001.75,6
HCPCS,495570,REREPAIR FEM HERNIA BLOCKED,,,779.19,779.19,1
HCPCS,49560,Rpr ventral hern init reduc,,,2419.02,3055.61,6
HCPCS,49561,Rpr ventral hern init block,,,2419.02,3055.61,6
HCPCS,49565,Rerepair ventrl hern reduce,,,2419.02,3055.61,6
HCPCS,49566,Rerepair ventrl hern block,,,2419.02,3055.61,6
HCPCS,49568,Hernia repair w/mesh,,,2419.02,3055.61,6
HCPCS,49570,Rpr epigastric hern reduce,,,2419.02,3055.61,6
HCPCS,49572,Rpr epigastric hern blocked,,,2419.02,3055.61,6
HCPCS,49580,Rpr umbil hern reduc < 5 yr,,,2376.39,3001.75,6
HCPCS,49582,Rpr umbil hern block < 5 yr,,,2376.39,3001.75,6
HCPCS,49585,Rpr umbil hern reduc > 5 yr,,,2376.39,3001.75,6
HCPCS,49587,Rpr umbil hern block > 5 yr,,,2376.39,3001.75,6
HCPCS,49590,Repair spigelian hernia,,,2419.02,3055.61,6
HCPCS,49591,RPR AA HERNIA 1ST < 3 CM REDUCIBLE,2622.0,1704.3,80.98,2622.0,31
HCPCS,49591,RPR AA HRN 1ST < 3 CM RDC,,,368.53,9115.0,19
HCPCS,49591,Rpr aa hrn 1st < 3 cm rdc,,,2419.02,3055.61,6
HCPCS,495910,RPR AA HRN 1ST < 3 CM RDC,,,368.53,368.53,1
HCPCS,49592,RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED,3722.0,2419.3,105.95,3722.0,31
HCPCS,49592,RPR AA HRN 1ST < 3 NCR/STRN,,,512.84,12649.85,18
HCPCS,49592,Rpr aa hrn 1st < 3 ncr/strn,,,2419.02,3055.61,6
HCPCS,495920,RPR AA HRN 1ST < 3 NCR/STRN,,,512.84,512.84,1
HCPCS,49593,RPR AA HERNIA 1ST 3-10 CM REDUCIBLE,4514.0,2934.1,126.28,4514.0,31
HCPCS,49593,RPR AA HRN 1ST 3-10 RDC,,,617.85,13528.81,19
HCPCS,49593,Rpr aa hrn 1st 3-10 rdc,,,2419.02,3055.61,6
HCPCS,495930,RPR AA HRN 1ST 3-10 RDC,,,617.85,617.85,1
HCPCS,49594,RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED,5922.0,3849.3,159.64,5922.0,31
HCPCS,49594,RPR AA HRN 1ST 3-10 NCR/STRN,,,804.66,12649.85,18
HCPCS,49594,Rpr aa hrn 1st 3-10 ncr/strn,,,2419.02,3055.61,6
HCPCS,495940,RPR AA HRN 1ST 3-10 NCR/STRN,,,804.66,804.66,1
HCPCS,49595,RPR AA HERNIA 1ST > 10 CM REDUCIBLE,6134.0,3987.1,165.45,6134.0,31
HCPCS,49595,RPR AA HRN 1ST > 10 RDC,,,831.6,13528.81,15
HCPCS,49595,Rpr aa hrn 1st > 10 rdc,,,2419.02,3055.61,6
HCPCS,495950,RPR AA HRN 1ST > 10 RDC,,,831.6,831.6,1
HCPCS,49596,RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED,8215.0,5339.75,215.38,8215.0,31
HCPCS,49596,RPR AA HRN 1ST > 10 NCR/STRN,,,1103.51,1103.51,1
HCPCS,49596,Rpr aa hrn 1st > 10 ncr/strn,,,2419.02,3055.61,6
HCPCS,495960,RPR AA HRN 1ST > 10 NCR/STRN,,,1103.51,1103.51,1
HCPCS,49600,REPAIR UMBILICAL LESION,,,791.88,7651.58,15
HCPCS,49600,Repair umbilical lesion,,,2419.02,3055.61,6
HCPCS,496000,REPAIR UMBILICAL LESION,,,791.88,791.88,1
HCPCS,49605,REPAIR UMBILICAL LESION,,,5284.06,5284.06,1
HCPCS,49605,Repair umbilical lesion,,,2419.02,3055.61,6
HCPCS,496050,REPAIR UMBILICAL LESION,,,5284.06,5284.06,1
HCPCS,49606,REPAIR UMBILICAL LESION,,,1222.98,1222.98,1
HCPCS,49606,Repair umbilical lesion,,,2419.02,3055.61,6
HCPCS,496060,REPAIR UMBILICAL LESION,,,1222.98,1222.98,1
HCPCS,49610,REPAIR UMBILICAL LESION,,,748.28,748.28,1
HCPCS,49610,Repair umbilical lesion,,,2419.02,3055.61,6
HCPCS,496100,REPAIR UMBILICAL LESION,,,748.28,748.28,1
HCPCS,49611,REPAIR UMBILICAL LESION,,,658.85,658.85,1
HCPCS,49611,Repair umbilical lesion,,,2419.02,3055.61,6
HCPCS,496110,REPAIR UMBILICAL LESION,,,658.85,658.85,1
HCPCS,49613,RPR AA HERNIA RECR < 3 CM REDUCIBLE,2968.0,1929.2,98.12,2968.0,31
HCPCS,49613,RPR AA HRN RCR < 3 RDC,,,454.27,7651.58,15
HCPCS,49613,Rpr aa hrn rcr < 3 rdc,,,2419.02,3055.61,6
HCPCS,496130,RPR AA HRN RCR < 3 RDC,,,454.27,454.27,1
HCPCS,49614,RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED,4100.0,2665.0,125.4,4100.0,31
HCPCS,49614,RPR AA HRN RCR < 3 NCR/STRN,,,616.05,12649.85,15
HCPCS,49614,Rpr aa hrn rcr < 3 ncr/strn,,,2419.02,3055.61,6
HCPCS,496140,RPR AA HRN RCR < 3 NCR/STRN,,,616.05,616.05,1
HCPCS,49615,RPR AA HERNIA RECR 3-10 CM REDUCIBLE,4584.0,2979.6,140.49,4584.0,31
HCPCS,49615,RPR AA HRN RCR 3-10 RDC,,,688.78,13528.81,17
HCPCS,49615,Rpr aa hrn rcr 3-10 rdc,,,2419.02,3055.61,6
HCPCS,496150,RPR AA HRN RCR 3-10 RDC,,,688.78,688.78,1
HCPCS,49616,RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED,6842.0,4447.3,182.3,6842.0,31
HCPCS,49616,RPR AA HRN RCR 3-10 NCR/STRN,,,926.31,18285.0,3
HCPCS,49616,Rpr aa hrn rcr 3-10 ncr/strn,,,2419.02,3055.61,6
HCPCS,496160,RPR AA HRN RCR 3-10 NCR/STRN,,,926.31,926.31,1
HCPCS,49617,RPR AA HERNIA RECR > 10 CM REDUCIBLE,6412.0,4167.8,190.71,6412.0,31
HCPCS,49617,RPR AA HRN RCR > 10 RDC,,,953.97,953.97,1
HCPCS,49617,Rpr aa hrn rcr > 10 rdc,,,2419.02,3055.61,6
HCPCS,496170,RPR AA HRN RCR > 10 RDC,,,953.97,953.97,1
HCPCS,49618,RPR AA HERNIA RECR > 10 CM NCRC8/STRANGULATED,9068.0,5894.2,258.35,9068.0,31
HCPCS,49618,RPR AA HRN RCR > 10 NCR/STRN,,,1337.46,11329.0,2
HCPCS,49618,Rpr aa hrn rcr > 10 ncr/strn,,,2419.02,3055.61,6
HCPCS,496180,RPR AA HRN RCR > 10 NCR/STRN,,,1337.46,1337.46,1
HCPCS,49621,RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE,5480.0,3562.0,159.07,5480.0,31
HCPCS,49621,RPR PARASTOMAL HERNIA RDC,,,799.59,799.59,1
HCPCS,49621,Rpr parastomal hernia rdc,,,2419.02,3055.61,6
HCPCS,496210,RPR PARASTOMAL HERNIA RDC,,,799.59,799.59,1
HCPCS,49622,RPR PARASTOMAL HRNA 1ST/RECR NCRC8/STRANGULATED,6824.0,4435.6,191.87,6824.0,31
HCPCS,49622,RPR PARASTOMAL HRNA NCR/STRN,,,986.31,986.31,1
HCPCS,49622,Rpr parastomal hrna ncr/strn,,,2419.02,3055.61,6
HCPCS,496220,RPR PARASTOMAL HRNA NCR/STRN,,,986.31,986.31,1
HCPCS,49623,RMVL NINFCT MESH HERNIA RPR,,,212.2,212.2,1
HCPCS,49623,RMVL NONINFCT MESH/PROSTH AA/PARASTOMAL HRNA RPR,1500.0,975.0,38.91,1500.0,31
HCPCS,49623,Rmvl ninfct mesh hernia rpr,,,2419.02,3055.61,6
HCPCS,496230,RMVL NINFCT MESH HERNIA RPR,,,212.2,212.2,1
HCPCS,49650,LAP ING HERNIA REPAIR INIT,,,466.25,12649.85,19
HCPCS,49650,LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA,2544.0,1653.6,291.85,2544.0,35
HCPCS,49650,Lap ing hernia repair init,,,2376.39,3001.75,6
HCPCS,496500,LAP ING HERNIA REPAIR INIT,,,466.25,466.25,1
HCPCS,49651,LAP ING HERNIA REPAIR RECUR,,,608.79,12649.85,17
HCPCS,49651,LAPS SURG RPR RECURRENT INGUINAL HERNIA,3352.0,2178.8,366.65,3352.0,35
HCPCS,49651,Lap ing hernia repair recur,,,2376.39,3001.75,6
HCPCS,496510,LAP ING HERNIA REPAIR RECUR,,,608.79,608.79,1
HCPCS,49652,Lap vent/abd hernia repair,,,2419.02,3055.61,6
HCPCS,49653,Lap vent/abd hern proc comp,,,2419.02,3055.61,6
HCPCS,49654,Lap inc hernia repair,,,2419.02,3055.61,6
HCPCS,49655,Lap inc hern repair comp,,,2419.02,3055.61,6
HCPCS,49656,Lap inc hernia repair recur,,,2419.02,3055.61,6
HCPCS,49657,Lap inc hern recur comp,,,2419.02,3055.61,6
HCPCS,49659,LAP REPAIR INITIAL FEMORAL HERNIA; INCAR OR STRANG (COMP CODE 49,3572.0,2321.8,447.39,3572.0,15
HCPCS,49659,LAP REPAIR OF ACUTE TRAUMATIC DIAPHRAGMATIC HERNIA (COMP 39540),6265.0,4072.25,447.39,6265.0,15
HCPCS,49659,LAP REPAIR OF FEMORAL HERNIA (COMP 49550),3359.0,2183.35,447.39,3359.0,15
HCPCS,49659,LAP. PERISTOMAL HERNIA REPAIR,5891.0,3829.15,447.39,5891.0,15
HCPCS,49659,LAPAROSCOPIC CONGENITAL HERNIA REPAIR W/ MESH (COMP 43282),10837.0,7044.05,447.39,10837.0,15
HCPCS,49659,LAPAROSCOPIC REPAIR RECURRENT FEMORAL HERNIA (COMP CODE 49555),4038.0,2624.7,447.39,4038.0,15
HCPCS,49659,"UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HER",3359.0,2183.35,447.39,3359.0,15
HCPCS,49659,UNLSTD LAPS PX HRNAP HRNRPHY,,,5856.41,12649.85,15
HCPCS,49659,Unlstd laps px hrnap hrnrphy,,,2419.02,3055.61,6
HCPCS,49900,REPAIR OF ABDOMINAL WALL,,,883.84,883.84,1
HCPCS,49900,Repair of abdominal wall,,,2290.02,2892.66,6
HCPCS,49900,SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN,4964.0,3226.6,417.64,4964.0,35
HCPCS,499000,REPAIR OF ABDOMINAL WALL,,,883.84,883.84,1
HCPCS,49904,OMENTAL FLAP EXTRA-ABDOM,,,1488.21,1488.21,1
HCPCS,49904,OMENTAL FLAP EXTRA-ABDOMINAL,8940.0,5811.0,948.99,8940.0,35
HCPCS,49904,Omental flap extra-abdom,,,2290.02,2892.66,6
HCPCS,499040,OMENTAL FLAP EXTRA-ABDOM,,,1488.21,1488.21,1
HCPCS,49905,OMENTAL FLAP INTRA-ABDOM,,,377.86,377.86,1
HCPCS,49905,OMENTAL FLAP INTRA-ABDOMINAL,2616.0,1700.4,259.46,2616.0,35
HCPCS,49905,Omental flap intra-abdom,,,2290.02,2892.66,6
HCPCS,499050,OMENTAL FLAP INTRA-ABDOM,,,377.86,377.86,1
HCPCS,49906,FREE OMENTAL FLAP MICROVASC,,,1954.64,1954.64,1
HCPCS,49906,Free omental flap microvasc,,,2290.02,2892.66,6
HCPCS,499060,FREE OMENTAL FLAP MICROVASC,,,1954.64,1954.64,1
HCPCS,49999,CORE NEEDLE BIOPSY ABDOMEN/PERITONEUM/OMENTUM AT TIME OF OTHER P,818.0,531.7,409.0,818.0,15
HCPCS,49999,CRYOABLATION OF INTRA ABDOMINAL MASS (COMP CODE 50593),17808.0,11575.199999999999,454.96,28857.6,63
HCPCS,49999,EXPL OF GROIN WOUND W/ RELEASE OF SCAR FORMATION (COMP CODE 3584,7471.0,4856.15,665.51,7471.0,15
HCPCS,49999,MANUAL REDUCTION OF INGUINAL HERNIA (COMP CODE 49505),7003.0,4551.95,454.96,8370.0,45
HCPCS,49999,MESENTERIC OR OMENTUM BIOPSY (COMP 49000),5016.0,3260.4,665.51,5016.0,15
HCPCS,49999,"OMENTAL FLAP, LAPARCOCOPIC (COMP CODE 49905)",2616.0,1700.4,665.51,2616.0,15
HCPCS,49999,PERCUTANEOUS CRYOABLATION ABDOMEN,7452.0,4843.8,454.96,8370.0,48
HCPCS,49999,PREOP WIRE LOCALIZATION INTRAPERITONEAL (COMP CODE 49411),4648.0,3021.2,454.96,8370.0,63
HCPCS,49999,RADIOFREQUENCY ABLATION INTRA ABDOMINAL MASS (COMP CODE 50592),18084.0,11754.6,454.96,30193.2,63
HCPCS,49999,"REMOVAL FOREIGN BODY, ABD WALL (COMP CODE 11008)",2000.0,1300.0,665.51,2000.0,15
HCPCS,49999,REPOSITION PERITONEAL DIALYSIS CATH (COMP CODE 36597),5824.5,3785.925,242.0,10048.5,63
HCPCS,49999,UNLISTED PROC OPEN DRAINAGE OF INTRA ABD FLUID (COMP CODE 49062),4888.0,3177.2,665.51,4888.0,15
HCPCS,49999,UNLISTED PROCEDURE ABD PERITONEUM,2923.0,1899.95,454.96,8370.0,96
HCPCS,49999,"UNLISTED PROCEDURE, ABDOMEN, PERITONEUM & OMENTUM COMPARED TO 44",5588.0,3632.2,665.51,5588.0,15
HCPCS,50010,RENAL EXPLORATION,,,759.4,759.4,1
HCPCS,50010,RNL EXPL X NECESSITATING OTH SPEC PX,4912.0,3192.8,508.77,4912.0,35
HCPCS,50010,Renal exploration,,,4333.98,5474.5,6
HCPCS,500100,RENAL EXPLORATION,,,759.4,759.4,1
HCPCS,50020,"ABCESS DRAINAGE,RENAL/PERIRENA",7232.0,4700.8,591.63,7232.0,35
HCPCS,50020,DRAINAGE PERIRENAL/RENAL ABSCESS OPEN,11779.0,7656.35,1228.71,10601.1,42
HCPCS,50020,DRG PERIRNL/RENAL ABSC OPEN,,,1091.35,1091.35,1
HCPCS,500200,DRG PERIRNL/RENAL ABSC OPEN,,,1091.35,1091.35,1
HCPCS,50040,NEPHROSTOMY/NEPHROTOMY W/DRAINAGE,6672.0,4336.8,599.52,6672.0,35
HCPCS,50040,NFROS NFROT W/DRG,,,994.84,994.84,1
HCPCS,50040,Nfros nfrot w/drg,,,4333.98,5474.5,6
HCPCS,500400,NFROS NFROT W/DRG,,,994.84,994.84,1
HCPCS,50045,NEPHROTOMY W/EXPLORATION,,,1002.14,1002.14,1
HCPCS,50045,Nephrotomy w/exploration,,,4333.98,5474.5,6
HCPCS,500450,NEPHROTOMY W/EXPLORATION,,,1002.14,1002.14,1
HCPCS,5005F,PT COUNSLD ON EXAM FOR MOLES,,,0.01,0.01,1
HCPCS,5005F0,PT COUNSLD ON EXAM FOR MOLES,,,0.01,0.01,1
HCPCS,50060,NEPHROLITHOTOMY REMOVAL STAGE 1,8380.0,5447.0,790.77,8380.0,35
HCPCS,50060,NL REMOVAL CALCULUS,,,1223.5,1223.5,1
HCPCS,50060,Nl removal calculus,,,4333.98,5474.5,6
HCPCS,500600,NL REMOVAL CALCULUS,,,1223.5,1223.5,1
HCPCS,50065,NL SEC SURG OPERJ CALCULUS,,,1296.54,1296.54,1
HCPCS,50065,Nl sec surg operj calculus,,,4333.98,5474.5,6
HCPCS,500650,NL SEC SURG OPERJ CALCULUS,,,1296.54,1296.54,1
HCPCS,50070,NEPHROLITHOTOMY COMP CGEN KDN ABNORMALITY,9614.0,6249.1,822.77,9614.0,35
HCPCS,50070,NL COMP CGEN KDN ABNORMALITY,,,1271.83,1271.83,1
HCPCS,50070,Nl comp cgen kdn abnormality,,,4333.98,5474.5,6
HCPCS,500700,NL COMP CGEN KDN ABNORMALITY,,,1271.83,1271.83,1
HCPCS,50075,NEPHROLITHOTOMY RMVL LG STAGHORN STAGE 1,10836.0,7043.4,1091.45,10836.0,35
HCPCS,50075,NL RMVL LG STAGHORN CALCULUS,,,1563.2,1563.2,1
HCPCS,50075,Nl rmvl lg staghorn calculus,,,4333.98,5474.5,6
HCPCS,500750,NL RMVL LG STAGHORN CALCULUS,,,1563.2,1563.2,1
HCPCS,50080,PERQ NL/PL LITHOTRP SIMPLE UP TO 2 CM 1 LOCATION,5460.0,3549.0,534.39,5460.0,35
HCPCS,50080,PERQ NL/PL LITHOTRP SMPL<2CM,,,749.09,20049.35,16
HCPCS,50080,Perq nl/pl lithotrp smpl<2cm,,,4333.98,5474.5,6
HCPCS,500800,PERQ NL/PL LITHOTRP SMPL<2CM,,,749.09,749.09,1
HCPCS,50081,PERQ NL/PL LITHOTRP COMPLEX >2 CM MLT LOCATIONS,9200.0,5980.0,858.4,9200.0,35
HCPCS,50081,PERQ NL/PL LITHOTRP CPLX>2CM,,,1208.48,20049.35,18
HCPCS,50081,Perq nl/pl lithotrp cplx>2cm,,,4333.98,5474.5,6
HCPCS,500810,PERQ NL/PL LITHOTRP CPLX>2CM,,,1208.48,1208.48,1
HCPCS,50100,TRNSXJ/REPOS ABRRNT RNL VSLS,,,1175.43,1175.43,1
HCPCS,50100,Trnsxj/repos abrrnt rnl vsls,,,4333.98,5474.5,6
HCPCS,501000,TRNSXJ/REPOS ABRRNT RNL VSLS,,,1175.43,1175.43,1
HCPCS,5010F,MACUL RESULT PHY/QHP MNG DM,,,0.01,0.01,1
HCPCS,5010F0,MACUL RESULT PHY/QHP MNG DM,,,0.01,0.01,1
HCPCS,50120,PYELOTOMY W/EXPLORATION,,,1020.52,1020.52,1
HCPCS,50120,Pyelotomy w/exploration,,,4333.98,5474.5,6
HCPCS,501200,PYELOTOMY W/EXPLORATION,,,1020.52,1020.52,1
HCPCS,50125,PYELOTOMY W/DRG PYELOSTOMY,,,1055.91,1055.91,1
HCPCS,50125,Pyelotomy w/drg pyelostomy,,,4333.98,5474.5,6
HCPCS,501250,PYELOTOMY W/DRG PYELOSTOMY,,,1055.91,1055.91,1
HCPCS,50130,PYELOTOMY W/REMOVAL CALCULUS,7528.0,4893.2,777.25,7528.0,36
HCPCS,50130,Pyelotomy w/removal calculus,,,1770.94,2236.98,6
HCPCS,501300,PYELOTOMY W/REMOVAL CALCULUS,,,1109.0,1109.0,1
HCPCS,50135,Pyelotomy complicated,,,4333.98,5474.5,6
HCPCS,5015F,DOC FX & TEST/TXMNT FOR OP,,,0.01,0.01,1
HCPCS,5015F0,DOC FX & TEST/TXMNT FOR OP,,,0.01,0.01,1
HCPCS,50200,RENAL BIOPSY PERQ,,,134.42,134.42,1
HCPCS,50200,RENAL BIOPSY PRQ TROCAR/NEEDLE,5181.5,3367.975,96.41,8384.4,277
HCPCS,502000,RENAL BIOPSY PERQ,,,134.42,134.42,1
HCPCS,50205,RENAL BIOPSY SURG EXPOSURE KIDNEY,4916.0,3195.4,454.47,4916.0,35
HCPCS,50205,RENAL BX SURG EXPOSURE KDN,,,819.83,819.83,1
HCPCS,50205,Renal bx surg exposure kdn,,,4333.98,5474.5,6
HCPCS,502050,RENAL BX SURG EXPOSURE KDN,,,819.83,819.83,1
HCPCS,5020F,TXMNTS 2 PHYS/QHP BY 1 MON,,,0.01,0.01,1
HCPCS,5020F0,TXMNTS 2 PHYS/QHP BY 1 MON,,,0.01,0.01,1
HCPCS,50220,NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ,7472.0,4856.8,787.53,7472.0,35
HCPCS,50220,REMOVE KIDNEY OPEN,,,1134.23,1134.23,1
HCPCS,50220,Remove kidney open,,,4333.98,5474.5,6
HCPCS,502200,REMOVE KIDNEY OPEN,,,1134.23,1134.23,1
HCPCS,50225,NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL,8752.0,5688.8,897.75,8752.0,35
HCPCS,50225,REMOVAL KIDNEY OPEN COMPLEX,,,1303.89,1303.89,1
HCPCS,50225,Removal kidney open complex,,,4333.98,5474.5,6
HCPCS,502250,REMOVAL KIDNEY OPEN COMPLEX,,,1303.89,1303.89,1
HCPCS,50230,NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD,9524.0,6190.6,976.36,9524.0,35
HCPCS,50230,REMOVAL KIDNEY OPEN RADICAL,,,1375.47,1375.47,1
HCPCS,50230,Removal kidney open radical,,,4333.98,5474.5,6
HCPCS,502300,REMOVAL KIDNEY OPEN RADICAL,,,1375.47,1375.47,1
HCPCS,50234,NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC,10582.0,6878.3,956.58,10582.0,35
HCPCS,50234,REMOVAL OF KIDNEY & URETER,,,1396.93,1396.93,1
HCPCS,50234,Removal of kidney & ureter,,,4333.98,5474.5,6
HCPCS,502340,REMOVAL OF KIDNEY & URETER,,,1396.93,1396.93,1
HCPCS,50236,NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN,10776.0,7004.4,1107.35,10776.0,35
HCPCS,50236,REMOVAL OF KIDNEY & URETER,,,1570.04,1570.04,1
HCPCS,50236,Removal of kidney & ureter,,,4333.98,5474.5,6
HCPCS,502360,REMOVAL OF KIDNEY & URETER,,,1570.04,1570.04,1
HCPCS,50240,NEPHRECTOMY PARTIAL,9684.0,6294.6,992.49,9684.0,36
HCPCS,50240,Nephrectomy partial,,,4333.98,5474.5,6
HCPCS,502400,NEPHRECTOMY PARTIAL,,,1427.27,1427.27,1
HCPCS,50250,OPEN ABLATION RENAL MASS CRYOSURG ULTRASOUND,8888.0,5777.2,770.45,8888.0,35
HCPCS,50250,OPN ABLTJ 1/> RNL MAS CRYSRG,,,1305.95,1305.95,1
HCPCS,50250,Opn abltj 1/> rnl mas crysrg,,,4333.98,5474.5,6
HCPCS,502500,OPN ABLTJ 1/> RNL MAS CRYSRG,,,1305.95,1305.95,1
HCPCS,50280,EXC/UNROOFING CYST KIDNEY,,,1016.67,1016.67,1
HCPCS,50280,EXCIS/UNROOF RENAL CYST,6836.0,4443.4,691.92,6836.0,35
HCPCS,50280,Exc/unroofing cyst kidney,,,4333.98,5474.5,6
HCPCS,502800,EXC/UNROOFING CYST KIDNEY,,,1016.67,1016.67,1
HCPCS,50290,EXCISION PERINEPHRIC CYST,6460.0,4199.0,624.28,6460.0,36
HCPCS,50290,Excision perinephric cyst,,,4333.98,5474.5,6
HCPCS,502900,EXCISION PERINEPHRIC CYST,,,966.9,966.9,1
HCPCS,50300,DONOR NEPHRECTOMY CADAVER DONOR UNI/BILATERAL,9502.0,6176.3,1834.5,9502.0,13
HCPCS,50300,REMOVE CADAVER DONOR KIDNEY,,,1260.18,1260.18,1
HCPCS,50300,Remove cadaver donor kidney,,,4618.62,5834.04,6
HCPCS,503000,REMOVE CADAVER DONOR KIDNEY,,,1260.18,1260.18,1
HCPCS,50320,"LIVING DONOR NEPHRECTOMY, OPEN",8972.0,5831.8,1009.16,8972.0,32
HCPCS,50320,REMOVE KIDNEY LIVING DONOR,,,1650.03,1650.03,1
HCPCS,50320,Remove kidney living donor,,,4618.62,5834.04,6
HCPCS,503200,REMOVE KIDNEY LIVING DONOR,,,1650.03,1650.03,1
HCPCS,50323,BKBENCH PREPJ CADAVER DONOR RENAL ALLOGRAFT,1136.0,738.4,108.32,1136.0,14
HCPCS,50323,PREP CADAVER RENAL ALLOGRAFT,,,234.93,234.93,1
HCPCS,50323,Prep cadaver renal allograft,,,3411.14,4308.8,6
HCPCS,503230,PREP CADAVER RENAL ALLOGRAFT,,,234.93,234.93,1
HCPCS,50325,BKBENCH PREPJ LIVING RENAL DONOR ALLOGRAFT,1136.0,738.4,108.32,1136.0,14
HCPCS,50325,PREP DONOR RENAL GRAFT,,,211.74,211.74,1
HCPCS,50325,Prep donor renal graft,,,3411.14,4308.8,6
HCPCS,503250,PREP DONOR RENAL GRAFT,,,211.74,211.74,1
HCPCS,50327,BKBENCH RCNSTJ RENAL ALGRFT VENOUS ANAST EA,1760.0,1144.0,157.36,1760.0,32
HCPCS,50327,PREP RENAL GRAFT/VENOUS,,,234.13,234.13,1
HCPCS,50327,Prep renal graft/venous,,,3411.14,4308.8,6
HCPCS,503270,PREP RENAL GRAFT/VENOUS,,,234.13,234.13,1
HCPCS,50328,BKBENCH RCNSTJ RENAL ALLOGRAFT ARTERIAL ANAST EA,1400.0,910.0,137.8,1400.0,32
HCPCS,50328,PREP RENAL GRAFT/ARTERIAL,,,205.3,205.3,1
HCPCS,50328,Prep renal graft/arterial,,,3411.14,4308.8,6
HCPCS,503280,PREP RENAL GRAFT/ARTERIAL,,,205.3,205.3,1
HCPCS,50329,BKBENCH RCNSTJ ALGRFT URETERAL ANAST EA,1336.0,868.4,131.55,1336.0,32
HCPCS,50329,PREP RENAL GRAFT/URETERAL,,,194.38,194.38,1
HCPCS,50329,Prep renal graft/ureteral,,,3411.14,4308.8,6
HCPCS,503290,PREP RENAL GRAFT/URETERAL,,,194.38,194.38,1
HCPCS,50340,RECIPIENT NEPHRECTOMY,,,1041.18,1041.18,1
HCPCS,50340,RECIPIENT NEPHRECTOMY SEPARATE PROCEDURE,6178.0,4015.7,628.59,6178.0,35
HCPCS,50340,Recipient nephrectomy,,,4333.98,5474.5,6
HCPCS,503400,RECIPIENT NEPHRECTOMY,,,1041.18,1041.18,1
HCPCS,50360,RENAL ALLOTRANSPLANTATION W/ GRAFT W/O RECIPIENT NEPHRECTOMY,17547.0,11405.55,1495.2,17547.0,35
HCPCS,50360,RNL ALTRNSPLJ W/O RCP NFRCT,,,2642.26,2642.26,1
HCPCS,50360,Rnl altrnsplj w/o rcp nfrct,,,4618.62,5834.04,6
HCPCS,503600,RNL ALTRNSPLJ W/O RCP NFRCT,,,2642.26,2642.26,1
HCPCS,50365,"RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT; WITH RECIPIENT",18452.0,11993.8,1769.96,18452.0,35
HCPCS,50365,RNL ALTRNSPLJ W/RCP NFRCT,,,3147.62,3147.62,1
HCPCS,50365,Rnl altrnsplj w/rcp nfrct,,,4618.62,5834.04,6
HCPCS,503650,RNL ALTRNSPLJ W/RCP NFRCT,,,3147.62,3147.62,1
HCPCS,50370,RMVL TRANSPLANTED RNL ALGRFT,,,1319.45,1319.45,1
HCPCS,50370,RMVL TRNSPLED RENAL ALLOGRAFT,7552.0,4908.8,665.67,7552.0,35
HCPCS,50370,Rmvl transplanted rnl algrft,,,4333.98,5474.5,6
HCPCS,503700,RMVL TRANSPLANTED RNL ALGRFT,,,1319.45,1319.45,1
HCPCS,50380,RENAL AUTOTRNSPLJ REIMPLANTATION KIDNEY,12044.0,7828.6,997.45,12044.0,35
HCPCS,50380,RNL AUTOTRNSPLJ RIMPLTJ KDN,,,2209.86,2209.86,1
HCPCS,50380,Rnl autotrnsplj rimpltj kdn,,,4618.62,5834.04,6
HCPCS,503800,RNL AUTOTRNSPLJ RIMPLTJ KDN,,,2209.86,2209.86,1
HCPCS,50382,CHANGE URETER STENT PERCUT,,,266.76,266.76,1
HCPCS,50382,RMV/RPLC INDW URET BI-S,11779.0,7656.35,304.33,10601.1,39
HCPCS,50382,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,6939.5,4510.675,192.56,10601.1,119
HCPCS,503820,CHANGE URETER STENT PERCUT,,,266.76,266.76,1
HCPCS,50384,REMOVAL INDWELLING URETERAL STENT PRQ,6839.5,4445.675,177.52,10601.1,133
HCPCS,50384,REMOVE URETER STENT PERCUT,,,240.94,240.94,1
HCPCS,50384,RMV ONLY INDW URET BI-S,11779.0,7656.35,275.36,10601.1,46
HCPCS,503840,REMOVE URETER STENT PERCUT,,,240.94,240.94,1
HCPCS,50385,CHANGE STENT VIA TRANSURETH,,,228.83,228.83,1
HCPCS,50385,REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL,6727.5,4372.875,159.26,10601.1,77
HCPCS,503850,CHANGE STENT VIA TRANSURETH,,,228.83,228.83,1
HCPCS,50386,REMOVE STENT VIA TRANSURETH,,,173.31,4441.51,15
HCPCS,50386,Remove stent via transureth,,,918.04,1159.63,6
HCPCS,503860,REMOVE STENT VIA TRANSURETH,,,173.31,173.31,1
HCPCS,50387,CHANGE NEPHROURETERAL CATH,,,88.21,88.21,1
HCPCS,50387,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,6239.5,4055.675,69.78,10601.1,179
HCPCS,503870,CHANGE NEPHROURETERAL CATH,,,88.21,88.21,1
HCPCS,50389,REMOVE RENAL TUBE W/FLUORO,,,56.79,56.79,1
HCPCS,50389,RMVL NFROS TUBE REQ FLUORO GUIDANCE,2161.0,1404.6499999999999,38.44,6289.0,179
HCPCS,503890,REMOVE RENAL TUBE W/FLUORO,,,56.79,56.79,1
HCPCS,50390,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,2415.0,1569.75,70.98,6317.0,228
HCPCS,50390,DRAINAGE OF KIDNEY LESION,,,100.47,100.47,1
HCPCS,503900,DRAINAGE OF KIDNEY LESION,,,100.47,100.47,1
HCPCS,50391,INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB,784.0,509.6,69.03,588.0,35
HCPCS,50391,INSTLL RX AGNT INTO RNAL TUB,,,105.38,527.32,15
HCPCS,50391,Instll rx agnt into rnal tub,,,248.59,314.0,6
HCPCS,50391,JELMYTO INSTILLATION W/O NEPHROSTOGRAM/URETEROGRAM,784.0,509.6,69.03,588.0,35
HCPCS,503910,INSTLL RX AGNT INTO RNAL TUB,,,105.38,105.38,1
HCPCS,50392,INTRO INTRACATH/CATH IN RNL PELVIS DRG&/NJX PRQ,2109.0,1370.85,354.31,1898.1,42
HCPCS,50393,INTRO URETER CATH/STNT RENAL PELVIS DRG&/NJX,3376.0,2194.4,567.17,3038.4,21
HCPCS,50394,INJECTION PROCEDURE PYELOGRAPHY VIA TUBE/CATH,845.0,549.25,141.96,760.5,21
HCPCS,50395,INTRO GUIDE PELVIS&/URETER W/DILAT NFROS TRACT,5529.0,3593.85,928.87,4976.1,21
HCPCS,50396,MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH,3838.0,2494.7,136.91,4151.0,49
HCPCS,50396,MEASURE KIDNEY PRESSURE,,,122.77,122.77,1
HCPCS,503960,MEASURE KIDNEY PRESSURE,,,122.77,122.77,1
HCPCS,50398,CHANGE NEPHROSTOMY/PYELOSTOMY TUBE,2109.0,1370.85,354.31,1898.1,45
HCPCS,50400,PYELOPLASTY SIMPLE,9359.0,6083.35,857.58,9359.0,35
HCPCS,50400,REVISION OF KIDNEY/URETER,,,1240.59,1240.59,1
HCPCS,50400,Revision of kidney/ureter,,,4333.98,5474.5,6
HCPCS,504000,REVISION OF KIDNEY/URETER,,,1240.59,1240.59,1
HCPCS,50405,PYELOPLASTY COMPLICATED,11378.0,7395.7,1019.23,11378.0,35
HCPCS,50405,REVISION OF KIDNEY/URETER,,,1497.07,1497.07,1
HCPCS,50405,Revision of kidney/ureter,,,4333.98,5474.5,6
HCPCS,504050,REVISION OF KIDNEY/URETER,,,1497.07,1497.07,1
HCPCS,50430,JELMYTO INSTILLATION VIA NEPHROSTOGRAM/URETEROGRAM,1160.0,754.0,128.34,870.0,31
HCPCS,50430,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,2499.0,1624.35,128.34,4214.0,175
HCPCS,50430,NJX PX NFROSGRM &/URTRGRM,,,162.76,162.76,1
HCPCS,504300,NJX PX NFROSGRM &/URTRGRM,,,162.76,162.76,1
HCPCS,50431,"JELMYTO INSTILLATION , ANTEGRADE VIA EXISTING ACCESS",440.0,286.0,50.65,330.0,31
HCPCS,50431,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,2139.0,1390.35,50.65,4214.0,224
HCPCS,50431,NJX PX NFROSGRM &/URTRGRM,,,69.95,69.95,1
HCPCS,504310,NJX PX NFROSGRM &/URTRGRM,,,69.95,69.95,1
HCPCS,50432,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,6689.5,4348.175,169.72,10601.1,224
HCPCS,50432,PLMT NEPHROSTOMY CATHETER,,,216.04,216.04,1
HCPCS,504320,PLMT NEPHROSTOMY CATHETER,,,216.04,216.04,1
HCPCS,50433,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,10925.5,7101.575,209.77,17847.9,129
HCPCS,50433,PLMT NEPHROURETERAL CATHETER,,,268.62,268.62,1
HCPCS,504330,PLMT NEPHROURETERAL CATHETER,,,268.62,268.62,1
HCPCS,50434,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,6639.5,4315.675,160.65,10601.1,129
HCPCS,50434,CONVERT NEPHROSTOMY CATHETER,,,201.72,201.72,1
HCPCS,504340,CONVERT NEPHROSTOMY CATHETER,,,201.72,201.72,1
HCPCS,50435,EXCHANGE NEPHROSTOMY CATH,,,105.35,105.35,1
HCPCS,50435,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,6290.0,4088.5,77.63,10601.1,273
HCPCS,504350,EXCHANGE NEPHROSTOMY CATH,,,105.35,105.35,1
HCPCS,50436,DILAT XST TRC NDURLGC PX,,,158.22,158.22,1
HCPCS,50436,PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG,10471.5,6806.474999999999,114.64,26432.0,115
HCPCS,504360,DILAT XST TRC NDURLGC PX,,,158.22,158.22,1
HCPCS,50437,DILAT XST TRC NEW ACCESS RCS,,,262.68,262.68,1
HCPCS,50437,PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS,10885.5,7075.575,190.47,26432.0,115
HCPCS,504370,DILAT XST TRC NEW ACCESS RCS,,,262.68,262.68,1
HCPCS,50500,NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY,8488.0,5517.2,848.82,8488.0,35
HCPCS,50500,REPAIR OF KIDNEY WOUND,,,1399.79,1399.79,1
HCPCS,50500,Repair of kidney wound,,,4333.98,5474.5,6
HCPCS,505000,REPAIR OF KIDNEY WOUND,,,1399.79,1399.79,1
HCPCS,5050F,PLAN 2 MAIN DR BY 1 MONTH,,,0.01,0.01,1
HCPCS,5050F0,PLAN 2 MAIN DR BY 1 MONTH,,,0.01,0.01,1
HCPCS,50520,CLOSE KIDNEY-SKIN FISTULA,,,1260.41,1260.41,1
HCPCS,50520,Close kidney-skin fistula,,,1770.94,2236.98,6
HCPCS,505200,CLOSE KIDNEY-SKIN FISTULA,,,1260.41,1260.41,1
HCPCS,50525,CLOSE NEPHROVISCERAL FISTULA,,,1598.42,1598.42,1
HCPCS,50525,CLSR NEPHROVISCERAL FISTULA W/VISC RPR ABDL APPR,9756.0,6341.4,891.74,9756.0,35
HCPCS,50525,Close nephrovisceral fistula,,,4333.98,5474.5,6
HCPCS,505250,CLOSE NEPHROVISCERAL FISTULA,,,1598.42,1598.42,1
HCPCS,50526,CLOSE NEPHROVISCERAL FISTULA,,,1711.86,1711.86,1
HCPCS,50526,Close nephrovisceral fistula,,,4333.98,5474.5,6
HCPCS,505260,CLOSE NEPHROVISCERAL FISTULA,,,1711.86,1711.86,1
HCPCS,50540,REVISION OF HORSESHOE KIDNEY,,,1231.5,1231.5,1
HCPCS,50540,Revision of horseshoe kidney,,,4333.98,5474.5,6
HCPCS,505400,REVISION OF HORSESHOE KIDNEY,,,1231.5,1231.5,1
HCPCS,50541,LAPARO ABLATE RENAL CYST,,,985.68,22573.24,15
HCPCS,50541,LAPAROSCOPY SURG ABLATION RENAL CYSTS,6744.0,4383.6,632.2,6744.0,35
HCPCS,50541,Laparo ablate renal cyst,,,1770.94,2236.98,6
HCPCS,505410,LAPARO ABLATE RENAL CYST,,,985.68,985.68,1
HCPCS,50542,LAPARO ABLATE RENAL MASS,,,1246.75,22573.24,15
HCPCS,50542,LAPS ABLTJ RENAL MASS LESION W/INTRAOP US,8544.0,5553.6,748.69,8544.0,35
HCPCS,50542,Laparo ablate renal mass,,,4333.98,5474.5,6
HCPCS,505420,LAPARO ABLATE RENAL MASS,,,1246.75,1246.75,1
HCPCS,50543,LAPARO PARTIAL NEPHRECTOMY,,,1598.98,22573.24,18
HCPCS,50543,LAPAROSC PARTIAL NEPHRECTOMY,10964.0,7126.6,941.74,10964.0,35
HCPCS,50543,Laparo partial nephrectomy,,,4333.98,5474.5,6
HCPCS,505430,LAPARO PARTIAL NEPHRECTOMY,,,1598.98,1598.98,1
HCPCS,50544,LAPAROSCOPY PYELOPLASTY,,,1331.62,22573.24,15
HCPCS,50544,"LAPAROSCOPY, SURGICAL; PYELOPLASTY",9348.0,6076.2,871.33,9348.0,35
HCPCS,50544,Laparoscopy pyeloplasty,,,4333.98,5474.5,6
HCPCS,505440,LAPAROSCOPY PYELOPLASTY,,,1331.62,1331.62,1
HCPCS,50545,LAPARO RADICAL NEPHRECTOMY,,,1432.81,18285.0,2
HCPCS,50545,LAPAROSCOPY RADICAL NEPHRECTOMY,10024.0,6515.6,985.45,10024.0,35
HCPCS,50545,Laparo radical nephrectomy,,,4333.98,5474.5,6
HCPCS,505450,LAPARO RADICAL NEPHRECTOMY,,,1432.81,1432.81,1
HCPCS,50546,LAPAROSCOPIC NEPHRECTOMY,,,1293.21,2772.0,3
HCPCS,50546,LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT,8748.0,5686.2,808.6,8748.0,35
HCPCS,50546,Laparoscopic nephrectomy,,,4333.98,5474.5,6
HCPCS,505460,LAPAROSCOPIC NEPHRECTOMY,,,1293.21,1293.21,1
HCPCS,50547,LAPARO REMOVAL DONOR KIDNEY,,,1757.14,1757.14,1
HCPCS,50547,LAPAROSCOPY DONOR NEPHRECTOMY LIVING DONOR,10536.0,6848.4,1038.14,10536.0,32
HCPCS,50547,Laparo removal donor kidney,,,4333.98,5474.5,6
HCPCS,505470,LAPARO REMOVAL DONOR KIDNEY,,,1757.14,1757.14,1
HCPCS,50548,LAPARO REMOVE W/URETER,,,1441.08,1441.08,1
HCPCS,50548,LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY,10144.0,6593.6,948.58,10144.0,35
HCPCS,50548,Laparo remove w/ureter,,,4333.98,5474.5,6
HCPCS,505480,LAPARO REMOVE W/URETER,,,1441.08,1441.08,1
HCPCS,50549,LAPAROSCOPIC RENAL AUTOTRANSPLANTATION (COMP CODE 50380),10840.0,7046.0,887.64,10840.0,15
HCPCS,50549,LAPAROSCOPIC RENAL CYST EXCISION (COMP CODE 50280),6836.0,4443.4,887.64,6836.0,15
HCPCS,50549,LAPAROSCOPIC URETEROPLASTY (COMP CODE 50700),6009.0,3905.85,887.64,6009.0,15
HCPCS,50549,"UNLISTED LAPAROSCOPY PROCEDURE, RENAL (COMP CODE 50234)",10341.0,6721.65,887.64,10341.0,15
HCPCS,50549,UNLISTED LAPS PX RENAL,,,5856.41,12649.85,14
HCPCS,50549,Unlisted laps px renal,,,918.04,1159.63,6
HCPCS,50551,KIDNEY ENDOSCOPY,,,313.62,11022.13,15
HCPCS,50551,Kidney endoscopy,,,1770.94,2236.98,6
HCPCS,50551,RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION,2236.0,1453.4,160.9,1677.0,35
HCPCS,505510,KIDNEY ENDOSCOPY,,,313.62,313.62,1
HCPCS,50553,KIDNEY ENDOSCOPY,,,335.37,11022.13,15
HCPCS,50553,Kidney endoscopy,,,1770.94,2236.98,6
HCPCS,50553,RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA,2392.0,1554.8,169.76,1794.0,35
HCPCS,505530,KIDNEY ENDOSCOPY,,,335.37,335.37,1
HCPCS,50555,KIDNEY ENDOSCOPY & BIOPSY,,,364.08,20049.35,15
HCPCS,50555,Kidney endoscopy & biopsy,,,1770.94,2236.98,6
HCPCS,50555,RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY,2608.0,1695.2,239.79,1956.0,35
HCPCS,505550,KIDNEY ENDOSCOPY & BIOPSY,,,364.08,364.08,1
HCPCS,50557,KIDNEY ENDOSCOPY & TREATMENT,,,368.81,20049.35,15
HCPCS,50557,Kidney endoscopy & treatment,,,1770.94,2236.98,6
HCPCS,50557,RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI,2644.0,1718.6,236.23,1983.0,35
HCPCS,505570,KIDNEY ENDOSCOPY & TREATMENT,,,368.81,368.81,1
HCPCS,50561,KIDNEY ENDOSCOPY & TREATMENT,,,421.55,11022.13,15
HCPCS,50561,Kidney endoscopy & treatment,,,1770.94,2236.98,6
HCPCS,50561,RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS,3032.0,1970.8,273.42,2274.0,35
HCPCS,505610,KIDNEY ENDOSCOPY & TREATMENT,,,421.55,421.55,1
HCPCS,50562,RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR,4360.0,2834.0,398.28,4360.0,35
HCPCS,50562,RENAL SCOPE W/TUMOR RESECT,,,618.09,20049.35,15
HCPCS,50562,Renal scope w/tumor resect,,,1770.94,2236.98,6
HCPCS,505620,RENAL SCOPE W/TUMOR RESECT,,,618.09,618.09,1
HCPCS,50570,KIDNEY ENDOSCOPY,,,524.86,7477.94,15
HCPCS,50570,Kidney endoscopy,,,1770.94,2236.98,6
HCPCS,50570,RENAL NDSC NEPHROTOMY W/WO IRRIGATION,3812.0,2477.8,298.19,3812.0,35
HCPCS,505700,KIDNEY ENDOSCOPY,,,524.86,524.86,1
HCPCS,50572,KIDNEY ENDOSCOPY,,,566.99,1447.18,15
HCPCS,50572,Kidney endoscopy,,,918.04,1159.63,6
HCPCS,50572,RNL NDSC NFROT W/URTRL CATHJ W/WO DILAT URETER,4132.0,2685.8,401.88,4132.0,35
HCPCS,505720,KIDNEY ENDOSCOPY,,,566.99,566.99,1
HCPCS,50574,KIDNEY ENDOSCOPY & BIOPSY,,,602.62,7477.94,15
HCPCS,50574,Kidney endoscopy & biopsy,,,1770.94,2236.98,6
HCPCS,50574,RENAL NDSC NEPHROTOMY W/BIOPSY,4400.0,2860.0,392.38,4400.0,35
HCPCS,505740,KIDNEY ENDOSCOPY & BIOPSY,,,602.62,602.62,1
HCPCS,50575,KIDNEY ENDOSCOPY,,,761.08,11022.13,15
HCPCS,50575,Kidney endoscopy,,,1770.94,2236.98,6
HCPCS,50575,RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY,5584.0,3629.6,538.99,5584.0,35
HCPCS,505750,KIDNEY ENDOSCOPY,,,761.08,761.08,1
HCPCS,50576,KIDNEY ENDOSCOPY & TREATMENT,,,600.78,20049.35,15
HCPCS,50576,Kidney endoscopy & treatment,,,1770.94,2236.98,6
HCPCS,505760,KIDNEY ENDOSCOPY & TREATMENT,,,600.78,600.78,1
HCPCS,50580,KIDNEY ENDOSCOPY & TREATMENT,,,647.71,11022.13,15
HCPCS,50580,Kidney endoscopy & treatment,,,1770.94,2236.98,6
HCPCS,50580,RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS,4736.0,3078.4,409.36,4736.0,35
HCPCS,505800,KIDNEY ENDOSCOPY & TREATMENT,,,647.71,647.71,1
HCPCS,50590,FRAGMENTING OF KIDNEY STONE,,,616.19,11329.0,17
HCPCS,50590,Fragmenting of kidney stone,,,1770.94,2236.98,6
HCPCS,50590,LITHOTRIPSY XTRCORP SHOCK WAVE,3908.0,2540.2,331.09,2931.0,35
HCPCS,505900,FRAGMENTING OF KIDNEY STONE,,,616.19,616.19,1
HCPCS,50592,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,18084.0,11754.6,251.03,30193.2,200
HCPCS,50592,PERC RF ABLATE RENAL TUMOR,,,363.3,363.3,1
HCPCS,505920,PERC RF ABLATE RENAL TUMOR,,,363.3,363.3,1
HCPCS,50593,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,17808.0,11575.199999999999,228.17,28857.6,204
HCPCS,50593,PERC CRYO ABLATE RENAL TUM,,,485.11,485.11,1
HCPCS,505930,PERC CRYO ABLATE RENAL TUM,,,485.11,485.11,1
HCPCS,50600,EXPLORATION OF URETER,,,1007.53,22573.24,11
HCPCS,50600,Exploration of ureter,,,1770.94,2236.98,6
HCPCS,50600,URTROTOMY W/EXPL/DRG SEPARATE PROCEDURE,6868.0,4464.2,669.77,6868.0,35
HCPCS,506000,EXPLORATION OF URETER,,,1007.53,1007.53,1
HCPCS,50605,INSERT URETERAL SUPPORT,,,1092.24,1092.24,1
HCPCS,50605,Insert ureteral support,,,1770.94,2236.98,6
HCPCS,50605,URETEROTOMY INSERTION INDWELLING STENT ALL TYPES,6716.0,4365.4,579.22,6716.0,35
HCPCS,506050,INSERT URETERAL SUPPORT,,,1092.24,1092.24,1
HCPCS,50606,ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC,1009.5,656.175,121.75,5474.5,93
HCPCS,50606,ENDOLUMINAL BX URTR RNL PLVS,,,149.14,149.14,1
HCPCS,506060,ENDOLUMINAL BX URTR RNL PLVS,,,149.14,149.14,1
HCPCS,5060F,FNDNGS MAMMO 2PT W/IN 3 DAYS,,,0.01,0.01,1
HCPCS,5060F0,FNDNGS MAMMO 2PT W/IN 3 DAYS,,,0.01,0.01,1
HCPCS,50610,REMOVAL OF URETER STONE,,,1014.58,1014.58,1
HCPCS,50610,Removal of ureter stone,,,1770.94,2236.98,6
HCPCS,506100,REMOVAL OF URETER STONE,,,1014.58,1014.58,1
HCPCS,50620,REMOVAL OF URETER STONE,,,970.61,970.61,1
HCPCS,50620,Removal of ureter stone,,,1770.94,2236.98,6
HCPCS,506200,REMOVAL OF URETER STONE,,,970.61,970.61,1
HCPCS,5062F,MAMMO RESULT COM TO PT 5 DAY,,,0.01,0.01,1
HCPCS,5062F0,MAMMO RESULT COM TO PT 5 DAY,,,0.01,0.01,1
HCPCS,50630,REMOVAL OF URETER STONE,,,959.39,959.39,1
HCPCS,50630,Removal of ureter stone,,,1770.94,2236.98,6
HCPCS,50630,URTROLITHOTOMY LOWER ONE-THIRD URETER,6484.0,4214.6,675.95,6484.0,35
HCPCS,506300,REMOVAL OF URETER STONE,,,959.39,959.39,1
HCPCS,50650,REMOVAL OF URETER,,,1117.1,1117.1,1
HCPCS,50650,Removal of ureter,,,2586.74,3267.46,6
HCPCS,50650,URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE,8281.0,5382.65,766.41,8281.0,35
HCPCS,506500,REMOVAL OF URETER,,,1117.1,1117.1,1
HCPCS,50660,REMOVAL OF URETER,,,1227.48,1227.48,1
HCPCS,50660,Removal of ureter,,,4333.98,5474.5,6
HCPCS,50660,URETERECTOMY TOT ECTOPIC URETER CMBN APPR,8408.0,5465.2,801.13,8408.0,35
HCPCS,506600,REMOVAL OF URETER,,,1227.48,1227.48,1
HCPCS,50684,INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH,481.0,312.65,30.79,4214.0,111
HCPCS,50684,INJECTION FOR URETER X-RAY,,,54.18,54.18,1
HCPCS,506840,INJECTION FOR URETER X-RAY,,,54.18,54.18,1
HCPCS,50686,MEASURE URETER PRESSURE,,,94.89,339.23,15
HCPCS,50686,Measure ureter pressure,,,53.02,66.97,6
HCPCS,506860,MEASURE URETER PRESSURE,,,94.89,94.89,1
HCPCS,50688,CHANGE OF URETER TUBE/STENT,,,82.47,82.47,1
HCPCS,50688,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,6129.5,3984.175,60.0,10601.1,179
HCPCS,506880,CHANGE OF URETER TUBE/STENT,,,82.47,82.47,1
HCPCS,50690,INJECTION FOR URETER X-RAY,,,74.2,74.2,1
HCPCS,50690,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,856.5,556.725,33.2,4214.0,184
HCPCS,506900,INJECTION FOR URETER X-RAY,,,74.2,74.2,1
HCPCS,50693,PLMT URETERAL STENT PRQ,,,214.9,214.9,1
HCPCS,50693,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,10707.5,6959.875,168.13,17847.9,154
HCPCS,506930,PLMT URETERAL STENT PRQ,,,214.9,214.9,1
HCPCS,50694,PLMT URETERAL STENT PRQ,,,280.75,280.75,1
HCPCS,50694,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,10965.5,7127.575,217.5,17847.9,154
HCPCS,506940,PLMT URETERAL STENT PRQ,,,280.75,280.75,1
HCPCS,50695,PLMT URETERAL STENT PRQ,,,360.5,360.5,1
HCPCS,50695,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,11275.5,7329.075,275.72,17847.9,154
HCPCS,506950,PLMT URETERAL STENT PRQ,,,360.5,360.5,1
HCPCS,50700,REVISION OF URETER,,,995.6,995.6,1
HCPCS,50700,Revision of ureter,,,4333.98,5474.5,6
HCPCS,50700,URETEROPLASTY PLASTIC OPERATION URETER,6676.0,4339.4,682.2,6676.0,35
HCPCS,507000,REVISION OF URETER,,,995.6,995.6,1
HCPCS,50705,URETERAL EMBOLIZATION/OCCL,,,189.9,189.9,1
HCPCS,50705,URETERAL EMBOLIZATION/OCCLUSION W/IMG GID RS&I,1183.5,769.275,126.84,5474.5,93
HCPCS,507050,URETERAL EMBOLIZATION/OCCL,,,189.9,189.9,1
HCPCS,50706,BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I,1576.5,1024.725,144.7,5474.5,93
HCPCS,50706,BALLOON DILATE URTRL STRIX,,,191.43,191.43,1
HCPCS,507060,BALLOON DILATE URTRL STRIX,,,191.43,191.43,1
HCPCS,50715,RELEASE OF URETER,,,1304.63,1304.63,1
HCPCS,50715,Release of ureter,,,1770.94,2236.98,6
HCPCS,50715,URETEROLYSIS W/WORPSG URETER RETROPERIT FIBROSIS,8256.0,5366.4,805.26,8256.0,35
HCPCS,507150,RELEASE OF URETER,,,1304.63,1304.63,1
HCPCS,50722,RELEASE OF URETER,,,1106.1,1106.1,1
HCPCS,50722,Release of ureter,,,1770.94,2236.98,6
HCPCS,50722,URETEROLYSIS FOR OVARIAN VEIN SYNDROME,7898.0,5133.7,721.94,7898.0,35
HCPCS,507220,RELEASE OF URETER,,,1106.1,1106.1,1
HCPCS,50725,RELEASE/REVISE URETER,,,1183.13,1183.13,1
HCPCS,50725,Release/revise ureter,,,4333.98,5474.5,6
HCPCS,507250,RELEASE/REVISE URETER,,,1183.13,1183.13,1
HCPCS,50727,REVISE URETER,,,551.75,7477.94,15
HCPCS,50727,REVJ URINARY-CUTANEOUS ANASTAMOSIS,3312.0,2152.8,362.36,3312.0,35
HCPCS,50727,Revise ureter,,,970.74,1226.2,6
HCPCS,507270,REVISE URETER,,,551.75,551.75,1
HCPCS,50728,REVISE URETER,,,753.93,753.93,1
HCPCS,50728,REVJ UR-CUTAN ANAST RPR FSCAL DFCT & HERNIA,4872.0,3166.8,525.15,4872.0,35
HCPCS,50728,Revise ureter,,,2586.74,3267.46,6
HCPCS,507280,REVISE URETER,,,753.93,753.93,1
HCPCS,50740,FUSION OF URETER & KIDNEY,,,1331.94,1331.94,1
HCPCS,50740,Fusion of ureter & kidney,,,4333.98,5474.5,6
HCPCS,50740,URETEROPYELOSTOMY ANAST URETER RENAL PELVIS,8028.0,5218.2,826.41,8028.0,35
HCPCS,507400,FUSION OF URETER & KIDNEY,,,1331.94,1331.94,1
HCPCS,50750,FUSION OF URETER & KIDNEY,,,1238.01,1238.01,1
HCPCS,50750,Fusion of ureter & kidney,,,4333.98,5474.5,6
HCPCS,50750,URETEROCALYCOSTOMY ANAST URETER RENAL CALYX,8488.0,5517.2,800.4,8488.0,35
HCPCS,507500,FUSION OF URETER & KIDNEY,,,1238.01,1238.01,1
HCPCS,50760,URETEROURETEROSTOMY,8028.0,5218.2,828.2,8028.0,36
HCPCS,50760,Ureteroureterostomy,,,4333.98,5474.5,6
HCPCS,507600,URETEROURETEROSTOMY,,,1218.09,1218.09,1
HCPCS,50770,SPLICING OF URETERS,,,1238.01,1238.01,1
HCPCS,50770,Splicing of ureters,,,4333.98,5474.5,6
HCPCS,50770,TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR,8488.0,5517.2,852.72,8488.0,35
HCPCS,507700,SPLICING OF URETERS,,,1238.01,1238.01,1
HCPCS,50780,REIMPLANT URETER IN BLADDER,,,1198.3,1198.3,1
HCPCS,50780,Reimplant ureter in bladder,,,2586.74,3267.46,6
HCPCS,50780,URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER,8778.0,5705.7,831.9,8778.0,35
HCPCS,507800,REIMPLANT URETER IN BLADDER,,,1198.3,1198.3,1
HCPCS,50782,REIMPLANT URETER IN BLADDER,,,1154.04,1154.04,1
HCPCS,50782,Reimplant ureter in bladder,,,4333.98,5474.5,6
HCPCS,50782,URETERONEOCYSTOSTOMY ANAST DUPLICATE URETER BLDR,7864.0,5111.6,821.63,7864.0,35
HCPCS,507820,REIMPLANT URETER IN BLADDER,,,1154.04,1154.04,1
HCPCS,50783,REIMPLANT URETER IN BLADDER,,,1210.05,1210.05,1
HCPCS,50783,Reimplant ureter in bladder,,,4333.98,5474.5,6
HCPCS,507830,REIMPLANT URETER IN BLADDER,,,1210.05,1210.05,1
HCPCS,50785,REIMPLANT URETER IN BLADDER,,,1302.7,1302.7,1
HCPCS,50785,Reimplant ureter in bladder,,,2586.74,3267.46,6
HCPCS,50785,URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP,8892.0,5779.8,887.98,8892.0,35
HCPCS,507850,REIMPLANT URETER IN BLADDER,,,1302.7,1302.7,1
HCPCS,50800,IMPLANT URETER IN BOWEL,,,991.13,991.13,1
HCPCS,50800,Implant ureter in bowel,,,4333.98,5474.5,6
HCPCS,50800,URETEROENTEROSTOMY ANAST URETER INTESTINE,7220.0,4693.0,647.14,7220.0,35
HCPCS,508000,IMPLANT URETER IN BOWEL,,,991.13,991.13,1
HCPCS,50810,FUSION OF URETER & BOWEL,,,1527.06,1527.06,1
HCPCS,50810,Fusion of ureter & bowel,,,4333.98,5474.5,6
HCPCS,50810,URETEROSIGMOIDOSTOMY W/SIGMOID BLADDER & COLOSTO,9044.0,5878.6,869.71,9044.0,35
HCPCS,508100,FUSION OF URETER & BOWEL,,,1527.06,1527.06,1
HCPCS,50815,URETEROCOLON CONDUIT INTESTINE ANASTOMOSIS,8904.0,5787.6,914.73,8904.0,35
HCPCS,50815,URINE SHUNT TO INTESTINE,,,1314.85,1314.85,1
HCPCS,50815,Urine shunt to intestine,,,4333.98,5474.5,6
HCPCS,508150,URINE SHUNT TO INTESTINE,,,1314.85,1314.85,1
HCPCS,50820,CONSTRUCT BOWEL BLADDER,,,1409.9,1409.9,1
HCPCS,50820,Construct bowel bladder,,,2586.74,3267.46,6
HCPCS,50820,URETEROILEAL CONDUIT W/INTESTINE ANASTOMOSIS,9628.0,6258.2,1003.17,9628.0,35
HCPCS,508200,CONSTRUCT BOWEL BLADDER,,,1409.9,1409.9,1
HCPCS,50825,CONSTRUCT BOWEL BLADDER,,,1765.89,1765.89,1
HCPCS,50825,CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN,12272.0,7976.8,1255.17,12272.0,35
HCPCS,50825,Construct bowel bladder,,,2586.74,3267.46,6
HCPCS,508250,CONSTRUCT BOWEL BLADDER,,,1765.89,1765.89,1
HCPCS,50830,REVISE URINE FLOW,,,1931.27,1931.27,1
HCPCS,50830,Revise urine flow,,,4333.98,5474.5,6
HCPCS,50830,URINARY UN-DIVERSION,13508.0,8780.2,1357.96,13508.0,35
HCPCS,508300,REVISE URINE FLOW,,,1931.27,1931.27,1
HCPCS,50840,REPLACE URETER BY BOWEL,,,1321.74,1321.74,1
HCPCS,50840,RPLCMT ALL/PART URETER INTESTINE SGM W/ANAST,8956.0,5821.4,871.36,8956.0,35
HCPCS,50840,Replace ureter by bowel,,,4333.98,5474.5,6
HCPCS,508400,REPLACE URETER BY BOWEL,,,1321.74,1321.74,1
HCPCS,50845,APPENDICO-VESICOSTOMY,,,1346.97,1346.97,1
HCPCS,50845,Appendico-vesicostomy,,,2586.74,3267.46,6
HCPCS,50845,CUTANANEOUS APPENDICO-VESICOSTOMY,8984.0,5839.6,906.81,8984.0,35
HCPCS,508450,APPENDICO-VESICOSTOMY,,,1346.97,1346.97,1
HCPCS,50860,TRANSPLANT URETER TO SKIN,,,1016.29,1016.29,1
HCPCS,50860,Transplant ureter to skin,,,4333.98,5474.5,6
HCPCS,50860,URETEROSTOMY TRANSPLANTATION URETER SKIN,6832.0,4440.8,685.11,6832.0,35
HCPCS,508600,TRANSPLANT URETER TO SKIN,,,1016.29,1016.29,1
HCPCS,50900,REPAIR OF URETER,,,906.52,906.52,1
HCPCS,50900,Repair of ureter,,,1770.94,2236.98,6
HCPCS,50900,URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE,6016.0,3910.4,616.78,6016.0,35
HCPCS,509000,REPAIR OF URETER,,,906.52,906.52,1
HCPCS,50920,CLOSURE URETER/SKIN FISTULA,,,947.97,947.97,1
HCPCS,50920,CLOSURE URETEROCUTANEOUS FISTULA,6324.0,4110.6,623.6,6324.0,35
HCPCS,50920,Closure ureter/skin fistula,,,1770.94,2236.98,6
HCPCS,509200,CLOSURE URETER/SKIN FISTULA,,,947.97,947.97,1
HCPCS,50930,CLOSURE URETER/BOWEL FISTULA,,,1182.04,1182.04,1
HCPCS,50930,CLOSURE URETEROCUTANEOUS FISTULA W/VISC RPR,8076.0,5249.4,771.65,8076.0,35
HCPCS,50930,Closure ureter/bowel fistula,,,2586.74,3267.46,6
HCPCS,509300,CLOSURE URETER/BOWEL FISTULA,,,1182.04,1182.04,1
HCPCS,50940,DELIGATION OF URETER,6372.0,4141.8,635.45,6372.0,35
HCPCS,50940,RELEASE OF URETER,,,954.14,954.14,1
HCPCS,50940,Release of ureter,,,1770.94,2236.98,6
HCPCS,509400,RELEASE OF URETER,,,954.14,954.14,1
HCPCS,50945,LAPAROSCOPY URETEROLITHOTOMY,,,1042.33,12649.85,15
HCPCS,50945,"LAPAROSCOPY, SURGICAL, URETEROLITHO",7188.0,4672.2,668.35,7188.0,35
HCPCS,50945,Laparoscopy ureterolithotomy,,,1770.94,2236.98,6
HCPCS,509450,LAPAROSCOPY URETEROLITHOTOMY,,,1042.33,1042.33,1
HCPCS,50947,LAPARO NEW URETER/BLADDER,,,1485.86,22573.24,15
HCPCS,50947,LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT,11343.0,7372.95,1009.39,11343.0,35
HCPCS,50947,Laparo new ureter/bladder,,,4333.98,5474.5,6
HCPCS,509470,LAPARO NEW URETER/BLADDER,,,1485.86,1485.86,1
HCPCS,50948,LAPARO NEW URETER/BLADDER,,,1362.97,22573.24,15
HCPCS,50948,LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT,10481.0,6812.65,923.26,10481.0,35
HCPCS,50948,Laparo new ureter/bladder,,,1770.94,2236.98,6
HCPCS,509480,LAPARO NEW URETER/BLADDER,,,1362.97,1362.97,1
HCPCS,50949,LAP ILEAL CONDUIT (COMP 50820),9628.0,6258.2,821.04,9628.0,15
HCPCS,50949,LAP URETEROURETEROSTOMY (COMP 50760),8630.0,5609.5,821.04,8630.0,15
HCPCS,50949,LAPAROSCOPIC DISSECTION'S OF THE URETER AND REIMPLANTATION INTO,9558.0,6212.7,821.04,9558.0,15
HCPCS,50949,LAPAROSCOPIC URETERECTOMY WITH BLADDER CUFF (COMP CODE 50650),8093.0,5260.45,821.04,8093.0,15
HCPCS,50949,LAPAROSCOPIC URETEROCALICOSTOMY (COMP CODE 50750),8488.0,5517.2,821.04,8488.0,15
HCPCS,50949,LAPAROSCOPIC URETEROLYSIS (COMP 50715),7431.0,4830.15,821.04,7431.0,15
HCPCS,50949,UNLISTED LAPS PX URETER,,,5856.41,12649.85,14
HCPCS,50949,Unlisted laps px ureter,,,918.04,1159.63,6
HCPCS,50951,ENDOSCOPY OF URETER,,,327.76,7477.94,15
HCPCS,50951,Endoscopy of ureter,,,918.04,1159.63,6
HCPCS,50951,URETERAL ENDOSCOPY VIA URETEROSTOMY,2332.0,1515.8,149.42,1749.0,35
HCPCS,509510,ENDOSCOPY OF URETER,,,327.76,327.76,1
HCPCS,50953,ENDOSCOPY OF URETER,,,348.44,7477.94,15
HCPCS,50953,Endoscopy of ureter,,,918.04,1159.63,6
HCPCS,509530,ENDOSCOPY OF URETER,,,348.44,348.44,1
HCPCS,50955,URETER ENDOSCOPY & BIOPSY,,,376.07,11022.13,15
HCPCS,50955,URETERAL ENDOSCOPY VIA URETEROSTOMY W/BIOPSY,2696.0,1752.4,209.75,2022.0,35
HCPCS,50955,Ureter endoscopy & biopsy,,,1770.94,2236.98,6
HCPCS,509550,URETER ENDOSCOPY & BIOPSY,,,376.07,376.07,1
HCPCS,50957,URETER ENDOSCOPY & TREATMENT,,,377.89,11022.13,15
HCPCS,50957,Ureter endoscopy & treatment,,,1770.94,2236.98,6
HCPCS,509570,URETER ENDOSCOPY & TREATMENT,,,377.89,377.89,1
HCPCS,50961,URETER ENDOSCOPY & TREATMENT,,,338.66,11022.13,15
HCPCS,50961,URETERAL ENDOSCOPY VIA URETEROST W/RMVL FB/STONE,2416.0,1570.4,201.12,1812.0,35
HCPCS,50961,Ureter endoscopy & treatment,,,1770.94,2236.98,6
HCPCS,509610,URETER ENDOSCOPY & TREATMENT,,,338.66,338.66,1
HCPCS,50970,URETER ENDOSCOPY,,,395.46,7477.94,15
HCPCS,50970,URETERAL ENDOSCOPY VIA URETEROTOMY W/O IMAGING,2852.0,1853.8,279.96,2852.0,35
HCPCS,50970,Ureter endoscopy,,,918.04,1159.63,6
HCPCS,509700,URETER ENDOSCOPY,,,395.46,395.46,1
HCPCS,50972,URETER ENDOSCOPY & CATHETER,,,381.64,7477.94,15
HCPCS,50972,Ureter endoscopy & catheter,,,918.04,1159.63,6
HCPCS,509720,URETER ENDOSCOPY & CATHETER,,,381.64,381.64,1
HCPCS,50974,URETER ENDOSCOPY & BIOPSY,,,504.86,11022.13,15
HCPCS,50974,Ureter endoscopy & biopsy,,,1770.94,2236.98,6
HCPCS,509740,URETER ENDOSCOPY & BIOPSY,,,504.86,504.86,1
HCPCS,50976,URETER ENDOSCOPY & TREATMENT,,,497.98,11022.13,15
HCPCS,50976,URETERAL ENDOSC VIA URETEROT W/DEST&/INC W/WO BX,3612.0,2347.8,323.33,3612.0,35
HCPCS,50976,Ureter endoscopy & treatment,,,1770.94,2236.98,6
HCPCS,509760,URETER ENDOSCOPY & TREATMENT,,,497.98,497.98,1
HCPCS,50980,URETER ENDOSCOPY & TREATMENT,,,379.81,11022.13,15
HCPCS,50980,Ureter endoscopy & treatment,,,1770.94,2236.98,6
HCPCS,509800,URETER ENDOSCOPY & TREATMENT,,,379.81,379.81,1
HCPCS,5100F,RSK FX REF W/N 24 HRS XRAY,,,0.01,0.01,1
HCPCS,5100F0,RSK FX REF W/N 24 HRS XRAY,,,0.01,0.01,1
HCPCS,51020,CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL,3076.0,1999.4,327.9,3076.0,35
HCPCS,51020,CYSTOTOMY/CYSTOSTOMY W/FULG,,,507.25,7477.94,15
HCPCS,51020,Cystotomy/cystostomy w/fulg,,,970.74,1226.2,6
HCPCS,510200,CYSTOTOMY/CYSTOSTOMY W/FULG,,,507.25,507.25,1
HCPCS,51030,Incise & treat bladder,,,970.74,1226.2,6
HCPCS,51040,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,6787.5,4411.875,226.22,10601.1,119
HCPCS,51040,INCISE & DRAIN BLADDER,,,314.14,314.14,1
HCPCS,510400,INCISE & DRAIN BLADDER,,,314.14,314.14,1
HCPCS,51045,CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX,3124.0,2030.6,312.88,3124.0,35
HCPCS,51045,INCISE BLADDER/DRAIN URETER,,,536.89,4441.51,15
HCPCS,51045,Incise bladder/drain ureter,,,970.74,1226.2,6
HCPCS,510450,INCISE BLADDER/DRAIN URETER,,,536.89,536.89,1
HCPCS,51050,CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS,3188.0,2072.2,344.95,3188.0,35
HCPCS,51050,REMOVAL OF BLADDER STONE,,,509.04,11022.13,15
HCPCS,51050,Removal of bladder stone,,,2586.74,3267.46,6
HCPCS,510500,REMOVAL OF BLADDER STONE,,,509.04,509.04,1
HCPCS,51060,REMOVAL OF URETER STONE,,,628.3,4441.51,15
HCPCS,51060,Removal of ureter stone,,,918.04,1159.63,6
HCPCS,510600,REMOVAL OF URETER STONE,,,628.3,628.3,1
HCPCS,51065,REMOVE URETER CALCULUS,,,625.6,7477.94,15
HCPCS,51065,Remove ureter calculus,,,970.74,1226.2,6
HCPCS,510650,REMOVE URETER CALCULUS,,,625.6,625.6,1
HCPCS,51080,DRAINAGE OF BLADDER ABSCESS,,,441.03,441.03,1
HCPCS,51080,DRG PRIVESICAL/PREVESICAL SPACE ABSC,9570.0,6220.5,295.61,14810.4,84
HCPCS,510800,DRAINAGE OF BLADDER ABSCESS,,,441.03,441.03,1
HCPCS,51100,ASPIRATION BLADDER NEEDLE,855.5,556.075,24.33,3920.0,182
HCPCS,51100,DRAIN BLADDER BY NEEDLE,,,42.15,42.15,1
HCPCS,511000,DRAIN BLADDER BY NEEDLE,,,42.15,42.15,1
HCPCS,51101,ASPIRATION BLADDER TROCAR/INTRACATHETER,408.0,265.2,34.63,306.0,35
HCPCS,51101,DRAIN BLADDER BY TROCAR/CATH,,,54.89,2205.87,15
HCPCS,51101,Drain bladder by trocar/cath,,,248.59,314.0,6
HCPCS,511010,DRAIN BLADDER BY TROCAR/CATH,,,54.89,54.89,1
HCPCS,51102,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,6429.5,4179.175,91.22,13665.0,323
HCPCS,51102,DRAIN BL W/CATH INSERTION,,,152.66,152.66,1
HCPCS,511020,DRAIN BL W/CATH INSERTION,,,152.66,152.66,1
HCPCS,51500,EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR,4420.0,2873.0,457.6,4420.0,35
HCPCS,51500,REMOVAL OF BLADDER CYST,,,686.44,12649.85,15
HCPCS,51500,Removal of bladder cyst,,,2376.39,3001.75,6
HCPCS,515000,REMOVAL OF BLADDER CYST,,,686.44,686.44,1
HCPCS,51520,REMOVAL OF BLADDER LESION,,,641.73,7477.94,15
HCPCS,51520,Removal of bladder lesion,,,970.74,1226.2,6
HCPCS,515200,REMOVAL OF BLADDER LESION,,,641.73,641.73,1
HCPCS,51525,CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE,6168.0,4009.2,638.03,6168.0,35
HCPCS,51525,REMOVAL OF BLADDER LESION,,,922.35,922.35,1
HCPCS,51525,Removal of bladder lesion,,,2586.74,3267.46,6
HCPCS,515250,REMOVAL OF BLADDER LESION,,,922.35,922.35,1
HCPCS,51530,"CYSTOTOMY,EXCIS BLADDER TUMOR",5484.0,3564.6,565.06,5484.0,35
HCPCS,51530,REMOVAL OF BLADDER LESION,,,828.6,828.6,1
HCPCS,51530,Removal of bladder lesion,,,2586.74,3267.46,6
HCPCS,515300,REMOVAL OF BLADDER LESION,,,828.6,828.6,1
HCPCS,51535,CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE,5560.0,3614.0,544.05,5560.0,35
HCPCS,51535,REPAIR OF URETER LESION,,,838.76,7477.94,15
HCPCS,51535,Repair of ureter lesion,,,970.74,1226.2,6
HCPCS,515350,REPAIR OF URETER LESION,,,838.76,838.76,1
HCPCS,51550,CYSTECTOMY PARTIAL SIMPLE,6892.0,4479.8,688.23,6892.0,35
HCPCS,51550,PARTIAL REMOVAL OF BLADDER,,,1037.46,1037.46,1
HCPCS,51550,Partial removal of bladder,,,2586.74,3267.46,6
HCPCS,515500,PARTIAL REMOVAL OF BLADDER,,,1037.46,1037.46,1
HCPCS,51555,CYSTECTOMY PARTIAL COMPLICATED,9272.0,6026.8,878.16,9272.0,35
HCPCS,51555,PARTIAL REMOVAL OF BLADDER,,,1355.42,1355.42,1
HCPCS,51555,Partial removal of bladder,,,2586.74,3267.46,6
HCPCS,515550,PARTIAL REMOVAL OF BLADDER,,,1355.42,1355.42,1
HCPCS,51565,CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST,9472.0,6156.8,970.09,9472.0,35
HCPCS,51565,REVISE BLADDER & URETER(S),,,1382.66,1382.66,1
HCPCS,51565,Revise bladder & ureter(s),,,2586.74,3267.46,6
HCPCS,515650,REVISE BLADDER & URETER(S),,,1382.66,1382.66,1
HCPCS,51570,CYSTECTOMY COMPLETE SEPARATE PROCEDURE,10984.0,7139.6,1039.41,10984.0,35
HCPCS,51570,REMOVAL OF BLADDER,,,1581.04,1581.04,1
HCPCS,51570,Removal of bladder,,,2586.74,3267.46,6
HCPCS,515700,REMOVAL OF BLADDER,,,1581.04,1581.04,1
HCPCS,51575,CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY,13672.0,8886.8,1371.13,13672.0,35
HCPCS,51575,REMOVAL OF BLADDER & NODES,,,1947.01,1947.01,1
HCPCS,51575,Removal of bladder & nodes,,,2586.74,3267.46,6
HCPCS,515750,REMOVAL OF BLADDER & NODES,,,1947.01,1947.01,1
HCPCS,51580,REMOVE BLADDER/REVISE TRACT,,,2032.57,2032.57,1
HCPCS,51580,Remove bladder/revise tract,,,3017.62,3811.73,6
HCPCS,515800,REMOVE BLADDER/REVISE TRACT,,,2032.57,2032.57,1
HCPCS,51585,REMOVAL OF BLADDER & NODES,,,2260.46,2260.46,1
HCPCS,51585,Removal of bladder & nodes,,,3017.62,3811.73,6
HCPCS,515850,REMOVAL OF BLADDER & NODES,,,2260.46,2260.46,1
HCPCS,51590,CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST,14532.0,9445.8,1401.67,14532.0,35
HCPCS,51590,REMOVE BLADDER/REVISE TRACT,,,2069.25,2069.25,1
HCPCS,51590,Remove bladder/revise tract,,,2586.74,3267.46,6
HCPCS,515900,REMOVE BLADDER/REVISE TRACT,,,2069.25,2069.25,1
HCPCS,51595,CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC,16528.0,10743.2,1662.67,16528.0,35
HCPCS,51595,REMOVE BLADDER/REVISE TRACT,,,2343.01,2343.01,1
HCPCS,51595,Remove bladder/revise tract,,,2586.74,3267.46,6
HCPCS,515950,REMOVE BLADDER/REVISE TRACT,,,2343.01,2343.01,1
HCPCS,51596,CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR,17704.0,11507.6,1796.21,17704.0,35
HCPCS,51596,REMOVE BLADDER/CREATE POUCH,,,2524.18,2524.18,1
HCPCS,51596,Remove bladder/create pouch,,,3017.62,3811.73,6
HCPCS,515960,REMOVE BLADDER/CREATE POUCH,,,2524.18,2524.18,1
HCPCS,51597,PELVIC EXENTERATION COMPLETE MALIGNANCY,17144.0,11143.6,1706.44,17144.0,35
HCPCS,51597,REMOVAL OF PELVIC STRUCTURES,,,2465.43,2465.43,1
HCPCS,51597,Removal of pelvic structures,,,3017.62,3811.73,6
HCPCS,515970,REMOVAL OF PELVIC STRUCTURES,,,2465.43,2465.43,1
HCPCS,51600,INJECTION FOR BLADDER X-RAY,,,46.48,46.48,1
HCPCS,51600,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,831.0,540.15,32.67,4151.0,184
HCPCS,516000,INJECTION FOR BLADDER X-RAY,,,46.48,46.48,1
HCPCS,51605,PREPARATION FOR BLADDER XRAY,,,41.27,41.27,1
HCPCS,51605,Preparation for bladder xray,,,223.78,282.67,6
HCPCS,516050,PREPARATION FOR BLADDER XRAY,,,41.27,41.27,1
HCPCS,51610,INJECTION FOR BLADDER X-RAY,,,68.43,68.43,1
HCPCS,51610,NJX RETROGRADE URETHROCSTOGRAPY,1044.5,678.925,30.58,4268.0,146
HCPCS,516100,INJECTION FOR BLADDER X-RAY,,,68.43,68.43,1
HCPCS,51700,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,831.5,540.475,24.33,4151.0,179
HCPCS,51700,IRRIGATION OF BLADDER,,,32.36,32.36,1
HCPCS,517000,IRRIGATION OF BLADDER,,,32.36,32.36,1
HCPCS,51701,INSERT BLADDER CATHETER,,,27.6,27.6,1
HCPCS,51701,INSJ NON-NDWELLG BLADDER CATHETER,480.5,312.325,18.59,3920.0,225
HCPCS,517010,INSERT BLADDER CATHETER,,,27.6,27.6,1
HCPCS,51702,INSERT TEMP BLADDER CATH,,,27.22,27.22,1
HCPCS,51702,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,480.5,312.325,22.72,3920.0,225
HCPCS,517020,INSERT TEMP BLADDER CATH,,,27.22,27.22,1
HCPCS,51703,INSERT BLADDER CATH COMPLEX,,,81.9,81.9,1
HCPCS,51703,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,744.0,483.6,41.9,3920.0,225
HCPCS,517030,INSERT BLADDER CATH COMPLEX,,,81.9,81.9,1
HCPCS,51705,CHANGE CYSTOSTOMY TUBE SIMPLE,879.5,571.675,35.48,4151.0,228
HCPCS,51705,CHANGE OF BLADDER TUBE,,,55.41,55.41,1
HCPCS,517050,CHANGE OF BLADDER TUBE,,,55.41,55.41,1
HCPCS,51710,CHANGE CYSTOSTOMY TUBE COMPLICATED,2189.0,1422.85,59.13,6289.0,179
HCPCS,51710,CHANGE OF BLADDER TUBE,,,85.84,85.84,1
HCPCS,517100,CHANGE OF BLADDER TUBE,,,85.84,85.84,1
HCPCS,51715,ENDOSCOPIC INJECTION/IMPLANT,,,214.29,214.29,1
HCPCS,51715,NDSC NJX IMPLT MATRL URT&/BLDR NCK,10661.5,6929.974999999999,103.81,17847.9,74
HCPCS,517150,ENDOSCOPIC INJECTION/IMPLANT,,,214.29,214.29,1
HCPCS,51720,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,2110.5,1371.8249999999998,41.33,4151.0,81
HCPCS,51720,TREATMENT OF BLADDER LESION,,,46.88,46.88,1
HCPCS,517200,TREATMENT OF BLADDER LESION,,,46.88,46.88,1
HCPCS,51721,INS TRURL ABLT TRNSDC THR US,,,227.25,227.25,1
HCPCS,51721,INSJ TRURL ABLTJ TRNSDCR DLVR THRM US PRST8 TISS,1782.0,1158.3,153.57,1336.5,25
HCPCS,51721,Ins trurl ablt trnsdc thr us,,,1043.57,1318.19,6
HCPCS,517210,INS TRURL ABLT TRNSDC THR US,,,227.25,227.25,1
HCPCS,51725,CMG SIMPLE,410.0,266.5,145.77,438.27,35
HCPCS,51725,COMPLEX CMG,1648.0,1071.2,145.77,1648.0,35
HCPCS,51725,"CYSTOMETROGRAM, SIMPLE",1172.0,761.8,65.64,2063.0,101
HCPCS,51725,SIMPLE CYSTOMETROGRAM,1399.0,909.35,154.93,4214.0,48
HCPCS,517250,SIMPLE CYSTOMETROGRAM,,,154.93,154.93,1
HCPCS,51725TC,SIMPLE CYSTOMETROGRAM,,,154.93,154.93,1
HCPCS,51726,BLADDER PRESSURE MEASUREMENT DURING FILLING,1399.0,909.35,74.17,4214.0,112
HCPCS,51726,COMPLEX CMG,752.0,488.8,195.83,752.0,35
HCPCS,51726,COMPLEX CYSTOMETROGRAM,,,220.37,220.37,2
HCPCS,517260,COMPLEX CYSTOMETROGRAM,,,220.37,220.37,1
HCPCS,51726TC,COMPLEX CYSTOMETROGRAM,,,220.37,220.37,1
HCPCS,51727,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,2341.0,1521.6499999999999,180.82,4214.0,84
HCPCS,51727,CYSTOMETROGRAM W/UP,,,264.9,264.9,2
HCPCS,517270,CYSTOMETROGRAM W/UP,,,264.9,264.9,1
HCPCS,51727TC,CYSTOMETROGRAM W/UP,,,264.9,264.9,1
HCPCS,51728,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,2383.0,1548.9499999999998,182.13,4214.0,81
HCPCS,51728,CYSTOMETROGRAM W/VP,,,265.24,265.24,2
HCPCS,517280,CYSTOMETROGRAM W/VP,,,265.24,265.24,1
HCPCS,51728TC,CYSTOMETROGRAM W/VP,,,265.24,265.24,1
HCPCS,51729,COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL,3838.0,2494.7,248.59,4214.0,46
HCPCS,51729,COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE,1104.0,717.6,192.49,1104.0,35
HCPCS,51729,CYSTOMETROGRAM W/VP&UP,,,263.6,263.6,2
HCPCS,517290,CYSTOMETROGRAM W/VP&UP,,,263.6,263.6,1
HCPCS,51729TC,CYSTOMETROGRAM W/VP&UP,,,263.6,263.6,1
HCPCS,51736,URINE FLOW MEASUREMENT,,,5.78,279.48,16
HCPCS,51736,Urine flow measurement,,,53.02,66.97,6
HCPCS,517360,URINE FLOW MEASUREMENT,,,5.78,5.78,1
HCPCS,51736TC,URINE FLOW MEASUREMENT,,,5.78,5.78,1
HCPCS,51741,COMPLEX UROFLOMETRY,1790.0,1163.5,8.58,3920.0,164
HCPCS,51741,COMPLEX UROFLOWMETRY,68.0,44.2,12.95,68.0,35
HCPCS,51741,ELECTRO-UROFLOWMETRY FIRST,,,6.11,6.11,2
HCPCS,517410,ELECTRO-UROFLOWMETRY FIRST,,,6.11,6.11,1
HCPCS,51741TC,ELECTRO-UROFLOWMETRY FIRST,,,6.11,6.11,1
HCPCS,51784,ANAL/URINARY MUSCLE STUDY,,,28.38,28.38,2
HCPCS,51784,EMG ANAL SPHINCTER,330.0,214.5,49.02,330.0,35
HCPCS,51784,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,900.0,585.0,36.73,3920.0,115
HCPCS,517840,ANAL/URINARY MUSCLE STUDY,,,28.38,28.38,1
HCPCS,51784TC,ANAL/URINARY MUSCLE STUDY,,,28.38,28.38,1
HCPCS,51785,ANAL/URINARY MUSCLE STUDY,,,349.95,349.95,2
HCPCS,51785,EMG NEEDLE STUDY ANAL URETH,673.0,437.45,202.48,849.68,35
HCPCS,51785,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,1399.0,909.35,67.07,4151.0,112
HCPCS,517850,ANAL/URINARY MUSCLE STUDY,,,349.95,349.95,1
HCPCS,51785TC,ANAL/URINARY MUSCLE STUDY,,,349.95,349.95,1
HCPCS,51792,URINARY REFLEX STUDY,,,59.62,222.1,16
HCPCS,51792,Urinary reflex study,,,82.59,104.33,6
HCPCS,517920,URINARY REFLEX STUDY,,,222.1,222.1,1
HCPCS,51792TC,URINARY REFLEX STUDY,,,222.1,222.1,1
HCPCS,51797,INTRAABDOMINAL PRESSURE TEST,,,151.8,151.8,2
HCPCS,51797,VOID PRESSURE STUDIES INTRAABDOMINAL,1419.0,922.35,34.53,4151.0,101
HCPCS,51797,VOIDING PRESSURE INTRAABD,352.0,228.8,97.32,360.39,35
HCPCS,517970,INTRAABDOMINAL PRESSURE TEST,,,151.8,151.8,1
HCPCS,51797TC,INTRAABDOMINAL PRESSURE TEST,,,151.8,151.8,1
HCPCS,51798,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,191.5,124.47500000000001,8.94,3920.0,274
HCPCS,51798,POST VOID RESIDUAL U.S.,42.0,27.3,8.94,42.0,35
HCPCS,51798,US URINE BLADDER CAPACTIY NON-IMG,42.0,27.3,8.94,42.0,35
HCPCS,51798,US URINE CAPACITY MEASURE,,,11.51,11.51,2
HCPCS,517980,US URINE CAPACITY MEASURE,,,11.51,11.51,1
HCPCS,51798TC,US URINE CAPACITY MEASURE,,,11.51,11.51,1
HCPCS,51800,CSTOPLASTY/CSTOURTP PLSTC ANY,7556.0,4911.4,770.48,7556.0,35
HCPCS,51800,REVISION OF BLADDER/URETHRA,,,1115.0,1115.0,1
HCPCS,51800,Revision of bladder/urethra,,,2586.74,3267.46,6
HCPCS,518000,REVISION OF BLADDER/URETHRA,,,1115.0,1115.0,1
HCPCS,51820,REVISION OF URINARY TRACT,,,1165.24,1165.24,1
HCPCS,51820,Revision of urinary tract,,,2586.74,3267.46,6
HCPCS,518200,REVISION OF URINARY TRACT,,,1165.24,1165.24,1
HCPCS,51840,ANT VESICOURETHROPEXY/URETHROPEXY SMPL,4544.0,2953.6,523.14,4544.0,35
HCPCS,51840,ATTACH BLADDER/URETHRA,,,748.41,5746.35,5
HCPCS,51840,Attach bladder/urethra,,,2586.74,3267.46,6
HCPCS,518400,ATTACH BLADDER/URETHRA,,,748.41,748.41,1
HCPCS,51841,ANT VESICOURETHROPEXY/URETHROPEXY COMP,5472.0,3556.8,600.83,5472.0,35
HCPCS,51841,ATTACH BLADDER/URETHRA,,,865.26,865.26,1
HCPCS,51841,Attach bladder/urethra,,,2586.74,3267.46,6
HCPCS,518410,ATTACH BLADDER/URETHRA,,,865.26,865.26,1
HCPCS,51845,ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL,4060.0,2639.0,448.86,4060.0,35
HCPCS,51845,REPAIR BLADDER NECK,,,627.65,10703.04,15
HCPCS,51845,Repair bladder neck,,,2586.74,3267.46,6
HCPCS,518450,REPAIR BLADDER NECK,,,627.65,627.65,1
HCPCS,51860,CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE,5040.0,3276.0,521.27,5040.0,35
HCPCS,51860,REPAIR OF BLADDER WOUND,,,803.8,20049.35,15
HCPCS,51860,Repair of bladder wound,,,2586.74,3267.46,6
HCPCS,518600,REPAIR OF BLADDER WOUND,,,803.8,803.8,1
HCPCS,51865,CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED,6320.0,4108.0,679.96,6320.0,35
HCPCS,51865,REPAIR OF BLADDER WOUND,,,964.25,964.25,1
HCPCS,51865,Repair of bladder wound,,,2586.74,3267.46,6
HCPCS,518650,REPAIR OF BLADDER WOUND,,,964.25,964.25,1
HCPCS,51880,CLOSE CYSTOSTOMY,3148.0,2046.2,336.46,3148.0,35
HCPCS,51880,REPAIR OF BLADDER OPENING,,,503.04,7477.94,15
HCPCS,51880,Repair of bladder opening,,,970.74,1226.2,6
HCPCS,518800,REPAIR OF BLADDER OPENING,,,503.04,503.04,1
HCPCS,51900,CLSR VESICOVAGINAL FISTUL AABDL APPROACH,5852.0,3803.8,610.08,5852.0,35
HCPCS,51900,REPAIR BLADDER/VAGINA LESION,,,886.39,886.39,1
HCPCS,51900,Repair bladder/vagina lesion,,,3423.14,4323.96,6
HCPCS,519000,REPAIR BLADDER/VAGINA LESION,,,886.39,886.39,1
HCPCS,51920,CLOSE BLADDER-UTERUS FISTULA,,,821.35,821.35,1
HCPCS,51920,Close bladder-uterus fistula,,,1486.15,1877.24,6
HCPCS,519200,CLOSE BLADDER-UTERUS FISTULA,,,821.35,821.35,1
HCPCS,51925,HYSTERECTOMY/BLADDER REPAIR,,,1164.74,1164.74,1
HCPCS,51925,Hysterectomy/bladder repair,,,2575.55,3253.32,6
HCPCS,519250,HYSTERECTOMY/BLADDER REPAIR,,,1164.74,1164.74,1
HCPCS,51940,CORRECTION OF BLADDER DEFECT,,,1759.41,1759.41,1
HCPCS,51940,Correction of bladder defect,,,3017.62,3811.73,6
HCPCS,519400,CORRECTION OF BLADDER DEFECT,,,1759.41,1759.41,1
HCPCS,51960,ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS,11176.0,7264.4,1056.79,11176.0,35
HCPCS,51960,REVISION OF BLADDER & BOWEL,,,1485.84,1485.84,1
HCPCS,51960,Revision of bladder & bowel,,,2586.74,3267.46,6
HCPCS,519600,REVISION OF BLADDER & BOWEL,,,1485.84,1485.84,1
HCPCS,51980,CONSTRUCT BLADDER OPENING,,,768.2,768.2,1
HCPCS,51980,CUTANEOUS VESICOSTOMY,5028.0,3268.2,495.81,5028.0,35
HCPCS,51980,Construct bladder opening,,,2586.74,3267.46,6
HCPCS,519800,CONSTRUCT BLADDER OPENING,,,768.2,768.2,1
HCPCS,51990,LAPARO URETHRAL SUSPENSION,,,801.18,12649.85,15
HCPCS,51990,LAPAROSCOPY URETHRAL SUSPENSION STRESS INCONT,5344.0,3473.6,517.43,5344.0,35
HCPCS,51990,Laparo urethral suspension,,,1849.92,2336.74,6
HCPCS,519900,LAPARO URETHRAL SUSPENSION,,,801.18,801.18,1
HCPCS,51992,LAPARO SLING OPERATION,,,904.93,12649.85,15
HCPCS,51992,"LAPAROSCOPY, SURGICAL; SLING OPERAT",5948.0,3866.2,563.45,5948.0,35
HCPCS,51992,Laparo sling operation,,,1849.92,2336.74,6
HCPCS,519920,LAPARO SLING OPERATION,,,904.93,904.93,1
HCPCS,51999,"EXCISION OF URACHAL CYST OR SINUS, W/WO UMBILICAL HERNIA REPAIR",4420.0,2873.0,566.99,4420.0,15
HCPCS,51999,LAP CYSTECTOMY W/ PELVIC LYMPHADENECTOMY (COMP 51575),13672.0,8886.8,566.99,13672.0,15
HCPCS,51999,LAP REPAIR BLADDER REPAIR (COMP 51860),5040.0,3276.0,566.99,5040.0,15
HCPCS,51999,LAPAROSCOPIC ANTERIOR VAGINECTOMY (COMP CODE 57106),3225.0,2096.25,566.99,3225.0,15
HCPCS,51999,LAPAROSCOPIC BLADDER REPAIR,3427.0,2227.55,566.99,3427.0,15
HCPCS,51999,"LAPAROSCOPIC CLOSURE OF VESICOVAGINAL FISTULA, ABDOMINAL APPROAC",6290.0,4088.5,566.99,6290.0,15
HCPCS,51999,LAPAROSCOPIC DIVERTICULECTOMY (COMP 51525),6168.0,4009.2,566.99,6168.0,15
HCPCS,51999,LAPAROSCOPY PARTIAL CYSTECTOMY (COMP 51555),14126.0,9181.9,566.99,14126.0,15
HCPCS,51999,ROBOTIC CYSTECTOMY W/ CONDUIT & PELVIC LYMPHADENECTOMY (COMP 515,16528.0,10743.2,566.99,16528.0,15
HCPCS,51999,"STONE REMOVAL FROM BLADDER, LAPAROSCOPIC APPROACH WITH ROBOTIC A",3427.0,2227.55,566.99,3427.0,15
HCPCS,51999,UNLISTED LAPAROSCOPIC PROCEDURE BLADDER (COMP CODE 51590),15621.0,10153.65,566.99,15621.0,15
HCPCS,51999,UNLISTED LAPS PX BLADDER,,,5856.41,12649.85,14
HCPCS,51999,UNLISTED PROC; LAPAROSCOPIC PARTICAL CYSTECTOMY (COMP TO 51550),6892.0,4479.8,566.99,6892.0,15
HCPCS,51999,Unlisted laps px bladder,,,970.74,1226.2,6
HCPCS,52000,CYSTOURETHROSCOPY,2255.5,1466.0749999999998,49.25,14866.0,177
HCPCS,520000,CYSTOURETHROSCOPY,,,86.18,86.18,1
HCPCS,52001,CYSTO W/IRRG&EVAC MLT CLOTS,,,306.68,306.68,1
HCPCS,52001,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,11003.5,7152.275,136.76,17847.9,130
HCPCS,520010,CYSTO W/IRRG&EVAC MLT CLOTS,,,306.68,306.68,1
HCPCS,52005,CYSTO BLADDER W/URETERAL CATHETERIZATION,6411.0,4167.150000000001,63.29,14866.0,116
HCPCS,52005,CYSTO W/URTRL CATHJ,,,142.37,142.37,1
HCPCS,52005,"JELMYTO INSTILLATION, RETROGRADE VIA CYSTOURETHROSCOPY",1043.0,677.95,63.29,782.25,35
HCPCS,520050,CYSTO W/URTRL CATHJ,,,142.37,142.37,1
HCPCS,52007,CYSTO URTRL CATHJ BRUSH BX,,,177.68,7477.94,15
HCPCS,52007,CYSTO W/URTRL CATHJ BRUSH BX URTR&/RENAL PELVIS,1208.0,785.2,114.79,906.0,35
HCPCS,52007,Cysto urtrl cathj brush bx,,,918.04,1159.63,6
HCPCS,520070,CYSTO URTRL CATHJ BRUSH BX,,,177.68,177.68,1
HCPCS,5200F,EVAL APPROS SURG THXPY EPI,,,0.01,0.01,1
HCPCS,5200F0,EVAL APPROS SURG THXPY EPI,,,0.01,0.01,1
HCPCS,52010,CYSTOSCOPY & DUCT CATHETER,,,176.58,1447.18,15
HCPCS,52010,Cystoscopy & duct catheter,,,1849.92,2336.74,6
HCPCS,520100,CYSTOSCOPY & DUCT CATHETER,,,176.58,176.58,1
HCPCS,52204,CYSTOSCOPY W/BIOPSY(S),,,151.33,151.33,1
HCPCS,52204,CYSTOURETHROSCOPY WITH BIOPSY,11779.0,7656.35,171.08,10601.1,39
HCPCS,52204,"CYSTOURETHROSCOPY,BIOPSY",1036.0,673.4,102.25,777.0,35
HCPCS,522040,CYSTOSCOPY W/BIOPSY(S),,,151.33,151.33,1
HCPCS,52214,CYSTO W/DESTRUCTION OF LESIONS,1400.0,910.0,130.57,1056.53,35
HCPCS,52214,CYSTOSCOPY AND TREATMENT,,,187.16,7477.94,15
HCPCS,52214,Cystoscopy and treatment,,,970.74,1226.2,6
HCPCS,522140,CYSTOSCOPY AND TREATMENT,,,187.16,187.16,1
HCPCS,52224,CYSTO W/REMOVAL OF LESIONS MINOR <0.5CM,10725.5,6971.575,127.33,17847.9,74
HCPCS,52224,CYSTOSCOPY AND TREATMENT,,,216.62,216.62,1
HCPCS,522240,CYSTOSCOPY AND TREATMENT,,,216.62,216.62,1
HCPCS,52234,CYSTO W/REMOVAL OF TUMORS SMALL,10839.5,7045.675,186.39,17847.9,74
HCPCS,52234,CYSTOSCOPY AND TREATMENT,,,262.32,262.32,1
HCPCS,522340,CYSTOSCOPY AND TREATMENT,,,262.32,262.32,1
HCPCS,52235,CYSTOSCOPY AND TREATMENT,,,308.03,7477.94,18
HCPCS,52235,CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM,2176.0,1414.4,218.3,2176.0,35
HCPCS,52235,Cystoscopy and treatment,,,970.74,1226.2,6
HCPCS,522350,CYSTOSCOPY AND TREATMENT,,,308.03,308.03,1
HCPCS,52240,CYSTOSCOPY AND TREATMENT,,,418.49,11022.13,15
HCPCS,52240,CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE,3300.0,2145.0,296.18,3300.0,35
HCPCS,52240,Cystoscopy and treatment,,,970.74,1226.2,6
HCPCS,522400,CYSTOSCOPY AND TREATMENT,,,418.49,418.49,1
HCPCS,52250,CYSTOSCOPY AND RADIOTRACER,,,255.05,7477.94,15
HCPCS,52250,Cystoscopy and radiotracer,,,970.74,1226.2,6
HCPCS,522500,CYSTOSCOPY AND RADIOTRACER,,,255.05,255.05,1
HCPCS,52260,CYSTOSCOPY AND TREATMENT,,,224.96,4441.51,17
HCPCS,52260,CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH,1564.0,1016.6,157.48,1564.0,35
HCPCS,52260,Cystoscopy and treatment,,,970.74,1226.2,6
HCPCS,522600,CYSTOSCOPY AND TREATMENT,,,224.96,224.96,1
HCPCS,52265,CYSTOSCOPY AND TREATMENT,,,173.75,4441.51,15
HCPCS,52265,"CYSTOSCOPY,DIL BLADDER,LOCAL ANESTH",1176.0,764.4,100.06,882.0,35
HCPCS,52265,Cystoscopy and treatment,,,970.74,1226.2,6
HCPCS,522650,CYSTOSCOPY AND TREATMENT,,,173.75,173.75,1
HCPCS,52270,CYSTOSCOPY & REVISE URETHRA,,,193.69,4441.51,15
HCPCS,52270,"CYSTOSCOPY,INTERN URETHROTOMY,FEMALE",1344.0,873.6,86.47,1008.0,35
HCPCS,52270,Cystoscopy & revise urethra,,,1849.92,2336.74,6
HCPCS,522700,CYSTOSCOPY & REVISE URETHRA,,,193.69,193.69,1
HCPCS,52275,CYSTOSCOPY & REVISE URETHRA,,,264.91,4441.51,15
HCPCS,52275,"CYSTOSCOPY,INTERN URETHROTOMY,MALE",1876.0,1219.4,118.35,1407.0,35
HCPCS,52275,Cystoscopy & revise urethra,,,1849.92,2336.74,6
HCPCS,522750,CYSTOSCOPY & REVISE URETHRA,,,264.91,264.91,1
HCPCS,52276,CYSTOSCOPY AND TREATMENT,,,281.93,4441.51,15
HCPCS,52276,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE,1996.0,1297.4,200.43,1996.0,35
HCPCS,52276,Cystoscopy and treatment,,,1849.92,2336.74,6
HCPCS,522760,CYSTOSCOPY AND TREATMENT,,,281.93,281.93,1
HCPCS,52277,CYSTOSCOPY AND TREATMENT,,,344.83,7477.94,15
HCPCS,52277,"CYSTOSCOPY,RESEC EXTERN SPHINCTER",2464.0,1601.6,244.6,2464.0,35
HCPCS,52277,Cystoscopy and treatment,,,1849.92,2336.74,6
HCPCS,522770,CYSTOSCOPY AND TREATMENT,,,344.83,344.83,1
HCPCS,52281,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,6494.5,4221.425,72.49,10601.1,130
HCPCS,52281,CYSTOSCOPY AND TREATMENT,,,162.4,162.4,1
HCPCS,522810,CYSTOSCOPY AND TREATMENT,,,162.4,162.4,1
HCPCS,52282,CYSTOSCOPY IMPLANT STENT,,,360.03,7477.94,15
HCPCS,52282,CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT,2556.0,1661.4,255.32,2556.0,35
HCPCS,52282,Cystoscopy implant stent,,,1849.92,2336.74,6
HCPCS,522820,CYSTOSCOPY IMPLANT STENT,,,360.03,360.03,1
HCPCS,52283,CYSTOSCOPY AND TREATMENT,,,215.08,4441.51,15
HCPCS,52283,"CYSTOSCOPY,STEROID INJ,STRICTURE",1492.0,969.8,98.3,1119.0,35
HCPCS,52283,Cystoscopy and treatment,,,1849.92,2336.74,6
HCPCS,522830,CYSTOSCOPY AND TREATMENT,,,215.08,215.08,1
HCPCS,52284,CYSTO RX BALO CATH URTL STRX,,,175.88,11022.13,15
HCPCS,52284,CYSTO W/DILAT RX BALO CATH URTL STRIX/STEN MALE,1364.0,886.6,118.2,4532.03,28
HCPCS,52284,Cysto rx balo cath urtl strx,,,1849.92,2336.74,6
HCPCS,522840,CYSTO RX BALO CATH URTL STRX,,,175.88,175.88,1
HCPCS,52285,CYSTOSCOPY AND TREATMENT,,,209.64,1447.18,15
HCPCS,52285,"CYSTOSCOPY,RX FEMALE URETHRAL SYND",1440.0,936.0,109.35,1080.0,35
HCPCS,52285,Cystoscopy and treatment,,,1849.92,2336.74,6
HCPCS,522850,CYSTOSCOPY AND TREATMENT,,,209.64,209.64,1
HCPCS,52287,CYSTOSCOPY CHEMODENERVATION,,,180.73,180.73,1
HCPCS,52287,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,6529.5,4244.175,98.97,10601.1,77
HCPCS,522870,CYSTOSCOPY CHEMODENERVATION,,,180.73,180.73,1
HCPCS,52290,CYSTOSCOPY AND TREATMENT,,,259.78,4441.51,15
HCPCS,52290,CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI,1832.0,1190.8,180.77,1832.0,35
HCPCS,52290,Cystoscopy and treatment,,,970.74,1226.2,6
HCPCS,522900,CYSTOSCOPY AND TREATMENT,,,259.78,259.78,1
HCPCS,52300,CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI,2120.0,1378.0,211.92,2120.0,35
HCPCS,52300,CYSTOSCOPY AND TREATMENT,,,298.66,7477.94,15
HCPCS,52300,Cystoscopy and treatment,,,2586.74,3267.46,6
HCPCS,523000,CYSTOSCOPY AND TREATMENT,,,298.66,298.66,1
HCPCS,52301,CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI,2200.0,1430.0,219.58,2200.0,35
HCPCS,52301,CYSTOSCOPY AND TREATMENT,,,309.57,7477.94,15
HCPCS,52301,Cystoscopy and treatment,,,970.74,1226.2,6
HCPCS,523010,CYSTOSCOPY AND TREATMENT,,,309.57,309.57,1
HCPCS,52305,CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT,2120.0,1378.0,210.39,2120.0,35
HCPCS,52305,CYSTOSCOPY AND TREATMENT,,,296.63,11022.13,15
HCPCS,52305,Cystoscopy and treatment,,,2586.74,3267.46,6
HCPCS,523050,CYSTOSCOPY AND TREATMENT,,,296.63,296.63,1
HCPCS,52310,CYSTO W/SIMPLE REMOVAL STONE & STENT,6451.5,4193.475,99.28,10601.1,130
HCPCS,52310,CYSTOSCOPY AND TREATMENT,,,161.97,161.97,1
HCPCS,523100,CYSTOSCOPY AND TREATMENT,,,161.97,161.97,1
HCPCS,52315,CYSTO W/COMPLEX REMOVAL STONE & STENT,6929.5,4504.175,149.55,10601.1,74
HCPCS,52315,CYSTOSCOPY AND TREATMENT,,,292.93,292.93,1
HCPCS,523150,CYSTOSCOPY AND TREATMENT,,,292.93,292.93,1
HCPCS,52317,LITHOLAPAXY SMPL/SM <2.5 CM,2684.0,1744.6,165.21,2013.0,35
HCPCS,52317,REMOVE BLADDER STONE,,,369.86,7477.94,16
HCPCS,52317,Remove bladder stone,,,970.74,1226.2,6
HCPCS,523170,REMOVE BLADDER STONE,,,369.86,369.86,1
HCPCS,52318,LITHOLAPAXY COMP/LG > 2.5 CM,3672.0,2386.8,357.96,3672.0,35
HCPCS,52318,REMOVE BLADDER STONE,,,505.65,7477.94,15
HCPCS,52318,Remove bladder stone,,,970.74,1226.2,6
HCPCS,523180,REMOVE BLADDER STONE,,,505.65,505.65,1
HCPCS,52320,CYSTOSCOPY AND TREATMENT,,,262.56,7477.94,15
HCPCS,52320,CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS,1876.0,1219.4,186.9,1876.0,35
HCPCS,52320,Cystoscopy and treatment,,,970.74,1226.2,6
HCPCS,523200,CYSTOSCOPY AND TREATMENT,,,262.56,262.56,1
HCPCS,52325,CYSTO FRAGMENTATION URETERAL STONE,2460.0,1599.0,242.05,2460.0,35
HCPCS,52325,CYSTOSCOPY STONE REMOVAL,,,341.38,11022.13,15
HCPCS,52325,Cystoscopy stone removal,,,2586.74,3267.46,6
HCPCS,523250,CYSTOSCOPY STONE REMOVAL,,,341.38,341.38,1
HCPCS,52327,CYSTO W/SUBURTRIC NJX IMPLT MATRL,2072.0,1346.8,195.83,2072.0,35
HCPCS,52327,CYSTOSCOPY INJECT MATERIAL,,,276.92,11022.13,15
HCPCS,52327,Cystoscopy inject material,,,2586.74,3267.46,6
HCPCS,523270,CYSTOSCOPY INJECT MATERIAL,,,276.92,276.92,1
HCPCS,52330,CYSTO MANJ W/O RMVL URETERAL STONE,2012.0,1307.8,125.43,1509.0,35
HCPCS,52330,CYSTOSCOPY AND TREATMENT,,,281.1,7477.94,15
HCPCS,52330,Cystoscopy and treatment,,,970.74,1226.2,6
HCPCS,523300,CYSTOSCOPY AND TREATMENT,,,281.1,281.1,1
HCPCS,52332,CYSTO W/INSERT URETERAL STENT,10479.5,6811.675,115.16,17847.9,116
HCPCS,52332,CYSTOSCOPY AND TREATMENT,,,166.05,166.05,1
HCPCS,523320,CYSTOSCOPY AND TREATMENT,,,166.05,166.05,1
HCPCS,52334,CREATE PASSAGE TO KIDNEY,,,194.73,7477.94,15
HCPCS,52334,CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR,1483.0,963.95,139.41,1483.0,35
HCPCS,52334,Create passage to kidney,,,918.04,1159.63,6
HCPCS,523340,CREATE PASSAGE TO KIDNEY,,,194.73,194.73,1
HCPCS,52341,CYSTO W/TX URETERAL STRICTURE,19831.0,12890.15,341.24,17847.9,39
HCPCS,52341,CYSTO W/URETER STRICTURE TX,2140.0,1391.0,214.98,2140.0,36
HCPCS,523410,CYSTO W/URETER STRICTURE TX,,,303.3,303.3,1
HCPCS,52342,CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE,2340.0,1521.0,234.13,2340.0,35
HCPCS,52342,CYSTO W/UP STRICTURE TX,,,330.18,7477.94,15
HCPCS,52342,Cysto w/up stricture tx,,,918.04,1159.63,6
HCPCS,523420,CYSTO W/UP STRICTURE TX,,,330.18,330.18,1
HCPCS,52343,CYSTO W/RENAL STRICTURE TX,,,366.88,7477.94,15
HCPCS,52343,CYSTO W/TX INTRA-RENAL STRICTURE,2620.0,1703.0,260.69,2620.0,35
HCPCS,52343,Cysto w/renal stricture tx,,,918.04,1159.63,6
HCPCS,523430,CYSTO W/RENAL STRICTURE TX,,,366.88,366.88,1
HCPCS,52344,CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE,2820.0,1833.0,279.58,2820.0,35
HCPCS,52344,CYSTO/URETERO STRICTURE TX,,,394.52,7477.94,16
HCPCS,52344,Cysto/uretero stricture tx,,,970.74,1226.2,6
HCPCS,523440,CYSTO/URETERO STRICTURE TX,,,394.52,394.52,1
HCPCS,52345,CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX,3020.0,1963.0,298.22,3020.0,35
HCPCS,52345,CYSTO/URETERO W/UP STRICTURE,,,421.07,7477.94,15
HCPCS,52345,Cysto/uretero w/up stricture,,,2586.74,3267.46,6
HCPCS,523450,CYSTO/URETERO W/UP STRICTURE,,,421.07,421.07,1
HCPCS,52346,CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE,3432.0,2230.8,337.28,3432.0,35
HCPCS,52346,CYSTOURETERO W/RENAL STRICT,,,476.32,11022.13,15
HCPCS,52346,Cystouretero w/renal strict,,,1770.94,2236.98,6
HCPCS,523460,CYSTOURETERO W/RENAL STRICT,,,476.32,476.32,1
HCPCS,52351,CYSTO W/URTROSCOPY&/PYELOSCOPY DX,2530.0,1644.5,229.54,2530.0,35
HCPCS,52351,CYSTOURETERO & OR PYELOSCOPE,,,323.4,7477.94,17
HCPCS,52351,Cystouretero & or pyeloscope,,,970.74,1226.2,6
HCPCS,523510,CYSTOURETERO & OR PYELOSCOPE,,,323.4,323.4,1
HCPCS,52352,CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES,2700.0,1755.0,268.35,2700.0,35
HCPCS,52352,CYSTOURETERO W/STONE REMOVE,,,377.78,7477.94,18
HCPCS,52352,Cystouretero w/stone remove,,,970.74,1226.2,6
HCPCS,523520,CYSTOURETERO W/STONE REMOVE,,,377.78,377.78,1
HCPCS,52353,CYSTO W/URETEROSCOPY W/LITHOTRIPSY,3000.0,1950.0,296.18,3000.0,35
HCPCS,52353,CYSTOURETERO W/LITHOTRIPSY,,,418.15,11022.13,18
HCPCS,52353,Cystouretero w/lithotripsy,,,1770.94,2236.98,6
HCPCS,523530,CYSTOURETERO W/LITHOTRIPSY,,,418.15,418.15,1
HCPCS,52354,CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION,3200.0,2080.0,312.27,3200.0,35
HCPCS,52354,CYSTOURETERO W/BIOPSY,,,445.04,11022.13,18
HCPCS,52354,Cystouretero w/biopsy,,,1770.94,2236.98,6
HCPCS,523540,CYSTOURETERO W/BIOPSY,,,445.04,445.04,1
HCPCS,52355,CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR,3600.0,2340.0,349.73,3600.0,35
HCPCS,52355,CYSTOURETERO W/EXCISE TUMOR,,,498.85,11022.13,15
HCPCS,52355,Cystouretero w/excise tumor,,,1770.94,2236.98,6
HCPCS,523550,CYSTOURETERO W/EXCISE TUMOR,,,498.85,498.85,1
HCPCS,52356,CYSTO/URETERO W/LITHOTRIPSY,,,443.69,443.69,1
HCPCS,52356,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT,16215.5,10540.075,301.79,26307.9,73
HCPCS,523560,CYSTO/URETERO W/LITHOTRIPSY,,,443.69,443.69,1
HCPCS,52400,CYSTO CGEN POST URTL VALVES,,,513.54,7477.94,15
HCPCS,52400,CYSTO INC FULG/RESCJ URTL VALVES/FOLDS,3476.0,2259.4,365.11,3476.0,35
HCPCS,52400,Cysto cgen post urtl valves,,,1849.92,2336.74,6
HCPCS,524000,CYSTO CGEN POST URTL VALVES,,,513.54,513.54,1
HCPCS,52402,CYSTO TRURL RESCJ EJACUL DUX,,,283.72,7477.94,15
HCPCS,52402,Cysto trurl rescj ejacul dux,,,1849.92,2336.74,6
HCPCS,524020,CYSTO TRURL RESCJ EJACUL DUX,,,283.72,283.72,1
HCPCS,52441,CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE,1760.0,1144.0,179.86,1978.57,31
HCPCS,52441,CYSTO INSJ TRNSPRSTC 1 IMPLT,,,223.82,223.82,1
HCPCS,52441,Cysto insj trnsprstc 1 implt,,,1043.57,1318.19,6
HCPCS,524410,CYSTO INSJ TRNSPRSTC 1 IMPLT,,,223.82,223.82,1
HCPCS,52442,CYSTO INS TRNSPRSTC IMPLT EA,,,54.13,54.13,1
HCPCS,52442,CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL,444.0,288.6,47.93,1507.15,31
HCPCS,52442,Cysto ins trnsprstc implt ea,,,2889.05,3649.33,6
HCPCS,524420,CYSTO INS TRNSPRSTC IMPLT EA,,,54.13,54.13,1
HCPCS,52443,CYSTO 1ST TRURL ANT PRST8 COMIS NONRX BALO CATH,1593.0,1035.45,186.16,1593.0,21
HCPCS,52443,CYSTO 1ST TRURL PRST8 COMIS,,,188.36,10874.19,5
HCPCS,52443,Cysto 1st trurl prst8 comis,,,2889.05,3649.33,6
HCPCS,524430,CYSTO 1ST TRURL PRST8 COMIS,,,188.36,188.36,1
HCPCS,52450,TRANSURETHRAL INC PROSTATE,,,511.65,7477.94,15
HCPCS,52450,TRANSURETHRAL INCISION OF PROSTATE,3112.0,2022.8,340.72,3112.0,35
HCPCS,52450,Transurethral inc prostate,,,1043.57,1318.19,6
HCPCS,524500,TRANSURETHRAL INC PROSTATE,,,511.65,511.65,1
HCPCS,52500,TRANSURETHRAL RESEC BLADDER NECK,3256.0,2116.4,376.47,3256.0,35
HCPCS,52500,TRURL RESECTION BLADDER NECK,,,531.32,7477.94,15
HCPCS,52500,Trurl resection bladder neck,,,970.74,1226.2,6
HCPCS,525000,TRURL RESECTION BLADDER NECK,,,531.32,531.32,1
HCPCS,5250F,ASTHMA DISCHARGE PLAN PRESNT,,,0.01,0.01,1
HCPCS,5250F0,ASTHMA DISCHARGE PLAN PRESNT,,,0.01,0.01,1
HCPCS,52597,TRURL RBTC WTRJT RESCJ PRST8,,,594.8,10874.19,5
HCPCS,52597,TRURL ROBOTIC-ASSISTED WATERJET RESECTION PRST8,4510.0,2931.5,589.1,4510.0,21
HCPCS,52597,Trurl rbtc wtrjt rescj prst8,,,2889.05,3649.33,6
HCPCS,525970,TRURL RBTC WTRJT RESCJ PRST8,,,594.8,594.8,1
HCPCS,52601,PROSTATECTOMY (TURP),,,783.67,11022.13,18
HCPCS,52601,Prostatectomy (turp),,,2889.05,3649.33,6
HCPCS,52601,TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE,5790.0,3763.5,558.14,5790.0,35
HCPCS,526010,PROSTATECTOMY (TURP),,,783.67,783.67,1
HCPCS,52630,REMOVE PROSTATE REGROWTH,,,436.7,11022.13,15
HCPCS,52630,Remove prostate regrowth,,,2889.05,3649.33,6
HCPCS,52630,TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS,2620.0,1703.0,314.3,2620.0,35
HCPCS,526300,REMOVE PROSTATE REGROWTH,,,436.7,436.7,1
HCPCS,52640,RELIEVE BLADDER CONTRACTURE,,,346.97,7477.94,15
HCPCS,52640,Relieve bladder contracture,,,970.74,1226.2,6
HCPCS,52640,TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE,1916.0,1245.4,251.24,1916.0,35
HCPCS,526400,RELIEVE BLADDER CONTRACTURE,,,346.97,346.97,1
HCPCS,52647,LASER SURGERY OF PROSTATE,,,5102.84,11022.13,10
HCPCS,52647,Laser surgery of prostate,,,2889.05,3649.33,6
HCPCS,52648,LASER SURGERY OF PROSTATE,,,745.73,11022.13,15
HCPCS,52648,LASER VAPORIZATION OF PROSTATE FOR URINE FLOW,4860.0,3159.0,456.57,3645.0,35
HCPCS,52648,Laser surgery of prostate,,,2889.05,3649.33,6
HCPCS,526480,LASER SURGERY OF PROSTATE,,,745.73,745.73,1
HCPCS,52649,LASER ENUCLEATION PROSTATE W/MORCELLATION,5824.0,3785.6,603.59,5824.0,35
HCPCS,52649,PROSTATE LASER ENUCLEATION,,,887.18,11022.13,18
HCPCS,52649,Prostate laser enucleation,,,2889.05,3649.33,6
HCPCS,526490,PROSTATE LASER ENUCLEATION,,,887.18,887.18,1
HCPCS,52700,DRAINAGE OF PROSTATE ABSCESS,,,477.15,7477.94,15
HCPCS,52700,Drainage of prostate abscess,,,1043.57,1318.19,6
HCPCS,52700,TRURL DRAINAGE PROSTATIC ABSCESS,2996.0,1947.4,280.66,2996.0,35
HCPCS,527000,DRAINAGE OF PROSTATE ABSCESS,,,477.15,477.15,1
HCPCS,53000,INCISION OF URETHRA,,,159.78,4441.51,15
HCPCS,53000,Incision of urethra,,,1849.92,2336.74,6
HCPCS,530000,INCISION OF URETHRA,,,159.78,159.78,1
HCPCS,53010,INCISION OF URETHRA,,,320.04,11022.13,15
HCPCS,53010,Incision of urethra,,,3664.3,4628.59,6
HCPCS,53010,URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA,1780.0,1157.0,193.15,1780.0,35
HCPCS,530100,INCISION OF URETHRA,,,320.04,320.04,1
HCPCS,53020,INCISION OF URETHRA,,,103.64,4441.51,15
HCPCS,53020,Incision of urethra,,,1849.92,2336.74,6
HCPCS,53020,MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT,708.0,460.2,73.79,708.0,35
HCPCS,530200,INCISION OF URETHRA,,,103.64,103.64,1
HCPCS,53025,INCISION OF URETHRA,,,73.5,4441.51,15
HCPCS,53025,Incision of urethra,,,1849.92,2336.74,6
HCPCS,530250,INCISION OF URETHRA,,,73.5,73.5,1
HCPCS,53040,DRAINAGE DEEP PERIURETHRAL ABSCESS,2620.0,1703.0,238.52,2620.0,35
HCPCS,53040,DRAINAGE OF URETHRA ABSCESS,,,422.87,7477.94,15
HCPCS,53040,Drainage of urethra abscess,,,1849.92,2336.74,6
HCPCS,530400,DRAINAGE OF URETHRA ABSCESS,,,422.87,422.87,1
HCPCS,53060,DRAINAGE OF URETHRA ABSCESS,,,179.53,179.53,1
HCPCS,53060,DRG OF SKENE'S GLAND ABSCESS OR CYST,1072.0,696.8,81.63,10601.1,130
HCPCS,530600,DRAINAGE OF URETHRA ABSCESS,,,179.53,179.53,1
HCPCS,53080,DRAINAGE OF URINARY LEAKAGE,,,453.71,1447.18,15
HCPCS,53080,Drainage of urinary leakage,,,248.59,314.0,6
HCPCS,530800,DRAINAGE OF URINARY LEAKAGE,,,453.71,453.71,1
HCPCS,53085,DRAINAGE OF URINARY LEAKAGE,,,697.76,4441.51,15
HCPCS,53085,Drainage of urinary leakage,,,1849.92,2336.74,6
HCPCS,530850,DRAINAGE OF URINARY LEAKAGE,,,697.76,697.76,1
HCPCS,53200,BIOPSY OF URETHRA,1036.0,673.4,92.84,4441.51,50
HCPCS,53200,Biopsy of urethra,,,1849.92,2336.74,6
HCPCS,532000,BIOPSY OF URETHRA,,,152.81,152.81,1
HCPCS,53210,REMOVAL OF URETHRA,,,835.65,7477.94,15
HCPCS,53210,Removal of urethra,,,1849.92,2336.74,6
HCPCS,53210,URETHRECTOMY TOT W/CYSTOST FEMALE,5488.0,3567.2,513.04,5488.0,35
HCPCS,532100,REMOVAL OF URETHRA,,,835.65,835.65,1
HCPCS,53215,REMOVAL OF URETHRA,,,995.84,11022.13,15
HCPCS,53215,Removal of urethra,,,3664.3,4628.59,6
HCPCS,53215,URETHRECTOMY TOT W/CYSTOST MALE,6740.0,4381.0,667.89,6740.0,35
HCPCS,532150,REMOVAL OF URETHRA,,,995.84,995.84,1
HCPCS,53220,EXC/FULGURATION CARCINOMA URETHRA,3052.0,1983.8,314.13,3052.0,35
HCPCS,53220,TREATMENT OF URETHRA LESION,,,487.49,7477.94,15
HCPCS,53220,Treatment of urethra lesion,,,1849.92,2336.74,6
HCPCS,532200,TREATMENT OF URETHRA LESION,,,487.49,487.49,1
HCPCS,53230,EXC URETHRAL DIVERTICULUM SPX FEMALE,4176.0,2714.4,455.26,4176.0,35
HCPCS,53230,REMOVAL OF URETHRA LESION,,,658.18,11022.13,16
HCPCS,53230,Removal of urethra lesion,,,3664.3,4628.59,6
HCPCS,532300,REMOVAL OF URETHRA LESION,,,658.18,658.18,1
HCPCS,53235,EXC URETHRAL DIVERTICULUM SPX MALE,4396.0,2857.4,406.36,4396.0,35
HCPCS,53235,REMOVAL OF URETHRA LESION,,,683.21,11022.13,15
HCPCS,53235,Removal of urethra lesion,,,3664.3,4628.59,6
HCPCS,532350,REMOVAL OF URETHRA LESION,,,683.21,683.21,1
HCPCS,53240,MARSUPIALIZATION URTL DIVERTICULUM MALE/FEMALE,2832.0,1840.8,289.26,2832.0,35
HCPCS,53240,SURGERY FOR URETHRA POUCH,,,458.37,7477.94,15
HCPCS,53240,Surgery for urethra pouch,,,1849.92,2336.74,6
HCPCS,532400,SURGERY FOR URETHRA POUCH,,,458.37,458.37,1
HCPCS,53250,EXCISION OF BULBOURETHRAL GLAND,2608.0,1695.2,264.29,2608.0,35
HCPCS,53250,REMOVAL OF URETHRA GLAND,,,427.16,7477.94,15
HCPCS,53250,Removal of urethra gland,,,1849.92,2336.74,6
HCPCS,532500,REMOVAL OF URETHRA GLAND,,,427.16,427.16,1
HCPCS,53260,EXC/FULGURATION URETHRAL POLYP DSTL URETHRA,1212.0,787.8,93.98,909.0,35
HCPCS,53260,TREATMENT OF URETHRA LESION,,,195.69,7477.94,15
HCPCS,53260,Treatment of urethra lesion,,,1849.92,2336.74,6
HCPCS,532600,TREATMENT OF URETHRA LESION,,,195.69,195.69,1
HCPCS,53265,EXC/FULGURATION URETHRAL CARUNCLE,1268.0,824.2,121.92,951.0,35
HCPCS,53265,TREATMENT OF URETHRA LESION,,,203.75,4441.51,15
HCPCS,53265,Treatment of urethra lesion,,,1849.92,2336.74,6
HCPCS,532650,TREATMENT OF URETHRA LESION,,,203.75,203.75,1
HCPCS,53270,EXCISION OR FULGURATION SKENES GLANDS,1256.0,816.4,95.73,942.0,35
HCPCS,53270,REMOVAL OF URETHRA GLAND,,,199.28,7477.94,15
HCPCS,53270,Removal of urethra gland,,,1849.92,2336.74,6
HCPCS,532700,REMOVAL OF URETHRA GLAND,,,199.28,199.28,1
HCPCS,53275,EXCISION/FULGURATION URETHRAL PROLAPSE,1828.0,1188.2,188.17,1828.0,35
HCPCS,53275,REPAIR OF URETHRA DEFECT,,,283.29,7477.94,15
HCPCS,53275,Repair of urethra defect,,,1849.92,2336.74,6
HCPCS,532750,REPAIR OF URETHRA DEFECT,,,283.29,283.29,1
HCPCS,53400,REVISE URETHRA STAGE 1,,,860.65,11022.13,15
HCPCS,53400,Revise urethra stage 1,,,3664.3,4628.59,6
HCPCS,53400,URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX,5652.0,3673.8,535.2,5652.0,35
HCPCS,534000,REVISE URETHRA STAGE 1,,,860.65,860.65,1
HCPCS,53405,REVISE URETHRA STAGE 2,,,938.95,11022.13,15
HCPCS,53405,Revise urethra stage 2,,,3664.3,4628.59,6
HCPCS,534050,REVISE URETHRA STAGE 2,,,938.95,938.95,1
HCPCS,53410,RECONSTRUCTION OF URETHRA,,,1053.13,11022.13,15
HCPCS,53410,Reconstruction of urethra,,,3664.3,4628.59,6
HCPCS,53410,URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA,7072.0,4596.8,660.91,7072.0,35
HCPCS,534100,RECONSTRUCTION OF URETHRA,,,1053.13,1053.13,1
HCPCS,53415,RECONSTRUCTION OF URETHRA,,,1213.09,1213.09,1
HCPCS,53415,Reconstruction of urethra,,,3664.3,4628.59,6
HCPCS,53415,URTP TRANSPUBIC/PRNL 1 STG RCNSTJ/RPR URT,8280.0,5382.0,802.13,8280.0,35
HCPCS,534150,RECONSTRUCTION OF URETHRA,,,1213.09,1213.09,1
HCPCS,53420,RECONSTRUCT URETHRA STAGE 1,,,904.0,11022.13,15
HCPCS,53420,Reconstruct urethra stage 1,,,3664.3,4628.59,6
HCPCS,53420,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 1ST STAGE,6068.0,3944.2,615.95,6068.0,35
HCPCS,534200,RECONSTRUCT URETHRA STAGE 1,,,904.0,904.0,1
HCPCS,53425,RECONSTRUCT URETHRA STAGE 2,,,1006.14,11022.13,15
HCPCS,53425,Reconstruct urethra stage 2,,,3664.3,4628.59,6
HCPCS,53425,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 2ND STAGE,6828.0,4438.2,631.63,6828.0,35
HCPCS,534250,RECONSTRUCT URETHRA STAGE 2,,,1006.14,1006.14,1
HCPCS,53430,RECONSTRUCTION OF URETHRA,,,1049.34,11022.13,15
HCPCS,53430,Reconstruction of urethra,,,3664.3,4628.59,6
HCPCS,53430,URETHROPLASTY RCNSTJ FEMALE URETHRA,6972.0,4531.8,629.05,6972.0,35
HCPCS,534300,RECONSTRUCTION OF URETHRA,,,1049.34,1049.34,1
HCPCS,53431,RECONSTRUCT URETHRA/BLADDER,,,1237.89,11022.13,15
HCPCS,53431,Reconstruct urethra/bladder,,,3664.3,4628.59,6
HCPCS,53431,URTP W/TUBULARIZATION POST URT&/LWR BLDR,8472.0,5506.8,767.49,8472.0,35
HCPCS,534310,RECONSTRUCT URETHRA/BLADDER,,,1237.89,1237.89,1
HCPCS,53440,MALE SLING PROCEDURE,,,810.4,28169.71,15
HCPCS,53440,Male sling procedure,,,3664.3,4628.59,6
HCPCS,53440,SLING OPRATION CORRJ MALE URINARY INCONTINENCE,5344.0,3473.6,578.05,5344.0,35
HCPCS,534400,MALE SLING PROCEDURE,,,810.4,810.4,1
HCPCS,53442,REMOVE/REVISE MALE SLING,,,845.62,11022.13,15
HCPCS,53442,RMVL/REVJ SLING MALE URINARY INCONTINENCE,5396.0,3507.4,420.46,5396.0,35
HCPCS,53442,Remove/revise male sling,,,3664.3,4628.59,6
HCPCS,534420,REMOVE/REVISE MALE SLING,,,845.62,845.62,1
HCPCS,53444,INSERT TANDEM CUFF,,,853.68,43642.04,15
HCPCS,53444,INSERTION TANDEM CUFF,5676.0,3689.4,549.21,5676.0,35
HCPCS,53444,Insert tandem cuff,,,3664.3,4628.59,6
HCPCS,534440,INSERT TANDEM CUFF,,,853.68,853.68,1
HCPCS,53445,INSERT URO/VES NCK SPHINCTER,,,814.43,43642.04,16
HCPCS,53445,INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,5200.0,3380.0,582.39,5200.0,35
HCPCS,53445,Insert uro/ves nck sphincter,,,2586.74,3267.46,6
HCPCS,534450,INSERT URO/VES NCK SPHINCTER,,,814.43,814.43,1
HCPCS,53446,REMOVE URO SPHINCTER,,,692.12,11022.13,15
HCPCS,53446,REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,4408.0,2865.2,481.79,4408.0,35
HCPCS,53446,Remove uro sphincter,,,3664.3,4628.59,6
HCPCS,534460,REMOVE URO SPHINCTER,,,692.12,692.12,1
HCPCS,53447,REMOVE/REPLACE UR SPHINCTER,,,867.18,43642.04,15
HCPCS,53447,RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC,5712.0,3712.8,582.84,5712.0,35
HCPCS,53447,Remove/replace ur sphincter,,,2586.74,3267.46,6
HCPCS,534470,REMOVE/REPLACE UR SPHINCTER,,,867.18,867.18,1
HCPCS,53448,REMOV/REPLC UR SPHINCTR COMP,,,1369.59,1369.59,1
HCPCS,53448,RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD,9376.0,6094.4,871.0,9376.0,35
HCPCS,53448,Remov/replc ur sphinctr comp,,,3664.3,4628.59,6
HCPCS,534480,REMOV/REPLC UR SPHINCTR COMP,,,1369.59,1369.59,1
HCPCS,53449,REPAIR URO SPHINCTER,,,659.93,20049.35,15
HCPCS,53449,RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER,4224.0,2745.6,446.98,4224.0,32
HCPCS,53449,Repair uro sphincter,,,3664.3,4628.59,6
HCPCS,534490,REPAIR URO SPHINCTER,,,659.93,659.93,1
HCPCS,53450,REVISION OF URETHRA,,,440.93,7477.94,15
HCPCS,53450,Revision of urethra,,,1849.92,2336.74,6
HCPCS,53450,URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT,2708.0,1760.2,244.2,2708.0,35
HCPCS,534500,REVISION OF URETHRA,,,440.93,440.93,1
HCPCS,53451,PERIURETHRAL TPRNL ADJTBL BALO CNTNC DEV BI INSJ (COMP CODE 5344,23698.0,15403.7,2345.0,28169.71,38
HCPCS,53451,TPRNL BALO CNTNC DEV BI,,,790.52,790.52,1
HCPCS,534510,TPRNL BALO CNTNC DEV BI,,,790.52,790.52,1
HCPCS,53452,PERIURETHRL TPRNL ADJTBL BALO CNTNC DEV UNI INSJ,6037.0,3924.05,739.38,6037.0,13
HCPCS,53452,PERIURETHRL TPRNL ADJTBL BALO CNTNC DEV UNI INSJ (COMP CODE 5344,23273.0,15127.45,1849.92,20945.7,38
HCPCS,53452,TPRNL BALO CNTNC DEV UNI,,,472.76,472.76,1
HCPCS,534520,TPRNL BALO CNTNC DEV UNI,,,472.76,472.76,1
HCPCS,53453,PERIURETHRAL TPRNL ADJTBL BALO CNTNC DEV RMVL EA (COMP CODE 5344,21556.0,14011.4,1849.92,19400.4,38
HCPCS,53453,TPRNL BALO CNTNC DEV RMVL EA,,,210.66,210.66,1
HCPCS,534530,TPRNL BALO CNTNC DEV RMVL EA,,,210.66,210.66,1
HCPCS,53454,PERIURETHRAL TPRNL ADJTBL BALO CNTNC DEV ADJMT (COMP CODE S2083),1399.0,909.35,244.13,4214.0,45
HCPCS,53454,TPRNL BALO CNTNC DEV ADJMT,,,57.48,57.48,1
HCPCS,534540,TPRNL BALO CNTNC DEV ADJMT,,,57.48,57.48,1
HCPCS,53460,REVISION OF URETHRA,,,494.0,7477.94,15
HCPCS,53460,Revision of urethra,,,1849.92,2336.74,6
HCPCS,534600,REVISION OF URETHRA,,,494.0,494.0,1
HCPCS,53500,URETHRLYS TRANSVAG W/ SCOPE,,,807.69,7477.94,15
HCPCS,53500,URETHROLSS TRVG SEC OPN W/CSTO,5200.0,3380.0,493.36,5200.0,35
HCPCS,53500,Urethrlys transvag w/ scope,,,1849.92,2336.74,6
HCPCS,535000,URETHRLYS TRANSVAG W/ SCOPE,,,807.69,807.69,1
HCPCS,53502,REPAIR OF URETHRA INJURY,,,524.67,7477.94,15
HCPCS,53502,Repair of urethra injury,,,1849.92,2336.74,6
HCPCS,53502,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE,3304.0,2147.6,337.8,3304.0,35
HCPCS,535020,REPAIR OF URETHRA INJURY,,,524.67,524.67,1
HCPCS,53505,REPAIR OF URETHRA INJURY,,,524.34,11022.13,15
HCPCS,53505,Repair of urethra injury,,,1849.92,2336.74,6
HCPCS,53505,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE,3304.0,2147.6,339.68,3304.0,35
HCPCS,535050,REPAIR OF URETHRA INJURY,,,524.34,524.34,1
HCPCS,53510,REPAIR OF URETHRA INJURY,,,681.37,11022.13,15
HCPCS,53510,Repair of urethra injury,,,3664.3,4628.59,6
HCPCS,53510,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PERINEAL,4384.0,2849.6,449.88,4384.0,35
HCPCS,535100,REPAIR OF URETHRA INJURY,,,681.37,681.37,1
HCPCS,53515,REPAIR OF URETHRA INJURY,,,855.47,11022.13,15
HCPCS,53515,Repair of urethra injury,,,3664.3,4628.59,6
HCPCS,535150,REPAIR OF URETHRA INJURY,,,855.47,855.47,1
HCPCS,53520,CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX,3792.0,2464.8,384.21,3792.0,35
HCPCS,53520,REPAIR OF URETHRA DEFECT,,,602.91,11022.13,15
HCPCS,53520,Repair of urethra defect,,,3664.3,4628.59,6
HCPCS,535200,REPAIR OF URETHRA DEFECT,,,602.91,602.91,1
HCPCS,53600,DILAT URETHRAL STRIX DILATOR MALE 1ST,941.5,611.975,38.89,3920.0,130
HCPCS,53600,DILATE URETHRA STRICTURE,,,68.08,68.08,1
HCPCS,536000,DILATE URETHRA STRICTURE,,,68.08,68.08,1
HCPCS,53601,DILAT URETHRAL STRIX DILATOR MALE SBSQ,566.5,368.225,30.33,3920.0,81
HCPCS,53601,DILATE URETHRA STRICTURE,,,57.07,57.07,1
HCPCS,536010,DILATE URETHRA STRICTURE,,,57.07,57.07,1
HCPCS,53605,DILAT URETHRAL STRIX/VESICAL NCK DILAT MALE ANES,512.0,332.8,47.34,512.0,35
HCPCS,53605,DILATE URETHRA STRICTURE,,,68.7,7477.94,15
HCPCS,53605,Dilate urethra stricture,,,248.59,314.0,6
HCPCS,536050,DILATE URETHRA STRICTURE,,,68.7,68.7,1
HCPCS,53620,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST,2243.0,1457.9499999999998,52.7,4151.0,81
HCPCS,53620,DILATE URETHRA STRICTURE,,,93.28,93.28,1
HCPCS,536200,DILATE URETHRA STRICTURE,,,93.28,93.28,1
HCPCS,53621,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ,969.5,630.175,41.85,4151.0,81
HCPCS,53621,DILATE URETHRA STRICTURE,,,77.07,77.07,1
HCPCS,536210,DILATE URETHRA STRICTURE,,,77.07,77.07,1
HCPCS,53660,DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI,592.0,384.8,23.94,3920.0,81
HCPCS,53660,DILATION OF URETHRA,,,44.57,44.57,1
HCPCS,536600,DILATION OF URETHRA,,,44.57,44.57,1
HCPCS,53661,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,514.5,334.42499999999995,23.2,3920.0,81
HCPCS,53661,DILATION OF URETHRA,,,43.26,43.26,1
HCPCS,536610,DILATION OF URETHRA,,,43.26,43.26,1
HCPCS,53665,DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES,304.0,197.6,28.34,304.0,35
HCPCS,53665,DILATION OF URETHRA,,,40.69,4441.51,15
HCPCS,53665,Dilation of urethra,,,248.59,314.0,6
HCPCS,536650,DILATION OF URETHRA,,,40.69,40.69,1
HCPCS,53850,PROSTATIC MICROWAVE THERMOTX,,,382.47,7477.94,15
HCPCS,53850,Prostatic microwave thermotx,,,1043.57,1318.19,6
HCPCS,53850,TRURL DSTRJ PRSTATE TISS MICROWAVE THERMOTH,2168.0,1409.2,325.8,3319.22,35
HCPCS,538500,PROSTATIC MICROWAVE THERMOTX,,,382.47,382.47,1
HCPCS,53852,PROSTATIC RF THERMOTX,,,410.1,7477.94,15
HCPCS,53852,Prostatic rf thermotx,,,1043.57,1318.19,6
HCPCS,53852,TRURL DSTRJ PRSTATE TISS RF THERMOTH,2372.0,1541.8,339.96,3064.05,35
HCPCS,538520,PROSTATIC RF THERMOTX,,,410.1,410.1,1
HCPCS,53854,TRURL DSTRJ PRST8 TISS RF WV,,,410.1,410.1,1
HCPCS,53854,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,11220.0,7293.0,288.66,26432.0,175
HCPCS,538540,TRURL DSTRJ PRST8 TISS RF WV,,,410.1,410.1,1
HCPCS,53855,INSERT PROST URETHRAL STENT,,,87.94,4441.51,15
HCPCS,53855,INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT,656.0,426.4,39.45,1235.21,35
HCPCS,53855,Insert prost urethral stent,,,1849.92,2336.74,6
HCPCS,538550,INSERT PROST URETHRAL STENT,,,87.94,87.94,1
HCPCS,53860,TRANSURETHRAL RF TREATMENT,,,239.91,4441.51,15
HCPCS,53860,TRURL RF FEMALE BLADDER NECK STRS URIN INCONT,1747.0,1135.55,177.43,2497.45,32
HCPCS,53860,Transurethral rf treatment,,,1849.92,2336.74,6
HCPCS,538600,TRANSURETHRAL RF TREATMENT,,,239.91,239.91,1
HCPCS,53865,CYSTO INSJ DEV ISCHMC RMDLG,,,172.58,172.58,1
HCPCS,53865,CYSTO INSJ TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,21632.5,14061.125,116.62,37710.9,71
HCPCS,538650,CYSTO INSJ DEV ISCHMC RMDLG,,,172.58,172.58,1
HCPCS,53866,CATHJ RMVL DEV ISCHMC RMDLG,,,86.17,86.17,1
HCPCS,53866,CATHJ RMVL TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,1025.0,666.25,53.02,4151.0,71
HCPCS,538660,CATHJ RMVL DEV ISCHMC RMDLG,,,86.17,86.17,1
HCPCS,53899,CYST SCLEROSIS,466.0,302.9,57.24,466.0,15
HCPCS,53899,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT (COMP CODE 5235,3440.0,2236.0,57.24,3440.0,15
HCPCS,53899,INJECTION INTO BLADDER LESIONS (NON CHEMODENERVATION) (COMP CODE,6529.5,4244.175,57.24,10601.1,60
HCPCS,53899,ITIND DEVICE INSERTION (COMP CODE 52441),1539.0,1000.35,57.24,1539.0,15
HCPCS,53899,PERCU RADIOFREQUENCY ABLATION RENAL SYSTE,2115.0,1374.75,57.24,2115.0,15
HCPCS,53899,PLCMNT RETRO NEPHROURETERAL CATHETER (COMP CODE 50688),6129.5,3984.175,57.24,10601.1,63
HCPCS,53899,SUPRA PUBIC CATHETER REPOSITION (COMP CODE 36597),5824.5,3785.925,57.24,10048.5,63
HCPCS,53899,UNLISTED PROCEDURE URINARY SYSTEM,346.0,224.9,97.23,6317.0,96
HCPCS,53899,URETERAL DILATION,2353.0,1529.45,57.24,2353.0,15
HCPCS,54000,SLITTING OF PREPUCE,,,122.57,7477.94,15
HCPCS,54000,Slitting of prepuce,,,248.59,314.0,6
HCPCS,540000,SLITTING OF PREPUCE,,,122.57,122.57,1
HCPCS,54001,SLITTING OF PREPUCE,,,155.7,155.7,1
HCPCS,54001,SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN,6337.5,4119.375,67.23,13665.0,81
HCPCS,540010,SLITTING OF PREPUCE,,,155.7,155.7,1
HCPCS,54015,I&D PENIS DEEP,,,337.86,3512.95,15
HCPCS,54015,I&d penis deep,,,1256.84,1587.59,6
HCPCS,54015,"INCIS/DRAIN PENIS,DEEP",2144.0,1393.6,180.93,2144.0,35
HCPCS,540150,I&D PENIS DEEP,,,337.86,337.86,1
HCPCS,54050,DESTRUCTION PENIS LESION(S),,,117.2,866.25,15
HCPCS,54050,Destruction penis lesion(s),,,248.59,314.0,6
HCPCS,540500,DESTRUCTION PENIS LESION(S),,,117.2,117.2,1
HCPCS,54055,DESTRUCTION PENIS LESION(S),,,105.61,105.61,1
HCPCS,54055,DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION,5509.0,3580.85,55.39,9466.2,81
HCPCS,540550,DESTRUCTION PENIS LESION(S),,,105.61,105.61,1
HCPCS,54056,CRYOSURGERY PENIS LESION(S),,,122.36,122.36,1
HCPCS,54056,DSTRJ LESION PENIS SIMPLE CRYOSURGERY,855.5,556.075,52.77,3920.0,81
HCPCS,540560,CRYOSURGERY PENIS LESION(S),,,122.36,122.36,1
HCPCS,54057,DSTRJ LESION PENIS SIMPLE LASER,516.0,335.4,46.52,387.0,35
HCPCS,54057,LASER SURG PENIS LESION(S),,,107.88,3966.07,15
HCPCS,54057,Laser surg penis lesion(s),,,1256.84,1587.59,6
HCPCS,540570,LASER SURG PENIS LESION(S),,,107.88,107.88,1
HCPCS,54060,DEST LESION PENIS SURGICAL,792.0,514.8,67.37,594.0,35
HCPCS,54060,DSTRJ LESION PENIS SIMPLE SURG EXCISION,792.0,514.8,67.37,594.0,35
HCPCS,54060,EXCISION OF PENIS LESION(S),,,145.65,3966.07,15
HCPCS,54060,Excision of penis lesion(s),,,1256.84,1587.59,6
HCPCS,540600,EXCISION OF PENIS LESION(S),,,145.65,145.65,1
HCPCS,54065,DESTRUCTION PENIS LESION(S),,,189.06,3966.07,15
HCPCS,54065,DSTRJ LESION PENIS EXTENSIVE,988.0,642.2,97.72,741.0,35
HCPCS,54065,Destruction penis lesion(s),,,1256.84,1587.59,6
HCPCS,540650,DESTRUCTION PENIS LESION(S),,,189.06,189.06,1
HCPCS,54100,BIOPSY OF PENIS,,,133.43,133.43,1
HCPCS,54100,BIOPSY PENIS SEPARATE PROCEDURE,5038.0,3274.7,57.7,8384.4,81
HCPCS,541000,BIOPSY OF PENIS,,,133.43,133.43,1
HCPCS,54105,BIOPSY OF PENIS,,,235.84,6205.4,15
HCPCS,54105,"BIOPSY OF PENIS,DEEP STRUCT",1416.0,920.4,102.08,1062.0,35
HCPCS,54105,Biopsy of penis,,,1256.84,1587.59,6
HCPCS,541050,BIOPSY OF PENIS,,,235.84,235.84,1
HCPCS,54110,EXCIS PENILE PLAQUE,4368.0,2839.2,416.79,4368.0,35
HCPCS,54110,TREATMENT OF PENIS LESION,,,692.41,7477.94,15
HCPCS,54110,Treatment of penis lesion,,,1256.84,1587.59,6
HCPCS,541100,TREATMENT OF PENIS LESION,,,692.41,692.41,1
HCPCS,54111,"EXCIS PENILE PLAQUE,GRAFT <5CM",5768.0,3749.2,603.77,5768.0,35
HCPCS,54111,TREAT PENIS LESION GRAFT,,,885.02,11022.13,15
HCPCS,54111,Treat penis lesion graft,,,1932.48,2441.03,6
HCPCS,541110,TREAT PENIS LESION GRAFT,,,885.02,885.02,1
HCPCS,54112,"EXCIS PENILE PLAQUE,GRAFT >5CM",6792.0,4414.8,650.99,6792.0,35
HCPCS,54112,TREAT PENIS LESION GRAFT,,,1037.52,20049.35,15
HCPCS,54112,Treat penis lesion graft,,,1932.48,2441.03,6
HCPCS,541120,TREAT PENIS LESION GRAFT,,,1037.52,1037.52,1
HCPCS,54115,REMV FOR.BODY DEEP PENILE TISS,2780.0,1807.0,275.79,2085.0,35
HCPCS,54115,TREATMENT OF PENIS LESION,,,473.62,6205.4,15
HCPCS,54115,Treatment of penis lesion,,,1256.84,1587.59,6
HCPCS,541150,TREATMENT OF PENIS LESION,,,473.62,473.62,1
HCPCS,54120,PARTIAL REMOVAL OF PENIS,,,701.83,7477.94,15
HCPCS,54120,Partial removal of penis,,,1932.48,2441.03,6
HCPCS,54120,"REMOVAL PENIS,PARTIAL",4404.0,2862.6,442.94,4404.0,35
HCPCS,541200,PARTIAL REMOVAL OF PENIS,,,701.83,701.83,1
HCPCS,54125,REMOVAL OF PENIS,,,911.39,911.39,1
HCPCS,54125,"REMOVAL PENIS,TOTAL",5824.0,3785.6,623.37,5824.0,35
HCPCS,54125,Removal of penis,,,1932.48,2441.03,6
HCPCS,541250,REMOVAL OF PENIS,,,911.39,911.39,1
HCPCS,54130,REMOVE PENIS & NODES,,,1319.6,1319.6,1
HCPCS,54130,Remove penis & nodes,,,1932.48,2441.03,6
HCPCS,541300,REMOVE PENIS & NODES,,,1319.6,1319.6,1
HCPCS,54135,AMPUTATION PENIS RADICAL W/LYMPH NODES,11268.0,7324.2,1048.91,11268.0,35
HCPCS,54135,REMOVE PENIS & NODES,,,1668.2,1668.2,1
HCPCS,54135,Remove penis & nodes,,,1932.48,2441.03,6
HCPCS,541350,REMOVE PENIS & NODES,,,1668.2,1668.2,1
HCPCS,54150,CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,760.0,494.0,48.41,570.0,35
HCPCS,54150,CIRCUMCISION W/REGIONL BLOCK,,,106.5,4441.51,15
HCPCS,54150,Circumcision w/regionl block,,,1256.84,1587.59,6
HCPCS,541500,CIRCUMCISION W/REGIONL BLOCK,,,106.5,106.5,1
HCPCS,54160,CIRCUMCISION NEONATE,,,161.38,1447.18,15
HCPCS,54160,Circumcision neonate,,,1256.84,1587.59,6
HCPCS,541600,CIRCUMCISION NEONATE,,,161.38,161.38,1
HCPCS,54161,CIRCUM 28 DAYS OR OLDER,,,218.64,218.64,1
HCPCS,54161,CIRCUMCISION AGE >28 DAYS,6553.5,4259.775000000001,143.79,36332.0,81
HCPCS,541610,CIRCUM 28 DAYS OR OLDER,,,218.64,218.64,1
HCPCS,54162,LYSIS PENIL CIRCUMIC LESION,,,222.11,4441.51,15
HCPCS,54162,LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS,1328.0,863.2,104.7,996.0,35
HCPCS,54162,Lysis penil circumic lesion,,,1256.84,1587.59,6
HCPCS,541620,LYSIS PENIL CIRCUMIC LESION,,,222.11,222.11,1
HCPCS,54163,REP INCOMPLETE CIRCUMCISION,1328.0,863.2,149.77,1328.0,35
HCPCS,54163,REPAIR OF CIRCUMCISION,,,242.59,4441.51,15
HCPCS,54163,Repair of circumcision,,,1256.84,1587.59,6
HCPCS,541630,REPAIR OF CIRCUMCISION,,,242.59,242.59,1
HCPCS,54164,FRENULOTOMY OF PENIS,1128.0,733.2,131.34,4441.51,50
HCPCS,54164,Frenulotomy of penis,,,1256.84,1587.59,6
HCPCS,541640,FRENULOTOMY OF PENIS,,,214.97,214.97,1
HCPCS,54200,INJECTION FOR PEYRONIE DIS,444.0,288.6,52.58,333.0,35
HCPCS,54200,INJECTION PEYRONIE DISEASE,921.5,598.975,52.58,4151.0,81
HCPCS,54200,INJECTION PX PEYRONIE DS,,,96.07,96.07,1
HCPCS,54200,TREATMENT OF PENIS LESION,444.0,288.6,52.58,333.0,35
HCPCS,542000,INJECTION PX PEYRONIE DS,,,96.07,96.07,1
HCPCS,54205,NJX PEYRONIE W/SURG EXPOS PLAQUE,3947.0,2565.55,336.68,3947.0,35
HCPCS,54205,NJX PX PEYRONIE DS EXPS PLAQ,,,590.7,11022.13,15
HCPCS,54205,Njx px peyronie ds exps plaq,,,1932.48,2441.03,6
HCPCS,542050,NJX PX PEYRONIE DS EXPS PLAQ,,,590.7,590.7,1
HCPCS,54220,IRRG CRPRA CAVRNOSA PRIAPISM,,,149.62,149.62,1
HCPCS,54220,IRRIGATION CORPORA CAVERNOSA PRIAPISM,1183.5,769.2750000000001,53.02,4151.0,130
HCPCS,542200,IRRG CRPRA CAVRNOSA PRIAPISM,,,149.62,149.62,1
HCPCS,54230,INJECTION CORPORA CAVERNOSOGRAPY,536.0,348.4,49.45,402.0,35
HCPCS,54230,NJX CORPORA CAVERNOSOGRAPY,,,87.91,87.91,1
HCPCS,54230,Njx corpora cavernosograpy,,,1256.84,1587.59,6
HCPCS,542300,NJX CORPORA CAVERNOSOGRAPY,,,87.91,87.91,1
HCPCS,54231,DYNAMIC CAVERNOSOMETRY,,,127.81,527.32,15
HCPCS,54231,DYNAMIC CAVERNOSOMETRY NJX VASOACTIVE DRUGS,898.0,583.7,71.31,673.5,35
HCPCS,54231,Dynamic cavernosometry,,,1256.84,1587.59,6
HCPCS,542310,DYNAMIC CAVERNOSOMETRY,,,127.81,127.81,1
HCPCS,54235,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,937.5,609.375,35.0,3920.0,179
HCPCS,54235,NJX CORPORA CAVERNOSA RX AGT,,,81.45,81.45,1
HCPCS,542350,NJX CORPORA CAVERNOSA RX AGT,,,81.45,81.45,1
HCPCS,54240,PENILE PLETHYSMOGRAPHY,524.0,340.6,45.92,675.17,51
HCPCS,54240,Penile plethysmography,,,53.02,66.97,6
HCPCS,542400,PENILE PLETHYSMOGRAPHY,,,45.92,45.92,1
HCPCS,54240TC,PENILE PLETHYSMOGRAPHY,,,45.92,45.92,1
HCPCS,54250,NCTRNL PEN TMSCN&/RGDITY TST,,,15.33,527.32,16
HCPCS,54250,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,888.0,577.2,81.17,888.0,63
HCPCS,54250,Nctrnl pen tmscn&/rgdity tst,,,53.02,66.97,6
HCPCS,542500,NCTRNL PEN TMSCN&/RGDITY TST,,,15.33,15.33,1
HCPCS,54250TC,NCTRNL PEN TMSCN&/RGDITY TST,,,15.33,15.33,1
HCPCS,54300,PENIS STRAIGHTENING CHORDEE,4480.0,2912.0,470.6,4480.0,35
HCPCS,54300,REVISION OF PENIS,,,715.07,7477.94,15
HCPCS,54300,Revision of penis,,,1256.84,1587.59,6
HCPCS,543000,REVISION OF PENIS,,,715.07,715.07,1
HCPCS,54304,PENIS CORRJ CHORDEE/1ST STAGE HYPOSPADIAS RPR,5312.0,3452.8,540.11,5312.0,35
HCPCS,54304,REVISION OF PENIS,,,828.12,7477.94,15
HCPCS,54304,Revision of penis,,,1256.84,1587.59,6
HCPCS,543040,REVISION OF PENIS,,,828.12,828.12,1
HCPCS,54308,RECONSTRUCTION OF URETHRA,,,793.57,11022.13,15
HCPCS,54308,Reconstruction of urethra,,,1932.48,2441.03,6
HCPCS,543080,RECONSTRUCTION OF URETHRA,,,793.57,793.57,1
HCPCS,54312,RECONSTRUCTION OF URETHRA,,,906.2,7477.94,15
HCPCS,54312,Reconstruction of urethra,,,1932.48,2441.03,6
HCPCS,543120,RECONSTRUCTION OF URETHRA,,,906.2,906.2,1
HCPCS,54316,RECONSTRUCTION OF URETHRA,,,1100.08,20049.35,15
HCPCS,54316,Reconstruction of urethra,,,1932.48,2441.03,6
HCPCS,543160,RECONSTRUCTION OF URETHRA,,,1100.08,1100.08,1
HCPCS,54318,RECONSTRUCTION OF URETHRA,,,789.02,7477.94,15
HCPCS,54318,Reconstruction of urethra,,,1932.48,2441.03,6
HCPCS,543180,RECONSTRUCTION OF URETHRA,,,789.02,789.02,1
HCPCS,54322,RECONSTRUCTION OF URETHRA,,,864.9,7477.94,15
HCPCS,54322,Reconstruction of urethra,,,1932.48,2441.03,6
HCPCS,543220,RECONSTRUCTION OF URETHRA,,,864.9,864.9,1
HCPCS,54324,RECONSTRUCTION OF URETHRA,,,1071.37,7477.94,15
HCPCS,54324,Reconstruction of urethra,,,1932.48,2441.03,6
HCPCS,543240,RECONSTRUCTION OF URETHRA,,,1071.37,1071.37,1
HCPCS,54326,RECONSTRUCTION OF URETHRA,,,1042.91,7477.94,15
HCPCS,54326,Reconstruction of urethra,,,1932.48,2441.03,6
HCPCS,543260,RECONSTRUCTION OF URETHRA,,,1042.91,1042.91,1
HCPCS,54328,REVISE PENIS/URETHRA,,,1036.13,7477.94,15
HCPCS,54328,Revise penis/urethra,,,1932.48,2441.03,6
HCPCS,543280,REVISE PENIS/URETHRA,,,1036.13,1036.13,1
HCPCS,54332,REVISE PENIS/URETHRA,,,1117.27,7477.94,15
HCPCS,54332,Revise penis/urethra,,,1932.48,2441.03,6
HCPCS,543320,REVISE PENIS/URETHRA,,,1117.27,1117.27,1
HCPCS,54336,REVISE PENIS/URETHRA,,,1313.51,7477.94,15
HCPCS,54336,Revise penis/urethra,,,1932.48,2441.03,6
HCPCS,543360,REVISE PENIS/URETHRA,,,1313.51,1313.51,1
HCPCS,54340,RPR HYPSPAD COMP SIMPLE,,,631.81,7477.94,15
HCPCS,54340,Rpr hypspad comp simple,,,1256.84,1587.59,6
HCPCS,543400,RPR HYPSPAD COMP SIMPLE,,,631.81,631.81,1
HCPCS,54344,RRP HYPSPAD COMP MOBLJ&URTP,,,1045.13,20049.35,15
HCPCS,54344,Rrp hypspad comp moblj&urtp,,,1932.48,2441.03,6
HCPCS,543440,RRP HYPSPAD COMP MOBLJ&URTP,,,1045.13,1045.13,1
HCPCS,54348,RPR HYPSPAD COMP DSJ & URTP,,,1117.45,11022.13,15
HCPCS,54348,Rpr hypspad comp dsj & urtp,,,1932.48,2441.03,6
HCPCS,543480,RPR HYPSPAD COMP DSJ & URTP,,,1117.45,1117.45,1
HCPCS,54352,REVJ PRIOR HYPSPAD REPAIR,,,1561.87,11022.13,15
HCPCS,54352,Revj prior hypspad repair,,,1932.48,2441.03,6
HCPCS,543520,REVJ PRIOR HYPSPAD REPAIR,,,1561.87,1561.87,1
HCPCS,54360,PENIS PLASTIC SURGERY,,,799.07,7477.94,15
HCPCS,54360,PLASTIC RPR PENIS CORRECT ANGULATION,5112.0,3322.8,510.96,5112.0,35
HCPCS,54360,Penis plastic surgery,,,1256.84,1587.59,6
HCPCS,543600,PENIS PLASTIC SURGERY,,,799.07,799.07,1
HCPCS,54380,REPAIR PENIS,,,885.1,4441.51,15
HCPCS,54380,Repair penis,,,1256.84,1587.59,6
HCPCS,543800,REPAIR PENIS,,,885.1,885.1,1
HCPCS,54385,REPAIR PENIS,,,1030.31,4441.51,15
HCPCS,54385,Repair penis,,,1256.84,1587.59,6
HCPCS,543850,REPAIR PENIS,,,1030.31,1030.31,1
HCPCS,54390,REPAIR PENIS AND BLADDER,,,1372.16,1372.16,1
HCPCS,54390,Repair penis and bladder,,,1932.48,2441.03,6
HCPCS,543900,REPAIR PENIS AND BLADDER,,,1372.16,1372.16,1
HCPCS,54400,INSERT SEMI-RIGID PROSTHESIS,,,590.43,28169.71,15
HCPCS,54400,INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID,3668.0,2384.2,381.71,3668.0,32
HCPCS,54400,Insert semi-rigid prosthesis,,,8231.18,10397.28,6
HCPCS,544000,INSERT SEMI-RIGID PROSTHESIS,,,590.43,590.43,1
HCPCS,54401,INSERT SELF-CONTD PROSTHESIS,,,735.98,43642.04,15
HCPCS,54401,INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED,4176.0,2714.4,435.81,4176.0,32
HCPCS,54401,Insert self-contd prosthesis,,,8231.18,10397.28,6
HCPCS,544010,INSERT SELF-CONTD PROSTHESIS,,,735.98,735.98,1
HCPCS,54405,INSERT MULTI-COMP PENIS PROS,,,894.78,43642.04,16
HCPCS,54405,INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH,5808.0,3775.2,547.09,5808.0,32
HCPCS,54405,Insert multi-comp penis pros,,,8231.18,10397.28,6
HCPCS,54405,PENILE IMPLANT,42000.0,27300.0,547.09,42000.0,32
HCPCS,544050,INSERT MULTI-COMP PENIS PROS,,,894.78,894.78,1
HCPCS,54406,REMOVE MUTI-COMP PENIS PROS,,,810.65,7477.94,15
HCPCS,54406,RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH,5156.0,3351.4,500.19,5156.0,35
HCPCS,54406,Remove muti-comp penis pros,,,1256.84,1587.59,6
HCPCS,544060,REMOVE MUTI-COMP PENIS PROS,,,810.65,810.65,1
HCPCS,54408,REPAIR MULTI-COMP PENIS PROS,,,876.46,11022.13,15
HCPCS,54408,RPR COMPONENT INFLATABLE PENILE PROSTHESIS,5564.0,3616.6,527.01,5564.0,32
HCPCS,54408,Repair multi-comp penis pros,,,1256.84,1587.59,6
HCPCS,544080,REPAIR MULTI-COMP PENIS PROS,,,876.46,876.46,1
HCPCS,54410,REMOVE/REPLACE PENIS PROSTH,,,956.1,43642.04,15
HCPCS,54410,RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS,6072.0,3946.8,623.68,6072.0,32
HCPCS,54410,Remove/replace penis prosth,,,8231.18,10397.28,6
HCPCS,544100,REMOVE/REPLACE PENIS PROSTH,,,956.1,956.1,1
HCPCS,54411,REMOV/REPLC PENIS PROS COMP,,,1138.38,43642.04,15
HCPCS,54411,RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL,7340.0,4771.0,678.39,7340.0,32
HCPCS,54411,Remov/replc penis pros comp,,,8231.18,10397.28,6
HCPCS,544110,REMOV/REPLC PENIS PROS COMP,,,1138.38,1138.38,1
HCPCS,54415,REMOVE SELF-CONTD PENIS PROS,,,590.74,7477.94,15
HCPCS,54415,RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT,3552.0,2308.8,370.47,3552.0,35
HCPCS,54415,Remove self-contd penis pros,,,1256.84,1587.59,6
HCPCS,544150,REMOVE SELF-CONTD PENIS PROS,,,590.74,590.74,1
HCPCS,54416,REMV/REPL PENIS CONTAIN PROS,,,795.07,43642.04,15
HCPCS,54416,RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI,4832.0,3140.8,482.59,4832.0,32
HCPCS,54416,Remv/repl penis contain pros,,,8231.18,10397.28,6
HCPCS,544160,REMV/REPL PENIS CONTAIN PROS,,,795.07,795.07,1
HCPCS,54417,REMV/REPLC PENIS PROS COMPL,,,995.49,28169.71,15
HCPCS,54417,RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD,6440.0,4186.0,595.53,6440.0,32
HCPCS,54417,Remv/replc penis pros compl,,,8231.18,10397.28,6
HCPCS,544170,REMV/REPLC PENIS PROS COMPL,,,995.49,995.49,1
HCPCS,54420,CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI,4956.0,3221.4,513.29,4956.0,35
HCPCS,54420,REVISION OF PENIS,,,778.82,7477.94,15
HCPCS,54420,Revision of penis,,,1256.84,1587.59,6
HCPCS,544200,REVISION OF PENIS,,,778.82,778.82,1
HCPCS,54430,CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI,4424.0,2875.6,459.09,4424.0,35
HCPCS,54430,REVISION OF PENIS,,,708.25,708.25,1
HCPCS,54430,Revision of penis,,,1256.84,1587.59,6
HCPCS,544300,REVISION OF PENIS,,,708.25,708.25,1
HCPCS,54435,CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM,2724.0,1770.6,282.52,2724.0,35
HCPCS,54435,REVISION OF PENIS,,,459.82,7477.94,15
HCPCS,54435,Revision of penis,,,1256.84,1587.59,6
HCPCS,544350,REVISION OF PENIS,,,459.82,459.82,1
HCPCS,54437,REPAIR CORPOREAL TEAR,,,752.33,7477.94,15
HCPCS,54437,REPAIR OF TRAUMATIC CORPOREAL TEAR(S),4600.0,2990.0,518.32,4600.0,31
HCPCS,54437,Repair corporeal tear,,,1932.48,2441.03,6
HCPCS,544370,REPAIR CORPOREAL TEAR,,,752.33,752.33,1
HCPCS,54438,Replantation of penis,,,3664.3,4628.59,6
HCPCS,54440,PLASTIC OPERATION PENIS INJURY,5550.0,3607.5,151.04,5550.0,16
HCPCS,54440,REPAIR OF PENIS,,,615.85,7477.94,15
HCPCS,54440,Repair of penis,,,1256.84,1587.59,6
HCPCS,544400,REPAIR OF PENIS,,,615.85,615.85,1
HCPCS,54450,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,923.5,600.275,36.79,4214.0,130
HCPCS,54450,PREPUTIAL STRETCHING,,,63.12,63.12,1
HCPCS,544500,PREPUTIAL STRETCHING,,,63.12,63.12,1
HCPCS,54500,BIOPSY OF TESTIS,,,82.25,6205.4,15
HCPCS,54500,BIOPSY TESTIS NEEDLE SEPARATE PROCEDURE,524.0,340.6,51.71,524.0,35
HCPCS,54500,Biopsy of testis,,,248.59,314.0,6
HCPCS,545000,BIOPSY OF TESTIS,,,82.25,82.25,1
HCPCS,54505,BIOPSY OF TESTIS,,,231.84,7477.94,15
HCPCS,54505,BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE,1400.0,910.0,145.6,1400.0,35
HCPCS,54505,Biopsy of testis,,,1256.84,1587.59,6
HCPCS,545050,BIOPSY OF TESTIS,,,231.84,231.84,1
HCPCS,54512,EXC XTRPARENCHYMAL LESION TESTIS,3732.0,2425.8,388.68,3732.0,35
HCPCS,54512,EXCISE LESION TESTIS,,,597.1,7477.94,15
HCPCS,54512,Excise lesion testis,,,1407.62,1778.05,6
HCPCS,545120,EXCISE LESION TESTIS,,,597.1,597.1,1
HCPCS,54520,ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH,2332.0,1515.8,254.05,2332.0,35
HCPCS,54520,REMOVAL OF TESTIS,,,364.66,7477.94,17
HCPCS,54520,Removal of testis,,,1407.62,1778.05,6
HCPCS,545200,REMOVAL OF TESTIS,,,364.66,364.66,1
HCPCS,54522,ORCHIECTOMY PARTIAL,,,651.57,7477.94,15
HCPCS,54522,Orchiectomy partial,,,1256.84,1587.59,6
HCPCS,54522,PARTIAL ORCHIECTOMY,4100.0,2665.0,441.34,4100.0,35
HCPCS,545220,ORCHIECTOMY PARTIAL,,,651.57,651.57,1
HCPCS,54530,ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH,3384.0,2199.6,392.75,3384.0,35
HCPCS,54530,REMOVAL OF TESTIS,,,564.87,7651.58,15
HCPCS,54530,Removal of testis,,,1256.84,1587.59,6
HCPCS,545300,REMOVAL OF TESTIS,,,564.87,564.87,1
HCPCS,54535,EXTENSIVE TESTIS SURGERY,,,825.0,7477.94,15
HCPCS,54535,Extensive testis surgery,,,1256.84,1587.59,6
HCPCS,54535,ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL,5276.0,3429.4,543.98,5276.0,35
HCPCS,545350,EXTENSIVE TESTIS SURGERY,,,825.0,825.0,1
HCPCS,54550,EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA,3364.0,2186.6,344.97,3364.0,35
HCPCS,54550,EXPLORATION FOR TESTIS,,,546.11,7651.58,15
HCPCS,54550,Exploration for testis,,,1407.62,1778.05,6
HCPCS,545500,EXPLORATION FOR TESTIS,,,546.11,546.11,1
HCPCS,54560,EXPLORATION FOR TESTIS,,,762.03,4441.51,15
HCPCS,54560,Exploration for testis,,,1256.84,1587.59,6
HCPCS,545600,EXPLORATION FOR TESTIS,,,762.03,762.03,1
HCPCS,54600,RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS,3056.0,1986.4,306.88,3056.0,35
HCPCS,54600,REDUCE TESTIS TORSION,,,503.12,7477.94,15
HCPCS,54600,Reduce testis torsion,,,1407.62,1778.05,6
HCPCS,546000,REDUCE TESTIS TORSION,,,503.12,503.12,1
HCPCS,54620,FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE,2084.0,1354.6,217.05,2084.0,35
HCPCS,54620,SUSPENSION OF TESTIS,,,330.61,7477.94,15
HCPCS,54620,Suspension of testis,,,1407.62,1778.05,6
HCPCS,546200,SUSPENSION OF TESTIS,,,330.61,330.61,1
HCPCS,54640,ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,3401.0,2210.65,333.45,3401.0,35
HCPCS,54640,ORCHIOPEXY INGUN/SCROT APPR,,,479.49,7651.58,16
HCPCS,54640,Orchiopexy ingun/scrot appr,,,1407.62,1778.05,6
HCPCS,546400,ORCHIOPEXY INGUN/SCROT APPR,,,479.49,479.49,1
HCPCS,54650,ORCHIOPEXY (FOWLER-STEPHENS),,,789.92,7651.58,15
HCPCS,54650,ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS,5452.0,3543.8,508.19,5452.0,35
HCPCS,54650,Orchiopexy (fowler-stephens),,,1256.84,1587.59,6
HCPCS,546500,ORCHIOPEXY (FOWLER-STEPHENS),,,789.92,789.92,1
HCPCS,54660,INSJ TESTICULAR PROSTH SEPARATE PROCEDURE,2296.0,1492.4,225.79,2296.0,32
HCPCS,54660,REVISION OF TESTIS,,,398.0,11022.13,15
HCPCS,54660,Revision of testis,,,1256.84,1587.59,6
HCPCS,546600,REVISION OF TESTIS,,,398.0,398.0,1
HCPCS,54670,REPAIR TESTIS INJURY,,,454.02,7477.94,15
HCPCS,54670,Repair testis injury,,,1407.62,1778.05,6
HCPCS,546700,REPAIR TESTIS INJURY,,,454.02,454.02,1
HCPCS,54680,RELOCATION OF TESTIS(ES),,,872.09,7477.94,15
HCPCS,54680,Relocation of testis(es),,,1256.84,1587.59,6
HCPCS,546800,RELOCATION OF TESTIS(ES),,,872.09,872.09,1
HCPCS,54690,LAPAROSCOPY ORCHIECTOMY,,,726.76,12649.85,15
HCPCS,54690,"LAPAROSCOPY, SURGICAL; ORCHIECTOMY",4680.0,3042.0,476.62,4680.0,35
HCPCS,54690,Laparoscopy orchiectomy,,,1256.84,1587.59,6
HCPCS,546900,LAPAROSCOPY ORCHIECTOMY,,,726.76,726.76,1
HCPCS,54692,LAPAROSCOPY ORCHIOPEXY,,,836.86,12649.85,15
HCPCS,54692,LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS,5496.0,3572.4,517.97,5496.0,35
HCPCS,54692,Laparoscopy orchiopexy,,,1256.84,1587.59,6
HCPCS,546920,LAPAROSCOPY ORCHIOPEXY,,,836.86,836.86,1
HCPCS,54699,UNLISTED LAPS PX TESTIS,,,5856.41,12649.85,14
HCPCS,54699,Unlisted laps px testis,,,1407.62,1778.05,6
HCPCS,54700,I&D EPDIDYMS TSTIS&/SCROT SP,,,236.49,236.49,1
HCPCS,54700,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,6583.5,4279.275000000001,130.25,36332.0,133
HCPCS,547000,I&D EPDIDYMS TSTIS&/SCROT SP,,,236.49,236.49,1
HCPCS,54800,BIOPSY EPIDIDYMIS NEEDLE,9316.0,6055.4,151.03,8384.4,49
HCPCS,54800,BIOPSY OF EPIDIDYMIS,,,138.74,138.74,1
HCPCS,54800,"BIOPSY OF EPIDIDYMIS,NEEDLE",932.0,605.8,89.98,932.0,35
HCPCS,548000,BIOPSY OF EPIDIDYMIS,,,138.74,138.74,1
HCPCS,54830,EXCISION LOCAL LESION EPIDIDYMIS,2404.0,1562.6,237.51,2404.0,35
HCPCS,54830,REMOVE EPIDIDYMIS LESION,,,413.68,7477.94,15
HCPCS,54830,Remove epididymis lesion,,,1407.62,1778.05,6
HCPCS,548300,REMOVE EPIDIDYMIS LESION,,,413.68,413.68,1
HCPCS,54840,EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY,2108.0,1370.2,248.68,2108.0,35
HCPCS,54840,REMOVE EPIDIDYMIS LESION,,,357.6,4441.51,15
HCPCS,54840,Remove epididymis lesion,,,1407.62,1778.05,6
HCPCS,548400,REMOVE EPIDIDYMIS LESION,,,357.6,357.6,1
HCPCS,54860,EPIDIDYMECTOMY UNILATERAL,2780.0,1807.0,299.9,2780.0,35
HCPCS,54860,REMOVAL OF EPIDIDYMIS,,,465.3,7477.94,15
HCPCS,54860,Removal of epididymis,,,1407.62,1778.05,6
HCPCS,548600,REMOVAL OF EPIDIDYMIS,,,465.3,465.3,1
HCPCS,54861,EPIDIDYMECTOMY BILATERAL,3880.0,2522.0,418.96,3880.0,35
HCPCS,54861,REMOVAL OF EPIDIDYMIS,,,631.08,7477.94,15
HCPCS,54861,Removal of epididymis,,,1256.84,1587.59,6
HCPCS,548610,REMOVAL OF EPIDIDYMIS,,,631.08,631.08,1
HCPCS,54865,EXPLORATION OF EPIDIDYMIS W/WO BIOPSY,2539.0,1650.35,227.72,2539.0,35
HCPCS,54865,EXPLORE EPIDIDYMIS,,,399.88,7477.94,15
HCPCS,54865,Explore epididymis,,,1407.62,1778.05,6
HCPCS,548650,EXPLORE EPIDIDYMIS,,,399.88,399.88,1
HCPCS,54900,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI,5680.0,3692.0,576.17,5680.0,32
HCPCS,54900,FUSION OF SPERMATIC DUCTS,,,886.22,4441.51,15
HCPCS,54900,Fusion of spermatic ducts,,,1407.62,1778.05,6
HCPCS,549000,FUSION OF SPERMATIC DUCTS,,,886.22,886.22,1
HCPCS,54901,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS BI,7640.0,4966.0,747.69,7640.0,32
HCPCS,54901,FUSION OF SPERMATIC DUCTS,,,1170.16,7477.94,15
HCPCS,54901,Fusion of spermatic ducts,,,1256.84,1587.59,6
HCPCS,549010,FUSION OF SPERMATIC DUCTS,,,1170.16,1170.16,1
HCPCS,55000,DRAINAGE OF HYDROCELE,,,93.52,93.52,1
HCPCS,55000,PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED,2309.0,1500.8500000000001,50.46,4151.0,81
HCPCS,550000,DRAINAGE OF HYDROCELE,,,93.52,93.52,1
HCPCS,55040,EXCISION HYDROCELE UNILATERAL,2180.0,1417.0,253.81,2180.0,35
HCPCS,55040,REMOVAL OF HYDROCELE,,,376.19,7651.58,16
HCPCS,55040,Removal of hydrocele,,,1256.84,1587.59,6
HCPCS,550400,REMOVAL OF HYDROCELE,,,376.19,376.19,1
HCPCS,55041,EXCISION HYDROCELE BILATERAL,3758.0,2442.7,372.5,3758.0,35
HCPCS,55041,REMOVAL OF HYDROCELES,,,568.26,7651.58,15
HCPCS,55041,Removal of hydroceles,,,1256.84,1587.59,6
HCPCS,550410,REMOVAL OF HYDROCELES,,,568.26,568.26,1
HCPCS,55060,REPAIR OF HYDROCELE,,,421.55,7477.94,15
HCPCS,55060,RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE,2460.0,1599.0,254.87,2460.0,35
HCPCS,55060,Repair of hydrocele,,,1407.62,1778.05,6
HCPCS,550600,REPAIR OF HYDROCELE,,,421.55,421.55,1
HCPCS,55100,DRAINAGE OF SCROTUM ABSCESS,,,186.0,186.0,1
HCPCS,55100,DRAINAGE SCROTAL WALL ABSCESS,5148.0,3346.2,96.6,8384.4,179
HCPCS,551000,DRAINAGE OF SCROTUM ABSCESS,,,186.0,186.0,1
HCPCS,55110,EXPLORE SCROTUM,2532.0,1645.8,244.44,7477.94,51
HCPCS,55110,Explore scrotum,,,1256.84,1587.59,6
HCPCS,551100,EXPLORE SCROTUM,,,431.06,431.06,1
HCPCS,55120,REMOVAL FOREIGN BODY SCROTUM,2288.0,1487.2,192.73,2288.0,35
HCPCS,55120,REMOVAL OF SCROTUM LESION,,,394.8,4441.51,15
HCPCS,55120,Removal of scrotum lesion,,,1407.62,1778.05,6
HCPCS,551200,REMOVAL OF SCROTUM LESION,,,394.8,394.8,1
HCPCS,55150,REMOVAL OF SCROTUM,,,547.38,7477.94,15
HCPCS,55150,RESECTION SCROTUM,3256.0,2116.4,332.54,3256.0,35
HCPCS,55150,Removal of scrotum,,,1407.62,1778.05,6
HCPCS,551500,REMOVAL OF SCROTUM,,,547.38,547.38,1
HCPCS,55175,REVISION OF SCROTUM,,,405.23,7477.94,15
HCPCS,55175,Revision of scrotum,,,1407.62,1778.05,6
HCPCS,55175,SCROTOPLASTY SIMPLE,2348.0,1526.2,255.25,2348.0,35
HCPCS,551750,REVISION OF SCROTUM,,,405.23,405.23,1
HCPCS,55180,REVISION OF SCROTUM,,,763.46,11022.13,15
HCPCS,55180,Revision of scrotum,,,1256.84,1587.59,6
HCPCS,55180,SCROTOPLASTY COMPLICATED,4712.0,3062.8,466.36,4712.0,35
HCPCS,551800,REVISION OF SCROTUM,,,763.46,763.46,1
HCPCS,55200,INCISION OF SPERM DUCT,,,308.21,7477.94,15
HCPCS,55200,Incision of sperm duct,,,1407.62,1778.05,6
HCPCS,55200,VASOTOMY CANNULIZATION W/WO VAS INC UNI/BI SPX,1820.0,1183.0,90.05,1365.0,35
HCPCS,552000,INCISION OF SPERM DUCT,,,308.21,308.21,1
HCPCS,55250,REMOVAL OF SPERM DUCT(S),,,253.88,253.88,1
HCPCS,55250,VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS,6563.5,4266.275000000001,154.3,36332.0,81
HCPCS,552500,REMOVAL OF SPERM DUCT(S),,,253.88,253.88,1
HCPCS,55300,PREPARE SPERM DUCT X-RAY,,,205.1,205.1,1
HCPCS,55300,Prepare sperm duct x-ray,,,53.02,66.97,6
HCPCS,55300,VASOTOMY VASOGRAMS UNI/BI,1400.0,910.0,130.15,1400.0,35
HCPCS,553000,PREPARE SPERM DUCT X-RAY,,,205.1,205.1,1
HCPCS,55400,REPAIR OF SPERM DUCT,,,555.26,7477.94,15
HCPCS,55400,Repair of sperm duct,,,1256.84,1587.59,6
HCPCS,55400,VASOVASOSTOMY VASOVASORRHAPHY,3788.0,2462.2,276.03,3788.0,32
HCPCS,554000,REPAIR OF SPERM DUCT,,,555.26,555.26,1
HCPCS,55500,EXC HYDROCELE SPRMATIC CORD UNI SPX,2488.0,1617.2,261.12,2488.0,35
HCPCS,55500,REMOVAL OF HYDROCELE,,,435.37,7477.94,15
HCPCS,55500,Removal of hydrocele,,,1407.62,1778.05,6
HCPCS,555000,REMOVAL OF HYDROCELE,,,435.37,435.37,1
HCPCS,55520,EXC LESION SPERMATIC CORD SEPARATE PROCEDURE,2664.0,1731.6,248.93,2664.0,35
HCPCS,55520,REMOVAL OF SPERM CORD LESION,,,511.97,7477.94,15
HCPCS,55520,Removal of sperm cord lesion,,,1407.62,1778.05,6
HCPCS,555200,REMOVAL OF SPERM CORD LESION,,,511.97,511.97,1
HCPCS,55530,EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX,2300.0,1495.0,269.71,2300.0,35
HCPCS,55530,REVISE SPERMATIC CORD VEINS,,,391.23,7477.94,15
HCPCS,55530,Revise spermatic cord veins,,,1256.84,1587.59,6
HCPCS,555300,REVISE SPERMATIC CORD VEINS,,,391.23,391.23,1
HCPCS,55535,EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL,2876.0,1869.4,290.39,2876.0,35
HCPCS,55535,REVISE SPERMATIC CORD VEINS,,,478.05,13528.81,15
HCPCS,55535,Revise spermatic cord veins,,,1407.62,1778.05,6
HCPCS,555350,REVISE SPERMATIC CORD VEINS,,,478.05,478.05,1
HCPCS,55540,EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR,3320.0,2158.0,331.79,3320.0,35
HCPCS,55540,REVISE HERNIA & SPERM VEINS,,,620.98,7651.58,15
HCPCS,55540,Revise hernia & sperm veins,,,1256.84,1587.59,6
HCPCS,555400,REVISE HERNIA & SPERM VEINS,,,620.98,620.98,1
HCPCS,55550,LAPARO LIGATE SPERMATIC VEIN,,,477.39,12649.85,15
HCPCS,55550,LAPS LIGATION SPERMATIC VEINS VARICOCELE,2880.0,1872.0,286.8,2880.0,35
HCPCS,55550,Laparo ligate spermatic vein,,,1256.84,1587.59,6
HCPCS,555500,LAPARO LIGATE SPERMATIC VEIN,,,477.39,477.39,1
HCPCS,55559,LAPAROSCOPIC EXCISION OF SPERMATIC CORD LESION (COMP 55520),2664.0,1731.6,305.68,2664.0,15
HCPCS,55559,UNLSTD LAPS PX SPRMATIC CORD,,,5856.41,12649.85,14
HCPCS,55559,Unlstd laps px sprmatic cord,,,1407.62,1778.05,6
HCPCS,55600,VESICULOTOMY,,,468.67,4441.51,15
HCPCS,55600,Vesiculotomy,,,1407.62,1778.05,6
HCPCS,556000,VESICULOTOMY,,,468.67,468.67,1
HCPCS,55605,VESICULOTOMY COMPLICATED,,,581.85,581.85,1
HCPCS,55605,Vesiculotomy complicated,,,1256.84,1587.59,6
HCPCS,556050,VESICULOTOMY COMPLICATED,,,581.85,581.85,1
HCPCS,55650,REMOVE SPERM DUCT POUCH,,,796.15,796.15,1
HCPCS,55650,Remove sperm duct pouch,,,1256.84,1587.59,6
HCPCS,55650,VESICULECTOMY ANY APPROACH,5060.0,3289.0,500.0,5060.0,35
HCPCS,556500,REMOVE SPERM DUCT POUCH,,,796.15,796.15,1
HCPCS,55680,REMOVE SPERM POUCH LESION,,,385.57,7477.94,15
HCPCS,55680,Remove sperm pouch lesion,,,1256.84,1587.59,6
HCPCS,556800,REMOVE SPERM POUCH LESION,,,385.57,385.57,1
HCPCS,55700,PROSTATE NEEDLE BIOPSY ANY APPROACH,9704.0,6307.6,1043.57,8733.6,90
HCPCS,55705,BIOPSY PROSTATE INCISIONAL ANY APPROACH,1844.0,1198.6,106.99,1844.0,35
HCPCS,55705,BX PRST8 ANY APPROACH NONIMG,,,293.19,7477.94,15
HCPCS,55705,Bx prst8 any approach nonimg,,,1043.57,1318.19,6
HCPCS,557050,BX PRST8 ANY APPROACH NONIMG,,,293.19,293.19,1
HCPCS,55706,BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID,11171.5,7261.474999999999,219.41,17847.9,81
HCPCS,55706,BX PRST8 NDL SAT SAMPLING,,,415.69,415.69,1
HCPCS,557060,BX PRST8 NDL SAT SAMPLING,,,415.69,415.69,1
HCPCS,55707,BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED,10932.5,7106.125,146.93,18637.2,83
HCPCS,55707,BX PRST8 TRCT US GUIDED,,,152.45,152.45,1
HCPCS,557070,BX PRST8 TRCT US GUIDED,,,152.45,152.45,1
HCPCS,55708,BX PROSTATE TRANSRECTAL US GID W/MRI FUS GDN 1ST,11100.0,7215.0,182.74,18637.2,83
HCPCS,55708,BX PRST8 TRCT US W/MRI FUS 1,,,190.19,190.19,1
HCPCS,557080,BX PRST8 TRCT US W/MRI FUS 1,,,190.19,190.19,1
HCPCS,55709,BX PROSTATE TRANSPERINEAL ULTRASOUND-GUIDED,11064.5,7191.925,175.74,18637.2,83
HCPCS,55709,BX PRST8 TPRNL US GUIDED,,,182.64,182.64,1
HCPCS,557090,BX PRST8 TPRNL US GUIDED,,,182.64,182.64,1
HCPCS,55710,BX PROSTATE TRANSPERINEAL US GID W/MRI FUS GDN 1,11192.0,7274.8,202.93,18637.2,83
HCPCS,55710,BX PRST8 TPRN US W/MRI FUS 1,,,211.31,211.31,1
HCPCS,557100,BX PRST8 TPRN US W/MRI FUS 1,,,211.31,211.31,1
HCPCS,55711,BX PROSTATE TRANSRECTAL MRI-US GID TRGT LES 1ST,10928.0,7103.200000000001,146.26,18637.2,83
HCPCS,55711,BX PRST8 TRCT MRI-US 1ST,,,151.7,151.7,1
HCPCS,557110,BX PRST8 TRCT MRI-US 1ST,,,151.7,151.7,1
HCPCS,55712,BX PROSTATE TPRNL MRI-US GID TRGT LES 1ST,11036.0,7173.400000000001,170.43,18637.2,83
HCPCS,55712,BX PRST8 TPRNL MRI-US 1ST,,,176.93,176.93,1
HCPCS,557120,BX PRST8 TPRNL MRI-US 1ST,,,176.93,176.93,1
HCPCS,55713,BX PROSTATE IN-BORE CT/MRI BX ADDL TRGT LES 1ST,16629.0,10808.85,200.66,28348.2,83
HCPCS,55713,BX PRST8 IN-BORE CT/MRI BX 1,,,209.23,209.23,1
HCPCS,557130,BX PRST8 IN-BORE CT/MRI BX 1,,,209.23,209.23,1
HCPCS,55714,BX PROSTATE IN-BORE CT/MRI TRGT LES ONLY 1ST,16545.5,10754.575,182.76,28348.2,83
HCPCS,55714,BX PRST8 IN-BORE CT/MRI 1,,,190.36,190.36,1
HCPCS,557140,BX PRST8 IN-BORE CT/MRI 1,,,190.36,190.36,1
HCPCS,55715,BX PROSTATE EA ADDL MRI-US FUSION/IN-BORE CT/MRI,15980.0,10387.0,51.22,28348.2,77
HCPCS,55715,BX PRST8 EA ADD MRI-US/CT/MR,,,53.22,53.22,1
HCPCS,557150,BX PRST8 EA ADD MRI-US/CT/MR,,,53.22,53.22,1
HCPCS,55720,DRAINAGE OF PROSTATE ABSCESS,,,502.08,7477.94,15
HCPCS,55720,Drainage of prostate abscess,,,1043.57,1318.19,6
HCPCS,557200,DRAINAGE OF PROSTATE ABSCESS,,,502.08,502.08,1
HCPCS,55725,DRAINAGE OF PROSTATE ABSCESS,,,660.87,7477.94,15
HCPCS,55725,Drainage of prostate abscess,,,1043.57,1318.19,6
HCPCS,557250,DRAINAGE OF PROSTATE ABSCESS,,,660.87,660.87,1
HCPCS,55801,PROSTATECTOMY PERINEAL SUBTOTAL,7920.0,5148.0,759.74,7920.0,35
HCPCS,55801,REMOVAL OF PROSTATE,,,1210.79,1210.79,1
HCPCS,55801,Removal of prostate,,,2889.05,3649.33,6
HCPCS,558010,REMOVAL OF PROSTATE,,,1210.79,1210.79,1
HCPCS,55810,EXTENSIVE PROSTATE SURGERY,,,1443.77,1443.77,1
HCPCS,55810,Extensive prostate surgery,,,2889.05,3649.33,6
HCPCS,55810,PROSTATECTOMY PERINEAL RADICAL,9716.0,6315.4,989.29,9716.0,35
HCPCS,558100,EXTENSIVE PROSTATE SURGERY,,,1443.77,1443.77,1
HCPCS,55812,EXTENSIVE PROSTATE SURGERY,,,1774.95,1774.95,1
HCPCS,55812,Extensive prostate surgery,,,2889.05,3649.33,6
HCPCS,55812,PROSTATECTOMY PERINEAL RADICAL W/LYMPH NODE BX,11204.0,7282.6,1116.74,11204.0,35
HCPCS,558120,EXTENSIVE PROSTATE SURGERY,,,1774.95,1774.95,1
HCPCS,55815,EXTENSIVE PROSTATE SURGERY,,,1943.31,1943.31,1
HCPCS,55815,Extensive prostate surgery,,,2889.05,3649.33,6
HCPCS,55815,PROSTATECTOMY PERINEAL RAD W/BI PELVIC LYMPH EXC,12421.0,8073.65,1341.73,12421.0,35
HCPCS,558150,EXTENSIVE PROSTATE SURGERY,,,1943.31,1943.31,1
HCPCS,55821,PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1/2 STAGES,6072.0,3946.8,642.65,6072.0,35
HCPCS,55821,REMOVAL OF PROSTATE,,,928.68,928.68,1
HCPCS,55821,Removal of prostate,,,2889.05,3649.33,6
HCPCS,558210,REMOVAL OF PROSTATE,,,928.68,928.68,1
HCPCS,55831,PROSTATECTOMY RETROPUBIC SUBTOTAL,6240.0,4056.0,658.99,6240.0,35
HCPCS,55831,REMOVAL OF PROSTATE,,,952.3,952.3,1
HCPCS,55831,Removal of prostate,,,2889.05,3649.33,6
HCPCS,558310,REMOVAL OF PROSTATE,,,952.3,952.3,1
HCPCS,55840,EXTENSIVE PROSTATE SURGERY,,,1293.92,1293.92,1
HCPCS,55840,Extensive prostate surgery,,,2889.05,3649.33,6
HCPCS,55840,PROSTATECTOMY RETROPUBIC W/WO NERVE SPARING,8544.0,5553.6,895.17,8544.0,35
HCPCS,558400,EXTENSIVE PROSTATE SURGERY,,,1293.92,1293.92,1
HCPCS,55842,EXTENSIVE PROSTATE SURGERY,,,1293.18,1293.18,1
HCPCS,55842,Extensive prostate surgery,,,2889.05,3649.33,6
HCPCS,55842,PROSTECT RETROPUBIC RAD W/WO NRV SPAR W/LYMPH BX,8544.0,5553.6,893.12,8544.0,35
HCPCS,558420,EXTENSIVE PROSTATE SURGERY,,,1293.18,1293.18,1
HCPCS,55845,EXTENSIVE PROSTATE SURGERY,,,1504.86,1504.86,1
HCPCS,55845,Extensive prostate surgery,,,2889.05,3649.33,6
HCPCS,55845,PROSTECT RETROPUB RAD W/WO NRV SPAR & BI PLV LYM,11079.0,7201.35,1039.43,11079.0,35
HCPCS,558450,EXTENSIVE PROSTATE SURGERY,,,1504.86,1504.86,1
HCPCS,55860,EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST,6970.0,4530.5,547.31,6970.0,35
HCPCS,55860,SURGICAL EXPOSURE PROSTATE,,,967.69,11022.13,15
HCPCS,55860,Surgical exposure prostate,,,2889.05,3649.33,6
HCPCS,558600,SURGICAL EXPOSURE PROSTATE,,,967.69,967.69,1
HCPCS,55862,EXTENSIVE PROSTATE SURGERY,,,1210.7,1210.7,1
HCPCS,55862,Extensive prostate surgery,,,2889.05,3649.33,6
HCPCS,558620,EXTENSIVE PROSTATE SURGERY,,,1210.7,1210.7,1
HCPCS,55865,EXTENSIVE PROSTATE SURGERY,,,1474.02,1474.02,1
HCPCS,55865,Extensive prostate surgery,,,2889.05,3649.33,6
HCPCS,558650,EXTENSIVE PROSTATE SURGERY,,,1474.02,1474.02,1
HCPCS,55866,LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT,9882.0,6423.3,913.04,9882.0,35
HCPCS,55866,LAPS SURG PRST8ECT RPBIC RAD,,,1322.37,22573.24,19
HCPCS,55866,Laps surg prst8ect rpbic rad,,,2889.05,3649.33,6
HCPCS,558660,LAPS SURG PRST8ECT RPBIC RAD,,,1322.37,1322.37,1
HCPCS,55867,LAPS SURG PRST8ECT SMPL STOT,,,1160.78,22573.24,15
HCPCS,55867,LAPS SURG PRST8ECT SMPL STOT ROBOTIC ASSISTANCE,7812.0,5077.8,759.87,7812.0,31
HCPCS,55867,Laps surg prst8ect smpl stot,,,2889.05,3649.33,6
HCPCS,558670,LAPS SURG PRST8ECT SMPL STOT,,,1160.78,1160.78,1
HCPCS,55868,LAP SRG PRST8CT LYMPH NOD BX,,,1242.93,12210.56,5
HCPCS,55868,LAPS SURG PRST8ECT RPBIC RADICAL W/LYMPH NODE BX,9882.0,6423.3,1195.42,9882.0,21
HCPCS,55868,Lap srg prst8ct lymph nod bx,,,2889.05,3649.33,6
HCPCS,558680,LAP SRG PRST8CT LYMPH NOD BX,,,1242.93,1242.93,1
HCPCS,55869,LAP SRG PRST8CT BI PL LMPHAD,,,1492.83,12210.56,5
HCPCS,55869,LAPS SURG PRST8ECT RPBIC RAD W/BI PEL LYMPHADEC,12060.0,7839.0,1435.45,12060.0,21
HCPCS,55869,Lap srg prst8ct bi pl lmphad,,,2889.05,3649.33,6
HCPCS,558690,LAP SRG PRST8CT BI PL LMPHAD,,,1492.83,1492.83,1
HCPCS,55870,ELECTROEJACULATION,,,156.74,1887.91,15
HCPCS,55870,Electroejaculation,,,248.59,314.0,6
HCPCS,558700,ELECTROEJACULATION,,,156.74,156.74,1
HCPCS,55873,CRYOABLATE PROSTATE,,,846.71,20049.35,15
HCPCS,55873,CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI,5440.0,3536.0,606.7,11333.29,35
HCPCS,55873,Cryoablate prostate,,,2889.05,3649.33,6
HCPCS,558730,CRYOABLATE PROSTATE,,,846.71,846.71,1
HCPCS,55874,TPRNL PLMT BIODEGRDABL MATRL,,,180.84,11022.13,15
HCPCS,55874,TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX,1212.0,787.8,127.67,5953.0,28
HCPCS,55874,Tprnl plmt biodegrdabl matrl,,,2889.05,3649.33,6
HCPCS,558740,TPRNL PLMT BIODEGRDABL MATRL,,,180.84,180.84,1
HCPCS,55875,TRANSPERI NEEDLE PLACE PROS,,,861.57,11022.13,15
HCPCS,55875,TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ,5384.0,3499.6,464.33,5384.0,35
HCPCS,55875,Transperi needle place pros,,,2889.05,3649.33,6
HCPCS,558750,TRANSPERI NEEDLE PLACE PROS,,,861.57,861.57,1
HCPCS,55876,PLACE RT DEVICE/MARKER PROS,,,112.63,112.63,1
HCPCS,55876,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,4280.0,2782.0,56.57,7081.2,182
HCPCS,558760,PLACE RT DEVICE/MARKER PROS,,,112.63,112.63,1
HCPCS,55877,ABLATION IRE PRST8 1 OR MORE TUMORS PERCUTANEOUS,5940.0,3861.0,720.55,5940.0,21
HCPCS,55877,ABLTJ IRE PRST8 1+ TUM PERQ,,,752.47,12210.56,5
HCPCS,55877,Abltj ire prst8 1+ tum perq,,,2889.05,3649.33,6
HCPCS,558770,ABLTJ IRE PRST8 1+ TUM PERQ,,,752.47,752.47,1
HCPCS,55880,ABLTJ MAL PRST8 TISS HIFU,,,1084.22,20049.35,15
HCPCS,55880,Abltj mal prst8 tiss hifu,,,2889.05,3649.33,6
HCPCS,55880,TRANSRECTAL ABLTJ MAL PRST8 TISSUE HIFU W/US,7092.0,4609.8,694.5,7092.0,31
HCPCS,558800,ABLTJ MAL PRST8 TISS HIFU,,,1084.22,1084.22,1
HCPCS,55881,ABLATION TRANSURETHRAL PRST8 TISSUE W/THERMAL US,4312.0,2802.8,346.93,14849.53,25
HCPCS,55881,ABLT TRURL PRST8 TIS THRM US,,,528.76,528.76,1
HCPCS,55881,Ablt trurl prst8 tis thrm us,,,1043.57,1318.19,6
HCPCS,558810,ABLT TRURL PRST8 TIS THRM US,,,528.76,528.76,1
HCPCS,55882,ABLT TRURL PRST8 TIS THRM US INS TRURL US TRNSDC,5060.0,3289.0,426.05,15376.36,25
HCPCS,55882,ABLT TRURL PRST8 TIS TRNSDCR,,,648.99,28169.71,15
HCPCS,55882,Ablt trurl prst8 tis trnsdcr,,,2889.05,3649.33,6
HCPCS,558820,ABLT TRURL PRST8 TIS TRNSDCR,,,648.99,648.99,1
HCPCS,55899,ASPIRATION OF SPERMATOCELE (COMP CODE 55000),1291.5,839.475,127.34,8370.0,60
HCPCS,55899,FREE FLAP PHALLOPLASTY (COMP CODE 15757),15975.0,10383.75,127.34,15975.0,15
HCPCS,55899,LAPAROSCOPIC VESICULECTOMY (COMP CODE 55650),5060.0,3289.0,127.34,5060.0,15
HCPCS,55899,MICRODISSECTION TESTICULAR SPERM EXTRACTION (54522),10150.0,6597.5,127.34,14948.1,63
HCPCS,55899,MICROSCOPIC CREMASTERIC LYSIS (COMP CODE 64722),3434.0,2232.1,127.34,3434.0,15
HCPCS,55899,UNLISTED PROCEDURE MALE GENITAL SYSTEM,592.0,384.8,166.35,8370.0,96
HCPCS,55920,PLACE NEEDLES PELVIC FOR RT,,,507.74,10703.04,15
HCPCS,55920,Place needles pelvic for rt,,,2586.74,3267.46,6
HCPCS,559200,PLACE NEEDLES PELVIC FOR RT,,,507.74,507.74,1
HCPCS,55970,SEX TRANSFORMATION M TO F,,,4367.53,10703.04,15
HCPCS,55970,Sex transformation m to f,,,1932.48,2441.03,6
HCPCS,559700,SEX TRANSFORMATION M TO F,,,4367.53,4367.53,1
HCPCS,55980,SEX TRANSFORMATION F TO M,,,3462.01,7477.94,15
HCPCS,55980,Sex transformation f to m,,,3423.14,4323.96,6
HCPCS,559800,SEX TRANSFORMATION F TO M,,,4610.81,4610.81,1
HCPCS,56405,I&D VULVA/PERINEAL ABSCESS,1172.5,762.125,65.79,4151.0,229
HCPCS,564050,I&D VULVA/PERINEAL ABSCESS,,,131.95,131.95,1
HCPCS,56420,I&D BARTHOLINS GLAND ABSCESS,,,115.38,115.38,1
HCPCS,56420,I&D OF BARTHOLINS GLAND ABSCESS,866.0,562.9,54.74,4151.0,179
HCPCS,564200,I&D BARTHOLINS GLAND ABSCESS,,,115.38,115.38,1
HCPCS,56440,MARSUP BARTHOLIN GLAND CYST,1156.0,751.4,140.43,1156.0,35
HCPCS,56440,MRSPLZATN BRTHLNS GLND CST,,,191.15,6893.74,15
HCPCS,56440,Mrsplzatn brthlns glnd cst,,,1571.68,1985.28,6
HCPCS,564400,MRSPLZATN BRTHLNS GLND CST,,,191.15,191.15,1
HCPCS,56441,LYSIS LABIAL ADHESIONS,808.0,525.2,104.49,606.0,35
HCPCS,56441,LYSIS OF LABIAL ADHESIONS,,,162.12,6893.74,15
HCPCS,56441,Lysis of labial adhesions,,,1571.68,1985.28,6
HCPCS,564410,LYSIS OF LABIAL ADHESIONS,,,162.12,162.12,1
HCPCS,56442,HYMENOTOMY,,,49.54,49.54,1
HCPCS,56442,HYMENOTOMY SIMPLE INCISION,18283.0,11883.95,55.75,16454.7,49
HCPCS,56442,"HYMENOTOMY, SIMPLE INCISION",272.0,176.8,27.81,272.0,35
HCPCS,564420,HYMENOTOMY,,,49.54,49.54,1
HCPCS,56501,DESTROY VULVA LESIONS SIM,,,138.75,138.75,1
HCPCS,56501,DESTRUCTION LESIONS VULVA SIMPLE,5575.0,3623.75,65.27,9466.2,81
HCPCS,565010,DESTROY VULVA LESIONS SIM,,,138.75,138.75,1
HCPCS,56515,DESTROY VULVA LESION/S COMPL,,,222.63,222.63,1
HCPCS,56515,DESTRUCTION LESIONS VULVA EXTENSIVE,5936.5,3858.725,104.22,13665.0,81
HCPCS,565150,DESTROY VULVA LESION/S COMPL,,,222.63,222.63,1
HCPCS,56605,BIOPSY OF VULVA/PERINEUM,,,62.27,62.27,1
HCPCS,56605,BIOPSY VULVA/PERINEUM 1 LESION SPX,2723.0,1769.95,28.79,4505.4,81
HCPCS,566050,BIOPSY OF VULVA/PERINEUM,,,62.27,62.27,1
HCPCS,56606,BIOPSY OF VULVA/PERINEUM,,,30.65,30.65,1
HCPCS,56606,BIOPSY VULVA/PERINEUM EACH ADDL LESION,600.0,390.0,19.23,3920.0,70
HCPCS,566060,BIOPSY OF VULVA/PERINEUM,,,30.65,30.65,1
HCPCS,56620,VULVECTOMY SIMPLE PARTIAL,3313.0,2153.45,378.82,10738.0,53
HCPCS,56620,Vulvectomy simple partial,,,1571.68,1985.28,6
HCPCS,566200,VULVECTOMY SIMPLE PARTIAL,,,612.95,612.95,1
HCPCS,56625,VULVECTOMY SIMPLE COMPLETE,4259.0,2768.35,478.98,6893.74,50
HCPCS,56625,Vulvectomy simple complete,,,3423.14,4323.96,6
HCPCS,566250,VULVECTOMY SIMPLE COMPLETE,,,701.61,701.61,1
HCPCS,56630,VULVECTOMY RADICAL PARTIAL,6512.0,4232.8,700.63,6512.0,40
HCPCS,56630,Vulvectomy radical partial,,,3423.14,4323.96,6
HCPCS,566300,VULVECTOMY RADICAL PARTIAL,,,1010.38,1010.38,1
HCPCS,56631,VLVCTMY RAD PRTL UNI LYMPHAD,,,1249.89,1249.89,1
HCPCS,56631,VULVECTOMY RAD PRTL UNI INGUINOFEM LMPHADECTOMY,7596.0,4937.4,883.28,7596.0,35
HCPCS,56631,Vlvctmy rad prtl uni lymphad,,,3423.14,4323.96,6
HCPCS,566310,VLVCTMY RAD PRTL UNI LYMPHAD,,,1249.89,1249.89,1
HCPCS,56632,VLVCTMY RAD PRTL BI LYMPHAD,,,1507.28,1507.28,1
HCPCS,56632,VULVECTOMY RAD PRTL BI INGUINOFEM LMPHADECTOMY,8744.0,5683.6,1033.32,8744.0,35
HCPCS,56632,Vlvctmy rad prtl bi lymphad,,,3423.14,4323.96,6
HCPCS,566320,VLVCTMY RAD PRTL BI LYMPHAD,,,1507.28,1507.28,1
HCPCS,56633,VULVECTOMY RADICAL COMPLETE,7848.0,5101.2,824.53,7848.0,36
HCPCS,56633,Vulvectomy radical complete,,,3423.14,4323.96,6
HCPCS,566330,VULVECTOMY RADICAL COMPLETE,,,1304.27,1304.27,1
HCPCS,56634,VLVCTMY RAD COMP UNI LYMPHAD,,,1364.63,1364.63,1
HCPCS,56634,VULVECTOMY RAD COMPL UNI INGUINOFEM LMPHADECTOMY,8264.0,5371.6,888.94,8264.0,35
HCPCS,56634,Vlvctmy rad comp uni lymphad,,,3423.14,4323.96,6
HCPCS,566340,VLVCTMY RAD COMP UNI LYMPHAD,,,1364.63,1364.63,1
HCPCS,56637,VLVCTMY RAD COMP BI LYMPHAD,,,1599.85,1599.85,1
HCPCS,56637,VULVECTOMY RAD COMPL BI INGUINOFEM LMPHADECTOMY,9900.0,6435.0,1035.44,9900.0,35
HCPCS,56637,Vlvctmy rad comp bi lymphad,,,3423.14,4323.96,6
HCPCS,566370,VLVCTMY RAD COMP BI LYMPHAD,,,1599.85,1599.85,1
HCPCS,56640,VLVCTMY RAD COMP W/LYMPHADEC,,,1607.81,1607.81,1
HCPCS,56640,VULVECTOMY RAD COMPL ILIAC & PELVIC LMPHADECTOMY,9912.0,6442.8,1111.21,9912.0,35
HCPCS,56640,Vlvctmy rad comp w/lymphadec,,,3423.14,4323.96,6
HCPCS,566400,VLVCTMY RAD COMP W/LYMPHADEC,,,1607.81,1607.81,1
HCPCS,56700,PRTL HYMENECTOMY/REVJ HYMENAL RING,1136.0,738.4,125.25,1136.0,35
HCPCS,56700,PRTL HYMNCTMY/REVJ HYMNL RNG,,,212.57,6893.74,15
HCPCS,56700,Prtl hymnctmy/revj hymnl rng,,,1571.68,1985.28,6
HCPCS,567000,PRTL HYMNCTMY/REVJ HYMNL RNG,,,212.57,212.57,1
HCPCS,56740,EXC BARTHOLINS GLAND/CYST,1952.0,1268.8,184.24,6893.74,50
HCPCS,56740,Exc bartholins gland/cyst,,,1571.68,1985.28,6
HCPCS,567400,EXC BARTHOLINS GLAND/CYST,,,331.04,331.04,1
HCPCS,56800,PLASTIC REPAIR INTROITUS,1572.0,1021.8,186.98,6893.74,50
HCPCS,56800,Plastic repair introitus,,,1571.68,1985.28,6
HCPCS,568000,PLASTIC REPAIR INTROITUS,,,266.25,266.25,1
HCPCS,56805,CLITOROPLASTY INTERSEX STATE,,,1228.27,6893.74,15
HCPCS,56805,Clitoroplasty intersex state,,,1571.68,1985.28,6
HCPCS,568050,CLITOROPLASTY INTERSEX STATE,,,1228.27,1228.27,1
HCPCS,56810,PERINEOPLASTY RPR PER NONOB,,,287.37,6893.74,16
HCPCS,56810,PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX,1716.0,1115.4,185.35,1716.0,35
HCPCS,56810,Perineoplasty rpr per nonob,,,1571.68,1985.28,6
HCPCS,568100,PERINEOPLASTY RPR PER NONOB,,,287.37,287.37,1
HCPCS,56820,COLPOSCOPY VULVA,1156.0,751.4,88.39,4151.0,47
HCPCS,56820,"COLPOSCOPY, VULVA",600.0,390.0,57.43,450.0,35
HCPCS,568200,COLPOSCOPY VULVA,,,88.39,88.39,1
HCPCS,56821,COLPOSCOPY VULVA W/BIOPSY,1284.5,834.925,74.42,4151.0,82
HCPCS,568210,COLPOSCOPY VULVA W/BIOPSY,,,119.45,119.45,1
HCPCS,57000,COLPOTOMY W/EXPLORATION,1208.0,785.2,137.98,6893.74,50
HCPCS,57000,Colpotomy w/exploration,,,1571.68,1985.28,6
HCPCS,570000,COLPOTOMY W/EXPLORATION,,,211.96,211.96,1
HCPCS,57010,COLPOTOMY DRG PEL ABSCESS,,,481.27,6893.74,15
HCPCS,57010,COLPOTOMY W/DRAINAGE PELVIC ABSCESS,2736.0,1778.4,240.87,2736.0,35
HCPCS,57010,Colpotomy drg pel abscess,,,1571.68,1985.28,6
HCPCS,570100,COLPOTOMY DRG PEL ABSCESS,,,481.27,481.27,1
HCPCS,57020,COLPOCENTESIS SEP PX,,,83.52,10703.04,15
HCPCS,57020,COLPOCENTESIS SEPARATE PROCEDURE,600.0,390.0,58.66,450.0,35
HCPCS,57020,Colpocentesis sep px,,,325.92,411.68,6
HCPCS,570200,COLPOCENTESIS SEP PX,,,83.52,83.52,1
HCPCS,57022,I&D VAGINAL HEMATOMA OB/PP,,,190.19,190.19,1
HCPCS,57022,"INCISION AND DRAINAGE HEMATOMA, VAGINAL OB/POSTPARTUM",4833.0,3141.45,206.8,7730.0,49
HCPCS,570220,I&D VAGINAL HEMATOMA OB/PP,,,190.19,190.19,1
HCPCS,57023,I&D VAGINAL HEMATOMA NON-OB,,,337.13,6205.4,15
HCPCS,57023,I&D VAGINAL HEMATOMA NON-OBSTETRICAL,2072.0,1346.8,170.79,2072.0,35
HCPCS,57023,I&d vaginal hematoma non-ob,,,1571.68,1985.28,6
HCPCS,570230,I&D VAGINAL HEMATOMA NON-OB,,,337.13,337.13,1
HCPCS,57061,DESTRUCTION VAG LESIONS SMPL,,,119.75,119.75,1
HCPCS,57061,DESTRUCTION VAGINAL LESIONS SIMPLE,9427.5,6127.875,56.38,16454.7,81
HCPCS,570610,DESTRUCTION VAG LESIONS SMPL,,,119.75,119.75,1
HCPCS,57065,DESTRUCTION VAG LESION XTNSV,,,194.79,6893.74,15
HCPCS,57065,DESTRUCTION VAGINAL LESIONS EXTENSIVE,1170.0,760.5,121.3,877.5,35
HCPCS,57065,Destruction vag lesion xtnsv,,,1571.68,1985.28,6
HCPCS,570650,DESTRUCTION VAG LESION XTNSV,,,194.79,194.79,1
HCPCS,57100,BIOPSY VAGINAL MUCOSA SIMPLE,2743.0,1782.95,37.55,4505.4,82
HCPCS,571000,BIOPSY VAGINAL MUCOSA SIMPLE,,,68.9,68.9,1
HCPCS,57105,BIOPSY VAGINAL MUCOSA EXTENSIVE,696.0,452.4,88.2,522.0,35
HCPCS,57105,BIOPSY VAGINAL MUCOSA XTNSV,,,152.58,6893.74,15
HCPCS,57105,Biopsy vaginal mucosa xtnsv,,,1571.68,1985.28,6
HCPCS,571050,BIOPSY VAGINAL MUCOSA XTNSV,,,152.58,152.58,1
HCPCS,57106,VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL,3000.0,1950.0,264.16,3000.0,35
HCPCS,57106,VAGNC PRTL RMVL VAG WALL,,,562.57,6893.74,15
HCPCS,57106,Vagnc prtl rmvl vag wall,,,1571.68,1985.28,6
HCPCS,571060,VAGNC PRTL RMVL VAG WALL,,,562.57,562.57,1
HCPCS,57107,VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T,9824.0,6385.6,771.93,9824.0,35
HCPCS,57107,VAGNC COMPL RMVL PARAVAG TIS,,,1535.99,6893.74,15
HCPCS,57107,Vagnc compl rmvl paravag tis,,,3423.14,4323.96,6
HCPCS,571070,VAGNC COMPL RMVL PARAVAG TIS,,,1535.99,1535.99,1
HCPCS,57109,VAGNC BI TOTAL PEL LYMPHADEC,,,1823.16,6893.74,15
HCPCS,57109,VAGNC PRTL RMVL VAG WALL W/BI TOT PEL LMPHADEC,11360.0,7384.0,880.13,11360.0,35
HCPCS,57109,Vagnc bi total pel lymphadec,,,3423.14,4323.96,6
HCPCS,571090,VAGNC BI TOTAL PEL LYMPHADEC,,,1823.16,1823.16,1
HCPCS,57110,VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL,6192.0,4024.8,604.1,6192.0,35
HCPCS,57110,VAGNC COMPL RMVL VAG WALL,,,952.11,952.11,1
HCPCS,57110,Vagnc compl rmvl vag wall,,,3423.14,4323.96,6
HCPCS,571100,VAGNC COMPL RMVL VAG WALL,,,952.11,952.11,1
HCPCS,57111,VAGINECTOMY COMPL RMVL VAG WALL & PARAVAG TISS,11360.0,7384.0,900.22,11360.0,35
HCPCS,57111,VAGNC COMPL RMVL PARAVAG TIS,,,1823.16,1823.16,1
HCPCS,57111,Vagnc compl rmvl paravag tis,,,3423.14,4323.96,6
HCPCS,571110,VAGNC COMPL RMVL PARAVAG TIS,,,1823.16,1823.16,1
HCPCS,57112,Vaginectomy w/nodes compl,,,3423.14,4323.96,6
HCPCS,57120,COLPOCLEISIS LE FORT TYPE,3312.0,2152.8,389.4,10703.04,50
HCPCS,57120,Colpocleisis le fort type,,,3423.14,4323.96,6
HCPCS,571200,COLPOCLEISIS LE FORT TYPE,,,557.98,557.98,1
HCPCS,57130,EXCIS VAGINAL SEPTUM,984.0,639.6,115.8,738.0,35
HCPCS,57130,EXCISION VAGINAL SEPTUM,,,181.29,6893.74,15
HCPCS,57130,Excision vaginal septum,,,1571.68,1985.28,6
HCPCS,571300,EXCISION VAGINAL SEPTUM,,,181.29,181.29,1
HCPCS,57135,EXCIS VAGINAL CYST/TUMOR,1080.0,702.0,109.43,810.0,35
HCPCS,57135,EXCISION VAGINAL CYST/TUMOR,,,196.92,6893.74,18
HCPCS,57135,Excision vaginal cyst/tumor,,,1571.68,1985.28,6
HCPCS,571350,EXCISION VAGINAL CYST/TUMOR,,,196.92,196.92,1
HCPCS,57150,IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE,200.0,130.0,23.69,150.0,35
HCPCS,57150,TREAT VAGINA INFECTION,,,27.17,128.79,15
HCPCS,57150,Treat vagina infection,,,132.47,167.33,6
HCPCS,571500,TREAT VAGINA INFECTION,,,27.17,27.17,1
HCPCS,57155,INSERT UTERI TANDEM/OVOIDS,,,296.18,296.18,1
HCPCS,57155,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,15325.5,9961.575,153.61,25546.5,130
HCPCS,571550,INSERT UTERI TANDEM/OVOIDS,,,296.18,296.18,1
HCPCS,57156,INS VAG BRACHYTX DEVICE,,,157.6,157.6,1
HCPCS,57156,INSERTION VAGINAL RADIATION DEVICE,1412.5,918.125,72.33,4214.0,127
HCPCS,571560,INS VAG BRACHYTX DEVICE,,,157.6,157.6,1
HCPCS,57160,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,756.0,491.4,30.08,3920.0,130
HCPCS,57160,INSERT PESSARY/OTHER DEVICE,,,48.33,48.33,1
HCPCS,571600,INSERT PESSARY/OTHER DEVICE,,,48.33,48.33,1
HCPCS,57170,DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS,760.0,494.0,27.47,3920.0,81
HCPCS,57170,FITTING OF DIAPHRAGM/CAP,,,49.74,49.74,1
HCPCS,571700,FITTING OF DIAPHRAGM/CAP,,,49.74,49.74,1
HCPCS,57180,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,904.0,587.6,59.67,4151.0,130
HCPCS,57180,TREAT VAGINAL BLEEDING,,,126.22,126.22,1
HCPCS,571800,TREAT VAGINAL BLEEDING,,,126.22,126.22,1
HCPCS,57200,COLPORRHAPHY SUTURE INJURY VAGINA,10025.5,6516.575000000001,185.47,16454.7,84
HCPCS,57200,REPAIR OF VAGINA,,,347.85,347.85,1
HCPCS,572000,REPAIR OF VAGINA,,,347.85,347.85,1
HCPCS,57210,COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU,2284.0,1484.6,232.19,2284.0,35
HCPCS,57210,REPAIR VAGINA/PERINEUM,,,412.83,6893.74,15
HCPCS,57210,Repair vagina/perineum,,,1571.68,1985.28,6
HCPCS,572100,REPAIR VAGINA/PERINEUM,,,412.83,412.83,1
HCPCS,57220,PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH,1940.0,1261.0,236.47,1940.0,35
HCPCS,57220,REVISION OF URETHRA,,,362.49,10703.04,15
HCPCS,57220,Revision of urethra,,,1849.92,2336.74,6
HCPCS,572200,REVISION OF URETHRA,,,362.49,362.49,1
HCPCS,57230,PLASTIC REPAIR URETHROCELE,2520.0,1638.0,258.7,2520.0,35
HCPCS,57230,REPAIR OF URETHRAL LESION,,,440.83,6893.74,15
HCPCS,57230,Repair of urethral lesion,,,1849.92,2336.74,6
HCPCS,572300,REPAIR OF URETHRAL LESION,,,440.83,440.83,1
HCPCS,57240,ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO,4032.0,2620.8,348.57,4032.0,35
HCPCS,57240,ANTERIOR COLPORRHAPHY,,,645.35,10703.04,16
HCPCS,57240,Anterior colporrhaphy,,,1849.92,2336.74,6
HCPCS,572400,ANTERIOR COLPORRHAPHY,,,645.35,645.35,1
HCPCS,57250,POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY,4435.0,2882.75,330.35,4435.0,35
HCPCS,57250,REPAIR RECTUM & VAGINA,,,648.24,10703.04,16
HCPCS,57250,Repair rectum & vagina,,,901.17,1138.32,6
HCPCS,572500,REPAIR RECTUM & VAGINA,,,648.24,648.24,1
HCPCS,57260,CMBN ANT PST COLPRHY,,,820.49,10703.04,16
HCPCS,57260,CMBND ANTERPOST COLPORRAPHY W/CYSTO,5830.0,3789.5,454.2,5830.0,35
HCPCS,57260,Cmbn ant pst colprhy,,,1849.92,2336.74,6
HCPCS,572600,CMBN ANT PST COLPRHY,,,820.49,820.49,1
HCPCS,57265,CMBN AP COLPRHY W/NTRCL RPR,,,918.12,10703.04,16
HCPCS,57265,CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR,6000.0,3900.0,554.77,6000.0,35
HCPCS,57265,Cmbn ap colprhy w/ntrcl rpr,,,901.17,1138.32,6
HCPCS,572650,CMBN AP COLPRHY W/NTRCL RPR,,,918.12,918.12,1
HCPCS,57267,INSERT MESH/PELVIC FLR ADDON,,,263.23,263.23,1
HCPCS,57267,INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE,1952.0,1268.8,190.73,1952.0,35
HCPCS,57267,Insert mesh/pelvic flr addon,,,3664.3,4628.59,6
HCPCS,572670,INSERT MESH/PELVIC FLR ADDON,,,263.23,263.23,1
HCPCS,57268,REPAIR ENTEROCELE VAGINAL APPROACH SPX,3028.0,1968.2,370.99,3028.0,35
HCPCS,57268,REPAIR OF BOWEL BULGE,,,531.6,10703.04,16
HCPCS,57268,Repair of bowel bulge,,,901.17,1138.32,6
HCPCS,572680,REPAIR OF BOWEL BULGE,,,531.6,531.6,1
HCPCS,57270,REPAIR ENTEROCELE ABDOMINAL APPROACH SPX,5468.0,3554.2,459.99,5468.0,35
HCPCS,57270,REPAIR OF BOWEL POUCH,,,856.53,856.53,1
HCPCS,57270,Repair of bowel pouch,,,901.17,1138.32,6
HCPCS,572700,REPAIR OF BOWEL POUCH,,,856.53,856.53,1
HCPCS,57280,COLPOPEXY ABDOMINAL APPROACH,6688.0,4347.2,550.9,6688.0,35
HCPCS,57280,SUSPENSION OF VAGINA,,,1016.12,1016.12,1
HCPCS,57280,Suspension of vagina,,,3423.14,4323.96,6
HCPCS,572800,SUSPENSION OF VAGINA,,,1016.12,1016.12,1
HCPCS,57282,COLPOPEXY EXTRAPERITONEAL,,,730.38,16033.17,16
HCPCS,57282,COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH,4652.0,3023.8,342.39,4652.0,35
HCPCS,57282,Colpopexy extraperitoneal,,,1571.68,1985.28,6
HCPCS,572820,COLPOPEXY EXTRAPERITONEAL,,,730.38,730.38,1
HCPCS,57283,COLPOPEXY INTRAPERITONEAL,,,735.71,16033.17,15
HCPCS,57283,COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH,4664.0,3031.6,492.76,4664.0,35
HCPCS,57283,Colpopexy intraperitoneal,,,1571.68,1985.28,6
HCPCS,572830,COLPOPEXY INTRAPERITONEAL,,,735.71,735.71,1
HCPCS,57284,PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR,5732.0,3725.8,556.04,5732.0,35
HCPCS,57284,REPAIR PARAVAG DEFECT OPEN,,,876.19,10703.04,15
HCPCS,57284,Repair paravag defect open,,,3423.14,4323.96,6
HCPCS,572840,REPAIR PARAVAG DEFECT OPEN,,,876.19,876.19,1
HCPCS,57285,PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH,4640.0,3016.0,396.41,4640.0,35
HCPCS,57285,REPAIR PARAVAG DEFECT VAG,,,728.61,16033.17,15
HCPCS,57285,Repair paravag defect vag,,,1571.68,1985.28,6
HCPCS,572850,REPAIR PARAVAG DEFECT VAG,,,728.61,728.61,1
HCPCS,57287,REVISE/REMOVE SLING REPAIR,,,777.0,6893.74,15
HCPCS,57287,RMVL/REVJ SLING STRESS INCONTINENCE,4460.0,2899.0,510.9,4460.0,35
HCPCS,57287,Revise/remove sling repair,,,1849.92,2336.74,6
HCPCS,572870,REVISE/REMOVE SLING REPAIR,,,777.0,777.0,1
HCPCS,57288,REPAIR BLADDER DEFECT,,,781.2,10703.04,18
HCPCS,57288,Repair bladder defect,,,1849.92,2336.74,6
HCPCS,57288,SLING OPER STRES INCONTINENCE,5337.0,3469.05,572.95,5337.0,35
HCPCS,572880,REPAIR BLADDER DEFECT,,,781.2,781.2,1
HCPCS,57289,PEREYA PROC+ANTER COLPORRHAPHY,5120.0,3328.0,438.13,5120.0,35
HCPCS,57289,REPAIR BLADDER & VAGINA,,,835.51,16033.17,15
HCPCS,57289,Repair bladder & vagina,,,1849.92,2336.74,6
HCPCS,572890,REPAIR BLADDER & VAGINA,,,835.51,835.51,1
HCPCS,57291,CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT,3456.0,2246.4,366.54,3456.0,35
HCPCS,57291,CONSTRUCTION OF VAGINA,,,579.06,10703.04,15
HCPCS,57291,Construction of vagina,,,3423.14,4323.96,6
HCPCS,572910,CONSTRUCTION OF VAGINA,,,579.06,579.06,1
HCPCS,57292,CONSTRUCT VAGINA WITH GRAFT,,,872.96,10703.04,15
HCPCS,57292,CONSTRUCTION ARTIFICIAL VAGINA W/GRAFT,5604.0,3642.6,539.42,5604.0,35
HCPCS,57292,Construct vagina with graft,,,3423.14,4323.96,6
HCPCS,572920,CONSTRUCT VAGINA WITH GRAFT,,,872.96,872.96,1
HCPCS,57295,REVISE VAG GRAFT VIA VAGINA,,,526.88,6893.74,15
HCPCS,57295,REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP,3128.0,2033.2,337.77,3128.0,35
HCPCS,57295,Revise vag graft via vagina,,,1571.68,1985.28,6
HCPCS,572950,REVISE VAG GRAFT VIA VAGINA,,,526.88,526.88,1
HCPCS,57296,REVISE VAG GRAFT OPEN ABD,,,1010.42,1010.42,1
HCPCS,57296,REVJ W/RMVL PROSTHETIC VAGINAL GRAFT ABDML APPR,6624.0,4305.6,548.39,6624.0,35
HCPCS,57296,Revise vag graft open abd,,,3423.14,4323.96,6
HCPCS,572960,REVISE VAG GRAFT OPEN ABD,,,1010.42,1010.42,1
HCPCS,57300,CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR,3484.0,2264.6,416.24,3484.0,35
HCPCS,57300,REPAIR RECTUM-VAGINA FISTULA,,,642.06,6893.74,15
HCPCS,57300,Repair rectum-vagina fistula,,,3423.14,4323.96,6
HCPCS,573000,REPAIR RECTUM-VAGINA FISTULA,,,642.06,642.06,1
HCPCS,57305,CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH,6140.0,3991.0,582.23,6140.0,35
HCPCS,57305,REPAIR RECTUM-VAGINA FISTULA,,,1026.67,1026.67,1
HCPCS,57305,Repair rectum-vagina fistula,,,1410.62,1781.83,6
HCPCS,573050,REPAIR RECTUM-VAGINA FISTULA,,,1026.67,1026.67,1
HCPCS,57307,CLSR RECTOVAG FSTL ABDL APPR W/CONCOMITANT CLST,6868.0,4464.2,609.45,6868.0,35
HCPCS,57307,FISTULA REPAIR & COLOSTOMY,,,1127.88,1127.88,1
HCPCS,57307,Fistula repair & colostomy,,,3423.14,4323.96,6
HCPCS,573070,FISTULA REPAIR & COLOSTOMY,,,1127.88,1127.88,1
HCPCS,57308,CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ,4236.0,2753.4,457.85,4236.0,35
HCPCS,57308,FISTULA REPAIR TRANSPERINE,,,695.58,695.58,1
HCPCS,57308,Fistula repair transperine,,,1571.68,1985.28,6
HCPCS,573080,FISTULA REPAIR TRANSPERINE,,,695.58,695.58,1
HCPCS,57310,CLOSE URETHROVAGINAL FISTULA,3060.0,1989.0,297.54,3060.0,35
HCPCS,57310,REPAIR URETHROVAGINAL LESION,,,515.94,16033.17,15
HCPCS,57310,Repair urethrovaginal lesion,,,3423.14,4323.96,6
HCPCS,573100,REPAIR URETHROVAGINAL LESION,,,515.94,515.94,1
HCPCS,57311,CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL,3564.0,2316.6,353.39,3564.0,35
HCPCS,57311,REPAIR URETHROVAGINAL LESION,,,581.91,581.91,1
HCPCS,57311,Repair urethrovaginal lesion,,,3423.14,4323.96,6
HCPCS,573110,REPAIR URETHROVAGINAL LESION,,,581.91,581.91,1
HCPCS,57320,CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH,3552.0,2308.8,419.36,3552.0,35
HCPCS,57320,REPAIR BLADDER-VAGINA LESION,,,594.75,10703.04,15
HCPCS,57320,Repair bladder-vagina lesion,,,3423.14,4323.96,6
HCPCS,573200,REPAIR BLADDER-VAGINA LESION,,,594.75,594.75,1
HCPCS,57330,CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR,5284.0,3434.6,539.72,5284.0,35
HCPCS,57330,REPAIR BLADDER-VAGINA LESION,,,802.93,16033.17,15
HCPCS,57330,Repair bladder-vagina lesion,,,3423.14,4323.96,6
HCPCS,573300,REPAIR BLADDER-VAGINA LESION,,,802.93,802.93,1
HCPCS,57335,REPAIR VAGINA,,,1240.6,10703.04,15
HCPCS,57335,Repair vagina,,,3423.14,4323.96,6
HCPCS,573350,REPAIR VAGINA,,,1240.6,1240.6,1
HCPCS,57400,DILATION OF VAGINA,,,137.03,6893.74,15
HCPCS,57400,DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL,908.0,590.2,97.13,908.0,35
HCPCS,57400,Dilation of vagina,,,1571.68,1985.28,6
HCPCS,574000,DILATION OF VAGINA,,,137.03,137.03,1
HCPCS,57410,PELVIC EXAMINATION,,,111.35,6893.74,16
HCPCS,57410,PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL,700.0,455.0,81.45,700.0,35
HCPCS,57410,Pelvic examination,,,132.47,167.33,6
HCPCS,574100,PELVIC EXAMINATION,,,111.35,111.35,1
HCPCS,57415,REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL,996.0,647.4,86.14,996.0,35
HCPCS,57415,REMOVE VAGINAL FOREIGN BODY,,,183.96,6893.74,15
HCPCS,57415,Remove vaginal foreign body,,,1571.68,1985.28,6
HCPCS,574150,REMOVE VAGINAL FOREIGN BODY,,,183.96,183.96,1
HCPCS,57420,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,1194.5,776.425,60.29,4151.0,130
HCPCS,57420,EXAM OF VAGINA W/SCOPE,,,94.36,94.36,1
HCPCS,574200,EXAM OF VAGINA W/SCOPE,,,94.36,94.36,1
HCPCS,57421,COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX,2943.0,1912.95,78.64,4505.4,81
HCPCS,57421,EXAM/BIOPSY OF VAG W/SCOPE,,,128.25,128.25,1
HCPCS,574210,EXAM/BIOPSY OF VAG W/SCOPE,,,128.25,128.25,1
HCPCS,57423,PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH,6432.0,4180.8,556.67,6432.0,35
HCPCS,57423,REPAIR PARAVAG DEFECT LAP,,,977.54,22573.24,15
HCPCS,57423,Repair paravag defect lap,,,3423.14,4323.96,6
HCPCS,574230,REPAIR PARAVAG DEFECT LAP,,,977.54,977.54,1
HCPCS,57425,LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX,6812.0,4427.8,618.48,6812.0,35
HCPCS,57425,LAPAROSCOPY SURG COLPOPEXY,,,1024.49,22573.24,17
HCPCS,57425,Laparoscopy surg colpopexy,,,3423.14,4323.96,6
HCPCS,574250,LAPAROSCOPY SURG COLPOPEXY,,,1024.49,1024.49,1
HCPCS,57426,REVISE PROSTH VAG GRAFT LAP,,,917.96,16033.17,15
HCPCS,57426,REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC,5720.0,3718.0,481.86,5720.0,35
HCPCS,57426,Revise prosth vag graft lap,,,3423.14,4323.96,6
HCPCS,574260,REVISE PROSTH VAG GRAFT LAP,,,917.96,917.96,1
HCPCS,57452,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,878.0,570.7,67.74,4151.0,130
HCPCS,57452,EXAM OF CERVIX W/SCOPE,,,95.27,95.27,1
HCPCS,574520,EXAM OF CERVIX W/SCOPE,,,95.27,95.27,1
HCPCS,57454,BX/CURETT OF CERVIX W/SCOPE,,,140.5,140.5,1
HCPCS,57454,COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE,1340.5,871.3249999999999,97.88,4151.0,81
HCPCS,574540,BX/CURETT OF CERVIX W/SCOPE,,,140.5,140.5,1
HCPCS,57455,BIOPSY OF CERVIX W/SCOPE,,,114.25,114.25,1
HCPCS,57455,COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX,1272.5,827.125,72.04,4151.0,81
HCPCS,574550,BIOPSY OF CERVIX W/SCOPE,,,114.25,114.25,1
HCPCS,57456,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,1244.5,808.925,67.25,4151.0,81
HCPCS,57456,ENDOCERV CURETTAGE W/SCOPE,,,106.51,106.51,1
HCPCS,574560,ENDOCERV CURETTAGE W/SCOPE,,,106.51,106.51,1
HCPCS,57460,BX OF CERVIX W/SCOPE LEEP,,,167.67,167.67,1
HCPCS,57460,COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX,9707.5,6309.875,94.59,16454.7,81
HCPCS,574600,BX OF CERVIX W/SCOPE LEEP,,,167.67,167.67,1
HCPCS,57461,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,9827.5,6387.875,115.13,16454.7,81
HCPCS,57461,CONZ OF CERVIX W/SCOPE LEEP,,,192.62,192.62,1
HCPCS,574610,CONZ OF CERVIX W/SCOPE LEEP,,,192.62,192.62,1
HCPCS,57465,CAM CERVIX UTERI DRG COLP,,,44.8,44.8,1
HCPCS,57465,COMPUTER-AIDED MAPG CERVIX UTERI DRG COLPOSCOPY,324.0,210.6,32.02,243.0,31
HCPCS,57465,Cam cervix uteri drg colp,,,325.92,411.68,6
HCPCS,574650,CAM CERVIX UTERI DRG COLP,,,44.8,44.8,1
HCPCS,57500,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,2767.0,1798.55,41.49,4505.4,179
HCPCS,57500,BIOPSY OF CERVIX,,,78.73,78.73,1
HCPCS,575000,BIOPSY OF CERVIX,,,78.73,78.73,1
HCPCS,57505,ENDOCERVICAL CURETTAGE,,,113.42,113.42,1
HCPCS,57505,ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C,2741.0,1781.65,53.75,4505.4,81
HCPCS,575050,ENDOCERVICAL CURETTAGE,,,113.42,113.42,1
HCPCS,57510,CAUTERIZATION OF CERVIX,,,119.17,119.17,1
HCPCS,57510,CAUTERY CERVIX ELECTRO/THERMAL,9521.5,6188.975,58.59,16454.7,81
HCPCS,575100,CAUTERIZATION OF CERVIX,,,119.17,119.17,1
HCPCS,57511,CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT,780.0,507.0,101.74,585.0,35
HCPCS,57511,CRYOCAUTERY OF CERVIX,,,154.08,659.53,15
HCPCS,57511,Cryocautery of cervix,,,325.92,411.68,6
HCPCS,575110,CRYOCAUTERY OF CERVIX,,,154.08,154.08,1
HCPCS,57513,CAUTERY CERVIX LASER ABLATION,780.0,507.0,99.29,585.0,35
HCPCS,57513,LASER SURGERY OF CERVIX,,,153.42,6893.74,15
HCPCS,57513,Laser surgery of cervix,,,1486.15,1877.24,6
HCPCS,575130,LASER SURGERY OF CERVIX,,,153.42,153.42,1
HCPCS,57520,CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER,1644.0,1068.6,176.04,1233.0,35
HCPCS,57520,CONIZATION OF CERVIX,,,310.98,10738.0,20
HCPCS,57520,Conization of cervix,,,1486.15,1877.24,6
HCPCS,575200,CONIZATION OF CERVIX,,,310.98,310.98,1
HCPCS,57522,CONIZATION CERVIX W/WO D&C RPR ELTRD EXC,9875.5,6419.075000000001,172.24,16454.7,81
HCPCS,57522,CONIZATION OF CERVIX,,,355.44,355.44,1
HCPCS,575220,CONIZATION OF CERVIX,,,355.44,355.44,1
HCPCS,57530,REMOVAL OF CERVIX,,,392.73,10703.04,15
HCPCS,57530,Removal of cervix,,,1486.15,1877.24,6
HCPCS,57530,TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX,2108.0,1370.2,232.59,2108.0,35
HCPCS,575300,REMOVAL OF CERVIX,,,392.73,392.73,1
HCPCS,57531,RAD TRACHELECTOMY W/BI PEL LMPHADEC,11980.0,7787.0,1231.91,11980.0,35
HCPCS,57531,REMOVAL OF CERVIX RADICAL,,,1945.02,1945.02,1
HCPCS,57531,Removal of cervix radical,,,2714.31,3428.6,6
HCPCS,575310,REMOVAL OF CERVIX RADICAL,,,1945.02,1945.02,1
HCPCS,57540,EXCISION CERVICAL STUMP ABDOMINAL APPROACH,5848.0,3801.2,430.26,5848.0,35
HCPCS,57540,REMOVAL OF RESIDUAL CERVIX,,,834.12,834.12,1
HCPCS,57540,Removal of residual cervix,,,2714.31,3428.6,6
HCPCS,575400,REMOVAL OF RESIDUAL CERVIX,,,834.12,834.12,1
HCPCS,57545,EXC CERVICAL STUMP ABDL APPR W/PELVIC FLOOR RPR,5694.0,3701.1,457.63,5694.0,35
HCPCS,57545,REMOVE CERVIX/REPAIR PELVIS,,,878.91,878.91,1
HCPCS,57545,Remove cervix/repair pelvis,,,2714.31,3428.6,6
HCPCS,575450,REMOVE CERVIX/REPAIR PELVIS,,,878.91,878.91,1
HCPCS,57550,EXCISION CERVICAL STUMP VAGINAL APPROACH,2536.0,1648.4,318.77,2536.0,35
HCPCS,57550,REMOVAL OF RESIDUAL CERVIX,,,454.11,10703.04,15
HCPCS,57550,Removal of residual cervix,,,1486.15,1877.24,6
HCPCS,575500,REMOVAL OF RESIDUAL CERVIX,,,454.11,454.11,1
HCPCS,57555,EXC CRV STUMP VAG APPR W/ANT &/POST REPAIR,3976.0,2584.4,476.44,3976.0,35
HCPCS,57555,REMOVE CERVIX/REPAIR VAGINA,,,651.94,10703.04,15
HCPCS,57555,Remove cervix/repair vagina,,,1486.15,1877.24,6
HCPCS,575550,REMOVE CERVIX/REPAIR VAGINA,,,651.94,651.94,1
HCPCS,57556,EXC CRV STUMP VAG APPR W/RPR NTRCL,4118.0,2676.7,406.57,4118.0,35
HCPCS,57556,REMOVE CERVIX REPAIR BOWEL,,,618.86,10703.04,15
HCPCS,57556,Remove cervix repair bowel,,,2714.31,3428.6,6
HCPCS,575560,REMOVE CERVIX REPAIR BOWEL,,,618.86,618.86,1
HCPCS,57558,D&C OF CERVICAL STUMP,,,134.83,6893.74,15
HCPCS,57558,D&c of cervical stump,,,1486.15,1877.24,6
HCPCS,57558,DILATION & CURETTAGE CERVICAL STUMP,688.0,447.2,63.29,516.0,35
HCPCS,575580,D&C OF CERVICAL STUMP,,,134.83,134.83,1
HCPCS,57700,CERCLAGE UTERINE CERVIX NONOBSTETRICAL,1740.0,1131.0,176.05,1740.0,35
HCPCS,57700,REVISION OF CERVIX,,,372.18,6893.74,15
HCPCS,57700,Revision of cervix,,,1486.15,1877.24,6
HCPCS,577000,REVISION OF CERVIX,,,372.18,372.18,1
HCPCS,57720,REVISION OF CERVIX,,,350.22,6893.74,15
HCPCS,57720,Revision of cervix,,,1486.15,1877.24,6
HCPCS,57720,TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG,1844.0,1198.6,191.24,1844.0,35
HCPCS,577200,REVISION OF CERVIX,,,350.22,350.22,1
HCPCS,57800,DILATION CERVICAL CANAL INSTRUMENTAL SPX,308.0,200.2,30.26,231.0,35
HCPCS,57800,DILATION OF CERVICAL CANAL,,,50.52,6893.74,15
HCPCS,57800,Dilation of cervical canal,,,1486.15,1877.24,6
HCPCS,578000,DILATION OF CERVICAL CANAL,,,50.52,50.52,1
HCPCS,58100,BIOPSY OF UTERUS LINING,,,66.65,66.65,1
HCPCS,58100,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,844.0,548.6,56.98,4151.0,176
HCPCS,581000,BIOPSY OF UTERUS LINING,,,66.65,66.65,1
HCPCS,58110,BX DONE W/COLPOSCOPY ADD-ON,,,42.34,42.34,1
HCPCS,58110,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,433.5,281.775,29.1,4151.0,108
HCPCS,581100,BX DONE W/COLPOSCOPY ADD-ON,,,42.34,42.34,1
HCPCS,58120,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,9859.5,6408.675,128.25,16454.7,81
HCPCS,58120,DILATION AND CURETTAGE,,,245.34,245.34,1
HCPCS,581200,DILATION AND CURETTAGE,,,245.34,245.34,1
HCPCS,58140,MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR,6316.0,4105.4,518.63,6316.0,35
HCPCS,58140,MYOMECTOMY ABDOM METHOD,,,972.1,972.1,1
HCPCS,58140,Myomectomy abdom method,,,3616.15,4567.76,6
HCPCS,581400,MYOMECTOMY ABDOM METHOD,,,972.1,972.1,1
HCPCS,58145,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,10923.5,7100.275000000001,432.33,16454.7,116
HCPCS,58145,MYOMECTOMY VAG METHOD,,,599.14,599.14,1
HCPCS,581450,MYOMECTOMY VAG METHOD,,,599.14,599.14,1
HCPCS,58146,MYOMECTOMY 5/> MYOMAS &/>250 GM ABDOMINA,8136.0,5288.4,745.58,8136.0,35
HCPCS,58146,MYOMECTOMY ABDOM COMPLEX,,,1218.3,6040.0,2
HCPCS,58146,Myomectomy abdom complex,,,3616.15,4567.76,6
HCPCS,581460,MYOMECTOMY ABDOM COMPLEX,,,1218.3,1218.3,1
HCPCS,58150,TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY,6348.5,4126.525,671.32,18285.0,67
HCPCS,58150,TOTAL HYSTERECTOMY,,,1070.98,1070.98,1
HCPCS,581500,TOTAL HYSTERECTOMY,,,1070.98,1070.98,1
HCPCS,58152,TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY,8744.0,5683.6,726.38,8744.0,35
HCPCS,58152,TOTAL HYSTERECTOMY,,,1305.82,1305.82,1
HCPCS,58152,Total hysterectomy,,,3616.15,4567.76,6
HCPCS,581520,TOTAL HYSTERECTOMY,,,1305.82,1305.82,1
HCPCS,58180,PARTIAL HYSTERECTOMY,,,1013.95,1013.95,1
HCPCS,58180,SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY,5832.0,3790.8,615.33,18285.0,67
HCPCS,581800,PARTIAL HYSTERECTOMY,,,1013.95,1013.95,1
HCPCS,58200,EXTENSIVE HYSTERECTOMY,,,1420.65,1420.65,1
HCPCS,58200,Extensive hysterectomy,,,3616.15,4567.76,6
HCPCS,58200,TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM,9240.0,6006.0,939.04,9240.0,35
HCPCS,582000,EXTENSIVE HYSTERECTOMY,,,1420.65,1420.65,1
HCPCS,58210,EXTENSIVE HYSTERECTOMY,,,1917.66,1917.66,1
HCPCS,58210,Extensive hysterectomy,,,3616.15,4567.76,6
HCPCS,58210,RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY,12364.0,8036.6,1261.1,12364.0,35
HCPCS,582100,EXTENSIVE HYSTERECTOMY,,,1917.66,1917.66,1
HCPCS,58240,PEL EXNTJ GYNECOLOGIC MAL,19732.0,12825.8,1799.8,19732.0,35
HCPCS,58240,REMOVAL OF PELVIS CONTENTS,,,3071.89,3071.89,1
HCPCS,58240,Removal of pelvis contents,,,3616.15,4567.76,6
HCPCS,582400,REMOVAL OF PELVIS CONTENTS,,,3071.89,3071.89,1
HCPCS,58260,VAGINAL HYSTERECTOMY,,,884.6,10703.04,15
HCPCS,58260,VAGINAL HYSTERECTOMY UTERUS 250 GM/<,5660.0,3679.0,580.02,5660.0,35
HCPCS,58260,Vaginal hysterectomy,,,2575.55,3253.32,6
HCPCS,582600,VAGINAL HYSTERECTOMY,,,884.6,884.6,1
HCPCS,58262,VAG HYST 250 GM/< W/RMVL TUBE&/OVARY,6376.0,4144.4,630.28,6376.0,35
HCPCS,58262,VAG HYST INCLUDING T/O,,,978.34,10703.04,15
HCPCS,58262,Vag hyst including t/o,,,2575.55,3253.32,6
HCPCS,582620,VAG HYST INCLUDING T/O,,,978.34,978.34,1
HCPCS,58263,VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL,6892.0,4479.8,688.28,6892.0,35
HCPCS,58263,VAG HYST W/T/O & VAG REPAIR,,,1048.89,10703.04,15
HCPCS,58263,Vag hyst w/t/o & vag repair,,,2575.55,3253.32,6
HCPCS,582630,VAG HYST W/T/O & VAG REPAIR,,,1048.89,1048.89,1
HCPCS,58267,VAG HYST 250 GM/< W/COLPO-URTCSTOPEXY,7344.0,4773.6,709.35,7344.0,35
HCPCS,58267,VAG HYST W/URINARY REPAIR,,,1127.94,1127.94,1
HCPCS,58267,Vag hyst w/urinary repair,,,2575.55,3253.32,6
HCPCS,582670,VAG HYST W/URINARY REPAIR,,,1127.94,1127.94,1
HCPCS,58270,VAG HYST W/ENTEROCELE REPAIR,,,942.78,10703.04,15
HCPCS,58270,VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE,6120.0,3978.0,637.77,6120.0,35
HCPCS,58270,Vag hyst w/enterocele repair,,,2575.55,3253.32,6
HCPCS,582700,VAG HYST W/ENTEROCELE REPAIR,,,942.78,942.78,1
HCPCS,58275,HYSTERECTOMY/REVISE VAGINA,,,1044.67,1044.67,1
HCPCS,58275,Hysterectomy/revise vagina,,,2575.55,3253.32,6
HCPCS,58275,VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY,6812.0,4427.8,695.49,6812.0,35
HCPCS,582750,HYSTERECTOMY/REVISE VAGINA,,,1044.67,1044.67,1
HCPCS,58280,HYSTERECTOMY/REVISE VAGINA,,,1118.35,1118.35,1
HCPCS,58280,Hysterectomy/revise vagina,,,2575.55,3253.32,6
HCPCS,58280,VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE,7332.0,4765.8,663.66,7332.0,35
HCPCS,582800,HYSTERECTOMY/REVISE VAGINA,,,1118.35,1118.35,1
HCPCS,58285,EXTENSIVE HYSTERECTOMY,,,1497.47,1497.47,1
HCPCS,58285,Extensive hysterectomy,,,2575.55,3253.32,6
HCPCS,582850,EXTENSIVE HYSTERECTOMY,,,1497.47,1497.47,1
HCPCS,58290,VAG HYST COMPLEX,,,1214.44,16033.17,15
HCPCS,58290,VAGINAL HYSTERECTOMY UTERUS > 250 GM,8108.0,5270.2,745.07,8108.0,35
HCPCS,58290,Vag hyst complex,,,3616.15,4567.76,6
HCPCS,582900,VAG HYST COMPLEX,,,1214.44,1214.44,1
HCPCS,58291,VAG HYST > 250 GM RMVL TUBE&/OVARY,8824.0,5735.6,819.34,8824.0,35
HCPCS,58291,VAG HYST INCL T/O COMPLEX,,,1312.16,10703.04,15
HCPCS,58291,Vag hyst incl t/o complex,,,3616.15,4567.76,6
HCPCS,582910,VAG HYST INCL T/O COMPLEX,,,1312.16,1312.16,1
HCPCS,58292,VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE,9340.0,6071.0,867.99,9340.0,35
HCPCS,58292,VAG HYST T/O & REPAIR COMPL,,,1383.08,16033.17,15
HCPCS,58292,Vag hyst t/o & repair compl,,,3616.15,4567.76,6
HCPCS,582920,VAG HYST T/O & REPAIR COMPL,,,1383.08,1383.08,1
HCPCS,58293,Vag hyst w/uro repair compl,,,2575.55,3253.32,6
HCPCS,58294,VAG HYST W/ENTEROCELE COMPL,,,1283.93,10703.04,15
HCPCS,58294,VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE,8620.0,5603.0,799.15,8620.0,35
HCPCS,58294,Vag hyst w/enterocele compl,,,3616.15,4567.76,6
HCPCS,582940,VAG HYST W/ENTEROCELE COMPL,,,1283.93,1283.93,1
HCPCS,58300,INSERT INTRAUTERINE DEVICE,444.0,288.6,35.32,333.0,25
HCPCS,58300,INSERTION INTRAUTERINE DEVICE IUD,628.0,408.2,105.5,18285.0,35
HCPCS,583000,INSERT INTRAUTERINE DEVICE,,,52.8,52.8,1
HCPCS,58301,REMOVAL INTRAUTERINE DEVICE IUD,1749.0,1136.85,78.23,3920.0,144
HCPCS,58301,REMOVE INTRAUTERINE DEVICE,559.0,363.35,33.29,419.25,36
HCPCS,583010,REMOVE INTRAUTERINE DEVICE,,,69.83,69.83,1
HCPCS,58321,ARTIFICIAL INSEMINATION,,,50.8,659.53,15
HCPCS,58321,Artificial insemination,,,307.33,388.2,6
HCPCS,583210,ARTIFICIAL INSEMINATION,,,50.8,50.8,1
HCPCS,58322,ARTIFICIAL INSEMINATION,,,60.69,436.17,15
HCPCS,58322,Artificial insemination,,,307.33,388.2,6
HCPCS,583220,ARTIFICIAL INSEMINATION,,,60.69,60.69,1
HCPCS,58323,SPERM WASHING,,,12.7,436.17,15
HCPCS,58323,Sperm washing,,,307.33,388.2,6
HCPCS,583230,SPERM WASHING,,,12.7,12.7,1
HCPCS,58340,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,713.0,463.45000000000005,27.29,36332.0,184
HCPCS,58340,CATHETER FOR HYSTEROGRAPHY,,,60.09,60.09,1
HCPCS,583400,CATHETER FOR HYSTEROGRAPHY,,,60.09,60.09,1
HCPCS,58345,REOPEN FALLOPIAN TUBE,,,304.42,304.42,1
HCPCS,58345,TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING,10081.5,6552.975,248.69,16454.7,129
HCPCS,583450,REOPEN FALLOPIAN TUBE,,,304.42,304.42,1
HCPCS,58346,INSERT HEYMAN UTERI CAPSULE,,,516.12,10703.04,15
HCPCS,58346,INSERTION HEYMAN CAPSULES CLINICAL BRACHYTHERAPY,3326.0,2161.9,296.27,3326.0,35
HCPCS,58346,Insert heyman uteri capsule,,,1486.15,1877.24,6
HCPCS,583460,INSERT HEYMAN UTERI CAPSULE,,,516.12,516.12,1
HCPCS,58350,CHROMOTUBATION OVIDUCT W/MATERIALS,424.0,275.6,69.84,318.0,31
HCPCS,58350,REOPEN FALLOPIAN TUBE,,,98.51,10703.04,17
HCPCS,58350,Reopen fallopian tube,,,1486.15,1877.24,6
HCPCS,583500,REOPEN FALLOPIAN TUBE,,,98.51,98.51,1
HCPCS,58353,ENDOMETR ABLATE THERMAL,,,242.43,10703.04,15
HCPCS,58353,ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID,1440.0,936.0,131.22,1540.59,35
HCPCS,58353,Endometr ablate thermal,,,1486.15,1877.24,6
HCPCS,583530,ENDOMETR ABLATE THERMAL,,,242.43,242.43,1
HCPCS,58356,ENDOMETRIAL CRYOABLATION,,,373.47,10703.04,15
HCPCS,58356,ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR,2564.0,1666.6,268.45,2876.23,35
HCPCS,58356,Endometrial cryoablation,,,2714.31,3428.6,6
HCPCS,583560,ENDOMETRIAL CRYOABLATION,,,373.47,373.47,1
HCPCS,58400,SUSPENSION OF UTERUS,,,487.25,487.25,1
HCPCS,58400,Suspension of uterus,,,1486.15,1877.24,6
HCPCS,58400,UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX,2856.0,1856.4,324.17,2856.0,32
HCPCS,584000,SUSPENSION OF UTERUS,,,487.25,487.25,1
HCPCS,58410,SUSPENSION OF UTERUS,,,860.05,860.05,1
HCPCS,58410,Suspension of uterus,,,2714.31,3428.6,6
HCPCS,58410,UTERINE SUSP W/WO SHORT LIGAMNTS W/SYMPATHECTOMY,5520.0,3588.0,423.1,5520.0,32
HCPCS,584100,SUSPENSION OF UTERUS,,,860.05,860.05,1
HCPCS,58520,HYSTERORRHAPHY REPAIR RUPT UTERUS NONOBSTETRICAL,5392.0,3504.8,429.65,5392.0,35
HCPCS,58520,REPAIR OF RUPTURED UTERUS,,,842.05,842.05,1
HCPCS,58520,Repair of ruptured uterus,,,2714.31,3428.6,6
HCPCS,585200,REPAIR OF RUPTURED UTERUS,,,842.05,842.05,1
HCPCS,58540,REVISION OF UTERINE ANOMALY,6284.0,4084.6,500.63,6284.0,35
HCPCS,58540,REVISION OF UTERUS,,,967.5,967.5,1
HCPCS,58540,Revision of uterus,,,2714.31,3428.6,6
HCPCS,585400,REVISION OF UTERUS,,,967.5,967.5,1
HCPCS,58541,LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<,4916.0,3195.4,492.98,4916.0,35
HCPCS,58541,LSH UTERUS 250 G OR LESS,,,769.75,22573.24,15
HCPCS,58541,Lsh uterus 250 g or less,,,3616.15,4567.76,6
HCPCS,585410,LSH UTERUS 250 G OR LESS,,,769.75,769.75,1
HCPCS,58542,LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR,6230.0,4049.5,545.89,6230.0,35
HCPCS,58542,LSH W/T/O UT 250 G OR LESS,,,874.86,22573.24,16
HCPCS,58542,Lsh w/t/o ut 250 g or less,,,3616.15,4567.76,6
HCPCS,585420,LSH W/T/O UT 250 G OR LESS,,,874.86,874.86,1
HCPCS,58543,"LAP, SUPRACERVIAL HYSTERECTOMY, >250G",6332.0,4115.8,555.17,6332.0,35
HCPCS,58543,LSH UTERUS ABOVE 250 G,,,888.9,22573.24,15
HCPCS,58543,Lsh uterus above 250 g,,,3616.15,4567.76,6
HCPCS,585430,LSH UTERUS ABOVE 250 G,,,888.9,888.9,1
HCPCS,58544,LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY,6240.0,4056.0,601.52,6240.0,35
HCPCS,58544,LSH W/T/O UTERUS ABOVE 250 G,,,955.59,22573.24,16
HCPCS,58544,Lsh w/t/o uterus above 250 g,,,3616.15,4567.76,6
HCPCS,585440,LSH W/T/O UTERUS ABOVE 250 G,,,955.59,955.59,1
HCPCS,58545,LAPAROSCOPIC MYOMECTOMY,,,952.1,12649.85,18
HCPCS,58545,LAPS MYOMECTOMY EXC 1-4 MYOMAS 250 GM/<,6220.0,4043.0,598.84,6220.0,35
HCPCS,58545,Laparoscopic myomectomy,,,3616.15,4567.76,6
HCPCS,585450,LAPAROSCOPIC MYOMECTOMY,,,952.1,952.1,1
HCPCS,58546,LAPARO-MYOMECTOMY COMPLEX,,,1175.77,22573.24,19
HCPCS,58546,LAPS MYOMECTOMY EXC 5/> MYOMAS >250 GRAMS,7976.0,5184.4,754.9,7976.0,35
HCPCS,58546,Laparo-myomectomy complex,,,3616.15,4567.76,6
HCPCS,585460,LAPARO-MYOMECTOMY COMPLEX,,,1175.77,1175.77,1
HCPCS,58548,LAP RADICAL HYST,,,1982.34,1982.34,1
HCPCS,58548,LAPS W/RAD HYST W/BILAT LMPHADEC RMVL TUBE/OVARY,12652.0,8223.8,1051.09,12652.0,35
HCPCS,58548,Lap radical hyst,,,3616.15,4567.76,6
HCPCS,585480,LAP RADICAL HYST,,,1982.34,1982.34,1
HCPCS,58550,LAPARO-ASST VAG HYSTERECTOMY,,,930.63,12649.85,15
HCPCS,58550,LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<,6040.0,3926.0,635.18,6040.0,35
HCPCS,58550,Laparo-asst vag hysterectomy,,,3616.15,4567.76,6
HCPCS,585500,LAPARO-ASST VAG HYSTERECTOMY,,,930.63,930.63,1
HCPCS,58552,LAPARO-VAG HYST INCL T/O,,,1033.98,22573.24,16
HCPCS,58552,LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES,6764.0,4396.6,583.06,6764.0,35
HCPCS,58552,Laparo-vag hyst incl t/o,,,3616.15,4567.76,6
HCPCS,585520,LAPARO-VAG HYST INCL T/O,,,1033.98,1033.98,1
HCPCS,58553,LAPARO-VAG HYST COMPLEX,,,1182.47,22573.24,15
HCPCS,58553,LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS,8024.0,5215.6,749.98,8024.0,35
HCPCS,58553,Laparo-vag hyst complex,,,3616.15,4567.76,6
HCPCS,585530,LAPARO-VAG HYST COMPLEX,,,1182.47,1182.47,1
HCPCS,58554,LAPARO-VAG HYST W/T/O COMPL,,,1376.81,22573.24,15
HCPCS,58554,LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR,9244.0,6008.6,742.47,9244.0,35
HCPCS,58554,Laparo-vag hyst w/t/o compl,,,3616.15,4567.76,6
HCPCS,585540,LAPARO-VAG HYST W/T/O COMPL,,,1376.81,1376.81,1
HCPCS,58555,HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE,18283.0,11883.95,178.31,36332.0,46
HCPCS,58555,HYSTEROSCOPY DX SEP PROC,,,158.77,158.77,1
HCPCS,58555,"HYSTEROSCOPY, DIAGNOSTIC (SEPARATE",1166.0,757.9,77.16,874.5,35
HCPCS,585550,HYSTEROSCOPY DX SEP PROC,,,158.77,158.77,1
HCPCS,58558,HYSTEROSCOPY BIOPSY,,,251.38,251.38,1
HCPCS,58558,HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C,10059.0,6538.35,111.78,36332.0,81
HCPCS,585580,HYSTEROSCOPY BIOPSY,,,251.38,251.38,1
HCPCS,58559,HYSTEROSCOPY LYSIS,,,298.56,10703.04,15
HCPCS,58559,HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS,2080.0,1352.0,216.77,2080.0,35
HCPCS,58559,Hysteroscopy lysis,,,1486.15,1877.24,6
HCPCS,585590,HYSTEROSCOPY LYSIS,,,298.56,298.56,1
HCPCS,58560,HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM,2300.0,1495.0,227.72,2300.0,35
HCPCS,58560,HYSTEROSCOPY RESECT SEPTUM,,,328.91,10703.04,16
HCPCS,58560,Hysteroscopy resect septum,,,1486.15,1877.24,6
HCPCS,585600,HYSTEROSCOPY RESECT SEPTUM,,,328.91,328.91,1
HCPCS,58561,HYSTEROSCOPY REMOVAL LEIOMYOMATA,15644.5,10168.925,273.2,25546.5,74
HCPCS,58561,HYSTEROSCOPY REMOVE MYOMA,,,376.51,376.51,1
HCPCS,585610,HYSTEROSCOPY REMOVE MYOMA,,,376.51,376.51,1
HCPCS,58562,HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY,9941.5,6461.975,107.34,36332.0,81
HCPCS,58562,HYSTEROSCOPY REMOVE FB,,,232.92,232.92,1
HCPCS,585620,HYSTEROSCOPY REMOVE FB,,,232.92,232.92,1
HCPCS,58563,HYSTEROSCOPY ABLATION,,,349.17,349.17,1
HCPCS,58563,HYSTEROSCOPY ENDOMETRIAL ABLATION,15176.0,9864.4,219.1,25546.5,74
HCPCS,585630,HYSTEROSCOPY ABLATION,,,349.17,349.17,1
HCPCS,58565,HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS,2848.0,1851.2,314.29,2863.41,32
HCPCS,58565,HYSTEROSCOPY STERILIZATION,,,481.36,10703.04,15
HCPCS,58565,Hysteroscopy sterilization,,,2714.31,3428.6,6
HCPCS,585650,HYSTEROSCOPY STERILIZATION,,,481.36,481.36,1
HCPCS,58570,LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<,5344.0,3473.6,554.44,5344.0,35
HCPCS,58570,TLH UTERUS 250 G OR LESS,,,850.38,22573.24,15
HCPCS,58570,Tlh uterus 250 g or less,,,3616.15,4567.76,6
HCPCS,585700,TLH UTERUS 250 G OR LESS,,,850.38,850.38,1
HCPCS,58571,LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY,6600.0,4290.0,606.07,6600.0,35
HCPCS,58571,TLH W/T/O 250 G OR LESS,,,957.5,22573.24,19
HCPCS,58571,Tlh w/t/o 250 g or less,,,3616.15,4567.76,6
HCPCS,585710,TLH W/T/O 250 G OR LESS,,,957.5,957.5,1
HCPCS,58572,LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM,7792.0,5064.8,688.89,7792.0,35
HCPCS,58572,TLH UTERUS OVER 250 G,,,1070.6,22573.24,16
HCPCS,58572,Tlh uterus over 250 g,,,3616.15,4567.76,6
HCPCS,585720,TLH UTERUS OVER 250 G,,,1070.6,1070.6,1
HCPCS,58573,LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR,8316.0,5405.4,774.73,8316.0,35
HCPCS,58573,TLH W/T/O UTERUS OVER 250 G,,,1284.62,22573.24,20
HCPCS,58573,Tlh w/t/o uterus over 250 g,,,3616.15,4567.76,6
HCPCS,585730,TLH W/T/O UTERUS OVER 250 G,,,1284.62,1284.62,1
HCPCS,58575,LAPS TOT HYST RESJ MAL,,,2034.99,2034.99,1
HCPCS,58575,LAPS TOT HYSTERECTOMY RESJ MALIGNANCY W/OMNTC,13040.0,8476.0,1422.46,13040.0,31
HCPCS,58575,Laps tot hyst resj mal,,,3616.15,4567.76,6
HCPCS,585750,LAPS TOT HYST RESJ MAL,,,2034.99,2034.99,1
HCPCS,58578,LAPARASCOPIC SUPRACERVICAL HYSTERECTOMY,5640.0,3666.0,745.31,5640.0,15
HCPCS,58578,LAPAROSCOPIC CERVICAL STOMA CREATION (COMP CODE 44187),6960.0,4524.0,745.31,6960.0,15
HCPCS,58578,LAPAROSCOPIC FIBROID ABLATION,3525.0,2291.25,745.31,3525.0,15
HCPCS,58578,LAPAROSCOPIC FIBROID EMBOLIZATION,3525.0,2291.25,745.31,3525.0,15
HCPCS,58578,LAPAROSCOPIC ISTHMOCELE REPAIR (COMP CODE 58520),5392.0,3504.8,745.31,5392.0,15
HCPCS,58578,LAPAROSCOPIC UTEROSACRAL NERVE ABLATION,1411.0,917.15,705.5,1411.0,15
HCPCS,58578,UNLISTED LAPS PX UTERUS,,,5856.41,12649.85,14
HCPCS,58578,UNLISTED PROC; ROBOTIC LAPAROSCOPIC TRACHELECTOMY AMPUTATION OF,2266.0,1472.9,745.31,2266.0,15
HCPCS,58578,Unlisted laps px uterus,,,1486.15,1877.24,6
HCPCS,58579,HYSTEROSCOPIC TRANSVAG TUBAL OCCLUSION,1848.0,1201.2,274.4,1848.0,15
HCPCS,58579,UNLISTED HYSTSC PX UTERUS,,,201.93,436.17,14
HCPCS,58579,Unlisted hystsc px uterus,,,325.92,411.68,6
HCPCS,58580,TRANSCERVICAL ABLATION UTERINE FIBROID RF,22846.0,14849.9,289.36,38268.0,73
HCPCS,58580,TRANSCRV ABLTJ UTRN FIBRD RF,,,418.01,418.01,1
HCPCS,585800,TRANSCRV ABLTJ UTRN FIBRD RF,,,418.01,418.01,1
HCPCS,58600,DIVISION OF FALLOPIAN TUBE,,,391.13,6893.74,15
HCPCS,58600,Division of fallopian tube,,,1486.15,1877.24,6
HCPCS,58600,LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI,2364.0,1536.6,228.1,2364.0,35
HCPCS,586000,DIVISION OF FALLOPIAN TUBE,,,391.13,391.13,1
HCPCS,58605,DIVISION OF FALLOPIAN TUBE,,,355.22,355.22,1
HCPCS,58605,Division of fallopian tube,,,1188.74,1501.57,6
HCPCS,586050,DIVISION OF FALLOPIAN TUBE,,,355.22,355.22,1
HCPCS,58611,LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG,638.0,414.7,44.64,638.0,35
HCPCS,58611,LIGATE OVIDUCT(S) ADD-ON,,,79.38,79.38,1
HCPCS,58611,Ligate oviduct(s) add-on,,,1188.74,1501.57,6
HCPCS,586110,LIGATE OVIDUCT(S) ADD-ON,,,79.38,79.38,1
HCPCS,58615,OCCLUDE FALLOPIAN TUBE(S),,,266.75,6893.74,15
HCPCS,58615,OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR,1576.0,1024.4,180.93,1576.0,35
HCPCS,58615,Occlude fallopian tube(s),,,1486.15,1877.24,6
HCPCS,586150,OCCLUDE FALLOPIAN TUBE(S),,,266.75,266.75,1
HCPCS,58660,LAPAROSCOPY LYSIS,,,723.25,12649.85,15
HCPCS,58660,LAPAROSCOPY W/LYSIS OF ADHESION,4636.0,3013.4,373.32,4636.0,35
HCPCS,58660,Laparoscopy lysis,,,2714.31,3428.6,6
HCPCS,586600,LAPAROSCOPY LYSIS,,,723.25,723.25,1
HCPCS,58661,LAPAROSCOPY REMOVE ADNEXA,,,688.29,12649.85,18
HCPCS,58661,LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES,4994.0,3246.1,421.73,4994.0,35
HCPCS,58661,Laparoscopy remove adnexa,,,2714.31,3428.6,6
HCPCS,586610,LAPAROSCOPY REMOVE ADNEXA,,,688.29,688.29,1
HCPCS,58662,LAPAROSCOPY EXCISE LESIONS,,,752.51,15651.0,20
HCPCS,58662,LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE,4860.0,3159.0,394.61,4860.0,35
HCPCS,58662,Laparoscopy excise lesions,,,2714.31,3428.6,6
HCPCS,586620,LAPAROSCOPY EXCISE LESIONS,,,752.51,752.51,1
HCPCS,58670,LAPAROSCOPY FULGURATION OVIDUCTS,2364.0,1536.6,284.53,2364.0,35
HCPCS,58670,LAPAROSCOPY TUBAL CAUTERY,,,391.79,12649.85,15
HCPCS,58670,Laparoscopy tubal cautery,,,2714.31,3428.6,6
HCPCS,586700,LAPAROSCOPY TUBAL CAUTERY,,,391.79,391.79,1
HCPCS,58671,LAPAROSCOPY TUBAL BLOCK,,,391.79,12649.85,15
HCPCS,58671,LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS,2364.0,1536.6,224.49,2364.0,35
HCPCS,58671,Laparoscopy tubal block,,,2714.31,3428.6,6
HCPCS,586710,LAPAROSCOPY TUBAL BLOCK,,,391.79,391.79,1
HCPCS,58672,LAPAROSCOPY FIMBRIOPLASTY,5164.0,3356.6,420.78,12649.85,50
HCPCS,58672,Laparoscopy fimbrioplasty,,,2714.31,3428.6,6
HCPCS,586720,LAPAROSCOPY FIMBRIOPLASTY,,,771.43,771.43,1
HCPCS,58673,LAPAROSCOPY SALPINGOSTOMY,5616.0,3650.4,454.33,22573.24,50
HCPCS,58673,Laparoscopy salpingostomy,,,2714.31,3428.6,6
HCPCS,586730,LAPAROSCOPY SALPINGOSTOMY,,,837.09,837.09,1
HCPCS,58674,LAPS ABLTJ UTERINE FIBROIDS,,,857.52,22573.24,15
HCPCS,58674,Laps abltj uterine fibroids,,,3616.15,4567.76,6
HCPCS,586740,LAPS ABLTJ UTERINE FIBROIDS,,,857.52,857.52,1
HCPCS,58679,"LAPAROSCOPIC SALPINOOOPHORECTOMY, UNLISTE",2277.0,1480.05,441.14,2277.0,15
HCPCS,58679,LAPAROSCOPIC TUBAL RE-ANASTOMOSIS (COMP CODE 58750),5631.0,3660.15,441.14,5631.0,15
HCPCS,58679,LAPAROSCOPIC UTERINE AND OVARIAN TRANSPOSITION (COMP CODE 58571),6600.0,4290.0,441.14,6600.0,15
HCPCS,58679,UNLISTED LAPAROSCOPIC DETORSION OF OVARY (COMP CODE 49322),2164.0,1406.6,441.14,2164.0,15
HCPCS,58679,"UNLISTED LAPAROSCOPY PROCEDURE, OVI",2605.0,1693.25,441.14,2605.0,15
HCPCS,58679,"UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT OVARY (COMPARISON CODE 5",4540.0,2951.0,441.14,4540.0,15
HCPCS,58679,UNLISTED LAPS PX OVIDCT OVRY,,,5856.41,12649.85,14
HCPCS,58679,"UNLISTED PROC, LAPAROSCOPIC BIL OVARIAN TRANSPOSITION (COMP CODE",4137.0,2689.05,441.14,4137.0,15
HCPCS,58679,Unlisted laps px ovidct ovry,,,1486.15,1877.24,6
HCPCS,58700,REMOVAL OF FALLOPIAN TUBE,,,843.92,843.92,1
HCPCS,58700,SALPINGECTOMY COMPLETE/PARTIAL UNI/BI SPX,5102.0,3316.3,419.21,18285.0,67
HCPCS,587000,REMOVAL OF FALLOPIAN TUBE,,,843.92,843.92,1
HCPCS,58720,REMOVAL OF OVARY/TUBE(S),,,800.3,800.3,1
HCPCS,58720,Removal of ovary/tube(s),,,2714.31,3428.6,6
HCPCS,58720,SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX,4864.0,3161.6,450.3,4864.0,35
HCPCS,587200,REMOVAL OF OVARY/TUBE(S),,,800.3,800.3,1
HCPCS,58740,ADHESIOLYSIS TUBE OVARY,,,950.56,950.56,1
HCPCS,58740,Adhesiolysis tube ovary,,,2714.31,3428.6,6
HCPCS,58740,LYSIS OF ADHESIONS SALPINX/OVARY,5960.0,3874.0,484.65,5960.0,35
HCPCS,587400,ADHESIOLYSIS TUBE OVARY,,,950.56,950.56,1
HCPCS,58750,REPAIR OVIDUCT,,,959.7,959.7,1
HCPCS,58750,Repair oviduct,,,2714.31,3428.6,6
HCPCS,58750,TUBOTUBAL ANASTOMOSIS,6256.0,4066.4,804.16,6256.0,31
HCPCS,587500,REPAIR OVIDUCT,,,959.7,959.7,1
HCPCS,58752,REVISE OVARIAN TUBE(S),,,957.4,957.4,1
HCPCS,58752,Revise ovarian tube(s),,,1486.15,1877.24,6
HCPCS,587520,REVISE OVARIAN TUBE(S),,,957.4,957.4,1
HCPCS,58760,FIMBRIOPLASTY,5572.0,3621.8,722.3,5572.0,32
HCPCS,58760,Fimbrioplasty,,,1486.15,1877.24,6
HCPCS,587600,FIMBRIOPLASTY,,,865.46,865.46,1
HCPCS,58770,CREATE NEW TUBAL OPENING,,,909.05,6893.74,15
HCPCS,58770,Create new tubal opening,,,1486.15,1877.24,6
HCPCS,58770,SALPINGOSTOMY,5908.0,3840.2,661.55,5908.0,34
HCPCS,587700,CREATE NEW TUBAL OPENING,,,909.05,909.05,1
HCPCS,58800,DRAINAGE OF OVARIAN CYST(S),,,331.62,6893.74,15
HCPCS,58800,DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR,1848.0,1201.2,155.34,1386.0,35
HCPCS,58800,Drainage of ovarian cyst(s),,,1486.15,1877.24,6
HCPCS,588000,DRAINAGE OF OVARIAN CYST(S),,,331.62,331.62,1
HCPCS,58805,DRAINAGE OF OVARIAN CYST(S),,,450.47,6893.74,15
HCPCS,58805,DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL,2568.0,1669.2,327.35,2568.0,35
HCPCS,58805,Drainage of ovarian cyst(s),,,1486.15,1877.24,6
HCPCS,588050,DRAINAGE OF OVARIAN CYST(S),,,450.47,450.47,1
HCPCS,58820,DRAIN OVARY ABSCESS OPEN,,,355.51,6893.74,15
HCPCS,58820,Drain ovary abscess open,,,1486.15,1877.24,6
HCPCS,588200,DRAIN OVARY ABSCESS OPEN,,,355.51,355.51,1
HCPCS,58822,DRAIN OVARY ABSCESS PERCUT,,,753.32,753.32,1
HCPCS,58822,DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH,3388.0,2202.2,344.74,18285.0,67
HCPCS,588220,DRAIN OVARY ABSCESS PERCUT,,,753.32,753.32,1
HCPCS,58825,TRANSPOSITION OVARY(S),,,747.99,747.99,1
HCPCS,58825,"TRANSPOSITION, OVARY(S)",4712.0,3062.8,385.78,4712.0,35
HCPCS,58825,Transposition ovary(s),,,2714.31,3428.6,6
HCPCS,588250,TRANSPOSITION OVARY(S),,,747.99,747.99,1
HCPCS,58900,BIOPSY OF OVARY(S),,,459.99,6893.74,15
HCPCS,58900,BIOPSY OVARY UNI/BI SEPARATE PROCEDURE,2636.0,1713.4,301.23,2636.0,35
HCPCS,58900,Biopsy of ovary(s),,,1486.15,1877.24,6
HCPCS,589000,BIOPSY OF OVARY(S),,,459.99,459.99,1
HCPCS,58920,PARTIAL REMOVAL OF OVARY(S),,,753.2,16033.17,15
HCPCS,58920,Partial removal of ovary(s),,,2714.31,3428.6,6
HCPCS,58920,WEDGE RESCJ/BISCTJ OVARY UNI/BI,4780.0,3107.0,389.68,4780.0,35
HCPCS,589200,PARTIAL REMOVAL OF OVARY(S),,,753.2,753.2,1
HCPCS,58925,OVARIAN CYSTECTOMY UNI/BI,4972.0,3231.8,421.68,4972.0,35
HCPCS,58925,REMOVAL OF OVARIAN CYST(S),,,808.5,10703.04,15
HCPCS,58925,Removal of ovarian cyst(s),,,2714.31,3428.6,6
HCPCS,589250,REMOVAL OF OVARIAN CYST(S),,,808.5,808.5,1
HCPCS,58940,OOPHORECTOMY PARTIAL/TOTAL UNI/BI,16001.0,10400.65,368.73,25546.5,74
HCPCS,58940,REMOVAL OF OVARY(S),,,583.36,583.36,1
HCPCS,589400,REMOVAL OF OVARY(S),,,583.36,583.36,1
HCPCS,58943,OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MALIGNANCY,7808.0,5075.2,827.72,7808.0,35
HCPCS,58943,REMOVAL OF OVARY(S),,,1263.54,1263.54,1
HCPCS,58943,Removal of ovary(s),,,2714.31,3428.6,6
HCPCS,589430,REMOVAL OF OVARY(S),,,1263.54,1263.54,1
HCPCS,58950,RESCJ OVARIAN/TUBAL/PERITONEAL MALIGNANCY W/BSO,7348.0,4776.2,717.05,7348.0,35
HCPCS,58950,RESECT OVARIAN MALIGNANCY,,,1210.03,1210.03,1
HCPCS,58950,Resect ovarian malignancy,,,2714.31,3428.6,6
HCPCS,589500,RESECT OVARIAN MALIGNANCY,,,1210.03,1210.03,1
HCPCS,58951,RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD,9704.0,6307.6,1075.5,9704.0,35
HCPCS,58951,RESECT OVARIAN MALIGNANCY,,,1519.29,1519.29,1
HCPCS,58951,Resect ovarian malignancy,,,3616.15,4567.76,6
HCPCS,589510,RESECT OVARIAN MALIGNANCY,,,1519.29,1519.29,1
HCPCS,58952,RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING,10916.0,7095.4,1160.81,10916.0,35
HCPCS,58952,RESECT OVARIAN MALIGNANCY,,,1734.45,1734.45,1
HCPCS,58952,Resect ovarian malignancy,,,2714.31,3428.6,6
HCPCS,589520,RESECT OVARIAN MALIGNANCY,,,1734.45,1734.45,1
HCPCS,58953,BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION,13652.0,8873.8,1337.83,13652.0,35
HCPCS,58953,TAH RAD DISSECT FOR DEBULK,,,2108.82,2108.82,1
HCPCS,58953,Tah rad dissect for debulk,,,3616.15,4567.76,6
HCPCS,589530,TAH RAD DISSECT FOR DEBULK,,,2108.82,2108.82,1
HCPCS,58954,BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY,14852.0,9653.8,1454.28,14852.0,35
HCPCS,58954,TAH RAD DEBULK/LYMPH REMOVE,,,2283.03,2283.03,1
HCPCS,58954,Tah rad debulk/lymph remove,,,3616.15,4567.76,6
HCPCS,589540,TAH RAD DEBULK/LYMPH REMOVE,,,2283.03,2283.03,1
HCPCS,58956,BSO OMENTECTOMY W/TAH,,,1433.69,1433.69,1
HCPCS,58956,BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC,9120.0,5928.0,973.61,9120.0,35
HCPCS,58956,Bso omentectomy w/tah,,,3616.15,4567.76,6
HCPCS,589560,BSO OMENTECTOMY W/TAH,,,1433.69,1433.69,1
HCPCS,58957,Resect recurrent gyn mal,,,3616.15,4567.76,6
HCPCS,58958,RESC RECR OVR TBL PP UTR MAL,,,1746.48,1746.48,1
HCPCS,58958,RESCJ RECR OVR TBL PP UTR MAL OMNTC PEL LMPHADEC,11688.0,7597.2,943.89,11688.0,35
HCPCS,58958,Resc recr ovr tbl pp utr mal,,,3616.15,4567.76,6
HCPCS,589580,RESC RECR OVR TBL PP UTR MAL,,,1746.48,1746.48,1
HCPCS,58960,EXPLORATION OF ABDOMEN,,,1048.69,1048.69,1
HCPCS,58960,Exploration of abdomen,,,2714.31,3428.6,6
HCPCS,58960,LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK,6316.0,4105.4,746.73,6316.0,35
HCPCS,589600,EXPLORATION OF ABDOMEN,,,1048.69,1048.69,1
HCPCS,58970,RETRIEVAL OF OOCYTE,,,206.1,1887.91,15
HCPCS,58970,Retrieval of oocyte,,,307.33,388.2,6
HCPCS,589700,RETRIEVAL OF OOCYTE,,,206.1,206.1,1
HCPCS,58974,EMBRYO TRANSFER INTRAUTERINE,,,153.23,1887.91,15
HCPCS,58974,Embryo transfer intrauterine,,,307.33,388.2,6
HCPCS,589740,EMBRYO TRANSFER INTRAUTERINE,,,153.23,153.23,1
HCPCS,58976,TRANSFER OF EMBRYO,,,222.34,659.53,15
HCPCS,58976,Transfer of embryo,,,307.33,388.2,6
HCPCS,589760,TRANSFER OF EMBRYO,,,222.34,222.34,1
HCPCS,58999,CHEMODENERVATION VAGINAL MUSCLE,354.0,230.1,99.47,8550.0,45
HCPCS,58999,LAPAROSCOPIC PARTIAL VAGINECTOMY (COMP CODE 57106),3094.0,2011.1,123.54,3094.0,15
HCPCS,58999,LAPAROSCOPIC REPAIR COLOVAGINAL FISTULA (COMP 57305),3655.0,2375.75,123.54,3655.0,15
HCPCS,58999,LAPAROSCOPIC RESECTION OF NEOVAGINA (COMP 57110),6656.0,4326.4,123.54,6656.0,15
HCPCS,58999,LYSIS OF ADHESIONS OF VAGINAL (COMP CODE 56441),398.0,258.7,123.54,398.0,15
HCPCS,58999,LYSIS VAGINAL ADHESIONS,18283.0,11883.95,201.93,16454.7,45
HCPCS,58999,UNLISTED LAPOROSCOPIC RADICAL PARTIAL VAGINECTOMY (COMP CODE 571,9944.0,6463.6,123.54,9944.0,15
HCPCS,58999,"UNLISTED PROC, EXCISION OF VAGINAL CUFF LESION (COMP TO 57135)",891.0,579.15,123.54,891.0,15
HCPCS,58999,UNLISTED PROCEDURE FEMALE GENITAL SYS,354.0,230.1,99.47,8550.0,96
HCPCS,58999,UNLISTED TRANSVAGINAL REPAIR OF CESAREAN SCAR DEFECT (COMP CODE,3255.0,2115.75,123.54,3255.0,15
HCPCS,58999,UNLISTED VAGINAL CUFF REPAIR (COMP CODE 57200),1768.0,1149.2,123.54,1768.0,15
HCPCS,58999,VAGINAL CUFF BIOPSY (COMP CODE 57100),2743.0,1782.95,123.54,8550.0,63
HCPCS,59000,AMNIOCENTESIS DIAGNOSIC,520.0,338.0,39.44,390.0,35
HCPCS,59000,AMNIOCENTESIS DIAGNOSTIC,,,70.11,1887.91,15
HCPCS,59000,Amniocentesis diagnostic,,,255.44,322.66,6
HCPCS,590000,AMNIOCENTESIS DIAGNOSTIC,,,70.11,70.11,1
HCPCS,59001,AMNIOCENTESIS THERAPEUTIC,,,154.86,659.53,15
HCPCS,59001,Amniocentesis therapeutic,,,255.44,322.66,6
HCPCS,590010,AMNIOCENTESIS THERAPEUTIC,,,154.86,154.86,1
HCPCS,59012,FETAL CORD PUNCTURE PRENATAL,,,175.35,659.53,15
HCPCS,59012,Fetal cord puncture prenatal,,,255.44,322.66,6
HCPCS,590120,FETAL CORD PUNCTURE PRENATAL,,,175.35,175.35,1
HCPCS,59015,CHORION BIOPSY,,,114.3,1887.91,15
HCPCS,59015,Chorion biopsy,,,255.44,322.66,6
HCPCS,590150,CHORION BIOPSY,,,114.3,114.3,1
HCPCS,59020,FETAL CONTRACT STRESS TEST,,,28.23,436.17,16
HCPCS,59020,Fetal contract stress test,,,127.35,160.86,6
HCPCS,590200,FETAL CONTRACT STRESS TEST,,,28.23,28.23,1
HCPCS,59020TC,FETAL CONTRACT STRESS TEST,,,28.23,28.23,1
HCPCS,59025,FETAL NON-STRESS TEST,,,16.42,436.17,16
HCPCS,59025,Fetal non-stress test,,,127.35,160.86,6
HCPCS,590250,FETAL NON-STRESS TEST,,,16.42,16.42,1
HCPCS,59025TC,FETAL NON-STRESS TEST,,,16.42,16.42,1
HCPCS,59030,FETAL SCALP BLOOD SAMPLING,,,97.61,659.53,15
HCPCS,59030,Fetal scalp blood sampling,,,127.35,160.86,6
HCPCS,590300,FETAL SCALP BLOOD SAMPLING,,,97.61,97.61,1
HCPCS,59050,FETAL MONITOR W/REPORT,,,43.29,43.29,1
HCPCS,59050,Fetal monitor w/report,,,127.35,160.86,6
HCPCS,590500,FETAL MONITOR W/REPORT,,,43.29,43.29,1
HCPCS,59051,FETAL MONITOR/INTERPRET ONLY,,,36.61,36.61,1
HCPCS,590510,FETAL MONITOR/INTERPRET ONLY,,,36.61,36.61,1
HCPCS,59070,TRANSABDOM AMNIOINFUS W/US,,,268.19,659.53,15
HCPCS,59070,Transabdom amnioinfus w/us,,,255.44,322.66,6
HCPCS,590700,TRANSABDOM AMNIOINFUS W/US,,,268.19,268.19,1
HCPCS,59072,UMBILICAL CORD OCCLUD W/US,,,305.34,659.53,15
HCPCS,59072,Umbilical cord occlud w/us,,,615.35,777.29,6
HCPCS,590720,UMBILICAL CORD OCCLUD W/US,,,452.69,452.69,1
HCPCS,59074,FETAL FLUID DRAINAGE W/US,,,268.19,659.53,15
HCPCS,59074,Fetal fluid drainage w/us,,,127.35,160.86,6
HCPCS,590740,FETAL FLUID DRAINAGE W/US,,,268.19,268.19,1
HCPCS,59076,FETAL SHUNT PLACEMENT W/US,,,305.34,659.53,15
HCPCS,59076,Fetal shunt placement w/us,,,615.35,777.29,6
HCPCS,590760,FETAL SHUNT PLACEMENT W/US,,,452.69,452.69,1
HCPCS,59100,HYSTEROTOMY ABDOMINAL,5348.0,3476.2,468.07,5348.0,35
HCPCS,59100,REMOVE UTERUS LESION,,,746.73,10703.04,15
HCPCS,59100,Remove uterus lesion,,,2349.16,2967.36,6
HCPCS,591000,REMOVE UTERUS LESION,,,746.73,746.73,1
HCPCS,59120,TREAT ECTOPIC PREGNANCY,,,712.14,712.14,1
HCPCS,59120,TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR,5068.0,3294.2,483.65,5068.0,35
HCPCS,59120,Treat ectopic pregnancy,,,2349.16,2967.36,6
HCPCS,591200,TREAT ECTOPIC PREGNANCY,,,712.14,712.14,1
HCPCS,59121,TREAT ECTOPIC PREGNANCY,,,712.67,712.67,1
HCPCS,59121,Treat ectopic pregnancy,,,2349.16,2967.36,6
HCPCS,591210,TREAT ECTOPIC PREGNANCY,,,712.67,712.67,1
HCPCS,59130,TREAT ECTOPIC PREGNANCY,,,827.71,827.71,1
HCPCS,59130,Treat ectopic pregnancy,,,2349.16,2967.36,6
HCPCS,591300,TREAT ECTOPIC PREGNANCY,,,827.71,827.71,1
HCPCS,59135,Treat ectopic pregnancy,,,2575.55,3253.32,6
HCPCS,59136,TREAT ECTOPIC PREGNANCY,,,785.19,785.19,1
HCPCS,59136,Treat ectopic pregnancy,,,2349.16,2967.36,6
HCPCS,591360,TREAT ECTOPIC PREGNANCY,,,785.19,785.19,1
HCPCS,59140,TREAT ECTOPIC PREGNANCY,,,362.89,362.89,1
HCPCS,59140,Treat ectopic pregnancy,,,2349.16,2967.36,6
HCPCS,591400,TREAT ECTOPIC PREGNANCY,,,362.89,362.89,1
HCPCS,59150,LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY,4916.0,3195.4,432.22,4916.0,35
HCPCS,59150,TREAT ECTOPIC PREGNANCY,,,690.84,12649.85,15
HCPCS,59150,Treat ectopic pregnancy,,,2349.16,2967.36,6
HCPCS,591500,TREAT ECTOPIC PREGNANCY,,,690.84,690.84,1
HCPCS,59151,LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY,4844.0,3148.6,426.65,4844.0,35
HCPCS,59151,TREAT ECTOPIC PREGNANCY,,,676.22,12649.85,16
HCPCS,59151,Treat ectopic pregnancy,,,2349.16,2967.36,6
HCPCS,591510,TREAT ECTOPIC PREGNANCY,,,676.22,676.22,1
HCPCS,59160,CURETTAGE POSTPARTUM,1104.0,717.6,118.16,828.0,35
HCPCS,59160,D & C AFTER DELIVERY,,,163.91,6893.74,15
HCPCS,59160,D & c after delivery,,,1188.74,1501.57,6
HCPCS,591600,D & C AFTER DELIVERY,,,163.91,163.91,1
HCPCS,59200,INSERT CERVICAL DILATOR,,,38.62,659.53,15
HCPCS,59200,Insert cervical dilator,,,255.44,322.66,6
HCPCS,592000,INSERT CERVICAL DILATOR,,,38.62,38.62,1
HCPCS,59300,EPISIOTOMY OR VAGINAL REPAIR,,,128.49,6893.74,15
HCPCS,59300,EPISIOTOMY/VAG RPR OTH/THN ATTENDING,868.0,564.2,71.17,651.0,35
HCPCS,59300,Episiotomy or vaginal repair,,,1188.74,1501.57,6
HCPCS,593000,EPISIOTOMY OR VAGINAL REPAIR,,,128.49,128.49,1
HCPCS,59320,REVISION OF CERVIX,,,131.66,6893.74,15
HCPCS,59320,Revision of cervix,,,1188.74,1501.57,6
HCPCS,593200,REVISION OF CERVIX,,,131.66,131.66,1
HCPCS,59325,REVISION OF CERVIX,,,209.28,209.28,1
HCPCS,59325,Revision of cervix,,,1188.74,1501.57,6
HCPCS,593250,REVISION OF CERVIX,,,209.28,209.28,1
HCPCS,59350,REPAIR OF UTERUS,,,242.95,242.95,1
HCPCS,59350,Repair of uterus,,,1188.74,1501.57,6
HCPCS,593500,REPAIR OF UTERUS,,,242.95,242.95,1
HCPCS,59400,OBSTETRICAL CARE,,,2094.23,2094.23,1
HCPCS,59400,Obstetrical care,,,1443.81,1823.76,6
HCPCS,594000,OBSTETRICAL CARE,,,2094.23,2094.23,1
HCPCS,59409,OBSTETRICAL CARE,,,696.57,696.57,1
HCPCS,59409,VAGINAL DELIVERY ONLY,15898.0,10333.7,853.0,14308.2,98
HCPCS,594090,OBSTETRICAL CARE,,,696.57,696.57,1
HCPCS,59410,OBSTETRICAL CARE,,,940.82,940.82,1
HCPCS,59410,Obstetrical care,,,1443.81,1823.76,6
HCPCS,594100,OBSTETRICAL CARE,,,940.82,940.82,1
HCPCS,59412,ANTEPARTUM MANIPULATION,,,89.34,6893.74,15
HCPCS,59412,Antepartum manipulation,,,255.44,322.66,6
HCPCS,594120,ANTEPARTUM MANIPULATION,,,89.34,89.34,1
HCPCS,59414,DELIVER PLACENTA,,,79.03,79.03,1
HCPCS,59414,DELIVERY PLACENTA SEPARATE PROCEDURE,15898.0,10333.7,111.43,14308.2,98
HCPCS,594140,DELIVER PLACENTA,,,79.03,79.03,1
HCPCS,59425,ANTEPARTUM CARE ONLY,,,377.86,377.86,1
HCPCS,59425,Antepartum care only,,,193.62,244.57,6
HCPCS,594250,ANTEPARTUM CARE ONLY,,,377.86,377.86,1
HCPCS,59426,ANTEPARTUM CARE ONLY,,,693.95,693.95,1
HCPCS,59426,Antepartum care only,,,193.62,244.57,6
HCPCS,594260,ANTEPARTUM CARE ONLY,,,693.95,693.95,1
HCPCS,59430,CARE AFTER DELIVERY,,,156.44,156.44,1
HCPCS,59430,Care after delivery,,,193.62,244.57,6
HCPCS,594300,CARE AFTER DELIVERY,,,156.44,156.44,1
HCPCS,59510,CESAREAN DELIVERY,,,2332.5,2332.5,1
HCPCS,59510,Cesarean delivery,,,1596.67,2016.85,6
HCPCS,595100,CESAREAN DELIVERY,,,2332.5,2332.5,1
HCPCS,59514,CESAREAN DELIVERY ONLY,,,790.8,790.8,1
HCPCS,59514,Cesarean delivery only,,,1596.67,2016.85,6
HCPCS,595140,CESAREAN DELIVERY ONLY,,,790.8,790.8,1
HCPCS,59515,CESAREAN DELIVERY,,,1168.74,1168.74,1
HCPCS,59515,Cesarean delivery,,,1596.67,2016.85,6
HCPCS,595150,CESAREAN DELIVERY,,,1168.74,1168.74,1
HCPCS,59525,REMOVE UTERUS AFTER CESAREAN,,,419.6,419.6,1
HCPCS,59525,STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY,5238.0,3404.7,581.93,18285.0,29
HCPCS,595250,REMOVE UTERUS AFTER CESAREAN,,,419.6,419.6,1
HCPCS,59610,VBAC DELIVERY,,,2199.63,2199.63,1
HCPCS,59610,Vbac delivery,,,1443.81,1823.76,6
HCPCS,596100,VBAC DELIVERY,,,2199.63,2199.63,1
HCPCS,59612,VBAC DELIVERY ONLY,,,790.66,6893.74,15
HCPCS,59612,Vbac delivery only,,,1443.81,1823.76,6
HCPCS,596120,VBAC DELIVERY ONLY,,,790.66,790.66,1
HCPCS,59614,VBAC CARE AFTER DELIVERY,,,1020.27,1020.27,1
HCPCS,59614,Vbac care after delivery,,,1443.81,1823.76,6
HCPCS,596140,VBAC CARE AFTER DELIVERY,,,1020.27,1020.27,1
HCPCS,59618,ATTEMPTED VBAC DELIVERY,,,2358.28,2358.28,1
HCPCS,59618,Attempted vbac delivery,,,1596.67,2016.85,6
HCPCS,596180,ATTEMPTED VBAC DELIVERY,,,2358.28,2358.28,1
HCPCS,59620,ATTEMPTED VBAC DELIVERY ONLY,,,819.15,819.15,1
HCPCS,59620,Attempted vbac delivery only,,,1596.67,2016.85,6
HCPCS,59620,CESAREAN DELIVERY ATTEMPTED VBAC,6664.0,4331.6,776.99,6664.0,32
HCPCS,596200,ATTEMPTED VBAC DELIVERY ONLY,,,819.15,819.15,1
HCPCS,59622,ATTEMPTED VBAC AFTER CARE,,,1210.89,1210.89,1
HCPCS,59622,Attempted vbac after care,,,1596.67,2016.85,6
HCPCS,596220,ATTEMPTED VBAC AFTER CARE,,,1210.89,1210.89,1
HCPCS,59812,TREATMENT OF MISCARRIAGE,,,267.6,267.6,1
HCPCS,59812,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,8837.0,5744.05,161.43,14308.2,84
HCPCS,598120,TREATMENT OF MISCARRIAGE,,,267.6,267.6,1
HCPCS,59820,CARE OF MISCARRIAGE,,,334.08,6893.74,16
HCPCS,59820,Care of miscarriage,,,1148.74,1451.04,6
HCPCS,59820,TX MISSED ABORTION FIRST TRIMESTER SURGICAL,1936.0,1258.4,190.59,1452.0,35
HCPCS,598200,CARE OF MISCARRIAGE,,,334.08,334.08,1
HCPCS,59821,TREATMENT OF MISCARRIAGE,,,327.8,327.8,1
HCPCS,59821,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,8967.0,5828.55,184.93,14308.2,130
HCPCS,598210,TREATMENT OF MISCARRIAGE,,,327.8,327.8,1
HCPCS,59830,TREAT UTERUS INFECTION,,,403.49,403.49,1
HCPCS,59830,TX SEPTIC ABORTION SURGICAL,2636.0,1713.4,281.03,2636.0,35
HCPCS,59830,Treat uterus infection,,,1148.74,1451.04,6
HCPCS,598300,TREAT UTERUS INFECTION,,,403.49,403.49,1
HCPCS,59840,INDUCED ABORTION D&C,,,192.79,6893.74,15
HCPCS,59840,INDUCED ABORTION DILATION AND CURETTAGE,1204.0,782.6,169.81,903.0,35
HCPCS,59840,Induced abortion d&c,,,1148.74,1451.04,6
HCPCS,598400,INDUCED ABORTION D&C,,,192.79,192.79,1
HCPCS,59841,INDUCED ABORTION DILAT&EVAC,,,324.75,6893.74,15
HCPCS,59841,Induced abortion dilat&evac,,,1148.74,1451.04,6
HCPCS,598410,INDUCED ABORTION DILAT&EVAC,,,324.75,324.75,1
HCPCS,59850,INDUCED ABORTION 1+ NJX,,,341.54,341.54,1
HCPCS,59850,Induced abortion 1+ njx,,,1148.74,1451.04,6
HCPCS,598500,INDUCED ABORTION 1+ NJX,,,341.54,341.54,1
HCPCS,59851,INDUCED ABORTION 1+NJX D&C,,,371.94,371.94,1
HCPCS,59851,Induced abortion 1+njx d&c,,,1148.74,1451.04,6
HCPCS,598510,INDUCED ABORTION 1+NJX D&C,,,371.94,371.94,1
HCPCS,59852,INDUCED ABORTION 1+NJX HYST,,,511.34,511.34,1
HCPCS,59852,Induced abortion 1+njx hyst,,,1148.74,1451.04,6
HCPCS,598520,INDUCED ABORTION 1+NJX HYST,,,511.34,511.34,1
HCPCS,59855,INDUCED ABORTION 1+VAG SUPP,,,370.97,370.97,1
HCPCS,59855,Induced abortion 1+vag supp,,,1148.74,1451.04,6
HCPCS,598550,INDUCED ABORTION 1+VAG SUPP,,,370.97,370.97,1
HCPCS,59856,INDUCED AB 1+VAG SUPP D&C,,,434.52,434.52,1
HCPCS,59856,Induced ab 1+vag supp d&c,,,1148.74,1451.04,6
HCPCS,598560,INDUCED AB 1+VAG SUPP D&C,,,434.52,434.52,1
HCPCS,59857,INDUCED AB 1+VAG SUPP HYST,,,506.55,506.55,1
HCPCS,59857,Induced ab 1+vag supp hyst,,,1148.74,1451.04,6
HCPCS,598570,INDUCED AB 1+VAG SUPP HYST,,,506.55,506.55,1
HCPCS,59866,ABORTION (MPR),,,207.18,659.53,15
HCPCS,59866,Abortion (mpr),,,1148.74,1451.04,6
HCPCS,598660,ABORTION (MPR),,,207.18,207.18,1
HCPCS,59870,EVACUATE MOLE OF UTERUS,,,462.75,6893.74,15
HCPCS,59870,Evacuate mole of uterus,,,2349.16,2967.36,6
HCPCS,59870,UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE,2628.0,1708.2,263.83,2628.0,35
HCPCS,598700,EVACUATE MOLE OF UTERUS,,,462.75,462.75,1
HCPCS,59871,REMOVE CERCLAGE SUTURE,,,115.93,6893.74,15
HCPCS,59871,Remove cerclage suture,,,1188.74,1501.57,6
HCPCS,598710,REMOVE CERCLAGE SUTURE,,,115.93,115.93,1
HCPCS,59897,UNLISTED FETAL INVAS PX W/US,,,201.93,436.17,14
HCPCS,59897,Unlisted fetal invas px w/us,,,127.35,160.86,6
HCPCS,59898,UNLSTD LAPS PX MAT CARE&DLVR,,,5856.41,12649.85,14
HCPCS,59898,Unlstd laps px mat care&dlvr,,,1188.74,1501.57,6
HCPCS,59899,JADA PROCEDURE (COMP CODE43460),1629.0,1058.85,82.79,1629.0,15
HCPCS,59899,UNLISTED PX MAT CARE&DLVR,,,201.93,467.61,15
HCPCS,59899,Unlisted px mat care&dlvr,,,255.44,322.66,6
HCPCS,598990,UNLISTED PX MAT CARE&DLVR,,,467.61,467.61,1
HCPCS,60000,I&D THYROGLOSSAL DUCT CYST INFECTED,7406.0,4813.9,188.4,6665.4,49
HCPCS,60000,I&D THYROGLSSL DUX CST INFCT,,,157.57,157.57,1
HCPCS,600000,I&D THYROGLSSL DUX CST INFCT,,,157.57,157.57,1
HCPCS,6005F,CARE LEVEL RATIONALE DOC,,,0.01,0.01,1
HCPCS,6005F0,CARE LEVEL RATIONALE DOC,,,0.01,0.01,1
HCPCS,60100,BIOPSY OF THYROID,,,76.56,76.56,1
HCPCS,60100,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,2071.0,1346.1499999999999,42.86,4151.0,277
HCPCS,601000,BIOPSY OF THYROID,,,76.56,76.56,1
HCPCS,6010F,DYSPHAG TEST DONE B/4 EATING,,,0.01,0.01,1
HCPCS,6010F0,DYSPHAG TEST DONE B/4 EATING,,,0.01,0.01,1
HCPCS,6015F,DYSPHAG TEST DONE B/4 EATING,,,0.01,0.01,1
HCPCS,6015F0,DYSPHAG TEST DONE B/4 EATING,,,0.01,0.01,1
HCPCS,60200,EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS,4008.0,2605.2,427.89,4008.0,35
HCPCS,60200,REMOVE THYROID LESION,,,674.87,12649.85,15
HCPCS,60200,Remove thyroid lesion,,,2719.47,3435.12,6
HCPCS,602000,REMOVE THYROID LESION,,,674.87,674.87,1
HCPCS,6020F,NPO (NOTHING-MOUTH) ORDERED,,,0.01,0.01,1
HCPCS,6020F0,NPO (NOTHING-MOUTH) ORDERED,,,0.01,0.01,1
HCPCS,60210,PARTIAL THYROID EXCISION,,,714.73,12649.85,15
HCPCS,60210,PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,4492.0,2919.8,528.63,4492.0,35
HCPCS,60210,Partial thyroid excision,,,2719.47,3435.12,6
HCPCS,602100,PARTIAL THYROID EXCISION,,,714.73,714.73,1
HCPCS,60212,PARTIAL THYROID EXCISION,,,1038.85,12649.85,15
HCPCS,60212,PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC,6572.0,4271.8,681.11,6572.0,35
HCPCS,60212,Partial thyroid excision,,,2719.47,3435.12,6
HCPCS,602120,PARTIAL THYROID EXCISION,,,1038.85,1038.85,1
HCPCS,60220,PARTIAL REMOVAL OF THYROID,,,713.38,12649.85,19
HCPCS,60220,Partial removal of thyroid,,,2719.47,3435.12,6
HCPCS,60220,TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,4924.0,3200.6,516.29,4924.0,35
HCPCS,602200,PARTIAL REMOVAL OF THYROID,,,713.38,713.38,1
HCPCS,60225,PARTIAL REMOVAL OF THYROID,,,945.91,12649.85,15
HCPCS,60225,Partial removal of thyroid,,,2719.47,3435.12,6
HCPCS,60225,TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC,6508.0,4230.2,666.11,6508.0,35
HCPCS,602250,PARTIAL REMOVAL OF THYROID,,,945.91,945.91,1
HCPCS,60240,REMOVAL OF THYROID,,,926.49,14834.0,17
HCPCS,60240,Removal of thyroid,,,2719.47,3435.12,6
HCPCS,60240,THYROIDECTOMY TOTAL/COMPLETE,6618.0,4301.7,689.42,6618.0,35
HCPCS,602400,REMOVAL OF THYROID,,,926.49,926.49,1
HCPCS,60252,REMOVAL OF THYROID,,,1332.28,12826.13,15
HCPCS,60252,Removal of thyroid,,,2719.47,3435.12,6
HCPCS,60252,THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT,8804.0,5722.6,862.42,8804.0,35
HCPCS,602520,REMOVAL OF THYROID,,,1332.28,1332.28,1
HCPCS,60254,EXTENSIVE THYROID SURGERY,,,1682.68,1682.68,1
HCPCS,60254,Extensive thyroid surgery,,,2719.47,3435.12,6
HCPCS,60254,THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT,11368.0,7389.2,1142.61,11368.0,35
HCPCS,602540,EXTENSIVE THYROID SURGERY,,,1682.68,1682.68,1
HCPCS,60260,REPEAT THYROID SURGERY,,,1098.5,12826.13,15
HCPCS,60260,Repeat thyroid surgery,,,2719.47,3435.12,6
HCPCS,60260,THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL,7304.0,4747.6,587.65,7304.0,35
HCPCS,602600,REPEAT THYROID SURGERY,,,1098.5,1098.5,1
HCPCS,60270,REMOVAL OF THYROID,,,1376.27,1376.27,1
HCPCS,60270,Removal of thyroid,,,2719.47,3435.12,6
HCPCS,60270,THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC,9280.0,6032.0,862.92,9280.0,35
HCPCS,602700,REMOVAL OF THYROID,,,1376.27,1376.27,1
HCPCS,60271,REMOVAL OF THYROID,,,1065.01,14834.0,16
HCPCS,60271,Removal of thyroid,,,2719.47,3435.12,6
HCPCS,60271,THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH,7048.0,4581.2,730.35,7048.0,35
HCPCS,602710,REMOVAL OF THYROID,,,1065.01,1065.01,1
HCPCS,60280,EXCISION THYROGLOSSAL DUCT CYST/SINUS,2464.0,1601.6,347.5,2464.0,35
HCPCS,60280,REMOVE THYROID DUCT LESION,,,456.18,12649.85,15
HCPCS,60280,Remove thyroid duct lesion,,,2719.47,3435.12,6
HCPCS,602800,REMOVE THYROID DUCT LESION,,,456.18,456.18,1
HCPCS,60281,EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT,3528.0,2293.2,375.91,3528.0,35
HCPCS,60281,REMOVE THYROID DUCT LESION,,,599.36,12649.85,15
HCPCS,60281,Remove thyroid duct lesion,,,2719.47,3435.12,6
HCPCS,602810,REMOVE THYROID DUCT LESION,,,599.36,599.36,1
HCPCS,60300,ASPIR/INJ THYROID CYST,,,48.36,48.36,1
HCPCS,60300,ASPIRATION AND/OR INJECTION THYROID CYST,1953.0,1269.4499999999998,23.51,4151.0,179
HCPCS,603000,ASPIR/INJ THYROID CYST,,,48.36,48.36,1
HCPCS,6030F,MAX STERILE BARRIERS FLWD,,,0.01,0.01,1
HCPCS,6030F0,MAX STERILE BARRIERS FLWD,,,0.01,0.01,1
HCPCS,6040F,APPRO RAD DS DVCS TECHS DOCD,,,0.01,0.01,1
HCPCS,6040F0,APPRO RAD DS DVCS TECHS DOCD,,,0.01,0.01,1
HCPCS,6045F,RADXPS IN END RPRT4FLURO PXD,,,0.01,0.01,1
HCPCS,6045F0,RADXPS IN END RPRT4FLURO PXD,,,0.01,0.01,1
HCPCS,60500,EXPLORE PARATHYROID GLANDS,,,980.35,12826.13,17
HCPCS,60500,Explore parathyroid glands,,,2719.47,3435.12,6
HCPCS,60500,PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS,6864.0,4461.6,744.56,6864.0,35
HCPCS,605000,EXPLORE PARATHYROID GLANDS,,,980.35,980.35,1
HCPCS,60502,PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR,8460.0,5499.0,863.15,8460.0,35
HCPCS,60502,RE-EXPLORE PARATHYROIDS,,,1317.83,12826.13,15
HCPCS,60502,Re-explore parathyroids,,,2719.47,3435.12,6
HCPCS,605020,RE-EXPLORE PARATHYROIDS,,,1317.83,1317.83,1
HCPCS,60505,EXPLORE PARATHYROID GLANDS,,,1413.69,1413.69,1
HCPCS,60505,Explore parathyroid glands,,,2719.47,3435.12,6
HCPCS,605050,EXPLORE PARATHYROID GLANDS,,,1413.69,1413.69,1
HCPCS,60512,AUTOTRANSPLANT PARATHYROID,,,243.62,390.0,2
HCPCS,60512,Autotransplant parathyroid,,,2719.47,3435.12,6
HCPCS,60512,PARATHYROID AUTOTRANSPLANTATION ADD-ON,1776.0,1154.4,183.58,1776.0,35
HCPCS,605120,AUTOTRANSPLANT PARATHYROID,,,243.62,243.62,1
HCPCS,60520,REMOVAL OF THYMUS GLAND,,,1061.11,12826.13,15
HCPCS,60520,Removal of thymus gland,,,3296.96,4164.58,6
HCPCS,60520,THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX,6864.0,4461.6,774.22,6864.0,35
HCPCS,605200,REMOVAL OF THYMUS GLAND,,,1061.11,1061.11,1
HCPCS,60521,REMOVAL OF THYMUS GLAND,,,1129.39,1129.39,1
HCPCS,60521,Removal of thymus gland,,,3296.96,4164.58,6
HCPCS,60521,THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX,7672.0,4986.8,838.05,7672.0,35
HCPCS,605210,REMOVAL OF THYMUS GLAND,,,1129.39,1129.39,1
HCPCS,60522,REMOVAL OF THYMUS GLAND,,,1368.39,1368.39,1
HCPCS,60522,Removal of thymus gland,,,3296.96,4164.58,6
HCPCS,60522,THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX,9392.0,6104.8,998.21,9392.0,35
HCPCS,605220,REMOVAL OF THYMUS GLAND,,,1368.39,1368.39,1
HCPCS,60540,ADRENALECTOMY W/EXPL W/WO BX ABDL/LMBR/DRSAL SPX,7929.0,5153.85,774.51,7929.0,35
HCPCS,60540,EXPLORE ADRENAL GLAND,,,1089.3,1089.3,1
HCPCS,60540,Explore adrenal gland,,,2290.02,2892.66,6
HCPCS,605400,EXPLORE ADRENAL GLAND,,,1089.3,1089.3,1
HCPCS,60545,ADRENALECTOMY EXPL W/EXC RETROPERTINEAL TUMOR,8372.0,5441.8,906.78,8372.0,35
HCPCS,60545,EXPLORE ADRENAL GLAND,,,1263.56,1263.56,1
HCPCS,60545,Explore adrenal gland,,,2290.02,2892.66,6
HCPCS,605450,EXPLORE ADRENAL GLAND,,,1263.56,1263.56,1
HCPCS,60600,EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY,10036.0,6523.4,809.68,10036.0,35
HCPCS,60600,REMOVE CAROTID BODY LESION,,,1379.73,1379.73,1
HCPCS,60600,Remove carotid body lesion,,,2940.84,3714.74,6
HCPCS,606000,REMOVE CAROTID BODY LESION,,,1379.73,1379.73,1
HCPCS,60605,EXC CAROTID BODY TUMOR W EXC CAROTID ARTERY,12784.0,8309.6,963.78,12784.0,35
HCPCS,60605,REMOVE CAROTID BODY LESION,,,1650.91,1650.91,1
HCPCS,60605,Remove carotid body lesion,,,2940.84,3714.74,6
HCPCS,606050,REMOVE CAROTID BODY LESION,,,1650.91,1650.91,1
HCPCS,60650,LAPAROSCOPY ADRENALECTOMY,,,1204.31,2345.0,2
HCPCS,60650,LAPAROSCOPY ADRENALECTOMY PARTIAL OR COM,8292.0,5389.8,757.23,8292.0,35
HCPCS,60650,Laparoscopy adrenalectomy,,,2290.02,2892.66,6
HCPCS,606500,LAPAROSCOPY ADRENALECTOMY,,,1204.31,1204.31,1
HCPCS,60659,UNLISTED LAPS PX ENDOC SYS,,,5856.41,12649.85,14
HCPCS,60659,Unlisted laps px endoc sys,,,2290.02,2892.66,6
HCPCS,60660,ABLTJ 1/+THYR NDUL 1LOBE PRQ,,,311.28,311.28,1
HCPCS,60660,ABLTJ 1/+THYROID NODULE 1 LOBE/ISTHMUS PERQ RF,5315.5,3455.075,225.77,8550.0,71
HCPCS,606600,ABLTJ 1/+THYR NDUL 1LOBE PRQ,,,311.28,311.28,1
HCPCS,60661,ABLTJ 1/+THYR NDUL ADDL LOBE PERQ RADIOFREQUENCY,1870.0,1215.5,156.85,1402.5,25
HCPCS,60661,ABLTJ 1/+THYR NDUL ADDL PRQ,,,216.4,216.4,1
HCPCS,60661,Abltj 1/+thyr ndul addl prq,,,2719.47,3435.12,6
HCPCS,606610,ABLTJ 1/+THYR NDUL ADDL PRQ,,,216.4,216.4,1
HCPCS,60699,AUTOTRANS OF CRYO TISSUE (COMP CODE 60512),1599.0,1039.35,586.19,1599.0,15
HCPCS,60699,CT BIOPSY ADRENAL,2233.0,1451.45,627.47,15651.0,41
HCPCS,60699,IMAGE GUIDED - CRYOABLATION OF ADRENAL GLAND (COMP CODE 50593),26119.0,16977.350000000002,586.19,44136.9,56
HCPCS,60699,MICROWAVE ABLATION ADRENAL GLAND (COMP CODE 50592),18084.0,11754.6,586.19,30193.2,56
HCPCS,60699,RADIOFREQUENCY ABLATION PARATHYROID ADENOMA (COMP CODE 20982),38396.0,24957.399999999998,586.19,66585.6,56
HCPCS,6070F,PT ASKED/CNSLD AED EFFECTS,,,0.01,0.01,1
HCPCS,6070F0,PT ASKED/CNSLD AED EFFECTS,,,0.01,0.01,1
HCPCS,6080F,PT/CAREGIVER QUERIED FALLS,,,0.01,0.01,1
HCPCS,6080F0,PT/CAREGIVER QUERIED FALLS,,,0.01,0.01,1
HCPCS,6090F,PT/CAREGIVER COUNSEL SAFETY,,,0.01,0.01,1
HCPCS,6090F0,PT/CAREGIVER COUNSEL SAFETY,,,0.01,0.01,1
HCPCS,61000,REMOVE CRANIAL CAVITY FLUID,,,111.26,1501.5,15
HCPCS,61000,Remove cranial cavity fluid,,,249.83,315.58,6
HCPCS,610000,REMOVE CRANIAL CAVITY FLUID,,,111.26,111.26,1
HCPCS,61001,REMOVE CRANIAL CAVITY FLUID,,,105.38,1501.5,15
HCPCS,61001,Remove cranial cavity fluid,,,249.83,315.58,6
HCPCS,610010,REMOVE CRANIAL CAVITY FLUID,,,105.38,105.38,1
HCPCS,6100F,VERIFY PT SITE PXD DOCD,,,0.01,0.01,1
HCPCS,6100F0,VERIFY PT SITE PXD DOCD,,,0.01,0.01,1
HCPCS,6101F,SAFETY COUNSELING DEMENTIA,,,0.01,0.01,1
HCPCS,6101F0,SAFETY COUNSELING DEMENTIA,,,0.01,0.01,1
HCPCS,61020,REMOVE BRAIN CAVITY FLUID,,,104.33,104.33,1
HCPCS,61020,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX,4141.5,2691.9750000000004,79.76,6911.1,84
HCPCS,610200,REMOVE BRAIN CAVITY FLUID,,,104.33,104.33,1
HCPCS,61026,INJECTION INTO BRAIN CANAL,,,106.56,106.56,1
HCPCS,61026,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ,3324.5,2160.9249999999997,87.32,6317.0,81
HCPCS,610260,INJECTION INTO BRAIN CANAL,,,106.56,106.56,1
HCPCS,6102F,SAFETY COUNSELING DEM ORDER,,,0.01,0.01,1
HCPCS,6102F0,SAFETY COUNSELING DEM ORDER,,,0.01,0.01,1
HCPCS,61050,CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,1575.0,1023.75,61.53,6317.0,84
HCPCS,61050,REMOVE BRAIN CANAL FLUID,,,76.38,76.38,1
HCPCS,610500,REMOVE BRAIN CANAL FLUID,,,76.38,76.38,1
HCPCS,61055,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,1693.0,1100.45,88.34,6317.0,179
HCPCS,61055,INJECTION INTO BRAIN CANAL,,,112.75,112.75,1
HCPCS,610550,INJECTION INTO BRAIN CANAL,,,112.75,112.75,1
HCPCS,61070,BRAIN CANAL SHUNT PROCEDURE,,,53.88,53.88,1
HCPCS,61070,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,3182.5,2068.625,43.15,6289.0,179
HCPCS,610700,BRAIN CANAL SHUNT PROCEDURE,,,53.88,53.88,1
HCPCS,61105,TDH SDRL/VENTR PNXR,,,455.7,455.7,1
HCPCS,61105,TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE,2180.0,1417.0,293.72,2180.0,35
HCPCS,61105,Tdh sdrl/ventr pnxr,,,3929.11,4963.09,6
HCPCS,611050,TDH SDRL/VENTR PNXR,,,455.7,455.7,1
HCPCS,61107,TDH PNXR IMPLT VENTR CATH,,,306.45,306.45,1
HCPCS,61107,TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE,6415.0,4169.75,241.03,18285.0,96
HCPCS,611070,TDH PNXR IMPLT VENTR CATH,,,306.45,306.45,1
HCPCS,61108,TDH PNXR EVAC&/DRG SDRL HMTA,,,888.78,888.78,1
HCPCS,61108,TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA,10655.0,6925.75,575.96,18285.0,99
HCPCS,611080,TDH PNXR EVAC&/DRG SDRL HMTA,,,888.78,888.78,1
HCPCS,6110F,COUNSEL PROV DRIVING RISKS,,,0.01,0.01,1
HCPCS,6110F0,COUNSEL PROV DRIVING RISKS,,,0.01,0.01,1
HCPCS,61120,BURR HOLE FOR VENTR PUNCTURE,,,738.28,738.28,1
HCPCS,61120,BURR HOLE VENTRICULAR PUNCTURE,3840.0,2496.0,402.67,3840.0,35
HCPCS,61120,Burr hole for ventr puncture,,,3929.11,4963.09,6
HCPCS,611200,BURR HOLE FOR VENTR PUNCTURE,,,738.28,738.28,1
HCPCS,61140,BURR HOLE/TREPH BX BRAIN/LES,,,1252.3,1252.3,1
HCPCS,61140,BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION,6892.0,4479.8,808.17,6892.0,35
HCPCS,61140,Burr hole/treph bx brain/les,,,3929.11,4963.09,6
HCPCS,611400,BURR HOLE/TREPH BX BRAIN/LES,,,1252.3,1252.3,1
HCPCS,61150,BUR HOL/TRPH DRG BRN ABS/CST,,,1329.64,1329.64,1
HCPCS,61150,BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST,7560.0,4914.0,867.68,7560.0,35
HCPCS,61150,Bur hol/trph drg brn abs/cst,,,3929.11,4963.09,6
HCPCS,611500,BUR HOL/TRPH DRG BRN ABS/CST,,,1329.64,1329.64,1
HCPCS,61151,BURR HOLE/TREPH SBSQ TAPPING,,,978.62,978.62,1
HCPCS,61151,BURR HOLE/TREPHINE W/SBSQ TAPPING ICRA ABSC/CST,5396.0,3507.4,508.77,5396.0,35
HCPCS,61151,Burr hole/treph sbsq tapping,,,3929.11,4963.09,6
HCPCS,611510,BURR HOLE/TREPH SBSQ TAPPING,,,978.62,978.62,1
HCPCS,61154,BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL,6828.0,4438.2,843.7,6828.0,35
HCPCS,61154,BURR HOLE W/EVAC&/DRG HMTMA,,,1257.2,1257.2,1
HCPCS,61154,Burr hole w/evac&/drg hmtma,,,3929.11,4963.09,6
HCPCS,611540,BURR HOLE W/EVAC&/DRG HMTMA,,,1257.2,1257.2,1
HCPCS,61156,BURR HOL ASPIR HMTM/CST ICER,,,1220.99,1220.99,1
HCPCS,61156,BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL,6980.0,4537.0,871.63,6980.0,35
HCPCS,61156,Burr hol aspir hmtm/cst icer,,,3929.11,4963.09,6
HCPCS,611560,BURR HOL ASPIR HMTM/CST ICER,,,1220.99,1220.99,1
HCPCS,61210,BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,4016.5,2610.725,282.64,18285.0,67
HCPCS,61210,BURR HOLE IMPLT VENTR CATH,,,359.19,359.19,1
HCPCS,612100,BURR HOLE IMPLT VENTR CATH,,,359.19,359.19,1
HCPCS,61215,INS SUBQ RSVR PMP/NFS SYS,,,506.07,13885.08,15
HCPCS,61215,INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH,2340.0,1521.0,293.93,2340.0,35
HCPCS,61215,Ins subq rsvr pmp/nfs sys,,,3094.77,3909.18,6
HCPCS,612150,INS SUBQ RSVR PMP/NFS SYS,,,506.07,506.07,1
HCPCS,61250,BURR HOLE/TREPH STTL EXPL,,,854.55,854.55,1
HCPCS,61250,Burr hole/treph sttl expl,,,3929.11,4963.09,6
HCPCS,612500,BURR HOLE/TREPH STTL EXPL,,,854.55,854.55,1
HCPCS,61253,BURR HOLE TREPH ITTL UNI/BI,,,978.62,978.62,1
HCPCS,61253,Burr hole treph ittl uni/bi,,,3929.11,4963.09,6
HCPCS,612530,BURR HOLE TREPH ITTL UNI/BI,,,978.62,978.62,1
HCPCS,61304,CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL,9364.0,6086.6,1231.65,9364.0,35
HCPCS,61304,CRNEC/CRNOT EXPL SUPRATNTORL,,,1613.65,1613.65,1
HCPCS,61304,Crnec/crnot expl supratntorl,,,2513.55,3175.01,6
HCPCS,613040,CRNEC/CRNOT EXPL SUPRATNTORL,,,1613.65,1613.65,1
HCPCS,61305,CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL,12602.0,8191.3,1469.42,12602.0,35
HCPCS,61305,CRNEC/CRNOT EXPL INFRATNTORL,,,1973.14,1973.14,1
HCPCS,61305,Crnec/crnot expl infratntorl,,,2513.55,3175.01,6
HCPCS,613050,CRNEC/CRNOT EXPL INFRATNTORL,,,1973.14,1973.14,1
HCPCS,61312,CRANIECTOMY HMTMA SUPRATENTORIAL EXTRA/SUBDURAL,12068.0,7844.2,1299.8,12068.0,35
HCPCS,61312,CRNEC/CRNOT STTL XDRL/SDRL,,,2037.15,2037.15,1
HCPCS,61312,Crnec/crnot sttl xdrl/sdrl,,,2513.55,3175.01,6
HCPCS,613120,CRNEC/CRNOT STTL XDRL/SDRL,,,2037.15,2037.15,1
HCPCS,61313,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,11236.0,7303.4,1309.52,11236.0,35
HCPCS,61313,CRNEC/CRNOT STTL ICERE,,,1953.21,1953.21,1
HCPCS,61313,Crnec/crnot sttl icere,,,2513.55,3175.01,6
HCPCS,613130,CRNEC/CRNOT STTL ICERE,,,1953.21,1953.21,1
HCPCS,61314,CRANIECTOMY HMTMA INFRATENTORIAL EXTRA/SUBDURAL,10360.0,6734.0,1326.24,10360.0,35
HCPCS,61314,CRNEC/CRNOT ITTL XDRL/SDRL,,,1795.39,1795.39,1
HCPCS,61314,Crnec/crnot ittl xdrl/sdrl,,,2513.55,3175.01,6
HCPCS,613140,CRNEC/CRNOT ITTL XDRL/SDRL,,,1795.39,1795.39,1
HCPCS,61315,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,11860.0,7709.0,1399.61,11860.0,35
HCPCS,61315,CRNEC/CRNOT ITTL NTRACEREBLR,,,2036.34,2036.34,1
HCPCS,61315,Crnec/crnot ittl ntracereblr,,,2513.55,3175.01,6
HCPCS,613150,CRNEC/CRNOT ITTL NTRACEREBLR,,,2036.34,2036.34,1
HCPCS,61316,INC&SUBQ PLMT CRNL BONE GRF,,,85.63,85.63,1
HCPCS,61316,INCISION & SUBCUTANEOUS PLMT CRANIAL BONE GRAF,556.0,361.4,60.04,556.0,35
HCPCS,61316,Inc&subq plmt crnl bone grf,,,2513.55,3175.01,6
HCPCS,613160,INC&SUBQ PLMT CRNL BONE GRF,,,85.63,85.63,1
HCPCS,61320,CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL,10968.0,7129.2,1202.55,10968.0,35
HCPCS,61320,CRNEC/CRNOT DRG ICR ABS STTL,,,1863.01,1863.01,1
HCPCS,61320,Crnec/crnot drg icr abs sttl,,,2513.55,3175.01,6
HCPCS,613200,CRNEC/CRNOT DRG ICR ABS STTL,,,1863.01,1863.01,1
HCPCS,61321,CRANIECTOMY/CRANIOTMY DRG ABSCESS INFRATENTORIAL,12212.0,7937.8,1307.54,12212.0,35
HCPCS,61321,CRNEC/CRNOT DRG ICR ABS ITTL,,,2090.06,2090.06,1
HCPCS,61321,Crnec/crnot drg icr abs ittl,,,2513.55,3175.01,6
HCPCS,613210,CRNEC/CRNOT DRG ICR ABS ITTL,,,2090.06,2090.06,1
HCPCS,61322,CRANIECT/CRANIOT W/WO DURAPLASTY W/O LOBECTOMY,13704.0,8907.6,1216.84,13704.0,35
HCPCS,61322,CRNEC/CRNOT DCMPRV W/O LOBEC,,,2343.62,2343.62,1
HCPCS,61322,Crnec/crnot dcmprv w/o lobec,,,2513.55,3175.01,6
HCPCS,613220,CRNEC/CRNOT DCMPRV W/O LOBEC,,,2343.62,2343.62,1
HCPCS,61323,CRANIECT/CRANIOT W/WO DURAPLASTY W/LOBECTOMY,14024.0,9115.6,1260.05,14024.0,35
HCPCS,61323,CRNEC/CRNOT DCMPRV W/LOBEC,,,2352.42,2352.42,1
HCPCS,61323,Crnec/crnot dcmprv w/lobec,,,2513.55,3175.01,6
HCPCS,613230,CRNEC/CRNOT DCMPRV W/LOBEC,,,2352.42,2352.42,1
HCPCS,61330,DCMPRN ORBIT ONLY TRANSCRNL,,,1765.84,7031.51,15
HCPCS,61330,DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH,10120.0,6578.0,876.96,10120.0,35
HCPCS,61330,Dcmprn orbit only transcrnl,,,2513.55,3175.01,6
HCPCS,613300,DCMPRN ORBIT ONLY TRANSCRNL,,,1765.84,1765.84,1
HCPCS,61333,EXPL ORBIT W/REMOVAL LESION,,,1984.52,1984.52,1
HCPCS,61333,Expl orbit w/removal lesion,,,2513.55,3175.01,6
HCPCS,613330,EXPL ORBIT W/REMOVAL LESION,,,1984.52,1984.52,1
HCPCS,61340,SUBTEMPORAL CRANIAL DCMPRN,,,1417.78,1417.78,1
HCPCS,61340,Subtemporal cranial dcmprn,,,2513.55,3175.01,6
HCPCS,613400,SUBTEMPORAL CRANIAL DCMPRN,,,1417.78,1417.78,1
HCPCS,61343,CRNEC SOPL CRV LAM DCMPRN,,,2155.42,2155.42,1
HCPCS,61343,CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD,12744.0,8283.6,1594.03,12744.0,35
HCPCS,61343,Crnec sopl crv lam dcmprn,,,2513.55,3175.01,6
HCPCS,613430,CRNEC SOPL CRV LAM DCMPRN,,,2155.42,2155.42,1
HCPCS,61345,OTH CRANIAL DCMPRN PST FOSSA,,,2009.93,2009.93,1
HCPCS,61345,OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA,11692.0,7599.8,1260.5,11692.0,35
HCPCS,61345,Oth cranial dcmprn pst fossa,,,2513.55,3175.01,6
HCPCS,613450,OTH CRANIAL DCMPRN PST FOSSA,,,2009.93,2009.93,1
HCPCS,61450,CRNEC STPL SCTJ CMPRN/DCMPRN,,,1889.9,1889.9,1
HCPCS,61450,CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION,11076.0,7199.4,1246.75,11076.0,35
HCPCS,61450,Crnec stpl sctj cmprn/dcmprn,,,2513.55,3175.01,6
HCPCS,614500,CRNEC STPL SCTJ CMPRN/DCMPRN,,,1889.9,1889.9,1
HCPCS,61458,CRNEC SOPL EXPL/DCMPRN CRNL NRV,11536.0,7498.4,1453.84,11536.0,35
HCPCS,61458,CRNEC SOPL XPL/DCMPR CRL NRV,,,1978.2,1978.2,1
HCPCS,61458,Crnec sopl xpl/dcmpr crl nrv,,,2513.55,3175.01,6
HCPCS,614580,CRNEC SOPL XPL/DCMPR CRL NRV,,,1978.2,1978.2,1
HCPCS,61460,CRNEC SOPL SCTJ 1+CRNL NRV,,,2072.44,2072.44,1
HCPCS,61460,Crnec sopl sctj 1+crnl nrv,,,2513.55,3175.01,6
HCPCS,614600,CRNEC SOPL SCTJ 1+CRNL NRV,,,2072.44,2072.44,1
HCPCS,61500,CRANIECTOMY W/EXCISION TUMOR/LESION SKULL,7672.0,4986.8,954.99,7672.0,35
HCPCS,61500,CRNEC EXC TUM/BONE LES SKULL,,,1268.3,1268.3,1
HCPCS,61500,Crnec exc tum/bone les skull,,,2513.55,3175.01,6
HCPCS,615000,CRNEC EXC TUM/BONE LES SKULL,,,1268.3,1268.3,1
HCPCS,61501,CRANIECTOMY F/OSTEOMYELITIS,,,1101.27,1101.27,1
HCPCS,61501,CRANIECTOMY OSTEOMYELITIS,6540.0,4251.0,840.56,6540.0,35
HCPCS,61501,Craniectomy f/osteomyelitis,,,2513.55,3175.01,6
HCPCS,615010,CRANIECTOMY F/OSTEOMYELITIS,,,1101.27,1101.27,1
HCPCS,6150F,PT NOTRCVNG1ST ANTITNF TXMNT,,,0.01,0.01,1
HCPCS,6150F0,PT NOTRCVNG1ST ANTITNF TXMNT,,,0.01,0.01,1
HCPCS,61510,CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR,13565.0,8817.25,1484.19,13565.0,35
HCPCS,61510,CRNEC TREPH EXC BRN TUM STTL,,,2164.44,2164.44,1
HCPCS,61510,Crnec treph exc brn tum sttl,,,2513.55,3175.01,6
HCPCS,615100,CRNEC TREPH EXC BRN TUM STTL,,,2164.44,2164.44,1
HCPCS,61512,CRNEC TREPH EXC MNGIOMA STTL,,,2509.46,2509.46,1
HCPCS,61512,CRNEC TREPHINE BONE FLAP MENINGIOMA SUPRATENTOR,14856.0,9656.4,1717.9,14856.0,35
HCPCS,61512,Crnec treph exc mngioma sttl,,,2513.55,3175.01,6
HCPCS,615120,CRNEC TREPH EXC MNGIOMA STTL,,,2509.46,2509.46,1
HCPCS,61514,CRNEC TREPH EXC BRN ABS STTL,,,1882.74,1882.74,1
HCPCS,61514,CRNEC TREPHINE BONE FLAP BRAIN ABSC SUPRATENTOR,10892.0,7079.8,1354.8,10892.0,35
HCPCS,61514,Crnec treph exc brn abs sttl,,,2513.55,3175.01,6
HCPCS,615140,CRNEC TREPH EXC BRN ABS STTL,,,1882.74,1882.74,1
HCPCS,61516,CRNEC TREPH EXC CYST STTL,,,1844.47,1844.47,1
HCPCS,61516,CRNEC TREPHINE BONE FLAP FENEST CYST SUPRATENTOR,10632.0,6910.8,1353.42,10632.0,35
HCPCS,61516,Crnec treph exc cyst sttl,,,2513.55,3175.01,6
HCPCS,615160,CRNEC TREPH EXC CYST STTL,,,1844.47,1844.47,1
HCPCS,61517,IMPLT BRN INTRCV CHEMOTX AGT,,,85.31,85.31,1
HCPCS,61517,IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT,552.0,358.8,50.99,552.0,35
HCPCS,61517,Implt brn intrcv chemotx agt,,,3929.11,4963.09,6
HCPCS,615170,IMPLT BRN INTRCV CHEMOTX AGT,,,85.31,85.31,1
HCPCS,61518,CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA,15956.0,10371.4,1818.99,15956.0,35
HCPCS,61518,REMOVAL OF BRAIN LESION,,,2723.24,2723.24,1
HCPCS,61518,Removal of brain lesion,,,2513.55,3175.01,6
HCPCS,615180,REMOVAL OF BRAIN LESION,,,2723.24,2723.24,1
HCPCS,61519,CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA,17372.0,11291.8,1967.23,17372.0,35
HCPCS,61519,REMOVE BRAIN LINING LESION,,,2890.77,2890.77,1
HCPCS,61519,Remove brain lining lesion,,,2513.55,3175.01,6
HCPCS,615190,REMOVE BRAIN LINING LESION,,,2890.77,2890.77,1
HCPCS,61520,CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM,22836.0,14843.4,2296.28,22836.0,35
HCPCS,61520,REMOVAL OF BRAIN LESION,,,3641.3,3641.3,1
HCPCS,61520,Removal of brain lesion,,,2513.55,3175.01,6
HCPCS,615200,REMOVAL OF BRAIN LESION,,,3641.3,3641.3,1
HCPCS,61521,CRNEC TUM INFRATTL/PFOSSA MIDLINE TUM BASE SKULL,18796.0,12217.4,2093.62,18796.0,35
HCPCS,61521,REMOVAL OF BRAIN LESION,,,3124.01,3124.01,1
HCPCS,61521,Removal of brain lesion,,,2513.55,3175.01,6
HCPCS,615210,REMOVAL OF BRAIN LESION,,,3124.01,3124.01,1
HCPCS,61522,CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS,12616.0,8200.4,1349.34,12616.0,35
HCPCS,61522,REMOVAL OF BRAIN ABSCESS,,,2152.58,2152.58,1
HCPCS,61522,Removal of brain abscess,,,2513.55,3175.01,6
HCPCS,615220,REMOVAL OF BRAIN ABSCESS,,,2152.58,2152.58,1
HCPCS,61524,CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST,13152.0,8548.8,1480.5,13152.0,35
HCPCS,61524,REMOVAL OF BRAIN LESION,,,2050.96,2050.96,1
HCPCS,61524,Removal of brain lesion,,,2513.55,3175.01,6
HCPCS,615240,REMOVAL OF BRAIN LESION,,,2050.96,2050.96,1
HCPCS,61526,CRNEC TRANSTEMPOR EXC CEREBELLOPONTINE ANGLE TUM,23795.0,15466.75,2007.27,23795.0,35
HCPCS,61526,REMOVAL OF BRAIN LESION,,,3253.86,3253.86,1
HCPCS,61526,Removal of brain lesion,,,2513.55,3175.01,6
HCPCS,615260,REMOVAL OF BRAIN LESION,,,3253.86,3253.86,1
HCPCS,61530,CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA,20046.0,13029.9,1557.26,20046.0,35
HCPCS,61530,REMOVAL OF BRAIN LESION,,,3018.89,3018.89,1
HCPCS,61530,Removal of brain lesion,,,2513.55,3175.01,6
HCPCS,615300,REMOVAL OF BRAIN LESION,,,3018.89,3018.89,1
HCPCS,61531,IMPLANT BRAIN ELECTRODES,,,1207.19,1207.19,1
HCPCS,61531,Implant brain electrodes,,,3929.11,4963.09,6
HCPCS,61531,SUBDURAL IMPLTJ ELECTRODES SEIZURE MONITORING,6564.0,4266.6,771.83,6564.0,35
HCPCS,615310,IMPLANT BRAIN ELECTRODES,,,1207.19,1207.19,1
HCPCS,61533,CRANIOT SUBDURAL IMPLT ELCTRD SEIZURE MONITORING,8584.0,5579.6,996.46,8584.0,35
HCPCS,61533,IMPLANT BRAIN ELECTRODES,,,1503.94,1503.94,1
HCPCS,61533,Implant brain electrodes,,,2513.55,3175.01,6
HCPCS,615330,IMPLANT BRAIN ELECTRODES,,,1503.94,1503.94,1
HCPCS,61534,CRANIOT EPILEPTOGENIC FOC W/O ELECTRCORTICOGRPHY,9204.0,5982.6,848.14,9204.0,35
HCPCS,61534,REMOVAL OF BRAIN LESION,,,1625.63,1625.63,1
HCPCS,61534,Removal of brain lesion,,,2513.55,3175.01,6
HCPCS,615340,REMOVAL OF BRAIN LESION,,,1625.63,1625.63,1
HCPCS,61535,CRANIOT RMVL EPID/SUBDURL ELCTRD W/O EXC TIS SPX,5260.0,3419.0,529.51,5260.0,35
HCPCS,61535,REMOVE BRAIN ELECTRODES,,,990.62,990.62,1
HCPCS,61535,Remove brain electrodes,,,2513.55,3175.01,6
HCPCS,615350,REMOVE BRAIN ELECTRODES,,,990.62,990.62,1
HCPCS,61536,CRANIOT EPILEPTOGENIC FOCUS W/ELECTROCORTCOGRPHY,15088.0,9807.2,1574.44,15088.0,35
HCPCS,61536,REMOVAL OF BRAIN LESION,,,2534.27,2534.27,1
HCPCS,61536,Removal of brain lesion,,,2513.55,3175.01,6
HCPCS,615360,REMOVAL OF BRAIN LESION,,,2534.27,2534.27,1
HCPCS,61537,CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY,16038.0,10424.7,1221.15,16038.0,35
HCPCS,61537,REMOVAL OF BRAIN TISSUE,,,2416.31,2416.31,1
HCPCS,61537,Removal of brain tissue,,,2513.55,3175.01,6
HCPCS,615370,REMOVAL OF BRAIN TISSUE,,,2416.31,2416.31,1
HCPCS,61538,CRANIOT LOBEC TEMPORAL LOBE W/ELECTROCORTCOGRPHY,15780.0,10257.0,1482.65,15780.0,35
HCPCS,61538,REMOVAL OF BRAIN TISSUE,,,2615.52,2615.52,1
HCPCS,61538,Removal of brain tissue,,,2513.55,3175.01,6
HCPCS,615380,REMOVAL OF BRAIN TISSUE,,,2615.52,2615.52,1
HCPCS,61539,CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/ECOG,13712.0,8912.8,1491.71,13712.0,35
HCPCS,61539,REMOVAL OF BRAIN TISSUE,,,2321.28,2321.28,1
HCPCS,61539,Removal of brain tissue,,,2513.55,3175.01,6
HCPCS,615390,REMOVAL OF BRAIN TISSUE,,,2321.28,2321.28,1
HCPCS,61540,CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG,13829.0,8988.85,1415.17,13829.0,35
HCPCS,61540,REMOVAL OF BRAIN TISSUE,,,2141.59,2141.59,1
HCPCS,61540,Removal of brain tissue,,,2513.55,3175.01,6
HCPCS,615400,REMOVAL OF BRAIN TISSUE,,,2141.59,2141.59,1
HCPCS,61541,CRANIOTOMY TRANSECTION CORPUS CALLOSUM,13614.0,8849.1,1326.8,13614.0,35
HCPCS,61541,INCISION OF BRAIN TISSUE,,,2115.45,2115.45,1
HCPCS,61541,Incision of brain tissue,,,2513.55,3175.01,6
HCPCS,615410,INCISION OF BRAIN TISSUE,,,2115.45,2115.45,1
HCPCS,61543,REMOVAL OF BRAIN TISSUE,,,2138.58,2138.58,1
HCPCS,61543,Removal of brain tissue,,,2513.55,3175.01,6
HCPCS,615430,REMOVAL OF BRAIN TISSUE,,,2138.58,2138.58,1
HCPCS,61544,REMOVE & TREAT BRAIN LESION,,,1869.05,1869.05,1
HCPCS,61544,Remove & treat brain lesion,,,2513.55,3175.01,6
HCPCS,615440,REMOVE & TREAT BRAIN LESION,,,1869.05,1869.05,1
HCPCS,61545,CRANIOTOMY EXCISION CRANIOPHARYNGIOMA,18572.0,12071.8,1902.4,18572.0,35
HCPCS,61545,EXCISION OF BRAIN TUMOR,,,3131.68,3131.68,1
HCPCS,61545,Excision of brain tumor,,,2513.55,3175.01,6
HCPCS,615450,EXCISION OF BRAIN TUMOR,,,3131.68,3131.68,1
HCPCS,61546,CRANIOT HYPOPHYSEC/EXC PITUITARY TUMOR ICRL APPR,13376.0,8694.4,1566.64,13376.0,35
HCPCS,61546,REMOVAL OF PITUITARY GLAND,,,2270.47,2270.47,1
HCPCS,61546,Removal of pituitary gland,,,2513.55,3175.01,6
HCPCS,615460,REMOVAL OF PITUITARY GLAND,,,2270.47,2270.47,1
HCPCS,61548,HYPOPHYSEC/EXC PITUITARY TUM TRANSNASAL/SEPTAL,9348.0,6076.2,1201.44,9348.0,35
HCPCS,61548,REMOVAL OF PITUITARY GLAND,,,1537.09,1537.09,1
HCPCS,61548,Removal of pituitary gland,,,3243.49,4097.04,6
HCPCS,615480,REMOVAL OF PITUITARY GLAND,,,1537.09,1537.09,1
HCPCS,61550,CRANIECTOMY CRANIOSYNOSTOSIS 1 CRANIAL SUTURE,6236.0,4053.4,679.89,6236.0,35
HCPCS,61550,RELEASE OF SKULL SEAMS,,,1178.49,1178.49,1
HCPCS,61550,Release of skull seams,,,2513.55,3175.01,6
HCPCS,615500,RELEASE OF SKULL SEAMS,,,1178.49,1178.49,1
HCPCS,61552,CRANIECT CRANIOSYNOSTOSIS MULT CRANIAL SUTURES,8160.0,5304.0,895.08,8160.0,35
HCPCS,61552,RELEASE OF SKULL SEAMS,,,1463.71,1463.71,1
HCPCS,61552,Release of skull seams,,,2513.55,3175.01,6
HCPCS,615520,RELEASE OF SKULL SEAMS,,,1463.71,1463.71,1
HCPCS,61556,CRANIEC CRANIOSYNOSTOSIS FRONT/PARIET BONE FLAP,9636.0,6263.4,1072.65,9636.0,35
HCPCS,61556,INCISE SKULL/SUTURES,,,1682.14,1682.14,1
HCPCS,61556,Incise skull/sutures,,,2513.55,3175.01,6
HCPCS,615560,INCISE SKULL/SUTURES,,,1682.14,1682.14,1
HCPCS,61557,CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP,9324.0,6060.6,1102.79,9324.0,35
HCPCS,61557,INCISE SKULL/SUTURES,,,1660.74,1660.74,1
HCPCS,61557,Incise skull/sutures,,,2513.55,3175.01,6
HCPCS,615570,INCISE SKULL/SUTURES,,,1660.74,1660.74,1
HCPCS,61558,EXCISION OF SKULL/SUTURES,,,1853.34,1853.34,1
HCPCS,61558,Excision of skull/sutures,,,2513.55,3175.01,6
HCPCS,61558,XTN CRANIECT MULTIPLE SUTURE CRANIOSYNOSTOSIS,10600.0,6890.0,1273.71,10600.0,35
HCPCS,615580,EXCISION OF SKULL/SUTURES,,,1853.34,1853.34,1
HCPCS,61559,EXCISION OF SKULL/SUTURES,,,2359.24,2359.24,1
HCPCS,61559,Excision of skull/sutures,,,2513.55,3175.01,6
HCPCS,61559,XTN CRNEC MLT SUTR CRANIOSYNOSTOSIS W/BONE GRAFT,13608.0,8845.2,1601.17,13608.0,35
HCPCS,615590,EXCISION OF SKULL/SUTURES,,,2359.24,2359.24,1
HCPCS,61563,EXC BENIGN TUM CRANIAL BONE W/O OPTIC NRV DCMPRN,11376.0,7394.4,1325.75,11376.0,35
HCPCS,61563,EXCISION OF SKULL TUMOR,,,1951.14,1951.14,1
HCPCS,61563,Excision of skull tumor,,,2513.55,3175.01,6
HCPCS,615630,EXCISION OF SKULL TUMOR,,,1951.14,1951.14,1
HCPCS,61564,EXC BENIGN TUM CRANIAL BONE W/OPTIC NRV DCMPRN,17247.0,11210.55,1584.06,17247.0,35
HCPCS,61564,EXCISION OF SKULL TUMOR,,,2366.83,2366.83,1
HCPCS,61564,Excision of skull tumor,,,2513.55,3175.01,6
HCPCS,615640,EXCISION OF SKULL TUMOR,,,2366.83,2366.83,1
HCPCS,61566,CRANIOTOMY SELECTIVE AMYGDALOHIPPOCAMPECTOMY,14278.0,9280.7,1401.49,14278.0,35
HCPCS,61566,REMOVAL OF BRAIN TISSUE,,,2204.1,2204.1,1
HCPCS,61566,Removal of brain tissue,,,2513.55,3175.01,6
HCPCS,615660,REMOVAL OF BRAIN TISSUE,,,2204.1,2204.1,1
HCPCS,61567,CRAN SUBPIAL TRANSE ELECTROC,18959.0,12323.35,1525.01,18959.0,35
HCPCS,61567,INCISION OF BRAIN TISSUE,,,2510.45,2510.45,1
HCPCS,61567,Incision of brain tissue,,,2513.55,3175.01,6
HCPCS,615670,INCISION OF BRAIN TISSUE,,,2510.45,2510.45,1
HCPCS,61570,REMOVE FOREIGN BODY BRAIN,,,1842.53,1842.53,1
HCPCS,61570,Remove foreign body brain,,,2513.55,3175.01,6
HCPCS,615700,REMOVE FOREIGN BODY BRAIN,,,1842.53,1842.53,1
HCPCS,61571,CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN,11368.0,7389.2,1211.13,11368.0,35
HCPCS,61571,INCISE SKULL FOR BRAIN WOUND,,,1960.07,1960.07,1
HCPCS,61571,Incise skull for brain wound,,,2513.55,3175.01,6
HCPCS,615710,INCISE SKULL FOR BRAIN WOUND,,,1960.07,1960.07,1
HCPCS,61575,SKULL BASE/BRAINSTEM SURGERY,,,2462.64,2462.64,1
HCPCS,61575,Skull base/brainstem surgery,,,3243.49,4097.04,6
HCPCS,61575,TRNSRAL SKULL BSE/BR STEM/CORD BX/DCOMPR/EXC LES,14624.0,9505.6,1790.09,14624.0,35
HCPCS,615750,SKULL BASE/BRAINSTEM SURGERY,,,2462.64,2462.64,1
HCPCS,61576,SKULL BASE/BRAINSTEM SURGERY,,,4067.85,4067.85,1
HCPCS,61576,Skull base/brainstem surgery,,,3243.49,4097.04,6
HCPCS,61576,TRNSRL SKUL BSE/BR STM/CORD BX/DCMP/ SPLT TONGUE,23976.0,15584.4,1845.98,23976.0,35
HCPCS,615760,SKULL BASE/BRAINSTEM SURGERY,,,4067.85,4067.85,1
HCPCS,61580,CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ,13804.0,8972.6,1407.98,13804.0,35
HCPCS,61580,CRANIOFACIAL APPROACH SKULL,,,2386.01,2386.01,1
HCPCS,61580,Craniofacial approach skull,,,3243.49,4097.04,6
HCPCS,615800,CRANIOFACIAL APPROACH SKULL,,,2386.01,2386.01,1
HCPCS,61581,CRANIOFACIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ,15652.0,10173.8,1535.55,15652.0,35
HCPCS,61581,CRANIOFACIAL APPROACH SKULL,,,2592.98,2592.98,1
HCPCS,61581,Craniofacial approach skull,,,3243.49,4097.04,6
HCPCS,615810,CRANIOFACIAL APPROACH SKULL,,,2592.98,2592.98,1
HCPCS,61582,CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT,14056.0,9136.4,1485.83,14056.0,35
HCPCS,61582,CRANIOFACIAL APPROACH SKULL,,,2895.61,2895.61,1
HCPCS,61582,Craniofacial approach skull,,,3243.49,4097.04,6
HCPCS,615820,CRANIOFACIAL APPROACH SKULL,,,2895.61,2895.61,1
HCPCS,61583,CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE,15400.0,10010.0,1667.27,15400.0,35
HCPCS,61583,CRANIOFACIAL APPROACH SKULL,,,2839.33,2839.33,1
HCPCS,61583,Craniofacial approach skull,,,3243.49,4097.04,6
HCPCS,615830,CRANIOFACIAL APPROACH SKULL,,,2839.33,2839.33,1
HCPCS,61584,ORBITOCRANIAL ANT CRANIAL FOSSA W/O ORBIT EXNTJ,16588.0,10782.2,1598.42,16588.0,35
HCPCS,61584,ORBITOCRANIAL APPROACH/SKULL,,,2798.32,2798.32,1
HCPCS,61584,Orbitocranial approach/skull,,,3243.49,4097.04,6
HCPCS,615840,ORBITOCRANIAL APPROACH/SKULL,,,2798.32,2798.32,1
HCPCS,61585,ORBITOCRANIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ,17028.0,11068.2,1779.08,17028.0,35
HCPCS,61585,ORBITOCRANIAL APPROACH/SKULL,,,3192.2,3192.2,1
HCPCS,61585,Orbitocranial approach/skull,,,3243.49,4097.04,6
HCPCS,615850,ORBITOCRANIAL APPROACH/SKULL,,,3192.2,3192.2,1
HCPCS,61586,RESECT NASOPHARYNX SKULL,,,2440.88,2440.88,1
HCPCS,61586,Resect nasopharynx skull,,,3243.49,4097.04,6
HCPCS,615860,RESECT NASOPHARYNX SKULL,,,2440.88,2440.88,1
HCPCS,61590,INFRATEMPORAL APPROACH/SKULL,,,2909.08,2909.08,1
HCPCS,61590,INFRATEMPORAL MID CRANIAL FOSSA W/WO DISARTICLTN,20698.0,13453.7,1946.57,20698.0,35
HCPCS,61590,Infratemporal approach/skull,,,3243.49,4097.04,6
HCPCS,615900,INFRATEMPORAL APPROACH/SKULL,,,2909.08,2909.08,1
HCPCS,61591,INFRATEMPO MID CRANIAL FOSSA W/WO DCOMPR&/MOBI,20689.0,13447.85,2024.83,20689.0,35
HCPCS,61591,INFRATEMPORAL APPROACH/SKULL,,,2963.84,2963.84,1
HCPCS,61591,Infratemporal approach/skull,,,3243.49,4097.04,6
HCPCS,615910,INFRATEMPORAL APPROACH/SKULL,,,2963.84,2963.84,1
HCPCS,61592,ORBITOCRANIAL APPROACH/SKULL,,,3088.95,3088.95,1
HCPCS,61592,ORBITOCRNL APPR MID CRANIAL FOSSA TEMPORAL LOBE,17232.0,11200.8,1839.61,17232.0,35
HCPCS,61592,Orbitocranial approach/skull,,,3243.49,4097.04,6
HCPCS,615920,ORBITOCRANIAL APPROACH/SKULL,,,3088.95,3088.95,1
HCPCS,61595,TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV,13496.0,8772.4,1382.51,13496.0,35
HCPCS,61595,TRANSTEMPORAL APPROACH/SKULL,,,2308.42,2308.42,1
HCPCS,61595,Transtemporal approach/skull,,,3243.49,4097.04,6
HCPCS,615950,TRANSTEMPORAL APPROACH/SKULL,,,2308.42,2308.42,1
HCPCS,61596,TRANSCOCHLEAR APPROACH/SKULL,,,2341.83,2341.83,1
HCPCS,61596,Transcochlear approach/skull,,,3243.49,4097.04,6
HCPCS,615960,TRANSCOCHLEAR APPROACH/SKULL,,,2341.83,2341.83,1
HCPCS,61597,TRANSCONDYLAR APPROACH/SKULL,,,2894.04,2894.04,1
HCPCS,61597,TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL,16328.0,10613.2,1726.33,16328.0,35
HCPCS,61597,Transcondylar approach/skull,,,3243.49,4097.04,6
HCPCS,615970,TRANSCONDYLAR APPROACH/SKULL,,,2894.04,2894.04,1
HCPCS,61598,TRANSPETROSAL APPROACH/SKULL,,,2777.37,2777.37,1
HCPCS,61598,TRANSPTRSAL POST CRNL FOSSA CLIVUS/FORAMN MAGNUM,14612.0,9497.8,1553.48,14612.0,35
HCPCS,61598,Transpetrosal approach/skull,,,3243.49,4097.04,6
HCPCS,615980,TRANSPETROSAL APPROACH/SKULL,,,2777.37,2777.37,1
HCPCS,61600,RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL,12004.0,7802.6,1197.26,12004.0,35
HCPCS,61600,RESECT/EXCISE CRANIAL LESION,,,2040.3,2040.3,1
HCPCS,61600,Resect/excise cranial lesion,,,2513.55,3175.01,6
HCPCS,616000,RESECT/EXCISE CRANIAL LESION,,,2040.3,2040.3,1
HCPCS,61601,RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF,13702.0,8906.3,1284.78,13702.0,35
HCPCS,61601,RESECT/EXCISE CRANIAL LESION,,,2363.97,2363.97,1
HCPCS,61601,Resect/excise cranial lesion,,,2513.55,3175.01,6
HCPCS,616010,RESECT/EXCISE CRANIAL LESION,,,2363.97,2363.97,1
HCPCS,61605,RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL,14331.0,9315.15,1357.76,14331.0,35
HCPCS,61605,RESECT/EXCISE CRANIAL LESION,,,2077.41,2077.41,1
HCPCS,61605,Resect/excise cranial lesion,,,2513.55,3175.01,6
HCPCS,616050,RESECT/EXCISE CRANIAL LESION,,,2077.41,2077.41,1
HCPCS,61606,RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR,18502.0,12026.3,1792.44,18502.0,35
HCPCS,61606,RESECT/EXCISE CRANIAL LESION,,,2827.27,2827.27,1
HCPCS,61606,Resect/excise cranial lesion,,,2513.55,3175.01,6
HCPCS,616060,RESECT/EXCISE CRANIAL LESION,,,2827.27,2827.27,1
HCPCS,61607,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL,16372.0,10641.8,1680.01,16372.0,35
HCPCS,61607,RESECT/EXCISE CRANIAL LESION,,,2965.19,2965.19,1
HCPCS,61607,Resect/excise cranial lesion,,,2513.55,3175.01,6
HCPCS,616070,RESECT/EXCISE CRANIAL LESION,,,2965.19,2965.19,1
HCPCS,61608,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL,18216.0,11840.4,1943.63,18216.0,35
HCPCS,61608,RESECT/EXCISE CRANIAL LESION,,,3203.77,3203.77,1
HCPCS,61608,Resect/excise cranial lesion,,,2513.55,3175.01,6
HCPCS,616080,RESECT/EXCISE CRANIAL LESION,,,3203.77,3203.77,1
HCPCS,61611,TRANSECT ARTERY SINUS,,,457.24,457.24,1
HCPCS,61611,Transect artery sinus,,,2940.84,3714.74,6
HCPCS,616110,TRANSECT ARTERY SINUS,,,457.24,457.24,1
HCPCS,61613,OBLTRJ CAROTID ARYSM ARTVEN CAROTID FISTULA DSJ,18012.0,11707.8,1894.98,18012.0,35
HCPCS,61613,REMOVE ANEURYSM SINUS,,,3209.2,3209.2,1
HCPCS,61613,Remove aneurysm sinus,,,2940.84,3714.74,6
HCPCS,616130,REMOVE ANEURYSM SINUS,,,3209.2,3209.2,1
HCPCS,61615,RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL,14308.0,9300.2,1491.63,14308.0,35
HCPCS,61615,RESECT/EXCISE LESION SKULL,,,2738.82,2738.82,1
HCPCS,61615,Resect/excise lesion skull,,,2513.55,3175.01,6
HCPCS,616150,RESECT/EXCISE LESION SKULL,,,2738.82,2738.82,1
HCPCS,61616,RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL,20566.0,13367.9,2005.36,20566.0,35
HCPCS,61616,RESECT/EXCISE LESION SKULL,,,3254.76,3254.76,1
HCPCS,61616,Resect/excise lesion skull,,,2513.55,3175.01,6
HCPCS,616160,RESECT/EXCISE LESION SKULL,,,3254.76,3254.76,1
HCPCS,61618,REPAIR DURA,,,1257.21,1257.21,1
HCPCS,61618,Repair dura,,,2513.55,3175.01,6
HCPCS,61618,SECONDARY RPR DURA CSF LEAK FREE TISSUE GRAFT,7476.0,4859.4,783.57,7476.0,35
HCPCS,616180,REPAIR DURA,,,1257.21,1257.21,1
HCPCS,61619,REPAIR DURA,,,1395.9,1395.9,1
HCPCS,61619,Repair dura,,,2513.55,3175.01,6
HCPCS,61619,SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP,8840.0,5746.0,959.95,8840.0,35
HCPCS,616190,REPAIR DURA,,,1395.9,1395.9,1
HCPCS,61623,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,32625.0,21206.25,370.33,55143.0,158
HCPCS,61623,EVASC TEMP BALO ARTL OCC H/N,,,561.01,561.01,1
HCPCS,616230,EVASC TEMP BALO ARTL OCC H/N,,,561.01,561.01,1
HCPCS,61624,TCAT PERM OCCLS/EMBOLJ CNS,,,1132.25,1132.25,1
HCPCS,61624,TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS,12991.5,8444.475,889.63,21057.68,105
HCPCS,616240,TCAT PERM OCCLS/EMBOLJ CNS,,,1132.25,1132.25,1
HCPCS,61626,TCAT PERM OCCLS/EMBOL NONCNS,,,877.27,877.27,1
HCPCS,61626,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,35970.0,23380.5,692.95,58770.0,158
HCPCS,616260,TCAT PERM OCCLS/EMBOL NONCNS,,,877.27,877.27,1
HCPCS,61630,BALLON ANGIOPLASTY  INTRACRANIAL PERCUTANEOUS,8828.0,5738.2,1112.42,8828.0,31
HCPCS,61630,BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS,32905.0,21388.25,1663.92,29614.5,64
HCPCS,61630,BALO ANGIOPLASTY ICR PERQ,,,1324.98,1324.98,1
HCPCS,616300,BALO ANGIOPLASTY ICR PERQ,,,1324.98,1324.98,1
HCPCS,61635,INTRACRAN ANGIOPLSTY W/STENT,,,1439.76,1439.76,1
HCPCS,61635,TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD,28538.5,18550.025,1211.3,42628.5,95
HCPCS,616350,INTRACRAN ANGIOPLSTY W/STENT,,,1439.76,1439.76,1
HCPCS,61640,DILATE IC VASOSPASM INIT,,,465.22,465.22,1
HCPCS,61640,Dilate ic vasospasm init,,,8216.69,10378.98,6
HCPCS,616400,DILATE IC VASOSPASM INIT,,,465.22,465.22,1
HCPCS,61641,DILAT IC VSPSM EA VSL SM TER,,,163.37,163.37,1
HCPCS,61641,Dilat ic vspsm ea vsl sm ter,,,8216.69,10378.98,6
HCPCS,616410,DILAT IC VSPSM EA VSL SM TER,,,163.37,163.37,1
HCPCS,61642,DILAT IC VSPSM EA DIFF TER,,,326.74,326.74,1
HCPCS,61642,Dilat ic vspsm ea diff ter,,,8216.69,10378.98,6
HCPCS,616420,DILAT IC VSPSM EA DIFF TER,,,326.74,326.74,1
HCPCS,61645,PERQ ART M-THROMBECT &/NFS,,,819.45,819.45,1
HCPCS,61645,PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL,10796.5,7017.725,634.67,18285.0,95
HCPCS,616450,PERQ ART M-THROMBECT &/NFS,,,819.45,819.45,1
HCPCS,61650,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST,6250.5,4062.825,434.25,18285.0,109
HCPCS,61650,EVASC PRLNG ADMN RX AGNT 1ST,,,567.18,567.18,1
HCPCS,616500,EVASC PRLNG ADMN RX AGNT 1ST,,,567.18,567.18,1
HCPCS,61651,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL,4750.5,3087.825,176.18,18285.0,109
HCPCS,61651,EVASC PRLNG ADMN RX AGNT ADD,,,242.25,242.25,1
HCPCS,616510,EVASC PRLNG ADMN RX AGNT ADD,,,242.25,242.25,1
HCPCS,61680,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL,13020.0,8463.0,1649.39,13020.0,35
HCPCS,61680,INTRACRANIAL VESSEL SURGERY,,,2232.01,2232.01,1
HCPCS,61680,Intracranial vessel surgery,,,2940.84,3714.74,6
HCPCS,616800,INTRACRANIAL VESSEL SURGERY,,,2232.01,2232.01,1
HCPCS,61682,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL,25364.0,16486.6,2468.21,25364.0,35
HCPCS,61682,INTRACRANIAL VESSEL SURGERY,,,4095.44,4095.44,1
HCPCS,61682,Intracranial vessel surgery,,,2940.84,3714.74,6
HCPCS,616820,INTRACRANIAL VESSEL SURGERY,,,4095.44,4095.44,1
HCPCS,61684,INTRACRANIAL ARVEN MALFRMJ INFRATENTRL SMPL,16656.0,10826.4,1840.79,16656.0,35
HCPCS,61684,INTRACRANIAL VESSEL SURGERY,,,2793.13,2793.13,1
HCPCS,61684,Intracranial vessel surgery,,,2940.84,3714.74,6
HCPCS,616840,INTRACRANIAL VESSEL SURGERY,,,2793.13,2793.13,1
HCPCS,61686,INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL,27000.0,17550.0,2575.69,27000.0,35
HCPCS,61686,INTRACRANIAL VESSEL SURGERY,,,4406.34,4406.34,1
HCPCS,61686,Intracranial vessel surgery,,,2940.84,3714.74,6
HCPCS,616860,INTRACRANIAL VESSEL SURGERY,,,4406.34,4406.34,1
HCPCS,61690,INTRACRANIAL VESSEL SURGERY,,,2146.59,2146.59,1
HCPCS,61690,Intracranial vessel surgery,,,2940.84,3714.74,6
HCPCS,616900,INTRACRANIAL VESSEL SURGERY,,,2146.59,2146.59,1
HCPCS,61692,INTRACRANIAL ARVEN MALFRMJ DURAL CMPL,21836.0,14193.4,2060.71,21836.0,35
HCPCS,61692,INTRACRANIAL VESSEL SURGERY,,,3581.86,3581.86,1
HCPCS,61692,Intracranial vessel surgery,,,2940.84,3714.74,6
HCPCS,616920,INTRACRANIAL VESSEL SURGERY,,,3581.86,3581.86,1
HCPCS,61697,BRAIN ANEURYSM REPR COMPLX,,,4145.04,4145.04,1
HCPCS,61697,Brain aneurysm repr complx,,,2940.84,3714.74,6
HCPCS,61697,COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION,25360.0,16484.0,2456.04,25360.0,35
HCPCS,616970,BRAIN ANEURYSM REPR COMPLX,,,4145.04,4145.04,1
HCPCS,61698,BRAIN ANEURYSM REPR COMPLX,,,4537.54,4537.54,1
HCPCS,61698,Brain aneurysm repr complx,,,2940.84,3714.74,6
HCPCS,61698,CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ,27852.0,18103.8,2363.88,27852.0,35
HCPCS,616980,BRAIN ANEURYSM REPR COMPLX,,,4537.54,4537.54,1
HCPCS,61700,BRAIN ANEURYSM REPR SIMPLE,,,3349.91,3349.91,1
HCPCS,61700,Brain aneurysm repr simple,,,2940.84,3714.74,6
HCPCS,61700,SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION,20248.0,13161.2,2122.57,20248.0,35
HCPCS,617000,BRAIN ANEURYSM REPR SIMPLE,,,3349.91,3349.91,1
HCPCS,61702,INNER SKULL VESSEL SURGERY,,,3944.75,3944.75,1
HCPCS,61702,Inner skull vessel surgery,,,2940.84,3714.74,6
HCPCS,61702,SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ,24016.0,15610.4,2283.22,24016.0,35
HCPCS,617020,INNER SKULL VESSEL SURGERY,,,3944.75,3944.75,1
HCPCS,61703,CLAMP NECK ARTERY,,,1339.44,1339.44,1
HCPCS,61703,Clamp neck artery,,,2940.84,3714.74,6
HCPCS,61703,ICRA CRV APPL OCCLUDING CLAMP CRV CRTD ART,7520.0,4888.0,809.06,7520.0,35
HCPCS,617030,CLAMP NECK ARTERY,,,1339.44,1339.44,1
HCPCS,61705,REVISE CIRCULATION TO HEAD,,,2557.73,2557.73,1
HCPCS,61705,Revise circulation to head,,,2940.84,3714.74,6
HCPCS,617050,REVISE CIRCULATION TO HEAD,,,2557.73,2557.73,1
HCPCS,61708,REVISE CIRCULATION TO HEAD,,,2503.05,2503.05,1
HCPCS,61708,Revise circulation to head,,,2940.84,3714.74,6
HCPCS,617080,REVISE CIRCULATION TO HEAD,,,2503.05,2503.05,1
HCPCS,61710,ARYSM VASC MALFRMJ IA EMBOLIZATION,12516.0,8135.4,1223.36,12516.0,35
HCPCS,61710,REVISE CIRCULATION TO HEAD,,,2111.37,2111.37,1
HCPCS,61710,Revise circulation to head,,,2940.84,3714.74,6
HCPCS,617100,REVISE CIRCULATION TO HEAD,,,2111.37,2111.37,1
HCPCS,61711,ANAST ARTL EXTRACRANIAL-INTRACRANIAL ARTERIES,15292.0,9939.8,1859.85,15292.0,35
HCPCS,61711,FUSION OF SKULL ARTERIES,,,2562.89,2562.89,1
HCPCS,61711,Fusion of skull arteries,,,2940.84,3714.74,6
HCPCS,617110,FUSION OF SKULL ARTERIES,,,2562.89,2562.89,1
HCPCS,61715,MRGFUS STEREOTACTIC ABLATION TARGET INTRACRANIAL,8801.0,5720.65,872.92,8801.0,14
HCPCS,61715,MRGFUS STRTCTC ABLT TRGT ICR,,,1151.57,27037.69,15
HCPCS,61715,Mrgfus strtctc ablt trgt icr,,,3699.03,4672.46,6
HCPCS,617150,MRGFUS STRTCTC ABLT TRGT ICR,,,1151.57,1151.57,1
HCPCS,61720,CRTJ LES STRTCTC BURR GLOBUS PALLIDUS/THALAMUS,7753.0,5039.45,907.49,7753.0,35
HCPCS,61720,INCISE SKULL/BRAIN SURGERY,,,1253.28,13885.08,15
HCPCS,61720,Incise skull/brain surgery,,,3929.11,4963.09,6
HCPCS,617200,INCISE SKULL/BRAIN SURGERY,,,1253.28,1253.28,1
HCPCS,61735,INCISE SKULL/BRAIN SURGERY,,,1571.67,1571.67,1
HCPCS,61735,Incise skull/brain surgery,,,3929.11,4963.09,6
HCPCS,617350,INCISE SKULL/BRAIN SURGERY,,,1571.67,1571.67,1
HCPCS,61736,LITT ICR 1 TRAJ 1 SMPL LES,,,1184.79,1184.79,1
HCPCS,61736,LITT LES ICR SINGLE TRAJECTORY 1 SIMPLE LESION,7624.0,4955.6,675.3,7624.0,28
HCPCS,61736,Litt icr 1 traj 1 smpl les,,,3929.11,4963.09,6
HCPCS,617360,LITT ICR 1 TRAJ 1 SMPL LES,,,1184.79,1184.79,1
HCPCS,61737,LITT ICR MLT TRJ MLT/CPLX LS,,,1428.81,1428.81,1
HCPCS,61737,LITT LES ICR MLT TRAJECTORIES MLT/CPLX LESIONS,9068.0,5894.2,804.94,9068.0,28
HCPCS,61737,Litt icr mlt trj mlt/cplx ls,,,3929.11,4963.09,6
HCPCS,617370,LITT ICR MLT TRJ MLT/CPLX LS,,,1428.81,1428.81,1
HCPCS,61750,INCISE SKULL/BRAIN BIOPSY,,,1385.85,1385.85,1
HCPCS,61750,Incise skull/brain biopsy,,,3929.11,4963.09,6
HCPCS,61750,STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES,7932.0,5155.8,821.46,7932.0,35
HCPCS,617500,INCISE SKULL/BRAIN BIOPSY,,,1385.85,1385.85,1
HCPCS,61751,BRAIN BIOPSY W/CT/MR GUIDE,,,1365.5,1365.5,1
HCPCS,61751,Brain biopsy w/ct/mr guide,,,3929.11,4963.09,6
HCPCS,61751,STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR,7516.0,4885.4,1001.89,7516.0,35
HCPCS,617510,BRAIN BIOPSY W/CT/MR GUIDE,,,1365.5,1365.5,1
HCPCS,61760,IMPLANT BRAIN ELECTRODES,,,1552.33,1552.33,1
HCPCS,61760,Implant brain electrodes,,,3929.11,4963.09,6
HCPCS,61760,STRTCTC IMPLTJ ELTRD CEREBRUM SEIZURE MONITORING,8956.0,5821.4,990.86,8956.0,35
HCPCS,617600,IMPLANT BRAIN ELECTRODES,,,1552.33,1552.33,1
HCPCS,61770,INCISE SKULL FOR TREATMENT,,,1597.21,13885.08,15
HCPCS,61770,Incise skull for treatment,,,3929.11,4963.09,6
HCPCS,617700,INCISE SKULL FOR TREATMENT,,,1597.21,1597.21,1
HCPCS,61781,SCAN PROC CRANIAL INTRA,,,230.58,230.58,1
HCPCS,61781,STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL,1500.0,975.0,136.38,1500.0,35
HCPCS,61781,Scan proc cranial intra,,,2310.44,2918.45,6
HCPCS,617810,SCAN PROC CRANIAL INTRA,,,230.58,230.58,1
HCPCS,61782,SCAN PROC CRANIAL EXTRA,,,165.82,6830.0,3
HCPCS,61782,STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL,1399.0,909.35,111.23,1399.0,35
HCPCS,61782,Scan proc cranial extra,,,2310.44,2918.45,6
HCPCS,617820,SCAN PROC CRANIAL EXTRA,,,165.82,165.82,1
HCPCS,61783,SCAN PROC SPINAL,,,225.29,6830.0,5
HCPCS,61783,STEREOTACTIC COMPUTER ASSISTED PX SPINAL,1500.0,975.0,112.6,1500.0,35
HCPCS,61783,Scan proc spinal,,,3094.77,3909.18,6
HCPCS,617830,SCAN PROC SPINAL,,,225.29,225.29,1
HCPCS,61790,CREATE LESION STRTCTC PRQ NEUROLYTIC GASSERIAN,4640.0,3016.0,618.27,4640.0,35
HCPCS,61790,TREAT TRIGEMINAL NERVE,,,866.95,4233.93,16
HCPCS,61790,Treat trigeminal nerve,,,2310.44,2918.45,6
HCPCS,617900,TREAT TRIGEMINAL NERVE,,,866.95,866.95,1
HCPCS,61791,CREATE LES STRTCTC PRQ NEUROLYTIC TRIGEMINAL TRC,6780.0,4407.0,595.9,6780.0,35
HCPCS,61791,TREAT TRIGEMINAL TRACT,,,1110.4,4233.93,15
HCPCS,61791,Treat trigeminal tract,,,2310.44,2918.45,6
HCPCS,617910,TREAT TRIGEMINAL TRACT,,,1110.4,1110.4,1
HCPCS,61796,SRS CRANIAL LESION SIMPLE,,,1002.74,1002.74,1
HCPCS,61796,STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES,5572.0,3621.8,572.24,5572.0,35
HCPCS,61796,Srs cranial lesion simple,,,3066.36,3873.3,6
HCPCS,617960,SRS CRANIAL LESION SIMPLE,,,1002.74,1002.74,1
HCPCS,61797,SRS CRAN LES SIMPLE ADDL,,,214.96,214.96,1
HCPCS,61797,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE,1392.0,904.8,157.41,1392.0,35
HCPCS,61797,Srs cran les simple addl,,,3066.36,3873.3,6
HCPCS,617970,SRS CRAN LES SIMPLE ADDL,,,214.96,214.96,1
HCPCS,61798,SRS CRANIAL LESION COMPLEX,,,1359.46,1359.46,1
HCPCS,61798,STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES,7940.0,5161.0,674.61,7940.0,35
HCPCS,61798,Srs cranial lesion complex,,,3066.36,3873.3,6
HCPCS,617980,SRS CRANIAL LESION COMPLEX,,,1359.46,1359.46,1
HCPCS,61799,SRS CRAN LES COMPLEX ADDL,,,297.02,297.02,1
HCPCS,61799,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX,1924.0,1250.6,217.67,1924.0,35
HCPCS,61799,Srs cran les complex addl,,,3066.36,3873.3,6
HCPCS,617990,SRS CRAN LES COMPLEX ADDL,,,297.02,297.02,1
HCPCS,61800,APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY,900.0,585.0,111.72,900.0,35
HCPCS,61800,APPLY SRS HEADFRAME ADD-ON,,,147.17,147.17,1
HCPCS,61800,Apply srs headframe add-on,,,3066.36,3873.3,6
HCPCS,618000,APPLY SRS HEADFRAME ADD-ON,,,147.17,147.17,1
HCPCS,61850,IMPLANT NEUROELECTRODES,,,971.91,971.91,1
HCPCS,61850,Implant neuroelectrodes,,,11520.56,14552.29,6
HCPCS,61850,TWIST/BURR HOLE IMPLTJ NSTIM ELTRD CORTICAL,5870.0,3815.5,618.61,5870.0,35
HCPCS,618500,IMPLANT NEUROELECTRODES,,,971.91,971.91,1
HCPCS,61860,IMPLANT NEUROELECTRODES,,,1539.53,1539.53,1
HCPCS,61860,Implant neuroelectrodes,,,11520.56,14552.29,6
HCPCS,618600,IMPLANT NEUROELECTRODES,,,1539.53,1539.53,1
HCPCS,61863,IMPLANT NEUROELECTRODE,,,1482.06,1482.06,1
HCPCS,61863,Implant neuroelectrode,,,11520.56,14552.29,6
HCPCS,61863,STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD 1ST ARRAY,8284.0,5384.6,791.63,8284.0,35
HCPCS,618630,IMPLANT NEUROELECTRODE,,,1482.06,1482.06,1
HCPCS,61864,IMPLANT NEUROELECTRDE ADDL,,,276.49,276.49,1
HCPCS,61864,Implant neuroelectrde addl,,,11520.56,14552.29,6
HCPCS,61864,STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD EA ARRAY,1796.0,1167.4,217.79,1796.0,35
HCPCS,618640,IMPLANT NEUROELECTRDE ADDL,,,276.49,276.49,1
HCPCS,61867,IMPLANT NEUROELECTRODE,,,2243.53,2243.53,1
HCPCS,61867,Implant neuroelectrode,,,11520.56,14552.29,6
HCPCS,61867,STRTCTC IMPLTJ NSTIM ELTRD W/RECORD 1ST ARRAY,14533.0,9446.45,1164.96,14533.0,35
HCPCS,618670,IMPLANT NEUROELECTRODE,,,2243.53,2243.53,1
HCPCS,61868,IMPLANT NEUROELECTRDE ADDL,,,488.53,488.53,1
HCPCS,61868,Implant neuroelectrde addl,,,11520.56,14552.29,6
HCPCS,61868,STRTCTC IMPLTJ NSTIM ELTRD W/RECORD EA ARRAY,3480.0,2262.0,359.15,3480.0,35
HCPCS,618680,IMPLANT NEUROELECTRDE ADDL,,,488.53,488.53,1
HCPCS,61870,Implant neuroelectrodes,,,11520.56,14552.29,6
HCPCS,61880,REVISE/REMOVE NEUROELECTRODE,,,575.55,7456.34,15
HCPCS,61880,REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS,2780.0,1807.0,302.82,2780.0,35
HCPCS,61880,Revise/remove neuroelectrode,,,1950.92,2464.32,6
HCPCS,618800,REVISE/REMOVE NEUROELECTRODE,,,575.55,575.55,1
HCPCS,61885,INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR,2662.0,1730.3,308.94,2662.0,35
HCPCS,61885,INSRT/REDO NEUROSTIM 1 ARRAY,,,515.57,46494.97,15
HCPCS,61885,Insrt/redo neurostim 1 array,,,11520.56,14552.29,6
HCPCS,618850,INSRT/REDO NEUROSTIM 1 ARRAY,,,515.57,515.57,1
HCPCS,61886,IMPLANT NEUROSTIM ARRAYS,,,860.21,66071.77,15
HCPCS,61886,INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS,4369.0,2839.85,428.87,4369.0,35
HCPCS,61886,Implant neurostim arrays,,,11520.56,14552.29,6
HCPCS,618860,IMPLANT NEUROSTIM ARRAYS,,,860.21,860.21,1
HCPCS,61888,REVISE/REMOVE NEURORECEIVER,,,390.48,27037.69,15
HCPCS,61888,REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR,2092.0,1359.8,212.65,2092.0,35
HCPCS,61888,Revise/remove neuroreceiver,,,1950.92,2464.32,6
HCPCS,618880,REVISE/REMOVE NEURORECEIVER,,,390.48,390.48,1
HCPCS,61889,INS SK-MNT CRNL NSTM PG/RCVR,,,1230.35,1230.35,1
HCPCS,61889,INSERTION SKULL-MNTD CRANIAL NSTIM PG/RECEIVER,11330.0,7364.5,925.73,11330.0,28
HCPCS,61889,Ins sk-mnt crnl nstm pg/rcvr,,,11520.56,14552.29,6
HCPCS,618890,INS SK-MNT CRNL NSTM PG/RCVR,,,1230.35,1230.35,1
HCPCS,61891,REV/RPLCMT SK-MNT CRNL NSTM,,,580.66,46494.97,15
HCPCS,61891,REVJ/RPLCMT SKULL-MNTD CRANIAL NSTIM PG/RECEIVER,4950.0,3217.5,436.9,4950.0,28
HCPCS,61891,Rev/rplcmt sk-mnt crnl nstm,,,3699.03,4672.46,6
HCPCS,618910,REV/RPLCMT SK-MNT CRNL NSTM,,,580.66,580.66,1
HCPCS,61892,REMOVAL SKULL-MNTD CRANIAL NSTIM PG/RCVR W/CRNOP,6600.0,4290.0,600.59,6600.0,28
HCPCS,61892,RMV SK-MNT CRNL NSTM PG/RCVR,,,798.22,7034.85,15
HCPCS,61892,Rmv sk-mnt crnl nstm pg/rcvr,,,1950.92,2464.32,6
HCPCS,618920,RMV SK-MNT CRNL NSTM PG/RCVR,,,798.22,798.22,1
HCPCS,62000,TREAT SKULL FRACTURE,,,1019.17,7031.51,15
HCPCS,62000,Treat skull fracture,,,3929.11,4963.09,6
HCPCS,620000,TREAT SKULL FRACTURE,,,1019.17,1019.17,1
HCPCS,62005,ELVTN DEPRS SKL FX COMPOUND/COMMIND XDRL,7052.0,4583.8,738.47,7052.0,35
HCPCS,62005,TREAT SKULL FRACTURE,,,1254.25,1254.25,1
HCPCS,62005,Treat skull fracture,,,2513.55,3175.01,6
HCPCS,620050,TREAT SKULL FRACTURE,,,1254.25,1254.25,1
HCPCS,62010,ELVTN DEPRS SKL FX W/RPR DURA&/DBRDMT BRN,8572.0,5571.8,1041.31,8572.0,35
HCPCS,62010,TREATMENT OF HEAD INJURY,,,1514.32,1514.32,1
HCPCS,62010,Treatment of head injury,,,2513.55,3175.01,6
HCPCS,620100,TREATMENT OF HEAD INJURY,,,1514.32,1514.32,1
HCPCS,62100,CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA,10353.0,6729.45,1166.19,10353.0,35
HCPCS,62100,REPAIR BRAIN FLUID LEAKAGE,,,1541.86,1541.86,1
HCPCS,62100,Repair brain fluid leakage,,,2513.55,3175.01,6
HCPCS,621000,REPAIR BRAIN FLUID LEAKAGE,,,1541.86,1541.86,1
HCPCS,62115,REDUCTION OF SKULL DEFECT,,,1659.82,1659.82,1
HCPCS,62115,Reduction of skull defect,,,3929.11,4963.09,6
HCPCS,621150,REDUCTION OF SKULL DEFECT,,,1659.82,1659.82,1
HCPCS,62117,REDUCTION OF SKULL DEFECT,,,1933.53,1933.53,1
HCPCS,62117,Reduction of skull defect,,,3929.11,4963.09,6
HCPCS,621170,REDUCTION OF SKULL DEFECT,,,1933.53,1933.53,1
HCPCS,62120,REPAIR SKULL CAVITY LESION,,,2018.31,2018.31,1
HCPCS,62120,RPR ENCEPHALOCELE SKULL VAULT W/CRANIOPLASTY,9836.0,6393.4,1155.11,9836.0,35
HCPCS,62120,Repair skull cavity lesion,,,3929.11,4963.09,6
HCPCS,621200,REPAIR SKULL CAVITY LESION,,,2018.31,2018.31,1
HCPCS,62121,CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE,10133.0,6586.45,1066.96,10133.0,35
HCPCS,62121,INCISE SKULL REPAIR,,,1510.6,1510.6,1
HCPCS,62121,Incise skull repair,,,3929.11,4963.09,6
HCPCS,621210,INCISE SKULL REPAIR,,,1510.6,1510.6,1
HCPCS,62140,CRANIOPLASTY SKULL DEFECT </5 CM DIAMETER,5820.0,3783.0,722.99,5820.0,35
HCPCS,62140,CRNOP SKULL DEFECT<5 CM DIAM,,,1001.82,1001.82,1
HCPCS,62140,Crnop skull defect<5 cm diam,,,3929.11,4963.09,6
HCPCS,621400,CRNOP SKULL DEFECT<5 CM DIAM,,,1001.82,1001.82,1
HCPCS,62141,CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER,6428.0,4178.2,843.13,6428.0,35
HCPCS,62141,CRNOP SKULL DEFECT>5 CM DIAM,,,1122.72,1122.72,1
HCPCS,62141,Crnop skull defect>5 cm diam,,,3929.11,4963.09,6
HCPCS,621410,CRNOP SKULL DEFECT>5 CM DIAM,,,1122.72,1122.72,1
HCPCS,62142,RMVL B1 FLP/PROSTC PLATE SKL,,,876.68,876.68,1
HCPCS,62142,RMVL BONE FLAP/PROSTHETIC PLATE SKULL,4732.0,3075.8,616.83,4732.0,35
HCPCS,62142,Rmvl b1 flp/prostc plate skl,,,3929.11,4963.09,6
HCPCS,621420,RMVL B1 FLP/PROSTC PLATE SKL,,,876.68,876.68,1
HCPCS,62143,RPL B1 FLP/PROSTC PLATE SKL,,,1026.35,1026.35,1
HCPCS,62143,RPLCMT BONE FLAP/PROSTHETIC PLATE SKULL,5660.0,3679.0,607.74,5660.0,35
HCPCS,62143,Rpl b1 flp/prostc plate skl,,,3929.11,4963.09,6
HCPCS,621430,RPL B1 FLP/PROSTC PLATE SKL,,,1026.35,1026.35,1
HCPCS,62145,REPAIR OF SKULL & BRAIN,,,1398.98,1398.98,1
HCPCS,62145,Repair of skull & brain,,,3929.11,4963.09,6
HCPCS,621450,REPAIR OF SKULL & BRAIN,,,1398.98,1398.98,1
HCPCS,62146,CRANIOPLASTY W/AUTOGRAFT </ 5 CM DIAMETER,6912.0,4492.8,744.99,6912.0,35
HCPCS,62146,CRNOP W/AUTOGRAFT<5 CM DIAM,,,1232.09,1232.09,1
HCPCS,62146,Crnop w/autograft<5 cm diam,,,3929.11,4963.09,6
HCPCS,621460,CRNOP W/AUTOGRAFT<5 CM DIAM,,,1232.09,1232.09,1
HCPCS,62147,CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER,8268.0,5374.2,892.97,8268.0,35
HCPCS,62147,CRNOP W/AUTOGRAFT>5 CM DIAM,,,1391.68,1391.68,1
HCPCS,62147,Crnop w/autograft>5 cm diam,,,3929.11,4963.09,6
HCPCS,621470,CRNOP W/AUTOGRAFT>5 CM DIAM,,,1391.68,1391.68,1
HCPCS,62148,INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT,800.0,520.0,81.78,800.0,35
HCPCS,62148,RETR BONE FLAP TO FIX SKULL,,,123.09,123.09,1
HCPCS,62148,Retr bone flap to fix skull,,,3929.11,4963.09,6
HCPCS,621480,RETR BONE FLAP TO FIX SKULL,,,123.09,123.09,1
HCPCS,62160,NEUROENDOSCOPY ADD-ON,,,184.03,184.03,1
HCPCS,62160,NUNDSC ICRA PLMT/RPLCMT VENTR CATH SHUNT SYS,1200.0,780.0,118.01,1200.0,35
HCPCS,62160,Neuroendoscopy add-on,,,3929.11,4963.09,6
HCPCS,621600,NEUROENDOSCOPY ADD-ON,,,184.03,184.03,1
HCPCS,62161,DISSECT BRAIN W/SCOPE,,,1501.96,1501.96,1
HCPCS,62161,Dissect brain w/scope,,,3929.11,4963.09,6
HCPCS,62161,NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS,8492.0,5519.8,840.29,8492.0,35
HCPCS,621610,DISSECT BRAIN W/SCOPE,,,1501.96,1501.96,1
HCPCS,62162,REMOVE COLLOID CYST W/SCOPE,,,1860.14,1860.14,1
HCPCS,62162,Remove colloid cyst w/scope,,,3929.11,4963.09,6
HCPCS,621620,REMOVE COLLOID CYST W/SCOPE,,,1860.14,1860.14,1
HCPCS,62163,Zneuroendoscopy w/fb removal,,,3929.11,4963.09,6
HCPCS,62164,NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY,11772.0,7651.8,1166.64,11772.0,35
HCPCS,62164,REMOVE BRAIN TUMOR W/SCOPE,,,2060.86,2060.86,1
HCPCS,62164,Remove brain tumor w/scope,,,3929.11,4963.09,6
HCPCS,621640,REMOVE BRAIN TUMOR W/SCOPE,,,2060.86,2060.86,1
HCPCS,62165,NUNDSC ICRA EXC PITUITRY TUM TRNSNSL/SPHENOID,9292.0,6039.8,913.27,9292.0,35
HCPCS,62165,REMOVE PITUIT TUMOR W/SCOPE,,,1480.2,1480.2,1
HCPCS,62165,Remove pituit tumor w/scope,,,3929.11,4963.09,6
HCPCS,621650,REMOVE PITUIT TUMOR W/SCOPE,,,1480.2,1480.2,1
HCPCS,62180,ESTABLISH BRAIN CAVITY SHUNT,,,1575.73,1575.73,1
HCPCS,62180,Establish brain cavity shunt,,,3571.24,4511.04,6
HCPCS,62180,VENTRICULO-CISTERNOSTOMY,9032.0,5870.8,870.0,9032.0,35
HCPCS,621800,ESTABLISH BRAIN CAVITY SHUNT,,,1575.73,1575.73,1
HCPCS,62190,CRTJ SHUNT SARACH/SDRL-ATR-JUG-AUR,4868.0,3164.2,563.8,4868.0,35
HCPCS,62190,ESTABLISH BRAIN CAVITY SHUNT,,,916.17,916.17,1
HCPCS,62190,Establish brain cavity shunt,,,3571.24,4511.04,6
HCPCS,621900,ESTABLISH BRAIN CAVITY SHUNT,,,916.17,916.17,1
HCPCS,62192,CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH,5340.0,3471.0,694.58,5340.0,35
HCPCS,62192,ESTABLISH BRAIN CAVITY SHUNT,,,978.7,978.7,1
HCPCS,62192,Establish brain cavity shunt,,,3571.24,4511.04,6
HCPCS,621920,ESTABLISH BRAIN CAVITY SHUNT,,,978.7,978.7,1
HCPCS,62194,REPLACE/IRRIGATE CATHETER,,,484.95,4233.93,15
HCPCS,62194,RPLCMT/IRRG SUBARACHNOID/SUBDURAL CATHETER,2312.0,1502.8,242.3,2312.0,35
HCPCS,62194,Replace/irrigate catheter,,,459.05,579.85,6
HCPCS,621940,REPLACE/IRRIGATE CATHETER,,,484.95,484.95,1
HCPCS,62200,ESTABLISH BRAIN CAVITY SHUNT,,,1356.15,1356.15,1
HCPCS,62200,Establish brain cavity shunt,,,3571.24,4511.04,6
HCPCS,62200,"VENTRICULO-CISTERNOSTOMY,3RD VENT",7716.0,5015.4,949.97,7716.0,35
HCPCS,622000,ESTABLISH BRAIN CAVITY SHUNT,,,1356.15,1356.15,1
HCPCS,62201,BRAIN CAVITY SHUNT W/SCOPE,,,1194.84,1194.84,1
HCPCS,62201,Brain cavity shunt w/scope,,,3571.24,4511.04,6
HCPCS,62201,VENTRICULOCISTERNOSTOMY 3RD VNTRC NEURONDSC,6416.0,4170.4,655.61,6416.0,35
HCPCS,622010,BRAIN CAVITY SHUNT W/SCOPE,,,1194.84,1194.84,1
HCPCS,62220,CREATE SHUNT; VENTRIC-ATR JUGUL AURICL,5640.0,3666.0,738.65,5640.0,35
HCPCS,62220,ESTABLISH BRAIN CAVITY SHUNT,,,958.94,958.94,1
HCPCS,62220,Establish brain cavity shunt,,,3571.24,4511.04,6
HCPCS,622200,ESTABLISH BRAIN CAVITY SHUNT,,,958.94,958.94,1
HCPCS,62223,CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS,6182.0,4018.3,730.82,6182.0,35
HCPCS,62223,ESTABLISH BRAIN CAVITY SHUNT,,,1013.35,1013.35,1
HCPCS,62223,Establish brain cavity shunt,,,3571.24,4511.04,6
HCPCS,622230,ESTABLISH BRAIN CAVITY SHUNT,,,1013.35,1013.35,1
HCPCS,62225,REPLACE/IRRIGATE CATHETER,,,525.59,13885.08,15
HCPCS,62225,RPLCMT/IRRIGATION VENTRICULAR CATHETER,2724.0,1770.6,272.18,2724.0,35
HCPCS,62225,Replace/irrigate catheter,,,3571.24,4511.04,6
HCPCS,622250,REPLACE/IRRIGATE CATHETER,,,525.59,525.59,1
HCPCS,62230,REPLACE/REVISE BRAIN SHUNT,,,826.61,826.61,1
HCPCS,62230,RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS,29903.5,19437.275,548.88,49711.5,77
HCPCS,622300,REPLACE/REVISE BRAIN SHUNT,,,826.61,826.61,1
HCPCS,62252,CSF SHUNT REPROGRAM,,,36.8,36.8,2
HCPCS,62252,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,1456.0,946.4000000000001,21.15,3920.0,130
HCPCS,622520,CSF SHUNT REPROGRAM,,,36.8,36.8,1
HCPCS,62252TC,CSF SHUNT REPROGRAM,,,36.8,36.8,1
HCPCS,62256,REMOVE BRAIN CAVITY SHUNT,,,601.01,601.01,1
HCPCS,62256,RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT,2952.0,1918.8,353.73,2952.0,35
HCPCS,62256,Remove brain cavity shunt,,,3571.24,4511.04,6
HCPCS,622560,REMOVE BRAIN CAVITY SHUNT,,,601.01,601.01,1
HCPCS,62258,REPLACE BRAIN CAVITY SHUNT,,,1096.05,1096.05,1
HCPCS,62258,RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT,6256.0,4066.4,780.1,6256.0,35
HCPCS,62258,Replace brain cavity shunt,,,3571.24,4511.04,6
HCPCS,622580,REPLACE BRAIN CAVITY SHUNT,,,1096.05,1096.05,1
HCPCS,62263,EPIDURAL LYSIS MULT SESSIONS,,,309.6,1930.3,15
HCPCS,62263,Epidural lysis mult sessions,,,459.05,579.85,6
HCPCS,62263,PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS,2000.0,1300.0,151.23,1500.0,35
HCPCS,622630,EPIDURAL LYSIS MULT SESSIONS,,,309.6,309.6,1
HCPCS,62264,EPIDURAL LYSIS ON SINGLE DAY,,,234.44,1930.3,15
HCPCS,62264,Epidural lysis on single day,,,459.05,579.85,6
HCPCS,62264,PRQ LYSIS EPIDURAL ADHESIONS MULT SESSIONS 1 DAY,1768.0,1149.2,155.14,1326.0,35
HCPCS,622640,EPIDURAL LYSIS ON SINGLE DAY,,,234.44,234.44,1
HCPCS,62267,INTERDISCAL PERQ ASPIR DX,,,147.14,147.14,1
HCPCS,62267,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,3634.5,2362.425,102.19,5462.1,179
HCPCS,622670,INTERDISCAL PERQ ASPIR DX,,,147.14,147.14,1
HCPCS,62268,DRAIN SPINAL CORD CYST,,,321.94,321.94,1
HCPCS,62268,PERCUTANEOUS ASPIRATION SPINAL CORD CYST/SYRINX,4785.5,3110.5750000000003,197.07,6911.1,84
HCPCS,622680,DRAIN SPINAL CORD CYST,,,321.94,321.94,1
HCPCS,62269,BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE,8151.0,5298.15,195.91,12577.5,84
HCPCS,62269,NEEDLE BIOPSY SPINAL CORD,,,247.03,247.03,1
HCPCS,622690,NEEDLE BIOPSY SPINAL CORD,,,247.03,247.03,1
HCPCS,62270,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,3255.0,2115.75,29.92,5375.7,372
HCPCS,62270,DX LMBR SPI PNXR,,,61.93,61.93,1
HCPCS,622700,DX LMBR SPI PNXR,,,61.93,61.93,1
HCPCS,62272,THER SPI PNXR DRG CSF,,,89.37,89.37,1
HCPCS,62272,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,3302.5,2146.625,53.21,5375.7,277
HCPCS,622720,THER SPI PNXR DRG CSF,,,89.37,89.37,1
HCPCS,62273,INJECT EPIDURAL PATCH,,,108.76,108.76,1
HCPCS,62273,INJECTION EPIDURAL BLOOD/CLOT PATCH,3459.5,2248.6749999999997,54.42,6317.0,277
HCPCS,622730,INJECT EPIDURAL PATCH,,,108.76,108.76,1
HCPCS,62280,INJX/INFUSION NEUROLYTIC SUBSTANCE SUBARACHNOID,1052.0,683.8,84.51,789.0,35
HCPCS,62280,TREAT SPINAL CORD LESION,,,152.85,1930.3,15
HCPCS,62280,Treat spinal cord lesion,,,459.05,579.85,6
HCPCS,622800,TREAT SPINAL CORD LESION,,,152.85,152.85,1
HCPCS,62281,INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC,1064.0,691.6,93.75,798.0,35
HCPCS,62281,TREAT SPINAL CORD LESION,,,148.56,1930.3,15
HCPCS,62281,Treat spinal cord lesion,,,459.05,579.85,6
HCPCS,622810,TREAT SPINAL CORD LESION,,,148.56,148.56,1
HCPCS,62282,INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL,1025.0,666.25,91.0,768.75,35
HCPCS,62282,TREAT SPINAL CANAL LESION,,,135.5,1930.3,15
HCPCS,62282,Treat spinal canal lesion,,,459.05,579.85,6
HCPCS,622820,TREAT SPINAL CANAL LESION,,,135.5,135.5,1
HCPCS,62284,INJECTION FOR MYELOGRAM,,,79.34,79.34,1
HCPCS,62284,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,1295.0,841.75,40.76,3920.0,184
HCPCS,622840,INJECTION FOR MYELOGRAM,,,79.34,79.34,1
HCPCS,62287,DCMPRN PQ NUC PUL 1/MLT LMBR,,,575.52,4233.93,15
HCPCS,62287,DCMPRN PX PERQ NUCLEUS PULPOSUS 1/MLT LVL LUMBAR,3612.0,2347.8,405.32,3612.0,35
HCPCS,62287,Dcmprn pq nuc pul 1/mlt lmbr,,,3094.77,3909.18,6
HCPCS,622870,DCMPRN PQ NUC PUL 1/MLT LMBR,,,575.52,575.52,1
HCPCS,62290,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,1914.5,1244.425,77.09,3920.0,146
HCPCS,62290,NJX PX DISCOGRAPHY LUMBAR,,,149.43,149.43,1
HCPCS,622900,NJX PX DISCOGRAPHY LUMBAR,,,149.43,149.43,1
HCPCS,62291,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,1537.0,999.05,122.28,3920.0,111
HCPCS,62291,NJX PX DISCOGRAPHY CRV/THRC,,,136.68,136.68,1
HCPCS,622910,NJX PX DISCOGRAPHY CRV/THRC,,,136.68,136.68,1
HCPCS,62292,INJECTION PX CHEMONUCLEOLYSIS 1/MLT LUMBAR,3696.0,2402.4,427.83,3696.0,35
HCPCS,62292,NJX CHEMONUCLEOLYSIS LMBR,,,557.24,4233.93,15
HCPCS,62292,Njx chemonucleolysis lmbr,,,459.05,579.85,6
HCPCS,622920,NJX CHEMONUCLEOLYSIS LMBR,,,557.24,557.24,1
HCPCS,62294,INJECTION INTO SPINAL ARTERY,,,893.66,1930.3,15
HCPCS,62294,Injection into spinal artery,,,459.05,579.85,6
HCPCS,622940,INJECTION INTO SPINAL ARTERY,,,939.59,939.59,1
HCPCS,62302,MYELOGRAPHY LUMBAR INJECTION,,,113.39,113.39,1
HCPCS,62302,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,3865.0,2512.25,93.39,6132.6,175
HCPCS,623020,MYELOGRAPHY LUMBAR INJECTION,,,113.39,113.39,1
HCPCS,62303,MYELOGRAPHY LUMBAR INJECTION,,,113.35,113.35,1
HCPCS,62303,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,3865.0,2512.25,94.65,6132.6,224
HCPCS,623030,MYELOGRAPHY LUMBAR INJECTION,,,113.35,113.35,1
HCPCS,62304,MYELOGRAPHY LUMBAR INJECTION,,,112.06,112.06,1
HCPCS,62304,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,3857.0,2507.05,91.81,6132.6,224
HCPCS,623040,MYELOGRAPHY LUMBAR INJECTION,,,112.06,112.06,1
HCPCS,62305,MYELOGRAPHY LUMBAR INJECTION,,,116.27,116.27,1
HCPCS,62305,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,3877.0,2520.05,95.78,6132.6,224
HCPCS,623050,MYELOGRAPHY LUMBAR INJECTION,,,116.27,116.27,1
HCPCS,62320,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,3382.5,2198.625,78.13,6317.0,175
HCPCS,62320,NJX INTERLAMINAR CRV/THRC,,,96.1,96.1,1
HCPCS,623200,NJX INTERLAMINAR CRV/THRC,,,96.1,96.1,1
HCPCS,62321,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,3415.5,2220.075,84.27,6317.0,175
HCPCS,62321,NJX INTERLAMINAR CRV/THRC,,,102.92,102.92,1
HCPCS,623210,NJX INTERLAMINAR CRV/THRC,,,102.92,102.92,1
HCPCS,62322,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,4180.5,2717.3250000000003,67.21,6911.1,175
HCPCS,62322,NJX INTERLAMINAR LMBR/SAC,,,76.36,76.36,1
HCPCS,623220,NJX INTERLAMINAR LMBR/SAC,,,76.36,76.36,1
HCPCS,62323,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,3382.5,2198.625,76.83,6317.0,175
HCPCS,62323,NJX INTERLAMINAR LMBR/SAC,,,95.21,95.21,1
HCPCS,623230,NJX INTERLAMINAR LMBR/SAC,,,95.21,95.21,1
HCPCS,62324,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,5973.0,3882.45,71.86,6911.1,126
HCPCS,62324,NJX INTERLAMINAR CRV/THRC,,,85.75,85.75,1
HCPCS,623240,NJX INTERLAMINAR CRV/THRC,,,85.75,85.75,1
HCPCS,62325,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,4323.5,2810.275,82.66,6911.1,126
HCPCS,62325,NJX INTERLAMINAR CRV/THRC,,,106.11,106.11,1
HCPCS,623250,NJX INTERLAMINAR CRV/THRC,,,106.11,106.11,1
HCPCS,62326,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,4231.0,2750.15,70.3,7730.0,126
HCPCS,62326,NJX INTERLAMINAR LMBR/SAC,,,82.11,82.11,1
HCPCS,623260,NJX INTERLAMINAR LMBR/SAC,,,82.11,82.11,1
HCPCS,62327,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,4257.5,2767.375,78.61,7730.0,126
HCPCS,62327,NJX INTERLAMINAR LMBR/SAC,,,102.82,102.82,1
HCPCS,623270,NJX INTERLAMINAR LMBR/SAC,,,102.82,102.82,1
HCPCS,62328,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,3332.5,2166.125,69.52,26432.0,236
HCPCS,62328,DX LMBR SPI PNXR W/FLUOR/CT,,,81.71,81.71,1
HCPCS,623280,DX LMBR SPI PNXR W/FLUOR/CT,,,81.71,81.71,1
HCPCS,62329,THER SPI PNXR CSF FLUOR/CT,,,100.29,100.29,1
HCPCS,62329,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,5973.0,3882.45,87.67,26432.0,248
HCPCS,623290,THER SPI PNXR CSF FLUOR/CT,,,100.29,100.29,1
HCPCS,62330,DCMPRN PERQ PRTL RMVL LIGA FLAVM BI 1NTRSPC LMBR,3520.0,2288.0,503.41,3520.0,21
HCPCS,62330,DCMPRN PRQ RMV LIG FLV 1LMBR,,,460.14,8335.26,5
HCPCS,62330,Dcmprn prq rmv lig flv 1lmbr,,,3094.77,3909.18,6
HCPCS,623300,DCMPRN PRQ RMV LIG FLV 1LMBR,,,460.14,460.14,1
HCPCS,62331,DCMPRN PRQ PRT RMV LIGA FLAVM BI ADD NTRSPC LMBR,1870.0,1215.5,200.75,1870.0,21
HCPCS,62331,DCMPRN PRQ RMV LIG FLV ADDL,,,184.97,184.97,1
HCPCS,62331,Dcmprn prq rmv lig flv addl,,,3094.77,3909.18,6
HCPCS,623310,DCMPRN PRQ RMV LIG FLV ADDL,,,184.97,184.97,1
HCPCS,62350,IMPLANT SPINAL CANAL CATH,,,385.46,13885.08,16
HCPCS,62350,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM,2662.0,1730.3,290.23,2662.0,35
HCPCS,62350,Implant spinal canal cath,,,3094.77,3909.18,6
HCPCS,623500,IMPLANT SPINAL CANAL CATH,,,385.46,385.46,1
HCPCS,62351,IMPLANT SPINAL CANAL CATH,,,891.58,15488.78,15
HCPCS,62351,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH W/LAM,4664.0,3031.6,445.14,4664.0,35
HCPCS,62351,Implant spinal canal cath,,,6141.85,7758.12,6
HCPCS,623510,IMPLANT SPINAL CANAL CATH,,,891.58,891.58,1
HCPCS,62355,REMOVE SPINAL CANAL CATHETER,,,266.37,4233.93,15
HCPCS,62355,RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH,1420.0,923.0,218.56,1420.0,35
HCPCS,62355,Remove spinal canal catheter,,,459.05,579.85,6
HCPCS,623550,REMOVE SPINAL CANAL CATHETER,,,266.37,266.37,1
HCPCS,62360,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS SUBQ RSVR,1732.0,1125.8,157.98,1732.0,35
HCPCS,62360,INSERT SPINE INFUSION DEVICE,,,300.23,38320.4,15
HCPCS,62360,Insert spine infusion device,,,7446.2,9405.72,6
HCPCS,623600,INSERT SPINE INFUSION DEVICE,,,300.23,300.23,1
HCPCS,62361,IMPLANT SPINE INFUSION PUMP,,,425.66,425.66,1
HCPCS,62361,IMPLTJ/RPLCMT FS NON-PRGRBL PUMP,23065.5,14992.575,259.03,46695.0,77
HCPCS,623610,IMPLANT SPINE INFUSION PUMP,,,425.66,425.66,1
HCPCS,62362,IMPLANT SPINE INFUSION PUMP,,,373.73,38320.4,16
HCPCS,62362,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP,2464.0,1601.6,299.75,2464.0,35
HCPCS,62362,Implant spine infusion pump,,,7446.2,9405.72,6
HCPCS,623620,IMPLANT SPINE INFUSION PUMP,,,373.73,373.73,1
HCPCS,62365,REMOVE SPINE INFUSION DEVICE,,,288.63,13885.08,15
HCPCS,62365,RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS,1572.0,1021.8,232.6,1572.0,35
HCPCS,62365,Remove spine infusion device,,,3094.77,3909.18,6
HCPCS,623650,REMOVE SPINE INFUSION DEVICE,,,288.63,288.63,1
HCPCS,62367,ANALYZE SPINE INFUS PUMP,,,23.95,23.95,1
HCPCS,62367,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,1398.5,909.0250000000001,12.17,3920.0,176
HCPCS,623670,ANALYZE SPINE INFUS PUMP,,,23.95,23.95,1
HCPCS,62368,ANALYZE SP INF PUMP W/REPROG,,,33.03,33.03,1
HCPCS,62368,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,1440.5,936.325,16.93,3920.0,179
HCPCS,623680,ANALYZE SP INF PUMP W/REPROG,,,33.03,33.03,1
HCPCS,62369,ANAL SP INF PMP W/REPRG&FILL,295.0,191.75,17.1,221.25,36
HCPCS,62369,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/REPRG&REFIL,2586.0,1680.9,41.1,4151.0,46
HCPCS,623690,ANAL SP INF PMP W/REPRG&FILL,,,33.63,33.63,1
HCPCS,62370,ANL SP INF PMP W/MDREPRG&FIL,,,44.03,44.03,1
HCPCS,62370,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR PHYS/QHP,2586.0,1680.9,54.99,4151.0,46
HCPCS,62370,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR&REF PHYS,396.0,257.4,22.19,297.0,35
HCPCS,623700,ANL SP INF PMP W/MDREPRG&FIL,,,44.03,44.03,1
HCPCS,62380,NDSC DCMPRN 1 NTRSPC LUMBAR,,,1274.09,15488.78,15
HCPCS,62380,NDSC DCMPRN SPINAL CORD 1 W/LAMOT NTRSPC LUMBAR,5916.0,3845.4,620.09,5916.0,16
HCPCS,62380,Ndsc dcmprn 1 ntrspc lumbar,,,3094.77,3909.18,6
HCPCS,623800,NDSC DCMPRN 1 NTRSPC LUMBAR,,,1274.09,1274.09,1
HCPCS,63001,LAM W/O FACETEC FORAMOT/DSC 1/2 VRT SGM CRV,7044.0,4578.6,892.18,7044.0,35
HCPCS,63001,REMOVE SPINE LAMINA 1/2 CRVL,,,1205.8,15488.78,15
HCPCS,63001,Remove spine lamina 1/2 crvl,,,3094.77,3909.18,6
HCPCS,630010,REMOVE SPINE LAMINA 1/2 CRVL,,,1205.8,1205.8,1
HCPCS,63003,LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC,7096.0,4612.4,898.72,7096.0,35
HCPCS,63003,REMOVE SPINE LAMINA 1/2 THRC,,,1210.32,15488.78,15
HCPCS,63003,Remove spine lamina 1/2 thrc,,,3094.77,3909.18,6
HCPCS,630030,REMOVE SPINE LAMINA 1/2 THRC,,,1210.32,1210.32,1
HCPCS,63005,LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR,6572.0,4271.8,844.0,6572.0,35
HCPCS,63005,REMOVE SPINE LAMINA 1/2 LMBR,,,1175.57,15488.78,15
HCPCS,63005,Remove spine lamina 1/2 lmbr,,,3094.77,3909.18,6
HCPCS,630050,REMOVE SPINE LAMINA 1/2 LMBR,,,1175.57,1175.57,1
HCPCS,63011,LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL,6364.0,4136.6,659.82,6364.0,35
HCPCS,63011,REMOVE SPINE LAMINA 1/2 SCRL,,,1058.48,15488.78,15
HCPCS,63011,Remove spine lamina 1/2 scrl,,,3094.77,3909.18,6
HCPCS,630110,REMOVE SPINE LAMINA 1/2 SCRL,,,1058.48,1058.48,1
HCPCS,63012,LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR,6740.0,4381.0,866.76,6740.0,35
HCPCS,63012,REMOVE LAMINA/FACETS LUMBAR,,,1166.73,15488.78,15
HCPCS,63012,Remove lamina/facets lumbar,,,3094.77,3909.18,6
HCPCS,630120,REMOVE LAMINA/FACETS LUMBAR,,,1166.73,1166.73,1
HCPCS,63015,LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL,8340.0,5421.0,1090.51,8340.0,35
HCPCS,63015,REMOVE SPINE LAMINA >2 CRVCL,,,1453.02,15488.78,15
HCPCS,63015,Remove spine lamina >2 crvcl,,,3094.77,3909.18,6
HCPCS,630150,REMOVE SPINE LAMINA >2 CRVCL,,,1453.02,1453.02,1
HCPCS,63016,LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC,8812.0,5727.8,1083.44,8812.0,35
HCPCS,63016,REMOVE SPINE LAMINA >2 THRC,,,1495.36,15488.78,15
HCPCS,63016,Remove spine lamina >2 thrc,,,3094.77,3909.18,6
HCPCS,630160,REMOVE SPINE LAMINA >2 THRC,,,1495.36,1495.36,1
HCPCS,63017,LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR,6932.0,4505.8,914.77,6932.0,35
HCPCS,63017,REMOVE SPINE LAMINA >2 LMBR,,,1240.39,15488.78,15
HCPCS,63017,Remove spine lamina >2 lmbr,,,3094.77,3909.18,6
HCPCS,630170,REMOVE SPINE LAMINA >2 LMBR,,,1240.39,1240.39,1
HCPCS,63020,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC,5964.0,3876.6,838.31,5964.0,35
HCPCS,63020,LAMOT DCMPRN NRV RT 1 CERV,,,1069.99,15488.78,15
HCPCS,63020,Lamot dcmprn nrv rt 1 cerv,,,3094.77,3909.18,6
HCPCS,630200,LAMOT DCMPRN NRV RT 1 CERV,,,1069.99,1069.99,1
HCPCS,63030,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR,4800.0,3120.0,688.29,4800.0,35
HCPCS,63030,LAMOT DCMPRN NRV RT 1 LMBR,,,890.2,15488.78,17
HCPCS,63030,Lamot dcmprn nrv rt 1 lmbr,,,3094.77,3909.18,6
HCPCS,630300,LAMOT DCMPRN NRV RT 1 LMBR,,,890.2,890.2,1
HCPCS,63032,LAMOT DCMPRN NRV RT RPR ANULR DFCT 1NTRSPC LMBR,1100.0,715.0,158.73,1100.0,21
HCPCS,63032,LAMOT RPR ANULR DFCT 1 LMBR,,,133.34,133.34,1
HCPCS,63032,Lamot rpr anulr dfct 1 lmbr,,,3094.77,3909.18,6
HCPCS,630320,LAMOT RPR ANULR DFCT 1 LMBR,,,133.34,133.34,1
HCPCS,63035,LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR,1544.0,1003.6,166.02,1544.0,35
HCPCS,63035,LAMOT DCMPRN NRV RT EA ADDL,,,226.56,226.56,1
HCPCS,63035,Lamot dcmprn nrv rt ea addl,,,3094.77,3909.18,6
HCPCS,630350,LAMOT DCMPRN NRV RT EA ADDL,,,226.56,226.56,1
HCPCS,63040,LAMINOTOMY SINGLE CERVICAL,,,1342.39,15488.78,15
HCPCS,63040,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL,8124.0,5280.6,1015.96,8124.0,35
HCPCS,63040,Laminotomy single cervical,,,3094.77,3909.18,6
HCPCS,630400,LAMINOTOMY SINGLE CERVICAL,,,1342.39,1342.39,1
HCPCS,63042,LAMINOTOMY SINGLE LUMBAR,,,1261.79,15488.78,15
HCPCS,63042,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR,7504.0,4877.6,954.38,7504.0,35
HCPCS,63042,Laminotomy single lumbar,,,3094.77,3909.18,6
HCPCS,630420,LAMINOTOMY SINGLE LUMBAR,,,1261.79,1261.79,1
HCPCS,63043,LAMINOTOMY ADDL CERVICAL,,,582.03,582.03,1
HCPCS,63043,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV,4346.0,2824.9,129.27,4346.0,17
HCPCS,63043,Laminotomy addl cervical,,,3094.77,3909.18,6
HCPCS,630430,LAMINOTOMY ADDL CERVICAL,,,582.03,582.03,1
HCPCS,63044,LAMINOTOMY ADDL LUMBAR,,,552.69,552.69,1
HCPCS,63044,LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR,3744.0,2433.6,129.27,3744.0,17
HCPCS,63044,Laminotomy addl lumbar,,,6141.85,7758.12,6
HCPCS,630440,LAMINOTOMY ADDL LUMBAR,,,552.69,552.69,1
HCPCS,63045,LAM FACETEC & FORAMOT CRV,,,1259.87,15488.78,16
HCPCS,63045,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM CERVICAL,7180.0,4667.0,951.35,7180.0,35
HCPCS,63045,Lam facetec & foramot crv,,,3094.77,3909.18,6
HCPCS,630450,LAM FACETEC & FORAMOT CRV,,,1259.87,1259.87,1
HCPCS,63046,LAM FACETEC & FORAMOT THRC,,,1201.08,15488.78,15
HCPCS,63046,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM THORACIC,7590.0,4933.5,920.08,7590.0,35
HCPCS,63046,Lam facetec & foramot thrc,,,3094.77,3909.18,6
HCPCS,630460,LAM FACETEC & FORAMOT THRC,,,1201.08,1201.08,1
HCPCS,63047,LAM FACETEC & FORAMOT LUMBAR,,,1077.8,15651.0,18
HCPCS,63047,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR,6763.0,4395.95,817.74,6763.0,35
HCPCS,63047,Lam facetec & foramot lumbar,,,3094.77,3909.18,6
HCPCS,630470,LAM FACETEC & FORAMOT LUMBAR,,,1077.8,1077.8,1
HCPCS,63048,LAM FACETEC &FORAMOT EA ADDL,,,204.52,521.0,2
HCPCS,63048,LAM FACETECTOMY&FORAMOT 1 VRT SGM EA ADDL SGM,1527.0,992.55,161.62,1527.0,35
HCPCS,63048,Lam facetec &foramot ea addl,,,3094.77,3909.18,6
HCPCS,630480,LAM FACETEC &FORAMOT EA ADDL,,,204.52,204.52,1
HCPCS,63050,CERVICAL LAMINOPLSTY 2/> SEG,,,1427.22,1427.22,1
HCPCS,63050,Cervical laminoplsty 2/> seg,,,6141.85,7758.12,6
HCPCS,63050,LAMOP CERVICAL W/DCMPRN SPI CORD 2/> VERT SEG,9684.0,6294.6,1031.44,9684.0,35
HCPCS,630500,CERVICAL LAMINOPLSTY 2/> SEG,,,1427.22,1427.22,1
HCPCS,63051,C-LAMINOPLASTY W/GRAFT/PLATE,,,1647.29,1647.29,1
HCPCS,63051,C-laminoplasty w/graft/plate,,,6141.85,7758.12,6
HCPCS,63051,LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ,11224.0,7295.6,1174.06,11224.0,35
HCPCS,630510,C-LAMINOPLASTY W/GRAFT/PLATE,,,1647.29,1647.29,1
HCPCS,63052,LAM FACETC/FRMT ARTHRD LUM 1,,,250.6,250.6,1
HCPCS,63052,LAM FACETEC/FORAMOT DRG ARTHRD LUMBAR 1 VRT SGM,1700.0,1105.0,193.05,1700.0,28
HCPCS,63052,Lam facetc/frmt arthrd lum 1,,,6141.85,7758.12,6
HCPCS,630520,LAM FACETC/FRMT ARTHRD LUM 1,,,250.6,250.6,1
HCPCS,63053,LAM FACETEC/FORAMOT DRG ARTHRD LMBR EA ADDL SGM,1512.0,982.8,144.36,1512.0,28
HCPCS,63053,LAM FACTC/FRMT ARTHRD LUM EA,,,222.71,222.71,1
HCPCS,63053,Lam factc/frmt arthrd lum ea,,,6141.85,7758.12,6
HCPCS,630530,LAM FACTC/FRMT ARTHRD LUM EA,,,222.71,222.71,1
HCPCS,63055,DECOMPRESS SPINAL CORD THRC,,,1592.24,15488.78,15
HCPCS,63055,Decompress spinal cord thrc,,,3094.77,3909.18,6
HCPCS,63055,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC,9420.0,6123.0,1218.88,9420.0,35
HCPCS,630550,DECOMPRESS SPINAL CORD THRC,,,1592.24,1592.24,1
HCPCS,63056,DECOMPRESS SPINAL CORD LMBR,,,1455.0,15488.78,16
HCPCS,63056,Decompress spinal cord lmbr,,,3094.77,3909.18,6
HCPCS,63056,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR,8744.0,5683.6,1124.67,8744.0,35
HCPCS,630560,DECOMPRESS SPINAL CORD LMBR,,,1455.0,1455.0,1
HCPCS,63057,DECOMPRESS SPINE CORD ADD-ON,,,312.53,312.53,1
HCPCS,63057,Decompress spine cord add-on,,,3094.77,3909.18,6
HCPCS,63057,TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR,2100.0,1365.0,225.82,2100.0,35
HCPCS,630570,DECOMPRESS SPINE CORD ADD-ON,,,312.53,312.53,1
HCPCS,63064,COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG,10488.0,6817.2,1295.97,10488.0,35
HCPCS,63064,DECOMPRESS SPINAL CORD THRC,,,1739.38,15488.78,15
HCPCS,63064,Decompress spinal cord thrc,,,3094.77,3909.18,6
HCPCS,630640,DECOMPRESS SPINAL CORD THRC,,,1739.38,1739.38,1
HCPCS,63066,COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG,1304.0,847.6,156.76,1304.0,35
HCPCS,63066,DECOMPRESS SPINE CORD ADD-ON,,,200.96,200.96,1
HCPCS,63066,Decompress spine cord add-on,,,3094.77,3909.18,6
HCPCS,630660,DECOMPRESS SPINE CORD ADD-ON,,,200.96,200.96,1
HCPCS,63075,DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC,7840.0,5096.0,998.88,7840.0,35
HCPCS,63075,NECK SPINE DISK SURGERY,,,1319.89,15488.78,15
HCPCS,63075,Neck spine disk surgery,,,6141.85,7758.12,6
HCPCS,630750,NECK SPINE DISK SURGERY,,,1319.89,1319.89,1
HCPCS,63076,DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC,1616.0,1050.4,187.15,1616.0,35
HCPCS,63076,NECK SPINE DISK SURGERY,,,234.2,234.2,1
HCPCS,63076,Neck spine disk surgery,,,6141.85,7758.12,6
HCPCS,630760,NECK SPINE DISK SURGERY,,,234.2,234.2,1
HCPCS,63077,DISCECTOMY ANT DCMPRN CORD THORACIC 1 NTRSPC,9152.0,5948.8,1076.49,9152.0,35
HCPCS,63077,SPINE DISK SURGERY THORAX,,,1409.4,1409.4,1
HCPCS,63077,Spine disk surgery thorax,,,3094.77,3909.18,6
HCPCS,630770,SPINE DISK SURGERY THORAX,,,1409.4,1409.4,1
HCPCS,63078,DISCECTOMY ANT DCMPRN CORD THORACIC EA NTRSPC,1312.0,852.8,150.32,1312.0,35
HCPCS,63078,SPINE DISK SURGERY THORAX,,,202.25,202.25,1
HCPCS,63078,Spine disk surgery thorax,,,6141.85,7758.12,6
HCPCS,630780,SPINE DISK SURGERY THORAX,,,202.25,202.25,1
HCPCS,63081,REMOVE VERT BODY DCMPRN CRVL,,,1721.42,1721.42,1
HCPCS,63081,Remove vert body dcmprn crvl,,,6141.85,7758.12,6
HCPCS,63081,VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG,10440.0,6786.0,1325.14,10440.0,35
HCPCS,630810,REMOVE VERT BODY DCMPRN CRVL,,,1721.42,1721.42,1
HCPCS,63082,REMOVE VERTEBRAL BODY ADD-ON,,,258.49,258.49,1
HCPCS,63082,Remove vertebral body add-on,,,9774.46,12346.69,6
HCPCS,63082,VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG,1744.0,1133.6,204.0,1744.0,35
HCPCS,630820,REMOVE VERTEBRAL BODY ADD-ON,,,258.49,258.49,1
HCPCS,63085,REMOVE VERT BODY DCMPRN THRC,,,1898.39,1898.39,1
HCPCS,63085,Remove vert body dcmprn thrc,,,9774.46,12346.69,6
HCPCS,63085,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG,11788.0,7662.2,1447.08,11788.0,35
HCPCS,630850,REMOVE VERT BODY DCMPRN THRC,,,1898.39,1898.39,1
HCPCS,63086,REMOVE VERTEBRAL BODY ADD-ON,,,186.28,186.28,1
HCPCS,63086,Remove vertebral body add-on,,,9774.46,12346.69,6
HCPCS,630860,REMOVE VERTEBRAL BODY ADD-ON,,,186.28,186.28,1
HCPCS,63087,REMOV VERTBR DCMPRN THRCLMBR,,,2362.37,2362.37,1
HCPCS,63087,Remov vertbr dcmprn thrclmbr,,,9774.46,12346.69,6
HCPCS,63087,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG,15012.0,9757.8,1703.49,15012.0,35
HCPCS,630870,REMOV VERTBR DCMPRN THRCLMBR,,,2362.37,2362.37,1
HCPCS,63088,REMOVE VERTEBRAL BODY ADD-ON,,,252.04,252.04,1
HCPCS,63088,Remove vertebral body add-on,,,9774.46,12346.69,6
HCPCS,63088,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG,1728.0,1123.2,198.13,1728.0,35
HCPCS,630880,REMOVE VERTEBRAL BODY ADD-ON,,,252.04,252.04,1
HCPCS,63090,REMOVE VERT BODY DCMPRN LMBR,,,1892.58,1892.58,1
HCPCS,63090,Remove vert body dcmprn lmbr,,,9774.46,12346.69,6
HCPCS,63090,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG,12372.0,8041.8,1450.44,12372.0,35
HCPCS,630900,REMOVE VERT BODY DCMPRN LMBR,,,1892.58,1892.58,1
HCPCS,63091,REMOVE VERTEBRAL BODY ADD-ON,,,169.73,169.73,1
HCPCS,63091,Remove vertebral body add-on,,,9774.46,12346.69,6
HCPCS,63091,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG,1212.0,787.8,133.79,1212.0,35
HCPCS,630910,REMOVE VERTEBRAL BODY ADD-ON,,,169.73,169.73,1
HCPCS,63101,REMOVE VERT BODY DCMPRN THRC,,,2274.13,2274.13,1
HCPCS,63101,Remove vert body dcmprn thrc,,,9774.46,12346.69,6
HCPCS,63101,VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG,13640.0,8866.0,1455.9,13640.0,35
HCPCS,631010,REMOVE VERT BODY DCMPRN THRC,,,2274.13,2274.13,1
HCPCS,63102,REMOVE VERT BODY DCMPRN LMBR,,,2229.64,2229.64,1
HCPCS,63102,Remove vert body dcmprn lmbr,,,9774.46,12346.69,6
HCPCS,63102,VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG,15004.0,9752.6,1455.9,15004.0,35
HCPCS,631020,REMOVE VERT BODY DCMPRN LMBR,,,2229.64,2229.64,1
HCPCS,63103,REMOVE VERTEBRAL BODY ADD-ON,,,285.08,285.08,1
HCPCS,63103,Remove vertebral body add-on,,,9774.46,12346.69,6
HCPCS,63103,VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG,2121.0,1378.65,170.33,2121.0,35
HCPCS,631030,REMOVE VERTEBRAL BODY ADD-ON,,,285.08,285.08,1
HCPCS,63170,INCISE SPINAL CORD TRACT(S),,,1570.03,1570.03,1
HCPCS,63170,Incise spinal cord tract(s),,,9774.46,12346.69,6
HCPCS,63170,LAM W/MYELOTOMY CERVICAL/THORACIC/THORACOLUMBAR,8884.0,5774.6,1039.59,8884.0,35
HCPCS,631700,INCISE SPINAL CORD TRACT(S),,,1570.03,1570.03,1
HCPCS,63172,DRAINAGE OF SPINAL CYST,,,1392.38,1392.38,1
HCPCS,63172,Drainage of spinal cyst,,,3094.77,3909.18,6
HCPCS,63172,LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID,7904.0,5137.6,1010.6,7904.0,35
HCPCS,631720,DRAINAGE OF SPINAL CYST,,,1392.38,1392.38,1
HCPCS,63173,DRAINAGE OF SPINAL CYST,,,1700.71,1700.71,1
HCPCS,63173,Drainage of spinal cyst,,,9774.46,12346.69,6
HCPCS,63173,LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL,9724.0,6320.6,1003.66,9724.0,35
HCPCS,631730,DRAINAGE OF SPINAL CYST,,,1700.71,1700.71,1
HCPCS,63180,Revise spinal cord ligaments,,,9774.46,12346.69,6
HCPCS,63182,Revise spinal cord ligaments,,,9774.46,12346.69,6
HCPCS,63185,INCISE SPINE NRV HALF SEGMNT,,,1210.56,1210.56,1
HCPCS,63185,Incise spine nrv half segmnt,,,3094.77,3909.18,6
HCPCS,63185,LAMINECTOMY W/RHIZOTOMY 1/2 SEGMENTS,7256.0,4716.4,819.76,7256.0,35
HCPCS,631850,INCISE SPINE NRV HALF SEGMNT,,,1210.56,1210.56,1
HCPCS,63190,INCISE SPINE NRV >2 SEGMNTS,,,1197.03,1197.03,1
HCPCS,63190,Incise spine nrv >2 segmnts,,,3094.77,3909.18,6
HCPCS,63190,LAMINECTOMY W/RHIZOTOMY > 2 SEGMENTS,7556.0,4911.4,940.62,7556.0,35
HCPCS,631900,INCISE SPINE NRV >2 SEGMNTS,,,1197.03,1197.03,1
HCPCS,63191,INCISE SPINE ACCESSORY NERVE,,,1361.08,1361.08,1
HCPCS,63191,Incise spine accessory nerve,,,3094.77,3909.18,6
HCPCS,631910,INCISE SPINE ACCESSORY NERVE,,,1361.08,1361.08,1
HCPCS,63194,Incise spine & cord cervical,,,9774.46,12346.69,6
HCPCS,63195,Incise spine & cord thoracic,,,9774.46,12346.69,6
HCPCS,63196,Incise spine&cord 2 trx crvl,,,9774.46,12346.69,6
HCPCS,63197,LAM W/CORDOTOMY 1STG THRC,,,1686.03,1686.03,1
HCPCS,63197,Lam w/cordotomy 1stg thrc,,,9774.46,12346.69,6
HCPCS,631970,LAM W/CORDOTOMY 1STG THRC,,,1686.03,1686.03,1
HCPCS,63198,Incise spin&cord 2 stgs crvl,,,9774.46,12346.69,6
HCPCS,63199,Incise spin&cord 2 stgs thrc,,,9774.46,12346.69,6
HCPCS,63200,LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR,9434.0,6132.1,855.96,9434.0,35
HCPCS,63200,RELEASE SPINAL CORD LUMBAR,,,1506.99,1506.99,1
HCPCS,63200,Release spinal cord lumbar,,,6141.85,7758.12,6
HCPCS,632000,RELEASE SPINAL CORD LUMBAR,,,1506.99,1506.99,1
HCPCS,63250,REVISE SPINAL CORD VSLS CRVL,,,2913.35,2913.35,1
HCPCS,63250,Revise spinal cord vsls crvl,,,9774.46,12346.69,6
HCPCS,632500,REVISE SPINAL CORD VSLS CRVL,,,2913.35,2913.35,1
HCPCS,63251,LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC,17856.0,11606.4,1754.58,17856.0,35
HCPCS,63251,REVISE SPINAL CORD VSLS THRC,,,2977.81,2977.81,1
HCPCS,63251,Revise spinal cord vsls thrc,,,9774.46,12346.69,6
HCPCS,632510,REVISE SPINAL CORD VSLS THRC,,,2977.81,2977.81,1
HCPCS,63252,LAM EXC/OCCLUSION AVM SPI CORD THORACOLUMBAR,17852.0,11603.8,1801.73,17852.0,35
HCPCS,63252,REVISE SPINE CORD VSL THRLMB,,,2977.47,2977.47,1
HCPCS,63252,Revise spine cord vsl thrlmb,,,9774.46,12346.69,6
HCPCS,632520,REVISE SPINE CORD VSL THRLMB,,,2977.47,2977.47,1
HCPCS,63265,EXCISE INTRASPINL LESION CRV,,,1639.49,15488.78,15
HCPCS,63265,Excise intraspinl lesion crv,,,3094.77,3909.18,6
HCPCS,63265,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL,9528.0,6193.2,1163.62,9528.0,35
HCPCS,632650,EXCISE INTRASPINL LESION CRV,,,1639.49,1639.49,1
HCPCS,63266,EXCISE INTRSPINL LESION THRC,,,1683.04,15488.78,15
HCPCS,63266,Excise intrspinl lesion thrc,,,3094.77,3909.18,6
HCPCS,63266,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC,9872.0,6416.8,1246.83,9872.0,35
HCPCS,632660,EXCISE INTRSPINL LESION THRC,,,1683.04,1683.04,1
HCPCS,63267,EXCISE INTRSPINL LESION LMBR,,,1342.23,15488.78,16
HCPCS,63267,Excise intrspinl lesion lmbr,,,3094.77,3909.18,6
HCPCS,63267,LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR,7780.0,5057.0,1020.23,7780.0,35
HCPCS,632670,EXCISE INTRSPINL LESION LMBR,,,1342.23,1342.23,1
HCPCS,63268,EXCISE INTRSPINL LESION SCRL,,,1440.6,15488.78,15
HCPCS,63268,Excise intrspinl lesion scrl,,,3094.77,3909.18,6
HCPCS,63268,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL SACRAL,8008.0,5205.2,852.47,8008.0,35
HCPCS,632680,EXCISE INTRSPINL LESION SCRL,,,1440.6,1440.6,1
HCPCS,63270,EXCISE INTRSPINL LESION CRVL,,,2045.12,2045.12,1
HCPCS,63270,Excise intrspinl lesion crvl,,,6141.85,7758.12,6
HCPCS,63270,LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL,11920.0,7748.0,1229.16,11920.0,35
HCPCS,632700,EXCISE INTRSPINL LESION CRVL,,,2045.12,2045.12,1
HCPCS,63271,EXCISE INTRSPINL LESION THRC,,,2038.9,2038.9,1
HCPCS,63271,Excise intrspinl lesion thrc,,,9774.46,12346.69,6
HCPCS,63271,LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC,11968.0,7779.2,1431.24,11968.0,35
HCPCS,632710,EXCISE INTRSPINL LESION THRC,,,2038.9,2038.9,1
HCPCS,63272,EXCISE INTRSPINL LESION LMBR,,,1835.44,1835.44,1
HCPCS,63272,Excise intrspinl lesion lmbr,,,6141.85,7758.12,6
HCPCS,63272,LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR,11000.0,7150.0,1302.74,11000.0,35
HCPCS,632720,EXCISE INTRSPINL LESION LMBR,,,1835.44,1835.44,1
HCPCS,63273,EXCISE INTRSPINL LESION SCRL,,,1839.92,1839.92,1
HCPCS,63273,Excise intrspinl lesion scrl,,,6141.85,7758.12,6
HCPCS,63273,LAM EXC ISPI LES OTH/THN NEO IDRL SACRAL,10588.0,6882.2,1135.51,10588.0,35
HCPCS,632730,EXCISE INTRSPINL LESION SCRL,,,1839.92,1839.92,1
HCPCS,63275,BX/EXC XDRL SPINE LESN CRVL,,,1766.79,1766.79,1
HCPCS,63275,Bx/exc xdrl spine lesn crvl,,,9774.46,12346.69,6
HCPCS,63275,LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL,10344.0,6723.6,1329.62,10344.0,35
HCPCS,632750,BX/EXC XDRL SPINE LESN CRVL,,,1766.79,1766.79,1
HCPCS,63276,BX/EXC XDRL SPINE LESN THRC,,,1755.93,1755.93,1
HCPCS,63276,Bx/exc xdrl spine lesn thrc,,,9774.46,12346.69,6
HCPCS,63276,LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC,10276.0,6679.4,1297.81,10276.0,35
HCPCS,632760,BX/EXC XDRL SPINE LESN THRC,,,1755.93,1755.93,1
HCPCS,63277,BX/EXC XDRL SPINE LESN LMBR,,,1529.0,1529.0,1
HCPCS,63277,Bx/exc xdrl spine lesn lmbr,,,9774.46,12346.69,6
HCPCS,63277,LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR,8956.0,5821.4,1166.65,8956.0,35
HCPCS,632770,BX/EXC XDRL SPINE LESN LMBR,,,1529.0,1529.0,1
HCPCS,63278,BX/EXC XDRL SPINE LESN SCRL,,,1570.55,1570.55,1
HCPCS,63278,Bx/exc xdrl spine lesn scrl,,,9774.46,12346.69,6
HCPCS,63278,LAMINECTOMY BX/EXC ISPI NEO XDRL SACRAL,8848.0,5751.2,1154.67,8848.0,35
HCPCS,632780,BX/EXC XDRL SPINE LESN SCRL,,,1570.55,1570.55,1
HCPCS,63280,BX/EXC IDRL SPINE LESN CRVL,,,2085.19,2085.19,1
HCPCS,63280,Bx/exc idrl spine lesn crvl,,,9774.46,12346.69,6
HCPCS,63280,LAM BX/EXC ISPI NEO IDRL XMED CERVICAL,12116.0,7875.4,1505.83,12116.0,35
HCPCS,632800,BX/EXC IDRL SPINE LESN CRVL,,,2085.19,2085.19,1
HCPCS,63281,BX/EXC IDRL SPINE LESN THRC,,,2067.74,2067.74,1
HCPCS,63281,Bx/exc idrl spine lesn thrc,,,9774.46,12346.69,6
HCPCS,63281,LAM BX/EXC ISPI NEO IDRL XMED THORACIC,11996.0,7797.4,1489.01,11996.0,35
HCPCS,632810,BX/EXC IDRL SPINE LESN THRC,,,2067.74,2067.74,1
HCPCS,63282,BX/EXC IDRL SPINE LESN LMBR,,,1947.84,1947.84,1
HCPCS,63282,Bx/exc idrl spine lesn lmbr,,,6141.85,7758.12,6
HCPCS,63282,LAM BX/EXC ISPI NEO IDRL XMED LUMBAR,11260.0,7319.0,1356.86,11260.0,35
HCPCS,632820,BX/EXC IDRL SPINE LESN LMBR,,,1947.84,1947.84,1
HCPCS,63283,BX/EXC IDRL SPINE LESN SCRL,,,1874.4,1874.4,1
HCPCS,63283,Bx/exc idrl spine lesn scrl,,,9774.46,12346.69,6
HCPCS,63283,LAM BX/EXC ISPI NEO IDRL SACRAL,10704.0,6957.6,1190.88,10704.0,35
HCPCS,632830,BX/EXC IDRL SPINE LESN SCRL,,,1874.4,1874.4,1
HCPCS,63285,BX/EXC IDRL IMED LESN CERVL,,,2571.66,2571.66,1
HCPCS,63285,Bx/exc idrl imed lesn cervl,,,9774.46,12346.69,6
HCPCS,63285,LAM BX/EXC ISPI NEO IDRL IMED CERVICAL,15220.0,9893.0,1644.58,15220.0,35
HCPCS,632850,BX/EXC IDRL IMED LESN CERVL,,,2571.66,2571.66,1
HCPCS,63286,BX/EXC IDRL IMED LESN THRC,,,2529.09,2529.09,1
HCPCS,63286,Bx/exc idrl imed lesn thrc,,,9774.46,12346.69,6
HCPCS,63286,LAM BX/EXC ISPI NEO IDRL IMED THORACIC,15048.0,9781.2,1731.35,15048.0,35
HCPCS,632860,BX/EXC IDRL IMED LESN THRC,,,2529.09,2529.09,1
HCPCS,63287,BX/EXC IDRL IMED LESN THRLMB,,,2696.77,2696.77,1
HCPCS,63287,Bx/exc idrl imed lesn thrlmb,,,9774.46,12346.69,6
HCPCS,63287,LAM BX/EXC ISPI NEO IDRL IMED THORACOLMBR,16032.0,10420.8,1691.24,16032.0,35
HCPCS,632870,BX/EXC IDRL IMED LESN THRLMB,,,2696.77,2696.77,1
HCPCS,63290,BX/EXC XDRL/IDRL LSN ANY LVL,,,2742.35,2742.35,1
HCPCS,63290,Bx/exc xdrl/idrl lsn any lvl,,,9774.46,12346.69,6
HCPCS,63290,LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL,16328.0,10613.2,1736.78,16328.0,35
HCPCS,632900,BX/EXC XDRL/IDRL LSN ANY LVL,,,2742.35,2742.35,1
HCPCS,63295,REPAIR LAMINECTOMY DEFECT,,,321.62,321.62,1
HCPCS,63295,Repair laminectomy defect,,,6141.85,7758.12,6
HCPCS,632950,REPAIR LAMINECTOMY DEFECT,,,321.62,321.62,1
HCPCS,63300,REMOVE VERT XDRL BODY CRVCL,,,1771.42,1771.42,1
HCPCS,63300,Remove vert xdrl body crvcl,,,9774.46,12346.69,6
HCPCS,63300,VCRPEC LES 1 SGM XDRL CERVICAL,10720.0,6968.0,1111.15,10720.0,35
HCPCS,633000,REMOVE VERT XDRL BODY CRVCL,,,1771.42,1771.42,1
HCPCS,63301,REMOVE VERT XDRL BODY THRC,,,2171.43,2171.43,1
HCPCS,63301,Remove vert xdrl body thrc,,,9774.46,12346.69,6
HCPCS,63301,VCRPEC LES 1 SGM XDRL THORACIC TTHRC,12628.0,8208.2,1260.28,12628.0,35
HCPCS,633010,REMOVE VERT XDRL BODY THRC,,,2171.43,2171.43,1
HCPCS,63302,REMOVE VERT XDRL BODY THRLMB,,,2145.36,2145.36,1
HCPCS,63302,Remove vert xdrl body thrlmb,,,9774.46,12346.69,6
HCPCS,63302,VCRPEC LES 1 SEG XDRL THRC THORACOLMBR,12460.0,8099.0,1310.0,12460.0,35
HCPCS,633020,REMOVE VERT XDRL BODY THRLMB,,,2145.36,2145.36,1
HCPCS,63303,REMOV VERT XDRL BDY LMBR/SAC,,,2276.99,2276.99,1
HCPCS,63303,Remov vert xdrl bdy lmbr/sac,,,9774.46,12346.69,6
HCPCS,63303,VCRPEC LES 1 SEG XDRL LMBR/SAC TRANSPRTL/RPR,13420.0,8723.0,1339.36,13420.0,35
HCPCS,633030,REMOV VERT XDRL BDY LMBR/SAC,,,2276.99,2276.99,1
HCPCS,63304,REMOVE VERT IDRL BODY CRVCL,,,2311.45,2311.45,1
HCPCS,63304,Remove vert idrl body crvcl,,,9774.46,12346.69,6
HCPCS,633040,REMOVE VERT IDRL BODY CRVCL,,,2311.45,2311.45,1
HCPCS,63305,REMOVE VERT IDRL BODY THRC,,,2459.66,2459.66,1
HCPCS,63305,Remove vert idrl body thrc,,,9774.46,12346.69,6
HCPCS,633050,REMOVE VERT IDRL BODY THRC,,,2459.66,2459.66,1
HCPCS,63306,REMOV VERT IDRL BDY THRCLMBR,,,2416.64,2416.64,1
HCPCS,63306,Remov vert idrl bdy thrclmbr,,,9774.46,12346.69,6
HCPCS,633060,REMOV VERT IDRL BDY THRCLMBR,,,2416.64,2416.64,1
HCPCS,63307,REMOV VERT IDRL BDY LMBR/SAC,,,2366.64,2366.64,1
HCPCS,63307,Remov vert idrl bdy lmbr/sac,,,9774.46,12346.69,6
HCPCS,633070,REMOV VERT IDRL BDY LMBR/SAC,,,2366.64,2366.64,1
HCPCS,63308,REMOVE VERTEBRAL BODY ADD-ON,,,312.44,312.44,1
HCPCS,63308,Remove vertebral body add-on,,,9774.46,12346.69,6
HCPCS,633080,REMOVE VERTEBRAL BODY ADD-ON,,,312.44,312.44,1
HCPCS,63600,REMOVE SPINAL CORD LESION,,,1078.33,4233.93,15
HCPCS,63600,Remove spinal cord lesion,,,3094.77,3909.18,6
HCPCS,636000,REMOVE SPINAL CORD LESION,,,1078.33,1078.33,1
HCPCS,63610,STIMULATION OF SPINAL CORD,,,568.17,4233.93,15
HCPCS,63610,Stimulation of spinal cord,,,3094.77,3909.18,6
HCPCS,636100,STIMULATION OF SPINAL CORD,,,568.17,568.17,1
HCPCS,63620,SRS SPINAL LESION,,,1109.21,1109.21,1
HCPCS,63620,Srs spinal lesion,,,3066.36,3873.3,6
HCPCS,636200,SRS SPINAL LESION,,,1109.21,1109.21,1
HCPCS,63621,SRS SPINAL LESION ADDL,,,246.87,246.87,1
HCPCS,63621,Srs spinal lesion addl,,,3066.36,3873.3,6
HCPCS,636210,SRS SPINAL LESION ADDL,,,246.87,246.87,1
HCPCS,63650,IMPLANT NEUROELECTRODES,,,398.58,14229.45,15
HCPCS,63650,Implant neuroelectrodes,,,3699.03,4672.46,6
HCPCS,63650,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,3146.0,2044.9,321.52,2359.5,35
HCPCS,636500,IMPLANT NEUROELECTRODES,,,398.58,398.58,1
HCPCS,63655,IMPLANT NEUROELECTRODES,,,818.91,46494.97,15
HCPCS,63655,Implant neuroelectrodes,,,11520.56,14552.29,6
HCPCS,63655,LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL,4805.0,3123.25,615.6,4805.0,35
HCPCS,636550,IMPLANT NEUROELECTRODES,,,818.91,818.91,1
HCPCS,63661,REMOVE SPINE ELTRD PERQ ARAY,,,318.87,4233.93,15
HCPCS,63661,RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,2235.0,1452.75,159.29,1676.25,35
HCPCS,63661,Remove spine eltrd perq aray,,,1950.92,2464.32,6
HCPCS,636610,REMOVE SPINE ELTRD PERQ ARAY,,,318.87,318.87,1
HCPCS,63662,REMOVE SPINE ELTRD PLATE,,,831.34,7456.34,15
HCPCS,63662,RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR,4840.0,3146.0,414.73,4840.0,35
HCPCS,63662,Remove spine eltrd plate,,,1950.92,2464.32,6
HCPCS,636620,REMOVE SPINE ELTRD PLATE,,,831.34,831.34,1
HCPCS,63663,REVISE SPINE ELTRD PERQ ARAY,,,435.99,14229.45,15
HCPCS,63663,REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR,3410.0,2216.5,217.97,2557.5,35
HCPCS,63663,Revise spine eltrd perq aray,,,3699.03,4672.46,6
HCPCS,636630,REVISE SPINE ELTRD PERQ ARAY,,,435.99,435.99,1
HCPCS,63664,REVISE SPINE ELTRD PLATE,,,865.61,27037.69,15
HCPCS,63664,REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR,5069.0,3294.85,431.5,5069.0,35
HCPCS,63664,Revise spine eltrd plate,,,11520.56,14552.29,6
HCPCS,636640,REVISE SPINE ELTRD PLATE,,,865.61,865.61,1
HCPCS,63685,INS/RPLC SPI NPG/RCVR POCKET,,,329.5,329.5,1
HCPCS,63685,INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ,26440.0,17186.0,262.47,66071.77,77
HCPCS,636850,INS/RPLC SPI NPG/RCVR POCKET,,,329.5,329.5,1
HCPCS,63688,REV/RMV IMP SP NPG/R DTCH CN,,,290.77,7456.34,15
HCPCS,63688,REVJ/RMVL IMPL SPI NPG/RCVR DTCH CONNJ ELTRD RA,1914.0,1244.1,232.35,1914.0,35
HCPCS,63688,Rev/rmv imp sp npg/r dtch cn,,,1950.92,2464.32,6
HCPCS,636880,REV/RMV IMP SP NPG/R DTCH CN,,,290.77,290.77,1
HCPCS,63700,REPAIR OF SPINAL HERNIATION,,,1292.36,1292.36,1
HCPCS,63700,Repair of spinal herniation,,,3094.77,3909.18,6
HCPCS,637000,REPAIR OF SPINAL HERNIATION,,,1292.36,1292.36,1
HCPCS,63702,REPAIR OF SPINAL HERNIATION,,,1411.84,1411.84,1
HCPCS,63702,Repair of spinal herniation,,,3094.77,3909.18,6
HCPCS,637020,REPAIR OF SPINAL HERNIATION,,,1411.84,1411.84,1
HCPCS,63704,REPAIR OF SPINAL HERNIATION,,,1641.63,1641.63,1
HCPCS,63704,Repair of spinal herniation,,,3094.77,3909.18,6
HCPCS,637040,REPAIR OF SPINAL HERNIATION,,,1641.63,1641.63,1
HCPCS,63706,REPAIR OF SPINAL HERNIATION,,,1822.41,1822.41,1
HCPCS,63706,Repair of spinal herniation,,,3094.77,3909.18,6
HCPCS,637060,REPAIR OF SPINAL HERNIATION,,,1822.41,1822.41,1
HCPCS,63707,REPAIR SPINAL FLUID LEAKAGE,,,916.02,916.02,1
HCPCS,63707,REPR DURAL/CSF LEAK,5060.0,3289.0,641.47,5060.0,35
HCPCS,63707,Repair spinal fluid leakage,,,3094.77,3909.18,6
HCPCS,637070,REPAIR SPINAL FLUID LEAKAGE,,,916.02,916.02,1
HCPCS,63709,REPAIR SPINAL FLUID LEAKAGE,,,1088.12,1088.12,1
HCPCS,63709,REPR DURAL/CSF LEAK W LAMINECTOMY,6260.0,4069.0,816.03,6260.0,35
HCPCS,63709,Repair spinal fluid leakage,,,6141.85,7758.12,6
HCPCS,637090,REPAIR SPINAL FLUID LEAKAGE,,,1088.12,1088.12,1
HCPCS,63710,"DURAL GRAFT REPAIR,SPINE DEFECT",6160.0,4004.0,650.95,6160.0,35
HCPCS,63710,GRAFT REPAIR OF SPINE DEFECT,,,1055.33,1055.33,1
HCPCS,63710,Graft repair of spine defect,,,6141.85,7758.12,6
HCPCS,637100,GRAFT REPAIR OF SPINE DEFECT,,,1055.33,1055.33,1
HCPCS,63740,INSTALL SPINAL SHUNT,,,970.08,970.08,1
HCPCS,63740,Install spinal shunt,,,3571.24,4511.04,6
HCPCS,637400,INSTALL SPINAL SHUNT,,,970.08,970.08,1
HCPCS,63741,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM,3648.0,2371.2,478.2,3648.0,35
HCPCS,63741,INSTALL SPINAL SHUNT,,,669.33,13885.08,15
HCPCS,63741,Install spinal shunt,,,3571.24,4511.04,6
HCPCS,637410,INSTALL SPINAL SHUNT,,,669.33,669.33,1
HCPCS,63744,REVISION OF SPINAL SHUNT,,,672.0,13885.08,15
HCPCS,63744,RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT,3576.0,2324.4,439.38,3576.0,35
HCPCS,63744,Revision of spinal shunt,,,3571.24,4511.04,6
HCPCS,637440,REVISION OF SPINAL SHUNT,,,672.0,672.0,1
HCPCS,63746,REMOVAL OF SPINAL SHUNT,,,600.61,4233.93,15
HCPCS,63746,RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT,2932.0,1905.8,318.03,2932.0,35
HCPCS,63746,Removal of spinal shunt,,,835.73,1055.66,6
HCPCS,637460,REMOVAL OF SPINAL SHUNT,,,600.61,600.61,1
HCPCS,64400,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,1438.0,934.7,24.49,4151.0,228
HCPCS,64400,NJX AA&/STRD TRIGEMINAL NRV,,,49.76,49.76,1
HCPCS,644000,NJX AA&/STRD TRIGEMINAL NRV,,,49.76,49.76,1
HCPCS,64405,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,1480.0,962.0,30.48,4151.0,225
HCPCS,64405,NJX AA&/STRD GR OCPL NRV,,,51.26,51.26,1
HCPCS,644050,NJX AA&/STRD GR OCPL NRV,,,51.26,51.26,1
HCPCS,64408,INJECTION AA&/STRD VAGUS NERVE,330.0,214.5,42.06,247.5,35
HCPCS,64408,NJX AA&/STRD VAGUS NRV,,,43.03,640.02,15
HCPCS,64408,Njx aa&/strd vagus nrv,,,249.83,315.58,6
HCPCS,644080,NJX AA&/STRD VAGUS NRV,,,43.03,43.03,1
HCPCS,64415,INJECTION AA&/STRD BRACHIAL PLEXUS,7679.0,4991.35,92.64,6911.1,49
HCPCS,64415,INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN,4169.5,2710.175,30.25,6911.1,81
HCPCS,64415,NJX AA&/STRD BRCH PLXS IMG,,,67.01,67.01,1
HCPCS,644150,NJX AA&/STRD BRCH PLXS IMG,,,67.01,67.01,1
HCPCS,64416,INJECTION AA&/STRD BRACH PLEX CONT NFS CATH IMG,4235.5,2753.0750000000003,56.97,6911.1,133
HCPCS,64416,NJX AA&/STRD BRCH PL NFS IMG,,,74.61,74.61,1
HCPCS,644160,NJX AA&/STRD BRCH PL NFS IMG,,,74.61,74.61,1
HCPCS,64417,INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN,576.0,374.4,29.26,432.0,35
HCPCS,64417,NJX AA&/STRD AX NERVE IMG,,,61.62,1930.3,15
HCPCS,64417,Njx aa&/strd ax nerve img,,,249.83,315.58,6
HCPCS,644170,NJX AA&/STRD AX NERVE IMG,,,61.62,61.62,1
HCPCS,64418,INJECTION AA&/STRD SUPRASCAPULAR NERVE,3228.5,2098.525,35.86,5375.7,179
HCPCS,64418,NJX AA&/STRD SPRSCAP NRV,,,53.44,53.44,1
HCPCS,644180,NJX AA&/STRD SPRSCAP NRV,,,53.44,53.44,1
HCPCS,64420,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,3224.0,2095.6,28.44,5375.7,130
HCPCS,64420,NJX AA&/STRD NTRCOST NRV 1,,,55.71,55.71,1
HCPCS,644200,NJX AA&/STRD NTRCOST NRV 1,,,55.71,55.71,1
HCPCS,64421,INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL,3949.5,2567.175,23.22,6911.1,81
HCPCS,64421,NJX AA&/STRD NTRCOST NRV EA,,,23.97,23.97,1
HCPCS,644210,NJX AA&/STRD NTRCOST NRV EA,,,23.97,23.97,1
HCPCS,64425,INJECTION AA&/STRD ILIOINGUINAL IH NERVES,3206.5,2084.225,39.15,5375.7,81
HCPCS,64425,NJX AA&/STRD II IH NERVES,,,52.16,52.16,1
HCPCS,644250,NJX AA&/STRD II IH NERVES,,,52.16,52.16,1
HCPCS,64430,INJECTION AA&/STRD PUDENDAL NERVE,4059.5,2638.675,32.37,6911.1,130
HCPCS,64430,NJX AA&/STRD PUDENDAL NERVE,,,52.54,52.54,1
HCPCS,644300,NJX AA&/STRD PUDENDAL NERVE,,,52.54,52.54,1
HCPCS,64435,INJECTION AA&/STRD PARACERVICAL NERVE,330.0,214.5,28.83,247.5,35
HCPCS,64435,NJX AA&/STRD PARACRV NRV,,,42.21,1501.5,15
HCPCS,64435,Njx aa&/strd paracrv nrv,,,249.83,315.58,6
HCPCS,644350,NJX AA&/STRD PARACRV NRV,,,42.21,42.21,1
HCPCS,64445,INJECTION AA&/STRD SCIATIC NERVE,5973.0,3882.45,90.25,5375.7,49
HCPCS,64445,INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN,3292.5,2140.125,28.83,5375.7,81
HCPCS,64445,NJX AA&/STRD SCIATIC NRV IMG,,,69.14,69.14,1
HCPCS,644450,NJX AA&/STRD SCIATIC NRV IMG,,,69.14,69.14,1
HCPCS,64446,INJECTION AA&/STRD SCIATIC NRV CONT NFS CATH IMG,4224.5,2745.925,52.68,6911.1,84
HCPCS,64446,NJX AA&/STRD SC NRV NFS IMG,,,72.94,72.94,1
HCPCS,644460,NJX AA&/STRD SC NRV NFS IMG,,,72.94,72.94,1
HCPCS,64447,INJECTION AA&/STRD FEMORAL NERVE,5973.0,3882.45,84.16,5375.7,49
HCPCS,64447,INJECTION AA&/STRD FEMORAL NERVE W/IMG GDN,3281.5,2132.975,25.32,5375.7,81
HCPCS,64447,NJX AA&/STRD FEMORAL NRV IMG,,,60.73,60.73,1
HCPCS,644470,NJX AA&/STRD FEMORAL NRV IMG,,,60.73,60.73,1
HCPCS,64448,INJECTION AA&/STRD FEM NRV CONT NFS CATH IMG GDN,4209.0,2735.8500000000004,54.22,6911.1,84
HCPCS,64448,NJX AA&/STRD FEM NRV NFS IMG,,,69.69,69.69,1
HCPCS,644480,NJX AA&/STRD FEM NRV NFS IMG,,,69.69,69.69,1
HCPCS,64449,INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH,559.0,363.35,49.79,559.0,35
HCPCS,64449,NJX AA&/STRD LMBR PLEX NFS,,,61.25,1930.3,15
HCPCS,64449,Njx aa&/strd lmbr plex nfs,,,911.56,1151.45,6
HCPCS,644490,NJX AA&/STRD LMBR PLEX NFS,,,61.25,61.25,1
HCPCS,64450,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,3151.5,2048.475,25.28,5375.7,228
HCPCS,64450,NJX AA&/STRD OTHER PN/BRANCH,,,40.23,40.23,1
HCPCS,644500,NJX AA&/STRD OTHER PN/BRANCH,,,40.23,40.23,1
HCPCS,64451,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,3321.0,2158.65,61.22,26432.0,224
HCPCS,64451,NJX AA&/STRD NRV NRVTG SI JT,,,78.26,78.26,1
HCPCS,644510,NJX AA&/STRD NRV NRVTG SI JT,,,78.26,78.26,1
HCPCS,64454,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,3321.0,2158.65,62.98,26432.0,175
HCPCS,64454,NJX AA&/STRD GNCLR NRV BRNCH,,,78.86,78.86,1
HCPCS,644540,NJX AA&/STRD GNCLR NRV BRNCH,,,78.86,78.86,1
HCPCS,64455,NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES,1438.0,934.7,24.58,3920.0,81
HCPCS,64455,NJX AA&/STRD PLTR COM DG NRV,,,32.28,32.28,1
HCPCS,644550,NJX AA&/STRD PLTR COM DG NRV,,,32.28,32.28,1
HCPCS,64461,PVB THORACIC SINGLE INJ SITE,,,75.39,1501.5,15
HCPCS,64461,PVB THORACIC SINGLE INJECTION SITE W/IMG GID,770.0,500.5,66.73,577.5,31
HCPCS,64461,Pvb thoracic single inj site,,,459.05,579.85,6
HCPCS,644610,PVB THORACIC SINGLE INJ SITE,,,75.39,75.39,1
HCPCS,64462,PVB THORACIC 2ND+ INJ SITE,,,46.69,46.69,1
HCPCS,64462,PVB THORACIC SECOND & ADDL INJ SITE W/IMG GID,484.0,314.6,41.9,363.0,31
HCPCS,64462,Pvb thoracic 2nd+ inj site,,,459.05,579.85,6
HCPCS,644620,PVB THORACIC 2ND+ INJ SITE,,,46.69,46.69,1
HCPCS,64463,PVB THORACIC CONT CATHETER INFUSION W/IMG GID,3404.5,2212.9249999999997,65.57,5375.7,80
HCPCS,64463,PVB THORACIC CONT INFUSION,,,78.85,78.85,1
HCPCS,644630,PVB THORACIC CONT INFUSION,,,78.85,78.85,1
HCPCS,64466,THORACIC FASCIAL PLANE BLOCK UNI INJECTION,660.0,429.0,47.22,495.0,25
HCPCS,64466,THRC FASCIAL PLN BLK UNI NJX,,,62.55,62.55,1
HCPCS,64466,Thrc fascial pln blk uni njx,,,249.83,315.58,6
HCPCS,644660,THRC FASCIAL PLN BLK UNI NJX,,,62.55,62.55,1
HCPCS,64467,THORACIC FASCIAL PLANE BLOCK UNI CONT INFUSION,766.0,497.9,54.4,574.5,25
HCPCS,64467,THRC FASCIAL PLN BLK UNI NFS,,,72.07,72.07,1
HCPCS,64467,Thrc fascial pln blk uni nfs,,,249.83,315.58,6
HCPCS,644670,THRC FASCIAL PLN BLK UNI NFS,,,72.07,72.07,1
HCPCS,64468,THORACIC FASCIAL PLANE BLOCK BI INJECTION,735.0,477.75,52.48,551.25,25
HCPCS,64468,THRC FASCIAL PLN BLK BI NJX,,,69.53,69.53,1
HCPCS,64468,Thrc fascial pln blk bi njx,,,911.56,1151.45,6
HCPCS,644680,THRC FASCIAL PLN BLK BI NJX,,,69.53,69.53,1
HCPCS,64469,THORACIC FASCIAL PLANE BLOCK BI CONT INFUSION,805.0,523.25,57.02,611.19,25
HCPCS,64469,THRC FASCIAL PLN BLK BI NFS,,,75.55,75.55,1
HCPCS,64469,Thrc fascial pln blk bi nfs,,,911.56,1151.45,6
HCPCS,644690,THRC FASCIAL PLN BLK BI NFS,,,75.55,75.55,1
HCPCS,64473,LOWER XTR FASCIAL PLANE BLOCK UNI INJECTION,590.0,383.5,42.18,442.5,25
HCPCS,64473,LWR XTR FSCL PLN BLK UNI NJX,,,55.88,55.88,1
HCPCS,64473,Lwr xtr fscl pln blk uni njx,,,249.83,315.58,6
HCPCS,644730,LWR XTR FSCL PLN BLK UNI NJX,,,55.88,55.88,1
HCPCS,64474,LOWER XTR FASCIAL PLANE BLOCK UNI CONT INFUSION,735.0,477.75,52.48,551.25,25
HCPCS,64474,LWR XTR FSCL PLN BLK UNI NFS,,,69.53,69.53,1
HCPCS,64474,Lwr xtr fscl pln blk uni nfs,,,249.83,315.58,6
HCPCS,644740,LWR XTR FSCL PLN BLK UNI NFS,,,69.53,69.53,1
HCPCS,64479,NJX AA&/STRD TFRM EPI C/T 1,,,124.79,124.79,1
HCPCS,64479,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,4343.5,2823.275,63.13,6911.1,130
HCPCS,644790,NJX AA&/STRD TFRM EPI C/T 1,,,124.79,124.79,1
HCPCS,64480,NJX AA&/STRD TFRM EPI C/T EA,,,58.51,58.51,1
HCPCS,64480,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,1114.5,724.4250000000001,32.3,4268.0,108
HCPCS,644800,NJX AA&/STRD TFRM EPI C/T EA,,,58.51,58.51,1
HCPCS,64483,NJX AA&/STRD TFRM EPI L/S 1,,,154.97,154.97,1
HCPCS,64483,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,4257.5,2767.375,53.59,6911.1,228
HCPCS,644830,NJX AA&/STRD TFRM EPI L/S 1,,,154.97,154.97,1
HCPCS,64484,NJX AA&/STRD TFRM EPI L/S EA,,,49.44,49.44,1
HCPCS,64484,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,1146.5,745.225,39.69,4268.0,108
HCPCS,644840,NJX AA&/STRD TFRM EPI L/S EA,,,49.44,49.44,1
HCPCS,64486,TAP BLOCK UNIL BY INJECTION,,,53.3,53.3,1
HCPCS,64486,TAP BLOCK UNILATERAL BY INJECTION(S),1143.5,743.275,48.52,3920.0,66
HCPCS,644860,TAP BLOCK UNIL BY INJECTION,,,53.3,53.3,1
HCPCS,64487,TAP BLOCK UNI BY INFUSION,,,61.18,61.18,1
HCPCS,64487,TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S),612.0,397.8,55.76,459.0,31
HCPCS,64487,Tap block uni by infusion,,,249.83,315.58,6
HCPCS,644870,TAP BLOCK UNI BY INFUSION,,,61.18,61.18,1
HCPCS,64488,TAP BLOCK BI INJECTION,,,66.4,66.4,1
HCPCS,64488,TAP BLOCK BILATERAL BY INJECTION(S),1187.5,771.875,60.25,3920.0,66
HCPCS,644880,TAP BLOCK BI INJECTION,,,66.4,66.4,1
HCPCS,64489,TAP BLOCK BI BY INFUSION,,,74.61,74.61,1
HCPCS,64489,TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S),770.0,500.5,67.2,577.5,31
HCPCS,64489,Tap block bi by infusion,,,911.56,1151.45,6
HCPCS,644890,TAP BLOCK BI BY INFUSION,,,74.61,74.61,1
HCPCS,64490,INJ PARAVERT F JNT C/T 1 LEV,,,100.7,100.7,1
HCPCS,64490,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,4240.0,2756.0,50.96,6911.1,130
HCPCS,644900,INJ PARAVERT F JNT C/T 1 LEV,,,100.7,100.7,1
HCPCS,64491,INJ PARAVERT F JNT C/T 2 LEV,,,56.93,56.93,1
HCPCS,64491,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,665.0,432.25,28.6,4214.0,108
HCPCS,644910,INJ PARAVERT F JNT C/T 2 LEV,,,56.93,56.93,1
HCPCS,64492,INJ PARAVERT F JNT C/T 3 LEV,,,57.83,57.83,1
HCPCS,64492,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,665.0,432.25,28.94,4214.0,70
HCPCS,644920,INJ PARAVERT F JNT C/T 3 LEV,,,57.83,57.83,1
HCPCS,64493,INJ PARAVERT F JNT L/S 1 LEV,,,86.43,86.43,1
HCPCS,64493,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,4174.0,2713.1000000000004,43.23,6911.1,179
HCPCS,644930,INJ PARAVERT F JNT L/S 1 LEV,,,86.43,86.43,1
HCPCS,64494,INJ PARAVERT F JNT L/S 2 LEV,,,48.85,48.85,1
HCPCS,64494,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,1305.5,848.575,24.66,4214.0,146
HCPCS,644940,INJ PARAVERT F JNT L/S 2 LEV,,,48.85,48.85,1
HCPCS,64495,INJ PARAVERT F JNT L/S 3 LEV,,,49.74,49.74,1
HCPCS,64495,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,1007.5,654.875,24.99,4214.0,108
HCPCS,644950,INJ PARAVERT F JNT L/S 3 LEV,,,49.74,49.74,1
HCPCS,64505,INJECTION ANES AGENT SPHENOPALATINE GANGLION,1572.0,1021.8000000000001,50.3,4151.0,81
HCPCS,64505,N BLOCK SPENOPALATINE GANGL,,,101.01,101.01,1
HCPCS,645050,N BLOCK SPENOPALATINE GANGL,,,101.01,101.01,1
HCPCS,64510,N BLOCK STELLATE GANGLION,,,73.38,73.38,1
HCPCS,64510,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,4108.0,2670.2000000000003,36.98,6911.1,81
HCPCS,645100,N BLOCK STELLATE GANGLION,,,73.38,73.38,1
HCPCS,64517,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,4323.5,2810.275,60.82,6911.1,84
HCPCS,64517,N BLOCK INJ HYPOGAS PLXS,,,120.54,120.54,1
HCPCS,645170,N BLOCK INJ HYPOGAS PLXS,,,120.54,120.54,1
HCPCS,64520,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,4136.5,2688.7250000000004,48.81,6911.1,179
HCPCS,64520,N BLOCK LUMBAR/THORACIC,,,81.03,81.03,1
HCPCS,645200,N BLOCK LUMBAR/THORACIC,,,81.03,81.03,1
HCPCS,64530,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,4187.0,2721.55,45.37,6911.1,179
HCPCS,64530,N BLOCK INJ CELIAC PELUS,,,90.22,90.22,1
HCPCS,645300,N BLOCK INJ CELIAC PELUS,,,90.22,90.22,1
HCPCS,64553,IMPLANT NEUROELECTRODES,,,442.34,27037.69,15
HCPCS,64553,Implant neuroelectrodes,,,11520.56,14552.29,6
HCPCS,645530,IMPLANT NEUROELECTRODES,,,442.34,442.34,1
HCPCS,64555,IMPLANT NEUROELECTRODES,,,311.13,311.13,1
HCPCS,64555,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,9707.5,6309.875,126.99,15651.0,77
HCPCS,645550,IMPLANT NEUROELECTRODES,,,311.13,311.13,1
HCPCS,64561,IMPLANT NEUROELECTRODES,,,291.99,291.99,1
HCPCS,64561,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,16463.5,10701.275,146.46,27479.7,74
HCPCS,645610,IMPLANT NEUROELECTRODES,,,291.99,291.99,1
HCPCS,64566,NEUROELTRD STIM POST TIBIAL,2546.0,1654.9,29.2,2849.0,50
HCPCS,64566,PERC TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,264.0,171.6,14.8,201.1,32
HCPCS,64566,POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,2546.0,1654.9,36.17,4151.0,46
HCPCS,645660,NEUROELTRD STIM POST TIBIAL,,,29.2,29.2,1
HCPCS,64567,PERQ ELEC NRV FIELD STIMJ CN,,,65.13,1041.86,5
HCPCS,64567,PERQ ELEC NRV FIELD STIMJ CRANIAL NRV W/O IMPLTJ,660.0,429.0,71.28,660.0,21
HCPCS,64567,Perq elec nrv field stimj cn,,,292.32,369.25,6
HCPCS,645670,PERQ ELEC NRV FIELD STIMJ CN,,,65.13,65.13,1
HCPCS,64568,OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN,3600.0,2340.0,298.19,3600.0,35
HCPCS,64568,OPN IMPLTJ CRNL NRV NEA&PG,,,583.52,66071.77,15
HCPCS,64568,Opn impltj crnl nrv nea&pg,,,11520.56,14552.29,6
HCPCS,645680,OPN IMPLTJ CRNL NRV NEA&PG,,,583.52,583.52,1
HCPCS,64569,REVISE/REPL VAGUS N ELTRD,,,755.19,27037.69,15
HCPCS,64569,REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV,4400.0,2860.0,375.77,4400.0,35
HCPCS,64569,Revise/repl vagus n eltrd,,,11520.56,14552.29,6
HCPCS,645690,REVISE/REPL VAGUS N ELTRD,,,755.19,755.19,1
HCPCS,64570,REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATOR,3640.0,2366.0,360.15,3640.0,35
HCPCS,64570,REMOVE VAGUS N ELTRD,,,723.0,13885.08,15
HCPCS,64570,Remove vagus n eltrd,,,1950.92,2464.32,6
HCPCS,645700,REMOVE VAGUS N ELTRD,,,723.0,723.0,1
HCPCS,64575,OPEN IMPLANTATION NEA PERIPHERAL NERVE,1768.0,1149.2,193.84,1768.0,35
HCPCS,64575,OPN IMPLTJ NEA PERPH NERVE,,,301.72,27037.69,15
HCPCS,64575,Opn impltj nea perph nerve,,,11520.56,14552.29,6
HCPCS,645750,OPN IMPLTJ NEA PERPH NERVE,,,301.72,301.72,1
HCPCS,64580,OPEN IMPLANTATION NEA NEUROMUSCULAR,1676.0,1089.4,208.59,1676.0,35
HCPCS,64580,OPN IMPLTJ NEA NEUROMUSCULAR,,,304.18,46494.97,15
HCPCS,64580,Opn impltj nea neuromuscular,,,11520.56,14552.29,6
HCPCS,645800,OPN IMPLTJ NEA NEUROMUSCULAR,,,304.18,304.18,1
HCPCS,64581,OPEN IMPLANTATION NEA SACRAL NERVE,14089.5,9158.175,503.5,20773.0,77
HCPCS,64581,OPN IMPLTJ NEA SACRAL NERVE,,,633.86,633.86,1
HCPCS,645810,OPN IMPLTJ NEA SACRAL NERVE,,,633.86,633.86,1
HCPCS,64582,OPEN IMPLTJ HPGLSL NRV NSTIM RA PG&RESPIR SENSOR,5600.0,3640.0,642.26,5600.0,28
HCPCS,64582,OPN MPLTJ HPGLSL NSTM ARY PG,,,806.63,66071.77,17
HCPCS,64582,Opn mpltj hpglsl nstm ary pg,,,11520.56,14552.29,6
HCPCS,645820,OPN MPLTJ HPGLSL NSTM ARY PG,,,806.63,806.63,1
HCPCS,64583,REV/RPLCT HPGLSL NSTM ARY PG,,,832.83,27037.69,15
HCPCS,64583,Rev/rplct hpglsl nstm ary pg,,,3699.03,4672.46,6
HCPCS,645830,REV/RPLCT HPGLSL NSTM ARY PG,,,832.83,832.83,1
HCPCS,64584,RMVL HPGLSL NSTIM ARY PG,,,701.91,13885.08,15
HCPCS,64584,Rmvl hpglsl nstim ary pg,,,1950.92,2464.32,6
HCPCS,645840,RMVL HPGLSL NSTIM ARY PG,,,701.91,701.91,1
HCPCS,64585,REV/RMV PERPH NSTIM ELTRD RA,,,137.88,137.88,1
HCPCS,64585,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,15252.5,9914.125,69.37,26694.9,84
HCPCS,645850,REV/RMV PERPH NSTIM ELTRD RA,,,137.88,137.88,1
HCPCS,64590,INS/RPL PRPH SAC/GSTR NPG/R,,,284.02,284.02,1
HCPCS,64590,INS/RPLC PERPH SAC/GSTRC NPG/RCVR PCKT CRTJ&CONN,18554.5,12060.425,77.76,46494.97,74
HCPCS,64590,INSERTION/RPLCMT PERIPHERAL/GASTRIC NPGR,34865.0,22662.25,354.22,46695.0,42
HCPCS,645900,INS/RPL PRPH SAC/GSTR NPG/R,,,284.02,284.02,1
HCPCS,64595,REV/RMV PRPH SAC/GSTR NPG/R,,,221.02,7456.34,16
HCPCS,64595,REV/RMV PRPH SAC/GSTRC NPG/RCV DTCH CONN ELTR RA,1516.0,985.4,61.31,1137.0,35
HCPCS,64595,Rev/rmv prph sac/gstr npg/r,,,1950.92,2464.32,6
HCPCS,645950,REV/RMV PRPH SAC/GSTR NPG/R,,,221.02,221.02,1
HCPCS,64596,INS/RPLCMT PRQ ELTRD RA PN 1,,,1969.35,27037.69,15
HCPCS,64596,INSJ/RPLCMT PERQ ELTRD RA PN W/INT NSTIM 1ST RA,2856.0,1856.4,1428.0,3966.56,13
HCPCS,64596,Ins/rplcmt prq eltrd ra pn 1,,,3699.03,4672.46,6
HCPCS,645960,INS/RPLCMT PRQ ELTRD RA PN 1,,,1969.35,1969.35,1
HCPCS,64597,INS/RPLCM PRQ ELTRD RA PN EA,,,590.65,590.65,1
HCPCS,64597,INSJ/RPLCMT PERQ ELTRD RA PN INT NSTIM EA ADD RA,2856.0,1856.4,1189.96,2856.0,13
HCPCS,64597,Ins/rplcm prq eltrd ra pn ea,,,3699.03,4672.46,6
HCPCS,645970,INS/RPLCM PRQ ELTRD RA PN EA,,,590.65,590.65,1
HCPCS,64598,REVISION/REMOVAL NSTIM ELTRD ARRAY PN INT NSTIM,1047.0,680.55,464.74,1047.0,13
HCPCS,64598,REVJ/RMVL NEA PN W/INT NSTIM,,,226.76,7456.34,15
HCPCS,64598,Revj/rmvl nea pn w/int nstim,,,1950.92,2464.32,6
HCPCS,645980,REVJ/RMVL NEA PN W/INT NSTIM,,,226.76,226.76,1
HCPCS,64600,DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH,1396.0,907.4,121.98,1047.0,35
HCPCS,64600,INJECTION TREATMENT OF NERVE,,,228.98,1930.3,16
HCPCS,64600,Injection treatment of nerve,,,911.56,1151.45,6
HCPCS,646000,INJECTION TREATMENT OF NERVE,,,228.98,228.98,1
HCPCS,64605,DSTRJ NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH,2260.0,1469.0,169.15,1695.0,35
HCPCS,64605,INJECTION TREATMENT OF NERVE,,,415.37,4233.93,15
HCPCS,64605,Injection treatment of nerve,,,911.56,1151.45,6
HCPCS,646050,INJECTION TREATMENT OF NERVE,,,415.37,415.37,1
HCPCS,64610,DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR,9861.5,6409.975,236.54,15158.7,81
HCPCS,64610,INJECTION TREATMENT OF NERVE,,,468.4,468.4,1
HCPCS,646100,INJECTION TREATMENT OF NERVE,,,468.4,468.4,1
HCPCS,64611,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS,2546.0,1654.9,137.2,4151.0,46
HCPCS,64611,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS BI,412.0,267.8,54.08,309.0,35
HCPCS,64611,CHEMODENERV SALIV GLANDS,,,108.0,108.0,1
HCPCS,646110,CHEMODENERV SALIV GLANDS,,,108.0,108.0,1
HCPCS,64612,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL,1583.0,1028.95,79.26,4151.0,81
HCPCS,64612,DESTROY NERVE FACE MUSCLE,,,113.83,113.83,1
HCPCS,646120,DESTROY NERVE FACE MUSCLE,,,113.83,113.83,1
HCPCS,64615,CHEMODENERV MUSC MIGRAINE,,,119.47,119.47,1
HCPCS,64615,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,1680.0,1092.0,82.41,3920.0,77
HCPCS,646150,CHEMODENERV MUSC MIGRAINE,,,119.47,119.47,1
HCPCS,64616,CHEMODENERV MUSC NECK DYSTON,,,106.34,106.34,1
HCPCS,64616,CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA,1609.5,1046.175,82.35,4151.0,77
HCPCS,646160,CHEMODENERV MUSC NECK DYSTON,,,106.34,106.34,1
HCPCS,64617,CHEMODENER MUSCLE LARYNX EMG,,,104.31,104.31,1
HCPCS,64617,CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG,3404.5,2212.9249999999997,82.69,5375.7,77
HCPCS,646170,CHEMODENER MUSCLE LARYNX EMG,,,104.31,104.31,1
HCPCS,64620,DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE,4475.5,2909.0750000000003,85.48,7730.0,81
HCPCS,64620,INJECTION TREATMENT OF NERVE,,,170.18,170.18,1
HCPCS,646200,INJECTION TREATMENT OF NERVE,,,170.18,170.18,1
HCPCS,64624,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,8921.5,5798.975,112.3,26432.0,224
HCPCS,64624,DSTRJ NULYT AGT GNCLR NRV,,,139.65,139.65,1
HCPCS,646240,DSTRJ NULYT AGT GNCLR NRV,,,139.65,139.65,1
HCPCS,64625,RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN,1356.0,881.4,148.6,1017.0,31
HCPCS,64625,RF ABLTJ NRV NRVTG SI JT,,,187.23,4233.93,15
HCPCS,64625,Rf abltj nrv nrvtg si jt,,,835.73,1055.66,6
HCPCS,646250,RF ABLTJ NRV NRVTG SI JT,,,187.23,187.23,1
HCPCS,64628,THERMAL DSTRJ INTRAOSSEOUS BVN 1ST 2 LMBR/SAC,29429.5,19129.175,340.05,50399.1,70
HCPCS,64628,TRML DSTRJ IOS BVN 1ST 2 L/S,,,397.4,397.4,1
HCPCS,646280,TRML DSTRJ IOS BVN 1ST 2 L/S,,,397.4,397.4,1
HCPCS,64629,THERMAL DSTRJ INTRAOSSEOUS BVN EA ADDL LMBR/SAC,12879.0,8371.35,160.76,21825.0,59
HCPCS,64629,TRML DSTRJ IOS BVN EA ADDL,,,189.38,189.38,1
HCPCS,646290,TRML DSTRJ IOS BVN EA ADDL,,,189.38,189.38,1
HCPCS,64630,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,4510.5,2931.8250000000003,104.78,6911.1,81
HCPCS,64630,INJECTION TREATMENT OF NERVE,,,183.95,183.95,1
HCPCS,646300,INJECTION TREATMENT OF NERVE,,,183.95,183.95,1
HCPCS,64632,N BLOCK INJ COMMON DIGIT,,,64.58,640.02,15
HCPCS,64632,N block inj common digit,,,249.83,315.58,6
HCPCS,646320,N BLOCK INJ COMMON DIGIT,,,64.58,64.58,1
HCPCS,64633,DESTROY CERV/THOR FACET JNT,,,184.01,184.01,1
HCPCS,64633,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,9152.0,5948.8,92.39,15158.7,130
HCPCS,646330,DESTROY CERV/THOR FACET JNT,,,184.01,184.01,1
HCPCS,64634,DESTROY C/TH FACET JNT ADDL,,,64.37,64.37,1
HCPCS,64634,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,862.0,560.3,32.22,4214.0,108
HCPCS,646340,DESTROY C/TH FACET JNT ADDL,,,64.37,64.37,1
HCPCS,64635,DESTROY LUMB/SAC FACET JNT,,,184.31,184.31,1
HCPCS,64635,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,9152.0,5948.8,92.39,15158.7,130
HCPCS,646350,DESTROY LUMB/SAC FACET JNT,,,184.31,184.31,1
HCPCS,64636,DESTROY L/S FACET JNT ADDL,,,56.29,56.29,1
HCPCS,64636,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,2297.0,1493.05,28.44,6317.0,108
HCPCS,646360,DESTROY L/S FACET JNT ADDL,,,56.29,56.29,1
HCPCS,64640,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,4275.0,2778.75,83.64,6911.1,81
HCPCS,64640,INJECTION TREATMENT OF NERVE,,,113.94,113.94,1
HCPCS,646400,INJECTION TREATMENT OF NERVE,,,113.94,113.94,1
HCPCS,64642,CHEMODENERV 1 EXTREMITY 1-4,,,103.5,103.5,1
HCPCS,64642,CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE,3349.5,2177.1749999999997,81.72,5375.7,77
HCPCS,646420,CHEMODENERV 1 EXTREMITY 1-4,,,103.5,103.5,1
HCPCS,64643,CHEMODENERV 1 EXTREM 1-4 EA,,,67.53,67.53,1
HCPCS,64643,CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,1997.5,1298.375,52.42,4151.0,66
HCPCS,646430,CHEMODENERV 1 EXTREM 1-4 EA,,,67.53,67.53,1
HCPCS,64644,CHEMODENERV 1 EXTREM 5/> MUS,,,111.82,111.82,1
HCPCS,64644,CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES,3387.0,2201.5499999999997,89.19,5375.7,77
HCPCS,646440,CHEMODENERV 1 EXTREM 5/> MUS,,,111.82,111.82,1
HCPCS,64645,CHEMODENERV 1 EXTREM 5/> EA,,,78.65,78.65,1
HCPCS,64645,CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES,1699.0,1104.3500000000001,60.12,4151.0,66
HCPCS,646450,CHEMODENERV 1 EXTREM 5/> EA,,,78.65,78.65,1
HCPCS,64646,CHEMODENERV TRUNK MUSC 1-5,,,112.43,112.43,1
HCPCS,64646,CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES,3382.5,2198.625,84.18,5375.7,77
HCPCS,646460,CHEMODENERV TRUNK MUSC 1-5,,,112.43,112.43,1
HCPCS,64647,CHEMODENERV TRUNK MUSC 6/>,,,129.72,129.72,1
HCPCS,64647,CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES,3408.5,2215.525,102.08,5375.7,77
HCPCS,646470,CHEMODENERV TRUNK MUSC 6/>,,,129.72,129.72,1
HCPCS,64650,CHEMODENERV ECCRINE GLANDS,,,39.3,39.3,1
HCPCS,64650,CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,1413.0,918.45,27.46,4151.0,81
HCPCS,646500,CHEMODENERV ECCRINE GLANDS,,,39.3,39.3,1
HCPCS,64653,CHEMODENERV ECCRINE GLANDS,,,50.06,50.06,1
HCPCS,64653,CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY,1449.0,941.85,33.55,4151.0,81
HCPCS,646530,CHEMODENERV ECCRINE GLANDS,,,50.06,50.06,1
HCPCS,64654,1ST OPN IMPLT BAT MODULJ SYS,,,548.08,548.08,1
HCPCS,64654,INITIAL OPEN IMPLANTATION BAT MODULATION SYSTEM,114921.5,74698.975,639.22,202502.7,60
HCPCS,646540,1ST OPN IMPLT BAT MODULJ SYS,,,548.08,548.08,1
HCPCS,64655,REVISION/RPLCMT BAT MODULATION SYSTEM LEAD ONLY,11415.5,7420.075000000001,720.12,37851.0,60
HCPCS,64655,REVJ/RPLCMT BAT MOD SYS LEAD,,,625.28,625.28,1
HCPCS,646550,REVJ/RPLCMT BAT MOD SYS LEAD,,,625.28,625.28,1
HCPCS,64656,REVISION/RPLCMT BAT MODULATION SYSTEM PG ONLY,21466.0,13952.9,484.25,37851.0,60
HCPCS,64656,REVJ/RPLCMT BAT MOD SYS PG,,,416.9,416.9,1
HCPCS,646560,REVJ/RPLCMT BAT MOD SYS PG,,,416.9,416.9,1
HCPCS,64657,REMOVAL BAT MODULATION SYSTEM TOTAL SYSTEM,5337.0,3469.05,719.53,5337.0,21
HCPCS,64657,RMVL BAT MODULJ SYS TOT SYS,,,618.18,3924.15,5
HCPCS,64657,Rmvl bat modulj sys tot sys,,,1950.92,2464.32,6
HCPCS,646570,RMVL BAT MODULJ SYS TOT SYS,,,618.18,618.18,1
HCPCS,64658,REMOVAL BAT MODULATION SYSTEM LEAD ONLY,3938.0,2559.7,541.23,3938.0,21
HCPCS,64658,RMVL BAT MODUL SYS LEAD ONLY,,,464.77,4016.0,5
HCPCS,64658,Rmvl bat modul sys lead only,,,1950.92,2464.32,6
HCPCS,646580,RMVL BAT MODUL SYS LEAD ONLY,,,464.77,464.77,1
HCPCS,64659,REMOVAL BAT MODULATION SYSTEM PG ONLY,3621.0,2353.65,501.71,3621.0,21
HCPCS,64659,RMVL BAT MODULJ SYS PG ONLY,,,430.92,4016.0,5
HCPCS,64659,Rmvl bat modulj sys pg only,,,1950.92,2464.32,6
HCPCS,646590,RMVL BAT MODULJ SYS PG ONLY,,,430.92,430.92,1
HCPCS,64680,DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS,4427.0,2877.55,77.59,7730.0,81
HCPCS,64680,INJECTION TREATMENT OF NERVE,,,153.23,153.23,1
HCPCS,646800,INJECTION TREATMENT OF NERVE,,,153.23,153.23,1
HCPCS,64681,DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS,1512.0,982.8,108.33,1134.0,35
HCPCS,64681,INJECTION TREATMENT OF NERVE,,,208.99,1930.3,15
HCPCS,64681,Injection treatment of nerve,,,911.56,1151.45,6
HCPCS,646810,INJECTION TREATMENT OF NERVE,,,208.99,208.99,1
HCPCS,64702,NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT,2504.0,1627.6,248.87,2504.0,35
HCPCS,64702,REVISE FINGER/TOE NERVE,,,495.18,4233.93,15
HCPCS,64702,Revise finger/toe nerve,,,835.73,1055.66,6
HCPCS,647020,REVISE FINGER/TOE NERVE,,,495.18,495.18,1
HCPCS,64704,NEUROPLASTY NERVE HAND/FOOT,1876.0,1219.4,240.13,1876.0,35
HCPCS,64704,REVISE HAND/FOOT NERVE,,,312.51,4233.93,15
HCPCS,64704,Revise hand/foot nerve,,,835.73,1055.66,6
HCPCS,647040,REVISE HAND/FOOT NERVE,,,312.51,312.51,1
HCPCS,64708,NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC,2544.0,1653.6,348.35,2544.0,35
HCPCS,64708,REVISE ARM/LEG NERVE,,,489.0,4233.93,15
HCPCS,64708,Revise arm/leg nerve,,,835.73,1055.66,6
HCPCS,647080,REVISE ARM/LEG NERVE,,,489.0,489.0,1
HCPCS,64712,NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV,3228.0,2098.2,432.93,3228.0,35
HCPCS,64712,REVISION OF SCIATIC NERVE,,,574.82,4233.93,15
HCPCS,64712,Revision of sciatic nerve,,,3157.38,3988.27,6
HCPCS,647120,REVISION OF SCIATIC NERVE,,,574.82,574.82,1
HCPCS,64713,NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS,4560.0,2964.0,542.17,4560.0,35
HCPCS,64713,REVISION OF ARM NERVE(S),,,776.41,4233.93,15
HCPCS,64713,Revision of arm nerve(s),,,3157.38,3988.27,6
HCPCS,647130,REVISION OF ARM NERVE(S),,,776.41,776.41,1
HCPCS,64714,NEURP MAJOR PRPH NRV OPN ARM/LEG LMBR PLEXUS,4220.0,2743.0,442.69,4220.0,35
HCPCS,64714,REVISE LOW BACK NERVE(S),,,740.66,4233.93,15
HCPCS,64714,Revise low back nerve(s),,,3157.38,3988.27,6
HCPCS,647140,REVISE LOW BACK NERVE(S),,,740.66,740.66,1
HCPCS,64716,NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE,3076.0,1999.4,303.82,3076.0,35
HCPCS,64716,REVISION OF CRANIAL NERVE,,,492.06,4233.93,15
HCPCS,64716,Revision of cranial nerve,,,3157.38,3988.27,6
HCPCS,647160,REVISION OF CRANIAL NERVE,,,492.06,492.06,1
HCPCS,64718,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW,2904.0,1887.6,340.03,2904.0,35
HCPCS,64718,REVISE ULNAR NERVE AT ELBOW,,,582.06,5038.0,16
HCPCS,64718,Revise ulnar nerve at elbow,,,835.73,1055.66,6
HCPCS,647180,REVISE ULNAR NERVE AT ELBOW,,,582.06,582.06,1
HCPCS,64719,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST,1988.0,1292.2,267.86,1988.0,35
HCPCS,64719,REVISE ULNAR NERVE AT WRIST,,,393.97,4233.93,15
HCPCS,64719,Revise ulnar nerve at wrist,,,835.73,1055.66,6
HCPCS,647190,REVISE ULNAR NERVE AT WRIST,,,393.97,393.97,1
HCPCS,64721,CARPAL TUNNEL SURGERY,,,421.56,421.56,1
HCPCS,64721,NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE,9415.5,6120.075000000001,249.89,15158.7,81
HCPCS,647210,CARPAL TUNNEL SURGERY,,,421.56,421.56,1
HCPCS,64722,DECOMPRESSION UNSPEC NERVE,,,358.95,4233.93,15
HCPCS,64722,DECOMPRESSION UNSPECIFIED NERVE,1928.0,1253.2,265.1,1928.0,35
HCPCS,64722,Decompression unspec nerve,,,835.73,1055.66,6
HCPCS,647220,DECOMPRESSION UNSPEC NERVE,,,358.95,358.95,1
HCPCS,64726,DCMPRN PLANTAR DIGITAL NERVE,,,259.15,4233.93,15
HCPCS,64726,DECOMPRESSION PLANTAR DIGITAL NERVE,1708.0,1110.2,156.62,1708.0,35
HCPCS,64726,Dcmprn plantar digital nerve,,,835.73,1055.66,6
HCPCS,647260,DCMPRN PLANTAR DIGITAL NERVE,,,259.15,259.15,1
HCPCS,64727,INTERNAL NEUROLYSIS,,,170.75,170.75,1
HCPCS,64727,INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE,1240.0,806.0,136.09,1240.0,35
HCPCS,64727,Internal neurolysis,,,3157.38,3988.27,6
HCPCS,647270,INTERNAL NEUROLYSIS,,,170.75,170.75,1
HCPCS,64728,DCMPRN MEDIAN NRV AT CARPL TUNL PERQ BALO DILAT,1188.0,772.2,130.02,1188.0,21
HCPCS,64728,DCMPRN MEDIAN NRV CARPL TUNL,,,119.75,2243.11,5
HCPCS,64728,Dcmprn median nrv carpl tunl,,,835.73,1055.66,6
HCPCS,647280,DCMPRN MEDIAN NRV CARPL TUNL,,,119.75,119.75,1
HCPCS,64732,INCISION OF BROW NERVE,,,444.42,4233.93,15
HCPCS,64732,Incision of brow nerve,,,835.73,1055.66,6
HCPCS,64732,TRANSECTION/AVULSION SUPRAORBITAL NERVE,1956.0,1271.4,223.01,1956.0,35
HCPCS,647320,INCISION OF BROW NERVE,,,444.42,444.42,1
HCPCS,64734,INCISION OF CHEEK NERVE,,,501.68,4233.93,15
HCPCS,64734,Incision of cheek nerve,,,835.73,1055.66,6
HCPCS,647340,INCISION OF CHEEK NERVE,,,501.68,501.68,1
HCPCS,64736,INCISION OF CHIN NERVE,,,317.82,4233.93,15
HCPCS,64736,Incision of chin nerve,,,835.73,1055.66,6
HCPCS,64736,TRANSECT OR AVULSE; MENTAL NERVE,2092.0,1359.8,232.64,2092.0,35
HCPCS,647360,INCISION OF CHIN NERVE,,,317.82,317.82,1
HCPCS,64738,INCISION OF JAW NERVE,,,428.16,4233.93,15
HCPCS,64738,Incision of jaw nerve,,,835.73,1055.66,6
HCPCS,64738,TRANSECTION/AVULSION INF ALVEOLAR NRV W/OSTEO,2544.0,1653.6,269.2,2544.0,35
HCPCS,647380,INCISION OF JAW NERVE,,,428.16,428.16,1
HCPCS,64740,INCISION OF TONGUE NERVE,,,436.05,4233.93,15
HCPCS,64740,Incision of tongue nerve,,,835.73,1055.66,6
HCPCS,647400,INCISION OF TONGUE NERVE,,,436.05,436.05,1
HCPCS,64742,INCISION OF FACIAL NERVE,,,469.14,4233.93,15
HCPCS,64742,Incision of facial nerve,,,835.73,1055.66,6
HCPCS,647420,INCISION OF FACIAL NERVE,,,469.14,469.14,1
HCPCS,64744,INCISE NERVE BACK OF HEAD,,,495.54,4233.93,15
HCPCS,64744,Incise nerve back of head,,,3157.38,3988.27,6
HCPCS,64744,TRANSECTION/AVULSION GREATER OCCIPITAL NERVE,2288.0,1487.2,295.73,2288.0,35
HCPCS,647440,INCISE NERVE BACK OF HEAD,,,495.54,495.54,1
HCPCS,64746,INCISE DIAPHRAGM NERVE,,,416.94,4233.93,15
HCPCS,64746,Incise diaphragm nerve,,,3157.38,3988.27,6
HCPCS,647460,INCISE DIAPHRAGM NERVE,,,416.94,416.94,1
HCPCS,64755,INCISION OF STOMACH NERVES,,,894.84,894.84,1
HCPCS,64755,Incision of stomach nerves,,,2290.02,2892.66,6
HCPCS,647550,INCISION OF STOMACH NERVES,,,894.84,894.84,1
HCPCS,64760,INCISION OF VAGUS NERVE,,,505.38,505.38,1
HCPCS,64760,Incision of vagus nerve,,,2290.02,2892.66,6
HCPCS,647600,INCISION OF VAGUS NERVE,,,505.38,505.38,1
HCPCS,64763,INCISE HIP/THIGH NERVE,,,500.08,4233.93,15
HCPCS,64763,Incise hip/thigh nerve,,,835.73,1055.66,6
HCPCS,64763,TRNSXJ/AVLSN OBTURAT NRV XPELV W/WO TENOTOMY,3326.0,2161.9,316.37,3326.0,35
HCPCS,647630,INCISE HIP/THIGH NERVE,,,500.08,500.08,1
HCPCS,64766,INCISE HIP/THIGH NERVE,,,617.4,4233.93,15
HCPCS,64766,Incise hip/thigh nerve,,,835.73,1055.66,6
HCPCS,647660,INCISE HIP/THIGH NERVE,,,617.4,617.4,1
HCPCS,64771,SEVER CRANIAL NERVE,,,557.83,4233.93,15
HCPCS,64771,Sever cranial nerve,,,3157.38,3988.27,6
HCPCS,64771,TRANSECTION/AVULSION OTH CRANIAL NRV XDRL,3260.0,2119.0,367.35,3260.0,35
HCPCS,647710,SEVER CRANIAL NERVE,,,557.83,557.83,1
HCPCS,64772,INCISION OF SPINAL NERVE,,,539.33,5038.0,16
HCPCS,64772,Incision of spinal nerve,,,835.73,1055.66,6
HCPCS,64772,TRANSECTION/AVULSION OTH SPINAL NRV XDRL,3136.0,2038.4,376.54,3136.0,35
HCPCS,647720,INCISION OF SPINAL NERVE,,,539.33,539.33,1
HCPCS,64774,EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE,2320.0,1508.0,217.72,2320.0,35
HCPCS,64774,REMOVE SKIN NERVE LESION,,,413.76,4233.93,15
HCPCS,64774,Remove skin nerve lesion,,,835.73,1055.66,6
HCPCS,647740,REMOVE SKIN NERVE LESION,,,413.76,413.76,1
HCPCS,64776,EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT,2240.0,1456.0,215.48,2240.0,35
HCPCS,64776,REMOVE DIGIT NERVE LESION,,,391.19,4233.93,15
HCPCS,64776,Remove digit nerve lesion,,,835.73,1055.66,6
HCPCS,647760,REMOVE DIGIT NERVE LESION,,,391.19,391.19,1
HCPCS,64778,DIGIT NERVE SURGERY ADD-ON,,,172.94,172.94,1
HCPCS,64778,Digit nerve surgery add-on,,,835.73,1055.66,6
HCPCS,64778,"EXCISE DIGITAL NEUROMA,ADDNL DIGIT",1244.0,808.6,117.76,1244.0,35
HCPCS,647780,DIGIT NERVE SURGERY ADD-ON,,,172.94,172.94,1
HCPCS,64782,EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE,2744.0,1783.6,285.29,2744.0,35
HCPCS,64782,REMOVE LIMB NERVE LESION,,,439.61,4233.93,15
HCPCS,64782,Remove limb nerve lesion,,,835.73,1055.66,6
HCPCS,647820,REMOVE LIMB NERVE LESION,,,439.61,439.61,1
HCPCS,64783,EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT,1484.0,964.6,152.77,1484.0,35
HCPCS,64783,LIMB NERVE SURGERY ADD-ON,,,206.23,206.23,1
HCPCS,64783,Limb nerve surgery add-on,,,835.73,1055.66,6
HCPCS,647830,LIMB NERVE SURGERY ADD-ON,,,206.23,206.23,1
HCPCS,64784,EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC,4248.0,2761.2,424.75,4248.0,35
HCPCS,64784,REMOVE NERVE LESION,,,699.21,4233.93,15
HCPCS,64784,Remove nerve lesion,,,835.73,1055.66,6
HCPCS,647840,REMOVE NERVE LESION,,,699.21,699.21,1
HCPCS,64786,EXCISE SCIATIC NERVE NEUROMA,6500.0,4225.0,757.14,6500.0,35
HCPCS,64786,REMOVE SCIATIC NERVE LESION,,,976.16,13885.08,15
HCPCS,64786,Remove sciatic nerve lesion,,,3157.38,3988.27,6
HCPCS,647860,REMOVE SCIATIC NERVE LESION,,,976.16,976.16,1
HCPCS,64787,IMPLANT NERVE END,,,224.73,224.73,1
HCPCS,64787,IMPLANT NERVE END TO BONE/MUSC,1716.0,1115.4,179.49,1716.0,35
HCPCS,64787,Implant nerve end,,,3157.38,3988.27,6
HCPCS,647870,IMPLANT NERVE END,,,224.73,224.73,1
HCPCS,64788,EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV,2096.0,1362.4,222.37,2096.0,35
HCPCS,64788,REMOVE SKIN NERVE LESION,,,394.57,4233.93,15
HCPCS,64788,Remove skin nerve lesion,,,835.73,1055.66,6
HCPCS,647880,REMOVE SKIN NERVE LESION,,,394.57,394.57,1
HCPCS,64790,EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV,4840.0,3146.0,505.08,4840.0,35
HCPCS,64790,REMOVAL OF NERVE LESION,,,824.49,4233.93,15
HCPCS,64790,Removal of nerve lesion,,,3157.38,3988.27,6
HCPCS,647900,REMOVAL OF NERVE LESION,,,824.49,824.49,1
HCPCS,64792,EXC NEUROFIBROMA/NEUROLEMMOMA EXTNSV,6344.0,4123.6,656.0,6344.0,35
HCPCS,64792,REMOVAL OF NERVE LESION,,,1043.27,13885.08,15
HCPCS,64792,Removal of nerve lesion,,,3157.38,3988.27,6
HCPCS,647920,REMOVAL OF NERVE LESION,,,1043.27,1043.27,1
HCPCS,64795,BIOPSY OF NERVE,1204.0,782.6,143.9,4233.93,50
HCPCS,64795,Biopsy of nerve,,,835.73,1055.66,6
HCPCS,647950,BIOPSY OF NERVE,,,188.94,188.94,1
HCPCS,64802,SYMPATHECTOMY CERVICAL,,,831.02,4233.93,15
HCPCS,64802,Sympathectomy cervical,,,835.73,1055.66,6
HCPCS,648020,SYMPATHECTOMY CERVICAL,,,831.02,831.02,1
HCPCS,64804,SYMPATHECTOMY CERVICOTHORAC,,,1173.32,4233.93,15
HCPCS,64804,"SYMPATHECTOMY,CERVICOTHORACIC",6364.0,4136.6,670.58,6364.0,35
HCPCS,64804,Sympathectomy cervicothorac,,,3157.38,3988.27,6
HCPCS,648040,SYMPATHECTOMY CERVICOTHORAC,,,1173.32,1173.32,1
HCPCS,64809,SYMPATHECTOMY THORACOLUMBAR,,,1073.16,1073.16,1
HCPCS,64809,"SYMPATHECTOMY,THORACOLUMBAR",5884.0,3824.6,510.27,5884.0,35
HCPCS,64809,Sympathectomy thoracolumbar,,,3157.38,3988.27,6
HCPCS,648090,SYMPATHECTOMY THORACOLUMBAR,,,1073.16,1073.16,1
HCPCS,64818,SYMPATHECTOMY LUMBAR,,,751.46,751.46,1
HCPCS,64818,"SYMPATHECTOMY,LUMBAR",4536.0,2948.4,504.13,4536.0,35
HCPCS,64818,Sympathectomy lumbar,,,3157.38,3988.27,6
HCPCS,648180,SYMPATHECTOMY LUMBAR,,,751.46,751.46,1
HCPCS,64820,SYMPATHECTOMY DIGITAL ARTERY,,,739.63,4233.93,15
HCPCS,64820,"SYMPATHECTOMY,DIGITAL ARTERIES",4296.0,2792.4,488.78,4296.0,35
HCPCS,64820,Sympathectomy digital artery,,,835.73,1055.66,6
HCPCS,648200,SYMPATHECTOMY DIGITAL ARTERY,,,739.63,739.63,1
HCPCS,64821,SYMPATHECTOMY RADIAL ARTERY,3732.0,2425.8,441.15,7034.85,50
HCPCS,64821,Sympathectomy radial artery,,,835.73,1055.66,6
HCPCS,648210,SYMPATHECTOMY RADIAL ARTERY,,,675.19,675.19,1
HCPCS,64822,SYMPATHECTOMY ULNAR ARTERY,3732.0,2425.8,441.15,7034.85,50
HCPCS,64822,Sympathectomy ulnar artery,,,835.73,1055.66,6
HCPCS,648220,SYMPATHECTOMY ULNAR ARTERY,,,675.19,675.19,1
HCPCS,64823,SYMPATHECTOMY SUPERFICIAL PALMAR ARCH,4376.0,2844.4,509.4,4376.0,35
HCPCS,64823,SYMPATHECTOMY SUPFC PALMAR,,,765.03,7034.85,15
HCPCS,64823,Sympathectomy supfc palmar,,,835.73,1055.66,6
HCPCS,648230,SYMPATHECTOMY SUPFC PALMAR,,,765.03,765.03,1
HCPCS,64831,REPAIR OF DIGIT NERVE,,,668.12,4233.93,16
HCPCS,64831,Repair of digit nerve,,,835.73,1055.66,6
HCPCS,64831,SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE,3664.0,2381.6,387.67,3664.0,35
HCPCS,648310,REPAIR OF DIGIT NERVE,,,668.12,668.12,1
HCPCS,64832,REPAIR NERVE ADD-ON,,,318.38,318.38,1
HCPCS,64832,Repair nerve add-on,,,3157.38,3988.27,6
HCPCS,64832,SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV,2260.0,1469.0,199.33,2260.0,35
HCPCS,648320,REPAIR NERVE ADD-ON,,,318.38,318.38,1
HCPCS,64834,REPAIR OF HAND OR FOOT NERVE,,,717.53,13885.08,15
HCPCS,64834,Repair of hand or foot nerve,,,3157.38,3988.27,6
HCPCS,64834,SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE,4324.0,2810.6,400.04,4324.0,35
HCPCS,648340,REPAIR OF HAND OR FOOT NERVE,,,717.53,717.53,1
HCPCS,64835,REPAIR OF HAND OR FOOT NERVE,,,788.18,13885.08,15
HCPCS,64835,Repair of hand or foot nerve,,,3157.38,3988.27,6
HCPCS,64835,SUTURE 1 NERVE MEDIAN MOTOR THENAR,5161.0,3354.65,468.09,5161.0,35
HCPCS,648350,REPAIR OF HAND OR FOOT NERVE,,,788.18,788.18,1
HCPCS,64836,REPAIR OF HAND OR FOOT NERVE,,,788.18,13885.08,15
HCPCS,64836,Repair of hand or foot nerve,,,3157.38,3988.27,6
HCPCS,64836,SUTURE 1 NERVE ULNAR MOTOR,4692.0,3049.8,487.93,4692.0,35
HCPCS,648360,REPAIR OF HAND OR FOOT NERVE,,,788.18,788.18,1
HCPCS,64837,REPAIR NERVE ADD-ON,,,348.12,348.12,1
HCPCS,64837,Repair nerve add-on,,,3157.38,3988.27,6
HCPCS,64837,SUTURE EACH ADDITIONAL NERVE HAND/FOOT,2500.0,1625.0,276.52,2500.0,35
HCPCS,648370,REPAIR NERVE ADD-ON,,,348.12,348.12,1
HCPCS,64840,REPAIR OF LEG NERVE,,,927.89,13885.08,15
HCPCS,64840,Repair of leg nerve,,,3157.38,3988.27,6
HCPCS,648400,REPAIR OF LEG NERVE,,,927.89,927.89,1
HCPCS,64856,REPAIR/TRANSPOSE NERVE,,,969.92,13885.08,15
HCPCS,64856,Repair/transpose nerve,,,3157.38,3988.27,6
HCPCS,64856,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS,6028.0,3918.2,608.47,6028.0,35
HCPCS,648560,REPAIR/TRANSPOSE NERVE,,,969.92,969.92,1
HCPCS,64857,REPAIR ARM/LEG NERVE,,,1013.64,13885.08,15
HCPCS,64857,Repair arm/leg nerve,,,3157.38,3988.27,6
HCPCS,64857,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS,6328.0,4113.2,657.11,6328.0,35
HCPCS,648570,REPAIR ARM/LEG NERVE,,,1013.64,1013.64,1
HCPCS,64858,REPAIR SCIATIC NERVE,,,1132.16,4233.93,15
HCPCS,64858,Repair sciatic nerve,,,3157.38,3988.27,6
HCPCS,648580,REPAIR SCIATIC NERVE,,,1132.16,1132.16,1
HCPCS,64859,NERVE SURGERY,,,236.62,236.62,1
HCPCS,64859,Nerve surgery,,,3157.38,3988.27,6
HCPCS,64859,SUTURE EACH ADDITIONAL PERIPHERAL NERVE,1700.0,1105.0,187.92,1700.0,35
HCPCS,648590,NERVE SURGERY,,,236.62,236.62,1
HCPCS,64861,REPAIR OF ARM NERVES,,,1497.34,4233.93,15
HCPCS,64861,Repair of arm nerves,,,3157.38,3988.27,6
HCPCS,64861,SUTURE BRACHIAL PLEXUS,8356.0,5431.4,867.99,8356.0,35
HCPCS,648610,REPAIR OF ARM NERVES,,,1497.34,1497.34,1
HCPCS,64862,REPAIR OF LOW BACK NERVES,,,1321.63,13885.08,15
HCPCS,64862,Repair of low back nerves,,,3157.38,3988.27,6
HCPCS,648620,REPAIR OF LOW BACK NERVES,,,1321.63,1321.63,1
HCPCS,64864,REPAIR OF FACIAL NERVE,,,825.39,13885.08,15
HCPCS,64864,Repair of facial nerve,,,3157.38,3988.27,6
HCPCS,64864,SUTURE FACIAL NERVE EXTRACRANIAL,5900.0,3835.0,558.36,5900.0,35
HCPCS,648640,REPAIR OF FACIAL NERVE,,,825.39,825.39,1
HCPCS,64865,REPAIR OF FACIAL NERVE,,,1038.77,13885.08,15
HCPCS,64865,Repair of facial nerve,,,3157.38,3988.27,6
HCPCS,64865,SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT,6436.0,4183.4,732.95,6436.0,35
HCPCS,648650,REPAIR OF FACIAL NERVE,,,1038.77,1038.77,1
HCPCS,64866,ANAST FACIAL-SPINAL ACCESS,6732.0,4375.8,732.31,6732.0,35
HCPCS,64866,FUSION OF FACIAL/OTHER NERVE,,,1185.11,1185.11,1
HCPCS,64866,Fusion of facial/other nerve,,,3157.38,3988.27,6
HCPCS,648660,FUSION OF FACIAL/OTHER NERVE,,,1185.11,1185.11,1
HCPCS,64868,FUSION OF FACIAL/OTHER NERVE,,,953.53,953.53,1
HCPCS,64868,Fusion of facial/other nerve,,,3157.38,3988.27,6
HCPCS,648680,FUSION OF FACIAL/OTHER NERVE,,,953.53,953.53,1
HCPCS,64872,"REPR NERVE,SECONDARY/DELAY",796.0,517.4,88.09,796.0,35
HCPCS,64872,SUBSEQUENT REPAIR OF NERVE,,,110.52,110.52,1
HCPCS,64872,Subsequent repair of nerve,,,3157.38,3988.27,6
HCPCS,648720,SUBSEQUENT REPAIR OF NERVE,,,110.52,110.52,1
HCPCS,64874,REPAIR & REVISE NERVE ADD-ON,,,165.8,165.8,1
HCPCS,64874,"REPR/TRANSPOSE NERVE,SECONADARY",1192.0,774.8,131.75,1192.0,35
HCPCS,64874,Repair & revise nerve add-on,,,3157.38,3988.27,6
HCPCS,648740,REPAIR & REVISE NERVE ADD-ON,,,165.8,165.8,1
HCPCS,64876,REPAIR NERVE/SHORTEN BONE,,,187.8,187.8,1
HCPCS,64876,Repair nerve/shorten bone,,,3157.38,3988.27,6
HCPCS,648760,REPAIR NERVE/SHORTEN BONE,,,187.8,187.8,1
HCPCS,64885,NERVE GRAFT HEAD/NECK <4 CM,,,1033.89,13885.08,15
HCPCS,64885,"NERVE GRAFT,HEAD/NECK,ONE,=<4CM",7040.0,4576.0,808.36,7040.0,35
HCPCS,64885,Nerve graft head/neck <4 cm,,,3157.38,3988.27,6
HCPCS,648850,NERVE GRAFT HEAD/NECK <4 CM,,,1033.89,1033.89,1
HCPCS,64886,NERVE GRAFT HEAD/NECK >4 CM,,,1237.29,13885.08,15
HCPCS,64886,"NERVE GRAFT,HEAD/NECK,ONE,>4CM",8328.0,5413.2,958.08,8328.0,35
HCPCS,64886,Nerve graft head/neck >4 cm,,,3157.38,3988.27,6
HCPCS,648860,NERVE GRAFT HEAD/NECK >4 CM,,,1237.29,1237.29,1
HCPCS,64890,"NERVE GRAFT,HAND/FOOT,ONE,=<4CM",6496.0,4222.4,744.98,6496.0,35
HCPCS,64890,NRV GRF 1STRND HND/FOOT <4CM,,,1039.71,13885.08,15
HCPCS,64890,Nrv grf 1strnd hnd/foot <4cm,,,3157.38,3988.27,6
HCPCS,648900,NRV GRF 1STRND HND/FOOT <4CM,,,1039.71,1039.71,1
HCPCS,64891,"NERVE GRAFT,HAND/FOOT,ONE,>4CM",6940.0,4511.0,708.37,6940.0,35
HCPCS,64891,NRV GRF 1STRND HND/FOOT >4CM,,,1105.67,13885.08,15
HCPCS,64891,Nrv grf 1strnd hnd/foot >4cm,,,3157.38,3988.27,6
HCPCS,648910,NRV GRF 1STRND HND/FOOT >4CM,,,1105.67,1105.67,1
HCPCS,64892,NRV GRF 1STRND ARM/LEG <4CM,,,1011.93,13885.08,15
HCPCS,64892,Nrv grf 1strnd arm/leg <4cm,,,3157.38,3988.27,6
HCPCS,648920,NRV GRF 1STRND ARM/LEG <4CM,,,1011.93,1011.93,1
HCPCS,64893,NRV GRF 1STRND ARM/LEG >4 CM,,,1078.84,13885.08,15
HCPCS,64893,Nrv grf 1strnd arm/leg >4 cm,,,3157.38,3988.27,6
HCPCS,648930,NRV GRF 1STRND ARM/LEG >4 CM,,,1078.84,1078.84,1
HCPCS,64895,NRV GR MUL HND/FT TO 4 CM,8156.0,5301.4,880.53,8156.0,35
HCPCS,64895,NRV GRF MLTST HND/FOOT <4 CM,,,1274.37,13885.08,15
HCPCS,64895,Nrv grf mltst hnd/foot <4 cm,,,3157.38,3988.27,6
HCPCS,648950,NRV GRF MLTST HND/FOOT <4 CM,,,1274.37,1274.37,1
HCPCS,64896,NERVE GRAFT MULT STR HND/FT; > 4CM,8784.0,5709.6,996.85,8784.0,35
HCPCS,64896,NRV GRF MLTST HND/FOOT >4 CM,,,1374.67,13885.08,15
HCPCS,64896,Nrv grf mltst hnd/foot >4 cm,,,3157.38,3988.27,6
HCPCS,648960,NRV GRF MLTST HND/FOOT >4 CM,,,1374.67,1374.67,1
HCPCS,64897,"NERV GRFT,ARM/LEG,MULT,=<4CM",7752.0,5038.8,844.57,7752.0,35
HCPCS,64897,NRV GRF MLTST ARM/LEG <4 CM,,,1218.46,13885.08,15
HCPCS,64897,Nrv grf mltst arm/leg <4 cm,,,3157.38,3988.27,6
HCPCS,648970,NRV GRF MLTST ARM/LEG <4 CM,,,1218.46,1218.46,1
HCPCS,64898,NERVE GRAFT MULTI STR ARM/LEG; > 4 CM,8388.0,5452.2,920.58,8388.0,35
HCPCS,64898,NRV GRF MLTST ARM/LEG >4 CM,,,1319.38,13885.08,15
HCPCS,64898,Nrv grf mltst arm/leg >4 cm,,,3157.38,3988.27,6
HCPCS,648980,NRV GRF MLTST ARM/LEG >4 CM,,,1319.38,1319.38,1
HCPCS,64901,NERVE GRAFT ADD-ON,,,568.24,568.24,1
HCPCS,64901,Nerve graft add-on,,,3157.38,3988.27,6
HCPCS,649010,NERVE GRAFT ADD-ON,,,568.24,568.24,1
HCPCS,64902,NERVE GRAFT ADD-ON,,,657.43,657.43,1
HCPCS,64902,Nerve graft add-on,,,3157.38,3988.27,6
HCPCS,649020,NERVE GRAFT ADD-ON,,,657.43,657.43,1
HCPCS,64905,NERVE PEDICLE TRANSFER,,,963.66,13885.08,15
HCPCS,64905,"NERVE PEDICLE XFER,FIRST STAGE",6044.0,3928.6,611.38,6044.0,35
HCPCS,64905,Nerve pedicle transfer,,,3157.38,3988.27,6
HCPCS,649050,NERVE PEDICLE TRANSFER,,,963.66,963.66,1
HCPCS,64907,NERVE PEDICLE TRANSFER,,,1250.73,13885.08,15
HCPCS,64907,Nerve pedicle transfer,,,3157.38,3988.27,6
HCPCS,649070,NERVE PEDICLE TRANSFER,,,1250.73,1250.73,1
HCPCS,64910,NERVE REPAIR W/ALLOGRAFT,,,730.72,13885.08,15
HCPCS,64910,NERVE REPAIR W/CONDUIT EACH NERVE,4629.0,3008.85,66.81,4629.0,35
HCPCS,64910,Nerve repair w/allograft,,,3157.38,3988.27,6
HCPCS,649100,NERVE REPAIR W/ALLOGRAFT,,,730.72,730.72,1
HCPCS,64911,NEURORRAPHY W/VEIN AUTOGRAFT,,,981.72,13885.08,15
HCPCS,64911,Neurorraphy w/vein autograft,,,3157.38,3988.27,6
HCPCS,649110,NEURORRAPHY W/VEIN AUTOGRAFT,,,981.72,981.72,1
HCPCS,64912,NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND,4800.0,3120.0,77.04,4800.0,31
HCPCS,64912,NRV RPR W/NRV ALGRFT 1ST,,,857.01,13885.08,15
HCPCS,64912,Nrv rpr w/nrv algrft 1st,,,3157.38,3988.27,6
HCPCS,649120,NRV RPR W/NRV ALGRFT 1ST,,,857.01,857.01,1
HCPCS,64913,NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND,1200.0,780.0,13.74,1200.0,31
HCPCS,64913,NRV RPR W/NRV ALGRFT EA ADDL,,,165.24,165.24,1
HCPCS,64913,Nrv rpr w/nrv algrft ea addl,,,3157.38,3988.27,6
HCPCS,649130,NRV RPR W/NRV ALGRFT EA ADDL,,,165.24,165.24,1
HCPCS,64999,ANTER CRANFAC RESECT W/ENDOS ASSIS (COMP CODE 61580),13756.0,8941.4,6878.0,13756.0,12
HCPCS,64999,"CHEMODENERVATION ECCRINE GLANDS, PALM/FOOT (COMP 64650)",281.0,182.65,140.5,281.0,12
HCPCS,64999,DISC BIOPSY,1819.0,1182.35,909.5,1819.0,12
HCPCS,64999,ENDOS TRANSNASAL INTRACRANIAL BIOPSY (COMP CODE 61570),8526.0,5541.9,4263.0,8526.0,12
HCPCS,64999,GANGLION IMPAR BLOCK INJ,594.0,386.1,297.0,594.0,12
HCPCS,64999,GANGLION IMPAR SYMPATHETIC INJECTION,853.0,554.45,426.5,853.0,12
HCPCS,64999,GANGLION OF IMPAR BLOCKADE UNDER FLUOROSCOPIC GUIDANCE (COMP COD,1080.0,702.0,540.0,1080.0,12
HCPCS,64999,IMPAR GANGLION COCCYGEAL NEUROLYSIS (COMP CODE 64680),4427.0,2877.55,249.83,8550.0,60
HCPCS,64999,INFERIORHYPOGASTRIC BLOCK,881.0,572.65,440.5,881.0,12
HCPCS,64999,"INJ, ANESTHETIC AGENT; CERVICAL PLEXUS (COMP 64425)",578.0,375.7,289.0,578.0,12
HCPCS,64999,LARYNGEAL REINNERVATION USING CERVICAL NERVE BRANCHES (COMP CODE,6059.0,3938.35,3029.5,6059.0,12
HCPCS,64999,LIGATION CSF PROXIMAL SHUNT (COMP CODE 49428),2748.0,1786.2,1374.0,2748.0,12
HCPCS,64999,MASSETER NRV TO FAC NRV ANASTOMOSIS (COMP 64865),6918.0,4496.7,3459.0,6918.0,12
HCPCS,64999,NERVE WRAPPING (COMP CODE 15271),646.0,419.9,323.0,646.0,12
HCPCS,64999,PARS INTERARTICULARIS INJ,946.0,614.9,249.83,8550.0,48
HCPCS,64999,PECS 1 & PECS 2 UNILAT CONTINUOUS INFUSION CATH (COMP CODE 64487,629.0,408.85,314.5,629.0,12
HCPCS,64999,PECTO-INTERCOSTAL NERVE BLOCK (COMP 64450),300.0,195.0,150.0,300.0,12
HCPCS,64999,PERCUTANEOUS GASSERIAN BALLOON DECOMPRESSION (COMP 64605),1855.0,1205.75,927.5,1855.0,12
HCPCS,64999,PERCUTANEOUS TIBIAL NERVE STIM PTNS,704.0,457.6,352.0,704.0,12
HCPCS,64999,QUTENZA APPLICATION (COMP 64632),559.5,363.67499999999995,136.0,8550.0,57
HCPCS,64999,REMOVAL OF SEEG ELECTRODES,4340.0,2821.0,2170.0,4340.0,12
HCPCS,64999,"SI JOINT, RADIO REFEQUENCY (RF) ABLATION , SIMPLICITY III",104.0,67.6,52.0,104.0,12
HCPCS,64999,SPINAL ACCESSORY NERVE BLOCK (COMP CODE 64405),1480.0,962.0,207.0,8550.0,60
HCPCS,64999,SUBTEMP SKULLBASE MID & POST FOSSA TMR (61616),17474.0,11358.1,8737.0,17474.0,12
HCPCS,64999,TRANSPALATAL APPROACH FOR REMOVAL OF FOREIGN BODY (61575),14624.0,9505.6,7312.0,14624.0,12
HCPCS,64999,TRIGEMINAL BALLOON COMPRESSION,2493.0,1620.4499999999998,249.83,8550.0,60
HCPCS,64999,"UNLIST PROC, NERVOUS SYSTEM COMPARED TO 64640",1939.0,1260.35,249.83,8550.0,57
HCPCS,64999,"UNLISTED PROC, INJECTION, ANESTHETIC AGENT, CERVICAL PLEXUS (COM",600.0,390.0,300.0,600.0,12
HCPCS,64999,"UNLISTED PROCEDURE, NERVOUS",1679.0,1091.35,249.83,8550.0,45
HCPCS,65091,EVISCERATION OCULAR CONTENTS W/O IMPLANT,2904.0,1887.6,370.95,2904.0,35
HCPCS,65091,REVISE EYE,,,791.42,8176.15,15
HCPCS,65091,Revise eye,,,1810.58,2287.04,6
HCPCS,650910,REVISE EYE,,,791.42,791.42,1
HCPCS,65093,EVISCERATION OCULAR CONTENTS W/IMPLANT,2816.0,1830.4,397.39,2816.0,35
HCPCS,65093,REVISE EYE WITH IMPLANT,,,784.49,8176.15,15
HCPCS,65093,Revise eye with implant,,,1810.58,2287.04,6
HCPCS,650930,REVISE EYE WITH IMPLANT,,,784.49,784.49,1
HCPCS,65101,ENUCLEATION OF EYE W/O IMPLANT,3320.0,2158.0,415.39,3320.0,35
HCPCS,65101,REMOVAL OF EYE,,,906.11,8176.15,15
HCPCS,65101,Removal of eye,,,1810.58,2287.04,6
HCPCS,651010,REMOVAL OF EYE,,,906.11,906.11,1
HCPCS,65103,ENUCLEATION EYE IMPLT MUSC X ATTACHED IMPLT,3536.0,2298.4,432.15,3536.0,35
HCPCS,65103,REMOVE EYE/INSERT IMPLANT,,,936.35,8176.15,15
HCPCS,65103,Remove eye/insert implant,,,1810.58,2287.04,6
HCPCS,651030,REMOVE EYE/INSERT IMPLANT,,,936.35,936.35,1
HCPCS,65105,ENUCLEATION EYE IMPLT MUSC ATTACHED IMPLT,4369.0,2839.85,481.63,4369.0,35
HCPCS,65105,REMOVE EYE/ATTACH IMPLANT,,,1019.09,8176.15,15
HCPCS,65105,Remove eye/attach implant,,,1810.58,2287.04,6
HCPCS,651050,REMOVE EYE/ATTACH IMPLANT,,,1019.09,1019.09,1
HCPCS,65110,EXENTERATION ORBIT REMVL ORBITAL CONTENTS ONLY,6280.0,4082.0,773.94,6280.0,35
HCPCS,65110,REMOVAL OF EYE,,,1412.28,8176.15,15
HCPCS,65110,Removal of eye,,,1810.58,2287.04,6
HCPCS,651100,REMOVAL OF EYE,,,1412.28,1412.28,1
HCPCS,65112,EXENTERATION ORBIT RMVL ORBIT CONTENTS & BONE,7404.0,4812.6,750.36,7404.0,35
HCPCS,65112,REMOVE EYE/REVISE SOCKET,,,1619.48,8176.15,15
HCPCS,65112,Remove eye/revise socket,,,1810.58,2287.04,6
HCPCS,651120,REMOVE EYE/REVISE SOCKET,,,1619.48,1619.48,1
HCPCS,65114,EXNTJ ORBIT RMVL ORB CNTS W/MUSC/MYOQ FLAP,7860.0,5109.0,806.89,7860.0,35
HCPCS,65114,REMOVE EYE/REVISE SOCKET,,,1690.74,8176.15,15
HCPCS,65114,Remove eye/revise socket,,,1810.58,2287.04,6
HCPCS,651140,REMOVE EYE/REVISE SOCKET,,,1690.74,1690.74,1
HCPCS,65125,REVISE OCULAR IMPLANT,,,314.41,5058.24,15
HCPCS,65125,Revise ocular implant,,,1810.58,2287.04,6
HCPCS,651250,REVISE OCULAR IMPLANT,,,314.41,314.41,1
HCPCS,65130,INSERT OCULAR IMPLANT,,,909.65,8176.15,15
HCPCS,65130,Insert ocular implant,,,1810.58,2287.04,6
HCPCS,651300,INSERT OCULAR IMPLANT,,,909.65,909.65,1
HCPCS,65135,INSERT OCULAR IMPLANT,,,920.97,8176.15,15
HCPCS,65135,Insert ocular implant,,,1810.58,2287.04,6
HCPCS,651350,INSERT OCULAR IMPLANT,,,920.97,920.97,1
HCPCS,65140,ATTACH OCULAR IMPLANT,,,989.81,8176.15,15
HCPCS,65140,Attach ocular implant,,,1810.58,2287.04,6
HCPCS,651400,ATTACH OCULAR IMPLANT,,,989.81,989.81,1
HCPCS,65150,REVISE OCULAR IMPLANT,,,745.72,8176.15,15
HCPCS,65150,Revise ocular implant,,,1810.58,2287.04,6
HCPCS,651500,REVISE OCULAR IMPLANT,,,745.72,745.72,1
HCPCS,65155,REINSERT OCULAR IMPLANT,,,1030.02,8176.15,15
HCPCS,65155,Reinsert ocular implant,,,1810.58,2287.04,6
HCPCS,651550,REINSERT OCULAR IMPLANT,,,1030.02,1030.02,1
HCPCS,65175,REMOVAL OF OCULAR IMPLANT,,,829.43,8176.15,15
HCPCS,65175,Removal of ocular implant,,,1810.58,2287.04,6
HCPCS,651750,REMOVAL OF OCULAR IMPLANT,,,829.43,829.43,1
HCPCS,65205,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,478.5,311.025,21.7,3920.0,133
HCPCS,65205,REMOVE FOREIGN BODY FROM EYE,,,31.36,31.36,1
HCPCS,652050,REMOVE FOREIGN BODY FROM EYE,,,31.36,31.36,1
HCPCS,65210,REMOVE FOREIGN BODY FROM EYE,,,38.64,38.64,1
HCPCS,65210,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,1281.5,832.975,27.94,3920.0,133
HCPCS,652100,REMOVE FOREIGN BODY FROM EYE,,,38.64,38.64,1
HCPCS,65220,REMOVE FOREIGN BODY FROM EYE,,,45.1,45.1,1
HCPCS,65220,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,1303.5,847.275,20.59,3920.0,133
HCPCS,652200,REMOVE FOREIGN BODY FROM EYE,,,45.1,45.1,1
HCPCS,65222,REMOVE FOREIGN BODY FROM EYE,,,54.29,54.29,1
HCPCS,65222,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,555.5,361.075,31.39,3920.0,133
HCPCS,652220,REMOVE FOREIGN BODY FROM EYE,,,54.29,54.29,1
HCPCS,65235,REMOVE FOREIGN BODY FROM EYE,,,783.59,783.59,1
HCPCS,65235,RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS,8359.0,5433.35,355.96,11802.6,133
HCPCS,652350,REMOVE FOREIGN BODY FROM EYE,,,783.59,783.59,1
HCPCS,65260,REMOVE FOREIGN BODY FROM EYE,,,1049.8,4945.0,15
HCPCS,65260,Remove foreign body from eye,,,624.8,789.22,6
HCPCS,652600,REMOVE FOREIGN BODY FROM EYE,,,1049.8,1049.8,1
HCPCS,65265,REMOVE FOREIGN BODY FROM EYE,,,1182.39,4945.0,15
HCPCS,65265,Remove foreign body from eye,,,624.8,789.22,6
HCPCS,652650,REMOVE FOREIGN BODY FROM EYE,,,1182.39,1182.39,1
HCPCS,65270,REPAIR OF EYE WOUND,,,150.64,5058.24,15
HCPCS,65270,RPR LAC CJNC W/WO NONPERFOR LAC SCLERA DIR CLSR,780.0,507.0,69.9,585.0,35
HCPCS,65270,Repair of eye wound,,,1069.15,1350.5,6
HCPCS,652700,REPAIR OF EYE WOUND,,,150.64,150.64,1
HCPCS,65272,REPAIR OF EYE WOUND,,,377.91,5058.24,15
HCPCS,65272,RPR LAC CJNC MOBLJ& REARGMT W/O HOSPITALIZATION,1848.0,1201.2,168.49,1386.0,35
HCPCS,65272,Repair of eye wound,,,856.52,1081.92,6
HCPCS,652720,REPAIR OF EYE WOUND,,,377.91,377.91,1
HCPCS,65273,REPAIR OF EYE WOUND,,,406.74,406.74,1
HCPCS,65273,Repair of eye wound,,,856.52,1081.92,6
HCPCS,652730,REPAIR OF EYE WOUND,,,406.74,406.74,1
HCPCS,65275,REPAIR OF EYE WOUND,,,493.47,8176.15,15
HCPCS,65275,Repair of eye wound,,,2010.76,2539.91,6
HCPCS,652750,REPAIR OF EYE WOUND,,,493.47,493.47,1
HCPCS,65280,REPAIR OF EYE WOUND,,,718.22,11187.1,15
HCPCS,65280,RPR LAC CORNEA&/SCLERA PERFOR X INVG UVEAL TIS,3640.0,2366.0,425.22,3640.0,35
HCPCS,65280,Repair of eye wound,,,2010.76,2539.91,6
HCPCS,652800,REPAIR OF EYE WOUND,,,718.22,718.22,1
HCPCS,65285,REPAIR OF EYE WOUND,,,1184.48,11187.1,15
HCPCS,65285,RPR LAC CORN&/SCLRA PERF W/REPOS/RESCJ UVEAL T,6144.0,3993.6,676.32,6144.0,35
HCPCS,65285,Repair of eye wound,,,2010.76,2539.91,6
HCPCS,652850,REPAIR OF EYE WOUND,,,1184.48,1184.48,1
HCPCS,65286,REPAIR OF EYE WOUND,,,530.52,4945.0,15
HCPCS,65286,RPR LAC APPL TISSUE GLUE WOUND CORNEA&/SCLERA,2652.0,1723.8,236.22,1989.0,35
HCPCS,65286,Repair of eye wound,,,351.76,444.32,6
HCPCS,652860,REPAIR OF EYE WOUND,,,530.52,530.52,1
HCPCS,65290,REPAIR OF EYE SOCKET WOUND,,,524.64,8176.15,15
HCPCS,65290,Repair of eye socket wound,,,1810.58,2287.04,6
HCPCS,652900,REPAIR OF EYE SOCKET WOUND,,,524.64,524.64,1
HCPCS,65400,EXCISION LESION CORNEA XCP PTERYGIUM,3000.0,1950.0,286.68,2250.0,35
HCPCS,65400,REMOVAL OF EYE LESION,,,644.85,2099.95,15
HCPCS,65400,Removal of eye lesion,,,351.76,444.32,6
HCPCS,654000,REMOVAL OF EYE LESION,,,644.85,644.85,1
HCPCS,65410,BIOPSY OF CORNEA,588.0,382.2,54.91,5058.24,50
HCPCS,65410,Biopsy of cornea,,,351.76,444.32,6
HCPCS,654100,BIOPSY OF CORNEA,,,110.03,110.03,1
HCPCS,65420,EXCISION/TRANSPOSITION PTERYGIUM W/O GRAFT,1744.0,1133.6,180.49,1308.0,35
HCPCS,65420,REMOVAL OF EYE LESION,,,406.52,5058.24,15
HCPCS,65420,Removal of eye lesion,,,351.76,444.32,6
HCPCS,654200,REMOVAL OF EYE LESION,,,406.52,406.52,1
HCPCS,65426,EXCISION/TRANSPOSITION PTERYGIUM W/GRAFG,2420.0,1573.0,227.17,1815.0,35
HCPCS,65426,REMOVAL OF EYE LESION,,,512.18,5058.24,15
HCPCS,65426,Removal of eye lesion,,,2010.76,2539.91,6
HCPCS,654260,REMOVAL OF EYE LESION,,,512.18,512.18,1
HCPCS,65430,CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE,588.0,382.2,64.48,441.0,35
HCPCS,65430,CORNEAL SMEAR,,,108.62,865.18,15
HCPCS,65430,Corneal smear,,,169.69,214.34,6
HCPCS,654300,CORNEAL SMEAR,,,108.62,108.62,1
HCPCS,65435,CURETTE/TREAT CORNEA,,,74.6,74.6,1
HCPCS,65435,RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION,2968.5,1929.5249999999999,48.19,5012.1,133
HCPCS,654350,CURETTE/TREAT CORNEA,,,74.6,74.6,1
HCPCS,65436,CURETTE/TREAT CORNEA,,,396.22,5058.24,15
HCPCS,65436,Curette/treat cornea,,,351.76,444.32,6
HCPCS,65436,RMVL CORNEAL EPITHELIUM W/APPL CHELATING AGENT,1928.0,1253.2,175.56,1446.0,35
HCPCS,654360,CURETTE/TREAT CORNEA,,,396.22,396.22,1
HCPCS,65450,DSTRJ LESION CRYOTHER PHOTO/THERMOCAUTZATION,1388.0,902.2,180.86,1041.0,35
HCPCS,65450,TREATMENT OF CORNEAL LESION,,,300.06,648.13,15
HCPCS,65450,Treatment of corneal lesion,,,351.76,444.32,6
HCPCS,654500,TREATMENT OF CORNEAL LESION,,,345.05,345.05,1
HCPCS,65600,MULT PUNC ANTER CORNEA,1680.0,1092.0,161.42,1260.0,35
HCPCS,65600,REVISION OF CORNEA,,,364.98,5058.24,15
HCPCS,65600,Revision of cornea,,,351.76,444.32,6
HCPCS,656000,REVISION OF CORNEA,,,364.98,364.98,1
HCPCS,65710,CORNEAL TRANSPLANT,,,1217.75,11187.1,15
HCPCS,65710,Corneal transplant,,,2010.76,2539.91,6
HCPCS,657100,CORNEAL TRANSPLANT,,,1217.75,1217.75,1
HCPCS,65730,CORNEAL TRANSPLANT,,,1339.73,8722.22,15
HCPCS,65730,Corneal transplant,,,2010.76,2539.91,6
HCPCS,65730,KERATOPLASTY PENTRG EXCEPT APHAKIA/PSEUDOPHAKIA,7194.0,4676.1,782.87,7194.0,35
HCPCS,657300,CORNEAL TRANSPLANT,,,1339.73,1339.73,1
HCPCS,65750,CORNEAL TRANSPLANT,,,1348.94,11187.1,15
HCPCS,65750,Corneal transplant,,,2010.76,2539.91,6
HCPCS,65750,KERATOPLASTY PENETRAING APHAKIA,6760.0,4394.0,825.5,6760.0,35
HCPCS,657500,CORNEAL TRANSPLANT,,,1348.94,1348.94,1
HCPCS,65755,CORNEAL TRANSPLANT,,,1344.83,8722.22,15
HCPCS,65755,Corneal transplant,,,2010.76,2539.91,6
HCPCS,65755,KERATOPLASTY PENETRATING PSEUDOPHAKIA,6716.0,4365.4,822.67,6716.0,35
HCPCS,657550,CORNEAL TRANSPLANT,,,1344.83,1344.83,1
HCPCS,65756,CORNEAL TRNSPL ENDOTHELIAL,,,1266.59,8722.22,15
HCPCS,65756,Corneal trnspl endothelial,,,2010.76,2539.91,6
HCPCS,65756,KERATOPLASTY ENDOTHELIAL,7410.0,4816.5,755.17,7410.0,35
HCPCS,657560,CORNEAL TRNSPL ENDOTHELIAL,,,1266.59,1266.59,1
HCPCS,65757,BACKBENCH PREPJ CORNEAL ENDOTHELIAL ALLOGRAFT,1284.0,834.6,97.64,1284.0,14
HCPCS,65757,PREP CORNEAL ENDO ALLOGRAFT,,,138.3,138.3,1
HCPCS,65757,Prep corneal endo allograft,,,2010.76,2539.91,6
HCPCS,657570,PREP CORNEAL ENDO ALLOGRAFT,,,138.3,138.3,1
HCPCS,65760,KERATOMILEUSIS,665.0,432.25,332.5,2348.46,14
HCPCS,65760,Keratomileusis,,,351.76,444.32,6
HCPCS,657600,KERATOMILEUSIS,,,1260.46,1260.46,1
HCPCS,65765,KERATOPHAKIA,,,1827.94,1827.94,1
HCPCS,65765,Keratophakia,,,351.76,444.32,6
HCPCS,657650,KERATOPHAKIA,,,1827.94,1827.94,1
HCPCS,65767,EPIKERATOPLASTY,,,1702.0,1702.0,1
HCPCS,65767,Epikeratoplasty,,,351.76,444.32,6
HCPCS,657670,EPIKERATOPLASTY,,,1702.0,1702.0,1
HCPCS,65770,KERATOPROSTHESIS,,,1508.14,30981.58,15
HCPCS,65770,Keratoprosthesis,,,2010.76,2539.91,6
HCPCS,657700,KERATOPROSTHESIS,,,1508.14,1508.14,1
HCPCS,65771,RADIAL KERATOTOMY,,,693.03,693.03,1
HCPCS,65771,Radial keratotomy,,,351.76,444.32,6
HCPCS,657710,RADIAL KERATOTOMY,,,693.03,693.03,1
HCPCS,65772,CORRECTION OF ASTIGMATISM,,,434.01,2099.95,15
HCPCS,65772,CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM,2036.0,1323.4,192.33,1527.0,35
HCPCS,65772,Correction of astigmatism,,,351.76,444.32,6
HCPCS,657720,CORRECTION OF ASTIGMATISM,,,434.01,434.01,1
HCPCS,65775,CORRECTION OF ASTIGMATISM,,,613.74,5058.24,15
HCPCS,65775,CRNL WEDGE RESCJ CORRJ INDUCED ASTIGMATISM,2764.0,1796.6,335.92,2764.0,35
HCPCS,65775,Correction of astigmatism,,,351.76,444.32,6
HCPCS,657750,CORRECTION OF ASTIGMATISM,,,613.74,613.74,1
HCPCS,65778,COVER EYE W/MEMBRANE,,,47.71,2099.95,15
HCPCS,65778,Cover eye w/membrane,,,351.76,444.32,6
HCPCS,65778,PLACE AMNIOTIC MEMBRA OCULAR SURFACE W/O SUTURES,336.0,218.4,37.09,1687.39,35
HCPCS,657780,COVER EYE W/MEMBRANE,,,47.71,47.71,1
HCPCS,65779,COVER EYE W/MEMBRANE SUTURE,,,126.54,8176.15,15
HCPCS,65779,Cover eye w/membrane suture,,,351.76,444.32,6
HCPCS,657790,COVER EYE W/MEMBRANE SUTURE,,,126.54,126.54,1
HCPCS,65780,OCULAR RECONST TRANSPLANT,,,631.68,8176.15,15
HCPCS,65780,OCULAR SURFACE RECONSTRUCTION AMNIOTIC MEMBRANE,2812.0,1827.8,449.88,2812.0,35
HCPCS,65780,Ocular reconst transplant,,,2010.76,2539.91,6
HCPCS,657800,OCULAR RECONST TRANSPLANT,,,631.68,631.68,1
HCPCS,65781,OCULAR RECONST TRANSPLANT,,,1420.03,11187.1,15
HCPCS,65781,Ocular reconst transplant,,,2010.76,2539.91,6
HCPCS,657810,OCULAR RECONST TRANSPLANT,,,1420.03,1420.03,1
HCPCS,65782,OCCULAR SURFACE RECONSTRUCTION LIMBAL AUTOGRAFT,6172.0,4011.8,688.66,6172.0,35
HCPCS,65782,OCULAR RECONST TRANSPLANT,,,1225.97,8176.15,15
HCPCS,65782,Ocular reconst transplant,,,2010.76,2539.91,6
HCPCS,657820,OCULAR RECONST TRANSPLANT,,,1225.97,1225.97,1
HCPCS,65785,IMPLTJ NTRSTRML CRNL RNG SEG,,,474.31,8722.22,15
HCPCS,65785,Impltj ntrstrml crnl rng seg,,,2010.76,2539.91,6
HCPCS,657850,IMPLTJ NTRSTRML CRNL RNG SEG,,,474.31,474.31,1
HCPCS,65800,DRAINAGE OF EYE,,,96.13,96.13,1
HCPCS,65800,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,6893.5,4480.775000000001,66.44,11802.6,130
HCPCS,658000,DRAINAGE OF EYE,,,96.13,96.13,1
HCPCS,65810,DRAINAGE OF EYE,,,496.88,4945.0,15
HCPCS,65810,Drainage of eye,,,599.44,757.19,6
HCPCS,658100,DRAINAGE OF EYE,,,496.88,496.88,1
HCPCS,65815,DRAINAGE OF EYE,,,509.9,4945.0,15
HCPCS,65815,Drainage of eye,,,599.44,757.19,6
HCPCS,65815,PARACEN ANT CHAM RMVL BLOOD W/WO IRRIG&/AIR IN,2400.0,1560.0,226.36,1800.0,35
HCPCS,658150,DRAINAGE OF EYE,,,509.9,509.9,1
HCPCS,65820,GONIOTOMY,,,877.05,8722.22,15
HCPCS,65820,Goniotomy,,,599.44,757.19,6
HCPCS,658200,GONIOTOMY,,,877.05,877.05,1
HCPCS,65850,TRABECULOTOMY AB EXTERNO,4556.0,2961.4,577.36,4945.0,50
HCPCS,65850,Trabeculotomy ab externo,,,2069.78,2614.46,6
HCPCS,658500,TRABECULOTOMY AB EXTERNO,,,903.5,903.5,1
HCPCS,65855,TRABECULOPLASTY BY LASER SURGERY,1320.0,858.0,179.03,990.0,35
HCPCS,65855,TRABECULOPLASTY LASER SURG,,,220.61,1189.46,15
HCPCS,65855,Trabeculoplasty laser surg,,,599.44,757.19,6
HCPCS,658550,TRABECULOPLASTY LASER SURG,,,220.61,220.61,1
HCPCS,65860,SEVERING ADHESIONS ANTERIOR SEGMENT LASER SPX,1436.0,933.4,148.39,1077.0,35
HCPCS,65860,SEVERING ADS ANT SGM LASER,,,267.18,1189.46,15
HCPCS,65860,Severing ads ant sgm laser,,,599.44,757.19,6
HCPCS,658600,SEVERING ADS ANT SGM LASER,,,267.18,267.18,1
HCPCS,65865,INCISE INNER EYE ADHESIONS,,,511.49,4945.0,15
HCPCS,65865,Incise inner eye adhesions,,,599.44,757.19,6
HCPCS,65865,SEVERING ADS ANT SEG INCAL TQ SPX GONIOSYNECHIAE,2308.0,1500.2,317.13,2308.0,35
HCPCS,658650,INCISE INNER EYE ADHESIONS,,,511.49,511.49,1
HCPCS,65870,INCISE INNER EYE ADHESIONS,,,635.79,4945.0,15
HCPCS,65870,Incise inner eye adhesions,,,599.44,757.19,6
HCPCS,65870,SEVERING ADS ANT SEG INCAL SPX ANT SYNECHIAE,2956.0,1921.4,328.1,2956.0,35
HCPCS,658700,INCISE INNER EYE ADHESIONS,,,635.79,635.79,1
HCPCS,65875,INCISE INNER EYE ADHESIONS,,,678.65,4945.0,15
HCPCS,65875,Incise inner eye adhesions,,,599.44,757.19,6
HCPCS,65875,SEVERING ADS ANT SEG INCAL SPX POST SYNECHIAE,3124.0,2030.6,345.1,3124.0,35
HCPCS,658750,INCISE INNER EYE ADHESIONS,,,678.65,678.65,1
HCPCS,65880,INCISE INNER EYE ADHESIONS,,,713.39,8722.22,15
HCPCS,65880,Incise inner eye adhesions,,,2069.78,2614.46,6
HCPCS,658800,INCISE INNER EYE ADHESIONS,,,713.39,713.39,1
HCPCS,65900,REMOVE EYE LESION,,,1059.67,4945.0,15
HCPCS,65900,RMVL EPITHELIAL DOWNGROWTH ANT CHAMBER EYE,5004.0,3252.6,535.66,5004.0,35
HCPCS,65900,Remove eye lesion,,,2069.78,2614.46,6
HCPCS,659000,REMOVE EYE LESION,,,1059.67,1059.67,1
HCPCS,65920,REMOVE IMPLANT OF EYE,,,847.0,4945.0,15
HCPCS,65920,RMVL IMPLANTED MATERIAL ANTERIO SEGMENT EYE,3996.0,2597.4,442.84,3996.0,35
HCPCS,65920,Remove implant of eye,,,599.44,757.19,6
HCPCS,659200,REMOVE IMPLANT OF EYE,,,847.0,847.0,1
HCPCS,65930,REMOVE BLOOD CLOT FROM EYE,,,687.7,4945.0,15
HCPCS,65930,RMVL BLOOD CLOT ANTERIOR SEGMENT EYE,3356.0,2181.4,405.14,3356.0,35
HCPCS,65930,Remove blood clot from eye,,,599.44,757.19,6
HCPCS,659300,REMOVE BLOOD CLOT FROM EYE,,,687.7,687.7,1
HCPCS,66020,"INJECT ANTER CHMBR EYE,AIR/FLUID",656.0,426.4,62.14,492.0,35
HCPCS,66020,INJECTION TREATMENT OF EYE,,,140.56,4945.0,15
HCPCS,66020,Injection treatment of eye,,,599.44,757.19,6
HCPCS,660200,INJECTION TREATMENT OF EYE,,,140.56,140.56,1
HCPCS,66030,"INJECT ANTER CHMBR EYE,MEDICATN",520.0,338.0,52.77,390.0,35
HCPCS,66030,INJECTION TREATMENT OF EYE,,,118.99,4945.0,15
HCPCS,66030,Injection treatment of eye,,,599.44,757.19,6
HCPCS,660300,INJECTION TREATMENT OF EYE,,,118.99,118.99,1
HCPCS,66130,REMOVE EYE LESION,,,605.47,5058.24,15
HCPCS,66130,"REMOVE EYE LESION,SCLERA",3132.0,2035.8,268.6,2349.0,35
HCPCS,66130,Remove eye lesion,,,599.44,757.19,6
HCPCS,661300,REMOVE EYE LESION,,,605.47,605.47,1
HCPCS,66150,GLAUCOMA SURGERY,,,937.72,8722.22,15
HCPCS,66150,Glaucoma surgery,,,2069.78,2614.46,6
HCPCS,661500,GLAUCOMA SURGERY,,,937.72,937.72,1
HCPCS,66155,GLAUCOMA SURGERY,,,937.34,8722.22,15
HCPCS,66155,Glaucoma surgery,,,2069.78,2614.46,6
HCPCS,661550,GLAUCOMA SURGERY,,,937.34,937.34,1
HCPCS,66160,FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT,5452.0,3543.8,548.59,5452.0,35
HCPCS,66160,GLAUCOMA SURGERY,,,1055.1,4945.0,15
HCPCS,66160,Glaucoma surgery,,,2069.78,2614.46,6
HCPCS,661600,GLAUCOMA SURGERY,,,1055.1,1055.1,1
HCPCS,66170,FSTLJ SCLERA GLAUCOMA TRABECULECT AB EXTERNO,5576.0,3624.4,633.17,5576.0,35
HCPCS,66170,GLAUCOMA SURGERY,,,1170.95,4945.0,15
HCPCS,66170,Glaucoma surgery,,,2069.78,2614.46,6
HCPCS,661700,GLAUCOMA SURGERY,,,1170.95,1170.95,1
HCPCS,66172,FSTLJ SCLERA GLC TRBEC AB EXTERNO SCARRING,5936.0,3858.4,718.9,5936.0,35
HCPCS,66172,INCISION OF EYE,,,1277.46,4945.0,15
HCPCS,66172,Incision of eye,,,2069.78,2614.46,6
HCPCS,661720,INCISION OF EYE,,,1277.46,1277.46,1
HCPCS,66174,TRLUML DIL AQ O/F CAN W/O ST,,,666.91,8722.22,15
HCPCS,66174,TRLUML DILAT AQUEOUS O/F CAN WO RETENTION DEV/ST,3353.0,2179.45,504.17,3353.0,32
HCPCS,66174,Trluml dil aq o/f can w/o st,,,2069.78,2614.46,6
HCPCS,661740,TRLUML DIL AQ O/F CAN W/O ST,,,666.91,666.91,1
HCPCS,66175,TRLUML DIL AQ O/F CAN W/ST,,,776.2,11187.1,15
HCPCS,66175,TRLUML DILAT AQUEOUS O/F CAN W/RETENTION DEV/ST,3736.0,2428.4,553.99,3736.0,32
HCPCS,66175,Trluml dil aq o/f can w/st,,,2069.78,2614.46,6
HCPCS,661750,TRLUML DIL AQ O/F CAN W/ST,,,776.2,776.2,1
HCPCS,66179,AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT,5600.0,3640.0,703.05,5600.0,31
HCPCS,66179,AQUEOUS SHUNT EYE W/O GRAFT,,,1157.09,11187.1,15
HCPCS,66179,Aqueous shunt eye w/o graft,,,2069.78,2614.46,6
HCPCS,661790,AQUEOUS SHUNT EYE W/O GRAFT,,,1157.09,1157.09,1
HCPCS,66180,AQUEOUS SHUNT EXTRAOC EQUAT PLATE RSVR W/GRAFT,6600.0,4290.0,792.76,6600.0,35
HCPCS,66180,AQUEOUS SHUNT EYE W/GRAFT,,,1219.58,11187.1,15
HCPCS,66180,Aqueous shunt eye w/graft,,,2069.78,2614.46,6
HCPCS,661800,AQUEOUS SHUNT EYE W/GRAFT,,,1219.58,1219.58,1
HCPCS,66183,INSERT ANT DRAINAGE DEVICE,,,1102.16,8722.22,15
HCPCS,66183,INSERT ANTER DRAINAGE DEV W/O EXTRAOC RESERVOIR,5808.0,3775.2,762.89,5808.0,28
HCPCS,66183,Insert ant drainage device,,,2069.78,2614.46,6
HCPCS,661830,INSERT ANT DRAINAGE DEVICE,,,1102.16,1102.16,1
HCPCS,66184,REVISION OF AQUEOUS SHUNT,,,846.51,4945.0,15
HCPCS,66184,REVJ SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT,3832.0,2490.8,489.83,3832.0,31
HCPCS,66184,Revision of aqueous shunt,,,599.44,757.19,6
HCPCS,661840,REVISION OF AQUEOUS SHUNT,,,846.51,846.51,1
HCPCS,66185,REVISE AQUEOUS SHUNT EYE,,,909.74,4945.0,15
HCPCS,66185,REVJ AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/GRAFT,4232.0,2750.8,455.44,4232.0,35
HCPCS,66185,Revise aqueous shunt eye,,,599.44,757.19,6
HCPCS,661850,REVISE AQUEOUS SHUNT EYE,,,909.74,909.74,1
HCPCS,66225,REPAIR/GRAFT EYE LESION,,,1002.74,11187.1,15
HCPCS,66225,Repair/graft eye lesion,,,2069.78,2614.46,6
HCPCS,662250,REPAIR/GRAFT EYE LESION,,,1002.74,1002.74,1
HCPCS,66250,FOLLOW-UP SURGERY OF EYE,,,595.57,5058.24,15
HCPCS,66250,Follow-up surgery of eye,,,599.44,757.19,6
HCPCS,66250,REVJ/RPR OPRATIVE WOUND ANTERIOR SEGMENT,2840.0,1846.0,264.65,2130.0,35
HCPCS,662500,FOLLOW-UP SURGERY OF EYE,,,595.57,595.57,1
HCPCS,66500,INCISION OF IRIS,,,419.69,4945.0,15
HCPCS,66500,Incision of iris,,,599.44,757.19,6
HCPCS,665000,INCISION OF IRIS,,,419.69,419.69,1
HCPCS,66505,INCISION OF IRIS,,,456.56,4945.0,15
HCPCS,66505,Incision of iris,,,599.44,757.19,6
HCPCS,665050,INCISION OF IRIS,,,456.56,456.56,1
HCPCS,66600,IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES,4048.0,2631.2,473.92,4048.0,35
HCPCS,66600,REMOVE IRIS AND LESION,,,964.75,8722.22,15
HCPCS,66600,Remove iris and lesion,,,2069.78,2614.46,6
HCPCS,666000,REMOVE IRIS AND LESION,,,964.75,964.75,1
HCPCS,66605,REMOVAL OF IRIS,,,1165.44,4945.0,15
HCPCS,66605,Removal of iris,,,2069.78,2614.46,6
HCPCS,666050,REMOVAL OF IRIS,,,1165.44,1165.44,1
HCPCS,66625,IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX,2120.0,1378.0,296.94,2120.0,35
HCPCS,66625,REMOVAL OF IRIS,,,458.84,4945.0,15
HCPCS,66625,Removal of iris,,,599.44,757.19,6
HCPCS,666250,REMOVAL OF IRIS,,,458.84,458.84,1
HCPCS,66630,REMOVAL OF IRIS,,,607.22,4945.0,15
HCPCS,66630,Removal of iris,,,599.44,757.19,6
HCPCS,666300,REMOVAL OF IRIS,,,607.22,607.22,1
HCPCS,66635,IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX,2948.0,1916.2,351.98,2948.0,35
HCPCS,66635,REMOVAL OF IRIS,,,612.67,4945.0,15
HCPCS,66635,Removal of iris,,,599.44,757.19,6
HCPCS,666350,REMOVAL OF IRIS,,,612.67,612.67,1
HCPCS,66680,REPAIR IRIS & CILIARY BODY,,,557.43,4945.0,15
HCPCS,66680,REPAIR IRIS/CILIARY BODY,3188.0,2072.2,308.14,3188.0,35
HCPCS,66680,Repair iris & ciliary body,,,599.44,757.19,6
HCPCS,666800,REPAIR IRIS & CILIARY BODY,,,557.43,557.43,1
HCPCS,66682,REPAIR IRIS & CILIARY BODY,,,757.66,4945.0,15
HCPCS,66682,Repair iris & ciliary body,,,599.44,757.19,6
HCPCS,66682,SUTURE IRIS CILIARY BODY SPX RETRIEVAL SUTURE,3496.0,2272.4,350.0,3496.0,35
HCPCS,666820,REPAIR IRIS & CILIARY BODY,,,757.66,757.66,1
HCPCS,66683,IMPLANTATION IRIS PROSTHESIS,,,812.1,35593.55,15
HCPCS,66683,IMPLTJ IRIS PROSTHESIS W/SUTR FIXJ&RPR/RMVL IRIS,4695.0,3051.75,539.8,4695.0,25
HCPCS,66683,Implantation iris prosthesis,,,2069.78,2614.46,6
HCPCS,666830,IMPLANTATION IRIS PROSTHESIS,,,812.1,812.1,1
HCPCS,66700,DESTRUCTION CILIARY BODY,,,419.73,4945.0,15
HCPCS,66700,Destruction ciliary body,,,599.44,757.19,6
HCPCS,667000,DESTRUCTION CILIARY BODY,,,419.73,419.73,1
HCPCS,66710,CILIARY TRANSSLERAL THERAPY,,,419.4,5058.24,15
HCPCS,66710,Ciliary transsleral therapy,,,599.44,757.19,6
HCPCS,667100,CILIARY TRANSSLERAL THERAPY,,,419.4,419.4,1
HCPCS,66711,ECP CILIARY BODY DESTRUCTION,,,540.13,4945.0,15
HCPCS,66711,Ecp ciliary body destruction,,,599.44,757.19,6
HCPCS,667110,ECP CILIARY BODY DESTRUCTION,,,540.13,540.13,1
HCPCS,66720,CILIARY BODY DESTRUCTION CRYOTHERAPY,1900.0,1235.0,241.97,1425.0,35
HCPCS,66720,DESTRUCTION CILIARY BODY,,,439.66,5058.24,15
HCPCS,66720,Destruction ciliary body,,,599.44,757.19,6
HCPCS,667200,DESTRUCTION CILIARY BODY,,,439.66,439.66,1
HCPCS,66740,DESTRUCTION CILIARY BODY,,,419.73,5058.24,15
HCPCS,66740,Destruction ciliary body,,,599.44,757.19,6
HCPCS,667400,DESTRUCTION CILIARY BODY,,,419.73,419.73,1
HCPCS,66761,IRIDOTOMY/IRIDECTOMY BY LASER,1320.0,858.0,172.34,990.0,35
HCPCS,66761,REVISION OF IRIS,,,252.94,1189.46,15
HCPCS,66761,Revision of iris,,,599.44,757.19,6
HCPCS,667610,REVISION OF IRIS,,,252.94,252.94,1
HCPCS,66762,IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS,2152.0,1398.8,204.82,1614.0,35
HCPCS,66762,REVISION OF IRIS,,,454.29,1189.46,15
HCPCS,66762,Revision of iris,,,599.44,757.19,6
HCPCS,667620,REVISION OF IRIS,,,454.29,454.29,1
HCPCS,66770,REMOVAL OF INNER EYE LESION,,,515.2,1189.46,15
HCPCS,66770,Removal of inner eye lesion,,,599.44,757.19,6
HCPCS,667700,REMOVAL OF INNER EYE LESION,,,515.2,515.2,1
HCPCS,66820,INCISION SECONDARY CATARACT,,,496.68,4945.0,15
HCPCS,66820,Incision secondary cataract,,,351.76,444.32,6
HCPCS,668200,INCISION SECONDARY CATARACT,,,496.68,496.68,1
HCPCS,66821,AFTER CATARACT LASER SURGERY,,,332.11,1189.46,15
HCPCS,66821,After cataract laser surgery,,,351.76,444.32,6
HCPCS,66821,POST-CATARACT LASER SURGERY,1505.0,978.25,148.6,1128.75,35
HCPCS,668210,AFTER CATARACT LASER SURGERY,,,332.11,332.11,1
HCPCS,66825,REPOSITION INTRAOCULAR LENS,,,887.06,4945.0,15
HCPCS,66825,REPOSITIONING IO LENS PROSTHESIS REQ INC SPX,3604.0,2342.6,417.76,3604.0,35
HCPCS,66825,Reposition intraocular lens,,,1056.74,1334.83,6
HCPCS,668250,REPOSITION INTRAOCULAR LENS,,,887.06,887.06,1
HCPCS,66830,REMOVAL OF LENS LESION,,,760.14,4945.0,15
HCPCS,66830,RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ,3788.0,2462.2,425.32,3788.0,35
HCPCS,66830,Removal of lens lesion,,,351.76,444.32,6
HCPCS,668300,REMOVAL OF LENS LESION,,,760.14,760.14,1
HCPCS,66840,REMOVAL OF LENS MATERIAL,,,741.87,4945.0,15
HCPCS,66840,RMVL LENS MATERIAL ASPIR TQ 1/> STAGES,3672.0,2386.8,436.91,3672.0,35
HCPCS,66840,Removal of lens material,,,1056.74,1334.83,6
HCPCS,668400,REMOVAL OF LENS MATERIAL,,,741.87,741.87,1
HCPCS,66850,REMOVAL OF LENS MATERIAL,,,843.91,4945.0,15
HCPCS,66850,RMVL LENS MATERIAL PHACOFRAGMENTATION ASPIR,4220.0,2743.0,500.51,4220.0,35
HCPCS,66850,Removal of lens material,,,1056.74,1334.83,6
HCPCS,668500,REMOVAL OF LENS MATERIAL,,,843.91,843.91,1
HCPCS,66852,REMOVAL OF LENS MATERIAL,,,898.41,8722.22,15
HCPCS,66852,RMVL LENS MATERIAL PARS PLANA W/WO VITRECTOMY,4564.0,2966.6,549.26,4564.0,35
HCPCS,66852,Removal of lens material,,,1056.74,1334.83,6
HCPCS,668520,REMOVAL OF LENS MATERIAL,,,898.41,898.41,1
HCPCS,66920,EXTRACTION OF LENS,,,801.78,4945.0,15
HCPCS,66920,Extraction of lens,,,1056.74,1334.83,6
HCPCS,66920,RMVL LENS MATERIAL INTRACAPSULAR,4052.0,2633.8,485.93,4052.0,35
HCPCS,669200,EXTRACTION OF LENS,,,801.78,801.78,1
HCPCS,66930,EXTRACTION OF LENS,,,918.09,8722.22,15
HCPCS,66930,Extraction of lens,,,1056.74,1334.83,6
HCPCS,669300,EXTRACTION OF LENS,,,918.09,918.09,1
HCPCS,66940,EXTRACTION OF LENS,,,839.82,4945.0,15
HCPCS,66940,Extraction of lens,,,1056.74,1334.83,6
HCPCS,669400,EXTRACTION OF LENS,,,839.82,839.82,1
HCPCS,66982,XCAPSL CTRC RMVL CPLX WO ECP,,,798.4,4945.0,15
HCPCS,66982,XCAPSL CTRC RMVL INSJ IO LENS PROSTH CPLX WO ECP,4510.0,2931.5,564.01,4510.0,35
HCPCS,66982,Xcapsl ctrc rmvl cplx wo ecp,,,1056.74,1334.83,6
HCPCS,669820,XCAPSL CTRC RMVL CPLX WO ECP,,,798.4,798.4,1
HCPCS,66983,CATARACT SURG W/IOL 1 STAGE,,,837.89,4945.0,15
HCPCS,66983,Cataract surg w/iol 1 stage,,,1056.74,1334.83,6
HCPCS,66983,ICAPSULAR CATARACT XTRJ INSJ IO LENS PRSTH 1 STG,4416.0,2870.4,459.85,4416.0,21
HCPCS,669830,CATARACT SURG W/IOL 1 STAGE,,,837.89,837.89,1
HCPCS,66984,XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP,3234.0,2102.1,411.84,3234.0,35
HCPCS,66984,XCAPSL CTRC RMVL W/O ECP,,,582.26,4945.0,15
HCPCS,66984,Xcapsl ctrc rmvl w/o ecp,,,1056.74,1334.83,6
HCPCS,669840,XCAPSL CTRC RMVL W/O ECP,,,582.26,582.26,1
HCPCS,66985,INSERT LENS PROSTHESIS,,,822.85,4945.0,15
HCPCS,66985,INSJ IO LENS PROSTHESIS NOT W/CONCURRENT RMVL,4391.0,2854.15,455.72,4391.0,35
HCPCS,66985,Insert lens prosthesis,,,1056.74,1334.83,6
HCPCS,669850,INSERT LENS PROSTHESIS,,,822.85,822.85,1
HCPCS,66986,EXCHANGE INTRAOCULAR LENS,4904.0,3187.6,633.81,4904.0,35
HCPCS,66986,EXCHANGE LENS PROSTHESIS,,,966.19,4945.0,15
HCPCS,66986,Exchange lens prosthesis,,,1056.74,1334.83,6
HCPCS,669860,EXCHANGE LENS PROSTHESIS,,,966.19,966.19,1
HCPCS,66987,XCAPSL CTRC RMVL CPLX W/ECP,,,975.12,8722.22,15
HCPCS,66987,Xcapsl ctrc rmvl cplx w/ecp,,,1056.74,1334.83,6
HCPCS,669870,XCAPSL CTRC RMVL CPLX W/ECP,,,975.12,975.12,1
HCPCS,66988,XCAPSL CTRC RMVL W/ECP,,,785.85,8722.22,15
HCPCS,66988,Xcapsl ctrc rmvl w/ecp,,,1056.74,1334.83,6
HCPCS,669880,XCAPSL CTRC RMVL W/ECP,,,785.85,785.85,1
HCPCS,66989,XCPSL CTRC RMVL CPLX INSJ 1+,,,917.56,11187.1,15
HCPCS,66989,Xcpsl ctrc rmvl cplx insj 1+,,,2069.78,2614.46,6
HCPCS,669890,XCPSL CTRC RMVL CPLX INSJ 1+,,,917.56,917.56,1
HCPCS,66990,OPHTHALMIC ENDOSCOPE ADD-ON,,,95.04,95.04,1
HCPCS,669900,OPHTHALMIC ENDOSCOPE ADD-ON,,,95.04,95.04,1
HCPCS,66991,XCAPSL CTRC RMVL INSJ 1+,,,731.64,11187.1,15
HCPCS,66991,Xcapsl ctrc rmvl insj 1+,,,2069.78,2614.46,6
HCPCS,669910,XCAPSL CTRC RMVL INSJ 1+,,,731.64,731.64,1
HCPCS,66999,CATARACT EXT; EYEONICS IOL SYS,2383.0,1548.95,357.5,2383.0,15
HCPCS,66999,CORNEAL RELAXING INCISION,323.0,209.95,161.5,429.0,15
HCPCS,66999,CRYSTALENS IOL UPGRADE,2653.0,1724.45,357.5,2653.0,15
HCPCS,66999,CRYSTALENS UPGRADE; PRO FEE,1172.0,761.8,357.5,1172.0,15
HCPCS,66999,CUSTOM BASIC PRK/LASIK SURGERY,466.0,302.9,233.0,466.0,15
HCPCS,66999,EPI-KERATOME - INITIAL TREATMENT,175.0,113.75,87.5,429.0,15
HCPCS,66999,INTRALASE - INITIAL TREATMENT,410.0,266.5,205.0,429.0,15
HCPCS,66999,INTRALASE - RETREATMENT,410.0,266.5,205.0,429.0,15
HCPCS,66999,LASER IN SITU KERATOMILEUSIS; PER EYE,634.0,412.1,317.0,634.0,15
HCPCS,66999,LIMBAL RELAXING INCISION,466.0,302.9,233.0,466.0,15
HCPCS,66999,LRI/NON-SURGICALLY INDUCED,468.0,304.2,234.0,468.0,15
HCPCS,66999,PHOTO REFRACTIVE KERATECTOMY,2115.0,1374.75,357.5,2115.0,15
HCPCS,66999,PTK,592.0,384.8,296.0,592.0,15
HCPCS,66999,RE-TREATMENT PRK/LASIK SURGERY CONVENTION,461.0,299.65,230.5,461.0,15
HCPCS,66999,RE-TREATMENT PRK/LASIK SURGERY CUSTOM,578.0,375.7,289.0,578.0,15
HCPCS,66999,RESTOR IOL UPGRADE,2653.0,1724.45,357.5,2653.0,15
HCPCS,66999,RESTOR IOL UPGRADE; PRO FEE,1104.0,717.6,357.5,1104.0,15
HCPCS,66999,TECHNIS MULTIFOCAL IOL UPGRADE,2653.0,1724.45,357.5,2653.0,15
HCPCS,66999,TECNIS MULTIFOCAL,2098.0,1363.7,357.5,2098.0,15
HCPCS,66999,TORIC UPGRADE,1486.0,965.9,357.5,1486.0,15
HCPCS,66999,TORRIC LENS,380.0,247.0,190.0,429.0,15
HCPCS,66999,UNLISTED PROCEDURE ANT SEG OF EYE,2954.5,1920.425,588.98,7730.0,96
HCPCS,67005,PARTIAL REMOVAL OF EYE FLUID,,,510.52,4945.0,15
HCPCS,67005,Partial removal of eye fluid,,,624.8,789.22,6
HCPCS,67005,RMVL VITREOUS ANT APPR PARTIAL REMOVAL,2356.0,1531.4,304.68,2356.0,35
HCPCS,670050,PARTIAL REMOVAL OF EYE FLUID,,,510.52,510.52,1
HCPCS,67010,PARTIAL REMOVAL OF EYE FLUID,,,584.72,4945.0,15
HCPCS,67010,Partial removal of eye fluid,,,624.8,789.22,6
HCPCS,67010,RMVL VITREOUS ANT APPR SUBTOT RMVL MECH VITRECT,2824.0,1835.6,367.59,2824.0,35
HCPCS,670100,PARTIAL REMOVAL OF EYE FLUID,,,584.72,584.72,1
HCPCS,67015,RELEASE OF EYE FLUID,,,645.52,4945.0,15
HCPCS,67015,Release of eye fluid,,,1959.49,2475.14,6
HCPCS,670150,RELEASE OF EYE FLUID,,,645.52,645.52,1
HCPCS,67025,REPLACE EYE FLUID,,,674.59,4945.0,15
HCPCS,67025,Replace eye fluid,,,624.8,789.22,6
HCPCS,670250,REPLACE EYE FLUID,,,674.59,674.59,1
HCPCS,67027,IMPLANT EYE DRUG SYSTEM,,,907.46,33313.48,15
HCPCS,67027,Implant eye drug system,,,1959.49,2475.14,6
HCPCS,670270,IMPLANT EYE DRUG SYSTEM,,,907.46,907.46,1
HCPCS,67028,INJECTION EYE DRUG,,,98.54,719.16,15
HCPCS,67028,INTRAVITREAL NJX PHARMACOLOGIC AGT SPX,634.0,412.1,79.17,475.5,35
HCPCS,67028,Injection eye drug,,,169.69,214.34,6
HCPCS,670280,INJECTION EYE DRUG,,,98.54,98.54,1
HCPCS,67030,INCISE INNER EYE STRANDS,,,594.57,4945.0,15
HCPCS,67030,Incise inner eye strands,,,624.8,789.22,6
HCPCS,670300,INCISE INNER EYE STRANDS,,,594.57,594.57,1
HCPCS,67031,LASER SURGERY EYE STRANDS,,,378.01,1189.46,15
HCPCS,67031,Laser surgery eye strands,,,624.8,789.22,6
HCPCS,67031,SEVERING VITREOUS STRANS LASER 1/> STAGES,1788.0,1162.2,177.75,1341.0,35
HCPCS,670310,LASER SURGERY EYE STRANDS,,,378.01,378.01,1
HCPCS,67036,REMOVAL OF INNER EYE FLUID,,,959.56,8722.22,15
HCPCS,67036,Removal of inner eye fluid,,,1959.49,2475.14,6
HCPCS,670360,REMOVAL OF INNER EYE FLUID,,,959.56,959.56,1
HCPCS,67039,LASER TREATMENT OF RETINA,,,1027.19,8722.22,15
HCPCS,67039,Laser treatment of retina,,,1959.49,2475.14,6
HCPCS,670390,LASER TREATMENT OF RETINA,,,1027.19,1027.19,1
HCPCS,67040,LASER TREATMENT OF RETINA,,,1109.1,8722.22,15
HCPCS,67040,Laser treatment of retina,,,1959.49,2475.14,6
HCPCS,670400,LASER TREATMENT OF RETINA,,,1109.1,1109.1,1
HCPCS,67041,VIT FOR MACULAR PUCKER,,,1223.43,8722.22,15
HCPCS,67041,Vit for macular pucker,,,1959.49,2475.14,6
HCPCS,670410,VIT FOR MACULAR PUCKER,,,1223.43,1223.43,1
HCPCS,67042,VIT FOR MACULAR HOLE,,,1223.43,8722.22,15
HCPCS,67042,Vit for macular hole,,,1959.49,2475.14,6
HCPCS,670420,VIT FOR MACULAR HOLE,,,1223.43,1223.43,1
HCPCS,67043,VIT FOR MEMBRANE DISSECT,,,1290.66,8722.22,15
HCPCS,67043,Vit for membrane dissect,,,1959.49,2475.14,6
HCPCS,670430,VIT FOR MEMBRANE DISSECT,,,1290.66,1290.66,1
HCPCS,67101,REPAIR DETACHED RETINA CRTX,,,304.27,4945.0,15
HCPCS,67101,Repair detached retina crtx,,,1959.49,2475.14,6
HCPCS,671010,REPAIR DETACHED RETINA CRTX,,,304.27,304.27,1
HCPCS,67105,REPAIR DETACHED RETINA PC,,,293.54,1189.46,15
HCPCS,67105,RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID PC,1356.0,881.4,224.69,1017.0,35
HCPCS,67105,Repair detached retina pc,,,624.8,789.22,6
HCPCS,671050,REPAIR DETACHED RETINA PC,,,293.54,293.54,1
HCPCS,67107,REPAIR DETACHED RETINA,,,1202.58,8722.22,15
HCPCS,67107,Repair detached retina,,,1959.49,2475.14,6
HCPCS,671070,REPAIR DETACHED RETINA,,,1202.58,1202.58,1
HCPCS,67108,REPAIR DETACHED RETINA,,,1273.5,8722.22,15
HCPCS,67108,Repair detached retina,,,1959.49,2475.14,6
HCPCS,671080,REPAIR DETACHED RETINA,,,1273.5,1273.5,1
HCPCS,67110,REPAIR DETACHED RETINA,,,869.29,4945.0,15
HCPCS,67110,Repair detached retina,,,624.8,789.22,6
HCPCS,671100,REPAIR DETACHED RETINA,,,869.29,869.29,1
HCPCS,67113,REPAIR RETINAL DETACH CPLX,,,1423.23,11187.1,15
HCPCS,67113,Repair retinal detach cplx,,,1959.49,2475.14,6
HCPCS,671130,REPAIR RETINAL DETACH CPLX,,,1423.23,1423.23,1
HCPCS,67115,RELEASE ENCIRCLING MATERIAL,,,533.36,8722.22,15
HCPCS,67115,Release encircling material,,,624.8,789.22,6
HCPCS,671150,RELEASE ENCIRCLING MATERIAL,,,533.36,533.36,1
HCPCS,67120,REMOVE EYE IMPLANT MATERIAL,,,593.79,4945.0,15
HCPCS,67120,Remove eye implant material,,,624.8,789.22,6
HCPCS,671200,REMOVE EYE IMPLANT MATERIAL,,,593.79,593.79,1
HCPCS,67121,REMOVE EYE IMPLANT MATERIAL,,,967.24,4945.0,15
HCPCS,67121,Remove eye implant material,,,624.8,789.22,6
HCPCS,671210,REMOVE EYE IMPLANT MATERIAL,,,967.24,967.24,1
HCPCS,67141,PROPH RTA DTCHMNT CRTX DTHRM,,,231.23,648.13,15
HCPCS,67141,Proph rta dtchmnt crtx dthrm,,,169.69,214.34,6
HCPCS,671410,PROPH RTA DTCHMNT CRTX DTHRM,,,231.23,231.23,1
HCPCS,67145,PROPH RTA DTCHMNT PC,,,231.23,1189.46,15
HCPCS,67145,"PROPHYLAXIS RETINA DETACH,PHOTOCOAG",1113.0,723.45,196.38,834.75,35
HCPCS,67145,Proph rta dtchmnt pc,,,624.8,789.22,6
HCPCS,671450,PROPH RTA DTCHMNT PC,,,231.23,231.23,1
HCPCS,67208,DSTRJ LOCLZD LESION RETINA 1/> SESS CRTX DTHRM,3060.0,1989.0,348.0,2295.0,35
HCPCS,67208,TREATMENT OF RETINAL LESION,,,300.06,648.13,15
HCPCS,67208,Treatment of retinal lesion,,,169.69,214.34,6
HCPCS,672080,TREATMENT OF RETINAL LESION,,,617.49,617.49,1
HCPCS,67210,DSTRJ LOCLZD LESION RETINA 1/> SESS PC,2544.0,1653.6,390.14,1908.0,35
HCPCS,67210,TREATMENT OF RETINAL LESION,,,532.96,1189.46,15
HCPCS,67210,Treatment of retinal lesion,,,624.8,789.22,6
HCPCS,672100,TREATMENT OF RETINAL LESION,,,532.96,532.96,1
HCPCS,67218,TREATMENT OF RETINAL LESION,,,1490.51,8176.15,15
HCPCS,67218,Treatment of retinal lesion,,,1959.49,2475.14,6
HCPCS,672180,TREATMENT OF RETINAL LESION,,,1490.51,1490.51,1
HCPCS,67220,TREATMENT OF CHOROID LESION,,,532.92,1189.46,15
HCPCS,67220,Treatment of choroid lesion,,,624.8,789.22,6
HCPCS,672200,TREATMENT OF CHOROID LESION,,,532.92,532.92,1
HCPCS,67221,OCULAR PHOTODYNAMIC THER,,,223.94,1189.46,15
HCPCS,67221,Ocular photodynamic ther,,,624.8,789.22,6
HCPCS,672210,OCULAR PHOTODYNAMIC THER,,,223.94,223.94,1
HCPCS,67225,DSTRJ LESION CHOROID PDT 2ND EYE 1 SESSION,188.0,122.2,18.82,141.0,35
HCPCS,67225,EYE PHOTODYNAMIC THER ADD-ON,,,29.61,29.61,1
HCPCS,67225,Eye photodynamic ther add-on,,,624.8,789.22,6
HCPCS,672250,EYE PHOTODYNAMIC THER ADD-ON,,,29.61,29.61,1
HCPCS,67227,DESTRUCTION RETINOPATHY CRYOTHERAPY DIATHERMY,1400.0,910.0,223.92,1050.0,35
HCPCS,67227,DSTRJ EXTENSIVE RETINOPATHY,,,272.64,8176.15,15
HCPCS,67227,Dstrj extensive retinopathy,,,1959.49,2475.14,6
HCPCS,672270,DSTRJ EXTENSIVE RETINOPATHY,,,272.64,272.64,1
HCPCS,67228,TREATMENT EXTENSIVE RETINOPATHY PHOTOCOAGULATION,1932.0,1255.8,257.11,1449.0,35
HCPCS,67228,TREATMENT X10SV RETINOPATHY,,,325.17,1189.46,15
HCPCS,67228,Treatment x10sv retinopathy,,,624.8,789.22,6
HCPCS,672280,TREATMENT X10SV RETINOPATHY,,,325.17,325.17,1
HCPCS,67229,TR RETINAL LES PRETERM INF,,,550.67,1239.49,15
HCPCS,67229,Tr retinal les preterm inf,,,624.8,789.22,6
HCPCS,672290,TR RETINAL LES PRETERM INF,,,1239.49,1239.49,1
HCPCS,67250,REINFORCE EYE WALL,,,963.54,5058.24,15
HCPCS,67250,Reinforce eye wall,,,624.8,789.22,6
HCPCS,672500,REINFORCE EYE WALL,,,963.54,963.54,1
HCPCS,67255,REINFORCE/GRAFT EYE WALL,,,736.5,8722.22,15
HCPCS,67255,Reinforce/graft eye wall,,,624.8,789.22,6
HCPCS,67255,SCLERAL REINFORCEMENT SPX W/GRAFT,3352.0,2178.8,504.47,3352.0,35
HCPCS,672550,REINFORCE/GRAFT EYE WALL,,,736.5,736.5,1
HCPCS,67299,UNLISTED PX POSTERIOR SEGMNT,,,2289.35,4945.0,14
HCPCS,67299,Unlisted px posterior segmnt,,,624.8,789.22,6
HCPCS,67311,REVISE EYE MUSCLE,,,488.01,5058.24,15
HCPCS,67311,Revise eye muscle,,,1283.27,1620.97,6
HCPCS,673110,REVISE EYE MUSCLE,,,488.01,488.01,1
HCPCS,67312,REVISE TWO EYE MUSCLES,,,713.12,8176.15,15
HCPCS,67312,Revise two eye muscles,,,1283.27,1620.97,6
HCPCS,673120,REVISE TWO EYE MUSCLES,,,713.12,713.12,1
HCPCS,67314,REVISE EYE MUSCLE,,,488.01,5058.24,15
HCPCS,67314,Revise eye muscle,,,1283.27,1620.97,6
HCPCS,673140,REVISE EYE MUSCLE,,,488.01,488.01,1
HCPCS,67316,REVISE TWO EYE MUSCLES,,,764.95,5058.24,15
HCPCS,67316,Revise two eye muscles,,,1283.27,1620.97,6
HCPCS,673160,REVISE TWO EYE MUSCLES,,,764.95,764.95,1
HCPCS,67318,REVISE EYE MUSCLE(S),,,739.32,5058.24,15
HCPCS,67318,Revise eye muscle(s),,,1283.27,1620.97,6
HCPCS,673180,REVISE EYE MUSCLE(S),,,739.32,739.32,1
HCPCS,67320,REVISE EYE MUSCLE(S) ADD-ON,,,188.29,188.29,1
HCPCS,67320,Revise eye muscle(s) add-on,,,1283.27,1620.97,6
HCPCS,673200,REVISE EYE MUSCLE(S) ADD-ON,,,188.29,188.29,1
HCPCS,67331,EYE SURGERY FOLLOW-UP ADD-ON,,,165.99,165.99,1
HCPCS,67331,Eye surgery follow-up add-on,,,1283.27,1620.97,6
HCPCS,673310,EYE SURGERY FOLLOW-UP ADD-ON,,,165.99,165.99,1
HCPCS,67332,REREVISE EYE MUSCLES ADD-ON,,,218.99,218.99,1
HCPCS,67332,Rerevise eye muscles add-on,,,1283.27,1620.97,6
HCPCS,673320,REREVISE EYE MUSCLES ADD-ON,,,218.99,218.99,1
HCPCS,67334,REVISE EYE MUSCLE W/SUTURE,,,163.78,163.78,1
HCPCS,67334,Revise eye muscle w/suture,,,1283.27,1620.97,6
HCPCS,673340,REVISE EYE MUSCLE W/SUTURE,,,163.78,163.78,1
HCPCS,67335,EYE SUTURE DURING SURGERY,,,201.1,201.1,1
HCPCS,67335,Eye suture during surgery,,,1283.27,1620.97,6
HCPCS,673350,EYE SUTURE DURING SURGERY,,,201.1,201.1,1
HCPCS,67340,REVISE EYE MUSCLE ADD-ON,,,314.33,314.33,1
HCPCS,67340,Revise eye muscle add-on,,,1283.27,1620.97,6
HCPCS,673400,REVISE EYE MUSCLE ADD-ON,,,314.33,314.33,1
HCPCS,67343,RELEASE EYE TISSUE,,,720.82,5058.24,15
HCPCS,67343,Release eye tissue,,,1283.27,1620.97,6
HCPCS,673430,RELEASE EYE TISSUE,,,720.82,720.82,1
HCPCS,67345,CHEMODENERVATION EXTRAOCULAR MUSCLE,1324.0,860.6,122.34,993.0,35
HCPCS,67345,DESTROY NERVE OF EYE MUSCLE,,,233.6,648.13,15
HCPCS,67345,Destroy nerve of eye muscle,,,169.69,214.34,6
HCPCS,673450,DESTROY NERVE OF EYE MUSCLE,,,233.6,233.6,1
HCPCS,67346,BIOPSY EYE MUSCLE,,,206.71,8176.15,15
HCPCS,67346,Biopsy eye muscle,,,1283.27,1620.97,6
HCPCS,673460,BIOPSY EYE MUSCLE,,,206.71,206.71,1
HCPCS,67399,UNLISTED PX EXTRAOCULAR MUSC,,,300.06,648.13,14
HCPCS,67399,Unlisted px extraocular musc,,,169.69,214.34,6
HCPCS,67400,EXPLORE/BIOPSY EYE SOCKET,,,1105.8,8176.15,15
HCPCS,67400,Explore/biopsy eye socket,,,1810.58,2287.04,6
HCPCS,67400,ORBITTMY W/O BN FLP EXP W W/O BX,4480.0,2912.0,546.17,4480.0,35
HCPCS,674000,EXPLORE/BIOPSY EYE SOCKET,,,1105.8,1105.8,1
HCPCS,67405,EXPLORE/DRAIN EYE SOCKET,,,964.47,5058.24,15
HCPCS,67405,Explore/drain eye socket,,,1810.58,2287.04,6
HCPCS,67405,ORBITTMY W/O BN FLP;W DRAINAGE,3680.0,2392.0,456.13,3680.0,35
HCPCS,674050,EXPLORE/DRAIN EYE SOCKET,,,964.47,964.47,1
HCPCS,67412,EXPLORE/TREAT EYE SOCKET,,,1053.71,5058.24,15
HCPCS,67412,Explore/treat eye socket,,,1810.58,2287.04,6
HCPCS,67412,ORBITTMY W/O BN FLP W REM LESION,4120.0,2678.0,547.03,4120.0,35
HCPCS,674120,EXPLORE/TREAT EYE SOCKET,,,1053.71,1053.71,1
HCPCS,67413,EXPLORE/TREAT EYE SOCKET,,,1027.23,5058.24,15
HCPCS,67413,Explore/treat eye socket,,,1810.58,2287.04,6
HCPCS,674130,EXPLORE/TREAT EYE SOCKET,,,1027.23,1027.23,1
HCPCS,67414,EXPLR/DECOMPRESS EYE SOCKET,,,1556.86,8176.15,15
HCPCS,67414,Explr/decompress eye socket,,,1810.58,2287.04,6
HCPCS,67414,ORBITOTOMY W/O BONE FLAP W/RMVL BONE DCMPRN,7176.0,4664.4,711.6,7176.0,35
HCPCS,674140,EXPLR/DECOMPRESS EYE SOCKET,,,1556.86,1556.86,1
HCPCS,67415,ASPIRATION ORBITAL CONTENTS,,,110.75,5058.24,15
HCPCS,67415,Aspiration orbital contents,,,624.8,789.22,6
HCPCS,67415,FINE NEEDLE ASPIRATION ORBITAL CONTENTS,704.0,457.6,76.02,704.0,35
HCPCS,674150,ASPIRATION ORBITAL CONTENTS,,,110.75,110.75,1
HCPCS,67420,EXPLORE/TREAT EYE SOCKET,,,1861.37,8176.15,15
HCPCS,67420,Explore/treat eye socket,,,3243.49,4097.04,6
HCPCS,674200,EXPLORE/TREAT EYE SOCKET,,,1861.37,1861.37,1
HCPCS,67430,EXPLORE/TREAT EYE SOCKET,,,1478.56,8176.15,15
HCPCS,67430,Explore/treat eye socket,,,1664.64,2102.7,6
HCPCS,674300,EXPLORE/TREAT EYE SOCKET,,,1478.56,1478.56,1
HCPCS,67440,EXPLORE/DRAIN EYE SOCKET,,,1434.27,8176.15,15
HCPCS,67440,Explore/drain eye socket,,,3243.49,4097.04,6
HCPCS,674400,EXPLORE/DRAIN EYE SOCKET,,,1434.27,1434.27,1
HCPCS,67445,EXPLR/DECOMPRESS EYE SOCKET,,,1636.6,8176.15,15
HCPCS,67445,Explr/decompress eye socket,,,3243.49,4097.04,6
HCPCS,67445,ORBITOTOMY BONE FLAP/WINDOW LAT RMVL BONE DCMPRN,7648.0,4971.2,740.53,7648.0,35
HCPCS,674450,EXPLR/DECOMPRESS EYE SOCKET,,,1636.6,1636.6,1
HCPCS,67450,EXPLORE/BIOPSY EYE SOCKET,,,1485.89,8176.15,15
HCPCS,67450,Explore/biopsy eye socket,,,3243.49,4097.04,6
HCPCS,67450,ORBITOTOMY BONE FLAP/WINDOW LAT EXPL W/WO BX,6164.0,4006.6,755.78,6164.0,35
HCPCS,674500,EXPLORE/BIOPSY EYE SOCKET,,,1485.89,1485.89,1
HCPCS,67500,INJECT/TREAT EYE SOCKET,,,70.1,648.13,15
HCPCS,67500,Inject/treat eye socket,,,169.69,214.34,6
HCPCS,67500,"RETROBULBAR INJECT,MEDICATN",472.0,306.8,38.19,354.0,35
HCPCS,675000,INJECT/TREAT EYE SOCKET,,,70.1,70.1,1
HCPCS,67505,INJECT/TREAT EYE SOCKET,,,77.63,648.13,15
HCPCS,67505,Inject/treat eye socket,,,169.69,214.34,6
HCPCS,67505,"RETROBULBAR INJECT,ALCOHOL",472.0,306.8,49.1,354.0,35
HCPCS,675050,INJECT/TREAT EYE SOCKET,,,77.63,77.63,1
HCPCS,67515,INJECT/TREAT EYE SOCKET,,,50.6,648.13,15
HCPCS,67515,INJECTION MEDICATION/OTHER SUBST TENON CAPSULE,330.0,214.5,34.68,247.5,35
HCPCS,67515,Inject/treat eye socket,,,169.69,214.34,6
HCPCS,675150,INJECT/TREAT EYE SOCKET,,,50.6,50.6,1
HCPCS,67516,SPRCHOROIDAL SPC NJX RX AGT,,,104.39,104.39,1
HCPCS,67516,SUPRACHOROIDAL SPACE NJX PHARMACOLOGIC AGENT,1290.5,838.825,30.69,4151.0,77
HCPCS,675160,SPRCHOROIDAL SPC NJX RX AGT,,,104.39,104.39,1
HCPCS,67550,INSERT EYE SOCKET IMPLANT,,,1156.82,8176.15,15
HCPCS,67550,Insert eye socket implant,,,1810.58,2287.04,6
HCPCS,67550,ORBITAL IMPLANT INSERTION,4708.0,3060.2,536.52,4708.0,35
HCPCS,675500,INSERT EYE SOCKET IMPLANT,,,1156.82,1156.82,1
HCPCS,67560,ORBITAL IMPLANT REMOVAL/REVISION,4872.0,3166.8,538.84,4872.0,35
HCPCS,67560,REVISE EYE SOCKET IMPLANT,,,1183.63,8176.15,15
HCPCS,67560,Revise eye socket implant,,,1810.58,2287.04,6
HCPCS,675600,REVISE EYE SOCKET IMPLANT,,,1183.63,1183.63,1
HCPCS,67570,DECOMPRESS OPTIC NERVE,,,1358.72,8176.15,15
HCPCS,67570,Decompress optic nerve,,,1810.58,2287.04,6
HCPCS,675700,DECOMPRESS OPTIC NERVE,,,1358.72,1358.72,1
HCPCS,67599,UNLISTED PROCEDURE ORBIT,743.0,482.95,168.32,2093.0,82
HCPCS,67700,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,1139.5,740.675,72.12,4214.0,133
HCPCS,67700,BLEPHAROTOMY DRG ABSC EYELID,,,124.53,124.53,1
HCPCS,677000,BLEPHAROTOMY DRG ABSC EYELID,,,124.53,124.53,1
HCPCS,67710,SEVERING TARSORRHAPHY,428.0,278.2,61.39,2099.95,50
HCPCS,67710,Severing tarsorrhaphy,,,856.52,1081.92,6
HCPCS,677100,SEVERING TARSORRHAPHY,,,104.77,104.77,1
HCPCS,67715,CANTHOTOMY,,,115.39,115.39,1
HCPCS,67715,CANTHOTOMY SEPARATE PROCEDURE,6961.5,4524.975,51.61,12073.5,84
HCPCS,677150,CANTHOTOMY,,,115.39,115.39,1
HCPCS,67800,"EXCIS CHALAZION,SINGLE",564.0,366.6,48.94,423.0,35
HCPCS,67800,REMOVE EYELID LESION,,,109.78,648.13,15
HCPCS,67800,Remove eyelid lesion,,,169.69,214.34,6
HCPCS,678000,REMOVE EYELID LESION,,,109.78,109.78,1
HCPCS,67801,"EXCIS CHALAZION,MULT,SAME LID",764.0,496.6,71.16,573.0,35
HCPCS,67801,REMOVE EYELID LESIONS,,,141.22,2099.95,15
HCPCS,67801,Remove eyelid lesions,,,856.52,1081.92,6
HCPCS,678010,REMOVE EYELID LESIONS,,,141.22,141.22,1
HCPCS,67805,EXCISION CHALAZION MULTIPLE DIFFERENT LIDS,1313.5,853.775,77.92,4214.0,81
HCPCS,67805,REMOVE EYELID LESIONS,,,175.24,175.24,1
HCPCS,678050,REMOVE EYELID LESIONS,,,175.24,175.24,1
HCPCS,67808,EXC CHALAZION ANES REQ HOSPIZATION SINGLE/MULT,1840.0,1196.0,174.97,1840.0,35
HCPCS,67808,REMOVE EYELID LESION(S),,,394.1,5058.24,15
HCPCS,67808,Remove eyelid lesion(s),,,856.52,1081.92,6
HCPCS,678080,REMOVE EYELID LESION(S),,,394.1,394.1,1
HCPCS,67810,INCAL BX EYELID SKN LID MRGN,,,73.59,73.59,1
HCPCS,67810,INCISIONAL BIOPSY EYELID SKIN & LID MARGIN,1119.0,727.3499999999999,51.23,4214.0,81
HCPCS,678100,INCAL BX EYELID SKN LID MRGN,,,73.59,73.59,1
HCPCS,67820,CORRECTION TRICHIASIS EPILATION FORCEPS ONLY,141.0,91.65,14.87,105.75,35
HCPCS,67820,REVISE EYELASHES,,,23.87,279.48,15
HCPCS,67820,Revise eyelashes,,,45.31,57.23,6
HCPCS,678200,REVISE EYELASHES,,,23.87,23.87,1
HCPCS,67825,CORRECTION TRICHIASIS EPILATION OTH/THAN FORCEPS,629.0,408.85,58.91,471.75,35
HCPCS,67825,REVISE EYELASHES,,,130.49,648.13,15
HCPCS,67825,Revise eyelashes,,,169.69,214.34,6
HCPCS,678250,REVISE EYELASHES,,,130.49,130.49,1
HCPCS,67830,REVISE EYELASHES,,,147.17,2099.95,15
HCPCS,67830,Revise eyelashes,,,169.69,214.34,6
HCPCS,678300,REVISE EYELASHES,,,147.17,147.17,1
HCPCS,67835,REVISE EYELASHES,,,472.35,5058.24,15
HCPCS,67835,Revise eyelashes,,,1069.15,1350.5,6
HCPCS,678350,REVISE EYELASHES,,,472.35,472.35,1
HCPCS,67840,EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE,836.0,543.4,106.71,627.0,35
HCPCS,67840,REMOVE EYELID LESION,,,168.39,2099.95,15
HCPCS,67840,Remove eyelid lesion,,,856.52,1081.92,6
HCPCS,678400,REMOVE EYELID LESION,,,168.39,168.39,1
HCPCS,67850,DESTRUCTION LESION LID MARGIN </ 1 CM,696.0,452.4,81.32,522.0,35
HCPCS,67850,DSTRJ LESION LID MARGIN <1CM,,,141.04,2099.95,15
HCPCS,67850,Dstrj lesion lid margin <1cm,,,169.69,214.34,6
HCPCS,678500,DSTRJ LESION LID MARGIN <1CM,,,141.04,141.04,1
HCPCS,67875,CLOSURE OF EYELID BY SUTURE,,,102.75,2099.95,15
HCPCS,67875,Closure of eyelid by suture,,,856.52,1081.92,6
HCPCS,67875,TEMP CLOSURE EYELID BY SUTURE,540.0,351.0,45.21,405.0,35
HCPCS,678750,CLOSURE OF EYELID BY SUTURE,,,102.75,102.75,1
HCPCS,67880,CONSTJ INTERMARGIN ADHES/TARSORRH/CANTHORRHAPY,2024.0,1315.6,174.9,1518.0,35
HCPCS,67880,REVISION OF EYELID,,,394.1,5058.24,15
HCPCS,67880,Revision of eyelid,,,856.52,1081.92,6
HCPCS,678800,REVISION OF EYELID,,,394.1,394.1,1
HCPCS,67882,REVISION OF EYELID,,,503.87,5058.24,15
HCPCS,67882,Revision of eyelid,,,1069.15,1350.5,6
HCPCS,678820,REVISION OF EYELID,,,503.87,503.87,1
HCPCS,67900,REPAIR BROW DEFECT,,,542.28,5058.24,15
HCPCS,67900,REPAIR BROW PTOSIS,3001.0,1950.65,240.65,2250.75,32
HCPCS,67900,Repair brow defect,,,1069.15,1350.5,6
HCPCS,679000,REPAIR BROW DEFECT,,,542.28,542.28,1
HCPCS,67901,REPAIR EYELID DEFECT,,,630.88,5058.24,15
HCPCS,67901,Repair eyelid defect,,,1069.15,1350.5,6
HCPCS,679010,REPAIR EYELID DEFECT,,,630.88,630.88,1
HCPCS,67902,REPAIR EYELID DEFECT,,,777.27,8176.15,15
HCPCS,67902,RPR BLEPHAROPT FRONTALIS MUSC AUTOL FASCAL SLING,3928.0,2553.2,395.68,3928.0,35
HCPCS,67902,Repair eyelid defect,,,1069.15,1350.5,6
HCPCS,679020,REPAIR EYELID DEFECT,,,777.27,777.27,1
HCPCS,67903,REPAIR EYELID DEFECT,,,514.64,5058.24,15
HCPCS,67903,RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT INTERNAL,2604.0,1692.6,281.73,1953.0,35
HCPCS,67903,Repair eyelid defect,,,1069.15,1350.5,6
HCPCS,679030,REPAIR EYELID DEFECT,,,514.64,514.64,1
HCPCS,67904,REPAIR EYELID DEFECT,,,638.24,5058.24,16
HCPCS,67904,RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL,3507.0,2279.55,283.06,2630.25,35
HCPCS,67904,Repair eyelid defect,,,1069.15,1350.5,6
HCPCS,679040,REPAIR EYELID DEFECT,,,638.24,638.24,1
HCPCS,67906,REPAIR EYELID DEFECT,,,540.91,8176.15,15
HCPCS,67906,Repair eyelid defect,,,1069.15,1350.5,6
HCPCS,679060,REPAIR EYELID DEFECT,,,540.91,540.91,1
HCPCS,67908,REPAIR EYELID DEFECT,,,461.93,5058.24,15
HCPCS,67908,RPR BLPOS CONJUNCTIVO-TARSO-MUSC-LEVATOR RESCJ,2332.0,1515.8,233.63,1749.0,35
HCPCS,67908,Repair eyelid defect,,,1069.15,1350.5,6
HCPCS,679080,REPAIR EYELID DEFECT,,,461.93,461.93,1
HCPCS,67909,REDUCTION OVERCORRECTION PTOSIS,2228.0,1448.2,231.85,1671.0,35
HCPCS,67909,REVISE EYELID DEFECT,,,468.22,5058.24,15
HCPCS,67909,Revise eyelid defect,,,1069.15,1350.5,6
HCPCS,679090,REVISE EYELID DEFECT,,,468.22,468.22,1
HCPCS,67911,REVISE EYELID DEFECT,,,599.58,5058.24,15
HCPCS,67911,Revise eyelid defect,,,856.52,1081.92,6
HCPCS,679110,REVISE EYELID DEFECT,,,599.58,599.58,1
HCPCS,67912,CORRECTION EYELID W/IMPLANT,,,521.8,5058.24,15
HCPCS,67912,CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD,2544.0,1653.6,231.94,1908.0,35
HCPCS,67912,Correction eyelid w/implant,,,856.52,1081.92,6
HCPCS,679120,CORRECTION EYELID W/IMPLANT,,,521.8,521.8,1
HCPCS,67914,"FIX ECTROPION,SUTURE",1500.0,975.0,156.0,1125.0,35
HCPCS,67914,REPAIR EYELID DEFECT,,,352.2,5058.24,15
HCPCS,67914,Repair eyelid defect,,,856.52,1081.92,6
HCPCS,679140,REPAIR EYELID DEFECT,,,352.2,352.2,1
HCPCS,67915,REPAIR EYELID DEFECT,,,213.2,5058.24,15
HCPCS,67915,Repair eyelid defect,,,856.52,1081.92,6
HCPCS,679150,REPAIR EYELID DEFECT,,,213.2,213.2,1
HCPCS,67916,"FIX ECTROPION,EXCIS TARSAL WEDGE",2192.0,1424.8,225.96,1644.0,35
HCPCS,67916,REPAIR EYELID DEFECT,,,459.97,5058.24,15
HCPCS,67916,Repair eyelid defect,,,856.52,1081.92,6
HCPCS,679160,REPAIR EYELID DEFECT,,,459.97,459.97,1
HCPCS,67917,REPAIR ECTROPION EXTENSIVE,2372.0,1541.8,250.44,1779.0,35
HCPCS,67917,REPAIR EYELID DEFECT,,,488.48,5058.24,15
HCPCS,67917,Repair eyelid defect,,,1069.15,1350.5,6
HCPCS,679170,REPAIR EYELID DEFECT,,,488.48,488.48,1
HCPCS,67921,ENTROPION REPAIR/SUTURE,1388.0,902.2,147.78,1041.0,35
HCPCS,67921,REPAIR EYELID DEFECT,,,333.74,5058.24,15
HCPCS,67921,Repair eyelid defect,,,856.52,1081.92,6
HCPCS,679210,REPAIR EYELID DEFECT,,,333.74,333.74,1
HCPCS,67922,REPAIR EYELID DEFECT,,,213.2,5058.24,15
HCPCS,67922,Repair eyelid defect,,,856.52,1081.92,6
HCPCS,679220,REPAIR EYELID DEFECT,,,213.2,213.2,1
HCPCS,67923,"FIX ENTROPION,EXCIS TARSAL WEDGE",2411.0,1567.15,255.58,1808.25,35
HCPCS,67923,REPAIR EYELID DEFECT,,,460.26,5058.24,15
HCPCS,67923,Repair eyelid defect,,,1069.15,1350.5,6
HCPCS,679230,REPAIR EYELID DEFECT,,,460.26,460.26,1
HCPCS,67924,REPAIR EYELID DEFECT,,,488.44,5058.24,15
HCPCS,67924,REPAIR OF ENTROPION; EXTENSIVE?,2372.0,1541.8,223.48,1779.0,35
HCPCS,67924,Repair eyelid defect,,,1069.15,1350.5,6
HCPCS,679240,REPAIR EYELID DEFECT,,,488.44,488.44,1
HCPCS,67930,REPAIR EYELID WOUND,,,254.11,254.11,1
HCPCS,67930,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK,7437.5,4834.375,112.27,12073.5,133
HCPCS,679300,REPAIR EYELID WOUND,,,254.11,254.11,1
HCPCS,67935,REPAIR EYELID WOUND,,,471.09,471.09,1
HCPCS,67935,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK,7979.5,5186.675,209.59,12073.5,133
HCPCS,679350,REPAIR EYELID WOUND,,,471.09,471.09,1
HCPCS,67938,REMOVAL EMBEDDED FOREIGN BODY EYELID,1719.0,1117.35,131.54,4151.0,98
HCPCS,67938,REMOVE EYELID FOREIGN BODY,,,125.76,125.76,1
HCPCS,67938,"REMOVE EYELID FOREIGN BODY,EMBEDDED",552.0,358.8,55.89,414.0,35
HCPCS,679380,REMOVE EYELID FOREIGN BODY,,,125.76,125.76,1
HCPCS,67950,CANTHOPLASTY LATERAL,2636.0,1713.4,233.75,1977.0,35
HCPCS,67950,REVISION OF EYELID,,,495.02,5058.24,15
HCPCS,67950,Revision of eyelid,,,856.52,1081.92,6
HCPCS,679500,REVISION OF EYELID,,,495.02,495.02,1
HCPCS,67961,EXCISION & REPAIR EYELID < ONE-FOURTH LID MARGIN,2344.0,1523.6,225.65,1758.0,35
HCPCS,67961,REVISION OF EYELID,,,486.14,5058.24,15
HCPCS,67961,Revision of eyelid,,,1069.15,1350.5,6
HCPCS,679610,REVISION OF EYELID,,,486.14,486.14,1
HCPCS,67966,EXCISION & REPAIR EYELID ONE-FOURTH LID MARGIN,3588.0,2332.2,310.84,2691.0,35
HCPCS,67966,REVISION OF EYELID,,,700.73,5058.24,15
HCPCS,67966,Revision of eyelid,,,1069.15,1350.5,6
HCPCS,679660,REVISION OF EYELID,,,700.73,700.73,1
HCPCS,67971,RCNSTJ EYELID FULL THICKNESS </TWO-THIRDS 1 STG,4004.0,2602.6,531.49,4004.0,35
HCPCS,67971,RECONSTRUCTION OF EYELID,,,770.22,5058.24,15
HCPCS,67971,Reconstruction of eyelid,,,1069.15,1350.5,6
HCPCS,679710,RECONSTRUCTION OF EYELID,,,770.22,770.22,1
HCPCS,67973,RECONSTRUCTION OF EYELID,,,991.81,5058.24,15
HCPCS,67973,Reconstruction of eyelid,,,1069.15,1350.5,6
HCPCS,679730,RECONSTRUCTION OF EYELID,,,991.81,991.81,1
HCPCS,67974,"RECONSTRUC EYELID,TOT UPPER,1 STAGE",5240.0,3406.0,658.42,5240.0,35
HCPCS,67974,RECONSTRUCTION OF EYELID,,,989.07,8176.15,15
HCPCS,67974,Reconstruction of eyelid,,,1069.15,1350.5,6
HCPCS,679740,RECONSTRUCTION OF EYELID,,,989.07,989.07,1
HCPCS,67975,RECONSTRUCTION OF EYELID,,,729.3,5058.24,15
HCPCS,67975,Reconstruction of eyelid,,,1069.15,1350.5,6
HCPCS,679750,RECONSTRUCTION OF EYELID,,,729.3,729.3,1
HCPCS,67999,FACELIFT - ENDOSCOPIC,2760.0,1794.0,143.6,2760.0,15
HCPCS,67999,FOREHEAD LIFT - ENDOSCOPIC,3346.0,2174.9,143.6,3346.0,15
HCPCS,67999,"ORBICULARIS OCULI LATERAL MYECTOMY, UNILATERAL (COMP CODE 15823)",2996.0,1947.4,143.6,2996.0,15
HCPCS,67999,REMOVAL OF IMPLANT EYELID (COMP CODE 67938),552.0,358.8,143.6,552.0,15
HCPCS,67999,UNLISTED PROCEDURE EYELIDS,,,300.06,648.13,14
HCPCS,67999,Unlisted procedure eyelids,,,169.69,214.34,6
HCPCS,68020,INCISE/DRAIN EYELID LINING,,,118.02,2099.95,15
HCPCS,68020,INCISION CONJUNCTIVA DRAINAGE OF CYST,568.0,369.2,52.6,426.0,35
HCPCS,68020,Incise/drain eyelid lining,,,856.52,1081.92,6
HCPCS,680200,INCISE/DRAIN EYELID LINING,,,118.02,118.02,1
HCPCS,68040,EXPRESS CONJUNC FOLLICLES,374.0,243.1,28.26,280.5,35
HCPCS,68040,TREATMENT OF EYELID LESIONS,,,51.53,648.13,15
HCPCS,68040,Treatment of eyelid lesions,,,169.69,214.34,6
HCPCS,680400,TREATMENT OF EYELID LESIONS,,,51.53,51.53,1
HCPCS,68100,BIOPSY CONJUNCTIVA,,,102.36,5058.24,15
HCPCS,68100,BIOPSY OF CONJUNCTIVA,540.0,351.0,47.93,405.0,35
HCPCS,68100,Biopsy conjunctiva,,,856.52,1081.92,6
HCPCS,681000,BIOPSY CONJUNCTIVA,,,102.36,102.36,1
HCPCS,68110,EXC LES CONJUNCTIVA <1 CM,,,158.76,5058.24,15
HCPCS,68110,EXCISION LESION CONJUNCTIVA </1 CM,728.0,473.2,70.02,546.0,35
HCPCS,68110,Exc les conjunctiva <1 cm,,,599.44,757.19,6
HCPCS,681100,EXC LES CONJUNCTIVA <1 CM,,,158.76,158.76,1
HCPCS,68115,EXC LES CONJUNCTIVA >1 CM,,,196.04,5058.24,15
HCPCS,68115,EXCISION LESION CONJUNCTIVA > 1 CM,964.0,626.6,86.96,723.0,35
HCPCS,68115,Exc les conjunctiva >1 cm,,,1069.15,1350.5,6
HCPCS,681150,EXC LES CONJUNCTIVA >1 CM,,,196.04,196.04,1
HCPCS,68130,EXC LES CONJUNCTIVA ADJ SCL,,,441.96,5058.24,15
HCPCS,68130,EXCISION LESION CONJUNCTIVA ADJACENT SCLERA,2040.0,1326.0,196.11,1530.0,35
HCPCS,68130,Exc les conjunctiva adj scl,,,1069.15,1350.5,6
HCPCS,681300,EXC LES CONJUNCTIVA ADJ SCL,,,441.96,441.96,1
HCPCS,68135,DESTRUCTION LES CONJUNCTIVA,,,160.07,5058.24,15
HCPCS,68135,DESTRUCTION LESION CONJUNCTIVA,756.0,491.4,95.86,567.0,35
HCPCS,68135,Destruction les conjunctiva,,,856.52,1081.92,6
HCPCS,681350,DESTRUCTION LES CONJUNCTIVA,,,160.07,160.07,1
HCPCS,68200,SUBCONJUNCTIVAL INJECTN,196.0,127.4,25.37,147.0,35
HCPCS,68200,TREAT EYELID BY INJECTION,,,36.56,865.18,15
HCPCS,68200,Treat eyelid by injection,,,45.31,57.23,6
HCPCS,682000,TREAT EYELID BY INJECTION,,,36.56,36.56,1
HCPCS,68320,CONJUNCTIVOPLASTY W/GRF/XTNSV REARRANGEMENT,2922.0,1899.3,256.6,2191.5,35
HCPCS,68320,REVISE/GRAFT EYELID LINING,,,577.37,5058.24,15
HCPCS,68320,Revise/graft eyelid lining,,,856.52,1081.92,6
HCPCS,683200,REVISE/GRAFT EYELID LINING,,,577.37,577.37,1
HCPCS,68325,REVISE/GRAFT EYELID LINING,,,702.01,8176.15,15
HCPCS,68325,Revise/graft eyelid lining,,,1069.15,1350.5,6
HCPCS,683250,REVISE/GRAFT EYELID LINING,,,702.01,702.01,1
HCPCS,68326,CJP RCNSTJ CUL-DE-SAC BUCCAL GRF/XTNSV REARRGMT,3368.0,2189.2,392.59,3368.0,35
HCPCS,68326,REVISE/GRAFT EYELID LINING,,,689.66,8176.15,15
HCPCS,68326,Revise/graft eyelid lining,,,1069.15,1350.5,6
HCPCS,683260,REVISE/GRAFT EYELID LINING,,,689.66,689.66,1
HCPCS,68328,REVISE/GRAFT EYELID LINING,,,753.53,5058.24,15
HCPCS,68328,Revise/graft eyelid lining,,,1069.15,1350.5,6
HCPCS,683280,REVISE/GRAFT EYELID LINING,,,753.53,753.53,1
HCPCS,68330,REVISE EYELID LINING,,,492.26,4945.0,15
HCPCS,68330,RPR SYMBLEPHARON CONJUNCTIVOPLASTY W/O GRAFT,2312.0,1502.8,218.13,1734.0,35
HCPCS,68330,Revise eyelid lining,,,856.52,1081.92,6
HCPCS,683300,REVISE EYELID LINING,,,492.26,492.26,1
HCPCS,68335,REVISE/GRAFT EYELID LINING,,,691.47,8176.15,15
HCPCS,68335,Revise/graft eyelid lining,,,1069.15,1350.5,6
HCPCS,683350,REVISE/GRAFT EYELID LINING,,,691.47,691.47,1
HCPCS,68340,RPR & DIV SYMBLEPHARON W/WO CONFORM/CONTACT LE,1988.0,1292.2,189.2,1491.0,35
HCPCS,68340,SEPARATE EYELID ADHESIONS,,,425.97,5058.24,15
HCPCS,68340,Separate eyelid adhesions,,,856.52,1081.92,6
HCPCS,683400,SEPARATE EYELID ADHESIONS,,,425.97,425.97,1
HCPCS,68360,REVISE EYELID LINING,,,439.1,8176.15,15
HCPCS,68360,Revise eyelid lining,,,1069.15,1350.5,6
HCPCS,683600,REVISE EYELID LINING,,,439.1,439.1,1
HCPCS,68362,"CONJUNC FLAP,TOTAL",3444.0,2238.6,405.17,3444.0,35
HCPCS,68362,REVISE EYELID LINING,,,700.91,5058.24,15
HCPCS,68362,Revise eyelid lining,,,1069.15,1350.5,6
HCPCS,683620,REVISE EYELID LINING,,,700.91,700.91,1
HCPCS,68371,HARVEST EYE TISSUE ALOGRAFT,,,440.89,5058.24,15
HCPCS,68371,Harvest eye tissue alograft,,,856.52,1081.92,6
HCPCS,683710,HARVEST EYE TISSUE ALOGRAFT,,,440.89,440.89,1
HCPCS,68399,UNLISTED PX CONJUNCTIVA,,,300.06,648.13,14
HCPCS,68399,Unlisted px conjunctiva,,,169.69,214.34,6
HCPCS,68400,I&D LACRIMAL GLAND,,,140.95,2099.95,15
HCPCS,68400,I&d lacrimal gland,,,856.52,1081.92,6
HCPCS,68400,INCISION DRAINAGE LACRIMAL GLAND,696.0,452.4,61.81,522.0,35
HCPCS,684000,I&D LACRIMAL GLAND,,,140.95,140.95,1
HCPCS,68420,I&D LACRIMAL SAC,,,179.04,5058.24,15
HCPCS,68420,I&d lacrimal sac,,,1069.15,1350.5,6
HCPCS,68420,INCISION DRAINAGE LACRIMAL SAC,940.0,611.0,79.51,705.0,35
HCPCS,684200,I&D LACRIMAL SAC,,,179.04,179.04,1
HCPCS,68440,SNIP INC LACRIMAL PUNCTUM,,,106.86,648.13,15
HCPCS,68440,SNIP INCISION LACRIMAL PUNCTUM,396.0,257.4,75.85,297.0,35
HCPCS,68440,Snip inc lacrimal punctum,,,169.69,214.34,6
HCPCS,684400,SNIP INC LACRIMAL PUNCTUM,,,106.86,106.86,1
HCPCS,68500,REMOVAL OF TEAR GLAND,,,1136.0,8176.15,15
HCPCS,68500,Removal of tear gland,,,1069.15,1350.5,6
HCPCS,685000,REMOVAL OF TEAR GLAND,,,1136.0,1136.0,1
HCPCS,68505,PARTIAL REMOVAL TEAR GLAND,,,1130.87,8176.15,15
HCPCS,68505,Partial removal tear gland,,,1069.15,1350.5,6
HCPCS,685050,PARTIAL REMOVAL TEAR GLAND,,,1130.87,1130.87,1
HCPCS,68510,BIOPSY LACRIMAL GLAND,1840.0,1196.0,145.29,1380.0,35
HCPCS,68510,BIOPSY OF TEAR GLAND,,,308.73,5058.24,15
HCPCS,68510,Biopsy of tear gland,,,1069.15,1350.5,6
HCPCS,685100,BIOPSY OF TEAR GLAND,,,308.73,308.73,1
HCPCS,68520,REMOVAL OF TEAR SAC,,,789.65,8176.15,15
HCPCS,68520,Removal of tear sac,,,1069.15,1350.5,6
HCPCS,685200,REMOVAL OF TEAR SAC,,,789.65,789.65,1
HCPCS,68525,BIOPSY OF TEAR SAC,,,278.05,5058.24,15
HCPCS,68525,Biopsy of tear sac,,,856.52,1081.92,6
HCPCS,685250,BIOPSY OF TEAR SAC,,,278.05,278.05,1
HCPCS,68530,CLEARANCE OF TEAR DUCT,,,272.75,648.13,15
HCPCS,68530,Clearance of tear duct,,,169.69,214.34,6
HCPCS,68530,RMVL FB/DACRYOLITH LACRIMAL PASSAGES,1480.0,962.0,120.17,1110.0,35
HCPCS,685300,CLEARANCE OF TEAR DUCT,,,272.75,272.75,1
HCPCS,68540,REMOVE TEAR GLAND LESION,,,1052.58,5058.24,15
HCPCS,68540,Remove tear gland lesion,,,1069.15,1350.5,6
HCPCS,685400,REMOVE TEAR GLAND LESION,,,1052.58,1052.58,1
HCPCS,68550,REMOVE TEAR GLAND LESION,,,1310.31,8176.15,15
HCPCS,68550,Remove tear gland lesion,,,1069.15,1350.5,6
HCPCS,685500,REMOVE TEAR GLAND LESION,,,1310.31,1310.31,1
HCPCS,68700,REPAIR TEAR DUCTS,,,644.85,5058.24,15
HCPCS,68700,Repair tear ducts,,,856.52,1081.92,6
HCPCS,687000,REPAIR TEAR DUCTS,,,644.85,644.85,1
HCPCS,68705,REVISE TEAR DUCT OPENING,,,177.41,648.13,15
HCPCS,68705,Revise tear duct opening,,,169.69,214.34,6
HCPCS,687050,REVISE TEAR DUCT OPENING,,,177.41,177.41,1
HCPCS,68720,CREATE TEAR SAC DRAIN,,,867.37,8176.15,15
HCPCS,68720,Create tear sac drain,,,1069.15,1350.5,6
HCPCS,68720,DACRYOCYSTORHINOSTOMY,4382.0,2848.3,493.34,4382.0,35
HCPCS,687200,CREATE TEAR SAC DRAIN,,,867.37,867.37,1
HCPCS,68745,CREATE TEAR DUCT DRAIN,,,871.41,8176.15,15
HCPCS,68745,Create tear duct drain,,,1069.15,1350.5,6
HCPCS,687450,CREATE TEAR DUCT DRAIN,,,871.41,871.41,1
HCPCS,68750,CONJUNCTIVORHINOSTOMY INSJ TUBE/STENT,4040.0,2626.0,481.91,4040.0,35
HCPCS,68750,CREATE TEAR DUCT DRAIN,,,919.95,8176.15,15
HCPCS,68750,Create tear duct drain,,,1069.15,1350.5,6
HCPCS,687500,CREATE TEAR DUCT DRAIN,,,919.95,919.95,1
HCPCS,68760,CLOSE TEAR DUCT OPENING,,,156.21,648.13,15
HCPCS,68760,CLSR LACRIMAL PUNCTUM THERMOCAUT LIG/LASER,712.0,462.8,68.88,534.0,35
HCPCS,68760,Close tear duct opening,,,169.69,214.34,6
HCPCS,687600,CLOSE TEAR DUCT OPENING,,,156.21,156.21,1
HCPCS,68761,CLOSE TEAR DUCT OPENING,,,125.12,648.13,15
HCPCS,68761,CLSR LACRIMAL PUNCTUM PLUG EACH,620.0,403.0,56.06,465.0,35
HCPCS,68761,Close tear duct opening,,,169.69,214.34,6
HCPCS,687610,CLOSE TEAR DUCT OPENING,,,125.12,125.12,1
HCPCS,68770,CLOSE TEAR SYSTEM FISTULA,,,670.77,5058.24,15
HCPCS,68770,Close tear system fistula,,,1069.15,1350.5,6
HCPCS,687700,CLOSE TEAR SYSTEM FISTULA,,,670.77,670.77,1
HCPCS,68801,DILATE TEAR DUCT OPENING,,,84.83,865.18,15
HCPCS,68801,DILATION LACRIMAL PUNCTUM W/WO IRRGATION,328.0,213.2,45.75,246.0,35
HCPCS,68801,Dilate tear duct opening,,,169.69,214.34,6
HCPCS,688010,DILATE TEAR DUCT OPENING,,,84.83,84.83,1
HCPCS,68810,PROBE NASOLACRIMAL DUCT,,,136.75,648.13,15
HCPCS,68810,PROBE NASOLACRIMAL DUCT W/WO IRRIGATION,678.0,440.7,86.65,508.5,35
HCPCS,68810,Probe nasolacrimal duct,,,169.69,214.34,6
HCPCS,688100,PROBE NASOLACRIMAL DUCT,,,136.75,136.75,1
HCPCS,68811,PROBE NASOLACRIMAL DUCT,,,144.77,5058.24,15
HCPCS,68811,PROBE NASOLACRIMAL DUCT W/WO IRRIG REQ GEN ANES,766.0,497.9,101.85,766.0,35
HCPCS,68811,Probe nasolacrimal duct,,,856.52,1081.92,6
HCPCS,688110,PROBE NASOLACRIMAL DUCT,,,144.77,144.77,1
HCPCS,68815,PROBE NASOLACRIMAL DUCT,,,237.74,5058.24,15
HCPCS,68815,PROBE NASOLACRIMAL DUCT W/WO IRRG INSJ TUBE/STNT,1188.0,772.2,113.9,891.0,35
HCPCS,68815,Probe nasolacrimal duct,,,856.52,1081.92,6
HCPCS,688150,PROBE NASOLACRIMAL DUCT,,,237.74,237.74,1
HCPCS,68816,PROBE NL DUCT W/BALLOON,,,168.44,5058.24,15
HCPCS,68816,Probe nl duct w/balloon,,,856.52,1081.92,6
HCPCS,688160,PROBE NL DUCT W/BALLOON,,,168.44,168.44,1
HCPCS,68840,EXPLORE/IRRIGATE TEAR DUCTS,,,125.18,125.18,1
HCPCS,68840,PROBE LACRIMAL CANALICULI W/WO IRRIGATION,1145.5,744.5749999999999,61.35,4151.0,84
HCPCS,688400,EXPLORE/IRRIGATE TEAR DUCTS,,,125.18,125.18,1
HCPCS,68841,INSJ RX ELUT IMPLT LAC CANAL,,,34.84,5058.24,15
HCPCS,68841,Insj rx elut implt lac canal,,,45.31,57.23,6
HCPCS,688410,INSJ RX ELUT IMPLT LAC CANAL,,,34.84,34.84,1
HCPCS,68850,INJECTION FOR TEAR SAC X-RAY,,,55.62,55.62,1
HCPCS,68850,Injection for tear sac x-ray,,,223.78,282.67,6
HCPCS,688500,INJECTION FOR TEAR SAC X-RAY,,,55.62,55.62,1
HCPCS,68899,UNLISTED PX LACRIMAL SYSTEM,,,300.06,648.13,14
HCPCS,68899,Unlisted px lacrimal system,,,169.69,214.34,6
HCPCS,69000,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,2089.0,1357.85,60.33,4151.0,133
HCPCS,69000,DRG XTRNL EAR ABSC/HEM SMPL,,,125.05,125.05,1
HCPCS,690000,DRG XTRNL EAR ABSC/HEM SMPL,,,125.05,125.05,1
HCPCS,69005,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,4482.5,2913.625,77.92,7290.9,133
HCPCS,69005,DRG XTRNL EAR ABSC/HEM COMP,,,161.77,161.77,1
HCPCS,690050,DRG XTRNL EAR ABSC/HEM COMP,,,161.77,161.77,1
HCPCS,69020,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,2065.0,1342.25,70.2,4151.0,179
HCPCS,69020,DRG XTRNL AUD CANAL ABSCESS,,,142.71,142.71,1
HCPCS,690200,DRG XTRNL AUD CANAL ABSCESS,,,142.71,142.71,1
HCPCS,69090,EAR PIERCING,67.0,43.55,30.94,67.0,14
HCPCS,69090,"EAR PIERCING, BOTH EARS W/EARRINGS",200.0,130.0,62.89,200.0,13
HCPCS,690900,EAR PIERCING,,,30.94,30.94,1
HCPCS,69100,BIOPSY EXTERNAL EAR,742.5,482.625,22.35,4151.0,81
HCPCS,69100,BIOPSY OF EXTERNAL EAR,,,46.26,46.26,1
HCPCS,691000,BIOPSY OF EXTERNAL EAR,,,46.26,46.26,1
HCPCS,69105,BIOPSY EXTERNAL AUDITORY CANAL,374.0,243.1,30.25,280.5,35
HCPCS,69105,BIOPSY OF EXTERNAL EAR CANAL,,,63.48,3211.66,15
HCPCS,69105,Biopsy of external ear canal,,,839.72,1060.7,6
HCPCS,691050,BIOPSY OF EXTERNAL EAR CANAL,,,63.48,63.48,1
HCPCS,69110,EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR,7861.0,5109.65,160.77,12879.0,81
HCPCS,69110,REMOVE EXTERNAL EAR PARTIAL,,,324.62,324.62,1
HCPCS,691100,REMOVE EXTERNAL EAR PARTIAL,,,324.62,324.62,1
HCPCS,69120,EXCISION EXTERNAL EAR COMPLETE AMPUTATION,1656.0,1076.4,216.71,1656.0,35
HCPCS,69120,REMOVAL OF EXTERNAL EAR,,,383.34,12826.13,15
HCPCS,69120,Removal of external ear,,,2132.36,2693.51,6
HCPCS,691200,REMOVAL OF EXTERNAL EAR,,,383.34,383.34,1
HCPCS,69140,EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL,3256.0,2116.4,454.58,3256.0,35
HCPCS,69140,REMOVE EAR CANAL LESION(S),,,885.6,12826.13,15
HCPCS,69140,Remove ear canal lesion(s),,,2132.36,2693.51,6
HCPCS,691400,REMOVE EAR CANAL LESION(S),,,885.6,885.6,1
HCPCS,69145,EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL,1080.0,702.0,126.08,810.0,35
HCPCS,69145,REMOVE EAR CANAL LESION(S),,,255.53,6205.4,15
HCPCS,69145,Remove ear canal lesion(s),,,1634.08,2064.1,6
HCPCS,691450,REMOVE EAR CANAL LESION(S),,,255.53,255.53,1
HCPCS,69150,EXTENSIVE EAR CANAL SURGERY,,,1003.76,12826.13,15
HCPCS,69150,Extensive ear canal surgery,,,2132.36,2693.51,6
HCPCS,69150,RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ,5988.0,3892.2,652.85,5988.0,35
HCPCS,691500,EXTENSIVE EAR CANAL SURGERY,,,1003.76,1003.76,1
HCPCS,69155,EXTENSIVE EAR/NECK SURGERY,,,1626.37,1626.37,1
HCPCS,69155,Extensive ear/neck surgery,,,2719.4,3435.04,6
HCPCS,691550,EXTENSIVE EAR/NECK SURGERY,,,1626.37,1626.37,1
HCPCS,69200,CLEAR OUTER EAR CANAL,,,47.48,47.48,1
HCPCS,69200,RMVL FB XTRNL AUDITORY CANAL W/O ANES,492.0,319.8,24.95,3920.0,161
HCPCS,692000,CLEAR OUTER EAR CANAL,,,47.48,47.48,1
HCPCS,69205,CLEAR OUTER EAR CANAL,,,94.99,3512.95,15
HCPCS,69205,Clear outer ear canal,,,839.72,1060.7,6
HCPCS,69205,RMVL FB XTRNL AUDITORY CANAL ANES,532.0,345.8,61.75,532.0,35
HCPCS,692050,CLEAR OUTER EAR CANAL,,,94.99,94.99,1
HCPCS,69209,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,278.0,180.7,9.46,3920.0,114
HCPCS,69209,REMOVE IMPACTED EAR WAX UNI,16.0,10.4,8.0,30.65,32
HCPCS,692090,REMOVE IMPACTED EAR WAX UNI,,,15.13,15.13,1
HCPCS,69210,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,283.0,183.95,15.95,3920.0,161
HCPCS,69210,REMOVE IMPACTED EAR WAX UNI,,,32.71,32.71,1
HCPCS,692100,REMOVE IMPACTED EAR WAX UNI,,,32.71,32.71,1
HCPCS,69220,CLEAN OUT MASTOID CAVITY,,,51.47,51.47,1
HCPCS,69220,"DEBRID MASTOIDECTOM CAVITY,SIMP",332.0,215.8,24.78,249.0,35
HCPCS,69220,DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE,994.0,646.1,58.73,3920.0,46
HCPCS,692200,CLEAN OUT MASTOID CAVITY,,,51.47,51.47,1
HCPCS,69222,CLEAN OUT MASTOID CAVITY,,,135.51,135.51,1
HCPCS,69222,"DEBRIDE MASTOID CAVITY,COMPLEX",580.0,377.0,66.58,435.0,35
HCPCS,69222,DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX,2546.0,1654.9,164.38,4268.0,45
HCPCS,692220,CLEAN OUT MASTOID CAVITY,,,135.51,135.51,1
HCPCS,69300,OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ,2576.0,1674.4,227.17,1932.0,35
HCPCS,69300,REVISE EXTERNAL EAR,,,470.83,7031.51,15
HCPCS,69300,Revise external ear,,,2132.36,2693.51,6
HCPCS,693000,REVISE EXTERNAL EAR,,,470.83,470.83,1
HCPCS,69310,REBUILD OUTER EAR CANAL,,,1098.4,12826.13,15
HCPCS,69310,RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX,4388.0,2852.2,574.39,4388.0,35
HCPCS,69310,Rebuild outer ear canal,,,2719.4,3435.04,6
HCPCS,693100,REBUILD OUTER EAR CANAL,,,1098.4,1098.4,1
HCPCS,69320,RCNSTJ XTRNL AUD CANAL CONGENITAL ATRESIA 1 STG,6872.0,4466.8,851.77,6872.0,35
HCPCS,69320,REBUILD OUTER EAR CANAL,,,1538.82,12826.13,15
HCPCS,69320,Rebuild outer ear canal,,,2132.36,2693.51,6
HCPCS,693200,REBUILD OUTER EAR CANAL,,,1538.82,1538.82,1
HCPCS,69399,ENDOSCOPIC EXTERNAL AUDITORY CANAL (COMP CODE 69200),339.0,220.35,169.5,339.0,15
HCPCS,69399,REVISION OF OSSEOINTEGRATED BONE ANCHORED IMPANT ABUTMENT (COMP,3164.0,2056.6,234.46,3164.0,15
HCPCS,69399,UNLISTED PX EXTERNAL EAR,,,233.1,503.49,14
HCPCS,69399,Unlisted px external ear,,,112.01,141.49,6
HCPCS,69420,INCISION OF EARDRUM,,,120.15,503.49,15
HCPCS,69420,Incision of eardrum,,,112.01,141.49,6
HCPCS,69420,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ,552.0,358.8,58.36,414.0,35
HCPCS,694200,INCISION OF EARDRUM,,,120.15,120.15,1
HCPCS,69421,INCISION OF EARDRUM,,,150.83,7031.51,15
HCPCS,69421,Incision of eardrum,,,839.72,1060.7,6
HCPCS,69421,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES,783.0,508.95,111.89,783.0,35
HCPCS,694210,INCISION OF EARDRUM,,,150.83,150.83,1
HCPCS,69424,REMOVE VENTILATING TUBE,,,60.25,7031.51,15
HCPCS,69424,Remove ventilating tube,,,839.72,1060.7,6
HCPCS,69424,VENTILATING TUBE RMVL REQUIRING GENERAL ANES,340.0,221.0,33.65,255.0,35
HCPCS,694240,REMOVE VENTILATING TUBE,,,60.25,60.25,1
HCPCS,69433,CREATE EARDRUM OPENING,,,132.18,132.18,1
HCPCS,69433,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,1587.0,1031.55,63.94,4214.0,128
HCPCS,694330,CREATE EARDRUM OPENING,,,132.18,132.18,1
HCPCS,69436,CREATE EARDRUM OPENING,,,159.57,3211.66,15
HCPCS,69436,Create eardrum opening,,,839.72,1060.7,6
HCPCS,69436,TYMPANOSTOMY GENERAL ANESTHESIA,884.0,574.6,107.9,884.0,35
HCPCS,694360,CREATE EARDRUM OPENING,,,159.57,159.57,1
HCPCS,69440,EXPLORATION OF MIDDLE EAR,,,686.89,7031.51,15
HCPCS,69440,Exploration of middle ear,,,1634.08,2064.1,6
HCPCS,69440,MIDDLE EAR EXPL THRU POSTAUR/EAR CANAL INC,3084.0,2004.6,430.78,3084.0,35
HCPCS,694400,EXPLORATION OF MIDDLE EAR,,,686.89,686.89,1
HCPCS,69450,EARDRUM REVISION,,,542.66,7031.51,15
HCPCS,69450,Eardrum revision,,,1634.08,2064.1,6
HCPCS,69450,TYMPANOLYSIS TRANSCANAL,2276.0,1479.4,332.91,2276.0,35
HCPCS,694500,EARDRUM REVISION,,,542.66,542.66,1
HCPCS,69501,MASTOIDECTOMY,,,708.65,12826.13,15
HCPCS,69501,Mastoidectomy,,,2719.4,3435.04,6
HCPCS,69501,TRANSMASTOID ANTROTOMY,3684.0,2394.6,511.94,3684.0,35
HCPCS,695010,MASTOIDECTOMY,,,708.65,708.65,1
HCPCS,69502,MASTOIDECTOMY,,,942.03,12826.13,15
HCPCS,69502,"MASTOIDECTOMY,COMPLETE",5024.0,3265.6,684.81,5024.0,35
HCPCS,69502,Mastoidectomy,,,2719.4,3435.04,6
HCPCS,695020,MASTOIDECTOMY,,,942.03,942.03,1
HCPCS,69505,"MASTOIDECTOMY,MOD RADICAL",5268.0,3424.2,728.53,5268.0,35
HCPCS,69505,REMOVE MASTOID STRUCTURES,,,1211.49,12826.13,15
HCPCS,69505,Remove mastoid structures,,,2132.36,2693.51,6
HCPCS,695050,REMOVE MASTOID STRUCTURES,,,1211.49,1211.49,1
HCPCS,69511,EXTENSIVE MASTOID SURGERY,,,1240.86,12826.13,15
HCPCS,69511,Extensive mastoid surgery,,,2719.4,3435.04,6
HCPCS,69511,"MASTOIDECTOMY,RADICAL",5480.0,3562.0,756.45,5480.0,35
HCPCS,695110,EXTENSIVE MASTOID SURGERY,,,1240.86,1240.86,1
HCPCS,69530,EXTENSIVE MASTOID SURGERY,,,1658.74,12826.13,15
HCPCS,69530,Extensive mastoid surgery,,,2719.4,3435.04,6
HCPCS,69530,PETROUS APICECTOMY RADICAL MASTOIDECTOMY,8152.0,5298.8,954.63,8152.0,35
HCPCS,695300,EXTENSIVE MASTOID SURGERY,,,1658.74,1658.74,1
HCPCS,69535,REMOVE PART OF TEMPORAL BONE,,,2651.1,2651.1,1
HCPCS,69535,"RESECT TEMPORAL BONE,EXTERN APPRCH",14968.0,9729.2,1645.94,14968.0,35
HCPCS,69535,Remove part of temporal bone,,,3243.49,4097.04,6
HCPCS,695350,REMOVE PART OF TEMPORAL BONE,,,2651.1,2651.1,1
HCPCS,69540,EXCISION AURAL POLYP,500.0,325.0,63.62,3211.66,50
HCPCS,69540,Excision aural polyp,,,839.72,1060.7,6
HCPCS,695400,EXCISION AURAL POLYP,,,128.83,128.83,1
HCPCS,69550,EXC AURL GLOMUS TUM TRNSCANL,,,1047.81,12826.13,15
HCPCS,69550,EXCISION AURAL GLOMUS TUMOR TRANSCANAL,4460.0,2899.0,629.57,4460.0,35
HCPCS,69550,Exc aurl glomus tum trnscanl,,,2132.36,2693.51,6
HCPCS,695500,EXC AURL GLOMUS TUM TRNSCANL,,,1047.81,1047.81,1
HCPCS,69552,EXC AURL GLOMUS TUM TRNSMSTD,,,1572.35,12826.13,15
HCPCS,69552,EXCISION AURAL GLOMUS TUMOR TRANSMASTOID,7924.0,5150.6,962.02,7924.0,35
HCPCS,69552,Exc aurl glomus tum trnsmstd,,,2719.4,3435.04,6
HCPCS,695520,EXC AURL GLOMUS TUM TRNSMSTD,,,1572.35,1572.35,1
HCPCS,69554,EXC AURL GLOMUS TUM EXTENDED,,,2522.37,2522.37,1
HCPCS,69554,Exc aurl glomus tum extended,,,1634.08,2064.1,6
HCPCS,695540,EXC AURL GLOMUS TUM EXTENDED,,,2522.37,2522.37,1
HCPCS,69601,REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY,5380.0,3497.0,728.37,5380.0,47
HCPCS,69601,REVJ MSTDC RSLTG COMPL MSTDC,,,1014.8,12826.13,15
HCPCS,69601,Revj mstdc rsltg compl mstdc,,,2719.4,3435.04,6
HCPCS,696010,REVJ MSTDC RSLTG COMPL MSTDC,,,1014.8,1014.8,1
HCPCS,69602,REV MSTDC RSLT MOD RAD MSTDC,,,1083.56,12826.13,15
HCPCS,69602,REVJ MASTOIDECTOMY RSLTG MODF RAD MSTDC,5504.0,3577.6,758.96,5504.0,35
HCPCS,69602,Rev mstdc rslt mod rad mstdc,,,2719.4,3435.04,6
HCPCS,696020,REV MSTDC RSLT MOD RAD MSTDC,,,1083.56,1083.56,1
HCPCS,69603,REVJ MASTOIDECTOMY RSLTG RAD MASTOIDECTOMY,5680.0,3692.0,782.59,5680.0,35
HCPCS,69603,REVJ MSTDC RSLTG RAD MSTDC,,,1267.83,12826.13,15
HCPCS,69603,Revj mstdc rsltg rad mstdc,,,2719.4,3435.04,6
HCPCS,696030,REVJ MSTDC RSLTG RAD MSTDC,,,1267.83,1267.83,1
HCPCS,69604,REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY,5680.0,3692.0,801.36,5680.0,35
HCPCS,69604,REVJ MSTDC RSLTG TYMPANPLSTY,,,1107.17,12826.13,15
HCPCS,69604,Revj mstdc rsltg tympanplsty,,,2719.4,3435.04,6
HCPCS,696040,REVJ MSTDC RSLTG TYMPANPLSTY,,,1107.17,1107.17,1
HCPCS,69605,Mastoid surgery revision,,,2719.4,3435.04,6
HCPCS,69610,TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH,4686.5,3046.225,139.56,6665.4,81
HCPCS,69610,TYMPANIC MEMBRANE REPAIR,,,289.11,289.11,1
HCPCS,696100,TYMPANIC MEMBRANE REPAIR,,,289.11,289.11,1
HCPCS,69620,MYRINGOPLASTY,2653.0,1724.45,242.3,7031.51,50
HCPCS,69620,Myringoplasty,,,1634.08,2064.1,6
HCPCS,696200,MYRINGOPLASTY,,,492.93,492.93,1
HCPCS,69631,REPAIR EARDRUM STRUCTURES,,,882.59,12826.13,15
HCPCS,69631,Repair eardrum structures,,,2132.36,2693.51,6
HCPCS,69631,TYMPANOPLASTY W/O MASTOIDECT W/O OSSICLE RECNSTJ,4020.0,2613.0,563.27,4020.0,35
HCPCS,696310,REPAIR EARDRUM STRUCTURES,,,882.59,882.59,1
HCPCS,69632,REBUILD EARDRUM STRUCTURES,,,1072.88,12826.13,15
HCPCS,69632,Rebuild eardrum structures,,,2719.4,3435.04,6
HCPCS,69632,TYMPNOPLSTY W/O MSTDC 1ST/REVJ W/OSICLE RECNSTJ,5184.0,3369.6,717.96,5184.0,35
HCPCS,696320,REBUILD EARDRUM STRUCTURES,,,1072.88,1072.88,1
HCPCS,69633,REBUILD EARDRUM STRUCTURES,,,1044.57,12826.13,15
HCPCS,69633,Rebuild eardrum structures,,,2719.4,3435.04,6
HCPCS,69633,TYMPANOPLASTY W/O MASTOIDEC 1ST/REVJ PROSTH TORP,4924.0,3200.6,685.65,4924.0,35
HCPCS,696330,REBUILD EARDRUM STRUCTURES,,,1044.57,1044.57,1
HCPCS,69635,REPAIR EARDRUM STRUCTURES,,,1264.49,12826.13,15
HCPCS,69635,Repair eardrum structures,,,2132.36,2693.51,6
HCPCS,696350,REPAIR EARDRUM STRUCTURES,,,1264.49,1264.49,1
HCPCS,69636,REBUILD EARDRUM STRUCTURES,,,1389.29,12826.13,15
HCPCS,69636,Rebuild eardrum structures,,,2719.4,3435.04,6
HCPCS,696360,REBUILD EARDRUM STRUCTURES,,,1389.29,1389.29,1
HCPCS,69637,REBUILD EARDRUM STRUCTURES,,,1383.57,12826.13,15
HCPCS,69637,Rebuild eardrum structures,,,2719.4,3435.04,6
HCPCS,696370,REBUILD EARDRUM STRUCTURES,,,1383.57,1383.57,1
HCPCS,69641,REVISE MIDDLE EAR & MASTOID,,,1035.66,12826.13,15
HCPCS,69641,Revise middle ear & mastoid,,,2719.4,3435.04,6
HCPCS,69641,TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ,5156.0,3351.4,716.46,5156.0,35
HCPCS,696410,REVISE MIDDLE EAR & MASTOID,,,1035.66,1035.66,1
HCPCS,69642,REVISE MIDDLE EAR & MASTOID,,,1331.16,12826.13,15
HCPCS,69642,Revise middle ear & mastoid,,,2719.4,3435.04,6
HCPCS,69642,TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ,6824.0,4435.6,936.99,6824.0,35
HCPCS,696420,REVISE MIDDLE EAR & MASTOID,,,1331.16,1331.16,1
HCPCS,69643,REVISE MIDDLE EAR & MASTOID,,,1216.32,12826.13,15
HCPCS,69643,Revise middle ear & mastoid,,,2719.4,3435.04,6
HCPCS,69643,TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR,6860.0,4459.0,865.94,6860.0,35
HCPCS,696430,REVISE MIDDLE EAR & MASTOID,,,1216.32,1216.32,1
HCPCS,69644,REVISE MIDDLE EAR & MASTOID,,,1487.72,12826.13,15
HCPCS,69644,Revise middle ear & mastoid,,,2719.4,3435.04,6
HCPCS,69644,TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR,6892.0,4479.8,954.89,6892.0,35
HCPCS,696440,REVISE MIDDLE EAR & MASTOID,,,1487.72,1487.72,1
HCPCS,69645,REVISE MIDDLE EAR & MASTOID,,,1459.14,12826.13,15
HCPCS,69645,Revise middle ear & mastoid,,,2719.4,3435.04,6
HCPCS,69645,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/O OCR,6684.0,4344.6,920.41,6684.0,35
HCPCS,696450,REVISE MIDDLE EAR & MASTOID,,,1459.14,1459.14,1
HCPCS,69646,REVISE MIDDLE EAR & MASTOID,,,1554.89,12826.13,15
HCPCS,69646,Revise middle ear & mastoid,,,2719.4,3435.04,6
HCPCS,69646,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/OCR,7348.0,4776.2,1000.09,7348.0,35
HCPCS,696460,REVISE MIDDLE EAR & MASTOID,,,1554.89,1554.89,1
HCPCS,69650,STAPES MOBILIZATION,,,799.23,7031.51,15
HCPCS,69650,Stapes mobilization,,,2132.36,2693.51,6
HCPCS,696500,STAPES MOBILIZATION,,,799.23,799.23,1
HCPCS,69660,REVISE MIDDLE EAR BONE,,,920.94,12826.13,15
HCPCS,69660,Revise middle ear bone,,,2132.36,2693.51,6
HCPCS,69660,STAPEDECTOMY/STAPEDOTOMY,4812.0,3127.8,670.67,4812.0,35
HCPCS,696600,REVISE MIDDLE EAR BONE,,,920.94,920.94,1
HCPCS,69661,REVISE MIDDLE EAR BONE,,,1200.25,12826.13,15
HCPCS,69661,Revise middle ear bone,,,2132.36,2693.51,6
HCPCS,69661,STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT,6368.0,4139.2,871.44,6368.0,35
HCPCS,696610,REVISE MIDDLE EAR BONE,,,1200.25,1200.25,1
HCPCS,69662,REVISE MIDDLE EAR BONE,,,1154.55,12826.13,15
HCPCS,69662,REVISION STAPEDECTOMY/STAPEDOTOMY,6240.0,4056.0,857.0,6240.0,35
HCPCS,69662,Revise middle ear bone,,,2132.36,2693.51,6
HCPCS,696620,REVISE MIDDLE EAR BONE,,,1154.55,1154.55,1
HCPCS,69666,REPAIR MIDDLE EAR STRUCTURES,,,804.27,7031.51,15
HCPCS,69666,REPAIR OVAL WINDOW FISTULA,3956.0,2571.4,560.51,3956.0,35
HCPCS,69666,Repair middle ear structures,,,1634.08,2064.1,6
HCPCS,696660,REPAIR MIDDLE EAR STRUCTURES,,,804.27,804.27,1
HCPCS,69667,REPAIR MIDDLE EAR STRUCTURES,,,806.99,7031.51,15
HCPCS,69667,Repair middle ear structures,,,1634.08,2064.1,6
HCPCS,696670,REPAIR MIDDLE EAR STRUCTURES,,,806.99,806.99,1
HCPCS,69670,MASTOID OBLITERATION,4692.0,3049.8,588.7,4692.0,35
HCPCS,69670,REMOVE MASTOID AIR CELLS,,,938.67,12826.13,15
HCPCS,69670,Remove mastoid air cells,,,2719.4,3435.04,6
HCPCS,696700,REMOVE MASTOID AIR CELLS,,,938.67,938.67,1
HCPCS,69676,REMOVE MIDDLE EAR NERVE,,,828.06,7031.51,15
HCPCS,69676,Remove middle ear nerve,,,2132.36,2693.51,6
HCPCS,696760,REMOVE MIDDLE EAR NERVE,,,828.06,828.06,1
HCPCS,69700,CLOSE MASTOID FISTULA,,,663.48,3211.66,15
HCPCS,69700,Close mastoid fistula,,,1634.08,2064.1,6
HCPCS,697000,CLOSE MASTOID FISTULA,,,663.48,663.48,1
HCPCS,69705,NPS SURG DILAT EUST TUBE UNI,,,174.2,12826.13,15
HCPCS,69705,Nps surg dilat eust tube uni,,,1193.97,1508.17,6
HCPCS,69705,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI,1200.0,780.0,128.76,4843.98,28
HCPCS,697050,NPS SURG DILAT EUST TUBE UNI,,,174.2,174.2,1
HCPCS,69706,NPS SURG DILAT EUST TUBE BI,,,243.67,12826.13,15
HCPCS,69706,Nps surg dilat eust tube bi,,,1193.97,1508.17,6
HCPCS,69706,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI,1708.0,1110.2,180.4,4993.5,28
HCPCS,697060,NPS SURG DILAT EUST TUBE BI,,,243.67,243.67,1
HCPCS,69710,IMPLANT/REPLACE HEARING AID,,,604.0,604.0,1
HCPCS,69710,Implant/replace hearing aid,,,5314.97,6713.64,6
HCPCS,697100,IMPLANT/REPLACE HEARING AID,,,604.0,604.0,1
HCPCS,69711,REMOVE/REPAIR HEARING AID,,,834.92,7031.51,15
HCPCS,69711,Remove/repair hearing aid,,,2132.36,2693.51,6
HCPCS,697110,REMOVE/REPAIR HEARING AID,,,834.92,834.92,1
HCPCS,69714,IMPL OI IMPLT SKULL PERQ ESP,,,494.1,27897.39,15
HCPCS,69714,Impl oi implt skull perq esp,,,5314.97,6713.64,6
HCPCS,697140,IMPL OI IMPLT SKULL PERQ ESP,,,494.1,494.1,1
HCPCS,69715,Temple bne implnt w/stimulat,,,5314.97,6713.64,6
HCPCS,69716,IMPL OI IMPLT SK TC ESP<100,,,620.57,27897.39,15
HCPCS,69716,Impl oi implt sk tc esp<100,,,5314.97,6713.64,6
HCPCS,697160,IMPL OI IMPLT SK TC ESP<100,,,620.57,620.57,1
HCPCS,69717,RPLCMT OI IMPLT SKL PRQ ESP,,,560.89,15488.78,15
HCPCS,69717,Rplcmt oi implt skl prq esp,,,2719.4,3435.04,6
HCPCS,697170,RPLCMT OI IMPLT SKL PRQ ESP,,,560.89,560.89,1
HCPCS,69718,Revise temple bone implant,,,5314.97,6713.64,6
HCPCS,69719,RPLCM OI IMPLT SK TC ESP<100,,,644.82,27897.39,15
HCPCS,69719,Rplcm oi implt sk tc esp<100,,,5314.97,6713.64,6
HCPCS,697190,RPLCM OI IMPLT SK TC ESP<100,,,644.82,644.82,1
HCPCS,69720,DCMPRN FACIAL NRV INTRATEMPORAL LAT GANGLION,5884.0,3824.6,811.78,5884.0,35
HCPCS,69720,RELEASE FACIAL NERVE,,,1169.76,12826.13,15
HCPCS,69720,Release facial nerve,,,2310.44,2918.45,6
HCPCS,697200,RELEASE FACIAL NERVE,,,1169.76,1169.76,1
HCPCS,69725,RELEASE FACIAL NERVE,,,1867.59,12826.13,15
HCPCS,69725,Release facial nerve,,,2310.44,2918.45,6
HCPCS,697250,RELEASE FACIAL NERVE,,,1867.59,1867.59,1
HCPCS,69726,RMV NTR OI IMPLT SKL PRQ ESP,,,475.88,7034.85,15
HCPCS,69726,Rmv ntr oi implt skl prq esp,,,1634.08,2064.1,6
HCPCS,697260,RMV NTR OI IMPLT SKL PRQ ESP,,,475.88,475.88,1
HCPCS,69727,RMV NTR OI IMP SK TC ESP<100,,,531.89,7034.85,15
HCPCS,69727,Rmv ntr oi imp sk tc esp<100,,,1634.08,2064.1,6
HCPCS,697270,RMV NTR OI IMP SK TC ESP<100,,,531.89,531.89,1
HCPCS,69728,RMV NTR OI IMP SK TC>=100,,,602.62,7034.85,15
HCPCS,69728,RMVL ENTIRE OI IMPLT SKL MAG TC ATTCH ESP>=100,3400.0,2210.0,234.26,3400.0,31
HCPCS,69728,Rmv ntr oi imp sk tc>=100,,,1634.08,2064.1,6
HCPCS,697280,RMV NTR OI IMP SK TC>=100,,,602.62,602.62,1
HCPCS,69729,IMPL OI IMPLT SK TC ESP>=100,,,673.89,27897.39,15
HCPCS,69729,IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100,3988.0,2592.2,254.29,3988.0,31
HCPCS,69729,Impl oi implt sk tc esp>=100,,,5314.97,6713.64,6
HCPCS,697290,IMPL OI IMPLT SK TC ESP>=100,,,673.89,673.89,1
HCPCS,69730,RPLC OI IMPLT SK TC ESP>=100,,,699.13,27897.39,15
HCPCS,69730,RPLCMT OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100,4100.0,2665.0,258.06,4100.0,31
HCPCS,69730,Rplc oi implt sk tc esp>=100,,,5314.97,6713.64,6
HCPCS,697300,RPLC OI IMPLT SK TC ESP>=100,,,699.13,699.13,1
HCPCS,69740,REPAIR FACIAL NERVE,,,1158.45,12826.13,15
HCPCS,69740,Repair facial nerve,,,2310.44,2918.45,6
HCPCS,697400,REPAIR FACIAL NERVE,,,1158.45,1158.45,1
HCPCS,69745,REPAIR FACIAL NERVE,,,1233.53,12826.13,15
HCPCS,69745,Repair facial nerve,,,2310.44,2918.45,6
HCPCS,697450,REPAIR FACIAL NERVE,,,1233.53,1233.53,1
HCPCS,69799,UNLISTED PX MIDDLE EAR,,,233.1,503.49,14
HCPCS,69799,Unlisted px middle ear,,,839.72,1060.7,6
HCPCS,69801,INCISE INNER EAR,,,124.87,124.87,1
HCPCS,69801,LABYRINTHOTOMY TRANSCANAL,4156.0,2701.3999999999996,96.2,6665.4,81
HCPCS,698010,INCISE INNER EAR,,,124.87,124.87,1
HCPCS,69805,"ENDOLYMPH SAC OPERATN,NO SHUNT",5884.0,3824.6,732.62,5884.0,35
HCPCS,69805,EXPLORE INNER EAR,,,1028.91,12826.13,15
HCPCS,69805,Explore inner ear,,,2719.4,3435.04,6
HCPCS,698050,EXPLORE INNER EAR,,,1028.91,1028.91,1
HCPCS,69806,ENDOLYMPH SAC OP W SHUNT,5052.0,3283.8,687.81,5052.0,35
HCPCS,69806,EXPLORE INNER EAR,,,919.61,12826.13,15
HCPCS,69806,Explore inner ear,,,2132.36,2693.51,6
HCPCS,698060,EXPLORE INNER EAR,,,919.61,919.61,1
HCPCS,69905,"EXCIS LABYRINTH,TRANSCANAL",4954.0,3220.1,636.69,4954.0,35
HCPCS,69905,REMOVE INNER EAR,,,913.03,12826.13,15
HCPCS,69905,Remove inner ear,,,2132.36,2693.51,6
HCPCS,699050,REMOVE INNER EAR,,,913.03,913.03,1
HCPCS,69910,EXCIS LABYRINTH W MASTOIDECTOMY,5564.0,3616.6,735.98,5564.0,35
HCPCS,69910,REMOVE INNER EAR & MASTOID,,,989.79,12826.13,15
HCPCS,69910,Remove inner ear & mastoid,,,2719.4,3435.04,6
HCPCS,699100,REMOVE INNER EAR & MASTOID,,,989.79,989.79,1
HCPCS,69915,INCISE INNER EAR NERVE,,,1504.15,7031.51,15
HCPCS,69915,Incise inner ear nerve,,,2132.36,2693.51,6
HCPCS,699150,INCISE INNER EAR NERVE,,,1504.15,1504.15,1
HCPCS,69930,IMPLANT COCHLEAR DEVICE,,,1214.88,68964.6,15
HCPCS,69930,Implant cochlear device,,,14455.15,18259.14,6
HCPCS,699300,IMPLANT COCHLEAR DEVICE,,,1214.88,1214.88,1
HCPCS,69949,UNLISTED PX INNER EAR,,,233.1,503.49,14
HCPCS,69949,Unlisted px inner ear,,,839.72,1060.7,6
HCPCS,69950,INCISE INNER EAR NERVE,,,1749.34,1749.34,1
HCPCS,69950,Incise inner ear nerve,,,3929.11,4963.09,6
HCPCS,699500,INCISE INNER EAR NERVE,,,1749.34,1749.34,1
HCPCS,69955,RELEASE FACIAL NERVE,,,1965.33,12826.13,15
HCPCS,69955,Release facial nerve,,,3929.11,4963.09,6
HCPCS,699550,RELEASE FACIAL NERVE,,,1965.33,1965.33,1
HCPCS,69960,RELEASE INNER EAR CANAL,,,1887.04,12826.13,15
HCPCS,69960,Release inner ear canal,,,3929.11,4963.09,6
HCPCS,699600,RELEASE INNER EAR CANAL,,,1887.04,1887.04,1
HCPCS,69970,REMOVE INNER EAR LESION,,,2126.56,12826.13,15
HCPCS,69970,"REMOVE TUMOR,TEMPORAL BONE",12964.0,8426.6,1298.53,12964.0,35
HCPCS,69970,Remove inner ear lesion,,,3243.49,4097.04,6
HCPCS,699700,REMOVE INNER EAR LESION,,,2126.56,2126.56,1
HCPCS,69979,UNLISTED PX TEMPORAL BONE,,,233.1,503.49,14
HCPCS,69979,Unlisted px temporal bone,,,1664.64,2102.7,6
HCPCS,69990,MICROSURG TQS REQ USE OPERATING MICROSCOPE,1384.0,899.6,125.3,1384.0,35
HCPCS,69990,MICROSURGERY ADD-ON,,,239.98,239.98,1
HCPCS,699900,MICROSURGERY ADD-ON,,,239.98,239.98,1
HCPCS,70010,CONTRAST X-RAY OF BRAIN,,,44.76,859.16,19
HCPCS,70010,Contrast x-ray of brain,,,350.47,442.7,6
HCPCS,700100,CONTRAST X-RAY OF BRAIN,,,44.76,44.76,1
HCPCS,70010TC,CONTRAST X-RAY OF BRAIN,,,44.76,44.76,1
HCPCS,70015,CISTERNOGRAPHY POSITIVE CONTRAST RS&I,6814.0,4429.1,146.0,6132.6,49
HCPCS,70015,CONTRAST X-RAY OF BRAIN,,,108.45,108.45,2
HCPCS,700150,CONTRAST X-RAY OF BRAIN,,,108.45,108.45,1
HCPCS,70015TC,CONTRAST X-RAY OF BRAIN,,,108.45,108.45,1
HCPCS,70030,"RAD EXAM,EYE,FOREIGN BODY",79.0,51.35,17.89,79.0,32
HCPCS,70030,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,760.0,494.0,6.96,839.0,147
HCPCS,70030,RADIOLOGICAL EXAM FOREIGN BODY,839.0,545.35,17.89,839.0,32
HCPCS,70030,X-RAY EYE FOR FOREIGN BODY,,,23.95,23.95,2
HCPCS,700300,X-RAY EYE FOR FOREIGN BODY,,,23.95,23.95,1
HCPCS,70030TC,X-RAY EYE FOR FOREIGN BODY,,,23.95,23.95,1
HCPCS,70100,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,760.0,494.0,7.53,832.0,147
HCPCS,70100,X-RAY EXAM OF JAW <4VIEWS,,,29.85,29.85,2
HCPCS,70100,XRAY MANDIBLE < 4 VIEWS,452.0,293.79999999999995,21.11,832.0,64
HCPCS,701000,X-RAY EXAM OF JAW <4VIEWS,,,29.85,29.85,1
HCPCS,70100TC,X-RAY EXAM OF JAW <4VIEWS,,,29.85,29.85,1
HCPCS,7010F,PT INFO INTO RECALL SYSTEM,,,0.01,0.01,1
HCPCS,7010F0,PT INFO INTO RECALL SYSTEM,,,0.01,0.01,1
HCPCS,70110,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,918.0,596.7,10.37,1018.0,196
HCPCS,70110,X-RAY EXAM OF JAW 4/> VIEWS,,,31.48,31.48,2
HCPCS,70110,XRAY MANDIBLE COMPLETE,559.0,363.35,26.53,1018.0,64
HCPCS,701100,X-RAY EXAM OF JAW 4/> VIEWS,,,31.48,31.48,1
HCPCS,70110TC,X-RAY EXAM OF JAW 4/> VIEWS,,,31.48,31.48,1
HCPCS,70120,"MASTOIDS,<3VIEWS PER SIDE",72.0,46.8,23.82,72.0,32
HCPCS,70120,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,918.0,596.7,7.82,990.0,147
HCPCS,70120,X-RAY EXAM OF MASTOIDS,,,29.19,29.19,2
HCPCS,70120,XRAY MASTOIDS < 3 VIEWS,990.0,643.5,23.82,990.0,32
HCPCS,701200,X-RAY EXAM OF MASTOIDS,,,29.19,29.19,1
HCPCS,70120TC,X-RAY EXAM OF MASTOIDS,,,29.19,29.19,1
HCPCS,70130,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,918.0,596.7,14.07,1068.0,147
HCPCS,70130,X-RAY EXAM OF MASTOIDS,,,45.24,45.24,2
HCPCS,70130,XRAY MASTOID COMPLETE,609.0,395.85,34.35,1068.0,64
HCPCS,701300,X-RAY EXAM OF MASTOIDS,,,45.24,45.24,1
HCPCS,70130TC,X-RAY EXAM OF MASTOIDS,,,45.24,45.24,1
HCPCS,70134,RADEX INTERNAL AUDITORY MEATI COMPLETE,4729.0,3073.85,14.93,4879.0,147
HCPCS,70134,X-RAY EXAM OF MIDDLE EAR,,,44.26,44.26,2
HCPCS,70134,"XRAY AUDITORY MEATI,CMPLT",150.0,97.5,32.99,150.0,32
HCPCS,70134,XRAY INTERNAL AUDITORY COMP,4879.0,3171.35,32.99,4879.0,32
HCPCS,701340,X-RAY EXAM OF MIDDLE EAR,,,44.26,44.26,1
HCPCS,70134TC,X-RAY EXAM OF MIDDLE EAR,,,44.26,44.26,1
HCPCS,70140,RADEX FACIAL BONES < 3 VIEWS,760.0,494.0,8.39,836.0,147
HCPCS,70140,X-RAY EXAM OF FACIAL BONES,,,22.31,22.31,2
HCPCS,70140,"XRAY FACIAL BONES ,3 VIEWS",760.0,494.0,24.07,760.0,32
HCPCS,70140,XRAY FACIAL BONES < 3 VIEWS,456.0,296.4,24.07,836.0,64
HCPCS,701400,X-RAY EXAM OF FACIAL BONES,,,22.31,22.31,1
HCPCS,70140TC,X-RAY EXAM OF FACIAL BONES,,,22.31,22.31,1
HCPCS,70150,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,918.0,596.7,10.65,1022.0,147
HCPCS,70150,X-RAY EXAM OF FACIAL BONES,,,34.43,34.43,2
HCPCS,70150,XRAY FACIAL BONES COMPLETE,563.0,365.95,31.41,1022.0,64
HCPCS,701500,X-RAY EXAM OF FACIAL BONES,,,34.43,34.43,1
HCPCS,70150TC,X-RAY EXAM OF FACIAL BONES,,,34.43,34.43,1
HCPCS,70160,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,760.0,494.0,7.25,828.0,147
HCPCS,70160,X-RAY EXAM OF NASAL BONES,,,29.19,29.19,2
HCPCS,70160,XRAY NASAL BONES COMPLETE,448.0,291.20000000000005,20.62,828.0,64
HCPCS,701600,X-RAY EXAM OF NASAL BONES,,,29.19,29.19,1
HCPCS,70160TC,X-RAY EXAM OF NASAL BONES,,,29.19,29.19,1
HCPCS,70170,X-RAY EXAM OF TEAR DUCT,,,233.56,524.34,19
HCPCS,70170,X-ray exam of tear duct,,,71.29,90.05,6
HCPCS,701700,X-RAY EXAM OF TEAR DUCT,,,233.56,233.56,1
HCPCS,70170TC,X-RAY EXAM OF TEAR DUCT,,,233.56,233.56,1
HCPCS,70190,RADEX OPTIC FORAMINA,760.0,494.0,8.95,844.0,147
HCPCS,70190,X-RAY EXAM OF EYE SOCKETS,,,26.57,26.57,2
HCPCS,701900,X-RAY EXAM OF EYE SOCKETS,,,26.57,26.57,1
HCPCS,70190TC,X-RAY EXAM OF EYE SOCKETS,,,26.57,26.57,1
HCPCS,70200,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,918.0,596.7,11.51,1030.0,147
HCPCS,70200,X-RAY EXAM OF EYE SOCKETS,,,34.11,34.11,2
HCPCS,70200,XRAY ORBITS COMPLETE,571.0,371.15,31.15,1030.0,64
HCPCS,702000,X-RAY EXAM OF EYE SOCKETS,,,34.11,34.11,1
HCPCS,70200TC,X-RAY EXAM OF EYE SOCKETS,,,34.11,34.11,1
HCPCS,7020F,MAMMO ASSESS CAT IN DBASE,,,0.01,0.01,1
HCPCS,7020F0,MAMMO ASSESS CAT IN DBASE,,,0.01,0.01,1
HCPCS,70210,RADEX SINUSES PARANASAL <3 VIEWS,760.0,494.0,7.25,828.0,147
HCPCS,70210,X-RAY EXAM OF SINUSES,,,23.62,23.62,2
HCPCS,70210,XRAY SINUS PARANASAL <3VWS,760.0,494.0,23.3,828.0,96
HCPCS,702100,X-RAY EXAM OF SINUSES,,,23.62,23.62,1
HCPCS,70210TC,X-RAY EXAM OF SINUSES,,,23.62,23.62,1
HCPCS,70220,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,760.0,494.0,10.27,857.0,147
HCPCS,70220,X-RAY EXAM OF SINUSES,,,26.9,26.9,2
HCPCS,70220,XRAY SINUS PARANASAL 3 VIEWS OR MORE,857.0,557.05,28.72,857.0,32
HCPCS,70220,XRAY SINUS PARANASAL COMP,97.0,63.05,28.72,97.0,32
HCPCS,702200,X-RAY EXAM OF SINUSES,,,26.9,26.9,1
HCPCS,70220TC,X-RAY EXAM OF SINUSES,,,26.9,26.9,1
HCPCS,70240,RADIOLOGIC EXAMINATION SELLA TURCICA,760.0,494.0,8.1,836.0,147
HCPCS,70240,X-RAY EXAM PITUITARY SADDLE,,,23.62,23.62,2
HCPCS,70240,XRAY SELLA TURCICA,456.0,296.4,18.66,836.0,64
HCPCS,702400,X-RAY EXAM PITUITARY SADDLE,,,23.62,23.62,1
HCPCS,70240TC,X-RAY EXAM PITUITARY SADDLE,,,23.62,23.62,1
HCPCS,70250,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,918.0,596.7,8.65,997.0,147
HCPCS,70250,X-RAY EXAM OF SKULL,,,26.9,26.9,2
HCPCS,70250,XRAY SKULL < 4 VIEWS,538.0,349.7,26.09,997.0,64
HCPCS,70250,XRAY SKULL < 4 VWS,918.0,596.7,26.09,918.0,32
HCPCS,702500,X-RAY EXAM OF SKULL,,,26.9,26.9,1
HCPCS,70250TC,X-RAY EXAM OF SKULL,,,26.9,26.9,1
HCPCS,7025F,PT INFOSYS ALARM 4 NXT MAMMO,,,0.01,0.01,1
HCPCS,7025F0,PT INFOSYS ALARM 4 NXT MAMMO,,,0.01,0.01,1
HCPCS,70260,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,918.0,596.7,13.18,1030.0,147
HCPCS,70260,X-RAY EXAM OF SKULL,,,30.83,30.83,2
HCPCS,70260,XRAY SKULL COMPLETE MIN 4VIEWS,1030.0,669.5,35.58,1030.0,32
HCPCS,70260,"XRAY SKULL,COMPLETE,MINIMUM 4 VIEWS",112.0,72.8,35.58,112.0,32
HCPCS,702600,X-RAY EXAM OF SKULL,,,30.83,30.83,1
HCPCS,70260TC,X-RAY EXAM OF SKULL,,,30.83,30.83,1
HCPCS,70300,RADIOLOGIC EXAMINATION TEETH 1 VIEW,760.0,494.0,4.98,800.0,98
HCPCS,70300,X-RAY EXAM OF TEETH,,,7.91,190.91,19
HCPCS,70300,X-ray exam of teeth,,,33.81,42.71,6
HCPCS,703000,X-RAY EXAM OF TEETH,,,7.91,7.91,1
HCPCS,70300TC,X-RAY EXAM OF TEETH,,,7.91,7.91,1
HCPCS,70310,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,2085.0,1355.25,6.96,2155.0,98
HCPCS,70310,X-RAY EXAM OF TEETH,,,32.14,524.34,19
HCPCS,70310,X-ray exam of teeth,,,33.81,42.71,6
HCPCS,703100,X-RAY EXAM OF TEETH,,,32.14,32.14,1
HCPCS,70310TC,X-RAY EXAM OF TEETH,,,32.14,32.14,1
HCPCS,70320,FULL MOUTH X-RAY OF TEETH,,,41.97,524.34,19
HCPCS,70320,Full mouth x-ray of teeth,,,33.81,42.71,6
HCPCS,703200,FULL MOUTH X-RAY OF TEETH,,,41.97,41.97,1
HCPCS,70320TC,FULL MOUTH X-RAY OF TEETH,,,41.97,41.97,1
HCPCS,70328,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,760.0,494.0,7.53,832.0,147
HCPCS,70328,X-RAY EXAM OF JAW JOINT,,,25.59,25.59,2
HCPCS,70328,XRAY TMJ UNILATERAL,452.0,293.79999999999995,20.32,832.0,64
HCPCS,703280,X-RAY EXAM OF JAW JOINT,,,25.59,25.59,1
HCPCS,70328TC,X-RAY EXAM OF JAW JOINT,,,25.59,25.59,1
HCPCS,70330,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,760.0,494.0,10.38,856.0,147
HCPCS,70330,X-RAY EXAM OF JAW JOINTS,,,40.99,40.99,2
HCPCS,70330,XRAY TMJ BILATERAL,476.0,309.4,32.06,856.0,64
HCPCS,703300,X-RAY EXAM OF JAW JOINTS,,,40.99,40.99,1
HCPCS,70330TC,X-RAY EXAM OF JAW JOINTS,,,40.99,40.99,1
HCPCS,70332,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,2085.0,1355.25,22.3,2301.0,98
HCPCS,70332,X-RAY EXAM OF JAW JOINT,,,56.38,524.34,19
HCPCS,70332,X-ray exam of jaw joint,,,71.29,90.05,6
HCPCS,703320,X-RAY EXAM OF JAW JOINT,,,56.38,56.38,1
HCPCS,70332TC,X-RAY EXAM OF JAW JOINT,,,56.38,56.38,1
HCPCS,70336,MAGNETIC IMAGE JAW JOINT,,,215.15,215.15,2
HCPCS,70336,MRI TEMPOROMANDIBULAR JOINT,2085.0,1355.25,60.79,2677.0,179
HCPCS,70336,MRI TM JOINT,2677.0,1740.05,249.3,2677.0,32
HCPCS,703360,MAGNETIC IMAGE JAW JOINT,,,215.15,215.15,1
HCPCS,70336TC,MAGNETIC IMAGE JAW JOINT,,,215.15,215.15,1
HCPCS,70350,X-RAY HEAD FOR ORTHODONTIA,,,8.23,190.91,19
HCPCS,70350,X-ray head for orthodontia,,,33.81,42.71,6
HCPCS,703500,X-RAY HEAD FOR ORTHODONTIA,,,8.23,8.23,1
HCPCS,70350TC,X-RAY HEAD FOR ORTHODONTIA,,,8.23,8.23,1
HCPCS,70355,PANORAMIC X-RAY OF JAWS,,,8.56,190.91,19
HCPCS,70355,Panoramic x-ray of jaws,,,33.81,42.71,6
HCPCS,703550,PANORAMIC X-RAY OF JAWS,,,8.56,8.56,1
HCPCS,70355TC,PANORAMIC X-RAY OF JAWS,,,8.56,8.56,1
HCPCS,70360,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,760.0,494.0,6.96,839.0,147
HCPCS,70360,X-RAY EXAM OF NECK,,,22.31,22.31,2
HCPCS,70360,XRAY NECK SOFT TISSUE,459.0,298.35,17.04,839.0,64
HCPCS,703600,X-RAY EXAM OF NECK,,,22.31,22.31,1
HCPCS,70360TC,X-RAY EXAM OF NECK,,,22.31,22.31,1
HCPCS,70370,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,760.0,494.0,33.81,684.0,49
HCPCS,70370,THROAT X-RAY & FLUOROSCOPY,,,86.51,86.51,2
HCPCS,703700,THROAT X-RAY & FLUOROSCOPY,,,86.51,86.51,1
HCPCS,70370TC,THROAT X-RAY & FLUOROSCOPY,,,86.51,86.51,1
HCPCS,70371,SPEECH EVALUATION COMPLEX,,,67.19,524.34,19
HCPCS,70371,Speech evaluation complex,,,71.29,90.05,6
HCPCS,703710,SPEECH EVALUATION COMPLEX,,,67.19,67.19,1
HCPCS,70371TC,SPEECH EVALUATION COMPLEX,,,67.19,67.19,1
HCPCS,70380,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,760.0,494.0,7.82,828.0,147
HCPCS,70380,X-RAY EXAM OF SALIVARY GLAND,,,29.19,29.19,2
HCPCS,703800,X-RAY EXAM OF SALIVARY GLAND,,,29.19,29.19,1
HCPCS,70380TC,X-RAY EXAM OF SALIVARY GLAND,,,29.19,29.19,1
HCPCS,70390,"RADIOLOGIC EXAM, SALIVARY GLAND FOR CALC",2237.0,1454.05,62.53,2237.0,32
HCPCS,70390,SIALOGRAPHY,1194.5,776.425,62.53,2237.0,64
HCPCS,70390,SIALOGRAPHY RS&I,2085.0,1355.25,16.05,2237.0,147
HCPCS,70390,X-RAY EXAM OF SALIVARY DUCT,,,96.34,96.34,2
HCPCS,703900,X-RAY EXAM OF SALIVARY DUCT,,,96.34,96.34,1
HCPCS,70390TC,X-RAY EXAM OF SALIVARY DUCT,,,96.34,96.34,1
HCPCS,70450,CT HEAD/BRAIN W/O CONTRAST MATERIAL,918.0,596.7,34.94,1746.0,147
HCPCS,70450,CT HEAD/BRAIN W/O DYE,,,71.23,71.23,2
HCPCS,70450,CT HEAD/BRAIN WO CONTRAST,833.0,541.4499999999999,95.92,1292.0,64
HCPCS,704500,CT HEAD/BRAIN W/O DYE,,,71.23,71.23,1
HCPCS,70450TC,CT HEAD/BRAIN W/O DYE,,,71.23,71.23,1
HCPCS,70460,CT HEAD/BRAIN W CONTRAST,1264.5,821.925,130.98,2032.0,64
HCPCS,70460,CT HEAD/BRAIN W/CONTRAST MATERIAL,1535.0,997.75,46.45,2032.0,147
HCPCS,70460,CT HEAD/BRAIN W/DYE,,,102.18,102.18,2
HCPCS,704600,CT HEAD/BRAIN W/DYE,,,102.18,102.18,1
HCPCS,70460TC,CT HEAD/BRAIN W/DYE,,,102.18,102.18,1
HCPCS,70470,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,1535.0,997.75,52.7,2094.0,147
HCPCS,70470,CT HEAD/BRAIN W/O & W/DYE,,,122.17,122.17,2
HCPCS,70470,CT HEAD/BRAIN W/WO CONTRAST,1326.5,862.2249999999999,154.47,2094.0,64
HCPCS,704700,CT HEAD/BRAIN W/O & W/DYE,,,122.17,122.17,1
HCPCS,70470TC,CT HEAD/BRAIN W/O & W/DYE,,,122.17,122.17,1
HCPCS,70471,CTA H&N C+ W/NONCONTRAST IMG,,,267.76,267.76,2
HCPCS,70471,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,3074.0,1998.1,123.29,4174.0,117
HCPCS,704710,CTA H&N C+ W/NONCONTRAST IMG,,,267.76,267.76,1
HCPCS,70471TC,CTA H&N C+ W/NONCONTRAST IMG,,,267.76,267.76,1
HCPCS,70472,CT CERE PRFU ALYS C+W/CT/CTA,,,124.18,124.18,2
HCPCS,70472,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,1535.0,997.75,38.06,1874.0,111
HCPCS,704720,CT CERE PRFU ALYS C+W/CT/CTA,,,124.18,124.18,1
HCPCS,70472TC,CT CERE PRFU ALYS C+W/CT/CTA,,,124.18,124.18,1
HCPCS,70473,CT CERE PRFU ALY C+WO CT/CTA,,,185.81,185.81,2
HCPCS,70473,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,1545.0,1004.25,49.45,1985.0,117
HCPCS,704730,CT CERE PRFU ALY C+WO CT/CTA,,,185.81,185.81,1
HCPCS,70473TC,CT CERE PRFU ALY C+WO CT/CTA,,,185.81,185.81,1
HCPCS,70480,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,918.0,596.7,53.27,1746.0,147
HCPCS,70480,CT ORBIT/EAR/FOSSA W/O DYE,,,106.01,106.01,2
HCPCS,70480,CT ORBITS SELLA W/O CONT,563.0,365.95,149.15,563.0,32
HCPCS,70480,CT ORBITS SELLA WO CONT,1481.0,962.65,149.15,1481.0,32
HCPCS,704800,CT ORBIT/EAR/FOSSA W/O DYE,,,106.01,106.01,1
HCPCS,70480TC,CT ORBIT/EAR/FOSSA W/O DYE,,,106.01,106.01,1
HCPCS,70481,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,1535.0,997.75,52.65,2032.0,147
HCPCS,70481,CT ORBIT/EAR/FOSSA W/DYE,,,136.61,136.61,2
HCPCS,70481,CT ORBITS SELLA W CONTRAST,1264.5,821.925,168.6,2032.0,64
HCPCS,704810,CT ORBIT/EAR/FOSSA W/DYE,,,136.61,136.61,1
HCPCS,70481TC,CT ORBIT/EAR/FOSSA W/DYE,,,136.61,136.61,1
HCPCS,70482,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,1535.0,997.75,59.04,2094.0,147
HCPCS,70482,CT ORBIT/EAR/FOSSA W/O&W/DYE,,,162.06,162.06,2
HCPCS,70482,CT ORBITS SELLA W/WO CONTRAST,1326.5,862.2249999999999,196.64,2094.0,64
HCPCS,704820,CT ORBIT/EAR/FOSSA W/O&W/DYE,,,162.06,162.06,1
HCPCS,70482TC,CT ORBIT/EAR/FOSSA W/O&W/DYE,,,162.06,162.06,1
HCPCS,70486,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,918.0,596.7,40.11,1746.0,147
HCPCS,70486,CT MAXILLOFACIAL W/O DYE,,,94.27,94.27,2
HCPCS,70486,CT MAXILLOFACIAL WO CONT,833.0,541.4499999999999,112.56,1292.0,64
HCPCS,704860,CT MAXILLOFACIAL W/O DYE,,,94.27,94.27,1
HCPCS,70486TC,CT MAXILLOFACIAL W/O DYE,,,94.27,94.27,1
HCPCS,70487,CT MAXILLOFACIAL W CONTRAST,1264.5,821.925,135.83,2032.0,64
HCPCS,70487,CT MAXILLOFACIAL W/CONTRAST MATERIAL,1535.0,997.75,52.65,2032.0,147
HCPCS,70487,CT MAXILLOFACIAL W/DYE,,,106.69,106.69,2
HCPCS,704870,CT MAXILLOFACIAL W/DYE,,,106.69,106.69,1
HCPCS,70487TC,CT MAXILLOFACIAL W/DYE,,,106.69,106.69,1
HCPCS,70488,CT MAXILLOFACIAL W WO CONT,1346.5,875.2249999999999,164.88,2094.0,64
HCPCS,70488,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,1535.0,997.75,58.81,2094.0,147
HCPCS,70488,CT MAXILLOFACIAL W/O & W/DYE,,,133.87,133.87,2
HCPCS,704880,CT MAXILLOFACIAL W/O & W/DYE,,,133.87,133.87,1
HCPCS,70488TC,CT MAXILLOFACIAL W/O & W/DYE,,,133.87,133.87,1
HCPCS,70490,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,918.0,596.7,53.27,1746.0,147
HCPCS,70490,CT SOFT TISSUE NECK W/O DYE,,,96.68,96.68,2
HCPCS,70490,CT SOFT TISSUE NECK WO CONT,1022.0,664.3,149.15,1481.0,64
HCPCS,704900,CT SOFT TISSUE NECK W/O DYE,,,96.68,96.68,1
HCPCS,70490TC,CT SOFT TISSUE NECK W/O DYE,,,96.68,96.68,1
HCPCS,70491,CT SOFT TISSUE NECK W CONT,1374.5,893.425,182.87,2142.0,64
HCPCS,70491,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,1535.0,997.75,56.96,2142.0,147
HCPCS,70491,CT SOFT TISSUE NECK W/DYE,,,128.36,128.36,2
HCPCS,704910,CT SOFT TISSUE NECK W/DYE,,,128.36,128.36,1
HCPCS,70491TC,CT SOFT TISSUE NECK W/DYE,,,128.36,128.36,1
HCPCS,70492,CT SFT TSUE NCK W/O & W/DYE,,,156.21,156.21,2
HCPCS,70492,CT SOFT TISS NECK W WO CONT,1480.5,962.325,207.66,2248.0,64
HCPCS,70492,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,1535.0,997.75,59.94,2248.0,147
HCPCS,704920,CT SFT TSUE NCK W/O & W/DYE,,,156.21,156.21,1
HCPCS,70492TC,CT SFT TSUE NCK W/O & W/DYE,,,156.21,156.21,1
HCPCS,70496,CT ANGIOGRAPHY HEAD,,,184.12,184.12,2
HCPCS,70496,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,1535.0,997.75,72.73,2305.0,147
HCPCS,70496,"CT ANGIOGRAPHY, HEAD",770.0,500.5,237.69,770.0,32
HCPCS,70496,"CTA HEAD WWO C,W/3D",2305.0,1498.25,237.69,2305.0,32
HCPCS,704960,CT ANGIOGRAPHY HEAD,,,184.12,184.12,1
HCPCS,70496TC,CT ANGIOGRAPHY HEAD,,,184.12,184.12,1
HCPCS,70498,CT ANGIOGRAPHY NECK,,,184.12,184.12,2
HCPCS,70498,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,1535.0,997.75,72.73,2305.0,147
HCPCS,70498,"CT ANGIOGRAPHY, NECK",770.0,500.5,236.28,770.0,32
HCPCS,70498,"CTA NECK, W/WO C,W/3D",2305.0,1498.25,236.28,2305.0,32
HCPCS,704980,CT ANGIOGRAPHY NECK,,,184.12,184.12,1
HCPCS,70498TC,CT ANGIOGRAPHY NECK,,,184.12,184.12,1
HCPCS,70540,MRI ORB FACE&NECK W/O CON,594.0,386.1,212.13,594.0,32
HCPCS,70540,MRI ORBIT FACE &/NECK W/O CONTRAST,2085.0,1355.25,55.96,2679.0,147
HCPCS,70540,MRI ORBIT FACE NECK,2679.0,1741.35,212.13,2679.0,32
HCPCS,70540,MRI ORBIT/FACE/NECK W/O DYE,,,180.13,180.13,2
HCPCS,705400,MRI ORBIT/FACE/NECK W/O DYE,,,180.13,180.13,1
HCPCS,70540TC,MRI ORBIT/FACE/NECK W/O DYE,,,180.13,180.13,1
HCPCS,70542,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,3080.0,2002.0,67.33,3728.0,147
HCPCS,70542,"MRI ORBIT,FACE &/OR NECK W/CONTRAST",3728.0,2423.2,251.99,3728.0,32
HCPCS,70542,MRI ORBIT/FACE/NECK W/DYE,,,212.72,212.72,2
HCPCS,70542,"MRI,ORBIT,FACE,NECK W/CON",648.0,421.2,251.99,648.0,32
HCPCS,705420,MRI ORBIT/FACE/NECK W/DYE,,,212.72,212.72,1
HCPCS,70542TC,MRI ORBIT/FACE/NECK W/DYE,,,212.72,212.72,1
HCPCS,70543,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,3080.0,2002.0,88.63,3940.0,196
HCPCS,70543,MRI ORBT/FAC/NCK W/O &W/DYE,,,263.3,263.3,2
HCPCS,70543,"MRI,ORBIT,FACE AND/OR NECK W/WO CONTRAST",3940.0,2561.0,318.62,3940.0,32
HCPCS,70543,"MRI,ORBT,FACE,NCK W/WO CN",860.0,559.0,318.62,860.0,32
HCPCS,705430,MRI ORBT/FAC/NCK W/O &W/DYE,,,263.3,263.3,1
HCPCS,70543TC,MRI ORBT/FAC/NCK W/O &W/DYE,,,263.3,263.3,1
HCPCS,70544,MR ANGIOGRAPHY HEAD W/O DYE,,,175.93,175.93,2
HCPCS,70544,MRA HEAD W/O CONTRST MATERIAL,2085.0,1355.25,242.63,2109.0,49
HCPCS,70544,"MRA, HEAD W/O CONTRAST",2085.0,1355.25,49.86,2565.0,130
HCPCS,70544,"MRA, HEAD, W/O CONTRAST",2565.0,1667.25,201.09,2565.0,32
HCPCS,705440,MR ANGIOGRAPHY HEAD W/O DYE,,,175.93,175.93,1
HCPCS,70544TC,MR ANGIOGRAPHY HEAD W/O DYE,,,175.93,175.93,1
HCPCS,70545,MR ANGIOGRAPHY HEAD W/DYE,,,188.67,188.67,2
HCPCS,70545,MRA HEAD W/CONTRAST MATERIAL,3080.0,2002.0,285.23,2772.0,49
HCPCS,70545,"MRA, HEAD WITH CONTRAST",3560.0,2314.0,212.34,3560.0,32
HCPCS,70545,"MRA, HEAD, WITH CONTRAST",3080.0,2002.0,49.57,3560.0,98
HCPCS,70545,"MRA, HEAD; W/CONTRAST",480.0,312.0,212.34,538.99,32
HCPCS,705450,MR ANGIOGRAPHY HEAD W/DYE,,,188.67,188.67,1
HCPCS,70545TC,MR ANGIOGRAPHY HEAD W/DYE,,,188.67,188.67,1
HCPCS,70546,MR ANGIOGRAPH HEAD W/O&W/DYE,,,286.7,286.7,2
HCPCS,70546,MRA HEAD W/O & W/CONTRAST MATERIAL,3080.0,2002.0,285.23,2772.0,49
HCPCS,70546,"MRA,HEAD; W/WO CONTRAST",2191.0,1424.15,306.89,3731.0,64
HCPCS,70546,MRA; HEAD W & WO CONTRAST,3080.0,2002.0,68.99,3731.0,98
HCPCS,705460,MR ANGIOGRAPH HEAD W/O&W/DYE,,,286.7,286.7,1
HCPCS,70546TC,MR ANGIOGRAPH HEAD W/O&W/DYE,,,286.7,286.7,1
HCPCS,70547,MR ANGIOGRAPHY NECK W/O DYE,,,176.29,176.29,2
HCPCS,70547,MRA NECK W/O CONTRST MATERIAL,2085.0,1355.25,242.63,2109.0,49
HCPCS,70547,"MRA, NECK; W/O CONTRAST",2085.0,1355.25,49.86,2613.0,130
HCPCS,705470,MR ANGIOGRAPHY NECK W/O DYE,,,176.29,176.29,1
HCPCS,70547TC,MR ANGIOGRAPHY NECK W/O DYE,,,176.29,176.29,1
HCPCS,70548,MR ANGIOGRAPHY NECK W/DYE,,,193.98,193.98,2
HCPCS,70548,MRA NECK W/CONTRAST MATERIAL,3080.0,2002.0,285.23,2772.0,49
HCPCS,70548,"MRA, NECK; W/CONTRAST",3080.0,2002.0,49.86,3680.0,130
HCPCS,705480,MR ANGIOGRAPHY NECK W/DYE,,,193.98,193.98,1
HCPCS,70548TC,MR ANGIOGRAPHY NECK W/DYE,,,193.98,193.98,1
HCPCS,70549,MR ANGIOGRAPH NECK W/O&W/DYE,,,288.11,288.11,2
HCPCS,70549,MRA NECK W/O &W/CONTRAST MATERIAL,3080.0,2002.0,285.23,2772.0,49
HCPCS,70549,"MRA, NECK; W/WO CONTRAST",720.0,468.0,342.72,843.61,32
HCPCS,70549,"MRA,NECK; W/WO CONTRAST",3080.0,2002.0,74.43,3800.0,98
HCPCS,705490,MR ANGIOGRAPH NECK W/O&W/DYE,,,288.11,288.11,1
HCPCS,70549TC,MR ANGIOGRAPH NECK W/O&W/DYE,,,288.11,288.11,1
HCPCS,70551,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,2085.0,1355.25,61.08,2736.0,147
HCPCS,70551,MRI BRAIN INCL BRAIN STEM W/O CONTRAST,2736.0,1778.4,189.4,2736.0,32
HCPCS,70551,MRI BRAIN STEM W/O DYE,,,140.52,140.52,2
HCPCS,70551,MRI BRAIN WO CONTRAST,651.0,423.15,189.4,651.0,32
HCPCS,705510,MRI BRAIN STEM W/O DYE,,,140.52,140.52,1
HCPCS,70551TC,MRI BRAIN STEM W/O DYE,,,140.52,140.52,1
HCPCS,70552,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,3080.0,2002.0,74.29,3863.0,147
HCPCS,70552,MRI BRAIN INCL BRAIN STEM W/CONTRAST,3863.0,2510.95,257.12,3863.0,32
HCPCS,70552,MRI BRAIN STEM W/DYE,,,206.71,206.71,2
HCPCS,70552,MRI BRAIN W CONTRAST,783.0,508.95,257.12,783.0,32
HCPCS,705520,MRI BRAIN STEM W/DYE,,,206.71,206.71,1
HCPCS,70552TC,MRI BRAIN STEM W/DYE,,,206.71,206.71,1
HCPCS,70553,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,3080.0,2002.0,98.01,4088.0,147
HCPCS,70553,MRI BRAIN INCL BRAIN STEM W/WO CON,4088.0,2657.2,303.75,4088.0,32
HCPCS,70553,MRI BRAIN STEM W/O & W/DYE,,,233.95,233.95,2
HCPCS,70553,MRI BRAIN W WO CONTRAST,1008.0,655.2,303.75,1008.0,32
HCPCS,705530,MRI BRAIN STEM W/O & W/DYE,,,233.95,233.95,1
HCPCS,70553TC,MRI BRAIN STEM W/O & W/DYE,,,233.95,233.95,1
HCPCS,70554,FMRI BRAIN BY TECH,,,309.69,309.69,2
HCPCS,70554,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,2298.5,1494.025,145.46,2512.0,130
HCPCS,705540,FMRI BRAIN BY TECH,,,309.69,309.69,1
HCPCS,70554TC,FMRI BRAIN BY TECH,,,309.69,309.69,1
HCPCS,70555,FMRI BRAIN BY PHYS/PSYCH,,,608.52,608.52,2
HCPCS,70555,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,2085.0,1355.25,110.24,3101.0,114
HCPCS,705550,FMRI BRAIN BY PHYS/PSYCH,,,608.52,608.52,1
HCPCS,70555TC,FMRI BRAIN BY PHYS/PSYCH,,,608.52,608.52,1
HCPCS,70557,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,4729.0,3073.85,145.46,4256.1,48
HCPCS,70557,MRI BRAIN W/O DYE,,,567.76,567.76,2
HCPCS,705570,MRI BRAIN W/O DYE,,,567.76,567.76,1
HCPCS,70557TC,MRI BRAIN W/O DYE,,,567.76,567.76,1
HCPCS,70558,MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL,1535.0,997.75,178.69,2109.0,48
HCPCS,70558,MRI BRAIN W/DYE,,,189.28,189.28,2
HCPCS,705580,MRI BRAIN W/DYE,,,189.28,189.28,1
HCPCS,70558TC,MRI BRAIN W/DYE,,,189.28,189.28,1
HCPCS,70559,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,1535.0,997.75,178.69,2109.0,48
HCPCS,70559,MRI BRAIN W/O & W/DYE,,,189.28,189.28,2
HCPCS,705590,MRI BRAIN W/O & W/DYE,,,189.28,189.28,1
HCPCS,70559TC,MRI BRAIN W/O & W/DYE,,,189.28,189.28,1
HCPCS,71045,RADIOLOGIC EXAM CHEST SINGLE VIEW,760.0,494.0,8.65,839.0,192
HCPCS,71045,X-RAY EXAM CHEST 1 VIEW,,,17.07,17.07,2
HCPCS,710450,X-RAY EXAM CHEST 1 VIEW,,,17.07,17.07,1
HCPCS,71045TC,X-RAY EXAM CHEST 1 VIEW,,,17.07,17.07,1
HCPCS,71046,RADIOLOGIC EXAM CHEST 2 VIEWS,760.0,494.0,10.27,857.0,241
HCPCS,71046,X-RAY EXAM CHEST 2 VIEWS,,,22.97,22.97,2
HCPCS,710460,X-RAY EXAM CHEST 2 VIEWS,,,22.97,22.97,1
HCPCS,71046TC,X-RAY EXAM CHEST 2 VIEWS,,,22.97,22.97,1
HCPCS,71047,RADIOLOGIC EXAM CHEST 3 VIEWS,760.0,494.0,12.86,879.0,192
HCPCS,71047,X-RAY EXAM CHEST 3 VIEWS,,,28.87,28.87,2
HCPCS,710470,X-RAY EXAM CHEST 3 VIEWS,,,28.87,28.87,1
HCPCS,71047TC,X-RAY EXAM CHEST 3 VIEWS,,,28.87,28.87,1
HCPCS,71048,RADIOLOGIC EXAM CHEST 4+ VIEWS,918.0,596.7,14.47,1054.0,192
HCPCS,71048,X-RAY EXAM CHEST 4+ VIEWS,,,30.83,30.83,2
HCPCS,710480,X-RAY EXAM CHEST 4+ VIEWS,,,30.83,30.83,1
HCPCS,71048TC,X-RAY EXAM CHEST 4+ VIEWS,,,30.83,30.83,1
HCPCS,71090,X-RAY & PACEMAKER INSERTION,134.0,87.1,67.0,134.0,12
HCPCS,71100,RADEX RIBS UNILATERAL 2 VIEWS,760.0,494.0,9.24,848.0,147
HCPCS,71100,X-RAY EXAM RIBS UNI 2 VIEWS,,,25.92,25.92,2
HCPCS,71100,XRAY RIBS UNILATERAL 2 VIEW,468.0,304.20000000000005,23.43,848.0,64
HCPCS,711000,X-RAY EXAM RIBS UNI 2 VIEWS,,,25.92,25.92,1
HCPCS,71100TC,X-RAY EXAM RIBS UNI 2 VIEWS,,,25.92,25.92,1
HCPCS,71101,RAD EXAM RIB/CHEST MIN 3V,1026.0,666.9,27.75,1026.0,32
HCPCS,71101,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,918.0,596.7,10.94,1026.0,147
HCPCS,71101,X-RAY EXAM UNILAT RIBS/CHEST,,,29.19,29.19,2
HCPCS,71101,XRAY UNI RIB W/CHEST 3VEW,108.0,70.2,27.75,108.0,32
HCPCS,711010,X-RAY EXAM UNILAT RIBS/CHEST,,,29.19,29.19,1
HCPCS,71101TC,X-RAY EXAM UNILAT RIBS/CHEST,,,29.19,29.19,1
HCPCS,71110,RADEX RIBS BILATERAL 3 VIEWS,918.0,596.7,11.22,1046.0,147
HCPCS,71110,X-RAY EXAM RIBS BIL 3 VIEWS,,,29.85,29.85,2
HCPCS,71110,XRAY RIBS BILATERAL 3 VIEW,918.0,596.7,31.85,1046.0,96
HCPCS,711100,X-RAY EXAM RIBS BIL 3 VIEWS,,,29.85,29.85,1
HCPCS,71110TC,X-RAY EXAM RIBS BIL 3 VIEWS,,,29.85,29.85,1
HCPCS,71111,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,918.0,596.7,13.21,1046.0,147
HCPCS,71111,X-RAY EXAM RIBS/CHEST4/> VWS,,,36.72,36.72,2
HCPCS,71111,XRAY RIBS BILAT/CHEST 4 V,128.0,83.2,36.58,128.0,32
HCPCS,71111,XRAY RIBS/CHEST BILAT 3 VIEW,982.0,638.3,36.58,1046.0,64
HCPCS,711110,X-RAY EXAM RIBS/CHEST4/> VWS,,,36.72,36.72,1
HCPCS,71111TC,X-RAY EXAM RIBS/CHEST4/> VWS,,,36.72,36.72,1
HCPCS,71120,RADEX STERNUM MINIMUM 2 VIEWS,760.0,494.0,8.38,848.0,196
HCPCS,71120,X-RAY EXAM BREASTBONE 2/>VWS,,,23.95,23.95,2
HCPCS,71120,XRAY STERNUM 2 VIEW,468.0,304.20000000000005,25.13,848.0,64
HCPCS,711200,X-RAY EXAM BREASTBONE 2/>VWS,,,23.95,23.95,1
HCPCS,71120TC,X-RAY EXAM BREASTBONE 2/>VWS,,,23.95,23.95,1
HCPCS,71130,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,760.0,494.0,9.24,857.0,147
HCPCS,71130,X-RAY STRENOCLAVIC JT 3/>VWS,,,30.5,30.5,2
HCPCS,71130,XRAY STERNOCLAVICULAR 3 VW,477.0,310.04999999999995,27.32,857.0,64
HCPCS,711300,X-RAY STRENOCLAVIC JT 3/>VWS,,,30.5,30.5,1
HCPCS,71130TC,X-RAY STRENOCLAVIC JT 3/>VWS,,,30.5,30.5,1
HCPCS,71250,CT THORAX DX C-,,,88.42,88.42,2
HCPCS,71250,CT THORAX WO CONTRAST,934.0,607.1,124.66,1393.0,64
HCPCS,71250,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,918.0,596.7,42.48,1746.0,147
HCPCS,712500,CT THORAX DX C-,,,88.42,88.42,1
HCPCS,71250TC,CT THORAX DX C-,,,88.42,88.42,1
HCPCS,71260,CT THORAX DX C+,,,120.45,120.45,2
HCPCS,71260,CT THORAX W CONTRAST,1277.5,830.375,155.76,2045.0,64
HCPCS,71260,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1535.0,997.75,51.56,2045.0,147
HCPCS,712600,CT THORAX DX C+,,,120.45,120.45,1
HCPCS,71260TC,CT THORAX DX C+,,,120.45,120.45,1
HCPCS,71270,CT THORAS W WO CONTRAST,550.0,357.5,183.32,550.0,32
HCPCS,71270,CT THORAX DX C-/C+,,,147.61,147.61,2
HCPCS,71270,CT THORAX W WO CONTRAST,2085.0,1355.25,183.32,2085.0,32
HCPCS,71270,"CTA CHEST, W/WO CONTRAST",2085.0,1355.25,183.32,2085.0,32
HCPCS,71270,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,1535.0,997.75,56.96,2085.0,147
HCPCS,712700,CT THORAX DX C-/C+,,,147.61,147.61,1
HCPCS,71270TC,CT THORAX DX C-/C+,,,147.61,147.61,1
HCPCS,71271,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,918.0,596.7,50.39,1746.0,143
HCPCS,71271,CT THORAX LUNG CANCER SCR C-,,,93.28,93.28,2
HCPCS,712710,CT THORAX LUNG CANCER SCR C-,,,93.28,93.28,1
HCPCS,71271TC,CT THORAX LUNG CANCER SCR C-,,,93.28,93.28,1
HCPCS,71275,CT ANGIOGRAPHY CHEST,,,184.12,184.12,2
HCPCS,71275,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,1535.0,997.75,79.69,2336.0,147
HCPCS,71275,"CT ANGIOGRPHY,CHST,WWO CN",801.0,520.65,241.52,801.0,32
HCPCS,712750,CT ANGIOGRAPHY CHEST,,,184.12,184.12,1
HCPCS,71275TC,CT ANGIOGRAPHY CHEST,,,184.12,184.12,1
HCPCS,71550,MRI CHEST,3253.0,2114.45,287.55,3253.0,32
HCPCS,71550,MRI CHEST W/O CONTRAST MATERIAL,2085.0,1355.25,60.22,2669.0,147
HCPCS,71550,MRI CHEST W/O DYE,,,252.34,252.34,2
HCPCS,71550,MRI CHEST WO/CONTRAST,584.0,379.6,287.55,584.0,32
HCPCS,715500,MRI CHEST W/O DYE,,,252.34,252.34,1
HCPCS,71550TC,MRI CHEST W/O DYE,,,252.34,252.34,1
HCPCS,71551,MRI CHEST W/CONTRAST MATERIAL,6814.0,4429.1,241.9,6132.6,49
HCPCS,71551,MRI CHEST W/DYE,,,322.01,322.01,2
HCPCS,71551,"MRI, CHEST; W/CONTRAST",692.0,449.8,346.0,692.0,32
HCPCS,71551,"MRI,CHEST; W/CONTRAST",6814.0,4429.1,71.88,7506.0,98
HCPCS,715510,MRI CHEST W/DYE,,,322.01,322.01,1
HCPCS,71551TC,MRI CHEST W/DYE,,,322.01,322.01,1
HCPCS,71552,MRI CHEST W/O & W/CONTRAST MATERIAL,3080.0,2002.0,93.47,3984.0,147
HCPCS,71552,MRI CHEST W/O & W/DYE,,,395.99,395.99,2
HCPCS,71552,"MRI, CHEST; W/WO CONTRAST",3984.0,2589.6,454.25,3984.0,32
HCPCS,71552,"MRI,CHEST; W/WO CONTRAST",904.0,587.6,452.0,904.0,32
HCPCS,715520,MRI CHEST W/O & W/DYE,,,395.99,395.99,1
HCPCS,71552TC,MRI CHEST W/O & W/DYE,,,395.99,395.99,1
HCPCS,71555,MR ANGIO CHEST (MRA),7843.0,5097.95,75.29,8639.0,98
HCPCS,71555,MRA CHEST W CON,7843.0,5097.95,285.23,7058.7,39
HCPCS,71555,MRA CHEST W CONTRAST,7843.0,5097.95,75.29,8639.0,137
HCPCS,71555,MRA CHEST W OR W/WO CONTRAST,8639.0,5615.35,318.89,8639.0,32
HCPCS,71555,MRA CHEST W(OR)WO/CONTRST,796.0,517.4,318.89,796.0,32
HCPCS,71555,MRA CHEST W/O & W/CONTRAST MATERIAL,7843.0,5097.95,75.29,8639.0,98
HCPCS,71555,MRA CHEST WITH OR W/O CONT,7843.0,5097.95,75.29,8639.0,98
HCPCS,71555,MRA CHEST WO,7843.0,5097.95,285.23,7058.7,39
HCPCS,71555,MRA CHEST WO CONTR,7843.0,5097.95,285.23,7058.7,39
HCPCS,71555,MRA CHEST WO/W,7843.0,5097.95,285.23,7058.7,39
HCPCS,71555,MRA CHEST WO/W CONTR,7843.0,5097.95,285.23,7058.7,39
HCPCS,71555,MRI ANGIO CHEST W OR W/O DYE,,,275.72,275.72,2
HCPCS,715550,MRI ANGIO CHEST W OR W/O DYE,,,275.72,275.72,1
HCPCS,71555TC,MRI ANGIO CHEST W OR W/O DYE,,,275.72,275.72,1
HCPCS,72020,RADEX SPINE 1 VIEW SPECIFY LEVEL,760.0,494.0,6.39,824.0,147
HCPCS,72020,X-RAY EXAM OF SPINE 1 VIEW,,,16.42,16.42,2
HCPCS,72020,XRAY SPINE 1 VIEW,444.0,288.6,17.18,824.0,64
HCPCS,720200,X-RAY EXAM OF SPINE 1 VIEW,,,16.42,16.42,1
HCPCS,72020TC,X-RAY EXAM OF SPINE 1 VIEW,,,16.42,16.42,1
HCPCS,72040,RADEX SPINE CERVICAL 2 OR 3 VIEWS,760.0,494.0,10.09,857.0,147
HCPCS,72040,X-RAY EXAM NECK SPINE 2-3 VW,,,28.53,28.53,2
HCPCS,72040,"XRAY SPINE CERV APLAT 2,3VIEWS",857.0,557.05,23.87,857.0,32
HCPCS,72040,XRAY SPINE CERVICAL AP LAT,428.5,278.525,23.87,760.0,64
HCPCS,720400,X-RAY EXAM NECK SPINE 2-3 VW,,,28.53,28.53,1
HCPCS,72040TC,X-RAY EXAM NECK SPINE 2-3 VW,,,28.53,28.53,1
HCPCS,72050,RADEX SPINE CERVICAL 4 OR 5 VIEWS,918.0,596.7,12.86,1037.0,147
HCPCS,72050,X-RAY EXAM NECK SPINE 4/5VWS,,,40.33,40.33,2
HCPCS,72050,XRAY SPINE 4 VIEW,977.5,635.375,35.06,1037.0,64
HCPCS,72050,XRAY SPINE CERVICAL 4 VW,119.0,77.35,35.06,119.0,32
HCPCS,720500,X-RAY EXAM NECK SPINE 4/5VWS,,,40.33,40.33,1
HCPCS,72050TC,X-RAY EXAM NECK SPINE 4/5VWS,,,40.33,40.33,1
HCPCS,72052,RADEX SPINE CERVICAL 6 OR MORE VIEWS,918.0,596.7,14.4,1050.0,147
HCPCS,72052,X-RAY EXAM NECK SPINE 6/>VWS,,,47.53,47.53,2
HCPCS,72052,XRAY CERV OBL FLEX AND/OR EXTENSIONA,1050.0,682.5,42.92,1050.0,32
HCPCS,72052,XRAY SPINE CERVICAL COMP,132.0,85.8,42.92,132.0,32
HCPCS,720520,X-RAY EXAM NECK SPINE 6/>VWS,,,47.53,47.53,1
HCPCS,72052TC,X-RAY EXAM NECK SPINE 6/>VWS,,,47.53,47.53,1
HCPCS,72070,RADEX SPINE THORACIC 2 VIEWS,918.0,596.7,9.24,1006.0,147
HCPCS,72070,X-RAY EXAM THORAC SPINE 2VWS,,,22.97,22.97,2
HCPCS,720700,X-RAY EXAM THORAC SPINE 2VWS,,,22.97,22.97,1
HCPCS,72070TC,X-RAY EXAM THORAC SPINE 2VWS,,,22.97,22.97,1
HCPCS,72072,RADEX SPINE THORACIC 3 VIEWS,918.0,596.7,8.95,1019.0,147
HCPCS,72072,X-RAY EXAM THORAC SPINE 3VWS,,,28.53,28.53,2
HCPCS,72072,XRAY THORACIC SWIMMER VIEW,968.5,629.5250000000001,27.45,1019.0,64
HCPCS,72072,XRAY THORACIC W/SWIM 3 V,101.0,65.65,27.45,101.0,32
HCPCS,720720,X-RAY EXAM THORAC SPINE 3VWS,,,28.53,28.53,1
HCPCS,72072TC,X-RAY EXAM THORAC SPINE 3VWS,,,28.53,28.53,1
HCPCS,72074,RADEX SPINE THORACIC MINIMUM 4 VIEWS,918.0,596.7,8.95,1028.0,147
HCPCS,72074,X-RAY EXAM THORAC SPINE4/>VW,,,32.46,32.46,2
HCPCS,72074,XRAY THOR MIN 4 VIEWS COMPLETE,1028.0,668.2,32.16,1028.0,32
HCPCS,72074,XRAY THORACIC COMPLETE,514.0,334.1,32.16,918.0,64
HCPCS,720740,X-RAY EXAM THORAC SPINE4/>VW,,,32.46,32.46,1
HCPCS,72074TC,X-RAY EXAM THORAC SPINE4/>VW,,,32.46,32.46,1
HCPCS,72080,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,760.0,494.0,9.95,844.0,147
HCPCS,72080,X-RAY EXAM THORACOLMB 2/> VW,,,24.28,24.28,2
HCPCS,72080,XRAY THORACOLUMBAR AP LAT,464.0,301.6,25.6,844.0,64
HCPCS,720800,X-RAY EXAM THORACOLMB 2/> VW,,,24.28,24.28,1
HCPCS,72080TC,X-RAY EXAM THORACOLMB 2/> VW,,,24.28,24.28,1
HCPCS,72081,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,760.0,494.0,12.21,874.0,192
HCPCS,72081,X-RAY EXAM ENTIRE SPI 1 VW,,,29.85,29.85,2
HCPCS,720810,X-RAY EXAM ENTIRE SPI 1 VW,,,29.85,29.85,1
HCPCS,72081TC,X-RAY EXAM ENTIRE SPI 1 VW,,,29.85,29.85,1
HCPCS,72082,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,918.0,596.7,15.05,1054.0,192
HCPCS,72082,X-RAY EXAM ENTIRE SPI 2/3 VW,,,54.41,54.41,2
HCPCS,720820,X-RAY EXAM ENTIRE SPI 2/3 VW,,,54.41,54.41,1
HCPCS,72082TC,X-RAY EXAM ENTIRE SPI 2/3 VW,,,54.41,54.41,1
HCPCS,72083,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,918.0,596.7,16.74,1072.0,192
HCPCS,72083,X-RAY EXAM ENTIRE SPI 4/5 VW,,,61.29,61.29,2
HCPCS,720830,X-RAY EXAM ENTIRE SPI 4/5 VW,,,61.29,61.29,1
HCPCS,72083TC,X-RAY EXAM ENTIRE SPI 4/5 VW,,,61.29,61.29,1
HCPCS,72084,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,918.0,596.7,19.9,1098.0,192
HCPCS,72084,X-RAY EXAM ENTIRE SPI 6/> VW,,,77.71,77.71,2
HCPCS,720840,X-RAY EXAM ENTIRE SPI 6/> VW,,,77.71,77.71,1
HCPCS,72084TC,X-RAY EXAM ENTIRE SPI 6/> VW,,,77.71,77.71,1
HCPCS,72100,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,918.0,596.7,10.09,1015.0,147
HCPCS,72100,X-RAY EXAM L-S SPINE 2/3 VWS,,,28.87,28.87,2
HCPCS,72100,XRAY LUMBOSACRAL AP LAT,918.0,596.7,25.6,1015.0,96
HCPCS,721000,X-RAY EXAM L-S SPINE 2/3 VWS,,,28.87,28.87,1
HCPCS,72100TC,X-RAY EXAM L-S SPINE 2/3 VWS,,,28.87,28.87,1
HCPCS,72110,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,918.0,596.7,12.53,1032.0,147
HCPCS,72110,X-RAY EXAM L-2 SPINE 4/>VWS,,,39.02,39.02,2
HCPCS,72110,XRAY LUMBOSACRAL COMP,918.0,596.7,35.54,1032.0,96
HCPCS,721100,X-RAY EXAM L-2 SPINE 4/>VWS,,,39.02,39.02,1
HCPCS,72110TC,X-RAY EXAM L-2 SPINE 4/>VWS,,,39.02,39.02,1
HCPCS,72114,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,918.0,596.7,14.72,1050.0,147
HCPCS,72114,X-RAY EXAM L-S SPINE BENDING,,,46.22,46.22,2
HCPCS,72114,XRAY LUMBOSAC BENDING,591.0,384.15,44.3,1050.0,64
HCPCS,721140,X-RAY EXAM L-S SPINE BENDING,,,46.22,46.22,1
HCPCS,72114TC,X-RAY EXAM L-S SPINE BENDING,,,46.22,46.22,1
HCPCS,72120,CT CERV SPINE WO CONTRAST,1015.0,659.75,31.09,1015.0,32
HCPCS,72120,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,918.0,596.7,10.38,1015.0,147
HCPCS,72120,X-RAY BEND ONLY L-S SPINE,,,29.52,29.52,2
HCPCS,72120,XRAY LUMBOSAC BEND COMPL,507.5,329.875,31.09,918.0,64
HCPCS,721200,X-RAY BEND ONLY L-S SPINE,,,29.52,29.52,1
HCPCS,72120TC,X-RAY BEND ONLY L-S SPINE,,,29.52,29.52,1
HCPCS,72125,CT CERV SPINE WO CONTRAST,899.0,584.35,121.11,1358.0,64
HCPCS,72125,CT CERVICAL SPINE W/O CONTRAST MATERIAL,918.0,596.7,44.18,1746.0,196
HCPCS,72125,CT NECK SPINE W/O DYE,,,89.46,89.46,2
HCPCS,721250,CT NECK SPINE W/O DYE,,,89.46,89.46,1
HCPCS,72125TC,CT NECK SPINE W/O DYE,,,89.46,89.46,1
HCPCS,72126,CT CERV SPINE W CONTRAST,488.0,317.2,157.69,488.0,32
HCPCS,72126,CT CERV SPINE WO CONTRAST,3568.0,2319.2,157.69,3568.0,32
HCPCS,72126,CT CERVICAL SPINE W/CONTRAST MATERIAL,3080.0,2002.0,50.71,3568.0,147
HCPCS,72126,CT NECK SPINE W/DYE,,,119.76,119.76,2
HCPCS,721260,CT NECK SPINE W/DYE,,,119.76,119.76,1
HCPCS,72126TC,CT NECK SPINE W/DYE,,,119.76,119.76,1
HCPCS,72127,CT CERV SPINE W WO CONTR,508.0,330.2,184.31,508.0,32
HCPCS,72127,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,1535.0,997.75,52.41,2043.0,147
HCPCS,72127,CT NECK SPINE W/O & W/DYE,,,147.96,147.96,2
HCPCS,72127,CT THORACIC SPINE WO CONTR,2043.0,1327.95,184.31,2043.0,32
HCPCS,721270,CT NECK SPINE W/O & W/DYE,,,147.96,147.96,1
HCPCS,72127TC,CT NECK SPINE W/O & W/DYE,,,147.96,147.96,1
HCPCS,72128,CT CHEST SPINE W/O DYE,,,89.11,89.11,2
HCPCS,72128,CT THORACIC SPINE W CONTR,1318.0,856.7,121.11,1318.0,32
HCPCS,72128,CT THORACIC SPINE W/O CONTRAST MATERIAL,918.0,596.7,41.62,1746.0,147
HCPCS,72128,CT THORACIC SPINE WO CONTR,400.0,260.0,121.11,400.0,32
HCPCS,721280,CT CHEST SPINE W/O DYE,,,89.11,89.11,1
HCPCS,72128TC,CT CHEST SPINE W/O DYE,,,89.11,89.11,1
HCPCS,72129,CT CHEST SPINE W/DYE,,,120.8,120.8,2
HCPCS,72129,CT THOR SPINE W WO CONTR,2023.0,1314.95,158.92,2023.0,32
HCPCS,72129,CT THORACIC SPINE W CONTR,488.0,317.2,158.92,488.0,32
HCPCS,72129,CT THORACIC SPINE W/CONTRAST MATERIAL,1535.0,997.75,50.71,2023.0,147
HCPCS,721290,CT CHEST SPINE W/DYE,,,120.8,120.8,1
HCPCS,72129TC,CT CHEST SPINE W/DYE,,,120.8,120.8,1
HCPCS,72130,CT CHEST SPINE W/O & W/DYE,,,149.0,149.0,2
HCPCS,72130,CT THOR SPINE W WO CONTR,508.0,330.2,186.07,508.0,32
HCPCS,72130,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,1535.0,997.75,52.7,2043.0,147
HCPCS,721300,CT CHEST SPINE W/O & W/DYE,,,149.0,149.0,1
HCPCS,72130TC,CT CHEST SPINE W/O & W/DYE,,,149.0,149.0,1
HCPCS,72131,CT LUMBAR SPINE W/O CONTRAST MATERIAL,918.0,596.7,41.62,1746.0,147
HCPCS,72131,CT LUMBAR SPINE W/O DYE,,,88.42,88.42,2
HCPCS,72131,CT LUMBAR SPINE WO CONTR,899.0,584.35,120.52,1358.0,64
HCPCS,721310,CT LUMBAR SPINE W/O DYE,,,88.42,88.42,1
HCPCS,72131TC,CT LUMBAR SPINE W/O DYE,,,88.42,88.42,1
HCPCS,72132,CT LUMBAR SPINE W CONTRAST,2077.0,1350.0500000000002,157.99,3617.0,64
HCPCS,72132,CT LUMBAR SPINE W/CONTRAST MATERIAL,3080.0,2002.0,50.71,3617.0,147
HCPCS,72132,CT LUMBAR SPINE W/DYE,,,120.11,120.11,2
HCPCS,721320,CT LUMBAR SPINE W/DYE,,,120.11,120.11,1
HCPCS,72132TC,CT LUMBAR SPINE W/DYE,,,120.11,120.11,1
HCPCS,72133,CT LUMBAR SPINE W WO CONT,1326.5,862.2249999999999,184.89,2094.0,64
HCPCS,72133,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,1535.0,997.75,52.7,2094.0,147
HCPCS,72133,CT LUMBAR SPINE W/O & W/DYE,,,148.31,148.31,2
HCPCS,721330,CT LUMBAR SPINE W/O & W/DYE,,,148.31,148.31,1
HCPCS,72133TC,CT LUMBAR SPINE W/O & W/DYE,,,148.31,148.31,1
HCPCS,72141,MRI CER SPINE CANAL WO CONT,1693.5,1100.775,179.08,2736.0,64
HCPCS,72141,MRI NECK SPINE W/O DYE,,,134.5,134.5,2
HCPCS,72141,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,2085.0,1355.25,66.76,2736.0,147
HCPCS,721410,MRI NECK SPINE W/O DYE,,,134.5,134.5,1
HCPCS,72141TC,MRI NECK SPINE W/O DYE,,,134.5,134.5,1
HCPCS,72142,MRI CER SPINE CANAL W CONT,2323.0,1509.9499999999998,257.86,3863.0,64
HCPCS,72142,MRI NECK SPINE W/DYE,,,211.66,211.66,2
HCPCS,72142,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,3080.0,2002.0,79.97,3863.0,147
HCPCS,721420,MRI NECK SPINE W/DYE,,,211.66,211.66,1
HCPCS,72142TC,MRI NECK SPINE W/DYE,,,211.66,211.66,1
HCPCS,72146,MRI CHEST SPINE W/O DYE,,,134.15,134.15,2
HCPCS,72146,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,2085.0,1355.25,66.76,2736.0,147
HCPCS,72146,MRI THOR SPINE CANAL WO CO,1693.5,1100.775,179.08,2736.0,64
HCPCS,721460,MRI CHEST SPINE W/O DYE,,,134.15,134.15,1
HCPCS,72146TC,MRI CHEST SPINE W/O DYE,,,134.15,134.15,1
HCPCS,72147,MRI CHEST SPINE W/DYE,,,209.54,209.54,2
HCPCS,72147,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,3080.0,2002.0,79.97,3863.0,147
HCPCS,72147,MRI THOR SPINE CANAL W CONT,3863.0,2510.95,255.45,3863.0,32
HCPCS,72147,MRI THORACIS SPINE W CONTRAST,783.0,508.95,255.45,783.0,32
HCPCS,721470,MRI CHEST SPINE W/DYE,,,209.54,209.54,1
HCPCS,72147TC,MRI CHEST SPINE W/DYE,,,209.54,209.54,1
HCPCS,72148,MRI LUMB SPINE CANAL WO CO,1634.5,1062.425,178.94,2677.0,64
HCPCS,72148,MRI LUMBAR SPINE W/O DYE,,,134.86,134.86,2
HCPCS,72148,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,2085.0,1355.25,62.22,2677.0,147
HCPCS,721480,MRI LUMBAR SPINE W/O DYE,,,134.86,134.86,1
HCPCS,72148TC,MRI LUMBAR SPINE W/O DYE,,,134.86,134.86,1
HCPCS,72149,MRI LUMB SPINE CANAL W CONT,2252.0,1463.8000000000002,254.01,3792.0,64
HCPCS,72149,MRI LUMBAR SPINE W/DYE,,,206.71,206.71,2
HCPCS,72149,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,3080.0,2002.0,74.58,3792.0,147
HCPCS,721490,MRI LUMBAR SPINE W/DYE,,,206.71,206.71,1
HCPCS,72149TC,MRI LUMBAR SPINE W/DYE,,,206.71,206.71,1
HCPCS,72156,MRI CERV SP W/WO CONTRAST,4088.0,2657.2,301.16,4088.0,32
HCPCS,72156,MRI NECK SPINE W/O & W/DYE,,,235.36,235.36,2
HCPCS,72156,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,3080.0,2002.0,107.1,4088.0,147
HCPCS,72156,MRI SPINE CANAL W WO CONT,1008.0,655.2,301.16,1008.0,32
HCPCS,721560,MRI NECK SPINE W/O & W/DYE,,,235.36,235.36,1
HCPCS,72156TC,MRI NECK SPINE W/O & W/DYE,,,235.36,235.36,1
HCPCS,72157,MRI CHEST SPINE W/O & W/DYE,,,236.07,236.07,2
HCPCS,72157,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,3080.0,2002.0,107.1,3996.0,147
HCPCS,72157,MRI THOR SPINE W WO CONTR,2456.0,1596.4,301.75,3996.0,64
HCPCS,721570,MRI CHEST SPINE W/O & W/DYE,,,236.07,236.07,1
HCPCS,72157TC,MRI CHEST SPINE W/O & W/DYE,,,236.07,236.07,1
HCPCS,72158,MRI LMBR SPINE W WO CONTR,916.0,595.4,300.57,916.0,32
HCPCS,72158,MRI LUMB SPINE W WO CONTR,3996.0,2597.4,300.57,3996.0,32
HCPCS,72158,MRI LUMBAR SPINE W/O & W/DYE,,,234.65,234.65,2
HCPCS,72158,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,3080.0,2002.0,99.15,3996.0,147
HCPCS,721580,MRI LUMBAR SPINE W/O & W/DYE,,,234.65,234.65,1
HCPCS,72158TC,MRI LUMBAR SPINE W/O & W/DYE,,,234.65,234.65,1
HCPCS,72159,MR ANGIO SPINE (MRA),3835.0,2492.75,73.15,4555.0,98
HCPCS,72159,MR ANGIO SPINE W/O&W/DYE,,,287.76,287.76,2
HCPCS,72159,MRA SPINAL CANAL WO/W,3835.0,2492.75,285.23,3451.5,39
HCPCS,72159,"MRA SPINAL CANAL, CONTENTS W/WO CONTRAST MATERIAL",3835.0,2492.75,285.23,3451.5,39
HCPCS,72159,MRA SPINAL CANL W/WO CONT,720.0,468.0,323.75,720.0,32
HCPCS,72159,MRA SPINE W/WO CON ANY SITE W/3D,4555.0,2960.75,323.75,4555.0,32
HCPCS,72159,MRA SPINE WITH OR W/O CONT,3835.0,2492.75,73.15,4555.0,98
HCPCS,72159,MRA W/CONTRAST SPINAL CANAL,3835.0,2492.75,285.23,3451.5,39
HCPCS,72159,MRA W/O CONTRAST SPINAL CANAL,3835.0,2492.75,285.23,3451.5,39
HCPCS,72159,MRA WO/W CONTRAST SPINAL CANAL,3835.0,2492.75,73.15,4555.0,98
HCPCS,721590,MR ANGIO SPINE W/O&W/DYE,,,287.76,287.76,1
HCPCS,72159TC,MR ANGIO SPINE W/O&W/DYE,,,287.76,287.76,1
HCPCS,72170,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,918.0,596.7,8.1,993.0,147
HCPCS,72170,X-RAY EXAM OF PELVIS,,,19.36,19.36,2
HCPCS,72170,XRAY PELVIC 1 OR 2 V,918.0,596.7,19.82,918.0,32
HCPCS,72170,XRAY PELVIS 1 OR 2 V,534.0,347.1,19.82,993.0,64
HCPCS,721700,X-RAY EXAM OF PELVIS,,,19.36,19.36,1
HCPCS,72170TC,X-RAY EXAM OF PELVIS,,,19.36,19.36,1
HCPCS,72190,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,918.0,596.7,9.81,1028.0,147
HCPCS,72190,X-RAY EXAM OF PELVIS,,,29.85,29.85,2
HCPCS,72190,XRAY PELVIC COMPLETE,569.0,369.85,26.13,1028.0,64
HCPCS,721900,X-RAY EXAM OF PELVIS,,,29.85,29.85,1
HCPCS,72190TC,X-RAY EXAM OF PELVIS,,,29.85,29.85,1
HCPCS,72191,CT ANGIOGRAPH PELV W/O&W/DYE,,,183.73,183.73,2
HCPCS,72191,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,1535.0,997.75,75.85,2259.0,147
HCPCS,72191,"CT ANGIOGRPHY,PELV WWO CN",724.0,470.6,244.87,724.0,32
HCPCS,72191,"CTA PELVIS W/WO C,INCL 3D",2259.0,1468.35,244.87,2259.0,32
HCPCS,721910,CT ANGIOGRAPH PELV W/O&W/DYE,,,183.73,183.73,1
HCPCS,72191TC,CT ANGIOGRAPH PELV W/O&W/DYE,,,183.73,183.73,1
HCPCS,72192,CT PELVIS W/O CONTRAST MATERIAL,918.0,596.7,44.74,1746.0,147
HCPCS,72192,CT PELVIS W/O DYE,,,88.08,88.08,2
HCPCS,72192,CT PELVIS WO CONTRAST,895.0,581.75,117.19,1354.0,64
HCPCS,721920,CT PELVIS W/O DYE,,,88.08,88.08,1
HCPCS,72192TC,CT PELVIS W/O DYE,,,88.08,88.08,1
HCPCS,72193,CT PELVIS W CONTRAST,1277.5,830.375,181.38,2045.0,64
HCPCS,72193,CT PELVIS W/CONTRAST MATERIAL,1535.0,997.75,48.44,2045.0,147
HCPCS,72193,CT PELVIS W/DYE,,,184.08,184.08,2
HCPCS,721930,CT PELVIS W/DYE,,,184.08,184.08,1
HCPCS,72193TC,CT PELVIS W/DYE,,,184.08,184.08,1
HCPCS,72194,CT PELVIS W WO CONTRAST,1304.5,847.925,211.86,2072.0,64
HCPCS,72194,CT PELVIS W/O & W/CONTRAST MATERIAL,1535.0,997.75,50.71,2072.0,147
HCPCS,72194,CT PELVIS W/O & W/DYE,,,184.08,184.08,2
HCPCS,721940,CT PELVIS W/O & W/DYE,,,184.08,184.08,1
HCPCS,72194TC,CT PELVIS W/O & W/DYE,,,184.08,184.08,1
HCPCS,72195,MRI PELVIS W/O CONTRAST MATERIAL,2085.0,1355.25,61.37,2727.0,188
HCPCS,72195,MRI PELVIS W/O DYE,,,177.3,177.3,2
HCPCS,72195,"MRI, PELVIS; WO CONTRAST",642.0,417.3,215.14,642.0,32
HCPCS,72195,"MRI,PELVIS; WO CONTRAST",2727.0,1772.55,215.14,2727.0,32
HCPCS,721950,MRI PELVIS W/O DYE,,,177.3,177.3,1
HCPCS,72195TC,MRI PELVIS W/O DYE,,,177.3,177.3,1
HCPCS,72196,MRI PELVIS W CONT,761.0,494.65,252.69,761.0,32
HCPCS,72196,MRI PELVIS W/CONTRAST,3841.0,2496.65,252.69,3841.0,32
HCPCS,72196,MRI PELVIS W/CONTRAST MATERIAL,3080.0,2002.0,72.16,3841.0,188
HCPCS,72196,MRI PELVIS W/DYE,,,207.41,207.41,2
HCPCS,721960,MRI PELVIS W/DYE,,,207.41,207.41,1
HCPCS,72196TC,MRI PELVIS W/DYE,,,207.41,207.41,1
HCPCS,72197,MRI PELVIS W/O & W/CONTRAST MATERIAL,3080.0,2002.0,93.18,4048.0,147
HCPCS,72197,MRI PELVIS W/O & W/DYE,,,258.7,258.7,2
HCPCS,72197,"MRI,PELVIS; W/WO CONTRAST",2508.0,1630.1999999999998,317.3,4048.0,64
HCPCS,721970,MRI PELVIS W/O & W/DYE,,,258.7,258.7,1
HCPCS,72197TC,MRI PELVIS W/O & W/DYE,,,258.7,258.7,1
HCPCS,72198,MR ANGIO PELVIS W/O & W/DYE,,,280.68,280.68,2
HCPCS,72198,MRA PELV W CONTR,7870.0,5115.5,285.23,7083.0,39
HCPCS,72198,MRA PELV W CONTRL,7870.0,5115.5,74.43,8662.0,137
HCPCS,72198,MRA PELV WO CONTR,7870.0,5115.5,285.23,7083.0,39
HCPCS,72198,MRA PELV WO CONTRL,7870.0,5115.5,74.43,8662.0,137
HCPCS,72198,MRA PELV WO/W CONTR,7870.0,5115.5,285.23,7083.0,78
HCPCS,72198,MRA PELVIS W WO CONTRAST,4727.0,3072.55,316.11,8662.0,64
HCPCS,72198,MRA PELVIS W/WO CONTRAST MATERIAL,7870.0,5115.5,74.43,8662.0,98
HCPCS,72198,MRA PELVIS WITH OR W/O CONT,7870.0,5115.5,74.43,8662.0,98
HCPCS,721980,MR ANGIO PELVIS W/O & W/DYE,,,280.68,280.68,1
HCPCS,72198TC,MR ANGIO PELVIS W/O & W/DYE,,,280.68,280.68,1
HCPCS,72200,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,918.0,596.7,7.25,993.0,147
HCPCS,72200,SACROILIAC JOINTS <3VIEWS,75.0,48.75,20.62,75.0,32
HCPCS,72200,X-RAY EXAM SI JOINTS,,,24.94,24.94,2
HCPCS,72200,XRAY SACROILIAC LESS THAN 3 VIEWS,993.0,645.45,20.62,993.0,32
HCPCS,722000,X-RAY EXAM SI JOINTS,,,24.94,24.94,1
HCPCS,72200TC,X-RAY EXAM SI JOINTS,,,24.94,24.94,1
HCPCS,72202,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,918.0,596.7,7.81,1019.0,147
HCPCS,72202,X-RAY EXAM SI JOINTS 3/> VWS,,,28.21,28.21,2
HCPCS,72202,XRAY SACROILIAC 3 VIEW,918.0,596.7,24.07,1019.0,96
HCPCS,722020,X-RAY EXAM SI JOINTS 3/> VWS,,,28.21,28.21,1
HCPCS,72202TC,X-RAY EXAM SI JOINTS 3/> VWS,,,28.21,28.21,1
HCPCS,72220,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,760.0,494.0,7.25,828.0,147
HCPCS,72220,X-RAY EXAM SACRUM TAILBONE,,,23.95,23.95,2
HCPCS,72220,XRAY SACRUM /COCCYX 2 VIEW,760.0,494.0,21.4,828.0,96
HCPCS,722200,X-RAY EXAM SACRUM TAILBONE,,,23.95,23.95,1
HCPCS,72220TC,X-RAY EXAM SACRUM TAILBONE,,,23.95,23.95,1
HCPCS,72240,MYELOGRAPHY CERVICAL RS&I,6814.0,4429.1,37.64,7178.0,147
HCPCS,72240,MYELOGRAPHY NECK SPINE,,,67.83,67.83,2
HCPCS,722400,MYELOGRAPHY NECK SPINE,,,67.83,67.83,1
HCPCS,72240TC,MYELOGRAPHY NECK SPINE,,,67.83,67.83,1
HCPCS,72255,MYELOGRAPHY THORACIC RS&I,6814.0,4429.1,37.5,7178.0,147
HCPCS,72255,MYELOGRAPHY THORACIC SPINE,,,63.9,63.9,2
HCPCS,722550,MYELOGRAPHY THORACIC SPINE,,,63.9,63.9,1
HCPCS,72255TC,MYELOGRAPHY THORACIC SPINE,,,63.9,63.9,1
HCPCS,72265,MYELOGRAPHY L-S SPINE,,,68.49,68.49,2
HCPCS,72265,MYELOGRAPY LUMBOSACRAL RS&I,6814.0,4429.1,34.38,7146.0,147
HCPCS,722650,MYELOGRAPHY L-S SPINE,,,68.49,68.49,1
HCPCS,72265TC,MYELOGRAPHY L-S SPINE,,,68.49,68.49,1
HCPCS,72270,MYELOGPHY 2/> SPINE REGIONS,,,86.83,86.83,2
HCPCS,72270,MYELOGRAPY 2/MORE REGIONS RS&I,6814.0,4429.1,55.26,7346.0,147
HCPCS,722700,MYELOGPHY 2/> SPINE REGIONS,,,86.83,86.83,1
HCPCS,72270TC,MYELOGPHY 2/> SPINE REGIONS,,,86.83,86.83,1
HCPCS,72275,Epidurography,,,136.83,172.84,6
HCPCS,72285,DISCOGRAPHY CERV/THOR SPINE,,,75.7,75.7,2
HCPCS,72285,DISKOGRAPY CERVICAL/THORACIC RS&I,16843.0,10947.95,49.6,17307.0,147
HCPCS,722850,DISCOGRAPHY CERV/THOR SPINE,,,75.7,75.7,1
HCPCS,72285TC,DISCOGRAPHY CERV/THOR SPINE,,,75.7,75.7,1
HCPCS,72295,DISKOGRAPY LUMBAR RS&I,16843.0,10947.95,36.1,17175.0,147
HCPCS,72295,X-RAY OF LOWER SPINE DISK,,,71.12,71.12,2
HCPCS,722950,X-RAY OF LOWER SPINE DISK,,,71.12,71.12,1
HCPCS,72295TC,X-RAY OF LOWER SPINE DISK,,,71.12,71.12,1
HCPCS,73000,RADEX CLAVICLE COMPLETE,760.0,494.0,6.96,824.0,147
HCPCS,73000,X-RAY EXAM OF COLLAR BONE,,,24.28,24.28,2
HCPCS,73000,XRAY CLAVICLE COMPLETE,760.0,494.0,20.17,824.0,96
HCPCS,730000,X-RAY EXAM OF COLLAR BONE,,,24.28,24.28,1
HCPCS,73000TC,X-RAY EXAM OF COLLAR BONE,,,24.28,24.28,1
HCPCS,73010,RADEX SCAPULA COMPLETE,918.0,596.7,8.39,993.0,147
HCPCS,73010,X-RAY EXAM OF SHOULDER BLADE,,,15.11,15.11,2
HCPCS,73010,XRAY SCAPULA COMPLETE,918.0,596.7,19.63,993.0,96
HCPCS,730100,X-RAY EXAM OF SHOULDER BLADE,,,15.11,15.11,1
HCPCS,73010TC,X-RAY EXAM OF SHOULDER BLADE,,,15.11,15.11,1
HCPCS,73020,RADEX SHOULDER 1 VIEW,760.0,494.0,6.39,826.0,147
HCPCS,73020,X-RAY EXAM OF SHOULDER,,,14.13,14.13,2
HCPCS,73020,XRAY SHOULDER 1 VIEW,760.0,494.0,17.72,826.0,96
HCPCS,730200,X-RAY EXAM OF SHOULDER,,,14.13,14.13,1
HCPCS,73020TC,X-RAY EXAM OF SHOULDER,,,14.13,14.13,1
HCPCS,73030,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,760.0,494.0,8.67,839.0,147
HCPCS,73030,X-RAY EXAM OF SHOULDER,,,25.59,25.59,2
HCPCS,73030,XRAY SHOULDER COMPLETE,760.0,494.0,21.72,839.0,96
HCPCS,730300,X-RAY EXAM OF SHOULDER,,,25.59,25.59,1
HCPCS,73030TC,X-RAY EXAM OF SHOULDER,,,25.59,25.59,1
HCPCS,73040,CONTRAST X-RAY OF SHOULDER,,,103.54,103.54,2
HCPCS,73040,RADEX SHOULDER ARTHROGRAPHY RS&I,3080.0,2002.0,23.3,3318.0,147
HCPCS,730400,CONTRAST X-RAY OF SHOULDER,,,103.54,103.54,1
HCPCS,73040TC,CONTRAST X-RAY OF SHOULDER,,,103.54,103.54,1
HCPCS,73050,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,760.0,494.0,8.98,839.0,147
HCPCS,73050,X-RAY EXAM OF SHOULDERS,,,19.7,19.7,2
HCPCS,73050,XRAY AC JOINTS BILATERAL,459.0,298.35,24.41,839.0,64
HCPCS,730500,X-RAY EXAM OF SHOULDERS,,,19.7,19.7,1
HCPCS,73050TC,X-RAY EXAM OF SHOULDERS,,,19.7,19.7,1
HCPCS,73060,RADEX HUMERUS MINIMUM 2 VIEWS,760.0,494.0,7.25,824.0,196
HCPCS,73060,X-RAY EXAM OF HUMERUS,,,23.95,23.95,2
HCPCS,73060,XRAY HUMEROUS 2 VIEW,760.0,494.0,21.4,824.0,96
HCPCS,730600,X-RAY EXAM OF HUMERUS,,,23.95,23.95,1
HCPCS,73060TC,X-RAY EXAM OF HUMERUS,,,23.95,23.95,1
HCPCS,73070,RADEX ELBOW 2 VIEWS,760.0,494.0,6.68,824.0,196
HCPCS,73070,X-RAY EXAM OF ELBOW,,,21.01,21.01,2
HCPCS,73070,XRAY ELBOW AP LAT,760.0,494.0,19.3,824.0,96
HCPCS,730700,X-RAY EXAM OF ELBOW,,,21.01,21.01,1
HCPCS,73070TC,X-RAY EXAM OF ELBOW,,,21.01,21.01,1
HCPCS,73080,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,760.0,494.0,7.25,828.0,147
HCPCS,73080,X-RAY EXAM OF ELBOW,,,24.28,24.28,2
HCPCS,73080,XRAY ELBOW COMPLETE,760.0,494.0,21.4,828.0,96
HCPCS,730800,X-RAY EXAM OF ELBOW,,,24.28,24.28,1
HCPCS,73080TC,X-RAY EXAM OF ELBOW,,,24.28,24.28,1
HCPCS,73085,CONTRAST X-RAY OF ELBOW,,,73.41,73.41,2
HCPCS,73085,RADEX ELBOW ARTHROGRAPHY RS&I,3080.0,2002.0,23.45,3296.0,196
HCPCS,730850,CONTRAST X-RAY OF ELBOW,,,73.41,73.41,1
HCPCS,73085TC,CONTRAST X-RAY OF ELBOW,,,73.41,73.41,1
HCPCS,73090,RADEX FOREARM 2 VIEWS,760.0,494.0,6.68,824.0,147
HCPCS,73090,X-RAY EXAM OF FOREARM,,,21.33,21.33,2
HCPCS,73090,XRAY FOREARM AP LAT,760.0,494.0,19.56,824.0,96
HCPCS,730900,X-RAY EXAM OF FOREARM,,,21.33,21.33,1
HCPCS,73090TC,X-RAY EXAM OF FOREARM,,,21.33,21.33,1
HCPCS,73092,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,918.0,596.7,6.68,982.0,147
HCPCS,73092,X-RAY EXAM OF ARM INFANT,,,23.62,23.62,2
HCPCS,73092,XRAY UPPER EXT INFANT,491.0,319.15000000000003,19.36,918.0,64
HCPCS,730920,X-RAY EXAM OF ARM INFANT,,,23.62,23.62,1
HCPCS,73092TC,X-RAY EXAM OF ARM INFANT,,,23.62,23.62,1
HCPCS,73100,RADEX WRIST 2 VIEWS,760.0,494.0,8.01,824.0,196
HCPCS,73100,X-RAY EXAM OF WRIST,,,25.59,25.59,2
HCPCS,73100,XRAY WRIST AP LAT,444.0,288.6,19.36,824.0,64
HCPCS,73100,XRAY WRIST APLAT,760.0,494.0,19.36,760.0,32
HCPCS,731000,X-RAY EXAM OF WRIST,,,25.59,25.59,1
HCPCS,73100TC,X-RAY EXAM OF WRIST,,,25.59,25.59,1
HCPCS,73110,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,760.0,494.0,7.25,835.0,196
HCPCS,73110,X-RAY EXAM OF WRIST,,,32.46,32.46,2
HCPCS,73110,XRAY WRIST COMPLETE,760.0,494.0,20.24,835.0,96
HCPCS,731100,X-RAY EXAM OF WRIST,,,32.46,32.46,1
HCPCS,73110TC,X-RAY EXAM OF WRIST,,,32.46,32.46,1
HCPCS,73115,CONTRAST X-RAY OF WRIST,,,106.49,106.49,2
HCPCS,73115,RADEX WRIST ARTHROGRAPHY RS&I,3080.0,2002.0,23.88,3296.0,196
HCPCS,731150,CONTRAST X-RAY OF WRIST,,,106.49,106.49,1
HCPCS,73115TC,CONTRAST X-RAY OF WRIST,,,106.49,106.49,1
HCPCS,73120,RADEX HAND 2 VIEWS,918.0,596.7,6.96,982.0,147
HCPCS,73120,X-RAY EXAM OF HAND,,,23.3,23.3,2
HCPCS,73120,XRAY HAND 2 VIEW,918.0,596.7,18.78,982.0,96
HCPCS,731200,X-RAY EXAM OF HAND,,,23.3,23.3,1
HCPCS,73120TC,X-RAY EXAM OF HAND,,,23.3,23.3,1
HCPCS,73130,RADEX HAND MINIMUM 3 VIEWS,760.0,494.0,7.25,835.0,147
HCPCS,73130,X-RAY EXAM OF HAND,,,28.53,28.53,2
HCPCS,73130,XRAY HAND 3 VIEW,760.0,494.0,20.24,835.0,96
HCPCS,731300,X-RAY EXAM OF HAND,,,28.53,28.53,1
HCPCS,73130TC,X-RAY EXAM OF HAND,,,28.53,28.53,1
HCPCS,73140,RADEX FINGR MINIMUM 2 VIEWS,760.0,494.0,5.83,812.0,196
HCPCS,73140,X-RAY EXAM OF FINGER(S),,,31.16,31.16,2
HCPCS,73140,XRAY FINGERS 2 VIEW,760.0,494.0,18.41,812.0,96
HCPCS,731400,X-RAY EXAM OF FINGER(S),,,31.16,31.16,1
HCPCS,73140TC,X-RAY EXAM OF FINGER(S),,,31.16,31.16,1
HCPCS,73200,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,918.0,596.7,42.48,1746.0,147
HCPCS,73200,CT UPPER EXTREMITY W/O DYE,,,110.08,110.08,2
HCPCS,73200,CT UPPER EXTREMITY WO CONT,440.0,286.0,137.17,440.0,32
HCPCS,732000,CT UPPER EXTREMITY W/O DYE,,,110.08,110.08,1
HCPCS,73200TC,CT UPPER EXTREMITY W/O DYE,,,110.08,110.08,1
HCPCS,73201,CT UPPER EXTREMITY W/CONTRAST MATERIAL,3080.0,2002.0,48.44,3590.0,147
HCPCS,73201,CT UPPER EXTREMITY W/DYE,,,156.56,156.56,2
HCPCS,73201,CT UPPER EXTRMT W CNTST,510.0,331.5,178.39,510.0,32
HCPCS,732010,CT UPPER EXTREMITY W/DYE,,,156.56,156.56,1
HCPCS,73201TC,CT UPPER EXTREMITY W/DYE,,,156.56,156.56,1
HCPCS,73202,CT ESTR UPPER L W/WO CONT,537.0,349.05,222.17,537.0,32
HCPCS,73202,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,1535.0,997.75,50.71,2072.0,147
HCPCS,73202,CT UPPR EXTREMITY W/O&W/DYE,,,184.08,184.08,2
HCPCS,732020,CT UPPR EXTREMITY W/O&W/DYE,,,184.08,184.08,1
HCPCS,73202TC,CT UPPR EXTREMITY W/O&W/DYE,,,184.08,184.08,1
HCPCS,73206,CT ANGIO UPR EXTRM W/O&W/DYE,,,183.73,183.73,2
HCPCS,73206,"CT ANGIOGR,UP EXT W/WO CN",724.0,470.6,247.22,724.0,32
HCPCS,73206,CT ANGIOGRAPHY UPPER EXTREMITY,1535.0,997.75,74.43,2259.0,147
HCPCS,73206,"CTA UPPER EXTREMITY W/WO C,INCL 3D",2259.0,1468.35,247.22,2259.0,32
HCPCS,732060,CT ANGIO UPR EXTRM W/O&W/DYE,,,183.73,183.73,1
HCPCS,73206TC,CT ANGIO UPR EXTRM W/O&W/DYE,,,183.73,183.73,1
HCPCS,73218,MRI UP EXTR NON-JOINT WO CONTRAST,2625.0,1706.25,281.72,2625.0,32
HCPCS,73218,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,2085.0,1355.25,55.82,2625.0,147
HCPCS,73218,MRI UPPER EXTREMITY W/O DYE,,,252.34,252.34,2
HCPCS,73218,"MRI,UP EXT-WO JNT-WO CON",540.0,351.0,270.0,540.0,32
HCPCS,732180,MRI UPPER EXTREMITY W/O DYE,,,252.34,252.34,1
HCPCS,73218TC,MRI UPPER EXTREMITY W/O DYE,,,252.34,252.34,1
HCPCS,73219,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,3080.0,2002.0,67.61,3728.0,147
HCPCS,73219,MRI UPPER EXTREMITY W/DYE,,,281.34,281.34,2
HCPCS,73219,"MRI,UP EXT-NON JOINT W/C",3728.0,2423.2,311.4,3728.0,32
HCPCS,73219,"MRI,UP EXT-WO JNT-W/CON",648.0,421.2,311.4,648.0,32
HCPCS,732190,MRI UPPER EXTREMITY W/DYE,,,281.34,281.34,1
HCPCS,73219TC,MRI UPPER EXTREMITY W/DYE,,,281.34,281.34,1
HCPCS,73220,MRI UP EXT NONJOINT W/WO CONTRAST,3940.0,2561.0,341.11,3940.0,32
HCPCS,73220,MRI UPEST WO JNT W/WO CON,860.0,559.0,341.11,860.0,32
HCPCS,73220,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,3080.0,2002.0,89.21,3940.0,147
HCPCS,73220,MRI UPPR EXTREMITY W/O&W/DYE,,,340.76,340.76,2
HCPCS,732200,MRI UPPR EXTREMITY W/O&W/DYE,,,340.76,340.76,1
HCPCS,73220TC,MRI UPPR EXTREMITY W/O&W/DYE,,,340.76,340.76,1
HCPCS,73221,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,2085.0,1355.25,57.39,2625.0,147
HCPCS,73221,MRI JOINT UPR EXTREM W/O DYE,,,153.95,153.95,2
HCPCS,73221,MRI UP EXTREM JOINT W/O CONTRAST,2625.0,1706.25,189.31,2625.0,32
HCPCS,73221,MRI UPPER EXT JNT WO CON,540.0,351.0,189.31,540.0,32
HCPCS,732210,MRI JOINT UPR EXTREM W/O DYE,,,153.95,153.95,1
HCPCS,73221TC,MRI JOINT UPR EXTREM W/O DYE,,,153.95,153.95,1
HCPCS,73222,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,6814.0,4429.1,67.61,7462.0,147
HCPCS,73222,MRI JOINT UPR EXTREM W/DYE,,,261.18,261.18,2
HCPCS,73222,"MRI,UPPER EXT JNT-W/CON",648.0,421.2,293.68,648.0,32
HCPCS,73222,"MRI,UPPER EXT JOINT W/CONTRAST",7462.0,4850.3,293.68,7462.0,32
HCPCS,732220,MRI JOINT UPR EXTREM W/DYE,,,261.18,261.18,1
HCPCS,73222TC,MRI JOINT UPR EXTREM W/DYE,,,261.18,261.18,1
HCPCS,73223,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,3080.0,2002.0,89.21,3940.0,147
HCPCS,73223,MRI JOINT UPR EXTR W/O&W/DYE,,,315.65,315.65,2
HCPCS,73223,"MRI,UP EXT JNT-W/WO CON",2400.0,1560.0,364.13,3940.0,64
HCPCS,732230,MRI JOINT UPR EXTR W/O&W/DYE,,,315.65,315.65,1
HCPCS,73223TC,MRI JOINT UPR EXTR W/O&W/DYE,,,315.65,315.65,1
HCPCS,73225,MR ANGIO UPPER EXTREM,5360.0,3484.0,70.02,6052.0,98
HCPCS,73225,MR ANGIO UPR EXTR W/O&W/DYE,,,287.76,287.76,2
HCPCS,73225,MRA UP EXT W AND/OR W/O CONTRAST,6052.0,3933.8,320.62,6052.0,32
HCPCS,73225,MRA UPPER EXT W CONT,5360.0,3484.0,285.23,4824.0,39
HCPCS,73225,MRA UPPER EXT W/OR/WO CON,692.0,449.8,320.62,692.0,32
HCPCS,73225,MRA UPPER EXT WO CONT,5360.0,3484.0,70.02,6052.0,137
HCPCS,73225,MRA UPPER EXT WO/W CONT,5360.0,3484.0,285.23,4824.0,39
HCPCS,73225,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,5360.0,3484.0,70.02,6052.0,98
HCPCS,732250,MR ANGIO UPR EXTR W/O&W/DYE,,,287.76,287.76,1
HCPCS,73225TC,MR ANGIO UPR EXTR W/O&W/DYE,,,287.76,287.76,1
HCPCS,73501,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,760.0,494.0,8.98,839.0,241
HCPCS,73501,X-RAY EXAM HIP UNI 1 VIEW,,,23.62,23.62,2
HCPCS,735010,X-RAY EXAM HIP UNI 1 VIEW,,,23.62,23.62,1
HCPCS,73501TC,X-RAY EXAM HIP UNI 1 VIEW,,,23.62,23.62,1
HCPCS,73502,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,760.0,494.0,10.59,857.0,241
HCPCS,73502,X-RAY EXAM HIP UNI 2-3 VIEWS,,,36.4,36.4,2
HCPCS,735020,X-RAY EXAM HIP UNI 2-3 VIEWS,,,36.4,36.4,1
HCPCS,73502TC,X-RAY EXAM HIP UNI 2-3 VIEWS,,,36.4,36.4,1
HCPCS,73503,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,918.0,596.7,13.43,1037.0,241
HCPCS,73503,X-RAY EXAM HIP UNI 4/> VIEWS,,,46.22,46.22,2
HCPCS,735030,X-RAY EXAM HIP UNI 4/> VIEWS,,,46.22,46.22,1
HCPCS,73503TC,X-RAY EXAM HIP UNI 4/> VIEWS,,,46.22,46.22,1
HCPCS,73521,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,918.0,596.7,10.59,1006.0,192
HCPCS,73521,X-RAY EXAM HIPS BI 2 VIEWS,,,30.18,30.18,2
HCPCS,735210,X-RAY EXAM HIPS BI 2 VIEWS,,,30.18,30.18,1
HCPCS,73521TC,X-RAY EXAM HIPS BI 2 VIEWS,,,30.18,30.18,1
HCPCS,73522,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,918.0,596.7,13.83,1046.0,192
HCPCS,73522,X-RAY EXAM HIPS BI 3-4 VIEWS,,,39.34,39.34,2
HCPCS,735220,X-RAY EXAM HIPS BI 3-4 VIEWS,,,39.34,39.34,1
HCPCS,73522TC,X-RAY EXAM HIPS BI 3-4 VIEWS,,,39.34,39.34,1
HCPCS,73523,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,918.0,596.7,15.05,1042.0,192
HCPCS,73523,X-RAY EXAM HIPS BI 5/> VIEWS,,,46.22,46.22,2
HCPCS,735230,X-RAY EXAM HIPS BI 5/> VIEWS,,,46.22,46.22,1
HCPCS,73523TC,X-RAY EXAM HIPS BI 5/> VIEWS,,,46.22,46.22,1
HCPCS,73525,ARTHROGRAPHY HIP,216.0,140.4,77.34,216.0,32
HCPCS,73525,CONTRAST X-RAY OF HIP,,,99.28,99.28,2
HCPCS,73525,RADEX HIP ARTHROGRAPHY RS&I,3080.0,2002.0,24.16,3296.0,147
HCPCS,735250,CONTRAST X-RAY OF HIP,,,99.28,99.28,1
HCPCS,73525TC,CONTRAST X-RAY OF HIP,,,99.28,99.28,1
HCPCS,73551,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,760.0,494.0,8.01,824.0,290
HCPCS,73551,X-RAY EXAM OF FEMUR 1,,,21.01,21.01,2
HCPCS,735510,X-RAY EXAM OF FEMUR 1,,,21.01,21.01,1
HCPCS,73551TC,X-RAY EXAM OF FEMUR 1,,,21.01,21.01,1
HCPCS,73552,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,760.0,494.0,8.65,839.0,241
HCPCS,73552,X-RAY EXAM OF FEMUR 2/>,,,26.57,26.57,2
HCPCS,735520,X-RAY EXAM OF FEMUR 2/>,,,26.57,26.57,1
HCPCS,73552TC,X-RAY EXAM OF FEMUR 2/>,,,26.57,26.57,1
HCPCS,73560,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,760.0,494.0,8.01,830.0,196
HCPCS,73560,X-RAY EXAM OF KNEE 1 OR 2,,,25.92,25.92,2
HCPCS,73560,XRAY KNEE 1 OR 2 VIEWS,760.0,494.0,19.87,830.0,96
HCPCS,735600,X-RAY EXAM OF KNEE 1 OR 2,,,25.92,25.92,1
HCPCS,73560TC,X-RAY EXAM OF KNEE 1 OR 2,,,25.92,25.92,1
HCPCS,73562,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,760.0,494.0,8.67,839.0,196
HCPCS,73562,X-RAY EXAM OF KNEE 3,,,31.48,31.48,2
HCPCS,73562,XRAY KNEE AP LAT OBLQ 3VWS,760.0,494.0,22.57,839.0,96
HCPCS,735620,X-RAY EXAM OF KNEE 3,,,31.48,31.48,1
HCPCS,73562TC,X-RAY EXAM OF KNEE 3,,,31.48,31.48,1
HCPCS,73564,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,918.0,596.7,10.38,1015.0,245
HCPCS,73564,X-RAY EXAM KNEE 4 OR MORE,,,35.74,35.74,2
HCPCS,73564,XRAY KNEE COMPLETE,556.0,361.4,25.38,1015.0,64
HCPCS,735640,X-RAY EXAM KNEE 4 OR MORE,,,35.74,35.74,1
HCPCS,73564TC,X-RAY EXAM KNEE 4 OR MORE,,,35.74,35.74,1
HCPCS,73565,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,760.0,494.0,8.33,824.0,147
HCPCS,73565,X-RAY BILATERAL KNEES STANDING,824.0,535.6,19.89,824.0,32
HCPCS,73565,X-RAY EXAM OF KNEES,,,31.48,31.48,2
HCPCS,73565,XRAY KNEES STANDING,760.0,494.0,19.89,824.0,96
HCPCS,735650,X-RAY EXAM OF KNEES,,,31.48,31.48,1
HCPCS,73565TC,X-RAY EXAM OF KNEES,,,31.48,31.48,1
HCPCS,73580,CONTRAST X-RAY OF KNEE JOINT,,,78.97,78.97,2
HCPCS,73580,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,3080.0,2002.0,24.88,3340.0,196
HCPCS,735800,CONTRAST X-RAY OF KNEE JOINT,,,78.97,78.97,1
HCPCS,73580TC,CONTRAST X-RAY OF KNEE JOINT,,,78.97,78.97,1
HCPCS,73590,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,760.0,494.0,7.25,824.0,196
HCPCS,73590,X-RAY EXAM OF LOWER LEG,,,23.62,23.62,2
HCPCS,73590,XRAY TIBIA/FIBULA AP LAT,444.0,288.6,19.82,824.0,64
HCPCS,73590,XRAY TINIA/FIBULA AP LAT,760.0,494.0,19.82,760.0,32
HCPCS,735900,X-RAY EXAM OF LOWER LEG,,,23.62,23.62,1
HCPCS,73590TC,X-RAY EXAM OF LOWER LEG,,,23.62,23.62,1
HCPCS,73592,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,760.0,494.0,6.96,830.0,147
HCPCS,73592,X-RAY EXAM OF LEG INFANT,,,23.62,23.62,2
HCPCS,73592,XRAY LOWER EXTREM INFANT,415.0,269.75,19.36,760.0,64
HCPCS,735920,X-RAY EXAM OF LEG INFANT,,,23.62,23.62,1
HCPCS,73592TC,X-RAY EXAM OF LEG INFANT,,,23.62,23.62,1
HCPCS,73600,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,760.0,494.0,6.96,824.0,196
HCPCS,73600,X-RAY EXAM OF ANKLE,,,24.28,24.28,2
HCPCS,73600,XRAY ANKLE AP LAT,760.0,494.0,19.36,824.0,96
HCPCS,736000,X-RAY EXAM OF ANKLE,,,24.28,24.28,1
HCPCS,73600TC,X-RAY EXAM OF ANKLE,,,24.28,24.28,1
HCPCS,73610,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,760.0,494.0,7.25,835.0,147
HCPCS,73610,X-RAY EXAM OF ANKLE,,,27.89,27.89,2
HCPCS,73610,XRAY ANKLE COMPLETE,760.0,494.0,20.24,835.0,96
HCPCS,736100,X-RAY EXAM OF ANKLE,,,27.89,27.89,1
HCPCS,73610TC,X-RAY EXAM OF ANKLE,,,27.89,27.89,1
HCPCS,73615,CONTRAST X-RAY OF ANKLE,,,99.28,99.28,2
HCPCS,73615,RADEX ANKLE ARTHROGRAPHY RS&I,3080.0,2002.0,24.16,3296.0,147
HCPCS,736150,CONTRAST X-RAY OF ANKLE,,,99.28,99.28,1
HCPCS,73615TC,CONTRAST X-RAY OF ANKLE,,,99.28,99.28,1
HCPCS,73620,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,760.0,494.0,6.39,824.0,147
HCPCS,73620,X-RAY EXAM OF FOOT,,,21.01,21.01,2
HCPCS,73620,XRAY FOOT AP LAT,760.0,494.0,18.78,824.0,96
HCPCS,736200,X-RAY EXAM OF FOOT,,,21.01,21.01,1
HCPCS,73620TC,X-RAY EXAM OF FOOT,,,21.01,21.01,1
HCPCS,73630,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,760.0,494.0,6.96,835.0,147
HCPCS,73630,X-RAY EXAM OF FOOT,,,25.92,25.92,2
HCPCS,73630,XRAY FOOT COMPLETE,760.0,494.0,20.24,835.0,96
HCPCS,736300,X-RAY EXAM OF FOOT,,,25.92,25.92,1
HCPCS,73630TC,X-RAY EXAM OF FOOT,,,25.92,25.92,1
HCPCS,73650,RADEX CALCANEUS MINIMUM 2 VIEWS,760.0,494.0,6.68,824.0,147
HCPCS,73650,X-RAY EXAM OF HEEL,,,20.68,20.68,2
HCPCS,73650,XRAY CALCANEUS 2 VIEW,760.0,494.0,18.87,824.0,96
HCPCS,736500,X-RAY EXAM OF HEEL,,,20.68,20.68,1
HCPCS,73650TC,X-RAY EXAM OF HEEL,,,20.68,20.68,1
HCPCS,73660,RADEX TOE MINIMUM 2 VIEWS,760.0,494.0,5.54,812.0,147
HCPCS,73660,X-RAY EXAM OF TOE(S),,,22.64,22.64,2
HCPCS,73660,XRAY TOE(S) 2 VIEW,760.0,494.0,16.42,812.0,96
HCPCS,736600,X-RAY EXAM OF TOE(S),,,22.64,22.64,1
HCPCS,73660TC,X-RAY EXAM OF TOE(S),,,22.64,22.64,1
HCPCS,73700,CT LOWER EXTREM WO CONTR,440.0,286.0,120.81,440.0,32
HCPCS,73700,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,918.0,596.7,42.19,1746.0,147
HCPCS,73700,CT LOWER EXTREMITY W/O DYE,,,88.77,88.77,2
HCPCS,737000,CT LOWER EXTREMITY W/O DYE,,,88.77,88.77,1
HCPCS,73700TC,CT LOWER EXTREMITY W/O DYE,,,88.77,88.77,1
HCPCS,73701,CT LOWER EXTREM W CONTR,510.0,331.5,155.76,510.0,32
HCPCS,73701,CT LOWER EXTREMITY W/CONTRAST MATERIAL,1535.0,997.75,48.44,2045.0,147
HCPCS,73701,CT LOWER EXTREMITY W/DYE,,,120.45,120.45,2
HCPCS,737010,CT LOWER EXTREMITY W/DYE,,,120.45,120.45,1
HCPCS,73701TC,CT LOWER EXTREMITY W/DYE,,,120.45,120.45,1
HCPCS,73702,CT LOWER EXTREM W/WO CONT,537.0,349.05,182.06,537.0,32
HCPCS,73702,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,1535.0,997.75,50.71,2072.0,147
HCPCS,73702,CT LWR EXTREMITY W/O&W/DYE,,,148.31,148.31,2
HCPCS,737020,CT LWR EXTREMITY W/O&W/DYE,,,148.31,148.31,1
HCPCS,73702TC,CT LWR EXTREMITY W/O&W/DYE,,,148.31,148.31,1
HCPCS,73706,"CT ANGIO LOW EXT,W/WO CON",760.0,494.0,247.22,760.0,32
HCPCS,73706,CT ANGIO LWR EXTR W/O&W/DYE,,,184.12,184.12,2
HCPCS,73706,CT ANGIOGRAPHY LOWER EXTREMITY,1535.0,997.75,79.12,2295.0,147
HCPCS,737060,CT ANGIO LWR EXTR W/O&W/DYE,,,184.12,184.12,1
HCPCS,73706TC,CT ANGIO LWR EXTR W/O&W/DYE,,,184.12,184.12,1
HCPCS,73718,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,2085.0,1355.25,55.96,2679.0,147
HCPCS,73718,MRI LOWER EXTREMITY W/O DYE,,,176.95,176.95,2
HCPCS,73718,"MRI,LOW EXT-NO JNT-WO CON",1636.5,1063.725,209.78,2679.0,64
HCPCS,737180,MRI LOWER EXTREMITY W/O DYE,,,176.95,176.95,1
HCPCS,73718TC,MRI LOWER EXTREMITY W/O DYE,,,176.95,176.95,1
HCPCS,73719,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,3080.0,2002.0,67.61,3793.0,147
HCPCS,73719,MRI LOWER EXTREMITY W/DYE,,,207.06,207.06,2
HCPCS,73719,"MRI,LOW EXT-NO JNT-W/CON",2253.0,1464.4499999999998,246.41,3793.0,64
HCPCS,737190,MRI LOWER EXTREMITY W/DYE,,,207.06,207.06,1
HCPCS,73719TC,MRI LOWER EXTREMITY W/DYE,,,207.06,207.06,1
HCPCS,73720,MRI LOW EXT-NO JNT W/WO,946.0,614.9,317.45,946.0,32
HCPCS,73720,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,3080.0,2002.0,88.92,4026.0,147
HCPCS,73720,MRI LOWER EXTREMITY NONJOINT W/WO C,4026.0,2616.9,317.45,4026.0,32
HCPCS,73720,MRI LWR EXTREMITY W/O&W/DYE,,,261.53,261.53,2
HCPCS,737200,MRI LWR EXTREMITY W/O&W/DYE,,,261.53,261.53,1
HCPCS,73720TC,MRI LWR EXTREMITY W/O&W/DYE,,,261.53,261.53,1
HCPCS,73721,MRI ANY JOINT LOW EXTREMITY WO/CONTRAST,594.0,386.1,189.03,594.0,32
HCPCS,73721,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,2085.0,1355.25,57.39,2679.0,147
HCPCS,73721,MRI JNT OF LWR EXTRE W/O DYE,,,153.61,153.61,2
HCPCS,73721,MRI LOWER EXTREMITY JOINT W/O C,2679.0,1741.35,189.03,2679.0,32
HCPCS,737210,MRI JNT OF LWR EXTRE W/O DYE,,,153.61,153.61,1
HCPCS,73721TC,MRI JNT OF LWR EXTRE W/O DYE,,,153.61,153.61,1
HCPCS,73722,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,6814.0,4429.1,68.33,7527.0,147
HCPCS,73722,MRI JOINT OF LWR EXTR W/DYE,,,261.89,261.89,2
HCPCS,73722,"MRI,LOW EXT JOINT W/CON",4120.0,2678.0,293.98,7527.0,64
HCPCS,737220,MRI JOINT OF LWR EXTR W/DYE,,,261.89,261.89,1
HCPCS,73722TC,MRI JOINT OF LWR EXTR W/DYE,,,261.89,261.89,1
HCPCS,73723,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,3080.0,2002.0,88.92,4026.0,147
HCPCS,73723,MRI JOINT LWR EXTR W/O&W/DYE,,,314.24,314.24,2
HCPCS,73723,"MRI,LOW EXT JNT W&WO CN",2486.0,1615.9,362.96,4026.0,64
HCPCS,737230,MRI JOINT LWR EXTR W/O&W/DYE,,,314.24,314.24,1
HCPCS,73723TC,MRI JOINT LWR EXTR W/O&W/DYE,,,314.24,314.24,1
HCPCS,73725,MR ANG LWR EXT W OR W/O DYE,,,277.5,277.5,2
HCPCS,73725,MR ANGIO LOWER EXTREM (MRA),7508.0,4880.2,75.28,8236.0,98
HCPCS,73725,MRA LOWER EXTREMITY W WO,8236.0,5353.4,313.82,8236.0,32
HCPCS,73725,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,7508.0,4880.2,75.28,8236.0,98
HCPCS,73725,MRA LOWER EXTRM W W/O CNT,728.0,473.2,313.82,728.0,32
HCPCS,73725,MRA LWR EX WO/W,7508.0,4880.2,285.23,6757.2,39
HCPCS,73725,MRA LWR EXT W,7508.0,4880.2,285.23,6757.2,39
HCPCS,73725,MRA LWR EXT W CONTR,7508.0,4880.2,285.23,6757.2,39
HCPCS,73725,MRA LWR EXT W CONTRL,7508.0,4880.2,75.28,8236.0,98
HCPCS,73725,MRA LWR EXT WITH OR W/O CONT,7508.0,4880.2,75.28,8236.0,98
HCPCS,73725,MRA LWR EXT WO,7508.0,4880.2,285.23,6757.2,39
HCPCS,73725,MRA LWR EXT WO CONTR,7508.0,4880.2,285.23,6757.2,39
HCPCS,73725,MRA LWR EXT WO/W CONTR,7508.0,4880.2,285.23,6757.2,39
HCPCS,737250,MR ANG LWR EXT W OR W/O DYE,,,277.5,277.5,1
HCPCS,73725TC,MR ANG LWR EXT W OR W/O DYE,,,277.5,277.5,1
HCPCS,74018,RADEX ABDOMEN 1 VIEW,,,21.33,21.33,2
HCPCS,74018,RADIOLOGIC EXAM ABDOMEN 1 VIEW,760.0,494.0,8.65,839.0,192
HCPCS,740180,RADEX ABDOMEN 1 VIEW,,,21.33,21.33,1
HCPCS,74018TC,RADEX ABDOMEN 1 VIEW,,,21.33,21.33,1
HCPCS,74019,RADEX ABDOMEN 2 VIEWS,,,25.59,25.59,2
HCPCS,74019,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,918.0,596.7,10.92,1019.0,192
HCPCS,740190,RADEX ABDOMEN 2 VIEWS,,,25.59,25.59,1
HCPCS,74019TC,RADEX ABDOMEN 2 VIEWS,,,25.59,25.59,1
HCPCS,74021,RADEX ABDOMEN 3+ VIEWS,,,29.85,29.85,2
HCPCS,74021,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,918.0,596.7,12.53,1037.0,192
HCPCS,740210,RADEX ABDOMEN 3+ VIEWS,,,29.85,29.85,1
HCPCS,74021TC,RADEX ABDOMEN 3+ VIEWS,,,29.85,29.85,1
HCPCS,74022,RADEX COMPL AQT ABD SERIES,,,34.43,34.43,2
HCPCS,74022,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,918.0,596.7,12.93,1059.0,147
HCPCS,74022,XRAY ABDOMEN COM W CHEST,988.5,642.5250000000001,32.22,1059.0,64
HCPCS,74022,XRAY ACUTE ABDOMEN COMP W/CHEST,141.0,91.65,32.22,141.0,32
HCPCS,740220,RADEX COMPL AQT ABD SERIES,,,34.43,34.43,1
HCPCS,74022TC,RADEX COMPL AQT ABD SERIES,,,34.43,34.43,1
HCPCS,74150,CT ABDOMEN W/O CONTRAST,918.0,596.7,49.58,1442.0,100
HCPCS,74150,CT ABDOMEN W/O CONTRAST MATERIAL,918.0,596.7,64.08,1746.0,49
HCPCS,74150,CT ABDOMEN WO CONTRAST,524.0,340.6,120.21,524.0,32
HCPCS,741500,CT ABDOMEN W/O CONTRAST,,,87.05,87.05,1
HCPCS,74150TC,CT ABDOMEN W/O CONTRAST,,,87.05,87.05,1
HCPCS,74160,CT ABDOMEN W CONTRAST,559.0,363.35,185.12,559.0,32
HCPCS,74160,CT ABDOMEN W/CONTRAST,1535.0,997.75,52.7,2094.0,100
HCPCS,74160,CT ABDOMEN W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
HCPCS,741600,CT ABDOMEN W/CONTRAST,,,184.08,184.08,1
HCPCS,74160TC,CT ABDOMEN W/CONTRAST,,,184.08,184.08,1
HCPCS,74170,CT ABD WO CNTRST FLWD CNTRST,,,184.08,184.08,2
HCPCS,74170,CT ABDOMEN W & W/O CONTRAST,1535.0,997.75,58.24,2151.0,98
HCPCS,74170,CT ABDOMEN W WO CONTRAST,616.0,400.4,213.67,616.0,32
HCPCS,74170,CT ABDOMEN W/O & W/CONTRAST MATERIAL,1535.0,997.75,178.69,1746.0,49
HCPCS,741700,CT ABD WO CNTRST FLWD CNTRST,,,184.08,184.08,1
HCPCS,74170TC,CT ABD WO CNTRST FLWD CNTRST,,,184.08,184.08,1
HCPCS,74174,CT ANGIO ABD&PELV W&WO CONTRAST,968.0,629.2,263.34,968.0,32
HCPCS,74174,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG,3080.0,2002.0,242.66,2772.0,49
HCPCS,74174,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMGES,3080.0,2002.0,90.04,4048.0,98
HCPCS,74174,CTA ABD&PLVS W/CONTRAST,,,297.3,297.3,2
HCPCS,741740,CTA ABD&PLVS W/CONTRAST,,,297.3,297.3,1
HCPCS,74174TC,CTA ABD&PLVS W/CONTRAST,,,297.3,297.3,1
HCPCS,74175,"CT ANGIO,ABDOMN W&WO CN",728.0,473.2,246.86,728.0,32
HCPCS,74175,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,1535.0,997.75,79.26,2263.0,147
HCPCS,74175,CTA ABDOMEN W/CONTRAST,,,183.73,183.73,2
HCPCS,741750,CTA ABDOMEN W/CONTRAST,,,183.73,183.73,1
HCPCS,74175TC,CTA ABDOMEN W/CONTRAST,,,183.73,183.73,1
HCPCS,74176,CT ABD & PELVIS W/O CONTRAST,2085.0,1355.25,71.01,2851.0,100
HCPCS,74176,CT ABDOMEN & PELVIS W/O CONTRAST,766.0,497.9,121.99,766.0,32
HCPCS,74176,CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL,2085.0,1355.25,196.56,1876.5,49
HCPCS,741760,CT ABD & PELVIS W/O CONTRAST,,,109.79,109.79,1
HCPCS,74176TC,CT ABD & PELVIS W/O CONTRAST,,,109.79,109.79,1
HCPCS,74177,CT ABD & PELVIS W/CONTRAST,3080.0,2002.0,74.13,3881.0,100
HCPCS,74177,CT ABDOMEN & PELVIS W/CONTRAST,801.0,520.65,175.85,801.0,32
HCPCS,74177,CT ABDOMEN & PELVIS W/CONTRAST MATERIAL,3080.0,2002.0,196.56,2772.0,49
HCPCS,741770,CT ABD & PELVIS W/CONTRAST,,,233.59,233.59,1
HCPCS,74177TC,CT ABD & PELVIS W/CONTRAST,,,233.59,233.59,1
HCPCS,74178,CT ABD & PELVIS W/WO CONTRST 1+ BODY REGNS,3080.0,2002.0,82.37,3884.0,98
HCPCS,74178,CT ABD&PLV WO CNTR FLWD CNTR,,,263.9,263.9,2
HCPCS,74178,CT ABDOMEN & PELVIS W/WO CONTRST 1/> BODY RE,3080.0,2002.0,196.56,2772.0,49
HCPCS,74178,CT ABDOMEN & PELVIS WWO CONTRAST,804.0,522.6,208.69,804.0,32
HCPCS,741780,CT ABD&PLV WO CNTR FLWD CNTR,,,263.9,263.9,1
HCPCS,74178TC,CT ABD&PLV WO CNTR FLWD CNTR,,,263.9,263.9,1
HCPCS,74181,MRI ABDOMEN W/O CONTRAST,2669.0,1734.85,141.22,2669.0,34
HCPCS,74181,MRI ABDOMEN W/O CONTRAST MATERIAL,2085.0,1355.25,145.46,2109.0,49
HCPCS,74181,MRI ABDOMEN WO CONTRAST,584.0,379.6,184.59,584.0,32
HCPCS,74181,"MRI, ABDOMEN (MRI)",2085.0,1355.25,60.51,2669.0,98
HCPCS,741810,MRI ABDOMEN W/O CONTRAST,,,141.22,141.22,1
HCPCS,74181TC,MRI ABDOMEN W/O CONTRAST,,,141.22,141.22,1
HCPCS,74182,MRI ABDOMEN W/CONTRAST,,,244.56,244.56,2
HCPCS,74182,MRI ABDOMEN W/CONTRAST MATERIAL,3080.0,2002.0,71.88,3841.0,147
HCPCS,74182,"MRI,ABDOMEN, W/CONTRAST",2301.0,1495.65,284.5,3841.0,64
HCPCS,741820,MRI ABDOMEN W/CONTRAST,,,244.56,244.56,1
HCPCS,74182TC,MRI ABDOMEN W/CONTRAST,,,244.56,244.56,1
HCPCS,74183,MRI ABD W/O CNTR FLWD CNTR,,,260.12,260.12,2
HCPCS,74183,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,3080.0,2002.0,93.18,4048.0,147
HCPCS,74183,"MRI,ABDOMEN,W&WO CONTRS",2508.0,1630.1999999999998,318.47,4048.0,64
HCPCS,741830,MRI ABD W/O CNTR FLWD CNTR,,,260.12,260.12,1
HCPCS,74183TC,MRI ABD W/O CNTR FLWD CNTR,,,260.12,260.12,1
HCPCS,74185,MR ABDOMINAL AORTA ANGIOGRAM,3224.0,2095.6,74.43,3944.0,98
HCPCS,74185,MRA ABD W CONT,3224.0,2095.6,285.23,2901.6,39
HCPCS,74185,MRA ABD W CONTR,3224.0,2095.6,74.43,3944.0,137
HCPCS,74185,MRA ABD W OR W/O CNTRST,,,279.27,279.27,2
HCPCS,74185,MRA ABD WITH OR W/O CONT,3224.0,2095.6,74.43,3944.0,98
HCPCS,74185,MRA ABD WO CONT,3224.0,2095.6,285.23,2901.6,39
HCPCS,74185,MRA ABD WO CONTR,3224.0,2095.6,285.23,2901.6,39
HCPCS,74185,MRA ABD WO/W CONTR,3224.0,2095.6,285.23,2901.6,39
HCPCS,74185,MRA ABDOMEN W OR WO CNRST,720.0,468.0,315.52,720.0,32
HCPCS,74185,MRA ABDOMEN W WO CONTR,3944.0,2563.6,315.52,3944.0,32
HCPCS,74185,MRA ABDOMEN WO/W CONT,3224.0,2095.6,285.23,2901.6,39
HCPCS,741850,MRA ABD W OR W/O CNTRST,,,279.27,279.27,1
HCPCS,74185TC,MRA ABD W OR W/O CNTRST,,,279.27,279.27,1
HCPCS,74190,PERITONEOGRAM RS&I,4729.0,3073.85,71.29,4256.1,50
HCPCS,741900,PERITONEOGRAM RS&I,,,525.7,525.7,1
HCPCS,74190TC,PERITONEOGRAM RS&I,,,525.7,525.7,1
HCPCS,74210,RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY,1535.0,997.75,14.63,1771.0,147
HCPCS,74210,X-RAY XM PHRNX&/CRV ESOPH C+,,,66.2,66.2,2
HCPCS,742100,X-RAY XM PHRNX&/CRV ESOPH C+,,,66.2,66.2,1
HCPCS,74210TC,X-RAY XM PHRNX&/CRV ESOPH C+,,,66.2,66.2,1
HCPCS,74220,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,1535.0,997.75,19.18,1775.0,147
HCPCS,74220,X-RAY XM ESOPHAGUS 1CNTRST,,,68.17,68.17,2
HCPCS,74220,XRAY ESOPHAGUS,1007.5,654.875,49.48,1775.0,64
HCPCS,742200,X-RAY XM ESOPHAGUS 1CNTRST,,,68.17,68.17,1
HCPCS,74220TC,X-RAY XM ESOPHAGUS 1CNTRST,,,68.17,68.17,1
HCPCS,74221,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,1535.0,997.75,33.0,1815.0,143
HCPCS,74221,X-RAY XM ESOPHAGUS 2CNTRST,,,75.7,75.7,2
HCPCS,742210,X-RAY XM ESOPHAGUS 2CNTRST,,,75.7,75.7,1
HCPCS,74221TC,X-RAY XM ESOPHAGUS 2CNTRST,,,75.7,75.7,1
HCPCS,74230,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,1535.0,997.75,22.02,1747.0,147
HCPCS,74230,X-RAY XM SWLNG FUNCJ C+,,,97.97,97.97,2
HCPCS,74230,XRAY SWALLOWING FUNCTION,979.5,636.675,64.11,1747.0,64
HCPCS,742300,X-RAY XM SWLNG FUNCJ C+,,,97.97,97.97,1
HCPCS,74230TC,X-RAY XM SWLNG FUNCJ C+,,,97.97,97.97,1
HCPCS,74235,REMOVE ESOPHAGUS OBSTRUCTION,,,102.56,102.56,2
HCPCS,74235,RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,1533.0,996.45,55.56,2057.0,66
HCPCS,74235,Remove esophagus obstruction,,,136.83,172.84,6
HCPCS,742350,REMOVE ESOPHAGUS OBSTRUCTION,,,102.56,102.56,1
HCPCS,74235TC,REMOVE ESOPHAGUS OBSTRUCTION,,,102.56,102.56,1
HCPCS,74240,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,1535.0,997.75,28.98,1855.0,147
HCPCS,74240,"UPPER GI,WITHOUT KUB",320.0,208.0,66.16,320.0,32
HCPCS,74240,X-RAY XM UPR GI TRC 1CNTRST,,,83.56,83.56,2
HCPCS,74240,XRAY GI UPPER WO KUB,1855.0,1205.75,66.16,1855.0,32
HCPCS,742400,X-RAY XM UPR GI TRC 1CNTRST,,,83.56,83.56,1
HCPCS,74240TC,X-RAY XM UPR GI TRC 1CNTRST,,,83.56,83.56,1
HCPCS,74241,XRAY GI UPPER W KUB,938.0,609.7,103.37,938.0,16
HCPCS,74241,XRAY GI UPPER W KUB W/WO DELAYS,143.0,92.95,71.5,143.0,16
HCPCS,74245,XRAY UGI SMALL BOWEL,625.0,406.25,85.0,1080.0,32
HCPCS,74246,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,1535.0,997.75,28.69,1895.0,147
HCPCS,74246,"UPPER GI W/AIR,BARIUM WO KUB",360.0,234.0,71.07,360.0,32
HCPCS,74246,X-RAY XM UPR GI TRC 2CNTRST,,,95.35,95.35,2
HCPCS,74246,XRAY UGI SM BOWEL WO KUB,1895.0,1231.75,71.07,1895.0,32
HCPCS,742460,X-RAY XM UPR GI TRC 2CNTRST,,,95.35,95.35,1
HCPCS,74246TC,X-RAY XM UPR GI TRC 2CNTRST,,,95.35,95.35,1
HCPCS,74247,XRAY UGI SM BOWEL W KUB,938.0,609.7,123.32,938.0,16
HCPCS,74247,XRAY UGI W AIR W KUB,143.0,92.95,71.5,154.7,16
HCPCS,74248,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,994.0,646.1,33.0,1274.0,130
HCPCS,74248,X-RAY SM INT F-THRU STD,,,48.84,48.84,2
HCPCS,742480,X-RAY SM INT F-THRU STD,,,48.84,48.84,1
HCPCS,74248TC,X-RAY SM INT F-THRU STD,,,48.84,48.84,1
HCPCS,74249,XRAY UGI SM BOWEL W BARIUM,1080.0,702.0,166.45,1080.0,16
HCPCS,74249,XRAY UGI W AIR & SM BOWEL,170.0,110.5,85.0,208.79,16
HCPCS,74250,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,1535.0,997.75,19.75,1859.0,147
HCPCS,74250,X-RAY XM SM INT 1CNTRST STD,,,82.58,82.58,2
HCPCS,74250,XRAY SMALL BOWEL MULTIPLE,1091.5,709.4749999999999,61.81,1859.0,64
HCPCS,742500,X-RAY XM SM INT 1CNTRST STD,,,82.58,82.58,1
HCPCS,74250TC,X-RAY XM SM INT 1CNTRST STD,,,82.58,82.58,1
HCPCS,74251,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,1535.0,997.75,28.69,2003.0,147
HCPCS,74251,X-RAY XM SM INT 2CNTRST STD,,,175.26,175.26,2
HCPCS,74251,XRAY SM BOWEL VIA ENT TUBE,1235.5,803.075,189.53,2003.0,64
HCPCS,742510,X-RAY XM SM INT 2CNTRST STD,,,175.26,175.26,1
HCPCS,74251TC,X-RAY XM SM INT 2CNTRST STD,,,175.26,175.26,1
HCPCS,74261,CT COLONOGRAPHY DX,,,110.08,110.08,2
HCPCS,74261,CT COLONOGRAPHY W/O DYE DIAG,1056.0,686.4,217.47,1056.0,32
HCPCS,74261,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,1056.0,686.4,64.08,1974.0,196
HCPCS,742610,CT COLONOGRAPHY DX,,,110.08,110.08,1
HCPCS,74261TC,CT COLONOGRAPHY DX,,,110.08,110.08,1
HCPCS,74262,CT COLONOGRAPHY DX W/DYE,,,183.68,183.68,2
HCPCS,74262,CT COLONOGRAPHY W/WO DYE DX,1100.0,715.0,312.25,1100.0,32
HCPCS,74262,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,1535.0,997.75,103.69,2635.0,147
HCPCS,742620,CT COLONOGRAPHY DX W/DYE,,,183.68,183.68,1
HCPCS,74262TC,CT COLONOGRAPHY DX W/DYE,,,183.68,183.68,1
HCPCS,74263,CT COLONOGRAPHY SCREENING,,,585.09,585.09,2
HCPCS,74263,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,2085.0,1355.25,64.08,2997.0,187
HCPCS,74263,CT COLONOGRAPHY W/DYE SCREENING,912.0,592.8,361.66,1073.6,29
HCPCS,742630,CT COLONOGRAPHY SCREENING,,,585.09,585.09,1
HCPCS,74263TC,CT COLONOGRAPHY SCREENING,,,585.09,585.09,1
HCPCS,74270,BARIUM ENEMA,416.0,270.4,77.76,416.0,32
HCPCS,74270,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,1535.0,997.75,28.69,1951.0,147
HCPCS,74270,X-RAY XM COLON 1CNTRST STD,,,103.2,103.2,2
HCPCS,74270,XRAY COLON BARIUM,1951.0,1268.15,77.76,1951.0,32
HCPCS,742700,X-RAY XM COLON 1CNTRST STD,,,103.2,103.2,1
HCPCS,74270TC,X-RAY XM COLON 1CNTRST STD,,,103.2,103.2,1
HCPCS,74280,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,1535.0,997.75,40.77,2039.0,147
HCPCS,74280,X-RAY XM COLON 2CNTRST STD,,,157.95,157.95,2
HCPCS,74280,XRAY COLON AIR CONTRAST,1271.5,826.4749999999999,130.25,2039.0,64
HCPCS,742800,X-RAY XM COLON 2CNTRST STD,,,157.95,157.95,1
HCPCS,74280TC,X-RAY XM COLON 2CNTRST STD,,,157.95,157.95,1
HCPCS,74283,THER NMA RDCTJ INTUS/OBSTRCJ,,,153.64,153.64,2
HCPCS,74283,THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ,1535.0,997.75,71.29,1381.5,49
HCPCS,742830,THER NMA RDCTJ INTUS/OBSTRCJ,,,153.64,153.64,1
HCPCS,74283TC,THER NMA RDCTJ INTUS/OBSTRCJ,,,153.64,153.64,1
HCPCS,74290,CHOLECYSTOGRAPHY ORAL CONTRST,1535.0,997.75,12.93,1676.0,98
HCPCS,74290,CONTRAST X-RAY GALLBLADDER,,,68.82,410.0,19
HCPCS,74290,Contrast x-ray gallbladder,,,71.29,90.05,6
HCPCS,742900,CONTRAST X-RAY GALLBLADDER,,,68.82,68.82,1
HCPCS,74290TC,CONTRAST X-RAY GALLBLADDER,,,68.82,68.82,1
HCPCS,74300,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,1376.0,894.4,13.11,1502.0,101
HCPCS,74300,X-RAY BILE DUCTS/PANCREAS,,,23.76,23.76,2
HCPCS,743000,X-RAY BILE DUCTS/PANCREAS,,,23.76,23.76,1
HCPCS,74300TC,X-RAY BILE DUCTS/PANCREAS,,,23.76,23.76,1
HCPCS,74301,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,268.0,174.2,9.52,350.0,101
HCPCS,74301,X-RAYS AT SURGERY ADD-ON,,,17.82,17.82,2
HCPCS,743010,X-RAYS AT SURGERY ADD-ON,,,17.82,17.82,1
HCPCS,74301TC,X-RAYS AT SURGERY ADD-ON,,,17.82,17.82,1
HCPCS,74328,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,545.0,354.25,22.48,729.0,101
HCPCS,74328,X-RAY BILE DUCT ENDOSCOPY,,,52.42,52.42,2
HCPCS,743280,X-RAY BILE DUCT ENDOSCOPY,,,52.42,52.42,1
HCPCS,74328TC,X-RAY BILE DUCT ENDOSCOPY,,,52.42,52.42,1
HCPCS,74329,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,946.0,614.9,22.8,1165.0,101
HCPCS,74329,X-RAY FOR PANCREAS ENDOSCOPY,,,42.18,42.18,2
HCPCS,743290,X-RAY FOR PANCREAS ENDOSCOPY,,,42.18,42.18,1
HCPCS,74329TC,X-RAY FOR PANCREAS ENDOSCOPY,,,42.18,42.18,1
HCPCS,74330,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,1159.0,753.35,26.36,1419.0,101
HCPCS,74330,X-RAY BILE/PANC ENDOSCOPY,,,71.23,71.23,2
HCPCS,743300,X-RAY BILE/PANC ENDOSCOPY,,,71.23,71.23,1
HCPCS,74330TC,X-RAY BILE/PANC ENDOSCOPY,,,71.23,71.23,1
HCPCS,74340,INTRO LONG GI TUBE W/FLUORO/FILMS,790.0,513.5,22.73,1001.0,66
HCPCS,74340,INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I,790.0,513.5,132.72,711.0,35
HCPCS,74340,X-RAY GUIDE FOR GI TUBE,,,74.17,74.17,2
HCPCS,743400,X-RAY GUIDE FOR GI TUBE,,,74.17,74.17,1
HCPCS,74340TC,X-RAY GUIDE FOR GI TUBE,,,74.17,74.17,1
HCPCS,74355,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,534.0,347.1,33.68,887.0,101
HCPCS,74355,X-RAY GUIDE INTESTINAL TUBE,,,95.27,95.27,2
HCPCS,743550,X-RAY GUIDE INTESTINAL TUBE,,,95.27,95.27,1
HCPCS,74355TC,X-RAY GUIDE INTESTINAL TUBE,,,95.27,95.27,1
HCPCS,74360,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,1118.0,726.7,24.74,1329.0,171
HCPCS,74360,X-RAY GUIDE GI DILATION,,,83.43,83.43,2
HCPCS,743600,X-RAY GUIDE GI DILATION,,,83.43,83.43,1
HCPCS,74360TC,X-RAY GUIDE GI DILATION,,,83.43,83.43,1
HCPCS,74363,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,2056.0,1336.4,37.79,2465.0,101
HCPCS,74363,X-RAY BILE DUCT DILATION,,,74.82,74.82,2
HCPCS,743630,X-RAY BILE DUCT DILATION,,,74.82,74.82,1
HCPCS,74363TC,X-RAY BILE DUCT DILATION,,,74.82,74.82,1
HCPCS,74400,UROGRAPHY IV +-KUB TOMOG,,,110.13,110.13,2
HCPCS,74400,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,1535.0,997.75,20.31,1751.0,147
HCPCS,744000,UROGRAPHY IV +-KUB TOMOG,,,110.13,110.13,1
HCPCS,74400TC,UROGRAPHY IV +-KUB TOMOG,,,110.13,110.13,1
HCPCS,74410,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,1535.0,997.75,20.6,1751.0,147
HCPCS,74410,UROGRAPHY NFS DRIP&/BOLUS,,,117.01,117.01,2
HCPCS,744100,UROGRAPHY NFS DRIP&/BOLUS,,,117.01,117.01,1
HCPCS,74410TC,UROGRAPHY NFS DRIP&/BOLUS,,,117.01,117.01,1
HCPCS,74415,UROGRAPHY NFS DRIP &/BOLUS W/NEPHROTOMOGRAPHY,1535.0,997.75,20.31,1751.0,147
HCPCS,74415,UROGRAPHY NFS DRIP&/BLS W/NF,,,126.18,126.18,2
HCPCS,744150,UROGRAPHY NFS DRIP&/BLS W/NF,,,126.18,126.18,1
HCPCS,74415TC,UROGRAPHY NFS DRIP&/BLS W/NF,,,126.18,126.18,1
HCPCS,74420,UROGRAPHY RETROGRADE WITH/WO KUB,3080.0,2002.0,15.49,3288.0,143
HCPCS,74420,UROGRAPHY RTRGR +-KUB,,,53.1,53.1,2
HCPCS,744200,UROGRAPHY RTRGR +-KUB,,,53.1,53.1,1
HCPCS,74420TC,UROGRAPHY RTRGR +-KUB,,,53.1,53.1,1
HCPCS,74425,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,3080.0,2002.0,15.2,3284.0,143
HCPCS,74425,UROGRAPHY ANTEGRADE,1744.0,1133.6,102.0,3284.0,56
HCPCS,74425,UROGRAPHY ANTEGRADE RS&I,,,110.42,110.42,2
HCPCS,744250,UROGRAPHY ANTEGRADE RS&I,,,110.42,110.42,1
HCPCS,74425TC,UROGRAPHY ANTEGRADE RS&I,,,110.42,110.42,1
HCPCS,74430,CONTRAST X-RAY BLADDER,,,25.92,25.92,2
HCPCS,74430,CYSTOGRAPHY 3 VIEW,1681.0,1092.65,30.12,3221.0,64
HCPCS,74430,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,3080.0,2002.0,12.93,3221.0,147
HCPCS,744300,CONTRAST X-RAY BLADDER,,,25.92,25.92,1
HCPCS,74430TC,CONTRAST X-RAY BLADDER,,,25.92,25.92,1
HCPCS,74440,VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I,2085.0,1355.25,71.29,1876.5,49
HCPCS,74440,X-RAY MALE GENITAL TRACT,,,78.65,78.65,2
HCPCS,744400,X-RAY MALE GENITAL TRACT,,,78.65,78.65,1
HCPCS,74440TC,X-RAY MALE GENITAL TRACT,,,78.65,78.65,1
HCPCS,74445,CORPORA CAVERNOSOGRAPHY,502.0,326.3,137.21,502.0,14
HCPCS,74445,CORPORA CAVERNOSOGRAPY RS&I,918.0,596.7,44.47,1420.0,114
HCPCS,74445,X-RAY EXAM OF PENIS,,,104.85,104.85,2
HCPCS,744450,X-RAY EXAM OF PENIS,,,104.85,104.85,1
HCPCS,74445TC,X-RAY EXAM OF PENIS,,,104.85,104.85,1
HCPCS,74450,URETHROCYSTOGRAPHY,1174.5,763.425,66.0,2217.0,28
HCPCS,74450,URETHROCYSTOGRAPHY RETROGRADE RS&I,2085.0,1355.25,14.35,2217.0,114
HCPCS,74450,X-RAY URETHRA/BLADDER,,,233.56,233.56,2
HCPCS,744500,X-RAY URETHRA/BLADDER,,,233.56,233.56,1
HCPCS,74450TC,X-RAY URETHRA/BLADDER,,,233.56,233.56,1
HCPCS,74455,URETHROCYSTOGRAPHY VOIDG,1174.5,763.425,55.25,2217.0,64
HCPCS,74455,URETHROCYSTOGRAPHY VOIDING RS&I,2085.0,1355.25,13.5,2217.0,147
HCPCS,74455,X-RAY URETHRA/BLADDER,,,87.16,87.16,2
HCPCS,744550,X-RAY URETHRA/BLADDER,,,87.16,87.16,1
HCPCS,74455TC,X-RAY URETHRA/BLADDER,,,87.16,87.16,1
HCPCS,74470,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,4729.0,3073.85,22.73,4967.0,114
HCPCS,74470,X-RAY EXAM OF KIDNEY LESION,,,525.7,525.7,2
HCPCS,744700,X-RAY EXAM OF KIDNEY LESION,,,525.7,525.7,1
HCPCS,74470TC,X-RAY EXAM OF KIDNEY LESION,,,525.7,525.7,1
HCPCS,74485,DILATION URETERS/URETHRA RS&I,17669.0,11484.85,22.3,18001.0,147
HCPCS,74485,DILATION URTR/URT RS&I,,,79.63,79.63,2
HCPCS,744850,DILATION URTR/URT RS&I,,,79.63,79.63,1
HCPCS,74485TC,DILATION URTR/URT RS&I,,,79.63,79.63,1
HCPCS,74710,X-ray measurement of pelvis,,,33.81,42.71,6
HCPCS,74712,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,2085.0,1355.25,141.71,3285.0,94
HCPCS,74712,MRI FETAL SNGL/1ST GESTATION,,,242.63,524.34,19
HCPCS,74712,Mri fetal sngl/1st gestation,,,145.46,183.74,6
HCPCS,747120,MRI FETAL SNGL/1ST GESTATION,,,252.34,252.34,1
HCPCS,74712TC,MRI FETAL SNGL/1ST GESTATION,,,252.34,252.34,1
HCPCS,74713,FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,2269.0,1474.85,87.52,3009.0,94
HCPCS,74713,MRI FETAL EA ADDL GESTATION,,,124.56,124.56,2
HCPCS,74713,Mri fetal ea addl gestation,,,145.46,183.74,6
HCPCS,747130,MRI FETAL EA ADDL GESTATION,,,124.56,124.56,1
HCPCS,74713TC,MRI FETAL EA ADDL GESTATION,,,124.56,124.56,1
HCPCS,74740,HYSTEROSALPINGOGRAPHY,1194.5,776.425,49.44,2237.0,64
HCPCS,74740,HYSTEROSALPINGOGRAPHY RS&I,2085.0,1355.25,15.48,2237.0,147
HCPCS,74740,X-RAY FEMALE GENITAL TRACT,,,74.39,74.39,2
HCPCS,747400,X-RAY FEMALE GENITAL TRACT,,,74.39,74.39,1
HCPCS,74740TC,X-RAY FEMALE GENITAL TRACT,,,74.39,74.39,1
HCPCS,74742,TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I,524.0,340.6,88.03,471.6,35
HCPCS,74742,X-RAY FALLOPIAN TUBE,,,52.75,52.75,2
HCPCS,747420,X-RAY FALLOPIAN TUBE,,,52.75,52.75,1
HCPCS,74742TC,X-RAY FALLOPIAN TUBE,,,52.75,52.75,1
HCPCS,74775,PERINEOGRAM,2085.0,1355.25,71.29,1876.5,48
HCPCS,74775,PERINEOGRAM/ VAGINOGRAM,2358.0,1532.7,119.44,2358.0,14
HCPCS,74775,PERINEOGRAM/VAGINOGRAM,273.0,177.45,119.44,342.61,14
HCPCS,74775,X-RAY EXAM OF PERINEUM,,,233.56,233.56,2
HCPCS,74775,X-RAY PERINEOGRAM,2085.0,1355.25,26.28,2358.0,66
HCPCS,747750,X-RAY EXAM OF PERINEUM,,,233.56,233.56,1
HCPCS,74775TC,X-RAY EXAM OF PERINEUM,,,233.56,233.56,1
HCPCS,75557,"CARD MRI MORPH FUNC,W/O C",940.0,611.0,257.23,940.0,32
HCPCS,75557,"CARD MRI MORPH/FUNC W/O C,INCL 3D",3025.0,1966.25,257.23,3025.0,32
HCPCS,75557,CARDIAC MRI FOR MORPH,,,188.27,188.27,2
HCPCS,75557,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,2085.0,1355.25,97.74,3025.0,147
HCPCS,755570,CARDIAC MRI FOR MORPH,,,188.27,188.27,1
HCPCS,75557TC,CARDIAC MRI FOR MORPH,,,188.27,188.27,1
HCPCS,75559,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,4729.0,3073.85,145.46,4256.1,49
HCPCS,75559,CARDIAC MRI W/STRESS IMG,,,265.02,265.02,2
HCPCS,755590,CARDIAC MRI W/STRESS IMG,,,265.02,265.02,1
HCPCS,75559TC,CARDIAC MRI W/STRESS IMG,,,265.02,265.02,1
HCPCS,75561,"CARD MRI MORPH/FUNCTION W/WO C,INCL 3D",4224.0,2745.6,334.15,4224.0,32
HCPCS,75561,"CARD MRI W/W/O C MORPH,FUNC",1144.0,743.6,334.15,1144.0,32
HCPCS,75561,CARDIAC MRI FOR MORPH W/DYE,,,268.96,268.96,2
HCPCS,75561,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,3080.0,2002.0,107.83,4224.0,147
HCPCS,755610,CARDIAC MRI FOR MORPH W/DYE,,,268.96,268.96,1
HCPCS,75561TC,CARDIAC MRI FOR MORPH W/DYE,,,268.96,268.96,1
HCPCS,75563,CARD MRI W/STRESS IMG & DYE,,,316.35,316.35,2
HCPCS,75563,CARD MRI W/W/O CON W/STRESS IMAGE,6814.0,4429.1,125.75,8014.0,98
HCPCS,75563,CARDIAC MRI W/W/O CONTRAST W/STRESS,6814.0,4429.1,241.9,6132.6,41
HCPCS,755630,CARD MRI W/STRESS IMG & DYE,,,316.35,316.35,1
HCPCS,75563TC,CARD MRI W/STRESS IMG & DYE,,,316.35,316.35,1
HCPCS,75565,CARD MRI VEL FLW MAP ADD ON,464.0,301.6,42.45,818.0,64
HCPCS,75565,CARD MRI VELOC FLOW MAPPING,,,37.14,37.14,2
HCPCS,75565,CARDIAC MRI FOR VELOCITY FLOW MAPPING,708.0,460.2,10.08,2109.0,134
HCPCS,755650,CARD MRI VELOC FLOW MAPPING,,,37.14,37.14,1
HCPCS,75565TC,CARD MRI VELOC FLOW MAPPING,,,37.14,37.14,1
HCPCS,75571,CT CALCIUM SCORING - SELF PAY,760.0,494.0,22.86,1746.0,148
HCPCS,75571,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,760.0,494.0,22.86,1746.0,148
HCPCS,75571,CT HEART W/O DYE W/COR CALCIUM,232.0,150.8,50.09,232.0,32
HCPCS,75571,CT HRT W/O DYE W/CA TEST,760.0,494.0,64.08,1746.0,52
HCPCS,755710,CT HRT W/O DYE W/CA TEST,,,77.81,77.81,1
HCPCS,75571TC,CT HRT W/O DYE W/CA TEST,,,77.81,77.81,1
HCPCS,75572,CCTA W/WO C W/STRXR MORPHOLOGY,700.0,455.0,168.41,700.0,32
HCPCS,75572,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,3080.0,2002.0,69.73,3780.0,148
HCPCS,75572,CT HRT W/3D IMAGE,,,157.29,157.29,2
HCPCS,75572,CTA HEART W/WO C W/STRXR MORPH,3780.0,2457.0,168.41,3780.0,32
HCPCS,755720,CT HRT W/3D IMAGE,,,157.29,157.29,1
HCPCS,75572TC,CT HRT W/3D IMAGE,,,157.29,157.29,1
HCPCS,75573,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,3080.0,2002.0,101.97,4100.0,198
HCPCS,75573,CT HRT C+ STRUX CGEN HRT DS,,,184.16,184.16,2
HCPCS,75573,CTA  HEART W/WO C W/STXR MORPH CONGENTL,1020.0,663.0,231.6,1020.0,32
HCPCS,75573,CTA HRT W/STRXR MORPH CONGENTL,4100.0,2665.0,231.6,4100.0,32
HCPCS,755730,CT HRT C+ STRUX CGEN HRT DS,,,184.16,184.16,1
HCPCS,75573TC,CT HRT C+ STRUX CGEN HRT DS,,,184.16,184.16,1
HCPCS,75574,CT ANGIO HRT W/3D IMAGE,,,183.77,183.77,2
HCPCS,75574,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,3080.0,2002.0,96.0,4040.0,148
HCPCS,75574,"CTA HRT W/ARTERY,STRX,MORPH IF DONE",2500.0,1625.0,283.81,4040.0,64
HCPCS,755740,CT ANGIO HRT W/3D IMAGE,,,183.77,183.77,1
HCPCS,75574TC,CT ANGIO HRT W/3D IMAGE,,,183.77,183.77,1
HCPCS,75577,QUAN&CHAR C ATHROSCLRTC PLAQ,,,957.12,957.12,2
HCPCS,75577,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,8198.0,5328.7,42.86,8572.0,111
HCPCS,755770,QUAN&CHAR C ATHROSCLRTC PLAQ,,,957.12,957.12,1
HCPCS,75577TC,QUAN&CHAR C ATHROSCLRTC PLAQ,,,957.12,957.12,1
HCPCS,75580,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,8775.0,5703.75,34.37,9105.0,143
HCPCS,75580,N-INVAS EST C FFR SW ALY CTA,,,854.41,854.41,2
HCPCS,755800,N-INVAS EST C FFR SW ALY CTA,,,854.41,854.41,1
HCPCS,75580TC,N-INVAS EST C FFR SW ALY CTA,,,854.41,854.41,1
HCPCS,75600,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,27148.0,17646.2,20.89,27344.0,147
HCPCS,75600,CONTRAST EXAM THORACIC AORTA,,,156.63,156.63,2
HCPCS,756000,CONTRAST EXAM THORACIC AORTA,,,156.63,156.63,1
HCPCS,75600TC,CONTRAST EXAM THORACIC AORTA,,,156.63,156.63,1
HCPCS,75605,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,46624.0,30305.6,47.87,47126.0,147
HCPCS,75605,CONTRAST EXAM THORACIC AORTA,,,67.23,67.23,2
HCPCS,756050,CONTRAST EXAM THORACIC AORTA,,,67.23,67.23,1
HCPCS,75605TC,CONTRAST EXAM THORACIC AORTA,,,67.23,67.23,1
HCPCS,75625,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,27148.0,17646.2,48.29,27724.0,147
HCPCS,75625,CONTRAST EXAM ABDOMINL AORTA,,,59.0,59.0,2
HCPCS,756250,CONTRAST EXAM ABDOMINL AORTA,,,59.0,59.0,1
HCPCS,75625TC,CONTRAST EXAM ABDOMINL AORTA,,,59.0,59.0,1
HCPCS,75630,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,27148.0,17646.2,62.16,27948.0,147
HCPCS,75630,X-RAY AORTA LEG ARTERIES,,,63.62,63.62,2
HCPCS,756300,X-RAY AORTA LEG ARTERIES,,,63.62,63.62,1
HCPCS,75630TC,X-RAY AORTA LEG ARTERIES,,,63.62,63.62,1
HCPCS,75635,CT ANGIO ABDOMINAL ARTERIES,,,184.12,184.12,2
HCPCS,75635,"CT ANGIO,ABD AORTA,ILIO",960.0,624.0,315.85,960.0,32
HCPCS,75635,CTA ABD AORTA FEMILIO RUNOFF,2495.0,1621.75,315.85,2495.0,32
HCPCS,75635,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,1535.0,997.75,99.44,2495.0,147
HCPCS,756350,CT ANGIO ABDOMINAL ARTERIES,,,184.12,184.12,1
HCPCS,75635TC,CT ANGIO ABDOMINAL ARTERIES,,,184.12,184.12,1
HCPCS,75705,ANGIOGRAPHY SPINAL SELECTIVE RS&I,46624.0,30305.6,89.93,47496.0,147
HCPCS,75705,ARTERY X-RAYS SPINE,,,133.42,133.42,2
HCPCS,757050,ARTERY X-RAYS SPINE,,,133.42,133.42,1
HCPCS,75705TC,ARTERY X-RAYS SPINE,,,133.42,133.42,1
HCPCS,75710,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,27148.0,17646.2,46.44,27848.0,147
HCPCS,75710,ARTERY X-RAYS ARM/LEG,,,67.88,67.88,2
HCPCS,757100,ARTERY X-RAYS ARM/LEG,,,67.88,67.88,1
HCPCS,75710TC,ARTERY X-RAYS ARM/LEG,,,67.88,67.88,1
HCPCS,75716,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,27148.0,17646.2,55.11,27936.0,147
HCPCS,75716,ARTERY X-RAYS ARMS/LEGS,,,70.83,70.83,2
HCPCS,757160,ARTERY X-RAYS ARMS/LEGS,,,70.83,70.83,1
HCPCS,75716TC,ARTERY X-RAYS ARMS/LEGS,,,70.83,70.83,1
HCPCS,75726,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,46624.0,30305.6,47.73,47444.0,147
HCPCS,75726,ARTERY X-RAYS ABDOMEN,,,76.4,76.4,2
HCPCS,757260,ARTERY X-RAYS ABDOMEN,,,76.4,76.4,1
HCPCS,75726TC,ARTERY X-RAYS ABDOMEN,,,76.4,76.4,1
HCPCS,75731,ANGIO ADRENAL UNILAT SELECT,27148.0,17646.2,47.45,27650.0,98
HCPCS,75731,ANGIOGRAPHY ADRENAL UNILATERAL SLCTV RS&I,27148.0,17646.2,208.44,24433.2,49
HCPCS,75731,ARTERY X-RAYS ADRENAL GLAND,,,98.39,98.39,2
HCPCS,757310,ARTERY X-RAYS ADRENAL GLAND,,,98.39,98.39,1
HCPCS,75731TC,ARTERY X-RAYS ADRENAL GLAND,,,98.39,98.39,1
HCPCS,75733,ANGIO ADRENAL BILAT SELECT,27148.0,17646.2,54.56,27724.0,98
HCPCS,75733,ANGIOGRAPHY ADRENAL BILATERAL SLCTV RS&I,27148.0,17646.2,242.83,24433.2,49
HCPCS,75733,ARTERY X-RAYS ADRENALS,,,110.55,110.55,2
HCPCS,757330,ARTERY X-RAYS ADRENALS,,,110.55,110.55,1
HCPCS,75733TC,ARTERY X-RAYS ADRENALS,,,110.55,110.55,1
HCPCS,75736,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,46624.0,30305.6,46.44,47080.0,147
HCPCS,75736,ARTERY X-RAYS PELVIS,,,90.85,90.85,2
HCPCS,757360,ARTERY X-RAYS PELVIS,,,90.85,90.85,1
HCPCS,75736TC,ARTERY X-RAYS PELVIS,,,90.85,90.85,1
HCPCS,75741,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,27148.0,17646.2,54.26,27672.0,147
HCPCS,75741,ARTERY X-RAYS LUNG,,,69.52,69.52,2
HCPCS,757410,ARTERY X-RAYS LUNG,,,69.52,69.52,1
HCPCS,75741TC,ARTERY X-RAYS LUNG,,,69.52,69.52,1
HCPCS,75743,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,27148.0,17646.2,69.03,27812.0,147
HCPCS,75743,ARTERY X-RAYS LUNGS,,,70.83,70.83,2
HCPCS,757430,ARTERY X-RAYS LUNGS,,,70.83,70.83,1
HCPCS,75743TC,ARTERY X-RAYS LUNGS,,,70.83,70.83,1
HCPCS,75746,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,27148.0,17646.2,47.59,27650.0,196
HCPCS,75746,ARTERY X-RAYS LUNG,,,81.64,81.64,2
HCPCS,757460,ARTERY X-RAYS LUNG,,,81.64,81.64,1
HCPCS,75746TC,ARTERY X-RAYS LUNG,,,81.64,81.64,1
HCPCS,75756,ANGIOGRAPHY INTERNAL MAMMARY RS&I,27148.0,17646.2,54.57,27604.0,147
HCPCS,75756,ARTERY X-RAYS CHEST,,,109.52,109.52,2
HCPCS,757560,ARTERY X-RAYS CHEST,,,109.52,109.52,1
HCPCS,75756TC,ARTERY X-RAYS CHEST,,,109.52,109.52,1
HCPCS,75774,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,5228.0,3398.2,15.2,5632.0,134
HCPCS,75774,ARTERY X-RAY EACH VESSEL,,,50.16,50.16,2
HCPCS,757740,ARTERY X-RAY EACH VESSEL,,,50.16,50.16,1
HCPCS,75774TC,ARTERY X-RAY EACH VESSEL,,,50.16,50.16,1
HCPCS,75801,LYMPH VESSEL X-RAY ARM/LEG,,,598.73,598.73,2
HCPCS,75801,LYMPHANGIOGRAM EXTREM UNILATER,5333.0,3466.45,39.79,5657.0,66
HCPCS,75801,LYMPHANGIOGRAPHY EXTREMITY ONLY UNILAT RS&I,5333.0,3466.45,146.0,4799.7,48
HCPCS,758010,LYMPH VESSEL X-RAY ARM/LEG,,,598.73,598.73,1
HCPCS,75801TC,LYMPH VESSEL X-RAY ARM/LEG,,,598.73,598.73,1
HCPCS,75803,LYMPH VESSEL X-RAY ARMS/LEGS,,,1526.23,1526.23,2
HCPCS,75803,LYMPHANGIO EXTREM BILAT,13399.0,8709.35,50.29,13914.0,66
HCPCS,75803,LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I,13399.0,8709.35,146.0,12059.1,48
HCPCS,758030,LYMPH VESSEL X-RAY ARMS/LEGS,,,1526.23,1526.23,1
HCPCS,75803TC,LYMPH VESSEL X-RAY ARMS/LEGS,,,1526.23,1526.23,1
HCPCS,75805,LYMPH VESSEL X-RAY TRUNK,,,3037.69,3037.69,2
HCPCS,75805,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,27148.0,17646.2,34.81,27472.0,114
HCPCS,758050,LYMPH VESSEL X-RAY TRUNK,,,3037.69,3037.69,1
HCPCS,75805TC,LYMPH VESSEL X-RAY TRUNK,,,3037.69,3037.69,1
HCPCS,75807,LYMPH VESSEL X-RAY TRUNK,,,3037.69,3037.69,2
HCPCS,75807,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,27148.0,17646.2,50.29,27616.0,114
HCPCS,758070,LYMPH VESSEL X-RAY TRUNK,,,3037.69,3037.69,1
HCPCS,75807TC,LYMPH VESSEL X-RAY TRUNK,,,3037.69,3037.69,1
HCPCS,75809,NONVASCULAR SHUNT X-RAY,,,58.34,58.34,2
HCPCS,75809,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,918.0,596.7,20.03,1125.0,147
HCPCS,758090,NONVASCULAR SHUNT X-RAY,,,58.34,58.34,1
HCPCS,75809TC,NONVASCULAR SHUNT X-RAY,,,58.34,58.34,1
HCPCS,75810,SPLENOPORTOGRAM,456.0,296.4,49.06,456.0,31
HCPCS,75810,SPLENOPORTOGRAPY RS&I,27148.0,17646.2,146.0,24433.2,48
HCPCS,75810,VEIN X-RAY SPLEEN/LIVER,,,3037.69,3037.69,2
HCPCS,758100,VEIN X-RAY SPLEEN/LIVER,,,3037.69,3037.69,1
HCPCS,75810TC,VEIN X-RAY SPLEEN/LIVER,,,3037.69,3037.69,1
HCPCS,75820,VEIN X-RAY ARM/LEG,,,58.34,58.34,2
HCPCS,75820,VENOGRAPHY EXTREMITY UNILATERAL RS&I,13399.0,8709.35,29.26,13819.0,147
HCPCS,758200,VEIN X-RAY ARM/LEG,,,58.34,58.34,1
HCPCS,75820TC,VEIN X-RAY ARM/LEG,,,58.34,58.34,1
HCPCS,75822,VEIN X-RAY ARMS/LEGS,,,64.56,64.56,2
HCPCS,75822,VENOGRAPHY EXTREMITY BILATERAL RS&I,13399.0,8709.35,44.17,13991.0,147
HCPCS,758220,VEIN X-RAY ARMS/LEGS,,,64.56,64.56,1
HCPCS,75822TC,VEIN X-RAY ARMS/LEGS,,,64.56,64.56,1
HCPCS,75825,VEIN X-RAY TRUNK,,,60.63,60.63,2
HCPCS,75825,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,27148.0,17646.2,47.44,27650.0,147
HCPCS,758250,VEIN X-RAY TRUNK,,,60.63,60.63,1
HCPCS,75825TC,VEIN X-RAY TRUNK,,,60.63,60.63,1
HCPCS,75827,VEIN X-RAY CHEST,,,64.89,64.89,2
HCPCS,75827,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,13399.0,8709.35,46.72,13855.0,147
HCPCS,758270,VEIN X-RAY CHEST,,,64.89,64.89,1
HCPCS,75827TC,VEIN X-RAY CHEST,,,64.89,64.89,1
HCPCS,75831,VEIN X-RAY KIDNEY,,,67.55,67.55,2
HCPCS,75831,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,27148.0,17646.2,51.14,27604.0,147
HCPCS,758310,VEIN X-RAY KIDNEY,,,67.55,67.55,1
HCPCS,75831TC,VEIN X-RAY KIDNEY,,,67.55,67.55,1
HCPCS,75833,VEIN X-RAY KIDNEYS,,,78.03,78.03,2
HCPCS,75833,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,27148.0,17646.2,60.21,27744.0,147
HCPCS,758330,VEIN X-RAY KIDNEYS,,,78.03,78.03,1
HCPCS,75833TC,VEIN X-RAY KIDNEYS,,,78.03,78.03,1
HCPCS,75840,VEIN X-RAY ADRENAL GLAND,,,73.77,73.77,2
HCPCS,75840,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,27148.0,17646.2,53.3,27604.0,147
HCPCS,758400,VEIN X-RAY ADRENAL GLAND,,,73.77,73.77,1
HCPCS,75840TC,VEIN X-RAY ADRENAL GLAND,,,73.77,73.77,1
HCPCS,75842,VEIN X-RAY ADRENAL GLANDS,,,5426.13,11720.45,10
HCPCS,75842,Vein x-ray adrenal glands,,,2928.25,3698.84,6
HCPCS,75857,VENO SUPR W SERIAL SI,1965.0,1277.25,146.0,1768.5,29
HCPCS,75860,VEIN X-RAY NECK,,,71.81,71.81,2
HCPCS,75860,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,27148.0,17646.2,48.3,27604.0,147
HCPCS,758600,VEIN X-RAY NECK,,,71.81,71.81,1
HCPCS,75860TC,VEIN X-RAY NECK,,,71.81,71.81,1
HCPCS,75870,VEIN X-RAY SKULL,,,96.38,96.38,2
HCPCS,75870,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,27148.0,17646.2,47.59,27650.0,147
HCPCS,758700,VEIN X-RAY SKULL,,,96.38,96.38,1
HCPCS,75870TC,VEIN X-RAY SKULL,,,96.38,96.38,1
HCPCS,75872,VEIN X-RAY SKULL EPIDURAL,,,73.77,73.77,2
HCPCS,75872,VENOGRAM EPIDURAL,5333.0,3466.45,51.61,5835.0,98
HCPCS,75872,VENOGRAPHY EPIDURAL RS&I,5333.0,3466.45,146.0,4799.7,49
HCPCS,758720,VEIN X-RAY SKULL EPIDURAL,,,73.77,73.77,1
HCPCS,75872TC,VEIN X-RAY SKULL EPIDURAL,,,73.77,73.77,1
HCPCS,75880,VEIN X-RAY EYE SOCKET,,,73.45,73.45,2
HCPCS,75880,VENOGRAM ORBITAL,5333.0,3466.45,28.98,5641.0,98
HCPCS,75880,VENOGRAPHY ORBITAL RS&I,5333.0,3466.45,146.0,4799.7,49
HCPCS,758800,VEIN X-RAY EYE SOCKET,,,73.45,73.45,1
HCPCS,75880TC,VEIN X-RAY EYE SOCKET,,,73.45,73.45,1
HCPCS,75885,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,27148.0,17646.2,59.66,27724.0,147
HCPCS,75885,VEIN X-RAY LIVER W/HEMODYNAM,,,71.16,71.16,2
HCPCS,758850,VEIN X-RAY LIVER W/HEMODYNAM,,,71.16,71.16,1
HCPCS,75885TC,VEIN X-RAY LIVER W/HEMODYNAM,,,71.16,71.16,1
HCPCS,75887,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,27148.0,17646.2,58.09,27724.0,147
HCPCS,75887,VEIN X-RAY LIVER W/O HEMODYN,,,71.81,71.81,2
HCPCS,758870,VEIN X-RAY LIVER W/O HEMODYN,,,71.81,71.81,1
HCPCS,75887TC,VEIN X-RAY LIVER W/O HEMODYN,,,71.81,71.81,1
HCPCS,75889,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,27148.0,17646.2,47.3,27604.0,147
HCPCS,75889,VEIN X-RAY LIVER W/HEMODYNAM,,,71.16,71.16,2
HCPCS,758890,VEIN X-RAY LIVER W/HEMODYNAM,,,71.16,71.16,1
HCPCS,75889TC,VEIN X-RAY LIVER W/HEMODYNAM,,,71.16,71.16,1
HCPCS,75891,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,27148.0,17646.2,47.3,27604.0,147
HCPCS,75891,VEIN X-RAY LIVER,,,71.81,71.81,2
HCPCS,758910,VEIN X-RAY LIVER,,,71.81,71.81,1
HCPCS,75891TC,VEIN X-RAY LIVER,,,71.81,71.81,1
HCPCS,75893,VENOUS SAMPLING BY CATHETER,,,78.69,78.69,2
HCPCS,75893,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,46624.0,30305.6,21.45,46840.0,147
HCPCS,758930,VENOUS SAMPLING BY CATHETER,,,78.69,78.69,1
HCPCS,75893TC,VENOUS SAMPLING BY CATHETER,,,78.69,78.69,1
HCPCS,75894,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3891.0,2529.15,57.67,4415.0,154
HCPCS,75894,X-RAYS TRANSCATH THERAPY,,,924.15,924.15,2
HCPCS,758940,X-RAYS TRANSCATH THERAPY,,,924.15,924.15,1
HCPCS,75894TC,X-RAYS TRANSCATH THERAPY,,,924.15,924.15,1
HCPCS,75898,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,27148.0,17646.2,41.61,27808.0,180
HCPCS,75898,FOLLOW-UP ANGIOGRAPHY,,,3037.69,3037.69,2
HCPCS,758980,FOLLOW-UP ANGIOGRAPHY,,,3037.69,3037.69,1
HCPCS,75898TC,FOLLOW-UP ANGIOGRAPHY,,,3037.69,3037.69,1
HCPCS,75901,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,900.0,585.0,20.31,1096.0,134
HCPCS,75901,REMOVE CVA DEVICE OBSTRUCT,,,201.83,201.83,2
HCPCS,759010,REMOVE CVA DEVICE OBSTRUCT,,,201.83,201.83,1
HCPCS,75901TC,REMOVE CVA DEVICE OBSTRUCT,,,201.83,201.83,1
HCPCS,75902,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,524.0,340.6,16.76,680.0,134
HCPCS,75902,REMOVE CVA LUMEN OBSTRUCT,,,68.82,68.82,2
HCPCS,759020,REMOVE CVA LUMEN OBSTRUCT,,,68.82,68.82,1
HCPCS,75902TC,REMOVE CVA LUMEN OBSTRUCT,,,68.82,68.82,1
HCPCS,75956,Xray endovasc thor ao repr,,,136.83,172.84,6
HCPCS,75957,Xray endovasc thor ao repr,,,136.83,172.84,6
HCPCS,75958,Xray place prox ext thor ao,,,136.83,172.84,6
HCPCS,75959,Xray place dist ext thor ao,,,136.83,172.84,6
HCPCS,75970,TRANSCATHETER BIOPSY RS&I,4588.0,2982.2,136.83,4129.2,35
HCPCS,75970,TRANSVASCULAR BIOPSY,4588.0,2982.2,35.37,4920.0,66
HCPCS,75970,VASCULAR BIOPSY,,,369.92,369.92,2
HCPCS,759700,VASCULAR BIOPSY,,,369.92,369.92,1
HCPCS,75970TC,VASCULAR BIOPSY,,,369.92,369.92,1
HCPCS,75984,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,1314.0,854.1,29.83,1646.0,134
HCPCS,75984,XRAY CONTROL CATHETER CHANGE,,,57.03,57.03,2
HCPCS,759840,XRAY CONTROL CATHETER CHANGE,,,57.03,57.03,1
HCPCS,75984TC,XRAY CONTROL CATHETER CHANGE,,,57.03,57.03,1
HCPCS,75989,ABSCESS DRAINAGE UNDER X-RAY,,,58.85,58.85,2
HCPCS,75989,PERQ DRAIN W/PLCMT CATH,476.0,309.4,98.08,476.0,32
HCPCS,75989,RAD GUIDE PERC DRAINAGE,3135.0,2037.75,98.08,3135.0,32
HCPCS,75989,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2659.0,1728.35,48.43,3135.0,278
HCPCS,759890,ABSCESS DRAINAGE UNDER X-RAY,,,58.85,58.85,1
HCPCS,75989TC,ABSCESS DRAINAGE UNDER X-RAY,,,58.85,58.85,1
HCPCS,76000,FLUOROSCOPY <1 HOUR,1162.5,755.625,39.26,2205.0,64
HCPCS,76000,FLUOROSCOPY <1 HR PHYS/QHP,,,27.55,27.55,2
HCPCS,76000,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,2085.0,1355.25,7.25,2205.0,196
HCPCS,760000,FLUOROSCOPY <1 HR PHYS/QHP,,,27.55,27.55,1
HCPCS,76000TC,FLUOROSCOPY <1 HR PHYS/QHP,,,27.55,27.55,1
HCPCS,76010,"FOREIGN BDY,NOSE-RECT PED",72.0,46.8,20.93,72.0,32
HCPCS,76010,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,760.0,494.0,7.53,832.0,147
HCPCS,76010,X-RAY NOSE TO RECTUM,,,20.68,20.68,2
HCPCS,760100,X-RAY NOSE TO RECTUM,,,20.68,20.68,1
HCPCS,76010TC,X-RAY NOSE TO RECTUM,,,20.68,20.68,1
HCPCS,76014,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,211.0,137.15,7.42,2109.0,92
HCPCS,76014,MR SFTY IMPLT&/FB ASMT STF 1,,,10.54,10.54,1
HCPCS,760140,MR SFTY IMPLT&/FB ASMT STF 1,,,10.54,10.54,1
HCPCS,76015,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,572.5,372.125,35.76,2109.0,79
HCPCS,76015,MR SFTY MPLT&/FB ASMT STF EA,,,50.81,50.81,1
HCPCS,760150,MR SFTY MPLT&/FB ASMT STF EA,,,50.81,50.81,1
HCPCS,76016,MR SAFETY DETER PHYS/QHP,,,43.36,43.36,2
HCPCS,76016,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,760.0,494.0,27.9,2109.0,128
HCPCS,760160,MR SAFETY DETER PHYS/QHP,,,43.36,43.36,1
HCPCS,76016TC,MR SAFETY DETER PHYS/QHP,,,43.36,43.36,1
HCPCS,76017,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,2085.0,1355.25,35.59,2419.0,128
HCPCS,76017,MR SFTY MED PHYSICS XM CSTMZ,,,182.34,182.34,2
HCPCS,760170,MR SFTY MED PHYSICS XM CSTMZ,,,182.34,182.34,1
HCPCS,76017TC,MR SFTY MED PHYSICS XM CSTMZ,,,182.34,182.34,1
HCPCS,76018,MR SAFETY IMPLANT ELEC PREPJ,,,76.42,76.42,2
HCPCS,76018,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,791.0,514.15,34.69,2109.0,128
HCPCS,760180,MR SAFETY IMPLANT ELEC PREPJ,,,76.42,76.42,1
HCPCS,76018TC,MR SAFETY IMPLANT ELEC PREPJ,,,76.42,76.42,1
HCPCS,76019,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,513.0,333.45,28.08,2109.0,128
HCPCS,76019,MR SAFETY IMPLT POS&/IMMOBLJ,,,116.85,116.85,2
HCPCS,760190,MR SAFETY IMPLT POS&/IMMOBLJ,,,116.85,116.85,1
HCPCS,76019TC,MR SAFETY IMPLT POS&/IMMOBLJ,,,116.85,116.85,1
HCPCS,76080,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,4729.0,3073.85,22.3,4945.0,147
HCPCS,76080,X-RAY EXAM OF FISTULA,,,34.77,34.77,2
HCPCS,760800,X-RAY EXAM OF FISTULA,,,34.77,34.77,1
HCPCS,76080TC,X-RAY EXAM OF FISTULA,,,34.77,34.77,1
HCPCS,76098,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,4729.0,3073.85,6.68,4853.0,196
HCPCS,76098,X-RAY EXAM SURGICAL SPECIMEN,,,27.23,27.23,2
HCPCS,760980,X-RAY EXAM SURGICAL SPECIMEN,,,27.23,27.23,1
HCPCS,76098TC,X-RAY EXAM SURGICAL SPECIMEN,,,27.23,27.23,1
HCPCS,76100,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,918.0,596.7,26.58,1150.0,147
HCPCS,76100,X-RAY EXAM OF BODY SECTION,,,60.96,60.96,2
HCPCS,761000,X-RAY EXAM OF BODY SECTION,,,60.96,60.96,1
HCPCS,76100TC,X-RAY EXAM OF BODY SECTION,,,60.96,60.96,1
HCPCS,76101,Complex body section x-ray,,,33.81,42.71,6
HCPCS,76102,Complex body section x-rays,,,33.81,42.71,6
HCPCS,76120,CINE/VIDEO X-RAYS,,,97.32,97.32,2
HCPCS,76120,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,911.5,592.475,16.05,1070.0,196
HCPCS,761200,CINE/VIDEO X-RAYS,,,97.32,97.32,1
HCPCS,76120TC,CINE/VIDEO X-RAYS,,,97.32,97.32,1
HCPCS,76125,CINE/VIDEO X-RAYS ADD-ON,,,28.67,28.67,2
HCPCS,76125,Cine/video x-rays add-on,,,33.81,42.71,6
HCPCS,761250,CINE/VIDEO X-RAYS ADD-ON,,,28.67,28.67,1
HCPCS,76125TC,CINE/VIDEO X-RAYS ADD-ON,,,28.67,28.67,1
HCPCS,76140,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,2165.0,1407.25,70.5,2306.0,36
HCPCS,76140,X-RAY CONSULTATION,,,136.06,136.06,1
HCPCS,761400,X-RAY CONSULTATION,,,136.06,136.06,1
HCPCS,76145,MED PHYSIC DOS EVAL RAD EXPS,,,285.46,1150.43,18
HCPCS,76145,Med physic dos eval rad exps,,,71.21,89.95,6
HCPCS,761450,MED PHYSIC DOS EVAL RAD EXPS,,,894.55,894.55,1
HCPCS,76376,3D RENDER W/INTRP POSTPROCES,,,16.21,16.21,2
HCPCS,76376,3D RENDER W/O POSTPROCESS,88.0,57.2,18.56,88.0,32
HCPCS,76376,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,708.0,460.2,8.38,2109.0,248
HCPCS,763760,3D RENDER W/INTRP POSTPROCES,,,16.21,16.21,1
HCPCS,76376TC,3D RENDER W/INTRP POSTPROCES,,,16.21,16.21,1
HCPCS,76377,3D RENDER W/INTRP POSTPROCES,,,42.04,42.04,2
HCPCS,76377,3D RENDER W/POSTPROCESS,316.0,205.4,55.39,316.0,32
HCPCS,76377,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1795.0,1166.75,32.67,2111.0,278
HCPCS,763770,3D RENDER W/INTRP POSTPROCES,,,42.04,42.04,1
HCPCS,76377TC,3D RENDER W/INTRP POSTPROCES,,,42.04,42.04,1
HCPCS,76380,CAT SCAN FOLLOW-UP STUDY,,,90.83,90.83,2
HCPCS,76380,CT LIMITED/LOCALIZED FOLLOW UP STUDY,760.0,494.0,40.34,1746.0,147
HCPCS,76380,CT LMTD OR LOC F/U STUDY,392.0,254.8,92.85,392.0,32
HCPCS,763800,CAT SCAN FOLLOW-UP STUDY,,,90.83,90.83,1
HCPCS,76380TC,CAT SCAN FOLLOW-UP STUDY,,,90.83,90.83,1
HCPCS,76390,MR SPECTROSCOPY,,,329.04,329.04,2
HCPCS,76390,MRI SPECTROSCOPY,760.0,494.0,58.11,1903.0,136
HCPCS,763900,MR SPECTROSCOPY,,,329.04,329.04,1
HCPCS,76390TC,MR SPECTROSCOPY,,,329.04,329.04,1
HCPCS,76391,MAGNETIC RESONANCE ELASTOGRAPHY,2085.0,1355.25,51.36,2569.0,184
HCPCS,76391,MR ELASTOGRAPHY,,,152.38,152.38,2
HCPCS,763910,MR ELASTOGRAPHY,,,152.38,152.38,1
HCPCS,76391TC,MR ELASTOGRAPHY,,,152.38,152.38,1
HCPCS,76496,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),24601.0,15990.65,21.42,25232.0,97
HCPCS,76496,BRONCHOGRAPHY,242.0,157.3,33.81,349.0,48
HCPCS,76496,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),27148.0,17646.2,21.42,27604.0,97
HCPCS,76496,UNLISTED FLUOROSCOPIC PROCEDURE,298.0,193.7,33.81,349.0,48
HCPCS,76496,"UNLISTED FLUOROSCOPIC PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL",520.0,338.0,21.42,677.0,49
HCPCS,76496,UNLISTED FLUOROSCOPIC PX,,,86.51,86.51,2
HCPCS,76496,VENOGRAM AZYGOS VEIN (COMP CODE 75705),42412.0,27567.8,21.42,43197.0,49
HCPCS,76496,VENOGRAM AZYGOS VEIN (COMP COMP CODE 75705),42412.0,27567.8,33.81,38170.8,48
HCPCS,76496,VENOGRAM CARDINAL VARIX (COMP CODE 75891),27148.0,17646.2,21.42,27604.0,97
HCPCS,76496,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),27148.0,17646.2,21.42,27604.0,97
HCPCS,76496,VENOGRAM GASTRIC VEIN (COMP CODE 75891),24601.0,15990.65,21.42,25012.0,97
HCPCS,76496,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),27148.0,17646.2,21.42,27604.0,97
HCPCS,76496,VENOGRAM GONADAL VEIN (COMP CODE 75831),24601.0,15990.65,21.42,25012.0,97
HCPCS,76496,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),46624.0,30305.6,21.42,47496.0,97
HCPCS,76496,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),24601.0,15990.65,21.42,25012.0,97
HCPCS,76496,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),42412.0,27567.8,21.42,43197.0,97
HCPCS,76496,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),46624.0,30305.6,21.42,47496.0,97
HCPCS,76496,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),42412.0,27567.8,21.42,42823.0,97
HCPCS,76496,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),13399.0,8709.35,21.42,13819.0,97
HCPCS,76496,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),46624.0,30305.6,21.42,47496.0,97
HCPCS,76496,VENOGRAM SPLENIC VEIN (COMP CODE 75891),27148.0,17646.2,21.42,27604.0,97
HCPCS,76496,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),27148.0,17646.2,21.42,27604.0,97
HCPCS,76496,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),5228.0,3398.2,21.42,5632.0,97
HCPCS,76496,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),4841.0,3146.65,21.42,5205.0,97
HCPCS,76496,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),46624.0,30305.6,21.42,47496.0,97
HCPCS,76496,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",27148.0,17646.2,21.42,27650.0,97
HCPCS,764960,UNLISTED FLUOROSCOPIC PX,,,86.51,86.51,1
HCPCS,76496TC,UNLISTED FLUOROSCOPIC PX,,,86.51,86.51,1
HCPCS,76497,CT ABDOMEN SCREENING,99.0,64.35,27.82,1746.0,48
HCPCS,76497,CT ABDOMEN SCREENING (COMP CODE 74176),89.0,57.849999999999994,19.89,134.0,29
HCPCS,76497,CT CALCIUM SCORING,65.0,42.25,18.27,1746.0,48
HCPCS,76497,CT CHEST WO SCREENING,99.0,64.35,27.82,1746.0,48
HCPCS,76497,CT CHEST/LUNG SCREENING (COMP CODE G0297),138.0,89.7,19.89,234.0,29
HCPCS,76497,CT PELVIS SCREENING,99.0,64.35,27.82,1746.0,48
HCPCS,76497,CT PELVIS SCREENING (COMP CODE 74176),87.0,56.55,19.89,133.87,29
HCPCS,76497,CTA HEART FYNCTION EJECTION WALL MOTION,284.0,184.6,133.87,284.0,13
HCPCS,76497,LOW DOSE WHOLE BODY CT,12580.0,8177.0,64.08,11322.0,48
HCPCS,76497,LOW DOSE WHOLE BODY CT (COMP CODE 78813),12580.0,8177.0,19.89,13380.0,49
HCPCS,76497,PROC CT UNLISTD,1137.0,739.05,64.08,1746.0,48
HCPCS,76497,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,520.0,338.0,15.0,550.0,49
HCPCS,76497,UNLISTED CT PROCEDURE,,,90.83,90.83,2
HCPCS,764970,UNLISTED CT PROCEDURE,,,90.83,90.83,1
HCPCS,76497TC,UNLISTED CT PROCEDURE,,,90.83,90.83,1
HCPCS,76498,MMR BRAIN WITH PC,3080.0,2002.0,17.21,3667.0,89
HCPCS,76498,MRI 3D CAD,1231.0,800.15,88.38,1903.0,40
HCPCS,76498,MRI 3D CAD (COMP CODE 76377),1231.0,800.15,17.21,1488.0,49
HCPCS,76498,MRI BRAIN LOCALIZATION W IVCON,2572.0,1671.8,88.38,2314.8,40
HCPCS,76498,MRI BRAIN LOCALIZATION WO CONT,2319.0,1507.35,17.21,4443.0,97
HCPCS,76498,MRI BRAIN LOCALIZATION WWO CONT,2572.0,1671.8,17.21,3488.0,89
HCPCS,76498,MRI BRAIN W/WO CONTAST PC,3080.0,2002.0,88.38,2772.0,40
HCPCS,76498,MRI BRAIN W/WO CONTRAST PC,3080.0,2002.0,17.21,3209.0,49
HCPCS,76498,MRI BREAST LIMITED,281.0,182.65,17.21,1903.0,89
HCPCS,76498,MRI CERVICAL LOCALIZATION W IVCON,2572.0,1671.8,17.21,3163.0,89
HCPCS,76498,MRI GAMMA KNIFE LOCAL W CONT,2455.0,1595.75,17.21,3042.0,89
HCPCS,76498,MRI LUMBAR LOCALIZATION W IVCON,1585.5,1030.575,17.21,3171.0,89
HCPCS,76498,MRI PRE- OP MAPPING W/WO CONTR,760.0,494.0,88.38,1903.0,40
HCPCS,76498,MRI PRE-OP MAPPING W/CONTRAST,760.0,494.0,17.21,1903.0,89
HCPCS,76498,MRI PRE-OP MAPPING W/O CONTRAST,760.0,494.0,88.38,1903.0,40
HCPCS,76498,MRI PRE-OP MAPPING W/O CONTRST,760.0,494.0,17.21,1283.0,49
HCPCS,76498,MRI PRE-OP MAPPING W/WO CNTRST,835.0,542.75,17.21,1595.0,49
HCPCS,76498,MRI PROSTATE LIMITED WO IVCON,438.0,284.7,17.21,508.0,49
HCPCS,76498,MRI THORACIC LOCALIZATION W IVCON,2572.0,1671.8,17.21,3163.0,89
HCPCS,76498,MRI-TRUS FUSION-GUIDED PROSTRATE BIOPSY,1347.0,875.55,69.93,1347.0,13
HCPCS,76498,UNLISTED MR PROCEDURE,,,93.43,93.43,2
HCPCS,76498,WHOLE BODY MRI,12580.0,8177.0,88.38,11322.0,40
HCPCS,76498,WHOLE BODY MRI (COMP CODE 78816),12580.0,8177.0,17.21,13481.0,49
HCPCS,764980,UNLISTED MR PROCEDURE,,,93.43,93.43,1
HCPCS,76498TC,UNLISTED MR PROCEDURE,,,93.43,93.43,1
HCPCS,76499,3D RENDERING LIVER (DONOR) S&I,1795.0,1166.75,33.81,2894.0,84
HCPCS,76499,BD WHOLE BODY COMPOSITION,918.0,596.7,31.5,981.0,36
HCPCS,76499,BREAST TOMO,122.0,79.3,31.6,212.0,48
HCPCS,76499,CT ABDOMEN W/O SCREENING,918.0,596.7,33.81,1442.0,84
HCPCS,76499,LYMPHANGIOGRAPHY OF FACE & NECK,13399.0,8709.35,33.81,12059.1,48
HCPCS,76499,LYMPHANGIOGRAPHY OF FACE & NECK (COMP CODE 75803),13399.0,8709.35,252.0,13903.0,36
HCPCS,76499,PROC XR UNLISTD,205.0,133.25,33.81,349.0,48
HCPCS,76499,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,520.0,338.0,33.0,586.0,36
HCPCS,76499,UNLISTED DXA BODY COMPOSITION STUDY,918.0,596.7,33.81,826.2,48
HCPCS,76499,UNLISTED DXA BODY COMPOSITION STUDY (COMP CODE 77080),918.0,596.7,42.5,1003.0,36
HCPCS,76499,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE,3466.0,2252.9,33.81,3119.4,48
HCPCS,76499,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE (COMP TO 78445),3466.0,2252.9,81.0,3628.0,36
HCPCS,76499,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP",27148.0,17646.2,33.81,24433.2,48
HCPCS,76499,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP (COMP CODE 7574",27148.0,17646.2,16.0,27180.0,36
HCPCS,76499,XR DEXA WHOLE BODY COMPOSITION,918.0,596.7,33.81,826.2,48
HCPCS,76506,ECHO EXAM OF HEAD,,,80.94,80.94,2
HCPCS,76506,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,918.0,596.7,26.42,1170.0,147
HCPCS,765060,ECHO EXAM OF HEAD,,,80.94,80.94,1
HCPCS,76506TC,ECHO EXAM OF HEAD,,,80.94,80.94,1
HCPCS,76510,OPH US DX B-SCAN&QUAN A-SCAN,,,29.85,279.48,19
HCPCS,76510,Oph us dx b-scan&quan a-scan,,,66.35,83.81,6
HCPCS,765100,OPH US DX B-SCAN&QUAN A-SCAN,,,29.85,29.85,1
HCPCS,76510TC,OPH US DX B-SCAN&QUAN A-SCAN,,,29.85,29.85,1
HCPCS,76511,OPH US DX QUAN A-SCAN ONLY,,,21.66,252.18,19
HCPCS,76511,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,918.0,596.7,20.91,1200.0,98
HCPCS,76511,Oph us dx quan a-scan only,,,66.35,83.81,6
HCPCS,765110,OPH US DX QUAN A-SCAN ONLY,,,21.66,21.66,1
HCPCS,76511TC,OPH US DX QUAN A-SCAN ONLY,,,21.66,21.66,1
HCPCS,76512,OPH US DX B-SCAN,,,17.73,17.73,2
HCPCS,76512,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,918.0,596.7,17.36,1164.0,147
HCPCS,765120,OPH US DX B-SCAN,,,17.73,17.73,1
HCPCS,76512TC,OPH US DX B-SCAN,,,17.73,17.73,1
HCPCS,76513,DX OPHTHALMIC US ANT SEGMENT IMMERSION UNI/BI,918.0,596.7,28.86,1182.0,147
HCPCS,76513,OPH US DX ANT SGM US UNI/BI,,,42.62,42.62,2
HCPCS,765130,OPH US DX ANT SGM US UNI/BI,,,42.62,42.62,1
HCPCS,76513TC,OPH US DX ANT SGM US UNI/BI,,,42.62,42.62,1
HCPCS,76514,ECHO EXAM OF EYE THICKNESS,,,3.65,53.1,19
HCPCS,76514,Echo exam of eye thickness,,,31.76,40.12,6
HCPCS,76514,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,211.0,137.15,3.8,273.0,98
HCPCS,765140,ECHO EXAM OF EYE THICKNESS,,,3.65,3.65,1
HCPCS,76514TC,ECHO EXAM OF EYE THICKNESS,,,3.65,3.65,1
HCPCS,76516,ECHO EXAM OF EYE,,,24.28,252.18,19
HCPCS,76516,Echo exam of eye,,,66.35,83.81,6
HCPCS,765160,ECHO EXAM OF EYE,,,24.28,24.28,1
HCPCS,76516TC,ECHO EXAM OF EYE,,,24.28,24.28,1
HCPCS,76519,ECHO EXAM OF EYE,,,37.7,252.18,19
HCPCS,76519,Echo exam of eye,,,66.35,83.81,6
HCPCS,76519,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,918.0,596.7,26.03,1134.0,98
HCPCS,76519,OPHTHALMIC BIOMETRY,1134.0,737.1,51.05,1134.0,32
HCPCS,76519,OPHTHALMIC BIOMETRY W IOL POWER CALCULATI,216.0,140.4,51.05,216.0,32
HCPCS,765190,ECHO EXAM OF EYE,,,37.7,37.7,1
HCPCS,76519TC,ECHO EXAM OF EYE,,,37.7,37.7,1
HCPCS,76529,ECHO EXAM OF EYE,,,53.1,190.91,19
HCPCS,76529,Echo exam of eye,,,31.76,40.12,6
HCPCS,765290,ECHO EXAM OF EYE,,,53.1,53.1,1
HCPCS,76529TC,ECHO EXAM OF EYE,,,53.1,53.1,1
HCPCS,76536,ECHO HEAD NECK SOFT TISSUE,705.0,458.25,59.89,1164.0,64
HCPCS,76536,US EXAM OF HEAD AND NECK,,,82.58,82.58,2
HCPCS,76536,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,918.0,596.7,23.15,1164.0,147
HCPCS,765360,US EXAM OF HEAD AND NECK,,,82.58,82.58,1
HCPCS,76536TC,US EXAM OF HEAD AND NECK,,,82.58,82.58,1
HCPCS,76604,ECHO CHEST  B-SCAN,695.0,451.75,51.82,1154.0,64
HCPCS,76604,US CHEST REAL TIME W/IMAGE DOCUMENTATION,918.0,596.7,22.58,1154.0,147
HCPCS,76604,US EXAM CHEST,,,29.85,29.85,2
HCPCS,766040,US EXAM CHEST,,,29.85,29.85,1
HCPCS,76604TC,US EXAM CHEST,,,29.85,29.85,1
HCPCS,76641,ULTRASOUND BREAST COMPLETE,,,67.19,67.19,2
HCPCS,76641,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,918.0,596.7,34.62,1239.0,241
HCPCS,766410,ULTRASOUND BREAST COMPLETE,,,67.19,67.19,1
HCPCS,76641TC,ULTRASOUND BREAST COMPLETE,,,67.19,67.19,1
HCPCS,76642,ULTRASOUND BREAST LIMITED,,,52.12,52.12,2
HCPCS,76642,US BREAST UNI REAL TIME WITH IMAGE LIMITED,760.0,494.0,32.36,1059.0,241
HCPCS,766420,ULTRASOUND BREAST LIMITED,,,52.12,52.12,1
HCPCS,76642TC,ULTRASOUND BREAST LIMITED,,,52.12,52.12,1
HCPCS,76700,ECHO ABDOMEN B-SCAN COMP,815.0,529.75,84.07,1274.0,64
HCPCS,76700,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,918.0,596.7,33.52,1274.0,147
HCPCS,76700,US EXAM ABDOM COMPLETE,,,77.38,77.38,2
HCPCS,767000,US EXAM ABDOM COMPLETE,,,77.38,77.38,1
HCPCS,76700TC,US EXAM ABDOM COMPLETE,,,77.38,77.38,1
HCPCS,76705,ECHO ABDOMEN LIMITED,260.0,169.0,60.86,260.0,32
HCPCS,76705,ECHO EXAM OF ABDOMEN,,,58.67,58.67,2
HCPCS,76705,ULTRASOUND ABDOM LIMITED,1178.0,765.7,60.86,1178.0,32
HCPCS,76705,US ABDOMINAL REAL TIME W/IMAGE LIMITED,918.0,596.7,24.29,1178.0,196
HCPCS,767050,ECHO EXAM OF ABDOMEN,,,58.67,58.67,1
HCPCS,76705TC,ECHO EXAM OF ABDOMEN,,,58.67,58.67,1
HCPCS,76706,US ABDL AORTA SCREEN AAA,,,79.63,79.63,2
HCPCS,76706,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,918.0,596.7,25.64,1138.0,143
HCPCS,767060,US ABDL AORTA SCREEN AAA,,,79.63,79.63,1
HCPCS,76706TC,US ABDL AORTA SCREEN AAA,,,79.63,79.63,1
HCPCS,76770,ECHO RETROPERITONEAL COMP,785.0,510.25,81.56,1244.0,64
HCPCS,76770,US EXAM ABDO BACK WALL COMP,,,72.42,72.42,2
HCPCS,76770,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,918.0,596.7,30.68,1244.0,147
HCPCS,767700,US EXAM ABDO BACK WALL COMP,,,72.42,72.42,1
HCPCS,76770TC,US EXAM ABDO BACK WALL COMP,,,72.42,72.42,1
HCPCS,76775,ECHO RETROPERITONEAL LTD,691.0,449.15,47.11,1150.0,64
HCPCS,76775,US EXAM ABDO BACK WALL LIM,,,32.14,32.14,2
HCPCS,76775,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,918.0,596.7,24.01,1150.0,147
HCPCS,767750,US EXAM ABDO BACK WALL LIM,,,32.14,32.14,1
HCPCS,76775TC,US EXAM ABDO BACK WALL LIM,,,32.14,32.14,1
HCPCS,76776,US EXAM K TRANSPL W/DOPPLER,,,110.13,110.13,2
HCPCS,76776,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,918.0,596.7,31.25,1222.0,147
HCPCS,767760,US EXAM K TRANSPL W/DOPPLER,,,110.13,110.13,1
HCPCS,76776TC,US EXAM K TRANSPL W/DOPPLER,,,110.13,110.13,1
HCPCS,76800,ULTRASOUND SPINAL CANAL & CONTENTS,918.0,596.7,45.73,1370.0,147
HCPCS,76800,US EXAM SPINAL CANAL,,,104.85,104.85,2
HCPCS,768000,US EXAM SPINAL CANAL,,,104.85,104.85,1
HCPCS,76800TC,US EXAM SPINAL CANAL,,,104.85,104.85,1
HCPCS,76801,OB US < 14 WKS SINGLE FETUS,,,69.8,69.8,2
HCPCS,76801,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,918.0,596.7,40.77,1354.0,147
HCPCS,76801,"US,PREG UTERUS,<14 WEEKS",436.0,283.4,71.39,436.0,32
HCPCS,768010,OB US < 14 WKS SINGLE FETUS,,,69.8,69.8,1
HCPCS,76801TC,OB US < 14 WKS SINGLE FETUS,,,69.8,69.8,1
HCPCS,76802,OB US < 14 WKS ADDL FETUS,,,20.63,20.63,2
HCPCS,76802,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,889.0,577.85,20.01,1254.0,134
HCPCS,768020,OB US < 14 WKS ADDL FETUS,,,20.63,20.63,1
HCPCS,76802TC,OB US < 14 WKS ADDL FETUS,,,20.63,20.63,1
HCPCS,76805,ECHO PREG UTERUS >/= 14 W,855.0,555.75,94.64,1314.0,64
HCPCS,76805,OB US >/= 14 WKS SNGL FETUS,,,87.53,87.53,2
HCPCS,76805,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,918.0,596.7,40.77,1314.0,147
HCPCS,768050,OB US >/= 14 WKS SNGL FETUS,,,87.53,87.53,1
HCPCS,76805TC,OB US >/= 14 WKS SNGL FETUS,,,87.53,87.53,1
HCPCS,76810,OB US >/= 14 WKS ADDL FETUS,,,40.65,40.65,2
HCPCS,76810,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,889.0,577.85,39.31,1281.0,134
HCPCS,76810,US PREG UTERUS EA ADD GES,392.0,254.8,69.44,392.0,32
HCPCS,768100,OB US >/= 14 WKS ADDL FETUS,,,40.65,40.65,1
HCPCS,76810TC,OB US >/= 14 WKS ADDL FETUS,,,40.65,40.65,1
HCPCS,76811,OB US DETAILED SNGL FETUS,,,86.92,524.34,19
HCPCS,76811,Ob us detailed sngl fetus,,,59.68,75.38,6
HCPCS,76811,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,2085.0,1355.25,79.14,2845.0,98
HCPCS,768110,OB US DETAILED SNGL FETUS,,,86.92,86.92,1
HCPCS,76811TC,OB US DETAILED SNGL FETUS,,,86.92,86.92,1
HCPCS,76812,OB US DETAILED ADDL FETUS,,,106.2,106.2,2
HCPCS,76812,Ob us detailed addl fetus,,,59.68,75.38,6
HCPCS,76812,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,818.0,531.7,74.03,1530.0,98
HCPCS,768120,OB US DETAILED ADDL FETUS,,,106.2,106.2,1
HCPCS,76812TC,OB US DETAILED ADDL FETUS,,,106.2,106.2,1
HCPCS,76813,OB US NUCHAL MEAS 1 GEST,,,59.32,252.18,19
HCPCS,76813,Ob us nuchal meas 1 gest,,,59.68,75.38,6
HCPCS,768130,OB US NUCHAL MEAS 1 GEST,,,59.32,59.32,1
HCPCS,76813TC,OB US NUCHAL MEAS 1 GEST,,,59.32,59.32,1
HCPCS,76814,OB US NUCHAL MEAS ADD-ON,,,27.55,27.55,2
HCPCS,76814,Ob us nuchal meas add-on,,,59.68,75.38,6
HCPCS,768140,OB US NUCHAL MEAS ADD-ON,,,27.55,27.55,1
HCPCS,76814TC,OB US NUCHAL MEAS ADD-ON,,,27.55,27.55,1
HCPCS,76815,ECHO PREG UTER LTD 1 +,286.0,185.9,60.45,286.0,32
HCPCS,76815,ECHO PREG UTER LTD 1+,1204.0,782.6,60.45,1204.0,32
HCPCS,76815,OB US LIMITED FETUS(S),,,49.82,49.82,2
HCPCS,76815,US PREGNANT UTERUS LIMITED 1/> FETUSES,918.0,596.7,26.28,1204.0,147
HCPCS,768150,OB US LIMITED FETUS(S),,,49.82,49.82,1
HCPCS,76815TC,OB US LIMITED FETUS(S),,,49.82,49.82,1
HCPCS,76816,OB US FOLLOW-UP PER FETUS,,,68.82,252.18,19
HCPCS,76816,Ob us follow-up per fetus,,,59.68,75.38,6
HCPCS,76816,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,918.0,596.7,35.66,1292.0,98
HCPCS,768160,OB US FOLLOW-UP PER FETUS,,,68.82,68.82,1
HCPCS,76816TC,OB US FOLLOW-UP PER FETUS,,,68.82,68.82,1
HCPCS,76817,TRANSVAGINAL US OBSTETRIC,,,56.38,56.38,2
HCPCS,76817,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,918.0,596.7,31.11,1218.0,147
HCPCS,76817,"US,PREG UTERUS,TRANSVAGINAL",300.0,195.0,65.56,300.0,32
HCPCS,768170,TRANSVAGINAL US OBSTETRIC,,,56.38,56.38,1
HCPCS,76817TC,TRANSVAGINAL US OBSTETRIC,,,56.38,56.38,1
HCPCS,76818,FETAL BIOPHYS PROFILE W/NST,,,68.26,252.18,19
HCPCS,76818,FETAL BIOPHYS W/NON STRES,420.0,273.0,73.41,420.0,32
HCPCS,76818,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,918.0,596.7,43.91,1338.0,98
HCPCS,76818,FETAL BIOPHYSICAL PROFILE W/NON-STRESS,1338.0,869.7,73.41,1338.0,32
HCPCS,76818,Fetal biophys profile w/nst,,,59.68,75.38,6
HCPCS,768180,FETAL BIOPHYS PROFILE W/NST,,,68.26,68.26,1
HCPCS,76818TC,FETAL BIOPHYS PROFILE W/NST,,,68.26,68.26,1
HCPCS,76819,FETAL BIOPHYS PROFIL W/O NST,,,48.89,48.89,2
HCPCS,76819,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,918.0,596.7,32.25,1257.0,196
HCPCS,76819,FETAL BIOPHYSICAL PROFILE WO STRESS,798.0,518.6999999999999,68.23,1257.0,64
HCPCS,768190,FETAL BIOPHYS PROFIL W/O NST,,,48.89,48.89,1
HCPCS,76819TC,FETAL BIOPHYS PROFIL W/O NST,,,48.89,48.89,1
HCPCS,76820,UMBILICAL ARTERY ECHO,,,21.01,252.18,19
HCPCS,76820,Umbilical artery echo,,,59.68,75.38,6
HCPCS,768200,UMBILICAL ARTERY ECHO,,,21.01,21.01,1
HCPCS,76820TC,UMBILICAL ARTERY ECHO,,,21.01,21.01,1
HCPCS,76821,MIDDLE CEREBRAL ARTERY ECHO,,,55.07,252.18,19
HCPCS,76821,Middle cerebral artery echo,,,59.68,75.38,6
HCPCS,768210,MIDDLE CEREBRAL ARTERY ECHO,,,55.07,55.07,1
HCPCS,76821TC,MIDDLE CEREBRAL ARTERY ECHO,,,55.07,55.07,1
HCPCS,76825,ECHO EXAM OF FETAL HEART,,,180.59,180.59,2
HCPCS,76825,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,4729.0,3073.85,59.68,5397.0,147
HCPCS,768250,ECHO EXAM OF FETAL HEART,,,180.59,180.59,1
HCPCS,76825TC,ECHO EXAM OF FETAL HEART,,,180.59,180.59,1
HCPCS,76826,ECHO EXAM OF FETAL HEART,,,116.02,116.02,2
HCPCS,76826,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,2085.0,1355.25,34.52,2450.0,147
HCPCS,768260,ECHO EXAM OF FETAL HEART,,,116.02,116.02,1
HCPCS,76826TC,ECHO EXAM OF FETAL HEART,,,116.02,116.02,1
HCPCS,76827,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,918.0,596.7,23.73,1150.0,147
HCPCS,76827,ECHO EXAM OF FETAL HEART,,,41.97,41.97,2
HCPCS,768270,ECHO EXAM OF FETAL HEART,,,41.97,41.97,1
HCPCS,76827TC,ECHO EXAM OF FETAL HEART,,,41.97,41.97,1
HCPCS,76828,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,918.0,596.7,17.08,1142.0,147
HCPCS,76828,ECHO EXAM OF FETAL HEART,,,22.31,22.31,2
HCPCS,768280,ECHO EXAM OF FETAL HEART,,,22.31,22.31,1
HCPCS,76828TC,ECHO EXAM OF FETAL HEART,,,22.31,22.31,1
HCPCS,76830,ECHO TRANSVAGINAL NON-OB,304.0,197.6,67.93,304.0,32
HCPCS,76830,TRANSVAGINAL US NON-OB,,,85.57,85.57,2
HCPCS,76830,ULTRASOUND TRANSVAGINAL,1222.0,794.3,67.93,1222.0,32
HCPCS,76830,US TRANSVAGINAL,918.0,596.7,28.55,1222.0,147
HCPCS,768300,TRANSVAGINAL US NON-OB,,,85.57,85.57,1
HCPCS,76830TC,TRANSVAGINAL US NON-OB,,,85.57,85.57,1
HCPCS,76831,ECHO EXAM UTERUS,,,80.94,80.94,2
HCPCS,76831,HYSTEROSONOGRAPHY,2373.0,1542.45,68.77,2373.0,32
HCPCS,76831,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,2085.0,1355.25,30.26,2373.0,147
HCPCS,76831,SALINE INFUSION SONOHYSTER W/WO DOPPLER,288.0,187.2,68.77,288.0,32
HCPCS,768310,ECHO EXAM UTERUS,,,80.94,80.94,1
HCPCS,76831TC,ECHO EXAM UTERUS,,,80.94,80.94,1
HCPCS,76856,ECHO PELVIC NOT OBSTETRIC,1222.0,794.3,67.93,1222.0,32
HCPCS,76856,ECHO PELVIS NON OB COMP,304.0,197.6,67.93,304.0,32
HCPCS,76856,US EXAM PELVIC COMPLETE,,,72.1,72.1,2
HCPCS,76856,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,918.0,596.7,28.27,1222.0,147
HCPCS,768560,US EXAM PELVIC COMPLETE,,,72.1,72.1,1
HCPCS,76856TC,US EXAM PELVIC COMPLETE,,,72.1,72.1,1
HCPCS,76857,BLADDER ULTRASOUND RESIDUAL,1118.0,726.7,38.73,1118.0,32
HCPCS,76857,ECHO PELVIC NOT OB FU,200.0,130.0,38.73,200.0,32
HCPCS,76857,ECHO PELVIC NOT OB LTD,1118.0,726.7,38.73,1118.0,32
HCPCS,76857,US EXAM PELVIC LIMITED,,,25.92,25.92,2
HCPCS,76857,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,918.0,596.7,16.34,1764.0,188
HCPCS,768570,US EXAM PELVIC LIMITED,,,25.92,25.92,1
HCPCS,76857TC,US EXAM PELVIC LIMITED,,,25.92,25.92,1
HCPCS,76870,ECHO SCROTUM,715.0,464.75,57.31,1174.0,64
HCPCS,76870,US EXAM SCROTUM,,,69.15,69.15,2
HCPCS,76870,US SCROTUM & CONTENTS,918.0,596.7,26.7,1174.0,147
HCPCS,768700,US EXAM SCROTUM,,,69.15,69.15,1
HCPCS,76870TC,US EXAM SCROTUM,,,69.15,69.15,1
HCPCS,76872,ECHO TRANSRECTAL,1056.0,686.4000000000001,89.5,1194.0,64
HCPCS,76872,"ULTRASOUND, TRANSRECTAL",276.0,179.4,89.5,292.51,32
HCPCS,76872,US TRANSRECTAL,918.0,596.7,66.35,826.2,51
HCPCS,76872,"US, TRANSRECTAL",918.0,596.7,28.98,1194.0,98
HCPCS,768720,US TRANSRECTAL,,,104.85,104.85,1
HCPCS,76872TC,US TRANSRECTAL,,,104.85,104.85,1
HCPCS,76873,ECHOGRAP TRANS R PROS STUDY,,,98.67,98.67,2
HCPCS,76873,PROSTATE VOLUME STUDY BRACHYTHRPY,682.0,443.3,103.31,682.0,32
HCPCS,76873,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,918.0,596.7,64.78,1600.0,147
HCPCS,768730,ECHOGRAP TRANS R PROS STUDY,,,98.67,98.67,1
HCPCS,76873TC,ECHOGRAP TRANS R PROS STUDY,,,98.67,98.67,1
HCPCS,76881,"ULTRASOUND EXT., NON-VASC COMPLETE",855.0,555.75,50.07,1314.0,64
HCPCS,76881,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,918.0,596.7,10.58,1314.0,147
HCPCS,76881,US COMPL JOINT R-T W/IMG,,,10.85,10.85,2
HCPCS,768810,US COMPL JOINT R-T W/IMG,,,10.85,10.85,1
HCPCS,76881TC,US COMPL JOINT R-T W/IMG,,,10.85,10.85,1
HCPCS,76882,"ULTRASOUND EXT., NON-VASC COMPLETE",304.0,197.6,27.46,304.0,32
HCPCS,76882,"ULTRASOUND EXT., NON-VASC LIMITED",1222.0,794.3,27.46,1222.0,32
HCPCS,76882,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,918.0,596.7,9.33,1222.0,147
HCPCS,76882,US LMTD JT/FCL EVL NVASC XTR,,,30.5,30.5,2
HCPCS,768820,US LMTD JT/FCL EVL NVASC XTR,,,30.5,30.5,1
HCPCS,76882TC,US LMTD JT/FCL EVL NVASC XTR,,,30.5,30.5,1
HCPCS,76883,US NRV&ACC STRUX 1XTR COMPRE,,,14.13,240.48,19
HCPCS,76883,Us nrv&acc strux 1xtr compre,,,66.35,83.81,6
HCPCS,768830,US NRV&ACC STRUX 1XTR COMPRE,,,14.13,14.13,1
HCPCS,76883TC,US NRV&ACC STRUX 1XTR COMPRE,,,14.13,14.13,1
HCPCS,76885,US EXAM INFANT HIPS DYNAMIC,,,86.88,86.88,2
HCPCS,76885,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,760.0,494.0,66.35,684.0,49
HCPCS,768850,US EXAM INFANT HIPS DYNAMIC,,,86.88,86.88,1
HCPCS,76885TC,US EXAM INFANT HIPS DYNAMIC,,,86.88,86.88,1
HCPCS,76886,US EXAM INFANT HIPS STATIC,,,69.48,69.48,2
HCPCS,76886,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,760.0,494.0,66.35,684.0,49
HCPCS,768860,US EXAM INFANT HIPS STATIC,,,69.48,69.48,1
HCPCS,76886TC,US EXAM INFANT HIPS STATIC,,,69.48,69.48,1
HCPCS,76932,ECHO GUIDE FOR HEART BIOPSY,,,59.35,59.35,2
HCPCS,76932,US ENDOMYOCARDIAL BIOPSY RS&I,1047.0,680.55,65.54,942.3,35
HCPCS,769320,ECHO GUIDE FOR HEART BIOPSY,,,59.35,59.35,1
HCPCS,76932TC,ECHO GUIDE FOR HEART BIOPSY,,,59.35,59.35,1
HCPCS,76936,ECHO GUIDE FOR ARTERY REPAIR,,,165.52,165.52,2
HCPCS,76936,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,2686.0,1745.9,86.22,3482.0,147
HCPCS,76936,US GUIDE AV FIST REPAIR,796.0,517.4,201.43,796.0,32
HCPCS,769360,ECHO GUIDE FOR ARTERY REPAIR,,,165.52,165.52,1
HCPCS,76936TC,ECHO GUIDE FOR ARTERY REPAIR,,,165.52,165.52,1
HCPCS,76937,US GUIDE FOR VASCULAR ACCESS,132.0,85.8,23.71,132.0,32
HCPCS,76937,US GUIDE VASCULAR ACCESS,,,24.28,24.28,2
HCPCS,76937,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,333.0,216.45,12.93,465.0,170
HCPCS,769370,US GUIDE VASCULAR ACCESS,,,24.28,24.28,1
HCPCS,76937TC,US GUIDE VASCULAR ACCESS,,,24.28,24.28,1
HCPCS,76940,US &MNTR PARENCHYMAL TISSUE ABLATION,873.0,567.45,65.54,1673.0,101
HCPCS,76940,US GUIDE TISSUE ABLATION,,,59.67,59.67,2
HCPCS,769400,US GUIDE TISSUE ABLATION,,,59.67,59.67,1
HCPCS,76940TC,US GUIDE TISSUE ABLATION,,,59.67,59.67,1
HCPCS,76941,ECHO GUIDE FOR TRANSFUSION,,,53.08,53.08,2
HCPCS,76941,Echo guide for transfusion,,,65.54,82.79,6
HCPCS,76941,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,905.0,588.25,56.96,1441.0,66
HCPCS,769410,ECHO GUIDE FOR TRANSFUSION,,,53.08,53.08,1
HCPCS,76941TC,ECHO GUIDE FOR TRANSFUSION,,,53.08,53.08,1
HCPCS,76942,ECHO GUIDE FOR BIOPSY,,,27.89,27.89,2
HCPCS,76942,US GUIDANCE FOR NEEDLE BX,1079.0,701.35,49.64,1079.0,32
HCPCS,76942,US GUIDANCE FOR NEEDLEBX,295.0,191.75,49.64,295.0,32
HCPCS,76942,US GUIDANCE NEEDLE PLACEMENT IMG S&I,1079.0,701.35,28.13,1374.0,170
HCPCS,769420,ECHO GUIDE FOR BIOPSY,,,27.89,27.89,1
HCPCS,76942TC,ECHO GUIDE FOR BIOPSY,,,27.89,27.89,1
HCPCS,76945,ECHO GUIDE VILLUS SAMPLING,,,55.05,55.05,2
HCPCS,76945,Echo guide villus sampling,,,65.54,82.79,6
HCPCS,76945,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,299.0,194.35,28.99,567.0,66
HCPCS,769450,ECHO GUIDE VILLUS SAMPLING,,,55.05,55.05,1
HCPCS,76945TC,ECHO GUIDE VILLUS SAMPLING,,,55.05,55.05,1
HCPCS,76946,ECHO GUIDE FOR AMNIOCENTESIS,,,15.11,15.11,2
HCPCS,76946,Echo guide for amniocentesis,,,65.54,82.79,6
HCPCS,76946,US GUIDANCE AMNIOCENTESIS IMG S&I,458.0,297.7,14.21,610.0,98
HCPCS,769460,ECHO GUIDE FOR AMNIOCENTESIS,,,15.11,15.11,1
HCPCS,76946TC,ECHO GUIDE FOR AMNIOCENTESIS,,,15.11,15.11,1
HCPCS,76948,ECHO GUIDE OVA ASPIRATION,,,48.51,48.51,2
HCPCS,76948,Echo guide ova aspiration,,,65.54,82.79,6
HCPCS,769480,ECHO GUIDE OVA ASPIRATION,,,48.51,48.51,1
HCPCS,76948TC,ECHO GUIDE OVA ASPIRATION,,,48.51,48.51,1
HCPCS,76965,ECHO GUIDANCE RADIOTHERAPY,,,27.23,27.23,2
HCPCS,76965,US GUIDANCE INTERSTITIAL RADIOELEMENT PLA,536.0,348.4,71.12,536.0,32
HCPCS,76965,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,1490.0,968.5,27.37,2026.0,137
HCPCS,769650,ECHO GUIDANCE RADIOTHERAPY,,,27.23,27.23,1
HCPCS,76965TC,ECHO GUIDANCE RADIOTHERAPY,,,27.23,27.23,1
HCPCS,76970,Ultrasound exam follow-up,,,66.35,83.81,6
HCPCS,76975,GI ENDOSCOPIC ULTRASOUND,,,233.56,524.34,19
HCPCS,76975,GI ENDOSCOPIC US S&I,1204.5,782.925,37.24,2085.0,66
HCPCS,76975,Gi endoscopic ultrasound,,,65.54,82.79,6
HCPCS,769750,GI ENDOSCOPIC ULTRASOUND,,,233.56,233.56,1
HCPCS,76975TC,GI ENDOSCOPIC ULTRASOUND,,,233.56,233.56,1
HCPCS,76977,US BONE DENSITY MEASURE,,,4.63,252.18,19
HCPCS,76977,Us bone density measure,,,44.5,56.21,6
HCPCS,769770,US BONE DENSITY MEASURE,,,4.63,4.63,1
HCPCS,76977TC,US BONE DENSITY MEASURE,,,4.63,4.63,1
HCPCS,76978,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,1535.0,997.75,75.46,2183.0,143
HCPCS,76978,US TRGT DYN MBUBB 1ST LES,,,143.21,143.21,2
HCPCS,769780,US TRGT DYN MBUBB 1ST LES,,,143.21,143.21,1
HCPCS,76978TC,US TRGT DYN MBUBB 1ST LES,,,143.21,143.21,1
HCPCS,76979,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDL LES,958.0,622.7,100.02,862.2,72
HCPCS,76979,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDLT LES,958.0,622.7,39.79,1298.0,94
HCPCS,76979,US TRGT DYN MBUBB EA ADDL,,,101.24,101.24,2
HCPCS,769790,US TRGT DYN MBUBB EA ADDL,,,101.24,101.24,1
HCPCS,76979TC,US TRGT DYN MBUBB EA ADDL,,,101.24,101.24,1
HCPCS,76981,ULTRASOUND ELASTOGRAPHY PARENCHYMA,918.0,596.7,28.23,1178.0,192
HCPCS,76981,USE PARENCHYMA,,,75.04,75.04,2
HCPCS,769810,USE PARENCHYMA,,,75.04,75.04,1
HCPCS,76981TC,USE PARENCHYMA,,,75.04,75.04,1
HCPCS,76982,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,918.0,596.7,27.9,1154.0,192
HCPCS,76982,USE 1ST TARGET LESION,,,64.24,64.24,2
HCPCS,769820,USE 1ST TARGET LESION,,,64.24,64.24,1
HCPCS,76982TC,USE 1ST TARGET LESION,,,64.24,64.24,1
HCPCS,76983,ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION,1288.0,837.2,66.35,1159.2,36
HCPCS,76983,ULTRASOUND ELASTOGRAPHY EA ADDL TARGET LESION,1288.0,837.2,22.8,1476.0,94
HCPCS,76983,USE EA ADDL TARGET LESION,1288.0,837.2,36.4,1159.2,38
HCPCS,769830,USE EA ADDL TARGET LESION,,,36.4,36.4,1
HCPCS,76983TC,USE EA ADDL TARGET LESION,,,36.4,36.4,1
HCPCS,76984,DX INTRAOP THORACIC AORTA US,,,32.53,32.53,1
HCPCS,769840,DX INTRAOP THORACIC AORTA US,,,32.53,32.53,1
HCPCS,76987,DX INTRAOP EPICAR CAR US CHD,,,99.25,99.25,1
HCPCS,769870,DX INTRAOP EPICAR CAR US CHD,,,99.25,99.25,1
HCPCS,76988,DX NTRAOP EPCAR CAR US CHD PLMT MNPJ&IMG ACQUISJ,1054.0,685.1,0.01,1582.0,57
HCPCS,76988,DX NTROP EPCR US CHD IMG ACQ,,,63.26,63.26,1
HCPCS,769880,DX NTROP EPCR US CHD IMG ACQ,,,63.26,63.26,1
HCPCS,76989,DX INTRAOP EPCAR US CHD I&R,,,37.11,37.11,1
HCPCS,769890,DX INTRAOP EPCAR US CHD I&R,,,37.11,37.11,1
HCPCS,76998,INTRA OP ULTRASONIC GUIDANCE,1054.0,685.1,48.93,1454.0,62
HCPCS,76998,ULTRASONIC GUIDANCE INTRAOPERATIVE,1054.0,685.1,65.54,948.6,35
HCPCS,76998,US GUIDE INTRAOP,,,48.81,48.81,1
HCPCS,769980,US GUIDE INTRAOP,,,48.81,48.81,1
HCPCS,76999,"ULTRASOUND, SOFT TISSUE BUTTOCKS",341.0,221.65,170.5,341.0,12
HCPCS,76999,UNLISTED US PROCEDURE,520.0,338.0,95.5,711.0,36
HCPCS,76999,US UNLISTED SOFT TISSUE,329.0,213.85,66.35,385.0,48
HCPCS,76999,US-SOFT TISSUE UNLISTED PROC,170.0,110.5,85.0,170.0,12
HCPCS,77001,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,1029.0,668.85,16.05,1196.0,134
HCPCS,77001,FLUOROGUIDE FOR VEIN DEVICE,,,79.63,79.63,2
HCPCS,77001,FLUOROGUIDE VEIN DEVICE,167.0,108.55,59.29,167.0,32
HCPCS,770010,FLUOROGUIDE FOR VEIN DEVICE,,,79.63,79.63,1
HCPCS,77001TC,FLUOROGUIDE FOR VEIN DEVICE,,,79.63,79.63,1
HCPCS,77002,FLUORO GUIDE LOC FOR NEEDLE BX,1286.0,835.9,59.74,1286.0,32
HCPCS,77002,FLUORO LOCALZ NEEDLE BX,238.0,154.7,59.74,238.0,32
HCPCS,77002,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,1048.0,681.2,23.16,1286.0,134
HCPCS,77002,NEEDLE LOCALIZATION BY XRAY,,,88.14,88.14,2
HCPCS,770020,NEEDLE LOCALIZATION BY XRAY,,,88.14,88.14,1
HCPCS,77002TC,NEEDLE LOCALIZATION BY XRAY,,,88.14,88.14,1
HCPCS,77003,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,1245.0,809.25,25.43,1509.0,134
HCPCS,77003,FLUOROGUIDE FOR SPINAL INJECTION,1509.0,980.85,52.92,1509.0,32
HCPCS,77003,FLUOROGUIDE FOR SPINE INJECT,,,75.7,75.7,2
HCPCS,770030,FLUOROGUIDE FOR SPINE INJECT,,,75.7,75.7,1
HCPCS,77003TC,FLUOROGUIDE FOR SPINE INJECT,,,75.7,75.7,1
HCPCS,77011,CT GUIDANCE STEREOTACTIC LOCALIZATION,1909.0,1240.85,47.94,2393.0,134
HCPCS,77011,CT SCAN FOR LOCALIZATION,,,165.8,165.8,2
HCPCS,770110,CT SCAN FOR LOCALIZATION,,,165.8,165.8,1
HCPCS,77011TC,CT SCAN FOR LOCALIZATION,,,165.8,165.8,1
HCPCS,77012,CT GUIDANCE NEEDLE PLACEMENT,2741.0,1781.65,46.87,3341.0,134
HCPCS,77012,CT SCAN FOR NEEDLE BIOPSY,,,72.95,72.95,2
HCPCS,770120,CT SCAN FOR NEEDLE BIOPSY,,,72.95,72.95,1
HCPCS,77012TC,CT SCAN FOR NEEDLE BIOPSY,,,72.95,72.95,1
HCPCS,77013,CT GUIDANCE &MONITORING VISC TISS ABLATION,3241.0,2106.65,47.94,4837.0,101
HCPCS,77013,CT GUIDE FOR TISSUE ABLATION,,,330.62,330.62,2
HCPCS,770130,CT GUIDE FOR TISSUE ABLATION,,,330.62,330.62,1
HCPCS,77013TC,CT GUIDE FOR TISSUE ABLATION,,,330.62,330.62,1
HCPCS,77014,CT SCAN FOR THERAPY GUIDE,366.0,237.9,95.91,366.0,23
HCPCS,77014,Ct scan for therapy guide,,,47.94,60.55,6
HCPCS,77021,MRI GUIDANCE NDL PLMT RS&I,,,377.5,377.5,2
HCPCS,77021,MRI GUIDANCE NEEDLE PLACEMENT RS&I,2566.0,1667.9,63.64,3166.0,126
HCPCS,770210,MRI GUIDANCE NDL PLMT RS&I,,,377.5,377.5,1
HCPCS,77021TC,MRI GUIDANCE NDL PLMT RS&I,,,377.5,377.5,1
HCPCS,77022,MRI GDN PARNCHYMA TISS ABLTJ,,,464.31,464.31,2
HCPCS,77022,MRI GUIDANCE FOR PARENCHYMAL TISSUE ABLATION,2043.0,1327.95,124.2,3739.0,93
HCPCS,770220,MRI GDN PARNCHYMA TISS ABLTJ,,,464.31,464.31,1
HCPCS,77022TC,MRI GDN PARNCHYMA TISS ABLTJ,,,464.31,464.31,1
HCPCS,77046,MRI BREAST C- UNILATERAL,,,148.45,148.45,2
HCPCS,77046,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,2085.0,1355.25,67.12,2723.0,135
HCPCS,770460,MRI BREAST C- UNILATERAL,,,148.45,148.45,1
HCPCS,77046TC,MRI BREAST C- UNILATERAL,,,148.45,148.45,1
HCPCS,77047,MRI BREAST C- BILATERAL,,,147.8,147.8,2
HCPCS,77047,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,2085.0,1355.25,74.49,2789.0,176
HCPCS,770470,MRI BREAST C- BILATERAL,,,147.8,147.8,1
HCPCS,77047TC,MRI BREAST C- BILATERAL,,,147.8,147.8,1
HCPCS,77048,MRI BREAST C-+ W/CAD UNI,,,242.82,242.82,2
HCPCS,77048,MRI BREAST W/OUT&WITH CONTRAST W/CAD UNILATERAL,6213.0,4038.45,241.9,5591.7,62
HCPCS,77048,MRI BREAST WITHOUT&WITH CONTRAST W/CAD UNILATERAL,6213.0,4038.45,99.33,7053.0,94
HCPCS,770480,MRI BREAST C-+ W/CAD UNI,,,242.82,242.82,1
HCPCS,77048TC,MRI BREAST C-+ W/CAD UNI,,,242.82,242.82,1
HCPCS,77049,MRI BREAST BIL W/ CONTR,7480.0,4862.0,241.9,6732.0,31
HCPCS,77049,MRI BREAST BILAT W CONTR,7480.0,4862.0,108.63,8400.0,94
HCPCS,77049,MRI BREAST BILAT WO/W CONTR,7480.0,4862.0,108.63,8400.0,125
HCPCS,77049,MRI BREAST C-+ W/CAD BI,,,240.53,240.53,2
HCPCS,77049,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,7480.0,4862.0,108.63,8400.0,125
HCPCS,770490,MRI BREAST C-+ W/CAD BI,,,240.53,240.53,1
HCPCS,77049TC,MRI BREAST C-+ W/CAD BI,,,240.53,240.53,1
HCPCS,77053,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,2085.0,1355.25,14.34,2229.0,147
HCPCS,77053,X-RAY OF MAMMARY DUCT,,,36.4,36.4,2
HCPCS,770530,X-RAY OF MAMMARY DUCT,,,36.4,36.4,1
HCPCS,77053TC,X-RAY OF MAMMARY DUCT,,,36.4,36.4,1
HCPCS,77054,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,2085.0,1355.25,18.89,2265.0,147
HCPCS,77054,X-RAY OF MAMMARY DUCTS,,,47.53,47.53,2
HCPCS,770540,X-RAY OF MAMMARY DUCTS,,,47.53,47.53,1
HCPCS,77054TC,X-RAY OF MAMMARY DUCTS,,,47.53,47.53,1
HCPCS,77061,BREAST TOMOSYNTHESIS UNI,,,85.85,85.85,2
HCPCS,77061,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,139.0,90.35,23.35,212.74,127
HCPCS,770610,BREAST TOMOSYNTHESIS UNI,,,85.85,85.85,1
HCPCS,77061TC,BREAST TOMOSYNTHESIS UNI,,,85.85,85.85,1
HCPCS,77062,BREAST TOMOSYNTHESIS BI,,,110.13,110.13,2
HCPCS,77062,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,168.0,109.2,27.88,271.22,127
HCPCS,770620,BREAST TOMOSYNTHESIS BI,,,110.13,110.13,1
HCPCS,77062TC,BREAST TOMOSYNTHESIS BI,,,110.13,110.13,1
HCPCS,77063,BREAST TOMOSYNTHESIS BI,,,23.58,156.76,7
HCPCS,77063,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,240.0,156.0,23.24,415.0,192
HCPCS,770630,BREAST TOMOSYNTHESIS BI,,,23.58,23.58,1
HCPCS,77063TC,BREAST TOMOSYNTHESIS BI,,,35.84,156.76,6
HCPCS,77065,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,704.0,457.6,27.88,1028.0,143
HCPCS,77065,DX MAMMO INCL CAD UNI,,,85.85,579.65,7
HCPCS,770650,DX MAMMO INCL CAD UNI,,,85.85,85.85,1
HCPCS,77065TC,DX MAMMO INCL CAD UNI,,,131.69,579.65,6
HCPCS,77066,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,883.0,573.95,27.88,1283.0,143
HCPCS,77066,DX MAMMO INCL CAD BI,,,110.13,744.95,7
HCPCS,770660,DX MAMMO INCL CAD BI,,,110.13,110.13,1
HCPCS,77066TC,DX MAMMO INCL CAD BI,,,167.52,744.95,6
HCPCS,77067,SCR MAMMO BI INCL CAD,,,90.76,613.28,7
HCPCS,77067,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,761.0,494.65,27.88,1065.0,143
HCPCS,770670,SCR MAMMO BI INCL CAD,,,90.76,90.76,1
HCPCS,77067TC,SCR MAMMO BI INCL CAD,,,138.27,613.28,6
HCPCS,77071,MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS,850.0,552.5,27.12,940.0,75
HCPCS,77071,MNL APPL STRS JT RADIOGRAPHY,,,55.66,55.66,1
HCPCS,770710,MNL APPL STRS JT RADIOGRAPHY,,,55.66,55.66,1
HCPCS,77072,BONE AGE STUDIES,918.0,596.7,7.81,994.0,181
HCPCS,770720,BONE AGE STUDIES,,,16.75,16.75,1
HCPCS,77072TC,BONE AGE STUDIES,,,16.75,16.75,1
HCPCS,77073,BONE LENGTH STUDIES,918.0,596.7,12.79,1022.0,181
HCPCS,770730,BONE LENGTH STUDIES,,,31.82,31.82,1
HCPCS,77073TC,BONE LENGTH STUDIES,,,31.82,31.82,1
HCPCS,77074,BONE SURVEY LIMITED,653.0,424.45,46.13,1112.0,64
HCPCS,77074,RADEX OSSEOUS SURVEY LMTD,,,43.93,43.93,2
HCPCS,77074,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,918.0,596.7,18.89,1112.0,147
HCPCS,770740,RADEX OSSEOUS SURVEY LMTD,,,43.93,43.93,1
HCPCS,77074TC,RADEX OSSEOUS SURVEY LMTD,,,43.93,43.93,1
HCPCS,77075,BONE SURVEY AXIAL & APPENDICULAR,242.0,157.3,68.16,242.0,32
HCPCS,77075,BONE SURVEY COMPLETE INFANT,1160.0,754.0,68.16,1160.0,32
HCPCS,77075,RADEX OSSEOUS SURVEY COMPL,,,72.47,72.47,2
HCPCS,77075,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,918.0,596.7,22.59,1160.0,147
HCPCS,770750,RADEX OSSEOUS SURVEY COMPL,,,72.47,72.47,1
HCPCS,77075TC,RADEX OSSEOUS SURVEY COMPL,,,72.47,72.47,1
HCPCS,77076,RADEX OSSEOUS SURVEY INFANT,,,73.13,73.13,2
HCPCS,77076,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,918.0,596.7,29.26,1198.0,147
HCPCS,770760,RADEX OSSEOUS SURVEY INFANT,,,73.13,73.13,1
HCPCS,77076TC,RADEX OSSEOUS SURVEY INFANT,,,73.13,73.13,1
HCPCS,77077,JOINT SURVEY SINGLE VIEW,,,30.18,30.18,2
HCPCS,77077,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,918.0,596.7,14.5,1050.0,147
HCPCS,77077,"JOINT SURVEY,SINGLE VIEW",591.0,384.15,29.22,1050.0,64
HCPCS,770770,JOINT SURVEY SINGLE VIEW,,,30.18,30.18,1
HCPCS,77077TC,JOINT SURVEY SINGLE VIEW,,,30.18,30.18,1
HCPCS,77078,CT BONE DENSITY AXIAL,,,88.38,190.91,19
HCPCS,77078,Ct bone density axial,,,44.5,56.21,6
HCPCS,770780,CT BONE DENSITY AXIAL,,,90.83,90.83,1
HCPCS,77078TC,CT BONE DENSITY AXIAL,,,90.83,90.83,1
HCPCS,77080,DUAL ENERGY XRAY ABSORP(DEXA)AXIAL SITE(S,1006.0,653.9,33.16,1006.0,32
HCPCS,77080,DXA BONE DENSITY AXIAL,,,29.19,29.19,2
HCPCS,77080,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,918.0,596.7,8.38,1006.0,147
HCPCS,77080,"DXA BONE DENSITY,AXIAL",88.0,57.2,33.16,88.0,32
HCPCS,770800,DXA BONE DENSITY AXIAL,,,29.19,29.19,1
HCPCS,77080TC,DXA BONE DENSITY AXIAL,,,29.19,29.19,1
HCPCS,77081,"DXA BMD, PERIPHERAL",848.0,551.2,22.71,848.0,32
HCPCS,77081,DXA BONE DENSITY APPENDICULR,,,21.99,21.99,2
HCPCS,77081,DXA BONE DENSITY PERIPHER,88.0,57.2,22.71,88.0,32
HCPCS,77081,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,760.0,494.0,9.24,848.0,147
HCPCS,770810,DXA BONE DENSITY APPENDICULR,,,21.99,21.99,1
HCPCS,77081TC,DXA BONE DENSITY APPENDICULR,,,21.99,21.99,1
HCPCS,77083,"RADIOGRAPH ABSORPTION,BONE",202.0,131.3,101.0,202.0,12
HCPCS,77084,BONE MARROW BLOOD SUPPLY,2085.0,1355.25,66.76,2789.0,139
HCPCS,77084,MRI BONE MARROW BLOOD SUPPLY,,,252.34,252.34,2
HCPCS,770840,MRI BONE MARROW BLOOD SUPPLY,,,252.34,252.34,1
HCPCS,77084TC,MRI BONE MARROW BLOOD SUPPLY,,,252.34,252.34,1
HCPCS,77085,DXA BONE DENSITY AXL VRT FX,,,38.73,38.73,2
HCPCS,77085,DXA BONE DENSITY STUDY AXIAL SKELETON,918.0,596.7,13.83,1050.0,192
HCPCS,770850,DXA BONE DENSITY AXL VRT FX,,,38.73,38.73,1
HCPCS,77085TC,DXA BONE DENSITY AXL VRT FX,,,38.73,38.73,1
HCPCS,77086,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,760.0,494.0,8.01,835.0,143
HCPCS,77086,VRT FRACTURE ASSMT VIA DXA,,,25.26,25.26,2
HCPCS,770860,VRT FRACTURE ASSMT VIA DXA,,,25.26,25.26,1
HCPCS,77086TC,VRT FRACTURE ASSMT VIA DXA,,,25.26,25.26,1
HCPCS,77089,TBS DXA CAL W/I&R FX RISK,,,40.4,93.44,4
HCPCS,77089,TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK,88.0,57.2,12.24,88.0,28
HCPCS,77089,Tbs dxa cal w/i&r fx risk,,,44.5,56.21,6
HCPCS,770890,TBS DXA CAL W/I&R FX RISK,,,40.4,40.4,1
HCPCS,77090,TBS TECHL PREP&TRANSMIS DATA,,,2.67,190.91,18
HCPCS,77090,Tbs techl prep&transmis data,,,44.5,56.21,6
HCPCS,770900,TBS TECHL PREP&TRANSMIS DATA,,,2.67,2.67,1
HCPCS,77091,TBS TECHL CALCULATION ONLY,,,27.55,27.55,1
HCPCS,77091,TBS TECHNICAL CALCULATION ONLY,459.0,298.35,3.08,684.0,77
HCPCS,770910,TBS TECHL CALCULATION ONLY,,,27.55,27.55,1
HCPCS,77092,TBS I&R FX RSK QHP,,,10.18,23.36,4
HCPCS,77092,TBS INTERPRETATION & REPORT FX RISK BY OTHER QHP,88.0,57.2,7.49,88.0,28
HCPCS,770920,TBS I&R FX RSK QHP,,,10.18,10.18,1
HCPCS,77261,THER RADIOLOGY TX PLNG SMPL,,,70.68,70.68,1
HCPCS,77261,THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE,572.0,371.8,53.42,572.0,32
HCPCS,77261,Ther radiology tx plng smpl,,,71.21,89.95,6
HCPCS,772610,THER RADIOLOGY TX PLNG SMPL,,,70.68,70.68,1
HCPCS,77262,THER RADIOLOGY TX PLNG INTRM,,,108.25,108.25,1
HCPCS,77262,THERAPEUTIC RADIOLOGY TX PLANNING INTERMEDIATE,880.0,572.0,81.23,880.0,32
HCPCS,77262,Ther radiology tx plng intrm,,,71.21,89.95,6
HCPCS,772620,THER RADIOLOGY TX PLNG INTRM,,,108.25,108.25,1
HCPCS,77263,THER RADIOLOGY TX PLNG CPLX,,,168.18,168.18,1
HCPCS,77263,THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX,1400.5,910.325,71.21,1482.0,71
HCPCS,772630,THER RADIOLOGY TX PLNG CPLX,,,168.18,168.18,1
HCPCS,77280,THER RAD SIMULAJ FIELD SMPL,,,218.87,218.87,2
HCPCS,77280,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,1145.0,744.25,29.12,1482.0,112
HCPCS,772800,THER RAD SIMULAJ FIELD SMPL,,,218.87,218.87,1
HCPCS,77280TC,THER RAD SIMULAJ FIELD SMPL,,,218.87,218.87,1
HCPCS,77285,THER RAD SIMULAJ FIELD INTRM,,,362.91,362.91,2
HCPCS,77285,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,3158.0,2052.7,43.9,3620.0,112
HCPCS,772850,THER RAD SIMULAJ FIELD INTRM,,,362.91,362.91,1
HCPCS,77285TC,THER RAD SIMULAJ FIELD INTRM,,,362.91,362.91,1
HCPCS,77290,THER RAD SIMULAJ FIELD CPLX,,,345.35,345.35,2
HCPCS,77290,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,3158.0,2052.7,64.92,3844.0,112
HCPCS,772900,THER RAD SIMULAJ FIELD CPLX,,,345.35,345.35,1
HCPCS,77290TC,THER RAD SIMULAJ FIELD CPLX,,,345.35,345.35,1
HCPCS,77293,RESPIRATOR MOTION MGMT SIMUL,,,286.87,286.87,2
HCPCS,77293,RESPIRATORY MOTION MANAGEMENT SIMULATION,3726.0,2421.9,71.21,4606.0,172
HCPCS,772930,RESPIRATOR MOTION MGMT SIMUL,,,286.87,286.87,1
HCPCS,77293TC,RESPIRATOR MOTION MGMT SIMUL,,,286.87,286.87,1
HCPCS,77295,3-D RADIOTHERAPY PLAN,,,243.02,243.02,2
HCPCS,77295,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,11801.0,7670.65,191.22,13689.0,112
HCPCS,772950,3-D RADIOTHERAPY PLAN,,,243.02,243.02,1
HCPCS,77295TC,3-D RADIOTHERAPY PLAN,,,243.02,243.02,1
HCPCS,77299,UNLIS PX THER RADIOL CLINICAL TX PLANNING,350.0,227.5,174.0,352.0,24
HCPCS,77299,UNLISTED PX THER RAD TX PLNG,,,133.27,287.87,14
HCPCS,77299,Unlisted px ther rad tx plng,,,71.21,89.95,6
HCPCS,77300,BASIC RAD DOSIMETRY CALCULATION,845.5,549.575,26.0,1418.0,63
HCPCS,77300,BASIC RADIATION DOSIMETRY CALCULATION,1145.0,744.25,91.62,1482.0,49
HCPCS,77300,RADIATION THERAPY DOSE PLAN,,,31.8,31.8,2
HCPCS,773000,RADIATION THERAPY DOSE PLAN,,,31.8,31.8,1
HCPCS,77300TC,RADIATION THERAPY DOSE PLAN,,,31.8,31.8,1
HCPCS,77301,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,11801.0,7670.65,334.57,11487.75,112
HCPCS,77301,RADIOTHERAPY DOSE PLAN IMRT,,,1349.34,1349.34,2
HCPCS,773010,RADIOTHERAPY DOSE PLAN IMRT,,,1349.34,1349.34,1
HCPCS,77301TC,RADIOTHERAPY DOSE PLAN IMRT,,,1349.34,1349.34,1
HCPCS,77306,TELETHX ISODOSE PLAN SIMPLE,,,71.14,71.14,2
HCPCS,77306,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,3158.0,2052.7,71.21,3774.0,157
HCPCS,773060,TELETHX ISODOSE PLAN SIMPLE,,,71.14,71.14,1
HCPCS,77306TC,TELETHX ISODOSE PLAN SIMPLE,,,71.14,71.14,1
HCPCS,77307,TELETHX ISODOSE PLAN CPLX,,,128.76,128.76,2
HCPCS,77307,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,3158.0,2052.7,110.51,4434.0,157
HCPCS,773070,TELETHX ISODOSE PLAN CPLX,,,128.76,128.76,1
HCPCS,77307TC,TELETHX ISODOSE PLAN CPLX,,,128.76,128.76,1
HCPCS,77316,BRACHYTX ISODOSE PLAN SIMPLE,,,163.71,163.71,2
HCPCS,77316,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,3438.0,2234.7,71.21,3718.0,126
HCPCS,773160,BRACHYTX ISODOSE PLAN SIMPLE,,,163.71,163.71,1
HCPCS,77316TC,BRACHYTX ISODOSE PLAN SIMPLE,,,163.71,163.71,1
HCPCS,77317,BRACHYTX ISODOSE INTERMED,,,215.62,215.62,2
HCPCS,77317,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,3158.0,2052.7,95.81,3890.0,157
HCPCS,773170,BRACHYTX ISODOSE INTERMED,,,215.62,215.62,1
HCPCS,77317TC,BRACHYTX ISODOSE INTERMED,,,215.62,215.62,1
HCPCS,77318,BRACHYTX ISODOSE COMPLEX,,,291.52,291.52,2
HCPCS,77318,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,3796.0,2467.3999999999996,110.51,4434.0,77
HCPCS,773180,BRACHYTX ISODOSE COMPLEX,,,291.52,291.52,1
HCPCS,77318TC,BRACHYTX ISODOSE COMPLEX,,,291.52,291.52,1
HCPCS,77321,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,3158.0,2052.7,39.49,3576.0,112
HCPCS,77321,SPECIAL TELETX PORT PLAN,,,42.17,42.17,2
HCPCS,773210,SPECIAL TELETX PORT PLAN,,,42.17,42.17,1
HCPCS,77321TC,SPECIAL TELETX PORT PLAN,,,42.17,42.17,1
HCPCS,77331,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,1145.0,744.25,36.37,1528.0,112
HCPCS,77331,SPECIAL RADIATION DOSIMETRY,,,18.27,18.27,2
HCPCS,773310,SPECIAL RADIATION DOSIMETRY,,,18.27,18.27,1
HCPCS,77331TC,SPECIAL RADIATION DOSIMETRY,,,18.27,18.27,1
HCPCS,77332,RADIATION TREATMENT AID(S),,,14.82,14.82,2
HCPCS,77332,TX DEVICES DESIGN & CONSTRUCTION SIMPLE,1145.0,744.25,54.56,1482.0,49
HCPCS,77332,TX DEVICES DESIGN/CONSTR SIMPLE,770.5,500.82500000000005,22.59,1343.0,63
HCPCS,773320,RADIATION TREATMENT AID(S),,,14.82,14.82,1
HCPCS,77332TC,RADIATION TREATMENT AID(S),,,14.82,14.82,1
HCPCS,77333,RADIATION TREATMENT AID(S),,,92.48,92.48,2
HCPCS,77333,TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE,1145.0,744.25,71.21,1482.0,49
HCPCS,77333,TX DEVICES DESIGN/CONSTR INTERMED,902.5,586.625,34.95,1475.0,63
HCPCS,773330,RADIATION TREATMENT AID(S),,,92.48,92.48,1
HCPCS,77333TC,RADIATION TREATMENT AID(S),,,92.48,92.48,1
HCPCS,77334,RADIATION TREATMENT AID(S),,,61.98,61.98,2
HCPCS,77334,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,3158.0,2052.7,110.51,2842.2,98
HCPCS,77334,TX DEVICES DESIGN/CONSTR COMPLEX,2085.0,1355.25,51.28,3664.0,63
HCPCS,773340,RADIATION TREATMENT AID(S),,,61.98,61.98,1
HCPCS,77334TC,RADIATION TREATMENT AID(S),,,61.98,61.98,1
HCPCS,77336,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,1118.0,726.7,39.49,1482.0,81
HCPCS,77336,RADIATION PHYSICS CONSULT,,,84.28,84.28,1
HCPCS,773360,RADIATION PHYSICS CONSULT,,,84.28,84.28,1
HCPCS,77338,DESIGN MLC DEVICE FOR IMRT,,,231.47,231.47,2
HCPCS,77338,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,3158.0,2052.7,110.51,5046.0,161
HCPCS,773380,DESIGN MLC DEVICE FOR IMRT,,,231.47,231.47,1
HCPCS,77338TC,DESIGN MLC DEVICE FOR IMRT,,,231.47,231.47,1
HCPCS,77370,RADIATION PHYSICS CONSULT,,,137.08,137.08,1
HCPCS,77370,SPEC MEDICAL RADJ PHYSICS CONSLTJ,1145.0,744.25,71.21,1482.0,49
HCPCS,77370,SPECIAL RADIATION PHYSICS CONSULT,2276.0,1479.4,94.93,2276.0,32
HCPCS,773700,RADIATION PHYSICS CONSULT,,,137.08,137.08,1
HCPCS,77371,SRS MULTISOURCE,,,1053.71,16574.51,16
HCPCS,77371,Srs multisource,,,3066.36,3873.3,6
HCPCS,773710,SRS MULTISOURCE,,,1053.71,1053.71,1
HCPCS,77371TC,SRS MULTISOURCE,,,1053.71,1053.71,1
HCPCS,77372,RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR,36264.0,23571.6,0.01,59340.6,81
HCPCS,77372,SRS LINEAR BASED,,,899.74,899.74,2
HCPCS,773720,SRS LINEAR BASED,,,899.74,899.74,1
HCPCS,77372TC,SRS LINEAR BASED,,,899.74,899.74,1
HCPCS,77373,STEREOTACTIC BODY RADIATION DELIVERY,14597.5,9488.375,0.01,14050.0,179
HCPCS,77373,STRTCTC BDY RAD THER TX DLVR,,,939.57,939.57,2
HCPCS,773730,STRTCTC BDY RAD THER TX DLVR,,,939.57,939.57,1
HCPCS,77373TC,STRTCTC BDY RAD THER TX DLVR,,,939.57,939.57,1
HCPCS,77385,NTSTY MODUL RAD TX DLVR SMPL,,,580.66,1254.22,10
HCPCS,77385,Ntsty modul rad tx dlvr smpl,,,280.79,354.68,6
HCPCS,77386,NTSTY MODUL RAD TX DLVR CPLX,,,580.66,1254.22,10
HCPCS,77386,Ntsty modul rad tx dlvr cplx,,,280.79,354.68,6
HCPCS,77387,GUIDANCE FOR LOC OF TARGET VOL RADIAJ TX DLVR,299.0,194.35,37.57,299.0,22
HCPCS,77387,GUIDANCE FOR LOCLZJ TARGET VOL FOR RADJ TX DLVR,490.0,318.5,49.58,1482.0,78
HCPCS,77387,GUIDANCE FOR RADJ TX DLVR,,,96.25,96.25,2
HCPCS,773870,GUIDANCE FOR RADJ TX DLVR,,,96.25,96.25,1
HCPCS,77387TC,GUIDANCE FOR RADJ TX DLVR,,,96.25,96.25,1
HCPCS,77399,UNLISTED PX MED RADJ PHYSICS,,,133.27,287.87,14
HCPCS,77399,Unlisted px med radj physics,,,71.21,89.95,6
HCPCS,77401,RADIATION TX DELIVERY SUPFC,,,109.91,237.41,10
HCPCS,77401,Radiation tx delivery supfc,,,107.19,135.4,6
HCPCS,77402,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,1121.0,728.65,63.45,1482.0,124
HCPCS,77402,RADIATION TX DELIVERY LVL 1,,,119.2,119.2,1
HCPCS,774020,RADIATION TX DELIVERY LVL 1,,,119.2,119.2,1
HCPCS,77407,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,4236.0,2753.4,107.19,4236.0,124
HCPCS,77407,RADIATION TX DELIVERY LVL 2,,,163.89,163.89,1
HCPCS,774070,RADIATION TX DELIVERY LVL 2,,,163.89,163.89,1
HCPCS,77412,RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX,6068.0,3944.2,107.19,6068.0,75
HCPCS,77412,RADIATION TX DELIVERY LVL 3,,,216.71,216.71,1
HCPCS,774120,RADIATION TX DELIVERY LVL 3,,,216.71,216.71,1
HCPCS,77417,THER RADIOLOGY PORT IMAGE(S),,,14.19,14.19,2
HCPCS,77417,THERAPEUTIC RADIOLOGY PORT IMAGES(S),595.0,386.75,8.93,1482.0,62
HCPCS,774170,THER RADIOLOGY PORT IMAGE(S),,,14.19,14.19,1
HCPCS,77417TC,THER RADIOLOGY PORT IMAGE(S),,,14.19,14.19,1
HCPCS,77423,NEUTRON BEAM TX COMPLEX,,,83.13,1254.22,16
HCPCS,77423,Neutron beam tx complex,,,280.79,354.68,6
HCPCS,774230,NEUTRON BEAM TX COMPLEX,,,83.13,83.13,1
HCPCS,77423TC,NEUTRON BEAM TX COMPLEX,,,83.13,83.13,1
HCPCS,77424,INTRAOP RADIAJ TX DELIVER XRAY SINGLE TX SESSION,65934.0,42857.1,832.44,59340.6,96
HCPCS,77424,IO RAD TX DELIVERY BY X-RAY,,,409.96,409.96,1
HCPCS,774240,IO RAD TX DELIVERY BY X-RAY,,,409.96,409.96,1
HCPCS,77425,INTRAOP RADIAJ TX DELIVER ELECTRONS SNGL TX SESS,65934.0,42857.1,832.44,59340.6,96
HCPCS,77425,IO RAD TX DELIVER BY ELCTRNS,,,444.15,444.15,1
HCPCS,774250,IO RAD TX DELIVER BY ELCTRNS,,,444.15,444.15,1
HCPCS,77427,RADIATION TREATMENT MANAGEMENT 5 TREATMENTS,1483.0,963.95,131.21,1483.0,32
HCPCS,77427,RADIATION TX MANAGEMENT X5,,,190.66,190.66,1
HCPCS,77427,Radiation tx management x5,,,187.77,237.18,6
HCPCS,774270,RADIATION TX MANAGEMENT X5,,,190.66,190.66,1
HCPCS,77431,RADIATION THERAPY MANAGEMENT,,,107.43,107.43,1
HCPCS,77431,RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY,796.0,517.4,69.88,796.0,32
HCPCS,77431,Radiation therapy management,,,187.77,237.18,6
HCPCS,774310,RADIATION THERAPY MANAGEMENT,,,107.43,107.43,1
HCPCS,77432,STEREOTACTIC RADIATION TRMT,,,425.34,425.34,1
HCPCS,77432,STERETCTC RADIATION TX MANAGEMENT CRANIAL LESION,3485.0,2265.25,314.94,2613.75,32
HCPCS,77432,Stereotactic radiation trmt,,,187.77,237.18,6
HCPCS,774320,STEREOTACTIC RADIATION TRMT,,,425.34,425.34,1
HCPCS,77435,SBRT MANAGEMENT,,,642.87,642.87,1
HCPCS,77435,STEREOTACTIC BODY RADIATION MANAGEMENT,3191.0,2074.15,187.77,3917.25,71
HCPCS,774350,SBRT MANAGEMENT,,,642.87,642.87,1
HCPCS,77436,SURF RADJ THER TX PLANNING,,,34.81,42.91,6
HCPCS,77436,Surf radj ther tx planning,,,71.21,89.95,6
HCPCS,774360,SURF RADJ THER TX PLANNING,,,34.81,34.81,1
HCPCS,77436TC,SURF RADJ THER TX PLANNING,,,34.81,34.81,1
HCPCS,77437,SURF RADJ THER SUPFC<=150KV,,,106.55,117.2,4
HCPCS,77437,Surf radj ther supfc<=150kv,,,107.19,135.4,6
HCPCS,77438,SURF RAD THR ORTHVLT>150-500,,,106.55,117.2,4
HCPCS,77438,Surf rad thr orthvlt>150-500,,,107.19,135.4,6
HCPCS,77439,SURF RAD THR IMG GDN US PLMT,,,16.08,16.08,1
HCPCS,77439,Surf rad thr img gdn us plmt,,,65.54,82.79,6
HCPCS,774390,SURF RAD THR IMG GDN US PLMT,,,16.08,16.08,1
HCPCS,77469,IO RADIATION TX MANAGEMENT,,,319.18,319.18,1
HCPCS,77469,Io radiation tx management,,,187.77,237.18,6
HCPCS,774690,IO RADIATION TX MANAGEMENT,,,319.18,319.18,1
HCPCS,77470,SPECIAL RADIATION TREATMENT,,,34.04,34.04,2
HCPCS,77470,SPECIAL TREATMENT PROCEDURE,4989.0,3242.85,87.23,5882.0,112
HCPCS,774700,SPECIAL RADIATION TREATMENT,,,34.04,34.04,1
HCPCS,77470TC,SPECIAL RADIATION TREATMENT,,,34.04,34.04,1
HCPCS,77499,Unlisted px ther rad tx mgmt,,,187.77,237.18,6
HCPCS,77520,PROTON TRMT SIMPLE W/O COMP,,,577.01,1254.22,16
HCPCS,77520,Proton trmt simple w/o comp,,,280.79,354.68,6
HCPCS,775200,PROTON TRMT SIMPLE W/O COMP,,,873.67,873.67,1
HCPCS,77520TC,PROTON TRMT SIMPLE W/O COMP,,,873.67,873.67,1
HCPCS,77522,PROTON TRMT SIMPLE W/COMP,,,875.55,2765.52,16
HCPCS,77522,Proton trmt simple w/comp,,,832.44,1051.5,6
HCPCS,775220,PROTON TRMT SIMPLE W/COMP,,,875.55,875.55,1
HCPCS,77522TC,PROTON TRMT SIMPLE W/COMP,,,875.55,875.55,1
HCPCS,77523,PROTON TRMT INTERMEDIATE,,,1018.77,2765.52,16
HCPCS,77523,Proton trmt intermediate,,,832.44,1051.5,6
HCPCS,775230,PROTON TRMT INTERMEDIATE,,,1018.77,1018.77,1
HCPCS,77523TC,PROTON TRMT INTERMEDIATE,,,1018.77,1018.77,1
HCPCS,77525,PROTON TREATMENT COMPLEX,,,1125.85,2765.52,16
HCPCS,77525,Proton treatment complex,,,832.44,1051.5,6
HCPCS,775250,PROTON TREATMENT COMPLEX,,,1125.85,1125.85,1
HCPCS,77525TC,PROTON TREATMENT COMPLEX,,,1125.85,1125.85,1
HCPCS,77600,HYPERTHERMIA EXT GEN SUPFC,,,447.66,447.66,2
HCPCS,77600,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,1422.5,924.625,107.19,2042.1,130
HCPCS,776000,HYPERTHERMIA EXT GEN SUPFC,,,447.66,447.66,1
HCPCS,77600TC,HYPERTHERMIA EXT GEN SUPFC,,,447.66,447.66,1
HCPCS,77605,HYPERTHERMIA EXT GEN DEEP,,,797.63,797.63,2
HCPCS,77605,HYPERTHERMIA EXTERNAL GENERATED DEEP,6352.0,4128.8,280.79,6720.0,81
HCPCS,776050,HYPERTHERMIA EXT GEN DEEP,,,797.63,797.63,1
HCPCS,77605TC,HYPERTHERMIA EXT GEN DEEP,,,797.63,797.63,1
HCPCS,77610,HYPERTHERMIA INTERSTITIAL PROBE 5/< APPLICATORS,4989.0,3242.85,280.79,4490.1,49
HCPCS,77610,HYPERTHERMIA NTRSTL PRB 5/<,,,581.32,581.32,2
HCPCS,776100,HYPERTHERMIA NTRSTL PRB 5/<,,,581.32,581.32,1
HCPCS,77610TC,HYPERTHERMIA NTRSTL PRB 5/<,,,581.32,581.32,1
HCPCS,77615,HYPERTHERMIA INTERSTIAL PROBE 5/> APPLICATORS,4989.0,3242.85,280.79,4490.1,49
HCPCS,77615,HYPERTHERMIA NTRSTL PRB>5,,,923.38,923.38,2
HCPCS,776150,HYPERTHERMIA NTRSTL PRB>5,,,923.38,923.38,1
HCPCS,77615TC,HYPERTHERMIA NTRSTL PRB>5,,,923.38,923.38,1
HCPCS,77620,HYPERTHERMIA GEN INTRCV PRB,,,523.79,523.79,2
HCPCS,77620,HYPERTHERMIA INTRACAVITARY PROBES,2806.5,1824.225,63.64,4490.1,80
HCPCS,776200,HYPERTHERMIA GEN INTRCV PRB,,,523.79,523.79,1
HCPCS,77620TC,HYPERTHERMIA GEN INTRCV PRB,,,523.79,523.79,1
HCPCS,77750,INFUSE RADIOACTIVE MATERIALS,2000.0,1300.0,125.34,2000.0,79
HCPCS,77750,Infuse radioactive materials,,,107.19,135.4,6
HCPCS,777500,INFUSE RADIOACTIVE MATERIALS,,,125.34,125.34,1
HCPCS,77750TC,INFUSE RADIOACTIVE MATERIALS,,,125.34,125.34,1
HCPCS,77761,APPLY INTRCAV RADIAT SIMPLE,,,208.74,208.74,2
HCPCS,77761,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,4989.0,3242.85,160.53,6529.0,112
HCPCS,777610,APPLY INTRCAV RADIAT SIMPLE,,,208.74,208.74,1
HCPCS,77761TC,APPLY INTRCAV RADIAT SIMPLE,,,208.74,208.74,1
HCPCS,77762,APPLY INTRCAV RADIAT INTERM,,,239.64,239.64,2
HCPCS,77762,INTRACAVITARY RADIATION SOURCE APPLIC INTERMED,4989.0,3242.85,241.23,7523.0,112
HCPCS,77762,IP INTRACAVITARY BRACHY APP INTERMED PC,2534.0,1647.1,307.12,2534.0,32
HCPCS,777620,APPLY INTRCAV RADIAT INTERM,,,239.64,239.64,1
HCPCS,77762TC,APPLY INTRCAV RADIAT INTERM,,,239.64,239.64,1
HCPCS,77763,APPLY INTRCAV RADIAT COMPL,,,313.07,313.07,2
HCPCS,77763,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,5984.0,3889.6,361.98,7086.0,112
HCPCS,77763,INTRACAVITY COMP,3464.0,2251.6,455.76,2598.0,32
HCPCS,777630,APPLY INTRCAV RADIAT COMPL,,,313.07,313.07,1
HCPCS,77763TC,APPLY INTRCAV RADIAT COMPL,,,313.07,313.07,1
HCPCS,77767,HDR RDNCL SKN SURF BRACHYTX,,,184.45,184.45,2
HCPCS,77767,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,2269.0,1474.85,54.98,2689.0,143
HCPCS,777670,HDR RDNCL SKN SURF BRACHYTX,,,184.45,184.45,1
HCPCS,77767TC,HDR RDNCL SKN SURF BRACHYTX,,,184.45,184.45,1
HCPCS,77768,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,2269.0,1474.85,73.0,2829.0,143
HCPCS,77768,HDR RDNCL SKN SURF BRACHYTX,,,276.98,276.98,2
HCPCS,777680,HDR RDNCL SKN SURF BRACHYTX,,,276.98,276.98,1
HCPCS,77768TC,HDR RDNCL SKN SURF BRACHYTX,,,276.98,276.98,1
HCPCS,77770,HDR RDNCL NTRSTL/ICAV BRCHTX,,,232.91,232.91,2
HCPCS,77770,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,5984.0,3889.6,101.95,6764.0,143
HCPCS,777700,HDR RDNCL NTRSTL/ICAV BRCHTX,,,232.91,232.91,1
HCPCS,77770TC,HDR RDNCL NTRSTL/ICAV BRCHTX,,,232.91,232.91,1
HCPCS,77771,HDR RDNCL NTRSTL/ICAV BRCHTX,,,384.99,384.99,2
HCPCS,77771,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,5984.0,3889.6,199.55,7504.0,143
HCPCS,777710,HDR RDNCL NTRSTL/ICAV BRCHTX,,,384.99,384.99,1
HCPCS,77771TC,HDR RDNCL NTRSTL/ICAV BRCHTX,,,384.99,384.99,1
HCPCS,77772,HDR RDNCL NTRSTL/ICAV BRCHTX,,,589.96,1504.29,16
HCPCS,77772,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,5984.0,3889.6,281.21,8144.0,94
HCPCS,77772,Hdr rdncl ntrstl/icav brchtx,,,832.44,1051.5,6
HCPCS,777720,HDR RDNCL NTRSTL/ICAV BRCHTX,,,589.96,589.96,1
HCPCS,77772TC,HDR RDNCL NTRSTL/ICAV BRCHTX,,,589.96,589.96,1
HCPCS,77778,APPLY INTERSTIT RADIAT COMPL,,,438.64,438.64,2
HCPCS,77778,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,5984.0,3889.6,460.39,7385.25,158
HCPCS,777780,APPLY INTERSTIT RADIAT COMPL,,,438.64,438.64,1
HCPCS,77778TC,APPLY INTERSTIT RADIAT COMPL,,,438.64,438.64,1
HCPCS,77789,APPLY SURF LDR RADIONUCLIDE,,,69.57,237.41,16
HCPCS,77789,Apply surf ldr radionuclide,,,107.19,135.4,6
HCPCS,77789,SURFACE APPLIC LOW DOSE RATE RADIONUCLIDE SOURCE,502.0,326.3,47.59,502.0,63
HCPCS,777890,APPLY SURF LDR RADIONUCLIDE,,,69.57,69.57,1
HCPCS,77789TC,APPLY SURF LDR RADIONUCLIDE,,,69.57,69.57,1
HCPCS,77790,RADIATION HANDLING,,,6.96,6.96,2
HCPCS,77790,SUPERVISION HANDLING LOADING RADIATION SOURCE,1201.0,780.65,15.36,2409.0,120
HCPCS,777900,RADIATION HANDLING,,,6.96,6.96,1
HCPCS,77790TC,RADIATION HANDLING,,,6.96,6.96,1
HCPCS,77799,UNLISTED PX CLIN BRACHYTX,,,106.55,237.41,14
HCPCS,77799,Unlisted px clin brachytx,,,107.19,135.4,6
HCPCS,78000,THYROID UPTAKE SINGLE,132.0,85.8,22.5,219.0,32
HCPCS,78001,THYROID UPTAKE MULTIPLE,294.0,191.1,80.58,294.0,16
HCPCS,78001,"THYROID,UPTAKE,MULTIPLE DETERMINATIONS",56.0,36.4,28.0,101.07,16
HCPCS,78006,THYROID IMAGE UPTAKE SING,299.5,194.67499999999998,56.5,486.0,32
HCPCS,78007,THYROID IMAGE UPTAKE MULT,551.0,358.15,198.22,551.0,16
HCPCS,78007,THYROID IMAGING W/UPTAKE/MULTIPLE,143.0,92.95,71.5,248.64,16
HCPCS,78010,THYROID IMAGING,221.0,143.65,56.5,329.0,32
HCPCS,78012,THYROID UPTAKE MEASUREMENT,,,71.2,71.2,2
HCPCS,78012,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,3466.0,2252.9,8.66,3542.0,143
HCPCS,780120,THYROID UPTAKE MEASUREMENT,,,71.2,71.2,1
HCPCS,78012TC,THYROID UPTAKE MEASUREMENT,,,71.2,71.2,1
HCPCS,78013,THYROID IMAGING W/BLOOD FLOW,,,151.82,151.82,2
HCPCS,78013,THYROID IMAGING WITH VASCULAR FLOW,3466.0,2252.9,16.99,3614.0,143
HCPCS,780130,THYROID IMAGING W/BLOOD FLOW,,,151.82,151.82,1
HCPCS,78013TC,THYROID IMAGING W/BLOOD FLOW,,,151.82,151.82,1
HCPCS,78014,THYROID IMAGING W/BLOOD FLOW,,,191.76,191.76,2
HCPCS,78014,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,3466.0,2252.9,22.81,3686.0,143
HCPCS,780140,THYROID IMAGING W/BLOOD FLOW,,,191.76,191.76,1
HCPCS,78014TC,THYROID IMAGING W/BLOOD FLOW,,,191.76,191.76,1
HCPCS,78015,THYROID CARCINOMA METASTASES IMG LMTD AREA,3466.0,2252.9,27.27,3734.0,98
HCPCS,78015,THYROID MET IMAGING,,,177.68,871.23,19
HCPCS,78015,Thyroid met imaging,,,225.17,284.42,6
HCPCS,780150,THYROID MET IMAGING,,,177.68,177.68,1
HCPCS,78015TC,THYROID MET IMAGING,,,177.68,177.68,1
HCPCS,78016,THYROID MET IMAGING/STUDIES,,,217.07,871.23,19
HCPCS,78016,Thyroid met imaging/studies,,,225.17,284.42,6
HCPCS,780160,THYROID MET IMAGING/STUDIES,,,217.07,217.07,1
HCPCS,78016TC,THYROID MET IMAGING/STUDIES,,,217.07,217.07,1
HCPCS,78018,THYROID CARCINOMA METASTASES IMG WHOLE BODY,4643.0,3017.95,34.36,4987.0,147
HCPCS,78018,THYROID MET IMAGING BODY,,,241.92,241.92,2
HCPCS,780180,THYROID MET IMAGING BODY,,,241.92,241.92,1
HCPCS,78018TC,THYROID MET IMAGING BODY,,,241.92,241.92,1
HCPCS,78020,THYROID CARCINOMA METASTASES UPTAKE,1104.0,717.6,109.59,2409.0,36
HCPCS,78020,THYROID MET UPTAKE,,,51.51,51.51,2
HCPCS,780200,THYROID MET UPTAKE,,,51.51,51.51,1
HCPCS,78020TC,THYROID MET UPTAKE,,,51.51,51.51,1
HCPCS,78070,PARATHYROID PLANAR IMAGING,3466.0,2252.9,33.23,3786.0,149
HCPCS,780700,PARATHYROID PLANAR IMAGING,,,228.5,228.5,1
HCPCS,78070TC,PARATHYROID PLANAR IMAGING,,,228.5,228.5,1
HCPCS,78071,PARATHYRD PLANAR W/WO SUBTRJ,,,260.92,260.92,2
HCPCS,78071,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,3466.0,2252.9,54.59,3946.0,143
HCPCS,780710,PARATHYRD PLANAR W/WO SUBTRJ,,,260.92,260.92,1
HCPCS,78071TC,PARATHYRD PLANAR W/WO SUBTRJ,,,260.92,260.92,1
HCPCS,78072,PARATHYRD PLANAR W/SPECT&CT,,,335.91,335.91,2
HCPCS,78072,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,4643.0,3017.95,71.65,5283.0,143
HCPCS,780720,PARATHYRD PLANAR W/SPECT&CT,,,335.91,335.91,1
HCPCS,78072TC,PARATHYRD PLANAR W/SPECT&CT,,,335.91,335.91,1
HCPCS,78075,ADRENAL CORTEX & MEDULLA IMG,,,364.82,364.82,2
HCPCS,78075,ADRENAL IMAGING CORTEX &/MEDULLA,11260.0,7319.0,29.53,11556.0,147
HCPCS,780750,ADRENAL CORTEX & MEDULLA IMG,,,364.82,364.82,1
HCPCS,78075TC,ADRENAL CORTEX & MEDULLA IMG,,,364.82,364.82,1
HCPCS,78099,UNLISTED ENDOCRINE PX DX NUC,,,403.35,871.23,17
HCPCS,78099,Unlisted endocrine px dx nuc,,,225.17,284.42,6
HCPCS,78102,BONE MARROW IMAGING LIMITED AREA,3466.0,2252.9,225.17,3119.4,49
HCPCS,78102,BONE MARROW IMAGING LTD,,,133.8,133.8,2
HCPCS,78102,"BONE MARROW IMAGING, LTD",3466.0,2252.9,22.3,3686.0,98
HCPCS,781020,BONE MARROW IMAGING LTD,,,133.8,133.8,1
HCPCS,78102TC,BONE MARROW IMAGING LTD,,,133.8,133.8,1
HCPCS,78103,BONE MARROW IMAGING MULT,,,139.36,139.36,2
HCPCS,78103,BONE MARROW IMAGING MULTIPLE AREAS,3466.0,2252.9,225.17,3119.4,49
HCPCS,78103,"BONE MARROW IMAGING, MULT",3466.0,2252.9,28.71,3766.0,98
HCPCS,781030,BONE MARROW IMAGING MULT,,,139.36,139.36,1
HCPCS,78103TC,BONE MARROW IMAGING MULT,,,139.36,139.36,1
HCPCS,78104,BONE MARROW IMAGING BODY,,,190.5,190.5,2
HCPCS,78104,BONE MARROW IMAGING WHOLE BODY,3466.0,2252.9,225.17,3119.4,49
HCPCS,78104,"BONE MARROW IMAGING, BODY",3466.0,2252.9,32.38,3786.0,98
HCPCS,781040,BONE MARROW IMAGING BODY,,,190.5,190.5,1
HCPCS,78104TC,BONE MARROW IMAGING BODY,,,190.5,190.5,1
HCPCS,78110,PLASMA VOLUME SINGLE,,,60.44,2862.43,19
HCPCS,78110,Plasma volume single,,,533.79,674.26,6
HCPCS,781100,PLASMA VOLUME SINGLE,,,60.44,60.44,1
HCPCS,78110TC,PLASMA VOLUME SINGLE,,,60.44,60.44,1
HCPCS,78111,PLASMA VOLUME MULTIPLE,,,63.39,2862.43,19
HCPCS,78111,Plasma volume multiple,,,533.79,674.26,6
HCPCS,781110,PLASMA VOLUME MULTIPLE,,,63.39,63.39,1
HCPCS,78111TC,PLASMA VOLUME MULTIPLE,,,63.39,63.39,1
HCPCS,78120,RED CELL MASS SINGLE,,,60.44,871.23,19
HCPCS,78120,Red cell mass single,,,225.17,284.42,6
HCPCS,781200,RED CELL MASS SINGLE,,,60.44,60.44,1
HCPCS,78120TC,RED CELL MASS SINGLE,,,60.44,60.44,1
HCPCS,78121,RED CELL MASS MULTIPLE,,,63.39,1167.06,19
HCPCS,78121,Red cell mass multiple,,,225.17,284.42,6
HCPCS,781210,RED CELL MASS MULTIPLE,,,63.39,63.39,1
HCPCS,78121TC,RED CELL MASS MULTIPLE,,,63.39,63.39,1
HCPCS,78122,WHL BLD VOLUME DETERMINATION,,,76.81,76.81,2
HCPCS,78122,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,4643.0,3017.95,17.18,4823.0,147
HCPCS,781220,WHL BLD VOLUME DETERMINATION,,,76.81,76.81,1
HCPCS,78122TC,WHL BLD VOLUME DETERMINATION,,,76.81,76.81,1
HCPCS,78130,RED CELL SURVIVAL STUDY,,,98.52,871.23,19
HCPCS,78130,Red cell survival study,,,225.17,284.42,6
HCPCS,781300,RED CELL SURVIVAL STUDY,,,98.52,98.52,1
HCPCS,78130TC,RED CELL SURVIVAL STUDY,,,98.52,98.52,1
HCPCS,78135,Red cell survival kinetics,,,225.17,284.42,6
HCPCS,78140,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,3466.0,2252.9,23.53,3710.0,98
HCPCS,78140,RED CELL SEQUESTRATION,,,84.06,871.23,19
HCPCS,78140,Red cell sequestration,,,225.17,284.42,6
HCPCS,781400,RED CELL SEQUESTRATION,,,84.06,84.06,1
HCPCS,78140TC,RED CELL SEQUESTRATION,,,84.06,84.06,1
HCPCS,78185,SPLEEN IMAGING,,,136.75,136.75,2
HCPCS,78185,SPLEEN IMAGING ONLY W/WO VASCULAR FLOW,3466.0,2252.9,15.77,3642.0,147
HCPCS,781850,SPLEEN IMAGING,,,136.75,136.75,1
HCPCS,78185TC,SPLEEN IMAGING,,,136.75,136.75,1
HCPCS,78191,PLATELET SURVIVAL STUDY,,,98.52,871.23,19
HCPCS,78191,Platelet survival study,,,225.17,284.42,6
HCPCS,781910,PLATELET SURVIVAL STUDY,,,98.52,98.52,1
HCPCS,78191TC,PLATELET SURVIVAL STUDY,,,98.52,98.52,1
HCPCS,78195,LYMPH SYSTEM IMAGING,,,264.57,264.57,2
HCPCS,78195,LYMPHATICS & LYMPH NODES IMAGING,4643.0,3017.95,49.28,5123.0,147
HCPCS,781950,LYMPH SYSTEM IMAGING,,,264.57,264.57,1
HCPCS,78195TC,LYMPH SYSTEM IMAGING,,,264.57,264.57,1
HCPCS,78199,UNLSTD HEMATOP RET/ENDO LYMP,,,403.35,871.23,17
HCPCS,78199,Unlstd hematop ret/endo lymp,,,225.17,284.42,6
HCPCS,78201,LIVER IMAGING STATIC ONLY,4643.0,3017.95,18.18,4837.0,149
HCPCS,782010,LIVER IMAGING STATIC ONLY,,,154.43,154.43,1
HCPCS,78201TC,LIVER IMAGING STATIC ONLY,,,154.43,154.43,1
HCPCS,78202,LIVER IMAGING W/VASCULAR FLOW,4643.0,3017.95,19.45,4847.0,147
HCPCS,78202,LIVER IMAGING WITH VASC FLOW,,,168.51,168.51,2
HCPCS,782020,LIVER IMAGING WITH VASC FLOW,,,168.51,168.51,1
HCPCS,78202TC,LIVER IMAGING WITH VASC FLOW,,,168.51,168.51,1
HCPCS,78215,LIVER & SPLEEN IMAGING STATIC ONLY,3466.0,2252.9,20.31,3662.0,147
HCPCS,78215,LVR&SPLEEN IMG STATIC ONLY,,,157.05,157.05,2
HCPCS,782150,LVR&SPLEEN IMG STATIC ONLY,,,157.05,157.05,1
HCPCS,78215TC,LVR&SPLEEN IMG STATIC ONLY,,,157.05,157.05,1
HCPCS,78216,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,3466.0,2252.9,22.86,3694.0,147
HCPCS,78216,LVR&SPLEEN IMG W/VASC FLOW,,,100.76,100.76,2
HCPCS,782160,LVR&SPLEEN IMG W/VASC FLOW,,,100.76,100.76,1
HCPCS,78216TC,LVR&SPLEEN IMG W/VASC FLOW,,,100.76,100.76,1
HCPCS,78226,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,3466.0,2252.9,29.82,3762.0,147
HCPCS,78226,HEPATOBILIARY SYSTEM IMAGING,2029.0,1318.8500000000001,148.0,3762.0,66
HCPCS,782260,HEPATOBILIARY SYSTEM IMAGING,,,257.97,257.97,1
HCPCS,78226TC,HEPATOBILIARY SYSTEM IMAGING,,,257.97,257.97,1
HCPCS,78227,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,4643.0,3017.95,35.78,5039.0,147
HCPCS,78227,HEPATOBIL SYST IMAGE W/DRUG,2717.5,1766.375,198.0,5039.0,66
HCPCS,782270,HEPATOBIL SYST IMAGE W/DRUG,,,350.74,350.74,1
HCPCS,78227TC,HEPATOBIL SYST IMAGE W/DRUG,,,350.74,350.74,1
HCPCS,78230,SALIVARY GLAND IMAGING,3466.0,2252.9,140.35,3119.4,51
HCPCS,782300,SALIVARY GLAND IMAGING,,,140.35,140.35,1
HCPCS,78230TC,SALIVARY GLAND IMAGING,,,140.35,140.35,1
HCPCS,78231,NM SALIVARY GLAND IMAGING,1790.0,1163.5,20.3,3372.0,63
HCPCS,78231,SALIVARY GLAND IMAGING SERIAL IMAGES,3466.0,2252.9,148.39,3119.4,49
HCPCS,78231,SALIVARY GLND IMG SERIAL IMG,,,82.1,82.1,2
HCPCS,782310,SALIVARY GLND IMG SERIAL IMG,,,82.1,82.1,1
HCPCS,78231TC,SALIVARY GLND IMG SERIAL IMG,,,82.1,82.1,1
HCPCS,78232,SALIVARY GLAND FUNCTION STD,,,82.1,82.1,2
HCPCS,78232,SALIVARY GLAND FUNCTION STUDY,3466.0,2252.9,17.74,3673.0,147
HCPCS,782320,SALIVARY GLAND FUNCTION STD,,,82.1,82.1,1
HCPCS,78232TC,SALIVARY GLAND FUNCTION STD,,,82.1,82.1,1
HCPCS,78258,ESOPHAGEAL MOTILITY,3466.0,2252.9,30.26,3762.0,149
HCPCS,782580,ESOPHAGEAL MOTILITY,,,162.29,162.29,1
HCPCS,78258TC,ESOPHAGEAL MOTILITY,,,162.29,162.29,1
HCPCS,78261,GASTRIC MUCOSA IMAGING,,,155.13,871.23,19
HCPCS,78261,Gastric mucosa imaging,,,225.17,284.42,6
HCPCS,782610,GASTRIC MUCOSA IMAGING,,,155.13,155.13,1
HCPCS,78261TC,GASTRIC MUCOSA IMAGING,,,155.13,155.13,1
HCPCS,78262,GASTROESOPHAGEAL REFLUX STD,,,191.48,191.48,2
HCPCS,78262,GASTROESOPHAGEAL REFLUX STUDY,3466.0,2252.9,26.84,3738.0,147
HCPCS,782620,GASTROESOPHAGEAL REFLUX STD,,,191.48,191.48,1
HCPCS,78262TC,GASTROESOPHAGEAL REFLUX STD,,,191.48,191.48,1
HCPCS,78264,GASTRIC EMPTYING IMAGING STUDY,3466.0,2252.9,225.17,3119.4,49
HCPCS,78264,GASTRIC EMPTYING IMG STUDY,,,261.28,261.28,2
HCPCS,78264,GASTRIC EMPTYING STUDY,3466.0,2252.9,32.67,3814.0,130
HCPCS,782640,GASTRIC EMPTYING IMG STUDY,,,261.28,261.28,1
HCPCS,78264TC,GASTRIC EMPTYING IMG STUDY,,,261.28,261.28,1
HCPCS,78265,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,3466.0,2252.9,44.64,3858.0,192
HCPCS,78265,GSTR EMPTG IMG SM BWL TRNST,,,309.11,309.11,2
HCPCS,782650,GSTR EMPTG IMG SM BWL TRNST,,,309.11,309.11,1
HCPCS,78265TC,GSTR EMPTG IMG SM BWL TRNST,,,309.11,309.11,1
HCPCS,78266,GSTR EMPT IMG SM BWL&COLON,,,354.35,354.35,2
HCPCS,78266,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,4643.0,3017.95,47.55,5075.0,192
HCPCS,782660,GSTR EMPT IMG SM BWL&COLON,,,354.35,354.35,1
HCPCS,78266TC,GSTR EMPT IMG SM BWL&COLON,,,354.35,354.35,1
HCPCS,78267,UREA BREATH TEST C-14 ISOTOPIC ACQUISJ ANALYSIS,2123.0,1379.95,5.78,2409.0,48
HCPCS,78267,UREA BREATH TST C-14 ACQUISJ,,,9.56,9.56,1
HCPCS,782670,UREA BREATH TST C-14 ACQUISJ,,,9.56,9.56,1
HCPCS,78268,UREA BREATH TEST C-14 ALYS,,,81.57,212.42,18
HCPCS,78268,Urea breath test c-14 alys,,,32.49,41.04,6
HCPCS,782680,UREA BREATH TEST C-14 ALYS,,,81.57,81.57,1
HCPCS,78278,ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,3466.0,2252.9,403.35,3119.4,49
HCPCS,78278,ACUTE GI BLOOD LOSS IMAGING,3466.0,2252.9,40.48,3862.0,100
HCPCS,782780,ACUTE GI BLOOD LOSS IMAGING,,,268.49,268.49,1
HCPCS,78278TC,ACUTE GI BLOOD LOSS IMAGING,,,268.49,268.49,1
HCPCS,78282,GI PROTEIN LOSS,,,393.06,871.23,19
HCPCS,78282,Gi protein loss,,,225.17,284.42,6
HCPCS,782820,GI PROTEIN LOSS,,,393.06,393.06,1
HCPCS,78282TC,GI PROTEIN LOSS,,,393.06,393.06,1
HCPCS,78290,INTESTINE IMAGING,3466.0,2252.9,28.12,3765.0,149
HCPCS,782900,INTESTINE IMAGING,,,264.89,264.89,1
HCPCS,78290TC,INTESTINE IMAGING,,,264.89,264.89,1
HCPCS,78291,PERITONEAL-VENOUS SHUNT PATENCY TEST,3466.0,2252.9,35.93,3818.0,147
HCPCS,78291,PERTL-VEN SHUNT PATENCY TEST,,,197.7,197.7,2
HCPCS,782910,PERTL-VEN SHUNT PATENCY TEST,,,197.7,197.7,1
HCPCS,78291TC,PERTL-VEN SHUNT PATENCY TEST,,,197.7,197.7,1
HCPCS,78299,UNLISTED GI PX DX NUC MED,,,403.35,871.23,17
HCPCS,78299,Unlisted gi px dx nuc med,,,225.17,284.42,6
HCPCS,78300,BONE &/JOINT IMAGING LIMITED AREA,3466.0,2252.9,25.42,3714.0,196
HCPCS,78300,BONE IMAGING LIMITED AREA,,,175.02,175.02,2
HCPCS,783000,BONE IMAGING LIMITED AREA,,,175.02,175.02,1
HCPCS,78300TC,BONE IMAGING LIMITED AREA,,,175.02,175.02,1
HCPCS,78305,BONE &/JOINT IMAGING MULTIPLE AREAS,3466.0,2252.9,33.8,3798.0,98
HCPCS,78305,BONE IMAGING MULTIPLE AREAS,,,207.81,871.23,19
HCPCS,78305,Bone imaging multiple areas,,,225.17,284.42,6
HCPCS,783050,BONE IMAGING MULTIPLE AREAS,,,207.81,207.81,1
HCPCS,78305TC,BONE IMAGING MULTIPLE AREAS,,,207.81,207.81,1
HCPCS,78306,BONE &/JOINT IMAGING WHOLE BODY,3466.0,2252.9,34.94,3844.0,147
HCPCS,78306,BONE IMAGING WHOLE BODY,2111.0,1372.1499999999999,148.1,3844.0,66
HCPCS,783060,BONE IMAGING WHOLE BODY,,,226.15,226.15,1
HCPCS,78306TC,BONE IMAGING WHOLE BODY,,,226.15,226.15,1
HCPCS,78315,BONE &/JOINT IMAGING 3 PHASE STUDY,3466.0,2252.9,41.61,3874.0,147
HCPCS,78315,BONE IMAGING 3 PHASE,,,265.22,265.22,2
HCPCS,78315,BONE IMAGING THREE PHASE,2141.0,1391.6499999999999,167.52,3874.0,64
HCPCS,783150,BONE IMAGING 3 PHASE,,,265.22,265.22,1
HCPCS,78315TC,BONE IMAGING 3 PHASE,,,265.22,265.22,1
HCPCS,78320,BONE IMAGING SPECT,654.5,425.425,113.0,1083.0,32
HCPCS,78350,BONE MINERAL SINGLE PHOTON,,,21.01,48.71,5
HCPCS,78350,Bone mineral single photon,,,225.17,284.42,6
HCPCS,783500,BONE MINERAL SINGLE PHOTON,,,21.01,21.01,1
HCPCS,78350TC,BONE MINERAL SINGLE PHOTON,,,21.01,21.01,1
HCPCS,78351,BONE MINERAL DUAL PHOTON,,,10.54,35.73,5
HCPCS,78351,Bone mineral dual photon,,,225.17,284.42,6
HCPCS,783510,BONE MINERAL DUAL PHOTON,,,10.54,10.54,1
HCPCS,78351TC,BONE MINERAL DUAL PHOTON,,,10.54,10.54,1
HCPCS,78399,UNLISTED MUSCSKEL PX DX NUC,,,403.35,871.23,17
HCPCS,78399,Unlisted muscskel px dx nuc,,,225.17,284.42,6
HCPCS,78414,NON-IMAGING HEART FUNCTION,,,47.8,1167.06,19
HCPCS,78414,Non-imaging heart function,,,225.17,284.42,6
HCPCS,784140,NON-IMAGING HEART FUNCTION,,,47.8,47.8,1
HCPCS,78414TC,NON-IMAGING HEART FUNCTION,,,47.8,47.8,1
HCPCS,78428,CARDIAC SHUNT DETECTION,3466.0,2252.9,31.96,3778.0,147
HCPCS,78428,CARDIAC SHUNT IMAGING,,,136.09,136.09,2
HCPCS,784280,CARDIAC SHUNT IMAGING,,,136.09,136.09,1
HCPCS,78428TC,CARDIAC SHUNT IMAGING,,,136.09,136.09,1
HCPCS,78429,MYOCRD IMG PET 1 STD W/CT,,,1296.0,1296.0,2
HCPCS,78429,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,12580.0,8177.0,14.82,26432.0,153
HCPCS,784290,MYOCRD IMG PET 1 STD W/CT,,,1296.0,1296.0,1
HCPCS,78429TC,MYOCRD IMG PET 1 STD W/CT,,,1296.0,1296.0,1
HCPCS,78430,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,12580.0,8177.0,14.82,26432.0,153
HCPCS,78430,MYOCRD IMG PET RST/STRS W/CT,,,1296.0,1296.0,2
HCPCS,784300,MYOCRD IMG PET RST/STRS W/CT,,,1296.0,1296.0,1
HCPCS,78430TC,MYOCRD IMG PET RST/STRS W/CT,,,1296.0,1296.0,1
HCPCS,78431,MYOCRD IMG PET PRFUJ MLT STD RST & STRS CNCRNT CT,19410.0,12616.5,84.98,20170.0,66
HCPCS,78431,MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT,19410.0,12616.5,859.52,26432.0,88
HCPCS,78431,MYOCRD IMG PET RST&STRS CT,,,1296.0,1296.0,2
HCPCS,784310,MYOCRD IMG PET RST&STRS CT,,,1296.0,1296.0,1
HCPCS,78431TC,MYOCRD IMG PET RST&STRS CT,,,1296.0,1296.0,1
HCPCS,78432,MYOCRD IMG PET 2RTRACER,,,1296.0,1296.0,2
HCPCS,78432,MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER,15960.0,10374.0,93.89,26432.0,153
HCPCS,784320,MYOCRD IMG PET 2RTRACER,,,1296.0,1296.0,1
HCPCS,78432TC,MYOCRD IMG PET 2RTRACER,,,1296.0,1296.0,1
HCPCS,78433,MYOCRD IMG PET 2RTRACER CT,,,1296.0,1296.0,2
HCPCS,78433,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,16823.0,10934.95,100.03,26432.0,153
HCPCS,784330,MYOCRD IMG PET 2RTRACER CT,,,1296.0,1296.0,1
HCPCS,78433TC,MYOCRD IMG PET 2RTRACER CT,,,1296.0,1296.0,1
HCPCS,78434,AQMBF PET REST & RX STRESS,,,1296.0,1296.0,2
HCPCS,78434,AQMBF PET REST AND PHARMACOLOGIC STRESS,4011.0,2607.15,28.3,4263.0,100
HCPCS,784340,AQMBF PET REST & RX STRESS,,,1296.0,1296.0,1
HCPCS,78434TC,AQMBF PET REST & RX STRESS,,,1296.0,1296.0,1
HCPCS,78445,NONCARDIAC VASCULAR FLOW IMAGING,3466.0,2252.9,18.88,3682.0,147
HCPCS,78445,VASCULAR FLOW IMAGING,,,161.97,161.97,2
HCPCS,784450,VASCULAR FLOW IMAGING,,,161.97,161.97,1
HCPCS,78445TC,VASCULAR FLOW IMAGING,,,161.97,161.97,1
HCPCS,78451,HT MUSCLE IMAGE SPECT SING,,,245.85,245.85,2
HCPCS,78451,HT MUSCLE IMAGE SPECT SINGLE,607.0,394.55,202.07,607.0,32
HCPCS,78451,MPI SPECT SING W/WALL MTN EJECTN FRCTN,11867.0,7713.55,202.07,11867.0,32
HCPCS,78451,MPI SPECT SNGL W/WALL MTN/EJECT FRCTN,11260.0,7319.0,202.07,11260.0,32
HCPCS,78451,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,11260.0,7319.0,55.24,11867.0,147
HCPCS,784510,HT MUSCLE IMAGE SPECT SING,,,245.85,245.85,1
HCPCS,78451TC,HT MUSCLE IMAGE SPECT SING,,,245.85,245.85,1
HCPCS,78452,HT MUSCLE IMAGE SPECT MULT,,,352.75,352.75,2
HCPCS,78452,HT MUSCLE IMAGE SPECT MULT PC,713.0,463.45,279.71,713.0,32
HCPCS,78452,MPI SPECT MULT W/WALL MTN & EJCTN FRCTN,11260.0,7319.0,279.71,11260.0,32
HCPCS,78452,MPI SPECT MULT W/WALL MTN & EJECT FRCTN,11973.0,7782.45,279.71,11973.0,32
HCPCS,78452,MYOCARDIAL SPECT MULTIPLE STUDIES,11260.0,7319.0,64.62,11973.0,147
HCPCS,784520,HT MUSCLE IMAGE SPECT MULT,,,352.75,352.75,1
HCPCS,78452TC,HT MUSCLE IMAGE SPECT MULT,,,352.75,352.75,1
HCPCS,78453,HT MUSCLE IMAGE PLANAR SING,,,218.01,2862.43,19
HCPCS,78453,HT MUSCLE IMAGE PLANAR SINGLE,400.0,260.0,180.05,400.0,32
HCPCS,78453,Ht muscle image planar sing,,,533.79,674.26,6
HCPCS,78453,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,11260.0,7319.0,40.19,11660.0,98
HCPCS,784530,HT MUSCLE IMAGE PLANAR SING,,,218.01,218.01,1
HCPCS,78453TC,HT MUSCLE IMAGE PLANAR SING,,,218.01,218.01,1
HCPCS,78454,HT MUSC IMAGE PLANAR MULT,536.0,348.4,256.02,580.49,34
HCPCS,78454,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,11260.0,7319.0,53.25,11796.0,147
HCPCS,784540,HT MUSC IMAGE PLANAR MULT,,,330.11,330.11,1
HCPCS,78454TC,HT MUSC IMAGE PLANAR MULT,,,330.11,330.11,1
HCPCS,78456,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,11260.0,7319.0,41.92,11660.0,147
HCPCS,78456,ACUTE VENOUS THROMBUS IMAGE,,,238.69,238.69,2
HCPCS,784560,ACUTE VENOUS THROMBUS IMAGE,,,238.69,238.69,1
HCPCS,78456TC,ACUTE VENOUS THROMBUS IMAGE,,,238.69,238.69,1
HCPCS,78457,VENOUS THROMBOSIS IMAGING,,,117.43,117.43,2
HCPCS,78457,VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL,4643.0,3017.95,31.53,4982.0,147
HCPCS,784570,VENOUS THROMBOSIS IMAGING,,,117.43,117.43,1
HCPCS,78457TC,VENOUS THROMBOSIS IMAGING,,,117.43,117.43,1
HCPCS,78458,VEN THROMBOSIS IMAGES BILAT,,,147.88,147.88,2
HCPCS,78458,VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL,3466.0,2252.9,35.06,3862.0,147
HCPCS,784580,VEN THROMBOSIS IMAGES BILAT,,,147.88,147.88,1
HCPCS,78458TC,VEN THROMBOSIS IMAGES BILAT,,,147.88,147.88,1
HCPCS,78459,MYOCARDIAL IMAGING METABOLIC PET,708.0,460.2,354.0,1856.69,14
HCPCS,78459,"MYOCARDIAL IMAGING, PET,METABOLIC EVAL",11968.0,7779.2,677.38,11968.0,14
HCPCS,78459,MYOCRD IMG PET METAB EVAL SINGLE STUDY,11260.0,7319.0,61.92,11968.0,114
HCPCS,78459,MYOCRD IMG PET SINGLE STUDY,,,1296.0,1296.0,2
HCPCS,784590,MYOCRD IMG PET SINGLE STUDY,,,1296.0,1296.0,1
HCPCS,78459TC,MYOCRD IMG PET SINGLE STUDY,,,1296.0,1296.0,1
HCPCS,78466,HEART INFARCT IMAGE,,,133.14,133.14,2
HCPCS,78466,"MYOCARD IMAG,INFARCT AVID",276.0,179.4,97.64,276.0,32
HCPCS,78466,MYOCARDIAL IMAGE INFARCT,3742.0,2432.3,97.64,3742.0,32
HCPCS,78466,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,3466.0,2252.9,28.55,3742.0,147
HCPCS,784660,HEART INFARCT IMAGE,,,133.14,133.14,1
HCPCS,78466TC,HEART INFARCT IMAGE,,,133.14,133.14,1
HCPCS,78468,HEART INFARCT IMAGE (EF),,,144.28,1167.06,19
HCPCS,78468,Heart infarct image (ef),,,225.17,284.42,6
HCPCS,78468,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,4643.0,3017.95,33.39,4963.0,98
HCPCS,78468,NM CARD INFARCT PLANAR EJECT FRAC PASS 1,320.0,208.0,123.12,320.0,32
HCPCS,784680,HEART INFARCT IMAGE (EF),,,144.28,144.28,1
HCPCS,78468TC,HEART INFARCT IMAGE (EF),,,144.28,144.28,1
HCPCS,78469,HEART INFARCT IMAGE (3D),,,160.65,160.65,2
HCPCS,78469,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,4643.0,3017.95,37.93,5011.0,196
HCPCS,784690,HEART INFARCT IMAGE (3D),,,160.65,160.65,1
HCPCS,78469TC,HEART INFARCT IMAGE (3D),,,160.65,160.65,1
HCPCS,78472,"BLOOD POOL IMAGING,GATED,SGL STUDY (MUGA)",392.0,254.8,177.52,392.0,32
HCPCS,78472,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,3466.0,2252.9,40.34,3858.0,147
HCPCS,78472,CARDIAC BLOOD POOL SINGLE,3858.0,2507.7,177.52,3858.0,32
HCPCS,78472,GATED HEART PLANAR SINGLE,,,162.62,162.62,2
HCPCS,784720,GATED HEART PLANAR SINGLE,,,162.62,162.62,1
HCPCS,78472TC,GATED HEART PLANAR SINGLE,,,162.62,162.62,1
HCPCS,78473,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,3466.0,2252.9,60.66,4054.0,147
HCPCS,78473,CARDIAC BLOOD POOL MULT,2321.0,1508.6499999999999,231.4,4054.0,64
HCPCS,78473,GATED HEART MULTIPLE,,,197.7,197.7,2
HCPCS,784730,GATED HEART MULTIPLE,,,197.7,197.7,1
HCPCS,78473TC,GATED HEART MULTIPLE,,,197.7,197.7,1
HCPCS,78481,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,4643.0,3017.95,40.78,5035.0,147
HCPCS,78481,CARDIAC BLD POOL IMAG MULT,392.0,254.8,143.73,392.0,32
HCPCS,78481,CARDIAC BLD POOL IMAGING,5035.0,3272.75,143.73,5035.0,32
HCPCS,78481,HEART FIRST PASS SINGLE,,,118.36,118.36,2
HCPCS,784810,HEART FIRST PASS SINGLE,,,118.36,118.36,1
HCPCS,78481TC,HEART FIRST PASS SINGLE,,,118.36,118.36,1
HCPCS,78483,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,4643.0,3017.95,61.24,5231.0,147
HCPCS,78483,HEART FIRST PASS MULTIPLE,,,152.14,152.14,2
HCPCS,784830,HEART FIRST PASS MULTIPLE,,,152.14,152.14,1
HCPCS,78483TC,HEART FIRST PASS MULTIPLE,,,152.14,152.14,1
HCPCS,78491,MYOCRD IMG PET 1STD RST/STRS,,,1296.0,1296.0,2
HCPCS,78491,MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS,12580.0,8177.0,62.78,13266.0,114
HCPCS,784910,MYOCRD IMG PET 1STD RST/STRS,,,1296.0,1296.0,1
HCPCS,78491TC,MYOCRD IMG PET 1STD RST/STRS,,,1296.0,1296.0,1
HCPCS,78492,MYOCRD IMG PET MLT RST&STRS,,,1296.0,1296.0,2
HCPCS,78492,MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS,12580.0,8177.0,79.27,13300.0,114
HCPCS,784920,MYOCRD IMG PET MLT RST&STRS,,,1296.0,1296.0,1
HCPCS,78492TC,MYOCRD IMG PET MLT RST&STRS,,,1296.0,1296.0,1
HCPCS,78494,HEART IMAGE SPECT,,,155.09,871.23,19
HCPCS,78494,Heart image spect,,,225.17,284.42,6
HCPCS,784940,HEART IMAGE SPECT,,,155.09,155.09,1
HCPCS,78494TC,HEART IMAGE SPECT,,,155.09,155.09,1
HCPCS,78496,HEART FIRST PASS ADD-ON,,,18.72,18.72,2
HCPCS,78496,Heart first pass add-on,,,225.17,284.42,6
HCPCS,784960,HEART FIRST PASS ADD-ON,,,18.72,18.72,1
HCPCS,78496TC,HEART FIRST PASS ADD-ON,,,18.72,18.72,1
HCPCS,78499,UNLISTED CV PX DX NUC MED,,,403.35,871.23,17
HCPCS,78499,Unlisted cv px dx nuc med,,,225.17,284.42,6
HCPCS,78579,LUNG VENTILATION IMAGING,1929.0,1253.8500000000001,98.0,3662.0,66
HCPCS,78579,PULMONARY VENTILATION IMAGING,3466.0,2252.9,19.74,3662.0,147
HCPCS,785790,LUNG VENTILATION IMAGING,,,147.51,147.51,1
HCPCS,78579TC,LUNG VENTILATION IMAGING,,,147.51,147.51,1
HCPCS,78580,LUNG PERFUSION IMAGING,,,179.65,179.65,2
HCPCS,78580,PULM PERFUSION PARTICULATE,2029.0,1318.8500000000001,120.94,3762.0,64
HCPCS,78580,PULMONARY PERFUSION IMAGING PARTICULATE,3466.0,2252.9,29.97,3762.0,147
HCPCS,785800,LUNG PERFUSION IMAGING,,,179.65,179.65,1
HCPCS,78580TC,LUNG PERFUSION IMAGING,,,179.65,179.65,1
HCPCS,78582,LUNG VENTILAT&PERFUS IMAGING,,,250.11,250.11,2
HCPCS,78582,LUNG VENTILATION&PERFUSION IMAGING,2749.5,1787.175,197.06,5071.0,64
HCPCS,78582,PULMONARY VENTILATION & PERFUSION IMAGING,4643.0,3017.95,42.45,5071.0,147
HCPCS,785820,LUNG VENTILAT&PERFUS IMAGING,,,250.11,250.11,1
HCPCS,78582TC,LUNG VENTILAT&PERFUS IMAGING,,,250.11,250.11,1
HCPCS,78597,LUNG PERFUSION DIFFERENTIAL,2033.0,1321.45,93.86,3766.0,66
HCPCS,78597,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,3466.0,2252.9,28.96,3766.0,147
HCPCS,785970,LUNG PERFUSION DIFFERENTIAL,,,148.17,148.17,1
HCPCS,78597TC,LUNG PERFUSION DIFFERENTIAL,,,148.17,148.17,1
HCPCS,78598,LUNG PERF&VENTILAT DIFERENTL,,,233.41,233.41,2
HCPCS,78598,LUNG PERFUS&VENTILAT DIFFERENTIAL,2661.5,1729.975,140.99,4983.0,64
HCPCS,78598,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,4643.0,3017.95,33.08,4983.0,147
HCPCS,785980,LUNG PERF&VENTILAT DIFERENTL,,,233.41,233.41,1
HCPCS,78598TC,LUNG PERF&VENTILAT DIFERENTL,,,233.41,233.41,1
HCPCS,78599,UNLISTED RESP PX DX NUC MED,,,403.35,871.23,17
HCPCS,78599,Unlisted resp px dx nuc med,,,225.17,284.42,6
HCPCS,78600,BRAIN IMAGE < 4 VIEWS,,,145.59,871.23,19
HCPCS,78600,Brain image < 4 views,,,225.17,284.42,6
HCPCS,786000,BRAIN IMAGE < 4 VIEWS,,,145.59,145.59,1
HCPCS,78600TC,BRAIN IMAGE < 4 VIEWS,,,145.59,145.59,1
HCPCS,78601,BRAIN IMAGE W/FLOW < 4 VIEWS,,,174.09,174.09,2
HCPCS,78601,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,3466.0,2252.9,20.88,3670.0,147
HCPCS,786010,BRAIN IMAGE W/FLOW < 4 VIEWS,,,174.09,174.09,1
HCPCS,78601TC,BRAIN IMAGE W/FLOW < 4 VIEWS,,,174.09,174.09,1
HCPCS,78605,BRAIN IMAGE 4+ VIEWS,,,158.36,1167.06,19
HCPCS,78605,Brain image 4+ views,,,225.17,284.42,6
HCPCS,786050,BRAIN IMAGE 4+ VIEWS,,,158.36,158.36,1
HCPCS,78605TC,BRAIN IMAGE 4+ VIEWS,,,158.36,158.36,1
HCPCS,78606,BRAIN IMAGE COMP W VAS FLOW,4899.0,3184.35,192.5,4899.0,32
HCPCS,78606,BRAIN IMAGE W/FLOW 4 + VIEWS,,,267.51,267.51,2
HCPCS,78606,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,4643.0,3017.95,25.42,4899.0,147
HCPCS,78606,"BRAIN IMAGING, MIN 4 VWS; W/VASC FLOW",256.0,166.4,128.0,438.87,32
HCPCS,786060,BRAIN IMAGE W/FLOW 4 + VIEWS,,,267.51,267.51,1
HCPCS,78606TC,BRAIN IMAGE W/FLOW 4 + VIEWS,,,267.51,267.51,1
HCPCS,78608,BRAIN IMAGING (PET),,,1296.0,1296.0,2
HCPCS,78608,BRAIN IMAGING PET METABOLIC EVALUATION,12580.0,8177.0,61.49,13180.0,210
HCPCS,786080,BRAIN IMAGING (PET),,,1296.0,1296.0,1
HCPCS,78608TC,BRAIN IMAGING (PET),,,1296.0,1296.0,1
HCPCS,78609,BRAIN IMAGING (PET),,,1296.0,1296.0,2
HCPCS,78609,Brain imaging (pet),,,859.52,1085.71,6
HCPCS,786090,BRAIN IMAGING (PET),,,1296.0,1296.0,1
HCPCS,78609TC,BRAIN IMAGING (PET),,,1296.0,1296.0,1
HCPCS,78610,BRAIN FLOW IMAGING ONLY,,,145.92,145.92,2
HCPCS,78610,BRAIN IMAGING VASCULAR FLOW ONLY,4643.0,3017.95,225.17,4178.7,49
HCPCS,78610,"BRAIN IMAGING, VASC FLOW ONLY",4643.0,3017.95,12.36,4763.0,98
HCPCS,786100,BRAIN FLOW IMAGING ONLY,,,145.92,145.92,1
HCPCS,78610TC,BRAIN FLOW IMAGING ONLY,,,145.92,145.92,1
HCPCS,78630,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,4643.0,3017.95,27.7,4915.0,147
HCPCS,78630,CEREBROSPINAL FLUID SCAN,,,272.1,272.1,2
HCPCS,786300,CEREBROSPINAL FLUID SCAN,,,272.1,272.1,1
HCPCS,78630TC,CEREBROSPINAL FLUID SCAN,,,272.1,272.1,1
HCPCS,78635,CSF VENTRICULOGRAPHY,,,275.37,1167.06,19
HCPCS,78635,Csf ventriculography,,,225.17,284.42,6
HCPCS,786350,CSF VENTRICULOGRAPHY,,,275.37,275.37,1
HCPCS,78635TC,CSF VENTRICULOGRAPHY,,,275.37,275.37,1
HCPCS,78645,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,4643.0,3017.95,23.15,4871.0,147
HCPCS,78645,CSF SHUNT EVALUATION,,,264.89,264.89,2
HCPCS,786450,CSF SHUNT EVALUATION,,,264.89,264.89,1
HCPCS,78645TC,CSF SHUNT EVALUATION,,,264.89,264.89,1
HCPCS,78650,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,11260.0,7319.0,23.53,11504.0,147
HCPCS,78650,CSF LEAKAGE IMAGING,,,220.02,220.02,2
HCPCS,786500,CSF LEAKAGE IMAGING,,,220.02,220.02,1
HCPCS,78650TC,CSF LEAKAGE IMAGING,,,220.02,220.02,1
HCPCS,78660,NUCLEAR EXAM OF TEAR FLOW,,,110.21,871.23,19
HCPCS,78660,Nuclear exam of tear flow,,,225.17,284.42,6
HCPCS,786600,NUCLEAR EXAM OF TEAR FLOW,,,110.21,110.21,1
HCPCS,78660TC,NUCLEAR EXAM OF TEAR FLOW,,,110.21,110.21,1
HCPCS,78699,UNLISTED NRVS SYS PX DX NUC,,,403.35,871.23,17
HCPCS,78699,Unlisted nrvs sys px dx nuc,,,225.17,284.42,6
HCPCS,78700,KIDNEY IMAGING MORPHOL,,,135.77,871.23,19
HCPCS,78700,KIDNEY IMAGING MORPHOLOGY,3466.0,2252.9,18.89,3646.0,98
HCPCS,78700,KIDNEY IMAGING STATIC,1913.0,1243.45,90.0,3646.0,64
HCPCS,78700,Kidney imaging morphol,,,225.17,284.42,6
HCPCS,787000,KIDNEY IMAGING MORPHOL,,,135.77,135.77,1
HCPCS,78700TC,KIDNEY IMAGING MORPHOL,,,135.77,135.77,1
HCPCS,78701,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,3466.0,2252.9,20.31,3662.0,98
HCPCS,78701,KIDNEY IMAGING WITH FLOW,,,182.27,871.23,19
HCPCS,78701,KIDNEY W VASCULAR FLOW,1929.0,1253.8500000000001,98.0,3662.0,64
HCPCS,78701,Kidney imaging with flow,,,225.17,284.42,6
HCPCS,787010,KIDNEY IMAGING WITH FLOW,,,182.27,182.27,1
HCPCS,78701TC,KIDNEY IMAGING WITH FLOW,,,182.27,182.27,1
HCPCS,78707,K FLOW/FUNCT IMAGE W/O DRUG,,,168.85,168.85,2
HCPCS,78707,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,4643.0,3017.95,38.63,5027.0,147
HCPCS,787070,K FLOW/FUNCT IMAGE W/O DRUG,,,168.85,168.85,1
HCPCS,78707TC,K FLOW/FUNCT IMAGE W/O DRUG,,,168.85,168.85,1
HCPCS,78708,K FLOW/FUNCT IMAGE W/DRUG,,,118.12,118.12,2
HCPCS,78708,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,4643.0,3017.95,48.71,5127.0,147
HCPCS,787080,K FLOW/FUNCT IMAGE W/DRUG,,,118.12,118.12,1
HCPCS,78708TC,K FLOW/FUNCT IMAGE W/DRUG,,,118.12,118.12,1
HCPCS,78709,K FLOW/FUNCT IMAGE MULTIPLE,,,269.15,269.15,2
HCPCS,78709,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,4643.0,3017.95,57.23,5207.0,196
HCPCS,787090,K FLOW/FUNCT IMAGE MULTIPLE,,,269.15,269.15,1
HCPCS,78709TC,K FLOW/FUNCT IMAGE MULTIPLE,,,269.15,269.15,1
HCPCS,78725,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,3466.0,2252.9,14.91,3618.0,98
HCPCS,78725,KIDNEY FUNCTION STUDY,,,78.78,871.23,19
HCPCS,78725,Kidney function study,,,225.17,284.42,6
HCPCS,787250,KIDNEY FUNCTION STUDY,,,78.78,78.78,1
HCPCS,78725TC,KIDNEY FUNCTION STUDY,,,78.78,78.78,1
HCPCS,78730,URINARY BLADDER RETENTION,,,59.98,59.98,2
HCPCS,78730,Urinary bladder retention,,,225.17,284.42,6
HCPCS,787300,URINARY BLADDER RETENTION,,,59.98,59.98,1
HCPCS,78730TC,URINARY BLADDER RETENTION,,,59.98,59.98,1
HCPCS,78740,URETERAL REFLUX STUDY,,,181.29,181.29,2
HCPCS,78740,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,3466.0,2252.9,24.01,3694.0,147
HCPCS,787400,URETERAL REFLUX STUDY,,,181.29,181.29,1
HCPCS,78740TC,URETERAL REFLUX STUDY,,,181.29,181.29,1
HCPCS,78761,TESTICULAR IMAGING W/FLOW,,,160.98,160.98,2
HCPCS,78761,TESTICULAR IMAGING WITH VASCULAR FLOW,3466.0,2252.9,29.55,3750.0,147
HCPCS,787610,TESTICULAR IMAGING W/FLOW,,,160.98,160.98,1
HCPCS,78761TC,TESTICULAR IMAGING W/FLOW,,,160.98,160.98,1
HCPCS,78799,UNLISTED GU PX DX NUC MED,,,403.35,871.23,17
HCPCS,78799,Unlisted gu px dx nuc med,,,225.17,284.42,6
HCPCS,78800,RP LOCLZJ TUM 1 AREA 1 D IMG,,,198.64,198.64,2
HCPCS,78800,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,3466.0,2252.9,27.56,3722.0,196
HCPCS,788000,RP LOCLZJ TUM 1 AREA 1 D IMG,,,198.64,198.64,1
HCPCS,78800TC,RP LOCLZJ TUM 1 AREA 1 D IMG,,,198.64,198.64,1
HCPCS,78801,RP LOCLZJ TUM 2+AREA 1+D IMG,,,212.07,212.07,2
HCPCS,78801,RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D,3466.0,2252.9,32.38,3787.0,147
HCPCS,788010,RP LOCLZJ TUM 2+AREA 1+D IMG,,,212.07,212.07,1
HCPCS,78801TC,RP LOCLZJ TUM 2+AREA 1+D IMG,,,212.07,212.07,1
HCPCS,78802,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,11260.0,7319.0,34.65,11612.0,147
HCPCS,78802,RP LOCLZJ TUM WHBDY 1 D IMG,,,240.89,240.89,2
HCPCS,788020,RP LOCLZJ TUM WHBDY 1 D IMG,,,240.89,240.89,1
HCPCS,78802TC,RP LOCLZJ TUM WHBDY 1 D IMG,,,240.89,240.89,1
HCPCS,78803,RP LOCLZJ TUM SPECT 1 AREA,,,293.01,293.01,2
HCPCS,78803,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,11260.0,7319.0,43.31,11740.0,147
HCPCS,788030,RP LOCLZJ TUM SPECT 1 AREA,,,293.01,293.01,1
HCPCS,78803TC,RP LOCLZJ TUM SPECT 1 AREA,,,293.01,293.01,1
HCPCS,78804,RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING,11260.0,7319.0,43.03,11704.0,147
HCPCS,78804,RP LOCLZJ TUM WHBDY 2+D IMG,,,530.96,530.96,2
HCPCS,788040,RP LOCLZJ TUM WHBDY 2+D IMG,,,530.96,530.96,1
HCPCS,78804TC,RP LOCLZJ TUM WHBDY 2+D IMG,,,530.96,530.96,1
HCPCS,78808,IV INJ RA DRUG DX STUDY,,,39.64,39.64,1
HCPCS,78808,NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS,3466.0,2252.9,58.03,3119.4,49
HCPCS,788080,IV INJ RA DRUG DX STUDY,,,39.64,39.64,1
HCPCS,78811,PET IMAGE LTD AREA,,,1296.0,1296.0,2
HCPCS,78811,PET IMAGING LIMITED AREA CHEST HEAD/NECK,11260.0,7319.0,67.33,11876.0,114
HCPCS,78811,TUMOR IMAGING PET-LTD AREA-CHEST/HEAD/NEC,616.0,400.4,308.0,1854.46,14
HCPCS,788110,PET IMAGE LTD AREA,,,1296.0,1296.0,1
HCPCS,78811TC,PET IMAGE LTD AREA,,,1296.0,1296.0,1
HCPCS,78812,PET IMAGE SKULL-THIGH,,,1296.0,1296.0,2
HCPCS,78812,PET IMAGING SKULL BASE TO MID-THIGH,12580.0,8177.0,81.24,13352.0,114
HCPCS,78812,TUMOR IMG PET SKULL BASE-MID HIGH NOS,772.0,501.8,386.0,2057.75,14
HCPCS,788120,PET IMAGE SKULL-THIGH,,,1296.0,1296.0,1
HCPCS,78812TC,PET IMAGE SKULL-THIGH,,,1296.0,1296.0,1
HCPCS,78813,PET IMAGE FULL BODY,12580.0,8177.0,85.23,13380.0,68
HCPCS,78813,PET IMAGING WHOLE BODY,12580.0,8177.0,859.52,11322.0,48
HCPCS,78813,TUMOR IMGING PET FULL BODY ANY SITE NOS,800.0,520.0,400.0,2060.32,14
HCPCS,788130,PET IMAGE FULL BODY,,,1296.0,1296.0,1
HCPCS,78813TC,PET IMAGE FULL BODY,,,1296.0,1296.0,1
HCPCS,78814,PET IMAGE W/CT LMTD,,,1296.0,1296.0,2
HCPCS,78814,PET IMAGING CT FOR ATTENUATION LIMITED AREA,12580.0,8177.0,93.46,13460.0,210
HCPCS,78814,TUMOR IMAG PET W/CONCRNT CT; LTD AREA,880.0,572.0,440.0,2073.04,14
HCPCS,788140,PET IMAGE W/CT LMTD,,,1296.0,1296.0,1
HCPCS,78814TC,PET IMAGE W/CT LMTD,,,1296.0,1296.0,1
HCPCS,78815,PET IMAGE W/CT SKULL-THIGH,,,1296.0,1296.0,2
HCPCS,78815,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,12580.0,8177.0,103.4,13556.0,210
HCPCS,78815,TUMOR IMG PET/CT SKULL-THIGH ANY SITE NOS,976.0,634.4,488.0,2087.89,14
HCPCS,788150,PET IMAGE W/CT SKULL-THIGH,,,1296.0,1296.0,1
HCPCS,78815TC,PET IMAGE W/CT SKULL-THIGH,,,1296.0,1296.0,1
HCPCS,78816,PET IMAGE W/CT FULL BODY,,,1296.0,1296.0,2
HCPCS,78816,PET IMAGING FOR CT ATTENUATION WHOLE BODY,12580.0,8177.0,104.24,13580.0,210
HCPCS,78816,TUMOR IMAG PET W/CONCURNT CT-WHOLE BODY,1000.0,650.0,500.0,2088.85,14
HCPCS,788160,PET IMAGE W/CT FULL BODY,,,1296.0,1296.0,1
HCPCS,78816TC,PET IMAGE W/CT FULL BODY,,,1296.0,1296.0,1
HCPCS,78830,RP LOCLZJ TUM SPECT W/CT 1,,,362.82,362.82,2
HCPCS,78830,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,11260.0,7319.0,65.59,26432.0,184
HCPCS,788300,RP LOCLZJ TUM SPECT W/CT 1,,,362.82,362.82,1
HCPCS,78830TC,RP LOCLZJ TUM SPECT W/CT 1,,,362.82,362.82,1
HCPCS,78831,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,11260.0,7319.0,82.25,26432.0,184
HCPCS,78831,RP LOCLZJ TUM SPECT 2 AREAS,,,557.82,557.82,2
HCPCS,788310,RP LOCLZJ TUM SPECT 2 AREAS,,,557.82,557.82,1
HCPCS,78831TC,RP LOCLZJ TUM SPECT 2 AREAS,,,557.82,557.82,1
HCPCS,78832,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,12580.0,8177.0,94.46,26432.0,184
HCPCS,78832,RP LOCLZJ TUM SPECT W/CT 2,,,715.11,715.11,2
HCPCS,788320,RP LOCLZJ TUM SPECT W/CT 2,,,715.11,715.11,1
HCPCS,78832TC,RP LOCLZJ TUM SPECT W/CT 2,,,715.11,715.11,1
HCPCS,78835,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,513.0,333.45,20.87,2409.0,130
HCPCS,78835,RP QUAN MEAS SINGLE AREA,,,67.19,67.19,2
HCPCS,788350,RP QUAN MEAS SINGLE AREA,,,67.19,67.19,1
HCPCS,78835TC,RP QUAN MEAS SINGLE AREA,,,67.19,67.19,1
HCPCS,78999,MRI FUSION TO PET (COMP CODE 76376),524.0,340.6,43.5,2409.0,84
HCPCS,79005,NUCLEAR RX ORAL ADMIN,,,50.52,50.52,2
HCPCS,79005,RP THERAPY ORAL ADMINISTRATION,1933.0,1256.45,43.51,2653.0,147
HCPCS,790050,NUCLEAR RX ORAL ADMIN,,,50.52,50.52,1
HCPCS,79005TC,NUCLEAR RX ORAL ADMIN,,,50.52,50.52,1
HCPCS,79101,NUCLEAR RX IV ADMIN,,,52.81,52.81,2
HCPCS,79101,RP THERAPY INTRAVENOUS ADMINISTRATION,1933.0,1256.45,46.95,2717.0,147
HCPCS,791010,NUCLEAR RX IV ADMIN,,,52.81,52.81,1
HCPCS,79101TC,NUCLEAR RX IV ADMIN,,,52.81,52.81,1
HCPCS,79200,NUCLEAR RX INTRACAV ADMIN,,,51.88,51.88,2
HCPCS,79200,RP THERAPY INRACAVITARY ADMINISTRATION,1934.0,1257.1,125.49,2409.0,49
HCPCS,792000,NUCLEAR RX INTRACAV ADMIN,,,51.88,51.88,1
HCPCS,79200TC,NUCLEAR RX INTRACAV ADMIN,,,51.88,51.88,1
HCPCS,79300,NUCLR RX INTERSTIT COLLOID,,,41.2,534.15,19
HCPCS,79300,Nuclr rx interstit colloid,,,125.49,158.51,6
HCPCS,793000,NUCLR RX INTERSTIT COLLOID,,,41.2,41.2,1
HCPCS,79300TC,NUCLR RX INTERSTIT COLLOID,,,41.2,41.2,1
HCPCS,79403,HEMATOPOIETIC NUCLEAR TX,,,99.41,99.41,2
HCPCS,79403,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,1933.0,1256.45,71.8,2833.0,147
HCPCS,794030,HEMATOPOIETIC NUCLEAR TX,,,99.41,99.41,1
HCPCS,79403TC,HEMATOPOIETIC NUCLEAR TX,,,99.41,99.41,1
HCPCS,79440,NUCLEAR RX INTRA-ARTICULAR,,,39.06,534.15,19
HCPCS,79440,Nuclear rx intra-articular,,,125.49,158.51,6
HCPCS,794400,NUCLEAR RX INTRA-ARTICULAR,,,39.06,39.06,1
HCPCS,79440TC,NUCLEAR RX INTRA-ARTICULAR,,,39.06,39.06,1
HCPCS,79445,NUCLEAR RX INTRA-ARTERIAL,,,86.7,86.7,2
HCPCS,79445,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,1933.0,1256.45,81.37,2893.0,162
HCPCS,794450,NUCLEAR RX INTRA-ARTERIAL,,,86.7,86.7,1
HCPCS,79445TC,NUCLEAR RX INTRA-ARTERIAL,,,86.7,86.7,1
HCPCS,79999,RP THERAPY UNLISTED PX,,,224.98,534.15,17
HCPCS,79999,Rp therapy unlisted px,,,125.49,158.51,6
HCPCS,80047,BASIC METABLC PNL IONIZED CA,,,11.86,22.94,4
HCPCS,80047,BASIC METABOLIC PANEL WITH CALCIUM IONIZED,226.0,146.9,5.77,226.0,33
HCPCS,80047,BMP I STAT ANALYZER,157.0,102.05,4.31,141.3,37
HCPCS,80047,BMP I STAT ANALYZER (POINT OF CARE LAB),157.0,102.05,4.31,141.3,37
HCPCS,800470,BASIC METABLC PNL IONIZED CA,,,11.86,11.86,1
HCPCS,80047QW,BASIC METABLC PNL IONIZED CA,,,21.17,22.94,3
HCPCS,80048,BASIC METABOLIC PANEL,154.0,100.1,4.31,138.6,37
HCPCS,80048,BASIC METABOLIC PANEL CALCIUM TOTAL,39.0,25.35,3.55,39.0,17
HCPCS,80048,BASIC METABOLIC PNL TOTAL CA,,,7.31,14.14,4
HCPCS,80048,BSC METABLC P,154.0,100.1,4.31,138.6,37
HCPCS,80048,BSC METABLC PNL PROFESSIONAL FEE,39.0,25.35,3.55,39.0,17
HCPCS,800480,BASIC METABOLIC PNL TOTAL CA,,,7.31,7.31,1
HCPCS,80048QW,BASIC METABOLIC PNL TOTAL CA,,,13.05,14.14,3
HCPCS,80050,GENERAL HEALTH PANEL,107.0,69.55,16.88,107.0,14
HCPCS,80050,General health panel,,,4.31,5.45,6
HCPCS,800500,GENERAL HEALTH PANEL,,,31.7,31.7,1
HCPCS,80051,ELECTROLYTE PANEL,142.0,92.3,2.94,129.6,95
HCPCS,800510,ELECTROLYTE PANEL,,,6.06,6.06,1
HCPCS,80051QW,ELECTROLYTE PANEL,,,10.81,11.71,3
HCPCS,80053,COMPRE META PANL,306.0,198.9,4.31,275.4,37
HCPCS,80053,COMPREHEN METABOLIC PANEL,,,9.13,17.65,4
HCPCS,80053,COMPREHENSIVE METABOLIC PANEL,36.0,23.4,4.44,36.0,17
HCPCS,800530,COMPREHEN METABOLIC PANEL,,,9.13,9.13,1
HCPCS,80053QW,COMPREHEN METABOLIC PANEL,,,16.28,17.65,3
HCPCS,80055,OB PANEL,406.0,263.9,4.31,365.4,37
HCPCS,80055,OBSTETRIC PANEL,,,41.31,41.31,1
HCPCS,800550,OBSTETRIC PANEL,,,41.31,41.31,1
HCPCS,80061,%NMRLIP CHOLESTEROL,26.0,16.9,4.31,23.4,37
HCPCS,80061,*LIPID PANEL,28.0,18.2,4.31,25.2,37
HCPCS,80061,CHD RISK PROFILE,113.0,73.45,5.62,113.0,17
HCPCS,80061,LIPID PANEL,43.5,28.275,5.62,74.0,38
HCPCS,80061,LIPID-LIPO PANEL 1,178.0,115.7,4.31,160.2,37
HCPCS,80061,LIPID-LIPO PANEL 1 (POINT OF CARE LAB),178.0,115.7,4.31,160.2,37
HCPCS,800610,LIPID PANEL,,,11.57,11.57,1
HCPCS,80061QW,LIPID PANEL,,,20.65,22.37,3
HCPCS,80069,RENAL FUNC PANL,144.0,93.6,4.31,129.6,37
HCPCS,80069,RENAL FUNCT PNL,105.0,68.25,3.65,105.0,17
HCPCS,80069,RENAL FUNCTION PANEL,,,7.5,14.5,4
HCPCS,800690,RENAL FUNCTION PANEL,,,7.5,7.5,1
HCPCS,80069QW,RENAL FUNCTION PANEL,,,13.38,14.5,3
HCPCS,80074,ACUTE HEP PAN,97.0,63.05,4.31,87.3,37
HCPCS,80074,ACUTE HEPATITIS PANEL,,,41.15,41.15,1
HCPCS,80074,CHLAMYDIA PSIT TOTAL,97.0,63.05,4.31,87.3,37
HCPCS,80074,HEPATITIS ACUTE PANEL,255.0,165.75,4.31,229.5,37
HCPCS,800740,ACUTE HEPATITIS PANEL,,,41.15,41.15,1
HCPCS,80076,HEP FUNC PANL,144.0,93.6,4.31,129.6,37
HCPCS,80076,HEPATIC FUNCTION PANEL,,,7.06,7.06,1
HCPCS,80076,HEPATIC FUNCTION PNL,24.0,15.6,3.43,24.0,17
HCPCS,800760,HEPATIC FUNCTION PANEL,,,7.06,7.06,1
HCPCS,80081,OBSTETRIC PANEL INC HIV TSTG,,,64.68,125.09,15
HCPCS,80081,Obstetric panel inc hiv tstg,,,4.31,5.45,6
HCPCS,800810,OBSTETRIC PANEL INC HIV TSTG,,,64.68,64.68,1
HCPCS,80143,ACETAMINOPHEN BL TEST,120.0,78.0,5.81,108.0,37
HCPCS,80143,DRUG ASSAY ACETAMINOPHEN,,,16.1,16.1,1
HCPCS,801430,DRUG ASSAY ACETAMINOPHEN,,,16.1,16.1,1
HCPCS,80145,ADALIMUMAB ACT NEUT AB,243.0,157.95,5.81,218.7,37
HCPCS,80145,ANSADA MEAS SER ADA,678.0,440.7,5.81,610.2,37
HCPCS,80145,DRUG ASSAY ADALIMUMAB,,,33.33,33.33,1
HCPCS,801450,DRUG ASSAY ADALIMUMAB,,,33.33,33.33,1
HCPCS,80150,AMIKACIN,41.0,26.65,5.81,36.9,37
HCPCS,80150,AMIKACIN ASSAY,131.0,85.15,5.81,117.9,37
HCPCS,80150,ASSAY OF AMIKACIN,,,13.02,13.02,1
HCPCS,80150,DRUG SCREEN QUANTITATIVE AMIKACIN,15.0,9.75,6.33,16.65,17
HCPCS,801500,ASSAY OF AMIKACIN,,,13.02,13.02,1
HCPCS,80151,AMIODARONE,169.0,109.85,5.81,152.1,37
HCPCS,80151,DRUG ASSAY AMIODARONE,,,16.1,16.1,1
HCPCS,801510,DRUG ASSAY AMIODARONE,,,16.1,16.1,1
HCPCS,80155,CAFFEINE,233.0,151.45,5.81,209.7,37
HCPCS,80155,DRUG ASSAY CAFFEINE,,,33.33,33.33,1
HCPCS,801550,DRUG ASSAY CAFFEINE,,,33.33,33.33,1
HCPCS,80156,ASSAY CARBAMAZEPINE TOTAL,,,12.59,12.59,1
HCPCS,80156,CARBAZEPINE TEGRETOL,196.0,127.4,5.81,176.4,37
HCPCS,80156,DRUG ASSAY CARBAMAZEPINE TOTAL,169.0,109.85,6.12,169.0,17
HCPCS,801560,ASSAY CARBAMAZEPINE TOTAL,,,12.59,12.59,1
HCPCS,80157,ASSAY CARBAMAZEPINE FREE,,,11.45,11.45,1
HCPCS,80157,CARBAMAZEPINE,26.0,16.9,5.81,23.4,37
HCPCS,80157,CARBAMAZEPINE FREE,26.0,16.9,5.81,23.4,37
HCPCS,801570,ASSAY CARBAMAZEPINE FREE,,,11.45,11.45,1
HCPCS,80158,CYCLOSPORINE ASSAY,76.0,49.4,5.81,85.5,74
HCPCS,80158,DRUG ASSAY CYCLOSPORINE,261.0,169.65,7.58,261.0,18
HCPCS,801580,DRUG ASSAY CYCLOSPORINE,,,15.6,15.6,1
HCPCS,80159,CLOZAPINE,97.0,63.05,5.81,87.3,37
HCPCS,80159,DRUG ASSAY CLOZAPINE,,,17.41,17.41,1
HCPCS,80159,DRUG SCREEN QUANT CLOZAPINE,85.0,55.25,5.81,76.5,37
HCPCS,801590,DRUG ASSAY CLOZAPINE,,,17.41,17.41,1
HCPCS,80161,"ASY CARBAMAZEPIN 10,11-EPXID",,,16.1,16.1,1
HCPCS,80161,CARBAMAZEPINE-10-11-EPOXI,153.0,99.45,5.81,137.7,37
HCPCS,801610,"ASY CARBAMAZEPIN 10,11-EPXID",,,16.1,16.1,1
HCPCS,80162,ASSAY OF DIGOXIN TOTAL,,,11.47,11.47,1
HCPCS,80162,DIGOXIN ASSAY,142.0,92.3,5.81,127.8,37
HCPCS,80162,DRUG SCREEN QUANTITATIVE DIGOXIN TOTAL,143.0,92.95,5.58,143.0,17
HCPCS,801620,ASSAY OF DIGOXIN TOTAL,,,11.47,11.47,1
HCPCS,80163,ASSAY OF DIGOXIN FREE,,,11.47,11.47,1
HCPCS,80163,DIGOXIN FREE,276.0,179.4,5.81,248.4,37
HCPCS,801630,ASSAY OF DIGOXIN FREE,,,11.47,11.47,1
HCPCS,80164,ASSAY DIPROPYLACETIC ACD TOT,,,11.7,11.7,1
HCPCS,80164,DRUG ASSAY VALPROIC DIPROPYLACETIC ACID TOTAL,119.0,77.35,5.69,119.0,17
HCPCS,80164,LAB-IP VALPORIC ACID,178.0,115.7,5.81,160.2,37
HCPCS,80164,VALPROIC ACID ASSAY,182.0,118.3,5.81,163.8,37
HCPCS,80164,"VALPROIC ACID, FREE",34.0,22.1,5.81,30.6,37
HCPCS,80164,VALPROIC ACID-DEPAKENE,178.0,115.7,5.81,160.2,37
HCPCS,801640,ASSAY DIPROPYLACETIC ACD TOT,,,11.7,11.7,1
HCPCS,80165,DIPROPYLACETIC ACID FREE,,,11.7,11.7,1
HCPCS,80165,VALPROIC ACID FREE,29.0,18.85,5.81,26.1,74
HCPCS,801650,DIPROPYLACETIC ACID FREE,,,11.7,11.7,1
HCPCS,80167,DRUG ASSAY FELBAMATE,,,16.1,16.1,1
HCPCS,80167,FELBAMATE,173.0,112.45,5.81,155.7,37
HCPCS,801670,DRUG ASSAY FELBAMATE,,,16.1,16.1,1
HCPCS,80168,ASSAY OF ETHOSUXIMIDE,,,14.12,14.12,1
HCPCS,80168,ETHOSUXIMIDE,25.0,16.25,5.81,25.0,37
HCPCS,80168,ETHOSUXIMIDE LEVEL,49.0,31.85,5.81,44.1,37
HCPCS,80168,ETHOSUXIMIDE ZARONTIN,25.0,16.25,5.81,25.0,37
HCPCS,801680,ASSAY OF ETHOSUXIMIDE,,,14.12,14.12,1
HCPCS,80169,DRUG ASSAY EVEROLIMUS,,,11.86,11.86,1
HCPCS,80169,DRUG SCREEN QUANT EVEROLIMUS,68.0,44.2,5.81,61.2,37
HCPCS,80169,EVEROLIMUS,67.0,43.55,5.81,60.3,37
HCPCS,801690,DRUG ASSAY EVEROLIMUS,,,11.86,11.86,1
HCPCS,80170,ASSAY OF GENTAMICIN,,,14.15,14.15,1
HCPCS,80170,DRUG SCREEN QUANTITATIVE GENTAMICIN,175.0,113.75,6.88,175.0,17
HCPCS,80170,GENTAMICIN ASSAY,144.0,93.6,5.81,129.6,37
HCPCS,801700,ASSAY OF GENTAMICIN,,,14.15,14.15,1
HCPCS,80171,DRUG SCREEN QUANT GABAPENTIN,62.0,40.3,5.81,55.8,38
HCPCS,80171,GABAPENTIN,39.0,25.35,5.81,36.21,37
HCPCS,801710,DRUG SCREEN QUANT GABAPENTIN,,,18.73,18.73,1
HCPCS,80173,ASSAY OF HALOPERIDOL,,,13.63,13.63,1
HCPCS,80173,HALDOL LEVEL,83.0,53.95,5.81,74.7,37
HCPCS,801730,ASSAY OF HALOPERIDOL,,,13.63,13.63,1
HCPCS,80175,DRUG SCREEN QUAN LAMOTRIGINE,24.0,15.6,5.81,22.14,38
HCPCS,801750,DRUG SCREEN QUAN LAMOTRIGINE,,,11.45,11.45,1
HCPCS,80176,ASSAY OF LIDOCAINE,,,12.69,12.69,1
HCPCS,80176,LIDOCAINE,50.0,32.5,5.81,45.0,37
HCPCS,80176,LIDOCAINE PLASMA,48.0,31.2,5.81,43.2,37
HCPCS,801760,ASSAY OF LIDOCAINE,,,12.69,12.69,1
HCPCS,80177,DRUG SCRN QUAN LEVETIRACETAM,142.0,92.3,5.81,127.8,38
HCPCS,80177,LEVETIRACETAM/KEPPRA,140.0,91.0,5.81,126.0,37
HCPCS,801770,DRUG SCRN QUAN LEVETIRACETAM,,,11.45,11.45,1
HCPCS,80178,ASSAY OF LITHIUM,,,5.71,11.05,4
HCPCS,80178,DRUG SCREEN QUANTITATIVE LITHIUM,86.0,55.9,2.78,86.0,17
HCPCS,80178,LITHIUM ASSAY,51.5,33.475,5.81,47.7,74
HCPCS,801780,ASSAY OF LITHIUM,,,5.71,5.71,1
HCPCS,80178QW,ASSAY OF LITHIUM,,,10.19,11.05,3
HCPCS,80179,DRUG ASSAY SALICYLATE,,,16.1,16.1,1
HCPCS,80179,SALICYLATE,58.0,37.7,5.81,52.2,37
HCPCS,801790,DRUG ASSAY SALICYLATE,,,16.1,16.1,1
HCPCS,80180,DRUG SCRN QUAN MYCOPHENOLATE,63.0,40.95,5.81,56.7,38
HCPCS,80180,MYCOPHENOLIC ACID,34.0,22.1,5.81,30.6,37
HCPCS,801800,DRUG SCRN QUAN MYCOPHENOLATE,,,15.6,15.6,1
HCPCS,80181,DRUG ASSAY FLECAINIDE,,,16.1,16.1,1
HCPCS,80181,FLECAINIDE,153.0,99.45,5.81,137.7,37
HCPCS,801810,DRUG ASSAY FLECAINIDE,,,16.1,16.1,1
HCPCS,80183,DRUG SCRN QUANT OXCARBAZEPIN,79.0,51.35,5.81,71.1,38
HCPCS,80183,OXCARBAZEPINE,77.0,50.05,5.81,69.3,37
HCPCS,801830,DRUG SCRN QUANT OXCARBAZEPIN,,,11.45,11.45,1
HCPCS,80184,ASSAY OF PHENOBARBITAL,,,13.22,13.22,1
HCPCS,80184,DRUG SCREEN QUANTITATIVE PHENOBARBITAL,60.0,39.0,6.43,60.0,17
HCPCS,80184,PHENOBARBITAL ASSAY,111.0,72.15,5.81,163.8,74
HCPCS,80184,PHENOBARBITAL FREE (UNBOUND),64.0,41.6,5.81,57.6,37
HCPCS,801840,ASSAY OF PHENOBARBITAL,,,13.22,13.22,1
HCPCS,80185,ASSAY OF PHENYTOIN TOTAL,,,11.45,11.45,1
HCPCS,80185,DRUG SCREEN QUANTITATIVE PHENYTOIN TOTAL,50.0,32.5,5.57,50.0,17
HCPCS,80185,PHENYTOIN-DILANTIN,144.0,93.6,5.81,129.6,37
HCPCS,801850,ASSAY OF PHENYTOIN TOTAL,,,11.45,11.45,1
HCPCS,80186,ASSAY OF PHENYTOIN FREE,,,11.89,11.89,1
HCPCS,80186,PHENYTOIN FREE,26.0,16.9,5.81,23.4,37
HCPCS,80186,PHENYTOIN FREE PLASMA,26.0,16.9,5.81,23.4,37
HCPCS,801860,ASSAY OF PHENYTOIN FREE,,,11.89,11.89,1
HCPCS,80187,DRUG ASSAY POSACONAZOLE,,,23.43,23.43,1
HCPCS,80187,POSACONAZOLE,230.0,149.5,5.81,207.0,37
HCPCS,801870,DRUG ASSAY POSACONAZOLE,,,23.43,23.43,1
HCPCS,80188,%FREE PRIMIDONE PLASMA,33.0,21.45,5.81,29.7,37
HCPCS,80188,*PRIMIDONE ASSAY,72.0,46.8,5.81,64.8,37
HCPCS,80188,ASSAY OF PRIMIDONE,,,14.33,14.33,1
HCPCS,801880,ASSAY OF PRIMIDONE,,,14.33,14.33,1
HCPCS,80189,DRUG ASSAY ITRACONAZOLE,,,23.43,23.43,1
HCPCS,80189,ITRACONAZOLE,241.0,156.65,5.81,216.9,37
HCPCS,801890,DRUG ASSAY ITRACONAZOLE,,,23.43,23.43,1
HCPCS,80190,ASSAY OF PROCAINAMIDE,,,51.84,100.26,15
HCPCS,80190,Assay of procainamide,,,5.81,7.34,6
HCPCS,801900,ASSAY OF PROCAINAMIDE,,,51.84,51.84,1
HCPCS,80192,ASSAY OF PROCAINAMIDE,,,14.47,14.47,1
HCPCS,80192,DRUG SCREEN QUANTITATIVE PROCAINAMIDE METABOLITE,153.0,99.45,7.04,153.0,17
HCPCS,80192,PROCAIN & NAP,85.0,55.25,5.81,76.5,37
HCPCS,80192,PROCAINAMIDE/NAPA,33.0,21.45,5.81,29.7,37
HCPCS,801920,ASSAY OF PROCAINAMIDE,,,14.47,14.47,1
HCPCS,80193,DRUG ASSAY LEFLUNOMIDE,,,33.33,33.33,1
HCPCS,80193,LEFLUNOMIDE METABOLITE,121.0,78.65,5.81,108.9,37
HCPCS,801930,DRUG ASSAY LEFLUNOMIDE,,,33.33,33.33,1
HCPCS,80194,ASSAY OF QUINIDINE,,,12.61,12.61,1
HCPCS,80194,DRUG SCREEN QUANTITATIVE QUINIDINE,112.0,72.8,6.13,112.0,17
HCPCS,80194,QUINIDINE,67.5,43.875,5.81,99.9,74
HCPCS,801940,ASSAY OF QUINIDINE,,,12.61,12.61,1
HCPCS,80195,ASSAY OF SIROLIMUS,,,11.86,11.86,1
HCPCS,80195,SIROLIMUS ASSAY,87.0,56.55,5.81,90.0,74
HCPCS,801950,ASSAY OF SIROLIMUS,,,11.86,11.86,1
HCPCS,80197,ASSAY OF TACROLIMUS,,,11.86,11.86,1
HCPCS,80197,DRUG SCREEN QUANTITATIVE TACROLIMUS,170.0,110.5,5.77,170.0,17
HCPCS,80197,TACROLIMUS ASSAY,100.5,65.32499999999999,5.81,111.6,74
HCPCS,801970,ASSAY OF TACROLIMUS,,,11.86,11.86,1
HCPCS,80198,ASSAY OF THEOPHYLLINE,,,12.21,12.21,1
HCPCS,80198,DRUG SCREEN QUANTITATIVE THEOPHYLLINE,151.0,98.15,5.94,151.0,17
HCPCS,80198,THEOPHYLLINE ASSAY,182.0,118.3,5.81,163.8,37
HCPCS,801980,ASSAY OF THEOPHYLLINE,,,12.21,12.21,1
HCPCS,80199,DRUG SCREEN QUANT TIAGABINE,,,23.43,23.43,1
HCPCS,80199,GABITRIL SERUM,43.0,27.95,5.81,43.0,37
HCPCS,801990,DRUG SCREEN QUANT TIAGABINE,,,23.43,23.43,1
HCPCS,80200,ASSAY OF TOBRAMYCIN,,,13.93,13.93,1
HCPCS,80200,DRUG SCREEN QUANTITATIVE TOBRAMYCIN,15.0,9.75,6.77,17.81,17
HCPCS,80200,TOBRAMYCIN AS,165.0,107.25,5.81,148.5,37
HCPCS,80200,TOBRAMYCIN ASSAY,147.5,95.875,5.81,163.8,74
HCPCS,802000,ASSAY OF TOBRAMYCIN,,,13.93,13.93,1
HCPCS,80201,ASSAY OF TOPIRAMATE,,,10.3,10.3,1
HCPCS,80201,TOPIRAMATE,40.0,26.0,5.81,36.0,37
HCPCS,80201,TOPIRAMATE LV,41.0,26.65,5.81,36.9,37
HCPCS,802010,ASSAY OF TOPIRAMATE,,,10.3,10.3,1
HCPCS,80202,ASSAY OF VANCOMYCIN,,,11.7,11.7,1
HCPCS,80202,DRUG SCREEN QUANTITATIVE VANCOMYCIN,128.0,83.2,5.69,128.0,17
HCPCS,80202,VANCOMYCIN,178.0,115.7,5.81,160.2,37
HCPCS,80202,VANCOMYCIN ASSAY,182.0,118.3,5.81,163.8,37
HCPCS,802020,ASSAY OF VANCOMYCIN,,,11.7,11.7,1
HCPCS,80203,DRUG SCREEN QUANT ZONISAMIDE,75.0,48.75,5.81,67.5,38
HCPCS,80203,ZONISAMIDE,74.0,48.1,5.81,66.6,37
HCPCS,802030,DRUG SCREEN QUANT ZONISAMIDE,,,11.45,11.45,1
HCPCS,80204,DRUG ASSAY METHOTREXATE,,,33.33,33.33,1
HCPCS,80204,METHOTREXATE,277.0,180.05,5.81,249.3,37
HCPCS,802040,DRUG ASSAY METHOTREXATE,,,33.33,33.33,1
HCPCS,80210,DRUG ASSAY RUFINAMIDE,,,23.43,23.43,1
HCPCS,80210,RUFINAMIDE,174.5,113.42500000000001,5.81,252.9,74
HCPCS,802100,DRUG ASSAY RUFINAMIDE,,,23.43,23.43,1
HCPCS,80220,DRUG ASY HYDROXYCHLOROQUINE,,,16.1,16.1,1
HCPCS,80220,"HYDROXYCHLOROQUINE, BLOOD",388.0,252.2,5.81,349.2,37
HCPCS,802200,DRUG ASY HYDROXYCHLOROQUINE,,,16.1,16.1,1
HCPCS,80230,ANSIFX MEAS SER ADA,678.0,440.7,5.81,610.2,37
HCPCS,80230,DRUG ASSAY INFLIXIMAB,,,33.33,33.33,1
HCPCS,80230,"INFLIXIMAB, SERUM",96.0,62.4,5.81,86.4,37
HCPCS,80230,INFLIXIMAB/BIOSIMILAR ACT NEUT AB,243.0,157.95,5.81,218.7,37
HCPCS,802300,DRUG ASSAY INFLIXIMAB,,,33.33,33.33,1
HCPCS,80235,DRUG ASSAY LACOSAMIDE,,,23.43,23.43,1
HCPCS,80235,LACOSAMIDE,418.0,271.7,5.81,376.2,37
HCPCS,802350,DRUG ASSAY LACOSAMIDE,,,23.43,23.43,1
HCPCS,80280,ANSVDZ MEAS SER VDZ,678.0,440.7,5.81,610.2,37
HCPCS,80280,DRUG ASSAY VEDOLIZUMAB,,,33.33,33.33,1
HCPCS,80280,"VEDOLIZUMAB QN, S",347.0,225.55,5.81,312.3,37
HCPCS,802800,DRUG ASSAY VEDOLIZUMAB,,,33.33,33.33,1
HCPCS,80285,DRUG ASSAY VORICONAZOLE,,,23.43,23.43,1
HCPCS,80285,VORICONAZOLE,241.0,156.65,5.81,216.9,37
HCPCS,802850,DRUG ASSAY VORICONAZOLE,,,23.43,23.43,1
HCPCS,80299,*DRUG QUANT NOS ASSAY,76.0,49.4,5.81,68.4,37
HCPCS,80299,"5-FLUCYTOSINE, S",129.0,83.85,5.81,116.1,37
HCPCS,80299,ACETAZOLAMIDE,136.0,88.4,5.81,122.4,37
HCPCS,80299,ADANEU THEARP DRG QNT,239.0,155.35,5.81,215.1,37
HCPCS,80299,ANSUST MEAS SER UST,431.0,280.15,5.81,387.9,37
HCPCS,80299,BRIVARACETAM - QUANTITATIVE ASSAY DRUG,68.0,44.2,5.81,61.2,37
HCPCS,80299,"BROMIDE, SER PL",110.0,71.5,5.81,99.0,37
HCPCS,80299,"CENOBAMATE (XCOPRI), PLASMA",121.0,78.65,5.81,108.9,37
HCPCS,80299,DEXAMETHASONE SERUM,377.0,245.05,5.81,339.3,37
HCPCS,80299,DIGITOXIN,128.0,83.2,5.81,115.2,37
HCPCS,80299,DRUG QUANT NOS ASSAY,80.0,52.0,5.81,131.4,518
HCPCS,80299,"ECULIZUMAB, SERUM",270.0,175.5,5.81,243.0,37
HCPCS,80299,ETHAMBUTOL,736.0,478.4,5.81,662.4,37
HCPCS,80299,FLECAINIDE BLOOD,141.0,91.65,5.81,126.9,37
HCPCS,80299,FLUCONAZOLE SERUM,221.0,143.65,5.81,198.9,37
HCPCS,80299,IBUPROFEN,129.0,83.85,5.81,116.1,37
HCPCS,80299,IFXNEU THEARP DRG QNT,227.0,147.55,5.81,204.3,37
HCPCS,80299,ISAVUCONAZOLE,94.0,61.1,5.81,84.6,37
HCPCS,80299,LEFLUNOMIDE METABOLITE,185.0,120.25,5.81,166.5,37
HCPCS,80299,METHOTREXATE IRL,167.0,108.55,5.81,150.3,37
HCPCS,80299,MEXILETINE PLASMA,195.0,126.75,5.81,175.5,37
HCPCS,80299,MITOTANE,209.0,135.85,5.81,188.1,37
HCPCS,80299,PERAMPANEL - QUANTITATIVE ASSAY DRUG,68.0,44.2,5.81,61.2,37
HCPCS,80299,QUANTITATIVE ASSAY DRUG,96.0,62.4,5.81,88.2,112
HCPCS,80299,QUETIAPINE,303.0,196.95,5.81,272.7,37
HCPCS,80299,SULFONAMIDES,130.0,84.5,5.81,117.0,37
HCPCS,80299,"SYNTHETIC GLUCOCORTICOID SCREEN, URINE",180.0,117.0,5.81,162.0,37
HCPCS,80299,THERAPEUTIC DRUG LEVEL,221.0,143.65,5.81,198.9,37
HCPCS,80299,THIOPURINE METAB LC-MS/MS,152.0,98.8,5.81,136.8,37
HCPCS,80299,"USTEKINUMAB QN, S",205.0,133.25,5.81,184.5,37
HCPCS,80299,WARFARIN/COUMADIN CHRM,239.0,155.35,5.81,215.1,37
HCPCS,802990,QUANTITATIVE ASSAY DRUG,,,16.1,16.1,1
HCPCS,80305,DRUG TEST PRSMV DIR OPT OBS,227.0,147.55,6.62,204.3,41
HCPCS,803050,DRUG TEST PRSMV DIR OPT OBS,,,10.89,10.89,1
HCPCS,80305QW,DRUG TEST PRSMV DIR OPT OBS,,,19.43,21.05,3
HCPCS,80306,DRUG TEST PRSMV INSTRMNT,,,14.81,28.64,15
HCPCS,80306,Drug test prsmv instrmnt,,,6.62,8.36,6
HCPCS,803060,DRUG TEST PRSMV INSTRMNT,,,14.81,14.81,1
HCPCS,80307,DATE RAPE PANEL,479.0,311.35,33.04,431.1,37
HCPCS,80307,DRG SCRN 9 PANEL SER OR PL,171.0,111.15,33.04,153.9,37
HCPCS,80307,DRUG ANALYSIS UR,144.0,93.6,33.04,129.6,37
HCPCS,80307,"DRUG SCRN, BLD",103.0,66.95,25.75,103.0,37
HCPCS,80307,DRUG TEST PRSMV CHEM ANLYZR,191.0,124.15,26.5,314.1,149
HCPCS,80307,DRUG TESTS PRESUMPTIVE,406.0,263.9,33.04,365.4,37
HCPCS,80307,ETHYL GLUC UR SCRN,182.0,118.3,33.04,163.8,37
HCPCS,80307,G HYDROXYBUTYRIC,237.0,154.05,33.04,213.3,37
HCPCS,80307,"MITRAGYNINE (KRATOM), URINE",186.0,120.9,33.04,167.4,37
HCPCS,80307,"OXYCODONE SCRN, UR",99.0,64.35,24.75,99.0,37
HCPCS,80307,UR ALCOHOL CONF RFLX,164.0,106.6,33.04,147.6,37
HCPCS,80307,UR BARBITURATE CONF RFLX,164.0,106.6,33.04,147.6,37
HCPCS,80307,UR BENZODIAZ CONF RFLX,164.0,106.6,33.04,147.6,37
HCPCS,80307,UR FLUNITRAZ CONF RFLX,164.0,106.6,33.04,147.6,37
HCPCS,80307,UR KETAMINE CONF RFLX,164.0,106.6,33.04,147.6,37
HCPCS,803070,DRUG TEST PRSMV CHEM ANLYZR,,,53.69,53.69,1
HCPCS,80320,DRUG SCREEN QUANTALCOHOLS,,,0.01,0.01,1
HCPCS,80320,Drug screen quantalcohols,,,6.62,8.36,6
HCPCS,803200,DRUG SCREEN QUANTALCOHOLS,,,0.01,0.01,1
HCPCS,80321,ALCOHOLS BIOMARKERS 1OR 2,,,0.01,0.01,1
HCPCS,80321,Alcohols biomarkers 1or 2,,,6.62,8.36,6
HCPCS,803210,ALCOHOLS BIOMARKERS 1OR 2,,,0.01,0.01,1
HCPCS,80322,ALCOHOLS BIOMARKERS 3/MORE,,,0.01,0.01,1
HCPCS,80322,Alcohols biomarkers 3/more,,,6.62,8.36,6
HCPCS,803220,ALCOHOLS BIOMARKERS 3/MORE,,,0.01,0.01,1
HCPCS,80323,ALKALOIDS NOS,,,0.01,0.01,1
HCPCS,80323,KRATOM (MITRAGYNINE) CONFIRMATION,286.0,185.9,6.62,257.4,27
HCPCS,803230,ALKALOIDS NOS,,,0.01,0.01,1
HCPCS,80324,DRUG SCREEN AMPHETAMINES 1/2,,,0.01,0.01,1
HCPCS,80324,Drug screen amphetamines 1/2,,,6.62,8.36,6
HCPCS,803240,DRUG SCREEN AMPHETAMINES 1/2,,,0.01,0.01,1
HCPCS,80325,AMPHETAMINES 3OR 4,,,0.01,0.01,1
HCPCS,80325,Amphetamines 3or 4,,,6.62,8.36,6
HCPCS,803250,AMPHETAMINES 3OR 4,,,0.01,0.01,1
HCPCS,80326,AMPHETAMINES 5 OR MORE,,,0.01,0.01,1
HCPCS,80326,Amphetamines 5 or more,,,6.62,8.36,6
HCPCS,803260,AMPHETAMINES 5 OR MORE,,,0.01,0.01,1
HCPCS,80327,ANABOLIC STEROID 1 OR 2,,,0.01,0.01,1
HCPCS,80327,Anabolic steroid 1 or 2,,,6.62,8.36,6
HCPCS,803270,ANABOLIC STEROID 1 OR 2,,,0.01,0.01,1
HCPCS,80328,ANABOLIC STEROID 3 OR MORE,,,0.01,0.01,1
HCPCS,80328,Anabolic steroid 3 or more,,,6.62,8.36,6
HCPCS,803280,ANABOLIC STEROID 3 OR MORE,,,0.01,0.01,1
HCPCS,80329,ANALGESICS NON-OPIOID 1 OR 2,,,0.01,0.01,1
HCPCS,80329,Analgesics non-opioid 1 or 2,,,6.62,8.36,6
HCPCS,803290,ANALGESICS NON-OPIOID 1 OR 2,,,0.01,0.01,1
HCPCS,80330,ANALGESICS NON-OPIOID 3-5,,,0.01,0.01,1
HCPCS,80330,Analgesics non-opioid 3-5,,,6.62,8.36,6
HCPCS,803300,ANALGESICS NON-OPIOID 3-5,,,0.01,0.01,1
HCPCS,80331,ANALGESICS NON-OPIOID 6/MORE,,,0.01,0.01,1
HCPCS,80331,Analgesics non-opioid 6/more,,,6.62,8.36,6
HCPCS,803310,ANALGESICS NON-OPIOID 6/MORE,,,0.01,0.01,1
HCPCS,80332,ANTIDEPRESSANTS CLASS 1 OR 2,,,0.01,0.01,1
HCPCS,80332,Antidepressants class 1 or 2,,,33.04,41.74,6
HCPCS,803320,ANTIDEPRESSANTS CLASS 1 OR 2,,,0.01,0.01,1
HCPCS,80333,ANTIDEPRESSANTS CLASS 3-5,,,0.01,0.01,1
HCPCS,80333,Antidepressants class 3-5,,,6.62,8.36,6
HCPCS,803330,ANTIDEPRESSANTS CLASS 3-5,,,0.01,0.01,1
HCPCS,80334,ANTIDEPRESSANTS CLASS 6/MORE,,,0.01,0.01,1
HCPCS,80334,Antidepressants class 6/more,,,6.62,8.36,6
HCPCS,803340,ANTIDEPRESSANTS CLASS 6/MORE,,,0.01,0.01,1
HCPCS,80335,ANTIDEPRESSANT TRICYCLIC 1/2,,,0.01,0.01,1
HCPCS,80335,Antidepressant tricyclic 1/2,,,6.62,8.36,6
HCPCS,803350,ANTIDEPRESSANT TRICYCLIC 1/2,,,0.01,0.01,1
HCPCS,80336,ANTIDEPRESSANT TRICYCLIC 3-5,,,0.01,0.01,1
HCPCS,80336,Antidepressant tricyclic 3-5,,,6.62,8.36,6
HCPCS,803360,ANTIDEPRESSANT TRICYCLIC 3-5,,,0.01,0.01,1
HCPCS,80337,TRICYCLIC & CYCLICALS 6/MORE,,,0.01,0.01,1
HCPCS,80337,Tricyclic & cyclicals 6/more,,,6.62,8.36,6
HCPCS,803370,TRICYCLIC & CYCLICALS 6/MORE,,,0.01,0.01,1
HCPCS,80338,ANTIDEPRESSANT NOT SPECIFIED,,,0.01,0.01,1
HCPCS,80338,VENLAFAXINE SERUM/PLASMA - ARUP,136.0,88.4,6.62,122.4,27
HCPCS,803380,ANTIDEPRESSANT NOT SPECIFIED,,,0.01,0.01,1
HCPCS,80339,ANTIEPILEPTICS NOS 1-3,,,0.01,0.01,1
HCPCS,80339,Antiepileptics nos 1-3,,,33.04,41.74,6
HCPCS,803390,ANTIEPILEPTICS NOS 1-3,,,0.01,0.01,1
HCPCS,80340,ANTIEPILEPTICS NOS 4-6,,,0.01,0.01,1
HCPCS,80340,Antiepileptics nos 4-6,,,6.62,8.36,6
HCPCS,803400,ANTIEPILEPTICS NOS 4-6,,,0.01,0.01,1
HCPCS,80341,ANTIEPILEPTICS NOS 7/MORE,,,0.01,0.01,1
HCPCS,80341,Antiepileptics nos 7/more,,,6.62,8.36,6
HCPCS,803410,ANTIEPILEPTICS NOS 7/MORE,,,0.01,0.01,1
HCPCS,80342,ANTIPSYCHOTICS NOS 1-3,,,0.01,0.01,1
HCPCS,80342,Antipsychotics nos 1-3,,,6.62,8.36,6
HCPCS,803420,ANTIPSYCHOTICS NOS 1-3,,,0.01,0.01,1
HCPCS,80343,ANTIPSYCHOTICS NOS 4-6,,,0.01,0.01,1
HCPCS,80343,Antipsychotics nos 4-6,,,6.62,8.36,6
HCPCS,803430,ANTIPSYCHOTICS NOS 4-6,,,0.01,0.01,1
HCPCS,80344,ANTIPSYCHOTICS NOS 7/MORE,,,0.01,0.01,1
HCPCS,80344,Antipsychotics nos 7/more,,,6.62,8.36,6
HCPCS,803440,ANTIPSYCHOTICS NOS 7/MORE,,,0.01,0.01,1
HCPCS,80345,DRUG SCREENING BARBITURATES,,,0.01,0.01,1
HCPCS,80345,Drug screening barbiturates,,,6.62,8.36,6
HCPCS,803450,DRUG SCREENING BARBITURATES,,,0.01,0.01,1
HCPCS,80346,BENZODIAZEPINES1-12,,,0.01,0.01,1
HCPCS,80346,Benzodiazepines1-12,,,6.62,8.36,6
HCPCS,803460,BENZODIAZEPINES1-12,,,0.01,0.01,1
HCPCS,80347,BENZODIAZEPINES 13 OR MORE,,,0.01,0.01,1
HCPCS,80347,Benzodiazepines 13 or more,,,6.62,8.36,6
HCPCS,803470,BENZODIAZEPINES 13 OR MORE,,,0.01,0.01,1
HCPCS,80348,DRUG SCREENING BUPRENORPHINE,,,0.01,0.01,1
HCPCS,80348,Drug screening buprenorphine,,,6.62,8.36,6
HCPCS,803480,DRUG SCREENING BUPRENORPHINE,,,0.01,0.01,1
HCPCS,80349,CANNABINOIDS NATURAL,45.0,29.25,0.01,40.5,28
HCPCS,803490,CANNABINOIDS NATURAL,,,0.01,0.01,1
HCPCS,80350,CANNABINOIDS SYNTHETIC 1-3,,,0.01,0.01,1
HCPCS,80350,Cannabinoids synthetic 1-3,,,6.62,8.36,6
HCPCS,803500,CANNABINOIDS SYNTHETIC 1-3,,,0.01,0.01,1
HCPCS,80351,CANNABINOIDS SYNTHETIC 4-6,,,0.01,0.01,1
HCPCS,80351,Cannabinoids synthetic 4-6,,,6.62,8.36,6
HCPCS,803510,CANNABINOIDS SYNTHETIC 4-6,,,0.01,0.01,1
HCPCS,80352,CANNABINOID SYNTHETIC 7/MORE,,,0.01,0.01,1
HCPCS,80352,Cannabinoid synthetic 7/more,,,6.62,8.36,6
HCPCS,803520,CANNABINOID SYNTHETIC 7/MORE,,,0.01,0.01,1
HCPCS,80353,DRUG SCREENING COCAINE,,,0.01,0.01,1
HCPCS,80353,Drug screening cocaine,,,6.62,8.36,6
HCPCS,803530,DRUG SCREENING COCAINE,,,0.01,0.01,1
HCPCS,80354,DRUG SCREENING FENTANYL,,,0.01,0.01,1
HCPCS,80354,Drug screening fentanyl,,,6.62,8.36,6
HCPCS,803540,DRUG SCREENING FENTANYL,,,0.01,0.01,1
HCPCS,80355,GABAPENTIN NON-BLOOD,,,0.01,0.01,1
HCPCS,80355,Gabapentin non-blood,,,6.62,8.36,6
HCPCS,803550,GABAPENTIN NON-BLOOD,,,0.01,0.01,1
HCPCS,80356,HEROIN METABOLITE,,,0.01,0.01,1
HCPCS,80356,Heroin metabolite,,,6.62,8.36,6
HCPCS,803560,HEROIN METABOLITE,,,0.01,0.01,1
HCPCS,80357,KETAMINE AND NORKETAMINE,,,0.01,0.01,1
HCPCS,80357,Ketamine and norketamine,,,6.62,8.36,6
HCPCS,803570,KETAMINE AND NORKETAMINE,,,0.01,0.01,1
HCPCS,80358,DRUG SCREENING METHADONE,,,0.01,0.01,1
HCPCS,80358,Drug screening methadone,,,6.62,8.36,6
HCPCS,803580,DRUG SCREENING METHADONE,,,0.01,0.01,1
HCPCS,80359,METHYLENEDIOXYAMPHETAMINES,,,0.01,0.01,1
HCPCS,80359,Methylenedioxyamphetamines,,,6.62,8.36,6
HCPCS,803590,METHYLENEDIOXYAMPHETAMINES,,,0.01,0.01,1
HCPCS,80360,METHYLPHENIDATE,,,0.01,0.01,1
HCPCS,80360,Methylphenidate,,,6.62,8.36,6
HCPCS,803600,METHYLPHENIDATE,,,0.01,0.01,1
HCPCS,80361,OPIATES 1 OR MORE,,,0.01,0.01,1
HCPCS,80361,Opiates 1 or more,,,6.62,8.36,6
HCPCS,803610,OPIATES 1 OR MORE,,,0.01,0.01,1
HCPCS,80362,OPIOIDS & OPIATE ANALOGS 1/2,,,0.01,0.01,1
HCPCS,80362,Opioids & opiate analogs 1/2,,,6.62,8.36,6
HCPCS,803620,OPIOIDS & OPIATE ANALOGS 1/2,,,0.01,0.01,1
HCPCS,80363,OPIOIDS & OPIATE ANALOGS 3/4,,,0.01,0.01,1
HCPCS,80363,Opioids & opiate analogs 3/4,,,6.62,8.36,6
HCPCS,803630,OPIOIDS & OPIATE ANALOGS 3/4,,,0.01,0.01,1
HCPCS,80364,OPIOID &OPIATE ANALOG 5/MORE,,,0.01,0.01,1
HCPCS,80364,Opioid &opiate analog 5/more,,,6.62,8.36,6
HCPCS,803640,OPIOID &OPIATE ANALOG 5/MORE,,,0.01,0.01,1
HCPCS,80365,DRUG SCREENING OXYCODONE,,,0.01,0.01,1
HCPCS,80365,Drug screening oxycodone,,,6.62,8.36,6
HCPCS,803650,DRUG SCREENING OXYCODONE,,,0.01,0.01,1
HCPCS,80366,DRUG SCREENING PREGABALIN,,,0.01,0.01,1
HCPCS,80366,"PREGABALIN, URINE",315.0,204.75,6.62,283.5,27
HCPCS,803660,DRUG SCREENING PREGABALIN,,,0.01,0.01,1
HCPCS,80367,DRUG SCREENING PROPOXYPHENE,,,0.01,0.01,1
HCPCS,80367,Drug screening propoxyphene,,,6.62,8.36,6
HCPCS,803670,DRUG SCREENING PROPOXYPHENE,,,0.01,0.01,1
HCPCS,80368,SEDATIVE HYPNOTICS,,,0.01,0.01,1
HCPCS,80368,Sedative hypnotics,,,6.62,8.36,6
HCPCS,803680,SEDATIVE HYPNOTICS,,,0.01,0.01,1
HCPCS,80369,SKELETAL MUSCLE RELAXANT 1/2,,,0.01,0.01,1
HCPCS,80369,Skeletal muscle relaxant 1/2,,,6.62,8.36,6
HCPCS,803690,SKELETAL MUSCLE RELAXANT 1/2,,,0.01,0.01,1
HCPCS,80370,SKEL MUSC RELAXANT 3 OR MORE,,,0.01,0.01,1
HCPCS,80370,Skel musc relaxant 3 or more,,,6.62,8.36,6
HCPCS,803700,SKEL MUSC RELAXANT 3 OR MORE,,,0.01,0.01,1
HCPCS,80371,STIMULANTS SYNTHETIC,,,0.01,0.01,1
HCPCS,80371,Stimulants synthetic,,,6.62,8.36,6
HCPCS,803710,STIMULANTS SYNTHETIC,,,0.01,0.01,1
HCPCS,80372,DRUG SCREENING TAPENTADOL,,,0.01,0.01,1
HCPCS,80372,Drug screening tapentadol,,,6.62,8.36,6
HCPCS,803720,DRUG SCREENING TAPENTADOL,,,0.01,0.01,1
HCPCS,80373,DRUG SCREENING TRAMADOL,,,0.01,0.01,1
HCPCS,80373,Drug screening tramadol,,,6.62,8.36,6
HCPCS,803730,DRUG SCREENING TRAMADOL,,,0.01,0.01,1
HCPCS,80374,STEREOISOMER ANALYSIS,,,0.01,0.01,1
HCPCS,80374,Stereoisomer analysis,,,6.62,8.36,6
HCPCS,803740,STEREOISOMER ANALYSIS,,,0.01,0.01,1
HCPCS,80375,DRUG/SUBSTANCE NOS 1-3,,,0.01,0.01,1
HCPCS,80375,Drug/substance nos 1-3,,,33.04,41.74,6
HCPCS,803750,DRUG/SUBSTANCE NOS 1-3,,,0.01,0.01,1
HCPCS,80376,DRUG/SUBSTANCE NOS 4-6,,,0.01,0.01,1
HCPCS,80376,Drug/substance nos 4-6,,,6.62,8.36,6
HCPCS,803760,DRUG/SUBSTANCE NOS 4-6,,,0.01,0.01,1
HCPCS,80377,DRUG/SUBSTANCE NOS 7/MORE,,,0.01,0.01,1
HCPCS,80377,Drug/substance nos 7/more,,,6.62,8.36,6
HCPCS,803770,DRUG/SUBSTANCE NOS 7/MORE,,,0.01,0.01,1
HCPCS,80400,%ACTH STIMULATION PANEL,244.0,158.6,16.61,219.6,37
HCPCS,80400,"*ACTH STIMULATION, 3 TIME POINT",290.0,188.5,16.61,261.0,37
HCPCS,80400,ACTH STIM W/2 TIME PTS,262.0,170.3,16.61,235.8,37
HCPCS,80400,ACTH STIMULATION PANEL,,,28.19,28.19,1
HCPCS,80400,ACTH STIMULATION PANEL ADRENAL INSUFFICIENCY,242.0,157.3,13.7,242.0,17
HCPCS,804000,ACTH STIMULATION PANEL,,,28.19,28.19,1
HCPCS,80402,ACTH STIMULATION PANEL,,,75.14,145.31,15
HCPCS,80402,Acth stimulation panel,,,16.61,20.98,6
HCPCS,804020,ACTH STIMULATION PANEL,,,75.14,75.14,1
HCPCS,80406,ACTH STIMULATION PANEL,,,67.62,130.77,15
HCPCS,80406,Acth stimulation panel,,,16.61,20.98,6
HCPCS,804060,ACTH STIMULATION PANEL,,,67.62,67.62,1
HCPCS,80408,ALDOSTERONE SUPPRESSION EVAL,,,108.43,209.71,15
HCPCS,80408,Aldosterone suppression eval,,,16.61,20.98,6
HCPCS,804080,ALDOSTERONE SUPPRESSION EVAL,,,108.43,108.43,1
HCPCS,80410,CALCITONIN STIMUL PANEL,,,69.44,134.3,15
HCPCS,80410,Calcitonin stimul panel,,,16.61,20.98,6
HCPCS,804100,CALCITONIN STIMUL PANEL,,,69.44,69.44,1
HCPCS,80412,CRH STIMULATION PANEL,,,692.6,1339.51,15
HCPCS,80412,Crh stimulation panel,,,325.19,410.76,6
HCPCS,804120,CRH STIMULATION PANEL,,,692.6,692.6,1
HCPCS,80414,TESTOSTERONE RESPONSE PANEL,,,44.61,86.29,15
HCPCS,80414,Testosterone response panel,,,16.61,20.98,6
HCPCS,804140,TESTOSTERONE RESPONSE PANEL,,,44.61,44.61,1
HCPCS,80415,TOT ESTRADIOL RESPONSE PANEL,,,48.29,93.39,15
HCPCS,80415,Tot estradiol response panel,,,16.61,20.98,6
HCPCS,804150,TOT ESTRADIOL RESPONSE PANEL,,,48.29,48.29,1
HCPCS,80416,RENIN STIMULATION PANEL,,,180.86,349.77,15
HCPCS,80416,Renin stimulation panel,,,76.88,97.12,6
HCPCS,804160,RENIN STIMULATION PANEL,,,180.86,180.86,1
HCPCS,80417,RENIN STIMULATION PANEL,,,38.01,73.51,15
HCPCS,80417,Renin stimulation panel,,,16.61,20.98,6
HCPCS,804170,RENIN STIMULATION PANEL,,,38.01,38.01,1
HCPCS,80418,PITUITARY EVALUATION PANEL,,,500.67,968.31,15
HCPCS,80418,Pituitary evaluation panel,,,170.1,214.86,6
HCPCS,804180,PITUITARY EVALUATION PANEL,,,500.67,500.67,1
HCPCS,80420,DEXAMETHASONE PANEL,,,139.86,270.5,15
HCPCS,80420,Dexamethasone panel,,,76.88,97.12,6
HCPCS,804200,DEXAMETHASONE PANEL,,,139.86,139.86,1
HCPCS,80422,GLUCAGON TOLERANCE PANEL,,,39.81,76.98,15
HCPCS,80422,Glucagon tolerance panel,,,16.61,20.98,6
HCPCS,804220,GLUCAGON TOLERANCE PANEL,,,39.81,39.81,1
HCPCS,80424,GLUCAGON TOLERANCE PANEL,,,43.63,84.39,15
HCPCS,80424,Glucagon tolerance panel,,,16.61,20.98,6
HCPCS,804240,GLUCAGON TOLERANCE PANEL,,,43.63,43.63,1
HCPCS,80426,GONADOTROPIN HORMONE PANEL,,,128.23,247.99,15
HCPCS,80426,Gonadotropin hormone panel,,,76.88,97.12,6
HCPCS,804260,GONADOTROPIN HORMONE PANEL,,,128.23,128.23,1
HCPCS,80428,GROWTH HORMONE PANEL,,,57.63,57.63,1
HCPCS,80428,GROWTH HORMONE STIM,591.0,384.15,16.61,531.9,37
HCPCS,80428,GROWTH HORMONE STIM PEDS,591.0,384.15,16.61,531.9,37
HCPCS,804280,GROWTH HORMONE PANEL,,,57.63,57.63,1
HCPCS,80430,GROWTH HORMONE PANEL,,,111.74,111.74,1
HCPCS,80430,GROWTH HORMONE SUPPRESS,806.0,523.9,16.61,725.4,37
HCPCS,804300,GROWTH HORMONE PANEL,,,111.74,111.74,1
HCPCS,80432,CPEPSP INSULIN SUPPRESSION PANEL,578.0,375.7,76.88,520.2,37
HCPCS,80432,INSULIN SUPPRESSION PANEL,,,143.09,143.09,1
HCPCS,804320,INSULIN SUPPRESSION PANEL,,,143.09,143.09,1
HCPCS,80434,INSULIN TOLERANCE PANEL,,,246.26,476.29,15
HCPCS,80434,Insulin tolerance panel,,,76.88,97.12,6
HCPCS,804340,INSULIN TOLERANCE PANEL,,,246.26,246.26,1
HCPCS,80435,INSULIN TOLERANCE PANEL,,,88.99,172.11,15
HCPCS,80435,Insulin tolerance panel,,,16.61,20.98,6
HCPCS,804350,INSULIN TOLERANCE PANEL,,,88.99,88.99,1
HCPCS,80436,METYRAPONE PANEL,,,78.76,152.33,15
HCPCS,80436,Metyrapone panel,,,16.61,20.98,6
HCPCS,804360,METYRAPONE PANEL,,,78.76,78.76,1
HCPCS,80438,TRH STIMULATION PANEL,,,43.56,84.24,15
HCPCS,80438,Trh stimulation panel,,,16.61,20.98,6
HCPCS,804380,TRH STIMULATION PANEL,,,43.56,43.56,1
HCPCS,80439,TRH STIMULATION PANEL,,,58.07,112.31,15
HCPCS,80439,Trh stimulation panel,,,16.61,20.98,6
HCPCS,804390,TRH STIMULATION PANEL,,,58.07,58.07,1
HCPCS,80500,Lab pathology consultation,,,56.79,71.74,6
HCPCS,80502,Lab pathology consultation,,,56.79,71.74,6
HCPCS,80503,PATH CLIN CONSLTJ SF 5-20,,,18.2,115.85,16
HCPCS,80503,Path clin consltj sf 5-20,,,56.79,71.74,6
HCPCS,805030,PATH CLIN CONSLTJ SF 5-20,,,18.2,18.2,1
HCPCS,80503TC,PATH CLIN CONSLTJ SF 5-20,,,18.2,18.2,1
HCPCS,80504,PATH CLIN CONSLTJ MOD 21-40,,,39.18,371.54,16
HCPCS,80504,Path clin consltj mod 21-40,,,56.79,71.74,6
HCPCS,805040,PATH CLIN CONSLTJ MOD 21-40,,,39.18,39.18,1
HCPCS,80504TC,PATH CLIN CONSLTJ MOD 21-40,,,39.18,39.18,1
HCPCS,80505,PATH CLIN CONSLTJ HIGH 41-60,,,73.63,371.54,16
HCPCS,80505,Path clin consltj high 41-60,,,56.79,71.74,6
HCPCS,805050,PATH CLIN CONSLTJ HIGH 41-60,,,73.63,73.63,1
HCPCS,80505TC,PATH CLIN CONSLTJ HIGH 41-60,,,73.63,73.63,1
HCPCS,80506,PATH CLIN CONSLTJ PROLNG SVC,,,35.2,35.2,2
HCPCS,80506,Path clin consltj prolng svc,,,56.79,71.74,6
HCPCS,805060,PATH CLIN CONSLTJ PROLNG SVC,,,35.2,35.2,1
HCPCS,80506TC,PATH CLIN CONSLTJ PROLNG SVC,,,35.2,35.2,1
HCPCS,81000,URINALYSIS,5.0,3.25,2.41,5.0,17
HCPCS,81000,URINALYSIS NONAUTO W SCPE (POINT OF CARE LAB),26.0,16.9,1.43,23.4,37
HCPCS,81000,URINALYSIS NONAUTO W/SCOPE,5.0,3.25,2.41,5.0,18
HCPCS,81000,URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,19.0,12.35,2.41,19.0,17
HCPCS,810000,URINALYSIS NONAUTO W/SCOPE,,,3.48,3.48,1
HCPCS,81001,URINALYSIS AUTO W SCPE,56.0,36.4,1.43,50.4,37
HCPCS,81001,URINALYSIS AUTO W/SCOPE,,,2.74,2.74,1
HCPCS,81001,URINALYSIS WITH MICRO (POINT OF CARE LAB),56.0,36.4,1.43,50.4,37
HCPCS,81001,"URINALYSIS, AUTOMATED WITH MICROSCOPY",33.0,21.45,1.9,33.0,17
HCPCS,81001,URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY,32.0,20.8,1.9,32.0,17
HCPCS,810010,URINALYSIS AUTO W/SCOPE,,,2.74,2.74,1
HCPCS,81002,N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB),37.0,24.05,1.43,33.3,37
HCPCS,81002,UA NON-AUTO W/O MICRO (POINT OF CARE LAB),39.0,25.35,1.43,35.1,37
HCPCS,81002,URINALYSIS BY DIP  NO MICRO,5.0,3.25,2.09,5.0,17
HCPCS,81002,URINALYSIS NONAUTO W/O SCOPE,,,3.0,3.0,1
HCPCS,81002,URINALYSIS W/OUT MICROSCOPY,33.0,21.45,2.09,33.0,17
HCPCS,81002,URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP,17.0,11.05,2.09,17.0,17
HCPCS,810020,URINALYSIS NONAUTO W/O SCOPE,,,3.0,3.0,1
HCPCS,81003,URINALYSIS (POINT OF CARE LAB),56.0,36.4,1.43,50.4,37
HCPCS,81003,URINALYSIS AUTO W/O SCOPE,,,1.94,3.76,4
HCPCS,81003,URINALYSIS AUTO WO SCPE,56.0,36.4,1.43,50.4,37
HCPCS,81003,URINALYSIS AUTO WO SCPE (POINT OF CARE LAB),56.0,36.4,1.43,50.4,74
HCPCS,81003,URINALYSIS ONLY,56.0,36.4,1.43,50.4,37
HCPCS,81003,"URINALYSIS,AUTOMATED, W/O MICROSCOPY",33.0,21.45,1.35,33.0,17
HCPCS,81003,URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY,7.0,4.55,1.35,7.0,17
HCPCS,810030,URINALYSIS AUTO W/O SCOPE,,,1.94,1.94,1
HCPCS,81003QW,URINALYSIS AUTO W/O SCOPE,,,3.47,3.76,3
HCPCS,81005,BILIRUBIN SCREEN URINE,35.0,22.75,1.43,31.5,37
HCPCS,81005,URINALYSIS,,,1.88,1.88,1
HCPCS,81005,"URINANALYSIS, QUAL OR SEMI-QUANT",35.0,22.75,1.43,31.5,37
HCPCS,810050,URINALYSIS,,,1.88,1.88,1
HCPCS,81007,URINE SCREEN FOR BACTERIA,,,25.9,50.1,18
HCPCS,81007,Urine screen for bacteria,,,1.43,1.8,6
HCPCS,810070,URINE SCREEN FOR BACTERIA,,,25.9,25.9,1
HCPCS,81007QW,URINE SCREEN FOR BACTERIA,,,46.23,50.1,3
HCPCS,81015,MICROSCOPIC EXAM OF URINE,,,2.64,2.64,1
HCPCS,81015,URINALYSIS MICROSCOP ONLY,25.0,16.25,1.43,22.5,37
HCPCS,81015,URINALYSIS MICROSCOP ONLY (POINT OF CARE LAB),25.0,16.25,1.43,22.5,37
HCPCS,81015,URINALYSIS MICROSCOPIC ONLY,41.0,26.65,1.83,41.0,17
HCPCS,810150,MICROSCOPIC EXAM OF URINE,,,2.64,2.64,1
HCPCS,81020,URINALYSIS GLASS TEST,,,4.06,7.85,15
HCPCS,81020,Urinalysis glass test,,,1.43,1.8,6
HCPCS,810200,URINALYSIS GLASS TEST,,,4.06,4.06,1
HCPCS,81025,HCG QUAL FLUID/URINE,109.0,70.85,1.43,98.1,37
HCPCS,81025,HCG URINE (POINT OF CARE LAB),40.0,26.0,1.43,36.0,37
HCPCS,81025,PREGNANCY TEST URINE (POINT OF CARE LAB),40.0,26.0,1.43,36.0,74
HCPCS,81025,URINE PREGNANCY TEST,10.0,6.5,5.0,10.0,18
HCPCS,81025,URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS,29.0,18.85,5.17,29.0,17
HCPCS,810250,URINE PREGNANCY TEST,,,7.44,7.44,1
HCPCS,81050,URINALYSIS VOLUME MEASURE,,,3.14,3.14,1
HCPCS,81050,VOL MEASURE TIMED UR OUT,13.0,8.45,1.43,11.7,37
HCPCS,81050,VOL MEASUREMNT TIMED,13.0,8.45,1.43,11.7,37
HCPCS,810500,URINALYSIS VOLUME MEASURE,,,3.14,3.14,1
HCPCS,81099,Unlisted urinalysis px,,,1.43,1.8,6
HCPCS,81105,HPA-1 GENOTYPING,336.0,218.4,22.32,330.3,75
HCPCS,811050,HPA-1 GENOTYPING,,,105.6,105.6,1
HCPCS,81106,HPA-2 GENOTYPING,336.0,218.4,22.32,330.3,75
HCPCS,811060,HPA-2 GENOTYPING,,,105.6,105.6,1
HCPCS,81107,HPA-3 GENOTYPING,336.0,218.4,22.32,330.3,75
HCPCS,811070,HPA-3 GENOTYPING,,,105.6,105.6,1
HCPCS,81108,HPA-4 GENOTYPING,336.0,218.4,22.32,330.3,75
HCPCS,811080,HPA-4 GENOTYPING,,,105.6,105.6,1
HCPCS,81109,HPA-5 GENOTYPING,336.0,218.4,22.32,330.3,75
HCPCS,811090,HPA-5 GENOTYPING,,,105.6,105.6,1
HCPCS,81110,HPA-6 GENOTYPING,336.0,218.4,22.32,330.3,75
HCPCS,811100,HPA-6 GENOTYPING,,,105.6,105.6,1
HCPCS,81111,HPA-9 GENOTYPING,336.0,218.4,22.32,330.3,75
HCPCS,811110,HPA-9 GENOTYPING,,,105.6,105.6,1
HCPCS,81112,HPA-15 GENOTYPING,336.0,218.4,22.32,330.3,75
HCPCS,811120,HPA-15 GENOTYPING,,,105.6,105.6,1
HCPCS,81120,%IDH12 IDH1,504.0,327.6,76.88,453.6,37
HCPCS,81120,IDH1 COMMON VARIANTS,878.0,570.7,76.88,790.2,38
HCPCS,81120,IDH1 HOTSPOT VARIANT BM,483.0,313.95,76.88,434.7,37
HCPCS,81120,IDH1 HOTSPOT VARIANT PB,483.0,313.95,76.88,434.7,37
HCPCS,811200,IDH1 COMMON VARIANTS,,,166.97,166.97,1
HCPCS,81121,%IDH12 IDH2,504.0,327.6,76.88,494.27,37
HCPCS,81121,IDH2 COMMON VARIANTS,878.0,570.7,76.88,790.2,38
HCPCS,81121,IDH2 HOTSPOT VARIANT PB,592.0,384.8,76.88,532.8,37
HCPCS,81121,IHD2 HOTSPOT VARIANT BM,592.0,384.8,76.88,532.8,37
HCPCS,811210,IDH2 COMMON VARIANTS,,,255.56,255.56,1
HCPCS,81161,DMD DUP/DELET ANALYSIS,,,241.06,466.21,15
HCPCS,81161,Dmd dup/delet analysis,,,76.88,97.12,6
HCPCS,811610,DMD DUP/DELET ANALYSIS,,,241.06,241.06,1
HCPCS,81162,BRCA1&2 GEN FULL SEQ DUP/DEL,,,1576.69,3049.37,15
HCPCS,81162,Brca1&2 gen full seq dup/del,,,1109.84,1401.9,6
HCPCS,811620,BRCA1&2 GEN FULL SEQ DUP/DEL,,,1576.69,1576.69,1
HCPCS,81163,BRCA1&2 GENE FULL SEQ ALYS,,,404.35,782.03,15
HCPCS,81163,Brca1&2 gene full seq alys,,,170.1,214.86,6
HCPCS,811630,BRCA1&2 GENE FULL SEQ ALYS,,,404.35,404.35,1
HCPCS,81164,BRCA1&2 GEN FUL DUP/DEL ALYS,,,504.77,976.25,15
HCPCS,81164,Brca1&2 gen ful dup/del alys,,,170.1,214.86,6
HCPCS,811640,BRCA1&2 GEN FUL DUP/DEL ALYS,,,504.77,504.77,1
HCPCS,81165,BRCA1 GENE FULL SEQ ALYS,,,244.4,472.69,15
HCPCS,81165,Brca1 gene full seq alys,,,76.88,97.12,6
HCPCS,811650,BRCA1 GENE FULL SEQ ALYS,,,244.4,244.4,1
HCPCS,81166,BRCA1 GENE FULL DUP/DEL ALYS,,,260.37,503.56,15
HCPCS,81166,Brca1 gene full dup/del alys,,,76.88,97.12,6
HCPCS,811660,BRCA1 GENE FULL DUP/DEL ALYS,,,260.37,260.37,1
HCPCS,81167,BRCA2 GENE FULL DUP/DEL ALYS,,,244.4,472.69,15
HCPCS,81167,Brca2 gene full dup/del alys,,,76.88,97.12,6
HCPCS,811670,BRCA2 GENE FULL DUP/DEL ALYS,,,244.4,244.4,1
HCPCS,81168,CCND1/IGH TRANSLOCATION ALYS,,,179.12,346.42,15
HCPCS,81168,Ccnd1/igh translocation alys,,,76.88,97.12,6
HCPCS,811680,CCND1/IGH TRANSLOCATION ALYS,,,179.12,179.12,1
HCPCS,81170,ABL1 GENE,389.0,252.85,76.88,389.0,38
HCPCS,81170,BCR-ABL1 KINASE MUT DET BY SANGER SEQ BM,2070.0,1345.5,76.88,1863.0,37
HCPCS,81170,BCR-ABL1 KINASE MUT DET SANGER BLD,2070.0,1345.5,76.88,1863.0,37
HCPCS,81170,KINASE TEST,383.0,248.95,76.88,383.0,37
HCPCS,811700,ABL1 GENE,,,259.2,259.2,1
HCPCS,81171,AFF2 GEN ALY DETC ABNL ALLEL,,,118.37,228.93,15
HCPCS,81171,Aff2 gen aly detc abnl allel,,,76.88,97.12,6
HCPCS,811710,AFF2 GEN ALY DETC ABNL ALLEL,,,118.37,118.37,1
HCPCS,81172,AFF2 GEN ALYS CHARAC ALLELES,,,237.45,459.24,15
HCPCS,81172,Aff2 gen alys charac alleles,,,76.88,97.12,6
HCPCS,811720,AFF2 GEN ALYS CHARAC ALLELES,,,237.45,237.45,1
HCPCS,81173,AR GENE FULL GENE SEQUENCE,,,260.37,503.56,15
HCPCS,81173,Ar gene full gene sequence,,,76.88,97.12,6
HCPCS,811730,AR GENE FULL GENE SEQUENCE,,,260.37,260.37,1
HCPCS,81174,AR GENE KNOWN FAMIL VARIANT,,,160.01,309.47,15
HCPCS,81174,Ar gene known famil variant,,,76.88,97.12,6
HCPCS,811740,AR GENE KNOWN FAMIL VARIANT,,,160.01,160.01,1
HCPCS,81175,ASXL1 FULL GENE SEQUENCE,,,584.5,1130.43,15
HCPCS,81175,Asxl1 full gene sequence,,,325.19,410.76,6
HCPCS,811750,ASXL1 FULL GENE SEQUENCE,,,584.5,584.5,1
HCPCS,81176,ASXL1 GENE TARGET SEQ ALYS,,,209.0,404.21,15
HCPCS,81176,Asxl1 gene target seq alys,,,76.88,97.12,6
HCPCS,811760,ASXL1 GENE TARGET SEQ ALYS,,,209.0,209.0,1
HCPCS,81177,ATN1 GENE DETC ABNOR ALLELES,,,118.37,118.37,1
HCPCS,81177,DRPLA DNA TEST,945.0,614.25,76.88,850.5,37
HCPCS,811770,ATN1 GENE DETC ABNOR ALLELES,,,118.37,118.37,1
HCPCS,81178,ATXN1 GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,81178,SCA1 DNA TEST,597.0,388.05,76.88,537.3,37
HCPCS,811780,ATXN1 GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,81179,ATXN2 GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,81179,SCA2 EXPANSION,641.0,416.65,76.88,576.9,37
HCPCS,811790,ATXN2 GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,81180,ATXN3 GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,81180,SCA3 DNA TEST,620.0,403.0,76.88,558.0,37
HCPCS,811800,ATXN3 GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,81181,ATXN7 GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,81181,SCA7 DNA TEST,663.0,430.95,76.88,596.7,37
HCPCS,811810,ATXN7 GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,81182,ATXN8OS GEN DETC ABNOR ALLEL,,,118.37,228.93,15
HCPCS,81182,Atxn8os gen detc abnor allel,,,76.88,97.12,6
HCPCS,811820,ATXN8OS GEN DETC ABNOR ALLEL,,,118.37,118.37,1
HCPCS,81183,ATXN10 GENE DETC ABNOR ALLEL,,,118.37,228.93,15
HCPCS,81183,Atxn10 gene detc abnor allel,,,76.88,97.12,6
HCPCS,811830,ATXN10 GENE DETC ABNOR ALLEL,,,118.37,118.37,1
HCPCS,81184,CACNA1A GEN DETC ABNOR ALLEL,,,118.37,118.37,1
HCPCS,81184,SCA6 DNA TEST,629.0,408.85,76.88,566.1,37
HCPCS,811840,CACNA1A GEN DETC ABNOR ALLEL,,,118.37,118.37,1
HCPCS,81185,CACNA1A GENE FULL GENE SEQ,,,731.18,731.18,1
HCPCS,81185,HEMMIG CACNA1A,1398.0,908.7,325.19,1398.0,37
HCPCS,811850,CACNA1A GENE FULL GENE SEQ,,,731.18,731.18,1
HCPCS,81186,CACNA1A GEN KNOWN FAMIL VRNT,,,160.01,309.47,15
HCPCS,81186,Cacna1a gen known famil vrnt,,,76.88,97.12,6
HCPCS,811860,CACNA1A GEN KNOWN FAMIL VRNT,,,160.01,160.01,1
HCPCS,81187,CNBP GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,81187,DM2 DNA TEST,517.0,336.05,76.88,465.3,37
HCPCS,811870,CNBP GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,81188,CSTB GENE DETC ABNOR ALLELE,,,118.37,228.93,15
HCPCS,81188,Cstb gene detc abnor allele,,,76.88,97.12,6
HCPCS,811880,CSTB GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,81189,CSTB GENE FULL GENE SEQUENCE,,,237.45,459.24,15
HCPCS,81189,Cstb gene full gene sequence,,,76.88,97.12,6
HCPCS,811890,CSTB GENE FULL GENE SEQUENCE,,,237.45,237.45,1
HCPCS,81190,CSTB GENE KNOWN FAMIL VRNT,,,160.01,309.47,15
HCPCS,81190,Cstb gene known famil vrnt,,,76.88,97.12,6
HCPCS,811900,CSTB GENE KNOWN FAMIL VRNT,,,160.01,160.01,1
HCPCS,81191,NTRK1 TRANSLOCATION ANALYSIS,,,179.12,346.42,15
HCPCS,81191,Ntrk1 translocation analysis,,,76.88,97.12,6
HCPCS,811910,NTRK1 TRANSLOCATION ANALYSIS,,,179.12,179.12,1
HCPCS,81192,NTRK2 TRANSLOCATION ANALYSIS,,,179.12,346.42,15
HCPCS,81192,Ntrk2 translocation analysis,,,76.88,97.12,6
HCPCS,811920,NTRK2 TRANSLOCATION ANALYSIS,,,179.12,179.12,1
HCPCS,81193,NTRK3 TRANSLOCATION ANALYSIS,,,179.12,346.42,15
HCPCS,81193,Ntrk3 translocation analysis,,,76.88,97.12,6
HCPCS,811930,NTRK3 TRANSLOCATION ANALYSIS,,,179.12,179.12,1
HCPCS,81194,NTRK NGS,2126.0,1381.9,170.1,1913.4,37
HCPCS,81194,NTRK TRANSLOCATION ANALYSIS,,,447.79,447.79,1
HCPCS,811940,NTRK TRANSLOCATION ANALYSIS,,,447.79,447.79,1
HCPCS,81195,CYTOG GENOM-WID ALYS HEM MAL,,,1091.69,2111.36,15
HCPCS,81195,Cytog genom-wid alys hem mal,,,1109.84,1401.9,6
HCPCS,811950,CYTOG GENOM-WID ALYS HEM MAL,,,1091.69,1091.69,1
HCPCS,81200,%AJPWO CANVAN,130.0,84.5,22.32,117.0,37
HCPCS,81200,AJPNL ASPA GENE,58.0,37.7,14.5,58.0,37
HCPCS,81200,ASPA GENE,,,40.82,40.82,1
HCPCS,81200,CANVAN TEST,1620.0,1053.0,22.32,1458.0,37
HCPCS,81200,CSPNL ASPA GENE,58.0,37.7,14.5,58.0,37
HCPCS,812000,ASPA GENE,,,40.82,40.82,1
HCPCS,81201,APC GENE FULL SEQUENCE,,,673.92,1303.38,15
HCPCS,81201,Apc gene full sequence,,,325.19,410.76,6
HCPCS,812010,APC GENE FULL SEQUENCE,,,673.92,673.92,1
HCPCS,81202,APC GENE KNOWN FAM VARIANTS,,,241.92,467.88,15
HCPCS,81202,Apc gene known fam variants,,,76.88,97.12,6
HCPCS,812020,APC GENE KNOWN FAM VARIANTS,,,241.92,241.92,1
HCPCS,81203,APC GENE DUP/DELET VARIANTS,,,172.8,334.2,15
HCPCS,81203,Apc gene dup/delet variants,,,76.88,97.12,6
HCPCS,812030,APC GENE DUP/DELET VARIANTS,,,172.8,172.8,1
HCPCS,81204,AR GENE CHARAC ALLELES,,,118.37,118.37,1
HCPCS,81204,KENNEDY'S DIS DNA,805.0,523.25,76.88,724.5,37
HCPCS,812040,AR GENE CHARAC ALLELES,,,118.37,118.37,1
HCPCS,81205,%AJPWO BCKDHB,261.0,169.65,22.32,234.9,37
HCPCS,81205,AJPNL BCKDHB GENE,117.0,76.05,22.32,117.0,37
HCPCS,81205,BCKDHB GENE,,,82.07,82.07,1
HCPCS,81205,CSPNL BCKDHB GENE,117.0,76.05,22.32,117.0,37
HCPCS,812050,BCKDHB GENE,,,82.07,82.07,1
HCPCS,81206,%ABLQUL BCR/ABL1 MAJ,1198.0,778.7,76.88,1078.2,37
HCPCS,81206,%BCRQL BCR/ABL1 MAJ BRKPT,872.0,566.8,76.88,784.8,37
HCPCS,81206,BCR/ABL QUANT BLOOD TEST,1008.0,655.2,76.88,907.2,37
HCPCS,81206,BCR/ABL QUANT BONE MARROW,1396.0,907.4,76.88,1256.4,37
HCPCS,81206,BCR/ABL1 GENE MAJOR BP,299.0,194.35,57.75,926.1,112
HCPCS,81206,BCRBM BCR/ABL1 GENE MAJOR BP,1257.0,817.05,76.88,1131.3,37
HCPCS,81206,BCRPB BCR/ABL1 GENE MAJOR BP,1257.0,817.05,76.88,1131.3,37
HCPCS,812060,BCR/ABL1 GENE MAJOR BP,,,141.66,141.66,1
HCPCS,81207,%BCRQL BCR/ABL1 MIN BRKPT,770.0,500.5,76.88,693.0,37
HCPCS,81207,190PCR BONE MARROW TEST,1344.0,873.6,76.88,1209.6,37
HCPCS,81207,BCR/ABL1 GENE MINOR BP,252.5,164.125,51.5,269.1,75
HCPCS,81207,BCRBM BCR/ABL1 GENE MINOR BP,1210.0,786.5,76.88,1089.0,37
HCPCS,81207,BCRPB BCR/ABL1 GENE MINOR BP,1210.0,786.5,76.88,1089.0,37
HCPCS,81207,P190PCR BLOOD,1344.0,873.6,76.88,1209.6,37
HCPCS,812070,BCR/ABL1 GENE MINOR BP,,,125.14,125.14,1
HCPCS,81208,%BCRQL BCR/ABL1 OTH BRKPT,849.0,551.85,76.88,764.1,37
HCPCS,81208,BCR/ABL1 GENE OTHER BP,299.0,194.35,74.75,299.0,38
HCPCS,812080,BCR/ABL1 GENE OTHER BP,,,185.44,185.44,1
HCPCS,81209,%AJPWO BLOOM,108.0,70.2,22.32,97.2,37
HCPCS,81209,AJPNL BLM GENE,48.0,31.2,12.0,48.0,37
HCPCS,81209,BLM GENE,,,33.97,33.97,1
HCPCS,81209,CSPNL BLM GENE,48.0,31.2,12.0,48.0,37
HCPCS,812090,BLM GENE,,,33.97,33.97,1
HCPCS,81210,%BRAFBM TEST,1009.0,655.85,76.88,908.1,37
HCPCS,81210,%NGSCOL BRAF,364.0,236.6,76.88,327.6,37
HCPCS,81210,%NGSMEL BRAF,338.0,219.7,76.88,304.2,37
HCPCS,81210,*BRAF GENE,311.0,202.15,76.88,293.09,37
HCPCS,81210,BRAF GENE,424.0,275.6,76.88,381.6,38
HCPCS,81210,BRAF V600E MUT DETECT BLOOD,484.0,314.6,76.88,435.6,37
HCPCS,81210,BRAF V600E MUT DETECT BM,484.0,314.6,76.88,435.6,37
HCPCS,81210,BRAF V600E MUT DETECT OTHER,484.0,314.6,76.88,435.6,37
HCPCS,81210,BRAF V600E/D AND V600K/R MUTATION DETECTION CIRCULATING TUMOR DN,1335.0,867.75,76.88,1201.5,37
HCPCS,81210,GISTCY BRAF GENE,426.0,276.9,76.88,383.4,37
HCPCS,81210,NGSCCY BRAF,364.0,236.6,76.88,327.6,37
HCPCS,81210,NGSMCY BRAF,400.0,260.0,76.88,360.0,37
HCPCS,812100,BRAF GENE,,,151.55,151.55,1
HCPCS,81212,BRCA1&2 185&5385&6174 VRNT,,,380.16,735.24,15
HCPCS,81212,Brca1&2 185&5385&6174 vrnt,,,170.1,214.86,6
HCPCS,812120,BRCA1&2 185&5385&6174 VRNT,,,380.16,380.16,1
HCPCS,81215,BRCA1 GENE KNOWN FAMIL VRNT,,,324.22,627.04,15
HCPCS,81215,Brca1 gene known famil vrnt,,,170.1,214.86,6
HCPCS,812150,BRCA1 GENE KNOWN FAMIL VRNT,,,324.22,324.22,1
HCPCS,81216,BRCA2 GENE FULL SEQ ALYS,,,159.95,309.34,15
HCPCS,81216,Brca2 gene full seq alys,,,76.88,97.12,6
HCPCS,812160,BRCA2 GENE FULL SEQ ALYS,,,159.95,159.95,1
HCPCS,81217,BRCA2 GENE KNOWN FAMIL VRNT,,,324.22,627.04,15
HCPCS,81217,Brca2 gene known famil vrnt,,,170.1,214.86,6
HCPCS,812170,BRCA2 GENE KNOWN FAMIL VRNT,,,324.22,324.22,1
HCPCS,81218,CEBPA GENE FULL SEQUENCE,,,209.0,404.21,15
HCPCS,81218,Cebpa gene full sequence,,,76.88,97.12,6
HCPCS,812180,CEBPA GENE FULL SEQUENCE,,,209.0,209.0,1
HCPCS,81219,CALR EXON 9 MUTATION,437.0,284.05,22.32,393.3,37
HCPCS,81219,CALR GENE ANALYSIS,839.0,545.35,22.32,755.1,37
HCPCS,81219,CALR GENE COM VARIANTS,446.0,289.9,22.32,401.4,38
HCPCS,812190,CALR GENE COM VARIANTS,,,105.08,105.08,1
HCPCS,81220,*CYSTIC FIBROSIS CARRIER SCR,699.0,454.35,170.1,699.0,37
HCPCS,81220,CF PATHOGENIC VARIANT,681.0,442.65,170.1,681.0,37
HCPCS,81220,CFNGS 139 VAR,681.0,442.65,170.1,681.0,37
HCPCS,81220,CFSCRN TEST,681.0,442.65,170.1,681.0,37
HCPCS,81220,CFTR GENE COM VARIANTS,748.5,486.52500000000003,170.1,798.0,112
HCPCS,81220,CSPNL CFTR GENE COM VARS,681.0,442.65,170.1,681.0,37
HCPCS,812200,CFTR GENE COM VARIANTS,,,480.9,480.9,1
HCPCS,81221,CFTR GENE KNOWN FAM VARIANTS,,,84.0,162.45,15
HCPCS,81221,Cftr gene known fam variants,,,22.32,28.19,6
HCPCS,812210,CFTR GENE KNOWN FAM VARIANTS,,,84.0,84.0,1
HCPCS,81222,CFTR GENE DUP/DELET VARIANTS,,,375.9,727.0,15
HCPCS,81222,Cftr gene dup/delet variants,,,170.1,214.86,6
HCPCS,812220,CFTR GENE DUP/DELET VARIANTS,,,375.9,375.9,1
HCPCS,81223,*CFTR GENE FULL SEQUENCE,1241.0,806.65,170.1,1116.9,37
HCPCS,81223,CFTR GENE FULL SEQUENCE,,,431.14,431.14,1
HCPCS,812230,CFTR GENE FULL SEQUENCE,,,431.14,431.14,1
HCPCS,81224,*CFTR GENE INTRON POLY T,1208.0,785.2,76.88,1087.2,37
HCPCS,81224,CFTR GENE INTRON POLY T,,,145.8,145.8,1
HCPCS,81224,CFTR TEST,750.0,487.5,76.88,675.0,37
HCPCS,812240,CFTR GENE INTRON POLY T,,,145.8,145.8,1
HCPCS,81225,2C19AO-CYP2C19 GTYP AN ON,363.0,235.95,76.88,363.0,37
HCPCS,81225,2C19PL TEST,2000.0,1300.0,76.88,1800.0,37
HCPCS,81225,CP2C19-CYP2C19 GENOTYPING,363.0,235.95,76.88,363.0,37
HCPCS,81225,CYP2C19 GENE COM VARIANTS,,,251.74,251.74,1
HCPCS,81225,CYTOCHROME P450 2C19,774.0,503.1,76.88,696.6,37
HCPCS,812250,CYP2C19 GENE COM VARIANTS,,,251.74,251.74,1
HCPCS,81226,2D6 TEST,616.0,400.4,154.0,616.0,37
HCPCS,81226,2D6AO-CYP2D6 GTYP AN ON,557.0,362.05,139.25,557.0,37
HCPCS,81226,CYP2D6 GENE COM VARIANTS,616.0,400.4,154.0,616.0,38
HCPCS,81226,CYTOCHROME P450 2D6 GENO,564.0,366.6,141.0,564.0,37
HCPCS,81226,PGPAIN CYP2D6 GENE COM VAR,564.0,366.6,141.0,564.0,37
HCPCS,812260,CYP2D6 GENE COM VARIANTS,,,389.59,389.59,1
HCPCS,81227,CYP2C9 GENE COM VARIANTS,,,151.04,151.04,1
HCPCS,81227,CYP2C9 GENE COM VARIANTS (WARSEN),351.0,228.15,76.88,315.9,37
HCPCS,81227,PHARMACOGENOMICS CYP2C9,366.0,237.9,76.88,329.4,37
HCPCS,812270,CYP2C9 GENE COM VARIANTS,,,151.04,151.04,1
HCPCS,81228,COL3A1 DELETION/DUP ANLS,2012.0,1307.8,325.19,1810.8,37
HCPCS,81228,CYTOG ALYS CHRML ABNR CGH,,,777.6,777.6,1
HCPCS,812280,CYTOG ALYS CHRML ABNR CGH,,,777.6,777.6,1
HCPCS,81229,CRMSNP TEST,2035.0,1322.75,508.75,1938.36,37
HCPCS,81229,CYTOG ALYS CHRML ABNR SNPCGH,,,1002.24,1002.24,1
HCPCS,81229,CYTOGENOMIC SNP MICROARRAY - FETAL,4500.0,2925.0,1109.84,4050.0,37
HCPCS,81229,"MICROARRAY ANALYSIS, POC FFPE",1335.0,867.75,333.75,1401.9,37
HCPCS,81229,"MICROARRAY ANALYSIS, SNP, FORMALIN FIXED PARAFFIN EMBEDDED TISSU",1335.0,867.75,333.75,1401.9,37
HCPCS,81229,POCHF PROD CONCEPT+SNP,2262.0,1470.3,565.5,2035.8,37
HCPCS,81229,"PRENATAL SNP MICROARRAY, AMNIOTIC FLUID, CVS",4580.0,2977.0,1109.84,4122.0,37
HCPCS,812290,CYTOG ALYS CHRML ABNR SNPCGH,,,1002.24,1002.24,1
HCPCS,81230,CYP3A4 GENE COMMON VARIANTS,,,151.04,292.11,15
HCPCS,81230,Cyp3a4 gene common variants,,,76.88,97.12,6
HCPCS,812300,CYP3A4 GENE COMMON VARIANTS,,,151.04,151.04,1
HCPCS,81231,CYP3A5 GENE COMMON VARIANTS,,,151.04,151.04,1
HCPCS,81231,PHARMACOGENOMICS CYP3A5,366.0,237.9,76.88,329.4,37
HCPCS,812310,CYP3A5 GENE COMMON VARIANTS,,,151.04,151.04,1
HCPCS,81232,5FUDPD DPYD GENE COMMON VARS,779.0,506.35,76.88,701.1,37
HCPCS,81232,DPD 5FU GENOTYPR,796.0,517.4,76.88,716.4,37
HCPCS,81232,DPYD GENE COMMON VARIANTS,,,151.04,151.04,1
HCPCS,81232,DPYDAO-DYPD GTYP AN ON,363.0,235.95,76.88,326.7,37
HCPCS,81232,DUPNL DPYD GENE COMMON VARIANTS,330.0,214.5,76.88,297.0,37
HCPCS,81232,DYPD GENOTYPING,363.0,235.95,76.88,326.7,37
HCPCS,812320,DPYD GENE COMMON VARIANTS,,,151.04,151.04,1
HCPCS,81233,BTK GENE ANALYISIS,987.0,641.55,76.88,888.3,37
HCPCS,81233,BTK GENE COMMON VARIANTS,,,151.55,151.55,1
HCPCS,812330,BTK GENE COMMON VARIANTS,,,151.55,151.55,1
HCPCS,81234,DM1 DNA TEST,517.0,336.05,76.88,465.3,37
HCPCS,81234,DMPK GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,812340,DMPK GENE DETC ABNOR ALLELE,,,118.37,118.37,1
HCPCS,81235,*EGFR GENE COM VARIANTS,964.5,626.925,154.75,1179.0,74
HCPCS,81235,EGFR GENE COM VARIANTS,1091.0,709.15,170.1,981.9,38
HCPCS,81235,EGFR GENETIC ANALYSIS,811.0,527.15,170.1,729.9,37
HCPCS,812350,EGFR GENE COM VARIANTS,,,280.43,280.43,1
HCPCS,81236,EZH2 GENE FULL GENE SEQUENCE,,,244.4,472.69,15
HCPCS,81236,Ezh2 gene full gene sequence,,,76.88,97.12,6
HCPCS,812360,EZH2 GENE FULL GENE SEQUENCE,,,244.4,244.4,1
HCPCS,81237,EZH2 GENE COMMON VARIANTS,,,151.55,293.09,15
HCPCS,81237,Ezh2 gene common variants,,,76.88,97.12,6
HCPCS,812370,EZH2 GENE COMMON VARIANTS,,,151.55,151.55,1
HCPCS,81238,F9 FULL GENE SEQUENCE,,,518.4,1002.6,15
HCPCS,81238,F9 full gene sequence,,,325.19,410.76,6
HCPCS,812380,F9 FULL GENE SEQUENCE,,,518.4,518.4,1
HCPCS,81239,DMPK GENE CHARAC ALLELES,,,237.45,459.24,15
HCPCS,81239,Dmpk gene charac alleles,,,76.88,97.12,6
HCPCS,812390,DMPK GENE CHARAC ALLELES,,,237.45,237.45,1
HCPCS,81240,F2 GENE,86.0,55.9,21.5,86.0,38
HCPCS,81240,PTGENEO TEST,800.0,520.0,22.32,720.0,37
HCPCS,812400,F2 GENE,,,56.75,56.75,1
HCPCS,81241,F5 GENE,95.0,61.75,22.32,95.0,38
HCPCS,81241,FACT V LEIDEN TEST,101.0,65.65,22.32,101.0,37
HCPCS,812410,F5 GENE,,,63.4,63.4,1
HCPCS,81242,%AJPWO FANCONI,101.0,65.65,22.32,90.9,37
HCPCS,81242,AJPNL FANCC GENE,45.0,29.25,11.25,45.0,37
HCPCS,81242,CSPNL FANCC GENE,45.0,29.25,11.25,45.0,37
HCPCS,81242,FANCC GENE,,,31.64,31.64,1
HCPCS,812420,FANCC GENE,,,31.64,31.64,1
HCPCS,81243,%FRAX FMR 1 TEST,733.0,476.45,22.32,659.7,37
HCPCS,81243,CSPNL FMR1 GENE DETECTION,72.0,46.8,18.0,72.0,37
HCPCS,81243,FMR1 GEN ALY DETC ABNL ALLEL,,,49.28,49.28,1
HCPCS,81243,FMR1 GENE DETECTION,414.0,269.1,22.32,372.6,37
HCPCS,812430,FMR1 GEN ALY DETC ABNL ALLEL,,,49.28,49.28,1
HCPCS,81244,FMR1 GEN ALYS CHARAC ALLELES,,,38.78,75.01,15
HCPCS,81244,Fmr1 gen alys charac alleles,,,22.32,28.19,6
HCPCS,812440,FMR1 GEN ALYS CHARAC ALLELES,,,38.78,38.78,1
HCPCS,81245,%FLT3 ITD TEST,616.0,400.4,76.88,554.4,37
HCPCS,81245,%FLT3MD VARIANTS,746.0,484.9,76.88,671.4,37
HCPCS,81245,F3MRW MUT ANSYS BM,678.0,440.7,76.88,610.2,37
HCPCS,81245,FLT3 GENE,484.0,314.6,76.88,435.6,38
HCPCS,81245,FLT3 ITD MUT ANSYS BLD,678.0,440.7,76.88,610.2,37
HCPCS,81245,FLT3 ITD MUT ANSYS BM,678.0,440.7,76.88,610.2,37
HCPCS,81245,FLT3PB MUT ANSYS BLD,678.0,440.7,76.88,610.2,37
HCPCS,812450,FLT3 GENE,,,143.0,143.0,1
HCPCS,81246,%FLT3 TKD TEST,551.0,358.15,22.32,495.9,37
HCPCS,81246,%FLT3MD TKD VARIANTS,287.0,186.55,22.32,258.3,37
HCPCS,81246,F3MRW GENE ANSYS BM,524.0,340.6,22.32,471.6,37
HCPCS,81246,FLT3 GENE ANALYSIS,107.0,69.55,22.32,107.0,75
HCPCS,81246,FLT3 TKDM BONE MARROW,537.0,349.05,22.32,483.3,37
HCPCS,81246,FLT3PB GENE ANSYS BLD,524.0,340.6,22.32,471.6,37
HCPCS,812460,FLT3 GENE ANALYSIS,,,71.71,71.71,1
HCPCS,81247,G6PD GENE ALYS CMN VARIANT,,,151.04,292.11,15
HCPCS,81247,G6pd gene alys cmn variant,,,76.88,97.12,6
HCPCS,812470,G6PD GENE ALYS CMN VARIANT,,,151.04,151.04,1
HCPCS,81248,G6PD KNOWN FAMILIAL VARIANT,,,324.22,627.04,15
HCPCS,81248,G6pd known familial variant,,,170.1,214.86,6
HCPCS,812480,G6PD KNOWN FAMILIAL VARIANT,,,324.22,324.22,1
HCPCS,81249,G6PD FULL GENE SEQUENCE,,,518.4,1002.6,15
HCPCS,81249,G6pd full gene sequence,,,325.19,410.76,6
HCPCS,812490,G6PD FULL GENE SEQUENCE,,,518.4,518.4,1
HCPCS,81250,%AJPWO G6PC,161.0,104.65,22.32,144.9,37
HCPCS,81250,AJPNL G6PC GENE,73.0,47.45,18.25,73.0,37
HCPCS,81250,CSPNL G6PC GENE,73.0,47.45,18.25,73.0,37
HCPCS,81250,G6PC GENE,,,50.53,50.53,1
HCPCS,812500,G6PC GENE,,,50.53,50.53,1
HCPCS,81251,%AJPWO GAUCHER,130.0,84.5,22.32,117.0,37
HCPCS,81251,AJPNL GBA GENE,58.0,37.7,14.5,58.0,37
HCPCS,81251,CSPNL GBA GENE,58.0,37.7,14.5,58.0,37
HCPCS,81251,GAUCHR TEST,661.0,429.65,22.32,594.9,37
HCPCS,81251,GBA GENE,675.0,438.75,22.32,607.5,38
HCPCS,812510,GBA GENE,,,40.82,40.82,1
HCPCS,81252,GJB2 GENE FULL SEQUENCE,,,87.37,168.97,15
HCPCS,81252,Gjb2 gene full sequence,,,22.32,28.19,6
HCPCS,812520,GJB2 GENE FULL SEQUENCE,,,87.37,87.37,1
HCPCS,81253,GJB2 GENE KNOWN FAM VARIANTS,,,53.16,102.8,15
HCPCS,81253,Gjb2 gene known fam variants,,,22.32,28.19,6
HCPCS,812530,GJB2 GENE KNOWN FAM VARIANTS,,,53.16,53.16,1
HCPCS,81254,GJB6 GENE COM VARIANTS,,,30.24,58.49,15
HCPCS,81254,Gjb6 gene com variants,,,22.32,28.19,6
HCPCS,812540,GJB6 GENE COM VARIANTS,,,30.24,30.24,1
HCPCS,81255,%AJPWO TAY SACHS,142.0,92.3,22.32,127.8,37
HCPCS,81255,AJPNL HEXA GENE,64.0,41.6,16.0,64.0,37
HCPCS,81255,CSPNL HEXA GENE,64.0,41.6,16.0,64.0,37
HCPCS,81255,HEXA GENE,,,44.45,44.45,1
HCPCS,812550,HEXA GENE,,,44.45,44.45,1
HCPCS,81256,HEMDNA TEST,188.0,122.2,22.32,169.2,37
HCPCS,81256,HFE GENE,191.0,124.15,22.32,171.9,38
HCPCS,81256,HFE TARGETED MUT BY SANGER SEQ,451.0,293.15,22.32,405.9,37
HCPCS,812560,HFE GENE,,,56.47,56.47,1
HCPCS,81257,ALPHA THALASSEMIA TEST,754.0,490.1,22.32,678.6,37
HCPCS,81257,HBA1/HBA2 GENE,769.0,499.85,22.32,692.1,38
HCPCS,812570,HBA1/HBA2 GENE,,,88.35,88.35,1
HCPCS,81258,HBA1/HBA2 GENE FAM VRNT,,,324.22,627.04,15
HCPCS,81258,Hba1/hba2 gene fam vrnt,,,170.1,214.86,6
HCPCS,812580,HBA1/HBA2 GENE FAM VRNT,,,324.22,324.22,1
HCPCS,81259,HBA1/HBA2 FULL GENE SEQUENCE,,,518.4,1002.6,15
HCPCS,81259,Hba1/hba2 full gene sequence,,,325.19,410.76,6
HCPCS,812590,HBA1/HBA2 FULL GENE SEQUENCE,,,518.4,518.4,1
HCPCS,81260,%AJPWO FAMILIAL DYSAUTO,108.0,70.2,22.32,97.2,37
HCPCS,81260,AJPNL IKBKAP GENE,48.0,31.2,12.0,48.0,37
HCPCS,81260,CSPNL IKBKAP GENE,48.0,31.2,12.0,48.0,37
HCPCS,81260,IKBKAP GENE,,,33.97,33.97,1
HCPCS,812600,IKBKAP GENE,,,33.97,33.97,1
HCPCS,81261,BCBMD I TEST,1559.0,1013.35,76.88,1403.1,37
HCPCS,81261,BCBMDM LGH REARR HCL,1406.0,913.9,76.88,1265.4,37
HCPCS,81261,BCBMDO LGH REARR HCL,1406.0,913.9,76.88,1265.4,37
HCPCS,81261,IGH GENE REARRANGE AMP METH,492.0,319.8,76.88,442.8,38
HCPCS,81261,IGHM LGH REARR HCL,1406.0,913.9,76.88,1265.4,37
HCPCS,81261,IGHO LGH REARR HCL,1406.0,913.9,76.88,1265.4,37
HCPCS,812610,IGH GENE REARRANGE AMP METH,,,171.06,171.06,1
HCPCS,81262,*MICRODISSECTION MANUAL,182.0,118.3,22.32,163.8,37
HCPCS,81262,IGH GENE REARRANG DIR PROBE,,,59.23,59.23,1
HCPCS,81262,IGHSB TEST,616.0,400.4,22.32,554.4,37
HCPCS,812620,IGH GENE REARRANG DIR PROBE,,,59.23,59.23,1
HCPCS,81263,IGH VARI REGIONAL MUTATION,741.5,481.975,76.88,773.1,75
HCPCS,812630,IGH VARI REGIONAL MUTATION,,,254.47,254.47,1
HCPCS,81264,BCBMDM LGK REARR KLCL,1406.0,913.9,76.88,1265.4,37
HCPCS,81264,BCBMDO LGK REARR KLCL,1406.0,913.9,76.88,1265.4,37
HCPCS,81264,IGK REARRANGEABN CLONAL POP,492.0,319.8,76.88,442.8,38
HCPCS,81264,IGKM LGK REARR KLCL,1406.0,913.9,76.88,1265.4,37
HCPCS,81264,IGKO LGK REARR KLCL,1406.0,913.9,76.88,1265.4,37
HCPCS,812640,IGK REARRANGEABN CLONAL POP,,,149.23,149.23,1
HCPCS,81265,BMENGS SNP MARKERS SPECIMEN ANAL,1319.0,857.35,76.88,1187.1,37
HCPCS,81265,FETAL CELL CONTAMINATION (FCC),1511.0,982.15,76.88,1359.9,37
HCPCS,81265,MATERNAL CELL CONTAMINATION,1608.0,1045.2,76.88,1447.2,37
HCPCS,81265,MATRNL TEST,392.0,254.8,76.88,389.46,37
HCPCS,81265,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, BLOOD",1608.0,1045.2,76.88,1447.2,37
HCPCS,81265,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, OTHER",1608.0,1045.2,76.88,1447.2,37
HCPCS,81265,"STR ANALYSIS FOR MOL PREG, BLD",1608.0,1045.2,76.88,1447.2,37
HCPCS,81265,"STR ANALYSIS FOR MOL PREG, OTHER",1608.0,1045.2,76.88,1447.2,37
HCPCS,81265,STR GENOTYPING,1401.0,910.65,76.88,1260.9,37
HCPCS,81265,STR MARKERS SPECIMEN ANAL,,,201.38,201.38,1
HCPCS,81265,TISSUE DNA FP FOR MOLAR PREG - IHC SENDOUT,660.0,429.0,76.88,594.0,37
HCPCS,812650,STR MARKERS SPECIMEN ANAL,,,201.38,201.38,1
HCPCS,81266,STR MARKERS SPEC ANAL ADDL,,,263.36,509.34,15
HCPCS,81266,Str markers spec anal addl,,,76.88,97.12,6
HCPCS,812660,STR MARKERS SPEC ANAL ADDL,,,263.36,263.36,1
HCPCS,81267,CHIMERISM ANAL NO CELL SELEC,447.0,290.55,76.88,477.0,75
HCPCS,81267,CHIMERISM/ENGRAFTMENT ANALY W/COMP TO BASLINE,3960.0,2574.0,76.88,3564.0,37
HCPCS,81267,POST-TX FOLLOW-UP ENGRAFTMENT MONITORING,2336.0,1518.4,76.88,2102.4,37
HCPCS,812670,CHIMERISM ANAL NO CELL SELEC,,,179.25,179.25,1
HCPCS,81268,BM ENGRAFT F/U TEST,2103.0,1366.95,76.88,1892.7,37
HCPCS,81268,BMFUNG CHIMERISM ANAL W/CELL SELECT,1187.0,771.55,76.88,1068.3,37
HCPCS,81268,CHIMERISM ANAL W/CELL SELECT,,,225.32,225.32,1
HCPCS,812680,CHIMERISM ANAL W/CELL SELECT,,,225.32,225.32,1
HCPCS,81269,HBA1 HBA2 DEL/DUP,673.0,437.45,76.88,605.7,37
HCPCS,81269,HBA1/HBA2 GENE DUP/DEL VRNTS,782.0,508.3,76.88,703.8,38
HCPCS,812690,HBA1/HBA2 GENE DUP/DEL VRNTS,,,174.87,174.87,1
HCPCS,81270,JAK2 GENE,307.5,199.875,22.32,343.8,75
HCPCS,81270,"JAK2 GENE ANALYSIS, VAL617PHE VARIANT",632.0,410.8,22.32,568.8,37
HCPCS,81270,JAK2 MUTATION,248.0,161.2,22.32,223.2,37
HCPCS,81270,JAK2 TEST,748.0,486.2,22.32,673.2,37
HCPCS,812700,JAK2 GENE,,,79.2,79.2,1
HCPCS,81271,HTT GENE DETC ABNOR ALLELES,,,118.37,118.37,1
HCPCS,81271,HUNTINGTON'S DISEASE,844.0,548.6,76.88,759.6,37
HCPCS,812710,HTT GENE DETC ABNOR ALLELES,,,118.37,118.37,1
HCPCS,81272,%KITGN KIT TARGET SEQ,867.0,563.55,76.88,780.3,37
HCPCS,81272,%NGSMEL KIT,703.0,456.95,76.88,632.7,37
HCPCS,81272,GISTCY KIT GENE,872.0,566.8,76.88,784.8,37
HCPCS,81272,KIT GENE TARGETED SEQ ANALYS,1103.0,716.95,76.88,992.7,38
HCPCS,81272,"KIT MUT EX 18-11, 17 SEQ",636.0,413.4,76.88,572.4,37
HCPCS,81272,KITBM KIT TARGET SEQ,849.0,551.85,76.88,764.1,37
HCPCS,81272,KITPB KIT TARGET SEQ,849.0,551.85,76.88,764.1,37
HCPCS,81272,NGSMCY KIT,657.0,427.05,76.88,591.3,37
HCPCS,812720,KIT GENE TARGETED SEQ ANALYS,,,284.7,284.7,1
HCPCS,81273,KIT D816V MUT DETECT BLD,369.0,239.85,22.32,332.1,37
HCPCS,81273,KIT D816V MUT DETECT BM,369.0,239.85,22.32,332.1,37
HCPCS,81273,KIT D816V MUT DETECT OTHER,369.0,239.85,22.32,332.1,37
HCPCS,81273,KIT D816V MUTATION PCR,428.0,278.2,22.32,385.2,37
HCPCS,81273,KIT GENE ANALYS D816 VARIANT,,,107.89,107.89,1
HCPCS,81273,KITBM MUT ANLYS,452.0,293.8,22.32,406.8,37
HCPCS,81273,KITPB MUT ANLYS,452.0,293.8,22.32,406.8,37
HCPCS,812730,KIT GENE ANALYS D816 VARIANT,,,107.89,107.89,1
HCPCS,81274,HTT GENE CHARAC ALLELES,,,237.45,459.24,15
HCPCS,81274,Htt gene charac alleles,,,76.88,97.12,6
HCPCS,812740,HTT GENE CHARAC ALLELES,,,237.45,237.45,1
HCPCS,81275,"%NGSCOL KRAS 12,13",364.0,236.6,76.88,327.6,37
HCPCS,81275,*KRAS GENE VARIANTS EXON 2,311.0,202.15,76.88,311.0,37
HCPCS,81275,KRAS GENE,783.0,508.95,76.88,704.7,37
HCPCS,81275,KRAS GENE VARIANTS EXON 2,370.0,240.5,76.88,333.0,38
HCPCS,81275,KRAS GENETIC ANALYSIS,483.0,313.95,76.88,434.7,37
HCPCS,81275,"NGSCCY KRAS 12,13",364.0,236.6,76.88,327.6,37
HCPCS,812750,KRAS GENE VARIANTS EXON 2,,,166.97,166.97,1
HCPCS,81276,%KRASGN KRAS ADD VAR,605.0,393.25,76.88,544.5,37
HCPCS,81276,%NGSCOL KRAS 61,400.0,260.0,76.88,360.0,37
HCPCS,81276,KRAS ADDITIONAL VARIANTS,483.0,313.95,76.88,434.7,37
HCPCS,81276,KRAS GENE ADDL VARIANTS,340.5,221.325,76.88,333.0,75
HCPCS,81276,NGSCCY KRAS 61,400.0,260.0,76.88,360.0,37
HCPCS,812760,KRAS GENE ADDL VARIANTS,,,166.97,166.97,1
HCPCS,81277,CYTOGENOMIC NEO MICRORA ALYS,,,1002.24,1002.24,1
HCPCS,81277,MICORARRAY SNP FFPET,3317.0,2156.05,829.25,2985.3,37
HCPCS,812770,CYTOGENOMIC NEO MICRORA ALYS,,,1002.24,1002.24,1
HCPCS,81278,IGH@/BCL2 TRANSLOCATION ALYS,,,179.12,346.42,15
HCPCS,81278,Igh@/bcl2 translocation alys,,,76.88,97.12,6
HCPCS,812780,IGH@/BCL2 TRANSLOCATION ALYS,,,179.12,179.12,1
HCPCS,81279,JAK2 EX 12-16 MUT DET BLD,758.0,492.7,76.88,682.2,37
HCPCS,81279,"JAK2 GENE ANALYSIS, EXONS 12 AND 13",1278.0,830.7,76.88,1150.2,37
HCPCS,81279,JAK2 GENE TRGT SEQUENCE ALYS,,,160.01,160.01,1
HCPCS,81279,JAKNON EX 12-16 SEQ BLD,758.0,492.7,76.88,682.2,37
HCPCS,812790,JAK2 GENE TRGT SEQUENCE ALYS,,,160.01,160.01,1
HCPCS,81283,IFNL3 GENE,,,63.4,63.4,1
HCPCS,81283,IL28B ASSOC VAR 2 SNP,484.0,314.6,22.32,435.6,37
HCPCS,812830,IFNL3 GENE,,,63.4,63.4,1
HCPCS,81284,FRIEDREICH ATAX DNA,640.0,416.0,76.88,576.0,37
HCPCS,81284,FXN GENE DETC ABNOR ALLELES,,,118.37,118.37,1
HCPCS,812840,FXN GENE DETC ABNOR ALLELES,,,118.37,118.37,1
HCPCS,81285,FXN GENE CHARAC ALLELES,,,237.45,459.24,15
HCPCS,81285,Fxn gene charac alleles,,,76.88,97.12,6
HCPCS,812850,FXN GENE CHARAC ALLELES,,,237.45,237.45,1
HCPCS,81286,FXN GENE FULL GENE SEQUENCE,,,237.45,459.24,15
HCPCS,81286,Fxn gene full gene sequence,,,76.88,97.12,6
HCPCS,812860,FXN GENE FULL GENE SEQUENCE,,,237.45,237.45,1
HCPCS,81287,MGMT GENE METHYLATION ANAL,999.0,649.35,22.32,899.1,37
HCPCS,81287,MGMT GENE PRMTR MTHYLTN ALYS,,,107.69,107.69,1
HCPCS,81287,MGMT TEST,979.0,636.35,22.32,881.1,37
HCPCS,812870,MGMT GENE PRMTR MTHYLTN ALYS,,,107.69,107.69,1
HCPCS,81288,MLH1 GENE,747.0,485.55,76.88,672.3,38
HCPCS,81288,MLH1 PROMOTER HYPERMETH,733.0,476.45,76.88,659.7,37
HCPCS,812880,MLH1 GENE,,,166.17,166.17,1
HCPCS,81289,FXN GENE KNOWN FAMIL VARIANT,,,160.01,309.47,15
HCPCS,81289,Fxn gene known famil variant,,,76.88,97.12,6
HCPCS,812890,FXN GENE KNOWN FAMIL VARIANT,,,160.01,160.01,1
HCPCS,81290,%AJPWO MUCOLIPIDOSIS IV,108.0,70.2,22.32,97.2,37
HCPCS,81290,AJPNL MCOLN1 GENE,48.0,31.2,12.0,48.0,37
HCPCS,81290,CSPNL MCOLN1 GENE,48.0,31.2,12.0,48.0,37
HCPCS,81290,MCOLN1 GENE,,,33.97,33.97,1
HCPCS,812900,MCOLN1 GENE,,,33.97,33.97,1
HCPCS,81291,MTHFR BY PCR,140.0,91.0,22.32,126.0,37
HCPCS,81291,MTHFR BY PCR TEST,136.0,88.4,22.32,122.4,37
HCPCS,81291,MTHFR GENE,,,56.45,56.45,1
HCPCS,81291,MTHRF 2 VARIANTS,255.0,165.75,22.32,229.5,37
HCPCS,812910,MTHFR GENE,,,56.45,56.45,1
HCPCS,81292,MLH1 GENE FULL SEQ,,,583.55,1128.59,15
HCPCS,81292,Mlh1 gene full seq,,,325.19,410.76,6
HCPCS,812920,MLH1 GENE FULL SEQ,,,583.55,583.55,1
HCPCS,81293,MLH1 GENE KNOWN VARIANTS,,,285.98,553.1,15
HCPCS,81293,Mlh1 gene known variants,,,76.88,97.12,6
HCPCS,812930,MLH1 GENE KNOWN VARIANTS,,,285.98,285.98,1
HCPCS,81294,MLH1 GENE DUP/DELETE VARIANT,,,174.87,338.21,15
HCPCS,81294,Mlh1 gene dup/delete variant,,,76.88,97.12,6
HCPCS,812940,MLH1 GENE DUP/DELETE VARIANT,,,174.87,174.87,1
HCPCS,81295,MSH2 GENE FULL SEQ,,,329.79,637.82,15
HCPCS,81295,Msh2 gene full seq,,,170.1,214.86,6
HCPCS,812950,MSH2 GENE FULL SEQ,,,329.79,329.79,1
HCPCS,81296,MSH2 GENE KNOWN VARIANTS,,,291.79,564.35,15
HCPCS,81296,Msh2 gene known variants,,,76.88,97.12,6
HCPCS,812960,MSH2 GENE KNOWN VARIANTS,,,291.79,291.79,1
HCPCS,81297,MSH2 GENE DUP/DELETE VARIANT,,,184.29,356.42,15
HCPCS,81297,Msh2 gene dup/delete variant,,,76.88,97.12,6
HCPCS,812970,MSH2 GENE DUP/DELETE VARIANT,,,184.29,184.29,1
HCPCS,81298,MSH6 GENE FULL SEQ,,,554.56,1072.53,15
HCPCS,81298,Msh6 gene full seq,,,325.19,410.76,6
HCPCS,812980,MSH6 GENE FULL SEQ,,,554.56,554.56,1
HCPCS,81299,MSH6 GENE KNOWN VARIANTS,,,266.11,514.67,15
HCPCS,81299,Msh6 gene known variants,,,76.88,97.12,6
HCPCS,812990,MSH6 GENE KNOWN VARIANTS,,,266.11,266.11,1
HCPCS,81300,MSH6 GENE DUP/DELETE VARIANT,,,205.63,397.7,15
HCPCS,81300,Msh6 gene dup/delete variant,,,76.88,97.12,6
HCPCS,813000,MSH6 GENE DUP/DELETE VARIANT,,,205.63,205.63,1
HCPCS,81301,MICROSATELLITE INSTABILITY,,,301.16,301.16,1
HCPCS,81301,MICROSATELLITE INSTABILITY (MSICCT),437.0,284.05,76.88,437.0,37
HCPCS,81301,MICROSATELLITE INSTABILITY DET (MSIID),696.0,452.4,76.88,626.4,37
HCPCS,813010,MICROSATELLITE INSTABILITY,,,301.16,301.16,1
HCPCS,81302,MECP2 GENE FULL SEQ,,,456.08,456.08,1
HCPCS,81302,RETTFG MECP2 GENE FULL SEQ,1836.0,1193.4,170.1,1652.4,37
HCPCS,813020,MECP2 GENE FULL SEQ,,,456.08,456.08,1
HCPCS,81303,MECP2 GENE KNOWN VARIANT,,,103.68,200.52,15
HCPCS,81303,Mecp2 gene known variant,,,22.32,28.19,6
HCPCS,813030,MECP2 GENE KNOWN VARIANT,,,103.68,103.68,1
HCPCS,81304,MECP2 GENE DUP/DELET VARIANT,,,129.6,129.6,1
HCPCS,81304,RETTFG MECP2 GENE DUP/DELET VARIANT,521.0,338.65,76.88,468.9,37
HCPCS,813040,MECP2 GENE DUP/DELET VARIANT,,,129.6,129.6,1
HCPCS,81305,MYD88 GENE P.LEU265PRO VRNT,,,151.55,151.55,1
HCPCS,81305,MYD88 L265P MUT ANLS,867.0,563.55,76.88,780.3,37
HCPCS,81305,MYD88 L265P MUT ANLS BM,1007.0,654.55,76.88,906.3,37
HCPCS,81305,MYD88 L265P MUT ANLS OTH,1007.0,654.55,76.88,906.3,37
HCPCS,813050,MYD88 GENE P.LEU265PRO VRNT,,,151.55,151.55,1
HCPCS,81306,NUDT15 GENE COMMON VARIANTS,,,251.74,486.86,15
HCPCS,81306,Nudt15 gene common variants,,,76.88,97.12,6
HCPCS,813060,NUDT15 GENE COMMON VARIANTS,,,251.74,251.74,1
HCPCS,81307,PALB2 GENE FULL GENE SEQ,,,584.5,1130.43,15
HCPCS,81307,Palb2 gene full gene seq,,,325.19,410.76,6
HCPCS,813070,PALB2 GENE FULL GENE SEQ,,,584.5,584.5,1
HCPCS,81308,PALB2 GENE KNOWN FAMIL VRNT,,,260.37,503.56,15
HCPCS,81308,Palb2 gene known famil vrnt,,,76.88,97.12,6
HCPCS,813080,PALB2 GENE KNOWN FAMIL VRNT,,,260.37,260.37,1
HCPCS,81309,PIK3CA GENE TRGT SEQ ALYS,,,237.45,459.24,15
HCPCS,81309,Pik3ca gene trgt seq alys,,,76.88,97.12,6
HCPCS,813090,PIK3CA GENE TRGT SEQ ALYS,,,237.45,237.45,1
HCPCS,81310,NMP1 MUTATION DETECTION BY RT-PCR,678.0,440.7,76.88,610.2,37
HCPCS,81310,NPM1 GENE,425.0,276.25,76.88,411.93,38
HCPCS,81310,NPM1 GENE ANALYSIS BM,493.0,320.45,76.88,443.7,37
HCPCS,81310,NPM1 GENE ANALYSIS OTHER,493.0,320.45,76.88,443.7,37
HCPCS,81310,NPM1 GENE ANALYSIS PB,493.0,320.45,76.88,443.7,37
HCPCS,813100,NPM1 GENE,,,213.0,213.0,1
HCPCS,81311,%NGSCOL NRAS,506.0,328.9,76.88,494.27,37
HCPCS,81311,%NGSMEL NRAS,470.0,305.5,76.88,470.0,37
HCPCS,81311,%NRAST BY PYROSEQ,913.0,593.45,76.88,821.7,37
HCPCS,81311,NGSCCY NRAS,506.0,328.9,76.88,494.27,37
HCPCS,81311,NGSMCY NRAS,506.0,328.9,76.88,494.27,37
HCPCS,81311,NRAS GENE VARIANTS EXON 2&3,374.0,243.1,76.88,374.0,38
HCPCS,813110,NRAS GENE VARIANTS EXON 2&3,,,255.56,255.56,1
HCPCS,81312,OPMD DNA TEST,605.0,393.25,76.88,544.5,37
HCPCS,81312,PABPN1 GENE DETC ABNOR ALLEL,,,118.37,118.37,1
HCPCS,813120,PABPN1 GENE DETC ABNOR ALLEL,,,118.37,118.37,1
HCPCS,81313,PCA3/KLK3 ANTIGEN,866.0,562.9,76.88,779.4,38
HCPCS,813130,PCA3/KLK3 ANTIGEN,,,220.36,220.36,1
HCPCS,81314,GISTCY PDGFRA GENE,872.0,566.8,76.88,784.8,37
HCPCS,81314,PDGFRA GENE,,,284.7,284.7,1
HCPCS,813140,PDGFRA GENE,,,284.7,284.7,1
HCPCS,81315,APLPCR RTPCR TEST,1430.0,929.5,76.88,1287.0,37
HCPCS,81315,PML/RARALPHA COM BREAKPOINTS,,,179.12,179.12,1
HCPCS,813150,PML/RARALPHA COM BREAKPOINTS,,,179.12,179.12,1
HCPCS,81316,PML/RARALPHA 1 BREAKPOINT,,,179.12,346.42,15
HCPCS,81316,Pml/raralpha 1 breakpoint,,,76.88,97.12,6
HCPCS,813160,PML/RARALPHA 1 BREAKPOINT,,,179.12,179.12,1
HCPCS,81317,PMS2 GENE FULL SEQ ANALYSIS,,,584.5,1130.43,15
HCPCS,81317,Pms2 gene full seq analysis,,,325.19,410.76,6
HCPCS,813170,PMS2 GENE FULL SEQ ANALYSIS,,,584.5,584.5,1
HCPCS,81318,PMS2 KNOWN FAMILIAL VARIANTS,,,285.98,553.1,15
HCPCS,81318,Pms2 known familial variants,,,76.88,97.12,6
HCPCS,813180,PMS2 KNOWN FAMILIAL VARIANTS,,,285.98,285.98,1
HCPCS,81319,PMS2 GENE DUP/DELET VARIANTS,,,175.82,340.05,15
HCPCS,81319,Pms2 gene dup/delet variants,,,76.88,97.12,6
HCPCS,813190,PMS2 GENE DUP/DELET VARIANTS,,,175.82,175.82,1
HCPCS,81320,PLCG2 GENE ANALYSIS,666.0,432.9,76.88,599.4,37
HCPCS,81320,PLCG2 GENE COMMON VARIANTS,,,251.74,251.74,1
HCPCS,813200,PLCG2 GENE COMMON VARIANTS,,,251.74,251.74,1
HCPCS,81321,PTEN ANALYSIS TEST,2225.0,1446.25,325.19,2002.5,37
HCPCS,81321,PTEN GENE FULL SEQUENCE,,,518.4,518.4,1
HCPCS,813210,PTEN GENE FULL SEQUENCE,,,518.4,518.4,1
HCPCS,81322,PTEN GENE KNOWN FAM VARIANT,,,40.26,77.87,15
HCPCS,81322,Pten gene known fam variant,,,22.32,28.19,6
HCPCS,813220,PTEN GENE KNOWN FAM VARIANT,,,40.26,40.26,1
HCPCS,81323,PTEN GENE DUP/DELET VARIANT,,,259.2,501.3,15
HCPCS,81323,Pten gene dup/delet variant,,,76.88,97.12,6
HCPCS,813230,PTEN GENE DUP/DELET VARIANT,,,259.2,259.2,1
HCPCS,81324,PMP22,2186.0,1420.9,325.19,1967.4,37
HCPCS,81324,PMP22 GENE DUP/DELET,,,655.23,655.23,1
HCPCS,813240,PMP22 GENE DUP/DELET,,,655.23,655.23,1
HCPCS,81325,PMP22 GENE FULL SEQUENCE,,,664.91,1285.97,15
HCPCS,81325,Pmp22 gene full sequence,,,325.19,410.76,6
HCPCS,813250,PMP22 GENE FULL SEQUENCE,,,664.91,664.91,1
HCPCS,81326,PMP22 GENE KNOWN FAM VARIANT,,,40.26,77.87,15
HCPCS,81326,Pmp22 gene known fam variant,,,22.32,28.19,6
HCPCS,813260,PMP22 GENE KNOWN FAM VARIANT,,,40.26,40.26,1
HCPCS,81327,SEPT9 GEN PRMTR MTHYLTN ALYS,,,165.89,320.83,15
HCPCS,81327,Sept9 gen prmtr mthyltn alys,,,76.88,97.12,6
HCPCS,813270,SEPT9 GEN PRMTR MTHYLTN ALYS,,,165.89,165.89,1
HCPCS,81328,SLCO1B1 GENE COM VARIANTS,,,151.04,292.11,15
HCPCS,81328,Slco1b1 gene com variants,,,76.88,97.12,6
HCPCS,813280,SLCO1B1 GENE COM VARIANTS,,,151.04,151.04,1
HCPCS,81329,CSPNL SMN1 GENE DOS/DEL,166.0,107.9,41.5,166.0,37
HCPCS,81329,SMA CARRIER SCRN DIAG,606.0,393.9,76.88,545.4,37
HCPCS,81329,SMN1 GENE DOS/DELETION ALYS,,,118.37,118.37,1
HCPCS,813290,SMN1 GENE DOS/DELETION ALYS,,,118.37,118.37,1
HCPCS,81330,%AJPWO NIEMANN PICK,130.0,84.5,22.32,117.0,37
HCPCS,81330,CSPNL SMPD1 GENE COMMON VARS,57.0,37.05,14.25,57.0,37
HCPCS,81330,SMPD1 GENE COMMON VARIANTS,,,40.61,40.61,1
HCPCS,813300,SMPD1 GENE COMMON VARIANTS,,,40.61,40.61,1
HCPCS,81331,PRADER-WILLI METH,906.0,588.9,22.32,815.4,37
HCPCS,81331,SNRPN/UBE3A GENE,,,44.13,44.13,1
HCPCS,813310,SNRPN/UBE3A GENE,,,44.13,44.13,1
HCPCS,81332,%HA1AT SERPINA1 GENE ANLY,79.0,51.35,19.75,72.94,37
HCPCS,81332,%SERPINA1 GENE ANALYSIS,374.0,243.1,22.32,336.6,37
HCPCS,81332,SERPINA1 GENE,78.5,51.025,19.25,72.94,75
HCPCS,81332,SERPINA1 TARG MUT BY SANGER SEQ,301.0,195.65,22.32,270.9,37
HCPCS,813320,SERPINA1 GENE,,,37.71,37.71,1
HCPCS,81333,TGFBI GENE COMMON VARIANTS,,,118.37,228.93,15
HCPCS,81333,Tgfbi gene common variants,,,76.88,97.12,6
HCPCS,813330,TGFBI GENE COMMON VARIANTS,,,118.37,118.37,1
HCPCS,81334,RUNX1 GENE TARGETED SEQ ALYS,,,284.7,550.61,15
HCPCS,81334,Runx1 gene targeted seq alys,,,76.88,97.12,6
HCPCS,813340,RUNX1 GENE TARGETED SEQ ALYS,,,284.7,284.7,1
HCPCS,81335,TPMT GENE COM VARIANTS,,,151.04,151.04,1
HCPCS,81335,TPMT GENOTYPE ASSAY,613.0,398.45000000000005,76.88,557.1,74
HCPCS,813350,TPMT GENE COM VARIANTS,,,151.04,151.04,1
HCPCS,81336,SMN1 GENE FULL GENE SEQUENCE,,,260.37,503.56,15
HCPCS,81336,Smn1 gene full gene sequence,,,76.88,97.12,6
HCPCS,813360,SMN1 GENE FULL GENE SEQUENCE,,,260.37,260.37,1
HCPCS,81337,SMN1 GEN NOWN FAMIL SEQ VRNT,,,160.01,309.47,15
HCPCS,81337,Smn1 gen nown famil seq vrnt,,,76.88,97.12,6
HCPCS,813370,SMN1 GEN NOWN FAMIL SEQ VRNT,,,160.01,160.01,1
HCPCS,81338,MPL GENE COMMON VARIANTS,,,129.88,129.88,1
HCPCS,81338,MPL MUTATION ANSYS BLD,1434.0,932.1,76.88,1290.6,37
HCPCS,81338,MPL MUTATION ANSYS BM,1434.0,932.1,76.88,1290.6,37
HCPCS,813380,MPL GENE COMMON VARIANTS,,,129.88,129.88,1
HCPCS,81339,MPL GENE ANALYSIS,1278.0,830.7,76.88,1150.2,37
HCPCS,81339,MPL GENE SEQ ALYS EXON 10,,,160.01,160.01,1
HCPCS,813390,MPL GENE SEQ ALYS EXON 10,,,160.01,160.01,1
HCPCS,81340,*TRB@GENE REARRANGE AMPLIFY,515.0,334.75,76.88,463.5,37
HCPCS,81340,TCBMD II TEST,1454.0,945.1,76.88,1308.6,37
HCPCS,81340,TCBMDM GENE REARRANGE AMP,1466.0,952.9,76.88,1319.4,37
HCPCS,81340,TCBMDO GENE REARRANGE AMP,1466.0,952.9,76.88,1319.4,37
HCPCS,81340,TCRB TEST,1511.0,982.15,76.88,1359.9,37
HCPCS,81340,TCRBM GENE REARRANGE AMP,1466.0,952.9,76.88,1319.4,37
HCPCS,81340,TCRBO GENE REARRANGE AMP,1466.0,952.9,76.88,1319.4,37
HCPCS,81340,TRB@ GENE REARRANGE AMPLIFY,,,180.51,180.51,1
HCPCS,813400,TRB@ GENE REARRANGE AMPLIFY,,,180.51,180.51,1
HCPCS,81341,*TRB@ GENE REARRANGE DIRPROBE,182.0,118.3,22.32,163.8,37
HCPCS,81341,TRB@ GENE REARRANGE DIRPROBE,,,42.84,42.84,1
HCPCS,813410,TRB@ GENE REARRANGE DIRPROBE,,,42.84,42.84,1
HCPCS,81342,*TRG GENE REARRANGEMENT ANAL,515.0,334.75,76.88,463.5,37
HCPCS,81342,T GAMMA TEST,1323.5,860.275,76.88,1414.8,74
HCPCS,81342,TCBMDM GENE REARRANGE ANAL,1466.0,952.9,76.88,1319.4,37
HCPCS,81342,TCBMDO GENE REARRANGE ANAL,1466.0,952.9,76.88,1319.4,37
HCPCS,81342,TCRGM GENE REARRANGE ANAL,1466.0,952.9,76.88,1319.4,37
HCPCS,81342,TCRGO GENE REARRANGE ANAL,1466.0,952.9,76.88,1319.4,37
HCPCS,81342,TRG GENE REARRANGEMENT ANAL,321.5,208.97500000000002,70.25,336.71,75
HCPCS,813420,TRG GENE REARRANGEMENT ANAL,,,174.1,174.1,1
HCPCS,81343,PPP2R2B GEN DETC ABNOR ALLEL,,,118.37,228.93,15
HCPCS,81343,Ppp2r2b gen detc abnor allel,,,76.88,97.12,6
HCPCS,813430,PPP2R2B GEN DETC ABNOR ALLEL,,,118.37,118.37,1
HCPCS,81344,SCA17 DNA TEST,806.0,523.9,76.88,725.4,37
HCPCS,81344,TBP GENE DETC ABNOR ALLELES,,,118.37,118.37,1
HCPCS,813440,TBP GENE DETC ABNOR ALLELES,,,118.37,118.37,1
HCPCS,81345,TERT GENE TARGETED SEQ ALYS,,,160.01,309.47,15
HCPCS,81345,Tert gene targeted seq alys,,,76.88,97.12,6
HCPCS,813450,TERT GENE TARGETED SEQ ALYS,,,160.01,160.01,1
HCPCS,81346,TYMS GENE COM VARIANTS,,,151.04,292.11,15
HCPCS,81346,Tyms gene com variants,,,76.88,97.12,6
HCPCS,813460,TYMS GENE COM VARIANTS,,,151.04,151.04,1
HCPCS,81347,SF3B1 GENE COMMON VARIANTS,,,166.97,166.97,1
HCPCS,81347,SF3B1 MUTATION ANALYS BLD,2294.0,1491.1,76.88,2064.6,37
HCPCS,81347,SF3B1 MUTATION ANALYS BM,2294.0,1491.1,76.88,2064.6,37
HCPCS,813470,SF3B1 GENE COMMON VARIANTS,,,166.97,166.97,1
HCPCS,81348,SRSF2 GENE COMMON VARIANTS,,,151.55,293.09,15
HCPCS,81348,Srsf2 gene common variants,,,76.88,97.12,6
HCPCS,813480,SRSF2 GENE COMMON VARIANTS,,,151.55,151.55,1
HCPCS,81349,CYTOG ALYS CHRML ABNR LW-PS,,,1035.02,2001.76,15
HCPCS,81349,Cytog alys chrml abnr lw-ps,,,1109.84,1401.9,6
HCPCS,813490,CYTOG ALYS CHRML ABNR LW-PS,,,1035.02,1035.02,1
HCPCS,81350,DUPNL UGT1A1 GENE COMMON VARIANTS,443.0,287.95,76.88,398.7,37
HCPCS,81350,UGT1A1 GENE COMMON VARIANTS,,,202.18,202.18,1
HCPCS,81350,UGT1A1 GENOTYPING,363.0,235.95,76.88,363.0,37
HCPCS,81350,UGT1A1 GENOTYPING ANALYSIS ONLY,363.0,235.95,76.88,363.0,37
HCPCS,81350,UGT1A1 TARG MUT DET BY SANGER,1615.0,1049.75,76.88,1453.5,37
HCPCS,813500,UGT1A1 GENE COMMON VARIANTS,,,202.18,202.18,1
HCPCS,81351,FULL GENE SEQUENCE ANALYSIS OF THE TP53 (TUMOR PROTEIN 53) GENE,1571.0,1021.15,325.19,1413.9,37
HCPCS,81351,TP53 GENE FULL GENE SEQUENCE,,,554.56,554.56,1
HCPCS,81351,TP53 SOMATIC MUT PROG,1571.0,1021.15,325.19,1413.9,37
HCPCS,813510,TP53 GENE FULL GENE SEQUENCE,,,554.56,554.56,1
HCPCS,81352,TP53 GENE TRGT SEQUENCE ALYS,,,284.7,284.7,1
HCPCS,81352,"TP53 SOMATIC MUT, PROGNOSTIC",1414.0,919.1,76.88,1272.6,74
HCPCS,813520,TP53 GENE TRGT SEQUENCE ALYS,,,284.7,284.7,1
HCPCS,81353,TP53 GENE KNOWN FAMIL VRNT,,,266.11,514.67,15
HCPCS,81353,Tp53 gene known famil vrnt,,,76.88,97.12,6
HCPCS,813530,TP53 GENE KNOWN FAMIL VRNT,,,266.11,266.11,1
HCPCS,81354,CYTOG ALYS CHRML ABNOR OGM,,,1091.7,1389.88,5
HCPCS,81354,Cytog alys chrml abnor ogm,,,22.32,28.19,6
HCPCS,813540,CYTOG ALYS CHRML ABNOR OGM,,,1091.7,1091.7,1
HCPCS,81355,VKORC1 GENE,,,76.2,76.2,1
HCPCS,81355,VKORCI GENE (WARSEN),351.0,228.15,22.32,315.9,37
HCPCS,81355,WRFSEN TPMT GENE VAR,141.0,91.65,22.32,141.0,37
HCPCS,813550,VKORC1 GENE,,,76.2,76.2,1
HCPCS,81357,U2AF1 GENE COMMON VARIANTS,,,166.97,322.92,15
HCPCS,81357,U2af1 gene common variants,,,76.88,97.12,6
HCPCS,813570,U2AF1 GENE COMMON VARIANTS,,,166.97,166.97,1
HCPCS,81360,ZRSR2 GENE COMMON VARIANTS,,,166.97,322.92,15
HCPCS,81360,Zrsr2 gene common variants,,,76.88,97.12,6
HCPCS,813600,ZRSR2 GENE COMMON VARIANTS,,,166.97,166.97,1
HCPCS,81361,HBB GENE COM VARIANTS,,,151.04,292.11,15
HCPCS,81361,Hbb gene com variants,,,76.88,97.12,6
HCPCS,813610,HBB GENE COM VARIANTS,,,151.04,151.04,1
HCPCS,81362,HBB GENE KNOWN FAM VARIANT,,,324.22,627.04,15
HCPCS,81362,Hbb gene known fam variant,,,170.1,214.86,6
HCPCS,813620,HBB GENE KNOWN FAM VARIANT,,,324.22,324.22,1
HCPCS,81363,HBB GENE DUP/DEL VARIANTS,,,174.87,338.21,15
HCPCS,81363,Hbb gene dup/del variants,,,76.88,97.12,6
HCPCS,813630,HBB GENE DUP/DEL VARIANTS,,,174.87,174.87,1
HCPCS,81364,HBB FULL GENE SEQUENCE,,,280.43,280.43,1
HCPCS,81364,HBB GENE SEQUENCING,1051.0,683.15,76.88,945.9,37
HCPCS,813640,HBB FULL GENE SEQUENCE,,,280.43,280.43,1
HCPCS,81370,HLA 1 & II TYPING LR,1164.0,756.6,170.1,1047.6,37
HCPCS,81370,HLA I & II TYPING LR,1164.0,756.6,170.1,1047.6,38
HCPCS,81370,"HLA-A,B,C,DR,DQ,DRB345_RT-PCR",2361.0,1534.65,170.1,2124.9,37
HCPCS,81370,"HLA-A,B,CW,DR,DQ,DRB345-RSSOP",1164.0,756.6,170.1,1047.6,37
HCPCS,81370,SOLID ORGAN NGS FEE,1417.0,921.05,170.1,1275.3,37
HCPCS,813700,HLA I & II TYPING LR,,,347.44,347.44,1
HCPCS,81371,HLA I & II TYPE VERIFY LR,,,349.51,349.51,1
HCPCS,81371,"HLA-A-B,CW,DR,DQ,DRB345-RSSOP-Q9 VERIF",1327.0,862.55,170.1,1194.3,37
HCPCS,813710,HLA I & II TYPE VERIFY LR,,,349.51,349.51,1
HCPCS,81372,*HLA I TYPING COMPLETE LR,565.0,367.25,141.25,565.0,37
HCPCS,81372,HLA I TYPING COMPLETE LR,629.0,408.85,157.25,629.0,38
HCPCS,81372,HLABC TEST,1498.0,973.7,170.1,1348.2,37
HCPCS,81372,"PLATELET RECIP HLA A,B TYPING",1469.0,954.85,170.1,1322.1,37
HCPCS,813720,HLA I TYPING COMPLETE LR,,,348.7,348.7,1
HCPCS,81373,HLA I TYPING 1 LOCUS LR,,,110.1,110.1,1
HCPCS,81373,HLA-B51,826.0,536.9,22.32,743.4,37
HCPCS,813730,HLA I TYPING 1 LOCUS LR,,,110.1,110.1,1
HCPCS,81374,%HLAA29 TEST,883.0,573.95,22.32,794.7,37
HCPCS,81374,B27PCR TEST,628.0,408.2,22.32,565.2,37
HCPCS,81374,HLA I TYPING 1 ANTIGEN LR,,,64.22,64.22,1
HCPCS,81374,HLA-B58,883.0,573.95,22.32,794.7,37
HCPCS,813740,HLA I TYPING 1 ANTIGEN LR,,,64.22,64.22,1
HCPCS,81375,*HLA II TYPING AG EQUIV LR,382.0,248.3,76.88,368.86,37
HCPCS,81375,HLA II TYPING AG EQUIV LR,,,190.72,190.72,1
HCPCS,813750,HLA II TYPING AG EQUIV LR,,,190.72,190.72,1
HCPCS,81376,*HLA II TYPING 1 LOCUS LR,545.0,354.25,22.32,490.5,37
HCPCS,81376,HLA II TYPING 1 LOCUS LR,454.0,295.1,22.32,566.1,112
HCPCS,81376,HLADR TEST,729.0,473.85,22.32,656.1,37
HCPCS,813760,HLA II TYPING 1 LOCUS LR,,,105.6,105.6,1
HCPCS,81377,HLA II TYPE 1 AG EQUIV LR,,,81.85,158.31,15
HCPCS,81377,Hla ii type 1 ag equiv lr,,,22.32,28.19,6
HCPCS,813770,HLA II TYPE 1 AG EQUIV LR,,,81.85,81.85,1
HCPCS,81378,HLA I & II TYPING HR,,,298.58,298.58,1
HCPCS,81378,"HLA-A,B,CW,DR,DQ,DP-NGS-BMT",1341.0,871.65,76.88,1206.9,37
HCPCS,813780,HLA I & II TYPING HR,,,298.58,298.58,1
HCPCS,81379,HLA I TYPING COMPLETE HR,,,289.76,560.42,15
HCPCS,81379,Hla i typing complete hr,,,76.88,97.12,6
HCPCS,813790,HLA I TYPING COMPLETE HR,,,289.76,289.76,1
HCPCS,81380,HLA I TYPING 1 LOCUS HR,471.0,306.15,76.88,423.9,38
HCPCS,813800,HLA I TYPING 1 LOCUS HR,,,153.14,153.14,1
HCPCS,81381,"HLA ALLELE, EA",681.0,442.65,76.88,612.9,37
HCPCS,81381,HLA B5701,667.0,433.55,76.88,600.3,37
HCPCS,81381,HLA I TYPING 1 ALLELE HR,318.0,206.7,76.88,286.2,38
HCPCS,81381,HLA-B*15:02,1062.0,690.3,76.88,955.8,37
HCPCS,813810,HLA I TYPING 1 ALLELE HR,,,146.79,146.79,1
HCPCS,81382,%CELCMP HLADQ2 TEST,535.0,347.75,22.32,481.5,37
HCPCS,81382,%CELCMP HLADQ8 TEST,164.0,106.6,22.32,164.0,37
HCPCS,81382,CELIAC GLUTEN FREE PANEL X2,476.0,309.4,22.32,428.4,37
HCPCS,81382,COMPREHENSIVE CELIAC PANEL 81382,271.0,176.15,22.32,243.9,37
HCPCS,81382,DPB1 LOCUS HI RES SBT,653.0,424.45,22.32,587.7,37
HCPCS,81382,HLA II TYPING 1 LOC HR,,,106.86,106.86,1
HCPCS,81382,HLADQ2 TEST,571.0,371.15,22.32,513.9,37
HCPCS,81382,HLADQ8 TEST,571.0,371.15,22.32,513.9,37
HCPCS,81382,NARCOLEPSY GENOTYPING (HLADQB1* 06:02),309.0,200.85,22.32,278.1,37
HCPCS,813820,HLA II TYPING 1 LOC HR,,,106.86,106.86,1
HCPCS,81383,HLA II TYPING 1 ALLELE HR,446.0,289.9,22.32,401.4,38
HCPCS,813830,HLA II TYPING 1 ALLELE HR,,,94.28,94.28,1
HCPCS,81400,%AJPWO MOL PATH LVL 1,176.0,114.4,22.32,158.4,37
HCPCS,81400,AJPNL MOPATH PROC LVL 1,79.0,51.35,19.75,79.0,37
HCPCS,81400,CSPNL MOPATH PROC LVL 1,79.0,51.35,19.75,79.0,37
HCPCS,81400,DYSTONIA DNA TEST,1571.0,1021.15,22.32,1413.9,37
HCPCS,81400,MOPATH PROCEDURE LEVEL 1,465.0,302.25,22.32,685.8,75
HCPCS,81400,PAIGEN TEST,217.0,141.05,22.32,195.3,37
HCPCS,814000,MOPATH PROCEDURE LEVEL 1,,,55.26,55.26,1
HCPCS,81401,%AJPWO MOL PATH LVL 2,377.0,245.05,76.88,339.3,37
HCPCS,81401,AJPNL MOPATH PROC LVL 2,167.0,108.55,41.75,167.0,37
HCPCS,81401,APOE GENOTYPING ALZHEIMER,486.0,315.9,76.88,437.4,37
HCPCS,81401,APOEG TEST,179.0,116.35,44.75,179.0,37
HCPCS,81401,CBFB-MYH11 INV(16),888.0,577.2,76.88,799.2,37
HCPCS,81401,CROHN TEST,691.0,449.15,76.88,621.9,37
HCPCS,81401,CSPNL MOPATH PROC LVL 2,167.0,108.55,41.75,167.0,37
HCPCS,81401,FRIED TEST,950.0,617.5,76.88,855.0,37
HCPCS,81401,LHON TEST,2059.0,1338.35,76.88,1853.1,37
HCPCS,81401,MOLEC PATH LEVEL II,1278.0,830.7,76.88,1150.2,37
HCPCS,81401,MOPATH PROCEDURE LEVEL 2,689.5,448.175,43.5,1310.4,223
HCPCS,81401,RUNX1-RUNX1T1,888.0,577.2,76.88,799.2,37
HCPCS,81401,SCA1 DNA TEST,629.0,408.85,76.88,566.1,37
HCPCS,81401,SCA17 TEST,836.0,543.4,76.88,752.4,37
HCPCS,81401,SCA2 DNA TEST,675.0,438.75,76.88,607.5,37
HCPCS,81401,SCA3 DNA TEST,651.0,423.15,76.88,585.9,37
HCPCS,814010,MOPATH PROCEDURE LEVEL 2,,,118.37,118.37,1
HCPCS,81402,%CYP21A2 COMMON VARI,1309.0,850.85,76.88,1178.1,37
HCPCS,81402,MOPATH PROCEDURE LEVEL 3,,,129.88,129.88,1
HCPCS,814020,MOPATH PROCEDURE LEVEL 3,,,129.88,129.88,1
HCPCS,81403,*MOPATH PROCEDURE LEVEL 4,311.0,202.15,76.88,309.47,37
HCPCS,81403,ARC ABO COM ALL DETERMIN,557.0,362.05,76.88,501.3,37
HCPCS,81403,ARC ABO VARIANTS,807.0,524.55,76.88,726.3,37
HCPCS,81403,CSF3R MUTATION ANLYS BLD,2294.0,1491.1,76.88,2064.6,37
HCPCS,81403,CSF3R MUTATION ANLYS BM,2294.0,1491.1,76.88,2064.6,37
HCPCS,81403,JAKNON TEST,758.0,492.7,76.88,682.2,37
HCPCS,81403,MCADD TEST,343.0,222.95,76.88,309.47,37
HCPCS,81403,MOPATH PROCEDURE LEVEL 4,455.0,295.75,57.75,1078.2,223
HCPCS,81403,MPL MUTATION ANLYS BLD,1175.0,763.75,76.88,1057.5,37
HCPCS,81403,MPL TEST,1434.0,932.1,76.88,1290.6,37
HCPCS,81403,PARD UNLISTED MOL PATH,463.0,300.95,76.88,416.7,37
HCPCS,81403,RED CELL GENOTYPING,397.0,258.05,76.88,357.3,37
HCPCS,81403,RHCE VARIANT ANTIGEN,645.0,419.25,76.88,580.5,37
HCPCS,81403,SANGER SEQ DNA BLD,1278.0,830.7,76.88,1150.2,37
HCPCS,81403,SANGER SEQ DNA OTHER,1278.0,830.7,76.88,1150.2,37
HCPCS,81403,SANGER SEQ RNA BLD,1278.0,830.7,76.88,1150.2,37
HCPCS,81403,SANGER SEQ RNA BONE MARROW,1278.0,830.7,76.88,1150.2,37
HCPCS,81403,SANGER SQ DNA BONE MARROW,1278.0,830.7,76.88,1150.2,37
HCPCS,81403,SF3B1 MUTATION ANLYS BLD,2294.0,1491.1,76.88,2064.6,37
HCPCS,81403,SF3B1 MUTATION ANLYS BM,2294.0,1491.1,76.88,2064.6,37
HCPCS,81403,UBA1 MUT DET BY DDPCR BLOOD,463.0,300.95,76.88,416.7,37
HCPCS,81403,UBA1 MUT DET BY DDPCR BONE MARROW,463.0,300.95,76.88,416.7,37
HCPCS,81403,UBA1 MUT DET BY DDPCR OTHER,463.0,300.95,76.88,416.7,37
HCPCS,81403,UBA1 MUTATION TESTING FOR VEXAS SYNDROME,3443.0,2237.95,76.88,3098.7,37
HCPCS,81403,UBA1 TARG MUT DET BY SANGER BM,1278.0,830.7,76.88,1150.2,37
HCPCS,81403,UBA1 TARG MUT DET BY SANGER OTHER,1278.0,830.7,76.88,1150.2,37
HCPCS,81403,UGTA1 TARG MUT DET BY SANGER BLD,1278.0,830.7,76.88,1150.2,37
HCPCS,81403,VWF TYPE 2A EX 28,762.0,495.3,76.88,685.8,37
HCPCS,81403,XCISE AMPD1 TEST,524.0,340.6,76.88,471.6,37
HCPCS,81403,YCMICR TEST,318.0,206.7,76.88,309.47,37
HCPCS,814030,MOPATH PROCEDURE LEVEL 4,,,160.01,160.01,1
HCPCS,81404,%PANCPL PRSS1,1241.0,806.65,76.88,1116.9,37
HCPCS,81404,%PANCPL SPINK1,1241.0,806.65,76.88,1116.9,37
HCPCS,81404,*MOPATH PROCEDURE LEVEL 5,959.5,623.6750000000001,76.88,1418.4,74
HCPCS,81404,*MOPATH PROCEDURE LEVEL5,1208.0,785.2,76.88,1087.2,37
HCPCS,81404,CPT2 TEST,1940.0,1261.0,76.88,1746.0,37
HCPCS,81404,FAMILAL MEDITER FEVER SEQ,1150.0,747.5,76.88,1035.0,37
HCPCS,81404,MOPATH PROCEDURE LEVEL 5,697.0,453.04999999999995,76.88,945.9,75
HCPCS,81404,TTR GENE FULL ANALYSIS,705.0,458.25,76.88,634.5,37
HCPCS,814040,MOPATH PROCEDURE LEVEL 5,,,237.45,237.45,1
HCPCS,81405,%PANCPL MOPATH LVL 6,1241.0,806.65,76.88,1116.9,37
HCPCS,81405,FHHE TEST,4125.0,2681.25,76.88,3712.5,37
HCPCS,81405,MOPATH PROCEDURE LEVEL 6,,,260.37,260.37,1
HCPCS,81405,P53MUT TEST,2770.0,1800.5,76.88,2493.0,37
HCPCS,81405,SHOX DNA DX,1839.0,1195.35,76.88,1655.1,37
HCPCS,81405,SLC2A1 TEST,2283.0,1483.95,76.88,2054.7,37
HCPCS,814050,MOPATH PROCEDURE LEVEL 6,,,260.37,260.37,1
HCPCS,81406,%BTKMUT MOL PATH LVL7,1217.0,791.05,76.88,1095.3,37
HCPCS,81406,BMHSNP MOPATH LVL 7,4275.0,2778.75,76.88,3847.5,37
HCPCS,81406,CADASL TEST,5699.0,3704.35,76.88,5129.1,37
HCPCS,81406,GALACTOSYLCERAMDE,1122.0,729.3,76.88,1009.8,37
HCPCS,81406,MEN2 TEST,583.0,378.95,76.88,524.7,37
HCPCS,81406,MOPATH PROCEDURE LEVEL 7,,,244.4,244.4,1
HCPCS,814060,MOPATH PROCEDURE LEVEL 7,,,244.4,244.4,1
HCPCS,81407,MOPATH PROCEDURE LEVEL 8,,,731.18,1414.12,15
HCPCS,81407,Mopath procedure level 8,,,325.19,410.76,6
HCPCS,814070,MOPATH PROCEDURE LEVEL 8,,,731.18,731.18,1
HCPCS,81408,COLA12 COL1A2 TEST,2456.0,1596.4,614.0,2456.0,37
HCPCS,81408,MOPATH PROCEDURE LEVEL 9,,,1728.0,1728.0,1
HCPCS,81408,VWFSEQ VON WILLEBRAND DISEASE SEQ,3207.0,2084.55,801.75,3207.0,37
HCPCS,814080,MOPATH PROCEDURE LEVEL 9,,,1728.0,1728.0,1
HCPCS,81410,AORTIC DYSFUNCTION/DILATION,,,435.46,842.18,15
HCPCS,81410,Aortic dysfunction/dilation,,,170.1,214.86,6
HCPCS,814100,AORTIC DYSFUNCTION/DILATION,,,435.46,435.46,1
HCPCS,81411,AORTIC DYSFUNCTION/DILATION,,,1166.56,2256.17,15
HCPCS,81411,Aortic dysfunction/dilation,,,1109.84,1401.9,6
HCPCS,814110,AORTIC DYSFUNCTION/DILATION,,,1166.56,1166.56,1
HCPCS,81412,ASHKENAZI JEWISH ASSOC DIS,,,2115.56,4091.54,15
HCPCS,81412,Ashkenazi jewish assoc dis,,,1109.84,1401.9,6
HCPCS,814120,ASHKENAZI JEWISH ASSOC DIS,,,2115.56,2115.56,1
HCPCS,81413,CAR ION CHNNLPATH INC 10 GNS,,,505.35,977.37,15
HCPCS,81413,Car ion chnnlpath inc 10 gns,,,170.1,214.86,6
HCPCS,814130,CAR ION CHNNLPATH INC 10 GNS,,,505.35,505.35,1
HCPCS,81414,CAR ION CHNNLPATH INC 2 GNS,,,505.35,977.37,15
HCPCS,81414,Car ion chnnlpath inc 2 gns,,,170.1,214.86,6
HCPCS,814140,CAR ION CHNNLPATH INC 2 GNS,,,505.35,505.35,1
HCPCS,81415,EXOME SEQUENCE ANALYSIS,,,4129.92,4129.92,1
HCPCS,81415,EXOME SEQUENCING AHUS1,11950.0,7767.5,1109.84,10755.0,37
HCPCS,814150,EXOME SEQUENCE ANALYSIS,,,4129.92,4129.92,1
HCPCS,81416,EXOME SEQUENCE ANALYSIS,,,10368.0,20052.0,15
HCPCS,81416,Exome sequence analysis,,,1109.84,1401.9,6
HCPCS,814160,EXOME SEQUENCE ANALYSIS,,,10368.0,10368.0,1
HCPCS,81417,EXOME RE-EVALUATION,,,276.48,534.72,15
HCPCS,81417,Exome re-evaluation,,,76.88,97.12,6
HCPCS,814170,EXOME RE-EVALUATION,,,276.48,276.48,1
HCPCS,81418,RX METAB GEN SEQ ALYS PNL 6,,,792.35,1532.44,15
HCPCS,81418,Rx metab gen seq alys pnl 6,,,325.19,410.76,6
HCPCS,814180,RX METAB GEN SEQ ALYS PNL 6,,,792.35,792.35,1
HCPCS,81419,EPILEPSY GEN SEQ ALYS PANEL,,,2115.56,4091.54,15
HCPCS,81419,Epilepsy gen seq alys panel,,,1109.84,1401.9,6
HCPCS,814190,EPILEPSY GEN SEQ ALYS PANEL,,,2115.56,2115.56,1
HCPCS,81420,FETAL CHRMOML ANEUPLOIDY,,,655.82,655.82,1
HCPCS,81420,MATERNIT21 PLUS,2650.0,1722.5,325.19,2385.0,37
HCPCS,814200,FETAL CHRMOML ANEUPLOIDY,,,655.82,655.82,1
HCPCS,81422,FETAL CHRMOML MICRODELTJ,,,655.82,1268.37,15
HCPCS,81422,Fetal chrmoml microdeltj,,,325.19,410.76,6
HCPCS,814220,FETAL CHRMOML MICRODELTJ,,,655.82,655.82,1
HCPCS,81425,GENOME SEQUENCE ANALYSIS,,,0.01,8407.14,15
HCPCS,81425,Genome sequence analysis,,,1109.84,1401.9,6
HCPCS,814250,GENOME SEQUENCE ANALYSIS,,,0.01,0.01,1
HCPCS,81426,GENOME SEQUENCE ANALYSIS,,,0.01,4528.33,15
HCPCS,81426,Genome sequence analysis,,,1109.84,1401.9,6
HCPCS,814260,GENOME SEQUENCE ANALYSIS,,,0.01,0.01,1
HCPCS,81427,GENOME RE-EVALUATION,,,0.01,3906.21,15
HCPCS,81427,Genome re-evaluation,,,1109.84,1401.9,6
HCPCS,814270,GENOME RE-EVALUATION,,,0.01,0.01,1
HCPCS,81430,HEARING LOSS SEQUENCE ANALYS,,,1404.0,2715.38,15
HCPCS,81430,Hearing loss sequence analys,,,1109.84,1401.9,6
HCPCS,814300,HEARING LOSS SEQUENCE ANALYS,,,1404.0,1404.0,1
HCPCS,81431,HEARING LOSS DUP/DEL ANALYS,,,587.15,1135.56,15
HCPCS,81431,Hearing loss dup/del analys,,,325.19,410.76,6
HCPCS,814310,HEARING LOSS DUP/DEL ANALYS,,,587.15,587.15,1
HCPCS,81432,HRDTRY BRST CA-RLATD DO 5+,,,586.7,2178.9,15
HCPCS,81432,Hrdtry brst ca-rlatd do 5+,,,325.19,410.76,6
HCPCS,814320,HRDTRY BRST CA-RLATD DO 5+,,,586.7,586.7,1
HCPCS,81433,HRDTRY BRST CA-RLATD DSORDRS,,,676.83,733.45,3
HCPCS,81433,Hrdtry brst ca-rlatd dsordrs,,,170.1,214.86,6
HCPCS,81434,HERED RTA DO GEN SEQ 15,,,516.6,999.11,15
HCPCS,81434,Hered rta do gen seq 15,,,170.1,214.86,6
HCPCS,814340,HERED RTA DO GEN SEQ 15,,,516.6,516.6,1
HCPCS,81435,HERED COLON CA-RLATD DO 5+,,,505.35,2178.9,15
HCPCS,81435,Hered colon ca-rlatd do 5+,,,170.1,214.86,6
HCPCS,814350,HERED COLON CA-RLATD DO 5+,,,505.35,505.35,1
HCPCS,81436,HEREDITARY COLON CA DSORDRS,,,901.92,977.37,3
HCPCS,81436,Hereditary colon ca dsordrs,,,170.1,214.86,6
HCPCS,81437,HERED NEUROEND TUM-RLT DO 5+,,,379.23,2178.9,15
HCPCS,81437,Hered neuroend tum-rlt do 5+,,,170.1,214.86,6
HCPCS,814370,HERED NEUROEND TUM-RLT DO 5+,,,379.23,379.23,1
HCPCS,81438,HEREDTRY NURONDCRN TUM DSRDR,,,676.83,733.45,3
HCPCS,81438,Heredtry nurondcrn tum dsrdr,,,170.1,214.86,6
HCPCS,81439,HRDTRY CARDMYPY GENE PANEL,,,505.35,977.37,15
HCPCS,81439,Hrdtry cardmypy gene panel,,,170.1,214.86,6
HCPCS,814390,HRDTRY CARDMYPY GENE PANEL,,,505.35,505.35,1
HCPCS,81440,MITOCHONDRIAL GENE,,,2871.94,5554.4,15
HCPCS,81440,Mitochondrial gene,,,1109.84,1401.9,6
HCPCS,814400,MITOCHONDRIAL GENE,,,2871.94,2871.94,1
HCPCS,81441,IBMFS SEQ ALYS PNL 30 GENES,,,2115.56,4091.54,15
HCPCS,81441,Ibmfs seq alys pnl 30 genes,,,1109.84,1401.9,6
HCPCS,814410,IBMFS SEQ ALYS PNL 30 GENES,,,2115.56,2115.56,1
HCPCS,81442,NOONAN SPECTRUM DISORDERS,,,1852.07,3581.96,15
HCPCS,81442,Noonan spectrum disorders,,,1109.84,1401.9,6
HCPCS,814420,NOONAN SPECTRUM DISORDERS,,,1852.07,1852.07,1
HCPCS,81443,GENETIC TSTG SEVERE INH COND,,,2115.56,2115.56,1
HCPCS,81443,GENOMIC SEQUENCING AHUS1,6121.0,3978.65,1109.84,5508.9,37
HCPCS,814430,GENETIC TSTG SEVERE INH COND,,,2115.56,2115.56,1
HCPCS,81445,GNMC SEQ ANLYS SOLID ORGAN 5-50 G,743.0,482.95,170.1,743.0,37
HCPCS,81445,HEAD AND NECK NGS,1788.0,1162.2,170.1,1609.2,37
HCPCS,81445,LNG 550 LUNG CANCER GENE PNL,1099.0,714.35,170.1,999.11,37
HCPCS,81445,LNG550 LUNG CANCER GENE PNL,2253.0,1464.45,170.1,2027.7,37
HCPCS,81445,LUNG CANCER HOTSPOT CYTO,2048.0,1331.2,170.1,1843.2,37
HCPCS,81445,NTRK GENE ANALYSIS,3280.0,2132.0,170.1,2952.0,37
HCPCS,81445,SARCOMA FUSION NGS PANEL,3438.0,2234.7,170.1,3094.2,37
HCPCS,81445,SO NEO GSAP 5-50DNA/DNA&RNA,,,516.6,516.6,1
HCPCS,814450,SO NEO GSAP 5-50DNA/DNA&RNA,,,516.6,516.6,1
HCPCS,81448,HRDTRY PERPH NEURPHY PANEL,,,505.35,977.37,15
HCPCS,81448,Hrdtry perph neurphy panel,,,170.1,214.86,6
HCPCS,814480,HRDTRY PERPH NEURPHY PANEL,,,505.35,505.35,1
HCPCS,81449,SO NEO GSAP 5-50 RNA ALYS,,,516.6,999.11,15
HCPCS,81449,So neo gsap 5-50 rna alys,,,1109.84,1401.9,6
HCPCS,814490,SO NEO GSAP 5-50 RNA ALYS,,,516.6,516.6,1
HCPCS,81450,ALLBM ALL PANEL NGS BM,2068.0,1344.2,325.19,1861.2,37
HCPCS,81450,ALLPB ALL PANEL NGS BLD,2068.0,1344.2,325.19,1861.2,37
HCPCS,81450,"B-CELL LYMPHOMA, NGS",3798.0,2468.7,325.19,3418.2,37
HCPCS,81450,GBL MYL NGS 5-50 GENE,1742.0,1132.3,325.19,1567.8,37
HCPCS,81450,GNMC SEQ ANLYS HMTLYMPHD 5-50 G,942.0,612.3,235.5,942.0,37
HCPCS,81450,"HISTIOCYTIC NEOPLASMS, NGS",2279.0,1481.35,325.19,2051.1,37
HCPCS,81450,HL NEO GSAP 5-50DNA/DNA&RNA,,,656.23,656.23,1
HCPCS,81450,MYELOID NGS PANEL,1224.0,795.6,306.0,1224.0,37
HCPCS,81450,NEOTYPE MDS/CMML PROFILE,2244.0,1458.6,325.19,2019.6,37
HCPCS,81450,ONKOSIGHT ADVANCED CHRONIC LYMPHOID NGS PANEL,3038.0,1974.7,325.19,2734.2,37
HCPCS,81450,"T-CELL LYMPHOMA, NGS",3798.0,2468.7,325.19,3418.2,37
HCPCS,81450,TARGETED B-ALL FUS ANLYS,2742.0,1782.3,325.19,2467.8,37
HCPCS,814500,HL NEO GSAP 5-50DNA/DNA&RNA,,,656.23,656.23,1
HCPCS,81451,HL NEO GSAP 5-50 RNA ALYS,,,656.23,1269.17,15
HCPCS,81451,Hl neo gsap 5-50 rna alys,,,325.19,410.76,6
HCPCS,814510,HL NEO GSAP 5-50 RNA ALYS,,,656.23,656.23,1
HCPCS,81455,"ACUTE LEUKEMIA RAPID NGS PANEL, BLOOD",3000.0,1950.0,750.0,3211.56,37
HCPCS,81455,"ACUTE LEUKEMIA RAPID NGS PANEL, BONE MARROW",3000.0,1950.0,750.0,3211.56,37
HCPCS,81455,GNMC SEQ ANLYS 51+ GENES,3581.0,2327.65,895.25,3581.0,37
HCPCS,81455,HDMNGS ACUTE LEUK NGS PNL BM,3000.0,1950.0,750.0,3211.56,37
HCPCS,81455,HDONGS ACUTE LEUK NGS PNL OTHER,3000.0,1950.0,750.0,3211.56,37
HCPCS,81455,HDPNGS ACUTE LEUK NGS PNL BLD,3000.0,1950.0,750.0,3211.56,37
HCPCS,81455,HEMATOLOGIC NEOPLASM NGS BLD,3677.0,2390.05,919.25,3677.0,37
HCPCS,81455,HEMATOLOGIC NEOPLASM NGS MARROW,3677.0,2390.05,919.25,3677.0,37
HCPCS,81455,HFMNGS HN FUSION NGS PNL BLD,1811.0,1177.15,452.75,3211.56,37
HCPCS,81455,HFONGS HN FUSION NGS PNL OTHER,1811.0,1177.15,452.75,3211.56,37
HCPCS,81455,HFPNGS HN FUSION NGS PNL BLD,1811.0,1177.15,452.75,3211.56,37
HCPCS,81455,HNMNGS HN NGS SEQ PANEL BM,1811.0,1177.15,452.75,3211.56,37
HCPCS,81455,HNONGS HN NGS SEQ PANEL OTHER,1811.0,1177.15,452.75,3211.56,37
HCPCS,81455,HNPNGS HN NGS SEQ PANEL P BLD,1811.0,1177.15,452.75,3211.56,37
HCPCS,81455,LPMNGS CHRONIC LYMPHOPRO NGS BM,1811.0,1177.15,452.75,3211.56,37
HCPCS,81455,LPONGS CHRONIC LYMPHOPRO NGS OTHER,1811.0,1177.15,452.75,3211.56,37
HCPCS,81455,LPPNGS CHRONIC LYMPHOPRO NGS P BLD,1811.0,1177.15,452.75,3211.56,37
HCPCS,81455,MYENGS PANEL NGS,5217.0,3391.05,1109.84,4878.65,37
HCPCS,81455,MYNGSM MYELOID PANEL NGS BM,1811.0,1177.15,452.75,3211.56,37
HCPCS,81455,MYNGSO MYELOID PANEL NGS OTHER,1811.0,1177.15,452.75,3211.56,37
HCPCS,81455,MYNGSP MYELOID PANEL NGS P BLD,1811.0,1177.15,452.75,3211.56,37
HCPCS,81455,PAN-SOLID TUMOR NGS,4706.0,3058.9,1109.84,4706.0,37
HCPCS,81455,SARCOMA FUSION NGS,1788.0,1162.2,447.0,3211.56,37
HCPCS,81455,SO/HL 51/>GSAP DNA/DNA&RNA,,,2522.53,2522.53,1
HCPCS,81455,TARGETED ONCOLOGY PANEL - FINE NEEDLE ASPIRATE,4400.0,2860.0,1100.0,4400.0,37
HCPCS,81455,TARGETED ONCOLOGY PANEL LOW PURITY,4400.0,2860.0,1100.0,4400.0,37
HCPCS,81455,"TOPBM TGT ONC NGS, BM",3300.0,2145.0,825.0,3300.0,37
HCPCS,81455,"TOPCY TGT ONC NGS, CYTO",3300.0,2145.0,825.0,3300.0,37
HCPCS,81455,"TOPPB TGT ONC NGS, PER BLD",3300.0,2145.0,825.0,3300.0,37
HCPCS,81455,"TOPTO TGT ONC NGS, OTH",3300.0,2145.0,825.0,3300.0,37
HCPCS,814550,SO/HL 51/>GSAP DNA/DNA&RNA,,,2522.53,2522.53,1
HCPCS,81456,SO/HL 51/>GSAP RNA ALYS,,,2522.53,4878.65,15
HCPCS,81456,So/hl 51/>gsap rna alys,,,1109.84,1401.9,6
HCPCS,814560,SO/HL 51/>GSAP RNA ALYS,,,2522.53,2522.53,1
HCPCS,81457,SO NEO GSAP DNA MCRSTL INS,,,774.9,1498.67,15
HCPCS,81457,So neo gsap dna mcrstl ins,,,170.1,214.86,6
HCPCS,814570,SO NEO GSAP DNA MCRSTL INS,,,774.9,774.9,1
HCPCS,81458,SO GSAP DNA CPY NMBR&MCRSTL,,,904.05,1748.45,15
HCPCS,81458,So gsap dna cpy nmbr&mcrstl,,,170.1,214.86,6
HCPCS,814580,SO GSAP DNA CPY NMBR&MCRSTL,,,904.05,904.05,1
HCPCS,81459,SO NEO GSAP DNA/DNA&RNA,,,2582.97,4995.54,15
HCPCS,81459,So neo gsap dna/dna&rna,,,170.1,214.86,6
HCPCS,814590,SO NEO GSAP DNA/DNA&RNA,,,2582.97,2582.97,1
HCPCS,81460,WHOLE MITOCHONDRIAL GENOME,,,1111.97,2150.58,15
HCPCS,81460,Whole mitochondrial genome,,,1109.84,1401.9,6
HCPCS,814600,WHOLE MITOCHONDRIAL GENOME,,,1111.97,1111.97,1
HCPCS,81462,SO GSAP CLL FR DNA/DNA&RNA,,,1033.19,1998.23,15
HCPCS,81462,So gsap cll fr dna/dna&rna,,,170.1,214.86,6
HCPCS,814620,SO GSAP CLL FR DNA/DNA&RNA,,,1033.19,1033.19,1
HCPCS,81463,SO GSAP CL FR CPY NMBR&MCRST,,,1162.35,2248.01,15
HCPCS,81463,So gsap cl fr cpy nmbr&mcrst,,,170.1,214.86,6
HCPCS,814630,SO GSAP CL FR CPY NMBR&MCRST,,,1162.35,1162.35,1
HCPCS,81464,SO GSAP CLL FR MCRSTL INS,,,2841.27,5495.1,15
HCPCS,81464,So gsap cll fr mcrstl ins,,,170.1,214.86,6
HCPCS,814640,SO GSAP CLL FR MCRSTL INS,,,2841.27,2841.27,1
HCPCS,81465,WHOLE MITOCHONDRIAL GENOME,,,808.7,1564.06,15
HCPCS,81465,Whole mitochondrial genome,,,325.19,410.76,6
HCPCS,814650,WHOLE MITOCHONDRIAL GENOME,,,808.7,808.7,1
HCPCS,81470,X-LINKED INTELLECTUAL DBLT,,,789.7,1527.29,15
HCPCS,81470,X-linked intellectual dblt,,,325.19,410.76,6
HCPCS,814700,X-LINKED INTELLECTUAL DBLT,,,789.7,789.7,1
HCPCS,81471,X-LINKED INTELLECTUAL DBLT,,,0.01,1527.29,15
HCPCS,81471,X-linked intellectual dblt,,,325.19,410.76,6
HCPCS,814710,X-LINKED INTELLECTUAL DBLT,,,0.01,0.01,1
HCPCS,81479,%5FLUO TEST,216.0,140.4,22.32,194.4,27
HCPCS,81479,%BTKNUT UNLIST MOL PATH,350.0,227.5,22.32,315.0,27
HCPCS,81479,*UNLISTED MOLECULAR PATHOLOGY,1419.0,922.35,22.32,1277.1,27
HCPCS,81479,3B1AO-HSD3B1 GTYP AN ON,330.0,214.5,22.32,297.0,27
HCPCS,81479,APOL1 SEQUENCING,426.0,276.9,22.32,383.4,27
HCPCS,81479,BCR ABL QUAL MPLEX PCR,1170.0,760.5,22.32,1053.0,27
HCPCS,81479,BCR/ABL KINASE DOMAIN RT-PCR,1062.0,690.3,22.32,955.8,27
HCPCS,81479,BLAU SYNDROME,1683.0,1093.95,22.32,1514.7,27
HCPCS,81479,C9ORF72 EXPANSION ASSAY,378.0,245.7,22.32,340.2,27
HCPCS,81479,COL3 TEST,2917.0,1896.05,22.32,2625.3,27
HCPCS,81479,CSF3RM MUTATION ANANLYSIS BM,1250.0,812.5,22.32,1125.0,27
HCPCS,81479,CSF3RP MUTATION ANANLYSIS BLD,1250.0,812.5,22.32,1125.0,27
HCPCS,81479,CSPNL UNLISTED MOPATH,72.0,46.8,12.1,64.8,27
HCPCS,81479,"CXCR4 MUTATION ANALYSIS, SOMATIC",908.0,590.2,22.32,817.2,27
HCPCS,81479,CYP2D6 REFLX ONLY UNLIST MOLEC PATH,550.0,357.5,22.32,495.0,27
HCPCS,81479,CYP2D6 UNLISTED MOLEC PATH,550.0,357.5,22.32,495.0,27
HCPCS,81479,DMD SEQUENCING,1975.0,1283.75,22.32,1777.5,27
HCPCS,81479,DNA FINGERPRNT TEST-NGS-FOLLOW UP,4128.0,2683.2,22.32,3715.2,27
HCPCS,81479,DNA FINGERPRNT TEST-NGS-GENOTYPING,4128.0,2683.2,22.32,3715.2,27
HCPCS,81479,ERBB2 GENE ANALYSIS,54.0,35.1,9.07,48.6,27
HCPCS,81479,GISTCY NGS UNLIST MOLEC,193.0,125.45,22.32,173.7,27
HCPCS,81479,HOTSPOT DESMOID NGS,1914.0,1244.1,22.32,1722.6,27
HCPCS,81479,IBDSGI UNLISTED MOL PATH,150.0,97.5,22.32,135.0,27
HCPCS,81479,IDH1&2-COMMON VARIANTS,1160.0,754.0,22.32,1044.0,27
HCPCS,81479,JK VARIANT DETERMINATION,550.0,357.5,22.32,495.0,27
HCPCS,81479,MNGS PATHOGEN DX,7250.0,4712.5,22.32,6525.0,27
HCPCS,81479,MUCKLE TEST,2199.0,1429.35,22.32,1979.1,27
HCPCS,81479,MYELOPROLIF NEOPL PNL BLD,932.0,605.8,22.32,838.8,27
HCPCS,81479,MYELOPROLIF NEOPL PNL BLOOD,978.0,635.7,22.32,880.2,27
HCPCS,81479,MYELOPROLIF NEOPL PNL BM,932.0,605.8,22.32,838.8,27
HCPCS,81479,MYELOPROLIF NEOPL PNL MARROW,978.0,635.7,22.32,880.2,27
HCPCS,81479,NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (NAIT)-INITIAL TESTING MATE,2727.0,1772.55,22.32,2667.6,81
HCPCS,81479,NTRK NGS,1914.0,1244.1,22.32,1722.6,27
HCPCS,81479,PARD UNLISTED MOL PATH,446.0,289.9,22.32,401.4,27
HCPCS,81479,POLE DROPLET DIGITAL PCR,378.0,245.7,22.32,340.2,27
HCPCS,81479,POLE TARG MUT DET BY SANGER,378.0,245.7,22.32,340.2,27
HCPCS,81479,RCGP UNLISTED MOL PATH,42.0,27.3,7.06,37.8,27
HCPCS,81479,SHOX DNA DIAGNOSTIC,505.0,328.25,22.32,454.5,27
HCPCS,81479,TRAPS TEST,1076.0,699.4,22.32,968.4,27
HCPCS,81479,UNLISTED MOLECULAR PATHOLOGY,426.5,277.225,1.85,701.1,216
HCPCS,81479,WEAK RHD ANLYS UNLISTED,435.0,282.75,22.32,391.5,27
HCPCS,81479,WRFSEN UNLISTED MOPATH,61.0,39.65,10.25,54.9,27
HCPCS,81490,AUTOIMMUNE RA ALYS 12 BMRK,,,726.32,1404.73,15
HCPCS,81490,Autoimmune ra alys 12 bmrk,,,325.19,410.76,6
HCPCS,814900,AUTOIMMUNE RA ALYS 12 BMRK,,,726.32,726.32,1
HCPCS,81493,COR ARTERY DISEASE MRNA,,,907.2,1754.55,15
HCPCS,81493,Cor artery disease mrna,,,1109.84,1401.9,6
HCPCS,814930,COR ARTERY DISEASE MRNA,,,907.2,907.2,1
HCPCS,81500,ONCO (OVAR) TWO PROTEINS,,,225.07,435.3,15
HCPCS,81500,Onco (ovar) two proteins,,,76.88,97.12,6
HCPCS,815000,ONCO (OVAR) TWO PROTEINS,,,225.07,225.07,1
HCPCS,81503,ONCO (OVAR) FIVE PROTEINS,,,775.01,775.01,1
HCPCS,81503,OVA1,2027.0,1317.55,325.19,1824.3,37
HCPCS,815030,ONCO (OVAR) FIVE PROTEINS,,,775.01,775.01,1
HCPCS,81504,ONCOLOGY TISSUE OF ORIGIN,,,449.28,868.92,15
HCPCS,81504,Oncology tissue of origin,,,170.1,214.86,6
HCPCS,815040,ONCOLOGY TISSUE OF ORIGIN,,,449.28,449.28,1
HCPCS,81506,ENDO ASSAY SEVEN ANAL,,,59.55,115.17,15
HCPCS,81506,Endo assay seven anal,,,22.32,28.19,6
HCPCS,815060,ENDO ASSAY SEVEN ANAL,,,59.55,59.55,1
HCPCS,81507,FETAL ANEUPLOIDY TRISOM RISK,,,686.88,1328.45,15
HCPCS,81507,Fetal aneuploidy trisom risk,,,325.19,410.76,6
HCPCS,815070,FETAL ANEUPLOIDY TRISOM RISK,,,686.88,686.88,1
HCPCS,81508,FTL CGEN ABNOR TWO PROTEINS,,,46.92,90.74,15
HCPCS,81508,Ftl cgen abnor two proteins,,,22.32,28.19,6
HCPCS,815080,FTL CGEN ABNOR TWO PROTEINS,,,46.92,46.92,1
HCPCS,81509,FTL CGEN ABNOR 3 PROTEINS,,,1285.09,2485.4,15
HCPCS,81509,Ftl cgen abnor 3 proteins,,,1109.84,1401.9,6
HCPCS,815090,FTL CGEN ABNOR 3 PROTEINS,,,1285.09,1285.09,1
HCPCS,81510,FTL CGEN ABNOR THREE ANAL,,,47.98,92.81,15
HCPCS,81510,Ftl cgen abnor three anal,,,22.32,28.19,6
HCPCS,815100,FTL CGEN ABNOR THREE ANAL,,,47.98,47.98,1
HCPCS,81511,FTL CGEN ABNOR FOUR ANAL,,,132.62,132.62,1
HCPCS,81511,PRENATAL QUAD SCREEN,383.0,248.95,76.88,344.7,37
HCPCS,815110,FTL CGEN ABNOR FOUR ANAL,,,132.62,132.62,1
HCPCS,81512,FTL CGEN ABNOR FIVE ANAL,,,60.07,116.17,15
HCPCS,81512,Ftl cgen abnor five anal,,,22.32,28.19,6
HCPCS,815120,FTL CGEN ABNOR FIVE ANAL,,,60.07,60.07,1
HCPCS,81513,BACTERIAL VAGINOSIS AMPLIFICATION,448.0,291.2,76.88,403.2,37
HCPCS,81513,NFCT DS BV RNA VAG FLU ALG,,,123.23,123.23,1
HCPCS,815130,NFCT DS BV RNA VAG FLU ALG,,,123.23,123.23,1
HCPCS,81514,NFCT DS BV&VAGINITIS DNA ALG,,,227.22,439.46,15
HCPCS,81514,Nfct ds bv&vaginitis dna alg,,,76.88,97.12,6
HCPCS,815140,NFCT DS BV&VAGINITIS DNA ALG,,,227.22,227.22,1
HCPCS,81515,NFCT DS BV&VAGINITIS DNA ALG,,,227.22,439.46,18
HCPCS,81515,Nfct ds bv&vaginitis dna alg,,,76.88,97.12,6
HCPCS,815150,NFCT DS BV&VAGINITIS DNA ALG,,,227.22,227.22,1
HCPCS,81515QW,NFCT DS BV&VAGINITIS DNA ALG,,,405.53,439.46,3
HCPCS,81517,ENHANCED LIVER FIBROSIS (ELF) SCORE,1142.0,742.3,76.88,1027.8,37
HCPCS,81517,LIVER DS ALYS 3 BMRK SRM ALG,,,152.23,152.23,1
HCPCS,815170,LIVER DS ALYS 3 BMRK SRM ALG,,,152.23,152.23,1
HCPCS,81518,ONC BRST MRNA 11 GENES,,,3346.27,6471.78,15
HCPCS,81518,Onc brst mrna 11 genes,,,1109.84,1401.9,6
HCPCS,815180,ONC BRST MRNA 11 GENES,,,3346.27,3346.27,1
HCPCS,81519,ONCOLOGY BREAST MRNA,,,3346.27,6471.78,15
HCPCS,81519,Oncology breast mrna,,,1109.84,1401.9,6
HCPCS,815190,ONCOLOGY BREAST MRNA,,,3346.27,3346.27,1
HCPCS,81520,ONC BREAST MRNA 58 GENES,,,2168.82,4194.56,15
HCPCS,81520,Onc breast mrna 58 genes,,,1109.84,1401.9,6
HCPCS,815200,ONC BREAST MRNA 58 GENES,,,2168.82,2168.82,1
HCPCS,81521,ONC BREAST MRNA 70 GENES,,,3346.27,6471.78,15
HCPCS,81521,Onc breast mrna 70 genes,,,1109.84,1401.9,6
HCPCS,815210,ONC BREAST MRNA 70 GENES,,,3346.27,3346.27,1
HCPCS,81522,ONC BREAST MRNA 12 GENES,,,3346.27,6471.78,15
HCPCS,81522,Onc breast mrna 12 genes,,,1109.84,1401.9,6
HCPCS,815220,ONC BREAST MRNA 12 GENES,,,3346.27,3346.27,1
HCPCS,81523,ONC BRST MRNA 70 CNT 31 GENE,,,3346.27,6471.78,15
HCPCS,81523,Onc brst mrna 70 cnt 31 gene,,,1109.84,1401.9,6
HCPCS,815230,ONC BRST MRNA 70 CNT 31 GENE,,,3346.27,3346.27,1
HCPCS,81524,"Onc cns tum dna mthyl 10,000",,,22.32,28.19,6
HCPCS,81525,ONCOLOGY COLON MRNA,,,2692.22,5206.84,15
HCPCS,81525,Oncology colon mrna,,,1109.84,1401.9,6
HCPCS,815250,ONCOLOGY COLON MRNA,,,2692.22,2692.22,1
HCPCS,81528,ONCOLOGY COLORECTAL SCR,,,439.67,850.32,15
HCPCS,81528,Oncology colorectal scr,,,170.1,214.86,6
HCPCS,815280,ONCOLOGY COLORECTAL SCR,,,439.67,439.67,1
HCPCS,81529,ONC CUTAN MLNMA MRNA 31 GENE,,,6214.75,12019.5,15
HCPCS,81529,Onc cutan mlnma mrna 31 gene,,,1109.84,1401.9,6
HCPCS,815290,ONC CUTAN MLNMA MRNA 31 GENE,,,6214.75,6214.75,1
HCPCS,81535,ONCOLOGY GYNECOLOGIC,,,500.66,968.28,15
HCPCS,81535,Oncology gynecologic,,,170.1,214.86,6
HCPCS,815350,ONCOLOGY GYNECOLOGIC,,,500.66,500.66,1
HCPCS,81536,ONCOLOGY GYNECOLOGIC,,,153.41,296.7,15
HCPCS,81536,Oncology gynecologic,,,76.88,97.12,6
HCPCS,815360,ONCOLOGY GYNECOLOGIC,,,153.41,153.41,1
HCPCS,81538,ONCOLOGY LUNG,,,2480.54,4797.44,15
HCPCS,81538,Oncology lung,,,1109.84,1401.9,6
HCPCS,815380,ONCOLOGY LUNG,,,2480.54,2480.54,1
HCPCS,81539,ONCOLOGY PROSTATE PROB SCORE,,,656.64,1269.96,15
HCPCS,81539,Oncology prostate prob score,,,325.19,410.76,6
HCPCS,815390,ONCOLOGY PROSTATE PROB SCORE,,,656.64,656.64,1
HCPCS,81540,ONCOLOGY TUM UNKNOWN ORIGIN,,,3240.0,6266.25,15
HCPCS,81540,Oncology tum unknown origin,,,1109.84,1401.9,6
HCPCS,815400,ONCOLOGY TUM UNKNOWN ORIGIN,,,3240.0,3240.0,1
HCPCS,81541,ONC PROSTATE MRNA 46 GENES,,,3346.27,6471.78,15
HCPCS,81541,Onc prostate mrna 46 genes,,,1109.84,1401.9,6
HCPCS,815410,ONC PROSTATE MRNA 46 GENES,,,3346.27,3346.27,1
HCPCS,81542,ONC PROSTATE MRNA 22 CNT GEN,,,3346.27,6471.78,15
HCPCS,81542,Onc prostate mrna 22 cnt gen,,,1109.84,1401.9,6
HCPCS,815420,ONC PROSTATE MRNA 22 CNT GEN,,,3346.27,3346.27,1
HCPCS,81545,Oncology thyroid,,,1109.84,1401.9,6
HCPCS,81546,"ONC THYR MRNA 10,196 GEN ALG",,,3110.4,6015.6,15
HCPCS,81546,"Onc thyr mrna 10,196 gen alg",,,1109.84,1401.9,6
HCPCS,815460,"ONC THYR MRNA 10,196 GEN ALG",,,3110.4,3110.4,1
HCPCS,81551,ONC PROSTATE 3 GENES,,,1753.92,3392.13,15
HCPCS,81551,Onc prostate 3 genes,,,1109.84,1401.9,6
HCPCS,815510,ONC PROSTATE 3 GENES,,,1753.92,1753.92,1
HCPCS,81552,ONC UVEAL MLNMA MRNA 15 GENE,,,6718.46,12993.7,15
HCPCS,81552,Onc uveal mlnma mrna 15 gene,,,1109.84,1401.9,6
HCPCS,815520,ONC UVEAL MLNMA MRNA 15 GENE,,,6718.46,6718.46,1
HCPCS,81554,PULM DS IPF MRNA 190 GEN ALG,,,4752.0,9098.6,15
HCPCS,81554,Pulm ds ipf mrna 190 gen alg,,,1109.84,1401.9,6
HCPCS,815540,PULM DS IPF MRNA 190 GEN ALG,,,4752.0,4752.0,1
HCPCS,81558,TRNSPL REJ KDN MRNA QPCR 139,,,2799.36,5414.04,15
HCPCS,81558,Trnspl rej kdn mrna qpcr 139,,,1109.84,1401.9,6
HCPCS,815580,TRNSPL REJ KDN MRNA QPCR 139,,,2799.36,2799.36,1
HCPCS,81560,INTESTINAL TRANSPLANT REJECTION RISK EVALUATION (PLEXIMMUNE),4152.0,2698.8,28.87,3736.8,37
HCPCS,81560,TRNSPLJ PD LVR&BWL CD154+CLL,,,553.59,553.59,1
HCPCS,815600,TRNSPLJ PD LVR&BWL CD154+CLL,,,553.59,553.59,1
HCPCS,81595,CARDIOLOGY HRT TRNSPL MRNA,,,2799.36,5414.04,15
HCPCS,81595,Cardiology hrt trnspl mrna,,,1109.84,1401.9,6
HCPCS,815950,CARDIOLOGY HRT TRNSPL MRNA,,,2799.36,2799.36,1
HCPCS,81596,LIVER FIBRO AND ACTI,503.0,326.95,22.32,452.7,37
HCPCS,81596,NFCT DS CHRNC HCV 6 ASSAYS,,,62.37,62.37,1
HCPCS,815960,NFCT DS CHRNC HCV 6 ASSAYS,,,62.37,62.37,1
HCPCS,81599,"LIVER FIBROSIS, CHRONIC VIRAL HEPATITIS (ARUP)",106.0,68.9,17.81,95.4,27
HCPCS,81599,UNLISTED MAAA,356.0,231.4,22.32,320.4,27
HCPCS,82009,ACETONE/KETONE SERUM QUAL,74.0,48.1,2.59,66.6,37
HCPCS,82009,KETONE BODIES SERUM QUALITATIVE,15.0,9.75,1.9,15.0,17
HCPCS,82009,KETONE BODYS QUAL,,,3.91,3.91,1
HCPCS,820090,KETONE BODYS QUAL,,,3.91,3.91,1
HCPCS,82010,ACETOACETATE,206.0,133.9,2.59,185.4,37
HCPCS,82010,ACETONE,53.0,34.45,2.59,47.7,37
HCPCS,82010,KETONE BODYS QUAN,,,7.06,13.65,4
HCPCS,82010,QUANT SERUM ACETONES/KETONES,55.0,35.75,2.59,49.5,37
HCPCS,820100,KETONE BODYS QUAN,,,7.06,7.06,1
HCPCS,82010QW,KETONE BODYS QUAN,,,12.6,13.65,3
HCPCS,82013,ACETYLCHOLINESTERASE ASSAY,,,10.62,20.54,15
HCPCS,82013,Acetylcholinesterase assay,,,5.78,7.3,6
HCPCS,820130,ACETYLCHOLINESTERASE ASSAY,,,10.62,10.62,1
HCPCS,82016,ACYLCARNITINES QUAL,,,14.25,27.55,15
HCPCS,82016,Acylcarnitines qual,,,5.78,7.3,6
HCPCS,820160,ACYLCARNITINES QUAL,,,14.25,14.25,1
HCPCS,82017,ACYLCARNITINES QUANT,,,14.58,14.58,1
HCPCS,82017,"ACYLCARNITINES, QUANTIT, P-MAYO",103.0,66.95,5.78,92.7,37
HCPCS,82017,UC5DC ACYLCARNITINES QUANT,370.0,240.5,5.78,333.0,37
HCPCS,82017,X C4 ACYLCARNITINE U,556.0,361.4,5.78,500.4,37
HCPCS,820170,ACYLCARNITINES QUANT,,,14.58,14.58,1
HCPCS,82024,ACTH,57.5,37.375,14.0,59.0,74
HCPCS,82024,ASSAY OF ACTH,,,33.37,33.37,1
HCPCS,820240,ASSAY OF ACTH,,,33.37,33.37,1
HCPCS,82030,ASSAY OF ADP & AMP,,,22.29,43.11,15
HCPCS,82030,Assay of adp & amp,,,6.33,7.99,6
HCPCS,820300,ASSAY OF ADP & AMP,,,22.29,22.29,1
HCPCS,82040,*ALBUMIN SERUM ASSAY,26.0,16.9,2.59,23.4,37
HCPCS,82040,ALBUMIN SERUM ASSAY,74.0,48.1,2.59,66.6,37
HCPCS,82040,ALBUMIN SERUM PLASMA/WHOLE BLOOD,40.0,26.0,2.08,40.0,17
HCPCS,82040,ASSAY OF SERUM ALBUMIN,,,4.28,8.27,4
HCPCS,82040,LYMRFX SERUM ALBUMIN,32.0,20.8,2.59,28.8,37
HCPCS,820400,ASSAY OF SERUM ALBUMIN,,,4.28,4.28,1
HCPCS,82040QW,ASSAY OF SERUM ALBUMIN,,,7.63,8.27,3
HCPCS,82042,ALBUMIN FLUID,46.0,29.9,2.59,41.4,37
HCPCS,82042,ALBUMIN URINE/OTHER QUANT,109.0,70.85,2.59,98.1,37
HCPCS,82042,LYMRFX CSF ALBUMIN,50.0,32.5,2.59,45.0,37
HCPCS,82042,OTHER SOURCE ALBUMIN QUAN EA,,,6.72,13.0,4
HCPCS,82042,OTHER SOURCE ALBUMIN QUANTITATIVE EACH SPECIMEN,50.0,32.5,1.95,50.0,17
HCPCS,820420,OTHER SOURCE ALBUMIN QUAN EA,,,6.72,6.72,1
HCPCS,82042QW,OTHER SOURCE ALBUMIN QUAN EA,,,12.0,13.0,3
HCPCS,82043,*MICROALBUMIN URINE QUANT,95.0,61.75,1.43,85.5,37
HCPCS,82043,MICROALB UR QNT,44.0,28.6,1.43,39.6,37
HCPCS,82043,UR ALBUMIN QUANTITATIVE,,,4.99,9.66,4
HCPCS,82043,URINE ALBUMIN QUANTITATIVE,15.0,9.75,1.95,15.0,17
HCPCS,820430,UR ALBUMIN QUANTITATIVE,,,4.99,4.99,1
HCPCS,82043QW,UR ALBUMIN QUANTITATIVE,,,8.91,9.66,3
HCPCS,82044,MICROALBUMIN UR SEMI QNT (POINT OF CARE LAB),28.0,18.2,1.43,25.2,37
HCPCS,82044,UR ALBUMIN SEMIQUANTITATIVE,,,5.38,10.41,4
HCPCS,820440,UR ALBUMIN SEMIQUANTITATIVE,,,5.38,5.38,1
HCPCS,82044QW,UR ALBUMIN SEMIQUANTITATIVE,,,9.61,10.41,3
HCPCS,82045,ALBUMIN ISCHEMIA MODIFIED,,,29.32,56.71,15
HCPCS,82045,Albumin ischemia modified,,,13.39,16.91,6
HCPCS,820450,ALBUMIN ISCHEMIA MODIFIED,,,29.32,29.32,1
HCPCS,82075,ASSAY OF BREATH ETHANOL,,,0.01,50.13,15
HCPCS,82075,Assay of breath ethanol,,,6.62,8.36,6
HCPCS,820750,ASSAY OF BREATH ETHANOL,,,0.01,0.01,1
HCPCS,82077,ASSAY SPEC XCP UR&BREATH IA,,,14.93,14.93,1
HCPCS,82077,ETHANOL PLASMA,173.0,112.45,6.62,155.7,37
HCPCS,820770,ASSAY SPEC XCP UR&BREATH IA,,,14.93,14.93,1
HCPCS,82085,ALDOLASE,21.5,13.975,2.59,21.6,74
HCPCS,82085,ASSAY OF ALDOLASE,,,8.39,8.39,1
HCPCS,820850,ASSAY OF ALDOLASE,,,8.39,8.39,1
HCPCS,82088,ALDOSTERONE,63.0,40.95,15.75,63.0,37
HCPCS,82088,ALDOSTERONE ASSAY,64.0,41.599999999999994,14.0,68.09,74
HCPCS,82088,ASSAY OF ALDOSTERONE,,,35.21,35.21,1
HCPCS,820880,ASSAY OF ALDOSTERONE,,,35.21,35.21,1
HCPCS,82103,%A1APHE A1A TOTAL,43.0,27.95,5.78,38.7,37
HCPCS,82103,%SERPINA1 A1A,132.0,85.8,5.78,118.8,37
HCPCS,82103,*ALPHA-1-ANTITRYPSIN; TOTAL,19.0,12.35,4.75,19.0,37
HCPCS,82103,ALPHA 1 ANTRY STOOL,162.0,105.3,5.78,145.8,37
HCPCS,82103,ALPHA-1 ANTITRYPSIN TOTAL,28.0,18.2,5.78,25.2,37
HCPCS,82103,ALPHA-1-ANTITRYPSIN TOTAL,,,11.61,11.61,1
HCPCS,82103,"ALPHA-1-ANTITRYPSIN,STOOL",166.0,107.9,5.78,149.4,37
HCPCS,82103,ALPHA-1-ANTITRYPSIN; TOTAL,36.0,23.4,5.78,32.4,37
HCPCS,82103,ANTITRYPSIN ALPHA 1 TOTL,19.0,12.35,4.75,19.0,37
HCPCS,821030,ALPHA-1-ANTITRYPSIN TOTAL,,,11.61,11.61,1
HCPCS,82104,%A1APHE A1A PHENOTYPE,46.0,29.9,5.78,41.4,37
HCPCS,82104,*ALPHA-1-ANTITRYPSIN PHENOTYPE,24.0,15.6,5.78,24.0,37
HCPCS,82104,ALPHA-1-ANTITRYPSIN PHENO,,,12.5,12.5,1
HCPCS,82104,ANTITRYPSIN ALPHA PHENO,50.0,32.5,5.78,45.0,37
HCPCS,821040,ALPHA-1-ANTITRYPSIN PHENO,,,12.5,12.5,1
HCPCS,82105,%2ND TRI AFP,178.0,115.7,5.78,160.2,37
HCPCS,82105,%SEQ2 ALPHA FETOPROTEIN,83.0,53.95,5.78,74.7,37
HCPCS,82105,ALPHA FETO PROTEIN SERUM,62.0,40.3,5.78,55.8,37
HCPCS,82105,ALPHA-FETOPROTEIN SERUM,161.5,104.975,5.78,179.0,55
HCPCS,821050,ALPHA-FETOPROTEIN SERUM,,,14.49,14.49,1
HCPCS,82106,AFP AMNIOTIC FLUID,200.0,130.0,5.78,180.0,37
HCPCS,82106,ALPHA-FETOPROTEIN AMNIOTIC,,,14.69,14.69,1
HCPCS,821060,ALPHA-FETOPROTEIN AMNIOTIC,,,14.69,14.69,1
HCPCS,82107,ALPHA-FETOPROTEIN L3,318.0,206.7,13.39,286.2,38
HCPCS,821070,ALPHA-FETOPROTEIN L3,,,55.65,55.65,1
HCPCS,82108,ALUM ASSAY,44.0,28.6,5.78,42.58,37
HCPCS,82108,ALUMINUM,40.0,26.0,5.78,40.0,37
HCPCS,82108,ASSAY OF ALUMINUM,,,22.01,22.01,1
HCPCS,821080,ASSAY OF ALUMINUM,,,22.01,22.01,1
HCPCS,82120,AMINES VAGINAL FLUID QUAL,,,5.17,10.01,18
HCPCS,82120,Amines vaginal fluid qual,,,2.59,3.28,6
HCPCS,821200,AMINES VAGINAL FLUID QUAL,,,5.17,5.17,1
HCPCS,82120QW,AMINES VAGINAL FLUID QUAL,,,9.24,10.01,3
HCPCS,82127,AMINO ACID SINGLE QUAL,,,12.25,23.69,15
HCPCS,82127,Amino acid single qual,,,5.78,7.3,6
HCPCS,821270,AMINO ACID SINGLE QUAL,,,12.25,12.25,1
HCPCS,82128,%NEO AMINO ACIDS X3,35.0,22.75,5.78,31.5,37
HCPCS,82128,AMINO ACIDS MULT QUAL,,,11.99,11.99,1
HCPCS,821280,AMINO ACIDS MULT QUAL,,,11.99,11.99,1
HCPCS,82131,AMINO ACID SINGL QUANT,77.0,50.05,5.78,69.3,37
HCPCS,82131,AMINO ACID SNGL QUANT,34.0,22.1,5.78,34.0,37
HCPCS,82131,AMINO ACIDS SINGLE QUANT,,,19.85,19.85,1
HCPCS,821310,AMINO ACIDS SINGLE QUANT,,,19.85,19.85,1
HCPCS,82135,24HR URINE FOR ALA,40.0,26.0,5.78,36.0,37
HCPCS,82135,AMINOLEVULINIC ACID (ALA) URINE,197.0,128.05,5.78,177.3,37
HCPCS,82135,"AMINOLEVULINIC ACID, UR",46.0,29.9,5.78,41.4,37
HCPCS,82135,ASSAY AMINOLEVULINIC ACID,,,14.21,14.21,1
HCPCS,821350,ASSAY AMINOLEVULINIC ACID,,,14.21,14.21,1
HCPCS,82136,AMINO ACIDS QUANT 2-5,,,16.95,16.95,1
HCPCS,82136,UCYS24 AMINO ACIDS QUANT 2-5,437.0,284.05,5.78,393.3,37
HCPCS,821360,AMINO ACIDS QUANT 2-5,,,16.95,16.95,1
HCPCS,82139,AMINO ACID >=6 QUANT EA,397.5,258.375,5.78,362.7,74
HCPCS,82139,AMINO ACID>=6 QUANT EA,506.0,328.9,5.78,455.4,37
HCPCS,82139,AMINO ACIDS QNT UR/BLD,392.0,254.8,5.78,352.8,37
HCPCS,82139,AMINO ACIDS QUAN 6 OR MORE,,,14.58,14.58,1
HCPCS,821390,AMINO ACIDS QUAN 6 OR MORE,,,14.58,14.58,1
HCPCS,82140,%SSAT24 AMMONIUM,41.0,26.65,5.78,36.9,37
HCPCS,82140,AMMONIA,182.0,118.3,5.78,163.8,37
HCPCS,82140,"AMMONIUM, 24 HOUR, URINE",459.0,298.35,5.78,413.1,37
HCPCS,82140,"AMMONIUM, RANDOM, URINE",459.0,298.35,5.78,413.1,37
HCPCS,82140,ASSAY OF AMMONIA,133.0,86.45,6.12,133.0,18
HCPCS,821400,ASSAY OF AMMONIA,,,12.59,12.59,1
HCPCS,82143,AMNIOTIC FLUID SCAN,,,8.08,15.62,15
HCPCS,82143,Amniotic fluid scan,,,2.59,3.28,6
HCPCS,821430,AMNIOTIC FLUID SCAN,,,8.08,8.08,1
HCPCS,82150,*AMYLASE ASSAY,19.0,12.35,2.59,17.1,74
HCPCS,82150,AMYLASE,108.5,70.525,2.59,160.2,74
HCPCS,82150,AMYLASE ASSAY,182.0,118.3,2.59,163.8,37
HCPCS,82150,AMYLASE FLUID,43.0,27.95,2.59,38.7,37
HCPCS,82150,AMYLASE UR TIME PROFESSIONAL FEE,13.0,8.45,2.72,13.0,17
HCPCS,82150,ASSAY OF AMYLASE,70.0,45.5,2.72,70.0,21
HCPCS,821500,ASSAY OF AMYLASE,,,5.59,5.59,1
HCPCS,82150QW,ASSAY OF AMYLASE,,,9.99,10.83,3
HCPCS,82154,ANDROSTANEDIOL GLUCURONIDE,,,24.9,48.17,15
HCPCS,82154,Androstanediol glucuronide,,,6.33,7.99,6
HCPCS,821540,ANDROSTANEDIOL GLUCURONIDE,,,24.9,24.9,1
HCPCS,82157,ANDROSTENEDIONE,45.5,29.575000000000003,6.33,47.0,74
HCPCS,82157,ASSAY OF ANDROSTENEDIONE,,,25.29,25.29,1
HCPCS,82157,CAHSP ASSAY OF ANDROSTENEDIONE,84.0,54.6,6.33,75.6,37
HCPCS,821570,ASSAY OF ANDROSTENEDIONE,,,25.29,25.29,1
HCPCS,82160,ASSAY OF ANDROSTERONE,,,22.08,42.69,15
HCPCS,82160,Assay of androsterone,,,6.33,7.99,6
HCPCS,821600,ASSAY OF ANDROSTERONE,,,22.08,22.08,1
HCPCS,82163,ANGIOTENSIN II,630.0,409.5,6.33,567.0,37
HCPCS,82163,ASSAY OF ANGIOTENSIN II,,,17.73,17.73,1
HCPCS,821630,ASSAY OF ANGIOTENSIN II,,,17.73,17.73,1
HCPCS,82164,ANGIOTENSIN 1 ENZYME TEST,21.0,13.65,5.25,21.0,37
HCPCS,82164,ANGIOTENSIN CONV ENZYM,31.0,20.15,5.78,27.9,37
HCPCS,82164,ANGIOTENSIN CONV ENZYME,24.0,15.6,5.78,24.0,37
HCPCS,82164,ANGIOTENSIN I ENZYME TEST,,,12.61,12.61,1
HCPCS,821640,ANGIOTENSIN I ENZYME TEST,,,12.61,12.61,1
HCPCS,82166,ASSAY ANTI-MULLERIAN HORM,,,33.37,33.37,1
HCPCS,82166,ASSAY OF ANTI-MULLERIAN HORMONE,56.0,36.4,5.78,56.0,37
HCPCS,821660,ASSAY ANTI-MULLERIAN HORM,,,33.37,33.37,1
HCPCS,82172,*APOLIPOPROTEIN EA ASSAY,67.0,43.55,5.78,60.3,37
HCPCS,82172,APOLIPOPROTEIN A1+B X2,37.0,24.05,5.78,35.24,37
HCPCS,82172,APOLIPOPROTEIN EA ASSAY,32.0,20.8,5.78,32.0,74
HCPCS,82172,ASSAY OF APOLIPOPROTEIN,,,18.22,18.22,1
HCPCS,821720,ASSAY OF APOLIPOPROTEIN,,,18.22,18.22,1
HCPCS,82175,%UTXM3 ARSENIC,92.0,59.8,5.78,82.8,37
HCPCS,82175,%UTXM4 ARSENIC,92.0,59.8,5.78,82.8,37
HCPCS,82175,*ARSENIC ASSAY,35.0,22.75,5.78,31.7,37
HCPCS,82175,ARSENIC,77.0,50.05,5.78,69.3,37
HCPCS,82175,ARSENIC ASSAY,112.5,73.125,5.78,151.2,74
HCPCS,82175,ARSENIC HAIR OR NAILS,440.0,286.0,5.78,396.0,37
HCPCS,82175,ARSENIC QUANTITATIVE,35.0,22.75,5.78,31.7,37
HCPCS,82175,ARSENIC URINE,145.0,94.25,5.78,130.5,37
HCPCS,82175,ASSAY OF ARSENIC,,,16.39,16.39,1
HCPCS,821750,ASSAY OF ARSENIC,,,16.39,16.39,1
HCPCS,82180,ASCORB ACD-VT,23.0,14.95,2.59,20.7,37
HCPCS,82180,ASSAY OF ASCORBIC ACID,189.0,122.85,2.59,170.1,38
HCPCS,821800,ASSAY OF ASCORBIC ACID,,,8.54,8.54,1
HCPCS,82190,ATOMIC ABSORP SPECTROSCOPY EA,81.0,52.65,5.78,72.9,37
HCPCS,82190,ATOMIC ABSORPTION,,,13.74,13.74,1
HCPCS,821900,ATOMIC ABSORPTION,,,13.74,13.74,1
HCPCS,82232,ASSAY OF BETA-2 PROTEIN,,,13.98,13.98,1
HCPCS,82232,BETA 2 MICROGLOBULIN ASSAY,28.0,18.2,6.0,28.8,74
HCPCS,82232,BETA 2 MICROGLOBULIN BLD,32.0,20.8,6.33,28.8,37
HCPCS,822320,ASSAY OF BETA-2 PROTEIN,,,13.98,13.98,1
HCPCS,82233,BETA-AMYLOID 1-40 (ABETA 40),,,128.92,141.81,4
HCPCS,82233,Beta-amyloid 1-40 (abeta 40),,,76.88,97.12,6
HCPCS,82234,BETA-AMYLOID; 1-42 (ABETA 42),112.0,72.8,28.0,141.81,30
HCPCS,82239,BILE ACIDS TOTAL,64.5,41.925,5.78,77.4,75
HCPCS,822390,BILE ACIDS TOTAL,,,14.8,14.8,1
HCPCS,82240,BILE ACIDS CHOLYLGLYCINE,,,22.96,44.42,15
HCPCS,82240,Bile acids cholylglycine,,,13.39,16.91,6
HCPCS,822400,BILE ACIDS CHOLYLGLYCINE,,,22.96,22.96,1
HCPCS,82247,*TOTAL BILIRUBIN,67.0,43.55,2.59,60.3,37
HCPCS,82247,BILIRUBIN TOTAL,87.5,56.875,2.11,117.9,58
HCPCS,82247,BILIRUBIN TOTAL (BACK OFFICE),131.0,85.15,2.59,117.9,37
HCPCS,82247,BILRBN NB TOT PROFESSIONAL FEE,13.0,8.45,2.11,13.0,17
HCPCS,82247,TOTAL BILIRUBIN,9.0,5.85,2.25,8.39,37
HCPCS,822470,BILIRUBIN TOTAL,,,4.34,4.34,1
HCPCS,82247QW,BILIRUBIN TOTAL,,,7.74,8.39,3
HCPCS,82248,BILIRUBIN DIR,131.0,85.15,2.59,117.9,37
HCPCS,82248,BILIRUBIN DIRECT,88.0,57.2,2.11,127.8,55
HCPCS,822480,BILIRUBIN DIRECT,,,4.34,4.34,1
HCPCS,82252,BILIRUBIN STOOL QL,13.0,8.45,2.59,11.7,37
HCPCS,82252,FECAL BILIRUBIN TEST,,,3.94,3.94,1
HCPCS,822520,FECAL BILIRUBIN TEST,,,3.94,3.94,1
HCPCS,82261,ASSAY OF BIOTINIDASE,,,14.58,14.58,1
HCPCS,82261,BIOTINIDASE ASSAY EA,145.0,94.25,5.78,130.5,37
HCPCS,82261,BIOTINIDASE EA SPEC,48.0,31.2,5.78,43.2,37
HCPCS,822610,ASSAY OF BIOTINIDASE,,,14.58,14.58,1
HCPCS,82270,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER,11.0,7.15,2.63,11.0,17
HCPCS,82270,"BLOOD; OCCULT, FECES, X",22.0,14.3,2.63,22.0,17
HCPCS,82270,OCCULT BLD FECES 1 DETER,5.0,3.25,2.5,5.0,17
HCPCS,82270,OCCULT BLOOD FECES,,,3.78,3.78,1
HCPCS,82270,OCCULT BLOOD FECES COLORECT,57.0,37.05,2.59,51.3,37
HCPCS,82270,OCCULT BLOOD SCREEN,48.0,31.2,2.59,43.2,37
HCPCS,822700,OCCULT BLOOD FECES,,,3.78,3.78,1
HCPCS,82271,%FGSTRO GSTRC OCCULT BLD,56.0,36.4,2.59,50.4,37
HCPCS,82271,BLOOD OCCULT PEROXIDASE ACTV QUAL OTHER SOURCES,26.0,16.9,3.19,26.0,17
HCPCS,82271,OCCLT BLD GST (POINT OF CARE LAB),57.0,37.05,2.59,51.3,37
HCPCS,82271,OCCLT BLD GSTRC,19.0,12.35,2.59,17.1,37
HCPCS,82271,OCCULT BLOOD OTHER SOURCES,,,4.6,8.89,4
HCPCS,822710,OCCULT BLOOD OTHER SOURCES,,,4.6,4.6,1
HCPCS,82271QW,OCCULT BLOOD OTHER SOURCES,,,8.2,8.89,3
HCPCS,82272,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC,11.0,7.15,2.54,11.0,17
HCPCS,82272,"BLOOD, OCCULT, SINGLE DRE DIAGNOSTIC",22.0,14.3,2.54,22.0,17
HCPCS,82272,HEMO SLIDE/OCCULT BLOOD FECES 1-3 CARD,5.0,3.25,2.5,5.0,17
HCPCS,82272,OCCULT BLD FECES 1-3 TESTS,5.0,3.25,2.5,5.0,18
HCPCS,82272,OCCULT BLOOD FECES 1-3 TEST,57.0,37.05,2.59,51.3,37
HCPCS,82272,OCCULT BLOOD FECES 1-3 TEST (POINT OF CARE LAB),57.0,37.05,2.59,51.3,37
HCPCS,822720,OCCULT BLD FECES 1-3 TESTS,,,3.65,3.65,1
HCPCS,82274,ASSAY TEST FOR BLOOD FECAL,,,13.76,26.6,4
HCPCS,82274,BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3,52.0,33.8,9.55,52.0,17
HCPCS,82274,HGB FECAL IA,36.0,23.4,5.78,32.4,37
HCPCS,82274,HGB FECALIA,13.0,8.45,6.5,17.57,17
HCPCS,82274,"IMMUNOASSAY, FECAL OCCULT BLOOD",39.0,25.35,5.78,35.1,37
HCPCS,822740,ASSAY TEST FOR BLOOD FECAL,,,13.76,13.76,1
HCPCS,82274QW,ASSAY TEST FOR BLOOD FECAL,,,24.55,26.6,3
HCPCS,82286,ASSAY OF BRADYKININ,,,4.46,8.62,15
HCPCS,82286,Assay of bradykinin,,,2.59,3.28,6
HCPCS,822860,ASSAY OF BRADYKININ,,,4.46,4.46,1
HCPCS,82300,%UTXM4 CADMIUM,99.0,64.35,5.78,89.1,37
HCPCS,82300,ASSAY OF CADMIUM,,,20.42,20.42,1
HCPCS,82300,CADMIUM ASSAY,42.0,27.3,5.78,42.3,74
HCPCS,82300,"CADMIUM, WHOLE BLOOD",41.0,26.65,5.78,39.5,37
HCPCS,823000,ASSAY OF CADMIUM,,,20.42,20.42,1
HCPCS,82306,*VIT D 25 HYDROXY ASSAY,53.0,34.45,13.25,49.46,37
HCPCS,82306,D2D3 25-OH VITAMIN,273.0,177.45,13.39,245.7,37
HCPCS,82306,VIT D 25 HYDROXY ASSAY,53.0,34.45,13.25,49.46,74
HCPCS,82306,VITAMIN D 25 HYDROXY,169.0,109.85,13.39,152.1,38
HCPCS,823060,VITAMIN D 25 HYDROXY,,,25.57,25.57,1
HCPCS,82308,ASSAY OF CALCITONIN,,,23.14,23.14,1
HCPCS,82308,CALCITONIN,39.0,25.35,6.33,39.0,37
HCPCS,82308,CALCITONIN FNA LYMPH ND,734.0,477.1,6.33,660.6,37
HCPCS,82308,UREA CLEARANCE 24 HR UR,37.0,24.05,6.33,37.0,37
HCPCS,823080,ASSAY OF CALCITONIN,,,23.14,23.14,1
HCPCS,82310,ASSAY OF CALCIUM,,,4.46,8.62,4
HCPCS,82310,CALCIUM,74.0,48.1,2.59,66.6,37
HCPCS,82310,CALCIUM; TOTAL,34.0,22.1,2.17,34.0,17
HCPCS,823100,ASSAY OF CALCIUM,,,4.46,4.46,1
HCPCS,82310QW,ASSAY OF CALCIUM,,,7.96,8.62,3
HCPCS,82330,*CALCIUM IONIZED,133.0,86.45,5.78,119.7,74
HCPCS,82330,ASSAY IONIZED CA,124.0,80.6,5.78,111.6,37
HCPCS,82330,ASSAY IONIZED CA (POINT OF CARE LAB),124.0,80.6,5.78,111.6,37
HCPCS,82330,ASSAY OF CALCIUM,,,11.82,22.86,4
HCPCS,82330,CALCIUM IONIZED (POINT OF CARE LAB),75.0,48.75,5.78,67.5,37
HCPCS,823300,ASSAY OF CALCIUM,,,11.82,11.82,1
HCPCS,82330QW,ASSAY OF CALCIUM,,,21.09,22.86,3
HCPCS,82331,CALCIUM INFUSION TEST,,,11.52,22.29,15
HCPCS,82331,Calcium infusion test,,,5.78,7.3,6
HCPCS,823310,CALCIUM INFUSION TEST,,,11.52,11.52,1
HCPCS,82340,*CA URINE QUANT TIMED,10.0,6.5,2.5,10.0,37
HCPCS,82340,ASSAY OF CALCIUM IN URINE,,,5.21,5.21,1
HCPCS,82340,CA URINE QUANT TIMED,74.0,48.1,2.59,66.6,74
HCPCS,82340,CALC URINE QUAN PROFESSIONAL FEE,13.0,8.45,2.53,13.0,17
HCPCS,82340,CALCIUM URINE QUANTITATIVE TIMED SPECIMEN,80.0,52.0,2.53,80.0,17
HCPCS,82340,"SSAT24 CALCIUM, UR",18.0,11.7,2.59,16.2,37
HCPCS,823400,ASSAY OF CALCIUM IN URINE,,,5.21,5.21,1
HCPCS,82355,CALCULUS ANALYSIS QUAL,,,10.0,19.35,15
HCPCS,82355,Calculus analysis qual,,,5.78,7.3,6
HCPCS,823550,CALCULUS ANALYSIS QUAL,,,10.0,10.0,1
HCPCS,82360,CALCULUS ASSAY QUANT,,,11.12,21.51,15
HCPCS,82360,Calculus assay quant,,,5.78,7.3,6
HCPCS,823600,CALCULUS ASSAY QUANT,,,11.12,11.12,1
HCPCS,82365,CALCULI (STONE) ANALYSIS,23.0,14.95,5.75,21.56,37
HCPCS,82365,CALCULUS INFRSP,23.0,14.95,5.75,21.56,37
HCPCS,82365,CALCULUS SPECTROSCOPY,,,11.15,11.15,1
HCPCS,823650,CALCULUS SPECTROSCOPY,,,11.15,11.15,1
HCPCS,82370,X-RAY ASSAY CALCULUS,,,10.82,20.92,15
HCPCS,82370,X-ray assay calculus,,,5.78,7.3,6
HCPCS,823700,X-RAY ASSAY CALCULUS,,,10.82,10.82,1
HCPCS,82373,ASSAY C-D TRANSFER MEASURE,,,15.61,15.61,1
HCPCS,82373,CARBOHYDR DEF TRANS PED,242.0,157.3,5.78,217.8,37
HCPCS,82373,CARBOHYDRATE DEF TRANSF,389.0,252.85,5.78,350.1,37
HCPCS,82373,CARBOHYDRATE DEF TRANSFER,505.0,328.25,5.78,454.5,37
HCPCS,823730,ASSAY C-D TRANSFER MEASURE,,,15.61,15.61,1
HCPCS,82374,ASSAY BLOOD CARBON DIOXIDE,,,4.21,8.15,4
HCPCS,82374,BICARONATE URINE,56.0,36.4,2.59,50.4,37
HCPCS,82374,CARBON DIOXIDE BICARBONATE,24.0,15.6,2.05,24.0,17
HCPCS,82374,CO2 BLOOD ASSAY,74.0,48.1,2.59,66.6,37
HCPCS,823740,ASSAY BLOOD CARBON DIOXIDE,,,4.21,4.21,1
HCPCS,82374QW,ASSAY BLOOD CARBON DIOXIDE,,,7.52,8.15,3
HCPCS,82375,ASSAY CARBOXYHB QUANT,,,10.65,10.65,1
HCPCS,82375,CARBON MONOXIDE QUAN,19.0,12.35,4.75,19.0,37
HCPCS,82375,CARBOXYHEMOGLOBIN,17.0,11.05,4.25,17.0,37
HCPCS,82375,CARBOXYHEMOGLOBIN (POINT OF CARE LAB),17.0,11.05,4.25,17.0,37
HCPCS,823750,ASSAY CARBOXYHB QUANT,,,10.65,10.65,1
HCPCS,82376,ASSAY CARBOXYHB QUAL,,,12.16,23.51,15
HCPCS,82376,Assay carboxyhb qual,,,5.78,7.3,6
HCPCS,823760,ASSAY CARBOXYHB QUAL,,,12.16,12.16,1
HCPCS,82378,CARCINOEMBRYONIC ANTIGEN,,,16.38,16.38,1
HCPCS,82378,CEA AG,182.0,118.3,5.78,163.8,37
HCPCS,82378,CEA FLUID,41.0,26.65,5.78,36.9,37
HCPCS,823780,CARCINOEMBRYONIC ANTIGEN,,,16.38,16.38,1
HCPCS,82379,ASSAY OF CARNITINE,,,14.58,14.58,1
HCPCS,82379,CARNITINE,100.0,65.0,5.78,90.0,37
HCPCS,82379,CARNITINE FR & TOT PLASMA,145.0,94.25,5.78,130.5,37
HCPCS,82379,CARNITINE TOTAL & FREE QUANT,100.0,65.0,5.78,90.0,37
HCPCS,82379,"CARNITINE, P",72.0,46.8,5.78,64.8,37
HCPCS,823790,ASSAY OF CARNITINE,,,14.58,14.58,1
HCPCS,82380,ASSAY OF CAROTENE,,,7.97,7.97,1
HCPCS,82380,CAROTENE,14.0,9.1,2.59,14.0,74
HCPCS,823800,ASSAY OF CAROTENE,,,7.97,7.97,1
HCPCS,82382,ASSAY URINE CATECHOLAMINES,,,23.59,23.59,1
HCPCS,82382,CATECHL TOT URN,50.0,32.5,6.33,45.62,37
HCPCS,823820,ASSAY URINE CATECHOLAMINES,,,23.59,23.59,1
HCPCS,82383,ASSAY BLOOD CATECHOLAMINES,,,25.12,48.59,15
HCPCS,82383,Assay blood catecholamines,,,6.33,7.99,6
HCPCS,823830,ASSAY BLOOD CATECHOLAMINES,,,25.12,25.12,1
HCPCS,82384,*CATECHOLAMINE FRACT ASSAY,37.0,24.05,6.33,37.0,74
HCPCS,82384,ASSAY THREE CATECHOLAMINES,,,21.82,21.82,1
HCPCS,82384,CATECHOLAMINE FRAC UR,59.0,38.35,6.33,53.1,37
HCPCS,82384,CATECHOLAMINE FRACT ASSAY,37.0,24.05,6.33,37.0,37
HCPCS,82384,CATECHOLAMINE FRACT PL,173.0,112.45,6.33,155.7,37
HCPCS,823840,ASSAY THREE CATECHOLAMINES,,,21.82,21.82,1
HCPCS,82387,ASSAY OF CATHEPSIN-D,,,15.61,30.18,15
HCPCS,82387,Assay of cathepsin-d,,,5.78,7.3,6
HCPCS,823870,ASSAY OF CATHEPSIN-D,,,15.61,15.61,1
HCPCS,82390,ASSAY OF CERULOPLASMIN,,,9.28,9.28,1
HCPCS,82390,CERULOPLASMIN,23.0,14.95,2.59,20.7,37
HCPCS,82390,CERULOPLASMIN LEVEL,23.0,14.95,2.59,20.7,37
HCPCS,823900,ASSAY OF CERULOPLASMIN,,,9.28,9.28,1
HCPCS,82397,ADANEU CHEMILUMINESCENT,265.0,172.25,5.78,238.5,37
HCPCS,82397,ALPHA SUBUNIT,122.0,79.3,5.78,109.8,37
HCPCS,82397,"ANTI-HMGCR ANTIBODY, IGG",109.0,70.85,5.78,108.9,74
HCPCS,82397,CHEMILUMINESCENT ASSAY,122.0,79.3,5.78,207.0,112
HCPCS,82397,CHEMILUMINESCENT ASY,188.0,122.2,5.78,169.2,37
HCPCS,82397,IBDSGI CHEMILUM X4,80.0,52.0,5.78,72.0,37
HCPCS,82397,IFXNEU CHEMILUMINESCENT,265.0,172.25,5.78,238.5,37
HCPCS,82397,IGFBP-3 INSULIN,47.0,30.55,5.78,42.3,37
HCPCS,82397,MCROHN SAA CHEMILUM,43.0,27.95,5.78,38.7,37
HCPCS,82397,PTH RELATED PEPTIDE,182.0,118.3,5.78,163.8,37
HCPCS,82397,TOTAL ANTIOXIDANT CAPACITY,312.0,202.8,5.78,280.8,37
HCPCS,82397,"VEDOLIZUMAB AB, S",127.0,82.55,5.78,114.3,37
HCPCS,823970,CHEMILUMINESCENT ASSAY,,,12.2,12.2,1
HCPCS,82415,ASSAY OF CHLORAMPHENICOL,,,10.95,21.17,15
HCPCS,82415,Assay of chloramphenicol,,,5.81,7.34,6
HCPCS,824150,ASSAY OF CHLORAMPHENICOL,,,10.95,10.95,1
HCPCS,82435,*CHLORIDE,73.0,47.45,2.59,65.7,37
HCPCS,82435,ASSAY BLOOD CHLORIDE,36.0,23.4,2.59,32.4,37
HCPCS,82435,ASSAY OF BLOOD CHLORIDE,,,3.97,7.69,4
HCPCS,82435,CHLORIDE,73.0,47.45,2.59,65.7,37
HCPCS,82435,CHLORIDE (POINT OF CARE LAB),73.0,47.45,2.59,65.7,37
HCPCS,82435,CHLORIDE BLD,22.0,14.3,1.93,22.0,17
HCPCS,824350,ASSAY OF BLOOD CHLORIDE,,,3.97,3.97,1
HCPCS,82435QW,ASSAY OF BLOOD CHLORIDE,,,7.09,7.69,3
HCPCS,82436,ASSAY OF URINE CHLORIDE,,,4.97,4.97,1
HCPCS,82436,CHLORD 24HR URN PROFESSIONAL FEE,13.0,8.45,2.42,13.0,17
HCPCS,82436,CHLORIDE URINE,43.0,27.95,2.42,43.0,17
HCPCS,82436,CL URINE ASSAY,92.0,59.8,2.59,82.8,37
HCPCS,82436,"SSAT24 CHLORIDE, UR",17.0,11.05,2.59,15.3,37
HCPCS,824360,ASSAY OF URINE CHLORIDE,,,4.97,4.97,1
HCPCS,82438,ASSAY OTHER FLUID CHLORIDES,,,4.32,4.32,1
HCPCS,82438,CHLORIDE OTHER SOURCE,52.0,33.8,2.1,52.0,17
HCPCS,82438,CHLORIDE STOOL,11.0,7.15,2.59,9.9,37
HCPCS,82438,CL OTHER SOURCE ASSAY,92.0,59.8,2.59,82.8,37
HCPCS,82438,NONENDOCRINE RECEPTOR ASSAY,11.0,7.15,2.59,9.9,37
HCPCS,824380,ASSAY OTHER FLUID CHLORIDES,,,4.32,4.32,1
HCPCS,82441,TEST FOR CHLOROHYDROCARBONS,,,5.19,10.04,15
HCPCS,82441,Test for chlorohydrocarbons,,,5.78,7.3,6
HCPCS,824410,TEST FOR CHLOROHYDROCARBONS,,,5.19,5.19,1
HCPCS,82465,*CHOLESTEROL BLOOD TOTAL,29.0,18.85,2.59,26.1,37
HCPCS,82465,ASSAY BLD/SERUM CHOLESTEROL,,,3.76,7.27,4
HCPCS,82465,CHOLESTEROL BLOOD TOTAL,109.0,70.85,2.59,98.1,37
HCPCS,82465,CHOLESTEROL FLUID,12.0,7.8,2.59,10.8,37
HCPCS,82465,CHOLESTEROL SERUM/WHOLE BLOOD TOTAL,52.0,33.8,1.83,52.0,17
HCPCS,82465,CHOLESTEROLTOT PROFESSIONAL FEE,13.0,8.45,1.83,13.0,17
HCPCS,824650,ASSAY BLD/SERUM CHOLESTEROL,,,3.76,3.76,1
HCPCS,82465QW,ASSAY BLD/SERUM CHOLESTEROL,,,6.71,7.27,3
HCPCS,82480,ASSAY SERUM CHOLINESTERASE,,,6.8,6.8,1
HCPCS,82480,CHOLINESTERASE PSEUDO,21.0,13.65,2.59,18.9,37
HCPCS,82480,PSEUDOCHOLINESTERASE TOTAL,21.0,13.65,2.59,18.9,37
HCPCS,824800,ASSAY SERUM CHOLINESTERASE,,,6.8,6.8,1
HCPCS,82482,ASSAY HCG,123.0,79.95,2.59,110.7,37
HCPCS,82482,ASSAY RBC CHOLINESTERASE,,,8.48,8.48,1
HCPCS,82482,CHOLINESTERASE RBC,21.0,13.65,2.59,18.9,37
HCPCS,824820,ASSAY RBC CHOLINESTERASE,,,8.48,8.48,1
HCPCS,82485,%UMUCPO CHONDRO QUANT,416.0,270.4,6.33,374.4,37
HCPCS,82485,ASSAY CHONDROITIN SULFATE,,,17.84,17.84,1
HCPCS,824850,ASSAY CHONDROITIN SULFATE,,,17.84,17.84,1
HCPCS,82495,ASSAY OF CHROMIUM,,,17.52,17.52,1
HCPCS,82495,CHROMIUM,66.0,42.9,5.78,90.0,74
HCPCS,82495,CHROMIUM BLOOD,26.0,16.9,5.78,26.0,37
HCPCS,82495,CHSER,98.0,63.7,5.78,88.2,37
HCPCS,824950,ASSAY OF CHROMIUM,,,17.52,17.52,1
HCPCS,82507,*CITRATE ASSAY,50.0,32.5,12.5,46.45,37
HCPCS,82507,ASSAY OF CITRATE,,,24.02,24.02,1
HCPCS,82507,CITRIC ACID URINE,45.0,29.25,11.0,46.0,74
HCPCS,82507,"SSAT24 CITRATE EXCR, UR",77.0,50.05,13.39,69.3,37
HCPCS,825070,ASSAY OF CITRATE,,,24.02,24.02,1
HCPCS,82523,COLLAGEN CROSS LINKS,98.5,64.025,5.78,144.9,148
HCPCS,82523,COLLAGEN CROSSLINKS,,,16.14,31.21,4
HCPCS,82523,CROSS-LINK N-TELOPEPTIDES,200.0,130.0,5.78,180.0,37
HCPCS,825230,COLLAGEN CROSSLINKS,,,16.14,16.14,1
HCPCS,82523QW,COLLAGEN CROSSLINKS,,,28.8,31.21,3
HCPCS,82525,ASSAY OF COPPER,,,10.72,10.72,1
HCPCS,82525,COPPER,80.0,52.0,5.78,72.0,37
HCPCS,82525,COPPER ASSAY,19.0,12.35,4.75,19.0,37
HCPCS,82525,COPPER BLOOD,98.0,63.7,5.78,88.2,37
HCPCS,82525,COPPER TISSUE,169.0,109.85,5.78,152.1,37
HCPCS,82525,COPPER URINE,158.0,102.7,5.78,142.2,37
HCPCS,82525,"COPPER, FREE, SERUM OR PLASMA",100.0,65.0,5.78,90.0,37
HCPCS,82525,"COPPER, TISSUE",179.0,116.35,5.78,161.1,37
HCPCS,825250,ASSAY OF COPPER,,,10.72,10.72,1
HCPCS,82528,ASSAY OF CORTICOSTERONE,,,19.46,19.46,1
HCPCS,82528,CORTICOSTERONE,164.0,106.6,6.33,147.6,37
HCPCS,825280,ASSAY OF CORTICOSTERONE,,,19.46,19.46,1
HCPCS,82530,CORTISOL FREE,77.0,50.05,5.78,69.3,38
HCPCS,82530,CORTISOL URINE FREE,28.0,18.2,5.78,27.92,37
HCPCS,82530,FREE CORTISOL UR LCM X3,81.0,52.65,5.78,72.9,37
HCPCS,82530,FREE CORTISOL URINE LCM,120.0,78.0,5.78,108.0,37
HCPCS,825300,CORTISOL FREE,,,14.44,14.44,1
HCPCS,82533,CAHSP TOTAL CORTISOL,47.0,30.55,6.33,42.3,37
HCPCS,82533,CORTISOL,162.0,105.3,6.33,145.8,37
HCPCS,82533,CORTISOL PLASMA,188.0,122.2,6.33,169.2,37
HCPCS,82533,CORTISOL TOTAL,123.5,80.275,6.33,422.1,148
HCPCS,82533,CORTISOL; TOTAL,180.0,117.0,6.85,180.0,17
HCPCS,82533,TOTAL CORTISOL,,,14.08,14.08,1
HCPCS,825330,TOTAL CORTISOL,,,14.08,14.08,1
HCPCS,82540,%PCA3 INTERP REPORT PC,73.0,47.45,2.59,65.7,37
HCPCS,82540,ASSAY OF CREATINE,,,4.01,4.01,1
HCPCS,82540,CREATINE,74.0,48.1,2.59,66.6,37
HCPCS,82540,CREATINE URINE,36.0,23.4,2.59,32.4,37
HCPCS,82540,"CREATINE, URINE",98.0,63.7,2.59,88.2,37
HCPCS,825400,ASSAY OF CREATINE,,,4.01,4.01,1
HCPCS,82542,%F2 MS/MS QUANTITATIVE,166.0,107.9,5.78,149.4,37
HCPCS,82542,%NEUR CHROMAT QN,286.0,185.9,5.78,257.4,37
HCPCS,82542,%UMPSSC QUAL,232.0,150.8,5.78,208.8,37
HCPCS,82542,*COL CHROMOTOGRAPHY QUAL/QUAN,101.0,65.65,5.78,90.9,37
HCPCS,82542,*PRO-PREDICTR METAB,180.0,117.0,5.78,162.0,37
HCPCS,82542,18 HYDROXYCORTICOSTERONE,705.0,458.25,5.78,634.5,37
HCPCS,82542,5 METHYLTETRAHYDROFOLATE,802.0,521.3,5.78,721.8,37
HCPCS,82542,7ALPHAC4,289.0,187.85,5.78,260.1,37
HCPCS,82542,AMIODARONE,41.0,26.65,5.78,40.25,37
HCPCS,82542,ANSADA MEAS AB ATI,422.0,274.3,5.78,379.8,37
HCPCS,82542,ANSIFX MEAS AB ATI,422.0,274.3,5.78,379.8,37
HCPCS,82542,ANSUST MEAS AB ATI,620.0,403.0,5.78,558.0,37
HCPCS,82542,ANSVDZ MEAS AB ATI,422.0,274.3,5.78,379.8,37
HCPCS,82542,CHOLESTEROL BIO INTERMED,748.0,486.2,5.78,673.2,37
HCPCS,82542,COENZYME Q10,658.0,427.7,5.78,592.2,37
HCPCS,82542,COL CHROMOTOGRAPHY QUAL/QUAN,210.5,136.825,5.78,340.2,223
HCPCS,82542,COLUMN CHROM QUANT,155.5,101.075,5.78,171.0,74
HCPCS,82542,COQ10 LEUKOCYTES,374.0,243.1,5.78,336.6,37
HCPCS,82542,DIHYDROTESTOSTERONE,91.0,59.15,5.78,81.9,37
HCPCS,82542,HEX4 GLC4,500.0,325.0,5.78,450.0,37
HCPCS,82542,HYPEROXALURIA,1174.0,763.1,5.78,1056.6,37
HCPCS,82542,"IOHEXOL GLOMERULAR FILTRATION RATE (GFR), PLASMA",717.0,466.05,5.78,645.3,37
HCPCS,82542,"LEUKOTRIENE E4, UR",851.0,553.15,5.78,765.9,37
HCPCS,82542,N-METHYLHISTAMINE UR,609.0,395.85,5.78,548.1,37
HCPCS,82542,NEOPTERIN CSF,572.0,371.8,5.78,514.8,37
HCPCS,82542,OMEGACHECK,50.0,32.5,5.78,45.0,37
HCPCS,82542,OXYSTEROLS,345.0,224.25,5.78,310.5,37
HCPCS,82542,PIPECOLIC ACID SERUM,539.0,350.35,5.78,485.1,37
HCPCS,82542,PLASMA THYMIDINE DETERMINATION,281.0,182.65,5.78,252.9,37
HCPCS,82542,PTH RELATED PEPTIDE,166.0,107.9,5.78,149.4,37
HCPCS,82542,PURINE&PYRIMIDINE,686.0,445.9,5.78,617.4,37
HCPCS,82542,PYRIDOXAL 5 PHOSPHATE,785.0,510.25,5.78,706.5,37
HCPCS,82542,"SMITH - LEMLI-OPITZ SCREEN, PL",748.0,486.2,5.78,673.2,37
HCPCS,82542,"SUCCINYLADENOSINE, CSF",785.0,510.25,5.78,706.5,37
HCPCS,82542,"TOTAL LIPID FATTY ACID PROFILE, RBC",237.0,154.05,5.78,213.3,37
HCPCS,82542,TRIMETHYLAMINE N-OXIDE,131.0,85.15,5.78,117.9,37
HCPCS,82542,UMHISR COL CHROMOTOGRAPHY,109.0,70.85,5.78,98.1,37
HCPCS,825420,COL CHROMOTOGRAPHY QUAL/QUAN,,,20.81,20.81,1
HCPCS,82550,*CREATINE KINASE TOTAL ASSAY,60.0,39.0,2.59,96.3,74
HCPCS,82550,ASSAY OF CK (CPK),,,5.63,10.88,4
HCPCS,82550,CREATINE KINASE TOTAL,24.0,15.6,2.73,24.0,17
HCPCS,825500,ASSAY OF CK (CPK),,,5.63,5.63,1
HCPCS,82550QW,ASSAY OF CK (CPK),,,10.04,10.88,3
HCPCS,82552,*CREATINE KINASE ISOENZYME,58.0,37.7,5.78,52.2,37
HCPCS,82552,ASSAY OF CPK IN BLOOD,,,11.57,11.57,1
HCPCS,825520,ASSAY OF CPK IN BLOOD,,,11.57,11.57,1
HCPCS,82553,*CREATINE KINASE MB FRACT,215.0,139.75,5.78,193.5,37
HCPCS,82553,CREATINE KINASE MB FRACTION ONLY,99.0,64.35,4.85,99.0,17
HCPCS,82553,CREATINE MB FRACTION,,,9.98,9.98,1
HCPCS,825530,CREATINE MB FRACTION,,,9.98,9.98,1
HCPCS,82554,CREATINE ISOFORMS,,,10.26,19.83,15
HCPCS,82554,Creatine isoforms,,,5.78,7.3,6
HCPCS,825540,CREATINE ISOFORMS,,,10.26,10.26,1
HCPCS,82565,*CREATININE BLOOD,86.0,55.9,2.59,77.4,37
HCPCS,82565,ASSAY OF CREATININE,,,4.43,8.56,4
HCPCS,82565,CREATININE BLOOD (POINT OF CARE LAB),86.0,55.9,2.59,77.4,37
HCPCS,82565,CREATININE BLOOD ASSAY,86.0,55.9,2.59,77.4,111
HCPCS,82565,CREATININE FLUID,39.0,25.35,2.59,35.1,37
HCPCS,82565,CREATININE SERUM (TRPHOS),50.0,32.5,2.59,45.0,37
HCPCS,82565,CREATININE; BLOOD,28.0,18.2,2.15,28.0,17
HCPCS,825650,ASSAY OF CREATININE,,,4.43,4.43,1
HCPCS,82565QW,ASSAY OF CREATININE,,,7.9,8.56,3
HCPCS,82570,%U17K CREATININE,47.0,30.55,2.59,42.3,37
HCPCS,82570,*CREATININE OTHER SOURCE ASSAY,41.0,26.650000000000002,2.5,96.3,222
HCPCS,82570,ASSAY OF URINE CREATININE,,,4.47,8.66,4
HCPCS,82570,CREATIN 24HR UR PROFESSIONAL FEE,13.0,8.45,2.18,13.0,17
HCPCS,82570,CREATININE OTHER SOURCE,129.0,83.85,2.59,116.1,37
HCPCS,82570,CREATININE URINE (TRPHOS),50.0,32.5,2.59,45.0,37
HCPCS,82570,"CREATININE, UR (LABCORP PORPHOBILINOGEN, QN, RANDOM UR)",26.0,16.9,2.59,23.4,37
HCPCS,82570,HEX4 CREATININE,500.0,325.0,2.59,450.0,37
HCPCS,82570,PURINE PROFILE URINARYX2,419.0,272.35,2.59,377.1,37
HCPCS,82570,"SSAT24 CREATININE, UR",14.0,9.1,2.59,12.6,37
HCPCS,82570,UMHISR UR CREATININE,22.0,14.3,2.59,19.8,37
HCPCS,825700,ASSAY OF URINE CREATININE,,,4.47,4.47,1
HCPCS,82570QW,ASSAY OF URINE CREATININE,,,7.99,8.66,3
HCPCS,82575,CREATININE CLEARANCE TEST,109.0,70.85,2.59,98.1,38
HCPCS,82575,CREATININE; CLEARANCE,111.0,72.15,3.97,111.0,17
HCPCS,825750,CREATININE CLEARANCE TEST,,,8.18,8.18,1
HCPCS,82585,ASSAY OF CRYOFIBRINOGEN,,,12.21,12.21,1
HCPCS,82585,CRYOFIBRINOGEN,41.0,26.650000000000002,4.75,56.7,74
HCPCS,825850,ASSAY OF CRYOFIBRINOGEN,,,12.21,12.21,1
HCPCS,82595,ASSAY OF CRYOGLOBULIN,,,5.59,5.59,1
HCPCS,82595,CRYOGLOBULIN QL,63.5,41.275,2.59,78.3,74
HCPCS,82595,CRYOGLOBULIN QUAL/SEMIQUANT,41.0,26.65,2.59,36.9,37
HCPCS,82595,CRYOGLOBULN QI W/REFLX T,48.0,31.2,2.59,43.2,37
HCPCS,825950,ASSAY OF CRYOGLOBULIN,,,5.59,5.59,1
HCPCS,82600,ASSAY OF CYANIDE,,,16.76,16.76,1
HCPCS,82600,CYANIDE,33.0,21.45,5.78,32.42,37
HCPCS,82600,CYANIDE BLOOD,153.0,99.45,5.78,137.7,37
HCPCS,826000,ASSAY OF CYANIDE,,,16.76,16.76,1
HCPCS,82607,CYANOCOBALAMIN VITAMIN B-12,161.0,104.65,6.33,161.0,17
HCPCS,82607,CYANOCOBLMN(VIT B12),62.0,40.3,6.33,55.8,37
HCPCS,82607,VIT B-12,144.0,93.6,6.33,129.6,37
HCPCS,82607,VITAMIN B-12,,,13.02,13.02,1
HCPCS,82607,VITAMIN B12 BLOOD,142.0,92.3,6.33,127.8,37
HCPCS,826070,VITAMIN B-12,,,13.02,13.02,1
HCPCS,82608,B-12 BINDING CAPACITY,,,12.38,12.38,1
HCPCS,82608,HALOPERIDOL,33.0,21.45,5.78,29.7,37
HCPCS,82608,VIT B12 UNSATURATED,34.0,22.1,5.78,30.6,37
HCPCS,826080,B-12 BINDING CAPACITY,,,12.38,12.38,1
HCPCS,82610,CYSTATIN C,83.0,53.95,5.78,74.7,38
HCPCS,82610,CYSTATIN C WITH GFR,275.0,178.75,5.78,247.5,37
HCPCS,826100,CYSTATIN C,,,16.01,16.01,1
HCPCS,82615,TEST FOR URINE CYSTINES,,,8.25,15.96,15
HCPCS,82615,Test for urine cystines,,,2.59,3.28,6
HCPCS,826150,TEST FOR URINE CYSTINES,,,8.25,8.25,1
HCPCS,82626,CAHSP DEHYDROEPIANDROSTERONE,69.0,44.85,5.78,62.1,37
HCPCS,82626,DEHYDROEPIANDROSTERONE,35.0,22.75,5.78,35.0,38
HCPCS,82626,DEHYDROEPIANDRSTRONE,36.0,23.4,5.78,36.0,37
HCPCS,826260,DEHYDROEPIANDROSTERONE,,,21.84,21.84,1
HCPCS,82627,DEHYDROEPIANDROSTERONE,,,19.2,19.2,1
HCPCS,82627,DEHYDROEPIANDRST SULFATE,32.0,20.8,6.33,32.0,37
HCPCS,82627,DHEA-S,39.0,25.35,6.33,37.15,37
HCPCS,826270,DEHYDROEPIANDROSTERONE,,,19.2,19.2,1
HCPCS,82633,11 DEOXYCORTICOSTERONE,250.0,162.5,16.61,225.0,37
HCPCS,82633,CAHSP DESOXYCORTICOSTERONE,85.0,55.25,16.61,76.5,37
HCPCS,82633,"DEOXYCORTICOSTERONE, 11",135.0,87.75,16.61,121.5,37
HCPCS,82633,DESOXYCORTICOSTERONE,,,26.76,26.76,1
HCPCS,826330,DESOXYCORTICOSTERONE,,,26.76,26.76,1
HCPCS,82634,11-DEOXYCORTISOL,72.0,46.8,6.33,64.8,37
HCPCS,82634,CAHSP DEOXYCORTISOL,84.0,54.6,6.33,75.6,37
HCPCS,82634,DEOXYCORTISL 11,73.0,47.45,6.33,65.7,37
HCPCS,82634,DEOXYCORTISOL,,,25.29,25.29,1
HCPCS,826340,DEOXYCORTISOL,,,25.29,25.29,1
HCPCS,82638,*DIBUCAINE NUMBER ASSAY,21.0,13.65,5.25,20.47,37
HCPCS,82638,ASSAY OF DIBUCAINE NUMBER,,,10.58,10.58,1
HCPCS,826380,ASSAY OF DIBUCAINE NUMBER,,,10.58,10.58,1
HCPCS,82642,DIHYDROTESTOSTERONE,83.0,53.95,6.33,74.7,38
HCPCS,826420,DIHYDROTESTOSTERONE,,,25.29,25.29,1
HCPCS,82652,DIHYDROXYVITAMIN D 1 25 ASSAY,56.0,36.4,13.39,56.0,37
HCPCS,82652,VIT D 1 25 DIHYDROXY,59.0,38.35,13.39,59.0,37
HCPCS,82652,VIT D 1 25-DIHYDROXY,,,33.26,33.26,1
HCPCS,826520,VIT D 1 25-DIHYDROXY,,,33.26,33.26,1
HCPCS,82653,EL-1 FECAL QUANTITATIVE,,,19.85,19.85,1
HCPCS,82653,ELASTASE PANCREATIC FECAL,191.0,124.15,5.78,171.9,37
HCPCS,826530,EL-1 FECAL QUANTITATIVE,,,19.85,19.85,1
HCPCS,82656,EL-1 FECAL QUAL/SEMIQ,,,9.96,9.96,1
HCPCS,82656,PANC ELASTASE FECAL QUAL/SEMI,289.0,187.85,5.78,260.1,37
HCPCS,826560,EL-1 FECAL QUAL/SEMIQ,,,9.96,9.96,1
HCPCS,82657,ALPHA GALACTOS SERUM,1154.0,750.1,5.78,1038.6,37
HCPCS,82657,"ALPHA GALACTOSIDASE, WBC",960.0,624.0,5.78,864.0,37
HCPCS,82657,ALPHA-GALACTOSIDASE,570.0,370.5,5.78,513.0,37
HCPCS,82657,"ARYLSULFATASE A, WBC",766.0,497.9,5.78,689.4,37
HCPCS,82657,ASPARAGINASE ENZYME ACTIVITY,463.0,300.95,5.78,416.7,37
HCPCS,82657,CPALMF ENZYME CELL ACTIVITY,95.0,61.75,5.78,85.5,37
HCPCS,82657,CPALMT ENZYME CELL ACTIVITY,212.0,137.8,5.78,190.8,37
HCPCS,82657,DISACCHARIDASE IN TISSUE,144.0,93.6,5.78,129.6,37
HCPCS,82657,ENZYME ACTIVITY BC; NOT RA,376.5,244.725,5.78,437.4,74
HCPCS,82657,ENZYME ACTIVITY NRADIOAC NOS,340.0,221.0,5.78,308.7,74
HCPCS,82657,ENZYME CELL ACTIVITY,,,19.16,19.16,1
HCPCS,82657,FAOACM ENZYME CELL ACTIVITY X8,119.0,77.35,5.78,107.1,37
HCPCS,82657,FAOSCM ENZYME CELL ACTIVITY X4,119.0,77.35,5.78,107.1,37
HCPCS,82657,GAUCHER GBA ACTIVITY LEUKOCYTES,200.0,130.0,5.78,180.0,37
HCPCS,82657,LYSO ACID LIPASE ACT,337.0,219.05,5.78,303.3,37
HCPCS,82657,NEURO CEROID LIPO CLN2,648.0,421.2,5.78,583.2,37
HCPCS,82657,NEURO CEROID LIPOFUCIN,648.0,421.2,5.78,583.2,37
HCPCS,82657,PBGDEP ENZYME CELL ACT,109.0,70.85,5.78,98.1,37
HCPCS,82657,PORPHOBILINOGEN SERUM,449.0,291.85,5.78,404.1,37
HCPCS,82657,SIALIC ACID URINE,1417.0,921.05,5.78,1275.3,37
HCPCS,82657,THIOPURINE METHYLT TPMT,281.0,182.65,5.78,252.9,37
HCPCS,826570,ENZYME CELL ACTIVITY,,,19.16,19.16,1
HCPCS,82658,CPALMF ENZYME CELL ACTIVITY RA X2,188.0,122.2,13.39,169.2,37
HCPCS,82658,CPALMT ENZYME CELL ACTIVITY RA X2,210.0,136.5,13.39,189.0,37
HCPCS,82658,ENZYME CELL ACTIVITY RA,,,38.04,38.04,1
HCPCS,826580,ENZYME CELL ACTIVITY RA,,,38.04,38.04,1
HCPCS,82664,CHYLOMICRON SCREEN,246.0,159.9,13.39,221.4,37
HCPCS,82664,"CHYLOSCREEN, BF ELECTROPHORESIS, REFLEX",182.0,118.3,13.39,163.8,37
HCPCS,82664,ELECTROPHORETIC TEST,,,53.14,53.14,1
HCPCS,82664,ISOELECTRIC FOCUSING HB,353.0,229.45,13.39,317.7,37
HCPCS,82664,MPS ELECTROPHORESIS,185.0,120.25,13.39,166.5,37
HCPCS,826640,ELECTROPHORETIC TEST,,,53.14,53.14,1
HCPCS,82668,ASSAY OF ERYTHROPOIETIN,,,16.23,16.23,1
HCPCS,82668,EPO ASSAY,33.0,21.45,5.78,31.4,37
HCPCS,82668,ERYTHROPOIETIN,32.0,20.8,5.78,31.4,37
HCPCS,826680,ASSAY OF ERYTHROPOIETIN,,,16.23,16.23,1
HCPCS,82670,ASSAY OF TOTAL ESTRADIOL,,,24.14,24.14,1
HCPCS,82670,ESTRADIOL,44.0,28.6,6.33,44.0,37
HCPCS,82670,ESTRADIOL TANDEM MASS SP,206.0,133.9,6.33,185.4,37
HCPCS,82670,ESTRADIOL-17B,123.0,79.95,6.33,110.7,37
HCPCS,826700,ASSAY OF TOTAL ESTRADIOL,,,24.14,24.14,1
HCPCS,82671,ASSAY OF ESTROGENS,,,27.91,27.91,1
HCPCS,82671,ESTROGENS; FRACTIONATED,69.0,44.85,16.61,62.1,37
HCPCS,826710,ASSAY OF ESTROGENS,,,27.91,27.91,1
HCPCS,82672,ASSAY OF ESTROGEN,,,18.75,18.75,1
HCPCS,82672,ESTROGENS TOTAL,67.0,43.55,6.33,60.3,37
HCPCS,826720,ASSAY OF ESTROGEN,,,18.75,18.75,1
HCPCS,82677,%SEQ2 ESTRIOL,117.0,76.05,6.33,105.3,37
HCPCS,82677,ASSAY OF ESTRIOL,,,20.89,20.89,1
HCPCS,82677,ESTRIOL,37.0,24.05,6.33,37.0,37
HCPCS,82677,ESTRIOL SERUM,36.0,23.4,6.33,36.0,37
HCPCS,826770,ASSAY OF ESTRIOL,,,20.89,20.89,1
HCPCS,82679,ASSAY OF ESTRONE,,,21.56,41.69,4
HCPCS,82679,ESTRONE,43.0,27.95,6.33,41.69,37
HCPCS,82679,ESTRONE SERUM,41.0,26.65,6.33,41.0,37
HCPCS,826790,ASSAY OF ESTRONE,,,21.56,21.56,1
HCPCS,82679QW,ASSAY OF ESTRONE,,,38.47,41.69,3
HCPCS,82681,ASSAY DIR MEAS FR ESTRADIOL,,,24.14,46.69,15
HCPCS,82681,Assay dir meas fr estradiol,,,6.33,7.99,6
HCPCS,826810,ASSAY DIR MEAS FR ESTRADIOL,,,24.14,24.14,1
HCPCS,82693,ASSAY OF ETHYLENE GLYCOL,,,12.87,12.87,1
HCPCS,82693,ETHYLENE GLYCOL,69.5,45.175,5.78,63.0,74
HCPCS,826930,ASSAY OF ETHYLENE GLYCOL,,,12.87,12.87,1
HCPCS,82696,ASSAY OF ETIOCHOLANOLONE,,,22.67,43.85,15
HCPCS,82696,Assay of etiocholanolone,,,6.33,7.99,6
HCPCS,826960,ASSAY OF ETIOCHOLANOLONE,,,22.67,22.67,1
HCPCS,82705,FAT OR LIPID FECES QUAL,45.0,29.25,2.59,40.5,37
HCPCS,82705,"FAT, FECAL QUAL",44.0,28.6,2.59,39.6,37
HCPCS,82705,FATS/LIPIDS FECES QUAL,,,4.41,4.41,1
HCPCS,82705,FECAL FAT QUALITATIVE,44.0,28.6,2.59,39.6,37
HCPCS,827050,FATS/LIPIDS FECES QUAL,,,4.41,4.41,1
HCPCS,82710,FAT OR LIPID FECES QUANT,45.0,29.25,5.78,40.5,37
HCPCS,82710,FATS/LIPIDS FECES QUANT,,,14.52,14.52,1
HCPCS,82710,FECAL FAT QUANT FECES,44.0,28.6,5.78,39.6,37
HCPCS,827100,FATS/LIPIDS FECES QUANT,,,14.52,14.52,1
HCPCS,82715,ASSAY OF FECAL FAT,,,19.85,38.38,15
HCPCS,82715,Assay of fecal fat,,,5.78,7.3,6
HCPCS,827150,ASSAY OF FECAL FAT,,,19.85,19.85,1
HCPCS,82725,ASSAY OF BLOOD FATTY ACIDS,,,16.22,31.36,15
HCPCS,82725,Assay of blood fatty acids,,,5.78,7.3,6
HCPCS,827250,ASSAY OF BLOOD FATTY ACIDS,,,16.22,16.22,1
HCPCS,82726,LONG CHAIN FATTY ACIDS,185.0,120.25,5.78,166.5,38
HCPCS,82726,VERY LNG CHN FATTY ACID,287.0,186.55,5.78,258.3,37
HCPCS,827260,LONG CHAIN FATTY ACIDS,,,17.06,17.06,1
HCPCS,82728,ASSAY FERRITIN,146.0,94.9,5.72,146.0,17
HCPCS,82728,ASSAY OF FERRITIN,,,11.77,11.77,1
HCPCS,82728,FERRITIN ASSAY,147.0,95.55,5.78,132.3,37
HCPCS,827280,ASSAY OF FERRITIN,,,11.77,11.77,1
HCPCS,82731,ASSAY OF FETAL FIBRONECTIN,,,55.65,55.65,1
HCPCS,82731,FETAL FIBRONECTIN,543.0,352.95,32.49,488.7,37
HCPCS,827310,ASSAY OF FETAL FIBRONECTIN,,,55.65,55.65,1
HCPCS,82735,ASSAY OF FLUORIDE,,,16.02,16.02,1
HCPCS,82735,FLUORIDE SERUM,436.0,283.4,5.78,392.4,37
HCPCS,827350,ASSAY OF FLUORIDE,,,16.02,16.02,1
HCPCS,82746,ASSAY OF FOLIC ACID SERUM,157.0,102.05,6.17,157.0,18
HCPCS,82746,FOLIC ACID SERUM ASSAY,111.0,72.15,5.78,99.9,37
HCPCS,827460,ASSAY OF FOLIC ACID SERUM,,,12.7,12.7,1
HCPCS,82747,ASSAY OF FOLIC ACID RBC,,,15.25,15.25,1
HCPCS,82747,FOLIC ACID RBC,24.0,15.6,5.78,24.0,37
HCPCS,82747,FOLIC ACID RBC TEST,140.0,91.0,5.78,126.0,37
HCPCS,82747,"RBC FOLATE (REFLAB ONLY, REQUIRES HCT WITHIN 24 HRS)",33.0,21.45,5.78,29.7,37
HCPCS,827470,ASSAY OF FOLIC ACID RBC,,,15.25,15.25,1
HCPCS,82757,ASSAY OF SEMEN FRUCTOSE,,,14.98,14.98,1
HCPCS,82757,FRUCTOSE SEME,83.0,53.95,5.78,74.7,37
HCPCS,82757,FRUCTOSE SEMEN ASSAY,39.0,25.35,5.78,35.1,37
HCPCS,827570,ASSAY OF SEMEN FRUCTOSE,,,14.98,14.98,1
HCPCS,82759,ASSAY OF RBC GALACTOKINASE,,,18.55,35.89,15
HCPCS,82759,Assay of rbc galactokinase,,,5.78,7.3,6
HCPCS,827590,ASSAY OF RBC GALACTOKINASE,,,18.55,18.55,1
HCPCS,82760,ASSAY OF GALACTOSE,,,9.68,9.68,1
HCPCS,82760,GALACTOSE QUANT UR,329.0,213.85,5.78,296.1,37
HCPCS,827600,ASSAY OF GALACTOSE,,,9.68,9.68,1
HCPCS,82775,ASSAY GALACTOSE TRANSFERASE,,,18.21,35.21,15
HCPCS,82775,Assay galactose transferase,,,5.78,7.3,6
HCPCS,827750,ASSAY GALACTOSE TRANSFERASE,,,18.21,18.21,1
HCPCS,82776,GALACTOSE TRANSFERASE TEST,,,10.14,19.62,15
HCPCS,82776,Galactose transferase test,,,5.78,7.3,6
HCPCS,827760,GALACTOSE TRANSFERASE TEST,,,10.14,10.14,1
HCPCS,82777,GALECTIN 3,105.0,68.25,13.39,94.5,37
HCPCS,82777,GALECTIN-3,,,38.23,38.23,1
HCPCS,82777,GALECTIN-3 SERUM,101.0,65.65,13.39,90.9,37
HCPCS,827770,GALECTIN-3,,,38.23,38.23,1
HCPCS,82784,%CELCMP GAMMALOBULIN,79.0,51.35,2.59,71.1,37
HCPCS,82784,*CRYSTAL EXAM FLUID/TIS,72.0,46.8,2.59,64.8,37
HCPCS,82784,*GAMMAGLOBULIN ASSAY,121.5,78.975,2.59,167.4,185
HCPCS,82784,*GAMMAGLOBULIN EA ASSAY,57.0,37.05,2.59,51.3,37
HCPCS,82784,ASSAY IGA/IGD/IGG/IGM EACH,,,8.04,8.04,1
HCPCS,82784,COMPREHENSIVE CELIAC PANEL 82784,86.0,55.9,2.59,77.4,37
HCPCS,82784,GAMMAGLOBULIN ASSAY,69.0,44.85,2.59,82.8,111
HCPCS,82784,IG-A SERMAN,13.0,8.45,3.91,13.0,17
HCPCS,82784,IG-G SERUM,13.0,8.45,3.91,13.0,17
HCPCS,82784,IG-M SERUM,13.0,8.45,3.91,13.0,17
HCPCS,82784,"IMGLB IGG, A, M X3",81.0,52.65,2.59,72.9,37
HCPCS,82784,"IMMUNOGLOB D QT, SERUM",119.0,77.35,2.59,107.1,37
HCPCS,82784,LYMRFX IGG QUANT,60.0,39.0,2.59,54.0,37
HCPCS,827840,ASSAY IGA/IGD/IGG/IGM EACH,,,8.04,8.04,1
HCPCS,82785,*GAMMAGLOBULIN ASSAY IGE,111.0,72.15,5.78,99.9,74
HCPCS,82785,ASSAY OF IGE,,,14.22,14.22,1
HCPCS,82785,"ASSAY, GAMMAGLOBULIN IGE",177.0,115.05,6.91,177.0,17
HCPCS,82785,ATLANTIC RESPIRATORY PANEL IGE TOTAL,41.0,26.65,5.78,36.9,37
HCPCS,82785,GAMMAGLOBULIN ASSAY IGE,111.0,72.15,5.78,99.9,37
HCPCS,82785,IG-E SERUM,111.0,72.15,5.78,99.9,37
HCPCS,827850,ASSAY OF IGE,,,14.22,14.22,1
HCPCS,82787,%IGG SUBCLASSES X4,70.0,45.5,2.59,63.0,37
HCPCS,82787,*GAMMAGLOBULIN IGG SUBC EA,22.0,14.3,2.59,19.8,37
HCPCS,82787,*GAMMAGLOBULIN IGG SUBCLASS EA,17.0,11.05,2.59,19.8,111
HCPCS,82787,IGG 1 2 3 OR 4 EACH,,,6.93,6.93,1
HCPCS,827870,IGG 1 2 3 OR 4 EACH,,,6.93,6.93,1
HCPCS,82800,BLOOD PH,,,9.5,18.38,15
HCPCS,82800,Blood ph,,,5.78,7.3,6
HCPCS,828000,BLOOD PH,,,9.5,9.5,1
HCPCS,82803,*BLOOD GAS MIXED WO O2 SAT,237.0,154.05,13.39,213.3,37
HCPCS,82803,BLOOD GAS ARTERIAL (POINT OF CARE LAB),231.0,150.15,13.39,207.9,37
HCPCS,82803,BLOOD GAS MIXED WO O2 SAT,52.0,33.8,13.0,46.8,37
HCPCS,82803,BLOOD GAS VENOUS (POINT OF CARE LAB),231.0,150.15,13.39,207.9,37
HCPCS,82803,BLOOD GASES ANY COMBINATION,,,22.53,22.53,1
HCPCS,82803,BLOOD GASES ANY COMBINATION PH PCO2 PO2 CO2 HCO3,183.0,118.95,10.95,183.0,17
HCPCS,828030,BLOOD GASES ANY COMBINATION,,,22.53,22.53,1
HCPCS,82805,BLD GAS PH/PO2/PCO2 W SAT (POINT OF CARE LAB),261.0,169.65,32.49,234.9,37
HCPCS,82805,BLOOD GAS,261.0,169.65,32.49,234.9,37
HCPCS,82805,BLOOD GAS (POINT OF CARE LAB),261.0,169.65,32.49,234.9,37
HCPCS,82805,BLOOD GASES W/O2 SATURATION,,,68.06,68.06,1
HCPCS,82805,GASES BLOOD PH DIRECT MEAS XCPT PULSE OXIMITRY,201.0,130.65,31.36,201.0,17
HCPCS,828050,BLOOD GASES W/O2 SATURATION,,,68.06,68.06,1
HCPCS,82810,BLOOD GAS O2 SATUR ONLY,89.0,57.85,2.59,80.1,37
HCPCS,82810,BLOOD GAS O2 SATUR ONLY (POINT OF CARE LAB),82.5,53.625,2.59,80.1,74
HCPCS,82810,BLOOD GASES O2 SAT ONLY,,,8.45,8.45,1
HCPCS,828100,BLOOD GASES O2 SAT ONLY,,,8.45,8.45,1
HCPCS,82820,HEMOGLOBIN-OXYGEN AFFINITY,,,11.52,11.52,1
HCPCS,82820,OXY DISSOC P50 BY HEMOX,1098.0,713.7,2.81,988.2,37
HCPCS,828200,HEMOGLOBIN-OXYGEN AFFINITY,,,11.52,11.52,1
HCPCS,82930,GASTRIC ANALY W/PH EA SPEC,,,5.8,11.21,15
HCPCS,82930,Gastric analy w/ph ea spec,,,2.59,3.28,6
HCPCS,829300,GASTRIC ANALY W/PH EA SPEC,,,5.8,5.8,1
HCPCS,82938,GASTRIN TEST,,,15.28,29.56,15
HCPCS,82938,Gastrin test,,,6.33,7.99,6
HCPCS,829380,GASTRIN TEST,,,15.28,15.28,1
HCPCS,82941,ASSAY OF GASTRIN,,,15.23,15.23,1
HCPCS,82941,GASTRIN,88.5,57.525,6.0,137.7,74
HCPCS,829410,ASSAY OF GASTRIN,,,15.23,15.23,1
HCPCS,82943,ASSAY OF GLUCAGON,,,12.34,12.34,1
HCPCS,82943,GLUCAGON,45.5,29.575,6.33,41.4,74
HCPCS,829430,ASSAY OF GLUCAGON,,,12.34,12.34,1
HCPCS,82945,GLUC BODY FLUID NOT BLOOD,22.0,14.3,2.59,19.8,37
HCPCS,82945,GLUCOSE BDY FLD PROFESSIONAL FEE,13.0,8.45,2.36,13.0,17
HCPCS,82945,GLUCOSE BF,57.0,37.05,2.59,51.3,37
HCPCS,82945,GLUCOSE BODY FLUID,12.0,7.8,2.59,10.8,37
HCPCS,82945,GLUCOSE OTHER FLUID,,,3.39,3.39,1
HCPCS,82945,GLUCOSE RANDOM UR,86.0,55.9,2.59,77.4,37
HCPCS,82945,"GLUCOSE RANDOM, UR",56.0,36.4,2.59,50.4,37
HCPCS,829450,GLUCOSE OTHER FLUID,,,3.39,3.39,1
HCPCS,82946,GLUCAGON TOLERANCE TEST,,,15.36,29.69,15
HCPCS,82946,Glucagon tolerance test,,,5.78,7.3,6
HCPCS,829460,GLUCAGON TOLERANCE TEST,,,15.36,15.36,1
HCPCS,82947,*GLUCOSE QUANT,80.0,52.0,2.59,72.0,74
HCPCS,82947,ASSAY GLUCOSE BLOOD QUANT,,,3.39,6.57,4
HCPCS,82947,GLUC BLOOD QUANT ASSAY,41.0,26.65,2.59,36.9,37
HCPCS,82947,"GLUC, FASTING",80.0,52.0,2.59,72.0,37
HCPCS,82947,GLUCOSE QUANT,80.0,52.0,2.59,72.0,37
HCPCS,82947,GLUCOSE QUANT (POINT OF CARE LAB),80.0,52.0,2.59,72.0,37
HCPCS,82947,GLUCOSE QUANT PROFESSIONAL FEE,13.0,8.45,2.36,13.0,17
HCPCS,82947,GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP,20.0,13.0,2.36,20.0,17
HCPCS,829470,ASSAY GLUCOSE BLOOD QUANT,,,3.39,3.39,1
HCPCS,82947QW,ASSAY GLUCOSE BLOOD QUANT,,,6.06,6.57,3
HCPCS,82948,REAGENT STRIP/BLOOD GLUCOSE,,,4.35,8.42,15
HCPCS,82948,Reagent strip/blood glucose,,,2.59,3.28,6
HCPCS,829480,REAGENT STRIP/BLOOD GLUCOSE,,,4.35,4.35,1
HCPCS,82950,GLUC NON GEST TOLERANCE,36.0,23.4,2.59,32.4,37
HCPCS,82950,GLUCOSE SCRN POST DOSE,36.0,23.4,2.59,32.4,37
HCPCS,82950,GLUCOSE TEST,,,4.1,7.94,4
HCPCS,829500,GLUCOSE TEST,,,4.1,4.1,1
HCPCS,82950QW,GLUCOSE TEST,,,7.32,7.94,3
HCPCS,82951,GLUCOSE TOLERANCE TEST (GTT),,,11.12,21.51,4
HCPCS,82951,GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS,121.0,78.65,7.72,121.0,17
HCPCS,82951,GTT 3SPEC,182.0,118.3,5.78,163.8,37
HCPCS,829510,GLUCOSE TOLERANCE TEST (GTT),,,11.12,11.12,1
HCPCS,82951QW,GLUCOSE TOLERANCE TEST (GTT),,,19.85,21.51,3
HCPCS,82952,GLUCOSE TOLERANCE EA ADDL BEYOND 3 SPECIMENS,46.0,29.9,2.35,46.0,17
HCPCS,82952,GTT EA ADD SPEC BEYOND 3,51.0,33.15,2.59,45.9,37
HCPCS,82952,GTT-ADDED SAMPLES,,,3.39,6.55,4
HCPCS,829520,GTT-ADDED SAMPLES,,,3.39,3.39,1
HCPCS,82952QW,GTT-ADDED SAMPLES,,,6.04,6.55,3
HCPCS,82955,ASSAY OF G6PD ENZYME,,,8.38,8.38,1
HCPCS,82955,G6PD QUANT,24.0,15.6,2.59,21.6,37
HCPCS,82955,GLUCOSE 6 PHOS DEHYD QT,24.0,15.6,2.59,21.6,37
HCPCS,829550,ASSAY OF G6PD ENZYME,,,8.38,8.38,1
HCPCS,82960,G6PD SREEN,21.0,13.65,2.59,18.9,37
HCPCS,82960,TEST FOR G6PD ENZYME,,,5.23,5.23,1
HCPCS,829600,TEST FOR G6PD ENZYME,,,5.23,5.23,1
HCPCS,82962,GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE,24.0,15.6,1.97,24.0,17
HCPCS,82962,GLUC BLOOD TEST BY DVC (POINT OF CARE LAB),24.0,15.6,2.59,21.6,37
HCPCS,82962,GLUCOMETER-ACCUCHECK,13.0,8.45,1.97,13.0,17
HCPCS,82962,GLUCOSE BLD BY MONIT DEV (POINT OF CARE LAB),24.0,15.6,2.59,21.6,37
HCPCS,82962,GLUCOSE BLOOD TEST,,,2.83,2.83,1
HCPCS,829620,GLUCOSE BLOOD TEST,,,2.83,2.83,1
HCPCS,82963,ASSAY OF GLUCOSIDASE,,,18.55,18.55,1
HCPCS,82963,BETA-GLUCOSIDASE LEUK,570.0,370.5,5.78,513.0,37
HCPCS,829630,ASSAY OF GLUCOSIDASE,,,18.55,18.55,1
HCPCS,82965,ASSAY OF GDH ENZYME,,,11.36,21.97,15
HCPCS,82965,Assay of gdh enzyme,,,5.78,7.3,6
HCPCS,829650,ASSAY OF GDH ENZYME,,,11.36,11.36,1
HCPCS,82977,*GLUTAMYLTRANSFERASE GAMMA,67.0,43.55,2.59,60.3,37
HCPCS,82977,ASSAY OF GGT,,,6.22,12.03,4
HCPCS,82977,ASSAY OF GLUTAMYLTRASE GAMMA,78.0,50.7,3.02,78.0,17
HCPCS,82977,"GAMMA GLUTAMYL TRANSFERASE, FIBROMETER",22.0,14.3,2.59,19.8,37
HCPCS,82977,GGT ASSAY,144.0,93.6,2.59,129.6,37
HCPCS,829770,ASSAY OF GGT,,,6.22,6.22,1
HCPCS,82977QW,ASSAY OF GGT,,,11.1,12.03,3
HCPCS,82978,ASSAY OF GLUTATHIONE,,,13.35,13.35,1
HCPCS,82978,GLUTATHIONE TOTAL,120.0,78.0,5.78,108.0,37
HCPCS,829780,ASSAY OF GLUTATHIONE,,,13.35,13.35,1
HCPCS,82979,ASSAY RBC GLUTATHIONE,,,8.15,15.77,15
HCPCS,82979,Assay rbc glutathione,,,2.59,3.28,6
HCPCS,829790,ASSAY RBC GLUTATHIONE,,,8.15,8.15,1
HCPCS,82985,ASSAY OF GLYCATED PROTEIN,50.0,32.5,5.78,45.0,41
HCPCS,82985,GLYCATED PROTEIN,34.0,22.1,5.78,38.7,74
HCPCS,82985,GLYCOPROTEINS,312.0,202.8,5.78,280.8,37
HCPCS,829850,ASSAY OF GLYCATED PROTEIN,,,14.48,14.48,1
HCPCS,82985QW,ASSAY OF GLYCATED PROTEIN,,,25.84,28.01,3
HCPCS,83001,ASSAY OF GONADOTROPIN (FSH),,,16.05,31.05,4
HCPCS,83001,FOLLICLE STIMLAT HORMONE,34.0,22.1,6.33,31.05,37
HCPCS,83001,GONADOTROPIN FOLLICLE STIMULATING HORMONE,199.0,129.35,7.8,199.0,17
HCPCS,83001,GONADOTROPIN FSH,182.0,118.3,6.33,163.8,37
HCPCS,830010,ASSAY OF GONADOTROPIN (FSH),,,16.05,16.05,1
HCPCS,83001QW,ASSAY OF GONADOTROPIN (FSH),,,28.65,31.05,3
HCPCS,83002,ASSAY OF GONADOTROPIN (LH),,,16.01,30.95,4
HCPCS,83002,GONADOTROPIN LH,182.0,118.3,6.33,163.8,37
HCPCS,83002,GONADOTROPIN LUTEINIZING HORMONE,198.0,128.7,7.78,198.0,17
HCPCS,83002,"LH, PEDIATRIC",281.0,182.65,6.33,252.9,37
HCPCS,83002,LUTEINING HORMONE,34.0,22.1,6.33,30.95,37
HCPCS,830020,ASSAY OF GONADOTROPIN (LH),,,16.01,16.01,1
HCPCS,83002QW,ASSAY OF GONADOTROPIN (LH),,,28.56,30.95,3
HCPCS,83003,ASSAY GROWTH HORMONE (HGH),,,14.41,14.41,1
HCPCS,83003,GROWTH HORMONE HUMAN,33.0,21.45,6.33,29.7,37
HCPCS,83003,GROWTH HORMONE(HGH),24.0,15.6,6.0,24.0,37
HCPCS,830030,ASSAY GROWTH HORMONE (HGH),,,14.41,14.41,1
HCPCS,83006,GROWTH STIMULATION GENE 2,,,65.32,65.32,1
HCPCS,83006,GVHPRE GROWTH STIMULATION GENE 2,825.0,536.25,16.61,742.5,37
HCPCS,83006,GVHPST GROWTH STIMULATION GENE 2,825.0,536.25,16.61,742.5,37
HCPCS,83006,GVHSYM GROWTH STIMULATION GENE 2,825.0,536.25,16.61,742.5,37
HCPCS,830060,GROWTH STIMULATION GENE 2,,,65.32,65.32,1
HCPCS,83009,H PYLORI (C-13) BLOOD,,,58.2,112.56,15
HCPCS,83009,H pylori (c-13) blood,,,32.49,41.04,6
HCPCS,830090,H PYLORI (C-13) BLOOD,,,58.2,58.2,1
HCPCS,83010,*HAPTOGLOBIN QUANT ASSAY,67.0,43.55,5.78,60.3,37
HCPCS,83010,ASSAY OF HAPTOGLOBIN QUANT,,,10.86,10.86,1
HCPCS,83010,HAPTOGLOBIN QUANT,109.0,70.85,5.78,98.1,37
HCPCS,83010,HAPTOGLOBIN QUANT ASSAY,47.0,30.55,5.78,42.3,37
HCPCS,830100,ASSAY OF HAPTOGLOBIN QUANT,,,10.86,10.86,1
HCPCS,83012,ASSAY OF HAPTOGLOBINS,,,23.23,44.93,15
HCPCS,83012,Assay of haptoglobins,,,13.39,16.91,6
HCPCS,830120,ASSAY OF HAPTOGLOBINS,,,23.23,23.23,1
HCPCS,83013,H PYLORI (C-13) BREATH,,,58.2,58.2,1
HCPCS,83013,H PYLORI BRTH TST,132.0,85.8,32.49,118.8,37
HCPCS,83013,H.PYLORI BREATH TEST,130.0,84.5,32.49,117.0,37
HCPCS,83013,HPYLORI BREATH ANAL UREASE ACT NON-RADACT ISTOPE,259.0,168.35,28.29,259.0,17
HCPCS,830130,H PYLORI (C-13) BREATH,,,58.2,58.2,1
HCPCS,83014,ADMIN DRUG H PYLORI (POINT OF CARE LAB),52.0,33.8,2.59,46.8,37
HCPCS,83014,H PYLORI DRUG ADMIN,,,6.79,6.79,1
HCPCS,83014,HELICOBACTER PYLORI ; DRUG ADMINISTRATION,28.0,18.2,3.3,28.0,17
HCPCS,830140,H PYLORI DRUG ADMIN,,,6.79,6.79,1
HCPCS,83015,HEAVY METAL QUAL ANY NUMBER,,,18.09,34.99,15
HCPCS,83015,Heavy metal qual any number,,,5.78,7.3,6
HCPCS,830150,HEAVY METAL QUAL ANY NUMBER,,,18.09,18.09,1
HCPCS,83018,*HEAVY METAL; QUAN,212.0,137.8,5.78,190.8,37
HCPCS,83018,ANTIMONY BLOOD,202.0,131.3,5.78,181.8,37
HCPCS,83018,COBALT QUANT,32.0,20.8,5.78,32.0,37
HCPCS,83018,HEAVY METAL QUAN EACH NES,,,18.98,18.98,1
HCPCS,83018,HEAVY METAL; QUAN,137.0,89.05,5.78,147.6,74
HCPCS,83018,IODIDE SERUM,108.0,70.2,5.78,97.2,37
HCPCS,83018,"IODINE, RANDOM URINE",76.0,49.4,5.78,68.4,37
HCPCS,83018,TIN,160.0,104.0,5.78,144.0,37
HCPCS,83018,TITANIUM SER/PLAS,603.0,391.95,5.78,542.7,37
HCPCS,83018,"TOXIC METAL, QUANT EA",46.0,29.9,5.78,41.4,37
HCPCS,830180,HEAVY METAL QUAN EACH NES,,,18.98,18.98,1
HCPCS,83020,HBSCN1 REFLEX,120.0,78.0,5.78,108.0,37
HCPCS,83020,HEMOGLOBIN ELECTROPHORESIS,,,11.12,11.12,1
HCPCS,83020,HEMOGLOBIN FRACT AND QUANT,180.0,117.0,5.78,162.0,37
HCPCS,83020,HGB ELECPHRSIS FRACT/QUANT,20.0,13.0,4.75,45.0,111
HCPCS,830200,HEMOGLOBIN ELECTROPHORESIS,,,11.12,11.12,1
HCPCS,83021,HEMOGLOBIN A2 ASCAA,33.0,21.45,2.81,30.18,37
HCPCS,83021,HEMOGLOBIN CHROMOTOGRAPHY,,,15.61,15.61,1
HCPCS,83021,HGB CHROMO FRACT/QUANT,34.0,22.1,2.81,57.6,111
HCPCS,830210,HEMOGLOBIN CHROMOTOGRAPHY,,,15.61,15.61,1
HCPCS,83026,HEMOGLOBIN COPPER SULFATE,,,3.47,6.7,15
HCPCS,83026,Hemoglobin copper sulfate,,,2.81,3.55,6
HCPCS,830260,HEMOGLOBIN COPPER SULFATE,,,3.47,3.47,1
HCPCS,83030,HEMOGLOBIN F FETAL CHEMICAL,,,9.28,17.95,15
HCPCS,83030,Hemoglobin f fetal chemical,,,2.59,3.28,6
HCPCS,830300,HEMOGLOBIN F FETAL CHEMICAL,,,9.28,9.28,1
HCPCS,83033,F(FETAL) QUAL,19.0,12.35,2.59,17.1,37
HCPCS,83033,HEMOGLOBIN FTL F ASSAY QUAL,,,6.91,6.91,1
HCPCS,830330,HEMOGLOBIN FTL F ASSAY QUAL,,,6.91,6.91,1
HCPCS,83036,HEMOGLOBIN GLYCOSYLATED A1C,37.0,24.05,4.08,37.0,21
HCPCS,83036,HEMOGLOBIN; GLYCOSYLATED,61.0,39.65,4.08,61.0,17
HCPCS,83036,HGB A1C GLYCOSYLATED,107.0,69.55,2.59,96.3,37
HCPCS,83036,HGB A1C GLYCOSYLATED (POINT OF CARE LAB),107.0,69.55,2.59,96.3,37
HCPCS,830360,HEMOGLOBIN GLYCOSYLATED A1C,,,8.39,8.39,1
HCPCS,83036QW,HEMOGLOBIN GLYCOSYLATED A1C,,,14.97,16.23,3
HCPCS,83037,HB GLYCOSYLATED A1C HOME DEV,,,8.39,16.23,18
HCPCS,83037,Hb glycosylated a1c home dev,,,2.59,3.28,6
HCPCS,830370,HB GLYCOSYLATED A1C HOME DEV,,,8.39,8.39,1
HCPCS,83037QW,HB GLYCOSYLATED A1C HOME DEV,,,14.97,16.23,3
HCPCS,83045,HGB METHEMOGLOBIN QUAL,,,5.61,10.84,15
HCPCS,83045,Hgb methemoglobin qual,,,2.59,3.28,6
HCPCS,830450,HGB METHEMOGLOBIN QUAL,,,5.61,5.61,1
HCPCS,83050,HEMGLBN METHEMOGLBN QUAN,11.0,7.15,2.59,11.0,37
HCPCS,83050,HGB METHEMOGLOBIN QUAN,,,7.08,7.08,1
HCPCS,83050,METHEMOGLOBIN QUANT,65.0,42.25,2.59,58.5,37
HCPCS,83050,METHEMOGLOBIN QUANT (POINT OF CARE LAB),65.0,42.25,2.59,58.5,37
HCPCS,830500,HGB METHEMOGLOBIN QUAN,,,7.08,7.08,1
HCPCS,83051,HEMOGLOBIN PLASMA,23.5,15.275,2.59,31.5,75
HCPCS,83051,HGB; PLASMA,36.0,23.4,2.59,32.4,37
HCPCS,830510,HEMOGLOBIN PLASMA,,,6.32,6.32,1
HCPCS,83060,HGB SULFHEMOGLOBIN QUAN,,,7.6,14.7,15
HCPCS,83060,Hgb sulfhemoglobin quan,,,2.59,3.28,6
HCPCS,830600,HGB SULFHEMOGLOBIN QUAN,,,7.6,7.6,1
HCPCS,83065,HEMOGLOBIN THERMOLABILE,,,7.78,15.04,15
HCPCS,83065,Hemoglobin thermolabile,,,2.59,3.28,6
HCPCS,830650,HEMOGLOBIN THERMOLABILE,,,7.78,7.78,1
HCPCS,83068,HEMOGLOBIN UNSTABLE SCREEN,,,8.19,8.19,1
HCPCS,83068,HGB UNSTABLE SCREEN,43.0,27.95,2.59,38.7,37
HCPCS,830680,HEMOGLOBIN UNSTABLE SCREEN,,,8.19,8.19,1
HCPCS,83069,HEMOGLOBIN URINE,8.0,5.2,2.0,7.2,38
HCPCS,830690,HEMOGLOBIN URINE,,,3.41,3.41,1
HCPCS,83070,ASSAY OF HEMOSIDERIN QUAL,,,4.1,4.1,1
HCPCS,83070,HEMOSIDERIN QUAL,14.0,9.1,2.59,12.6,37
HCPCS,83070,HEMOSIDERIN URINE,43.0,27.95,2.59,38.7,37
HCPCS,830700,ASSAY OF HEMOSIDERIN QUAL,,,4.1,4.1,1
HCPCS,83080,ASSAY OF B HEXOSAMINIDASE EA,,,14.58,14.58,1
HCPCS,83080,ASSAY OF B-HEXOSAMINIDASE EACH ASSAY,128.0,83.2,7.09,128.0,17
HCPCS,83080,B-HEXOSAMINIDASE EA ASSA,213.0,138.45,5.78,191.7,37
HCPCS,83080,MISC SENDOUT CPT 83080,1371.0,891.15,5.78,1233.9,37
HCPCS,83080,PROC CHEM UNL,44.0,28.6,5.78,39.6,37
HCPCS,830800,ASSAY OF B HEXOSAMINIDASE EA,,,14.58,14.58,1
HCPCS,83088,ASSAY OF HISTAMINE,,,25.51,25.51,1
HCPCS,83088,HISTAMINE,62.0,40.3,13.39,55.8,37
HCPCS,83088,HISTAMINE ASSAY,72.0,46.8,13.39,64.8,37
HCPCS,830880,ASSAY OF HISTAMINE,,,25.51,25.51,1
HCPCS,83090,ASSAY OF HOMOCYSTEINE,180.0,117.0,7.53,180.0,18
HCPCS,83090,ASSAY OF HOMOCYSTINE,24.5,15.925,6.0,25.0,74
HCPCS,83090,HOMOCYST QUAN,13.0,8.45,6.5,18.63,17
HCPCS,83090,HOMOCYSTEINE ASSAY,81.0,52.65,6.33,72.9,37
HCPCS,830900,ASSAY OF HOMOCYSTEINE,,,15.49,15.49,1
HCPCS,83150,ASSAY OF HOMOVANILLIC ACID,,,19.36,19.36,1
HCPCS,83150,HOMOVANILLIC ACID (HVA),325.0,211.25,6.33,292.5,37
HCPCS,83150,HOMOVANILLIC ACID URINE,142.0,92.3,6.33,127.8,37
HCPCS,83150,HOMOVNLLC ACID(HVA),36.0,23.4,6.33,36.0,37
HCPCS,831500,ASSAY OF HOMOVANILLIC ACID,,,19.36,19.36,1
HCPCS,83491,*HYDROXYCORTICOSTEROID17,68.0,44.2,6.33,61.2,37
HCPCS,83491,ASY HYDROXYCORTICOSTEROIDS17,,,15.47,15.47,1
HCPCS,834910,ASY HYDROXYCORTICOSTEROIDS17,,,15.47,15.47,1
HCPCS,83497,5 HIAA URINE,128.0,83.2,6.33,115.2,37
HCPCS,83497,"5-HIAA, PLASMA - LABCORP",45.0,29.25,6.33,40.5,37
HCPCS,83497,ASSAY OF 5-HIAA,,,11.15,11.15,1
HCPCS,83497,HYDRXINDOL ACD5(HIAA)QT,39.0,25.35,6.33,35.1,37
HCPCS,834970,ASSAY OF 5-HIAA,,,11.15,11.15,1
HCPCS,83498,17-HYDROXYPROGESTERONE UR,289.0,187.85,6.33,260.1,37
HCPCS,83498,17-OH PROGESTERONE,98.0,63.7,6.33,88.2,37
HCPCS,83498,ASY HYDROXYPROGESTERONE 17-D,,,23.48,23.48,1
HCPCS,83498,CAHSP ASY HYDROXYPROGESTERONE 17-D,75.0,48.75,6.33,67.5,37
HCPCS,83498,HYDRXYPRGSTRONE 17-D,37.0,24.05,6.33,37.0,37
HCPCS,834980,ASY HYDROXYPROGESTERONE 17-D,,,23.48,23.48,1
HCPCS,83500,ASSAY FREE HYDROXYPROLINE,,,19.57,37.85,15
HCPCS,83500,Assay free hydroxyproline,,,6.33,7.99,6
HCPCS,835000,ASSAY FREE HYDROXYPROLINE,,,19.57,19.57,1
HCPCS,83505,ASSAY TOTAL HYDROXYPROLINE,,,21.0,21.0,1
HCPCS,83505,HYDRXYPROLINE TOTAL,56.0,36.4,6.33,50.4,37
HCPCS,835050,ASSAY TOTAL HYDROXYPROLINE,,,21.0,21.0,1
HCPCS,83516,%ANCA C+P EIA X2,74.0,48.1,5.78,66.6,37
HCPCS,83516,%CELCMP TRANSGLUT IGA,79.0,51.35,5.78,71.1,37
HCPCS,83516,%RHEUMA IMMUNO X2,207.0,134.55,5.78,186.3,37
HCPCS,83516,*GLIADIN ANTIBODY,25.0,16.25,5.78,22.5,37
HCPCS,83516,*IMMUNOASSAY NONINF QUAL/SEMI,90.5,58.825,5.78,349.2,296
HCPCS,83516,*IMMUNOASSY NONINF QUAL/SEMI,53.0,34.45,5.78,72.9,148
HCPCS,83516,ACESTR IMMUNOASSAY NONANTIBODY X2,69.0,44.85,5.78,62.1,37
HCPCS,83516,ACETYLCHOL REC MOD,197.0,128.05,5.78,177.3,37
HCPCS,83516,ALLOGEN AUTOANTIBODY,1059.0,688.35,5.78,953.1,37
HCPCS,83516,ANTI ALPHA FODRIN AB IGA,121.0,78.65,5.78,108.9,37
HCPCS,83516,ANTI ALPHA FODRIN AB IGG,121.0,78.65,5.78,108.9,37
HCPCS,83516,ANTI ALPHA FODRIN AB IGG IGA X2,109.0,70.85,5.78,98.1,37
HCPCS,83516,ANTI IGE,157.0,102.05,5.78,141.3,37
HCPCS,83516,ANTI-C1Q AB IGG,426.0,276.9,5.78,383.4,37
HCPCS,83516,ANTI-CN-1A (NT5C1A) IBM,231.0,150.15,5.78,207.9,37
HCPCS,83516,ANTI-HMGCR AUTO AB,829.0,538.85,5.78,746.1,37
HCPCS,83516,"ANTI-SP100 AND ANTI-GP210 ANTIBODIES, IGG",120.0,78.0,5.78,108.0,37
HCPCS,83516,ANTIBODY IMMUNOASSAY (POLMYO),75.0,48.75,5.78,67.5,37
HCPCS,83516,AT1R-ANTIBODY-REFERENCE SAMPLE,289.0,187.85,5.78,260.1,37
HCPCS,83516,"BULLOUS PEMPHIGOID, BP180 AND BP230, IGG ANTIBODIES",35.0,22.75,5.78,31.5,37
HCPCS,83516,COMPREHENSIVE CELIAC PANEL 83516,80.0,52.0,5.78,72.0,37
HCPCS,83516,DERMATOMYOSITIS PANEL,75.0,48.75,5.78,67.5,37
HCPCS,83516,DERMATOMYOSITIS PANEL X6,47.0,30.55,5.78,42.3,37
HCPCS,83516,GANGLIOSIDE ABS X6,89.0,57.85,5.78,80.1,37
HCPCS,83516,GBMGP IMMUNOASSAY NONANTIBODY,67.0,43.55,5.78,60.3,37
HCPCS,83516,GLOM BASE MEM AB IGG,167.0,108.55,5.78,150.3,37
HCPCS,83516,GM1 ANTIBODY PANEL X2,216.0,140.4,5.78,194.4,37
HCPCS,83516,HSP-70 AB,227.0,147.55,5.78,204.3,37
HCPCS,83516,HYDROXYLASE-21 AB,118.0,76.7,5.78,106.2,37
HCPCS,83516,IMMUNOASSAY (MYOSPL),51.0,33.15,5.78,45.9,37
HCPCS,83516,IMMUNOASSAY N,176.0,114.4,5.78,158.4,37
HCPCS,83516,IMMUNOASSAY NONANTIBODY,123.0,79.95,5.78,110.7,41
HCPCS,83516,IMMUNOASSAY NONINF QUAL/SEMI,65.5,42.575,5.78,252.9,370
HCPCS,83516,IMMUNOASSY NONINF QUAL/SEMI,50.0,32.5,5.78,425.7,185
HCPCS,83516,MAG ANTIBODY IGM,52.0,33.8,5.78,46.8,37
HCPCS,83516,MYELOPEROXIDASE ABS,83.0,53.95,5.78,74.7,37
HCPCS,83516,"PT AB, IGG",75.0,48.75,5.78,67.5,37
HCPCS,83516,RNA POLYMER III IGG,354.0,230.1,5.78,318.6,37
HCPCS,83516,SENMOT IMMUNOASSAY (ARUP),35.0,22.75,5.78,31.5,37
HCPCS,83516,SENNRO IMMUNOASSAY (ARUP),35.0,22.75,5.78,31.5,37
HCPCS,83516,SGPG ANTIBODY IGM,197.0,128.05,5.78,177.3,37
HCPCS,83516,TH/TO ANTIBODY,561.0,364.65,5.78,504.9,37
HCPCS,83516,TYSABRI ANTIBODIES,932.0,605.8,5.78,838.8,37
HCPCS,835160,IMMUNOASSAY NONANTIBODY,,,9.96,9.96,1
HCPCS,83516QW,IMMUNOASSAY NONANTIBODY,,,17.78,19.27,3
HCPCS,83518,IMMUNOASSAY ANALYTE QUAL/SEMIQUAL SINGLE STEP,33.0,21.45,5.78,33.0,17
HCPCS,83518,IMMUNOASSAY DIPSTICK,,,8.33,16.11,18
HCPCS,83518,Immunoassay dipstick,,,2.59,3.28,6
HCPCS,835180,IMMUNOASSAY DIPSTICK,,,8.33,8.33,1
HCPCS,83518QW,IMMUNOASSAY DIPSTICK,,,14.86,16.11,3
HCPCS,83519,%CEPHAL IA/RIA,397.0,258.05,5.78,357.3,37
HCPCS,83519,%LAMBRT IA;QNT RIA X4 MOD,328.0,213.2,5.78,295.2,37
HCPCS,83519,%MYGRAV ACHR ABX2,97.0,63.05,5.78,87.3,37
HCPCS,83519,%PARNEO AB BIND X2 MOD,92.0,59.8,5.78,82.8,37
HCPCS,83519,*IMMUNOASSAY NONINF QUANT RIA,388.0,252.2,5.78,349.2,37
HCPCS,83519,ACESTR RIA NONANTIBODY,135.0,87.75,5.78,121.5,37
HCPCS,83519,ACETYLCHOL REC MOD,180.0,117.0,5.78,162.0,37
HCPCS,83519,ADIPONECTIN,202.0,131.3,5.78,181.8,37
HCPCS,83519,AIDYSA RIA NONAB,121.0,78.65,5.78,108.9,37
HCPCS,83519,ENCSER RIA NON AB X3,98.0,63.7,5.78,88.2,37
HCPCS,83519,GANGLIONIC ACHR AUTOAB,789.0,512.85,5.78,710.1,37
HCPCS,83519,GANGLIONIC NACHR ANTIBOD,991.0,644.15,5.78,891.9,37
HCPCS,83519,IA 2 AB,79.0,51.35,5.78,71.1,37
HCPCS,83519,IGF BINDING PROTEIN 2,166.0,107.9,5.78,149.4,37
HCPCS,83519,IGF-II INSULIN LIKE GR,120.0,78.0,5.78,108.0,37
HCPCS,83519,IMMUNOASSAY,154.0,100.1,5.78,138.6,37
HCPCS,83519,IMMUNOASSAY NONINF QUANT RIA,95.0,61.75,5.78,131.4,74
HCPCS,83519,IMMUNOASSY NONINF QUANT RIA,84.0,54.6,5.78,167.4,333
HCPCS,83519,INTERLEUKIN 4,534.0,347.1,5.78,480.6,37
HCPCS,83519,MELANOCYTE STIM HORMONE ALP,392.0,254.8,5.78,352.8,37
HCPCS,83519,"MG/LES EVAL, SER",134.0,87.1,5.78,120.6,37
HCPCS,83519,MUSCLE MODULATING AB,1064.0,691.6,5.78,957.6,37
HCPCS,83519,MUSK ANTIBODY,1442.0,937.3,5.78,1297.8,37
HCPCS,83519,MYASTHENIA GRAVIS EVAL,47.0,30.55,5.78,42.3,37
HCPCS,83519,NEURO VG K CHAN ABS MOD,711.0,462.15,5.78,639.9,37
HCPCS,83519,"OREXIN A, SPINAL FLUID (ORXCSF)",1164.0,756.6,5.78,1047.6,37
HCPCS,83519,PANCREASTATIN,361.0,234.65,5.78,324.9,37
HCPCS,83519,PANCREATIC POLYPE,263.0,170.95,5.78,236.7,37
HCPCS,83519,PROCOL TYPEL N TARMINAL,869.0,564.85,5.78,782.1,37
HCPCS,83519,RADIOIMMUNOASSAY (RIA),330.0,214.5,5.78,297.0,37
HCPCS,83519,RIA NONANTIBODY,1472.0,956.8,5.78,1324.8,38
HCPCS,83519,TRYPSINOGEN,136.0,88.4,5.78,122.4,37
HCPCS,83519,VOLTAGE-GATED CAL IGG AB,395.0,256.75,5.78,355.5,37
HCPCS,83519,VOLTAGE-GATED KCHANNEL AB,455.0,295.75,5.78,409.5,37
HCPCS,835190,RIA NONANTIBODY,,,15.9,15.9,1
HCPCS,83520,%CEPHAL IA QNTNOS NONABX4,319.0,207.35,5.78,287.1,37
HCPCS,83520,%CROHN ELISA X5,105.0,68.25,5.78,94.5,37
HCPCS,83520,%INHAB IMMUNO QT,184.0,119.6,5.78,165.6,37
HCPCS,83520,%PARNEO STRIATIONAL AB,95.0,61.75,5.78,85.5,37
HCPCS,83520,%SENNRO SENSRY NEU IMMX6,372.0,241.8,5.78,334.8,37
HCPCS,83520,*IMMUNOASSAY QUANT NOS,75.0,48.75,5.78,108.9,370
HCPCS,83520,*IMMUNOASSY QUANT NOS,81.0,52.65,5.78,99.0,74
HCPCS,83520,"14.3.3 ETA PROTEIN, SER",47.0,30.55,5.78,42.3,37
HCPCS,83520,ADAMTS13 ANTIBODY,200.0,130.0,5.78,180.0,37
HCPCS,83520,ADIPONECTIN,302.0,196.3,5.78,361.8,74
HCPCS,83520,ADMARK PHOS TAU CSF X3,762.0,495.3,5.78,685.8,37
HCPCS,83520,AIDYSA IMMUNO QNT NOS NONAB,72.0,46.8,5.78,64.8,37
HCPCS,83520,ANTI IGE,124.0,80.6,5.78,111.6,37
HCPCS,83520,ANTI MULLERIAN HORMONE,262.0,170.3,5.78,235.8,37
HCPCS,83520,ANTI-IGA ANTIBODY,790.0,513.5,5.78,711.0,37
HCPCS,83520,CAR AUTOANTIBODY,315.0,204.75,5.78,283.5,37
HCPCS,83520,COLLAGEN TYPE II AB,355.0,230.75,5.78,319.5,37
HCPCS,83520,"CXCL9 QUANTITATION, SERUM",154.0,100.1,5.78,138.6,37
HCPCS,83520,CYTOKINE PANEL,31.0,20.15,5.78,28.86,37
HCPCS,83520,GQ1B AUTOANTIBODY,337.0,219.05,5.78,303.3,37
HCPCS,83520,GROWTH DIFF FACTOR 15,204.0,132.6,5.78,183.6,37
HCPCS,83520,GVHPRE IMMUNOASSAY QUANT NOS NONAB,165.0,107.25,5.78,148.5,37
HCPCS,83520,GVHPST IMMUNOASSAY QUANT NOS NONAB,165.0,107.25,5.78,148.5,37
HCPCS,83520,GVHSYM IMMUNOASSAY QUANT NOS NONAB,165.0,107.25,5.78,148.5,37
HCPCS,83520,HU AUTOANTIBODY,340.0,221.0,5.78,306.0,37
HCPCS,83520,HUMAN ANTI-MOUSE AB (HAMA),426.5,277.22499999999997,5.78,666.9,74
HCPCS,83520,HUMAN TGB-B1,231.0,150.15,5.78,207.9,37
HCPCS,83520,IBDSGI ELISA X6,66.0,42.9,5.78,59.4,37
HCPCS,83520,IMMUNOASSAY ANALYTE QUANTITATIVE NOS,26.0,16.9,7.25,26.0,17
HCPCS,83520,IMMUNOASSAY QUANT NOS,131.0,85.15,5.78,513.0,629
HCPCS,83520,IMMUNOASSAY QUANT NOS NONAB,235.0,152.75,5.78,388.8,152
HCPCS,83520,IMMUNOASSY QUANT NOS,96.0,62.4,5.78,136.8,74
HCPCS,83520,INHIBIN B,145.5,94.57499999999999,5.78,215.1,74
HCPCS,83520,INTERLEUKIN 2,616.0,400.4,5.78,554.4,37
HCPCS,83520,INTERLEUKIN 2 RECEPTOR,411.0,267.15,5.78,369.9,37
HCPCS,83520,INTERLEUKIN 4,121.0,78.65,5.78,108.9,37
HCPCS,83520,INTERLEUKIN 5,534.0,347.1,5.78,480.6,37
HCPCS,83520,INTERLEUKIN 6,523.0,339.95,5.78,470.7,37
HCPCS,83520,LEPTIN,110.0,71.5,5.78,99.0,37
HCPCS,83520,MANNOSE BINDING LECTIN,143.0,92.95,5.78,128.7,37
HCPCS,83520,MANNOSE BINDING PROTEIN,385.0,250.25,5.78,346.5,37
HCPCS,83520,MATRIX METALLOPRO-9 MMP-9,206.0,133.9,5.78,185.4,37
HCPCS,83520,MCROHN IMM QNT NOS NONAB,51.0,33.15,5.78,45.9,37
HCPCS,83520,MELATONIN,267.0,173.55,5.78,240.3,37
HCPCS,83520,NEOPTERIN BLD/CSF,638.0,414.7,5.78,574.2,37
HCPCS,83520,NEOSEN NEURO PARANEO X3,294.0,191.1,5.78,264.6,37
HCPCS,83520,"NERUON SPEC ENOLASE, SER",154.0,100.1,5.78,138.6,37
HCPCS,83520,NEUROFILAMENT LIGHT (NFL),498.0,323.7,5.78,448.2,37
HCPCS,83520,NEURON SPECIFIC ENO CSF,142.0,92.3,5.78,127.8,37
HCPCS,83520,"NITROGEN, URINE 24 HR",110.0,71.5,5.78,99.0,37
HCPCS,83520,OXIDIZED LDL,54.0,35.1,5.78,48.6,37
HCPCS,83520,"PAN.ELASTASE, FECAL",834.0,542.1,5.78,750.6,37
HCPCS,83520,"PHOSPHOLIPASE A2 RECEPTOR AB, ELISA, SERUM",237.0,154.05,5.78,213.3,37
HCPCS,83520,PHOSPHOLIPASE A2 RECEPTOR IGG ANTIBODY ELISA,237.0,154.05,5.78,213.3,37
HCPCS,83520,"PRIMARY MEMBRANOUS NEPHROPATHY DIAG CASCADE, SER",330.0,214.5,5.78,297.0,37
HCPCS,83520,RECOMBX MA TA AUTOAB,561.0,364.65,5.78,504.9,37
HCPCS,83520,SENMOT IMMUNOASSAY X11,267.0,173.55,5.78,240.3,37
HCPCS,83520,SULFATIDE AUTOANTIBODYX2,480.0,312.0,5.78,432.0,37
HCPCS,83520,TUMOR NECROSIS SERUM,136.0,88.4,5.78,122.4,37
HCPCS,83520,UFLCKL IMMUNO QNT NOS NAB,61.0,39.65,5.78,54.9,37
HCPCS,83520,"USTEKINUMAB AB, S",190.0,123.5,5.78,171.0,37
HCPCS,83520,VASC ENDO GROWTH FACT,287.0,186.55,5.78,258.3,37
HCPCS,83520,YO AUTOANTIBODY,890.0,578.5,5.78,801.0,37
HCPCS,835200,IMMUNOASSAY QUANT NOS NONAB,,,14.93,14.93,1
HCPCS,83520QW,IMMUNOASSAY QUANT NOS NONAB,,,26.63,28.86,3
HCPCS,83521,IG LIGHT CHAINS FREE EACH,,,14.93,14.93,1
HCPCS,83521,IMMUNOGL LT CHNS FR EA,142.0,92.3,5.78,127.8,37
HCPCS,835210,IG LIGHT CHAINS FREE EACH,,,14.93,14.93,1
HCPCS,83525,*INSULIN TOTAL ASSAY,19.0,12.35,4.75,19.0,37
HCPCS,83525,ASSAY OF INSULIN,,,9.87,9.87,1
HCPCS,83525,INSULIN ASSAY,25.0,16.25,6.25,22.5,37
HCPCS,83525,INSULIN TOTAL,19.0,12.35,4.75,19.0,37
HCPCS,835250,ASSAY OF INSULIN,,,9.87,9.87,1
HCPCS,83527,*INSULIN FREE ASSAY,19.0,12.35,4.75,19.0,37
HCPCS,83527,ASSAY OF INSULIN,,,11.19,11.19,1
HCPCS,83527,INSULIN FREE,121.0,78.65,6.33,108.9,37
HCPCS,835270,ASSAY OF INSULIN,,,11.19,11.19,1
HCPCS,83528,ASSAY OF INTRINSIC FACTOR,,,17.13,33.12,15
HCPCS,83528,Assay of intrinsic factor,,,5.78,7.3,6
HCPCS,835280,ASSAY OF INTRINSIC FACTOR,,,17.13,17.13,1
HCPCS,83529,"ADALIMUMAB, SERUM",43.0,27.95,5.78,38.7,37
HCPCS,83529,ASAY OF INTERLEUKIN-6 (IL-6),,,14.93,14.93,1
HCPCS,83529,ASSAY OF INTERLEUKIN-6 (IL-6),167.0,108.55,5.78,150.3,37
HCPCS,83529,CYTOKP INTERLEUKIN-6,67.0,43.55,5.78,60.3,37
HCPCS,835290,ASAY OF INTERLEUKIN-6 (IL-6),,,14.93,14.93,1
HCPCS,83540,*FE ASSAY,144.0,93.6,2.59,129.6,37
HCPCS,83540,ASSAY OF IRON,70.0,45.5,2.72,70.0,18
HCPCS,83540,FE ASSAY,112.0,72.8,2.59,129.6,74
HCPCS,835400,ASSAY OF IRON,,,5.59,5.59,1
HCPCS,83550,*FE BINDING CAPACITY,80.0,52.0,2.59,72.0,37
HCPCS,83550,FE BINDING CAPACITY,80.0,52.0,2.59,72.0,37
HCPCS,83550,IRON BINDING CAPACITY,94.0,61.1,3.67,94.0,17
HCPCS,83550,IRON BINDING TEST,,,7.55,7.55,1
HCPCS,835500,IRON BINDING TEST,,,7.55,7.55,1
HCPCS,83570,ASSAY OF IDH ENZYME,,,7.65,14.79,15
HCPCS,83570,Assay of idh enzyme,,,2.59,3.28,6
HCPCS,835700,ASSAY OF IDH ENZYME,,,7.65,7.65,1
HCPCS,83582,ASSAY OF KETOGENIC STEROIDS,,,13.37,13.37,1
HCPCS,83582,KETOGENIC STEROIDS FRACT,129.0,83.85,6.33,116.1,37
HCPCS,835820,ASSAY OF KETOGENIC STEROIDS,,,13.37,13.37,1
HCPCS,83586,%U17K 17KETOSTEROIDS 24UR,31.0,20.15,6.33,27.9,37
HCPCS,83586,ASSAY 17- KETOSTEROIDS,,,11.06,11.06,1
HCPCS,83586,KETOSTEROID 17 TOTAL,32.0,20.8,6.33,28.8,37
HCPCS,835860,ASSAY 17- KETOSTEROIDS,,,11.06,11.06,1
HCPCS,83593,FRACTIONATION KETOSTEROIDS,,,24.62,24.62,1
HCPCS,83593,KETOSTRD 17 FRCT,386.0,250.9,6.33,347.4,37
HCPCS,835930,FRACTIONATION KETOSTEROIDS,,,24.62,24.62,1
HCPCS,83605,*LACTATE (LACTIC ACID),178.0,115.7,5.78,160.2,37
HCPCS,83605,ASSAY LACTIC ACID,98.0,63.7,5.78,88.2,37
HCPCS,83605,ASSAY LACTIC ACID (POINT OF CARE LAB),98.0,63.7,5.78,88.2,37
HCPCS,83605,ASSAY OF LACTATE,89.0,57.85,4.86,89.0,17
HCPCS,83605,ASSAY OF LACTIC ACID,35.0,22.75,5.78,31.5,41
HCPCS,83605,LACTATE(LACTIC ACID),100.0,65.0,5.5,160.2,74
HCPCS,836050,ASSAY OF LACTIC ACID,,,10.0,10.0,1
HCPCS,83605QW,ASSAY OF LACTIC ACID,,,17.84,19.33,3
HCPCS,83615,*LAC (LD)(LDH),11.0,7.15,2.59,10.09,37
HCPCS,83615,LAC (LD)(LDH),71.5,46.475,2.59,108.9,74
HCPCS,83615,LACTATE (LD) (LDH) ENZYME,,,5.22,5.22,1
HCPCS,83615,LACTATE DEHYDROGENASE LDH,35.0,22.75,2.54,35.0,17
HCPCS,83615,LDH BODY FLUID,55.0,35.75,2.59,49.5,37
HCPCS,836150,LACTATE (LD) (LDH) ENZYME,,,5.22,5.22,1
HCPCS,83625,%LDISO LD ISOENZYMES,28.0,18.2,5.78,25.2,37
HCPCS,83625,*LAC (LD)(LDH) ASSAY ENZYME,19.0,12.35,4.75,19.0,37
HCPCS,83625,ASSAY OF LDH ENZYMES,,,11.05,11.05,1
HCPCS,836250,ASSAY OF LDH ENZYMES,,,11.05,11.05,1
HCPCS,83630,"IMMUNOASSAY, LACTOFERRIN, FECAL, QUALITATIVE",65.0,42.25,5.78,58.5,37
HCPCS,83630,LACTOFERRIN FECAL (QUAL),,,17.02,17.02,1
HCPCS,83630,"LACTOFERRIN, FECAL",143.0,92.95,5.78,128.7,37
HCPCS,836300,LACTOFERRIN FECAL (QUAL),,,17.02,17.02,1
HCPCS,83631,LACTOFERRIN FECAL (QUANT),,,16.96,32.8,15
HCPCS,83631,Lactoferrin fecal (quant),,,5.78,7.3,6
HCPCS,836310,LACTOFERRIN FECAL (QUANT),,,16.96,16.96,1
HCPCS,83632,HUMAN PLACENTAL LACTOGEN,540.0,351.0,5.78,486.0,37
HCPCS,83632,PLACENTAL LACTOGEN,,,17.47,17.47,1
HCPCS,836320,PLACENTAL LACTOGEN,,,17.47,17.47,1
HCPCS,83633,TEST URINE FOR LACTOSE,,,9.72,18.8,15
HCPCS,83633,Test urine for lactose,,,5.78,7.3,6
HCPCS,836330,TEST URINE FOR LACTOSE,,,9.72,9.72,1
HCPCS,83655,%OSHA LEAD,106.0,68.9,5.78,95.4,37
HCPCS,83655,%UTXM3 LEAD,74.0,48.1,5.78,66.6,37
HCPCS,83655,%UTXM4 LEAD,74.0,48.1,5.78,66.6,37
HCPCS,83655,ASSAY OF LEAD,,,10.47,20.24,4
HCPCS,83655,LEAD ASSAY,36.0,23.4,5.25,45.9,74
HCPCS,83655,LEAD CONCENTRATION,79.0,51.35,5.78,71.1,37
HCPCS,83655,LEAD UR 24HR,21.0,13.65,5.25,20.24,37
HCPCS,836550,ASSAY OF LEAD,,,10.47,10.47,1
HCPCS,83655QW,ASSAY OF LEAD,,,18.67,20.24,3
HCPCS,83661,L/S RATIO FETAL LUNG,,,19.0,36.75,15
HCPCS,83661,L/s ratio fetal lung,,,5.78,7.3,6
HCPCS,836610,L/S RATIO FETAL LUNG,,,19.0,19.0,1
HCPCS,83662,FOAM STABILITY FETAL LUNG,,,16.34,31.6,15
HCPCS,83662,Foam stability fetal lung,,,5.78,7.3,6
HCPCS,836620,FOAM STABILITY FETAL LUNG,,,16.34,16.34,1
HCPCS,83663,FLUORO POLARIZE FETAL LUNG,,,16.34,31.6,15
HCPCS,83663,Fluoro polarize fetal lung,,,5.78,7.3,6
HCPCS,836630,FLUORO POLARIZE FETAL LUNG,,,16.34,16.34,1
HCPCS,83664,LAMELLAR BDY FETAL LUNG,,,16.7,16.7,1
HCPCS,83664,LAMELLAR BODY COUNT,141.0,91.65,5.78,126.9,37
HCPCS,836640,LAMELLAR BDY FETAL LUNG,,,16.7,16.7,1
HCPCS,83670,ASSAY OF LAP ENZYME,,,8.48,8.48,1
HCPCS,83670,LAP-LEUCNE AMINO-PPTIDSE,76.0,49.4,2.59,68.4,37
HCPCS,83670,LEUCINE AMINOPEPTIDASE,164.0,106.6,2.59,147.6,37
HCPCS,836700,ASSAY OF LAP ENZYME,,,8.48,8.48,1
HCPCS,83690,ASSAY OF LIPASE,74.0,48.1,2.89,74.0,18
HCPCS,83690,LIPASE ASSAY,118.0,76.7,2.59,193.5,74
HCPCS,836900,ASSAY OF LIPASE,,,5.95,5.95,1
HCPCS,83695,ASSAY OF LIPOPROTEIN(A),,,12.38,12.38,1
HCPCS,83695,LIPOPROTEIN (A),29.0,18.85,5.78,26.1,37
HCPCS,83695,LP (A),119.0,77.35,5.78,107.1,37
HCPCS,836950,ASSAY OF LIPOPROTEIN(A),,,12.38,12.38,1
HCPCS,83698,ASSAY LIPOPROTEIN PLA2,,,40.01,40.01,1
HCPCS,83698,LIPOPROTEIN (LP-PLA2) ASSAY,110.0,71.5,13.39,99.0,37
HCPCS,83698,LP-PLA2 ACTIVITY,83.0,53.95,13.39,77.38,37
HCPCS,836980,ASSAY LIPOPROTEIN PLA2,,,40.01,40.01,1
HCPCS,83700,"CHYLOSCREEN, BODY FLUID",19.0,12.35,4.75,18.82,37
HCPCS,83700,LIPOPRO BLD ELECTROPHORETIC,,,9.73,9.73,1
HCPCS,83700,LIPOPROTEIN BLD ELP QN,34.0,22.1,5.78,30.6,37
HCPCS,83700,LIPOPROTEIN ELECTROPHOR,327.0,212.55,5.78,294.3,37
HCPCS,837000,LIPOPRO BLD ELECTROPHORETIC,,,9.73,9.73,1
HCPCS,83701,*VAP CHOLESTEROL,50.0,32.5,12.5,50.0,37
HCPCS,83701,HDL CHOL SUBFRACTIONS,230.0,149.5,13.39,207.0,37
HCPCS,83701,LIPOPROTEIN BLD HR FRACTION,,,29.26,29.26,1
HCPCS,837010,LIPOPROTEIN BLD HR FRACTION,,,29.26,29.26,1
HCPCS,83704,*LIPOPROTEIN MR SPECTROSCOPY,44.0,28.6,11.0,44.0,37
HCPCS,83704,LIPOPROTEIN BLD QUAN PART,,,29.54,29.54,1
HCPCS,83704,LIPOPROTEIN BLOOD QUAN NUMBERS & SUBCLASSES,193.0,125.45,14.36,193.0,17
HCPCS,83704,NMRLIPO PARTICLE QT,50.0,32.5,12.5,50.0,37
HCPCS,837040,LIPOPROTEIN BLD QUAN PART,,,29.54,29.54,1
HCPCS,83718,ASSAY OF LIPOPROTEIN,,,7.07,13.69,4
HCPCS,83718,"CHOLESTEROL, HDL",56.0,36.4,3.44,56.0,17
HCPCS,83718,HDL CHOLESTEROL DIR ASSAY,74.0,48.1,2.59,66.6,37
HCPCS,83718,LIPOPROTEIN DIR MEAS HIGH DENSITY CHOLESTEROL,88.0,57.2,3.44,88.0,17
HCPCS,837180,ASSAY OF LIPOPROTEIN,,,7.07,7.07,1
HCPCS,83718QW,ASSAY OF LIPOPROTEIN,,,12.63,13.69,3
HCPCS,83719,ASSAY OF BLOOD LIPOPROTEIN,,,11.02,21.31,15
HCPCS,83719,Assay of blood lipoprotein,,,5.78,7.3,6
HCPCS,837190,ASSAY OF BLOOD LIPOPROTEIN,,,11.02,11.02,1
HCPCS,83721,ASSAY OF BLOOD LIPOPROTEIN,,,9.07,17.55,4
HCPCS,83721,LDL CHOLESTE,109.0,70.85,2.59,98.1,37
HCPCS,83721,LDL CHOLESTEROL,24.0,15.6,2.59,21.6,37
HCPCS,83721,LDL CHOLESTEROL DIR ASSAY,39.0,25.35,2.59,53.1,74
HCPCS,83721,LIPOPROTEIN DIRECT MEASUREMENT LDL CHOLESTEROL,37.0,24.05,4.41,37.0,17
HCPCS,83721,OXIDIZED LOW-DENSITY LIPOPROTEIN (OXLDL),59.0,38.35,2.59,53.1,37
HCPCS,837210,ASSAY OF BLOOD LIPOPROTEIN,,,9.07,9.07,1
HCPCS,83721QW,ASSAY OF BLOOD LIPOPROTEIN,,,16.19,17.55,3
HCPCS,83722,LIPOPRTN DIR MEAS SD LDL CHL,,,29.54,57.13,15
HCPCS,83722,Lipoprtn dir meas sd ldl chl,,,13.39,16.91,6
HCPCS,837220,LIPOPRTN DIR MEAS SD LDL CHL,,,29.54,29.54,1
HCPCS,83727,ASSAY OF LRH HORMONE,,,14.85,28.72,15
HCPCS,83727,Assay of lrh hormone,,,6.33,7.99,6
HCPCS,837270,ASSAY OF LRH HORMONE,,,14.85,14.85,1
HCPCS,83735,%STCATH MAGNESIUM,88.0,57.2,2.59,79.2,37
HCPCS,83735,*MAG ASSAY,67.0,43.55,2.59,60.3,37
HCPCS,83735,ASSAY OF MAGNESIUM,24.0,15.6,2.81,24.0,18
HCPCS,83735,MAG ASSAY,77.5,50.375,2.59,116.1,148
HCPCS,83735,MAGNESIUM,88.0,57.2,2.59,79.2,37
HCPCS,83735,MAGNESIUM RBC,149.0,96.85,2.59,134.1,37
HCPCS,83735,MAGNESIUM URINE,13.0,8.45,2.81,13.0,17
HCPCS,83735,"SSAT24 MAGNESIUM, UR",19.0,12.35,2.59,17.1,37
HCPCS,83735,STCATH ASSAY OF MAGNESIUM,237.0,154.05,2.59,213.3,37
HCPCS,837350,ASSAY OF MAGNESIUM,,,5.79,5.79,1
HCPCS,83775,ASSAY MALATE DEHYDROGENASE,,,6.37,12.32,15
HCPCS,83775,Assay malate dehydrogenase,,,2.59,3.28,6
HCPCS,837750,ASSAY MALATE DEHYDROGENASE,,,6.37,6.37,1
HCPCS,83785,ASSAY OF MANGANESE,,,23.03,23.03,1
HCPCS,83785,MANGANESE,100.0,65.0,5.78,90.0,37
HCPCS,83785,MANGANESE BLOOD,209.0,135.85,5.78,188.1,37
HCPCS,83785,MANGANESE URINE,190.0,123.5,5.78,171.0,37
HCPCS,837850,ASSAY OF MANGANESE,,,23.03,23.03,1
HCPCS,83789,*MASS SPECTRMTRY QUANT EA,55.0,35.75,5.78,49.5,74
HCPCS,83789,ATMS MASS SPEC QUAL,227.0,147.55,5.78,204.3,37
HCPCS,83789,BILE ACIDS FRACTIONATED,622.0,404.3,5.78,559.8,37
HCPCS,83789,"GFR, RENAL FUNCTION",188.0,122.2,5.78,169.2,37
HCPCS,83789,MASS SPECTRMTRY QUANT EA,295.0,191.75,5.78,270.0,111
HCPCS,83789,MASS SPECTROMETRY QUAL/QUAN,,,20.83,20.83,1
HCPCS,83789,PLTHY MASS SPEC QUANT,437.0,284.05,5.78,393.3,37
HCPCS,83789,SILVER UR QUANT,392.0,254.8,5.78,352.8,37
HCPCS,83789,TETRAHYDROBIO NECPT CFS,846.0,549.9,5.78,761.4,37
HCPCS,837890,MASS SPECTROMETRY QUAL/QUAN,,,20.83,20.83,1
HCPCS,83825,%UTXM3 MERCURY,80.0,52.0,5.78,72.0,37
HCPCS,83825,%UTXM4 MERCURY,80.0,52.0,5.78,72.0,37
HCPCS,83825,ASSAY OF MERCURY,,,14.05,14.05,1
HCPCS,83825,MERCURY QUANT,28.0,18.2,5.78,27.17,37
HCPCS,83825,MERCURY QUANT ASSAY,32.5,21.125,5.78,29.7,74
HCPCS,83825,MERCURY URINE,128.0,83.2,5.78,115.2,37
HCPCS,838250,ASSAY OF MERCURY,,,14.05,14.05,1
HCPCS,83835,ASSAY OF METANEPHRINES,,,14.63,14.63,1
HCPCS,83835,METANEPHRINES ASSAY,48.0,31.2,6.33,46.8,111
HCPCS,83835,METANEPHRINES URINE,51.0,33.15,6.33,45.9,37
HCPCS,838350,ASSAY OF METANEPHRINES,,,14.63,14.63,1
HCPCS,83857,ASSAY OF METHEMALBUMIN,,,9.28,17.95,15
HCPCS,83857,Assay of methemalbumin,,,2.59,3.28,6
HCPCS,838570,ASSAY OF METHEMALBUMIN,,,9.28,9.28,1
HCPCS,83861,MICROFLUID ANALY TEARS,,,19.42,37.56,18
HCPCS,83861,Microfluid analy tears,,,5.78,7.3,6
HCPCS,838610,MICROFLUID ANALY TEARS,,,19.42,19.42,1
HCPCS,83861QW,MICROFLUID ANALY TEARS,,,34.66,37.56,3
HCPCS,83864,MUCOPOLYSACCHARIDES,,,24.62,24.62,1
HCPCS,83864,MUCOPOLYSACCHARIDES MG/MMOL CRT,86.0,55.9,13.39,77.4,37
HCPCS,838640,MUCOPOLYSACCHARIDES,,,24.62,24.62,1
HCPCS,83872,ASSAY SYNOVIAL FLUID MUCIN,,,5.07,5.07,1
HCPCS,83872,MUCIN SYNOVIAL FLUID(ROP,12.0,7.8,2.59,10.8,37
HCPCS,838720,ASSAY SYNOVIAL FLUID MUCIN,,,5.07,5.07,1
HCPCS,83873,ASSAY OF CSF PROTEIN,,,14.86,14.86,1
HCPCS,83873,MYELIN BASIC PROTEIN,36.0,23.4,5.78,32.4,37
HCPCS,83873,MYELIN BASIC PROTEIN CSF,37.0,24.05,5.78,33.3,37
HCPCS,838730,ASSAY OF CSF PROTEIN,,,14.86,14.86,1
HCPCS,83874,ASSAY OF MYOGLOBIN,,,11.17,11.17,1
HCPCS,83874,MYOGLOBIN ASSAY,22.5,14.625,4.75,23.4,74
HCPCS,83874,MYOGLOBIN BLOOD,136.0,88.4,5.78,122.4,37
HCPCS,83874,MYOGLOBIN URINE,83.0,53.95,5.78,74.7,37
HCPCS,838740,ASSAY OF MYOGLOBIN,,,11.17,11.17,1
HCPCS,83876,ASSAY MYELOPEROXIDASE,,,43.95,43.95,1
HCPCS,83876,MYELOPEROXIDASE (MPO),318.0,206.7,13.39,286.2,37
HCPCS,838760,ASSAY MYELOPEROXIDASE,,,43.95,43.95,1
HCPCS,83880,ASSAY OF NATRIURETIC PEPTIDE,,,33.92,65.6,4
HCPCS,83880,B-TUP NATRIURETC PEPTIDE (POINT OF CARE LAB),177.0,115.05,13.39,159.3,37
HCPCS,83880,NATRIURETIC PEPTIDE,319.0,207.35,16.49,319.0,17
HCPCS,83880,NATRIURETIC PEPTIDE ASSAY,149.0,96.85,13.39,193.5,74
HCPCS,83880,NT PRO BNP,215.0,139.75,13.39,193.5,37
HCPCS,838800,ASSAY OF NATRIURETIC PEPTIDE,,,33.92,33.92,1
HCPCS,83880QW,ASSAY OF NATRIURETIC PEPTIDE,,,60.54,65.6,3
HCPCS,83883,*KAPPA LAM LTCHN,47.0,30.55,5.23,42.3,37
HCPCS,83883,*NEPHELOMETRY ASSAY EA NOS,57.0,37.05,5.0,71.1,185
HCPCS,83883,ASSAY NEPHELOMETRY NOT SPEC,,,11.75,11.75,1
HCPCS,83883,"BJP, QT FR KAPPA LAMBDA UR 83883",56.0,36.4,5.23,50.4,37
HCPCS,83883,CHRONIC VIRAL HEPATITIS NEPHELOMETRY (ARUP),85.0,55.25,5.23,76.5,37
HCPCS,83883,KAPPA & LAMBDA SERUM X2,46.0,29.9,5.23,41.4,37
HCPCS,83883,"KAPPA FREE, URINE",145.0,94.25,5.23,130.5,37
HCPCS,83883,KAPPA/LAMDA FR LT CH UR,56.0,36.4,5.23,50.4,37
HCPCS,83883,"LAMBDA FREE, URINE",145.0,94.25,5.23,130.5,37
HCPCS,83883,NEPHELOMETRY ASSAY EA NOS,23.0,14.95,5.0,198.9,111
HCPCS,83883,NEPHELOMETRY EA ANALYTE NES,79.0,51.35,5.23,71.1,74
HCPCS,83883,RETINOL BINDING PROTEIN,129.0,83.85,5.23,116.1,37
HCPCS,838830,ASSAY NEPHELOMETRY NOT SPEC,,,11.75,11.75,1
HCPCS,83884,NEUROFILAMENT LIGHT (NFL),498.0,323.7,76.88,448.2,30
HCPCS,83885,ASSAY OF NICKEL,,,21.18,21.18,1
HCPCS,83885,NICKEL,64.0,41.6,5.78,57.6,37
HCPCS,83885,NICKEL SERUM,87.0,56.55,5.78,78.3,37
HCPCS,838850,ASSAY OF NICKEL,,,21.18,21.18,1
HCPCS,83915,ASSAY OF NUCLEOTIDASE,,,9.63,9.63,1
HCPCS,83915,NUCLEOTIDASE 5-,20.0,13.0,5.0,18.63,37
HCPCS,83915,NUCLEOTIDASE-5,20.0,13.0,5.0,18.63,37
HCPCS,839150,ASSAY OF NUCLEOTIDASE,,,9.63,9.63,1
HCPCS,83916,OLIGOCLONAL BAND TEST,46.0,29.9,11.5,45.77,37
HCPCS,83916,OLIGOCLONAL BANDS,47.0,30.55,11.75,45.77,38
HCPCS,839160,OLIGOCLONAL BANDS,,,23.66,23.66,1
HCPCS,83918,%UORA ORG ACIDS UR QNT,158.0,102.7,5.78,142.2,37
HCPCS,83918,ASSAY ORGANIC ACD QNT,425.0,276.25,5.78,382.5,37
HCPCS,83918,ORGANIC ACIDS TOTAL QUANT,,,20.39,20.39,1
HCPCS,839180,ORGANIC ACIDS TOTAL QUANT,,,20.39,20.39,1
HCPCS,83919,ORGANIC ACIDS QUAL EACH,,,14.21,27.49,15
HCPCS,83919,Organic acids qual each,,,5.78,7.3,6
HCPCS,839190,ORGANIC ACIDS QUAL EACH,,,14.21,14.21,1
HCPCS,83921,3 METHYLGLUTACONIC ACID,748.0,486.2,5.78,673.2,37
HCPCS,83921,3-METHYLGLUTACONIC ACID,137.0,89.05,5.78,123.3,37
HCPCS,83921,METHYLMALONIC ACID BL,176.0,114.4,5.78,158.4,37
HCPCS,83921,METHYLMALONIC ACID URINE,189.0,122.85,5.78,170.1,37
HCPCS,83921,METHYLMALONIC SERUM,35.0,22.75,5.78,35.0,37
HCPCS,83921,ORGANIC ACID SINGLE QUANT,,,18.33,18.33,1
HCPCS,83921,ORGANIC ACID SNGL QUANT,67.0,43.55,5.78,112.5,111
HCPCS,83921,ORGANIC ACID SNGL QUANT-LABCORP,191.0,124.15,5.78,171.9,37
HCPCS,839210,ORGANIC ACID SINGLE QUANT,,,18.33,18.33,1
HCPCS,83930,ASSAY OF BLOOD OSMOLALITY,,,5.71,5.71,1
HCPCS,83930,ASSAY OF OSMOLALITY BLOOD,94.0,61.1,2.78,94.0,17
HCPCS,83930,OSMOLALITY BLOOD ASSAY,109.0,70.85,2.59,98.1,37
HCPCS,83930,"OSMOLALITY, BODY FLUID",107.0,69.55,2.59,96.3,37
HCPCS,839300,ASSAY OF BLOOD OSMOLALITY,,,5.71,5.71,1
HCPCS,83935,ASSAY OF OSMOLALITY URINE,96.0,62.4,2.86,96.0,17
HCPCS,83935,ASSAY OF URINE OSMOLALITY,,,5.9,5.9,1
HCPCS,83935,OSMOLALITY URINE ASSAY,59.5,38.675,2.5,98.1,111
HCPCS,83935,"SSAT24 OSMOLALITY, UR",20.0,13.0,2.59,18.0,37
HCPCS,839350,ASSAY OF URINE OSMOLALITY,,,5.9,5.9,1
HCPCS,83937,ASSAY OF OSTEOCALCIN,,,25.79,25.79,1
HCPCS,83937,OSTEOCALCIN,135.5,88.075,13.75,194.4,74
HCPCS,839370,ASSAY OF OSTEOCALCIN,,,25.79,25.79,1
HCPCS,83945,*OXALATE ASSAY,22.0,14.3,5.5,22.0,37
HCPCS,83945,ASSAY OF OXALATE,,,12.48,12.48,1
HCPCS,83945,OXALATE,107.0,69.55,4.75,175.5,74
HCPCS,83945,OXALATE URINE,29.0,18.85,5.78,26.1,37
HCPCS,83945,"SSAT24 OXOLATE, UR",41.0,26.65,5.78,36.9,37
HCPCS,839450,ASSAY OF OXALATE,,,12.48,12.48,1
HCPCS,83950,HER-2/NEU PLA,95.0,61.75,13.39,95.0,37
HCPCS,83950,HER-2/NEU SERUM,669.0,434.85,13.39,602.1,37
HCPCS,83950,ONCOPROTEIN HER-2/NEU,,,55.65,55.65,1
HCPCS,839500,ONCOPROTEIN HER-2/NEU,,,55.65,55.65,1
HCPCS,83951,ONCOPROTEIN DCP,,,55.65,55.65,1
HCPCS,83951,PIVKA II,545.0,354.25,13.39,490.5,37
HCPCS,839510,ONCOPROTEIN DCP,,,55.65,55.65,1
HCPCS,83970,ASSAY OF PARATHORMONE,396.0,257.4,17.34,396.0,18
HCPCS,83970,PARATHYROID HORMONE ASSAY,91.5,59.475,16.61,99.0,111
HCPCS,839700,ASSAY OF PARATHORMONE,,,35.66,35.66,1
HCPCS,83986,"%SSAT24 PH, UR",50.0,32.5,2.59,45.0,37
HCPCS,83986,ASSAY PH BODY FLUID NOS,12.0,7.8,2.59,10.8,41
HCPCS,83986,PH BODY FLUID,13.0,8.45,2.15,13.0,17
HCPCS,83986,PH BODY FLUID EXCEPT BLD (POINT OF CARE),39.0,25.35,2.59,35.1,37
HCPCS,83986,PH BODY FLUID NOT ELSEWHERE SPECIFIED,17.0,11.05,2.15,17.0,17
HCPCS,83986,"PH BODY FLUID, NES",20.0,13.0,2.59,18.0,37
HCPCS,83986,"PH BODY FLUID, NES (POINT OF CARE LAB)",20.0,13.0,2.59,18.0,37
HCPCS,83986,PH FLUID,12.0,7.8,2.59,10.8,37
HCPCS,83986,"PH, BODY FLUID EXCEPT BLOOD",33.0,21.45,2.15,33.0,17
HCPCS,83986,SSAT24 PH,10.0,6.5,2.5,9.0,37
HCPCS,83986,STOOL PH,20.0,13.0,2.59,18.0,37
HCPCS,839860,ASSAY PH BODY FLUID NOS,,,3.09,3.09,1
HCPCS,83986QW,ASSAY PH BODY FLUID NOS,,,5.52,5.98,3
HCPCS,83987,EXHALED BREATH CONDENSATE,,,3.09,5.98,15
HCPCS,83987,Exhaled breath condensate,,,2.59,3.28,6
HCPCS,839870,EXHALED BREATH CONDENSATE,,,3.09,3.09,1
HCPCS,83992,ASSAY FOR PHENCYCLIDINE,,,0.01,0.01,1
HCPCS,83992,Assay for phencyclidine,,,5.78,7.3,6
HCPCS,839920,ASSAY FOR PHENCYCLIDINE,,,0.01,0.01,1
HCPCS,83993,ASSAY FOR CALPROTECTIN FECAL,273.0,177.45,5.78,245.7,38
HCPCS,839930,ASSAY FOR CALPROTECTIN FECAL,,,16.96,16.96,1
HCPCS,84030,ASSAY OF BLOOD PKU,,,4.75,4.75,1
HCPCS,84030,PHENYLALANINE (PKU) EA,143.0,92.95,2.59,128.7,37
HCPCS,840300,ASSAY OF BLOOD PKU,,,4.75,4.75,1
HCPCS,84035,ASSAY OF PHENYLKETONES,,,3.43,6.65,15
HCPCS,84035,Assay of phenylketones,,,2.59,3.28,6
HCPCS,840350,ASSAY OF PHENYLKETONES,,,3.43,3.43,1
HCPCS,84060,ACID PHOSPHATASE TOTL,72.0,46.8,2.59,64.8,37
HCPCS,84060,ASSAY ACID PHOSPHATASE,,,6.6,6.6,1
HCPCS,84060,PHOSPHATASE ACID TOTAL,21.0,13.65,2.59,18.9,37
HCPCS,840600,ASSAY ACID PHOSPHATASE,,,6.6,6.6,1
HCPCS,84066,ASSAY PROSTATE PHOSPHATASE,,,8.35,8.35,1
HCPCS,84066,PROSTATIC ACID PHOS,14.0,9.1,2.59,14.0,74
HCPCS,840660,ASSAY PROSTATE PHOSPHATASE,,,8.35,8.35,1
HCPCS,84075,*ALKA PHOSPHTAS ASSAY,12.0,7.8,2.59,10.8,37
HCPCS,84075,ALKA PHOSPHTA,144.0,93.6,2.59,129.6,37
HCPCS,84075,ASSAY ALKALINE PHOSPHATASE,,,4.47,8.66,4
HCPCS,84075,ASSAY OF PHOSPHATASE ALKALINE,50.0,32.5,2.18,50.0,17
HCPCS,840750,ASSAY ALKALINE PHOSPHATASE,,,4.47,4.47,1
HCPCS,84075QW,ASSAY ALKALINE PHOSPHATASE,,,7.99,8.66,3
HCPCS,84078,ASSAY ALKALINE PHOSPHATASE,,,7.14,13.8,15
HCPCS,84078,Assay alkaline phosphatase,,,2.59,3.28,6
HCPCS,840780,ASSAY ALKALINE PHOSPHATASE,,,7.14,7.14,1
HCPCS,84080,*ALKA PHOSPHTAS ISOENZYME,24.0,15.6,5.78,24.0,37
HCPCS,84080,ALK-P BONE SPECIFIC,86.0,55.9,5.78,77.4,37
HCPCS,84080,ALKA PHOSPHTAS ISOENZYME,87.0,56.55,5.78,78.3,37
HCPCS,84080,ASSAY ALKALINE PHOSPHATASES,,,12.77,12.77,1
HCPCS,840800,ASSAY ALKALINE PHOSPHATASES,,,12.77,12.77,1
HCPCS,84081,ASSAY PHOSPHATIDYLGLYCEROL,,,14.28,27.6,15
HCPCS,84081,Assay phosphatidylglycerol,,,5.78,7.3,6
HCPCS,840810,ASSAY PHOSPHATIDYLGLYCEROL,,,14.28,14.28,1
HCPCS,84085,ASSAY OF RBC PG6D ENZYME,,,8.15,15.77,15
HCPCS,84085,Assay of rbc pg6d enzyme,,,2.59,3.28,6
HCPCS,840850,ASSAY OF RBC PG6D ENZYME,,,8.15,8.15,1
HCPCS,84087,ASSAY PHOSPHOHEXOSE ENZYMES,,,9.27,17.93,15
HCPCS,84087,Assay phosphohexose enzymes,,,2.59,3.28,6
HCPCS,840870,ASSAY PHOSPHOHEXOSE ENZYMES,,,9.27,9.27,1
HCPCS,84100,%STCATH PHOSPOROUS,88.0,57.2,2.59,79.2,37
HCPCS,84100,ASSAY OF PHOSPHORUS,,,4.09,4.09,1
HCPCS,84100,ASSAY OF PHOSPHORUS INORGANIC,51.0,33.15,1.99,51.0,17
HCPCS,84100,"INORGANIC PHOSPHATE, SERUM (TRPHOS)",50.0,32.5,2.59,45.0,37
HCPCS,84100,PHOSPHATE,88.0,57.2,2.59,79.2,37
HCPCS,84100,PHOSPHOROUS ASSAY,107.0,69.55,2.59,96.3,37
HCPCS,841000,ASSAY OF PHOSPHORUS,,,4.09,4.09,1
HCPCS,84105,*PHOSPHOROUS URINE ASSAY,128.0,83.2,2.59,115.2,37
HCPCS,84105,ASSAY OF PHOSPHORUS INORGANIC URINE,57.0,37.05,2.43,57.0,17
HCPCS,84105,ASSAY OF URINE PHOSPHORUS,,,4.99,4.99,1
HCPCS,84105,"INORGANIC PHOSPHATE, URINE (TRPHOS)",50.0,32.5,2.59,45.0,37
HCPCS,84105,PHOSPHOROUS URINE ASSAY,118.5,77.025,2.59,115.2,74
HCPCS,84105,"SSAT24 PHOSPHORUS, UR",17.0,11.05,2.59,15.3,37
HCPCS,841050,ASSAY OF URINE PHOSPHORUS,,,4.99,4.99,1
HCPCS,84106,*PORPHOBILINOGEN URINE QUANT,15.0,9.75,2.59,13.5,74
HCPCS,84106,PORPHOBILINOGEN UR SCN,15.0,9.75,2.59,13.5,37
HCPCS,84106,TEST FOR PORPHOBILINOGEN,,,5.03,5.03,1
HCPCS,841060,TEST FOR PORPHOBILINOGEN,,,5.03,5.03,1
HCPCS,84110,ASSAY OF PORPHOBILINOGEN,,,7.29,7.29,1
HCPCS,84110,"PORPHOBILINOGEN, QN, RANDOM UR",43.0,27.95,2.59,38.7,37
HCPCS,841100,ASSAY OF PORPHOBILINOGEN,,,7.29,7.29,1
HCPCS,84112,EVAL AMNIOTIC FLUID PROTEIN,,,84.77,163.94,15
HCPCS,84112,Eval amniotic fluid protein,,,32.49,41.04,6
HCPCS,841120,EVAL AMNIOTIC FLUID PROTEIN,,,84.77,84.77,1
HCPCS,84119,%PORPHYRIN SCREEN,28.0,18.2,5.78,25.2,37
HCPCS,84119,*PORPHYRINS URINE QUAL,19.0,12.35,4.75,19.0,74
HCPCS,84119,TEST URINE FOR PORPHYRINS,,,11.55,11.55,1
HCPCS,841190,TEST URINE FOR PORPHYRINS,,,11.55,11.55,1
HCPCS,84120,ASSAY OF URINE PORPHYRINS,,,12.71,12.71,1
HCPCS,84120,PORPHYRINS URINE,523.0,339.95,5.78,470.7,37
HCPCS,841200,ASSAY OF URINE PORPHYRINS,,,12.71,12.71,1
HCPCS,84126,ASSAY OF FECES PORPHYRINS,,,33.79,33.79,1
HCPCS,84126,PORPHYRINS FECES QUANT,157.0,102.05,13.39,141.3,37
HCPCS,84126,PORPHYRINS STOOL,193.0,125.45,13.39,173.7,37
HCPCS,84126,"PORPHYRINS, FECAL",196.0,127.4,13.39,176.4,37
HCPCS,84126,STFRTP ASSAY OF FECES PORPHYRINS,210.0,136.5,13.39,189.0,37
HCPCS,841260,ASSAY OF FECES PORPHYRINS,,,33.79,33.79,1
HCPCS,84132,*POTASSIUM SERUM,56.0,36.4,2.59,50.4,74
HCPCS,84132,ASSAY OF SERUM POTASSIUM,,,4.11,7.95,4
HCPCS,84132,POTASSIUM,35.0,22.75,2.59,31.5,37
HCPCS,84132,POTASSIUM (POINT OF CARE LAB),56.0,36.4,2.59,50.4,37
HCPCS,84132,POTASSIUM BLOOD (POINT OF CARE LAB),56.0,36.4,2.59,50.4,37
HCPCS,84132,POTASSIUM SERUM PLASMA/WHOLE BLOOD,22.0,14.3,2.0,22.0,17
HCPCS,841320,ASSAY OF SERUM POTASSIUM,,,4.11,4.11,1
HCPCS,84132QW,ASSAY OF SERUM POTASSIUM,,,7.34,7.95,3
HCPCS,84133,ASSAY OF URINE POTASSIUM,,,4.08,4.08,1
HCPCS,84133,K URINE ASSAY,11.0,7.15,1.75,82.8,111
HCPCS,84133,POTASSIUM 24HR UR PROFESSIONAL FEE,13.0,8.45,1.99,13.0,17
HCPCS,84133,POTASSIUM URINE,52.0,33.8,1.99,52.0,17
HCPCS,84133,"SSAT24 POTASSIUM, UR",13.0,8.45,2.59,11.7,37
HCPCS,841330,ASSAY OF URINE POTASSIUM,,,4.08,4.08,1
HCPCS,84134,ASSAY OF PREALBUMIN,,,12.6,12.6,1
HCPCS,84134,PREALBUMIN ASSAY,144.0,93.6,5.78,129.6,37
HCPCS,84134,PREALBUMIN BLD,145.0,94.25,6.13,145.0,17
HCPCS,841340,ASSAY OF PREALBUMIN,,,12.6,12.6,1
HCPCS,84135,ASSAY OF PREGNANEDIOL,,,18.38,35.54,15
HCPCS,84135,Assay of pregnanediol,,,6.33,7.99,6
HCPCS,841350,ASSAY OF PREGNANEDIOL,,,18.38,18.38,1
HCPCS,84138,*PREGNANETRIOL ASSAY,131.0,85.15,6.33,117.9,37
HCPCS,84138,ASSAY OF PREGNANETRIOL,,,18.19,18.19,1
HCPCS,841380,ASSAY OF PREGNANETRIOL,,,18.19,18.19,1
HCPCS,84140,ASSAY OF PREGNENOLONE,,,17.86,17.86,1
HCPCS,84140,PREGNENOLONE,122.0,79.3,6.33,109.8,37
HCPCS,84140,PREGNENOLONE SERUM,120.0,78.0,6.33,108.0,37
HCPCS,841400,ASSAY OF PREGNENOLONE,,,17.86,17.86,1
HCPCS,84143,17 HYDROXYPREGNENOLONE,76.0,49.4,6.33,68.4,37
HCPCS,84143,ASSAY OF 17-HYDROXYPREGNENO,,,19.71,19.71,1
HCPCS,84143,CAHSP ASSAY OF 17-HYDROXYPREGNENO,63.0,40.95,6.33,56.7,37
HCPCS,84143,HYDROXYPREGNENELONE-17,75.0,48.75,6.33,67.5,37
HCPCS,841430,ASSAY OF 17-HYDROXYPREGNENO,,,19.71,19.71,1
HCPCS,84144,ASSAY OF PROGESTERONE,,,18.03,18.03,1
HCPCS,84144,CAHSP ASSAY OF PROGESTERONE,61.0,39.65,6.33,54.9,37
HCPCS,84144,PROGESTERONE,34.5,22.425,6.33,34.86,74
HCPCS,841440,ASSAY OF PROGESTERONE,,,18.03,18.03,1
HCPCS,84145,IMMUNOASSAY QUANT NOS,206.0,133.9,6.33,185.4,37
HCPCS,84145,PROCALCITONIN,202.0,131.3,6.33,181.8,37
HCPCS,84145,PROCALCITONIN (PCT),,,23.52,23.52,1
HCPCS,841450,PROCALCITONIN (PCT),,,23.52,23.52,1
HCPCS,84146,*PROLACTIN ASSAY,58.0,37.7,6.33,52.2,37
HCPCS,84146,ASSAY OF PROLACTIN,,,16.74,16.74,1
HCPCS,84146,PROLACTIN,202.0,131.3,6.33,181.8,37
HCPCS,84146,PROLACTIN ASSAY,39.5,25.675,6.33,42.3,74
HCPCS,84146,PROLACTIN MACROADENOMA,67.0,43.55,6.33,60.3,37
HCPCS,841460,ASSAY OF PROLACTIN,,,16.74,16.74,1
HCPCS,84150,ASSAY OF PROSTAGLANDIN,,,36.09,36.09,1
HCPCS,84150,PROSTAGLANDIN EACH,370.0,240.5,16.61,333.0,37
HCPCS,841500,ASSAY OF PROSTAGLANDIN,,,36.09,36.09,1
HCPCS,84152,ASSAY OF PSA COMPLEXED,,,15.89,30.73,15
HCPCS,84152,Assay of psa complexed,,,5.78,7.3,6
HCPCS,841520,ASSAY OF PSA COMPLEXED,,,15.89,15.89,1
HCPCS,84153,ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL,51.0,33.15,7.72,51.0,17
HCPCS,84153,ASSAY OF PSA TOTAL,,,15.89,15.89,1
HCPCS,84153,PHI PROST SPEC AG TOT,40.0,26.0,5.78,36.0,37
HCPCS,84153,PSA DIAGNOSTIC,109.0,70.85,5.78,98.1,37
HCPCS,84153,PSA SCREENING,107.0,69.55,5.78,96.3,37
HCPCS,84153,PSA TOTAL,111.0,72.15,5.78,99.9,37
HCPCS,841530,ASSAY OF PSA TOTAL,,,15.89,15.89,1
HCPCS,84154,ASSAY OF PSA FREE,,,15.89,15.89,1
HCPCS,84154,PSA FREE,43.5,28.275000000000002,5.78,47.7,111
HCPCS,841540,ASSAY OF PSA FREE,,,15.89,15.89,1
HCPCS,84155,ASSAY OF PROTEIN SERUM,,,3.18,6.13,4
HCPCS,84155,PROTEIN TOTAL,73.0,47.45,2.59,65.7,37
HCPCS,84155,PROTEIN TOTAL SERUM ASSAY,74.0,48.1,2.59,66.6,37
HCPCS,84155,PROTEIN XCPT REFRACTOMETRY SERUM PLASMA/WHL BLD,31.0,20.15,1.54,31.0,17
HCPCS,841550,ASSAY OF PROTEIN SERUM,,,3.18,3.18,1
HCPCS,84155QW,ASSAY OF PROTEIN SERUM,,,5.66,6.13,3
HCPCS,84156,"*PROTEIN ELECT, UR 24 HR",8.0,5.2,2.0,7.2,74
HCPCS,84156,*PROTEIN TOTAL URINE ASSAY,20.0,13.0,2.0,65.7,111
HCPCS,84156,ASSAY OF PROTEIN URINE,,,3.18,3.18,1
HCPCS,84156,"BJP, QT FR KAPPA LAMBDA UR 84156",55.0,35.75,2.59,49.5,37
HCPCS,84156,PROTEIN TOTAL XCPT REFRACTOMETRY URINE,31.0,20.15,1.54,31.0,17
HCPCS,84156,PROTEIN UR 24HRN PROFESSIONAL FEE,13.0,8.45,1.54,13.0,17
HCPCS,84156,UFLCKL PROTEIN UR,26.0,16.9,2.59,23.4,37
HCPCS,841560,ASSAY OF PROTEIN URINE,,,3.18,3.18,1
HCPCS,84157,%CSFPE PROTEIN TOTAL CSF,21.0,13.65,2.59,18.9,37
HCPCS,84157,ASSAY OF PROTEIN OTHER,,,3.46,6.68,4
HCPCS,84157,CPALMF ASSAY OF PROTEIN OTHER,19.0,12.35,2.59,17.1,37
HCPCS,84157,CPALMT ASSAY OF PROTEIN OTHER,48.0,31.2,2.59,43.2,37
HCPCS,84157,FAOACM ASSAY OF PROTEIN OTHER,63.0,40.95,2.59,56.7,37
HCPCS,84157,FAOSCM ASSAY OF PROTEIN OTHER,63.0,40.95,2.59,56.7,37
HCPCS,84157,PROT OTHR SOURC PROFESSIONAL FEE,13.0,8.45,1.68,13.0,17
HCPCS,84157,PROTEIN TOTAL OTHER ASSAY,74.0,48.1,2.59,66.6,37
HCPCS,84157,PROTEIN TOTAL XCPT REFRACTOMETRY OTH SRC,31.0,20.15,1.68,31.0,17
HCPCS,84157,"PROTEIN TOTAL, OTHER SOURCE",14.0,9.1,2.59,12.6,37
HCPCS,841570,ASSAY OF PROTEIN OTHER,,,3.46,3.46,1
HCPCS,84157QW,ASSAY OF PROTEIN OTHER,,,6.17,6.68,3
HCPCS,84160,ASSAY OF PROTEIN ANY SOURCE,,,4.85,9.37,15
HCPCS,84160,Assay of protein any source,,,2.59,3.28,6
HCPCS,841600,ASSAY OF PROTEIN ANY SOURCE,,,4.85,4.85,1
HCPCS,84163,%1ST TRI PAPP-A,145.0,94.25,5.78,130.5,37
HCPCS,84163,PAPP-A,358.0,232.7,5.78,322.2,37
HCPCS,84163,PAPPA SERUM,,,13.0,13.0,1
HCPCS,841630,PAPPA SERUM,,,13.0,13.0,1
HCPCS,84165,PROTEIN E-PHORESIS SERUM,,,9.28,9.28,1
HCPCS,84165,PROTEIN ELCTRC SERUM QN,77.0,50.05,2.59,69.3,37
HCPCS,84165,PROTEIN ELECPHRSIS SERUM,182.0,118.3,2.59,163.8,37
HCPCS,84165,PROTEIN ELECTROPHORETIC FRACTIONATION QUA,67.0,43.55,4.51,67.0,17
HCPCS,84165,PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM,160.0,104.0,4.51,160.0,48
HCPCS,841650,PROTEIN E-PHORESIS SERUM,,,9.28,9.28,1
HCPCS,84166,%CSFPE PROT ELEC SCF QT,26.0,16.9,5.78,26.0,37
HCPCS,84166,*PROTEIN ELECPHRSIS OTHER,59.0,38.35,5.78,53.1,74
HCPCS,84166,PROTEIN E-PHORESIS/URINE/CSF,40.0,26.0,5.78,36.0,38
HCPCS,84166,PROTEIN ELECPHRSIS OTHER,64.0,41.6,5.78,57.6,37
HCPCS,84166,PROTEIN ELECTRO.FLUID QT,34.0,22.1,5.78,30.6,37
HCPCS,841660,PROTEIN E-PHORESIS/URINE/CSF,,,15.4,15.4,1
HCPCS,84181,HUWB WESTERN BLOT TEST,173.0,112.45,5.23,155.7,37
HCPCS,84181,INNER EAR 68KD ANTIBODY,249.0,161.85,5.23,224.1,37
HCPCS,84181,WESTERN BLOT BLOOD OR BODY FL,322.0,209.3,5.23,289.8,37
HCPCS,84181,WESTERN BLOT TEST,,,14.71,14.71,1
HCPCS,84181,WESTERN BLOT TEST I&R,224.0,145.6,5.23,297.0,111
HCPCS,841810,WESTERN BLOT TEST,,,14.71,14.71,1
HCPCS,84182,%CJD WESTERN BLOT,75.0,48.75,18.75,67.5,37
HCPCS,84182,*WESTERN BLOT TEST I&R BAND ID,228.0,148.2,19.47,205.2,37
HCPCS,84182,CRMP 5 IGG WEST BLOT CSF,870.0,565.5,19.47,783.0,37
HCPCS,84182,CRMP-5 WB BAND ID,791.0,514.15,19.47,711.9,37
HCPCS,84182,DERMYO PROT WB IMMUNO,112.0,72.8,19.47,100.8,37
HCPCS,84182,IMMUNOBLOT (POLMYO),188.0,122.2,19.47,169.2,37
HCPCS,84182,"MA2/TA ANTIBODY, IGG CSF",409.0,265.85,19.47,368.1,37
HCPCS,84182,"MA2/TA ANTIBODY, IGG SERUM",409.0,265.85,19.47,368.1,37
HCPCS,84182,MLPTHY CRMP-5 WB,146.0,94.9,19.47,131.4,37
HCPCS,84182,"NEURONAL AB (TR/DNER) IGG, CSF",204.0,132.6,19.47,183.6,37
HCPCS,84182,"NEURONAL AB (TR/DNER) IGG, SER",204.0,132.6,19.47,183.6,37
HCPCS,84182,NEURONAL NUC AB IGG X4,51.0,33.15,12.75,48.81,37
HCPCS,84182,"NEURONAL NUCLEAR AB (HU) IGG, IB, CSF",204.0,132.6,19.47,183.6,37
HCPCS,84182,"NEURONAL NUCLEAR AB (HU) IGG, IB, SERUM",204.0,132.6,19.47,183.6,37
HCPCS,84182,PARA AB WB BND ID,724.0,470.6,19.47,651.6,37
HCPCS,84182,PARA AB WB CSF,878.0,570.7,19.47,790.2,37
HCPCS,84182,PROT WB IMMUNO (MYOSPL),112.0,72.8,19.47,100.8,37
HCPCS,84182,PROTEIN WB; IM ID FOR BANDS,76.0,49.4,19.0,68.4,37
HCPCS,84182,PROTEIN WESTERN BLOT TEST,,,25.24,25.24,1
HCPCS,84182,REFLEX IMMUNOBLOT SER FOR PARNEO,168.0,109.2,19.47,151.2,37
HCPCS,84182,RFLX IMBLOT PARNEO AIDYSA,168.0,109.2,19.47,151.2,37
HCPCS,84182,RFLX IMMUNBLOT PARCSF,168.0,109.2,19.47,151.2,37
HCPCS,84182,WESTERN BLOT TEST I&R BAND ID,281.0,182.65,19.47,299.7,148
HCPCS,841820,PROTEIN WESTERN BLOT TEST,,,25.24,25.24,1
HCPCS,84202,ASSAY RBC PROTOPORPHYRIN,,,12.4,12.4,1
HCPCS,84202,PROTOPORPHYRIN RBC QUANT,98.5,64.025,5.78,155.7,74
HCPCS,84202,ZINC PROTOPORPHYRINS,132.0,85.8,5.78,118.8,37
HCPCS,842020,ASSAY RBC PROTOPORPHYRIN,,,12.4,12.4,1
HCPCS,84203,TEST RBC PROTOPORPHYRIN,,,8.41,16.28,15
HCPCS,84203,Test rbc protoporphyrin,,,2.59,3.28,6
HCPCS,842030,TEST RBC PROTOPORPHYRIN,,,8.41,8.41,1
HCPCS,84206,ASSAY OF PROINSULIN,,,23.06,23.06,1
HCPCS,84206,PRO-INSULIN,43.0,27.95,6.33,43.0,37
HCPCS,84206,PROINSULIN,147.0,95.55,6.33,132.3,37
HCPCS,84206,PROINSULIN SERUM,41.0,26.65,6.33,41.0,37
HCPCS,842060,ASSAY OF PROINSULIN,,,23.06,23.06,1
HCPCS,84207,ASSAY OF VITAMIN B-6,,,24.28,24.28,1
HCPCS,84207,VITAMIN B6,56.0,36.4,13.39,50.4,37
HCPCS,84207,VITAMIN B6 PLASMA,182.0,118.3,13.39,163.8,37
HCPCS,842070,ASSAY OF VITAMIN B-6,,,24.28,24.28,1
HCPCS,84210,ASSAY OF PYRUVATE,,,12.51,12.51,1
HCPCS,84210,PYRUVATE,26.0,16.9,5.78,24.2,37
HCPCS,84210,PYRUVIC ACID CSF,89.0,57.85,5.78,80.1,37
HCPCS,842100,ASSAY OF PYRUVATE,,,12.51,12.51,1
HCPCS,84220,ASSAY OF PYRUVATE KINASE,,,8.15,15.77,15
HCPCS,84220,Assay of pyruvate kinase,,,2.59,3.28,6
HCPCS,842200,ASSAY OF PYRUVATE KINASE,,,8.15,8.15,1
HCPCS,84228,ASSAY OF QUININE,,,10.04,19.43,15
HCPCS,84228,Assay of quinine,,,5.81,7.34,6
HCPCS,842280,ASSAY OF QUININE,,,10.04,10.04,1
HCPCS,84233,ASSAY OF ESTROGEN,,,75.92,146.85,15
HCPCS,84233,Assay of estrogen,,,16.61,20.98,6
HCPCS,842330,ASSAY OF ESTROGEN,,,75.92,75.92,1
HCPCS,84234,ASSAY OF PROGESTERONE,,,56.05,108.41,15
HCPCS,84234,Assay of progesterone,,,16.61,20.98,6
HCPCS,842340,ASSAY OF PROGESTERONE,,,56.05,56.05,1
HCPCS,84235,ASSAY OF ENDOCRINE HORMONE,,,61.54,61.54,1
HCPCS,84235,ENDOCRINE RECEPTOR ASSAY,95.0,61.75,16.61,95.0,37
HCPCS,842350,ASSAY OF ENDOCRINE HORMONE,,,61.54,61.54,1
HCPCS,84238,ASSAY NONENDOCRINE RECEPTOR,314.0,204.1,13.39,282.6,38
HCPCS,84238,INTERLEUKIN 2 RECEPTOR,172.0,111.8,13.39,154.8,37
HCPCS,84238,NONENDOCRINE RECEPTOR ASSAY,56.0,36.4,13.39,56.0,37
HCPCS,84238,SOLUBLE TRANSFERRINE RECEPTOR,314.0,204.1,13.39,282.6,37
HCPCS,842380,ASSAY NONENDOCRINE RECEPTOR,,,31.6,31.6,1
HCPCS,84244,ASSAY OF RENIN,,,19.0,19.0,1
HCPCS,84244,RENIN,80.0,52.0,6.33,72.0,37
HCPCS,84244,RENIN PLASMA,79.0,51.35,6.33,71.1,37
HCPCS,842440,ASSAY OF RENIN,,,19.0,19.0,1
HCPCS,84252,ASSAY OF VITAMIN B-2,,,17.49,17.49,1
HCPCS,84252,RIBOFLAVIN(VITAMIN B2),88.0,57.2,5.78,79.2,37
HCPCS,84252,VIT B-2 ASSAY,126.0,81.9,5.78,158.4,74
HCPCS,842520,ASSAY OF VITAMIN B-2,,,17.49,17.49,1
HCPCS,84255,ASSAY OF SELENIUM,,,22.05,22.05,1
HCPCS,84255,SELENIUM BLOOD,76.0,49.4,5.78,68.4,37
HCPCS,84255,"SELENIUM, PLASMA",73.0,47.45,5.78,69.3,74
HCPCS,842550,ASSAY OF SELENIUM,,,22.05,22.05,1
HCPCS,84260,ASSAY OF SEROTONIN,,,26.76,26.76,1
HCPCS,84260,SEROTONIN,50.0,32.5,12.5,50.0,37
HCPCS,84260,SEROTONIN ASSAY,84.0,54.6,16.61,75.6,37
HCPCS,84260,SEROTONIN SERUM,171.0,111.15,16.61,153.9,37
HCPCS,842600,ASSAY OF SEROTONIN,,,26.76,26.76,1
HCPCS,84270,*SEX HORMONE BINDING GLOBULIN,99.0,64.35000000000001,5.78,149.4,74
HCPCS,84270,ASSAY OF SEX HORMONE GLOBUL,,,18.77,18.77,1
HCPCS,84270,BTSTFC ASSAY OF SEX HORMONE GLOBUL,75.0,48.75,5.78,67.5,37
HCPCS,84270,SEX HORMONE BIND GLOBULI,92.0,59.8,5.78,82.8,37
HCPCS,84270,SEX-HORMONE BIND GLOBULIN,26.0,16.9,5.78,26.0,37
HCPCS,842700,ASSAY OF SEX HORMONE GLOBUL,,,18.77,18.77,1
HCPCS,84275,ASSAY OF SIALIC ACID,,,11.61,11.61,1
HCPCS,84275,LIPID ASSOC SIALIC ACID,147.0,95.55,5.78,132.3,37
HCPCS,842750,ASSAY OF SIALIC ACID,,,11.61,11.61,1
HCPCS,84285,ASSAY OF SILICA,,,21.78,21.78,1
HCPCS,84285,SILICA,176.0,114.4,5.78,158.4,37
HCPCS,842850,ASSAY OF SILICA,,,21.78,21.78,1
HCPCS,84295,*SODIUM BLOOD,73.0,47.45,2.59,65.7,37
HCPCS,84295,ASSAY OF SERUM SODIUM,,,4.16,8.04,4
HCPCS,84295,SODIUM,73.0,47.45,2.59,65.7,37
HCPCS,84295,SODIUM BLOOD (POINT OF CARE LAB),73.0,47.45,2.59,65.7,37
HCPCS,84295,SODIUM SERUM PLASMA OR WHOLE BLOOD,22.0,14.3,2.02,22.0,17
HCPCS,842950,ASSAY OF SERUM SODIUM,,,4.16,4.16,1
HCPCS,84295QW,ASSAY OF SERUM SODIUM,,,7.42,8.04,3
HCPCS,84300,*NA URINE ASSAY,9.0,5.85,2.25,8.46,37
HCPCS,84300,ASSAY OF URINE SODIUM,58.0,37.7,2.13,58.0,18
HCPCS,84300,NA URINE ASSAY,109.0,70.85,2.59,98.1,37
HCPCS,84300,SODIUM 24HR URIN PROFESSIONAL FEE,13.0,8.45,2.13,13.0,17
HCPCS,84300,"SSAT24 SODIUM, UR",14.0,9.1,2.59,12.6,37
HCPCS,843000,ASSAY OF URINE SODIUM,,,4.37,4.37,1
HCPCS,84302,ASSAY OF SWEAT SODIUM,,,4.2,4.2,1
HCPCS,84302,SODIUM FECES,12.0,7.8,2.59,10.8,37
HCPCS,84302,SODIUM FLUID,28.0,18.2,2.59,40.5,74
HCPCS,843020,ASSAY OF SWEAT SODIUM,,,4.2,4.2,1
HCPCS,84305,ASSAY OF SOMATOMEDIN,,,18.37,18.37,1
HCPCS,84305,INSULIN LIK GR FAC 1,201.0,130.65,6.33,180.9,37
HCPCS,84305,SOMATOMEDIN,106.0,68.9,6.33,95.4,37
HCPCS,84305,SOMATOMEDIN ASSAY,37.0,24.05,6.33,35.53,37
HCPCS,843050,ASSAY OF SOMATOMEDIN,,,18.37,18.37,1
HCPCS,84307,ASSAY OF SOMATOSTATIN,,,15.79,15.79,1
HCPCS,84307,SOMATOSTATIN,43.5,28.275,6.33,39.6,74
HCPCS,843070,ASSAY OF SOMATOSTATIN,,,15.79,15.79,1
HCPCS,84311,"ADENOSINE DEAMINASE, PF",188.0,122.2,2.59,169.2,37
HCPCS,84311,"ADENOSINE DEAMINASE, SER",172.0,111.8,2.59,154.8,37
HCPCS,84311,"CHYMOTRYPSIN, STOOL",190.0,123.5,2.59,171.0,37
HCPCS,84311,FAOACM SPECTROPHOTOMETRY X8,69.0,44.85,2.59,62.1,37
HCPCS,84311,FAOSCM SPECTROPHOTOMETRY X4,69.0,44.85,2.59,62.1,37
HCPCS,84311,PBG DEAMINASE,487.0,316.55,2.59,438.3,37
HCPCS,84311,PHOSPHOLIPIDS,131.0,85.15,2.59,117.9,37
HCPCS,84311,PORPHYRINS PLASMA,97.0,63.05,2.59,87.3,37
HCPCS,84311,PORPHYRINS SERUM TOTAL,109.0,70.85,2.59,98.1,37
HCPCS,84311,SPECTROPHOTOMETRY,,,7.0,7.0,1
HCPCS,84311,SPECTROPHOTOMETRY ANALYTE NES,130.0,84.5,2.59,158.4,148
HCPCS,84311,SPECTROPHOTOMETRY NOS,58.0,37.7,2.59,174.6,407
HCPCS,843110,SPECTROPHOTOMETRY,,,7.0,7.0,1
HCPCS,84315,BODY FLUID SPECIFIC GRAVITY,,,2.83,2.83,1
HCPCS,84315,SP-GR EXCEPT URINE,19.0,12.35,2.59,17.1,37
HCPCS,84315,SPECIFIC GRAVITY BDY FLD,19.0,12.35,2.59,17.1,37
HCPCS,84315,SPECIFIC GRAVITY NOT URINE,10.0,6.5,2.5,9.0,37
HCPCS,843150,BODY FLUID SPECIFIC GRAVITY,,,2.83,2.83,1
HCPCS,84375,CHROMATOGRAM ASSAY SUGARS,,,33.7,65.17,15
HCPCS,84375,Chromatogram assay sugars,,,13.39,16.91,6
HCPCS,843750,CHROMATOGRAM ASSAY SUGARS,,,33.7,33.7,1
HCPCS,84376,SUGARS SINGLE QUAL,,,4.75,4.75,1
HCPCS,84376,SUGARS; SINGLE QUAL EA SPECIMEN,19.0,12.35,2.59,17.1,37
HCPCS,843760,SUGARS SINGLE QUAL,,,4.75,4.75,1
HCPCS,84377,"CARBOHYDRATE, UR",125.0,81.25,2.59,112.5,37
HCPCS,84377,SUGARS MULTIPLE QUAL,,,4.75,4.75,1
HCPCS,843770,SUGARS MULTIPLE QUAL,,,4.75,4.75,1
HCPCS,84378,"15AGTL - 1,5 ANHYDROGLUCITOL",44.0,28.6,5.78,39.6,37
HCPCS,84378,GALACTOSE-1-PHOSPHATE,474.0,308.1,5.78,426.6,37
HCPCS,84378,GLYCOMARK,81.0,52.65,5.78,72.9,37
HCPCS,84378,SUGARS SINGLE QUANT,,,9.96,9.96,1
HCPCS,843780,SUGARS SINGLE QUANT,,,9.96,9.96,1
HCPCS,84379,"CARBOHYDRATE, UR",74.0,48.1,5.78,66.6,37
HCPCS,84379,SUGARS MULTIPLE QUANT,,,9.96,9.96,1
HCPCS,843790,SUGARS MULTIPLE QUANT,,,9.96,9.96,1
HCPCS,84392,ASSAY OF URINE SULFATE,,,4.74,4.74,1
HCPCS,84392,"SSAT24 SULFATE, UR",15.0,9.75,1.43,13.5,37
HCPCS,84392,USO4 ASSAY OF URINE SULFATE,33.0,21.45,1.43,29.7,37
HCPCS,843920,ASSAY OF URINE SULFATE,,,4.74,4.74,1
HCPCS,84393,"TAU, PHOSPHORYLATED (EG, PTAU 181, PTAU 217), EACH",112.0,72.8,5.23,141.81,60
HCPCS,84394,"TAU, TOTAL (TTAU)",112.0,72.8,28.0,141.81,30
HCPCS,84402,*TESTOSTERONE FREE ASSAY,57.0,37.05,6.33,51.3,74
HCPCS,84402,ASSAY OF FREE TESTOSTERONE,,,22.01,22.01,1
HCPCS,84402,BTSTFC TESTOSTERONE FR,112.0,72.8,6.33,100.8,37
HCPCS,84402,FTTESM TESTO FR AD MALE,97.0,63.05,6.33,87.3,37
HCPCS,84402,TESTOSTERONE FR AD MALE,157.0,102.05,6.33,141.3,37
HCPCS,84402,TESTOSTERONE FREE,43.0,27.95,6.33,42.56,37
HCPCS,84402,"TESTOSTERONE, FREE, SERUM",112.0,72.8,6.33,100.8,37
HCPCS,84402,TESTOSTERONE; FREE,63.0,40.95,6.33,56.7,37
HCPCS,844020,ASSAY OF FREE TESTOSTERONE,,,22.01,22.01,1
HCPCS,84403,*BIOAVAILABLE TESTOSTERONE,55.0,35.75,6.33,49.5,37
HCPCS,84403,*TESTOSTERONE TOTAL ASSAY,55.0,35.75,6.33,49.5,111
HCPCS,84403,ASSAY OF TESTOSTERONE TOTAL,70.0,45.5,10.84,70.0,17
HCPCS,84403,ASSAY OF TOTAL TESTOSTERONE,,,22.3,22.3,1
HCPCS,84403,CAHSP ASSAY OF TOTAL TESTOSTERONE,72.0,46.8,6.33,64.8,37
HCPCS,84403,FTTESM TESTOSTERONE,91.0,59.15,6.33,81.9,37
HCPCS,84403,TESTOSTER TOT,55.0,35.75,6.33,49.5,37
HCPCS,84403,TESTOSTERONE TOTAL ASSAY,136.0,88.4,6.33,195.3,74
HCPCS,84403,"TESTOSTERONE, TOTAL, SERUM",72.0,46.8,6.33,64.8,37
HCPCS,844030,ASSAY OF TOTAL TESTOSTERONE,,,22.3,22.3,1
HCPCS,84410,TESTOSTERONE BIOAVAILABLE,,,44.3,85.69,15
HCPCS,84410,Testosterone bioavailable,,,16.61,20.98,6
HCPCS,844100,TESTOSTERONE BIOAVAILABLE,,,44.3,44.3,1
HCPCS,84425,ASSAY OF VITAMIN B-1,,,18.34,18.34,1
HCPCS,84425,VIT B-1 ASSAY,48.0,31.2,5.78,45.9,74
HCPCS,84425,VITAMIN B WHOLE BLOOD,131.0,85.15,5.78,117.9,37
HCPCS,84425,VITAMIN B1 PLASMA,135.0,87.75,5.78,121.5,37
HCPCS,844250,ASSAY OF VITAMIN B-1,,,18.34,18.34,1
HCPCS,84430,ASSAY OF THIOCYANATE,,,10.04,10.04,1
HCPCS,84430,THIOCYANATE,52.5,34.125,5.78,69.3,74
HCPCS,844300,ASSAY OF THIOCYANATE,,,10.04,10.04,1
HCPCS,84431,THROMBOXANE URINE,,,30.34,58.67,15
HCPCS,84431,Thromboxane urine,,,13.39,16.91,6
HCPCS,844310,THROMBOXANE URINE,,,30.34,30.34,1
HCPCS,84432,ASSAY OF THYROGLOBULIN,,,13.88,13.88,1
HCPCS,84432,"MONOCLONAL PROTEIN, UR,24HR",95.0,61.75,6.33,85.5,37
HCPCS,84432,THYROGLOB AB INTERFERENCE,244.0,158.6,6.33,219.6,37
HCPCS,84432,THYROGLOBULIN,89.0,57.849999999999994,6.0,138.6,74
HCPCS,84432,THYROGLOBULIN FLUID,56.0,36.4,6.33,50.4,37
HCPCS,84432,"THYROGLOBULIN, FNA",57.0,37.05,6.33,51.3,37
HCPCS,844320,ASSAY OF THYROGLOBULIN,,,13.88,13.88,1
HCPCS,84433,ASY THIOPURIN S-MTHYLTRNSFRS,,,19.16,19.16,1
HCPCS,84433,TPMT ASY THIOPURIN S-MTHYLTRNSFRS,253.0,164.45,5.78,227.7,37
HCPCS,844330,ASY THIOPURIN S-MTHYLTRNSFRS,,,19.16,19.16,1
HCPCS,84436,*THYROXINE TOTAL ASSAY,12.0,7.8,3.0,11.48,37
HCPCS,84436,ASSAY OF TOTAL THYROXINE,,,5.94,5.94,1
HCPCS,84436,"ASSAY, TOTAL THYROXINE",76.0,49.4,2.89,76.0,17
HCPCS,84436,THYROXINE TOTAL ASSAY,74.0,48.1,6.33,66.6,37
HCPCS,844360,ASSAY OF TOTAL THYROXINE,,,5.94,5.94,1
HCPCS,84437,ASSAY OF NEONATAL THYROXINE,,,5.59,10.81,15
HCPCS,84437,Assay of neonatal thyroxine,,,6.33,7.99,6
HCPCS,844370,ASSAY OF NEONATAL THYROXINE,,,5.59,5.59,1
HCPCS,84439,ASSAY OF FREE THYROXINE,123.0,79.95,3.79,123.0,18
HCPCS,84439,THYROXIN FREE,182.0,118.3,6.33,163.8,37
HCPCS,84439,THYROXINE FREE ASSAY,82.5,53.625,6.33,75.6,74
HCPCS,844390,ASSAY OF FREE THYROXINE,,,7.8,7.8,1
HCPCS,84442,ASSAY OF THYROID ACTIVITY,,,12.77,12.77,1
HCPCS,84442,TBG-THYROXINE BND GLOBLN,23.0,14.95,5.75,23.0,37
HCPCS,84442,THYROXINE BIND GLOBULIN,23.0,14.95,5.75,23.0,37
HCPCS,844420,ASSAY OF THYROID ACTIVITY,,,12.77,12.77,1
HCPCS,84443,ASSAY OF THYROID STIMULATING HORMONE TSH,59.0,38.35,7.06,59.0,17
HCPCS,84443,ASSAY THYROID STIM HORMONE,,,14.52,28.07,4
HCPCS,84443,THYROID STIMULATING HORMONE (TSH),156.0,101.4,6.33,140.4,37
HCPCS,84443,TSH,156.0,101.4,6.33,140.4,37
HCPCS,844430,ASSAY THYROID STIM HORMONE,,,14.52,14.52,1
HCPCS,84443QW,ASSAY THYROID STIM HORMONE,,,25.91,28.07,3
HCPCS,84445,%TRAB THYROID STIM IMMUN,89.0,57.85,16.61,84.99,37
HCPCS,84445,*TSI ASSAY,74.0,48.1,16.61,74.0,37
HCPCS,84445,ASSAY OF TSI GLOBULIN,,,43.95,43.95,1
HCPCS,84445,THYRD STIM IMMUNGLBN(TSI,91.0,59.15,16.61,84.99,37
HCPCS,844450,ASSAY OF TSI GLOBULIN,,,43.95,43.95,1
HCPCS,84446,ASSAY OF VITAMIN E,,,12.25,12.25,1
HCPCS,84446,VIT E ALPHA-TOCO TEST,21.0,13.65,5.25,21.0,37
HCPCS,84446,VITAMIN E,21.0,13.65,5.25,21.0,37
HCPCS,844460,ASSAY OF VITAMIN E,,,12.25,12.25,1
HCPCS,84449,ASSAY OF TRANSCORTIN,,,15.55,15.55,1
HCPCS,84449,CORTICOSTEROID-BINDING GLOGULIN,118.0,76.7,6.33,106.2,37
HCPCS,84449,TRANSCORTIN,120.0,78.0,6.33,108.0,37
HCPCS,844490,ASSAY OF TRANSCORTIN,,,15.55,15.55,1
HCPCS,84450,"ASPARTATE AMINOTRANSFERASE, FIBROMETER",16.0,10.4,2.59,14.4,37
HCPCS,84450,AST/SGOT,109.0,70.85,2.59,98.1,37
HCPCS,84450,TRANSFERASE (AST) (SGOT),,,4.47,8.66,4
HCPCS,84450,TRANSFERASE ASPARTATE AMINO AST SGOT,40.0,26.0,2.18,40.0,17
HCPCS,844500,TRANSFERASE (AST) (SGOT),,,4.47,4.47,1
HCPCS,84450QW,TRANSFERASE (AST) (SGOT),,,7.99,8.66,3
HCPCS,84460,*TRANSFERASE; ALANINE AMINO,67.0,43.55,2.59,60.3,37
HCPCS,84460,ALANINE AMINO (ALT) (SGPT),,,4.58,8.86,4
HCPCS,84460,"ALANINE AMINOTRANSFERASE, FIBROMETER",16.0,10.4,2.59,14.4,37
HCPCS,84460,ALT/SGPT,116.0,75.4,2.59,104.4,37
HCPCS,84460,TRANSFERASE ALANINE AMINO ALT SGPT,57.0,37.05,2.23,57.0,17
HCPCS,844600,ALANINE AMINO (ALT) (SGPT),,,4.58,4.58,1
HCPCS,84460QW,ALANINE AMINO (ALT) (SGPT),,,8.17,8.86,3
HCPCS,84466,ASSAY OF TRANSFERRIN,,,11.03,11.03,1
HCPCS,84466,TRANSFERRIN,43.5,28.275000000000002,4.75,61.2,74
HCPCS,844660,ASSAY OF TRANSFERRIN,,,11.03,11.03,1
HCPCS,84478,*VAP CHOLESTE,50.0,32.5,2.59,45.0,37
HCPCS,84478,ASSAY OF TRIGLYCERIDES,62.0,40.3,2.41,62.0,21
HCPCS,84478,TRIGLYCERIDES ASSAY,109.0,70.85,2.59,98.1,37
HCPCS,84478,TRIGLYCERIDES BF W REFLEX TO CHYLOMICRON ELECTROPH,35.0,22.75,2.59,31.5,37
HCPCS,84478,TRIGLYCERIDES FLUID,12.0,7.8,2.59,10.8,37
HCPCS,84478,"TRIGLYCERIDES, BLOOD",35.0,22.75,2.41,35.0,17
HCPCS,844780,ASSAY OF TRIGLYCERIDES,,,4.96,4.96,1
HCPCS,84478QW,ASSAY OF TRIGLYCERIDES,,,8.85,9.59,3
HCPCS,84479,%T4TFI T4 UPTAKE,68.0,44.2,6.33,61.2,37
HCPCS,84479,*T3/T4 UPTAKE ASSAY,12.0,7.8,3.0,10.81,37
HCPCS,84479,ASSAY OF THYROID (T3 OR T4),,,5.59,5.59,1
HCPCS,84479,T3/T4 UPTAKE,12.0,7.8,3.0,10.81,37
HCPCS,84479,THYROID HORM UPTK/THYROID HORMONE BINDING RATIO,70.0,45.5,2.72,70.0,17
HCPCS,844790,ASSAY OF THYROID (T3 OR T4),,,5.59,5.59,1
HCPCS,84480,ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3,210.0,136.5,5.96,210.0,17
HCPCS,84480,ASSAY TRIIODOTHYRONINE (T3),,,12.25,12.25,1
HCPCS,84480,TRIIODOTHYRONINE TOTAL(TT-3),144.0,93.6,6.33,129.6,37
HCPCS,844800,ASSAY TRIIODOTHYRONINE (T3),,,12.25,12.25,1
HCPCS,84481,ASSAY OF TRIIODOTHYRONINE T3 FREE,210.0,136.5,7.11,210.0,17
HCPCS,84481,FREE ASSAY (FT-3),,,14.63,14.63,1
HCPCS,84481,T3 DIAL FREE,74.0,48.1,6.33,66.6,37
HCPCS,84481,T3 FREE,46.0,29.9,6.33,41.4,37
HCPCS,84481,TRIIODOTHYRONINE FREE(FT-3),75.0,48.75,6.33,67.5,37
HCPCS,844810,FREE ASSAY (FT-3),,,14.63,14.63,1
HCPCS,84482,REVERSE T3,25.0,16.25,6.25,25.0,74
HCPCS,84482,T3 REVERSE,,,13.62,13.62,1
HCPCS,844820,T3 REVERSE,,,13.62,13.62,1
HCPCS,84484,*TROPONIN - I,178.0,115.7,5.78,160.2,37
HCPCS,84484,ASSAY OF TROPONIN QUANT,,,10.78,10.78,1
HCPCS,84484,ASSAY OF TROPONIN QUANTITATIVE,141.0,91.65,5.24,141.0,17
HCPCS,84484,TROPONIN I,178.0,115.7,5.78,160.2,37
HCPCS,84484,TROPONIN T,178.0,115.7,5.78,160.2,37
HCPCS,844840,ASSAY OF TROPONIN QUANT,,,10.78,10.78,1
HCPCS,84485,ASSAY DUODENAL FLUID TRYPSIN,,,6.22,12.03,15
HCPCS,84485,Assay duodenal fluid trypsin,,,2.59,3.28,6
HCPCS,844850,ASSAY DUODENAL FLUID TRYPSIN,,,6.22,6.22,1
HCPCS,84488,TEST FECES FOR TRYPSIN,,,6.31,12.2,15
HCPCS,84488,Test feces for trypsin,,,2.59,3.28,6
HCPCS,844880,TEST FECES FOR TRYPSIN,,,6.31,6.31,1
HCPCS,84490,ASSAY OF FECES FOR TRYPSIN,,,8.58,16.59,15
HCPCS,84490,Assay of feces for trypsin,,,2.59,3.28,6
HCPCS,844900,ASSAY OF FECES FOR TRYPSIN,,,8.58,8.58,1
HCPCS,84510,ASSAY OF TYROSINE,,,9.18,9.18,1
HCPCS,84510,"TYROSINE, PLASMA, EA",143.0,92.95,2.59,128.7,37
HCPCS,845100,ASSAY OF TYROSINE,,,9.18,9.18,1
HCPCS,84512,ASSAY OF TROPONIN QUAL,,,8.72,8.72,1
HCPCS,84512,ASSAY OF TROPONIN QUALITATIVE,15.0,9.75,4.24,15.0,17
HCPCS,84512,TROPONIN ASSAY QUAL (POINT OF CARE LAB),109.0,70.85,2.59,98.1,37
HCPCS,845120,ASSAY OF TROPONIN QUAL,,,8.72,8.72,1
HCPCS,84520,ASSAY OF UREA NITROGEN,,,3.41,6.6,4
HCPCS,84520,ASSAY OF UREA NITROGEN QUANTITATIVE,20.0,13.0,1.66,20.0,17
HCPCS,84520,BLD UREA NTRG Q PROFESSIONAL FEE,13.0,8.45,1.66,13.0,17
HCPCS,84520,BUN,80.0,52.0,2.59,72.0,37
HCPCS,84520,"UREA NITROGEN, SERUM, FIBROMETER",12.0,7.8,2.59,10.8,37
HCPCS,84520,UREA NITROGEN; QUAN,8.0,5.2,2.0,7.2,37
HCPCS,84520,UREA NTRG POC PROFESSIONAL FEE,13.0,8.45,1.66,13.0,17
HCPCS,845200,ASSAY OF UREA NITROGEN,,,3.41,3.41,1
HCPCS,84520QW,ASSAY OF UREA NITROGEN,,,6.09,6.6,3
HCPCS,84525,UREA NITROGEN SEMI-QUANT,,,4.43,8.57,15
HCPCS,84525,Urea nitrogen semi-quant,,,2.59,3.28,6
HCPCS,845250,UREA NITROGEN SEMI-QUANT,,,4.43,4.43,1
HCPCS,84540,ASSAY OF UREA NITROGEN URINE,40.0,26.0,2.34,40.0,17
HCPCS,84540,ASSAY OF URINE/UREA-N,,,4.81,4.81,1
HCPCS,84540,SSAT24 UREA NITROGEN,15.0,9.75,2.59,13.5,37
HCPCS,84540,UREA NITROGEN URINE ASSAY,131.0,85.15,2.59,117.9,37
HCPCS,84540,UREA NTRGN URIN PROFESSIONAL FEE,13.0,8.45,2.34,13.0,17
HCPCS,845400,ASSAY OF URINE/UREA-N,,,4.81,4.81,1
HCPCS,84545,UREA-N CLEARANCE TEST,,,6.22,12.03,15
HCPCS,84545,Urea-n clearance test,,,2.59,3.28,6
HCPCS,845450,UREA-N CLEARANCE TEST,,,6.22,6.22,1
HCPCS,84550,ASSAY OF BLOOD/URIC ACID,16.0,10.4,1.9,16.0,21
HCPCS,84550,URIC ACID BLOOD,110.0,71.5,2.59,99.0,37
HCPCS,84550,URIC ACID BLOOD ASSAY,107.0,69.55,2.59,96.3,37
HCPCS,845500,ASSAY OF BLOOD/URIC ACID,,,3.91,3.91,1
HCPCS,84550QW,ASSAY OF BLOOD/URIC ACID,,,6.97,7.55,3
HCPCS,84560,*URIC ACID OTHER SOURCE ASSAY,9.0,5.85,2.25,8.49,37
HCPCS,84560,ASSAY OF URIC ACID OTHER SOURCE,51.0,33.15,2.13,51.0,17
HCPCS,84560,ASSAY OF URINE/URIC ACID,,,4.38,4.38,1
HCPCS,84560,"SSAT24 URIC ACID, UR",14.0,9.1,2.59,12.6,37
HCPCS,84560,URIC ACD UR 24H PROFESSIONAL FEE,13.0,8.45,2.13,13.0,17
HCPCS,84560,URIC ACID BODY FLUID,55.0,35.75,2.59,49.5,37
HCPCS,84560,URIC ACID OTHER SOURCE ASSAY,57.0,37.05,2.59,51.3,37
HCPCS,845600,ASSAY OF URINE/URIC ACID,,,4.38,4.38,1
HCPCS,84577,ASSAY OF FECES/UROBILINOGEN,,,14.52,28.07,15
HCPCS,84577,Assay of feces/urobilinogen,,,5.78,7.3,6
HCPCS,845770,ASSAY OF FECES/UROBILINOGEN,,,14.52,14.52,1
HCPCS,84578,TEST URINE UROBILINOGEN,,,3.87,7.47,15
HCPCS,84578,Test urine urobilinogen,,,2.59,3.28,6
HCPCS,845780,TEST URINE UROBILINOGEN,,,3.87,3.87,1
HCPCS,84580,ASSAY OF URINE UROBILINOGEN,,,8.25,15.96,15
HCPCS,84580,Assay of urine urobilinogen,,,2.59,3.28,6
HCPCS,845800,ASSAY OF URINE UROBILINOGEN,,,8.25,8.25,1
HCPCS,84583,ASSAY OF URINE UROBILINOGEN,,,5.23,10.11,15
HCPCS,84583,Assay of urine urobilinogen,,,2.59,3.28,6
HCPCS,845830,ASSAY OF URINE UROBILINOGEN,,,5.23,5.23,1
HCPCS,84585,ASSAY OF URINE VMA,,,13.39,13.39,1
HCPCS,84585,VMA URINE,100.0,65.0,6.33,130.5,74
HCPCS,845850,ASSAY OF URINE VMA,,,13.39,13.39,1
HCPCS,84586,ASSAY OF VIP,,,30.52,30.52,1
HCPCS,84586,VASOACTIVE INTST POLYPEP,84.0,54.6,16.61,75.6,37
HCPCS,84586,VIP,83.0,53.95,16.61,74.7,37
HCPCS,845860,ASSAY OF VIP,,,30.52,30.52,1
HCPCS,84588,ASSAY OF VASOPRESSIN,,,29.32,29.32,1
HCPCS,84588,"COPEPTIN PROAVP, PLASMA",57.0,37.05,14.25,56.71,37
HCPCS,84588,VASOPRESSIN (ADH),58.0,37.7,14.5,56.71,37
HCPCS,845880,ASSAY OF VASOPRESSIN,,,29.32,29.32,1
HCPCS,84590,ASSAY OF VITAMIN A,,,10.03,10.03,1
HCPCS,84590,VIT A,21.0,13.65,5.25,19.4,37
HCPCS,84590,VIT A (RETINAL) TEST,21.0,13.65,5.25,19.4,37
HCPCS,845900,ASSAY OF VITAMIN A,,,10.03,10.03,1
HCPCS,84591,ASSAY OF NOS VITAMIN,,,14.74,14.74,1
HCPCS,84591,VITAMIN B3 (NIACIN AND METABOLITES),136.0,88.4,5.78,122.4,37
HCPCS,84591,VITAMIN B5,583.0,378.95,5.78,524.7,37
HCPCS,84591,VITAMIN B7 (BIOTIN),561.0,364.65,5.78,504.9,37
HCPCS,84591,VITAMIN NOS,145.0,94.25,5.78,130.5,37
HCPCS,845910,ASSAY OF NOS VITAMIN,,,14.74,14.74,1
HCPCS,84597,ASSAY OF VITAMIN K,,,11.86,11.86,1
HCPCS,84597,VITAMIN K,114.0,74.1,5.78,104.4,74
HCPCS,845970,ASSAY OF VITAMIN K,,,11.86,11.86,1
HCPCS,84600,ASSAY OF VOLATILES,,,14.79,14.79,1
HCPCS,84600,METHYL ETHYL KETONE URIN,243.0,157.95,5.78,218.7,37
HCPCS,84600,PROPYLENE GLYCOL,536.0,348.4,5.78,482.4,37
HCPCS,84600,TOLUENE BLOOD,352.0,228.8,5.78,316.8,37
HCPCS,84600,VOLATILES ASSAY,150.0,97.5,5.78,135.0,37
HCPCS,846000,ASSAY OF VOLATILES,,,14.79,14.79,1
HCPCS,84620,XYLOSE ABSORP TEST,41.0,26.65,5.78,36.9,37
HCPCS,84620,XYLOSE ABSORPTION URINE,29.0,18.85,5.78,26.1,37
HCPCS,84620,XYLOSE TOLERANCE TEST,,,11.16,11.16,1
HCPCS,846200,XYLOSE TOLERANCE TEST,,,11.16,11.16,1
HCPCS,84630,ASSAY OF ZINC,,,9.84,9.84,1
HCPCS,84630,ZINC ASSAY,73.0,47.45,5.78,65.7,74
HCPCS,84630,ZINC BLOOD,25.0,16.25,5.78,22.5,37
HCPCS,84630,ZINC WHOL BLOOD,268.0,174.2,5.78,241.2,37
HCPCS,84630,"ZINC, UR QNT",44.0,28.6,5.78,39.6,37
HCPCS,84630,"ZINC, URINE QUANTITATIVE",34.0,22.1,5.78,30.6,37
HCPCS,846300,ASSAY OF ZINC,,,9.84,9.84,1
HCPCS,84681,ASSAY OF C-PEPTIDE,,,17.98,17.98,1
HCPCS,84681,C-PEPTID,32.0,20.8,5.78,32.0,37
HCPCS,84681,C-PEPTIDE SERUM,37.0,24.05,5.78,34.77,37
HCPCS,846810,ASSAY OF C-PEPTIDE,,,17.98,17.98,1
HCPCS,84702,%SEQ2 HCG QUANT,73.0,47.45,6.33,65.7,37
HCPCS,84702,BETA HCG QUANT SERUM,77.0,50.05,6.33,69.3,37
HCPCS,84702,BETA HCG QUANT TUMOR MARKER,63.0,40.95,6.33,56.7,37
HCPCS,84702,BETA-HCG QNT TM CSF,74.0,48.1,6.33,66.6,37
HCPCS,84702,CHORIONIC GONADOTROPIN TEST,,,13.0,13.0,1
HCPCS,84702,GONA CHR(HCG),249.0,161.85,6.33,224.1,37
HCPCS,84702,GONADOTROPIN CHORIONIC QUANTITATIVE,180.0,117.0,9.03,180.0,17
HCPCS,84702,HCG QUANT SERUM,249.0,161.85,6.33,224.1,37
HCPCS,847020,CHORIONIC GONADOTROPIN TEST,,,13.0,13.0,1
HCPCS,84703,CHORIONIC GONADOTROPIN ASSAY,,,6.5,12.57,4
HCPCS,84703,GONADOTROPIN CHORIONIC QUALITATIVE,24.0,15.6,3.16,24.0,17
HCPCS,84703,HCG TEST QUAL,94.0,61.1,2.59,84.6,37
HCPCS,84703,HCG TEST QUAL (POINT OF CARE LAB),94.0,61.1,2.59,84.6,37
HCPCS,84703,UA DIP URINE HCG (POINT OF CARE LAB),81.0,52.65,2.59,72.9,37
HCPCS,847030,CHORIONIC GONADOTROPIN ASSAY,,,6.5,6.5,1
HCPCS,84703QW,CHORIONIC GONADOTROPIN ASSAY,,,11.6,12.57,3
HCPCS,84704,BETA HCG QNT TUMOR MKR,69.0,44.85,5.78,62.1,37
HCPCS,84704,HCG FREE BETACHAIN TEST,,,13.21,13.21,1
HCPCS,847040,HCG FREE BETACHAIN TEST,,,13.21,13.21,1
HCPCS,84830,OVULATION TESTS,,,10.97,21.22,15
HCPCS,84830,Ovulation tests,,,6.33,7.99,6
HCPCS,848300,OVULATION TESTS,,,10.97,10.97,1
HCPCS,84999,CHITOTRIOSIDASE,288.0,187.2,5.78,259.2,27
HCPCS,84999,FECAL WT 24HR WET WEIGHT,19.0,12.35,3.19,17.1,27
HCPCS,84999,"NITROGEN, TOTAL, FECES",732.0,475.8,5.78,658.8,27
HCPCS,84999,"OSMOLALITY, STOOL",72.0,46.8,5.78,64.8,27
HCPCS,84999,"POTASSIUM, BODY FLUID",39.5,25.675,4.37,47.7,54
HCPCS,84999,"POTASSIUM, STOOL",59.0,38.35,5.78,53.1,27
HCPCS,84999,PROMETHEUS ANSER ADA,2008.0,1305.2,5.78,1807.2,27
HCPCS,84999,PROMETHEUS ANSER IFX,2008.0,1305.2,5.78,1807.2,27
HCPCS,84999,PROMETHEUS ANSER UST,2008.0,1305.2,5.78,1807.2,27
HCPCS,84999,PROMETHEUS ANSER VDZ,2008.0,1305.2,5.78,1807.2,27
HCPCS,84999,UNLISTED CHEMISTRY TEST,191.0,124.15,5.78,171.9,27
HCPCS,85002,BLEEDING TIME TEST,15.0,9.75,2.02,15.0,32
HCPCS,85002,Bleeding time test,,,2.12,2.68,6
HCPCS,850020,BLEEDING TIME TEST,,,4.17,4.17,1
HCPCS,85004,AUTOMATED DIFF WBC COUNT,,,5.59,10.81,15
HCPCS,85004,Automated diff wbc count,,,2.81,3.55,6
HCPCS,850040,AUTOMATED DIFF WBC COUNT,,,5.59,5.59,1
HCPCS,85007,AVN MANUAL DIFF,73.0,47.45,2.81,65.7,37
HCPCS,85007,BL SMEAR W/DIFF WBC COUNT,,,3.28,3.28,1
HCPCS,85007,BLOOD COUNT SMEAR MCRSCP W/MNL DIFRNTL WBC COUNT,15.0,9.75,1.6,15.0,17
HCPCS,85007,WBC COUNT MANUAL DIFF,74.0,48.1,2.81,66.6,37
HCPCS,850070,BL SMEAR W/DIFF WBC COUNT,,,3.28,3.28,1
HCPCS,85008,BL SMEAR W/O DIFF WBC COUNT,,,2.96,5.73,15
HCPCS,85008,Bl smear w/o diff wbc count,,,2.81,3.55,6
HCPCS,850080,BL SMEAR W/O DIFF WBC COUNT,,,2.96,2.96,1
HCPCS,85009,BUFFY COAT SEZARY CELL,34.0,22.1,2.81,30.6,37
HCPCS,85009,MANUAL DIFF WBC COUNT B-COAT,,,4.38,4.38,1
HCPCS,850090,MANUAL DIFF WBC COUNT B-COAT,,,4.38,4.38,1
HCPCS,85013,BLOOD COUNT SPUN MICRO HCT,34.0,22.1,2.81,30.6,37
HCPCS,85013,SPUN MICROHEMATOCRIT,,,6.05,6.05,1
HCPCS,850130,SPUN MICROHEMATOCRIT,,,6.05,6.05,1
HCPCS,85014,*BLOOD COUNT HCT,44.0,28.6,2.37,39.6,74
HCPCS,85014,BLOOD COUNT HCT (POINT OF CARE LAB),44.0,28.6,2.37,39.6,37
HCPCS,85014,BLOOD COUNT HEMATOCRIT,34.0,22.1,1.42,34.0,17
HCPCS,85014,HEMATOCRIT,44.0,28.6,2.05,39.6,41
HCPCS,85014,HEMATOCRIT (POINT OF CARE LAB),44.0,28.6,2.37,39.6,37
HCPCS,850140,HEMATOCRIT,,,2.05,2.05,1
HCPCS,85014QW,HEMATOCRIT,,,3.65,3.96,3
HCPCS,85018,*BLOOD COUNT HGB,44.0,28.6,2.37,39.6,37
HCPCS,85018,BLOOD COUNT HEMOGLOBIN,19.0,12.35,1.42,19.0,17
HCPCS,85018,BLOOD COUNT HGB,44.0,28.6,2.37,39.6,37
HCPCS,85018,BLOOD COUNT HGB (POINT OF CARE LAB),44.0,28.6,2.37,39.6,37
HCPCS,85018,HEMOGLOBIN,,,2.05,3.96,4
HCPCS,850180,HEMOGLOBIN,,,2.05,2.05,1
HCPCS,85018QW,HEMOGLOBIN,,,3.65,3.96,3
HCPCS,85025,BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC,62.0,40.3,3.26,62.0,17
HCPCS,85025,CBC / DIFF & PLATLT,48.0,31.2,3.26,48.0,17
HCPCS,85025,CBC AUTO W AUTO DIFF,154.0,100.1,2.81,138.6,37
HCPCS,85025,COMPLETE CBC W/AUTO DIFF WBC,,,6.72,12.98,4
HCPCS,850250,COMPLETE CBC W/AUTO DIFF WBC,,,6.72,6.72,1
HCPCS,85025QW,COMPLETE CBC W/AUTO DIFF WBC,,,11.98,12.98,3
HCPCS,85027,BLOOD COUNT COMPLETE AUTOMATED,73.0,47.45,2.72,73.0,17
HCPCS,85027,CBC AUTO WO DIFF,144.0,93.6,2.81,129.6,37
HCPCS,85027,CBC WO DIFF PROFESSIONAL FEE,13.0,8.45,2.72,13.0,17
HCPCS,85027,COMPLETE CBC AUTOMATED,,,5.59,5.59,1
HCPCS,850270,COMPLETE CBC AUTOMATED,,,5.59,5.59,1
HCPCS,85032,BLOOD COUNT MANUAL CELL COUNT EACH,49.0,31.85,1.81,49.0,17
HCPCS,85032,MANUAL CELL COUNT EA,123.0,79.95,2.81,110.7,37
HCPCS,85032,MANUAL CELL COUNT EACH,,,3.73,3.73,1
HCPCS,85032,"SMEAR, PARASITEMIA CELL COUNT",28.0,18.2,2.81,25.2,37
HCPCS,850320,MANUAL CELL COUNT EACH,,,3.73,3.73,1
HCPCS,85041,AUTOMATED RBC COUNT,105.0,68.25,2.61,94.5,38
HCPCS,85041,HGB EVAL CASCADE,107.0,69.55,2.81,96.3,37
HCPCS,850410,AUTOMATED RBC COUNT,,,2.61,2.61,1
HCPCS,85044,BLOOD COUNT RETICULOCYTE AUTOMATED,15.0,9.75,1.81,15.0,17
HCPCS,85044,MANUAL RETICULOCYTE COUNT,,,3.73,3.73,1
HCPCS,85044,RETICULOCTYE COUNT MANUAL,74.0,48.1,2.81,66.6,37
HCPCS,850440,MANUAL RETICULOCYTE COUNT,,,3.73,3.73,1
HCPCS,85045,AUTOMATED RETICULOCYTE COUNT,,,3.45,3.45,1
HCPCS,85045,RETICULOCYTE COUNT AUTO,74.0,48.1,2.81,66.6,37
HCPCS,850450,AUTOMATED RETICULOCYTE COUNT,,,3.45,3.45,1
HCPCS,85046,RETICULOCYTE HEMOGLOBIN,55.0,35.75,2.81,49.5,37
HCPCS,85046,RETICYTE/HGB CONCENTRATE,,,4.82,4.82,1
HCPCS,850460,RETICYTE/HGB CONCENTRATE,,,4.82,4.82,1
HCPCS,85048,*LEUKO (WBC) COUNT AUTO,20.0,13.0,2.54,18.0,37
HCPCS,85048,AUTOMATED LEUKOCYTE COUNT,,,2.19,2.19,1
HCPCS,85048,BLOOD COUNT LEUKOCYTE WBC AUTOMATED,40.0,26.0,1.07,40.0,17
HCPCS,85048,LEUKO (WBC) COUNT AUTO,51.0,33.15,2.54,45.9,74
HCPCS,850480,AUTOMATED LEUKOCYTE COUNT,,,2.19,2.19,1
HCPCS,85049,AUTOMATED PLATELET COUNT,,,3.87,3.87,1
HCPCS,85049,BLOOD COUNT PLATELET AUTOMATED,38.0,24.7,1.88,38.0,17
HCPCS,85049,PLT COUNT AUTO,86.0,55.9,2.81,77.4,37
HCPCS,850490,AUTOMATED PLATELET COUNT,,,3.87,3.87,1
HCPCS,85055,IMMATURE PLATELET FRACT,166.0,107.9,12.26,149.4,37
HCPCS,85055,RETICULATED PLATELET ASSAY,,,30.88,30.88,1
HCPCS,850550,RETICULATED PLATELET ASSAY,,,30.88,30.88,1
HCPCS,85060,BLOOD SMEAR INTERPRETATION,,,19.6,19.6,2
HCPCS,85060,BLOOD SMEAR PERIPH PHYS I&R,23.0,14.95,2.81,28.44,28
HCPCS,85060,BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT,194.0,126.1,10.11,194.0,31
HCPCS,85060,STAFF REVIEW,23.0,14.95,2.81,28.44,28
HCPCS,850600,BLOOD SMEAR INTERPRETATION,,,19.6,19.6,1
HCPCS,85060TC,BLOOD SMEAR INTERPRETATION,,,19.6,19.6,1
HCPCS,85097,BONE MARROW INTERPRETATION,,,39.53,1771.17,16
HCPCS,85097,BONE MARROW SMEAR INTERPRETATION,405.0,263.25,20.24,303.75,31
HCPCS,85097,Bone marrow interpretation,,,325.19,410.76,6
HCPCS,850970,BONE MARROW INTERPRETATION,,,39.53,39.53,1
HCPCS,85097TC,BONE MARROW INTERPRETATION,,,39.53,39.53,1
HCPCS,85130,CHROMOGENIC SUBSTRATE ASSAY,,,10.27,19.87,15
HCPCS,85130,Chromogenic substrate assay,,,2.81,3.55,6
HCPCS,851300,CHROMOGENIC SUBSTRATE ASSAY,,,10.27,10.27,1
HCPCS,85170,BLOOD CLOT RETRACTION,,,14.08,27.24,15
HCPCS,85170,Blood clot retraction,,,2.12,2.68,6
HCPCS,851700,BLOOD CLOT RETRACTION,,,14.08,14.08,1
HCPCS,85175,BLOOD CLOT LYSIS TIME,,,17.6,34.04,15
HCPCS,85175,Blood clot lysis time,,,12.26,15.48,6
HCPCS,851750,BLOOD CLOT LYSIS TIME,,,17.6,17.6,1
HCPCS,85210,CLOT FACTOR II PROTHROM SPEC,,,11.21,11.21,1
HCPCS,85210,COAG FACT ASSAY 2,81.0,52.65,2.12,72.9,37
HCPCS,85210,FACTOR II TEST PRO SPECIFIC,83.0,53.95,2.12,74.7,37
HCPCS,852100,CLOT FACTOR II PROTHROM SPEC,,,11.21,11.21,1
HCPCS,85220,BLOOC CLOT FACTOR V TEST,,,15.25,15.25,1
HCPCS,85220,COAG FACT ASSAY 5,80.0,52.0,2.12,72.0,37
HCPCS,85220,FACTOR V TEST LABILE FACTOR,81.0,52.65,2.12,72.9,37
HCPCS,852200,BLOOC CLOT FACTOR V TEST,,,15.25,15.25,1
HCPCS,85230,CLOT FACTOR VII PROCONVERTIN,,,15.47,15.47,1
HCPCS,85230,COAG FACT ASSAY 7,79.0,51.35,2.12,71.1,37
HCPCS,85230,FACTOR VII TEST STABLE FACTOR,80.0,52.0,2.12,72.0,37
HCPCS,852300,CLOT FACTOR VII PROCONVERTIN,,,15.47,15.47,1
HCPCS,85240,%VWD2N ONE STAGE,206.0,133.9,2.12,185.4,37
HCPCS,85240,*FACTOR VII TEST 1 STAGE,293.0,190.45,2.12,263.7,37
HCPCS,85240,*FACTOR VIII TEST 1 STAGE,79.5,51.675,2.12,72.0,74
HCPCS,85240,CLOT FACTOR VIII AHG 1 STAGE,,,15.47,15.47,1
HCPCS,85240,COAG FACT ASSAY 8,209.0,135.85,2.12,188.1,37
HCPCS,85240,FACTOR VIII TEST 1 STAGE,105.5,68.575,2.12,115.2,74
HCPCS,852400,CLOT FACTOR VIII AHG 1 STAGE,,,15.47,15.47,1
HCPCS,85244,CLOT FACTOR VIII RELTD ANTGN,,,17.65,34.12,15
HCPCS,85244,Clot factor viii reltd antgn,,,12.26,15.48,6
HCPCS,852440,CLOT FACTOR VIII RELTD ANTGN,,,17.65,17.65,1
HCPCS,85245,*FACTOR VIII TEST VW FACTOR,92.0,59.8,12.26,94.5,74
HCPCS,85245,CLOT FACTOR VIII VW RISTOCTN,48.0,31.2,12.0,43.2,38
HCPCS,85245,FACTOR VIII TEST VW FACTOR,50.0,32.5,12.26,45.0,37
HCPCS,852450,CLOT FACTOR VIII VW RISTOCTN,,,19.82,19.82,1
HCPCS,85246,%VWD2N FACTOR ANTIGEN,892.0,579.8,12.26,802.8,37
HCPCS,85246,*FACTOR VIII TEST VW AG,79.0,51.35,9.75,263.7,111
HCPCS,85246,CLOT FACTOR VIII VW ANTIGEN,,,19.82,19.82,1
HCPCS,85246,FACTOR VIII TEST VW AG,114.0,74.1,12.26,159.3,74
HCPCS,85246,VON WILLEBRAND ANTIGEN,289.0,187.85,12.26,260.1,37
HCPCS,852460,CLOT FACTOR VIII VW ANTIGEN,,,19.82,19.82,1
HCPCS,85247,*FACTOR VIII TEST VW MULT,97.5,63.375,12.26,104.4,74
HCPCS,85247,CLOT FACTOR VIII MULTIMETRIC,,,19.82,19.82,1
HCPCS,85247,FACTOR VIII TEST VW MULT,89.0,57.85,12.26,80.1,37
HCPCS,85247,VWF MULTIMER,88.0,57.2,12.26,79.2,37
HCPCS,852470,CLOT FACTOR VIII MULTIMETRIC,,,19.82,19.82,1
HCPCS,85250,CLOT FACTOR IX PTC/CHRSTMAS,,,16.45,16.45,1
HCPCS,85250,COAG FACT ASSAY 9,166.0,107.9,12.26,149.4,37
HCPCS,85250,FACTOR IX TEST PTC,169.0,109.85,12.26,152.1,37
HCPCS,852500,CLOT FACTOR IX PTC/CHRSTMAS,,,16.45,16.45,1
HCPCS,85260,CLOT FACTOR X STUART-POWER,,,15.47,15.47,1
HCPCS,85260,COAG FACT ASSAY 10,134.0,87.1,2.12,120.6,37
HCPCS,85260,FACTOR X TEST STUART-PROWER,79.0,51.35,2.12,71.1,37
HCPCS,852600,CLOT FACTOR X STUART-POWER,,,15.47,15.47,1
HCPCS,85270,CLOT FACTOR XI PTA,,,15.47,15.47,1
HCPCS,85270,COAG FACT ASSAY 11,76.0,49.4,2.12,68.4,37
HCPCS,85270,FACTOR XI TEST PTA,77.0,50.05,2.12,69.3,37
HCPCS,852700,CLOT FACTOR XI PTA,,,15.47,15.47,1
HCPCS,85280,CLOT FACTOR XII HAGEMAN,,,16.72,16.72,1
HCPCS,85280,COAG FACT ASSAY 12,76.0,49.4,12.26,68.4,37
HCPCS,85280,FACTOR XII TEST HAGEMAN,77.0,50.05,12.26,69.3,37
HCPCS,852800,CLOT FACTOR XII HAGEMAN,,,16.72,16.72,1
HCPCS,85290,CLOT FACTOR XIII FIBRIN STAB,,,14.12,14.12,1
HCPCS,85290,COAG FACTOR ASSAY 13,32.0,20.8,2.12,28.8,37
HCPCS,85290,FACTOR XIII TEST FIBRIN STABL,24.0,15.6,2.12,24.0,37
HCPCS,852900,CLOT FACTOR XIII FIBRIN STAB,,,14.12,14.12,1
HCPCS,85291,CLOT FACTOR XIII FIBRIN SCRN,,,7.87,15.22,15
HCPCS,85291,Clot factor xiii fibrin scrn,,,2.12,2.68,6
HCPCS,852910,CLOT FACTOR XIII FIBRIN SCRN,,,7.87,7.87,1
HCPCS,85292,CLOT FACTOR FLETCHER FACT,,,16.35,16.35,1
HCPCS,85292,FLETCHER FACTOR ASSAY,124.0,80.6,2.12,111.6,37
HCPCS,85292,PREKALLIKREIN FLETCHER,652.0,423.8,2.12,586.8,37
HCPCS,852920,CLOT FACTOR FLETCHER FACT,,,16.35,16.35,1
HCPCS,85293,CLOT FACTOR WGHT KININOGEN,,,16.35,16.35,1
HCPCS,85293,CLOTTING; HMW KININOGEN ASSAY,306.0,198.9,2.12,275.4,37
HCPCS,852930,CLOT FACTOR WGHT KININOGEN,,,16.35,16.35,1
HCPCS,85300,ANTITHROMBIN 3,20.0,13.0,2.12,19.8,37
HCPCS,85300,ANTITHROMBIN III ACTIVITY,20.0,13.0,2.12,19.8,38
HCPCS,853000,ANTITHROMBIN III ACTIVITY,,,10.24,10.24,1
HCPCS,85301,ANTITHROMBIN III AG ASSAY,33.0,21.45,2.12,29.7,37
HCPCS,85301,ANTITHROMBIN III ANTIGEN,,,9.34,9.34,1
HCPCS,853010,ANTITHROMBIN III ANTIGEN,,,9.34,9.34,1
HCPCS,85302,CLOT INHIBIT PROT C ANTIGEN,,,10.38,10.38,1
HCPCS,85302,PROTEIN C AG,39.0,25.35,2.12,35.1,37
HCPCS,85302,PROTEIN C IMMUNO,37.0,24.05,2.12,33.3,37
HCPCS,853020,CLOT INHIBIT PROT C ANTIGEN,,,10.38,10.38,1
HCPCS,85303,CLOT INHIBIT PROT C ACTIVITY,,,11.96,11.96,1
HCPCS,85303,PROTEIN C ACTIVITY,52.0,33.8,2.12,46.8,37
HCPCS,85303,PROTEIN C FUNCTIONAL,51.0,33.15,2.12,45.9,37
HCPCS,853030,CLOT INHIBIT PROT C ACTIVITY,,,11.96,11.96,1
HCPCS,85305,*PROTEIN S TOTAL,25.0,16.25,2.12,22.5,37
HCPCS,85305,CLOT INHIBIT PROT S TOTAL,,,10.03,10.03,1
HCPCS,85305,PROTEIN S TOTAL,25.0,16.25,2.12,22.5,37
HCPCS,853050,CLOT INHIBIT PROT S TOTAL,,,10.03,10.03,1
HCPCS,85306,*PROTEIN S FREE,25.0,16.25,2.12,25.0,37
HCPCS,85306,CLOT INHIBIT PROT S FREE,,,13.24,13.24,1
HCPCS,85306,CLOTTING INHIBITORS PROTEIN S FREE,375.0,243.75,6.43,375.0,17
HCPCS,85306,PROTEIN S FREE,34.5,22.425,2.12,39.6,74
HCPCS,853060,CLOT INHIBIT PROT S FREE,,,13.24,13.24,1
HCPCS,85307,ACTIVATED PROTEIN C APC RESISTANCE ASSAY,265.0,172.25,6.43,265.0,17
HCPCS,85307,APC RESISTANCE,37.0,24.05,2.81,33.3,37
HCPCS,85307,APC RESISTANCE ASSAY,39.0,25.35,2.81,35.1,37
HCPCS,85307,ASSAY ACTIVATED PROTEIN C,,,13.24,13.24,1
HCPCS,853070,ASSAY ACTIVATED PROTEIN C,,,13.24,13.24,1
HCPCS,85335,%AD13IN FACTR INHIB TEST,173.0,112.45,2.12,155.7,37
HCPCS,85335,*FACTOR INHIBITOR TEST,81.0,52.65,2.12,72.9,37
HCPCS,85335,FACTOR INHIBITOR TEST,129.0,83.85,2.12,347.4,112
HCPCS,853350,FACTOR INHIBITOR TEST,,,11.12,11.12,1
HCPCS,85337,THROMBOMODULIN,,,14.93,28.86,15
HCPCS,85337,Thrombomodulin,,,2.12,2.68,6
HCPCS,853370,THROMBOMODULIN,,,14.93,14.93,1
HCPCS,85345,COAGULATION TIME LEE & WHITE,,,4.05,7.84,15
HCPCS,85345,Coagulation time lee & white,,,2.12,2.68,6
HCPCS,853450,COAGULATION TIME LEE & WHITE,,,4.05,4.05,1
HCPCS,85347,*COAG TIME ACTIVATED,109.0,70.85,2.12,98.1,37
HCPCS,85347,ACTIVATED COAGULATION,63.0,40.949999999999996,2.12,98.1,74
HCPCS,85347,COAG TIME ACTIVATED,109.0,70.85,2.12,98.1,37
HCPCS,85347,COAGULATION TIME,50.0,32.5,1.8,50.0,17
HCPCS,85347,COAGULATION TIME ACTIVATED,,,3.69,3.69,1
HCPCS,853470,COAGULATION TIME ACTIVATED,,,3.69,3.69,1
HCPCS,85348,COAGULATION TIME OTR METHOD,,,3.88,7.5,15
HCPCS,85348,Coagulation time otr method,,,2.12,2.68,6
HCPCS,853480,COAGULATION TIME OTR METHOD,,,3.88,3.88,1
HCPCS,85360,EUGLOBULIN LYSIS,34.0,22.1,2.81,30.6,38
HCPCS,85360,EUGLOBULIN LYSIS TIME,87.5,56.875,2.81,97.2,74
HCPCS,853600,EUGLOBULIN LYSIS,,,7.27,7.27,1
HCPCS,85362,DEGRADATION PRODUCTS,59.0,38.35,2.12,53.1,37
HCPCS,85362,FIBRIN DEGRADATION PRODUCTS,,,5.95,5.95,1
HCPCS,853620,FIBRIN DEGRADATION PRODUCTS,,,5.95,5.95,1
HCPCS,85366,FIBRINOGEN TEST,,,69.52,134.45,15
HCPCS,85366,Fibrinogen test,,,12.26,15.48,6
HCPCS,853660,FIBRINOGEN TEST,,,69.52,69.52,1
HCPCS,85370,FIBRINOGEN TEST,,,10.74,20.77,15
HCPCS,85370,Fibrinogen test,,,2.12,2.68,6
HCPCS,853700,FIBRINOGEN TEST,,,10.74,10.74,1
HCPCS,85378,FIBRIN DEGRADE SEMIQUANT,,,8.4,16.24,15
HCPCS,85378,Fibrin degrade semiquant,,,2.12,2.68,6
HCPCS,853780,FIBRIN DEGRADE SEMIQUANT,,,8.4,8.4,1
HCPCS,85379,D-DIMER (POINT OF CARE LAB),143.0,92.95,2.12,128.7,37
HCPCS,85379,D-DIMER QUANT,143.5,93.275,2.12,129.6,74
HCPCS,85379,FIBRIN DEGRADATION QUANT,,,8.79,8.79,1
HCPCS,85379,FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,199.0,129.35,4.28,199.0,17
HCPCS,853790,FIBRIN DEGRADATION QUANT,,,8.79,8.79,1
HCPCS,85380,FIBRIN DEGRADJ D-DIMER,,,8.79,17.01,15
HCPCS,85380,Fibrin degradj d-dimer,,,2.81,3.55,6
HCPCS,853800,FIBRIN DEGRADJ D-DIMER,,,8.79,8.79,1
HCPCS,85384,*FIBRINOGEN ACTIVITY,144.0,93.6,2.12,129.6,37
HCPCS,85384,FIBRINOGEN,91.5,59.474999999999994,2.12,129.6,74
HCPCS,85384,FIBRINOGEN ACTIVITY,51.0,33.15,4.08,51.0,18
HCPCS,85384,MANUAL HEME - FIBRINOGEN,62.0,40.3,2.12,55.8,37
HCPCS,85384,MANUAL HEME- FIBRINOGEN,39.0,25.35,2.12,35.1,37
HCPCS,853840,FIBRINOGEN ACTIVITY,,,8.4,8.4,1
HCPCS,85385,FIBRIN AG,56.0,36.4,2.12,50.4,37
HCPCS,85385,FIBRINOGEN ANTIGEN,,,12.5,12.5,1
HCPCS,853850,FIBRINOGEN ANTIGEN,,,12.5,12.5,1
HCPCS,85390,*FIBRINOLYSINS OR COAG SCREEN,51.0,33.15,2.12,45.9,74
HCPCS,85390,*FIBRINOLYSINS SCREEN I&R,79.0,51.349999999999994,2.12,96.3,111
HCPCS,85390,COAGULOPATHY INTERPRET,131.0,85.15,2.12,117.9,37
HCPCS,85390,FIBRINOLYSINS OR COAG SCREEN,105.0,68.25,2.12,96.3,111
HCPCS,85390,FIBRINOLYSINS SCREEN I&R,51.0,33.15,2.12,45.9,38
HCPCS,85390,FIBRINOLYSINS/COAGULOPATHY SCREEN INTERP&REPOR,323.0,209.95,5.24,323.0,17
HCPCS,85390,PLTEMS FIBRINOLYSINS SCREEN I&R,67.0,43.55,2.12,60.3,37
HCPCS,853900,FIBRINOLYSINS SCREEN I&R,,,13.37,13.37,1
HCPCS,85396,CLOTTING ASSAY WHOLE BLOOD,,,15.95,15.95,2
HCPCS,85396,COAGJ/FBRNLYS ASSAY WHOLE BLOOD ADDITIVE PER DAY,160.0,104.0,8.18,160.0,31
HCPCS,85396,COAGULATION/FIBRINOLYSIS,73.0,47.45,12.26,65.7,28
HCPCS,853960,CLOTTING ASSAY WHOLE BLOOD,,,15.95,15.95,1
HCPCS,85396TC,CLOTTING ASSAY WHOLE BLOOD,,,15.95,15.95,1
HCPCS,85397,%AD13AC COAG/FIBFUNC ACT,270.0,175.5,12.26,243.0,37
HCPCS,85397,*CLOTTING FUNCT ACTIVITY,86.0,55.9,12.26,77.4,37
HCPCS,85397,CLOTTING FUNCT ACTIVITY,226.5,147.225,12.26,308.7,75
HCPCS,85397,VWF GPIBM ACTIVITY,176.0,114.4,12.26,158.4,37
HCPCS,853970,CLOTTING FUNCT ACTIVITY,,,26.67,26.67,1
HCPCS,85400,FIBRINOLYTIC PLASMIN,,,6.66,12.88,15
HCPCS,85400,Fibrinolytic plasmin,,,2.12,2.68,6
HCPCS,854000,FIBRINOLYTIC PLASMIN,,,6.66,6.66,1
HCPCS,85410,ALPHA 2 ANTIPLASMIN,103.0,66.95,2.12,92.7,37
HCPCS,85410,FIBRIN ALPHA-2 ANTIPLASMIN,106.0,68.9,2.12,95.4,37
HCPCS,85410,FIBRINOLYTIC ANTIPLASMIN,,,6.66,6.66,1
HCPCS,854100,FIBRINOLYTIC ANTIPLASMIN,,,6.66,6.66,1
HCPCS,85415,FIBRIN PLASMINOGEN ACTIVATOR,169.0,109.85,2.12,152.1,37
HCPCS,85415,FIBRINOLYTIC PLASMINOGEN,,,14.85,14.85,1
HCPCS,85415,PLASMINOGEN ACTIV INHIB AG,440.0,286.0,2.12,396.0,37
HCPCS,854150,FIBRINOLYTIC PLASMINOGEN,,,14.85,14.85,1
HCPCS,85420,FIBRIN PLASMINOGEN NOT AG,40.0,26.0,2.12,36.0,37
HCPCS,85420,FIBRINOLYTIC PLASMINOGEN,,,5.64,5.64,1
HCPCS,85420,PLASMINOGEN FUNCTIONAL,39.0,25.35,2.12,35.1,37
HCPCS,854200,FIBRINOLYTIC PLASMINOGEN,,,5.64,5.64,1
HCPCS,85421,FIBRINOLYTIC PLASMINOGEN,,,8.79,17.01,15
HCPCS,85421,Fibrinolytic plasminogen,,,2.12,2.68,6
HCPCS,854210,FIBRINOLYTIC PLASMINOGEN,,,8.79,8.79,1
HCPCS,85441,HEINZ BODIES DIRECT,,,3.63,3.63,1
HCPCS,85441,HEINZ BODY STAIN,33.0,21.45,2.81,29.7,37
HCPCS,854410,HEINZ BODIES DIRECT,,,3.63,3.63,1
HCPCS,85445,HEINZ BODIES INDUCED,,,5.9,11.4,15
HCPCS,85445,Heinz bodies induced,,,2.81,3.55,6
HCPCS,854450,HEINZ BODIES INDUCED,,,5.9,5.9,1
HCPCS,85460,HEMOGLOBIN FETAL,,,6.67,6.67,1
HCPCS,85460,HGB FETAL DIFF LYSIS,23.0,14.95,2.81,20.7,37
HCPCS,85460,HGB/RBCS FETAL FETOMATERNAL HEMRRG DIFRNTL LYSIS,83.0,53.95,3.25,83.0,17
HCPCS,85460,KLEIHAUER BETKE ST,68.0,44.2,2.81,61.2,37
HCPCS,854600,HEMOGLOBIN FETAL,,,6.67,6.67,1
HCPCS,85461,HEMOGLOBIN FETAL,,,8.09,8.09,1
HCPCS,85461,HGB FETAL ROS,74.0,48.1,2.81,66.6,37
HCPCS,85461,HGB/RBCS FETAL FETOMATERNAL HEMRRG ROSETTE,60.0,39.0,3.93,60.0,17
HCPCS,854610,HEMOGLOBIN FETAL,,,8.09,8.09,1
HCPCS,85475,HEMOLYSIN ACID,,,7.67,14.82,15
HCPCS,85475,Hemolysin acid,,,2.12,2.68,6
HCPCS,854750,HEMOLYSIN ACID,,,7.67,7.67,1
HCPCS,85520,*HEPARIN ASSAY,19.0,12.35,2.12,19.0,37
HCPCS,85520,ANTIXA,51.0,33.15,2.12,45.9,37
HCPCS,85520,HEPARIN ASSAY,51.5,33.474999999999994,2.12,57.6,149
HCPCS,855200,HEPARIN ASSAY,,,11.31,11.31,1
HCPCS,85525,HEPARIN NEUTRALIZATION,,,10.23,19.78,15
HCPCS,85525,Heparin neutralization,,,2.12,2.68,6
HCPCS,855250,HEPARIN NEUTRALIZATION,,,10.23,10.23,1
HCPCS,85530,HEPARIN-PROTAMINE TOLERANCE,,,11.31,21.87,15
HCPCS,85530,Heparin-protamine tolerance,,,2.12,2.68,6
HCPCS,855300,HEPARIN-PROTAMINE TOLERANCE,,,11.31,11.31,1
HCPCS,85536,IRON STAIN MISC,84.0,54.6,2.81,75.6,37
HCPCS,85536,IRON STAIN PERIPHERAL BLOOD,,,5.94,5.94,1
HCPCS,855360,IRON STAIN PERIPHERAL BLOOD,,,5.94,5.94,1
HCPCS,85540,WBC ALKA PHOSPHTAS W COUNT,28.0,18.2,2.81,25.2,37
HCPCS,85540,WBC ALKALINE PHOSPHATASE,,,7.43,7.43,1
HCPCS,855400,WBC ALKALINE PHOSPHATASE,,,7.43,7.43,1
HCPCS,85547,RBC MECHANICAL FRAGILITY,,,7.43,14.37,15
HCPCS,85547,Rbc mechanical fragility,,,2.81,3.55,6
HCPCS,855470,RBC MECHANICAL FRAGILITY,,,7.43,7.43,1
HCPCS,85549,MURAMIDASE,32.0,20.8,2.81,31.33,38
HCPCS,855490,MURAMIDASE,,,16.2,16.2,1
HCPCS,85555,OSMOTIC FRAG ERYTHRO,107.0,69.55,2.81,96.3,37
HCPCS,85555,OSMOTIC FRAG RBC; UNINCUBATED,109.0,70.85,2.81,98.1,37
HCPCS,85555,RBC OSMOTIC FRAGILITY,,,6.46,6.46,1
HCPCS,855550,RBC OSMOTIC FRAGILITY,,,6.46,6.46,1
HCPCS,85557,OSMOTIC FRAGILITY INCUBATED,34.0,22.1,2.81,30.6,37
HCPCS,85557,RBC OSMOTIC FRAGILITY,,,11.55,11.55,1
HCPCS,855570,RBC OSMOTIC FRAGILITY,,,11.55,11.55,1
HCPCS,85576,*BLOOD PLT AGGREGATION EA,110.5,71.825,12.26,110.7,222
HCPCS,85576,BLOOD PLATELET AGGREGATION,,,21.52,41.62,4
HCPCS,85576,BLOOD PLT AGGREGATION EA,121.0,78.65,12.26,108.9,37
HCPCS,85576,P2Y12 RESPONSE ASSAY,123.0,79.95,12.26,110.7,37
HCPCS,85576,PLATELET AGGREGATION IN VITRO EACH AGENT,160.0,104.0,10.46,160.0,17
HCPCS,855760,BLOOD PLATELET AGGREGATION,,,21.52,21.52,1
HCPCS,85576QW,BLOOD PLATELET AGGREGATION,,,38.41,41.62,3
HCPCS,85597,PHOSPHOLIPID PLTLT NEUTRALIZ,,,15.53,15.53,1
HCPCS,85597,PLATELET NEUTRALIZATION,101.5,65.975,2.12,132.3,74
HCPCS,85597,PLT NEUTRALIZATION,56.0,36.4,2.12,50.4,37
HCPCS,855970,PHOSPHOLIPID PLTLT NEUTRALIZ,,,15.53,15.53,1
HCPCS,85598,HEXAGNAL PHOSPH PLTLT NEUTRL,,,15.53,15.53,1
HCPCS,85598,HEXAGOAL PHASE PHOSPHOLIPID NEUTRALIZATION,50.0,32.5,2.12,45.0,37
HCPCS,85598,LUPUS ANTICOAG INTERP PANEL,50.0,32.5,2.12,45.0,37
HCPCS,855980,HEXAGNAL PHOSPH PLTLT NEUTRL,,,15.53,15.53,1
HCPCS,85610,*PRO TIME,59.5,38.675,2.12,96.3,74
HCPCS,85610,CLOTTING TEST,105.0,68.25,2.12,94.5,37
HCPCS,85610,CLOTTING TEST (POINT OF CARE LAB),107.0,69.55,2.12,96.3,37
HCPCS,85610,MANUAL HEME - PRO TIME,58.0,37.7,2.12,52.2,37
HCPCS,85610,PRO TIME (POINT OF CARE LAB),81.5,52.974999999999994,2.12,96.3,74
HCPCS,85610,PROTHROMBIN TIME,40.0,26.0,2.12,50.4,128
HCPCS,85610,PROTHROMBIN TIME AND INR (POINT OF CARE LAB),107.0,69.55,2.12,96.3,37
HCPCS,856100,PROTHROMBIN TIME,,,3.7,3.7,1
HCPCS,85610QW,PROTHROMBIN TIME,,,6.62,7.17,3
HCPCS,85611,*PRO TIME TEST PLASMA FRACT EA,62.0,40.3,2.12,55.8,37
HCPCS,85611,PRO TIME TEST PLASMA FRACT EA,52.0,33.8,2.12,51.3,74
HCPCS,85611,PROTHROMBIN TEST,,,3.4,3.4,1
HCPCS,856110,PROTHROMBIN TEST,,,3.4,3.4,1
HCPCS,85612,RUSSELL VIPER VENOM UNDILUTED,24.0,15.6,2.12,24.0,37
HCPCS,85612,VIPER VENOM PROTHROMBIN TIME,,,15.11,15.11,1
HCPCS,856120,VIPER VENOM PROTHROMBIN TIME,,,15.11,15.11,1
HCPCS,85613,DILUTE RVVT X2,164.0,106.6,2.12,147.6,37
HCPCS,85613,RUSSELL VIPER VENOM DILUTED,57.0,37.05,2.12,51.3,38
HCPCS,85613,RUSSELL VIPER VENOM TIME DILUT,57.0,37.05,2.12,51.3,37
HCPCS,856130,RUSSELL VIPER VENOM DILUTED,,,8.27,8.27,1
HCPCS,85635,REPTILASE R TIME,55.0,35.75,2.81,49.5,37
HCPCS,85635,REPTILASE TEST,56.0,36.4,2.81,50.4,38
HCPCS,85635,REPTILASE TIME 1:1 MIX BILL,91.0,59.15,2.81,81.9,37
HCPCS,856350,REPTILASE TEST,,,8.51,8.51,1
HCPCS,85651,RBC SED RATE NONAUTOMATED,,,3.69,7.14,15
HCPCS,85651,Rbc sed rate nonautomated,,,2.81,3.55,6
HCPCS,856510,RBC SED RATE NONAUTOMATED,,,3.69,3.69,1
HCPCS,85652,RBC SED RATE AUTOMATED,,,2.33,2.33,1
HCPCS,85652,SEDIMENTATION RATE AUTO,57.0,37.05,2.7,51.3,37
HCPCS,85652,SEDIMENTATION RATE RBC AUTOMATED,72.0,46.8,1.13,72.0,17
HCPCS,856520,RBC SED RATE AUTOMATED,,,2.33,2.33,1
HCPCS,85660,RBC SICKLE CELL TEST,,,4.76,4.76,1
HCPCS,85660,RBC SICKLING REDUC,92.0,59.8,2.81,98.1,74
HCPCS,85660,SICKLING RBC REDUCTION,59.0,38.35,2.31,59.0,17
HCPCS,856600,RBC SICKLE CELL TEST,,,4.76,4.76,1
HCPCS,85670,*TT PLASMA,50.0,32.5,2.12,45.0,37
HCPCS,85670,THROMBIN TIME,59.5,38.675,2.12,69.0,54
HCPCS,85670,THROMBIN TIME PLASMA,,,4.99,4.99,1
HCPCS,85670,THROMBIN TIME; PLASMA,50.0,32.5,2.12,45.0,37
HCPCS,85670,TT PLASMA,50.0,32.5,2.12,45.0,74
HCPCS,856700,THROMBIN TIME PLASMA,,,4.99,4.99,1
HCPCS,85675,THROMBIN TIME TITER,,,5.92,11.45,15
HCPCS,85675,Thrombin time titer,,,2.12,2.68,6
HCPCS,856750,THROMBIN TIME TITER,,,5.92,5.92,1
HCPCS,85705,THROMBOPLASTIN INHIBITION,,,8.32,16.09,15
HCPCS,85705,Thromboplastin inhibition,,,2.12,2.68,6
HCPCS,857050,THROMBOPLASTIN INHIBITION,,,8.32,8.32,1
HCPCS,85730,*PTT PLASMA WHOLE BLOOD,37.0,24.05,2.12,33.3,37
HCPCS,85730,*PTT PLASMA/WHOLE BLOOD,32.0,20.8,2.12,108.9,111
HCPCS,85730,MANUAL HEME - PTT PLASMA/WHOLE BLOOD,69.0,44.85,2.12,62.1,37
HCPCS,85730,PTT; PLASMA OR WHOLE BLOOD,19.0,12.35,2.12,17.1,37
HCPCS,85730,THROMBOPLASTIN TIME PARTIAL,,,5.19,5.19,1
HCPCS,85730,THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD,72.0,46.8,2.52,72.0,17
HCPCS,857300,THROMBOPLASTIN TIME PARTIAL,,,5.19,5.19,1
HCPCS,85732,*PTT PLASMA FRACT EA,55.0,35.75,2.12,49.5,148
HCPCS,85732,*PTT;SUBSTITU PLASMA FRAC EA,55.0,35.75,2.12,49.5,37
HCPCS,85732,PTT PLASMA FRACT EA,55.0,35.75,2.12,49.5,74
HCPCS,85732,PTT; SUBST PLASMA FRACTIONS EA,55.0,35.75,2.12,49.5,37
HCPCS,85732,THROMBOPLASTIN TIME PARTIAL,,,5.59,5.59,1
HCPCS,857320,THROMBOPLASTIN TIME PARTIAL,,,5.59,5.59,1
HCPCS,85810,BLOOD VISCOSITY EXAMINATION,,,10.09,10.09,1
HCPCS,85810,VISCOSITY,126.0,81.9,4.9,126.0,17
HCPCS,85810,VISCOSITY BLOOD,22.0,14.3,2.81,19.8,37
HCPCS,85810,VISCOSITY EXAM,22.0,14.3,2.81,19.8,37
HCPCS,85810,VISCOSITY SERUM,95.0,61.75,2.81,85.5,37
HCPCS,858100,BLOOD VISCOSITY EXAMINATION,,,10.09,10.09,1
HCPCS,85999,Unlisted hematology&coagj px,,,2.81,3.55,6
HCPCS,86000,*AGGLUT FEBRILE EA AG,26.0,16.9,5.23,23.4,37
HCPCS,86000,AGGLUTININS FEBRILE ANTIGEN,,,6.03,6.03,1
HCPCS,86000,TULRFX AB AGG RFLX,64.0,41.6,5.23,57.6,37
HCPCS,860000,AGGLUTININS FEBRILE ANTIGEN,,,6.03,6.03,1
HCPCS,86001,%ABPA2 IGG TOTAL,25.0,16.25,5.23,22.5,37
HCPCS,86001,*ALLERGEN IGG QUANT/SEMI EA,13.0,8.45,3.25,13.0,74
HCPCS,86001,ALGN FOOD PANEL IGG X19,13.0,8.45,3.25,13.0,37
HCPCS,86001,ALLERG SP IGG QUAN OR SEMIQUAN,29.5,19.174999999999997,3.25,41.4,74
HCPCS,86001,ALLERGEN IGG EACH,76.0,49.4,5.23,68.4,37
HCPCS,86001,ALLERGEN SPECIFIC IGG,,,6.76,6.76,1
HCPCS,86001,HYPERSENSITIVITY PNEUMONITIS EVALUATION X8,28.0,18.2,5.23,25.2,37
HCPCS,860010,ALLERGEN SPECIFIC IGG,,,6.76,6.76,1
HCPCS,86003,*ALLERG SP IGE;QT OR QUAL,26.0,16.9,5.22,23.4,74
HCPCS,86003,*ALLERGEN IGE QUANT/SEMI,17.0,11.05,4.25,15.3,74
HCPCS,86003,*ALLERGEN IGE QUANT/SEMI EA,10.5,6.825,2.5,9.9,74
HCPCS,86003,*ALLERGEN IGE QUANT/SEMI IGGE,46.0,29.9,5.22,41.4,37
HCPCS,86003,ALLERGEN IGE EACH,79.0,51.35,5.22,71.1,37
HCPCS,86003,ALLERGEN IGE QUANT/SEMI EA,14.0,9.1,3.5,12.6,37
HCPCS,86003,ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH,70.0,45.5,2.19,70.0,17
HCPCS,86003,"ALLERGEN, FOOD, ANCHOVY IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, ANNATTO SEED IGE",37.0,24.05,5.22,33.3,37
HCPCS,86003,"ALLERGEN, FOOD, APRICOT",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, ASPARAGUS IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, BLACK OLIVE IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, CAROB GUM IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, CAULIFLOWER IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, EGGPLANT",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, GINGER IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, GOAT MILK IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, LAMB",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, LIMA BEAN/WHITE BEAN",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, NAVY BEAN IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, NUTMEG IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, SARDINE IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, SPINACH",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, SUMMER SQUASH IGE",26.0,16.9,5.22,23.4,37
HCPCS,86003,"ALLERGEN, FOOD, TEA IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FOOD, TURMERIC IGE",31.0,20.15,5.22,27.9,37
HCPCS,86003,"ALLERGEN, FUNGI/MOLD, B. SPICIFERA IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, FUNGI/MOLD, CURVULARIA LUNATA",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, HONEY BEE IGE WITH REFLEX TO COMPONENTS",15.0,9.75,3.75,13.5,37
HCPCS,86003,"ALLERGEN, INSECT, BUMBLE BEE VENOM IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, INSECT, FIRE ANT, IMPORTED",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, INSECT, MOSQUITO, IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, PAPER WASP IGE WITH REFLEX TO COMPONENT",15.0,9.75,3.75,13.5,37
HCPCS,86003,"ALLERGEN, REGION 3 SOUTH ATLANTIC RESPIRATORY PANEL IGE",13.0,8.45,3.25,11.7,37
HCPCS,86003,"ALLERGEN, SESAME SEED WITH COMPONENT REFLEX",14.0,9.1,3.5,12.6,37
HCPCS,86003,"ALLERGEN, TOTAL VENOM PANEL IGE WITH REFLEX TO COMPONENTS",15.0,9.75,3.75,13.5,37
HCPCS,86003,"ALLERGEN, TREE, PALM/QUEEN TREE IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, WEED, SAGEBRUSH/WORMWOOD IGE",16.0,10.4,4.0,14.4,37
HCPCS,86003,"ALLERGEN, WHEAT WITH COMPONENT REFLEX",14.0,9.1,3.5,12.6,37
HCPCS,86003,"ALLERGEN, YELLOW JACKET (COMMON WASP) IGE WITH REFLEX TO COMPONE",15.0,9.75,3.75,13.5,37
HCPCS,86003,ALLG SPEC IGE CRUDE XTRC EA,,,4.51,4.51,1
HCPCS,86003,CHEESE MOZZARELLA IGE,16.0,10.4,4.0,14.4,37
HCPCS,86003,CHEESE PARMESAN IGE,16.0,10.4,4.0,14.4,37
HCPCS,86003,CHEESE SWISS IGE,16.0,10.4,4.0,14.4,37
HCPCS,86003,F324-IGE HOP (FOOD),16.0,10.4,4.0,14.4,37
HCPCS,86003,"HOPS, IGE ALLERGEN",37.0,24.05,5.22,33.3,37
HCPCS,86003,HYPERSENSITIVITY PNEUMO IGE QUANT,16.0,10.4,4.0,14.4,37
HCPCS,86003,LUPINE SEED (LUPINUS ALBUS) IGE,42.0,27.3,5.22,37.8,37
HCPCS,860030,ALLG SPEC IGE CRUDE XTRC EA,,,4.51,4.51,1
HCPCS,86005,ALLG SPEC IGE MULTIALLG SCR,,,6.89,6.89,1
HCPCS,86005,HYPERSENSITIVITY PNEUMO IGE QUAL,24.0,15.6,5.23,21.6,37
HCPCS,860050,ALLG SPEC IGE MULTIALLG SCR,,,6.89,6.89,1
HCPCS,86008,%PNUTCP ALLG IGE RECOMBX5,59.0,38.35,5.23,53.1,37
HCPCS,86008,"ALGN FOOD, ALPHA-GAL IGE",98.0,63.7,5.23,88.2,37
HCPCS,86008,"ALLERGEN, BROMELAIN IGE",155.0,100.75,5.23,139.5,37
HCPCS,86008,"ALLERGEN, PAPER WASP COMPONENT IGE",45.0,29.25,5.23,40.5,37
HCPCS,86008,"ALLERGEN, SESAME SEED RSES I 1 COMPONENT",50.0,32.5,5.23,45.0,37
HCPCS,86008,"ALLERGEN, WHEAT, RTRI A OMEGA-5-GLIADIN COMPONENT",50.0,32.5,5.23,45.0,37
HCPCS,86008,"ALLERGEN, YELLOW JACKET (COMMON WASP) COMPONENTS IGE",45.0,29.25,5.23,40.5,37
HCPCS,86008,ALLG SPEC IGE IN HOUSE,107.0,69.55,5.23,96.3,37
HCPCS,86008,ALLG SPEC IGE RECOMB EA,36.0,23.4,5.23,32.4,38
HCPCS,86008,"GALAC-ALPHA 1,3-GALAC IGE",94.0,61.1,5.23,84.6,37
HCPCS,860080,ALLG SPEC IGE RECOMB EA,,,15.49,15.49,1
HCPCS,86015,ACTIN ANTIBODY EACH,,,10.41,10.41,1
HCPCS,86015,ACTIN SMOOTH MUSCLE AB EA,130.0,84.5,5.23,117.0,37
HCPCS,860150,ACTIN ANTIBODY EACH,,,10.41,10.41,1
HCPCS,86021,*PLATELET AB SCREEN,41.0,26.65,5.23,36.9,37
HCPCS,86021,AB ID LEUKO AB,134.0,87.1,5.23,166.5,74
HCPCS,86021,WBC ANTIBODY IDENTIFICATION,,,13.0,13.0,1
HCPCS,860210,WBC ANTIBODY IDENTIFICATION,,,13.0,13.0,1
HCPCS,86022,*AB ID PLT AB,231.0,150.15,5.23,241.2,148
HCPCS,86022,*AB ID PLT RPT,159.5,103.675,5.23,241.2,74
HCPCS,86022,*PLATELET AB SCREEN,41.0,26.65,5.23,36.9,37
HCPCS,86022,AB ID PLT AB,56.0,36.4,5.23,50.4,37
HCPCS,86022,ANTI PLATELET FACT 4 X2,189.0,122.85,5.23,170.1,37
HCPCS,86022,PLATELET AB DETECTION,414.0,269.1,5.23,372.6,37
HCPCS,86022,PLATELET ANTIBODIES,52.5,34.125,5.23,49.5,75
HCPCS,86022,PLATELET SURFACE GLYCOPROTEIN EXPRESSION,55.0,35.75,5.23,49.5,37
HCPCS,86022,SEROTONIN RELEASE LMWH,420.0,273.0,5.23,378.0,37
HCPCS,860220,PLATELET ANTIBODIES,,,15.88,15.88,1
HCPCS,86023,*AB ID PLT IG ASSAY,70.0,45.5,5.23,63.0,74
HCPCS,86023,*AB ID PLT IG ASSAY RPT,70.0,45.5,5.23,63.0,37
HCPCS,86023,AB ID PLT IG ASSAY,207.0,134.55,5.23,186.3,37
HCPCS,86023,IMMUNOGLOBULIN ASSAY,,,10.77,10.77,1
HCPCS,860230,IMMUNOGLOBULIN ASSAY,,,10.77,10.77,1
HCPCS,86036,ANCA SCREEN EACH ANTIBODY,,,10.41,10.41,1
HCPCS,86036,ANTINEUT CYT AB SCR EA,130.0,84.5,5.23,117.0,37
HCPCS,86036,ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,142.0,92.3,5.06,142.0,13
HCPCS,86036,IBDSER ANTINEUT CYT AB SCR EA,144.0,93.6,5.23,129.6,37
HCPCS,860360,ANCA SCREEN EACH ANTIBODY,,,10.41,10.41,1
HCPCS,86037,ANCA TITER EACH ANTIBODY,,,10.41,20.14,15
HCPCS,86037,Anca titer each antibody,,,5.23,6.6,6
HCPCS,860370,ANCA TITER EACH ANTIBODY,,,10.41,10.41,1
HCPCS,86038,ANTINUCLEAR,125.0,81.25,5.23,112.5,37
HCPCS,86038,ANTINUCLEAR AB (ANA),51.0,33.15,5.23,45.9,74
HCPCS,86038,ANTINUCLEAR AB(ANA),51.0,33.15,5.23,45.9,37
HCPCS,86038,ANTINUCLEAR ANTIBODIES,,,10.44,10.44,1
HCPCS,860380,ANTINUCLEAR ANTIBODIES,,,10.44,10.44,1
HCPCS,86039,*%ANA,14.0,9.1,3.5,14.0,37
HCPCS,86039,ANA (POLMYO),75.0,48.75,5.23,67.5,37
HCPCS,86039,ANTINUCLEAR AB (ANA) TITER,53.0,34.45,5.23,47.7,37
HCPCS,86039,ANTINUCLEAR AB (ANA); TITER,17.0,11.05,4.25,17.0,37
HCPCS,86039,ANTINUCLEAR AB(ANA) TITER,18.0,11.7,4.25,18.65,111
HCPCS,86039,ANTINUCLEAR ANTIBODIES (ANA),,,9.64,9.64,1
HCPCS,86039,SEMIQUANTITATIVE ANA (DERMYO),75.0,48.75,5.23,67.5,37
HCPCS,86039,SEMIQUANTITATIVE ANA (MYOSPL),75.0,48.75,5.23,67.5,37
HCPCS,860390,ANTINUCLEAR ANTIBODIES (ANA),,,9.64,9.64,1
HCPCS,86041,ACETYLCHOLINE RECEPTOR (ACHR) BINDING ANTIBODY,46.0,29.9,5.23,41.4,37
HCPCS,86041,ACETYLCHOLINE RECEPTOR BINDING ANTIBODY,55.0,35.75,5.23,49.5,37
HCPCS,86041,ACETYLCHOLN RCPTR BNDNG ANTB,,,15.9,15.9,1
HCPCS,860410,ACETYLCHOLN RCPTR BNDNG ANTB,,,15.9,15.9,1
HCPCS,86042,ACETYLCHOLINE RECEPTOR (ACHR) BLOCKING ANTIBODY,46.0,29.9,5.23,41.4,37
HCPCS,86042,ACETYLCHOLINE RECEPTOR BLOCKING ANTIBODY,55.0,35.75,5.23,49.5,37
HCPCS,86042,ACETYLCHOLN RCPTR BLCKG ANTB,,,15.9,15.9,1
HCPCS,860420,ACETYLCHOLN RCPTR BLCKG ANTB,,,15.9,15.9,1
HCPCS,86043,ACETYLCHOLINE RECEPTOR MODULATING ANTIBODY,60.0,39.0,5.23,54.0,37
HCPCS,86043,ACETYLCHOLN RCPTR MODLG ANTB,,,10.41,10.41,1
HCPCS,860430,ACETYLCHOLN RCPTR MODLG ANTB,,,10.41,10.41,1
HCPCS,86051,AQUAPORIN-4 ANTB ELISA,,,9.96,19.27,15
HCPCS,86051,Aquaporin-4 antb elisa,,,5.23,6.6,6
HCPCS,860510,AQUAPORIN-4 ANTB ELISA,,,9.96,9.96,1
HCPCS,86052,AQPCSF AQ-4 AB EA,394.0,256.1,5.23,354.6,37
HCPCS,86052,AQUAPORIN-4 ANTB CBA EACH,,,10.41,10.41,1
HCPCS,86052,"NMO/AQP4 AB IGG CBA-IFA SCREEN, CSF",121.0,78.65,5.23,108.9,37
HCPCS,86052,"NMO/AQP4 AB IGG CBA-IFA SCREEN, SERUM",162.0,105.3,5.23,182.7,74
HCPCS,86052,NMOIFA AQ-4 AB EA,188.0,122.2,5.23,169.2,37
HCPCS,860520,AQUAPORIN-4 ANTB CBA EACH,,,10.41,10.41,1
HCPCS,86053,AQAPRN-4 ANTB FLO CYTMTRY EA,,,32.59,32.59,1
HCPCS,86053,CDS1SE AQ4 AB FL CYT EA,402.0,261.3,19.47,361.8,37
HCPCS,86053,MLPTHY NMO/AQP4 FACS,189.0,122.85,19.47,170.1,37
HCPCS,86053,NMO/AQP4 FACS SER RFLX,128.0,83.2,19.47,115.2,37
HCPCS,86053,NMOA4 FACS ASSAY SERUM,424.0,275.6,19.47,381.6,37
HCPCS,860530,AQAPRN-4 ANTB FLO CYTMTRY EA,,,32.59,32.59,1
HCPCS,86060,*ANTISTREPTOLYSIN 0 TITER,17.0,11.05,4.25,15.3,37
HCPCS,86060,ANTI-STREPTOLYSIN O,17.0,11.05,4.25,15.3,37
HCPCS,86060,ANTISTREPTOLYSIN O TITER,,,6.31,6.31,1
HCPCS,860600,ANTISTREPTOLYSIN O TITER,,,6.31,6.31,1
HCPCS,86063,ANTISTREPTOLYSIN O SCREEN,,,4.99,9.64,15
HCPCS,86063,Antistreptolysin o screen,,,5.23,6.6,6
HCPCS,860630,ANTISTREPTOLYSIN O SCREEN,,,4.99,4.99,1
HCPCS,86077,*PHYS SVC EVAL IRREGULAR AB,44.0,28.6,11.4,71.74,38
HCPCS,86077,BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REP,405.0,263.25,20.66,303.75,31
HCPCS,86077,PHYS BLOOD BANK SERV XMATCH,,,40.31,40.31,2
HCPCS,860770,PHYS BLOOD BANK SERV XMATCH,,,40.31,40.31,1
HCPCS,86077TC,PHYS BLOOD BANK SERV XMATCH,,,40.31,40.31,1
HCPCS,86078,BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT,405.0,263.25,202.5,405.0,12
HCPCS,86078,PHYS BLOOD BANK SERV REACTJ,,,40.31,371.54,16
HCPCS,86078,Phys blood bank serv reactj,,,56.79,71.74,6
HCPCS,860780,PHYS BLOOD BANK SERV REACTJ,,,40.31,40.31,1
HCPCS,86078TC,PHYS BLOOD BANK SERV REACTJ,,,40.31,40.31,1
HCPCS,86079,PHYS BLOOD BANK SERV AUTHRJ,,,40.31,115.85,16
HCPCS,86079,Phys blood bank serv authrj,,,56.79,71.74,6
HCPCS,860790,PHYS BLOOD BANK SERV AUTHRJ,,,40.31,40.31,1
HCPCS,86079TC,PHYS BLOOD BANK SERV AUTHRJ,,,40.31,40.31,1
HCPCS,86140,%IBDSGI C REAC PROTEIN,26.0,16.9,5.18,23.4,37
HCPCS,86140,C-REACTIVE PROTEIN,132.5,86.125,2.18,127.8,55
HCPCS,861400,C-REACTIVE PROTEIN,,,4.47,4.47,1
HCPCS,86141,C-REACTIVE PROTEIN HIGH SENSE,65.0,42.25,5.23,58.5,37
HCPCS,86141,C-REACTIVE PROTEIN HIGH SENSITIVITY,57.0,37.05,5.44,57.0,17
HCPCS,86141,C-REACTIVE PROTEIN HS,,,11.19,11.19,1
HCPCS,86141,MCROHN C-REAC PROTEIN HS,37.0,24.05,5.23,33.3,37
HCPCS,861410,C-REACTIVE PROTEIN HS,,,11.19,11.19,1
HCPCS,86146,*BETA 2 GLYCOPROTEIN I AB EA,59.0,38.35,5.23,53.1,37
HCPCS,86146,BETA 2 GLYCOPROTEIN I AB EA,59.0,38.35,5.23,53.1,37
HCPCS,86146,BETA-2 GLYCOPROTEIN ANTIBODY,,,21.99,21.99,1
HCPCS,86146,BETA2 GLYCOPROT IGG/MX2,43.0,27.95,5.23,42.53,37
HCPCS,861460,BETA-2 GLYCOPROTEIN ANTIBODY,,,21.99,21.99,1
HCPCS,86147,*CARDIOLIPIN AB EA IG CLASS,58.0,37.7,5.23,52.2,74
HCPCS,86147,CARDIOLIPIN AB EA IG CLASS,58.0,37.7,5.23,52.2,37
HCPCS,86147,CARDIOLIPIN AB SCREEN,43.0,27.95,5.23,42.53,37
HCPCS,86147,CARDIOLIPIN ANTIBODY EA IG,,,21.99,21.99,1
HCPCS,861470,CARDIOLIPIN ANTIBODY EA IG,,,21.99,21.99,1
HCPCS,86148,*PHOSPHOLIPID AB,46.0,29.9,5.23,41.4,74
HCPCS,86148,ANTI-PHOSPHOLIPID ANTIBODY,,,13.89,13.89,1
HCPCS,861480,ANTI-PHOSPHOLIPID ANTIBODY,,,13.89,13.89,1
HCPCS,86152,CELL ENUMERATION & ID,1042.0,677.3,76.88,937.8,38
HCPCS,861520,CELL ENUMERATION & ID,,,216.67,216.67,1
HCPCS,86153,CELL ENUMERATION PHYS INTERP,,,27.52,27.52,2
HCPCS,86153,Cell enumeration phys interp,,,19.47,24.59,6
HCPCS,861530,CELL ENUMERATION PHYS INTERP,,,27.52,27.52,1
HCPCS,86153TC,CELL ENUMERATION PHYS INTERP,,,27.52,27.52,1
HCPCS,86155,*CHEMOTAXIS ASSAY,64.0,41.6,5.23,57.6,37
HCPCS,86155,CHEMOTAXIS ASSAY,,,13.81,13.81,1
HCPCS,861550,CHEMOTAXIS ASSAY,,,13.81,13.81,1
HCPCS,86156,COLD AGGLUTININ SCREEN,,,6.98,13.48,15
HCPCS,86156,Cold agglutinin screen,,,5.23,6.6,6
HCPCS,861560,COLD AGGLUTININ SCREEN,,,6.98,6.98,1
HCPCS,86157,COLD AGGLUT TITER,13.0,8.45,3.25,13.0,37
HCPCS,86157,COLD AGGLUTININ TITER,,,6.97,6.97,1
HCPCS,86157,COLD AGGLUTININS,13.0,8.45,3.25,13.0,37
HCPCS,861570,COLD AGGLUTININ TITER,,,6.97,6.97,1
HCPCS,86160,C1 ESTERASE INHIBITOR,105.0,68.25,5.23,94.5,37
HCPCS,86160,C3 COMPLEMENT B1C/B1A,26.0,16.9,5.23,23.4,37
HCPCS,86160,C3 NEPHRITIC FACTOR,99.0,64.35,5.23,89.1,37
HCPCS,86160,COMPLEMENT AG EA,80.0,52.0,5.23,88.2,148
HCPCS,86160,"COMPLEMENT AG, EA",98.0,63.7,5.23,88.2,37
HCPCS,86160,COMPLEMENT ANTIGEN,,,10.37,10.37,1
HCPCS,86160,COMPLEMENT C2,44.0,28.6,5.23,39.6,37
HCPCS,86160,"COMPLEMENT C3, SER",561.0,364.65,5.23,504.9,37
HCPCS,86160,"COMPLEMENT C4, SER",207.0,134.55,5.23,186.3,37
HCPCS,86160,COMPLEMENT COMP3A,355.0,230.75,5.23,319.5,37
HCPCS,86160,COMPLEMENT COMP4A,541.0,351.65,5.23,486.9,37
HCPCS,86160,COMPLEMENT FACTOR B,321.0,208.65,5.23,288.9,37
HCPCS,86160,COMPLEMENT FACTOR H,341.0,221.65,5.23,306.9,37
HCPCS,86160,COMPLEMENT FACTOR I,341.0,221.65,5.23,306.9,37
HCPCS,86160,SC5B-9 LEVEL MAC COMPLEX,358.0,232.7,5.23,322.2,37
HCPCS,861600,COMPLEMENT ANTIGEN,,,10.37,10.37,1
HCPCS,86161,C5COMF COMPLEMENT/FUNCTION ACTIVITY,234.0,152.1,5.23,210.6,37
HCPCS,86161,COMPLEMENT C1,206.0,133.9,5.23,185.4,37
HCPCS,86161,"COMPLEMENT C7, FUNC",648.0,421.2,5.23,583.2,37
HCPCS,86161,COMPLEMENT C9 FUNCTIONAL,78.0,50.7,5.23,70.2,37
HCPCS,86161,COMPLEMENT FUNCT ACT C8,70.0,45.5,5.23,63.0,37
HCPCS,86161,COMPLEMENT/FUNC ACTIVITY EA,72.0,46.8,5.23,188.1,111
HCPCS,86161,COMPLEMENT/FUNCTION ACTIVITY,,,10.37,10.37,1
HCPCS,861610,COMPLEMENT/FUNCTION ACTIVITY,,,10.37,10.37,1
HCPCS,86162,COMPLEMENT DEFICIENCY,176.0,114.4,5.23,158.4,37
HCPCS,86162,COMPLEMENT TOTAL (CH50),,,17.56,17.56,1
HCPCS,86162,COMPLEMENT TOTAL(CH50),32.0,20.8,5.23,32.0,37
HCPCS,861620,COMPLEMENT TOTAL (CH50),,,17.56,17.56,1
HCPCS,86171,COMPLEMENT FIXATION EA AG,97.0,63.05,5.23,87.3,37
HCPCS,86171,COMPLEMENT FIXATION EACH,,,8.65,8.65,1
HCPCS,861710,COMPLEMENT FIXATION EACH,,,8.65,8.65,1
HCPCS,86200,CCP AB,23.0,14.95,5.23,21.64,37
HCPCS,86200,CCP ANTIBODY,,,11.19,11.19,1
HCPCS,86200,CYCLIC CITRU PEPT ANTI IG,23.0,14.95,5.23,21.64,37
HCPCS,862000,CCP ANTIBODY,,,11.19,11.19,1
HCPCS,86215,*DEOXYRIBONUCLEASE AB,19.0,12.35,4.75,19.0,37
HCPCS,86215,DEOXYRIBONUCLEASE ANTIBODY,,,11.45,11.45,1
HCPCS,86215,DNA AB,58.0,37.7,5.23,52.2,37
HCPCS,862150,DEOXYRIBONUCLEASE ANTIBODY,,,11.45,11.45,1
HCPCS,86225,DNA AB DOUBLE STRANDED,609.0,395.85,5.23,548.1,37
HCPCS,86225,DNA AB NATIVE/DOUBLE STRAND,55.0,35.75,5.23,49.5,37
HCPCS,86225,DNA ANTIBODY,29.0,18.85,5.23,26.1,37
HCPCS,86225,DNA ANTIBODY NATIVE,,,11.87,11.87,1
HCPCS,862250,DNA ANTIBODY NATIVE,,,11.87,11.87,1
HCPCS,86226,DNA AB SNGL STRAND,43.5,28.275,5.23,39.6,74
HCPCS,86226,DNA ANTIBODY SINGLE STRAND,,,10.47,10.47,1
HCPCS,86226,SS DNA ANTIBODY IGG,149.0,96.85,5.23,134.1,37
HCPCS,862260,DNA ANTIBODY SINGLE STRAND,,,10.47,10.47,1
HCPCS,86231,EMA EACH IG CLASS,,,10.44,20.2,15
HCPCS,86231,Ema each ig class,,,5.23,6.6,6
HCPCS,862310,EMA EACH IG CLASS,,,10.44,10.44,1
HCPCS,86235,*EX NUC AB,56.0,36.4,5.23,50.4,37
HCPCS,86235,*EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,185
HCPCS,86235,*FAB TITER EA AB,56.0,36.4,5.23,50.4,37
HCPCS,86235,ENA (MYOSPL),74.0,48.1,5.23,66.6,37
HCPCS,86235,ENA ANY METHOD,34.0,22.1,5.23,30.6,37
HCPCS,86235,EXTRACT NUC AG EA AB,56.0,36.4,5.23,50.4,370
HCPCS,86235,IMMUNOASSAY ENA (POLMYO),117.0,76.05,5.23,105.3,37
HCPCS,86235,NUCLEAR ANTIGEN ANTIBODY,,,15.49,15.49,1
HCPCS,86235,PM - 1 ANTIBODY,191.0,124.15,5.23,171.9,37
HCPCS,86235,U3 RNP AB,143.0,92.95,5.23,128.7,37
HCPCS,862350,NUCLEAR ANTIGEN ANTIBODY,,,15.49,15.49,1
HCPCS,86255,%CEPHAL FLOUR AB X3,333.0,216.45,5.23,299.7,37
HCPCS,86255,%IBDSER NEUTROPH SP ABS,83.0,53.95,5.23,74.7,37
HCPCS,86255,%PARNEO FLUORESCENT X9,59.0,38.35,5.23,53.1,37
HCPCS,86255,*FAB SCREEN EA AB,33.0,21.45,5.23,40.5,148
HCPCS,86255,ACESTR FLUORESCENT ANTIBODY SCREEN,84.0,54.6,5.23,75.6,37
HCPCS,86255,ACHR MODULATING FL RFLX,129.0,83.85,5.23,116.1,37
HCPCS,86255,ADRENAL ANTIBODY,25.0,16.25,5.23,22.5,37
HCPCS,86255,AIDYSA FLUOR AB SCRN,80.0,52.0,5.23,72.0,37
HCPCS,86255,ALPHA INTERNEXIN CBA,673.0,437.45,5.23,605.7,37
HCPCS,86255,AMPA RECEPTOR AB CBA,1573.0,1022.45,5.23,1415.7,37
HCPCS,86255,ANTI NEUT CY AB,84.0,54.6,5.23,75.6,37
HCPCS,86255,"APBCSR - AP3B2 AB, CB ASSAY, SER, REFLEX ONLY",438.0,284.7,5.23,394.2,37
HCPCS,86255,AQUAPORIN4 REC AB IGG CSF,397.0,258.05,5.23,357.3,37
HCPCS,86255,CASPR2 IGG REFLEX,374.0,243.1,5.23,336.6,37
HCPCS,86255,CNS DEMYELINATING DIS EVAL SER X2,406.0,263.9,5.23,365.4,37
HCPCS,86255,DPCBAX FLUOR AB SCRN,629.0,408.85,5.23,566.1,37
HCPCS,86255,DPPX AB CBA CSF RFLX,673.0,437.45,5.23,605.7,37
HCPCS,86255,ENCCSF FLUORESCENT AB X21,50.0,32.5,5.23,45.0,37
HCPCS,86255,ENCSER FLUORESCENT AB SCRN,64.0,41.6,5.23,57.6,37
HCPCS,86255,EPIDERMAL ABS & REFLEXX2,355.0,230.75,5.23,319.5,37
HCPCS,86255,FAB SCREEN E,131.0,85.15,5.23,117.9,37
HCPCS,86255,FAB SCREEN EA AB,29.5,19.175,4.25,74.7,370
HCPCS,86255,FLUORESCENT AB; SCRN EA AB,25.0,16.25,5.0,234.9,111
HCPCS,86255,FLUORESCENT ANTIBODY SCREEN,,,10.41,10.41,1
HCPCS,86255,"FLUORESCENT IMMUNOASSAY SCREEN QUAL, CSF",121.0,78.65,5.23,108.9,37
HCPCS,86255,"FLUORESCENT IMMUNOASSAY SCREEN QUAL, SERUM",121.0,78.65,5.23,108.9,37
HCPCS,86255,GABA-B RECEPTOR AB CBA,1122.0,729.3,5.23,1009.8,37
HCPCS,86255,GBMGP FLUORESCENT ANTIBODY SCREEN,67.0,43.55,5.23,60.3,37
HCPCS,86255,GFAP CBA RFLX,673.0,437.45,5.23,605.7,37
HCPCS,86255,"GLOM BASE AB, IGG IFA",167.0,108.55,5.23,150.3,37
HCPCS,86255,HUANT FLUORESCENT ANTIBODY SCREEN,86.0,55.9,5.23,77.4,37
HCPCS,86255,IGLON5 CBA RFLX,673.0,437.45,5.23,605.7,37
HCPCS,86255,LGI1 IGG,374.0,243.1,5.23,336.6,37
HCPCS,86255,LRP4 AB TEST,1042.0,677.3,5.23,937.8,37
HCPCS,86255,MGLUR1 AB CBA CSF RFLX,673.0,437.45,5.23,605.7,37
HCPCS,86255,"MGLUR1 AB CBA, SER",673.0,437.45,5.23,605.7,37
HCPCS,86255,MLPTHY FLUORESCENT AB SCREEN,121.0,78.65,5.23,108.9,37
HCPCS,86255,MOG-IGG1 FACS,741.0,481.65,5.23,666.9,37
HCPCS,86255,MYELIN ANTIBODY IGG,510.0,331.5,5.23,459.0,37
HCPCS,86255,N-METHYL-D-ASP CSF,729.0,473.85,5.23,656.1,37
HCPCS,86255,"NCDCFX - NEUROCHONDRIN AB CB ASSAY, SF, REFLEX ONLY",438.0,284.7,5.23,394.2,37
HCPCS,86255,"NCDCSR - NEUROCHONDRIN AB CB ASSAY, SER, REFLEX ONLY",438.0,284.7,5.23,394.2,37
HCPCS,86255,NIF HEAVY CHAIN CBA RFLX,673.0,437.45,5.23,605.7,37
HCPCS,86255,NIF LIGHT CHAIN CBA RFLX,673.0,437.45,5.23,605.7,37
HCPCS,86255,NMDA IGG,294.0,191.1,5.23,264.6,37
HCPCS,86255,NMO AQUAPORIN4 IGG,264.0,171.6,5.23,237.6,37
HCPCS,86255,NMO AQUAPORIN4 IGG CSF,406.0,263.9,5.23,365.4,37
HCPCS,86255,NMO AUTOANTIBODY IGG,268.0,174.2,5.23,241.2,37
HCPCS,86255,NMOA4 AQUAPORIN4 IGG,428.0,278.2,5.23,385.2,37
HCPCS,86255,PARANEOPLAST ABS CSF X9,77.0,50.05,5.23,69.3,37
HCPCS,86255,PARANEOPLSTC AB PANEL X2,165.0,107.25,5.23,148.5,37
HCPCS,86255,PARIETAL CELL AB SCR,146.0,94.9,5.23,131.4,37
HCPCS,86255,"PCCA/ANNA BY IFA, SERUM",167.0,108.55,5.23,150.3,37
HCPCS,86255,PHOSPHOLIP A2-R AB IGG,255.0,165.75,5.23,229.5,37
HCPCS,86255,"PLA2R, IMMUNOFLUORESCENCE, S (REFLEX ONLY)",330.0,214.5,5.23,297.0,37
HCPCS,86255,RETICULIN IGA IGG ABS,124.0,80.6,5.23,111.6,37
HCPCS,86255,"SEND-OUT PHOSPHOLIPASE A2 RECEPTOR (PLA2R) ANTIBODY, IGG BY IMMU",255.0,165.75,5.23,229.5,37
HCPCS,86255,SENMOT FLUORESCENT ANTIBODY (ARUP),36.0,23.4,5.23,32.4,37
HCPCS,86255,SENNRO FLUORESCENT AB (ARUP),36.0,23.4,5.23,32.4,37
HCPCS,86255,SKELETAL MUSCLE AB SCREEN,124.0,80.6,5.23,111.6,37
HCPCS,86255,"SP7CFX - SEPTIN-7 AB CB ASSAY, SF, REFLEX ONLY",438.0,284.7,5.23,394.2,37
HCPCS,86255,"SP7CSR - SEPTIN-7 AB CB ASSAY, SER, REFLEX ONLY",438.0,284.7,5.23,394.2,37
HCPCS,86255,SPSDEV FLUORESCENT AB SCREEN,36.0,23.4,5.23,32.4,37
HCPCS,86255,"THSD7A AB, S",440.0,286.0,5.23,396.0,37
HCPCS,86255,"TRIM46 AB CBA, CSF",950.0,617.5,5.23,855.0,37
HCPCS,86255,"TRIM46 AB CBA, S",950.0,617.5,5.23,855.0,37
HCPCS,862550,FLUORESCENT ANTIBODY SCREEN,,,10.41,10.41,1
HCPCS,86256,*FAB TITER EA AB,28.0,18.2,4.75,33.3,111
HCPCS,86256,ADRENAL AB TITER RFLX,57.0,37.05,5.23,51.3,37
HCPCS,86256,"AGNTFX - AGNA-1 TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"AGNTSR - AGNA-1 TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"AMPA RECEPTOR AB IGG TITER, CSF",78.0,50.7,5.23,70.2,37
HCPCS,86256,"AMPA RECEPTOR AB IGG TITER, SERUM - REFLEX",78.0,50.7,5.23,70.2,37
HCPCS,86256,AMPA-RECEP AB TITER,275.0,178.75,5.23,247.5,37
HCPCS,86256,AMPIFC FLUORESCENT ANTIBODY TITER,156.0,101.4,5.23,140.4,37
HCPCS,86256,"AN1TFX - ANNA-1 TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"AN1TSR - ANNA-1 TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"AN2TFX - ANNA-2 TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"AN2TSR- ANNA-2 TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"AN3TFX - ANNA-3 TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"AN3TSR - ANNA-3 TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"APBTSR - AP3B2 AB, TISS IMMFL TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"APHCFX - AMPHIPHYSIN AB TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"APHTSR - AMPHIPHYSIN AB TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"CASPR2 AB IGG CBA-IFA TITER, CSF",312.0,202.8,5.23,280.8,37
HCPCS,86256,"CASPR2 AB IGG TITER BY CBA-IFA, SER",275.0,178.75,5.23,247.5,37
HCPCS,86256,"CRMCFX - CRMP-5 IGG TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"CRMTSR - CRMP-5 NEURONAL IGG TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"CV2 ANTIBODY TITER, IGG",241.0,156.65,5.23,216.9,37
HCPCS,86256,DPIFAX FLUOR AB TITER,165.0,107.25,5.23,148.5,37
HCPCS,86256,DPPX AB IFA TITER CSF RFLX,184.0,119.6,5.23,165.6,37
HCPCS,86256,"DPPX AB IGG CBA-IFA TITER, CSF",420.0,273.0,5.23,378.0,37
HCPCS,86256,"DPPX AB IGG TITER BY CBA-IFA, SER",420.0,273.0,5.23,378.0,37
HCPCS,86256,ENDOMYSTAL AB IGG,315.0,204.75,5.23,283.5,37
HCPCS,86256,FAB TITER EA AB,50.0,32.5,5.23,61.2,222
HCPCS,86256,FLUORESCENT ANTIBODY TITER,24.0,15.6,5.23,21.6,38
HCPCS,86256,"GABA-A RECE$TOR IGG CBA-IFA TITER, SERUM",623.0,404.95,5.23,560.7,37
HCPCS,86256,"GABA-AR AB IGG CBA-IFA TITER, CSF",806.0,523.9,5.23,725.4,37
HCPCS,86256,"GABA-BR AB IGG CBA-IFA TITER, CSF",375.0,243.75,5.23,337.5,37
HCPCS,86256,"GABA-BR AB IGG CBA-IFA TITER, SER",375.0,243.75,5.23,337.5,37
HCPCS,86256,GABTTR FLUORESCENT ANTIBODY TITER,271.0,176.15,5.23,243.9,37
HCPCS,86256,GFAP IFA TITER RFLX,184.0,119.6,5.23,165.6,37
HCPCS,86256,HUTIT FLUORESCENT ANTIBODY TITER,86.0,55.9,5.23,77.4,37
HCPCS,86256,IGLON5 IFA TITER RFLX,184.0,119.6,5.23,165.6,37
HCPCS,86256,"LGI1 AB IGG CBA-IFA TITER, CSF",345.0,224.25,5.23,310.5,37
HCPCS,86256,"LGI1 AB IGG TITER BY CBA-IFA, SER",303.0,196.95,5.23,272.7,37
HCPCS,86256,MGLUR1 AB IFA TITER CSF RFLX,184.0,119.6,5.23,165.6,37
HCPCS,86256,"MGLUR1 AB IFA TITER, SER",184.0,119.6,5.23,165.6,37
HCPCS,86256,"MGLUR1 AB IGG CBA-IFA TITER, CSF",723.0,469.95,5.23,650.7,37
HCPCS,86256,"MOG AB IGG TITER BY CBA-IFA, SER",375.0,243.75,5.23,337.5,37
HCPCS,86256,NANNTR FLUORESCENT ANTIBODY TITER,168.0,109.2,5.23,151.2,37
HCPCS,86256,"NCDTSR - NEUROCHONDRIN AB, TISS IMMFL TITER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"NCTCFX - NEUROCHONDRIN AB TISS IMMFL TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,NEURO OPTICA/AQP4 IGG REF,136.0,88.4,5.23,122.4,37
HCPCS,86256,"NEURONAL NUCLEAR AB (ANNA) IFA TITER, IGG",121.0,78.65,5.23,108.9,37
HCPCS,86256,"NEURONAL NUCLEAR ANTIBODY (ANNA) IFA TITER, IGG, CSF",185.0,120.25,5.23,166.5,37
HCPCS,86256,NIF IFA TITER RFLX,184.0,119.6,5.23,165.6,37
HCPCS,86256,NMDAG TITER,176.0,114.4,5.23,158.4,37
HCPCS,86256,NMO/AQP4 FACS TITER,140.0,91.0,5.23,126.0,37
HCPCS,86256,PARIETAL CELL TITER,59.0,38.35,5.23,53.1,37
HCPCS,86256,"PC1TSR - PCA-1 TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"PC2TSR  - PCA-2 TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"PCA1FX - PCA-1 TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"PCA2FX - PCA-2 TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"PCCTFX - PCA-TR TITER SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"PCTTSR - PCATR TITER SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"PDE10A AB IFA TITER, CSF",121.0,78.65,5.23,108.9,37
HCPCS,86256,"PDE10A AB IFA TITER, S",121.0,78.65,5.23,108.9,37
HCPCS,86256,PEMPHIGUS BASIC SCREEN,174.0,113.1,5.23,156.6,37
HCPCS,86256,"PHOSPHOLIPASE RECEPTOR A2 ANTIBODY, IGG TITER",83.0,53.95,5.23,74.7,37
HCPCS,86256,PLA2R AB IGG TITER,595.0,386.75,5.23,535.5,37
HCPCS,86256,"PURKINJE CELL ANTIBODY, TITER",121.0,78.65,5.23,108.9,37
HCPCS,86256,"PURKINJE CELL ANTIBODY, TITER, CSF",186.0,120.9,5.23,167.4,37
HCPCS,86256,"REFLEX MGLUR1 AB IGG CBA-IFA TITER, SERUM",559.0,363.35,5.23,503.1,37
HCPCS,86256,"SP7TFX - SEPTIN-7 AB, TISS IMMFL TITER, SF, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,"SP7TSR - SEPTIN-7 AB, TISS IMMFL TITER, SER, REFLEX ONLY",147.0,95.55,5.23,132.3,37
HCPCS,86256,STRIATED MUSCLE TITER,250.0,162.5,5.23,225.0,37
HCPCS,86256,"TRIM46 AB IFA TITER, CSF",121.0,78.65,5.23,108.9,37
HCPCS,86256,"TRIM46 AB IFA TITER, S",121.0,78.65,5.23,108.9,37
HCPCS,862560,FLUORESCENT ANTIBODY TITER,,,10.41,10.41,1
HCPCS,86258,DGP ANTIBODY EACH IG CLASS,,,10.41,10.41,1
HCPCS,86258,GLIADIN ANTIBODY EACH,120.0,78.0,5.23,108.0,37
HCPCS,862580,DGP ANTIBODY EACH IG CLASS,,,10.41,10.41,1
HCPCS,86277,GROWTH HORMONE ANTIBODY,,,13.6,26.3,15
HCPCS,86277,Growth hormone antibody,,,5.23,6.6,6
HCPCS,862770,GROWTH HORMONE ANTIBODY,,,13.6,13.6,1
HCPCS,86280,HEMAGGLUTINATION INHIBITION,,,7.07,13.69,15
HCPCS,86280,Hemagglutination inhibition,,,5.23,6.6,6
HCPCS,862800,HEMAGGLUTINATION INHIBITION,,,7.07,7.07,1
HCPCS,86294,IMMUNOASSAY TUMOR QUAL,,,22.1,42.73,18
HCPCS,86294,Immunoassay tumor qual,,,5.23,6.6,6
HCPCS,862940,IMMUNOASSAY TUMOR QUAL,,,22.1,22.1,1
HCPCS,86294QW,IMMUNOASSAY TUMOR QUAL,,,39.43,42.73,3
HCPCS,86300,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 15-3,157.0,102.05,8.74,157.0,17
HCPCS,86300,IMMUNOASSAY TUMOR CA 15-3,,,17.98,17.98,1
HCPCS,86300,IMMUNOASSY TUMOR CA 15-3,65.5,42.575,5.23,85.5,74
HCPCS,863000,IMMUNOASSAY TUMOR CA 15-3,,,17.98,17.98,1
HCPCS,86301,CA 19-9,36.0,23.4,5.23,34.77,37
HCPCS,86301,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9,170.0,110.5,8.74,170.0,17
HCPCS,86301,IMMUNOASSAY TUMOR CA 19-9,,,17.98,17.98,1
HCPCS,86301,IMMUNOASSY TUMOR CA 19-9,118.0,76.7,5.23,106.2,37
HCPCS,863010,IMMUNOASSAY TUMOR CA 19-9,,,17.98,17.98,1
HCPCS,86304,IA QUANT; CA 125,105.0,68.25,5.23,94.5,37
HCPCS,86304,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125,186.0,120.9,8.74,186.0,17
HCPCS,86304,IMMUNOASSAY TUMOR CA 125,,,17.98,17.98,1
HCPCS,86304,IMMUNOASSY TUMOR CA 125,92.0,59.8,5.23,82.8,37
HCPCS,863040,IMMUNOASSAY TUMOR CA 125,,,17.98,17.98,1
HCPCS,86305,HE4,619.0,402.35,5.23,557.1,37
HCPCS,86305,HUMAN EPIDIDYMIS PROTEIN 4,,,17.98,17.98,1
HCPCS,863050,HUMAN EPIDIDYMIS PROTEIN 4,,,17.98,17.98,1
HCPCS,86308,HETEROPHILE ANTIBODIES SCREEN,121.5,78.975,3.11,197.1,54
HCPCS,86308,HETEROPHILE ANTIBODY SCREEN,,,4.47,8.66,4
HCPCS,86308,HETRPHL AB SCRN,149.0,96.85,5.18,134.1,37
HCPCS,86308,HTEROPHIL AB SCREEN,219.0,142.35,5.18,197.1,37
HCPCS,86308,HTEROPHIL AB SCREEN (POINT OF CARE LAB),219.0,142.35,5.18,197.1,37
HCPCS,863080,HETEROPHILE ANTIBODY SCREEN,,,4.47,4.47,1
HCPCS,86308QW,HETEROPHILE ANTIBODY SCREEN,,,7.99,8.66,3
HCPCS,86309,HETEROPHILE AB TITER,142.0,92.3,5.23,127.8,37
HCPCS,86309,HETEROPHILE ANTIBODY TITER,,,5.59,5.59,1
HCPCS,863090,HETEROPHILE ANTIBODY TITER,,,5.59,5.59,1
HCPCS,86310,HETEROPHILE ANTIBODY ABSRBJ,,,6.37,12.32,15
HCPCS,86310,Heterophile antibody absrbj,,,5.23,6.6,6
HCPCS,863100,HETEROPHILE ANTIBODY ABSRBJ,,,6.37,6.37,1
HCPCS,86316,AFP CSF TUMOR MARKER,85.0,55.25,5.23,76.5,37
HCPCS,86316,CHROMOGRANIN A,144.0,93.6,5.23,129.6,74
HCPCS,86316,CNSE IMMUNOASSAY TUMOR OT,128.0,83.2,5.23,115.2,37
HCPCS,86316,IA; OTHER TUMOR AGA QUAN EA,76.0,49.4,5.23,68.4,37
HCPCS,86316,IMMUNOASSAY TUMOR OTHER,,,17.98,17.98,1
HCPCS,86316,IMMUNOASSY TUMOR AG QUANT,68.0,44.2,5.23,61.2,37
HCPCS,86316,"NEURON SPECIFIC ENOLASE, SER",153.0,99.45,5.23,137.7,37
HCPCS,86316,S-100B PROTEIN,715.0,464.75,5.23,643.5,37
HCPCS,86316,TUMOR OR OTHER AG QUANT,146.0,94.9,5.23,131.4,37
HCPCS,863160,IMMUNOASSAY TUMOR OTHER,,,17.98,17.98,1
HCPCS,86317,%HUMOR PNEUMO IGG X14,53.0,34.45,5.23,47.7,37
HCPCS,86317,*HEP C AB,47.0,30.55,5.23,42.3,37
HCPCS,86317,*IMMUNOASSAY INFECT AB QUANT,47.0,30.55,5.23,42.3,74
HCPCS,86317,*IMMUNOASSY INFECT AB QUANT,47.0,30.55,5.23,42.3,37
HCPCS,86317,ASPERGILLUS FUMIGATUS ANTIBODY IGG,129.0,83.85,5.23,116.1,37
HCPCS,86317,CJD IMASSAY IA AB QNT,64.0,41.6,5.23,57.6,37
HCPCS,86317,DIPHTHERIA TOXOID IGG,64.0,41.6,5.23,57.6,37
HCPCS,86317,DIPTHERIA TETANUS AB,41.0,26.65,5.23,51.3,74
HCPCS,86317,HAEMOPHILUS INFLU B IGG,57.0,37.05,5.23,51.3,37
HCPCS,86317,HEPATITIS B SUR AB QUANT,160.0,104.0,5.23,144.0,37
HCPCS,86317,HUMORAL IMMUNITY PANELS 1/2,18.0,11.7,4.5,18.0,37
HCPCS,86317,IA INFECTIOUS AGENT AB QUAN,79.0,51.35,5.23,71.1,37
HCPCS,86317,IMMUNOASSAY INFECTIOUS AGENT,,,12.95,12.95,1
HCPCS,86317,IMMUNOASSY INFECT AB QUANT,157.0,102.05,5.23,141.3,37
HCPCS,86317,N MENINGITIIDIS IGG X4,158.0,102.7,5.23,142.2,37
HCPCS,86317,STREP PNEUMO ABS X14,31.0,20.15,5.23,27.9,37
HCPCS,86317,TETANUS TOXOID IGG,92.0,59.8,5.23,82.8,37
HCPCS,863170,IMMUNOASSAY INFECTIOUS AGENT,,,12.95,12.95,1
HCPCS,86318,*IMMUNOASSY INFECT AB QUAL/SQ,64.0,41.6,5.23,57.6,37
HCPCS,86318,IA INFECTIOUS AGENT ANTIBODY,,,15.63,30.23,4
HCPCS,863180,IA INFECTIOUS AGENT ANTIBODY,,,15.63,15.63,1
HCPCS,86318QW,IA INFECTIOUS AGENT ANTIBODY,,,27.89,30.23,3
HCPCS,86320,SERUM IMMUNOELECTROPHORESIS,,,25.86,50.0,15
HCPCS,86320,Serum immunoelectrophoresis,,,19.47,24.59,6
HCPCS,863200,SERUM IMMUNOELECTROPHORESIS,,,25.86,25.86,1
HCPCS,86325,OTHER IMMUNOELECTROPHORESIS,,,19.98,38.65,15
HCPCS,86325,Other immunoelectrophoresis,,,5.23,6.6,6
HCPCS,863250,OTHER IMMUNOELECTROPHORESIS,,,19.98,19.98,1
HCPCS,86327,IMMUNOELECTROPHORESIS ASSAY,,,46.14,50.0,3
HCPCS,86327,Immunoelectrophoresis assay,,,19.47,24.59,6
HCPCS,86328,IA NFCT AB SARSCOV2 COVID19,,,45.28,97.7,21
HCPCS,86328,Ia nfct ab sarscov2 covid19,,,5.23,6.6,6
HCPCS,863280,IA NFCT AB SARSCOV2 COVID19,,,48.85,48.85,1
HCPCS,86328QW,IA NFCT AB SARSCOV2 COVID19,,,69.82,75.66,3
HCPCS,86329,IMMUNODIFFUSION NES,,,12.14,12.14,1
HCPCS,86329,IMMUNODIFFUSION NOS,33.0,21.45,5.23,29.7,37
HCPCS,86329,TEICHOIC ACID ANTIBODIES,113.0,73.45,5.23,101.7,37
HCPCS,863290,IMMUNODIFFUSION NES,,,12.14,12.14,1
HCPCS,86331,%ABPA2 ASPERG QUAL OUCHT,97.0,63.05,5.23,87.3,37
HCPCS,86331,*IMMUNODIF QUAL EA AB/AG,37.5,24.375,5.23,47.7,74
HCPCS,86331,*IMMUNODIFFUSION QUAL EA AB/AG,46.0,29.9,5.23,41.4,37
HCPCS,86331,BIRD FANCIERS PRECIPITIN,35.0,22.75,5.23,31.5,37
HCPCS,86331,HYPERSENSITIVITY PNEUMO ID QUAL,36.0,23.4,5.23,32.4,37
HCPCS,86331,ID; GEL QUAL; EA AB/AG,36.0,23.4,5.23,32.4,37
HCPCS,86331,IMMUNODIFFUSION OUCHTERLONY,,,10.35,10.35,1
HCPCS,863310,IMMUNODIFFUSION OUCHTERLONY,,,10.35,10.35,1
HCPCS,86332,C1Q BINDING ASSAY,32.0,20.8,5.23,32.0,37
HCPCS,86332,IMMUNE CMPLX ASSAY,121.0,78.65,5.23,117.0,111
HCPCS,86332,IMMUNE COMPLEX ASSAY,,,21.06,21.06,1
HCPCS,863320,IMMUNE COMPLEX ASSAY,,,21.06,21.06,1
HCPCS,86334,%IMMUNOFIXATION,28.0,18.2,5.23,28.0,37
HCPCS,86334,*IMMUNOFIX ELECPHRSIS SERUM,67.0,43.55,5.23,64.8,74
HCPCS,86334,IMMUNOFIX E-PHORESIS SERUM,,,19.3,19.3,1
HCPCS,86334,IMMUNOFIX ELEC GEL,65.0,42.25,5.23,58.5,37
HCPCS,86334,IMMUNOFIX ELECPHRSIS SERUM,36.0,23.4,5.23,36.0,37
HCPCS,86334,IMMUNOFIXATION SCREEN SERUM,62.0,40.3,5.23,55.8,37
HCPCS,863340,IMMUNOFIX E-PHORESIS SERUM,,,19.3,19.3,1
HCPCS,86335,*IMMUNOFIX ELECPHRSIS OTHER,72.0,46.8,18.0,64.8,37
HCPCS,86335,"BJP, QT FR KAPPA LAMBDA UR 86335",56.0,36.4,14.0,50.4,37
HCPCS,86335,IMMUNFIX E-PHORSIS/URINE/CSF,,,25.36,25.36,1
HCPCS,86335,IMMUNOFIX ELECPHRSIS OTHER,59.0,38.35,11.25,65.7,74
HCPCS,86335,IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS,264.5,171.925,7.38,366.0,48
HCPCS,86335,"MONOCLONAL PROTEIN,FLUID",44.0,28.6,11.0,44.0,37
HCPCS,863350,IMMUNFIX E-PHORSIS/URINE/CSF,,,25.36,25.36,1
HCPCS,86336,INHIBIN A,98.0,63.699999999999996,5.23,107.1,75
HCPCS,863360,INHIBIN A,,,13.47,13.47,1
HCPCS,86337,*INSULIN AB,32.0,20.8,5.23,32.0,37
HCPCS,86337,INSULIN AB,32.0,20.8,5.23,32.0,37
HCPCS,86337,INSULIN ANTIBODIES,,,18.5,18.5,1
HCPCS,86337,INSULIN ANTIBODY,195.0,126.75,5.23,175.5,37
HCPCS,863370,INSULIN ANTIBODIES,,,18.5,18.5,1
HCPCS,86340,INT FAC AB,45.0,29.25,5.23,40.5,37
HCPCS,86340,INTRINSIC FACTOR ANTIBODY,,,13.02,13.02,1
HCPCS,863400,INTRINSIC FACTOR ANTIBODY,,,13.02,13.02,1
HCPCS,86341,%CEPHAL ISLET CELL AB,572.0,371.8,5.23,514.8,37
HCPCS,86341,AIDYSA ISLET CELL AB,101.0,65.65,5.23,90.9,37
HCPCS,86341,ENCCSF ISLET CELL AB,81.0,52.65,5.23,72.9,37
HCPCS,86341,ENCSER ISLET CELL AB,123.0,79.95,5.23,110.7,37
HCPCS,86341,GAD65 ANTIBODY,602.5,391.625,5.23,661.5,74
HCPCS,86341,GLUTAMIC ACID DECARBOXYLASE ANTIBODY,71.0,46.15,5.23,63.9,37
HCPCS,86341,GLUTAMIC ACID DECARBOXYLASE ANTIBODY CSF,71.0,46.15,5.23,63.9,37
HCPCS,86341,ISLET CELL AB,120.5,78.32499999999999,5.23,235.8,148
HCPCS,86341,ISLET CELL ANTIBODY,191.0,124.15,5.23,171.9,38
HCPCS,86341,MLPTHY GAD65 AB,118.0,76.7,5.23,106.2,37
HCPCS,86341,SPSDEV GAD65 AB,71.0,46.15,5.23,63.9,37
HCPCS,86341,ZINC TRANSPORTER 8 ANTIBODY,385.0,250.25,5.23,346.5,37
HCPCS,863410,ISLET CELL ANTIBODY,,,20.37,20.37,1
HCPCS,86343,LEUKOCYTE HISTAMINE RELEASE,,,10.77,10.77,1
HCPCS,86343,LHR TEST,185.0,120.25,5.23,166.5,37
HCPCS,863430,LEUKOCYTE HISTAMINE RELEASE,,,10.77,10.77,1
HCPCS,86344,LEUKOCYTE PHAGOCYTOSIS,,,8.97,17.36,15
HCPCS,86344,Leukocyte phagocytosis,,,5.23,6.6,6
HCPCS,863440,LEUKOCYTE PHAGOCYTOSIS,,,8.97,8.97,1
HCPCS,86352,CELL FUNCTION ASSAY W/STIM,209.0,135.85,19.47,209.0,38
HCPCS,86352,FLOW CD107A CELL FUNCTION,881.0,572.65,19.47,792.9,37
HCPCS,86352,IMMUNE FUN ASSY ATP,358.0,232.7,19.47,322.2,37
HCPCS,86352,NEUTROPHIL OX BURST BLD,303.0,196.95,19.47,272.7,37
HCPCS,86352,PSTAT5 CELL FUNCTION,881.0,572.65,19.47,792.9,37
HCPCS,86352,URTICARIA-IND ACTIVITY,206.0,133.9,19.47,206.0,37
HCPCS,863520,CELL FUNCTION ASSAY W/STIM,,,117.39,117.39,1
HCPCS,86353,%RETROVIR LYMPH TRANSF,416.0,270.4,19.47,374.4,37
HCPCS,86353,*LYMPHOCYTE TRANSFORMATION,182.0,118.3,19.47,163.8,37
HCPCS,86353,LPT TO BERYLLIUM,425.0,276.25,19.47,382.5,37
HCPCS,86353,LYMPH TRANS TEST,425.0,276.25,19.47,382.5,37
HCPCS,86353,LYMPHOCYTE ANTIGEN PROLIFERATION,318.0,206.7,19.47,286.2,37
HCPCS,86353,LYMPHOCYTE TRANSFORMATION,91.0,59.15,19.47,393.3,112
HCPCS,863530,LYMPHOCYTE TRANSFORMATION,,,42.36,42.36,1
HCPCS,86355,*B CELL TOTAL COUNT,56.0,36.4,14.0,56.0,37
HCPCS,86355,B CELL TOTAL-ARUP,264.0,171.6,19.47,237.6,37
HCPCS,86355,B CELLS TOTAL COUNT,353.0,229.45,19.47,317.7,38
HCPCS,86355,"B CELLS, TOTAL COUNT",189.0,122.85,19.47,170.1,37
HCPCS,86355,CD45RR B CELLS TOTAL COUNT,110.0,71.5,19.47,99.0,37
HCPCS,863550,B CELLS TOTAL COUNT,,,32.59,32.59,1
HCPCS,86356,%PNH CELL AG,204.0,132.6,19.47,183.6,37
HCPCS,86356,*MONONUCLEAR CELL ANTIGEN,84.0,54.6,9.25,117.9,148
HCPCS,86356,BAL FCM MARKERS,67.0,43.55,16.75,60.3,37
HCPCS,86356,BPHENO MONONUCLEAR AG - ARUP,187.0,121.55,19.47,168.3,37
HCPCS,86356,"CD20 MONONUCLEAR CELL ANTIGEN, QUANT",107.0,69.55,19.47,96.3,37
HCPCS,86356,CD45RR MONONUCLEAR CELL ANTIGEN X2,77.0,50.05,19.25,69.3,37
HCPCS,86356,MONONUCLEAR CELL ANTIGEN,,,23.13,23.13,1
HCPCS,863560,MONONUCLEAR CELL ANTIGEN,,,23.13,23.13,1
HCPCS,86357,*NATURAL KILLER TOTAL COUNT,56.0,36.4,14.0,56.0,37
HCPCS,86357,CD45RR NK CELLS TOTAL COUNT,110.0,71.5,19.47,99.0,37
HCPCS,86357,NK CELLS TOTAL COUNT,249.0,161.85,19.47,224.1,38
HCPCS,863570,NK CELLS TOTAL COUNT,,,32.59,32.59,1
HCPCS,86359,*T CELL TOTAL COUNT,56.0,36.4,14.0,56.0,111
HCPCS,86359,CD45RR T CELLS TOTAL COUNT,110.0,71.5,19.47,99.0,37
HCPCS,86359,T CELLS TOTAL COUNT,58.0,37.7,14.5,58.0,38
HCPCS,863590,T CELLS TOTAL COUNT,,,32.59,32.59,1
HCPCS,86360,*T CELL ABSOLUTE COUNT W RATIO,69.0,44.85,17.25,69.0,37
HCPCS,86360,CD45RR T CELL ABSOLUTE COUNT/RATIO,132.0,85.8,19.47,118.8,37
HCPCS,86360,T CELL ABSOLUTE COUNT/RATIO,415.0,269.75,19.47,373.5,38
HCPCS,863600,T CELL ABSOLUTE COUNT/RATIO,,,40.59,40.59,1
HCPCS,86361,%CD4ABS ABSOLUTE COUNT,45.0,29.25,11.25,44.75,37
HCPCS,86361,*T CELL ABSOLUTE CD4 COUNT,37.0,24.05,9.25,37.0,37
HCPCS,86361,"LYMPHOCYTE SUBSET 2, CD4 PCT. AND ABSL",45.0,29.25,11.25,44.75,37
HCPCS,86361,T CELL ABSOLUTE COUNT,,,23.13,23.13,1
HCPCS,863610,T CELL ABSOLUTE COUNT,,,23.13,23.13,1
HCPCS,86362,"MOG AB IGG CBA-IFA SCREEN, SERUM",162.0,105.3,5.23,182.7,74
HCPCS,86362,MOG-IGG1 ANTB CBA EACH,,,10.41,10.41,1
HCPCS,863620,MOG-IGG1 ANTB CBA EACH,,,10.41,10.41,1
HCPCS,86363,CDS1SE MOG-IGG1 AB FL EA,402.0,261.3,19.47,361.8,37
HCPCS,86363,MLPTHY MOG FACS,189.0,122.85,19.47,170.1,37
HCPCS,86363,"MOG AB IGG CBA-IFA SCREEN, SERUM",721.0,468.65,19.47,648.9,37
HCPCS,86363,"MOG FACS TITNER, SERUM RFLX",133.0,86.45,19.47,119.7,37
HCPCS,86363,MOG-IGG1 ANTB FLO CYTMTRY EA,,,32.59,32.59,1
HCPCS,863630,MOG-IGG1 ANTB FLO CYTMTRY EA,,,32.59,32.59,1
HCPCS,86364,TISS TRNSGLTMNASE EA IG CLAS,,,9.96,9.96,1
HCPCS,86364,TISSUE TRANSGLUTAMINASE EA,144.0,93.6,5.23,129.6,37
HCPCS,863640,TISS TRNSGLTMNASE EA IG CLAS,,,9.96,9.96,1
HCPCS,86366,"MUSCLE-SPECIFIC KINASE (MUSK) AUTOANTIBODY, SERUM",1238.0,804.7,5.23,1114.2,37
HCPCS,86366,MUSCLE-SPECIFIC KINASE ANTB,,,15.9,15.9,1
HCPCS,863660,MUSCLE-SPECIFIC KINASE ANTB,,,15.9,15.9,1
HCPCS,86367,PB STEM CELL COUNT,399.0,259.35,19.47,359.1,37
HCPCS,86367,STEM CELLS TOTAL COUNT,,,67.2,67.2,1
HCPCS,863670,STEM CELLS TOTAL COUNT,,,67.2,67.2,1
HCPCS,86376,MICROSOMAL AB EA,132.5,86.125,5.23,191.7,74
HCPCS,86376,MICROSOMAL ANTIBODIES EA,59.0,38.35,5.23,53.1,37
HCPCS,86376,MICROSOMAL ANTIBODY EACH,,,12.57,12.57,1
HCPCS,86376,THYROID PEROXIDASE AB,169.0,109.85,5.23,152.1,37
HCPCS,863760,MICROSOMAL ANTIBODY EACH,,,12.57,12.57,1
HCPCS,86381,MITOCHONDRIAL ANTIBODY EACH,130.0,84.5,5.23,117.0,38
HCPCS,863810,MITOCHONDRIAL ANTIBODY EACH,,,21.99,21.99,1
HCPCS,86382,*VIRUS AB NOS,58.0,37.7,5.23,52.2,37
HCPCS,86382,NEUTRALIZATION TEST VIRAL,318.0,206.7,5.23,286.2,38
HCPCS,863820,NEUTRALIZATION TEST VIRAL,,,14.61,14.61,1
HCPCS,86384,*NITROBLUE TETRAZLIUM DYE TEST,271.5,176.47500000000002,5.23,431.1,74
HCPCS,86384,NITROBLUE TETRAZLIUM DYE TEST,318.0,206.7,5.23,286.2,37
HCPCS,86384,NITROBLUE TETRAZOLIUM DYE,,,11.76,11.76,1
HCPCS,863840,NITROBLUE TETRAZOLIUM DYE,,,11.76,11.76,1
HCPCS,86386,NUCLEAR MATRIX PROTEIN 22,,,18.81,36.39,18
HCPCS,86386,Nuclear matrix protein 22,,,5.23,6.6,6
HCPCS,863860,NUCLEAR MATRIX PROTEIN 22,,,18.81,18.81,1
HCPCS,86386QW,NUCLEAR MATRIX PROTEIN 22,,,33.58,36.39,3
HCPCS,86403,*PARTCL AGGLUT SCREEN EA,20.5,13.325,4.25,21.6,148
HCPCS,86403,CRYPTOCOCCAL ANTIGEN,79.0,51.35,5.23,71.1,37
HCPCS,86403,PARTCL AGGLUT SCREEN EA,106.5,69.225,5.23,119.7,74
HCPCS,86403,PARTICLE AGGLUT ANTBDY SCRN,,,9.97,9.97,1
HCPCS,864030,PARTICLE AGGLUT ANTBDY SCRN,,,9.97,9.97,1
HCPCS,86406,PA; TITER EA AB,113.0,73.45,5.23,101.7,37
HCPCS,86406,PARTICLE AGGLUT ANTBDY TITR,,,9.19,9.19,1
HCPCS,864060,PARTICLE AGGLUT ANTBDY TITR,,,9.19,9.19,1
HCPCS,86408,NEUTRLZG ANTB SARSCOV2 SCR,,,42.13,91.0,18
HCPCS,86408,Neutrlzg antb sarscov2 scr,,,5.23,6.6,6
HCPCS,864080,NEUTRLZG ANTB SARSCOV2 SCR,,,45.5,45.5,1
HCPCS,86409,NEUTRLZG ANTB SARSCOV2 TITER,,,79.61,227.51,18
HCPCS,86409,Neutrlzg antb sarscov2 titer,,,5.23,6.6,6
HCPCS,864090,NEUTRLZG ANTB SARSCOV2 TITER,,,113.76,113.76,1
HCPCS,86413,SARS-COV-2 ANTB QUANTITATIVE,,,45.5,91.0,18
HCPCS,86413,Sars-cov-2 antb quantitative,,,19.47,24.59,6
HCPCS,864130,SARS-COV-2 ANTB QUANTITATIVE,,,45.5,45.5,1
HCPCS,86430,RHEUMATOID FACTOR TEST QUAL,,,5.3,10.26,15
HCPCS,86430,Rheumatoid factor test qual,,,5.23,6.6,6
HCPCS,864300,RHEUMATOID FACTOR TEST QUAL,,,5.3,5.3,1
HCPCS,86431,*RHEUMATOID FACTOR QUANT,116.0,75.4,5.23,104.4,37
HCPCS,86431,RA FACTOR QUANT,19.0,12.35,4.75,17.1,37
HCPCS,86431,RHEUMATOID FACTOR QUANT,98.0,63.7,4.9,88.2,38
HCPCS,86431,RHEUMATOID FACTOR QUANTITATIVE,79.0,51.35,2.38,79.0,17
HCPCS,86431,RHEUMATOID FACTOR TEST QUANT,109.0,70.85,5.23,98.1,37
HCPCS,864310,RHEUMATOID FACTOR QUANT,,,4.9,4.9,1
HCPCS,86480,"QUANTIFERON-TB GOLD PLUS, BLOOD",136.0,88.4,19.47,122.4,37
HCPCS,86480,TB GOLD PLUS,156.0,101.4,19.47,140.4,37
HCPCS,86480,TB TEST CELL IMMUN MEASURE,,,53.55,53.55,1
HCPCS,86480,TB TEST CELL IMMUNITY MEAS,157.0,102.05,19.47,141.3,74
HCPCS,864800,TB TEST CELL IMMUN MEASURE,,,53.55,53.55,1
HCPCS,86481,TB AG RESPONSE T-CELL SUSP,,,86.4,167.1,15
HCPCS,86481,Tb ag response t-cell susp,,,19.47,24.59,6
HCPCS,864810,TB AG RESPONSE T-CELL SUSP,,,86.4,86.4,1
HCPCS,86485,CANDIDA; SKIN TEST BO,48.0,31.2,8.32,48.0,13
HCPCS,86485,SKIN TEST CANDIDA,,,14.94,53.1,15
HCPCS,86485,Skin test candida,,,5.23,6.6,6
HCPCS,864850,SKIN TEST CANDIDA,,,14.94,14.94,1
HCPCS,86486,SKIN TEST UNLISTED ANTIGEN EACH,35.0,22.75,2.76,35.0,31
HCPCS,86486,SKIN TEST UNLISTED ANTIGN EA,,,5.01,53.1,15
HCPCS,86486,Skin test unlisted antign ea,,,5.23,6.6,6
HCPCS,864860,SKIN TEST UNLISTED ANTIGN EA,,,5.01,5.01,1
HCPCS,86490,COCCIDIOIDOMYCOSIS SKIN TEST,56.0,36.4,5.6,110.68,19
HCPCS,86490,Coccidioidomycosis skin test,,,19.47,24.59,6
HCPCS,86510,HISTOPLASMOSIS SKIN TEST,,,6.06,85.1,15
HCPCS,86510,Histoplasmosis skin test,,,19.47,24.59,6
HCPCS,865100,HISTOPLASMOSIS SKIN TEST,,,6.06,6.06,1
HCPCS,86580,HISTOPLASMOSIS SKIN TEST,45.0,29.25,6.34,45.0,31
HCPCS,86580,SKIN TEST TB,45.0,29.25,6.34,45.0,31
HCPCS,86580,SKIN TEST TUBERCULOSIS INTRADERMAL,29.0,18.85,6.34,29.0,31
HCPCS,86580,TB INTRADERMAL TEST,,,8.15,8.15,1
HCPCS,86580,TUBERCULOSIS INTRADERMAL (POINT OF CARE LAB),58.0,37.7,5.23,53.1,38
HCPCS,865800,TB INTRADERMAL TEST,,,8.15,8.15,1
HCPCS,86581,PNEUMO ABS SEROTYPES X23,31.0,20.15,7.75,101.23,30
HCPCS,86581,STREP PNEUMO ABS X14,123.0,79.95,19.47,110.7,30
HCPCS,86590,STREPTOKINASE ANTIBODY,,,10.94,21.15,15
HCPCS,86590,Streptokinase antibody,,,5.23,6.6,6
HCPCS,865900,STREPTOKINASE ANTIBODY,,,10.94,10.94,1
HCPCS,86592,SYPHILIS TEST NON-TREP QUAL,75.0,48.75,1.79,75.0,18
HCPCS,86592,SYPHILIS TEST QUAL,62.0,40.3,3.75,98.1,74
HCPCS,86592,VDRL-CSF QUAL,9.0,5.85,2.25,8.1,37
HCPCS,86592,VDRL/RPR QUAL,34.0,22.1,4.27,30.6,37
HCPCS,86592,WHIIVF SYPHILIS TEST,8.0,5.2,2.0,7.2,37
HCPCS,865920,SYPHILIS TEST NON-TREP QUAL,,,3.69,3.69,1
HCPCS,86593,SYPHILIS TEST NON-TREP QUANT,69.0,44.85,3.8,62.1,38
HCPCS,86593,SYPHILIS TEST QUANT,12.0,7.8,2.75,40.5,111
HCPCS,86593,SYPHILIS TEST QUANTITATIVE,75.0,48.75,1.85,75.0,17
HCPCS,86593,VDRL/RPR QUAN,21.0,13.65,4.4,18.9,37
HCPCS,865930,SYPHILIS TEST NON-TREP QUANT,,,3.8,3.8,1
HCPCS,86596,%PARNEO VOLTAGE-GTD CA CHNL ANTB EA,91.0,59.15,5.23,81.9,37
HCPCS,86596,VOLTAGE-GATED NA CH AB EA,384.0,249.6,5.23,345.6,37
HCPCS,86596,VOLTAGE-GTD CA CHNL ANTB EA,,,10.41,10.41,1
HCPCS,865960,VOLTAGE-GTD CA CHNL ANTB EA,,,10.41,10.41,1
HCPCS,86602,ANTINOMYCES ANTIBODY,,,8.79,17.01,15
HCPCS,86602,Antinomyces antibody,,,5.23,6.6,6
HCPCS,866020,ANTINOMYCES ANTIBODY,,,8.79,8.79,1
HCPCS,86603,*ADENOVIRUS AB,23.0,14.95,5.23,21.51,74
HCPCS,86603,ADENOVIRUS AB,99.0,64.35,5.23,89.1,37
HCPCS,86603,ADENOVIRUS ANTIBODY,97.0,63.05,5.23,87.3,38
HCPCS,866030,ADENOVIRUS ANTIBODY,,,11.12,11.12,1
HCPCS,86606,%ABPA IMMDIFF QUAL,45.0,29.25,5.23,40.5,37
HCPCS,86606,*ASPERGILLUS AB,35.5,23.075,5.23,41.4,74
HCPCS,86606,*HYPERSENSITIVITY PNEU II,24.0,15.6,5.23,24.0,37
HCPCS,86606,"A FUMIGATUS AB, IGG",116.0,75.4,5.23,104.4,37
HCPCS,86606,ASPERGILLUS AB,84.0,54.599999999999994,5.23,120.6,74
HCPCS,86606,ASPERGILLUS AB IMDIFF,80.0,52.0,5.23,72.0,37
HCPCS,86606,ASPERGILLUS AB RPT,32.0,20.8,5.23,28.8,37
HCPCS,86606,ASPERGILLUS ANTIBODY,,,13.0,13.0,1
HCPCS,86606,ASPERGILLUS ID,75.0,48.75,5.23,105.3,74
HCPCS,86606,ASPERGILLUS QUAL OR SEMI-QUANT,61.0,39.65,5.23,54.9,37
HCPCS,86606,FUNCF ASPERGILLUS ID,83.0,53.95,5.23,74.7,37
HCPCS,86606,HYPERSENSITIVITY PNEUMO IA QUAL,45.0,29.25,5.23,40.5,37
HCPCS,866060,ASPERGILLUS ANTIBODY,,,13.0,13.0,1
HCPCS,86609,BACTERIUM ANTIBODY,,,11.12,11.12,1
HCPCS,86609,DNA CRITHIDIA ANTIBODY,19.0,12.35,4.75,19.0,37
HCPCS,86609,RICKETTSIAL AB,53.0,34.45,5.23,47.7,37
HCPCS,86609,STREPTO.PNEUM.X14,70.0,45.5,5.23,63.0,37
HCPCS,866090,BACTERIUM ANTIBODY,,,11.12,11.12,1
HCPCS,86611,*BARTONELLA AB,47.0,30.55,5.23,42.3,37
HCPCS,86611,BARTONELLA,47.0,30.55,5.23,42.3,37
HCPCS,86611,BARTONELLA AB,47.0,30.55,5.23,42.3,37
HCPCS,86611,BARTONELLA ANTIBODY,,,8.79,8.79,1
HCPCS,866110,BARTONELLA ANTIBODY,,,8.79,8.79,1
HCPCS,86612,%FABCSF BLASTOMYCES,25.0,16.25,5.23,22.5,37
HCPCS,86612,*BLASTOMYCES AB,25.0,16.25,5.23,22.5,37
HCPCS,86612,AB; BLASTOMYCES,197.0,128.05,5.23,177.3,37
HCPCS,86612,BLASOMYCES DERMATITIDIS AB,56.0,36.4,5.23,50.4,37
HCPCS,86612,BLASTOMYCES AB,25.0,16.25,5.23,22.5,37
HCPCS,86612,BLASTOMYCES AB RPT,25.0,16.25,5.23,22.5,37
HCPCS,86612,BLASTOMYCES ANTIBODY,,,11.15,11.15,1
HCPCS,86612,BLASTOMYCES D AB RFLX,46.0,29.9,5.23,41.4,37
HCPCS,86612,BLASTOMYCES ID,25.0,16.25,5.23,22.5,37
HCPCS,86612,FUNCF BLASOMYCES DERMATITIDIS AB,56.0,36.4,5.23,50.4,37
HCPCS,866120,BLASTOMYCES ANTIBODY,,,11.15,11.15,1
HCPCS,86615,*BORDTL AB,29.0,18.85,5.23,26.1,74
HCPCS,86615,B PERTUSSIS AB IGA IB,107.0,69.55,5.23,96.3,37
HCPCS,86615,B PERTUSSIS AB IGG IB,107.0,69.55,5.23,96.3,37
HCPCS,86615,B PERTUSSIS AB IGM IB,107.0,69.55,5.23,96.3,37
HCPCS,86615,BORDETELLA ANTIBODY,,,11.39,11.39,1
HCPCS,86615,BORDETELLA QUAL OR SEMI-QUANT,109.0,70.85,5.23,98.1,37
HCPCS,86615,PERTUSSIS/PARAPERT GAM X3,29.0,18.85,5.23,26.1,37
HCPCS,866150,BORDETELLA ANTIBODY,,,11.39,11.39,1
HCPCS,86617,*LYME WESTERN BLOT,24.0,15.6,5.23,24.0,74
HCPCS,86617,B BURGDO AB IGG IGM X2,57.0,37.05,5.23,51.3,37
HCPCS,86617,LYME DISEASE AB RFLX,103.0,66.95,5.23,92.7,37
HCPCS,86617,LYME DISEASE ANTIBODY,,,13.38,13.38,1
HCPCS,86617,LYME WESTERN BLOT,100.0,65.0,5.23,90.0,37
HCPCS,866170,LYME DISEASE ANTIBODY,,,13.38,13.38,1
HCPCS,86618,*LYME AB IGG/IGM CSF,45.0,29.25,5.23,40.5,74
HCPCS,86618,BORELIA BURGDORFERI LYME,44.0,28.6,5.23,39.6,37
HCPCS,86618,LYME AB IGM,86.0,55.9,5.23,77.4,37
HCPCS,86618,LYME ANTIBODY TITER,34.0,22.1,5.23,30.6,37
HCPCS,86618,LYME DISEASE ANTIBODY,,,14.71,28.46,4
HCPCS,86618,LYME IGG & IGM SERUM,154.0,100.1,5.23,138.6,37
HCPCS,86618,LYME IGG CSF,110.0,71.5,5.23,99.0,37
HCPCS,86618,"LYME REFLEX PNL, CSF",188.0,122.2,5.23,169.2,37
HCPCS,86618,LYMRFX BORRELIA ANTIBODY,110.0,71.5,5.23,99.0,37
HCPCS,866180,LYME DISEASE ANTIBODY,,,14.71,14.71,1
HCPCS,86618QW,LYME DISEASE ANTIBODY,,,26.26,28.46,3
HCPCS,86619,BORRELIA ANTIBODY,,,11.56,22.36,15
HCPCS,86619,Borrelia antibody,,,5.23,6.6,6
HCPCS,866190,BORRELIA ANTIBODY,,,11.56,11.56,1
HCPCS,86622,*BRUCELLA AB,36.0,23.4,4.25,49.5,111
HCPCS,86622,BRUCELLA AB,178.0,115.7,5.23,160.2,37
HCPCS,86622,BRUCELLA AB TOTAL,81.0,52.65,5.23,72.9,37
HCPCS,86622,BRUCELLA ANTIBODY,,,7.71,7.71,1
HCPCS,86622,"BRUCELLA IGG/IGM CONF, REFLEX ONLY",197.0,128.05,5.23,177.3,37
HCPCS,866220,BRUCELLA ANTIBODY,,,7.71,7.71,1
HCPCS,86625,CAMPY JEJUNI AB IGG,239.0,155.35,5.23,215.1,37
HCPCS,86625,CAMPYLOBACTER ANTIBODY,,,11.34,11.34,1
HCPCS,866250,CAMPYLOBACTER ANTIBODY,,,11.34,11.34,1
HCPCS,86628,%CANDA ALBICAN AB X3,149.0,96.85,5.23,134.1,37
HCPCS,86628,*CANDIDA AB,84.0,54.6,5.23,75.6,37
HCPCS,86628,*CANDIDA AB QUAL,84.0,54.6,5.23,75.6,37
HCPCS,86628,"CANDIDA ABS IGA,G,M X3",129.0,83.85,5.23,116.1,37
HCPCS,86628,CANDIDA ANTIBODY,,,10.38,10.38,1
HCPCS,866280,CANDIDA ANTIBODY,,,10.38,10.38,1
HCPCS,86631,%CIGIM ABS X3,53.0,34.45,5.23,47.7,37
HCPCS,86631,*CHLAMY PNEU IGA,22.0,14.3,5.23,19.8,37
HCPCS,86631,*CHLAMYDIA AB,29.0,18.85,4.75,35.1,111
HCPCS,86631,*CHLAMYDIA IGG AB,55.0,35.75,5.23,49.5,37
HCPCS,86631,*Q FEVER (COXIELLA) AB,29.0,18.85,5.23,26.1,37
HCPCS,86631,CHLAMYDIA,19.0,12.35,4.75,19.0,37
HCPCS,86631,CHLAMYDIA ANTIBODY,,,10.22,10.22,1
HCPCS,866310,CHLAMYDIA ANTIBODY,,,10.22,10.22,1
HCPCS,86632,%CIGIM IGM ABS X3,48.0,31.2,5.23,43.2,37
HCPCS,86632,*CHLAMYDIA IGM,50.0,32.5,5.23,45.0,37
HCPCS,86632,*CHLAMYDIA IGM AB,39.0,25.35,5.23,35.1,74
HCPCS,86632,AB; CHLAMYDIA IGM,19.0,12.35,4.75,19.0,37
HCPCS,86632,CHLAMYDIA IGM,19.0,12.35,4.75,19.0,37
HCPCS,86632,CHLAMYDIA IGM ANTIBODY,,,10.95,10.95,1
HCPCS,86632,CHLAMYDIA IGM PANEL X3,37.0,24.05,5.23,33.3,37
HCPCS,866320,CHLAMYDIA IGM ANTIBODY,,,10.95,10.95,1
HCPCS,86635,%FABCSF COCCIDIODE IGG/M ABS,31.0,20.15,5.23,27.9,37
HCPCS,86635,*COCCIDIOIDES AB,25.0,16.25,5.23,22.5,37
HCPCS,86635,COCCIDIODES IGG/M ABS X2,63.0,40.95,5.23,56.7,37
HCPCS,86635,COCCIDIOIDES AB,32.0,20.8,5.23,28.8,37
HCPCS,86635,COCCIDIOIDES AB RPT,32.0,20.8,5.23,28.8,37
HCPCS,86635,COCCIDIOIDES ANTIBODY,,,9.91,9.91,1
HCPCS,86635,COCCIDIOIDES ID,31.0,20.15,5.23,27.9,37
HCPCS,86635,"COCCIDOIDES AB, CF",94.0,61.1,5.23,84.6,37
HCPCS,86635,FUNCF COCCIDOIDES AB,55.0,35.75,5.23,49.5,37
HCPCS,866350,COCCIDIOIDES ANTIBODY,,,9.91,9.91,1
HCPCS,86638,*COXIELLA ABS,20.0,13.0,5.0,20.0,37
HCPCS,86638,*Q FEVER (COXIELLA) AB,29.0,18.85,5.23,26.1,37
HCPCS,86638,COXIELLA BURNETII IGG X2,110.0,71.5,5.23,99.0,37
HCPCS,86638,Q FEVER ANTIBODY,,,10.48,10.48,1
HCPCS,86638,QFEVER AB IGG IGM PH I&II,36.0,23.4,5.23,32.4,37
HCPCS,866380,Q FEVER ANTIBODY,,,10.48,10.48,1
HCPCS,86641,CRYPTOCOCCUS ANTIBODY,,,12.45,24.08,15
HCPCS,86641,Cryptococcus antibody,,,5.23,6.6,6
HCPCS,866410,CRYPTOCOCCUS ANTIBODY,,,12.45,12.45,1
HCPCS,86644,%IDM CMV,70.0,45.5,5.23,63.0,37
HCPCS,86644,CMV AB IGG EIA,52.0,33.8,5.23,46.8,37
HCPCS,86644,CMV ANTIBODY,,,12.43,12.43,1
HCPCS,86644,CMV IGG ANTIBODY,29.0,18.85,5.23,26.1,37
HCPCS,86644,CMV IGG AVIDITY,133.0,86.45,5.23,119.7,37
HCPCS,86644,WHIIVF2 CMV IGG AB,22.0,14.3,5.23,22.0,37
HCPCS,866440,CMV ANTIBODY,,,12.43,12.43,1
HCPCS,86645,%TORCHM AB CMV IGM,45.0,29.25,5.23,40.5,37
HCPCS,86645,CMV AB IGM,24.0,15.6,5.23,24.0,37
HCPCS,86645,CMV ANTIBODY IGM,,,14.56,14.56,1
HCPCS,86645,CMV IGM EIA AB,33.0,21.45,5.23,29.7,37
HCPCS,86645,WHIIVF2 CMV IGM EIA AB,17.0,11.05,4.25,18.54,37
HCPCS,866450,CMV ANTIBODY IGM,,,14.56,14.56,1
HCPCS,86648,%DIPHTHERIA,25.0,16.25,5.23,25.0,37
HCPCS,86648,*DIPHTHERIA ABMA,25.0,16.25,5.23,25.0,37
HCPCS,86648,DIPHTHERIA ANTIBODY,,,13.14,13.14,1
HCPCS,866480,DIPHTHERIA ANTIBODY,,,13.14,13.14,1
HCPCS,86651,*ENCEPHALITIS AB,56.0,36.4,5.23,50.4,37
HCPCS,86651,*ENCEPHALITIS CALIF AB,56.0,36.4,5.23,50.4,37
HCPCS,86651,ARBOVIRUS AB,56.0,36.4,5.23,50.4,37
HCPCS,86651,ENCEPH CALIF LACROSSE,56.0,36.4,5.23,50.4,37
HCPCS,86651,ENCEPHALITIS CALIFORN ANTBDY,,,11.39,11.39,1
HCPCS,866510,ENCEPHALITIS CALIFORN ANTBDY,,,11.39,11.39,1
HCPCS,86652,*ENCEPHALITIS EAST EQUINE AB,37.0,24.05,4.75,49.5,74
HCPCS,86652,ENCEPH EASTERN,56.0,36.4,5.23,50.4,37
HCPCS,86652,ENCEPHALTIS EAST EQNE ANBDY,,,11.39,11.39,1
HCPCS,866520,ENCEPHALTIS EAST EQNE ANBDY,,,11.39,11.39,1
HCPCS,86653,*ENCEPH AB STL,19.0,12.35,4.75,19.0,37
HCPCS,86653,*ENCEPHALITIS ST LOUIS AB,55.0,35.75,5.23,49.5,37
HCPCS,86653,ARBOVIRUS ST LOUIS,56.0,36.4,5.23,50.4,37
HCPCS,86653,ENCEPH AB STL IGG,233.0,151.45,5.23,209.7,37
HCPCS,86653,ENCEPH ST LOUIS AB,46.0,29.9,5.23,41.4,37
HCPCS,86653,ENCEPHALTIS ST LOUIS ANTBODY,,,11.39,11.39,1
HCPCS,866530,ENCEPHALTIS ST LOUIS ANTBODY,,,11.39,11.39,1
HCPCS,86654,*ENCEPHALITIS WEST EQUINE AB,55.0,35.75,5.23,49.5,37
HCPCS,86654,ENCEPH WESTERN,56.0,36.4,5.23,50.4,37
HCPCS,86654,ENCEPHALITIS WEST EQUINE AB,19.0,12.35,4.75,19.0,37
HCPCS,86654,ENCEPHALTIS WEST EQNE ANTBDY,,,11.39,11.39,1
HCPCS,866540,ENCEPHALTIS WEST EQNE ANTBDY,,,11.39,11.39,1
HCPCS,86658,*COXSACKIE B ANTIBODY,24.0,15.6,5.23,21.77,37
HCPCS,86658,*ENTEROVIRUS AB,26.5,17.225,5.0,29.7,74
HCPCS,86658,AB; ENTEROVIRUS,65.0,42.25,5.23,58.5,37
HCPCS,86658,COXSACKIE A AB,55.0,35.75,5.23,49.5,37
HCPCS,86658,COXSACKIE A ABS,53.0,34.45,5.23,47.7,37
HCPCS,86658,COXSACKIE A DIFF AB X6,188.0,122.2,5.23,169.2,37
HCPCS,86658,ECHO VIRUS(ENTEROVIRUS),29.0,18.85,5.23,26.1,37
HCPCS,86658,ECHOVIRUS ANTIBODIES X5,32.0,20.8,5.23,28.8,37
HCPCS,86658,ENTEROVIRUS ANTIBODY,,,11.25,11.25,1
HCPCS,86658,POLIOVIRUS AB,25.0,16.25,5.23,22.5,37
HCPCS,86658,POLIOVIRUS ABS NEUTRAL X2,64.0,41.6,5.23,57.6,37
HCPCS,866580,ENTEROVIRUS ANTIBODY,,,11.25,11.25,1
HCPCS,86663,EBV EARLY AG EA,19.0,12.35,4.75,19.0,37
HCPCS,86663,EBV-EA IFA,28.0,18.2,5.23,25.2,37
HCPCS,86663,EPSTEIN-BARR ANTIBODY,,,11.34,11.34,1
HCPCS,866630,EPSTEIN-BARR ANTIBODY,,,11.34,11.34,1
HCPCS,86664,EBV EBNA,24.0,15.6,5.23,24.0,37
HCPCS,86664,EBV-NA IFA,31.0,20.15,5.23,27.9,37
HCPCS,86664,EPSTEIN-BARR NUCLEAR ANTIGEN,,,13.21,13.21,1
HCPCS,866640,EPSTEIN-BARR NUCLEAR ANTIGEN,,,13.21,13.21,1
HCPCS,86665,EBV-VCA IFA IGG,34.0,22.1,5.23,30.6,37
HCPCS,86665,EPSTEIN-BARR CAPSID VCA,,,15.67,15.67,1
HCPCS,86665,EPSTEIN-BARR VIRUS IGM,55.0,35.75,5.23,49.5,37
HCPCS,866650,EPSTEIN-BARR CAPSID VCA,,,15.67,15.67,1
HCPCS,86666,*COXSACKIE B AB,24.0,15.6,5.23,21.6,37
HCPCS,86666,*EHRLICHIA AB,73.0,47.45,5.23,65.7,37
HCPCS,86666,*EHRLICHIA AB TITER,73.0,47.45,5.23,65.7,37
HCPCS,86666,"A PHAGO AB, IGG/IGM X2",62.0,40.3,5.23,55.8,37
HCPCS,86666,EHRLICHIA,72.0,46.8,5.23,64.8,37
HCPCS,86666,EHRLICHIA ANTIBODY,,,8.79,8.79,1
HCPCS,86666,EHRLICHIA CHAF IGG/IGMX2,29.0,18.85,5.23,26.1,37
HCPCS,866660,EHRLICHIA ANTIBODY,,,8.79,8.79,1
HCPCS,86668,FRANCISELLA TULARENSIS,,,12.24,12.24,1
HCPCS,86668,FRANCISELLA TULARENSIS AB,61.5,39.975,5.23,67.5,74
HCPCS,866680,FRANCISELLA TULARENSIS,,,12.24,12.24,1
HCPCS,86671,%IBDSER SACCH CEREV X2,83.0,53.95,5.23,74.7,37
HCPCS,86671,*FUNGI AB NOS,69.0,44.85,5.23,62.1,74
HCPCS,86671,FUNGI AB NOS,121.0,78.65,5.23,108.9,37
HCPCS,86671,FUNGUS NES ANTIBODY,,,10.58,10.58,1
HCPCS,866710,FUNGUS NES ANTIBODY,,,10.58,10.58,1
HCPCS,86674,GIARDIA LAMBLIA ANTIBODY,,,12.72,12.72,1
HCPCS,86674,GIARDIA LAMBLIA IG/GAM X3,41.0,26.65,5.23,36.9,37
HCPCS,866740,GIARDIA LAMBLIA ANTIBODY,,,12.72,12.72,1
HCPCS,86677,*H PYLORI AB,89.0,57.85,5.23,112.5,74
HCPCS,86677,*HELICOBACTER PYLORI AB,37.0,24.05,5.23,33.3,74
HCPCS,86677,*TOXO IGG CSF,34.0,22.1,5.23,30.6,37
HCPCS,86677,AB; HELICOBACTER PYLORI,57.0,37.05,7.08,57.0,17
HCPCS,86677,H PYLORI AB,125.0,81.25,5.23,112.5,37
HCPCS,86677,H PYLORI AB (BACK OFFICE),125.0,81.25,5.23,112.5,37
HCPCS,86677,"HELICO PYLORI AB, IGM",125.0,81.25,5.23,112.5,37
HCPCS,86677,HELICOBACTER PYLORI AB,49.5,32.175,5.23,67.5,74
HCPCS,86677,HELICOBACTER PYLORI ANTIBODY,,,14.56,14.56,1
HCPCS,866770,HELICOBACTER PYLORI ANTIBODY,,,14.56,14.56,1
HCPCS,86682,CYSTICERCOS IGG AB SERUM,101.0,65.65,5.23,90.9,37
HCPCS,86682,ECHINOCOCCUS AB,43.0,27.95,5.23,38.7,37
HCPCS,86682,FILARIA AB (HAI),216.0,140.4,5.23,194.4,37
HCPCS,86682,FILARIASIS ABS IGG4,528.0,343.2,5.23,475.2,37
HCPCS,86682,HELMINTH ANTIBODY,,,11.24,11.24,1
HCPCS,86682,"HELMINTH, NES",146.0,94.9,5.23,131.4,37
HCPCS,86682,PARAGPMONUS WESTERMAN AB,121.0,78.65,5.23,108.9,37
HCPCS,86682,SCHISTOSOMA IGG AB,652.0,423.8,5.23,586.8,37
HCPCS,86682,SCHISTOSOMIASIS AB,202.0,131.3,5.23,181.8,37
HCPCS,86682,STRONGYLOIDES IGG AB,142.0,92.3,5.23,127.8,37
HCPCS,86682,STRONGYLOIDES IGG ABS,140.0,91.0,5.23,126.0,37
HCPCS,86682,TOXOCARA,128.0,83.2,5.23,115.2,37
HCPCS,86682,TOXOCARA ANTIBODIES,182.0,118.3,5.23,163.8,37
HCPCS,866820,HELMINTH ANTIBODY,,,11.24,11.24,1
HCPCS,86684,H.INFLUENZA A,40.0,26.0,5.23,36.0,37
HCPCS,86684,HEMOPHILUS INFLUENZA ANTIBDY,,,13.68,13.68,1
HCPCS,866840,HEMOPHILUS INFLUENZA ANTIBDY,,,13.68,13.68,1
HCPCS,86687,%IDM ANTI HTLV I,62.0,40.3,5.23,55.8,37
HCPCS,86687,HTLV-I ANTIBODY,,,7.85,7.85,1
HCPCS,866870,HTLV-I ANTIBODY,,,7.85,7.85,1
HCPCS,86688,HTLV-II ANTIBODY,,,12.1,23.39,15
HCPCS,86688,Htlv-ii antibody,,,5.23,6.6,6
HCPCS,866880,HTLV-II ANTIBODY,,,12.1,12.1,1
HCPCS,86689,AB; HTLV OR HIV WB,100.0,65.0,5.23,90.0,37
HCPCS,86689,HIV  CONFIRMATION,98.0,63.7,5.23,88.2,37
HCPCS,86689,HIV AB CONFIRM/WESTERN BLOT,35.0,22.75,5.23,32.33,37
HCPCS,86689,HIV CONFIRM WESTERN BLOT,70.0,45.5,5.23,63.0,37
HCPCS,86689,HIV2 AB CONF SERUM,355.0,230.75,5.23,319.5,37
HCPCS,86689,HTLV AB CONFIRM,47.0,30.55,5.23,42.3,37
HCPCS,86689,HTLV/HIV CONFIRMJ ANTIBODY,,,16.72,16.72,1
HCPCS,866890,HTLV/HIV CONFIRMJ ANTIBODY,,,16.72,16.72,1
HCPCS,86692,HEP DELTA AB,29.0,18.85,5.23,28.67,37
HCPCS,86692,HEPATITIS DELTA AB,29.0,18.85,5.23,28.67,37
HCPCS,86692,HEPATITIS DELTA AGENT ANTBDY,,,14.83,14.83,1
HCPCS,866920,HEPATITIS DELTA AGENT ANTBDY,,,14.83,14.83,1
HCPCS,86694,*HERPES SIMPLEX NONSPECIFIC AB,39.0,25.35,5.23,35.1,37
HCPCS,86694,HERPES I&II IGG AB,45.0,29.25,5.23,40.5,37
HCPCS,86694,HERPES IGM,19.0,12.35,4.75,19.0,37
HCPCS,86694,HERPES SIMPLEX IGM ABS,131.0,85.15,5.23,117.9,37
HCPCS,86694,HERPES SIMPLEX NES ANTBDY,,,12.43,12.43,1
HCPCS,866940,HERPES SIMPLEX NES ANTBDY,,,12.43,12.43,1
HCPCS,86695,%HIVIFA HSV 1 IGM,73.0,47.45,5.23,65.7,37
HCPCS,86695,%HSVG12 IGG 1,28.0,18.2,5.23,25.2,37
HCPCS,86695,%HSVIFA HSV 2 IGM,87.0,56.55,5.23,78.3,37
HCPCS,86695,*HERPES SIMPLEX TYPE 1 AB,55.0,35.75,5.23,49.5,37
HCPCS,86695,AB; HSV I,55.0,35.75,5.23,49.5,37
HCPCS,86695,HERPES SIMPLEX TYPE 1 TEST,,,11.39,11.39,1
HCPCS,86695,HERPES SIMPLEX TYPE I,55.0,35.75,5.23,49.5,37
HCPCS,866950,HERPES SIMPLEX TYPE 1 TEST,,,11.39,11.39,1
HCPCS,86696,%HSVG12 IGG 2,35.0,22.75,5.23,32.33,37
HCPCS,86696,*AB; HSV II,56.0,36.4,5.23,50.4,37
HCPCS,86696,*HERPES SIMPLEX TYPE 2 AB,56.0,36.4,5.23,50.4,37
HCPCS,86696,HERPES SIMPLEX TYPE 2 TEST,,,16.72,16.72,1
HCPCS,866960,HERPES SIMPLEX TYPE 2 TEST,,,16.72,16.72,1
HCPCS,86698,*HISTOPLASMA AB,24.0,15.6,5.23,23.04,74
HCPCS,86698,FUNCF HISTOPLASMA AB X2,55.0,35.75,5.23,49.5,37
HCPCS,86698,HISTO ID,25.0,16.25,5.23,23.04,37
HCPCS,86698,HISTOPLASMA,23.0,14.95,5.23,23.0,37
HCPCS,86698,HISTOPLASMA AB,25.0,16.25,5.23,23.04,37
HCPCS,86698,HISTOPLASMA AB RPT,25.0,16.25,5.23,23.04,37
HCPCS,86698,"HISTOPLASMA AB, CF X2",70.0,45.5,5.23,63.0,37
HCPCS,86698,HISTOPLASMA ANTIBODY,,,11.91,11.91,1
HCPCS,866980,HISTOPLASMA ANTIBODY,,,11.91,11.91,1
HCPCS,86701,HIV ANTIBODY,109.0,70.85,5.23,98.1,37
HCPCS,86701,HIV I AB,12.0,7.8,3.0,12.0,37
HCPCS,86701,HIV-1ANTIBODY,,,7.68,14.86,4
HCPCS,867010,HIV-1ANTIBODY,,,7.68,7.68,1
HCPCS,86701QW,HIV-1ANTIBODY,,,13.71,14.86,3
HCPCS,86702,HIV-2 AB,74.0,48.1,5.23,66.6,37
HCPCS,86702,HIV-2 ANTIBODY,,,11.69,11.69,1
HCPCS,867020,HIV-2 ANTIBODY,,,11.69,11.69,1
HCPCS,86703,HIV 1&2 ANTIBODY SCREEN,145.0,94.25,5.23,130.5,37
HCPCS,86703,HIV-1/HIV-2 1 RESULT ANTBDY,,,11.85,11.85,1
HCPCS,86703,HIV-1/HIV2 SNG ASSY (POINT OF CARE LAB),19.0,12.35,4.75,19.0,37
HCPCS,86703,HIV1 HIV2 SNGL ASSAY AB,83.0,53.95,5.23,74.7,37
HCPCS,867030,HIV-1/HIV-2 1 RESULT ANTBDY,,,11.85,11.85,1
HCPCS,86704,*HEP B CORE AB TOTAL,44.5,28.925,5.23,58.5,74
HCPCS,86704,HBC AB IGG &I,144.0,93.6,5.23,129.6,37
HCPCS,86704,HEP B CORE AB TOTAL,58.0,37.7,5.23,57.6,74
HCPCS,86704,HEP B CORE AB(IGG & IGM),19.0,12.35,4.75,19.0,37
HCPCS,86704,HEP B CORE ANTIBODY TOTAL,,,10.41,10.41,1
HCPCS,86704,HEPATITIS B CORE ANTIBODY HBCAB TOTAL,155.0,100.75,5.06,155.0,17
HCPCS,86704,IDM HEP B CORE AB TOTAL,36.0,23.4,5.23,32.4,37
HCPCS,867040,HEP B CORE ANTIBODY TOTAL,,,10.41,10.41,1
HCPCS,86705,HBC AB(IGM),23.0,14.95,5.23,20.7,37
HCPCS,86705,HEP B CORE ANTIBODY IGM,,,10.17,10.17,1
HCPCS,86705,HEP B CORE IGM AB,64.0,41.6,5.23,57.6,37
HCPCS,867050,HEP B CORE ANTIBODY IGM,,,10.17,10.17,1
HCPCS,86706,*HEP B SURFACE AB,40.5,26.325,5.23,51.3,74
HCPCS,86706,HBS AB,13.0,8.45,4.51,13.0,17
HCPCS,86706,HEP B SURFACE AB,19.0,12.35,4.75,17.95,37
HCPCS,86706,HEP B SURFACE ANTIBODY,,,9.28,9.28,1
HCPCS,86706,HEPATITIS B SURF ANTIBODY HBSAB,133.0,86.45,4.51,133.0,17
HCPCS,867060,HEP B SURFACE ANTIBODY,,,9.28,9.28,1
HCPCS,86707,HEPATITIS BE,19.0,12.35,4.75,19.0,37
HCPCS,86707,HEPATITIS BE ANTIBODY,26.0,16.9,5.23,23.4,38
HCPCS,867070,HEPATITIS BE ANTIBODY,,,10.0,10.0,1
HCPCS,86708,HEP A AB IGGI,28.0,18.2,5.23,25.2,37
HCPCS,86708,HEP A AB TOTAL,65.0,42.25,5.23,58.5,37
HCPCS,86708,HEPATITIS A ANTIBODY,,,10.7,10.7,1
HCPCS,867080,HEPATITIS A ANTIBODY,,,10.7,10.7,1
HCPCS,86709,HEP A AB IGM,20.0,13.0,5.0,18.82,37
HCPCS,86709,"HEP A, HEP A AB IGM",62.0,40.3,5.23,55.8,37
HCPCS,86709,HEPATITIS A IGM ANTIBODY,,,9.73,9.73,1
HCPCS,867090,HEPATITIS A IGM ANTIBODY,,,9.73,9.73,1
HCPCS,86710,*INFLUENZA VIRUS AB,103.0,66.95,5.23,92.7,74
HCPCS,86710,INFLUENZA A AB,33.0,21.45,5.23,29.7,37
HCPCS,86710,INFLUENZA A+B CF X2,107.0,69.55,5.23,96.3,37
HCPCS,86710,INFLUENZA VIRUS ANTIBODY,,,11.71,11.71,1
HCPCS,867100,INFLUENZA VIRUS ANTIBODY,,,11.71,11.71,1
HCPCS,86711,JOHN CUNNINGHAM ANTIBODY,,,14.59,28.22,15
HCPCS,86711,John cunningham antibody,,,5.23,6.6,6
HCPCS,867110,JOHN CUNNINGHAM ANTIBODY,,,14.59,14.59,1
HCPCS,86713,LEGIONELLA AB,24.0,15.6,5.23,24.0,37
HCPCS,86713,LEGIONELLA ANTIBODY,,,13.22,13.22,1
HCPCS,86713,LEGIONELLA IGM ABS,97.0,63.05,5.23,87.3,37
HCPCS,86713,LEGIONELLA PNEUMOPHILA AB,124.0,80.6,5.23,111.6,37
HCPCS,867130,LEGIONELLA ANTIBODY,,,13.22,13.22,1
HCPCS,86717,LEISHMANIA AB,146.5,95.225,5.23,176.4,74
HCPCS,86717,LEISHMANIA ANTIBODY,,,10.58,10.58,1
HCPCS,86717,LEISHMANIASIS,208.0,135.2,5.23,187.2,37
HCPCS,867170,LEISHMANIA ANTIBODY,,,10.58,10.58,1
HCPCS,86720,AB; LEPTOSPIRA,67.0,43.55,5.23,60.3,37
HCPCS,86720,LEPTOSPIRA ANTIBODY,177.0,115.05,5.23,159.3,38
HCPCS,86720,LEPTOSPIROSIS,41.0,26.65,5.23,36.9,37
HCPCS,867200,LEPTOSPIRA ANTIBODY,,,14.0,14.0,1
HCPCS,86723,LISTERIA ANTIBODY,532.0,345.8,5.23,478.8,37
HCPCS,86723,LISTERIA MONOCYTOGENES,,,11.39,11.39,1
HCPCS,867230,LISTERIA MONOCYTOGENES,,,11.39,11.39,1
HCPCS,86727,*LYMPH CHORIOMENINGITIS AB,39.0,25.35,5.23,35.1,37
HCPCS,86727,LYMPH CHORIOMENINGITIS AB,,,11.12,11.12,1
HCPCS,867270,LYMPH CHORIOMENINGITIS AB,,,11.12,11.12,1
HCPCS,86732,MUCORMYCOSIS ANTIBODY,,,12.96,25.07,15
HCPCS,86732,Mucormycosis antibody,,,5.23,6.6,6
HCPCS,867320,MUCORMYCOSIS ANTIBODY,,,12.96,12.96,1
HCPCS,86735,ANTIBODY MUMPS,51.0,33.15,5.48,51.0,17
HCPCS,86735,MUMPS AB IGM,23.0,14.95,5.23,21.81,74
HCPCS,86735,MUMPS ANTIBODY,,,11.28,11.28,1
HCPCS,86735,MUMPS IGG ANTIBODY,22.0,14.3,5.23,21.81,37
HCPCS,86735,MUMPS VIRUS AB IGM,76.0,49.4,5.23,68.4,37
HCPCS,867350,MUMPS ANTIBODY,,,11.28,11.28,1
HCPCS,86738,MYCOPLASMA AB,119.0,77.35,5.23,107.1,37
HCPCS,86738,MYCOPLASMA ANTIBODY,,,11.44,11.44,1
HCPCS,86738,MYCOPLASMA IGM AB,116.0,75.4,5.23,104.4,37
HCPCS,86738,MYCOPLASMA IGM TITER,22.0,14.3,4.75,22.5,74
HCPCS,867380,MYCOPLASMA ANTIBODY,,,11.44,11.44,1
HCPCS,86741,"N. MENINGITIDIS A, C, W-135 AND Y IGG",79.0,51.35,5.23,71.1,37
HCPCS,86741,NEISSERIA MENINGITIDIS,,,11.39,11.39,1
HCPCS,867410,NEISSERIA MENINGITIDIS,,,11.39,11.39,1
HCPCS,86744,NOCARDIA ANTIBODY,,,13.81,26.72,15
HCPCS,86744,Nocardia antibody,,,5.23,6.6,6
HCPCS,867440,NOCARDIA ANTIBODY,,,13.81,13.81,1
HCPCS,86747,*PARVOVIRUS AB,24.0,15.6,5.23,24.0,74
HCPCS,86747,PARVO B19 AB IGG & IGMX2,31.0,20.15,5.23,27.9,37
HCPCS,86747,PARVOVIRUS AB,59.0,38.35,5.23,74.7,74
HCPCS,86747,PARVOVIRUS ANTIBODY,,,12.98,12.98,1
HCPCS,867470,PARVOVIRUS ANTIBODY,,,12.98,12.98,1
HCPCS,86750,MALARIA AB SCREEN,69.0,44.85,5.23,62.1,37
HCPCS,86750,MALARIA ANTIBODY,,,11.39,11.39,1
HCPCS,867500,MALARIA ANTIBODY,,,11.39,11.39,1
HCPCS,86753,%IDM CHAGAS,59.0,38.35,5.23,53.1,37
HCPCS,86753,*BRUCELLA AB,55.0,35.75,5.23,49.5,37
HCPCS,86753,*PROTOZOA AB NOS,33.0,21.45,5.23,29.7,74
HCPCS,86753,AMOEBIC AB,41.0,26.65,5.23,36.9,37
HCPCS,86753,BABESIA MICROTI G+M X2,32.0,20.8,5.23,28.8,37
HCPCS,86753,E HISTOLYTICA AB,73.0,47.45,5.23,65.7,37
HCPCS,86753,ENTAMOEBA HISTO IGG,72.0,46.8,5.23,64.8,37
HCPCS,86753,PROTOZOA ANTIBODY NOS,,,10.7,10.7,1
HCPCS,86753,TRYPANOSOMA CRUZI AB IGG,46.0,29.9,5.23,41.4,37
HCPCS,86753,TRYPANOSOMA CRUZI AB IGM,46.0,29.9,5.23,41.4,37
HCPCS,867530,PROTOZOA ANTIBODY NOS,,,10.7,10.7,1
HCPCS,86756,RESPIRATORY VIRUS ANTIBODY,,,13.73,26.55,15
HCPCS,86756,Respiratory virus antibody,,,5.23,6.6,6
HCPCS,867560,RESPIRATORY VIRUS ANTIBODY,,,13.73,13.73,1
HCPCS,86757,*RICKETTSIA AB,29.0,18.85,5.23,32.0,111
HCPCS,86757,*RICKETTSIAL AB IGG,32.0,20.8,5.23,32.0,37
HCPCS,86757,RICKETTSIA ANTIBODY,,,16.72,16.72,1
HCPCS,867570,RICKETTSIA ANTIBODY,,,16.72,16.72,1
HCPCS,86759,ROTAVIRUS ANTIBODY,,,15.75,30.46,15
HCPCS,86759,Rotavirus antibody,,,5.23,6.6,6
HCPCS,867590,ROTAVIRUS ANTIBODY,,,15.75,15.75,1
HCPCS,86762,RUBELLA ANTIBODY,,,12.43,12.43,1
HCPCS,86762,RUBELLA IGG SEMI-QUANT,29.0,18.85,5.23,26.1,37
HCPCS,86762,RUBELLA IGM IFA,63.0,40.95,5.23,56.7,37
HCPCS,86762,RUBELLA TITER,50.0,32.5,5.23,45.0,37
HCPCS,86762,RUBELLA VIRUS IGM,50.0,32.5,5.23,45.0,37
HCPCS,86762,WHIIVF2 RUBELLA IGG SEMI-QUANT,12.0,7.8,3.0,15.83,37
HCPCS,867620,RUBELLA ANTIBODY,,,12.43,12.43,1
HCPCS,86765,MEASLES-RUBEOLA IGG AB,112.0,72.8,5.23,100.8,37
HCPCS,86765,MEASLES-RUBEOLA IGM AB,101.0,65.65,5.23,90.9,37
HCPCS,86765,RUBEOLA ANTIBODY,,,11.12,11.12,1
HCPCS,86765,RUBEOLA IGG,19.0,12.35,4.75,19.0,37
HCPCS,86765,RUBEOLA IGM,28.0,18.2,5.23,25.2,37
HCPCS,867650,RUBEOLA ANTIBODY,,,11.12,11.12,1
HCPCS,86768,*AB; SALMONELLA,26.5,17.225,4.75,30.6,148
HCPCS,86768,AB; SALMONELLA,92.0,59.8,5.23,82.8,37
HCPCS,86768,ANTIBODY SALMONELLA,15.0,9.75,5.54,15.0,17
HCPCS,86768,SALMONELLA ANTIBODY,,,11.39,11.39,1
HCPCS,867680,SALMONELLA ANTIBODY,,,11.39,11.39,1
HCPCS,86769,COVID19 IGG QUAL BY CIA,124.0,80.6,5.23,111.6,37
HCPCS,86769,SARS-COV-2 COVID-19 ANTIBODY,,,45.5,45.5,1
HCPCS,867690,SARS-COV-2 COVID-19 ANTIBODY,,,45.5,45.5,1
HCPCS,86771,SHIGELLA ANTIBODY,,,21.15,40.91,15
HCPCS,86771,Shigella antibody,,,5.23,6.6,6
HCPCS,867710,SHIGELLA ANTIBODY,,,21.15,21.15,1
HCPCS,86774,TETANUS AB,33.0,21.45,5.23,29.7,37
HCPCS,86774,TETANUS ANTIBODY,,,12.79,12.79,1
HCPCS,867740,TETANUS ANTIBODY,,,12.79,12.79,1
HCPCS,86777,%CSFTOX TOXOPLAS IGG,33.0,21.45,5.23,29.7,37
HCPCS,86777,*TOXOPLASMOSIS,56.0,36.4,5.23,50.4,37
HCPCS,86777,TOXOPLAS IGG,141.0,91.65,5.23,126.9,37
HCPCS,86777,TOXOPLASMA ANTIBODY,,,12.43,12.43,1
HCPCS,86777,TOXOPLSMOSIS IGG AB TITR,55.0,35.75,5.23,49.5,37
HCPCS,867770,TOXOPLASMA ANTIBODY,,,12.43,12.43,1
HCPCS,86778,%CSFTOX TOXOPLAS IGM,68.0,44.2,5.23,61.2,37
HCPCS,86778,*TOXOPLSMOSIS IGM AB CSF,34.0,22.1,5.23,30.6,37
HCPCS,86778,TOXOPLASMA ANTIBODY IGM,,,12.45,12.45,1
HCPCS,86778,TOXOPLASMOSIS IGM AB,125.0,81.25,5.23,112.5,37
HCPCS,86778,TOXOPLSMOSIS IGM AB TITR,24.0,15.6,5.23,24.0,37
HCPCS,867780,TOXOPLASMA ANTIBODY IGM,,,12.45,12.45,1
HCPCS,86780,SYPHILIS T PALLIDUM IGG,141.0,91.65,5.23,126.9,37
HCPCS,86780,TREPONEMA PALLIDUM,34.5,22.424999999999997,4.75,62.1,152
HCPCS,86780,WHIIVF SYPHILIS,17.0,11.05,4.25,17.0,37
HCPCS,86780,WHIIVF SYPHILIS T PALLIDUM REFLEX,17.0,11.05,4.25,17.0,37
HCPCS,867800,TREPONEMA PALLIDUM,,,11.44,11.44,1
HCPCS,86780QW,TREPONEMA PALLIDUM,,,20.42,22.12,3
HCPCS,86784,TRICHINELLA ANTIBODY,,,10.85,10.85,1
HCPCS,86784,TRICHINELLA IGG AB,44.0,28.6,5.23,39.6,37
HCPCS,86784,TRICHINOSIS AB,45.0,29.25,5.23,40.5,37
HCPCS,867840,TRICHINELLA ANTIBODY,,,10.85,10.85,1
HCPCS,86787,AB; VARICELLA-ZOSTER,57.5,37.375,5.23,52.2,74
HCPCS,86787,VARICELLA IMMUNITY,46.0,29.9,5.23,41.4,37
HCPCS,86787,VARICELLA ZOSTER IGG AB,28.0,18.2,5.23,25.2,37
HCPCS,86787,VARICELLA ZOSTER IGM,49.0,31.85,5.23,52.2,74
HCPCS,86787,VARICELLA-ZOSTER ANTIBODY,,,11.12,11.12,1
HCPCS,86787,"VZV IGG AB, CSF",29.0,18.85,5.23,26.1,37
HCPCS,867870,VARICELLA-ZOSTER ANTIBODY,,,11.12,11.12,1
HCPCS,86788,%CNILE WEST NILE VRS IGM,92.0,59.8,5.23,82.8,37
HCPCS,86788,*WEST NILE IGM,95.0,61.75,5.23,85.5,37
HCPCS,86788,"*WEST NILE VIRUS AB, IGM",55.0,35.75,5.23,49.5,37
HCPCS,86788,WEST NILE VIRUS AB IGM,,,14.56,14.56,1
HCPCS,867880,WEST NILE VIRUS AB IGM,,,14.56,14.56,1
HCPCS,86789,%CNILE WEST NILE VRS IGG,92.0,59.8,5.23,82.8,37
HCPCS,86789,*WEST NILE VIRUS AB,24.0,15.6,5.23,24.0,37
HCPCS,86789,*WEST NILE VIRUS SEROLOGY,95.0,61.75,5.23,85.5,37
HCPCS,86789,WEST NILE VIRUS ANTIBODY,,,12.43,12.43,1
HCPCS,867890,WEST NILE VIRUS ANTIBODY,,,12.43,12.43,1
HCPCS,86790,*VIRUS AB NOS,82.0,53.300000000000004,5.23,171.9,259
HCPCS,86790,AB; VIRUS NES,92.0,59.8,5.23,82.8,37
HCPCS,86790,CHIKUNGUNYA AB IGG IGM X2,83.0,53.95,5.23,74.7,37
HCPCS,86790,CHIKUNGUNYA IGG TITER,200.0,130.0,5.23,180.0,37
HCPCS,86790,CHIKUNGUNYA IGM TITER,207.0,134.55,5.23,186.3,37
HCPCS,86790,DENGUE FEVER ABS IGG/M X2,118.0,76.7,5.23,106.2,37
HCPCS,86790,DENGUE VIRUS IGG AB,91.0,59.15,5.23,81.9,37
HCPCS,86790,DENGUE VIRUS IGM AB,92.0,59.8,5.23,82.8,37
HCPCS,86790,HATAVIRUS IGG & IGM,116.0,75.4,5.23,104.4,37
HCPCS,86790,HEPATITIS E IGG,123.0,79.95,5.23,110.7,37
HCPCS,86790,HEPATITIS E IGG/IGM ABX2,286.0,185.9,5.23,257.4,37
HCPCS,86790,HEPATITIS E IGM,123.0,79.95,5.23,110.7,37
HCPCS,86790,HERPES VIRUS 6 IGG AB,176.0,114.4,5.23,158.4,37
HCPCS,86790,HERPESVIRUS 6 IGM AB,273.0,177.45,5.23,245.7,37
HCPCS,86790,HTLV I/II ANTIBODY EIA,25.0,16.25,5.23,22.5,37
HCPCS,86790,HV6 HUMAN IGG/IGM ABSX2,349.0,226.85,5.23,314.1,37
HCPCS,86790,VIRUS AB NOS,60.0,39.0,5.23,191.7,444
HCPCS,86790,VIRUS ANTIBODY NOS,,,11.12,11.12,1
HCPCS,867900,VIRUS ANTIBODY NOS,,,11.12,11.12,1
HCPCS,86793,YERSINIA ANTIBODY,,,11.39,11.39,1
HCPCS,86793,YERSINIA ANTIBODY TITER,85.0,55.25,5.23,76.5,37
HCPCS,867930,YERSINIA ANTIBODY,,,11.39,11.39,1
HCPCS,86794,ZIKA VIRUS IGM,135.0,87.75,5.23,121.5,37
HCPCS,86794,ZIKA VIRUS IGM ANTIBODY,105.0,68.25,5.23,94.5,38
HCPCS,867940,ZIKA VIRUS IGM ANTIBODY,,,14.56,14.56,1
HCPCS,86800,THRYOGLOB ANTIBODY,24.0,15.6,5.23,24.0,37
HCPCS,86800,THYROGLOBULIN AB,131.0,85.15,5.23,117.9,37
HCPCS,86800,THYROGLOBULIN ANTIBODY,,,13.75,13.75,1
HCPCS,868000,THYROGLOBULIN ANTIBODY,,,13.75,13.75,1
HCPCS,86803,*HEP C AB,50.0,32.5,5.23,68.4,74
HCPCS,86803,HEPATITIS C A,24.0,15.6,5.23,23.85,37
HCPCS,86803,HEPATITIS C AB TEST,,,12.33,23.85,4
HCPCS,86803,IDM HEP C AB,43.0,27.95,5.23,38.7,37
HCPCS,868030,HEPATITIS C AB TEST,,,12.33,12.33,1
HCPCS,86803QW,HEPATITIS C AB TEST,,,22.0,23.85,3
HCPCS,86804,HEP C AB TEST CONFIRM,,,13.38,13.38,1
HCPCS,86804,HEP C CONFIRM TEST,97.0,63.05,5.23,87.3,37
HCPCS,868040,HEP C AB TEST CONFIRM,,,13.38,13.38,1
HCPCS,86805,LYMPHOCYTOTOXICITY ASSAY,,,163.74,316.67,15
HCPCS,86805,Lymphocytotoxicity assay,,,81.35,102.76,6
HCPCS,868050,LYMPHOCYTOTOXICITY ASSAY,,,163.74,163.74,1
HCPCS,86806,LYMPHOCYTOTOXICITY ASSAY,,,41.12,79.52,15
HCPCS,86806,Lymphocytotoxicity assay,,,28.87,36.47,6
HCPCS,868060,LYMPHOCYTOTOXICITY ASSAY,,,41.12,41.12,1
HCPCS,86807,AB SCREEN CYTOTOXIC PRA,209.0,135.85,28.87,188.1,37
HCPCS,86807,CYTOTOXIC ANTIBODY SCREENING,,,67.95,67.95,1
HCPCS,868070,CYTOTOXIC ANTIBODY SCREENING,,,67.95,67.95,1
HCPCS,86808,CYTOTOXIC ANTIBODY SCREENING,,,25.64,49.6,15
HCPCS,86808,Cytotoxic antibody screening,,,2.08,2.63,6
HCPCS,868080,CYTOTOXIC ANTIBODY SCREENING,,,25.64,25.64,1
HCPCS,86812,HLA TYPING A B OR C,,,22.3,22.3,1
HCPCS,86812,HLA TYPING A/B/C SNGL AG,40.0,26.0,2.08,40.0,37
HCPCS,868120,HLA TYPING A B OR C,,,22.3,22.3,1
HCPCS,86813,HLA ABCDR TT UPDATE,476.0,309.4,28.87,428.4,37
HCPCS,86813,HLA TYPE; A B C MULTI AG,103.0,66.95,25.75,96.92,37
HCPCS,86813,HLA TYPING A B OR C,,,50.11,50.11,1
HCPCS,86813,HLA TYPING A/B/C MULT AG,236.0,153.39999999999998,28.87,286.2,74
HCPCS,86813,"HLA-A,B TYPING",444.0,288.6,28.87,399.6,37
HCPCS,868130,HLA TYPING A B OR C,,,50.11,50.11,1
HCPCS,86816,HLA TYPING DR/DQ,,,26.07,50.41,15
HCPCS,86816,Hla typing dr/dq,,,28.87,36.47,6
HCPCS,868160,HLA TYPING DR/DQ,,,26.07,26.07,1
HCPCS,86817,HLA TYPING DR/DQ,,,91.7,91.7,1
HCPCS,86817,HLA TYPING DR/DQ MULT AG,430.0,279.5,28.87,387.0,37
HCPCS,86817,"HLA-DR,DQ,DRW TYPING",645.0,419.25,28.87,580.5,37
HCPCS,868170,HLA TYPING DR/DQ,,,91.7,91.7,1
HCPCS,86821,LYMPHOCYTE CULTURE MIXED,,,31.59,61.09,15
HCPCS,86821,Lymphocyte culture mixed,,,28.87,36.47,6
HCPCS,868210,LYMPHOCYTE CULTURE MIXED,,,31.59,31.59,1
HCPCS,86825,*HLA X-MATCH NON-CYTOTOXIC,757.5,492.375,28.87,946.8,74
HCPCS,86825,HLA X-MATH NON-CYTOTOXIC,,,94.6,94.6,1
HCPCS,86825,XM T&B FLOW ALLO DECEASED DONOR,714.0,464.1,28.87,642.6,37
HCPCS,868250,HLA X-MATH NON-CYTOTOXIC,,,94.6,94.6,1
HCPCS,86826,*HLA X-MATCH NON-CYTOTOXIC,295.0,191.75,28.87,265.5,37
HCPCS,86826,HLA X-MATCH NONCYTOTOXC ADDL,,,31.56,31.56,1
HCPCS,86826,XM T & B FLOW ALLO- ADD SERUM SAMPLE,579.0,376.35,28.87,521.1,37
HCPCS,868260,HLA X-MATCH NONCYTOTOXC ADDL,,,31.56,31.56,1
HCPCS,86828,*HLA CLASS I&II ANTIBODY QUAL,86.0,55.9,20.25,91.0,111
HCPCS,86828,AB PRA FLOW,81.0,52.65,20.25,81.0,37
HCPCS,86828,AB PRA FLOW REPEAT,227.0,147.55,28.87,204.3,37
HCPCS,86828,HLA CLASS I&II ANTIBODY QUAL,248.0,161.2,28.87,286.2,75
HCPCS,868280,HLA CLASS I&II ANTIBODY QUAL,,,55.46,55.46,1
HCPCS,86829,HLA CLASS I/II ANTIBODY QUAL,,,55.46,107.26,15
HCPCS,86829,Hla class i/ii antibody qual,,,28.87,36.47,6
HCPCS,868290,HLA CLASS I/II ANTIBODY QUAL,,,55.46,55.46,1
HCPCS,86830,HLA CLASS I PHENOTYPE QUAL,,,82.53,159.61,15
HCPCS,86830,Hla class i phenotype qual,,,28.87,36.47,6
HCPCS,868300,HLA CLASS I PHENOTYPE QUAL,,,82.53,82.53,1
HCPCS,86831,HLA CLASS II PHENOTYPE QUAL,,,70.74,136.82,15
HCPCS,86831,Hla class ii phenotype qual,,,28.87,36.47,6
HCPCS,868310,HLA CLASS II PHENOTYPE QUAL,,,70.74,70.74,1
HCPCS,86832,*HLA CLASS I HIGH DEFIN QUAL,406.0,263.9,81.35,406.0,74
HCPCS,86832,AB ID & VPRA -CLASS I LUMINEX,406.0,263.9,81.35,406.0,37
HCPCS,86832,AB ID & VPRA -CLASS I LUMINEX REPEAT,971.0,631.15,81.35,873.9,37
HCPCS,86832,AB ID CLASS I PHENO BEADS,971.0,631.15,81.35,873.9,37
HCPCS,86832,AB ID DILUTION - CLASS I LUMINEX,971.0,631.15,81.35,873.9,37
HCPCS,86832,HLA CLASS I HIGH DEFIN QUAL,572.0,371.79999999999995,81.35,664.2,75
HCPCS,86832,XM POST-TX DSA MONITORING  CLASS I,360.0,234.0,81.35,360.0,37
HCPCS,868320,HLA CLASS I HIGH DEFIN QUAL,,,279.72,279.72,1
HCPCS,86833,*HLA CLASS II HIGH DEFIN QUAL,411.0,267.15,81.35,411.0,74
HCPCS,86833,AB ID & VPRA -CLASS II LUMINEX,411.0,267.15,81.35,411.0,37
HCPCS,86833,AB ID & VPRA -CLASS II LUMINEX REPEAT,518.0,336.7,81.35,518.0,37
HCPCS,86833,AB ID CLASS II PHENO BEADS,518.0,336.7,81.35,518.0,37
HCPCS,86833,AB ID DILUTION - CLASS II LUMINEX,518.0,336.7,81.35,518.0,37
HCPCS,86833,HLA CLASS II HIGH DEFIN QUAL,523.5,340.275,81.35,572.4,75
HCPCS,86833,XM POST-TX DSA MONITORING  CLASS II,462.0,300.3,81.35,462.0,37
HCPCS,868330,HLA CLASS II HIGH DEFIN QUAL,,,281.49,281.49,1
HCPCS,86834,HLA CLASS  I SEMIQUANT PANEL,843.0,547.95,81.35,758.7,37
HCPCS,86834,HLA CLASS I SEMIQUANT PANEL,498.0,323.7,81.35,498.0,38
HCPCS,868340,HLA CLASS I SEMIQUANT PANEL,,,308.93,308.93,1
HCPCS,86835,HLA CLASS II SEMIQUANT PANEL,843.0,547.95,81.35,758.7,75
HCPCS,868350,HLA CLASS II SEMIQUANT PANEL,,,279.04,279.04,1
HCPCS,86849,"PT AB, IGG & IGM X2",314.0,204.1,5.23,282.6,27
HCPCS,86850,*RBC AB SCREEN EA SERUM,105.0,68.25,2.08,115.85,74
HCPCS,86850,ANTIBODY SCREEN RBC EACH SERUM TECHNIQUE,123.0,79.95,4.1,123.0,13
HCPCS,86850,RBC AB SCREEN EA SERUM,105.0,68.25,2.08,115.85,74
HCPCS,86850,RBC ANTIBODY SCREEN,,,8.45,8.45,1
HCPCS,86850,WHIVF RBC AB ACRN,13.0,8.45,2.08,115.85,37
HCPCS,868500,RBC ANTIBODY SCREEN,,,8.45,8.45,1
HCPCS,86860,ANTIBODY ELUTION RBC EACH ELUTION,15.0,9.75,7.5,15.0,13
HCPCS,86860,RBC AB ELUTION EA ELUTION,209.0,135.85,54.13,371.54,37
HCPCS,86860,RBC ANTIB ELUTION,549.0,356.85,81.35,494.1,37
HCPCS,86860,RBC ANTIBODY ELUTION,,,23.85,23.85,1
HCPCS,868600,RBC ANTIBODY ELUTION,,,23.85,23.85,1
HCPCS,86870,ANTIBODY ID RBC ANTIBODIES EA PANEL EA SERUM TQ,118.0,76.7,17.44,118.0,13
HCPCS,86870,CRC AB ID PANEL,307.0,199.55,79.51,779.93,37
HCPCS,86870,RBC AB ID EA PANL,374.0,243.1,81.35,779.93,74
HCPCS,86870,RBC ANTIBODY IDENTIFICATION,,,32.75,32.75,1
HCPCS,868700,RBC ANTIBODY IDENTIFICATION,,,32.75,32.75,1
HCPCS,86880,AGT DIR MONOSPECIF C3,173.0,112.45,2.08,155.7,37
HCPCS,86880,ANTIHUMAN GLOBULIN DIRECT EACH ANTISERUM,166.0,107.9,2.26,166.0,17
HCPCS,86880,COOMBS TEST DIR EA ANTISERUM,138.0,89.7,2.08,128.79,37
HCPCS,86880,COOMBS TEST DIRECT,,,4.65,4.65,1
HCPCS,86880,COOMBS; DIRECT,52.0,33.8,2.08,128.79,111
HCPCS,868800,COOMBS TEST DIRECT,,,4.65,4.65,1
HCPCS,86885,COOMBS TEST INDIRECT QUAL,146.0,94.9,2.08,371.54,38
HCPCS,86885,"CRC AB ID, EACH CELL",133.0,86.45,2.08,371.54,37
HCPCS,868850,COOMBS TEST INDIRECT QUAL,,,4.95,4.95,1
HCPCS,86886,ANTIBODY TITER,189.0,122.85,2.08,371.54,37
HCPCS,86886,ANTIHUMAN GLOBULIN INDIRECT EACH ANTIBODY TITER,39.0,25.35,2.18,39.0,17
HCPCS,86886,CMBS INDIR -N PROFESSIONAL FEE,13.0,8.45,2.18,13.0,17
HCPCS,86886,COOMBS TEST INDIRECT TITER,189.0,122.85,2.08,371.54,38
HCPCS,86886,RBC AB TITER -N PROFESSIONAL FEE,13.0,8.45,2.18,13.0,17
HCPCS,868860,COOMBS TEST INDIRECT TITER,,,4.47,4.47,1
HCPCS,86890,AUTOLOGOUS BLOOD PROCESS,,,74.93,74.93,1
HCPCS,86890,COLL/STORE AUTOLOGOUS BLOOD,345.0,224.25,51.52,371.54,37
HCPCS,868900,AUTOLOGOUS BLOOD PROCESS,,,74.93,74.93,1
HCPCS,86891,AUTOLOGOUS BLOOD OP SALVAGE,,,105.85,105.85,1
HCPCS,86891,CELL SALVAGE 1 UNIT,805.0,523.25,51.52,1771.17,37
HCPCS,86891,CELL SALVAGE SUPPLY,805.0,523.25,51.52,1771.17,37
HCPCS,86891,SALVAGED BL PROCESSING EA,805.0,523.25,51.52,1771.17,37
HCPCS,868910,AUTOLOGOUS BLOOD OP SALVAGE,,,105.85,105.85,1
HCPCS,86900,*BLOOD TYPING ABO,145.0,94.25,2.08,279.48,37
HCPCS,86900,ABO BLOOD TYPING,145.0,94.25,2.08,279.48,37
HCPCS,86900,BLOOD TYPING SEROLOGIC ABO,73.0,47.45,1.26,73.0,18
HCPCS,869000,BLOOD TYPING SEROLOGIC ABO,,,2.58,2.58,1
HCPCS,86901,*BLOOD TYPING RH(D),57.0,37.05,2.08,85.1,74
HCPCS,86901,BLOOD TYPING SEROLOGIC RH (D),63.0,40.95,1.26,63.0,17
HCPCS,86901,BLOOD TYPING SEROLOGIC RH(D),,,2.58,2.58,1
HCPCS,86901,WHIVF BLD TYPE RHD,7.0,4.55,1.81,85.1,37
HCPCS,86901,WKD D AG TYPING,19.0,12.35,2.08,85.1,37
HCPCS,869010,BLOOD TYPING SEROLOGIC RH(D),,,2.58,2.58,1
HCPCS,86902,BLOOD TYPE AN,359.0,233.35,2.08,779.93,37
HCPCS,86902,BLOOD TYPE ANTIGEN DONOR EA,359.0,233.35,2.08,779.93,38
HCPCS,86902,SPECIAL ANTIGEN SCREEN,359.0,233.35,2.08,779.93,37
HCPCS,869020,BLOOD TYPE ANTIGEN DONOR EA,,,5.49,5.49,1
HCPCS,86904,AG SCREEN W P,154.0,100.1,2.08,138.6,37
HCPCS,86904,BLOOD TYPING ANTIGEN SCREEN PATIENT SERUM/UNIT,15.0,9.75,6.86,15.0,17
HCPCS,86904,BLOOD TYPING PATIENT SERUM,,,14.12,14.12,1
HCPCS,869040,BLOOD TYPING PATIENT SERUM,,,14.12,14.12,1
HCPCS,86905,BLOOD TYPING RBC ANTIGENS,359.0,233.35,2.08,779.93,38
HCPCS,86905,RBC AG NOT AB,87.0,56.55,2.08,779.93,37
HCPCS,86905,RBC AG NOT ABO/RH(D) EA,400.0,260.0,2.08,779.93,37
HCPCS,86905,RBC ANTIGEN TYPING,359.0,233.35,2.08,779.93,37
HCPCS,869050,BLOOD TYPING RBC ANTIGENS,,,3.3,3.3,1
HCPCS,86906,BLD TYPING SEROLOGIC RH PHNT,,,6.7,85.1,15
HCPCS,86906,Bld typing serologic rh phnt,,,2.08,2.63,6
HCPCS,869060,BLD TYPING SEROLOGIC RH PHNT,,,6.7,6.7,1
HCPCS,86910,BLOOD TYPING PATERNITY TEST,,,19.39,19.39,1
HCPCS,86910,Blood typing paternity test,,,2.08,2.63,6
HCPCS,869100,BLOOD TYPING PATERNITY TEST,,,19.39,19.39,1
HCPCS,86911,BLOOD TYPING ANTIGEN SYSTEM,,,16.77,16.77,1
HCPCS,86911,Blood typing antigen system,,,2.08,2.63,6
HCPCS,869110,BLOOD TYPING ANTIGEN SYSTEM,,,16.77,16.77,1
HCPCS,86920,COMPATIBILITY EACH UNIT IMMEDIATE SPIN TECHNIQUE,100.0,65.0,14.09,100.0,13
HCPCS,86920,COMPATIBILITY TEST SPIN,197.0,128.05,26.46,371.54,75
HCPCS,86920,PLATELET CROSSMATCH,197.0,128.05,51.02,371.54,37
HCPCS,869200,COMPATIBILITY TEST SPIN,,,26.46,26.46,1
HCPCS,86921,*INCUBATION CROSSMATCH,180.0,117.0,46.62,371.54,37
HCPCS,86921,COMPATIBILITY TEST INCUBATE,387.0,251.55,23.85,371.54,38
HCPCS,86921,INCUBATION CROSSMATCH,186.0,120.9,48.17,371.54,37
HCPCS,869210,COMPATIBILITY TEST INCUBATE,,,23.85,23.85,1
HCPCS,86922,COMPATIBILITY EACH UNIT ANTIGLOBULIN,210.0,136.5,15.07,210.0,13
HCPCS,86922,COMPATIBILITY TEST ANTIGLOB,281.0,182.65,28.3,371.54,38
HCPCS,869220,COMPATIBILITY TEST ANTIGLOB,,,28.3,28.3,1
HCPCS,86923,COMPATABILITY TEST ELECTR,188.0,122.2,48.69,371.54,37
HCPCS,86923,COMPATIBILITY TEST ELECTRIC,,,21.22,21.22,1
HCPCS,86923,ELECTRONIC CROSSMATCH,188.0,122.2,48.69,371.54,37
HCPCS,869230,COMPATIBILITY TEST ELECTRIC,,,21.22,21.22,1
HCPCS,86927,FRESH FROZEN PLASMA THAWING EACH UNIT,153.0,99.45,7.95,153.0,13
HCPCS,86927,PLASMA FRESH FROZEN,,,14.94,14.94,1
HCPCS,86927,THAW FFP EA UNIT,180.0,117.0,46.62,371.54,37
HCPCS,869270,PLASMA FRESH FROZEN,,,14.94,14.94,1
HCPCS,86930,FROZEN BLOOD PREP,,,88.3,371.54,15
HCPCS,86930,Frozen blood prep,,,51.52,65.08,6
HCPCS,869300,FROZEN BLOOD PREP,,,88.3,88.3,1
HCPCS,86931,FROZEN BLOOD THAW,,,66.29,371.54,15
HCPCS,86931,Frozen blood thaw,,,51.52,65.08,6
HCPCS,869310,FROZEN BLOOD THAW,,,66.29,66.29,1
HCPCS,86932,FROZEN BLOOD FREEZE/THAW,,,39.0,85.1,15
HCPCS,86932,Frozen blood freeze/thaw,,,51.52,65.08,6
HCPCS,869320,FROZEN BLOOD FREEZE/THAW,,,74.93,74.93,1
HCPCS,86940,ARCDL HEMOLYSINS/AGG AU,121.0,78.65,2.08,108.9,37
HCPCS,86940,HEMOLYSINS/AGGLUTININS AUTO,,,7.58,7.58,1
HCPCS,869400,HEMOLYSINS/AGGLUTININS AUTO,,,7.58,7.58,1
HCPCS,86941,ARCDL HEMOLYSINS INCUB,160.0,104.0,2.08,144.0,37
HCPCS,86941,HEMOLYSINS/AGGLUTININS,,,10.47,10.47,1
HCPCS,869410,HEMOLYSINS/AGGLUTININS,,,10.47,10.47,1
HCPCS,86945,BLOOD PRODUCT/IRRADIATION,,,22.01,22.01,1
HCPCS,86945,IRRADIATION BLOOD PRODUCT,95.0,61.75,24.61,85.5,37
HCPCS,869450,BLOOD PRODUCT/IRRADIATION,,,22.01,22.01,1
HCPCS,86950,LEUKACYTE TRANSFUSION,,,57.38,371.54,15
HCPCS,86950,Leukacyte transfusion,,,51.52,65.08,6
HCPCS,869500,LEUKACYTE TRANSFUSION,,,57.38,57.38,1
HCPCS,86960,VOL REDUCTION OF BLOOD/PROD,,,24.62,371.54,15
HCPCS,86960,Vol reduction of blood/prod,,,51.52,65.08,6
HCPCS,869600,VOL REDUCTION OF BLOOD/PROD,,,24.62,24.62,1
HCPCS,86965,POOLING BLOOD PLATELETS,,,24.62,24.62,1
HCPCS,86965,POOLING BLOOD PLT,180.0,117.0,46.62,371.54,37
HCPCS,86965,POOLING BLOOD PLT OR OTHER BLD PRD,180.0,117.0,46.62,371.54,37
HCPCS,869650,POOLING BLOOD PLATELETS,,,24.62,24.62,1
HCPCS,86970,DTT TREATMENT,202.0,131.3,51.52,181.8,37
HCPCS,86970,PRETREAT RBC AB ID DRUG,178.0,115.7,46.1,160.2,37
HCPCS,86970,RBC PRETX INCUBATJ W/CHEMICL,,,22.01,22.01,1
HCPCS,869700,RBC PRETX INCUBATJ W/CHEMICL,,,22.01,22.01,1
HCPCS,86971,PRETREATMENT W/ENZYME,257.0,167.05,51.52,371.54,37
HCPCS,86971,RBC PRETX INCUBATJ W/ENZYMES,,,17.55,17.55,1
HCPCS,869710,RBC PRETX INCUBATJ W/ENZYMES,,,17.55,17.55,1
HCPCS,86972,PRETREAT RBC AB ID DENSITYSEP,323.0,209.95,51.52,371.54,37
HCPCS,86972,RBC PRETX INCUBATJ W/DENSITY,,,30.92,30.92,1
HCPCS,869720,RBC PRETX INCUBATJ W/DENSITY,,,30.92,30.92,1
HCPCS,86975,RBC SERUM PRETX INCUBJ DRUGS,,,23.85,865.18,15
HCPCS,86975,Rbc serum pretx incubj drugs,,,51.52,65.08,6
HCPCS,869750,RBC SERUM PRETX INCUBJ DRUGS,,,23.85,23.85,1
HCPCS,86976,PREWARM MODIFICATION,98.0,63.7,24.58,88.2,37
HCPCS,86976,RBC SERUM PRETX ID DILUTION,,,26.46,26.46,1
HCPCS,869760,RBC SERUM PRETX ID DILUTION,,,26.46,26.46,1
HCPCS,86977,*PRETREAT SERUM AB ID INCUBATE,180.0,117.0,46.62,371.54,37
HCPCS,86977,PRETREAT SERUM AB ID INCUBATE,180.0,117.0,46.62,371.54,37
HCPCS,86977,R E S ABSORP TEST,180.0,117.0,46.62,371.54,37
HCPCS,86977,RBC SERUM PRETX INCUBJ/INHIB,,,26.46,26.46,1
HCPCS,869770,RBC SERUM PRETX INCUBJ/INHIB,,,26.46,26.46,1
HCPCS,86978,PRETREAT SERUM AB ID ABSORP,409.0,265.85,51.52,368.1,37
HCPCS,86978,RBC PRETREATMENT SERUM,,,26.46,26.46,1
HCPCS,86978,TRIPLE ABSORPTION X3,442.0,287.3,51.52,397.8,37
HCPCS,869780,RBC PRETREATMENT SERUM,,,26.46,26.46,1
HCPCS,86985,SPLIT BLOOD OR PRODUCTS,,,19.39,19.39,1
HCPCS,86985,SPLITTING BLOOD/BLOOD PRODUCTS EACH UNIT,189.0,122.85,48.95,371.54,37
HCPCS,869850,SPLIT BLOOD OR PRODUCTS,,,19.39,19.39,1
HCPCS,86999,UNLISTED TRANSFUSION MED PX,,,24.58,53.1,14
HCPCS,86999,Unlisted transfusion med px,,,2.08,2.63,6
HCPCS,87003,SMALL ANIMAL INOCULATION,,,14.55,28.14,15
HCPCS,87003,Small animal inoculation,,,4.02,5.08,6
HCPCS,870030,SMALL ANIMAL INOCULATION,,,14.55,14.55,1
HCPCS,87015,*CONC FOR INFECTIOUS AGENT,14.0,9.1,3.5,12.6,37
HCPCS,87015,*CONCENTRATION FOR INFECT AGNT,43.0,27.95,4.02,38.7,37
HCPCS,87015,CONCENTRATION FOR INFECT AGNT,37.0,24.05,4.02,33.3,37
HCPCS,87015,PROCESSING AFB REDIGESTION,40.0,26.0,4.02,36.0,37
HCPCS,87015,"PROCESSING, AFB CONCENTRATION",45.0,29.25,4.02,40.5,37
HCPCS,87015,"PROCESSING, CYTOSPIN",40.0,26.0,4.02,36.0,37
HCPCS,87015,"PROCESSING, FLUID CONCENTRATION",74.0,48.1,4.02,66.6,37
HCPCS,87015,"PROCESSING, THICK SMEAR PREPARATION",40.0,26.0,4.02,36.0,37
HCPCS,87015,SPECIMEN INFECT AGNT CONCNTJ,,,5.77,5.77,1
HCPCS,870150,SPECIMEN INFECT AGNT CONCNTJ,,,5.77,5.77,1
HCPCS,87040,BLOOD CULTURE FOR BACTERIA,,,8.92,8.92,1
HCPCS,87040,CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES,193.0,125.45,4.33,193.0,17
HCPCS,87040,"CULTURE, BACTERIAL, BLOOD, AEROBIC AND ANAEROBIC",249.0,161.85,4.02,224.1,37
HCPCS,870400,BLOOD CULTURE FOR BACTERIA,,,8.92,8.92,1
HCPCS,87045,*CULT STOOL AEROBIC SALM SHIG,13.0,8.45,3.25,13.0,37
HCPCS,87045,CUL BACT STOOL AEROBIC ISOL SALMONELLA&SHIGELL,155.0,100.75,3.96,155.0,17
HCPCS,87045,"CULTURE, BACTERIAL, STOOL, SALMONELLA SHIGELLA",73.0,47.45,4.02,65.7,37
HCPCS,87045,FECES CULTURE AEROBIC BACT,,,8.15,8.15,1
HCPCS,870450,FECES CULTURE AEROBIC BACT,,,8.15,8.15,1
HCPCS,87046,*CULT AEROBIC ADD PATH PRES ID,17.0,11.05,3.25,18.9,74
HCPCS,87046,CUL BACT STOOL AEROBIC ADDL PATHOGENS&ID EA,117.0,76.05,3.96,117.0,17
HCPCS,87046,CULT AEROBIC ADD PATH,25.5,16.575,4.02,28.8,74
HCPCS,87046,"CULTURE, BACTERIAL, STOOL, EACH PLATE",96.0,62.4,4.02,86.4,37
HCPCS,87046,STOOL CULTR AEROBIC BACT EA,,,8.15,8.15,1
HCPCS,870460,STOOL CULTR AEROBIC BACT EA,,,8.15,8.15,1
HCPCS,87070,%IOHWC CULTURE,111.0,72.15,4.02,99.9,37
HCPCS,87070,*BACTERIAL CULTURE OTHR SOURCE,80.0,52.0,4.02,72.0,37
HCPCS,87070,*BACTERIAL CULTURE-OTHR SOURCE,44.0,28.6,4.02,39.6,37
HCPCS,87070,BACTERIAL CULTURE OTHR SOURCE,215.0,139.75,4.02,193.5,74
HCPCS,87070,CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL,100.0,65.0,3.62,100.0,17
HCPCS,87070,CULT AEROBIC OTHER PRES ID,34.5,22.425,4.02,42.3,74
HCPCS,87070,CULT FLD EX CSF,13.0,8.45,3.62,13.0,17
HCPCS,87070,CULTURE AEROBIC OTHER PRES ID,20.0,13.0,4.02,18.0,37
HCPCS,87070,CULTURE OTHR SPECIMN AEROBIC,,,7.45,7.45,1
HCPCS,87070,"CULTURE, BACTERIAL, AEROBIC",215.0,139.75,4.02,193.5,37
HCPCS,87070,HELI PYL CULT,13.0,8.45,3.62,13.0,17
HCPCS,870700,CULTURE OTHR SPECIMN AEROBIC,,,7.45,7.45,1
HCPCS,87071,CULTURE AEROBIC QUANT OTHER,,,8.54,8.54,1
HCPCS,87071,"CULTURE, BACTERIAL, AEROBIC, QUANTITATIVE",89.0,57.85,4.02,80.1,37
HCPCS,870710,CULTURE AEROBIC QUANT OTHER,,,8.54,8.54,1
HCPCS,87073,CULTURE BACTERIA ANAEROBIC,,,8.35,16.14,15
HCPCS,87073,Culture bacteria anaerobic,,,4.02,5.08,6
HCPCS,870730,CULTURE BACTERIA ANAEROBIC,,,8.35,8.35,1
HCPCS,87075,CULTR BACTERIA EXCEPT BLOOD,,,8.19,8.19,1
HCPCS,87075,CULTURE BACTERIAL ANY SOURCE ANAEROBIC ISO&ID,231.0,150.15,3.98,231.0,17
HCPCS,87075,"CULTURE, BACTERIAL, ANAEROBIC",253.0,164.45,4.02,227.7,37
HCPCS,870750,CULTR BACTERIA EXCEPT BLOOD,,,8.19,8.19,1
HCPCS,87076,CUL BACT ANAEROBIC ADDL METHS DEFINITIVE EA ISOL,87.0,56.55,3.39,87.0,17
HCPCS,87076,CULT ANAEROBIC DEFIN ID EA,68.0,44.2,4.02,61.2,37
HCPCS,87076,CULTURE ANAEROBE IDENT EACH,,,6.98,6.98,1
HCPCS,87076,"IDENTIFICATION, ANAEROBIC ISOLATE",77.0,50.05,4.02,69.3,37
HCPCS,870760,CULTURE ANAEROBE IDENT EACH,,,6.98,6.98,1
HCPCS,87077,CUL BACT AEROBIC ADDL METHS DEFINITIVE EA ISOL,29.0,18.85,3.39,29.0,17
HCPCS,87077,CULT AEROBIC DEFIN ID EA ISOL,51.0,33.15,4.02,55.8,74
HCPCS,87077,CULT AEROBIC ID PROFESSIONAL FEE,13.0,8.45,3.39,13.0,17
HCPCS,87077,CULTURE AEROBIC IDENTIFY,,,6.98,13.5,4
HCPCS,87077,ID BACT/YST/MALD TOF,12.0,7.8,3.0,12.0,37
HCPCS,87077,"IDENTIFICATION, AEROBIC ISOLATE",64.0,41.6,4.02,57.6,37
HCPCS,87077,"IDENTIFICATION, AEROBIC ISOLATE (POINT OF CARE LAB)",64.0,41.6,4.02,57.6,37
HCPCS,870770,CULTURE AEROBIC IDENTIFY,,,6.98,6.98,1
HCPCS,87077QW,CULTURE AEROBIC IDENTIFY,,,12.46,13.5,3
HCPCS,87081,*CULTURE P PATHOG-SCREEN,43.0,27.95,4.02,38.7,37
HCPCS,87081,CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ,79.0,51.35,2.78,79.0,17
HCPCS,87081,CULT BAC SCREEN PROFESSIONAL FEE,13.0,8.45,2.78,13.0,17
HCPCS,87081,CULT SCREEN ONLY,19.0,12.35,4.02,17.1,37
HCPCS,87081,CULTURE SCREEN ONLY,,,5.72,5.72,1
HCPCS,87081,"CULTURE, PRESUMPTIVE SCREENING",182.0,118.3,4.02,163.8,37
HCPCS,870810,CULTURE SCREEN ONLY,,,5.72,5.72,1
HCPCS,87084,CULTURE OF SPECIMEN BY KIT,,,23.39,45.23,15
HCPCS,87084,Culture of specimen by kit,,,4.02,5.08,6
HCPCS,87084,RAPID FLU TESTING,20.0,13.0,9.52,20.0,17
HCPCS,870840,CULTURE OF SPECIMEN BY KIT,,,23.39,23.39,1
HCPCS,87086,CULT/COLONY COUNT QUANT URINE,142.0,92.3,4.02,127.8,37
HCPCS,87086,CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE,29.0,18.85,3.39,29.0,17
HCPCS,87086,"CULTURE,  BACTERIAL, URINE, QUANTITATIVE",142.0,92.3,4.02,127.8,37
HCPCS,87086,URINE CULTURE/COLONY COUNT,,,6.98,6.98,1
HCPCS,870860,URINE CULTURE/COLONY COUNT,,,6.98,6.98,1
HCPCS,87088,"IDENTIFICATION, URINE, PRESUMPTIVE",101.0,65.65,4.02,90.9,37
HCPCS,87088,URINE BACTERIA CULTURE,,,6.99,6.99,1
HCPCS,870880,URINE BACTERIA CULTURE,,,6.99,6.99,1
HCPCS,87101,*CULT FUNGUS W P ID; SKIN HR NL,24.0,15.6,4.02,21.6,37
HCPCS,87101,CULT FUNGI SKIN HAIR NAIL,24.0,15.6,4.02,21.6,37
HCPCS,87101,"CULTURE, FUNGAL ISOLATION, HAIR, SKIN, NAIL",24.0,15.6,4.02,21.6,37
HCPCS,87101,SKIN FUNGI CULTURE,,,6.66,6.66,1
HCPCS,871010,SKIN FUNGI CULTURE,,,6.66,6.66,1
HCPCS,87102,*CULT FUNGI PRES ID OTHER,18.5,12.024999999999999,3.25,21.6,74
HCPCS,87102,CULT FUNGI PRES ID OTHER,21.5,13.975,4.02,21.6,74
HCPCS,87102,"CULTURE, FUNGAL ISOLATION",13.0,8.45,3.25,13.0,37
HCPCS,87102,FUNGUS ISOLATION CULTURE,,,7.27,7.27,1
HCPCS,871020,FUNGUS ISOLATION CULTURE,,,7.27,7.27,1
HCPCS,87103,*CULT FUNGI PRES ID BLOOD,48.0,31.2,4.02,43.2,37
HCPCS,87103,BLOOD FUNGUS CULTURE,,,17.68,17.68,1
HCPCS,87103,"CULTURE, FUNGAL ISOLATION, BLOOD",48.0,31.2,4.02,43.2,37
HCPCS,871030,BLOOD FUNGUS CULTURE,,,17.68,17.68,1
HCPCS,87106,CULT FUNGI DEFIN ID YEAST,50.5,32.825,4.02,61.2,74
HCPCS,87106,FUNGI IDENTIFICATION YEAST,,,8.92,8.92,1
HCPCS,87106,"IDENTIFICATION, YEAST",131.0,85.15,4.02,117.9,37
HCPCS,871060,FUNGI IDENTIFICATION YEAST,,,8.92,8.92,1
HCPCS,87107,CULT FUNGI DEFIN ID MOLD,34.0,22.1,4.02,30.6,37
HCPCS,87107,FUNGI IDENTIFICATION MOLD,,,8.92,8.92,1
HCPCS,87107,"IDENTIFICATION, MOLD",33.0,21.45,4.02,29.7,37
HCPCS,871070,FUNGI IDENTIFICATION MOLD,,,8.92,8.92,1
HCPCS,87109,CULT MYCOPLASMA ANY SOURCE,106.0,68.9,4.02,154.8,74
HCPCS,87109,"CULTURE, MYCOPLASMA",143.0,92.95,4.02,128.7,37
HCPCS,87109,MYCOPLASMA,,,13.29,13.29,1
HCPCS,871090,MYCOPLASMA,,,13.29,13.29,1
HCPCS,87110,*CULT CHLAMYDIA ANY SOURCE,63.0,40.95,4.02,56.7,37
HCPCS,87110,CHLAMYDIA CULTURE,,,16.93,16.93,1
HCPCS,871100,CHLAMYDIA CULTURE,,,16.93,16.93,1
HCPCS,87116,*CULT TUBERCLE PRES ID,57.0,37.05,4.02,51.3,37
HCPCS,87116,CULT TUBERCLE PRES ID,31.5,20.475,4.02,30.6,74
HCPCS,87116,"CULTURE, ACID FAST",56.0,36.4,4.02,50.4,37
HCPCS,87116,MYCOBACTERIA CULTURE,,,9.33,9.33,1
HCPCS,871160,MYCOBACTERIA CULTURE,,,9.33,9.33,1
HCPCS,87118,CULT MYCOBACTERIA DEFIN ID,99.0,64.35,4.02,89.1,37
HCPCS,87118,"IDENTIFICATION, MYCOBACTERIAL",97.0,63.05,4.02,87.3,37
HCPCS,87118,MYCOBACTERIC IDENTIFICATION,,,12.63,12.63,1
HCPCS,871180,MYCOBACTERIC IDENTIFICATION,,,12.63,12.63,1
HCPCS,87140,*CULT TYPE IF EA ANTISERUM,63.0,40.95,4.02,56.7,37
HCPCS,87140,CULT TYPE IF EA ANTISERUM,122.0,79.3,4.02,109.8,37
HCPCS,87140,CULTURE TYPE IMMUNOFLUORESC,,,4.82,4.82,1
HCPCS,871400,CULTURE TYPE IMMUNOFLUORESC,,,4.82,4.82,1
HCPCS,87143,CULTURE TYPING GLC/HPLC,,,10.82,20.92,15
HCPCS,87143,Culture typing glc/hplc,,,4.02,5.08,6
HCPCS,871430,CULTURE TYPING GLC/HPLC,,,10.82,10.82,1
HCPCS,87147,CULTURE TYPE IMMUNOLOGIC,48.0,31.2,4.02,43.2,38
HCPCS,87147,TYPING BY IMMUNOLOGIC METHOD,56.0,36.4,4.02,50.4,37
HCPCS,871470,CULTURE TYPE IMMUNOLOGIC,,,4.47,4.47,1
HCPCS,87149,CULT TYPE ID BY NUCLEIC ACID,56.0,36.4,4.02,50.4,37
HCPCS,87149,DNA/RNA DIRECT PROBE,,,17.32,17.32,1
HCPCS,87149,GNB BLD CULT ID VERIGENE,172.0,111.8,4.02,154.8,37
HCPCS,87149,GPC BLD CULT ID VERIGENE,172.0,111.8,4.02,154.8,37
HCPCS,87149,MICRO ID BY PNA FISH,172.0,111.8,4.02,154.8,37
HCPCS,871490,DNA/RNA DIRECT PROBE,,,17.32,17.32,1
HCPCS,87150,"AMPLIFICATION, STREPTOCOCCUS, GROUP B WITH LIM BROTH",242.0,157.3,25.65,217.8,37
HCPCS,87150,BCID DNA/RNA AMP PROBE,107.0,69.55,25.65,96.3,37
HCPCS,87150,CLARITHROMYCIN RESIST,419.0,272.35,25.65,377.1,37
HCPCS,87150,CLARITHROMYCIN RESISTANCE,129.0,83.85,25.65,116.1,37
HCPCS,87150,DNA/RNA AMPLIFIED PROBE,427.0,277.54999999999995,25.65,385.2,75
HCPCS,87150,ID M. CHEL ABSC GRP 2,129.0,83.85,25.65,116.1,37
HCPCS,871500,DNA/RNA AMPLIFIED PROBE,,,30.32,30.32,1
HCPCS,87152,CULTURE TYPE PULSE FIELD GEL,,,6.69,12.93,15
HCPCS,87152,Culture type pulse field gel,,,4.02,5.08,6
HCPCS,871520,CULTURE TYPE PULSE FIELD GEL,,,6.69,6.69,1
HCPCS,87153,DNA/RNA SEQUENCING,,,99.67,99.67,1
HCPCS,87153,"IDENTIFICATION, NUCLEIC ACID SEQUENCING",856.0,556.4,92.55,770.4,37
HCPCS,871530,DNA/RNA SEQUENCING,,,99.67,99.67,1
HCPCS,87154,CUL TYP ID BLD PTHGN 6+ TRGT,,,188.41,188.41,1
HCPCS,87154,"IDENTIFICATION, BLOOD PATHOGEN PANEL",351.0,228.15,87.75,351.0,37
HCPCS,871540,CUL TYP ID BLD PTHGN 6+ TRGT,,,188.41,188.41,1
HCPCS,87158,CULTURE TYPING ADDED METHOD,,,6.69,6.69,1
HCPCS,87158,CULTURE TYPING OTHER METHODS,168.0,109.2,3.25,168.0,17
HCPCS,87158,CULTURE;OTHER METHODS,179.0,116.35,4.02,161.1,37
HCPCS,87158,ID BY PYROSEQUENCING,108.5,70.525,4.02,158.4,74
HCPCS,87158,"IDENTIFICATION, OTHER METHODS",102.0,66.3,4.02,91.8,37
HCPCS,871580,CULTURE TYPING ADDED METHOD,,,6.69,6.69,1
HCPCS,87164,DARK FIELD EXAM SPEC COLLJ,,,9.28,17.95,15
HCPCS,87164,Dark field exam spec collj,,,4.02,5.08,6
HCPCS,871640,DARK FIELD EXAM SPEC COLLJ,,,9.28,9.28,1
HCPCS,87166,DARK FIELD EXAM W/O COLLJ,,,9.76,18.88,15
HCPCS,87166,Dark field exam w/o collj,,,4.02,5.08,6
HCPCS,871660,DARK FIELD EXAM W/O COLLJ,,,9.76,9.76,1
HCPCS,87168,MACROSCOPIC EXAM ARTHROPOD,57.0,37.05,3.69,51.3,38
HCPCS,87168,"MACROSCOPIC EXAM, ARTHROPOD",50.0,32.5,4.02,45.0,37
HCPCS,871680,MACROSCOPIC EXAM ARTHROPOD,,,3.69,3.69,1
HCPCS,87169,MACROSCOPIC EXAM PARASITE,14.0,9.1,3.5,12.6,38
HCPCS,87169,"MACROSCOPIC EXAM, PARASITE",14.0,9.1,3.5,12.6,37
HCPCS,871690,MACROSCOPIC EXAM PARASITE,,,3.73,3.73,1
HCPCS,87172,PIN WORM PREP,46.0,29.9,2.56,46.0,17
HCPCS,87172,PINWORM EXAM,14.0,9.1,3.5,12.6,38
HCPCS,87172,PINWORM PREP PERIANAL,36.0,23.4,4.02,32.4,37
HCPCS,87172,PINWORM PREP PERIANAL (POINT OF CARE LAB),36.0,23.4,4.02,32.4,37
HCPCS,871720,PINWORM EXAM,,,3.69,3.69,1
HCPCS,87176,"PROCESSING, TISSUE HOMOGENIZATION",44.0,28.6,4.02,39.6,37
HCPCS,87176,TISSUE HOMOGENIZATION CULTR,,,5.08,5.08,1
HCPCS,871760,TISSUE HOMOGENIZATION CULTR,,,5.08,5.08,1
HCPCS,87177,*OVA & PARASITE DIR SMEAR ID,12.0,7.8,3.0,12.0,37
HCPCS,87177,"CONCENTRATION AND ID, OVA AND PARASITE",12.0,7.8,3.0,12.0,37
HCPCS,87177,OVA & PARASITE DIR SMEAR ID,12.0,7.8,3.0,12.0,37
HCPCS,87177,OVA AND PARASITES SMEARS,,,7.69,7.69,1
HCPCS,87177,OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID,98.0,63.7,3.74,98.0,17
HCPCS,871770,OVA AND PARASITES SMEARS,,,7.69,7.69,1
HCPCS,87181,SC STD AGAR DILUTION PER AGT,,,4.1,4.1,1
HCPCS,87181,"SUSCEPTIBILITY, AGAR DILUTION, PER AGENT",35.0,22.75,4.02,31.5,37
HCPCS,871810,SC STD AGAR DILUTION PER AGT,,,4.1,4.1,1
HCPCS,87182,"SUSCEPTIBILITY, CARBAPENAMASE ENZYME DETECTION, PER ISOLATE",260.0,169.0,4.02,234.0,27
HCPCS,87183,SC STD CARBAPENEM RESIST GEN,,,30.32,38.6,5
HCPCS,87183,Sc std carbapenem resist gen,,,25.65,32.4,6
HCPCS,871830,SC STD CARBAPENEM RESIST GEN,,,30.32,30.32,1
HCPCS,87184,SC STD DISK METHOD PER PLATE,,,6.46,6.46,1
HCPCS,87184,SENSITIVITY - DISK PER PLATE,64.0,41.6,4.02,57.6,37
HCPCS,87184,"SUSCEPTIBILITY, DISK METHOD, PER PLATE",72.0,46.8,4.02,64.8,37
HCPCS,871840,SC STD DISK METHOD PER PLATE,,,6.46,6.46,1
HCPCS,87185,SC STD ENZYME DETCJ PER NZM,,,4.1,4.1,1
HCPCS,87185,"SUSCEPTIBILITY, ENZYME DETECTION, PER ENZYME",34.0,22.1,4.02,30.6,37
HCPCS,871850,SC STD ENZYME DETCJ PER NZM,,,4.1,4.1,1
HCPCS,87186,*SUSCEPTIBILITY MIC,42.5,27.625,4.02,56.7,74
HCPCS,87186,MICRO SENSITIVITY,43.0,27.95,4.02,38.7,37
HCPCS,87186,MISC SENDOUT CPT 87186,99.0,64.35,4.02,89.1,37
HCPCS,87186,SC STD MICRODIL/AGAR DIL,,,7.47,7.47,1
HCPCS,87186,SUSCEPTIBILITY MIC,32.0,20.8,4.02,31.5,111
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL",107.0,69.55,4.02,96.3,37
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL AFB",93.0,60.45,4.02,83.7,37
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL PHOENIX",93.0,60.45,4.02,83.7,37
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL SENSITITRE",93.0,60.45,4.02,83.7,37
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL VITEK",93.0,60.45,4.02,83.7,37
HCPCS,87186,SUSCEPTIBLTY STDY ANTIMICRBIAL MICRO/AGAR DILUTJ,29.0,18.85,3.63,29.0,17
HCPCS,871860,SC STD MICRODIL/AGAR DIL,,,7.47,7.47,1
HCPCS,87187,SC STD MICRODIL/AGAR MLC,,,34.71,67.12,15
HCPCS,87187,Sc std microdil/agar mlc,,,25.65,32.4,6
HCPCS,871870,SC STD MICRODIL/AGAR MLC,,,34.71,34.71,1
HCPCS,87188,AMBCAN AMPHOTERICIN B/CANDIN SUSCEPTIBILITY PANEL X4,69.0,44.85,4.02,62.1,37
HCPCS,87188,AZOLE PANEL X4,207.0,134.55,4.02,186.3,37
HCPCS,87188,MOLD SUSCEPT 2 DRUG X2,103.0,66.95,4.02,92.7,37
HCPCS,87188,MOLD SUSCEPT 3 DRUGS X3,103.0,66.95,4.02,92.7,37
HCPCS,87188,SC STD MACROBROTH DIL METH,,,5.73,5.73,1
HCPCS,87188,SUSCEPTIBILITY MACROBROTH,245.0,159.25,4.02,286.2,74
HCPCS,871880,SC STD MACROBROTH DIL METH,,,5.73,5.73,1
HCPCS,87190,SC STD MYOBACTERIA PROP METH,,,6.32,12.22,15
HCPCS,87190,Sc std myobacteria prop meth,,,4.02,5.08,6
HCPCS,871900,SC STD MYOBACTERIA PROP METH,,,6.32,6.32,1
HCPCS,87197,SERUM BACTERICIDAL TITER,,,12.98,25.1,15
HCPCS,87197,Serum bactericidal titer,,,4.02,5.08,6
HCPCS,871970,SERUM BACTERICIDAL TITER,,,12.98,12.98,1
HCPCS,87205,%IOHWC GRAM STAIN,56.0,36.4,4.02,50.4,37
HCPCS,87205,*SMEAR GRAM STAIN,74.0,48.1,4.02,66.6,37
HCPCS,87205,GRAM STAIN,13.0,8.45,1.79,13.0,17
HCPCS,87205,KRUGER'S TEST,81.0,52.65,4.02,72.9,37
HCPCS,87205,SMEAR - GRAM OR GIEMSA,46.0,29.900000000000002,4.02,52.2,74
HCPCS,87205,SMEAR GRAM STAIN,,,3.69,3.69,1
HCPCS,87205,"SMEAR, GRAM STAIN",74.0,48.1,4.02,66.6,37
HCPCS,87205,SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL,58.0,37.7,1.79,58.0,17
HCPCS,872050,SMEAR GRAM STAIN,,,3.69,3.69,1
HCPCS,87206,*SMEAR FLUORESCENT/ACID STAIN,10.5,6.824999999999999,2.25,10.8,74
HCPCS,87206,SMEAR FLUORESCENT/ACID STAI,,,4.65,4.65,1
HCPCS,87206,SMEAR FLUORESCENT/ACID STAIN,15.0,9.75,2.25,20.7,111
HCPCS,87206,"SMEAR, ACID FAST FLUORESCENT",32.0,20.8,4.02,28.8,37
HCPCS,87206,"SMEAR, FUNGAL FLUORESCENT",12.0,7.8,3.0,10.8,37
HCPCS,872060,SMEAR FLUORESCENT/ACID STAI,,,4.65,4.65,1
HCPCS,87207,EHRLICHIA AND ANAPLASMA MICRO,176.0,114.4,4.02,158.4,37
HCPCS,87207,SMEAR SPECIAL STAIN,73.0,47.449999999999996,4.02,98.1,75
HCPCS,87207,"SMEAR, BLOOD PARASITE",109.0,70.85,4.02,98.1,37
HCPCS,87207,"SMEAR, PARASITE SPECIAL STAIN",111.5,72.475,2.52,160.0,54
HCPCS,872070,SMEAR SPECIAL STAIN,,,5.17,5.17,1
HCPCS,87209,SMEAR COMPLEX STAIN,,,15.53,15.53,1
HCPCS,87209,"SMEAR, TRICHROME STAIN",149.0,96.85,4.02,134.1,37
HCPCS,872090,SMEAR COMPLEX STAIN,,,15.53,15.53,1
HCPCS,87210,KOH PREP,13.0,8.45,3.49,13.0,17
HCPCS,87210,SMEAR - INFECTIOUS WET MOUNT,9.0,5.85,2.25,9.0,37
HCPCS,87210,SMEAR WET MOUNT,74.0,48.1,4.02,66.6,37
HCPCS,87210,SMEAR WET MOUNT SALINE/INK,,,5.03,9.73,4
HCPCS,87210,SMR PRIM SRC WET MOUNT NFCT AGT,31.0,20.15,3.49,31.0,17
HCPCS,87210,WET MNT W/SMP S PROFESSIONAL FEE,13.0,8.45,3.49,13.0,17
HCPCS,872100,SMEAR WET MOUNT SALINE/INK,,,5.03,5.03,1
HCPCS,87210QW,SMEAR WET MOUNT SALINE/INK,,,8.97,9.73,3
HCPCS,87220,KOH EXAM (POINT OF CARE LAB),37.0,24.05,4.02,33.3,37
HCPCS,87220,KOH FOR FUNGI/PARASITES/MITES,9.0,5.85,2.25,8.1,37
HCPCS,87220,TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT,29.0,18.85,2.56,29.0,17
HCPCS,87220,TISSUE EXAM FOR FUNGI,,,3.69,3.69,1
HCPCS,87220,TISSUE EXAM KOH,41.0,26.65,4.02,36.9,37
HCPCS,872200,TISSUE EXAM FOR FUNGI,,,3.69,3.69,1
HCPCS,87230,C DIFF CYTOTOX CELL ASY,157.0,102.05,4.02,141.3,37
HCPCS,87230,TOXIN/ANTITOXIN ASSAY TISSUE CULTURE,75.0,48.75,8.29,75.0,17
HCPCS,87230,TOXIN/ANTITOXIN ASY TISS CUL,,,17.05,17.05,1
HCPCS,872300,TOXIN/ANTITOXIN ASY TISS CUL,,,17.05,17.05,1
HCPCS,87250,VIRUS INOCULATE EGGS/ANIMAL,,,16.9,32.68,15
HCPCS,87250,Virus inoculate eggs/animal,,,4.02,5.08,6
HCPCS,872500,VIRUS INOCULATE EGGS/ANIMAL,,,16.9,16.9,1
HCPCS,87251,OTHER VIRUSID,13.0,8.45,6.5,13.0,12
HCPCS,87252,%HSVCUL VIR INNOC TISSUE,56.0,36.4,4.02,50.4,37
HCPCS,87252,*VIRUS INOCULATION TIS CYTPATH,77.0,50.05,4.02,69.3,37
HCPCS,87252,ENTEROVIRUS CULTURE,227.0,147.55,4.02,204.3,37
HCPCS,87252,OTHR VIRUS CULT,13.0,8.45,6.5,28.8,17
HCPCS,87252,PARAINFLUENZA CULTURE,131.0,85.15,10.95,131.0,17
HCPCS,87252,TISSUE CULTURE,75.0,48.75,4.02,67.5,37
HCPCS,87252,VIRUS INOCULATION TISSUE,,,22.53,22.53,1
HCPCS,87252,VIRUS TISS CUL INOCULATION CYTOPATHIC EFFECT,15.0,9.75,7.5,28.8,17
HCPCS,872520,VIRUS INOCULATION TISSUE,,,22.53,22.53,1
HCPCS,87253,%HSVCUL VIR INNOC TIS ADD,56.0,36.4,4.02,50.4,37
HCPCS,87253,*VIRUS INOCULATION ADD STUDY,479.0,311.35,4.02,431.1,37
HCPCS,87253,CULT BLOOD ISOL W PRES ID,59.0,38.35,4.02,53.1,37
HCPCS,87253,VIRUS CULTURE W/STAIN,230.0,149.5,4.02,207.0,37
HCPCS,87253,VIRUS INOCULATE TISSUE ADDL,,,17.45,17.45,1
HCPCS,87253,VIRUS INOCULATION ADD STUDY,57.0,37.05,4.02,71.1,222
HCPCS,872530,VIRUS INOCULATE TISSUE ADDL,,,17.45,17.45,1
HCPCS,87254,*VIRUS INOCULATION SHELL VIAL,75.0,48.75,4.02,67.5,37
HCPCS,87254,CULTURE ANTIGEN DFA,77.0,50.05,4.02,69.3,37
HCPCS,87254,CYTOMEGALOVIRUS,109.0,70.85,4.02,98.1,37
HCPCS,87254,IN HOUSE CULT ANTIGEN DFA,150.0,97.5,4.02,135.0,37
HCPCS,87254,VIRUS INOCULATION SHELL VIA,,,16.9,16.9,1
HCPCS,872540,VIRUS INOCULATION SHELL VIA,,,16.9,16.9,1
HCPCS,87255,GENET VIRUS ISOLATE HSV,,,29.26,29.26,1
HCPCS,87255,HERPES SIMPLEX CULTURE,362.0,235.3,25.65,325.8,37
HCPCS,87255,HSVCUL GENETIC VIRUS ISOLATION HSV,109.0,70.85,25.65,98.1,37
HCPCS,87255,VIRUS ID NON-IMMUNOLOGIC,362.0,235.3,25.65,325.8,37
HCPCS,872550,GENET VIRUS ISOLATE HSV,,,29.26,29.26,1
HCPCS,87260,*%DFA ADENO,95.0,61.75,4.02,85.5,37
HCPCS,87260,*ADENOVIRUS AG IF,25.0,16.25,4.02,24.11,37
HCPCS,87260,ADENOVIRUS AG IF,35.0,22.75,4.02,31.5,38
HCPCS,872600,ADENOVIRUS AG IF,,,12.46,12.46,1
HCPCS,87265,*BORDATELLA P AG BY DFA,17.0,11.05,4.02,17.0,37
HCPCS,87265,*BORDATELLA PERTUSSIS AG BY DFA,17.0,11.05,4.02,17.0,37
HCPCS,87265,BORDETELLA PERTUSS DFA X2,17.0,11.05,4.02,17.0,37
HCPCS,87265,PERTUSSIS AG IF,,,10.35,10.35,1
HCPCS,872650,PERTUSSIS AG IF,,,10.35,10.35,1
HCPCS,87267,ENTEROVIRUS ANTIBODY DFA,,,11.6,22.42,15
HCPCS,87267,Enterovirus antibody dfa,,,4.02,5.08,6
HCPCS,872670,ENTEROVIRUS ANTIBODY DFA,,,11.6,11.6,1
HCPCS,87269,GIARDIA AG IF,,,11.76,22.74,15
HCPCS,87269,Giardia ag if,,,4.02,5.08,6
HCPCS,872690,GIARDIA AG IF,,,11.76,11.76,1
HCPCS,87270,CHLAMYDIA TRACHOMATIS AG IF,,,10.35,20.02,15
HCPCS,87270,Chlamydia trachomatis ag if,,,4.02,5.08,6
HCPCS,872700,CHLAMYDIA TRACHOMATIS AG IF,,,10.35,10.35,1
HCPCS,87271,CYTOMEGALOVIRUS DFA,,,11.6,22.42,15
HCPCS,87271,Cytomegalovirus dfa,,,4.02,5.08,6
HCPCS,872710,CYTOMEGALOVIRUS DFA,,,11.6,11.6,1
HCPCS,87272,CRYPTOSPORIDIUM AG IF,,,10.35,20.02,15
HCPCS,87272,Cryptosporidium ag if,,,4.02,5.08,6
HCPCS,872720,CRYPTOSPORIDIUM AG IF,,,10.35,10.35,1
HCPCS,87273,HERPES SIMPLEX 2 AG IF,,,10.35,20.02,15
HCPCS,87273,Herpes simplex 2 ag if,,,4.02,5.08,6
HCPCS,872730,HERPES SIMPLEX 2 AG IF,,,10.35,10.35,1
HCPCS,87274,HERPES SIMPLEX 1 AG IF,,,10.35,20.02,15
HCPCS,87274,Herpes simplex 1 ag if,,,4.02,5.08,6
HCPCS,872740,HERPES SIMPLEX 1 AG IF,,,10.35,10.35,1
HCPCS,87275,INFLUENZA B AG IF,,,10.58,20.47,15
HCPCS,87275,Influenza b ag if,,,4.02,5.08,6
HCPCS,872750,INFLUENZA B AG IF,,,10.58,10.58,1
HCPCS,87276,INFLUENZA A AG IF,,,13.89,26.85,15
HCPCS,87276,Influenza a ag if,,,4.02,5.08,6
HCPCS,872760,INFLUENZA A AG IF,,,13.89,13.89,1
HCPCS,87278,LEGION PNEUMOPHILIA AG IF,,,13.48,26.07,15
HCPCS,87278,Legion pneumophilia ag if,,,4.02,5.08,6
HCPCS,872780,LEGION PNEUMOPHILIA AG IF,,,13.48,13.48,1
HCPCS,87279,*PARAINFLUENZA AG IF,27.0,17.55,4.02,27.45,148
HCPCS,87279,PARAINFLUENZA AG IF,,,14.19,14.19,1
HCPCS,872790,PARAINFLUENZA AG IF,,,14.19,14.19,1
HCPCS,87280,RESPIRATORY SYNCYTIAL AG IF,,,11.6,22.42,15
HCPCS,87280,Respiratory syncytial ag if,,,4.02,5.08,6
HCPCS,872800,RESPIRATORY SYNCYTIAL AG IF,,,11.6,11.6,1
HCPCS,87281,PNEUMOCYSTIS CARINII AG IF,,,10.35,20.02,15
HCPCS,87281,Pneumocystis carinii ag if,,,4.02,5.08,6
HCPCS,872810,PNEUMOCYSTIS CARINII AG IF,,,10.35,10.35,1
HCPCS,87283,RUBEOLA AG IF,,,52.53,101.6,15
HCPCS,87283,Rubeola ag if,,,25.65,32.4,6
HCPCS,872830,RUBEOLA AG IF,,,52.53,52.53,1
HCPCS,87285,TREPONEMA PALLIDUM AG IF,,,10.52,20.35,15
HCPCS,87285,Treponema pallidum ag if,,,4.02,5.08,6
HCPCS,872850,TREPONEMA PALLIDUM AG IF,,,10.52,10.52,1
HCPCS,87290,VARICELLA ZOSTER AG IF,,,11.6,11.6,1
HCPCS,87290,VARICELLA ZOSTER DFA,71.5,46.475,4.02,92.7,74
HCPCS,872900,VARICELLA ZOSTER AG IF,,,11.6,11.6,1
HCPCS,87299,ANTIBODY DETECTION NOS IF,,,13.91,26.9,15
HCPCS,87299,Antibody detection nos if,,,4.02,5.08,6
HCPCS,872990,ANTIBODY DETECTION NOS IF,,,13.91,13.91,1
HCPCS,87300,AG DETECTION POLYVAL IF,,,10.35,10.35,1
HCPCS,87300,HERPES SIMPLEX DFA,123.0,79.95,4.02,110.7,37
HCPCS,87300,POLYVALENT MULT ORGANISM IF,44.0,28.6,4.02,39.6,37
HCPCS,873000,AG DETECTION POLYVAL IF,,,10.35,10.35,1
HCPCS,87301,%ROTAD ADENOV 40-41,67.0,43.55,4.02,60.3,37
HCPCS,87301,ADENOVIRUS AG IA,,,10.35,10.35,1
HCPCS,87301,ROTAD ADENOV 40-41,63.0,40.95,4.02,56.7,37
HCPCS,873010,ADENOVIRUS AG IA,,,10.35,10.35,1
HCPCS,87305,"ASPER GALACTOMAN, BAL",250.0,162.5,4.02,225.0,37
HCPCS,87305,ASPERGILLUS AG EIA,185.0,120.25,4.02,228.6,111
HCPCS,87305,ASPERGILLUS AG IA,,,10.35,10.35,1
HCPCS,87305,ASPERGILLUS GALACT SERUM,182.0,118.3,4.02,163.8,37
HCPCS,873050,ASPERGILLUS AG IA,,,10.35,10.35,1
HCPCS,87320,CHLMYD TRACH AG IA,,,12.96,25.07,15
HCPCS,87320,Chlmyd trach ag ia,,,4.02,5.08,6
HCPCS,873200,CHLMYD TRACH AG IA,,,12.96,12.96,1
HCPCS,87324,CLOSTRIDIUM AG IA,,,10.35,10.35,1
HCPCS,87324,IAAD IA CLOSTRIDIUM DIFFICILE TOXIN,183.0,118.95,5.03,183.0,17
HCPCS,87324,"IMMUNOASSAY, CLOSTRIDIUM DIFFICILE TOXIN",109.0,70.85,4.02,98.1,37
HCPCS,873240,CLOSTRIDIUM AG IA,,,10.35,10.35,1
HCPCS,87327,CRYPTOCOCCUS NEOFORM AG IA,,,11.6,22.42,15
HCPCS,87327,Cryptococcus neoform ag ia,,,4.02,5.08,6
HCPCS,873270,CRYPTOCOCCUS NEOFORM AG IA,,,11.6,11.6,1
HCPCS,87328,CRYPTOSPORIDIUM AG IA,,,11.94,11.94,1
HCPCS,87328,IAAD IA CRYPTOSPORIDIUM,128.0,83.2,5.8,128.0,17
HCPCS,87328,"IMMUNOASSAY, CRYPTOSPORIDIUM",52.0,33.8,4.02,46.8,37
HCPCS,873280,CRYPTOSPORIDIUM AG IA,,,11.94,11.94,1
HCPCS,87329,GIARDIA AG EIA,75.0,48.75,4.02,67.5,37
HCPCS,87329,GIARDIA AG IA,,,10.35,10.35,1
HCPCS,87329,"GIARDIA ANTIGEN, STOOL",75.0,48.75,4.02,67.5,37
HCPCS,87329,IAAD IA GIARDIA,134.0,87.1,5.03,134.0,17
HCPCS,87329,"IMMUNOASSAY, GIARDIA",74.0,48.1,4.02,66.6,37
HCPCS,873290,GIARDIA AG IA,,,10.35,10.35,1
HCPCS,87332,CYTOMEGALOVIRUS AG IA,,,10.35,20.02,15
HCPCS,87332,Cytomegalovirus ag ia,,,4.02,5.08,6
HCPCS,873320,CYTOMEGALOVIRUS AG IA,,,10.35,10.35,1
HCPCS,87335,E COLI 0157 AG IA,,,10.94,21.15,15
HCPCS,87335,E coli 0157 ag ia,,,4.02,5.08,6
HCPCS,873350,E COLI 0157 AG IA,,,10.94,10.94,1
HCPCS,87336,ENTAMOEB HIST DISPR AG IA,,,13.82,26.74,15
HCPCS,87336,Entamoeb hist dispr ag ia,,,4.02,5.08,6
HCPCS,873360,ENTAMOEB HIST DISPR AG IA,,,13.82,13.82,1
HCPCS,87337,ENTAMOEB HIST GROUP AG EIA,125.0,81.25,4.02,112.5,37
HCPCS,87337,ENTAMOEB HIST GROUP AG IA,,,10.35,10.35,1
HCPCS,87337,ENTAMOEBA HISTOLYT AG,321.0,208.65,4.02,288.9,37
HCPCS,873370,ENTAMOEB HIST GROUP AG IA,,,10.35,10.35,1
HCPCS,87338,HPYLORI STOOL AG IA,,,12.42,24.03,4
HCPCS,87338,"IMMUNOASSAY, H. PYLORI",56.0,36.4,4.02,50.4,37
HCPCS,873380,HPYLORI STOOL AG IA,,,12.42,12.42,1
HCPCS,87338QW,HPYLORI STOOL AG IA,,,22.17,24.03,3
HCPCS,87339,H PYLORI AG IA,,,13.82,26.74,15
HCPCS,87339,H pylori ag ia,,,4.02,5.08,6
HCPCS,873390,H PYLORI AG IA,,,13.82,13.82,1
HCPCS,87340,*%HEP HBSAG,55.0,35.75,4.02,49.5,37
HCPCS,87340,*HEP B SURF AG EIA,24.0,15.6,4.02,21.6,37
HCPCS,87340,*HEP B SURFACE AG EIA,56.0,36.4,4.02,50.4,37
HCPCS,87340,HEP B SURFACE AG EIA,55.0,35.75,4.02,90.9,111
HCPCS,87340,HEPATITIS B SURFACE AG IA,,,8.92,8.92,1
HCPCS,87340,IAAD IA HEPATITIS B SURFACE ANTIGEN,147.0,95.55,4.34,147.0,17
HCPCS,873400,HEPATITIS B SURFACE AG IA,,,8.92,8.92,1
HCPCS,87341,HEP B SURFACE AG NEUTRAL,69.0,44.85,4.02,62.1,37
HCPCS,87341,HEP B SURFACE AG NEUTRLZJ IA,,,8.92,8.92,1
HCPCS,87341,HEPATITIS HBSAG CONF,68.0,44.2,4.02,61.2,37
HCPCS,873410,HEP B SURFACE AG NEUTRLZJ IA,,,8.92,8.92,1
HCPCS,87350,HEP BE AG EIA,19.0,12.35,4.02,19.0,37
HCPCS,87350,HEPATITIS BE AG IA,,,9.96,9.96,1
HCPCS,87350,HEPATITIS BE ANTIGEN,26.0,16.9,4.02,23.4,37
HCPCS,873500,HEPATITIS BE AG IA,,,9.96,9.96,1
HCPCS,87380,HEPATITIS DELTA AGENT AG IA,,,15.87,30.68,15
HCPCS,87380,Hepatitis delta agent ag ia,,,4.02,5.08,6
HCPCS,873800,HEPATITIS DELTA AGENT AG IA,,,15.87,15.87,1
HCPCS,87385,HISTOPLASMA ANTIGEN UR,160.0,104.0,4.02,144.0,37
HCPCS,87385,HISTOPLASMA CAPSUL AG EIA,128.0,83.2,4.02,188.1,111
HCPCS,87385,HISTOPLASMA CAPSUL AG IA,,,11.45,11.45,1
HCPCS,87385,HISTOPLASMA CAPSULA AG,182.0,118.3,4.02,163.8,37
HCPCS,87385,"HISTOPLASMA GALACTOMANNAN EIA, BAL",338.0,219.7,4.02,304.2,37
HCPCS,87385,"HISTOPLASMA GALACTOMANNAN EIA, CSF",338.0,219.7,4.02,304.2,37
HCPCS,873850,HISTOPLASMA CAPSUL AG IA,,,11.45,11.45,1
HCPCS,87389,HIV 1&2 ANTIGEN/ANTIBODY,186.0,120.9,4.02,167.4,37
HCPCS,87389,HIV-1 AG W/HIV-1&-2 AB AG IA,,,20.8,40.24,4
HCPCS,87389,WHIIVF HIV 1&2 AG/AB,29.0,18.85,4.02,29.0,37
HCPCS,873890,HIV-1 AG W/HIV-1&-2 AB AG IA,,,20.8,20.8,1
HCPCS,87389QW,HIV-1 AG W/HIV-1&-2 AB AG IA,,,37.13,40.24,3
HCPCS,87390,HIV-1 AG EIA,118.0,76.7,4.02,106.2,37
HCPCS,87390,HIV-1 AG IA,,,20.79,20.79,1
HCPCS,87390,"HIV-1 AG, EIA",237.0,154.05,4.02,213.3,37
HCPCS,873900,HIV-1 AG IA,,,20.79,20.79,1
HCPCS,87391,HIV-2 AG IA,,,18.92,36.59,15
HCPCS,87391,Hiv-2 ag ia,,,4.02,5.08,6
HCPCS,873910,HIV-2 AG IA,,,18.92,18.92,1
HCPCS,87400,IAAD IA INFLUENZA A/B EACH,38.0,24.7,5.93,38.0,17
HCPCS,87400,INFLUENZA A/B EACH AG IA,,,12.2,23.61,18
HCPCS,87400,Influenza a/b each ag ia,,,4.02,5.08,6
HCPCS,874000,INFLUENZA A/B EACH AG IA,,,12.2,12.2,1
HCPCS,87400QW,INFLUENZA A/B EACH AG IA,,,21.79,23.61,3
HCPCS,87420,IAAD IA RESPIRATORY SYNCTIAL VIRUS,15.0,9.75,5.84,15.0,17
HCPCS,87420,RESP SYNCYTIAL VIRUS AG IA,,,12.02,23.24,18
HCPCS,87420,Resp syncytial virus ag ia,,,4.02,5.08,6
HCPCS,874200,RESP SYNCYTIAL VIRUS AG IA,,,12.02,12.02,1
HCPCS,87420QW,RESP SYNCYTIAL VIRUS AG IA,,,21.45,23.24,3
HCPCS,87425,IAAD IA ROTAVIRUS,128.0,83.2,5.03,128.0,17
HCPCS,87425,"IMMUNOASSAY, ROTAVIRUS",22.0,14.3,4.02,20.02,37
HCPCS,87425,ROTAVIRUS AG EIA,22.0,14.3,4.02,20.02,37
HCPCS,87425,ROTAVIRUS AG IA,,,10.35,10.35,1
HCPCS,874250,ROTAVIRUS AG IA,,,10.35,10.35,1
HCPCS,87426,SARSCOV CORONAVIRUS AG IA,,,35.33,97.7,21
HCPCS,87426,Sarscov coronavirus ag ia,,,4.02,5.08,6
HCPCS,874260,SARSCOV CORONAVIRUS AG IA,,,48.85,48.85,1
HCPCS,87426QW,SARSCOV CORONAVIRUS AG IA,,,54.48,59.04,3
HCPCS,87427,%STOOL SHIGA LIKE TOX X2,146.0,94.9,4.02,131.4,37
HCPCS,87427,SHIGA-LIKE TOXIN AG IA,,,10.35,10.35,1
HCPCS,874270,SHIGA-LIKE TOXIN AG IA,,,10.35,10.35,1
HCPCS,87428,SARSCOV & INF VIR A&B AG IA,,,70.29,158.74,21
HCPCS,87428,Sarscov & inf vir a&b ag ia,,,25.65,32.4,6
HCPCS,874280,SARSCOV & INF VIR A&B AG IA,,,79.37,79.37,1
HCPCS,87428QW,SARSCOV & INF VIR A&B AG IA,,,108.39,117.45,3
HCPCS,87430,IAAD IA STREPTOCOCCUS GROUP A,43.0,27.95,7.06,43.0,17
HCPCS,87430,STREP A AG IA,,,14.53,28.09,4
HCPCS,87430,STREP SCREEN,241.5,156.975,4.02,382.5,74
HCPCS,874300,STREP A AG IA,,,14.53,14.53,1
HCPCS,87430QW,STREP A AG IA,,,25.92,28.09,3
HCPCS,87449,*INFECT AGENT NOS EIA MULT,84.0,54.6,4.02,98.1,111
HCPCS,87449,AG DETECT NOS IA MULT,153.0,99.45,4.02,137.7,74
HCPCS,87449,BLASTOMYCES ANTIGEN,190.0,123.5,4.02,171.0,37
HCPCS,87449,FUNGI ASSAY FOR B-D GLUC,249.0,161.85,4.02,224.1,37
HCPCS,87449,INFECT AGENT NOS EIA MULT,176.0,114.4,4.02,227.7,111
HCPCS,87449,NORWALK-LIKE VIRUS AG,639.0,415.35,4.02,575.1,37
HCPCS,87449,NOS EACH ORGANISM AG IA,,,10.35,20.02,4
HCPCS,874490,NOS EACH ORGANISM AG IA,,,10.35,10.35,1
HCPCS,87449QW,NOS EACH ORGANISM AG IA,,,18.47,20.02,3
HCPCS,87450,Ag detect nos ia single,,,4.02,5.08,6
HCPCS,87451,POLYVALENT MULT ORG EA AG IA,,,9.08,17.56,15
HCPCS,87451,Polyvalent mult org ea ag ia,,,4.02,5.08,6
HCPCS,874510,POLYVALENT MULT ORG EA AG IA,,,9.08,9.08,1
HCPCS,87467,HEPATITIS B SURFACE AG QUAN,,,21.88,42.31,15
HCPCS,87467,Hepatitis b surface ag quan,,,4.02,5.08,6
HCPCS,874670,HEPATITIS B SURFACE AG QUAN,,,21.88,21.88,1
HCPCS,87468,ANAPLSMA PHGCYTOPHLM AMP PRB,,,30.32,30.32,1
HCPCS,87468,EHRANA ANAPLSMA PHGCYTOPHLM AMP PRB,97.0,63.05,24.25,87.3,37
HCPCS,874680,ANAPLSMA PHGCYTOPHLM AMP PRB,,,30.32,30.32,1
HCPCS,87469,BABESIA MICROTI AMP PRB,,,30.32,58.64,15
HCPCS,87469,Babesia microti amp prb,,,25.65,32.4,6
HCPCS,874690,BABESIA MICROTI AMP PRB,,,30.32,30.32,1
HCPCS,87471,*BARTONELLA DNA AMPL PROBE,385.5,250.575,25.65,583.2,74
HCPCS,87471,*INFECT AGENT NOS AMPL PROBE,160.0,104.0,25.65,144.0,37
HCPCS,87471,BARTONELLA AMPLIF NAP,312.0,202.8,25.65,280.8,37
HCPCS,87471,BARTONELLA DNA AMP PROBE,,,30.32,30.32,1
HCPCS,874710,BARTONELLA DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87472,BARTONELLA DNA QUANT,,,37.01,71.59,15
HCPCS,87472,Bartonella dna quant,,,25.65,32.4,6
HCPCS,874720,BARTONELLA DNA QUANT,,,37.01,37.01,1
HCPCS,87475,LYME DIS DNA DIR PROBE,,,17.32,33.5,15
HCPCS,87475,Lyme dis dna dir probe,,,4.02,5.08,6
HCPCS,874750,LYME DIS DNA DIR PROBE,,,17.32,17.32,1
HCPCS,87476,LYME DIS DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87476,LYME DISEASE DNA AMPL PROBE,249.0,161.85,25.65,224.1,37
HCPCS,874760,LYME DIS DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87478,BORRELIA MIYAMOTOI AMP PRB,,,30.32,58.64,15
HCPCS,87478,Borrelia miyamotoi amp prb,,,25.65,32.4,6
HCPCS,874780,BORRELIA MIYAMOTOI AMP PRB,,,30.32,30.32,1
HCPCS,87480,%VAGONA CANDIDA,215.0,139.75,4.02,193.5,37
HCPCS,87480,CANDIDA DNA DIR PROBE,,,17.32,17.32,1
HCPCS,874800,CANDIDA DNA DIR PROBE,,,17.32,17.32,1
HCPCS,87481,CANDIDA DNA AMP PROBE,275.0,178.75,25.65,247.5,38
HCPCS,874810,CANDIDA DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87482,CANDIDA DNA QUANT,,,48.16,93.14,15
HCPCS,87482,Candida dna quant,,,25.65,32.4,6
HCPCS,874820,CANDIDA DNA QUANT,,,48.16,48.16,1
HCPCS,87483,CNS DNA AMP PROBE TYPE 12-25,1076.0,699.4,92.55,968.4,38
HCPCS,87483,"FILM ARRAY, MENINGITIS/ENCEPHALITIS",1076.0,699.4,92.55,968.4,37
HCPCS,874830,CNS DNA AMP PROBE TYPE 12-25,,,360.09,360.09,1
HCPCS,87484,EHRANA EHRLICHA CHAFFEENSIS AMP PRB,97.0,63.05,24.25,87.3,37
HCPCS,87484,EHRLICHA CHAFFEENSIS AMP PRB,,,30.32,30.32,1
HCPCS,874840,EHRLICHA CHAFFEENSIS AMP PRB,,,30.32,30.32,1
HCPCS,87485,CHLMYD PNEUM DNA DIR PROBE,,,17.32,33.5,15
HCPCS,87485,Chlmyd pneum dna dir probe,,,4.02,5.08,6
HCPCS,874850,CHLMYD PNEUM DNA DIR PROBE,,,17.32,17.32,1
HCPCS,87486,%E18RP CHLAMYDIA PNEU AMP,208.0,135.2,25.65,187.2,37
HCPCS,87486,CHLAMYDIA PNEUM DNA AMPL PROB,112.0,72.8,25.65,100.8,37
HCPCS,87486,CHLMYD PNEUM DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87486,RPRAPD CHLAMYDIA PNEU AMP,86.0,55.9,21.5,77.4,37
HCPCS,874860,CHLMYD PNEUM DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87487,CHLMYD PNEUM DNA QUANT,,,37.01,71.59,15
HCPCS,87487,Chlmyd pneum dna quant,,,25.65,32.4,6
HCPCS,874870,CHLMYD PNEUM DNA QUANT,,,37.01,37.01,1
HCPCS,87490,CHLAMYDIA TRACH DNA DIR PROBE,32.0,20.8,4.02,32.0,37
HCPCS,87490,CHLMYD TRACH DNA DIR PROBE,,,19.66,19.66,1
HCPCS,874900,CHLMYD TRACH DNA DIR PROBE,,,19.66,19.66,1
HCPCS,87491,%CTNG CTRACH SUREPATH TMA,242.5,157.625,25.65,295.2,74
HCPCS,87491,%CTNGAO CHLAMYDIA OCULAR,107.0,69.55,25.65,96.3,37
HCPCS,87491,*CHLAMYDIA TRACH DNA AMPL PROB,50.0,32.5,12.5,50.0,37
HCPCS,87491,CHLAMYDIA T AMPLIF NA PROBE,134.5,87.425,14.75,189.0,74
HCPCS,87491,CHLAMYDIA TRACH AMPLIFY,55.0,35.75,13.75,55.0,37
HCPCS,87491,CHLMYD TRACH DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87491,LYMPHOGRANULOMA VENEREUM PCR,215.0,139.75,25.65,193.5,37
HCPCS,87491,UCTGC CHLAMYDIA TRACH AMP,173.0,112.45,25.65,155.7,37
HCPCS,87491,WHIIVF CHLAMYDIA TRACH AM,26.0,16.9,6.5,38.6,37
HCPCS,874910,CHLMYD TRACH DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87492,CHLMYD TRACH DNA QUANT,,,46.2,89.35,15
HCPCS,87492,Chlmyd trach dna quant,,,25.65,32.4,6
HCPCS,874920,CHLMYD TRACH DNA QUANT,,,46.2,46.2,1
HCPCS,87493,"AMPLIFICATION, CLOSTRIDIUM DIFFICILE",347.0,225.55,25.65,312.3,37
HCPCS,87493,C DIFF AMPLIFIED PROBE,103.0,66.95,25.65,92.7,38
HCPCS,874930,C DIFF AMPLIFIED PROBE,,,32.21,32.21,1
HCPCS,87494,"AMPLIFIED PROBE, GC/CT",484.0,314.6,4.02,435.6,30
HCPCS,87494,CHLMY TRCH&NEISRA GONOR MULT,,,60.63,60.63,1
HCPCS,87494,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, OTHER",484.0,314.6,4.02,435.6,30
HCPCS,874940,CHLMY TRCH&NEISRA GONOR MULT,,,60.63,60.63,1
HCPCS,87495,CYTOMEG DNA DIR PROBE,,,25.94,50.18,15
HCPCS,87495,Cytomeg dna dir probe,,,25.65,32.4,6
HCPCS,874950,CYTOMEG DNA DIR PROBE,,,25.94,25.94,1
HCPCS,87496,CMV DNA AMPL PROB,125.0,81.25,25.65,112.5,37
HCPCS,87496,CMV PCR M4,942.0,612.3,25.65,847.8,37
HCPCS,87496,CYTOMEG DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87496,"CYTOMEGALOVIRUS (CMV) PCR, AMNIOTIC FLUID",135.0,87.75,25.65,121.5,37
HCPCS,87496,CYTOMEGALOVIRUS CMV,240.0,156.0,25.65,216.0,37
HCPCS,874960,CYTOMEG DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87497,CMV DNA QUANT,109.0,70.85,25.65,98.1,37
HCPCS,87497,CYTOMEG DNA QUANT,,,37.01,37.01,1
HCPCS,87497,CYTOMEGALOVIRUS NA QUAN,310.0,201.5,25.65,279.0,37
HCPCS,87497,"QUANTIFICATION, CYTOMEGALOVIRUS",624.0,405.6,25.65,561.6,37
HCPCS,874970,CYTOMEG DNA QUANT,,,37.01,37.01,1
HCPCS,87498,ENTEROVIRUS BY PCR,312.0,202.8,25.65,280.8,37
HCPCS,87498,ENTEROVIRUS DNA AMPL PROBE,360.0,234.0,25.65,324.0,37
HCPCS,87498,ENTEROVIRUS PCR,352.0,228.8,25.65,316.8,37
HCPCS,87498,ENTEROVIRUS PROBE&REVRS TRNS,,,30.32,30.32,1
HCPCS,87498,"ENTEROVIRUS, REAL-TIME PCR, AMNIOTIC FLUID",352.0,228.8,25.65,316.8,37
HCPCS,874980,ENTEROVIRUS PROBE&REVRS TRNS,,,30.32,30.32,1
HCPCS,87500,VANOMYCIN DNA AMP PROBE,,,30.32,58.64,15
HCPCS,87500,Vanomycin dna amp probe,,,25.65,32.4,6
HCPCS,875000,VANOMYCIN DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87501,INFLUENZA DNA AMP PROB 1+,,,44.33,85.74,15
HCPCS,87501,Influenza dna amp prob 1+,,,25.65,32.4,6
HCPCS,875010,INFLUENZA DNA AMP PROB 1+,,,44.33,44.33,1
HCPCS,87502,FLUPCR RAPID PCR FLU,241.0,156.65,60.25,216.9,37
HCPCS,87502,FLUPCR RAPID PCR FLU (POINT OF CARE LAB),241.0,156.65,60.25,216.9,37
HCPCS,87502,INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,214.0,139.1,40.24,214.0,17
HCPCS,87502,INFLUENZA A&B MOLECULAR (POINT OF CARE LAB),243.0,157.95,60.75,218.7,37
HCPCS,87502,INFLUENZA DNA AMP PROBE,198.5,129.02499999999998,31.0,245.7,78
HCPCS,87502,"SEQUENCING, INFLUENZA",620.0,403.0,92.55,558.0,37
HCPCS,875020,INFLUENZA DNA AMP PROBE,,,82.77,82.77,1
HCPCS,87502QW,INFLUENZA DNA AMP PROBE,,,147.72,160.08,3
HCPCS,87503,INFLUENZA DNA AMP PROB ADDL,,,25.25,25.25,1
HCPCS,87503,"SEQUENCING, INFLUENZA PLUS",189.0,122.85,25.65,170.1,37
HCPCS,875030,INFLUENZA DNA AMP PROB ADDL,,,25.25,25.25,1
HCPCS,87505,"GASTROINTESTINAL PANEL, 5 VIRAL TARGETS",832.0,540.8,92.55,748.8,37
HCPCS,87505,NFCT AGENT DETECTION GI,542.0,352.3,92.55,487.8,75
HCPCS,875050,NFCT AGENT DETECTION GI,,,110.84,110.84,1
HCPCS,87506,IADNA-DNA/RNA PROBE TQ 6-11,334.0,217.1,83.5,334.0,38
HCPCS,875060,IADNA-DNA/RNA PROBE TQ 6-11,,,227.22,227.22,1
HCPCS,87507,IADNA-DNA/RNA PROBE TQ 12-25,2613.0,1698.45,92.55,2351.7,38
HCPCS,87507,STOOL GASTROINT PNL PCR,2613.0,1698.45,92.55,2351.7,37
HCPCS,875070,IADNA-DNA/RNA PROBE TQ 12-25,,,360.09,360.09,1
HCPCS,87510,GARDNER VAG DNA DIR PROBE,,,17.32,33.5,15
HCPCS,87510,Gardner vag dna dir probe,,,4.02,5.08,6
HCPCS,875100,GARDNER VAG DNA DIR PROBE,,,17.32,17.32,1
HCPCS,87511,GARDNER VAG DNA AMP PROBE,,,30.32,58.64,15
HCPCS,87511,Gardner vag dna amp probe,,,25.65,32.4,6
HCPCS,875110,GARDNER VAG DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87512,GARDNER VAG DNA QUANT,,,36.08,69.78,15
HCPCS,87512,Gardner vag dna quant,,,25.65,32.4,6
HCPCS,875120,GARDNER VAG DNA QUANT,,,36.08,36.08,1
HCPCS,87513,H PYLRI CLRTHMCN RST AMP PRB,,,30.32,58.64,15
HCPCS,87513,H pylri clrthmcn rst amp prb,,,25.65,32.4,6
HCPCS,875130,H PYLRI CLRTHMCN RST AMP PRB,,,30.32,30.32,1
HCPCS,87516,%IDM HBVNAT,166.0,107.9,25.65,149.4,37
HCPCS,87516,HEPATITIS B DNA AMP PROBE,,,30.32,30.32,1
HCPCS,875160,HEPATITIS B DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87517,HEP B DNA QUANT,191.0,124.15,25.65,171.9,37
HCPCS,87517,HEPATITIS B DNA QUANT,,,37.01,37.01,1
HCPCS,87517,"QUANTIFICATION, HEPATITIS B VIRUS",188.0,122.2,25.65,169.2,37
HCPCS,875170,HEPATITIS B DNA QUANT,,,37.01,37.01,1
HCPCS,87520,HEP C DIR PROBE,224.0,145.6,25.65,201.6,37
HCPCS,87520,HEPATITIS C RNA DIR PROBE,,,26.98,26.98,1
HCPCS,875200,HEPATITIS C RNA DIR PROBE,,,26.98,26.98,1
HCPCS,87521,*HEP C AMP PROBE,326.0,211.9,25.65,293.4,37
HCPCS,87521,HEPATITIS C AMPLIFIED PROBE,166.0,107.9,25.65,149.4,37
HCPCS,87521,HEPATITIS C PROBE&RVRS TRNSC,,,30.32,58.64,4
HCPCS,875210,HEPATITIS C PROBE&RVRS TRNSC,,,30.32,30.32,1
HCPCS,87521QW,HEPATITIS C PROBE&RVRS TRNSC,,,54.11,58.64,3
HCPCS,87522,HEP C QUANT,133.0,86.45,25.65,119.7,37
HCPCS,87522,HEPATITIS C REVRS TRNSCRPJ,,,37.01,37.01,1
HCPCS,87522,"QUANTIFICATION, HEPATITIS C VIRUS",131.0,85.15,25.65,117.9,37
HCPCS,875220,HEPATITIS C REVRS TRNSCRPJ,,,37.01,37.01,1
HCPCS,87523,HEPATITIS D QUANTIFICATION,,,37.01,37.01,1
HCPCS,87523,HEPATITIS DELTA VIRUS BY QUANTITATIVE PCR,495.0,321.75,25.65,445.5,37
HCPCS,875230,HEPATITIS D QUANTIFICATION,,,37.01,37.01,1
HCPCS,87525,HEPATITIS G DNA DIR PROBE,,,25.75,49.8,15
HCPCS,87525,Hepatitis g dna dir probe,,,4.02,5.08,6
HCPCS,875250,HEPATITIS G DNA DIR PROBE,,,25.75,25.75,1
HCPCS,87526,HEPATITIS G DNA AMP PROBE,,,33.92,65.6,15
HCPCS,87526,Hepatitis g dna amp probe,,,25.65,32.4,6
HCPCS,875260,HEPATITIS G DNA AMP PROBE,,,33.92,33.92,1
HCPCS,87527,HEPATITIS G DNA QUANT,,,36.08,69.78,15
HCPCS,87527,Hepatitis g dna quant,,,25.65,32.4,6
HCPCS,875270,HEPATITIS G DNA QUANT,,,36.08,36.08,1
HCPCS,87528,HSV DNA DIR PROBE,,,17.32,33.5,15
HCPCS,87528,Hsv dna dir probe,,,4.02,5.08,6
HCPCS,875280,HSV DNA DIR PROBE,,,17.32,17.32,1
HCPCS,87529,*HERPES SIMPLEX DNA AMPL,146.0,94.9,25.65,131.4,37
HCPCS,87529,*HERPES SIMPLEX DNA AMPL PROBE,146.0,94.9,25.65,131.4,37
HCPCS,87529,"AMPLIFIED PROBE, HERPES SIMPLEX VIRUS",105.0,68.25,25.65,94.5,37
HCPCS,87529,HERP SIMP DNA RAPID CSF,146.0,94.9,25.65,131.4,37
HCPCS,87529,HSV DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87529,HSV DNA AMP PROBE X2,293.0,190.45,25.65,263.7,37
HCPCS,87529,HSV PCR MISC SPEC,132.0,85.8,25.65,118.8,37
HCPCS,87529,IADNA HERPES SOMPLX VIRUS AMPLIFIED PROBE TQ,157.0,102.05,14.74,157.0,17
HCPCS,87529,PCRHSV HSV DNA AMP PROBE X2,108.0,70.2,25.65,97.2,37
HCPCS,875290,HSV DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87530,HSV DNA QUANT,,,37.01,71.59,15
HCPCS,87530,Hsv dna quant,,,25.65,32.4,6
HCPCS,875300,HSV DNA QUANT,,,37.01,37.01,1
HCPCS,87531,HHV-6 DNA DIR PROBE,,,50.11,96.92,15
HCPCS,87531,Hhv-6 dna dir probe,,,25.65,32.4,6
HCPCS,875310,HHV-6 DNA DIR PROBE,,,50.11,50.11,1
HCPCS,87532,HHV-6 DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87532,HHV-6 PCR,505.0,328.25,25.65,454.5,37
HCPCS,875320,HHV-6 DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87533,HHV-6 DNA QUANT,,,36.08,36.08,1
HCPCS,87533,HHV-6A HHV-6B QT PCR,426.0,276.9,25.65,383.4,37
HCPCS,875330,HHV-6 DNA QUANT,,,36.08,36.08,1
HCPCS,87534,HIV-1 DNA DIR PROBE,,,18.94,36.63,15
HCPCS,87534,Hiv-1 dna dir probe,,,4.02,5.08,6
HCPCS,875340,HIV-1 DNA DIR PROBE,,,18.94,18.94,1
HCPCS,87535,HIV-1 DNA AMPL PROBE,152.0,98.8,25.65,136.8,37
HCPCS,87535,HIV-1 DNA BY PCR,306.0,198.9,25.65,275.4,37
HCPCS,87535,HIV-1 PROBE&REVERSE TRNSCRPJ,,,30.32,30.32,1
HCPCS,87535,HIV-1 RNA,227.0,147.55,25.65,204.3,37
HCPCS,87535,"HIV-1 RNA QUAL, TMA",215.0,139.75,25.65,193.5,37
HCPCS,87535,IDM HIV-1 DNA BY PCR,166.0,107.9,25.65,149.4,37
HCPCS,875350,HIV-1 PROBE&REVERSE TRNSCRPJ,,,30.32,30.32,1
HCPCS,87536,*HIV 1 DNA QUANT,123.0,79.95,25.65,123.0,37
HCPCS,87536,HIV 1 DNA QUANT,250.5,162.825,25.65,333.9,74
HCPCS,87536,HIV-1 QUANT&REVRSE TRNSCRPJ,,,73.53,73.53,1
HCPCS,87536,"QUANTIFICATION, HIV-1",121.0,78.65,25.65,121.0,37
HCPCS,875360,HIV-1 QUANT&REVRSE TRNSCRPJ,,,73.53,73.53,1
HCPCS,87537,HIV-2 DNA DIR PROBE,,,18.94,36.63,15
HCPCS,87537,Hiv-2 dna dir probe,,,4.02,5.08,6
HCPCS,875370,HIV-2 DNA DIR PROBE,,,18.94,18.94,1
HCPCS,87538,HIV-2 DNA AMPL PROBE,408.0,265.2,25.65,367.2,37
HCPCS,87538,HIV-2 PROBE&REVRSE TRNSCRIPJ,,,30.32,30.32,1
HCPCS,87538,HIV-2 RNA,227.0,147.55,25.65,204.3,37
HCPCS,875380,HIV-2 PROBE&REVRSE TRNSCRIPJ,,,30.32,30.32,1
HCPCS,87539,HIV-2 QUANT&REVRSE TRNSCRIPJ,,,50.65,97.95,15
HCPCS,87539,Hiv-2 quant&revrse trnscripj,,,25.65,32.4,6
HCPCS,875390,HIV-2 QUANT&REVRSE TRNSCRIPJ,,,50.65,50.65,1
HCPCS,87540,LEGION PNEUMO DNA DIR PROB,,,17.32,33.5,15
HCPCS,87540,Legion pneumo dna dir prob,,,4.02,5.08,6
HCPCS,875400,LEGION PNEUMO DNA DIR PROB,,,17.32,17.32,1
HCPCS,87541,*LEGIONELLA AMPLIF NA PROBE,50.0,32.5,12.5,50.0,37
HCPCS,87541,LEGION PNEUMO DNA AMP PROB,,,30.32,30.32,1
HCPCS,87541,LEGIONELLA PCR,62.0,40.3,15.5,58.64,37
HCPCS,87541,LEGIONELLA PNEUM PCR,59.0,38.35,14.75,58.64,37
HCPCS,875410,LEGION PNEUMO DNA AMP PROB,,,30.32,30.32,1
HCPCS,87542,LEGION PNEUMO DNA QUANT,,,36.08,69.78,15
HCPCS,87542,Legion pneumo dna quant,,,25.65,32.4,6
HCPCS,875420,LEGION PNEUMO DNA QUANT,,,36.08,36.08,1
HCPCS,87550,ID DNA PROBE 1,32.0,20.8,4.02,32.0,37
HCPCS,87550,ID DNA PROBE 2,79.0,51.35,4.02,71.1,37
HCPCS,87550,ID-PROBE M GORDONAE,169.0,109.85,4.02,152.1,37
HCPCS,87550,MYCOBACTERIA DNA DIR PROBE,,,17.32,17.32,1
HCPCS,875500,MYCOBACTERIA DNA DIR PROBE,,,17.32,17.32,1
HCPCS,87551,%AFBPCR MYCOBACT PROBE,777.0,505.05,25.65,699.3,37
HCPCS,87551,*MYCOBACTERIA AMPLIF NA PROBE,360.0,234.0,25.65,362.7,74
HCPCS,87551,ID MTB COMPLEX VS NTM,304.0,197.6,25.65,273.6,37
HCPCS,87551,MYCOBACTERIA DNA AMP PROBE,,,41.68,41.68,1
HCPCS,875510,MYCOBACTERIA DNA AMP PROBE,,,41.68,41.68,1
HCPCS,87552,MYCOBACTERIA DNA QUANT,,,37.01,71.59,15
HCPCS,87552,Mycobacteria dna quant,,,25.65,32.4,6
HCPCS,875520,MYCOBACTERIA DNA QUANT,,,37.01,37.01,1
HCPCS,87555,M.TUBERCULO DNA DIR PROBE,,,23.22,44.92,15
HCPCS,87555,M.tuberculo dna dir probe,,,4.02,5.08,6
HCPCS,875550,M.TUBERCULO DNA DIR PROBE,,,23.22,23.22,1
HCPCS,87556,*MYCOBACTERIA TB DNA AMP PROB,317.0,206.05,25.65,285.3,37
HCPCS,87556,*MYCOBACTERIA TB DNA AMPL PROB,81.0,52.65,20.25,72.9,37
HCPCS,87556,"AMPLIFICATION, MYCOBACTERIA TUBERCULOSIS",238.0,154.7,25.65,214.2,37
HCPCS,87556,M.TUBERCULO DNA AMP PROBE,,,36.01,36.01,1
HCPCS,87556,MYCOBACTERIA TB AMPLIFIED PROBE,403.0,261.95,25.65,362.7,37
HCPCS,87556,MYCOBACTERIA TB DNA AMPL PROB,390.0,253.5,25.65,401.4,74
HCPCS,875560,M.TUBERCULO DNA AMP PROBE,,,36.01,36.01,1
HCPCS,87557,M.TUBERCULO DNA QUANT,,,37.01,71.59,15
HCPCS,87557,M.tuberculo dna quant,,,25.65,32.4,6
HCPCS,875570,M.TUBERCULO DNA QUANT,,,37.01,37.01,1
HCPCS,87560,M.AVIUM-INTRA DNA DIR PROB,,,23.58,23.58,1
HCPCS,87560,MYCOBACTERIA AVIUM DNA DIRPRO,240.0,156.0,4.02,216.0,37
HCPCS,875600,M.AVIUM-INTRA DNA DIR PROB,,,23.58,23.58,1
HCPCS,87561,*MYCOBACTERIA AMPL NA PROBE,81.0,52.65,20.25,72.9,37
HCPCS,87561,*MYCOBACTERIA AMPLIF NA PROBE,317.0,206.05,25.65,285.3,37
HCPCS,87561,M.AVIUM-INTRA DNA AMP PROB,,,30.32,30.32,1
HCPCS,875610,M.AVIUM-INTRA DNA AMP PROB,,,30.32,30.32,1
HCPCS,87562,M.AVIUM-INTRA DNA QUANT,,,37.01,71.59,15
HCPCS,87562,M.avium-intra dna quant,,,25.65,32.4,6
HCPCS,875620,M.AVIUM-INTRA DNA QUANT,,,37.01,37.01,1
HCPCS,87563,M. GENITALIUM AMP PROBE,,,30.32,30.32,1
HCPCS,87563,MYCOPLASMA GENITALIUM PCR,215.0,139.75,25.65,193.5,37
HCPCS,87563,URMPCR MYCOPLAS GENITALIUM AMP,109.0,70.85,25.65,98.1,37
HCPCS,875630,M. GENITALIUM AMP PROBE,,,30.32,30.32,1
HCPCS,87564,"AMPLIFICATION, MYCOBACTERIUM TUBERCULOSIS",497.0,323.05,25.65,447.3,37
HCPCS,87564,MTB RIF RES,497.0,323.05,25.65,447.3,37
HCPCS,87564,MTB RIFAMPIN RST AMP PRB TQ,,,66.33,66.33,1
HCPCS,875640,MTB RIFAMPIN RST AMP PRB TQ,,,66.33,66.33,1
HCPCS,87580,M.PNEUMON DNA DIR PROBE,,,17.32,33.5,15
HCPCS,87580,M.pneumon dna dir probe,,,4.02,5.08,6
HCPCS,875800,M.PNEUMON DNA DIR PROBE,,,17.32,17.32,1
HCPCS,87581,%E18RP MYCOPLAS PNEU AMP,185.0,120.25,25.65,166.5,37
HCPCS,87581,M.PNEUMON DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87581,MYCOPLASMA PNEUM DNA AMPL,189.0,122.85,25.65,170.1,37
HCPCS,87581,RPRAPD M.PNEUM AMP PRB,86.0,55.9,21.5,77.4,37
HCPCS,875810,M.PNEUMON DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87582,M.PNEUMON DNA QUANT,,,261.47,505.68,15
HCPCS,87582,M.pneumon dna quant,,,92.55,116.9,6
HCPCS,875820,M.PNEUMON DNA QUANT,,,261.47,261.47,1
HCPCS,87590,N.GONORRHOEAE DNA DIR PROB,,,23.22,23.22,1
HCPCS,87590,NEISSERIA GONORR DNA DIR,37.0,24.05,4.02,37.0,37
HCPCS,875900,N.GONORRHOEAE DNA DIR PROB,,,23.22,23.22,1
HCPCS,87591,%CTNGAO NGONORRHOEAE OCUL,107.0,69.55,25.65,96.3,37
HCPCS,87591,*NEISSERIA GONORR DNA AMPL,50.0,32.5,12.5,50.0,37
HCPCS,87591,GC AMPLIFICATION,55.0,35.75,13.75,55.0,37
HCPCS,87591,N.GONORRHOEAE DNA AMP PROB,,,30.32,30.32,1
HCPCS,87591,NEISSERIA AMPLIF NA PROBE,209.0,135.85,25.65,188.1,37
HCPCS,87591,NEISSERIA GONORR DNA AMPL,59.0,38.35,14.75,58.64,37
HCPCS,87591,UCTGC GC AMPLIFICATION,173.0,112.45,25.65,155.7,37
HCPCS,87591,WHIIVF GC AMP,23.0,14.95,5.75,38.6,37
HCPCS,875910,N.GONORRHOEAE DNA AMP PROB,,,30.32,30.32,1
HCPCS,87592,N.GONORRHOEAE DNA QUANT,,,37.01,71.59,15
HCPCS,87592,N.gonorrhoeae dna quant,,,25.65,32.4,6
HCPCS,875920,N.GONORRHOEAE DNA QUANT,,,37.01,37.01,1
HCPCS,87593,"AMPLIFICATION, ORTHOPOX VIRUS",183.0,118.95,25.65,164.7,37
HCPCS,87593,MONKEYPOX VIRUS QUAL PCR,183.0,118.95,25.65,164.7,37
HCPCS,87593,ORTHOPOXVIRUS AMP PRB EACH,,,55.41,55.41,1
HCPCS,875930,ORTHOPOXVIRUS AMP PRB EACH,,,55.41,55.41,1
HCPCS,87594,"AMPLIFIED PROBE, PNEUMOCYSTIS JIROVECII",227.0,147.55,25.65,204.3,37
HCPCS,87594,PNEUMCYSTS JIROVECII AMP PRB,,,30.32,30.32,1
HCPCS,875940,PNEUMCYSTS JIROVECII AMP PRB,,,30.32,30.32,1
HCPCS,87623,HPV LOW-RISK TYPES,55.0,35.75,13.75,55.0,38
HCPCS,876230,HPV LOW-RISK TYPES,,,30.32,30.32,1
HCPCS,87624,HPV DNA 16 18 PCR,69.0,44.85,17.25,62.1,37
HCPCS,87624,HPV DNA HI RISK ANL RECT,162.0,105.3,25.65,145.8,37
HCPCS,87624,HPV DNA PROBE REFLEX,80.0,52.0,20.0,72.0,37
HCPCS,87624,HPV HI-RISK TYP POOLED RSLT,,,30.32,30.32,1
HCPCS,87624,HPV HIGH-RISK TYPES,70.0,45.5,12.5,81.9,111
HCPCS,87624,HPV SCREEN BY TMA (ARUP),88.0,57.2,22.0,79.2,37
HCPCS,87624,HPVSFX HPV HIGH-RISK TYPE,131.0,85.15,25.65,117.9,37
HCPCS,87624,IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES,307.0,199.55,14.74,307.0,13
HCPCS,876240,HPV HI-RISK TYP POOLED RSLT,,,30.32,30.32,1
HCPCS,87625,HPV GENOTYPE BY TMA (ARUP REFLEX),122.0,79.3,25.65,109.8,37
HCPCS,87625,HPV TYPES 16 & 18 ONLY,63.0,40.95,15.75,63.0,38
HCPCS,876250,HPV TYPES 16 & 18 ONLY,,,35.04,35.04,1
HCPCS,87626,HPV SEP HI-RSK TYP&POOL RSLT,,,60.65,60.65,1
HCPCS,87626,IADNA HPV SEP RPRT HI-RSK TYP&HI-RSK POOLD RSLTS,455.0,295.75,25.65,409.5,37
HCPCS,876260,HPV SEP HI-RSK TYP&POOL RSLT,,,60.65,60.65,1
HCPCS,87627,JT SPC PTHGN&RX RSIST GEN26+,,,587.33,747.75,5
HCPCS,87627,Jt spc pthgn&rx rsist gen26+,,,22.32,28.19,6
HCPCS,876270,JT SPC PTHGN&RX RSIST GEN26+,,,587.33,587.33,1
HCPCS,87631,INFLUENZA RAPID PCR,639.0,415.35,92.55,575.1,37
HCPCS,87631,RESP VIRUS 3-5 TARGETS,180.0,117.0,45.0,238.33,41
HCPCS,87631,RPRAPD INFLUENZA RAPID PCR,349.0,226.85,87.25,314.1,37
HCPCS,876310,RESP VIRUS 3-5 TARGETS,,,123.23,123.23,1
HCPCS,87631QW,RESP VIRUS 3-5 TARGETS,,,219.94,238.33,3
HCPCS,87632,RESP VIRUS 6-11 TARGETS,,,188.41,364.38,15
HCPCS,87632,Resp virus 6-11 targets,,,92.55,116.9,6
HCPCS,876320,RESP VIRUS 6-11 TARGETS,,,188.41,188.41,1
HCPCS,87633,RESP VIRUS 12-25 TARGETS,580.0,377.0,92.55,696.44,41
HCPCS,87633,RVP BY PCR,521.0,338.65,92.55,521.0,37
HCPCS,876330,RESP VIRUS 12-25 TARGETS,,,360.09,360.09,1
HCPCS,87633QW,RESP VIRUS 12-25 TARGETS,,,642.67,696.44,3
HCPCS,87634,RSV DNA/RNA AMP PROBE,,,60.65,117.3,4
HCPCS,87634,RSV RAPID PCR (POINT OF CARE LAB),455.0,295.75,25.65,409.5,37
HCPCS,876340,RSV DNA/RNA AMP PROBE,,,60.65,60.65,1
HCPCS,87634QW,RSV DNA/RNA AMP PROBE,,,108.25,117.3,3
HCPCS,87635,COVID-19 MOLECULAR (POINT OF CARE LAB),333.0,216.45,25.65,299.7,37
HCPCS,87635,COVID19 INHOUSE,156.0,101.4,25.65,140.4,37
HCPCS,87635,COVID19 INHOUSE (POINT OF CARE LAB),156.0,101.4,25.65,140.4,37
HCPCS,87635,COVID19 SENDOUT,156.0,101.4,25.65,140.4,37
HCPCS,87635,IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ,150.0,97.5,30.79,150.0,13
HCPCS,87635,SARS-COV-2 COVID-19 AMP PRB,,,55.41,85.74,4
HCPCS,876350,SARS-COV-2 COVID-19 AMP PRB,,,55.41,55.41,1
HCPCS,87635QW,SARS-COV-2 COVID-19 AMP PRB,,,79.12,85.74,3
HCPCS,87636,COVID-19 MOLECULAR (POC) & INFLUENZA A&B MOLECULAR (POC),925.0,601.25,25.65,832.5,37
HCPCS,87636,SARSCOV2 & INF A&B AMP PRB,549.0,356.85,25.65,564.3,78
HCPCS,876360,SARSCOV2 & INF A&B AMP PRB,,,154.04,154.04,1
HCPCS,87636QW,SARSCOV2 & INF A&B AMP PRB,,,219.94,238.33,3
HCPCS,87637,"AMPLIFICATION, EXPEDITED, COVID, FLU A/B, RSV",393.0,255.45,25.65,353.7,37
HCPCS,87637,"COVID & INFLUENZA A/B & RSV NAAT, ROUTINE",285.0,185.25,25.65,308.08,37
HCPCS,87637,IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ,560.0,364.0,85.58,560.0,13
HCPCS,87637,SARSCOV2&INF A&B&RSV AMP PRB,,,154.04,238.33,4
HCPCS,876370,SARSCOV2&INF A&B&RSV AMP PRB,,,154.04,154.04,1
HCPCS,87637QW,SARSCOV2&INF A&B&RSV AMP PRB,,,219.94,238.33,3
HCPCS,87640,"AMPLIFICATION, STAPHYLOCOCCUS AUREUS",298.0,193.7,25.65,268.2,37
HCPCS,87640,STAPH A DNA AMP PROBE,,,30.32,30.32,1
HCPCS,876400,STAPH A DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87641,"AMPLIFICATION, METHICILLIN RESISTANCE",251.0,163.15,25.65,225.9,37
HCPCS,87641,MR-STAPH DNA AMP PROBE,,,30.32,30.32,1
HCPCS,876410,MR-STAPH DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87650,STREP A DNA DIR PROBE,,,17.32,33.5,18
HCPCS,87650,Strep a dna dir probe,,,4.02,5.08,6
HCPCS,876500,STREP A DNA DIR PROBE,,,17.32,17.32,1
HCPCS,87650QW,STREP A DNA DIR PROBE,,,30.92,33.5,3
HCPCS,87651,"AMPLIFICATION, STREPTOCOCCUS, GROUP A",255.0,165.75,25.65,229.5,37
HCPCS,87651,GROUP A STREP PCR (POINT OF CARE LAB),255.0,165.75,25.65,229.5,37
HCPCS,87651,STREP A (MOLECULAR),98.0,63.7,21.05,98.0,17
HCPCS,87651,STREP A DNA AMP PROBE,,,30.32,58.64,4
HCPCS,876510,STREP A DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87651QW,STREP A DNA AMP PROBE,,,54.11,58.64,3
HCPCS,87652,STREP A DNA QUANT,,,36.08,69.78,15
HCPCS,87652,Strep a dna quant,,,25.65,32.4,6
HCPCS,876520,STREP A DNA QUANT,,,36.08,36.08,1
HCPCS,87653,"AMPLIFICATION, STREPTOCOCCUS, GROUP B",373.0,242.45,25.65,335.7,37
HCPCS,87653,STREP B DNA AMP PROBE,,,30.32,30.32,1
HCPCS,876530,STREP B DNA AMP PROBE,,,30.32,30.32,1
HCPCS,87660,TRICHOMONAS VAGIN DIR PROBE,,,17.32,33.5,15
HCPCS,87660,Trichomonas vagin dir probe,,,4.02,5.08,6
HCPCS,876600,TRICHOMONAS VAGIN DIR PROBE,,,17.32,17.32,1
HCPCS,87661,TRICHOMONAS VAG AMP,75.0,48.75,18.75,67.5,37
HCPCS,87661,TRICHOMONAS VAGINALIS AMPLIF,124.5,80.925,19.0,155.7,75
HCPCS,876610,TRICHOMONAS VAGINALIS AMPLIF,,,30.32,30.32,1
HCPCS,87662,ZIKA VIRUS DNA/RNA AMP PROBE,,,44.33,44.33,1
HCPCS,87662,ZIKA VIRUS RT-PCR,162.0,105.3,25.65,145.8,37
HCPCS,87662,"ZIKA VIRUS RT-PCR, UR",210.0,136.5,25.65,189.0,37
HCPCS,876620,ZIKA VIRUS DNA/RNA AMP PROBE,,,44.33,44.33,1
HCPCS,87797,DETECT AGENT NOS DNA DIR,,,25.94,50.18,15
HCPCS,87797,Detect agent nos dna dir,,,25.65,32.4,6
HCPCS,877970,DETECT AGENT NOS DNA DIR,,,25.94,25.94,1
HCPCS,87798,%IDM W NILE RNA PCR,150.0,97.5,25.65,135.0,37
HCPCS,87798,%MTBAM1 PROBE PCR,629.0,408.85,25.65,566.1,37
HCPCS,87798,*INFECT AGENT NOS AMPL,70.0,45.5,17.5,63.0,37
HCPCS,87798,*INFECT AGENT NOS AMPL PROBE,144.0,93.6,11.5,183.6,185
HCPCS,87798,"ACANTHAMOEBA SPECIES DETECTION, PCR",351.0,228.15,25.65,315.9,37
HCPCS,87798,ADENOVIRUS PCR,202.0,131.3,25.65,181.8,37
HCPCS,87798,AMPLIF NA PROBE NOS AGENT,160.5,104.325,25.65,207.0,148
HCPCS,87798,"AMPLIFICATION, RIFAMPIN RESISTANCE",219.0,142.35,25.65,236.7,74
HCPCS,87798,"AMPLIFIED PROBE, VARICELLA ZOSTER VIRUS",289.0,187.85,25.65,260.1,37
HCPCS,87798,ASPERGILLUS DNA QL PCR,130.0,84.5,25.65,117.0,37
HCPCS,87798,BORDETELLA PERTUSSIS,295.0,191.75,25.65,265.5,37
HCPCS,87798,CARBAPENEM RESISTANCE GENE PCR,295.0,191.75,25.65,265.5,37
HCPCS,87798,CHIKUNGUNYA BY PCR,241.0,156.65,25.65,216.9,37
HCPCS,87798,DENGUE VIRUS PCR,81.0,52.65,20.25,72.9,37
HCPCS,87798,DETECT AGENT NOS DNA AMP,,,30.32,30.32,1
HCPCS,87798,EHRLICHIA/ANAPLASMA PCR,97.0,63.05,24.25,87.3,37
HCPCS,87798,"EPSTEIN-BARR VIRUS BY QUALITATIVE PCR, CSF",140.0,91.0,25.65,126.0,37
HCPCS,87798,HTLV I/II DNA PCR X2,801.0,520.65,25.65,720.9,37
HCPCS,87798,HUMAN METAPNEUM RT-PCR,348.0,226.2,25.65,313.2,37
HCPCS,87798,INFECT AGENT NOS AMPL PROBE,265.0,172.25,20.75,432.0,481
HCPCS,87798,JC VIRUS BY PCR,315.0,204.75,25.65,283.5,37
HCPCS,87798,JC VIRUS DNA PCR,315.0,204.75,25.65,283.5,37
HCPCS,87798,M HOMINTS PCR,485.0,315.25,25.65,436.5,37
HCPCS,87798,MEASLES VIRUS QUAL NAAT,227.0,147.55,25.65,204.3,37
HCPCS,87798,MONKEYPOX VIRUS QUAL PCR,166.0,107.9,25.65,149.4,37
HCPCS,87798,MUCORALES BY PCR,351.0,228.15,25.65,315.9,37
HCPCS,87798,MUMPS VIRUS BY PCR,362.0,235.3,25.65,325.8,37
HCPCS,87798,MYPCRF DETECT AGENT NOS DNA AMP,422.0,274.3,25.65,379.8,37
HCPCS,87798,NOROVIR 1 & 2 DETECT X2,132.0,85.8,25.65,118.8,37
HCPCS,87798,P JIROVECI PCR,163.0,105.95,25.65,146.7,37
HCPCS,87798,PARVO B19 PLASMA PCR,300.0,195.0,25.65,270.0,37
HCPCS,87798,"PARVOVIRUS B19 PCR, AMNIOTIC FLUID",275.0,178.75,25.65,247.5,37
HCPCS,87798,PLASMODIUM SP DIFF PCR X5,285.0,185.25,25.65,256.5,37
HCPCS,87798,RPRAPD INFECT AGENT NOS AMP,156.0,101.4,25.65,140.4,37
HCPCS,87798,"RT-QUIC ANALYSIS, CSF",132.0,85.8,25.65,118.8,37
HCPCS,87798,STAPH AUREUS AMPLIFICATION,263.0,170.95,25.65,236.7,37
HCPCS,87798,"TOXOPLASMA GONDII, PCR, AMNIOTIC FLUID",275.0,178.75,25.65,247.5,37
HCPCS,87798,TOXOPLASMA PCR,616.0,400.4,25.65,554.4,37
HCPCS,87798,UREAPLASMA SPECIES BY PCR,295.0,191.75,25.65,265.5,37
HCPCS,87798,UREAPLASMA SPECIES MOLEC DETEC PCR FLU TIS,88.0,57.2,22.0,79.2,37
HCPCS,87798,URMPCR DETECT AGENT NOS DNA AMP,99.0,64.35,24.75,89.1,37
HCPCS,87798,VARICELLA ZOSTER PCR,96.0,62.4,24.0,86.4,37
HCPCS,87798,WEST NILE VIRUS PCR PLS,168.0,109.2,25.65,151.2,37
HCPCS,87798,WHIPPLE DNA WHOLE BLD,253.0,164.45,25.65,227.7,37
HCPCS,87798,ZIKA RT-PCR,146.0,94.9,25.65,131.4,37
HCPCS,877980,DETECT AGENT NOS DNA AMP,,,30.32,30.32,1
HCPCS,87799,ADENOVIRUS PCR QUANT,405.0,263.25,25.65,364.5,37
HCPCS,87799,ADENOVIRUS QT RT-PCR,209.0,135.85,25.65,188.1,37
HCPCS,87799,BK VIRUS QUANT URINE,212.5,138.125,25.65,243.0,74
HCPCS,87799,DETECT AGENT NOS DNA QUANT,,,37.01,37.01,1
HCPCS,87799,EBV BY PCR QUANT CSF,330.0,214.5,25.65,297.0,37
HCPCS,87799,HEPATITIS E QNT PCR,229.0,148.85,25.65,206.1,37
HCPCS,87799,HERPESVIRUS 7 PCR QUANT,993.0,645.45,25.65,893.7,37
HCPCS,87799,HHV8 BY QUANTITATIVE PCR,214.0,139.1,25.65,192.6,37
HCPCS,87799,INFECT AGENT NOS QUANT,176.0,114.4,25.65,297.0,111
HCPCS,87799,JC VIRUS QUANT PCR,359.0,233.35,25.65,323.1,37
HCPCS,87799,JCV DNA QNT RT-PCR CSF,363.0,235.95,25.65,326.7,37
HCPCS,87799,NA QUAN NOS AGENT,413.0,268.45,25.65,371.7,37
HCPCS,87799,NY BK VIRUS QNT PCR BLD,168.0,109.2,25.65,151.2,37
HCPCS,87799,"QUANTIFICATION, BK VIRUS",109.0,70.85,25.65,98.1,37
HCPCS,87799,"QUANTIFICATION, EPSTEIN-BARR VIRUS",323.0,209.95,25.65,290.7,37
HCPCS,877990,DETECT AGENT NOS DNA QUANT,,,37.01,37.01,1
HCPCS,87800,DETECT AGNT MULT DNA DIREC,,,37.74,72.97,15
HCPCS,87800,Detect agnt mult dna direc,,,25.65,32.4,6
HCPCS,878000,DETECT AGNT MULT DNA DIREC,,,37.74,37.74,1
HCPCS,87801,*DNA/RNA;MULTI ORG-AMP PR,403.0,261.95,25.65,362.7,37
HCPCS,87801,"BACTERIAL PCR, DIRECT SPEC",624.0,405.6,25.65,561.6,37
HCPCS,87801,BARTONELLA PCR,273.0,177.45,25.65,245.7,37
HCPCS,87801,DETECT AGNT MULT DNA AMPLI,,,60.65,117.3,4
HCPCS,87801,DNA/RNA;MULTI ORG-AMP PR,636.0,413.4,25.65,572.4,74
HCPCS,87801,MULT ORGANISMS DNA AMPL PROBE,209.0,135.85,25.65,188.1,37
HCPCS,87801,UNIVERSAL FUNGAL PCR,624.0,405.6,25.65,561.6,37
HCPCS,878010,DETECT AGNT MULT DNA AMPLI,,,60.65,60.65,1
HCPCS,87801QW,DETECT AGNT MULT DNA AMPLI,,,108.25,117.3,3
HCPCS,87802,IAADIADOO STREPTOCOCCUS GROUP B,15.0,9.75,5.35,15.0,17
HCPCS,87802,STREP B ASSAY W/OPTIC,,,10.99,21.27,15
HCPCS,87802,STREP B IA DIR,13.0,8.45,5.35,13.25,17
HCPCS,87802,Strep b assay w/optic,,,4.02,5.08,6
HCPCS,878020,STREP B ASSAY W/OPTIC,,,10.99,10.99,1
HCPCS,87803,CDT A IA DIR PROFESSIONAL FEE,13.0,8.45,6.5,13.25,17
HCPCS,87803,CLOSTRIDIUM TOXIN A W/OPTIC,,,13.82,26.74,15
HCPCS,87803,Clostridium toxin a w/optic,,,4.02,5.08,6
HCPCS,87803,IAADIADOO CLOSTRIDIUM DIFFICILE TOXIN A,15.0,9.75,6.72,15.0,17
HCPCS,878030,CLOSTRIDIUM TOXIN A W/OPTIC,,,13.82,13.82,1
HCPCS,87804,*INFLUENZA A,74.0,48.1,4.02,66.6,37
HCPCS,87804,*INFLUENZA B,74.0,48.1,4.02,66.6,37
HCPCS,87804,IAADIADOO INFLUENZA,108.0,70.2,9.93,108.0,17
HCPCS,87804,INF A IA DIR,16.5,10.725,6.5,20.0,34
HCPCS,87804,INFLUENZA ASSAY W/OPTIC,20.0,13.0,9.93,27.66,21
HCPCS,87804,INFLUENZA OIA (POINT OF CARE LAB),74.0,48.1,4.02,66.6,37
HCPCS,87804,RAPID FLU X2,74.0,48.1,4.02,66.6,37
HCPCS,87804,RAPID INFLUENZA TEST,77.0,50.05,9.93,77.0,17
HCPCS,878040,INFLUENZA ASSAY W/OPTIC,,,14.3,14.3,1
HCPCS,87804QW,INFLUENZA ASSAY W/OPTIC,,,25.52,27.66,3
HCPCS,87806,HIV AG W/HIV1&2 ANTB W/OPTIC,,,28.32,54.76,4
HCPCS,87806,HIV ANTIGEN W/HIV ANTIBODIES,172.0,111.8,25.65,154.8,37
HCPCS,87806,HIV ANTIGEN W/HIV ANTIBODIES (POINT OF CARE LAB),172.0,111.8,25.65,154.8,37
HCPCS,878060,HIV AG W/HIV1&2 ANTB W/OPTIC,,,28.32,28.32,1
HCPCS,87806QW,HIV AG W/HIV1&2 ANTB W/OPTIC,,,50.53,54.76,3
HCPCS,87807,RSV ASSAY W/OPTIC,,,11.32,21.89,4
HCPCS,87807,RSV DIRECT OPTICAL,109.0,70.85,4.02,98.1,37
HCPCS,87807,RSV IA W DIR OBSERV,109.0,70.85,4.02,98.1,37
HCPCS,87807,RSV IA W DIR OBSERV (POINT OF CARE LAB),109.0,70.85,4.02,98.1,37
HCPCS,878070,RSV ASSAY W/OPTIC,,,11.32,11.32,1
HCPCS,87807QW,RSV ASSAY W/OPTIC,,,20.2,21.89,3
HCPCS,87808,TRICHOMONAS ANTIGEN,105.0,68.25,4.02,94.5,37
HCPCS,87808,TRICHOMONAS ASSAY W/OPTIC,69.0,44.85,4.02,62.1,41
HCPCS,878080,TRICHOMONAS ASSAY W/OPTIC,,,13.21,13.21,1
HCPCS,87808QW,TRICHOMONAS ASSAY W/OPTIC,,,23.58,25.55,3
HCPCS,87809,ADENOVIRUS,20.0,13.0,9.14,20.0,17
HCPCS,87809,ADENOVIRUS ASSAY W/OPTIC,20.0,13.0,9.14,36.36,35
HCPCS,87809,Adenovirus assay w/optic,,,4.02,5.08,6
HCPCS,87809,IAADIADOO ADENOVIRUS,92.0,59.8,9.14,92.0,17
HCPCS,878090,ADENOVIRUS ASSAY W/OPTIC,,,18.8,18.8,1
HCPCS,87809QW,ADENOVIRUS ASSAY W/OPTIC,,,33.55,36.36,3
HCPCS,87810,CHLMYD TRACH ASSAY W/OPTIC,,,30.49,58.97,15
HCPCS,87810,Chlmyd trach assay w/optic,,,25.65,32.4,6
HCPCS,878100,CHLMYD TRACH ASSAY W/OPTIC,,,30.49,30.49,1
HCPCS,87811,SARS-COV-2 COVID19 W/OPTIC,,,41.38,89.38,21
HCPCS,87811,Sars-cov-2 covid19 w/optic,,,4.02,5.08,6
HCPCS,878110,SARS-COV-2 COVID19 W/OPTIC,,,44.69,44.69,1
HCPCS,87811QW,SARS-COV-2 COVID19 W/OPTIC,,,63.81,69.15,3
HCPCS,87812,SARSCOV2&INF TYP A&B W/OPTIC,,,64.35,81.93,5
HCPCS,87812,Sarscov2&inf typ a&b w/optic,,,4.02,5.08,6
HCPCS,878120,SARSCOV2&INF TYP A&B W/OPTIC,,,64.35,64.35,1
HCPCS,87850,N. GONORRHOEAE ASSAY W/OPTIC,,,21.22,41.04,15
HCPCS,87850,N. gonorrhoeae assay w/optic,,,4.02,5.08,6
HCPCS,878500,N. GONORRHOEAE ASSAY W/OPTIC,,,21.22,21.22,1
HCPCS,87880,IAADIADOO STREPTOCOCCUS GROUP A,47.0,30.55,9.92,47.0,17
HCPCS,87880,RAPID STREP A TEST,86.0,55.9,9.92,86.0,17
HCPCS,87880,STREP A ASSAY,20.0,13.0,9.92,20.0,17
HCPCS,87880,STREP A ASSAY W/OPTIC,98.0,63.7,4.02,158.4,58
HCPCS,87880,STREP A ASSAY W/OPTIC N/C,176.0,114.4,4.02,158.4,37
HCPCS,87880,STREP ASSAY (POINT OF CARE LAB),176.0,114.4,4.02,158.4,37
HCPCS,878800,STREP A ASSAY W/OPTIC,,,14.28,14.28,1
HCPCS,87880QW,STREP A ASSAY W/OPTIC,,,25.49,27.62,3
HCPCS,87899,AGENT NOS ASSAY W/OPTIC,,,13.89,26.85,4
HCPCS,87899,CRYPTOCOCCUS AG DETECTION,93.0,60.45,4.02,83.7,37
HCPCS,87899,HIV I/II POST EXP AG SRN,84.0,54.6,4.02,75.6,37
HCPCS,87899,HIV-1/2 AG/AB COMBO,91.0,59.15,4.02,81.9,37
HCPCS,87899,IAADIADOO NOT OTHERWISE SPECIFIED,15.0,9.75,6.75,15.0,17
HCPCS,87899,"IMMUNOASSAY, CAD",65.0,42.25,4.02,58.5,37
HCPCS,87899,"IMMUNOASSAY, CAD TITER",88.0,57.2,4.02,79.2,37
HCPCS,87899,"IMMUNOASSAY, MALARIA P. FALCIPARUM",91.0,59.15,4.02,81.9,37
HCPCS,87899,"IMMUNOASSAY, PAN-MALARIAL",96.0,62.4,4.02,86.4,37
HCPCS,87899,"IMMUNOASSAY, STREP PNEUMONIAE ANTIGEN",150.0,97.5,4.02,135.0,37
HCPCS,87899,INFECT AGENT NOS W DIR OPTIC,100.0,65.0,4.02,137.7,185
HCPCS,87899,LIMULUS AMEBOCYTE LT,425.0,276.25,4.02,382.5,37
HCPCS,878990,AGENT NOS ASSAY W/OPTIC,,,13.89,13.89,1
HCPCS,87899QW,AGENT NOS ASSAY W/OPTIC,,,24.78,26.85,3
HCPCS,87900,%HIVPHS PHENOTYPE,359.0,233.35,89.75,323.1,37
HCPCS,87900,*PHENOTYPE INFECT AGENT DRUG,237.5,154.375,45.0,265.5,74
HCPCS,87900,CYTSEQ PHENOTYPE INFECT AGENT DRUG,358.0,232.7,89.5,322.2,37
HCPCS,87900,HIVNGS PHENOTYPE INFECT AGENT DRUG,397.0,258.05,92.55,357.3,37
HCPCS,87900,PHENOTYPE INFECT AGENT DRUG,,,112.62,112.62,1
HCPCS,879000,PHENOTYPE INFECT AGENT DRUG,,,112.62,112.62,1
HCPCS,87901,%HIVGEN HIV GENOTYPING,362.0,235.3,76.88,362.0,37
HCPCS,87901,%HIVPHS GENOTYPE,707.0,459.55,76.88,636.3,37
HCPCS,87901,*HIV 1 GENOTYPE DNA REVERSE,362.0,235.3,76.88,362.0,37
HCPCS,87901,HIV 1 GENOTYPE RNA REVERSE,721.0,468.65,76.88,648.9,37
HCPCS,87901,HIVNGS GENOTYPE DNA HIV REVERSE T,781.0,507.65,76.88,702.9,37
HCPCS,87901,NFCT AGT GNTYP ALYS HIV1 REV,,,222.44,222.44,1
HCPCS,879010,NFCT AGT GNTYP ALYS HIV1 REV,,,222.44,222.44,1
HCPCS,87902,*HEP C GENOTYPE DNA REVERSE,464.0,301.6,76.88,430.2,37
HCPCS,87902,"GENOTYPE, HEPATITIS C VIRUS",1346.0,874.9,76.88,1211.4,37
HCPCS,87902,HCV NS5A DRG RES SEQ,688.0,447.2,76.88,619.2,37
HCPCS,87902,NFCT AGT GNTYP ALYS HEP C,,,222.44,222.44,1
HCPCS,879020,NFCT AGT GNTYP ALYS HEP C,,,222.44,222.44,1
HCPCS,87903,%HIVPHE ANALYSIS NUCLEIC ACID,1672.0,1086.8,170.1,1504.8,37
HCPCS,87903,%HIVPHS PHENO 1-10 DRUGS,1339.0,870.35,170.1,1205.1,37
HCPCS,87903,*HIV PHENOTYPE DNA DRUGS 1-10,680.0,442.0,170.0,680.0,37
HCPCS,87903,HIV PHENOTYPE DNA DRUGS 1-10,3438.0,2234.7,170.1,3094.2,37
HCPCS,87903,PHENOTYPE DNA HIV W/CULTURE,,,422.2,422.2,1
HCPCS,879030,PHENOTYPE DNA HIV W/CULTURE,,,422.2,422.2,1
HCPCS,87904,%HIVPHS PHENO EA ADD X12,72.0,46.8,18.0,64.8,37
HCPCS,87904,*HIV PHENOTYPE DNA DRUG EA ADD,129.0,83.85,13.25,117.9,185
HCPCS,87904,PHENOTYPE DNA HIV W/CLT ADD,,,22.53,22.53,1
HCPCS,879040,PHENOTYPE DNA HIV W/CLT ADD,,,22.53,22.53,1
HCPCS,87905,IA NZMTC ACTV OTH/THN VIRUS,,,10.56,20.42,18
HCPCS,87905,INFECTIOUS AGENT ENZYMATIC ACTV OTH/THN VIRUS,29.0,18.85,5.13,29.0,17
HCPCS,87905,Ia nzmtc actv oth/thn virus,,,4.02,5.08,6
HCPCS,879050,IA NZMTC ACTV OTH/THN VIRUS,,,10.56,10.56,1
HCPCS,87905QW,IA NZMTC ACTV OTH/THN VIRUS,,,18.84,20.42,3
HCPCS,87906,GENOSURE INTEGRASE,446.0,289.9,92.55,401.4,37
HCPCS,87906,GENOTYPE DNA HIV OTHER REGION,312.0,202.8,78.0,280.8,37
HCPCS,87906,HIVNGS GENOTYPE DNA/RNA HIV,391.0,254.15,92.55,351.9,37
HCPCS,87906,NFCT AGT GNTYP ALYS HIV1,,,111.22,111.22,1
HCPCS,879060,NFCT AGT GNTYP ALYS HIV1,,,111.22,111.22,1
HCPCS,87910,CYTSEQ NFCT AGT GNTYP ALYS CMV,710.0,461.5,92.55,639.0,37
HCPCS,87910,GENOTYPE CYTOMEGALOVIRUS,979.0,636.35,92.55,881.1,37
HCPCS,87910,NFCT AGT GNTYP ALYS CMV,,,222.44,222.44,1
HCPCS,879100,NFCT AGT GNTYP ALYS CMV,,,222.44,222.44,1
HCPCS,87912,GENOTYPE DNA HEPATITIS B,515.0,334.75,92.55,463.5,37
HCPCS,87912,HBV DRUG RESISTANCE SEQ,1309.0,850.85,92.55,1178.1,37
HCPCS,87912,HEPATITIS B GENOTYPING,864.0,561.6,92.55,1091.7,74
HCPCS,87912,NFCT AGT GNTYP ALYS HEP B,,,222.44,222.44,1
HCPCS,879120,NFCT AGT GNTYP ALYS HEP B,,,222.44,222.44,1
HCPCS,87913,NFCT AGT GNTYP ALYS SARSCOV2,,,0.01,430.2,15
HCPCS,87913,Nfct agt gntyp alys sarscov2,,,92.55,116.9,6
HCPCS,879130,NFCT AGT GNTYP ALYS SARSCOV2,,,0.01,0.01,1
HCPCS,87999,TROFILE CO-RECEPT PROFILE,3094.0,2011.1,4.02,2784.6,27
HCPCS,87999,TROFILE CO-RECEPTOR,116.0,75.4,4.02,104.4,27
HCPCS,88000,AUTOPSY (NECROPSY) GROSS,,,166.11,166.11,1
HCPCS,88000,Autopsy (necropsy) gross,,,92.91,117.36,6
HCPCS,880000,AUTOPSY (NECROPSY) GROSS,,,166.11,166.11,1
HCPCS,88005,AUTOPSY (NECROPSY) GROSS,,,193.62,193.62,1
HCPCS,88005,Autopsy (necropsy) gross,,,92.91,117.36,6
HCPCS,880050,AUTOPSY (NECROPSY) GROSS,,,193.62,193.62,1
HCPCS,88007,AUTOPSY (NECROPSY) GROSS,,,202.79,202.79,1
HCPCS,88007,Autopsy (necropsy) gross,,,92.91,117.36,6
HCPCS,880070,AUTOPSY (NECROPSY) GROSS,,,202.79,202.79,1
HCPCS,88012,AUTOPSY (NECROPSY) GROSS,,,166.11,166.11,1
HCPCS,88012,Autopsy (necropsy) gross,,,92.91,117.36,6
HCPCS,880120,AUTOPSY (NECROPSY) GROSS,,,166.11,166.11,1
HCPCS,88014,AUTOPSY (NECROPSY) GROSS,,,152.23,152.23,1
HCPCS,88014,Autopsy (necropsy) gross,,,92.91,117.36,6
HCPCS,880140,AUTOPSY (NECROPSY) GROSS,,,152.23,152.23,1
HCPCS,88016,AUTOPSY (NECROPSY) GROSS,,,212.23,212.23,1
HCPCS,88016,Autopsy (necropsy) gross,,,92.91,117.36,6
HCPCS,880160,AUTOPSY (NECROPSY) GROSS,,,212.23,212.23,1
HCPCS,88020,AUTOPSY (NECROPSY) COMPLETE,,,285.85,285.85,1
HCPCS,88020,Autopsy (necropsy) complete,,,92.91,117.36,6
HCPCS,880200,AUTOPSY (NECROPSY) COMPLETE,,,285.85,285.85,1
HCPCS,88025,AUTOPSY (NECROPSY) COMPLETE,,,276.67,276.67,1
HCPCS,88025,NECROPSY COMPLT W BRAIN,651.0,423.15,92.91,585.9,27
HCPCS,880250,AUTOPSY (NECROPSY) COMPLETE,,,276.67,276.67,1
HCPCS,88027,AUTOPSY (NECROPSY) COMPLETE,,,295.02,295.02,1
HCPCS,88027,Autopsy (necropsy) complete,,,92.91,117.36,6
HCPCS,880270,AUTOPSY (NECROPSY) COMPLETE,,,295.02,295.02,1
HCPCS,88028,AUTOPSY (NECROPSY) COMPLETE,,,166.11,166.11,1
HCPCS,88028,Autopsy (necropsy) complete,,,92.91,117.36,6
HCPCS,880280,AUTOPSY (NECROPSY) COMPLETE,,,166.11,166.11,1
HCPCS,88029,AUTOPSY (NECROPSY) COMPLETE,,,166.11,166.11,1
HCPCS,88029,Autopsy (necropsy) complete,,,92.91,117.36,6
HCPCS,880290,AUTOPSY (NECROPSY) COMPLETE,,,166.11,166.11,1
HCPCS,88036,LIMITED AUTOPSY,,,83.05,83.05,1
HCPCS,88036,Limited autopsy,,,92.91,117.36,6
HCPCS,880360,LIMITED AUTOPSY,,,83.05,83.05,1
HCPCS,88037,LIMITED AUTOPSY,,,73.88,73.88,1
HCPCS,88037,Limited autopsy,,,92.91,117.36,6
HCPCS,880370,LIMITED AUTOPSY,,,73.88,73.88,1
HCPCS,88040,FORENSIC AUTOPSY (NECROPSY),,,461.13,461.13,1
HCPCS,88040,Forensic autopsy (necropsy),,,92.91,117.36,6
HCPCS,880400,FORENSIC AUTOPSY (NECROPSY),,,461.13,461.13,1
HCPCS,88045,CORONERS AUTOPSY (NECROPSY),,,46.12,46.12,1
HCPCS,88045,Coroners autopsy (necropsy),,,92.91,117.36,6
HCPCS,880450,CORONERS AUTOPSY (NECROPSY),,,46.12,46.12,1
HCPCS,88099,Unlisted necropsy (autopsy),,,92.91,117.36,6
HCPCS,88104,CYTOPATH FL NONGYN SMEARS,,,38.59,38.59,2
HCPCS,88104,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,241.0,156.65,16.12,241.0,62
HCPCS,88104,CYTPATH NONGYN SMEAR INTERP,151.5,98.475,11.52,174.6,76
HCPCS,881040,CYTOPATH FL NONGYN SMEARS,,,38.59,38.59,1
HCPCS,88104TC,CYTOPATH FL NONGYN SMEARS,,,38.59,38.59,1
HCPCS,88106,CYTOPATH FL NONGYN FILTER,,,24.58,53.1,16
HCPCS,88106,CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ,175.0,113.75,11.13,176.0,62
HCPCS,88106,Cytopath fl nongyn filter,,,11.52,14.56,6
HCPCS,881060,CYTOPATH FL NONGYN FILTER,,,41.73,41.73,1
HCPCS,88106TC,CYTOPATH FL NONGYN FILTER,,,41.73,41.73,1
HCPCS,88108,CYTOLOGY FLUID,109.0,70.85,11.52,101.35,38
HCPCS,88108,CYTOPATH CONCENTRATE TECH,,,36.98,36.98,2
HCPCS,88108,"CYTOPATHOLOGY,BRONCHIAL WASH",190.0,123.5,41.39,190.0,31
HCPCS,88108,CYTP CONCENTRATION SMEARS & INTERPRETATION,325.5,211.575,13.13,461.0,62
HCPCS,88108,CYTPATH SACCOMENNO SMEAR,111.0,72.15,11.52,101.35,38
HCPCS,881080,CYTOPATH CONCENTRATE TECH,,,36.98,36.98,1
HCPCS,88108TC,CYTOPATH CONCENTRATE TECH,,,36.98,36.98,1
HCPCS,88112,BILIARY TRACT MALIG,597.0,388.05,11.52,537.3,38
HCPCS,88112,CYTOLOGY FLUID TP,232.0,150.8,11.52,208.8,38
HCPCS,88112,CYTOPATH CELL ENHANCE TECH,238.0,154.7,11.52,214.2,40
HCPCS,88112,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,241.0,156.65,16.12,241.0,62
HCPCS,881120,CYTOPATH CELL ENHANCE TECH,,,32.52,32.52,1
HCPCS,88112TC,CYTOPATH CELL ENHANCE TECH,,,32.52,32.52,1
HCPCS,88120,CYTP URNE 3-5 PROBES EA SPEC,843.5,548.275,101.52,923.4,78
HCPCS,88120,FISH FOR BLADDER CANCER W/URINARY CYTO,2124.0,1380.6,101.52,1911.6,38
HCPCS,881200,CYTP URNE 3-5 PROBES EA SPEC,,,411.72,411.72,1
HCPCS,88120TC,CYTP URNE 3-5 PROBES EA SPEC,,,411.72,411.72,1
HCPCS,88121,CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA,431.0,280.15,215.5,607.56,31
HCPCS,88121,CYTP URINE 3-5 PROBES CMPTR,688.0,447.2,101.52,619.2,40
HCPCS,881210,CYTP URINE 3-5 PROBES CMPTR,,,292.99,292.99,1
HCPCS,88121TC,CYTP URINE 3-5 PROBES CMPTR,,,292.99,292.99,1
HCPCS,88125,FORENSIC CYTOPATHOLOGY,,,12.09,115.85,16
HCPCS,88125,Forensic cytopathology,,,11.52,14.56,6
HCPCS,881250,FORENSIC CYTOPATHOLOGY,,,12.09,12.09,1
HCPCS,88125TC,FORENSIC CYTOPATHOLOGY,,,12.09,12.09,1
HCPCS,88130,SEX CHROMATIN ID BARR BODIES,39.0,25.35,2.34,35.1,37
HCPCS,88130,SEX CHROMATIN IDENTIFICATION,,,15.53,15.53,1
HCPCS,881300,SEX CHROMATIN IDENTIFICATION,,,15.53,15.53,1
HCPCS,88140,SEX CHROMATIN IDENTIFICATION,,,6.9,13.35,15
HCPCS,88140,Sex chromatin identification,,,2.34,2.95,6
HCPCS,881400,SEX CHROMATIN IDENTIFICATION,,,6.9,6.9,1
HCPCS,88141,CYTOPATH C/V INTERPRET,,,19.57,19.57,2
HCPCS,88141,CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN,112.0,72.8,14.51,112.0,31
HCPCS,88141,PAP SMEAR INTRP,45.0,29.25,7.56,40.5,28
HCPCS,881410,CYTOPATH C/V INTERPRET,,,19.57,19.57,1
HCPCS,88141TC,CYTOPATH C/V INTERPRET,,,19.57,19.57,1
HCPCS,88142,CYTOLOGY GYN SC THIN PREP,167.0,108.55,9.95,150.3,37
HCPCS,88142,CYTOLOGY SUREPATH PAP,32.0,20.8,8.0,32.0,37
HCPCS,88142,CYTOPATH C/V THIN LAYER,,,17.51,17.51,1
HCPCS,88142,CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN,194.0,126.1,12.16,194.0,17
HCPCS,88142,PAP AND REFLEX HPV SCREEN- ARUP,51.0,33.15,9.95,45.9,37
HCPCS,88142,PAP SMR THN PRP,109.0,70.85,9.95,98.1,37
HCPCS,88142,PAP WITH REFLEX HPV SCREEN-ARUP,51.0,33.15,9.95,45.9,37
HCPCS,881420,CYTOPATH C/V THIN LAYER,,,17.51,17.51,1
HCPCS,88143,CYTOPATH C/V THIN LAYER REDO,,,19.9,38.5,15
HCPCS,88143,Cytopath c/v thin layer redo,,,9.95,12.56,6
HCPCS,881430,CYTOPATH C/V THIN LAYER REDO,,,19.9,19.9,1
HCPCS,88147,CYTOPATH C/V AUTOMATED,,,43.69,84.49,15
HCPCS,88147,Cytopath c/v automated,,,9.95,12.56,6
HCPCS,881470,CYTOPATH C/V AUTOMATED,,,43.69,43.69,1
HCPCS,88148,CYTOPATH C/V AUTO RESCREEN,,,15.35,30.4,15
HCPCS,88148,Cytopath c/v auto rescreen,,,9.95,12.56,6
HCPCS,881480,CYTOPATH C/V AUTO RESCREEN,,,15.35,15.35,1
HCPCS,88150,CYTO CERV/VAG PROFESSIONAL FEE,13.0,8.45,6.5,13.0,17
HCPCS,88150,CYTOLOGY GYN SCREENING,109.0,70.85,9.95,98.1,37
HCPCS,88150,CYTOPATH C/V MANUAL,,,15.35,15.35,1
HCPCS,88150,CYTP SLIDES C/V MNL SCR UNDER PHYS,93.0,60.45,10.66,93.0,17
HCPCS,881500,CYTOPATH C/V MANUAL,,,15.35,15.35,1
HCPCS,88152,CYTOPATH C/V AUTO REDO,,,23.88,46.19,15
HCPCS,88152,Cytopath c/v auto redo,,,9.95,12.56,6
HCPCS,881520,CYTOPATH C/V AUTO REDO,,,23.88,23.88,1
HCPCS,88153,CYTOPATH C/V REDO,,,20.76,40.15,15
HCPCS,88153,Cytopath c/v redo,,,9.95,12.56,6
HCPCS,881530,CYTOPATH C/V REDO,,,20.76,20.76,1
HCPCS,88155,CYTOPATH C/V INDEX ADD-ON,,,12.66,12.66,1
HCPCS,88155,CYTP SLIDES C/V DEFINITIVE HORMONAL EVAL,44.0,28.6,6.62,44.0,17
HCPCS,88155,CYTPATH HORMONAL EVAL,39.0,25.35,9.75,35.1,37
HCPCS,881550,CYTOPATH C/V INDEX ADD-ON,,,12.66,12.66,1
HCPCS,88160,CYTOPATH SMEAR OTHER SOURCE,,,43.3,43.3,2
HCPCS,88160,CYTP SMRS ANY OTH SRC SCR&INTERPJ,216.0,140.4,14.92,216.0,62
HCPCS,88160,CYTPATH SMEAR OTHER,109.0,70.85,11.52,120.07,38
HCPCS,881600,CYTOPATH SMEAR OTHER SOURCE,,,43.3,43.3,1
HCPCS,88160TC,CYTOPATH SMEAR OTHER SOURCE,,,43.3,43.3,1
HCPCS,88161,CYTOPATH SMEAR OTHER SOURCE,,,44.87,44.87,2
HCPCS,88161,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,177.0,115.05000000000001,14.73,216.0,62
HCPCS,88161,CYTPATH SMEAR OTHER W PREP,86.0,55.9,11.52,122.16,38
HCPCS,88161,PATH TOUCH PREP INIT,255.0,165.75,11.52,229.5,38
HCPCS,881610,CYTOPATH SMEAR OTHER SOURCE,,,44.87,44.87,1
HCPCS,88161TC,CYTOPATH SMEAR OTHER SOURCE,,,44.87,44.87,1
HCPCS,88162,CYTOPATH SMEAR OTHER SOURCE,,,71.37,71.37,2
HCPCS,88162,"CYTOPATHOLOGY, EXTENSIVE",205.0,133.25,72.61,205.0,31
HCPCS,88162,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,290.0,188.5,22.91,327.0,62
HCPCS,88162,CYTPATH SMEAR OTHER EXTENDED,69.0,44.85,11.52,188.54,38
HCPCS,881620,CYTOPATH SMEAR OTHER SOURCE,,,71.37,71.37,1
HCPCS,88162TC,CYTOPATH SMEAR OTHER SOURCE,,,71.37,71.37,1
HCPCS,88164,CYTOPATH TBS C/V MANUAL,,,15.35,15.35,1
HCPCS,88164,CYTPATH CERV/VAG SCREENING,28.0,18.2,7.0,28.0,37
HCPCS,881640,CYTOPATH TBS C/V MANUAL,,,15.35,15.35,1
HCPCS,88165,CYTOPATH TBS C/V REDO,,,36.48,70.55,15
HCPCS,88165,Cytopath tbs c/v redo,,,9.95,12.56,6
HCPCS,881650,CYTOPATH TBS C/V REDO,,,36.48,36.48,1
HCPCS,88166,CYTOPATH TBS C/V AUTO REDO,,,15.35,30.4,15
HCPCS,88166,Cytopath tbs c/v auto redo,,,9.95,12.56,6
HCPCS,881660,CYTOPATH TBS C/V AUTO REDO,,,15.35,15.35,1
HCPCS,88167,CYTOPATH TBS C/V SELECT,,,15.35,30.4,15
HCPCS,88167,Cytopath tbs c/v select,,,9.95,12.56,6
HCPCS,881670,CYTOPATH TBS C/V SELECT,,,15.35,15.35,1
HCPCS,88172,CYTP DX EVAL FNA 1ST EA SITE,,,17.06,17.06,2
HCPCS,88172,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,297.0,193.05,20.51,297.0,62
HCPCS,88172,CYTPATH FNA IMMEDIATE EVAL,188.0,122.2,48.69,371.54,38
HCPCS,881720,CYTP DX EVAL FNA 1ST EA SITE,,,17.06,17.06,1
HCPCS,88172TC,CYTP DX EVAL FNA 1ST EA SITE,,,17.06,17.06,1
HCPCS,88173,CYTOPATH EVAL FNA REPORT,,,78.71,78.71,2
HCPCS,88173,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,598.0,388.7,40.63,598.0,62
HCPCS,88173,CYTPATH FNA I&R,186.0,120.9,48.17,241.64,38
HCPCS,881730,CYTOPATH EVAL FNA REPORT,,,78.71,78.71,1
HCPCS,88173TC,CYTOPATH EVAL FNA REPORT,,,78.71,78.71,1
HCPCS,88174,CYTOPATH C/V AUTO IN FLUID,,,21.92,42.39,15
HCPCS,88174,Cytopath c/v auto in fluid,,,9.95,12.56,6
HCPCS,881740,CYTOPATH C/V AUTO IN FLUID,,,21.92,21.92,1
HCPCS,88175,CYTO IMAGER GYN TP DIAG,191.0,124.15,9.95,171.9,37
HCPCS,88175,CYTO IMAGER GYN TP SCREEN,196.0,127.4,9.95,176.4,37
HCPCS,88175,CYTOPATH C/V AUTO FLUID REDO,40.0,26.0,9.95,40.0,75
HCPCS,88175,PAP WITH REFLEX HPV SCREEN-ARUP,216.0,140.4,9.95,194.4,37
HCPCS,881750,CYTOPATH C/V AUTO FLUID REDO,,,22.99,22.99,1
HCPCS,88177,CYTO SECOND PASS ADEQ,37.0,24.05,6.22,40.01,28
HCPCS,88177,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL,181.0,117.65,17.71,181.0,31
HCPCS,88177,CYTP FNA EVAL EA ADDL,39.0,25.35,6.54,40.01,30
HCPCS,881770,CYTP FNA EVAL EA ADDL,,,6.54,6.54,1
HCPCS,88177TC,CYTP FNA EVAL EA ADDL,,,6.54,6.54,1
HCPCS,88182,CELL MARKER STUDY,,,102.36,102.36,2
HCPCS,88182,"FLOW CYTO, DNA",173.0,112.45,11.52,221.05,38
HCPCS,88182,FLOW CYTOMETRY CELL CYCLE/DNA ANALYSIS,216.0,140.4,22.31,243.64,62
HCPCS,88182,"FLOW CYTORACTRY,EACH CELL",175.0,113.75,86.67,243.64,31
HCPCS,88182,TELOMERE LENGTH MEASUREMENT,639.0,415.35,11.52,575.1,38
HCPCS,881820,CELL MARKER STUDY,,,102.36,102.36,1
HCPCS,88182TC,CELL MARKER STUDY,,,102.36,102.36,1
HCPCS,88184,%ACLUK2 1ST MARK,374.0,243.1,96.87,779.93,38
HCPCS,88184,%BLYMPHOMA 1ST MARKER,209.0,135.85,54.13,779.93,38
HCPCS,88184,%CD2 CD3 MONITOR 1ST MARK,374.0,243.1,96.87,779.93,38
HCPCS,88184,%CVID FLOW FIRST MARKER,374.0,243.1,96.87,779.93,38
HCPCS,88184,%LGLYM 1ST MRK,226.0,146.9,58.53,779.93,38
HCPCS,88184,%NKFUNC FIRST MARKER,789.0,512.85,101.52,779.93,38
HCPCS,88184,%NUCLEAR TDT BY FCM 1ST MARKER,374.0,243.1,96.87,779.93,38
HCPCS,88184,%PLAFLW FLOW 1ST MARKER,132.0,85.8,34.19,779.93,38
HCPCS,88184,%PNH BY FCM 1ST MARK X2,122.0,79.3,31.6,779.93,38
HCPCS,88184,%PNH PANEL 1ST MARKER,374.0,243.1,96.87,779.93,38
HCPCS,88184,%RLLLIP 1ST MARKER,374.0,243.1,96.87,779.93,38
HCPCS,88184,%SURFACE/CYTO IGM 1ST MARKER,374.0,243.1,96.87,779.93,38
HCPCS,88184,%T CELL VBETA 1ST MARKER,374.0,243.1,96.87,779.93,38
HCPCS,88184,%ZAP70 FIRST MARKER,374.0,243.1,96.87,779.93,38
HCPCS,88184,*FLOW CYTOMETRY TC 1ST MARKER,374.0,243.1,96.87,779.93,76
HCPCS,88184,"*FLOW CYTOMETRY TC, 1ST MARKER",374.0,243.1,96.87,779.93,38
HCPCS,88184,ALPS FLOW CYTOMETRY,175.0,113.75,45.33,779.93,38
HCPCS,88184,B CELL CD20 1ST MRK,230.0,149.5,59.57,779.93,38
HCPCS,88184,CD52EX FIRST MARKER,865.0,562.25,101.52,779.93,38
HCPCS,88184,FL CYT LAB1243 1ST MKR,230.0,149.5,59.57,779.93,38
HCPCS,88184,FLOW CD107A,865.0,562.25,101.52,779.93,38
HCPCS,88184,FLOW CYTO CEL FIRST MRKR,374.0,243.1,96.87,779.93,38
HCPCS,88184,"FLOW CYTO, 1ST MARKER",374.0,243.1,96.87,779.93,38
HCPCS,88184,FLOW CYTOMETRY TC 1ST MARKER,374.0,243.1,96.87,779.93,76
HCPCS,88184,FLOW CYTOMETRY TC 1ST MRK,374.0,243.1,96.87,779.93,38
HCPCS,88184,"FLOW CYTOMETRY TC, 1ST MARKER",302.0,196.3,59.57,779.93,76
HCPCS,88184,FLOW PERFORIN/GRANZYME B,865.0,562.25,101.52,779.93,38
HCPCS,88184,FLOW PSTAT5,865.0,562.25,101.52,779.93,38
HCPCS,88184,FLOW SAP (XLP1) AND XIAP (XLP2),865.0,562.25,101.52,779.93,38
HCPCS,88184,FLOW SCRN TUBE 1ST MKR,129.0,83.85,33.41,779.93,38
HCPCS,88184,FLOW TH17,865.0,562.25,101.52,779.93,38
HCPCS,88184,FLOWCYTOMETRY/ TC 1 MARKER,,,61.38,61.38,1
HCPCS,88184,FLW CYT LYMP WKUP LAB2500,230.0,149.5,59.57,779.93,38
HCPCS,88184,"KIRFLW FLOW CYTOMETRY; FIRST CELL SURFACE, CYTOPLASMIC OR NUCLEA",865.0,562.25,101.52,779.93,38
HCPCS,88184,LYMPH TISS FIRST MARKER,374.0,243.1,96.87,779.93,38
HCPCS,88184,NUCLEAR TDT BY FLOW CYTOMETRY,374.0,243.1,96.87,779.93,38
HCPCS,88184,RBCB3 PROTEIN RED,374.0,243.1,96.87,779.93,38
HCPCS,881840,FLOWCYTOMETRY/ TC 1 MARKER,,,61.38,61.38,1
HCPCS,88185,%NKFUNC ADDTL MARKERS X2,252.0,163.8,11.52,226.8,28
HCPCS,88185,%PLAFLW FLW ADD MARKER X5,132.0,85.8,11.52,118.8,28
HCPCS,88185,%PNH BY FCM ADD MARK X7,62.0,40.3,10.42,55.8,28
HCPCS,88185,%ZAP70 ADDTL MARKERS,185.0,120.25,11.52,166.5,28
HCPCS,88185,*CIRCULATING TUMOR CELLS,101.0,65.65,11.52,90.9,84
HCPCS,88185,*FLOW CYTOMETRY TC ADD MARKER,21.0,13.649999999999999,3.19,35.89,84
HCPCS,88185,"*FLOW CYTOMETRY TC, ADD MARKER",46.0,29.9,7.73,41.4,28
HCPCS,88185,ADDITIONAL MARKERS,138.0,89.7,11.52,124.2,28
HCPCS,88185,ALPS FLOW MARKERS,53.0,34.45,8.9,47.7,28
HCPCS,88185,B CELL CD20 ADDTL MRK,174.0,113.1,11.52,156.6,28
HCPCS,88185,CD52EX ADDITIONAL MARKERS,83.0,53.95,11.52,74.7,28
HCPCS,88185,FLOW CD107A ADDITIONAL,83.0,53.95,11.52,74.7,28
HCPCS,88185,"FLOW CYTO, EA ADD MARKER",43.0,27.95,7.22,38.7,28
HCPCS,88185,FLOW CYTOMETRY TC ADD MARKER,23.0,14.95,3.86,35.89,28
HCPCS,88185,FLOW CYTOMETRY TC ADD MKR,15.0,9.75,2.52,35.89,28
HCPCS,88185,"FLOW CYTOMETRY TC, ADD MARKER",51.5,33.475,6.55,57.6,56
HCPCS,88185,FLOW EA ADD MARK 10,21.0,13.65,3.53,35.89,28
HCPCS,88185,FLOW EA ADD MARKER,92.0,59.8,0.67,162.0,56
HCPCS,88185,FLOW PERFORIN/GRANZYME B ADDITIONAL,611.0,397.15,11.52,549.9,28
HCPCS,88185,FLOW PSTAT5 ADDITIONAL,611.0,397.15,11.52,549.9,28
HCPCS,88185,FLOW SAP (XLP1) AND XIAP (XLP2) ADDITIONAL,611.0,397.15,11.52,549.9,28
HCPCS,88185,FLOW TH17 ADDITIONAL,83.0,53.95,11.52,74.7,28
HCPCS,88185,FLOWCYTOMETRY/TC ADD-ON,,,18.6,18.6,1
HCPCS,88185,"KIRFLW FLOW CYTOMETRY; ADDITIONAL CELL SURFACE, CYTOPLASMIC OR N",83.0,53.95,11.52,74.7,28
HCPCS,881850,FLOWCYTOMETRY/TC ADD-ON,,,18.6,18.6,1
HCPCS,88187,*FLOW CYTOMETRY 2-8 MARKERS,44.5,28.924999999999997,7.22,51.08,56
HCPCS,88187,FLOW CYTOMETRY INTERPRETATION 2-8 MARKE,319.0,207.35,21.42,319.0,31
HCPCS,88187,FLOWCYTOMETRY/READ 2-8,,,29.51,29.51,2
HCPCS,881870,FLOWCYTOMETRY/READ 2-8,,,29.51,29.51,1
HCPCS,88187TC,FLOWCYTOMETRY/READ 2-8,,,29.51,29.51,1
HCPCS,88188,ALPS FLOW INTERP,151.0,98.15,11.52,135.9,28
HCPCS,88188,FLOW CYTOMETRY INTERP 9-15 MARKERS,528.0,343.2,37.05,528.0,31
HCPCS,88188,FLOWCYTOMETRY/READ 9-15,,,50.71,50.71,2
HCPCS,881880,FLOWCYTOMETRY/READ 9-15,,,50.71,50.71,1
HCPCS,88188TC,FLOWCYTOMETRY/READ 9-15,,,50.71,50.71,1
HCPCS,88189,*FLOW CYTOMETRY>16 MARKER,21.0,13.649999999999999,3.19,115.8,56
HCPCS,88189,FLOW CYTOMETRY INTERP 16 OR MORE MARKERS,732.0,475.8,50.14,732.0,31
HCPCS,88189,FLOWCYTOMETRY/READ 16 & >,,,68.83,68.83,2
HCPCS,881890,FLOWCYTOMETRY/READ 16 & >,,,68.83,68.83,1
HCPCS,88189TC,FLOWCYTOMETRY/READ 16 & >,,,68.83,68.83,1
HCPCS,88199,UNLISTED CYTOPATHOLOGY PX,,,53.63,115.85,14
HCPCS,88199,Unlisted cytopathology px,,,11.52,14.56,6
HCPCS,88230,%CHROMO BLD TISSUE CULT,488.0,317.2,101.52,439.2,37
HCPCS,88230,*TIS CULT LYMPHOCYTE,388.0,252.2,97.0,349.2,37
HCPCS,88230,CHRCON BLD TISSUE CULT,363.0,235.95,90.75,326.7,37
HCPCS,88230,CHRMOS TIS CUL LYMPHOCYTE,488.0,317.2,101.52,439.2,37
HCPCS,88230,TISS CULT F/NON,167.0,108.55,41.75,167.0,37
HCPCS,88230,TISSUE CULTURE LYMPHOCYTE,,,100.65,100.65,1
HCPCS,882300,TISSUE CULTURE LYMPHOCYTE,,,100.65,100.65,1
HCPCS,88233,*TIS CULT SKIN/BX,311.0,202.15,77.75,279.9,37
HCPCS,88233,CHROM TISSUE CULT PROCESS,1247.0,810.55,101.52,1122.3,37
HCPCS,88233,CPALMF TISSUE CULTURE SKIN/BIOPSY,596.0,387.4,101.52,536.4,37
HCPCS,88233,POCHF CHROM TIS CUL PROC,754.0,490.1,101.52,678.6,37
HCPCS,88233,TIS CULT SKIN/BX,472.0,306.8,101.52,424.8,37
HCPCS,88233,TISSUE CULTURE SKIN/BIOPSY,,,121.59,121.59,1
HCPCS,882330,TISSUE CULTURE SKIN/BIOPSY,,,121.59,121.59,1
HCPCS,88235,%CHROMO CULT AMNIOTIC,413.0,268.45,101.52,371.7,37
HCPCS,88235,AMNIOTIC FLUID FETAL CELL CULTURE,974.0,633.1,101.52,876.6,37
HCPCS,88235,CHROMOSOME AMNIOTIC FLUID,974.0,633.1,101.52,876.6,37
HCPCS,88235,CVS FETAL CELL CULTURE,974.0,633.1,101.52,876.6,37
HCPCS,88235,"LABCORP CMBP CHROMOSOME ANALYSIS, CHORIONIC VILLUS",413.0,268.45,101.52,371.7,37
HCPCS,88235,REFLEX AMNIOTIC FLUID CULTURE,974.0,633.1,101.52,876.6,37
HCPCS,88235,REFLEX AMNIOTIC FLUID CULTURE PROCESSING FEE,974.0,633.1,101.52,876.6,37
HCPCS,88235,TISSUE CULTURE PLACENTA,,,129.86,129.86,1
HCPCS,882350,TISSUE CULTURE PLACENTA,,,129.86,129.86,1
HCPCS,88237,*TIS CULT BONE MARROW,613.5,398.775,58.25,894.6,111
HCPCS,88237,20Q8 TISSUE CULT BLD,484.0,314.6,101.52,435.6,37
HCPCS,88237,BCRFSH TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
HCPCS,88237,CHRAML CULT PROC,781.0,507.65,101.52,702.9,37
HCPCS,88237,CHROM LEUK BLD CULT PROC,1178.0,765.7,101.52,1060.2,37
HCPCS,88237,CLLFSH TISSUE CULT BLD,440.0,286.0,101.52,396.0,37
HCPCS,88237,CLLFSM TISSUE CULT BLD,396.0,257.4,99.0,356.4,37
HCPCS,88237,CRIGBP TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
HCPCS,88237,CRIGHB TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
HCPCS,88237,CRIGHM TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
HCPCS,88237,CRIGMP TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
HCPCS,88237,CRL2FB TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
HCPCS,88237,CRLF2M TISSUE CULT BLOOD,436.0,283.4,101.52,392.4,37
HCPCS,88237,FISH 3Q26 TISSUE CULT BM,288.0,187.2,72.0,259.2,37
HCPCS,88237,FISH3Q36 TISSUE CULT BLOOD,288.0,187.2,72.0,259.2,37
HCPCS,88237,PDGFRA TISSUE CULT BLOOD,428.0,278.2,101.52,385.2,37
HCPCS,88237,PDGFRB TISSUE CULT BLOOD,428.0,278.2,101.52,385.2,37
HCPCS,88237,TISS CULT BONE MARROW,359.5,233.67499999999998,68.25,401.4,74
HCPCS,88237,TISSUE CULT F/BN MARROW,198.0,128.7,45.0,216.0,74
HCPCS,88237,TISSUE CULTURE BONE MAR/BLOOD (NG),180.0,117.0,45.0,180.0,37
HCPCS,88237,TISSUE CULTURE BONE MARROW,,,124.2,124.2,1
HCPCS,882370,TISSUE CULTURE BONE MARROW,,,124.2,124.2,1
HCPCS,88239,%CHROMO SOL TUMOR CULTURE,340.0,221.0,85.0,306.0,37
HCPCS,88239,*TIS CULT SOLID TISSUE,340.0,221.0,85.0,306.0,37
HCPCS,88239,TIS CULT SOLID TUMOR,340.0,221.0,85.0,306.0,74
HCPCS,88239,TISSUE CULT SOLID TUMOR,340.0,221.0,85.0,306.0,37
HCPCS,88239,TISSUE CULTURE TUMOR,,,127.46,127.46,1
HCPCS,882390,TISSUE CULTURE TUMOR,,,127.46,127.46,1
HCPCS,88240,CELL CRYOPRESERVE/STORAGE,157.0,102.05,2.34,141.3,38
HCPCS,88240,CELL PROCESSING AND STORAGE,250.0,162.5,2.34,225.0,37
HCPCS,88240,CPALMF CELL CRYOPRESERVE/STORAGE,56.0,36.4,2.34,50.4,37
HCPCS,882400,CELL CRYOPRESERVE/STORAGE,,,11.3,11.3,1
HCPCS,88241,FROZEN CELL PREPARATION,,,10.44,20.2,15
HCPCS,88241,Frozen cell preparation,,,2.34,2.95,6
HCPCS,882410,FROZEN CELL PREPARATION,,,10.44,10.44,1
HCPCS,88245,CHROMOSOME ANALYSIS 20-25,,,149.62,289.37,15
HCPCS,88245,Chromosome analysis 20-25,,,76.88,97.12,6
HCPCS,882450,CHROMOSOME ANALYSIS 20-25,,,149.62,149.62,1
HCPCS,88248,CHROMOSOME ANALYSIS 50-100,,,149.62,289.37,15
HCPCS,88248,Chromosome analysis 50-100,,,76.88,97.12,6
HCPCS,882480,CHROMOSOME ANALYSIS 50-100,,,149.62,149.62,1
HCPCS,88249,CHROMOSOME ANALYSIS 100,,,149.62,289.37,15
HCPCS,88249,Chromosome analysis 100,,,76.88,97.12,6
HCPCS,882490,CHROMOSOME ANALYSIS 100,,,149.62,149.62,1
HCPCS,88261,%CRMCON CHROMANALY SCELL,1568.0,1019.2,76.88,1411.2,37
HCPCS,88261,CHROM ANAL 5 CELL BAND,337.0,219.05,76.88,337.0,37
HCPCS,88261,CHROMOSOME ANALYSIS 5,,,228.39,228.39,1
HCPCS,88261,"REFLEX COUNT 5, 1 KARYOTYPE",1713.0,1113.45,76.88,1541.7,74
HCPCS,882610,CHROMOSOME ANALYSIS 5,,,228.39,228.39,1
HCPCS,88262,%CHROMO HEM KAROTYPES,363.0,235.95,22.32,326.7,37
HCPCS,88262,%CHROMO POC KARY 15-20,745.0,484.25,22.32,670.5,37
HCPCS,88262,*CHROM ANALYSS 15-20CELL BAND,968.0,629.2,22.32,871.2,37
HCPCS,88262,*CHROMO ANALYSS 15-20CELL BAND,364.0,236.6,22.32,872.1,148
HCPCS,88262,CHRMSM ANAL 2 KARYO BAND,216.0,140.4,22.32,209.69,37
HCPCS,88262,CHROMO ANALYSIS 15-20CELL BAND,355.5,231.075,22.32,401.4,74
HCPCS,88262,CHROMOSOME ANALYSIS 15-20,,,108.42,108.42,1
HCPCS,88262,POCHF CHR ANLS KARY 15-20,607.0,394.55,22.32,546.3,37
HCPCS,882620,CHROMOSOME ANALYSIS 15-20,,,108.42,108.42,1
HCPCS,88263,CHRMOS CHROM ANLS 45,864.0,561.6,76.88,777.6,37
HCPCS,88263,CHROMOSOME ANALYSIS 45,,,129.85,129.85,1
HCPCS,882630,CHROMOSOME ANALYSIS 45,,,129.85,129.85,1
HCPCS,88264,*CHROMO ANALYSIS 20-25 CELLS,265.0,172.25,66.25,241.64,37
HCPCS,88264,BMCHFX CHROM ANLY 20-25,564.0,366.6,76.88,507.6,37
HCPCS,88264,CHRAML CHROM ANLY 20-25,602.0,391.3,76.88,541.8,37
HCPCS,88264,CHRBLL CHROM ANLY 20-25,650.0,422.5,76.88,585.0,37
HCPCS,88264,CHRMDS CHROM ANLY 20-25,602.0,391.3,76.88,541.8,37
HCPCS,88264,CHROMO ANALYSIS 20-25 CELLS,193.5,125.775,47.5,197.0,74
HCPCS,88264,CHROMOSOME ANALYSIS 20-25,,,124.95,124.95,1
HCPCS,882640,CHROMOSOME ANALYSIS 20-25,,,124.95,124.95,1
HCPCS,88267,%CHROMO AMNIOTIC FL,637.0,414.05,76.88,573.3,37
HCPCS,88267,%CVC CHROMOSOME ANALYSIS,523.0,339.95,76.88,470.7,37
HCPCS,88267,CHROMOSOME ANALYS PLACENTA,,,162.93,162.93,1
HCPCS,88267,CHROMOSOME ANALYSIS CVS,1222.0,794.3,76.88,1099.8,37
HCPCS,882670,CHROMOSOME ANALYS PLACENTA,,,162.93,162.93,1
HCPCS,88269,CHROMOSOME ANALYS AMNIOTIC,,,150.04,150.04,1
HCPCS,88269,"CHROMOSOME ANALYSIS 6-12 COLONIES, 1 KARYOTYPE",1126.0,731.9,76.88,1013.4,37
HCPCS,88269,CHROMOSOME ANALYSIS AMNIOTIC FLUID,1126.0,731.9,76.88,1013.4,37
HCPCS,88269,FAMCYT CHROMOSOME ANALYSIS AMNIOTIC,512.0,332.8,76.88,460.8,37
HCPCS,882690,CHROMOSOME ANALYS AMNIOTIC,,,150.04,150.04,1
HCPCS,88271,%20Q8FH PROBE X2,274.0,178.1,21.42,246.6,37
HCPCS,88271,%CLLFSH PROBE X7,277.0,180.05,21.42,249.3,37
HCPCS,88271,%DGEORG DNA PROBEX2,355.0,230.75,21.42,319.5,37
HCPCS,88271,%FAMLPN PROBE,277.0,180.05,21.42,249.3,37
HCPCS,88271,%FSHMDS PROBE X6,277.0,180.05,21.42,249.3,37
HCPCS,88271,%FSHPCM DNA PROBE,259.0,168.35,21.42,233.1,37
HCPCS,88271,%IGH/CCND1 BM PROBE X2,293.0,190.45,21.42,263.7,37
HCPCS,88271,%INV16F PROBE X2,309.0,200.85,21.42,278.1,37
HCPCS,88271,%ISIGHT TIS CULT AM FLX2,309.0,200.85,21.42,278.1,37
HCPCS,88271,%UROFISH MOLE GEN DNA X4,309.0,200.85,21.42,278.1,37
HCPCS,88271,"13, 21 AMNIO ANEUPLOID FISH",148.0,96.2,21.42,133.2,37
HCPCS,88271,"18, XY AMNIO ANEUPLOID FISH",148.0,96.2,21.42,133.2,37
HCPCS,88271,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),75.0,48.75,16.0,77.4,148
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-I(12P), GERM CELL",64.0,41.6,16.0,57.6,37
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FI",64.0,41.6,16.0,57.6,37
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-NR4A3, REARRANGEM",43.0,27.95,10.75,38.7,37
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PDGFB (22Q13), FI",64.0,41.6,16.0,57.6,37
HCPCS,88271,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PLASMA CELL PROLI,64.0,41.6,16.0,57.6,37
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PRKACA, REARRANGE",64.0,41.6,16.0,57.6,37
HCPCS,88271,"ALK, (2P23), IMT, FISH",700.0,455.0,21.42,630.0,37
HCPCS,88271,CHROMOSOME FISH PRENATAL,139.0,90.35,21.42,125.1,37
HCPCS,88271,CLLFSM PROBE X7,234.0,152.1,21.42,210.6,37
HCPCS,88271,CRIGBP PROBE X4,234.0,152.1,21.42,210.6,37
HCPCS,88271,CRIGHB PROBE,234.0,152.1,21.42,210.6,37
HCPCS,88271,CRIGHM PROBE,234.0,152.1,21.42,210.6,37
HCPCS,88271,CRIGMP PROBE X4,234.0,152.1,21.42,210.6,37
HCPCS,88271,CRL2FB PROBE,234.0,152.1,21.42,210.6,37
HCPCS,88271,CRL2FB PROBE X2,234.0,152.1,21.42,210.6,37
HCPCS,88271,CYTOGEN DNA PROBE EA,157.0,102.05,21.42,141.3,37
HCPCS,88271,CYTOGENETICS DNA PROBE,,,18.51,18.51,1
HCPCS,88271,DDIT3 PROBE X2,253.0,164.45,21.42,227.7,37
HCPCS,88271,FISH 3Q26 BLD PROBE,43.0,27.95,10.75,38.7,37
HCPCS,88271,FISH 3Q36 BM PROBE,43.0,27.95,10.75,38.7,37
HCPCS,88271,FISH FOR AML 1/ETO PROBE,347.0,225.55,21.42,312.3,37
HCPCS,88271,FISH FOR BCR/ABL 1 PROBE X2,277.0,180.05,21.42,249.3,37
HCPCS,88271,FISH FOR BCR/ABL 88271,530.0,344.5,21.42,477.0,37
HCPCS,88271,FISH FOR CCND1 PROBE,354.0,230.1,21.42,318.6,37
HCPCS,88271,FISH FOR CLL PROBE,110.0,71.5,21.42,99.0,37
HCPCS,88271,FISH FOR IGH/CCND1 88271,330.0,214.5,21.42,297.0,37
HCPCS,88271,FISH FOR MDS 88271,1560.0,1014.0,21.42,1404.0,37
HCPCS,88271,FISH FOR MYELOPROF NEOP 88271,343.0,222.95,21.42,308.7,37
HCPCS,88271,FISH FOR PDGFRA PROBE X3,239.0,155.35,21.42,215.1,37
HCPCS,88271,FISH FOR PDGFRB PROBE X2,239.0,155.35,21.42,215.1,37
HCPCS,88271,FISH FOR PML/RARA PROBE,530.0,344.5,21.42,477.0,37
HCPCS,88271,"FUS (16P11.2), FISH",700.0,455.0,21.42,630.0,37
HCPCS,88271,"I(12P), GERM CELL TUMOR, FISH, TS",715.0,464.75,21.42,643.5,37
HCPCS,88271,ISIGHT DNA PROBE,76.0,49.4,19.0,68.4,37
HCPCS,88271,"JAK2 (9P24.1), FISH",1050.0,682.5,21.42,945.0,37
HCPCS,88271,MAML2 FISH DNA PROBES,600.0,390.0,21.42,540.0,37
HCPCS,88271,MOLECULAR CYTOGENETIC TEST,139.0,90.35,21.42,125.1,37
HCPCS,88271,"NR4A3, REARRANGEMENT, FISH",750.0,487.5,21.42,675.0,37
HCPCS,88271,"PDGFB (22Q13), FISH, TS",715.0,464.75,21.42,643.5,37
HCPCS,88271,PLASMA CELL MYELOMA BY FISH 88271,1044.0,678.6,21.42,939.6,37
HCPCS,88271,"PLASMA CELL PROLIFERATIVE DISORDER, FISH",1050.0,682.5,21.42,945.0,37
HCPCS,88271,"PRKACA, REARRANGEMENT, FISH",1050.0,682.5,21.42,945.0,37
HCPCS,88271,SET 3 DNA PROBES MAYO (IF APPROPRIATE),75.0,48.75,16.0,77.4,148
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",64.0,41.6,16.0,57.6,37
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",64.0,41.6,16.0,57.6,37
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",43.0,27.95,10.75,38.7,37
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",64.0,41.6,16.0,57.6,37
HCPCS,88271,SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,64.0,41.6,16.0,57.6,37
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",64.0,41.6,16.0,57.6,37
HCPCS,88271,SET 4 DNA PROBES MAYO (IF APPROPRIATE),75.0,48.75,16.0,77.4,148
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",64.0,41.6,16.0,57.6,37
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",64.0,41.6,16.0,57.6,37
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",43.0,27.95,10.75,38.7,37
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",64.0,41.6,16.0,57.6,37
HCPCS,88271,SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,64.0,41.6,16.0,57.6,37
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",64.0,41.6,16.0,57.6,37
HCPCS,88271,SET 5 DNA PROBES MAYO (IF APPROPRIATE),75.0,48.75,16.0,77.4,148
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",64.0,41.6,16.0,57.6,37
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",64.0,41.6,16.0,57.6,37
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",43.0,27.95,10.75,38.7,37
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",64.0,41.6,16.0,57.6,37
HCPCS,88271,SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,64.0,41.6,16.0,57.6,37
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",64.0,41.6,16.0,57.6,37
HCPCS,88271,T-CELL ALL FISH 10 PROBE SETS,139.0,90.35,21.42,125.1,37
HCPCS,88271,T-CELL ALL FISH ADDITIONAL PROBE SET,139.0,90.35,21.42,125.1,37
HCPCS,88271,"T-LYMPHOBLASTIC LEUKEMIA/LYMPHOMA, FISH",500.0,325.0,21.42,450.0,37
HCPCS,882710,CYTOGENETICS DNA PROBE,,,18.51,18.51,1
HCPCS,88272,CYTOGENETICS 3-5,,,35.16,68.01,15
HCPCS,88272,Cytogenetics 3-5,,,22.32,28.19,6
HCPCS,882720,CYTOGENETICS 3-5,,,35.16,35.16,1
HCPCS,88273,CYTOGENETICS 10-30,,,30.08,58.17,15
HCPCS,88273,Cytogenetics 10-30,,,22.32,28.19,6
HCPCS,882730,CYTOGENETICS 10-30,,,30.08,30.08,1
HCPCS,88274,CYTOGEN INTERPHASE 25-99CELL,157.0,102.05,22.32,141.3,37
HCPCS,88274,CYTOGENETICS 25-99,,,36.61,36.61,1
HCPCS,88274,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),148.5,96.525,22.32,153.0,148
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-I(12P), GERM CELL TUMO",106.0,68.9,22.32,95.4,37
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FISH",106.0,68.9,22.32,95.4,37
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-NR4A3, REARRANGEMENT,",85.0,55.25,21.25,76.5,37
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PDGFB (22Q13), FISH, T",106.0,68.9,22.32,95.4,37
HCPCS,88274,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PLASMA CELL PROLIFERAT,106.0,68.9,22.32,95.4,37
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PRKACA, REARRANGEMENT,",106.0,68.9,22.32,95.4,37
HCPCS,88274,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),148.5,96.525,22.32,153.0,148
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-I(12P), GERM CELL",106.0,68.9,22.32,95.4,37
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FIS",106.0,68.9,22.32,95.4,37
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-NR4A3, REARRANGEME",85.0,55.25,21.25,76.5,37
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PDGFB (22Q13), FIS",106.0,68.9,22.32,95.4,37
HCPCS,88274,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PLASMA CELL PROLIF,106.0,68.9,22.32,95.4,37
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PRKACA, REARRANGEM",106.0,68.9,22.32,95.4,37
HCPCS,88274,INTER FISH ANALYSIS 25-99 CELLS,157.0,102.05,22.32,141.3,37
HCPCS,88274,ISIGHT CYTOGENETICS 25-99,128.5,83.525,22.32,136.8,74
HCPCS,882740,CYTOGENETICS 25-99,,,36.61,36.61,1
HCPCS,88275,%20Q8FH ANALY 100-300,365.0,237.25,22.32,328.5,37
HCPCS,88275,%BCRFSH ANALY 100-300,391.0,254.15,22.32,351.9,37
HCPCS,88275,%CLLFSH ANALY 100-300 X3,391.0,254.15,22.32,351.9,37
HCPCS,88275,%FSHMDS ANALY 100-300 X3,391.0,254.15,22.32,351.9,37
HCPCS,88275,%IGH/CCND1 BM 100-300,411.0,267.15,22.32,369.9,37
HCPCS,88275,%PDGFRA ANALY 100-300,338.0,219.7,22.32,304.2,37
HCPCS,88275,%PDGFRB ANALY 100-300,338.0,219.7,22.32,304.2,37
HCPCS,88275,CHROMOSOME ANALYSIS AMNIOTIC FLUID,332.0,215.8,22.32,298.8,37
HCPCS,88275,CLLFSM ANALY 100-300 X3,328.0,213.2,22.32,295.2,37
HCPCS,88275,CRIGBP ANALY 100-300 X2,328.0,213.2,22.32,295.2,37
HCPCS,88275,CRIGHB ANALY 100-300,328.0,213.2,22.32,295.2,37
HCPCS,88275,CRIGHM ANALY 100-300,328.0,213.2,22.32,295.2,37
HCPCS,88275,CRIGMP ANALY 100-300 X2,328.0,213.2,22.32,295.2,37
HCPCS,88275,CRL2FB ANALY 100-300,328.0,213.2,22.32,295.2,37
HCPCS,88275,CRLF2M ANALY 100-300,328.0,213.2,22.32,295.2,37
HCPCS,88275,CYTOGEN INTERPHASE 100-300,289.0,187.85,22.32,260.1,37
HCPCS,88275,CYTOGENETICS 100-300,,,44.23,44.23,1
HCPCS,88275,DDIT3 ANALY 100-300,338.0,219.7,22.32,304.2,37
HCPCS,88275,FHT410 100-300,348.0,226.2,22.32,313.2,37
HCPCS,88275,FISH 3Q26 BLD ANALYSIS,102.0,66.3,22.32,91.8,37
HCPCS,88275,FISH 3Q26 BM ANALYSIS,102.0,66.3,22.32,91.8,37
HCPCS,88275,FISH FOR AML 1/ETO ANALY 100-300,347.0,225.55,22.32,312.3,37
HCPCS,88275,FISH FOR BCR/ABL 88275,530.0,344.5,22.32,477.0,37
HCPCS,88275,FISH FOR CCND1 ANALY 100-300,354.0,230.1,22.32,318.6,37
HCPCS,88275,"FISH FOR CLL ANALY, 100-300",110.0,71.5,22.32,99.0,37
HCPCS,88275,FISH FOR IGH/CCND1 88275,330.0,214.5,22.32,297.0,37
HCPCS,88275,FISH FOR MDS 88275,1560.0,1014.0,22.32,1404.0,37
HCPCS,88275,FISH FOR MYELOPROF NEOP 88275,343.0,222.95,22.32,308.7,37
HCPCS,88275,FISH FOR PML/RARA ANALY 100-300,530.0,344.5,22.32,477.0,37
HCPCS,88275,FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE),154.0,100.1,22.32,138.6,37
HCPCS,88275,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FISH",106.0,68.9,22.32,95.4,37
HCPCS,88275,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-NR4A3, REARRANGEMEN",102.0,66.3,22.32,91.8,37
HCPCS,88275,FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-PLASMA CELL PROLIFE,106.0,68.9,22.32,95.4,37
HCPCS,88275,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-PRKACA, REARRANGEME",106.0,68.9,22.32,95.4,37
HCPCS,88275,FISH MAYO GREATER THAN 100 CELLS (IF APPROPRIATE),205.0,133.25,22.32,184.5,37
HCPCS,88275,INTERPHASE IN SITU HYBRIDIZATION,332.0,215.8,22.32,298.8,37
HCPCS,88275,PLASMA CELL MYELOMA BY FISH 88275,1044.0,678.6,22.32,939.6,37
HCPCS,88275,T-CELL ALL FISH 100-300 CELLS ADDITIONAL PROBE SET,332.0,215.8,22.32,298.8,37
HCPCS,88275,TALLAF FISH 100-300 CELLS,332.0,215.8,22.32,298.8,37
HCPCS,882750,CYTOGENETICS 100-300,,,44.23,44.23,1
HCPCS,88280,CHROMO ANALYSIS ADD KAROTYPE,47.5,30.875,11.0,51.0,74
HCPCS,88280,"CHROMOSOME ANAL, KAROTYPE EA",133.0,86.45,22.32,119.7,37
HCPCS,88280,CHROMOSOME ANALYSIS ADDITIONAL KARYOTYPE,51.0,33.15,12.75,51.0,37
HCPCS,88280,CHROMOSOME KARYOTYPE STUDY,,,28.92,28.92,1
HCPCS,88280,CVCYTO CHROMOSOME KARYOTYPE,234.0,152.1,22.32,210.6,37
HCPCS,882800,CHROMOSOME KARYOTYPE STUDY,,,28.92,28.92,1
HCPCS,88283,CHROMOSOME BANDING STUDY,,,59.27,114.63,15
HCPCS,88283,Chromosome banding study,,,22.32,28.19,6
HCPCS,882830,CHROMOSOME BANDING STUDY,,,59.27,59.27,1
HCPCS,88285,ADDITIONAL CELLS COUNTED,37.0,24.05,9.25,37.0,37
HCPCS,88285,CHROMO COUNT ADD,37.0,24.05,9.25,37.0,37
HCPCS,88285,CHROMOSOME COUNT ADDITIONAL,,,23.25,23.25,1
HCPCS,88285,CVCYTO CHROMOSOME COUNT ADDITIONAL,63.0,40.95,15.75,56.7,37
HCPCS,88285,FAMCYT CHROMOSOME COUNT ADDITIONAL,63.0,40.95,15.75,56.7,37
HCPCS,882850,CHROMOSOME COUNT ADDITIONAL,,,23.25,23.25,1
HCPCS,88289,CHRBLD CHROMO STDY ADD,123.0,79.95,22.32,110.7,37
HCPCS,88289,CHROMOSOME STUDY ADDITIONAL,,,29.74,29.74,1
HCPCS,88289,CHROMS STUDY ADDTL,132.0,85.8,22.32,118.8,37
HCPCS,882890,CHROMOSOME STUDY ADDITIONAL,,,29.74,29.74,1
HCPCS,88291,*MOL CYTOGEN I&R,309.0,200.85,20.16,306.0,140
HCPCS,88291,CYTO/MOLECULAR REPORT,,,27.6,27.6,2
HCPCS,88291,MOL CYTOGEN I&R,241.0,156.65,40.49,216.9,28
HCPCS,882910,CYTO/MOLECULAR REPORT,,,27.6,27.6,1
HCPCS,88291TC,CYTO/MOLECULAR REPORT,,,27.6,27.6,1
HCPCS,88299,UNLISTED CYTOGENETIC STUDY,,,53.63,115.85,14
HCPCS,88299,Unlisted cytogenetic study,,,22.32,28.19,6
HCPCS,88300,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,35.0,22.75,2.75,35.0,62
HCPCS,88300,SURG PATH GROSS ONLY LVL I,103.0,66.95,19.72,92.7,38
HCPCS,88300,SURG PATH GROSS ONLY LVL I MOD,103.0,66.95,19.72,92.7,38
HCPCS,88300,SURGICAL PATH GROSS,,,9.47,9.47,2
HCPCS,883000,SURGICAL PATH GROSS,,,9.47,9.47,1
HCPCS,88300TC,SURGICAL PATH GROSS,,,9.47,9.47,1
HCPCS,88302,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,56.0,36.4,4.15,59.36,62
HCPCS,88302,SURG PATH GROSS MICRO LVL II,195.0,126.75,19.72,175.5,38
HCPCS,88302,SURG PATH GROSS MICRO LVL II MOD,195.0,126.75,19.72,175.5,38
HCPCS,88302,TISSUE EXAM BY PATHOLOGIST,,,21.0,21.0,2
HCPCS,883020,TISSUE EXAM BY PATHOLOGIST,,,21.0,21.0,1
HCPCS,88302TC,TISSUE EXAM BY PATHOLOGIST,,,21.0,21.0,1
HCPCS,88304,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,95.0,61.75,6.74,95.0,62
HCPCS,88304,PATHOLOGY LEVEL 3 MOD,222.0,144.3,19.72,199.8,38
HCPCS,88304,SKIN MICRO LVL III,246.0,159.9,19.72,221.4,38
HCPCS,88304,SURG PATH GROSS MICRO LVL III,241.0,156.65,19.72,216.9,38
HCPCS,88304,SURG PATH GROSS MICRO LVL III MOD,241.0,156.65,19.72,216.9,38
HCPCS,88304,TISSUE EXAM BY PATHOLOGIST,,,25.19,25.19,2
HCPCS,883040,TISSUE EXAM BY PATHOLOGIST,,,25.19,25.19,1
HCPCS,88304TC,TISSUE EXAM BY PATHOLOGIST,,,25.19,25.19,1
HCPCS,88305,EM THICK ONLY,158.0,102.7,19.72,142.2,38
HCPCS,88305,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,323.0,209.95,21.71,323.0,62
HCPCS,88305,PROSTATE NDL BIOPSY ANY METHOD,1517.0,986.05,19.72,1365.3,38
HCPCS,88305,SAT BIOPSY PROSTATE 1-20 SPC,1517.0,986.05,19.72,1365.3,38
HCPCS,88305,SAT BIOPSY PROSTATE 21-40,2387.0,1551.55,19.72,2148.3,38
HCPCS,88305,SAT BIOPSY PROSTATE 41-60,4121.0,2678.65,19.72,3708.9,38
HCPCS,88305,SAT BIOPSY PROSTATE: >60,4987.0,3241.55,19.72,4488.3,38
HCPCS,88305,SKIN MICRO LEVEL 4,278.0,180.7,19.72,250.2,38
HCPCS,88305,SP BIOPSY PROSTATE,1151.0,748.15,19.72,1035.9,38
HCPCS,88305,SURG PATH GROSS MICRO LVL IV,254.0,165.1,19.72,228.6,38
HCPCS,88305,SURG PATH GROSS MICRO LVL IV MOD,254.0,165.1,19.72,228.6,38
HCPCS,88305,SURGERY PATH GROSS MICRO LEVEL 4,254.0,165.1,19.72,228.6,38
HCPCS,88305,TISSUE EXAM BY PATHOLOGIST,,,28.07,28.07,2
HCPCS,883050,TISSUE EXAM BY PATHOLOGIST,,,28.07,28.07,1
HCPCS,88305TC,TISSUE EXAM BY PATHOLOGIST,,,28.07,28.07,1
HCPCS,88307,%AHTBX PATH LVL V,517.0,336.05,94.71,779.93,38
HCPCS,88307,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,684.0,444.6,47.77,684.0,62
HCPCS,88307,SURG PATH GROSS MICRO LVL V MOD,359.0,233.35,92.98,779.93,38
HCPCS,88307,TISSUE EXAM BY PATH LVL V,359.0,233.35,92.98,779.93,38
HCPCS,88307,TISSUE EXAM BY PATHOLOGIST,,,164.42,164.42,2
HCPCS,883070,TISSUE EXAM BY PATHOLOGIST,,,164.42,164.42,1
HCPCS,88307TC,TISSUE EXAM BY PATHOLOGIST,,,164.42,164.42,1
HCPCS,88309,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,1205.0,783.25,84.2,1205.0,62
HCPCS,88309,SURG PATH GROSS MICRO LVL VI MOD,791.0,514.15,94.71,1771.17,38
HCPCS,88309,TISSUE EXAM BY PATH LVL VI,791.0,514.15,94.71,1771.17,38
HCPCS,88309,TISSUE EXAM BY PATHOLOGIST,,,230.71,230.71,2
HCPCS,883090,TISSUE EXAM BY PATHOLOGIST,,,230.71,230.71,1
HCPCS,88309TC,TISSUE EXAM BY PATHOLOGIST,,,230.71,230.71,1
HCPCS,88311,DECALCIFICATION PROC,84.0,54.6,14.11,75.6,28
HCPCS,88311,DECALCIFICATION PROCEDURE,104.0,67.6,7.14,104.0,62
HCPCS,88311,DECALCIFY TISSUE,,,6.85,6.85,2
HCPCS,883110,DECALCIFY TISSUE,,,6.85,6.85,1
HCPCS,88311TC,DECALCIFY TISSUE,,,6.85,6.85,1
HCPCS,88312,E SPEC STAIN GP I TECH,145.0,94.25,19.72,163.29,38
HCPCS,88312,SPEC STN GRP I,95.0,61.75,19.72,163.29,38
HCPCS,88312,SPECIAL STAIN GROUP 1,177.0,115.05,19.72,163.29,38
HCPCS,88312,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,233.0,151.45,15.52,233.0,62
HCPCS,88312,"SPECIAL STAIN GRP I EA, SEMEN",232.0,150.8,19.72,208.8,38
HCPCS,88312,SPECIAL STAINS GROUP 1,,,68.42,68.42,2
HCPCS,883120,SPECIAL STAINS GROUP 1,,,68.42,68.42,1
HCPCS,88312TC,SPECIAL STAINS GROUP 1,,,68.42,68.42,1
HCPCS,88313,"*SPEC STN GRP II, REV TO 312",44.0,28.6,11.4,279.48,38
HCPCS,88313,E SPEC STAIN GRP II TECH,152.0,98.8,19.72,279.48,38
HCPCS,88313,O/S PATHOL/HYSTOL,142.0,92.3,19.72,279.48,38
HCPCS,88313,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,104.0,67.6,7.14,120.71,62
HCPCS,88313,SPEC STN GRP II,92.0,59.8,11.4,279.48,152
HCPCS,88313,"SPECIAL STAIN GRP II EA, SEMEN",145.0,94.25,19.72,279.48,38
HCPCS,88313,SPECIAL STAINS GROUP 2,,,56.11,56.11,2
HCPCS,883130,SPECIAL STAINS GROUP 2,,,56.11,56.11,1
HCPCS,88313TC,SPECIAL STAINS GROUP 2,,,56.11,56.11,1
HCPCS,88314,HISTOCHEMICAL STAIN,141.0,91.65,19.72,126.9,28
HCPCS,88314,HISTOCHEMICAL STAINS ADD-ON,,,54.3,54.3,2
HCPCS,88314,SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU,194.0,126.1,11.93,194.0,62
HCPCS,88314,SPECIAL STAIN ON FS,138.0,89.7,19.72,124.2,28
HCPCS,88314,SPECIAL STAINS HISTOCHEM,113.0,73.45,53.5,129.3,31
HCPCS,883140,HISTOCHEMICAL STAINS ADD-ON,,,54.3,54.3,1
HCPCS,88314TC,HISTOCHEMICAL STAINS ADD-ON,,,54.3,54.3,1
HCPCS,88319,ENZYME HISTOCHEMISTRY,,,87.06,87.06,2
HCPCS,88319,HISTOCHEM ID EN,779.0,506.35,94.71,1771.17,38
HCPCS,88319,HISTOCHEMISTRY FOR ENZYME,779.0,506.35,94.71,1771.17,38
HCPCS,88319,PEROXIDASE STAIN LEUKOCT,779.0,506.35,94.71,1771.17,38
HCPCS,88319,SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS,228.0,148.2,15.72,228.0,62
HCPCS,883190,ENZYME HISTOCHEMISTRY,,,87.06,87.06,1
HCPCS,88319TC,ENZYME HISTOCHEMISTRY,,,87.06,87.06,1
HCPCS,88321,CONSLTJ&REPRT SLD PREP ELSWR,,,68.39,68.39,2
HCPCS,88321,CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE,701.0,455.65,49.7,525.75,31
HCPCS,88321,CONSULT SLIDE PREP ELSEWHERE,117.0,76.05,30.3,105.3,38
HCPCS,88321,EPATH CONSULT 1-7 SLIDES,362.0,235.3,39.0,325.8,38
HCPCS,88321,EPATH CONSULT 8+ SLIDES,392.0,254.8,39.0,352.8,38
HCPCS,88321,PATHOUT MICROSLIDE CONSULT,212.0,137.8,49.7,159.0,31
HCPCS,883210,CONSLTJ&REPRT SLD PREP ELSWR,,,68.39,68.39,1
HCPCS,88321TC,CONSLTJ&REPRT SLD PREP ELSWR,,,68.39,68.39,1
HCPCS,88323,CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES,787.0,511.55,51.41,787.0,62
HCPCS,88323,CONSLTJ&REPRT MATRL PREP SLD,,,23.35,23.35,2
HCPCS,88323,CONSULT SLIDE W PREP,149.0,96.85,38.59,157.41,38
HCPCS,883230,CONSLTJ&REPRT MATRL PREP SLD,,,23.35,23.35,1
HCPCS,88323TC,CONSLTJ&REPRT MATRL PREP SLD,,,23.35,23.35,1
HCPCS,88325,CONSLTJ COMPRE REVIEW REPRT REFERRED MATRL,1226.0,796.9,80.1,919.5,31
HCPCS,88325,CONSLTJ COMPRE RVW REC REPRT,,,110.42,110.42,2
HCPCS,88325,CONSULT COMPRE DATA REVIEW,289.0,187.85,56.79,371.54,38
HCPCS,883250,CONSLTJ COMPRE RVW REC REPRT,,,110.42,110.42,1
HCPCS,88325TC,CONSLTJ COMPRE RVW REC REPRT,,,110.42,110.42,1
HCPCS,88329,PATH CONSLTJ DRG SURG,,,28.85,128.79,16
HCPCS,88329,PATHOLOGY CONSULTATION DURING SURGERY,289.0,187.85,21.17,216.75,31
HCPCS,88329,Path consltj drg surg,,,56.79,71.74,6
HCPCS,883290,PATH CONSLTJ DRG SURG,,,28.85,28.85,1
HCPCS,88329TC,PATH CONSLTJ DRG SURG,,,28.85,28.85,1
HCPCS,88331,PATH CONSLTJ SURG 1 BLK 1SPC,,,32.52,32.52,2
HCPCS,88331,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,512.0,332.8,36.04,512.0,62
HCPCS,88331,PATH CONSULT OR 1ST BLOCK,353.0,229.45,56.79,371.54,38
HCPCS,883310,PATH CONSLTJ SURG 1 BLK 1SPC,,,32.52,32.52,1
HCPCS,88331TC,PATH CONSLTJ SURG 1 BLK 1SPC,,,32.52,32.52,1
HCPCS,88332,PATH CONSLTJ SURG EA ADD BLK,,,19.69,19.69,2
HCPCS,88332,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,254.0,165.1,17.72,254.0,62
HCPCS,88332,PATH CONSULT OR ADD TIS BLOCK,177.0,115.05,29.74,159.3,28
HCPCS,883320,PATH CONSLTJ SURG EA ADD BLK,,,19.69,19.69,1
HCPCS,88332TC,PATH CONSLTJ SURG EA ADD BLK,,,19.69,19.69,1
HCPCS,88333,PATH CONSLTJ SURG CYTO XM 1,,,25.19,25.19,2
HCPCS,88333,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,517.0,336.05,35.84,517.0,62
HCPCS,88333,PATH CONSULT CYTO EXAM INIT,779.0,506.35,56.79,1771.17,38
HCPCS,88333,PATH TOUCH PREP INIT,779.0,506.35,56.79,1771.17,38
HCPCS,883330,PATH CONSLTJ SURG CYTO XM 1,,,25.19,25.19,1
HCPCS,88333TC,PATH CONSLTJ SURG CYTO XM 1,,,25.19,25.19,1
HCPCS,88334,PATH CONSLTJ SURG CYTO XM EA,,,15.2,15.2,2
HCPCS,88334,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,314.0,204.1,21.71,314.0,62
HCPCS,88334,PATH CONSULT CYTO EXAM ADD,117.0,76.05,19.66,105.3,28
HCPCS,88334,PATH TOUCH PREP EA ADD,113.0,73.45,18.98,101.7,28
HCPCS,883340,PATH CONSLTJ SURG CYTO XM EA,,,15.2,15.2,1
HCPCS,88334TC,PATH CONSLTJ SURG CYTO XM EA,,,15.2,15.2,1
HCPCS,88341,EIHC EACH ADD AB/BLK,168.0,109.2,19.72,151.2,28
HCPCS,88341,IHC EA ADDTL AB/BLOCK,244.0,158.6,19.72,219.6,28
HCPCS,88341,IMHCHEM/IMCYTCHM EA ADD ANTB,,,50.05,50.05,2
HCPCS,88341,IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE,241.0,156.65,54.4,241.0,27
HCPCS,88341,IMMUNO H/C EA ADDTL AB STAIN,250.5,162.825,19.72,231.3,56
HCPCS,883410,IMHCHEM/IMCYTCHM EA ADD ANTB,,,50.05,50.05,1
HCPCS,88341TC,IMHCHEM/IMCYTCHM EA ADD ANTB,,,50.05,50.05,1
HCPCS,88342,%REFMYL IHC REFLEX MY X2,240.0,156.0,62.16,371.54,38
HCPCS,88342,EIMMUNOCYTOCHEM TC,158.0,102.7,40.92,371.54,38
HCPCS,88342,IMHCHEM/IMCYTCHM 1ST ANTB,,,56.89,56.89,2
HCPCS,88342,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,302.0,196.3,20.32,302.0,62
HCPCS,88342,IMMUNOCYTOCHEM EA AB,188.0,122.2,48.69,371.54,38
HCPCS,88342,IMMUNOHISTOCHEM EA AB,224.0,145.6,48.69,371.54,190
HCPCS,883420,IMHCHEM/IMCYTCHM 1ST ANTB,,,56.89,56.89,1
HCPCS,88342TC,IMHCHEM/IMCYTCHM 1ST ANTB,,,56.89,56.89,1
HCPCS,88344,IHC EA MULTIPLEX AB,359.0,233.35,92.98,779.93,38
HCPCS,88344,IMHCHEM/IMCYTCHM EA MLT ANTB,,,106.93,106.93,2
HCPCS,88344,IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE,332.0,215.8,103.79,332.0,27
HCPCS,88344,IMMUNO H/C EA MULTIPLEX AB STAIN,359.0,233.35,92.98,779.93,76
HCPCS,883440,IMHCHEM/IMCYTCHM EA MLT ANTB,,,106.93,106.93,1
HCPCS,88344TC,IMHCHEM/IMCYTCHM EA MLT ANTB,,,106.93,106.93,1
HCPCS,88346,%CROHN IFA FIRST,134.0,87.1,34.71,371.54,38
HCPCS,88346,%IBDSGI IFA FIRST,109.0,70.85,28.23,371.54,38
HCPCS,88346,%PEMGUS IFL FIRST,491.0,319.15,94.71,441.9,38
HCPCS,88346,*IMMUNOFLUOR ANTB 1ST STAIN,331.0,215.14999999999998,78.48,371.54,76
HCPCS,88346,CIFAB AB IGG FIRST,359.0,233.35,92.98,371.54,38
HCPCS,88346,DIRECT IMMUNOFLUOR-EACH,374.0,243.1,94.71,371.54,38
HCPCS,88346,IF STUDY EA AB DIR METHOD,359.0,233.35,92.98,371.54,38
HCPCS,88346,IMFLUOR 1ST 1ANTB STAIN PX,,,90.72,90.72,2
HCPCS,88346,IMMUNOFLUOR ANTB 1ST STAIN,359.0,233.35,92.98,371.54,38
HCPCS,88346,IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,319.0,207.35,20.92,319.0,62
HCPCS,883460,IMFLUOR 1ST 1ANTB STAIN PX,,,90.72,90.72,1
HCPCS,88346TC,IMFLUOR 1ST 1ANTB STAIN PX,,,90.72,90.72,1
HCPCS,88348,CILIARY MOTILITY - EM DIAG,2362.0,1535.3,94.71,2125.8,38
HCPCS,88348,ELECTRON MICRO DX,779.0,506.35,94.71,1771.17,38
HCPCS,88348,ELECTRON MICROSCOPY,650.0,422.5,44.82,746.31,62
HCPCS,88348,ELECTRON MICROSCOPY DX,,,322.59,322.59,2
HCPCS,88348,PLTEMS ELECTRON MICROSCOPY,1507.0,979.55,94.71,1771.17,38
HCPCS,883480,ELECTRON MICROSCOPY DX,,,322.59,322.59,1
HCPCS,88348TC,ELECTRON MICROSCOPY DX,,,322.59,322.59,1
HCPCS,88350,%CROHN IFA ADDTL,134.0,87.1,19.72,158.86,28
HCPCS,88350,%ENTERO AB ADDTL X2,303.0,196.95,19.72,272.7,28
HCPCS,88350,%IBDSGI IFA ADDTL,109.0,70.85,18.31,158.86,28
HCPCS,88350,%PEMGUS IFL ADDTL,340.5,221.325,19.72,405.0,56
HCPCS,88350,*IMMUNOFLUOR ANTB ADDL STAIN,206.5,134.22500000000002,19.72,253.8,84
HCPCS,88350,CIFAB AB IGG ADDTL,99.0,64.35,16.63,158.86,28
HCPCS,88350,IMFLUOR EA ADDL 1ANTB STN PX,,,67.63,67.63,2
HCPCS,88350,IMMUNOFLUOR ADDTL,98.0,63.7,16.46,158.86,28
HCPCS,88350,IMMUNOFLUOR ANTB ADDL STAIN,168.5,109.525,16.8,213.3,56
HCPCS,88350,IMMUNOFLUORESCENCE PER SPEC ADD SINGL ANTB STAIN,254.0,165.1,16.92,254.0,31
HCPCS,883500,IMFLUOR EA ADDL 1ANTB STN PX,,,67.63,67.63,1
HCPCS,88350TC,IMFLUOR EA ADDL 1ANTB STN PX,,,67.63,67.63,1
HCPCS,88355,M/PHMTRC ALYS SKELETAL MUSC,,,41.47,371.54,16
HCPCS,88355,M/phmtrc alys skeletal musc,,,94.71,119.63,6
HCPCS,883550,M/PHMTRC ALYS SKELETAL MUSC,,,41.47,41.47,1
HCPCS,88355TC,M/PHMTRC ALYS SKELETAL MUSC,,,41.47,41.47,1
HCPCS,88356,ANALYSIS NERVE,,,53.63,115.85,16
HCPCS,88356,Analysis nerve,,,19.72,24.91,6
HCPCS,883560,ANALYSIS NERVE,,,92.18,92.18,1
HCPCS,88356TC,ANALYSIS NERVE,,,92.18,92.18,1
HCPCS,88358,ANALYSIS TUMOR,,,69.99,371.54,16
HCPCS,88358,Analysis tumor,,,94.71,119.63,6
HCPCS,883580,ANALYSIS TUMOR,,,69.99,69.99,1
HCPCS,88358TC,ANALYSIS TUMOR,,,69.99,69.99,1
HCPCS,88360,"E IHC QUANTITATIVE, TC",138.0,89.7,35.74,371.54,38
HCPCS,88360,IMMUNOHISTOCHEM QT,391.0,254.15,94.71,371.54,38
HCPCS,88360,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,366.0,237.9,72.3,366.0,31
HCPCS,88360,"PD-L1 (28-8), SEMIQUANT IHC, MANUAL",504.0,327.6,94.71,453.6,38
HCPCS,88360,"PD-L1 (SP142) SEMIQUANT IHC, MANUAL",504.0,327.6,94.71,453.6,38
HCPCS,88360,"PD-L1 (SP263) SEMIQUANT IHC, MANUAL",504.0,327.6,94.71,453.6,38
HCPCS,88360,TUMOR IMMUNOHISTOCHEM MANUAL,246.0,159.9,55.94,371.54,76
HCPCS,88360,TUMOR IMMUNOHISTOCHEM/MANUAL,691.0,449.15,63.18,621.9,40
HCPCS,883600,TUMOR IMMUNOHISTOCHEM/MANUAL,,,63.18,63.18,1
HCPCS,88360TC,TUMOR IMMUNOHISTOCHEM/MANUAL,,,63.18,63.18,1
HCPCS,88361,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST,265.0,172.25,25.31,266.0,62
HCPCS,88361,TUMOR IMMUNOHISTOCHEM CAD,359.0,233.35,92.98,779.93,38
HCPCS,88361,TUMOR IMMUNOHISTOCHEM/COMPUT,,,60.83,60.83,2
HCPCS,883610,TUMOR IMMUNOHISTOCHEM/COMPUT,,,60.83,60.83,1
HCPCS,88361TC,TUMOR IMMUNOHISTOCHEM/COMPUT,,,60.83,60.83,1
HCPCS,88362,NERVE TEASING PREP,779.0,506.35,94.71,1771.17,38
HCPCS,88362,NERVE TEASING PREPARATIONS,702.5,456.625,65.04,934.0,64
HCPCS,883620,NERVE TEASING PREPARATIONS,,,95.74,95.74,1
HCPCS,88362TC,NERVE TEASING PREPARATIONS,,,95.74,95.74,1
HCPCS,88363,XM ARCHIVE TISSUE MOLEC ANAL,,,15.69,53.1,16
HCPCS,88363,Xm archive tissue molec anal,,,11.52,14.56,6
HCPCS,883630,XM ARCHIVE TISSUE MOLEC ANAL,,,15.69,15.69,1
HCPCS,88363TC,XM ARCHIVE TISSUE MOLEC ANAL,,,15.69,15.69,1
HCPCS,88364,CISH ADDTL,926.0,601.9,19.72,833.4,28
HCPCS,88364,IN SITU HYBRIDIZATION EA ADDL PROBE STAIN,302.0,196.3,19.72,302.0,31
HCPCS,88364,INSITU HYBRID EA ADDTL SNGL PRB,906.0,588.9,19.72,815.4,28
HCPCS,88364,INSITU HYBRIDIZATION (FISH),,,79.16,79.16,2
HCPCS,883640,INSITU HYBRIDIZATION (FISH),,,79.16,79.16,1
HCPCS,88364TC,INSITU HYBRIDIZATION (FISH),,,79.16,79.16,1
HCPCS,88365,CISH EA PROBE,383.0,248.95,94.71,371.54,38
HCPCS,88365,CISH EACH PROBE,550.5,357.82500000000005,82.1,705.6,76
HCPCS,88365,CISH FOR EPSTEIN BARR,761.0,494.65,94.71,684.9,38
HCPCS,88365,CISH KAPPA,789.0,512.85,94.71,710.1,38
HCPCS,88365,CISH LAMDA,789.0,512.85,94.71,710.1,38
HCPCS,88365,EIHC ISH TECH ONLY,334.0,217.1,86.51,371.54,38
HCPCS,88365,IN SITU HYBRIDIZATION 1ST PROBE STAIN,379.0,246.35,24.91,379.0,62
HCPCS,88365,INSITU HYBRID EA PROBE,527.0,342.54999999999995,94.71,565.2,114
HCPCS,88365,INSITU HYBRIDIZATION (FISH),180.0,117.0,46.62,371.54,40
HCPCS,883650,INSITU HYBRIDIZATION (FISH),,,106.97,106.97,1
HCPCS,88365TC,INSITU HYBRIDIZATION (FISH),,,106.97,106.97,1
HCPCS,88366,INSITU HYBRID EA ADDTL MULTI PRB,359.0,233.35,92.98,397.21,38
HCPCS,88366,INSITU HYBRIDIZATION (FISH),1029.0,668.85,94.71,926.1,40
HCPCS,88366,INSITU HYBRIDIZATION DUAL,1029.0,668.85,94.71,926.1,38
HCPCS,88366,"RET GENE REARRANGEMENTS, FISH",472.0,306.8,94.71,424.8,38
HCPCS,88366,"SEND OUT ALK GENE REARRANGEMENTS BY FISH, LUNG",1182.0,768.3,94.71,1063.8,38
HCPCS,88366,SEND OUT ROS1 BY FISH,1182.0,768.3,94.71,1063.8,38
HCPCS,883660,INSITU HYBRIDIZATION (FISH),,,166.97,166.97,1
HCPCS,88366TC,INSITU HYBRIDIZATION (FISH),,,166.97,166.97,1
HCPCS,88367,INSITU  HYBRIDIZATION AUTO,359.0,233.35,92.98,779.93,38
HCPCS,88367,INSITU HYBRIDIZATION AUTO,359.0,233.35,62.65,779.93,40
HCPCS,88367,M/PHMTRC ALYS CAT INTL SNG PROBE,359.0,233.35,92.98,779.93,38
HCPCS,88367,M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN,366.0,237.9,19.32,371.0,62
HCPCS,883670,INSITU HYBRIDIZATION AUTO,,,62.65,62.65,1
HCPCS,88367TC,INSITU HYBRIDIZATION AUTO,,,62.65,62.65,1
HCPCS,88368,*INSITU HYBRID EA PROBE MANUAL,498.0,323.7,94.71,779.93,76
HCPCS,88368,INSITU HYBRID EA PROBE MAN,498.0,323.7,94.71,779.93,38
HCPCS,88368,INSITU HYBRID EA PROBE MANUAL,498.0,323.7,94.71,779.93,228
HCPCS,88368,INSITU HYBRIDIZATION MANUAL,498.0,323.7,84.43,779.93,40
HCPCS,88368,QFEVER ABS IGG PH2 RFLX,498.0,323.7,94.71,779.93,38
HCPCS,883680,INSITU HYBRIDIZATION MANUAL,,,84.43,84.43,1
HCPCS,88368TC,INSITU HYBRIDIZATION MANUAL,,,84.43,84.43,1
HCPCS,88369,M/PHMTRC ALYSISHQUANT/SEMIQ,,,75.49,75.49,2
HCPCS,88369,M/phmtrc alysishquant/semiq,,,19.72,24.91,6
HCPCS,883690,M/PHMTRC ALYSISHQUANT/SEMIQ,,,75.49,75.49,1
HCPCS,88369TC,M/PHMTRC ALYSISHQUANT/SEMIQ,,,75.49,75.49,1
HCPCS,88371,PROTEIN WESTERN BLOT TISSUE,,,19.2,37.15,4
HCPCS,88371,Protein western blot tissue,,,11.52,14.56,6
HCPCS,883710,PROTEIN WESTERN BLOT TISSUE,,,19.2,19.2,1
HCPCS,88372,PROTEIN ANALYSIS W/PROBE,,,22.66,43.81,4
HCPCS,88372,Protein analysis w/probe,,,11.52,14.56,6
HCPCS,883720,PROTEIN ANALYSIS W/PROBE,,,22.66,22.66,1
HCPCS,88373,M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH,147.0,95.55,14.58,147.0,31
HCPCS,88373,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,34.1,34.1,2
HCPCS,88373,M/phmtrc alys ishquant/semiq,,,19.72,24.91,6
HCPCS,883730,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,34.1,34.1,1
HCPCS,88373TC,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,34.1,34.1,1
HCPCS,88374,M/PHMTRC ALYS CAT EA MULTIPLEX PR,343.0,222.95,88.84,403.02,38
HCPCS,88374,M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR EACH MULTIPRB,244.0,158.6,24.51,244.0,31
HCPCS,88374,M/PHMTRC ALYS ISHQUANT/SEMIQ,343.0,222.95,88.84,403.02,40
HCPCS,883740,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,194.18,194.18,1
HCPCS,88374TC,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,194.18,194.18,1
HCPCS,88375,OPTICAL ENDOMICROSCPY INTERP,,,39.18,39.18,2
HCPCS,88375,Optical endomicroscpy interp,,,56.79,71.74,6
HCPCS,883750,OPTICAL ENDOMICROSCPY INTERP,,,39.18,39.18,1
HCPCS,88375TC,OPTICAL ENDOMICROSCPY INTERP,,,39.18,39.18,1
HCPCS,88377,1P19Q FISH FOR 1P/19Q,801.0,520.65,94.71,720.9,38
HCPCS,88377,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"7 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"7 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"8 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"8 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, FISH",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-SLL, FISH",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, FISH",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,ALK FISH LUNG NSCLC,909.0,590.85,94.71,818.1,38
HCPCS,88377,"B-CELL LYMPHOMA, FISH, TISSUE",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,FISH CUTANE MELANOMA,604.0,392.6,94.71,580.48,38
HCPCS,88377,FISH FOR 19Q,801.0,520.65,94.71,720.9,38
HCPCS,88377,FISH FOR 1P36,817.0,531.05,94.71,735.3,38
HCPCS,88377,FISH FOR AGG B CL LYM,778.0,505.7,94.71,700.2,38
HCPCS,88377,FISH FOR ALK CYTO BLOCK,817.0,531.05,94.71,735.3,38
HCPCS,88377,FISH FOR ALK TRANS,817.0,531.05,94.71,735.3,38
HCPCS,88377,FISH FOR ANGIO MYC AMP,801.0,520.65,94.71,720.9,38
HCPCS,88377,FISH FOR BIRC3/MALT1,801.0,520.65,94.71,720.9,38
HCPCS,88377,FISH FOR DUSP22-IRF4 TISS,801.0,520.65,94.71,720.9,38
HCPCS,88377,FISH FOR EGFR,801.0,520.65,94.71,720.9,38
HCPCS,88377,FISH FOR IGH/BCL2 TIS X2,801.0,520.65,94.71,720.9,38
HCPCS,88377,FISH FOR IGH/CCND1 TIS X2,801.0,520.65,94.71,720.9,38
HCPCS,88377,FISH FOR MALT 1 18Q21,778.0,505.7,94.71,700.2,38
HCPCS,88377,FISH FOR MDM2,801.0,520.65,94.71,720.9,38
HCPCS,88377,FISH FOR RET CYTO BLOCK,778.0,505.7,94.71,700.2,38
HCPCS,88377,FISH FOR RET PRFN,817.0,531.05,94.71,735.3,38
HCPCS,88377,FISH FOR ROS1,906.0,588.9,94.71,815.4,38
HCPCS,88377,FISH FOR ROS1 CYTO BLOCK,817.0,531.05,94.71,735.3,38
HCPCS,88377,FISH FOR ROS1 PRFN,801.0,520.65,94.71,720.9,38
HCPCS,88377,FISH FOR TP63 TISSUE,801.0,520.65,94.71,720.9,38
HCPCS,88377,FISH HER-2,778.0,505.7,94.71,700.2,38
HCPCS,88377,FISH TP63 DUSP22 PANEL,801.0,520.65,94.71,720.9,38
HCPCS,88377,"HER2 AMPLIFICATION, MISCELLANEOUS TUMOR, FISH",1494.0,971.1,94.71,1344.6,38
HCPCS,88377,"ISH, QUANT/SEMI QUANT, MULTIPLEX PROBE STAIN",1182.0,768.3,94.71,1063.8,38
HCPCS,88377,M/PHMTRC ALYS EA MULTIPLEX PROBE,596.0,387.4,94.71,580.48,38
HCPCS,88377,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB,603.0,391.95,37.09,603.0,31
HCPCS,88377,M/PHMTRC ALYS ISHQUANT/SEMIQ,1026.0,666.9,94.71,1215.9,116
HCPCS,88377,"MDM2, FISH",896.0,582.4,94.71,806.4,38
HCPCS,88377,"MORPHOMETRIC ANALYSIS, IN SITU HYBRID (HER2FGAST)",747.0,485.55,94.71,672.3,38
HCPCS,88377,"MYCN (N-MYC), FISH",590.0,383.5,94.71,580.48,38
HCPCS,88377,NG FISH MANUAL TC MULTIPLEX PROBE,330.0,214.5,85.47,580.48,38
HCPCS,88377,"SLL, FISH",1490.0,968.5,94.71,1341.0,38
HCPCS,88377,"T-CELL LYMPHOMA, FISH",1490.0,968.5,94.71,1341.0,38
HCPCS,883770,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,262.38,262.38,1
HCPCS,88377TC,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,262.38,262.38,1
HCPCS,88380,ATMS MICRODISECTION,369.0,239.85,61.99,332.1,28
HCPCS,88380,MICRODISSECTION LASER,,,58.01,58.01,2
HCPCS,88380,MICRODISSECTION LASER CAPTURE,131.0,85.15,22.01,168.5,28
HCPCS,883800,MICRODISSECTION LASER,,,58.01,58.01,1
HCPCS,88380TC,MICRODISSECTION LASER,,,58.01,58.01,1
HCPCS,88381,%NRAST MICRODISSECT,406.0,263.9,19.72,365.4,28
HCPCS,88381,*MICRODISECTION MANUAL,619.0,402.35,19.72,557.1,28
HCPCS,88381,*MICRODISSECTION MANUAL,29.0,18.85,4.87,284.47,28
HCPCS,88381,MICRODISECTION MANUAL,40.0,26.0,6.72,284.47,28
HCPCS,88381,MICRODISSECTION MANUAL,1310.0,851.5,19.72,1179.0,30
HCPCS,88381,MICRODISSECTION PREP IDENTIFIED TARGET MANUAL,228.0,148.2,114.0,292.86,31
HCPCS,88381,"MICRODISSECTION, MANUAL",303.0,196.95,19.72,284.47,28
HCPCS,883810,MICRODISSECTION MANUAL,,,140.57,140.57,1
HCPCS,88381TC,MICRODISSECTION MANUAL,,,140.57,140.57,1
HCPCS,88387,MACROSCOPIC XM DSJ&PREP TISS,,,5.8,5.8,2
HCPCS,88387,Macroscopic xm dsj&prep tiss,,,19.72,24.91,6
HCPCS,883870,MACROSCOPIC XM DSJ&PREP TISS,,,5.8,5.8,1
HCPCS,88387TC,MACROSCOPIC XM DSJ&PREP TISS,,,5.8,5.8,1
HCPCS,88388,Tiss ex molecul study add-on,,,56.79,71.74,6
HCPCS,88399,EM PROCESSING AND HOLD,55.0,35.75,11.52,115.85,37
HCPCS,88399,H&E UNSTAINED SLIDES,62.0,40.3,11.52,115.85,37
HCPCS,88399,PARATHYROID GLAND CRYOPRESERVA,2188.0,1422.2,11.52,1969.2,37
HCPCS,88720,BILIRUBIN TOTAL TRANSCUT,,,4.34,8.39,15
HCPCS,88720,Bilirubin total transcut,,,2.81,3.55,6
HCPCS,887200,BILIRUBIN TOTAL TRANSCUT,,,4.34,4.34,1
HCPCS,88738,HGB QUANT TRANSCUTANEOUS,,,4.34,8.39,15
HCPCS,88738,Hgb quant transcutaneous,,,2.81,3.55,6
HCPCS,887380,HGB QUANT TRANSCUTANEOUS,,,4.34,4.34,1
HCPCS,88740,TRANSCUTANEOUS CARBOXYHB,,,8.1,15.66,15
HCPCS,88740,Transcutaneous carboxyhb,,,2.81,3.55,6
HCPCS,887400,TRANSCUTANEOUS CARBOXYHB,,,8.1,8.1,1
HCPCS,88741,TRANSCUTANEOUS METHB,,,8.1,15.66,15
HCPCS,88741,Transcutaneous methb,,,2.81,3.55,6
HCPCS,887410,TRANSCUTANEOUS METHB,,,8.1,8.1,1
HCPCS,88749,UNLISTED IN VIVO LAB SERVICE,,,13.02,13.02,2
HCPCS,88749,Unlisted in vivo lab service,,,2.34,2.95,6
HCPCS,887490,UNLISTED IN VIVO LAB SERVICE,,,13.02,13.02,1
HCPCS,88749TC,UNLISTED IN VIVO LAB SERVICE,,,13.02,13.02,1
HCPCS,89049,CHCT FOR MAL HYPERTHERMIA,,,51.86,371.54,16
HCPCS,89049,Chct for mal hyperthermia,,,101.52,128.23,6
HCPCS,890490,CHCT FOR MAL HYPERTHERMIA,,,51.86,51.86,1
HCPCS,89049TC,CHCT FOR MAL HYPERTHERMIA,,,51.86,51.86,1
HCPCS,89050,BODY FLUID CELL COUNT,,,4.08,7.89,15
HCPCS,89050,Body fluid cell count,,,2.34,2.95,6
HCPCS,890500,BODY FLUID CELL COUNT,,,4.08,4.08,1
HCPCS,89051,BODY FLUID CELL COUNT,,,4.84,4.84,1
HCPCS,89051,CELL COUNT & DIFF,107.0,69.55,2.34,96.3,37
HCPCS,89051,CELL COUNT FLUID DIFF COUNT,109.0,70.85,2.34,98.1,37
HCPCS,89051,CELL COUNT MISC BODY FLUIDS W/DIFFERENTIAL COUNT,59.0,38.35,2.35,59.0,17
HCPCS,890510,BODY FLUID CELL COUNT,,,4.84,4.84,1
HCPCS,89055,FECAL LEUKOCYTES,142.0,92.3,2.34,127.8,37
HCPCS,89055,LEUKO ASSESS FECAL QUAL,92.0,59.8,2.34,82.8,37
HCPCS,89055,LEUKOCYTE ASSESSMENT FECAL,,,3.69,3.69,1
HCPCS,89055,LEUKOCYTE ASSMT FECAL QUAL/SEMIQUANTITATIVE,15.0,9.75,2.56,15.0,17
HCPCS,890550,LEUKOCYTE ASSESSMENT FECAL,,,3.69,3.69,1
HCPCS,89060,CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,160.0,104.0,3.08,160.0,17
HCPCS,89060,EXAM SYNOVIAL FLUID CRYSTALS,64.0,41.6,2.34,57.6,75
HCPCS,890600,EXAM SYNOVIAL FLUID CRYSTALS,,,6.33,6.33,1
HCPCS,89125,SPEC FAT STAIN,11.0,7.15,2.34,9.9,37
HCPCS,89125,SPECIMEN FAT STAIN,,,5.08,5.08,1
HCPCS,891250,SPECIMEN FAT STAIN,,,5.08,5.08,1
HCPCS,89160,EXAM FECES FOR MEAT FIBERS,,,4.19,8.1,15
HCPCS,89160,Exam feces for meat fibers,,,2.34,2.95,6
HCPCS,891600,EXAM FECES FOR MEAT FIBERS,,,4.19,4.19,1
HCPCS,89190,EOSINOPHIL SMEAR MISC,36.0,23.4,2.34,32.4,37
HCPCS,89190,NASAL SMEAR EOSINOPHILS,36.0,23.4,3.47,36.0,17
HCPCS,89190,NASAL SMEAR FOR EOSINOPHILS,28.0,18.2,2.34,25.2,38
HCPCS,891900,NASAL SMEAR FOR EOSINOPHILS,,,5.0,5.0,1
HCPCS,89220,COLL SPUTUM AEROSOL,180.0,117.0,30.94,371.54,38
HCPCS,89220,SPUTUM OBTAINING SPEC AEROSOL INDUCED TX SPX,72.0,46.8,8.2,72.0,31
HCPCS,89220,SPUTUM SPECIMEN COLLECTION,,,15.23,15.23,1
HCPCS,892200,SPUTUM SPECIMEN COLLECTION,,,15.23,15.23,1
HCPCS,89230,COLLECT SWEAT FOR TEST,,,2.4,115.85,15
HCPCS,89230,Collect sweat for test,,,11.52,14.56,6
HCPCS,892300,COLLECT SWEAT FOR TEST,,,2.4,2.4,1
HCPCS,89240,CRYOPS WITHDRAW,107.0,69.55,11.52,115.85,37
HCPCS,89250,CULTR OOCYTE/EMBRYO <4 DAYS,,,172.01,865.67,15
HCPCS,89250,Cultr oocyte/embryo <4 days,,,59.1,74.65,6
HCPCS,892500,CULTR OOCYTE/EMBRYO <4 DAYS,,,865.67,865.67,1
HCPCS,89251,CULTR OOCYTE/EMBRYO <4 DAYS,,,172.01,900.51,15
HCPCS,89251,Cultr oocyte/embryo <4 days,,,59.1,74.65,6
HCPCS,892510,CULTR OOCYTE/EMBRYO <4 DAYS,,,900.51,900.51,1
HCPCS,89253,EMBRYO HATCHING,,,172.01,371.54,16
HCPCS,89253,Embryo hatching,,,59.1,74.65,6
HCPCS,892530,EMBRYO HATCHING,,,333.98,333.98,1
HCPCS,89253TC,EMBRYO HATCHING,,,333.98,333.98,1
HCPCS,89254,OOCYTE IDENTIFICATION,,,172.01,471.26,16
HCPCS,89254,Oocyte identification,,,59.1,74.65,6
HCPCS,892540,OOCYTE IDENTIFICATION,,,471.26,471.26,1
HCPCS,89254TC,OOCYTE IDENTIFICATION,,,471.26,471.26,1
HCPCS,89255,PREPARE EMBRYO FOR TRANSFER,,,53.63,360.15,16
HCPCS,89255,Prepare embryo for transfer,,,59.1,74.65,6
HCPCS,892550,PREPARE EMBRYO FOR TRANSFER,,,360.15,360.15,1
HCPCS,89255TC,PREPARE EMBRYO FOR TRANSFER,,,360.15,360.15,1
HCPCS,89257,PERCUTANEOUS SPERM ASPIRATION,1166.0,757.9,53.63,1049.4,37
HCPCS,89257,SPERM IDENTIFICATION,,,448.68,448.68,2
HCPCS,892570,SPERM IDENTIFICATION,,,448.68,448.68,1
HCPCS,89257TC,SPERM IDENTIFICATION,,,448.68,448.68,1
HCPCS,89258,CRYOPRESERVATION EMBRYO(S),,,532.8,1771.17,16
HCPCS,89258,Cryopreservation embryo(s),,,59.1,74.65,6
HCPCS,892580,CRYOPRESERVATION EMBRYO(S),,,532.8,532.8,1
HCPCS,89258TC,CRYOPRESERVATION EMBRYO(S),,,532.8,532.8,1
HCPCS,89259,CRYOPRESERVATION SPERM,624.0,405.6,59.1,561.6,39
HCPCS,89259,SEMEN CRYOPRESERVATION INITIAL-BW,624.0,405.6,59.1,561.6,37
HCPCS,892590,CRYOPRESERVATION SPERM,,,180.13,180.13,1
HCPCS,89259TC,CRYOPRESERVATION SPERM,,,180.13,180.13,1
HCPCS,89260,SPERM ISOLATION SIMPLE,,,126.81,126.81,2
HCPCS,89260,SPERM WASH FOR INSEMINATI,310.0,201.5,53.63,279.0,37
HCPCS,892600,SPERM ISOLATION SIMPLE,,,126.81,126.81,1
HCPCS,89260TC,SPERM ISOLATION SIMPLE,,,126.81,126.81,1
HCPCS,89261,SPERM ISOLATION COMPLEX,,,115.27,115.27,2
HCPCS,89261,SPERM WASH SECOND INSEM,578.0,375.7,53.63,520.2,37
HCPCS,892610,SPERM ISOLATION COMPLEX,,,115.27,115.27,1
HCPCS,89261TC,SPERM ISOLATION COMPLEX,,,115.27,115.27,1
HCPCS,89264,IDENTIFY SPERM TISSUE,,,412.18,412.18,2
HCPCS,89264,TESTICULAR BIOPSY PREP,1870.0,1215.5,53.63,1683.0,37
HCPCS,892640,IDENTIFY SPERM TISSUE,,,412.18,412.18,1
HCPCS,89264TC,IDENTIFY SPERM TISSUE,,,412.18,412.18,1
HCPCS,89268,INSEMINATION OF OOCYTES,,,172.01,439.16,16
HCPCS,89268,Insemination of oocytes,,,59.1,74.65,6
HCPCS,892680,INSEMINATION OF OOCYTES,,,439.16,439.16,1
HCPCS,89268TC,INSEMINATION OF OOCYTES,,,439.16,439.16,1
HCPCS,89272,EXTENDED CULTURE OF OOCYTES,,,636.94,1771.17,16
HCPCS,89272,Extended culture of oocytes,,,59.1,74.65,6
HCPCS,892720,EXTENDED CULTURE OF OOCYTES,,,636.94,636.94,1
HCPCS,89272TC,EXTENDED CULTURE OF OOCYTES,,,636.94,636.94,1
HCPCS,89280,ASSIST OOCYTE FERTILIZATION,,,768.23,1771.17,16
HCPCS,89280,Assist oocyte fertilization,,,59.1,74.65,6
HCPCS,892800,ASSIST OOCYTE FERTILIZATION,,,768.23,768.23,1
HCPCS,89280TC,ASSIST OOCYTE FERTILIZATION,,,768.23,768.23,1
HCPCS,89281,ASSIST OOCYTE FERTILIZATION,,,172.01,1031.48,16
HCPCS,89281,Assist oocyte fertilization,,,59.1,74.65,6
HCPCS,892810,ASSIST OOCYTE FERTILIZATION,,,1031.48,1031.48,1
HCPCS,89281TC,ASSIST OOCYTE FERTILIZATION,,,1031.48,1031.48,1
HCPCS,89290,BIOPSY OOCYTE POLAR BODY <=5,,,172.01,937.97,16
HCPCS,89290,Biopsy oocyte polar body <=5,,,59.1,74.65,6
HCPCS,892900,BIOPSY OOCYTE POLAR BODY <=5,,,937.97,937.97,1
HCPCS,89290TC,BIOPSY OOCYTE POLAR BODY <=5,,,937.97,937.97,1
HCPCS,89291,BIOPSY OOCYTE POLAR BODY,,,172.01,879.12,16
HCPCS,89291,Biopsy oocyte polar body,,,59.1,74.65,6
HCPCS,892910,BIOPSY OOCYTE POLAR BODY,,,879.12,879.12,1
HCPCS,89291TC,BIOPSY OOCYTE POLAR BODY,,,879.12,879.12,1
HCPCS,89300,SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER,185.0,120.25,5.9,185.0,17
HCPCS,89300,SEMEN ANALYSIS W/HUHNER,,,8.5,16.44,18
HCPCS,89300,Semen analysis w/huhner,,,2.34,2.95,6
HCPCS,893000,SEMEN ANALYSIS W/HUHNER,,,8.5,8.5,1
HCPCS,89300QW,SEMEN ANALYSIS W/HUHNER,,,15.17,16.44,3
HCPCS,89310,SEMEN ANALYSIS W/COUNT,,,7.44,7.44,1
HCPCS,89310,SPERM COUNT/MOTILITY SEMEN,188.0,122.2,2.34,169.2,37
HCPCS,893100,SEMEN ANALYSIS W/COUNT,,,7.44,7.44,1
HCPCS,89320,CASA,262.0,170.3,2.34,235.8,37
HCPCS,89320,SEMEN ANAL VOL/COUNT/MOT,314.0,204.1,7.39,314.0,18
HCPCS,89320,SEMEN ANLYS CMP PROFESSIONAL FEE,13.0,8.45,6.5,13.31,17
HCPCS,893200,SEMEN ANAL VOL/COUNT/MOT,,,10.64,10.64,1
HCPCS,89321,SEMEN ANAL POST VASEC,243.0,157.95,2.34,218.7,37
HCPCS,89321,SEMEN ANAL SPERM DETECTION,,,10.41,20.14,4
HCPCS,89321,SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM,50.0,32.5,5.06,50.0,17
HCPCS,893210,SEMEN ANAL SPERM DETECTION,,,10.41,10.41,1
HCPCS,89321QW,SEMEN ANAL SPERM DETECTION,,,18.58,20.14,3
HCPCS,89322,SEMEN ANAL STRICT CRITERIA,,,13.39,13.39,1
HCPCS,89322,SPERM DIFFERENTIAL,138.0,89.7,2.34,124.2,37
HCPCS,893220,SEMEN ANAL STRICT CRITERIA,,,13.39,13.39,1
HCPCS,89325,ANTI SPERM AB TYPING,281.0,182.65,2.34,252.9,37
HCPCS,89325,SPERM ANTIBODY TEST,,,9.22,9.22,1
HCPCS,89325,TEST SPERM AB,48.0,31.2,2.34,51.3,74
HCPCS,893250,SPERM ANTIBODY TEST,,,9.22,9.22,1
HCPCS,89329,SPERM EVALUATION TEST,,,16.92,32.73,15
HCPCS,89329,Sperm evaluation test,,,2.34,2.95,6
HCPCS,893290,SPERM EVALUATION TEST,,,16.92,16.92,1
HCPCS,89330,EVALUATION CERVICAL MUCUS,,,8.96,17.34,15
HCPCS,89330,Evaluation cervical mucus,,,2.34,2.95,6
HCPCS,893300,EVALUATION CERVICAL MUCUS,,,8.96,8.96,1
HCPCS,89331,RETRO AN SPERM COUNT,326.0,211.9,2.34,293.4,37
HCPCS,89331,RETROGRADE EJACULATION ANAL,,,16.92,16.92,1
HCPCS,893310,RETROGRADE EJACULATION ANAL,,,16.92,16.92,1
HCPCS,89335,CRYOPRESERVE TESTICULAR TISS,,,53.63,197.62,16
HCPCS,89335,Cryopreserve testicular tiss,,,59.1,74.65,6
HCPCS,893350,CRYOPRESERVE TESTICULAR TISS,,,197.62,197.62,1
HCPCS,89335TC,CRYOPRESERVE TESTICULAR TISS,,,197.62,197.62,1
HCPCS,89337,CRYOPRESERVATION OOCYTE(S),,,172.01,687.3,16
HCPCS,89337,Cryopreservation oocyte(s),,,59.1,74.65,6
HCPCS,893370,CRYOPRESERVATION OOCYTE(S),,,687.3,687.3,1
HCPCS,89337TC,CRYOPRESERVATION OOCYTE(S),,,687.3,687.3,1
HCPCS,89342,STORAGE/YEAR EMBRYO(S),,,168.42,371.54,16
HCPCS,89342,Storage/year embryo(s),,,59.1,74.65,6
HCPCS,893420,STORAGE/YEAR EMBRYO(S),,,168.42,168.42,1
HCPCS,89342TC,STORAGE/YEAR EMBRYO(S),,,168.42,168.42,1
HCPCS,89343,STORAGE SEMEN/SPERM PER YEAR,367.0,238.55,59.1,371.54,37
HCPCS,89343,STORAGE/YEAR SPERM/SEMEN,,,121.5,121.5,2
HCPCS,893430,STORAGE/YEAR SPERM/SEMEN,,,121.5,121.5,1
HCPCS,89343TC,STORAGE/YEAR SPERM/SEMEN,,,121.5,121.5,1
HCPCS,89344,STORAGE/YEAR REPROD TISSUE,,,111.01,371.54,16
HCPCS,89344,Storage/year reprod tissue,,,59.1,74.65,6
HCPCS,893440,STORAGE/YEAR REPROD TISSUE,,,111.01,111.01,1
HCPCS,89344TC,STORAGE/YEAR REPROD TISSUE,,,111.01,111.01,1
HCPCS,89346,STORAGE/YEAR OOCYTE(S),,,172.01,371.54,16
HCPCS,89346,Storage/year oocyte(s),,,59.1,74.65,6
HCPCS,893460,STORAGE/YEAR OOCYTE(S),,,264.6,264.6,1
HCPCS,89346TC,STORAGE/YEAR OOCYTE(S),,,264.6,264.6,1
HCPCS,89352,THAWING CRYOPRESRVED EMBRYO,,,41.98,371.54,16
HCPCS,89352,Thawing cryopresrved embryo,,,59.1,74.65,6
HCPCS,893520,THAWING CRYOPRESRVED EMBRYO,,,41.98,41.98,1
HCPCS,89352TC,THAWING CRYOPRESRVED EMBRYO,,,41.98,41.98,1
HCPCS,89353,THAW CRYOPRESERVE SPERM/SEMEN,266.0,172.9,53.63,239.4,37
HCPCS,89353,THAWING CRYOPRESRVED SPERM,,,17.99,17.99,2
HCPCS,893530,THAWING CRYOPRESRVED SPERM,,,17.99,17.99,1
HCPCS,89353TC,THAWING CRYOPRESRVED SPERM,,,17.99,17.99,1
HCPCS,89354,THAW CRYOPRSVRD REPROD TISS,,,12.29,371.54,16
HCPCS,89354,Thaw cryoprsvrd reprod tiss,,,59.1,74.65,6
HCPCS,893540,THAW CRYOPRSVRD REPROD TISS,,,12.29,12.29,1
HCPCS,89354TC,THAW CRYOPRSVRD REPROD TISS,,,12.29,12.29,1
HCPCS,89356,THAWING CRYOPRESRVED OOCYTE,,,24.84,371.54,16
HCPCS,89356,Thawing cryopresrved oocyte,,,59.1,74.65,6
HCPCS,893560,THAWING CRYOPRESRVED OOCYTE,,,24.84,24.84,1
HCPCS,89356TC,THAWING CRYOPRESRVED OOCYTE,,,24.84,24.84,1
HCPCS,89398,UNLISTED REPROD MED LAB PROC,,,53.63,115.85,14
HCPCS,89398,Unlisted reprod med lab proc,,,11.52,14.56,6
HCPCS,9001F,AORTIC ANEURYSM<5CM DIAM CT,,,0.01,0.01,1
HCPCS,9001F0,AORTIC ANEURYSM<5CM DIAM CT,,,0.01,0.01,1
HCPCS,9002F,AORTIC ANEURYSM 5-5.4CM DIAM,,,0.01,0.01,1
HCPCS,9002F0,AORTIC ANEURYSM 5-5.4CM DIAM,,,0.01,0.01,1
HCPCS,9003F,AORTIC ANRYSM5.5-5.9CM DIAM,,,0.01,0.01,1
HCPCS,9003F0,AORTIC ANRYSM5.5-5.9CM DIAM,,,0.01,0.01,1
HCPCS,9004F,AORTIC ANRYSM 6/> CM DIAM,,,0.01,0.01,1
HCPCS,9004F0,AORTIC ANRYSM 6/> CM DIAM,,,0.01,0.01,1
HCPCS,9005F,ASYMPT CAROT/VRTBRBAS STEN,,,0.01,0.01,1
HCPCS,9005F0,ASYMPT CAROT/VRTBRBAS STEN,,,0.01,0.01,1
HCPCS,9006F,SYMPT STEN-TIA/STRK<120DAYS,,,0.01,0.01,1
HCPCS,9006F0,SYMPT STEN-TIA/STRK<120DAYS,,,0.01,0.01,1
HCPCS,9007F,OTHER CAROT STEN 120 DAYS/>,,,0.01,0.01,1
HCPCS,9007F0,OTHER CAROT STEN 120 DAYS/>,,,0.01,0.01,1
HCPCS,90103,PROSTATE SCREEN PROFESSIONAL FEE,13.0,8.45,6.5,13.0,12
HCPCS,90281,HUMAN IG IM,,,104.74,265.73,7
HCPCS,90281,IMMUNE GLOBULIN IG HUMAN IM USE,220.0,143.0,97.93,220.0,13
HCPCS,902810,HUMAN IG IM,,,104.74,104.74,1
HCPCS,90283,HUMAN IG IV,,,81.92,207.83,7
HCPCS,90283,IMMUNE GLOBULIN IGIV HUMAN IV USE,261.0,169.65,74.37,261.0,13
HCPCS,902830,HUMAN IG IV,,,81.92,81.92,1
HCPCS,90284,HUMAN IG SC,,,16.38,41.57,7
HCPCS,902840,HUMAN IG SC,,,16.38,16.38,1
HCPCS,90287,Botulinum antitoxin,,,61.99,78.3,6
HCPCS,90288,BOTULISM IG IV,,,63617.4,161399.7,7
HCPCS,90288,Botulism ig iv,,,10052.3,12697.64,6
HCPCS,902880,BOTULISM IG IV,,,63617.4,63617.4,1
HCPCS,90291,CMV IG IV,,,1935.35,4910.05,7
HCPCS,90291,Cmv ig iv,,,2562.41,3236.72,6
HCPCS,902910,CMV IG IV,,,1935.35,1935.35,1
HCPCS,90371,HEP B IG IM,,,148.86,148.86,1
HCPCS,90371,HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM,5650.0,3672.5,137.83,5650.0,13
HCPCS,90371,HYPERHEP B 220 UNIT/ML (5 ML) INTRAMUSCULAR SOLUTION,593.46,385.75,127.0,652.67,47
HCPCS,90371,HYPERHEP B 220 UNIT/ML INTRAMUSCULAR SOLUTION,618.45,401.99,127.0,652.67,47
HCPCS,90371,HYPERHEP B NEONATAL 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,655.92,426.35,127.0,655.92,47
HCPCS,90371,NABI-HB GREATER THAN 1560 UNIT/5 ML INTRAMUSCULAR SOLUTION,569.07,369.9,127.0,652.67,47
HCPCS,903710,HEP B IG IM,,,148.86,148.86,1
HCPCS,90375,HYPERRAB (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,2498.79,1624.21,257.09,2498.79,141
HCPCS,90375,RABIES IG IM/SC,,,302.35,302.35,1
HCPCS,90375,RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ,923.0,599.95,279.95,923.0,13
HCPCS,903750,RABIES IG IM/SC,,,302.35,302.35,1
HCPCS,90376,IMOGAM RABIES-HT (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,1629.24,1059.01,352.44,1629.24,39
HCPCS,90376,RABIES IG HEAT TREATED,,,498.55,498.55,1
HCPCS,903760,RABIES IG HEAT TREATED,,,498.55,498.55,1
HCPCS,90377,RABIES IG HT&SOL HUMAN IM/SC,,,225.88,657.96,29
HCPCS,90377,Rabies ig ht&sol human im/sc,,,746.88,943.43,6
HCPCS,903770,RABIES IG HT&SOL HUMAN IM/SC,,,259.34,259.34,1
HCPCS,90378,RSV MAB IM 50MG,,,436.75,5088.37,21
HCPCS,90378,Rsv mab im 50mg,,,516.7,652.67,6
HCPCS,903780,RSV MAB IM 50MG,,,2005.64,2005.64,1
HCPCS,90380,BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE,4284.4349999999995,2784.88,516.7,4284.45,64
HCPCS,90380,RSV MONOC ANTB SEASN .5ML IM,,,612.64,612.64,1
HCPCS,90380,RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE,2340.0,1521.0,436.8,2600.0,45
HCPCS,903800,RSV MONOC ANTB SEASN .5ML IM,,,612.64,612.64,1
HCPCS,90381,BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE,2142.21,1392.44,359.89,2142.21,58
HCPCS,90381,RSV MONOC ANTB SEASN 1 ML IM,,,612.64,612.64,1
HCPCS,90381,RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE,2340.0,1521.0,436.8,2600.0,45
HCPCS,903810,RSV MONOC ANTB SEASN 1 ML IM,,,612.64,612.64,1
HCPCS,90382,RSV MONOC ANTB SEASN .7ML IM,,,720.58,1828.13,4
HCPCS,90382,Rsv monoc antb seasn .7ml im,,,516.7,652.67,6
HCPCS,903820,RSV MONOC ANTB SEASN .7ML IM,,,720.58,720.58,1
HCPCS,90384,RH IG FULL-DOSE IM,,,91.25,231.5,7
HCPCS,90384,Rh ig full-dose im,,,61.99,78.3,6
HCPCS,903840,RH IG FULL-DOSE IM,,,91.25,91.25,1
HCPCS,90385,RH IG MINIDOSE IM,,,32.88,88.0,8
HCPCS,903850,RH IG MINIDOSE IM,,,32.88,32.88,1
HCPCS,90386,RH IG IV,,,11.35,28.8,7
HCPCS,90386,Rh ig iv,,,1073.13,1355.53,6
HCPCS,903860,RH IG IV,,,11.35,11.35,1
HCPCS,90389,TETANUS IG IM,,,715.12,1814.29,7
HCPCS,90389,Tetanus ig im,,,61.99,78.3,6
HCPCS,903890,TETANUS IG IM,,,715.12,715.12,1
HCPCS,90393,Vaccina ig im,,,61.99,78.3,6
HCPCS,90396,VARICELLA-ZOSTER IG IM,,,2250.71,6374.25,21
HCPCS,90396,Varicella-zoster ig im,,,273.36,345.3,6
HCPCS,903960,VARICELLA-ZOSTER IG IM,,,2512.48,2512.48,1
HCPCS,90460,IM ADMIN 1ST/ONLY COMPONENT,,,10.8,10.8,1
HCPCS,90460,IMADM THROUGH 18YR ANY ROUTE 1ST VAC/TOXOID,96.0,62.4,14.25,96.0,32
HCPCS,90460,VFC IM ADMIN 1ST/ONLY THRU 18,21.25,13.81,3.57,44.0,31
HCPCS,904600,IM ADMIN 1ST/ONLY COMPONENT,,,10.8,10.8,1
HCPCS,90461,IM ADMIN EACH ADDL COMPONENT,,,5.4,5.4,1
HCPCS,90461,IMADM THROUGH 18YR ANY ROUTE EA ADDL VAC/TOXOID,72.0,46.8,8.65,72.0,31
HCPCS,90461,Im admin each addl component,,,25.75,32.53,6
HCPCS,904610,IM ADMIN EACH ADDL COMPONENT,,,5.4,5.4,1
HCPCS,90471,ADMIN FEE FOR 1 INJECTION,68.0,44.2,12.3,68.0,32
HCPCS,90471,ADMIN FLU VIRUS VACCINE,68.0,44.2,12.3,68.0,32
HCPCS,90471,ADMIN VACCINE FLU,268.0,174.2,25.75,241.2,41
HCPCS,90471,ADMIN VACCINE PNEUMONIA,268.0,174.2,25.75,241.2,41
HCPCS,90471,ADMIN VACCINE SNGL,268.0,174.2,25.75,241.2,41
HCPCS,90471,ADMINISTRATION FLU VACC,68.0,44.2,12.3,68.0,32
HCPCS,90471,IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE,68.0,44.2,12.3,68.0,32
HCPCS,90471,IMMUNIZ INJ-FLU VACCINE ONLY,268.0,174.2,25.75,241.2,41
HCPCS,90471,IMMUNIZ INJ-HEP B VACC ONLY,268.0,174.2,25.75,241.2,41
HCPCS,90471,IMMUNIZATION ADMIN,68.0,44.2,10.8,68.0,33
HCPCS,90471,RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE,36.0,23.4,9.32,154.31,41
HCPCS,904710,IMMUNIZATION ADMIN,,,10.8,10.8,1
HCPCS,90472,ADMIN FEE FOR 2 INJECTIONS OR MORE,60.0,39.0,9.36,60.0,32
HCPCS,90472,ADMIN VACCINE EA ADD,80.0,52.0,13.44,72.0,31
HCPCS,90472,IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE,60.0,39.0,9.36,60.0,32
HCPCS,90472,IMMUNIZATION ADMIN EACH ADD,60.0,39.0,9.36,60.0,33
HCPCS,904720,IMMUNIZATION ADMIN EACH ADD,,,10.8,10.8,1
HCPCS,90473,IM ADM INTRANSL/ORAL 1 VACCINE,68.0,44.2,12.3,68.0,32
HCPCS,90473,IMMUNE ADMIN ORAL/NASAL,,,3.24,154.31,15
HCPCS,90473,Immune admin oral/nasal,,,25.75,32.53,6
HCPCS,904730,IMMUNE ADMIN ORAL/NASAL,,,3.24,3.24,1
HCPCS,90474,IM ADM INTRANSL/ORAL EA VACCINE,60.0,39.0,9.36,60.0,32
HCPCS,90474,IMMUNE ADMIN ORAL/NASAL ADDL,,,3.24,3.24,1
HCPCS,90474,Immune admin oral/nasal addl,,,25.75,32.53,6
HCPCS,904740,IMMUNE ADMIN ORAL/NASAL ADDL,,,3.24,3.24,1
HCPCS,90476,Adenovirus vaccine type 4,,,17.89,22.6,6
HCPCS,90477,Adenovirus vaccine type 7,,,17.89,22.6,6
HCPCS,90480,ADMINISTRATION COVID VACCINE,358.0,232.7,25.75,322.2,40
HCPCS,90480,ADMINISTRATION COVID VACCINE (2023-2024),293.0,190.45,44.78,293.0,13
HCPCS,90480,ADMN SARSCOV2 VAC 1/ONLY CMP,,,43.2,43.2,1
HCPCS,90480,VFC ADMINISTRATION COVID VACCINE,21.25,13.81,10.63,44.78,13
HCPCS,904800,ADMN SARSCOV2 VAC 1/ONLY CMP,,,43.2,43.2,1
HCPCS,90481,IMM ADMN SARSCOV2 VACCINE EACH ADDL COMPONENT,358.0,232.7,25.75,358.0,42
HCPCS,90482,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS 3<10 MIN,97.0,63.050000000000004,14.78,106.0,43
HCPCS,90483,IMM CNSL PHYS/QHP IMM NOT ADMN SM DOS>10<20 MIN,154.0,100.1,14.78,220.0,43
HCPCS,90484,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS>20 MIN,209.0,135.85,14.78,330.0,43
HCPCS,90581,ANTHRAX VACCINE SC OR IM,,,109.06,276.69,7
HCPCS,90581,Anthrax vaccine sc or im,,,79.26,100.12,6
HCPCS,905810,ANTHRAX VACCINE SC OR IM,,,109.06,109.06,1
HCPCS,90584,Dengue vacc quad 2 dose subq,,,79.26,100.12,6
HCPCS,90585,BCG VACCINE PERCUT,,,200.46,508.57,7
HCPCS,90585,Bcg vaccine percut,,,17.89,22.6,6
HCPCS,905850,BCG VACCINE PERCUT,,,200.46,200.46,1
HCPCS,90586,BCG VACCINE INTRAVESICAL,,,130.03,449.28,15
HCPCS,90586,Bcg vaccine intravesical,,,79.26,100.12,6
HCPCS,905860,BCG VACCINE INTRAVESICAL,,,177.09,177.09,1
HCPCS,90587,DENGUE VACC QUAD 3 DOSE SUBQ,,,72.71,184.46,4
HCPCS,90587,Dengue vacc quad 3 dose subq,,,79.26,100.12,6
HCPCS,905870,DENGUE VACC QUAD 3 DOSE SUBQ,,,72.71,72.71,1
HCPCS,90589,CHIKUNGUNYA VACCINE LIVE IM,,,356.4,356.4,1
HCPCS,90589,"CHIKUNGUNYA VACCINE, LIVE",990.0,643.5,79.26,990.0,29
HCPCS,90589,CHIKUNGUNYA VIRUS VACCINE LIVE FOR IM USE,990.0,643.5,283.25,990.0,13
HCPCS,905890,CHIKUNGUNYA VACCINE LIVE IM,,,356.4,356.4,1
HCPCS,90593,CHIKUNGUNYA VACC RECOMB IM,,,356.4,904.2,4
HCPCS,90593,Chikungunya vacc recomb im,,,79.26,100.12,6
HCPCS,905930,CHIKUNGUNYA VACC RECOMB IM,,,356.4,356.4,1
HCPCS,90611,JYNNEOS VACCINE (MPOX) 0.5 ML,785.7,510.71,0.01,785.7,52
HCPCS,90611,SMALLPOX&MONKEYPOX VAC 0.5ML,,,297.43,297.43,1
HCPCS,906110,SMALLPOX&MONKEYPOX VAC 0.5ML,,,297.43,297.43,1
HCPCS,90612,Inf&sarscov2 vacc 31.7/.32im,,,17.89,22.6,6
HCPCS,90613,Inf&sarscov2 vacc 40/0.4 im,,,17.89,22.6,6
HCPCS,90619,MENACWY-TT VACCINE IM,,,194.96,194.96,1
HCPCS,90619,"MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)",617.0,401.05,79.26,617.0,42
HCPCS,90619,MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION,1269.78,825.36,79.26,1269.78,58
HCPCS,906190,MENACWY-TT VACCINE IM,,,194.96,194.96,1
HCPCS,90620,BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1804.02,1172.61,79.26,1804.02,58
HCPCS,90620,MENB RECOMBINANT PROT W/OUT MEMBR VESIC VACC IM,852.0,553.8,237.13,852.0,13
HCPCS,90620,MENB RP W/OMV VACCINE IM,852.0,553.8,79.26,852.0,29
HCPCS,90620,MENB-4C VACCINE IM,,,261.08,261.08,1
HCPCS,906200,MENB-4C VACCINE IM,,,261.08,261.08,1
HCPCS,90621,MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM,604.0,392.6,225.16,604.0,13
HCPCS,90621,MENB-FHBP VACC 2/3 DOSE IM,,,228.25,228.25,1
HCPCS,90621,TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1621.14,1053.74,79.26,1621.14,58
HCPCS,906210,MENB-FHBP VACC 2/3 DOSE IM,,,228.25,228.25,1
HCPCS,90622,VACCINIA VRS VAC 0.3 ML PERQ,,,0.01,0.02,18
HCPCS,90622,Vaccinia vrs vac 0.3 ml perq,,,17.89,22.6,6
HCPCS,906220,VACCINIA VRS VAC 0.3 ML PERQ,,,0.01,0.01,1
HCPCS,90623,MENACWY-TT MENB-FHBP VACC IM,,,260.97,662.09,7
HCPCS,90623,Menacwy-tt menb-fhbp vacc im,,,79.26,100.12,6
HCPCS,906230,MENACWY-TT MENB-FHBP VACC IM,,,260.97,260.97,1
HCPCS,90624,MENB-4C&MENACWY VACC IM,,,276.09,700.45,4
HCPCS,90624,Menb-4c&menacwy vacc im,,,79.26,100.12,6
HCPCS,906240,MENB-4C&MENACWY VACC IM,,,276.09,276.09,1
HCPCS,90625,CHOLERA VACCINE ADULT 1 DOSE LIVE FOR ORAL USE,734.0,477.1,300.25,734.0,13
HCPCS,90625,CHOLERA VACCINE LIVE ORAL,,,321.12,814.68,4
HCPCS,90625,Cholera vaccine live oral,,,17.89,22.6,6
HCPCS,906250,CHOLERA VACCINE LIVE ORAL,,,321.12,321.12,1
HCPCS,90626,TIC-BRN ENCEPH VAC 0.25ML IM,,,334.78,334.78,1
HCPCS,90626,TICK-BORNE ENCEPH VACC INACTIVATED 0.25ML IM USE,304.0,197.6,51.07,304.0,29
HCPCS,906260,TIC-BRN ENCEPH VAC 0.25ML IM,,,334.78,334.78,1
HCPCS,90627,TIC-BRN ENCEPH VAC 0.5ML IM,,,334.78,334.78,1
HCPCS,90627,TICK-BORNE ENCEPH VACC INACTIVATED 0.5ML IM USE,304.0,197.6,51.07,304.0,29
HCPCS,906270,TIC-BRN ENCEPH VAC 0.5ML IM,,,334.78,334.78,1
HCPCS,90630,Flu vacc iiv4 no preserv id,,,17.89,22.6,6
HCPCS,90631,H5 vaccine pandemic im use,,,17.89,22.6,6
HCPCS,90632,HAVRIX (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE,319.74,207.83,17.89,319.74,37
HCPCS,90632,HEP A/ADULT,308.0,200.2,17.89,308.0,37
HCPCS,90632,HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE,308.0,200.2,84.94,308.0,13
HCPCS,90632,HEPA VACCINE ADULT IM,308.0,200.2,79.42,308.0,14
HCPCS,90632,HEPATITIS A VACCINE (PER DOSE),308.0,200.2,84.94,308.0,13
HCPCS,90632,VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION,298.74,194.18,17.89,298.74,37
HCPCS,90632,VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE,298.74,194.18,17.89,298.74,74
HCPCS,906320,HEPA VACCINE ADULT IM,,,79.42,79.42,1
HCPCS,90633,HAVRIX (PF) 720 ELISA UNIT/0.5 ML INTRAMUSCULAR SYRINGE,284.61,185.0,17.89,284.61,29
HCPCS,90633,HEPA VACC PED/ADOL 2 DOSE IM,,,43.98,43.98,1
HCPCS,90633,HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE,138.0,89.7,39.56,138.0,13
HCPCS,90633,VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION,282.51,183.63,17.89,282.51,29
HCPCS,90633,VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,282.51,183.63,17.89,282.51,29
HCPCS,906330,HEPA VACC PED/ADOL 2 DOSE IM,,,43.98,43.98,1
HCPCS,90634,HEPA VACC PED/ADOL 3 DOSE,,,33.21,84.26,4
HCPCS,90634,HEPA VACCINE 3 DOSE SCHEDULE PED/ADOLESC IM USE,88.0,57.2,24.28,88.0,13
HCPCS,90634,Hepa vacc ped/adol 3 dose,,,17.89,22.6,6
HCPCS,906340,HEPA VACC PED/ADOL 3 DOSE,,,33.21,33.21,1
HCPCS,90635,H5n1 vacc drv cll cul adj im,,,17.89,22.6,6
HCPCS,90636,HEP A / HEP B VACC ADULT IM,472.0,306.8,132.43,472.0,13
HCPCS,90636,HEP A/HEP B VACC ADULT IM,,,145.62,145.62,1
HCPCS,90636,HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM,472.0,306.8,132.43,472.0,13
HCPCS,90636,IM ADULT HEPA-HEPB,472.0,306.8,79.26,472.0,29
HCPCS,90636,TWINRIX,472.0,306.8,132.43,472.0,13
HCPCS,90636,TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE,504.36,327.83,79.26,504.36,29
HCPCS,906360,HEP A/HEP B VACC ADULT IM,,,145.62,145.62,1
HCPCS,90637,Vacc qirv mrna 30mcg/.5ml im,,,17.89,22.6,6
HCPCS,90638,Vacc qirv mrna 60mcg/.5ml im,,,17.89,22.6,6
HCPCS,90644,HIB-MENCY VACC 6WK-18M0 IM,,,26.95,68.36,7
HCPCS,90644,Hib-mency vacc 6wk-18m0 im,,,79.26,100.12,6
HCPCS,906440,HIB-MENCY VACC 6WK-18M0 IM,,,26.95,26.95,1
HCPCS,90647,HIB PRP-OMP VACC 3 DOSE IM,,,34.94,34.94,1
HCPCS,90647,HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE,108.0,70.2,31.47,108.0,13
HCPCS,90647,PEDVAX HIB (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLUTION,221.22,143.79,17.89,221.22,29
HCPCS,906470,HIB PRP-OMP VACC 3 DOSE IM,,,34.94,34.94,1
HCPCS,90648,ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION,47.37,30.79,7.96,47.37,58
HCPCS,90648,HIB PRP-T VACCINE 4 DOSE IM,,,15.17,15.17,1
HCPCS,90648,HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE,47.0,30.55,13.91,47.0,13
HCPCS,90648,"HIB, PRP-T",47.0,30.55,7.9,47.0,29
HCPCS,906480,HIB PRP-T VACCINE 4 DOSE IM,,,15.17,15.17,1
HCPCS,90649,4VHPV VACCINE 3 DOSE IM,,,176.3,447.28,7
HCPCS,90649,4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE,442.0,287.3,164.98,442.0,13
HCPCS,90649,4vhpv vaccine 3 dose im,,,79.26,100.12,6
HCPCS,90649,VHPV 4 VACCINE 3 DOSE IM,442.0,287.3,164.98,442.0,13
HCPCS,906490,4VHPV VACCINE 3 DOSE IM,,,176.3,176.3,1
HCPCS,90650,2VHPV VACCINE 3 DOSE IM,,,152.55,387.03,7
HCPCS,90650,2vhpv vaccine 3 dose im,,,17.89,22.6,6
HCPCS,906500,2VHPV VACCINE 3 DOSE IM,,,152.55,152.55,1
HCPCS,90651,9VHPV VACC 2/3 DOSE SCHED IM USE,1106.0,718.9,329.09,1106.0,13
HCPCS,90651,9VHPV VACCINE 2/3 DOSE IM,,,362.39,362.39,1
HCPCS,90651,GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION,2364.06,1536.64,79.26,2364.06,29
HCPCS,90651,GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,2364.06,1536.64,79.26,2364.06,58
HCPCS,90651,HPV VIRUS VACCINE 9 VAL IM,1106.0,718.9,79.26,1106.0,29
HCPCS,906510,9VHPV VACCINE 2/3 DOSE IM,,,362.39,362.39,1
HCPCS,90653,IIV ADJUVANT VACCINE IM,,,106.01,268.96,14
HCPCS,90653,IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE,244.0,158.6,86.23,244.0,13
HCPCS,90653,Iiv adjuvant vaccine im,,,17.89,22.6,6
HCPCS,906530,IIV ADJUVANT VACCINE IM,,,106.01,106.01,1
HCPCS,90654,Flu vacc iiv3 no preserv id,,,17.89,22.6,6
HCPCS,90655,IIV3 VACC NO PRSV 0.25 ML IM,,,17.6,44.66,7
HCPCS,90655,Iiv3 vacc no prsv 0.25 ml im,,,17.89,22.6,6
HCPCS,906550,IIV3 VACC NO PRSV 0.25 ML IM,,,17.6,17.6,1
HCPCS,90656,FLU VACCINE NO PRESERV 0.25 ML,74.7,48.56,12.55,74.7,36
HCPCS,90656,FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE,149.4,97.11,17.89,149.4,36
HCPCS,90656,IIV3 VACC NO PRSV 0.5 ML IM,,,25.08,25.08,1
HCPCS,90656,IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE,74.7,48.56,21.07,74.7,13
HCPCS,90656,INFLUENZA VACCINE,74.7,48.56,12.55,74.7,36
HCPCS,906560,IIV3 VACC NO PRSV 0.5 ML IM,,,25.08,25.08,1
HCPCS,90657,IIV3 VACCINE SPLIT VIRUS 0.25 ML DOSAGE IM USE,24.0,15.6,10.06,24.0,13
HCPCS,90657,IIV3 VACCINE SPLT 0.25 ML IM,,,11.91,30.22,14
HCPCS,90657,Iiv3 vaccine splt 0.25 ml im,,,17.89,22.6,6
HCPCS,906570,IIV3 VACCINE SPLT 0.25 ML IM,,,11.91,11.91,1
HCPCS,90658,IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE,69.7,45.31,11.71,69.7,85
HCPCS,90658,IIV3 VACCINE SPLT 0.5 ML IM,,,23.84,23.84,1
HCPCS,90658,INFLUENZA VACCINE,24.0,15.6,12.0,24.0,13
HCPCS,906580,IIV3 VACCINE SPLT 0.5 ML IM,,,23.84,23.84,1
HCPCS,90660,FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY SYRINGE,61.06,39.69,10.26,61.06,36
HCPCS,90660,FLUMIST VACC NSPR 0.2ML,62.9,40.89,10.57,62.9,36
HCPCS,90660,LAIV3 VACCINE INTRANASAL,,,32.09,32.09,1
HCPCS,90660,LAIV3 VACCINE LIVE FOR INTRANASAL USE,62.9,40.89,25.44,62.9,13
HCPCS,906600,LAIV3 VACCINE INTRANASAL,,,32.09,32.09,1
HCPCS,90661,CCIIV3 VAC ABX FR 0.5 ML IM,,,53.46,135.63,14
HCPCS,90661,Cciiv3 vac abx fr 0.5 ml im,,,17.89,22.6,6
HCPCS,906610,CCIIV3 VAC ABX FR 0.5 ML IM,,,53.46,53.46,1
HCPCS,90662,FLU VACC PRSV FREE INC ANTIG,203.3,132.15,17.89,203.3,37
HCPCS,90662,FLUZONE HIGH-DOSE 2025-2026 (PF) 180 MCG/0.5 ML INTRAMUSCULAR SYRINGE,406.53,264.24,17.89,406.53,37
HCPCS,90662,HIGH DOSE FLU,98.0,63.7,49.0,98.0,13
HCPCS,90662,IIV NO PRSV INCREASED AG IM,98.0,63.7,49.0,106.01,14
HCPCS,90662,IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM,203.3,132.15,86.23,203.3,13
HCPCS,906620,IIV NO PRSV INCREASED AG IM,,,106.01,106.01,1
HCPCS,90664,LAIV VACC PANDEMIC INTRANASL,,,0.01,0.01,1
HCPCS,90664,Laiv vacc pandemic intranasl,,,17.89,22.6,6
HCPCS,906640,LAIV VACC PANDEMIC INTRANASL,,,0.01,0.01,1
HCPCS,90666,Flu vac pandem prsrv free im,,,17.89,22.6,6
HCPCS,90667,Iiv vacc pandemic adjuvt im,,,17.89,22.6,6
HCPCS,90668,IIV VACCINE PANDEMIC IM,22.0,14.3,11.0,22.0,12
HCPCS,90668,Iiv vaccine pandemic im,,,17.89,22.6,6
HCPCS,90670,PCV13 VACCINE FOR INTRAMUSCULAR USE,814.0,529.1,257.99,814.0,13
HCPCS,90670,PCV13 VACCINE IM,814.0,529.1,249.3,814.0,14
HCPCS,90670,PREVAR 13,814.0,529.1,257.99,814.0,13
HCPCS,90670,PREVIA 13,814.0,529.1,257.99,814.0,13
HCPCS,90670,PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,1650.375,1072.745,79.26,1675.86,90
HCPCS,906700,PCV13 VACCINE IM,,,249.3,249.3,1
HCPCS,90671,PCV15 VACCINE IM,,,228.2,737.91,15
HCPCS,90671,Pcv15 vaccine im,,,79.26,100.12,6
HCPCS,906710,PCV15 VACCINE IM,,,290.85,290.85,1
HCPCS,90672,FLU VACCINE 4 VALENT NASAL,57.0,37.05,9.58,57.0,30
HCPCS,90672,LAIV4 VACCINE FOR INTRANASAL USE,57.0,37.05,27.79,57.0,13
HCPCS,90672,LAIV4 VACCINE INTRANASAL,,,26.85,26.85,1
HCPCS,906720,LAIV4 VACCINE INTRANASAL,,,26.85,26.85,1
HCPCS,90673,FLUBLOK TRIVALENT,284.6,184.99,17.89,284.6,36
HCPCS,90673,RIV3 VACCINE NO PRESERV IM,,,106.01,106.01,1
HCPCS,90673,RIV3 VACCINE PRESERVATIVE FREE FOR IM USE,284.6,184.99,98.16,284.6,13
HCPCS,906730,RIV3 VACCINE NO PRESERV IM,,,106.01,106.01,1
HCPCS,90674,CCIIV4 VAC NO PRSV 0.5 ML IM,,,33.02,33.02,1
HCPCS,90674,CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE,109.0,70.85,17.89,109.0,30
HCPCS,906740,CCIIV4 VAC NO PRSV 0.5 ML IM,,,33.02,33.02,1
HCPCS,90675,IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION,1561.71,1015.11,79.26,1561.71,94
HCPCS,90675,RABAVERT (PF) 2.5 UNIT IM SUSPENSION,1564.59,1016.98,79.26,1564.59,94
HCPCS,90675,RABIES VACCINE IM,,,345.33,345.33,1
HCPCS,90675,"RABIES VACCINE, IM",1491.0,969.15,332.54,1491.0,13
HCPCS,906750,RABIES VACCINE IM,,,345.33,345.33,1
HCPCS,90676,RABIES VACCINE ID,,,85.32,571.26,21
HCPCS,90676,"RABIES VACCINE, ID",456.0,296.4,195.94,456.0,13
HCPCS,90676,Rabies vaccine id,,,79.26,100.12,6
HCPCS,906760,RABIES VACCINE ID,,,85.32,85.32,1
HCPCS,90677,PCV20 VACCINE FOR INTRAMUSCULAR USE,1018.0,661.7,298.49,1018.0,13
HCPCS,90677,PCV20 VACCINE IM,,,337.93,337.93,1
HCPCS,90677,PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677,1018.0,661.7,79.26,1018.0,37
HCPCS,90677,PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,2182.965,1418.925,79.26,2216.73,74
HCPCS,906770,PCV20 VACCINE IM,,,337.93,337.93,1
HCPCS,90678,ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION,1148.64,746.62,17.89,1148.64,29
HCPCS,90678,RSV VACC PREF BIVALENT IM,,,337.98,337.98,1
HCPCS,90678,RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE,1106.0,718.9,319.07,1106.0,13
HCPCS,90678,"RSV VACCINE, BIVALENT (ABRYSVO)",1106.0,718.9,17.89,1106.0,42
HCPCS,906780,RSV VACC PREF BIVALENT IM,,,337.98,337.98,1
HCPCS,90679,RSV VACC PREF RECOMB ADJT IM,,,337.48,337.48,1
HCPCS,90679,"RSV VACCINE, ADJUVANTED (AREXVY)",363.0,235.95,17.89,363.0,42
HCPCS,906790,RSV VACC PREF RECOMB ADJT IM,,,337.48,337.48,1
HCPCS,90680,ROTATEQ VACCINE 2 ML ORAL SOLUTION,153.0,99.45,25.7,153.0,29
HCPCS,90680,RV5 VACC 3 DOSE LIVE ORAL,,,113.04,113.04,1
HCPCS,906800,RV5 VACC 3 DOSE LIVE ORAL,,,113.04,113.04,1
HCPCS,90681,RV1 VACC 2 DOSE LIVE ORAL,,,161.82,410.53,7
HCPCS,90681,Rv1 vacc 2 dose live oral,,,17.89,22.6,6
HCPCS,906810,RV1 VACC 2 DOSE LIVE ORAL,,,161.82,161.82,1
HCPCS,90682,FLUBLOK QUADRIVALENT PFS,233.0,151.45,17.89,233.0,30
HCPCS,90682,RIV4 VACC RECOMBINANT DNA IM,,,70.92,70.92,1
HCPCS,90682,RIV4 VACC RECOMBINANT DNA PRSRV ANTIBIO FREE IM,233.0,151.45,73.4,233.0,13
HCPCS,906820,RIV4 VACC RECOMBINANT DNA IM,,,70.92,70.92,1
HCPCS,90683,RSV VACC MRNA LIPID NANO IM,,,319.46,810.49,7
HCPCS,90683,Rsv vacc mrna lipid nano im,,,17.89,22.6,6
HCPCS,906830,RSV VACC MRNA LIPID NANO IM,,,319.46,319.46,1
HCPCS,90684,PCV21 VACCINE IM,,,371.79,943.25,14
HCPCS,90684,Pcv21 vaccine im,,,79.26,100.12,6
HCPCS,906840,PCV21 VACCINE IM,,,371.79,371.79,1
HCPCS,90685,FLU VAC NO PRSV 4 VAL 6-35 M,46.0,29.9,7.73,46.0,29
HCPCS,90685,IIV4 VACC NO PRSV 0.25 ML IM,,,20.91,20.91,1
HCPCS,90685,IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE,34.0,22.1,17.0,34.0,13
HCPCS,906850,IIV4 VACC NO PRSV 0.25 ML IM,,,20.91,20.91,1
HCPCS,90686,FLU VAC NO PRSV 4 VAL,70.0,45.5,11.76,70.0,30
HCPCS,90686,IIV4 VACC NO PRSV 0.5 ML IM,,,21.6,21.6,1
HCPCS,90686,IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE,70.0,45.5,22.35,70.0,13
HCPCS,906860,IIV4 VACC NO PRSV 0.5 ML IM,,,21.6,21.6,1
HCPCS,90687,IIV4 VACCINE SPLT 0.25 ML IM,,,9.4,25.59,8
HCPCS,90687,Iiv4 vaccine splt 0.25 ml im,,,17.89,22.6,6
HCPCS,906870,IIV4 VACCINE SPLT 0.25 ML IM,,,10.09,10.09,1
HCPCS,90688,FLUZONE QUADRIVALENT MDV,67.0,43.55,11.26,67.0,30
HCPCS,90688,IIV4 VACC SPLIT VIRUS 0.5 ML DOS FOR IM USE,67.0,43.55,20.88,67.0,13
HCPCS,90688,IIV4 VACCINE SPLT 0.5 ML IM,67.0,43.55,20.17,67.0,14
HCPCS,906880,IIV4 VACCINE SPLT 0.5 ML IM,,,20.17,20.17,1
HCPCS,90689,IIV4 VACC INACTIVATED PRSRV FR 0.25ML DOS IM USE,44.0,28.6,22.0,44.0,12
HCPCS,90689,Vacc iiv4 no prsrv 0.25ml im,,,17.89,22.6,6
HCPCS,90690,TYPHOID VACCINE ORAL,,,129.18,129.18,1
HCPCS,90690,"TYPHOID VACCINE, ORAL",115.0,74.75,57.5,117.28,13
HCPCS,90690,VIVOTIF 2 BILLION UNIT CAPSULEDELAYED RELEASE,70.38,45.75,11.82,70.38,29
HCPCS,906900,TYPHOID VACCINE ORAL,,,129.18,129.18,1
HCPCS,90691,TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,802.41,521.57,17.89,802.41,29
HCPCS,90691,TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1163.52,756.29,17.89,1163.52,29
HCPCS,90691,TYPHOID VACCINE,441.0,286.65,161.6,441.0,13
HCPCS,90691,TYPHOID VACCINE IM,441.0,286.65,161.6,441.0,14
HCPCS,90691,TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM,441.0,286.65,161.6,441.0,13
HCPCS,906910,TYPHOID VACCINE IM,,,178.02,178.02,1
HCPCS,90694,VACC AIIV4 NO PRSRV 0.5ML IM,,,69.62,189.66,8
HCPCS,90694,Vacc aiiv4 no prsrv 0.5ml im,,,17.89,22.6,6
HCPCS,906940,VACC AIIV4 NO PRSRV 0.5ML IM,,,74.76,74.76,1
HCPCS,90695,H5n8 vacc drv cll cul adj im,,,17.89,22.6,6
HCPCS,90696,DTAP-IPV VACCINE 4-6 YRS IM,,,71.88,71.88,1
HCPCS,90696,KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE,447.93,291.15,17.89,447.93,29
HCPCS,90696,QUADRACEL (PF) 15 LF-48 MCG-5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION,443.34,288.17,17.89,443.34,29
HCPCS,906960,DTAP-IPV VACCINE 4-6 YRS IM,,,71.88,71.88,1
HCPCS,90697,DTAP-IPV-HIB-HEPB VACCINE IM,526.05,341.93,17.89,526.05,30
HCPCS,90697,DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR,526.05,341.93,167.44,526.05,13
HCPCS,90697,VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SUSPENSION,1172.58,762.18,17.89,1172.58,29
HCPCS,90697,VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1172.58,762.18,17.89,1172.58,29
HCPCS,906970,DTAP-IPV-HIB-HEPB VACCINE IM,,,177.77,177.77,1
HCPCS,90698,DTAP-IPV/HIB VACCINE IM,,,137.75,137.75,1
HCPCS,90698,PENTACEL (PF) 15 LF-20 MCG-5 LF-62 DU-10 MCG/0.5 ML INTRAMUSCULAR KIT,467.67,303.99,17.89,467.67,29
HCPCS,906980,DTAP-IPV/HIB VACCINE IM,,,137.75,137.75,1
HCPCS,90700,DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP,210.75,136.99,17.89,210.75,58
HCPCS,90700,DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM,102.0,66.3,30.56,102.0,13
HCPCS,90700,DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE,102.0,66.3,17.14,102.0,42
HCPCS,90700,DTAP VACCINE < 7 YRS IM,,,33.7,33.7,1
HCPCS,90700,INFANRIX (DTAP)(PF) 25 LF UNIT-58MCG-10 LF/0.5ML INTRAMUSCULAR SYRINGE,204.72,133.07,17.89,204.72,29
HCPCS,907000,DTAP VACCINE < 7 YRS IM,,,33.7,33.7,1
HCPCS,90702,DT VACCINE UNDER 7 YRS IM,,,72.53,72.53,1
HCPCS,90702,DT VACCINE YOUNGER THAN 7 YRS FOR IM USE,222.0,144.3,66.09,222.0,13
HCPCS,90702,TETANUSDIPHTHERIA TOXOID PED (PF) 5 LF UNIT-25 LF UNIT/0.5 ML IM SUSP,442.89,287.88,17.89,442.89,29
HCPCS,907020,DT VACCINE UNDER 7 YRS IM,,,72.53,72.53,1
HCPCS,90707,M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION,344.67,224.04,17.89,344.67,58
HCPCS,90707,MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ,336.0,218.4,96.6,336.0,13
HCPCS,90707,MMR VACCINE SC,336.0,218.4,96.6,336.0,14
HCPCS,907070,MMR VACCINE SC,,,108.15,108.15,1
HCPCS,90710,"MMR+VARICELLA,SQ-COMBINED VACCINE",992.0,644.8,289.17,992.0,13
HCPCS,90710,MMRV VACCINE SC,,,318.0,318.0,1
HCPCS,90710,PROQUAD (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUBCUTANEOUS SUSPENSION,1030.2,669.63,17.89,1030.2,29
HCPCS,907100,MMRV VACCINE SC,,,318.0,318.0,1
HCPCS,90713,IPOL 40 UNIT-8 UNIT-32 UNIT/0.5 ML SUSPENSION FOR INJECTION,338.85,220.25,17.89,338.85,29
HCPCS,90713,POLIOVIRUS IPV SC/IM,,,55.0,55.0,1
HCPCS,90713,POLIOVIRUS VACCINE INACTIVATED SUBQ/IM,151.0,98.15,47.81,151.0,13
HCPCS,907130,POLIOVIRUS IPV SC/IM,,,55.0,55.0,1
HCPCS,90714,DECAVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE,141.48,91.96,16.95,141.48,37
HCPCS,90714,TD VACC NO PRESV 7 YRS+ IM,141.0,91.65,42.09,141.0,14
HCPCS,90714,TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE,141.0,91.65,45.91,141.0,13
HCPCS,90714,TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION,319.77,207.85,16.95,319.77,37
HCPCS,90714,TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE,319.755,207.84,16.95,319.77,74
HCPCS,90714,TETANUS & DIPHTHERIA,141.0,91.65,45.91,141.0,13
HCPCS,907140,TD VACC NO PRESV 7 YRS+ IM,,,42.09,42.09,1
HCPCS,90715,ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE,351.57,228.52,17.89,351.57,74
HCPCS,90715,ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP,351.57,228.52,17.89,351.57,74
HCPCS,90715,BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE,344.82,224.13,17.89,344.82,37
HCPCS,90715,TDAP / ADACEL,170.0,110.5,50.3,170.0,13
HCPCS,90715,TDAP VACCINE 7 YRS/> IM,170.0,110.5,42.87,170.0,14
HCPCS,90715,TDAP VACCINE >7 IM,170.0,110.5,17.89,170.0,37
HCPCS,907150,TDAP VACCINE 7 YRS/> IM,,,42.87,42.87,1
HCPCS,90716,VAR VACCINE LIVE FOR SUBCUTANEOUS USE,657.0,427.05,192.12,657.0,13
HCPCS,90716,VAR VACCINE LIVE SUBQ,,,211.5,211.5,1
HCPCS,90716,VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION,688.92,447.8,79.26,688.92,29
HCPCS,907160,VAR VACCINE LIVE SUBQ,,,211.5,211.5,1
HCPCS,90717,YELLOW FEVER VACCINE LIVE SUBQ,648.0,421.2,256.33,648.0,13
HCPCS,90717,YELLOW FEVER VACCINE SUBQ,,,282.37,716.37,4
HCPCS,90717,Yellow fever vaccine subq,,,79.26,100.12,6
HCPCS,907170,YELLOW FEVER VACCINE SUBQ,,,282.37,282.37,1
HCPCS,90723,DTAP-HEP B-IPV VACCINE IM,,,118.8,118.8,1
HCPCS,90723,PEDIARIX (PF) 10 MCG-25 LF-25 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE,773.7,502.91,17.89,773.7,29
HCPCS,907230,DTAP-HEP B-IPV VACCINE IM,,,118.8,118.8,1
HCPCS,90732,PNEUMOCOCCAL VACCINE,423.0,274.95,117.08,423.0,13
HCPCS,90732,PNEUMOCOCCAL VACCINE 23V,423.0,274.95,17.89,423.0,37
HCPCS,90732,PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE,842.97,547.93,17.89,842.97,74
HCPCS,90732,PPSV23 VACC 2 YRS+ SUBQ/IM,423.0,274.95,117.08,423.0,14
HCPCS,90732,PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE,423.0,274.95,117.08,423.0,13
HCPCS,907320,PPSV23 VACC 2 YRS+ SUBQ/IM,,,144.15,144.15,1
HCPCS,90733,MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE,344.0,223.6,147.65,344.0,13
HCPCS,90733,MPSV4 VACCINE SUBQ,,,135.54,343.87,7
HCPCS,90733,Mpsv4 vaccine subq,,,79.26,100.12,6
HCPCS,907330,MPSV4 VACCINE SUBQ,,,135.54,135.54,1
HCPCS,90734,MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE,565.0,367.25,166.75,565.0,13
HCPCS,90734,MENACWYD/MENACWYCRM VACC IM,,,183.56,183.56,1
HCPCS,90734,"MENINGOCOCCAL VACCINE, IM",565.0,367.25,79.26,565.0,29
HCPCS,90734,MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS),633.45,411.74,79.26,633.45,29
HCPCS,907340,MENACWYD/MENACWYCRM VACC IM,,,183.56,183.56,1
HCPCS,90736,HZV VACC LIVE SUBQ,804.0,522.6,219.05,804.0,13
HCPCS,90736,HZV VACCINE LIVE SUBQ,,,234.27,594.36,7
HCPCS,90736,Hzv vaccine live subq,,,79.26,100.12,6
HCPCS,90736,ZOSTER,804.0,522.6,219.05,804.0,13
HCPCS,90736,ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE,804.0,522.6,219.05,804.0,13
HCPCS,907360,HZV VACCINE LIVE SUBQ,,,234.27,234.27,1
HCPCS,90738,INACTIVATED JE VACC IM,,,325.07,325.07,1
HCPCS,90738,IXIARO (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,2124.57,1380.97,79.26,2124.57,29
HCPCS,907380,INACTIVATED JE VACC IM,,,325.07,325.07,1
HCPCS,90739,HEPB VACC 2 DOSE ADULT IM,562.0,365.3,17.89,562.0,37
HCPCS,90739,HEPB VACC 2/4 DOSE ADULT IM,,,191.76,191.76,1
HCPCS,90739,HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE,562.0,365.3,155.75,562.0,13
HCPCS,90739,HEPLISAV-B (PF) 20 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1121.4,728.91,17.89,1121.4,37
HCPCS,907390,HEPB VACC 2/4 DOSE ADULT IM,,,191.76,191.76,1
HCPCS,90740,ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SUSPENSION,267.66,173.98,44.97,267.66,37
HCPCS,90740,HEPB VACC 3 DOSE IMMUNSUP IM,,,177.57,177.57,1
HCPCS,90740,RECOMBIVAX HB (PF) 40 MCG/ML INTRAMUSCULAR SUSPENSION,703.23,457.1,79.26,703.23,37
HCPCS,907400,HEPB VACC 3 DOSE IMMUNSUP IM,,,177.57,177.57,1
HCPCS,90743,HEPB VACC 2 DOSE ADOLESC IM,,,67.63,205.91,15
HCPCS,90743,HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM,139.0,90.35,69.5,139.0,13
HCPCS,90743,Hepb vacc 2 dose adolesc im,,,17.89,22.6,6
HCPCS,907430,HEPB VACC 2 DOSE ADOLESC IM,,,81.16,81.16,1
HCPCS,90744,ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE,211.38,137.4,17.89,211.38,74
HCPCS,90744,HEPB VACC 3 DOSE PED/ADOL IM,,,35.86,35.86,1
HCPCS,90744,HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM,104.0,67.6,29.26,104.0,13
HCPCS,90744,RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION,205.32,133.46,17.89,205.32,74
HCPCS,90744,RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE,205.32,133.46,17.89,205.32,37
HCPCS,907440,HEPB VACC 3 DOSE PED/ADOL IM,,,35.86,35.86,1
HCPCS,90746,ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE,267.66,173.98,17.89,267.66,37
HCPCS,90746,HEPATITIS B VACCINE (PER DOSE),258.0,167.7,72.23,258.0,13
HCPCS,90746,HEPB VACCINE 3 DOSE ADULT IM,258.0,167.7,72.23,258.0,14
HCPCS,90746,HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE,258.0,167.7,72.23,258.0,13
HCPCS,90746,IMMUNIZATION HEPATITIS,258.0,167.7,17.89,258.0,37
HCPCS,90746,RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SUSPENSION,257.28,167.23,17.89,257.28,37
HCPCS,90746,RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE,257.28,167.23,17.89,257.28,37
HCPCS,907460,HEPB VACCINE 3 DOSE ADULT IM,,,81.16,81.16,1
HCPCS,90747,HEPB VACC 4 DOSE IMMUNSUP IM,,,126.68,450.51,15
HCPCS,90747,HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM,230.0,149.5,115.0,230.0,13
HCPCS,90747,Hepb vacc 4 dose immunsup im,,,79.26,100.12,6
HCPCS,907470,HEPB VACC 4 DOSE IMMUNSUP IM,,,177.57,177.57,1
HCPCS,90748,HIB-HEPB VACCINE FOR INTRAMUSCULAR USE,132.0,85.8,50.47,132.0,13
HCPCS,90748,HIB-HEPB VACCINE IM,,,46.33,117.55,7
HCPCS,90748,Hib-hepb vaccine im,,,17.89,22.6,6
HCPCS,907480,HIB-HEPB VACCINE IM,,,46.33,46.33,1
HCPCS,90749,Unlisted vaccine/toxoid,,,17.89,22.6,6
HCPCS,90750,HZV VACC RECOMBINANT IM,777.0,505.05,215.51,777.0,14
HCPCS,90750,HZV VACC RECOMBINANT IM NJX,777.0,505.05,79.26,777.0,29
HCPCS,90750,HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX,777.0,505.05,215.51,777.0,13
HCPCS,90750,SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT,810.36,526.735,79.26,844.89,58
HCPCS,90750,SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION,810.36,526.735,79.26,844.89,58
HCPCS,907500,HZV VACC RECOMBINANT IM,,,237.41,237.41,1
HCPCS,90756,CCIIV4 VACC ABX FREE IM,,,29.14,79.38,8
HCPCS,90756,Cciiv4 vacc abx free im,,,17.89,22.6,6
HCPCS,907560,CCIIV4 VACC ABX FREE IM,,,31.29,31.29,1
HCPCS,90758,Zaire ebolavirus vac live im,,,79.26,100.12,6
HCPCS,90759,HEP B VAC 3AG 10MCG 3 DOS IM,,,79.73,79.73,1
HCPCS,90759,HEP B VACC 3 AG 10 MCG 3 DOSE SCHED FOR IM USE,104.0,67.6,17.47,104.0,50
HCPCS,907590,HEP B VAC 3AG 10MCG 3 DOS IM,,,79.73,79.73,1
HCPCS,90785,PSYCHOTHERAPY COMPLEX INTERACTIVE,168.0,109.2,5.91,171.9,59
HCPCS,90785,PSYTX COMPLEX INTERACTIVE,,,13.87,13.87,1
HCPCS,907850,PSYTX COMPLEX INTERACTIVE,,,13.87,13.87,1
HCPCS,90791,PSYCH DIAGNOSTIC EVALUATION,,,157.81,157.81,1
HCPCS,90791,PSYCHIATRIC DIAGNOSTIC EVALUATION,1069.5,695.175,73.28,1819.0,72
HCPCS,90791,VIRTUAL VISIT PSYCH DIAGNOSTIC EVAL,1536.0,998.4,73.28,1152.0,31
HCPCS,907910,PSYCH DIAGNOSTIC EVALUATION,,,157.81,157.81,1
HCPCS,90792,PSYCH DIAG EVAL W/MED SRVCS,,,180.44,180.44,1
HCPCS,90792,PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES,1133.5,736.775,83.51,1819.0,72
HCPCS,90792,VIRTUAL VISIT DIAGNOSTIC EVAL W/MEDICAL  (PSYCHIATRISTS/MID LEVE,1664.0,1081.6,83.51,1248.0,31
HCPCS,907920,PSYCH DIAG EVAL W/MED SRVCS,,,180.44,180.44,1
HCPCS,90832,PSYCHOTHERAPY 30 MINUTES PATIENT,744.0,483.6,33.8,558.0,31
HCPCS,90832,PSYCHOTHERAPY W/PATIENT 30 MINUTES,603.0,391.95,74.14,542.7,76
HCPCS,90832,PSYTX W PT 30 MINUTES,,,73.05,73.05,1
HCPCS,90832,VIRTUAL VISIT PSYTX PT&/FAMILY 30 MINS,744.0,483.6,33.8,558.0,31
HCPCS,908320,PSYTX W PT 30 MINUTES,,,73.05,73.05,1
HCPCS,90833,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 30 MIN,656.0,426.4,35.01,492.0,31
HCPCS,90833,PSYTX W PT W E/M 30 MIN,,,68.21,68.21,1
HCPCS,90833,Psytx w pt w e/m 30 min,,,74.14,93.65,6
HCPCS,908330,PSYTX W PT W E/M 30 MIN,,,68.21,68.21,1
HCPCS,90834,PSYCHOTHERAPY 45 MINUTES WITH PATIENT,980.0,637.0,46.96,735.0,31
HCPCS,90834,PSYCHOTHERAPY W/PATIENT 45 MINUTES,603.0,391.95,82.19,542.7,76
HCPCS,90834,PSYTX W PT 45 MINUTES,,,96.54,96.54,1
HCPCS,90834,VIRTUAL VISIT PSYTX PT&/FAMILY 45 MINS,980.0,637.0,46.96,735.0,31
HCPCS,908340,PSYTX W PT 45 MINUTES,,,96.54,96.54,1
HCPCS,90836,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN,832.0,540.8,45.08,624.0,31
HCPCS,90836,PSYTX W PT W E/M 45 MIN,,,86.3,86.3,1
HCPCS,90836,Psytx w pt w e/m 45 min,,,82.19,103.82,6
HCPCS,908360,PSYTX W PT W E/M 45 MIN,,,86.3,86.3,1
HCPCS,90837,PSYCHOTHERAPY 60 MINUTES WITH PATIENT,1452.0,943.8,71.98,1089.0,31
HCPCS,90837,PSYCHOTHERAPY W/PATIENT 60 MINUTES,603.0,391.95,82.19,1819.0,117
HCPCS,90837,PSYTX W PT 60 MINUTES,,,142.51,142.51,1
HCPCS,90837,VIRTUAL VISIT PSYTX PT&/FAMILY 60 MINS,1452.0,943.8,71.98,1089.0,31
HCPCS,908370,PSYTX W PT 60 MINUTES,,,142.51,142.51,1
HCPCS,90838,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 60 MIN,1096.0,712.4,73.06,822.0,31
HCPCS,90838,PSYTX W PT W E/M 60 MIN,,,114.32,114.32,1
HCPCS,90838,Psytx w pt w e/m 60 min,,,82.19,103.82,6
HCPCS,908380,PSYTX W PT W E/M 60 MIN,,,114.32,114.32,1
HCPCS,90839,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINS,1509.0,980.85,92.44,1131.75,28
HCPCS,90839,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,603.0,391.95,82.19,1819.0,41
HCPCS,90839,PSYTX CRISIS INITIAL 60 MIN,,,137.68,137.68,1
HCPCS,908390,PSYTX CRISIS INITIAL 60 MIN,,,137.68,137.68,1
HCPCS,90840,PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,734.0,477.1,44.51,1819.0,59
HCPCS,90840,PSYTX CRISIS EA ADDL 30 MIN,,,68.91,68.91,1
HCPCS,908400,PSYTX CRISIS EA ADDL 30 MIN,,,68.91,68.91,1
HCPCS,90845,PSYCHOANALYSIS,,,92.5,348.36,15
HCPCS,90845,Psychoanalysis,,,82.19,103.82,6
HCPCS,908450,PSYCHOANALYSIS,,,92.5,92.5,1
HCPCS,90846,FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS,827.5,537.875,54.78,789.0,70
HCPCS,90846,FAMILY PSYTX W/O PT 50 MIN,,,103.97,103.97,1
HCPCS,908460,FAMILY PSYTX W/O PT 50 MIN,,,103.97,103.97,1
HCPCS,90847,FAM THERAPY W PATIENT DTOX,603.0,391.95,97.85,542.7,38
HCPCS,90847,FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS,849.5,552.175,64.32,822.0,73
HCPCS,90847,FAMILY PSYTX W/PT 50 MIN,,,108.58,108.58,1
HCPCS,90847,VIRTUAL VISIT FAMILY PSYTX W/PATIENT,1096.0,712.4,64.32,822.0,35
HCPCS,908470,FAMILY PSYTX W/PT 50 MIN,,,108.58,108.58,1
HCPCS,90849,MULTIPLE FAMILY GROUP PSYCHOTHERAPY,431.5,280.475,21.77,1819.0,76
HCPCS,90849,MULTIPLE FAMILY GROUP PSYTX,,,30.89,30.89,1
HCPCS,908490,MULTIPLE FAMILY GROUP PSYTX,,,30.89,30.89,1
HCPCS,90853,GROUP PSYCHOTHERAPY,260.0,169.0,22.21,195.0,36
HCPCS,90853,GROUP THERAPY,348.0,226.2,36.6,313.2,38
HCPCS,90853,VIRTUAL VISIT GROUP PSYCHOTHERAPY,260.0,169.0,22.21,195.0,35
HCPCS,908530,GROUP PSYCHOTHERAPY,,,25.65,25.65,1
HCPCS,90863,PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY,192.0,124.8,19.14,192.0,17
HCPCS,90863,PHARMACOLOGIC MGMT W/PSYTX,,,24.59,24.59,1
HCPCS,90863,Pharmacologic mgmt w/psytx,,,16.06,20.29,6
HCPCS,908630,PHARMACOLOGIC MGMT W/PSYTX,,,24.59,24.59,1
HCPCS,90865,NARCOSYNTHESIS,,,128.87,348.36,15
HCPCS,90865,Narcosynthesis,,,149.38,188.69,6
HCPCS,908650,NARCOSYNTHESIS,,,128.87,128.87,1
HCPCS,90867,REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M,485.0,315.25,90.36,485.0,18
HCPCS,90867,TCRANIAL MAGN STIM TX PLAN,,,225.48,675.17,15
HCPCS,90867,Tcranial magn stim tx plan,,,292.32,369.25,6
HCPCS,908670,TCRANIAL MAGN STIM TX PLAN,,,260.73,260.73,1
HCPCS,90868,TCRANIAL MAGN STIM TX DELI,,,167.15,675.17,15
HCPCS,90868,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,485.0,315.25,18.79,485.0,18
HCPCS,90868,Tcranial magn stim tx deli,,,292.32,369.25,6
HCPCS,908680,TCRANIAL MAGN STIM TX DELI,,,167.15,167.15,1
HCPCS,90869,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN,515.0,334.75,75.5,515.0,18
HCPCS,90869,TCRAN MAGN STIM REDETEMINE,,,225.48,675.17,15
HCPCS,90869,Tcran magn stim redetemine,,,292.32,369.25,6
HCPCS,908690,TCRAN MAGN STIM REDETEMINE,,,238.01,238.01,1
HCPCS,90870,ELECTROCONVULSIVE THERAPY,,,110.62,1150.43,15
HCPCS,90870,Electroconvulsive therapy,,,292.32,369.25,6
HCPCS,908700,ELECTROCONVULSIVE THERAPY,,,110.62,110.62,1
HCPCS,90875,PSYCHOPHYSIOLOGICAL THERAPY,,,61.13,61.13,1
HCPCS,90875,Psychophysiological therapy,,,72.09,91.06,6
HCPCS,908750,PSYCHOPHYSIOLOGICAL THERAPY,,,61.13,61.13,1
HCPCS,90876,PSYCHOPHYSIOLOGICAL THERAPY,,,96.99,96.99,1
HCPCS,90876,Psychophysiological therapy,,,72.09,91.06,6
HCPCS,908760,PSYCHOPHYSIOLOGICAL THERAPY,,,96.99,96.99,1
HCPCS,90880,HYPNOTHERAPY,,,91.44,200.56,15
HCPCS,90880,Hypnotherapy,,,74.14,93.65,6
HCPCS,908800,HYPNOTHERAPY,,,91.44,91.44,1
HCPCS,90882,ENVRN IVNTJ MED MGMT PSYC PT,,,83.06,83.06,1
HCPCS,90882,Envrn ivntj med mgmt psyc pt,,,49.36,62.35,6
HCPCS,908820,ENVRN IVNTJ MED MGMT PSYC PT,,,83.06,83.06,1
HCPCS,90885,PSY EVALUATION OF RECORDS,,,49.55,49.55,1
HCPCS,90885,Psy evaluation of records,,,49.36,62.35,6
HCPCS,908850,PSY EVALUATION OF RECORDS,,,49.55,49.55,1
HCPCS,90887,INTERPJ/EXPLNAJ RSLT PSYC XM,,,75.22,75.22,1
HCPCS,90887,Interpj/explnaj rslt psyc xm,,,97.85,123.6,6
HCPCS,908870,INTERPJ/EXPLNAJ RSLT PSYC XM,,,75.22,75.22,1
HCPCS,90889,PREPARATION OF REPORT,,,69.82,69.82,1
HCPCS,90889,Preparation of report,,,49.36,62.35,6
HCPCS,908890,PREPARATION OF REPORT,,,69.82,69.82,1
HCPCS,90899,UNLISTED PSYC SVC/THERAPY,,,29.9,64.59,14
HCPCS,90899,Unlisted psyc svc/therapy,,,74.14,93.65,6
HCPCS,90901,BIOFDBK TRAIN ANY METHOD GP,399.0,259.35,23.22,723.0,49
HCPCS,90901,BIOFEEDBACK TRAIN ANY METH,,,20.07,20.07,1
HCPCS,90901,BIOFEEDBACK TRAINING ANY MODALITY,399.0,259.35,23.22,1819.0,41
HCPCS,90901,"BIOFEEDBACK TRAINING,ANY MODALITY",180.0,117.0,16.75,135.0,31
HCPCS,909010,BIOFEEDBACK TRAIN ANY METH,,,20.07,20.07,1
HCPCS,90912,BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT,334.0,217.1,52.06,1819.0,90
HCPCS,90912,BFB TRAING W/EMG &AMP;/MANOMETRY 1ST 15 MIN CNTCT,396.0,257.4,39.03,297.0,27
HCPCS,90912,BFB TRAINING 1ST 15 MIN,,,44.37,44.37,1
HCPCS,909120,BFB TRAINING 1ST 15 MIN,,,44.37,44.37,1
HCPCS,90913,BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT,334.0,217.1,29.16,1819.0,90
HCPCS,90913,BFB TRAING W/EMG&AMP;/MANOMETRY EA ADDL 15 MIN CNTCT,220.0,143.0,22.0,165.0,27
HCPCS,90913,BFB TRAINING EA ADDL 15 MIN,,,24.98,24.98,1
HCPCS,909130,BFB TRAINING EA ADDL 15 MIN,,,24.98,24.98,1
HCPCS,90935,HEMO 1 EVAL IP,6035.0,3922.75,87.55,5431.5,38
HCPCS,90935,HEMO 1 EVAL OP,6035.0,3922.75,87.55,5431.5,38
HCPCS,90935,HEMODIALYSIS,6035.0,3922.75,87.55,5431.5,41
HCPCS,90935,HEMODIALYSIS ONE EVALUATION,,,73.9,73.9,1
HCPCS,90935,HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION,3343.0,2172.95,52.72,5431.5,73
HCPCS,909350,HEMODIALYSIS ONE EVALUATION,,,73.9,73.9,1
HCPCS,90937,HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX,928.0,603.2,77.62,928.0,35
HCPCS,90937,HEMODIALYSIS REPEATED EVAL,,,106.23,106.23,1
HCPCS,90937,Hemodialysis repeated eval,,,565.8,714.7,6
HCPCS,909370,HEMODIALYSIS REPEATED EVAL,,,106.23,106.23,1
HCPCS,90940,HEMODIALYSIS ACCESS STUDY,,,39.81,39.81,2
HCPCS,90940,Hemodialysis access study,,,433.73,547.87,6
HCPCS,909400,HEMODIALYSIS ACCESS STUDY,,,39.81,39.81,1
HCPCS,90940TC,HEMODIALYSIS ACCESS STUDY,,,39.81,39.81,1
HCPCS,90945,CONTIN AV HEMOFILTRATION CAVH,3673.0,2387.45,105.79,3305.7,38
HCPCS,90945,CRRT - SINGLE EVALUATION,3673.0,2387.45,105.79,3305.7,38
HCPCS,90945,CRRT DURING TRANSPLANT,3673.0,2387.45,105.79,3305.7,38
HCPCS,90945,DIALYSIS ONE EVALUATION,,,88.61,88.61,1
HCPCS,90945,DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL,686.0,445.9,57.33,686.0,35
HCPCS,90945,PERITON DIALYS CCPD,3673.0,2387.45,105.79,3305.7,38
HCPCS,90945,PERITONEAL DIALYSIS CAPD,3673.0,2387.45,105.79,3305.7,41
HCPCS,90945,PERITONEAL DIALYSIS CCPD,3673.0,2387.45,105.79,3305.7,41
HCPCS,90945,PERITONEAL DIALYSIS NON-CAPD,3673.0,2387.45,105.79,3305.7,41
HCPCS,90945,ULTRAFILTRATION,3673.0,2387.45,105.79,3305.7,38
HCPCS,909450,DIALYSIS ONE EVALUATION,,,88.61,88.61,1
HCPCS,90947,CONTIN RENAL RPLC,931.0,605.15,150.32,837.9,28
HCPCS,90947,DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS,1008.0,655.2,91.19,1008.0,35
HCPCS,90947,DIALYSIS REPEATED EVAL,,,127.41,127.41,1
HCPCS,909470,DIALYSIS REPEATED EVAL,,,127.41,127.41,1
HCPCS,90951,ESRD RELATED SVC MONTHLY & <2 YR OLD 4/> VISITS,9568.0,6219.2,570.89,7176.0,35
HCPCS,90951,ESRD SERV 4 VISITS P MO <2YR,,,1221.49,1221.49,1
HCPCS,90951,Esrd serv 4 visits p mo <2yr,,,353.32,446.3,6
HCPCS,909510,ESRD SERV 4 VISITS P MO <2YR,,,1221.49,1221.49,1
HCPCS,90952,ESRD SERV 2-3 VSTS P MO <2YR,,,850.71,850.71,1
HCPCS,90952,Esrd serv 2-3 vsts p mo <2yr,,,353.32,446.3,6
HCPCS,909520,ESRD SERV 2-3 VSTS P MO <2YR,,,850.71,850.71,1
HCPCS,90953,ESRD SERV 1 VISIT P MO <2YRS,,,566.54,566.54,1
HCPCS,90953,Esrd serv 1 visit p mo <2yrs,,,353.32,446.3,6
HCPCS,909530,ESRD SERV 1 VISIT P MO <2YRS,,,566.54,566.54,1
HCPCS,90954,ESRD RELATED SVC MONTHLY 2-11 YR OLD 4/> VISITS,8344.0,5423.6,490.51,6258.0,35
HCPCS,90954,ESRD SERV 4 VSTS P MO 2-11,,,1047.99,1047.99,1
HCPCS,90954,Esrd serv 4 vsts p mo 2-11,,,353.32,446.3,6
HCPCS,909540,ESRD SERV 4 VSTS P MO 2-11,,,1047.99,1047.99,1
HCPCS,90955,ESRD RELATED SVC MONTHLY 2-11 YR OLD 2/3 VISITS,4128.0,2683.2,277.32,3096.0,35
HCPCS,90955,ESRD SRV 2-3 VSTS P MO 2-11,,,543.32,543.32,1
HCPCS,90955,Esrd srv 2-3 vsts p mo 2-11,,,353.32,446.3,6
HCPCS,909550,ESRD SRV 2-3 VSTS P MO 2-11,,,543.32,543.32,1
HCPCS,90956,ESRD RELATED SVC MONTHLY 2-11 YR OLD 1 VISIT,2656.0,1726.4,214.29,2656.0,35
HCPCS,90956,ESRD SRV 1 VISIT P MO 2-11,,,361.31,361.31,1
HCPCS,90956,Esrd srv 1 visit p mo 2-11,,,353.32,446.3,6
HCPCS,909560,ESRD SRV 1 VISIT P MO 2-11,,,361.31,361.31,1
HCPCS,90957,ESRD RELATED SVC MONTHLY 12-19 YR OLD 4/> VISITS,6184.0,4019.6,374.96,4638.0,35
HCPCS,90957,ESRD SRV 4 VSTS P MO 12-19,,,800.53,800.53,1
HCPCS,90957,Esrd srv 4 vsts p mo 12-19,,,353.32,446.3,6
HCPCS,909570,ESRD SRV 4 VSTS P MO 12-19,,,800.53,800.53,1
HCPCS,90958,ESRD RELATED SVC MONTHLY 12-19 YR OLD 2/3 VISITS,3948.0,2566.2,243.94,2961.0,35
HCPCS,90958,ESRD SRV 2-3 VSTS P MO 12-19,,,520.32,520.32,1
HCPCS,90958,Esrd srv 2-3 vsts p mo 12-19,,,353.32,446.3,6
HCPCS,909580,ESRD SRV 2-3 VSTS P MO 12-19,,,520.32,520.32,1
HCPCS,90959,ESRD RELATED SVC MONTHLY 12-19 YR OLD 1 VISIT,2476.0,1609.4,198.31,2476.0,35
HCPCS,90959,ESRD SERV 1 VST P MO 12-19,,,338.59,338.59,1
HCPCS,90959,Esrd serv 1 vst p mo 12-19,,,353.32,446.3,6
HCPCS,909590,ESRD SERV 1 VST P MO 12-19,,,338.59,338.59,1
HCPCS,90960,ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS,2708.0,1760.2,198.67,2708.0,35
HCPCS,90960,ESRD SRV 4 VISITS P MO 20+,,,367.34,367.34,1
HCPCS,90960,Esrd srv 4 visits p mo 20+,,,353.32,446.3,6
HCPCS,909600,ESRD SRV 4 VISITS P MO 20+,,,367.34,367.34,1
HCPCS,90961,ESRD RELATED SVC MONTHLY 20/>YR OLD 2/3 VISITS,2208.0,1435.2,152.42,2208.0,35
HCPCS,90961,ESRD SRV 2-3 VSTS P MO 20+,,,304.74,304.74,1
HCPCS,90961,Esrd srv 2-3 vsts p mo 20+,,,353.32,446.3,6
HCPCS,909610,ESRD SRV 2-3 VSTS P MO 20+,,,304.74,304.74,1
HCPCS,90962,ESRD RELATED SVC MONTHLY 20&/>YR OLD 1 VISIT,1428.0,928.2,116.0,1428.0,35
HCPCS,90962,ESRD SERV 1 VISIT P MO 20+,,,209.55,209.55,1
HCPCS,90962,Esrd serv 1 visit p mo 20+,,,353.32,446.3,6
HCPCS,909620,ESRD SERV 1 VISIT P MO 20+,,,209.55,209.55,1
HCPCS,90963,ESRD HOME PT SERV P MO <2YRS,,,631.57,631.57,1
HCPCS,90963,ESRD SVC HOME DIALYSIS FULL MONTH <2YR OLD,4836.0,3143.4,384.44,3627.0,35
HCPCS,90963,Esrd home pt serv p mo <2yrs,,,353.32,446.3,6
HCPCS,909630,ESRD HOME PT SERV P MO <2YRS,,,631.57,631.57,1
HCPCS,90964,ESRD HOME PT SERV P MO 2-11,,,541.04,541.04,1
HCPCS,90964,ESRD SVC HOME DIALYSIS FULL MONTH 2-11 YR OLD,4100.0,2665.0,321.24,3075.0,35
HCPCS,90964,Esrd home pt serv p mo 2-11,,,353.32,446.3,6
HCPCS,909640,ESRD HOME PT SERV P MO 2-11,,,541.04,541.04,1
HCPCS,90965,ESRD HOME PT SERV P MO 12-19,,,519.11,519.11,1
HCPCS,90965,ESRD SVC HOME DIALYSIS FULL MONTH 12-19 YR OLD,3920.0,2548.0,305.19,2940.0,35
HCPCS,90965,Esrd home pt serv p mo 12-19,,,353.32,446.3,6
HCPCS,909650,ESRD HOME PT SERV P MO 12-19,,,519.11,519.11,1
HCPCS,90966,ESRD HOME PT SERV P MO 20+,,,304.74,304.74,1
HCPCS,90966,ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD,2208.0,1435.2,158.75,2208.0,35
HCPCS,90966,Esrd home pt serv p mo 20+,,,353.32,446.3,6
HCPCS,909660,ESRD HOME PT SERV P MO 20+,,,304.74,304.74,1
HCPCS,90967,ESRD RELATED SVC <FULL MONTH <2 YR OLD,140.0,91.0,13.28,140.0,35
HCPCS,90967,ESRD SVC PR DAY PT <2,,,18.24,18.24,1
HCPCS,90967,Esrd svc pr day pt <2,,,565.8,714.7,6
HCPCS,909670,ESRD SVC PR DAY PT <2,,,18.24,18.24,1
HCPCS,90968,ESRD RELATED SVC <FULL MONTH 2-11 YR OLD,136.0,88.4,8.39,136.0,35
HCPCS,90968,ESRD SVC PR DAY PT 2-11,,,17.87,17.87,1
HCPCS,90968,Esrd svc pr day pt 2-11,,,565.8,714.7,6
HCPCS,909680,ESRD SVC PR DAY PT 2-11,,,17.87,17.87,1
HCPCS,90969,ESRD RELATED SVC <FULL MONTH 12-19 YR OLD,132.0,85.8,9.17,132.0,35
HCPCS,90969,ESRD SVC PR DAY PT 12-19,,,17.52,17.52,1
HCPCS,90969,Esrd svc pr day pt 12-19,,,565.8,714.7,6
HCPCS,909690,ESRD SVC PR DAY PT 12-19,,,17.52,17.52,1
HCPCS,90970,ESRD RELATED SVC <FULL MONTH 20/>YR OLD,72.0,46.8,5.42,72.0,35
HCPCS,90970,ESRD SVC PR DAY PT 20+,,,9.78,9.78,1
HCPCS,90970,Esrd svc pr day pt 20+,,,565.8,714.7,6
HCPCS,909700,ESRD SVC PR DAY PT 20+,,,9.78,9.78,1
HCPCS,90989,DIALYSIS TRAINING COMPLETE,,,424.82,424.82,1
HCPCS,90989,DIALYSIS TRAINING PATIENT COMPLETED COURSE,2512.0,1632.8,744.16,2512.0,13
HCPCS,90989,Dialysis training complete,,,41.57,52.51,6
HCPCS,909890,DIALYSIS TRAINING COMPLETE,,,424.82,424.82,1
HCPCS,90993,DIALYSIS TRAINING INCOMPL,,,92.57,92.57,1
HCPCS,90993,DIALYSIS TRAINING PATIENT PER TRAINING SESSION,534.0,347.1,162.22,534.0,13
HCPCS,90993,Dialysis training incompl,,,41.57,52.51,6
HCPCS,909930,DIALYSIS TRAINING INCOMPL,,,92.57,92.57,1
HCPCS,90997,HEMOPERFUSION,,,91.52,91.52,1
HCPCS,90997,Hemoperfusion,,,565.8,714.7,6
HCPCS,909970,HEMOPERFUSION,,,91.52,91.52,1
HCPCS,90999,Unlisted dialysis procedure,,,565.8,714.7,6
HCPCS,91010,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,1807.0,1174.55,117.42,2849.0,76
HCPCS,91010,ESOPHAGUS MOTILITY STUDY,,,155.0,155.0,2
HCPCS,910100,ESOPHAGUS MOTILITY STUDY,,,155.0,155.0,1
HCPCS,91010TC,ESOPHAGUS MOTILITY STUDY,,,155.0,155.0,1
HCPCS,91013,ESOPHGL MOTIL W/STIM/PERFUS,79.0,51.35,12.83,79.0,37
HCPCS,91013,ESOPHGL MOTILITY STD W/I&R STIM/PERFUSION,79.0,51.35,12.83,79.0,35
HCPCS,91013,Esophgl motil w/stim/perfus,,,181.25,228.95,6
HCPCS,910130,ESOPHGL MOTIL W/STIM/PERFUS,,,16.05,16.05,1
HCPCS,91013TC,ESOPHGL MOTIL W/STIM/PERFUS,,,16.05,16.05,1
HCPCS,91020,GASTRIC MOTILITY MANOMETRIC,576.0,374.4,138.9,576.0,35
HCPCS,91020,GASTRIC MOTILITY MANOMETRIC STUDIES,576.0,374.4,65.26,576.0,66
HCPCS,91020,GASTRIC MOTILITY STUDIES,576.0,374.4,138.9,1150.43,51
HCPCS,91020,Gastric motility studies,,,181.25,228.95,6
HCPCS,910200,GASTRIC MOTILITY STUDIES,,,201.87,201.87,1
HCPCS,91020TC,GASTRIC MOTILITY STUDIES,,,201.87,201.87,1
HCPCS,91022,DUODENAL MOTILITY STUDY,,,100.96,1150.43,16
HCPCS,91022,Duodenal motility study,,,181.25,228.95,6
HCPCS,910220,DUODENAL MOTILITY STUDY,,,100.96,100.96,1
HCPCS,91022TC,DUODENAL MOTILITY STUDY,,,100.96,100.96,1
HCPCS,91030,ACID PERFUSION OF ESOPHAGUS,,,98.67,1150.43,16
HCPCS,91030,Acid perfusion of esophagus,,,181.25,228.95,6
HCPCS,91030,ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,364.0,236.6,73.93,364.0,35
HCPCS,910300,ACID PERFUSION OF ESOPHAGUS,,,98.67,98.67,1
HCPCS,91030TC,ACID PERFUSION OF ESOPHAGUS,,,98.67,98.67,1
HCPCS,91034,"ACID REFLUX TEST (PLACEMENT,RECORDING)",388.0,252.2,142.98,388.0,35
HCPCS,91034,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,3051.0,1983.15,43.51,3439.0,107
HCPCS,91034,GASTROESOPHAGEAL REFLUX TEST,388.0,252.2,140.26,388.0,37
HCPCS,910340,GASTROESOPHAGEAL REFLUX TEST,,,140.26,140.26,1
HCPCS,91034TC,GASTROESOPHAGEAL REFLUX TEST,,,140.26,140.26,1
HCPCS,91035,G-ESOPH REFLX TST W/ELECTROD,,,368.54,368.54,2
HCPCS,91035,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,3051.0,1983.15,71.52,3751.0,107
HCPCS,91035,GE REFLUX TEST W/TELEMETRY,700.0,455.0,334.73,794.15,35
HCPCS,910350,G-ESOPH REFLX TST W/ELECTROD,,,368.54,368.54,1
HCPCS,91035TC,G-ESOPH REFLX TST W/ELECTROD,,,368.54,368.54,1
HCPCS,91037,ESOPH IMPED FUNCTION TEST,,,118.97,118.97,2
HCPCS,91037,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,1089.0,707.85,126.39,1611.0,76
HCPCS,910370,ESOPH IMPED FUNCTION TEST,,,118.97,118.97,1
HCPCS,91037TC,ESOPH IMPED FUNCTION TEST,,,118.97,118.97,1
HCPCS,91038,ESOPH IMPED FUNCT TEST > 1HR,,,342.34,342.34,2
HCPCS,91038,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,1745.5,1134.575,181.25,2745.9,76
HCPCS,910380,ESOPH IMPED FUNCT TEST > 1HR,,,342.34,342.34,1
HCPCS,91038TC,ESOPH IMPED FUNCT TEST > 1HR,,,342.34,342.34,1
HCPCS,91040,ESOPH BALLOON DISTENSION TST,,,389.68,1150.43,17
HCPCS,91040,ESOPHGL BALO DISTENSION DX STD W/PROVOCATION,388.0,252.2,194.0,898.23,35
HCPCS,91040,Esoph balloon distension tst,,,181.25,228.95,6
HCPCS,910400,ESOPH BALLOON DISTENSION TST,,,459.86,459.86,1
HCPCS,91040TC,ESOPH BALLOON DISTENSION TST,,,459.86,459.86,1
HCPCS,91065,BREATH HYDROGEN TEST,538.0,349.70000000000005,44.0,988.0,70
HCPCS,91065,BREATH HYDROGEN/METHANE TEST,900.0,585.0,8.96,988.0,144
HCPCS,91065,SMALL BOWEL TRANSIT TECH,900.0,585.0,44.72,900.0,35
HCPCS,910650,BREATH HYDROGEN/METHANE TEST,,,63.26,63.26,1
HCPCS,91065TC,BREATH HYDROGEN/METHANE TEST,,,63.26,63.26,1
HCPCS,91110,CAPSULE ENDOSCOPY GI IMAGING INTRALUMINAL,6377.0,4145.05,533.37,6377.0,35
HCPCS,91110,GI TRACT CAPSULE ENDOSCOPY,986.0,640.9,493.0,1268.55,35
HCPCS,91110,GI TRC IMG INTRAL ESOPH-ILE,,,609.21,609.21,2
HCPCS,91110,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,5391.0,3504.15,108.17,6377.0,148
HCPCS,911100,GI TRC IMG INTRAL ESOPH-ILE,,,609.21,609.21,1
HCPCS,91110TC,GI TRC IMG INTRAL ESOPH-ILE,,,609.21,609.21,1
HCPCS,91111,GI TRACT IMAGING INTRALUMINAL ESOPHAGUS WI&R,2893.5,1880.775,181.25,4851.9,76
HCPCS,91111,GI TRC IMG INTRAL ESOPHAGUS,,,815.86,815.86,2
HCPCS,911110,GI TRC IMG INTRAL ESOPHAGUS,,,815.86,815.86,1
HCPCS,91111TC,GI TRC IMG INTRAL ESOPHAGUS,,,815.86,815.86,1
HCPCS,91112,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,5391.0,3504.15,101.96,6315.0,103
HCPCS,91112,GI WIRELESS CAPSULE MEASURE,,,1479.45,1479.45,2
HCPCS,911120,GI WIRELESS CAPSULE MEASURE,,,1479.45,1479.45,1
HCPCS,91112TC,GI WIRELESS CAPSULE MEASURE,,,1479.45,1479.45,1
HCPCS,91113,GI TRACT IMAGING INTRALUMINAL COLON I&R,5243.0,3407.95,74.76,6207.0,100
HCPCS,91113,GI TRC IMG INTRAL COLON I&R,,,761.55,761.55,2
HCPCS,911130,GI TRC IMG INTRAL COLON I&R,,,761.55,761.55,1
HCPCS,91113TC,GI TRC IMG INTRAL COLON I&R,,,761.55,761.55,1
HCPCS,91117,COLON MOTILITY 6 HR STUDY,,,140.24,675.17,15
HCPCS,91117,COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R,980.0,637.0,80.64,980.0,35
HCPCS,91117,Colon motility 6 hr study,,,181.25,228.95,6
HCPCS,911170,COLON MOTILITY 6 HR STUDY,,,140.24,140.24,1
HCPCS,91120,RECTAL SENSATION TEST,,,312.58,675.17,12
HCPCS,91120,"RECTAL SENSATION, TONE, COMPLIANCE TEST",1616.0,1050.4,345.48,1616.0,26
HCPCS,91120,"RECTAL SENSATION,TONE,COMPLIANCE TEST",1158.0,752.7,175.0,1966.0,52
HCPCS,91120,Rectal sensation test,,,82.59,104.33,6
HCPCS,91122,ANORECTAL MANOMETRY,,,312.58,675.17,12
HCPCS,91122,Anorectal manometry,,,82.59,104.33,6
HCPCS,91122,RECTAL MANOMETRY,1616.0,1050.4,141.47,2254.0,78
HCPCS,91124,RCT SNSATN TONE&CMPLIANC STD,,,596.58,596.58,2
HCPCS,91124,RECTAL SENSATION TONE&COMPLIANCE STUDY,1903.0,1236.95,82.59,3245.0,106
HCPCS,911240,RCT SNSATN TONE&CMPLIANC STD,,,596.58,596.58,1
HCPCS,91124TC,RCT SNSATN TONE&CMPLIANC STD,,,596.58,596.58,1
HCPCS,91125,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,2193.0,1425.45,82.59,3381.0,106
HCPCS,91125,ANRCT MANO RCT SNSATN&BALO,,,202.28,202.28,2
HCPCS,911250,ANRCT MANO RCT SNSATN&BALO,,,202.28,202.28,1
HCPCS,91125TC,ANRCT MANO RCT SNSATN&BALO,,,202.28,202.28,1
HCPCS,91132,ELECTROGASTROGRAPHY,,,404.51,404.51,2
HCPCS,91132,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,999.0,649.35,82.59,1611.0,73
HCPCS,911320,ELECTROGASTROGRAPHY,,,404.51,404.51,1
HCPCS,91132TC,ELECTROGASTROGRAPHY,,,404.51,404.51,1
HCPCS,91133,ELECTROGASTROGRAPHY W/TEST,,,129.39,419.91,16
HCPCS,91133,Electrogastrography w/test,,,82.59,104.33,6
HCPCS,911330,ELECTROGASTROGRAPHY W/TEST,,,419.91,419.91,1
HCPCS,91133TC,ELECTROGASTROGRAPHY W/TEST,,,419.91,419.91,1
HCPCS,91200,LIVER ELASTOGRAPHY,,,20.02,20.02,2
HCPCS,91200,LIVER ELASTOGRAPHY W/O IMAG W/I&R,900.0,585.0,10.27,992.0,152
HCPCS,912000,LIVER ELASTOGRAPHY,,,20.02,20.02,1
HCPCS,91200TC,LIVER ELASTOGRAPHY,,,20.02,20.02,1
HCPCS,91299,AGILE PATENCY CAPSULE,205.0,133.25,102.5,205.0,15
HCPCS,91299,PROC GASTROENTERO UNLISTED (COMP 91110),485.0,315.25,125.62,521.0,40
HCPCS,91299,WIRELESS CAPSULE ENDOSCOPY,2588.0,1682.2,148.83,2588.0,15
HCPCS,91300,Sarscov2 vac 30mcg/0.3ml im,,,17.89,22.6,6
HCPCS,91301,Sarscov2 vac 100mcg/0.5ml im,,,17.89,22.6,6
HCPCS,91302,Sarscov2 vac 5x1010vp/.5mlim,,,17.89,22.6,6
HCPCS,91303,Sarscov2 vac ad26 .5ml im,,,17.89,22.6,6
HCPCS,91304,SARSCOV2 VAC 5MCG/0.5ML IM,,,133.38,525.86,15
HCPCS,91304,Sarscov2 vac 5mcg/0.5ml im,,,17.89,22.6,6
HCPCS,913040,SARSCOV2 VAC 5MCG/0.5ML IM,,,207.27,207.27,1
HCPCS,91305,Sarscov2 vac 30 mcg trs-sucr,,,17.89,22.6,6
HCPCS,91306,Sarscov2 vac 50mcg/0.25ml im,,,17.89,22.6,6
HCPCS,91307,Sarscov2 vac 10 mcg trs-sucr,,,17.89,22.6,6
HCPCS,91308,Sarscov2 vac 3 mcg trs-sucr,,,17.89,22.6,6
HCPCS,91309,Sarscov2 vac 50mcg/0.5ml im,,,17.89,22.6,6
HCPCS,91310,Sarscov2 vac 5mcg/0.5ml as03,,,17.89,22.6,6
HCPCS,91311,Sarscov2 vac 25mcg/0.25ml im,,,17.89,22.6,6
HCPCS,91312,Sarscov2 vac bvl 30mcg/0.3ml,,,17.89,22.6,6
HCPCS,91313,Sarscov2 vac bvl 50mcg/0.5ml,,,17.89,22.6,6
HCPCS,91314,Sarscov2 vac bvl 25mcg/.25ml,,,17.89,22.6,6
HCPCS,91315,Sarscov2 vac bvl 10mcg/0.2ml,,,17.89,22.6,6
HCPCS,91316,Sarscov2 vac bvl 10mcg/0.2ml,,,17.89,22.6,6
HCPCS,91317,Sarscov2 vac bvl 3mcg/0.2ml,,,17.89,22.6,6
HCPCS,91318,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON) AGE 6 MO - 4 Y,140.0,91.0,17.89,140.0,43
HCPCS,91318,SARSCOV2 VAC 3MCG TRS-SUC IM,,,70.79,70.79,1
HCPCS,913180,SARSCOV2 VAC 3MCG TRS-SUC IM,,,70.79,70.79,1
HCPCS,91319,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON)?AGE 5 YR - 11,278.0,180.7,17.89,278.0,50
HCPCS,91319,SARSCV2 VAC 10MCG TRS-SUC IM,,,102.38,102.38,1
HCPCS,913190,SARSCV2 VAC 10MCG TRS-SUC IM,,,102.38,102.38,1
HCPCS,91320,COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE,2038.14,1324.79,17.89,2038.14,37
HCPCS,91320,SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE,532.7,346.26,17.89,532.7,50
HCPCS,91320,SARSCV2 VAC 30MCG TRS-SUC IM,,,181.84,181.84,1
HCPCS,913200,SARSCV2 VAC 30MCG TRS-SUC IM,,,181.84,181.84,1
HCPCS,91321,SARSCOV2 VAC 25 MCG/.25ML IM,,,158.82,158.82,1
HCPCS,91321,SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE,465.4,302.51,17.89,465.4,50
HCPCS,91321,SPIKEVAX 2025-26 (6M-11Y) (PF) 25 MCG/0.25 ML INTRAMUSCULAR SYRINGE,1857.6,1207.44,17.89,1857.6,37
HCPCS,913210,SARSCOV2 VAC 25 MCG/.25ML IM,,,158.82,158.82,1
HCPCS,91322,SARSCOV2 VAC 50 MCG/0.5ML IM,,,131.33,442.92,15
HCPCS,91322,Sarscov2 vac 50 mcg/0.5ml im,,,17.89,22.6,6
HCPCS,913220,SARSCOV2 VAC 50 MCG/0.5ML IM,,,174.58,174.58,1
HCPCS,91323,SARSCOV2 VAC 10 MCG/0.2ML IM,,,218.06,553.23,11
HCPCS,91323,Sarscov2 vac 10 mcg/0.2ml im,,,17.89,22.6,6
HCPCS,913230,SARSCOV2 VAC 10 MCG/0.2ML IM,,,218.06,218.06,1
HCPCS,92002,INTRM OPH EXAM NEW PATIENT,,,41.17,41.17,1
HCPCS,92002,OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT,564.0,366.6,16.82,666.9,67
HCPCS,920020,INTRM OPH EXAM NEW PATIENT,,,41.17,41.17,1
HCPCS,92004,"ANNUAL EYE EXAM EXECUTIVE HEALTH, NEW PT",728.0,473.2,34.71,546.0,35
HCPCS,92004,COMPRE OPH EXAM NEW PT 1/>,,,85.15,85.15,1
HCPCS,92004,OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST,734.5,477.42499999999995,34.71,666.9,67
HCPCS,92004,OPTHAMOLOGY VISIT NEW,728.0,473.2,34.71,546.0,35
HCPCS,920040,COMPRE OPH EXAM NEW PT 1/>,,,85.15,85.15,1
HCPCS,92012,INTRM OPH EXAM EST PATIENT,,,45.36,45.36,1
HCPCS,92012,OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT,554.5,360.42499999999995,18.4,666.9,67
HCPCS,920120,INTRM OPH EXAM EST PATIENT,,,45.36,45.36,1
HCPCS,92014,COMPRE OPH EXAM EST PT 1/>,,,68.42,68.42,1
HCPCS,92014,OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>,654.5,425.42499999999995,32.99,666.9,67
HCPCS,920140,COMPRE OPH EXAM EST PT 1/>,,,68.42,68.42,1
HCPCS,92015,DETERMINATION REFRACTIVE STATE,65.0,42.25,14.55,48.75,24
HCPCS,92015,DETERMINE REFRACTIVE STATE,,,17.0,17.0,1
HCPCS,920150,DETERMINE REFRACTIVE STATE,,,17.0,17.0,1
HCPCS,92018,COMPL OPH EXAM GENERAL ANES,,,125.87,5058.24,15
HCPCS,92018,Compl oph exam general anes,,,169.69,214.34,6
HCPCS,92018,OPHTH XM&EVAL ANES W/WO MANJ GLOBE COMPL,1000.0,650.0,59.47,1000.0,35
HCPCS,920180,COMPL OPH EXAM GENERAL ANES,,,125.87,125.87,1
HCPCS,92019,LMTD OPH EXAM GENERAL ANES,,,65.88,5058.24,15
HCPCS,92019,Lmtd oph exam general anes,,,169.69,214.34,6
HCPCS,920190,LMTD OPH EXAM GENERAL ANES,,,65.88,65.88,1
HCPCS,92020,GONIOSCOPY,,,18.37,279.48,15
HCPCS,92020,GONIOSCOPY SEPARATE PROCEDURE,163.0,105.95,11.12,122.25,35
HCPCS,92020,Gonioscopy,,,45.31,57.23,6
HCPCS,920200,GONIOSCOPY,,,18.37,18.37,1
HCPCS,92025,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,154.0,100.1,11.88,154.0,35
HCPCS,92025,CPTRIZED CORNEAL TOPOGRAPHY,,,15.02,128.79,16
HCPCS,92025,Cptrized corneal topography,,,31.76,40.12,6
HCPCS,920250,CPTRIZED CORNEAL TOPOGRAPHY,,,15.02,15.02,1
HCPCS,92025TC,CPTRIZED CORNEAL TOPOGRAPHY,,,15.02,15.02,1
HCPCS,92060,SENSORIMOTOR EXAMINATION,,,23.67,128.79,16
HCPCS,92060,SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX,276.0,179.4,21.69,276.0,35
HCPCS,92060,Sensorimotor examination,,,45.31,57.23,6
HCPCS,920600,SENSORIMOTOR EXAMINATION,,,23.67,23.67,1
HCPCS,92060TC,SENSORIMOTOR EXAMINATION,,,23.67,23.67,1
HCPCS,92065,ORTHOP TRAING PFRMD PHYS/QHP,,,30.57,30.57,1
HCPCS,92065,Orthop traing pfrmd phys/qhp,,,72.09,91.06,6
HCPCS,920650,ORTHOP TRAING PFRMD PHYS/QHP,,,30.57,30.57,1
HCPCS,92066,ORTHOP TRAING SUPVJ PHYS/QHP,,,22.81,128.79,15
HCPCS,92066,Orthop traing supvj phys/qhp,,,72.09,91.06,6
HCPCS,920660,ORTHOP TRAING SUPVJ PHYS/QHP,,,22.81,22.81,1
HCPCS,92071,CONTACT LENS FITTING FOR TX,,,29.17,29.17,1
HCPCS,92071,Contact lens fitting for tx,,,45.31,57.23,6
HCPCS,920710,CONTACT LENS FITTING FOR TX,,,29.17,29.17,1
HCPCS,92072,FITG C-LENS KERATOCONUS 1ST,,,84.88,84.88,1
HCPCS,92072,Fitg c-lens keratoconus 1st,,,45.31,57.23,6
HCPCS,920720,FITG C-LENS KERATOCONUS 1ST,,,84.88,84.88,1
HCPCS,92081,LIMITED VISUAL FIELD XM,,,15.31,128.79,16
HCPCS,92081,Limited visual field xm,,,45.31,57.23,6
HCPCS,92081,VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM,132.0,85.8,19.69,132.0,35
HCPCS,920810,LIMITED VISUAL FIELD XM,,,15.31,15.31,1
HCPCS,92081TC,LIMITED VISUAL FIELD XM,,,15.31,15.31,1
HCPCS,92082,INTERMEDIATE VISUAL FIELD XM,,,23.09,128.79,16
HCPCS,92082,Intermediate visual field xm,,,45.31,57.23,6
HCPCS,92082,VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM,176.0,114.4,25.64,176.0,35
HCPCS,920820,INTERMEDIATE VISUAL FIELD XM,,,23.09,23.09,1
HCPCS,92082TC,INTERMEDIATE VISUAL FIELD XM,,,23.09,23.09,1
HCPCS,92083,EXTENDED VISUAL FIELD XM,,,32.03,279.48,16
HCPCS,92083,Extended visual field xm,,,45.31,57.23,6
HCPCS,92083,VISUAL FIELD EXTENDED,220.0,143.0,29.44,220.0,35
HCPCS,92083,VISUAL FIELD EXTENDED TC,220.0,143.0,29.44,220.0,35
HCPCS,92083,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,480.5,312.325,29.44,741.0,70
HCPCS,920830,EXTENDED VISUAL FIELD XM,,,32.03,32.03,1
HCPCS,92083TC,EXTENDED VISUAL FIELD XM,,,32.03,32.03,1
HCPCS,92100,SERIAL TONOMETRY,,,29.17,29.17,1
HCPCS,92100,SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRES,268.0,174.2,12.64,201.0,35
HCPCS,92100,Serial tonometry,,,45.31,57.23,6
HCPCS,921000,SERIAL TONOMETRY,,,29.17,29.17,1
HCPCS,92132,CPTRIZED OPH DX IMG ANTERIOR SEGMENT UNI/BI,128.0,83.2,14.23,128.0,35
HCPCS,92132,CPTRZD OPH DX IMG ANT SGM,,,13.29,128.79,16
HCPCS,92132,Cptrzd oph dx img ant sgm,,,31.76,40.12,6
HCPCS,921320,CPTRZD OPH DX IMG ANT SGM,,,13.29,13.29,1
HCPCS,92132TC,CPTRZD OPH DX IMG ANT SGM,,,13.29,13.29,1
HCPCS,92133,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI OPTIC NRV,136.0,88.4,17.43,136.0,35
HCPCS,92133,CPTRZD OPH DX IMG PST SGM ON,,,13.29,128.79,16
HCPCS,92133,Cptrzd oph dx img pst sgm on,,,31.76,40.12,6
HCPCS,921330,CPTRZD OPH DX IMG PST SGM ON,,,13.29,13.29,1
HCPCS,92133TC,CPTRZD OPH DX IMG PST SGM ON,,,13.29,13.29,1
HCPCS,92134,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA,141.0,91.65,17.43,141.0,35
HCPCS,92134,CPTRZ OPH DX IMG PST SGM RTA,,,13.87,128.79,16
HCPCS,92134,Cptrz oph dx img pst sgm rta,,,31.76,40.12,6
HCPCS,921340,CPTRZ OPH DX IMG PST SGM RTA,,,13.87,13.87,1
HCPCS,92134TC,CPTRZ OPH DX IMG PST SGM RTA,,,13.87,13.87,1
HCPCS,92136,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,238.0,154.7,36.0,238.0,35
HCPCS,92136,OPHTHALMIC BIOMETRY,,,15.02,279.48,16
HCPCS,92136,Ophthalmic biometry,,,31.76,40.12,6
HCPCS,921360,OPHTHALMIC BIOMETRY,,,15.02,15.02,1
HCPCS,92136TC,OPHTHALMIC BIOMETRY,,,15.02,15.02,1
HCPCS,92137,CPTRIZD OPH DX IMG PST SGM UNI/BI RTA OCT ANGRPH,282.0,183.3,33.86,282.0,28
HCPCS,92137,CPTRZ OPH IMG PST SG RTA OCT,,,20.21,700.65,19
HCPCS,92137,Cptrz oph img pst sg rta oct,,,31.76,40.12,6
HCPCS,921370,CPTRZ OPH IMG PST SG RTA OCT,,,20.21,20.21,1
HCPCS,92137TC,CPTRZ OPH IMG PST SG RTA OCT,,,20.21,20.21,1
HCPCS,92145,CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI,40.0,26.0,13.1,40.0,28
HCPCS,92145,CORNEAL HYSTERESIS DETER,,,6.66,128.79,16
HCPCS,92145,Corneal hysteresis deter,,,45.31,57.23,6
HCPCS,921450,CORNEAL HYSTERESIS DETER,,,6.66,6.66,1
HCPCS,92145TC,CORNEAL HYSTERESIS DETER,,,6.66,6.66,1
HCPCS,92201,OPSCPY EXTND RTA DRAW UNI/BI,,,20.51,128.79,15
HCPCS,92201,Opscpy extnd rta draw uni/bi,,,31.76,40.12,6
HCPCS,922010,OPSCPY EXTND RTA DRAW UNI/BI,,,20.51,20.51,1
HCPCS,92202,OPSCPY EXTND ON/MAC DRAW,,,13.17,128.79,15
HCPCS,92202,Opscpy extnd on/mac draw,,,31.76,40.12,6
HCPCS,922020,OPSCPY EXTND ON/MAC DRAW,,,13.17,13.17,1
HCPCS,92227,IMG RTA DETCJ/MNTR DS STAFF,,,15.31,128.79,15
HCPCS,92227,Img rta detcj/mntr ds staff,,,31.76,40.12,6
HCPCS,922270,IMG RTA DETCJ/MNTR DS STAFF,,,15.31,15.31,1
HCPCS,92228,IMG RTA DETC/MNTR DS PHY/QHP,,,11.57,85.1,16
HCPCS,92228,Img rta detc/mntr ds phy/qhp,,,31.76,40.12,6
HCPCS,922280,IMG RTA DETC/MNTR DS PHY/QHP,,,11.57,11.57,1
HCPCS,92228TC,IMG RTA DETC/MNTR DS PHY/QHP,,,11.57,11.57,1
HCPCS,92229,IMG RETINA DETCJ/MNTR DS POC AUTO A/R UNI/BI,341.0,221.65,27.91,839.0,72
HCPCS,92229,IMG RTA DETC/MNTR DS POC ALY,,,35.49,35.49,1
HCPCS,922290,IMG RTA DETC/MNTR DS POC ALY,,,35.49,35.49,1
HCPCS,92230,FLUORESCEIN ANGIOSCOPY I&R,,,31.2,1150.43,15
HCPCS,92230,FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT,240.0,156.0,14.62,180.0,35
HCPCS,92230,Fluorescein angioscopy i&r,,,169.69,214.34,6
HCPCS,922300,FLUORESCEIN ANGIOSCOPY I&R,,,31.2,31.2,1
HCPCS,92235,FLUORESCEIN ANGRPH MLTIFRAME,,,104.66,675.17,16
HCPCS,92235,FLUORESCEIN ANGRPH W/MULTIFRAME I&R UNI/BI,330.0,214.5,51.06,330.0,35
HCPCS,92235,Fluorescein angrph mltiframe,,,169.69,214.34,6
HCPCS,922350,FLUORESCEIN ANGRPH MLTIFRAME,,,104.66,104.66,1
HCPCS,92235TC,FLUORESCEIN ANGRPH MLTIFRAME,,,104.66,104.66,1
HCPCS,92240,ICG ANGIOGRAPHY I&R UNI/BI,,,122.82,675.17,16
HCPCS,92240,Icg angiography i&r uni/bi,,,169.69,214.34,6
HCPCS,922400,ICG ANGIOGRAPHY I&R UNI/BI,,,122.82,122.82,1
HCPCS,92240TC,ICG ANGIOGRAPHY I&R UNI/BI,,,122.82,122.82,1
HCPCS,92242,FLUORESCEIN&ICG ANGIOGRAPHY,,,197.18,675.17,16
HCPCS,92242,Fluorescein&icg angiography,,,169.69,214.34,6
HCPCS,922420,FLUORESCEIN&ICG ANGIOGRAPHY,,,197.18,197.18,1
HCPCS,92242TC,FLUORESCEIN&ICG ANGIOGRAPHY,,,197.18,197.18,1
HCPCS,92250,FUNDUS PHOTOGRAPHY W/I&R,,,14.45,14.45,2
HCPCS,92250,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,458.5,298.025,28.09,839.0,76
HCPCS,922500,FUNDUS PHOTOGRAPHY W/I&R,,,14.45,14.45,1
HCPCS,92250TC,FUNDUS PHOTOGRAPHY W/I&R,,,14.45,14.45,1
HCPCS,92260,OPHTHALMODYNAMOMETRY,,,9.83,85.1,15
HCPCS,92260,Ophthalmodynamometry,,,31.76,40.12,6
HCPCS,922600,OPHTHALMODYNAMOMETRY,,,9.83,9.83,1
HCPCS,92265,NDL OCULOELECTROMYOGRAPHY 1+,,,36.64,128.79,16
HCPCS,92265,Ndl oculoelectromyography 1+,,,45.31,57.23,6
HCPCS,922650,NDL OCULOELECTROMYOGRAPHY 1+,,,36.64,36.64,1
HCPCS,92265TC,NDL OCULOELECTROMYOGRAPHY 1+,,,36.64,36.64,1
HCPCS,92270,ELECTRO-OCULOGRAPHY W/I&R,,,65.79,279.48,16
HCPCS,92270,ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT,324.0,210.6,36.08,324.0,35
HCPCS,92270,Electro-oculography w/i&r,,,45.31,57.23,6
HCPCS,922700,ELECTRO-OCULOGRAPHY W/I&R,,,65.79,65.79,1
HCPCS,92270TC,ELECTRO-OCULOGRAPHY W/I&R,,,65.79,65.79,1
HCPCS,92273,FULL FIELD ERG W/I&R,,,78.47,675.17,16
HCPCS,92273,Full field erg w/i&r,,,45.31,57.23,6
HCPCS,922730,FULL FIELD ERG W/I&R,,,78.47,78.47,1
HCPCS,92273TC,FULL FIELD ERG W/I&R,,,78.47,78.47,1
HCPCS,92274,MULTIFOCAL ERG W/I&R,,,49.32,339.23,16
HCPCS,92274,Multifocal erg w/i&r,,,45.31,57.23,6
HCPCS,922740,MULTIFOCAL ERG W/I&R,,,49.32,49.32,1
HCPCS,92274TC,MULTIFOCAL ERG W/I&R,,,49.32,49.32,1
HCPCS,92283,COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV,68.0,44.2,16.07,79.29,35
HCPCS,92283,EXTND COLOR VISION XM,,,39.81,128.79,16
HCPCS,92283,Extnd color vision xm,,,45.31,57.23,6
HCPCS,922830,EXTND COLOR VISION XM,,,39.81,39.81,1
HCPCS,92283TC,EXTND COLOR VISION XM,,,39.81,39.81,1
HCPCS,92284,DX DARK ADAPTATION EXAM I&R,,,32.31,865.18,15
HCPCS,92284,Dx dark adaptation exam i&r,,,45.31,57.23,6
HCPCS,922840,DX DARK ADAPTATION EXAM I&R,,,32.31,32.31,1
HCPCS,92285,EXTERNAL OCULAR PHOTOGRAPHY,,,17.61,85.1,16
HCPCS,92285,External ocular photography,,,31.76,40.12,6
HCPCS,92285,XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE,22.0,14.3,11.0,34.47,35
HCPCS,922850,EXTERNAL OCULAR PHOTOGRAPHY,,,17.61,17.61,1
HCPCS,92285TC,EXTERNAL OCULAR PHOTOGRAPHY,,,17.61,17.61,1
HCPCS,92286,ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY,176.0,114.4,29.62,176.0,35
HCPCS,92286,ANT SGM IMG I&R SPECLR MIC,,,15.61,279.48,16
HCPCS,92286,Ant sgm img i&r speclr mic,,,31.76,40.12,6
HCPCS,922860,ANT SGM IMG I&R SPECLR MIC,,,15.61,15.61,1
HCPCS,92286TC,ANT SGM IMG I&R SPECLR MIC,,,15.61,15.61,1
HCPCS,92287,ANT SGM IMG IR FLRSCN ANGRPH,,,98.31,279.48,16
HCPCS,92287,Ant sgm img ir flrscn angrph,,,31.76,40.12,6
HCPCS,922870,ANT SGM IMG IR FLRSCN ANGRPH,,,98.31,98.31,1
HCPCS,92287TC,ANT SGM IMG IR FLRSCN ANGRPH,,,98.31,98.31,1
HCPCS,92288,SCR DARK ADAPTATION MEAS I&R,,,21.08,21.08,1
HCPCS,92288,SCREENING DARK ADAPTATION MEASUREMENT W/I&R,1185.0,770.25,31.91,2065.5,40
HCPCS,922880,SCR DARK ADAPTATION MEAS I&R,,,21.08,21.08,1
HCPCS,92310,CONTACT LENS FIT SPECIAL,468.0,304.2,49.72,351.0,21
HCPCS,92310,CONTACT LENS FITTING OU,,,52.27,52.27,1
HCPCS,92310,Contact lens fitting ou,,,45.31,57.23,6
HCPCS,92310,RX&FITG C-LENS SUPVJ CRNL LENS OU XCPT APHK,468.0,304.2,49.72,351.0,21
HCPCS,92310,STANDARD CL EVAL,55.0,35.75,27.5,117.56,21
HCPCS,923100,CONTACT LENS FITTING OU,,,52.27,52.27,1
HCPCS,92311,CONTACT LENS FITG APHAKIA 1,,,46.6,865.18,15
HCPCS,92311,Contact lens fitg aphakia 1,,,45.31,57.23,6
HCPCS,923110,CONTACT LENS FITG APHAKIA 1,,,46.6,46.6,1
HCPCS,92312,CONTACT LENS FITG APHAKIA OU,,,55.5,279.48,15
HCPCS,92312,Contact lens fitg aphakia ou,,,45.31,57.23,6
HCPCS,923120,CONTACT LENS FITG APHAKIA OU,,,55.5,55.5,1
HCPCS,92313,C-LENS FITG CORNEOSCLRL LENS,,,38.94,279.48,15
HCPCS,92313,C-lens fitg corneosclrl lens,,,45.31,57.23,6
HCPCS,923130,C-LENS FITG CORNEOSCLRL LENS,,,38.94,38.94,1
HCPCS,92314,C-LENS FITG TECH OU,,,30.92,30.92,1
HCPCS,92314,C-lens fitg tech ou,,,45.31,57.23,6
HCPCS,92314,RX&FTG CONTACT CORNEAL LENS EYES XCPT APHAKIA,304.0,197.6,24.16,228.0,21
HCPCS,923140,C-LENS FITG TECH OU,,,30.92,30.92,1
HCPCS,92315,C-LENS FITG TECH APHAKIA 1,,,18.89,279.48,15
HCPCS,92315,C-lens fitg tech aphakia 1,,,45.31,57.23,6
HCPCS,923150,C-LENS FITG TECH APHAKIA 1,,,18.89,18.89,1
HCPCS,92316,C-LENS FITG TECH APHAKIA OU,,,28.47,279.48,15
HCPCS,92316,C-lens fitg tech aphakia ou,,,45.31,57.23,6
HCPCS,92316,RX CONTACT CORNEAL LENS APHAKIA BOTH EYES,299.0,194.35,25.78,224.25,32
HCPCS,923160,C-LENS FITG TECH APHAKIA OU,,,28.47,28.47,1
HCPCS,92317,C-LENS FITG TECH CORNEOSCLRL,,,18.89,85.1,15
HCPCS,92317,C-lens fitg tech corneosclrl,,,45.31,57.23,6
HCPCS,923170,C-LENS FITG TECH CORNEOSCLRL,,,18.89,18.89,1
HCPCS,92325,MODIFICATION OF CONTACT LENS,,,35.49,279.48,15
HCPCS,92325,Modification of contact lens,,,45.31,57.23,6
HCPCS,923250,MODIFICATION OF CONTACT LENS,,,35.49,35.49,1
HCPCS,92326,REPLACEMENT OF CONTACT LENS,,,34.05,128.79,15
HCPCS,92326,Replacement of contact lens,,,45.31,57.23,6
HCPCS,923260,REPLACEMENT OF CONTACT LENS,,,34.05,34.05,1
HCPCS,92340,FIT SPECTACLES MONOFOCAL,,,16.39,16.39,1
HCPCS,92340,Fit spectacles monofocal,,,45.31,57.23,6
HCPCS,923400,FIT SPECTACLES MONOFOCAL,,,16.39,16.39,1
HCPCS,92341,FIT SPECTACLES BIFOCAL,,,21.04,21.04,1
HCPCS,92341,Fit spectacles bifocal,,,45.31,57.23,6
HCPCS,923410,FIT SPECTACLES BIFOCAL,,,21.04,21.04,1
HCPCS,92342,FIT SPECTACLES MULTIFOCAL,,,23.8,23.8,1
HCPCS,92342,Fit spectacles multifocal,,,45.31,57.23,6
HCPCS,923420,FIT SPECTACLES MULTIFOCAL,,,23.8,23.8,1
HCPCS,92352,FIT APHAKIA SPECTCL MONOFOCL,,,16.39,128.79,15
HCPCS,92352,Fit aphakia spectcl monofocl,,,45.31,57.23,6
HCPCS,923520,FIT APHAKIA SPECTCL MONOFOCL,,,16.39,16.39,1
HCPCS,92353,FIT APHAKIA SPECTCL MULTIFOC,,,22.27,128.79,15
HCPCS,92353,Fit aphakia spectcl multifoc,,,45.31,57.23,6
HCPCS,923530,FIT APHAKIA SPECTCL MULTIFOC,,,22.27,22.27,1
HCPCS,92354,FITG SPECT LOW VIS 1SYSTEM,,,12.14,85.1,15
HCPCS,92354,FITTING SPECTACLE MOUNTED LW VIS AID 1 ELMNT,128.0,83.2,12.88,128.0,21
HCPCS,92354,Fitg spect low vis 1system,,,45.31,57.23,6
HCPCS,923540,FITG SPECT LOW VIS 1SYSTEM,,,12.14,12.14,1
HCPCS,92355,FITG SPECT LW VIS CMPND LENS,,,18.77,85.1,15
HCPCS,92355,FITTING SPECTACLE MOUNTED LW VIS AID TLSCP,210.0,136.5,19.96,210.0,21
HCPCS,92355,Fitg spect lw vis cmpnd lens,,,45.31,57.23,6
HCPCS,923550,FITG SPECT LW VIS CMPND LENS,,,18.77,18.77,1
HCPCS,92358,APHAKIA PROSTH SERVICE TEMP,,,10.13,128.79,15
HCPCS,92358,Aphakia prosth service temp,,,45.31,57.23,6
HCPCS,923580,APHAKIA PROSTH SERVICE TEMP,,,10.13,10.13,1
HCPCS,92370,RPR&REFITG SPECT XCP APHAKIA,,,14.23,14.23,1
HCPCS,923700,RPR&REFITG SPECT XCP APHAKIA,,,14.23,14.23,1
HCPCS,92371,RPR&REFIT SPCT PRSTH APHAKIA,,,10.41,128.79,15
HCPCS,92371,Rpr&refit spct prsth aphakia,,,45.31,57.23,6
HCPCS,923710,RPR&REFIT SPCT PRSTH APHAKIA,,,10.41,10.41,1
HCPCS,92499,CORNEAL TOPOGRAPHY,189.0,122.85,56.87,189.0,15
HCPCS,92499,EXECUTIVE HEALTH TONOMERTY/IOP CHECK,107.0,69.55,53.5,107.0,15
HCPCS,92499,UNLISTED OPH SVC/PROCEDURE,,,24.58,53.1,14
HCPCS,92499,Unlisted oph svc/procedure,,,45.31,57.23,6
HCPCS,92502,EAR AND THROAT EXAMINATION,,,98.61,1104.14,15
HCPCS,92502,Ear and throat examination,,,112.01,141.49,6
HCPCS,92502,OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA,604.0,392.6,73.02,604.0,35
HCPCS,925020,EAR AND THROAT EXAMINATION,,,98.61,98.61,1
HCPCS,92504,BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE,97.5,63.375,3.89,450.0,60
HCPCS,92504,EAR MICROSCOPY EXAMINATION,,,9.46,9.46,1
HCPCS,925040,EAR MICROSCOPY EXAMINATION,,,9.46,9.46,1
HCPCS,92507,SPEECH/HEARING THERAPY INDIV,591.0,384.15,98.27,723.0,49
HCPCS,92507,TX SP LANG VOICE COMM INDIV,,,78.49,78.49,1
HCPCS,92507,TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND,520.0,338.0,54.37,520.0,32
HCPCS,92507,VV SPEECH THERAPY (92507),555.5,361.075,54.37,723.0,81
HCPCS,925070,TX SP LANG VOICE COMM INDIV,,,78.49,78.49,1
HCPCS,92508,SLT-SPEECH/LANGUAG THERAPY GRP,354.0,230.1,20.97,723.0,49
HCPCS,92508,TX SP LANG VOICE COMM GROUP,,,24.75,24.75,1
HCPCS,92508,TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV,132.0,85.8,18.95,132.0,32
HCPCS,925080,TX SP LANG VOICE COMM GROUP,,,24.75,24.75,1
HCPCS,92511,NASOPHARYNGOSCOPY,,,39.14,39.14,1
HCPCS,92511,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,619.5,402.67499999999995,23.39,2849.0,117
HCPCS,925110,NASOPHARYNGOSCOPY,,,39.14,39.14,1
HCPCS,92512,NASAL FUNCTION STUDIES,220.0,143.0,13.32,675.17,50
HCPCS,92512,Nasal function studies,,,81.82,103.36,6
HCPCS,925120,NASAL FUNCTION STUDIES,,,28.47,28.47,1
HCPCS,92516,FACIAL NERVE FUNCTION STUDIES,172.0,111.8,18.71,129.0,35
HCPCS,92516,FACIAL NERVE FUNCTION TEST,,,23.45,675.17,15
HCPCS,92516,Facial nerve function test,,,81.82,103.36,6
HCPCS,925160,FACIAL NERVE FUNCTION TEST,,,23.45,23.45,1
HCPCS,92517,CERVICAL VEMP TESTING W/I&R,551.5,358.475,34.07,704.7,72
HCPCS,92517,VEMP TEST I&R CERVICAL,,,43.63,43.63,1
HCPCS,925170,VEMP TEST I&R CERVICAL,,,43.63,43.63,1
HCPCS,92518,OCULAR VEMP TESTING W/I&R,320.0,208.0,34.07,240.0,31
HCPCS,92518,VEMP TEST I&R OCULAR,,,44.38,339.23,15
HCPCS,92518,Vemp test i&r ocular,,,81.82,103.36,6
HCPCS,925180,VEMP TEST I&R OCULAR,,,44.38,44.38,1
HCPCS,92519,CERVICAL & OCULAR VEMP TESTING W/I&R,1019.0,662.35,51.0,1402.2,72
HCPCS,92519,VEMP TST I&R CERVICAL&OCULAR,,,65.59,65.59,1
HCPCS,925190,VEMP TST I&R CERVICAL&OCULAR,,,65.59,65.59,1
HCPCS,92520,LARYNGEAL FUNCTION STUDIES,645.0,419.25,41.18,723.0,50
HCPCS,92520,LARYNGEAL FUNCTION STUDY,300.0,195.0,19.07,225.0,35
HCPCS,925200,LARYNGEAL FUNCTION STUDIES,,,41.18,41.18,1
HCPCS,92521,EVAL OF SPEECH FLUENCY,741.0,481.65,126.0,723.0,49
HCPCS,92521,EVALUATION OF SPEECH FLUENCY,,,136.73,136.73,1
HCPCS,92521,"EVALUATION OF SPEECH FLUENCY (EG, STUTTERING, CLUTTERING)",896.0,582.4,84.85,896.0,28
HCPCS,92521,EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER),741.0,481.65,126.0,723.0,49
HCPCS,92521,VV FLUENCY EVAL (92521),741.0,481.65,126.0,723.0,49
HCPCS,92521,VV FLUENCY EVALUATION (92521),896.0,582.4,84.85,896.0,28
HCPCS,925210,EVALUATION OF SPEECH FLUENCY,,,136.73,136.73,1
HCPCS,92522,EVAL OF SPEECH PRODUCTION,716.0,465.4,126.0,723.0,49
HCPCS,92522,EVALUATE SPEECH PRODUCTION,,,114.69,114.69,1
HCPCS,92522,EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE,742.0,482.29999999999995,69.05,768.0,77
HCPCS,92522,VV SOUND PRODUCTION EVALUATION (92522),742.0,482.29999999999995,69.05,768.0,77
HCPCS,925220,EVALUATE SPEECH PRODUCTION,,,114.69,114.69,1
HCPCS,92523,EVAL SPEECH SOUND LANG COMPREH,1253.0,814.45,126.0,1127.7,49
HCPCS,92523,EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION,1394.5,906.425,126.0,1536.0,77
HCPCS,92523,SPEECH SOUND LANG COMPREHEN,,,234.37,234.37,1
HCPCS,92523,VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVAL (92523),1253.0,814.45,126.0,1127.7,49
HCPCS,92523,VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVALUATION (92523),1536.0,998.4,143.21,1536.0,28
HCPCS,925230,SPEECH SOUND LANG COMPREHEN,,,234.37,234.37,1
HCPCS,92524,BEHAV QUAL ANLYS VOICE MO,680.0,442.0,126.0,723.0,49
HCPCS,92524,BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE,680.0,442.0,126.0,723.0,49
HCPCS,92524,BEHAVIORAL AND QUALITATIVE ANALYSIS OF VOICE AND RESONANCE,768.0,499.2,72.11,768.0,28
HCPCS,92524,BEHAVRAL QUALIT ANALYS VOICE,,,113.05,113.05,1
HCPCS,92524,VV VOICE EVAL (92524),680.0,442.0,126.0,723.0,49
HCPCS,92524,VV VOICE EVALUATION (92524),768.0,499.2,72.11,768.0,28
HCPCS,925240,BEHAVRAL QUALIT ANALYS VOICE,,,113.05,113.05,1
HCPCS,92526,ORAL FUNCTION THERAPY,,,87.61,87.61,1
HCPCS,92526,TREAT SWALLOWING DYSFUNCTION,830.0,539.5,20.97,747.0,49
HCPCS,92526,TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING,536.0,348.4,52.4,536.0,35
HCPCS,925260,ORAL FUNCTION THERAPY,,,87.61,87.61,1
HCPCS,92531,SPONTANEOUS NYSTAGMUS STUDY,730.0,474.5,6.24,1179.0,47
HCPCS,925310,SPONTANEOUS NYSTAGMUS STUDY,,,15.61,15.61,1
HCPCS,92532,POSITIONAL NYSTAGMUS STUDY,215.0,139.75,6.24,215.0,16
HCPCS,92532,POSITIONAL NYSTAGMUS TEST,,,18.32,18.32,1
HCPCS,92532,Positional nystagmus test,,,19.1,24.12,6
HCPCS,925320,POSITIONAL NYSTAGMUS TEST,,,18.32,18.32,1
HCPCS,92533,CALORIC VESTIBULAR TEST,,,26.11,26.11,1
HCPCS,92533,CALORIC VESTIBULAR TEST EACH IRRIGATION,258.0,167.7,15.9,258.0,16
HCPCS,92533,Caloric vestibular test,,,19.1,24.12,6
HCPCS,925330,CALORIC VESTIBULAR TEST,,,26.11,26.11,1
HCPCS,92534,OPTOKINETIC NYSTAGMUS TEST,,,19.99,19.99,1
HCPCS,92534,Optokinetic nystagmus test,,,81.82,103.36,6
HCPCS,925340,OPTOKINETIC NYSTAGMUS TEST,,,19.99,19.99,1
HCPCS,92537,CALORIC VEST TEST BITHERMAL,783.0,508.95,51.71,704.7,41
HCPCS,92537,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,264.0,171.6,29.87,264.0,31
HCPCS,92537,CALORIC VSTBLR TEST W/REC,,,9.21,9.21,2
HCPCS,925370,CALORIC VSTBLR TEST W/REC,,,9.21,9.21,1
HCPCS,92537TC,CALORIC VSTBLR TEST W/REC,,,9.21,9.21,1
HCPCS,92538,CALORIC VEST TEST MONOTHERMAL,783.0,508.95,28.31,704.7,41
HCPCS,92538,CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL,132.0,85.8,16.85,132.0,31
HCPCS,92538,CALORIC VSTBLR TEST W/REC,,,6.6,6.6,2
HCPCS,925380,CALORIC VSTBLR TEST W/REC,,,6.6,6.6,1
HCPCS,92538TC,CALORIC VSTBLR TEST W/REC,,,6.6,6.6,1
HCPCS,92540,BASIC VESTIBULAR EVAL,783.0,508.95,81.82,704.7,41
HCPCS,92540,BASIC VESTIBULAR EVALUATION,,,30.5,30.5,2
HCPCS,92540,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRKG,626.0,406.9,59.35,626.0,35
HCPCS,925400,BASIC VESTIBULAR EVALUATION,,,30.5,30.5,1
HCPCS,92540TC,BASIC VESTIBULAR EVALUATION,,,30.5,30.5,1
HCPCS,92541,SPONTANEOUS NYSTAGMUS TEST,410.5,266.825,4.3,580.5,78
HCPCS,925410,SPONTANEOUS NYSTAGMUS TEST,,,4.3,4.3,1
HCPCS,92541TC,SPONTANEOUS NYSTAGMUS TEST,,,4.3,4.3,1
HCPCS,92542,POSITIONAL NYSTAGMUS TEST,428.0,278.2,4.3,580.5,78
HCPCS,925420,POSITIONAL NYSTAGMUS TEST,,,4.3,4.3,1
HCPCS,92542TC,POSITIONAL NYSTAGMUS TEST,,,4.3,4.3,1
HCPCS,92544,OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC,119.0,77.35,13.79,119.0,35
HCPCS,92544,OPTOKINETIC NYSTAGMUS TEST,900.0,585.0,3.65,810.0,43
HCPCS,925440,OPTOKINETIC NYSTAGMUS TEST,,,3.65,3.65,1
HCPCS,92544TC,OPTOKINETIC NYSTAGMUS TEST,,,3.65,3.65,1
HCPCS,92545,OSCILLATING TRACKING TEST,1790.0,1163.5,3.65,1611.0,43
HCPCS,92545,OSCILLATING TRACKING TEST W/RECORDING,110.0,71.5,13.02,110.0,35
HCPCS,925450,OSCILLATING TRACKING TEST,,,3.65,3.65,1
HCPCS,92545TC,OSCILLATING TRACKING TEST,,,3.65,3.65,1
HCPCS,92546,SINUSOIDAL ROTATIONAL TEST,,,116.02,116.02,2
HCPCS,92546,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,514.0,334.1,44.71,810.0,76
HCPCS,925460,SINUSOIDAL ROTATIONAL TEST,,,116.02,116.02,1
HCPCS,92546TC,SINUSOIDAL ROTATIONAL TEST,,,116.02,116.02,1
HCPCS,92547,SUPPLEMENTAL ELECTRICAL TEST,,,8.51,8.51,2
HCPCS,92547,Supplemental electrical test,,,81.82,103.36,6
HCPCS,92547,USE VERTICAL ELECTRODES,187.0,121.55,4.03,187.0,35
HCPCS,925470,SUPPLEMENTAL ELECTRICAL TEST,,,8.51,8.51,1
HCPCS,92547TC,SUPPLEMENTAL ELECTRICAL TEST,,,8.51,8.51,1
HCPCS,92548,CDP-SOT 6 COND W/I&R,,,13.8,13.8,2
HCPCS,92548,CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT,504.5,327.92499999999995,35.75,666.9,76
HCPCS,925480,CDP-SOT 6 COND W/I&R,,,13.8,13.8,1
HCPCS,92548TC,CDP-SOT 6 COND W/I&R,,,13.8,13.8,1
HCPCS,92549,CDP-SOT 6 COND W/I&R MCT&ADT,,,20.02,279.48,16
HCPCS,92549,Cdp-sot 6 cond w/i&r mct&adt,,,81.82,103.36,6
HCPCS,925490,CDP-SOT 6 COND W/I&R MCT&ADT,,,20.02,20.02,1
HCPCS,92549TC,CDP-SOT 6 COND W/I&R MCT&ADT,,,20.02,20.02,1
HCPCS,92550,TYMP & REFLEX THRESH,783.0,508.95,28.88,704.7,41
HCPCS,92550,TYMPANOMETRY & REFLEX THRESH,,,22.45,22.45,1
HCPCS,92550,TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS,154.0,100.1,12.91,154.0,35
HCPCS,925500,TYMPANOMETRY & REFLEX THRESH,,,22.45,22.45,1
HCPCS,92551,PURE TONE HEARING TEST AIR,,,12.48,12.48,1
HCPCS,92551,Pure tone hearing test air,,,19.1,24.12,6
HCPCS,92551,SCREENING TEST PURE TONE AIR ONLY,62.0,40.3,6.64,62.0,21
HCPCS,925510,PURE TONE HEARING TEST AIR,,,12.48,12.48,1
HCPCS,92552,AUDIOMETRY THRESHOLD TEST,645.0,419.25,19.1,580.5,41
HCPCS,92552,PURE TONE AUDIOMETRY AIR,,,37.38,37.38,1
HCPCS,92552,PURE TONE AUDIOMETRY AIR ONLY,127.0,82.55,12.75,127.0,35
HCPCS,925520,PURE TONE AUDIOMETRY AIR,,,37.38,37.38,1
HCPCS,92553,AUDIOMETRY AIR & BONE,,,45.24,45.24,1
HCPCS,92553,AUDIOMETRY AIR AND BONE,783.0,508.95,47.57,704.7,41
HCPCS,92553,PURE TONE AUDIOMETRY AIR & BONE,166.0,107.9,19.17,166.0,35
HCPCS,925530,AUDIOMETRY AIR & BONE,,,45.24,45.24,1
HCPCS,92555,SPEECH AUDIOMETRY THRESHOLD,191.0,124.14999999999999,11.0,450.0,76
HCPCS,92555,SPEECH THRESHOLD AUDIOMETRY,,,28.53,28.53,1
HCPCS,925550,SPEECH THRESHOLD AUDIOMETRY,,,28.53,28.53,1
HCPCS,92556,SPEECH AUDIOMETRY COMPLETE,,,44.26,44.26,1
HCPCS,92556,SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ,147.0,95.55,16.78,147.0,35
HCPCS,92556,SPEECH RECEPTION THRESHOLD,298.0,193.7,19.1,450.0,41
HCPCS,925560,SPEECH AUDIOMETRY COMPLETE,,,44.26,44.26,1
HCPCS,92557,AUDIOMETRY EVAL & SPEECH RECOG,783.0,508.95,37.02,704.7,41
HCPCS,92557,COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ,523.5,340.275,26.19,704.7,76
HCPCS,92557,COMPREHENSIVE HEARING TEST,,,32.79,32.79,1
HCPCS,925570,COMPREHENSIVE HEARING TEST,,,32.79,32.79,1
HCPCS,92558,EVOKED AUDITORY TEST QUAL,,,8.78,8.78,1
HCPCS,92558,Evoked auditory test qual,,,19.1,24.12,6
HCPCS,925580,EVOKED AUDITORY TEST QUAL,,,8.78,8.78,1
HCPCS,92559,Group audiometric testing,,,19.1,24.12,6
HCPCS,92560,Bekesy audiometry screen,,,19.1,24.12,6
HCPCS,92561,Bekesy audiometry diagnosis,,,19.1,24.12,6
HCPCS,92562,LOUDNESS BALANCE BINAURAL/MONAURAL,104.0,67.6,11.83,104.0,32
HCPCS,92562,LOUDNESS BALANCE TEST,,,47.53,675.17,15
HCPCS,92562,Loudness balance test,,,19.1,24.12,6
HCPCS,925620,LOUDNESS BALANCE TEST,,,47.53,47.53,1
HCPCS,92563,TONE DECAY,98.0,63.7,11.0,98.0,32
HCPCS,92563,TONE DECAY HEARING TEST,,,34.11,85.1,15
HCPCS,92563,Tone decay hearing test,,,19.1,24.12,6
HCPCS,925630,TONE DECAY HEARING TEST,,,34.11,34.11,1
HCPCS,92564,Sisi hearing test,,,19.1,24.12,6
HCPCS,92565,PURE TONE STENGER,100.0,65.0,11.51,100.0,32
HCPCS,92565,STENGER TEST PURE TONE,,,20.68,128.79,15
HCPCS,92565,Stenger test pure tone,,,19.1,24.12,6
HCPCS,925650,STENGER TEST PURE TONE,,,20.68,20.68,1
HCPCS,92567,TYMPANOMETRY,142.0,92.30000000000001,9.02,450.0,77
HCPCS,925670,TYMPANOMETRY,,,11.17,11.17,1
HCPCS,92568,ACOUSTIC REFL THRESHOLD TST,,,15.38,15.38,1
HCPCS,92568,ACOUSTIC REFLEX,116.0,75.4,11.0,87.0,35
HCPCS,92568,ACOUSTIC REFLEX THRESHOLD,196.0,127.4,18.09,450.0,41
HCPCS,925680,ACOUSTIC REFL THRESHOLD TST,,,15.38,15.38,1
HCPCS,92570,ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY,242.0,157.3,15.59,181.5,35
HCPCS,92570,ACOUSTIC IMMITANCE TESTING,,,30.01,339.23,15
HCPCS,92570,Acoustic immitance testing,,,47.57,60.08,6
HCPCS,925700,ACOUSTIC IMMITANCE TESTING,,,30.01,30.01,1
HCPCS,92571,FILTERED SPEECH TEST,,,30.5,85.1,15
HCPCS,92571,Filtered speech test,,,19.1,24.12,6
HCPCS,925710,FILTERED SPEECH TEST,,,30.5,30.5,1
HCPCS,92572,STAGGERED SPONDAIC WORD TEST,,,52.44,339.23,15
HCPCS,92572,Staggered spondaic word test,,,47.57,60.08,6
HCPCS,925720,STAGGERED SPONDAIC WORD TEST,,,52.44,52.44,1
HCPCS,92575,SENSORINEURAL ACUITY LVL TST,,,39.0,85.1,15
HCPCS,92575,Sensorineural acuity lvl tst,,,19.1,24.12,6
HCPCS,925750,SENSORINEURAL ACUITY LVL TST,,,72.79,72.79,1
HCPCS,92576,SYNTHETIC SENTENCE ID TEST,,,39.0,85.1,15
HCPCS,92576,Synthetic sentence id test,,,19.1,24.12,6
HCPCS,925760,SYNTHETIC SENTENCE ID TEST,,,41.97,41.97,1
HCPCS,92577,SPEECH STENGER,144.0,93.6,15.07,144.0,32
HCPCS,92577,STENGER TEST SPEECH,,,21.66,1150.43,15
HCPCS,92577,Stenger test speech,,,47.57,60.08,6
HCPCS,925770,STENGER TEST SPEECH,,,21.66,21.66,1
HCPCS,92579,VISUAL AUDIOMETRY (VRA),,,38.03,339.23,15
HCPCS,92579,Visual audiometry (vra),,,47.57,60.08,6
HCPCS,925790,VISUAL AUDIOMETRY (VRA),,,38.03,38.03,1
HCPCS,92582,AUDIOMETRY CONDITION PLAY,783.0,508.95,47.57,704.7,41
HCPCS,92582,CONDITIONING PLAY AUDIOMETRY,168.0,109.2,20.79,168.0,36
HCPCS,925820,CONDITIONING PLAY AUDIOMETRY,,,85.2,85.2,1
HCPCS,92583,SELECT PICTURE AUDIOMETRY,181.0,117.65,25.98,181.0,47
HCPCS,92583,Select picture audiometry,,,19.1,24.12,6
HCPCS,925830,SELECT PICTURE AUDIOMETRY,,,56.05,56.05,1
HCPCS,92584,ELECTROCOCHLEOGRAPHY,611.5,397.475,47.57,704.7,74
HCPCS,925840,ELECTROCOCHLEOGRAPHY,,,112.1,112.1,1
HCPCS,92585,Auditor evoke potent compre,,,47.57,60.08,6
HCPCS,92586,Auditor evoke potent limit,,,47.57,60.08,6
HCPCS,92587,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,154.0,100.1,16.6,154.0,35
HCPCS,92587,EVOKED AUDITORY TEST LIMITED,,,3.65,3.65,2
HCPCS,92587,TEST EVOKED AUDITORY LTD,1558.0,1012.7,29.07,1402.2,41
HCPCS,925870,EVOKED AUDITORY TEST LIMITED,,,3.65,3.65,1
HCPCS,92587TC,EVOKED AUDITORY TEST LIMITED,,,3.65,3.65,1
HCPCS,92588,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,242.0,157.3,25.53,242.0,35
HCPCS,92588,EVOKED AUDITORY TST COMPLETE,,,4.96,4.96,2
HCPCS,92588,TEST EVOKED AUDITORY COMPR,1558.0,1012.7,44.89,1402.2,41
HCPCS,925880,EVOKED AUDITORY TST COMPLETE,,,4.96,4.96,1
HCPCS,92588TC,EVOKED AUDITORY TST COMPLETE,,,4.96,4.96,1
HCPCS,92590,Hearing aid xm&slctn monaurl,,,19.1,24.12,6
HCPCS,92591,Hearing aid xm&slctn binaurl,,,19.1,24.12,6
HCPCS,92592,Hearing aid check monaural,,,19.1,24.12,6
HCPCS,92593,Hearing aid check binaural,,,19.1,24.12,6
HCPCS,92594,Electro hearng aid test one,,,19.1,24.12,6
HCPCS,92595,Electro hearng aid tst both,,,19.1,24.12,6
HCPCS,92596,EAR PROTECTOR ATTEN MEASURES,121.0,78.65,36.61,133.85,31
HCPCS,92596,EAR PROTECTOR EVALUATION,,,39.0,85.1,15
HCPCS,92596,Ear protector evaluation,,,19.1,24.12,6
HCPCS,925960,EAR PROTECTOR EVALUATION,,,75.7,75.7,1
HCPCS,92597,EVAL OF PT PRESCIP OF VOICE PROTHESIS,504.0,327.6,69.95,504.0,32
HCPCS,92597,EVAL&/FITG VOICE PROSTC DEV SUPLMNT ORAL SPEEC,504.0,327.6,69.95,504.0,32
HCPCS,92597,FIT PROSTHTIC VOICE DVC 440,795.0,516.75,93.3,723.0,49
HCPCS,92597,ORAL SPEECH DEVICE EVAL,,,75.28,75.28,1
HCPCS,925970,ORAL SPEECH DEVICE EVAL,,,75.28,75.28,1
HCPCS,92601,COCHLEAR IMPLT F/UP EXAM <7,,,126.18,339.23,15
HCPCS,92601,Cochlear implt f/up exam <7,,,21.15,26.71,6
HCPCS,926010,COCHLEAR IMPLT F/UP EXAM <7,,,126.18,126.18,1
HCPCS,92602,REPROGRAM COCHLEAR IMPLT <7,,,71.11,339.23,15
HCPCS,92602,Reprogram cochlear implt <7,,,21.15,26.71,6
HCPCS,926020,REPROGRAM COCHLEAR IMPLT <7,,,71.11,71.11,1
HCPCS,92603,COCHLEAR IMPLT F/UP EXAM 7/>,,,122.74,339.23,15
HCPCS,92603,Cochlear implt f/up exam 7/>,,,21.15,26.71,6
HCPCS,926030,COCHLEAR IMPLT F/UP EXAM 7/>,,,122.74,122.74,1
HCPCS,92604,REPROGRAM COCHLEAR IMPLT 7/>,,,68.0,339.23,15
HCPCS,92604,Reprogram cochlear implt 7/>,,,21.15,26.71,6
HCPCS,926040,REPROGRAM COCHLEAR IMPLT 7/>,,,68.0,68.0,1
HCPCS,92605,EX FOR NONSPEECH DEVICE RX,,,89.27,89.27,1
HCPCS,92605,Ex for nonspeech device rx,,,179.21,226.37,6
HCPCS,926050,EX FOR NONSPEECH DEVICE RX,,,89.27,89.27,1
HCPCS,92606,NON-SPEECH DEVICE SERVICE,,,70.99,70.99,1
HCPCS,92606,Non-speech device service,,,17.96,22.69,6
HCPCS,926060,NON-SPEECH DEVICE SERVICE,,,70.99,70.99,1
HCPCS,92607,EVAL SPCH - GEN DEV 1 HR,1775.0,1153.75,126.0,1597.5,49
HCPCS,92607,EX FOR SPEECH DEVICE RX 1HR,,,127.97,127.97,1
HCPCS,92607,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR,740.0,481.0,76.98,740.0,32
HCPCS,926070,EX FOR SPEECH DEVICE RX 1HR,,,127.97,127.97,1
HCPCS,92608,EVAL SPCH - GEN DEV 30 MN,215.0,139.75,53.75,723.0,49
HCPCS,92608,EX FOR SPEECH DEVICE RX ADDL,,,50.14,50.14,1
HCPCS,92608,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV EA 30 MIN,280.0,182.0,15.39,280.0,32
HCPCS,926080,EX FOR SPEECH DEVICE RX ADDL,,,50.14,50.14,1
HCPCS,92609,SLT-THERA SVC COM DEV PRG MOD,786.0,510.9,20.97,723.0,49
HCPCS,92609,THER SP-GENRATJ DEV PRGRMG&MODIFICAJ,600.0,390.0,41.79,600.0,32
HCPCS,92609,USE OF SPEECH DEVICE SERVICE,,,106.5,106.5,1
HCPCS,926090,USE OF SPEECH DEVICE SERVICE,,,106.5,106.5,1
HCPCS,92610,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,616.5,400.725,47.66,723.0,84
HCPCS,92610,EVALUATE SWALLOWING FUNCTION,713.0,463.45,73.12,723.0,50
HCPCS,926100,EVALUATE SWALLOWING FUNCTION,,,73.12,73.12,1
HCPCS,92611,MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,786.0,510.9,62.07,932.4,84
HCPCS,92611,MOTION FLUOROSCOPY/SWALLOW,,,94.99,94.99,1
HCPCS,92611,SWALLOW EVAL FUNC FLUORO GN,1036.0,673.4,71.29,932.4,49
HCPCS,926110,MOTION FLUOROSCOPY/SWALLOW,,,94.99,94.99,1
HCPCS,92612,ENDOSCOPY SWALLOW (FEES) VID,,,68.85,68.85,1
HCPCS,92612,FEES W CINE OR VIDEO,1355.0,880.75,74.78,1219.5,49
HCPCS,92612,FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC,931.5,605.475,42.16,1219.5,84
HCPCS,926120,ENDOSCOPY SWALLOW (FEES) VID,,,68.85,68.85,1
HCPCS,92613,ENDOSCOPY SWALLOW (FEES) I&R,,,37.82,37.82,1
HCPCS,92613,Endoscopy swallow (fees) i&r,,,112.01,141.49,6
HCPCS,92613,FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC I&R,312.0,202.8,31.37,312.0,31
HCPCS,926130,ENDOSCOPY SWALLOW (FEES) I&R,,,37.82,37.82,1
HCPCS,92614,LARYNGOSCOPIC SENSORY VID,,,67.91,171.43,22
HCPCS,92614,Laryngoscopic sensory vid,,,112.01,141.49,6
HCPCS,926140,LARYNGOSCOPIC SENSORY VID,,,67.91,67.91,1
HCPCS,92615,LARYNGOSCOPIC SENSORY I&R,,,33.96,33.96,1
HCPCS,92615,Laryngoscopic sensory i&r,,,112.01,141.49,6
HCPCS,926150,LARYNGOSCOPIC SENSORY I&R,,,33.96,33.96,1
HCPCS,92616,FEES W/LARYNGEAL SENSE TEST,,,103.06,103.06,1
HCPCS,92616,FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V REC,637.0,414.05,48.01,723.0,84
HCPCS,926160,FEES W/LARYNGEAL SENSE TEST,,,103.06,103.06,1
HCPCS,92617,FEES W/LARYNGEAL SENSE I&R,,,42.38,42.38,1
HCPCS,92617,FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V I&R,348.0,226.2,35.26,348.0,31
HCPCS,92617,Fees w/laryngeal sense i&r,,,112.01,141.49,6
HCPCS,926170,FEES W/LARYNGEAL SENSE I&R,,,42.38,42.38,1
HCPCS,92618,EX FOR NONSPEECH DEV RX ADD,,,33.04,33.04,1
HCPCS,92618,Ex for nonspeech dev rx add,,,179.21,226.37,6
HCPCS,926180,EX FOR NONSPEECH DEV RX ADD,,,33.04,33.04,1
HCPCS,92620,AUDITORY FUNCTION 60 MIN,,,81.66,339.23,15
HCPCS,92620,Auditory function 60 min,,,179.21,226.37,6
HCPCS,926200,AUDITORY FUNCTION 60 MIN,,,81.66,81.66,1
HCPCS,92621,AUDITORY FUNCTION + 15 MIN,,,19.18,19.18,1
HCPCS,92621,Auditory function + 15 min,,,179.21,226.37,6
HCPCS,926210,AUDITORY FUNCTION + 15 MIN,,,19.18,19.18,1
HCPCS,92622,DX ALY AUD OI SND PRCSR 1ST,,,68.32,339.23,15
HCPCS,92622,Dx aly aud oi snd prcsr 1st,,,21.15,26.71,6
HCPCS,926220,DX ALY AUD OI SND PRCSR 1ST,,,68.32,68.32,1
HCPCS,92623,DX ALY AUD OI SND PRCSR EACH,,,18.13,18.13,1
HCPCS,92623,Dx aly aud oi snd prcsr each,,,21.15,26.71,6
HCPCS,926230,DX ALY AUD OI SND PRCSR EACH,,,18.13,18.13,1
HCPCS,92625,TINNITUS ASSESSMENT,460.0,299.0,25.63,345.0,47
HCPCS,92625,Tinnitus assessment,,,47.57,60.08,6
HCPCS,926250,TINNITUS ASSESSMENT,,,62.8,62.8,1
HCPCS,92626,EVAL AUD FUNCJ 1ST HOUR,,,76.7,76.7,1
HCPCS,92626,EVAL AUD REHAB STATUS,783.0,508.95,86.36,704.7,41
HCPCS,926260,EVAL AUD FUNCJ 1ST HOUR,,,76.7,76.7,1
HCPCS,92627,EVAL AUD FUNCJ EA ADDL 15,,,18.13,18.13,1
HCPCS,92627,Eval aud funcj ea addl 15,,,179.21,226.37,6
HCPCS,926270,EVAL AUD FUNCJ EA ADDL 15,,,18.13,18.13,1
HCPCS,92628,EVALUATION HEARING AID CANDIDACY 1ST 30 MINUTES,245.5,159.575,19.1,450.0,42
HCPCS,92629,EVALUATION HEARING AID CANDIDACY EA ADDL 15 MIN,196.0,127.4,19.1,450.0,30
HCPCS,92630,AUD REHAB PRE-LING HEAR LOSS,,,95.18,95.18,1
HCPCS,92630,Aud rehab pre-ling hear loss,,,17.96,22.69,6
HCPCS,926300,AUD REHAB PRE-LING HEAR LOSS,,,95.18,95.18,1
HCPCS,92631,HEARING AID SELECTION SERVICES 1ST 30 MINUTES,245.5,159.575,19.1,450.0,42
HCPCS,92632,HEARING AID SELECTION SERVICES EA ADDL 15 MIN,196.0,127.4,19.1,450.0,30
HCPCS,92633,AUD REHAB POSTLING HEAR LOSS,,,59.54,59.54,1
HCPCS,92633,Aud rehab postling hear loss,,,17.96,22.69,6
HCPCS,926330,AUD REHAB POSTLING HEAR LOSS,,,59.54,59.54,1
HCPCS,92634,HEARING AID FITTING SERVICES 1ST 60 MINUTES,541.5,351.975,19.1,704.7,42
HCPCS,92635,HEARING AID FITTING SERVICES EA ADDL 15 MINUTES,196.0,127.4,19.1,450.0,30
HCPCS,92636,HEARING AID POST-FITTING F-UP SVC 1ST 30 MINUTES,220.5,143.325,19.1,450.0,42
HCPCS,92637,HEARING AID POST-FITTING F-UP SVC EA ADDL 15 MIN,110.5,71.825,12.5,450.0,42
HCPCS,92638,BEHAVIORAL VERIFICATION OF AMPLIFICATION,783.0,508.95,19.1,704.7,30
HCPCS,92639,HEARING AID MEAS VERIF W/PROBE MICROPHONE,783.0,508.95,19.1,704.7,30
HCPCS,92640,AUD BRAINSTEM IMPLT PROGRAMG,,,96.2,339.23,15
HCPCS,92640,Aud brainstem implt programg,,,20.97,26.48,6
HCPCS,926400,AUD BRAINSTEM IMPLT PROGRAMG,,,96.2,96.2,1
HCPCS,92641,HEARING DEVICE VERIFICATION ELECTROACOUSTIC ALYS,783.0,508.95,19.1,704.7,30
HCPCS,92642,HEARING ASSISTIVE DEVICE SUPPL TECH FITTING SVC,441.5,286.975,19.1,704.7,42
HCPCS,92650,AEP SCR AUDITORY POTENTIAL,,,27.42,27.42,1
HCPCS,92650,AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS,449.5,292.175,19.1,839.0,80
HCPCS,926500,AEP SCR AUDITORY POTENTIAL,,,27.42,27.42,1
HCPCS,92651,AEP HEARING STATUS DETER BROADBAND STIMULI I&R,979.0,636.35,47.57,1402.2,72
HCPCS,92651,AEP HEARING STATUS DETER I&R,,,84.64,84.64,1
HCPCS,926510,AEP HEARING STATUS DETER I&R,,,84.64,84.64,1
HCPCS,92652,AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R,1079.0,701.35,47.57,1402.2,113
HCPCS,92652,AEP THRSHLD EST MLT FREQ I&R,,,115.19,115.19,1
HCPCS,926520,AEP THRSHLD EST MLT FREQ I&R,,,115.19,115.19,1
HCPCS,92653,AEP NEURODIAGNOSTIC I&R,,,85.17,85.17,1
HCPCS,92653,AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT,989.0,642.85,47.57,1402.2,113
HCPCS,926530,AEP NEURODIAGNOSTIC I&R,,,85.17,85.17,1
HCPCS,92700,EPLEY MANUVER,101.0,65.65,39.43,101.0,15
HCPCS,92700,ESTABLISHED PT. MINIMUM SERVICE,45.0,29.25,22.5,47.32,15
HCPCS,92700,FISTULA,51.0,33.15,25.5,51.0,15
HCPCS,92700,HAEARING AID CLEANING MON.,11.0,7.15,5.5,47.32,15
HCPCS,92700,HEARING AID CLEANING BIR.,30.0,19.5,15.0,47.32,15
HCPCS,92700,PIPB,30.0,19.5,15.0,47.32,15
HCPCS,92700,REPLACE BATTERY DOOR,5.0,3.25,2.5,47.32,15
HCPCS,92700,SWIMPLUG,48.0,31.2,24.0,48.0,15
HCPCS,92700,VIDEO HEAD IMPULSE TEST,319.0,207.35,24.58,450.0,40
HCPCS,92700,VIDEO HEAD IMPULSE TEST (COMP CODE 92541),172.0,111.8,39.43,172.0,15
HCPCS,92920,PRQ CARD ANGIOPLAST 1 ART LC,40980.0,26637.0,512.69,44585.0,49
HCPCS,92920,PRQ CARD ANGIOPLAST 1 ART LD,40980.0,26637.0,512.69,44585.0,49
HCPCS,92920,PRQ CARD ANGIOPLAST 1 ART LM,40980.0,26637.0,512.69,44585.0,49
HCPCS,92920,PRQ CARD ANGIOPLAST 1 ART RC,40980.0,26637.0,512.69,44585.0,49
HCPCS,92920,PRQ CARD ANGIOPLAST 1 ART RI,40980.0,26637.0,512.69,44585.0,49
HCPCS,92920,PRQ CARDIAC ANGIOPLAST 1 ART,40980.0,26637.0,512.69,44585.0,49
HCPCS,92920,PRQ TRLUML C ANGIOP 1ART&/BR,,,547.3,547.3,1
HCPCS,92920,PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH,22657.0,14727.05,303.24,44585.0,80
HCPCS,929200,PRQ TRLUML C ANGIOP 1ART&/BR,,,547.3,547.3,1
HCPCS,92921,Prq cardiac angio addl art,,,5298.24,6692.51,6
HCPCS,92924,PRQ CARD ANGIO/ATHREC 1 ART LC,37755.0,24540.75,621.79,44585.0,49
HCPCS,92924,PRQ CARD ANGIO/ATHREC 1 ART LD,37755.0,24540.75,621.79,44585.0,49
HCPCS,92924,PRQ CARD ANGIO/ATHREC 1 ART LM,37755.0,24540.75,621.79,44585.0,49
HCPCS,92924,PRQ CARD ANGIO/ATHREC 1 ART RC,37755.0,24540.75,621.79,44585.0,49
HCPCS,92924,PRQ CARD ANGIO/ATHREC 1 ART RI,37755.0,24540.75,621.79,44585.0,49
HCPCS,92924,PRQ CARDIAC ANGIO/ARTHRECT 1 ART,37755.0,24540.75,621.79,44585.0,49
HCPCS,92924,PRQ TRLUML C ATHRC 1 ART&/BR,,,652.87,652.87,1
HCPCS,92924,PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH,21225.5,13796.575,360.16,44585.0,80
HCPCS,929240,PRQ TRLUML C ATHRC 1 ART&/BR,,,652.87,652.87,1
HCPCS,92925,Prq card angio/athrect addl,,,5298.24,6692.51,6
HCPCS,92928,PRQ CARDIAC STENT W/ANGIO 1 VSL,52851.0,34353.15,614.16,47565.9,49
HCPCS,92928,PRQ PLC BM STNT W/ANG 1 VSL LC,52851.0,34353.15,614.16,47565.9,49
HCPCS,92928,PRQ PLC BM STNT W/ANG 1 VSL RI,52851.0,34353.15,614.16,47565.9,49
HCPCS,92928,PRQ TCAT PLMT NTRAC ST 1 LES,,,608.94,608.94,1
HCPCS,92928,PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH,4822.0,3134.3,337.02,4822.0,31
HCPCS,929280,PRQ TCAT PLMT NTRAC ST 1 LES,,,608.94,608.94,1
HCPCS,92929,Prq card stent w/angio addl,,,5298.24,6692.51,6
HCPCS,92930,PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS,83407.5,54214.875,532.19,145381.5,60
HCPCS,92930,PRQ TCAT PLMT NTRAC ST 2+LES,,,592.8,592.8,1
HCPCS,929300,PRQ TCAT PLMT NTRAC ST 2+LES,,,592.8,592.8,1
HCPCS,92933,PRQ PLC BM STENT/ATH/ANGIO LC,56518.0,36736.7,733.03,50866.2,49
HCPCS,92933,PRQ PLC BM STENT/ATH/ANGIO LD,56518.0,36736.7,733.03,50866.2,49
HCPCS,92933,PRQ PLC BM STENT/ATH/ANGIO LM,56518.0,36736.7,733.03,50866.2,49
HCPCS,92933,PRQ PLC BM STENT/ATH/ANGIO RC,56518.0,36736.7,733.03,50866.2,49
HCPCS,92933,PRQ PLC BM STENT/ATH/ANGIO RI,56518.0,36736.7,733.03,50866.2,49
HCPCS,92933,PRQ PLC DES/ATH/ANGIO 1 ART RI,56518.0,36736.7,733.03,50866.2,49
HCPCS,92933,PRQ TRLML C ATHRC ST ANGIOP1,,,682.99,682.99,1
HCPCS,92933,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,30963.0,20125.949999999997,376.99,50866.2,80
HCPCS,929330,PRQ TRLML C ATHRC ST ANGIOP1,,,682.99,682.99,1
HCPCS,92934,Prq card stent/ath/angio,,,5298.24,6692.51,6
HCPCS,92937,PRQ BM REVASC CABG 1 VSL,55843.0,36297.95,693.62,50258.7,49
HCPCS,92937,PRQ BM REVASC CABG 1 VSL RI,55843.0,36297.95,693.62,50258.7,49
HCPCS,92937,PRQ BM REVASC CAGB 1 VSL LM,55843.0,36297.95,693.62,50258.7,49
HCPCS,92937,PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL,4818.0,3131.7,336.78,4818.0,31
HCPCS,92937,PRQ TRLUML REVSC CAB GRF 1,,,608.95,608.95,1
HCPCS,929370,PRQ TRLUML REVSC CAB GRF 1,,,608.95,608.95,1
HCPCS,92938,Prq revasc byp graft addl,,,5298.24,6692.51,6
HCPCS,92941,PRQ BM REVASC W/AMI 1 VSL LD,41313.0,26853.45,780.97,44585.0,39
HCPCS,92941,PRQ BM REVASC W/AMI 1 VSL LM,41313.0,26853.45,780.97,44585.0,39
HCPCS,92941,PRQ BM REVASC W/AMI 1 VSL RC,41313.0,26853.45,780.97,44585.0,39
HCPCS,92941,PRQ BM REVASC W/AMI 1 VSL RI,41313.0,26853.45,780.97,44585.0,39
HCPCS,92941,PRQ CARD REVASC MI 1 VSL,41313.0,26853.45,780.97,44585.0,39
HCPCS,92941,PRQ TRLML REVSC TOT OCCL AMI,,,683.67,683.67,1
HCPCS,92941,PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL,4924.0,3200.6,377.76,4924.0,31
HCPCS,929410,PRQ TRLML REVSC TOT OCCL AMI,,,683.67,683.67,1
HCPCS,92943,PRQ BM REVASC CTO 1 VSL LD,47928.0,31153.2,840.03,44585.0,49
HCPCS,92943,PRQ BM REVASC CTO 1 VSL LM,47928.0,31153.2,840.03,44585.0,49
HCPCS,92943,PRQ BM REVASC CTO 1 VSL RI,47928.0,31153.2,840.03,44585.0,49
HCPCS,92943,PRQ DES REVASC CHRONIC 1VSL,47928.0,31153.2,840.03,44585.0,49
HCPCS,92943,PRQ DES REVASC CTO 1 VSL RI,47928.0,31153.2,840.03,44585.0,49
HCPCS,92943,PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL,5416.0,3520.4,377.76,5416.0,31
HCPCS,92943,PRQ TRLUML REVSC CH OCC ANT,,,683.72,683.72,1
HCPCS,929430,PRQ TRLUML REVSC CH OCC ANT,,,683.72,683.72,1
HCPCS,92944,Prq card revasc chronic addl,,,5298.24,6692.51,6
HCPCS,92945,PERQ TRLUML REVSC CHRNC TOT OCCLS 1 ANTGRD&RTRGR,54162.5,35205.625,665.63,91552.5,60
HCPCS,92945,PRQ TRL RVS CH OCC ANT&RTRGR,,,741.29,741.29,1
HCPCS,929450,PRQ TRL RVS CH OCC ANT&RTRGR,,,741.29,741.29,1
HCPCS,92950,CARDIO-PULMONARY RESUSCITATION,1760.0,1144.0,88.61,1320.0,35
HCPCS,92950,CARDIOPULMONARY RESUSCITATION,2239.0,1455.35,225.48,2015.1,82
HCPCS,92950,HEART/LUNG RESUSCITATION CPR,,,210.91,210.91,1
HCPCS,929500,HEART/LUNG RESUSCITATION CPR,,,210.91,210.91,1
HCPCS,92953,TEMPORARY EXTERNAL PACING,,,1.17,1.17,1
HCPCS,92953,TEMPORARY TRANSCUTANEOUS PACING,2354.5,1530.425,0.96,4233.6,125
HCPCS,929530,TEMPORARY EXTERNAL PACING,,,1.17,1.17,1
HCPCS,92960,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,2792.0,1814.8,53.02,4233.6,174
HCPCS,92960,CARDIOVERSION ELECTRIC EXT,,,122.32,122.32,1
HCPCS,929600,CARDIOVERSION ELECTRIC EXT,,,122.32,122.32,1
HCPCS,92961,CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX,3220.0,2093.0,146.39,4233.6,76
HCPCS,92961,CARDIOVERSION ELECTRIC INT,,,277.85,277.85,1
HCPCS,92961,"CARDIOVERSION, INTERNAL",4704.0,3057.6,282.29,37851.0,49
HCPCS,929610,CARDIOVERSION ELECTRIC INT,,,277.85,277.85,1
HCPCS,92970,CARDIOASSIST INTERNAL,,,214.71,214.71,1
HCPCS,92970,Cardioassist internal,,,2417.66,3053.89,6
HCPCS,929700,CARDIOASSIST INTERNAL,,,214.71,214.71,1
HCPCS,92971,CARDIOASSIST EXTERNAL,,,113.71,113.71,1
HCPCS,92971,Cardioassist external,,,404.42,510.84,6
HCPCS,929710,CARDIOASSIST EXTERNAL,,,113.71,113.71,1
HCPCS,92972,PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY,3817.5,2481.375,104.37,37851.0,64
HCPCS,92972,PERQ TRLUML CORONRY LITHOTRP,,,165.86,165.86,1
HCPCS,929720,PERQ TRLUML CORONRY LITHOTRP,,,165.86,165.86,1
HCPCS,92973,PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY,3044.0,1978.6,92.9,37851.0,74
HCPCS,92973,PRQ TRLUML C MCHN ASP THRMBC,,,200.65,200.65,1
HCPCS,929730,PRQ TRLUML C MCHN ASP THRMBC,,,200.65,200.65,1
HCPCS,92974,CATH PLACE CARDIO BRACHYTX,,,183.88,183.88,1
HCPCS,92974,TCAT PLACEMENT RADJ DLVR DEV SBSQ C IV BRACHYTX,1200.0,780.0,114.05,1200.0,35
HCPCS,929740,CATH PLACE CARDIO BRACHYTX,,,183.88,183.88,1
HCPCS,92975,Dissolve clot heart vessel,,,2928.25,3698.84,6
HCPCS,92977,DISSOLVE CLOT HEART VESSEL,,,332.94,719.16,10
HCPCS,92977,Dissolve clot heart vessel,,,307.14,387.97,6
HCPCS,92978,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,6328.0,4113.2,78.16,37851.0,86
HCPCS,92978,ENDOLUMINL IVUS OCT C 1ST,,,186.06,186.06,2
HCPCS,929780,ENDOLUMINL IVUS OCT C 1ST,,,186.06,186.06,1
HCPCS,92978TC,ENDOLUMINL IVUS OCT C 1ST,,,186.06,186.06,1
HCPCS,92979,ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,4881.0,3172.65,62.81,37851.0,86
HCPCS,92979,ENDOLUMINL IVUS OCT C EA,,,93.21,93.21,2
HCPCS,929790,ENDOLUMINL IVUS OCT C EA,,,93.21,93.21,1
HCPCS,92979TC,ENDOLUMINL IVUS OCT C EA,,,93.21,93.21,1
HCPCS,92986,PRQ BALLOON VALVULOPLASTY AORTIC VALVE,17619.5,11452.675,888.29,44585.0,84
HCPCS,92986,PTCA AORTIC VALVE,26199.0,17029.35,1519.68,44585.0,49
HCPCS,92986,REVISION OF AORTIC VALVE,,,1508.73,1508.73,1
HCPCS,929860,REVISION OF AORTIC VALVE,,,1508.73,1508.73,1
HCPCS,92987,PRQ BALLOON VALVULOPLASTY MITRAL VALVE,27185.5,17670.575,916.71,44585.0,84
HCPCS,92987,PTCA MITRAL VALVE,45019.0,29262.35,1569.43,44585.0,49
HCPCS,92987,REVISION OF MITRAL VALVE,,,1555.02,1555.02,1
HCPCS,929870,REVISION OF MITRAL VALVE,,,1555.02,1555.02,1
HCPCS,92990,REVISION OF PULMONARY VALVE,,,1243.62,24588.22,15
HCPCS,92990,Revision of pulmonary valve,,,5298.24,6692.51,6
HCPCS,929900,REVISION OF PULMONARY VALVE,,,1243.62,1243.62,1
HCPCS,92992,Revision of heart chamber,,,5298.24,6692.51,6
HCPCS,92993,Revision of heart chamber,,,5298.24,6692.51,6
HCPCS,92997,PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL,43151.0,28048.15,473.63,73359.0,84
HCPCS,92997,PUL ART BALLOON REPR PERCUT,,,720.96,720.96,1
HCPCS,929970,PUL ART BALLOON REPR PERCUT,,,720.96,720.96,1
HCPCS,92998,PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL,4819.5,3132.675,238.22,44585.0,74
HCPCS,92998,PUL ART BALLOON REPR PERCUT,,,362.39,362.39,1
HCPCS,929980,PUL ART BALLOON REPR PERCUT,,,362.39,362.39,1
HCPCS,93000,ECG ROUTINE ECG W/LEAST 12 LDS W/I&R,297.0,193.05,10.98,467.1,74
HCPCS,93000,EKG PROF /TECH,75.0,48.75,10.98,75.0,35
HCPCS,93000,ELECTROCARDIOGRAM COMPLETE,75.0,48.75,10.98,75.0,36
HCPCS,930000,ELECTROCARDIOGRAM COMPLETE,,,16.19,16.19,1
HCPCS,93005,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,361.5,234.975,4.85,385.2,133
HCPCS,93005,ELECTROCARDIOGRAM TRACING,,,6.89,6.89,2
HCPCS,930050,ELECTROCARDIOGRAM TRACING,,,6.89,6.89,1
HCPCS,93005TC,ELECTROCARDIOGRAM TRACING,,,6.89,6.89,1
HCPCS,93010,ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY,75.0,48.75,6.13,75.0,35
HCPCS,93010,ELECTROCARDIOGRAM REPORT,,,9.29,9.29,1
HCPCS,93010,Electrocardiogram report,,,16.03,20.24,6
HCPCS,930100,ELECTROCARDIOGRAM REPORT,,,9.29,9.29,1
HCPCS,93015,CV STRESS TEST SUPVJ I&R,,,80.64,80.64,1
HCPCS,93015,CV STRS TST XERS&/OR RX CONT ECG W/SI&R,330.0,214.5,55.92,330.0,35
HCPCS,93015,Cv stress test supvj i&r,,,103.01,130.12,6
HCPCS,930150,CV STRESS TEST SUPVJ I&R,,,80.64,80.64,1
HCPCS,93016,CV STRESS TEST SUPVJ ONLY,,,23.97,23.97,1
HCPCS,93016,CV STRS TST XERS&/OR RX CONT ECG W/O I&R,198.0,128.7,15.83,198.0,35
HCPCS,93016,Cv stress test supvj only,,,103.01,130.12,6
HCPCS,930160,CV STRESS TEST SUPVJ ONLY,,,23.97,23.97,1
HCPCS,93017,CV STRESS TEST TRACING ONLY,,,40.8,40.8,2
HCPCS,93017,CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,1378.0,895.6999999999999,30.88,2693.0,81
HCPCS,930170,CV STRESS TEST TRACING ONLY,,,40.8,40.8,1
HCPCS,93017TC,CV STRESS TEST TRACING ONLY,,,40.8,40.8,1
HCPCS,93018,CV STRESS TEST I&R ONLY,,,15.88,15.88,1
HCPCS,93018,CV STRS TST XERS&/OR RX CONT ECG I&R ONLY,132.0,85.8,10.72,132.0,35
HCPCS,93018,Cv stress test i&r only,,,103.01,130.12,6
HCPCS,930180,CV STRESS TEST I&R ONLY,,,15.88,15.88,1
HCPCS,93024,ERGONOVINE PROVOCATION TEST,,,62.83,865.18,16
HCPCS,93024,ERGONOVINE PROVOCATION TST,2868.0,1864.2,47.82,3383.0,101
HCPCS,93024,Ergonovine provocation test,,,103.01,130.12,6
HCPCS,930240,ERGONOVINE PROVOCATION TEST,,,62.83,62.83,1
HCPCS,93024TC,ERGONOVINE PROVOCATION TEST,,,62.83,62.83,1
HCPCS,93025,MICROVOLT T-WAVE ASSESS,300.0,195.0,95.93,339.23,51
HCPCS,93025,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,1125.0,731.25,31.69,1425.0,101
HCPCS,93025,MICROVOLT T-WAVE ASSESSMENT,1425.0,926.25,97.79,1425.0,35
HCPCS,93025,Microvolt t-wave assess,,,33.85,42.76,6
HCPCS,930250,MICROVOLT T-WAVE ASSESS,,,95.93,95.93,1
HCPCS,93025TC,MICROVOLT T-WAVE ASSESS,,,95.93,95.93,1
HCPCS,93040,RHYTHM ECG 1-3 LEADS W/INTERPRETATION & REPORT,60.0,39.0,10.43,60.0,32
HCPCS,93040,RHYTHM ECG WITH REPORT,,,14.68,14.68,1
HCPCS,93040,Rhythm ecg with report,,,16.03,20.24,6
HCPCS,930400,RHYTHM ECG WITH REPORT,,,14.68,14.68,1
HCPCS,93041,RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R,72.0,46.8,3.88,72.0,32
HCPCS,93041,RHYTHM ECG TRACING,,,6.89,128.79,16
HCPCS,93041,Rhythm ecg tracing,,,16.03,20.24,6
HCPCS,930410,RHYTHM ECG TRACING,,,6.89,6.89,1
HCPCS,93041TC,RHYTHM ECG TRACING,,,6.89,6.89,1
HCPCS,93042,RHYTHM ECG 1-3 LEADS INTERPRETATION & REPRT ON,66.0,42.9,6.07,66.0,32
HCPCS,93042,RHYTHM ECG REPORT,,,7.78,7.78,1
HCPCS,93042,Rhythm ecg report,,,16.03,20.24,6
HCPCS,930420,RHYTHM ECG REPORT,,,7.78,7.78,1
HCPCS,93050,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,176.0,114.4,8.01,244.0,97
HCPCS,93050,ART PRESSURE WAVEFORM ANALYS,,,8.69,53.1,16
HCPCS,93050,Art pressure waveform analys,,,33.85,42.76,6
HCPCS,930500,ART PRESSURE WAVEFORM ANALYS,,,8.69,8.69,1
HCPCS,93050TC,ART PRESSURE WAVEFORM ANALYS,,,8.69,8.69,1
HCPCS,93145,INTERROG CRTD SINS BAT IP WO,,,29.55,29.55,1
HCPCS,93145,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP WO,710.0,461.5,21.15,2693.0,63
HCPCS,931450,INTERROG CRTD SINS BAT IP WO,,,29.55,29.55,1
HCPCS,93146,INTERROG CRTD SINS BAT IP W/,,,41.56,41.56,1
HCPCS,93146,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP W/,765.0,497.25,21.15,2693.0,63
HCPCS,931460,INTERROG CRTD SINS BAT IP W/,,,41.56,41.56,1
HCPCS,93150,THER ACTIVATION IMPL PHRENIC NRV STIMULATOR SYS,582.5,378.625,21.15,839.0,69
HCPCS,93150,THERAPY ACTIVATION IPNSS,,,48.68,48.68,1
HCPCS,931500,THERAPY ACTIVATION IPNSS,,,48.68,48.68,1
HCPCS,93151,INTERROG&PRGRMG IMPL PHRENIC NRV STIMULATOR SYS,571.5,371.475,21.15,839.0,69
HCPCS,93151,INTERROG&PRGRMG IPNSS,,,45.98,45.98,1
HCPCS,931510,INTERROG&PRGRMG IPNSS,,,45.98,45.98,1
HCPCS,93152,INTERROG&PRGRMG IPNSS DURING POLYSOMNOGRAPHY,1693.5,1100.775,21.15,2327.4,69
HCPCS,93152,INTERROG&PRGRMG IPNSS POLYSM,,,107.19,107.19,1
HCPCS,931520,INTERROG&PRGRMG IPNSS POLYSM,,,107.19,107.19,1
HCPCS,93153,INTERROG W/O PRGRMG IPNSS,,,24.76,24.76,1
HCPCS,93153,INTERROGATION WITHOUT PROGRAMMING IPNSS,490.0,318.5,15.58,839.0,69
HCPCS,931530,INTERROG W/O PRGRMG IPNSS,,,24.76,24.76,1
HCPCS,93224,XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I,172.0,111.8,53.87,172.0,35
HCPCS,93224,XTRNL ECG REC UP TO 48 HRS,,,79.34,79.34,1
HCPCS,93224,Xtrnl ecg rec up to 48 hrs,,,33.85,42.76,6
HCPCS,932240,XTRNL ECG REC UP TO 48 HRS,,,79.34,79.34,1
HCPCS,93225,XTRNL ECG & 48 HR RECORDING,641.5,416.975,10.71,833.4,84
HCPCS,93225,XTRNL ECG REC<48 HRS REC,,,19.86,19.86,2
HCPCS,932250,XTRNL ECG REC<48 HRS REC,,,19.86,19.86,1
HCPCS,93225TC,XTRNL ECG REC<48 HRS REC,,,19.86,19.86,1
HCPCS,93226,EXTERNAL ECG SCANNING ANALYSIS REPORT,750.0,487.5,20.28,750.0,35
HCPCS,93226,XTRNL ECG REC<48 HR SCAN A/R,,,38.6,128.79,16
HCPCS,93226,Xtrnl ecg rec<48 hr scan a/r,,,33.85,42.76,6
HCPCS,932260,XTRNL ECG REC<48 HR SCAN A/R,,,38.6,38.6,1
HCPCS,93226TC,XTRNL ECG REC<48 HR SCAN A/R,,,38.6,38.6,1
HCPCS,93227,XTRNL ECG CONTINUOUS RHYTHM W/I&R UP TO 48 HRS,172.0,111.8,13.79,172.0,35
HCPCS,93227,XTRNL ECG REC<48 HR R&I,,,20.88,20.88,1
HCPCS,93227,Xtrnl ecg rec<48 hr r&i,,,33.85,42.76,6
HCPCS,932270,XTRNL ECG REC<48 HR R&I,,,20.88,20.88,1
HCPCS,93228,REMOTE 30 DAY ECG REV/REPORT,,,28.49,28.49,1
HCPCS,93228,Remote 30 day ecg rev/report,,,23.85,30.13,6
HCPCS,93228,XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS,211.0,137.15,19.15,211.0,35
HCPCS,932280,REMOTE 30 DAY ECG REV/REPORT,,,28.49,28.49,1
HCPCS,93229,REMOTE 30 DAY ECG TECH SUPP,,,312.58,880.19,15
HCPCS,93229,Remote 30 day ecg tech supp,,,23.85,30.13,6
HCPCS,932290,REMOTE 30 DAY ECG TECH SUPP,,,880.19,880.19,1
HCPCS,93241,EXTERNAL ECG REC>48HR<7D SCAN ALYS REPORT R&I,220.0,143.0,65.25,449.4,31
HCPCS,93241,XTRNL ECG REC>48HR<7D,,,281.16,281.16,1
HCPCS,93241,Xtrnl ecg rec>48hr<7d,,,33.85,42.76,6
HCPCS,932410,XTRNL ECG REC>48HR<7D,,,281.16,281.16,1
HCPCS,93242,EXT ECG>48HR<7D RECORDING,,,13.01,13.01,1
HCPCS,93242,EXTERNAL ECG REC>48HR<7D RECORDING,305.5,198.575,6.99,474.0,80
HCPCS,932420,EXT ECG>48HR<7D RECORDING,,,13.01,13.01,1
HCPCS,93243,EXT ECG>48HR<7D SCAN A/R,,,129.39,279.48,15
HCPCS,93243,EXTERNAL ECG REC>48HR<7D SCANNING ALYS W/REPORT,370.0,240.5,136.96,387.95,31
HCPCS,93243,Ext ecg>48hr<7d scan a/r,,,33.85,42.76,6
HCPCS,932430,EXT ECG>48HR<7D SCAN A/R,,,241.78,241.78,1
HCPCS,93244,EXT ECG>48HR<7D REV&INTERPJ,,,26.35,26.35,1
HCPCS,93244,EXTERNAL ECG REC>48HR<7D REVIEW & INTERPRETATION,200.0,130.0,17.36,200.0,31
HCPCS,93244,Ext ecg>48hr<7d rev&interpj,,,33.85,42.76,6
HCPCS,932440,EXT ECG>48HR<7D REV&INTERPJ,,,26.35,26.35,1
HCPCS,93245,EXT ECG>7D<15D REC SCAN A/R,,,295.74,295.74,1
HCPCS,93245,EXTERNAL ECG REC>7D<15D SCAN ALYS REPORT R&I,220.0,143.0,65.25,472.52,31
HCPCS,93245,Ext ecg>7d<15d rec scan a/r,,,33.85,42.76,6
HCPCS,932450,EXT ECG>7D<15D REC SCAN A/R,,,295.74,295.74,1
HCPCS,93246,EXT ECG>7D<15D RECORDING,,,13.01,13.01,1
HCPCS,93246,EXTERNAL ECG REC>7D<15D RECORDING,305.5,198.575,6.99,474.0,80
HCPCS,932460,EXT ECG>7D<15D RECORDING,,,13.01,13.01,1
HCPCS,93247,EXT ECG>7D<15D SCAN A/R,,,129.39,279.48,15
HCPCS,93247,EXTERNAL ECG REC>7D<15D SCANNING ALYS W/REPORT,370.0,240.5,142.05,407.0,31
HCPCS,93247,Ext ecg>7d<15d scan a/r,,,33.85,42.76,6
HCPCS,932470,EXT ECG>7D<15D SCAN A/R,,,253.67,253.67,1
HCPCS,93248,EXT ECG>7D<15D REV&INTERPJ,,,29.05,29.05,1
HCPCS,93248,EXTERNAL ECG REC>7D<15D REVIEW & INTERPRETATION,242.0,157.3,19.15,242.0,31
HCPCS,93248,Ext ecg>7d<15d rev&interpj,,,33.85,42.76,6
HCPCS,932480,EXT ECG>7D<15D REV&INTERPJ,,,29.05,29.05,1
HCPCS,93260,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,321.0,208.64999999999998,21.15,2693.0,77
HCPCS,93260,PRGRMG DEV EVAL IMPLTBL SYS,,,37.88,37.88,2
HCPCS,932600,PRGRMG DEV EVAL IMPLTBL SYS,,,37.88,37.88,1
HCPCS,93260TC,PRGRMG DEV EVAL IMPLTBL SYS,,,37.88,37.88,1
HCPCS,93261,INTERROGATE SUBQ DEFIB,,,37.52,37.52,2
HCPCS,93261,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,297.0,193.05,21.15,2693.0,77
HCPCS,932610,INTERROGATE SUBQ DEFIB,,,37.52,37.52,1
HCPCS,93261TC,INTERROGATE SUBQ DEFIB,,,37.52,37.52,1
HCPCS,93264,REM MNTR WRLS P-ART PRS SNR,,,40.67,40.67,1
HCPCS,93264,REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D,288.0,187.2,23.85,2693.0,77
HCPCS,932640,REM MNTR WRLS P-ART PRS SNR,,,40.67,40.67,1
HCPCS,93268,ECG RECORD/REVIEW,,,191.16,191.16,1
HCPCS,93268,Ecg record/review,,,23.85,30.13,6
HCPCS,93268,XTRNL PT ACTIV ECG TRANSMIS W/R&I </30 DAYS,208.0,135.2,104.0,305.03,35
HCPCS,932680,ECG RECORD/REVIEW,,,191.16,191.16,1
HCPCS,93270,REMOTE 30 DAY ECG REV/REPORT,,,9.05,9.05,2
HCPCS,93270,XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS,402.5,261.625,6.13,537.0,84
HCPCS,932700,REMOTE 30 DAY ECG REV/REPORT,,,9.05,9.05,1
HCPCS,93270TC,REMOTE 30 DAY ECG REV/REPORT,,,9.05,9.05,1
HCPCS,93271,ECG/MONITORING AND ANALYSIS,,,154.6,154.6,2
HCPCS,93271,XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS,463.5,301.275,23.85,594.0,84
HCPCS,932710,ECG/MONITORING AND ANALYSIS,,,154.6,154.6,1
HCPCS,93271TC,ECG/MONITORING AND ANALYSIS,,,154.6,154.6,1
HCPCS,93272,ECG/REVIEW INTERPRET ONLY,,,27.51,27.51,1
HCPCS,93272,Ecg/review interpret only,,,23.85,30.13,6
HCPCS,93272,XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS,208.0,135.2,18.13,208.0,35
HCPCS,932720,ECG/REVIEW INTERPRET ONLY,,,27.51,27.51,1
HCPCS,93278,ECG/SIGNAL-AVERAGED,,,20.94,128.79,16
HCPCS,93278,Ecg/signal-averaged,,,16.03,20.24,6
HCPCS,93278,SAECG,528.0,343.2,25.25,528.0,32
HCPCS,93278,SIGNAL AVERAGED ECG W OR,100.0,65.0,25.25,100.0,32
HCPCS,93278,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,428.0,278.2,10.66,528.0,98
HCPCS,932780,ECG/SIGNAL-AVERAGED,,,20.94,20.94,1
HCPCS,93278TC,ECG/SIGNAL-AVERAGED,,,20.94,20.94,1
HCPCS,93279,PPM PROG SINGLE LEAD PRO COMP,260.0,169.0,43.07,260.0,35
HCPCS,93279,"PPM PROG, SINGLE LEAD",528.0,343.2,43.07,528.0,35
HCPCS,93279,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,268.0,174.2,15.36,2693.0,150
HCPCS,93279,PRGRMG DEV EVAL PM/LDLS PM,,,39.68,39.68,2
HCPCS,932790,PRGRMG DEV EVAL PM/LDLS PM,,,39.68,39.68,1
HCPCS,93279TC,PRGRMG DEV EVAL PM/LDLS PM,,,39.68,39.68,1
HCPCS,93280,PM DEVICE PROGR EVAL DUAL,,,45.8,45.8,2
HCPCS,93280,PPM DEVICE PROG DUAL LEAD,576.0,374.4,50.2,576.0,35
HCPCS,93280,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,288.0,187.2,17.37,2693.0,150
HCPCS,932800,PM DEVICE PROGR EVAL DUAL,,,45.8,45.8,1
HCPCS,93280TC,PM DEVICE PROGR EVAL DUAL,,,45.8,45.8,1
HCPCS,93281,PM DEVICE PROGR EVAL MULTI,,,46.53,46.53,2
HCPCS,93281,PPM PROG MULTIPLE LEAD PRO,642.0,417.3,57.9,642.0,35
HCPCS,93281,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,321.0,208.64999999999998,19.96,2693.0,150
HCPCS,932810,PM DEVICE PROGR EVAL MULTI,,,46.53,46.53,1
HCPCS,93281TC,PM DEVICE PROGR EVAL MULTI,,,46.53,46.53,1
HCPCS,93282,"ICD DEVICE PROG EVAL, SNGL",642.0,417.3,53.61,642.0,35
HCPCS,93282,"ICD DEVICE PROG EVAL, SNGL, PRO COMP",374.0,243.1,53.61,374.0,35
HCPCS,93282,PRGRMG EVAL IMPLANTABLE DFB,,,42.2,42.2,2
HCPCS,93282,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,374.0,243.1,17.95,2693.0,150
HCPCS,932820,PRGRMG EVAL IMPLANTABLE DFB,,,42.2,42.2,1
HCPCS,93282TC,PRGRMG EVAL IMPLANTABLE DFB,,,42.2,42.2,1
HCPCS,93283,"ICD DEVICE PROGR EVAL, DUAL",774.0,503.1,68.84,774.0,35
HCPCS,93283,"ICD DEVICE PROGR EVAL, DUAL PRO COMP",506.0,328.9,68.84,506.0,35
HCPCS,93283,PRGRMG EVAL IMPLANTABLE DFB,,,46.16,46.16,2
HCPCS,93283,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,506.0,328.9,20.53,2693.0,150
HCPCS,932830,PRGRMG EVAL IMPLANTABLE DFB,,,46.16,46.16,1
HCPCS,93283TC,PRGRMG EVAL IMPLANTABLE DFB,,,46.16,46.16,1
HCPCS,93284,"ICD DEVICE PROGR EVAL, MULT PRO COMP",550.0,357.5,76.27,550.0,35
HCPCS,93284,"ICD DEVICE PROGR EVAL, MULTIPLE",818.0,531.7,76.27,818.0,35
HCPCS,93284,PRGRMG EVAL IMPLANTABLE DFB,,,49.4,49.4,2
HCPCS,93284,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,550.0,357.5,21.15,2693.0,199
HCPCS,932840,PRGRMG EVAL IMPLANTABLE DFB,,,49.4,49.4,1
HCPCS,93284TC,PRGRMG EVAL IMPLANTABLE DFB,,,49.4,49.4,1
HCPCS,93285,ILR DEVICE EVAL PROGR,476.0,309.4,35.33,476.0,35
HCPCS,93285,ILR DEVICE EVAL PROGR PRO COMP,208.0,135.2,35.33,208.0,35
HCPCS,93285,PRGRMG DEV EVAL SCRMS IP,,,37.88,37.88,2
HCPCS,93285,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,268.0,174.2,13.93,2693.0,150
HCPCS,932850,PRGRMG DEV EVAL SCRMS IP,,,37.88,37.88,1
HCPCS,93285TC,PRGRMG DEV EVAL SCRMS IP,,,37.88,37.88,1
HCPCS,93286,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,378.0,245.7,9.9,2693.0,140
HCPCS,93286,PERI-PX EVAL PM/LDLS PM IP,,,33.19,33.19,2
HCPCS,93286,PRE-OP PM DEVICE EVAL,510.0,331.5,21.98,510.0,35
HCPCS,93286,PRE-OP PM DEVICE EVAL PRO COMP,132.0,85.8,21.98,132.0,35
HCPCS,932860,PERI-PX EVAL PM/LDLS PM IP,,,33.19,33.19,1
HCPCS,93286TC,PERI-PX EVAL PM/LDLS PM IP,,,33.19,33.19,1
HCPCS,93287,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,424.0,275.6,11.05,2693.0,140
HCPCS,93287,PERI-PX DEVICE EVAL & PRGR,,,33.56,33.56,2
HCPCS,93287,PRE-OP ICD DEVICE EVAL,622.0,404.3,29.09,622.0,35
HCPCS,93287,PRE-OP ICD DEVICE EVAL PRO COMP,198.0,128.7,29.09,198.0,35
HCPCS,932870,PERI-PX DEVICE EVAL & PRGR,,,33.56,33.56,1
HCPCS,93287TC,PERI-PX DEVICE EVAL & PRGR,,,33.56,33.56,1
HCPCS,93288,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,268.0,174.2,14.21,2693.0,191
HCPCS,93288,INTERROG EVL PM/LDLS PM IP,,,38.96,38.96,2
HCPCS,93288,PM DEVICE EVAL IN PERSON PRO FEE,172.0,111.8,31.73,172.0,35
HCPCS,93288,PM DEVICE INTERROGATE IN PERSON,440.0,286.0,31.73,440.0,35
HCPCS,932880,INTERROG EVL PM/LDLS PM IP,,,38.96,38.96,1
HCPCS,93288TC,INTERROG EVL PM/LDLS PM IP,,,38.96,38.96,1
HCPCS,93289,ICD DEVICE INTERROGATE,330.0,214.5,54.13,330.0,35
HCPCS,93289,ICD DEVICE INTERROGATE IN PERSON,598.0,388.7,54.13,598.0,35
HCPCS,93289,INTERROG DEVICE EVAL HEART,,,39.31,39.31,2
HCPCS,93289,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,330.0,214.5,17.37,2693.0,150
HCPCS,932890,INTERROG DEVICE EVAL HEART,,,39.31,39.31,1
HCPCS,93289TC,INTERROG DEVICE EVAL HEART,,,39.31,39.31,1
HCPCS,93290,INTERROG DEV EVAL ICPMS IP,,,35.35,35.35,2
HCPCS,93290,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,268.0,174.2,8.18,2693.0,150
HCPCS,932900,INTERROG DEV EVAL ICPMS IP,,,35.35,35.35,1
HCPCS,93290TC,INTERROG DEV EVAL ICPMS IP,,,35.35,35.35,1
HCPCS,93291,ILR DEV INTERROGATE IN PERSON,339.0,220.35,30.59,339.0,35
HCPCS,93291,ILR DEV INTERROGATE IN PERSON PRO,163.0,105.95,30.59,163.0,35
HCPCS,93291,INTERROG DEV EVAL SCRMS IP,,,33.91,33.91,2
HCPCS,93291,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,176.0,114.4,12.78,2693.0,150
HCPCS,932910,INTERROG DEV EVAL SCRMS IP,,,33.91,33.91,1
HCPCS,93291TC,INTERROG DEV EVAL SCRMS IP,,,33.91,33.91,1
HCPCS,93292,WCD DEVICE INTERROGATE,,,33.19,80.85,16
HCPCS,93292,Wcd device interrogate,,,21.15,26.71,6
HCPCS,932920,WCD DEVICE INTERROGATE,,,33.19,33.19,1
HCPCS,93292TC,WCD DEVICE INTERROGATE,,,33.19,33.19,1
HCPCS,93293,PM PHONE R-STRIP DEVICE EVAL,,,32.48,80.85,16
HCPCS,93293,Pm phone r-strip device eval,,,21.15,26.71,6
HCPCS,932930,PM PHONE R-STRIP DEVICE EVAL,,,32.48,32.48,1
HCPCS,93293TC,PM PHONE R-STRIP DEVICE EVAL,,,32.48,32.48,1
HCPCS,93294,REM INTERROG EVL PM/LDLS PM,,,33.64,33.64,1
HCPCS,93294,REM INTERROG PM/LDLS PM <90 D PHYS/QHP,240.0,156.0,22.21,240.0,35
HCPCS,93294,Rem interrog evl pm/ldls pm,,,21.15,26.71,6
HCPCS,932940,REM INTERROG EVL PM/LDLS PM,,,33.64,33.64,1
HCPCS,93295,DEV INTERROG REMOTE 1/2/MLT,,,41.75,41.75,1
HCPCS,93295,Dev interrog remote 1/2/mlt,,,21.15,26.71,6
HCPCS,93295,INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB,326.0,211.9,27.32,326.0,35
HCPCS,932950,DEV INTERROG REMOTE 1/2/MLT,,,41.75,41.75,1
HCPCS,93296,REM INTERROG EVL PM/IDS,,,23.1,23.1,1
HCPCS,93296,REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW,183.5,119.27499999999999,15.32,2693.0,84
HCPCS,932960,REM INTERROG EVL PM/IDS,,,23.1,23.1,1
HCPCS,93297,REM INTERROG DEV EVAL ICPMS,,,38.96,38.96,2
HCPCS,93297,REM INTERROG ICPMS <30 D PHYS/QHP,238.0,154.7,20.45,2693.0,150
HCPCS,932970,REM INTERROG DEV EVAL ICPMS,,,38.96,38.96,1
HCPCS,93297TC,REM INTERROG DEV EVAL ICPMS,,,38.96,38.96,1
HCPCS,93298,REM INTERROG DEV EVAL SCRMS,,,83.68,83.68,2
HCPCS,93298,REM INTERROG SCRMS <30 D PHYS/QHP,238.0,154.7,22.6,2693.0,150
HCPCS,932980,REM INTERROG DEV EVAL SCRMS,,,83.68,83.68,1
HCPCS,93298TC,REM INTERROG DEV EVAL SCRMS,,,83.68,83.68,1
HCPCS,93303,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,3941.0,2561.65,54.28,4513.0,248
HCPCS,93303,ECHO TRANSTHORACIC,,,172.35,172.35,2
HCPCS,933030,ECHO TRANSTHORACIC,,,172.35,172.35,1
HCPCS,93303TC,ECHO TRANSTHORACIC,,,172.35,172.35,1
HCPCS,93304,ECHO TRANSTHORACIC,,,130.15,130.15,2
HCPCS,93304,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,2135.5,1388.075,31.11,3941.0,248
HCPCS,933040,ECHO TRANSTHORACIC,,,130.15,130.15,1
HCPCS,93304TC,ECHO TRANSTHORACIC,,,130.15,130.15,1
HCPCS,93306,ECHO TTHRC R-T 2D M-MODE COMPL SPEC&COLR D W/O CONTRAST,3941.0,2561.65,273.49,3546.9,49
HCPCS,93306,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,3941.0,2561.65,54.56,4583.0,150
HCPCS,93306,TTE W/DOPPLER COMPLETE,,,139.57,139.57,2
HCPCS,93306,TTE W/DOPPLER COMPLETE PRO,642.0,417.3,148.34,642.0,35
HCPCS,93306,"TTE W/DOPPLER, COMPLETE",4583.0,2978.95,148.34,4583.0,35
HCPCS,933060,TTE W/DOPPLER COMPLETE,,,139.57,139.57,1
HCPCS,93306TC,TTE W/DOPPLER COMPLETE,,,139.57,139.57,1
HCPCS,93307,ECHO 2-D,2143.0,1392.95,97.57,2143.0,35
HCPCS,93307,ECHO COMPLETE TECHNICAL,1738.0,1129.7,97.57,1738.0,35
HCPCS,93307,ECHO INTERPRETATION ONLY,405.0,263.25,97.57,405.0,35
HCPCS,93307,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,1738.0,1129.7,38.79,2693.0,150
HCPCS,93307,TTE W/O DOPPLER COMPLETE,,,101.69,101.69,2
HCPCS,933070,TTE W/O DOPPLER COMPLETE,,,101.69,101.69,1
HCPCS,93307TC,TTE W/O DOPPLER COMPLETE,,,101.69,101.69,1
HCPCS,93308,ECHO LIMITED PROF COMP,233.0,151.45,74.55,233.0,35
HCPCS,93308,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1738.0,1129.7,21.74,2693.0,248
HCPCS,93308,"ECHO, LIMITED STUDY",1971.0,1281.15,74.55,1971.0,35
HCPCS,93308,"ECHO, LIMITED STUDY TC",1738.0,1129.7,74.55,1738.0,35
HCPCS,93308,TTE F-UP OR LMTD,,,80.44,80.44,2
HCPCS,933080,TTE F-UP OR LMTD,,,80.44,80.44,1
HCPCS,93308TC,TTE F-UP OR LMTD,,,80.44,80.44,1
HCPCS,93312,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,3941.0,2561.65,89.63,4953.0,199
HCPCS,93312,ECHO TRANSESOPHAGEAL,,,142.45,142.45,2
HCPCS,933120,ECHO TRANSESOPHAGEAL,,,142.45,142.45,1
HCPCS,93312TC,ECHO TRANSESOPHAGEAL,,,142.45,142.45,1
HCPCS,93313,ECHO R-T 2D W/PROBE PLACEMENT ONLY,2027.5,1317.875,8.48,3546.9,84
HCPCS,93313,ECHO TRANSESOPHAGEAL,,,12.9,12.9,1
HCPCS,933130,ECHO TRANSESOPHAGEAL,,,12.9,12.9,1
HCPCS,93314,ECHO IMAGE ACQUISTION,814.0,529.1,152.67,814.0,35
HCPCS,93314,ECHO IMAGE AQUISITION,3610.0,2346.5,152.67,3610.0,35
HCPCS,93314,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,2796.0,1817.4,51.14,3610.0,140
HCPCS,93314,ECHO TRANSESOPHAGEAL,,,150.37,150.37,2
HCPCS,933140,ECHO TRANSESOPHAGEAL,,,150.37,150.37,1
HCPCS,93314TC,ECHO TRANSESOPHAGEAL,,,150.37,150.37,1
HCPCS,93315,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,3941.0,2561.65,120.91,5125.0,213
HCPCS,93315,ECHO TRANSESOPHAGEAL,,,578.26,578.26,2
HCPCS,933150,ECHO TRANSESOPHAGEAL,,,578.26,578.26,1
HCPCS,93315TC,ECHO TRANSESOPHAGEAL,,,578.26,578.26,1
HCPCS,93316,ECHO TRANSESOPHAG CONGEN PROBE PLCMT ONLY,3941.0,2561.65,34.69,3546.9,49
HCPCS,93316,ECHO TRANSESOPHAGEAL,,,29.73,29.73,1
HCPCS,933160,ECHO TRANSESOPHAGEAL,,,29.73,29.73,1
HCPCS,93317,ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT,810.0,526.5,80.54,1543.0,69
HCPCS,93317,ECHO TRANSESOPHAGEAL,,,93.21,93.21,2
HCPCS,93317,Echo transesophageal,,,284.16,358.94,6
HCPCS,933170,ECHO TRANSESOPHAGEAL,,,93.21,93.21,1
HCPCS,93317TC,ECHO TRANSESOPHAGEAL,,,93.21,93.21,1
HCPCS,93318,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,3941.0,2561.65,97.87,4887.0,117
HCPCS,93318,ECHO TRANSESOPHAGEAL INTRAOP,,,578.26,578.26,2
HCPCS,933180,ECHO TRANSESOPHAGEAL INTRAOP,,,578.26,578.26,1
HCPCS,93318TC,ECHO TRANSESOPHAGEAL INTRAOP,,,578.26,578.26,1
HCPCS,93319,3D ECHO IMG CGEN CAR ANOMAL,,,26.81,26.81,1
HCPCS,93319,3D ECHO IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,648.0,421.2,29.34,2693.0,39
HCPCS,93319,ECHO 3D IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,220.0,143.0,3.36,165.0,31
HCPCS,933190,3D ECHO IMG CGEN CAR ANOMAL,,,26.81,26.81,1
HCPCS,93320,DOPPLER ECHO COMPLETE,,,36.07,36.07,2
HCPCS,93320,DOPPLER ECHO COMPLTE TECH,1666.0,1082.9,38.3,1666.0,35
HCPCS,93320,DOPPLER ECHO W DISPLAY,1833.0,1191.45,38.3,1833.0,35
HCPCS,93320,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,1666.0,1082.9,15.77,2693.0,179
HCPCS,93320,INTERPRETATION ONLY DOPPL,167.0,108.55,38.3,167.0,35
HCPCS,933200,DOPPLER ECHO COMPLETE,,,36.07,36.07,1
HCPCS,93320TC,DOPPLER ECHO COMPLETE,,,36.07,36.07,1
HCPCS,93321,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,750.0,487.5,6.39,2693.0,179
HCPCS,93321,DOPPLER ECHO F-UP/LMTD STD,,,19.45,19.45,2
HCPCS,93321,DOPPLER ECHO PULSE/CONT WAVE FU/LTD,816.0,530.4,18.89,816.0,35
HCPCS,93321,DOPPLER ECHO PULSED OR CO,66.0,42.9,18.89,66.0,35
HCPCS,933210,DOPPLER ECHO F-UP/LMTD STD,,,19.45,19.45,1
HCPCS,93321TC,DOPPLER ECHO F-UP/LMTD STD,,,19.45,19.45,1
HCPCS,93325,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,1333.0,866.45,2.91,2693.0,140
HCPCS,93325,DOPPL COLOR FLOW TECH,1333.0,866.45,17.06,1333.0,35
HCPCS,93325,DOPPLER COLOR FLOW,31.0,20.15,15.5,40.44,35
HCPCS,93325,DOPPLER COLOR FLOW ECHO,1364.0,886.6,17.06,1364.0,35
HCPCS,93325,DOPPLER ECHO COLOR FLOW MAPG,,,21.98,21.98,2
HCPCS,933250,DOPPLER ECHO COLOR FLOW MAPG,,,21.98,21.98,1
HCPCS,93325TC,DOPPLER ECHO COLOR FLOW MAPG,,,21.98,21.98,1
HCPCS,93350,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3941.0,2561.65,61.53,4583.0,248
HCPCS,93350,ECHO WO M-MODE RECORDING,4583.0,2978.95,98.28,4583.0,35
HCPCS,93350,"STRESS ECHO, MD INTERPT & REPORT",642.0,417.3,98.28,642.0,35
HCPCS,93350,STRESS TTE ONLY,,,127.62,127.62,2
HCPCS,933500,STRESS TTE ONLY,,,127.62,127.62,1
HCPCS,93350TC,STRESS TTE ONLY,,,127.62,127.62,1
HCPCS,93351,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,3941.0,2561.65,73.75,4711.0,248
HCPCS,93351,STRESS TTE COMPLETE,,,163.75,163.75,2
HCPCS,933510,STRESS TTE COMPLETE,,,163.75,163.75,1
HCPCS,93351TC,STRESS TTE COMPLETE,,,163.75,163.75,1
HCPCS,93352,ADMIN ECG CONTRAST AGENT,,,38.23,38.23,1
HCPCS,93352,Admin ecg contrast agent,,,284.16,358.94,6
HCPCS,93352,USE OF ECHO CONTRAST AGENT DURING STRESS ECHO,84.0,54.6,26.81,84.0,35
HCPCS,933520,ADMIN ECG CONTRAST AGENT,,,38.23,38.23,1
HCPCS,93355,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,3555.0,2310.75,168.51,4554.0,148
HCPCS,93355,ECHO TRANSESOPHAGEAL (TEE),,,255.04,255.04,1
HCPCS,933550,ECHO TRANSESOPHAGEAL (TEE),,,255.04,255.04,1
HCPCS,93356,HOSPITAL MYOCRD STRAIN,86.0,55.9,14.08,2693.0,39
HCPCS,93356,MYOCRD STRAIN IMG SPCKL TRCK,,,13.19,13.19,1
HCPCS,93356,MYOCRD STRAIN IMG SPECKLE TRCK ASSMT MYOCRD MECH,106.0,68.9,9.11,2693.0,82
HCPCS,933560,MYOCRD STRAIN IMG SPCKL TRCK,,,13.19,13.19,1
HCPCS,93451,RIGHT HEART CATH,,,781.55,781.55,2
HCPCS,93451,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,23118.0,15026.7,130.86,37851.0,115
HCPCS,934510,RIGHT HEART CATH,,,781.55,781.55,1
HCPCS,93451TC,RIGHT HEART CATH,,,781.55,781.55,1
HCPCS,93452,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,12549.0,8156.85,459.61,37851.0,84
HCPCS,93452,LEFT HRT CATH W/VENTRCLGRPHY,,,707.43,707.43,2
HCPCS,934520,LEFT HRT CATH W/VENTRCLGRPHY,,,707.43,707.43,1
HCPCS,93452TC,LEFT HRT CATH W/VENTRCLGRPHY,,,707.43,707.43,1
HCPCS,93453,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,12877.0,8370.050000000001,582.56,37851.0,84
HCPCS,93453,R&L HRT CATH W/VENTRICLGRPHY,,,887.92,887.92,2
HCPCS,934530,R&L HRT CATH W/VENTRICLGRPHY,,,887.92,887.92,1
HCPCS,93453TC,R&L HRT CATH W/VENTRICLGRPHY,,,887.92,887.92,1
HCPCS,93454,CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I,23118.0,15026.7,1224.45,37851.0,49
HCPCS,93454,CATH PLMT & NJX CORONARY ART ANGIO IMG S&I,1998.0,1298.7,460.6,1998.0,35
HCPCS,93454,CORONARY ARTERY ANGIO S&I,,,712.83,712.83,2
HCPCS,934540,CORONARY ARTERY ANGIO S&I,,,712.83,712.83,1
HCPCS,93454TC,CORONARY ARTERY ANGIO S&I,,,712.83,712.83,1
HCPCS,93455,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,12723.0,8269.95,512.04,37851.0,84
HCPCS,93455,CORONARY ART/GRFT ANGIO S&I,,,781.28,781.28,2
HCPCS,934550,CORONARY ART/GRFT ANGIO S&I,,,781.28,781.28,1
HCPCS,93455TC,CORONARY ART/GRFT ANGIO S&I,,,781.28,781.28,1
HCPCS,93456,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,12857.0,8357.050000000001,572.2,37851.0,84
HCPCS,93456,R HRT CORONARY ARTERY ANGIO,,,872.07,872.07,2
HCPCS,934560,R HRT CORONARY ARTERY ANGIO,,,872.07,872.07,1
HCPCS,93456TC,R HRT CORONARY ARTERY ANGIO,,,872.07,872.07,1
HCPCS,93457,CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I,23118.0,15026.7,1513.2,37851.0,49
HCPCS,93457,CATH PLMT R HRT/ARTS/GRFTS W/NJX&ANGIO IMG S&I,2922.0,1899.3,624.15,2922.0,35
HCPCS,93457,R HRT ART/GRFT ANGIO,,,939.85,939.85,2
HCPCS,934570,R HRT ART/GRFT ANGIO,,,939.85,939.85,1
HCPCS,93457TC,R HRT ART/GRFT ANGIO,,,939.85,939.85,1
HCPCS,93458,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,12791.0,8314.15,527.99,37851.0,84
HCPCS,93458,L HRT ARTERY/VENTRICLE ANGIO,,,798.94,798.94,2
HCPCS,934580,L HRT ARTERY/VENTRICLE ANGIO,,,798.94,798.94,1
HCPCS,93458TC,L HRT ARTERY/VENTRICLE ANGIO,,,798.94,798.94,1
HCPCS,93459,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,12956.0,8421.4,567.77,37851.0,84
HCPCS,93459,L HRT ART/GRFT ANGIO,,,841.86,841.86,2
HCPCS,934590,L HRT ART/GRFT ANGIO,,,841.86,841.86,1
HCPCS,93459TC,L HRT ART/GRFT ANGIO,,,841.86,841.86,1
HCPCS,93460,R & L HRT CATH WINJX HRT ART& L VENTR IMG,13121.0,8528.65,630.9,37851.0,84
HCPCS,93460,R&L HRT ART/VENTRICLE ANGIO,,,930.84,930.84,2
HCPCS,934600,R&L HRT ART/VENTRICLE ANGIO,,,930.84,930.84,1
HCPCS,93460TC,R&L HRT ART/VENTRICLE ANGIO,,,930.84,930.84,1
HCPCS,93461,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,13286.0,8635.9,695.5,37851.0,84
HCPCS,93461,R&L HRT ART/VENTRICLE ANGIO,,,1026.0,1026.0,2
HCPCS,934610,R&L HRT ART/VENTRICLE ANGIO,,,1026.0,1026.0,1
HCPCS,93461TC,R&L HRT ART/VENTRICLE ANGIO,,,1026.0,1026.0,1
HCPCS,93462,L HRT CATH TRNSPTL PUNCTURE,,,235.55,235.55,1
HCPCS,93462,LEFT HEART CATH BY TRANSEPTAL PUNCTURE,6753.5,4389.775,101.42,37851.0,74
HCPCS,934620,L HRT CATH TRNSPTL PUNCTURE,,,235.55,235.55,1
HCPCS,93463,DRUG ADMIN & HEMODYNMIC MEAS,,,110.84,110.84,1
HCPCS,93463,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,3271.5,2126.475,30.69,37851.0,113
HCPCS,934630,DRUG ADMIN & HEMODYNMIC MEAS,,,110.84,110.84,1
HCPCS,93464,EXERCISE W/HEMODYNAMIC MEAS,3539.0,2300.35,103.01,37851.0,41
HCPCS,93464,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU,3539.0,2300.35,103.01,37851.0,39
HCPCS,93464,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASURE,720.0,468.0,134.6,720.0,35
HCPCS,934640,EXERCISE W/HEMODYNAMIC MEAS,,,141.99,141.99,1
HCPCS,93464TC,EXERCISE W/HEMODYNAMIC MEAS,,,141.99,141.99,1
HCPCS,93503,INSERT/PLACE HEART CATHETER,,,100.49,100.49,1
HCPCS,93503,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,6022.5,3914.625,65.87,37851.0,171
HCPCS,935030,INSERT/PLACE HEART CATHETER,,,100.49,100.49,1
HCPCS,93505,ENDOMYOCARDIAL BIOPSY,22623.0,14704.95,212.48,37851.0,117
HCPCS,935050,ENDOMYOCARDIAL BIOPSY,,,450.06,450.06,1
HCPCS,93505TC,ENDOMYOCARDIAL BIOPSY,,,450.06,450.06,1
HCPCS,93530,Rt heart cath congenital,,,1513.2,1911.41,6
HCPCS,93531,R & l heart cath congenital,,,1513.2,1911.41,6
HCPCS,93531,RHC & RETROGR LHC CONGENITAL,1835.0,1192.75,917.5,1835.0,12
HCPCS,93531,"RHC & RETROGR LHC, CONGENITAL",1835.0,1192.75,917.5,1835.0,12
HCPCS,93532,R & l heart cath congenital,,,1513.2,1911.41,6
HCPCS,93533,R & l heart cath congenital,,,1513.2,1911.41,6
HCPCS,93561,Cardiac output measurement,,,223.78,282.67,6
HCPCS,93562,Card output measure subsq,,,223.78,282.67,6
HCPCS,93563,NJX CGEN CAR CTH SLCTV C ANG,,,58.69,58.69,1
HCPCS,93563,NJX SEL HRT ART CONGENITAL HRT CATH W/S&I,3538.0,2299.7,28.1,37851.0,74
HCPCS,935630,NJX CGEN CAR CTH SLCTV C ANG,,,58.69,58.69,1
HCPCS,93564,NJX CGEN CAR CATH SLCTV OPAC,,,63.15,63.15,1
HCPCS,93564,NJX SEL HRT ART/GRFT CONGENITAL HRT CATH W/S&I,3701.0,2405.65,29.1,37851.0,74
HCPCS,935640,NJX CGEN CAR CATH SLCTV OPAC,,,63.15,63.15,1
HCPCS,93565,NJX CAR CTH SLCTV LV/LA ANG,,,30.8,30.8,1
HCPCS,93565,NJX SEL L VENT/ATRIAL ANGIO HRT CATH W/S&I,2751.5,1788.475,22.35,37851.0,74
HCPCS,935650,NJX CAR CTH SLCTV LV/LA ANG,,,30.8,30.8,1
HCPCS,93566,NJX CAR CTH SLCTV RV/RA ANG,,,29.57,29.57,1
HCPCS,93566,NJX SEL R VENT/ATRIAL ANGIO HRT CATH W/S&I,2627.5,1707.875,24.54,37851.0,74
HCPCS,935660,NJX CAR CTH SLCTV RV/RA ANG,,,29.57,29.57,1
HCPCS,93567,NJX CAR CTH SPRVLV AORTGRPHY,,,42.87,42.87,1
HCPCS,93567,NJX SUPRAVALV AORTOG HRT CATH W/S&I,3020.5,1963.3249999999998,25.16,37851.0,74
HCPCS,935670,NJX CAR CTH SPRVLV AORTGRPHY,,,42.87,42.87,1
HCPCS,93568,NJX CAR CTH NSLC P-ART ANGRP,,,52.96,52.96,1
HCPCS,93568,NJX DRG C-CATHJ NSLCTV P-ART ANGIOGRAPHY,3030.5,1969.825,23.02,37851.0,74
HCPCS,935680,NJX CAR CTH NSLC P-ART ANGRP,,,52.96,52.96,1
HCPCS,93569,NJX CTH SLCT P-ART ANGRP UNI,,,43.03,43.03,1
HCPCS,93569,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY UNI,8235.5,5353.075000000001,7.84,37851.0,70
HCPCS,935690,NJX CTH SLCT P-ART ANGRP UNI,,,43.03,43.03,1
HCPCS,93571,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,5781.0,3757.65,74.45,37851.0,86
HCPCS,93571,IV DOP VEL&/PRESS C FLO 1ST,,,141.83,141.83,2
HCPCS,935710,IV DOP VEL&/PRESS C FLO 1ST,,,141.83,141.83,1
HCPCS,93571TC,IV DOP VEL&/PRESS C FLO 1ST,,,141.83,141.83,1
HCPCS,93572,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,5938.0,3859.7,53.95,37851.0,86
HCPCS,93572,IV DOP VEL&/PRESS C FLO EA,,,62.76,62.76,2
HCPCS,935720,IV DOP VEL&/PRESS C FLO EA,,,62.76,62.76,1
HCPCS,93572TC,IV DOP VEL&/PRESS C FLO EA,,,62.76,62.76,1
HCPCS,93573,NJX CATH SLCT P-ART ANGRP BI,,,71.3,71.3,1
HCPCS,93573,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY BI,11029.0,7168.849999999999,13.07,37851.0,70
HCPCS,935730,NJX CATH SLCT P-ART ANGRP BI,,,71.3,71.3,1
HCPCS,93574,NJX CATH SLCT PULM VN ANGRPH,,,79.46,79.46,1
HCPCS,93574,NJX DRG C-CATHJ SLCTV PULM VEN ANGIOGRAPHY,1171.5,761.4749999999999,14.51,37851.0,70
HCPCS,935740,NJX CATH SLCT PULM VN ANGRPH,,,79.46,79.46,1
HCPCS,93575,NJX CATH SLCT P ANGRPH MAPCA,,,105.42,105.42,1
HCPCS,93575,NJX DRG C-CATHJ SLCTV PULM ANGRPH MAPCA CHD EA,3312.0,2152.8,19.45,37851.0,70
HCPCS,935750,NJX CATH SLCT P ANGRPH MAPCA,,,105.42,105.42,1
HCPCS,93580,CLSR ASD TX CATH W IMP,42320.0,27508.0,1116.27,39131.0,49
HCPCS,93580,PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT,25113.5,16323.775,667.69,39131.0,84
HCPCS,93580,TRANSCATH CLOSURE OF ASD,,,1110.2,1110.2,1
HCPCS,935800,TRANSCATH CLOSURE OF ASD,,,1110.2,1110.2,1
HCPCS,93581,PRQ TCAT CLSR CGEN VENTR SEPTAL DFCT W/IMPLT,31278.0,20330.7,893.35,47520.0,84
HCPCS,93581,TRANSCATH CLOSURE OF VSD,,,1507.26,1507.26,1
HCPCS,935810,TRANSCATH CLOSURE OF VSD,,,1507.26,1507.26,1
HCPCS,93582,PERCUTAN TRANSCATH CLOSURE PAT DUCT ARTERIOSUS,34515.0,22434.75,488.05,57695.4,80
HCPCS,93582,PERQ TRANSCATH CLOSURE PDA,,,753.0,753.0,1
HCPCS,935820,PERQ TRANSCATH CLOSURE PDA,,,753.0,753.0,1
HCPCS,93583,PERCUTANEOUS TRANSCATHETER SEPTAL REDUCTION THER,6388.0,4152.2,543.26,37851.0,70
HCPCS,93583,PERQ TRANSCATH SEPTAL REDUXN,,,844.68,844.68,1
HCPCS,935830,PERQ TRANSCATH SEPTAL REDUXN,,,844.68,844.68,1
HCPCS,93584,VENOGRAPHY CHD ANOMALOUS/PERSISTENT SVC NT DRG,37477.0,24360.05,42.18,66983.4,67
HCPCS,93584,VNGRPH CHD ANOM/PERSIST SVC,,,67.04,67.04,1
HCPCS,935840,VNGRPH CHD ANOM/PERSIST SVC,,,67.04,67.04,1
HCPCS,93585,VENOGRAPHY CHD AZYGOS/HEMIAZYGOS VENOUS SYSTEM,37461.5,24349.975000000002,39.76,66983.4,67
HCPCS,93585,VNGRPH CHD AZYGS/HEMIAZYGS,,,63.18,63.18,1
HCPCS,935850,VNGRPH CHD AZYGS/HEMIAZYGS,,,63.18,63.18,1
HCPCS,93586,VENOGRAPHY CHD CORONARY SINUS,37527.5,24392.875,50.24,66983.4,67
HCPCS,93586,VNGRPH CHD CORONARY SINUS,,,79.82,79.82,1
HCPCS,935860,VNGRPH CHD CORONARY SINUS,,,79.82,79.82,1
HCPCS,93587,VENOGRAPHY CHD VENOVENOUS COLTRL AT/ABOVE HRT,37677.0,24490.05,74.14,66983.4,67
HCPCS,93587,VNGRPH CHD VNVN CLTRL AT/ABV,,,117.82,117.82,1
HCPCS,935870,VNGRPH CHD VNVN CLTRL AT/ABV,,,117.82,117.82,1
HCPCS,93588,VENOGRAPHY CHD VENOVENOUS COLLATERAL BELOW HEART,37681.5,24492.975000000002,74.86,66983.4,67
HCPCS,93588,VNGRPH CHD VNVN CLTRL BELOW,,,118.96,118.96,1
HCPCS,935880,VNGRPH CHD VNVN CLTRL BELOW,,,118.96,118.96,1
HCPCS,93590,PERQ TRANSCATH CLS MITRAL,,,1211.04,1211.04,1
HCPCS,93590,PERQ TRANSCATH CLS PARAVALVR LEAK 1 MITRAL VALVE,42704.5,27757.925,800.19,69056.1,80
HCPCS,935900,PERQ TRANSCATH CLS MITRAL,,,1211.04,1211.04,1
HCPCS,93591,PERQ TRANSCATH CLS AORTIC,,,995.58,995.58,1
HCPCS,93591,PERQ TRANSCATH CLS PARAVALVR LEAK 1 AORTIC VALVE,44410.5,28866.824999999997,663.33,73469.7,80
HCPCS,935910,PERQ TRANSCATH CLS AORTIC,,,995.58,995.58,1
HCPCS,93592,PERQ TRANSCATH CLOSURE EACH,,,436.42,436.42,1
HCPCS,93592,PERQ TRANSCATH CLS PARAVALVR LEAK EACH OCCLS DEV,3709.0,2410.85,288.52,37851.0,70
HCPCS,935920,PERQ TRANSCATH CLOSURE EACH,,,436.42,436.42,1
HCPCS,93593,R HRT CATH CHD NML NT CNJ,,,213.22,213.22,1
HCPCS,93593,R HRT CATH CHD W/IMG CATH TRGT ZONE NML NT CONNJ,12357.0,8032.05,183.09,37851.0,79
HCPCS,935930,R HRT CATH CHD NML NT CNJ,,,213.22,213.22,1
HCPCS,93594,R HRT CATH CHD ABNL NT CNJ,,,324.06,324.06,1
HCPCS,93594,R HRT CATH CHD W/IMG CATH TRGT ZON ABNL NT CONNJ,12779.0,8306.35,280.61,37851.0,79
HCPCS,935940,R HRT CATH CHD ABNL NT CNJ,,,324.06,324.06,1
HCPCS,93595,L HRT CATH CHD IMG CATH TRGT ZON NML/ABNL NT CNJ,12829.5,8339.175000000001,249.37,37851.0,79
HCPCS,93595,L HRT CATH CHD NM/ABN NT CNJ,,,293.62,293.62,1
HCPCS,935950,L HRT CATH CHD NM/ABN NT CNJ,,,293.62,293.62,1
HCPCS,93596,R&L HRT CATH CHD IMG CATH TRGT ZONE NML NT CONNJ,12927.0,8402.550000000001,310.75,37851.0,79
HCPCS,93596,R&L HRT CATH CHD NML NT CNJ,,,1023.3,1023.3,2
HCPCS,935960,R&L HRT CATH CHD NML NT CNJ,,,1023.3,1023.3,1
HCPCS,93596TC,R&L HRT CATH CHD NML NT CNJ,,,1023.3,1023.3,1
HCPCS,93597,R&L HRT CATH CHD ABNL NT CNJ,,,1782.59,1782.59,2
HCPCS,93597,R&L HRT CATH CHD IMG CATH TRGT ZON ABNL NT CONNJ,23118.0,15026.7,1513.2,37851.0,48
HCPCS,935970,R&L HRT CATH CHD ABNL NT CNJ,,,1782.59,1782.59,1
HCPCS,93597TC,R&L HRT CATH CHD ABNL NT CNJ,,,1782.59,1782.59,1
HCPCS,93598,CAR OUTP MEAS DRG CAR CATH EVAL CGEN HRT DEFECT,841.0,546.65,141.29,37851.0,38
HCPCS,93598,CAR OUTP MEAS DRG CATH CHD,,,75.56,75.56,1
HCPCS,935980,CAR OUTP MEAS DRG CATH CHD,,,75.56,75.56,1
HCPCS,93600,BUNDLE OF HIS RECORDING,25934.0,16857.1,78.89,44585.0,119
HCPCS,936000,BUNDLE OF HIS RECORDING,,,81.59,81.59,1
HCPCS,93600TC,BUNDLE OF HIS RECORDING,,,81.59,81.59,1
HCPCS,93602,INTRA-ATRIAL RECORDING,54540.0,35451.0,44.43,55473.0,119
HCPCS,936020,INTRA-ATRIAL RECORDING,,,46.76,46.76,1
HCPCS,93602TC,INTRA-ATRIAL RECORDING,,,46.76,46.76,1
HCPCS,93603,RIGHT VENTRICULAR RECORDING,8725.0,5671.25,67.52,44585.0,119
HCPCS,936030,RIGHT VENTRICULAR RECORDING,,,70.73,70.73,1
HCPCS,93603TC,RIGHT VENTRICULAR RECORDING,,,70.73,70.73,1
HCPCS,93609,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,7454.0,4845.1,109.13,44585.0,107
HCPCS,93609,INTRA-VNTR MAPG TCHYCAR SITE,,,111.68,111.68,2
HCPCS,936090,INTRA-VNTR MAPG TCHYCAR SITE,,,111.68,111.68,1
HCPCS,93609TC,INTRA-VNTR MAPG TCHYCAR SITE,,,111.68,111.68,1
HCPCS,93610,INTRA-ATRIAL PACING,54540.0,35451.0,55.04,55869.0,119
HCPCS,936100,INTRA-ATRIAL PACING,,,56.58,56.58,1
HCPCS,93610TC,INTRA-ATRIAL PACING,,,56.58,56.58,1
HCPCS,93612,INTRAVENTRICULAR PACING,54540.0,35451.0,65.02,55869.0,119
HCPCS,936120,INTRAVENTRICULAR PACING,,,65.29,65.29,1
HCPCS,93612TC,INTRAVENTRICULAR PACING,,,65.29,65.29,1
HCPCS,93613,3-D INTRACARD MAP ADD ON,18770.0,12200.5,217.28,18770.0,35
HCPCS,93613,3-D INTRACARDIAC MAPPING - PROF COMP,2092.0,1359.8,217.28,2092.0,35
HCPCS,93613,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,9385.0,6100.25,217.28,44585.0,113
HCPCS,93613,INTRACARDIAC EPHYS 3D MAPG,,,87.74,87.74,2
HCPCS,936130,INTRACARDIAC EPHYS 3D MAPG,,,87.74,87.74,1
HCPCS,93613TC,INTRACARDIAC EPHYS 3D MAPG,,,87.74,87.74,1
HCPCS,93615,ESOPHAGEAL RECORDING,,,10.13,2632.13,16
HCPCS,93615,ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS,8725.0,5671.25,11.63,9051.0,69
HCPCS,93615,Esophageal recording,,,4038.75,5101.58,6
HCPCS,936150,ESOPHAGEAL RECORDING,,,10.13,10.13,1
HCPCS,93615TC,ESOPHAGEAL RECORDING,,,10.13,10.13,1
HCPCS,93616,ESOPHAGEAL RECORDING W/PACG,,,20.68,20.68,2
HCPCS,93616,ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG,8725.0,5671.25,12.8,44585.0,117
HCPCS,936160,ESOPHAGEAL RECORDING W/PACG,,,20.68,20.68,1
HCPCS,93616TC,ESOPHAGEAL RECORDING W/PACG,,,20.68,20.68,1
HCPCS,93618,INDCTJ ARRHYTHMIA ELEC PACG,,,151.6,151.6,2
HCPCS,93618,INDUCTION ARRHYTHMIA ELECTRICAL PACING,8725.0,5671.25,158.21,44585.0,117
HCPCS,936180,INDCTJ ARRHYTHMIA ELEC PACG,,,151.6,151.6,1
HCPCS,93618TC,INDCTJ ARRHYTHMIA ELEC PACG,,,151.6,151.6,1
HCPCS,93619,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,54540.0,35451.0,307.88,57540.0,117
HCPCS,93619,COMPREHENSIVE EP EVALUATION,,,306.45,306.45,2
HCPCS,936190,COMPREHENSIVE EP EVALUATION,,,306.45,306.45,1
HCPCS,93619TC,COMPREHENSIVE EP EVALUATION,,,306.45,306.45,1
HCPCS,93620,COMP EP EVL R AT VEN PAC&REC,,,217.24,217.24,2
HCPCS,93620,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,54540.0,35451.0,249.43,54540.0,117
HCPCS,936200,COMP EP EVL R AT VEN PAC&REC,,,217.24,217.24,1
HCPCS,93620TC,COMP EP EVL R AT VEN PAC&REC,,,217.24,217.24,1
HCPCS,93621,COMP EP EVL L PAC&REC C SINS,,,29.01,29.01,2
HCPCS,93621,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,18235.0,11852.75,33.31,44585.0,107
HCPCS,936210,COMP EP EVL L PAC&REC C SINS,,,29.01,29.01,1
HCPCS,93621TC,COMP EP EVL L PAC&REC C SINS,,,29.01,29.01,1
HCPCS,93622,COMP EP EVAL L VENTR PAC&REC,,,59.46,59.46,2
HCPCS,93622,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,13143.0,8542.95,68.27,44585.0,107
HCPCS,936220,COMP EP EVAL L VENTR PAC&REC,,,59.46,59.46,1
HCPCS,93622TC,COMP EP EVAL L VENTR PAC&REC,,,59.46,59.46,1
HCPCS,93623,PRGRMD STIMJ&PACG IV RX NFS,,,23.92,23.92,2
HCPCS,93623,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,12080.0,7852.0,27.47,44585.0,107
HCPCS,936230,PRGRMD STIMJ&PACG IV RX NFS,,,23.92,23.92,1
HCPCS,93623TC,PRGRMD STIMJ&PACG IV RX NFS,,,23.92,23.92,1
HCPCS,93624,ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT,54540.0,35451.0,79.96,56542.0,117
HCPCS,93624,EP F-UP STUDY PACG&REC,,,71.45,71.45,2
HCPCS,936240,EP F-UP STUDY PACG&REC,,,71.45,71.45,1
HCPCS,93624TC,EP F-UP STUDY PACG&REC,,,71.45,71.45,1
HCPCS,93631,INTRAOP EPICAR& ENDOCAR PACG& MAPG,16734.5,10877.425,159.48,30129.0,69
HCPCS,93631,NTRAOP EPICAR&ENDCAR PAC&MAP,,,138.9,138.9,2
HCPCS,93631,Ntraop epicar&endcar pac&map,,,4038.75,5101.58,6
HCPCS,936310,NTRAOP EPICAR&ENDCAR PAC&MAP,,,138.9,138.9,1
HCPCS,93631TC,NTRAOP EPICAR&ENDCAR PAC&MAP,,,138.9,138.9,1
HCPCS,93640,EP EVAL 1/2CHMBR PACG CVDFB,,,279.64,279.64,2
HCPCS,93640,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,4436.0,2883.4,174.54,26432.0,107
HCPCS,936400,EP EVAL 1/2CHMBR PACG CVDFB,,,279.64,279.64,1
HCPCS,93640TC,EP EVAL 1/2CHMBR PACG CVDFB,,,279.64,279.64,1
HCPCS,93641,EP EVL 1/2CHMB PAC CVDFB TST,,,288.34,288.34,2
HCPCS,93641,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,4923.0,3199.95,285.55,26432.0,145
HCPCS,936410,EP EVL 1/2CHMB PAC CVDFB TST,,,288.34,288.34,1
HCPCS,93641TC,EP EVL 1/2CHMB PAC CVDFB TST,,,288.34,288.34,1
HCPCS,93642,EP EVL 1/2CHMB TRNSVNS CVDFB,,,88.41,88.41,2
HCPCS,93642,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,8725.0,5671.25,79.84,26432.0,150
HCPCS,936420,EP EVL 1/2CHMB TRNSVNS CVDFB,,,88.41,88.41,1
HCPCS,93642TC,EP EVL 1/2CHMB TRNSVNS CVDFB,,,88.41,88.41,1
HCPCS,93644,EP EVAL SUBQ IMPL DFB,,,54.81,54.81,2
HCPCS,93644,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,7216.0,4690.4,48.35,8554.0,172
HCPCS,936440,EP EVAL SUBQ IMPL DFB,,,54.81,54.81,1
HCPCS,93644TC,EP EVAL SUBQ IMPL DFB,,,54.81,54.81,1
HCPCS,93650,ICAR CATH ABLTJ AV NODE FUNC,,,659.67,659.67,1
HCPCS,93650,ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION,15855.0,10305.75,435.33,44585.0,84
HCPCS,936500,ICAR CATH ABLTJ AV NODE FUNC,,,659.67,659.67,1
HCPCS,93653,COMPRE EP EVAL ABLTJ 3D MAPG TX SVT,52442.0,34087.3,580.08,88455.6,80
HCPCS,93653,COMPRE EP EVAL TX SVT,,,949.05,949.05,1
HCPCS,936530,COMPRE EP EVAL TX SVT,,,949.05,949.05,1
HCPCS,93654,COMPRE EP EVAL ABLTJ 3D MAPG TX VT,50735.0,32977.75,752.7,84155.4,80
HCPCS,93654,COMPRE EP EVAL TX VT,,,1143.46,1143.46,1
HCPCS,936540,COMPRE EP EVAL TX VT,,,1143.46,1143.46,1
HCPCS,93655,ICAR CATH ABLTJ DSCRT ARRHYT,,,347.82,347.82,1
HCPCS,93655,ICAR CATHETER ABLATION ARRHYTHMIA ADD ON,5508.0,3580.2,229.28,44585.0,70
HCPCS,936550,ICAR CATH ABLTJ DSCRT ARRHYT,,,347.82,347.82,1
HCPCS,93656,COMPRE EP EVAL ABLTJ ATR FIB,,,1076.06,1076.06,1
HCPCS,93656,COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION,47257.5,30717.375,707.76,78331.5,80
HCPCS,936560,COMPRE EP EVAL ABLTJ ATR FIB,,,1076.06,1076.06,1
HCPCS,93657,ABLATE L/R ATRIAL FIBRIL W/ ISOLATED PULM VEIN,2420.0,1573.0,229.54,2420.0,31
HCPCS,93657,ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN,8334.0,5417.1,343.91,44585.0,39
HCPCS,93657,TX L/R ATRIAL FIB ADDL,,,348.18,348.18,1
HCPCS,936570,TX L/R ATRIAL FIB ADDL,,,348.18,348.18,1
HCPCS,93660,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,3814.0,2479.1,53.85,4646.0,150
HCPCS,93660,TILT TABLE EVALUATION,2739.0,1780.35,79.05,4646.0,72
HCPCS,936600,TILT TABLE EVALUATION,,,79.05,79.05,1
HCPCS,93660TC,TILT TABLE EVALUATION,,,79.05,79.05,1
HCPCS,93662,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,8591.0,5584.15,28.3,37851.0,145
HCPCS,93662,INTRACARDIAC ECG (ICE),,,24.65,24.65,2
HCPCS,936620,INTRACARDIAC ECG (ICE),,,24.65,24.65,1
HCPCS,93662TC,INTRACARDIAC ECG (ICE),,,24.65,24.65,1
HCPCS,93668,PERIPHERAL ARTERIAL DISEASE REHAB PER SESSION,105.0,68.25,14.45,105.0,31
HCPCS,93668,PERIPHERAL VASCULAR REHAB,,,14.45,128.79,16
HCPCS,93668,Peripheral vascular rehab,,,103.01,130.12,6
HCPCS,936680,PERIPHERAL VASCULAR REHAB,,,14.45,14.45,1
HCPCS,93668TC,PERIPHERAL VASCULAR REHAB,,,14.45,14.45,1
HCPCS,93701,BIOIMPEDANCE CV ANALYSIS,,,19.36,279.48,16
HCPCS,93701,BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS,187.0,121.55,20.05,187.0,35
HCPCS,93701,Bioimpedance cv analysis,,,33.85,42.76,6
HCPCS,937010,BIOIMPEDANCE CV ANALYSIS,,,19.36,19.36,1
HCPCS,93701TC,BIOIMPEDANCE CV ANALYSIS,,,19.36,19.36,1
HCPCS,93702,BIS XTRACELL FLUID ANALYSIS,,,132.31,339.23,15
HCPCS,93702,Bis xtracell fluid analysis,,,33.85,42.76,6
HCPCS,937020,BIS XTRACELL FLUID ANALYSIS,,,132.31,132.31,1
HCPCS,93722,PLETHYSMOGRAPHY REPORT,53.0,34.45,26.5,53.0,12
HCPCS,93724,ELEC ALYS ANTITCHYCAR PM SYS,,,45.57,45.57,2
HCPCS,93724,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,2155.0,1400.75,31.45,4302.0,150
HCPCS,937240,ELEC ALYS ANTITCHYCAR PM SYS,,,45.57,45.57,1
HCPCS,93724TC,ELEC ALYS ANTITCHYCAR PM SYS,,,45.57,45.57,1
HCPCS,93740,TEMPERATURE GRADIENT STUDIES,,,1.31,339.23,16
HCPCS,937400,TEMPERATURE GRADIENT STUDIES,,,1.31,1.31,1
HCPCS,93740TC,TEMPERATURE GRADIENT STUDIES,,,1.31,1.31,1
HCPCS,93745,SET-UP CARDIOVERT-DEFIBRILL,,,35.54,650.25,16
HCPCS,93745,Set-up cardiovert-defibrill,,,33.85,42.76,6
HCPCS,937450,SET-UP CARDIOVERT-DEFIBRILL,,,35.54,35.54,1
HCPCS,93745TC,SET-UP CARDIOVERT-DEFIBRILL,,,35.54,35.54,1
HCPCS,93750,INTERROGATION VAD IN PERSON,,,41.57,41.57,1
HCPCS,93750,INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS,660.0,429.0,21.15,2693.0,98
HCPCS,93750,INTERROGATION VAD IN PRSON W/PHYSICIAN ANALYSIS,330.0,214.5,19.24,247.5,35
HCPCS,937500,INTERROGATION VAD IN PERSON,,,41.57,41.57,1
HCPCS,93770,DERMINATION OF VENOUS PRESSUE,70.0,45.5,5.87,70.0,24
HCPCS,93770,DETERMINATION VENOUS PRESS,,,0.66,0.66,2
HCPCS,93770,Determination venous press,,,33.85,42.76,6
HCPCS,937700,DETERMINATION VENOUS PRESS,,,0.66,0.66,1
HCPCS,93770TC,DETERMINATION VENOUS PRESS,,,0.66,0.66,1
HCPCS,93784,AMBL BP MNTR W/SOFTWARE,,,46.55,46.55,1
HCPCS,93784,AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R,167.0,108.55,35.23,167.0,34
HCPCS,93784,Ambl bp mntr w/software,,,33.85,42.76,6
HCPCS,937840,AMBL BP MNTR W/SOFTWARE,,,46.55,46.55,1
HCPCS,93786,AMBL BP MNTR W/SW REC ONLY,,,22.31,22.31,2
HCPCS,93786,AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY,601.0,390.65,22.2,839.0,72
HCPCS,937860,AMBL BP MNTR W/SW REC ONLY,,,22.31,22.31,1
HCPCS,93786TC,AMBL BP MNTR W/SW REC ONLY,,,22.31,22.31,1
HCPCS,93788,AMBL BP MNTR W/SW A/R,,,5.62,5.62,2
HCPCS,93788,AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R,531.0,345.15,5.74,839.0,72
HCPCS,937880,AMBL BP MNTR W/SW A/R,,,5.62,5.62,1
HCPCS,93788TC,AMBL BP MNTR W/SW A/R,,,5.62,5.62,1
HCPCS,93790,AMBL BP MNTR W/SW I&R,,,18.62,18.62,1
HCPCS,93790,AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R,167.0,108.55,15.77,167.0,31
HCPCS,93790,Ambl bp mntr w/sw i&r,,,33.85,42.76,6
HCPCS,937900,AMBL BP MNTR W/SW I&R,,,18.62,18.62,1
HCPCS,93792,PT/CAREGIVER TRAING HOME INR,,,69.24,69.24,1
HCPCS,93792,PT/CAREGIVER TRAINJ FOR INITIATION HOME INR MNTR,535.0,347.75,40.36,535.0,28
HCPCS,93792,Pt/caregiver traing home inr,,,41.57,52.51,6
HCPCS,937920,PT/CAREGIVER TRAING HOME INR,,,69.24,69.24,1
HCPCS,93793,ANTICOAG MGMT PT WARFARIN,,,11.75,11.75,1
HCPCS,93793,ANTICOAGULANT MGMT FOR PT TAKING WARFARIN,79.0,51.35,8.91,79.0,28
HCPCS,93793,Anticoag mgmt pt warfarin,,,75.64,95.54,6
HCPCS,937930,ANTICOAG MGMT PT WARFARIN,,,11.75,11.75,1
HCPCS,93797,CARDIAC REHAB PHASE IV,977.0,635.05,1.01,732.75,35
HCPCS,93797,OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR,72.0,46.8,1.01,54.0,35
HCPCS,93797,PHYS/QHP OP CAR RHAB WO ECG,,,9.14,9.14,1
HCPCS,93797,REHAB CARD PHASE I,905.0,588.25,10.95,814.5,41
HCPCS,937970,PHYS/QHP OP CAR RHAB WO ECG,,,9.14,9.14,1
HCPCS,93798,CARDIAC REHAB PHASE III SESSION,1017.0,661.05,9.63,762.75,35
HCPCS,93798,OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING,112.0,72.8,9.63,84.0,35
HCPCS,93798,PHYS/QHP OP CAR RHAB W/ECG,,,14.08,272.99,15
HCPCS,93798,Phys/qhp op car rhab w/ecg,,,92.65,117.04,6
HCPCS,937980,PHYS/QHP OP CAR RHAB W/ECG,,,14.08,14.08,1
HCPCS,93799,AORTIC SCALLOP INTENTIONAL LACERATION (BASILICA) (COMP CODE 9298,9718.0,6316.7,329.82,9718.0,15
HCPCS,93799,CARDIOVASCULAR PROCEDURE,1432.0,930.8,16.03,37851.0,48
HCPCS,93799,CEREBRAL PROTECTION (COMP CODE 33370),3628.0,2358.2,16.03,37851.0,48
HCPCS,93799,"PREPOST- CARDIOVERSION, THROUGH DEVICE 93799",1432.0,930.8,16.03,2693.0,48
HCPCS,93799,PROCAINAMIDE INFUSION CHALLENGE,4779.0,3106.35,16.03,4301.1,48
HCPCS,93799,"STAND ALONE IVUS, ADD'L VESSEL (COMP TO 92979)",1206.0,783.9,16.03,37851.0,48
HCPCS,93799,TELEMETRY,362.0,235.3,16.03,474.0,40
HCPCS,93799,TRANS-SEPTAL PUNCTURE,1705.0,1108.25,329.82,1705.0,15
HCPCS,93880,DUPLEX SCAN EXTRACRANIAL,1738.0,1129.7,127.76,2090.0,105
HCPCS,93880,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,1738.0,1129.7,25.29,2090.0,150
HCPCS,93880,EXTRACRANIAL BILAT STUDY,,,150.13,150.13,2
HCPCS,938800,EXTRACRANIAL BILAT STUDY,,,150.13,150.13,1
HCPCS,93880TC,EXTRACRANIAL BILAT STUDY,,,150.13,150.13,1
HCPCS,93882,DUPLEX SCAN EXTRACR UNI,582.0,378.3,90.73,964.0,70
HCPCS,93882,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,764.0,496.6,17.47,1017.0,150
HCPCS,93882,EXTRACRANIAL UNI/LTD STUDY,,,99.65,99.65,2
HCPCS,93882,TC CAROTID US UNILATERAL/LIMITED,764.0,496.6,90.73,764.0,35
HCPCS,938820,EXTRACRANIAL UNI/LTD STUDY,,,99.65,99.65,1
HCPCS,93882TC,EXTRACRANIAL UNI/LTD STUDY,,,99.65,99.65,1
HCPCS,93886,INTRACRANIAL COMPLETE STUDY,,,225.13,225.13,2
HCPCS,93886,TRANSCRANIAL DOPPLER,360.0,234.0,152.06,478.96,35
HCPCS,93886,TRANSCRANIAL DOPPLER COMPLETE,2098.0,1363.7,152.06,2098.0,35
HCPCS,93886,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,1738.0,1129.7,39.21,2098.0,150
HCPCS,938860,INTRACRANIAL COMPLETE STUDY,,,225.13,225.13,1
HCPCS,93886TC,INTRACRANIAL COMPLETE STUDY,,,225.13,225.13,1
HCPCS,93888,INTRACRANIAL LIMITED STUDY,,,104.89,104.89,2
HCPCS,93888,TRANSCRANIAL DOPPLER LTD,321.0,208.65,81.04,321.0,35
HCPCS,93888,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,764.0,496.6,26.43,1085.0,150
HCPCS,93888,TRANSCRANIAL DPLR STDY OF INTRACRANIAL LM,1085.0,705.25,81.04,1085.0,35
HCPCS,938880,INTRACRANIAL LIMITED STUDY,,,104.89,104.89,1
HCPCS,93888TC,INTRACRANIAL LIMITED STUDY,,,104.89,104.89,1
HCPCS,93890,TCD VASOREACTIVITY STUDY,447.5,290.875,113.0,669.0,38
HCPCS,93890,Tcd vasoreactivity study,,,66.35,83.81,6
HCPCS,93892,TCD EMBOLI DETECT W/O INJ,,,104.89,104.89,2
HCPCS,93892,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,764.0,496.6,47.88,1224.0,150
HCPCS,93892,TRANSCRANIAL DOPPLER; EMBOLI W/O INTRA BU,460.0,299.0,155.01,571.71,35
HCPCS,93892,TRANSCRANIAL DOPPLER; EMBOLI W/O TNTR BUB,1224.0,795.6,155.01,1224.0,35
HCPCS,938920,TCD EMBOLI DETECT W/O INJ,,,104.89,104.89,1
HCPCS,93892TC,TCD EMBOLI DETECT W/O INJ,,,104.89,104.89,1
HCPCS,93893,TCD EMBOLI DECTION,842.0,547.3,192.33,1224.0,70
HCPCS,93893,TCD STD ICR ART VEN-ART SHNT,,,104.85,104.85,2
HCPCS,93893,TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX,764.0,496.6,48.16,1224.0,150
HCPCS,938930,TCD STD ICR ART VEN-ART SHNT,,,104.85,104.85,1
HCPCS,93893TC,TCD STD ICR ART VEN-ART SHNT,,,104.85,104.85,1
HCPCS,93895,CAROTID INTIMA ATHEROMA EVAL,,,129.66,129.66,1
HCPCS,93895,Carotid intima atheroma eval,,,66.35,83.81,6
HCPCS,938950,CAROTID INTIMA ATHEROMA EVAL,,,129.66,129.66,1
HCPCS,93896,VASOREACTIVITY STUDY W/TCD ICR ARTERIES COMPLETE,356.0,231.4,40.11,356.0,28
HCPCS,93896,VSRCTV STD TCD ICR ART COMPL,,,145.02,145.02,2
HCPCS,93896,Vsrctv std tcd icr art compl,,,100.02,126.34,6
HCPCS,938960,VSRCTV STD TCD ICR ART COMPL,,,145.02,145.02,1
HCPCS,93896TC,VSRCTV STD TCD ICR ART COMPL,,,145.02,145.02,1
HCPCS,93897,EMBOLI DETCJ W/O IV MBUBB NJX TCD ICR ART COMPL,321.0,208.65,36.56,321.0,28
HCPCS,93897,EMBOLI DETCJ WO IV MBUBB NJX,,,197.23,197.23,2
HCPCS,93897,Emboli detcj wo iv mbubb njx,,,100.02,126.34,6
HCPCS,938970,EMBOLI DETCJ WO IV MBUBB NJX,,,197.23,197.23,1
HCPCS,93897TC,EMBOLI DETCJ WO IV MBUBB NJX,,,197.23,197.23,1
HCPCS,93898,VEN-ARTL SHNT DETC IV MBUB NJX TCD ICR ART COMPL,374.0,243.1,42.95,374.0,28
HCPCS,93898,VEN-ARTL SHUNT DET MBUBB NJX,,,201.73,201.73,2
HCPCS,93898,Ven-artl shunt det mbubb njx,,,100.02,126.34,6
HCPCS,938980,VEN-ARTL SHUNT DET MBUBB NJX,,,201.73,201.73,1
HCPCS,93898TC,VEN-ARTL SHUNT DET MBUBB NJX,,,201.73,201.73,1
HCPCS,93922,DOPPLER UP/LOW EXT ART,1036.0,673.4,62.55,1036.0,35
HCPCS,93922,EXTR STUDY DOP WAVE SING,110.0,71.5,55.0,144.91,35
HCPCS,93922,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,926.0,601.9,10.08,1764.0,191
HCPCS,93922,TC DOPPLER UP/LOW EXT ART,926.0,601.9,62.55,926.0,35
HCPCS,93922,UPR/L XTREMITY ART 2 LEVELS,,,69.52,69.52,2
HCPCS,939220,UPR/L XTREMITY ART 2 LEVELS,,,69.52,69.52,1
HCPCS,93922TC,UPR/L XTREMITY ART 2 LEVELS,,,69.52,69.52,1
HCPCS,93923,EXTR STUDY DOP WAVE COMP,760.5,494.32500000000005,98.36,1323.0,70
HCPCS,93923,EXTR STUDY DOP WV COMP,1125.0,731.25,98.36,1125.0,35
HCPCS,93923,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,1125.0,731.25,19.03,1323.0,150
HCPCS,93923,UPR/LXTR ART STDY 3+ LVLS,,,107.22,107.22,2
HCPCS,939230,UPR/LXTR ART STDY 3+ LVLS,,,107.22,107.22,1
HCPCS,93923TC,UPR/LXTR ART STDY 3+ LVLS,,,107.22,107.22,1
HCPCS,93924,DOPPLER BILATERAL EXTREMITIES,1325.0,861.25,117.83,1325.0,35
HCPCS,93924,LWR XTR VASC STDY BILAT,,,134.41,134.41,2
HCPCS,93924,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,1125.0,731.25,21.31,1325.0,150
HCPCS,93924,NONINVASIVE STUDY OF LOWER ARTERIED,200.0,130.0,100.0,281.28,35
HCPCS,93924,TC DOPPLER LOWER EXTS BIL,1125.0,731.25,117.83,1125.0,35
HCPCS,939240,LWR XTR VASC STDY BILAT,,,134.41,134.41,1
HCPCS,93924TC,LWR XTR VASC STDY BILAT,,,134.41,134.41,1
HCPCS,93925,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,1738.0,1129.7,24.15,2058.0,150
HCPCS,93925,DUPLEX SCAN LOW EXT BIL,2058.0,1337.7,127.74,2058.0,35
HCPCS,93925,DUPLEX SCN LO EXT ART BIL,320.0,208.0,127.74,421.38,35
HCPCS,93925,LOWER EXTREMITY STUDY,,,199.95,199.95,2
HCPCS,93925,TC LOWER EXT ART DUP BIL,1738.0,1129.7,127.74,1738.0,35
HCPCS,939250,LOWER EXTREMITY STUDY,,,199.95,199.95,1
HCPCS,93925TC,LOWER EXTREMITY STUDY,,,199.95,199.95,1
HCPCS,93926,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,764.0,496.6,16.9,1017.0,150
HCPCS,93926,DUPLEX LOW EXT UNI LTD,200.0,130.0,85.32,253.1,35
HCPCS,93926,DUPLEX SCN LOW EXT ART UN,964.0,626.6,85.32,964.0,35
HCPCS,93926,LOWER EXTREMITY STUDY,,,104.93,104.93,2
HCPCS,93926,TC DUP LOW EXT UNI LTD,764.0,496.6,85.32,764.0,35
HCPCS,939260,LOWER EXTREMITY STUDY,,,104.93,104.93,1
HCPCS,93926TC,LOWER EXTREMITY STUDY,,,104.93,104.93,1
HCPCS,93930,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,1738.0,1129.7,19.6,2058.0,150
HCPCS,93930,DUPLEX SCAN UPPER EXTR BILATERAL,2058.0,1337.7,131.1,2058.0,35
HCPCS,93930,DUPLEX SCN UP EXT ART BIL,320.0,208.0,131.1,348.03,35
HCPCS,93930,TC DUP UPP EXT ART BIL,1738.0,1129.7,131.1,1738.0,35
HCPCS,93930,UPPER EXTREMITY STUDY,,,157.99,157.99,2
HCPCS,939300,UPPER EXTREMITY STUDY,,,157.99,157.99,1
HCPCS,93930TC,UPPER EXTREMITY STUDY,,,157.99,157.99,1
HCPCS,93931,DUP UP EXT ART/GR UNILAT,200.0,130.0,87.13,217.44,35
HCPCS,93931,DUP UPP EXT ART/GR UNILAT,964.0,626.6,87.13,964.0,35
HCPCS,93931,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,764.0,496.6,13.21,1017.0,150
HCPCS,93931,UPPER EXTREMITY STUDY,,,98.99,98.99,2
HCPCS,939310,UPPER EXTREMITY STUDY,,,98.99,98.99,1
HCPCS,93931TC,UPPER EXTREMITY STUDY,,,98.99,98.99,1
HCPCS,93970,DUP SCAN EXT VEIN BILAT,1738.0,1129.7,100.02,1564.2,49
HCPCS,93970,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,1738.0,1129.7,29.12,2018.0,101
HCPCS,93970,DUPLEX EXT VEINS BILAT,1149.0,746.85,140.0,2018.0,70
HCPCS,93970,EXTREMITY STUDY,,,152.1,152.1,2
HCPCS,93970,TC DUP EXT VEINS BIL,1738.0,1129.7,141.19,1738.0,35
HCPCS,93970,"VEIN MAPPING, COMPLETE",2018.0,1311.7,141.19,2018.0,35
HCPCS,939700,EXTREMITY STUDY,,,152.1,152.1,1
HCPCS,93970TC,EXTREMITY STUDY,,,152.1,152.1,1
HCPCS,93971,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,764.0,496.6,19.03,1017.0,150
HCPCS,93971,DUPLEX EXT VEIN UNI,863.0,560.95,89.79,962.0,70
HCPCS,93971,DUPLEX EXT VEIN UNILAT,198.0,128.7,89.79,208.45,35
HCPCS,93971,EXTREMITY STUDY,,,96.7,96.7,2
HCPCS,93971,VEIN MAPPING LIMITED F/U,962.0,625.3,89.79,962.0,35
HCPCS,939710,EXTREMITY STUDY,,,96.7,96.7,1
HCPCS,93971TC,EXTREMITY STUDY,,,96.7,96.7,1
HCPCS,93975,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1738.0,1129.7,54.37,2248.0,199
HCPCS,93975,DUPLEX SCAN ARTERIAL INFL,510.0,331.5,188.72,510.0,35
HCPCS,93975,DUPLEX SCAN VISCERAL COMPLETE,2248.0,1461.2,188.72,2248.0,35
HCPCS,93975,TC DUPLEX ARTERIAL INFLOW/OUTFLOW,1738.0,1129.7,188.72,1738.0,35
HCPCS,93975,VASCULAR STUDY,,,206.83,206.83,2
HCPCS,939750,VASCULAR STUDY,,,206.83,206.83,1
HCPCS,93975TC,VASCULAR STUDY,,,206.83,206.83,1
HCPCS,93976,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,764.0,496.6,37.21,1116.0,199
HCPCS,93976,DUPLEX SCAN ARTERIAL FU,352.0,228.8,119.9,352.0,35
HCPCS,93976,DUPLEX SCAN VISCERAL LTD,1116.0,725.4,119.9,1116.0,35
HCPCS,93976,TC DUPLEX ARTERIAL/ABD/PELVIC LIMITED,764.0,496.6,119.9,764.0,35
HCPCS,93976,VASCULAR STUDY,,,104.89,104.89,2
HCPCS,939760,VASCULAR STUDY,,,104.89,104.89,1
HCPCS,93976TC,VASCULAR STUDY,,,104.89,104.89,1
HCPCS,93978,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,1738.0,1129.7,27.98,2090.0,150
HCPCS,93978,DUPLEX SCAN AORTA COMPLETE,2090.0,1358.5,126.34,2090.0,35
HCPCS,93978,DUPLEX SCAN AORTA IVC ILI,352.0,228.8,126.34,352.0,35
HCPCS,93978,"TC DUPLEX SCAN OF AORTA, IVC BYPASS GRAFT",1738.0,1129.7,126.34,1738.0,35
HCPCS,93978,VASCULAR STUDY,,,140.64,140.64,2
HCPCS,939780,VASCULAR STUDY,,,140.64,140.64,1
HCPCS,93978TC,VASCULAR STUDY,,,140.64,140.64,1
HCPCS,93979,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,764.0,496.6,18.75,1017.0,150
HCPCS,93979,DUPLEX SCAN AORTA IVC UNI,220.0,143.0,88.71,220.0,35
HCPCS,93979,DUPLEX SCAN AORTA LTD UNILAT,984.0,639.6,88.71,984.0,35
HCPCS,93979,"TC DUPLEX AORTA,IVC,BYPASS GR UNILAT/LIMI",764.0,496.6,88.71,764.0,35
HCPCS,93979,VASCULAR STUDY,,,93.1,93.1,2
HCPCS,939790,VASCULAR STUDY,,,93.1,93.1,1
HCPCS,93979TC,VASCULAR STUDY,,,93.1,93.1,1
HCPCS,93980,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,764.0,496.6,52.42,1264.0,150
HCPCS,93980,DUPLEX SCAN PENILE COMP,500.0,325.0,89.36,500.0,35
HCPCS,93980,DUPLEX SCAN PENILE COMPLETE,1264.0,821.6,89.36,1264.0,35
HCPCS,93980,PENILE VASCULAR STUDY,,,57.36,57.36,2
HCPCS,939800,PENILE VASCULAR STUDY,,,57.36,57.36,1
HCPCS,93980TC,PENILE VASCULAR STUDY,,,57.36,57.36,1
HCPCS,93981,DUP SCAN PENILE LTD,176.0,114.4,53.87,176.0,35
HCPCS,93981,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,764.0,496.6,18.61,1017.0,150
HCPCS,93981,DUPLEX SCAN PENILE LTD,940.0,611.0,53.87,940.0,35
HCPCS,93981,PENILE VASCULAR STUDY,,,49.17,49.17,2
HCPCS,939810,PENILE VASCULAR STUDY,,,49.17,49.17,1
HCPCS,93981TC,PENILE VASCULAR STUDY,,,49.17,49.17,1
HCPCS,93985,DUP-SCAN HEMO COMPL BI STD,,,207.17,207.17,2
HCPCS,93985,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL BI STD,1738.0,1129.7,39.78,2058.0,97
HCPCS,93985,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,1738.0,1129.7,66.35,26432.0,143
HCPCS,939850,DUP-SCAN HEMO COMPL BI STD,,,207.17,207.17,1
HCPCS,93985TC,DUP-SCAN HEMO COMPL BI STD,,,207.17,207.17,1
HCPCS,93986,DUP-SCAN HEMO COMPL UNI STD,,,104.93,104.93,2
HCPCS,93986,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL UNI STD,764.0,496.6,23.48,964.0,97
HCPCS,93986,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,764.0,496.6,66.35,26432.0,143
HCPCS,939860,DUP-SCAN HEMO COMPL UNI STD,,,104.93,104.93,1
HCPCS,93986TC,DUP-SCAN HEMO COMPL UNI STD,,,104.93,104.93,1
HCPCS,93990,DOPPLER FLOW TESTING,,,104.93,104.93,2
HCPCS,93990,DUP SCAN HEMODIALYSIS ACCESS,964.0,626.6,80.31,964.0,35
HCPCS,93990,DUPLEX SCAN HEMODIALYSIS ACCESS,764.0,496.6,11.08,1017.0,185
HCPCS,939900,DOPPLER FLOW TESTING,,,104.93,104.93,1
HCPCS,93990TC,DOPPLER FLOW TESTING,,,104.93,104.93,1
HCPCS,93998,UNLISTD NONINVAS VASC DX STD,,,100.85,100.85,1
HCPCS,93998,UNLISTED NONINVASIVE VASCULAR DIAGNOSTIC STUDY,127.0,82.55,63.5,127.0,12
HCPCS,93998,US TEMPORAL ARTERIES (COMP CODE 93880),961.0,624.65,24.58,1419.3,60
HCPCS,939980,UNLISTD NONINVAS VASC DX STD,,,100.85,100.85,1
HCPCS,94002,VENT MGMT INPAT INIT DAY,,,95.49,95.49,1
HCPCS,94002,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,2338.5,1520.025,63.41,3420.9,76
HCPCS,940020,VENT MGMT INPAT INIT DAY,,,95.49,95.49,1
HCPCS,94003,VENT MGMT INPAT SUBQ DAY,,,67.09,67.09,1
HCPCS,94003,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA,2202.0,1431.3,45.07,3420.9,76
HCPCS,940030,VENT MGMT INPAT SUBQ DAY,,,67.09,67.09,1
HCPCS,94004,VENT MGMT NF PER DAY,,,49.73,49.73,1
HCPCS,94004,Vent mgmt nf per day,,,834.39,1053.96,6
HCPCS,940040,VENT MGMT NF PER DAY,,,49.73,49.73,1
HCPCS,94005,HOME VENT MGMT SUPERVISION,,,93.63,93.63,1
HCPCS,94005,Home vent mgmt supervision,,,34.32,43.36,6
HCPCS,940050,HOME VENT MGMT SUPERVISION,,,93.63,93.63,1
HCPCS,94010,BREATHING CAPACITY TEST,,,19.04,19.04,2
HCPCS,94010,SPIROMETRY,525.0,341.25,20.8,975.0,70
HCPCS,94010,SPIROMETRY TC CHARGE,720.0,468.0,20.8,720.0,35
HCPCS,94010,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,900.0,585.0,6.96,1272.0,150
HCPCS,940100,BREATHING CAPACITY TEST,,,19.04,19.04,1
HCPCS,94010TC,BREATHING CAPACITY TEST,,,19.04,19.04,1
HCPCS,94011,SPIROMETRY UP TO 2 YRS OLD,,,88.33,339.23,15
HCPCS,94011,Spirometry up to 2 yrs old,,,38.83,49.04,6
HCPCS,940110,SPIROMETRY UP TO 2 YRS OLD,,,88.33,88.33,1
HCPCS,94012,SPIRMTRY W/BRNCHDIL INF-2 YR,,,144.28,675.17,15
HCPCS,94012,Spirmtry w/brnchdil inf-2 yr,,,65.68,82.97,6
HCPCS,940120,SPIRMTRY W/BRNCHDIL INF-2 YR,,,144.28,144.28,1
HCPCS,94013,MEAS LUNG VOL THRU 2 YRS,,,19.46,1150.43,15
HCPCS,94013,Meas lung vol thru 2 yrs,,,65.68,82.97,6
HCPCS,940130,MEAS LUNG VOL THRU 2 YRS,,,19.46,19.46,1
HCPCS,94014,PATIENT RECORDED SPIROMETRY,,,33.17,865.18,16
HCPCS,94014,Patient recorded spirometry,,,65.68,82.97,6
HCPCS,940140,PATIENT RECORDED SPIROMETRY,,,33.17,33.17,1
HCPCS,94014TC,PATIENT RECORDED SPIROMETRY,,,33.17,33.17,1
HCPCS,94015,PATIENT RECORDED SPIROMETRY,,,31.48,31.48,2
HCPCS,94015,PATIENT-INITIATED SPIROMETRIC RECORDING,1790.0,1163.5,51.78,1611.0,49
HCPCS,940150,PATIENT RECORDED SPIROMETRY,,,31.48,31.48,1
HCPCS,94015TC,PATIENT RECORDED SPIROMETRY,,,31.48,31.48,1
HCPCS,94016,PATIENT-INITIATED SPIROMETRIC PHYS/QHP R&I ONLY,208.0,135.2,15.15,208.0,35
HCPCS,94016,REVIEW PATIENT SPIROMETRY,,,25.34,64.78,22
HCPCS,94016,Review patient spirometry,,,38.83,49.04,6
HCPCS,940160,REVIEW PATIENT SPIROMETRY,,,25.34,25.34,1
HCPCS,94060,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,1790.0,1163.5,9.95,1887.0,188
HCPCS,94060,BRONCHOSPASM EVAL,97.0,63.05,29.87,97.0,35
HCPCS,94060,BRONCHOSPASM EVALULATION,1887.0,1226.55,29.87,1887.0,35
HCPCS,94060,BRONCHOSPASM TC CHARGE,1790.0,1163.5,29.87,1790.0,35
HCPCS,94060,EVALUATION OF WHEEZING,,,28.53,28.53,2
HCPCS,940600,EVALUATION OF WHEEZING,,,28.53,28.53,1
HCPCS,94060TC,EVALUATION OF WHEEZING,,,28.53,28.53,1
HCPCS,94070,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,1790.0,1163.5,24.28,2030.0,150
HCPCS,94070,EVALUATION OF WHEEZING,,,35.46,35.46,2
HCPCS,940700,EVALUATION OF WHEEZING,,,35.46,35.46,1
HCPCS,94070TC,EVALUATION OF WHEEZING,,,35.46,35.46,1
HCPCS,94150,VITAL CAPACITY TEST,,,21.33,21.33,2
HCPCS,94150,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,900.0,585.0,3.27,1272.0,116
HCPCS,941500,VITAL CAPACITY TEST,,,21.33,21.33,1
HCPCS,94150TC,VITAL CAPACITY TEST,,,21.33,21.33,1
HCPCS,94200,LUNG FUNCTION TEST (MBC/MVV),,,12.16,12.16,2
HCPCS,94200,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,341.0,221.65,2.84,1272.0,150
HCPCS,94200,MAXIMUM BREATHING TC CHARGE,341.0,221.65,11.49,341.0,35
HCPCS,94200,MAXIMUM VOLUNTARY VENTILATION,361.0,234.65,11.49,361.0,35
HCPCS,942000,LUNG FUNCTION TEST (MBC/MVV),,,12.16,12.16,1
HCPCS,94200TC,LUNG FUNCTION TEST (MBC/MVV),,,12.16,12.16,1
HCPCS,94240,"LUNG VOLUMES, HELIUM DILUTION",47.0,30.55,23.5,47.0,12
HCPCS,94250,Expired gas collection,,,38.83,49.04,6
HCPCS,94260,THORACIC GAS VOLUME,35.0,22.75,17.5,35.0,12
HCPCS,94360,MEASURE AIRFLOW RESISTANCE,176.0,114.4,88.0,176.0,12
HCPCS,94375,RESPIRATORY FLOW VOLUME LOOP,,,24.6,675.17,16
HCPCS,94375,Respiratory flow volume loop,,,65.68,82.97,6
HCPCS,943750,RESPIRATORY FLOW VOLUME LOOP,,,24.6,24.6,1
HCPCS,94375TC,RESPIRATORY FLOW VOLUME LOOP,,,24.6,24.6,1
HCPCS,94400,Co2 breathing response curve,,,38.83,49.04,6
HCPCS,94450,BREATHING RESPONSE HYPOXIA,,,59.69,339.23,16
HCPCS,94450,BREATHING RESPONSE TO HYPOXIA,176.0,114.4,16.05,176.0,31
HCPCS,94450,Breathing response hypoxia,,,38.83,49.04,6
HCPCS,944500,BREATHING RESPONSE HYPOXIA,,,59.69,59.69,1
HCPCS,94450TC,BREATHING RESPONSE HYPOXIA,,,59.69,59.69,1
HCPCS,94452,HAST W/I&R PHYS/QHP,,,36.07,36.07,2
HCPCS,94452,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,741.0,481.65,12.07,1272.0,147
HCPCS,944520,HAST W/I&R PHYS/QHP,,,36.07,36.07,1
HCPCS,94452TC,HAST W/I&R PHYS/QHP,,,36.07,36.07,1
HCPCS,94453,HAST W/SUPPL OXYGEN TITRJ,,,48.23,48.23,2
HCPCS,94453,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,741.0,481.65,15.48,1272.0,147
HCPCS,944530,HAST W/SUPPL OXYGEN TITRJ,,,48.23,48.23,1
HCPCS,94453TC,HAST W/SUPPL OXYGEN TITRJ,,,48.23,48.23,1
HCPCS,94610,INTRAPULM SURFACTANT ADMN,,,58.75,440.98,15
HCPCS,94610,Intrapulm surfactant admn,,,38.83,49.04,6
HCPCS,946100,INTRAPULM SURFACTANT ADMN,,,58.75,58.75,1
HCPCS,94617,EXERCISE TST BRNCSPSM W/ECG,,,57.12,57.12,2
HCPCS,94617,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,741.0,481.65,30.32,1272.0,146
HCPCS,946170,EXERCISE TST BRNCSPSM W/ECG,,,57.12,57.12,1
HCPCS,94617TC,EXERCISE TST BRNCSPSM W/ECG,,,57.12,57.12,1
HCPCS,94618,ADULT - OXIMETRY WITH AMBULATION,392.5,255.125,21.51,593.0,62
HCPCS,94618,ADULT - SIX MINUTE WALK,593.0,385.45,25.37,593.0,31
HCPCS,94618,OXYGEN TITRATION-TRANSPLANT,392.5,255.125,21.51,593.0,62
HCPCS,94618,PULMONARY STRESS TESTING,466.5,303.22499999999997,12.16,1272.0,148
HCPCS,946180,PULMONARY STRESS TESTING,,,12.16,12.16,1
HCPCS,94618TC,PULMONARY STRESS TESTING,,,12.16,12.16,1
HCPCS,94619,EXERCISE TST BRNCSPSM WO ECG,,,43.32,128.79,16
HCPCS,94619,Exercise tst brncspsm wo ecg,,,38.83,49.04,6
HCPCS,94619,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG,341.0,221.65,20.62,537.0,97
HCPCS,946190,EXERCISE TST BRNCSPSM WO ECG,,,43.32,43.32,1
HCPCS,94619TC,EXERCISE TST BRNCSPSM WO ECG,,,43.32,43.32,1
HCPCS,94621,CARDIOPULM EXERCISE TESTING,,,86.92,86.92,2
HCPCS,94621,CARDIOPULMONARY EXERCISE TESTING,1790.0,1163.5,57.52,2358.0,150
HCPCS,946210,CARDIOPULM EXERCISE TESTING,,,86.92,86.92,1
HCPCS,94621TC,CARDIOPULM EXERCISE TESTING,,,86.92,86.92,1
HCPCS,94625,PHY/QHP OP PULM RHB W/O MNTR,,,19.34,128.79,15
HCPCS,94625,PHYS/QHP SVCS OP PULM REHAB WO CONT OXIMTRY MNTR,158.0,102.7,3.28,118.5,31
HCPCS,94625,Phy/qhp op pulm rhb w/o mntr,,,22.83,28.84,6
HCPCS,946250,PHY/QHP OP PULM RHB W/O MNTR,,,19.34,19.34,1
HCPCS,94626,PHY/QHP OP PULM RHB W/MNTR,,,28.54,128.79,15
HCPCS,94626,PHYS/QHP SVCS OP PULM REHAB W/CONT OXIMTRY MNTR,246.0,159.9,19.85,184.5,31
HCPCS,94626,Phy/qhp op pulm rhb w/mntr,,,22.83,28.84,6
HCPCS,946260,PHY/QHP OP PULM RHB W/MNTR,,,28.54,28.54,1
HCPCS,94640,AIRWAY INHALATION TREATMENT,,,7.91,7.91,1
HCPCS,94640,DAILY PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,3627.0,2357.55,12.59,3264.3,41
HCPCS,94640,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,662.0,430.3,7.5,1764.0,158
HCPCS,946400,AIRWAY INHALATION TREATMENT,,,7.91,7.91,1
HCPCS,94642,AEROSOL INHALATION TREATMENT,,,43.75,43.75,1
HCPCS,94642,PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH,764.5,496.925,38.83,1053.0,53
HCPCS,946420,AEROSOL INHALATION TREATMENT,,,43.75,43.75,1
HCPCS,94644,CONT INHLJ TX 1ST HOUR,,,58.71,58.71,1
HCPCS,94644,CONTINUOUS INHALATION TREATMENT 1ST HR,741.0,481.65,38.83,666.9,41
HCPCS,94644,"CONTINUOUS INHALATION TX, 1ST HR",121.0,78.65,29.92,121.0,35
HCPCS,946440,CONT INHLJ TX 1ST HOUR,,,58.71,58.71,1
HCPCS,94645,CONT INHLJ TX EACH ADDL HOUR,,,16.09,16.09,1
HCPCS,94645,CONTINUOUS INHALATION TREATMENT EA ADDL HR,203.0,131.95,24.49,509.0,31
HCPCS,946450,CONT INHLJ TX EACH ADDL HOUR,,,16.09,16.09,1
HCPCS,94660,CPAP INITIATION&MGMT,,,38.72,38.72,1
HCPCS,94660,CPAP VENTILATION CPAP INITIATION&MGMT,737.0,479.05,18.25,1053.0,76
HCPCS,946600,CPAP INITIATION&MGMT,,,38.72,38.72,1
HCPCS,94662,NEG PRESS VENTILATION CNP,,,663.6,1433.37,10
HCPCS,94662,Neg press ventilation cnp,,,834.39,1053.96,6
HCPCS,94664,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,647.0,420.55,9.36,1053.0,76
HCPCS,94664,DEMO&/EVAL PT USE INHALER,,,17.78,17.78,1
HCPCS,946640,DEMO&/EVAL PT USE INHALER,,,17.78,17.78,1
HCPCS,94667,MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL,469.0,304.85,15.75,666.9,76
HCPCS,94667,MNPJ CHEST WALL 1ST,,,24.65,24.65,1
HCPCS,946670,MNPJ CHEST WALL 1ST,,,24.65,24.65,1
HCPCS,94668,MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ,741.0,481.65,38.83,666.9,41
HCPCS,94668,MNPJ CHEST WALL SBSQ,,,38.78,38.78,1
HCPCS,946680,MNPJ CHEST WALL SBSQ,,,38.78,38.78,1
HCPCS,94669,MECHANICAL CHEST WALL OSCILL,,,20.39,20.39,1
HCPCS,94669,MECHANICAL CHEST WALL OSCILLATION LUNG FUNCTION,765.0,497.25,17.13,1053.0,69
HCPCS,946690,MECHANICAL CHEST WALL OSCILL,,,20.39,20.39,1
HCPCS,94680,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,900.0,585.0,10.65,1004.0,101
HCPCS,94680,O2 UPTK RST&XERS DIR SIMPLE,,,41.03,339.23,16
HCPCS,94680,O2 uptk rst&xers dir simple,,,38.83,49.04,6
HCPCS,946800,O2 UPTK RST&XERS DIR SIMPLE,,,41.03,41.03,1
HCPCS,94680TC,O2 UPTK RST&XERS DIR SIMPLE,,,41.03,41.03,1
HCPCS,94681,O2 UPTK CO2 OUTP % O2 XTRC,,,38.08,38.08,2
HCPCS,94681,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,1790.0,1163.5,8.09,1878.0,150
HCPCS,946810,O2 UPTK CO2 OUTP % O2 XTRC,,,38.08,38.08,1
HCPCS,94681TC,O2 UPTK CO2 OUTP % O2 XTRC,,,38.08,38.08,1
HCPCS,94690,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,341.0,221.65,3.27,369.0,101
HCPCS,94690,O2 UPTK REST INDIRECT,,,44.26,128.79,16
HCPCS,94690,O2 uptk rest indirect,,,38.83,49.04,6
HCPCS,946900,O2 UPTK REST INDIRECT,,,44.26,44.26,1
HCPCS,94690TC,O2 UPTK REST INDIRECT,,,44.26,44.26,1
HCPCS,94720,CARBON MONOXIDE DIFFUSING CAPACITY,282.0,183.3,141.0,282.0,12
HCPCS,94725,MEMBRANE DIFFUSION CAPACITY,487.0,316.55,243.5,487.0,12
HCPCS,94726,PLETHYSMOGRAPHY LUNG VOLUMES,,,43.64,43.64,2
HCPCS,94726,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,1790.0,1163.5,10.37,1904.0,150
HCPCS,947260,PLETHYSMOGRAPHY LUNG VOLUMES,,,43.64,43.64,1
HCPCS,94726TC,PLETHYSMOGRAPHY LUNG VOLUMES,,,43.64,43.64,1
HCPCS,94727,GAS DIL/WSHOT DETER LNG VOL,,,32.46,32.46,2
HCPCS,94727,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V,900.0,585.0,38.83,1272.0,49
HCPCS,94727,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&VOL,900.0,585.0,10.37,1014.0,101
HCPCS,947270,GAS DIL/WSHOT DETER LNG VOL,,,32.46,32.46,1
HCPCS,94727TC,GAS DIL/WSHOT DETER LNG VOL,,,32.46,32.46,1
HCPCS,94728,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,900.0,585.0,10.37,1004.0,101
HCPCS,94728,AIRWAY RESISTANCE BY OSCILLOMETRY,900.0,585.0,65.68,1272.0,49
HCPCS,94728,AIRWY RESIST BY OSCILLOMETRY,,,31.82,31.82,2
HCPCS,947280,AIRWY RESIST BY OSCILLOMETRY,,,31.82,31.82,1
HCPCS,94728TC,AIRWY RESIST BY OSCILLOMETRY,,,31.82,31.82,1
HCPCS,94729,CO DIFFUSING CAPACITY,756.0,491.4,38.83,1272.0,39
HCPCS,94729,DIFFUSING CAPACITY,756.0,491.4,6.96,832.0,103
HCPCS,947290,DIFFUSING CAPACITY,,,47.21,47.21,1
HCPCS,94729TC,DIFFUSING CAPACITY,,,47.21,47.21,1
HCPCS,94750,Pulmonary compliance study,,,38.83,49.04,6
HCPCS,94760,N-INVAS EAR/PLS OXIMETRY 1,,,2.67,2.67,2
HCPCS,94760,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,277.5,180.375,2.72,1272.0,97
HCPCS,947600,N-INVAS EAR/PLS OXIMETRY 1,,,2.67,2.67,1
HCPCS,94760TC,N-INVAS EAR/PLS OXIMETRY 1,,,2.67,2.67,1
HCPCS,94761,N-INVAS EAR/PLS OXIMETRY MLT,,,3.97,3.97,2
HCPCS,94761,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,316.5,205.725,4.12,1272.0,97
HCPCS,947610,N-INVAS EAR/PLS OXIMETRY MLT,,,3.97,3.97,1
HCPCS,94761TC,N-INVAS EAR/PLS OXIMETRY MLT,,,3.97,3.97,1
HCPCS,94762,N-INVAS EAR/PLS OXIMTRY CONT,,,24.94,24.94,2
HCPCS,94762,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,572.5,372.125,13.06,1272.0,80
HCPCS,947620,N-INVAS EAR/PLS OXIMTRY CONT,,,24.94,24.94,1
HCPCS,94762TC,N-INVAS EAR/PLS OXIMTRY CONT,,,24.94,24.94,1
HCPCS,94770,Exhaled carbon dioxide test,,,38.83,49.04,6
HCPCS,94772,CIRCADIAN RESPIR PATTERN REC,,,186.57,1150.43,16
HCPCS,94772,Circadian respir pattern rec,,,65.68,82.97,6
HCPCS,947720,CIRCADIAN RESPIR PATTERN REC,,,186.57,186.57,1
HCPCS,94772TC,CIRCADIAN RESPIR PATTERN REC,,,186.57,186.57,1
HCPCS,94774,PED HOME APNEA MNTR EVNT REC,,,320.39,320.39,1
HCPCS,94774,Ped home apnea mntr evnt rec,,,38.83,49.04,6
HCPCS,947740,PED HOME APNEA MNTR EVNT REC,,,320.39,320.39,1
HCPCS,94775,PED HOME APNEA MNTR ATT ONLY,,,50.17,339.23,15
HCPCS,94775,Ped home apnea mntr att only,,,38.83,49.04,6
HCPCS,947750,PED HOME APNEA MNTR ATT ONLY,,,50.17,50.17,1
HCPCS,94776,PED HOME APNEA MNTR DL&ALYS,,,134.37,339.23,15
HCPCS,94776,Ped home apnea mntr dl&alys,,,38.83,49.04,6
HCPCS,947760,PED HOME APNEA MNTR DL&ALYS,,,239.73,239.73,1
HCPCS,94777,PED HOME APNEA MNTR RVW I&R,,,30.18,30.18,1
HCPCS,94777,Ped home apnea mntr rvw i&r,,,38.83,49.04,6
HCPCS,947770,PED HOME APNEA MNTR RVW I&R,,,30.18,30.18,1
HCPCS,94780,CARS/BD TST INFT-12MO 60 MIN,,,24.27,85.1,15
HCPCS,94780,Cars/bd tst inft-12mo 60 min,,,38.83,49.04,6
HCPCS,947800,CARS/BD TST INFT-12MO 60 MIN,,,24.27,24.27,1
HCPCS,94781,CARS/BD TST INFT-12MO +30MIN,,,8.45,8.45,1
HCPCS,94781,Cars/bd tst inft-12mo +30min,,,38.83,49.04,6
HCPCS,947810,CARS/BD TST INFT-12MO +30MIN,,,8.45,8.45,1
HCPCS,94799,MINI-BAL RT,450.0,292.5,38.83,671.0,40
HCPCS,94799,RESPIRATORY THERAPY EVAL-HOSP,365.0,237.25,38.83,509.0,40
HCPCS,94799,RT DAILY ASSESSMENT,533.0,346.45,38.83,509.0,40
HCPCS,94799,RT MONITORING TRANSPORT,515.0,334.75,38.83,509.0,40
HCPCS,94799,TRACH ASPIRATION,432.0,280.8,38.83,671.0,40
HCPCS,95004,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,169.0,109.85,2.81,2205.87,76
HCPCS,95004,PERQ TESTS W/ALRGNC XTRCS,,,3.01,3.01,1
HCPCS,950040,PERQ TESTS W/ALRGNC XTRCS,,,3.01,3.01,1
HCPCS,95012,NITRIC OXIDE EXP GAS DETER,,,15.35,15.35,1
HCPCS,95012,NITRIC OXIDE EXPIRED GAS DETERMINATION,109.5,71.175,11.56,1272.0,81
HCPCS,950120,NITRIC OXIDE EXP GAS DETER,,,15.35,15.35,1
HCPCS,95017,ALL TSTG PERQ&IQ W/VENOMS,,,3.18,3.18,1
HCPCS,95017,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/ I&R,28.0,18.2,3.16,21.0,31
HCPCS,95017,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/I&R,91.0,59.15,4.17,323.0,41
HCPCS,950170,ALL TSTG PERQ&IQ W/VENOMS,,,3.18,3.18,1
HCPCS,95018,ALL TSTG PERQ&IQ DRUGS/BIOL,,,6.05,6.05,1
HCPCS,95018,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/ I&R,165.0,107.25,5.38,123.75,31
HCPCS,95018,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/I&R,165.0,107.25,8.52,323.0,41
HCPCS,950180,ALL TSTG PERQ&IQ DRUGS/BIOL,,,6.05,6.05,1
HCPCS,95024,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,163.0,105.95,0.82,323.0,76
HCPCS,95024,IQ TESTS W/ALLERGENIC XTRCS,,,0.86,0.86,1
HCPCS,950240,IQ TESTS W/ALLERGENIC XTRCS,,,0.86,0.86,1
HCPCS,95027,INTRACUTANEOUS TESTS W/ALLERGENIC XTRCS AIRBORNE,5.0,3.25,2.5,9.11,35
HCPCS,95027,IQ TSTS SEQL&INCRL AIRBORNE,,,4.09,53.1,15
HCPCS,95027,Iq tsts seql&incrl airborne,,,19.39,24.49,6
HCPCS,950270,IQ TSTS SEQL&INCRL AIRBORNE,,,4.09,4.09,1
HCPCS,95028,IC TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING,48.0,31.2,6.25,48.0,35
HCPCS,95028,IQ TSTS ALLERGY DELAYED RXN,,,10.24,85.1,15
HCPCS,95028,Iq tsts allergy delayed rxn,,,19.39,24.49,6
HCPCS,950280,IQ TSTS ALLERGY DELAYED RXN,,,10.24,10.24,1
HCPCS,95044,PATCH TEST(S) SPECIFY NUMBER,408.0,265.2,3.83,408.0,35
HCPCS,95044,PATCH/APPLICATION TESTS,,,4.06,2205.87,15
HCPCS,95044,Patch/application tests,,,25.14,31.75,6
HCPCS,950440,PATCH/APPLICATION TESTS,,,4.06,4.06,1
HCPCS,95052,PHOTO PATCH TEST(S) SPECIFY NUM,52.0,33.8,4.34,52.0,35
HCPCS,95052,PHOTO PATCH TESTS,,,5.14,128.79,15
HCPCS,95052,Photo patch tests,,,19.39,24.49,6
HCPCS,950520,PHOTO PATCH TESTS,,,5.14,5.14,1
HCPCS,95056,PHOTO TESTS,,,42.24,279.48,15
HCPCS,95056,PHOTOSENSITIVITY TESTS,53.0,34.45,23.99,91.56,35
HCPCS,95056,Photo tests,,,25.14,31.75,6
HCPCS,950560,PHOTO TESTS,,,42.24,42.24,1
HCPCS,95060,OPH MUCOUS MEMBRANE TESTS,,,31.73,279.48,15
HCPCS,95060,Oph mucous membrane tests,,,25.14,31.75,6
HCPCS,950600,OPH MUCOUS MEMBRANE TESTS,,,31.73,31.73,1
HCPCS,95065,DIR NSL MUCOUS MEMBRANE TEST,,,23.4,85.1,15
HCPCS,95065,Dir nsl mucous membrane test,,,19.39,24.49,6
HCPCS,950650,DIR NSL MUCOUS MEMBRANE TEST,,,23.4,23.4,1
HCPCS,95070,INHLJ BRNCL CHALLENGE TSTG,,,28.27,28.27,1
HCPCS,95070,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,1258.5,818.025,25.14,1791.0,125
HCPCS,950700,INHLJ BRNCL CHALLENGE TSTG,,,28.27,28.27,1
HCPCS,95071,Bronchial allergy tests,,,19.39,24.49,6
HCPCS,95076,INGEST CHALLENGE INI 120 MIN,,,62.69,1150.43,15
HCPCS,95076,INGESTION CHALLENGE TEST INITIAL 120 MINUTES,660.0,429.0,53.82,495.0,31
HCPCS,95076,Ingest challenge ini 120 min,,,181.25,228.95,6
HCPCS,950760,INGEST CHALLENGE INI 120 MIN,,,62.69,62.69,1
HCPCS,95079,INGEST CHALLENGE ADDL 60 MIN,,,57.81,57.81,1
HCPCS,95079,INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES,607.0,394.55,38.34,455.25,31
HCPCS,95079,Ingest challenge addl 60 min,,,181.25,228.95,6
HCPCS,950790,INGEST CHALLENGE ADDL 60 MIN,,,57.81,57.81,1
HCPCS,95115,IMMUNOTHERAPY 1 INJ,173.0,112.45,14.05,671.0,41
HCPCS,95115,IMMUNOTHERAPY ONE INJECTION,,,8.36,8.36,1
HCPCS,95115,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX,60.0,39.0,7.13,60.0,35
HCPCS,951150,IMMUNOTHERAPY ONE INJECTION,,,8.36,8.36,1
HCPCS,95117,IMMUNOTHERAPY INJECTIONS,,,9.97,9.97,1
HCPCS,95117,IMMUNOTHERAPY>=2 INJ,198.0,128.7,14.05,671.0,41
HCPCS,95117,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS,198.0,128.7,8.72,198.0,35
HCPCS,951170,IMMUNOTHERAPY INJECTIONS,,,9.97,9.97,1
HCPCS,95120,IMMUNOTHERAPY ONE INJECTION,,,10.29,10.29,1
HCPCS,95120,Immunotherapy one injection,,,14.05,17.75,6
HCPCS,95120,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 1 NJX,39.0,25.35,19.5,39.0,13
HCPCS,951200,IMMUNOTHERAPY ONE INJECTION,,,10.29,10.29,1
HCPCS,95125,IMMUNOTHERAPY 2/> INJECTIONS,,,12.8,12.8,1
HCPCS,95125,Immunotherapy 2/> injections,,,14.05,17.75,6
HCPCS,95125,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 2/> NJX,40.0,26.0,20.0,40.0,13
HCPCS,951250,IMMUNOTHERAPY 2/> INJECTIONS,,,12.8,12.8,1
HCPCS,95130,IMMNTX 1 STING INSECT,,,17.79,17.79,1
HCPCS,95130,Immntx 1 sting insect,,,14.05,17.75,6
HCPCS,951300,IMMNTX 1 STING INSECT,,,17.79,17.79,1
HCPCS,95131,IMMNTX 2 STING INSECTS,,,23.08,23.08,1
HCPCS,95131,Immntx 2 sting insects,,,14.05,17.75,6
HCPCS,951310,IMMNTX 2 STING INSECTS,,,23.08,23.08,1
HCPCS,95132,IMMNTX 3 STING INSECTS,,,27.81,27.81,1
HCPCS,95132,Immntx 3 sting insects,,,14.05,17.75,6
HCPCS,951320,IMMNTX 3 STING INSECTS,,,27.81,27.81,1
HCPCS,95133,IMMNTX 4 STING INSECTS,,,33.07,33.07,1
HCPCS,95133,Immntx 4 sting insects,,,14.05,17.75,6
HCPCS,951330,IMMNTX 4 STING INSECTS,,,33.07,33.07,1
HCPCS,95134,IMMNTX 5 STING INSECTS,,,39.77,39.77,1
HCPCS,95134,Immntx 5 sting insects,,,14.05,17.75,6
HCPCS,951340,IMMNTX 5 STING INSECTS,,,39.77,39.77,1
HCPCS,95144,ANTIGEN THERAPY SERVICES,,,2.88,100.04,15
HCPCS,95144,Antigen therapy services,,,14.05,17.75,6
HCPCS,95144,PREPJ& ANTIGEN PRV ALLERGEN IMMUNOTHERAPY 1 DO,24.0,15.6,2.35,18.0,35
HCPCS,951440,ANTIGEN THERAPY SERVICES,,,2.88,2.88,1
HCPCS,95145,ANTIGEN THERAPY SERVICES,,,2.61,2.61,1
HCPCS,95145,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT,24.0,15.6,2.35,30.99,35
HCPCS,95145,VENOM INSECT 1 VIAL,173.0,112.45,3.66,671.0,41
HCPCS,951450,ANTIGEN THERAPY SERVICES,,,2.61,2.61,1
HCPCS,95146,ANTIGEN THERAPY SERVICES,,,2.61,2.61,1
HCPCS,95146,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 2 INSECT,24.0,15.6,2.35,54.79,35
HCPCS,95146,VENOM MULTIDOSE 2 VIAL,173.0,112.45,3.66,671.0,41
HCPCS,951460,ANTIGEN THERAPY SERVICES,,,2.61,2.61,1
HCPCS,95147,ANTIGEN THERAPY SERVICES,,,2.61,2.61,1
HCPCS,95147,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 3 INSECT,24.0,15.6,2.35,49.33,35
HCPCS,95147,VENOM MULTIDOSE 3 VIAL,268.0,174.2,3.66,671.0,41
HCPCS,951470,ANTIGEN THERAPY SERVICES,,,2.61,2.61,1
HCPCS,95148,ANTIGEN THERAPY SERVICES,,,2.61,2.61,1
HCPCS,95148,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 4 INSECT,24.0,15.6,2.35,73.63,35
HCPCS,95148,VENOM MULTIDOSE 4 VIAL,268.0,174.2,3.66,671.0,41
HCPCS,951480,ANTIGEN THERAPY SERVICES,,,2.61,2.61,1
HCPCS,95149,ANTIGEN THERAPY SERVICES,,,2.61,2.61,1
HCPCS,95149,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 5 INSECT,24.0,15.6,2.35,98.42,35
HCPCS,95149,VENOM MULTIDOSE 5 VIAL,268.0,174.2,3.66,671.0,41
HCPCS,951490,ANTIGEN THERAPY SERVICES,,,2.61,2.61,1
HCPCS,95165,ANTIGEN THERAPY SERVICES,,,2.88,2.88,1
HCPCS,95165,PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN,124.0,80.6,2.59,671.0,76
HCPCS,951650,ANTIGEN THERAPY SERVICES,,,2.88,2.88,1
HCPCS,95170,ANTIGEN THERAPY SERVICES,,,2.61,100.04,15
HCPCS,95170,Antigen therapy services,,,14.05,17.75,6
HCPCS,95170,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY WHL INSE,24.0,15.6,2.35,18.0,35
HCPCS,951700,ANTIGEN THERAPY SERVICES,,,2.61,2.61,1
HCPCS,95180,RAPID DESENSITIZATION,,,86.93,86.93,1
HCPCS,95180,RAPID DESENSITIZATION PROCEDURE EACH HOUR,1150.0,747.5,25.14,1346.4,76
HCPCS,951800,RAPID DESENSITIZATION,,,86.93,86.93,1
HCPCS,95199,UNLISTED ALL/IMMLG SVC/PX,,,24.58,53.1,14
HCPCS,95199,Unlisted all/immlg svc/px,,,19.39,24.49,6
HCPCS,95249,CONT GLUC MNTR PT PROV EQP,,,59.62,128.79,15
HCPCS,95249,CONT GLUC MONITORING PATIENT PROVIDED EQUIPTMENT,297.0,193.05,41.17,297.0,28
HCPCS,95249,Cont gluc mntr pt prov eqp,,,41.57,52.51,6
HCPCS,952490,CONT GLUC MNTR PT PROV EQP,,,64.37,64.37,1
HCPCS,95250,CONT GLUC MNTR PHYS/QHP EQP,,,129.36,279.41,16
HCPCS,95250,CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT,393.0,255.45,102.08,393.0,32
HCPCS,95250,Cont gluc mntr phys/qhp eqp,,,33.85,42.76,6
HCPCS,952500,CONT GLUC MNTR PHYS/QHP EQP,,,145.26,145.26,1
HCPCS,95250TC,CONT GLUC MNTR PHYS/QHP EQP,,,145.26,145.26,1
HCPCS,95251,CONT GLUC MNTR ANALYSIS I&R,,,36.15,36.15,1
HCPCS,95251,CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,280.0,182.0,25.63,280.0,32
HCPCS,95251,Cont gluc mntr analysis i&r,,,33.85,42.76,6
HCPCS,952510,CONT GLUC MNTR ANALYSIS I&R,,,36.15,36.15,1
HCPCS,95700,EEG CONT REC W/VID EEG TECH,,,261.41,261.41,1
HCPCS,95700,EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,1350.0,877.5,157.05,1863.0,133
HCPCS,957000,EEG CONT REC W/VID EEG TECH,,,261.41,261.41,1
HCPCS,95705,EEG W/O VID 2-12 HR UNMNTR,,,176.32,176.32,1
HCPCS,95705,EEG W/O VIDEO BY TECH 2-12 HR UNMONITORED,2686.0,1745.9,222.5,2417.4,48
HCPCS,957050,EEG W/O VID 2-12 HR UNMNTR,,,176.32,176.32,1
HCPCS,95706,EEG W/O VIDEO BY TECH 2-12 HR INTERMITTENT MNTR,2686.0,1745.9,222.5,2417.4,48
HCPCS,95706,EEG WO VID 2-12HR INTMT MNTR,,,404.15,404.15,1
HCPCS,957060,EEG WO VID 2-12HR INTMT MNTR,,,404.15,404.15,1
HCPCS,95707,EEG W/O VID 2-12HR CONT MNTR,,,477.38,477.38,1
HCPCS,95707,EEG W/O VIDEO BY TECH 2-12HR CONTINUOUS R-T MNTR,2686.0,1745.9,222.5,2417.4,48
HCPCS,957070,EEG W/O VID 2-12HR CONT MNTR,,,477.38,477.38,1
HCPCS,95708,EEG W/O VID BY TECH EA INCR 12-26HR UNMONITORED,2986.0,1940.9,101.96,4118.4,65
HCPCS,95708,EEG WO VID EA 12-26HR UNMNTR,,,237.33,237.33,1
HCPCS,957080,EEG WO VID EA 12-26HR UNMNTR,,,237.33,237.33,1
HCPCS,95709,EEG W/O VID BY TECH EA INCR 12-26 HR INTMT MNTR,4576.0,2974.4,306.01,4118.4,48
HCPCS,95709,EEG W/O VID EA 12-26HR INTMT,,,776.78,776.78,1
HCPCS,957090,EEG W/O VID EA 12-26HR INTMT,,,776.78,776.78,1
HCPCS,95710,EEG W/O VID EA 12-26HR CONT,,,978.85,978.85,1
HCPCS,95710,EEG W/O VID TECH EA INCR 12-26 HR CONT R-T MNTR,4576.0,2974.4,306.01,4118.4,48
HCPCS,957100,EEG W/O VID EA 12-26HR CONT,,,978.85,978.85,1
HCPCS,95711,VEEG 2-12 HR UNMONITORED,,,195.98,195.98,1
HCPCS,95711,VEEG BY TECH 2-12 HOURS UNMONITORED,2686.0,1745.9,222.5,2417.4,48
HCPCS,957110,VEEG 2-12 HR UNMONITORED,,,195.98,195.98,1
HCPCS,95712,VEEG 2-12 HR INTMT MNTR,,,489.61,489.61,1
HCPCS,95712,VEEG BY TECH 2-12 HR INTERMITTENT MONITORING,2686.0,1745.9,222.5,2417.4,48
HCPCS,957120,VEEG 2-12 HR INTMT MNTR,,,489.61,489.61,1
HCPCS,95713,VEEG 2-12 HR CONT MNTR,,,628.93,628.93,1
HCPCS,95713,VEEG BY TECH 2-12 HR CONTINUOUS R-T MONITORING,4576.0,2974.4,222.5,4118.4,48
HCPCS,957130,VEEG 2-12 HR CONT MNTR,,,628.93,628.93,1
HCPCS,95714,VEEG BY TECH EA INCR 12-26 HR UNMONITORED,4576.0,2974.4,306.01,4118.4,48
HCPCS,95714,VEEG EA 12-26 HR UNMNTR,,,263.12,263.12,1
HCPCS,957140,VEEG EA 12-26 HR UNMNTR,,,263.12,263.12,1
HCPCS,95715,VEEG BY TECH EA INCR 12-26 HR INTERMITTENT MNTR,4576.0,2974.4,306.01,4118.4,48
HCPCS,95715,VEEG EA 12-26HR INTMT MNTR,,,904.92,904.92,1
HCPCS,957150,VEEG EA 12-26HR INTMT MNTR,,,904.92,904.92,1
HCPCS,95716,VEEG BY TECH EA INCR 12-26 HR CONT R-T MNTR,8775.0,5703.75,306.01,7897.5,48
HCPCS,95716,VEEG EA 12-26HR CONT MNTR,,,1201.27,1201.27,1
HCPCS,957160,VEEG EA 12-26HR CONT MNTR,,,1201.27,1201.27,1
HCPCS,95717,EEG PHYS/QHP 2-12 HR W/O VID,,,109.61,109.61,1
HCPCS,95717,EEG PHYS/QHP 2-12 HR WITHOUT VIDEO,880.0,572.0,76.23,660.0,31
HCPCS,95717,Eeg phys/qhp 2-12 hr w/o vid,,,222.5,281.05,6
HCPCS,957170,EEG PHYS/QHP 2-12 HR W/O VID,,,109.61,109.61,1
HCPCS,95718,EEG PHYS/QHP 2-12 HR W/VEEG,,,138.94,138.94,1
HCPCS,95718,EEG PHYS/QHP 2-12 HR WITH VEEG,1100.0,715.0,100.67,825.0,31
HCPCS,95718,Eeg phys/qhp 2-12 hr w/veeg,,,222.5,281.05,6
HCPCS,957180,EEG PHYS/QHP 2-12 HR W/VEEG,,,138.94,138.94,1
HCPCS,95719,EEG PHYS/QHP EA INCR W/O VID,,,165.89,165.89,1
HCPCS,95719,EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR WO VID,1320.0,858.0,117.61,990.0,31
HCPCS,95719,Eeg phys/qhp ea incr w/o vid,,,222.5,281.05,6
HCPCS,957190,EEG PHYS/QHP EA INCR W/O VID,,,165.89,165.89,1
HCPCS,95720,EEG PHY/QHP EA INCR W/VEEG,,,213.86,213.86,1
HCPCS,95720,EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR W/VEEG,1698.0,1103.7,154.55,1273.5,31
HCPCS,95720,Eeg phy/qhp ea incr w/veeg,,,222.5,281.05,6
HCPCS,957200,EEG PHY/QHP EA INCR W/VEEG,,,213.86,213.86,1
HCPCS,95721,EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/O VIDEO,1698.0,1103.7,154.79,1273.5,31
HCPCS,95721,EEG PHY/QHP>36<60 HR W/O VID,,,213.49,213.49,1
HCPCS,95721,Eeg phy/qhp>36<60 hr w/o vid,,,222.5,281.05,6
HCPCS,957210,EEG PHY/QHP>36<60 HR W/O VID,,,213.49,213.49,1
HCPCS,95722,EEG PHY/QHP>36<60 HR W/VEEG,,,259.1,259.1,1
HCPCS,95722,Eeg phy/qhp>36<60 hr w/veeg,,,306.01,386.54,6
HCPCS,957220,EEG PHY/QHP>36<60 HR W/VEEG,,,259.1,259.1,1
HCPCS,95723,EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/O VIDEO,2090.0,1358.5,191.9,1567.5,31
HCPCS,95723,EEG PHY/QHP>60<84 HR W/O VID,,,259.14,259.14,1
HCPCS,95723,Eeg phy/qhp>60<84 hr w/o vid,,,306.01,386.54,6
HCPCS,957230,EEG PHY/QHP>60<84 HR W/O VID,,,259.14,259.14,1
HCPCS,95724,EEG PHY/QHP>60<84 HR W/VEEG,,,326.08,326.08,1
HCPCS,95724,Eeg phy/qhp>60<84 hr w/veeg,,,306.01,386.54,6
HCPCS,957240,EEG PHY/QHP>60<84 HR W/VEEG,,,326.08,326.08,1
HCPCS,95725,EEG COMPLETE STD PHYS/QHP&GT;84 HR W/O VID,2376.0,1544.4,218.86,1782.0,31
HCPCS,95725,EEG PHY/QHP>84 HR W/O VID,,,298.86,298.86,1
HCPCS,95725,Eeg phy/qhp>84 hr w/o vid,,,306.01,386.54,6
HCPCS,957250,EEG PHY/QHP>84 HR W/O VID,,,298.86,298.86,1
HCPCS,95726,EEG COMPLETE STD PHYS/QHP&GT;84 HR W/VEEG,3335.0,2167.75,305.05,2501.25,31
HCPCS,95726,EEG PHY/QHP>84 HR W/VEEG,,,417.6,417.6,1
HCPCS,95726,Eeg phy/qhp>84 hr w/veeg,,,306.01,386.54,6
HCPCS,957260,EEG PHY/QHP>84 HR W/VEEG,,,417.6,417.6,1
HCPCS,95782,POLYSOM <6 YRS 4/> PARAMTRS,,,996.48,996.48,2
HCPCS,95782,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,8775.0,5703.75,118.45,9919.0,146
HCPCS,957820,POLYSOM <6 YRS 4/> PARAMTRS,,,996.48,996.48,1
HCPCS,95782TC,POLYSOM <6 YRS 4/> PARAMTRS,,,996.48,996.48,1
HCPCS,95783,POLYSOM <6 YRS CPAP/BILVL,,,1052.29,1052.29,2
HCPCS,95783,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,8775.0,5703.75,129.05,10020.0,146
HCPCS,957830,POLYSOM <6 YRS CPAP/BILVL,,,1052.29,1052.29,1
HCPCS,95783TC,POLYSOM <6 YRS CPAP/BILVL,,,1052.29,1052.29,1
HCPCS,95800,SLP STDY UNATTENDED,,,112.95,339.23,16
HCPCS,95800,Slp stdy unattended,,,90.87,114.78,6
HCPCS,958000,SLP STDY UNATTENDED,,,112.95,112.95,1
HCPCS,95800TC,SLP STDY UNATTENDED,,,112.95,112.95,1
HCPCS,95801,SLP STDY UNATND W/ANAL,,,59.62,128.79,16
HCPCS,95801,Slp stdy unatnd w/anal,,,90.87,114.78,6
HCPCS,958010,SLP STDY UNATND W/ANAL,,,66.57,66.57,1
HCPCS,95801TC,SLP STDY UNATND W/ANAL,,,66.57,66.57,1
HCPCS,95803,ACTIGRAPHY TESTING,,,59.62,128.79,16
HCPCS,95803,Actigraphy testing,,,33.85,42.76,6
HCPCS,958030,ACTIGRAPHY TESTING,,,109.41,109.41,1
HCPCS,95803TC,ACTIGRAPHY TESTING,,,109.41,109.41,1
HCPCS,95805,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,4576.0,2974.4,50.01,5104.0,150
HCPCS,95805,MULTIPLE SLEEP LATENCY TEST,,,436.55,436.55,2
HCPCS,958050,MULTIPLE SLEEP LATENCY TEST,,,436.55,436.55,1
HCPCS,95805TC,MULTIPLE SLEEP LATENCY TEST,,,436.55,436.55,1
HCPCS,95806,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1350.0,877.5,42.45,3288.0,147
HCPCS,95806,SLEEP STUDY UNATT&RESP EFFT,,,59.62,59.62,2
HCPCS,958060,SLEEP STUDY UNATT&RESP EFFT,,,59.62,59.62,1
HCPCS,95806TC,SLEEP STUDY UNATT&RESP EFFT,,,59.62,59.62,1
HCPCS,95807,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,4576.0,2974.4,52.42,5139.0,98
HCPCS,95807,SLEEP STUDY ATTENDED,,,389.68,1150.43,16
HCPCS,95807,Sleep study attended,,,453.85,573.29,6
HCPCS,958070,SLEEP STUDY ATTENDED,,,408.67,408.67,1
HCPCS,95807TC,SLEEP STUDY ATTENDED,,,408.67,408.67,1
HCPCS,95808,POLYSOM ANY AGE 1-3> PARAM,,,500.36,2205.87,16
HCPCS,95808,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,8775.0,5703.75,73.75,9541.0,101
HCPCS,95808,Polysom any age 1-3> param,,,453.85,573.29,6
HCPCS,958080,POLYSOM ANY AGE 1-3> PARAM,,,500.36,500.36,1
HCPCS,95808TC,POLYSOM ANY AGE 1-3> PARAM,,,500.36,500.36,1
HCPCS,95810,POLYSOM 6/> YRS 4/> PARAM,,,590.13,590.13,2
HCPCS,95810,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,8775.0,5703.75,102.85,9875.0,199
HCPCS,958100,POLYSOM 6/> YRS 4/> PARAM,,,590.13,590.13,1
HCPCS,95810TC,POLYSOM 6/> YRS 4/> PARAM,,,590.13,590.13,1
HCPCS,95811,POLYSOM 6/>YRS CPAP 4/> PARM,,,617.62,617.62,2
HCPCS,95811,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,8775.0,5703.75,107.25,9919.0,199
HCPCS,958110,POLYSOM 6/>YRS CPAP 4/> PARM,,,617.62,617.62,1
HCPCS,95811TC,POLYSOM 6/>YRS CPAP 4/> PARM,,,617.62,617.62,1
HCPCS,95812,EEG 41-60 MINUTES,,,290.02,290.02,2
HCPCS,95812,EEG UP TO 1 HOUR,3118.0,2026.7,168.99,3118.0,35
HCPCS,95812,EEG UP TO 1 HR PROF,432.0,280.8,168.99,611.68,35
HCPCS,95812,EEG UP TO 1 HR TECH,2686.0,1745.9,168.99,2686.0,35
HCPCS,95812,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,2686.0,1745.9,45.76,3118.0,150
HCPCS,958120,EEG 41-60 MINUTES,,,290.02,290.02,1
HCPCS,95812TC,EEG 41-60 MINUTES,,,290.02,290.02,1
HCPCS,95813,EEG EXTENDED MONITORING 61-119 MINUTES,2686.0,1745.9,73.18,3338.0,150
HCPCS,95813,EEG EXTND MNTR 61-119 MIN,,,353.28,353.28,2
HCPCS,95813,EEG GREATER THAN 1 HOUR,3338.0,2169.7,209.1,3338.0,35
HCPCS,95813,EEG GREATER THAN 1 HR PC,652.0,423.8,209.1,773.62,35
HCPCS,95813,EEG GREATER THAN 1 HR TECH,2686.0,1745.9,209.1,2686.0,35
HCPCS,958130,EEG EXTND MNTR 61-119 MIN,,,353.28,353.28,1
HCPCS,95813TC,EEG EXTND MNTR 61-119 MIN,,,353.28,353.28,1
HCPCS,95816,EEG AWAKE AND DROWSY,,,333.62,333.62,2
HCPCS,95816,EEG; AWAK/DROWSY SAME FACILITY,3161.0,2054.65,186.41,3161.0,35
HCPCS,95816,EEG; AWAKE/DROWSY PROF,475.0,308.75,186.41,688.93,35
HCPCS,95816,EEG; AWAKE/DROWSY TECH,2686.0,1745.9,186.41,2686.0,35
HCPCS,95816,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,2686.0,1745.9,46.18,3161.0,150
HCPCS,958160,EEG AWAKE AND DROWSY,,,333.62,333.62,1
HCPCS,95816TC,EEG AWAKE AND DROWSY,,,333.62,333.62,1
HCPCS,95819,EEG AWAKE AND ASLEEP,,,392.62,392.62,2
HCPCS,95819,EEG AWAKE/ASLEEP PROF,475.0,308.75,218.79,793.32,35
HCPCS,95819,EEG AWAKE/ASLEEP TECH,2686.0,1745.9,218.79,2686.0,35
HCPCS,95819,EEG W VENT/STIMULATION,3161.0,2054.65,218.79,3161.0,35
HCPCS,95819,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,2686.0,1745.9,45.76,3161.0,150
HCPCS,958190,EEG AWAKE AND ASLEEP,,,392.62,392.62,1
HCPCS,95819TC,EEG AWAKE AND ASLEEP,,,392.62,392.62,1
HCPCS,95822,EEG COMA OR SLEEP ONLY,,,351.64,351.64,2
HCPCS,95822,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,2686.0,1745.9,45.76,3161.0,150
HCPCS,958220,EEG COMA OR SLEEP ONLY,,,351.64,351.64,1
HCPCS,95822TC,EEG COMA OR SLEEP ONLY,,,351.64,351.64,1
HCPCS,95824,EEG CEREBRAL DEATH ONLY,,,58.69,58.69,2
HCPCS,95824,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,4576.0,2974.4,32.26,4872.0,114
HCPCS,958240,EEG CEREBRAL DEATH ONLY,,,58.69,58.69,1
HCPCS,95824TC,EEG CEREBRAL DEATH ONLY,,,58.69,58.69,1
HCPCS,95829,ELECTROCORTICOGRAM SURGERY SPX,3389.0,2202.85,222.5,3050.1,78
HCPCS,95829,SURGERY ELECTROCORTICOGRAM,3389.0,2202.85,260.04,6117.0,103
HCPCS,958290,SURGERY ELECTROCORTICOGRAM,,,1422.48,1422.48,1
HCPCS,95829TC,SURGERY ELECTROCORTICOGRAM,,,1422.48,1422.48,1
HCPCS,95830,EEG W/ELECTRODES,680.0,442.0,44.05,510.0,32
HCPCS,95830,INSERT ELECTRODES FOR EEG,680.0,442.0,44.05,510.0,33
HCPCS,95830,INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP,1085.0,705.25,44.05,1323.75,66
HCPCS,958300,INSERT ELECTRODES FOR EEG,,,94.81,94.81,1
HCPCS,95836,ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS,556.5,361.72499999999997,23.85,1863.0,129
HCPCS,95836,ECOG IMPLTD BRN NPGT <30 D,,,109.54,109.54,1
HCPCS,958360,ECOG IMPLTD BRN NPGT <30 D,,,109.54,109.54,1
HCPCS,95851,RANGE OF MOTION MEASUREMENTS,,,8.09,20.4,22
HCPCS,958510,RANGE OF MOTION MEASUREMENTS,,,8.09,8.09,1
HCPCS,95852,RANGE OF MOTION MEASUREMENTS,,,5.64,14.78,22
HCPCS,958520,RANGE OF MOTION MEASUREMENTS,,,5.64,5.64,1
HCPCS,95857,CHOLINESTERASE CHALLENGE,,,29.39,29.39,1
HCPCS,95857,CHOLINESTERASE INHIBITOR CHALLENGE TEST,1449.0,941.85,13.81,2417.4,76
HCPCS,958570,CHOLINESTERASE CHALLENGE,,,29.39,29.39,1
HCPCS,95860,EMG 1 EXTREMITY,384.0,249.6,55.73,384.0,35
HCPCS,95860,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,1111.0,722.15,39.49,1495.0,142
HCPCS,95860,NEEDLE EMG 1 EXTREMITY,,,61.61,61.61,2
HCPCS,95860,NEEDLE/EXTREMITY,1495.0,971.75,55.73,1495.0,35
HCPCS,958600,NEEDLE EMG 1 EXTREMITY,,,61.61,61.61,1
HCPCS,95860TC,NEEDLE EMG 1 EXTREMITY,,,61.61,61.61,1
HCPCS,95861,EMG 2 EXTREMITIES,616.0,400.4,82.39,616.0,35
HCPCS,95861,EMG NEEDLE 2 EXTREMITIES,1727.0,1122.55,82.39,1727.0,35
HCPCS,95861,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,1111.0,722.15,51.55,1727.0,142
HCPCS,95861,NEEDLE EMG 2 EXTREMITIES,,,78.65,78.65,2
HCPCS,958610,NEEDLE EMG 2 EXTREMITIES,,,78.65,78.65,1
HCPCS,95861TC,NEEDLE EMG 2 EXTREMITIES,,,78.65,78.65,1
HCPCS,95863,EMG 3 EXTREMETIES,748.0,486.2,105.2,748.0,35
HCPCS,95863,EMG NEEDLE 3 EXTREMITIES,2098.0,1363.7,105.2,2098.0,35
HCPCS,95863,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,1350.0,877.5,62.46,2098.0,142
HCPCS,95863,NEEDLE EMG 3 EXTREMITIES,,,108.45,108.45,2
HCPCS,958630,NEEDLE EMG 3 EXTREMITIES,,,108.45,108.45,1
HCPCS,95863TC,NEEDLE EMG 3 EXTREMITIES,,,108.45,108.45,1
HCPCS,95864,EMG FOUR EXTREMITIES,796.0,517.4,128.6,796.0,35
HCPCS,95864,EMG NEEDLE 4 EXTREMITIES,2146.0,1394.9,128.6,2146.0,35
HCPCS,95864,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,1350.0,877.5,69.07,2146.0,142
HCPCS,95864,NEEDLE EMG 4 EXTREMITIES,,,126.18,126.18,2
HCPCS,958640,NEEDLE EMG 4 EXTREMITIES,,,126.18,126.18,1
HCPCS,95864TC,NEEDLE EMG 4 EXTREMITIES,,,126.18,126.18,1
HCPCS,95865,NEEDLE ELECTROMYOGRAPHY LARYNX,1111.0,722.15,37.19,1739.0,101
HCPCS,95865,NEEDLE ELECTROMYOGRAPHY; LARYNX,1739.0,1130.35,74.96,1739.0,35
HCPCS,95865,NEEDLE ELECTROMYOGRAPHY; LARYNX PC,628.0,408.2,74.96,628.0,35
HCPCS,95865,NEEDLE ELECTROMYOGRAPHY; LARYNX TC,1111.0,722.15,74.96,1111.0,35
HCPCS,95865,NEEDLE EMG LARYNX,,,66.85,279.48,16
HCPCS,95865,Needle emg larynx,,,82.59,104.33,6
HCPCS,958650,NEEDLE EMG LARYNX,,,66.85,66.85,1
HCPCS,95865TC,NEEDLE EMG LARYNX,,,66.85,66.85,1
HCPCS,95866,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,1350.0,877.5,40.64,1850.0,101
HCPCS,95866,NEEDLE ELECTROMYOGRAPHY; HEMIDIAPHRAGM,1850.0,1202.5,64.11,1850.0,35
HCPCS,95866,NEEDLE ELECTROMYOGRAPHY; HEMIDIAPHRAGM PC,500.0,325.0,64.11,500.0,35
HCPCS,95866,NEEDLE ELECTROMYOGRAPHY; HEMIDIAPHRAGM TC,1350.0,877.5,64.11,1350.0,35
HCPCS,95866,NEEDLE EMG HEMIDIAPHRAGM,,,59.32,339.23,16
HCPCS,95866,Needle emg hemidiaphragm,,,82.59,104.33,6
HCPCS,958660,NEEDLE EMG HEMIDIAPHRAGM,,,59.32,59.32,1
HCPCS,95866TC,NEEDLE EMG HEMIDIAPHRAGM,,,59.32,59.32,1
HCPCS,95867,EMG CRANIAL NERVE UNILAT,316.0,205.4,53.1,316.0,35
HCPCS,95867,EMG CRANIAL NERVE UNILATERAL,3002.0,1951.3,53.1,3002.0,35
HCPCS,95867,NDL EMG CRANIAL NRV MUSC UNI,,,64.56,64.56,2
HCPCS,95867,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,2686.0,1745.9,33.68,3002.0,142
HCPCS,958670,NDL EMG CRANIAL NRV MUSC UNI,,,64.56,64.56,1
HCPCS,95867TC,NDL EMG CRANIAL NRV MUSC UNI,,,64.56,64.56,1
HCPCS,95868,EMG CRANIAL MUSCLES BIL,472.0,306.8,71.76,472.0,35
HCPCS,95868,EMG CRANIAL MUSCLES BILAT,3158.0,2052.7,71.76,3158.0,35
HCPCS,95868,NDL EMG CRANIAL NRV MUSC BI,,,76.02,76.02,2
HCPCS,95868,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,2686.0,1745.9,50.02,3158.0,142
HCPCS,958680,NDL EMG CRANIAL NRV MUSC BI,,,76.02,76.02,1
HCPCS,95868TC,NDL EMG CRANIAL NRV MUSC BI,,,76.02,76.02,1
HCPCS,95869,EMG THORACIC,2834.0,1842.1,48.82,2834.0,35
HCPCS,95869,EMG THORACIC LTD,148.0,96.2,48.82,165.98,35
HCPCS,95869,NDL EMG THRC PARASPINAL MUSC,,,74.39,74.39,2
HCPCS,95869,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,2686.0,1745.9,15.49,2834.0,183
HCPCS,958690,NDL EMG THRC PARASPINAL MUSC,,,74.39,74.39,1
HCPCS,95869TC,NDL EMG THRC PARASPINAL MUSC,,,74.39,74.39,1
HCPCS,95870,EMG OTHER THAN PARASPINAL,148.0,96.2,42.25,148.0,35
HCPCS,95870,EMP OTHER THAN PARASPINAL,1259.0,818.35,42.25,1259.0,35
HCPCS,95870,NDL EMG LMTD STD MUSC 1 XTR,,,62.6,62.6,2
HCPCS,95870,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,1111.0,722.15,15.78,1259.0,142
HCPCS,958700,NDL EMG LMTD STD MUSC 1 XTR,,,62.6,62.6,1
HCPCS,95870TC,NDL EMG LMTD STD MUSC 1 XTR,,,62.6,62.6,1
HCPCS,95872,NDL EMG SINGLE FIBER ELTRD,,,41.63,41.63,2
HCPCS,95872,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,1350.0,877.5,35.18,2502.0,142
HCPCS,958720,NDL EMG SINGLE FIBER ELTRD,,,41.63,41.63,1
HCPCS,95872TC,NDL EMG SINGLE FIBER ELTRD,,,41.63,41.63,1
HCPCS,95873,ELECTRICAL STIM GUIDE CHEMODENERVATION PC,163.0,105.95,37.32,163.0,35
HCPCS,95873,ELECTRICAL STIM GUIDE CHEMODENERVATION TC,94.0,61.1,37.32,122.34,35
HCPCS,95873,ELECTRICAL STIM GUIDE CHEMODENRVATION,257.0,167.05,37.32,257.0,35
HCPCS,95873,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,163.0,105.95,15.79,395.0,132
HCPCS,95873,GUIDE NERV DESTR ELEC STIM,,,50.44,50.44,2
HCPCS,958730,GUIDE NERV DESTR ELEC STIM,,,50.44,50.44,1
HCPCS,95873TC,GUIDE NERV DESTR ELEC STIM,,,50.44,50.44,1
HCPCS,95874,GUIDE NERV DESTR NEEDLE EMG,,,56.01,56.01,2
HCPCS,95874,NEEDLE EMG GUID W/CHEMODENERVATION,978.0,635.7,115.13,880.2,31
HCPCS,95874,NEEDLE EMG GUIDANCE FOR CHEMODENERVATION,978.0,635.7,16.06,1141.0,101
HCPCS,95874,NEEDLE EMG GUIDE CHEMODENERVATION,1141.0,741.65,39.29,1141.0,35
HCPCS,95874,NEEDLE EMG GUIDE CHEMODENERVATION PC,163.0,105.95,39.29,163.0,35
HCPCS,95874,NEEDLE EMG GUIDE CHEMODENERVATION TC,978.0,635.7,39.29,978.0,35
HCPCS,958740,GUIDE NERV DESTR NEEDLE EMG,,,56.01,56.01,1
HCPCS,95874TC,GUIDE NERV DESTR NEEDLE EMG,,,56.01,56.01,1
HCPCS,95875,EMG ISCHEMIC LIMB,1115.0,724.75,67.23,1790.0,64
HCPCS,95875,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,1350.0,877.5,47.04,1790.0,139
HCPCS,95875,LIMB EXERCISE TEST,,,63.58,63.58,2
HCPCS,958750,LIMB EXERCISE TEST,,,63.58,63.58,1
HCPCS,95875TC,LIMB EXERCISE TEST,,,63.58,63.58,1
HCPCS,95885,MUSC TST DONE W/NERV TST LIM,,,42.91,42.91,2
HCPCS,95885,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,1246.0,809.9,14.92,1386.0,132
HCPCS,958850,MUSC TST DONE W/NERV TST LIM,,,42.91,42.91,1
HCPCS,95885TC,MUSC TST DONE W/NERV TST LIM,,,42.91,42.91,1
HCPCS,95886,MUSC TEST DONE W/N TEST COMP,,,51.09,51.09,2
HCPCS,95886,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,1833.0,1191.45,34.03,2211.0,132
HCPCS,958860,MUSC TEST DONE W/N TEST COMP,,,51.09,51.09,1
HCPCS,95886TC,MUSC TEST DONE W/N TEST COMP,,,51.09,51.09,1
HCPCS,95887,MUSC TST DONE W/N TST NONEXT,,,45.85,45.85,2
HCPCS,95887,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,698.0,453.7,31.27,1010.0,132
HCPCS,958870,MUSC TST DONE W/N TST NONEXT,,,45.85,45.85,1
HCPCS,95887TC,MUSC TST DONE W/N TST NONEXT,,,45.85,45.85,1
HCPCS,95900,MOTOR NERVE COND W/O F-WAVE TC,266.0,172.9,54.38,266.0,16
HCPCS,95900,NERVE CONDUCT WO F WAVE,222.0,144.29999999999998,45.5,353.0,32
HCPCS,95903,MOTOR NERVE COND WITH F-WAVE,175.0,113.75,63.77,175.0,16
HCPCS,95903,MOTOR NERVE TEST W F WAVE,235.5,153.075,63.77,323.0,32
HCPCS,95904,SENSORY NERVE COND-TC,266.0,172.9,48.1,266.0,16
HCPCS,95904,SENSORY NERVE TEST EACH,222.0,144.29999999999998,45.5,353.0,32
HCPCS,95905,MOTOR &/ SENS NRVE CNDJ TEST,,,30.5,865.18,16
HCPCS,95905,Motor &/ sens nrve cndj test,,,82.59,104.33,6
HCPCS,959050,MOTOR &/ SENS NRVE CNDJ TEST,,,30.5,30.5,1
HCPCS,95905TC,MOTOR &/ SENS NRVE CNDJ TEST,,,30.5,30.5,1
HCPCS,95907,NERVE CONDUCTION STUDIES 1-2 STUDIES,1350.0,877.5,35.76,1790.0,138
HCPCS,95907,NVR CNDJ TST 1-2 STUDIES,,,37.7,37.7,2
HCPCS,959070,NVR CNDJ TST 1-2 STUDIES,,,37.7,37.7,1
HCPCS,95907TC,NVR CNDJ TST 1-2 STUDIES,,,37.7,37.7,1
HCPCS,95908,NERVE CONDUCTION STUDIES 3-4 STUDIES,2686.0,1745.9,44.48,3236.0,138
HCPCS,95908,NRV CNDJ TST 3-4 STUDIES,,,46.22,46.22,2
HCPCS,959080,NRV CNDJ TST 3-4 STUDIES,,,46.22,46.22,1
HCPCS,95908TC,NRV CNDJ TST 3-4 STUDIES,,,46.22,46.22,1
HCPCS,95909,NERVE CONDUCTION STUDIES 5-6 STUDIES,2686.0,1745.9,53.51,3346.0,138
HCPCS,95909,NRV CNDJ TST 5-6 STUDIES,,,55.72,55.72,2
HCPCS,959090,NRV CNDJ TST 5-6 STUDIES,,,55.72,55.72,1
HCPCS,95909TC,NRV CNDJ TST 5-6 STUDIES,,,55.72,55.72,1
HCPCS,95910,NERVE CONDUCTION STUDIES 7-8 STUDIES,2686.0,1745.9,68.04,3566.0,138
HCPCS,95910,NRV CNDJ TEST 7-8 STUDIES,,,70.78,70.78,2
HCPCS,959100,NRV CNDJ TEST 7-8 STUDIES,,,70.78,70.78,1
HCPCS,95910TC,NRV CNDJ TEST 7-8 STUDIES,,,70.78,70.78,1
HCPCS,95911,NERVE CONDUCTION STUDIES 9-10 STUDIES,4576.0,2974.4,76.76,5676.0,138
HCPCS,95911,NRV CNDJ TEST 9-10 STUDIES,,,80.94,80.94,2
HCPCS,959110,NRV CNDJ TEST 9-10 STUDIES,,,80.94,80.94,1
HCPCS,95911TC,NRV CNDJ TEST 9-10 STUDIES,,,80.94,80.94,1
HCPCS,95912,NERVE CONDUCTION STUDIES 11-12 STUDIES,4576.0,2974.4,82.59,5896.0,138
HCPCS,95912,NRV CNDJ TEST 11-12 STUDIES,,,91.47,91.47,2
HCPCS,959120,NRV CNDJ TEST 11-12 STUDIES,,,91.47,91.47,1
HCPCS,95912TC,NRV CNDJ TEST 11-12 STUDIES,,,91.47,91.47,1
HCPCS,95913,NERVE CONDUCTION STUDIES 13/> STUDIES,4576.0,2974.4,82.59,6142.0,138
HCPCS,95913,NRV CNDJ TEST 13/> STUDIES,,,101.29,101.29,2
HCPCS,959130,NRV CNDJ TEST 13/> STUDIES,,,101.29,101.29,1
HCPCS,95913TC,NRV CNDJ TEST 13/> STUDIES,,,101.29,101.29,1
HCPCS,95919,QUAN PUPLMTRY PHY/QHP UNI/BI,,,5.94,279.48,16
HCPCS,95919,QUANTITATIVE PUPILLOMETRY PHYS/QHP I&R UNI/BI,591.5,384.47499999999997,6.38,1111.0,97
HCPCS,95919,Quan puplmtry phy/qhp uni/bi,,,82.59,104.33,6
HCPCS,959190,QUAN PUPLMTRY PHY/QHP UNI/BI,,,5.94,5.94,1
HCPCS,95919TC,QUAN PUPLMTRY PHY/QHP UNI/BI,,,5.94,5.94,1
HCPCS,95921,AUTONOMIC NERVE FUNCT-CARDIOVAGAL,1350.0,877.5,43.4,1350.0,35
HCPCS,95921,AUTONOMIC NERVE TEST,1035.0,672.75,43.4,1710.0,70
HCPCS,95921,AUTONOMIC NRV PARASYM INERVJ,,,43.6,43.6,2
HCPCS,95921,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,1350.0,877.5,33.46,1710.0,142
HCPCS,959210,AUTONOMIC NRV PARASYM INERVJ,,,43.6,43.6,1
HCPCS,95921TC,AUTONOMIC NRV PARASYM INERVJ,,,43.6,43.6,1
HCPCS,95922,AUTONOMIC NERVE FUNCTION-VASOMOTOR,1111.0,722.15,49.48,1111.0,35
HCPCS,95922,AUTONOMIC NRV ADRENRG INERVJ,,,48.89,48.89,2
HCPCS,95922,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,1111.0,722.15,40.21,1495.0,142
HCPCS,95922,VASOMOTOR TEST,939.5,610.675,49.48,1495.0,70
HCPCS,959220,AUTONOMIC NRV ADRENRG INERVJ,,,48.89,48.89,1
HCPCS,95922TC,AUTONOMIC NRV ADRENRG INERVJ,,,48.89,48.89,1
HCPCS,95923,AUTONOMIC NERVE FUNCTION-SUDOMOTOR,1111.0,722.15,61.65,1111.0,32
HCPCS,95923,AUTONOMIC NRV SYST FUNJ TEST,,,77.0,77.0,2
HCPCS,95923,SUDOMOTOR TEST,915.5,595.075,61.65,1471.0,64
HCPCS,95923,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,1111.0,722.15,38.65,1471.0,139
HCPCS,959230,AUTONOMIC NRV SYST FUNJ TEST,,,77.0,77.0,1
HCPCS,95923TC,AUTONOMIC NRV SYST FUNJ TEST,,,77.0,77.0,1
HCPCS,95924,ANS PARASYMP & SYMP W/TILT,,,64.93,64.93,2
HCPCS,95924,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,2686.0,1745.9,61.19,3447.0,135
HCPCS,959240,ANS PARASYMP & SYMP W/TILT,,,64.93,64.93,1
HCPCS,95924TC,ANS PARASYMP & SYMP W/TILT,,,64.93,64.93,1
HCPCS,95925,NERVE STDY CNS SHORT LAC,216.0,140.4,90.25,307.65,35
HCPCS,95925,NERVE STUDY CNS SHORT LACENCY,2902.0,1886.3,90.25,2902.0,35
HCPCS,95925,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,2686.0,1745.9,22.59,2902.0,142
HCPCS,95925,SOMATOSENSORY TESTING,,,146.2,146.2,2
HCPCS,959250,SOMATOSENSORY TESTING,,,146.2,146.2,1
HCPCS,95925TC,SOMATOSENSORY TESTING,,,146.2,146.2,1
HCPCS,95926,NERVE STDY LOWER LIMB LAT,216.0,140.4,78.08,275.46,35
HCPCS,95926,NERVESTUDY LOWER LIMB LAT,2902.0,1886.3,78.08,2902.0,35
HCPCS,95926,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,2686.0,1745.9,23.16,2902.0,142
HCPCS,95926,SOMATOSENSORY TESTING,,,128.84,128.84,2
HCPCS,959260,SOMATOSENSORY TESTING,,,128.84,128.84,1
HCPCS,95926TC,SOMATOSENSORY TESTING,,,128.84,128.84,1
HCPCS,95927,IOM TRUNK OR HEAD SSEP,2686.0,1745.9,82.59,2417.4,41
HCPCS,95927,NERVE STDY TRUNK/HEAD LAT,216.0,140.4,73.48,318.64,35
HCPCS,95927,NERVESRUDY TRUNK/HEAD LAT,2902.0,1886.3,73.48,2902.0,35
HCPCS,95927,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,2686.0,1745.9,22.59,2902.0,142
HCPCS,95927,SOMATOSENSORY TESTING,,,153.12,153.12,2
HCPCS,959270,SOMATOSENSORY TESTING,,,153.12,153.12,1
HCPCS,95927TC,SOMATOSENSORY TESTING,,,153.12,153.12,1
HCPCS,95928,C MOTOR EVOKED UPPR LIMBS,,,160.56,160.56,2
HCPCS,95928,"CENTRAL MOTOR EVOKED, UPPR LIMBS",4987.5,3241.875,115.89,9375.0,70
HCPCS,95928,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,8775.0,5703.75,64.38,9375.0,142
HCPCS,959280,C MOTOR EVOKED UPPR LIMBS,,,160.56,160.56,1
HCPCS,95928TC,C MOTOR EVOKED UPPR LIMBS,,,160.56,160.56,1
HCPCS,95929,C MOTOR EVOKED LWR LIMBS,,,163.51,163.51,2
HCPCS,95929,"CENTRAL MOTOR EVOKED, LOWER LIMBS",2888.0,1877.2,119.18,5176.0,70
HCPCS,95929,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,4576.0,2974.4,64.38,5176.0,142
HCPCS,959290,C MOTOR EVOKED LWR LIMBS,,,163.51,163.51,1
HCPCS,95929TC,C MOTOR EVOKED LWR LIMBS,,,163.51,163.51,1
HCPCS,95930,VEP TEST CNS CHECK/FLASH,1483.0,963.95,42.94,2826.0,70
HCPCS,95930,VISUAL EP TEST CNS W/I&R,,,48.51,48.51,2
HCPCS,95930,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2686.0,1745.9,14.92,2826.0,183
HCPCS,959300,VISUAL EP TEST CNS W/I&R,,,48.51,48.51,1
HCPCS,95930TC,VISUAL EP TEST CNS W/I&R,,,48.51,48.51,1
HCPCS,95933,BLINK REFLEX,236.0,153.4,43.99,236.0,32
HCPCS,95933,BLINK REFLEX TEST,749.0,486.85,43.99,749.0,34
HCPCS,95933,BLINK REFLEX-ELECTRODIAGNOSTIC TEST,513.0,333.45,43.99,513.0,32
HCPCS,95933,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,513.0,333.45,25.44,839.0,139
HCPCS,959330,BLINK REFLEX TEST,,,50.8,50.8,1
HCPCS,95933TC,BLINK REFLEX TEST,,,50.8,50.8,1
HCPCS,95934,H REFLEX AMP/LAT GAST/SOL,135.5,88.075,48.0,175.0,32
HCPCS,95936,H REFLEX AMP/LAT WO G/S,144.0,93.6,41.97,175.0,32
HCPCS,95937,NEUROMUSC JUNCT TEST,935.0,607.75,52.44,1610.0,70
HCPCS,95937,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,1350.0,877.5,28.14,1610.0,142
HCPCS,95937,NEUROMUSCULAR JUNCTION TEST,,,69.15,69.15,2
HCPCS,959370,NEUROMUSCULAR JUNCTION TEST,,,69.15,69.15,1
HCPCS,95937TC,NEUROMUSCULAR JUNCTION TEST,,,69.15,69.15,1
HCPCS,95938,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB,4576.0,2974.4,82.59,4118.4,41
HCPCS,95938,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMBS,4576.0,2974.4,36.95,4920.0,101
HCPCS,95938,SOMATOSENSORY TESTING,,,325.11,325.11,2
HCPCS,959380,SOMATOSENSORY TESTING,,,325.11,325.11,1
HCPCS,95938TC,SOMATOSENSORY TESTING,,,325.11,325.11,1
HCPCS,95939,C MOTOR EVOKED UPR&LWR LIMBS,,,434.87,434.87,2
HCPCS,95939,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI,8775.0,5703.75,82.59,7897.5,41
HCPCS,95939,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LIMB,4837.5,3144.375,97.35,8775.0,101
HCPCS,959390,C MOTOR EVOKED UPR&LWR LIMBS,,,434.87,434.87,1
HCPCS,95939TC,C MOTOR EVOKED UPR&LWR LIMBS,,,434.87,434.87,1
HCPCS,95940,IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES,509.0,330.85,17.1,839.0,56
HCPCS,95940,IONM IN OPERATNG ROOM 15 MIN,,,33.21,33.21,1
HCPCS,959400,IONM IN OPERATNG ROOM 15 MIN,,,33.21,33.21,1
HCPCS,95941,IONM REMOTE/>1 PT OR PER HR,,,491.15,491.15,1
HCPCS,95941,IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR,1767.0,1148.55,65.13,1767.0,25
HCPCS,959410,IONM REMOTE/>1 PT OR PER HR,,,491.15,491.15,1
HCPCS,95943,Parasymp&symp hrt rate test,,,82.59,104.33,6
HCPCS,95954,EEG MONITORING/GIVING DRUGS,,,279.06,279.06,2
HCPCS,95954,RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE,4576.0,2974.4,99.85,5654.0,150
HCPCS,959540,EEG MONITORING/GIVING DRUGS,,,279.06,279.06,1
HCPCS,95954TC,EEG MONITORING/GIVING DRUGS,,,279.06,279.06,1
HCPCS,95955,EEG DURING SURGERY,,,135.96,135.96,2
HCPCS,95955,EEG NONINTRACRANIAL SURGERY,947.5,615.875,42.91,1863.0,137
HCPCS,959550,EEG DURING SURGERY,,,135.96,135.96,1
HCPCS,95955TC,EEG DURING SURGERY,,,135.96,135.96,1
HCPCS,95957,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,792.0,514.8,84.69,1138.0,101
HCPCS,95957,EEG DIGITAL ANALYSIS,,,190.46,190.46,2
HCPCS,95957,Eeg digital analysis,,,21.15,26.71,6
HCPCS,959570,EEG DIGITAL ANALYSIS,,,190.46,190.46,1
HCPCS,95957TC,EEG DIGITAL ANALYSIS,,,190.46,190.46,1
HCPCS,95958,EEG MONITORING/FUNCTION TEST,,,472.99,472.99,2
HCPCS,95958,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,8775.0,5703.75,181.32,10471.0,150
HCPCS,959580,EEG MONITORING/FUNCTION TEST,,,472.99,472.99,1
HCPCS,95958TC,EEG MONITORING/FUNCTION TEST,,,472.99,472.99,1
HCPCS,95961,ELECTRODE STIMULATION BRAIN,,,166.8,166.8,2
HCPCS,95961,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,8775.0,5703.75,101.24,9963.0,199
HCPCS,959610,ELECTRODE STIMULATION BRAIN,,,166.8,166.8,1
HCPCS,95961TC,ELECTRODE STIMULATION BRAIN,,,166.8,166.8,1
HCPCS,95962,ELECTRODE STIM BRAIN ADD-ON,,,107.51,107.51,2
HCPCS,95962,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,1284.0,834.6,63.04,2034.0,179
HCPCS,959620,ELECTRODE STIM BRAIN ADD-ON,,,107.51,107.51,1
HCPCS,95962TC,ELECTRODE STIM BRAIN ADD-ON,,,107.51,107.51,1
HCPCS,95965,MEG SPONTANEOUS,,,896.76,2205.87,16
HCPCS,95965,Meg spontaneous,,,2535.1,3202.24,6
HCPCS,959650,MEG SPONTANEOUS,,,1591.78,1591.78,1
HCPCS,95965TC,MEG SPONTANEOUS,,,1591.78,1591.78,1
HCPCS,95966,MEG EVOKED SINGLE,,,767.52,2205.87,16
HCPCS,95966,Meg evoked single,,,2535.1,3202.24,6
HCPCS,959660,MEG EVOKED SINGLE,,,767.52,767.52,1
HCPCS,95966TC,MEG EVOKED SINGLE,,,767.52,767.52,1
HCPCS,95967,MEG EVOKED EACH ADDL,,,665.99,665.99,2
HCPCS,95967,Meg evoked each addl,,,2535.1,3202.24,6
HCPCS,959670,MEG EVOKED EACH ADDL,,,665.99,665.99,1
HCPCS,95967TC,MEG EVOKED EACH ADDL,,,665.99,665.99,1
HCPCS,95970,ALYS NPGT W/O PRGRMG,,,18.93,18.93,1
HCPCS,95970,ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING,632.5,411.125,16.61,999.9,76
HCPCS,959700,ALYS NPGT W/O PRGRMG,,,18.93,18.93,1
HCPCS,95971,ALYS SMPL SP/PN NPGT W/PRGRM,,,40.47,40.47,1
HCPCS,95971,ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG,567.0,368.54999999999995,19.24,839.0,76
HCPCS,959710,ALYS SMPL SP/PN NPGT W/PRGRM,,,40.47,40.47,1
HCPCS,95972,ALYS CPLX SP/PN NPGT W/PRGRM,,,41.88,41.88,1
HCPCS,95972,ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG,571.5,371.475,26.93,839.0,76
HCPCS,959720,ALYS CPLX SP/PN NPGT W/PRGRM,,,41.88,41.88,1
HCPCS,95976,ALYS SMPL CN NPGT PRGRMG,,,40.31,40.31,1
HCPCS,95976,ELEC ALYS IMPLT SMPL CN NPGT PRGRMG,321.0,208.65,28.85,839.0,113
HCPCS,959760,ALYS SMPL CN NPGT PRGRMG,,,40.31,40.31,1
HCPCS,95977,ALYS CPLX CN NPGT PRGRMG,,,53.65,53.65,1
HCPCS,95977,ELEC ALYS IMPLT CPLX CN NPGT PRGRMG,589.5,383.17499999999995,38.55,839.0,113
HCPCS,959770,ALYS CPLX CN NPGT PRGRMG,,,53.65,53.65,1
HCPCS,95980,ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG,447.5,290.875,22.03,839.0,63
HCPCS,95980,IO ANAL GAST N-STIM INIT,,,47.28,47.28,1
HCPCS,959800,IO ANAL GAST N-STIM INIT,,,47.28,47.28,1
HCPCS,95981,ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG,316.5,205.725,8.55,839.0,73
HCPCS,95981,IO ANAL GAST N-STIM SUBSQ,,,18.58,18.58,1
HCPCS,959810,IO ANAL GAST N-STIM SUBSQ,,,18.58,18.58,1
HCPCS,95982,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,290.5,188.825,17.59,839.0,105
HCPCS,95982,IO GA N-STIM SUBSQ W/REPROG,,,37.97,37.97,1
HCPCS,959820,IO GA N-STIM SUBSQ W/REPROG,,,37.97,37.97,1
HCPCS,95983,ALYS BRN NPGT PRGRMG 15 MIN,,,51.13,51.13,1
HCPCS,95983,ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN,595.5,387.075,37.79,839.0,72
HCPCS,959830,ALYS BRN NPGT PRGRMG 15 MIN,,,51.13,51.13,1
HCPCS,95984,ALYS BRN NPGT PRGRMG ADDL 15,,,44.83,44.83,1
HCPCS,95984,ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN,400.5,260.32500000000005,32.94,839.0,62
HCPCS,959840,ALYS BRN NPGT PRGRMG ADDL 15,,,44.83,44.83,1
HCPCS,95990,REFILL SPINE/BRAIN PUMP,2861.0,1859.65,30.69,2574.9,49
HCPCS,95990,REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,217.0,141.05,44.22,217.0,35
HCPCS,95990,SPIN/BRAIN PUMP REFIL & MAIN,,,88.97,88.97,1
HCPCS,959900,SPIN/BRAIN PUMP REFIL & MAIN,,,88.97,88.97,1
HCPCS,95991,REFILL SPINE/BRAIN PUMP PHYS,821.0,533.65,30.69,1801.0,49
HCPCS,95991,RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP,1442.5,937.625,19.4,2291.4,76
HCPCS,95991,SPIN/BRAIN PUMP REFIL & MAIN,,,41.5,41.5,1
HCPCS,959910,SPIN/BRAIN PUMP REFIL & MAIN,,,41.5,41.5,1
HCPCS,95992,CANALITH REPOSITIONING PROC,,,37.25,37.25,1
HCPCS,95992,CANALITH REPOSITIONING PROCEDURE,300.0,195.0,17.59,1764.0,174
HCPCS,959920,CANALITH REPOSITIONING PROC,,,37.25,37.25,1
HCPCS,95999,UNLISTED NEUROLOGICAL DX PX,,,134.37,339.23,14
HCPCS,95999,Unlisted neurological dx px,,,82.59,104.33,6
HCPCS,96000,COMPRE CPTR MTN ALYS VIDEO TAPING 3D KINEMATICS,720.0,468.0,59.85,720.0,32
HCPCS,96000,MOTION ANALYSIS VIDEO/3D,,,86.59,1150.43,15
HCPCS,96000,Motion analysis video/3d,,,82.59,104.33,6
HCPCS,960000,MOTION ANALYSIS VIDEO/3D,,,86.59,86.59,1
HCPCS,96001,COMPRE CPTR MTN ALYS W/DYN PLNTR PRES MEAS WALKG,946.0,614.9,70.18,946.0,32
HCPCS,96001,MOTION TEST W/FT PRESS MEAS,,,114.35,2205.87,15
HCPCS,96001,Motion test w/ft press meas,,,82.59,104.33,6
HCPCS,960010,MOTION TEST W/FT PRESS MEAS,,,114.35,114.35,1
HCPCS,96002,DYN SURF EMG WALKG/FUNCJAL ACTV 1-12 MUSC,180.0,117.0,13.96,180.0,32
HCPCS,96002,DYNAMIC SURFACE EMG,,,22.08,675.17,15
HCPCS,96002,Dynamic surface emg,,,82.59,104.33,6
HCPCS,960020,DYNAMIC SURFACE EMG,,,22.08,22.08,1
HCPCS,96003,DYN FINE WIRE EMG WALKG/FUNCJAL ACTV 1 MUSC,72.0,46.8,16.06,72.0,19
HCPCS,96003,Dynamic fine wire emg,,,82.59,104.33,6
HCPCS,96004,PHYS REVIEW OF MOTION TESTS,,,112.03,112.03,1
HCPCS,96004,PHYS/QHP R&I CPTR MTN ALYS WALK/FUNCJL ACTV REPR,856.0,556.4,75.43,856.0,32
HCPCS,960040,PHYS REVIEW OF MOTION TESTS,,,112.03,112.03,1
HCPCS,96020,TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP,10620.0,6903.0,147.89,11992.0,74
HCPCS,96041,GENETIC COUNSELING SVC EA 30,,,49.5,49.5,1
HCPCS,96041,MED GENETICS&GENETIC COUNSELING SVCS EACH 30 MIN,650.0,422.5,51.04,650.0,16
HCPCS,960410,GENETIC COUNSELING SVC EA 30,,,49.5,49.5,1
HCPCS,96105,ASSESS APHASIA PER HR,600.0,390.0,124.17,723.0,49
HCPCS,96105,ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR,700.0,455.0,47.51,700.0,35
HCPCS,96105,ASSESSMENT OF APHASIA,,,100.22,100.22,1
HCPCS,961050,ASSESSMENT OF APHASIA,,,100.22,100.22,1
HCPCS,96110,DEVELOPMENTAL SCREEN W/SCORE,,,11.5,11.5,1
HCPCS,96110,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,215.5,140.075,8.54,1819.0,88
HCPCS,96110,DEVELOPMENTAL TEST LIMITED,395.0,256.75,66.36,723.0,38
HCPCS,96110,"SLT-DEVELOPMENTAL TEST,LIM",395.0,256.75,66.36,723.0,38
HCPCS,961100,DEVELOPMENTAL SCREEN W/SCORE,,,11.5,11.5,1
HCPCS,96112,DEVEL TST PHYS/QHP 1ST HR,1350.0,877.5,126.0,1215.0,99
HCPCS,96112,DEVELOPMENTAL TST ADMIN PHYS/QHP 1ST HOUR,1187.0,771.55,33.2,1819.0,72
HCPCS,961120,DEVEL TST PHYS/QHP 1ST HR,,,129.7,129.7,1
HCPCS,96113,DEVEL TST PHYS/QHP EA ADDL,378.0,245.7,59.37,723.0,118
HCPCS,96113,DEVELOPMENTAL TST ADMIN PHYS/QHP EA ADDL 30 MIN,421.0,273.65,17.56,1819.0,62
HCPCS,961130,DEVEL TST PHYS/QHP EA ADDL,,,59.37,59.37,1
HCPCS,96116,NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR,1715.0,1114.75,51.93,2417.4,76
HCPCS,96116,NUBHVL XM PHYS/QHP 1ST HR,,,83.93,83.93,1
HCPCS,961160,NUBHVL XM PHYS/QHP 1ST HR,,,83.93,83.93,1
HCPCS,96121,NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR,620.0,403.0,47.79,1819.0,59
HCPCS,96121,NUBHVL XM PHY/QHP EA ADDL HR,,,70.17,70.17,1
HCPCS,961210,NUBHVL XM PHY/QHP EA ADDL HR,,,70.17,70.17,1
HCPCS,96125,COGNITIVE TEST BY HC PRO,828.0,538.2,106.25,745.2,50
HCPCS,96125,COGNITIVE TEST BY HCPRO GN,828.0,538.2,126.0,745.2,49
HCPCS,96125,STANDARDIZED COGNITIVE PERFORMANCE TESTING,680.0,442.0,50.35,680.0,32
HCPCS,961250,COGNITIVE TEST BY HC PRO,,,106.25,106.25,1
HCPCS,96127,BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,112.0,72.8,4.08,1819.0,69
HCPCS,96127,BRIEF EMOTIONAL/BEHAV ASSMT,,,4.63,4.63,1
HCPCS,96127,DEPRESSION SCREENING AUTO BILLING,112.0,72.8,4.08,112.0,28
HCPCS,96127,VIRTUAL BRIEF EMOTIONAL/BEHAV ASSMT,112.0,72.8,7.13,1819.0,41
HCPCS,961270,BRIEF EMOTIONAL/BEHAV ASSMT,,,4.63,4.63,1
HCPCS,96130,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR,1147.0,745.55,48.23,1819.0,72
HCPCS,96130,PSYCL TST EVAL PHYS/QHP 1ST,,,115.16,115.16,1
HCPCS,961300,PSYCL TST EVAL PHYS/QHP 1ST,,,115.16,115.16,1
HCPCS,96131,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR,675.0,438.75,48.23,1819.0,62
HCPCS,96131,PSYCL TST EVAL PHYS/QHP EA,,,80.18,80.18,1
HCPCS,961310,PSYCL TST EVAL PHYS/QHP EA,,,80.18,80.18,1
HCPCS,96132,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR,1558.0,1012.7,81.41,1819.0,72
HCPCS,96132,NRPSYC TST EVAL PHYS/QHP 1ST,,,111.42,111.42,1
HCPCS,961320,NRPSYC TST EVAL PHYS/QHP 1ST,,,111.42,111.42,1
HCPCS,96133,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR,675.0,438.75,61.5,1819.0,62
HCPCS,96133,NRPSYC TST EVAL PHYS/QHP EA,,,80.5,80.5,1
HCPCS,961330,NRPSYC TST EVAL PHYS/QHP EA,,,80.5,80.5,1
HCPCS,96136,PSYCL/NRPSYC TST PHY/QHP 1ST,,,24.44,24.44,1
HCPCS,96136,PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN,363.0,235.95000000000002,17.41,1819.0,72
HCPCS,961360,PSYCL/NRPSYC TST PHY/QHP 1ST,,,24.44,24.44,1
HCPCS,96137,PSYCL/NRPSYC TST PHY/QHP EA,,,18.88,18.88,1
HCPCS,96137,PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN,345.0,224.25,16.02,1819.0,62
HCPCS,961370,PSYCL/NRPSYC TST PHY/QHP EA,,,18.88,18.88,1
HCPCS,96138,PSYCL/NRPSYC TECH 1ST,,,33.78,33.78,1
HCPCS,96138,PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN,1142.0,742.3,33.82,1819.0,68
HCPCS,961380,PSYCL/NRPSYC TECH 1ST,,,33.78,33.78,1
HCPCS,96139,PSYCL/NRPSYC TST TECH EA,,,34.77,34.77,1
HCPCS,96139,PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN,638.0,414.70000000000005,33.82,1819.0,58
HCPCS,961390,PSYCL/NRPSYC TST TECH EA,,,34.77,34.77,1
HCPCS,96146,PSYCL/NRPSYC TST AUTO RESULT,,,2.33,2.33,1
HCPCS,96146,PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT,147.0,95.55,1.53,1819.0,69
HCPCS,961460,PSYCL/NRPSYC TST AUTO RESULT,,,2.33,2.33,1
HCPCS,96156,HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,920.0,598.0,87.9,690.0,27
HCPCS,96156,HLTH BHV ASSMT/REASSESSMENT,,,92.85,200.56,15
HCPCS,96156,Hlth bhv assmt/reassessment,,,149.38,188.69,6
HCPCS,96156,VV HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,920.0,598.0,87.9,690.0,27
HCPCS,961560,HLTH BHV ASSMT/REASSESSMENT,,,93.48,93.48,1
HCPCS,96158,HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,636.0,413.4,60.41,477.0,27
HCPCS,96158,HLTH BHV IVNTJ INDIV 1ST 30,,,62.68,348.36,15
HCPCS,96158,Hlth bhv ivntj indiv 1st 30,,,74.14,93.65,6
HCPCS,96158,VV HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,636.0,413.4,60.41,477.0,27
HCPCS,961580,HLTH BHV IVNTJ INDIV 1ST 30,,,62.68,62.68,1
HCPCS,96159,HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,220.0,143.0,20.49,165.0,27
HCPCS,96159,HLTH BHV IVNTJ INDIV EA ADDL,,,21.03,21.03,1
HCPCS,96159,VV HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,220.0,143.0,20.49,165.0,27
HCPCS,961590,HLTH BHV IVNTJ INDIV EA ADDL,,,21.03,21.03,1
HCPCS,96160,PT-FOCUSED HLTH RISK ASSMT,,,2.95,64.59,15
HCPCS,96160,PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,46.0,29.9,2.54,46.0,28
HCPCS,96160,Pt-focused hlth risk assmt,,,12.84,16.22,6
HCPCS,96160,VV PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,46.0,29.9,2.54,46.0,28
HCPCS,961600,PT-FOCUSED HLTH RISK ASSMT,,,2.95,2.95,1
HCPCS,96161,CAREGIVER HEALTH RISK ASSMT,,,2.95,64.59,15
HCPCS,96161,CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,2.54,89.0,28
HCPCS,96161,Caregiver health risk assmt,,,12.84,16.22,6
HCPCS,96161,VV CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,2.54,89.0,28
HCPCS,961610,CAREGIVER HEALTH RISK ASSMT,,,2.95,2.95,1
HCPCS,96164,HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,92.0,59.8,9.63,69.0,27
HCPCS,96164,HLTH BHV IVNTJ GRP 1ST 30,,,9.91,64.59,15
HCPCS,96164,Hlth bhv ivntj grp 1st 30,,,145.21,183.42,6
HCPCS,96164,VV HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,92.0,59.8,9.63,69.0,27
HCPCS,961640,HLTH BHV IVNTJ GRP 1ST 30,,,9.91,9.91,1
HCPCS,96165,HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,44.0,28.6,4.03,33.0,27
HCPCS,96165,HLTH BHV IVNTJ GRP EA ADDL,,,4.26,4.26,1
HCPCS,96165,VV HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,44.0,28.6,4.03,33.0,27
HCPCS,961650,HLTH BHV IVNTJ GRP EA ADDL,,,4.26,4.26,1
HCPCS,96167,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,680.0,442.0,63.76,510.0,27
HCPCS,96167,HLTH BHV IVNTJ FAM 1ST 30,,,29.9,66.28,15
HCPCS,96167,Hlth bhv ivntj fam 1st 30,,,97.85,123.6,6
HCPCS,96167,VV HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,680.0,442.0,63.76,510.0,27
HCPCS,961670,HLTH BHV IVNTJ FAM 1ST 30,,,66.28,66.28,1
HCPCS,96168,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,240.0,156.0,23.11,180.0,27
HCPCS,96168,HLTH BHV IVNTJ FAM EA ADDL,,,23.51,23.51,1
HCPCS,96168,VV HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,240.0,156.0,23.11,180.0,27
HCPCS,961680,HLTH BHV IVNTJ FAM EA ADDL,,,23.51,23.51,1
HCPCS,96170,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,600.0,390.0,72.15,450.0,16
HCPCS,96170,HLTH BHV IVNTJ FAM WO PT 1ST,,,76.26,76.26,1
HCPCS,96170,Hlth bhv ivntj fam wo pt 1st,,,97.85,123.6,6
HCPCS,96170,VV HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,600.0,390.0,72.15,450.0,16
HCPCS,961700,HLTH BHV IVNTJ FAM WO PT 1ST,,,76.26,76.26,1
HCPCS,96171,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,216.0,140.4,25.96,162.0,16
HCPCS,96171,HLTH BHV IVNTJ FAM W/O PT EA,,,27.41,27.41,1
HCPCS,96171,VV HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,216.0,140.4,25.96,162.0,16
HCPCS,961710,HLTH BHV IVNTJ FAM W/O PT EA,,,27.41,27.41,1
HCPCS,96202,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING 1ST 60,239.0,155.35,17.76,275.4,65
HCPCS,96202,MLT FAM GRP BHV TRAIN 1ST 60,,,22.05,22.05,1
HCPCS,962020,MLT FAM GRP BHV TRAIN 1ST 60,,,22.05,22.05,1
HCPCS,96203,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING EA ADDL,61.0,39.65,5.32,183.42,65
HCPCS,96203,MLT FAM GRP BHV TRAIN EA ADD,,,5.95,5.95,1
HCPCS,962030,MLT FAM GRP BHV TRAIN EA ADD,,,5.95,5.95,1
HCPCS,96360,HYDRATION IV INFUSION INIT,,,32.36,32.36,1
HCPCS,96360,IV HYDRATE INIT 31-60MIN,391.0,254.15,47.36,1801.0,49
HCPCS,96360,IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR,75.0,48.75,23.75,75.0,35
HCPCS,963600,HYDRATION IV INFUSION INIT,,,32.36,32.36,1
HCPCS,96361,HYDRATE IV INFUSION ADD-ON,,,12.45,12.45,1
HCPCS,96361,IV HYDRATE EA ADD HR,195.0,126.75,18.0,1801.0,49
HCPCS,96361,IV INFUSION HYDRATION EACH ADDITIONAL HOUR,40.0,26.0,9.19,40.0,35
HCPCS,963610,HYDRATE IV INFUSION ADD-ON,,,12.45,12.45,1
HCPCS,96365,IV INF INIT UP TO 1 HR,421.0,273.65,88.41,1801.0,49
HCPCS,96365,IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR,92.0,59.8,45.7,110.39,35
HCPCS,96365,THER/PROPH/DIAG IV INF INIT,,,62.42,62.42,1
HCPCS,96365,THERAPEUTIC IV INFUSION 1ST HR,421.0,273.65,88.41,1801.0,49
HCPCS,963650,THER/PROPH/DIAG IV INF INIT,,,62.42,62.42,1
HCPCS,96366,IV INF SEQ EA ADD HR,195.0,126.75,29.39,1801.0,49
HCPCS,96366,IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR,79.0,51.35,15.32,79.0,35
HCPCS,96366,THER/PROPH/DIAG IV INF ADDON,,,20.6,20.6,1
HCPCS,96366,THERAP IV INFUSION EA ADDL HR,195.0,126.75,29.39,1801.0,49
HCPCS,963660,THER/PROPH/DIAG IV INF ADDON,,,20.6,20.6,1
HCPCS,96367,IV INF SEQ UP TO 1HR,241.0,156.65,41.67,1801.0,49
HCPCS,96367,IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR,84.0,54.6,20.94,84.0,35
HCPCS,96367,TX/PROPH/DG ADDL SEQ IV INF,,,28.49,28.49,1
HCPCS,963670,TX/PROPH/DG ADDL SEQ IV INF,,,28.49,28.49,1
HCPCS,96368,IV INF CONCUR THERAPY,241.0,156.65,28.5,1801.0,39
HCPCS,96368,IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS,75.0,48.75,14.55,75.0,35
HCPCS,96368,THER/DIAG CONCURRENT INF,,,19.92,19.92,1
HCPCS,963680,THER/DIAG CONCURRENT INF,,,19.92,19.92,1
HCPCS,96369,SC THER INFUSION UP TO 1 HR,,,139.67,456.81,15
HCPCS,96369,Sc ther infusion up to 1 hr,,,166.76,210.65,6
HCPCS,963690,SC THER INFUSION UP TO 1 HR,,,139.67,139.67,1
HCPCS,96370,SC THER INFUSION ADDL HR,,,16.34,100.04,15
HCPCS,96370,Sc ther infusion addl hr,,,307.14,387.97,6
HCPCS,963700,SC THER INFUSION ADDL HR,,,16.34,16.34,1
HCPCS,96371,SC THER INFUSION RESET PUMP,,,59.32,154.31,15
HCPCS,96371,Sc ther infusion reset pump,,,166.76,210.65,6
HCPCS,963710,SC THER INFUSION RESET PUMP,,,59.32,59.32,1
HCPCS,96372,IM/SC INJECTION (MONTHLY),614.0,399.1,20.57,1801.0,49
HCPCS,96372,INJ SQ/IM,614.0,399.1,20.57,1801.0,49
HCPCS,96372,THER/PROPH/DIAG INJ SC/IM,,,14.67,14.67,1
HCPCS,96372,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,614.0,399.1,10.98,1801.0,122
HCPCS,963720,THER/PROPH/DIAG INJ SC/IM,,,14.67,14.67,1
HCPCS,96373,THER/PROPH/DIAG INJ IA,1818.0,1181.7,18.93,1801.0,50
HCPCS,96373,THERAPEUTIC PROPHYLACTIC/DX NJX INTRA-ARTERIAL,75.0,48.75,13.47,75.0,35
HCPCS,963730,THER/PROPH/DIAG INJ IA,,,18.93,18.93,1
HCPCS,96374,INJ IVPUSH INIT DRUG,238.0,154.7,30.69,1801.0,49
HCPCS,96374,INJECTION IV PUSH INIT,1818.0,1181.7,30.69,1801.0,49
HCPCS,96374,THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG,948.5,616.525,26.81,1636.2,73
HCPCS,96374,THER/PROPH/DIAG INJ IV PUSH,,,36.69,36.69,1
HCPCS,963740,THER/PROPH/DIAG INJ IV PUSH,,,36.69,36.69,1
HCPCS,96375,INJ IV PUSH SEQ NEW DRUG,200.0,130.0,21.87,1801.0,49
HCPCS,96375,INJ IVPUSH SEQ NEW DRUG,200.0,130.0,21.87,1801.0,49
HCPCS,96375,THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG,221.0,143.65,11.23,358.2,73
HCPCS,96375,TX/PRO/DX INJ NEW DRUG ADDON,,,15.43,15.43,1
HCPCS,963750,TX/PRO/DX INJ NEW DRUG ADDON,,,15.43,15.43,1
HCPCS,96376,INJ IV PUSH SEQ SAME DRUG,200.0,130.0,30.69,1801.0,38
HCPCS,96376,THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC,610.0,396.5,30.69,549.0,27
HCPCS,96376,TX/PRO/DX INJ SAME DRUG ADON,,,9.83,9.83,1
HCPCS,963760,TX/PRO/DX INJ SAME DRUG ADON,,,9.83,9.83,1
HCPCS,96377,APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,175.0,113.75,13.79,2849.0,118
HCPCS,96377,APPLICATON ON-BODY INJECTOR,,,18.6,18.6,1
HCPCS,963770,APPLICATON ON-BODY INJECTOR,,,18.6,18.6,1
HCPCS,96379,UNL THER/PROP/DIAG INJ/INF,,,46.31,100.04,15
HCPCS,96379,Unl ther/prop/diag inj/inf,,,30.69,38.77,6
HCPCS,963790,UNL THER/PROP/DIAG INJ/INF,,,53.05,53.05,1
HCPCS,96380,ADMN RSV MONOC ANTB IM CNSL,,,10.8,10.8,1
HCPCS,96380,"VFC ADMIN BEYFORTUS, W/COUNSELING",21.25,13.81,3.57,44.0,31
HCPCS,963800,ADMN RSV MONOC ANTB IM CNSL,,,10.8,10.8,1
HCPCS,96381,ADMN RSV MONOC ANTB IM NJX,,,10.8,10.8,1
HCPCS,96381,Admn rsv monoc antb im njx,,,25.75,32.53,6
HCPCS,963810,ADMN RSV MONOC ANTB IM NJX,,,10.8,10.8,1
HCPCS,96401,CHEMO ANTI-NEOPL SQ/IM,,,79.81,79.81,1
HCPCS,96401,"CHEMOTHER,NON-HORMONE ANTI-NEOPL, SUB-Q/IM",92.0,59.8,41.68,121.91,35
HCPCS,96401,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,614.0,399.1,30.69,1764.0,188
HCPCS,964010,CHEMO ANTI-NEOPL SQ/IM,,,79.81,79.81,1
HCPCS,96402,CHEMO HORMON ANTINEOPL SQ/IM,,,39.66,39.66,1
HCPCS,96402,CHEMOTHER HORMON ANTINEOPL SUB-Q/IM,84.0,54.6,26.66,84.0,35
HCPCS,96402,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,614.0,399.1,30.69,1089.0,147
HCPCS,964020,CHEMO HORMON ANTINEOPL SQ/IM,,,39.66,39.66,1
HCPCS,96405,CHEMO INTRALESIONAL UP TO 7,,,33.19,33.19,1
HCPCS,96405,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7,421.5,273.975,22.33,1089.0,84
HCPCS,964050,CHEMO INTRALESIONAL UP TO 7,,,33.19,33.19,1
HCPCS,96406,CHEMO INTRALESIONAL OVER 7,,,51.58,51.58,1
HCPCS,96406,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL >7,1085.0,705.25,30.69,1636.2,84
HCPCS,964060,CHEMO INTRALESIONAL OVER 7,,,51.58,51.58,1
HCPCS,96409,CHEMO IV PUSH SNGL DRUG,,,111.2,111.2,1
HCPCS,96409,"CHEMOTHER, IV PUSH, SNGL DRUG",106.0,68.9,53.0,170.27,35
HCPCS,96409,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,2861.0,1859.65,30.69,2574.9,147
HCPCS,964090,CHEMO IV PUSH SNGL DRUG,,,111.2,111.2,1
HCPCS,96411,CHEMO IV PUSH ADDL DRUG,,,60.65,60.65,1
HCPCS,96411,"CHEMOTHER, IV PUSH,EA ADD DRUG",88.0,57.2,40.09,92.4,35
HCPCS,96411,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,614.0,399.1,30.69,1089.0,147
HCPCS,964110,CHEMO IV PUSH ADDL DRUG,,,60.65,60.65,1
HCPCS,96413,CHEMO IV INFUSION 1 HR,,,143.67,143.67,1
HCPCS,96413,"CHEMOTHER, IV INFUSION, 1 HR",123.0,79.95,61.5,219.88,35
HCPCS,96413,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,2861.0,1859.65,166.76,2574.9,98
HCPCS,964130,CHEMO IV INFUSION 1 HR,,,143.67,143.67,1
HCPCS,96415,CHEMO IV INFUSION ADDL HR,,,31.22,31.22,1
HCPCS,96415,"CHEMOTHER, IV INFUSION, EA ADD HR",84.0,54.6,20.17,84.0,35
HCPCS,96415,CHEMOTHERAPY ADMN IV INFUSION TQ EA HR,614.0,399.1,39.38,1089.0,98
HCPCS,964150,CHEMO IV INFUSION ADDL HR,,,31.22,31.22,1
HCPCS,96416,CHEMO PROLONG INFUSE W/PUMP,,,141.22,141.22,1
HCPCS,96416,CHEMOTHER PROLONG INFUSE W/PUMP,92.0,59.8,46.0,216.53,35
HCPCS,96416,CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,2861.0,1859.65,193.36,2574.9,98
HCPCS,964160,CHEMO PROLONG INFUSE W/PUMP,,,141.22,141.22,1
HCPCS,96417,CHEMO IV INFUS EACH ADDL SEQ,,,71.01,71.01,1
HCPCS,96417,"CHEMOTHER, IV INFUSE, EACH SEQU INFUS",92.0,59.8,46.0,108.49,35
HCPCS,96417,CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR,614.0,399.1,71.44,1089.0,98
HCPCS,964170,CHEMO IV INFUS EACH ADDL SEQ,,,71.01,71.01,1
HCPCS,96420,CHEMO IA PUSH TECNIQUE,,,113.15,113.15,1
HCPCS,96420,CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ,1468.0,954.2,30.69,2574.9,84
HCPCS,964200,CHEMO IA PUSH TECNIQUE,,,113.15,113.15,1
HCPCS,96422,CHEMO IA INFUSION UP TO 1 HR,,,172.71,172.71,1
HCPCS,96422,CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS </1 HR,1464.5,951.9250000000001,34.0,2574.9,84
HCPCS,964220,CHEMO IA INFUSION UP TO 1 HR,,,172.71,172.71,1
HCPCS,96423,CHEMO IA INFUSE EACH ADDL HR,,,80.82,80.82,1
HCPCS,96423,CHEMOTHERAPY ADMN INTRAARTERIAL INFUSION EA HR,236.5,153.725,37.5,1089.0,84
HCPCS,964230,CHEMO IA INFUSE EACH ADDL HR,,,80.82,80.82,1
HCPCS,96425,CHEMOTHERAPY ADMIN INTRA-ARTERIAL  INFUSION TECHNIQUE >8 HR PRTB,2861.0,1859.65,253.09,2574.9,49
HCPCS,96425,CHEMOTHERAPY INFUSION METHOD,,,186.39,186.39,1
HCPCS,96425,CHEMOTX ADMN IA NFS >8 HR PRTBLE IMPLTBL PMP,75.0,48.75,37.5,286.98,35
HCPCS,964250,CHEMOTHERAPY INFUSION METHOD,,,186.39,186.39,1
HCPCS,96440,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,1854.5,1205.4250000000002,82.83,2574.9,122
HCPCS,96440,CHMOTX ADMN PLRL CAV THRCNTS,,,155.38,155.38,1
HCPCS,964400,CHMOTX ADMN PLRL CAV THRCNTS,,,155.38,155.38,1
HCPCS,96446,CHEMOTX ADMN PERTL CAV IMPL,,,24.15,24.15,1
HCPCS,96446,CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH,1512.0,982.8000000000001,16.11,2574.9,81
HCPCS,964460,CHEMOTX ADMN PERTL CAV IMPL,,,24.15,24.15,1
HCPCS,96450,CHEMOTHERAPY INTO CNS,,,89.07,89.07,1
HCPCS,96450,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,1736.5,1128.7250000000001,48.3,2574.9,122
HCPCS,964500,CHEMOTHERAPY INTO CNS,,,89.07,89.07,1
HCPCS,96521,FILL PORTABLE PUMP,1818.0,1181.7,30.69,1801.0,49
HCPCS,96521,REFILL/MAINT PORTABLE PUMP,,,137.55,137.55,1
HCPCS,96521,"REFILL/MAINT, PORTABLE PUMP",92.0,59.8,46.0,210.93,35
HCPCS,965210,REFILL/MAINT PORTABLE PUMP,,,137.55,137.55,1
HCPCS,96522,FILL IMP PUMP RESVOIR IV OR IA,1818.0,1181.7,30.69,1801.0,49
HCPCS,96522,FILL IMP PUMP SYSTEMIC,1818.0,1181.7,30.69,1801.0,49
HCPCS,96522,REFILL/MAINT PUMP/RESVR SYST,,,130.58,130.58,1
HCPCS,96522,REFILL/MAINT SYSTEMIC PUMP/RESVR,92.0,59.8,46.0,200.32,35
HCPCS,965220,REFILL/MAINT PUMP/RESVR SYST,,,130.58,130.58,1
HCPCS,96523,IRRIG DRUG DELIVERY DEVICE,329.0,213.85,27.7,1801.0,50
HCPCS,96523,IRRIG IMP VAD,513.0,333.45,30.69,1801.0,49
HCPCS,96523,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,265.5,172.575,9.0,1764.0,155
HCPCS,965230,IRRIG DRUG DELIVERY DEVICE,,,27.7,27.7,1
HCPCS,96542,CHEMOTHERAPY INJECTION,,,48.84,48.84,1
HCPCS,96542,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,1580.5,1027.325,20.39,2574.9,84
HCPCS,965420,CHEMOTHERAPY INJECTION,,,48.84,48.84,1
HCPCS,96547,INTRAOP HIPEC PX 1ST 60 MIN,,,735.75,735.75,1
HCPCS,96547,INTRAOPERATIVE HIPEC PX FIRST 60 MINUTES,2612.0,1697.8,159.61,2612.0,27
HCPCS,965470,INTRAOP HIPEC PX 1ST 60 MIN,,,735.75,735.75,1
HCPCS,96548,INTRAOPERATIVE HIPEC PX EACH ADDL 30 MINUTES,1200.0,780.0,79.81,1200.0,27
HCPCS,96548,NTRAOP HIPEC PX EA ADD 30MIN,,,509.26,509.26,1
HCPCS,965480,NTRAOP HIPEC PX EA ADD 30MIN,,,509.26,509.26,1
HCPCS,96549,CONCURRENT CHEMO INFUSION UNLISTED,136.0,88.4,28.56,1089.0,48
HCPCS,96549,UNLISTED CHEMOTHERAPY PX,,,0.32,0.32,1
HCPCS,965490,UNLISTED CHEMOTHERAPY PX,,,0.32,0.32,1
HCPCS,96567,PDT DSTR PRMLG LES SKN,,,134.65,134.65,1
HCPCS,96567,PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY,593.0,385.45,70.52,671.0,73
HCPCS,965670,PDT DSTR PRMLG LES SKN,,,134.65,134.65,1
HCPCS,96570,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX 30 MIN,440.0,286.0,48.58,440.0,32
HCPCS,96570,PHOTODYNMC TX 30 MIN ADD-ON,,,52.71,52.71,1
HCPCS,96570,Photodynmc tx 30 min add-on,,,136.83,172.84,6
HCPCS,965700,PHOTODYNMC TX 30 MIN ADD-ON,,,52.71,52.71,1
HCPCS,96571,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX A 15 MIN,220.0,143.0,22.3,220.0,32
HCPCS,96571,PHOTODYNAMIC TX ADDL 15 MIN,,,26.17,26.17,1
HCPCS,96571,Photodynamic tx addl 15 min,,,136.83,172.84,6
HCPCS,965710,PHOTODYNAMIC TX ADDL 15 MIN,,,26.17,26.17,1
HCPCS,96573,PDT DSTR PRMLG LES PHYS/QHP,,,224.33,224.33,1
HCPCS,96573,PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP,478.0,310.7,98.33,671.0,69
HCPCS,965730,PDT DSTR PRMLG LES PHYS/QHP,,,224.33,224.33,1
HCPCS,96574,DBRDMT PRMLG LES W/PDT,,,199.45,430.81,15
HCPCS,96574,DEBRIDEMENT PRMLG HYPERKERATOTIC LES W/PDT,444.0,288.6,184.54,483.4,28
HCPCS,96574,Dbrdmt prmlg les w/pdt,,,98.33,124.2,6
HCPCS,965740,DBRDMT PRMLG LES W/PDT,,,276.26,276.26,1
HCPCS,96900,ACTINOTHERAPY ULTRAVIOLET LIGHT,92.0,59.8,11.68,92.0,35
HCPCS,96900,ACTINOTHERAPY UV LIGHT,,,24.6,85.1,15
HCPCS,96900,Actinotherapy uv light,,,17.96,22.69,6
HCPCS,969000,ACTINOTHERAPY UV LIGHT,,,24.6,24.6,1
HCPCS,96902,MCRSCP XM HAIR PLUCK/CLIPPED,,,20.73,20.73,1
HCPCS,96902,Mcrscp xm hair pluck/clipped,,,2.34,2.95,6
HCPCS,969020,MCRSCP XM HAIR PLUCK/CLIPPED,,,20.73,20.73,1
HCPCS,96904,WHOLE BODY PHOTOGRAPHY,,,67.51,67.51,1
HCPCS,969040,WHOLE BODY PHOTOGRAPHY,,,67.51,67.51,1
HCPCS,96910,PHOTCHMTX TAR&UVB/PTRLTM&UVB,,,59.62,128.79,15
HCPCS,96910,PHOTOCHEMOTX TAR&UVB/PETROLATUM/UVB,134.0,87.1,57.53,206.48,35
HCPCS,96910,Photchmtx tar&uvb/ptrltm&uvb,,,20.97,26.48,6
HCPCS,969100,PHOTCHMTX TAR&UVB/PTRLTM&UVB,,,116.68,116.68,1
HCPCS,96912,PHOTOCHEMOTHERAPY PUVA,,,59.62,128.79,15
HCPCS,96912,PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA,167.0,108.55,49.31,175.87,35
HCPCS,96912,Photochemotherapy puva,,,20.97,26.48,6
HCPCS,969120,PHOTOCHEMOTHERAPY PUVA,,,99.33,99.33,1
HCPCS,96913,PHOTOCHEMOTX SEV DERMATOSES,,,150.45,866.25,15
HCPCS,96913,Photochemotx sev dermatoses,,,98.33,124.2,6
HCPCS,969130,PHOTOCHEMOTX SEV DERMATOSES,,,150.45,150.45,1
HCPCS,96920,EXCIMER LASER TX PSORIASIS TOT AREA <250 SQ CM,332.0,215.8,36.19,249.0,35
HCPCS,96920,EXCIMER LSR PSRIASIS<250SQCM,,,65.47,430.81,15
HCPCS,96920,Excimer lsr psriasis<250sqcm,,,254.67,321.68,6
HCPCS,969200,EXCIMER LSR PSRIASIS<250SQCM,,,65.47,65.47,1
HCPCS,96921,EXCIMER LASER TX PSORIASIS 250-500 SQ CM,360.0,234.0,37.72,270.0,35
HCPCS,96921,EXCIMER LSR PSRIASIS 250-500,,,74.19,430.81,15
HCPCS,96921,Excimer lsr psriasis 250-500,,,254.67,321.68,6
HCPCS,969210,EXCIMER LSR PSRIASIS 250-500,,,74.19,74.19,1
HCPCS,96922,EXCIMER LASER TX PSORIASIS >500 SQ CM,460.0,299.0,61.55,345.0,35
HCPCS,96922,EXCIMER LSR PSRIASIS>500SQCM,,,119.45,866.25,15
HCPCS,96922,Excimer lsr psriasis>500sqcm,,,254.67,321.68,6
HCPCS,969220,EXCIMER LSR PSRIASIS>500SQCM,,,119.45,119.45,1
HCPCS,96931,RCM IMG ACQUISJ&I&R 1ST LES,,,169.44,169.44,1
HCPCS,96931,Rcm img acquisj&i&r 1st les,,,20.85,26.34,6
HCPCS,969310,RCM IMG ACQUISJ&I&R 1ST LES,,,169.44,169.44,1
HCPCS,96932,RCM IMG ACQUISJ ONLY 1ST LES,,,124.83,124.83,1
HCPCS,96932,Rcm img acquisj only 1st les,,,20.85,26.34,6
HCPCS,969320,RCM IMG ACQUISJ ONLY 1ST LES,,,124.83,124.83,1
HCPCS,96933,RCM I&R ONLY 1ST LESION,,,44.61,44.61,1
HCPCS,96933,Rcm i&r only 1st lesion,,,20.85,26.34,6
HCPCS,969330,RCM I&R ONLY 1ST LESION,,,44.61,44.61,1
HCPCS,96934,RCM IMG ACQUISJ&I&R EA ADDL,,,118.17,118.17,1
HCPCS,96934,Rcm img acquisj&i&r ea addl,,,20.85,26.34,6
HCPCS,969340,RCM IMG ACQUISJ&I&R EA ADDL,,,118.17,118.17,1
HCPCS,96935,RCM IMG ACQUISJ ONLY EA ADDL,,,75.98,75.98,1
HCPCS,96935,Rcm img acquisj only ea addl,,,20.85,26.34,6
HCPCS,969350,RCM IMG ACQUISJ ONLY EA ADDL,,,75.98,75.98,1
HCPCS,96936,RCM I&R ONLY EA ADDL LESION,,,42.2,42.2,1
HCPCS,96936,Rcm i&r only ea addl lesion,,,20.85,26.34,6
HCPCS,969360,RCM I&R ONLY EA ADDL LESION,,,42.2,42.2,1
HCPCS,96999,ABELLA ENLIGHTER,51.0,33.15,25.5,103.31,15
HCPCS,96999,ACNE SPOT TREATMENT,31.0,20.15,15.5,103.31,15
HCPCS,96999,ACUPUNCTURE CONSULTATION; NO TREATMENT,113.0,73.45,56.5,113.0,15
HCPCS,96999,AHA MARINE FADE CREAM,68.0,44.2,34.0,103.31,15
HCPCS,96999,ALPHA & BETA TONER 8 OZ,33.0,21.45,16.5,103.31,15
HCPCS,96999,AQUA GUARD SUNBLOCK,18.0,11.7,9.0,103.31,15
HCPCS,96999,BACK/SHOULDER TREATMENT,86.0,55.9,43.0,103.31,15
HCPCS,96999,BIOMEDICA ANTIBAC WASH 60 1OZ,31.0,20.15,15.5,103.31,15
HCPCS,96999,BLENDER,91.0,59.15,45.5,103.31,15
HCPCS,96999,BLUSH,29.0,18.85,14.5,103.31,15
HCPCS,96999,BRONZE BLAST,5.0,3.25,2.5,103.31,15
HCPCS,96999,BRUSHES - HANDI,42.0,27.3,21.0,103.31,15
HCPCS,96999,CAMMAGLOUGE MAKEUP,45.0,29.25,22.5,103.31,15
HCPCS,96999,CHAMOMILE FACIAL CLEANSER,23.0,14.95,11.5,103.31,15
HCPCS,96999,CHIN WAX,15.0,9.75,7.5,103.31,15
HCPCS,96999,CIRCLE DELETE,32.0,20.8,16.0,103.31,15
HCPCS,96999,CLEAR,96.0,62.4,48.0,103.31,15
HCPCS,96999,CONSULT W ACUPUNCTURE; IST OF 4 TREATMENT,431.0,280.15,86.09,431.0,15
HCPCS,96999,CUSTOMIZED FACIAL-LYMPH MASSAGE 1 HR,91.0,59.15,45.5,103.31,15
HCPCS,96999,D20,19.0,12.35,9.5,103.31,15
HCPCS,96999,DERMAL REPAIR,113.0,73.45,56.5,113.0,15
HCPCS,96999,EFFACLAR K ACNE TX FLUID 1OZ,19.0,12.35,9.5,103.31,15
HCPCS,96999,EMPLOYEE BRONZE BLAST,4.0,2.6,2.0,103.31,15
HCPCS,96999,ENZYMEPEEL,91.0,59.15,45.5,103.31,15
HCPCS,96999,EUROPEAN FACIAL,81.0,52.65,40.5,103.31,15
HCPCS,96999,EXFODERM,63.0,40.95,31.5,103.31,15
HCPCS,96999,EXPRESS FACIAL,51.0,33.15,25.5,103.31,15
HCPCS,96999,EYE BROW WAX,12.0,7.8,6.0,103.31,15
HCPCS,96999,"FACIAL, OTHER",96.0,62.4,48.0,103.31,15
HCPCS,96999,FOAMING CLEANSER,37.0,24.05,18.5,103.31,15
HCPCS,96999,GENTLE CLEANSER,37.0,24.05,18.5,103.31,15
HCPCS,96999,GLYCOLIC PEEL,81.0,52.65,40.5,103.31,15
HCPCS,96999,HEALTHY SKIN PROTECT SPF 35,43.0,27.95,21.5,103.31,15
HCPCS,96999,HYDRATING EYE GEL,33.0,21.45,16.5,103.31,15
HCPCS,96999,JESSNER PEEL,189.0,122.85,86.09,189.0,15
HCPCS,96999,LAVENDER CLEANSER 8.3 OZ,23.0,14.95,11.5,103.31,15
HCPCS,96999,LIPID DROPS,36.0,23.4,18.0,103.31,15
HCPCS,96999,MARINE LIP & EYE THERAPY,43.0,27.95,21.5,103.31,15
HCPCS,96999,MICROPEEL,58.0,37.7,29.0,103.31,15
HCPCS,96999,MITTS,15.0,9.75,7.5,103.31,15
HCPCS,96999,MULTI - COMPLEX CREAM,63.0,40.95,31.5,103.31,15
HCPCS,96999,PAPAYA MINT SCRUB,33.0,21.45,16.5,103.31,15
HCPCS,96999,"PERMANENT MAKEUP, AREOLA",278.0,180.7,86.09,278.0,15
HCPCS,96999,PRESSED POWDER,45.0,29.25,22.5,103.31,15
HCPCS,96999,REPLENISH SUNBLOCK SPF 36,37.0,24.05,18.5,103.31,15
HCPCS,96999,RETIN A 1.0,69.0,44.85,34.5,103.31,15
HCPCS,96999,SALICYLIC FACE & BODY WASH,23.0,14.95,11.5,103.31,15
HCPCS,96999,SKIN CARE CONSULTATION,39.0,25.35,19.5,103.31,15
HCPCS,96999,STARTER KIT,358.0,232.7,86.09,358.0,15
HCPCS,96999,SUNFADER,70.0,45.5,35.0,103.31,15
HCPCS,96999,TANNING,29.0,18.85,14.5,103.31,15
HCPCS,96999,TEENAGE FACIAL,73.0,47.45,36.5,103.31,15
HCPCS,96999,TNS RECOVERY COMPLEX,148.0,96.2,74.0,148.0,15
HCPCS,96999,ULTRA FIRMING MARINE NECK & CHEST,69.0,44.85,34.5,103.31,15
HCPCS,96999,UNDERARM WAX,15.0,9.75,7.5,103.31,15
HCPCS,96999,UPLIFTING EYE SERUM,51.0,33.15,25.5,103.31,15
HCPCS,96999,VAGINAL LASER THERAPY - FEMILIFT (SELF PAY),531.0,345.15,86.09,531.0,52
HCPCS,96999,VITAMIN C CREAM,63.0,40.95,31.5,103.31,15
HCPCS,96999,WAXING,34.0,22.1,17.0,103.31,15
HCPCS,97007,MCHNL SCLP COOL CAP SPLY HEAD MEAS FITG&EDUCAJ,12510.0,8131.5,110.51,11259.0,31
HCPCS,97007,MCHNL SCLP COOL MEAS FITG,,,1671.54,1671.54,1
HCPCS,970070,MCHNL SCLP COOL MEAS FITG,,,1671.54,1671.54,1
HCPCS,97008,MCHNL SCLP COOL HAIR PREPJ CAP PLMT THER&PRECOOL,15098.0,9813.7,14.57,13588.2,28
HCPCS,97008,MCHNL SCLP COOL PREP PLMT,,,9.91,9.91,1
HCPCS,970080,MCHNL SCLP COOL PREP PLMT,,,9.91,9.91,1
HCPCS,97009,MCHNL SCLP COOL AFTER CHEMO,,,6.25,6.25,1
HCPCS,97009,MCHNL SCLP COOL AFTER CHEMO EACH 30 MINUTES,3775.0,2453.75,9.42,3397.5,28
HCPCS,970090,MCHNL SCLP COOL AFTER CHEMO,,,6.25,6.25,1
HCPCS,97010,APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS,24.0,15.6,5.0,24.0,20
HCPCS,97010,HOT OR COLD PACKS THERAPY,,,4.01,4.01,1
HCPCS,97010,Hot or cold packs therapy,,,17.96,22.69,6
HCPCS,970100,HOT OR COLD PACKS THERAPY,,,4.01,4.01,1
HCPCS,97012,APPL MODALITY 1/> AREAS TRACTION MECHANICAL,100.0,65.0,12.81,100.0,32
HCPCS,97012,APPLY TRACTION MECH GP,243.0,157.95,17.96,723.0,49
HCPCS,97012,MECHANICAL TRACTION THERAPY,,,9.05,9.05,1
HCPCS,970120,MECHANICAL TRACTION THERAPY,,,9.05,9.05,1
HCPCS,97014,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,146.5,95.225,11.3,723.0,58
HCPCS,97014,ELECTRIC STIMULATION THERAPY,,,7.89,7.89,1
HCPCS,97014,ELECTRICAL STIM. UNATTENDED,221.0,143.65,17.96,723.0,38
HCPCS,970140,ELECTRIC STIMULATION THERAPY,,,7.89,7.89,1
HCPCS,97016,APPL MODALITY 1/> AREAS VASOPNEUMATIC DEVICES,72.0,46.8,10.71,72.0,32
HCPCS,97016,JOBST COMPRESSION UT,254.0,165.1,14.87,723.0,49
HCPCS,97016,VASOPNEUMATIC DEVICE THERAPY,,,7.5,7.5,1
HCPCS,97016,VASOPNEUMATIC DVC GP,254.0,165.1,14.87,723.0,49
HCPCS,970160,VASOPNEUMATIC DEVICE THERAPY,,,7.5,7.5,1
HCPCS,97018,APPL MODALITY 1/> AREAS PARAFFIN BATH,24.0,15.6,4.7,24.0,35
HCPCS,97018,PARAFFIN,208.0,135.2,7.7,723.0,49
HCPCS,97018,PARAFFIN BATH GO,208.0,135.2,7.7,723.0,49
HCPCS,97018,PARAFFIN BATH THERAPY,,,3.6,3.6,1
HCPCS,970180,PARAFFIN BATH THERAPY,,,3.6,3.6,1
HCPCS,97022,APPLICATION MODALITY 1/> AREAS WHIRLPOOL,68.0,44.2,10.84,68.0,32
HCPCS,97022,WHIRLPOOL GO,224.0,145.6,17.96,723.0,49
HCPCS,97022,WHIRLPOOL GP,224.0,145.6,17.96,723.0,98
HCPCS,97022,WHIRLPOOL THERAPY,,,10.72,10.72,1
HCPCS,970220,WHIRLPOOL THERAPY,,,10.72,10.72,1
HCPCS,97024,DIATHERMY EG MICROWAVE,,,4.61,18.84,22
HCPCS,97024,Diathermy eg microwave,,,17.96,22.69,6
HCPCS,970240,DIATHERMY EG MICROWAVE,,,4.61,4.61,1
HCPCS,97026,INFRARED THERAPY,,,4.21,17.88,22
HCPCS,97026,Infrared therapy,,,17.96,22.69,6
HCPCS,970260,INFRARED THERAPY,,,4.21,4.21,1
HCPCS,97028,ULTRAVIOLET THERAPY,,,5.26,21.21,22
HCPCS,97028,Ultraviolet therapy,,,17.96,22.69,6
HCPCS,970280,ULTRAVIOLET THERAPY,,,5.26,5.26,1
HCPCS,97032,APPL MODALITY 1+ESTIM EA 15,,,9.26,9.26,1
HCPCS,97032,APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN,100.0,65.0,11.68,100.0,32
HCPCS,97032,ELECTR STIM 15MIN GP,299.0,194.35,17.96,723.0,49
HCPCS,97032,OT ELECTRICAL STIMULATION 15 M,299.0,194.35,17.96,723.0,49
HCPCS,970320,APPL MODALITY 1+ESTIM EA 15,,,9.26,9.26,1
HCPCS,97033,APP MDLTY 1+IONTPHRSIS EA 15,,,12.32,12.32,1
HCPCS,97033,APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN,104.0,67.6,17.59,104.0,31
HCPCS,97033,IONTOPHORESIS 15MIN GO,236.0,153.4,17.96,723.0,49
HCPCS,97033,PT IONTOPHORESIS 15MIN GP,236.0,153.4,17.96,723.0,49
HCPCS,970330,APP MDLTY 1+IONTPHRSIS EA 15,,,12.32,12.32,1
HCPCS,97034,APP MDLTY 1+CNTRST BTH EA 15,,,8.97,8.97,1
HCPCS,97034,APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN,121.0,78.65,9.69,723.0,81
HCPCS,97034,"CONTRAST BATH, EA 15 MIN",158.0,102.7,17.37,723.0,98
HCPCS,970340,APP MDLTY 1+CNTRST BTH EA 15,,,8.97,8.97,1
HCPCS,97035,APP MDLTY 1+ULTRASOUND EA 15,,,8.97,8.97,1
HCPCS,97035,APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN,84.0,54.6,9.9,84.0,32
HCPCS,97035,US 15MIN GO,218.0,141.7,17.72,723.0,49
HCPCS,97035,US 15MIN GP,218.0,141.7,17.72,723.0,49
HCPCS,970350,APP MDLTY 1+ULTRASOUND EA 15,,,8.97,8.97,1
HCPCS,97036,APP MDLTY 1+HUBBRD TNK EA 15,,,21.9,21.9,1
HCPCS,97036,HUBBARD 15MIN GP,290.0,188.5,20.97,723.0,49
HCPCS,970360,APP MDLTY 1+HUBBRD TNK EA 15,,,21.9,21.9,1
HCPCS,97037,APPL MODALITY 1+LLLT PO PAIN,,,39.0,85.1,14
HCPCS,97037,Appl modality 1+lllt po pain,,,17.96,22.69,6
HCPCS,97039,UNLISTED MODALITY,,,8.61,8.61,1
HCPCS,97039,Unlisted modality,,,17.96,22.69,6
HCPCS,970390,UNLISTED MODALITY,,,8.61,8.61,1
HCPCS,97110,"PT THERAPEUT PROC/EXER, 15 MIN",323.0,209.95,20.97,723.0,49
HCPCS,97110,THERA EXER 1,323.0,209.95,20.97,723.0,49
HCPCS,97110,THERA EXER 15MIN,323.0,209.95,20.97,723.0,49
HCPCS,97110,THERAPEUTIC EXERCISES,,,18.79,18.79,1
HCPCS,97110,"THERAPEUTIC EXERCISES RE, EA 15 MIN.",198.0,128.7,17.96,198.0,32
HCPCS,97110,VV THERAPEUTIC EXERCISE  OT (97110),323.0,209.95,20.97,723.0,49
HCPCS,97110,VV THERAPEUTIC EXERCISE OT (97110),198.0,128.7,17.96,198.0,32
HCPCS,97110,VV THERAPEUTIC EXERCISE PT (97110),260.5,169.325,17.96,723.0,81
HCPCS,971100,THERAPEUTIC EXERCISES,,,18.79,18.79,1
HCPCS,97112,NEURMSCL THERAPY 15MIN,326.0,211.9,20.97,723.0,98
HCPCS,97112,NEUROMUSCULAR REEDUCATION,,,21.52,21.52,1
HCPCS,97112,THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA,220.0,143.0,18.5,220.0,32
HCPCS,97112,VV NEUROMUSCULAR EDUCATION  OT (97112),326.0,211.9,20.97,723.0,49
HCPCS,97112,VV NEUROMUSCULAR EDUCATION OT (97112),220.0,143.0,18.5,220.0,32
HCPCS,97112,VV NEUROMUSCULAR EDUCATION PT (97112),273.0,177.45,18.5,723.0,81
HCPCS,971120,NEUROMUSCULAR REEDUCATION,,,21.52,21.52,1
HCPCS,97113,AQUATIC THERAPY/EXERCISES,,,23.32,95.35,22
HCPCS,97113,Aquatic therapy/exercises,,,20.97,26.48,6
HCPCS,97113,THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS,211.0,137.15,21.18,211.0,32
HCPCS,971130,AQUATIC THERAPY/EXERCISES,,,23.32,23.32,1
HCPCS,97116,GAIT TRAINING THERAPY,,,18.79,18.79,1
HCPCS,97116,GAIT TRAINING THERAPY 15M,285.0,185.25,17.96,723.0,49
HCPCS,97116,THER PX 1/> AREAS EA 15 MIN GAIT TRAING W/STAIR,198.0,128.7,15.74,198.0,32
HCPCS,97116,VV GAIT TRAINING THERAPY  (97116),285.0,185.25,17.96,723.0,49
HCPCS,97116,VV GAIT TRAINING THERAPY PT (97116),198.0,128.7,15.74,198.0,32
HCPCS,971160,GAIT TRAINING THERAPY,,,18.79,18.79,1
HCPCS,97124,MASSAGE THERAPY,,,19.2,78.42,22
HCPCS,97124,Massage therapy,,,17.96,22.69,6
HCPCS,97124,THER PX 1/> AREAS EACH 15 MINUTES MASSAGE,140.0,91.0,14.2,140.0,32
HCPCS,971240,MASSAGE THERAPY,,,19.2,19.2,1
HCPCS,97129,THER IVNTJ 1ST 15 MIN,,,14.42,14.42,1
HCPCS,97129,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,228.0,148.2,18.75,1819.0,363
HCPCS,971290,THER IVNTJ 1ST 15 MIN,,,14.42,14.42,1
HCPCS,97130,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,224.0,145.6,18.49,1819.0,363
HCPCS,97130,THER IVNTJ EA ADDL 15 MIN,,,13.77,13.77,1
HCPCS,971300,THER IVNTJ EA ADDL 15 MIN,,,13.77,13.77,1
HCPCS,97139,UNLISTED THERAPEUTIC PX,,,11.99,11.99,1
HCPCS,97139,Unlisted therapeutic px,,,17.96,22.69,6
HCPCS,971390,UNLISTED THERAPEUTIC PX,,,11.99,11.99,1
HCPCS,97140,MANUAL THERAPY 1/> REGIONS,,,17.32,17.32,1
HCPCS,97140,MANUAL THERAPY 15MIN,301.0,195.65,20.97,723.0,49
HCPCS,97140,MANUAL THERAPY 15MIN GP,301.0,195.65,20.97,723.0,49
HCPCS,97140,MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES,245.0,159.25,16.78,723.0,81
HCPCS,971400,MANUAL THERAPY 1/> REGIONS,,,17.32,17.32,1
HCPCS,97150,GROUP THERAPEUTIC PROCEDURES,,,11.57,11.57,1
HCPCS,97150,GROUP THERAPY GO,293.0,190.45,20.97,723.0,49
HCPCS,97150,THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS,116.0,75.4,14.03,116.0,32
HCPCS,971500,GROUP THERAPEUTIC PROCEDURES,,,11.57,11.57,1
HCPCS,97151,BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN,325.0,211.25,59.5,1819.0,53
HCPCS,97151,BHV ID ASSMT BY PHYS/QHP,,,30.47,30.47,1
HCPCS,971510,BHV ID ASSMT BY PHYS/QHP,,,30.47,30.47,1
HCPCS,97152,BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN,412.0,267.79999999999995,73.12,1819.0,53
HCPCS,97152,BHV ID SUPRT ASSMT BY 1 TECH,,,26.06,26.06,1
HCPCS,971520,BHV ID SUPRT ASSMT BY 1 TECH,,,26.06,26.06,1
HCPCS,97153,ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN,388.5,252.52499999999998,58.06,477.9,50
HCPCS,97153,ADAPTIVE BEHAVIOR TX BY TECH,,,21.03,21.03,1
HCPCS,971530,ADAPTIVE BEHAVIOR TX BY TECH,,,21.03,21.03,1
HCPCS,97154,GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN,176.0,114.4,8.26,181.0,50
HCPCS,97154,GRP ADAPT BHV TX BY TECH,,,2.95,2.95,1
HCPCS,971540,GRP ADAPT BHV TX BY TECH,,,2.95,2.95,1
HCPCS,97155,ADAPT BEHAVIOR TX PHYS/QHP,,,21.03,21.03,1
HCPCS,97155,ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN,585.0,380.25,58.06,831.6,50
HCPCS,971550,ADAPT BEHAVIOR TX PHYS/QHP,,,21.03,21.03,1
HCPCS,97156,FAM ADAPT BHV TX GDN PHY/QHP,,,21.86,21.86,1
HCPCS,97156,FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN,134.5,87.42500000000001,29.9,153.9,50
HCPCS,971560,FAM ADAPT BHV TX GDN PHY/QHP,,,21.86,21.86,1
HCPCS,97157,MULT FAM ADAPT BHV TX GDN,,,12.82,12.82,1
HCPCS,97157,MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN,154.0,100.1,18.08,153.9,50
HCPCS,971570,MULT FAM ADAPT BHV TX GDN,,,12.82,12.82,1
HCPCS,97158,GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN,123.0,79.95,9.54,153.9,50
HCPCS,97158,GRP ADAPT BHV TX BY PHY/QHP,,,3.38,3.38,1
HCPCS,971580,GRP ADAPT BHV TX BY PHY/QHP,,,3.38,3.38,1
HCPCS,97161,PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS,686.0,445.9,68.99,723.0,77
HCPCS,97161,PT EVAL - LOW,756.0,491.4,126.19,723.0,49
HCPCS,97161,PT EVAL LOW COMPLEX 20 MIN,,,64.28,64.28,1
HCPCS,97161,VV EVALUATION LOW COMPLEXITY  (97161),756.0,491.4,126.19,723.0,49
HCPCS,97161,VV EVALUATION LOW COMPLEXITY OT (97161),616.0,400.4,68.99,616.0,28
HCPCS,97161,VV EVALUATION LOW COMPLEXITY PT (97161),616.0,400.4,68.99,616.0,28
HCPCS,971610,PT EVAL LOW COMPLEX 20 MIN,,,64.28,64.28,1
HCPCS,97162,PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS,616.0,400.4,68.99,616.0,28
HCPCS,97162,PT EVAL - MOD,756.0,491.4,126.19,723.0,49
HCPCS,97162,PT EVAL MOD COMPLEX 30 MIN,,,64.28,64.28,1
HCPCS,97162,VV EVALUATION MODERATE COMPLEXITY  (97162),756.0,491.4,126.19,723.0,49
HCPCS,97162,VV EVALUATION MODERATE COMPLEXITY OT (97162),616.0,400.4,68.99,616.0,28
HCPCS,97162,VV EVALUATION MODERATE COMPLEXITY PT (97162),616.0,400.4,68.99,616.0,28
HCPCS,971620,PT EVAL MOD COMPLEX 30 MIN,,,64.28,64.28,1
HCPCS,97163,PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS,616.0,400.4,68.99,616.0,28
HCPCS,97163,PT EVAL - HIGH,756.0,491.4,126.19,723.0,49
HCPCS,97163,PT EVAL HIGH COMPLEX 45 MIN,,,64.28,64.28,1
HCPCS,97163,VV EVALUATION HIGH COMPLEXITY (97163),756.0,491.4,126.19,723.0,49
HCPCS,97163,VV EVALUATION HIGH COMPLEXITY OT (97163),616.0,400.4,68.99,616.0,28
HCPCS,97163,VV EVALUATION HIGH COMPLEXITY PT (97163),616.0,400.4,68.99,616.0,28
HCPCS,971630,PT EVAL HIGH COMPLEX 45 MIN,,,64.28,64.28,1
HCPCS,97164,PHYSICAL THERAPY RE-EVAL EST PLAN CARE 20 MINS,384.0,249.6,46.74,384.0,28
HCPCS,97164,PT RE-EVAL,479.0,311.35,86.04,723.0,49
HCPCS,97164,PT RE-EVAL EST PLAN CARE,,,44.42,44.42,1
HCPCS,971640,PT RE-EVAL EST PLAN CARE,,,44.42,44.42,1
HCPCS,97165,OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS,616.0,400.4,66.98,616.0,28
HCPCS,97165,OT EVAL - LOW,843.0,547.95,126.0,758.7,49
HCPCS,97165,OT EVAL LOW COMPLEX 30 MIN,,,64.9,64.9,1
HCPCS,97165,VV EVALUATION LOW COMPLEXITY (97165),843.0,547.95,126.0,758.7,49
HCPCS,971650,OT EVAL LOW COMPLEX 30 MIN,,,64.9,64.9,1
HCPCS,97166,OCCUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS,616.0,400.4,66.98,616.0,28
HCPCS,97166,OT EVAL - MOD,843.0,547.95,126.0,758.7,49
HCPCS,97166,OT EVAL MOD COMPLEX 45 MIN,,,64.9,64.9,1
HCPCS,97166,VV EVALUATION MODERATE COMPLEXITY (97166),843.0,547.95,126.0,758.7,49
HCPCS,971660,OT EVAL MOD COMPLEX 45 MIN,,,64.9,64.9,1
HCPCS,97167,OCCUPATIONAL THERAPY EVAL HIGH COMPLEX 60 MINS,616.0,400.4,66.98,616.0,28
HCPCS,97167,OT EVAL - HIGH,843.0,547.95,126.0,758.7,49
HCPCS,97167,OT EVAL HIGH COMPLEX 60 MIN,,,64.9,64.9,1
HCPCS,97167,VV EVALUATION HIGH COMPLEXITY (97167),843.0,547.95,126.0,758.7,49
HCPCS,971670,OT EVAL HIGH COMPLEX 60 MIN,,,64.9,64.9,1
HCPCS,97168,OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS,431.5,280.475,44.12,723.0,77
HCPCS,97168,OT RE-EVAL EST PLAN CARE,,,44.63,44.63,1
HCPCS,971680,OT RE-EVAL EST PLAN CARE,,,44.63,44.63,1
HCPCS,97169,ATHLETIC TRN EVAL LOW CMPLX,,,33.22,33.22,1
HCPCS,971690,ATHLETIC TRN EVAL LOW CMPLX,,,33.22,33.22,1
HCPCS,97170,ATHLETIC TRN EVAL MOD CMPLX,,,33.22,33.22,1
HCPCS,971700,ATHLETIC TRN EVAL MOD CMPLX,,,33.22,33.22,1
HCPCS,97171,ATHLETIC TRN EVAL HIGH CMPLX,,,33.22,33.22,1
HCPCS,971710,ATHLETIC TRN EVAL HIGH CMPLX,,,33.22,33.22,1
HCPCS,97172,ATHLETIC TRN RE-EVAL PLAN CR,,,16.83,16.83,1
HCPCS,971720,ATHLETIC TRN RE-EVAL PLAN CR,,,16.83,16.83,1
HCPCS,97530,THERA ACTIVITY DIR 15MIN,343.0,222.95,20.97,723.0,49
HCPCS,97530,THERA FUNC ACTIVITIES 15M,343.0,222.95,20.97,723.0,49
HCPCS,97530,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,259.5,168.675,19.28,723.0,81
HCPCS,97530,THERAPEUTIC ACTIVITIES,,,23.23,23.23,1
HCPCS,97530,VV THERAPEUTIC ACTIVITIES (97530),343.0,222.95,20.97,723.0,49
HCPCS,97530,VV THERAPEUTIC ACTIVITIES PT (97530),176.0,114.4,19.28,176.0,32
HCPCS,975300,THERAPEUTIC ACTIVITIES,,,23.23,23.23,1
HCPCS,97533,PT SENSORY INTEGRATIVE TCH/15M,235.0,152.75,20.97,723.0,49
HCPCS,97533,SENSORY INTEGRATION,,,38.96,38.96,1
HCPCS,97533,"SENSORY INTEGRATION, EA 1",235.0,152.75,20.97,723.0,49
HCPCS,97533,SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES,192.0,124.8,23.36,192.0,32
HCPCS,97533,SENSORY INTEGRATN EA 15M,235.0,152.75,20.97,723.0,49
HCPCS,975330,SENSORY INTEGRATION,,,38.96,38.96,1
HCPCS,97535,EDUC HOME MGMT EA 15MIN GO,343.0,222.95,17.96,723.0,49
HCPCS,97535,EDUC HOME MGMT EA 15MIN GP,343.0,222.95,17.96,723.0,49
HCPCS,97535,SELF CARE MNGMENT TRAINING,,,20.82,20.82,1
HCPCS,97535,SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES,261.5,169.975,17.96,723.0,130
HCPCS,97535,VV SELF-CARE HOME MANAGEMENT  PT (97535),343.0,222.95,17.96,723.0,49
HCPCS,97535,VV SELF-CARE HOME MANAGEMENT OT (97535),261.5,169.975,17.96,723.0,81
HCPCS,97535,VV SELF-CARE HOME MANAGEMENT PT (97535),180.0,117.0,23.37,180.0,32
HCPCS,975350,SELF CARE MNGMENT TRAINING,,,20.82,20.82,1
HCPCS,97537,COMMUNITY/WORK REINTEGRATION,,,20.27,20.27,1
HCPCS,97537,COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN,206.0,133.9,20.97,723.0,81
HCPCS,97537,OT COMMUNITY REINTEGRATION/15M,220.0,143.0,20.97,723.0,49
HCPCS,97537,P.T. COMMUNITY REINTEG 15 MIN,220.0,143.0,20.97,723.0,49
HCPCS,975370,COMMUNITY/WORK REINTEGRATION,,,20.27,20.27,1
HCPCS,97542,OT WHEELCHAIR MANAGEMENT 15 MI,318.0,206.7,20.97,723.0,49
HCPCS,97542,WHEELCHAIR MGMT EA 15 MIN,255.0,165.75,20.97,723.0,130
HCPCS,97542,WHEELCHAIR MNGMENT TRAINING,,,20.27,20.27,1
HCPCS,975420,WHEELCHAIR MNGMENT TRAINING,,,20.27,20.27,1
HCPCS,97545,PT/OT WORK CONDITION,1255.0,815.75,17.96,1129.5,38
HCPCS,97545,WORK HARDENING,,,104.89,104.89,1
HCPCS,97545,WORK HARDENING INIT 2HR GO,1255.0,815.75,17.96,1129.5,38
HCPCS,975450,WORK HARDENING,,,104.89,104.89,1
HCPCS,97546,WC/WH EA ADDTL HR,629.0,408.85,17.96,723.0,38
HCPCS,97546,WORK HARDENING (ADDL HR),629.0,408.85,17.96,723.0,38
HCPCS,97546,WORK HARDENING ADD-ON,,,41.83,41.83,1
HCPCS,975460,WORK HARDENING ADD-ON,,,41.83,41.83,1
HCPCS,97550,CAREGIVER TRAING 1ST 30 MIN,,,47.88,47.88,1
HCPCS,97550,CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,774.5,503.425,38.35,998.1,66
HCPCS,97550,OT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,1109.0,720.85,41.57,998.1,49
HCPCS,97550,PT/OT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,1109.0,720.85,41.57,998.1,38
HCPCS,97550,SLT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,1109.0,720.85,41.57,998.1,49
HCPCS,975500,CAREGIVER TRAING 1ST 30 MIN,,,47.88,47.88,1
HCPCS,97551,CAREGIVER TRAING EA ADDL 15,,,25.68,25.68,1
HCPCS,97551,CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,673.5,437.775,17.77,998.1,66
HCPCS,97551,PT/OT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,1109.0,720.85,30.26,998.1,38
HCPCS,97551,SLT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,1109.0,720.85,30.26,998.1,49
HCPCS,975510,CAREGIVER TRAING EA ADDL 15,,,25.68,25.68,1
HCPCS,97552,GROUP CAREGIVER TRAINING,,,11.26,11.26,1
HCPCS,97552,GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,605.0,393.25,9.69,998.1,66
HCPCS,97552,SLT GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,1109.0,720.85,13.13,998.1,49
HCPCS,97552,SLT GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE?,1109.0,720.85,13.13,998.1,38
HCPCS,975520,GROUP CAREGIVER TRAINING,,,11.26,11.26,1
HCPCS,97597,DBRDMT OPN WND 1ST 20 CM/<,,,37.12,37.12,1
HCPCS,97597,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,725.5,471.57500000000005,10.82,2849.0,114
HCPCS,97597,TX WOUND<=20CM,1143.0,742.95,44.41,2849.0,49
HCPCS,975970,DBRDMT OPN WND 1ST 20 CM/<,,,37.12,37.12,1
HCPCS,97598,DBRDMT OPN WND ADDL 20CM/<,,,25.77,25.77,1
HCPCS,97598,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,576.5,374.725,9.79,2849.0,164
HCPCS,97598,TX WOUND>21CM,933.0,606.45,30.09,2849.0,39
HCPCS,975980,DBRDMT OPN WND ADDL 20CM/<,,,25.77,25.77,1
HCPCS,97602,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,643.5,418.27500000000003,22.56,1028.7,127
HCPCS,97602,WOUND(S) CARE NON-SELECTIVE,,,86.8,86.8,1
HCPCS,976020,WOUND(S) CARE NON-SELECTIVE,,,86.8,86.8,1
HCPCS,97605,NEG PRS WND THER DME<=50SQCM,,,25.38,25.38,1
HCPCS,97605,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,692.5,450.125,21.45,1764.0,149
HCPCS,976050,NEG PRS WND THER DME<=50SQCM,,,25.38,25.38,1
HCPCS,97606,NEG PRS WND THER DME>50 SQCM,,,27.83,27.83,1
HCPCS,97606,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,1281.0,832.65,23.47,2068.2,108
HCPCS,976060,NEG PRS WND THER DME>50 SQCM,,,27.83,27.83,1
HCPCS,97607,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,1239.0,805.35,20.25,2068.2,66
HCPCS,97607,NEG PRS WND THR NDME<=50SQCM,,,22.2,22.2,1
HCPCS,976070,NEG PRS WND THR NDME<=50SQCM,,,22.2,22.2,1
HCPCS,97608,NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM,1250.0,812.5,24.04,2068.2,66
HCPCS,97608,NEG PRS WND THER NDME>50SQCM,,,26.1,26.1,1
HCPCS,976080,NEG PRS WND THER NDME>50SQCM,,,26.1,26.1,1
HCPCS,97610,LOW FREQUENCY NON-THERMAL US,,,18.68,18.68,1
HCPCS,97610,MIST WOUND ULTRASOUND,1143.0,742.95,22.52,1028.7,49
HCPCS,976100,LOW FREQUENCY NON-THERMAL US,,,18.68,18.68,1
HCPCS,97750,PHYSICAL PERFORMANCE TEST,,,21.63,21.63,1
HCPCS,97750,PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN,180.0,117.0,20.18,180.0,32
HCPCS,97750,TEST PHYSCL PERF EA 15MIN GO,340.0,221.0,20.97,723.0,49
HCPCS,97750,TEST PHYSCL PERF EA 15MIN GP,340.0,221.0,20.97,723.0,49
HCPCS,977500,PHYSICAL PERFORMANCE TEST,,,21.63,21.63,1
HCPCS,97755,ASSISTIVE TECHNOLOGY ASSESS,,,24.63,24.63,1
HCPCS,97755,ASSTV TECHNOL ASSMT DIR CNTCT W/REPRT EA 15 MIN,370.0,240.5,48.65,723.0,49
HCPCS,977550,ASSISTIVE TECHNOLOGY ASSESS,,,24.63,24.63,1
HCPCS,97760,ORTHO MGMT EXT/TRUNK 15MN GO,369.0,239.85,20.97,723.0,49
HCPCS,97760,ORTHO MGMT EXT/TRUNK 15MN GP,369.0,239.85,20.97,723.0,49
HCPCS,97760,ORTHOTIC MGMT&TRAING 1ST ENC,,,30.06,30.06,1
HCPCS,97760,ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS,200.0,130.0,31.24,200.0,32
HCPCS,977600,ORTHOTIC MGMT&TRAING 1ST ENC,,,30.06,30.06,1
HCPCS,97761,PROSTHETIC TRAING 1ST ENC,,,26.41,26.41,1
HCPCS,97761,PROSTHETICS TRAINING INITIAL ENCTR EA 15 MINS,200.0,130.0,22.4,200.0,32
HCPCS,97761,PROSTHTIC TRAINING EXT 15M GO,338.0,219.7,20.97,723.0,49
HCPCS,977610,PROSTHETIC TRAING 1ST ENC,,,26.41,26.41,1
HCPCS,97763,ORTH/PROS MGMT EA 15 MIN GO,400.0,260.0,20.97,723.0,49
HCPCS,97763,ORTH/PROS MGMT EA 15 MIN GP,400.0,260.0,20.97,723.0,49
HCPCS,97763,ORTHC/PROSTC MGMT SBSQ ENC,,,53.0,53.0,1
HCPCS,97763,ORTHOTICS/PROSTH MGMT &/TRAINJ SBSQ ENCTR 15 MIN,192.0,124.8,40.69,192.0,28
HCPCS,977630,ORTHC/PROSTC MGMT SBSQ ENC,,,53.0,53.0,1
HCPCS,97799,4 NUTRITION CONSULTS 4 PERSONAL TRAINING,659.0,428.35,27.05,659.0,15
HCPCS,97799,AFTER CARE REHAB PROGRAM,33.0,21.45,16.5,33.0,15
HCPCS,97799,BASEBALL SPECIFIC ADVANCE HOME TRAINING,68.0,44.2,27.05,68.0,15
HCPCS,97799,CHAMPIONS GOLF PACKAGE,410.0,266.5,27.05,410.0,15
HCPCS,97799,EXECUTIVE FITNESS EVALUATION,194.0,126.1,27.05,194.0,15
HCPCS,97799,GOLF EVAL W/VIDEO ANALYSIS (MASTERS PKG),323.0,209.95,27.05,323.0,15
HCPCS,97799,"GROUP PRG INITIATION (PRE-POST-TESTS,HEP)",56.0,36.4,27.05,56.0,15
HCPCS,97799,HOLE IN ONE PACKAGE,471.0,306.15,27.05,471.0,15
HCPCS,97799,INDIVIDUAL BASEBALL TRAINING,72.0,46.8,27.05,72.0,15
HCPCS,97799,JUMP RIGHT GROUP TRAINING SESSIONS,30.0,19.5,15.0,32.46,15
HCPCS,97799,MASTERS GOLF PACKAGE,323.0,209.95,27.05,323.0,15
HCPCS,97799,MATCH PLAY PACKAGE,410.0,266.5,27.05,410.0,15
HCPCS,97799,METABOLISM MEASURE INDIRECT CALORIMETRY,148.0,96.2,27.05,148.0,15
HCPCS,97799,NUTRITION CONSULT&PERSONAL TRAIN SESSION,210.0,136.5,27.05,210.0,15
HCPCS,97799,PERSONAL TRAINING 6 SESSIONS,387.0,251.55,27.05,387.0,15
HCPCS,97799,PREP F/U 30 MIN (SELF PAY),60.0,39.0,27.05,60.0,15
HCPCS,97799,PREP F/U 45 MIN (SELF PAY),80.0,52.0,27.05,80.0,15
HCPCS,97799,PREP F/U 60 MIN (SELF PAY),100.0,65.0,27.05,100.0,15
HCPCS,97799,RE-VIDEO AND TRAINING,68.0,44.2,27.05,68.0,15
HCPCS,97799,SPEECH & VOICE ENHNCMNT SESSION 2,175.0,113.75,27.05,175.0,15
HCPCS,97799,SPORTS NUTRITION COMPREHENSIVE EVAL,148.0,96.2,27.05,148.0,15
HCPCS,97799,SUPERVISED FITNESS PER MONTH,86.0,55.9,27.05,86.0,15
HCPCS,97799,THROW RIGHT INIT EVAL & VIDEO ANALYSIS,297.0,193.05,27.05,297.0,15
HCPCS,97799,Unlisted physcl med/rehab px,,,17.96,22.69,6
HCPCS,97802,MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI,212.0,137.8,17.83,675.0,73
HCPCS,97802,MEDICAL NUTRITION INDIV IN,,,43.8,43.8,1
HCPCS,97802,"MEDICAL NUTRITION, INDIVIDUAL,INT. 15 MIN",212.0,137.8,17.83,159.0,32
HCPCS,97802,"NUTRITION THERAPY, INITIAL 15 MIN",212.0,137.8,35.63,675.0,41
HCPCS,97802,"VIRTUAL VISIT MNT, INITIAL, EA. 15 MIN INCREMENT 97802",212.0,137.8,17.83,159.0,32
HCPCS,97802,WEIGHT LOSS NUTRITION VISIT,212.0,137.8,17.83,159.0,32
HCPCS,978020,MEDICAL NUTRITION INDIV IN,,,43.8,43.8,1
HCPCS,97803,MED NUTRITION INDIV SUBSEQ,,,37.35,37.35,1
HCPCS,97803,MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M,180.0,117.0,15.26,675.0,73
HCPCS,97803,"NUTRITION THERAPY, REASSES EA 15 MIN",180.0,117.0,29.84,675.0,41
HCPCS,97803,"VIRTUAL VISIT MNT, RE ASSES, EA. 15 MIN INCREMENT 97803",180.0,117.0,15.26,135.0,32
HCPCS,978030,MED NUTRITION INDIV SUBSEQ,,,37.35,37.35,1
HCPCS,97804,MEDICAL NUTRITION GROUP,,,21.21,21.21,1
HCPCS,97804,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,100.0,65.0,8.18,675.0,114
HCPCS,97804,"MEDICAL NUTRITION THERAPY,GROUP EACH 30MI",100.0,65.0,8.18,75.0,32
HCPCS,97804,"VV MNT GROUP, EA. 30 MIN",100.0,65.0,8.18,75.0,32
HCPCS,978040,MEDICAL NUTRITION GROUP,,,21.21,21.21,1
HCPCS,97810,ACUP 1/> WO ESTIM 1ST 15 MIN,,,24.58,53.1,15
HCPCS,97810,Acup 1/> wo estim 1st 15 min,,,17.96,22.69,6
HCPCS,978100,ACUP 1/> WO ESTIM 1ST 15 MIN,,,31.9,31.9,1
HCPCS,97811,ACUP 1/> W/O ESTIM EA ADD 15,,,26.62,26.62,1
HCPCS,97811,Acup 1/> w/o estim ea add 15,,,17.96,22.69,6
HCPCS,978110,ACUP 1/> W/O ESTIM EA ADD 15,,,26.62,26.62,1
HCPCS,97813,ACUP 1/> W/ESTIM 1ST 15 MIN,,,24.58,53.1,15
HCPCS,97813,ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,76.0,49.4,27.85,59.03,32
HCPCS,97813,Acup 1/> w/estim 1st 15 min,,,17.96,22.69,6
HCPCS,978130,ACUP 1/> W/ESTIM 1ST 15 MIN,,,34.68,34.68,1
HCPCS,97814,ACUP 1/> W/ESTIM EA ADDL 15,,,29.44,29.44,1
HCPCS,97814,Acup 1/> w/estim ea addl 15,,,17.96,22.69,6
HCPCS,978140,ACUP 1/> W/ESTIM EA ADDL 15,,,29.44,29.44,1
HCPCS,97999,BIOMEDIC 21-DAY INTENSIVE WRINKLE,165.0,107.25,82.5,165.0,12
HCPCS,97999,CCF BENZOYL 2.5% SHAVE CREAM,16.0,10.4,8.0,16.0,12
HCPCS,97999,COMPLEX B HQ PLUS 2OZ 4%HQ AHA,56.0,36.4,28.0,56.0,12
HCPCS,97999,DIROSEAL,45.0,29.25,22.5,45.0,12
HCPCS,97999,ELTA MD UV DAILY SPF 40 PUMP 1.7 OZ,28.0,18.2,14.0,28.0,12
HCPCS,97999,GLYTONE BODY LOTION,33.0,21.45,16.5,33.0,12
HCPCS,97999,ILLUMINATING EYE SERUM,73.0,47.45,36.5,73.0,12
HCPCS,97999,LIPIKAR BODY EMOLLIENT LOTION 6.8 OZ,20.0,13.0,10.0,20.0,12
HCPCS,97999,NEOVA NIGHT THERAPY,65.0,42.25,32.5,65.0,12
HCPCS,97999,POST SURGERY,41.0,26.65,20.5,41.0,12
HCPCS,97999,PRE SURGERY PRO,101.0,65.65,50.5,101.0,12
HCPCS,97999,RETRINOL 0.1% CREAM,58.0,37.7,29.0,58.0,12
HCPCS,97999,ROSALIAC ANTI-REDNESS MOISTURIZER,33.0,21.45,16.5,33.0,12
HCPCS,97999,STRIA,67.0,43.55,33.5,67.0,12
HCPCS,97999,SUNSTICK SPF 15,9.0,5.85,4.5,9.0,12
HCPCS,97999,T1-SIL GT SPF 60 4OZ,32.0,20.8,16.0,32.0,12
HCPCS,97999,T1-SILC SHEER SPF 45 4OZ,56.0,36.4,28.0,56.0,12
HCPCS,97999,THERMAL SPRING WATER,12.0,7.8,6.0,12.0,12
HCPCS,97999,TL TAN SUNLESS TANNING LOTION,31.0,20.15,15.5,31.0,12
HCPCS,97999,TOLERINE FACIAL FLUID,22.0,14.3,11.0,22.0,12
HCPCS,97999,VANICREAM CLEANSING BAR,6.0,3.9,3.0,6.0,12
HCPCS,97999,Z SILE SUNBLOCK SPF 30 3.5 OZ,32.0,20.8,16.0,32.0,12
HCPCS,98000,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?SF MDM 15 MIN,372.0,241.8,32.03,279.0,17
HCPCS,98000,SYNCH AUDIO-VIDEO NEW SF 15,,,37.09,37.09,1
HCPCS,98000,SYNCHRONOUS AUDIO-VIDEO VISIT NEW SF MDM 15 MIN,372.0,241.8,32.03,279.0,17
HCPCS,980000,SYNCH AUDIO-VIDEO NEW SF 15,,,37.09,37.09,1
HCPCS,98001,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?LOW MDM 30 MIN,640.0,416.0,55.31,480.0,17
HCPCS,98001,SYNCH AUDIO-VIDEO NEW LOW 30,,,64.04,64.04,1
HCPCS,98001,SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?LOW MDM 30 MIN,640.0,416.0,55.31,480.0,17
HCPCS,980010,SYNCH AUDIO-VIDEO NEW LOW 30,,,64.04,64.04,1
HCPCS,98002,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?MOD MDM 45 MIN,1040.0,676.0,89.74,780.0,17
HCPCS,98002,SYNCH AUDIO-VIDEO NEW MOD 45,,,103.9,103.9,1
HCPCS,98002,SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?MOD MDM 45 MIN,1040.0,676.0,89.74,780.0,17
HCPCS,980020,SYNCH AUDIO-VIDEO NEW MOD 45,,,103.9,103.9,1
HCPCS,98003,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VST NEW?HIGH MDM 60 MIN,1400.0,910.0,169.46,1050.0,16
HCPCS,98003,SYNCH AUDIO-VIDEO NEW HI 60,,,139.62,139.62,1
HCPCS,98003,SYNCHRONOUS?AUDIO-VIDEO?VST NEW?HIGH MDM 60 MIN,1400.0,910.0,169.46,1050.0,16
HCPCS,980030,SYNCH AUDIO-VIDEO NEW HI 60,,,139.62,139.62,1
HCPCS,98004,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?SF MDM 10 MIN,280.0,182.0,23.98,210.0,17
HCPCS,98004,SYNCH AUDIO-VIDEO EST SF 10,,,27.77,27.77,1
HCPCS,98004,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?SF MDM 10 MIN,280.0,182.0,23.98,210.0,17
HCPCS,980040,SYNCH AUDIO-VIDEO EST SF 10,,,27.77,27.77,1
HCPCS,98005,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?LOW MDM 20 MIN,520.0,338.0,44.61,390.0,17
HCPCS,98005,SYNCH AUDIO-VIDEO EST LOW 20,,,51.66,51.66,1
HCPCS,98005,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?LOW MDM 20 MIN,520.0,338.0,44.61,390.0,17
HCPCS,980050,SYNCH AUDIO-VIDEO EST LOW 20,,,51.66,51.66,1
HCPCS,98006,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?MOD MDM 30 MIN,768.0,499.2,66.5,576.0,17
HCPCS,98006,SYNCH AUDIO-VIDEO EST MOD 30,,,76.98,76.98,1
HCPCS,98006,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?MOD MDM 30 MIN,768.0,499.2,66.5,576.0,17
HCPCS,980060,SYNCH AUDIO-VIDEO EST MOD 30,,,76.98,76.98,1
HCPCS,98007,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?HIGH MDM 40 MIN,1120.0,728.0,126.19,840.0,16
HCPCS,98007,SYNCH AUDIO-VIDEO EST HI 40,,,103.9,103.9,1
HCPCS,98007,SYNCHRONOUS AUDIO-VIDEO VST EST HIGH MDM 40 MIN,1040.0,676.0,126.19,780.0,16
HCPCS,980070,SYNCH AUDIO-VIDEO EST HI 40,,,103.9,103.9,1
HCPCS,98008,SYNCH AUDIO-ONLY NEW SF 15,,,35.43,35.43,1
HCPCS,98008,SYNCHRONOUS AUDIO-ONLY VISIT NEW SF MDM 15 MIN,360.0,234.0,30.6,270.0,17
HCPCS,980080,SYNCH AUDIO-ONLY NEW SF 15,,,35.43,35.43,1
HCPCS,9800812,BARIATRIC NUTRITION INITIAL,342.0,222.3,171.0,342.0,12
HCPCS,9800813,NUTRITION PROBLEM FOCUSED,212.0,137.8,106.0,212.0,12
HCPCS,98009,SYNCH AUDIO-ONLY NEW LOW 30,,,61.54,61.54,1
HCPCS,98009,SYNCHRONOUS AUDIO-ONLY VISIT NEW LOW MDM 30 MIN,620.0,403.0,53.15,465.0,17
HCPCS,980090,SYNCH AUDIO-ONLY NEW LOW 30,,,61.54,61.54,1
HCPCS,98010,SYNCH AUDIO-ONLY NEW MOD 45,,,97.04,97.04,1
HCPCS,98010,SYNCHRONOUS AUDIO-ONLY VISIT NEW MOD MDM 45 MIN,968.0,629.2,83.82,726.0,17
HCPCS,980100,SYNCH AUDIO-ONLY NEW MOD 45,,,97.04,97.04,1
HCPCS,98011,SYNCH AUDIO-ONLY NEW HIGH 60,,,127.5,127.5,1
HCPCS,98011,SYNCHRONOUS AUDIO-ONLY VISIT NEW HIGH MDM 60 MIN,1280.0,832.0,154.49,960.0,16
HCPCS,980110,SYNCH AUDIO-ONLY NEW HIGH 60,,,127.5,127.5,1
HCPCS,98012,SYNCH AUDIO-ONLY EST SF 10,,,26.1,26.1,1
HCPCS,98012,SYNCHRONOUS AUDIO-ONLY VISIT EST SF MDM 10 MIN,260.0,169.0,22.54,195.0,17
HCPCS,980120,SYNCH AUDIO-ONLY EST SF 10,,,26.1,26.1,1
HCPCS,98013,SYNCH AUDIO-ONLY EST LOW 20,,,47.53,47.53,1
HCPCS,98013,SYNCHRONOUS AUDIO-ONLY VISIT EST LOW MDM 20 MIN,480.0,312.0,41.05,360.0,17
HCPCS,980130,SYNCH AUDIO-ONLY EST LOW 20,,,47.53,47.53,1
HCPCS,98014,SYNCH AUDIO-ONLY EST MOD 30,,,70.37,70.37,1
HCPCS,98014,SYNCHRONOUS AUDIO-ONLY VISIT EST MOD MDM 30 MIN,700.0,455.0,60.79,525.0,17
HCPCS,980140,SYNCH AUDIO-ONLY EST MOD 30,,,70.37,70.37,1
HCPCS,98015,SYNCH AUDIO-ONLY EST HIGH 40,,,103.9,103.9,1
HCPCS,98015,SYNCHRONOUS AUDIO-ONLY VISIT EST HIGH MDM 40 MIN,1040.0,676.0,126.19,780.0,16
HCPCS,980150,SYNCH AUDIO-ONLY EST HIGH 40,,,103.9,103.9,1
HCPCS,98016,BRIEF COMMUNICATION TECH-BSD SVC EST PT 5-10 MIN,132.0,85.8,10.67,99.0,25
HCPCS,98016,BRIEF COMUNICAJ TECH-BSD SVC,,,12.34,12.34,1
HCPCS,98016,Brief comunicaj tech-bsd svc,,,27.04,34.15,6
HCPCS,980160,BRIEF COMUNICAJ TECH-BSD SVC,,,12.34,12.34,1
HCPCS,98925,OSTEOPATH MANJ 1-2 REGIONS,,,14.81,14.81,1
HCPCS,98925,"OSTEOPATHIC MANIP,1-2 BODY REGN",148.5,96.525,11.34,151.5,73
HCPCS,98925,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,95.0,61.75,17.96,1764.0,120
HCPCS,989250,OSTEOPATH MANJ 1-2 REGIONS,,,14.81,14.81,1
HCPCS,98926,OSTEOPATH MANJ 3-4 REGIONS,,,22.43,22.43,1
HCPCS,98926,"OSTEOPATHIC MANIP,3-4 BODY REGN",312.0,202.8,16.93,234.0,35
HCPCS,98926,OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,95.0,61.75,17.96,1764.0,79
HCPCS,989260,OSTEOPATH MANJ 3-4 REGIONS,,,22.43,22.43,1
HCPCS,98927,OSTEOPATH MANJ 5-6 REGIONS,,,29.86,29.86,1
HCPCS,98927,"OSTEOPATHIC MANIP,5-6 BODY REGN",422.0,274.3,22.35,316.5,35
HCPCS,98927,OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS,95.0,61.75,17.96,85.5,38
HCPCS,989270,OSTEOPATH MANJ 5-6 REGIONS,,,29.86,29.86,1
HCPCS,98928,OSTEOPATH MANJ 7-8 REGIONS,,,37.72,37.72,1
HCPCS,98928,"OSTEOPATHIC MANIP,7-8 BODY REGN",532.0,345.8,28.27,399.0,35
HCPCS,98928,OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS,95.0,61.75,17.96,85.5,38
HCPCS,989280,OSTEOPATH MANJ 7-8 REGIONS,,,37.72,37.72,1
HCPCS,98929,OSTEOPATH MANJ 9-10 REGIONS,,,45.14,45.14,1
HCPCS,98929,"OSTEOPATHIC MANIP,9-10 BODY REGN",642.0,417.3,34.03,481.5,35
HCPCS,98929,OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS,95.0,61.75,17.96,89.37,38
HCPCS,989290,OSTEOPATH MANJ 9-10 REGIONS,,,45.14,45.14,1
HCPCS,98940,CHIROPRACT MANJ 1-2 REGIONS,,,16.64,54.85,15
HCPCS,98940,Chiropract manj 1-2 regions,,,17.96,22.69,6
HCPCS,989400,CHIROPRACT MANJ 1-2 REGIONS,,,16.64,16.64,1
HCPCS,98941,CHIROPRACT MANJ 3-4 REGIONS,,,22.55,54.85,15
HCPCS,98941,Chiropract manj 3-4 regions,,,17.96,22.69,6
HCPCS,989410,CHIROPRACT MANJ 3-4 REGIONS,,,25.6,25.6,1
HCPCS,98942,CHIROPRACTIC MANJ 5 REGIONS,,,22.55,54.85,15
HCPCS,98942,Chiropractic manj 5 regions,,,17.96,22.69,6
HCPCS,989420,CHIROPRACTIC MANJ 5 REGIONS,,,34.31,34.31,1
HCPCS,98943,CHIROPRACT MANJ XTRSPINL 1/>,,,17.19,17.19,1
HCPCS,98943,Chiropract manj xtrspinl 1/>,,,17.96,22.69,6
HCPCS,989430,CHIROPRACT MANJ XTRSPINL 1/>,,,17.19,17.19,1
HCPCS,98960,EDU&TRN PT SELF-MGMT NQHP 1,,,30.22,30.22,1
HCPCS,98960,EDUCATION&TRAINING PT SELF-MGMT NQHP INDIV PT,158.0,102.7,26.54,675.0,30
HCPCS,98960,VIRTUAL MGMT DIABETES SNGL 30 MIN,77.0,50.05,23.12,77.0,20
HCPCS,989600,EDU&TRN PT SELF-MGMT NQHP 1,,,30.22,30.22,1
HCPCS,98961,EDU&TRN PT SLF-MGMT NQHP 2-4,,,14.45,14.45,1
HCPCS,98961,Edu&trn pt slf-mgmt nqhp 2-4,,,25.5,32.21,6
HCPCS,989610,EDU&TRN PT SLF-MGMT NQHP 2-4,,,14.45,14.45,1
HCPCS,98962,EDU&TRN PT SLF-MGMT NQHP 5-8,,,10.85,10.85,1
HCPCS,98962,Edu&trn pt slf-mgmt nqhp 5-8,,,25.5,32.21,6
HCPCS,989620,EDU&TRN PT SLF-MGMT NQHP 5-8,,,10.85,10.85,1
HCPCS,98966,PH1 ASSMT&MGMT NQHP 5-10,,,11.98,31.4,22
HCPCS,98966,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN,100.0,65.0,10.37,75.0,31
HCPCS,989660,PH1 ASSMT&MGMT NQHP 5-10,,,11.98,11.98,1
HCPCS,98967,PH1 ASSMT&MGMT NQHP 11-20,,,23.31,61.39,22
HCPCS,98967,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN,200.0,130.0,20.72,150.0,31
HCPCS,989670,PH1 ASSMT&MGMT NQHP 11-20,,,23.31,23.31,1
HCPCS,98968,PH1 ASSMT&MGMT NQHP 21-30,,,32.62,87.43,22
HCPCS,98968,Ph1 assmt&mgmt nqhp 21-30,,,75.64,95.54,6
HCPCS,98968,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN,300.0,195.0,29.79,225.0,31
HCPCS,989680,PH1 ASSMT&MGMT NQHP 21-30,,,32.62,32.62,1
HCPCS,98970,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,65.0,42.25,10.7,65.0,27
HCPCS,98970,NQHP OL DIG ASSMT&MGMT 5-10,,,12.3,31.4,22
HCPCS,98970,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 5-10 MIN,65.0,42.25,10.7,65.0,27
HCPCS,989700,NQHP OL DIG ASSMT&MGMT 5-10,,,12.3,12.3,1
HCPCS,98971,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,80.0,52.0,19.72,80.0,27
HCPCS,98971,NQHP OL DIG ASSMT&MGMT 11-20,,,21.81,58.0,22
HCPCS,98971,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 11-20 MIN,80.0,52.0,19.72,80.0,27
HCPCS,989710,NQHP OL DIG ASSMT&MGMT 11-20,,,21.81,21.81,1
HCPCS,98972,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,120.0,78.0,30.08,90.0,27
HCPCS,98972,NQHP OL DIG ASSMT&MGMT 21+,,,32.1,88.28,22
HCPCS,98972,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 21+ MIN,120.0,78.0,30.08,90.0,27
HCPCS,989720,NQHP OL DIG ASSMT&MGMT 21+,,,32.1,32.1,1
HCPCS,98975,REMOTE THERAPEUTIC MNTR 1ST SET-UP&PT EDUCAJ EQ,741.0,481.65,31.62,723.0,49
HCPCS,98975,REMOTE THERAPEUTIC MNTR 1ST SET-UP&PT EDUCAJ EQP,741.0,481.65,31.62,723.0,49
HCPCS,98975,RTM 1ST SET-UP&PT EDUCAJ EQP,,,19.74,19.74,1
HCPCS,989750,RTM 1ST SET-UP&PT EDUCAJ EQP,,,19.74,19.74,1
HCPCS,98976,RTM DEV SPLY RESP SYS 16-30D,,,37.43,80.85,15
HCPCS,98976,Rtm dev sply resp sys 16-30d,,,23.85,30.13,6
HCPCS,989760,RTM DEV SPLY RESP SYS 16-30D,,,46.55,46.55,1
HCPCS,98977,REM THER MNTR DEV SPLY DATA MUSCSKEL SYS EA 30 D,215.0,139.75,23.85,723.0,98
HCPCS,98977,RTM DEV SPLY MSCSKL 16-30 D,,,46.55,46.55,1
HCPCS,989770,RTM DEV SPLY MSCSKL 16-30 D,,,46.55,46.55,1
HCPCS,98978,REM THER MNTR DEV SPLY DATA COG BHV THER EA 30 D,199.0,129.35,33.85,671.0,53
HCPCS,98978,RTM DEV SPLY CBT 16-30 D,,,48.14,48.14,1
HCPCS,989780,RTM DEV SPLY CBT 16-30 D,,,48.14,48.14,1
HCPCS,98979,RTM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,329.0,213.85,11.69,723.0,105
HCPCS,98979,RTM TX MGMT 1ST 10 MIN,,,12.2,12.2,1
HCPCS,989790,RTM TX MGMT 1ST 10 MIN,,,12.2,12.2,1
HCPCS,98980,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,90.0,58.5,22.5,723.0,126
HCPCS,98980,RTM TX MGMT 1ST 20 MIN,,,31.96,31.96,1
HCPCS,989800,RTM TX MGMT 1ST 20 MIN,,,31.96,31.96,1
HCPCS,98981,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,90.0,58.5,22.5,723.0,126
HCPCS,98981,RTM TX MGMT EA ADDL 20 MIN,,,31.6,31.6,1
HCPCS,989810,RTM TX MGMT EA ADDL 20 MIN,,,31.6,31.6,1
HCPCS,98984,RTM DEV SPLY DATA RESPIR SYS 2-15 DAYS IN 30D PD,329.0,213.85,23.85,1272.0,42
HCPCS,98984,RTM DEV SPLY RESP SYS 2-15 D,,,51.41,51.41,1
HCPCS,989840,RTM DEV SPLY RESP SYS 2-15 D,,,51.41,51.41,1
HCPCS,98985,RTM DEV SPLY DATA MUSCSKEL SYS 2-15 D IN 30D PD,194.0,126.1,23.85,723.0,63
HCPCS,98985,RTM DEV SPLY MSCSK SYS 2-15D,,,50.75,50.75,1
HCPCS,989850,RTM DEV SPLY MSCSK SYS 2-15D,,,50.75,50.75,1
HCPCS,98986,RTM DEV SPLY DATA CBT 2-15 DAYS IN 30 D PD,293.5,190.77499999999998,23.85,296.1,42
HCPCS,99000,HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB,39.0,25.35,2.34,39.0,13
HCPCS,99000,SPECIMEN ACQUISITION KIT- DD WAIT LIST,41.0,26.65,2.52,36.9,27
HCPCS,99000,SPECIMEN HANDLING OFFICE-LAB,,,7.56,7.56,1
HCPCS,990000,SPECIMEN HANDLING OFFICE-LAB,,,7.56,7.56,1
HCPCS,99001,HANDLG&/OR CONVEY OF SPEC FOR TR FROM PT TO LAB,48.0,31.2,2.76,48.0,13
HCPCS,99001,SERUM PROCESSING AND STORAGE,28.0,18.2,2.52,25.2,27
HCPCS,99001,SPECIMEN HANDLING PT-LAB,,,14.04,14.04,1
HCPCS,990010,SPECIMEN HANDLING PT-LAB,,,14.04,14.04,1
HCPCS,99002,DEVICE HANDLING PHYS/QHP,,,7.47,7.47,1
HCPCS,990020,DEVICE HANDLING PHYS/QHP,,,7.47,7.47,1
HCPCS,99024,POSTOP FOLLOW-UP VISIT,,,2.71,2.71,1
HCPCS,990240,POSTOP FOLLOW-UP VISIT,,,2.71,2.71,1
HCPCS,99026,IN-HOSPITAL ON CALL SERVICE,,,59.14,59.14,1
HCPCS,990260,IN-HOSPITAL ON CALL SERVICE,,,59.14,59.14,1
HCPCS,99027,OUT-OF-HOSP ON CALL SERVICE,,,39.86,39.86,1
HCPCS,990270,OUT-OF-HOSP ON CALL SERVICE,,,39.86,39.86,1
HCPCS,99050,MEDICAL SERVICES AFTER HRS,,,10.8,10.8,1
HCPCS,99050,Medical services after hrs,,,27.04,34.15,6
HCPCS,99050,SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS,143.0,92.95,7.95,143.0,17
HCPCS,990500,MEDICAL SERVICES AFTER HRS,,,10.8,10.8,1
HCPCS,99051,MED SERV EVE/WKEND/HOLIDAY,,,10.8,10.8,1
HCPCS,99051,Med serv eve/wkend/holiday,,,27.04,34.15,6
HCPCS,990510,MED SERV EVE/WKEND/HOLIDAY,,,10.8,10.8,1
HCPCS,99053,MED SERV 10PM-8AM 24 HR FAC,,,10.8,10.8,1
HCPCS,99053,Med serv 10pm-8am 24 hr fac,,,27.04,34.15,6
HCPCS,990530,MED SERV 10PM-8AM 24 HR FAC,,,10.8,10.8,1
HCPCS,99056,MED SERVICE OUT OF OFFICE,,,10.8,10.8,1
HCPCS,99056,SVC TYPICAL PRV OFFICE PRV OUT OFFICE REQUEST PT,255.0,165.75,30.94,255.0,13
HCPCS,990560,MED SERVICE OUT OF OFFICE,,,10.8,10.8,1
HCPCS,99058,OFFICE EMERGENCY CARE,,,10.8,10.8,1
HCPCS,99058,Office emergency care,,,27.04,34.15,6
HCPCS,99058,SVC PRV EMER BASIS IN OFFICE DISRUPTING SVCS,211.0,137.15,37.88,211.0,13
HCPCS,990580,OFFICE EMERGENCY CARE,,,10.8,10.8,1
HCPCS,99060,OUT OF OFFICE EMERG MED SERV,,,10.8,10.8,1
HCPCS,99060,Out of office emerg med serv,,,27.04,34.15,6
HCPCS,990600,OUT OF OFFICE EMERG MED SERV,,,10.8,10.8,1
HCPCS,99070,ADVCD HYDRATING CMLX CRM - ALLERGAN,63.0,40.95,31.5,63.0,12
HCPCS,99070,AFFIRM 1X,32.0,20.8,16.0,32.0,12
HCPCS,99070,AHA ENHANCED GEL (15%),35.0,22.75,17.5,35.0,12
HCPCS,99070,ALLYVN DRESSING,25.0,16.25,12.5,25.0,12
HCPCS,99070,BATTERIES,4.0,2.6,2.0,4.0,12
HCPCS,99070,"BB,LEUKOCYTE FILTER RBC",33.0,21.45,16.5,33.0,12
HCPCS,99070,"BB,LEUKOCYTE FILTER,PLT",116.0,75.4,58.0,116.0,12
HCPCS,99070,BICROS ITE HEARING AID,1262.0,820.3,631.0,1262.0,12
HCPCS,99070,BODY ADHESIVE,6.0,3.9,3.0,6.0,12
HCPCS,99070,BONE CONDUCT HEARING AID,1133.0,736.45,566.5,1133.0,12
HCPCS,99070,CALCITEST,24.0,15.6,12.0,24.0,12
HCPCS,99070,CAPTURE THE MAGIC,99.0,64.35,49.5,99.0,12
HCPCS,99070,CONSTRICTION BANDS,12.0,7.8,6.0,12.0,12
HCPCS,99070,CORS ITE HEARING AID,1230.0,799.5,615.0,1230.0,12
HCPCS,99070,COTY SPF 58 SUNBLOCK,32.0,20.8,16.0,32.0,12
HCPCS,99070,CROS BTE HEARING AID,1165.0,757.25,582.5,1165.0,12
HCPCS,99070,DAILY LIP REJUVENATOR,8.0,5.2,4.0,8.0,12
HCPCS,99070,DERMAL REPAIR,93.0,60.45,46.5,93.0,12
HCPCS,99070,DIAPHARGM,33.0,21.45,16.5,33.0,12
HCPCS,99070,DUODERM 8 X 8,24.0,15.6,12.0,24.0,12
HCPCS,99070,FACIAL CLEANSER - ALLERGAN,37.0,24.05,18.5,37.0,12
HCPCS,99070,FREE & CLEAR CONDITIONER,9.0,5.85,4.5,9.0,12
HCPCS,99070,GLYCOLIC CHEM PEEL KIT II ALLERGAN,128.0,83.2,64.0,128.0,12
HCPCS,99070,HALF SHELL HEARING AID,2200.0,1430.0,1100.0,2200.0,12
HCPCS,99070,HELIX HEARING AID MONAURA,2200.0,1430.0,1100.0,2200.0,12
HCPCS,99070,MITRAFLEX 4 X 4,8.0,5.2,4.0,8.0,12
HCPCS,99070,MULTICROS BTE,1165.0,757.25,582.5,1165.0,12
HCPCS,99070,OLIGOSPERMIA CUP,61.0,39.65,30.5,61.0,12
HCPCS,99070,OPTI CHAMBER,17.0,11.05,8.5,17.0,12
HCPCS,99070,OVUSTICK,61.0,39.65,30.5,61.0,12
HCPCS,99070,POST PEEL NUTRICREAM,32.0,20.8,16.0,32.0,12
HCPCS,99070,PRP KIT - SUPPLY,307.0,199.55,153.5,307.0,12
HCPCS,99070,REJUVENATING EYE CRM -ALLERGAN,67.0,43.55,33.5,67.0,12
HCPCS,99070,ROBATHOL BATH OIL,8.0,5.2,4.0,8.0,12
HCPCS,99070,SANICREAM SUNSCREEN SPF 15,13.0,8.45,6.5,13.0,12
HCPCS,99070,SKIN REJUVENATION LOTION I ALLERGAN,58.0,37.7,29.0,58.0,12
HCPCS,99070,SPECIAL SUPPLIES PHYS/QHP,,,7.58,7.58,1
HCPCS,99070,STOCKING AIDE,39.0,25.35,19.5,39.0,12
HCPCS,99070,SUPPLIES&MATERIALS ABOVE/BEYOND PROV BY PHYS/QHP,49.0,31.85,24.5,49.0,12
HCPCS,99070,SUPPORT HOSE; ULCER CARE,104.0,67.6,52.0,104.0,12
HCPCS,99070,SURGICAL SUPPLY KIT,128.0,83.2,64.0,128.0,12
HCPCS,99070,SWIM PLUG BINAURAL,150.0,97.5,25.2,135.0,21
HCPCS,99070,SWIM PLUG MONAURAL,75.0,48.75,12.6,67.5,21
HCPCS,99070,TINNITUS AID MASKER ITE B,2060.0,1339.0,1030.0,2060.0,12
HCPCS,99070,TMS RECOVERY COMPLEX,160.0,104.0,80.0,160.0,12
HCPCS,99070,TOTAL BLOCK SPF 60 SUNBLOCK,32.0,20.8,16.0,32.0,12
HCPCS,99070,ULTRA SHEER MOISTURIZER,37.0,24.05,18.5,37.0,12
HCPCS,99070,UPLIFTING EYE CREAM,44.0,28.6,22.0,44.0,12
HCPCS,99070,VAGNIAL DILATOR,260.0,169.0,130.0,260.0,12
HCPCS,99070,VANICREAM SUNSCREEN SPF 35,13.0,8.45,6.5,13.0,12
HCPCS,99070,VITAMIN C COMPLEX,76.0,49.4,38.0,76.0,12
HCPCS,990700,SPECIAL SUPPLIES PHYS/QHP,,,7.58,7.58,1
HCPCS,99071,EDUCATIONAL SUPPLIES PRV BY THE PHYS AT COST,16.0,10.4,8.0,16.0,12
HCPCS,99071,PATIENT EDUCATION MATERIALS,,,7.24,7.24,1
HCPCS,990710,PATIENT EDUCATION MATERIALS,,,7.24,7.24,1
HCPCS,99072,ADDL SUPL MATRL&STAF TM PHE,,,7.84,7.84,1
HCPCS,990720,ADDL SUPL MATRL&STAF TM PHE,,,7.84,7.84,1
HCPCS,99075,MEDICAL TESTIMONY,,,43.2,43.2,1
HCPCS,990750,MEDICAL TESTIMONY,,,43.2,43.2,1
HCPCS,99078,CHOLESTEROL TRIG/HEART DZ 4 CLASS 1HOUR,222.0,144.3,42.75,222.0,13
HCPCS,99078,GROUP HEALTH EDUCATION,222.0,144.3,27.0,222.0,14
HCPCS,99078,Group health education,,,25.5,32.21,6
HCPCS,99078,PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING,79.0,51.35,39.5,79.0,13
HCPCS,99078,"PHYSICIAN EDUCATIONAL SRV, GROUP",222.0,144.3,42.75,222.0,13
HCPCS,99078,WEIGHT LOSS CLASSES (8),222.0,144.3,42.75,222.0,13
HCPCS,990780,GROUP HEALTH EDUCATION,,,27.0,27.0,1
HCPCS,99080,SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG,129.0,83.85,64.5,129.0,12
HCPCS,99080,SPECIAL REPORTS OR FORMS,,,6.71,6.71,1
HCPCS,990800,SPECIAL REPORTS OR FORMS,,,6.71,6.71,1
HCPCS,99082,UNUSUAL PHYSICIAN TRAVEL,99.0,64.35,3.82,99.0,14
HCPCS,990820,UNUSUAL PHYSICIAN TRAVEL,,,29.48,29.48,1
HCPCS,99091,COLLJ & INTERPJ DATA EA 30 D,,,56.6,56.6,1
HCPCS,99091,Collj & interpj data ea 30 d,,,23.85,30.13,6
HCPCS,990910,COLLJ & INTERPJ DATA EA 30 D,,,56.6,56.6,1
HCPCS,99100,ANES PT EXTEME AGE<1 YR&>70,,,51.84,51.84,1
HCPCS,99100,ANESTHESIA EXTREME AGE PATIENT UNDER 1 YR/<,136.0,88.4,53.0,136.0,17
HCPCS,99100,Anes pt exteme age<1 yr&>70,,,13.94,17.6,6
HCPCS,991000,ANES PT EXTEME AGE<1 YR&>70,,,51.84,51.84,1
HCPCS,99116,ANES COMP TOT BDY HYPTHRM,,,51.84,51.84,1
HCPCS,99116,ANES COMPLICJ UTILIZATION TOTAL BODY HYPOTHERMIA,133.0,86.45,53.0,133.0,17
HCPCS,99116,Anes comp tot bdy hypthrm,,,13.94,17.6,6
HCPCS,991160,ANES COMP TOT BDY HYPTHRM,,,51.84,51.84,1
HCPCS,99135,ANES COMP CTRLD HYPOTENSION,,,51.84,51.84,1
HCPCS,99135,ANES COMPLICJ UTILIZATION CONTROLLED HYPOTENSION,136.0,88.4,53.0,136.0,17
HCPCS,99135,Anes comp ctrld hypotension,,,13.94,17.6,6
HCPCS,991350,ANES COMP CTRLD HYPOTENSION,,,51.84,51.84,1
HCPCS,99140,ANES COMP EMERGENCY COND,,,51.84,51.84,1
HCPCS,99140,ANES COMPLICJ EMERGENCY CONDITIONS SPECIFY,137.0,89.05,53.0,137.0,17
HCPCS,99140,Anes comp emergency cond,,,13.94,17.6,6
HCPCS,991400,ANES COMP EMERGENCY COND,,,51.84,51.84,1
HCPCS,99151,MOD SED SAME PHYS/QHP <5 YRS,,,24.98,24.98,1
HCPCS,99151,MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS,840.5,546.325,13.94,1314.9,59
HCPCS,991510,MOD SED SAME PHYS/QHP <5 YRS,,,24.98,24.98,1
HCPCS,99152,MOD SED SAME PHYS/QHP 5/>YRS,,,12.72,12.72,1
HCPCS,99152,MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,493.0,320.45,9.6,788.4,87
HCPCS,99152,MODERATE SEDATION FOR ENDOSCOPY,876.0,569.4,13.94,788.4,28
HCPCS,991520,MOD SED SAME PHYS/QHP 5/>YRS,,,12.72,12.72,1
HCPCS,99153,MOD SED SAME PHYS/QHP EA,,,11.55,11.55,1
HCPCS,99153,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,227.5,147.875,8.19,310.5,87
HCPCS,991530,MOD SED SAME PHYS/QHP EA,,,11.55,11.55,1
HCPCS,99155,MOD SED OTH PHYS/QHP <5 YRS,,,87.24,87.24,1
HCPCS,99155,MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS,828.0,538.2,13.94,806.4,59
HCPCS,991550,MOD SED OTH PHYS/QHP <5 YRS,,,87.24,87.24,1
HCPCS,99156,MOD SED OTH PHYS/QHP 5/>YRS,,,78.73,78.73,1
HCPCS,99156,MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS,695.0,451.75,13.94,660.0,59
HCPCS,991560,MOD SED OTH PHYS/QHP 5/>YRS,,,78.73,78.73,1
HCPCS,99157,MOD SED OTHER PHYS/QHP EA,,,62.12,62.12,1
HCPCS,99157,MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS,422.5,274.625,13.94,500.0,59
HCPCS,991570,MOD SED OTHER PHYS/QHP EA,,,62.12,62.12,1
HCPCS,99170,ANOGENITAL EXAM CHILD W IMAG,,,88.33,88.33,1
HCPCS,99170,ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG,1446.0,939.9,102.77,1764.0,35
HCPCS,991700,ANOGENITAL EXAM CHILD W IMAG,,,88.33,88.33,1
HCPCS,99172,OCULAR FUNCTION SCREEN,,,13.85,13.85,2
HCPCS,991720,OCULAR FUNCTION SCREEN,,,13.85,13.85,1
HCPCS,99172TC,OCULAR FUNCTION SCREEN,,,13.85,13.85,1
HCPCS,99173,VISUAL ACUITY SCREEN,,,3.32,3.32,1
HCPCS,991730,VISUAL ACUITY SCREEN,,,3.32,3.32,1
HCPCS,99174,OCULAR INSTRUMNT SCREEN BIL,,,6.26,6.26,1
HCPCS,991740,OCULAR INSTRUMNT SCREEN BIL,,,6.26,6.26,1
HCPCS,99175,INDUCTION OF VOMITING,,,29.52,29.52,1
HCPCS,99175,IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED,230.0,149.5,38.64,1764.0,25
HCPCS,991750,INDUCTION OF VOMITING,,,29.52,29.52,1
HCPCS,99177,OCULAR INSTRUMNT SCREEN BIL,,,4.36,4.36,1
HCPCS,991770,OCULAR INSTRUMNT SCREEN BIL,,,4.36,4.36,1
HCPCS,99183,HYPERBARIC OXYGEN THERAPY,,,110.73,110.73,1
HCPCS,991830,HYPERBARIC OXYGEN THERAPY,,,110.73,110.73,1
HCPCS,99184,HYPOTHERMIA ILL NEONATE,,,223.4,223.4,1
HCPCS,991840,HYPOTHERMIA ILL NEONATE,,,223.4,223.4,1
HCPCS,99188,APP TOPICAL FLUORIDE VARNISH,,,10.18,10.18,1
HCPCS,99188,App topical fluoride varnish,,,81.86,103.4,6
HCPCS,991880,APP TOPICAL FLUORIDE VARNISH,,,10.18,10.18,1
HCPCS,99190,SPECIAL PUMP SERVICES,,,439.08,439.08,1
HCPCS,991900,SPECIAL PUMP SERVICES,,,439.08,439.08,1
HCPCS,99191,SPECIAL PUMP SERVICES,,,307.52,307.52,1
HCPCS,991910,SPECIAL PUMP SERVICES,,,307.52,307.52,1
HCPCS,99192,SPECIAL PUMP SERVICES,,,219.69,219.69,1
HCPCS,991920,SPECIAL PUMP SERVICES,,,219.69,219.69,1
HCPCS,99195,PHLEBOTOMY,447.0,290.55,44.56,1801.0,50
HCPCS,99195,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,739.5,480.67499999999995,44.56,999.9,114
HCPCS,991950,PHLEBOTOMY,,,94.26,94.26,1
HCPCS,99199,NUTRITIONAL COUNSELING,94.0,61.1,47.0,94.0,12
HCPCS,99199,SANE EVAL,741.0,481.65,0.02,839.0,24
HCPCS,99202,NEW PATIENT VISIT LEVEL 2,372.0,241.8,23.51,279.0,35
HCPCS,99202,OD NEW ONLINE E&M LEVEL 2,372.0,241.8,23.51,279.0,35
HCPCS,99202,OFFC VISIT NEW EXPANDED,372.0,241.8,23.51,279.0,35
HCPCS,99202,OFFICE O/P NEW SF 15 MIN,,,39.85,39.85,1
HCPCS,99202,OFFICE VISIT NEW LVL 2,372.0,241.8,23.51,279.0,35
HCPCS,99202,OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES,372.0,241.8,23.51,279.0,35
HCPCS,99202,OFFICE/OUTPATIENT NEW SF MDM 15-29 MINUTES,170.0,110.5,28.56,158.0,22
HCPCS,99202,OV NEW PATIENT LEVEL II,372.0,241.8,23.51,279.0,35
HCPCS,992020,OFFICE O/P NEW SF 15 MIN,,,39.85,39.85,1
HCPCS,99203,NEW PATIENT VISIT LEVEL 3,640.0,416.0,40.11,480.0,35
HCPCS,99203,OD NEW ONLINE E&M LEVEL 3,640.0,416.0,40.11,480.0,35
HCPCS,99203,OFFICE O/P NEW LOW 30 MIN,,,69.01,69.01,1
HCPCS,99203,OFFICE VISIT NEW  LVL 3,640.0,416.0,40.11,480.0,35
HCPCS,99203,OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES,640.0,416.0,40.11,480.0,35
HCPCS,99203,OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES,174.0,113.1,29.23,158.0,22
HCPCS,99203,OV NEW PATIENT LEVEL III,640.0,416.0,40.11,480.0,35
HCPCS,992030,OFFICE O/P NEW LOW 30 MIN,,,69.01,69.01,1
HCPCS,99204,NEW PATIENT VISIT LEVEL 4,1040.0,676.0,64.93,780.0,35
HCPCS,99204,OD NEW ONLINE E&M LEVEL 4,1040.0,676.0,64.93,780.0,35
HCPCS,99204,OFFICE O/P NEW MOD 45 MIN,,,112.21,112.21,1
HCPCS,99204,OFFICE VISIT NEW  LVL 4,1040.0,676.0,64.93,780.0,35
HCPCS,99204,OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES,1040.0,676.0,64.93,780.0,35
HCPCS,99204,OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES,218.0,141.7,36.62,196.2,22
HCPCS,992040,OFFICE O/P NEW MOD 45 MIN,,,112.21,112.21,1
HCPCS,99205,NEW PATIENT VISIT LEVEL  5,1400.0,910.0,88.11,1050.0,35
HCPCS,99205,OD NEW ONLINE E&M LEVEL 5,1400.0,910.0,88.11,1050.0,35
HCPCS,99205,OFFICE O/P NEW HI 60 MIN,,,152.55,152.55,1
HCPCS,99205,OFFICE VISIT NEW  LVL  5,1400.0,910.0,88.11,1050.0,35
HCPCS,99205,OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES,1400.0,910.0,88.11,1050.0,35
HCPCS,99205,OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES,294.0,191.1,49.39,264.6,22
HCPCS,99205,OV NEW PATIENT LEVEL V,1400.0,910.0,88.11,1050.0,35
HCPCS,992050,OFFICE O/P NEW HI 60 MIN,,,152.55,152.55,1
HCPCS,99211,EST PATIENT VISIT LEVEL 1,79.0,51.35,5.59,59.25,35
HCPCS,99211,OD EST ONLINE E&M LEVEL 1,79.0,51.35,5.59,59.25,35
HCPCS,99211,OFF/OP EST MAY X REQ PHY/QHP,,,7.35,7.35,1
HCPCS,99211,OFFICE VISIT EST  LVL 1,79.0,51.35,5.59,59.25,35
HCPCS,99211,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,133.5,86.775,5.59,169.2,123
HCPCS,99211,OV EST PATIENT LEVEL I,79.0,51.35,5.59,59.25,35
HCPCS,992110,OFF/OP EST MAY X REQ PHY/QHP,,,7.35,7.35,1
HCPCS,99212,EST PATIENT VISIT LEVEL 2,280.0,182.0,17.42,210.0,35
HCPCS,99212,OD EST ONLINE E&M LEVEL 2,280.0,182.0,17.42,210.0,35
HCPCS,99212,OFFICE O/P EST SF 10 MIN,,,29.7,29.7,1
HCPCS,99212,OFFICE VISIT EST LVL 2,280.0,182.0,17.42,210.0,35
HCPCS,99212,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN,280.0,182.0,17.42,210.0,35
HCPCS,99212,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN,188.0,122.2,31.58,169.2,66
HCPCS,99212,WORK PERMIT PHYSICAL,30.0,19.5,15.0,67.22,35
HCPCS,992120,OFFICE O/P EST SF 10 MIN,,,29.7,29.7,1
HCPCS,99213,EST OFC VISIT BARIATRIC NUTRITIONAL,520.0,338.0,32.05,390.0,35
HCPCS,99213,EST PATIENT VISIT LEVEL 3,520.0,338.0,32.05,390.0,35
HCPCS,99213,OD EST ONLINE E&M LEVEL 3,520.0,338.0,32.05,390.0,35
HCPCS,99213,OFFICE O/P EST LOW 20 MIN,,,55.37,55.37,1
HCPCS,99213,OFFICE VISIT LVL 3,520.0,338.0,32.05,390.0,35
HCPCS,99213,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN,520.0,338.0,32.05,390.0,35
HCPCS,99213,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN,188.0,122.2,31.58,169.2,44
HCPCS,992130,OFFICE O/P EST LOW 20 MIN,,,55.37,55.37,1
HCPCS,99214,EST PATIENT VISIT LEVEL 4,768.0,499.2,47.02,576.0,35
HCPCS,99214,OD EST ONLINE E&M LEVEL 4,768.0,499.2,47.02,576.0,35
HCPCS,99214,OFFICE O/P EST MOD 30 MIN,,,81.64,81.64,1
HCPCS,99214,OFFICE VISIT EST LVL 4,768.0,499.2,47.02,576.0,35
HCPCS,99214,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN,768.0,499.2,47.02,576.0,35
HCPCS,99214,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN,234.0,152.1,39.31,210.6,44
HCPCS,99214,OV EST PATIENT LEVEL IV,768.0,499.2,47.02,576.0,35
HCPCS,992140,OFFICE O/P EST MOD 30 MIN,,,81.64,81.64,1
HCPCS,99215,EST PATIENT VISIT LEVEL 5,1120.0,728.0,69.86,840.0,35
HCPCS,99215,OD EST ONLINE E&M LEVEL 5,1120.0,728.0,69.86,840.0,35
HCPCS,99215,OFFICE O/P EST HI 40 MIN,,,121.09,121.09,1
HCPCS,99215,OFFICE VISIT EST LVL 5,1120.0,728.0,69.86,840.0,35
HCPCS,99215,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN,1120.0,728.0,69.86,840.0,35
HCPCS,99215,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN,300.0,195.0,50.4,270.0,22
HCPCS,992150,OFFICE O/P EST HI 40 MIN,,,121.09,121.09,1
HCPCS,99217,0BSERVATION CARE DISCHARGE,1009.0,655.85,59.73,1009.0,16
HCPCS,99217,DISCHARGE/OBSERVATION CARE MGMT,1009.0,655.85,59.73,1009.0,16
HCPCS,99221,1ST HOSP IP/OBS SF/LOW 40,,,69.69,69.69,1
HCPCS,99221,1ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES,652.0,423.8,47.83,652.0,35
HCPCS,99221,"INITIAL HOSPITAL CARE, LEVEL I",652.0,423.8,47.83,652.0,35
HCPCS,99221,"VIRTUAL INITIAL HOSPITAL CARE, E&M (30 MIN)",652.0,423.8,47.83,652.0,35
HCPCS,992210,1ST HOSP IP/OBS SF/LOW 40,,,69.69,69.69,1
HCPCS,99222,1ST HOSP IP/OBS MODERATE 55,,,109.8,109.8,1
HCPCS,99222,1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES,1040.0,676.0,64.28,1040.0,35
HCPCS,99222,VIRTUAL 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES,1040.0,676.0,64.28,1040.0,35
HCPCS,992220,1ST HOSP IP/OBS MODERATE 55,,,109.8,109.8,1
HCPCS,99223,1ST HOSP IP/OBS HIGH 75,,,145.44,145.44,1
HCPCS,99223,1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES,1400.0,910.0,94.19,1400.0,35
HCPCS,992230,1ST HOSP IP/OBS HIGH 75,,,145.44,145.44,1
HCPCS,99231,SBSQ HOSP IP/OBS SF/LOW 25,,,41.64,41.64,1
HCPCS,99231,SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES,400.0,260.0,18.41,400.0,35
HCPCS,99231,VIRTUAL  SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES,400.0,260.0,18.41,400.0,35
HCPCS,992310,SBSQ HOSP IP/OBS SF/LOW 25,,,41.64,41.64,1
HCPCS,99232,SBSQ HOSP IP/OBS MODERATE 35,,,66.21,66.21,1
HCPCS,99232,SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES,636.0,413.4,33.87,636.0,35
HCPCS,99232,VIRTUAL SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES,636.0,413.4,33.87,636.0,35
HCPCS,992320,SBSQ HOSP IP/OBS MODERATE 35,,,66.21,66.21,1
HCPCS,99233,SBSQ HOSP IP/OBS HIGH 50,,,99.62,99.62,1
HCPCS,99233,SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES,960.0,624.0,48.66,960.0,35
HCPCS,99233,VIRTUAL SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES,960.0,624.0,48.66,960.0,35
HCPCS,992330,SBSQ HOSP IP/OBS HIGH 50,,,99.62,99.62,1
HCPCS,99234,HOSP IP/OBS SM DT SF/LOW 45,,,82.21,82.21,1
HCPCS,99234,HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN,800.0,520.0,61.98,800.0,35
HCPCS,99234,VV HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN (99234),800.0,520.0,61.98,800.0,35
HCPCS,992340,HOSP IP/OBS SM DT SF/LOW 45,,,82.21,82.21,1
HCPCS,99235,HOSP IP/OBS SAME DATE MOD 70,,,133.9,133.9,1
HCPCS,99235,HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN,1296.0,842.4,80.1,1296.0,35
HCPCS,99235,VV HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN (99235),1296.0,842.4,80.1,1296.0,35
HCPCS,992350,HOSP IP/OBS SAME DATE MOD 70,,,133.9,133.9,1
HCPCS,99236,HOSP IP/OBS SAME DATE HI 85,,,175.13,175.13,1
HCPCS,99236,HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN,1720.0,1118.0,100.61,1720.0,35
HCPCS,99236,VV HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN (99236),1720.0,1118.0,100.61,1720.0,35
HCPCS,992360,HOSP IP/OBS SAME DATE HI 85,,,175.13,175.13,1
HCPCS,99238,HOSP IP/OBS DSCHRG MGMT 30/<,,,67.79,67.79,1
HCPCS,99238,HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<,600.0,390.0,34.19,600.0,35
HCPCS,99238,Hosp ip/obs dschrg mgmt 30/<,,,75.64,95.54,6
HCPCS,99238,VIRTUAL IP/OBS DISCHARGE =/<30 MIN,600.0,390.0,34.19,600.0,35
HCPCS,992380,HOSP IP/OBS DSCHRG MGMT 30/<,,,67.79,67.79,1
HCPCS,99239,HOSP IP/OBS DSCHRG MGMT >30,,,95.71,95.71,1
HCPCS,99239,HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN,860.0,559.0,49.97,860.0,35
HCPCS,99239,Hosp ip/obs dschrg mgmt >30,,,75.64,95.54,6
HCPCS,99239,VIRTUAL IP/OBS DISCHARGE DAY > 30 MIN,860.0,559.0,49.97,860.0,35
HCPCS,992390,HOSP IP/OBS DSCHRG MGMT >30,,,95.71,95.71,1
HCPCS,99241,OFFICE CONSULT LEVEL I,175.0,113.75,27.99,175.0,16
HCPCS,99241,OFFICE CONSULT LVL 1,175.0,113.75,27.99,175.0,16
HCPCS,99242,OFF/OP CONSLTJ NEW/EST SF 20,,,51.73,51.73,1
HCPCS,99242,OFFICE CONSULT LEVEL II,475.0,308.75,32.22,356.25,24
HCPCS,99242,OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,475.0,308.75,32.22,356.25,24
HCPCS,99242,VV OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,475.0,308.75,32.22,356.25,24
HCPCS,992420,OFF/OP CONSLTJ NEW/EST SF 20,,,51.73,51.73,1
HCPCS,99243,OFF/OP CNSLTJ NEW/EST LOW 30,,,81.93,81.93,1
HCPCS,99243,OFFICE CONSULT LEVEL III,720.0,468.0,45.37,540.0,24
HCPCS,99243,OFFICE CONSULT LVL 3,720.0,468.0,45.37,540.0,24
HCPCS,99243,OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,720.0,468.0,45.37,540.0,24
HCPCS,99243,VV OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,720.0,468.0,45.37,540.0,24
HCPCS,992430,OFF/OP CNSLTJ NEW/EST LOW 30,,,81.93,81.93,1
HCPCS,99244,OFF/OP CNSLTJ NEW/EST MOD 40,,,124.59,124.59,1
HCPCS,99244,OFFICE CONSULT LEVEL IV,1076.0,699.4,72.49,807.0,24
HCPCS,99244,OFFICE CONSULT LVL 4,1076.0,699.4,72.49,807.0,24
HCPCS,99244,OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,1076.0,699.4,72.49,807.0,24
HCPCS,99244,VV OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,1076.0,699.4,72.49,807.0,24
HCPCS,992440,OFF/OP CNSLTJ NEW/EST MOD 40,,,124.59,124.59,1
HCPCS,99245,INITIAL COMP BARIATRIC NUTRITIONAL CONSUL,1500.0,975.0,89.76,1125.0,24
HCPCS,99245,OFF/OP CONSLTJ NEW/EST HI 55,,,167.81,167.81,1
HCPCS,99245,OFFICE CONSULT LEVEL V,1500.0,975.0,89.76,1125.0,24
HCPCS,99245,OFFICE CONSULT LVL 5,1500.0,975.0,89.76,1125.0,24
HCPCS,99245,OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,1500.0,975.0,89.76,1125.0,24
HCPCS,99245,VV OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,1500.0,975.0,89.76,1125.0,24
HCPCS,992450,OFF/OP CONSLTJ NEW/EST HI 55,,,167.81,167.81,1
HCPCS,99252,IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES,600.0,390.0,37.22,600.0,24
HCPCS,99252,IP/OBS CONSLTJ NEW/EST SF 35,,,66.13,66.13,1
HCPCS,992520,IP/OBS CONSLTJ NEW/EST SF 35,,,66.13,66.13,1
HCPCS,99253,IP/OBS CNSLTJ NEW/EST LOW 45,,,92.45,92.45,1
HCPCS,99253,IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES,880.0,572.0,54.42,880.0,24
HCPCS,99253,VIRTUAL INPATIENT CONSULTATION SERVICES (45 MIN),880.0,572.0,54.42,880.0,24
HCPCS,992530,IP/OBS CNSLTJ NEW/EST LOW 45,,,92.45,92.45,1
HCPCS,99254,IP/OBS CNSLTJ NEW/EST MOD 60,,,128.17,128.17,1
HCPCS,99254,IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES,1197.0,778.05,78.41,1197.0,24
HCPCS,992540,IP/OBS CNSLTJ NEW/EST MOD 60,,,128.17,128.17,1
HCPCS,99255,IP/OBS CONSLTJ NEW/EST HI 80,,,173.08,173.08,1
HCPCS,99255,IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES,1698.0,1103.7,94.85,1698.0,24
HCPCS,992550,IP/OBS CONSLTJ NEW/EST HI 80,,,173.08,173.08,1
HCPCS,99281,EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP,435.0,282.75,11.7,1764.0,121
HCPCS,99281,EMR DPT VST MAYX REQ PHY/QHP,,,9.71,9.71,1
HCPCS,992810,EMR DPT VST MAYX REQ PHY/QHP,,,9.71,9.71,1
HCPCS,99282,EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM,887.5,576.875,20.39,1764.0,121
HCPCS,99282,EMERGENCY DEPT VISIT SF MDM,,,35.45,35.45,1
HCPCS,992820,EMERGENCY DEPT VISIT SF MDM,,,35.45,35.45,1
HCPCS,99283,EMERGENCY DEPARTMENT VISIT LOW MDM,1546.5,1005.2249999999999,35.8,2150.1,121
HCPCS,99283,EMERGENCY DEPT VISIT LOW MDM,,,60.35,60.35,1
HCPCS,992830,EMERGENCY DEPT VISIT LOW MDM,,,60.35,60.35,1
HCPCS,99284,EMERGENCY DEPARTMENT VISIT MODERATE MDM,2439.5,1585.675,59.76,3732.0,121
HCPCS,99284,EMERGENCY DEPT VISIT MOD MDM,,,102.73,102.73,1
HCPCS,992840,EMERGENCY DEPT VISIT MOD MDM,,,102.73,102.73,1
HCPCS,99285,EMERGENCY DEPARTMENT VISIT HIGH MDM,3524.0,2290.6,89.52,4759.2,121
HCPCS,99285,EMERGENCY DEPT VISIT HI MDM,,,148.88,148.88,1
HCPCS,992850,EMERGENCY DEPT VISIT HI MDM,,,148.88,148.88,1
HCPCS,99288,DIRECT ADVANCED LIFE SUPPORT,,,132.26,132.26,1
HCPCS,992880,DIRECT ADVANCED LIFE SUPPORT,,,132.26,132.26,1
HCPCS,99291,CRITICAL CARE FIRST HOUR,,,179.43,179.43,1
HCPCS,99291,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,4624.0,3005.6,104.05,6541.2,121
HCPCS,992910,CRITICAL CARE FIRST HOUR,,,179.43,179.43,1
HCPCS,99292,CRITICAL CARE ADDL 30 MIN,,,90.45,90.45,1
HCPCS,99292,CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN,2049.5,1332.175,52.28,2798.1,60
HCPCS,992920,CRITICAL CARE ADDL 30 MIN,,,90.45,90.45,1
HCPCS,99304,1ST NF CARE SF/LOW MDM 25,,,67.26,67.26,1
HCPCS,99304,INITIAL NURSING FACILITY CARE SF/LOW MDM 25 MIN,600.0,390.0,42.25,600.0,35
HCPCS,993040,1ST NF CARE SF/LOW MDM 25,,,67.26,67.26,1
HCPCS,99305,1ST NF CARE MODERATE MDM 35,,,111.7,111.7,1
HCPCS,99305,INITIAL NURSING FACILITY CARE MOD MDM 35 MINUTES,1000.0,650.0,60.99,1000.0,35
HCPCS,993050,1ST NF CARE MODERATE MDM 35,,,111.7,111.7,1
HCPCS,99306,1ST NF CARE HIGH MDM 50,,,152.72,152.72,1
HCPCS,99306,INITIAL NURSING FACILITY CARE HI MDM 50 MINUTES,1400.0,910.0,78.25,1400.0,35
HCPCS,993060,1ST NF CARE HIGH MDM 50,,,152.72,152.72,1
HCPCS,99307,SBSQ NF CARE SF MDM 10,,,33.62,33.62,1
HCPCS,99307,SBSQ NURSING FACILITY CARE SF MDM 10 MINUTES,280.0,182.0,20.71,280.0,35
HCPCS,993070,SBSQ NF CARE SF MDM 10,,,33.62,33.62,1
HCPCS,99308,SBSQ NF CARE LOW MDM 20,,,62.2,62.2,1
HCPCS,99308,SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES,520.0,338.0,32.72,520.0,35
HCPCS,993080,SBSQ NF CARE LOW MDM 20,,,62.2,62.2,1
HCPCS,99309,SBSQ NF CARE MODERATE MDM 30,,,90.04,90.04,1
HCPCS,99309,SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES,768.0,499.2,43.07,768.0,35
HCPCS,993090,SBSQ NF CARE MODERATE MDM 30,,,90.04,90.04,1
HCPCS,99310,SBSQ NF CARE HIGH MDM 45,,,128.67,128.67,1
HCPCS,99310,SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES,1120.0,728.0,63.45,1120.0,35
HCPCS,993100,SBSQ NF CARE HIGH MDM 45,,,128.67,128.67,1
HCPCS,99315,NF DSCHRG MGMT 30 MIN/LESS,,,68.28,68.28,1
HCPCS,99315,NURSING FACILITY DSCHRG MGMT 30 MIN/< TOT TIME,600.0,390.0,34.36,600.0,35
HCPCS,993150,NF DSCHRG MGMT 30 MIN/LESS,,,68.28,68.28,1
HCPCS,99316,NF DSCHRG MGMT 30 MIN+,,,109.86,109.86,1
HCPCS,99316,NURSING FACILITY DSCHRG MGMT 30 MIN+ TOT TIME,1000.0,650.0,49.15,1000.0,35
HCPCS,993160,NF DSCHRG MGMT 30 MIN+,,,109.86,109.86,1
HCPCS,99339,Domicil/r-home care supervis,,,75.64,95.54,6
HCPCS,99340,Domicil/r-home care supervis,,,75.64,95.54,6
HCPCS,99341,HOME/RES VISIT NEW PATIENT SF MDM 15 MINUTES,440.0,286.0,37.53,440.0,35
HCPCS,99341,HOME/RES VST NEW SF MDM 15,,,41.5,41.5,1
HCPCS,993410,HOME/RES VST NEW SF MDM 15,,,41.5,41.5,1
HCPCS,99342,HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES,726.0,471.9,53.35,726.0,35
HCPCS,99342,HOME/RES VST NEW LOW MDM 30,,,65.97,65.97,1
HCPCS,993420,HOME/RES VST NEW LOW MDM 30,,,65.97,65.97,1
HCPCS,99344,HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES,1263.0,820.95,98.9,1263.0,35
HCPCS,99344,HOME/RES VST NEW MOD MDM 60,,,119.48,119.48,1
HCPCS,993440,HOME/RES VST NEW MOD MDM 60,,,119.48,119.48,1
HCPCS,99345,HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES,1707.0,1109.55,119.43,1707.0,35
HCPCS,99345,HOME/RES VST NEW HIGH MDM 75,,,169.32,169.32,1
HCPCS,993450,HOME/RES VST NEW HIGH MDM 75,,,169.32,169.32,1
HCPCS,99347,HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES,396.0,257.4,30.02,396.0,35
HCPCS,99347,HOME/RES VST EST SF MDM 20,,,38.09,38.09,1
HCPCS,993470,HOME/RES VST EST SF MDM 20,,,38.09,38.09,1
HCPCS,99348,HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES,660.0,429.0,44.95,660.0,35
HCPCS,99348,HOME/RES VST EST LOW MDM 30,,,64.26,64.26,1
HCPCS,993480,HOME/RES VST EST LOW MDM 30,,,64.26,64.26,1
HCPCS,99349,HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES,1074.0,698.1,66.62,1074.0,35
HCPCS,99349,HOME/RES VST EST MOD MDM 40,,,106.77,106.77,1
HCPCS,993490,HOME/RES VST EST MOD MDM 40,,,106.77,106.77,1
HCPCS,99350,HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES,1584.0,1029.6,96.77,1584.0,35
HCPCS,99350,HOME/RES VST EST HIGH MDM 60,,,155.65,155.65,1
HCPCS,993500,HOME/RES VST EST HIGH MDM 60,,,155.65,155.65,1
HCPCS,99358,PROLONG SERVICE W/O CONTACT,,,73.84,73.84,1
HCPCS,99358,PROLONGED E&M SERVICE-1ST HOUR,792.0,514.8,88.01,792.0,20
HCPCS,993580,PROLONG SERVICE W/O CONTACT,,,73.84,73.84,1
HCPCS,99359,PROLONG SERV W/O CONTACT ADD,,,30.84,30.84,1
HCPCS,99359,"PROLONGED SERV,NO CONTCT,EA ADD 1/2",330.0,214.5,35.91,330.0,20
HCPCS,993590,PROLONG SERV W/O CONTACT ADD,,,30.84,30.84,1
HCPCS,99360,"PHYSICIAN STANDBY SERV,EA 30 MIN",480.0,312.0,44.17,480.0,19
HCPCS,99360,PHYSICIAN STANDBY SERVICES,,,49.22,49.22,1
HCPCS,993600,PHYSICIAN STANDBY SERVICES,,,49.22,49.22,1
HCPCS,99366,TEAM CONF W/PAT BY HC PROF,,,33.66,33.66,1
HCPCS,99366,TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN,328.0,213.2,34.81,246.0,20
HCPCS,99366,Team conf w/pat by hc prof,,,75.64,95.54,6
HCPCS,993660,TEAM CONF W/PAT BY HC PROF,,,33.66,33.66,1
HCPCS,99367,TEAM CONF W/O PAT BY PHYS,,,45.26,45.26,1
HCPCS,99367,Team conf w/o pat by phys,,,75.64,95.54,6
HCPCS,993670,TEAM CONF W/O PAT BY PHYS,,,45.26,45.26,1
HCPCS,99368,TEAM CONF W/O PAT BY HC PRO,,,29.42,29.42,1
HCPCS,99368,Team conf w/o pat by hc pro,,,75.64,95.54,6
HCPCS,993680,TEAM CONF W/O PAT BY HC PRO,,,29.42,29.42,1
HCPCS,99374,"HOME HEALTH CARE SUPERV,15-29 MIN",440.0,286.0,47.03,330.0,20
HCPCS,99374,HOME HEALTH CARE SUPERVISION,,,45.26,45.26,1
HCPCS,99374,Home health care supervision,,,34.32,43.36,6
HCPCS,993740,HOME HEALTH CARE SUPERVISION,,,45.26,45.26,1
HCPCS,99375,CARE PLAN OVERSIGHT/30-60,692.0,449.8,76.04,519.0,20
HCPCS,99375,HOME HEALTH CARE SUPERVISION,,,70.72,70.72,1
HCPCS,99375,Home health care supervision,,,34.32,43.36,6
HCPCS,993750,HOME HEALTH CARE SUPERVISION,,,70.72,70.72,1
HCPCS,99377,HOSPICE CARE SUPERVISION,,,45.26,45.26,1
HCPCS,99377,"HOSPICE CARE SUPERVISION,15-29 MIN",440.0,286.0,47.03,330.0,20
HCPCS,99377,Hospice care supervision,,,34.32,43.36,6
HCPCS,993770,HOSPICE CARE SUPERVISION,,,45.26,45.26,1
HCPCS,99378,HOSPICE CARE SUPERVISION,,,70.72,70.72,1
HCPCS,99378,"HOSPICE CARE SUPERVISION,30+ MIN",692.0,449.8,76.9,519.0,20
HCPCS,99378,Hospice care supervision,,,34.32,43.36,6
HCPCS,993780,HOSPICE CARE SUPERVISION,,,70.72,70.72,1
HCPCS,99379,NURSING FAC CARE SUPERVISION,,,45.26,45.26,1
HCPCS,99379,"NURSING FAC CARE SUPERVN,15-29 MIN",440.0,286.0,47.03,330.0,20
HCPCS,99379,Nursing fac care supervision,,,34.32,43.36,6
HCPCS,993790,NURSING FAC CARE SUPERVISION,,,45.26,45.26,1
HCPCS,99380,NURSING FAC CARE SUPERVISION,,,70.72,70.72,1
HCPCS,99380,"NURSING FAC CARE SUPERVN,30+ MIN",692.0,449.8,74.03,519.0,20
HCPCS,99380,Nursing fac care supervision,,,34.32,43.36,6
HCPCS,993800,NURSING FAC CARE SUPERVISION,,,70.72,70.72,1
HCPCS,99381,INIT PM E/M NEW PAT INFANT,,,61.78,61.78,1
HCPCS,99381,"PREVENTIVE VISIT,NEW,INFANT",600.0,390.0,39.58,450.0,27
HCPCS,993810,INIT PM E/M NEW PAT INFANT,,,61.78,61.78,1
HCPCS,99382,INIT PM E/M NEW PAT 1-4 YRS,,,66.05,66.05,1
HCPCS,99382,"PREVENTIVE VISIT,NEW,AGE 1-4",640.0,416.0,43.85,480.0,27
HCPCS,993820,INIT PM E/M NEW PAT 1-4 YRS,,,66.05,66.05,1
HCPCS,99383,PREV VISIT NEW AGE 5-11,,,70.02,70.02,1
HCPCS,99383,PREVENTATIVE 5-11 SCHOOL OR SPORT,680.0,442.0,40.19,510.0,27
HCPCS,99383,PREVENTATIVE VST 5-11YR,680.0,442.0,40.19,510.0,27
HCPCS,99383,"PREVENTIVE VISIT,NEW,AGE5-11",680.0,442.0,40.19,510.0,27
HCPCS,993830,PREV VISIT NEW AGE 5-11,,,70.02,70.02,1
HCPCS,99384,INITIAL PREVENTIVE MEDICINE NEW PT AGE 12-17 YR,233.0,151.45,39.14,209.7,21
HCPCS,99384,PREV MED VST-NEW 12-17,800.0,520.0,48.5,600.0,27
HCPCS,99384,PREV VISIT NEW AGE 12-17,,,82.54,82.54,1
HCPCS,99384,PREVENTATIVE 12-17 SCHOOL OR SPORT,800.0,520.0,48.5,600.0,27
HCPCS,99384,WELLNESS EXAMS NEW 12-17 YRS,800.0,520.0,48.5,600.0,27
HCPCS,993840,PREV VISIT NEW AGE 12-17,,,82.54,82.54,1
HCPCS,99385,INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS,230.0,149.5,38.64,207.0,21
HCPCS,99385,NEW PREVENTATIVE 18 -39YRS,768.0,499.2,46.52,576.0,27
HCPCS,99385,NEW PREVENTATIVE 99385A- (18YR-39YRS),768.0,499.2,46.52,576.0,27
HCPCS,99385,NEW PREVENTATIVE MEDICINE 99385B- 18-39 YRS,768.0,499.2,46.52,576.0,27
HCPCS,99385,PREV VISIT NEW AGE 18-39,,,79.15,79.15,1
HCPCS,99385,PREVENTATIVE 18-39 SCHOOL OR SPORT,768.0,499.2,46.52,576.0,27
HCPCS,99385,WELLNESS EXAM NEW 18-39 YRS,768.0,499.2,46.52,576.0,27
HCPCS,993850,PREV VISIT NEW AGE 18-39,,,79.15,79.15,1
HCPCS,99386,INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS,318.0,206.7,53.42,286.2,21
HCPCS,99386,NEW PREVENTATIVE 40 - 64YRS,932.0,605.8,59.18,699.0,27
HCPCS,99386,NEW PREVENTATIVE 99386A- (40 - 64YRS),932.0,605.8,59.18,699.0,27
HCPCS,99386,NEW PREVENTATIVE MEDICINE 99386B  40-64 YRS,932.0,605.8,59.18,699.0,27
HCPCS,99386,PREV VISIT NEW AGE 40-64,,,95.94,95.94,1
HCPCS,99386,PREVENTIVE MED E&M VISIT- NEW PT 40-64 YR,932.0,605.8,59.18,699.0,27
HCPCS,99386,WELLNESS EXAMS NEW 40-64 YRS,932.0,605.8,59.18,699.0,27
HCPCS,993860,PREV VISIT NEW AGE 40-64,,,95.94,95.94,1
HCPCS,99387,INIT PM E/M NEW PAT 65+ YRS,,,103.04,103.04,1
HCPCS,99387,INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>,364.0,236.6,61.15,327.6,21
HCPCS,99387,NEW PREVENTATIVE 65+YRS,1000.0,650.0,63.58,750.0,27
HCPCS,99387,NEW PREVENTATIVE 99385A- (65 & OVER),1000.0,650.0,63.58,750.0,27
HCPCS,99387,NEW PREVENTATIVE MEDICINE 99387- 65 YRS & OVER,1000.0,650.0,63.58,750.0,27
HCPCS,99387,PREV MED INIT E&M NEW PT; 65 YRS/>,1000.0,650.0,63.58,750.0,27
HCPCS,99387,WELLNESS EXAMS NEW 65+ YRS,1000.0,650.0,63.58,750.0,27
HCPCS,993870,INIT PM E/M NEW PAT 65+ YRS,,,103.04,103.04,1
HCPCS,99391,PER PM REEVAL EST PAT INFANT,,,56.37,56.37,1
HCPCS,99391,"PREVENTIVE VISIT,EST,INFANT",548.0,356.2,35.52,411.0,27
HCPCS,993910,PER PM REEVAL EST PAT INFANT,,,56.37,56.37,1
HCPCS,99392,PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS,191.0,124.15,32.09,171.9,21
HCPCS,99392,PREV VISIT EST AGE 1-4,,,61.78,61.78,1
HCPCS,99392,"PREVENTIVE VISIT,EST,AGE 1-4",600.0,390.0,38.88,450.0,27
HCPCS,993920,PREV VISIT EST AGE 1-4,,,61.78,61.78,1
HCPCS,99393,PREV VISIT EST AGE 5-11,,,61.78,61.78,1
HCPCS,99393,PREVENTATIVE EST 5-11 SCHOOL OR SPORT,600.0,390.0,36.01,450.0,27
HCPCS,99393,"PREVENTIVE VISIT,EST,AGE5-11",600.0,390.0,36.01,450.0,27
HCPCS,993930,PREV VISIT EST AGE 5-11,,,61.78,61.78,1
HCPCS,99394,PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS,264.0,171.6,44.35,237.6,21
HCPCS,99394,PREV MED-EST PT 12-17,680.0,442.0,40.76,510.0,27
HCPCS,99394,PREV VISIT EST AGE 12-17,,,70.02,70.02,1
HCPCS,99394,"PREVENTIVE VISIT,EST,12-17",680.0,442.0,40.76,510.0,27
HCPCS,993940,PREV VISIT EST AGE 12-17,,,70.02,70.02,1
HCPCS,99395,EHPREV MED EST PT 18-39,700.0,455.0,41.92,525.0,27
HCPCS,99395,EST PREVENTATIVE 18-39YRS,700.0,455.0,41.92,525.0,27
HCPCS,99395,ESTABLISHED PREVENTATIVE 99395A - 18-39YRS,700.0,455.0,41.92,525.0,27
HCPCS,99395,ESTABLISHED PREVENTATIVE MEDICINE 99395B - 18-39YRS,700.0,455.0,41.92,525.0,27
HCPCS,99395,HOLLAND AMERICA EST 18-39,700.0,455.0,41.92,525.0,27
HCPCS,99395,PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS,391.0,254.15,65.69,351.9,21
HCPCS,99395,PREV MED-EST PT 18-39,700.0,455.0,41.92,525.0,27
HCPCS,99395,PREV VISIT EST AGE 18-39,,,72.31,72.31,1
HCPCS,99395,WELLNESS EXAMS EST 18-39 YRS,700.0,455.0,41.92,525.0,27
HCPCS,993950,PREV VISIT EST AGE 18-39,,,72.31,72.31,1
HCPCS,99396,EST PREVENTATIVE 40 - 64YRS,760.0,494.0,46.03,570.0,27
HCPCS,99396,ESTABLISHED PREVENTATIVE 99396 - 64YRS,760.0,494.0,46.03,570.0,27
HCPCS,99396,ESTABLISHED PREVENTATIVE MEDICINE 99396B 40-64 YRS,760.0,494.0,46.03,570.0,27
HCPCS,99396,PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS,288.0,187.2,48.38,259.2,21
HCPCS,99396,PREV VISIT EST AGE 40-64,,,78.57,78.57,1
HCPCS,99396,PREVENTATIVE EST 40-64 SCHOOL OR SPORT,760.0,494.0,46.03,570.0,27
HCPCS,99396,WELLNESS EXAMS EST 40-64 YRS,760.0,494.0,46.03,570.0,27
HCPCS,993960,PREV VISIT EST AGE 40-64,,,78.57,78.57,1
HCPCS,99397,EST PREVENTATIVE RE-EVAL 65+YRS,800.0,520.0,48.5,600.0,27
HCPCS,99397,ESTABLISHED PREVENTATIVE 99397A - 65 YRS & OVER,800.0,520.0,48.5,600.0,27
HCPCS,99397,ESTABLISHED PREVENTATIVE MEDICINE 99397B 65 YRS & OLDER,800.0,520.0,48.5,600.0,27
HCPCS,99397,PER PM REEVAL EST PAT 65+ YR,,,82.54,82.54,1
HCPCS,99397,PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER,304.0,197.6,51.07,273.6,21
HCPCS,99397,PREVENTATIVE EST 65 > SCHOOL OR SPORT,800.0,520.0,48.5,600.0,27
HCPCS,99397,WELLNESS EXAMS EST 65+ YRS,800.0,520.0,48.5,600.0,27
HCPCS,993970,PER PM REEVAL EST PAT 65+ YR,,,82.54,82.54,1
HCPCS,99401,PREV MED CNSL INDIV APPRX 15,,,19.92,19.92,1
HCPCS,99401,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN,173.5,112.775,17.81,158.0,51
HCPCS,994010,PREV MED CNSL INDIV APPRX 15,,,19.92,19.92,1
HCPCS,99402,PREV MED CNSL INDIV APPRX 30,,,40.42,40.42,1
HCPCS,99402,PREVENT MED COUNSEL 30 MIN,392.0,254.8,29.07,294.0,24
HCPCS,99402,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN,335.0,217.75,29.07,294.0,51
HCPCS,994020,PREV MED CNSL INDIV APPRX 30,,,40.42,40.42,1
HCPCS,99403,PREV MED CNSL INDIV APPRX 45,,,60.34,60.34,1
HCPCS,99403,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 MIN,584.0,379.6,43.19,438.0,21
HCPCS,99403,Prev med cnsl indiv apprx 45,,,40.76,51.49,6
HCPCS,994030,PREV MED CNSL INDIV APPRX 45,,,60.34,60.34,1
HCPCS,99404,PREV MED CNSL INDIV APPRX 60,,,80.56,80.56,1
HCPCS,99404,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN,780.0,507.0,59.39,585.0,21
HCPCS,99404,Prev med cnsl indiv apprx 60,,,40.76,51.49,6
HCPCS,994040,PREV MED CNSL INDIV APPRX 60,,,80.56,80.56,1
HCPCS,99406,BEHAV CHNG SMOKING 3-10 MIN,,,9.98,9.98,1
HCPCS,99406,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,103.5,67.275,7.33,675.0,76
HCPCS,994060,BEHAV CHNG SMOKING 3-10 MIN,,,9.98,9.98,1
HCPCS,99407,BEHAV CHNG SMOKING > 10 MIN,,,21.07,21.07,1
HCPCS,99407,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,155.5,101.075,12.84,675.0,76
HCPCS,994070,BEHAV CHNG SMOKING > 10 MIN,,,21.07,21.07,1
HCPCS,99408,ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN,260.0,169.0,27.85,195.0,20
HCPCS,99408,AUDIT/DAST 15-30 MIN,,,26.76,26.76,1
HCPCS,99408,Audit/dast 15-30 min,,,12.84,16.22,6
HCPCS,994080,AUDIT/DAST 15-30 MIN,,,26.76,26.76,1
HCPCS,99409,AUDIT/DAST OVER 30 MIN,,,53.52,53.52,1
HCPCS,99409,Audit/dast over 30 min,,,12.84,16.22,6
HCPCS,994090,AUDIT/DAST OVER 30 MIN,,,53.52,53.52,1
HCPCS,99411,PREVENTIVE COUNSELING GROUP,,,6.26,6.26,1
HCPCS,99411,Preventive counseling group,,,40.76,51.49,6
HCPCS,994110,PREVENTIVE COUNSELING GROUP,,,6.26,6.26,1
HCPCS,99412,PREVENTIVE COUNSELING GROUP,,,10.53,10.53,1
HCPCS,99412,Preventive counseling group,,,40.76,51.49,6
HCPCS,994120,PREVENTIVE COUNSELING GROUP,,,10.53,10.53,1
HCPCS,99415,PROLNG CLIN STAFF SVC 1ST HR,,,16.51,16.51,1
HCPCS,99415,PROLNG CLINCL STAFF SVC DURING O/P E/M 1ST HR,273.0,177.45,7.43,273.0,31
HCPCS,994150,PROLNG CLIN STAFF SVC 1ST HR,,,16.51,16.51,1
HCPCS,99416,PROLNG CLIN STAFF SVC EA ADD,,,7.73,7.73,1
HCPCS,99416,PROLNG CLINCL STAFF SVC DURING O/P E/M EA 30 MIN,273.0,177.45,0.69,273.0,31
HCPCS,994160,PROLNG CLIN STAFF SVC EA ADD,,,7.73,7.73,1
HCPCS,99417,PROLNG OP E/M EACH 15 MIN,,,25.34,25.34,1
HCPCS,99417,PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES,268.0,174.2,21.73,201.0,17
HCPCS,99417,VIRTUAL PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES,268.0,174.2,21.73,201.0,17
HCPCS,994170,PROLNG OP E/M EACH 15 MIN,,,25.34,25.34,1
HCPCS,99418,PROLNG IP/OBS E/M EA 15 MIN,,,33.32,33.32,1
HCPCS,99418,PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN,356.0,231.4,28.53,356.0,17
HCPCS,99418,VV?PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN,356.0,231.4,28.53,356.0,17
HCPCS,994180,PROLNG IP/OBS E/M EA 15 MIN,,,33.32,33.32,1
HCPCS,99421,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 5-10 MINUTES,65.0,42.25,9.89,48.75,28
HCPCS,99421,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,65.0,42.25,9.89,48.75,28
HCPCS,99421,OL DIG E/M SVC 5-10 MIN,,,10.74,10.74,1
HCPCS,99421,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 5-10 MINUTES,65.0,42.25,9.89,48.75,28
HCPCS,994210,OL DIG E/M SVC 5-10 MIN,,,10.74,10.74,1
HCPCS,99422,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 11-20 MINUTES,80.0,52.0,20.31,60.0,28
HCPCS,99422,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,80.0,52.0,20.31,60.0,28
HCPCS,99422,OL DIG E/M SVC 11-20 MIN,,,21.2,21.2,1
HCPCS,99422,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 11-20 MINUTES,80.0,52.0,20.31,60.0,28
HCPCS,994220,OL DIG E/M SVC 11-20 MIN,,,21.2,21.2,1
HCPCS,99423,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 21+ MINUTES,120.0,78.0,32.36,90.0,28
HCPCS,99423,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,120.0,78.0,32.36,90.0,28
HCPCS,99423,OL DIG E/M SVC 21+ MIN,,,33.91,33.91,1
HCPCS,99423,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 21+ MINUTES,120.0,78.0,32.36,90.0,28
HCPCS,994230,OL DIG E/M SVC 21+ MIN,,,33.91,33.91,1
HCPCS,99424,PRIN CARE MGMT PHYS 1ST 30,,,62.78,62.78,1
HCPCS,99424,PRINCIPAL CARE MGMT SVC 1ST 30 PHYS/QHP CAL MO,580.0,377.0,68.27,435.0,27
HCPCS,99424,Prin care mgmt phys 1st 30,,,34.32,43.36,6
HCPCS,994240,PRIN CARE MGMT PHYS 1ST 30,,,62.78,62.78,1
HCPCS,99425,PRIN CARE MGMT PHYS EA ADDL,,,43.17,43.17,1
HCPCS,99425,PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO,400.0,260.0,46.32,300.0,27
HCPCS,99425,Prin care mgmt phys ea addl,,,34.32,43.36,6
HCPCS,994250,PRIN CARE MGMT PHYS EA ADDL,,,43.17,43.17,1
HCPCS,99426,PRIN CARE MGMT STAFF 1ST 30,,,41.87,41.87,1
HCPCS,99426,PRINCIPAL CARE MGMT SVC 1ST 30 STAFF CAL MO,798.0,518.7,34.32,718.2,38
HCPCS,994260,PRIN CARE MGMT STAFF 1ST 30,,,41.87,41.87,1
HCPCS,99427,PRIN CARE MGMT STAFF EA ADDL,,,29.34,29.34,1
HCPCS,99427,PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO,798.0,518.7,34.32,718.2,28
HCPCS,994270,PRIN CARE MGMT STAFF EA ADDL,,,29.34,29.34,1
HCPCS,99437,CHRNC CARE MGMT PHYS EA ADDL,,,42.37,42.37,1
HCPCS,99437,CHRONIC CARE MGMT SVC PHYS EA ADDL 30 MIN CAL MO,440.0,286.0,45.98,330.0,27
HCPCS,99437,Chrnc care mgmt phys ea addl,,,34.32,43.36,6
HCPCS,994370,CHRNC CARE MGMT PHYS EA ADDL,,,42.37,42.37,1
HCPCS,99439,CHRNC CARE MGMT STAF EA ADDL,,,29.4,29.4,1
HCPCS,99439,CHRONIC CARE MANAGEMENT SERVICES EA ADDL 20 MIN,280.0,182.0,32.31,210.0,30
HCPCS,99439,CHRONIC CARE MGMT SVC STAF EA ADDL 20 MIN CAL MO,309.0,200.85,34.32,278.1,28
HCPCS,994390,CHRNC CARE MGMT STAF EA ADDL,,,29.4,29.4,1
HCPCS,99445,REM MNTR PHYSIOL PARAM DEV SPLY W/REC 2-15 DAYS,183.0,118.95,18.5,296.1,52
HCPCS,99446,NTRPROF PH1/NTRNET/EHR 5-10,,,14.98,14.98,1
HCPCS,99446,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN,154.0,100.1,13.07,154.0,28
HCPCS,994460,NTRPROF PH1/NTRNET/EHR 5-10,,,14.98,14.98,1
HCPCS,99447,NTRPROF PH1/NTRNET/EHR 11-20,,,30.52,30.52,1
HCPCS,99447,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN,280.0,182.0,25.84,280.0,28
HCPCS,994470,NTRPROF PH1/NTRNET/EHR 11-20,,,30.52,30.52,1
HCPCS,99448,NTRPROF PH1/NTRNET/EHR 21-30,,,45.21,45.21,1
HCPCS,99448,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN,420.0,273.0,39.37,420.0,28
HCPCS,994480,NTRPROF PH1/NTRNET/EHR 21-30,,,45.21,45.21,1
HCPCS,99449,NTRPROF PH1/NTRNET/EHR 31/>,,,60.16,60.16,1
HCPCS,99449,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 31/> MIN,560.0,364.0,52.09,560.0,28
HCPCS,994490,NTRPROF PH1/NTRNET/EHR 31/>,,,60.16,60.16,1
HCPCS,99450,BASIC LIFE DISABILITY EXAM,,,139.17,139.17,1
HCPCS,994500,BASIC LIFE DISABILITY EXAM,,,139.17,139.17,1
HCPCS,99451,NTRPROF PH1/NTRNET/EHR 5/>,,,29.4,29.4,1
HCPCS,99451,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5/> MIN,280.0,182.0,25.76,280.0,28
HCPCS,994510,NTRPROF PH1/NTRNET/EHR 5/>,,,29.4,29.4,1
HCPCS,99452,NTRPROF PH1/NTRNET/EHR RFRL,,,28.58,28.58,1
HCPCS,99452,NTRPROF PHONE/NTRNET/EHR REFERRAL SVC 30 MIN,280.0,182.0,24.16,280.0,28
HCPCS,994520,NTRPROF PH1/NTRNET/EHR RFRL,,,28.58,28.58,1
HCPCS,99453,REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP,37.0,24.05,13.59,37.0,31
HCPCS,99453,REM MNTR PHYSIOL PARAM SETUP,,,15.89,279.41,15
HCPCS,99453,Rem mntr physiol param setup,,,33.85,42.76,6
HCPCS,994530,REM MNTR PHYSIOL PARAM SETUP,,,15.89,15.89,1
HCPCS,99454,REM MNTR PHYSIOL PARAM 16-30,,,37.43,80.85,15
HCPCS,99454,REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D,118.0,76.7,33.96,118.0,31
HCPCS,99454,Rem mntr physiol param 16-30,,,23.85,30.13,6
HCPCS,994540,REM MNTR PHYSIOL PARAM 16-30,,,37.48,37.48,1
HCPCS,99455,WORK RELATED DISABILITY EXAM,,,90.93,90.93,1
HCPCS,99455,WORK RELATED/MED DBLT XM TREATING PHYS,193.0,125.45,96.5,193.0,12
HCPCS,994550,WORK RELATED DISABILITY EXAM,,,90.93,90.93,1
HCPCS,99456,DISABILITY EXAMINATION,,,815.91,815.91,1
HCPCS,99456,"MED DISAB,EXAM OTHE THAN",918.0,596.7,459.0,918.0,12
HCPCS,99456,WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS,918.0,596.7,459.0,918.0,12
HCPCS,99456,WORK RELT/DISAB EX-NUT TX,918.0,596.7,459.0,918.0,12
HCPCS,994560,DISABILITY EXAMINATION,,,815.91,815.91,1
HCPCS,99457,REMOTE PHYSIOLOGIC MONITORING 20 MIN+ PER MONTH,244.0,158.6,24.09,183.0,31
HCPCS,99457,RPM TX MGMT 1ST 20 MIN,,,25.17,25.17,1
HCPCS,99457,Rpm tx mgmt 1st 20 min,,,23.85,30.13,6
HCPCS,994570,RPM TX MGMT 1ST 20 MIN,,,25.17,25.17,1
HCPCS,99458,REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO,244.0,158.6,27.66,183.0,31
HCPCS,99458,RPM TX MGMT EA ADDL 20 MIN,,,25.17,25.17,1
HCPCS,99458,Rpm tx mgmt ea addl 20 min,,,23.85,30.13,6
HCPCS,994580,RPM TX MGMT EA ADDL 20 MIN,,,25.17,25.17,1
HCPCS,99459,PELVIC EXAMINATION,53.0,34.45,15.42,53.0,32
HCPCS,994590,PELVIC EXAMINATION,,,17.93,17.93,1
HCPCS,99460,INIT NB EM PER DAY HOSP,,,77.91,279.41,15
HCPCS,994600,INIT NB EM PER DAY HOSP,,,77.91,77.91,1
HCPCS,99461,INIT NB EM PER DAY NON-FAC,,,51.28,51.28,1
HCPCS,994610,INIT NB EM PER DAY NON-FAC,,,51.28,51.28,1
HCPCS,99462,SBSQ NB EM PER DAY HOSP,,,34.28,34.28,1
HCPCS,994620,SBSQ NB EM PER DAY HOSP,,,34.28,34.28,1
HCPCS,99463,SAME DAY NB DISCHARGE,,,90.64,279.41,15
HCPCS,994630,SAME DAY NB DISCHARGE,,,90.64,90.64,1
HCPCS,99464,ATTENDANCE AT DELIVERY,,,60.9,60.9,1
HCPCS,994640,ATTENDANCE AT DELIVERY,,,60.9,60.9,1
HCPCS,99465,NB RESUSCITATION,,,119.24,1418.8,15
HCPCS,99465,Nb resuscitation,,,451.12,569.83,6
HCPCS,994650,NB RESUSCITATION,,,119.24,119.24,1
HCPCS,99466,PED CRIT CARE TRANSPORT,,,194.63,194.63,1
HCPCS,994660,PED CRIT CARE TRANSPORT,,,194.63,194.63,1
HCPCS,99467,PED CRIT CARE TRANSPORT ADDL,,,97.74,97.74,1
HCPCS,994670,PED CRIT CARE TRANSPORT ADDL,,,97.74,97.74,1
HCPCS,99468,NEONATE CRIT CARE INITIAL,,,750.12,750.12,1
HCPCS,994680,NEONATE CRIT CARE INITIAL,,,750.12,750.12,1
HCPCS,99469,NEONATE CRIT CARE SUBSQ,,,324.36,324.36,1
HCPCS,994690,NEONATE CRIT CARE SUBSQ,,,324.36,324.36,1
HCPCS,99470,RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,190.0,123.5,14.0,219.6,49
HCPCS,99470,RPM TX MGMT 1ST 10 MIN,,,11.45,11.45,1
HCPCS,994700,RPM TX MGMT 1ST 10 MIN,,,11.45,11.45,1
HCPCS,99471,INITIAL PED CRITICAL CARE 29 DAYS THRU 24 MONTHS,7031.0,4570.15,565.82,7031.0,35
HCPCS,99471,PED CRITICAL CARE INITIAL,,,649.88,649.88,1
HCPCS,994710,PED CRITICAL CARE INITIAL,,,649.88,649.88,1
HCPCS,99472,PED CRITICAL CARE SUBSQ,,,332.62,332.62,1
HCPCS,994720,PED CRITICAL CARE SUBSQ,,,332.62,332.62,1
HCPCS,99473,SELF-MEAS BP PT EDUCAJ/TRAIN,,,11.37,53.1,15
HCPCS,99473,Self-meas bp pt educaj/train,,,33.85,42.76,6
HCPCS,994730,SELF-MEAS BP PT EDUCAJ/TRAIN,,,11.37,11.37,1
HCPCS,99474,SELF-MEAS BP 2 READG 1 MIN APART BID 30 DAY PD,72.0,46.8,6.39,54.0,31
HCPCS,99474,SELF-MEAS BP 2 READG BID 30D,,,7.35,7.35,1
HCPCS,99474,Self-meas bp 2 readg bid 30d,,,23.85,30.13,6
HCPCS,994740,SELF-MEAS BP 2 READG BID 30D,,,7.35,7.35,1
HCPCS,99475,PED CRIT CARE AGE 2-5 INIT,,,468.1,468.1,1
HCPCS,994750,PED CRIT CARE AGE 2-5 INIT,,,468.1,468.1,1
HCPCS,99476,PED CRIT CARE AGE 2-5 SUBSQ,,,281.69,281.69,1
HCPCS,994760,PED CRIT CARE AGE 2-5 SUBSQ,,,281.69,281.69,1
HCPCS,99477,INIT DAY HOSP NEONATE CARE,,,284.13,284.13,1
HCPCS,994770,INIT DAY HOSP NEONATE CARE,,,284.13,284.13,1
HCPCS,99478,"SBSQ IC VLBW INF<1,500 GM",,,111.9,111.9,1
HCPCS,994780,"SBSQ IC VLBW INF<1,500 GM",,,111.9,111.9,1
HCPCS,99479,"SBSQ IC LBW INF 1,500-2,500",,,101.69,101.69,1
HCPCS,994790,"SBSQ IC LBW INF 1,500-2,500",,,101.69,101.69,1
HCPCS,99480,"SBSQ IC INF PBW 2,501-5,000",,,97.74,97.74,1
HCPCS,994800,"SBSQ IC INF PBW 2,501-5,000",,,97.74,97.74,1
HCPCS,99483,ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT,1690.0,1098.5,139.96,1267.5,28
HCPCS,99483,ASSMT & CARE PLN PT COG IMP,,,92.85,200.56,15
HCPCS,99483,Assmt & care pln pt cog imp,,,49.36,62.35,6
HCPCS,994830,ASSMT & CARE PLN PT COG IMP,,,162.14,162.14,1
HCPCS,99484,CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS,372.0,241.8,27.71,279.0,30
HCPCS,99484,CARE MGMT SVC BHVL HLTH COND,,,29.9,64.59,15
HCPCS,99484,Care mgmt svc bhvl hlth cond,,,45.19,57.08,6
HCPCS,994840,CARE MGMT SVC BHVL HLTH COND,,,37.14,37.14,1
HCPCS,99485,SUPRV INTERFACILTY TRANSPORT,,,61.39,61.39,1
HCPCS,994850,SUPRV INTERFACILTY TRANSPORT,,,61.39,61.39,1
HCPCS,99486,SUPRV INTERFAC TRNSPORT ADDL,,,53.2,53.2,1
HCPCS,994860,SUPRV INTERFAC TRNSPORT ADDL,,,53.2,53.2,1
HCPCS,99487,COMPLX CHRON CARE COORD W/O PT VST 1ST HR PER MO,1055.0,685.75,34.32,1247.4,65
HCPCS,99487,CPLX CHRNC CARE 1ST 60 MIN,,,75.74,75.74,1
HCPCS,994870,CPLX CHRNC CARE 1ST 60 MIN,,,75.74,75.74,1
HCPCS,99489,COMPLX CHRON CARE COORD EA ADDL 30 MIN PER MONTH,333.5,216.775,34.32,400.0,55
HCPCS,99489,CPLX CHRNC CARE EA ADDL 30,,,42.11,42.11,1
HCPCS,994890,CPLX CHRNC CARE EA ADDL 30,,,42.11,42.11,1
HCPCS,99490,CHRNC CARE MGMT STAFF 1ST 20,,,42.11,42.11,1
HCPCS,99490,CHRONIC CARE MGMT SVCS STAFF 1ST 20 MIN CAL MO,599.0,389.35,34.32,718.2,68
HCPCS,994900,CHRNC CARE MGMT STAFF 1ST 20,,,42.11,42.11,1
HCPCS,99491,CHRNC CARE MGMT PHYS 1ST 30,,,63.28,63.28,1
HCPCS,99491,CHRONIC CARE MGMT SVC AT LEAST 30 MIN PER MONTH,600.0,390.0,68.39,600.0,27
HCPCS,99491,Chrnc care mgmt phys 1st 30,,,34.32,43.36,6
HCPCS,994910,CHRNC CARE MGMT PHYS 1ST 30,,,63.28,63.28,1
HCPCS,99492,1ST PSYC COLLAB CARE MGMT,,,78.82,200.56,15
HCPCS,99492,1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS,827.0,537.55,86.57,620.25,30
HCPCS,99492,1st psyc collab care mgmt,,,45.19,57.08,6
HCPCS,994920,1ST PSYC COLLAB CARE MGMT,,,78.82,78.82,1
HCPCS,99493,SBSQ PSYC COLLAB CARE MGMT,,,86.18,200.56,15
HCPCS,99493,SBSQ PSYCHIATRIC COLLAB CARE MGMT 1ST 60 MINS,902.0,586.3,91.86,676.5,30
HCPCS,99493,Sbsq psyc collab care mgmt,,,45.19,57.08,6
HCPCS,994930,SBSQ PSYC COLLAB CARE MGMT,,,86.18,86.18,1
HCPCS,99494,1ST/SBSQ PSYC COLLAB CARE,,,34.45,34.45,1
HCPCS,99494,1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS,361.0,234.65,37.31,270.75,30
HCPCS,99494,1st/sbsq psyc collab care,,,45.19,57.08,6
HCPCS,994940,1ST/SBSQ PSYC COLLAB CARE,,,34.45,34.45,1
HCPCS,99495,TRANSJ CARE MGMT MOD F2F 14D,,,117.47,117.47,1
HCPCS,99495,TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE,1111.5,722.4749999999999,75.64,999.9,65
HCPCS,994950,TRANSJ CARE MGMT MOD F2F 14D,,,117.47,117.47,1
HCPCS,99496,TRANSJ CARE MGMT HIGH F2F 7D,,,159.57,159.57,1
HCPCS,99496,TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE,1313.5,853.775,75.64,1137.0,65
HCPCS,994960,TRANSJ CARE MGMT HIGH F2F 7D,,,159.57,159.57,1
HCPCS,99497,ADVANCE CARE PLANNING FIRST 30 MINS,699.0,454.35,53.12,718.2,66
HCPCS,99497,ADVNCD CARE PLAN 30 MIN,,,63.28,63.28,1
HCPCS,994970,ADVNCD CARE PLAN 30 MIN,,,63.28,63.28,1
HCPCS,99498,ADVANCE CARE PLANNING EA ADDL 30 MINS,341.5,221.975,20.66,560.0,56
HCPCS,99498,ADVNCD CARE PLAN ADDL 30 MIN,,,59.58,59.58,1
HCPCS,994980,ADVNCD CARE PLAN ADDL 30 MIN,,,59.58,59.58,1
HCPCS,99499,COSMETIC ASSESSMENT,121.0,78.65,60.5,121.0,12
HCPCS,99499,COSMETIC CONSULT,122.0,79.3,61.0,122.0,12
HCPCS,99499,COSMETIC ESTABLISHED,75.0,48.75,37.5,75.0,12
HCPCS,99499,FOLLOW COSMETIC CONSULT,124.0,80.6,62.0,124.0,12
HCPCS,99499,LASIK EVALUATION,194.0,126.1,97.0,194.0,12
HCPCS,99499,MARITIME TELEPHONE CONSULT,297.0,193.05,148.5,297.0,12
HCPCS,99499,NO SHOW APPOINTMENT HOLDING FEE VA ONLY,113.0,73.45,56.5,113.0,12
HCPCS,99499,PILOT EXAMINATION,124.0,80.6,62.0,124.0,12
HCPCS,99499,SPORTS EXAM OR PHYSICAL,35.0,22.75,17.5,35.0,12
HCPCS,99500,HOME VISIT PRENATAL,,,54.0,54.0,1
HCPCS,995000,HOME VISIT PRENATAL,,,54.0,54.0,1
HCPCS,99501,HOME VISIT POSTNATAL,,,54.0,54.0,1
HCPCS,995010,HOME VISIT POSTNATAL,,,54.0,54.0,1
HCPCS,99502,HOME VISIT NB CARE,,,54.0,54.0,1
HCPCS,995020,HOME VISIT NB CARE,,,54.0,54.0,1
HCPCS,99503,HOME VISIT RESP THERAPY,,,27.0,27.0,1
HCPCS,995030,HOME VISIT RESP THERAPY,,,27.0,27.0,1
HCPCS,99504,HOME VISIT MECH VENTILATOR,,,27.0,27.0,1
HCPCS,995040,HOME VISIT MECH VENTILATOR,,,27.0,27.0,1
HCPCS,99505,HOME VISIT STOMA CARE,,,27.0,27.0,1
HCPCS,995050,HOME VISIT STOMA CARE,,,27.0,27.0,1
HCPCS,99506,HOME VISIT IM INJECTION,,,27.0,27.0,1
HCPCS,995060,HOME VISIT IM INJECTION,,,27.0,27.0,1
HCPCS,99507,HOME VISIT CATH MAINTAIN,,,27.0,27.0,1
HCPCS,995070,HOME VISIT CATH MAINTAIN,,,27.0,27.0,1
HCPCS,99509,HOME VISIT DAY LIFE ACTIVITY,,,10.8,10.8,1
HCPCS,995090,HOME VISIT DAY LIFE ACTIVITY,,,10.8,10.8,1
HCPCS,99510,HOME VISIT SING/M/FAM COUNS,,,117.0,117.0,1
HCPCS,995100,HOME VISIT SING/M/FAM COUNS,,,117.0,117.0,1
HCPCS,99511,HOME VISIT FECAL/ENEMA MGMT,,,27.0,27.0,1
HCPCS,995110,HOME VISIT FECAL/ENEMA MGMT,,,27.0,27.0,1
HCPCS,99512,HOME VISIT FOR HEMODIALYSIS,,,27.0,27.0,1
HCPCS,995120,HOME VISIT FOR HEMODIALYSIS,,,27.0,27.0,1
HCPCS,99600,UNLISTED HOME VISIT SVC/PX,,,27.0,27.0,1
HCPCS,996000,UNLISTED HOME VISIT SVC/PX,,,27.0,27.0,1
HCPCS,99601,HOME NFS VISIT <2 HRS,,,64.8,64.8,1
HCPCS,996010,HOME NFS VISIT <2 HRS,,,64.8,64.8,1
HCPCS,99602,HOME NFS VISIT EACH ADDL HR,,,32.4,32.4,1
HCPCS,996020,HOME NFS VISIT EACH ADDL HR,,,32.4,32.4,1
HCPCS,99605,MTMS BY PHARM NP 15 MIN,,,66.46,66.46,1
HCPCS,996050,MTMS BY PHARM NP 15 MIN,,,66.46,66.46,1
HCPCS,99606,MTMS BY PHARM EST 15 MIN,,,36.67,36.67,1
HCPCS,996060,MTMS BY PHARM EST 15 MIN,,,36.67,36.67,1
HCPCS,99607,MTMS BY PHARM ADDL 15 MIN,,,44.42,44.42,1
HCPCS,996070,MTMS BY PHARM ADDL 15 MIN,,,44.42,44.42,1
HCPCS,A0021,Outside state ambulance serv,,,6.1,6.1,1
HCPCS,A00210,Outside state ambulance serv,,,6.1,6.1,1
HCPCS,A0080,Noninterest escort in non er,,,1.53,1.53,1
HCPCS,A00800,Noninterest escort in non er,,,1.53,1.53,1
HCPCS,A0090,Interest escort in non er,,,0.77,0.77,1
HCPCS,A00900,Interest escort in non er,,,0.77,0.77,1
HCPCS,A0100,Nonemergency transport taxi,,,10.61,10.61,1
HCPCS,A01000,Nonemergency transport taxi,,,10.61,10.61,1
HCPCS,A0110,Nonemergency transport bus,,,34.35,34.35,1
HCPCS,A01100,Nonemergency transport bus,,,34.35,34.35,1
HCPCS,A0120,Noner transport mini-bus,,,27.08,27.08,1
HCPCS,A01200,Noner transport mini-bus,,,27.08,27.08,1
HCPCS,A0130,Noner transport wheelch van,,,6.39,6.39,1
HCPCS,A01300,Noner transport wheelch van,,,6.39,6.39,1
HCPCS,A0140,Nonemergency transport air,,,64.82,64.82,1
HCPCS,A01400,Nonemergency transport air,,,64.82,64.82,1
HCPCS,A0160,Noner transport case worker,,,0.32,0.32,1
HCPCS,A01600,Noner transport case worker,,,0.32,0.32,1
HCPCS,A0170,Transport parking fees/tolls,,,19.44,19.44,1
HCPCS,A01700,Transport parking fees/tolls,,,19.44,19.44,1
HCPCS,A0180,Noner transport lodgng recip,,,84.52,84.52,1
HCPCS,A01800,Noner transport lodgng recip,,,84.52,84.52,1
HCPCS,A0190,Noner transport meals recip,,,17.64,17.64,1
HCPCS,A01900,Noner transport meals recip,,,17.64,17.64,1
HCPCS,A0200,Noner transport lodgng escrt,,,86.09,86.09,1
HCPCS,A02000,Noner transport lodgng escrt,,,86.09,86.09,1
HCPCS,A0210,Noner transport meals escort,,,15.39,15.39,1
HCPCS,A02100,Noner transport meals escort,,,15.39,15.39,1
HCPCS,A0225,Neonatal emergency transport,,,347.27,511.57,4
HCPCS,A02250,Neonatal emergency transport,,,347.27,347.27,1
HCPCS,A0380,Basic life support mileage,,,5.13,7.56,4
HCPCS,A03800,Basic life support mileage,,,5.13,5.13,1
HCPCS,A0382,Basic support routine suppls,,,7.06,7.06,1
HCPCS,A03820,Basic support routine suppls,,,7.06,7.06,1
HCPCS,A0384,Bls defibrillation supplies,,,35.63,35.63,1
HCPCS,A03840,Bls defibrillation supplies,,,35.63,35.63,1
HCPCS,A0390,Advanced life support mileag,,,5.13,7.56,4
HCPCS,A03900,Advanced life support mileag,,,5.13,5.13,1
HCPCS,A0392,Als defibrillation supplies,,,35.63,35.63,1
HCPCS,A03920,Als defibrillation supplies,,,35.63,35.63,1
HCPCS,A0394,Als iv drug therapy supplies,,,17.01,17.01,1
HCPCS,A03940,Als iv drug therapy supplies,,,17.01,17.01,1
HCPCS,A0396,Als esophageal intub suppls,,,28.24,28.24,1
HCPCS,A03960,Als esophageal intub suppls,,,28.24,28.24,1
HCPCS,A0398,Als routine disposble suppls,,,7.06,7.06,1
HCPCS,A03980,Als routine disposble suppls,,,7.06,7.06,1
HCPCS,A0420,Ambulance waiting 1/2 hr,,,63.55,63.55,1
HCPCS,A04200,Ambulance waiting 1/2 hr,,,63.55,63.55,1
HCPCS,A0422,Ambulance 02 life sustaining,,,26.32,26.32,1
HCPCS,A04220,Ambulance 02 life sustaining,,,26.32,26.32,1
HCPCS,A0424,Extra ambulance attendant,,,17.76,222.46,4
HCPCS,A04240,Extra ambulance attendant,,,17.76,17.76,1
HCPCS,A0425,Ground mileage,,,5.13,15.29,4
HCPCS,A04250,Ground mileage,,,5.13,5.13,1
HCPCS,A0426,Als 1,,,263.51,569.79,4
HCPCS,A04260,Als 1,,,263.51,263.51,1
HCPCS,A0427,Als1-emergency,,,276.99,902.19,4
HCPCS,A04270,Als1-emergency,,,276.99,276.99,1
HCPCS,A0428,Bls,,,231.74,474.83,4
HCPCS,A04280,Bls,,,231.74,231.74,1
HCPCS,A0429,Bls-emergency,,,240.4,759.74,4
HCPCS,A04290,Bls-emergency,,,240.4,240.4,1
HCPCS,A0430,Fixed wing air transport,,,5832.01,6319.91,4
HCPCS,A04300,Fixed wing air transport,,,6119.54,6119.54,1
HCPCS,A0431,Rotary wing air transport,,,6780.61,7347.85,4
HCPCS,A04310,Rotary wing air transport,,,7114.89,7114.89,1
HCPCS,A0432,Pi volunteer ambulance co,,,546.49,830.95,4
HCPCS,A04320,Pi volunteer ambulance co,,,546.49,546.49,1
HCPCS,A0433,Als 2,,,858.77,1305.79,4
HCPCS,A04330,Als 2,,,858.77,858.77,1
HCPCS,A0434,Specialty care transport,,,1014.91,1543.2,4
HCPCS,A04340,Specialty care transport,,,1014.91,1014.91,1
HCPCS,A0435,Fixed wing air mileage,,,16.58,17.96,4
HCPCS,A04350,Fixed wing air mileage,,,17.01,17.01,1
HCPCS,A0436,Rotary wing air mileage,,,44.19,47.89,4
HCPCS,A04360,Rotary wing air mileage,,,45.35,45.35,1
HCPCS,A0888,Noncovered ambulance mileage,,,7.05,7.05,1
HCPCS,A08880,Noncovered ambulance mileage,,,7.05,7.05,1
HCPCS,A0998,Ambulance response/treatment,,,92.62,121.42,4
HCPCS,A09980,Ambulance response/treatment,,,121.42,121.42,1
HCPCS,A2001,"Innovamatrix ac, per sq cm",,,129.95,3288.0,8
HCPCS,A20010,"Innovamatrix ac, per sq cm",,,1296.0,1296.0,1
HCPCS,A2002,Mirragen adv wnd mat per sq,,,114.53,142.95,5
HCPCS,A20020,Mirragen adv wnd mat per sq,,,114.53,114.53,1
HCPCS,A2004,"Xcellistem, 1 mg",,,13.48,34.2,4
HCPCS,A20040,"Xcellistem, 1 mg",,,13.48,13.48,1
HCPCS,A2005,"Microlyte matrix, per sq cm",,,129.95,167.54,5
HCPCS,A20050,"Microlyte matrix, per sq cm",,,167.54,167.54,1
HCPCS,A2006,Novosorb synpath per sq cm,,,129.95,142.95,4
HCPCS,A2007,"Restrata, per sq cm",,,129.95,530.46,8
HCPCS,A20070,"Restrata, per sq cm",,,209.09,209.09,1
HCPCS,A2008,"Theragenesis, per sq cm",,,129.95,390.12,8
HCPCS,A20080,"Theragenesis, per sq cm",,,153.77,153.77,1
HCPCS,A2009,"Symphony, per sq cm",,,110.16,142.95,5
HCPCS,A20090,"Symphony, per sq cm",,,110.16,110.16,1
HCPCS,A2010,"Apis, per square centimeter",,,129.95,142.95,4
HCPCS,A2011,"Supra sdrm, per sq cm",,,129.95,371.52,5
HCPCS,A20110,"Supra sdrm, per sq cm",,,371.52,371.52,1
HCPCS,A2012,"Suprathel, per sq cm",,,129.95,142.95,4
HCPCS,A2013,"Innovamatrix fs, per sq cm",,,129.95,3551.04,8
HCPCS,A20130,"Innovamatrix fs, per sq cm",,,1399.68,1399.68,1
HCPCS,A2014,Omeza collag compl 100 mg,,,132.84,337.02,4
HCPCS,A20140,Omeza collag compl 100 mg,,,132.84,132.84,1
HCPCS,A2015,"Phoenix wnd mtrx, per sq cm",,,129.95,607.99,5
HCPCS,A20150,"Phoenix wnd mtrx, per sq cm",,,607.99,607.99,1
HCPCS,A2016,"Permeaderm b, per sq cm",,,129.95,142.95,4
HCPCS,A2018,"Permeaderm c, per sq cm",,,129.95,142.95,4
HCPCS,A2019,Kerecis marigen shld sq cm,,,129.95,1566.13,8
HCPCS,A20190,Kerecis marigen shld sq cm,,,617.31,617.31,1
HCPCS,A2021,Neomatrix per sq cm,,,129.95,4535.41,8
HCPCS,A20210,Neomatrix per sq cm,,,1787.68,1787.68,1
HCPCS,A2022,Innovabrn/innovamatx xl sqcm,,,129.95,3748.32,8
HCPCS,A20220,Innovabrn/innovamatx xl sqcm,,,1477.44,1477.44,1
HCPCS,A2023,"Innovamatrix pd, 1 mg",,,16.85,42.74,4
HCPCS,A20230,"Innovamatrix pd, 1 mg",,,16.85,16.85,1
HCPCS,A2024,Resolve or xenopatch sq cm,,,129.95,1277.28,5
HCPCS,A20240,Resolve or xenopatch sq cm,,,1277.28,1277.28,1
HCPCS,A2025,Miro3d per cubic cm,,,129.95,548.0,8
HCPCS,A20250,Miro3d per cubic cm,,,216.0,216.0,1
HCPCS,A2027,Matriderm per sq cm,,,129.95,142.95,4
HCPCS,A2028,Micromatrix flex per mg,,,811.19,2058.01,4
HCPCS,A20280,Micromatrix flex per mg,,,811.19,811.19,1
HCPCS,A2029,Mirotract matrix sheet,,,129.95,1096.0,8
HCPCS,A20290,Mirotract matrix sheet,,,432.0,432.0,1
HCPCS,A2030,"Miro3d fibers, per mg",,,4.75,12.06,4
HCPCS,A20300,"Miro3d fibers, per mg",,,4.75,4.75,1
HCPCS,A2031,"Mirodry, per sq cm",,,129.95,1315.2,8
HCPCS,A20310,"Mirodry, per sq cm",,,518.4,518.4,1
HCPCS,A2032,"Myriad matrix, per sq cm",,,17.88,45.37,4
HCPCS,A20320,"Myriad matrix, per sq cm",,,17.88,17.88,1
HCPCS,A2033,"Myriad morcells, 4 mg",,,11.4,28.93,4
HCPCS,A20330,"Myriad morcells, 4 mg",,,11.4,11.4,1
HCPCS,A2036,Cohealyx col dml mx pr sq cm,,,129.95,142.95,4
HCPCS,A2038,"Marigen pacto, per sq cm",,,129.95,142.95,4
HCPCS,A2039,"Innovamatrix fd, per sq cm",,,129.95,142.95,4
HCPCS,A4100,Nosht skin sub fda clrd nos,,,3.24,3.24,1
HCPCS,A41000,Nosht skin sub fda clrd nos,,,3.24,3.24,1
HCPCS,A4206,1 cc sterile syringe&needle,,,0.22,0.22,2
HCPCS,A42060,1 cc sterile syringe&needle,,,0.22,0.22,1
HCPCS,A4206NU,1 cc sterile syringe&needle,,,0.22,0.22,1
HCPCS,A4207,2 cc sterile syringe&needle,,,0.16,0.16,1
HCPCS,A42070,2 cc sterile syringe&needle,,,0.16,0.16,1
HCPCS,A4208,3 cc sterile syringe&needle,,,0.22,0.22,2
HCPCS,A42080,3 cc sterile syringe&needle,,,0.22,0.22,1
HCPCS,A4208NU,3 cc sterile syringe&needle,,,0.22,0.22,1
HCPCS,A4209,5+ cc sterile syringe&needle,,,0.22,0.22,2
HCPCS,A42090,5+ cc sterile syringe&needle,,,0.22,0.22,1
HCPCS,A4209NU,5+ cc sterile syringe&needle,,,0.22,0.22,1
HCPCS,A4210,Nonneedle injection device,,,367.44,816.05,7
HCPCS,A42100,Nonneedle injection device,,,367.44,367.44,1
HCPCS,A4210NU,Nonneedle injection device,,,740.67,802.63,3
HCPCS,A4211,Supp for self-adm injections,,,2.7,2.7,3
HCPCS,A42110,Supp for self-adm injections,,,2.7,2.7,1
HCPCS,A4211NU,Supp for self-adm injections,,,2.7,2.7,1
HCPCS,A4211RR,Supp for self-adm injections,,,2.7,2.7,1
HCPCS,A4212,Non coring needle or stylet,,,3.62,3.62,1
HCPCS,A42120,Non coring needle or stylet,,,3.62,3.62,1
HCPCS,A4213,20+ cc syringe only,,,0.42,0.42,1
HCPCS,A42130,20+ cc syringe only,,,0.42,0.42,1
HCPCS,A4215,STERILE NEEDLE,252.0,163.8,126.0,252.0,12
HCPCS,A4215,Sterile needle,,,0.16,0.16,1
HCPCS,A42150,Sterile needle,,,0.16,0.16,1
HCPCS,A4216,"Sterile water/saline, 10 ml",,,0.03,0.37,3
HCPCS,A42160,"Sterile water/saline, 10 ml",,,0.37,0.37,1
HCPCS,A4216NU,"Sterile water/saline, 10 ml",,,0.37,0.37,1
HCPCS,A4216RR,"Sterile water/saline, 10 ml",,,0.03,0.03,1
HCPCS,A4217,"Sterile water/saline, 500 ml",,,1.3,3.0,3
HCPCS,A42170,"Sterile water/saline, 500 ml",,,3.0,3.0,1
HCPCS,A4217AU,"Sterile water/saline, 500 ml",,,1.3,1.3,1
HCPCS,A4217NU,"Sterile water/saline, 500 ml",,,3.0,3.0,1
HCPCS,A4218,Sterile saline or water,,,1.89,1.89,1
HCPCS,A42180,Sterile saline or water,,,1.89,1.89,1
HCPCS,A4220,Infusion pump refill kit,,,21.6,21.6,1
HCPCS,A42200,Infusion pump refill kit,,,21.6,21.6,1
HCPCS,A4221,Supp non-insulin inf cath/wk,,,17.17,17.17,1
HCPCS,A42210,Supp non-insulin inf cath/wk,,,17.17,17.17,1
HCPCS,A4222,Infusion supplies with pump,,,32.56,32.56,1
HCPCS,A42220,Infusion supplies with pump,,,32.56,32.56,1
HCPCS,A4223,Infusion supplies w/o pump,,,21.6,21.6,1
HCPCS,A42230,Infusion supplies w/o pump,,,21.6,21.6,1
HCPCS,A4224,Supply insulin inf cath/wk,,,17.17,17.17,1
HCPCS,A42240,Supply insulin inf cath/wk,,,17.17,17.17,1
HCPCS,A4225,Sup/ext insulin inf pump syr,,,2.3,2.3,1
HCPCS,A42250,Sup/ext insulin inf pump syr,,,2.3,2.3,1
HCPCS,A4226,Weekly supply maint cgs pump,,,14.04,14.04,1
HCPCS,A42260,Weekly supply maint cgs pump,,,14.04,14.04,1
HCPCS,A4230,Infus insulin pump non needl,,,12.96,12.96,1
HCPCS,A42300,Infus insulin pump non needl,,,12.96,12.96,1
HCPCS,A4231,Infusion insulin pump needle,,,24.61,62.44,4
HCPCS,A42310,Infusion insulin pump needle,,,24.61,24.61,1
HCPCS,A4232,Syringe w/needle insulin 3cc,,,0.99,0.99,1
HCPCS,A42320,Syringe w/needle insulin 3cc,,,0.99,0.99,1
HCPCS,A4233,Alkalin batt for glucose mon,,,0.36,0.61,11
HCPCS,A42330,Alkalin batt for glucose mon,,,0.36,0.36,1
HCPCS,A4233NU,Alkalin batt for glucose mon,,,0.36,0.61,4
HCPCS,A4233UE,Alkalin batt for glucose mon,,,0.42,0.46,3
HCPCS,A4234,J-cell batt for glucose mon,,,1.65,3.31,11
HCPCS,A42340,J-cell batt for glucose mon,,,1.65,1.65,1
HCPCS,A4234NU,J-cell batt for glucose mon,,,1.65,3.26,4
HCPCS,A4234UE,J-cell batt for glucose mon,,,2.25,2.44,3
HCPCS,A4235,Lithium batt for glucose mon,,,0.7,1.21,11
HCPCS,A42350,Lithium batt for glucose mon,,,0.7,0.7,1
HCPCS,A4235NU,Lithium batt for glucose mon,,,0.7,1.21,4
HCPCS,A4235UE,Lithium batt for glucose mon,,,0.84,0.91,3
HCPCS,A4236,Silvr oxide batt glucose mon,,,0.81,1.32,11
HCPCS,A42360,Silvr oxide batt glucose mon,,,0.81,0.81,1
HCPCS,A4236NU,Silvr oxide batt glucose mon,,,0.81,1.32,4
HCPCS,A4236UE,Silvr oxide batt glucose mon,,,0.91,0.99,3
HCPCS,A4238,Adju cgm supply allowance,,,174.78,459.88,4
HCPCS,A42380,Adju cgm supply allowance,,,174.78,174.78,1
HCPCS,A4238KF,Adju cgm supply allowance,,,424.37,459.88,3
HCPCS,A4239,Non-adju cgm supply allow,,,183.68,520.92,7
HCPCS,A42390,Non-adju cgm supply allow,,,183.68,183.68,1
HCPCS,A4239KF,Non-adju cgm supply allow,,,480.7,520.92,3
HCPCS,A4244,Alcohol or peroxide per pint,,,0.42,0.42,1
HCPCS,A42440,Alcohol or peroxide per pint,,,0.42,0.42,1
HCPCS,A4245,Alcohol wipes per box,,,1.27,1.27,1
HCPCS,A42450,Alcohol wipes per box,,,1.27,1.27,1
HCPCS,A4246,Betadine/phisohex solution,,,1.27,1.27,1
HCPCS,A42460,Betadine/phisohex solution,,,1.27,1.27,1
HCPCS,A4247,Betadine/iodine swabs/wipes,,,1.91,1.91,1
HCPCS,A42470,Betadine/iodine swabs/wipes,,,1.91,1.91,1
HCPCS,A4248,Chlorhexidine antisept,,,0.02,0.05,4
HCPCS,A42480,Chlorhexidine antisept,,,0.02,0.02,1
HCPCS,A4250,Urine reagent strips/tablets,,,7.45,18.11,7
HCPCS,A42500,Urine reagent strips/tablets,,,7.45,7.45,1
HCPCS,A4250NU,Urine reagent strips/tablets,,,16.71,18.11,3
HCPCS,A4252,Blood ketone test or strip,,,1.33,12.64,4
HCPCS,A42520,Blood ketone test or strip,,,12.64,12.64,1
HCPCS,A4253,Blood glucose/reagent strips,,,5.84,5.84,2
HCPCS,A42530,Blood glucose/reagent strips,,,5.84,5.84,1
HCPCS,A4253NU,Blood glucose/reagent strips,,,5.84,5.84,1
HCPCS,A4255,Glucose monitor platforms,,,3.75,3.75,1
HCPCS,A42550,Glucose monitor platforms,,,3.75,3.75,1
HCPCS,A4256,Calibrator solution/chips,,,2.38,2.38,1
HCPCS,A42560,Calibrator solution/chips,,,2.38,2.38,1
HCPCS,A4257,Replace lensshield cartridge,,,10.95,12.23,4
HCPCS,A42570,Replace lensshield cartridge,,,12.23,12.23,1
HCPCS,A4258,Lancet device each,,,1.49,1.49,1
HCPCS,A42580,Lancet device each,,,1.49,1.49,1
HCPCS,A4259,Lancets per box,,,0.99,0.99,1
HCPCS,A42590,Lancets per box,,,0.99,0.99,1
HCPCS,A4261,Cervical cap contraceptive,,,7.49,86.4,4
HCPCS,A42610,Cervical cap contraceptive,,,86.4,86.4,1
HCPCS,A4262,Temporary tear duct plug,,,0.22,0.22,1
HCPCS,A42620,Temporary tear duct plug,,,0.22,0.22,1
HCPCS,A4263,PERMANENT TEAR DUCT PLUG,68.0,44.2,10.63,68.0,13
HCPCS,A4263,Permanent tear duct plug,,,17.03,17.03,1
HCPCS,A42630,Permanent tear duct plug,,,17.03,17.03,1
HCPCS,A4264,Intratubal occlusion device,,,2352.6,2352.6,1
HCPCS,A4264,PR INTRATUBAL OCCLUSION DEVICE,3891.0,2529.15,1945.5,3891.0,12
HCPCS,A42640,Intratubal occlusion device,,,2352.6,2352.6,1
HCPCS,A4265,Paraffin,,,3.26,3.26,1
HCPCS,A42650,Paraffin,,,3.26,3.26,1
HCPCS,A4266,Diaphragm,,,40.98,62.69,4
HCPCS,A42660,Diaphragm,,,40.98,40.98,1
HCPCS,A4267,Male condom,,,0.22,0.22,1
HCPCS,A42670,Male condom,,,0.22,0.22,1
HCPCS,A4268,Female condom,,,0.16,1.05,4
HCPCS,A42680,Female condom,,,1.05,1.05,1
HCPCS,A4269,Spermicide,,,0.42,0.95,4
HCPCS,A42690,Spermicide,,,0.42,0.42,1
HCPCS,A4270,DISPOSABLE ENDOSCOPE SHEATH,135.0,87.75,67.5,135.0,12
HCPCS,A4270,Disposable endoscope sheath,,,27.97,27.97,1
HCPCS,A42700,Disposable endoscope sheath,,,27.97,27.97,1
HCPCS,A4271,Home lancing/test cartridges,,,22.92,55.86,4
HCPCS,A42710,Home lancing/test cartridges,,,22.92,22.92,1
HCPCS,A4280,Brst prsths adhsv attchmnt,,,5.11,5.11,1
HCPCS,A42800,Brst prsths adhsv attchmnt,,,5.11,5.11,1
HCPCS,A4281,Replacement breastpump tube,,,13.21,21.6,5
HCPCS,A42810,Replacement breastpump tube,,,21.6,21.6,1
HCPCS,A4281NU,Replacement breastpump tube,,,21.6,21.6,1
HCPCS,A4282,Replacement breastpump adpt,,,15.06,21.6,5
HCPCS,A42820,Replacement breastpump adpt,,,21.6,21.6,1
HCPCS,A4282NU,Replacement breastpump adpt,,,21.6,21.6,1
HCPCS,A4283,Replacement breastpump cap,,,3.24,10.8,5
HCPCS,A42830,Replacement breastpump cap,,,10.8,10.8,1
HCPCS,A4283NU,Replacement breastpump cap,,,10.8,10.8,1
HCPCS,A4284,Replcmnt breast pump shield,,,5.44,7.45,5
HCPCS,A42840,Replcmnt breast pump shield,,,7.45,7.45,1
HCPCS,A4284NU,Replcmnt breast pump shield,,,7.45,7.45,1
HCPCS,A4285,Replcmnt breast pump bottle,,,5.06,13.5,5
HCPCS,A42850,Replcmnt breast pump bottle,,,13.5,13.5,1
HCPCS,A4285NU,Replcmnt breast pump bottle,,,13.5,13.5,1
HCPCS,A4286,Replcmnt breastpump lok ring,,,4.05,10.8,5
HCPCS,A42860,Replcmnt breastpump lok ring,,,10.8,10.8,1
HCPCS,A4286NU,Replcmnt breastpump lok ring,,,10.8,10.8,1
HCPCS,A4287,Disp col sto bag breast milk,,,0.27,0.27,1
HCPCS,A42870,Disp col sto bag breast milk,,,0.27,0.27,1
HCPCS,A4290,Sacral nerve stim test lead,,,62.28,62.28,1
HCPCS,A42900,Sacral nerve stim test lead,,,62.28,62.28,1
HCPCS,A4295,Straigh tip hydrophilic cath,,,1.71,1.71,1
HCPCS,A42950,Straigh tip hydrophilic cath,,,1.71,1.71,1
HCPCS,A4300,Cath impl vasc access portal,,,17.56,17.56,1
HCPCS,A43000,Cath impl vasc access portal,,,17.56,17.56,1
HCPCS,A4301,Implantable access syst perc,,,36.0,36.0,1
HCPCS,A43010,Implantable access syst perc,,,36.0,36.0,1
HCPCS,A4305,Drug delivery system >=50 ml,,,5.53,5.53,1
HCPCS,A43050,Drug delivery system >=50 ml,,,5.53,5.53,1
HCPCS,A4306,Drug delivery system <=50 ml,,,7.67,7.67,1
HCPCS,A43060,Drug delivery system <=50 ml,,,7.67,7.67,1
HCPCS,A4310,INSERT TRAY W/O BAG/CATH,11.0,7.15,3.58,11.0,17
HCPCS,A4310,Insert tray w/o bag/cath,,,7.4,7.4,1
HCPCS,A43100,Insert tray w/o bag/cath,,,7.4,7.4,1
HCPCS,A4311,Catheter w/o bag 2-way latex,,,14.19,14.19,1
HCPCS,A43110,Catheter w/o bag 2-way latex,,,14.19,14.19,1
HCPCS,A4312,Cath w/o bag 2-way silicone,,,17.28,17.28,1
HCPCS,A43120,Cath w/o bag 2-way silicone,,,17.28,17.28,1
HCPCS,A4313,Catheter w/bag 3-way,,,17.74,17.74,1
HCPCS,A43130,Catheter w/bag 3-way,,,17.74,17.74,1
HCPCS,A4314,Cath w/drainage 2-way latex,,,24.21,24.21,1
HCPCS,A43140,Cath w/drainage 2-way latex,,,24.21,24.21,1
HCPCS,A4315,Cath w/drainage 2-way silcne,,,25.26,25.26,1
HCPCS,A43150,Cath w/drainage 2-way silcne,,,25.26,25.26,1
HCPCS,A4316,Cath w/drainage 3-way,,,27.21,27.21,1
HCPCS,A43160,Cath w/drainage 3-way,,,27.21,27.21,1
HCPCS,A4320,IRRIGATION TRAY,7.0,4.55,2.92,7.0,17
HCPCS,A4320,Irrigation tray,,,4.56,4.56,1
HCPCS,A43200,Irrigation tray,,,4.56,4.56,1
HCPCS,A4321,Cath therapeutic irrig agent,,,2.41,2.41,1
HCPCS,A43210,Cath therapeutic irrig agent,,,2.41,2.41,1
HCPCS,A4322,Irrigation syringe,,,2.79,2.79,1
HCPCS,A43220,Irrigation syringe,,,2.79,2.79,1
HCPCS,A4326,Male external catheter,,,9.94,9.94,1
HCPCS,A43260,Male external catheter,,,9.94,9.94,1
HCPCS,A4327,Fem urinary collect dev cup,,,40.49,40.49,1
HCPCS,A43270,Fem urinary collect dev cup,,,40.49,40.49,1
HCPCS,A4328,Fem urinary collect pouch,,,9.07,9.07,1
HCPCS,A43280,Fem urinary collect pouch,,,9.07,9.07,1
HCPCS,A4330,Stool collection pouch,,,5.83,5.83,1
HCPCS,A43300,Stool collection pouch,,,5.83,5.83,1
HCPCS,A4331,Extension drainage tubing,,,3.05,3.05,1
HCPCS,A43310,Extension drainage tubing,,,3.05,3.05,1
HCPCS,A4332,Lube sterile packet,,,0.11,0.11,1
HCPCS,A43320,Lube sterile packet,,,0.11,0.11,1
HCPCS,A4333,Urinary cath anchor device,,,2.13,2.13,1
HCPCS,A43330,Urinary cath anchor device,,,2.13,2.13,1
HCPCS,A4334,Urinary cath leg strap,,,4.71,4.71,1
HCPCS,A43340,Urinary cath leg strap,,,4.71,4.71,1
HCPCS,A4335,Incontinence supply,,,0.55,0.55,1
HCPCS,A43350,Incontinence supply,,,0.55,0.55,1
HCPCS,A4336,Urethral insert,,,1.37,1.37,1
HCPCS,A43360,Urethral insert,,,1.37,1.37,1
HCPCS,A4337,Incontinent rectal insert,,,11.88,11.88,1
HCPCS,A43370,Incontinent rectal insert,,,11.88,11.88,1
HCPCS,A4338,INDWELLING CATHETER LATEX,19.0,12.35,6.7,19.0,17
HCPCS,A4338,Indwelling catheter latex,,,11.75,11.75,1
HCPCS,A43380,Indwelling catheter latex,,,11.75,11.75,1
HCPCS,A4340,Indwelling catheter special,,,25.84,25.84,1
HCPCS,A43400,Indwelling catheter special,,,25.84,25.84,1
HCPCS,A4341,Iduc valve pat inst repl,,,233.72,233.72,1
HCPCS,A43410,Iduc valve pat inst repl,,,233.72,233.72,1
HCPCS,A4342,Iduc valve sply repl,,,590.14,590.14,1
HCPCS,A43420,Iduc valve sply repl,,,590.14,590.14,1
HCPCS,A4344,CATH INDW FOLEY 2 WAY SILICN,26.0,16.9,8.74,26.0,17
HCPCS,A4344,Cath indw foley 2 way silicn,,,15.34,15.34,1
HCPCS,A43440,Cath indw foley 2 way silicn,,,15.34,15.34,1
HCPCS,A4346,Cath indw foley 3 way,,,18.76,18.76,1
HCPCS,A43460,Cath indw foley 3 way,,,18.76,18.76,1
HCPCS,A4349,Disposable male external cat,,,1.92,1.92,1
HCPCS,A43490,Disposable male external cat,,,1.92,1.92,1
HCPCS,A4351,FEMALE SELF-CATHETER,3.0,1.95,0.99,3.0,17
HCPCS,A4351,STRAIGHT ROBINSON,6.0,3.9,0.99,6.0,17
HCPCS,A4351,STRAIGHT TIP URINE CATHETER,3.0,1.95,0.99,3.0,17
HCPCS,A4351,Straight tip urine catheter,,,1.63,1.63,1
HCPCS,A43510,Straight tip urine catheter,,,1.63,1.63,1
HCPCS,A4352,COUDE TIP URINARY CATHETER,9.0,5.85,2.98,9.0,17
HCPCS,A4352,Coude tip urinary catheter,,,5.23,5.23,1
HCPCS,A43520,Coude tip urinary catheter,,,5.23,5.23,1
HCPCS,A4353,Intermittent urinary cath,,,6.7,6.7,1
HCPCS,A43530,Intermittent urinary cath,,,6.7,6.7,1
HCPCS,A4354,Cath insertion tray w/bag,,,11.31,11.31,1
HCPCS,A43540,Cath insertion tray w/bag,,,11.31,11.31,1
HCPCS,A4355,Bladder irrigation tubing,,,8.54,8.54,1
HCPCS,A43550,Bladder irrigation tubing,,,8.54,8.54,1
HCPCS,A4356,Ext ureth clmp or compr dvc,,,43.71,43.71,1
HCPCS,A43560,Ext ureth clmp or compr dvc,,,43.71,43.71,1
HCPCS,A4357,BEDSIDE DRAINAGE BAG,15.0,9.75,5.3,15.0,17
HCPCS,A4357,Bedside drainage bag,,,9.3,9.3,1
HCPCS,A43570,Bedside drainage bag,,,9.3,9.3,1
HCPCS,A4358,URINARY LEG BAG,13.0,8.45,3.62,13.0,17
HCPCS,A4358,Urinary leg or abdomen bag,,,6.35,6.35,1
HCPCS,A43580,Urinary leg or abdomen bag,,,6.35,6.35,1
HCPCS,A4360,Disposable ext urethral dev,,,0.48,0.48,1
HCPCS,A43600,Disposable ext urethral dev,,,0.48,0.48,1
HCPCS,A4361,Ostomy face plate,,,17.58,17.58,1
HCPCS,A43610,Ostomy face plate,,,17.58,17.58,1
HCPCS,A4362,SOLID SKIN BARRIER,9.0,5.85,1.86,9.0,17
HCPCS,A4362,Solid skin barrier,,,3.26,3.26,1
HCPCS,A4362,W OST SKIN BARIER,53.0,34.45,8.9,47.7,21
HCPCS,A4362,W OST SKIN PROTEC,131.0,85.15,22.01,117.9,21
HCPCS,A43620,Solid skin barrier,,,3.26,3.26,1
HCPCS,A4363,"Ostomy clamp, replacement",,,2.27,2.27,1
HCPCS,A43630,"Ostomy clamp, replacement",,,2.27,2.27,1
HCPCS,A4364,"Adhesive, liquid or equal",,,2.4,2.4,1
HCPCS,A4364,W OST ADHESV MEDC,74.0,48.1,12.43,66.6,21
HCPCS,A4364,W OST PASTE KARYA,15.0,9.75,2.52,13.5,21
HCPCS,A4364,W OST PASTE STMA,40.0,26.0,6.72,36.0,21
HCPCS,A4364,W OST SKIN BOND,65.0,42.25,10.92,58.5,21
HCPCS,A43640,"Adhesive, liquid or equal",,,2.4,2.4,1
HCPCS,A4366,Ostomy vent,,,1.23,1.23,1
HCPCS,A43660,Ostomy vent,,,1.23,1.23,1
HCPCS,A4367,Ostomy belt,,,7.05,7.05,1
HCPCS,A4367,W OST BLT A/S,34.0,22.1,5.71,30.6,21
HCPCS,A43670,Ostomy belt,,,7.05,7.05,1
HCPCS,A4368,Ostomy filter,,,0.24,0.24,1
HCPCS,A43680,Ostomy filter,,,0.24,0.24,1
HCPCS,A4369,Skin barrier liquid per oz,,,2.32,2.32,1
HCPCS,A43690,Skin barrier liquid per oz,,,2.32,2.32,1
HCPCS,A4371,SKIN BARRIER POWDER PER OZ,12.0,7.8,1.99,12.0,17
HCPCS,A4371,Skin barrier powder per oz,,,3.5,3.5,1
HCPCS,A4371,W OST POWDR KARYA,53.0,34.45,8.9,47.7,21
HCPCS,A43710,Skin barrier powder per oz,,,3.5,3.5,1
HCPCS,A4372,Skin barrier solid 4x4 equiv,,,4.02,4.02,1
HCPCS,A43720,Skin barrier solid 4x4 equiv,,,4.02,4.02,1
HCPCS,A4373,Skin barrier with flange,,,6.0,6.0,1
HCPCS,A43730,Skin barrier with flange,,,6.0,6.0,1
HCPCS,A4375,Drainable plastic pch w fcpl,,,16.45,16.45,1
HCPCS,A43750,Drainable plastic pch w fcpl,,,16.45,16.45,1
HCPCS,A4376,Drainable rubber pch w fcplt,,,45.58,45.58,1
HCPCS,A43760,Drainable rubber pch w fcplt,,,45.58,45.58,1
HCPCS,A4377,Drainable plstic pch w/o fp,,,4.1,4.1,1
HCPCS,A43770,Drainable plstic pch w/o fp,,,4.1,4.1,1
HCPCS,A4378,Drainable rubber pch w/o fp,,,29.45,29.45,1
HCPCS,A43780,Drainable rubber pch w/o fp,,,29.45,29.45,1
HCPCS,A4379,Urinary plastic pouch w fcpl,,,14.39,14.39,1
HCPCS,A43790,Urinary plastic pouch w fcpl,,,14.39,14.39,1
HCPCS,A4380,Urinary rubber pouch w fcplt,,,35.76,35.76,1
HCPCS,A43800,Urinary rubber pouch w fcplt,,,35.76,35.76,1
HCPCS,A4381,Urinary plastic pouch w/o fp,,,4.43,4.43,1
HCPCS,A43810,Urinary plastic pouch w/o fp,,,4.43,4.43,1
HCPCS,A4382,Urinary hvy plstc pch w/o fp,,,23.58,23.58,1
HCPCS,A43820,Urinary hvy plstc pch w/o fp,,,23.58,23.58,1
HCPCS,A4383,Urinary rubber pouch w/o fp,,,27.0,27.0,1
HCPCS,A43830,Urinary rubber pouch w/o fp,,,27.0,27.0,1
HCPCS,A4384,Ostomy faceplt/silicone ring,,,9.2,9.2,1
HCPCS,A43840,Ostomy faceplt/silicone ring,,,9.2,9.2,1
HCPCS,A4385,Ost skn barrier sld ext wear,,,4.88,4.88,1
HCPCS,A43850,Ost skn barrier sld ext wear,,,4.88,4.88,1
HCPCS,A4387,Ost clsd pouch w att st barr,,,2.16,2.16,1
HCPCS,A43870,Ost clsd pouch w att st barr,,,2.16,2.16,1
HCPCS,A4388,Drainable pch w ex wear barr,,,4.18,4.18,1
HCPCS,A43880,Drainable pch w ex wear barr,,,4.18,4.18,1
HCPCS,A4389,Drainable pch w st wear barr,,,5.95,5.95,1
HCPCS,A43890,Drainable pch w st wear barr,,,5.95,5.95,1
HCPCS,A4390,Drainable pch ex wear convex,,,9.2,9.2,1
HCPCS,A43900,Drainable pch ex wear convex,,,9.2,9.2,1
HCPCS,A4391,Urinary pouch w ex wear barr,,,6.77,6.77,1
HCPCS,A43910,Urinary pouch w ex wear barr,,,6.77,6.77,1
HCPCS,A4392,Urinary pouch w st wear barr,,,7.83,7.83,1
HCPCS,A43920,Urinary pouch w st wear barr,,,7.83,7.83,1
HCPCS,A4393,Urine pch w ex wear bar conv,,,8.65,8.65,1
HCPCS,A43930,Urine pch w ex wear bar conv,,,8.65,8.65,1
HCPCS,A4394,Ostomy pouch liq deodorant,,,2.48,2.48,1
HCPCS,A43940,Ostomy pouch liq deodorant,,,2.48,2.48,1
HCPCS,A4395,Ostomy pouch solid deodorant,,,0.03,0.03,1
HCPCS,A43950,Ostomy pouch solid deodorant,,,0.03,0.03,1
HCPCS,A4396,Peristomal hernia supprt blt,,,38.77,38.77,1
HCPCS,A43960,Peristomal hernia supprt blt,,,38.77,38.77,1
HCPCS,A4398,Ostomy irrigation bag,,,13.24,13.24,1
HCPCS,A4398,W OST BG URO DRN,269.0,174.85,45.19,242.1,21
HCPCS,A43980,Ostomy irrigation bag,,,13.24,13.24,1
HCPCS,A4399,Ostomy irrig cone/cath w brs,,,9.99,9.99,1
HCPCS,A43990,Ostomy irrig cone/cath w brs,,,9.99,9.99,1
HCPCS,A4400,Ostomy irrigation set,,,46.81,46.81,1
HCPCS,A4400,W OST IRR CONE,334.0,217.1,56.11,300.6,21
HCPCS,A44000,Ostomy irrigation set,,,46.81,46.81,1
HCPCS,A4402,Lubricant per ounce,,,1.53,1.53,1
HCPCS,A4402,W OST SKIN GEL 20,13.0,8.45,2.18,11.7,21
HCPCS,A44020,Lubricant per ounce,,,1.53,1.53,1
HCPCS,A4404,Ostomy ring each,,,1.48,1.48,1
HCPCS,A44040,Ostomy ring each,,,1.48,1.48,1
HCPCS,A4405,Nonpectin based ostomy paste,,,3.27,3.27,1
HCPCS,A44050,Nonpectin based ostomy paste,,,3.27,3.27,1
HCPCS,A4406,Pectin based ostomy paste,,,5.49,5.49,1
HCPCS,A44060,Pectin based ostomy paste,,,5.49,5.49,1
HCPCS,A4407,"Ext wear ost skn barr <=4sq""",,,8.39,8.39,1
HCPCS,A44070,"Ext wear ost skn barr <=4sq""",,,8.39,8.39,1
HCPCS,A4408,"Ext wear ost skn barr >4sq""",,,9.46,9.46,1
HCPCS,A44080,"Ext wear ost skn barr >4sq""",,,9.46,9.46,1
HCPCS,A4409,Ost skn barr convex <=4 sq i,,,5.95,5.95,1
HCPCS,A44090,Ost skn barr convex <=4 sq i,,,5.95,5.95,1
HCPCS,A4410,Ost skn barr extnd >4 sq,,,8.65,8.65,1
HCPCS,A44100,Ost skn barr extnd >4 sq,,,8.65,8.65,1
HCPCS,A4411,Ost skn barr extnd =4sq,,,4.88,4.88,1
HCPCS,A44110,Ost skn barr extnd =4sq,,,4.88,4.88,1
HCPCS,A4412,Ost pouch drain high output,,,2.59,2.59,1
HCPCS,A44120,Ost pouch drain high output,,,2.59,2.59,1
HCPCS,A4413,2 pc drainable ost pouch,,,5.28,5.28,1
HCPCS,A44130,2 pc drainable ost pouch,,,5.28,5.28,1
HCPCS,A4414,Ost sknbar w/o conv<=4 sq in,,,4.71,4.71,1
HCPCS,A44140,Ost sknbar w/o conv<=4 sq in,,,4.71,4.71,1
HCPCS,A4415,Ost skn barr w/o conv >4 sqi,,,5.75,5.75,1
HCPCS,A44150,Ost skn barr w/o conv >4 sqi,,,5.75,5.75,1
HCPCS,A4416,Ost pch clsd w barrier/filtr,,,2.64,2.64,1
HCPCS,A44160,Ost pch clsd w barrier/filtr,,,2.64,2.64,1
HCPCS,A4417,Ost pch w bar/bltinconv/fltr,,,3.57,3.57,1
HCPCS,A44170,Ost pch w bar/bltinconv/fltr,,,3.57,3.57,1
HCPCS,A4418,Ost pch clsd w/o bar w filtr,,,1.74,1.74,1
HCPCS,A44180,Ost pch clsd w/o bar w filtr,,,1.74,1.74,1
HCPCS,A4419,Ost pch for bar w flange/flt,,,1.65,1.65,1
HCPCS,A44190,Ost pch for bar w flange/flt,,,1.65,1.65,1
HCPCS,A4420,Ost pch clsd for bar w lk fl,,,0.73,0.73,1
HCPCS,A44200,Ost pch clsd for bar w lk fl,,,0.73,0.73,1
HCPCS,A4421,Ostomy supply misc,,,5.4,5.4,1
HCPCS,A44210,Ostomy supply misc,,,5.4,5.4,1
HCPCS,A4422,Ost pouch absorbent material,,,0.11,0.11,1
HCPCS,A44220,Ost pouch absorbent material,,,0.11,0.11,1
HCPCS,A4423,Ost pch for bar w lk fl/fltr,,,1.77,1.77,1
HCPCS,A44230,Ost pch for bar w lk fl/fltr,,,1.77,1.77,1
HCPCS,A4424,Ost pch drain w bar & filter,,,4.56,4.56,1
HCPCS,A44240,Ost pch drain w bar & filter,,,4.56,4.56,1
HCPCS,A4425,Ost pch drain for barrier fl,,,3.42,3.42,1
HCPCS,A44250,Ost pch drain for barrier fl,,,3.42,3.42,1
HCPCS,A4426,Ost pch drain 2 piece system,,,2.61,2.61,1
HCPCS,A4426,W OST PCH DRNBLE,63.0,40.95,10.58,56.7,21
HCPCS,A44260,Ost pch drain 2 piece system,,,2.61,2.61,1
HCPCS,A4427,Ost pch drain/barr lk flng/f,,,2.68,2.68,1
HCPCS,A44270,Ost pch drain/barr lk flng/f,,,2.68,2.68,1
HCPCS,A4428,Urine ost pouch w faucet/tap,,,6.25,6.25,1
HCPCS,A44280,Urine ost pouch w faucet/tap,,,6.25,6.25,1
HCPCS,A4429,Urine ost pouch w bltinconv,,,7.91,7.91,1
HCPCS,A44290,Urine ost pouch w bltinconv,,,7.91,7.91,1
HCPCS,A4430,Ost urine pch w b/bltin conv,,,8.15,8.15,1
HCPCS,A44300,Ost urine pch w b/bltin conv,,,8.15,8.15,1
HCPCS,A4431,Ost pch urine w barrier/tapv,,,5.95,5.95,1
HCPCS,A44310,Ost pch urine w barrier/tapv,,,5.95,5.95,1
HCPCS,A4432,Os pch urine w bar/fange/tap,,,3.43,3.43,1
HCPCS,A44320,Os pch urine w bar/fange/tap,,,3.43,3.43,1
HCPCS,A4433,Urine ost pch bar w lock fln,,,3.22,3.22,1
HCPCS,A44330,Urine ost pch bar w lock fln,,,3.22,3.22,1
HCPCS,A4434,Ost pch urine w lock flng/ft,,,3.6,3.6,1
HCPCS,A44340,Ost pch urine w lock flng/ft,,,3.6,3.6,1
HCPCS,A4435,1pc ost pch drain hgh output,,,5.52,5.52,1
HCPCS,A44350,1pc ost pch drain hgh output,,,5.52,5.52,1
HCPCS,A4436,Irr supply sleev reus per mo,,,4.45,11.29,4
HCPCS,A44360,Irr supply sleev reus per mo,,,4.45,4.45,1
HCPCS,A4437,Irr supply sleev disp per mo,,,3.6,9.12,4
HCPCS,A44370,Irr supply sleev disp per mo,,,3.6,3.6,1
HCPCS,A4438,Adhesive clip ext ens contr,,,1.32,3.23,4
HCPCS,A44380,Adhesive clip ext ens contr,,,1.32,1.32,1
HCPCS,A4450,NON-WATERPROOF TAPE,4.0,2.6,0.06,4.0,13
HCPCS,A4450,Non-waterproof tape,,,0.04,0.22,4
HCPCS,A44500,Non-waterproof tape,,,0.22,0.22,1
HCPCS,A4450AU,Non-waterproof tape,,,0.04,0.04,1
HCPCS,A4450AV,Non-waterproof tape,,,0.04,0.04,1
HCPCS,A4450AW,Non-waterproof tape,,,0.04,0.04,1
HCPCS,A4452,WATERPROOF TAPE,4.0,2.6,0.21,4.0,13
HCPCS,A4452,Waterproof tape,,,0.15,0.22,4
HCPCS,A44520,Waterproof tape,,,0.22,0.22,1
HCPCS,A4452AU,Waterproof tape,,,0.15,0.15,1
HCPCS,A4452AV,Waterproof tape,,,0.15,0.15,1
HCPCS,A4452AW,Waterproof tape,,,0.16,0.16,1
HCPCS,A4453,"Rec cath any transanal, each",,,56.17,56.17,1
HCPCS,A44530,"Rec cath any transanal, each",,,56.17,56.17,1
HCPCS,A4455,Adhesive remover per ounce,,,1.36,1.36,1
HCPCS,A44550,Adhesive remover per ounce,,,1.36,1.36,1
HCPCS,A4456,"Adhesive remover, wipes",,,0.23,0.23,1
HCPCS,A44560,"Adhesive remover, wipes",,,0.23,0.23,1
HCPCS,A4458,Reusable enema bag,,,2.16,2.16,1
HCPCS,A44580,Reusable enema bag,,,2.16,2.16,1
HCPCS,A4459,"Transanal irrigation, any",,,332.45,332.45,1
HCPCS,A44590,"Transanal irrigation, any",,,332.45,332.45,1
HCPCS,A4461,Surgicl dress hold non-reuse,,,3.16,3.16,1
HCPCS,A44610,Surgicl dress hold non-reuse,,,3.16,3.16,1
HCPCS,A4463,Surgical dress holder reuse,,,12.74,12.74,1
HCPCS,A44630,Surgical dress holder reuse,,,12.74,12.74,1
HCPCS,A4465,Non-elastic extremity binder,,,3.83,3.83,1
HCPCS,A44650,Non-elastic extremity binder,,,3.83,3.83,1
HCPCS,A4467,Belt strap sleev grmnt cover,,,26.56,26.56,1
HCPCS,A44670,Belt strap sleev grmnt cover,,,26.56,26.56,1
HCPCS,A4470,Gravlee jet washer,,,2.76,2.76,1
HCPCS,A44700,Gravlee jet washer,,,2.76,2.76,1
HCPCS,A4480,Vabra aspirator,,,2.13,2.13,1
HCPCS,A44800,Vabra aspirator,,,2.13,2.13,1
HCPCS,A4481,Tracheostoma filter,,,0.35,0.35,2
HCPCS,A44810,Tracheostoma filter,,,0.35,0.35,1
HCPCS,A4481NU,Tracheostoma filter,,,0.35,0.35,1
HCPCS,A4483,Moisture exchanger,,,5.4,5.4,3
HCPCS,A44830,Moisture exchanger,,,5.4,5.4,1
HCPCS,A4483NU,Moisture exchanger,,,5.4,5.4,1
HCPCS,A4483RR,Moisture exchanger,,,5.4,5.4,1
HCPCS,A4490,Above knee surgical stocking,,,2.76,4.61,7
HCPCS,A44900,Above knee surgical stocking,,,2.76,2.76,1
HCPCS,A4490NU,Above knee surgical stocking,,,4.25,4.61,3
HCPCS,A4495,Thigh length surg stocking,,,2.76,4.61,7
HCPCS,A44950,Thigh length surg stocking,,,2.76,2.76,1
HCPCS,A4495NU,Thigh length surg stocking,,,4.25,4.61,3
HCPCS,A4500,Below knee surgical stocking,,,2.13,3.55,7
HCPCS,A45000,Below knee surgical stocking,,,2.13,2.13,1
HCPCS,A4500NU,Below knee surgical stocking,,,3.28,3.55,3
HCPCS,A4510,Full length surg stocking,,,5.11,8.53,7
HCPCS,A45100,Full length surg stocking,,,5.11,5.11,1
HCPCS,A4510NU,Full length surg stocking,,,7.87,8.53,3
HCPCS,A4520,Incontinence garment anytype,,,1.08,1.08,1
HCPCS,A45200,Incontinence garment anytype,,,1.08,1.08,1
HCPCS,A4541,Monthly supp use with e0733,,,27.6,67.27,4
HCPCS,A45410,Monthly supp use with e0733,,,27.6,27.6,1
HCPCS,A4542,Supp ext up limb tremor stim,,,354.1,863.1,4
HCPCS,A45420,Supp ext up limb tremor stim,,,354.1,354.1,1
HCPCS,A4544,Electro nerve stimulator rls,,,4.27,10.39,4
HCPCS,A45440,Electro nerve stimulator rls,,,4.27,4.27,1
HCPCS,A4545,Suppl accessor tibial stim,,,25.91,68.34,4
HCPCS,A45450,Suppl accessor tibial stim,,,25.91,25.91,1
HCPCS,A4550,SUPPLY TRAY,118.0,76.7,7.84,118.0,13
HCPCS,A4550,SURGICAL TRAY,118.0,76.7,7.84,118.0,13
HCPCS,A4550,SURGICAL TRAYS,147.0,95.55,7.84,147.0,13
HCPCS,A4550,Surgical trays,,,12.56,12.56,1
HCPCS,A45500,Surgical trays,,,12.56,12.56,1
HCPCS,A4553,"Nondisp underpads, all sizes",,,6.56,6.56,1
HCPCS,A45530,"Nondisp underpads, all sizes",,,6.56,6.56,1
HCPCS,A4554,Disposable underpads,,,1.27,1.27,1
HCPCS,A45540,Disposable underpads,,,1.27,1.27,1
HCPCS,A4555,Ca tx e-stim electr/transduc,,,22.43,25.48,4
HCPCS,A45550,Ca tx e-stim electr/transduc,,,22.43,22.43,1
HCPCS,A4556,"Electrodes, pair",,,11.63,11.63,1
HCPCS,A45560,"Electrodes, pair",,,11.63,11.63,1
HCPCS,A4557,"Lead wires, pair",,,8.76,8.76,1
HCPCS,A45570,"Lead wires, pair",,,8.76,8.76,1
HCPCS,A4558,Conductive gel or paste,,,5.23,5.23,1
HCPCS,A45580,Conductive gel or paste,,,5.23,5.23,1
HCPCS,A4559,Coupling gel or paste,,,0.09,0.09,1
HCPCS,A45590,Coupling gel or paste,,,0.09,0.09,1
HCPCS,A4561,"PESSARY RUBBER, ANY TYPE",147.0,95.55,11.24,147.0,17
HCPCS,A4561,Pessary reusable rub anytype,,,19.63,19.63,1
HCPCS,A4561,"RUBBER PESSARY, ANY TYPE",109.0,70.85,18.31,106.82,29
HCPCS,A45610,Pessary reusable rub anytype,,,19.63,19.63,1
HCPCS,A4562,"PESSARY, NON RUBBER",115.0,74.75,19.32,112.7,29
HCPCS,A4562,"PESSARY, NON RUBBER,ANY TYPE",147.0,95.55,27.94,147.0,17
HCPCS,A4562,Pessary reusable nonrubber,,,48.77,48.77,1
HCPCS,A45620,Pessary reusable nonrubber,,,48.77,48.77,1
HCPCS,A4563,Vag inser rectal control sys,,,1129.53,2768.18,4
HCPCS,A45630,Vag inser rectal control sys,,,1129.53,1129.53,1
HCPCS,A4564,"PESSARY, DISPOSABLE, ANY TYPE",76.0,49.4,38.0,76.0,12
HCPCS,A4565,"ARM, ELEVATOR, EACH",60.0,39.0,4.2,60.0,13
HCPCS,A4565,SLINGS AND SWATHE,24.0,15.6,4.2,24.0,13
HCPCS,A4565,Slings,,,7.38,7.38,1
HCPCS,A45650,Slings,,,7.38,7.38,1
HCPCS,A4566,Should sling/vest/abrestrain,,,23.73,23.73,2
HCPCS,A45660,Should sling/vest/abrestrain,,,23.73,23.73,1
HCPCS,A4566NU,Should sling/vest/abrestrain,,,23.73,23.73,1
HCPCS,A4570,Splint,,,7.45,12.44,7
HCPCS,A45700,Splint,,,7.45,7.45,1
HCPCS,A4570NU,Splint,,,11.48,12.44,3
HCPCS,A4575,Hyperbaric o2 chamber disps,,,783.41,783.41,1
HCPCS,A45750,Hyperbaric o2 chamber disps,,,783.41,783.41,1
HCPCS,A4580,CAST SUPPLIES (PLASTER),76.0,49.4,38.0,76.0,12
HCPCS,A4580,Cast supplies (plaster),,,9.72,63.92,7
HCPCS,A4580,"PLASTER CAST; ARM, SHORT",60.0,39.0,30.0,60.0,12
HCPCS,A4580,"PLASTER CAST; LEG, SHORT",60.0,39.0,30.0,60.0,12
HCPCS,A45800,Cast supplies (plaster),,,9.72,9.72,1
HCPCS,A4580NU,Cast supplies (plaster),,,58.98,63.92,3
HCPCS,A4590,"FIBERGLASS CAST; ARM, SHORT",95.5,62.075,10.36,128.0,26
HCPCS,A4590,"FIBERGLASS CAST; LEG, SHORT",70.0,45.5,10.36,70.0,13
HCPCS,A4590,Special casting material,,,16.6,36.88,7
HCPCS,A45900,Special casting material,,,16.6,16.6,1
HCPCS,A4590NU,Special casting material,,,33.47,36.27,3
HCPCS,A4593,Neuromod sti sys adj rehab,,,35.97,35.97,1
HCPCS,A4593RR,Neuromod sti sys adj rehab,,,35.97,35.97,1
HCPCS,A4594,Neuromod adj rehab mouthpie,,,2130.17,2130.17,2
HCPCS,A45940,Neuromod adj rehab mouthpie,,,2130.17,2130.17,1
HCPCS,A4594NU,Neuromod adj rehab mouthpie,,,2130.17,2130.17,1
HCPCS,A4595,TENS SUPPL 2 LEAD PER MONTH,103.0,66.95,5.01,103.0,17
HCPCS,A4595,Tens suppl 2 lead per month,,,8.45,8.45,1
HCPCS,A45950,Tens suppl 2 lead per month,,,8.45,8.45,1
HCPCS,A4596,Ces system monthly supp,,,27.6,27.6,1
HCPCS,A45960,Ces system monthly supp,,,27.6,27.6,1
HCPCS,A4600,"Sleeve, inter limb comp dev",,,33.52,37.84,5
HCPCS,A46000,"Sleeve, inter limb comp dev",,,33.52,33.52,1
HCPCS,A4600NU,"Sleeve, inter limb comp dev",,,33.52,33.52,1
HCPCS,A4601,Lith ion non prosth recharge,,,33.03,33.03,2
HCPCS,A46010,Lith ion non prosth recharge,,,33.03,33.03,1
HCPCS,A4601NU,Lith ion non prosth recharge,,,33.03,33.03,1
HCPCS,A4602,Replace lithium battery 1.5v,,,0.36,3.57,4
HCPCS,A46020,Replace lithium battery 1.5v,,,3.57,3.57,1
HCPCS,A4602NU,Replace lithium battery 1.5v,,,3.57,3.57,1
HCPCS,A4602RR,Replace lithium battery 1.5v,,,0.36,0.36,1
HCPCS,A4602UE,Replace lithium battery 1.5v,,,2.68,2.68,1
HCPCS,A4604,Tubing with heating element,,,3.3,33.05,4
HCPCS,A46040,Tubing with heating element,,,33.05,33.05,1
HCPCS,A4604NU,Tubing with heating element,,,33.05,33.05,1
HCPCS,A4604RR,Tubing with heating element,,,3.3,3.3,1
HCPCS,A4604UE,Tubing with heating element,,,24.79,24.79,1
HCPCS,A4605,Trach suction cath close sys,,,1.58,15.71,4
HCPCS,A46050,Trach suction cath close sys,,,15.71,15.71,1
HCPCS,A4605NU,Trach suction cath close sys,,,15.71,15.71,1
HCPCS,A4605RR,Trach suction cath close sys,,,1.58,1.58,1
HCPCS,A4605UE,Trach suction cath close sys,,,11.78,11.78,1
HCPCS,A4606,Oxygen probe used w oximeter,,,2.7,2.7,1
HCPCS,A46060,Oxygen probe used w oximeter,,,2.7,2.7,1
HCPCS,A4608,Transtracheal oxygen cath,,,48.02,48.02,1
HCPCS,A46080,Transtracheal oxygen cath,,,48.02,48.02,1
HCPCS,A4611,Heavy duty battery,,,7.87,75.78,4
HCPCS,A46110,Heavy duty battery,,,75.78,75.78,1
HCPCS,A4611NU,Heavy duty battery,,,75.78,75.78,1
HCPCS,A4611RR,Heavy duty battery,,,7.87,7.87,1
HCPCS,A4611UE,Heavy duty battery,,,56.84,56.84,1
HCPCS,A4612,Battery cables,,,3.2,30.87,4
HCPCS,A46120,Battery cables,,,30.87,30.87,1
HCPCS,A4612NU,Battery cables,,,30.87,30.87,1
HCPCS,A4612RR,Battery cables,,,3.2,3.2,1
HCPCS,A4612UE,Battery cables,,,23.41,23.41,1
HCPCS,A4613,Battery charger,,,5.53,55.57,4
HCPCS,A46130,Battery charger,,,55.57,55.57,1
HCPCS,A4613NU,Battery charger,,,55.57,55.57,1
HCPCS,A4613RR,Battery charger,,,5.53,5.53,1
HCPCS,A4613UE,Battery charger,,,40.23,40.23,1
HCPCS,A4614,Hand-held pefr meter,,,22.78,22.78,1
HCPCS,A4614,INCENTIVE SPIROMETER,67.0,43.55,12.98,67.0,17
HCPCS,A4614,"PEAK EXPIR FLOW METER,HAND HELD",37.0,24.05,12.98,37.0,17
HCPCS,A4614,"PEAK EXPIRE FLOW MTR,HAND HELD",37.0,24.05,6.22,33.3,21
HCPCS,A4614,PEAK FLOW METER,31.0,20.15,12.98,31.0,17
HCPCS,A4614,SPACER,18.0,11.7,9.0,25.55,17
HCPCS,A46140,Hand-held pefr meter,,,22.78,22.78,1
HCPCS,A4615,Cannula nasal,,,0.7,0.7,1
HCPCS,A46150,Cannula nasal,,,0.7,0.7,1
HCPCS,A4616,Tubing (oxygen) per foot,,,0.05,0.05,1
HCPCS,A46160,Tubing (oxygen) per foot,,,0.05,0.05,1
HCPCS,A4617,Mouth piece,,,2.97,2.97,1
HCPCS,A46170,Mouth piece,,,2.97,2.97,1
HCPCS,A4618,Breathing circuits,,,0.84,7.25,4
HCPCS,A46180,Breathing circuits,,,7.25,7.25,1
HCPCS,A4618NU,Breathing circuits,,,7.25,7.25,1
HCPCS,A4618RR,Breathing circuits,,,0.84,0.84,1
HCPCS,A4618UE,Breathing circuits,,,5.43,5.43,1
HCPCS,A4619,Face tent,,,1.71,1.71,2
HCPCS,A46190,Face tent,,,1.71,1.71,1
HCPCS,A4619NU,Face tent,,,1.71,1.71,1
HCPCS,A4620,Variable concentration mask,,,0.62,0.62,1
HCPCS,A46200,Variable concentration mask,,,0.62,0.62,1
HCPCS,A4623,Tracheostomy inner cannula,,,5.35,5.35,1
HCPCS,A46230,Tracheostomy inner cannula,,,5.35,5.35,1
HCPCS,A4624,Tracheal suction tube,,,0.25,2.53,4
HCPCS,A46240,Tracheal suction tube,,,2.53,2.53,1
HCPCS,A4624NU,Tracheal suction tube,,,2.53,2.53,1
HCPCS,A4624RR,Tracheal suction tube,,,0.25,0.25,1
HCPCS,A4624UE,Tracheal suction tube,,,1.9,1.9,1
HCPCS,A4625,Trach care kit for new trach,,,6.63,6.63,1
HCPCS,A4625,W KIT PER-FIT TRACHEOSTOMY,419.0,272.35,70.39,377.1,21
HCPCS,A46250,Trach care kit for new trach,,,6.63,6.63,1
HCPCS,A4626,Tracheostomy cleaning brush,,,3.06,3.06,1
HCPCS,A46260,Tracheostomy cleaning brush,,,3.06,3.06,1
HCPCS,A4627,AEROCHAMBER SPACER WITH MASK,19.0,12.35,4.52,19.0,13
HCPCS,A4627,SPACER BAG/RESERVOIR,48.0,31.2,8.06,43.2,21
HCPCS,A4627,Spacer bag/reservoir,,,7.24,7.24,1
HCPCS,A46270,Spacer bag/reservoir,,,7.24,7.24,1
HCPCS,A4628,Oropharyngeal suction cath,,,0.36,3.59,4
HCPCS,A46280,Oropharyngeal suction cath,,,3.59,3.59,1
HCPCS,A4628NU,Oropharyngeal suction cath,,,3.59,3.59,1
HCPCS,A4628RR,Oropharyngeal suction cath,,,0.36,0.36,1
HCPCS,A4628UE,Oropharyngeal suction cath,,,2.69,2.69,1
HCPCS,A4629,Tracheostomy care kit,,,4.46,4.46,1
HCPCS,A46290,Tracheostomy care kit,,,4.46,4.46,1
HCPCS,A4630,Repl bat t.e.n.s. own by pt,,,0.51,5.08,4
HCPCS,A46300,Repl bat t.e.n.s. own by pt,,,5.08,5.08,1
HCPCS,A4630NU,Repl bat t.e.n.s. own by pt,,,5.08,5.08,1
HCPCS,A4630RR,Repl bat t.e.n.s. own by pt,,,0.51,0.51,1
HCPCS,A4630UE,Repl bat t.e.n.s. own by pt,,,3.81,3.81,1
HCPCS,A4633,Uvl replacement bulb,,,3.93,39.31,4
HCPCS,A46330,Uvl replacement bulb,,,39.31,39.31,1
HCPCS,A4633NU,Uvl replacement bulb,,,39.31,39.31,1
HCPCS,A4633RR,Uvl replacement bulb,,,3.93,3.93,1
HCPCS,A4633UE,Uvl replacement bulb,,,29.48,29.48,1
HCPCS,A4634,Replacement bulb th lightbox,,,8.64,16.96,3
HCPCS,A46340,Replacement bulb th lightbox,,,8.64,8.64,1
HCPCS,A4634NU,Replacement bulb th lightbox,,,8.64,8.64,1
HCPCS,A4634RR,Replacement bulb th lightbox,,,16.96,16.96,1
HCPCS,A4635,Underarm crutch pad,,,0.57,4.21,4
HCPCS,A46350,Underarm crutch pad,,,4.21,4.21,1
HCPCS,A4635NU,Underarm crutch pad,,,4.21,4.21,1
HCPCS,A4635RR,Underarm crutch pad,,,0.57,0.57,1
HCPCS,A4635UE,Underarm crutch pad,,,3.18,3.18,1
HCPCS,A4636,Handgrip for cane etc,,,0.27,2.64,4
HCPCS,A46360,Handgrip for cane etc,,,2.64,2.64,1
HCPCS,A4636NU,Handgrip for cane etc,,,2.64,2.64,1
HCPCS,A4636RR,Handgrip for cane etc,,,0.27,0.27,1
HCPCS,A4636UE,Handgrip for cane etc,,,1.98,1.98,1
HCPCS,A4637,Repl tip cane/crutch/walker,,,0.15,1.46,4
HCPCS,A46370,Repl tip cane/crutch/walker,,,1.46,1.46,1
HCPCS,A4637NU,Repl tip cane/crutch/walker,,,1.46,1.46,1
HCPCS,A4637RR,Repl tip cane/crutch/walker,,,0.15,0.15,1
HCPCS,A4637UE,Repl tip cane/crutch/walker,,,1.09,1.09,1
HCPCS,A4638,Repl batt pulse gen sys,,,3.78,37.8,4
HCPCS,A46380,Repl batt pulse gen sys,,,37.8,37.8,1
HCPCS,A4638NU,Repl batt pulse gen sys,,,37.8,37.8,1
HCPCS,A4638RR,Repl batt pulse gen sys,,,3.78,3.78,1
HCPCS,A4638UE,Repl batt pulse gen sys,,,28.35,28.35,1
HCPCS,A4639,Infrared ht sys replcmnt pad,,,24.66,481.31,16
HCPCS,A46390,Infrared ht sys replcmnt pad,,,275.18,275.18,1
HCPCS,A4639NU,Infrared ht sys replcmnt pad,,,275.18,481.31,4
HCPCS,A4639RR,Infrared ht sys replcmnt pad,,,24.66,27.52,4
HCPCS,A4639UE,Infrared ht sys replcmnt pad,,,206.39,360.75,4
HCPCS,A4640,Alternating pressure pad,,,4.65,64.09,16
HCPCS,A46400,Alternating pressure pad,,,46.53,46.53,1
HCPCS,A4640NU,Alternating pressure pad,,,46.53,64.09,4
HCPCS,A4640RR,Alternating pressure pad,,,4.65,8.04,4
HCPCS,A4640UE,Alternating pressure pad,,,34.89,40.85,4
HCPCS,A4641,INDIUM 111 DTPA INCLD DEL,656.0,426.4,328.0,656.0,12
HCPCS,A4641,RADIOISOTOPE I-131 HIPPURAN,825.0,536.25,412.5,825.0,12
HCPCS,A4641,TC 99 DTPA AEROSOL PENTET,52.0,33.8,26.0,52.0,12
HCPCS,A4641,TC-99 SUCCIMER DMSA 10MCI,215.0,139.75,107.5,215.0,12
HCPCS,A4642,In111 satumomab,,,1447.2,3671.6,4
HCPCS,A46420,In111 satumomab,,,1447.2,1447.2,1
HCPCS,A4648,BARD US BIOPSY CLIP,110.0,71.5,18.48,107.8,29
HCPCS,A4648,FIDUCIAL MARKER DOUBLE STRANDED,395.0,256.75,66.36,355.5,27
HCPCS,A4648,FIDUCIAL MARKER SINGLE STRANDED,206.0,133.9,34.61,185.4,27
HCPCS,A4648,HOLOGIC STEREO BIOPSY CLIP,90.0,58.5,15.12,88.2,29
HCPCS,A4648,HYDROMARK US BIOPSY CLIP,136.0,88.4,22.85,133.28,29
HCPCS,A4648,IMPLANTABLE TISSUE MARKER,200.0,130.0,100.0,200.0,12
HCPCS,A4648,Implantable tissue marker,,,117.17,117.17,1
HCPCS,A4648,MAGSEED 7CM - TISSUE MARKER IMPLANTABLE,1940.0,1261.0,325.92,1746.0,30
HCPCS,A4648,NEEDLE LOC WIRE,33.0,21.45,5.54,32.34,29
HCPCS,A4648,TISSUE MARKER,180.0,117.0,30.24,176.4,29
HCPCS,A4648,W IMP TISSUE MARKER BREAST,270.0,175.5,45.36,264.6,29
HCPCS,A46480,Implantable tissue marker,,,117.17,117.17,1
HCPCS,A4649,CONTOUR THREAD; 1 EACH,321.0,208.65,160.5,321.0,12
HCPCS,A4649,MESALT GAUZE RIBBON PER YARD,13.0,8.45,6.5,13.0,12
HCPCS,A4649,SURGICAL BRA,36.0,23.4,18.0,36.0,12
HCPCS,A4649,Surgical supplies,,,0.25,0.25,1
HCPCS,A46490,Surgical supplies,,,0.25,0.25,1
HCPCS,A4650,Implant radiation dosimeter,,,22.68,22.68,1
HCPCS,A46500,Implant radiation dosimeter,,,22.68,22.68,1
HCPCS,A4651,Calibrated microcap tube,,,0.04,0.04,2
HCPCS,A46510,Calibrated microcap tube,,,0.04,0.04,1
HCPCS,A4651NU,Calibrated microcap tube,,,0.04,0.04,1
HCPCS,A4652,Microcapillary tube sealant,,,0.13,0.13,1
HCPCS,A46520,Microcapillary tube sealant,,,0.13,0.13,1
HCPCS,A4653,Pd catheter anchor belt,,,21.6,21.6,1
HCPCS,A46530,Pd catheter anchor belt,,,21.6,21.6,1
HCPCS,A4657,Syringe w/wo needle,,,0.54,0.54,1
HCPCS,A46570,Syringe w/wo needle,,,0.54,0.54,1
HCPCS,A4660,Sphyg/bp app w cuff and stet,,,5.53,5.53,1
HCPCS,A46600,Sphyg/bp app w cuff and stet,,,5.53,5.53,1
HCPCS,A4663,Dialysis blood pressure cuff,,,10.85,10.85,1
HCPCS,A46630,Dialysis blood pressure cuff,,,10.85,10.85,1
HCPCS,A4670,"Automatic bp monitor, dial",,,27.67,27.67,1
HCPCS,A46700,"Automatic bp monitor, dial",,,27.67,27.67,1
HCPCS,A4671,Disposable cycler set,,,16.2,16.2,1
HCPCS,A46710,Disposable cycler set,,,16.2,16.2,1
HCPCS,A4672,"Drainage ext line, dialysis",,,10.8,10.8,1
HCPCS,A46720,"Drainage ext line, dialysis",,,10.8,10.8,1
HCPCS,A4673,Ext line w easy lock connect,,,5.4,5.4,1
HCPCS,A46730,Ext line w easy lock connect,,,5.4,5.4,1
HCPCS,A4674,"Chem/antisept solution, 8oz",,,6.48,6.48,1
HCPCS,A46740,"Chem/antisept solution, 8oz",,,6.48,6.48,1
HCPCS,A4680,"Activated carbon filter, ea",,,28.1,28.1,1
HCPCS,A46800,"Activated carbon filter, ea",,,28.1,28.1,1
HCPCS,A4690,"Dialyzer, each",,,278.45,278.45,1
HCPCS,A46900,"Dialyzer, each",,,278.45,278.45,1
HCPCS,A4706,Bicarbonate conc sol per gal,,,6.48,6.48,1
HCPCS,A47060,Bicarbonate conc sol per gal,,,6.48,6.48,1
HCPCS,A4707,Bicarbonate conc pow per pac,,,1.08,1.08,1
HCPCS,A47070,Bicarbonate conc pow per pac,,,1.08,1.08,1
HCPCS,A4708,Acetate conc sol per gallon,,,6.48,6.48,1
HCPCS,A47080,Acetate conc sol per gallon,,,6.48,6.48,1
HCPCS,A4709,Acid conc sol per gallon,,,5.4,5.4,1
HCPCS,A47090,Acid conc sol per gallon,,,5.4,5.4,1
HCPCS,A4714,Treated water per gallon,,,2.16,2.16,1
HCPCS,A47140,Treated water per gallon,,,2.16,2.16,1
HCPCS,A4719,"""y set"" tubing",,,4.32,4.32,1
HCPCS,A47190,"""y set"" tubing",,,4.32,4.32,1
HCPCS,A4720,Dialysat sol fld vol > 249cc,,,16.2,16.2,1
HCPCS,A47200,Dialysat sol fld vol > 249cc,,,16.2,16.2,1
HCPCS,A4721,Dialysat sol fld vol > 999cc,,,21.6,21.6,1
HCPCS,A47210,Dialysat sol fld vol > 999cc,,,21.6,21.6,1
HCPCS,A4722,Dialys sol fld vol > 1999cc,,,37.8,37.8,1
HCPCS,A47220,Dialys sol fld vol > 1999cc,,,37.8,37.8,1
HCPCS,A4723,Dialys sol fld vol > 2999cc,,,37.8,37.8,1
HCPCS,A47230,Dialys sol fld vol > 2999cc,,,37.8,37.8,1
HCPCS,A4724,Dialys sol fld vol > 3999cc,,,128.52,128.52,1
HCPCS,A47240,Dialys sol fld vol > 3999cc,,,128.52,128.52,1
HCPCS,A4725,Dialys sol fld vol > 4999cc,,,37.8,37.8,1
HCPCS,A47250,Dialys sol fld vol > 4999cc,,,37.8,37.8,1
HCPCS,A4726,Dialys sol fld vol > 5999cc,,,37.8,37.8,1
HCPCS,A47260,Dialys sol fld vol > 5999cc,,,37.8,37.8,1
HCPCS,A4728,"Dialysate solution, non-dex",,,37.8,37.8,1
HCPCS,A47280,"Dialysate solution, non-dex",,,37.8,37.8,1
HCPCS,A4730,"Fistula cannulation set, ea",,,22.43,22.43,1
HCPCS,A47300,"Fistula cannulation set, ea",,,22.43,22.43,1
HCPCS,A4736,"Topical anesthetic, per gram",,,16.2,16.2,1
HCPCS,A47360,"Topical anesthetic, per gram",,,16.2,16.2,1
HCPCS,A4737,Inj anesthetic per 10 ml,,,4.32,4.32,1
HCPCS,A47370,Inj anesthetic per 10 ml,,,4.32,4.32,1
HCPCS,A4740,Shunt accessory,,,44.83,44.83,1
HCPCS,A47400,Shunt accessory,,,44.83,44.83,1
HCPCS,A4750,Art or venous blood tubing,,,5.32,5.32,1
HCPCS,A47500,Art or venous blood tubing,,,5.32,5.32,1
HCPCS,A4755,Comb art/venous blood tubing,,,8.64,8.64,1
HCPCS,A47550,Comb art/venous blood tubing,,,8.64,8.64,1
HCPCS,A4760,"Dialysate sol test kit, each",,,25.92,25.92,1
HCPCS,A47600,"Dialysate sol test kit, each",,,25.92,25.92,1
HCPCS,A4765,Dialysate conc pow per pack,,,307.8,307.8,1
HCPCS,A47650,Dialysate conc pow per pack,,,307.8,307.8,1
HCPCS,A4766,Dialysate conc sol add 10 ml,,,37.8,37.8,1
HCPCS,A47660,Dialysate conc sol add 10 ml,,,37.8,37.8,1
HCPCS,A4770,Blood collection tube/vacuum,,,4.32,4.32,1
HCPCS,A47700,Blood collection tube/vacuum,,,4.32,4.32,1
HCPCS,A4771,Serum clotting time tube,,,4.32,4.32,1
HCPCS,A47710,Serum clotting time tube,,,4.32,4.32,1
HCPCS,A4772,Blood glucose test strips,,,11.29,11.29,1
HCPCS,A47720,Blood glucose test strips,,,11.29,11.29,1
HCPCS,A4773,Occult blood test strips,,,7.02,7.02,1
HCPCS,A47730,Occult blood test strips,,,7.02,7.02,1
HCPCS,A4774,Ammonia test strips,,,33.62,33.62,1
HCPCS,A47740,Ammonia test strips,,,33.62,33.62,1
HCPCS,A4802,Protamine sulfate per 50 mg,,,13.8,35.02,4
HCPCS,A48020,Protamine sulfate per 50 mg,,,13.8,13.8,1
HCPCS,A4860,Disposable catheter tips,,,0.27,0.27,1
HCPCS,A48600,Disposable catheter tips,,,0.27,0.27,1
HCPCS,A4870,Plumb/elec wk hm hemo equip,,,1296.0,1296.0,1
HCPCS,A48700,Plumb/elec wk hm hemo equip,,,1296.0,1296.0,1
HCPCS,A4890,Repair/maint cont hemo equip,,,672.56,672.56,1
HCPCS,A48900,Repair/maint cont hemo equip,,,672.56,672.56,1
HCPCS,A4911,Drain bag/bottle,,,10.8,10.8,1
HCPCS,A49110,Drain bag/bottle,,,10.8,10.8,1
HCPCS,A4913,Misc dialysis supplies noc,,,8.64,8.64,1
HCPCS,A49130,Misc dialysis supplies noc,,,8.64,8.64,1
HCPCS,A4918,Venous pressure clamp,,,1.08,1.08,1
HCPCS,A49180,Venous pressure clamp,,,1.08,1.08,1
HCPCS,A4927,Non-sterile gloves,,,1.71,1.71,1
HCPCS,A49270,Non-sterile gloves,,,1.71,1.71,1
HCPCS,A4928,Surgical mask,,,1.35,1.35,1
HCPCS,A49280,Surgical mask,,,1.35,1.35,1
HCPCS,A4929,"Tourniquet for dialysis, ea",,,0.22,0.22,1
HCPCS,A49290,"Tourniquet for dialysis, ea",,,0.22,0.22,1
HCPCS,A4930,"Sterile, gloves per pair",,,0.42,0.42,1
HCPCS,A49300,"Sterile, gloves per pair",,,0.42,0.42,1
HCPCS,A4931,Reusable oral thermometer,,,0.32,0.32,1
HCPCS,A49310,Reusable oral thermometer,,,0.32,0.32,1
HCPCS,A4932,Reusable rectal thermometer,,,2.16,2.16,1
HCPCS,A49320,Reusable rectal thermometer,,,2.16,2.16,1
HCPCS,A5051,Pouch clsd w barr attached,,,1.98,1.98,1
HCPCS,A5051,W OST PCH FEC,13.0,8.45,2.18,11.7,21
HCPCS,A50510,Pouch clsd w barr attached,,,1.98,1.98,1
HCPCS,A5052,Clsd ostomy pouch w/o barr,,,1.43,1.43,1
HCPCS,A5052,W PCH ILEO ODRPR,40.0,26.0,6.72,36.0,21
HCPCS,A50520,Clsd ostomy pouch w/o barr,,,1.43,1.43,1
HCPCS,A5053,Clsd ostomy pouch faceplate,,,1.65,1.65,1
HCPCS,A50530,Clsd ostomy pouch faceplate,,,1.65,1.65,1
HCPCS,A5054,Clsd ostomy pouch w/flange,,,1.72,1.72,1
HCPCS,A5054,W OST CLAMP BG,11.0,7.15,1.85,9.9,21
HCPCS,A50540,Clsd ostomy pouch w/flange,,,1.72,1.72,1
HCPCS,A5055,Stoma cap,,,1.26,1.26,1
HCPCS,A50550,Stoma cap,,,1.26,1.26,1
HCPCS,A5056,1 pc ost pouch w filter,,,4.48,4.48,1
HCPCS,A50560,1 pc ost pouch w filter,,,4.48,4.48,1
HCPCS,A5057,1 pc ost pou w built-in conv,,,9.2,9.2,1
HCPCS,A50570,1 pc ost pou w built-in conv,,,9.2,9.2,1
HCPCS,A5061,Pouch drainable w barrier at,,,3.38,3.38,1
HCPCS,A50610,Pouch drainable w barrier at,,,3.38,3.38,1
HCPCS,A5062,Drnble ostomy pouch w/o barr,,,1.99,1.99,1
HCPCS,A50620,Drnble ostomy pouch w/o barr,,,1.99,1.99,1
HCPCS,A5063,Drain ostomy pouch w/flange,,,2.59,2.59,1
HCPCS,A50630,Drain ostomy pouch w/flange,,,2.59,2.59,1
HCPCS,A5071,Urinary pouch w/barrier,,,5.76,5.76,1
HCPCS,A50710,Urinary pouch w/barrier,,,5.76,5.76,1
HCPCS,A5072,Urinary pouch w/o barrier,,,3.38,3.38,1
HCPCS,A50720,Urinary pouch w/o barrier,,,3.38,3.38,1
HCPCS,A5073,Urinary pouch on barr w/flng,,,3.0,3.0,1
HCPCS,A50730,Urinary pouch on barr w/flng,,,3.0,3.0,1
HCPCS,A5081,"Stoma plug or seal, any type",,,3.18,3.18,1
HCPCS,A50810,"Stoma plug or seal, any type",,,3.18,3.18,1
HCPCS,A5082,Continent stoma catheter,,,11.4,11.4,1
HCPCS,A50820,Continent stoma catheter,,,11.4,11.4,1
HCPCS,A5083,Stoma absorptive cover,,,0.62,0.62,1
HCPCS,A50830,Stoma absorptive cover,,,0.62,0.62,1
HCPCS,A5093,Ostomy accessory convex inse,,,1.6,1.6,1
HCPCS,A50930,Ostomy accessory convex inse,,,1.6,1.6,1
HCPCS,A5102,Bedside drain btl w/wo tube,,,21.45,21.45,1
HCPCS,A51020,Bedside drain btl w/wo tube,,,21.45,21.45,1
HCPCS,A5105,Urinary suspensory,,,39.05,39.05,1
HCPCS,A51050,Urinary suspensory,,,39.05,39.05,1
HCPCS,A5112,Urinary leg bag,,,30.18,30.18,1
HCPCS,A51120,Urinary leg bag,,,30.18,30.18,1
HCPCS,A5113,Latex leg strap,,,3.84,3.84,1
HCPCS,A51130,Latex leg strap,,,3.84,3.84,1
HCPCS,A5114,FOAM/FABRIC LEG STRAP,14.0,9.1,4.4,14.0,17
HCPCS,A5114,Foam/fabric leg strap,,,7.29,7.29,1
HCPCS,A51140,Foam/fabric leg strap,,,7.29,7.29,1
HCPCS,A5120,"Skin barrier, wipe or swab",,,0.22,0.22,1
HCPCS,A51200,"Skin barrier, wipe or swab",,,0.22,0.22,1
HCPCS,A5121,Solid skin barrier 6x6,,,6.84,6.84,1
HCPCS,A51210,Solid skin barrier 6x6,,,6.84,6.84,1
HCPCS,A5122,Solid skin barrier 8x8,,,12.3,12.3,1
HCPCS,A51220,Solid skin barrier 8x8,,,12.3,12.3,1
HCPCS,A5126,Disk/foam pad +or- adhesive,,,1.07,1.07,1
HCPCS,A51260,Disk/foam pad +or- adhesive,,,1.07,1.07,1
HCPCS,A5131,Appliance cleaner,,,12.91,12.91,1
HCPCS,A51310,Appliance cleaner,,,12.91,12.91,1
HCPCS,A5200,Percutaneous catheter anchor,,,10.82,10.82,1
HCPCS,A52000,Percutaneous catheter anchor,,,10.82,10.82,1
HCPCS,A5500,Diab shoe for density insert,,,55.95,148.47,4
HCPCS,A55000,Diab shoe for density insert,,,55.95,55.95,1
HCPCS,A5501,Diabetic custom molded shoe,,,182.67,445.27,4
HCPCS,A55010,Diabetic custom molded shoe,,,182.67,182.67,1
HCPCS,A5503,Diabetic shoe w/roller/rockr,,,31.06,75.63,4
HCPCS,A55030,Diabetic shoe w/roller/rockr,,,31.06,31.06,1
HCPCS,A5504,Diabetic shoe with wedge,,,31.06,75.63,4
HCPCS,A55040,Diabetic shoe with wedge,,,31.06,31.06,1
HCPCS,A5505,Diab shoe w/metatarsal bar,,,31.06,75.63,4
HCPCS,A55050,Diab shoe w/metatarsal bar,,,31.06,31.06,1
HCPCS,A5506,Diabetic shoe w/off set heel,,,31.06,75.63,4
HCPCS,A55060,Diabetic shoe w/off set heel,,,31.06,31.06,1
HCPCS,A5507,Modification diabetic shoe,,,31.06,75.63,4
HCPCS,A55070,Modification diabetic shoe,,,31.06,31.06,1
HCPCS,A5508,Diabetic deluxe shoe,,,32.4,32.4,1
HCPCS,A55080,Diabetic deluxe shoe,,,32.4,32.4,1
HCPCS,A5510,Compression form shoe insert,,,27.0,27.0,1
HCPCS,A55100,Compression form shoe insert,,,27.0,27.0,1
HCPCS,A5512,Multi den insert direct form,,,24.84,60.56,4
HCPCS,A55120,Multi den insert direct form,,,24.84,24.84,1
HCPCS,A5513,Multi den insert custom mold,,,37.08,90.37,4
HCPCS,A55130,Multi den insert custom mold,,,37.08,37.08,1
HCPCS,A5514,Mult den insert dir carv/cam,,,37.08,90.37,4
HCPCS,A55140,Mult den insert dir carv/cam,,,37.08,37.08,1
HCPCS,A6000,Wound warming wound cover,,,66.96,66.96,1
HCPCS,A60000,Wound warming wound cover,,,66.96,66.96,1
HCPCS,A6010,Collagen based wound filler,,,29.67,29.67,1
HCPCS,A60100,Collagen based wound filler,,,29.67,29.67,1
HCPCS,A6011,Collagen gel/paste wound fil,,,2.19,2.19,1
HCPCS,A60110,Collagen gel/paste wound fil,,,2.19,2.19,1
HCPCS,A6021,COLLAGEN DRESSING <=16 SQ IN,58.0,37.7,11.48,58.0,17
HCPCS,A6021,COLLAGEN PLUS WOUND DRESSING TO 16 SQ IN,47.0,30.55,11.48,47.0,17
HCPCS,A6021,Collagen dressing <=16 sq in,,,20.14,20.14,1
HCPCS,A6021,PROMOGRAN PRISMA MATRIX UP TO 16 SQ IN,47.0,30.55,11.48,47.0,17
HCPCS,A60210,Collagen dressing <=16 sq in,,,20.14,20.14,1
HCPCS,A6022,Collagen drsg>16<=48 sq in,,,20.14,20.14,1
HCPCS,A60220,Collagen drsg>16<=48 sq in,,,20.14,20.14,1
HCPCS,A6023,Collagen dressing >48 sq in,,,182.29,182.29,1
HCPCS,A60230,Collagen dressing >48 sq in,,,182.29,182.29,1
HCPCS,A6024,Collagen dsg wound filler,,,5.93,5.93,1
HCPCS,A60240,Collagen dsg wound filler,,,5.93,5.93,1
HCPCS,A6025,"SILICONE GEL SHEET, EACH",14.0,9.1,6.51,14.0,13
HCPCS,A6025,"Silicone gel sheet, each",,,10.43,10.43,1
HCPCS,A60250,"Silicone gel sheet, each",,,10.43,10.43,1
HCPCS,A6154,Wound pouch each,,,13.35,13.35,1
HCPCS,A61540,Wound pouch each,,,13.35,13.35,1
HCPCS,A6196,"ALGINATE DRESS,<16 SQ IN, EACH",28.0,18.2,4.02,28.0,17
HCPCS,A6196,ALGINATE DRESSING 4X4 EA.,22.0,14.3,4.02,22.0,17
HCPCS,A6196,"AQUACEL, DRSG.4X4",24.0,15.6,4.02,24.0,17
HCPCS,A6196,Alginate dressing <=16 sq in,,,7.05,7.05,1
HCPCS,A6196,DRSG HDRCLD 25X9CM AQCEL AG,68.0,44.2,11.42,61.2,21
HCPCS,A6196,DRSG HDRCLD 30X9CM AQCEL PU,66.0,42.9,11.09,59.4,21
HCPCS,A61960,Alginate dressing <=16 sq in,,,7.05,7.05,1
HCPCS,A6197,"ALGINATE DRESS,16-48 SQ IN,EACH",72.0,46.8,8.98,72.0,17
HCPCS,A6197,Alginate drsg >16 <=48 sq in,,,15.76,15.76,1
HCPCS,A61970,Alginate drsg >16 <=48 sq in,,,15.76,15.76,1
HCPCS,A6198,Alginate dressing > 48 sq in,,,21.6,21.6,1
HCPCS,A61980,Alginate dressing > 48 sq in,,,21.6,21.6,1
HCPCS,A6199,"ALGINATE DRESSING,FILLER,PER 6 IN",45.0,29.25,2.88,45.0,17
HCPCS,A6199,Alginate drsg wound filler,,,5.05,5.05,1
HCPCS,A61990,Alginate drsg wound filler,,,5.05,5.05,1
HCPCS,A6203,"COMPOSITE DRESS,<16 SQ IN,EACH",6.0,3.9,1.84,6.0,17
HCPCS,A6203,Composite drsg <= 16 sq in,,,3.23,3.23,1
HCPCS,A62030,Composite drsg <= 16 sq in,,,3.23,3.23,1
HCPCS,A6204,ALLDRESS W/BORDER 6X6,8.0,5.2,3.4,8.0,17
HCPCS,A6204,"COMPOSITE DRESS,16-48 SQ IN,EACH",9.0,5.85,3.4,9.0,17
HCPCS,A6204,Composite drsg >16<=48 sq in,,,5.96,5.96,1
HCPCS,A6204,RESTORE TRIACT 4X5 ABSORBENT DRESSING,13.0,8.45,3.4,13.0,17
HCPCS,A62040,Composite drsg >16<=48 sq in,,,5.96,5.96,1
HCPCS,A6205,Composite drsg > 48 sq in,,,8.1,8.1,1
HCPCS,A62050,Composite drsg > 48 sq in,,,8.1,8.1,1
HCPCS,A6206,"CONTACT LAYER,<16 SQ IN, EACH",37.0,24.05,1.2,37.0,13
HCPCS,A6206,Contact layer <= 16 sq in,,,1.91,1.91,1
HCPCS,A62060,Contact layer <= 16 sq in,,,1.91,1.91,1
HCPCS,A6207,"CONTACT LAYER,16-48 SQ IN, EACH",20.0,13.0,4.01,20.0,17
HCPCS,A6207,Contact layer >16<= 48 sq in,,,7.03,7.03,1
HCPCS,A6207,NON ADHERENT PAD-TELFA 3X4,16.0,10.4,4.01,16.0,17
HCPCS,A6207,RESTORE TRIACT 4X5 LAYER,16.0,10.4,4.01,16.0,17
HCPCS,A62070,Contact layer >16<= 48 sq in,,,7.03,7.03,1
HCPCS,A6208,Contact layer > 48 sq in,,,34.56,34.56,1
HCPCS,A62080,Contact layer > 48 sq in,,,34.56,34.56,1
HCPCS,A6209,FOAM DRESS W/O ADHESIVE 4X4,10.0,6.5,4.08,10.0,17
HCPCS,A6209,"FOAM DRESS,<16 SQ IN,NO ADHESIVE,EA",12.0,7.8,4.08,12.0,17
HCPCS,A6209,Foam drsg <=16 sq in w/o bdr,,,7.16,7.16,1
HCPCS,A6209,HYDROFERA BLUE 4X4,16.0,10.4,4.08,16.0,17
HCPCS,A6209,POLYMEM FOAM DRESS W/O BORDER 4X4,48.0,31.2,4.08,48.0,17
HCPCS,A62090,Foam drsg <=16 sq in w/o bdr,,,7.16,7.16,1
HCPCS,A6210,"FOAM DRESS,16-48 SQ IN,NO ADHESIVE",86.0,55.9,10.88,86.0,17
HCPCS,A6210,Foam drg >16<=48 sq in w/o b,,,19.08,19.08,1
HCPCS,A62100,Foam drg >16<=48 sq in w/o b,,,19.08,19.08,1
HCPCS,A6211,Foam drg > 48 sq in w/o brdr,,,28.13,28.13,1
HCPCS,A62110,Foam drg > 48 sq in w/o brdr,,,28.13,28.13,1
HCPCS,A6212,"FOAM DRESS,<16 SQ IN,ADHESIVE,EACH",39.0,25.35,5.3,39.0,17
HCPCS,A6212,Foam drg <=16 sq in w/border,,,9.3,9.3,1
HCPCS,A62120,Foam drg <=16 sq in w/border,,,9.3,9.3,1
HCPCS,A6213,Foam drg >16<=48 sq in w/bdr,,,9.16,9.16,1
HCPCS,A6213,W DRSG ACTCT SILCRYST BRN 13X4IN,75.0,48.75,12.6,67.5,21
HCPCS,A62130,Foam drg >16<=48 sq in w/bdr,,,9.16,9.16,1
HCPCS,A6214,Foam drg > 48 sq in w/border,,,9.86,9.86,1
HCPCS,A62140,Foam drg > 48 sq in w/border,,,9.86,9.86,1
HCPCS,A6215,Foam dressing wound filler,,,3.09,3.09,1
HCPCS,A62150,Foam dressing wound filler,,,3.09,3.09,1
HCPCS,A6216,Non-sterile gauze<=16 sq in,,,0.03,0.03,1
HCPCS,A62160,Non-sterile gauze<=16 sq in,,,0.03,0.03,1
HCPCS,A6217,Non-sterile gauze>16<=48 sq,,,0.16,0.16,1
HCPCS,A62170,Non-sterile gauze>16<=48 sq,,,0.16,0.16,1
HCPCS,A6218,Non-sterile gauze > 48 sq in,,,0.22,0.22,1
HCPCS,A62180,Non-sterile gauze > 48 sq in,,,0.22,0.22,1
HCPCS,A6219,Gauze <= 16 sq in w/border,,,0.92,0.92,1
HCPCS,A62190,Gauze <= 16 sq in w/border,,,0.92,0.92,1
HCPCS,A6220,Gauze >16 <=48 sq in w/bordr,,,2.48,2.48,1
HCPCS,A62200,Gauze >16 <=48 sq in w/bordr,,,2.48,2.48,1
HCPCS,A6221,Gauze > 48 sq in w/border,,,1.83,1.83,1
HCPCS,A62210,Gauze > 48 sq in w/border,,,1.83,1.83,1
HCPCS,A6222,"GAUZE,IMPREG,<16 SQ IN,NO ADHESV,EA",3.0,1.95,1.16,3.0,17
HCPCS,A6222,Gauze <=16 in no w/sal w/o b,,,2.04,2.04,1
HCPCS,A6222,IODOFLEX 0.9% 1 1/4 X 2 1/4,5.0,3.25,1.16,5.0,17
HCPCS,A6222,MESALT GAUZE W/O BORDER 3X3,3.0,1.95,1.16,3.0,17
HCPCS,A62220,Gauze <=16 in no w/sal w/o b,,,2.04,2.04,1
HCPCS,A6223,"GAUZE,IMPREG,16-48 SQ IN,NO ADHSV,EA",6.0,3.9,1.32,6.0,17
HCPCS,A6223,Gauze >16<=48 no w/sal w/o b,,,2.32,2.32,1
HCPCS,A62230,Gauze >16<=48 no w/sal w/o b,,,2.32,2.32,1
HCPCS,A6224,"GAUZE,IMPREG,>48 SQ IN,NO ADHESV,EA",23.0,14.95,1.96,23.0,17
HCPCS,A6224,Gauze > 48 in no w/sal w/o b,,,3.45,3.45,1
HCPCS,A62240,Gauze > 48 in no w/sal w/o b,,,3.45,3.45,1
HCPCS,A6228,Gauze <= 16 sq in water/sal,,,0.85,0.85,1
HCPCS,A62280,Gauze <= 16 sq in water/sal,,,0.85,0.85,1
HCPCS,A6229,Gauze >16<=48 sq in watr/sal,,,3.45,3.45,1
HCPCS,A62290,Gauze >16<=48 sq in watr/sal,,,3.45,3.45,1
HCPCS,A6230,Gauze > 48 sq in water/salne,,,1.27,1.27,1
HCPCS,A62300,Gauze > 48 sq in water/salne,,,1.27,1.27,1
HCPCS,A6231,HYDROGEL DSG<=16 SQ IN,19.0,12.35,2.55,19.0,17
HCPCS,A6231,Hydrogel dsg<=16 sq in,,,4.48,4.48,1
HCPCS,A62310,Hydrogel dsg<=16 sq in,,,4.48,4.48,1
HCPCS,A6232,Hydrogel dsg>16<=48 sq in,,,6.58,6.58,1
HCPCS,A62320,Hydrogel dsg>16<=48 sq in,,,6.58,6.58,1
HCPCS,A6233,Hydrogel dressing >48 sq in,,,18.36,18.36,1
HCPCS,A62330,Hydrogel dressing >48 sq in,,,18.36,18.36,1
HCPCS,A6234,DUODERM XTRA THIN 4 X 4,15.0,9.75,3.58,15.0,17
HCPCS,A6234,"HYDROCOLLOID,<16 SQ IN,NO ADHES,EA",6.0,3.9,3.0,7.02,17
HCPCS,A6234,Hydrocolld drg <=16 w/o bdr,,,6.27,6.27,1
HCPCS,A62340,Hydrocolld drg <=16 w/o bdr,,,6.27,6.27,1
HCPCS,A6235,Hydrocolld drg >16<=48 w/o b,,,16.11,16.11,1
HCPCS,A62350,Hydrocolld drg >16<=48 w/o b,,,16.11,16.11,1
HCPCS,A6236,Hydrocolld drg > 48 in w/o b,,,26.1,26.1,1
HCPCS,A62360,Hydrocolld drg > 48 in w/o b,,,26.1,26.1,1
HCPCS,A6237,"HYDROCOLLOID,<16 SQ IN,ADHESIVE,EA",19.0,12.35,4.32,19.0,17
HCPCS,A6237,Hydrocolld drg <=16 in w/bdr,,,7.57,7.57,1
HCPCS,A62370,Hydrocolld drg <=16 in w/bdr,,,7.57,7.57,1
HCPCS,A6238,Hydrocolld drg >16<=48 w/bdr,,,21.84,21.84,1
HCPCS,A62380,Hydrocolld drg >16<=48 w/bdr,,,21.84,21.84,1
HCPCS,A6239,Hydrocolld drg > 48 in w/bdr,,,3.24,3.24,1
HCPCS,A62390,Hydrocolld drg > 48 in w/bdr,,,3.24,3.24,1
HCPCS,A6240,Hydrocolld drg filler paste,,,11.73,11.73,1
HCPCS,A62400,Hydrocolld drg filler paste,,,11.73,11.73,1
HCPCS,A6241,Hydrocolloid drg filler dry,,,2.46,2.46,1
HCPCS,A62410,Hydrocolloid drg filler dry,,,2.46,2.46,1
HCPCS,A6242,Hydrogel drg <=16 in w/o bdr,,,5.8,5.8,1
HCPCS,A62420,Hydrogel drg <=16 in w/o bdr,,,5.8,5.8,1
HCPCS,A6243,Hydrogel drg >16<=48 w/o bdr,,,11.8,11.8,1
HCPCS,A62430,Hydrogel drg >16<=48 w/o bdr,,,11.8,11.8,1
HCPCS,A6244,Hydrogel drg >48 in w/o bdr,,,37.63,37.63,1
HCPCS,A62440,Hydrogel drg >48 in w/o bdr,,,37.63,37.63,1
HCPCS,A6245,Hydrogel drg <= 16 in w/bdr,,,6.97,6.97,1
HCPCS,A62450,Hydrogel drg <= 16 in w/bdr,,,6.97,6.97,1
HCPCS,A6246,Hydrogel drg >16<=48 in w/b,,,9.51,9.51,1
HCPCS,A62460,Hydrogel drg >16<=48 in w/b,,,9.51,9.51,1
HCPCS,A6247,Hydrogel drg > 48 sq in w/b,,,22.78,22.78,1
HCPCS,A62470,Hydrogel drg > 48 sq in w/b,,,22.78,22.78,1
HCPCS,A6248,"HYDROGEL,FILLER,GEL,PER FLUID OZ",26.0,16.9,8.87,26.0,17
HCPCS,A6248,Hydrogel drsg gel filler,,,15.56,15.56,1
HCPCS,A62480,Hydrogel drsg gel filler,,,15.56,15.56,1
HCPCS,A6250,AHA OIL FREE LOTION SPF 15,21.0,13.65,0.03,21.0,13
HCPCS,A6250,PERLE,68.0,44.2,0.03,68.0,13
HCPCS,A6250,PROTECTIVE OINTMENT 8 OZ,34.0,22.1,0.03,34.0,13
HCPCS,A6250,Skin seal protect moisturizr,,,0.03,0.08,4
HCPCS,A62500,Skin seal protect moisturizr,,,0.03,0.03,1
HCPCS,A6251,Absorpt drg <=16 sq in w/o b,,,1.9,1.9,1
HCPCS,A62510,Absorpt drg <=16 sq in w/o b,,,1.9,1.9,1
HCPCS,A6252,Absorpt drg >16 <=48 w/o bdr,,,3.12,3.12,1
HCPCS,A62520,Absorpt drg >16 <=48 w/o bdr,,,3.12,3.12,1
HCPCS,A6253,Absorpt drg > 48 sq in w/o b,,,6.07,6.07,1
HCPCS,A6253,"SPEC ABSORP,>48 SQ IN,NO ADHESV",26.0,16.9,3.46,26.0,17
HCPCS,A62530,Absorpt drg > 48 sq in w/o b,,,6.07,6.07,1
HCPCS,A6254,Absorpt drg <=16 sq in w/bdr,,,1.14,1.14,1
HCPCS,A62540,Absorpt drg <=16 sq in w/bdr,,,1.14,1.14,1
HCPCS,A6255,Absorpt drg >16<=48 in w/bdr,,,2.92,2.92,1
HCPCS,A6255,W DRSG SILVERLON WND/ABS,67.0,43.55,11.26,60.3,21
HCPCS,A62550,Absorpt drg >16<=48 in w/bdr,,,2.92,2.92,1
HCPCS,A6256,Absorpt drg > 48 sq in w/bdr,,,4.32,4.32,1
HCPCS,A62560,Absorpt drg > 48 sq in w/bdr,,,4.32,4.32,1
HCPCS,A6257,Transparent film <= 16 sq in,,,1.47,1.47,1
HCPCS,A62570,Transparent film <= 16 sq in,,,1.47,1.47,1
HCPCS,A6258,Transparent film >16<=48 in,,,4.13,4.13,1
HCPCS,A62580,Transparent film >16<=48 in,,,4.13,4.13,1
HCPCS,A6259,Transparent film > 48 sq in,,,10.48,10.48,1
HCPCS,A62590,Transparent film > 48 sq in,,,10.48,10.48,1
HCPCS,A6260,"WOUND CLEANSERS, ANY TYPE, ANY SIZE",39.0,25.35,0.26,39.0,13
HCPCS,A6260,Wound cleanser any type/size,,,0.42,0.42,1
HCPCS,A62600,Wound cleanser any type/size,,,0.42,0.42,1
HCPCS,A6261,Wound filler gel/paste /oz,,,1.71,1.71,1
HCPCS,A62610,Wound filler gel/paste /oz,,,1.71,1.71,1
HCPCS,A6262,Wound filler dry form / gram,,,0.42,0.42,1
HCPCS,A62620,Wound filler dry form / gram,,,0.42,0.42,1
HCPCS,A6266,Impreg gauze no h20/sal/yard,,,1.84,1.84,1
HCPCS,A62660,Impreg gauze no h20/sal/yard,,,1.84,1.84,1
HCPCS,A6402,Sterile gauze <= 16 sq in,,,0.11,0.11,1
HCPCS,A64020,Sterile gauze <= 16 sq in,,,0.11,0.11,1
HCPCS,A6403,Sterile gauze>16 <= 48 sq in,,,0.39,0.39,1
HCPCS,A64030,Sterile gauze>16 <= 48 sq in,,,0.39,0.39,1
HCPCS,A6404,Sterile gauze > 48 sq in,,,0.22,0.22,1
HCPCS,A64040,Sterile gauze > 48 sq in,,,0.22,0.22,1
HCPCS,A6407,"Packing strips, non-impreg",,,1.79,1.79,1
HCPCS,A64070,"Packing strips, non-impreg",,,1.79,1.79,1
HCPCS,A6410,Sterile eye pad,,,0.36,0.36,1
HCPCS,A64100,Sterile eye pad,,,0.36,0.36,1
HCPCS,A6411,Non-sterile eye pad,,,0.16,0.16,1
HCPCS,A64110,Non-sterile eye pad,,,0.16,0.16,1
HCPCS,A6412,Occlusive eye patch,,,0.22,0.22,1
HCPCS,A64120,Occlusive eye patch,,,0.22,0.22,1
HCPCS,A6413,"Adhesive bandage, first-aid",,,0.17,0.28,7
HCPCS,A64130,"Adhesive bandage, first-aid",,,0.28,0.28,1
HCPCS,A6413NU,"Adhesive bandage, first-aid",,,0.17,0.19,3
HCPCS,A6441,"Pad band w>=3"" <5""/yd",,,0.65,0.65,1
HCPCS,A64410,"Pad band w>=3"" <5""/yd",,,0.65,0.65,1
HCPCS,A6442,"Conform band n/s w<3""/yd",,,0.15,0.15,1
HCPCS,A64420,"Conform band n/s w<3""/yd",,,0.15,0.15,1
HCPCS,A6443,"Conform band n/s w>=3""<5""/yd",,,0.27,0.27,1
HCPCS,A64430,"Conform band n/s w>=3""<5""/yd",,,0.27,0.27,1
HCPCS,A6444,"Conform band n/s w>=5""/yd",,,0.53,0.53,1
HCPCS,A64440,"Conform band n/s w>=5""/yd",,,0.53,0.53,1
HCPCS,A6445,"Conform band s w <3""/yd",,,0.3,0.3,1
HCPCS,A64450,"Conform band s w <3""/yd",,,0.3,0.3,1
HCPCS,A6446,"Conform band s w>=3"" <5""/yd",,,0.37,0.37,1
HCPCS,A64460,"Conform band s w>=3"" <5""/yd",,,0.37,0.37,1
HCPCS,A6447,CONFORM BAND S W >=5?/YD,2.0,1.3,0.37,2.0,17
HCPCS,A6447,"Conform band s w >=5""/yd",,,0.65,0.65,1
HCPCS,A64470,"Conform band s w >=5""/yd",,,0.65,0.65,1
HCPCS,A6448,"Lt compres band <3""/yd",,,1.1,1.1,1
HCPCS,A64480,"Lt compres band <3""/yd",,,1.1,1.1,1
HCPCS,A6449,ELASTIC BANDAGE >3 <5 IN PER YD,6.0,3.9,0.96,6.0,17
HCPCS,A6449,LT COMPRES BAND >=3? <5?/YD,7.0,4.55,0.96,7.0,17
HCPCS,A6449,"Lt compres band >=3"" <5""/yd",,,1.67,1.67,1
HCPCS,A6449,PROFORE BANDAGE LAYER 3 PER YD,6.0,3.9,0.96,6.0,17
HCPCS,A64490,"Lt compres band >=3"" <5""/yd",,,1.67,1.67,1
HCPCS,A6450,"Lt compres band >=5""/yd",,,1.67,1.67,1
HCPCS,A64500,"Lt compres band >=5""/yd",,,1.67,1.67,1
HCPCS,A6451,"Mod compres band w>=3""<5""/yd",,,1.67,1.67,1
HCPCS,A64510,"Mod compres band w>=3""<5""/yd",,,1.67,1.67,1
HCPCS,A6452,HIGH COMPRES BAND W>=3?<5?YD,24.0,15.6,3.22,24.0,17
HCPCS,A6452,"High compres band w>=3""<5""yd",,,5.65,5.65,1
HCPCS,A64520,"High compres band w>=3""<5""yd",,,5.65,5.65,1
HCPCS,A6453,"Self-adher band w <3""/yd",,,0.6,0.6,1
HCPCS,A64530,"Self-adher band w <3""/yd",,,0.6,0.6,1
HCPCS,A6454,SELF-ADHER BAND W>=3? <5?/YD,2.0,1.3,0.43,2.0,17
HCPCS,A6454,"Self-adher band w>=3"" <5""/yd",,,0.76,0.76,1
HCPCS,A64540,"Self-adher band w>=3"" <5""/yd",,,0.76,0.76,1
HCPCS,A6455,"Self-adher band >=5""/yd",,,1.34,1.34,1
HCPCS,A64550,"Self-adher band >=5""/yd",,,1.34,1.34,1
HCPCS,A6456,ZINC PASTE BAND W >=3?<5?/YD,3.0,1.95,0.68,3.0,17
HCPCS,A6456,"Zinc paste band w >=3""<5""/yd",,,1.2,1.2,1
HCPCS,A64560,"Zinc paste band w >=3""<5""/yd",,,1.2,1.2,1
HCPCS,A6457,TUBULAR DRESSING,2.0,1.3,0.62,2.0,17
HCPCS,A6457,Tubular dressing,,,1.09,1.09,1
HCPCS,A64570,Tubular dressing,,,1.09,1.09,1
HCPCS,A6460,Synthetic drsg <= 16 sq in,,,54.0,54.0,1
HCPCS,A64600,Synthetic drsg <= 16 sq in,,,54.0,54.0,1
HCPCS,A6461,Synthetic drsg >16<=48 sq in,,,8.64,8.64,1
HCPCS,A64610,Synthetic drsg >16<=48 sq in,,,8.64,8.64,1
HCPCS,A6501,Compres burngarment bodysuit,,,5.4,5.4,1
HCPCS,A65010,Compres burngarment bodysuit,,,5.4,5.4,1
HCPCS,A6502,Compres burngarment chinstrp,,,108.0,108.0,1
HCPCS,A65020,Compres burngarment chinstrp,,,108.0,108.0,1
HCPCS,A6503,Compres burngarment facehood,,,54.0,54.0,1
HCPCS,A65030,Compres burngarment facehood,,,54.0,54.0,1
HCPCS,A6504,Cmprsburngarment glove-wrist,,,97.2,97.2,1
HCPCS,A65040,Cmprsburngarment glove-wrist,,,97.2,97.2,1
HCPCS,A6505,Cmprsburngarment glove-elbow,,,81.0,81.0,1
HCPCS,A65050,Cmprsburngarment glove-elbow,,,81.0,81.0,1
HCPCS,A6506,Cmprsburngrmnt glove-axilla,,,43.2,43.2,1
HCPCS,A65060,Cmprsburngrmnt glove-axilla,,,43.2,43.2,1
HCPCS,A6507,Cmprs burngarment foot-knee,,,2.19,2.19,1
HCPCS,A65070,Cmprs burngarment foot-knee,,,2.19,2.19,1
HCPCS,A6508,Cmprs burngarment foot-thigh,,,3.03,3.03,1
HCPCS,A65080,Cmprs burngarment foot-thigh,,,3.03,3.03,1
HCPCS,A6509,Compres burn garment jacket,,,1.36,1.36,1
HCPCS,A65090,Compres burn garment jacket,,,1.36,1.36,1
HCPCS,A6510,Compres burn garment leotard,,,1.36,1.36,1
HCPCS,A65100,Compres burn garment leotard,,,1.36,1.36,1
HCPCS,A6511,Compres burn garment panty,,,1.36,1.36,1
HCPCS,A65110,Compres burn garment panty,,,1.36,1.36,1
HCPCS,A6512,"Compres burn garment, noc",,,1.36,1.36,1
HCPCS,A65120,"Compres burn garment, noc",,,1.36,1.36,1
HCPCS,A6513,Compress burn mask face/neck,,,32.12,32.12,1
HCPCS,A65130,Compress burn mask face/neck,,,32.12,32.12,1
HCPCS,A6520,G com garmnt glove nghttime,,,83.92,205.75,4
HCPCS,A65200,G com garmnt glove nghttime,,,83.92,83.92,1
HCPCS,A6521,G com garmnt glove nght cust,,,332.97,816.38,4
HCPCS,A65210,G com garmnt glove nght cust,,,332.97,332.97,1
HCPCS,A6522,G com garment arm nighttime,,,203.91,499.93,4
HCPCS,A65220,G com garment arm nighttime,,,203.91,203.91,1
HCPCS,A6523,G com garment arm nght custm,,,483.8,1186.16,4
HCPCS,A65230,G com garment arm nght custm,,,483.8,483.8,1
HCPCS,A6524,G com garmnt lwr leg/ft nght,,,254.39,623.72,4
HCPCS,A65240,G com garmnt lwr leg/ft nght,,,254.39,254.39,1
HCPCS,A6525,G com garm lwrleg/ft ngt cus,,,513.58,1259.18,4
HCPCS,A65250,G com garm lwrleg/ft ngt cus,,,513.58,513.58,1
HCPCS,A6526,G com garmt full leg/ft nght,,,459.94,1127.66,4
HCPCS,A65260,G com garmt full leg/ft nght,,,459.94,459.94,1
HCPCS,A6527,G garmt full leg/ft nght cus,,,845.77,2073.61,4
HCPCS,A65270,G garmt full leg/ft nght cus,,,845.77,845.77,1
HCPCS,A6528,G com garment bra nighttime,,,442.26,1084.31,4
HCPCS,A65280,G com garment bra nighttime,,,442.26,442.26,1
HCPCS,A6529,G com garmt bra night custm,,,698.85,1713.39,4
HCPCS,A65290,G com garmt bra night custm,,,698.85,698.85,1
HCPCS,A6530,Compression stocking bk18-30,,,25.92,63.56,4
HCPCS,A65300,Compression stocking bk18-30,,,25.92,25.92,1
HCPCS,A6531,Compress stking bk30-40 surg,,,17.87,101.01,5
HCPCS,A65310,Compress stking bk30-40 surg,,,32.57,32.57,1
HCPCS,A6531AW,Compress stking bk30-40 surg,,,17.87,101.01,4
HCPCS,A6532,Compress stking bk40-50 surg,,,25.19,142.34,5
HCPCS,A65320,Compress stking bk40-50 surg,,,45.99,45.99,1
HCPCS,A6532AW,Compress stking bk40-50 surg,,,25.19,142.34,4
HCPCS,A6533,Gc stocking thighlngth 18-30,,,36.41,89.26,4
HCPCS,A65330,Gc stocking thighlngth 18-30,,,36.41,36.41,1
HCPCS,A6534,Gc stocking thighlngth 30-40,,,41.57,101.93,4
HCPCS,A65340,Gc stocking thighlngth 30-40,,,41.57,41.57,1
HCPCS,A6535,Gc stocking thighlngth 40+,,,47.87,117.35,4
HCPCS,A65350,Gc stocking thighlngth 40+,,,47.87,47.87,1
HCPCS,A6536,Gc stocking full lngth 18-30,,,49.08,120.33,4
HCPCS,A65360,Gc stocking full lngth 18-30,,,49.08,49.08,1
HCPCS,A6537,Gc stocking full lngth 30-40,,,58.18,142.65,4
HCPCS,A65370,Gc stocking full lngth 30-40,,,58.18,58.18,1
HCPCS,A6538,Gc stocking full lngth 40+,,,68.13,167.02,4
HCPCS,A65380,Gc stocking full lngth 40+,,,68.13,68.13,1
HCPCS,A6539,Gc stocking waistlngth 18-30,,,64.94,159.23,4
HCPCS,A65390,Gc stocking waistlngth 18-30,,,64.94,64.94,1
HCPCS,A6540,Gc stocking waistlngth 30-40,,,77.44,189.84,4
HCPCS,A65400,Gc stocking waistlngth 30-40,,,77.44,77.44,1
HCPCS,A6541,Gc stocking waistlngth 40+,,,91.72,224.88,4
HCPCS,A65410,Gc stocking waistlngth 40+,,,91.72,91.72,1
HCPCS,A6544,Gc stocking garter belt,,,11.4,27.0,4
HCPCS,A65440,Gc stocking garter belt,,,27.0,27.0,1
HCPCS,A6545,Grad com non-elastic bk surg,,,64.29,198.9,4
HCPCS,A65450,Grad com non-elastic bk surg,,,64.29,64.29,1
HCPCS,A6545AW,Grad com non-elastic bk surg,,,183.54,198.9,3
HCPCS,A6549,Grad com garm noc day use,,,75.6,85.22,4
HCPCS,A65490,Grad com garm noc day use,,,75.6,75.6,1
HCPCS,A6550,Neg pres wound ther drsg set,,,21.18,21.18,1
HCPCS,A65500,Neg pres wound ther drsg set,,,21.18,21.18,1
HCPCS,A6552,Grad com stocking bk 30-40,,,38.48,94.33,4
HCPCS,A65520,Grad com stocking bk 30-40,,,38.48,38.48,1
HCPCS,A6553,G com stcking bk 30-40 custm,,,150.24,368.34,4
HCPCS,A65530,G com stcking bk 30-40 custm,,,150.24,150.24,1
HCPCS,A6554,Grad com stocking bk 40+,,,52.9,129.7,4
HCPCS,A65540,Grad com stocking bk 40+,,,52.9,52.9,1
HCPCS,A6555,G com stcking bk 40+ custm,,,150.24,368.34,4
HCPCS,A65550,G com stcking bk 40+ custm,,,150.24,150.24,1
HCPCS,A6556,G com stcking thgh18-30 cust,,,205.89,504.79,4
HCPCS,A65560,G com stcking thgh18-30 cust,,,205.89,205.89,1
HCPCS,A6557,G com stcking thgh30-40 cust,,,205.89,504.79,4
HCPCS,A65570,G com stcking thgh30-40 cust,,,205.89,205.89,1
HCPCS,A6558,G com stcking thgh 40+ cust,,,212.48,520.93,4
HCPCS,A65580,G com stcking thgh 40+ cust,,,212.48,212.48,1
HCPCS,A6562,G com stckng waist18-30 cust,,,673.83,1652.08,4
HCPCS,A65620,G com stckng waist18-30 cust,,,673.83,673.83,1
HCPCS,A6563,G com stckng waist30-40 cust,,,673.83,1652.08,4
HCPCS,A65630,G com stckng waist30-40 cust,,,673.83,673.83,1
HCPCS,A6564,G com stckng waist 40+ cust,,,725.87,1779.65,4
HCPCS,A65640,G com stckng waist 40+ cust,,,725.87,725.87,1
HCPCS,A6565,Grad comp gauntlet custom,,,116.43,285.47,4
HCPCS,A65650,Grad comp gauntlet custom,,,116.43,116.43,1
HCPCS,A6566,Grad com garment neck/head,,,169.06,414.49,4
HCPCS,A65660,Grad com garment neck/head,,,169.06,169.06,1
HCPCS,A6567,G com garment neck/head cust,,,531.19,1302.34,4
HCPCS,A65670,G com garment neck/head cust,,,531.19,531.19,1
HCPCS,A6568,G com garment torso/shldr,,,110.33,270.52,4
HCPCS,A65680,G com garment torso/shldr,,,110.33,110.33,1
HCPCS,A6569,G com garmnt torso/shdr cust,,,628.29,1540.41,4
HCPCS,A65690,G com garmnt torso/shdr cust,,,628.29,628.29,1
HCPCS,A6570,Grad com garment genital,,,75.18,184.31,4
HCPCS,A65700,Grad com garment genital,,,75.18,75.18,1
HCPCS,A6571,G com garment genital custm,,,451.83,1107.77,4
HCPCS,A65710,G com garment genital custm,,,451.83,451.83,1
HCPCS,A6572,Grad com garment toe caps,,,69.76,171.03,4
HCPCS,A65720,Grad com garment toe caps,,,69.76,69.76,1
HCPCS,A6573,Grad com garmnt toe cap cust,,,165.53,405.84,4
HCPCS,A65730,Grad com garmnt toe cap cust,,,165.53,165.53,1
HCPCS,A6574,Custom gradient sleev/glov,,,211.03,517.39,4
HCPCS,A65740,Custom gradient sleev/glov,,,211.03,211.03,1
HCPCS,A6575,Gradient comp sleev/glov,,,68.39,167.67,4
HCPCS,A65750,Gradient comp sleev/glov,,,68.39,68.39,1
HCPCS,A6576,Custom grad com sleeve med,,,129.52,317.54,4
HCPCS,A65760,Custom grad com sleeve med,,,129.52,129.52,1
HCPCS,A6577,Custom grad cm sleeve heavy,,,107.2,262.81,4
HCPCS,A65770,Custom grad cm sleeve heavy,,,107.2,107.2,1
HCPCS,A6578,Gradient comp sleeve,,,52.79,129.44,4
HCPCS,A65780,Gradient comp sleeve,,,52.79,52.79,1
HCPCS,A6579,Custom grad com glove med,,,207.89,509.69,4
HCPCS,A65790,Custom grad com glove med,,,207.89,207.89,1
HCPCS,A6580,Custom grad com glove heavy,,,206.36,505.95,4
HCPCS,A65800,Custom grad com glove heavy,,,206.36,206.36,1
HCPCS,A6581,Gradient comp glove,,,48.44,118.76,4
HCPCS,A65810,Gradient comp glove,,,48.44,48.44,1
HCPCS,A6582,Gradient comp gauntlet,,,32.3,79.21,4
HCPCS,A65820,Gradient comp gauntlet,,,32.3,32.3,1
HCPCS,A6583,Grad com wrap w straps bk,,,106.27,260.54,4
HCPCS,A65830,Grad com wrap w straps bk,,,106.27,106.27,1
HCPCS,A6585,Grad com wrap w straps ak,,,125.83,308.5,4
HCPCS,A65850,Grad com wrap w straps ak,,,125.83,125.83,1
HCPCS,A6586,Grad com wrap w strap fu leg,,,370.7,908.86,4
HCPCS,A65860,Grad com wrap w strap fu leg,,,370.7,370.7,1
HCPCS,A6587,Grad com wrap w straps foot,,,48.56,119.06,4
HCPCS,A65870,Grad com wrap w straps foot,,,48.56,48.56,1
HCPCS,A6588,Grad com wrap w strap arm,,,161.84,396.8,4
HCPCS,A65880,Grad com wrap w strap arm,,,161.84,161.84,1
HCPCS,A6589,Grad com wrap w straps bra,,,63.89,156.64,4
HCPCS,A65890,Grad com wrap w straps bra,,,63.89,63.89,1
HCPCS,A6590,Urinary cath disp suc pump,,,272.31,272.31,1
HCPCS,A65900,Urinary cath disp suc pump,,,272.31,272.31,1
HCPCS,A6591,Urinary cath suc pump,,,60.92,60.92,1
HCPCS,A65910,Urinary cath suc pump,,,60.92,60.92,1
HCPCS,A6594,G comp bandge liner lwr extr,,,23.26,57.03,4
HCPCS,A65940,G comp bandge liner lwr extr,,,23.26,23.26,1
HCPCS,A6595,G comp bandge liner upr extr,,,22.87,56.1,4
HCPCS,A65950,G comp bandge liner upr extr,,,22.87,22.87,1
HCPCS,A6596,G comp bandge conform gauze,,,0.12,0.3,4
HCPCS,A65960,G comp bandge conform gauze,,,0.12,0.12,1
HCPCS,A6597,G comp bandage long stretch,,,1.04,2.52,4
HCPCS,A65970,G comp bandage long stretch,,,1.04,1.04,1
HCPCS,A6598,G comp bandage med stretch,,,0.5,1.22,4
HCPCS,A65980,G comp bandage med stretch,,,0.5,0.5,1
HCPCS,A6599,G comp bandage short stretch,,,1.13,2.77,4
HCPCS,A65990,G comp bandage short stretch,,,1.13,1.13,1
HCPCS,A6600,G com bandge hgh dn foam sht,,,2.04,5.0,4
HCPCS,A66000,G com bandge hgh dn foam sht,,,2.04,2.04,1
HCPCS,A6601,G com bandge hgh dn foam pad,,,2.29,5.61,4
HCPCS,A66010,G com bandge hgh dn foam pad,,,2.29,2.29,1
HCPCS,A6602,G com bandge hgh dn foamroll,,,3.34,8.19,4
HCPCS,A66020,G com bandge hgh dn foamroll,,,3.34,3.34,1
HCPCS,A6603,G com bandge low dn foamchnl,,,1.57,3.84,4
HCPCS,A66030,G com bandge low dn foamchnl,,,1.57,1.57,1
HCPCS,A6604,G com bandge low dn foam flt,,,0.92,2.24,4
HCPCS,A66040,G com bandge low dn foam flt,,,0.92,0.92,1
HCPCS,A6605,G com bandage padded foam,,,1.05,2.56,4
HCPCS,A66050,G com bandage padded foam,,,1.05,1.05,1
HCPCS,A6606,G com bandage padded textile,,,3.1,7.6,4
HCPCS,A66060,G com bandage padded textile,,,3.1,3.1,1
HCPCS,A6607,G com bandage tub protct lyr,,,0.83,2.04,4
HCPCS,A66070,G com bandage tub protct lyr,,,0.83,0.83,1
HCPCS,A6608,G com bandage tub protct pad,,,3.46,8.47,4
HCPCS,A66080,G com bandage tub protct pad,,,3.46,3.46,1
HCPCS,A6610,G com stcking bk 18-30 custm,,,150.24,368.34,4
HCPCS,A66100,G com stcking bk 18-30 custm,,,150.24,150.24,1
HCPCS,A7000,Disposable canister for pump,,,7.01,17.08,5
HCPCS,A70000,Disposable canister for pump,,,7.01,7.01,1
HCPCS,A7000NU,Disposable canister for pump,,,7.01,17.08,4
HCPCS,A7001,Nondisposable pump canister,,,3.16,65.64,7
HCPCS,A70010,Nondisposable pump canister,,,31.68,31.68,1
HCPCS,A7001NU,Nondisposable pump canister,,,31.68,65.64,4
HCPCS,A7001RR,Nondisposable pump canister,,,3.16,3.16,1
HCPCS,A7001UE,Nondisposable pump canister,,,23.76,23.76,1
HCPCS,A7002,Tubing used w suction pump,,,0.37,7.62,7
HCPCS,A70020,Tubing used w suction pump,,,3.67,3.67,1
HCPCS,A7002NU,Tubing used w suction pump,,,3.67,7.62,4
HCPCS,A7002RR,Tubing used w suction pump,,,0.37,0.37,1
HCPCS,A7002UE,Tubing used w suction pump,,,2.75,2.75,1
HCPCS,A7003,Nebulizer administration set,,,1.25,3.07,5
HCPCS,A70030,Nebulizer administration set,,,1.25,1.25,1
HCPCS,A7003NU,Nebulizer administration set,,,1.25,3.07,4
HCPCS,A7004,Disposable nebulizer sml vol,,,1.05,2.59,5
HCPCS,A70040,Disposable nebulizer sml vol,,,1.05,1.05,1
HCPCS,A7004NU,Disposable nebulizer sml vol,,,1.05,2.59,4
HCPCS,A7005,Nondisposable nebulizer set,,,10.68,24.43,5
HCPCS,A70050,Nondisposable nebulizer set,,,10.68,10.68,1
HCPCS,A7005NU,Nondisposable nebulizer set,,,10.68,24.43,4
HCPCS,A7006,Filtered nebulizer admin set,,,6.58,15.56,5
HCPCS,A70060,Filtered nebulizer admin set,,,6.58,6.58,1
HCPCS,A7006NU,Filtered nebulizer admin set,,,6.58,15.56,4
HCPCS,A7007,Lg vol nebulizer disposable,,,2.91,6.78,5
HCPCS,A70070,Lg vol nebulizer disposable,,,2.91,2.91,1
HCPCS,A7007NU,Lg vol nebulizer disposable,,,2.91,6.78,4
HCPCS,A7008,Disposable nebulizer prefill,,,1.06,21.82,7
HCPCS,A70080,Disposable nebulizer prefill,,,10.53,10.53,1
HCPCS,A7008NU,Disposable nebulizer prefill,,,10.53,21.82,4
HCPCS,A7008RR,Disposable nebulizer prefill,,,1.06,1.06,1
HCPCS,A7008UE,Disposable nebulizer prefill,,,7.89,7.89,1
HCPCS,A7009,Nebulizer reservoir bottle,,,4.03,91.15,7
HCPCS,A70090,Nebulizer reservoir bottle,,,40.28,40.28,1
HCPCS,A7009NU,Nebulizer reservoir bottle,,,40.28,91.15,4
HCPCS,A7009RR,Nebulizer reservoir bottle,,,4.03,4.03,1
HCPCS,A7009UE,Nebulizer reservoir bottle,,,30.22,30.22,1
HCPCS,A7010,Disposable corrugated tubing,,,13.33,32.84,5
HCPCS,A70100,Disposable corrugated tubing,,,13.33,13.33,1
HCPCS,A7010NU,Disposable corrugated tubing,,,13.33,32.84,4
HCPCS,A7012,Nebulizer water collec devic,,,2.32,6.03,5
HCPCS,A70120,Nebulizer water collec devic,,,2.32,2.32,1
HCPCS,A7012NU,Nebulizer water collec devic,,,2.32,6.03,4
HCPCS,A7013,Disposable compressor filter,,,0.49,1.19,5
HCPCS,A70130,Disposable compressor filter,,,0.49,0.49,1
HCPCS,A7013NU,Disposable compressor filter,,,0.49,1.19,4
HCPCS,A7014,Compressor nondispos filter,,,2.81,6.67,5
HCPCS,A70140,Compressor nondispos filter,,,2.81,2.81,1
HCPCS,A7014NU,Compressor nondispos filter,,,2.81,6.67,4
HCPCS,A7015,Aerosol mask used w nebulize,,,1.07,2.67,5
HCPCS,A70150,Aerosol mask used w nebulize,,,1.07,1.07,1
HCPCS,A7015NU,Aerosol mask used w nebulize,,,1.07,2.67,4
HCPCS,A7016,Nebulizer dome & mouthpiece,,,0.69,15.26,7
HCPCS,A70160,Nebulizer dome & mouthpiece,,,6.96,6.96,1
HCPCS,A7016NU,Nebulizer dome & mouthpiece,,,6.96,15.26,4
HCPCS,A7016RR,Nebulizer dome & mouthpiece,,,0.69,0.69,1
HCPCS,A7016UE,Nebulizer dome & mouthpiece,,,5.22,5.22,1
HCPCS,A7017,Nebulizer not used w oxygen,,,10.27,254.34,13
HCPCS,A70170,Nebulizer not used w oxygen,,,102.72,102.72,1
HCPCS,A7017NU,Nebulizer not used w oxygen,,,102.72,254.34,4
HCPCS,A7017RR,Nebulizer not used w oxygen,,,10.27,25.43,4
HCPCS,A7017UE,Nebulizer not used w oxygen,,,77.05,190.76,4
HCPCS,A7018,Water distilled w/nebulizer,,,0.29,0.67,4
HCPCS,A70180,Water distilled w/nebulizer,,,0.29,0.29,1
HCPCS,A7020,"Interface, cough stim device",,,1.38,32.55,7
HCPCS,A70200,"Interface, cough stim device",,,13.87,13.87,1
HCPCS,A7020NU,"Interface, cough stim device",,,13.87,32.55,4
HCPCS,A7020RR,"Interface, cough stim device",,,1.38,1.38,1
HCPCS,A7020UE,"Interface, cough stim device",,,10.4,10.4,1
HCPCS,A7021,Suppl and access lung expan,,,90.95,221.89,5
HCPCS,A70210,Suppl and access lung expan,,,90.95,90.95,1
HCPCS,A7021NU,Suppl and access lung expan,,,90.95,221.89,4
HCPCS,A7025,Replace chest compress vest,,,41.67,416.64,4
HCPCS,A70250,Replace chest compress vest,,,416.64,416.64,1
HCPCS,A7025NU,Replace chest compress vest,,,416.64,416.64,1
HCPCS,A7025RR,Replace chest compress vest,,,41.67,41.67,1
HCPCS,A7025UE,Replace chest compress vest,,,312.48,312.48,1
HCPCS,A7026,Replace chst cmprss sys hose,,,2.75,67.11,7
HCPCS,A70260,Replace chst cmprss sys hose,,,27.53,27.53,1
HCPCS,A7026NU,Replace chst cmprss sys hose,,,27.53,67.11,4
HCPCS,A7026RR,Replace chst cmprss sys hose,,,2.75,2.75,1
HCPCS,A7026UE,Replace chst cmprss sys hose,,,20.65,20.65,1
HCPCS,A7027,Combination oral/nasal mask,,,101.66,250.05,5
HCPCS,A70270,Combination oral/nasal mask,,,101.66,101.66,1
HCPCS,A7027NU,Combination oral/nasal mask,,,101.66,250.05,4
HCPCS,A7028,Repl oral cushion combo mask,,,28.72,69.91,5
HCPCS,A70280,Repl oral cushion combo mask,,,28.72,28.72,1
HCPCS,A7028NU,Repl oral cushion combo mask,,,28.72,69.91,4
HCPCS,A7029,Repl nasal pillow comb mask,,,12.82,31.25,5
HCPCS,A70290,Repl nasal pillow comb mask,,,12.82,12.82,1
HCPCS,A7029NU,Repl nasal pillow comb mask,,,12.82,31.25,4
HCPCS,A7030,Cpap full face mask,,,73.54,179.88,5
HCPCS,A70300,Cpap full face mask,,,73.54,73.54,1
HCPCS,A7030NU,Cpap full face mask,,,73.54,179.88,4
HCPCS,A7031,Replacement facemask interfa,,,27.81,69.76,5
HCPCS,A70310,Replacement facemask interfa,,,27.81,27.81,1
HCPCS,A7031NU,Replacement facemask interfa,,,27.81,69.76,4
HCPCS,A7032,Replacement nasal cushion,,,15.33,39.13,5
HCPCS,A70320,Replacement nasal cushion,,,15.33,15.33,1
HCPCS,A7032NU,Replacement nasal cushion,,,15.33,39.13,4
HCPCS,A7033,Replacement nasal pillows,,,12.88,31.5,5
HCPCS,A70330,Replacement nasal pillows,,,12.88,12.88,1
HCPCS,A7033NU,Replacement nasal pillows,,,12.88,31.5,4
HCPCS,A7034,Nasal application device,,,46.56,113.49,5
HCPCS,A70340,Nasal application device,,,46.56,46.56,1
HCPCS,A7034NU,Nasal application device,,,46.56,113.49,4
HCPCS,A7035,Pos airway press headgear,,,15.27,37.25,5
HCPCS,A70350,Pos airway press headgear,,,15.27,15.27,1
HCPCS,A7035NU,Pos airway press headgear,,,15.27,37.25,4
HCPCS,A7036,Pos airway press chinstrap,,,9.02,21.67,5
HCPCS,A70360,Pos airway press chinstrap,,,9.02,9.02,1
HCPCS,A7036NU,Pos airway press chinstrap,,,9.02,21.67,4
HCPCS,A7037,Pos airway pressure tubing,,,9.89,24.03,5
HCPCS,A70370,Pos airway pressure tubing,,,9.89,9.89,1
HCPCS,A7037NU,Pos airway pressure tubing,,,9.89,24.03,4
HCPCS,A7038,Pos airway pressure filter,,,1.73,4.19,5
HCPCS,A70380,Pos airway pressure filter,,,1.73,1.73,1
HCPCS,A7038NU,Pos airway pressure filter,,,1.73,4.19,4
HCPCS,A7039,"Filter, non disposable w pap",,,5.23,12.32,5
HCPCS,A70390,"Filter, non disposable w pap",,,5.23,5.23,1
HCPCS,A7039NU,"Filter, non disposable w pap",,,5.23,12.32,4
HCPCS,A7040,One way chest drain valve,,,38.74,38.74,1
HCPCS,A70400,One way chest drain valve,,,38.74,38.74,1
HCPCS,A7041,Water seal drain container,,,72.81,72.81,1
HCPCS,A70410,Water seal drain container,,,72.81,72.81,1
HCPCS,A7044,Pap oral interface,,,72.42,172.83,5
HCPCS,A70440,Pap oral interface,,,72.42,72.42,1
HCPCS,A7044NU,Pap oral interface,,,72.42,172.83,4
HCPCS,A7045,Repl exhalation port for pap,,,1.07,23.8,13
HCPCS,A70450,Repl exhalation port for pap,,,10.66,10.66,1
HCPCS,A7045NU,Repl exhalation port for pap,,,10.66,23.8,4
HCPCS,A7045RR,Repl exhalation port for pap,,,1.07,2.37,4
HCPCS,A7045UE,Repl exhalation port for pap,,,7.99,17.85,4
HCPCS,A7046,"Repl water chamber, pap dev",,,11.42,27.69,5
HCPCS,A70460,"Repl water chamber, pap dev",,,11.42,11.42,1
HCPCS,A7046NU,"Repl water chamber, pap dev",,,11.42,27.69,4
HCPCS,A7047,Resp suction oral interface,,,11.58,115.81,4
HCPCS,A70470,Resp suction oral interface,,,115.81,115.81,1
HCPCS,A7047NU,Resp suction oral interface,,,115.81,115.81,1
HCPCS,A7047RR,Resp suction oral interface,,,11.58,11.58,1
HCPCS,A7047UE,Resp suction oral interface,,,86.85,86.85,1
HCPCS,A7048,Vacuum drain bottle/tube kit,,,40.54,40.54,1
HCPCS,A70480,Vacuum drain bottle/tube kit,,,40.54,40.54,1
HCPCS,A7501,Tracheostoma valve w diaphra,,,100.59,100.59,1
HCPCS,A75010,Tracheostoma valve w diaphra,,,100.59,100.59,1
HCPCS,A7502,Replacement diaphragm/fplate,,,47.82,47.82,1
HCPCS,A75020,Replacement diaphragm/fplate,,,47.82,47.82,1
HCPCS,A7503,Hmes filter holder or cap,,,10.86,10.86,1
HCPCS,A75030,Hmes filter holder or cap,,,10.86,10.86,1
HCPCS,A7504,Tracheostoma hmes filter,,,0.65,0.65,1
HCPCS,A75040,Tracheostoma hmes filter,,,0.65,0.65,1
HCPCS,A7505,Hmes or trach valve housing,,,4.49,4.49,1
HCPCS,A75050,Hmes or trach valve housing,,,4.49,4.49,1
HCPCS,A7506,Hmes/trachvalve adhesivedisk,,,0.31,0.31,1
HCPCS,A75060,Hmes/trachvalve adhesivedisk,,,0.31,0.31,1
HCPCS,A7507,Integrated filter & holder,,,2.4,2.4,1
HCPCS,A75070,Integrated filter & holder,,,2.4,2.4,1
HCPCS,A7508,Housing & integrated adhesiv,,,2.75,2.75,1
HCPCS,A75080,Housing & integrated adhesiv,,,2.75,2.75,1
HCPCS,A7509,Heat & moisture exchange sys,,,1.35,1.35,1
HCPCS,A75090,Heat & moisture exchange sys,,,1.35,1.35,1
HCPCS,A7520,Trach/laryn tube non-cuffed,,,45.48,45.48,1
HCPCS,A7520,W TUBE TRACH UNCUF W/DIC,84.0,54.6,14.11,82.32,29
HCPCS,A75200,Trach/laryn tube non-cuffed,,,45.48,45.48,1
HCPCS,A7521,Trach/laryn tube cuffed,,,45.06,45.06,1
HCPCS,A7521,W TRACH TUBE BIVONA,305.0,198.25,51.24,274.5,21
HCPCS,A75210,Trach/laryn tube cuffed,,,45.06,45.06,1
HCPCS,A7522,Trach/laryn tube stainless,,,43.25,43.25,1
HCPCS,A75220,Trach/laryn tube stainless,,,43.25,43.25,1
HCPCS,A7523,Tracheostomy shower protect,,,1.89,1.89,1
HCPCS,A75230,Tracheostomy shower protect,,,1.89,1.89,1
HCPCS,A7524,Tracheostoma stent/stud/bttn,,,74.15,74.15,1
HCPCS,A75240,Tracheostoma stent/stud/bttn,,,74.15,74.15,1
HCPCS,A7525,Tracheostomy mask,,,1.98,1.98,1
HCPCS,A75250,Tracheostomy mask,,,1.98,1.98,1
HCPCS,A7526,Tracheostomy tube collar,,,3.25,3.25,1
HCPCS,A7526,W TRACH COLLAR,10.0,6.5,1.68,9.8,29
HCPCS,A75260,Tracheostomy tube collar,,,3.25,3.25,1
HCPCS,A7527,Trach/laryn tube plug/stop,,,3.42,3.42,1
HCPCS,A75270,Trach/laryn tube plug/stop,,,3.42,3.42,1
HCPCS,A8000,Soft protect helmet prefab,,,14.69,358.06,13
HCPCS,A80000,Soft protect helmet prefab,,,146.9,146.9,1
HCPCS,A8000NU,Soft protect helmet prefab,,,146.9,358.06,4
HCPCS,A8000RR,Soft protect helmet prefab,,,14.69,35.81,4
HCPCS,A8000UE,Soft protect helmet prefab,,,110.2,268.61,4
HCPCS,A8001,Hard protect helmet prefab,,,14.69,358.06,13
HCPCS,A80010,Hard protect helmet prefab,,,146.9,146.9,1
HCPCS,A8001NU,Hard protect helmet prefab,,,146.9,358.06,4
HCPCS,A8001RR,Hard protect helmet prefab,,,14.69,35.81,4
HCPCS,A8001UE,Hard protect helmet prefab,,,110.2,268.61,4
HCPCS,A8002,Soft protect helmet custom,,,46.01,460.08,4
HCPCS,A80020,Soft protect helmet custom,,,460.08,460.08,1
HCPCS,A8002NU,Soft protect helmet custom,,,460.08,460.08,1
HCPCS,A8002RR,Soft protect helmet custom,,,46.01,46.01,1
HCPCS,A8002UE,Soft protect helmet custom,,,345.06,345.06,1
HCPCS,A8003,Hard protect helmet custom,,,62.1,621.0,4
HCPCS,A80030,Hard protect helmet custom,,,621.0,621.0,1
HCPCS,A8003NU,Hard protect helmet custom,,,621.0,621.0,1
HCPCS,A8003RR,Hard protect helmet custom,,,62.1,62.1,1
HCPCS,A8003UE,Hard protect helmet custom,,,465.75,465.75,1
HCPCS,A9150,Misc/exper non-prescript dru,,,4.43,4.43,1
HCPCS,A91500,Misc/exper non-prescript dru,,,4.43,4.43,1
HCPCS,A9153,Multi-vitamin nos,,,34.15,34.15,1
HCPCS,A91530,Multi-vitamin nos,,,34.15,34.15,1
HCPCS,A9154,"Artificial saliva, 1 ml",,,0.23,0.58,4
HCPCS,A91540,"Artificial saliva, 1 ml",,,0.23,0.23,1
HCPCS,A9155,Artificial saliva,,,7.99,7.99,1
HCPCS,A91550,Artificial saliva,,,7.99,7.99,1
HCPCS,A9156,Oral mucoadhesive per 1 ml,,,2.52,6.38,4
HCPCS,A91560,Oral mucoadhesive per 1 ml,,,2.52,2.52,1
HCPCS,A9180,"Lice treatment, topical",,,0.93,2.36,4
HCPCS,A91800,"Lice treatment, topical",,,0.93,0.93,1
HCPCS,A9270,1ST STEP OTS INSOLES 3/4 LGTH W 7-8,58.0,37.7,29.0,58.0,12
HCPCS,A9270,ACNE TREATMENT KIT,34.0,22.1,17.0,34.0,12
HCPCS,A9270,AFTERCARE ENV PROTECTOR SPF 30,29.0,18.85,14.5,29.0,12
HCPCS,A9270,BODY WASH,15.0,9.75,7.5,15.0,12
HCPCS,A9270,"BRA, CHAMPION",48.0,31.2,24.0,48.0,12
HCPCS,A9270,FACIAL CLEANSER II,34.0,22.1,17.0,34.0,12
HCPCS,A9270,GLYCARE CLEANSING GEL,34.0,22.1,17.0,34.0,12
HCPCS,A9270,HAND AND BODY CREAM,39.0,25.35,19.5,39.0,12
HCPCS,A9270,KERATOSIS PILARIS KIT,39.0,25.35,19.5,39.0,12
HCPCS,A9270,MALLETT SPLINT,5.0,3.25,2.5,5.0,12
HCPCS,A9270,MILD GEL FACIAL WASH,15.0,9.75,7.5,15.0,12
HCPCS,A9270,NORMAL SKIN REGIMEN KIT,132.0,85.8,66.0,132.0,12
HCPCS,A9270,Non-covered item or service,,,1.17,1.17,1
HCPCS,A9270,ROYCE MEDICAL FORM FIT BACK SUPPORT,67.0,43.55,33.5,67.0,12
HCPCS,A9270,SENSITIVE SKIN REGIMEN KIT,48.0,31.2,24.0,48.0,12
HCPCS,A9270,SINUS RINSE; KIT,4.0,2.6,2.0,4.0,12
HCPCS,A9270,SINUS RINSE;KIT,12.0,7.8,6.0,12.0,12
HCPCS,A9270,SPF 20 SUN PROTECTOR,29.0,18.85,14.5,29.0,12
HCPCS,A9270,THER PUTTY,28.0,18.2,14.0,28.0,12
HCPCS,A9270,TOTAL DAILY PROTECTOR SPF 15,21.0,13.65,10.5,21.0,12
HCPCS,A9270,TX OF SPEECH/SWALLOWING DYSFUNCTION N/C,205.0,133.25,102.5,205.0,12
HCPCS,A9270,ULTRA HEEL & ELBOW CREAM,34.0,22.1,17.0,34.0,12
HCPCS,A92700,Non-covered item or service,,,1.17,1.17,1
HCPCS,A9272,"Disp wound suct, drsg/access",,,12.55,85.49,10
HCPCS,A92720,"Disp wound suct, drsg/access",,,85.49,85.49,1
HCPCS,A9272NU,"Disp wound suct, drsg/access",,,16.74,18.14,3
HCPCS,A9272UE,"Disp wound suct, drsg/access",,,12.55,13.6,3
HCPCS,A9273,Hot/cold botle/cap/col/wrap,,,5.53,5.53,1
HCPCS,A92730,Hot/cold botle/cap/col/wrap,,,5.53,5.53,1
HCPCS,A9274,Ext amb insulin delivery sys,,,21.38,21.38,2
HCPCS,A92740,Ext amb insulin delivery sys,,,21.38,21.38,1
HCPCS,A9274NU,Ext amb insulin delivery sys,,,21.38,21.38,1
HCPCS,A9275,Disp home glucose monitor,,,0.2,0.97,4
HCPCS,A92750,Disp home glucose monitor,,,0.97,0.97,1
HCPCS,A9276,"Disposable sensor, cgm sys",,,12.4,12.4,2
HCPCS,A92760,"Disposable sensor, cgm sys",,,12.4,12.4,1
HCPCS,A9276NU,"Disposable sensor, cgm sys",,,12.4,12.4,1
HCPCS,A9277,"External transmitter, cgm",,,332.27,332.27,1
HCPCS,A92770,"External transmitter, cgm",,,332.27,332.27,1
HCPCS,A9278,"External receiver, cgm sys",,,473.45,473.45,1
HCPCS,A92780,"External receiver, cgm sys",,,473.45,473.45,1
HCPCS,A9281,Reaching/grabbing device,,,43.09,43.09,1
HCPCS,A92810,Reaching/grabbing device,,,43.09,43.09,1
HCPCS,A9282,Wig any type,,,655.35,1080.0,4
HCPCS,A92820,Wig any type,,,1080.0,1080.0,1
HCPCS,A9283,Foot press off load supp dev,,,29.35,29.35,1
HCPCS,A92830,Foot press off load supp dev,,,29.35,29.35,1
HCPCS,A9284,Non-electronic spirometer,,,10.69,10.69,1
HCPCS,A92840,Non-electronic spirometer,,,10.69,10.69,1
HCPCS,A9285,Inversion eversion cor devic,,,167.36,167.36,1
HCPCS,A92850,Inversion eversion cor devic,,,167.36,167.36,1
HCPCS,A9286,"Any hygienic item, device",,,3.36,3.36,1
HCPCS,A92860,"Any hygienic item, device",,,3.36,3.36,1
HCPCS,A9300,Exercise equipment,,,24.24,24.24,1
HCPCS,A93000,Exercise equipment,,,24.24,24.24,1
HCPCS,A9500,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,66.0,42.9,11.09,2409.0,29
HCPCS,A9500,"SUPPLY TECHNICIUM SESTAMIBI,PER DOSE",73.0,47.45,36.5,450.58,14
HCPCS,A9500,TC99M SESTAMIBI PER DOSE,73.0,47.45,12.26,2409.0,58
HCPCS,A9500,"TC99M,SESTAMIBI, CARDIOLITE PER DOSE",189.0,122.85,94.5,450.58,14
HCPCS,A9500,Tc99m sestamibi,,,110.68,110.68,1
HCPCS,A95000,Tc99m sestamibi,,,110.68,110.68,1
HCPCS,A9501,Technetium tc-99m teboroxime,,,162.0,162.0,1
HCPCS,A95010,Technetium tc-99m teboroxime,,,162.0,162.0,1
HCPCS,A9502,MYOVIEW KIT 1.38 MG INTRAVENOUS SOLUTION,62.0,40.3,10.42,2409.0,29
HCPCS,A9502,SUPPLY TECHNICIUM TETROFOSMIN / DOSE,68.0,44.2,34.0,91.68,14
HCPCS,A9502,TC99M TETROFOSMIN PER DOSE 1 SYR,68.0,44.2,11.42,2409.0,29
HCPCS,A9502,TC99M TETROFOSMIN PER DOSE 2 SYR,68.0,44.2,11.42,2409.0,29
HCPCS,A9502,TC99M TETROFOSMIN/PER DOSE,68.0,44.2,11.42,2409.0,29
HCPCS,A9502,Tc99m tetrofosmin,,,88.41,88.41,1
HCPCS,A95020,Tc99m tetrofosmin,,,88.41,88.41,1
HCPCS,A9503,DRAXIMAGE MDP-25 25 MG INTRAVENOUS SOLUTION,56.0,36.4,9.41,2409.0,29
HCPCS,A9503,"SUPPLY TECHNETIUM MEDRONATE,TO 30 MC",62.0,40.3,13.0,62.0,14
HCPCS,A9503,TC99M MEDRONATE<30MCI,62.0,40.3,10.42,2409.0,29
HCPCS,A9503,Tc99m medronate,,,13.48,13.48,1
HCPCS,A95030,Tc99m medronate,,,13.48,13.48,1
HCPCS,A9504,Tc99m apcitide,,,432.0,1096.0,4
HCPCS,A95040,Tc99m apcitide,,,432.0,432.0,1
HCPCS,A9505,Tl201 thallium,,,33.86,85.9,4
HCPCS,A95050,Tl201 thallium,,,33.86,33.86,1
HCPCS,A9506,Tc-99m graphite crucible,,,321.41,815.42,21
HCPCS,A95060,Tc-99m graphite crucible,,,321.41,321.41,1
HCPCS,A9507,In111 capromab,,,1730.29,11563.27,8
HCPCS,A95070,In111 capromab,,,4557.78,4557.78,1
HCPCS,A9508,"I131 iodobenguate, dx",,,678.24,1048.31,5
HCPCS,A95080,"I131 iodobenguate, dx",,,678.24,678.24,1
HCPCS,A9509,I-123 CAP PER 1 MCI,231.0,150.15,38.81,2409.0,26
HCPCS,A9509,Iodine i-123 sod iodide mil,,,111.12,111.12,1
HCPCS,A95090,Iodine i-123 sod iodide mil,,,111.12,111.12,1
HCPCS,A9510,Tc99m disofenin,,,72.58,184.13,4
HCPCS,A95100,Tc99m disofenin,,,72.58,72.58,1
HCPCS,A9512,TC99 PERTECHNET,37.0,24.05,6.22,2409.0,26
HCPCS,A9512,Tc99m pertechnetate,,,1.75,1.75,1
HCPCS,A95120,Tc99m pertechnetate,,,1.75,1.75,1
HCPCS,A9513,"LUTETIUM LU 177 DOTATATE, TX",671.0,436.15,296.25,25906.15,36
HCPCS,A9513,"LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MILLICURIE",117172.0,76161.8,335.22,117172.0,13
HCPCS,A9513,Lutetium lu 177 dotatat ther,,,316.25,316.25,1
HCPCS,A95130,Lutetium lu 177 dotatat ther,,,316.25,316.25,1
HCPCS,A9515,Choline c-11,,,2062.94,13152.0,21
HCPCS,A95150,Choline c-11,,,5184.0,5184.0,1
HCPCS,A9516,I-123 SODIUM CAP 100 UCI,231.0,150.15,38.81,2409.0,29
HCPCS,A9516,I-123 SODIUM CAP 200 UCI,231.0,150.15,38.81,2409.0,29
HCPCS,A9516,Iodine i-123 sod iodide mic,,,110.14,110.14,1
HCPCS,A9516,SODIUM IODIDE-123 3.7 MBQ (100 MICROCI) CAPSULE,210.0,136.5,35.28,2409.0,29
HCPCS,A95160,Iodine i-123 sod iodide mic,,,110.14,110.14,1
HCPCS,A9517,I131 THERA CAPSL /MCI,198.0,128.7,23.13,581.52,37
HCPCS,A9517,"I131 iodide cap, rx",,,63.02,63.02,1
HCPCS,A95170,"I131 iodide cap, rx",,,63.02,63.02,1
HCPCS,A9520,KIT FOR THE PREP OF TC-99M-TILMANOCEPT 250 MCG SOLUTION FOR INJECTION,1190.0,773.5,199.92,2409.0,29
HCPCS,A9520,TC99 TILMANOCEPT DIAG 0.5MCI,1309.0,850.85,219.91,2409.0,29
HCPCS,A9520,Tc99 tilmanocept diag 0.5mci,,,685.92,685.92,1
HCPCS,A95200,Tc99 tilmanocept diag 0.5mci,,,685.92,685.92,1
HCPCS,A9521,CERETEC 0.5 MG INTRAVENOUS SOLUTION,3128.0,2033.2,802.34,2815.2,36
HCPCS,A9521,TC99M EXAMETAZIME<25MCI,3441.0,2236.65,802.34,3096.9,36
HCPCS,A9521,Tc99m exametazime,,,1777.04,1777.04,1
HCPCS,A95210,Tc99m exametazime,,,1777.04,1777.04,1
HCPCS,A9524,I131 SERUM ALBUMIN DX PER 5UCI,198.0,128.7,33.26,2409.0,26
HCPCS,A9524,"I131 serum albumin, dx",,,387.5,387.5,1
HCPCS,A95240,"I131 serum albumin, dx",,,387.5,387.5,1
HCPCS,A9526,Nitrogen n-13 ammonia,,,751.57,1906.77,4
HCPCS,A95260,Nitrogen n-13 ammonia,,,751.57,751.57,1
HCPCS,A9527,Iodine i-125 sodium iodide,,,135.39,452.24,15
HCPCS,A95270,Iodine i-125 sodium iodide,,,135.39,135.39,1
HCPCS,A9528,I131 DX CAPSL /MCI,198.0,128.7,33.26,2409.0,26
HCPCS,A9528,"Iodine i-131 iodide cap, dx",,,62.16,62.16,1
HCPCS,A9528,SODIUM IODIDE-131 (I-131) 3.7 MBQ (100 MICROCI) CAPSULE,180.0,117.0,30.24,2409.0,26
HCPCS,A95280,"Iodine i-131 iodide cap, dx",,,62.16,62.16,1
HCPCS,A9529,"I131 iodide sol, dx",,,1.13,1.13,1
HCPCS,A9529,"IODINE I-131 SODIUM IODID SOLUTION, DIAG, PER MCI",180.0,117.0,30.24,2409.0,26
HCPCS,A95290,"I131 iodide sol, dx",,,1.13,1.13,1
HCPCS,A9530,"I131 iodide sol, rx",,,7.24,581.52,24
HCPCS,A95300,"I131 iodide sol, rx",,,7.24,7.24,1
HCPCS,A9531,I131 max 100uci,,,2.76,2.76,1
HCPCS,A95310,I131 max 100uci,,,2.76,2.76,1
HCPCS,A9532,"I125 serum albumin, dx",,,22.68,515.97,8
HCPCS,A95320,"I125 serum albumin, dx",,,22.68,22.68,1
HCPCS,A9536,Tc99m depreotide,,,1209.6,3068.8,4
HCPCS,A95360,Tc99m depreotide,,,1209.6,1209.6,1
HCPCS,A9537,CHOLETEC 45 MG INTRAVENOUS SOLUTION,62.0,40.3,10.42,2409.0,29
HCPCS,A9537,TC99M MEBROFENIN,68.0,44.2,34.0,68.0,14
HCPCS,A9537,TC99M MEBROFENIN<15MCI,68.0,44.2,11.42,2409.0,29
HCPCS,A9537,Tc99m mebrofenin,,,57.35,57.35,1
HCPCS,A95370,Tc99m mebrofenin,,,57.35,57.35,1
HCPCS,A9538,KIT PREPARATION OF TC-99M-SODIUM PYROPHOSPHATE 12 MG IV SOLUTION,118.0,76.7,19.82,2409.0,29
HCPCS,A9538,TC99M PYROPHOSPHATE =< 25 MCI,130.0,84.5,21.84,2409.0,29
HCPCS,A9538,TC99M PYROPHOSPHATE<25MCI,130.0,84.5,21.84,2409.0,29
HCPCS,A9538,"TECHNETIUM TC-99M PYROPHOSPHATE, DIAGNOSTIC",130.0,84.5,64.05,130.0,14
HCPCS,A9538,Tc99m pyrophosphate,,,66.41,66.41,1
HCPCS,A95380,Tc99m pyrophosphate,,,66.41,66.41,1
HCPCS,A9539,DRAXIMAGE DTPA 20 MG INTRAVENOUS SOLUTION,426.0,276.9,71.57,2409.0,26
HCPCS,A9539,TC99M PENTETATE<25MCI,264.0,171.6,44.35,2409.0,26
HCPCS,A9539,Tc99m pentetate,,,32.49,32.49,1
HCPCS,A95390,Tc99m pentetate,,,32.49,32.49,1
HCPCS,A9540,DRAXIMAGE MAA 2.5 MG INTRAVENOUS SOLUTION,1092.0,709.8,183.46,2409.0,29
HCPCS,A9540,TC99M MAA<10MCI,1201.0,780.65,201.77,2409.0,29
HCPCS,A9540,Tc99m maa,,,31.1,31.1,1
HCPCS,A95400,Tc99m maa,,,31.1,31.1,1
HCPCS,A9541,KIT FOR PREPARATION OF TC 99M-SODIUM THIOSULFATE 2 MG SOLUTION,200.0,130.0,33.6,2409.0,29
HCPCS,A9541,TC99M FILTERED SULFR COLLOID,220.0,143.0,36.96,2409.0,87
HCPCS,A9541,TC99M FILTERED SULFUR COLLOID,220.0,143.0,36.96,2409.0,29
HCPCS,A9541,TC99M SULFUR COLLOID =< 20MCI,220.0,143.0,36.96,2409.0,29
HCPCS,A9541,Tc99m sulfur colloid,,,277.2,277.2,1
HCPCS,A95410,Tc99m sulfur colloid,,,277.2,277.2,1
HCPCS,A9542,"In111 ibritumomab, dx",,,798.02,2619.93,14
HCPCS,A95420,"In111 ibritumomab, dx",,,2619.93,2619.93,1
HCPCS,A9543,"Y90 ibritumomab, rx",,,70302.0,70302.0,1
HCPCS,A9543,ZEVALIN (Y-90) 3.2 MG/2 ML INTRAVENOUS KIT,148248.86,96361.76,14774.74,148248.86,45
HCPCS,A95430,"Y90 ibritumomab, rx",,,70302.0,70302.0,1
HCPCS,A9546,Co57/58,,,0.85,0.85,1
HCPCS,A95460,Co57/58,,,0.85,0.85,1
HCPCS,A9547,IN111 OXYQUINOLINE,5533.0,3596.45,2104.98,5533.0,14
HCPCS,A9547,IN111 OXYQUINOLINE 0.5MCI,5533.0,3596.45,772.64,4979.7,39
HCPCS,A9547,INDIUM IN-111 OXYQUINOLINE 1 MCI/ML (37 MBQ/ML)(1 ML) INTRAVENOUS SOLN,5030.0,3269.5,772.64,4527.0,39
HCPCS,A9547,In111 oxyquinoline,,,2182.44,2182.44,1
HCPCS,A95470,In111 oxyquinoline,,,2182.44,2182.44,1
HCPCS,A9548,IN111 DTPA.5MCI,4970.0,3230.5,715.29,4473.0,39
HCPCS,A9548,IN111 PENTETATE,4970.0,3230.5,885.5,4970.0,13
HCPCS,A9548,INDIUM IN-111 DTPA 1.5 MCI/1.5 ML INTRATHECAL SOLUTION,4518.0,2936.7,715.29,4066.2,39
HCPCS,A9548,In111 pentetate,,,918.09,918.09,1
HCPCS,A95480,In111 pentetate,,,918.09,918.09,1
HCPCS,A9550,Tc99m gluceptate,,,237.6,237.6,1
HCPCS,A95500,Tc99m gluceptate,,,237.6,237.6,1
HCPCS,A9551,Tc99m succimer,,,621.48,1576.71,8
HCPCS,A95510,Tc99m succimer,,,621.48,621.48,1
HCPCS,A9552,F18 FDG,250.0,162.5,125.0,359.05,13
HCPCS,A9552,F18 FDG DOSE,275.0,178.75,46.2,2409.0,26
HCPCS,A9552,F18 fdg,,,326.55,326.55,1
HCPCS,A9552,FLUDEOXYGLUCOSE F-18 20 MCI TO 500 MCI/ML INTRAVENOUS SOLUTION,250.0,162.5,42.0,2409.0,26
HCPCS,A9552,PET SCAN ISOTP UP TO 45MCI,275.0,178.75,46.2,2409.0,26
HCPCS,A95520,F18 fdg,,,326.55,326.55,1
HCPCS,A9553,Cr51 chromate,,,274.83,2109.76,5
HCPCS,A95530,Cr51 chromate,,,274.83,274.83,1
HCPCS,A9554,"I125 iothalamate, dx",,,38.88,714.6,8
HCPCS,A95540,"I125 iothalamate, dx",,,38.88,38.88,1
HCPCS,A9555,RB82<60MCI,800.0,520.0,134.4,2409.0,26
HCPCS,A9555,Rb82 rubidium,,,297.6,297.6,1
HCPCS,A95550,Rb82 rubidium,,,297.6,297.6,1
HCPCS,A9556,GA67 CITRTE1MCI,2889.0,1877.85,485.35,2600.1,29
HCPCS,A9556,Ga67 gallium,,,139.99,139.99,1
HCPCS,A95560,Ga67 gallium,,,139.99,139.99,1
HCPCS,A9557,NEUROLITE 0.9 MG INTRAVENOUS SOLUTION,3766.0,2447.9,683.8,3389.4,39
HCPCS,A9557,TC99M BICISATE<25MCI,4143.0,2692.95,683.8,3728.7,39
HCPCS,A9557,Tc99m bicisate,,,3801.24,3801.24,1
HCPCS,A95570,Tc99m bicisate,,,3801.24,3801.24,1
HCPCS,A9558,XENON XE-133  370 MBQ (10 MCI) GAS FOR INHALATION,460.0,299.0,77.28,2409.0,26
HCPCS,A9558,Xe133 xenon 10mci,,,264.49,264.49,1
HCPCS,A95580,Xe133 xenon 10mci,,,264.49,264.49,1
HCPCS,A9559,Co57 cyano,,,75.96,192.7,4
HCPCS,A95590,Co57 cyano,,,75.96,75.96,1
HCPCS,A9560,TC99 RBC DOSE,385.0,250.25,64.68,2409.0,29
HCPCS,A9560,TC99M LABELED RBC,385.0,250.25,100.0,385.0,13
HCPCS,A9560,Tc99m labeled rbc,,,96.83,96.83,1
HCPCS,A9560,ULTRATAG RBC INTRAVENOUS SOLUTION,350.0,227.5,58.8,2409.0,29
HCPCS,A95600,Tc99m labeled rbc,,,96.83,96.83,1
HCPCS,A9561,TC99M OXIDRONATE<30MCI,90.0,58.5,15.12,2409.0,26
HCPCS,A9561,TECHNESCAN HDP 3.15 MG INTRAVENOUS SOLUTION,82.0,53.3,13.78,2409.0,26
HCPCS,A9561,Tc99m oxidronate,,,45.62,45.62,1
HCPCS,A95610,Tc99m oxidronate,,,45.62,45.62,1
HCPCS,A9562,KIT FOR PREP TC-99M-MERTIATIDE (BETIATIDE) 1 MG INTRAVENOUS SOLUTION,568.0,369.2,95.42,2409.0,29
HCPCS,A9562,TC99M MERTIATIDE,625.0,406.25,312.5,883.24,13
HCPCS,A9562,TC99M MERTIATIDE<15MCI,625.0,406.25,105.0,2409.0,29
HCPCS,A9562,Tc99m mertiatide,,,505.59,505.59,1
HCPCS,A95620,Tc99m mertiatide,,,505.59,505.59,1
HCPCS,A9563,P32 na phosphate,,,179.12,581.52,24
HCPCS,A95630,P32 na phosphate,,,316.09,316.09,1
HCPCS,A9564,P32 chromic phosphate,,,99.63,581.52,7
HCPCS,A95640,P32 chromic phosphate,,,99.63,99.63,1
HCPCS,A9566,Tc99m fanolesomab,,,223.26,223.26,1
HCPCS,A95660,Tc99m fanolesomab,,,223.26,223.26,1
HCPCS,A9567,TC99M AERO<75MCI,264.0,171.6,44.35,2409.0,29
HCPCS,A9567,Technetium tc-99m aerosol,,,13.41,13.41,1
HCPCS,A95670,Technetium tc-99m aerosol,,,13.41,13.41,1
HCPCS,A9568,Technetium tc99m arcitumomab,,,809.51,2849.6,17
HCPCS,A95680,Technetium tc99m arcitumomab,,,1123.2,1123.2,1
HCPCS,A9569,TC99M CERETEC WBC,2568.0,1669.2,934.13,2409.0,39
HCPCS,A9569,"TECHNETIUM TC-99M EXAMETAZIME LBLD AUTO WHT BLD CELLS,DIAG,PER S",2568.0,1669.2,934.13,2409.0,39
HCPCS,A9569,Technetium tc-99m auto wbc,,,1777.04,1777.04,1
HCPCS,A95690,Technetium tc-99m auto wbc,,,1777.04,1777.04,1
HCPCS,A9570,IN111 AUTO WBC DIAG/PER DOSE,5421.0,3523.65,1031.39,4878.9,36
HCPCS,A9570,Indium in-111 auto wbc,,,4364.88,4364.88,1
HCPCS,A95700,Indium in-111 auto wbc,,,4364.88,4364.88,1
HCPCS,A9571,Indium in-111 auto platelet,,,4364.88,11073.87,4
HCPCS,A95710,Indium in-111 auto platelet,,,4364.88,4364.88,1
HCPCS,A9572,IND111 PENTETREOTIDE DOSE,11614.0,7549.1,1390.0,10452.6,39
HCPCS,A9572,Indium in-111 pentetreotide,,,4012.42,4012.42,1
HCPCS,A9572,OCTREOSCAN 3 MCI/ML-10 MCG INTRAVENOUS KIT,10558.0,6862.7,1390.0,9502.2,39
HCPCS,A95720,Indium in-111 pentetreotide,,,4012.42,4012.42,1
HCPCS,A9573,ELUCIREM 0.5 MMOL/ML INTRAVENOUS SOLUTION,39.75,25.84,4.61,39.75,84
HCPCS,A9573,"INJ, GADOPICLENOL, 1 ML",4.0,2.6,0.67,4.61,34
HCPCS,A9573,"Inj, gadopiclenol, 1 ml",,,3.56,3.56,1
HCPCS,A95730,"Inj, gadopiclenol, 1 ml",,,3.56,3.56,1
HCPCS,A9575,10 ML DOTAREM INJ 0.1ML,2.0,1.3,0.1,2.0,14
HCPCS,A9575,15 ML DOTAREM INJ 0.1ML,2.0,1.3,0.1,2.0,14
HCPCS,A9575,20 ML DOTAREM INJ 0.1 ML,2.0,1.3,0.1,2.0,14
HCPCS,A9575,CLARISCAN 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,18.0,11.7,0.12,18.0,63
HCPCS,A9575,CLARISCAN 0.5 MMOL/ML INTRAVENOUS SYRINGE,19.8,12.87,0.12,19.8,21
HCPCS,A9575,DOTAREM 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,11.88,7.72,0.12,19.08,84
HCPCS,A9575,DOTAREM 0.5 MMOL/ML INTRAVENOUS SYRINGE,19.740000000000002,12.83,0.12,20.28,84
HCPCS,A9575,DOTAREM 10 MMOL SYRINGE 20ML,1.83,1.19,0.12,1.83,21
HCPCS,A9575,DOTAREM 7.5 MMOL SYRING 15ML,1.83,1.19,0.12,1.83,21
HCPCS,A9575,"DOTAREM INJ 0.1 ML, 10 ML",1.83,1.19,0.12,1.83,21
HCPCS,A9575,"DOTAREM INJ 0.1 ML, 15 ML",1.83,1.19,0.12,1.83,21
HCPCS,A9575,"DOTAREM INJ 0.1ML, 20 ML",1.83,1.19,0.12,1.83,21
HCPCS,A9575,Inj gadoterate meglumi 0.1ml,,,0.11,0.11,1
HCPCS,A95750,Inj gadoterate meglumi 0.1ml,,,0.11,0.11,1
HCPCS,A9576,Inj prohance multipack,,,1.34,3.92,5
HCPCS,A95760,Inj prohance multipack,,,1.53,1.53,1
HCPCS,A9577,"INJ MULTIHANCE 10ML, MR CONTRAST",37.0,24.05,1.8,37.0,13
HCPCS,A9577,"INJ MULTIHANCE 15ML, MR CONTRAST",37.0,24.05,1.8,37.0,13
HCPCS,A9577,"INJ MULTIHANCE 20 ML, PER 1ML",16.27,10.58,1.64,16.27,21
HCPCS,A9577,INJ MULTIHANCE PER 1 ML,14.0,9.100000000000001,1.8,17.0,26
HCPCS,A9577,Inj multihance,,,1.94,1.94,1
HCPCS,A9577,MULTIHANCE 529 MG/ML (0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,20.43,13.28,1.64,20.94,63
HCPCS,A95770,Inj multihance,,,1.94,1.94,1
HCPCS,A9578,Inj multihance multipack,,,1.56,4.88,5
HCPCS,A95780,Inj multihance multipack,,,1.9,1.9,1
HCPCS,A9579,GAD-BASE MR CONTRAST NOS PER 1 ML,3.0,1.95,1.46,3.0,13
HCPCS,A9579,"Gad-base mr contrast nos,1ml",,,1.58,1.58,1
HCPCS,A9579,INJ OPTIMARK 20ML,57.0,37.05,1.46,57.0,13
HCPCS,A9579,OMNISCAN 10 MMOL/20 ML (287 MG/ML) INTRAVENOUS SOLUTION,17.34,11.27,1.36,17.34,21
HCPCS,A95790,"Gad-base mr contrast nos,1ml",,,1.58,1.58,1
HCPCS,A9580,SODIUM FLUORIDE F-18 10-200 MCI/ML (370-7400 MBQ/ML) INTRAVENOUS SOLN,500.0,325.0,84.0,2409.0,26
HCPCS,A9580,Sodium fluoride f-18,,,311.04,311.04,1
HCPCS,A95800,Sodium fluoride f-18,,,311.04,311.04,1
HCPCS,A9581,EOVIST 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,51.12,33.23,8.59,51.12,21
HCPCS,A9581,Gadoxetate disodium inj,,,15.93,15.93,1
HCPCS,A9581,INJ EOVIST GADOXETATE DISODIUM PER ML,84.0,54.6,14.75,84.0,13
HCPCS,A9581,"INJ EOVIST GADOXETATE DISODIUM, PER 1ML",49.24,32.01,8.27,49.24,21
HCPCS,A95810,Gadoxetate disodium inj,,,15.93,15.93,1
HCPCS,A9582,I-123 MIBG DOSE UP TO 15MCI,9698.0,6303.7,1390.0,8728.2,39
HCPCS,A9582,Iodine i-123 iobenguane,,,5296.4,5296.4,1
HCPCS,A9582,PR IODINE I-123 IOBENGUANE,9698.0,6303.7,4849.0,9698.0,13
HCPCS,A95820,Iodine i-123 iobenguane,,,5296.4,5296.4,1
HCPCS,A9583,Gadofosveset trisodium inj,,,47.71,47.71,1
HCPCS,A95830,Gadofosveset trisodium inj,,,47.71,47.71,1
HCPCS,A9584,GENERIC IOFLUPANE1-123 UP TO 5 MCI,4620.0,3003.0,1387.74,4158.0,39
HCPCS,A9584,IODINE I-123 IOFLUPANE,4620.0,3003.0,2310.0,4620.0,13
HCPCS,A9584,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5 ML) INTRAVENOUS SOLUTION,3150.0,2047.5,1231.65,2998.12,39
HCPCS,A9584,IOFLUPANE I-123 UP TO 5 MCI,4620.0,3003.0,1387.74,4158.0,39
HCPCS,A9584,Iodine i-123 ioflupane,,,2687.39,2687.39,1
HCPCS,A95840,Iodine i-123 ioflupane,,,2687.39,2687.39,1
HCPCS,A9585,GADAVIST GADOBUTROL INJ 0.1ML,2.99,1.94,0.31,2.99,21
HCPCS,A9585,Gadobutrol injection,,,0.3,0.3,1
HCPCS,A95850,Gadobutrol injection,,,0.3,0.3,1
HCPCS,A9586,AMYVID 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,5720.0,3718.0,1390.0,5148.0,36
HCPCS,A9586,FLORBETAPAIR F18 AMYVID TO 10MCI,6292.0,4089.8,1825.64,6292.0,36
HCPCS,A9586,FLORBETAPIR F18,6292.0,4089.8,2857.4,6292.0,13
HCPCS,A9586,Florbetapir f18,,,2962.55,2962.55,1
HCPCS,A95860,Florbetapir f18,,,2962.55,2962.55,1
HCPCS,A9587,GALLIUM GA-68,154.0,100.1,60.67,154.0,13
HCPCS,A9587,Gallium ga-68,,,59.9,59.9,1
HCPCS,A9587,NETSPOT (GA-68 DOTATATE),154.0,100.1,49.63,2409.0,36
HCPCS,A95870,Gallium ga-68,,,59.9,59.9,1
HCPCS,A9588,AXUMIN 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,9888.0,6427.2,268.42,8899.2,36
HCPCS,A9588,"AXUMIN FLUCICLOVINE F-18, DIAGNOSTIC, 1 MILLICURE",1089.0,707.85,268.42,2409.0,36
HCPCS,A9588,Fluciclovine f-18,,,569.31,569.31,1
HCPCS,A95880,Fluciclovine f-18,,,569.31,569.31,1
HCPCS,A9589,CYSVIEW 100 MG INTRAVESICAL SOLUTION,97.2,63.18,16.33,1189.66,24
HCPCS,A9589,HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLUTION,64.8,42.12,10.89,1189.66,24
HCPCS,A9589,Insti hexaminolevulinate hcl,,,1538.75,1538.75,1
HCPCS,A95890,Insti hexaminolevulinate hcl,,,1538.75,1538.75,1
HCPCS,A9590,Iodine i-131 iobenguane 1mci,,,332.19,842.77,4
HCPCS,A95900,Iodine i-131 iobenguane 1mci,,,332.19,332.19,1
HCPCS,A9591,FLUOROESTRADIOL F 18 DIAGNOSTIC 1 MCI,1562.0,1015.3,460.42,2409.0,49
HCPCS,A9591,Fluoroestradiol f 18,,,797.47,797.47,1
HCPCS,A95910,Fluoroestradiol f 18,,,797.47,797.47,1
HCPCS,A9592,"COPPER CU-64, DOTATATE, DIAGNOSTIC, 1 MILLICURIE",2119.0,1377.35,594.28,2409.0,36
HCPCS,A9592,Copper cu 64 dotatate diag,,,997.92,997.92,1
HCPCS,A9592,DETECTNET 148 MBQ/4 ML (4 MCI/4 ML) INTRAVENOUS SOLUTION,7700.0,5005.0,594.28,6930.0,36
HCPCS,A95920,Copper cu 64 dotatate diag,,,997.92,997.92,1
HCPCS,A9593,GA-64 PSMA,2068.0,1344.2,534.91,2409.0,36
HCPCS,A9593,Gallium ga-68 psma-11 ucsf,,,806.48,806.48,1
HCPCS,A95930,Gallium ga-68 psma-11 ucsf,,,806.48,806.48,1
HCPCS,A9594,GALLIUM GA-68 GOZETOTIDE 18.5 MBQ TO 185 MBQ/ML (0.5-5 MCI/ML) IV SOLN,16335.0,10617.75,363.5,14701.5,36
HCPCS,A9594,"Gallium ga-68 psma-11, ucla",,,789.63,789.63,1
HCPCS,A95940,"Gallium ga-68 psma-11, ucla",,,789.63,789.63,1
HCPCS,A9595,F-18 PSMA PYLARIFY,1206.0,783.9,332.44,2409.0,36
HCPCS,A9595,"Piflu f-18, dia 1 millicurie",,,637.7,637.7,1
HCPCS,A95950,"Piflu f-18, dia 1 millicurie",,,637.7,637.7,1
HCPCS,A9596,"GA-68 GOZETOTIDE, DIAGNOSTIC",2068.0,1344.2,478.52,2409.0,36
HCPCS,A9596,Gallium illuccix 1 millicure,,,1071.22,1071.22,1
HCPCS,A95960,Gallium illuccix 1 millicure,,,1071.22,1071.22,1
HCPCS,A9600,Sr89 strontium,,,1740.72,10192.6,27
HCPCS,A96000,Sr89 strontium,,,3888.0,3888.0,1
HCPCS,A9601,Flortaucipir inj 1 millicuri,,,362.88,8013.6,21
HCPCS,A96010,Flortaucipir inj 1 millicuri,,,362.88,362.88,1
HCPCS,A9602,Fluorodopa f-18 diag per mci,,,498.62,1312.21,21
HCPCS,A96020,Fluorodopa f-18 diag per mci,,,517.22,517.22,1
HCPCS,A9603,CYTALUX 3.2 MG/1.6 ML INTRAVENOUS SOLUTION,9562.5,6215.63,1606.5,9562.5,26
HCPCS,A9603,"Inj, pafolacianine, 0.1 mg",,,137.7,137.7,1
HCPCS,A96030,"Inj, pafolacianine, 0.1 mg",,,137.7,137.7,1
HCPCS,A9604,QUADRAMET INJ SAMARIUM 153,39662.0,25780.3,3159.8,35695.8,37
HCPCS,A9604,Sm 153 lexidronam,,,16882.1,16882.1,1
HCPCS,A96040,Sm 153 lexidronam,,,16882.1,16882.1,1
HCPCS,A9606,RADIUM 223 DICHLORIDE PER UCI,337.0,219.05,87.28,10192.6,37
HCPCS,A9606,RADIUM RA223 DICHLORIDE THER,337.0,219.05,168.5,337.0,13
HCPCS,A9606,Radium ra223 dichloride ther,,,175.24,175.24,1
HCPCS,A96060,Radium ra223 dichloride ther,,,175.24,175.24,1
HCPCS,A9607,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC",494.5,321.425,238.5,25906.15,48
HCPCS,A9607,Lutetium lu 177 vipivotide,,,257.54,257.54,1
HCPCS,A96070,Lutetium lu 177 vipivotide,,,257.54,257.54,1
HCPCS,A9608,"FLOTUFOLASTAT F18, DIAGNOSTIC, 1 MILLICURIE",1230.0,799.5,318.57,2409.0,52
HCPCS,A9608,Flotufolastat f18 diag 1 mci,,,711.63,711.63,1
HCPCS,A9608,POSLUMA 296 MBQ/ML TO 5846 MBQ/ML INTRAVENOUS SOLUTION,9836.0,6393.4,651.67,8852.4,39
HCPCS,A96080,Flotufolastat f18 diag 1 mci,,,711.63,711.63,1
HCPCS,A9609,"F18 fdg, 15 millicuries",,,460.37,581.52,6
HCPCS,A9610,"Xe129 xenon, diagnostic",,,1078.27,2735.62,4
HCPCS,A96100,"Xe129 xenon, diagnostic",,,1078.27,1078.27,1
HCPCS,A9611,"Flurpiridaz f18, diag, 1 mci",,,518.4,1315.2,8
HCPCS,A96110,"Flurpiridaz f18, diag, 1 mci",,,518.4,518.4,1
HCPCS,A9612,"Inj, fluorescein, 1 mg",,,0.39,0.99,4
HCPCS,A96120,"Inj, fluorescein, 1 mg",,,0.39,0.39,1
HCPCS,A9615,"Inj, pegulicianine, 1 mg",,,36.69,93.08,21
HCPCS,A96150,"Inj, pegulicianine, 1 mg",,,36.69,36.69,1
HCPCS,A9616,Gallium gozellix 1 millicuri,,,982.0,2491.37,8
HCPCS,A96160,Gallium gozellix 1 millicuri,,,982.0,982.0,1
HCPCS,A9697,"Inj, magtrace per study dose",,,1137.96,2457.99,17
HCPCS,A9699,RADIUM RA 223 DICHLORIDE INJ,10285.0,6685.25,1727.88,9256.5,21
HCPCS,A9699,Radiopharm rx agent noc,,,29761.17,29761.17,1
HCPCS,A96990,Radiopharm rx agent noc,,,29761.17,29761.17,1
HCPCS,A9700,ECHOCARDIOGRAPHY CONTRAST,450.0,292.5,74.81,450.0,13
HCPCS,A9700,Echocardiography contrast,,,111.8,111.8,1
HCPCS,A9700,PERFLEXANE LIPID MICROSPHERES,358.0,232.7,74.81,358.0,13
HCPCS,A97000,Echocardiography contrast,,,111.8,111.8,1
HCPCS,A9800,Gallium locametz 1 millicuri,,,362.5,1886.63,21
HCPCS,A98000,Gallium locametz 1 millicuri,,,634.64,634.64,1
HCPCS,A9900,Supply/accessory/service,,,5.67,5.67,1
HCPCS,A99000,Supply/accessory/service,,,5.67,5.67,1
HCPCS,A9901,Delivery/set up/dispensing,,,7.3,7.3,1
HCPCS,A99010,Delivery/set up/dispensing,,,7.3,7.3,1
HCPCS,B4034,Enter feed supkit syr by day,,,2.99,6.42,4
HCPCS,B40340,Enter feed supkit syr by day,,,2.99,2.99,1
HCPCS,B4035,Enteral feed supp pump per d,,,5.27,11.55,4
HCPCS,B40350,Enteral feed supp pump per d,,,5.27,5.27,1
HCPCS,B4036,Enteral feed sup kit grav by,,,4.08,8.87,4
HCPCS,B40360,Enteral feed sup kit grav by,,,4.08,4.08,1
HCPCS,B4081,Enteral ng tubing w/ stylet,,,14.97,31.3,4
HCPCS,B40810,Enteral ng tubing w/ stylet,,,14.97,14.97,1
HCPCS,B4082,Enteral ng tubing w/o stylet,,,10.55,22.91,4
HCPCS,B40820,Enteral ng tubing w/o stylet,,,10.55,10.55,1
HCPCS,B4083,Enteral stomach tube levine,,,1.56,3.44,4
HCPCS,B40830,Enteral stomach tube levine,,,1.56,1.56,1
HCPCS,B4087,"Gastro/jejuno tube, std",,,26.09,54.19,4
HCPCS,B40870,"Gastro/jejuno tube, std",,,26.09,26.09,1
HCPCS,B4088,"Gastro/jejuno tube, low-pro",,,30.11,61.88,4
HCPCS,B40880,"Gastro/jejuno tube, low-pro",,,30.11,30.11,1
HCPCS,B4100,Food thickener oral,,,0.41,0.41,1
HCPCS,B41000,Food thickener oral,,,0.41,0.41,1
HCPCS,B4102,Ef adult fluids and electro,,,4.06,4.06,1
HCPCS,B41020,Ef adult fluids and electro,,,4.06,4.06,1
HCPCS,B4103,Ef ped fluid and electrolyte,,,3.61,3.61,1
HCPCS,B41030,Ef ped fluid and electrolyte,,,3.61,3.61,1
HCPCS,B4104,Additive for enteral formula,,,0.08,0.08,1
HCPCS,B41040,Additive for enteral formula,,,0.08,0.08,1
HCPCS,B4105,Enzyme cartridge enteral nut,,,166.69,166.69,1
HCPCS,B41050,Enzyme cartridge enteral nut,,,166.69,166.69,1
HCPCS,B4148,Enteral feed elastomer daily,,,5.61,12.28,4
HCPCS,B41480,Enteral feed elastomer daily,,,5.61,5.61,1
HCPCS,B4149,Ef blenderized foods,,,0.97,2.12,4
HCPCS,B41490,Ef blenderized foods,,,0.97,0.97,1
HCPCS,B4150,Ef complet w/intact nutrient,,,0.37,0.79,4
HCPCS,B41500,Ef complet w/intact nutrient,,,0.37,0.37,1
HCPCS,B4152,Ef calorie dense>/=1.5kcal,,,0.3,0.65,4
HCPCS,B41520,Ef calorie dense>/=1.5kcal,,,0.3,0.3,1
HCPCS,B4153,Ef hydrolyzed/amino acids,,,1.18,2.52,4
HCPCS,B41530,Ef hydrolyzed/amino acids,,,1.18,1.18,1
HCPCS,B4154,Ef spec metabolic noninherit,,,0.64,1.39,4
HCPCS,B41540,Ef spec metabolic noninherit,,,0.64,0.64,1
HCPCS,B4155,Ef incomplete/modular,,,0.69,1.49,4
HCPCS,B41550,Ef incomplete/modular,,,0.69,0.69,1
HCPCS,B4157,Ef special metabolic inherit,,,6.71,6.71,1
HCPCS,B41570,Ef special metabolic inherit,,,6.71,6.71,1
HCPCS,B4158,Ef ped complete intact nut,,,1.88,1.88,1
HCPCS,B41580,Ef ped complete intact nut,,,1.88,1.88,1
HCPCS,B4159,Ef ped complete soy based,,,2.0,2.0,1
HCPCS,B41590,Ef ped complete soy based,,,2.0,2.0,1
HCPCS,B4160,Ef ped caloric dense>/=0.7kc,,,1.05,1.05,1
HCPCS,B41600,Ef ped caloric dense>/=0.7kc,,,1.05,1.05,1
HCPCS,B4161,Ef ped hydrolyzed/amino acid,,,3.25,3.25,1
HCPCS,B41610,Ef ped hydrolyzed/amino acid,,,3.25,3.25,1
HCPCS,B4162,Ef ped specmetabolic inherit,,,2.28,2.28,1
HCPCS,B41620,Ef ped specmetabolic inherit,,,2.28,2.28,1
HCPCS,B4164,Parenteral 50% dextrose solu,,,19.76,41.21,4
HCPCS,B41640,Parenteral 50% dextrose solu,,,19.76,19.76,1
HCPCS,B4168,Parenteral sol amino acid 3.,,,28.83,60.09,4
HCPCS,B41680,Parenteral sol amino acid 3.,,,28.83,28.83,1
HCPCS,B4172,Parenteral sol amino acid 5.,,,32.11,32.11,1
HCPCS,B41720,Parenteral sol amino acid 5.,,,32.11,32.11,1
HCPCS,B4176,Parenteral sol amino acid 7-,,,55.76,116.25,4
HCPCS,B41760,Parenteral sol amino acid 7-,,,55.76,55.76,1
HCPCS,B4178,Parenteral sol amino acid >,,,66.92,139.51,4
HCPCS,B41780,Parenteral sol amino acid >,,,66.92,66.92,1
HCPCS,B4180,Parenteral sol carb > 50%,,,28.37,59.15,4
HCPCS,B41800,Parenteral sol carb > 50%,,,28.37,28.37,1
HCPCS,B4185,Pn soln nos 10 grams lipids,,,13.06,13.06,1
HCPCS,B41850,Pn soln nos 10 grams lipids,,,13.06,13.06,1
HCPCS,B4187,"Omegaven, 10 grams lipids",,,13.06,23.17,4
HCPCS,B41870,"Omegaven, 10 grams lipids",,,13.06,13.06,1
HCPCS,B4189,Parenteral sol amino acid &,,,206.72,430.95,4
HCPCS,B41890,Parenteral sol amino acid &,,,206.72,206.72,1
HCPCS,B4193,Parenteral sol 52-73 gm prot,,,267.12,556.84,4
HCPCS,B41930,Parenteral sol 52-73 gm prot,,,267.12,267.12,1
HCPCS,B4197,Parenteral sol 74-100 gm pro,,,325.21,677.96,4
HCPCS,B41970,Parenteral sol 74-100 gm pro,,,325.21,325.21,1
HCPCS,B4199,Parenteral sol > 100gm prote,,,371.6,774.68,4
HCPCS,B41990,Parenteral sol > 100gm prote,,,371.6,371.6,1
HCPCS,B4216,Parenteral nutrition additiv,,,8.97,18.72,4
HCPCS,B42160,Parenteral nutrition additiv,,,8.97,8.97,1
HCPCS,B4220,Parenteral supply kit premix,,,9.31,19.4,4
HCPCS,B42200,Parenteral supply kit premix,,,9.31,9.31,1
HCPCS,B4222,Parenteral supply kit homemi,,,11.48,23.95,4
HCPCS,B42220,Parenteral supply kit homemi,,,11.48,11.48,1
HCPCS,B4224,Parenteral administration ki,,,29.07,60.61,4
HCPCS,B42240,Parenteral administration ki,,,29.07,29.07,1
HCPCS,B5000,Parenteral sol renal-amirosy,,,13.83,28.82,4
HCPCS,B50000,Parenteral sol renal-amirosy,,,13.83,13.83,1
HCPCS,B5100,Parenteral solution hepatic,,,5.4,11.26,4
HCPCS,B51000,Parenteral solution hepatic,,,5.4,5.4,1
HCPCS,B5200,Parenteral sol hepatic fream,,,0.12,0.12,1
HCPCS,B52000,Parenteral sol hepatic fream,,,0.12,0.12,1
HCPCS,B9002,Enter nutr inf pump any type,,,30.7,1333.46,17
HCPCS,B90020,Enter nutr inf pump any type,,,614.11,614.11,1
HCPCS,B9002MS,Enter nutr inf pump any type,,,30.7,66.67,4
HCPCS,B9002NU,Enter nutr inf pump any type,,,614.11,1333.46,4
HCPCS,B9002RR,Enter nutr inf pump any type,,,61.41,133.35,4
HCPCS,B9002UE,Enter nutr inf pump any type,,,460.59,1000.09,4
HCPCS,B9004,Parenteral infus pump portab,,,232.25,6117.21,17
HCPCS,B90040,Parenteral infus pump portab,,,2934.37,2934.37,1
HCPCS,B9004MS,Parenteral infus pump portab,,,232.25,484.17,4
HCPCS,B9004NU,Parenteral infus pump portab,,,2934.37,6117.21,4
HCPCS,B9004RR,Parenteral infus pump portab,,,464.52,968.36,4
HCPCS,B9004UE,Parenteral infus pump portab,,,2200.77,4587.9,4
HCPCS,B9006,Parenteral infus pump statio,,,232.25,6117.21,17
HCPCS,B90060,Parenteral infus pump statio,,,2934.37,2934.37,1
HCPCS,B9006MS,Parenteral infus pump statio,,,232.25,484.17,4
HCPCS,B9006NU,Parenteral infus pump statio,,,2934.37,6117.21,4
HCPCS,B9006RR,Parenteral infus pump statio,,,464.52,968.36,4
HCPCS,B9006UE,Parenteral infus pump statio,,,2200.77,4587.9,4
HCPCS,C1052,"Hemostatic agent, gi, topic",,,713.86,713.86,1
HCPCS,C10520,"Hemostatic agent, gi, topic",,,713.86,713.86,1
HCPCS,C1062,Intravertebral fx aug impl,,,3801.85,3801.85,1
HCPCS,C10620,Intravertebral fx aug impl,,,3801.85,3801.85,1
HCPCS,C1605,AVEIR DUAL CHAMBER LEADLESS PACEMAKER SYSTEM MFG DR-SYSTEM-AVEIR,41300.0,26845.0,6938.4,37170.0,33
HCPCS,C1605,AVEIR LEADLESS DUAL PACEMAKER,41300.0,26845.0,6938.4,37170.0,66
HCPCS,C1605,S 275 C1605 ABBOTT AVIER DR LEADLESS,41300.0,26845.0,6938.4,37170.0,33
HCPCS,C1713,"Anchor/screw bn/bn,tis/bn",,,271.85,271.85,1
HCPCS,C1713,GRAFT BN INFS RHBMP-2 2XS KT,1850.0,1202.5,310.8,1813.0,32
HCPCS,C1713,W ANCH SUT FASTAK,218.0,141.7,36.62,213.64,29
HCPCS,C1713,W ANCH/SCRW BN/BN,855.0,555.75,143.64,837.9,29
HCPCS,C1713,W ANCHOR BIOCOMPOSITE,800.0,520.0,134.4,784.0,29
HCPCS,C1713,W ANCHOR BIOCORKSCREW FT SUTURE,544.0,353.6,91.39,533.12,29
HCPCS,C1713,W ANCHOR SUT 1 BSUT TK FBRWR S,544.0,353.6,91.39,533.12,29
HCPCS,C1713,W ANCHOR TITAN,300.0,195.0,50.4,294.0,29
HCPCS,C1713,W ANCHR CORKSCRW FT II #2 FBRWR,424.0,275.6,71.23,415.52,29
HCPCS,C1713,W ANCHR SUT 3.5MM 2USP STATAK,393.0,255.45,66.02,385.14,29
HCPCS,C1713,W BIO PUSH LOCK 35MM X 14MM,920.0,598.0,154.56,901.6,29
HCPCS,C1713,W CORKSCREW BIOCOMPOSITE #2,636.0,413.4,106.85,623.28,29
HCPCS,C1713,W GLEN PLT,2800.0,1820.0,470.4,2744.0,32
HCPCS,C1713,W IMP ANCH BIOROC,863.0,560.95,144.98,845.74,29
HCPCS,C1713,W IMP ANCH CONTCK,818.0,531.7,137.42,801.64,29
HCPCS,C1713,W IMP ANCH FSTN,571.0,371.15,95.93,559.58,29
HCPCS,C1713,W IMP ANCH FSTNRC,756.0,491.4,127.01,740.88,29
HCPCS,C1713,W IMP ANCH KNTLES,737.0,479.05,123.82,722.26,29
HCPCS,C1713,W IMP ANCH MICRO,776.0,504.4,130.37,760.48,29
HCPCS,C1713,W IMP ANCH MINI,827.0,537.55,138.94,810.46,29
HCPCS,C1713,W IMP ANCH MINIRO,737.0,479.05,123.82,722.26,29
HCPCS,C1713,W IMP ANCH MITEK,818.0,531.7,137.42,801.64,29
HCPCS,C1713,W IMP ANCH PANALK,832.0,540.8,139.78,815.36,58
HCPCS,C1713,W IMP ANCH ROC EZ,863.0,560.95,144.98,845.74,29
HCPCS,C1713,W IMP ANCH ROC XS,797.0,518.05,133.9,781.06,29
HCPCS,C1713,W IMP ANCH ROTATR,853.0,554.45,143.3,835.94,29
HCPCS,C1713,W IMP ANCH SUPER,814.0,529.1,136.75,797.72,29
HCPCS,C1713,W IMP ANCH TACIT,737.0,479.05,123.82,722.26,29
HCPCS,C1713,W NAIL KT GAMMA 3 125DEG STRY,2194.0,1426.1,368.59,2150.12,32
HCPCS,C1713,W PIN BONE POSITIONING 4.5MM,328.0,213.2,55.1,321.44,29
HCPCS,C1713,W PLATE 1 LVL 14MM 1868-01-014,2940.0,1911.0,493.92,2881.2,32
HCPCS,C1713,W PLATE 100 TUBLR 5 HOLE 143555,75.0,48.75,12.6,73.5,29
HCPCS,C1713,W PLATE 100 TUBLR 7 HOLE 143557,84.0,54.6,14.11,82.32,29
HCPCS,C1713,W PLATE 100 TUBULAR 4 HOLE,71.0,46.15,11.93,69.58,29
HCPCS,C1713,W PLATE 100 TUBULAR 6 HOLE,80.0,52.0,13.44,78.4,29
HCPCS,C1713,W PLATE 14-18 MM,821.0,533.65,137.93,804.58,29
HCPCS,C1713,W PLATE 25MM INTERA X 4-HOLE,2764.0,1796.6,464.35,2708.72,32
HCPCS,C1713,W PLATE 3HOLES HD 2.0MM 10HOLES,444.0,288.6,74.59,435.12,29
HCPCS,C1713,W PLATE 4.5MM LCP PROX 4H RT,2504.0,1627.6,420.67,2453.92,32
HCPCS,C1713,W PLATE 4.5MM LCP PROX 6H RT,2534.0,1647.1,425.71,2483.32,32
HCPCS,C1713,W PLATE 6 HOLE,492.0,319.8,82.66,482.16,29
HCPCS,C1713,W PLATE 6 HOLE CLAVICLE,1605.0,1043.25,269.64,1572.9,29
HCPCS,C1713,W PLATE 75MM,1590.0,1033.5,267.12,1558.2,29
HCPCS,C1713,W PLATE ADPT TI NEURO 5 HOLE,406.0,263.9,68.21,397.88,29
HCPCS,C1713,W PLATE ATLANTS VISION 21 MM,800.0,520.0,134.4,784.0,29
HCPCS,C1713,W PLATE BOX 2X2 HOLE SQUARE,225.0,146.25,37.8,220.5,29
HCPCS,C1713,W PLATE BOX 4 HOLE,478.0,310.7,80.3,468.44,29
HCPCS,C1713,W PLATE BUTTON TI 7 HOLE,692.0,449.8,116.26,678.16,29
HCPCS,C1713,W PLATE CALCANEAL SM 814113001,470.0,305.5,78.96,460.6,29
HCPCS,C1713,W PLATE CNTR BN MEDIAL TIB LT,1476.0,959.4,247.97,1446.48,29
HCPCS,C1713,W PLATE CURVED 16 HOLE,2062.0,1340.3,346.42,2020.76,32
HCPCS,C1713,W PLATE CVR BUR HOLE LP,285.0,185.25,47.88,279.3,29
HCPCS,C1713,W PLATE DBL Y XRIGD 2HOLE 12MM,70.0,45.5,11.76,68.6,29
HCPCS,C1713,W PLATE DCP TI 3.5MM 9 HOLE,382.0,248.3,64.18,374.36,29
HCPCS,C1713,W PLATE DOUBLE Y LW PROF 530608,294.0,191.1,49.39,288.12,29
HCPCS,C1713,W PLATE DVR NARROW SHORT RT,1782.0,1158.3,299.38,1746.36,32
HCPCS,C1713,W PLATE DVR NARROW SHOT LEFT,173.0,112.45,29.06,169.54,29
HCPCS,C1713,W PLATE DVRA EXT/SR/STD,1604.0,1042.6,269.47,1571.92,29
HCPCS,C1713,W PLATE FEMORAL 6 HOLE RIGHT,3350.0,2177.5,562.8,3283.0,32
HCPCS,C1713,W PLATE FIBULA 5 HOLE,1350.0,877.5,226.8,1323.0,29
HCPCS,C1713,W PLATE FIBULAR COMPOSITE 11H,185.0,120.25,31.08,181.3,29
HCPCS,C1713,W PLATE FIBULAR COMPOSITE 14H,206.0,133.9,34.61,201.88,29
HCPCS,C1713,W PLATE LCP 137MM SS 3.5MM 10H,661.0,429.65,111.05,647.78,29
HCPCS,C1713,W PLATE LCP 3.5MM 6 HOLE,610.0,396.5,102.48,597.8,29
HCPCS,C1713,W PLATE LCP 3.5MM 7 HOLE,636.0,413.4,106.85,623.28,29
HCPCS,C1713,W PLATE LCP BROAD 12 HOLES,1354.0,880.1,227.47,1326.92,29
HCPCS,C1713,W PLATE LEFT LEVEL 1 54-25376,1837.0,1194.05,308.62,1800.26,32
HCPCS,C1713,W PLATE LPC METAL 3.5MM 9 HOLE,1872.0,1216.8,314.5,1834.56,32
HCPCS,C1713,W PLATE LW PROF 2HOLE 16MM BAR,80.0,52.0,13.44,78.4,29
HCPCS,C1713,W PLATE MESH,3000.0,1950.0,504.0,2940.0,32
HCPCS,C1713,W PLATE NEURO STRT 2HL,76.0,49.4,12.77,74.48,29
HCPCS,C1713,W PLATE PROFYLE L COMP STR 4H,452.0,293.8,75.94,442.96,29
HCPCS,C1713,W PLATE PROFYLE L COMP STR 5H,480.0,312.0,80.64,470.4,29
HCPCS,C1713,W PLATE PROX HUM LCP SS,3136.0,2038.4,526.85,3073.28,32
HCPCS,C1713,W PLATE PROXIMAL HUMERAL 3.5,3136.0,2038.4,526.85,3073.28,32
HCPCS,C1713,W PLATE SHLDR REPLCTR EQUINOXE,1514.0,984.1,254.35,1483.72,29
HCPCS,C1713,W PLATE SMALL BONE FIXATION SYS,650.0,422.5,109.2,637.0,29
HCPCS,C1713,W PLATE T OC 60MM,2500.0,1625.0,420.0,2450.0,32
HCPCS,C1713,W PLATE T PROFYLE L COMP NAR 6H,536.0,348.4,90.05,525.28,29
HCPCS,C1713,W PLATE TACK PLPTACK,90.0,58.5,15.12,88.2,29
HCPCS,C1713,W PLATE TI CERVICAL SPINE LKING,1100.0,715.0,184.8,1078.0,29
HCPCS,C1713,W PLATE TITANIUM FUSION,3404.0,2212.6,571.87,3335.92,32
HCPCS,C1713,W PLATE VOLAR RADIUS 6 HOLE,1500.0,975.0,252.0,1470.0,29
HCPCS,C1713,W PLT LCP LAT DIST FIB 2.7X3.5,1149.0,746.85,193.03,1126.02,29
HCPCS,C1713,W PUSHLOCK 3.5X14 AR-1926PS,627.0,407.55,105.34,614.46,29
HCPCS,C1713,W PUSHLOCK BIO SP 4.5MMX18.5MM,683.0,443.95,114.74,669.34,29
HCPCS,C1713,W SCREW 1.7 X 10 59-17010,111.0,72.15,18.65,108.78,29
HCPCS,C1713,W SCREW 2.0X14MM,112.0,72.8,18.82,109.76,29
HCPCS,C1713,W SCREW 2.7 14 MM LOCKING,624.0,405.6,104.83,611.52,29
HCPCS,C1713,W SCREW 207 LONG/SHRT THRD,348.0,226.2,58.46,341.04,29
HCPCS,C1713,W SCREW 3.5 14 MM CORTICAL,38.0,24.7,6.38,37.24,29
HCPCS,C1713,W SCREW 3.5 14 MM LOCKING,219.0,142.35,36.79,214.62,29
HCPCS,C1713,W SCREW 3.5 16 MM LOCKING,75.0,48.75,12.6,73.5,29
HCPCS,C1713,W SCREW 4.0 CANN LAG 24-50MM,165.0,107.25,27.72,161.7,29
HCPCS,C1713,W SCREW 4.5MM CANN FULLY THRD,408.0,265.2,68.54,399.84,29
HCPCS,C1713,W SCREW 400.689 MOD HAND 1.3X9M,162.0,105.3,27.22,158.76,29
HCPCS,C1713,W SCREW 40081196 MOD HAND 1.5X,113.0,73.45,18.98,110.74,29
HCPCS,C1713,W SCREW 5.0MM SELF DRILLING,334.0,217.1,56.11,327.32,29
HCPCS,C1713,W SCREW 6.5X35 TI LO PROF,284.0,184.6,47.71,278.32,29
HCPCS,C1713,W SCREW 7.0 MULT COMP 16MM,594.0,386.1,99.79,582.12,29
HCPCS,C1713,W SCREW 7.0 MULT COMP 85X16MM,2050.0,1332.5,344.4,2009.0,32
HCPCS,C1713,W SCREW ACUTRAK FUSION 24MM,398.0,258.7,66.86,390.04,29
HCPCS,C1713,W SCREW BIO-COMPRESSION,258.0,167.7,43.34,252.84,29
HCPCS,C1713,W SCREW BIOCOMPOSITE-TENODESIS,581.0,377.65,97.61,569.38,29
HCPCS,C1713,W SCREW BIOTENODESIS,526.0,341.9,88.37,515.48,29
HCPCS,C1713,W SCREW BN 2MM LCP DCP SS,54.0,35.1,9.07,52.92,29
HCPCS,C1713,W SCREW BN 5MM LCP SS,310.0,201.5,52.08,303.8,29
HCPCS,C1713,W SCREW BN 5MM/65-70MM,237.0,154.05,39.82,232.26,29
HCPCS,C1713,W SCREW BONE 6.5MM X 35MM,30.0,19.5,5.04,29.4,29
HCPCS,C1713,W SCREW BONE CORT FT 4.5X46MM,27.0,17.55,4.54,26.46,29
HCPCS,C1713,W SCREW BONE CORT FT 4.5X52MM,86.0,55.9,14.45,84.28,29
HCPCS,C1713,W SCREW BONE HERBERT,599.0,389.35,100.63,587.02,29
HCPCS,C1713,W SCREW BONE LOCK SLFTP T8,242.0,157.3,40.66,237.16,29
HCPCS,C1713,W SCREW BONE NON LK RAD 2.7,155.0,100.75,26.04,151.9,29
HCPCS,C1713,W SCREW BONE PINN CANN 6.5,107.0,69.55,17.98,104.86,29
HCPCS,C1713,W SCREW BONE RECON INT 6.4X95MM,718.0,466.7,120.62,703.64,29
HCPCS,C1713,W SCREW CANC FL THRD 4.0MM,34.0,22.1,5.71,33.32,29
HCPCS,C1713,W SCREW CANC PARTIAL THRD 4.0MM,34.0,22.1,5.71,33.32,29
HCPCS,C1713,W SCREW CANC PARTIAL THREADED,67.0,43.55,11.26,65.66,29
HCPCS,C1713,W SCREW CANC SLFTAP 4.35X14MM,500.0,325.0,84.0,490.0,29
HCPCS,C1713,W SCREW CANC TI FL THRD 4.0MM,34.5,22.425,5.38,36.26,58
HCPCS,C1713,W SCREW CANC TITM FL THRD 6.5MM,69.0,44.85,11.59,67.62,29
HCPCS,C1713,W SCREW CANCELLOUS SLF-TAP BONE,288.0,187.2,48.38,282.24,29
HCPCS,C1713,W SCREW CANCELLUS SLFTP 14/16MM,480.0,312.0,80.64,470.4,29
HCPCS,C1713,W SCREW CANN INTERFRNCE ARTHREX,175.0,113.75,29.4,171.5,29
HCPCS,C1713,W SCREW CANN LOCK 7.3MM X 55MM,606.0,393.9,101.81,593.88,29
HCPCS,C1713,W SCREW CANN LOCKING 8.0X75MM,594.0,386.1,99.79,582.12,29
HCPCS,C1713,W SCREW CANN MS LEG 6.5 X 50 5,3508.0,2280.2,589.34,3437.84,32
HCPCS,C1713,W SCREW CANN PT THREAD 3.75,369.0,239.85,61.99,361.62,29
HCPCS,C1713,W SCREW CANN SPINE MEDT GRP 18,3509.0,2280.85,589.51,3438.82,32
HCPCS,C1713,W SCREW CANN SYNT 4.5MM,342.0,222.3,57.46,335.16,29
HCPCS,C1713,W SCREW CANN SYNT 6.5 MM,492.0,319.8,82.66,482.16,29
HCPCS,C1713,W SCREW CANN SYNT 7.3 MM,492.0,319.8,82.66,482.16,29
HCPCS,C1713,W SCREW CANNLATED 6.5MM X 115MM,512.0,332.8,86.02,501.76,29
HCPCS,C1713,W SCREW CANNLTD PARTIALLY THRD,332.0,215.8,55.78,325.36,29
HCPCS,C1713,W SCREW CANNULATED 3.0,355.0,230.75,59.64,347.9,29
HCPCS,C1713,W SCREW CANNULATED 3.2X22,508.0,330.2,85.34,497.84,29
HCPCS,C1713,W SCREW CANNULATED 6.2,1770.0,1150.5,297.36,1734.6,32
HCPCS,C1713,W SCREW CERV/SS/TI GLOB GRP 8,1250.0,812.5,210.0,1225.0,29
HCPCS,C1713,W SCREW CERVICAL LOCKING 1.8MM,20.0,13.0,3.36,19.6,29
HCPCS,C1713,W SCREW CLAW LK HEX 3.5,286.0,185.9,48.05,280.28,29
HCPCS,C1713,W SCREW CLICKX 6.2X65MM,1060.0,689.0,178.08,1038.8,29
HCPCS,C1713,W SCREW COMPR LK CAP,256.0,166.4,43.01,250.88,29
HCPCS,C1713,W SCREW COMPRESSION CHARLOTTE,344.0,223.6,57.79,337.12,29
HCPCS,C1713,W SCREW COMPRESSION OMEGA 32MM,179.0,116.35,30.07,175.42,29
HCPCS,C1713,W SCREW CONICAL EXTRACTION,1858.0,1207.7,312.14,1820.84,32
HCPCS,C1713,W SCREW CONSTRNED SELF DRL16MM,1000.0,650.0,168.0,980.0,29
HCPCS,C1713,W SCREW CORT SLFTAP HEX 4.5,60.0,39.0,10.08,58.8,29
HCPCS,C1713,W SCREW CORTCL THRD UPGRD 3.5MM,45.0,29.25,7.22,46.06,58
HCPCS,C1713,W SCREW CORTCL/CANC LOCKING,276.0,179.4,46.37,270.48,29
HCPCS,C1713,W SCREW CORTEX 2.4MM,110.0,71.5,18.48,107.8,29
HCPCS,C1713,W SCREW CORTEX 2.7MM TI 10/12MM,112.0,72.8,18.82,109.76,29
HCPCS,C1713,W SCREW CORTEX 3.5MM,47.0,30.55,7.9,46.06,29
HCPCS,C1713,W SCREW CORTEX 4.5/214,42.0,27.3,7.06,41.16,29
HCPCS,C1713,W SCREW CORTEX SELF-TAP 2.7,58.0,37.7,9.74,56.84,29
HCPCS,C1713,W SCREW CORTEX SELFTAPING 4.5MM,38.0,24.7,6.38,37.24,29
HCPCS,C1713,W SCREW CORTEX SLF TAPPNG 3.5MM,52.0,33.8,8.74,50.96,29
HCPCS,C1713,W SCREW CORTEX SLFTP LOCKING,310.0,201.5,52.08,303.8,29
HCPCS,C1713,W SCREW CORTEX TI 2.7X20MM,242.0,157.3,40.66,237.16,29
HCPCS,C1713,W SCREW CORTEX TI 4.5MM,32.0,20.8,5.38,31.36,29
HCPCS,C1713,W SCREW CORTEX TI SLFTP 4.5,46.0,29.9,7.73,45.08,29
HCPCS,C1713,W SCREW CORTICAL 3.5 DPY,180.0,117.0,30.24,176.4,29
HCPCS,C1713,W SCREW CORTICAL 3.5MM,91.5,59.475,5.54,147.0,58
HCPCS,C1713,W SCREW CORTICAL 3.5MM X 20MM,140.0,91.0,23.52,137.2,29
HCPCS,C1713,W SCREW CORTICAL 3.5X20MM,192.0,124.8,32.26,188.16,29
HCPCS,C1713,W SCREW CORTICAL FT 2.7,100.0,65.0,16.8,98.0,29
HCPCS,C1713,W SCREW CORTICAL S/T 4.5MM,61.0,39.65,10.25,59.78,29
HCPCS,C1713,W SCREW CRANIAL 1.5MMX5MM,136.0,88.4,22.85,133.28,29
HCPCS,C1713,W SCREW DARCO LOCK 2.7X16,254.0,165.1,42.67,248.92,29
HCPCS,C1713,W SCREW DARCO LOCKED 2.7,262.0,170.3,44.02,256.76,29
HCPCS,C1713,W SCREW DISTRACTION 12MM,90.0,58.5,15.12,88.2,29
HCPCS,C1713,W SCREW DISTRACTION 14MM STRL,1362.0,885.3,228.82,1334.76,29
HCPCS,C1713,W SCREW DXTEND NOLOCK D4.5,339.0,220.35,50.4,370.44,58
HCPCS,C1713,W SCREW EXP 6.35 TI UNI/POLY,1300.0,845.0,218.4,1274.0,29
HCPCS,C1713,W SCREW EXP TI MONO,1100.0,715.0,184.8,1078.0,29
HCPCS,C1713,W SCREW FUSION MTP CHARLTTE 2.7,198.0,128.7,33.26,194.04,29
HCPCS,C1713,W SCREW GAMMA 3 SET TI,321.0,208.65,53.93,314.58,29
HCPCS,C1713,W SCREW GUIDE PIN 1.2MM,480.0,312.0,80.64,470.4,29
HCPCS,C1713,W SCREW HERBT WHPL 22MM 1152-22,470.0,305.5,78.96,460.6,29
HCPCS,C1713,W SCREW HYBRID STRYK,393.0,255.45,66.02,385.14,29
HCPCS,C1713,W SCREW INTERFER ARTHX,262.0,170.3,44.02,256.76,29
HCPCS,C1713,W SCREW INTERNAL HEX,430.0,279.5,72.24,421.4,29
HCPCS,C1713,W SCREW INTERNAL HEX 5.0,430.0,279.5,72.24,421.4,29
HCPCS,C1713,W SCREW LAG GAMMA 10.5 X 100MM,913.0,593.45,153.38,894.74,29
HCPCS,C1713,W SCREW LAG RECON 6.5X90MM,1297.0,843.05,217.9,1271.06,29
HCPCS,C1713,W SCREW LAG T2 6.5X95MM,447.0,290.55,75.1,438.06,29
HCPCS,C1713,W SCREW LAG TI/GAMMA/BONE,914.0,594.1,153.55,895.72,29
HCPCS,C1713,W SCREW LK HEX CLAW 3.5X20MM,520.0,338.0,87.36,509.6,29
HCPCS,C1713,W SCREW LOCK 5.0MM,410.0,266.5,68.88,401.8,29
HCPCS,C1713,W SCREW LOCK EQUINOXE 3201505,256.0,166.4,43.01,250.88,29
HCPCS,C1713,W SCREW LOCK FULL THRD STRY,242.0,157.3,40.66,237.16,29
HCPCS,C1713,W SCREW LOCK POLY/SHFT DPY,143.0,92.95,24.02,140.14,29
HCPCS,C1713,W SCREW LOCK SYNTHES 5.0MM,410.0,266.5,68.88,401.8,29
HCPCS,C1713,W SCREW LOCK TI 3.0MM,450.0,292.5,75.6,441.0,29
HCPCS,C1713,W SCREW LOCKING 2.7 X 22MM,198.0,128.7,33.26,194.04,29
HCPCS,C1713,W SCREW LOCKING 3.5X18MM,218.0,141.7,36.62,213.64,29
HCPCS,C1713,W SCREW LOCKING 5.0X14MM,440.0,286.0,73.92,431.2,29
HCPCS,C1713,W SCREW LOCKING SYNTHS 3.5MM,256.0,166.4,43.01,250.88,29
HCPCS,C1713,W SCREW LOCKING TI 4.0MM,402.0,261.3,67.54,393.96,29
HCPCS,C1713,W SCREW LOK TI STRDRV 4.0X38MM,70.0,45.5,11.76,68.6,29
HCPCS,C1713,W SCREW LOW PRO TI 6.7 CANN 18,406.0,263.9,68.21,397.88,29
HCPCS,C1713,W SCREW LOW PROF TI3X28MM CANN,194.0,126.1,32.59,190.12,29
HCPCS,C1713,W SCREW MIS CANN POLYTI,2940.0,1911.0,493.92,2881.2,32
HCPCS,C1713,W SCREW MIS SINGLE INNER,387.0,251.55,65.02,379.26,29
HCPCS,C1713,W SCREW MTP FUSION 16MM,94.0,61.1,15.79,92.12,29
HCPCS,C1713,W SCREW MTP FUSION HEX CHAROLET,190.0,123.5,31.92,186.2,29
HCPCS,C1713,W SCREW MULT COMP 4.3MM,720.0,468.0,120.96,705.6,29
HCPCS,C1713,W SCREW MULT COMPR 3X30MM,600.0,390.0,100.8,588.0,29
HCPCS,C1713,W SCREW MULT SPINE MEDT GRP 17,2474.0,1608.1,415.63,2424.52,32
HCPCS,C1713,W SCREW OC 4.5,200.0,130.0,33.6,196.0,29
HCPCS,C1713,W SCREW OMEGA+ LAG 80MM,523.0,339.95,87.86,512.54,29
HCPCS,C1713,W SCREW PEDCL MA PROTEX,2614.0,1699.1,439.15,2561.72,32
HCPCS,C1713,W SCREW PEG FULL THREAD 2.5MM,173.0,112.45,29.06,169.54,29
HCPCS,C1713,W SCREW PINN CANCELL BONE DEP,107.0,69.55,17.98,104.86,29
HCPCS,C1713,W SCREW PIVOT PA PEDICLE 6X35MM,1618.0,1051.7,271.82,1585.64,29
HCPCS,C1713,W SCREW PIVOT PEDICLE PA,3816.0,2480.4,641.09,3739.68,32
HCPCS,C1713,W SCREW PLT 6.5MM GAP II,30.0,19.5,5.04,29.4,29
HCPCS,C1713,W SCREW RETRO STL 20MM,358.0,232.7,60.14,350.84,29
HCPCS,C1713,W SCREW REV 4.5MM CAN LOCKING,300.0,195.0,50.4,294.0,29
HCPCS,C1713,W SCREW RND BIO-INTERFERENCE,358.0,232.7,60.14,350.84,29
HCPCS,C1713,W SCREW SCHANZ 6.2,1100.0,715.0,184.8,1078.0,29
HCPCS,C1713,W SCREW SCHANZ 80MM 294.30,158.0,102.7,26.54,154.84,29
HCPCS,C1713,W SCREW SELF DRILLING 1.5X5MM,94.0,61.1,15.79,92.12,29
HCPCS,C1713,W SCREW SELFTAP 1.5 X 5MM,70.0,45.5,11.76,68.6,29
HCPCS,C1713,W SCREW SET HEX FIX,28.0,18.2,4.7,27.44,29
HCPCS,C1713,W SCREW SET HEX W/G4,410.0,266.5,68.88,401.8,29
HCPCS,C1713,W SCREW SHAFT 3.5MMX26MM,36.0,23.4,6.05,35.28,29
HCPCS,C1713,W SCREW SKY VARIABLE S-D/LRG-D,500.0,325.0,84.0,490.0,29
HCPCS,C1713,W SCREW SLF TAP X-PIN 2.7X12MM,31.0,20.15,5.21,30.38,29
HCPCS,C1713,W SCREW SLFTP LOW PROF,144.0,93.6,24.19,141.12,29
HCPCS,C1713,W SCREW SPADE POINT 6.0 MM,129.0,83.85,21.67,126.42,29
HCPCS,C1713,W SCREW SPINE MEDT GRP 1,50.0,32.5,8.4,49.0,29
HCPCS,C1713,W SCREW SPINE MEDT GRP 12,1250.0,812.5,210.0,1225.0,29
HCPCS,C1713,W SCREW SPINE MEDT GRP 13,1280.0,832.0,215.04,1254.4,29
HCPCS,C1713,W SCREW SPINE MEDT GRP 3,500.0,325.0,84.0,490.0,29
HCPCS,C1713,W SCREW SPINE STRY GRP 2,500.0,325.0,84.0,490.0,29
HCPCS,C1713,W SCREW SPINE STRY GRP 7,1000.0,650.0,168.0,980.0,29
HCPCS,C1713,W SCREW SPINE STRY GRP 9,1200.0,780.0,201.6,1176.0,29
HCPCS,C1713,W SCREW SQ TORQ DEFINING KT,884.0,574.6,148.51,866.32,29
HCPCS,C1713,W SCREW SS MONO SPN GLOB GRP 5,1050.0,682.5,176.4,1029.0,29
HCPCS,C1713,W SCREW STARDRVE RECSS/LK SLFTP,278.0,180.7,46.7,272.44,29
HCPCS,C1713,W SCREW STRNL LOCK TI,204.0,132.6,34.27,199.92,29
HCPCS,C1713,W SCREW SYNAPSE,1180.0,767.0,198.24,1156.4,29
HCPCS,C1713,W SCREW SYNAPSE LOCKING CAP,20.0,13.0,3.36,19.6,29
HCPCS,C1713,W SCREW TI CORTEX 4.5 MM,49.0,31.85,8.23,48.02,29
HCPCS,C1713,W SCREW TI CORTEX SLFTP 3.5MM,52.0,33.8,8.74,50.96,29
HCPCS,C1713,W SCREW TITANIUM CORTEX SLFTP,113.0,73.45,18.98,110.74,29
HCPCS,C1713,W SCREW TSRH SPINE MEDT GRP 7,835.0,542.75,140.28,818.3,29
HCPCS,C1713,W SCREW TWIN FIX 58-30420,536.0,348.4,90.05,525.28,29
HCPCS,C1713,W SCREW USS,1060.0,689.0,178.08,1038.8,29
HCPCS,C1713,W SCREW VA SELF TAPPNG 4.0X12MM,400.0,260.0,67.2,392.0,29
HCPCS,C1713,W SCREW VIPER 2 X-TAB 6X50,5370.0,3490.5,902.16,5262.6,35
HCPCS,C1713,W SCREW VIPER X-TAB 6X45,3380.0,2197.0,567.84,3312.4,32
HCPCS,C1713,W SCREW XPIN SLFTAP NLOK,137.0,89.05,23.02,134.26,29
HCPCS,C1713,W SCREW XPIN SLFTAP NLOK 1.4,140.0,91.0,23.52,137.2,29
HCPCS,C1713,W SCRW ATL/FIX SPN MEDT GRP 10,1050.0,682.5,176.4,1029.0,29
HCPCS,C1713,W SCRW BONE CRTCL LK 3.5 X 14MM,176.0,114.4,29.57,172.48,29
HCPCS,C1713,W SCRW BONE LK RAD 2.7 X 14MM,177.0,115.05,29.74,173.46,29
HCPCS,C1713,W SCRW CANN FLL THRD 3.5MMX30MM,386.0,250.9,64.85,378.28,29
HCPCS,C1713,W SCRW PLY TSRH SPN MEDT GRP 4,750.0,487.5,126.0,735.0,29
HCPCS,C1713,W T-PLATE TI 3H/5H SHAFT 441.15,332.0,215.8,55.78,325.36,29
HCPCS,C1713,W VALVE PROGRAM INLINE,5200.0,3380.0,873.6,5096.0,35
HCPCS,C1713,W WASHER SYNT CANN SCREW,43.0,27.95,7.22,42.14,29
HCPCS,C17130,"Anchor/screw bn/bn,tis/bn",,,271.85,271.85,1
HCPCS,C1714,"Cath, trans atherectomy, dir",,,17604.0,17604.0,1
HCPCS,C1714,W CATH ATHR TRANSLUM DIREC,2095.0,1361.75,351.96,1885.5,21
HCPCS,C1714,W CATH CROSSER CTO,2261.0,1469.65,379.85,2034.9,21
HCPCS,C17140,"Cath, trans atherectomy, dir",,,17604.0,17604.0,1
HCPCS,C1715,Brachytherapy needle,,,65.48,65.48,1
HCPCS,C1715,W NDL BRACHYTHRPY,43.0,27.95,7.22,38.7,21
HCPCS,C1715,W NDL BRCHTX BARD,329.0,213.85,55.27,296.1,21
HCPCS,C17150,Brachytherapy needle,,,65.48,65.48,1
HCPCS,C1716,"Brachytx, non-str, gold-198",,,140.34,1882.68,21
HCPCS,C17160,"Brachytx, non-str, gold-198",,,239.05,239.05,1
HCPCS,C1717,BRACHYTX NON-STR HDR IR-192,500.0,325.0,129.5,742.36,45
HCPCS,C1717,"BRACHYTX SOURCE, HDR IR-192",972.0,631.8,486.0,972.0,12
HCPCS,C1717,"Brachytx, non-str,hdr ir-192",,,334.26,334.26,1
HCPCS,C17170,"Brachytx, non-str,hdr ir-192",,,334.26,334.26,1
HCPCS,C1719,"Brachytx, ns, non-hdrir-192",,,140.34,1223.93,21
HCPCS,C17190,"Brachytx, ns, non-hdrir-192",,,234.14,234.14,1
HCPCS,C1721,"AICD, DUAL C1721 9000",18000.0,11700.0,3024.0,17640.0,35
HCPCS,C1721,"Aicd, dual chamber",,,40544.28,40544.28,1
HCPCS,C1721,"COBALT DR MRI SURESCAN ICD, IS1, DF4",26460.0,17199.0,4445.28,25930.8,35
HCPCS,C1721,DEFIB CARD .99CM 5.37X7.79CM,18600.0,12090.0,3124.8,18228.0,35
HCPCS,C1721,DEFIB EVERA MRI XT DR DF4,27000.0,17550.0,4536.0,26460.0,35
HCPCS,C1721,DEFIBRILLATORS & LEADS VIGILANT EL ICD DR DF4-LLHH IS-1,21600.0,14040.0,3628.8,21168.0,35
HCPCS,C1721,DEFIBRILLATORS & LEADS?COBALT DF4 DUAL CHAMBER,28841.0,18746.65,4845.29,28264.18,35
HCPCS,C1721,DEFIBRILLATORS & LEADSMOMENTUM EL ICD DR,21600.0,14040.0,3628.8,21168.0,35
HCPCS,C1721,"GALLANT DR ICD, DUAL",15000.0,9750.0,2520.0,14700.0,35
HCPCS,C1721,"GALLANT DR ICD, SINGLE",19400.0,12610.0,3259.2,19012.0,35
HCPCS,C1721,ICD RESONATE EL DR,22600.0,14690.0,3796.8,22148.0,35
HCPCS,C1721,"ILIVIA NEO 7 PROMRI ICD, DR-T, DF-1",16980.0,11037.0,2852.64,16640.4,35
HCPCS,C1721,"PERCIVA ICD DR, MODEL D401",23760.0,15444.0,3991.68,23284.8,35
HCPCS,C1721,W CARDIOVRTR/DFIB,66088.0,42957.2,11102.78,64766.24,35
HCPCS,C1721,W DEFIB CARD EVERA XT DR DF1,32500.0,21125.0,5460.0,31850.0,35
HCPCS,C1721,W DEFIB CARD INCEPTA DR DF4,18600.0,12090.0,3124.8,18228.0,35
HCPCS,C1721,W DEFIB CARD INOGEN EL DR,16600.0,10790.0,2788.8,16268.0,35
HCPCS,C1721,W DEFIB EVERA MRI XT DR DF4,28030.0,18219.5,4445.28,29008.0,70
HCPCS,C1721,W DEFIB EVERA S DR DF4,31300.0,20345.0,5258.4,30674.0,35
HCPCS,C1721,W DEFIBRILLATOR DC ATLAS V265,27800.0,18070.0,4670.4,27244.0,35
HCPCS,C1721,W DEFIBRILLATOR DC VITALITY 2DR,26000.0,16900.0,4368.0,25480.0,35
HCPCS,C1721,W DEFIRBRILLATOR EPIC II HFV355,36000.0,23400.0,6048.0,35280.0,35
HCPCS,C1721,W DFIB DC ATLAS,40000.0,26000.0,6720.0,39200.0,35
HCPCS,C1721,W DFIB DC ATLAS+,27800.0,18070.0,4670.4,27244.0,35
HCPCS,C1721,W DFIB DC ENTRUST,30210.0,19636.5,5075.28,29605.8,35
HCPCS,C1721,W DFIB DC EPIC+,27800.0,18070.0,4670.4,27244.0,35
HCPCS,C1721,W DFIB DC GEM II,72581.0,47177.65,12193.61,71129.38,35
HCPCS,C1721,W DFIB DC INTRNSC,58500.0,38025.0,9828.0,57330.0,35
HCPCS,C1721,W DFIB DC MAXIMO,26000.0,16900.0,4368.0,25480.0,35
HCPCS,C1721,W DFIB DC VITALTY,26500.0,17225.0,4233.6,27244.0,140
HCPCS,C1721,W DFIB DC VNTK,36250.0,23562.5,6090.0,35525.0,35
HCPCS,C1721,W DFIB EPIC II DR,27800.0,18070.0,4670.4,27244.0,35
HCPCS,C1721,W ICD ATLAS V-268,27800.0,18070.0,4670.4,27244.0,35
HCPCS,C1721,W ICD CONFIENT DR E030,24500.0,15925.0,4116.0,24010.0,35
HCPCS,C1721,W ICD CURRENT 2207-30,22400.0,14560.0,3763.2,21952.0,35
HCPCS,C1721,W ICD CURRENT DR 220736,25800.0,16770.0,4334.4,25284.0,35
HCPCS,C1721,W ICD CURRENT DR 2211-36,24500.0,15925.0,4116.0,24010.0,35
HCPCS,C1721,W ICD CURRENT PLUS DR SJ4 CONTR,24500.0,15925.0,4116.0,24010.0,35
HCPCS,C1721,W ICD DYNAGEN D152 DR DF4,18600.0,12090.0,3124.8,18228.0,35
HCPCS,C1721,W ICD ELLIPSE DR,15000.0,9750.0,2520.0,14700.0,35
HCPCS,C1721,W ICD FORTIFY DR DUAL CHAMBER,24500.0,15925.0,4116.0,24010.0,35
HCPCS,C1721,W ICD PROTECTA DR D334DRG,28500.0,18525.0,4788.0,27930.0,35
HCPCS,C1721,W ICD PROTECTA XT DR D314DRG,31700.0,20605.0,5325.6,31066.0,35
HCPCS,C1721,W ICD SECURA DR DC D224DRG,29700.0,19305.0,4989.6,29106.0,35
HCPCS,C1721,W ICD TELIGEN E110,24500.0,15925.0,4116.0,24010.0,35
HCPCS,C1721,W ICD VIRTUOSO DR DC,28500.0,18525.0,4788.0,27930.0,35
HCPCS,C17210,"Aicd, dual chamber",,,40544.28,40544.28,1
HCPCS,C1722,AURORA EV-ICD MRI SURESCAN DEVICE,80000.0,52000.0,13440.0,72000.0,33
HCPCS,C1722,"Aicd, single chamber",,,39123.0,39123.0,1
HCPCS,C1722,DEFIB ACTICOR 7 VR-T DX ICD,24200.0,15730.0,4065.6,23716.0,35
HCPCS,C1722,DEFIB COBALT XT 57SQ CM 13MM TIT DIOX POLYUR,24141.0,15691.65,4055.69,23658.18,35
HCPCS,C1722,DEFIB DYNAGEN EL VR DF4,15114.0,9824.1,2539.15,14811.72,35
HCPCS,C1722,DEFIBRILLATOR VIGILANT,14114.0,9174.1,2371.15,13831.72,35
HCPCS,C1722,"GALLANT VR ICD, SINGLE",15000.0,9750.0,2520.0,14700.0,35
HCPCS,C1722,ICD COBALT XT VR MRI IS1 DF1,30870.0,20065.5,5186.16,30252.6,35
HCPCS,C1722,INTICA NEO 7 PROMRI ICD,16980.0,11037.0,2852.64,16640.4,35
HCPCS,C1722,MOMENTUM EL ICD VR MODEL D120,19925.0,12951.25,3347.4,19526.5,35
HCPCS,C1722,PERCIVA ICD VR MODEL D412,19926.0,12951.9,3347.57,17933.4,33
HCPCS,C1722,RESONATE EL ICD VR SINGLE CHAMBER ICD,19114.0,12424.1,3211.15,18731.72,35
HCPCS,C1722,W CARDIOVRTR/DFIB,53242.0,34607.3,8944.66,52177.16,35
HCPCS,C1722,W DEFIB CARD EVERA XT VR DF4,26000.0,16900.0,4368.0,25480.0,35
HCPCS,C1722,W DEFIB CARD INOGEN EL VR DF4,13114.0,8524.1,2203.15,12851.72,35
HCPCS,C1722,W DEFIB EVERA MRI XT VR DF4,23600.0,15340.0,3964.8,23128.0,35
HCPCS,C1722,W DEFIB ICD EMBLEM MRI,34000.0,22100.0,5712.0,33320.0,35
HCPCS,C1722,W DEFIB SC EVER S VR,24700.0,16055.0,4149.6,24206.0,35
HCPCS,C1722,W DEFIB-VR VISIA AF/DF4,22000.0,14300.0,3696.0,21560.0,35
HCPCS,C1722,W DFIB CARD SQRXS-ICD,32000.0,20800.0,5376.0,31360.0,35
HCPCS,C1722,W DFIB SC ATLAS+,37150.0,24147.5,4149.6,48608.0,70
HCPCS,C1722,W DFIB SC ENTRUST,41000.0,26650.0,6888.0,40180.0,35
HCPCS,C1722,W DFIB SC EPIC+,49600.0,32240.0,8332.8,48608.0,35
HCPCS,C1722,W DFIB SC MAXIMO,47750.0,31037.5,8022.0,46795.0,35
HCPCS,C1722,W DFIB SC VITALTY,22800.0,14820.0,3830.4,22344.0,105
HCPCS,C1722,W ICD ASSURA/ELLIPSE VR,17700.0,11505.0,2973.6,17346.0,35
HCPCS,C1722,W ICD CURRENT,17700.0,11505.0,2973.6,17346.0,35
HCPCS,C1722,W ICD CURRENT 120730,20000.0,13000.0,3360.0,19600.0,35
HCPCS,C1722,W ICD EVERA XT VR SNGL CHAMBER,22000.0,14300.0,3696.0,21560.0,35
HCPCS,C1722,W ICD FORTIFY VR SJ4,17700.0,11505.0,2973.6,17346.0,35
HCPCS,C1722,W ICD GENRTR PACEMKR 83.1X69,3400.0,2210.0,571.2,3332.0,32
HCPCS,C1722,W ICD INOGEN MIN VR DF4,13114.0,8524.1,2203.15,12851.72,35
HCPCS,C1722,W ICD PROTECTA VR D334VRG,21700.0,14105.0,3645.6,21266.0,35
HCPCS,C1722,W ICD PROTECTA XT VR D314VRG,23000.0,14950.0,3864.0,22540.0,35
HCPCS,C1722,W ICD SECURA D224VRC,23000.0,14950.0,3864.0,22540.0,35
HCPCS,C1722,W ICD TELIGEN E102,17700.0,11505.0,2973.6,17346.0,35
HCPCS,C17220,"Aicd, single chamber",,,39123.0,39123.0,1
HCPCS,C1724,CATH ROTALINK 1.5MM X 135CM ATHERECTOMY BURR,2356.0,1531.4,395.81,2120.4,21
HCPCS,C1724,"Cath, trans atherec,rotation",,,8100.0,8100.0,1
HCPCS,C1724,W CATH ATHRCM G3 CRV CTRL POD,4590.0,2983.5,771.12,4131.0,21
HCPCS,C1724,W CATH ATHRCTMY STEALTH 360,4583.0,2978.95,769.94,4124.7,21
HCPCS,C1724,W CATH DIAMONDBACK ATHRCTMY,3773.0,2452.45,633.86,3395.7,21
HCPCS,C1724,W SYS COR ROTLNK CATH/BURR,1343.0,872.95,225.62,1208.7,21
HCPCS,C1724,W SYS ROTABLATOR RTLNK + ATHRCM,1290.0,838.5,216.72,1161.0,21
HCPCS,C17240,"Cath, trans atherec,rotation",,,8100.0,8100.0,1
HCPCS,C1725,10MM DIA X 40 MM EVERCROSS .035 OTW PTA BALLOON,158.0,102.7,26.54,142.2,21
HCPCS,C1725,20MM X 4CM ATLAS GOLD PTA DILITATION CATH,428.0,278.2,71.9,385.2,21
HCPCS,C1725,22MM X 3.5CM BALLOON 110CM PERFUSION CATHETER?VALVULOPLASTY,1755.0,1140.75,294.84,1579.5,21
HCPCS,C1725,4.00MM X 10MM WOLVERINE MONORAIL CUTTING BALLOON CATH,1029.0,668.85,172.87,926.1,21
HCPCS,C1725,ARMADA 35 PTA CATHETER 14MM X 40MM BALLOON 135CM SHAFT 0.035IN M,180.0,117.0,30.24,162.0,21
HCPCS,C1725,BALLOON 110CM CATH TRUE FLOW VALVULOPLASTY PERF CATH,1755.0,1140.75,294.84,1579.5,21
HCPCS,C1725,BALLOON CATHETER,375.0,243.75,63.0,337.5,21
HCPCS,C1725,CATH 135CM TURNPIKE,1043.0,677.95,175.22,938.7,21
HCPCS,C1725,CATH BLDL 1.20MM 12MM 145CM,123.0,79.95,20.66,110.7,21
HCPCS,C1725,CATH BLDL 1.2MM 15MM COR RX,123.0,79.95,20.66,110.7,21
HCPCS,C1725,CATH BLDL 10MMX2.50MM RX,1029.0,668.85,172.87,926.1,21
HCPCS,C1725,CATH BLDL 2.25MM 15MM RX NC,105.0,68.25,17.64,94.5,21
HCPCS,C1725,CATH BLDL 3.8FR 6MM 60MM 135MM,251.0,163.15,42.17,225.9,21
HCPCS,C1725,CATH BLDL 5FR 6MM 20MM 135CM,140.0,91.0,23.52,126.0,21
HCPCS,C1725,CATH BLDL 5FR 6MM 20MM 75CM,258.0,167.7,43.34,232.2,21
HCPCS,C1725,CATH BLDL 6 MM X 100MM X135CM,158.0,102.7,26.54,142.2,21
HCPCS,C1725,CATH BLDL 6MM 20MM 80CM,251.0,163.15,42.17,225.9,21
HCPCS,C1725,CATH BLDL 7FR 6MM 2CM 90CM,1050.0,682.5,176.4,945.0,21
HCPCS,C1725,CATH BLDL 8FR 12MM 4CM 75CM,248.0,161.2,41.66,223.2,21
HCPCS,C1725,CATH BLDL MOZEC PTCA,158.0,102.7,26.54,142.2,21
HCPCS,C1725,CATH BLLN TRUE DILTN,938.0,609.7,157.58,844.2,21
HCPCS,C1725,CATH IAB 7.5FR 40CC W/STAT,1388.0,902.2,233.18,1249.2,21
HCPCS,C1725,CATH IAB SENSATION PLUS,1388.0,902.2,233.18,1249.2,21
HCPCS,C1725,CATH STERLING 6MM PEBAX BIOSLIDE 80CM 40MM BALLOON DLTN OTW TAPE,251.0,163.15,42.17,225.9,21
HCPCS,C1725,CATH STINGRAY LP CTO,1250.0,812.5,210.0,1125.0,21
HCPCS,C1725,COYOTE ES OTW PTA BALLOON DILATION CATH 4MM X 40MM L 145CM SHAFT,251.0,163.15,42.17,225.9,21
HCPCS,C1725,"Cath, translumin non-laser",,,167.78,167.78,1
HCPCS,C1725,GW THREADER OTW MIC DIL,675.0,438.75,113.4,607.5,21
HCPCS,C1725,"MAQUET SENSATION FIBER-OPTIC IAB CATHETERINSERTION KIT 7FR, 34CC",1332.0,865.8,223.78,1198.8,21
HCPCS,C1725,MUSTANG OTW PTA BALL DIL CATH 0.035IN MAX GUIDEWIRE 9MM X 60MM B,270.0,175.5,45.36,243.0,21
HCPCS,C1725,PERIPHERAL CATH SHOCKWAVE IVL,4658.0,3027.7,782.54,4192.2,21
HCPCS,C1725,W CATH ANG SURPAS,912.0,592.8,153.22,820.8,21
HCPCS,C1725,W CATH ANG TRNSLU,668.0,434.2,112.22,601.2,21
HCPCS,C1725,W CATH ANGIOSCULPT OTW 2-3.5MM,1275.0,828.75,214.2,1147.5,21
HCPCS,C1725,W CATH ANGIOSCULPT OTW 4-5.0MM,1463.0,950.95,245.78,1316.7,21
HCPCS,C1725,W CATH BALLN 135CM ULTRA THIN,249.0,161.85,41.83,224.1,21
HCPCS,C1725,W CATH BALLN 5.8 FR XXL,401.0,260.65,67.37,360.9,21
HCPCS,C1725,W CATH BALLN 75CM SHFT PROFILR,245.0,159.25,41.16,220.5,21
HCPCS,C1725,W CATH BALLN 90CM SYMTRY GLDX,263.0,170.95,44.18,236.7,21
HCPCS,C1725,W CATH BALLN AVIATOR PLUS,330.0,214.5,55.44,297.0,21
HCPCS,C1725,W CATH BALLN CONQST 75CM SHFT,273.0,177.45,45.86,245.7,21
HCPCS,C1725,W CATH BALLN DILAT ADMRL XTRM,278.0,180.7,46.7,250.2,21
HCPCS,C1725,W CATH BALLN DLTN PCFC XTREM,300.0,195.0,50.4,270.0,21
HCPCS,C1725,W CATH BALLN DORADO 12-20CM PTA,353.0,229.45,59.3,317.7,21
HCPCS,C1725,W CATH BALLN DORADO 2-10CM PTA,260.0,169.0,43.68,234.0,21
HCPCS,C1725,W CATH BALLN POWERSAIL/VOYAGER,236.0,153.4,39.65,212.4,21
HCPCS,C1725,W CATH BALLN RELIANT STNT GRAFT,375.0,243.75,63.0,337.5,21
HCPCS,C1725,W CATH BALLN SPRINTER OTW,240.0,156.0,40.32,216.0,21
HCPCS,C1725,W CATH BALLN ULTRA THIN DIAMOND,236.0,153.4,39.65,212.4,21
HCPCS,C1725,W CATH BALLN ULTRA2 MONORAIL,1088.0,707.2,182.78,979.2,21
HCPCS,C1725,W CATH BALLN VIATRAC 14 PLUS,330.0,214.5,55.44,297.0,21
HCPCS,C1725,W CATH BALLN XXL 5.8 FR 75CM,300.0,195.0,50.4,270.0,21
HCPCS,C1725,W CATH BALLOON FOX PLUS PTA,193.0,125.45,32.42,173.7,21
HCPCS,C1725,W CATH BALLOON MAV/NC/QUA,255.0,165.75,42.84,229.5,21
HCPCS,C1725,W CATH BALLOON POWERFLEX P3 PTA,193.0,125.45,32.42,173.7,21
HCPCS,C1725,W CATH BALLOON ULTRAVERSE PTA,263.0,170.95,44.18,236.7,21
HCPCS,C1725,W CATH BLDL ADMIRAL XTREME,166.0,107.9,27.89,149.4,21
HCPCS,C1725,W CATH BLDL NC QUANTUM APEX,193.0,125.45,32.42,173.7,21
HCPCS,C1725,W CATH BLDL ULTRAVERSE,147.0,95.55,24.7,132.3,21
HCPCS,C1725,W CATH BLLN 120CM SAVVY PTA,375.0,243.75,63.0,337.5,21
HCPCS,C1725,W CATH BLLN 135/150 SYMTRY GLDX,263.0,170.95,44.18,236.7,21
HCPCS,C1725,W CATH BLLN ANGIOSCULPT 40MMOTW,1418.0,921.7,238.22,1276.2,21
HCPCS,C1725,W CATH BLLN COYOTE OTW,330.0,214.5,55.44,297.0,21
HCPCS,C1725,W CATH BLLN DIL NC EUPHORA,202.0,131.3,33.94,181.8,21
HCPCS,C1725,W CATH BLLN DILL STERLING OTW,330.0,214.5,55.44,297.0,21
HCPCS,C1725,W CATH BLLN DLTN AMPHRN DEEP,278.0,180.7,46.7,250.2,21
HCPCS,C1725,W CATH BLLN EMERGE MONORAIL,193.0,125.45,32.42,173.7,21
HCPCS,C1725,W CATH BLLN MAXI LD PTA DIL,474.0,308.1,79.63,426.6,21
HCPCS,C1725,W CATH BLLN MUSTANG OTW PTA,258.0,167.7,43.34,232.2,21
HCPCS,C1725,W CATH BLLN NANOCROSS,278.0,180.7,46.7,250.2,21
HCPCS,C1725,W CATH BLLN NC STORMER MX2,240.0,156.0,40.32,216.0,21
HCPCS,C1725,W CATH BLLN PERC MITRAL,3105.0,2018.25,521.64,2794.5,21
HCPCS,C1725,W CATH BLLN PTA PACIFIC PLUS,263.0,170.95,44.18,236.7,21
HCPCS,C1725,W CATH BLLN SAVVY LONG PTA,338.0,219.7,56.78,304.2,21
HCPCS,C1725,W CATH BLLN SLEEK RX PTA,450.0,292.5,75.6,405.0,21
HCPCS,C1725,W CATH BLLN STINGRAY CTO,1553.0,1009.45,260.9,1397.7,21
HCPCS,C1725,W CATH BLLN SYNERGY,236.0,153.4,39.65,212.4,21
HCPCS,C1725,W CATH BLLN TORNUS OTW TRNSLMNL,1043.0,677.95,175.22,938.7,21
HCPCS,C1725,W CATH BLLN TREK/NC TREK,196.0,127.4,32.93,176.4,21
HCPCS,C1725,W CATH BLN ATLAS PTA 12MM/14MM,375.0,243.75,63.0,337.5,21
HCPCS,C1725,W CATH BLN ATLAS PTA 16MM/18MM,420.0,273.0,70.56,378.0,21
HCPCS,C1725,W CATH BLN MARSHL,880.0,572.0,147.84,792.0,21
HCPCS,C1725,W CATH DIL BALLOON PTA RIVAL,193.0,125.45,32.42,173.7,21
HCPCS,C1725,W CATH DIL C RX,912.0,592.8,153.22,820.8,21
HCPCS,C1725,W CATH FLEXTOME CUTTING BALLOON,1088.0,707.2,182.78,979.2,21
HCPCS,C1725,W CATH MICRO ASAHI CORSAIR,1493.0,970.45,250.82,1343.7,21
HCPCS,C1725,W CATH OPTIPLST5F,637.0,414.05,107.02,573.3,21
HCPCS,C1725,W CATH PTA 2-3.5MM X 40-80MM,938.0,609.7,157.58,844.2,21
HCPCS,C1725,W CATH PTA 2.5-3MM X 100-120MM,975.0,633.75,163.8,877.5,21
HCPCS,C1725,W CATH PTA 4-6MM X 40-80MM,900.0,585.0,151.2,810.0,21
HCPCS,C1725,W CATH PTCA MAV,912.0,592.8,153.22,820.8,21
HCPCS,C1725,W CATH STINGRAY LP CTO,2815.0,1829.75,472.92,2533.5,21
HCPCS,C1725,W COIL EMBL STRETCH RESIS,2892.0,1879.8,485.86,2834.16,32
HCPCS,C1725,W GCTH AVE 6F,229.0,148.85,38.47,206.1,21
HCPCS,C1725,W GCTH AVE 7F,229.0,148.85,38.47,206.1,21
HCPCS,C1725,W GCTH AVE 8F,229.0,148.85,38.47,206.1,21
HCPCS,C1725,WOLVERINE MONORAIL CUTTING BALLOON 3.50MM X 10MM,967.0,628.55,162.46,870.3,21
HCPCS,C1725,Z-MED II 7 ATM BALLOON CATH,744.0,483.6,124.99,669.6,21
HCPCS,C1725,Z-MED II BALLOON CATH,1060.0,689.0,178.08,954.0,21
HCPCS,C1725,"Z-MED II BALLOON CATH, 8MM X 2CM BALLOON, 100CM SHAFT, 15ATM",589.0,382.85,98.95,530.1,21
HCPCS,C17250,"Cath, translumin non-laser",,,167.78,167.78,1
HCPCS,C1726,BALLOON CATHETER,1260.0,819.0,211.68,1134.0,21
HCPCS,C1726,CATH BLDL 10MM 15CM 30 ATM,308.0,200.2,51.74,277.2,21
HCPCS,C1726,CATH BLLN,938.0,609.7,157.58,844.2,21
HCPCS,C1726,CATH BLLN ELAT 2CM OD 10-12,300.0,195.0,50.4,270.0,21
HCPCS,C1726,CATH BLN ESOPH,377.0,245.05,63.34,339.3,21
HCPCS,C1726,"Cath, bal dil, non-vascular",,,151.08,151.08,1
HCPCS,C1726,W ACHALASIA BALLOON,675.0,438.75,113.4,607.5,21
HCPCS,C1726,W BALLOON CATH CRE FIXED WIRE,299.0,194.35,50.23,269.1,21
HCPCS,C1726,W BLLN DIL BIL 4X4 MAXFRC,387.0,251.55,65.02,348.3,21
HCPCS,C1726,W BLLN DIL BIL 6X4 5FR MAXFRC,346.0,224.9,58.13,311.4,21
HCPCS,C1726,W CATH AMPLATZER SZ BLLN II,414.0,269.1,69.55,372.6,21
HCPCS,C1726,W CATH BIL BLN INFL DEV,339.0,220.35,56.95,305.1,21
HCPCS,C1726,W CATH BIL INFL DEV,234.0,152.1,39.31,210.6,21
HCPCS,C1726,W CATH BLLN CRE WIREGD GI DIL,471.0,306.15,79.13,423.9,21
HCPCS,C1726,W CATH BLN DIL,656.0,426.4,110.21,590.4,21
HCPCS,C1726,W CATH BLN DIL GD,508.0,330.2,85.34,457.2,21
HCPCS,C1726,W CATH BLN DIL GUID CRE,263.0,170.95,44.18,236.7,21
HCPCS,C1726,W CATH BLN DIL RENAL 12CM X30FR,450.0,292.5,75.6,405.0,21
HCPCS,C1726,W CATH BLN DLTN RIGIFLEX II,662.0,430.3,111.22,595.8,21
HCPCS,C1726,W CATH BLN URO 18FR KIT 225122,506.0,328.9,85.01,455.4,21
HCPCS,C1726,W CATH BLN UROMAS ULTRA,458.0,297.7,76.94,412.2,21
HCPCS,C1726,W CATH BLN UROMAX,901.0,585.65,151.37,810.9,21
HCPCS,C1726,W CATH ENDSCP 6MM 16MM SIN BLN,1172.0,761.8,196.9,1054.8,21
HCPCS,C1726,W CATH SIN 6MM 16MM BLDL RLV,1026.0,666.9,172.37,923.4,21
HCPCS,C1726,W CATH SINUS BALLOON 516-716,968.0,629.2,162.62,871.2,21
HCPCS,C1726,W CATH SINUS BALLOON 524-724,1020.0,663.0,171.36,918.0,21
HCPCS,C1726,W CTH BLN DIL REN 7F 2.3MMX12CM,492.0,319.8,82.66,442.8,21
HCPCS,C1726,W DILATION BALLOON BILIARY,344.0,223.6,57.79,309.6,21
HCPCS,C1726,W DILATION BALLOON CRE 6-20,338.0,219.7,56.78,304.2,21
HCPCS,C1726,W DILATOR PUMONARY BALLOON,434.0,282.1,72.91,390.6,21
HCPCS,C1726,W ST DIL RENAL,439.0,285.35,73.75,395.1,21
HCPCS,C17260,"Cath, bal dil, non-vascular",,,151.08,151.08,1
HCPCS,C1727,BLN DISECT LAPSCP PDB SPCMKR,445.0,289.25,74.76,400.5,21
HCPCS,C1727,"Cath, bal tis dis, non-vas",,,270.0,270.0,1
HCPCS,C1727,W TROCAR SPACEMKR BLN,514.0,334.1,86.35,462.6,21
HCPCS,C17270,"Cath, bal tis dis, non-vas",,,270.0,270.0,1
HCPCS,C1728,"Cath, brachytx seed adm",,,3192.52,3192.52,1
HCPCS,C1728,W CATHETER MAMMOSITE,3713.0,2413.45,623.78,3341.7,21
HCPCS,C17280,"Cath, brachytx seed adm",,,3192.52,3192.52,1
HCPCS,C1729,"6FR PERICARDIOCENTESIS PROC KIT, PIGTAIL CATH",166.0,107.9,27.89,149.4,21
HCPCS,C1729,"Cath, drainage",,,6.02,6.02,1
HCPCS,C1729,W CATH 14.0FR ULTRATHANE,107.0,69.55,17.98,96.3,21
HCPCS,C1729,W CATH BACTISEAL PERITONEAL,457.0,297.05,76.78,411.3,21
HCPCS,C1729,W CATH DRAIN PIG LK 10F 25CM,133.0,86.45,22.34,119.7,21
HCPCS,C1729,W CATH DRAINAGE EXODUS BILIARY,131.0,85.15,22.01,117.9,21
HCPCS,C1729,W CATH DRAINAGE SKATER,100.0,65.0,16.8,90.0,21
HCPCS,C1729,W CATH DRN CHAIT PERC CECOSTMY,225.0,146.25,37.8,202.5,21
HCPCS,C1729,W CATH DRNG 10FR/14FR 25CM,175.0,113.75,29.4,157.5,21
HCPCS,C1729,W CATH DRNG 12FR/14FR 25CM,128.0,83.2,21.5,115.2,21
HCPCS,C1729,W CATH DRNG 18FR 25CM ULTTHN,114.0,74.1,19.15,102.6,21
HCPCS,C1729,W CATH DRNG 6FR 25CM,170.0,110.5,28.56,153.0,21
HCPCS,C1729,W CATH DRNG 8FR 25CM,175.0,113.75,29.4,157.5,21
HCPCS,C1729,W CATH DRNG BLRY 12FR 35CM,129.0,83.85,21.67,116.1,21
HCPCS,C1729,W CATH DRNG BLRY 8FR/10FR 35CM,138.0,89.7,23.18,124.2,21
HCPCS,C1729,W CATH DRNGE AMPLTZ ULTRTHN,127.0,82.55,21.34,114.3,21
HCPCS,C1729,W CATH FLX W/PGTL,189.0,122.85,31.75,170.1,21
HCPCS,C1729,W CATH SAFE-T-CENTESIS PLUS,120.0,78.0,20.16,108.0,21
HCPCS,C1729,W CATH TOTAL ABSCESSION DRAIN,121.0,78.65,20.33,108.9,21
HCPCS,C1729,W CATHETER BACTISEAL KIT,808.0,525.2,135.74,727.2,21
HCPCS,C1729,W CATHETER KIT PLEURX PLEURAL,690.0,448.5,115.92,621.0,21
HCPCS,C1729,W CATHETER SUPRAPUBIC BONANNO,81.0,52.65,13.61,72.9,21
HCPCS,C1729,W CHEST TUBE TRAY THAL QUICK,213.0,138.45,35.78,191.7,21
HCPCS,C1729,W DRAINAGE SET ABSCESS THALQK,122.0,79.3,20.5,109.8,21
HCPCS,C1729,W INTRDCR 16 FR PLEURX CATH KIT,689.0,447.85,115.75,620.1,21
HCPCS,C1729,W KIT CATH 25F 35CM,149.0,96.85,25.03,134.1,21
HCPCS,C1729,W KIT DRNAGE PLEURAL EFFUSION,91.0,59.15,15.29,81.9,21
HCPCS,C1729,W KIT DRNGE 80CM LMBR CLS,245.0,159.25,41.16,220.5,21
HCPCS,C17290,"Cath, drainage",,,6.02,6.02,1
HCPCS,C1730,6F RESPONSE QUAD 2-5-2 EP CATHETER,1424.0,925.6,239.23,1281.6,21
HCPCS,C1730,CATH MAP ADVISOR HD GRID,2970.0,1930.5,498.96,2673.0,21
HCPCS,C1730,"Cath, ep, 19 or few elect",,,229.33,229.33,1
HCPCS,C1730,"EPSTAR FIXED ELCTROPHYSIOLOGY CATH, 8 ELECTRODES, SPACING 5-5-5M",2025.0,1316.25,340.2,1822.5,21
HCPCS,C1730,INQUIRY DECAPOLAR STEERABLE EP CATH,450.0,292.5,75.6,405.0,21
HCPCS,C1730,LRG CURVE 6FRX110CM 2-6-2MM SPCNG DYNAMIC XT STEERABLE DECAPOLAR,555.0,360.75,93.24,499.5,21
HCPCS,C1730,MULTI-TRACK ANGIOGRAPHIC CATHETER,92.0,59.8,15.46,82.8,21
HCPCS,C1730,W CATH DX EP JOSEPHSON CURVED,306.0,198.9,51.41,275.4,21
HCPCS,C1730,W CATH EP 6FR 110CM 2-10-2MM,244.0,158.6,40.99,219.6,21
HCPCS,C1730,W CATH EP 6FR 120CM,67.0,43.55,11.26,60.3,21
HCPCS,C1730,W CATH EP 7FR 20MM 115CM,468.0,304.2,78.62,421.2,21
HCPCS,C1730,W CATH EP ACHIEVE MAPPING,1200.0,780.0,201.6,1080.0,21
HCPCS,C1730,W CATH EP DX NOT3,1262.0,820.3,212.02,1135.8,21
HCPCS,C1730,W CATH EP LASSO,1403.0,911.95,235.7,1262.7,21
HCPCS,C1730,W CATH EP-XT 6FR X 110CM,617.0,401.05,103.66,555.3,21
HCPCS,C1730,W CATH GUD ATN SLT2 6248V-90,242.0,157.3,40.66,217.8,21
HCPCS,C1730,W CATH SUPREME EP QUAD,166.0,107.9,27.89,149.4,21
HCPCS,C1730,W CTH 6FRX110CM DYNAMIC LG CURV,611.0,397.15,102.65,549.9,21
HCPCS,C1730,"WEBSTER CS BI-DIRECTIONAL DEFLECTABLE CATHETER 7FR?D-F CURVE, 12",1431.0,930.15,240.41,1287.9,21
HCPCS,C17300,"Cath, ep, 19 or few elect",,,229.33,229.33,1
HCPCS,C1731,"Cath, ep, 20 or more elec",,,4596.86,4596.86,1
HCPCS,C1731,DF CURVE OPTRELL MAPPING CATHETER,2928.0,1903.2,491.9,2635.2,21
HCPCS,C1731,W CATH DIAG STEERABLE ORBITER,1190.0,773.5,199.92,1071.0,21
HCPCS,C1731,W CATH EP 7FR 110CM HALO XP,501.0,325.65,84.17,450.9,21
HCPCS,C1731,W CATH EP BIDIR REFLEXION,2025.0,1316.25,340.2,1822.5,21
HCPCS,C1731,W CATH EP DECAPOLR,1630.0,1059.5,273.84,1467.0,21
HCPCS,C1731,W CATH EP DX NOT3,4496.0,2922.4,755.33,4046.4,21
HCPCS,C1731,W CATH EP PENTARAY HIGH DENSTY,2099.0,1364.35,352.63,1889.1,21
HCPCS,C1731,W CATH EP REFLEXION SPIRAL,2295.0,1491.75,385.56,2065.5,21
HCPCS,C1731,W CATH HALO XP 7X110,1407.0,914.55,236.38,1266.3,21
HCPCS,C1731,W CATH LVWIRE STRABLE ELECTRPHS,1389.0,902.85,233.35,1250.1,21
HCPCS,C17310,"Cath, ep, 20 or more elec",,,4596.86,4596.86,1
HCPCS,C1732,CATH ABLT OI 7 110 2.5 QUAD K,3173.0,2062.45,533.06,2855.7,21
HCPCS,C1732,CATH EP 7FR 2-6-2MM SPC D CRV,2107.0,1369.55,353.98,1896.3,21
HCPCS,C1732,CATH MAP ORION INTELLAMAP,3848.0,2501.2,646.46,3463.2,21
HCPCS,C1732,CATH NAV BI FJ SMARTTOUCH SF,3715.0,2414.75,624.12,3343.5,21
HCPCS,C1732,CATH NAV UNI F SMARTTOUCH SF,3776.0,2454.4,634.37,3398.4,21
HCPCS,C1732,"Cath, ep, diag/abl, 3d/vect",,,7182.0,7182.0,1
HCPCS,C1732,EZ STEER 7FR X 115CM NAV BI-DIRCTL NAV DIG/ABLTN DEFLCT TIP CATH,2619.0,1702.35,439.99,2357.1,21
HCPCS,C1732,OCTARAY MAPPING CATHETER,2928.0,1903.2,491.9,2635.2,21
HCPCS,C1732,W CATH ABL NAV DS,2565.0,1667.25,430.92,2308.5,21
HCPCS,C1732,W CATH ABLT 25-15MM LASSO NAV,1315.0,854.75,220.92,1183.5,21
HCPCS,C1732,W CATH ABLT 7FR 115CM 2MM,1329.0,863.85,223.27,1196.1,21
HCPCS,C1732,W CATH ABLT NAV SF UNI CART3 D,3375.0,2193.75,567.0,3037.5,21
HCPCS,C1732,W CATH ENDSCP ABLTN RADIOFRQ,1825.0,1186.25,306.6,1642.5,21
HCPCS,C1732,W CATH EP 7FR 2-6-2MM SPC F CRV,2425.0,1576.25,407.4,2182.5,21
HCPCS,C1732,W CATH EP 7FR LASSO CRV VAR,2099.0,1364.35,352.63,1889.1,21
HCPCS,C1732,W CATH EP DX/ABL,2160.0,1404.0,362.88,1944.0,21
HCPCS,C1732,W CATH NAV UNI F SMARTTOUCH SF,3574.0,2323.1,600.43,3216.6,21
HCPCS,C1732,W CTH ABL DEFL TP,3105.0,2018.25,521.64,2794.5,21
HCPCS,C17320,"Cath, ep, diag/abl, 3d/vect",,,7182.0,7182.0,1
HCPCS,C1733,CATH ABLT 7FR 4MM 115CM 2-5-2,900.0,585.0,151.2,810.0,21
HCPCS,C1733,CATH ABLT BLZR2 XP,1688.0,1097.2,283.58,1519.2,21
HCPCS,C1733,CATH ABLT XP K2,3645.0,2369.25,612.36,3280.5,21
HCPCS,C1733,"Cath, ep, othr than cool-tip",,,6444.36,6444.36,1
HCPCS,C1733,D-F CURVE 7FR X 115CM EZ STEER BI-DIRCTL DIAG/ABLTN DEFLCTBL TIP,1148.0,746.2,192.86,1033.2,21
HCPCS,C1733,FARAWAVE 2.0 NAV CATHETER 31 MM,11408.0,7415.2,1916.54,10267.2,21
HCPCS,C1733,W CATH ABLATION EZ STEER NAV,3105.0,2018.25,521.64,2794.5,21
HCPCS,C1733,W CATH ABLT 7FR 4MM 110 CM MED,713.0,463.45,119.78,641.7,21
HCPCS,C1733,W CATH ABLT 7FR WEBST CS EZ,303.0,196.95,50.9,272.7,21
HCPCS,C1733,W CATH ABLT SAFIRE BLU,2025.0,1316.25,340.2,1822.5,21
HCPCS,C1733,W CATH ABLTN CELSIUS 7FR 115CM,921.0,598.65,154.73,828.9,21
HCPCS,C1733,W CATH BRAID TIP,1200.0,780.0,201.6,1080.0,21
HCPCS,C1733,W CATH CRYABL ARCTIC CARDIAC,5670.0,3685.5,952.56,5103.0,21
HCPCS,C1733,W CATH EP 7FR WEBSTER DEFL CRV,858.0,557.7,144.14,772.2,21
HCPCS,C1733,W CATH EP FJ WEBSTER DEFL,262.0,170.3,44.02,235.8,21
HCPCS,C1733,W CATH FRZR X 3 ABLT AV 108CM,2160.0,1404.0,362.88,1944.0,21
HCPCS,C17330,"Cath, ep, othr than cool-tip",,,6444.36,6444.36,1
HCPCS,C1734,"Orth/devic/drug bn/bn,tis/bn",,,5573.71,5573.71,1
HCPCS,C17340,"Orth/devic/drug bn/bn,tis/bn",,,5573.71,5573.71,1
HCPCS,C1736,"RECOR MEDICAL PARADISE RDN CATHETER(S), INTRAVASCULAR FOR RENAL",27000.0,17550.0,4536.0,24300.0,21
HCPCS,C1747,AMBU DISPOSABLE SCOPE,250.0,162.5,125.0,250.0,12
HCPCS,C1747,ENDOSCOPE SINGLE USE IE DISPOSABLE URINARY TRACT IMAGING ILLUMIN,25.0,16.25,4.2,22.5,21
HCPCS,C1748,"Endoscope, single, ugi",,,1669.23,1669.23,1
HCPCS,C17480,"Endoscope, single, ugi",,,1669.23,1669.23,1
HCPCS,C1750,"Cath, hemodialysis,long-term",,,1005.64,1005.64,1
HCPCS,C1750,W CATH 13.5 FR HICKMAN DIALYSIS,660.0,429.0,110.88,646.8,29
HCPCS,C1750,W CATH 16CM MAHURKAR TRPL LMEN,198.0,128.7,33.26,194.04,29
HCPCS,C1750,W CATH 20 CM MAHURKAR TRPL LMEN,195.0,126.75,32.76,191.1,29
HCPCS,C1750,W CATH 23 CM HEMOSPLIT STD KIT,814.0,529.1,136.75,797.72,29
HCPCS,C1750,W CATH 23CM 16FR EQUISTREAM,620.0,403.0,104.16,607.6,29
HCPCS,C1750,W CATH 27 CM HEMOSPLIT STD KIT,806.0,523.9,135.41,789.88,29
HCPCS,C1750,W CATH DECATH GOLD HD,690.0,448.5,115.92,676.2,29
HCPCS,C1750,W CATH DIALYS 2LUMN SPIRL Z TIP,640.0,416.0,107.52,627.2,29
HCPCS,C1750,W CATH DIALYSIS KIT DUAL LUMEN,700.0,455.0,117.6,686.0,29
HCPCS,C1750,W CATH DIALYSIS RUBY VENTRC KT,890.0,578.5,149.52,872.2,29
HCPCS,C1750,W CATH DIALYSIS SAPPHIRE PLNDRM,1253.0,814.45,210.5,1227.94,29
HCPCS,C1750,W CATH DIALYSIS SPORTPAC VENTRC,640.0,416.0,107.52,627.2,29
HCPCS,C1750,W CATH HEMODIAL,600.0,390.0,100.8,588.0,29
HCPCS,C1750,W CATH KT DIALYSIS VAXCEL PLUS,988.0,642.2,165.98,968.24,29
HCPCS,C1750,W CATH SWAN NECK PERTNL 2 CUFF,374.0,243.1,62.83,366.52,29
HCPCS,C1750,W KIT CATH LT DLYS GLIDEPATH,620.0,403.0,104.16,607.6,29
HCPCS,C1750,W VENOUS OUTFLOW COMP VAD HERO,3390.0,2203.5,569.52,3322.2,32
HCPCS,C17500,"Cath, hemodialysis,long-term",,,1005.64,1005.64,1
HCPCS,C1751,ACCUCATH 20G 2.25IN POWER INJECTIBLE,87.0,56.55,14.62,78.3,27
HCPCS,C1751,ACCUCATH 20G X 2-1/4IN,107.0,69.55,17.98,96.3,27
HCPCS,C1751,ARROW MULTI-LUMEN CVC KIT 7FR X 20CM,204.0,132.6,34.27,183.6,21
HCPCS,C1751,ARROWGUARD BLUE PLUS CATHERIZATION PRESSURE INJECTABLE 7F,83.0,53.95,13.94,74.7,21
HCPCS,C1751,ARROWGUARD BLUE PLUS CATHETER,204.0,132.6,34.27,183.6,21
HCPCS,C1751,BARD PICC/SHERLOCK 5FR DOUBLE,145.0,94.25,24.36,130.5,21
HCPCS,C1751,CATH ART 8FR 110CM THRMDIL CCO,347.0,225.55,58.3,312.3,21
HCPCS,C1751,CATH DUAL LUMEN POWERPICC,499.0,324.35,83.83,449.1,21
HCPCS,C1751,"Cath, inf, per/cent/midline",,,58.62,58.62,1
HCPCS,C1751,KIT 7FR 6IN CATH 3 LUMEN PRESS INJ CENTRAL VENOUS,196.0,127.4,32.93,176.4,21
HCPCS,C1751,KIT CATH CV 9FR 10CM 2 LUM,119.0,77.35,19.99,107.1,21
HCPCS,C1751,LUMEN CENTRAL VENOUS ACCESS KIT,124.0,80.6,20.83,111.6,21
HCPCS,C1751,MIDLINE CATHETER,225.0,146.25,37.8,202.5,21
HCPCS,C1751,PICC CATHETER,334.0,217.1,56.11,300.6,21
HCPCS,C1751,POWERGLIDE MIDLINE BASIC KIT,118.0,76.7,19.82,106.2,21
HCPCS,C1751,POWERGLIDE MIDLINE FULL KIT,191.0,124.15,32.09,171.9,21
HCPCS,C1751,PSI KIT WITH ARROWGARD BLUE SHEATH 9FR X 10CM,156.0,101.4,26.21,140.4,21
HCPCS,C1751,W CATH 7FR DUAL F/TRAY V-CUFF,357.0,232.05,59.98,321.3,21
HCPCS,C1751,W CATH CV 9.3FR 38CM ICY,1214.0,789.1,203.95,1092.6,21
HCPCS,C1751,W CATH CV POWERPICC DUAL LUM,210.0,136.5,35.28,189.0,21
HCPCS,C1751,W CATH EKOS SYS ENDOVASCULAR,3234.0,2102.1,543.31,2910.6,21
HCPCS,C1751,W CATH GROSHONG DUAL LUMEN,600.0,390.0,100.8,540.0,21
HCPCS,C1751,W CATH GROSHONG SINGLE LUMEN,477.0,310.05,80.14,429.3,21
HCPCS,C1751,W CATH HICKMAN,541.0,351.65,59.64,2086.2,63
HCPCS,C1751,W CATH INF P/C/M,173.0,112.45,29.06,155.7,21
HCPCS,C1751,W CATH INFU,341.0,221.65,57.29,306.9,21
HCPCS,C1751,W CATH INFUSION UNIFUSE,179.0,116.35,30.07,161.1,21
HCPCS,C1751,W CATH KIT PICC 2LUM 4F 60CM,119.0,77.35,19.99,107.1,21
HCPCS,C1751,W CATH KIT PICC XCELA DUAL LUMN,193.0,125.45,32.42,173.7,21
HCPCS,C1751,W CATH PICC BIO FLO KT,173.0,112.45,29.06,155.7,21
HCPCS,C1751,W CATH PICC DUAL LUMEN,157.0,102.05,26.38,141.3,21
HCPCS,C1751,W CATH PICC XCELA DUAL LUM,149.0,96.85,25.03,134.1,21
HCPCS,C1751,W CATH POLYFLW 18,331.0,215.15,55.61,297.9,21
HCPCS,C1751,W CATH QUATTRO 9.3F 45CM,1293.0,840.45,217.22,1163.7,21
HCPCS,C1751,W CATH SWAN GZ DBL LUMEN,117.0,76.05,19.66,105.3,21
HCPCS,C1751,W CATH SWAN GZ DL FLOW DIRECT,122.0,79.3,20.5,109.8,21
HCPCS,C1751,W CATH SWAN-GANZ ART THRMDIL,323.0,209.95,54.26,290.7,21
HCPCS,C1751,W CATH TRIP-LUMEN,95.0,61.75,15.96,85.5,21
HCPCS,C1751,W CATH TRIPLE LUMEN ARROW,123.0,79.95,20.66,110.7,21
HCPCS,C1751,W CVC KIT VANTEX AMC TLC,79.0,51.35,13.27,71.1,21
HCPCS,C1751,W KIT CATH 7FR 16CM 3LUM,187.0,121.55,31.42,168.3,21
HCPCS,C1751,W KIT CATH CV DOUBLE LUM ARROW,116.0,75.4,19.49,104.4,21
HCPCS,C1751,W KIT CATH CV MULTI-LUMEN,148.0,96.2,24.86,133.2,21
HCPCS,C1751,W KIT CATH CV TRIPLE LUM ARROW,82.0,53.3,13.78,73.8,21
HCPCS,C1751,W KIT CATH MAC 2LUMN CVA,229.0,148.85,38.47,206.1,21
HCPCS,C1751,W KIT CATH VEN HP EDWR,154.0,100.1,25.87,138.6,21
HCPCS,C1751,W KIT PICC BIOFLO,103.0,66.95,17.3,92.7,21
HCPCS,C1751,W KIT PICC XCELA DUAL 5F CUST,248.0,161.2,41.66,223.2,21
HCPCS,C1751,W KIT VENOUS ACCESS CVC ARROW,129.0,83.85,21.67,116.1,21
HCPCS,C1751,W PICC LINE 6 FR TRIPLE LUMEN,256.0,166.4,43.01,230.4,21
HCPCS,C1751,W PICC LINE KIT,75.0,48.75,12.6,67.5,21
HCPCS,C1751,W PICC PFM DUAL LUMEN CT,144.0,93.6,24.19,129.6,21
HCPCS,C1751,W TRAY CATH 5FR 2LUM FULL PRC,375.0,243.75,63.0,337.5,21
HCPCS,C1751,W TRAY CATH 5FR POWRHOHN 1 LUM,338.0,219.7,56.78,304.2,21
HCPCS,C17510,"Cath, inf, per/cent/midline",,,58.62,58.62,1
HCPCS,C1752,"Cath,hemodialysis,short-term",,,10.11,10.11,1
HCPCS,C1752,POWER-TRIALYSIS SHORT TERM DIALYSIS CATH TRAY 13FR,380.0,247.0,63.84,372.4,29
HCPCS,C1752,W KIT CTH 20CM 12FR MAK 3 LUM,180.0,117.0,30.24,176.4,29
HCPCS,C1752,W TRAY CATH 20CM 12FR MAHRK 3,245.0,159.25,41.16,240.1,29
HCPCS,C1752,W TRAY CTH 19.5CM 11.5FR MAK,206.0,133.9,34.61,201.88,29
HCPCS,C1752,W TRAY HMDIAL 20CM 12FR MK 3,211.0,137.15,35.45,189.9,21
HCPCS,C17520,"Cath,hemodialysis,short-term",,,10.11,10.11,1
HCPCS,C1753,ACUNAV ULTRASOUND CATH,4725.0,3071.25,793.8,4252.5,21
HCPCS,C1753,"Cath, intravas ultrasound",,,4635.96,4635.96,1
HCPCS,C1753,OPTICROSS IVUS HD 60MHZ CATH,1088.0,707.2,182.78,979.2,21
HCPCS,C1753,W CATH ATLANTS SR,1812.0,1177.8,304.42,1630.8,21
HCPCS,C1753,W CATH US 5FR INTVASC OPTICROSS,938.0,609.7,157.58,844.2,21
HCPCS,C1753,W CATH US INTRVAS,960.0,624.0,161.28,864.0,21
HCPCS,C17530,"Cath, intravas ultrasound",,,4635.96,4635.96,1
HCPCS,C1754,"Catheter, intradiscal",,,1396.36,1396.36,1
HCPCS,C17540,"Catheter, intradiscal",,,1396.36,1396.36,1
HCPCS,C1755,"Catheter, intraspinal",,,35.64,35.64,1
HCPCS,C1755,W CATH DRUG ADMIN 8709,1050.0,682.5,176.4,1029.0,29
HCPCS,C1755,W CATH INTRATHECAL ASCENDA,1800.0,1170.0,302.4,1764.0,32
HCPCS,C1755,W CATH INTRATHECAL SUTURELESS,1290.0,838.5,216.72,1264.2,29
HCPCS,C17550,"Catheter, intraspinal",,,35.64,35.64,1
HCPCS,C1756,"Cath, pacing, transesoph",,,1034.33,1034.33,1
HCPCS,C17560,"Cath, pacing, transesoph",,,1034.33,1034.33,1
HCPCS,C1757,ALPHAVAC MULTIPURPOSE MECHANICAL ASPIRATION 25FR (C180) X 77CM,12150.0,7897.5,2041.2,10935.0,21
HCPCS,C1757,CATH THROMCTMY CLEANER15,975.0,633.75,163.8,877.5,21
HCPCS,C1757,"Cath, thrombectomy/embolect",,,54.01,54.01,1
HCPCS,C1757,FOGARTY THRU-LUMEN EMBOLECTOMY CATHETER,128.0,83.2,21.5,115.2,21
HCPCS,C1757,LIGHTNING BOLT 7 ARTERIAL THROMBECTOMY DEVICE W/ ASPIRATION TUBI,10719.0,6967.35,1800.79,9647.1,21
HCPCS,C1757,TRIEVER24 THROMBECTOMY CATHETER,13500.0,8775.0,2268.0,12150.0,21
HCPCS,C1757,W CATH ANGIO XFEEDER 120CM,1448.0,941.2,243.26,1303.2,21
HCPCS,C1757,W CATH ANGIOJET AVX 50CM,675.0,438.75,113.4,607.5,21
HCPCS,C1757,W CATH ANGIOJET DVX 90CM,1573.0,1022.45,264.26,1415.7,21
HCPCS,C1757,W CATH ASPIRATION COR VSL FETCH,488.0,317.2,81.98,439.2,21
HCPCS,C1757,W CATH DVX THROMBECTOMY SET,1910.0,1241.5,320.88,1719.0,21
HCPCS,C1757,W CATH EMB 120CM 3FR FGRTY OTW,183.0,118.95,30.74,164.7,21
HCPCS,C1757,W CATH EMB 60CM 2FR FGRTY ART,107.0,69.55,17.98,96.3,21
HCPCS,C1757,W CATH EMB EXPORTAP BRD ASP,750.0,487.5,126.0,675.0,21
HCPCS,C1757,W CATH EMBOL ART LF 4F 40CM,164.0,106.6,27.55,147.6,21
HCPCS,C1757,W CATH EMBOL ART LF 80CM,226.0,146.9,37.97,203.4,21
HCPCS,C1757,W CATH EMBOLECTOMY ARTL 2F LONG,311.0,202.15,52.25,279.9,21
HCPCS,C1757,W CATH EMBOLECTOMY FOGRTY ARTL,52.0,33.8,8.74,46.8,21
HCPCS,C1757,W CATH EXPORT ASPIRATION,1035.0,672.75,173.88,931.5,21
HCPCS,C1757,W CATH FGRT EMBLA,118.0,76.7,19.82,106.2,21
HCPCS,C1757,W CATH FOGARTY ARTRL EMBLCTMY,52.0,33.8,8.74,46.8,21
HCPCS,C1757,W CATH SPIROFLEX THROMBECTOMY,2491.0,1619.15,418.49,2241.9,21
HCPCS,C1757,W CATH THRMB SOLENT DISTA SET,2599.0,1689.35,436.63,2339.1,21
HCPCS,C1757,W CATH THRMB/EMB2,3461.0,2249.65,581.45,3114.9,21
HCPCS,C1757,W CATH THRMB/EMB3,2423.0,1574.95,407.06,2180.7,21
HCPCS,C1757,W CATH THRMB/EMB4,5035.0,3272.75,845.88,4531.5,21
HCPCS,C1757,W CATH THRMBCTY SOLITAIRE DVC,8320.0,5408.0,1397.76,7488.0,21
HCPCS,C1757,W CATH THRMCTMY ANGIOJET SET,2167.0,1408.55,364.06,1950.3,21
HCPCS,C1757,W CATH THROMB/EMB,1262.0,820.3,212.02,1135.8,21
HCPCS,C1757,W CATH THROMBCTMY,374.0,243.1,62.83,336.6,21
HCPCS,C1757,W CATH THROMCTMY ANGIOJET AVX,1050.0,682.5,176.4,945.0,21
HCPCS,C1757,W CATH TRELLIS-8 PERIPHL INF,2828.0,1838.2,475.1,2545.2,21
HCPCS,C1757,W CATH XPEEDIOR THROMBECTOMY SET,1640.0,1066.0,275.52,1476.0,21
HCPCS,C1757,W CTH ANGJET RHEO,915.0,594.75,153.72,823.5,21
HCPCS,C1757,W DEV RETRV TREVO PROVUE NRSC,8498.0,5523.7,1427.66,7648.2,21
HCPCS,C1757,W KT IPG ITREL 3 STIMULATR 7425,15590.0,10133.5,2619.12,15278.2,35
HCPCS,C1757,W PERIPHERAL INFUSION SYSTEM,2828.0,1838.2,475.1,2545.2,21
HCPCS,C1757,W RETRV ENDSCP TREVO XP PVUE,8863.0,5760.95,1488.98,7976.7,21
HCPCS,C17570,"Cath, thrombectomy/embolect",,,54.01,54.01,1
HCPCS,C1758,"Catheter, ureteral",,,72.87,72.87,1
HCPCS,C1758,W CATH URET,74.0,48.1,12.43,66.6,21
HCPCS,C1758,W CATH URET 10FR DUAL LUMEN,149.0,96.85,25.03,134.1,21
HCPCS,C1758,W CATH URETERAL,426.0,276.9,7.22,901.8,63
HCPCS,C17580,"Catheter, ureteral",,,72.87,72.87,1
HCPCS,C1759,CATH US SOUNDSTAR 3D,2954.0,1920.1,496.27,2658.6,21
HCPCS,C1759,"Cath, intra echocardiography",,,3574.45,3574.45,1
HCPCS,C1759,REPROCESSED BIOSENSE WEBSTER 10FR X 90CM SOUNDSTAR ECO DIAGNOSTI,3110.0,2021.5,522.48,2799.0,21
HCPCS,C1759,SOUNDSTAR 10FR X 90CM ECO DIAGNOSTIC ULTRASOUND CATHETER,6684.0,4344.6,1122.91,6015.6,21
HCPCS,C1759,W CATH ACUNAV ULTRASOUND,1519.0,987.35,255.19,1367.1,21
HCPCS,C1759,W CATH ECHO INTRA,2565.0,1667.25,430.92,2308.5,21
HCPCS,C1759,W CATH US 10FR 90CM INTRCRD 4W,1088.0,707.2,182.78,979.2,21
HCPCS,C1759,W CATH US 8FR 90CM INTRCRD 4W,1088.0,707.2,182.78,979.2,21
HCPCS,C1759,W CATH US VIEWFLEX XTRA BIDIR,2430.0,1579.5,408.24,2187.0,21
HCPCS,C17590,"Cath, intra echocardiography",,,3574.45,3574.45,1
HCPCS,C1760,"Closure dev, vasc",,,124.05,124.05,1
HCPCS,C1760,DEV CLSR 6FR EXOSEAL VASC,350.0,227.5,58.8,343.0,29
HCPCS,C1760,DEV TISS CLSR LP 40MM ATRICLIP,1900.0,1235.0,319.2,1862.0,32
HCPCS,C1760,DEVICE VES CLOS MYNX CONTROL VCD 6FR-12FR,430.0,279.5,72.24,387.0,27
HCPCS,C1760,SYS CMPR VASCADE VASC,346.0,224.9,58.13,339.08,29
HCPCS,C1760,W APPL IN CLP 135D 230CM ROT,130.0,84.5,21.84,127.4,29
HCPCS,C1760,W DEV CLOSR VASC 6/7FR MYNX,420.0,273.0,70.56,411.6,29
HCPCS,C1760,W DEVICE CLSURE 8FR ANGIO-SEAL,350.0,227.5,58.8,343.0,29
HCPCS,C1760,W DEVICE CLSURE VASC IMP/INSRT,380.0,247.0,63.84,372.4,29
HCPCS,C1760,W VAS CLS 610097,875.0,568.75,147.0,857.5,29
HCPCS,C1760,W VAS CLS ANGIOSL,736.0,478.4,123.65,721.28,58
HCPCS,C1760,W VAS CLS ART CLS,736.0,478.4,123.65,721.28,29
HCPCS,C1760,W VAS CLS ART PER,881.0,572.65,148.01,863.38,29
HCPCS,C1760,W VAS CLS VASOSL,1061.0,689.65,178.25,1039.78,29
HCPCS,C17600,"Closure dev, vasc",,,124.05,124.05,1
HCPCS,C1761,"CATHETER, CORONARY IVL SHOCKWAVE",6345.0,4124.25,1065.96,5710.5,21
HCPCS,C1762,"Conn tiss, human(inc fascia)",,,2299.13,2299.13,1
HCPCS,C1762,GRAFT ST TIS 12X7CM TTPLST,3702.0,2406.3,621.94,3627.96,32
HCPCS,C1762,W ALLOGRAFT FLEX HD 471816,7760.0,5044.0,1303.68,7604.8,35
HCPCS,C1762,W ALLOGRAFT FLEXHD 16X20 472620,21193.0,13775.45,3560.42,20769.14,35
HCPCS,C1762,W FASCIA TUTOPLAST 937201,1320.0,858.0,221.76,1293.6,29
HCPCS,C1762,W FASCIA TUTOPLAST 937227,825.0,536.25,138.6,808.5,29
HCPCS,C1762,W GRAFT FLEXHD 0.8-1.7MM 6X16CM,5502.0,3576.3,924.34,5391.96,35
HCPCS,C1762,W GRAFT FLEXHD 1.8-4MM 6X16CM,5726.0,3721.9,961.97,5611.48,35
HCPCS,C1762,W GRFT BARD FSL14,784.0,509.6,131.71,768.32,29
HCPCS,C1762,W SLING TRANSPLAST FASCA 2X12CM,1187.0,771.55,199.42,1163.26,29
HCPCS,C1762,W SLING TRANSPLAST FASCA 4X7CM,1319.0,857.35,221.59,1292.62,29
HCPCS,C1762,W TISSUE POCKET VASC CANGAROO,1950.0,1267.5,327.6,1911.0,32
HCPCS,C1762,W TISSUE TIBIALIS ANTERIOR,2808.0,1825.2,471.74,2751.84,32
HCPCS,C17620,"Conn tiss, human(inc fascia)",,,2299.13,2299.13,1
HCPCS,C1763,"Conn tiss, non-human",,,436.58,436.58,1
HCPCS,C1763,W DURAGEN 3X3 ID3301,1200.0,780.0,201.6,1176.0,29
HCPCS,C1763,W DURAGEN 4 X 5 ID4501,2078.0,1350.7,349.1,2036.44,32
HCPCS,C1763,W GRAFT CSAH8H20X20 SURGISI GLD,8640.0,5616.0,1451.52,8467.2,35
HCPCS,C1763,W GRFT PERICARDL,1950.0,1267.5,327.6,1911.0,32
HCPCS,C1763,W PLUG SURGISIS AFP 0.6X9.5,1611.0,1047.15,270.65,1578.78,29
HCPCS,C1763,W SLING UPHOLD VAG SUPPORT SYS,3168.0,2059.2,532.22,3104.64,32
HCPCS,C1763,W SUPPORT SYS AVAULTA PLUS ANT,3100.0,2015.0,520.8,3038.0,32
HCPCS,C1763,W TENDO-GRAFT,4433.0,2881.45,744.74,4344.34,32
HCPCS,C1763,W TISS CONN N-HUM,2495.0,1621.75,419.16,2445.1,32
HCPCS,C1763,W TISS CONN NHUM2,2316.0,1505.4,389.09,2269.68,32
HCPCS,C1763,W TISSUE CONN APOGEE W/INTEXEN,3324.0,2160.6,558.43,3257.52,32
HCPCS,C1763,W TISSUE CONN ELEVATE AP/POS,4400.0,2860.0,739.2,4312.0,32
HCPCS,C1763,W TISSUE CONN PERIGEE W/INTEXEN,3732.0,2425.8,626.98,3657.36,32
HCPCS,C17630,"Conn tiss, non-human",,,436.58,436.58,1
HCPCS,C1764,C1764 LOOP RECORDER TIER 2,9990.0,6493.5,1678.32,9790.2,35
HCPCS,C1764,"Event recorder, cardiac",,,4496.4,4496.4,1
HCPCS,C1764,LUX-DX INSERTABLE CARDIAC MONITOR SYSTEM,9000.0,5850.0,1512.0,8820.0,35
HCPCS,C1764,SYS CARD MNTR RVL LINQ,9290.0,6038.5,1560.72,9104.2,35
HCPCS,C1764,"W EVENT RECORDER,CARDIAC IMPLAN",8437.5,5484.375,1407.0,8330.0,70
HCPCS,C1764,W IMP RCRDR CARD,7829.0,5088.85,1315.27,7672.42,35
HCPCS,C1764,W LOOP RECORDER REVEAL DX 9528,7200.0,4680.0,1209.6,7056.0,35
HCPCS,C1764,W LOOP RECORDER SLEUTH AT 9006,8600.0,5590.0,1444.8,8428.0,35
HCPCS,C1764,W SYS CARD MNTR RVL LINQ INS,9290.0,6038.5,1560.72,9104.2,35
HCPCS,C17640,"Event recorder, cardiac",,,4496.4,4496.4,1
HCPCS,C1765,Adhesion barrier,,,409.38,409.38,1
HCPCS,C1765,BARR ADH 3X5IN BIORESBL MEMBR,415.0,269.75,69.72,373.5,21
HCPCS,C1765,MNTR CARD BIOMONITOR 3 SIL IR,8400.0,5460.0,1411.2,8232.0,35
HCPCS,C1765,W BARRIER ADHESION,521.0,338.65,87.53,510.58,29
HCPCS,C1765,W BARRIER SEPRAFILM 430102,480.0,312.0,80.64,470.4,29
HCPCS,C17650,Adhesion barrier,,,409.38,409.38,1
HCPCS,C1766,AGILIS NXT STEERABLE INTRODUCER 13FR MEDIUM CURL,1755.0,1140.75,294.84,1579.5,21
HCPCS,C1766,AGILIS SMALL AND MEDIUM CURL,1200.0,780.0,201.6,1080.0,21
HCPCS,C1766,INTRO SHTH 8.5FR 71CM GUID,1206.0,783.9,202.61,1085.4,21
HCPCS,C1766,INTRO SHTH 8.5FR 71CM GUIDE LG,1206.0,783.9,202.61,1085.4,21
HCPCS,C1766,"Intro/sheath,strble,non-peel",,,3163.32,3163.32,1
HCPCS,C1766,SHTH INTRO NAGARE,1238.0,804.7,207.98,1114.2,21
HCPCS,C1766,"STEERABLE SHEATH CLEAR, 13F",1755.0,1140.75,294.84,1579.5,21
HCPCS,C1766,TRICLIP 80CM STEERABLE GUIDE CATHETER,108000.0,70200.0,18144.0,97200.0,21
HCPCS,C1766,W INTDCR AGILIS STRABLE W/TIP,1499.0,974.35,251.83,1349.1,21
HCPCS,C1766,W INTRO SHTH FLEXCATH ADV STR,1350.0,877.5,226.8,1215.0,21
HCPCS,C17660,"Intro/sheath,strble,non-peel",,,3163.32,3163.32,1
HCPCS,C1767,"Generator, neuro non-recharg",,,14252.13,14252.13,1
HCPCS,C1767,W GEN INS/IPG CSTM SYNERGY VEST,16000.0,10400.0,2688.0,15680.0,35
HCPCS,C1767,W GEN NEURO INTRSTM II IPG 3058,17720.0,11518.0,2976.96,17365.6,35
HCPCS,C1767,W GEN NEUROSTIM ACTIVA DUAL PC,34400.0,22360.0,5779.2,33712.0,35
HCPCS,C1767,W GEN NEUROSTIM ACTIVA SC,17090.0,11108.5,2871.12,16748.2,35
HCPCS,C1767,W GEN NEUROSTIM ENTERRA 3116,16900.0,10985.0,2839.2,16562.0,35
HCPCS,C1767,W GEN NEUROSTIM IPG 3023,15840.0,10296.0,2661.12,15523.2,35
HCPCS,C1767,W GENERATOR DEMIPULSE,37310.0,24251.5,6268.08,36563.8,35
HCPCS,C1767,W GENERATOR PULSE SOLTRA 7426,17090.0,11108.5,2871.12,16748.2,35
HCPCS,C1767,W GENERATOR VAGUS NERVE SNG/DL,27302.0,17746.3,4586.74,26755.96,35
HCPCS,C1767,W IMP GEN NSTIM,31866.0,20712.9,5353.49,31228.68,35
HCPCS,C1767,W NEUROSTIM PRIME ADVANCE 37702,22000.0,14300.0,3696.0,21560.0,35
HCPCS,C1767,W NEUROSTIMULATOR KINETRA 7428,34190.0,22223.5,5743.92,33506.2,35
HCPCS,C1767,W NEURSTM+EXT ITR,25544.0,16603.6,4291.39,25033.12,35
HCPCS,C17670,"Generator, neuro non-recharg",,,14252.13,14252.13,1
HCPCS,C1768,GRAFT VASC 45CM 4-7MM GORE,2466.0,1602.9,414.29,2416.68,32
HCPCS,C1768,"Graft, vascular",,,348.59,348.59,1
HCPCS,C1768,PATCH CV 8X.8CM VSGRD TAPR,385.0,250.25,64.68,377.3,29
HCPCS,C1768,W FABRIC HEMASHLD KNTTD DOUBLE,202.0,131.3,33.94,197.96,29
HCPCS,C1768,W GRAF DIST FLX CUF 6MM X 80CM,5092.0,3309.8,855.46,4990.16,32
HCPCS,C1768,W GRAFT BYPASS DISTAFLO,2604.0,1692.6,437.47,2551.92,32
HCPCS,C1768,W GRAFT DISTAFLO BYPS 8MMX80CM,3428.0,2228.2,575.9,3359.44,32
HCPCS,C1768,W GRAFT HEMA MPV 2X6IN,505.0,328.25,84.84,494.9,29
HCPCS,C1768,W GRAFT HMDV STRGHT 8MM X 15CM,496.0,322.4,83.33,486.08,29
HCPCS,C1768,W GRAFT HWDVS PLAT 24MM X 30CM,735.0,477.75,123.48,720.3,29
HCPCS,C1768,W GRAFT HWDVS PLAT 30CM,743.0,482.95000000000005,117.94,768.32,58
HCPCS,C1768,W GRAFT HWDVS PLAT 30MM X 30CM,752.0,488.8,126.34,736.96,29
HCPCS,C1768,W GRAFT HWDVS PLAT 32MM X 60CM,1012.0,657.8,170.02,991.76,29
HCPCS,C1768,W GRAFT IMPRA FLEX 10MM X 80CM,2670.0,1735.5,448.56,2616.6,32
HCPCS,C1768,W GRAFT PROPATEN HT087080A,5216.0,3390.4,876.29,5111.68,35
HCPCS,C1768,W GRAFT VAS BIF 50CM,922.0,599.3,154.9,903.56,29
HCPCS,C1768,W GRAFT VASC 40CM 8MM GORE,2636.0,1713.4,442.85,2583.28,32
HCPCS,C1768,W GRAFT VASC TAP 7-4MM ID 40CM,1200.0,780.0,201.6,1176.0,29
HCPCS,C1768,W GRAFT VASCLR HEMSHLD VLR FBRC,245.0,159.25,41.16,240.1,29
HCPCS,C1768,W GRF ARTR SYN AS,936.0,608.4,157.25,917.28,29
HCPCS,C1768,W GRFT CV FELT 4,146.0,94.9,24.53,143.08,29
HCPCS,C1768,W GRFT CV FELT 6,282.0,183.3,47.38,276.36,29
HCPCS,C1768,W GRFT CV PLEDGET,87.0,56.55,14.62,85.26,29
HCPCS,C1768,W GRFT STD TAPERED 4-7MM X 30CM,820.0,533.0,137.76,803.6,29
HCPCS,C1768,W GRFT V ACCESS,2889.0,1877.85,485.35,2831.22,32
HCPCS,C1768,W GRFT V CNTRFLX,1772.0,1151.8,297.7,1736.56,32
HCPCS,C1768,W GRFT V EXXCEL,4133.0,2686.45,694.34,4050.34,32
HCPCS,C1768,W GRFT V IMP VEN,2114.0,1374.1,355.15,2071.72,32
HCPCS,C1768,W GRFT VASC BIF C,2114.0,1374.1,355.15,2071.72,32
HCPCS,C1768,W GRFT VASC BIF D,2636.0,1713.4,442.85,2583.28,32
HCPCS,C1768,W GRFT VASC STR G,1312.0,852.8,220.42,1285.76,29
HCPCS,C1768,W GRFT VASC STR M,2127.0,1382.55,357.34,2084.46,64
HCPCS,C1768,W GRFT VASC STR W,2758.0,1792.7,463.34,2702.84,32
HCPCS,C1768,W GRFT VASCULAR,6063.0,3940.95,1018.58,5941.74,35
HCPCS,C1768,W GRFT VASCULAR 2,19756.0,12841.4,3319.01,19360.88,35
HCPCS,C1768,W GRFT VASCULAR 3,20574.0,13373.1,3456.43,20162.52,35
HCPCS,C1768,W PATCH PERICARDIAL 10X15 4700,350.0,227.5,58.8,343.0,29
HCPCS,C1768,W PATCH VASC PERICARDIUM 1X6CM,236.0,153.4,39.65,231.28,29
HCPCS,C1768,W PATCH VASC PERICARDIUM 2X9CM,370.0,240.5,62.16,362.6,29
HCPCS,C1768,W PATCH VASCU-GUARD VG-0108N,420.0,273.0,70.56,411.6,29
HCPCS,C1768,W STENT GRAFT W/XCELERANT,4800.0,3120.0,806.4,4704.0,32
HCPCS,C17680,"Graft, vascular",,,348.59,348.59,1
HCPCS,C1769,.018IN X 300CM GLIDEWIRE ADVANTAGE GDWR,330.0,214.5,55.44,297.0,21
HCPCS,C1769,0.014X180CM ASAHI GRAND SLAM PTCA GUIDEWIRE STR,149.0,96.85,25.03,134.1,21
HCPCS,C1769,0.018IN X 300CM 12GM VICTORY 18 GUIDEWIRE STR,206.0,133.9,34.61,185.4,21
HCPCS,C1769,0.018IN X 300CM PLATINUM PLUS COR GUIDEWIRE STR,112.0,72.8,18.82,100.8,21
HCPCS,C1769,AMPLATZ EXTRA STIFF SUPPORT 0.032IN X 260CM WIRE GUIDE,186.0,120.9,31.25,167.4,21
HCPCS,C1769,AMPLATZ SS ST GUIDEWIRE,332.0,215.8,55.78,298.8,21
HCPCS,C1769,"ASAHI HYDROPHILIC COATED SPRING COIL GUIDE WIRE, 1.5J CE, 0.35IN",70.0,45.5,11.76,63.0,21
HCPCS,C1769,ASAHI PROWATER PTCA GUIDEWIRE .014 X 180CM,525.0,341.25,88.2,472.5,21
HCPCS,C1769,CIRCULO GUIDEWIRE 0.035IN X 275CM (DAIBW-001),278.0,180.7,46.7,250.2,21
HCPCS,C1769,"CPS COURIER GUIDEWIRE, EXTRA FIRM, 0.014IN X 195CM",123.0,79.95,20.66,110.7,21
HCPCS,C1769,"CPS COURIER GUIDEWIRE, FIRM, 195CM X .014IN",473.0,307.45,79.46,425.7,21
HCPCS,C1769,"CPS COURIER GUIDEWIRE, MED 195CM X 0.014IN",158.0,102.7,26.54,142.2,21
HCPCS,C1769,FIGHTER SPECIALITY CROSSING GUIDEWIRE 0.009IN X 190CM,223.0,144.95,37.46,200.7,21
HCPCS,C1769,GALT MICRO-INTRODUCER 4FR X 10CM X 0.018IN KIT W/40CM NITINOL MA,65.0,42.25,10.92,58.5,21
HCPCS,C1769,GLIDEWIRE GT GUIDEWIRE 0.018IN X 180CM 45DEG ANGL 2CM TIP,254.0,165.1,42.67,228.6,21
HCPCS,C1769,GUIDEWIRE .014IN X 300CM SYNCHRO2,912.0,592.8,153.22,820.8,21
HCPCS,C1769,GUIDEWIRE HI TORQUE STEELCORE 018IN STRAIGHT PLAT,145.0,94.25,24.36,130.5,21
HCPCS,C1769,GUIDEWIRE MINAMO,131.0,85.15,22.01,117.9,21
HCPCS,C1769,GUIDEWIRE VICTORY .014IN 12GA STRAIGHT STAINLESS STEEL PTFE HYDR,263.0,170.95,44.18,236.7,21
HCPCS,C1769,GUIDEWIRE VICTORY .014IN 18GA STRAIGHT,206.0,133.9,34.61,185.4,21
HCPCS,C1769,GW 0.014IN X 185CM COMET II,900.0,585.0,151.2,810.0,21
HCPCS,C1769,GW 0.014IN X 190CM STRAIGHT,131.0,85.15,22.01,117.9,21
HCPCS,C1769,GW 0.018IN X 300CM 25GM,206.0,133.9,34.61,185.4,21
HCPCS,C1769,GW 0035IN 150CM REG STR 3CM,65.0,42.25,10.92,58.5,21
HCPCS,C1769,GW 018IN X 300CM 5CM RADIOPAQUE STRAIGHT TIP,145.0,94.25,24.36,130.5,21
HCPCS,C1769,GW 5FR X 100CM GLIDECATH COBRA 2 (C2) .038,91.0,59.15,15.29,81.9,21
HCPCS,C1769,GW ANGTP HYBRD .035IN,65.0,42.25,10.92,58.5,21
HCPCS,C1769,GW CARDIOMEMS STEER,299.0,194.35,50.23,269.1,21
HCPCS,C1769,GW COR CONFIDA BRECKER,293.0,190.45,49.22,263.7,21
HCPCS,C1769,GW ENDSCP .035IN NTNL SOLO,71.0,46.15,11.93,63.9,21
HCPCS,C1769,GW HI-TORQUE COMMAND,263.0,170.95,44.18,236.7,21
HCPCS,C1769,GW STRAIGHT-TIP MARVEL,123.0,79.95,20.66,110.7,21
HCPCS,C1769,GW VASC .014IN 300CM,210.0,136.5,35.28,189.0,42
HCPCS,C1769,GW VASC .014IN 300CM STR TIP,112.0,72.8,18.82,100.8,21
HCPCS,C1769,GW VASC .014IN 3CM STR,525.0,341.25,88.2,472.5,21
HCPCS,C1769,GW VASC .018IN 300CM SHRT TAPR,137.0,89.05,23.02,123.3,21
HCPCS,C1769,GW VASC .035IN 180CM 3CM STR,81.0,52.65,13.61,72.9,21
HCPCS,C1769,GW VASC .035IN 260CM STR STND,270.0,175.5,45.36,243.0,21
HCPCS,C1769,GW VASC 260CM .025IN RADPQ,142.0,92.3,23.86,127.8,21
HCPCS,C1769,GW VASC 300M JUDO 3 STRAIGHT,199.0,129.35,30.91,192.6,42
HCPCS,C1769,GW VASC 300M JUDO 6 STRAIGHT,215.0,139.75,36.12,193.5,21
HCPCS,C1769,GW VASC 98CM ATN HBRD,230.0,149.5,38.64,207.0,21
HCPCS,C1769,GW VASC AMPLTZ SS PTFE STR,72.0,46.8,12.1,64.8,21
HCPCS,C1769,GW VASC LUNDERQUIST PTFE SS,194.0,126.1,32.59,174.6,21
HCPCS,C1769,GW VASC OPT PRSS SNSR FR 185CM,900.0,585.0,151.2,810.0,21
HCPCS,C1769,GW VASC PROSTREAM SS,269.0,174.85,45.19,242.1,21
HCPCS,C1769,GW VASC ROADRUNNER ANG X,172.0,111.8,28.9,154.8,21
HCPCS,C1769,GW VASC SS STR SHRT,212.0,137.8,35.62,190.8,21
HCPCS,C1769,"GW VICTORY .018 300CM 18, 30GM STR",206.0,133.9,34.61,185.4,21
HCPCS,C1769,GWIRE .014 300CM STR VICTORY,206.0,133.9,34.61,185.4,21
HCPCS,C1769,Guide wire,,,143.52,143.52,1
HCPCS,C1769,MIGHTY WIRE DOUBLE CURVE 75MM 15MM,263.0,170.95,44.18,236.7,21
HCPCS,C1769,PLATINUM PLUS COR GUIDEWIRE STR STNLS STEEL 0.018IN X 300CM,112.0,72.8,18.82,100.8,21
HCPCS,C1769,PTFE-NITINOL GUIDEWIRE W HYDROPHILIC TIP,118.0,76.7,19.82,106.2,21
HCPCS,C1769,SAFARI2 GUIDEWIRE X-SM PRE-SHAPED TAVR/TAVI 0.035IN X 275CM (MFR,375.0,243.75,63.0,337.5,21
HCPCS,C1769,VICTORY 18 STRAIGHT TIP 18GR 300CM,255.0,165.75,42.84,229.5,21
HCPCS,C1769,VICTORY PERIPHERAL VASCULAR GUIDEWIRE 300CM 25-GAUGE,323.0,209.95,54.26,290.7,21
HCPCS,C1769,W 035IN X 180CM GLIDEWIRE PERIPHERAL GUIDEWIRE,69.0,44.85,11.59,62.1,21
HCPCS,C1769,W CLP WR ROTABLDR,248.0,161.2,41.66,223.2,21
HCPCS,C1769,W GDEWIRE 150CM FELX ANGLD TIP,81.0,52.65,13.61,72.9,21
HCPCS,C1769,W GDEWIRE SAFE-T-J COATED CRVD,26.0,16.9,4.37,23.4,21
HCPCS,C1769,W GDWIRE 180CM FLEX ANGLE TIP,94.0,61.1,15.79,84.6,21
HCPCS,C1769,W GDWIRE 25CM TIP FTHM STRABLE,495.0,321.75,83.16,445.5,21
HCPCS,C1769,W GDWIRE INQWIRE FXD CORE PTFE,32.0,20.8,5.38,28.8,21
HCPCS,C1769,W GDWIRE ROADRUNNER TM EXTRA,156.0,101.4,26.21,140.4,21
HCPCS,C1769,W GDWIRE STD HPERF NITVU,88.0,57.2,14.78,79.2,21
HCPCS,C1769,W GDWIRE SUPER STIFF-FIXED CORE,37.0,24.05,6.22,33.3,21
HCPCS,C1769,W GDWIRE TRNSND STRBLE HYDRPLC,341.0,221.65,57.29,306.9,21
HCPCS,C1769,W GDWIRE VNUS MICRO INTRO SHTH,55.0,35.75,9.24,49.5,21
HCPCS,C1769,W GDWR 150CM FLXBLE ANG/STR TIP,60.0,39.0,10.08,54.0,21
HCPCS,C1769,W GDWR 15CM TAPER PTFE COATED,33.0,21.45,5.54,29.7,21
HCPCS,C1769,W GDWR 260CM FLXBLE ANG/STR TIP,90.0,58.5,15.12,81.0,21
HCPCS,C1769,W GDWR 260CM FLXBLE STR TIP,82.0,53.3,13.78,73.8,21
HCPCS,C1769,W GDWR 260CM STD ANG TIP,139.0,90.35,23.35,125.1,21
HCPCS,C1769,W GDWR 7CM STRGHT TP SUPR STIFF,57.0,37.05,9.58,51.3,21
HCPCS,C1769,W GDWR ADVANTAGE 180CM SPIRAL,263.0,170.95,44.18,236.7,21
HCPCS,C1769,W GDWR ANGLD TP STD ZPWR HDRPLC,66.0,42.9,11.09,59.4,21
HCPCS,C1769,W GDWR BALL TIP 2.5X800MM,132.0,85.8,22.18,118.8,21
HCPCS,C1769,W GDWR BALL TIPPED STRL 3X800MM,235.0,152.75,39.48,211.5,21
HCPCS,C1769,W GDWR ENDSCP 480 CM STR TIP,187.0,121.55,31.42,168.3,21
HCPCS,C1769,W GDWR FINISHING WIRE 90 CM,228.0,148.2,38.3,205.2,21
HCPCS,C1769,W GDWR FLPPY ANGLD SGWY HYDRPLC,223.0,144.95,37.46,200.7,21
HCPCS,C1769,W GDWR FLX ANG TP GLIDEWIRE,72.0,46.8,12.1,64.8,21
HCPCS,C1769,W GDWR GLDE CTD 3X.035X150 ANGL,73.0,47.45,12.26,65.7,21
HCPCS,C1769,W GDWR GLIDE CTD 3X.035X150 STR,80.0,52.0,13.44,72.0,21
HCPCS,C1769,W GDWR GW BENTSON ANG/STIFF .038,117.0,76.05,19.66,105.3,21
HCPCS,C1769,W GDWR HI TORQUE IRON MAN,130.0,84.5,21.84,117.0,21
HCPCS,C1769,W GDWR JAGWIRE STRGHT,257.0,167.05,43.18,231.3,21
HCPCS,C1769,W GDWR LNDRQST STRGHT EXCHG SS,153.0,99.45,25.7,137.7,21
HCPCS,C1769,W GDWR NS CORONARY RUNTHROUGH,114.0,74.1,19.15,102.6,21
HCPCS,C1769,W GDWR PROLN NITINOL MANDRL,40.0,26.0,6.72,36.0,21
HCPCS,C1769,W GDWR STABILIZER EXTRA SUPPORT,40.0,26.0,6.72,36.0,21
HCPCS,C1769,W GDWR STD ANGL H20 HYDROPHILIC,68.0,44.2,11.42,61.2,21
HCPCS,C1769,W GDWR STRGHT FXD CORE PTFE INQ,38.0,24.7,6.38,34.2,21
HCPCS,C1769,W GDWR STRGHT TP AMPLTZ SPR,88.0,57.2,14.78,79.2,21
HCPCS,C1769,W GDWR SUPER STIFF .035 X 180CM,158.0,102.7,26.54,142.2,21
HCPCS,C1769,W GDWR THRD 3.2 X 400MM,156.0,101.4,26.21,140.4,21
HCPCS,C1769,W GDWR TROOPER/PATRT EXTSN WIRE,162.0,105.3,27.22,145.8,21
HCPCS,C1769,W GDWR VASC 190CM A FLDR XT,207.0,134.55,34.78,186.3,21
HCPCS,C1769,W GDWR VASC 300CM 3CM STR,130.0,84.5,21.84,117.0,21
HCPCS,C1769,W GDWR VASC 300CM STINGRAY HPC,375.0,243.75,63.0,337.5,21
HCPCS,C1769,W GDWRE 180CM FLPPY PLTNM PLS,145.0,94.25,24.36,130.5,21
HCPCS,C1769,W GDWRE 260CM FLPPY PLTNM PLS,170.0,110.5,28.56,153.0,21
HCPCS,C1769,W GUIDE WIRE,197.0,128.05,12.6,282.6,105
HCPCS,C1769,W GUIDE WIRE .035,225.0,146.25,37.8,202.5,21
HCPCS,C1769,W GUIDE WIRE ATTAIN,255.0,165.75,42.84,229.5,21
HCPCS,C1769,W GUIDE WIRE J,106.0,68.9,17.81,95.4,21
HCPCS,C1769,W GUIDE WIRE SUPER STIFF,301.0,195.65,50.57,270.9,21
HCPCS,C1769,W GUIDE WRE STR AQ,174.0,113.1,29.23,156.6,21
HCPCS,C1769,W GUIDEWIRE,149.0,96.85,25.03,134.1,21
HCPCS,C1769,W GUIDEWIRE .062X7 LONG,65.0,42.25,10.92,58.5,21
HCPCS,C1769,W GUIDEWIRE 1.37 MM SHARP/BLNT,228.0,148.2,38.3,205.2,21
HCPCS,C1769,W GUIDEWIRE 2.8MM X 450MM THRD,141.0,91.65,23.69,126.9,21
HCPCS,C1769,W GUIDEWIRE 900.721 1.25X150,57.0,37.05,9.58,51.3,21
HCPCS,C1769,W GUIDEWIRE 900.722 1.25X150MM,61.0,39.65,10.25,54.9,21
HCPCS,C1769,W GUIDEWIRE AMPLATX SUPERST,244.0,158.6,40.99,219.6,21
HCPCS,C1769,W GUIDEWIRE ASAHI GRAND SLAM,131.0,85.15,22.01,117.9,21
HCPCS,C1769,W GUIDEWIRE ASAHI MIRACLEBROS,245.0,159.25,41.16,220.5,21
HCPCS,C1769,W GUIDEWIRE BALL-TIPPED,316.0,205.4,53.09,284.4,21
HCPCS,C1769,W GUIDEWIRE BALL-TIPPED STERILE,450.0,292.5,75.6,405.0,21
HCPCS,C1769,W GUIDEWIRE BEN/STR/PTFE/STRTR,20.0,13.0,3.36,18.0,21
HCPCS,C1769,W GUIDEWIRE EMERALD J3MM 150CM,15.0,9.75,2.52,13.5,21
HCPCS,C1769,W GUIDEWIRE EXCHNGE AMPLTZ SUPR,82.0,53.3,13.78,73.8,21
HCPCS,C1769,W GUIDEWIRE FLOPPY 185CM,50.0,32.5,8.4,45.0,21
HCPCS,C1769,W GUIDEWIRE FORTE STRT TIP,131.0,85.15,22.01,117.9,21
HCPCS,C1769,W GUIDEWIRE HALO,219.0,142.35,36.79,197.1,21
HCPCS,C1769,W GUIDEWIRE HALO .035 INX260CM,219.0,142.35,36.79,197.1,21
HCPCS,C1769,W GUIDEWIRE HI-TORQUE FLOPPY II,149.0,96.85,25.03,134.1,21
HCPCS,C1769,W GUIDEWIRE HI-TORQUE PILOT,149.0,96.85,25.03,134.1,21
HCPCS,C1769,W GUIDEWIRE HI-TORQUE WIGGLE,149.0,96.85,25.03,134.1,21
HCPCS,C1769,W GUIDEWIRE II,85.0,55.25,14.28,76.5,21
HCPCS,C1769,W GUIDEWIRE III,143.0,92.95,24.02,128.7,21
HCPCS,C1769,W GUIDEWIRE INQWIRE BENTSON,27.0,17.55,4.54,24.3,21
HCPCS,C1769,W GUIDEWIRE INQWIRE FIXED CORE,13.0,8.45,2.18,11.7,21
HCPCS,C1769,W GUIDEWIRE IV,227.0,147.55,38.14,204.3,21
HCPCS,C1769,W GUIDEWIRE JAGWIRE .025 260CM,199.0,129.35,33.43,179.1,21
HCPCS,C1769,W GUIDEWIRE JAGWIRE .035 450CM,288.0,187.2,48.38,259.2,21
HCPCS,C1769,W GUIDEWIRE JSFC/PTFE STRTR,23.0,14.95,3.86,20.7,21
HCPCS,C1769,W GUIDEWIRE KATZEN INFUSION,272.0,176.8,45.7,244.8,21
HCPCS,C1769,W GUIDEWIRE PORTER,219.0,142.35,36.79,197.1,21
HCPCS,C1769,W GUIDEWIRE PT2 MS 2CM STRGHT,111.0,72.15,18.65,99.9,21
HCPCS,C1769,W GUIDEWIRE ROADRUNNER PC FIRM,59.0,38.35,9.91,53.1,21
HCPCS,C1769,W GUIDEWIRE ROS/PTFE/3/5 STRTR,21.0,13.65,3.53,18.9,21
HCPCS,C1769,W GUIDEWIRE ROS/PTFE/STARTER,34.0,22.1,5.71,30.6,21
HCPCS,C1769,W GUIDEWIRE RR 5F 180CM RDRUNNR,142.0,92.3,23.86,127.8,21
HCPCS,C1769,W GUIDEWIRE SHAFT VIPERWIRE ADV,225.0,146.25,37.8,202.5,21
HCPCS,C1769,W GUIDEWIRE SYNT,65.0,42.25,10.92,58.5,21
HCPCS,C1769,W GUIDEWIRE TENOR STEERABLE,293.0,190.45,49.22,263.7,21
HCPCS,C1769,W GUIDEWIRE VIGOR SINUS,233.0,151.45,39.14,209.7,21
HCPCS,C1769,W GUIDEWIRE VIPERWIRE COR FLP,293.0,190.45,49.22,263.7,21
HCPCS,C1769,W GUIDEWIRE/HYDRAWIRE,262.0,170.3,44.02,235.8,21
HCPCS,C1769,W GUIDEWIRED VI,46.25,30.06,7.77,41.63,21
HCPCS,C1769,W GUIDEWRE 035IN X145CM 11CM,64.0,41.6,10.75,57.6,21
HCPCS,C1769,W GUIDEWRE STD WHOLEY HI-TORQUE,124.0,80.6,20.83,111.6,21
HCPCS,C1769,W GUIDWIRE 292.68 THREAD 2.8MM,82.0,53.3,13.78,73.8,21
HCPCS,C1769,"W GW 0.035 X 260CM, BEN/STR/PTF",42.0,27.3,7.06,37.8,21
HCPCS,C1769,W GW ATHERECTOMY JETSTREAM,175.0,113.75,29.4,157.5,21
HCPCS,C1769,W GW C HI-TORQ WHISPER,131.0,85.15,22.01,117.9,21
HCPCS,C1769,W GW ENDSCP .035,257.0,167.05,43.18,231.3,21
HCPCS,C1769,W GW ENDSCP .035IN 150CM FLX,79.0,51.35,13.27,71.1,21
HCPCS,C1769,W GW ENDSCP BIL PATHFR EXCHG,206.0,133.9,34.61,185.4,21
HCPCS,C1769,W GW FEM CATH,41.0,26.65,6.89,36.9,21
HCPCS,C1769,W GW HI-TORG CROSSIT 100XT,149.0,96.85,25.03,134.1,21
HCPCS,C1769,W GW HI-TORQ ALL STAR,149.0,96.85,25.03,134.1,21
HCPCS,C1769,W GW HI-TORQ BALANCE MW,149.0,96.85,25.03,134.1,21
HCPCS,C1769,W GW HI-TORQ HW,327.0,212.55,54.94,294.3,21
HCPCS,C1769,W GW HI-TORQ200XT,327.0,212.55,54.94,294.3,21
HCPCS,C1769,W GW HI-TORQIRNMN,327.0,212.55,54.94,294.3,21
HCPCS,C1769,W GW HP JAGWIRE,410.0,266.5,68.88,369.0,21
HCPCS,C1769,W GW INTR,65.0,42.25,10.92,58.5,21
HCPCS,C1769,W GW JINDO TAPERD,315.0,204.75,52.92,283.5,21
HCPCS,C1769,W GW LUGE VASC STRAIGHT,114.0,74.1,19.15,102.6,21
HCPCS,C1769,W GW NEURVASC ASAHI CHIKAI,663.0,430.95,111.38,596.7,21
HCPCS,C1769,W GW PLATINUM PLS,327.0,212.55,54.94,294.3,21
HCPCS,C1769,W GW PTCA CHOICE 182/300,131.0,85.15,22.01,117.9,21
HCPCS,C1769,W GW PTCA LUGE,327.0,212.55,54.94,294.3,21
HCPCS,C1769,W GW PTCA PATRIOT,327.0,212.55,54.94,294.3,21
HCPCS,C1769,W GW PTCA PTGRPHX MED182/300,131.0,85.15,22.01,117.9,21
HCPCS,C1769,W GW SYNCHRO2 STD HYDROPHILIC,886.0,575.9,148.85,797.4,21
HCPCS,C1769,W GW SYS WHOLEY,407.5,264.875,54.94,439.2,63
HCPCS,C1769,W GW TAD,526.0,341.9,88.37,473.4,21
HCPCS,C1769,W GW TRQ PLX,370.0,240.5,62.16,333.0,21
HCPCS,C1769,W GW VASC .035 STRGHT,81.0,52.65,13.61,72.9,21
HCPCS,C1769,W GW VASC 175CM PRSS RADPQ,987.0,641.55,165.82,888.3,21
HCPCS,C1769,W GW VASC 300CM 11CM STR,207.0,134.55,34.78,186.3,21
HCPCS,C1769,W GW VASC AMPL XSTF SS,63.0,40.95,10.58,56.7,21
HCPCS,C1769,W GW VASC AMPLTZ JTIP,83.0,53.95,13.94,74.7,21
HCPCS,C1769,W GW VASC ANG  STNDRD TIP STR,112.0,72.8,18.82,100.8,21
HCPCS,C1769,W GW VASC ANG NITREX NITL,103.0,66.95,17.3,92.7,21
HCPCS,C1769,W GW VASC ANGLD HYDROPHILIC,97.0,63.05,16.3,87.3,21
HCPCS,C1769,W GW VASC ASAHI TREASURE PRPH,255.0,165.75,42.84,229.5,21
HCPCS,C1769,W GW VASC CHOICE,114.0,74.1,19.15,102.6,21
HCPCS,C1769,W GW VASC CONTROLWIRE TAPER SCI,141.0,91.65,23.69,126.9,21
HCPCS,C1769,W GW VASC MICROPNT PLUSH SS,71.0,46.15,11.93,63.9,21
HCPCS,C1769,W GW VASC PC COR ASTATO PTFE,248.0,161.2,41.66,223.2,21
HCPCS,C1769,W GW VASC SFT SYNCH HYDR NTNL,720.0,468.0,120.96,648.0,21
HCPCS,C1769,W GW VASC STR MAILMAN,114.0,74.1,19.15,102.6,21
HCPCS,C1769,W GW VASC STR SS HYDRO ASAHI,210.0,136.5,35.28,189.0,21
HCPCS,C1769,W GW VASC STRBL SFT AGLTY STR,413.0,268.45,69.38,371.7,21
HCPCS,C1769,W GW VASC STRT TRAXCESS NTL,506.0,328.9,85.01,455.4,21
HCPCS,C1769,W GW VASC TRANSEND EX,606.0,393.9,101.81,545.4,21
HCPCS,C1769,W GW VASC TRANSND X SUPPORT,810.0,526.5,136.08,729.0,21
HCPCS,C1769,W GW VASCULAR TRANSEND,726.0,471.9,121.97,653.4,21
HCPCS,C1769,W GWIRE ANG STF 0.035IN X 150CM,364.0,236.6,61.15,327.6,21
HCPCS,C1769,W GWIRE HYDRA ANG/STR/DRM,262.0,170.3,44.02,235.8,21
HCPCS,C1769,W GWIRE LUNDERQUIST 260MM X 7CM,164.0,106.6,27.55,147.6,21
HCPCS,C1769,W GWIRE NON-THRD SHARP 18IN,161.0,104.65,27.05,144.9,21
HCPCS,C1769,W HYDRATOME CANNLTG SPHNCTME,623.0,404.95,104.66,560.7,21
HCPCS,C1769,W JAGWIRE PULMONARY,206.0,133.9,34.61,185.4,21
HCPCS,C1769,W SHTH AXCESS INTRODUCER KIT,37.0,24.05,6.22,33.3,21
HCPCS,C1769,W SPHINTOM 25MM 5.5FR FUS,330.0,214.5,55.44,297.0,21
HCPCS,C1769,W SPHINTOM DRMTOME RX,611.0,397.15,102.65,549.9,21
HCPCS,C1769,W SPHINTOM FUS OMNI W/WIRE,330.0,214.5,55.44,297.0,21
HCPCS,C1769,W SPHINTOM W/WIRE 25MM TRI,394.0,256.1,66.19,354.6,21
HCPCS,C17690,Guide wire,,,143.52,143.52,1
HCPCS,C1770,"Imaging coil, mr, insertable",,,572.34,572.34,1
HCPCS,C17700,"Imaging coil, mr, insertable",,,572.34,572.34,1
HCPCS,C1771,"Rep dev, urinary, w/sling",,,4067.9,4067.9,1
HCPCS,C1771,SLING DESARA BLU URINARY INCON,1587.0,1031.55,266.62,1555.26,29
HCPCS,C1771,W SLING ADVANCE MALE,8002.0,5201.3,1344.34,7841.96,35
HCPCS,C1771,W SLING BIOARC SYSTEM,3000.0,1950.0,504.0,2940.0,32
HCPCS,C1771,W SLING FEMALE ISTOP IS-5,1390.0,903.5,233.52,1362.2,29
HCPCS,C1771,W SLING GYNCR TVT OBTURATOR SYS,1873.0,1217.45,314.66,1835.54,32
HCPCS,C1771,W SLING I-STOP TOMS MALE,6000.0,3900.0,1008.0,5880.0,35
HCPCS,C1771,W SLING MALE INVANCE,9300.0,6045.0,1562.4,9114.0,35
HCPCS,C1771,W SLING MINIARC,2520.0,1638.0,423.36,2469.6,32
HCPCS,C1771,W SLING MONARC,1700.0,1105.0,285.6,1666.0,29
HCPCS,C1771,W SLING TRANSOBTURATOR ARIS,1600.0,1040.0,268.8,1568.0,29
HCPCS,C1771,W SLING TVT DEVICE 810041B,1709.0,1110.85,287.11,1674.82,29
HCPCS,C1771,W SLING URTH VIRT VNTRL SYS,8800.0,5720.0,1478.4,8624.0,35
HCPCS,C1771,W SLING Y INTEPRO,724.0,470.6,121.63,709.52,29
HCPCS,C17710,"Rep dev, urinary, w/sling",,,4067.9,4067.9,1
HCPCS,C1772,"Infusion pump, programmable",,,54.0,54.0,1
HCPCS,C1772,W PUMP SYNCH II US MKTJUN,20800.0,13520.0,3494.4,20384.0,35
HCPCS,C17720,"Infusion pump, programmable",,,54.0,54.0,1
HCPCS,C1773,"12-20MM X 120CM STANDARD EN SNARE, 6FR X 100CM CATH",413.0,268.45,69.38,371.7,21
HCPCS,C1773,AVEIR RETRIEVAL CATHETER 105CM,4050.0,2632.5,680.4,3645.0,21
HCPCS,C1773,"EVOLUTION RL CONTROLLED-ROTATION DILATOR SHEATH SET, LEAD EXTRAC",2358.0,1532.7,396.14,2122.2,21
HCPCS,C1773,"EVOLUTION SHORTIE RL CONTROLLED-ROTATIONAL DILATOR SHEATH SET, L",1885.0,1225.25,316.68,1696.5,21
HCPCS,C1773,NEEDLE'S EYE SNARE W/WORKSTATION 13MM,1612.0,1047.8,270.82,1450.8,21
HCPCS,C1773,"Ret dev, insertable",,,182.28,182.28,1
HCPCS,C1773,SET SHTH 13FR LD EXTR GDRL DIL,2558.0,1662.7,429.74,2302.2,21
HCPCS,C1773,SET SHTH FR LD EXTR GDRL DIL,2558.0,1662.7,429.74,2302.2,21
HCPCS,C1773,SET SHTH FR LD EXTR SUB-C,2288.0,1487.2,384.38,2059.2,21
HCPCS,C1773,SNARE VASC 120CM 7FR 8-30MM,413.0,268.45,69.38,371.7,21
HCPCS,C1773,W DEV LD LOCKING,1180.0,767.0,198.24,1156.4,29
HCPCS,C1773,W DEV RETRIEV INS,683.0,443.95,114.74,614.7,21
HCPCS,C1773,W DEV RETRV 3MM ALGTR,3207.0,2084.55,538.78,2886.3,21
HCPCS,C1773,W FILTER GUNTHR TULIP VENA CAVA,376.0,244.4,63.17,338.4,21
HCPCS,C1773,W KT ACCESS LD LOCK RMVL,762.0,495.3,128.02,685.8,21
HCPCS,C1773,W LEAD LOCKING DVCE CLRS LLD EZ,763.0,495.95,128.18,686.7,21
HCPCS,C1773,W LIBERATOR LOCKING STYLET,643.0,417.95,108.02,578.7,21
HCPCS,C1773,W NEEDLE'S EYE SNARE 12FR FMRL,746.0,484.9,125.33,671.4,21
HCPCS,C1773,W SNARE 3F X 150CM CATH,923.0,599.95,155.06,830.7,21
HCPCS,C1773,W SNARE 6F X 100CM,488.0,317.2,81.98,439.2,21
HCPCS,C1773,W SNARE AMPLATZ GOOSE NECK KT,884.0,574.6,148.51,795.6,21
HCPCS,C1773,W SNARE AMPLTZ GOOSE NECK KT,428.0,278.2,71.9,385.2,21
HCPCS,C1773,W SNARE EXPRO ELITE SNARE,593.0,385.45,99.62,533.7,21
HCPCS,C1773,W SNARE RETRIEVAL SET,1190.0,773.5,199.92,1071.0,21
HCPCS,C17730,"Ret dev, insertable",,,182.28,182.28,1
HCPCS,C1776,Joint device (implantable),,,3394.05,3394.05,1
HCPCS,C1776,W ADAPTER SIGMA FEM 5DEG,2555.0,1660.75,429.24,2503.9,32
HCPCS,C1776,W ALUMINA C-TAPER HEAD GRP-6,1400.0,910.0,235.2,1372.0,29
HCPCS,C1776,W ARTICULR SURFACE INSRTR TIP,280.0,182.0,47.04,274.4,29
HCPCS,C1776,W AUGMENT PFC SIGMA DIST,1242.0,807.3,208.66,1217.16,29
HCPCS,C1776,W BI-POLAR HIP,3850.0,2502.5,646.8,3773.0,32
HCPCS,C1776,W BIOLOX DELTA HEAD GRP-7,1400.0,910.0,235.2,1372.0,29
HCPCS,C1776,W C-TAPER COCR LFIT HEAD GRP-3,1000.0,650.0,168.0,980.0,29
HCPCS,C1776,W C-TAPER COCR LFIT HEAD GRP-4,1400.0,910.0,235.2,1372.0,29
HCPCS,C1776,W CEMENTED KNEE/ALL POLY TIBIA,3836.0,2493.4,644.45,3759.28,32
HCPCS,C1776,W COMPNT FEMORAL HIGH FLEX,2470.0,1605.5,414.96,2420.6,32
HCPCS,C1776,W CUP DXTEND STAND PE D42 +3MM,1827.0,1187.55,306.94,1790.46,32
HCPCS,C1776,W EPIPHYSIS HUM SZ 1 130708110,7068.0,4594.2,1187.42,6926.64,35
HCPCS,C1776,W EXETER FEMEROL HEAD GRP-2,1000.0,650.0,168.0,980.0,29
HCPCS,C1776,W EXETER HIP STEM GRP-1,2499.0,1624.35,419.83,2449.02,32
HCPCS,C1776,W FEMORAL COMP PKR RM/LL/LM/RL,5001.0,3250.65,840.17,4900.98,32
HCPCS,C1776,W FEMORAL DISTAL AUGMENT RIGHT,1387.0,901.55,233.02,1359.26,29
HCPCS,C1776,W FEMORAL PFC TC3 LT/RT,7605.0,4943.25,1277.64,7452.9,35
HCPCS,C1776,W FEMUR POST AUG TRAITH 5MM,1387.0,901.55,233.02,1359.26,29
HCPCS,C1776,W FEMUR POST/DISTAL AUG TRAITH,1456.0,946.4,244.61,1426.88,29
HCPCS,C1776,W FINGER JOINT/HAND IMPLANT,1998.0,1298.7,335.66,1958.04,32
HCPCS,C1776,W GLEN EQNX SHLDR KLD/PGD M/L,1400.0,910.0,235.2,1372.0,29
HCPCS,C1776,W GLENOSPHERE,1500.0,975.0,252.0,1470.0,29
HCPCS,C1776,W GLENOSPHERE 42MM DIA.,2993.0,1945.45,502.82,2933.14,32
HCPCS,C1776,W GLENOSPHERE ECC D42MM,3371.0,2191.15,566.33,3303.58,32
HCPCS,C1776,W HD EQNX HMRAL EXP/TALL/SH,1400.0,910.0,235.2,1372.0,29
HCPCS,C1776,W HEAD ART M 40MM 12/14,1100.0,715.0,184.8,1078.0,29
HCPCS,C1776,W HEAD ARTICUL/EZESROM 36MM,565.0,367.25,94.92,553.7,29
HCPCS,C1776,W HEAD FEM ARTICULEZE MOM,565.0,367.25,94.92,553.7,29
HCPCS,C1776,W HEAD FEM CER BIOLOX DELTA,585.0,380.25,98.28,573.3,29
HCPCS,C1776,W HEAD FEM CER DELTA +0 28MM,585.0,380.25,98.28,573.3,29
HCPCS,C1776,W HEAD FEM LFIT V40 26MM +8MM,1000.0,650.0,168.0,980.0,29
HCPCS,C1776,W HEAD RADL 24MM EXPLOR ELB,1250.0,812.5,210.0,1225.0,29
HCPCS,C1776,W HEAD SELF CENT BIPL 52X28 BLU,1842.0,1197.3,309.46,1805.16,32
HCPCS,C1776,W HIGH DEMAND BI-POLAR HIP,5560.0,3614.0,934.08,5448.8,35
HCPCS,C1776,W HIGH DEMAND UNI-POLAR HIP,4640.0,3016.0,779.52,4547.2,32
HCPCS,C1776,W HIP 1249-52 DURALOC LOCK RING,397.0,258.05,66.7,389.06,29
HCPCS,C1776,W HIP FEMORAL HEAD ARTICUL/EZE,360.0,234.0,60.48,352.8,29
HCPCS,C1776,W IMPL APERFIX FEMORAL WINSERTR,1960.0,1274.0,329.28,1920.8,32
HCPCS,C1776,W IMPL APERFIX TIBIAL W INSERTR,950.0,617.5,159.6,931.0,29
HCPCS,C1776,W INSERT PINN METAL NEUTRAL,1797.0,1168.05,301.9,1761.06,32
HCPCS,C1776,W INSERT TIBIAL UNI 8MM STRY,1800.0,1170.0,302.4,1764.0,32
HCPCS,C1776,W JOINT PROX INTERPHALANGEAL,2952.0,1918.8,495.94,2892.96,32
HCPCS,C1776,W KNEE IMPLANT MBT REVISION CEM,5733.0,3726.45,963.14,5618.34,35
HCPCS,C1776,W LINER ACTB,1800.0,1170.0,302.4,1764.0,32
HCPCS,C1776,W LINER HIP FEM ACET 36MM,3148.0,2046.2,528.86,3085.04,32
HCPCS,C1776,W LINER PINN MAR 28X48MM NEUTRL,364.0,236.6,61.15,356.72,29
HCPCS,C1776,W LINER PINN MAR 36X56MM,797.0,518.05,133.9,781.06,29
HCPCS,C1776,W LINER REF XLPE 32MM 50-52 E,4394.0,2856.1,738.19,4306.12,32
HCPCS,C1776,W METAGLENE DTLA XTEND,2363.0,1535.95,396.98,2315.74,32
HCPCS,C1776,W MOLD TIB KNEE CEMT 75MM,1940.0,1261.0,325.92,1901.2,32
HCPCS,C1776,W MOLDED FEMORAL CEMENTED KNEE,4092.0,2659.8,687.46,4010.16,32
HCPCS,C1776,W NAIL BONE FEM 130DEG 11X360MM,3494.0,2271.1,586.99,3424.12,32
HCPCS,C1776,W OMNIFT/CROSSFIRE INSERT GRP10,1534.0,997.1,257.71,1503.32,29
HCPCS,C1776,W PATELLA PFC SIGMA OV 3PEG,393.0,255.45,66.02,385.14,29
HCPCS,C1776,W REV SHLDR HMRAL ADAPT TY,3000.0,1950.0,504.0,2940.0,32
HCPCS,C1776,W SECUR-FIT HA XTRA GRP-11,2317.0,1506.05,389.26,2270.66,32
HCPCS,C1776,W SHELL HEMI CLUSTER HOLE,4390.0,2853.5,737.52,4302.2,32
HCPCS,C1776,W SLEEVE S-ROM PROX,1506.0,978.9,253.01,1475.88,29
HCPCS,C1776,W SLEEVE S-ROM PROX 18D-SM,1506.0,978.9,253.01,1475.88,29
HCPCS,C1776,W SPACER HUM DXTEND +9MM,2237.0,1454.05,375.82,2192.26,32
HCPCS,C1776,W SPACER INTERSPACE HIP 46MM,5980.0,3887.0,1004.64,5860.4,35
HCPCS,C1776,W SPACER LORDOTIC ALLOGRAFT ACF,2110.0,1371.5,354.48,2067.8,32
HCPCS,C1776,W STABILIZER FEMUR COMP,7336.0,4768.4,1232.45,7189.28,35
HCPCS,C1776,W STEM CORAIL DEP,4302.0,2796.3,722.74,4215.96,32
HCPCS,C1776,W STEM CORAIL2 NON COL HO,4302.0,2796.3,722.74,4215.96,32
HCPCS,C1776,W STEM EQNX HMRAL PRESS FIT,3000.0,1950.0,504.0,2940.0,32
HCPCS,C1776,W STEM FEM ACCOLADE CEMENT,1456.0,946.4,244.61,1426.88,29
HCPCS,C1776,W STEM FEMORAL ACCOLADE C CMNT,1456.0,946.4,244.61,1426.88,29
HCPCS,C1776,W STEM FEMORAL CORAIL2 STD,4302.0,2796.3,722.74,4215.96,32
HCPCS,C1776,W STEM FEMORAL SROM DEP,2796.0,1817.4,469.73,2740.08,32
HCPCS,C1776,W STEM FLTD TRIATHLON PRESSFIT,1446.0,939.9,242.93,1417.08,29
HCPCS,C1776,W STEM HIP ACCOLADE TMZF,3066.0,1992.9,515.09,3004.68,32
HCPCS,C1776,W STEM HUMERAL AFFINITI STD,5000.0,3250.0,840.0,4900.0,32
HCPCS,C1776,W STEM HUMERAL REV/FX CEMENTED,5000.0,3250.0,840.0,4900.0,32
HCPCS,C1776,W STEM RADL 24MM EXPLOR ELB,1750.0,1137.5,294.0,1715.0,32
HCPCS,C1776,W STEM S-ROM MOD HIP,2000.0,1300.0,336.0,1960.0,32
HCPCS,C1776,W STEM TRIATH CEMENTED 15X50,1304.0,847.6,219.07,1277.92,29
HCPCS,C1776,W STEM UNIV FLUTED DPY,1957.0,1272.05,328.78,1917.86,32
HCPCS,C1776,W SURFACE ARTICULAR FEM KNEE,1710.0,1111.5,287.28,1675.8,29
HCPCS,C1776,W THR ASR XL HIP,9470.0,6155.5,1590.96,9280.6,35
HCPCS,C1776,W THR CERAMIC ON CERAMIC HIP,8520.0,5538.0,1431.36,8349.6,35
HCPCS,C1776,W THR HYBRID HIP,4200.0,2730.0,705.6,4116.0,32
HCPCS,C1776,W THR HYBRID/HIGH DEMAND HIP,6484.0,4214.6,1089.31,6354.32,35
HCPCS,C1776,W THR METAL ON METAL HIP,8500.0,5525.0,1428.0,8330.0,35
HCPCS,C1776,W THR POROUS HIP,5628.0,3658.2,945.5,5515.44,35
HCPCS,C1776,W THR UNCEMENTED/NEW TECH HIP,6484.0,4214.6,1089.31,6354.32,35
HCPCS,C1776,W TI SLEEVE BIOLOX HEAD GRP-5,508.0,330.2,85.34,497.84,29
HCPCS,C1776,W TIBIA ART SURFACE SZ 3 8 MM,1844.0,1198.6,309.79,1807.12,32
HCPCS,C1776,W TIBIAL COMPNT PRECOAT LM/RL,1520.0,988.0,255.36,1489.6,29
HCPCS,C1776,W TIBIAL INSERT PLUS X3 POLY TS,2959.0,1923.35,497.11,2899.82,32
HCPCS,C1776,W TKR CEM PFC HIGHDEMAND KNEE,5136.0,3338.4,862.85,5033.28,32
HCPCS,C1776,W TKR CEMENTED PFC KNEE,4536.0,2948.4,762.05,4445.28,32
HCPCS,C1776,W TKR HYBRI PFC HIGHDEMAND KNEE,5808.0,3775.2,975.74,5691.84,35
HCPCS,C1776,W TKR HYBRID PFC KNEE,5208.0,3385.2,874.94,5103.84,35
HCPCS,C1776,W TKR LCS COMP CEMENTED KNEE,6216.0,4040.4,1044.29,6091.68,35
HCPCS,C1776,W TKR LCS COMP NONCEMHYBRI KNEE,7056.0,4586.4,1185.41,6914.88,35
HCPCS,C1776,W TKR NONCEM PFC KNEE,5880.0,3822.0,987.84,5762.4,35
HCPCS,C1776,W TKR NONCEMPFC HIGHDEMAND KNEE,6480.0,4212.0,1088.64,6350.4,35
HCPCS,C1776,W TKR PFC SIGMA ROTATING KNEE,5880.0,3822.0,987.84,5762.4,35
HCPCS,C1776,W TKR ROTATING PLATFORM KNEE,6680.0,4342.0,1122.24,6546.4,35
HCPCS,C1776,W TRAY IMP KNEE SLEEVE M/L 29MM,3146.0,2044.9,528.53,3083.08,32
HCPCS,C1776,W UNI-KNEE,4260.0,2769.0,715.68,4174.8,32
HCPCS,C1776,W UNI-POLAR HIP,2774.0,1803.1,466.03,2718.52,32
HCPCS,C17760,Joint device (implantable),,,3394.05,3394.05,1
HCPCS,C1777,ENV DEFIB AIGISRX R MED ABS,1790.0,1163.5,300.72,1754.2,32
HCPCS,C1777,LEAD OPTISURE 8FR 65CM DEFIBRILLATOR 1 COIL DF4,4200.0,2730.0,705.6,4116.0,32
HCPCS,C1777,LEAD RELIANCE 4-FRONT AF,5200.0,3380.0,873.6,5096.0,35
HCPCS,C1777,LEADS ICD RV LEAD,6174.0,4013.1,1037.23,6050.52,35
HCPCS,C1777,"Lead, aicd, endo single coil",,,9266.4,9266.4,1
HCPCS,C1777,PLEXA PROMRI ICD LEAD,5400.0,3510.0,907.2,5292.0,35
HCPCS,C1777,S DX 65/15 PAMIRA ICD LEAD,4600.0,2990.0,772.8,4140.0,30
HCPCS,C1777,W IMP LD CARDV/DF,8500.0,5525.0,1428.0,8330.0,35
HCPCS,C1777,W LEAD AICD DURATA SINGLE COIL,6000.0,3900.0,1008.0,5880.0,35
HCPCS,C1777,W LEAD DEFIB SINGLE COIL,7900.0,5135.0,1327.2,7742.0,35
HCPCS,C1777,W LEAD ENDOTACK RELIANCE SG,6000.0,3900.0,1008.0,5880.0,35
HCPCS,C1777,W LEAD PACE 55CM 1COIL SQ SCR,6174.0,4013.1,1037.23,6050.52,35
HCPCS,C1777,W LEAD RIATA DEFIB,6600.0,4290.0,1108.8,6468.0,35
HCPCS,C17770,"Lead, aicd, endo single coil",,,9266.4,9266.4,1
HCPCS,C1778,"Lead, neurostimulator",,,1156.44,1156.44,1
HCPCS,C1778,W IMP LD NSTIM,7614.0,4949.1,1279.15,7461.72,35
HCPCS,C1778,W KIT NRSTM 60CM OCTRODE PERC,2908.0,1890.2,488.54,2849.84,32
HCPCS,C1778,W KT LEAD PISCES QUAD,2090.0,1358.5,351.12,2048.2,32
HCPCS,C1778,W LD KT RESUME II INLNE 3587A25,3024.0,1965.6,508.03,2963.52,32
HCPCS,C1778,W LD NEURSTM MONARCH/MNPRO/SCS,10400.0,6760.0,1747.2,10192.0,35
HCPCS,C1778,W LD NSTIM INTRST,5555.0,3610.75,933.24,5443.9,70
HCPCS,C1778,W LD OCTAD/SUBCMPT/STD NEURSTIM,3230.0,2099.5,542.64,3165.4,32
HCPCS,C1778,W LEAD 8 CHANNEL NS PRECISION,3230.0,2099.5,542.64,3165.4,32
HCPCS,C1778,W LEAD BIPOLAR VAGUS NERVE CYBX,9168.0,5959.2,1540.22,8984.64,35
HCPCS,C1778,W LEAD INTERSTIM 3093/3889,5170.0,3360.5,868.56,5066.6,35
HCPCS,C1778,W LEAD KT LOW IMPED 45CM,3230.0,2099.5,542.64,3165.4,32
HCPCS,C1778,W LEAD MONARCH 30/45/60,5800.0,3770.0,974.4,5684.0,35
HCPCS,C1778,W LEAD NRSTM 60CM SS MRI 1X8,3158.0,2052.7,530.54,3094.84,32
HCPCS,C1778,W LEAD NRSTM 90CM OCTRDE KT 8,5816.0,3780.4,977.09,5699.68,35
HCPCS,C1778,W LEAD PERENNIA CYBX,10580.0,6877.0,1777.44,10368.4,35
HCPCS,C1778,W LEAD RESUME TO IN-LINE 3986A,3420.0,2223.0,574.56,3351.6,32
HCPCS,C1778,W LEAD SPECIFY 20CM 3998,3420.0,2223.0,574.56,3351.6,32
HCPCS,C1778,W LEAD UNIPOLAR IM 435135,4400.0,2860.0,739.2,4312.0,32
HCPCS,C17780,"Lead, neurostimulator",,,1156.44,1156.44,1
HCPCS,C1779,"Lead, pmkr, transvenous vdd",,,2947.32,2947.32,1
HCPCS,C17790,"Lead, pmkr, transvenous vdd",,,2947.32,2947.32,1
HCPCS,C1780,"Lens, intraocular (new tech)",,,1211.85,1211.85,1
HCPCS,C17800,"Lens, intraocular (new tech)",,,1211.85,1211.85,1
HCPCS,C1781,MESH SRG PARIETENE 15X15CM,92.0,59.8,15.46,90.16,29
HCPCS,C1781,MESH SRG PARTENE DS 25X20CM,1645.0,1069.25,276.36,1612.1,29
HCPCS,C1781,MESH SRG RESTORELLE L 24X8CM,1440.0,936.0,241.92,1411.2,29
HCPCS,C1781,MESH SRG SRGPRO PLG/PTCH LG,168.0,109.2,28.22,164.64,29
HCPCS,C1781,Mesh (implantable),,,871.79,871.79,1
HCPCS,C1781,W GRFT MESH MRSLN,119.0,77.35,19.99,116.62,29
HCPCS,C1781,W GRFT MESH SS,1407.0,914.55,236.38,1378.86,29
HCPCS,C1781,W IMP MESH,436.0,283.4,73.25,427.28,29
HCPCS,C1781,W MESH 3D MAX LG RIGHT 4X6IN LF,314.0,204.1,52.75,307.72,29
HCPCS,C1781,W MESH 3DMAX MD/ PERFIX PLUG,258.0,167.7,43.34,252.84,29
HCPCS,C1781,W MESH APOGEE W/INTEPRO LITE,2240.0,1456.0,376.32,2195.2,32
HCPCS,C1781,W MESH BARD 3DMAX,557.0,362.04999999999995,90.38,564.48,58
HCPCS,C1781,W MESH COMPOSIX,710.0,461.5,119.28,695.8,29
HCPCS,C1781,W MESH COMPOSIX EX ELLIP 6X8IN,1500.0,975.0,252.0,1470.0,29
HCPCS,C1781,W MESH COMPOSIX EX ELLIP 7X9IN,1988.0,1292.2,333.98,1948.24,32
HCPCS,C1781,W MESH COMPOSIX KUGEL 8X12CM,533.0,346.45,89.54,522.34,29
HCPCS,C1781,W MESH COMPOSIX LP CIRCLE 4.5IN,1120.0,728.0,188.16,1097.6,29
HCPCS,C1781,W MESH COMPOSIX VNTRL HERNIA,2480.0,1612.0,416.64,2430.4,32
HCPCS,C1781,W MESH COMPOSXKUG,4316.0,2805.4,725.09,4229.68,32
HCPCS,C1781,W MESH COMPSX 80,4360.0,2834.0,732.48,4272.8,32
HCPCS,C1781,W MESH COMPSX E/X,2376.5,1544.725,162.46,4627.56,125
HCPCS,C1781,W MESH DUAL 285CM,2733.0,1776.45,459.14,2678.34,32
HCPCS,C1781,W MESH DUAL+150CM,1598.0,1038.7,268.46,1566.04,29
HCPCS,C1781,W MESH DUAL+285CM,2733.0,1776.45,459.14,2678.34,32
HCPCS,C1781,W MESH DUAL+432CM,4219.0,2742.35,708.79,4134.62,32
HCPCS,C1781,W MESH DUALMESH PLUS 20X30X1,3372.0,2191.8,566.5,3304.56,32
HCPCS,C1781,W MESH ELEVATE ANTERIOR,3790.0,2463.5,636.72,3714.2,32
HCPCS,C1781,W MESH FLAT 7.5X15CM 3X6IN,210.0,136.5,35.28,205.8,29
HCPCS,C1781,W MESH GORTX15X19,1516.0,985.4,254.69,1485.68,29
HCPCS,C1781,W MESH H POLYPRO,1215.0,789.75,204.12,1190.7,29
HCPCS,C1781,W MESH H PTCH BRD,1451.0,943.15,176.23,2663.64,148
HCPCS,C1781,W MESH HIATAL PTCH,1034.0,672.0999999999999,147.34,1167.18,58
HCPCS,C1781,W MESH HRNIA PRLN,621.0,403.65,104.33,608.58,29
HCPCS,C1781,W MESH KUGEL COMPOSIX XLG,2676.0,1739.4,449.57,2622.48,32
HCPCS,C1781,W MESH MARLEX PLG,912.0,592.8,153.22,893.76,29
HCPCS,C1781,W MESH MYCRO 5X10CM OVAL,2278.0,1480.7,382.7,2232.44,32
HCPCS,C1781,W MESH MYCRO PLUS OVAL 6X12X1,350.0,227.5,58.8,343.0,29
HCPCS,C1781,W MESH MYCRO RECT,2086.0,1355.9,350.45,2044.28,32
HCPCS,C1781,W MESH OVL COMPOSIX KUGEL 11X14,1584.0,1029.6,266.11,1552.32,29
HCPCS,C1781,W MESH OVL COMPOSIX KUGEL 14X18,2158.0,1402.7,362.54,2114.84,32
HCPCS,C1781,W MESH OVL COMPOSIX KUGEL 8X10,1600.0,1040.0,268.8,1568.0,29
HCPCS,C1781,W MESH PATCH CRURASFT 2.8X2.4IN,698.0,453.7,117.26,684.04,29
HCPCS,C1781,W MESH PATCH CRURASOFT 4.3X3.1,447.0,290.55,75.1,438.06,29
HCPCS,C1781,W MESH PERFIX PLUG SM/MD,268.0,174.2,45.02,262.64,29
HCPCS,C1781,W MESH PERIGEE W/INTERPRO,2668.0,1734.2,448.22,2614.64,32
HCPCS,C1781,W MESH PHYSIOMESH 15X20 OVAL,1648.0,1071.2,276.86,1615.04,29
HCPCS,C1781,W MESH PLUG PERFX,330.0,214.5,55.44,323.4,29
HCPCS,C1781,W MESH PROCEED 6X8 OVAL,2553.0,1659.45,428.9,2501.94,32
HCPCS,C1781,W MESH PROLENE,1312.0,852.8,220.42,1285.76,29
HCPCS,C1781,W MESH PROLENE 12 X 12,170.0,110.5,28.56,166.6,29
HCPCS,C1781,W MESH PROLENE 3X6 PMII,65.0,42.25,10.92,63.7,29
HCPCS,C1781,W MESH PROLENE 6X6 PMH,243.0,157.95,40.82,238.14,29
HCPCS,C1781,W MESH PROLENE HERNIA EXTENDED,426.0,276.9,71.57,417.48,29
HCPCS,C1781,W MESH PROLENE HERNIA SYS PHSE6,427.0,277.55,71.74,418.46,29
HCPCS,C1781,W MESH PROLENE SOFT 3INX6IN,819.0,532.35,137.59,802.62,29
HCPCS,C1781,W MESH PROLENE SOFT 6INX6IN,990.0,643.5,166.32,970.2,29
HCPCS,C1781,W MESH SRG 3D W/SLIT 13X9CM,193.0,125.45,32.42,189.14,29
HCPCS,C1781,W MESH SRG ANAT EASGRIP 12X8CM,235.0,152.75,39.48,230.3,29
HCPCS,C1781,W MESH SRG ANAT EASGRIP 14X9CM,258.0,167.7,43.34,252.84,29
HCPCS,C1781,W MESH SRG ANAT W/SLIT & GRIP,274.0,178.1,46.03,268.52,29
HCPCS,C1781,W MESH SRG ANATOMICAL 15X10CM,254.0,165.10000000000002,40.66,260.68,58
HCPCS,C1781,W MESH SRG FLDNG W/SLIT 14X10CM,264.0,171.6,44.35,258.72,29
HCPCS,C1781,W MESH SRG MRLX 6X6 GROIN HERN,271.0,176.15,45.53,265.58,29
HCPCS,C1781,W MESH SRG PRTX 12CM RND,750.0,487.5,126.0,735.0,29
HCPCS,C1781,W MESH SRG PRTX 13X9CM,136.0,88.4,22.85,133.28,29
HCPCS,C1781,W MESH SRG PRTX 15CM RND,981.0,637.65,164.81,961.38,29
HCPCS,C1781,W MESH SRG PRTX 15X10CM,449.5,292.175,25.03,735.0,58
HCPCS,C1781,W MESH SRG PRTX 15X15CM,180.0,117.0,30.24,176.4,29
HCPCS,C1781,W MESH SRG PRTX 20CM RND,1442.0,937.3,242.26,1413.16,29
HCPCS,C1781,W MESH SRG PRTX 20X15CM,1202.0,781.3,201.94,1177.96,29
HCPCS,C1781,W MESH SRG PRTX 20X20/30X30,217.0,141.05,36.46,212.66,29
HCPCS,C1781,W MESH SRG PRTX 25X20CM,1827.0,1187.55,306.94,1790.46,32
HCPCS,C1781,W MESH SRG PRTX 30X20CM,2497.0,1623.05,419.5,2447.06,32
HCPCS,C1781,W MESH SRG PRTX 37X28CM,2966.0,1927.9,498.29,2906.68,32
HCPCS,C1781,W MESH SRG PRTX 3D 13X9CM,175.0,113.75,29.4,171.5,29
HCPCS,C1781,W MESH SRG PRTX 3D 15X10CM,242.0,157.3,40.66,237.16,29
HCPCS,C1781,W MESH SRG PRTX 3D 15X15CM,243.0,157.95,40.82,238.14,29
HCPCS,C1781,W MESH SRG PRTX 3D 20X20CM,281.0,182.65,47.21,275.38,29
HCPCS,C1781,W MESH SRG PRTX 3D 30X30CM,313.0,203.45,52.58,306.74,29
HCPCS,C1781,W MESH SRG PRTX 3D 50X50CM,1249.0,811.85,209.83,1224.02,29
HCPCS,C1781,W MESH SRG PRTX 9CM RND,547.0,355.55,91.9,536.06,29
HCPCS,C1781,W MESH SRG PRTX FLDNG 14X10CM,233.0,151.45,39.14,228.34,29
HCPCS,C1781,W MESH SRG PRTX HEART SHP 8X8CM,742.0,482.3,124.66,727.16,29
HCPCS,C1781,W MESH SRG PRTX HRSHOE 9X8CM,796.0,517.4,133.73,780.08,29
HCPCS,C1781,W MESH SRG PRTX LTWT 20X20CM,199.0,129.35,33.43,195.02,29
HCPCS,C1781,W MESH SRG PRTX LTWT 30X30CM,446.0,289.9,74.93,437.08,29
HCPCS,C1781,W MESH SRG PRTX LTWT 45X30CM,661.0,429.65,111.05,647.78,29
HCPCS,C1781,W MESH SRG PRTX LTWT 6X11CM,48.0,31.2,8.06,47.04,29
HCPCS,C1781,W MESH SRG PRTX PLUG 6CM,206.0,133.9,34.61,201.88,29
HCPCS,C1781,W MESH SRG PRTX PLUG 8CM,215.0,139.75,36.12,210.7,29
HCPCS,C1781,W MESH SRG PRTX PROGRIP,366.0,237.9,61.49,358.68,29
HCPCS,C1781,W MESH SRG PRTX SKRTD 15X10CM,952.0,618.8,159.94,932.96,29
HCPCS,C1781,W MESH SRG PRTX SKRTD 20X15CM,1467.0,953.55,246.46,1437.66,29
HCPCS,C1781,W MESH SRG PRTX SKRTD 25X20CM,2451.0,1593.15,411.77,2401.98,32
HCPCS,C1781,W MESH SRG PRTX SKRTD 30X20CM,2997.0,1948.05,503.5,2937.06,32
HCPCS,C1781,W MESH SRG PRTX SKRTD RND 8CM,752.0,488.8,126.34,736.96,29
HCPCS,C1781,W MESH SRG PRTX STOMY HOLE 15CM,1249.0,811.85,209.83,1224.02,29
HCPCS,C1781,W MESH SRG PRTX W/SLIT 15X10CM,250.0,162.5,42.0,245.0,29
HCPCS,C1781,W MESH SRG RGD KNITTED 15X10CM,129.0,83.85,21.67,126.42,29
HCPCS,C1781,W MESH SRG RGD KNITTED 15X15CM,114.0,74.1,19.15,111.72,29
HCPCS,C1781,W MESH SRG STOMY NO HOLE 15CM,1405.0,913.25,236.04,1376.9,29
HCPCS,C1781,W MESH SRG STOMY NO HOLE 20CM,1561.0,1014.65,262.25,1529.78,29
HCPCS,C1781,W MESH SRG SURGIPRO 15X10CM,52.0,33.8,8.74,50.96,29
HCPCS,C1781,W MESH SRG SURGIPRO 15X15CM,56.0,36.4,9.41,54.88,29
HCPCS,C1781,W MESH SRG SURGIPRO 2.5X10CM,46.0,29.9,7.73,45.08,29
HCPCS,C1781,W MESH SRG SURGIPRO 35X20CM,138.0,89.7,23.18,135.24,29
HCPCS,C1781,W MESH SRG SURGIPRO 7.5X12.5CM,48.0,31.2,8.06,47.04,29
HCPCS,C1781,W MESH SRG SURGIPRO PATCH LG,154.0,100.1,25.87,150.92,29
HCPCS,C1781,W MESH SRG SURGIPRO PATCH SM,122.0,79.3,20.5,119.56,29
HCPCS,C1781,W MESH SURG PROCEED OVAL,1410.0,916.5,236.88,1381.8,29
HCPCS,C1781,W MESH VENTRALEX SMALL,731.0,475.15,122.81,716.38,29
HCPCS,C1781,W MESH VENTRALIGHT ST 11.4 CM,1880.0,1222.0,315.84,1842.4,32
HCPCS,C1781,W MESH VENTRALIGHT ST 4X6 INCH,1450.0,942.5,243.6,1421.0,29
HCPCS,C1781,W MESH VENTRALIGHT ST 6X8 INCH,2540.0,1651.0,426.72,2489.2,32
HCPCS,C1781,W MESH VENTRALIGHT ST 7X9 INCH,3370.0,2190.5,566.16,3302.6,32
HCPCS,C1781,W MESH VENTRALIGHT ST 8X10 INCH,4300.0,2795.0,722.4,4214.0,32
HCPCS,C1781,W MESH VICRYL 12 X 12IN VWML,2235.0,1452.75,375.48,2190.3,32
HCPCS,C1781,"W MESH,SURGICAL",3779.5,2456.675,627.14,3749.48,64
HCPCS,C1781,W MSH PLYTETFLUTH,352.0,228.8,59.14,344.96,29
HCPCS,C1781,W PATCH COMPOSIX KUGEL CIR 12CM,1210.0,786.5,203.28,1185.8,29
HCPCS,C1781,W PATCH COMPOSIX KUGEL SM CIR,1890.0,1228.5,317.52,1852.2,32
HCPCS,C1781,W PATCH VENTRALEX LG CIR 8CM,1152.0,748.8,193.54,1128.96,29
HCPCS,C1781,W PATCH VENTRALEX MD CIR 6.4CM,890.0,578.5,149.52,872.2,29
HCPCS,C1781,W PERMACOL 0.5MM-2CM X 5CM,880.0,572.0,147.84,862.4,29
HCPCS,C1781,W PERMACOL 1.5MM-10CM X 15CM,3654.0,2375.1,613.87,3580.92,32
HCPCS,C1781,W PERMACOL 1.5MM-10CM X 20CM,4020.0,2613.0,675.36,3939.6,32
HCPCS,C1781,W PERMACOL 1.5MM-15CM X 20CM,5670.0,3685.5,952.56,5556.6,35
HCPCS,C1781,W PERMACOL 1.5MM-18CM X 28CM,9976.0,6484.4,1675.97,9776.48,35
HCPCS,C1781,W PERMACOL 1.5MM-20CM X 30CM,11866.0,7712.9,1993.49,11628.68,35
HCPCS,C1781,W PERMACOL 1.5MM-20CM X 40CM,19278.0,12530.7,3238.7,18892.44,35
HCPCS,C1781,W PERMACOL 1.5MM-20CM X 50CM,24102.0,15666.3,4049.14,23619.96,35
HCPCS,C1781,W PERMACOL 1MM-10CM X 10CM,2436.0,1583.4,409.25,2387.28,32
HCPCS,C1781,W PERMACOL 1MM-10CM X 15CM,3654.0,2375.1,613.87,3580.92,32
HCPCS,C1781,W PERMACOL 1MM-15CM X 20CM,5670.0,3685.5,952.56,5556.6,35
HCPCS,C1781,W PERMACOL 1MM-18CM X 28CM,9976.0,6484.4,1675.97,9776.48,35
HCPCS,C1781,W PERMACOL 1MM-1CM X 4CM,410.0,266.5,68.88,401.8,29
HCPCS,C1781,W PERMACOL 1MM-2CM X 4CM,710.0,461.5,119.28,695.8,29
HCPCS,C1781,W PERMACOL 1MM-2CM X 5CM,880.0,572.0,147.84,862.4,29
HCPCS,C1781,W PERMACOL 1MM-3CM X 8CM,1340.0,871.0,225.12,1313.2,29
HCPCS,C1781,W PERMACOL 1MM-5CM X 10CM,1848.0,1201.2,310.46,1811.04,32
HCPCS,C1781,W PERMACOL 1MM-5CM X 5CM,946.0,614.9,158.93,927.08,29
HCPCS,C17810,Mesh (implantable),,,871.79,871.79,1
HCPCS,C1782,Morcellator,,,2298.42,2298.42,1
HCPCS,C1782,W MORCLLTR GYNCR,1349.0,876.85,226.63,1214.1,21
HCPCS,C17820,Morcellator,,,2298.42,2298.42,1
HCPCS,C1783,"Ocular imp, aqueous drain de",,,340.32,340.32,1
HCPCS,C17830,"Ocular imp, aqueous drain de",,,340.32,340.32,1
HCPCS,C1784,"Ocular dev, intraop, det ret",,,2147.04,2147.04,1
HCPCS,C17840,"Ocular dev, intraop, det ret",,,2147.04,2147.04,1
HCPCS,C1785,PACEMAKER DUAL CHAMBER TIER 0,2674.0,1738.1,449.23,2620.52,32
HCPCS,C1785,PACEMKR AZURE XT DR MRI,8036.0,5223.4,1350.05,7875.28,35
HCPCS,C1785,"Pmkr, dual, rate-resp",,,297.45,297.45,1
HCPCS,C1785,W PACEMAKER ACCENT DR 2110,5000.0,3250.0,840.0,4900.0,32
HCPCS,C1785,W PACEMAKER DC ADAPTA ADDRSI,7650.0,4972.5,1285.2,7497.0,35
HCPCS,C1785,W PACEMAKER DC RATE-RESP,17822.0,11584.3,2994.1,17465.56,35
HCPCS,C1785,W PACEMAKER DC RR$,6600.0,4290.0,1108.8,6468.0,35
HCPCS,C1785,W PACEMAKER DUAL 5326L ST J,18624.0,12105.6,3128.83,18251.52,35
HCPCS,C1785,W PACEMKR ACCOLDE 2CH IS CONN,4224.0,2745.6,709.63,4139.52,32
HCPCS,C1785,W PM ACCENT RF DR,5650.0,3672.5,949.2,5537.0,35
HCPCS,C1785,W PM ACCOLADE/ESSNT DR EL MRI,6100.0,3965.0,1024.8,5978.0,35
HCPCS,C1785,W PM ADVANTIO DR K063,5650.0,3672.5,949.2,5537.0,35
HCPCS,C1785,W PM ADVISA DR MRI,8250.0,5362.5,1386.0,8085.0,35
HCPCS,C1785,W PM AFNTY 5330L,14546.0,9454.9,2443.73,14255.08,35
HCPCS,C1785,W PM AFNTY 5330R,14546.0,9454.9,2443.73,14255.08,35
HCPCS,C1785,W PM ALTRUA 60 DDDR S603,5650.0,3672.5,949.2,5537.0,35
HCPCS,C1785,W PM ALTRUA DR S203/S208/S404,5000.0,3250.0,840.0,4900.0,32
HCPCS,C1785,W PM ALTRUA S202,5000.0,3250.0,840.0,4900.0,32
HCPCS,C1785,W PM ALTRUA S205,5000.0,3250.0,840.0,4900.0,32
HCPCS,C1785,W PM ALTRUA S402,5000.0,3250.0,840.0,4900.0,32
HCPCS,C1785,W PM ALTRUA S403,5000.0,3250.0,840.0,4900.0,32
HCPCS,C1785,W PM ALTRUA S602,5650.0,3672.5,949.2,5537.0,35
HCPCS,C1785,W PM ALTRUA S606 DC IS-1,5650.0,3672.5,949.2,5537.0,35
HCPCS,C1785,W PM ASSURITY DR,4000.0,2600.0,672.0,3920.0,32
HCPCS,C1785,W PM DC DISCOVERY,19118.0,12426.7,3211.82,18735.64,35
HCPCS,C1785,W PM DC DR ADAPTA,7650.0,4972.5,1285.2,7497.0,35
HCPCS,C1785,W PM DC ELA BR112,13307.0,8649.55,2235.58,13040.86,35
HCPCS,C1785,W PM DC IDENTITY ADX,15982.0,10388.3,2684.98,15662.36,35
HCPCS,C1785,W PM DC PULSR MAX,18624.0,12105.6,3128.83,18251.52,35
HCPCS,C1785,W PM DC RR ATR/VNT BI/UNI,15982.0,10388.3,2684.98,15662.36,35
HCPCS,C1785,W PM DC RR DISCOVERY II,9375.0,6093.75,1575.0,9187.5,35
HCPCS,C1785,W PM DC RR ENPULSE 2,16000.0,10400.0,2688.0,15680.0,35
HCPCS,C1785,W PM DC RR ENRYTHM P1501DR,6300.0,4095.0,1058.4,6174.0,35
HCPCS,C1785,W PM DC RR ENTRA INSIGNIA 1295,10875.0,7068.75,1827.0,10657.5,35
HCPCS,C1785,W PM DC RR INSIGNA ENTR DR,10875.0,7068.75,1827.0,10657.5,35
HCPCS,C1785,W PM DC RR INSIGNA PLUS,10875.0,7068.75,1827.0,10657.5,35
HCPCS,C1785,W PM DC RR INSIGNA SR,10875.0,7068.75,1827.0,10657.5,35
HCPCS,C1785,W PM DC RR INSIGNA ULTRA,7000.0,4550.0,1176.0,6860.0,35
HCPCS,C1785,W PM DC RR INSIGNA ULTRA DR,7000.0,4550.0,1176.0,6860.0,35
HCPCS,C1785,W PM DC RR KAPPA KDR701,15750.0,10237.5,2646.0,15435.0,35
HCPCS,C1785,W PM DC RR KAPPA KDR901,14750.0,9587.5,2478.0,14455.0,35
HCPCS,C1785,W PM DC RR VICTORY DR,6600.0,4290.0,1108.8,6468.0,35
HCPCS,C1785,W PM DC RR VITATRON,16000.0,10400.0,2688.0,15680.0,35
HCPCS,C1785,W PM DC VERSA VEDR01,6450.0,4192.5,1083.6,6321.0,35
HCPCS,C1785,W PM DC ZEPHYR,5800.0,3770.0,974.4,5684.0,35
HCPCS,C1785,W PM DR INTEGRITY,16931.0,11005.15,2844.41,16592.38,35
HCPCS,C1785,W PM ELUNA DR PROMRI UNI/BI,8730.0,5674.5,1466.64,8555.4,35
HCPCS,C1785,W PM ESSENTIO DC DR,3608.0,2345.2,606.14,3535.84,32
HCPCS,C1785,W PM ESSENTIO DR MRI,5608.0,3645.2,942.14,5495.84,35
HCPCS,C1785,W PM EVIA DR-T 2CH,5650.0,3672.5,949.2,5537.0,35
HCPCS,C1785,W PM INGENIO DDDR RF PPM,6850.0,4452.5,1150.8,6713.0,35
HCPCS,C1785,W PM INTG AFX5342,15445.0,10039.25,2594.76,15136.1,35
HCPCS,C1785,W PM KAPPA 700DR,19010.0,12356.5,3193.68,18629.8,35
HCPCS,C1785,W PM REVO SURESCAN DC RR,7850.0,5102.5,1318.8,7693.0,35
HCPCS,C1785,W PM SENSIA DR,5800.0,3770.0,974.4,5684.0,35
HCPCS,C1785,W PM SYMPHONY DR 2550,7000.0,4550.0,1176.0,6860.0,35
HCPCS,C1785,W PM ZEPHYR 5820,5000.0,3250.0,840.0,4900.0,32
HCPCS,C17850,"Pmkr, dual, rate-resp",,,297.45,297.45,1
HCPCS,C1786,ABBOTT AVERI AR LEADLESS PACEMAKER,25300.0,16445.0,4250.4,29400.0,35
HCPCS,C1786,"ASSURITY MRI PACEMAKER MODEL PM1272, SINGLE CHAMBER, SR",3200.0,2080.0,537.6,3136.0,32
HCPCS,C1786,AVEIR AR LEADLESS PACER SYSTEM MFG AR-SYSTEM-AVEIR,25300.0,16445.0,4250.4,22770.0,33
HCPCS,C1786,AVEIR LEADLESS AR PACEMAKER,25300.0,16445.0,4250.4,22770.0,33
HCPCS,C1786,AVEIR LEADLESS VENTRICAL PACEMAKER,16000.0,10400.0,2688.0,14400.0,33
HCPCS,C1786,AVEIR VR LEADLESS PACER SYSTEM MFG VR-SYSTEM-AVEIR,16000.0,10400.0,2688.0,14400.0,33
HCPCS,C1786,LEAD PACE ATR TRNSVEN BPLR,810.0,526.5,136.08,793.8,29
HCPCS,C1786,MICRA AV LEADLESS PACEMAKER,24440.0,15886.0,4105.92,23951.2,35
HCPCS,C1786,MICRA AV2 DUAL CHAMBER TRANSCATHETER PACING SYSTEM,24440.0,15886.0,4105.92,23951.2,35
HCPCS,C1786,MICRA VR LEADLESS PACEMAKER,22500.0,14625.0,3780.0,22050.0,35
HCPCS,C1786,MICRA VR2 DUAL CHAMBER TRANSCATHETER PACING SYSTEM,18820.0,12233.0,3161.76,18443.6,35
HCPCS,C1786,PACEMAKER TRANSCATHETER DUAL CHAMBER MICRA AV VDD,26500.0,17225.0,4452.0,25970.0,35
HCPCS,C1786,PACEMKR AZURE XT SR MRI,6664.0,4331.6,1119.55,6530.72,35
HCPCS,C1786,"Pmkr, single, rate-resp",,,5955.12,5955.12,1
HCPCS,C1786,S 275 C1786 ABBOTT AVERI AR LEADLESS,25300.0,16445.0,4250.4,22770.0,33
HCPCS,C1786,S 275 C1786 ABBOTT AVIER VR LEADLESS,16000.0,10400.0,2688.0,14400.0,33
HCPCS,C1786,W PACEMKR ACCLDE 1 CHMBR IS-1,3344.0,2173.6,561.79,3277.12,32
HCPCS,C1786,W PACEMKR ACCOLADE SR MRI,5344.0,3473.6,897.79,5237.12,35
HCPCS,C1786,W PM ACCENT SR,4500.0,2925.0,756.0,4410.0,32
HCPCS,C1786,W PM ACCENT SR RF,4500.0,2925.0,756.0,4410.0,32
HCPCS,C1786,W PM ADAPTA ADSR01,5300.0,3445.0,890.4,5194.0,35
HCPCS,C1786,W PM ADVANTIO SR K062,4500.0,2925.0,756.0,4410.0,32
HCPCS,C1786,W PM AFNTY5131M/S,12863.0,8360.95,2160.98,12605.74,35
HCPCS,C1786,W PM ALTRUA S201,4000.0,2600.0,672.0,3920.0,32
HCPCS,C1786,W PM ALTRUA S204,4000.0,2600.0,672.0,3920.0,32
HCPCS,C1786,W PM ALTRUA S401,4500.0,2925.0,756.0,4410.0,32
HCPCS,C1786,W PM ALTRUA S601,4500.0,2925.0,756.0,4410.0,32
HCPCS,C1786,W PM ASSURITY SR VVIR,4400.0,2860.0,739.2,4312.0,32
HCPCS,C1786,W PM CARD ADVISA SR MR,6800.0,4420.0,1142.4,6664.0,35
HCPCS,C1786,W PM ESSENTIO SR MRI,5168.0,3359.2,868.22,5064.64,35
HCPCS,C1786,W PM INGENIO CHMBR IS-1,4400.0,2860.0,739.2,4312.0,32
HCPCS,C1786,W PM INTG SR 5142,14257.0,9267.05,2395.18,13971.86,35
HCPCS,C1786,W PM KAPPA 700SR,16992.0,11044.8,2854.66,16652.16,35
HCPCS,C1786,W PM MICRA LEADLESS,22500.0,14625.0,3780.0,22050.0,35
HCPCS,C1786,W PM SC DSCVRY SR,18201.0,11830.65,3057.77,17836.98,35
HCPCS,C1786,W PM SC INTEGRITY,14257.0,9267.05,2395.18,13971.86,35
HCPCS,C1786,W PM SC RATE-RESP,13069.0,8494.85,2195.59,12807.62,35
HCPCS,C1786,W PM SC RR ATR/VNT BI,11750.0,7637.5,1974.0,11515.0,35
HCPCS,C1786,W PM SC RR IDENTITY ADX,5700.0,3705.0,957.6,5586.0,35
HCPCS,C1786,W PM SC RR INSIGNA,8625.0,5606.25,1449.0,8452.5,35
HCPCS,C1786,W PM SC RR INSIGNA ENTR,8625.0,5606.25,1449.0,8452.5,35
HCPCS,C1786,W PM SC RR INSIGNA ENTR 5/6,8625.0,5606.25,1449.0,8452.5,35
HCPCS,C1786,W PM SC RR INSIGNIA ULTRA,10250.0,6662.5,1722.0,10045.0,35
HCPCS,C1786,W PM SC SR1180,15223.0,9894.95,2557.46,14918.54,35
HCPCS,C1786,W PM SENSIA SESR01,5300.0,3445.0,890.4,5194.0,35
HCPCS,C1786,W PM TEMPO VR1102,10876.0,7069.4,1827.17,10658.48,35
HCPCS,C1786,W PM VICTORY SC5610 ST JUDE,5700.0,3705.0,957.6,5586.0,35
HCPCS,C1786,W PM ZEPHYR SR,4500.0,2925.0,756.0,4410.0,32
HCPCS,C17860,"Pmkr, single, rate-resp",,,5955.12,5955.12,1
HCPCS,C1787,"Patient progr, neurostim",,,1367.6,1367.6,1
HCPCS,C1787,W PRGMR NRSTM ACTIVA PC RCHG,1350.0,877.5,226.8,1215.0,21
HCPCS,C1787,W PROGRAM PT INTERSTIM 3031A,1493.0,970.45,250.82,1343.7,21
HCPCS,C1787,W PROGRAM PT INTERSTM ICON 3037,1526.0,991.9,256.37,1373.4,21
HCPCS,C1787,W PROGRAMMER CTRL ACC REV THER,848.0,551.2,142.46,763.2,21
HCPCS,C1787,W PROGRAMMER DUAL,990.0,643.5,166.32,891.0,21
HCPCS,C1787,W PROGRAMMER PATIENT NS,1050.0,682.5,176.4,945.0,21
HCPCS,C1787,W PROGRAMMER PT NEUROSTIM,945.0,614.25,158.76,850.5,21
HCPCS,C1787,W PROGRMR PT NSTM,2364.0,1536.6,397.15,2127.6,21
HCPCS,C17870,"Patient progr, neurostim",,,1367.6,1367.6,1
HCPCS,C1788,"Port, indwelling, imp",,,530.84,530.84,1
HCPCS,C1788,W CATH PORTACATH,1615.0,1049.75,271.32,1582.7,29
HCPCS,C1788,W CTH PORT 8FR PLS 2 HP PUR KIT,500.0,325.0,84.0,490.0,29
HCPCS,C1788,W IMP DEV PRT/RES,1126.0,731.9,189.17,1103.48,29
HCPCS,C1788,W IMP PORT INDWEL,1126.0,731.9,189.17,1103.48,29
HCPCS,C1788,W PORT 8FR VACCESS,670.0,435.5,112.56,656.6,29
HCPCS,C1788,W PORT 9F DUAL CHMBR,590.0,383.5,99.12,578.2,29
HCPCS,C1788,W PORT CT 8FR,490.0,318.5,82.32,480.2,29
HCPCS,C1788,W PORT HICKMAN TI 1LUMEN 9.6F,460.0,299.0,77.28,450.8,29
HCPCS,C1788,W PORT INF MINI DTCH PU,500.0,325.0,84.0,490.0,29
HCPCS,C1788,W PORT INJECTION REALIZE RLZPT2,1710.0,1111.5,287.28,1675.8,29
HCPCS,C1788,W PORT MRI INF 6.6FR PLAS 1 LUM,538.0,349.7,90.38,527.24,29
HCPCS,C1788,W PORT PWRPRT MRI SILICONE 8F,1067.0,693.55,179.26,1045.66,29
HCPCS,C1788,W PORT TITANIUM CHRFLEX ATT 8FR,656.0,426.4,110.21,642.88,29
HCPCS,C1788,W PORT VASC,490.0,318.5,82.32,480.2,29
HCPCS,C1788,W PORT W OPEN-ENDED 9.6FR CATH,648.0,421.2,108.86,635.04,29
HCPCS,C1788,W PORTACATH,1575.0,1023.75,264.6,1543.5,29
HCPCS,C17880,"Port, indwelling, imp",,,530.84,530.84,1
HCPCS,C1789,"Prosthesis, breast, imp",,,3570.94,3570.94,1
HCPCS,C1789,W IMP PROSTH BRST,1799.0,1169.35,302.23,1763.02,32
HCPCS,C1789,W IMPLANT BREAST SALINE SMRDMOD,850.0,552.5,142.8,833.0,29
HCPCS,C1789,W IMPLANT BREAST SALINE SMTHRND,750.0,487.5,126.0,735.0,29
HCPCS,C1789,W IMPLANT BREAST SILICONE GEL I,1450.0,942.5,243.6,1421.0,29
HCPCS,C1789,W IMPLANT BREAST SILICONE GELII,1500.0,975.0,252.0,1470.0,29
HCPCS,C1789,W PROS BRST SILTX,1799.0,1169.35,302.23,1763.02,32
HCPCS,C17890,"Prosthesis, breast, imp",,,3570.94,3570.94,1
HCPCS,C1813,"Prosthesis, penile, inflatab",,,7694.65,7694.65,1
HCPCS,C1813,"W CRX,PRECONNECT,MS,IZ,72404261",12278.0,7980.7,2062.7,12032.44,35
HCPCS,C1813,"W LGX PRECONNECT PS,IZ,72404252",12278.0,7980.7,2062.7,12032.44,35
HCPCS,C1813,W PROS AMBICOR 16CM X 11CM,12070.0,7845.5,2027.76,11828.6,35
HCPCS,C1813,W PROS PENILE CX PRECONNECT MS,12278.0,7980.7,2062.7,12032.44,35
HCPCS,C1813,W PROS PENILE INF,13824.0,8985.6,2322.43,13547.52,35
HCPCS,C1813,W PROS PENILE INFLATABLE,12070.0,7845.5,2027.76,11828.6,35
HCPCS,C1813,W PROS PENL AMCR 18CM CYL,18040.0,11726.0,3030.72,17679.2,35
HCPCS,C1813,W PROS PENL AMS 700MS 18CM,12769.0,8299.85,2145.19,12513.62,35
HCPCS,C1813,W PROS PENL TTN 18 CM INFL CYL,13738.0,8929.7,2307.98,13463.24,35
HCPCS,C18130,"Prosthesis, penile, inflatab",,,7694.65,7694.65,1
HCPCS,C1814,"Retinal tamp, silicone oil",,,1723.97,1723.97,1
HCPCS,C18140,"Retinal tamp, silicone oil",,,1723.97,1723.97,1
HCPCS,C1815,"Pros, urinary sph, imp",,,5244.48,5244.48,1
HCPCS,C1815,W CUFF BELT AMS800 W/IZ,6426.0,4176.9,1058.4,6420.96,56
HCPCS,C1815,W PROS URINRY SPH,17806.0,11573.9,2991.41,17449.88,35
HCPCS,C18150,"Pros, urinary sph, imp",,,5244.48,5244.48,1
HCPCS,C1816,"PENETRATION 22MM, 18 GA X 16CM",55.4,36.01,9.31,49.86,21
HCPCS,C1816,"Receiver/transmitter, neuro",,,11957.76,11957.76,1
HCPCS,C18160,"Receiver/transmitter, neuro",,,11957.76,11957.76,1
HCPCS,C1817,AMPLATZER DUCT OCCLUDER II 6MM X 6MM,10290.0,6688.5,1728.72,10084.2,35
HCPCS,C1817,AMPLATZER MUSCULAR VSD OCCLUDER,17540.0,11401.0,2946.72,15786.0,33
HCPCS,C1817,CARDIOFRM OCCLUDER,16302.0,10596.3,2738.74,15975.96,35
HCPCS,C1817,OCCL CV 20MM EPTFE SEPT GORE,16530.0,10744.5,2777.04,16199.4,35
HCPCS,C1817,Septal defect imp sys,,,27218.16,27218.16,1
HCPCS,C1817,W OCCL CV AMPLATZER PFO 2 DISK,19990.0,12993.5,3358.32,19590.2,35
HCPCS,C1817,W OCCLUDER CV SEPT SLFEXP DLV,11232.0,7300.8,1886.98,11007.36,35
HCPCS,C1817,W OCCLUDER SEPTL 20MM CARDIFRM,16530.0,10744.5,2777.04,16199.4,35
HCPCS,C18170,Septal defect imp sys,,,27218.16,27218.16,1
HCPCS,C1819,Tissue localization-excision,,,66.23,66.23,1
HCPCS,C1819,W DEVICE ELCTRD STARBURST TALON,3564.0,2316.6,598.75,3207.6,21
HCPCS,C18190,Tissue localization-excision,,,66.23,66.23,1
HCPCS,C1820,EDORA 8 DR-T PACEMAKER,6500.0,4225.0,1092.0,6370.0,35
HCPCS,C1820,Generator neuro rechg bat sy,,,12602.37,12602.37,1
HCPCS,C1820,"PENETRATION 22MM, 18 GUAGE X 20CM",55.32,35.96,9.29,49.79,21
HCPCS,C1820,W DEVICE IPG RESTRE ULTRA 37712,27000.0,17550.0,4536.0,26460.0,35
HCPCS,C1820,W GEN NEUROSTIM & EXT CHG SYS,24828.0,16138.2,4171.1,24331.44,35
HCPCS,C1820,W GEN NEUROSTM RESTR 37714,26600.0,17290.0,4468.8,26068.0,35
HCPCS,C1820,W GEN RESTORE ADV IPG 37713,25000.0,16250.0,4200.0,24500.0,35
HCPCS,C1820,W GEN STIMULATOR RECHRG 37711,18000.0,11700.0,3024.0,17640.0,35
HCPCS,C1820,W NEUROSTIMLTOR ACTIVA RC 37612,53800.0,34970.0,9038.4,52724.0,35
HCPCS,C1820,W NRSTM IMP PRIME ADV MRI,19800.0,12870.0,3326.4,19404.0,35
HCPCS,C1820,W NRSTM IMP RESTORE ADV MRI,18000.0,11700.0,3024.0,17640.0,35
HCPCS,C1820,W NRSTM IMP RESTORE SNSR MRI,25000.0,16250.0,4200.0,24500.0,35
HCPCS,C18200,Generator neuro rechg bat sy,,,12602.37,12602.37,1
HCPCS,C1821,Interspinous implant,,,4320.0,4320.0,1
HCPCS,C1821,W X-STOP IPD SYSTEM,8800.0,5720.0,1478.4,8624.0,35
HCPCS,C18210,Interspinous implant,,,4320.0,4320.0,1
HCPCS,C1822,INTICA NEO 7 ICD,28200.0,18330.0,4737.6,27636.0,35
HCPCS,C1824,"GENERATOR, CARDIAC CONTRACTILITY MODULATION (IMPLANTABLE)",46000.0,29900.0,7728.0,45080.0,35
HCPCS,C1824,OPTIMIZER SMART IPG,52000.0,33800.0,8736.0,50960.0,35
HCPCS,C1830,PWR BONE MARROW BX NEEDLE102MM,225.75,146.74,37.93,203.18,21
HCPCS,C1830,Power bone marrow bx needle,,,164.46,164.46,1
HCPCS,C18300,Power bone marrow bx needle,,,164.46,164.46,1
HCPCS,C1874,14 FR NUDEL STENT DELIVERY SYSTEM,15656.0,10176.4,2630.21,15342.88,35
HCPCS,C1874,2MM X 15MM XIENCE SKYPOINT RX EVEROLIMUS DRUG ELUTING STENT,730.0,474.5,122.64,715.4,29
HCPCS,C1874,ELUVIA 6MM X 100MM X 130CM DRUG-ELUTING STENT,5190.0,3373.5,871.92,5086.2,35
HCPCS,C1874,ELUVIA DRUG-ELUTING STENT 6MM X 120MM X 130CM,5790.0,3763.5,972.72,5674.2,35
HCPCS,C1874,MULTI-SYNERGY XD EVEROLIMUS DRUG ELUTING STENT MONORAIL PLATINUM,1300.0,845.0,218.4,1274.0,29
HCPCS,C1874,MULTI-SYNGERY XD EVEROLIMUS ELUTING COR STENT MONORAIL PLAT CHRO,2000.0,1300.0,336.0,1960.0,32
HCPCS,C1874,NUDEL STENT GRAFT DELIVERY SYSTEM,16486.0,10715.9,2769.65,16156.28,35
HCPCS,C1874,"OTW DELIVERY, ZILVER PTX DRUG-ELUTING PERIPHERAL STENT, 0.035IN",2350.0,1527.5,394.8,2303.0,32
HCPCS,C1874,PAPYRUS COVERED CORONARY STENT,5400.0,3510.0,907.2,5292.0,35
HCPCS,C1874,PAPYRUS COVERED CORONARY STENT 5FR 2.5MM X 15MM X 140CM PK,5940.0,3861.0,997.92,5346.0,33
HCPCS,C1874,PAPYRUS COVERED CORONARY STENT 5FR 3.5MM X 15MM X 140CM PK,5940.0,3861.0,997.92,5346.0,33
HCPCS,C1874,STENT COR MR SYNERGY,1800.0,1170.0,302.4,1764.0,32
HCPCS,C1874,STENT COVERED STRAIGHT 6MM X 80CM,4800.0,3120.0,806.4,4704.0,32
HCPCS,C1874,STENT ELUVIA 7MM 40MM 130CM VASCULAR DRUG ELUTE DELIVERY SYST,3990.0,2593.5,670.32,3910.2,32
HCPCS,C1874,STENT ENDOPROS 25CM 6MM HPRN,12000.0,7800.0,2016.0,11760.0,35
HCPCS,C1874,STENT TRCHBR 10MM 30MM FULL,4000.0,2600.0,672.0,3920.0,32
HCPCS,C1874,STENT TRCHBR 10MM 40MM FULL,4400.0,2860.0,739.2,4312.0,32
HCPCS,C1874,STENT VIABAHN ENDOPROS W HEP,5510.0,3581.5,925.68,5399.8,35
HCPCS,C1874,SYNERGY 3.50MM X 28MM MEGATRON EVEROLIMUS-ELUTING PLATINUM CHROM,2800.0,1820.0,470.4,2520.0,30
HCPCS,C1874,SYNERGY MEGA EVEROLIMUS-ELUTING CORONARY STENT 4.00MM X 12MM,1400.0,910.0,235.2,1372.0,29
HCPCS,C1874,SYNERGY MEGA EVEROLIMUS-ELUTING PLTNM CHRMM CORONARY STENT 3.50M,2000.0,1300.0,336.0,1960.0,32
HCPCS,C1874,"SYNERGY XD EVEROLIMUS-ELUTING CORONARY STENT, MONORAIL, PLAT CHR",700.0,455.0,117.6,686.0,29
HCPCS,C1874,SYS COR STNT XIENCE SIERRA,1000.0,650.0,168.0,980.0,29
HCPCS,C1874,SYSTEM CORONARY RESOLUTE ONYX,1650.0,1072.5,277.2,1617.0,29
HCPCS,C1874,"Stent, coated/cov w/del sys",,,1411.47,1411.47,1
HCPCS,C1874,VIABAHN ENDOPROSTHESIS STENT GRAFT W RADIOPAQUE MARKERS 7MM DIAX,5768.0,3749.2,969.02,5191.2,33
HCPCS,C1874,VIABAHN VBX BALLOON-ENDOPROS,5460.0,3549.0,917.28,5350.8,35
HCPCS,C1874,W STENT AAA BIFUR 22F 36X95MM,16424.0,10675.6,2759.23,16095.52,35
HCPCS,C1874,W STENT AAA EXT LEG 14 X 56MM,5992.0,3894.8,1006.66,5872.16,35
HCPCS,C1874,W STENT AERO BRONCHIAL 10X20MM,3600.0,2340.0,604.8,3528.0,32
HCPCS,C1874,W STENT BILIARY AXIOS W DLVRY,8800.0,5720.0,1478.4,8624.0,35
HCPCS,C1874,W STENT COR ELUT,3840.0,2496.0,645.12,3763.2,32
HCPCS,C1874,W STENT COR RX XIENCE,3108.0,2020.2,522.14,3045.84,32
HCPCS,C1874,W STENT CORONARY XIENCE ALPN,2100.0,1365.0,352.8,2058.0,32
HCPCS,C1874,W STENT COVERED 80CM ICAST PTFE,3500.0,2275.0,588.0,3430.0,32
HCPCS,C1874,W STENT COVERED W DEL SYS GORE,6570.0,4270.5,1103.76,6438.6,35
HCPCS,C1874,W STENT CYPHER RX,2900.0,1885.0,487.2,2842.0,32
HCPCS,C1874,W STENT DES XIENCE,2958.0,1922.7,496.94,2898.84,32
HCPCS,C1874,W STENT DRUG ELUTING PROMUS,2600.0,1690.0,436.8,2548.0,32
HCPCS,C1874,W STENT ESOPHAGEAL,3960.0,2574.0,665.28,3880.8,32
HCPCS,C1874,W STENT GRAFT 6MM 10X120CM,6100.0,3965.0,1024.8,5978.0,35
HCPCS,C1874,W STENT GRAFT ENDPRSTHESIS 10CM,5780.0,3757.0,971.04,5664.4,35
HCPCS,C1874,W STENT GRAFT ENDPRSTHESIS 15CM,6780.0,4407.0,1139.04,6644.4,35
HCPCS,C1874,W STENT GRAFT FLUENCY,3990.0,2593.5,670.32,3910.2,32
HCPCS,C1874,W STENT GRAFT VIABAHN END 120CM,6920.0,4498.0,1162.56,6781.6,35
HCPCS,C1874,W STENT GRAFT VIABIL BILIARY,4740.0,3081.0,796.32,4645.2,32
HCPCS,C1874,W STENT GRAFT VIATORR ENDOPRTHS,7536.0,4898.4,1266.05,7385.28,35
HCPCS,C1874,W STENT GRFT MAIN BODY BIFUR,16424.0,10675.6,2759.23,16095.52,35
HCPCS,C1874,W STENT ICAST PTFE COVERED,3500.0,2275.0,588.0,3430.0,32
HCPCS,C1874,W STENT JOSTENT OTW,4790.0,3113.5,804.72,4694.2,32
HCPCS,C1874,W STENT TAXUS,3000.0,1950.0,504.0,2940.0,32
HCPCS,C1874,W STENT TRACHEOBRONCHIAL,4000.0,2600.0,672.0,3920.0,32
HCPCS,C1874,W STENT ULTRAFLEX,3780.0,2457.0,635.04,3704.4,32
HCPCS,C1874,W STENT ULTRAFLEX ESOPHAG METAL,3140.0,2041.0,527.52,3077.2,32
HCPCS,C1874,W STENT VIABAHN ENDOPROS DEL,6788.0,4412.2,1140.38,6652.24,35
HCPCS,C1874,W STENT VIABAHN VBH061502,7120.0,4628.0,1196.16,6977.6,35
HCPCS,C1874,W STENT WALL PERMALUNE,3700.0,2405.0,621.6,3626.0,32
HCPCS,C1874,W STENT WALLFLEX BILIARY,3700.0,2405.0,535.92,5445.86,99
HCPCS,C1874,W STENT WALLFLEX ESOP,3445.0,2239.25,554.4,3518.2,64
HCPCS,C1874,W STENT WLLGRFT ENDPRSTHS DLVRY,3200.0,2080.0,537.6,3136.0,32
HCPCS,C1874,W STNT ACCLNK CAROTID RPD EXCH,4100.0,2665.0,688.8,4018.0,32
HCPCS,C1874,W STNT C BXVELOC,4235.0,2752.75,711.48,4150.3,192
HCPCS,C1874,W STNT COAT/COV,2495.0,1621.75,419.16,2445.1,32
HCPCS,C1874,W STNT TAPER RPD EXCH RX ACCLNK,4500.0,2925.0,756.0,4410.0,32
HCPCS,C1874,W ZENITH FLX MAIN BODY GFT 36X9,15244.0,9908.6,2560.99,14939.12,35
HCPCS,C1874,W ZENITH ILIAC LEG GRAFT 16X54,5562.0,3615.3,934.42,5450.76,35
HCPCS,C1874,W ZENITH ILIAC LEG GRAFT 16X71,5562.0,3615.3,934.42,5450.76,35
HCPCS,C1874,XIENCE SKYPOINT RX EVEROLIMUS ELUTING CORONARY STENT,1000.0,650.0,168.0,980.0,29
HCPCS,C1874,XIENCE SKYPOINT RX EVEROLIMUS ELUTING CORONARY STENT SYSTEM 3.0M,528.0,343.2,88.7,517.44,29
HCPCS,C1874,XIENCE SKYPOINT RX EVEROLIMUS ELUTING CORONARY STENT SYSTEM 3MM,440.0,286.0,73.92,431.2,29
HCPCS,C1874,ZILVER PTX DRUG-ELUTING PERIPHERAL STENT 0.035 IN MAX GW,2990.0,1943.5,502.32,2930.2,32
HCPCS,C1874,"ZILVER PTX DRUG-ELUTING PERIPHERAL STENT 7.0MM X 120MM, 125CM OT",3190.0,2073.5,535.92,3126.2,32
HCPCS,C18740,"Stent, coated/cov w/del sys",,,1411.47,1411.47,1
HCPCS,C1875,"Stent, coated/cov w/o del sy",,,1109.91,1109.91,1
HCPCS,C1875,W STENT BRONCHIAL ULTRAFLEX COV,5119.0,3327.35,859.99,5016.62,32
HCPCS,C1875,W STENT EXPRESS LD 7X17MM,1750.0,1137.5,294.0,1715.0,32
HCPCS,C18750,"Stent, coated/cov w/o del sy",,,1109.91,1109.91,1
HCPCS,C1876,"EPIC VASCULAR STENT SELF-EXPANDING, NITINOL, 12MM X 40MM, 120CM",1170.0,760.5,196.56,1053.0,27
HCPCS,C1876,H020002- ?NF ATLAS STENT 3.0 X 21MM NO TIP,6155.6,4001.14,1034.14,6032.49,35
HCPCS,C1876,H020002- ?NF ATLAS STENT 4.0 X 21MM NO TIP,6155.6,4001.14,1034.14,6032.49,35
HCPCS,C1876,H020002- NF ATLAS STENT 4.5 X 21MM NO TIP,6155.6,4001.14,1034.14,6032.49,35
HCPCS,C1876,H020002- NF ATLAS STENT 4.5 X 30MM NO TIP,6155.6,4001.14,1034.14,6032.49,35
HCPCS,C1876,H020002-NF ATLAS STENT 3.0 X 15MM NO TIP,6155.6,4001.14,1034.14,6032.49,35
HCPCS,C1876,INNOVA SELF EXPANDING STENT,1220.0,793.0,204.96,1195.6,29
HCPCS,C1876,STENT BARE METAL PRO-KINETIC ENERGY,620.0,403.0,104.16,607.6,29
HCPCS,C1876,SURPASS FLOWDIVERTER <40MM,25200.0,16380.0,4233.6,24696.0,35
HCPCS,C1876,SURPASS FLOWDIVERTER >40MM,27600.0,17940.0,4636.8,27048.0,35
HCPCS,C1876,"Stent, non-coa/non-cov w/del",,,1315.83,1315.83,1
HCPCS,C1876,W BALLOON ULTRATHIN DIAMOND BS,572.0,371.8,96.1,560.56,29
HCPCS,C1876,W BILIARY STENT,326.0,211.9,54.77,319.48,29
HCPCS,C1876,W H060001 STENT CODEMAN ENF,4975.0,3233.75,835.8,4875.5,32
HCPCS,C1876,W STENT 130CM FLEXSTAR SELF EXP,2500.0,1625.0,420.0,2450.0,32
HCPCS,C1876,W STENT 6MMX170MM LIFESTENT XL,3300.0,2145.0,554.4,3234.0,32
HCPCS,C1876,W STENT ABSLT BILRY SLF-EXPDNG,2150.0,1397.5,361.2,2107.0,32
HCPCS,C1876,W STENT BIL 10MM 7FR 25MM 135CM,1400.0,910.0,235.2,1372.0,29
HCPCS,C1876,W STENT BIL HERCULNK ELITE,2010.0,1306.5,337.68,1969.8,32
HCPCS,C1876,W STENT BIL PLMZ GN TRNS  SS GW,1200.0,780.0,201.6,1176.0,29
HCPCS,C1876,W STENT BIL SMART CNTRL ILIAC,1300.0,845.0,218.4,1274.0,29
HCPCS,C1876,W STENT BILIARY LUMINEXX,2000.0,1300.0,336.0,1960.0,32
HCPCS,C1876,W STENT BILIARY XPERT,2800.0,1820.0,470.4,2744.0,32
HCPCS,C1876,W STENT COR MULTI LINK VIS RX,760.0,494.0,127.68,744.8,29
HCPCS,C1876,W STENT COR MULTI-LINK VIS LOW,2750.0,1787.5,462.0,2695.0,32
HCPCS,C1876,W STENT COR PRECISE PRO RX,3900.0,2535.0,655.2,3822.0,32
HCPCS,C1876,W STENT CORONARY ABBT,1324.0,860.6,222.43,1297.52,29
HCPCS,C1876,W STENT EXPRESS LD BILIARY,1750.0,1137.5,294.0,1715.0,32
HCPCS,C1876,W STENT EXPRESS SD BILIARY,1800.0,1170.0,302.4,1764.0,32
HCPCS,C1876,W STENT INNOVA VASC SE TRIAXL,2000.0,1300.0,336.0,1960.0,32
HCPCS,C1876,W STENT INTEGRITY RX,1200.0,780.0,201.6,1176.0,29
HCPCS,C1876,W STENT LIFE FLEXSTAR SELF EXP,1850.0,1202.5,310.8,1813.0,32
HCPCS,C1876,W STENT LUMINEXX 3 BILIARY,2200.0,1430.0,369.6,2156.0,32
HCPCS,C1876,W STENT LUMINEXX BILIARY,2200.0,1430.0,369.6,2156.0,32
HCPCS,C1876,W STENT OTW SUPERA,1960.0,1274.0,329.28,1920.8,32
HCPCS,C1876,W STENT PRECISE PRO RX NITINOL,4400.0,2860.0,739.2,4312.0,32
HCPCS,C1876,W STENT SELF EXPND FLEXSTAR XL,2700.0,1755.0,453.6,2646.0,32
HCPCS,C1876,W STENT SENTINEL 7X59X1350,1600.0,1040.0,268.8,1568.0,29
HCPCS,C1876,W STENT SMART BIL NINTL MMKR,950.0,617.5,159.6,931.0,29
HCPCS,C1876,W STENT SMART BILIARY 120MM,2400.0,1560.0,403.2,2352.0,32
HCPCS,C1876,W STENT SMART BILIARY 150MM,2600.0,1690.0,436.8,2548.0,32
HCPCS,C1876,W STENT SMART BILIARY/ILIAC,1650.0,1072.5,277.2,1617.0,29
HCPCS,C1876,W STENT SMART CNTRL SE ILIAC,950.0,617.5,159.6,931.0,29
HCPCS,C1876,W STENT SMART FLEX BIL SE,1250.0,812.5,210.0,1225.0,29
HCPCS,C1876,W STENT ULTRAFLEX TRACHEOBRNCHL,3500.0,2275.0,588.0,3430.0,32
HCPCS,C1876,W STENT VASC 6MM 6FR 120CM,1780.0,1157.0,299.04,1744.4,32
HCPCS,C1876,W STENT VASC 8-6MM 40MM TAPR,3870.0,2515.5,650.16,3792.6,32
HCPCS,C1876,W STENT VASC EPIC SE NTNL,1450.0,942.5,243.6,1421.0,29
HCPCS,C1876,W STENT VASC SE ILIAC  NTNL,1150.0,747.5,193.2,1127.0,29
HCPCS,C1876,W STENT VASCULAR SE INNOVA,1790.0,1163.5,300.72,1754.2,32
HCPCS,C1876,W STENT WALL 5570/5580/5590,3380.0,2197.0,567.84,3312.4,32
HCPCS,C1876,W STENT WALLFLEX BILIARY NONCOV,2900.0,1885.0,487.2,2842.0,32
HCPCS,C1876,W STENT WALLFLEX BILIARY/ESOP,3190.0,2073.5,535.92,3126.2,32
HCPCS,C1876,W STENT WALLFLEX COLONIC,4345.5,2824.575,638.4,4793.18,64
HCPCS,C1876,W STENT WALLFLEX DUODENAL,3800.0,2470.0,638.4,3724.0,32
HCPCS,C1876,W STENT XCD BLIRY NTNL SLF-XPND,3000.0,1950.0,504.0,2940.0,32
HCPCS,C1876,W STNT ABSLT BLRY SLF-EXPNDNG,2050.0,1332.5,344.4,2009.0,32
HCPCS,C1876,W STNT AVTR BLLN 135CM PLMZ MED,1600.0,1040.0,268.8,1568.0,29
HCPCS,C1876,W STNT B BLN PLMZ,4238.0,2754.7,711.98,4153.24,32
HCPCS,C1876,W STNT B PALMAZ,4477.0,2910.05,752.14,4387.46,32
HCPCS,C1876,W STNT BLN EXP DS,2100.0,1365.0,352.8,2058.0,32
HCPCS,C1876,W STNT CRWN PALMZ,2472.0,1606.8,415.3,2422.56,32
HCPCS,C1876,W STNT DBL J,621.0,403.65,104.33,608.58,29
HCPCS,C1876,W STNT DBL J URET,986.5,641.225,114.07,1268.12,58
HCPCS,C1876,W STNT DBL PGTL,182.0,118.3,30.58,178.36,29
HCPCS,C1876,W STNT ELITE PM15,4969.0,3229.85,834.79,4869.62,32
HCPCS,C1876,W STNT ELITE PM25,4969.0,3229.85,834.79,4869.62,32
HCPCS,C1876,W STNT ELITE PM31,4969.0,3229.85,834.79,4869.62,32
HCPCS,C1876,W STNT ENDOPYLTMY,3986.0,2590.9,669.65,3906.28,32
HCPCS,C1876,W STNT HERCULINK BILIARY 135CM,2400.0,1560.0,403.2,2352.0,32
HCPCS,C1876,W STNT MLTLNK TET,5228.0,3398.2,878.3,5123.44,35
HCPCS,C1876,W STNT MLTLNK TRI,4248.0,2761.2,713.66,4163.04,32
HCPCS,C1876,W STNT NCOAT/COV,4248.0,2761.2,713.66,4163.04,32
HCPCS,C1876,W STNT NCOAT/COV2,1990.0,1293.5,334.32,1950.2,32
HCPCS,C1876,W STNT NCOAT/COV3,1990.0,1293.5,334.32,1950.2,32
HCPCS,C1876,W STNT NCOAT/COV4,2614.0,1699.1,439.15,2561.72,32
HCPCS,C1876,W STNT NEPHR MALC,458.0,297.7,76.94,448.84,29
HCPCS,C1876,W STNT XCEED NITINL SLF-EXPNDNG,2600.0,1690.0,436.8,2548.0,32
HCPCS,C1876,W WSTNT B ENDPR,4938.0,3209.7,829.58,4839.24,32
HCPCS,C1876,W WSTNT ILIAC END,4938.0,3209.7,829.58,4839.24,32
HCPCS,C1876,W WSTNT TBRNC END,2625.0,1706.25,441.0,2572.5,32
HCPCS,C1876,W WSTNT TIPS ENDP,4938.0,3209.7,829.58,4839.24,32
HCPCS,C18760,"Stent, non-coa/non-cov w/del",,,1315.83,1315.83,1
HCPCS,C1877,PALMAZ GENESIS TRANSHEPATIC BILIARY STENT 10-12MM X 19MM UNMNTD,1800.0,1170.0,302.4,1620.0,30
HCPCS,C1877,"Stent, non-coat/cov w/o del",,,195.96,195.96,1
HCPCS,C1877,W STENT BIL UNMTD TRNSH PLMZ,1600.0,1040.0,268.8,1568.0,29
HCPCS,C1877,W STENT BILAIRY ZIMMON,79.0,51.35,13.27,77.42,29
HCPCS,C1877,W STNT U UROLUME,6137.0,3989.05,1031.02,6014.26,35
HCPCS,C1877,W WSTNT TRNSHEPAT,826.0,536.9,138.77,809.48,29
HCPCS,C18770,"Stent, non-coat/cov w/o del",,,195.96,195.96,1
HCPCS,C1878,Matrl for vocal cord,,,459.68,459.68,1
HCPCS,C1878,W IMPL SYNTH VOCAL CORD,7540.0,4901.0,1266.72,7389.2,35
HCPCS,C1878,W RADIESSE VOICEGEL 1CC INJ IMP,440.0,286.0,73.92,431.2,29
HCPCS,C18780,Matrl for vocal cord,,,459.68,459.68,1
HCPCS,C1880,FILTER FEMORAL W NAVALIGN,1700.0,1105.0,285.6,1666.0,29
HCPCS,C1880,Vena cava filter,,,61.65,61.65,1
HCPCS,C1880,W FILTER FEMORAL 65CM,2200.0,1430.0,369.6,2156.0,32
HCPCS,C1880,W FILTER FEMORAL KIT GEN2,2200.0,1430.0,369.6,2156.0,32
HCPCS,C1880,W FILTER GNTHR TULP VNA CAVA ST,1900.0,1235.0,319.2,1862.0,32
HCPCS,C1880,W FILTER IVC RTRVBL 10F,1600.0,1040.0,268.8,1568.0,29
HCPCS,C1880,W FILTER JUGLAR REC GEN2,2200.0,1430.0,369.6,2156.0,32
HCPCS,C1880,W FILTER VENA CAVA ECLIPSE,1500.0,975.0,252.0,1470.0,29
HCPCS,C1880,W FILTER VENCAV FEM JUG 150CM,2174.0,1413.1,365.23,2130.52,32
HCPCS,C1880,W FLTR EMBL FEM VC DLV KIT,1900.0,1235.0,319.2,1862.0,32
HCPCS,C1880,W FLTR EMBL VC JUG NAVALIGN DLV,1398.0,908.7,234.86,1370.04,29
HCPCS,C1880,W FLTR LW PRFL VNA CAVA IVC SYS,2103.0,1366.95,353.3,2060.94,32
HCPCS,C1880,W FLTR VENA CAVA,2804.0,1822.6,435.12,2957.64,64
HCPCS,C18800,Vena cava filter,,,61.65,61.65,1
HCPCS,C1881,Dialysis access system,,,356.4,356.4,1
HCPCS,C18810,Dialysis access system,,,356.4,356.4,1
HCPCS,C1882,"Aicd, other than sing/dual",,,46170.0,46170.0,1
HCPCS,C1882,"BIOTRONIK CRT-DEFIBRILLATOR, ACTICOR HF-T CRT-DX DF4 IS1",21980.0,14287.0,3692.64,21540.4,35
HCPCS,C1882,COBALT DF1 HF CARDIAC RESYNCHRO THERAPY DEFIB,38242.0,24857.3,6424.66,37477.16,35
HCPCS,C1882,COBALT HF MRI SURESCAN,30400.0,19760.0,5107.2,29792.0,35
HCPCS,C1882,COBALT QUAD MRI SURESCAN,35084.0,22804.6,5894.11,34382.32,35
HCPCS,C1882,COBALT XT QUAD CRT-D (W/ PERFORMA LV LEAD),42100.0,27365.0,7072.8,37890.0,35
HCPCS,C1882,CRD-T DEFIBRILLATOR,26736.0,17378.4,4491.65,26201.28,35
HCPCS,C1882,DEFIB CLARIA MRI CRT-D,35084.0,22804.6,5894.11,34382.32,35
HCPCS,C1882,DEFIB CLARIA MRI CRT-D VENT,36800.0,23920.0,6182.4,36064.0,35
HCPCS,C1882,GALLANT HF CRT-D,19400.0,12610.0,3259.2,19012.0,35
HCPCS,C1882,"INTICA NEO 7 ICD, HF-T, DF-1/IS-1",43600.0,28340.0,7324.8,39240.0,33
HCPCS,C1882,PACEMAKER COBALT HF CARDIAC 2 CHAMBER,35084.0,22804.6,5894.11,34382.32,35
HCPCS,C1882,RIVACOR 7 HF-T QP DF4/IS4 PROMRI DEFIBRILLATOR,21980.0,14287.0,3692.64,21540.4,35
HCPCS,C1882,VIGILANT X4 CRT D CARDIAC RESYNCH DEFIB,26736.0,17378.4,4491.65,26201.28,35
HCPCS,C1882,W CARDIOVRTR/DFIB,70915.0,46094.75,11913.72,69496.7,35
HCPCS,C1882,W DEFIB CARD DYNAGEN CON STRL,22736.0,14778.4,3819.65,22281.28,35
HCPCS,C1882,W DEFIB CARD QUAD ASSURA MP DF1,24426.0,15876.9,4103.57,23937.48,35
HCPCS,C1882,W DEFIB CARD QUAD ASSURA MP DF4,19400.0,12610.0,3259.2,19012.0,35
HCPCS,C1882,W DEFIB CARD VIVA XT DF-1,38000.0,24700.0,6384.0,37240.0,35
HCPCS,C1882,W DEFIB SURESCAN MRI CRTD AMPLIA,37400.0,24310.0,6283.2,36652.0,35
HCPCS,C1882,W DEFIB UNIFY QUADRA ICD CARD,31200.0,20280.0,5241.6,30576.0,35
HCPCS,C1882,W DEFIB VIVA S CRT-D DF1,37000.0,24050.0,6216.0,36260.0,35
HCPCS,C1882,W DEFIBRILLATOR CONCERTO,36000.0,23400.0,6048.0,35280.0,35
HCPCS,C1882,W DEFIBRILLATOR RENEWAL H219,38000.0,24700.0,6384.0,37240.0,35
HCPCS,C1882,W DFIB ATLAS+ HF,44250.0,28762.5,6048.0,51450.0,70
HCPCS,C1882,W DFIB CARD ENERGEN CRT-D PLS,30000.0,19500.0,5040.0,29400.0,35
HCPCS,C1882,W DFIB CARD VIVA QUAD S,33600.0,21840.0,5644.8,32928.0,35
HCPCS,C1882,W DFIB CRD INOGN X4 CRT-D DF4,25600.0,16640.0,4300.8,25088.0,35
HCPCS,C1882,W DFIB EPIC HF,57500.0,37375.0,9660.0,56350.0,35
HCPCS,C1882,W DFIB MAXIMO,57250.0,37212.5,9618.0,56105.0,35
HCPCS,C1882,W DFIB RENEW 3 HE,52500.0,34125.0,8820.0,51450.0,35
HCPCS,C1882,W DFIB RENEW 3 RF,38000.0,24700.0,6048.0,55125.0,105
HCPCS,C1882,W DFIB RENEW 3 SE,50000.0,32500.0,8400.0,49000.0,35
HCPCS,C1882,W DFIB RENEWAL,48750.0,31687.5,7980.0,49000.0,70
HCPCS,C1882,W DFIB RENEWAL 3,52500.0,34125.0,8820.0,51450.0,35
HCPCS,C1882,W DFIB SENTRY,71000.0,46150.0,11886.0,69825.0,70
HCPCS,C1882,W ICD ATLAS II V-366,36000.0,23400.0,6048.0,35280.0,35
HCPCS,C1882,W ICD BI V COGNIS,30000.0,19500.0,5040.0,29400.0,35
HCPCS,C1882,W ICD COGNIS N118,30000.0,19500.0,5040.0,29400.0,35
HCPCS,C1882,W ICD CONSULTA CRT-D D224TRK,37200.0,24180.0,6249.6,36456.0,35
HCPCS,C1882,W ICD INSYNC SENTRY 7299ID,38000.0,24700.0,6384.0,37240.0,35
HCPCS,C1882,W ICD LIVIAN H 220,29000.0,18850.0,4872.0,28420.0,35
HCPCS,C1882,W ICD LIVIAN H 227,30000.0,19500.0,5040.0,29400.0,35
HCPCS,C1882,W ICD LIVIAN RF H225,29000.0,18850.0,4872.0,28420.0,35
HCPCS,C1882,W ICD LIVIAN RF HE H229,30000.0,19500.0,5040.0,29400.0,35
HCPCS,C1882,W ICD PROMOTE CRT/RF 36 JOULES,30000.0,19500.0,5040.0,29400.0,35
HCPCS,C1882,W ICD PROMOTE RF 3207,29000.0,18850.0,4872.0,28420.0,35
HCPCS,C1882,W ICD PROTECTA CRTD D334TRG,36000.0,23400.0,6048.0,35280.0,35
HCPCS,C1882,W ICD PROTECTA XT CRTD D314TRG,39200.0,25480.0,6585.6,38416.0,35
HCPCS,C1882,W ICD QUADRA ASSURA CRTD IS4,31200.0,20280.0,5241.6,30576.0,35
HCPCS,C1882,W ICD UNIFY ASSURA CRTD IS1,19400.0,12610.0,3259.2,19012.0,35
HCPCS,C1882,W ICD UNIFY CRT-D SJ4,30000.0,19500.0,5040.0,29400.0,35
HCPCS,C1882,W ICD VIRTUOSO VR,23700.0,15405.0,3981.6,23226.0,35
HCPCS,C18820,"Aicd, other than sing/dual",,,46170.0,46170.0,1
HCPCS,C1883,"Adapt/ext, pacing/neuro lead",,,4119.82,4119.82,1
HCPCS,C1883,W ADAPTR RECPTCLE BIPLR EXTND,550.0,357.5,92.4,539.0,29
HCPCS,C1883,W ADPT 25CM Y UNPLR PIN PLG,200.0,130.0,33.6,196.0,29
HCPCS,C1883,W ADPT INTRO SEAL EXT WNG,422.0,274.3,70.9,413.56,29
HCPCS,C1883,W EXT SYN/VERS/QUAD/NLINE/ITREL,930.0,604.5,156.24,911.4,29
HCPCS,C1883,W EXTEN INTERSTIM QUAD,940.0,611.0,157.92,921.2,29
HCPCS,C1883,W EXTENSION DBS NEUROSTIM 7482A,1190.0,773.5,199.92,1166.2,29
HCPCS,C1883,W EXTENSION NEUROSTIM,1390.0,903.5,233.52,1362.2,29
HCPCS,C1883,W EXTN KT NEURO PAIN 40CM,930.0,604.5,156.24,911.4,29
HCPCS,C1883,W KIT ADAPT POCKET TIP 74002,1980.0,1287.0,332.64,1940.4,32
HCPCS,C1883,W KIT EXTENSION DUAL QUAD,2600.0,1690.0,436.8,2548.0,32
HCPCS,C1883,W LD ADPTR KIT BPLR PLSE GNRTR,1750.0,1137.5,294.0,1715.0,32
HCPCS,C1883,W LD PM ADAPTOR,372.0,241.8,62.5,364.56,29
HCPCS,C1883,W LD PM EXTENSION,1470.0,955.5,246.96,1440.6,29
HCPCS,C1883,W LEAD ADAPTOR 6986,700.0,455.0,117.6,686.0,29
HCPCS,C1883,W LEAD ADAPTOR 6987,800.0,520.0,134.4,784.0,29
HCPCS,C1883,W LEAD NS EXTNS PRECISIN LINEAR,930.0,604.5,156.24,911.4,29
HCPCS,C18830,"Adapt/ext, pacing/neuro lead",,,4119.82,4119.82,1
HCPCS,C1884,Embolization protect syst,,,9129.24,9129.24,1
HCPCS,C1884,SENTINEL CEREBRAL PROTECTION SYSTEM,2984.0,1939.6,501.31,2685.6,21
HCPCS,C1884,SYS EMBL PROTCT 3MM 320CM .014,1350.0,877.5,226.8,1215.0,21
HCPCS,C1884,W COIL EMBOL AZUR 4/6MM X 20CM,2035.0,1322.75,341.88,1994.3,32
HCPCS,C1884,W COIL EMBOL AZUR 4MM X 10CM,1802.0,1171.3,302.74,1765.96,32
HCPCS,C1884,W EMBLIC PRTCTN RX ACCNT SYS,2093.0,1360.45,351.62,1883.7,21
HCPCS,C1884,W EMBO PARTICLES LC BEAD 2ML,6000.0,3900.0,1008.0,5880.0,35
HCPCS,C1884,W EMBOLI CAPTURE SYS ANGIOGUARD,2228.0,1448.2,374.3,2005.2,21
HCPCS,C1884,W EMBOLIC PROTECTION SYSTM NAV6,1852.0,1203.8,311.14,1666.8,21
HCPCS,C1884,W EMBOLZN PROTECT,1748.0,1136.2,293.66,1573.2,21
HCPCS,C1884,W SYR EMBO LC BEAD 100-300UM 2ML,2261.0,1469.65,379.85,2034.9,21
HCPCS,C1884,W SYS EMBL PROTCT SPIDERFX,1493.0,970.45,250.82,1343.7,21
HCPCS,C18840,Embolization protect syst,,,9129.24,9129.24,1
HCPCS,C1885,CATH ATHRCM 135CM 4FR .9MM,2835.0,1842.75,476.28,2551.5,21
HCPCS,C1885,"Cath, translumin angio laser",,,237.6,237.6,1
HCPCS,C1885,W CATH ATHER TURBO ELITE OTW,2835.0,1842.75,476.28,2551.5,21
HCPCS,C18850,"Cath, translumin angio laser",,,237.6,237.6,1
HCPCS,C1886,AERIN STYLUS,1900.0,1235.0,319.2,1710.0,21
HCPCS,C1886,CATH TACTI SEN EN 8FR D C 115CM ABLA C FORCE,3476.0,2259.4,583.97,3128.4,21
HCPCS,C1886,"Catheter, ablation",,,2298.42,2298.42,1
HCPCS,C1886,W CATHETER THERMOPLASTY ATS2-5,3375.0,2193.75,567.0,3037.5,21
HCPCS,C18860,"Catheter, ablation",,,2298.42,2298.42,1
HCPCS,C1887,5FR X 100CM GLIDECATH ANGLE TAPER .038 GUIDEWIRE,91.0,59.15,15.29,81.9,21
HCPCS,C1887,"6FR X 100CM ADROIT GUIDING CATHETER, XB 3.5, .072IN ID",65.0,42.25,10.92,58.5,21
HCPCS,C1887,6FR X 75CM R2P DESTINATION SLENDER GUIDING SHEATH,426.0,276.9,71.57,383.4,21
HCPCS,C1887,ACCU-VU DIAGNOSTIC CATHETER 5FR X 100CM,183.0,118.95,30.74,164.7,21
HCPCS,C1887,ACUITY PRO INNER CATH 7FR X 69CM,165.0,107.25,27.72,148.5,21
HCPCS,C1887,AGILIS HISPRO SLITTER,61.0,39.65,10.25,54.9,21
HCPCS,C1887,CATH DECAP 3F 5-5-5 10 ELECT,1185.0,770.25,199.08,1066.5,21
HCPCS,C1887,CATH GUID 8.4FR 5.7FR 43CM,525.0,341.25,88.2,472.5,21
HCPCS,C1887,CATH GUIDING ADROIT H-STICK,65.0,42.25,10.92,58.5,21
HCPCS,C1887,CATH GUIDING ATTAIN SELECTII,254.0,165.1,42.67,228.6,21
HCPCS,C1887,CATH GUIDING HEARTRAILIII 6FR,175.0,113.75,29.4,157.5,21
HCPCS,C1887,CATH INTVN 120D .014IN MIC,773.0,502.45,129.86,695.7,21
HCPCS,C1887,CATH RUBICON 18 SPPRT 4F 135CM,210.0,136.5,35.28,189.0,21
HCPCS,C1887,CATH SELECTSITE GUIDING,305.0,198.25,51.24,274.5,21
HCPCS,C1887,CATH SOFT TIP TURNPIKE,920.0,598.0,154.56,828.0,21
HCPCS,C1887,CATH SPRT 132CM .057-.063IN,233.0,151.45,39.14,209.7,21
HCPCS,C1887,CATH SUPERCROSS OTW,681.0,442.65,114.41,612.9,21
HCPCS,C1887,CATH VASC TWINPASS DUAL ACCESS,623.0,404.95,104.66,560.7,21
HCPCS,C1887,CATHETER 150CM MICROCATHETER,900.0,585.0,151.2,810.0,21
HCPCS,C1887,CATHETER ADROIT TRUELUMEN,74.0,48.1,12.43,66.6,21
HCPCS,C1887,CATHETER F6ST+ 125CM,253.0,164.45,42.5,227.7,21
HCPCS,C1887,"CPS AIM SL SLIT INNER GUIDING SHEATH CATHETER, INTEGR VALVE (SUB",359.0,233.35,60.31,323.1,21
HCPCS,C1887,CPS AIM SL SLITTABLE INNER GUIDING SHEATH CATH 65CM,257.0,167.05,43.18,231.3,21
HCPCS,C1887,"Catheter, guiding",,,93.87,93.87,1
HCPCS,C1887,DESTINO TWST 8.5FR X 90CM X 108CM DEFLCTBL STEERBL GUIDNG SHTH S,975.0,633.75,163.8,877.5,21
HCPCS,C1887,"LAUNCHER GUIDING CATH, EXTRA BACK UP SUPPORT LEFT 3.75",68.0,44.2,11.42,61.2,21
HCPCS,C1887,"LONG CURVED-TIP, ATTAIN SELECT II SUREVALVE DELIVERY CATHETER (6",242.0,157.3,40.66,217.8,21
HCPCS,C1887,"MACH 1 GUIDING CATH 6FR , JR4",68.0,44.2,11.42,61.2,21
HCPCS,C1887,MITRACLIP G5 STEERABLE GUIDE CATHETER,90000.0,58500.0,15120.0,81000.0,21
HCPCS,C1887,NAVICROSS SUPPORT GUIDING CATH 150CM,293.0,190.45,49.22,263.7,21
HCPCS,C1887,OPTITORQUE CATHETER 6FR X 110CM,293.0,190.45,49.22,263.7,21
HCPCS,C1887,PROGREAT MICROCATH W/ RO MARKER 2.4FR X 130CM,437.0,284.05,73.42,393.3,21
HCPCS,C1887,RIGHTSITE FIXED SHAPE CATHETER,528.0,343.2,88.7,475.2,21
HCPCS,C1887,SUPER TORQUE PLUS CATHETER 5FR X 125CM,75.0,48.75,12.6,67.5,21
HCPCS,C1887,VISTA BRITE TIP 6FR X 125CM X 0.070IN,241.0,156.65,40.49,216.9,21
HCPCS,C1887,"VISTA BRITE TIP GUIDING CATHETER, AMPLATZ LT CORONARY 6FRX100CM",65.0,42.25,10.92,58.5,21
HCPCS,C1887,W BALLOON CATHETER WEDGE,68.0,44.2,11.42,61.2,21
HCPCS,C1887,W CATH ACTY PRO GUID,203.0,131.95,34.1,182.7,21
HCPCS,C1887,W CATH ACUMEN C315 FXD SHP HIS,660.0,429.0,110.88,594.0,21
HCPCS,C1887,W CATH ADVANCED HEADWAY,1008.0,655.2,169.34,907.2,21
HCPCS,C1887,W CATH ANG 135CM CROSSBOSS,1313.0,853.45,220.58,1181.7,21
HCPCS,C1887,W CATH ANG MIC REG HEADWAY,1152.0,748.8,193.54,1036.8,21
HCPCS,C1887,W CATH ANGIO MARINER,135.0,87.75,22.68,121.5,21
HCPCS,C1887,W CATH CORONARY DX OPTITORQUE,93.0,60.45,15.62,83.7,21
HCPCS,C1887,W CATH CPS LUMINARY LARGE CURL,1235.0,802.75,207.48,1111.5,21
HCPCS,C1887,W CATH CRBRVASC EXCLS 18CM,1295.0,841.75,217.56,1165.5,21
HCPCS,C1887,W CATH EXCLS SL-10 INF,1165.0,757.25,195.72,1048.5,21
HCPCS,C1887,W CATH F5INF 100CM,68.0,44.2,11.42,61.2,21
HCPCS,C1887,W CATH GD 3-2.4FR .021IN 20CM,723.0,469.95,121.46,650.7,21
HCPCS,C1887,W CATH GD ACUITY CRNRY SINUS,743.0,482.95,124.82,668.7,21
HCPCS,C1887,W CATH GD CORONARY ACUITY PRO,368.0,239.2,61.82,331.2,21
HCPCS,C1887,W CATH GD MICROSTRGHT MAESTRO,525.0,341.25,88.2,472.5,21
HCPCS,C1887,W CATH GD MULTIPURPOSE ENVOY,573.0,372.45,96.26,515.7,21
HCPCS,C1887,W CATH GD SLITABLE INNER CATH,488.0,317.2,81.98,439.2,21
HCPCS,C1887,W CATH GDE 7FR .078 100CM AL2,241.0,156.65,40.49,216.9,21
HCPCS,C1887,W CATH GLIDECATH 4/5FR,91.0,59.15,15.29,81.9,21
HCPCS,C1887,W CATH GUID ATTN CMND 6250V-EH,318.0,206.7,53.42,286.2,21
HCPCS,C1887,W CATH GUID ATTN CMND 6250VC,318.0,206.7,53.42,286.2,21
HCPCS,C1887,W CATH GUID CS LD DLV SYS EXT,276.0,179.4,46.37,248.4,21
HCPCS,C1887,W CATH GUID EP FINECROSS,900.0,585.0,151.2,810.0,21
HCPCS,C1887,W CATH GUID LH GW CRV KIT ATN,827.0,537.55,138.94,744.3,21
HCPCS,C1887,W CATH GUID MPC CURVE ENVOY,461.0,299.65,77.45,414.9,21
HCPCS,C1887,W CATH GUID MPD CRV ENVOY,428.0,278.2,71.9,385.2,21
HCPCS,C1887,W CATH GUID MPD CRV ENVOY DA,825.0,536.25,138.6,742.5,21
HCPCS,C1887,W CATH GUIDING 2,487.0,316.55,81.82,438.3,21
HCPCS,C1887,W CATH GUIDING 59CM CPS,359.0,233.35,60.31,323.1,21
HCPCS,C1887,W CATH GUIDING 8FR ACTY EXHK,229.0,148.85,38.47,206.1,21
HCPCS,C1887,W CATH GUIDING ACUITY,254.0,165.1,42.67,228.6,21
HCPCS,C1887,W CATH GUIDING AL1/SPECIAL,241.0,156.65,40.49,216.9,21
HCPCS,C1887,W CATH GUIDING CS ACUITY,182.0,118.3,30.58,163.8,21
HCPCS,C1887,W CATH GUIDING SUPPORT CXI,293.0,190.45,49.22,263.7,21
HCPCS,C1887,W CATH GUIDING VISTA BRITE RDC,105.0,68.25,17.64,94.5,21
HCPCS,C1887,W CATH GUIDING VISTA BRITE TIP,92.0,59.8,15.46,82.8,21
HCPCS,C1887,W CATH GUIDING WISEGUIDE VL6,83.0,53.95,13.94,74.7,21
HCPCS,C1887,W CATH INF 250 PSI 5FR .014,938.0,609.7,157.58,844.2,21
HCPCS,C1887,W CATH INF EXCELSIOR SL-10,1250.0,812.5,210.0,1125.0,21
HCPCS,C1887,W CATH INF SEL PLS PRWL TRULMN,1049.0,681.85,176.23,944.1,21
HCPCS,C1887,W CATH INFSN MICRO RDPQ MRKMN,1463.0,950.95,245.78,1316.7,21
HCPCS,C1887,W CATH INTVN 8FR 2.24MM 20CM,563.0,365.95,94.58,506.7,21
HCPCS,C1887,W CATH JUDKINS VIKING GUIDING,105.0,68.25,17.64,94.5,21
HCPCS,C1887,W CATH LANGSTON PIGTAIL 6F,207.0,134.55,34.78,186.3,21
HCPCS,C1887,W CATH MICRO DIREXION HI-FLO,1269.0,824.85,213.19,1142.1,21
HCPCS,C1887,W CATH MICRO DIREXION TORQABL,861.0,559.65,144.65,774.9,21
HCPCS,C1887,W CATH MICRO HDWAY 21 ADV STR,938.0,609.7,157.58,844.2,21
HCPCS,C1887,W CATH MICRO RENEGADE HI FLO,580.0,377.0,97.44,522.0,21
HCPCS,C1887,W CATH MICRO VEL 3D DEL SYSTM,1451.0,943.15,243.77,1305.9,21
HCPCS,C1887,W CATH MICROSHEATH CROSSER,413.0,268.45,69.38,371.7,21
HCPCS,C1887,W CATH MODEL IMPULSE IM T (SGL),15.0,9.75,2.52,13.5,21
HCPCS,C1887,W CATH NAVIEN DSTL INTRCRNL,1418.0,921.7,238.22,1276.2,21
HCPCS,C1887,W CATH NEURON MAX SEL SIM,219.0,142.35,36.79,197.1,21
HCPCS,C1887,W CATH NEURON SELECT SS,219.0,142.35,36.79,197.1,21
HCPCS,C1887,W CATH PRGRT MCRO W/DISTAL MRKR,413.0,268.45,69.38,371.7,21
HCPCS,C1887,W CATH RAPIDO 53/58CM SINUS EXT,142.0,92.3,23.86,127.8,21
HCPCS,C1887,W CATH RAPIDO 63CM SINUS EXTD,443.0,287.95,74.42,398.7,21
HCPCS,C1887,W CATH RAPIDO SINUS GUIDING,142.0,92.3,23.86,127.8,21
HCPCS,C1887,W CATH RENEGADE HI FLO FATHOM,924.0,600.6,155.23,831.6,21
HCPCS,C1887,W CATH RENEGADE HI-FLO KIT,848.0,551.2,142.46,763.2,21
HCPCS,C1887,W CATH REPERFUSION 5MAX ACE,2687.0,1746.55,451.42,2418.3,21
HCPCS,C1887,W CATH RNGD FBR BRD HYDRO PASS,617.0,401.05,103.66,555.3,21
HCPCS,C1887,W CATH SINUS GUIDE 000-110S,555.0,360.75,93.24,499.5,21
HCPCS,C1887,W CATH THROMCTMY 5MAX ACE 64,3861.0,2509.65,648.65,3474.9,21
HCPCS,C1887,W CATH VERPATH PERIPHERAL GDNG,96.0,62.4,16.13,86.4,21
HCPCS,C1887,W CATHETER GUIDING MACH 1,83.0,53.95,13.94,74.7,21
HCPCS,C1887,W CATHETER GUIDING SHERPA EBU,102.0,66.3,17.14,91.8,21
HCPCS,C1887,W CATHETER MICRO GUIDE XP,375.0,243.75,63.0,337.5,21
HCPCS,C1887,W CTH MICR CBRVSC EXCLS 6CM,1493.0,970.45,250.82,1343.7,21
HCPCS,C1887,W GCATH CORDIS 8F,229.0,148.85,38.47,206.1,21
HCPCS,C1887,W GCTH WISEGD 6,229.0,148.85,38.47,206.1,21
HCPCS,C1887,W KIT ATTAIN ACCESS LEAD DELVRY,782.0,508.3,131.38,766.36,29
HCPCS,C1887,W KIT LIVER BIOPSY W CATHS,600.0,390.0,100.8,540.0,21
HCPCS,C1887,W MCATH CORD TRAN,818.0,531.7,137.42,736.2,21
HCPCS,C1887,W RAPIDO DELIV SYS RLDS,1118.0,726.7,187.82,1006.2,21
HCPCS,C18870,"Catheter, guiding",,,93.87,93.87,1
HCPCS,C1888,Endovas non-cardiac abl cath,,,1076.67,1076.67,1
HCPCS,C18880,Endovas non-cardiac abl cath,,,1076.67,1076.67,1
HCPCS,C1889,EMBLEM S ICD ELECTRODE DELIVERY SYSTEM,2000.0,1300.0,336.0,1960.0,32
HCPCS,C1889,GRAFT THORACIC STNT VALIANT NAVION,36990.0,24043.5,6214.32,36250.2,35
HCPCS,C1889,SET SPNL MN INV LMBR,3038.0,1974.7,510.38,2734.2,21
HCPCS,C1889,W CAGE CERVICAL AERO C,10038.0,6524.7,1686.38,9837.24,35
HCPCS,C1889,W COIL 3D AXIUM PRIME DES,4550.0,2957.5,764.4,4459.0,32
HCPCS,C1889,W COIL 3D AXIUM PRIME SS,1972.0,1281.8,331.3,1932.56,32
HCPCS,C1889,W COIL AX PRIME BARE HELIX ES,3390.0,2203.5,569.52,3322.2,32
HCPCS,C1889,W DEVICE PIPELN FLX PLTINM TNGSTN,25800.0,16770.0,4334.4,25284.0,35
HCPCS,C1889,W OCCL CV AMPLATZER DUCTAL,8200.0,5330.0,1377.6,8036.0,35
HCPCS,C1889,W PLUG CV 18MM 22MM AMPLZ 2,1600.0,1040.0,268.8,1568.0,29
HCPCS,C1889,W PLUG CV 7MM 10MM AMPLZR,1100.0,715.0,184.8,1078.0,29
HCPCS,C1889,W PLUG MCR VASC MVP 3Q,3000.0,1950.0,504.0,2940.0,32
HCPCS,C1889,W PLUG MCR VASC MVP 5/7Q,3390.0,2203.5,569.52,3322.2,32
HCPCS,C1889,"WATCHMAN ACCESS SHEATH W/DILATOR, FIXED CURVE SINGLE",1350.0,877.5,226.8,1215.0,21
HCPCS,C1891,W IMP PMP CONSFLW,30826.0,20036.9,5178.77,30209.48,35
HCPCS,C1891,W IMPLANT INFUSION PUMP,30285.0,19685.25,5087.88,29679.3,35
HCPCS,C1892,INTRO LD SAFSHTH CSG,368.0,239.2,61.82,331.2,21
HCPCS,C1892,"Intro/sheath,fixed,peel-away",,,344.8,344.8,1
HCPCS,C1892,PRELUDE SNAP SPLITTABLE  10.5FR X 3.5MM HEMOSTATIC INTRODUCER SY,57.0,37.05,9.58,51.3,21
HCPCS,C1892,SSPC NXT PLUS WITH DELIVERY CATHETER AND DILATOR,525.0,341.25,88.2,472.5,21
HCPCS,C1892,W GINTRO EP IC FC,193.0,125.45,32.42,173.7,21
HCPCS,C1892,W INTRO LD 49CM 9FR SSHTH CSG,503.0,326.95,84.5,452.7,21
HCPCS,C1892,W INTRO SHTH PRELUDE SNAP,54.0,35.1,9.07,48.6,21
HCPCS,C1892,W SHEATH BYRD DILATOR SET 8.5FR,247.0,160.55,41.5,222.3,21
HCPCS,C1892,W SHTH DLTR SSV SPLTAWAY VLV,77.0,50.05,12.94,69.3,21
HCPCS,C1892,WORLEY HEMOSTATIC SAFESHEATH 9FR X 40CM,450.0,292.5,75.6,405.0,21
HCPCS,C18920,"Intro/sheath,fixed,peel-away",,,344.8,344.8,1
HCPCS,C1893,ACQCROSS QX VZ 71 CM INTE TRANSSEPTAL DILATOR/NEEDLE,735.0,477.75,123.48,661.5,21
HCPCS,C1893,COMPATIBLE STEADYSHEATH EVOLUTION SHORTIE TISSUE STABILIZATION S,395.0,256.75,66.36,355.5,21
HCPCS,C1893,COMPATIBLE STEADYSHEATH EVOLUTION TISSUE STABILIZATION SHEATH 11,439.0,285.35,73.75,395.1,21
HCPCS,C1893,HYDROPHILIC PTFE 90CM 5CM GUIDING,168.0,109.2,28.22,151.2,21
HCPCS,C1893,INTRO SHTH 8.5FR 63CM BRAID,233.0,151.45,39.14,209.7,21
HCPCS,C1893,"Intro/sheath, fixed,non-peel",,,609.09,609.09,1
HCPCS,C1893,SELECTRA ACCESSORY KIT,219.0,142.35,36.79,197.1,21
HCPCS,C1893,"SELECTRA GUIDING CATH, EXTENDED HOOK",320.0,208.0,53.76,288.0,21
HCPCS,C1893,SWARTZ BRAIDED LAMP 8.5FRX85CM 90 TRNSPTL GUID INTRDCR SHEATH W/,257.0,167.05,43.18,231.3,21
HCPCS,C1893,SWRTZ BRD LMP 8.5FRX85CM 135 TRNSPTL GD INTRO STH W/ HEMOST V &,261.0,169.65,43.85,234.9,21
HCPCS,C1893,W CATH GUID CPS DIRECT,300.0,195.0,50.4,270.0,21
HCPCS,C1893,W GDNG CATH CPS DIRECT,1148.0,746.2,192.86,1033.2,21
HCPCS,C1893,W GDNG INTRDCR FAST CTH 60CM,240.0,156.0,40.32,216.0,21
HCPCS,C1893,W GDNG INTRDCR FAST CTH 63CM,240.0,156.0,40.32,216.0,21
HCPCS,C1893,W GDNG SHTH CTH CPS DIRECT SLII,645.0,419.25,108.36,580.5,21
HCPCS,C1893,W GINTRO EP IC FC,505.0,328.25,84.84,454.5,21
HCPCS,C1893,W SHEATH DILATOR VISISHEATH,353.0,229.45,59.3,317.7,21
HCPCS,C1893,W SHEATH GUIDING INTRDCR SWARTZ,240.0,156.0,40.32,216.0,21
HCPCS,C1893,W SHEATH MULI 8F X 62CM,222.0,144.3,37.3,199.8,21
HCPCS,C1893,W SHTH BRD TRANSEPTAL WTIP MRKR,338.0,219.7,56.78,304.2,21
HCPCS,C18930,"Intro/sheath, fixed,non-peel",,,609.09,609.09,1
HCPCS,C1894,16FR X 35CM CHECK-FLO INTRO LG VALVE ASSEMBLY,169.0,109.85,28.39,152.1,21
HCPCS,C1894,6FR X 10CM GLIDESHEATH SLENDER SHEATH ACCESS KIT,154.0,100.1,25.87,138.6,21
HCPCS,C1894,"6FR X 80CM, FLEXOR TUOHY-BORST SIDEARM INTRODUCER",149.0,96.85,25.03,134.1,21
HCPCS,C1894,9 FR. X 4-1/4IN ARROW-FLEX POLYURETHANE SHEATH,69.0,44.85,11.59,62.1,21
HCPCS,C1894,ACCESS SET?ARROWG+ARD BLUE(R) PSI KIT?,85.0,55.25,14.28,76.5,21
HCPCS,C1894,ARROW PSI KIT 8.5FRX10CM ARROWG+ARD BLUE PSI KIT CATH-GARD FOR U,139.0,90.35,23.35,125.1,21
HCPCS,C1894,AVANTI SHEATH INTRODUCER 11FR X 11CM 0.035IN GUIDEWIRE,80.0,52.0,13.44,72.0,21
HCPCS,C1894,AVEIR DELIVERY SYSTEM CATHETER,2363.0,1535.95,396.98,2126.7,21
HCPCS,C1894,AVEIR INTRODUCER 25F X 50CM,900.0,585.0,151.2,810.0,21
HCPCS,C1894,CATH MICRO MAMBA FLEX 135,900.0,585.0,151.2,810.0,21
HCPCS,C1894,"CHECK FLO INTRODUCER SET, 0.038IN MAX GUIDEWIRE 16FR X 13CM",76.0,49.4,12.77,68.4,21
HCPCS,C1894,"CHECK-FLO INTRODUCER SET, MULLINS TYPE ,0.038IN MAX GW 7FR X 85C",126.0,81.9,21.17,113.4,21
HCPCS,C1894,"CHECK-FLO PERFORMER INTRO SET, 0.035IN GW, 14FR X 45CM",252.0,163.8,42.34,226.8,21
HCPCS,C1894,CHK-FLO PERF INTR SET 11FR X 63CM MULLINS TYPE 0.038IN MAX GUIDE,170.0,110.5,28.56,153.0,21
HCPCS,C1894,CHK-FLO PERFORMER INTRDCR SET 9FR X 63CM MULLINS TYPE 0.038IN MA,133.0,86.45,22.34,119.7,21
HCPCS,C1894,CONVATEC 9CM X 15CM AQUACEL AG SURGICAL COVER DRESSING,53.0,34.45,8.9,47.7,21
HCPCS,C1894,DESTINATION SLENDER GUIDING SHEATH,426.0,276.9,71.57,383.4,21
HCPCS,C1894,DRYSEAL 18FR X 65CM FLEX HYDRO SHEATH AO,1338.0,869.7,224.78,1204.2,21
HCPCS,C1894,DRYSEAL FLEX 14FR X 33CM INTRODUCER SHEATH,1320.0,858.0,221.76,1188.0,21
HCPCS,C1894,DRYSEAL FLEX INTRODUCER SHEATH,269.0,174.85,45.19,242.1,21
HCPCS,C1894,DRYSEAL FLEX INTRODUCER SHEATH 12FR X 45CM,1112.0,722.8,186.82,1000.8,21
HCPCS,C1894,DRYSEAL FLEX INTRODUCER SHEATH 24FR X 33CM,356.0,231.4,59.81,320.4,21
HCPCS,C1894,DRYSEAL FLEX INTRODUCER SHEATH 26FR X 33CM,872.0,566.8,146.5,784.8,21
HCPCS,C1894,INTRO SHTH 16FR 82CM 70CM LG,175.0,113.75,29.4,157.5,21
HCPCS,C1894,INTRO SHTH CHECK FLO LG,165.0,107.25,27.72,148.5,21
HCPCS,C1894,INTRO SHTH GLIDESHEATH STR,88.0,57.2,14.78,79.2,21
HCPCS,C1894,INTRODUCER 9.5FR SAFESHEATH II,375.0,243.75,63.0,337.5,21
HCPCS,C1894,INTRODUCER ARROWG+ARD 8.5FR BLUE SHEATH,91.0,59.15,15.29,81.9,21
HCPCS,C1894,INTRODUCER KCFW 4.0-18/3545 RB-ANLO,43.0,27.95,7.22,38.7,21
HCPCS,C1894,INTRODUCER SHEATH,1362.0,885.3,228.82,1225.8,21
HCPCS,C1894,"Intro/sheath, non-laser",,,104.55,104.55,1
HCPCS,C1894,KIT BRIDGE BALLOON ACCESSORY,318.0,206.7,53.42,286.2,21
HCPCS,C1894,LEAD EXTRACTION CURVED FEMORAL INTRDCR SHEATH SET 16FR,869.0,564.85,145.99,782.1,21
HCPCS,C1894,LEAD EXTRACTION CURVED INNER FEMORAL SHEATH 12FR,349.0,226.85,58.63,314.1,21
HCPCS,C1894,"PINNACLE GUIDING SHEATH W/ DILATOR, MULTI, CROSS-CUT VALVE 7FR X",168.0,109.2,28.22,151.2,21
HCPCS,C1894,PINNACLE R/O II RADIOPAQUE SHEATH INTRODUCER 7 FR X 10CM?W/ 2.5C,75.0,48.75,12.6,67.5,21
HCPCS,C1894,PRELUDE IDEAL HYDROPHILIC SHEATH,380.0,247.0,63.84,342.0,21
HCPCS,C1894,SAFESHEATH II 8FRX13CM PEEL-AWAY HEMOSTASIS INTRODUCER (MFR?D BY,57.0,37.05,9.58,51.3,21
HCPCS,C1894,SAFESHEATH II 9.5FRX13CM TEAR-AWAY VALVED SYSTEM W SIDE PORT 0.0,57.0,37.05,9.58,51.3,21
HCPCS,C1894,SENTRANT INTRDCR SHTH W HYDRPHLC COAT 18FR X 28CM WRKNG LGTH,270.0,175.5,45.36,243.0,21
HCPCS,C1894,SET INTRO 30CM 14FR CKFL .038,102.0,66.3,17.14,91.8,21
HCPCS,C1894,SET MPNCH INTRODUCER,62.0,40.3,10.42,55.8,21
HCPCS,C1894,SET SHTH 11FR LD EXTR SUB-C,2288.0,1487.2,384.38,2059.2,21
HCPCS,C1894,SHEATH DILATOR FIXED CURVE DOUBLE,1350.0,877.5,226.8,1215.0,21
HCPCS,C1894,SHEATH HEARTSPAN STEERABLE,1125.0,731.25,189.0,1012.5,21
HCPCS,C1894,SHEATH INRO PINNACLE RADIO,50.0,32.5,8.4,45.0,21
HCPCS,C1894,SHEATH INTRO 18FR X 6.0 X?33CM,872.0,566.8,146.5,784.8,21
HCPCS,C1894,SHEATH INTRODUCER SET 8 FR,524.0,340.6,88.03,471.6,21
HCPCS,C1894,SHTH ACC NAV 36CM 13FR 11FR 2,297.0,193.05,49.9,267.3,21
HCPCS,C1894,SHTH ACC NAV 46CM 13FR 11FR 2,297.0,193.05,49.9,267.3,21
HCPCS,C1894,SHTH GUID 7FR 2.5CM 65CM .038,168.0,109.2,28.22,151.2,21
HCPCS,C1894,SHTH INTRO 33CM 16FR 6.1MM 5.3,269.0,174.85,45.19,242.1,21
HCPCS,C1894,SHTH INTRO 33CM 26FR 9.5MM 8.7,356.0,231.4,59.81,320.4,21
HCPCS,C1894,SHTH INTRO DRYSEAL,323.0,209.95,54.26,290.7,21
HCPCS,C1894,SUPER ARROW-FLEX SHEATH SETW/HEMOSTASIS PORT 9FR X 11CM,80.0,52.0,13.44,72.0,21
HCPCS,C1894,THE FLEXOR CHECK-FLO II INTRODUCER SET 9FR X 30CM 0.038IN MAX GU,95.0,61.75,15.96,85.5,21
HCPCS,C1894,VSI MICRO-INTRODUCER KIT 5FR X 40CM,64.0,41.6,10.75,57.6,21
HCPCS,C1894,W BAND TR BND 29CM LONG BLN,97.0,63.05,16.3,87.3,21
HCPCS,C1894,W GDNG SHTH STRGHT CRSS-CUT VLV,158.0,102.7,26.54,142.2,21
HCPCS,C1894,W INTDCR MLLNS TRNSPT 67CM DLTR,126.0,81.9,21.17,113.4,21
HCPCS,C1894,W INTRDCR 6/7FRX10CM PINNACLE,47.0,30.55,7.9,42.3,21
HCPCS,C1894,W INTRDCR FLEXOR CHECK FLO,65.0,42.25,10.92,58.5,21
HCPCS,C1894,W INTRDCR GALT PTFE TEARAWAY,88.0,57.2,14.78,79.2,21
HCPCS,C1894,W INTRDCR GALT STIFFEN MICRO,79.0,51.35,13.27,71.1,21
HCPCS,C1894,W INTRDCR KT ECHO NTNL PLTN GWR,83.0,53.95,13.94,74.7,21
HCPCS,C1894,W INTRDCR RADIAL ACC GLIDESHT,360.0,234.0,60.48,324.0,21
HCPCS,C1894,W INTRDCR SHTH MRKR RADIOPAQUE,56.0,36.4,9.41,50.4,21
HCPCS,C1894,W INTRDCR TRACH 30FR PERC BLLN,64.0,41.6,10.75,57.6,21
HCPCS,C1894,W INTRO ACCUST RO MRKR SS GW,107.0,69.55,17.98,96.3,21
HCPCS,C1894,W INTRO CATH 45CM 16FR CK-FLOW,144.0,93.6,24.19,129.6,21
HCPCS,C1894,W INTRO CATH 7FR CURVE TRNSPT,88.0,57.2,14.78,79.2,21
HCPCS,C1894,W INTRO CATH HEM 60D TRNSPT,70.0,45.5,11.76,63.0,21
HCPCS,C1894,W INTRO COOK CHCK,166.0,107.9,27.89,149.4,21
HCPCS,C1894,W INTRO ENDSCP 7 FR 170CM PCRV,122.0,79.3,20.5,109.8,21
HCPCS,C1894,W INTRO EP IC N-L,83.0,53.95,13.94,74.7,21
HCPCS,C1894,W INTRO EP IC NL2,332.0,215.8,55.78,298.8,21
HCPCS,C1894,W INTRO HEMO FAST CATH LUER LK,16.0,10.4,2.69,14.4,21
HCPCS,C1894,W INTRO HMSTS DISTL GW GSPC,210.0,136.5,35.28,189.0,21
HCPCS,C1894,W INTRO LD VLV TEARWY SFSHTH,68.0,44.2,11.42,61.2,21
HCPCS,C1894,W INTRO LG RB 16F 0.038IN 30IN,140.0,91.0,23.52,126.0,21
HCPCS,C1894,W INTRO MICRO NITINOL GW,67.0,43.55,11.26,60.3,21
HCPCS,C1894,W INTRO MICRO SHTH STD SS PT,65.0,42.25,10.92,58.5,21
HCPCS,C1894,W INTRO MPNCH NITINOL GW,62.0,40.3,10.42,55.8,21
HCPCS,C1894,W INTRO SET MPNCH 4FR CATH,68.0,44.2,11.42,61.2,21
HCPCS,C1894,W INTRO SHTH 23FR 55.7CM MICRA,1200.0,780.0,201.6,1080.0,21
HCPCS,C1894,W INTRO SHTH 4FR MPNCH PDL,79.0,51.35,13.27,71.1,21
HCPCS,C1894,W INTRO SHTH CLASSIC,82.0,53.3,13.78,73.8,21
HCPCS,C1894,W INTRO SHTH FLEXOR CHECK-FLO,105.0,68.25,17.64,94.5,21
HCPCS,C1894,W INTRO SHTH FLEXOR TOUHY-BORST,144.0,93.6,24.19,129.6,21
HCPCS,C1894,W INTRO SHTH FLX CHK FLO II,102.0,66.3,17.14,91.8,21
HCPCS,C1894,W INTRO SHTH RING TRANSJUGULAR,578.0,375.7,97.1,520.2,21
HCPCS,C1894,W INTRO/SHEATH 7FRX13CM,507.0,329.55,85.18,456.3,21
HCPCS,C1894,W INTRODCER SHEATH PERITNL 61CM,58.0,37.7,9.74,52.2,21
HCPCS,C1894,W INTRODUCER 12F 0.038IN 13CM,68.0,44.2,11.42,61.2,21
HCPCS,C1894,W INTRODUCER SHEATH 12FRX30CM,149.0,96.85,25.03,134.1,21
HCPCS,C1894,W INTRODUCR W/HEMO 7F 0.035IN,76.0,49.4,12.77,68.4,21
HCPCS,C1894,W LEAD INTRO KT INTRSTIM 355018,420.0,273.0,70.56,378.0,21
HCPCS,C1894,W MARKER INTRODUCER SYSTEM,173.0,112.45,29.06,155.7,21
HCPCS,C1894,W MICRO-INTRODUCER KIT 4FR,56.0,36.4,9.41,50.4,21
HCPCS,C1894,W NEEDLE ACC TRNSJUG 10F 40CM,525.0,341.25,88.2,472.5,21
HCPCS,C1894,W SHEATH 10.5FR TEARAWAY PORT,123.0,79.95,20.66,110.7,21
HCPCS,C1894,W SHEATH 15CM PEEL-WY INTRDUCR,43.0,27.95,7.22,38.7,21
HCPCS,C1894,W SHEATH 30CM GALT PTFE INTRDCR,75.0,48.75,12.6,67.5,21
HCPCS,C1894,W SHEATH 35CM BRITE TIP,50.0,32.5,8.4,45.0,21
HCPCS,C1894,W SHEATH 45/55CM BRITE TIP,62.0,40.3,10.42,55.8,21
HCPCS,C1894,W SHEATH 6FR PINNACLE 25 CM,63.0,40.95,10.58,56.7,21
HCPCS,C1894,W SHEATH 7F TEARAWAY SIDEPORT,128.0,83.2,21.5,115.2,21
HCPCS,C1894,W SHEATH 7FR 45CM GUID STR,143.0,92.95,24.02,128.7,21
HCPCS,C1894,W SHEATH 8FR PINNACLE INTRDCR,69.0,44.85,11.59,62.1,21
HCPCS,C1894,W SHEATH 9FR TEARAWAY SIDE PORT,138.0,89.7,23.18,124.2,21
HCPCS,C1894,W SHEATH CHECK-FLO PFRMR SET,196.0,127.4,32.93,176.4,21
HCPCS,C1894,W SHEATH DIALEASE INTRDCR,35.0,22.75,5.88,31.5,21
HCPCS,C1894,W SHEATH DILATOR 8/10 260120,109.0,70.85,18.31,98.1,21
HCPCS,C1894,W SHEATH FLEX 7F X 24CM,85.0,55.25,14.28,76.5,21
HCPCS,C1894,W SHEATH FLEX SUPER ARROW 45CM,123.0,79.95,20.66,110.7,21
HCPCS,C1894,W SHEATH FLEXOR BLKN/ANSL SET,103.0,66.95,17.3,92.7,21
HCPCS,C1894,W SHEATH GALT PTFE MICROACCESS,42.0,27.3,7.06,37.8,21
HCPCS,C1894,W SHEATH GALT PTFE TRWY INTRDCR,42.0,27.3,7.06,37.8,21
HCPCS,C1894,W SHEATH GALT SPECIAL PTFE,88.0,57.2,14.78,79.2,21
HCPCS,C1894,W SHEATH HEMST VALVE SDPRT DLTR,31.0,20.15,5.21,27.9,21
HCPCS,C1894,W SHEATH INTRO CK FLO,153.0,99.45,25.7,137.7,21
HCPCS,C1894,W SHEATH INTRO GORE 18F X 30CM,219.0,142.35,36.79,197.1,21
HCPCS,C1894,W SHEATH INTRO PINNACLE 10CM,16.0,10.4,2.69,14.4,21
HCPCS,C1894,W SHEATH INTRODUCER 4FR X 11CM,16.0,10.4,2.69,14.4,21
HCPCS,C1894,W SHEATH LONG 7FR X 45CM MULTI,88.0,57.2,14.78,79.2,21
HCPCS,C1894,W SHEATH MINI TEAR AWAY,315.0,204.75,52.92,283.5,21
HCPCS,C1894,W SHEATH PEELAWAY 16F X 30CM,79.0,51.35,13.27,71.1,21
HCPCS,C1894,W SHEATH PINNACLE DESTINATION,143.0,92.95,24.02,128.7,21
HCPCS,C1894,W SHEATH RB BLKN 8F 40CM FLEXOR,74.0,48.1,12.43,66.6,21
HCPCS,C1894,W SHEATH SET W/INTGR HEMOSTASIS,84.0,54.6,14.11,75.6,21
HCPCS,C1894,W SHEATH SHUTTLE FLEXOR TOUHY,202.0,131.3,33.94,181.8,21
HCPCS,C1894,W SHEATH TEARAWAY 7F 13CM,60.0,39.0,10.08,54.0,21
HCPCS,C1894,W SHEATH TEARAWAY 9FRX25CM,110.0,71.5,18.48,99.0,21
HCPCS,C1894,W SHEATH URET NAVIGATOR ACCESS,220.0,143.0,36.96,198.0,21
HCPCS,C1894,W SHEATH URT ACC 9.5F 28CM HYDR,222.0,144.3,37.3,199.8,21
HCPCS,C1894,W SHETH CK FLO (RCFW180P3840RB),225.0,146.25,37.8,202.5,21
HCPCS,C1894,W SHTH HEMST VLV SIDEPORT DLTR,38.0,24.7,6.38,34.2,21
HCPCS,C1894,W SHTH TEARAWAY PORT 20CM DLTR,123.0,79.95,20.66,110.7,21
HCPCS,C1894,W SYS ROTLNK ADVN,300.0,195.0,50.4,270.0,21
HCPCS,C18940,"Intro/sheath, non-laser",,,104.55,104.55,1
HCPCS,C1895,"Lead, aicd, endo dual coil",,,11156.4,11156.4,1
HCPCS,C1895,W IMP LD CARDV-DF 0184 ENDO REL,8500.0,5525.0,1428.0,8330.0,35
HCPCS,C1895,W LEAD DURATA AICD DUAL COIL,6000.0,3900.0,1008.0,5880.0,35
HCPCS,C1895,W LEAD ENDOTAK RELIANCE G,6000.0,3900.0,1008.0,5880.0,35
HCPCS,C1895,W LEAD ICD SPRINT QUATTRO SECUR,6600.0,4290.0,1108.8,6468.0,35
HCPCS,C1895,W LEAD OPTISR DFB OPTM INSLTN,6000.0,3900.0,1008.0,5880.0,35
HCPCS,C18950,"Lead, aicd, endo dual coil",,,11156.4,11156.4,1
HCPCS,C1896,MEDTRONIC 63CM CARDIAC DEFIBRILLATOR LEAD,21560.0,14014.0,3622.08,19404.0,33
HCPCS,C1896,W BIPOLAR DEFIB. LEAD 6931,8500.0,5525.0,1428.0,8330.0,35
HCPCS,C1896,W ELECTRODE Q-TRAK,8000.0,5200.0,1344.0,7840.0,35
HCPCS,C1896,W IMP LD CARDV/DF,2822.0,1834.3,474.1,2765.56,32
HCPCS,C1896,W IMP LD CARDV/DF 6931 BIPLOAR,8500.0,5525.0,1428.0,8330.0,35
HCPCS,C1896,W LD ENDTK SQ ARRY XP MODEL0085,7550.0,4907.5,1268.4,7399.0,35
HCPCS,C1896,W LD ICD DF1 TRANSVENE 65CM,2400.0,1560.0,403.2,2352.0,32
HCPCS,C1896,W LEAD DBS 1-4ELECT,6476.0,4209.4,1087.97,6346.48,35
HCPCS,C1896,W LEAD PACE 58CM 7.5FR SUBQ,3200.0,2080.0,537.6,3136.0,32
HCPCS,C1897,"Lead, neurostim test kit",,,768.39,768.39,1
HCPCS,C1897,W IMP LD NSTM TST,950.0,617.5,159.6,931.0,29
HCPCS,C1897,W KT STM INTERSTM,915.0,594.75,153.72,896.7,29
HCPCS,C1897,W LEAD KIT MEDT ACTIVA DBS 40CM,5950.0,3867.5,999.6,5831.0,35
HCPCS,C1897,W LEAD KIT TST INTERSTM 3065USC,610.0,396.5,102.48,597.8,29
HCPCS,C1897,W LEAD TEST STIM 30576SC,1380.0,897.0,231.84,1352.4,29
HCPCS,C1897,W LEAD TST OCT STIM/SC TRL,2780.0,1807.0,467.04,2724.4,32
HCPCS,C1897,W LEAD TST STIM 30571SC,230.0,149.5,38.64,225.4,29
HCPCS,C1897,W LEAD TST STIM PK TL22,840.0,546.0,141.12,823.2,29
HCPCS,C1897,W TEMP LEAD PACE 200CM BPLR,560.0,364.0,94.08,548.8,29
HCPCS,C18970,"Lead, neurostim test kit",,,768.39,768.39,1
HCPCS,C1898,"CAPSURE SENSE, TRANSVENOUS TINED PACING LEAD, STERIOD ELUTING, B",850.0,552.5,142.8,833.0,29
HCPCS,C1898,ISOFLEX OPTIM PASSIVE-FIXATION LEAD BIPOLAR J-SHAPED IS-1 7FR X,604.0,392.6,101.47,543.6,27
HCPCS,C1898,LEAD PACE STR ATR MRI,680.0,442.0,114.24,666.4,29
HCPCS,C1898,LEAD PM CAPSUREFIX,794.0,516.1,133.39,778.12,29
HCPCS,C1898,"Lead, pmkr, other than trans",,,1304.53,1304.53,1
HCPCS,C1898,SOLIA S 45 PACEMAKER LEAD,778.0,505.7,130.7,762.44,29
HCPCS,C1898,SOLIA S 53 PACEMAKER LEAD,563.0,365.95,94.58,551.74,29
HCPCS,C1898,SOLIA S 60  PACEMAKER LEAD,778.0,505.7,130.7,762.44,29
HCPCS,C1898,"TERMINAL CAPS, MODEL 4033",108.0,70.2,18.14,97.2,27
HCPCS,C1898,ULTIPACE PACING LEAD,500.0,325.0,84.0,490.0,29
HCPCS,C1898,W LD FNLINEII STRX EZ4472/4473,720.0,468.0,120.96,705.6,29
HCPCS,C1898,W LD PM CAPSR FIX,794.0,516.1,133.39,778.12,29
HCPCS,C1898,W LD PM CAPSUR SP,3123.0,2029.95,524.66,3060.54,32
HCPCS,C1898,W LD PM CAPSURE,2614.0,1699.1,439.15,2561.72,32
HCPCS,C1898,W LD PM ENDOCARDIAL FLEXION,730.0,474.5,122.64,715.4,29
HCPCS,C1898,W LD PM FLEXION,2751.0,1788.15,462.17,2695.98,32
HCPCS,C1898,W LD PM SELUTE,2751.0,1788.15,462.17,2695.98,32
HCPCS,C1898,W LD PMDX1336T/52,2227.0,1447.55,374.14,2182.46,32
HCPCS,C1898,W LD PMDX1388T/85,2227.0,1447.55,374.14,2182.46,32
HCPCS,C1898,W LD PMSDX1488T52,2227.0,1447.55,374.14,2182.46,32
HCPCS,C1898,W LEAD ELAFIX P2P 752,1000.0,650.0,168.0,980.0,29
HCPCS,C1898,W LEAD ELAFIX P2P 758,1000.0,650.0,168.0,980.0,29
HCPCS,C1898,W LEAD PACE 45CM ATR VENT BPLR,794.0,516.1,133.39,778.12,29
HCPCS,C1898,W LEAD PACE SETROX S BRDYCRD,720.0,468.0,120.96,705.6,29
HCPCS,C1898,W LEAD PACEMAKER 1699,730.0,474.5,122.64,715.4,29
HCPCS,C1898,W LEAD PACING DEXTRUS STRD ELUT,720.0,468.0,120.96,705.6,29
HCPCS,C1898,W LEAD PM INGEVITY MRI IS-1,680.0,442.0,114.24,666.4,29
HCPCS,C1898,W LEAD PM SELECTSECURE,794.0,516.1,133.39,778.12,29
HCPCS,C1898,W LEAD PM TENDRIL 1788,730.0,474.5,122.64,715.4,29
HCPCS,C1898,W LEAD PM TENDRIL SDX/STS,544.0,353.6,91.39,533.12,29
HCPCS,C1898,W LEAD TENDRIL 1788-52,858.0,557.7,144.14,840.84,29
HCPCS,C18980,"Lead, pmkr, other than trans",,,1304.53,1304.53,1
HCPCS,C1900,ATTAIN PERFORMA S QUAD TRANSVENOUS LEAD STR 88CM,3000.0,1950.0,504.0,2940.0,32
HCPCS,C1900,ATTAIN STABILITY QUAD MRI SURESCAN LV PACING LEAD,3862.0,2510.3,648.82,3784.76,32
HCPCS,C1900,LEAD PACE ACTY X4 STP SPR 95CM,2450.0,1592.5,411.6,2401.0,32
HCPCS,C1900,"Lead, coronary venous",,,5135.4,5135.4,1
HCPCS,C1900,SENTUS PRO MRI,3650.0,2372.5,613.2,3577.0,32
HCPCS,C1900,W LD LFT VNT COR2,7600.0,4940.0,1276.8,7448.0,35
HCPCS,C1900,W LEAD ACUITY 4554-4555,4200.0,2730.0,705.6,4116.0,32
HCPCS,C1900,W LEAD ACUITY SPIRAL 4591-4593,2350.0,1527.5,394.8,2303.0,32
HCPCS,C1900,W LEAD ATTAIN LFT VENT COR,3300.0,2145.0,554.4,3234.0,32
HCPCS,C1900,W LEAD ATTAIN OTW STARFIX 4195,3000.0,1950.0,504.0,2940.0,32
HCPCS,C1900,W LEAD ATTN ABILITY MULTPLR,2794.0,1816.1,469.39,2738.12,32
HCPCS,C1900,W LEAD CORONARY VENOUS 4555,7528.0,4893.2,1264.7,7377.44,35
HCPCS,C1900,W LEAD EASYTRAK LFT VENT COR,4200.0,2730.0,705.6,4116.0,32
HCPCS,C1900,W LEAD PACE ACUITY X4 LV,2450.0,1592.5,411.6,2401.0,32
HCPCS,C1900,W LEAD PACE ATTN IS4 C CRV,3234.0,2102.1,543.31,3169.32,32
HCPCS,C1900,W LEAD PACE ATTN IS4 S CRV,3234.0,2102.1,543.31,3169.32,32
HCPCS,C1900,W LEAD PACE LV QUARTET,2720.0,1768.0,456.96,2665.6,32
HCPCS,C1900,W LEAD QUICKFLEX 1158T,3000.0,1950.0,504.0,2940.0,32
HCPCS,C1900,W LEAD QUICKFLEX LFT VENT COR,2350.0,1527.5,394.8,2303.0,32
HCPCS,C1900,W LEAD QUICKSITE LEFT HEART,2550.0,1657.5,428.4,2499.0,32
HCPCS,C19000,"Lead, coronary venous",,,5135.4,5135.4,1
HCPCS,C2596,"Probe, robotic, water-jet",,,5140.04,5140.04,1
HCPCS,C25960,"Probe, robotic, water-jet",,,5140.04,5140.04,1
HCPCS,C2614,"Probe, perc lumb disc",,,2413.37,2413.37,1
HCPCS,C26140,"Probe, perc lumb disc",,,2413.37,2413.37,1
HCPCS,C2615,"Sealant, pulmonary, liquid",,,1215.92,1215.92,1
HCPCS,C26150,"Sealant, pulmonary, liquid",,,1215.92,1215.92,1
HCPCS,C2616,"Brachytx, non-str,yttrium-90",,,21565.72,21565.72,1
HCPCS,C2616,"H980006 BRACHYTX,NON-STR,90 TH",33432.0,21730.8,6962.14,37910.58,54
HCPCS,C2616,YTTRIUM-90,33000.0,21450.0,6962.14,37910.58,54
HCPCS,C26160,"Brachytx, non-str,yttrium-90",,,21565.72,21565.72,1
HCPCS,C2617,STENT BIL 7FR 5CM POLYETH C-L,90.0,58.5,15.12,88.2,29
HCPCS,C2617,STENT PANCREATIC 5FR X 3CM,154.0,100.1,25.87,150.92,29
HCPCS,C2617,"Stent, non-cor, tem w/o del",,,183.88,183.88,1
HCPCS,C2617,W STENT BIL ADVANIX 2 PGTL CRV,102.0,66.3,17.14,99.96,29
HCPCS,C2617,W STENT BILIARY ADVANIX PGTL,154.0,100.1,25.87,150.92,29
HCPCS,C2617,W STENT SOF-FLEX DOUBLE PIGTL,209.0,135.85,35.11,204.82,29
HCPCS,C2617,W STENT UR DIVERSION 7FR 90CM,260.0,169.0,43.68,254.8,29
HCPCS,C2617,W STENT URETH POLARIS,406.0,263.9,68.21,397.88,29
HCPCS,C2617,W STENT UROPASS URETERL 12FRX54,974.0,633.1,163.63,876.6,21
HCPCS,C2617,W STNT PERCU SFT,718.0,466.7,120.62,703.64,29
HCPCS,C2617,W STNT U PERCUFLX,212.0,137.8,35.62,207.76,29
HCPCS,C26170,"Stent, non-cor, tem w/o del",,,183.88,183.88,1
HCPCS,C2618,PROBE CRYABL 10CM CRYOICE MAL,2295.0,1491.75,385.56,2065.5,21
HCPCS,C2618,"Probe/needle, cryo",,,245.16,245.16,1
HCPCS,C2618,W NEEDLE CRYO SEEDNET ICEROD EA,844.0,548.6,141.79,759.6,21
HCPCS,C2618,W PROBE CRYOABLAT,3875.5,2519.0750000000003,104.5,6416.1,42
HCPCS,C2618,W PROBE/NEEDLE CRYOABLATION,1823.0,1184.95,306.26,1640.7,21
HCPCS,C26180,"Probe/needle, cryo",,,245.16,245.16,1
HCPCS,C2619,W PM PULSAR DDD,17588.0,11432.2,2954.78,17236.24,35
HCPCS,C2620,W PM SC NRATE-RES,10396.0,6757.4,1746.53,10188.08,35
HCPCS,C2621,CARDIAC RESYNCHRONIZATION THERAPY PACEMAKER,11136.0,7238.4,1870.85,10913.28,35
HCPCS,C2621,EDORA 8 HF-T QP CRT-P,10400.0,6760.0,1747.2,10192.0,35
HCPCS,C2621,PACEMAKER CONSULTA CRT-P,14000.0,9100.0,2352.0,13720.0,35
HCPCS,C2621,PACEMAKER QUADRA ALLURE MP BIVEN PULSE GEN 2 CHAMBER,9478.0,6160.7,1592.3,9288.44,35
HCPCS,C2621,PACEMKR PERCEPTA MRI QUAD DF,12936.0,8408.4,2173.25,12677.28,35
HCPCS,C2621,PACEMKR SERENA MRI QUAD DF,12650.0,8222.5,2125.2,12397.0,35
HCPCS,C2621,"Pmkr, other than sing/dual",,,9493.2,9493.2,1
HCPCS,C2621,"QUADRA ALLURE MP CARDIAC RESYNCH THERAPY DEVICE, PULSE GEN DDDRV",7900.0,5135.0,1327.2,7742.0,35
HCPCS,C2621,"VISIONIST X4 CRT-P, MODEL U228",10124.0,6580.6,1700.83,9921.52,35
HCPCS,C2621,W PACEMAKER CONTAK RENEWAL H120,12600.0,8190.0,2116.8,12348.0,35
HCPCS,C2621,W PACEMAKER CONTAK RENEWAL H125,12600.0,8190.0,2116.8,12348.0,35
HCPCS,C2621,W PACEMAKER INSYNC III 8042,13600.0,8840.0,2284.8,13328.0,35
HCPCS,C2621,W PACEMAKER INTUA CRT P LV1,8624.0,5605.6,1448.83,8451.52,35
HCPCS,C2621,W PACEMAKER INTUA CRT-P IS-1,9800.0,6370.0,1646.4,9604.0,35
HCPCS,C2621,W PACEMAKER VIVA CRT-P,13700.0,8905.0,2301.6,13426.0,35
HCPCS,C2621,W PACER DC FRONTIER II 5586,13600.0,8840.0,2284.8,13328.0,35
HCPCS,C2621,W PM ALLURE QUADRA RF,7600.0,4940.0,1276.8,7448.0,35
HCPCS,C2621,W PM ANTHEM CRT,13200.0,8580.0,2217.6,12936.0,35
HCPCS,C2621,W PM INSYNC III DC 8042,16200.0,10530.0,2721.6,15876.0,35
HCPCS,C2621,W PM INVIVE IS-1 CONN RSYN,13200.0,8580.0,2217.6,12936.0,35
HCPCS,C2621,W PM NOT SC/DC,28812.0,18727.8,4840.42,28235.76,35
HCPCS,C2621,W PM VALITUDE X4 IS-4,8624.0,5605.6,1448.83,8451.52,35
HCPCS,C26210,"Pmkr, other than sing/dual",,,9493.2,9493.2,1
HCPCS,C2622,W PROS PENILE N-I,13818.0,8981.7,2321.42,13541.64,35
HCPCS,C2623,"Cath, translumin, drug-coat",,,7039.44,7039.44,1
HCPCS,C2623,W CATH BLN OTW LUTONIX COATED,2565.0,1667.25,430.92,2308.5,21
HCPCS,C2623,W CATH IN.PACT ADMIRAL DCB,1604.0,1042.6,269.47,1443.6,21
HCPCS,C2623,W CATH INPACT ADMIRAL DCB/DEB,1796.0,1167.4,301.73,1616.4,21
HCPCS,C26230,"Cath, translumin, drug-coat",,,7039.44,7039.44,1
HCPCS,C2624,CARDIOMEMS SENSOR/DELIV SYSTEM,35000.0,22750.0,5880.0,34300.0,35
HCPCS,C2624,G190020 CORDELLA PULM ART SENSOR,24500.0,15925.0,4116.0,22050.0,21
HCPCS,C2625,STENT BIL 10FR 10CM .035IN,242.0,157.3,40.66,237.16,29
HCPCS,C2625,STENT BIL 7FR 12CM PLAS RX BL,205.0,133.25,34.44,200.9,29
HCPCS,C2625,STENT PROPEL SINUS IMPLANT,1590.0,1033.5,267.12,1558.2,29
HCPCS,C2625,"Stent, non-cor, tem w/del sy",,,197.91,197.91,1
HCPCS,C2625,W STENT BIL DDNL BND RX,258.0,167.7,43.34,252.84,29
HCPCS,C2625,W STENT BILIARY ZIMMON,211.0,137.15,35.45,206.78,29
HCPCS,C2625,W STENT OASIS PRLDED CTTN LEUNG,202.0,131.3,33.94,197.96,29
HCPCS,C2625,W STENT RX BILIARY SET,186.0,120.9,31.25,182.28,29
HCPCS,C2625,W STENT URET INLAY OPTIMA,134.0,87.1,22.51,131.32,29
HCPCS,C26250,"Stent, non-cor, tem w/del sy",,,197.91,197.91,1
HCPCS,C2626,"Infusion pump, non-prog,temp",,,1121.62,1121.62,1
HCPCS,C26260,"Infusion pump, non-prog,temp",,,1121.62,1121.62,1
HCPCS,C2627,"Cath, suprapubic/cystoscopic",,,54.0,54.0,1
HCPCS,C2627,W BALLOON SPRPUB PERC RUTNER,63.0,40.95,10.58,56.7,21
HCPCS,C2627,W CATH BLN OB/GYN,1319.0,857.35,221.59,1187.1,21
HCPCS,C2627,W CATH CYSTO,208.0,135.2,34.94,187.2,21
HCPCS,C2627,W CATH SUPRAPUBIC,353.0,229.45,59.3,317.7,21
HCPCS,C2627,W CATH SUPRPUB/CY,155.0,100.75,26.04,139.5,21
HCPCS,C2627,W STNT U INLAY DB,425.0,276.25,71.4,416.5,29
HCPCS,C26270,"Cath, suprapubic/cystoscopic",,,54.0,54.0,1
HCPCS,C2628,CATH BLLN OCC BRIDGE 90CM 20MM,1275.0,828.75,214.2,1147.5,21
HCPCS,C2628,"Catheter, occlusion",,,219.76,219.76,1
HCPCS,C2628,W BALLOON CATH COOK G31236,543.0,352.95,91.22,488.7,21
HCPCS,C2628,W CATH ANGIO OCCLSN VNGR BLN,133.0,86.45,22.34,119.7,21
HCPCS,C2628,W CATH BLLN HYPERFORM 7MMX150CM,1755.0,1140.75,294.84,1579.5,21
HCPCS,C2628,W CATH BLLN LUMEN BRNSTN OCCLSN,357.0,232.05,59.98,321.3,21
HCPCS,C2628,W CATH BLLN OCCL SCEPTER,1833.0,1191.45,307.94,1649.7,21
HCPCS,C2628,W CATH BLLN OCCLUSION 10FX35CM,543.0,352.95,91.22,488.7,21
HCPCS,C2628,W CATH BLN PCC 10F 35MM 120/40,603.0,391.95,101.3,542.7,21
HCPCS,C26280,"Catheter, occlusion",,,219.76,219.76,1
HCPCS,C2629,"Intro/sheath, laser",,,114.48,114.48,1
HCPCS,C2629,W SHEATH LASER SLSII,3051.0,1983.15,512.57,2745.9,21
HCPCS,C2629,W SHTH LSR 50CM 14FR GLIDLGHT,3726.0,2421.9,625.97,3353.4,21
HCPCS,C2629,W SHTH LSR500-001,70.0,45.5,11.76,63.0,21
HCPCS,C26290,"Intro/sheath, laser",,,114.48,114.48,1
HCPCS,C2630,CATH ABLT 115CM 8FR 3.5MM,3645.0,2369.25,612.36,3280.5,21
HCPCS,C2630,"Cath, ep, cool-tip",,,3247.43,3247.43,1
HCPCS,C2630,EZ STEER 7.5FR X 115CM 3.5MM SENSOR THERMOCOOL BI-DIRECTIONAL AB,4125.0,2681.25,693.0,3712.5,21
HCPCS,C2630,"FLEXABILITY SENSOR ENABLED ABLATION CATHETER 8F, D-F CURVE, 2.7M",2498.0,1623.7,419.66,2248.2,21
HCPCS,C2630,W CATH ABL QT TACTICATH,2970.0,1930.5,498.96,2673.0,21
HCPCS,C2630,W CATH ABLT FLX 115CM 8FR 4MM,2228.0,1448.2,374.3,2005.2,21
HCPCS,C2630,W CATH EP ABLT THRMCL BIDIRECT,2037.0,1324.05,342.22,1833.3,21
HCPCS,C2630,W CATH EP COOLTIP,1418.0,921.7,238.22,1276.2,21
HCPCS,C26300,"Cath, ep, cool-tip",,,3247.43,3247.43,1
HCPCS,C2631,"Rep dev, urinary, w/o sling",,,1896.23,1896.23,1
HCPCS,C2631,W DEV CAPIO SUT,2126.0,1381.9,357.17,2083.48,32
HCPCS,C2631,W DEVICE CAPIO REPAIR WO SLING,650.0,422.5,109.2,637.0,29
HCPCS,C26310,"Rep dev, urinary, w/o sling",,,1896.23,1896.23,1
HCPCS,C2634,"Brachytx, non-str, ha, i-125",,,163.46,2050.09,21
HCPCS,C26340,"Brachytx, non-str, ha, i-125",,,229.86,229.86,1
HCPCS,C2635,"Brachytx, non-str, ha, p-103",,,53.79,177.28,21
HCPCS,C26350,"Brachytx, non-str, ha, p-103",,,53.79,53.79,1
HCPCS,C2636,"Brachy linear, non-str,p-103",,,53.11,2050.09,21
HCPCS,C26360,"Brachy linear, non-str,p-103",,,57.5,57.5,1
HCPCS,C2637,"Brachy,non-str,ytterbium-169",,,140.34,177.28,6
HCPCS,C2638,"BRACHY SOURCE TX, STRANDED I-125",210.0,136.5,36.04,205.8,45
HCPCS,C2638,"Brachytx, stranded, i-125",,,71.18,71.18,1
HCPCS,C26380,"Brachytx, stranded, i-125",,,71.18,71.18,1
HCPCS,C2639,"Brachytx, non-stranded,i-125",,,38.79,38.79,1
HCPCS,C2639,W IODINE 1-125 SEEDS NONSTRANDE,140.0,91.0,35.24,177.28,45
HCPCS,C26390,"Brachytx, non-stranded,i-125",,,38.79,38.79,1
HCPCS,C2640,"Brachytx, stranded, p-103",,,69.95,2050.09,21
HCPCS,C26400,"Brachytx, stranded, p-103",,,156.22,156.22,1
HCPCS,C2641,"Brachytx, non-stranded,p-103",,,3.72,3.72,1
HCPCS,C2641,W PALLADIUM NONSTRANDED SEEDS,147.0,95.55,38.07,2050.09,45
HCPCS,C26410,"Brachytx, non-stranded,p-103",,,3.72,3.72,1
HCPCS,C2642,"BRACHYTHERAPY SOURCE, STRANDED, CESIUM-131, PER SOURCE",293.0,190.45,75.89,2050.09,45
HCPCS,C2642,"Brachytx, stranded, c-131",,,173.61,173.61,1
HCPCS,C26420,"Brachytx, stranded, c-131",,,173.61,173.61,1
HCPCS,C2643,"BRACHYTHERAPY SOURCE, NON-STRANDED, CESIUM-131, PER SOURCE",241.0,156.65,62.42,2050.09,45
HCPCS,C2643,"Brachytx, non-stranded,c-131",,,172.59,172.59,1
HCPCS,C26430,"Brachytx, non-stranded,c-131",,,172.59,172.59,1
HCPCS,C2644,Brachytx cesium-131 chloride,,,206.1,2050.09,7
HCPCS,C26440,Brachytx cesium-131 chloride,,,206.1,206.1,1
HCPCS,C2645,"Brachytx planar, p-103",,,4.71,177.28,21
HCPCS,C26450,"Brachytx planar, p-103",,,10.37,10.37,1
HCPCS,C2698,"Brachytx, stranded, nos",,,36.04,177.28,21
HCPCS,C26980,"Brachytx, stranded, nos",,,71.18,71.18,1
HCPCS,C2699,"Brachytx, non-stranded, nos",,,35.24,177.28,20
HCPCS,C5271,Low cost skin substitute app,,,614.44,1492.5,16
HCPCS,C5272,Low cost skin substitute app,,,1181.56,1492.5,6
HCPCS,C5273,Low cost skin substitute app,,,1181.56,3966.07,16
HCPCS,C5274,Low cost skin substitute app,,,1181.56,1492.5,6
HCPCS,C5275,Low cost skin substitute app,,,614.44,1492.5,16
HCPCS,C5276,Low cost skin substitute app,,,1181.56,1492.5,6
HCPCS,C5277,Low cost skin substitute app,,,614.44,1492.5,16
HCPCS,C5278,Low cost skin substitute app,,,1181.56,1492.5,6
HCPCS,C7500,Deb bone 20 cm2 w/drug dev,,,613.49,774.94,6
HCPCS,C7501,Perc bx breast lesions stero,,,816.59,1031.48,6
HCPCS,C7502,Perc bx breast lesions mr,,,816.59,1031.48,6
HCPCS,C7503,Open exc cerv node(s) w/ id,,,1977.31,2497.66,6
HCPCS,C7504,Perq cvt&ls inj vert bodies,,,3094.77,3909.18,6
HCPCS,C7505,Perq ls&cvt inj vert bodies,,,3094.77,3909.18,6
HCPCS,C7506,Fusion of finger joints,,,815.24,1029.78,6
HCPCS,C7507,Perq thor&lumb vert aug,,,3094.77,3909.18,6
HCPCS,C7508,Perq lumb&thor vert aug,,,3094.77,3909.18,6
HCPCS,C7509,Dx bronch w/ navigation,,,1152.77,1456.13,6
HCPCS,C7510,Bronch/lavag w/ navigation,,,1152.77,1456.13,6
HCPCS,C7511,Bronch/bpsy(s) w/ navigation,,,1152.77,1456.13,6
HCPCS,C7512,Bronch/bpsy(s) w/ ebus,,,2523.58,3187.68,6
HCPCS,C7513,Cath/angio dialcir w/aplasty,,,2417.66,3053.89,6
HCPCS,C7514,Cath/angio dial cir w/stents,,,6649.91,8399.88,6
HCPCS,C7515,Cath/angio dial cir w/embol,,,6649.91,8399.88,6
HCPCS,C7516,Cor angio w/ ivus or oct,,,1513.2,1911.41,6
HCPCS,C7517,Cor angio w/ilic/fem angio,,,1513.2,1911.41,6
HCPCS,C7518,Cor/gft angio w/ ivus or oct,,,1513.2,1911.41,6
HCPCS,C7519,Cor/gft angio w/ flow resrv,,,1513.2,1911.41,6
HCPCS,C7520,Cor/gft angio w/ilic/fem ang,,,1513.2,1911.41,6
HCPCS,C7521,R hrt angio w/ ivus or oct,,,1513.2,1911.41,6
HCPCS,C7522,R hrt angio w/flow resrv,,,1513.2,1911.41,6
HCPCS,C7523,L hrt angio w/ ivus or oct,,,1513.2,1911.41,6
HCPCS,C7524,L hrt angio w/flow resrv,,,1513.2,1911.41,6
HCPCS,C7525,L hrt gft ang w/ ivus or oct,,,1513.2,1911.41,6
HCPCS,C7526,L hrt gft ang w/flow resrv,,,1513.2,1911.41,6
HCPCS,C7527,R&l hrt angio w/ ivus or oct,,,1513.2,1911.41,6
HCPCS,C7528,R&l hrt angio w/flow resrv,,,1513.2,1911.41,6
HCPCS,C7529,R&l hrt gft ang w/flow resrv,,,1513.2,1911.41,6
HCPCS,C7530,Cath/aplasty dial cir w/stnt,,,6649.91,8399.88,6
HCPCS,C7531,Angio fem/pop w/ us,,,4153.67,5246.74,6
HCPCS,C7532,Angio w/ us non-coronary,,,5298.24,6692.51,6
HCPCS,C7533,Ptca w/ plcmt brachytx dev,,,5298.24,6692.51,6
HCPCS,C7534,Fem/pop revasc w/arthr & us,,,6649.91,8399.88,6
HCPCS,C7535,Fem/pop revasc w/stent & us,,,6649.91,8399.88,6
HCPCS,C7537,Insrt atril pm w/l vent lead,,,4706.22,5944.7,6
HCPCS,C7538,Insrt vent pm w/l vent lead,,,4706.22,5944.7,6
HCPCS,C7539,Insrt a & v pm w/l vent lead,,,4706.22,5944.7,6
HCPCS,C7540,Rmv&rplc pm dul w/l vnt lead,,,4706.22,5944.7,6
HCPCS,C7541,Ercp w/ pancreatoscopy,,,1642.89,2075.23,6
HCPCS,C7542,Ercp w/bx & pancreatoscopy,,,1642.89,2075.23,6
HCPCS,C7543,"Ercp w/otomy, pancreatoscopy",,,1642.89,2075.23,6
HCPCS,C7544,Ercp rmv calc pancreatoscopy,,,2720.71,3436.69,6
HCPCS,C7545,Exch bil cath w/ rmv calculi,,,3427.97,4330.07,6
HCPCS,C7546,Rep nph/urt cath w/dil stric,,,1770.94,2236.98,6
HCPCS,C7547,Cnvrt neph cath w/ dil stric,,,1770.94,2236.98,6
HCPCS,C7548,Exch neph cath w/ dil stric,,,1770.94,2236.98,6
HCPCS,C7549,Chge urtr stent w/ dil stric,,,1770.94,2236.98,6
HCPCS,C7550,Cysto w/ bx(s) w/ blue light,,,970.74,1226.2,6
HCPCS,C7551,Exc neuroma w/ implnt nv end,,,3157.38,3988.27,6
HCPCS,C7552,R hrt art/grft ang hrt flow,,,1513.2,1911.41,6
HCPCS,C7553,R&i hrt art/vent ang drg ad,,,1513.2,1911.41,6
HCPCS,C7554,Cystureth blu li cyst fl img,,,970.74,1226.2,6
HCPCS,C7555,Rmvl thyrd w/autotran parath,,,2719.47,3435.12,6
HCPCS,C7556,Bronch lavage w/ebus,,,2523.58,3187.68,6
HCPCS,C7557,Cor angio/vent w/ffr,,,1513.2,1911.41,6
HCPCS,C7558,Cor angio/vent w/drug admin,,,1513.2,1911.41,6
HCPCS,C7560,Ercp remove forgn body&endo,,,2720.71,3436.69,6
HCPCS,C7562,R&l hrt angio w/ffr & 3d map,,,1513.2,1911.41,6
HCPCS,C7563,Trluml ballo angiop all art,,,2417.66,3053.89,6
HCPCS,C7564,Vein mech throm w/intrvas us,,,2417.66,3053.89,6
HCPCS,C7565,Rpr aa hrn < 3 rdc w/ rmvl,,,2419.02,3055.61,6
HCPCS,C7566,Fuse finger joints w/grafts,,,815.24,1029.78,6
HCPCS,C7567,Bronch/needle bx(s) w/ nav,,,1152.77,1456.13,6
HCPCS,C7568,COR ANGIO W/ FLOW RESRV,34836.0,22643.4,1513.2,37851.0,35
HCPCS,C7568,COR ANGIO W/FLOW RESRV,3045.0,1979.25,1522.5,3045.0,12
HCPCS,C7569,PTCA W/ IVUS OR OCT,28945.5,18814.575,2851.0,46970.1,47
HCPCS,C7570,COR ANGIO W/ FFR & 3D MAP,28899.0,18784.35,1513.2,37851.0,35
HCPCS,C7570,COR ANGIO W/FFR & 3D MAP,2605.0,1693.25,1302.5,2605.0,12
HCPCS,C7571,PCTA W/ COR LITHOTRIP,32654.0,21225.1,3064.5,53261.1,47
HCPCS,C7900,"Hopd mntl hlt, 15-29 min",,,29.9,104.56,20
HCPCS,C7901,"Hopd mntl hlt, 30-60 min",,,82.77,200.56,20
HCPCS,C7903,"HOPD MNTL HLT, GRP",111.0,72.15,28.75,183.42,37
HCPCS,C8001,3d anat seg imaging preop,,,88.38,198.11,17
HCPCS,C8002,"Prep skin cell susp, automtd",,,115.89,13552.11,20
HCPCS,C8003,Imp extar knee shck absrb,,,4645.92,39872.66,20
HCPCS,C8004,Sim ang w/prs cath rad emb,,,2417.66,13260.89,10
HCPCS,C8005,Pef bronch ablt 3d nav ebus,,,2523.58,19676.76,10
HCPCS,C8006,Inst pleu-perit shnt w pump,,,2290.02,7436.52,10
HCPCS,C8007,Opn mplnt hpgls ns ary ps gn,,,11520.56,14552.29,6
HCPCS,C8008,Rv/rpl hpgls ns inc cnt pg,,,3699.03,4672.46,6
HCPCS,C8009,Rmv hpgls ns ary and pg,,,1950.92,2464.32,6
HCPCS,C8010,Pc plm pm c ctd emb prtc,,,4153.67,5246.74,6
HCPCS,C8011,Opn mplnt hpgls ns ary rec,,,11520.56,14552.29,6
HCPCS,C8012,Rv/rpl hpgls ns ary rec,,,3699.03,4672.46,6
HCPCS,C8013,Rmv hpls ns ary rec,,,1950.92,2464.32,6
HCPCS,C8900,"Mra w/cont, abd",,,285.23,859.16,25
HCPCS,C89000,"Mra w/cont, abd",,,459.68,459.68,1
HCPCS,C8900TC,"Mra w/cont, abd",,,459.68,459.68,1
HCPCS,C8901,"Mra w/o cont, abd",,,242.63,524.34,25
HCPCS,C89010,"Mra w/o cont, abd",,,270.0,270.0,1
HCPCS,C8901TC,"Mra w/o cont, abd",,,270.0,270.0,1
HCPCS,C8902,"Mra w/o fol w/cont, abd",,,285.23,859.16,25
HCPCS,C89020,"Mra w/o fol w/cont, abd",,,429.06,429.06,1
HCPCS,C8902TC,"Mra w/o fol w/cont, abd",,,429.06,429.06,1
HCPCS,C8903,"Mri w/cont, breast,  uni",,,178.69,410.0,19
HCPCS,C8903,"Mri w/cont, breast, uni",,,241.9,305.56,6
HCPCS,C89030,"Mri w/cont, breast,  uni",,,256.04,256.04,1
HCPCS,C8903TC,"Mri w/cont, breast,  uni",,,256.04,256.04,1
HCPCS,C8905,"Mri w/o fol w/cont, brst, un",,,241.9,859.16,25
HCPCS,C89050,"Mri w/o fol w/cont, brst, un",,,369.45,369.45,1
HCPCS,C8905TC,"Mri w/o fol w/cont, brst, un",,,369.45,369.45,1
HCPCS,C8906,"Mri w/cont, breast,  bi",,,358.48,859.16,19
HCPCS,C8906,"Mri w/cont, breast, bi",,,241.9,305.56,6
HCPCS,C89060,"Mri w/cont, breast,  bi",,,451.82,451.82,1
HCPCS,C8906TC,"Mri w/cont, breast,  bi",,,451.82,451.82,1
HCPCS,C8908,"Mri w/o fol w/cont, breast,",,,241.9,859.16,25
HCPCS,C89080,"Mri w/o fol w/cont, breast,",,,432.04,432.04,1
HCPCS,C8908TC,"Mri w/o fol w/cont, breast,",,,432.04,432.04,1
HCPCS,C8909,"Mra w/cont, chest",,,285.23,859.16,25
HCPCS,C89090,"Mra w/cont, chest",,,459.68,459.68,1
HCPCS,C8909TC,"Mra w/cont, chest",,,459.68,459.68,1
HCPCS,C8910,"Mra w/o cont, chest",,,242.63,524.34,25
HCPCS,C89100,"Mra w/o cont, chest",,,302.57,302.57,1
HCPCS,C8910TC,"Mra w/o cont, chest",,,302.57,302.57,1
HCPCS,C8911,"Mra w/o fol w/cont, chest",,,285.23,859.16,25
HCPCS,C89110,"Mra w/o fol w/cont, chest",,,459.0,459.0,1
HCPCS,C8911TC,"Mra w/o fol w/cont, chest",,,459.0,459.0,1
HCPCS,C8912,"Mra w/cont, lwr ext",,,285.23,859.16,25
HCPCS,C89120,"Mra w/cont, lwr ext",,,451.82,451.82,1
HCPCS,C8912TC,"Mra w/cont, lwr ext",,,451.82,451.82,1
HCPCS,C8913,"Mra w/o cont, lwr ext",,,242.63,524.34,25
HCPCS,C89130,"Mra w/o cont, lwr ext",,,287.39,287.39,1
HCPCS,C8913TC,"Mra w/o cont, lwr ext",,,287.39,287.39,1
HCPCS,C8914,"Mra w/o fol w/cont, lwr ext",,,285.23,859.16,25
HCPCS,C89140,"Mra w/o fol w/cont, lwr ext",,,459.0,459.0,1
HCPCS,C8914TC,"Mra w/o fol w/cont, lwr ext",,,459.0,459.0,1
HCPCS,C8918,"Mra w/cont, pelvis",,,285.23,859.16,25
HCPCS,C89180,"Mra w/cont, pelvis",,,459.68,459.68,1
HCPCS,C8918TC,"Mra w/cont, pelvis",,,459.68,459.68,1
HCPCS,C8919,"Mra w/o cont, pelvis",,,242.63,524.34,25
HCPCS,C89190,"Mra w/o cont, pelvis",,,287.39,287.39,1
HCPCS,C8919TC,"Mra w/o cont, pelvis",,,287.39,287.39,1
HCPCS,C8920,MR ANGIO PELVIS(MRA),7870.0,5115.5,396.0,8662.0,40
HCPCS,C8920,"Mra w/o fol w/cont, pelvis",,,285.23,859.16,25
HCPCS,C89200,"Mra w/o fol w/cont, pelvis",,,451.82,451.82,1
HCPCS,C8920TC,"Mra w/o fol w/cont, pelvis",,,451.82,451.82,1
HCPCS,C8921,TTE CONGENITAL ANOMALIES W/CONTRAST,5679.0,3691.35,284.16,5111.1,48
HCPCS,C8921,"Tte w or w/o fol w/cont, com",,,1627.56,1627.56,1
HCPCS,C89210,"Tte w or w/o fol w/cont, com",,,1627.56,1627.56,1
HCPCS,C8922,"TTE CONGENITAL ANOMALIES, LIMITED W/CONTRAST",5679.0,3691.35,284.16,5111.1,48
HCPCS,C8922,"Tte w or w/o fol w/cont, f/u",,,1002.88,1002.88,1
HCPCS,C89220,"Tte w or w/o fol w/cont, f/u",,,1002.88,1002.88,1
HCPCS,C8923,"2d tte w or w/o fol w/con,co",,,284.16,1712.98,21
HCPCS,C89230,"2d tte w or w/o fol w/con,co",,,774.98,774.98,1
HCPCS,C8924,2DTTE W CONTR LTD,2566.0,1667.9,284.16,2693.0,48
HCPCS,C8924,"2d tte w or w/o fol w/con,fu",,,376.46,376.46,1
HCPCS,C89240,"2d tte w or w/o fol w/con,fu",,,376.46,376.46,1
HCPCS,C8925,"2d tee w or w/o fol w/con,in",,,756.95,756.95,1
HCPCS,C8925,TEE W/CONTRAST 2D,5679.0,3691.35,284.16,5111.1,48
HCPCS,C89250,"2d tee w or w/o fol w/con,in",,,756.95,756.95,1
HCPCS,C8926,TEE W/CONTRAST CONGENITAL ANOMALIES,5679.0,3691.35,284.16,5111.1,48
HCPCS,C8926,"Tee w or w/o fol w/cont,cong",,,1243.86,1243.86,1
HCPCS,C89260,"Tee w or w/o fol w/cont,cong",,,1243.86,1243.86,1
HCPCS,C8927,"Tee w or w/o fol w/cont, mon",,,284.16,1712.98,21
HCPCS,C89270,"Tee w or w/o fol w/cont, mon",,,1243.86,1243.86,1
HCPCS,C8928,2D TTE W CONTR STRESS,5679.0,3691.35,284.16,5111.1,96
HCPCS,C8928,"Tte w or w/o fol w/con,stres",,,796.96,796.96,1
HCPCS,C89280,"Tte w or w/o fol w/con,stres",,,796.96,796.96,1
HCPCS,C8929,"TTE W/DOPPLER, COMPLETE W/CONT",5679.0,3691.35,284.16,5111.1,48
HCPCS,C8929,"Tte w or wo fol wcon,doppler",,,803.63,803.63,1
HCPCS,C89290,"Tte w or wo fol wcon,doppler",,,803.63,803.63,1
HCPCS,C8930,STRESS ECHO W/CONTRAST,5679.0,3691.35,284.16,5111.1,48
HCPCS,C8930,"Tte w or w/o contr, cont ecg",,,835.42,835.42,1
HCPCS,C89300,"Tte w or w/o contr, cont ecg",,,835.42,835.42,1
HCPCS,C8931,"Mra, w/dye, spinal canal",,,285.23,2078.84,25
HCPCS,C89310,"Mra, w/dye, spinal canal",,,2078.84,2078.84,1
HCPCS,C8931TC,"Mra, w/dye, spinal canal",,,2078.84,2078.84,1
HCPCS,C8932,"Mra, w/o dye, spinal canal",,,236.1,524.34,25
HCPCS,C89320,"Mra, w/o dye, spinal canal",,,236.1,236.1,1
HCPCS,C8932TC,"Mra, w/o dye, spinal canal",,,236.1,236.1,1
HCPCS,C8933,"Mra, w/o&w/dye, spinal canal",,,285.23,2078.84,25
HCPCS,C89330,"Mra, w/o&w/dye, spinal canal",,,2078.84,2078.84,1
HCPCS,C8933TC,"Mra, w/o&w/dye, spinal canal",,,2078.84,2078.84,1
HCPCS,C8934,"Mra, w/dye, upper extremity",,,256.04,859.16,25
HCPCS,C89340,"Mra, w/dye, upper extremity",,,256.04,256.04,1
HCPCS,C8934TC,"Mra, w/dye, upper extremity",,,256.04,256.04,1
HCPCS,C8935,"Mra, w/o dye, upper extr",,,236.1,524.34,25
HCPCS,C89350,"Mra, w/o dye, upper extr",,,236.1,236.1,1
HCPCS,C8935TC,"Mra, w/o dye, upper extr",,,236.1,236.1,1
HCPCS,C8936,"Mra, w/o&w/dye, upper extr",,,256.04,859.16,25
HCPCS,C89360,"Mra, w/o&w/dye, upper extr",,,256.04,256.04,1
HCPCS,C8936TC,"Mra, w/o&w/dye, upper extr",,,256.04,256.04,1
HCPCS,C8937,Cad breast mri,,,378.51,378.51,1
HCPCS,C8937,MRI BREAST 3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1663.0,1080.95,279.38,1903.0,21
HCPCS,C89370,Cad breast mri,,,378.51,378.51,1
HCPCS,C8957,"PROLONGED IV INF, REQ PUMP",1649.5,1072.175,192.15,2145.6,96
HCPCS,C8957,"Prolonged iv inf, req pump",,,327.16,327.16,1
HCPCS,C89570,"Prolonged iv inf, req pump",,,327.16,327.16,1
HCPCS,C9046,COCAINE 4 % NASAL SOLUTION,193.8,125.97,4.66,193.8,23
HCPCS,C9046,Cocaine hcl nasal (goprelto),,,1.84,1.84,1
HCPCS,C90460,Cocaine hcl nasal (goprelto),,,1.84,1.84,1
HCPCS,C9047,CABLIVI 11 MG INJECTION KIT,32092.38,20860.05,802.25,32092.38,38
HCPCS,C9047,"Injection, caplacizumab-yhdp",,,807.92,807.92,1
HCPCS,C90470,"Injection, caplacizumab-yhdp",,,807.92,807.92,1
HCPCS,C9055,"Inj, brexanolone",,,2697.73,3407.66,6
HCPCS,C9061,"Injection, teprotumumab-trbw",,,10052.3,12697.64,6
HCPCS,C9062,Daratumumab hyaluronidase,,,2562.41,3236.72,6
HCPCS,C9063,"Injection, eptinezumab-jjmr",,,97.89,123.65,6
HCPCS,C9064,Mitomycin pyelocalyceal inst,,,10052.3,12697.64,6
HCPCS,C9065,Romidepsin non-lyophilized,,,1073.13,1355.53,6
HCPCS,C9066,Sacituzumab govitecan-hziy,,,2697.73,3407.66,6
HCPCS,C9067,Gallium ga-68 dotatoc,,,3.61,19.92,21
HCPCS,C90670,Gallium ga-68 dotatoc,,,7.85,7.85,1
HCPCS,C9069,Belantamab mafodontin-blmf,,,4469.75,5646.0,6
HCPCS,C9070,"Injection, tafasitamab-cxix",,,2562.41,3236.72,6
HCPCS,C9071,"Injection, viltolarsen",,,10052.3,12697.64,6
HCPCS,C9072,"Inj, imm glob asceniv",,,746.88,943.43,6
HCPCS,C9073,Brexucabtagene autoleucel ca,,,24125.92,30474.84,6
HCPCS,C9074,"Injection, lumasiran",,,10052.3,12697.64,6
HCPCS,C9075,"Injection, casimersen, 10 mg",,,10052.3,12697.64,6
HCPCS,C9076,Lisocabtagene car pos t,,,24125.92,30474.84,6
HCPCS,C9077,Inj cabotegravir/rilpivirine,,,2562.41,3236.72,6
HCPCS,C9078,"Inj, trilaciclib, 1 mg",,,516.7,652.67,6
HCPCS,C9079,"Inj, evinacumab-dgnb, 5 mg",,,2697.73,3407.66,6
HCPCS,C9080,"Inj, melphalan flufen, 1 mg",,,4469.75,5646.0,6
HCPCS,C9081,Idecabtagene car pos t,,,24125.92,30474.84,6
HCPCS,C9082,"Inj dostarlimab-gxly, 100 mg",,,4469.75,5646.0,6
HCPCS,C9083,"Inj, amivantamab-vmjw, 10 mg",,,2697.73,3407.66,6
HCPCS,C9084,"Loncastuximab-lpyl, 0.1 mg",,,10052.3,12697.64,6
HCPCS,C9085,Inj avalglucosid alfa-ngpt,,,14450.94,18253.82,6
HCPCS,C9086,"Inj, anifrolumab-fnia",,,1073.13,1355.53,6
HCPCS,C9087,Inj cyclophosphamd auromedic,,,74.65,94.3,6
HCPCS,C9088,"Instill, bupivac and meloxic",,,0.77,1.66,13
HCPCS,C9089,"Bupivacaine implant, 1 mg",,,0.85,2.19,13
HCPCS,C9090,"Plasminogen, human-tvmh 1 mg",,,31.1,383.26,10
HCPCS,C90900,"Plasminogen, human-tvmh 1 mg",,,31.1,31.1,1
HCPCS,C9091,"Sirolimus, protein-bound,1mg",,,70.35,5646.0,10
HCPCS,C90910,"Sirolimus, protein-bound,1mg",,,70.35,70.35,1
HCPCS,C9092,"Inj., xipere, 1 mg",,,47.52,120.56,10
HCPCS,C90920,"Inj., xipere, 1 mg",,,47.52,47.52,1
HCPCS,C9093,"Inj., susvimo, 0.1 mg",,,82.94,3407.66,10
HCPCS,C90930,"Inj., susvimo, 0.1 mg",,,82.94,82.94,1
HCPCS,C9094,"Inj, sutimlimab-jome, 10 mg",,,2697.73,3407.66,6
HCPCS,C9095,"Inj, tebentafusp-tebn, 1 mcg",,,10052.3,12697.64,6
HCPCS,C9096,"Inj, releuko, 1 mcg",,,74.0,93.47,6
HCPCS,C9097,"Inj, faricimab-svoa, 0.1 mg",,,746.88,943.43,6
HCPCS,C9098,Ciltacabtagene car pos t,,,24125.92,30474.84,6
HCPCS,C9101,"Inj, oliceridine 0.1 mg",,,1.23,3.4,17
HCPCS,C91010,"Inj, oliceridine 0.1 mg",,,1.34,1.34,1
HCPCS,C9122,Mometasone furoate (sinuva),,,516.7,652.67,6
HCPCS,C9132,"Kcentra, per i.u.",,,1073.13,1355.53,6
HCPCS,C9142,"Inj, alymsys, 10 mg",,,516.7,652.67,6
HCPCS,C9143,Cocaine hcl nasal (numbrino),,,2.32,5.89,4
HCPCS,C91430,Cocaine hcl nasal (numbrino),,,2.32,2.32,1
HCPCS,C9144,"Inj, bupivacaine (posimir)",,,0.5,1.26,17
HCPCS,C91440,"Inj, bupivacaine (posimir)",,,0.5,0.5,1
HCPCS,C9145,"Inj, aponvie, 1 mg",,,1.86,78.3,27
HCPCS,C91450,"Inj, aponvie, 1 mg",,,1.98,1.98,1
HCPCS,C9146,"Inj, elahere, 1 mg",,,14450.94,18253.82,6
HCPCS,C9147,"Inj, tremelimumab-actl, 1 mg",,,2697.73,3407.66,6
HCPCS,C9148,"Inj, teclistamab-cqyv, 0.5mg",,,2562.41,3236.72,6
HCPCS,C9149,"Inj, teplizumab-mzwv, 5 mcg",,,14450.94,18253.82,6
HCPCS,C9151,"Inj, pegcetacoplan 1 mg",,,2562.41,3236.72,6
HCPCS,C9152,"Inj, abilify asimtufii, 1 mg",,,746.88,943.43,6
HCPCS,C9155,"Inj epcoritamab-bysp,0.16 mg",,,2562.41,3236.72,6
HCPCS,C9157,"Inj, tofersen, 1 mg",,,10052.3,12697.64,6
HCPCS,C9158,"Inj, uzedy, 1 mg",,,516.7,652.67,6
HCPCS,C9159,"Inj, balfaxar, per i.u",,,1073.13,1355.53,6
HCPCS,C9160,Inj daxibotulinumtoxina-lanm,,,74.0,93.47,6
HCPCS,C9161,"Inj, aflibercept hd, 1 mg",,,746.88,943.43,6
HCPCS,C9162,"Inj, avacincaptad peg 0.1 mg",,,746.88,943.43,6
HCPCS,C9163,Inj talquetamab-tgvs 0.25 mg,,,2697.73,3407.66,6
HCPCS,C9164,YCANTH 0.7 % TOPICAL SOLUTION APPLICATOR,1725.6,1121.64,97.89,1725.6,29
HCPCS,C9165,"Inj, elranatamab-bcmm, 1 mg",,,2697.73,3407.66,6
HCPCS,C9166,"Injection, secukinumab",,,746.88,943.43,6
HCPCS,C9168,"Injection, mirikizumab-mrkz",,,2697.73,3407.66,6
HCPCS,C9169,"Inj, nogapendekin pmln 1 mcg",,,2562.41,3236.72,6
HCPCS,C9170,"Inj, tarlatamab-dlle, 1 mg",,,4469.75,5646.0,6
HCPCS,C9172,"Inj, beqvez, per tx dose",,,14450.94,18253.82,6
HCPCS,C9173,"Inj, nypozi, 1 mcg",,,0.54,93.47,19
HCPCS,C9174,"Datopotamab deruxtecan, 1 mg",,,10052.3,12697.64,6
HCPCS,C9175,"Inj, treosulfan, 50 mg",,,2697.73,3407.66,6
HCPCS,C9176,NON-HEU TC-99M ADD-ON/DOSE,12.0,7.8,3.0,2409.0,32
HCPCS,C9248,"Inj, clevidipine butyrate",,,2.83,78.3,19
HCPCS,C9250,ARTISS 2.5 UNIT TO 6.5 UNIT/ML (4ML) TOPICAL SYRINGE,246.5,160.23,63.84,298.84,33
HCPCS,C9250,ARTISS 2.5 UNIT TO 6.5 UNIT/ML(10ML) TOPICAL SYRINGE,220.66,143.43,57.15,298.84,33
HCPCS,C9250,Artiss fibrin sealant,,,190.66,190.66,1
HCPCS,C92500,Artiss fibrin sealant,,,190.66,190.66,1
HCPCS,C9254,"Injection, lacosamide",,,0.21,0.21,1
HCPCS,C9254,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,11.79,7.66,1.98,11.79,23
HCPCS,C9254,VIMPAT 200 MG/20 ML INTRAVENOUS SOLUTION,17.85,11.6,3.0,17.85,23
HCPCS,C92540,"Injection, lacosamide",,,0.21,0.21,1
HCPCS,C9257,Bevacizumab injection,,,1.82,39.43,21
HCPCS,C92570,Bevacizumab injection,,,15.54,15.54,1
HCPCS,C9285,"Patch, lidocaine/tetracaine",,,17.57,44.58,4
HCPCS,C92850,"Patch, lidocaine/tetracaine",,,17.57,17.57,1
HCPCS,C9293,"Injection, glucarpidase",,,448.24,448.24,1
HCPCS,C9293,VORAXAZE 1000 UNIT INTRAVENOUS SOLUTION,155638.8,101165.22,448.69,155638.8,38
HCPCS,C92930,"Injection, glucarpidase",,,448.24,448.24,1
HCPCS,C9301,AUCATZYL INTRAVENOUS SUSPENSION,2520000.0,1638000.0,24125.92,2268000.0,27
HCPCS,C9302,"Inj zanidatamab, 2 mg",,,4469.75,5646.0,6
HCPCS,C9303,"Inj zolbetuximab, 1 mg",,,2697.73,3407.66,6
HCPCS,C9304,"Inj marstacimab, 0.5 mg",,,14450.94,18253.82,6
HCPCS,C9305,"Inj, nipocalimab-aahu, 3 mg",,,32.35,5646.0,9
HCPCS,C9306,Telisotuzumab vedotin-tllv,,,144.95,5646.0,9
HCPCS,C9307,Inj linvoseltamab-gcpt 1 mg,,,97.46,97.46,1
HCPCS,C9307,LYNOZYFIC 2 MG/ML INTRAVENOUS SOLUTION,902.4,586.56,96.82,5646.0,32
HCPCS,C9307,LYNOZYFIC 20 MG/ML INTRAVENOUS SOLUTION,9024.0,5865.6,96.82,9024.0,38
HCPCS,C93070,Inj linvoseltamab-gcpt 1 mg,,,97.46,97.46,1
HCPCS,C9308,"Inj, carboplatin (avyxa)",,,5.15,13.15,8
HCPCS,C93080,"Inj, carboplatin (avyxa)",,,5.18,5.18,1
HCPCS,C9309,Inj onase abepar-brve treat,,,14450.94,18253.82,6
HCPCS,C9352,"Neuragen nerve guide, per cm",,,1076.2,2730.36,4
HCPCS,C93520,"Neuragen nerve guide, per cm",,,1076.2,1076.2,1
HCPCS,C9353,"Neurawrap nerve protector,cm",,,1147.87,2912.18,4
HCPCS,C93530,"Neurawrap nerve protector,cm",,,1147.87,1147.87,1
HCPCS,C9354,"Veritas collagen matrix, cm2",,,19.7,19.7,1
HCPCS,C9354,W COLLAGEN MATRIX VERITAS SQCM,46.5,30.225,7.39,48.02,116
HCPCS,C93540,"Veritas collagen matrix, cm2",,,19.7,19.7,1
HCPCS,C9355,"Neuromatrix nerve cuff, cm",,,185.24,469.96,4
HCPCS,C93550,"Neuromatrix nerve cuff, cm",,,185.24,185.24,1
HCPCS,C9356,"Tenoglide tendon prot, cm2",,,113.9,288.96,4
HCPCS,C93560,"Tenoglide tendon prot, cm2",,,113.9,113.9,1
HCPCS,C9358,"Surgimend, fetal",,,20.54,52.11,4
HCPCS,C93580,"Surgimend, fetal",,,20.54,20.54,1
HCPCS,C9359,"Implnt,bon void filler-putty",,,125.28,317.84,4
HCPCS,C93590,"Implnt,bon void filler-putty",,,125.28,125.28,1
HCPCS,C9360,"Surgimend, neonatal",,,22.01,55.84,4
HCPCS,C93600,"Surgimend, neonatal",,,22.01,22.01,1
HCPCS,C9361,Neuromend nerve wrap,,,180.18,457.11,4
HCPCS,C93610,Neuromend nerve wrap,,,180.18,180.18,1
HCPCS,C9362,"Implnt,bon void filler-strip",,,745.2,745.2,1
HCPCS,C93620,"Implnt,bon void filler-strip",,,745.2,745.2,1
HCPCS,C9363,Integra meshed bil wound mat,,,69.94,177.44,8
HCPCS,C93630,Integra meshed bil wound mat,,,69.94,69.94,1
HCPCS,C9364,"Porcine implant, permacol",,,18.68,18.68,1
HCPCS,C9364,W PERMACOL I PER SQ CM,19.0,12.35,3.19,19.0,23
HCPCS,C9364,W PERMACOL II PER SQ CM,23.0,14.95,3.86,23.0,23
HCPCS,C9364,W PERMACOL III PER SQ CM,26.0,16.9,4.37,26.0,23
HCPCS,C9364,W PERMACOL IV PER SQ CM,31.0,20.15,5.21,31.0,23
HCPCS,C9364,W PERMACOL V PER SQ CM,35.0,22.75,5.88,35.0,23
HCPCS,C9364,W PERMACOL VI PER SQ CM,63.0,40.95,10.58,63.0,23
HCPCS,C93640,"Porcine implant, permacol",,,18.68,18.68,1
HCPCS,C9399,ADBRY 150 MG/ML SUBCUTANEOUS SYRINGE,3662.43,2380.58,615.29,3662.43,26
HCPCS,C9399,ADMELOG U-100 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLUTION,35.31,22.95,5.93,35.31,22
HCPCS,C9399,AMTAGVI 7.5 X 10EXP9 TO 72 X 10EXP9 CELL INTRAVENOUS SUSPENSION,2940384.0,1911249.6,493984.51,2646345.6,21
HCPCS,C9399,ANTIVENIN MICRURUS FULVIUS 250 UNIT SOLUTION FOR INJECTION,33279.78,21631.86,5591.0,33279.78,29
HCPCS,C9399,BESREMI 500 MCG/ML SUBCUTANEOUS SYRINGE,33084.0,21504.6,5558.11,33084.0,29
HCPCS,C9399,BILDYOS 60 MG/ML SUBCUTANEOUS SYRINGE,3038.4,1974.96,510.45,3038.4,26
HCPCS,C9399,BILPREVDA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,3574.59,2323.48,600.53,3574.59,26
HCPCS,C9399,BIMZELX AUTOINJECTOR 320 MG/2 ML SUBCUTANEOUS AUTO-INJECTOR,38029.84,24719.4,6389.01,38029.84,29
HCPCS,C9399,BLENREP 70 MG INTRAVENOUS SOLUTION,115200.0,74880.0,19353.6,115200.0,29
HCPCS,C9399,BOMYNTRA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SYRINGE,7086.18,4606.02,1190.48,7086.18,29
HCPCS,C9399,BRIVIACT 50 MG/5 ML INTRAVENOUS SOLUTION,45.45,29.54,7.64,45.45,23
HCPCS,C9399,COSENTYX 150 MG/ML SUBCUTANEOUS SYRINGE,27472.44,17857.09,4615.37,27472.44,29
HCPCS,C9399,COSENTYX 300 MG/2 SYRINGES (150 MG/ML) SUBCUTANEOUS SYRINGE,13736.22,8928.54,2307.68,13736.22,29
HCPCS,C9399,COSENTYX PEN 150 MG/ML SUBCUTANEOUS PEN INJECTOR,27472.44,17857.09,4615.37,27472.44,29
HCPCS,C9399,DANZITEN 71 MG TABLET,386.26,251.07,64.89,386.26,23
HCPCS,C9399,DANZITEN 95 MG TABLET,386.26,251.07,64.89,386.26,23
HCPCS,C9399,DUPIXENT 200 MG/1.14 ML SUBCUTANEOUS PEN INJECTOR,6620.58,4303.38,1112.26,6620.58,29
HCPCS,C9399,DUPIXENT 200 MG/1.14 ML SUBCUTANEOUS SYRINGE,6620.58,4303.38,1112.26,6620.58,29
HCPCS,C9399,DUPIXENT 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,3773.73,2452.92,633.99,3773.73,26
HCPCS,C9399,DUPIXENT 300 MG/2 ML SUBCUTANEOUS SYRINGE,3773.73,2452.92,633.99,3773.73,26
HCPCS,C9399,GIAPREZA 0.5 MG/ML INTRAVENOUS SOLUTION,1890.0,1228.5,317.52,1890.0,23
HCPCS,C9399,GIAPREZA 2.5 MG/ML INTRAVENOUS SOLUTION,6836.4,4443.66,1148.52,6836.4,29
HCPCS,C9399,GOMEKLI 1 MG CAPSULE,534.6,347.49,89.81,534.6,23
HCPCS,C9399,GOMEKLI 2 MG CAPSULE,1069.2,694.98,179.63,1069.2,23
HCPCS,C9399,KESIMPTA PEN 20 MG/0.4 ML SUBCUTANEOUS PEN INJECTOR,84123.63,54680.36,14132.77,84123.63,29
HCPCS,C9399,KEVZARA 200 MG/1.14 ML SUBCUTANEOUS SYRINGE,7705.14,5008.34,1294.46,7705.14,29
HCPCS,C9399,LIPIODOL 480 MG IODINE/ML OIL FOR INJECTION,440.64,286.42,74.03,440.64,23
HCPCS,C9399,OGSIVEO 100 MG TABLET,1327.98,863.19,223.1,1327.98,22
HCPCS,C9399,OGSIVEO 150 MG TABLET,1327.98,863.19,223.1,1327.98,22
HCPCS,C9399,OMISIRGE INTRAVENOUS SUSPENSION,3330720.0,2164968.0,559560.96,2997648.0,21
HCPCS,C9399,OMNIPAQUE 12  MG IODINE/ML ORAL SOLUTION,0.03,0.02,0.01,0.03,23
HCPCS,C9399,OMNIPAQUE 9 MG IODINE/ML ORAL SOLUTION,0.02,0.01,0.01,0.02,23
HCPCS,C9399,PRAXBIND 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,187.35,121.78,31.47,187.35,23
HCPCS,C9399,REVUFORJ 110 MG TABLET,1639.26,1065.52,275.4,1639.26,23
HCPCS,C9399,REVUFORJ 160 MG TABLET,1639.26,1065.52,275.4,1639.26,23
HCPCS,C9399,REVUFORJ 25 MG TABLET,830.0,539.5,139.44,830.0,23
HCPCS,C9399,SIMPONI 50 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,45692.85,29700.35,7676.4,45692.85,29
HCPCS,C9399,TERLIVAZ 0.85 MG INTRAVENOUS SOLUTION,3556.8,2311.92,597.54,3556.8,26
HCPCS,C9399,TISSEEL VHSD (WITH APROTININ SYNTHETIC) 2 ML TOPICAL SYRINGE,207.68,134.99,34.89,207.68,23
HCPCS,C9399,TRULICITY 0.75 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1776.93,1155.0,298.52,1776.93,23
HCPCS,C9399,TRULICITY 1.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1776.93,1155.0,298.52,1776.93,23
HCPCS,C9399,XACDURO 1 GRAM-1 GRAM (0.5 GRAM X 2) INTRAVENOUS SOLUTION,630.0,409.5,105.84,630.0,23
HCPCS,C9460,"Injection, cangrelor",,,20.76,20.76,1
HCPCS,C9460,KENGREAL 50 MG INTRAVENOUS SOLUTION,3780.93,2457.6,18.82,3780.93,84
HCPCS,C94600,"Injection, cangrelor",,,20.76,20.76,1
HCPCS,C9462,"Injection, delafloxacin",,,0.52,1.32,7
HCPCS,C94620,"Injection, delafloxacin",,,0.52,0.52,1
HCPCS,C9482,SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,1186.56,771.26,22.83,1186.56,39
HCPCS,C9482,Sotalol hydrochloride iv,,,25.03,25.03,1
HCPCS,C94820,Sotalol hydrochloride iv,,,25.03,25.03,1
HCPCS,C9488,Conivaptan hcl,,,46.2,46.2,1
HCPCS,C9488,VAPRISOL IN 5 % DEXTROSE 20 MG/100 ML INTRAVENOUS SOLUTION,33.42,21.72,5.61,345.3,29
HCPCS,C94880,Conivaptan hcl,,,46.2,46.2,1
HCPCS,C9507,Covid-19 convalescent plasma,,,74.43,922.81,21
HCPCS,C95070,Covid-19 convalescent plasma,,,810.54,810.54,1
HCPCS,C9600,PERC DES W/ ANGIO SINGLE MAJOR,52061.0,33839.65,5298.24,46854.9,48
HCPCS,C9600,Perc drug-el cor stent sing,,,11118.18,11118.18,1
HCPCS,C96000,Perc drug-el cor stent sing,,,11118.18,11118.18,1
HCPCS,C9601,PERC DES W/ANGIO ADDTL BRANCH,23253.0,15114.45,521.0,44585.0,38
HCPCS,C9601,Perc drug-el cor stent bran,,,39778.56,39778.56,1
HCPCS,C96010,Perc drug-el cor stent bran,,,39778.56,39778.56,1
HCPCS,C9602,PERC DES/ATHER/ANGIO 1 MAJ ART,55871.0,36316.15,5298.24,50283.9,48
HCPCS,C9602,Perc d-e cor stent ather s,,,20744.49,20744.49,1
HCPCS,C96020,Perc d-e cor stent ather s,,,20744.49,20744.49,1
HCPCS,C9603,PERC DES/ ATHER/ANGIO ADDTL BR,18221.0,11843.65,521.0,44585.0,38
HCPCS,C9604,PERC DES REVASC CABG 1 VSL,53235.0,34602.75,5298.24,47911.5,48
HCPCS,C9604,Perc d-e cor revasc t cabg s,,,17488.4,17488.4,1
HCPCS,C96040,Perc d-e cor revasc t cabg s,,,17488.4,17488.4,1
HCPCS,C9605,PERC DES  REVASC CABG ADDTL BR,23253.0,15114.45,521.0,44585.0,38
HCPCS,C9606,PERC DES REVASC W/AMI 1 VSL,41313.0,26853.45,2932.0,44585.0,38
HCPCS,C9606,Perc d-e cor revasc w ami s,,,25848.0,25848.0,1
HCPCS,C96060,Perc d-e cor revasc w ami s,,,25848.0,25848.0,1
HCPCS,C9607,PERC DES REVASC CTO SINGLE VSL,64068.0,41644.2,5298.24,57661.2,48
HCPCS,C9607,Perc d-e cor revasc chro sin,,,17860.25,17860.25,1
HCPCS,C96070,Perc d-e cor revasc chro sin,,,17860.25,17860.25,1
HCPCS,C9608,PERC DES REVASC CTO ADDTL VESSEL,41313.0,26853.45,521.0,44585.0,38
HCPCS,C9610,AGENT BALLOON 3.50MM X 30MM DRUG-COATED,11300.0,7345.0,1898.4,10170.0,33
HCPCS,C9610,AGENT BALLOON CATHETER-DRUG COATED,22600.0,14690.0,3796.8,20340.0,35
HCPCS,C9725,Place endorectal app,,,862.0,1976.74,21
HCPCS,C97250,Place endorectal app,,,862.0,862.0,1
HCPCS,C9726,Rxt breast appl place/remov,,,816.59,1297.92,7
HCPCS,C97260,Rxt breast appl place/remov,,,1297.92,1297.92,1
HCPCS,C9727,Insert palate implants,,,839.72,3211.66,21
HCPCS,C97270,Insert palate implants,,,1494.01,1494.01,1
HCPCS,C9728,"Place device/marker, non pro",,,635.48,2966.61,21
HCPCS,C97280,"Place device/marker, non pro",,,834.56,834.56,1
HCPCS,C9733,Non-ophthalmic fva,,,223.78,859.16,24
HCPCS,C97330,Non-ophthalmic fva,,,482.72,482.72,1
HCPCS,C9734,"U/s trtmt, not leiomyomata",,,2290.02,14747.88,11
HCPCS,C97340,"U/s trtmt, not leiomyomata",,,12311.54,12311.54,1
HCPCS,C9738,Blue light cysto imag agent,,,409.32,1226.2,7
HCPCS,C97380,Blue light cysto imag agent,,,409.32,409.32,1
HCPCS,C9739,Cystoscopy prostatic imp 1-3,,,2889.05,11022.13,21
HCPCS,C97390,Cystoscopy prostatic imp 1-3,,,4737.28,4737.28,1
HCPCS,C9740,Cysto impl 4 or more,,,2889.05,20049.35,21
HCPCS,C97400,Cysto impl 4 or more,,,7246.88,7246.88,1
HCPCS,C9745,Nasal endo eustachian tube,,,357.79,451.94,6
HCPCS,C9747,"Ablation, hifu, prostate",,,2889.05,3649.33,6
HCPCS,C9749,Repair nasal stenosis w/imp,,,1634.08,2064.1,6
HCPCS,C9751,"Microwave bronch, 3d, ebus",,,2523.58,8131.7,16
HCPCS,C9752,Intraosseous des lumb/sacrum,,,3094.77,3909.18,6
HCPCS,C9753,Intraosseous destruct add'l,,,6141.85,7758.12,6
HCPCS,C9756,Fluorescence lymph map w/icg,,,390.0,390.0,1
HCPCS,C9757,Spine device implant surgery,,,6141.85,27897.39,21
HCPCS,C97570,Spine device implant surgery,,,17859.66,17859.66,1
HCPCS,C9758,Blind interatrial shunt ide,,,8538.66,37943.97,21
HCPCS,C97580,Blind interatrial shunt ide,,,18076.62,18076.62,1
HCPCS,C9759,Transcath intraop microinf,,,2417.66,3053.89,6
HCPCS,C9760,Non-blind interatrial shunt,,,8538.66,59625.62,20
HCPCS,C9761,"Cysto, litho, vacuum kidney",,,1770.94,20049.35,21
HCPCS,C97610,"Cysto, litho, vacuum kidney",,,10588.91,10588.91,1
HCPCS,C9762,Cardiac mri seg dys strain,,,145.46,1685.24,24
HCPCS,C97620,Cardiac mri seg dys strain,,,1685.24,1685.24,1
HCPCS,C9763,Cardiac mri seg dys stress,,,145.46,1685.24,24
HCPCS,C97630,Cardiac mri seg dys stress,,,1685.24,1685.24,1
HCPCS,C9764,IVL W/ANGIOPLASTY,81510.0,52981.5,2345.0,73359.0,48
HCPCS,C9764,REVASC ENDOV W/IVL INCL ANGIOPLASTY,81510.0,52981.5,2345.0,73359.0,40
HCPCS,C9764,Revasc intravasc lithotripsy,,,24872.24,24872.24,1
HCPCS,C97640,Revasc intravasc lithotripsy,,,24872.24,24872.24,1
HCPCS,C9765,IVL & STENT W/ANGIOPLASTY,46639.0,30315.35,2345.0,41975.1,48
HCPCS,C9765,REVASC ENDOV W/IVL W/STENT INCL ANGIOPLASTY,46639.0,30315.35,2345.0,41975.1,40
HCPCS,C9765,Revasc intra lithotrip-stent,,,16679.13,16679.13,1
HCPCS,C97650,Revasc intra lithotrip-stent,,,16679.13,16679.13,1
HCPCS,C9766,IVL & ATHERECTOMY W/ANGIOPLASTY,129064.0,83891.6,2772.0,116157.6,48
HCPCS,C9766,REVASC ENDOV W/IVL W/ATHERECTOMY INCL ANGIOPLASTY,129064.0,83891.6,2772.0,116157.6,40
HCPCS,C9766,Revasc intra lithotrip-ather,,,37698.74,37698.74,1
HCPCS,C97660,Revasc intra lithotrip-ather,,,37698.74,37698.74,1
HCPCS,C9767,IVL STENT  ATHERECTOMY W/ANGIOPLASTY,43076.0,27999.4,2772.0,38933.13,48
HCPCS,C9767,REVASC ENDOV W/IVL W/STENT-ATHER INCL ANGIOPLASTY,43076.0,27999.4,2772.0,38933.13,40
HCPCS,C9767,Revasc lithotrip-stent-ather,,,17080.28,17080.28,1
HCPCS,C97670,Revasc lithotrip-stent-ather,,,17080.28,17080.28,1
HCPCS,C9768,Endo us-guide hep porto grad,,,1333.44,1684.34,6
HCPCS,C9769,Cysto w/temp pros implant,,,2889.05,3649.33,6
HCPCS,C9770,"Vitrec/mech pars, subret inj",,,1959.49,2475.14,6
HCPCS,C9771,Nsl/sins cryo post nasal tis,,,1193.97,1508.17,6
HCPCS,C9772,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES), W/IVL,",33536.0,21798.4,2345.0,30182.4,40
HCPCS,C9772,Revasc lithotrip tibi/perone,,,11766.86,11766.86,1
HCPCS,C97720,Revasc lithotrip tibi/perone,,,11766.86,11766.86,1
HCPCS,C9773,"REVASC ENDOV, OPEN OR PERC,  TIBIAL/PERONEAL ARTERY(IES); W/IVL,",57686.0,37495.9,2345.0,51917.4,40
HCPCS,C9773,Revasc lithotr-stent tib/per,,,19470.37,19470.37,1
HCPCS,C97730,Revasc lithotr-stent tib/per,,,19470.37,19470.37,1
HCPCS,C9774,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",45430.0,29529.5,2345.0,40887.0,40
HCPCS,C9774,Revasc lithotr-ather tib/per,,,19470.37,19470.37,1
HCPCS,C97740,Revasc lithotr-ather tib/per,,,19470.37,19470.37,1
HCPCS,C9775,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",48549.0,31556.85,2345.0,43694.1,40
HCPCS,C9775,Revasc lith-sten-ath tib/per,,,19470.37,19470.37,1
HCPCS,C97750,Revasc lith-sten-ath tib/per,,,19470.37,19470.37,1
HCPCS,C9776,Fluo bile duct imaging w/icg,,,136.83,172.84,6
HCPCS,C9777,Esophag muc integ w/eso egd,,,616.53,8701.74,21
HCPCS,C97770,Esophag muc integ w/eso egd,,,8701.74,8701.74,1
HCPCS,C9778,"Colpopexy, min/inv, ex-perit",,,1571.68,11992.06,21
HCPCS,C97780,"Colpopexy, min/inv, ex-perit",,,11992.06,11992.06,1
HCPCS,C9779,Esd endoscopy or colonoscopy,,,1333.44,8248.85,22
HCPCS,C97790,Esd endoscopy or colonoscopy,,,7105.98,7105.98,1
HCPCS,C9780,Insert cv cath inf & sup app,,,1311.96,20506.25,21
HCPCS,C97800,Insert cv cath inf & sup app,,,20506.25,20506.25,1
HCPCS,C9781,Arthro/shoul surg; w/spacer,,,3407.88,27897.39,21
HCPCS,C97810,Arthro/shoul surg; w/spacer,,,16366.94,16366.94,1
HCPCS,C9782,Blind myocar trpl bon marrow,,,5298.24,37943.97,20
HCPCS,C9783,Blind cor sinus reducer impl,,,5298.24,24588.22,20
HCPCS,C9784,Endo sleeve gastro w/tube,,,3143.0,22573.24,16
HCPCS,C9785,Endo outlet restrict w/tube,,,2324.53,22573.24,20
HCPCS,C9786,Echo cad for hf preserved ef,,,66.35,83.81,6
HCPCS,C9787,Gastric ep mapg simult pt sx,,,181.25,228.95,6
HCPCS,C9788,Uni breas optoacoustic imag,,,66.35,83.81,6
HCPCS,C9789,INSTILL PHARM RENAL PELVIS,12940.0,8411.0,248.59,11646.0,37
HCPCS,C9790,Kidney histotripsy w/image,,,1770.94,2236.98,6
HCPCS,C9791,Mri hyperpolarized xenon129,,,196.56,2813.63,23
HCPCS,C9792,Blind/nonblind trans atrial,,,8538.66,21140.69,20
HCPCS,C9793,Pre 3d mdl w/ccta and/or mri,,,242.66,2205.87,20
HCPCS,C9794,Complex simulation w/pet-ct,,,635.48,802.72,6
HCPCS,C9795,Sbrt w/positron emission del,,,832.44,1051.5,6
HCPCS,C9796,Rpr intst excl anrect fist,,,1250.66,5945.95,20
HCPCS,C9797,Vasc emb/occ w/prs cath,,,6649.91,38933.13,20
HCPCS,C9803,Hopd covid-19 spec collect,,,2.52,3.18,6
HCPCS,C9809,GEN 2 SMART TIP 190,525.0,341.25,88.2,525.0,33
HCPCS,C9810,COLD THERAPY NON-OPIOID DEV,261.0,169.65,130.5,261.0,12
HCPCS,C9810,ICEMAN (COLD THERAPY SYSTEM),261.0,169.65,43.85,234.9,21
HCPCS,C9817,CRYPNM CMPRS NONOPIOID DEV,261.0,169.65,130.5,261.0,12
HCPCS,C9817,SYSTEM CRYO/CUFF IC UNIVERSAL COMPRESSION THERAPY COOLER,261.0,169.65,43.85,234.9,21
HCPCS,C9901,Endo defect closure gi tract,,,2495.61,22573.24,20
HCPCS,COSANES1,COSMETIC ANES 1 HOUR 45 MINUTES,1351.0,878.15,675.5,1351.0,12
HCPCS,COSANES1,COSMETIC ANES 2 HOURS,1448.0,941.2,724.0,1448.0,12
HCPCS,COSANES1,COSMETIC ANES 2 HOURS 15 MINUTES,1544.0,1003.6,772.0,1544.0,12
HCPCS,COSANES1,COSMETIC ANES 2 HOURS 30 MINUTES,1641.0,1066.65,820.5,1641.0,12
HCPCS,COSANES1,COSMETIC ANES 2 HOURS 45 MINUTES,1737.0,1129.05,868.5,1737.0,12
HCPCS,COSANES1,COSMETIC ANES 3 HOURS,1834.0,1192.1,917.0,1834.0,12
HCPCS,COSANES1,COSMETIC ANES 3 HOURS 15 MINUTES,1930.0,1254.5,965.0,1930.0,12
HCPCS,COSANES2,COSMETIC ANES 3 HOURS 30 MINUTES,2027.0,1317.55,1013.5,2027.0,12
HCPCS,COSANES2,COSMETIC ANES 3 HOURS 45 MINUTES,2123.0,1379.95,1061.5,2123.0,12
HCPCS,COSANES2,COSMETIC ANES 4 HOURS,2220.0,1443.0,1110.0,2220.0,12
HCPCS,COSANES2,COSMETIC ANES 4 HOURS 15 MINUTES,2316.0,1505.4,1158.0,2316.0,12
HCPCS,COSANES2,COSMETIC ANES 4 HOURS 30 MINUTES,2413.0,1568.45,1206.5,2413.0,12
HCPCS,COSANES2,COSMETIC ANES 4 HOURS 45 MINUTES,2509.0,1630.85,1254.5,2509.0,12
HCPCS,COSANES3,COSMETIC ANES 30 MINUTES,579.0,376.35,289.5,579.0,12
HCPCS,COSANES3,COSMETIC ANES 5 HOURS,2606.0,1693.9,1303.0,2606.0,12
HCPCS,COSANES3,COSMETIC ANES 5 HOURS 15 MINUTES,2702.0,1756.3,1351.0,2702.0,12
HCPCS,COSANES3,COSMETIC ANES 5 HOURS 30 MINUTES,2799.0,1819.35,1399.5,2799.0,12
HCPCS,COSANES3,COSMETIC ANES 5 HOURS 45 MINUTES,2895.0,1881.75,1447.5,2895.0,12
HCPCS,COSANES3,COSMETIC ANES 6 HOURS,2992.0,1944.8,1496.0,2992.0,12
HCPCS,COSANES3,COSMETIC ANES 6 HOURS 15 MINUTES,3088.0,2007.2,1544.0,3088.0,12
HCPCS,COSANES3,COSMETIC ANES 6 HOURS 30 MINUTES,3185.0,2070.25,1592.5,3185.0,12
HCPCS,COSANES4,COSMETIC ANES 45 MINUTES,772.0,501.8,386.0,772.0,12
HCPCS,COSANES4,COSMETIC ANES 6 HOURS 45 MINUTES,3281.0,2132.65,1640.5,3281.0,12
HCPCS,COSANES4,COSMETIC ANES 7 HOURS,3378.0,2195.7,1689.0,3378.0,12
HCPCS,COSANES4,COSMETIC ANES 7 HOURS 15 MINUTES,3472.0,2256.8,1736.0,3472.0,12
HCPCS,COSANES4,COSMETIC ANES 7 HOURS 30 MINUTES,3571.0,2321.15,1785.5,3571.0,12
HCPCS,COSANES4,COSMETIC ANES 7 HOURS 45 MINUTES,3667.0,2383.55,1833.5,3667.0,12
HCPCS,COSANES4,COSMETIC ANES 8 HOURS,3764.0,2446.6,1882.0,3764.0,12
HCPCS,COSANES4,COSMETIC ANES 8 HOURS 15 MINUTES,3860.0,2509.0,1930.0,3860.0,12
HCPCS,COSANES5,COSMETIC ANES 8 HOURS 30 MINUTES,3957.0,2572.05,1978.5,3957.0,12
HCPCS,COSANES5,COSMETIC ANES 8 HOURS 45 MINUTES,4053.0,2634.45,2026.5,4053.0,12
HCPCS,COSANES5,COSMETIC ANES 9 HOURS,4150.0,2697.5,2075.0,4150.0,12
HCPCS,COSANES5,COSMETIC ANES 9 HOURS 15 MINUTES,4247.0,2760.55,2123.5,4247.0,12
HCPCS,COSANES5,COSMETIC ANES 9 HOURS 30 MINUTES,4343.0,2822.95,2171.5,4343.0,12
HCPCS,COSANES5,COSMETIC ANES 9 HOURS 45 MINUTES,4440.0,2886.0,2220.0,4440.0,12
HCPCS,COSANES6,COSMETIC ANES 1 HOUR,1062.0,690.3,531.0,1062.0,12
HCPCS,COSANES6,COSMETIC ANES 10 HOURS,4536.0,2948.4,2268.0,4536.0,12
HCPCS,COSANES7,COSMETIC ANES 1 HOUR 15 MINUTES,1158.0,752.7,579.0,1158.0,12
HCPCS,COSANES9,COSMETIC ANES 1 HOUR 30 MINUTES,1258.0,817.7,629.0,1258.0,12
HCPCS,COSNANES,NON CCF PHYSICIANS COSMETIC CASES,1351.0,878.15,675.5,1351.0,12
HCPCS,CPETVO2,CARDIOPULMONARY EXERCISE TESTING W VO2 MAX AND SUBMAX,150.0,97.5,75.0,150.0,12
HCPCS,CPT,HEMO SLIDES/ OCULT BLD FECES 1-3,5.0,3.25,2.5,5.0,12
HCPCS,D0120,Periodic oral evaluation,,,17.25,279.41,21
HCPCS,D01200,Periodic oral evaluation,,,17.25,17.25,1
HCPCS,D0140,Limit oral eval problm focus,,,24.69,279.41,21
HCPCS,D01400,Limit oral eval problm focus,,,24.69,24.69,1
HCPCS,D0145,"Oral evaluation, pt < 3yrs",,,24.69,98.46,7
HCPCS,D01450,"Oral evaluation, pt < 3yrs",,,24.69,24.69,1
HCPCS,D0150,Comprehensve oral evaluation,,,24.69,279.41,21
HCPCS,D01500,Comprehensve oral evaluation,,,24.69,24.69,1
HCPCS,D0160,Extensv oral eval prob focus,,,44.99,279.41,21
HCPCS,D01600,Extensv oral eval prob focus,,,44.99,44.99,1
HCPCS,D0170,"Re-eval,est pt,problem focus",,,22.33,279.41,21
HCPCS,D01700,"Re-eval,est pt,problem focus",,,22.33,22.33,1
HCPCS,D0171,Re-eval post-op visit,,,17.25,279.41,21
HCPCS,D01710,Re-eval post-op visit,,,17.25,17.25,1
HCPCS,D0180,Comp periodontal evaluation,,,24.69,279.41,21
HCPCS,D01800,Comp periodontal evaluation,,,24.69,24.69,1
HCPCS,D0190,Screening of a patient,,,17.25,98.46,7
HCPCS,D01900,Screening of a patient,,,17.25,17.25,1
HCPCS,D0191,Assessment of a patient,,,12.52,279.41,21
HCPCS,D01910,Assessment of a patient,,,12.52,12.52,1
HCPCS,D0210,Intraor comprehensive series,,,29.91,524.09,22
HCPCS,D02100,Intraor comprehensive series,,,29.91,29.91,1
HCPCS,D0210TC,Intraor comprehensive series,,,29.91,29.91,1
HCPCS,D0220,Intraoral periapical first,,,7.67,190.91,22
HCPCS,D02200,Intraoral periapical first,,,7.67,7.67,1
HCPCS,D0220TC,Intraoral periapical first,,,7.67,7.67,1
HCPCS,D0230,Intraoral periapical ea add,,,3.81,28.75,8
HCPCS,D02300,Intraoral periapical ea add,,,3.81,3.81,1
HCPCS,D0230TC,Intraoral periapical ea add,,,3.81,3.81,1
HCPCS,D0240,Intraoral occlusal film,,,8.94,190.91,22
HCPCS,D02400,Intraoral occlusal film,,,8.94,8.94,1
HCPCS,D0240TC,Intraoral occlusal film,,,8.94,8.94,1
HCPCS,D0250,Extraoral 2d project image,,,14.97,190.91,22
HCPCS,D02500,Extraoral 2d project image,,,14.97,14.97,1
HCPCS,D0250TC,Extraoral 2d project image,,,14.97,14.97,1
HCPCS,D0251,Extraoral posterior image,,,14.97,190.91,22
HCPCS,D02510,Extraoral posterior image,,,14.97,14.97,1
HCPCS,D0251TC,Extraoral posterior image,,,14.97,14.97,1
HCPCS,D0270,Dental bitewing single image,,,7.67,190.91,22
HCPCS,D02700,Dental bitewing single image,,,7.67,7.67,1
HCPCS,D0270TC,Dental bitewing single image,,,7.67,7.67,1
HCPCS,D0272,Dental bitewings two images,,,8.94,190.91,22
HCPCS,D02720,Dental bitewings two images,,,8.94,8.94,1
HCPCS,D0272TC,Dental bitewings two images,,,8.94,8.94,1
HCPCS,D0273,Bitewings - three images,,,12.12,524.09,22
HCPCS,D02730,Bitewings - three images,,,12.12,12.12,1
HCPCS,D0273TC,Bitewings - three images,,,12.12,12.12,1
HCPCS,D0274,Bitewings four images,,,14.97,524.09,22
HCPCS,D02740,Bitewings four images,,,14.97,14.97,1
HCPCS,D0274TC,Bitewings four images,,,14.97,14.97,1
HCPCS,D0277,Vert bitewings 7 to 8 images,,,17.83,524.09,22
HCPCS,D02770,Vert bitewings 7 to 8 images,,,17.83,17.83,1
HCPCS,D0277TC,Vert bitewings 7 to 8 images,,,17.83,17.83,1
HCPCS,D0310,Dental saliography,,,77.37,524.09,22
HCPCS,D03100,Dental saliography,,,77.37,77.37,1
HCPCS,D0310TC,Dental saliography,,,77.37,77.37,1
HCPCS,D0320,Dental tmj arthrogram incl i,,,86.94,524.09,21
HCPCS,D03200,Dental tmj arthrogram incl i,,,237.62,237.62,1
HCPCS,D0321,Other tmj images by report,,,22.76,190.91,22
HCPCS,D03210,Other tmj images by report,,,48.73,48.73,1
HCPCS,D0321TC,Other tmj images by report,,,48.73,48.73,1
HCPCS,D0322,Dental tomographic survey,,,99.33,230.56,22
HCPCS,D03220,Dental tomographic survey,,,99.33,99.33,1
HCPCS,D0322TC,Dental tomographic survey,,,99.33,99.33,1
HCPCS,D0330,Panoramic image,,,22.76,524.09,22
HCPCS,D03300,Panoramic image,,,25.78,25.78,1
HCPCS,D0330TC,Panoramic image,,,25.78,25.78,1
HCPCS,D0340,2d cephalometric image,,,28.95,190.91,22
HCPCS,D03400,2d cephalometric image,,,28.95,28.95,1
HCPCS,D0340TC,2d cephalometric image,,,28.95,28.95,1
HCPCS,D0350,Oral/facial photo images,,,22.76,190.91,21
HCPCS,D03500,Oral/facial photo images,,,23.7,23.7,1
HCPCS,D0351,3d photographic image,,,22.76,28.75,6
HCPCS,D0364,Cone beam ct capt & interp,,,106.74,230.56,22
HCPCS,D03640,Cone beam ct capt & interp,,,148.69,148.69,1
HCPCS,D0364TC,Cone beam ct capt & interp,,,148.69,148.69,1
HCPCS,D0365,Cone beam ct interprete man,,,106.74,230.56,22
HCPCS,D03650,Cone beam ct interprete man,,,148.69,148.69,1
HCPCS,D0365TC,Cone beam ct interprete man,,,148.69,148.69,1
HCPCS,D0366,Cone beam ct interprete max,,,106.74,230.56,22
HCPCS,D03660,Cone beam ct interprete max,,,148.69,148.69,1
HCPCS,D0366TC,Cone beam ct interprete max,,,148.69,148.69,1
HCPCS,D0367,Cone beam ct interp both jaw,,,106.74,230.56,22
HCPCS,D03670,Cone beam ct interp both jaw,,,148.69,148.69,1
HCPCS,D0367TC,Cone beam ct interp both jaw,,,148.69,148.69,1
HCPCS,D0368,Cone beam ct interprete tmj,,,106.74,230.56,22
HCPCS,D03680,Cone beam ct interprete tmj,,,217.76,217.76,1
HCPCS,D0368TC,Cone beam ct interprete tmj,,,217.76,217.76,1
HCPCS,D0369,Max mri capture & interprete,,,106.74,441.09,22
HCPCS,D03690,Max mri capture & interprete,,,441.09,441.09,1
HCPCS,D0369TC,Max mri capture & interprete,,,441.09,441.09,1
HCPCS,D0370,Max ultrasound capt & interp,,,66.35,230.56,22
HCPCS,D03700,Max ultrasound capt & interp,,,113.98,113.98,1
HCPCS,D0370TC,Max ultrasound capt & interp,,,113.98,113.98,1
HCPCS,D0371,Sialoendoscopy capt & interp,,,86.94,190.91,22
HCPCS,D03710,Sialoendoscopy capt & interp,,,154.73,154.73,1
HCPCS,D0371TC,Sialoendoscopy capt & interp,,,154.73,154.73,1
HCPCS,D0372,Tomo comp series images,,,22.76,59.41,7
HCPCS,D03720,Tomo comp series images,,,59.41,59.41,1
HCPCS,D0373,Tomo bitewing image,,,22.76,28.75,7
HCPCS,D03730,Tomo bitewing image,,,23.7,23.7,1
HCPCS,D0374,Tomo periapical image,,,22.76,28.75,7
HCPCS,D03740,Tomo periapical image,,,23.7,23.7,1
HCPCS,D0380,Cone beam ct capture limited,,,106.74,230.56,22
HCPCS,D03800,Cone beam ct capture limited,,,118.75,118.75,1
HCPCS,D0380TC,Cone beam ct capture limited,,,118.75,118.75,1
HCPCS,D0381,Cone beam ct capt mandible,,,106.74,230.56,22
HCPCS,D03810,Cone beam ct capt mandible,,,118.75,118.75,1
HCPCS,D0381TC,Cone beam ct capt mandible,,,118.75,118.75,1
HCPCS,D0382,Cone beam ct capt maxilla,,,106.74,230.56,22
HCPCS,D03820,Cone beam ct capt maxilla,,,118.75,118.75,1
HCPCS,D0382TC,Cone beam ct capt maxilla,,,118.75,118.75,1
HCPCS,D0383,Cone beam ct both jaws,,,106.74,230.56,22
HCPCS,D03830,Cone beam ct both jaws,,,118.75,118.75,1
HCPCS,D0383TC,Cone beam ct both jaws,,,118.75,118.75,1
HCPCS,D0384,Cone beam ct capture tmj,,,106.74,230.56,22
HCPCS,D03840,Cone beam ct capture tmj,,,173.79,173.79,1
HCPCS,D0384TC,Cone beam ct capture tmj,,,173.79,173.79,1
HCPCS,D0385,Max mri image capture,,,106.74,327.62,22
HCPCS,D03850,Max mri image capture,,,327.62,327.62,1
HCPCS,D0385TC,Max mri image capture,,,327.62,327.62,1
HCPCS,D0386,Max ultrasound image capture,,,66.35,230.56,21
HCPCS,D03860,Max ultrasound image capture,,,95.13,95.13,1
HCPCS,D0387,Comp image capture only,,,22.76,46.79,8
HCPCS,D03870,Comp image capture only,,,46.79,46.79,1
HCPCS,D0387TC,Comp image capture only,,,46.79,46.79,1
HCPCS,D0388,Bitewing image capture only,,,11.79,28.75,8
HCPCS,D03880,Bitewing image capture only,,,11.79,11.79,1
HCPCS,D0388TC,Bitewing image capture only,,,11.79,11.79,1
HCPCS,D0389,Periopic image capture only,,,11.79,28.75,8
HCPCS,D03890,Periopic image capture only,,,11.79,11.79,1
HCPCS,D0389TC,Periopic image capture only,,,11.79,11.79,1
HCPCS,D0391,Imterprete diagnostic image,,,77.95,185.35,7
HCPCS,D03910,Imterprete diagnostic image,,,185.35,185.35,1
HCPCS,D0393,Trtmnt simulation 3d image,,,77.95,190.91,22
HCPCS,D03930,Trtmnt simulation 3d image,,,179.56,179.56,1
HCPCS,D0393TC,Trtmnt simulation 3d image,,,179.56,179.56,1
HCPCS,D0394,Digital sub 2 or more images,,,21.64,190.91,22
HCPCS,D03940,Digital sub 2 or more images,,,21.64,21.64,1
HCPCS,D0394TC,Digital sub 2 or more images,,,21.64,21.64,1
HCPCS,D0395,Fusion 2 or more 3d images,,,27.09,190.91,22
HCPCS,D03950,Fusion 2 or more 3d images,,,27.09,27.09,1
HCPCS,D0395TC,Fusion 2 or more 3d images,,,27.09,27.09,1
HCPCS,D0396,3d print of 3d surface scan,,,22.76,47.71,7
HCPCS,D03960,3d print of 3d surface scan,,,47.71,47.71,1
HCPCS,D0411,Hba1c in office testing,,,2.59,11.75,7
HCPCS,D04110,Hba1c in office testing,,,11.75,11.75,1
HCPCS,D0412,Blood glucose level test,,,2.59,11.75,7
HCPCS,D04120,Blood glucose level test,,,11.75,11.75,1
HCPCS,D0414,Lab process microbial spec,,,4.02,34.95,7
HCPCS,D04140,Lab process microbial spec,,,34.95,34.95,1
HCPCS,D0415,Collection of microorganisms,,,4.02,55.91,7
HCPCS,D04150,Collection of microorganisms,,,55.91,55.91,1
HCPCS,D0416,Viral culture,,,4.02,51.15,7
HCPCS,D04160,Viral culture,,,51.15,51.15,1
HCPCS,D0417,Collect & prep saliva sample,,,2.52,11.75,7
HCPCS,D04170,Collect & prep saliva sample,,,11.75,11.75,1
HCPCS,D0418,Analysis of saliva sample,,,2.34,55.91,7
HCPCS,D04180,Analysis of saliva sample,,,55.91,55.91,1
HCPCS,D0419,Assess of salivary flow,,,65.12,98.46,7
HCPCS,D04190,Assess of salivary flow,,,65.12,65.12,1
HCPCS,D0422,Collect & prep genetic samp,,,11.75,28.19,7
HCPCS,D04220,Collect & prep genetic samp,,,11.75,11.75,1
HCPCS,D0423,Genetic test spec analysis,,,22.32,177.87,7
HCPCS,D04230,Genetic test spec analysis,,,177.87,177.87,1
HCPCS,D0425,Caries susceptibility test,,,4.02,30.18,7
HCPCS,D04250,Caries susceptibility test,,,30.18,30.18,1
HCPCS,D0426,"Coll, analys of saliva",,,2.52,3.18,6
HCPCS,D0431,Diag tst detect mucos abnorm,,,25.41,98.46,7
HCPCS,D04310,Diag tst detect mucos abnorm,,,25.41,25.41,1
HCPCS,D0460,Pulp vitality test,,,18.74,3604.86,21
HCPCS,D04600,Pulp vitality test,,,18.74,18.74,1
HCPCS,D0461,Testing for cracked tooth,,,81.86,103.4,6
HCPCS,D0470,Diagnostic casts,,,29.22,98.46,7
HCPCS,D04700,Diagnostic casts,,,29.22,29.22,1
HCPCS,D0472,"Gross exam, prep & report",,,19.72,34.95,7
HCPCS,D04720,"Gross exam, prep & report",,,34.95,34.95,1
HCPCS,D0473,"Micro exam, prep & report",,,19.72,46.7,7
HCPCS,D04730,"Micro exam, prep & report",,,46.7,46.7,1
HCPCS,D0474,Micro w exam of surg margins,,,19.72,55.91,7
HCPCS,D04740,Micro w exam of surg margins,,,55.91,55.91,1
HCPCS,D0475,Decalcification procedure,,,2.34,18.74,8
HCPCS,D04750,Decalcification procedure,,,18.74,18.74,1
HCPCS,D0475TC,Decalcification procedure,,,18.74,18.74,1
HCPCS,D0476,Spec stains for microorganis,,,2.34,109.29,7
HCPCS,D04760,Spec stains for microorganis,,,109.29,109.29,1
HCPCS,D0477,Spec stains not for microorg,,,2.34,109.29,7
HCPCS,D04770,Spec stains not for microorg,,,109.29,109.29,1
HCPCS,D0478,Immunohistochemical stains,,,2.34,31.77,8
HCPCS,D04780,Immunohistochemical stains,,,31.77,31.77,1
HCPCS,D0478TC,Immunohistochemical stains,,,31.77,31.77,1
HCPCS,D0479,Tissue in-situ hybridization,,,2.34,76.87,7
HCPCS,D04790,Tissue in-situ hybridization,,,76.87,76.87,1
HCPCS,D0480,Cytopath smear prep & report,,,19.72,24.91,8
HCPCS,D04800,Cytopath smear prep & report,,,24.15,24.15,1
HCPCS,D0480TC,Cytopath smear prep & report,,,24.15,24.15,1
HCPCS,D0481,Electron microscopy,,,2.34,44.8,8
HCPCS,D04810,Electron microscopy,,,44.8,44.8,1
HCPCS,D0481TC,Electron microscopy,,,44.8,44.8,1
HCPCS,D0482,Direct immunofluorescence,,,2.34,27.96,7
HCPCS,D04820,Direct immunofluorescence,,,27.96,27.96,1
HCPCS,D0483,Indirect immunofluorescence,,,2.34,37.17,7
HCPCS,D04830,Indirect immunofluorescence,,,37.17,37.17,1
HCPCS,D0484,Consult slides prep elsewher,,,51.15,71.74,7
HCPCS,D04840,Consult slides prep elsewher,,,51.15,51.15,1
HCPCS,D0485,Consult inc prep of slides,,,55.91,71.74,7
HCPCS,D04850,Consult inc prep of slides,,,55.91,55.91,1
HCPCS,D0486,Access of transep cytol samp,,,19.72,48.92,7
HCPCS,D04860,Access of transep cytol samp,,,48.92,48.92,1
HCPCS,D0502,Other oral pathology procedu,,,2.34,62.9,7
HCPCS,D05020,Other oral pathology procedu,,,62.9,62.9,1
HCPCS,D0600,Non-ionizing diag proc,,,58.0,3604.86,21
HCPCS,D06000,Non-ionizing diag proc,,,58.0,58.0,1
HCPCS,D0601,Caries risk assess low risk,,,6.99,98.46,7
HCPCS,D06010,Caries risk assess low risk,,,6.99,6.99,1
HCPCS,D0602,Caries risk assess mod risk,,,6.99,98.46,7
HCPCS,D06020,Caries risk assess mod risk,,,6.99,6.99,1
HCPCS,D0603,Caries risk assess high risk,,,6.99,98.46,7
HCPCS,D06030,Caries risk assess high risk,,,6.99,6.99,1
HCPCS,D0604,Antigen test pub hlth pathog,,,4.02,46.7,7
HCPCS,D06040,Antigen test pub hlth pathog,,,46.7,46.7,1
HCPCS,D0605,Antibody test pub hlth path,,,5.23,46.7,8
HCPCS,D06050,Antibody test pub hlth path,,,46.7,46.7,1
HCPCS,D0605TC,Antibody test pub hlth path,,,46.7,46.7,1
HCPCS,D0606,Molecular test pub hlth path,,,4.02,93.09,7
HCPCS,D06060,Molecular test pub hlth path,,,93.09,93.09,1
HCPCS,D0701,Pano radio image,,,19.38,190.91,22
HCPCS,D07010,Pano radio image,,,19.38,19.38,1
HCPCS,D0701TC,Pano radio image,,,19.38,19.38,1
HCPCS,D0702,2d cephal radio image,,,22.76,190.91,22
HCPCS,D07020,2d cephal radio image,,,23.19,23.19,1
HCPCS,D0702TC,2d cephal radio image,,,23.19,23.19,1
HCPCS,D0703,2d oral/facial photo image,,,18.74,190.91,21
HCPCS,D07030,2d oral/facial photo image,,,18.74,18.74,1
HCPCS,D0704,3d photo image capture only,,,22.76,28.75,6
HCPCS,D0705,Extra oral post radio image,,,12.07,190.91,22
HCPCS,D07050,Extra oral post radio image,,,12.07,12.07,1
HCPCS,D0705TC,Extra oral post radio image,,,12.07,12.07,1
HCPCS,D0706,Intraoral occlus radio image,,,6.04,190.91,22
HCPCS,D07060,Intraoral occlus radio image,,,6.04,6.04,1
HCPCS,D0706TC,Intraoral occlus radio image,,,6.04,6.04,1
HCPCS,D0707,Intraoral periap radio image,,,3.18,190.91,22
HCPCS,D07070,Intraoral periap radio image,,,3.18,3.18,1
HCPCS,D0707TC,Intraoral periap radio image,,,3.18,3.18,1
HCPCS,D0708,Intraoral bite radio image,,,4.45,190.91,22
HCPCS,D07080,Intraoral bite radio image,,,4.45,4.45,1
HCPCS,D0708TC,Intraoral bite radio image,,,4.45,4.45,1
HCPCS,D0709,Intraoral comp image capture,,,22.24,190.91,22
HCPCS,D07090,Intraoral comp image capture,,,22.24,22.24,1
HCPCS,D0709TC,Intraoral comp image capture,,,22.24,22.24,1
HCPCS,D0801,3d dental scan direct,,,93.09,93.09,1
HCPCS,D0801,3d intraoral scan direct,,,22.76,28.75,6
HCPCS,D08010,3d dental scan direct,,,93.09,93.09,1
HCPCS,D0802,3d dental scan indirect,,,22.76,93.09,7
HCPCS,D08020,3d dental scan indirect,,,93.09,93.09,1
HCPCS,D0803,3d facial scan direct,,,22.76,69.89,7
HCPCS,D08030,3d facial scan direct,,,69.89,69.89,1
HCPCS,D0804,3d facial scan indirect,,,22.76,69.89,7
HCPCS,D08040,3d facial scan indirect,,,69.89,69.89,1
HCPCS,D0999,Unspecified diagnostic proce,,,77.95,98.46,6
HCPCS,D1110,Dental prophylaxis adult,,,38.13,279.41,21
HCPCS,D1110,PROPHYLAXIS - ADULT,143.0,92.95,68.82,143.0,13
HCPCS,D11100,Dental prophylaxis adult,,,38.13,38.13,1
HCPCS,D1120,Dental prophylaxis child,,,25.65,103.4,7
HCPCS,D11200,Dental prophylaxis child,,,25.65,25.65,1
HCPCS,D1206,Topical fluoride varnish,,,15.8,103.4,7
HCPCS,D12060,Topical fluoride varnish,,,15.8,15.8,1
HCPCS,D1208,Topical app fluorid ex vrnsh,,,12.48,103.4,7
HCPCS,D12080,Topical app fluorid ex vrnsh,,,12.48,12.48,1
HCPCS,D1301,Immunization counseling,,,30.57,51.49,7
HCPCS,D13010,Immunization counseling,,,30.57,30.57,1
HCPCS,D1310,Nutri counsel-control caries,,,30.57,103.4,7
HCPCS,D13100,Nutri counsel-control caries,,,30.57,30.57,1
HCPCS,D1320,Tobacco counseling,,,12.84,27.62,7
HCPCS,D13200,Tobacco counseling,,,27.62,27.62,1
HCPCS,D1321,Couns for high risk sub use,,,12.84,27.62,7
HCPCS,D13210,Couns for high risk sub use,,,27.62,27.62,1
HCPCS,D1330,Oral hygiene instruction,,,17.77,17.77,1
HCPCS,D1330,Oral hygiene instructions,,,81.86,103.4,6
HCPCS,D13300,Oral hygiene instruction,,,17.77,17.77,1
HCPCS,D1351,Dental sealant per tooth,,,20.06,38.77,7
HCPCS,D13510,Dental sealant per tooth,,,20.06,20.06,1
HCPCS,D1352,"Prev resin rest, perm tooth",,,81.86,103.4,6
HCPCS,D1353,Sealant repair per tooth,,,20.06,38.77,7
HCPCS,D13530,Sealant repair per tooth,,,20.06,20.06,1
HCPCS,D1354,Int caries med app per tooth,,,63.8,103.4,7
HCPCS,D13540,Int caries med app per tooth,,,63.8,63.8,1
HCPCS,D1355,Caries med app per tooth,,,76.63,103.4,7
HCPCS,D13550,Caries med app per tooth,,,76.63,76.63,1
HCPCS,D1510,Space maintainer fxd unilat,,,81.86,3604.86,21
HCPCS,D15100,Space maintainer fxd unilat,,,102.28,102.28,1
HCPCS,D1516,"Fixed bilat space maint, max",,,81.86,3604.86,21
HCPCS,D15160,"Fixed bilat space maint, max",,,153.26,153.26,1
HCPCS,D1517,"Fixed bilat space maint, man",,,81.86,3604.86,21
HCPCS,D15170,"Fixed bilat space maint, man",,,153.26,153.26,1
HCPCS,D1520,Remove unilat space maintain,,,81.86,3604.86,21
HCPCS,D15200,Remove unilat space maintain,,,127.61,127.61,1
HCPCS,D1526,"Remove bilat space main, max",,,81.86,3604.86,21
HCPCS,D15260,"Remove bilat space main, max",,,178.91,178.91,1
HCPCS,D1527,"Remove bilat space main, man",,,81.86,3604.86,21
HCPCS,D15270,"Remove bilat space main, man",,,178.91,178.91,1
HCPCS,D1551,Recement space maint - max,,,30.57,3604.86,21
HCPCS,D15510,Recement space maint - max,,,30.57,30.57,1
HCPCS,D1552,Recement space maint - man,,,30.57,3604.86,21
HCPCS,D15520,Recement space maint - man,,,30.57,30.57,1
HCPCS,D1553,Recement unilat space maint,,,30.57,3604.86,21
HCPCS,D15530,Recement unilat space maint,,,30.57,30.57,1
HCPCS,D1556,Rem fixed unilat space maint,,,27.62,103.4,7
HCPCS,D15560,Rem fixed unilat space maint,,,27.62,27.62,1
HCPCS,D1557,Remove fixed bilat maint max,,,27.62,103.4,7
HCPCS,D15570,Remove fixed bilat maint max,,,27.62,27.62,1
HCPCS,D1558,Remove fixed bilat man,,,27.62,103.4,7
HCPCS,D15580,Remove fixed bilat man,,,27.62,27.62,1
HCPCS,D1575,"Dist space maint, fixed unil",,,81.86,3604.86,21
HCPCS,D15750,"Dist space maint, fixed unil",,,102.28,102.28,1
HCPCS,D1701,Pfizer vacc admin 1st dose,,,25.75,43.2,7
HCPCS,D17010,Pfizer vacc admin 1st dose,,,43.2,43.2,1
HCPCS,D1702,Pfizer vacc admin 2nd dose,,,25.75,43.2,7
HCPCS,D17020,Pfizer vacc admin 2nd dose,,,43.2,43.2,1
HCPCS,D1703,Moderna vacc admin 1st dose,,,25.75,43.2,7
HCPCS,D17030,Moderna vacc admin 1st dose,,,43.2,43.2,1
HCPCS,D1704,Moderna vacc admin 2nd dose,,,25.75,43.2,7
HCPCS,D17040,Moderna vacc admin 2nd dose,,,43.2,43.2,1
HCPCS,D1705,Astrazeneca vacc adm 1st dos,,,25.75,32.53,6
HCPCS,D1706,Astrazeneca vacc adm 2nd dos,,,25.75,32.53,6
HCPCS,D1707,Janssen vaccine admin,,,25.75,32.53,6
HCPCS,D1708,Pfizer vacc admin 3rd dose,,,25.75,43.2,7
HCPCS,D17080,Pfizer vacc admin 3rd dose,,,43.2,43.2,1
HCPCS,D1709,Pfizer vaccine admin booster,,,25.75,43.2,7
HCPCS,D17090,Pfizer vaccine admin booster,,,43.2,43.2,1
HCPCS,D1710,Moderna vacc admin 3rd dose,,,25.75,43.2,7
HCPCS,D17100,Moderna vacc admin 3rd dose,,,43.2,43.2,1
HCPCS,D1711,Moderna vacc admin booster,,,25.75,43.2,7
HCPCS,D17110,Moderna vacc admin booster,,,43.2,43.2,1
HCPCS,D1712,Janssen vacc admin booster,,,25.75,32.53,6
HCPCS,D1713,Pfizer vacc adm ped 1st dose,,,25.75,43.2,7
HCPCS,D17130,Pfizer vacc adm ped 1st dose,,,43.2,43.2,1
HCPCS,D1714,Pfizer vacc adm ped 2nd dose,,,25.75,43.2,7
HCPCS,D17140,Pfizer vacc adm ped 2nd dose,,,43.2,43.2,1
HCPCS,D1720,Influenza vacc admin,,,25.75,32.53,6
HCPCS,D1781,Vac admin human pap dose 1,,,25.75,50.99,7
HCPCS,D17810,Vac admin human pap dose 1,,,50.99,50.99,1
HCPCS,D1782,Vac admin human pap dose 2,,,25.75,50.99,7
HCPCS,D17820,Vac admin human pap dose 2,,,50.99,50.99,1
HCPCS,D1783,Vac admin human pap dose 3,,,25.75,50.99,7
HCPCS,D17830,Vac admin human pap dose 3,,,50.99,50.99,1
HCPCS,D1999,Unspecified preventive proc,,,81.86,103.4,6
HCPCS,D2140,Amalgam one surface permanen,,,46.74,3604.86,21
HCPCS,D21400,Amalgam one surface permanen,,,46.74,46.74,1
HCPCS,D2150,"AMALGAM - TWO SURFACES, PRIMARY OR PERMANENT",274.0,178.1,96.74,274.0,13
HCPCS,D2150,Amalgam two surfaces permane,,,52.12,3604.86,21
HCPCS,D21500,Amalgam two surfaces permane,,,52.12,52.12,1
HCPCS,D2160,Amalgam three surfaces perma,,,63.55,3604.86,21
HCPCS,D21600,Amalgam three surfaces perma,,,63.55,63.55,1
HCPCS,D2161,Amalgam 4 or > surfaces perm,,,77.34,3604.86,21
HCPCS,D21610,Amalgam 4 or > surfaces perm,,,77.34,77.34,1
HCPCS,D2330,Resin one surface-anterior,,,46.74,3604.86,21
HCPCS,D23300,Resin one surface-anterior,,,46.74,46.74,1
HCPCS,D2331,Resin two surfaces-anterior,,,70.26,3604.86,21
HCPCS,D23310,Resin two surfaces-anterior,,,70.26,70.26,1
HCPCS,D2332,Resin three surfaces-anterio,,,82.06,3604.86,21
HCPCS,D23320,Resin three surfaces-anterio,,,82.06,82.06,1
HCPCS,D2335,Resin 4/> surf or w incis an,,,93.8,3604.86,21
HCPCS,D23350,Resin 4/> surf or w incis an,,,93.8,93.8,1
HCPCS,D2390,Ant resin-based cmpst crown,,,160.06,3604.86,21
HCPCS,D23900,Ant resin-based cmpst crown,,,160.06,160.06,1
HCPCS,D2391,Post 1 srfc resinbased cmpst,,,46.74,3604.86,21
HCPCS,D23910,Post 1 srfc resinbased cmpst,,,46.74,46.74,1
HCPCS,D2392,Post 2 srfc resinbased cmpst,,,93.8,3604.86,21
HCPCS,D23920,Post 2 srfc resinbased cmpst,,,93.8,93.8,1
HCPCS,D2393,Post 3 srfc resinbased cmpst,,,126.75,3604.86,21
HCPCS,D23930,Post 3 srfc resinbased cmpst,,,126.75,126.75,1
HCPCS,D2394,Post >=4srfc resinbase cmpst,,,133.82,3604.86,21
HCPCS,D23940,Post >=4srfc resinbase cmpst,,,133.82,133.82,1
HCPCS,D2410,Dental gold foil one surface,,,187.63,3604.86,21
HCPCS,D24100,Dental gold foil one surface,,,187.63,187.63,1
HCPCS,D2420,Dental gold foil two surface,,,223.6,3604.86,21
HCPCS,D24200,Dental gold foil two surface,,,223.6,223.6,1
HCPCS,D2430,Dental gold foil three surfa,,,277.06,3604.86,21
HCPCS,D24300,Dental gold foil three surfa,,,277.06,277.06,1
HCPCS,D2510,Dental inlay metalic 1 surf,,,267.63,3604.86,21
HCPCS,D25100,Dental inlay metalic 1 surf,,,267.63,267.63,1
HCPCS,D2520,Dental inlay metallic 2 surf,,,303.31,3604.86,21
HCPCS,D25200,Dental inlay metallic 2 surf,,,303.31,303.31,1
HCPCS,D2530,Dental inlay metl 3/more sur,,,305.66,3604.86,21
HCPCS,D25300,Dental inlay metl 3/more sur,,,305.66,305.66,1
HCPCS,D2542,Dental onlay metallic 2 surf,,,347.68,3604.86,21
HCPCS,D25420,Dental onlay metallic 2 surf,,,347.68,347.68,1
HCPCS,D2543,Dental onlay metallic 3 surf,,,364.14,3604.86,21
HCPCS,D25430,Dental onlay metallic 3 surf,,,364.14,364.14,1
HCPCS,D2544,Dental onlay metl 4/more sur,,,399.81,3604.86,21
HCPCS,D25440,Dental onlay metl 4/more sur,,,399.81,399.81,1
HCPCS,D2610,Inlay porcelain/ceramic 1 su,,,293.55,3604.86,21
HCPCS,D26100,Inlay porcelain/ceramic 1 su,,,293.55,293.55,1
HCPCS,D2620,Inlay porcelain/ceramic 2 su,,,305.66,3604.86,21
HCPCS,D26200,Inlay porcelain/ceramic 2 su,,,305.66,305.66,1
HCPCS,D2630,Dental onlay porc 3/more sur,,,399.81,3604.86,21
HCPCS,D26300,Dental onlay porc 3/more sur,,,399.81,399.81,1
HCPCS,D2642,Dental onlay porcelin 2 surf,,,328.87,3604.86,21
HCPCS,D26420,Dental onlay porcelin 2 surf,,,328.87,328.87,1
HCPCS,D2643,Dental onlay porcelin 3 surf,,,375.93,3604.86,21
HCPCS,D26430,Dental onlay porcelin 3 surf,,,375.93,375.93,1
HCPCS,D2644,Dental onlay porc 4/more sur,,,434.1,3604.86,21
HCPCS,D26440,Dental onlay porc 4/more sur,,,434.1,434.1,1
HCPCS,D2650,Inlay composite/resin one su,,,270.0,3604.86,21
HCPCS,D26500,Inlay composite/resin one su,,,270.0,270.0,1
HCPCS,D2651,Inlay composite/resin two su,,,305.66,3604.86,21
HCPCS,D26510,Inlay composite/resin two su,,,305.66,305.66,1
HCPCS,D2652,Dental inlay resin 3/mre sur,,,399.81,3604.86,21
HCPCS,D26520,Dental inlay resin 3/mre sur,,,399.81,399.81,1
HCPCS,D2662,Dental onlay resin 2 surface,,,305.66,3604.86,21
HCPCS,D26620,Dental onlay resin 2 surface,,,305.66,305.66,1
HCPCS,D2663,Dental onlay resin 3 surface,,,375.93,3604.86,21
HCPCS,D26630,Dental onlay resin 3 surface,,,375.93,375.93,1
HCPCS,D2664,Dental onlay resin 4/mre sur,,,399.81,3604.86,21
HCPCS,D26640,Dental onlay resin 4/mre sur,,,399.81,399.81,1
HCPCS,D2710,Crown resin-based indirect,,,235.4,3604.86,21
HCPCS,D27100,Crown resin-based indirect,,,235.4,235.4,1
HCPCS,D2712,Crown 3/4 resin-based compos,,,340.62,3604.86,21
HCPCS,D27120,Crown 3/4 resin-based compos,,,340.62,340.62,1
HCPCS,D2720,Crown resin w/ high noble me,,,469.76,3604.86,21
HCPCS,D27200,Crown resin w/ high noble me,,,469.76,469.76,1
HCPCS,D2721,Crown resin w/ base metal,,,352.4,3604.86,21
HCPCS,D27210,Crown resin w/ base metal,,,352.4,352.4,1
HCPCS,D2722,Crown resin w/ noble metal,,,399.81,3604.86,21
HCPCS,D27220,Crown resin w/ noble metal,,,399.81,399.81,1
HCPCS,D2740,Crown porcelain/ceramic,,,469.76,3604.86,21
HCPCS,D27400,Crown porcelain/ceramic,,,469.76,469.76,1
HCPCS,D2750,Crown porcelain w/ h noble m,,,516.81,3604.86,21
HCPCS,D27500,Crown porcelain w/ h noble m,,,516.81,516.81,1
HCPCS,D2751,Crown porcelain fused base m,,,375.93,3604.86,21
HCPCS,D27510,Crown porcelain fused base m,,,375.93,375.93,1
HCPCS,D2752,Crown porcelain w/ noble met,,,422.67,3604.86,21
HCPCS,D27520,Crown porcelain w/ noble met,,,422.67,422.67,1
HCPCS,D2753,Crown porc fused to titanium,,,422.67,3604.86,21
HCPCS,D27530,Crown porc fused to titanium,,,422.67,422.67,1
HCPCS,D2780,Crown 3/4 cast hi noble met,,,422.67,3604.86,21
HCPCS,D27800,Crown 3/4 cast hi noble met,,,422.67,422.67,1
HCPCS,D2781,Crown 3/4 cast base metal,,,305.66,3604.86,21
HCPCS,D27810,Crown 3/4 cast base metal,,,305.66,305.66,1
HCPCS,D2782,Crown 3/4 cast noble metal,,,352.4,3604.86,21
HCPCS,D27820,Crown 3/4 cast noble metal,,,352.4,352.4,1
HCPCS,D2783,Crown 3/4 porcelain/ceramic,,,446.55,3604.86,21
HCPCS,D27830,Crown 3/4 porcelain/ceramic,,,446.55,446.55,1
HCPCS,D2790,Crown full cast high noble m,,,446.55,3604.86,21
HCPCS,D27900,Crown full cast high noble m,,,446.55,446.55,1
HCPCS,D2791,Crown full cast base metal,,,328.87,3604.86,21
HCPCS,D27910,Crown full cast base metal,,,328.87,328.87,1
HCPCS,D2792,Crown full cast noble metal,,,375.93,3604.86,21
HCPCS,D27920,Crown full cast noble metal,,,375.93,375.93,1
HCPCS,D2794,Crown-titanium,,,366.85,3604.86,21
HCPCS,D27940,Crown-titanium,,,366.85,366.85,1
HCPCS,D2799,Interim crown,,,136.18,3604.86,21
HCPCS,D27990,Interim crown,,,136.18,136.18,1
HCPCS,D2910,Recement inlay onlay or part,,,35.32,3604.86,21
HCPCS,D29100,Recement inlay onlay or part,,,35.32,35.32,1
HCPCS,D2915,Recement cast or prefab post,,,37.66,3604.86,21
HCPCS,D29150,Recement cast or prefab post,,,37.66,37.66,1
HCPCS,D2920,Re-cement or re-bond crown,,,35.32,3604.86,21
HCPCS,D29200,Re-cement or re-bond crown,,,35.32,35.32,1
HCPCS,D2921,Reattach tooth fragment,,,46.74,3604.86,21
HCPCS,D29210,Reattach tooth fragment,,,46.74,46.74,1
HCPCS,D2928,Prefab porc/cer crown perm,,,187.63,3604.86,21
HCPCS,D29280,Prefab porc/cer crown perm,,,187.63,187.63,1
HCPCS,D2929,Prefab porc/ceram crown pri,,,140.89,3604.86,21
HCPCS,D29290,Prefab porc/ceram crown pri,,,140.89,140.89,1
HCPCS,D2930,Prefab stnlss steel crwn pri,,,93.8,3604.86,21
HCPCS,D29300,Prefab stnlss steel crwn pri,,,93.8,93.8,1
HCPCS,D2931,Prefab stnlss steel crown pe,,,140.89,3604.86,21
HCPCS,D29310,Prefab stnlss steel crown pe,,,140.89,140.89,1
HCPCS,D2932,Prefabricated resin crown,,,112.65,3604.86,21
HCPCS,D29320,Prefabricated resin crown,,,112.65,112.65,1
HCPCS,D2933,Prefab stainless steel crown,,,105.58,3604.86,21
HCPCS,D29330,Prefab stainless steel crown,,,105.58,105.58,1
HCPCS,D2934,Prefab steel crown primary,,,126.75,3604.86,21
HCPCS,D29340,Prefab steel crown primary,,,126.75,126.75,1
HCPCS,D2940,Place direct restoration,,,166.94,210.88,6
HCPCS,D2940,Protective restoration,,,35.32,3604.86,15
HCPCS,D29400,Protective restoration,,,35.32,35.32,1
HCPCS,D2941,Int therapeutic restoration,,,166.94,210.88,6
HCPCS,D2949,Restorative foundation,,,82.06,3604.86,21
HCPCS,D29490,Restorative foundation,,,82.06,82.06,1
HCPCS,D2950,Core build-up incl any pins,,,93.8,3604.86,21
HCPCS,D29500,Core build-up incl any pins,,,93.8,93.8,1
HCPCS,D2951,Tooth pin retention,,,23.53,3604.86,21
HCPCS,D29510,Tooth pin retention,,,23.53,23.53,1
HCPCS,D2952,Post and core cast + crown,,,187.63,3604.86,21
HCPCS,D29520,Post and core cast + crown,,,187.63,187.63,1
HCPCS,D2953,Each addtnl cast post,,,152.67,1671.04,7
HCPCS,D29530,Each addtnl cast post,,,152.67,152.67,1
HCPCS,D2954,Prefab post/core + crown,,,117.35,3604.86,21
HCPCS,D29540,Prefab post/core + crown,,,117.35,117.35,1
HCPCS,D2955,Post removal,,,93.8,1671.04,7
HCPCS,D29550,Post removal,,,93.8,93.8,1
HCPCS,D2956,Indirect rest remov,,,1322.9,1671.04,6
HCPCS,D2956,REMOVAL INDIRECT RESTORATION,,,79.69,79.69,1
HCPCS,D29560,REMOVAL INDIRECT RESTORATION,,,79.69,79.69,1
HCPCS,D2957,Each addtnl prefab post,,,82.06,3604.86,21
HCPCS,D29570,Each addtnl prefab post,,,82.06,82.06,1
HCPCS,D2960,Labial veneer resin direct,,,140.89,3604.86,21
HCPCS,D29600,Labial veneer resin direct,,,140.89,140.89,1
HCPCS,D2961,Labial veneer resin indirect,,,235.4,3604.86,21
HCPCS,D29610,Labial veneer resin indirect,,,235.4,235.4,1
HCPCS,D2962,Labial veneer porc indirect,,,338.61,3604.86,21
HCPCS,D29620,Labial veneer porc indirect,,,338.61,338.61,1
HCPCS,D2971,Add proc construct new crown,,,57.15,3604.86,21
HCPCS,D29710,Add proc construct new crown,,,57.15,57.15,1
HCPCS,D2975,Coping,,,197.37,3604.86,21
HCPCS,D29750,Coping,,,197.37,197.37,1
HCPCS,D2976,Band stabilization per tooth,,,52.12,1671.04,7
HCPCS,D29760,Band stabilization per tooth,,,52.12,52.12,1
HCPCS,D2980,Crown repair,,,96.51,3604.86,21
HCPCS,D29800,Crown repair,,,96.51,96.51,1
HCPCS,D2981,Inlay repair,,,247.37,3604.86,21
HCPCS,D29810,Inlay repair,,,247.37,247.37,1
HCPCS,D2982,Onlay repair,,,248.93,3604.86,21
HCPCS,D29820,Onlay repair,,,248.93,248.93,1
HCPCS,D2983,Veneer repair,,,248.86,3604.86,21
HCPCS,D29830,Veneer repair,,,248.86,248.86,1
HCPCS,D2989,Excavate tooth non-restorabl,,,59.19,210.88,7
HCPCS,D29890,Excavate tooth non-restorabl,,,59.19,59.19,1
HCPCS,D2990,Resin infiltration of lesion,,,23.53,3604.86,21
HCPCS,D29900,Resin infiltration of lesion,,,23.53,23.53,1
HCPCS,D2991,App of hydroxyapatite,,,93.8,210.88,7
HCPCS,D29910,App of hydroxyapatite,,,93.8,93.8,1
HCPCS,D2999,Dental unspec restorative pr,,,675.11,3604.86,20
HCPCS,D3110,Pulp cap direct,,,34.96,3604.86,21
HCPCS,D31100,Pulp cap direct,,,34.96,34.96,1
HCPCS,D3120,Pulp cap indirect,,,27.57,3604.86,21
HCPCS,D31200,Pulp cap indirect,,,27.57,27.57,1
HCPCS,D3220,Therapeutic pulpotomy,,,84.06,3604.86,21
HCPCS,D32200,Therapeutic pulpotomy,,,84.06,84.06,1
HCPCS,D3221,Gross pulpal debridement,,,86.66,3604.86,21
HCPCS,D32210,Gross pulpal debridement,,,111.99,111.99,1
HCPCS,D3222,Part pulp for apexogenesis,,,86.66,3604.86,21
HCPCS,D32220,Part pulp for apexogenesis,,,89.79,89.79,1
HCPCS,D3230,Pulpal therapy anterior prim,,,86.66,3604.86,21
HCPCS,D32300,Pulpal therapy anterior prim,,,92.82,92.82,1
HCPCS,D3240,Pulpal therapy posterior pri,,,86.66,3604.86,21
HCPCS,D32400,Pulpal therapy posterior pri,,,103.89,103.89,1
HCPCS,D3310,"End thxpy, anterior tooth",,,155.86,3604.86,21
HCPCS,D33100,"End thxpy, anterior tooth",,,286.49,286.49,1
HCPCS,D3320,"End thxpy, premolar tooth",,,155.86,3604.86,21
HCPCS,D33200,"End thxpy, premolar tooth",,,322.48,322.48,1
HCPCS,D3330,"End thxpy, molar tooth",,,185.69,3604.86,21
HCPCS,D33300,"End thxpy, molar tooth",,,392.43,392.43,1
HCPCS,D3331,Non-surg tx root canal obs,,,86.66,3604.86,21
HCPCS,D33310,Non-surg tx root canal obs,,,283.12,283.12,1
HCPCS,D3332,Incomplete endodontic tx,,,86.66,3604.86,21
HCPCS,D33320,Incomplete endodontic tx,,,151.3,151.3,1
HCPCS,D3333,Internal root repair,,,86.66,3604.86,21
HCPCS,D33330,Internal root repair,,,111.99,111.99,1
HCPCS,D3346,Retreat root canal anterior,,,185.69,3604.86,21
HCPCS,D33460,Retreat root canal anterior,,,308.69,308.69,1
HCPCS,D3347,Retreat root canal premolar,,,185.69,3604.86,21
HCPCS,D33470,Retreat root canal premolar,,,375.61,375.61,1
HCPCS,D3348,Retreat root canal molar,,,185.69,3604.86,21
HCPCS,D33480,Retreat root canal molar,,,462.69,462.69,1
HCPCS,D3351,Apexification/recalc initial,,,86.66,3604.86,21
HCPCS,D33510,Apexification/recalc initial,,,140.22,140.22,1
HCPCS,D3352,Apexification/recalc interim,,,86.66,3604.86,21
HCPCS,D33520,Apexification/recalc interim,,,106.6,106.6,1
HCPCS,D3353,Apexification/recalc final,,,155.86,3604.86,21
HCPCS,D33530,Apexification/recalc final,,,224.27,224.27,1
HCPCS,D3355,Pulpal regeneration initial,,,86.66,3604.86,21
HCPCS,D33550,Pulpal regeneration initial,,,168.1,168.1,1
HCPCS,D3356,Pulpal regeneration interim,,,86.66,3604.86,21
HCPCS,D33560,Pulpal regeneration interim,,,120.7,120.7,1
HCPCS,D3357,Pulpal regeneration complete,,,86.66,3604.86,21
HCPCS,D33570,Pulpal regeneration complete,,,120.7,120.7,1
HCPCS,D3410,Apicoectomy - anterior,,,155.86,3604.86,21
HCPCS,D34100,Apicoectomy - anterior,,,255.23,255.23,1
HCPCS,D3421,Root surgery premolar,,,185.69,3604.86,21
HCPCS,D34210,Root surgery premolar,,,294.22,294.22,1
HCPCS,D3425,Root surgery molar,,,185.69,3604.86,21
HCPCS,D34250,Root surgery molar,,,328.17,328.17,1
HCPCS,D3426,Root surgery ea add root,,,140.22,234.55,7
HCPCS,D34260,Root surgery ea add root,,,140.22,140.22,1
HCPCS,D3427,Periradicular surgery,,,86.66,109.46,6
HCPCS,D3428,Bone graft peri per tooth,,,151.3,3604.86,21
HCPCS,D34280,Bone graft peri per tooth,,,151.3,151.3,1
HCPCS,D3429,Bone graft peri each addl,,,86.66,148.63,7
HCPCS,D34290,Bone graft peri each addl,,,148.63,148.63,1
HCPCS,D3430,Retrograde filling,,,84.06,3604.86,21
HCPCS,D34300,Retrograde filling,,,84.06,84.06,1
HCPCS,D3431,Biological materials,,,86.66,3604.86,21
HCPCS,D34310,Biological materials,,,366.85,366.85,1
HCPCS,D3432,Guided tissue regeneration,,,155.86,3604.86,21
HCPCS,D34320,Guided tissue regeneration,,,448.91,448.91,1
HCPCS,D3450,Root amputation,,,140.22,3604.86,21
HCPCS,D34500,Root amputation,,,140.22,140.22,1
HCPCS,D3460,Endodontic endosseous implan,,,185.69,3604.86,21
HCPCS,D34600,Endodontic endosseous implan,,,434.1,434.1,1
HCPCS,D3470,Intentional replantation,,,185.69,3604.86,21
HCPCS,D34700,Intentional replantation,,,280.44,280.44,1
HCPCS,D3471,Surg rep root res anterior,,,155.86,3604.86,21
HCPCS,D34710,Surg rep root res anterior,,,224.27,224.27,1
HCPCS,D3472,Surg rep root res premolar,,,155.86,3604.86,21
HCPCS,D34720,Surg rep root res premolar,,,224.27,224.27,1
HCPCS,D3473,Surg rep root res molar,,,155.86,3604.86,21
HCPCS,D34730,Surg rep root res molar,,,224.27,224.27,1
HCPCS,D3501,Surg exp root surf anterior,,,155.86,3604.86,21
HCPCS,D35010,Surg exp root surf anterior,,,224.27,224.27,1
HCPCS,D3502,Surg exp root surf premolar,,,155.86,3604.86,21
HCPCS,D35020,Surg exp root surf premolar,,,224.27,224.27,1
HCPCS,D3503,Surg exp root surf molar,,,155.86,3604.86,21
HCPCS,D35030,Surg exp root surf molar,,,224.27,224.27,1
HCPCS,D3910,Isolation- tooth w rubb dam,,,72.98,3604.86,21
HCPCS,D39100,Isolation- tooth w rubb dam,,,72.98,72.98,1
HCPCS,D3911,Intraorifice barrier,,,86.66,3604.86,21
HCPCS,D39110,Intraorifice barrier,,,125.17,125.17,1
HCPCS,D3920,Tooth splitting,,,86.66,3604.86,21
HCPCS,D39200,Tooth splitting,,,176.87,176.87,1
HCPCS,D3921,Decor or submerg erupt tooth,,,86.66,3604.86,21
HCPCS,D39210,Decor or submerg erupt tooth,,,140.22,140.22,1
HCPCS,D3950,Canal prep/fitting of dowel,,,84.06,3604.86,21
HCPCS,D39500,Canal prep/fitting of dowel,,,84.06,84.06,1
HCPCS,D3999,Endodontic procedure,,,86.66,3604.86,20
HCPCS,D4210,Gingivectomy/plasty 4 or mor,,,215.87,7031.51,21
HCPCS,D42100,Gingivectomy/plasty 4 or mor,,,215.87,215.87,1
HCPCS,D4211,Gingivectomy/plasty 1 to 3,,,79.69,7031.51,21
HCPCS,D42110,Gingivectomy/plasty 1 to 3,,,79.69,79.69,1
HCPCS,D4212,Gingivectomy/plasty rest,,,79.69,7031.51,21
HCPCS,D42120,Gingivectomy/plasty rest,,,79.69,79.69,1
HCPCS,D4230,Ana crown exp 4 or> per quad,,,209.15,7031.51,21
HCPCS,D42300,Ana crown exp 4 or> per quad,,,209.15,209.15,1
HCPCS,D4231,Ana crown exp 1-3 per quad,,,183.93,3211.66,21
HCPCS,D42310,Ana crown exp 1-3 per quad,,,183.93,183.93,1
HCPCS,D4240,Gingival flap proc w/ planin,,,247.81,7031.51,21
HCPCS,D42400,Gingival flap proc w/ planin,,,247.81,247.81,1
HCPCS,D4241,Gngvl flap w rootplan 1-3 th,,,200.08,3211.66,21
HCPCS,D42410,Gngvl flap w rootplan 1-3 th,,,200.08,200.08,1
HCPCS,D4245,Apically positioned flap,,,293.21,3211.66,21
HCPCS,D42450,Apically positioned flap,,,293.21,293.21,1
HCPCS,D4249,Crown lengthen hard tissue,,,232.02,3604.86,21
HCPCS,D42490,Crown lengthen hard tissue,,,232.02,232.02,1
HCPCS,D4260,Osseous surgery 4 or more,,,363.47,12826.13,21
HCPCS,D42600,Osseous surgery 4 or more,,,363.47,363.47,1
HCPCS,D4261,Osseous surg 1 to 3 teeth,,,282.13,7031.51,21
HCPCS,D42610,Osseous surg 1 to 3 teeth,,,282.13,282.13,1
HCPCS,D4263,Bone replce graft first site,,,215.87,3604.86,21
HCPCS,D42630,Bone replce graft first site,,,215.87,215.87,1
HCPCS,D4264,Bone replce graft each add,,,176.87,796.57,7
HCPCS,D42640,Bone replce graft each add,,,176.87,176.87,1
HCPCS,D4265,Bio mtrls to aid soft/os reg,,,149.97,3604.86,21
HCPCS,D42650,Bio mtrls to aid soft/os reg,,,149.97,149.97,1
HCPCS,D4266,Guided tiss regen resorble,,,315.76,3211.66,21
HCPCS,D42660,Guided tiss regen resorble,,,315.76,315.76,1
HCPCS,D4267,Guided tiss regen nonresorb,,,363.47,3211.66,21
HCPCS,D42670,Guided tiss regen nonresorb,,,363.47,363.47,1
HCPCS,D4268,Surgical revision procedure,,,302.64,3604.86,21
HCPCS,D42680,Surgical revision procedure,,,302.64,302.64,1
HCPCS,D4270,Pedicle soft tissue graft pr,,,277.41,3211.66,21
HCPCS,D42700,Pedicle soft tissue graft pr,,,277.41,277.41,1
HCPCS,D4273,Auto tissue graft 1st tooth,,,375.27,3211.66,21
HCPCS,D42730,Auto tissue graft 1st tooth,,,375.27,375.27,1
HCPCS,D4274,Mesial/distal wedge proc,,,232.02,3604.86,21
HCPCS,D42740,Mesial/distal wedge proc,,,232.02,232.02,1
HCPCS,D4275,Non-auto graft 1st tooth,,,323.14,3211.66,21
HCPCS,D42750,Non-auto graft 1st tooth,,,323.14,323.14,1
HCPCS,D4276,Con tissue w pedicle graft,,,363.47,3211.66,21
HCPCS,D42760,Con tissue w pedicle graft,,,363.47,363.47,1
HCPCS,D4277,Soft tissue graft firsttooth,,,662.16,3211.66,21
HCPCS,D42770,Soft tissue graft firsttooth,,,681.94,681.94,1
HCPCS,D4278,Soft tissue graft addl tooth,,,227.3,836.41,7
HCPCS,D42780,Soft tissue graft addl tooth,,,227.3,227.3,1
HCPCS,D4283,Auto tissue graft addl tooth,,,188.65,796.57,7
HCPCS,D42830,Auto tissue graft addl tooth,,,188.65,188.65,1
HCPCS,D4285,Non-auto graft addl tooth,,,161.38,836.41,7
HCPCS,D42850,Non-auto graft addl tooth,,,161.38,161.38,1
HCPCS,D4286,Remove non-resorb barrier,,,67.91,796.57,7
HCPCS,D42860,Remove non-resorb barrier,,,67.91,67.91,1
HCPCS,D4320,Provision splnt intracoronal,,,630.62,796.57,6
HCPCS,D4321,Provisional splint extracoro,,,630.62,796.57,6
HCPCS,D4322,Splint intra-coronal,,,188.65,3604.86,21
HCPCS,D43220,Splint intra-coronal,,,188.65,188.65,1
HCPCS,D4323,Splint extra-coronal,,,97.84,3604.86,21
HCPCS,D43230,Splint extra-coronal,,,97.84,97.84,1
HCPCS,D4341,Periodontal scaling & root,,,113.67,3604.86,21
HCPCS,D43410,Periodontal scaling & root,,,113.67,113.67,1
HCPCS,D4342,Periodontal scaling 1-3teeth,,,61.19,3604.86,21
HCPCS,D43420,Periodontal scaling 1-3teeth,,,61.19,61.19,1
HCPCS,D4346,Scaling gingiv inflammation,,,204.43,3604.86,21
HCPCS,D43460,Scaling gingiv inflammation,,,204.43,204.43,1
HCPCS,D4355,Full mouth debridement,,,56.83,3604.86,21
HCPCS,D43550,Full mouth debridement,,,56.83,56.83,1
HCPCS,D4381,Localized delivery antimicro,,,77.34,3604.86,21
HCPCS,D43810,Localized delivery antimicro,,,77.34,77.34,1
HCPCS,D4910,Periodontal maint procedures,,,45.4,3604.86,21
HCPCS,D49100,Periodontal maint procedures,,,45.4,45.4,1
HCPCS,D4920,Unscheduled dressing change,,,29.58,3604.86,21
HCPCS,D49200,Unscheduled dressing change,,,29.58,29.58,1
HCPCS,D4921,Gingival irrigation per quad,,,22.86,279.41,21
HCPCS,D49210,Gingival irrigation per quad,,,22.86,22.86,1
HCPCS,D4999,Unspecified periodontal proc,,,233.1,796.57,20
HCPCS,D5110,Dentures complete maxillary,,,188.28,723.61,7
HCPCS,D51100,Dentures complete maxillary,,,723.61,723.61,1
HCPCS,D5120,Dentures complete mandible,,,188.28,723.61,7
HCPCS,D51200,Dentures complete mandible,,,723.61,723.61,1
HCPCS,D5130,Dentures immediat maxillary,,,188.28,795.93,7
HCPCS,D51300,Dentures immediat maxillary,,,795.93,795.93,1
HCPCS,D5140,Dentures immediat mandible,,,188.28,795.93,7
HCPCS,D51400,Dentures immediat mandible,,,795.93,795.93,1
HCPCS,D5211,Dentures maxill part resin,,,158.09,491.95,7
HCPCS,D52110,Dentures maxill part resin,,,491.95,491.95,1
HCPCS,D5212,Dentures mand part resin,,,158.09,512.46,7
HCPCS,D52120,Dentures mand part resin,,,512.46,512.46,1
HCPCS,D5213,Dentures maxill part metal,,,188.28,867.88,7
HCPCS,D52130,Dentures maxill part metal,,,867.88,867.88,1
HCPCS,D5214,Dentures mandibl part metal,,,188.28,867.88,7
HCPCS,D52140,Dentures mandibl part metal,,,867.88,867.88,1
HCPCS,D5221,Immed max part denture resin,,,158.09,491.95,7
HCPCS,D52210,Immed max part denture resin,,,491.95,491.95,1
HCPCS,D5222,Immed man part denture resin,,,158.09,512.46,7
HCPCS,D52220,Immed man part denture resin,,,512.46,512.46,1
HCPCS,D5223,Immed max part dent metal,,,158.09,867.88,7
HCPCS,D52230,Immed max part dent metal,,,867.88,867.88,1
HCPCS,D5224,Immed mand part dent metal,,,158.09,867.88,7
HCPCS,D52240,Immed mand part dent metal,,,867.88,867.88,1
HCPCS,D5225,Maxillary part denture flex,,,188.28,616.35,7
HCPCS,D52250,Maxillary part denture flex,,,616.35,616.35,1
HCPCS,D5226,Mandibular part denture flex,,,188.28,616.35,7
HCPCS,D52260,Mandibular part denture flex,,,616.35,616.35,1
HCPCS,D5227,Immed max part denture,,,158.09,433.78,7
HCPCS,D52270,Immed max part denture,,,433.78,433.78,1
HCPCS,D5228,Immed mand part denture,,,158.09,433.78,7
HCPCS,D52280,Immed mand part denture,,,433.78,433.78,1
HCPCS,D5282,"Remove unil part denture,max",,,158.09,387.35,7
HCPCS,D52820,"Remove unil part denture,max",,,387.35,387.35,1
HCPCS,D5283,"Remove unil part denture,man",,,158.09,387.35,7
HCPCS,D52830,"Remove unil part denture,man",,,387.35,387.35,1
HCPCS,D5284,Rem unilat dent flex base,,,158.09,387.35,7
HCPCS,D52840,Rem unilat dent flex base,,,387.35,387.35,1
HCPCS,D5286,Rem unilat dent 1 pc resin,,,158.09,387.35,7
HCPCS,D52860,Rem unilat dent 1 pc resin,,,387.35,387.35,1
HCPCS,D5410,Dentures adjust cmplt maxil,,,34.29,210.88,7
HCPCS,D54100,Dentures adjust cmplt maxil,,,34.29,34.29,1
HCPCS,D5411,Dentures adjust cmplt mand,,,34.29,210.88,7
HCPCS,D54110,Dentures adjust cmplt mand,,,34.29,34.29,1
HCPCS,D5421,Dentures adjust part maxill,,,34.29,210.88,7
HCPCS,D54210,Dentures adjust part maxill,,,34.29,34.29,1
HCPCS,D5422,Dentures adjust part mandbl,,,34.29,210.88,7
HCPCS,D54220,Dentures adjust part mandbl,,,34.29,34.29,1
HCPCS,D5511,Rep broke comp dent base man,,,86.77,137.7,7
HCPCS,D55110,Rep broke comp dent base man,,,86.77,86.77,1
HCPCS,D5512,Rep broke comp dent base max,,,86.77,137.7,7
HCPCS,D55120,Rep broke comp dent base max,,,86.77,86.77,1
HCPCS,D5520,Replace denture teeth complt,,,57.81,137.7,7
HCPCS,D55200,Replace denture teeth complt,,,57.81,57.81,1
HCPCS,D5611,Rep resin part dent base man,,,86.77,137.7,7
HCPCS,D56110,Rep resin part dent base man,,,86.77,86.77,1
HCPCS,D5612,Rep resin part dent base max,,,86.77,137.7,7
HCPCS,D56120,Rep resin part dent base max,,,86.77,86.77,1
HCPCS,D5621,Rep cast part frame man,,,109.01,137.7,7
HCPCS,D56210,Rep cast part frame man,,,118.7,118.7,1
HCPCS,D5622,Rep cast part frame max,,,109.01,137.7,7
HCPCS,D56220,Rep cast part frame max,,,118.7,118.7,1
HCPCS,D5630,Rep partial denture clasp,,,106.92,137.7,7
HCPCS,D56300,Rep partial denture clasp,,,106.92,106.92,1
HCPCS,D5640,Replace part denture teeth,,,86.77,137.7,7
HCPCS,D56400,Replace part denture teeth,,,86.77,86.77,1
HCPCS,D5650,Add tooth to partial denture,,,86.77,137.7,7
HCPCS,D56500,Add tooth to partial denture,,,86.77,86.77,1
HCPCS,D5660,Add clasp to partial denture,,,109.01,144.58,7
HCPCS,D56600,Add clasp to partial denture,,,144.58,144.58,1
HCPCS,D5670,Replc tth&acrlc on mtl frmwk,,,158.09,431.07,7
HCPCS,D56700,Replc tth&acrlc on mtl frmwk,,,431.07,431.07,1
HCPCS,D5671,Replc tth&acrlc mandibular,,,158.09,431.07,7
HCPCS,D56710,Replc tth&acrlc mandibular,,,431.07,431.07,1
HCPCS,D5710,Dentures rebase cmplt maxil,,,158.09,289.52,7
HCPCS,D57100,Dentures rebase cmplt maxil,,,289.52,289.52,1
HCPCS,D5711,Dentures rebase cmplt mand,,,158.09,289.52,7
HCPCS,D57110,Dentures rebase cmplt mand,,,289.52,289.52,1
HCPCS,D5720,Dentures rebase part maxill,,,158.09,231.34,7
HCPCS,D57200,Dentures rebase part maxill,,,231.34,231.34,1
HCPCS,D5721,Dentures rebase part mandbl,,,158.09,231.34,7
HCPCS,D57210,Dentures rebase part mandbl,,,231.34,231.34,1
HCPCS,D5725,Rebase hybrid prosthesis,,,158.09,240.42,7
HCPCS,D57250,Rebase hybrid prosthesis,,,240.42,240.42,1
HCPCS,D5730,Denture reln cmplt max dir,,,109.01,173.49,7
HCPCS,D57300,Denture reln cmplt max dir,,,173.49,173.49,1
HCPCS,D5731,Denture reln cmplt mand dir,,,109.01,173.49,7
HCPCS,D57310,Denture reln cmplt mand dir,,,173.49,173.49,1
HCPCS,D5740,Denture reln part max dir,,,109.01,144.58,7
HCPCS,D57400,Denture reln part max dir,,,144.58,144.58,1
HCPCS,D5741,Denture reln part mand dir,,,109.01,144.58,7
HCPCS,D57410,Denture reln part mand dir,,,144.58,144.58,1
HCPCS,D5750,Denture reln cmplt max indir,,,109.01,231.34,7
HCPCS,D57500,Denture reln cmplt max indir,,,231.34,231.34,1
HCPCS,D5751,Denture reln cmplt mand ind,,,109.01,231.34,7
HCPCS,D57510,Denture reln cmplt mand ind,,,231.34,231.34,1
HCPCS,D5760,Denture reln part max indir,,,109.01,231.34,7
HCPCS,D57600,Denture reln part max indir,,,231.34,231.34,1
HCPCS,D5761,Denture reln part mand indir,,,109.01,231.34,7
HCPCS,D57610,Denture reln part mand indir,,,231.34,231.34,1
HCPCS,D5765,Liner compl/partial rem dent,,,109.01,542.51,7
HCPCS,D57650,Liner compl/partial rem dent,,,542.51,542.51,1
HCPCS,D5810,Denture interm cmplt maxill,,,158.09,347.01,7
HCPCS,D58100,Denture interm cmplt maxill,,,347.01,347.01,1
HCPCS,D5811,Denture interm cmplt mandbl,,,158.09,347.01,7
HCPCS,D58110,Denture interm cmplt mandbl,,,347.01,347.01,1
HCPCS,D5820,Denture interm part maxill,,,158.09,289.52,7
HCPCS,D58200,Denture interm part maxill,,,289.52,289.52,1
HCPCS,D5821,Denture interm part mandbl,,,158.09,289.52,7
HCPCS,D58210,Denture interm part mandbl,,,289.52,289.52,1
HCPCS,D5850,Denture tiss conditn maxill,,,75.34,137.7,7
HCPCS,D58500,Denture tiss conditn maxill,,,75.34,75.34,1
HCPCS,D5851,Denture tiss condtin mandbl,,,75.34,137.7,7
HCPCS,D58510,Denture tiss condtin mandbl,,,75.34,75.34,1
HCPCS,D5862,Precision attachment,,,109.01,257.22,7
HCPCS,D58620,Precision attachment,,,257.22,257.22,1
HCPCS,D5863,Overdenture complete max,,,188.28,766.66,7
HCPCS,D58630,Overdenture complete max,,,766.66,766.66,1
HCPCS,D5864,Overdenture partial max,,,188.28,781.11,7
HCPCS,D58640,Overdenture partial max,,,781.11,781.11,1
HCPCS,D5865,Overdenture complete mandib,,,188.28,766.66,7
HCPCS,D58650,Overdenture complete mandib,,,766.66,766.66,1
HCPCS,D5866,Overdenture partial mandib,,,188.28,781.11,7
HCPCS,D58660,Overdenture partial mandib,,,781.11,781.11,1
HCPCS,D5867,Replacement of precision att,,,109.94,199.69,7
HCPCS,D58670,Replacement of precision att,,,109.94,109.94,1
HCPCS,D5875,Prosthesis modification,,,141.91,199.69,7
HCPCS,D58750,Prosthesis modification,,,141.91,141.91,1
HCPCS,D5876,Add metal sub to acrylc dent,,,98.86,137.7,7
HCPCS,D58760,Add metal sub to acrylc dent,,,98.86,98.86,1
HCPCS,D5877,Dup of complt dent-maxill,,,188.28,237.83,6
HCPCS,D5878,Dup of complt dent-mandib,,,188.28,237.83,6
HCPCS,D5899,Removable prosthodontic proc,,,109.01,137.7,6
HCPCS,D5909,Max guid prothes w/ flange,,,1829.98,2311.55,6
HCPCS,D5911,Facial moulage sectional,,,115.68,3604.86,21
HCPCS,D59110,Facial moulage sectional,,,115.68,115.68,1
HCPCS,D5912,Facial moulage complete,,,173.49,3604.86,21
HCPCS,D59120,Facial moulage complete,,,173.49,173.49,1
HCPCS,D5913,Nasal prosthesis,,,1829.98,2893.11,7
HCPCS,D59130,Nasal prosthesis,,,2893.11,2893.11,1
HCPCS,D5914,Auricular prosthesis,,,1829.98,2893.11,7
HCPCS,D59140,Auricular prosthesis,,,2893.11,2893.11,1
HCPCS,D5915,Orbital prosthesis,,,1829.98,3905.93,7
HCPCS,D59150,Orbital prosthesis,,,3905.93,3905.93,1
HCPCS,D5916,Ocular prosthesis,,,1829.98,4050.51,7
HCPCS,D59160,Ocular prosthesis,,,4050.51,4050.51,1
HCPCS,D5919,Facial prosthesis,,,1829.98,2311.55,6
HCPCS,D5922,Nasal septal prosthesis,,,1829.98,2311.55,7
HCPCS,D59220,Nasal septal prosthesis,,,1880.33,1880.33,1
HCPCS,D5923,Ocular prosthesis interim,,,1829.98,2314.43,7
HCPCS,D59230,Ocular prosthesis interim,,,2314.43,2314.43,1
HCPCS,D5924,Cranial prosthesis,,,414.72,2311.55,7
HCPCS,D59240,Cranial prosthesis,,,414.72,414.72,1
HCPCS,D5925,Facial augmentation implant,,,567.0,2311.55,7
HCPCS,D59250,Facial augmentation implant,,,567.0,567.0,1
HCPCS,D5926,Replacement nasal prosthesis,,,1446.56,2311.55,7
HCPCS,D59260,Replacement nasal prosthesis,,,1446.56,1446.56,1
HCPCS,D5927,Auricular replacement,,,1446.56,2311.55,7
HCPCS,D59270,Auricular replacement,,,1446.56,1446.56,1
HCPCS,D5928,Orbital replacement,,,1829.98,2311.55,7
HCPCS,D59280,Orbital replacement,,,1952.96,1952.96,1
HCPCS,D5929,Facial replacement,,,1829.98,2311.55,6
HCPCS,D5930,Max guid prothes w/o flange,,,1829.98,2311.55,6
HCPCS,D5931,Surgical obturator,,,926.05,2311.55,7
HCPCS,D59310,Surgical obturator,,,926.05,926.05,1
HCPCS,D5932,Postsurgical obturator,,,1829.98,2311.55,7
HCPCS,D59320,Postsurgical obturator,,,2169.86,2169.86,1
HCPCS,D5933,Refitting of obturator,,,433.78,2311.55,7
HCPCS,D59330,Refitting of obturator,,,433.78,433.78,1
HCPCS,D5934,Mandibular flange prosthesis,,,1829.98,2311.55,7
HCPCS,D59340,Mandibular flange prosthesis,,,2169.86,2169.86,1
HCPCS,D5935,Mandibular denture prosth,,,1829.98,2311.55,7
HCPCS,D59350,Mandibular denture prosth,,,2169.86,2169.86,1
HCPCS,D5936,Temp obturator prosthesis,,,795.93,2311.55,7
HCPCS,D59360,Temp obturator prosthesis,,,795.93,795.93,1
HCPCS,D5937,Trismus appliance,,,263.28,1396.08,7
HCPCS,D59370,Trismus appliance,,,263.28,263.28,1
HCPCS,D5938,Resct proth max comp remov,,,1829.98,2311.55,6
HCPCS,D5939,Resct proth mand comp remov,,,1829.98,2311.55,6
HCPCS,D5940,Resct proth max part remov,,,1105.23,1396.08,6
HCPCS,D5941,Resct proth mand part remov,,,1105.23,1396.08,6
HCPCS,D5942,Proth max implt sup remv,,,1829.98,2311.55,6
HCPCS,D5943,Proth mandib implt sup remv,,,1829.98,2311.55,6
HCPCS,D5944,Max implt sup remv part,,,1105.23,1396.08,6
HCPCS,D5945,Mand implt sup remv part,,,1105.23,1396.08,6
HCPCS,D5946,Max implt sup fix,,,1829.98,2311.55,6
HCPCS,D5947,Mand implt sup fix,,,1829.98,2311.55,6
HCPCS,D5948,Max implt sup fix part,,,1829.98,2311.55,6
HCPCS,D5949,Mand implt sup fix part,,,1829.98,2311.55,6
HCPCS,D5951,Feeding aid,,,867.88,2311.55,7
HCPCS,D59510,Feeding aid,,,867.88,867.88,1
HCPCS,D5952,Pediatric speech aid,,,867.88,2311.55,7
HCPCS,D59520,Pediatric speech aid,,,867.88,867.88,1
HCPCS,D5953,Adult speech aid,,,867.88,2311.55,7
HCPCS,D59530,Adult speech aid,,,867.88,867.88,1
HCPCS,D5954,Superimposed prosthesis,,,1829.98,2430.78,7
HCPCS,D59540,Superimposed prosthesis,,,2430.78,2430.78,1
HCPCS,D5955,Palatal lift prosthesis,,,1829.98,2311.55,7
HCPCS,D59550,Palatal lift prosthesis,,,1880.33,1880.33,1
HCPCS,D5958,Intraoral con def inter plt,,,1099.22,2311.55,7
HCPCS,D59580,Intraoral con def inter plt,,,1099.22,1099.22,1
HCPCS,D5959,Intraoral con def mod palat,,,347.01,2311.55,7
HCPCS,D59590,Intraoral con def mod palat,,,347.01,347.01,1
HCPCS,D5960,Modify speech aid prosthesis,,,231.34,2311.55,7
HCPCS,D59600,Modify speech aid prosthesis,,,231.34,231.34,1
HCPCS,D5982,Surgical stent,,,156.36,2311.55,7
HCPCS,D59820,Surgical stent,,,156.36,156.36,1
HCPCS,D5983,Radiation applicator,,,495.64,3604.86,21
HCPCS,D59830,Radiation applicator,,,495.64,495.64,1
HCPCS,D5984,Radiation shield,,,495.64,3604.86,21
HCPCS,D59840,Radiation shield,,,495.64,495.64,1
HCPCS,D5985,Radiation cone locator,,,675.11,3604.86,21
HCPCS,D59850,Radiation cone locator,,,810.02,810.02,1
HCPCS,D5986,Fluoride applicator,,,86.77,210.88,7
HCPCS,D59860,Fluoride applicator,,,86.77,86.77,1
HCPCS,D5987,Commissure splint,,,289.52,3604.86,21
HCPCS,D59870,Commissure splint,,,289.52,289.52,1
HCPCS,D5988,Surgical splint,,,309.7,3604.86,21
HCPCS,D59880,Surgical splint,,,309.7,309.7,1
HCPCS,D5991,Vesiculobullous disease carr,,,78.0,1396.08,7
HCPCS,D59910,Vesiculobullous disease carr,,,78.0,78.0,1
HCPCS,D5992,Adjust max prost appliance,,,124.07,1396.08,7
HCPCS,D59920,Adjust max prost appliance,,,124.07,124.07,1
HCPCS,D5993,Main/clean max prosthesis,,,219.91,1396.08,7
HCPCS,D59930,Main/clean max prosthesis,,,219.91,219.91,1
HCPCS,D5994,Peridontal medicament,,,109.01,137.7,6
HCPCS,D5995,"Peri medicament w/seal, max",,,69.61,1396.08,7
HCPCS,D59950,"Peri medicament w/seal, max",,,69.61,69.61,1
HCPCS,D5996,"Peri medicament w/seal, mand",,,69.61,1396.08,7
HCPCS,D59960,"Peri medicament w/seal, mand",,,69.61,69.61,1
HCPCS,D5999,Maxillofacial prosthesis,,,1829.98,2311.55,6
HCPCS,D6010,Odontics endosteal implant,,,770.35,1009.54,7
HCPCS,D60100,Odontics endosteal implant,,,770.35,770.35,1
HCPCS,D6011,Second stage implant surgery,,,121.37,1009.54,7
HCPCS,D60110,Second stage implant surgery,,,121.37,121.37,1
HCPCS,D6012,Endosteal implant,,,583.39,1009.54,7
HCPCS,D60120,Endosteal implant,,,583.39,583.39,1
HCPCS,D6013,Surgical place mini implant,,,588.1,1009.54,7
HCPCS,D60130,Surgical place mini implant,,,588.1,588.1,1
HCPCS,D6040,Odontics eposteal implant,,,879.14,2777.45,7
HCPCS,D60400,Odontics eposteal implant,,,2777.45,2777.45,1
HCPCS,D6049,Scale implt peri-implt inflm,,,166.94,210.88,6
HCPCS,D6050,Odontics transosteal implnt,,,879.14,2216.92,7
HCPCS,D60500,Odontics transosteal implnt,,,2216.92,2216.92,1
HCPCS,D6051,Interim implant abutment,,,133.15,1009.54,7
HCPCS,D60510,Interim implant abutment,,,133.15,133.15,1
HCPCS,D6052,Semi precision attach abut,,,799.22,1009.54,6
HCPCS,D6055,Implant connecting bar,,,799.22,1009.54,7
HCPCS,D60550,Implant connecting bar,,,875.62,875.62,1
HCPCS,D6056,Prefabricated abutment,,,247.48,1009.54,7
HCPCS,D60560,Prefabricated abutment,,,247.48,247.48,1
HCPCS,D6057,Custom abutment,,,345.69,1009.54,7
HCPCS,D60570,Custom abutment,,,345.69,345.69,1
HCPCS,D6058,Abutment supported crown,,,469.41,1009.54,7
HCPCS,D60580,Abutment supported crown,,,469.41,469.41,1
HCPCS,D6059,Abutment supported mtl crown,,,457.3,1009.54,7
HCPCS,D60590,Abutment supported mtl crown,,,457.3,457.3,1
HCPCS,D6060,Abutment supported mtl crown,,,422.67,1009.54,7
HCPCS,D60600,Abutment supported mtl crown,,,422.67,422.67,1
HCPCS,D6061,Abutment supported mtl crown,,,432.1,1009.54,7
HCPCS,D60610,Abutment supported mtl crown,,,432.1,432.1,1
HCPCS,D6062,Abutment supported mtl crown,,,438.81,1009.54,7
HCPCS,D60620,Abutment supported mtl crown,,,438.81,438.81,1
HCPCS,D6063,Abutment supported mtl crown,,,408.89,1009.54,7
HCPCS,D60630,Abutment supported mtl crown,,,408.89,408.89,1
HCPCS,D6064,Abutment supported mtl crown,,,429.73,1009.54,7
HCPCS,D60640,Abutment supported mtl crown,,,429.73,429.73,1
HCPCS,D6065,Implant supported crown,,,583.39,1009.54,7
HCPCS,D60650,Implant supported crown,,,583.39,583.39,1
HCPCS,D6066,Implant supported mtl crown,,,583.39,1009.54,7
HCPCS,D60660,Implant supported mtl crown,,,583.39,583.39,1
HCPCS,D6067,Implant supported mtl crown,,,583.39,1009.54,7
HCPCS,D60670,Implant supported mtl crown,,,583.39,583.39,1
HCPCS,D6068,Abutment supported retainer,,,415.28,1009.54,7
HCPCS,D60680,Abutment supported retainer,,,415.28,415.28,1
HCPCS,D6069,Abutment supported retainer,,,455.31,1009.54,7
HCPCS,D60690,Abutment supported retainer,,,455.31,455.31,1
HCPCS,D6070,Abutment supported retainer,,,412.93,1009.54,7
HCPCS,D60700,Abutment supported retainer,,,412.93,412.93,1
HCPCS,D6071,Abutment supported retainer,,,432.1,1009.54,7
HCPCS,D60710,Abutment supported retainer,,,432.1,432.1,1
HCPCS,D6072,Abutment supported retainer,,,455.31,1009.54,7
HCPCS,D60720,Abutment supported retainer,,,455.31,455.31,1
HCPCS,D6073,Abutment supported retainer,,,394.43,1009.54,7
HCPCS,D60730,Abutment supported retainer,,,394.43,394.43,1
HCPCS,D6074,Abutment supported retainer,,,399.15,1009.54,7
HCPCS,D60740,Abutment supported retainer,,,399.15,399.15,1
HCPCS,D6075,Implant supported retainer,,,471.41,1009.54,7
HCPCS,D60750,Implant supported retainer,,,471.41,471.41,1
HCPCS,D6076,Implant supported retainer,,,457.3,1009.54,7
HCPCS,D60760,Implant supported retainer,,,457.3,457.3,1
HCPCS,D6077,Implant supported retainer,,,508.77,1009.54,7
HCPCS,D60770,Implant supported retainer,,,508.77,508.77,1
HCPCS,D6080,Implant maintenance,,,82.06,210.88,7
HCPCS,D60800,Implant maintenance,,,82.06,82.06,1
HCPCS,D6081,"Scale & debride, single imp",,,116.69,210.88,7
HCPCS,D60810,"Scale & debride, single imp",,,116.69,116.69,1
HCPCS,D6082,Imp crown porc to base alloy,,,513.79,1009.54,7
HCPCS,D60820,Imp crown porc to base alloy,,,513.79,513.79,1
HCPCS,D6083,Imp crown porc to noble allo,,,583.39,1009.54,7
HCPCS,D60830,Imp crown porc to noble allo,,,583.39,583.39,1
HCPCS,D6084,Imp crown porc to titanium,,,583.39,1009.54,7
HCPCS,D60840,Imp crown porc to titanium,,,583.39,583.39,1
HCPCS,D6085,Interim implant crown,,,139.87,1009.54,7
HCPCS,D60850,Interim implant crown,,,139.87,139.87,1
HCPCS,D6086,Imp crown base alloys,,,396.78,1009.54,7
HCPCS,D60860,Imp crown base alloys,,,396.78,396.78,1
HCPCS,D6087,Implant crown noble alloys,,,466.73,1009.54,7
HCPCS,D60870,Implant crown noble alloys,,,466.73,466.73,1
HCPCS,D6088,Imp crown titanium alloys,,,443.52,1009.54,7
HCPCS,D60880,Imp crown titanium alloys,,,443.52,443.52,1
HCPCS,D6089,Access/retorq implant screw,,,88.78,210.88,7
HCPCS,D60890,Access/retorq implant screw,,,88.78,88.78,1
HCPCS,D6090,Repair implant,,,260.92,1009.54,7
HCPCS,D60900,Repair implant,,,260.92,260.92,1
HCPCS,D6091,Repl semi/precision attach,,,205.46,1009.54,7
HCPCS,D60910,Repl semi/precision attach,,,205.46,205.46,1
HCPCS,D6092,Recement supp crown,,,53.81,210.88,7
HCPCS,D60920,Recement supp crown,,,53.81,53.81,1
HCPCS,D6093,Recement supp part denture,,,58.53,210.88,7
HCPCS,D60930,Recement supp part denture,,,58.53,58.53,1
HCPCS,D6094,Abut support crown titanium,,,394.43,1009.54,7
HCPCS,D60940,Abut support crown titanium,,,394.43,394.43,1
HCPCS,D6095,Odontics repr abutment,,,799.22,1009.54,6
HCPCS,D6096,Remove broken imp ret screw,,,116.69,210.88,7
HCPCS,D60960,Remove broken imp ret screw,,,116.69,116.69,1
HCPCS,D6097,Abut crown porc to titanium,,,441.16,1009.54,7
HCPCS,D60970,Abut crown porc to titanium,,,441.16,441.16,1
HCPCS,D6098,Imp retain porc to base allo,,,419.99,1009.54,7
HCPCS,D60980,Imp retain porc to base allo,,,419.99,419.99,1
HCPCS,D6099,Imp retainer for fpd,,,429.73,1009.54,7
HCPCS,D60990,Imp retainer for fpd,,,429.73,429.73,1
HCPCS,D6100,Surg removal of implant body,,,300.94,1009.54,7
HCPCS,D61000,Surg removal of implant body,,,300.94,300.94,1
HCPCS,D6101,Debridement of a periimplant,,,149.3,210.88,7
HCPCS,D61010,Debridement of a periimplant,,,149.3,149.3,1
HCPCS,D6102,Debridement & contouring,,,166.94,260.92,7
HCPCS,D61020,Debridement & contouring,,,260.92,260.92,1
HCPCS,D6103,Bone graft repair perimplant,,,175.53,836.41,7
HCPCS,D61030,Bone graft repair perimplant,,,175.53,175.53,1
HCPCS,D6104,Bone graft time of implant,,,236.06,1009.54,7
HCPCS,D61040,Bone graft time of implant,,,236.06,236.06,1
HCPCS,D6105,Remove implant body,,,82.06,1009.54,7
HCPCS,D61050,Remove implant body,,,82.06,82.06,1
HCPCS,D6106,Tissue regen resorbable,,,166.94,324.48,7
HCPCS,D61060,Tissue regen resorbable,,,324.48,324.48,1
HCPCS,D6107,Tissue regen non-resorbable,,,166.94,373.25,7
HCPCS,D61070,Tissue regen non-resorbable,,,373.25,373.25,1
HCPCS,D6110,Implnt/abut remov dent max,,,799.22,1009.54,7
HCPCS,D61100,Implnt/abut remov dent max,,,879.97,879.97,1
HCPCS,D6111,Implnt/abut remov dent mand,,,799.22,1009.54,7
HCPCS,D61110,Implnt/abut remov dent mand,,,879.97,879.97,1
HCPCS,D6112,Imp/abut rem dent part max,,,799.22,1009.54,7
HCPCS,D61120,Imp/abut rem dent part max,,,872.91,872.91,1
HCPCS,D6113,Imp/abut rem dent part mand,,,799.22,1009.54,7
HCPCS,D61130,Imp/abut rem dent part mand,,,872.91,872.91,1
HCPCS,D6114,Implnt/abut fixed dent max,,,879.14,1530.96,7
HCPCS,D61140,Implnt/abut fixed dent max,,,1530.96,1530.96,1
HCPCS,D6115,Implnt/abut fixed dent mand,,,879.14,1530.96,7
HCPCS,D61150,Implnt/abut fixed dent mand,,,1530.96,1530.96,1
HCPCS,D6116,Imp/abut fixed dent part max,,,879.14,1173.85,7
HCPCS,D61160,Imp/abut fixed dent part max,,,1173.85,1173.85,1
HCPCS,D6117,Imp/abut fixed dent part man,,,879.14,1173.85,7
HCPCS,D61170,Imp/abut fixed dent part man,,,1173.85,1173.85,1
HCPCS,D6118,Imp/abut int fixed dent man,,,799.22,1009.54,7
HCPCS,D61180,Imp/abut int fixed dent man,,,991.96,991.96,1
HCPCS,D6119,Int/abut int fixed dent max,,,799.22,1009.54,7
HCPCS,D61190,Int/abut int fixed dent max,,,991.96,991.96,1
HCPCS,D6120,Imp retain porc to titanium,,,441.16,1009.54,7
HCPCS,D61200,Imp retain porc to titanium,,,441.16,441.16,1
HCPCS,D6121,Retain metal fpd base alloys,,,419.99,1009.54,7
HCPCS,D61210,Retain metal fpd base alloys,,,419.99,419.99,1
HCPCS,D6122,Retain metal fpd noble alloy,,,432.1,1009.54,7
HCPCS,D61220,Retain metal fpd noble alloy,,,432.1,432.1,1
HCPCS,D6123,Retain metal fpd titanium,,,443.52,1009.54,7
HCPCS,D61230,Retain metal fpd titanium,,,443.52,443.52,1
HCPCS,D6180,IMPLANT MAINTENANCE FIXED,,,45.41,45.41,1
HCPCS,D6180,Implnt maint proced,,,166.94,210.88,6
HCPCS,D61800,IMPLANT MAINTENANCE FIXED,,,45.41,45.41,1
HCPCS,D6190,Radio/surgical implant index,,,86.94,109.82,7
HCPCS,D61900,Radio/surgical implant index,,,92.15,92.15,1
HCPCS,D6191,Semi precision abutment,,,258.13,1009.54,7
HCPCS,D61910,Semi precision abutment,,,258.13,258.13,1
HCPCS,D6192,Semi precision attachment,,,254.25,1009.54,7
HCPCS,D61920,Semi precision attachment,,,254.25,254.25,1
HCPCS,D6193,REPLACEMENT IMPLANT SCREW,,,147.32,147.32,1
HCPCS,D6193,Replace implnt screw,,,166.94,210.88,6
HCPCS,D61930,REPLACEMENT IMPLANT SCREW,,,147.32,147.32,1
HCPCS,D6194,Abut support retainer titani,,,471.41,1009.54,7
HCPCS,D61940,Abut support retainer titani,,,471.41,471.41,1
HCPCS,D6195,Abut retain porc to titanium,,,518.15,1009.54,7
HCPCS,D61950,Abut retain porc to titanium,,,518.15,518.15,1
HCPCS,D6196,Remv of ind rest on implt,,,799.22,1009.54,6
HCPCS,D6197,Replace material prosthesis,,,116.69,1009.54,7
HCPCS,D61970,Replace material prosthesis,,,116.69,116.69,1
HCPCS,D6198,Remove interim implant,,,116.69,1009.54,7
HCPCS,D61980,Remove interim implant,,,116.69,116.69,1
HCPCS,D6199,Implant procedure,,,799.22,1009.54,6
HCPCS,D6205,Pontic-indirect resin based,,,236.0,338.61,7
HCPCS,D62050,Pontic-indirect resin based,,,338.61,338.61,1
HCPCS,D6210,Prosthodont high noble metal,,,291.95,466.73,7
HCPCS,D62100,Prosthodont high noble metal,,,466.73,466.73,1
HCPCS,D6211,Bridge base metal cast,,,236.0,326.83,7
HCPCS,D62110,Bridge base metal cast,,,326.83,326.83,1
HCPCS,D6212,Bridge noble metal cast,,,236.0,373.25,7
HCPCS,D62120,Bridge noble metal cast,,,373.25,373.25,1
HCPCS,D6214,Pontic titanium,,,291.95,368.78,7
HCPCS,D62140,Pontic titanium,,,361.83,361.83,1
HCPCS,D6240,Bridge porcelain high noble,,,291.95,513.79,7
HCPCS,D62400,Bridge porcelain high noble,,,513.79,513.79,1
HCPCS,D6241,Bridge porcelain base metal,,,236.0,419.99,7
HCPCS,D62410,Bridge porcelain base metal,,,419.99,419.99,1
HCPCS,D6242,Bridge porcelain nobel metal,,,291.95,466.73,7
HCPCS,D62420,Bridge porcelain nobel metal,,,466.73,466.73,1
HCPCS,D6243,Pontic porcelain to titanium,,,236.0,443.52,7
HCPCS,D62430,Pontic porcelain to titanium,,,443.52,443.52,1
HCPCS,D6245,Bridge porcelain/ceramic,,,291.95,368.78,7
HCPCS,D62450,Bridge porcelain/ceramic,,,352.4,352.4,1
HCPCS,D6250,Bridge resin w/high noble,,,236.0,466.73,7
HCPCS,D62500,Bridge resin w/high noble,,,466.73,466.73,1
HCPCS,D6251,Bridge resin base metal,,,236.0,326.83,7
HCPCS,D62510,Bridge resin base metal,,,326.83,326.83,1
HCPCS,D6252,Bridge resin w/noble metal,,,236.0,419.99,7
HCPCS,D62520,Bridge resin w/noble metal,,,419.99,419.99,1
HCPCS,D6253,Interim pontic,,,63.09,247.48,7
HCPCS,D62530,Interim pontic,,,247.48,247.48,1
HCPCS,D6280,Implt maint procd remv implt,,,166.94,210.88,6
HCPCS,D6545,Dental retainr cast metl,,,63.09,221.25,7
HCPCS,D65450,Dental retainr cast metl,,,221.25,221.25,1
HCPCS,D6548,Porcelain/ceramic retainer,,,236.0,320.11,7
HCPCS,D65480,Porcelain/ceramic retainer,,,320.11,320.11,1
HCPCS,D6549,Resin retainer,,,63.09,221.25,7
HCPCS,D65490,Resin retainer,,,221.25,221.25,1
HCPCS,D6600,Porcelain/ceramic inlay 2srf,,,236.0,333.55,7
HCPCS,D66000,Porcelain/ceramic inlay 2srf,,,333.55,333.55,1
HCPCS,D6601,Porc/ceram inlay >= 3 surfac,,,236.0,359.47,7
HCPCS,D66010,Porc/ceram inlay >= 3 surfac,,,359.47,359.47,1
HCPCS,D6602,Cst hgh nble mtl inlay 2 srf,,,236.0,342.98,7
HCPCS,D66020,Cst hgh nble mtl inlay 2 srf,,,342.98,342.98,1
HCPCS,D6603,Cst hgh nble mtl inlay >=3sr,,,236.0,350.04,7
HCPCS,D66030,Cst hgh nble mtl inlay >=3sr,,,350.04,350.04,1
HCPCS,D6604,Cst bse mtl inlay 2 surfaces,,,236.0,326.83,7
HCPCS,D66040,Cst bse mtl inlay 2 surfaces,,,326.83,326.83,1
HCPCS,D6605,Cst bse mtl inlay >= 3 surfa,,,236.0,352.4,7
HCPCS,D66050,Cst bse mtl inlay >= 3 surfa,,,352.4,352.4,1
HCPCS,D6606,Cast noble metal inlay 2 sur,,,236.0,331.54,7
HCPCS,D66060,Cast noble metal inlay 2 sur,,,331.54,331.54,1
HCPCS,D6607,Cst noble mtl inlay >=3 surf,,,236.0,357.11,7
HCPCS,D66070,Cst noble mtl inlay >=3 surf,,,357.11,357.11,1
HCPCS,D6608,Onlay porc/crmc 2 surfaces,,,236.0,361.83,7
HCPCS,D66080,Onlay porc/crmc 2 surfaces,,,361.83,361.83,1
HCPCS,D6609,Onlay porc/crmc >=3 surfaces,,,236.0,387.35,7
HCPCS,D66090,Onlay porc/crmc >=3 surfaces,,,387.35,387.35,1
HCPCS,D6610,Onlay cst hgh nbl mtl 2 srfc,,,236.0,371.21,7
HCPCS,D66100,Onlay cst hgh nbl mtl 2 srfc,,,371.21,371.21,1
HCPCS,D6611,Onlay cst hgh nbl mtl >=3srf,,,291.95,392.07,7
HCPCS,D66110,Onlay cst hgh nbl mtl >=3srf,,,392.07,392.07,1
HCPCS,D6612,Onlay cst base mtl 2 surface,,,236.0,352.4,7
HCPCS,D66120,Onlay cst base mtl 2 surface,,,352.4,352.4,1
HCPCS,D6613,Onlay cst base mtl >=3 surfa,,,236.0,385.35,7
HCPCS,D66130,Onlay cst base mtl >=3 surfa,,,385.35,385.35,1
HCPCS,D6614,Onlay cst nbl mtl 2 surfaces,,,236.0,369.21,7
HCPCS,D66140,Onlay cst nbl mtl 2 surfaces,,,369.21,369.21,1
HCPCS,D6615,Onlay cst nbl mtl >=3 surfac,,,236.0,394.43,7
HCPCS,D66150,Onlay cst nbl mtl >=3 surfac,,,394.43,394.43,1
HCPCS,D6624,Inlay titanium,,,236.0,371.21,7
HCPCS,D66240,Inlay titanium,,,371.21,371.21,1
HCPCS,D6634,Onlay titanium,,,291.95,385.35,7
HCPCS,D66340,Onlay titanium,,,385.35,385.35,1
HCPCS,D6710,Crown-indirect resin based,,,236.0,352.4,7
HCPCS,D67100,Crown-indirect resin based,,,352.4,352.4,1
HCPCS,D6720,Retain crown resin w hi nble,,,291.95,466.73,7
HCPCS,D67200,Retain crown resin w hi nble,,,466.73,466.73,1
HCPCS,D6721,Crown resin w/base metal,,,291.95,368.78,7
HCPCS,D67210,Crown resin w/base metal,,,350.04,350.04,1
HCPCS,D6722,Crown resin w/noble metal,,,291.95,396.78,7
HCPCS,D67220,Crown resin w/noble metal,,,396.78,396.78,1
HCPCS,D6740,Crown porcelain/ceramic,,,291.95,373.25,7
HCPCS,D67400,Crown porcelain/ceramic,,,373.25,373.25,1
HCPCS,D6750,Crown porcelain high noble,,,291.95,560.53,7
HCPCS,D67500,Crown porcelain high noble,,,560.53,560.53,1
HCPCS,D6751,Crown porcelain base metal,,,236.0,373.25,7
HCPCS,D67510,Crown porcelain base metal,,,373.25,373.25,1
HCPCS,D6752,Crown porcelain noble metal,,,291.95,466.73,7
HCPCS,D67520,Crown porcelain noble metal,,,466.73,466.73,1
HCPCS,D6753,Retain crown porc to titaniu,,,236.0,443.52,7
HCPCS,D67530,Retain crown porc to titaniu,,,443.52,443.52,1
HCPCS,D6780,Crown 3/4 high noble metal,,,291.95,443.52,7
HCPCS,D67800,Crown 3/4 high noble metal,,,443.52,443.52,1
HCPCS,D6781,Crown 3/4 cast based metal,,,291.95,368.78,7
HCPCS,D67810,Crown 3/4 cast based metal,,,364.14,364.14,1
HCPCS,D6782,Crown 3/4 cast noble metal,,,291.95,368.78,7
HCPCS,D67820,Crown 3/4 cast noble metal,,,366.85,366.85,1
HCPCS,D6783,Crown 3/4 porcelain/ceramic,,,291.95,369.21,7
HCPCS,D67830,Crown 3/4 porcelain/ceramic,,,369.21,369.21,1
HCPCS,D6784,Retainer crown 3/4 titanium,,,236.0,366.85,7
HCPCS,D67840,Retainer crown 3/4 titanium,,,366.85,366.85,1
HCPCS,D6790,Crown full high noble metal,,,291.95,443.52,7
HCPCS,D67900,Crown full high noble metal,,,443.52,443.52,1
HCPCS,D6791,Crown full base metal cast,,,291.95,368.78,7
HCPCS,D67910,Crown full base metal cast,,,326.83,326.83,1
HCPCS,D6792,Crown full noble metal cast,,,291.95,396.78,7
HCPCS,D67920,Crown full noble metal cast,,,396.78,396.78,1
HCPCS,D6793,Interim retainer crown,,,63.09,221.25,7
HCPCS,D67930,Interim retainer crown,,,221.25,221.25,1
HCPCS,D6794,Crown titanium,,,291.95,368.78,7
HCPCS,D67940,Crown titanium,,,322.48,322.48,1
HCPCS,D6920,Dental connector bar,,,63.09,3604.86,21
HCPCS,D69200,Dental connector bar,,,312.72,312.72,1
HCPCS,D6930,Recement/bond part denture,,,46.74,79.69,7
HCPCS,D69300,Recement/bond part denture,,,46.74,46.74,1
HCPCS,D6940,Stress breaker,,,63.09,116.69,7
HCPCS,D69400,Stress breaker,,,116.69,116.69,1
HCPCS,D6950,Precision attachment,,,63.09,186.61,7
HCPCS,D69500,Precision attachment,,,186.61,186.61,1
HCPCS,D6980,Fixed partial repair,,,109.01,137.7,7
HCPCS,D69800,Fixed partial repair,,,121.37,121.37,1
HCPCS,D6985,Pediatric partial denture fx,,,63.09,315.09,7
HCPCS,D69850,Pediatric partial denture fx,,,315.09,315.09,1
HCPCS,D6999,Fixed prosthodontic proc,,,109.01,137.7,6
HCPCS,D7111,Extraction coronal remnants,,,62.22,3604.86,21
HCPCS,D71110,Extraction coronal remnants,,,62.22,62.22,1
HCPCS,D7140,Extraction erupted tooth/exr,,,67.91,3604.86,21
HCPCS,D71400,Extraction erupted tooth/exr,,,67.91,67.91,1
HCPCS,D7210,Rem imp tooth w mucoper flp,,,123.72,3211.66,21
HCPCS,D72100,Rem imp tooth w mucoper flp,,,123.72,123.72,1
HCPCS,D7220,Impact tooth remov soft tiss,,,142.58,3604.86,21
HCPCS,D72200,Impact tooth remov soft tiss,,,142.58,142.58,1
HCPCS,D7230,Impact tooth remov part bony,,,185.63,3604.86,21
HCPCS,D72300,Impact tooth remov part bony,,,185.63,185.63,1
HCPCS,D7240,Impact tooth remov comp bony,,,222.94,3604.86,21
HCPCS,D72400,Impact tooth remov comp bony,,,222.94,222.94,1
HCPCS,D7241,Impact tooth rem bony w/comp,,,309.36,3604.86,21
HCPCS,D72410,Impact tooth rem bony w/comp,,,309.36,309.36,1
HCPCS,D7250,Tooth root removal,,,123.72,3604.86,21
HCPCS,D72500,Tooth root removal,,,123.72,123.72,1
HCPCS,D7251,Coronectomy,,,293.55,3211.66,21
HCPCS,D72510,Coronectomy,,,293.55,293.55,1
HCPCS,D7252,PART EXTRACT IMMEDIATE IMPLANT,,,90.15,90.15,1
HCPCS,D7252,Part extract for implant,,,844.88,1067.22,6
HCPCS,D72520,PART EXTRACT IMMEDIATE IMPLANT,,,90.15,90.15,1
HCPCS,D7259,Nerve dissection,,,844.88,1067.22,6
HCPCS,D7260,Oral antral fistula closure,,,370.55,3604.86,21
HCPCS,D72600,Oral antral fistula closure,,,370.55,370.55,1
HCPCS,D7261,Primary closure sinus perf,,,324.48,3604.86,21
HCPCS,D72610,Primary closure sinus perf,,,324.48,324.48,1
HCPCS,D7270,Tooth reimplantation,,,222.94,3604.86,21
HCPCS,D72700,Tooth reimplantation,,,222.94,222.94,1
HCPCS,D7272,Tooth transplantation,,,309.36,3604.86,21
HCPCS,D72720,Tooth transplantation,,,309.36,309.36,1
HCPCS,D7280,Exposure of unerupted tooth,,,185.63,3604.86,21
HCPCS,D72800,Exposure of unerupted tooth,,,185.63,185.63,1
HCPCS,D7282,Mobilize erupted/malpos toot,,,225.97,1067.22,7
HCPCS,D72820,Mobilize erupted/malpos toot,,,225.97,225.97,1
HCPCS,D7283,Place device impacted tooth,,,235.4,1067.22,7
HCPCS,D72830,Place device impacted tooth,,,235.4,235.4,1
HCPCS,D7284,Exc biopsy of saliv glands,,,200.74,1067.22,7
HCPCS,D72840,Exc biopsy of saliv glands,,,200.74,200.74,1
HCPCS,D7285,Biopsy of oral tissue hard,,,160.73,1067.22,7
HCPCS,D72850,Biopsy of oral tissue hard,,,160.73,160.73,1
HCPCS,D7286,Biopsy of oral tissue soft,,,123.72,1067.22,7
HCPCS,D72860,Biopsy of oral tissue soft,,,123.72,123.72,1
HCPCS,D7287,Exfoliative cytolog collect,,,67.91,1067.22,7
HCPCS,D72870,Exfoliative cytolog collect,,,67.91,67.91,1
HCPCS,D7288,Brush biopsy,,,77.34,1067.22,7
HCPCS,D72880,Brush biopsy,,,77.34,77.34,1
HCPCS,D7290,Repositioning of teeth,,,510.09,1067.22,7
HCPCS,D72900,Repositioning of teeth,,,510.09,510.09,1
HCPCS,D7291,Transseptal fiberotomy,,,117.35,3604.86,21
HCPCS,D72910,Transseptal fiberotomy,,,117.35,117.35,1
HCPCS,D7292,Screw retained plate,,,1209.93,3245.52,7
HCPCS,D72920,Screw retained plate,,,3245.52,3245.52,1
HCPCS,D7293,Temp anchorage dev w flap,,,1209.93,3430.79,7
HCPCS,D72930,Temp anchorage dev w flap,,,3430.79,3430.79,1
HCPCS,D7294,Temp anchorage dev w/o flap,,,1209.93,2256.27,7
HCPCS,D72940,Temp anchorage dev w/o flap,,,2256.27,2256.27,1
HCPCS,D7295,"Bone harvest,auto graft proc",,,844.88,1067.22,7
HCPCS,D72950,"Bone harvest,auto graft proc",,,865.52,865.52,1
HCPCS,D7296,"Corticotomy, 1-3 teeth",,,742.12,1067.22,7
HCPCS,D72960,"Corticotomy, 1-3 teeth",,,742.12,742.12,1
HCPCS,D7297,"Corticotomy, 4 or more teeth",,,772.71,1067.22,7
HCPCS,D72970,"Corticotomy, 4 or more teeth",,,772.71,772.71,1
HCPCS,D7298,Remove screw retained plate,,,378.0,1528.33,7
HCPCS,D72980,Remove screw retained plate,,,378.0,378.0,1
HCPCS,D7299,Rem anchorage device w/flap,,,1209.93,1528.33,6
HCPCS,D7300,Rem anchorage dev w/o flap,,,318.96,1067.22,7
HCPCS,D73000,Rem anchorage dev w/o flap,,,318.96,318.96,1
HCPCS,D7310,Alveoplasty w/ extraction,,,129.81,3211.66,21
HCPCS,D73100,Alveoplasty w/ extraction,,,129.81,129.81,1
HCPCS,D7311,Alveoloplasty w/extract 1-3,,,163.75,3211.66,21
HCPCS,D73110,Alveoloplasty w/extract 1-3,,,163.75,163.75,1
HCPCS,D7320,Alveoplasty w/o extraction,,,163.75,3211.66,21
HCPCS,D73200,Alveoplasty w/o extraction,,,163.75,163.75,1
HCPCS,D7321,Alveoloplasty not w/extracts,,,238.05,3211.66,21
HCPCS,D73210,Alveoloplasty not w/extracts,,,238.05,238.05,1
HCPCS,D7340,Vestibuloplasty ridge extens,,,370.55,12826.13,21
HCPCS,D73400,Vestibuloplasty ridge extens,,,370.55,370.55,1
HCPCS,D7350,Vestibuloplasty exten graft,,,865.52,12826.13,21
HCPCS,D73500,Vestibuloplasty exten graft,,,865.52,865.52,1
HCPCS,D7410,Rad exc lesion up to 1.25 cm,,,154.67,3211.66,21
HCPCS,D74100,Rad exc lesion up to 1.25 cm,,,154.67,154.67,1
HCPCS,D7411,Excision benign lesion>1.25c,,,256.56,3211.66,21
HCPCS,D74110,Excision benign lesion>1.25c,,,256.56,256.56,1
HCPCS,D7412,Excision benign lesion compl,,,336.93,3211.66,21
HCPCS,D74120,Excision benign lesion compl,,,336.93,336.93,1
HCPCS,D7413,Excision malig lesion<=1.25c,,,309.36,3211.66,21
HCPCS,D74130,Excision malig lesion<=1.25c,,,309.36,309.36,1
HCPCS,D7414,Excision malig lesion>1.25cm,,,435.79,3211.66,21
HCPCS,D74140,Excision malig lesion>1.25cm,,,435.79,435.79,1
HCPCS,D7415,Excision malig les complicat,,,438.81,3211.66,21
HCPCS,D74150,Excision malig les complicat,,,438.81,438.81,1
HCPCS,D7440,Malig tumor exc to 1.25 cm,,,244.11,7031.51,21
HCPCS,D74400,Malig tumor exc to 1.25 cm,,,244.11,244.11,1
HCPCS,D7441,Malig tumor > 1.25 cm,,,494.62,7031.51,21
HCPCS,D74410,Malig tumor > 1.25 cm,,,494.62,494.62,1
HCPCS,D7450,Rem odontogen cyst to 1.25cm,,,210.17,7031.51,21
HCPCS,D74500,Rem odontogen cyst to 1.25cm,,,210.17,210.17,1
HCPCS,D7451,Rem odontogen cyst > 1.25 cm,,,272.04,7031.51,21
HCPCS,D74510,Rem odontogen cyst > 1.25 cm,,,272.04,272.04,1
HCPCS,D7460,Rem nonodonto cyst to 1.25cm,,,206.8,3604.86,21
HCPCS,D74600,Rem nonodonto cyst to 1.25cm,,,206.8,206.8,1
HCPCS,D7461,Rem nonodonto cyst > 1.25 cm,,,293.55,3604.86,21
HCPCS,D74610,Rem nonodonto cyst > 1.25 cm,,,293.55,293.55,1
HCPCS,D7465,Lesion destruction,,,162.42,1067.22,7
HCPCS,D74650,Lesion destruction,,,162.42,162.42,1
HCPCS,D7471,Rem exostosis any site,,,262.61,7031.51,21
HCPCS,D74710,Rem exostosis any site,,,262.61,262.61,1
HCPCS,D7472,Removal of torus palatinus,,,324.48,3604.86,21
HCPCS,D74720,Removal of torus palatinus,,,324.48,324.48,1
HCPCS,D7473,Remove torus mandibularis,,,222.94,3604.86,21
HCPCS,D74730,Remove torus mandibularis,,,222.94,222.94,1
HCPCS,D7485,Surg reduct osseoustuberosit,,,244.11,12826.13,21
HCPCS,D74850,Surg reduct osseoustuberosit,,,244.11,244.11,1
HCPCS,D7490,Maxilla or mandible resectio,,,3243.49,4097.04,7
HCPCS,D74900,Maxilla or mandible resectio,,,3832.64,3832.64,1
HCPCS,D7509,Marsupialization odon cyst,,,232.02,1067.22,7
HCPCS,D75090,Marsupialization odon cyst,,,232.02,232.02,1
HCPCS,D7510,I&d absc intraoral soft tiss,,,83.39,1525.5,21
HCPCS,D75100,I&d absc intraoral soft tiss,,,83.39,83.39,1
HCPCS,D7511,Incision/drain abscess intra,,,135.86,1525.5,21
HCPCS,D75110,Incision/drain abscess intra,,,135.86,135.86,1
HCPCS,D7520,I&d abscess extraoral,,,166.94,1525.5,21
HCPCS,D75200,I&d abscess extraoral,,,185.63,185.63,1
HCPCS,D7521,Incision/drain abscess extra,,,232.02,1525.5,21
HCPCS,D75210,Incision/drain abscess extra,,,232.02,232.02,1
HCPCS,D7530,Removal fb skin/areolar tiss,,,129.81,3604.86,21
HCPCS,D75300,Removal fb skin/areolar tiss,,,129.81,129.81,1
HCPCS,D7540,Removal of fb reaction,,,262.61,3604.86,21
HCPCS,D75400,Removal of fb reaction,,,262.61,262.61,1
HCPCS,D7550,Removal of sloughed off bone,,,216.23,3604.86,21
HCPCS,D75500,Removal of sloughed off bone,,,216.23,216.23,1
HCPCS,D7560,Maxillary sinusotomy,,,402.17,1528.33,7
HCPCS,D75600,Maxillary sinusotomy,,,402.17,402.17,1
HCPCS,D7610,Maxilla open reduct simple,,,1792.91,4097.04,7
HCPCS,D76100,Maxilla open reduct simple,,,1792.91,1792.91,1
HCPCS,D7620,Clsd reduct simpl maxilla fx,,,1483.55,2102.7,7
HCPCS,D76200,Clsd reduct simpl maxilla fx,,,1483.55,1483.55,1
HCPCS,D7630,Open red simpl mandible fx,,,2040.04,4097.04,7
HCPCS,D76300,Open red simpl mandible fx,,,2040.04,2040.04,1
HCPCS,D7640,Clsd red simpl mandible fx,,,1236.07,2102.7,7
HCPCS,D76400,Clsd red simpl mandible fx,,,1236.07,1236.07,1
HCPCS,D7650,Open red simp malar/zygom fx,,,1664.64,2102.7,7
HCPCS,D76500,Open red simp malar/zygom fx,,,1946.92,1946.92,1
HCPCS,D7660,Clsd red simp malar/zygom fx,,,310.03,1174.52,7
HCPCS,D76600,Clsd red simp malar/zygom fx,,,1174.52,1174.52,1
HCPCS,D7670,Closd rductn splint alveolus,,,310.03,7031.51,21
HCPCS,D76700,Closd rductn splint alveolus,,,618.03,618.03,1
HCPCS,D7671,Alveolus open reduction,,,310.03,12826.13,21
HCPCS,D76710,Alveolus open reduction,,,370.55,370.55,1
HCPCS,D7680,Reduct simple facial bone fx,,,2936.52,4097.04,7
HCPCS,D76800,Reduct simple facial bone fx,,,2936.52,2936.52,1
HCPCS,D7710,Maxilla open reduct compound,,,2132.86,4097.04,7
HCPCS,D77100,Maxilla open reduct compound,,,2132.86,2132.86,1
HCPCS,D7720,Clsd reduct compd maxilla fx,,,310.03,1360.15,7
HCPCS,D77200,Clsd reduct compd maxilla fx,,,1360.15,1360.15,1
HCPCS,D7730,Open reduct compd mandble fx,,,2380.0,4097.04,7
HCPCS,D77300,Open reduct compd mandble fx,,,2380.0,2380.0,1
HCPCS,D7740,Clsd reduct compd mandble fx,,,1390.74,4097.04,7
HCPCS,D77400,Clsd reduct compd mandble fx,,,1390.74,1390.74,1
HCPCS,D7750,Open red comp malar/zygma fx,,,2009.13,4097.04,7
HCPCS,D77500,Open red comp malar/zygma fx,,,2009.13,2009.13,1
HCPCS,D7760,Clsd red comp malar/zygma fx,,,310.03,1854.41,7
HCPCS,D77600,Clsd red comp malar/zygma fx,,,1854.41,1854.41,1
HCPCS,D7770,Open reduc compd alveolus fx,,,310.03,12826.13,21
HCPCS,D77700,Open reduc compd alveolus fx,,,1174.52,1174.52,1
HCPCS,D7771,Alveolus clsd reduc stblz te,,,310.03,7031.51,21
HCPCS,D77710,Alveolus clsd reduc stblz te,,,726.32,726.32,1
HCPCS,D7780,Reduct compnd facial bone fx,,,3243.49,4097.04,7
HCPCS,D77800,Reduct compnd facial bone fx,,,3770.73,3770.73,1
HCPCS,D7810,Tmj open reduct-dislocation,,,1946.92,4097.04,7
HCPCS,D78100,Tmj open reduct-dislocation,,,1946.92,1946.92,1
HCPCS,D7820,Closed tmp manipulation,,,278.08,1067.22,7
HCPCS,D78200,Closed tmp manipulation,,,278.08,278.08,1
HCPCS,D7830,Tmj manipulation under anest,,,281.1,799.25,7
HCPCS,D78300,Tmj manipulation under anest,,,281.1,281.1,1
HCPCS,D7840,Removal of tmj condyle,,,2658.43,4097.04,7
HCPCS,D78400,Removal of tmj condyle,,,2658.43,2658.43,1
HCPCS,D7850,Tmj meniscectomy,,,2534.35,4097.04,7
HCPCS,D78500,Tmj meniscectomy,,,2534.35,2534.35,1
HCPCS,D7852,Tmj repair of joint disc,,,3028.98,4097.04,7
HCPCS,D78520,Tmj repair of joint disc,,,3028.98,3028.98,1
HCPCS,D7854,Tmj excisn of joint membrane,,,3090.84,4097.04,7
HCPCS,D78540,Tmj excisn of joint membrane,,,3090.84,3090.84,1
HCPCS,D7856,Tmj cutting of a muscle,,,1514.47,4097.04,7
HCPCS,D78560,Tmj cutting of a muscle,,,1514.47,1514.47,1
HCPCS,D7858,Tmj reconstruction,,,3243.49,4097.04,7
HCPCS,D78580,Tmj reconstruction,,,3461.75,3461.75,1
HCPCS,D7860,Tmj cutting into joint,,,927.04,4097.04,7
HCPCS,D78600,Tmj cutting into joint,,,927.04,927.04,1
HCPCS,D7865,Tmj reshaping components,,,2596.22,4097.04,7
HCPCS,D78650,Tmj reshaping components,,,2596.22,2596.22,1
HCPCS,D7870,Tmj aspiration joint fluid,,,123.72,191.0,7
HCPCS,D78700,Tmj aspiration joint fluid,,,123.72,123.72,1
HCPCS,D7871,Lysis + lavage w catheters,,,844.88,1214.55,7
HCPCS,D78710,Lysis + lavage w catheters,,,1214.55,1214.55,1
HCPCS,D7872,Tmj diagnostic arthroscopy,,,803.66,1067.22,7
HCPCS,D78720,Tmj diagnostic arthroscopy,,,803.66,803.66,1
HCPCS,D7873,Tmj arthroscopy lysis adhesn,,,880.64,4097.04,7
HCPCS,D78730,Tmj arthroscopy lysis adhesn,,,880.64,880.64,1
HCPCS,D7874,Tmj arthroscopy disc reposit,,,1112.66,7034.85,21
HCPCS,D78740,Tmj arthroscopy disc reposit,,,1112.66,1112.66,1
HCPCS,D7875,Tmj arthroscopy synovectomy,,,1190.0,4097.04,7
HCPCS,D78750,Tmj arthroscopy synovectomy,,,1190.0,1190.0,1
HCPCS,D7876,Tmj arthroscopy discectomy,,,1236.07,4097.04,7
HCPCS,D78760,Tmj arthroscopy discectomy,,,1236.07,1236.07,1
HCPCS,D7877,Tmj arthroscopy debridement,,,1143.6,4097.04,7
HCPCS,D78770,Tmj arthroscopy debridement,,,1143.6,1143.6,1
HCPCS,D7880,Occlusal orthotic appliance,,,438.81,1067.22,7
HCPCS,D78800,Occlusal orthotic appliance,,,438.81,438.81,1
HCPCS,D7881,Occ orthotic device adjust,,,139.2,210.88,7
HCPCS,D78810,Occ orthotic device adjust,,,139.2,139.2,1
HCPCS,D7899,Tmj unspecified therapy,,,844.88,1067.22,6
HCPCS,D7910,Dent sutur recent wnd to 5cm,,,129.81,1067.22,7
HCPCS,D79100,Dent sutur recent wnd to 5cm,,,129.81,129.81,1
HCPCS,D7911,Dental suture wound to 5 cm,,,166.77,1067.22,7
HCPCS,D79110,Dental suture wound to 5 cm,,,166.77,166.77,1
HCPCS,D7912,Suture complicate wnd > 5 cm,,,247.14,1067.22,7
HCPCS,D79120,Suture complicate wnd > 5 cm,,,247.14,247.14,1
HCPCS,D7920,Dental skin graft,,,1019.84,1528.33,7
HCPCS,D79200,Dental skin graft,,,1019.84,1019.84,1
HCPCS,D7921,Collect & appl blood product,,,107.94,210.88,7
HCPCS,D79210,Collect & appl blood product,,,107.94,107.94,1
HCPCS,D7922,Place intra-socket bio dress,,,123.72,3604.86,21
HCPCS,D79220,Place intra-socket bio dress,,,123.72,123.72,1
HCPCS,D7939,Indexing for osteotomy,,,86.94,109.82,6
HCPCS,D7940,Reshaping bone orthognathic,,,675.11,4097.04,21
HCPCS,D79400,Reshaping bone orthognathic,,,1637.87,1637.87,1
HCPCS,D7941,Bone cutting ramus closed,,,3243.49,4327.26,7
HCPCS,D79410,Bone cutting ramus closed,,,4327.26,4327.26,1
HCPCS,D7943,Cutting ramus open w/graft,,,3243.49,4389.13,7
HCPCS,D79430,Cutting ramus open w/graft,,,4389.13,4389.13,1
HCPCS,D7944,Bone cutting segmented,,,3243.49,4097.04,7
HCPCS,D79440,Bone cutting segmented,,,3461.75,3461.75,1
HCPCS,D7945,Bone cutting body mandible,,,3243.49,4097.04,7
HCPCS,D79450,Bone cutting body mandible,,,3492.69,3492.69,1
HCPCS,D7946,Reconstruction maxilla total,,,3243.49,4097.04,7
HCPCS,D79460,Reconstruction maxilla total,,,3863.55,3863.55,1
HCPCS,D7947,Reconstruct maxilla segment,,,3243.49,4097.04,7
HCPCS,D79470,Reconstruct maxilla segment,,,3863.55,3863.55,1
HCPCS,D7948,Reconstruct midface no graft,,,3243.49,4327.26,7
HCPCS,D79480,Reconstruct midface no graft,,,4327.26,4327.26,1
HCPCS,D7949,Reconstruct midface w/graft,,,3243.49,6305.45,7
HCPCS,D79490,Reconstruct midface w/graft,,,6305.45,6305.45,1
HCPCS,D7950,Mandible graft,,,1328.89,12826.13,21
HCPCS,D79500,Mandible graft,,,1328.89,1328.89,1
HCPCS,D7951,Sinus aug w bone or bone sub,,,1211.88,2102.7,7
HCPCS,D79510,Sinus aug w bone or bone sub,,,1211.88,1211.88,1
HCPCS,D7952,Sinus augmentation vertical,,,988.93,2102.7,7
HCPCS,D79520,Sinus augmentation vertical,,,988.93,988.93,1
HCPCS,D7953,Bone replacement graft,,,587.09,2102.7,7
HCPCS,D79530,Bone replacement graft,,,587.09,587.09,1
HCPCS,D7955,Repair maxillofacial defects,,,1390.74,2102.7,7
HCPCS,D79550,Repair maxillofacial defects,,,1390.74,1390.74,1
HCPCS,D7956,Tiss regen edent resorb,,,166.94,429.73,7
HCPCS,D79560,Tiss regen edent resorb,,,429.73,429.73,1
HCPCS,D7957,Tiss regen edent nonresorb,,,166.94,494.62,7
HCPCS,D79570,Tiss regen edent nonresorb,,,494.62,494.62,1
HCPCS,D7960,Frenulectomy/frenectomy,,,844.88,1067.22,6
HCPCS,D7961,Buccal/labial frenectomy,,,185.63,1067.22,7
HCPCS,D79610,Buccal/labial frenectomy,,,185.63,185.63,1
HCPCS,D7962,Lingual frenectomy,,,216.23,1067.22,7
HCPCS,D79620,Lingual frenectomy,,,216.23,216.23,1
HCPCS,D7963,Frenuloplasty,,,219.56,1067.22,7
HCPCS,D79630,Frenuloplasty,,,219.56,219.56,1
HCPCS,D7970,Excision hyperplastic tissue,,,247.14,1067.22,7
HCPCS,D79700,Excision hyperplastic tissue,,,247.14,247.14,1
HCPCS,D7971,Excision pericoronal gingiva,,,105.27,796.57,7
HCPCS,D79710,Excision pericoronal gingiva,,,105.27,105.27,1
HCPCS,D7972,Surg redct fibrous tuberosit,,,318.78,1067.22,7
HCPCS,D79720,Surg redct fibrous tuberosit,,,318.78,318.78,1
HCPCS,D7979,Non-surgical sialolithotomy,,,126.75,1067.22,7
HCPCS,D79790,Non-surgical sialolithotomy,,,126.75,126.75,1
HCPCS,D7980,Surgical sialolithotomy,,,256.56,1528.33,7
HCPCS,D79800,Surgical sialolithotomy,,,256.56,256.56,1
HCPCS,D7981,Excision of salivary gland,,,844.88,1236.07,7
HCPCS,D79810,Excision of salivary gland,,,1236.07,1236.07,1
HCPCS,D7982,Sialodochoplasty,,,757.23,2435.39,7
HCPCS,D79820,Sialodochoplasty,,,757.23,757.23,1
HCPCS,D7983,Closure of salivary fistula,,,525.58,1067.22,7
HCPCS,D79830,Closure of salivary fistula,,,525.58,525.58,1
HCPCS,D7990,Emergency tracheotomy,,,513.13,1837.78,7
HCPCS,D79900,Emergency tracheotomy,,,513.13,513.13,1
HCPCS,D7991,Dental coronoidectomy,,,1916.32,4097.04,7
HCPCS,D79910,Dental coronoidectomy,,,1916.32,1916.32,1
HCPCS,D7993,Surg place craniofacial impl,,,1664.64,2102.7,7
HCPCS,D79930,Surg place craniofacial impl,,,1700.09,1700.09,1
HCPCS,D7994,Surg place zygomatic impl,,,1664.64,2102.7,7
HCPCS,D79940,Surg place zygomatic impl,,,1700.09,1700.09,1
HCPCS,D7995,Synthetic graft facial bones,,,298.34,4097.04,7
HCPCS,D79950,Synthetic graft facial bones,,,298.34,298.34,1
HCPCS,D7996,Implant mandible for augment,,,1080.0,2102.7,7
HCPCS,D79960,Implant mandible for augment,,,1080.0,1080.0,1
HCPCS,D7997,Appliance removal,,,123.72,1067.22,7
HCPCS,D79970,Appliance removal,,,123.72,123.72,1
HCPCS,D7998,Intraoral place of fix dev,,,844.88,1067.22,7
HCPCS,D79980,Intraoral place of fix dev,,,899.81,899.81,1
HCPCS,D7999,Oral surgery procedure,,,844.88,1067.22,6
HCPCS,D8010,Limited dental tx primary,,,601.51,1157.09,7
HCPCS,D80100,Limited dental tx primary,,,601.51,601.51,1
HCPCS,D8020,Limited dental tx transition,,,711.04,1157.09,7
HCPCS,D80200,Limited dental tx transition,,,711.04,711.04,1
HCPCS,D8030,Limited dental tx adolescent,,,916.03,1157.09,7
HCPCS,D80300,Limited dental tx adolescent,,,957.04,957.04,1
HCPCS,D8040,Limited dental tx adult,,,916.03,1157.09,7
HCPCS,D80400,Limited dental tx adult,,,929.74,929.74,1
HCPCS,D8050,Intercep dental tx primary,,,916.03,1157.09,6
HCPCS,D8060,Intercep dental tx transitn,,,916.03,1157.09,6
HCPCS,D8070,Compre dental tx transition,,,916.03,2980.64,7
HCPCS,D80700,Compre dental tx transition,,,2980.64,2980.64,1
HCPCS,D8080,Compre dental tx adolescent,,,916.03,2488.3,7
HCPCS,D80800,Compre dental tx adolescent,,,2488.3,2488.3,1
HCPCS,D8090,Compre dental tx adult,,,916.03,2597.83,7
HCPCS,D80900,Compre dental tx adult,,,2597.83,2597.83,1
HCPCS,D8091,Compre ortho treat w surg,,,1664.64,2102.7,6
HCPCS,D8210,Orthodontic rem appliance tx,,,325.29,1051.87,7
HCPCS,D82100,Orthodontic rem appliance tx,,,325.29,325.29,1
HCPCS,D8220,Fixed appliance therapy habt,,,391.04,1051.87,7
HCPCS,D82200,Fixed appliance therapy habt,,,391.04,391.04,1
HCPCS,D8660,Preorthodontic tx visit,,,98.34,1051.87,7
HCPCS,D86600,Preorthodontic tx visit,,,98.34,98.34,1
HCPCS,D8670,Periodic orthodontc tx visit,,,73.99,1051.87,7
HCPCS,D86700,Periodic orthodontc tx visit,,,73.99,73.99,1
HCPCS,D8671,PERIODIC ORTHODONTIC TREATMENT,,,78.67,78.67,1
HCPCS,D8671,Periodic orth treat w surg,,,832.73,1051.87,6
HCPCS,D86710,PERIODIC ORTHODONTIC TREATMENT,,,78.67,78.67,1
HCPCS,D8680,Orthodontic retention,,,229.54,1051.87,7
HCPCS,D86800,Orthodontic retention,,,229.54,229.54,1
HCPCS,D8681,Removable retainer adjust,,,88.81,210.88,7
HCPCS,D86810,Removable retainer adjust,,,88.81,88.81,1
HCPCS,D8690,Orthodontic treatment,,,832.73,1051.87,6
HCPCS,D8695,Remove fixed ortho appliance,,,109.52,210.88,7
HCPCS,D86950,Remove fixed ortho appliance,,,109.52,109.52,1
HCPCS,D8696,Rep of ortho appliance max,,,88.81,210.88,7
HCPCS,D86960,Rep of ortho appliance max,,,88.81,88.81,1
HCPCS,D8697,Rep of ortho appliance man,,,88.81,210.88,7
HCPCS,D86970,Rep of ortho appliance man,,,88.81,88.81,1
HCPCS,D8698,Recement fixed retainer max,,,93.06,210.88,7
HCPCS,D86980,Recement fixed retainer max,,,93.06,93.06,1
HCPCS,D8699,Recement fixed retainer man,,,93.06,210.88,7
HCPCS,D86990,Recement fixed retainer man,,,93.06,93.06,1
HCPCS,D8701,Repair fixed retainer max,,,136.83,210.88,7
HCPCS,D87010,Repair fixed retainer max,,,136.83,136.83,1
HCPCS,D8702,Repair of fixed retainer man,,,136.83,210.88,7
HCPCS,D87020,Repair of fixed retainer man,,,136.83,136.83,1
HCPCS,D8703,Replace broken retainer max,,,139.43,210.88,7
HCPCS,D87030,Replace broken retainer max,,,139.43,139.43,1
HCPCS,D8704,Replace broken retainer man,,,139.43,210.88,7
HCPCS,D87040,Replace broken retainer man,,,139.43,139.43,1
HCPCS,D8999,Orthodontic procedure,,,832.73,1051.87,6
HCPCS,D9110,Palliative tx dental pain,,,36.84,210.88,7
HCPCS,D91100,Palliative tx dental pain,,,36.84,36.84,1
HCPCS,D9120,Fix partial denture section,,,64.45,210.88,7
HCPCS,D91200,Fix partial denture section,,,64.45,64.45,1
HCPCS,D9128,Photobio therpy-first 15 min,,,166.94,210.88,6
HCPCS,D9129,Photobio therpy-sub 15 mins,,,166.94,210.88,6
HCPCS,D9130,Temporomandibular joint dysf,,,11.19,22.69,7
HCPCS,D91300,Temporomandibular joint dysf,,,11.19,11.19,1
HCPCS,D9210,Dent anesthesia w/o surgery,,,16.78,37.3,7
HCPCS,D9210,LOCAL ANESTHESIA NOT IN CONJUNCTION WITH OPERATIVE OR SURGICAL P,285.0,185.25,30.37,285.0,13
HCPCS,D92100,Dent anesthesia w/o surgery,,,16.78,16.78,1
HCPCS,D9211,Regional block anesthesia,,,22.02,37.3,7
HCPCS,D92110,Regional block anesthesia,,,22.02,22.02,1
HCPCS,D9212,Trigeminal block anesthesia,,,29.53,70.06,7
HCPCS,D92120,Trigeminal block anesthesia,,,70.06,70.06,1
HCPCS,D9215,Local anesthesia,,,14.82,37.3,7
HCPCS,D92150,Local anesthesia,,,14.82,14.82,1
HCPCS,D9219,Eval mod/deep sed/gen anest,,,73.68,98.46,7
HCPCS,D92190,Eval mod/deep sed/gen anest,,,73.68,73.68,1
HCPCS,D9222,"Deep anest, 1st 15 min",,,29.53,75.6,7
HCPCS,D92220,"Deep anest, 1st 15 min",,,75.6,75.6,1
HCPCS,D9223,General anesth ea addl 15 mi,,,29.53,75.6,7
HCPCS,D92230,General anesth ea addl 15 mi,,,75.6,75.6,1
HCPCS,D9224,Gen anes adv air-15 min,,,29.53,37.3,6
HCPCS,D9225,Gen anes adv air-sub 15 min,,,29.53,37.3,6
HCPCS,D9230,Analgesia,,,16.78,37.3,7
HCPCS,D92300,Analgesia,,,16.78,16.78,1
HCPCS,D9239,"Iv mod sedation, 1st 15 min",,,29.53,75.6,7
HCPCS,D92390,"Iv mod sedation, 1st 15 min",,,75.6,75.6,1
HCPCS,D9243,Iv sedation ea addl 15m,,,29.53,75.6,7
HCPCS,D92430,Iv sedation ea addl 15m,,,75.6,75.6,1
HCPCS,D9244,Office min sed drug enteral,,,29.53,37.3,6
HCPCS,D9245,Admin mod sedation-enteral,,,29.53,37.3,6
HCPCS,D9246,Mod sedation noniv-15 min,,,29.53,37.3,6
HCPCS,D9247,Mod sedation noniv-sub15min,,,29.53,37.3,6
HCPCS,D9248,Sedation (non-iv),,,29.53,37.3,6
HCPCS,D9310,Dental consultation,,,29.59,29.59,1
HCPCS,D93100,Dental consultation,,,29.59,29.59,1
HCPCS,D9311,Consult w/med hlth care prof,,,33.22,33.22,1
HCPCS,D93110,Consult w/med hlth care prof,,,33.22,33.22,1
HCPCS,D9410,Dental house call,,,55.24,55.24,1
HCPCS,D94100,Dental house call,,,55.24,55.24,1
HCPCS,D9420,Hospital/asc call,,,55.24,55.24,1
HCPCS,D94200,Hospital/asc call,,,55.24,55.24,1
HCPCS,D9430,Office visit during hours,,,22.02,210.88,7
HCPCS,D94300,Office visit during hours,,,22.02,22.02,1
HCPCS,D9440,Office visit after hours,,,36.84,210.88,7
HCPCS,D94400,Office visit after hours,,,36.84,36.84,1
HCPCS,D9450,Case presentation tx plan,,,35.19,95.54,7
HCPCS,D94500,Case presentation tx plan,,,35.19,35.19,1
HCPCS,D9610,Dent therapeutic drug inject,,,18.4,38.77,7
HCPCS,D96100,Dent therapeutic drug inject,,,18.4,18.4,1
HCPCS,D9612,Thera par drugs 2 or > admin,,,30.69,46.05,7
HCPCS,D96120,Thera par drugs 2 or > admin,,,46.05,46.05,1
HCPCS,D9613,Infiltration thera drug,,,14.82,38.77,7
HCPCS,D96130,Infiltration thera drug,,,14.82,14.82,1
HCPCS,D9630,Drugs/meds disp for home use,,,9.21,210.88,7
HCPCS,D96300,Drugs/meds disp for home use,,,9.21,9.21,1
HCPCS,D9910,Dent appl desensitizing med,,,16.78,210.88,7
HCPCS,D99100,Dent appl desensitizing med,,,16.78,16.78,1
HCPCS,D9911,Appl desensitizing resin,,,20.06,210.88,7
HCPCS,D99110,Appl desensitizing resin,,,20.06,20.06,1
HCPCS,D9912,Pre-visit patient screening,,,7.25,7.25,1
HCPCS,D99120,Pre-visit patient screening,,,7.25,7.25,1
HCPCS,D9913,ADMINISTRATION NEUROMODULATORS,,,26.87,26.87,1
HCPCS,D9913,Admin of neuromod,,,166.94,210.88,6
HCPCS,D99130,ADMINISTRATION NEUROMODULATORS,,,26.87,26.87,1
HCPCS,D9914,ADMINISTRATION DERMAL FILLERS,,,23.05,23.05,1
HCPCS,D9914,Admin of dermal fill,,,166.94,210.88,6
HCPCS,D99140,ADMINISTRATION DERMAL FILLERS,,,23.05,23.05,1
HCPCS,D9920,Behavior management,,,29.59,210.88,7
HCPCS,D99200,Behavior management,,,29.59,29.59,1
HCPCS,D9930,Treatment of complications,,,31.23,3604.86,21
HCPCS,D99300,Treatment of complications,,,31.23,31.23,1
HCPCS,D9932,Clean & inspect rem dent max,,,14.82,210.88,7
HCPCS,D99320,Clean & inspect rem dent max,,,14.82,14.82,1
HCPCS,D9933,Clean & inspect rem dent man,,,14.82,210.88,7
HCPCS,D99330,Clean & inspect rem dent man,,,14.82,14.82,1
HCPCS,D9934,Clean rem part denture max,,,14.82,210.88,7
HCPCS,D99340,Clean rem part denture max,,,14.82,14.82,1
HCPCS,D9935,Clean rem part denture mand,,,14.82,210.88,7
HCPCS,D99350,Clean rem part denture mand,,,14.82,14.82,1
HCPCS,D9936,Clean occ guard,,,166.94,210.88,6
HCPCS,D9938,Fab removable appliance,,,166.94,210.88,6
HCPCS,D9939,Placemnt removable appliance,,,27.62,210.88,7
HCPCS,D99390,Placemnt removable appliance,,,27.62,27.62,1
HCPCS,D9941,Fabrication athletic guard,,,53.62,210.88,7
HCPCS,D99410,Fabrication athletic guard,,,53.62,53.62,1
HCPCS,D9942,Repair/reline occlusal guard,,,62.8,210.88,7
HCPCS,D99420,Repair/reline occlusal guard,,,62.8,62.8,1
HCPCS,D9943,Occlusal guard adjustment,,,58.86,210.88,7
HCPCS,D99430,Occlusal guard adjustment,,,58.86,58.86,1
HCPCS,D9944,"Occ guard, hard, full arch",,,158.5,3604.86,21
HCPCS,D99440,"Occ guard, hard, full arch",,,158.5,158.5,1
HCPCS,D9945,"Occ guard, soft, full arch",,,109.01,3604.86,21
HCPCS,D99450,"Occ guard, soft, full arch",,,130.89,130.89,1
HCPCS,D9946,"Occ guard, hard, part arch",,,109.01,3604.86,21
HCPCS,D99460,"Occ guard, hard, part arch",,,120.04,120.04,1
HCPCS,D9947,Sleep apnea appliance,,,92.08,210.88,7
HCPCS,D99470,Sleep apnea appliance,,,92.08,92.08,1
HCPCS,D9948,Adjust sleep apnea appliance,,,46.05,46.05,1
HCPCS,D99480,Adjust sleep apnea appliance,,,46.05,46.05,1
HCPCS,D9949,Repair sleep apnea appliance,,,189.0,189.0,1
HCPCS,D99490,Repair sleep apnea appliance,,,189.0,189.0,1
HCPCS,D9950,Occlusion analysis,,,82.54,3604.86,21
HCPCS,D99500,Occlusion analysis,,,82.54,82.54,1
HCPCS,D9951,Limited occlusal adjustment,,,42.43,3604.86,21
HCPCS,D99510,Limited occlusal adjustment,,,42.43,42.43,1
HCPCS,D9952,Complete occlusal adjustment,,,109.01,3604.86,21
HCPCS,D99520,Complete occlusal adjustment,,,147.67,147.67,1
HCPCS,D9953,Reline sleep apnea appliance,,,46.05,46.05,1
HCPCS,D99530,Reline sleep apnea appliance,,,46.05,46.05,1
HCPCS,D9954,Fab/del oral appliance thxpy,,,166.94,210.88,6
HCPCS,D9955,Oral app thxpy titration vis,,,36.84,98.46,7
HCPCS,D99550,Oral app thxpy titration vis,,,36.84,36.84,1
HCPCS,D9956,Admin home sleep apnea test,,,81.86,103.4,7
HCPCS,D99560,Admin home sleep apnea test,,,92.08,92.08,1
HCPCS,D9957,Screening sleep disorders,,,18.4,103.4,7
HCPCS,D99570,Screening sleep disorders,,,18.4,18.4,1
HCPCS,D9961,Dup/copy patient's records,,,36.84,36.84,1
HCPCS,D99610,Dup/copy patient's records,,,36.84,36.84,1
HCPCS,D9970,Enamel microabrasion,,,49.64,210.88,7
HCPCS,D99700,Enamel microabrasion,,,49.64,49.64,1
HCPCS,D9971,Odontoplasty per tooth,,,49.64,210.88,7
HCPCS,D99710,Odontoplasty per tooth,,,49.64,49.64,1
HCPCS,D9972,Extrnl bleaching per arch,,,103.26,210.88,7
HCPCS,D99720,Extrnl bleaching per arch,,,103.26,103.26,1
HCPCS,D9973,Extrnl bleaching per tooth,,,66.42,210.88,7
HCPCS,D99730,Extrnl bleaching per tooth,,,66.42,66.42,1
HCPCS,D9974,Intrnl bleaching per tooth,,,75.64,210.88,7
HCPCS,D99740,Intrnl bleaching per tooth,,,75.64,75.64,1
HCPCS,D9975,External bleaching home app,,,88.81,210.88,7
HCPCS,D99750,External bleaching home app,,,88.81,88.81,1
HCPCS,D9986,Missed appointment,,,57.96,57.96,1
HCPCS,D99860,Missed appointment,,,57.96,57.96,1
HCPCS,D9987,Cancelled appointment,,,56.24,56.24,1
HCPCS,D99870,Cancelled appointment,,,56.24,56.24,1
HCPCS,D9990,Trans or sign language svcs,,,18.4,18.4,1
HCPCS,D99900,Trans or sign language svcs,,,18.4,18.4,1
HCPCS,D9991,"Case mgmt, appt barriers",,,9.21,95.54,7
HCPCS,D99910,"Case mgmt, appt barriers",,,9.21,9.21,1
HCPCS,D9992,"Case mgmt, care coordination",,,18.4,95.54,7
HCPCS,D99920,"Case mgmt, care coordination",,,18.4,18.4,1
HCPCS,D9993,"Case mgmt, interviewing",,,9.21,95.54,7
HCPCS,D99930,"Case mgmt, interviewing",,,9.21,9.21,1
HCPCS,D9994,"Case mgmt, pt education",,,9.21,52.51,7
HCPCS,D99940,"Case mgmt, pt education",,,9.21,9.21,1
HCPCS,D9995,Teledentistry real-time,,,18.4,210.88,7
HCPCS,D99950,Teledentistry real-time,,,18.4,18.4,1
HCPCS,D9996,Teledentistry dent review,,,14.82,210.88,7
HCPCS,D99960,Teledentistry dent review,,,14.82,14.82,1
HCPCS,D9997,Dent case mgmt special needs,,,18.4,95.54,7
HCPCS,D99970,Dent case mgmt special needs,,,18.4,18.4,1
HCPCS,D9999,Adjunctive procedure,,,166.94,210.88,6
HCPCS,E0100,Cane adjust/fixed with tip,,,4.8,49.21,14
HCPCS,E01000,Cane adjust/fixed with tip,,,14.53,14.53,1
HCPCS,E0100MS,Cane adjust/fixed with tip,,,4.8,4.8,1
HCPCS,E0100NU,Cane adjust/fixed with tip,,,14.53,49.21,4
HCPCS,E0100RR,Cane adjust/fixed with tip,,,4.8,11.75,4
HCPCS,E0100UE,Cane adjust/fixed with tip,,,12.46,39.22,4
HCPCS,E0105,Cane adjust/fixed quad/3 pro,,,7.19,114.68,14
HCPCS,E01050,Cane adjust/fixed quad/3 pro,,,37.57,37.57,1
HCPCS,E0105MS,Cane adjust/fixed quad/3 pro,,,7.19,7.19,1
HCPCS,E0105NU,Cane adjust/fixed quad/3 pro,,,37.57,114.68,4
HCPCS,E0105RR,Cane adjust/fixed quad/3 pro,,,7.19,17.6,4
HCPCS,E0105UE,Cane adjust/fixed quad/3 pro,,,29.14,88.38,4
HCPCS,E0110,Crutch forearm pair,,,12.96,169.67,14
HCPCS,E01100,Crutch forearm pair,,,53.45,53.45,1
HCPCS,E0110MS,Crutch forearm pair,,,12.96,12.96,1
HCPCS,E0110NU,Crutch forearm pair,,,53.45,169.67,4
HCPCS,E0110RR,Crutch forearm pair,,,12.96,33.57,4
HCPCS,E0110UE,Crutch forearm pair,,,40.07,127.25,4
HCPCS,E0111,Crutch forearm each,,,6.84,105.66,14
HCPCS,E01110,Crutch forearm each,,,39.94,39.94,1
HCPCS,E0111MS,Crutch forearm each,,,6.84,6.84,1
HCPCS,E0111NU,Crutch forearm each,,,39.94,105.66,4
HCPCS,E0111RR,Crutch forearm each,,,6.84,16.78,4
HCPCS,E0111UE,Crutch forearm each,,,32.62,81.58,4
HCPCS,E0112,Crutch underarm pair wood,,,8.06,73.44,14
HCPCS,E01120,Crutch underarm pair wood,,,27.03,27.03,1
HCPCS,E0112MS,Crutch underarm pair wood,,,8.06,8.06,1
HCPCS,E0112NU,Crutch underarm pair wood,,,27.03,73.44,4
HCPCS,E0112RR,Crutch underarm pair wood,,,8.06,19.73,4
HCPCS,E0112UE,Crutch underarm pair wood,,,21.24,56.01,4
HCPCS,E0113,Crutch underarm each wood,,,4.17,41.96,14
HCPCS,E01130,Crutch underarm each wood,,,14.57,14.57,1
HCPCS,E0113MS,Crutch underarm each wood,,,4.17,4.17,1
HCPCS,E0113NU,Crutch underarm each wood,,,14.57,41.96,4
HCPCS,E0113RR,Crutch underarm each wood,,,4.17,10.19,4
HCPCS,E0113UE,Crutch underarm each wood,,,10.92,31.46,4
HCPCS,E0114,CRUTCHES ALUMINUM PAIR,58.0,37.7,22.73,58.0,13
HCPCS,E0114,Crutch underarm pair no wood,,,6.94,97.24,14
HCPCS,E01140,Crutch underarm pair no wood,,,32.51,32.51,1
HCPCS,E0114MS,Crutch underarm pair no wood,,,6.94,6.94,1
HCPCS,E0114NU,Crutch underarm pair no wood,,,32.51,97.24,4
HCPCS,E0114RR,Crutch underarm pair no wood,,,6.94,16.99,4
HCPCS,E0114UE,Crutch underarm pair no wood,,,24.58,72.87,4
HCPCS,E0116,Crutch underarm each no wood,,,4.38,55.06,14
HCPCS,E01160,Crutch underarm each no wood,,,19.12,19.12,1
HCPCS,E0116MS,Crutch underarm each no wood,,,4.38,4.38,1
HCPCS,E0116NU,Crutch underarm each no wood,,,19.12,55.06,4
HCPCS,E0116RR,Crutch underarm each no wood,,,4.38,10.74,4
HCPCS,E0116UE,Crutch underarm each no wood,,,14.4,41.44,4
HCPCS,E0117,Underarm springassist crutch,,,15.61,156.1,8
HCPCS,E01170,Underarm springassist crutch,,,156.1,156.1,1
HCPCS,E0117MS,Underarm springassist crutch,,,15.61,15.61,1
HCPCS,E0117NU,Underarm springassist crutch,,,156.1,156.1,1
HCPCS,E0117RR,Underarm springassist crutch,,,15.61,44.97,4
HCPCS,E0117UE,Underarm springassist crutch,,,117.08,117.08,1
HCPCS,E0118,Crutch substitute,,,2.7,27.0,5
HCPCS,E01180,Crutch substitute,,,27.0,27.0,1
HCPCS,E0118MS,Crutch substitute,,,2.7,2.7,1
HCPCS,E0118NU,Crutch substitute,,,27.0,27.0,1
HCPCS,E0118RR,Crutch substitute,,,2.7,2.7,1
HCPCS,E0118UE,Crutch substitute,,,21.6,21.6,1
HCPCS,E0130,Walker rigid adjust/fixed ht,,,3.28,93.34,14
HCPCS,E01300,Walker rigid adjust/fixed ht,,,32.83,32.83,1
HCPCS,E0130MS,Walker rigid adjust/fixed ht,,,3.28,3.28,1
HCPCS,E0130NU,Walker rigid adjust/fixed ht,,,32.83,93.34,4
HCPCS,E0130RR,Walker rigid adjust/fixed ht,,,3.28,9.34,4
HCPCS,E0130UE,Walker rigid adjust/fixed ht,,,24.62,70.0,4
HCPCS,E0135,Walker folding adjust/fixed,,,3.29,93.74,14
HCPCS,E01350,Walker folding adjust/fixed,,,32.95,32.95,1
HCPCS,E0135MS,Walker folding adjust/fixed,,,3.29,3.29,1
HCPCS,E0135NU,Walker folding adjust/fixed,,,32.95,93.74,4
HCPCS,E0135RR,Walker folding adjust/fixed,,,3.29,9.37,4
HCPCS,E0135UE,Walker folding adjust/fixed,,,24.72,70.32,4
HCPCS,E0140,Walker w trunk support,,,21.36,213.67,8
HCPCS,E01400,Walker w trunk support,,,213.67,213.67,1
HCPCS,E0140MS,Walker w trunk support,,,21.36,21.36,1
HCPCS,E0140NU,Walker w trunk support,,,213.67,213.67,1
HCPCS,E0140RR,Walker w trunk support,,,21.36,58.62,4
HCPCS,E0140UE,Walker w trunk support,,,160.25,160.25,1
HCPCS,E0141,Rigid wheeled walker adj/fix,,,3.39,99.07,14
HCPCS,E01410,Rigid wheeled walker adj/fix,,,33.84,33.84,1
HCPCS,E0141MS,Rigid wheeled walker adj/fix,,,3.39,3.39,1
HCPCS,E0141NU,Rigid wheeled walker adj/fix,,,33.84,99.07,4
HCPCS,E0141RR,Rigid wheeled walker adj/fix,,,3.39,9.91,4
HCPCS,E0141UE,Rigid wheeled walker adj/fix,,,25.38,74.29,4
HCPCS,E0143,Walker folding wheeled w/o s,,,3.39,99.07,14
HCPCS,E01430,Walker folding wheeled w/o s,,,33.84,33.84,1
HCPCS,E0143MS,Walker folding wheeled w/o s,,,3.39,3.39,1
HCPCS,E0143NU,Walker folding wheeled w/o s,,,33.84,99.07,4
HCPCS,E0143RR,Walker folding wheeled w/o s,,,3.39,9.91,4
HCPCS,E0143UE,Walker folding wheeled w/o s,,,25.38,74.29,4
HCPCS,E0144,Enclosed walker w rear seat,,,19.29,192.93,8
HCPCS,E01440,Enclosed walker w rear seat,,,192.93,192.93,1
HCPCS,E0144MS,Enclosed walker w rear seat,,,19.29,19.29,1
HCPCS,E0144NU,Enclosed walker w rear seat,,,192.93,192.93,1
HCPCS,E0144RR,Enclosed walker w rear seat,,,19.29,55.91,4
HCPCS,E0144UE,Enclosed walker w rear seat,,,144.7,144.7,1
HCPCS,E0147,Walker variable wheel resist,,,28.78,825.31,14
HCPCS,E01470,Walker variable wheel resist,,,287.77,287.77,1
HCPCS,E0147MS,Walker variable wheel resist,,,28.78,28.78,1
HCPCS,E0147NU,Walker variable wheel resist,,,287.77,825.31,4
HCPCS,E0147RR,Walker variable wheel resist,,,28.78,82.53,4
HCPCS,E0147UE,Walker variable wheel resist,,,215.83,618.97,4
HCPCS,E0148,Heavyduty walker no wheels,,,5.92,171.33,14
HCPCS,E01480,Heavyduty walker no wheels,,,59.19,59.19,1
HCPCS,E0148MS,Heavyduty walker no wheels,,,5.92,5.92,1
HCPCS,E0148NU,Heavyduty walker no wheels,,,59.19,171.33,4
HCPCS,E0148RR,Heavyduty walker no wheels,,,5.92,17.13,4
HCPCS,E0148UE,Heavyduty walker no wheels,,,44.4,128.5,4
HCPCS,E0149,Heavy duty wheeled walker,,,8.41,84.18,8
HCPCS,E01490,Heavy duty wheeled walker,,,84.18,84.18,1
HCPCS,E0149MS,Heavy duty wheeled walker,,,8.41,8.41,1
HCPCS,E0149NU,Heavy duty wheeled walker,,,84.18,84.18,1
HCPCS,E0149RR,Heavy duty wheeled walker,,,8.41,25.53,4
HCPCS,E0149UE,Heavy duty wheeled walker,,,63.13,63.13,1
HCPCS,E0153,Forearm crutch platform atta,,,5.41,137.72,14
HCPCS,E01530,Forearm crutch platform atta,,,47.81,47.81,1
HCPCS,E0153MS,Forearm crutch platform atta,,,5.41,5.41,1
HCPCS,E0153NU,Forearm crutch platform atta,,,47.81,137.72,4
HCPCS,E0153RR,Forearm crutch platform atta,,,5.41,15.57,4
HCPCS,E0153UE,Forearm crutch platform atta,,,35.85,103.27,4
HCPCS,E0154,Walker platform attachment,,,3.48,96.83,14
HCPCS,E01540,Walker platform attachment,,,34.77,34.77,1
HCPCS,E0154MS,Walker platform attachment,,,3.48,3.48,1
HCPCS,E0154NU,Walker platform attachment,,,34.77,96.83,4
HCPCS,E0154RR,Walker platform attachment,,,3.48,9.69,4
HCPCS,E0154UE,Walker platform attachment,,,26.07,72.64,4
HCPCS,E0155,"Walker wheel attachment,pair",,,1.5,41.31,14
HCPCS,E01550,"Walker wheel attachment,pair",,,14.96,14.96,1
HCPCS,E0155MS,"Walker wheel attachment,pair",,,1.5,1.5,1
HCPCS,E0155NU,"Walker wheel attachment,pair",,,14.96,41.31,4
HCPCS,E0155RR,"Walker wheel attachment,pair",,,1.5,4.13,4
HCPCS,E0155UE,"Walker wheel attachment,pair",,,11.22,31.0,4
HCPCS,E0156,Walker seat attachment,,,1.1,32.67,14
HCPCS,E01560,Walker seat attachment,,,11.05,11.05,1
HCPCS,E0156MS,Walker seat attachment,,,1.1,1.1,1
HCPCS,E0156NU,Walker seat attachment,,,11.05,32.67,4
HCPCS,E0156RR,Walker seat attachment,,,1.1,3.28,4
HCPCS,E0156UE,Walker seat attachment,,,8.28,24.51,4
HCPCS,E0157,Walker crutch attachment,,,4.23,116.84,14
HCPCS,E01570,Walker crutch attachment,,,42.3,42.3,1
HCPCS,E0157MS,Walker crutch attachment,,,4.23,4.23,1
HCPCS,E0157NU,Walker crutch attachment,,,42.3,116.84,4
HCPCS,E0157RR,Walker crutch attachment,,,4.23,11.68,4
HCPCS,E0157UE,Walker crutch attachment,,,31.73,87.63,4
HCPCS,E0158,Walker leg extenders set of4,,,1.61,43.83,14
HCPCS,E01580,Walker leg extenders set of4,,,16.05,16.05,1
HCPCS,E0158MS,Walker leg extenders set of4,,,1.61,1.61,1
HCPCS,E0158NU,Walker leg extenders set of4,,,16.05,43.83,4
HCPCS,E0158RR,Walker leg extenders set of4,,,1.61,4.38,4
HCPCS,E0158UE,Walker leg extenders set of4,,,12.03,32.89,4
HCPCS,E0159,Brake for wheeled walker,,,1.1,30.45,14
HCPCS,E01590,Brake for wheeled walker,,,10.99,10.99,1
HCPCS,E0159MS,Brake for wheeled walker,,,1.1,1.1,1
HCPCS,E0159NU,Brake for wheeled walker,,,10.99,30.45,4
HCPCS,E0159RR,Brake for wheeled walker,,,1.1,3.04,4
HCPCS,E0159UE,Brake for wheeled walker,,,8.24,22.84,4
HCPCS,E0160,Sitz type bath or equipment,,,2.13,54.32,14
HCPCS,E01600,Sitz type bath or equipment,,,21.25,21.25,1
HCPCS,E0160MS,Sitz type bath or equipment,,,2.13,2.13,1
HCPCS,E0160NU,Sitz type bath or equipment,,,21.25,54.32,4
HCPCS,E0160RR,Sitz type bath or equipment,,,2.13,5.43,4
HCPCS,E0160UE,Sitz type bath or equipment,,,15.95,40.76,4
HCPCS,E0161,Sitz bath/equipment w/faucet,,,1.8,50.9,14
HCPCS,E01610,Sitz bath/equipment w/faucet,,,18.06,18.06,1
HCPCS,E0161MS,Sitz bath/equipment w/faucet,,,1.8,1.8,1
HCPCS,E0161NU,Sitz bath/equipment w/faucet,,,18.06,50.9,4
HCPCS,E0161RR,Sitz bath/equipment w/faucet,,,1.8,5.1,4
HCPCS,E0161UE,Sitz bath/equipment w/faucet,,,13.55,38.18,4
HCPCS,E0162,Sitz bath chair,,,12.4,340.18,14
HCPCS,E01620,Sitz bath chair,,,113.39,113.39,1
HCPCS,E0162MS,Sitz bath chair,,,12.4,12.4,1
HCPCS,E0162NU,Sitz bath chair,,,113.39,340.18,4
HCPCS,E0162RR,Sitz bath chair,,,12.4,35.71,4
HCPCS,E0162UE,Sitz bath chair,,,82.84,263.78,4
HCPCS,E0163,Commode chair with fixed arm,,,3.75,111.04,14
HCPCS,E01630,Commode chair with fixed arm,,,37.41,37.41,1
HCPCS,E0163MS,Commode chair with fixed arm,,,3.75,3.75,1
HCPCS,E0163NU,Commode chair with fixed arm,,,37.41,111.04,4
HCPCS,E0163RR,Commode chair with fixed arm,,,3.75,11.1,4
HCPCS,E0163UE,Commode chair with fixed arm,,,28.06,83.28,4
HCPCS,E0165,Commode chair with detacharm,,,8.76,87.56,8
HCPCS,E01650,Commode chair with detacharm,,,87.56,87.56,1
HCPCS,E0165MS,Commode chair with detacharm,,,8.76,8.76,1
HCPCS,E0165NU,Commode chair with detacharm,,,87.56,87.56,1
HCPCS,E0165RR,Commode chair with detacharm,,,8.76,25.57,4
HCPCS,E0165UE,Commode chair with detacharm,,,65.66,65.66,1
HCPCS,E0167,Commode chair pail or pan,,,0.81,20.55,14
HCPCS,E01670,Commode chair pail or pan,,,8.11,8.11,1
HCPCS,E0167MS,Commode chair pail or pan,,,0.81,0.81,1
HCPCS,E0167NU,Commode chair pail or pan,,,8.11,20.55,4
HCPCS,E0167RR,Commode chair pail or pan,,,0.81,2.06,4
HCPCS,E0167UE,Commode chair pail or pan,,,6.09,15.42,4
HCPCS,E0168,Heavyduty/wide commode chair,,,8.32,244.89,14
HCPCS,E01680,Heavyduty/wide commode chair,,,83.14,83.14,1
HCPCS,E0168MS,Heavyduty/wide commode chair,,,8.32,8.32,1
HCPCS,E0168NU,Heavyduty/wide commode chair,,,83.14,244.89,4
HCPCS,E0168RR,Heavyduty/wide commode chair,,,8.32,24.5,4
HCPCS,E0168UE,Heavyduty/wide commode chair,,,62.35,183.66,4
HCPCS,E0170,Commode chair electric,,,117.18,1171.84,8
HCPCS,E01700,Commode chair electric,,,1171.84,1171.84,1
HCPCS,E0170MS,Commode chair electric,,,117.18,117.18,1
HCPCS,E0170NU,Commode chair electric,,,1171.84,1171.84,1
HCPCS,E0170RR,Commode chair electric,,,117.18,328.65,4
HCPCS,E0170UE,Commode chair electric,,,878.88,878.88,1
HCPCS,E0171,Commode chair non-electric,,,21.97,219.73,8
HCPCS,E01710,Commode chair non-electric,,,219.73,219.73,1
HCPCS,E0171MS,Commode chair non-electric,,,21.97,21.97,1
HCPCS,E0171NU,Commode chair non-electric,,,219.73,219.73,1
HCPCS,E0171RR,Commode chair non-electric,,,21.97,60.39,4
HCPCS,E0171UE,Commode chair non-electric,,,164.79,164.79,1
HCPCS,E0172,Seat lift mechanism toilet,,,19.44,194.4,4
HCPCS,E01720,Seat lift mechanism toilet,,,194.4,194.4,1
HCPCS,E0172MS,Seat lift mechanism toilet,,,19.44,19.44,1
HCPCS,E0172NU,Seat lift mechanism toilet,,,194.4,194.4,1
HCPCS,E0172RR,Seat lift mechanism toilet,,,19.44,19.44,1
HCPCS,E0175,Commode chair foot rest,,,4.91,154.63,14
HCPCS,E01750,Commode chair foot rest,,,49.27,49.27,1
HCPCS,E0175MS,Commode chair foot rest,,,4.91,4.91,1
HCPCS,E0175NU,Commode chair foot rest,,,49.27,154.63,4
HCPCS,E0175RR,Commode chair foot rest,,,4.91,15.46,4
HCPCS,E0175UE,Commode chair foot rest,,,36.96,113.83,4
HCPCS,E0181,Press pad alternating w/ pum,,,10.83,108.35,8
HCPCS,E01810,Press pad alternating w/ pum,,,108.35,108.35,1
HCPCS,E0181MS,Press pad alternating w/ pum,,,10.83,10.83,1
HCPCS,E0181NU,Press pad alternating w/ pum,,,108.35,108.35,1
HCPCS,E0181RR,Press pad alternating w/ pum,,,10.83,32.17,4
HCPCS,E0181UE,Press pad alternating w/ pum,,,81.26,81.26,1
HCPCS,E0182,"Replace pump, alt press pad",,,15.94,159.43,8
HCPCS,E01820,"Replace pump, alt press pad",,,159.43,159.43,1
HCPCS,E0182MS,"Replace pump, alt press pad",,,15.94,15.94,1
HCPCS,E0182NU,"Replace pump, alt press pad",,,159.43,159.43,1
HCPCS,E0182RR,"Replace pump, alt press pad",,,15.94,39.9,4
HCPCS,E0182UE,"Replace pump, alt press pad",,,119.58,119.58,1
HCPCS,E0183,Press underlay alter w/pump,,,10.83,108.35,8
HCPCS,E01830,Press underlay alter w/pump,,,108.35,108.35,1
HCPCS,E0183MS,Press underlay alter w/pump,,,10.83,10.83,1
HCPCS,E0183NU,Press underlay alter w/pump,,,108.35,108.35,1
HCPCS,E0183RR,Press underlay alter w/pump,,,10.83,32.17,4
HCPCS,E0183UE,Press underlay alter w/pump,,,81.26,81.26,1
HCPCS,E0184,Dry pressure mattress,,,10.93,328.92,14
HCPCS,E01840,Dry pressure mattress,,,109.27,109.27,1
HCPCS,E0184MS,Dry pressure mattress,,,10.93,10.93,1
HCPCS,E0184NU,Dry pressure mattress,,,109.27,328.92,4
HCPCS,E0184RR,Dry pressure mattress,,,10.93,32.89,4
HCPCS,E0184UE,Dry pressure mattress,,,81.95,246.69,4
HCPCS,E0185,Gel pressure mattress pad,,,11.69,351.21,14
HCPCS,E01850,Gel pressure mattress pad,,,116.89,116.89,1
HCPCS,E0185MS,Gel pressure mattress pad,,,11.69,11.69,1
HCPCS,E0185NU,Gel pressure mattress pad,,,116.89,351.21,4
HCPCS,E0185RR,Gel pressure mattress pad,,,11.69,35.12,4
HCPCS,E0185UE,Gel pressure mattress pad,,,87.66,263.42,4
HCPCS,E0186,Air pressure mattress,,,13.5,135.02,8
HCPCS,E01860,Air pressure mattress,,,135.02,135.02,1
HCPCS,E0186MS,Air pressure mattress,,,13.5,13.5,1
HCPCS,E0186NU,Air pressure mattress,,,135.02,135.02,1
HCPCS,E0186RR,Air pressure mattress,,,13.5,36.65,4
HCPCS,E0186UE,Air pressure mattress,,,101.26,101.26,1
HCPCS,E0187,Water pressure mattress,,,15.93,159.26,8
HCPCS,E01870,Water pressure mattress,,,159.26,159.26,1
HCPCS,E0187MS,Water pressure mattress,,,15.93,15.93,1
HCPCS,E0187NU,Water pressure mattress,,,159.26,159.26,1
HCPCS,E0187RR,Water pressure mattress,,,15.93,39.97,4
HCPCS,E0187UE,Water pressure mattress,,,119.44,119.44,1
HCPCS,E0188,Synthetic sheepskin pad,,,1.83,48.91,14
HCPCS,E01880,Synthetic sheepskin pad,,,18.26,18.26,1
HCPCS,E0188MS,Synthetic sheepskin pad,,,1.83,1.83,1
HCPCS,E0188NU,Synthetic sheepskin pad,,,18.26,48.91,4
HCPCS,E0188RR,Synthetic sheepskin pad,,,1.83,4.9,4
HCPCS,E0188UE,Synthetic sheepskin pad,,,13.69,36.68,4
HCPCS,E0189,Lambswool sheepskin pad,,,3.43,101.55,14
HCPCS,E01890,Lambswool sheepskin pad,,,34.37,34.37,1
HCPCS,E0189MS,Lambswool sheepskin pad,,,3.43,3.43,1
HCPCS,E0189NU,Lambswool sheepskin pad,,,34.37,101.55,4
HCPCS,E0189RR,Lambswool sheepskin pad,,,3.43,10.16,4
HCPCS,E0189UE,Lambswool sheepskin pad,,,25.77,76.16,4
HCPCS,E0190,Positioning cushion,,,5.22,52.15,5
HCPCS,E01900,Positioning cushion,,,52.15,52.15,1
HCPCS,E0190MS,Positioning cushion,,,5.22,5.22,1
HCPCS,E0190NU,Positioning cushion,,,52.15,52.15,1
HCPCS,E0190RR,Positioning cushion,,,5.22,5.22,1
HCPCS,E0190UE,Positioning cushion,,,39.12,39.12,1
HCPCS,E0191,Protector heel or elbow,,,0.84,21.57,14
HCPCS,E01910,Protector heel or elbow,,,8.06,8.06,1
HCPCS,E0191MS,Protector heel or elbow,,,0.84,0.84,1
HCPCS,E0191NU,Protector heel or elbow,,,8.06,21.57,4
HCPCS,E0191RR,Protector heel or elbow,,,0.84,2.14,4
HCPCS,E0191UE,Protector heel or elbow,,,6.03,16.19,4
HCPCS,E0193,Powered air flotation bed,,,508.85,5088.51,8
HCPCS,E01930,Powered air flotation bed,,,5088.51,5088.51,1
HCPCS,E0193MS,Powered air flotation bed,,,508.85,508.85,1
HCPCS,E0193NU,Powered air flotation bed,,,5088.51,5088.51,1
HCPCS,E0193RR,Powered air flotation bed,,,508.85,1407.13,4
HCPCS,E0193UE,Powered air flotation bed,,,3816.37,3816.37,1
HCPCS,E0194,Air fluidized bed,,,2412.62,24126.26,8
HCPCS,E01940,Air fluidized bed,,,24126.26,24126.26,1
HCPCS,E0194MS,Air fluidized bed,,,2412.62,2412.62,1
HCPCS,E0194NU,Air fluidized bed,,,24126.26,24126.26,1
HCPCS,E0194RR,Air fluidized bed,,,2412.62,6702.03,4
HCPCS,E0194UE,Air fluidized bed,,,18094.7,18094.7,1
HCPCS,E0196,Gel pressure mattress,,,23.68,236.83,8
HCPCS,E01960,Gel pressure mattress,,,236.83,236.83,1
HCPCS,E0196MS,Gel pressure mattress,,,23.68,23.68,1
HCPCS,E0196NU,Gel pressure mattress,,,236.83,236.83,1
HCPCS,E0196RR,Gel pressure mattress,,,23.68,61.36,4
HCPCS,E0196UE,Gel pressure mattress,,,177.62,177.62,1
HCPCS,E0197,Air pressure pad for mattres,,,13.2,131.93,8
HCPCS,E01970,Air pressure pad for mattres,,,131.93,131.93,1
HCPCS,E0197MS,Air pressure pad for mattres,,,13.2,13.2,1
HCPCS,E0197NU,Air pressure pad for mattres,,,131.93,131.93,1
HCPCS,E0197RR,Air pressure pad for mattres,,,13.2,34.36,4
HCPCS,E0197UE,Air pressure pad for mattres,,,98.95,98.95,1
HCPCS,E0198,Water pressure pad for mattr,,,17.96,179.63,8
HCPCS,E01980,Water pressure pad for mattr,,,179.63,179.63,1
HCPCS,E0198MS,Water pressure pad for mattr,,,17.96,17.96,1
HCPCS,E0198NU,Water pressure pad for mattr,,,179.63,179.63,1
HCPCS,E0198RR,Water pressure pad for mattr,,,17.96,51.75,4
HCPCS,E0198UE,Water pressure pad for mattr,,,134.72,134.72,1
HCPCS,E0199,Dry pressure pad for mattres,,,2.04,60.12,14
HCPCS,E01990,Dry pressure pad for mattres,,,20.46,20.46,1
HCPCS,E0199MS,Dry pressure pad for mattres,,,2.04,2.04,1
HCPCS,E0199NU,Dry pressure pad for mattres,,,20.46,60.12,4
HCPCS,E0199RR,Dry pressure pad for mattres,,,2.04,6.02,4
HCPCS,E0199UE,Dry pressure pad for mattres,,,15.35,45.1,4
HCPCS,E0200,Heat lamp without stand,,,8.73,157.32,14
HCPCS,E02000,Heat lamp without stand,,,64.25,64.25,1
HCPCS,E0200MS,Heat lamp without stand,,,8.73,8.73,1
HCPCS,E0200NU,Heat lamp without stand,,,64.25,157.32,4
HCPCS,E0200RR,Heat lamp without stand,,,8.73,21.36,4
HCPCS,E0200UE,Heat lamp without stand,,,48.22,118.07,4
HCPCS,E0201,Penile contractur devic manu,,,8.53,85.33,5
HCPCS,E02010,Penile contractur devic manu,,,85.3,85.3,1
HCPCS,E0201MS,Penile contractur devic manu,,,8.53,8.53,1
HCPCS,E0201NU,Penile contractur devic manu,,,85.33,85.33,1
HCPCS,E0201RR,Penile contractur devic manu,,,8.53,8.53,1
HCPCS,E0201UE,Penile contractur devic manu,,,64.0,64.0,1
HCPCS,E0202,Phototherapy light w/ photom,,,50.76,507.58,8
HCPCS,E02020,Phototherapy light w/ photom,,,507.58,507.58,1
HCPCS,E0202MS,Phototherapy light w/ photom,,,50.76,50.76,1
HCPCS,E0202NU,Phototherapy light w/ photom,,,507.58,507.58,1
HCPCS,E0202RR,Phototherapy light w/ photom,,,50.76,124.29,4
HCPCS,E0202UE,Phototherapy light w/ photom,,,380.68,380.68,1
HCPCS,E0203,Therapeutic lightbox tabletp,,,21.6,216.0,8
HCPCS,E02030,Therapeutic lightbox tabletp,,,216.0,216.0,1
HCPCS,E0203MS,Therapeutic lightbox tabletp,,,21.6,21.6,1
HCPCS,E0203NU,Therapeutic lightbox tabletp,,,216.0,216.0,1
HCPCS,E0203RR,Therapeutic lightbox tabletp,,,21.6,21.6,1
HCPCS,E0203UE,Therapeutic lightbox tabletp,,,189.0,189.0,1
HCPCS,E0205,Heat lamp with stand,,,17.3,385.12,14
HCPCS,E02050,Heat lamp with stand,,,157.28,157.28,1
HCPCS,E0205MS,Heat lamp with stand,,,17.3,17.3,1
HCPCS,E0205NU,Heat lamp with stand,,,157.28,385.12,4
HCPCS,E0205RR,Heat lamp with stand,,,17.3,42.38,4
HCPCS,E0205UE,Heat lamp with stand,,,117.96,288.85,4
HCPCS,E0210,Electric heat pad standard,,,2.49,64.82,14
HCPCS,E02100,Electric heat pad standard,,,26.47,26.47,1
HCPCS,E0210MS,Electric heat pad standard,,,2.49,2.49,1
HCPCS,E0210NU,Electric heat pad standard,,,26.47,64.82,4
HCPCS,E0210RR,Electric heat pad standard,,,2.49,6.17,4
HCPCS,E0210UE,Electric heat pad standard,,,19.83,48.56,4
HCPCS,E0215,Electric heat pad moist,,,6.02,140.58,14
HCPCS,E02150,Electric heat pad moist,,,57.41,57.41,1
HCPCS,E0215MS,Electric heat pad moist,,,6.02,6.02,1
HCPCS,E0215NU,Electric heat pad moist,,,57.41,140.58,4
HCPCS,E0215RR,Electric heat pad moist,,,6.02,14.72,4
HCPCS,E0215UE,Electric heat pad moist,,,43.07,105.46,4
HCPCS,E0217,Water circ heat pad w pump,,,38.08,985.24,14
HCPCS,E02170,Water circ heat pad w pump,,,342.01,342.01,1
HCPCS,E0217MS,Water circ heat pad w pump,,,38.08,38.08,1
HCPCS,E0217NU,Water circ heat pad w pump,,,342.01,985.24,4
HCPCS,E0217RR,Water circ heat pad w pump,,,38.08,109.68,4
HCPCS,E0217UE,Water circ heat pad w pump,,,256.5,738.88,4
HCPCS,E0218,Fluid circ cold pad w pump,,,18.2,156.89,5
HCPCS,E02180,Fluid circ cold pad w pump,,,156.89,156.89,1
HCPCS,E0218MS,Fluid circ cold pad w pump,,,18.2,18.2,1
HCPCS,E0218NU,Fluid circ cold pad w pump,,,156.89,156.89,1
HCPCS,E0218RR,Fluid circ cold pad w pump,,,18.2,18.2,1
HCPCS,E0218UE,Fluid circ cold pad w pump,,,117.62,117.62,1
HCPCS,E0221,Infrared heating pad system,,,10.67,106.7,5
HCPCS,E02210,Infrared heating pad system,,,106.7,106.7,1
HCPCS,E0221MS,Infrared heating pad system,,,10.67,10.67,1
HCPCS,E0221NU,Infrared heating pad system,,,106.7,106.7,1
HCPCS,E0221RR,Infrared heating pad system,,,10.67,10.67,1
HCPCS,E0221UE,Infrared heating pad system,,,80.03,80.03,1
HCPCS,E0225,Hydrocollator unit,,,26.4,771.28,14
HCPCS,E02250,Hydrocollator unit,,,267.74,267.74,1
HCPCS,E0225MS,Hydrocollator unit,,,26.4,26.4,1
HCPCS,E0225NU,Hydrocollator unit,,,267.74,771.28,4
HCPCS,E0225RR,Hydrocollator unit,,,26.4,76.01,4
HCPCS,E0225UE,Hydrocollator unit,,,200.8,578.47,4
HCPCS,E0231,Wound warming device,,,5.4,5.4,2
HCPCS,E02310,Wound warming device,,,5.4,5.4,1
HCPCS,E0231NU,Wound warming device,,,5.4,5.4,1
HCPCS,E0232,Warming card for nwt,,,37.8,37.8,2
HCPCS,E02320,Warming card for nwt,,,37.8,37.8,1
HCPCS,E0232NU,Warming card for nwt,,,37.8,37.8,1
HCPCS,E0235,Paraffin bath unit portable,,,11.89,118.86,8
HCPCS,E02350,Paraffin bath unit portable,,,118.86,118.86,1
HCPCS,E0235MS,Paraffin bath unit portable,,,11.89,11.89,1
HCPCS,E0235NU,Paraffin bath unit portable,,,118.86,118.86,1
HCPCS,E0235RR,Paraffin bath unit portable,,,11.89,40.27,4
HCPCS,E0235UE,Paraffin bath unit portable,,,89.14,89.14,1
HCPCS,E0236,Pump for water circulating p,,,30.48,304.79,8
HCPCS,E02360,Pump for water circulating p,,,304.79,304.79,1
HCPCS,E0236MS,Pump for water circulating p,,,30.48,30.48,1
HCPCS,E0236NU,Pump for water circulating p,,,304.79,304.79,1
HCPCS,E0236RR,Pump for water circulating p,,,30.48,87.81,4
HCPCS,E0236UE,Pump for water circulating p,,,228.58,228.58,1
HCPCS,E0239,Hydrocollator unit portable,,,31.0,1050.22,14
HCPCS,E02390,Hydrocollator unit portable,,,309.9,309.9,1
HCPCS,E0239MS,Hydrocollator unit portable,,,31.0,31.0,1
HCPCS,E0239NU,Hydrocollator unit portable,,,309.9,1050.22,4
HCPCS,E0239RR,Hydrocollator unit portable,,,31.0,105.04,4
HCPCS,E0239UE,Hydrocollator unit portable,,,232.43,787.69,4
HCPCS,E0240,Bath/shower chair,,,16.2,16.2,1
HCPCS,E02400,Bath/shower chair,,,16.2,16.2,1
HCPCS,E0241,Bath tub wall rail,,,10.98,10.98,1
HCPCS,E02410,Bath tub wall rail,,,10.98,10.98,1
HCPCS,E0242,Bath tub rail floor,,,24.68,24.68,1
HCPCS,E02420,Bath tub rail floor,,,24.68,24.68,1
HCPCS,E0243,Toilet rail,,,19.63,19.63,1
HCPCS,E02430,Toilet rail,,,19.63,19.63,1
HCPCS,E0244,Toilet seat raised,,,14.95,14.95,1
HCPCS,E02440,Toilet seat raised,,,14.95,14.95,1
HCPCS,E0245,Tub stool or bench,,,24.49,24.49,1
HCPCS,E02450,Tub stool or bench,,,24.49,24.49,1
HCPCS,E0246,Transfer tub rail attachment,,,33.5,33.5,1
HCPCS,E02460,Transfer tub rail attachment,,,33.5,33.5,1
HCPCS,E0247,Trans bench w/wo comm open,,,2.34,24.14,5
HCPCS,E02470,Trans bench w/wo comm open,,,24.14,24.14,1
HCPCS,E0247MS,Trans bench w/wo comm open,,,2.34,2.34,1
HCPCS,E0247NU,Trans bench w/wo comm open,,,24.14,24.14,1
HCPCS,E0247RR,Trans bench w/wo comm open,,,2.34,2.34,1
HCPCS,E0247UE,Trans bench w/wo comm open,,,16.75,16.75,1
HCPCS,E0248,Hdtrans bench w/wo comm open,,,2.32,22.77,5
HCPCS,E02480,Hdtrans bench w/wo comm open,,,22.77,22.77,1
HCPCS,E0248MS,Hdtrans bench w/wo comm open,,,2.32,2.32,1
HCPCS,E0248NU,Hdtrans bench w/wo comm open,,,22.77,22.77,1
HCPCS,E0248RR,Hdtrans bench w/wo comm open,,,2.32,2.32,1
HCPCS,E0248UE,Hdtrans bench w/wo comm open,,,16.68,16.68,1
HCPCS,E0249,Pad water circulating heat u,,,7.54,197.66,14
HCPCS,E02490,Pad water circulating heat u,,,68.62,68.62,1
HCPCS,E0249MS,Pad water circulating heat u,,,7.54,7.54,1
HCPCS,E0249NU,Pad water circulating heat u,,,68.62,197.66,4
HCPCS,E0249RR,Pad water circulating heat u,,,7.54,21.72,4
HCPCS,E0249UE,Pad water circulating heat u,,,51.45,148.23,4
HCPCS,E0250,Hosp bed fixed ht w/ mattres,,,42.12,421.15,8
HCPCS,E02500,Hosp bed fixed ht w/ mattres,,,421.15,421.15,1
HCPCS,E0250MS,Hosp bed fixed ht w/ mattres,,,42.12,42.12,1
HCPCS,E0250NU,Hosp bed fixed ht w/ mattres,,,421.15,421.15,1
HCPCS,E0250RR,Hosp bed fixed ht w/ mattres,,,42.12,125.21,4
HCPCS,E0250UE,Hosp bed fixed ht w/ mattres,,,315.86,315.86,1
HCPCS,E0251,Hosp bed fixd ht w/o mattres,,,40.88,408.79,8
HCPCS,E02510,Hosp bed fixd ht w/o mattres,,,408.79,408.79,1
HCPCS,E0251MS,Hosp bed fixd ht w/o mattres,,,40.88,40.88,1
HCPCS,E0251NU,Hosp bed fixd ht w/o mattres,,,408.79,408.79,1
HCPCS,E0251RR,Hosp bed fixd ht w/o mattres,,,40.88,115.72,4
HCPCS,E0251UE,Hosp bed fixd ht w/o mattres,,,306.59,306.59,1
HCPCS,E0255,Hospital bed var ht w/ mattr,,,42.62,426.2,8
HCPCS,E02550,Hospital bed var ht w/ mattr,,,426.2,426.2,1
HCPCS,E0255MS,Hospital bed var ht w/ mattr,,,42.62,42.62,1
HCPCS,E0255NU,Hospital bed var ht w/ mattr,,,426.2,426.2,1
HCPCS,E0255RR,Hospital bed var ht w/ mattr,,,42.62,126.81,4
HCPCS,E0255UE,Hospital bed var ht w/ mattr,,,319.65,319.65,1
HCPCS,E0256,Hospital bed var ht w/o matt,,,41.21,412.18,8
HCPCS,E02560,Hospital bed var ht w/o matt,,,412.18,412.18,1
HCPCS,E0256MS,Hospital bed var ht w/o matt,,,41.21,41.21,1
HCPCS,E0256NU,Hospital bed var ht w/o matt,,,412.18,412.18,1
HCPCS,E0256RR,Hospital bed var ht w/o matt,,,41.21,120.68,4
HCPCS,E0256UE,Hospital bed var ht w/o matt,,,309.13,309.13,1
HCPCS,E0260,Hosp bed semi-electr w/ matt,,,42.62,426.2,8
HCPCS,E02600,Hosp bed semi-electr w/ matt,,,426.2,426.2,1
HCPCS,E0260MS,Hosp bed semi-electr w/ matt,,,42.62,42.62,1
HCPCS,E0260NU,Hosp bed semi-electr w/ matt,,,426.2,426.2,1
HCPCS,E0260RR,Hosp bed semi-electr w/ matt,,,42.62,127.16,4
HCPCS,E0260UE,Hosp bed semi-electr w/ matt,,,319.65,319.65,1
HCPCS,E0261,Hosp bed semi-electr w/o mat,,,42.62,426.2,8
HCPCS,E02610,Hosp bed semi-electr w/o mat,,,426.2,426.2,1
HCPCS,E0261MS,Hosp bed semi-electr w/o mat,,,42.62,42.62,1
HCPCS,E0261NU,Hosp bed semi-electr w/o mat,,,426.2,426.2,1
HCPCS,E0261RR,Hosp bed semi-electr w/o mat,,,42.62,126.68,4
HCPCS,E0261UE,Hosp bed semi-electr w/o mat,,,319.65,319.65,1
HCPCS,E0265,Hosp bed total electr w/ mat,,,103.32,1033.27,8
HCPCS,E02650,Hosp bed total electr w/ mat,,,1033.27,1033.27,1
HCPCS,E0265MS,Hosp bed total electr w/ mat,,,103.32,103.32,1
HCPCS,E0265NU,Hosp bed total electr w/ mat,,,1033.27,1033.27,1
HCPCS,E0265RR,Hosp bed total electr w/ mat,,,103.32,299.39,4
HCPCS,E0265UE,Hosp bed total electr w/ mat,,,774.94,774.94,1
HCPCS,E0266,Hosp bed total elec w/o matt,,,89.91,899.08,8
HCPCS,E02660,Hosp bed total elec w/o matt,,,899.08,899.08,1
HCPCS,E0266MS,Hosp bed total elec w/o matt,,,89.91,89.91,1
HCPCS,E0266NU,Hosp bed total elec w/o matt,,,899.08,899.08,1
HCPCS,E0266RR,Hosp bed total elec w/o matt,,,89.91,260.51,4
HCPCS,E0266UE,Hosp bed total elec w/o matt,,,674.31,674.31,1
HCPCS,E0270,Hospital bed institutional t,,,21.6,216.0,5
HCPCS,E02700,Hospital bed institutional t,,,216.0,216.0,1
HCPCS,E0270MS,Hospital bed institutional t,,,21.6,21.6,1
HCPCS,E0270NU,Hospital bed institutional t,,,216.0,216.0,1
HCPCS,E0270RR,Hospital bed institutional t,,,21.6,21.6,1
HCPCS,E0270UE,Hospital bed institutional t,,,162.0,162.0,1
HCPCS,E0271,Mattress innerspring,,,8.79,258.14,14
HCPCS,E02710,Mattress innerspring,,,87.9,87.9,1
HCPCS,E0271MS,Mattress innerspring,,,8.79,8.79,1
HCPCS,E0271NU,Mattress innerspring,,,87.9,258.14,4
HCPCS,E0271RR,Mattress innerspring,,,8.79,25.82,4
HCPCS,E0271UE,Mattress innerspring,,,65.92,193.6,4
HCPCS,E0272,Mattress foam rubber,,,9.91,289.89,14
HCPCS,E02720,Mattress foam rubber,,,99.14,99.14,1
HCPCS,E0272MS,Mattress foam rubber,,,9.91,9.91,1
HCPCS,E0272NU,Mattress foam rubber,,,99.14,289.89,4
HCPCS,E0272RR,Mattress foam rubber,,,9.91,28.99,4
HCPCS,E0272UE,Mattress foam rubber,,,74.36,217.41,4
HCPCS,E0273,Bed board,,,4.69,11.89,5
HCPCS,E02730,Bed board,,,11.89,11.89,1
HCPCS,E0273MS,Bed board,,,4.69,4.69,1
HCPCS,E0273NU,Bed board,,,11.89,11.89,1
HCPCS,E0273RR,Bed board,,,4.69,4.69,1
HCPCS,E0273UE,Bed board,,,9.36,9.36,1
HCPCS,E0274,Over-bed table,,,8.28,19.09,5
HCPCS,E02740,Over-bed table,,,19.09,19.09,1
HCPCS,E0274MS,Over-bed table,,,8.28,8.28,1
HCPCS,E0274NU,Over-bed table,,,19.09,19.09,1
HCPCS,E0274RR,Over-bed table,,,8.28,8.28,1
HCPCS,E0274UE,Over-bed table,,,15.31,15.31,1
HCPCS,E0275,Bed pan standard,,,0.98,27.74,14
HCPCS,E02750,Bed pan standard,,,9.78,9.78,1
HCPCS,E0275MS,Bed pan standard,,,0.98,0.98,1
HCPCS,E0275NU,Bed pan standard,,,9.78,27.74,4
HCPCS,E0275RR,Bed pan standard,,,0.98,2.77,4
HCPCS,E0275UE,Bed pan standard,,,7.33,20.8,4
HCPCS,E0276,Bed pan fracture,,,0.87,23.13,14
HCPCS,E02760,Bed pan fracture,,,8.7,8.7,1
HCPCS,E0276MS,Bed pan fracture,,,0.87,0.87,1
HCPCS,E0276NU,Bed pan fracture,,,8.7,23.13,4
HCPCS,E0276RR,Bed pan fracture,,,0.87,2.31,4
HCPCS,E0276UE,Bed pan fracture,,,6.52,17.34,4
HCPCS,E0277,Powered pres-redu air mattrs,,,129.17,1291.66,8
HCPCS,E02770,Powered pres-redu air mattrs,,,1291.66,1291.66,1
HCPCS,E0277MS,Powered pres-redu air mattrs,,,129.17,129.17,1
HCPCS,E0277NU,Powered pres-redu air mattrs,,,1291.66,1291.66,1
HCPCS,E0277RR,Powered pres-redu air mattrs,,,129.17,409.28,4
HCPCS,E0277UE,Powered pres-redu air mattrs,,,968.74,968.74,1
HCPCS,E0280,Bed cradle,,,2.21,62.11,14
HCPCS,E02800,Bed cradle,,,22.16,22.16,1
HCPCS,E0280MS,Bed cradle,,,2.21,2.21,1
HCPCS,E0280NU,Bed cradle,,,22.16,62.11,4
HCPCS,E0280RR,Bed cradle,,,2.21,6.22,4
HCPCS,E0280UE,Bed cradle,,,16.61,46.59,4
HCPCS,E0290,Hosp bed fx ht w/o rails w/m,,,40.41,404.16,8
HCPCS,E02900,Hosp bed fx ht w/o rails w/m,,,404.16,404.16,1
HCPCS,E0290MS,Hosp bed fx ht w/o rails w/m,,,40.41,40.41,1
HCPCS,E0290NU,Hosp bed fx ht w/o rails w/m,,,404.16,404.16,1
HCPCS,E0290RR,Hosp bed fx ht w/o rails w/m,,,40.41,114.86,4
HCPCS,E0290UE,Hosp bed fx ht w/o rails w/m,,,303.12,303.12,1
HCPCS,E0291,Hosp bed fx ht w/o rail w/o,,,30.94,309.42,8
HCPCS,E02910,Hosp bed fx ht w/o rail w/o,,,309.42,309.42,1
HCPCS,E0291MS,Hosp bed fx ht w/o rail w/o,,,30.94,30.94,1
HCPCS,E0291NU,Hosp bed fx ht w/o rail w/o,,,309.42,309.42,1
HCPCS,E0291RR,Hosp bed fx ht w/o rail w/o,,,30.94,87.44,4
HCPCS,E0291UE,Hosp bed fx ht w/o rail w/o,,,232.06,232.06,1
HCPCS,E0292,Hosp bed var ht no sr w/matt,,,41.85,418.48,8
HCPCS,E02920,Hosp bed var ht no sr w/matt,,,418.48,418.48,1
HCPCS,E0292MS,Hosp bed var ht no sr w/matt,,,41.85,41.85,1
HCPCS,E0292NU,Hosp bed var ht no sr w/matt,,,418.48,418.48,1
HCPCS,E0292RR,Hosp bed var ht no sr w/matt,,,41.85,121.7,4
HCPCS,E0292UE,Hosp bed var ht no sr w/matt,,,313.86,313.86,1
HCPCS,E0293,Hosp bed var ht no sr no mat,,,39.47,394.77,8
HCPCS,E02930,Hosp bed var ht no sr no mat,,,394.77,394.77,1
HCPCS,E0293MS,Hosp bed var ht no sr no mat,,,39.47,39.47,1
HCPCS,E0293NU,Hosp bed var ht no sr no mat,,,394.77,394.77,1
HCPCS,E0293RR,Hosp bed var ht no sr no mat,,,39.47,110.95,4
HCPCS,E0293UE,Hosp bed var ht no sr no mat,,,296.08,296.08,1
HCPCS,E0294,Hosp bed semi-elect w/ mattr,,,42.62,426.2,8
HCPCS,E02940,Hosp bed semi-elect w/ mattr,,,426.2,426.2,1
HCPCS,E0294MS,Hosp bed semi-elect w/ mattr,,,42.62,42.62,1
HCPCS,E0294NU,Hosp bed semi-elect w/ mattr,,,426.2,426.2,1
HCPCS,E0294RR,Hosp bed semi-elect w/ mattr,,,42.62,126.95,4
HCPCS,E0294UE,Hosp bed semi-elect w/ mattr,,,319.65,319.65,1
HCPCS,E0295,Hosp bed semi-elect w/o matt,,,42.62,426.2,8
HCPCS,E02950,Hosp bed semi-elect w/o matt,,,426.2,426.2,1
HCPCS,E0295MS,Hosp bed semi-elect w/o matt,,,42.62,42.62,1
HCPCS,E0295NU,Hosp bed semi-elect w/o matt,,,426.2,426.2,1
HCPCS,E0295RR,Hosp bed semi-elect w/o matt,,,42.62,126.68,4
HCPCS,E0295UE,Hosp bed semi-elect w/o matt,,,319.65,319.65,1
HCPCS,E0296,Hosp bed total elect w/ matt,,,80.62,806.18,8
HCPCS,E02960,Hosp bed total elect w/ matt,,,806.18,806.18,1
HCPCS,E0296MS,Hosp bed total elect w/ matt,,,80.62,80.62,1
HCPCS,E0296NU,Hosp bed total elect w/ matt,,,806.18,806.18,1
HCPCS,E0296RR,Hosp bed total elect w/ matt,,,80.62,233.59,4
HCPCS,E0296UE,Hosp bed total elect w/ matt,,,604.64,604.64,1
HCPCS,E0297,Hosp bed total elect w/o mat,,,71.14,711.44,8
HCPCS,E02970,Hosp bed total elect w/o mat,,,711.44,711.44,1
HCPCS,E0297MS,Hosp bed total elect w/o mat,,,71.14,71.14,1
HCPCS,E0297NU,Hosp bed total elect w/o mat,,,711.44,711.44,1
HCPCS,E0297RR,Hosp bed total elect w/o mat,,,71.14,206.13,4
HCPCS,E0297UE,Hosp bed total elect w/o mat,,,533.57,533.57,1
HCPCS,E0300,Enclosed ped crib hosp grade,,,179.65,1796.44,8
HCPCS,E03000,Enclosed ped crib hosp grade,,,1796.44,1796.44,1
HCPCS,E0300MS,Enclosed ped crib hosp grade,,,179.65,179.65,1
HCPCS,E0300NU,Enclosed ped crib hosp grade,,,1796.44,1796.44,1
HCPCS,E0300RR,Enclosed ped crib hosp grade,,,179.65,520.52,4
HCPCS,E0300UE,Enclosed ped crib hosp grade,,,1347.32,1347.32,1
HCPCS,E0301,"Hd hosp bed, 350-600 lbs",,,113.11,1131.04,8
HCPCS,E03010,"Hd hosp bed, 350-600 lbs",,,1131.04,1131.04,1
HCPCS,E0301MS,"Hd hosp bed, 350-600 lbs",,,113.11,113.11,1
HCPCS,E0301NU,"Hd hosp bed, 350-600 lbs",,,1131.04,1131.04,1
HCPCS,E0301RR,"Hd hosp bed, 350-600 lbs",,,113.11,341.55,4
HCPCS,E0301UE,"Hd hosp bed, 350-600 lbs",,,848.28,848.28,1
HCPCS,E0302,Ex hd hosp bed > 600 lbs,,,323.77,3237.72,8
HCPCS,E03020,Ex hd hosp bed > 600 lbs,,,3237.72,3237.72,1
HCPCS,E0302MS,Ex hd hosp bed > 600 lbs,,,323.77,323.77,1
HCPCS,E0302NU,Ex hd hosp bed > 600 lbs,,,3237.72,3237.72,1
HCPCS,E0302RR,Ex hd hosp bed > 600 lbs,,,323.77,982.25,4
HCPCS,E0302UE,Ex hd hosp bed > 600 lbs,,,2428.28,2428.28,1
HCPCS,E0303,Hosp bed hvy dty xtra wide,,,115.12,1151.17,8
HCPCS,E03030,Hosp bed hvy dty xtra wide,,,1151.17,1151.17,1
HCPCS,E0303MS,Hosp bed hvy dty xtra wide,,,115.12,115.12,1
HCPCS,E0303NU,Hosp bed hvy dty xtra wide,,,1151.17,1151.17,1
HCPCS,E0303RR,Hosp bed hvy dty xtra wide,,,115.12,348.05,4
HCPCS,E0303UE,Hosp bed hvy dty xtra wide,,,863.38,863.38,1
HCPCS,E0304,Hosp bed xtra hvy dty x wide,,,341.74,3417.4,8
HCPCS,E03040,Hosp bed xtra hvy dty x wide,,,3417.4,3417.4,1
HCPCS,E0304MS,Hosp bed xtra hvy dty x wide,,,341.74,341.74,1
HCPCS,E0304NU,Hosp bed xtra hvy dty x wide,,,3417.4,3417.4,1
HCPCS,E0304RR,Hosp bed xtra hvy dty x wide,,,341.74,1020.35,4
HCPCS,E0304UE,Hosp bed xtra hvy dty x wide,,,2563.06,2563.06,1
HCPCS,E0305,Rails bed side half length,,,7.57,75.74,8
HCPCS,E03050,Rails bed side half length,,,75.74,75.74,1
HCPCS,E0305MS,Rails bed side half length,,,7.57,7.57,1
HCPCS,E0305NU,Rails bed side half length,,,75.74,75.74,1
HCPCS,E0305RR,Rails bed side half length,,,7.57,22.36,4
HCPCS,E0305UE,Rails bed side half length,,,56.8,56.8,1
HCPCS,E0310,Rails bed side full length,,,7.71,236.35,14
HCPCS,E03100,Rails bed side full length,,,77.07,77.07,1
HCPCS,E0310MS,Rails bed side full length,,,7.71,7.71,1
HCPCS,E0310NU,Rails bed side full length,,,77.07,236.35,4
HCPCS,E0310RR,Rails bed side full length,,,7.71,23.63,4
HCPCS,E0310UE,Rails bed side full length,,,57.8,177.26,4
HCPCS,E0315,Bed accessory brd/tbl/supprt,,,267.84,267.84,2
HCPCS,E03150,Bed accessory brd/tbl/supprt,,,267.84,267.84,1
HCPCS,E0315NU,Bed accessory brd/tbl/supprt,,,267.84,267.84,1
HCPCS,E0316,Bed safety enclosure,,,138.65,1386.51,8
HCPCS,E03160,Bed safety enclosure,,,1386.51,1386.51,1
HCPCS,E0316MS,Bed safety enclosure,,,138.65,138.65,1
HCPCS,E0316NU,Bed safety enclosure,,,1386.51,1386.51,1
HCPCS,E0316RR,Bed safety enclosure,,,138.65,425.15,4
HCPCS,E0316UE,Bed safety enclosure,,,1039.89,1039.89,1
HCPCS,E0325,Urinal male jug-type,,,0.64,17.91,14
HCPCS,E03250,Urinal male jug-type,,,6.38,6.38,1
HCPCS,E0325MS,Urinal male jug-type,,,0.64,0.64,1
HCPCS,E0325NU,Urinal male jug-type,,,6.38,17.91,4
HCPCS,E0325RR,Urinal male jug-type,,,0.64,1.79,4
HCPCS,E0325UE,Urinal male jug-type,,,4.61,13.43,4
HCPCS,E0326,Urinal female jug-type,,,0.7,19.18,14
HCPCS,E03260,Urinal female jug-type,,,6.98,6.98,1
HCPCS,E0326MS,Urinal female jug-type,,,0.7,0.7,1
HCPCS,E0326NU,Urinal female jug-type,,,6.98,19.18,4
HCPCS,E0326RR,Urinal female jug-type,,,0.7,1.92,4
HCPCS,E0326UE,Urinal female jug-type,,,5.24,14.39,4
HCPCS,E0328,"Ped hospital bed, manual",,,1188.28,11882.76,5
HCPCS,E03280,"Ped hospital bed, manual",,,11882.76,11882.76,1
HCPCS,E0328MS,"Ped hospital bed, manual",,,1188.28,1188.28,1
HCPCS,E0328NU,"Ped hospital bed, manual",,,11882.76,11882.76,1
HCPCS,E0328RR,"Ped hospital bed, manual",,,1188.28,1188.28,1
HCPCS,E0328UE,"Ped hospital bed, manual",,,8912.07,8912.07,1
HCPCS,E0329,Ped hospital bed semi/elect,,,2326.0,23259.97,5
HCPCS,E03290,Ped hospital bed semi/elect,,,23259.97,23259.97,1
HCPCS,E0329MS,Ped hospital bed semi/elect,,,2326.0,2326.0,1
HCPCS,E0329NU,Ped hospital bed semi/elect,,,23259.97,23259.97,1
HCPCS,E0329RR,Ped hospital bed semi/elect,,,2326.0,2326.0,1
HCPCS,E0329UE,Ped hospital bed semi/elect,,,17444.98,17444.98,1
HCPCS,E0350,Control unit bowel system,,,35.24,352.35,5
HCPCS,E03500,Control unit bowel system,,,352.35,352.35,1
HCPCS,E0350MS,Control unit bowel system,,,35.24,35.24,1
HCPCS,E0350NU,Control unit bowel system,,,352.35,352.35,1
HCPCS,E0350RR,Control unit bowel system,,,35.24,35.24,1
HCPCS,E0350UE,Control unit bowel system,,,264.27,264.27,1
HCPCS,E0352,Disposable pack w/bowel syst,,,3.82,4.32,4
HCPCS,E03520,Disposable pack w/bowel syst,,,4.32,4.32,1
HCPCS,E0370,Air elevator for heel,,,0.81,24.06,8
HCPCS,E03700,Air elevator for heel,,,8.64,8.64,1
HCPCS,E0370MS,Air elevator for heel,,,0.81,0.81,1
HCPCS,E0370NU,Air elevator for heel,,,8.64,8.64,1
HCPCS,E0370RR,Air elevator for heel,,,0.81,0.81,1
HCPCS,E0370UE,Air elevator for heel,,,6.48,6.48,1
HCPCS,E0371,Nonpower mattress overlay,,,129.17,1291.66,8
HCPCS,E03710,Nonpower mattress overlay,,,1291.66,1291.66,1
HCPCS,E0371MS,Nonpower mattress overlay,,,129.17,129.17,1
HCPCS,E0371NU,Nonpower mattress overlay,,,1291.66,1291.66,1
HCPCS,E0371RR,Nonpower mattress overlay,,,129.17,409.28,4
HCPCS,E0371UE,Nonpower mattress overlay,,,968.74,968.74,1
HCPCS,E0372,Powered air mattress overlay,,,129.17,1291.66,8
HCPCS,E03720,Powered air mattress overlay,,,1291.66,1291.66,1
HCPCS,E0372MS,Powered air mattress overlay,,,129.17,129.17,1
HCPCS,E0372NU,Powered air mattress overlay,,,1291.66,1291.66,1
HCPCS,E0372RR,Powered air mattress overlay,,,129.17,409.28,4
HCPCS,E0372UE,Powered air mattress overlay,,,968.74,968.74,1
HCPCS,E0373,Nonpowered pressure mattress,,,129.17,1291.66,8
HCPCS,E03730,Nonpowered pressure mattress,,,1291.66,1291.66,1
HCPCS,E0373MS,Nonpowered pressure mattress,,,129.17,129.17,1
HCPCS,E0373NU,Nonpowered pressure mattress,,,1291.66,1291.66,1
HCPCS,E0373RR,Nonpowered pressure mattress,,,129.17,409.28,4
HCPCS,E0373UE,Nonpowered pressure mattress,,,968.74,968.74,1
HCPCS,E0424,Stationary compressed gas 02,,,55.77,557.71,8
HCPCS,E04240,Stationary compressed gas 02,,,557.71,557.71,1
HCPCS,E0424MS,Stationary compressed gas 02,,,55.77,55.77,1
HCPCS,E0424NU,Stationary compressed gas 02,,,557.71,557.71,1
HCPCS,E0424RR,Stationary compressed gas 02,,,55.77,163.04,4
HCPCS,E0424UE,Stationary compressed gas 02,,,418.28,418.28,1
HCPCS,E0425,Gas system stationary compre,,,147.78,1477.79,5
HCPCS,E04250,Gas system stationary compre,,,1477.79,1477.79,1
HCPCS,E0425MS,Gas system stationary compre,,,147.78,147.78,1
HCPCS,E0425NU,Gas system stationary compre,,,1477.79,1477.79,1
HCPCS,E0425RR,Gas system stationary compre,,,147.78,147.78,1
HCPCS,E0425UE,Gas system stationary compre,,,1115.37,1115.37,1
HCPCS,E0430,Oxygen system gas portable,,,66.92,669.18,5
HCPCS,E04300,Oxygen system gas portable,,,669.18,669.18,1
HCPCS,E0430MS,Oxygen system gas portable,,,66.92,66.92,1
HCPCS,E0430NU,Oxygen system gas portable,,,669.18,669.18,1
HCPCS,E0430RR,Oxygen system gas portable,,,66.92,66.92,1
HCPCS,E0430UE,Oxygen system gas portable,,,501.84,501.84,1
HCPCS,E0431,Portable gaseous 02,,,12.42,124.21,8
HCPCS,E04310,Portable gaseous 02,,,124.21,124.21,1
HCPCS,E0431MS,Portable gaseous 02,,,12.42,12.42,1
HCPCS,E0431NU,Portable gaseous 02,,,124.21,124.21,1
HCPCS,E0431RR,Portable gaseous 02,,,12.42,36.03,4
HCPCS,E0431UE,Portable gaseous 02,,,93.15,93.15,1
HCPCS,E0433,Portable liquid oxygen sys,,,25.98,259.88,8
HCPCS,E04330,Portable liquid oxygen sys,,,259.88,259.88,1
HCPCS,E0433MS,Portable liquid oxygen sys,,,25.98,25.98,1
HCPCS,E0433NU,Portable liquid oxygen sys,,,259.88,259.88,1
HCPCS,E0433RR,Portable liquid oxygen sys,,,25.98,78.0,4
HCPCS,E0433UE,Portable liquid oxygen sys,,,194.91,194.91,1
HCPCS,E0434,Portable liquid 02,,,25.98,259.88,8
HCPCS,E04340,Portable liquid 02,,,259.88,259.88,1
HCPCS,E0434MS,Portable liquid 02,,,25.98,25.98,1
HCPCS,E0434NU,Portable liquid 02,,,259.88,259.88,1
HCPCS,E0434RR,Portable liquid 02,,,25.98,78.0,4
HCPCS,E0434UE,Portable liquid 02,,,194.91,194.91,1
HCPCS,E0435,Oxygen system liquid portabl,,,46.01,460.05,5
HCPCS,E04350,Oxygen system liquid portabl,,,460.05,460.05,1
HCPCS,E0435MS,Oxygen system liquid portabl,,,46.01,46.01,1
HCPCS,E0435NU,Oxygen system liquid portabl,,,460.05,460.05,1
HCPCS,E0435RR,Oxygen system liquid portabl,,,46.01,46.01,1
HCPCS,E0435UE,Oxygen system liquid portabl,,,345.12,345.12,1
HCPCS,E0439,Stationary liquid 02,,,55.77,557.71,8
HCPCS,E04390,Stationary liquid 02,,,557.71,557.71,1
HCPCS,E0439MS,Stationary liquid 02,,,55.77,55.77,1
HCPCS,E0439NU,Stationary liquid 02,,,557.71,557.71,1
HCPCS,E0439RR,Stationary liquid 02,,,55.77,163.04,4
HCPCS,E0439UE,Stationary liquid 02,,,418.28,418.28,1
HCPCS,E0440,Oxygen system liquid station,,,93.42,934.16,5
HCPCS,E04400,Oxygen system liquid station,,,934.16,934.16,1
HCPCS,E0440MS,Oxygen system liquid station,,,93.42,93.42,1
HCPCS,E0440NU,Oxygen system liquid station,,,934.16,934.16,1
HCPCS,E0440RR,Oxygen system liquid station,,,93.42,93.42,1
HCPCS,E0440UE,Oxygen system liquid station,,,700.52,700.52,1
HCPCS,E0441,"Stationary o2 contents, gas",,,3.79,111.09,7
HCPCS,E04410,"Stationary o2 contents, gas",,,37.94,37.94,1
HCPCS,E0441MS,"Stationary o2 contents, gas",,,3.79,3.79,1
HCPCS,E0441NU,"Stationary o2 contents, gas",,,37.94,37.94,1
HCPCS,E0441RR,"Stationary o2 contents, gas",,,3.79,3.79,1
HCPCS,E0442,"Stationary o2 contents, liq",,,3.79,111.09,7
HCPCS,E04420,"Stationary o2 contents, liq",,,37.94,37.94,1
HCPCS,E0442MS,"Stationary o2 contents, liq",,,3.79,3.79,1
HCPCS,E0442NU,"Stationary o2 contents, liq",,,37.94,37.94,1
HCPCS,E0442RR,"Stationary o2 contents, liq",,,3.79,3.79,1
HCPCS,E0443,"Portable 02 contents, gas",,,3.4,100.64,7
HCPCS,E04430,"Portable 02 contents, gas",,,34.06,34.06,1
HCPCS,E0443MS,"Portable 02 contents, gas",,,3.4,3.4,1
HCPCS,E0443NU,"Portable 02 contents, gas",,,34.06,34.06,1
HCPCS,E0443RR,"Portable 02 contents, gas",,,3.4,3.4,1
HCPCS,E0444,"Portable 02 contents, liquid",,,3.4,100.64,7
HCPCS,E04440,"Portable 02 contents, liquid",,,34.06,34.06,1
HCPCS,E0444MS,"Portable 02 contents, liquid",,,3.4,3.4,1
HCPCS,E0444NU,"Portable 02 contents, liquid",,,34.06,34.06,1
HCPCS,E0444RR,"Portable 02 contents, liquid",,,3.4,3.4,1
HCPCS,E0445,Oximeter non-invasive,,,64.8,648.0,4
HCPCS,E04450,Oximeter non-invasive,,,648.0,648.0,1
HCPCS,E0445MS,Oximeter non-invasive,,,64.8,64.8,1
HCPCS,E0445NU,Oximeter non-invasive,,,648.0,648.0,1
HCPCS,E0445RR,Oximeter non-invasive,,,64.8,64.8,1
HCPCS,E0446,"Topical ox deliver sys, nos",,,12.87,13.95,3
HCPCS,E0447,"Port o2 cont, liq over 4 lpm",,,51.09,150.97,4
HCPCS,E04470,"Port o2 cont, liq over 4 lpm",,,51.09,51.09,1
HCPCS,E0455,Oxygen tent excl croup/ped t,,,0.54,5.4,4
HCPCS,E04550,Oxygen tent excl croup/ped t,,,5.4,5.4,1
HCPCS,E0455MS,Oxygen tent excl croup/ped t,,,0.54,0.54,1
HCPCS,E0455NU,Oxygen tent excl croup/ped t,,,5.4,5.4,1
HCPCS,E0455RR,Oxygen tent excl croup/ped t,,,0.54,0.54,1
HCPCS,E0457,Chest shell,,,25.4,254.88,5
HCPCS,E04570,Chest shell,,,254.88,254.88,1
HCPCS,E0457MS,Chest shell,,,25.4,25.4,1
HCPCS,E0457NU,Chest shell,,,254.88,254.88,1
HCPCS,E0457RR,Chest shell,,,25.4,25.4,1
HCPCS,E0457UE,Chest shell,,,191.12,191.12,1
HCPCS,E0459,Chest wrap,,,21.07,211.11,5
HCPCS,E04590,Chest wrap,,,211.11,211.11,1
HCPCS,E0459MS,Chest wrap,,,21.07,21.07,1
HCPCS,E0459NU,Chest wrap,,,211.11,211.11,1
HCPCS,E0459RR,Chest wrap,,,21.07,21.07,1
HCPCS,E0459UE,Chest wrap,,,158.34,158.34,1
HCPCS,E0462,Rocking bed w/ or w/o side r,,,233.49,2334.9,8
HCPCS,E04620,Rocking bed w/ or w/o side r,,,2334.9,2334.9,1
HCPCS,E0462MS,Rocking bed w/ or w/o side r,,,233.49,233.49,1
HCPCS,E0462NU,Rocking bed w/ or w/o side r,,,2334.9,2334.9,1
HCPCS,E0462RR,Rocking bed w/ or w/o side r,,,233.49,680.36,4
HCPCS,E0462UE,Rocking bed w/ or w/o side r,,,1751.18,1751.18,1
HCPCS,E0465,Home vent invasive interface,,,773.63,7736.26,8
HCPCS,E04650,Home vent invasive interface,,,7736.26,7736.26,1
HCPCS,E0465MS,Home vent invasive interface,,,773.63,773.63,1
HCPCS,E0465NU,Home vent invasive interface,,,7736.26,7736.26,1
HCPCS,E0465RR,Home vent invasive interface,,,773.63,2228.55,4
HCPCS,E0465UE,Home vent invasive interface,,,5802.19,5802.19,1
HCPCS,E0466,Home vent non-invasive inter,,,773.63,7736.26,8
HCPCS,E04660,Home vent non-invasive inter,,,7736.26,7736.26,1
HCPCS,E0466MS,Home vent non-invasive inter,,,773.63,773.63,1
HCPCS,E0466NU,Home vent non-invasive inter,,,7736.26,7736.26,1
HCPCS,E0466RR,Home vent non-invasive inter,,,773.63,2228.55,4
HCPCS,E0466UE,Home vent non-invasive inter,,,5802.19,5802.19,1
HCPCS,E0467,Home vent multi-function,,,903.26,9032.6,8
HCPCS,E04670,Home vent multi-function,,,9032.6,9032.6,1
HCPCS,E0467MS,Home vent multi-function,,,903.26,903.26,1
HCPCS,E0467NU,Home vent multi-function,,,9032.6,9032.6,1
HCPCS,E0467RR,Home vent multi-function,,,903.26,2586.26,4
HCPCS,E0467UE,Home vent multi-function,,,6774.45,6774.45,1
HCPCS,E0468,Home vent dual fnct incl all,,,831.71,8317.13,8
HCPCS,E04680,Home vent dual fnct incl all,,,8317.13,8317.13,1
HCPCS,E0468MS,Home vent dual fnct incl all,,,831.71,831.71,1
HCPCS,E0468NU,Home vent dual fnct incl all,,,8317.13,8317.13,1
HCPCS,E0468RR,Home vent dual fnct incl all,,,831.71,2381.73,4
HCPCS,E0468UE,Home vent dual fnct incl all,,,6237.84,6237.84,1
HCPCS,E0469,Lung expans high oscil neb,,,891.43,8914.28,8
HCPCS,E04690,Lung expans high oscil neb,,,8914.28,8914.28,1
HCPCS,E0469MS,Lung expans high oscil neb,,,891.43,891.43,1
HCPCS,E0469NU,Lung expans high oscil neb,,,8914.28,8914.28,1
HCPCS,E0469RR,Lung expans high oscil neb,,,891.43,2560.69,4
HCPCS,E0469UE,Lung expans high oscil neb,,,6685.71,6685.71,1
HCPCS,E0470,Rad w/o backup non-inv intfc,,,76.74,767.45,8
HCPCS,E04700,Rad w/o backup non-inv intfc,,,767.45,767.45,1
HCPCS,E0470MS,Rad w/o backup non-inv intfc,,,76.74,76.74,1
HCPCS,E0470NU,Rad w/o backup non-inv intfc,,,767.45,767.45,1
HCPCS,E0470RR,Rad w/o backup non-inv intfc,,,76.74,217.93,4
HCPCS,E0470UE,Rad w/o backup non-inv intfc,,,575.59,575.59,1
HCPCS,E0471,Rad w/backup non inv intrfc,,,193.18,1931.81,8
HCPCS,E04710,Rad w/backup non inv intrfc,,,1931.81,1931.81,1
HCPCS,E0471MS,Rad w/backup non inv intrfc,,,193.18,193.18,1
HCPCS,E0471NU,Rad w/backup non inv intrfc,,,1931.81,1931.81,1
HCPCS,E0471RR,Rad w/backup non inv intrfc,,,193.18,536.73,4
HCPCS,E0471UE,Rad w/backup non inv intrfc,,,1448.85,1448.85,1
HCPCS,E0472,Rad w backup invasive intrfc,,,299.84,2998.39,8
HCPCS,E04720,Rad w backup invasive intrfc,,,2998.39,2998.39,1
HCPCS,E0472MS,Rad w backup invasive intrfc,,,299.84,299.84,1
HCPCS,E0472NU,Rad w backup invasive intrfc,,,2998.39,2998.39,1
HCPCS,E0472RR,Rad w backup invasive intrfc,,,299.84,811.37,4
HCPCS,E0472UE,Rad w backup invasive intrfc,,,2248.8,2248.8,1
HCPCS,E0480,Percussor elect/pneum home m,,,35.62,356.23,8
HCPCS,E04800,Percussor elect/pneum home m,,,356.23,356.23,1
HCPCS,E0480MS,Percussor elect/pneum home m,,,35.62,35.62,1
HCPCS,E0480NU,Percussor elect/pneum home m,,,356.23,356.23,1
HCPCS,E0480RR,Percussor elect/pneum home m,,,35.62,87.23,4
HCPCS,E0480UE,Percussor elect/pneum home m,,,267.17,267.17,1
HCPCS,E0481,Intrpulmnry percuss vent sys,,,194.8,2110.91,13
HCPCS,E04810,Intrpulmnry percuss vent sys,,,542.16,542.16,1
HCPCS,E0481NU,Intrpulmnry percuss vent sys,,,1947.95,2110.91,3
HCPCS,E0481RR,Intrpulmnry percuss vent sys,,,194.8,211.09,3
HCPCS,E0481UE,Intrpulmnry percuss vent sys,,,1460.96,1583.18,3
HCPCS,E0482,Cough stimulating device,,,348.54,3485.35,8
HCPCS,E04820,Cough stimulating device,,,3485.35,3485.35,1
HCPCS,E0482MS,Cough stimulating device,,,348.54,348.54,1
HCPCS,E0482NU,Cough stimulating device,,,3485.35,3485.35,1
HCPCS,E0482RR,Cough stimulating device,,,348.54,919.02,4
HCPCS,E0482UE,Cough stimulating device,,,2614.02,2614.02,1
HCPCS,E0483,Hi freq chest wall oscil sys,,,861.66,8616.56,8
HCPCS,E04830,Hi freq chest wall oscil sys,,,8616.56,8616.56,1
HCPCS,E0483MS,Hi freq chest wall oscil sys,,,861.66,861.66,1
HCPCS,E0483NU,Hi freq chest wall oscil sys,,,8616.56,8616.56,1
HCPCS,E0483RR,Hi freq chest wall oscil sys,,,861.66,2482.12,4
HCPCS,E0483UE,Hi freq chest wall oscil sys,,,6462.43,6462.43,1
HCPCS,E0484,Non-elec oscillatory pep dvc,,,2.99,86.24,14
HCPCS,E04840,Non-elec oscillatory pep dvc,,,29.94,29.94,1
HCPCS,E0484MS,Non-elec oscillatory pep dvc,,,2.99,2.99,1
HCPCS,E0484NU,Non-elec oscillatory pep dvc,,,29.94,86.24,4
HCPCS,E0484RR,Non-elec oscillatory pep dvc,,,2.99,8.62,4
HCPCS,E0484UE,Non-elec oscillatory pep dvc,,,22.45,64.68,4
HCPCS,E0485,Oral device/appliance prefab,,,27.11,271.07,5
HCPCS,E04850,Oral device/appliance prefab,,,271.07,271.07,1
HCPCS,E0485MS,Oral device/appliance prefab,,,27.11,27.11,1
HCPCS,E0485NU,Oral device/appliance prefab,,,271.07,271.07,1
HCPCS,E0485RR,Oral device/appliance prefab,,,27.11,27.11,1
HCPCS,E0485UE,Oral device/appliance prefab,,,203.3,203.3,1
HCPCS,E0486,Oral device/appliance cusfab,,,194.32,1943.27,5
HCPCS,E04860,Oral device/appliance cusfab,,,1943.27,1943.27,1
HCPCS,E0486MS,Oral device/appliance cusfab,,,194.32,194.32,1
HCPCS,E0486NU,Oral device/appliance cusfab,,,1943.27,1943.27,1
HCPCS,E0486RR,Oral device/appliance cusfab,,,194.32,194.32,1
HCPCS,E0486UE,Oral device/appliance cusfab,,,1457.45,1457.45,1
HCPCS,E0487,Electronic spirometer,,,11.49,114.91,5
HCPCS,E04870,Electronic spirometer,,,114.91,114.91,1
HCPCS,E0487MS,Electronic spirometer,,,11.49,11.49,1
HCPCS,E0487NU,Electronic spirometer,,,114.91,114.91,1
HCPCS,E0487RR,Electronic spirometer,,,11.49,11.49,1
HCPCS,E0487UE,Electronic spirometer,,,86.18,86.18,1
HCPCS,E0490,Control unit nm hw remote,,,72.55,725.58,8
HCPCS,E04900,Control unit nm hw remote,,,725.58,725.58,1
HCPCS,E0490MS,Control unit nm hw remote,,,72.55,72.55,1
HCPCS,E0490NU,Control unit nm hw remote,,,725.58,725.58,1
HCPCS,E0490RR,Control unit nm hw remote,,,72.55,120.79,4
HCPCS,E0490UE,Control unit nm hw remote,,,544.18,544.18,1
HCPCS,E0491,Oral dv nm mouthpc hw remote,,,59.92,90.14,4
HCPCS,E04910,Oral dv nm mouthpc hw remote,,,59.92,59.92,1
HCPCS,E0500,Ippb all types,,,88.96,889.64,8
HCPCS,E05000,Ippb all types,,,889.64,889.64,1
HCPCS,E0500MS,Ippb all types,,,88.96,88.96,1
HCPCS,E0500NU,Ippb all types,,,889.64,889.64,1
HCPCS,E0500RR,Ippb all types,,,88.96,256.26,4
HCPCS,E0500UE,Ippb all types,,,667.22,667.22,1
HCPCS,E0530,Electronic posa treatment,,,21.11,211.11,8
HCPCS,E05300,Electronic posa treatment,,,211.11,211.11,1
HCPCS,E0530MS,Electronic posa treatment,,,21.11,21.11,1
HCPCS,E0530NU,Electronic posa treatment,,,211.11,211.11,1
HCPCS,E0530RR,Electronic posa treatment,,,21.11,60.81,4
HCPCS,E0530UE,Electronic posa treatment,,,158.33,158.33,1
HCPCS,E0550,Humidif extens supple w ippb,,,34.54,345.42,8
HCPCS,E05500,Humidif extens supple w ippb,,,345.42,345.42,1
HCPCS,E0550MS,Humidif extens supple w ippb,,,34.54,34.54,1
HCPCS,E0550NU,Humidif extens supple w ippb,,,345.42,345.42,1
HCPCS,E0550RR,Humidif extens supple w ippb,,,34.54,117.05,4
HCPCS,E0550UE,Humidif extens supple w ippb,,,259.06,259.06,1
HCPCS,E0555,Humidifier for use w/ regula,,,2.34,3.24,5
HCPCS,E05550,Humidifier for use w/ regula,,,3.24,3.24,1
HCPCS,E0555MS,Humidifier for use w/ regula,,,2.34,2.34,1
HCPCS,E0555NU,Humidifier for use w/ regula,,,3.24,3.24,1
HCPCS,E0555RR,Humidifier for use w/ regula,,,2.34,2.34,1
HCPCS,E0555UE,Humidifier for use w/ regula,,,2.7,2.7,1
HCPCS,E0560,Humidifier supplemental w/ i,,,14.04,305.83,14
HCPCS,E05600,Humidifier supplemental w/ i,,,119.8,119.8,1
HCPCS,E0560MS,Humidifier supplemental w/ i,,,14.04,14.04,1
HCPCS,E0560NU,Humidifier supplemental w/ i,,,119.8,305.83,4
HCPCS,E0560RR,Humidifier supplemental w/ i,,,14.04,39.94,4
HCPCS,E0560UE,Humidifier supplemental w/ i,,,89.86,229.33,4
HCPCS,E0561,Humidifier nonheated w pap,,,5.4,150.06,14
HCPCS,E05610,Humidifier nonheated w pap,,,53.98,53.98,1
HCPCS,E0561MS,Humidifier nonheated w pap,,,5.4,5.4,1
HCPCS,E0561NU,Humidifier nonheated w pap,,,53.98,150.06,4
HCPCS,E0561RR,Humidifier nonheated w pap,,,5.4,15.01,4
HCPCS,E0561UE,Humidifier nonheated w pap,,,40.49,112.54,4
HCPCS,E0562,Humidifier heated used w pap,,,9.57,282.83,14
HCPCS,E05620,Humidifier heated used w pap,,,95.66,95.66,1
HCPCS,E0562MS,Humidifier heated used w pap,,,9.57,9.57,1
HCPCS,E0562NU,Humidifier heated used w pap,,,95.66,282.83,4
HCPCS,E0562RR,Humidifier heated used w pap,,,9.57,28.29,4
HCPCS,E0562UE,Humidifier heated used w pap,,,71.73,212.12,4
HCPCS,E0565,Compressor air power source,,,30.4,304.07,8
HCPCS,E05650,Compressor air power source,,,304.07,304.07,1
HCPCS,E0565MS,Compressor air power source,,,30.4,30.4,1
HCPCS,E0565NU,Compressor air power source,,,304.07,304.07,1
HCPCS,E0565RR,Compressor air power source,,,30.4,84.57,4
HCPCS,E0565UE,Compressor air power source,,,228.05,228.05,1
HCPCS,E0570,Nebulizer with compression,,,4.33,43.31,8
HCPCS,E05700,Nebulizer with compression,,,43.31,43.31,1
HCPCS,E0570MS,Nebulizer with compression,,,4.33,4.33,1
HCPCS,E0570NU,Nebulizer with compression,,,43.31,43.31,1
HCPCS,E0570RR,Nebulizer with compression,,,4.33,11.96,4
HCPCS,E0570UE,Nebulizer with compression,,,32.48,32.48,1
HCPCS,E0572,Aerosol compressor adjust pr,,,22.15,221.51,8
HCPCS,E05720,Aerosol compressor adjust pr,,,221.51,221.51,1
HCPCS,E0572MS,Aerosol compressor adjust pr,,,22.15,22.15,1
HCPCS,E0572NU,Aerosol compressor adjust pr,,,221.51,221.51,1
HCPCS,E0572RR,Aerosol compressor adjust pr,,,22.15,64.18,4
HCPCS,E0572UE,Aerosol compressor adjust pr,,,166.13,166.13,1
HCPCS,E0574,Ultrasonic generator w svneb,,,32.63,326.22,8
HCPCS,E05740,Ultrasonic generator w svneb,,,326.22,326.22,1
HCPCS,E0574MS,Ultrasonic generator w svneb,,,32.63,32.63,1
HCPCS,E0574NU,Ultrasonic generator w svneb,,,326.22,326.22,1
HCPCS,E0574RR,Ultrasonic generator w svneb,,,32.63,86.49,4
HCPCS,E0574UE,Ultrasonic generator w svneb,,,244.67,244.67,1
HCPCS,E0575,Nebulizer ultrasonic,,,83.3,833.03,8
HCPCS,E05750,Nebulizer ultrasonic,,,833.03,833.03,1
HCPCS,E0575MS,Nebulizer ultrasonic,,,83.3,83.3,1
HCPCS,E0575NU,Nebulizer ultrasonic,,,833.03,833.03,1
HCPCS,E0575RR,Nebulizer ultrasonic,,,83.3,236.26,4
HCPCS,E0575UE,Nebulizer ultrasonic,,,624.77,624.77,1
HCPCS,E0580,Nebulizer for use w/ regulat,,,9.36,269.75,14
HCPCS,E05800,Nebulizer for use w/ regulat,,,93.64,93.64,1
HCPCS,E0580MS,Nebulizer for use w/ regulat,,,9.36,9.36,1
HCPCS,E0580NU,Nebulizer for use w/ regulat,,,93.64,269.75,4
HCPCS,E0580RR,Nebulizer for use w/ regulat,,,9.36,26.99,4
HCPCS,E0580UE,Nebulizer for use w/ regulat,,,70.22,202.26,4
HCPCS,E0585,Nebulizer w/ compressor & he,,,21.61,216.16,8
HCPCS,E05850,Nebulizer w/ compressor & he,,,216.16,216.16,1
HCPCS,E0585MS,Nebulizer w/ compressor & he,,,21.61,21.61,1
HCPCS,E0585NU,Nebulizer w/ compressor & he,,,216.16,216.16,1
HCPCS,E0585RR,Nebulizer w/ compressor & he,,,21.61,60.52,4
HCPCS,E0585UE,Nebulizer w/ compressor & he,,,162.12,162.12,1
HCPCS,E0600,Suction pump portab hom modl,,,37.11,371.08,8
HCPCS,E06000,Suction pump portab hom modl,,,371.08,371.08,1
HCPCS,E0600MS,Suction pump portab hom modl,,,37.11,37.11,1
HCPCS,E0600NU,Suction pump portab hom modl,,,371.08,371.08,1
HCPCS,E0600RR,Suction pump portab hom modl,,,37.11,106.89,4
HCPCS,E0600UE,Suction pump portab hom modl,,,278.31,278.31,1
HCPCS,E0601,Cont airway pressure device,,,29.56,295.64,8
HCPCS,E06010,Cont airway pressure device,,,295.64,295.64,1
HCPCS,E0601MS,Cont airway pressure device,,,29.56,29.56,1
HCPCS,E0601NU,Cont airway pressure device,,,295.64,295.64,1
HCPCS,E0601RR,Cont airway pressure device,,,29.56,84.52,4
HCPCS,E0601UE,Cont airway pressure device,,,221.72,221.72,1
HCPCS,E0602,Manual breast pump,,,2.41,68.91,14
HCPCS,E06020,Manual breast pump,,,23.92,23.92,1
HCPCS,E0602MS,Manual breast pump,,,2.41,2.41,1
HCPCS,E0602NU,Manual breast pump,,,23.92,68.91,4
HCPCS,E0602RR,Manual breast pump,,,2.41,6.95,4
HCPCS,E0602UE,Manual breast pump,,,17.95,51.7,4
HCPCS,E0603,Electric breast pump,,,18.36,183.6,5
HCPCS,E06030,Electric breast pump,,,183.6,183.6,1
HCPCS,E0603MS,Electric breast pump,,,183.6,183.6,1
HCPCS,E0603NU,Electric breast pump,,,183.6,183.6,1
HCPCS,E0603RR,Electric breast pump,,,18.36,18.36,1
HCPCS,E0603UE,Electric breast pump,,,146.88,146.88,1
HCPCS,E0604,Hosp grade elec breast pump,,,38.55,100.33,5
HCPCS,E06040,Hosp grade elec breast pump,,,100.33,100.33,1
HCPCS,E0604MS,Hosp grade elec breast pump,,,38.55,38.55,1
HCPCS,E0604NU,Hosp grade elec breast pump,,,100.33,100.33,1
HCPCS,E0604RR,Hosp grade elec breast pump,,,38.55,38.55,1
HCPCS,E0604UE,Hosp grade elec breast pump,,,75.3,75.3,1
HCPCS,E0605,Vaporizer room type,,,2.49,60.59,14
HCPCS,E06050,Vaporizer room type,,,20.29,20.29,1
HCPCS,E0605MS,Vaporizer room type,,,2.49,2.49,1
HCPCS,E0605NU,Vaporizer room type,,,20.29,60.59,4
HCPCS,E0605RR,Vaporizer room type,,,2.49,7.15,4
HCPCS,E0605UE,Vaporizer room type,,,15.21,45.45,4
HCPCS,E0606,Drainage board postural,,,18.6,185.99,8
HCPCS,E06060,Drainage board postural,,,185.99,185.99,1
HCPCS,E0606MS,Drainage board postural,,,18.6,18.6,1
HCPCS,E0606NU,Drainage board postural,,,185.99,185.99,1
HCPCS,E0606RR,Drainage board postural,,,18.6,45.53,4
HCPCS,E0606UE,Drainage board postural,,,139.48,139.48,1
HCPCS,E0607,Blood glucose monitor home,,,5.41,156.0,14
HCPCS,E06070,Blood glucose monitor home,,,54.15,54.15,1
HCPCS,E0607MS,Blood glucose monitor home,,,5.41,5.41,1
HCPCS,E0607NU,Blood glucose monitor home,,,54.15,156.0,4
HCPCS,E0607RR,Blood glucose monitor home,,,5.41,15.59,4
HCPCS,E0607UE,Blood glucose monitor home,,,40.61,116.97,4
HCPCS,E0610,Pacemaker monitr audible/vis,,,20.34,555.31,14
HCPCS,E06100,Pacemaker monitr audible/vis,,,192.77,192.77,1
HCPCS,E0610MS,Pacemaker monitr audible/vis,,,20.34,20.34,1
HCPCS,E0610NU,Pacemaker monitr audible/vis,,,192.77,555.31,4
HCPCS,E0610RR,Pacemaker monitr audible/vis,,,20.34,58.57,4
HCPCS,E0610UE,Pacemaker monitr audible/vis,,,144.6,416.53,4
HCPCS,E0615,Pacemaker monitr digital/vis,,,47.41,1117.83,14
HCPCS,E06150,Pacemaker monitr digital/vis,,,359.87,359.87,1
HCPCS,E0615MS,Pacemaker monitr digital/vis,,,47.41,47.41,1
HCPCS,E0615NU,Pacemaker monitr digital/vis,,,359.87,1117.83,4
HCPCS,E0615RR,Pacemaker monitr digital/vis,,,47.41,135.75,4
HCPCS,E0615UE,Pacemaker monitr digital/vis,,,269.88,838.47,4
HCPCS,E0616,Cardiac event recorder,,,7.18,71.81,5
HCPCS,E06160,Cardiac event recorder,,,71.81,71.81,1
HCPCS,E0616MS,Cardiac event recorder,,,7.18,7.18,1
HCPCS,E0616NU,Cardiac event recorder,,,71.81,71.81,1
HCPCS,E0616RR,Cardiac event recorder,,,7.18,7.18,1
HCPCS,E0616UE,Cardiac event recorder,,,53.86,53.86,1
HCPCS,E0617,Automatic ext defibrillator,,,125.6,2464.15,9
HCPCS,E06170,Automatic ext defibrillator,,,2464.15,2464.15,1
HCPCS,E0617KF,Automatic ext defibrillator,,,125.6,125.6,1
HCPCS,E0617MS,Automatic ext defibrillator,,,246.41,246.41,1
HCPCS,E0617NU,Automatic ext defibrillator,,,2464.15,2464.15,1
HCPCS,E0617RR,Automatic ext defibrillator,,,246.41,709.84,4
HCPCS,E0617UE,Automatic ext defibrillator,,,1848.12,1848.12,1
HCPCS,E0618,Apnea monitor,,,227.23,2272.29,8
HCPCS,E06180,Apnea monitor,,,2272.29,2272.29,1
HCPCS,E0618MS,Apnea monitor,,,227.23,227.23,1
HCPCS,E0618NU,Apnea monitor,,,2272.29,2272.29,1
HCPCS,E0618RR,Apnea monitor,,,227.23,556.38,4
HCPCS,E0618UE,Apnea monitor,,,1704.22,1704.22,1
HCPCS,E0619,Apnea monitor w recorder,,,64.8,1286.82,5
HCPCS,E06190,Apnea monitor w recorder,,,1286.82,1286.82,1
HCPCS,E0619MS,Apnea monitor w recorder,,,64.8,64.8,1
HCPCS,E0619NU,Apnea monitor w recorder,,,1286.82,1286.82,1
HCPCS,E0619RR,Apnea monitor w recorder,,,64.8,64.8,1
HCPCS,E0619UE,Apnea monitor w recorder,,,965.12,965.12,1
HCPCS,E0620,Cap bld skin piercing laser,,,70.86,708.59,8
HCPCS,E06200,Cap bld skin piercing laser,,,708.59,708.59,1
HCPCS,E0620MS,Cap bld skin piercing laser,,,70.86,70.86,1
HCPCS,E0620NU,Cap bld skin piercing laser,,,708.59,708.59,1
HCPCS,E0620RR,Cap bld skin piercing laser,,,70.86,204.11,4
HCPCS,E0620UE,Cap bld skin piercing laser,,,531.44,531.44,1
HCPCS,E0621,Patient lift sling or seat,,,6.04,162.32,14
HCPCS,E06210,Patient lift sling or seat,,,60.42,60.42,1
HCPCS,E0621MS,Patient lift sling or seat,,,6.04,6.04,1
HCPCS,E0621NU,Patient lift sling or seat,,,60.42,162.32,4
HCPCS,E0621RR,Patient lift sling or seat,,,6.04,16.23,4
HCPCS,E0621UE,Patient lift sling or seat,,,45.31,121.75,4
HCPCS,E0625,Patient lift bathroom or toi,,,50.89,508.9,5
HCPCS,E06250,Patient lift bathroom or toi,,,508.9,508.9,1
HCPCS,E0625MS,Patient lift bathroom or toi,,,50.89,50.89,1
HCPCS,E0625NU,Patient lift bathroom or toi,,,508.9,508.9,1
HCPCS,E0625RR,Patient lift bathroom or toi,,,50.89,50.89,1
HCPCS,E0625UE,Patient lift bathroom or toi,,,381.67,381.67,1
HCPCS,E0627,"Seat lift mech, electric any",,,19.0,527.42,14
HCPCS,E06270,"Seat lift mech, electric any",,,189.94,189.94,1
HCPCS,E0627MS,"Seat lift mech, electric any",,,19.0,19.0,1
HCPCS,E0627NU,"Seat lift mech, electric any",,,189.94,527.42,4
HCPCS,E0627RR,"Seat lift mech, electric any",,,19.0,52.74,4
HCPCS,E0627UE,"Seat lift mech, electric any",,,142.45,395.56,4
HCPCS,E0629,"Seat lift mech, non-electric",,,18.77,525.03,14
HCPCS,E06290,"Seat lift mech, non-electric",,,187.69,187.69,1
HCPCS,E0629MS,"Seat lift mech, non-electric",,,18.77,18.77,1
HCPCS,E0629NU,"Seat lift mech, non-electric",,,187.69,525.03,4
HCPCS,E0629RR,"Seat lift mech, non-electric",,,18.77,52.5,4
HCPCS,E0629UE,"Seat lift mech, non-electric",,,140.77,393.77,4
HCPCS,E0630,Patient lift hydraulic,,,41.66,416.58,8
HCPCS,E06300,Patient lift hydraulic,,,416.58,416.58,1
HCPCS,E0630MS,Patient lift hydraulic,,,41.66,41.66,1
HCPCS,E0630NU,Patient lift hydraulic,,,416.58,416.58,1
HCPCS,E0630RR,Patient lift hydraulic,,,41.66,120.51,4
HCPCS,E0630UE,Patient lift hydraulic,,,312.43,312.43,1
HCPCS,E0635,Patient lift electric,,,81.08,810.76,8
HCPCS,E06350,Patient lift electric,,,810.76,810.76,1
HCPCS,E0635MS,Patient lift electric,,,81.08,81.08,1
HCPCS,E0635NU,Patient lift electric,,,810.76,810.76,1
HCPCS,E0635RR,Patient lift electric,,,81.08,235.78,4
HCPCS,E0635UE,Patient lift electric,,,608.06,608.06,1
HCPCS,E0636,Pt support & positioning sys,,,700.23,7002.26,8
HCPCS,E06360,Pt support & positioning sys,,,7002.26,7002.26,1
HCPCS,E0636MS,Pt support & positioning sys,,,700.23,700.23,1
HCPCS,E0636NU,Pt support & positioning sys,,,7002.26,7002.26,1
HCPCS,E0636RR,Pt support & positioning sys,,,700.23,1992.4,4
HCPCS,E0636UE,Pt support & positioning sys,,,5251.68,5251.68,1
HCPCS,E0637,Combination sit to stand sys,,,83.22,831.48,5
HCPCS,E06370,Combination sit to stand sys,,,831.48,831.48,1
HCPCS,E0637MS,Combination sit to stand sys,,,83.22,83.22,1
HCPCS,E0637NU,Combination sit to stand sys,,,831.48,831.48,1
HCPCS,E0637RR,Combination sit to stand sys,,,83.22,83.22,1
HCPCS,E0637UE,Combination sit to stand sys,,,623.61,623.61,1
HCPCS,E0638,Standing frame sys,,,46.09,460.93,5
HCPCS,E06380,Standing frame sys,,,460.93,460.93,1
HCPCS,E0638MS,Standing frame sys,,,46.09,46.09,1
HCPCS,E0638NU,Standing frame sys,,,460.93,460.93,1
HCPCS,E0638RR,Standing frame sys,,,46.09,46.09,1
HCPCS,E0638UE,Standing frame sys,,,345.7,345.7,1
HCPCS,E0639,Moveable patient lift system,,,80.56,805.53,5
HCPCS,E06390,Moveable patient lift system,,,805.53,805.53,1
HCPCS,E0639MS,Moveable patient lift system,,,80.56,80.56,1
HCPCS,E0639NU,Moveable patient lift system,,,805.53,805.53,1
HCPCS,E0639RR,Moveable patient lift system,,,80.56,80.56,1
HCPCS,E0639UE,Moveable patient lift system,,,604.14,604.14,1
HCPCS,E0640,Fixed patient lift system,,,80.56,805.53,5
HCPCS,E06400,Fixed patient lift system,,,805.53,805.53,1
HCPCS,E0640MS,Fixed patient lift system,,,80.56,80.56,1
HCPCS,E0640NU,Fixed patient lift system,,,805.53,805.53,1
HCPCS,E0640RR,Fixed patient lift system,,,80.56,80.56,1
HCPCS,E0640UE,Fixed patient lift system,,,604.14,604.14,1
HCPCS,E0641,Multi-position stnd fram sys,,,298.21,2982.06,5
HCPCS,E06410,Multi-position stnd fram sys,,,2982.06,2982.06,1
HCPCS,E0641MS,Multi-position stnd fram sys,,,298.21,298.21,1
HCPCS,E0641NU,Multi-position stnd fram sys,,,2982.06,2982.06,1
HCPCS,E0641RR,Multi-position stnd fram sys,,,298.21,298.21,1
HCPCS,E0641UE,Multi-position stnd fram sys,,,2236.55,2236.55,1
HCPCS,E0642,Dynamic standing frame,,,506.39,5063.85,5
HCPCS,E06420,Dynamic standing frame,,,5063.85,5063.85,1
HCPCS,E0642MS,Dynamic standing frame,,,506.39,506.39,1
HCPCS,E0642NU,Dynamic standing frame,,,5063.85,5063.85,1
HCPCS,E0642RR,Dynamic standing frame,,,506.39,506.39,1
HCPCS,E0642UE,Dynamic standing frame,,,3797.88,3797.88,1
HCPCS,E0650,Pneuma compresor non-segment,,,70.84,1554.31,14
HCPCS,E06500,Pneuma compresor non-segment,,,534.68,534.68,1
HCPCS,E0650MS,Pneuma compresor non-segment,,,70.84,70.84,1
HCPCS,E0650NU,Pneuma compresor non-segment,,,534.68,1554.31,4
HCPCS,E0650RR,Pneuma compresor non-segment,,,70.84,191.53,4
HCPCS,E0650UE,Pneuma compresor non-segment,,,385.15,1195.73,4
HCPCS,E0651,Pneum compressor segmental,,,64.64,2144.21,14
HCPCS,E06510,Pneum compressor segmental,,,632.7,632.7,1
HCPCS,E0651MS,Pneum compressor segmental,,,64.64,64.64,1
HCPCS,E0651NU,Pneum compressor segmental,,,632.7,2144.21,4
HCPCS,E0651RR,Pneum compressor segmental,,,64.64,219.05,4
HCPCS,E0651UE,Pneum compressor segmental,,,474.54,1608.22,4
HCPCS,E0652,Pneum compres w/cal pressure,,,424.63,12377.38,14
HCPCS,E06520,Pneum compres w/cal pressure,,,4246.61,4246.61,1
HCPCS,E0652MS,Pneum compres w/cal pressure,,,424.63,424.63,1
HCPCS,E0652NU,Pneum compres w/cal pressure,,,4246.61,12377.38,4
HCPCS,E0652RR,Pneum compres w/cal pressure,,,424.63,1223.26,4
HCPCS,E0652UE,Pneum compres w/cal pressure,,,3184.97,9274.74,4
HCPCS,E0655,Pneumatic appliance half arm,,,8.74,241.01,14
HCPCS,E06550,Pneumatic appliance half arm,,,74.36,74.36,1
HCPCS,E0655MS,Pneumatic appliance half arm,,,8.74,8.74,1
HCPCS,E0655NU,Pneumatic appliance half arm,,,74.36,241.01,4
HCPCS,E0655RR,Pneumatic appliance half arm,,,8.74,25.18,4
HCPCS,E0655UE,Pneumatic appliance half arm,,,55.84,180.79,4
HCPCS,E0656,Segmental pneumatic trunk,,,46.84,468.37,8
HCPCS,E06560,Segmental pneumatic trunk,,,468.37,468.37,1
HCPCS,E0656MS,Segmental pneumatic trunk,,,46.84,46.84,1
HCPCS,E0656NU,Segmental pneumatic trunk,,,468.37,468.37,1
HCPCS,E0656RR,Segmental pneumatic trunk,,,46.84,134.92,4
HCPCS,E0656UE,Segmental pneumatic trunk,,,351.28,351.28,1
HCPCS,E0657,Segmental pneumatic chest,,,44.0,439.98,8
HCPCS,E06570,Segmental pneumatic chest,,,439.98,439.98,1
HCPCS,E0657MS,Segmental pneumatic chest,,,44.0,44.0,1
HCPCS,E0657NU,Segmental pneumatic chest,,,439.98,439.98,1
HCPCS,E0657RR,Segmental pneumatic chest,,,44.0,126.75,4
HCPCS,E0657UE,Segmental pneumatic chest,,,329.98,329.98,1
HCPCS,E0658,Seg pneum comp 2 arm chest,,,104.33,1043.25,5
HCPCS,E06580,Seg pneum comp 2 arm chest,,,1043.25,1043.25,1
HCPCS,E0658MS,Seg pneum comp 2 arm chest,,,104.33,104.33,1
HCPCS,E0658NU,Seg pneum comp 2 arm chest,,,1043.25,1043.25,1
HCPCS,E0658RR,Seg pneum comp 2 arm chest,,,104.33,104.33,1
HCPCS,E0658UE,Seg pneum comp 2 arm chest,,,782.43,782.43,1
HCPCS,E0659,Seg pneum comp head neck che,,,104.33,1043.25,5
HCPCS,E06590,Seg pneum comp head neck che,,,1043.25,1043.25,1
HCPCS,E0659MS,Seg pneum comp head neck che,,,104.33,104.33,1
HCPCS,E0659NU,Seg pneum comp head neck che,,,1043.25,1043.25,1
HCPCS,E0659RR,Seg pneum comp head neck che,,,104.33,104.33,1
HCPCS,E0659UE,Seg pneum comp head neck che,,,782.43,782.43,1
HCPCS,E0660,Pneumatic appliance full leg,,,11.45,318.48,14
HCPCS,E06600,Pneumatic appliance full leg,,,110.05,110.05,1
HCPCS,E0660MS,Pneumatic appliance full leg,,,11.45,11.45,1
HCPCS,E0660NU,Pneumatic appliance full leg,,,110.05,318.48,4
HCPCS,E0660RR,Pneumatic appliance full leg,,,11.45,32.99,4
HCPCS,E0660UE,Pneumatic appliance full leg,,,82.53,238.87,4
HCPCS,E0665,Pneumatic appliance full arm,,,9.69,294.25,14
HCPCS,E06650,Pneumatic appliance full arm,,,94.38,94.38,1
HCPCS,E0665MS,Pneumatic appliance full arm,,,9.69,9.69,1
HCPCS,E0665NU,Pneumatic appliance full arm,,,94.38,294.25,4
HCPCS,E0665RR,Pneumatic appliance full arm,,,9.69,29.44,4
HCPCS,E0665UE,Pneumatic appliance full arm,,,70.87,220.72,4
HCPCS,E0666,Pneumatic appliance half leg,,,9.8,322.4,14
HCPCS,E06660,Pneumatic appliance half leg,,,95.14,95.14,1
HCPCS,E0666MS,Pneumatic appliance half leg,,,9.8,9.8,1
HCPCS,E0666NU,Pneumatic appliance half leg,,,95.14,322.4,4
HCPCS,E0666RR,Pneumatic appliance half leg,,,9.8,32.65,4
HCPCS,E0666UE,Pneumatic appliance half leg,,,71.37,241.84,4
HCPCS,E0667,Seg pneumatic appl full leg,,,26.27,755.89,14
HCPCS,E06670,Seg pneumatic appl full leg,,,262.4,262.4,1
HCPCS,E0667MS,Seg pneumatic appl full leg,,,26.27,26.27,1
HCPCS,E0667NU,Seg pneumatic appl full leg,,,262.4,755.89,4
HCPCS,E0667RR,Seg pneumatic appl full leg,,,26.27,85.35,4
HCPCS,E0667UE,Seg pneumatic appl full leg,,,196.81,566.95,4
HCPCS,E0668,Seg pneumatic appl full arm,,,30.05,1031.66,14
HCPCS,E06680,Seg pneumatic appl full arm,,,304.41,304.41,1
HCPCS,E0668MS,Seg pneumatic appl full arm,,,30.05,30.05,1
HCPCS,E0668NU,Seg pneumatic appl full arm,,,304.41,1031.66,4
HCPCS,E0668RR,Seg pneumatic appl full arm,,,30.05,101.81,4
HCPCS,E0668UE,Seg pneumatic appl full arm,,,228.32,773.77,4
HCPCS,E0669,Seg pneumatic appli half leg,,,14.1,406.39,14
HCPCS,E06690,Seg pneumatic appli half leg,,,141.06,141.06,1
HCPCS,E0669MS,Seg pneumatic appli half leg,,,14.1,14.1,1
HCPCS,E0669NU,Seg pneumatic appli half leg,,,141.06,406.39,4
HCPCS,E0669RR,Seg pneumatic appli half leg,,,14.1,40.62,4
HCPCS,E0669UE,Seg pneumatic appli half leg,,,105.8,304.81,4
HCPCS,E0670,Seg pneum int legs/trunk,,,101.88,2934.84,14
HCPCS,E06700,Seg pneum int legs/trunk,,,1018.82,1018.82,1
HCPCS,E0670MS,Seg pneum int legs/trunk,,,101.88,101.88,1
HCPCS,E0670NU,Seg pneum int legs/trunk,,,1018.82,2934.84,4
HCPCS,E0670RR,Seg pneum int legs/trunk,,,101.88,314.16,4
HCPCS,E0670UE,Seg pneum int legs/trunk,,,764.08,2201.02,4
HCPCS,E0671,Pressure pneum appl full leg,,,33.69,969.73,14
HCPCS,E06710,Pressure pneum appl full leg,,,336.64,336.64,1
HCPCS,E0671MS,Pressure pneum appl full leg,,,33.69,33.69,1
HCPCS,E0671NU,Pressure pneum appl full leg,,,336.64,969.73,4
HCPCS,E0671RR,Pressure pneum appl full leg,,,33.69,97.03,4
HCPCS,E0671UE,Pressure pneum appl full leg,,,252.46,727.24,4
HCPCS,E0672,Pressure pneum appl full arm,,,26.18,753.45,14
HCPCS,E06720,Pressure pneum appl full arm,,,261.55,261.55,1
HCPCS,E0672MS,Pressure pneum appl full arm,,,26.18,26.18,1
HCPCS,E0672NU,Pressure pneum appl full arm,,,261.55,753.45,4
HCPCS,E0672RR,Pressure pneum appl full arm,,,26.18,75.41,4
HCPCS,E0672UE,Pressure pneum appl full arm,,,196.18,565.13,4
HCPCS,E0673,Pressure pneum appl half leg,,,21.73,626.07,14
HCPCS,E06730,Pressure pneum appl half leg,,,217.34,217.34,1
HCPCS,E0673MS,Pressure pneum appl half leg,,,21.73,21.73,1
HCPCS,E0673NU,Pressure pneum appl half leg,,,217.34,626.07,4
HCPCS,E0673RR,Pressure pneum appl half leg,,,21.73,62.61,4
HCPCS,E0673UE,Pressure pneum appl half leg,,,163.04,469.65,4
HCPCS,E0675,Pneumatic compression device,,,311.67,3116.66,8
HCPCS,E06750,Pneumatic compression device,,,3116.66,3116.66,1
HCPCS,E0675MS,Pneumatic compression device,,,311.67,311.67,1
HCPCS,E0675NU,Pneumatic compression device,,,3116.66,3116.66,1
HCPCS,E0675RR,Pneumatic compression device,,,311.67,897.79,4
HCPCS,E0675UE,Pneumatic compression device,,,2337.5,2337.5,1
HCPCS,E0676,Inter limb compress dev nos,,,48.6,486.0,5
HCPCS,E06760,Inter limb compress dev nos,,,486.0,486.0,1
HCPCS,E0676MS,Inter limb compress dev nos,,,486.0,486.0,1
HCPCS,E0676NU,Inter limb compress dev nos,,,486.0,486.0,1
HCPCS,E0676RR,Inter limb compress dev nos,,,48.6,48.6,1
HCPCS,E0676UE,Inter limb compress dev nos,,,388.8,388.8,1
HCPCS,E0677,Non pneum seq comp trunk,,,46.84,468.37,8
HCPCS,E06770,Non pneum seq comp trunk,,,468.37,468.37,1
HCPCS,E0677MS,Non pneum seq comp trunk,,,46.84,46.84,1
HCPCS,E0677NU,Non pneum seq comp trunk,,,468.37,468.37,1
HCPCS,E0677RR,Non pneum seq comp trunk,,,46.84,134.92,4
HCPCS,E0677UE,Non pneum seq comp trunk,,,351.28,351.28,1
HCPCS,E0678,Non pneum seq comp full leg,,,26.23,262.38,8
HCPCS,E06780,Non pneum seq comp full leg,,,262.38,262.38,1
HCPCS,E0678MS,Non pneum seq comp full leg,,,26.23,26.23,1
HCPCS,E0678NU,Non pneum seq comp full leg,,,262.38,262.38,1
HCPCS,E0678RR,Non pneum seq comp full leg,,,26.23,75.6,4
HCPCS,E0678UE,Non pneum seq comp full leg,,,196.78,196.78,1
HCPCS,E0679,Non pneum seq comp half leg,,,14.1,141.08,8
HCPCS,E06790,Non pneum seq comp half leg,,,141.08,141.08,1
HCPCS,E0679MS,Non pneum seq comp half leg,,,14.1,14.1,1
HCPCS,E0679NU,Non pneum seq comp half leg,,,141.08,141.08,1
HCPCS,E0679RR,Non pneum seq comp half leg,,,14.1,40.64,4
HCPCS,E0679UE,Non pneum seq comp half leg,,,105.81,105.81,1
HCPCS,E0680,Non pneum comp control cal,,,424.67,4246.62,8
HCPCS,E06800,Non pneum comp control cal,,,4246.62,4246.62,1
HCPCS,E0680MS,Non pneum comp control cal,,,424.67,424.67,1
HCPCS,E0680NU,Non pneum comp control cal,,,4246.62,4246.62,1
HCPCS,E0680RR,Non pneum comp control cal,,,424.67,1237.74,4
HCPCS,E0680UE,Non pneum comp control cal,,,3184.97,3184.97,1
HCPCS,E0681,Non pneu comp control w/o ca,,,63.28,632.73,8
HCPCS,E06810,Non pneu comp control w/o ca,,,632.73,632.73,1
HCPCS,E0681MS,Non pneu comp control w/o ca,,,63.28,63.28,1
HCPCS,E0681NU,Non pneu comp control w/o ca,,,632.73,632.73,1
HCPCS,E0681RR,Non pneu comp control w/o ca,,,63.28,214.42,4
HCPCS,E0681UE,Non pneu comp control w/o ca,,,474.55,474.55,1
HCPCS,E0682,Non pneum compress full arm,,,30.45,304.43,8
HCPCS,E06820,Non pneum compress full arm,,,304.43,304.43,1
HCPCS,E0682MS,Non pneum compress full arm,,,30.45,30.45,1
HCPCS,E0682NU,Non pneum compress full arm,,,304.43,304.43,1
HCPCS,E0682RR,Non pneum compress full arm,,,30.45,103.17,4
HCPCS,E0682UE,Non pneum compress full arm,,,228.32,228.32,1
HCPCS,E0683,Non pneu peristalic comp pmp,,,46.36,463.68,8
HCPCS,E06830,Non pneu peristalic comp pmp,,,463.68,463.68,1
HCPCS,E0683MS,Non pneu peristalic comp pmp,,,46.36,46.36,1
HCPCS,E0683NU,Non pneu peristalic comp pmp,,,463.68,463.68,1
HCPCS,E0683RR,Non pneu peristalic comp pmp,,,46.36,133.56,4
HCPCS,E0683UE,Non pneu peristalic comp pmp,,,347.76,347.76,1
HCPCS,E0691,Uvl pnl 2 sq ft or less,,,72.82,2097.94,14
HCPCS,E06910,Uvl pnl 2 sq ft or less,,,728.29,728.29,1
HCPCS,E0691MS,Uvl pnl 2 sq ft or less,,,72.82,72.82,1
HCPCS,E0691NU,Uvl pnl 2 sq ft or less,,,728.29,2097.94,4
HCPCS,E0691RR,Uvl pnl 2 sq ft or less,,,72.82,209.78,4
HCPCS,E0691UE,Uvl pnl 2 sq ft or less,,,546.22,1573.46,4
HCPCS,E0692,Uvl sys panel 4 ft,,,91.44,2634.45,14
HCPCS,E06920,Uvl sys panel 4 ft,,,914.53,914.53,1
HCPCS,E0692MS,Uvl sys panel 4 ft,,,91.44,91.44,1
HCPCS,E0692NU,Uvl sys panel 4 ft,,,914.53,2634.45,4
HCPCS,E0692RR,Uvl sys panel 4 ft,,,91.44,263.4,4
HCPCS,E0692UE,Uvl sys panel 4 ft,,,685.9,1975.82,4
HCPCS,E0693,Uvl sys panel 6 ft,,,112.74,3247.52,14
HCPCS,E06930,Uvl sys panel 6 ft,,,1127.36,1127.36,1
HCPCS,E0693MS,Uvl sys panel 6 ft,,,112.74,112.74,1
HCPCS,E0693NU,Uvl sys panel 6 ft,,,1127.36,3247.52,4
HCPCS,E0693RR,Uvl sys panel 6 ft,,,112.74,324.78,4
HCPCS,E0693UE,Uvl sys panel 6 ft,,,845.52,2435.63,4
HCPCS,E0694,Uvl md cabinet sys 6 ft,,,358.82,10336.57,14
HCPCS,E06940,Uvl md cabinet sys 6 ft,,,3588.28,3588.28,1
HCPCS,E0694MS,Uvl md cabinet sys 6 ft,,,358.82,358.82,1
HCPCS,E0694NU,Uvl md cabinet sys 6 ft,,,3588.28,10336.57,4
HCPCS,E0694RR,Uvl md cabinet sys 6 ft,,,358.82,1033.65,4
HCPCS,E0694UE,Uvl md cabinet sys 6 ft,,,2691.23,7752.49,4
HCPCS,E0700,Safety equipment,,,1.62,16.2,4
HCPCS,E07000,Safety equipment,,,16.2,16.2,1
HCPCS,E0700MS,Safety equipment,,,1.62,1.62,1
HCPCS,E0700NU,Safety equipment,,,16.2,16.2,1
HCPCS,E0700RR,Safety equipment,,,1.62,1.62,1
HCPCS,E0705,Transfer device,,,3.19,31.88,5
HCPCS,E07050,Transfer device,,,31.88,31.88,1
HCPCS,E0705MS,Transfer device,,,3.19,3.19,1
HCPCS,E0705NU,Transfer device,,,31.88,31.88,1
HCPCS,E0705RR,Transfer device,,,3.19,3.19,1
HCPCS,E0705UE,Transfer device,,,23.91,23.91,1
HCPCS,E0710,Restraints any type,,,18.14,18.14,1
HCPCS,E07100,Restraints any type,,,18.14,18.14,1
HCPCS,E0720,Tens two lead,,,5.13,148.69,8
HCPCS,E07200,Tens two lead,,,51.31,51.31,1
HCPCS,E0720MS,Tens two lead,,,5.13,5.13,1
HCPCS,E0720NU,Tens two lead,,,51.31,148.69,4
HCPCS,E0720RR,Tens two lead,,,5.13,5.13,1
HCPCS,E0720UE,Tens two lead,,,38.48,38.48,1
HCPCS,E0730,Tens four lead,,,5.18,150.24,8
HCPCS,E07300,Tens four lead,,,51.85,51.85,1
HCPCS,E0730MS,Tens four lead,,,5.18,5.18,1
HCPCS,E0730NU,Tens four lead,,,51.85,150.24,4
HCPCS,E0730RR,Tens four lead,,,5.18,5.18,1
HCPCS,E0730UE,Tens four lead,,,38.89,38.89,1
HCPCS,E0731,Conductive garment for tens/,,,6.29,186.25,7
HCPCS,E07310,Conductive garment for tens/,,,62.87,62.87,1
HCPCS,E0731MS,Conductive garment for tens/,,,6.29,6.29,1
HCPCS,E0731NU,Conductive garment for tens/,,,62.87,186.25,4
HCPCS,E0731RR,Conductive garment for tens/,,,6.29,6.29,1
HCPCS,E0732,Ces system,,,29.78,297.71,8
HCPCS,E07320,Ces system,,,297.71,297.71,1
HCPCS,E0732MS,Ces system,,,29.78,29.78,1
HCPCS,E0732NU,Ces system,,,297.71,297.71,1
HCPCS,E0732RR,Ces system,,,29.78,85.82,4
HCPCS,E0732UE,Ces system,,,223.29,223.29,1
HCPCS,E0733,Trans elec nerv for trigemin,,,29.78,297.71,8
HCPCS,E07330,Trans elec nerv for trigemin,,,297.71,297.71,1
HCPCS,E0733MS,Trans elec nerv for trigemin,,,29.78,29.78,1
HCPCS,E0733NU,Trans elec nerv for trigemin,,,297.71,297.71,1
HCPCS,E0733RR,Trans elec nerv for trigemin,,,29.78,85.82,4
HCPCS,E0733UE,Trans elec nerv for trigemin,,,223.29,223.29,1
HCPCS,E0734,Ext up limb tremor stim wris,,,254.97,2549.69,8
HCPCS,E07340,Ext up limb tremor stim wris,,,2549.69,2549.69,1
HCPCS,E0734MS,Ext up limb tremor stim wris,,,254.97,254.97,1
HCPCS,E0734NU,Ext up limb tremor stim wris,,,2549.69,2549.69,1
HCPCS,E0734RR,Ext up limb tremor stim wris,,,254.97,734.47,4
HCPCS,E0734UE,Ext up limb tremor stim wris,,,1912.27,1912.27,1
HCPCS,E0735,Non-invasive vagus nerv stim,,,29.78,297.71,8
HCPCS,E07350,Non-invasive vagus nerv stim,,,297.71,297.71,1
HCPCS,E0735MS,Non-invasive vagus nerv stim,,,29.78,29.78,1
HCPCS,E0735NU,Non-invasive vagus nerv stim,,,297.71,297.71,1
HCPCS,E0735RR,Non-invasive vagus nerv stim,,,29.78,85.82,4
HCPCS,E0735UE,Non-invasive vagus nerv stim,,,223.29,223.29,1
HCPCS,E0736,Transcut tibial nerv stimula,,,29.78,297.71,8
HCPCS,E07360,Transcut tibial nerv stimula,,,297.71,297.71,1
HCPCS,E0736MS,Transcut tibial nerv stimula,,,29.78,29.78,1
HCPCS,E0736NU,Transcut tibial nerv stimula,,,297.71,297.71,1
HCPCS,E0736RR,Transcut tibial nerv stimula,,,29.78,85.82,4
HCPCS,E0736UE,Transcut tibial nerv stimula,,,223.29,223.29,1
HCPCS,E0738,Upper extremity rehab,,,1159.95,11599.51,8
HCPCS,E07380,Upper extremity rehab,,,11599.51,11599.51,1
HCPCS,E0738MS,Upper extremity rehab,,,1159.95,1159.95,1
HCPCS,E0738NU,Upper extremity rehab,,,11599.51,11599.51,1
HCPCS,E0738RR,Upper extremity rehab,,,1159.95,3341.42,4
HCPCS,E0738UE,Upper extremity rehab,,,8699.64,8699.64,1
HCPCS,E0739,Rehab sys active assist rt,,,908.59,9085.94,8
HCPCS,E07390,Rehab sys active assist rt,,,9085.94,9085.94,1
HCPCS,E0739MS,Rehab sys active assist rt,,,908.59,908.59,1
HCPCS,E0739NU,Rehab sys active assist rt,,,9085.94,9085.94,1
HCPCS,E0739RR,Rehab sys active assist rt,,,908.59,2617.34,4
HCPCS,E0739UE,Rehab sys active assist rt,,,6814.45,6814.45,1
HCPCS,E0740,Non-implant pelv flr e-stim,,,42.38,423.82,8
HCPCS,E07400,Non-implant pelv flr e-stim,,,423.82,423.82,1
HCPCS,E0740MS,Non-implant pelv flr e-stim,,,42.38,42.38,1
HCPCS,E0740NU,Non-implant pelv flr e-stim,,,423.82,423.82,1
HCPCS,E0740RR,Non-implant pelv flr e-stim,,,42.38,122.08,4
HCPCS,E0740UE,Non-implant pelv flr e-stim,,,317.87,317.87,1
HCPCS,E0743,Ext low ext nerve stimu rls,,,137.73,1377.37,8
HCPCS,E07430,Ext low ext nerve stimu rls,,,1377.37,1377.37,1
HCPCS,E0743MS,Ext low ext nerve stimu rls,,,137.73,137.73,1
HCPCS,E0743NU,Ext low ext nerve stimu rls,,,1377.37,1377.37,1
HCPCS,E0743RR,Ext low ext nerve stimu rls,,,137.73,396.78,4
HCPCS,E0743UE,Ext low ext nerve stimu rls,,,1033.03,1033.03,1
HCPCS,E0744,Neuromuscular stim for scoli,,,63.41,634.1,8
HCPCS,E07440,Neuromuscular stim for scoli,,,634.1,634.1,1
HCPCS,E0744MS,Neuromuscular stim for scoli,,,63.41,63.41,1
HCPCS,E0744NU,Neuromuscular stim for scoli,,,634.1,634.1,1
HCPCS,E0744RR,Neuromuscular stim for scoli,,,63.41,213.8,4
HCPCS,E0744UE,Neuromuscular stim for scoli,,,475.57,475.57,1
HCPCS,E0745,Neuromuscular stim for shock,,,72.55,725.58,8
HCPCS,E07450,Neuromuscular stim for shock,,,725.58,725.58,1
HCPCS,E0745MS,Neuromuscular stim for shock,,,72.55,72.55,1
HCPCS,E0745NU,Neuromuscular stim for shock,,,725.58,725.58,1
HCPCS,E0745RR,Neuromuscular stim for shock,,,72.55,209.01,4
HCPCS,E0745UE,Neuromuscular stim for shock,,,544.18,544.18,1
HCPCS,E0746,Electromyograph biofeedback,,,11.89,118.9,5
HCPCS,E07460,Electromyograph biofeedback,,,118.9,118.9,1
HCPCS,E0746MS,Electromyograph biofeedback,,,11.89,11.89,1
HCPCS,E0746NU,Electromyograph biofeedback,,,118.9,118.9,1
HCPCS,E0746RR,Electromyograph biofeedback,,,11.89,11.89,1
HCPCS,E0746UE,Electromyograph biofeedback,,,89.18,89.18,1
HCPCS,E0747,Elec osteogen stim not spine,,,315.39,3173.9,5
HCPCS,E0747,"OSTEOGENESIS STIMULATOR,NOT SPINAL",5913.0,3843.45,2137.31,5913.0,13
HCPCS,E07470,Elec osteogen stim not spine,,,3173.9,3173.9,1
HCPCS,E0747MS,Elec osteogen stim not spine,,,315.39,315.39,1
HCPCS,E0747NU,Elec osteogen stim not spine,,,3173.9,3173.9,1
HCPCS,E0747RR,Elec osteogen stim not spine,,,315.39,315.39,1
HCPCS,E0747UE,Elec osteogen stim not spine,,,2358.15,2358.15,1
HCPCS,E0748,Elec osteogen stim spinal,,,315.32,3153.35,5
HCPCS,E07480,Elec osteogen stim spinal,,,3153.35,3153.35,1
HCPCS,E0748MS,Elec osteogen stim spinal,,,315.32,315.32,1
HCPCS,E0748NU,Elec osteogen stim spinal,,,3153.35,3153.35,1
HCPCS,E0748RR,Elec osteogen stim spinal,,,315.32,315.32,1
HCPCS,E0748UE,Elec osteogen stim spinal,,,2365.02,2365.02,1
HCPCS,E0749,Elec osteogen stim implanted,,,195.9,1959.01,5
HCPCS,E07490,Elec osteogen stim implanted,,,1959.01,1959.01,1
HCPCS,E0749MS,Elec osteogen stim implanted,,,195.9,195.9,1
HCPCS,E0749NU,Elec osteogen stim implanted,,,1959.01,1959.01,1
HCPCS,E0749RR,Elec osteogen stim implanted,,,195.9,195.9,1
HCPCS,E0749UE,Elec osteogen stim implanted,,,1469.26,1469.26,1
HCPCS,E0755,Electronic salivary reflex s,,,1.08,10.8,5
HCPCS,E07550,Electronic salivary reflex s,,,10.8,10.8,1
HCPCS,E0755MS,Electronic salivary reflex s,,,1.08,1.08,1
HCPCS,E0755NU,Electronic salivary reflex s,,,10.8,10.8,1
HCPCS,E0755RR,Electronic salivary reflex s,,,1.08,1.08,1
HCPCS,E0755UE,Electronic salivary reflex s,,,8.1,8.1,1
HCPCS,E0760,Osteogen ultrasound stimltor,,,262.04,2620.37,5
HCPCS,E07600,Osteogen ultrasound stimltor,,,2620.37,2620.37,1
HCPCS,E0760MS,Osteogen ultrasound stimltor,,,262.04,262.04,1
HCPCS,E0760NU,Osteogen ultrasound stimltor,,,2620.37,2620.37,1
HCPCS,E0760RR,Osteogen ultrasound stimltor,,,262.04,262.04,1
HCPCS,E0760UE,Osteogen ultrasound stimltor,,,1965.25,1965.25,1
HCPCS,E0761,Nontherm electromgntc device,,,129.6,1296.0,8
HCPCS,E07610,Nontherm electromgntc device,,,1296.0,1296.0,1
HCPCS,E0761MS,Nontherm electromgntc device,,,129.6,129.6,1
HCPCS,E0761NU,Nontherm electromgntc device,,,1296.0,1296.0,1
HCPCS,E0761RR,Nontherm electromgntc device,,,129.6,129.6,1
HCPCS,E0761UE,Nontherm electromgntc device,,,972.0,972.0,1
HCPCS,E0762,Trans elec jt stim dev sys,,,75.75,757.53,5
HCPCS,E07620,Trans elec jt stim dev sys,,,757.53,757.53,1
HCPCS,E0762MS,Trans elec jt stim dev sys,,,75.75,75.75,1
HCPCS,E0762NU,Trans elec jt stim dev sys,,,757.53,757.53,1
HCPCS,E0762RR,Trans elec jt stim dev sys,,,75.75,75.75,1
HCPCS,E0762UE,Trans elec jt stim dev sys,,,568.14,568.14,1
HCPCS,E0764,Functional neuromuscularstim,,,896.93,8969.28,5
HCPCS,E07640,Functional neuromuscularstim,,,8969.28,8969.28,1
HCPCS,E0764MS,Functional neuromuscularstim,,,896.93,896.93,1
HCPCS,E0764NU,Functional neuromuscularstim,,,8969.28,8969.28,1
HCPCS,E0764RR,Functional neuromuscularstim,,,896.93,896.93,1
HCPCS,E0764UE,Functional neuromuscularstim,,,6726.96,6726.96,1
HCPCS,E0765,Nerve stimulator for tx n&v,,,6.84,196.41,14
HCPCS,E07650,Nerve stimulator for tx n&v,,,68.18,68.18,1
HCPCS,E0765MS,Nerve stimulator for tx n&v,,,6.84,6.84,1
HCPCS,E0765NU,Nerve stimulator for tx n&v,,,68.18,196.41,4
HCPCS,E0765RR,Nerve stimulator for tx n&v,,,6.84,19.68,4
HCPCS,E0765UE,Nerve stimulator for tx n&v,,,51.16,147.37,4
HCPCS,E0766,Elec stim cancer treatment,,,9318.06,93180.61,5
HCPCS,E07660,Elec stim cancer treatment,,,93180.61,93180.61,1
HCPCS,E0766MS,Elec stim cancer treatment,,,9318.06,9318.06,1
HCPCS,E0766NU,Elec stim cancer treatment,,,93180.61,93180.61,1
HCPCS,E0766RR,Elec stim cancer treatment,,,9318.06,9318.06,1
HCPCS,E0766UE,Elec stim cancer treatment,,,69885.45,69885.45,1
HCPCS,E0769,Electric wound treatment dev,,,15.23,152.28,5
HCPCS,E07690,Electric wound treatment dev,,,152.28,152.28,1
HCPCS,E0769MS,Electric wound treatment dev,,,15.23,15.23,1
HCPCS,E0769NU,Electric wound treatment dev,,,152.28,152.28,1
HCPCS,E0769RR,Electric wound treatment dev,,,15.23,15.23,1
HCPCS,E0769UE,Electric wound treatment dev,,,114.21,114.21,1
HCPCS,E0770,Functional electric stim nos,,,47.06,470.55,5
HCPCS,E07700,Functional electric stim nos,,,470.55,470.55,1
HCPCS,E0770MS,Functional electric stim nos,,,47.06,47.06,1
HCPCS,E0770NU,Functional electric stim nos,,,470.55,470.55,1
HCPCS,E0770RR,Functional electric stim nos,,,47.06,47.06,1
HCPCS,E0770UE,Functional electric stim nos,,,352.91,352.91,1
HCPCS,E0776,Iv pole,,,10.31,298.93,14
HCPCS,E07760,Iv pole,,,103.16,103.16,1
HCPCS,E0776MS,Iv pole,,,10.31,10.31,1
HCPCS,E0776NU,Iv pole,,,103.16,298.93,4
HCPCS,E0776RR,Iv pole,,,10.31,29.89,4
HCPCS,E0776UE,Iv pole,,,77.37,224.2,4
HCPCS,E0779,Amb infusion pump mechanical,,,13.38,133.83,8
HCPCS,E07790,Amb infusion pump mechanical,,,133.83,133.83,1
HCPCS,E0779MS,Amb infusion pump mechanical,,,13.38,13.38,1
HCPCS,E0779NU,Amb infusion pump mechanical,,,133.83,133.83,1
HCPCS,E0779RR,Amb infusion pump mechanical,,,13.38,35.93,4
HCPCS,E0779UE,Amb infusion pump mechanical,,,100.38,100.38,1
HCPCS,E0780,Mech amb infusion pump <8hrs,,,0.84,24.21,7
HCPCS,E07800,Mech amb infusion pump <8hrs,,,8.4,8.4,1
HCPCS,E0780MS,Mech amb infusion pump <8hrs,,,0.84,0.84,1
HCPCS,E0780NU,Mech amb infusion pump <8hrs,,,8.4,24.21,4
HCPCS,E0780RR,Mech amb infusion pump <8hrs,,,0.84,0.84,1
HCPCS,E0781,External ambulatory infus pu,,,173.7,1736.97,8
HCPCS,E07810,External ambulatory infus pu,,,1736.97,1736.97,1
HCPCS,E0781MS,External ambulatory infus pu,,,173.7,173.7,1
HCPCS,E0781NU,External ambulatory infus pu,,,1736.97,1736.97,1
HCPCS,E0781RR,External ambulatory infus pu,,,173.7,503.31,4
HCPCS,E0781UE,External ambulatory infus pu,,,1302.73,1302.73,1
HCPCS,E0782,Non-programble infusion pump,,,328.33,3283.38,5
HCPCS,E07820,Non-programble infusion pump,,,3283.38,3283.38,1
HCPCS,E0782MS,Non-programble infusion pump,,,328.33,328.33,1
HCPCS,E0782NU,Non-programble infusion pump,,,3283.38,3283.38,1
HCPCS,E0782RR,Non-programble infusion pump,,,328.33,328.33,1
HCPCS,E0782UE,Non-programble infusion pump,,,2462.55,2462.55,1
HCPCS,E0783,Programmable infusion pump,,,663.54,6635.33,5
HCPCS,E07830,Programmable infusion pump,,,6635.33,6635.33,1
HCPCS,E0783MS,Programmable infusion pump,,,663.54,663.54,1
HCPCS,E0783NU,Programmable infusion pump,,,6635.33,6635.33,1
HCPCS,E0783RR,Programmable infusion pump,,,663.54,663.54,1
HCPCS,E0783UE,Programmable infusion pump,,,4976.52,4976.52,1
HCPCS,E0784,Ext amb infusn pump insulin,,,313.2,3131.99,8
HCPCS,E07840,Ext amb infusn pump insulin,,,3131.99,3131.99,1
HCPCS,E0784MS,Ext amb infusn pump insulin,,,313.2,313.2,1
HCPCS,E0784NU,Ext amb infusn pump insulin,,,3131.99,3131.99,1
HCPCS,E0784RR,Ext amb infusn pump insulin,,,313.2,907.49,4
HCPCS,E0784UE,Ext amb infusn pump insulin,,,2348.99,2348.99,1
HCPCS,E0785,Replacement impl pump cathet,,,30.15,301.54,5
HCPCS,E07850,Replacement impl pump cathet,,,301.54,301.54,1
HCPCS,E0785KF,Replacement impl pump cathet,,,195.19,195.19,1
HCPCS,E0785MS,Replacement impl pump cathet,,,30.15,30.15,1
HCPCS,E0785NU,Replacement impl pump cathet,,,301.54,301.54,1
HCPCS,E0785RR,Replacement impl pump cathet,,,30.15,30.15,1
HCPCS,E0786,Implantable pump replacement,,,647.23,6472.35,5
HCPCS,E07860,Implantable pump replacement,,,6472.35,6472.35,1
HCPCS,E0786MS,Implantable pump replacement,,,647.23,647.23,1
HCPCS,E0786NU,Implantable pump replacement,,,6472.35,6472.35,1
HCPCS,E0786RR,Implantable pump replacement,,,647.23,647.23,1
HCPCS,E0786UE,Implantable pump replacement,,,4854.27,4854.27,1
HCPCS,E0791,Parenteral infusion pump sta,,,206.34,2063.5,8
HCPCS,E07910,Parenteral infusion pump sta,,,2063.5,2063.5,1
HCPCS,E0791MS,Parenteral infusion pump sta,,,206.34,206.34,1
HCPCS,E0791NU,Parenteral infusion pump sta,,,2063.5,2063.5,1
HCPCS,E0791RR,Parenteral infusion pump sta,,,206.34,597.92,4
HCPCS,E0791UE,Parenteral infusion pump sta,,,1547.62,1547.62,1
HCPCS,E0830,Ambulatory traction device,,,3.03,30.3,5
HCPCS,E08300,Ambulatory traction device,,,30.3,30.3,1
HCPCS,E0830MS,Ambulatory traction device,,,3.03,3.03,1
HCPCS,E0830NU,Ambulatory traction device,,,30.3,30.3,1
HCPCS,E0830RR,Ambulatory traction device,,,3.03,3.03,1
HCPCS,E0830UE,Ambulatory traction device,,,22.73,22.73,1
HCPCS,E0840,Tract frame attach headboard,,,13.23,171.06,14
HCPCS,E08400,Tract frame attach headboard,,,59.29,59.29,1
HCPCS,E0840MS,Tract frame attach headboard,,,13.23,13.23,1
HCPCS,E0840NU,Tract frame attach headboard,,,59.29,171.06,4
HCPCS,E0840RR,Tract frame attach headboard,,,13.23,38.12,4
HCPCS,E0840UE,Tract frame attach headboard,,,44.52,128.25,4
HCPCS,E0849,Cervical pneum trac equip,,,41.77,417.7,8
HCPCS,E08490,Cervical pneum trac equip,,,417.7,417.7,1
HCPCS,E0849MS,Cervical pneum trac equip,,,41.77,41.77,1
HCPCS,E0849NU,Cervical pneum trac equip,,,417.7,417.7,1
HCPCS,E0849RR,Cervical pneum trac equip,,,41.77,120.33,4
HCPCS,E0849UE,Cervical pneum trac equip,,,313.28,313.28,1
HCPCS,E0850,Traction stand free standing,,,11.7,245.25,14
HCPCS,E08500,Traction stand free standing,,,85.14,85.14,1
HCPCS,E0850MS,Traction stand free standing,,,11.7,11.7,1
HCPCS,E0850NU,Traction stand free standing,,,85.14,245.25,4
HCPCS,E0850RR,Traction stand free standing,,,11.7,33.69,4
HCPCS,E0850UE,Traction stand free standing,,,54.28,183.96,4
HCPCS,E0855,Cervical traction equipment,,,40.06,400.59,8
HCPCS,E0855,DELUXE HOME TRACTION KIT,631.0,410.15,106.01,567.9,21
HCPCS,E08550,Cervical traction equipment,,,400.59,400.59,1
HCPCS,E0855MS,Cervical traction equipment,,,40.06,40.06,1
HCPCS,E0855NU,Cervical traction equipment,,,400.59,400.59,1
HCPCS,E0855RR,Cervical traction equipment,,,40.06,115.4,4
HCPCS,E0855UE,Cervical traction equipment,,,300.45,300.45,1
HCPCS,E0856,Cervic collar w air bladders,,,12.47,124.74,8
HCPCS,E08560,Cervic collar w air bladders,,,124.74,124.74,1
HCPCS,E0856MS,Cervic collar w air bladders,,,12.47,12.47,1
HCPCS,E0856NU,Cervic collar w air bladders,,,124.74,124.74,1
HCPCS,E0856RR,Cervic collar w air bladders,,,12.47,35.93,4
HCPCS,E0856UE,Cervic collar w air bladders,,,93.56,93.56,1
HCPCS,E0860,Tract equip cervical tract,,,5.29,87.19,14
HCPCS,E08600,Tract equip cervical tract,,,31.23,31.23,1
HCPCS,E0860MS,Tract equip cervical tract,,,5.29,5.29,1
HCPCS,E0860NU,Tract equip cervical tract,,,31.23,87.19,4
HCPCS,E0860RR,Tract equip cervical tract,,,5.29,12.93,4
HCPCS,E0860UE,Tract equip cervical tract,,,23.91,68.9,4
HCPCS,E0870,Tract frame attach footboard,,,10.49,230.83,14
HCPCS,E08700,Tract frame attach footboard,,,94.27,94.27,1
HCPCS,E0870MS,Tract frame attach footboard,,,10.49,10.49,1
HCPCS,E0870NU,Tract frame attach footboard,,,94.27,230.83,4
HCPCS,E0870RR,Tract frame attach footboard,,,10.49,31.31,4
HCPCS,E0870UE,Tract frame attach footboard,,,71.02,173.9,4
HCPCS,E0880,Trac stand free stand extrem,,,15.97,293.09,14
HCPCS,E08800,Trac stand free stand extrem,,,101.75,101.75,1
HCPCS,E0880MS,Trac stand free stand extrem,,,15.97,15.97,1
HCPCS,E0880NU,Trac stand free stand extrem,,,101.75,293.09,4
HCPCS,E0880RR,Trac stand free stand extrem,,,15.97,46.02,4
HCPCS,E0880UE,Trac stand free stand extrem,,,77.01,221.84,4
HCPCS,E0890,Traction frame attach pelvic,,,26.61,238.94,14
HCPCS,E08900,Traction frame attach pelvic,,,82.94,82.94,1
HCPCS,E0890MS,Traction frame attach pelvic,,,26.61,26.61,1
HCPCS,E0890NU,Traction frame attach pelvic,,,82.94,238.94,4
HCPCS,E0890RR,Traction frame attach pelvic,,,26.61,72.4,4
HCPCS,E0890UE,Traction frame attach pelvic,,,68.45,192.48,4
HCPCS,E0900,Trac stand free stand pelvic,,,19.04,254.29,14
HCPCS,E09000,Trac stand free stand pelvic,,,93.02,93.02,1
HCPCS,E0900MS,Trac stand free stand pelvic,,,19.04,19.04,1
HCPCS,E0900NU,Trac stand free stand pelvic,,,93.02,254.29,4
HCPCS,E0900RR,Trac stand free stand pelvic,,,19.04,64.5,4
HCPCS,E0900UE,Trac stand free stand pelvic,,,77.91,190.76,4
HCPCS,E0910,Trapeze bar attached to bed,,,8.09,80.85,8
HCPCS,E09100,Trapeze bar attached to bed,,,80.85,80.85,1
HCPCS,E0910MS,Trapeze bar attached to bed,,,8.09,8.09,1
HCPCS,E0910NU,Trapeze bar attached to bed,,,80.85,80.85,1
HCPCS,E0910RR,Trapeze bar attached to bed,,,8.09,22.71,4
HCPCS,E0910UE,Trapeze bar attached to bed,,,60.63,60.63,1
HCPCS,E0911,Hd trapeze bar attach to bed,,,29.39,293.86,8
HCPCS,E09110,Hd trapeze bar attach to bed,,,293.86,293.86,1
HCPCS,E0911MS,Hd trapeze bar attach to bed,,,29.39,29.39,1
HCPCS,E0911NU,Hd trapeze bar attach to bed,,,293.86,293.86,1
HCPCS,E0911RR,Hd trapeze bar attach to bed,,,29.39,86.27,4
HCPCS,E0911UE,Hd trapeze bar attach to bed,,,220.38,220.38,1
HCPCS,E0912,Hd trapeze bar free standing,,,57.82,578.26,8
HCPCS,E09120,Hd trapeze bar free standing,,,578.26,578.26,1
HCPCS,E0912MS,Hd trapeze bar free standing,,,57.82,57.82,1
HCPCS,E0912NU,Hd trapeze bar free standing,,,578.26,578.26,1
HCPCS,E0912RR,Hd trapeze bar free standing,,,57.82,173.13,4
HCPCS,E0912UE,Hd trapeze bar free standing,,,433.7,433.7,1
HCPCS,E0920,Fracture frame attached to b,,,37.41,374.1,8
HCPCS,E09200,Fracture frame attached to b,,,374.1,374.1,1
HCPCS,E0920MS,Fracture frame attached to b,,,37.41,37.41,1
HCPCS,E0920NU,Fracture frame attached to b,,,374.1,374.1,1
HCPCS,E0920RR,Fracture frame attached to b,,,37.41,107.76,4
HCPCS,E0920UE,Fracture frame attached to b,,,280.57,280.57,1
HCPCS,E0930,Fracture frame free standing,,,37.02,370.18,8
HCPCS,E09300,Fracture frame free standing,,,370.18,370.18,1
HCPCS,E0930MS,Fracture frame free standing,,,37.02,37.02,1
HCPCS,E0930NU,Fracture frame free standing,,,370.18,370.18,1
HCPCS,E0930RR,Fracture frame free standing,,,37.02,106.64,4
HCPCS,E0930UE,Fracture frame free standing,,,277.64,277.64,1
HCPCS,E0935,Cont pas motion exercise dev,,,18.44,184.38,8
HCPCS,E09350,Cont pas motion exercise dev,,,184.38,184.38,1
HCPCS,E0935MS,Cont pas motion exercise dev,,,18.44,18.44,1
HCPCS,E0935NU,Cont pas motion exercise dev,,,184.38,184.38,1
HCPCS,E0935RR,Cont pas motion exercise dev,,,18.44,53.1,4
HCPCS,E0935UE,Cont pas motion exercise dev,,,138.28,138.28,1
HCPCS,E0936,"Cpm device, other than knee",,,176.36,176.36,1
HCPCS,E09360,"Cpm device, other than knee",,,176.36,176.36,1
HCPCS,E0940,Trapeze bar free standing,,,15.04,150.47,8
HCPCS,E09400,Trapeze bar free standing,,,150.47,150.47,1
HCPCS,E0940MS,Trapeze bar free standing,,,15.04,15.04,1
HCPCS,E0940NU,Trapeze bar free standing,,,150.47,150.47,1
HCPCS,E0940RR,Trapeze bar free standing,,,15.04,42.84,4
HCPCS,E0940UE,Trapeze bar free standing,,,112.85,112.85,1
HCPCS,E0941,Gravity assisted traction de,,,31.02,310.13,8
HCPCS,E09410,Gravity assisted traction de,,,310.13,310.13,1
HCPCS,E0941MS,Gravity assisted traction de,,,31.02,31.02,1
HCPCS,E0941NU,Gravity assisted traction de,,,310.13,310.13,1
HCPCS,E0941RR,Gravity assisted traction de,,,31.02,101.33,4
HCPCS,E0941UE,Gravity assisted traction de,,,232.6,232.6,1
HCPCS,E0942,Cervical head harness/halter,,,1.62,46.34,14
HCPCS,E09420,Cervical head harness/halter,,,13.67,13.67,1
HCPCS,E0942MS,Cervical head harness/halter,,,1.62,1.62,1
HCPCS,E0942NU,Cervical head harness/halter,,,13.67,46.34,4
HCPCS,E0942RR,Cervical head harness/halter,,,1.62,5.03,4
HCPCS,E0942UE,Cervical head harness/halter,,,10.23,34.67,4
HCPCS,E0944,Pelvic belt/harness/boot,,,3.19,91.04,14
HCPCS,E09440,Pelvic belt/harness/boot,,,31.6,31.6,1
HCPCS,E0944MS,Pelvic belt/harness/boot,,,3.19,3.19,1
HCPCS,E0944NU,Pelvic belt/harness/boot,,,31.6,91.04,4
HCPCS,E0944RR,Pelvic belt/harness/boot,,,3.19,9.16,4
HCPCS,E0944UE,Pelvic belt/harness/boot,,,23.71,68.28,4
HCPCS,E0945,Belt/harness extremity,,,3.59,87.94,14
HCPCS,E09450,Belt/harness extremity,,,35.92,35.92,1
HCPCS,E0945MS,Belt/harness extremity,,,3.59,3.59,1
HCPCS,E0945NU,Belt/harness extremity,,,35.92,87.94,4
HCPCS,E0945RR,Belt/harness extremity,,,3.59,8.77,4
HCPCS,E0945UE,Belt/harness extremity,,,27.81,68.09,4
HCPCS,E0946,Fracture frame dual w cross,,,40.76,407.6,8
HCPCS,E09460,Fracture frame dual w cross,,,407.6,407.6,1
HCPCS,E0946MS,Fracture frame dual w cross,,,40.76,40.76,1
HCPCS,E0946NU,Fracture frame dual w cross,,,407.6,407.6,1
HCPCS,E0946RR,Fracture frame dual w cross,,,40.76,119.63,4
HCPCS,E0946UE,Fracture frame dual w cross,,,305.7,305.7,1
HCPCS,E0947,Fracture frame attachmnts pe,,,43.32,1203.52,14
HCPCS,E09470,Fracture frame attachmnts pe,,,417.8,417.8,1
HCPCS,E0947MS,Fracture frame attachmnts pe,,,43.32,43.32,1
HCPCS,E0947NU,Fracture frame attachmnts pe,,,417.8,1203.52,4
HCPCS,E0947RR,Fracture frame attachmnts pe,,,43.32,124.77,4
HCPCS,E0947UE,Fracture frame attachmnts pe,,,313.34,902.61,4
HCPCS,E0948,Fracture frame attachmnts ce,,,40.4,1164.07,14
HCPCS,E09480,Fracture frame attachmnts ce,,,404.1,404.1,1
HCPCS,E0948MS,Fracture frame attachmnts ce,,,40.4,40.4,1
HCPCS,E0948NU,Fracture frame attachmnts ce,,,404.1,1164.07,4
HCPCS,E0948RR,Fracture frame attachmnts ce,,,40.4,116.37,4
HCPCS,E0948UE,Fracture frame attachmnts ce,,,285.02,821.05,4
HCPCS,E0950,Tray,,,5.35,153.77,14
HCPCS,E09500,Tray,,,53.45,53.45,1
HCPCS,E0950MS,Tray,,,5.35,5.35,1
HCPCS,E0950NU,Tray,,,53.45,153.77,4
HCPCS,E0950RR,Tray,,,5.35,15.37,4
HCPCS,E0950UE,Tray,,,40.08,115.32,4
HCPCS,E0951,Loop heel,,,0.94,26.62,14
HCPCS,E09510,Loop heel,,,9.41,9.41,1
HCPCS,E0951MS,Loop heel,,,0.94,0.94,1
HCPCS,E0951NU,Loop heel,,,9.41,26.62,4
HCPCS,E0951RR,Loop heel,,,0.94,2.66,4
HCPCS,E0951UE,Loop heel,,,7.05,19.97,4
HCPCS,E0952,"Toe loop/holder, each",,,1.16,33.74,14
HCPCS,E09520,"Toe loop/holder, each",,,11.19,11.19,1
HCPCS,E0952MS,"Toe loop/holder, each",,,1.16,1.16,1
HCPCS,E0952NU,"Toe loop/holder, each",,,11.19,33.74,4
HCPCS,E0952RR,"Toe loop/holder, each",,,1.16,3.38,4
HCPCS,E0952UE,"Toe loop/holder, each",,,8.39,25.32,4
HCPCS,E0953,W/c lateral thigh/knee sup,,,5.45,151.89,14
HCPCS,E09530,W/c lateral thigh/knee sup,,,54.6,54.6,1
HCPCS,E0953MS,W/c lateral thigh/knee sup,,,5.45,5.45,1
HCPCS,E0953NU,W/c lateral thigh/knee sup,,,54.6,151.89,4
HCPCS,E0953RR,W/c lateral thigh/knee sup,,,5.45,15.19,4
HCPCS,E0953UE,W/c lateral thigh/knee sup,,,40.95,113.93,4
HCPCS,E0954,"Foot box, any type each foot",,,3.76,108.33,14
HCPCS,E09540,"Foot box, any type each foot",,,37.15,37.15,1
HCPCS,E0954MS,"Foot box, any type each foot",,,3.76,3.76,1
HCPCS,E0954NU,"Foot box, any type each foot",,,37.15,108.33,4
HCPCS,E0954RR,"Foot box, any type each foot",,,3.76,10.83,4
HCPCS,E0954UE,"Foot box, any type each foot",,,27.86,81.28,4
HCPCS,E0955,Cushioned headrest,,,10.23,102.23,8
HCPCS,E09550,Cushioned headrest,,,102.23,102.23,1
HCPCS,E0955MS,Cushioned headrest,,,10.23,10.23,1
HCPCS,E0955NU,Cushioned headrest,,,102.23,102.23,1
HCPCS,E0955RR,Cushioned headrest,,,10.23,28.81,4
HCPCS,E0955UE,Cushioned headrest,,,76.67,76.67,1
HCPCS,E0956,W/c lateral trunk/hip suppor,,,5.45,151.89,14
HCPCS,E09560,W/c lateral trunk/hip suppor,,,54.6,54.6,1
HCPCS,E0956MS,W/c lateral trunk/hip suppor,,,5.45,5.45,1
HCPCS,E0956NU,W/c lateral trunk/hip suppor,,,54.6,151.89,4
HCPCS,E0956RR,W/c lateral trunk/hip suppor,,,5.45,15.19,4
HCPCS,E0956UE,W/c lateral trunk/hip suppor,,,40.95,113.93,4
HCPCS,E0957,W/c medial thigh support,,,8.33,240.99,14
HCPCS,E09570,W/c medial thigh support,,,83.27,83.27,1
HCPCS,E0957MS,W/c medial thigh support,,,8.33,8.33,1
HCPCS,E0957NU,W/c medial thigh support,,,83.27,240.99,4
HCPCS,E0957RR,W/c medial thigh support,,,8.33,24.1,4
HCPCS,E0957UE,W/c medial thigh support,,,62.46,180.75,4
HCPCS,E0958,Whlchr att- conv 1 arm drive,,,29.13,291.24,8
HCPCS,E09580,Whlchr att- conv 1 arm drive,,,291.24,291.24,1
HCPCS,E0958MS,Whlchr att- conv 1 arm drive,,,29.13,29.13,1
HCPCS,E0958NU,Whlchr att- conv 1 arm drive,,,291.24,291.24,1
HCPCS,E0958RR,Whlchr att- conv 1 arm drive,,,29.13,82.21,4
HCPCS,E0958UE,Whlchr att- conv 1 arm drive,,,218.43,218.43,1
HCPCS,E0959,Amputee adapter,,,2.94,29.39,5
HCPCS,E09590,Amputee adapter,,,29.39,29.39,1
HCPCS,E0959MS,Amputee adapter,,,2.94,2.94,1
HCPCS,E0959NU,Amputee adapter,,,29.39,29.39,1
HCPCS,E0959RR,Amputee adapter,,,2.94,2.94,1
HCPCS,E0959UE,Amputee adapter,,,22.04,22.04,1
HCPCS,E0960,W/c shoulder harness/straps,,,5.22,146.01,14
HCPCS,E09600,W/c shoulder harness/straps,,,52.17,52.17,1
HCPCS,E0960MS,W/c shoulder harness/straps,,,5.22,5.22,1
HCPCS,E0960NU,W/c shoulder harness/straps,,,52.17,146.01,4
HCPCS,E0960RR,W/c shoulder harness/straps,,,5.22,14.6,4
HCPCS,E0960UE,W/c shoulder harness/straps,,,39.13,109.5,4
HCPCS,E0961,Wheelchair brake extension,,,1.4,14.03,5
HCPCS,E09610,Wheelchair brake extension,,,14.03,14.03,1
HCPCS,E0961MS,Wheelchair brake extension,,,1.4,1.4,1
HCPCS,E0961NU,Wheelchair brake extension,,,14.03,14.03,1
HCPCS,E0961RR,Wheelchair brake extension,,,1.4,1.4,1
HCPCS,E0961UE,Wheelchair brake extension,,,10.23,10.23,1
HCPCS,E0966,Wheelchair head rest extensi,,,5.04,50.4,5
HCPCS,E09660,Wheelchair head rest extensi,,,50.4,50.4,1
HCPCS,E0966MS,Wheelchair head rest extensi,,,5.04,5.04,1
HCPCS,E0966NU,Wheelchair head rest extensi,,,50.4,50.4,1
HCPCS,E0966RR,Wheelchair head rest extensi,,,5.04,5.04,1
HCPCS,E0966UE,Wheelchair head rest extensi,,,37.81,37.81,1
HCPCS,E0967,Man wc rim/projection rep ea,,,5.07,144.19,14
HCPCS,E09670,Man wc rim/projection rep ea,,,50.68,50.68,1
HCPCS,E0967MS,Man wc rim/projection rep ea,,,5.07,5.07,1
HCPCS,E0967NU,Man wc rim/projection rep ea,,,50.68,144.19,4
HCPCS,E0967RR,Man wc rim/projection rep ea,,,5.07,14.42,4
HCPCS,E0967UE,Man wc rim/projection rep ea,,,38.02,108.15,4
HCPCS,E0968,Wheelchair commode seat,,,14.53,145.24,8
HCPCS,E09680,Wheelchair commode seat,,,145.24,145.24,1
HCPCS,E0968MS,Wheelchair commode seat,,,14.53,14.53,1
HCPCS,E0968NU,Wheelchair commode seat,,,145.24,145.24,1
HCPCS,E0968RR,Wheelchair commode seat,,,14.53,41.84,4
HCPCS,E0968UE,Wheelchair commode seat,,,108.93,108.93,1
HCPCS,E0969,Wheelchair narrowing device,,,10.68,365.68,14
HCPCS,E09690,Wheelchair narrowing device,,,107.9,107.9,1
HCPCS,E0969MS,Wheelchair narrowing device,,,10.68,10.68,1
HCPCS,E0969NU,Wheelchair narrowing device,,,107.9,365.68,4
HCPCS,E0969RR,Wheelchair narrowing device,,,10.68,36.21,4
HCPCS,E0969UE,Wheelchair narrowing device,,,80.94,274.28,4
HCPCS,E0970,Wheelchair no. 2 footplates,,,2.16,61.46,17
HCPCS,E09700,Wheelchair no. 2 footplates,,,23.41,23.41,1
HCPCS,E0970MS,Wheelchair no. 2 footplates,,,2.16,2.16,1
HCPCS,E0970NU,Wheelchair no. 2 footplates,,,23.41,61.46,4
HCPCS,E0970RR,Wheelchair no. 2 footplates,,,2.16,5.67,4
HCPCS,E0970UE,Wheelchair no. 2 footplates,,,17.66,38.54,4
HCPCS,E0971,Wheelchair anti-tipping devi,,,2.1,20.9,5
HCPCS,E09710,Wheelchair anti-tipping devi,,,20.9,20.9,1
HCPCS,E0971MS,Wheelchair anti-tipping devi,,,2.1,2.1,1
HCPCS,E0971NU,Wheelchair anti-tipping devi,,,20.9,20.9,1
HCPCS,E0971RR,Wheelchair anti-tipping devi,,,2.1,2.1,1
HCPCS,E0971UE,Wheelchair anti-tipping devi,,,15.67,15.67,1
HCPCS,E0973,W/ch access det adj armrest,,,3.69,36.95,5
HCPCS,E09730,W/ch access det adj armrest,,,36.95,36.95,1
HCPCS,E0973MS,W/ch access det adj armrest,,,3.69,3.69,1
HCPCS,E0973NU,W/ch access det adj armrest,,,36.95,36.95,1
HCPCS,E0973RR,W/ch access det adj armrest,,,3.69,3.69,1
HCPCS,E0973UE,W/ch access det adj armrest,,,27.71,27.71,1
HCPCS,E0974,W/ch access anti-rollback,,,5.21,52.02,5
HCPCS,E09740,W/ch access anti-rollback,,,52.02,52.02,1
HCPCS,E0974MS,W/ch access anti-rollback,,,5.21,5.21,1
HCPCS,E0974NU,W/ch access anti-rollback,,,52.02,52.02,1
HCPCS,E0974RR,W/ch access anti-rollback,,,5.21,5.21,1
HCPCS,E0974UE,W/ch access anti-rollback,,,39.02,39.02,1
HCPCS,E0978,"W/c acc,saf belt pelv strap",,,1.74,17.33,5
HCPCS,E09780,"W/c acc,saf belt pelv strap",,,17.33,17.33,1
HCPCS,E0978MS,"W/c acc,saf belt pelv strap",,,1.74,1.74,1
HCPCS,E0978NU,"W/c acc,saf belt pelv strap",,,17.33,17.33,1
HCPCS,E0978RR,"W/c acc,saf belt pelv strap",,,1.74,1.74,1
HCPCS,E0978UE,"W/c acc,saf belt pelv strap",,,12.99,12.99,1
HCPCS,E0980,Wheelchair safety vest,,,2.58,65.59,14
HCPCS,E09800,Wheelchair safety vest,,,25.91,25.91,1
HCPCS,E0980MS,Wheelchair safety vest,,,2.58,2.58,1
HCPCS,E0980NU,Wheelchair safety vest,,,25.91,65.59,4
HCPCS,E0980RR,Wheelchair safety vest,,,2.58,6.58,4
HCPCS,E0980UE,Wheelchair safety vest,,,19.43,48.91,4
HCPCS,E0981,"Seat upholstery, replacement",,,2.84,84.57,14
HCPCS,E09810,"Seat upholstery, replacement",,,27.99,27.99,1
HCPCS,E0981MS,"Seat upholstery, replacement",,,2.84,2.84,1
HCPCS,E0981NU,"Seat upholstery, replacement",,,27.99,84.57,4
HCPCS,E0981RR,"Seat upholstery, replacement",,,2.84,8.46,4
HCPCS,E0981UE,"Seat upholstery, replacement",,,21.19,63.43,4
HCPCS,E0982,"Back upholstery, replacement",,,3.06,93.63,14
HCPCS,E09820,"Back upholstery, replacement",,,30.6,30.6,1
HCPCS,E0982MS,"Back upholstery, replacement",,,3.06,3.06,1
HCPCS,E0982NU,"Back upholstery, replacement",,,30.6,93.63,4
HCPCS,E0982RR,"Back upholstery, replacement",,,3.06,9.36,4
HCPCS,E0982UE,"Back upholstery, replacement",,,22.95,70.23,4
HCPCS,E0983,Add pwr joystick,,,202.56,2025.66,8
HCPCS,E09830,Add pwr joystick,,,2025.66,2025.66,1
HCPCS,E0983MS,Add pwr joystick,,,202.56,202.56,1
HCPCS,E0983NU,Add pwr joystick,,,2025.66,2025.66,1
HCPCS,E0983RR,Add pwr joystick,,,202.56,567.35,4
HCPCS,E0983UE,Add pwr joystick,,,1519.25,1519.25,1
HCPCS,E0984,Add pwr tiller,,,131.61,1316.13,8
HCPCS,E09840,Add pwr tiller,,,1316.13,1316.13,1
HCPCS,E0984MS,Add pwr tiller,,,131.61,131.61,1
HCPCS,E0984NU,Add pwr tiller,,,1316.13,1316.13,1
HCPCS,E0984RR,Add pwr tiller,,,131.61,446.04,4
HCPCS,E0984UE,Add pwr tiller,,,987.1,987.1,1
HCPCS,E0985,W/c seat lift mechanism,,,15.63,156.29,8
HCPCS,E09850,W/c seat lift mechanism,,,156.29,156.29,1
HCPCS,E0985MS,W/c seat lift mechanism,,,15.63,15.63,1
HCPCS,E0985NU,W/c seat lift mechanism,,,156.29,156.29,1
HCPCS,E0985RR,W/c seat lift mechanism,,,15.63,42.23,4
HCPCS,E0985UE,W/c seat lift mechanism,,,117.21,117.21,1
HCPCS,E0986,Man w/c powr assist syst,,,394.25,3942.5,8
HCPCS,E09860,Man w/c powr assist syst,,,3942.5,3942.5,1
HCPCS,E0986MS,Man w/c powr assist syst,,,394.25,394.25,1
HCPCS,E0986NU,Man w/c powr assist syst,,,3942.5,3942.5,1
HCPCS,E0986RR,Man w/c powr assist syst,,,394.25,1135.7,4
HCPCS,E0986UE,Man w/c powr assist syst,,,2956.88,2956.88,1
HCPCS,E0988,Lever-activated wheel drive,,,242.62,2426.2,8
HCPCS,E09880,Lever-activated wheel drive,,,2426.2,2426.2,1
HCPCS,E0988MS,Lever-activated wheel drive,,,242.62,242.62,1
HCPCS,E0988NU,Lever-activated wheel drive,,,2426.2,2426.2,1
HCPCS,E0988RR,Lever-activated wheel drive,,,242.62,672.01,4
HCPCS,E0988UE,Lever-activated wheel drive,,,1819.65,1819.65,1
HCPCS,E0990,Wheelchair elevating leg res,,,4.94,49.35,5
HCPCS,E09900,Wheelchair elevating leg res,,,49.35,49.35,1
HCPCS,E0990MS,Wheelchair elevating leg res,,,4.94,4.94,1
HCPCS,E0990NU,Wheelchair elevating leg res,,,49.35,49.35,1
HCPCS,E0990RR,Wheelchair elevating leg res,,,4.94,4.94,1
HCPCS,E0990UE,Wheelchair elevating leg res,,,37.01,37.01,1
HCPCS,E0992,Wheelchair solid seat insert,,,5.69,56.98,5
HCPCS,E09920,Wheelchair solid seat insert,,,56.98,56.98,1
HCPCS,E0992MS,Wheelchair solid seat insert,,,5.69,5.69,1
HCPCS,E0992NU,Wheelchair solid seat insert,,,56.98,56.98,1
HCPCS,E0992RR,Wheelchair solid seat insert,,,5.69,5.69,1
HCPCS,E0992UE,Wheelchair solid seat insert,,,42.74,42.74,1
HCPCS,E0994,Wheelchair arm rest,,,1.45,41.17,14
HCPCS,E09940,Wheelchair arm rest,,,14.29,14.29,1
HCPCS,E0994MS,Wheelchair arm rest,,,1.45,1.45,1
HCPCS,E0994NU,Wheelchair arm rest,,,14.29,41.17,4
HCPCS,E0994RR,Wheelchair arm rest,,,1.45,4.16,4
HCPCS,E0994UE,Wheelchair arm rest,,,10.71,30.86,4
HCPCS,E0995,"Wc calf rest, pad replacemnt",,,1.81,18.05,5
HCPCS,E09950,"Wc calf rest, pad replacemnt",,,18.05,18.05,1
HCPCS,E0995MS,"Wc calf rest, pad replacemnt",,,1.81,1.81,1
HCPCS,E0995NU,"Wc calf rest, pad replacemnt",,,18.05,18.05,1
HCPCS,E0995RR,"Wc calf rest, pad replacemnt",,,1.81,1.81,1
HCPCS,E0995UE,"Wc calf rest, pad replacemnt",,,13.52,13.52,1
HCPCS,E1002,Pwr seat tilt,,,260.24,2602.38,8
HCPCS,E10020,Pwr seat tilt,,,2602.38,2602.38,1
HCPCS,E1002MS,Pwr seat tilt,,,260.24,260.24,1
HCPCS,E1002NU,Pwr seat tilt,,,2602.38,2602.38,1
HCPCS,E1002RR,Pwr seat tilt,,,260.24,754.06,4
HCPCS,E1002UE,Pwr seat tilt,,,1951.78,1951.78,1
HCPCS,E1003,Pwr seat recline,,,304.6,3046.03,8
HCPCS,E10030,Pwr seat recline,,,3046.03,3046.03,1
HCPCS,E1003MS,Pwr seat recline,,,304.6,304.6,1
HCPCS,E1003NU,Pwr seat recline,,,3046.03,3046.03,1
HCPCS,E1003RR,Pwr seat recline,,,304.6,882.59,4
HCPCS,E1003UE,Pwr seat recline,,,2284.52,2284.52,1
HCPCS,E1004,Pwr seat recline mech,,,334.8,3348.02,8
HCPCS,E10040,Pwr seat recline mech,,,3348.02,3348.02,1
HCPCS,E1004MS,Pwr seat recline mech,,,334.8,334.8,1
HCPCS,E1004NU,Pwr seat recline mech,,,3348.02,3348.02,1
HCPCS,E1004RR,Pwr seat recline mech,,,334.8,970.08,4
HCPCS,E1004UE,Pwr seat recline mech,,,2511.02,2511.02,1
HCPCS,E1005,Pwr seat recline pwr,,,366.25,3662.49,8
HCPCS,E10050,Pwr seat recline pwr,,,3662.49,3662.49,1
HCPCS,E1005MS,Pwr seat recline pwr,,,366.25,366.25,1
HCPCS,E1005NU,Pwr seat recline pwr,,,3662.49,3662.49,1
HCPCS,E1005RR,Pwr seat recline pwr,,,366.25,1060.53,4
HCPCS,E1005UE,Pwr seat recline pwr,,,2746.86,2746.86,1
HCPCS,E1006,Pwr seat combo w/o shear,,,450.95,4509.53,8
HCPCS,E10060,Pwr seat combo w/o shear,,,4509.53,4509.53,1
HCPCS,E1006MS,Pwr seat combo w/o shear,,,450.95,450.95,1
HCPCS,E1006NU,Pwr seat combo w/o shear,,,4509.53,4509.53,1
HCPCS,E1006RR,Pwr seat combo w/o shear,,,450.95,1299.04,4
HCPCS,E1006UE,Pwr seat combo w/o shear,,,3382.15,3382.15,1
HCPCS,E1007,Pwr seat combo w/shear,,,560.53,5605.29,8
HCPCS,E10070,Pwr seat combo w/shear,,,5605.29,5605.29,1
HCPCS,E1007MS,Pwr seat combo w/shear,,,560.53,560.53,1
HCPCS,E1007NU,Pwr seat combo w/shear,,,5605.29,5605.29,1
HCPCS,E1007RR,Pwr seat combo w/shear,,,560.53,1624.15,4
HCPCS,E1007UE,Pwr seat combo w/shear,,,4203.96,4203.96,1
HCPCS,E1008,Pwr seat combo pwr shear,,,574.95,5749.51,8
HCPCS,E10080,Pwr seat combo pwr shear,,,5749.51,5749.51,1
HCPCS,E1008MS,Pwr seat combo pwr shear,,,574.95,574.95,1
HCPCS,E1008NU,Pwr seat combo pwr shear,,,5749.51,5749.51,1
HCPCS,E1008RR,Pwr seat combo pwr shear,,,574.95,1665.94,4
HCPCS,E1008UE,Pwr seat combo pwr shear,,,4312.13,4312.13,1
HCPCS,E1009,Add mech leg elevation,,,6.07,53.9,5
HCPCS,E10090,Add mech leg elevation,,,53.9,53.9,1
HCPCS,E1009MS,Add mech leg elevation,,,6.07,6.07,1
HCPCS,E1009NU,Add mech leg elevation,,,53.9,53.9,1
HCPCS,E1009RR,Add mech leg elevation,,,6.07,6.07,1
HCPCS,E1009UE,Add mech leg elevation,,,40.42,40.42,1
HCPCS,E1010,Add pwr leg elevation,,,78.14,781.35,8
HCPCS,E10100,Add pwr leg elevation,,,781.35,781.35,1
HCPCS,E1010MS,Add pwr leg elevation,,,78.14,78.14,1
HCPCS,E1010NU,Add pwr leg elevation,,,781.35,781.35,1
HCPCS,E1010RR,Add pwr leg elevation,,,78.14,226.39,4
HCPCS,E1010UE,Add pwr leg elevation,,,586.01,586.01,1
HCPCS,E1011,Ped wc modify width adjustm,,,619.92,619.92,2
HCPCS,E10110,Ped wc modify width adjustm,,,619.92,619.92,1
HCPCS,E1011NU,Ped wc modify width adjustm,,,619.92,619.92,1
HCPCS,E1012,Ctr mount pwr elev leg rest,,,78.14,781.35,8
HCPCS,E10120,Ctr mount pwr elev leg rest,,,781.35,781.35,1
HCPCS,E1012MS,Ctr mount pwr elev leg rest,,,78.14,78.14,1
HCPCS,E1012NU,Ctr mount pwr elev leg rest,,,781.35,781.35,1
HCPCS,E1012RR,Ctr mount pwr elev leg rest,,,78.14,226.39,4
HCPCS,E1012UE,Ctr mount pwr elev leg rest,,,586.01,586.01,1
HCPCS,E1014,Reclining back add ped w/c,,,29.6,296.05,8
HCPCS,E10140,Reclining back add ped w/c,,,296.05,296.05,1
HCPCS,E1014MS,Reclining back add ped w/c,,,29.6,29.6,1
HCPCS,E1014NU,Reclining back add ped w/c,,,296.05,296.05,1
HCPCS,E1014RR,Reclining back add ped w/c,,,29.6,85.29,4
HCPCS,E1014UE,Reclining back add ped w/c,,,222.04,222.04,1
HCPCS,E1015,Shock absorber for man w/c,,,8.72,238.13,14
HCPCS,E10150,Shock absorber for man w/c,,,87.21,87.21,1
HCPCS,E1015MS,Shock absorber for man w/c,,,8.72,8.72,1
HCPCS,E1015NU,Shock absorber for man w/c,,,87.21,238.13,4
HCPCS,E1015RR,Shock absorber for man w/c,,,8.72,23.81,4
HCPCS,E1015UE,Shock absorber for man w/c,,,65.4,178.6,4
HCPCS,E1016,Shock absorber for power w/c,,,8.33,217.25,14
HCPCS,E10160,Shock absorber for power w/c,,,83.27,83.27,1
HCPCS,E1016MS,Shock absorber for power w/c,,,8.33,8.33,1
HCPCS,E1016NU,Shock absorber for power w/c,,,83.27,217.25,4
HCPCS,E1016RR,Shock absorber for power w/c,,,8.33,21.72,4
HCPCS,E1016UE,Shock absorber for power w/c,,,62.46,162.94,4
HCPCS,E1018,Hd shck absrber for hd powwc,,,13.82,138.24,5
HCPCS,E10180,Hd shck absrber for hd powwc,,,138.24,138.24,1
HCPCS,E1018MS,Hd shck absrber for hd powwc,,,13.82,13.82,1
HCPCS,E1018NU,Hd shck absrber for hd powwc,,,138.24,138.24,1
HCPCS,E1018RR,Hd shck absrber for hd powwc,,,13.82,13.82,1
HCPCS,E1018UE,Hd shck absrber for hd powwc,,,103.68,103.68,1
HCPCS,E1020,Residual limb support system,,,12.61,126.11,8
HCPCS,E10200,Residual limb support system,,,126.11,126.11,1
HCPCS,E1020MS,Residual limb support system,,,12.61,12.61,1
HCPCS,E1020NU,Residual limb support system,,,126.11,126.11,1
HCPCS,E1020RR,Residual limb support system,,,12.61,36.48,4
HCPCS,E1020UE,Residual limb support system,,,94.58,94.58,1
HCPCS,E1028,W/c manual swingaway,,,9.19,91.9,8
HCPCS,E10280,W/c manual swingaway,,,91.9,91.9,1
HCPCS,E1028MS,W/c manual swingaway,,,9.19,9.19,1
HCPCS,E1028NU,W/c manual swingaway,,,91.9,91.9,1
HCPCS,E1028RR,W/c manual swingaway,,,9.19,27.97,4
HCPCS,E1028UE,W/c manual swingaway,,,68.91,68.91,1
HCPCS,E1029,W/c vent tray fixed,,,25.8,258.03,8
HCPCS,E10290,W/c vent tray fixed,,,258.03,258.03,1
HCPCS,E1029MS,W/c vent tray fixed,,,25.8,25.8,1
HCPCS,E1029NU,W/c vent tray fixed,,,258.03,258.03,1
HCPCS,E1029RR,W/c vent tray fixed,,,25.8,74.34,4
HCPCS,E1029UE,W/c vent tray fixed,,,193.53,193.53,1
HCPCS,E1030,W/c vent tray gimbaled,,,81.4,814.02,8
HCPCS,E10300,W/c vent tray gimbaled,,,814.02,814.02,1
HCPCS,E1030MS,W/c vent tray gimbaled,,,81.4,81.4,1
HCPCS,E1030NU,W/c vent tray gimbaled,,,814.02,814.02,1
HCPCS,E1030RR,W/c vent tray gimbaled,,,81.4,234.49,4
HCPCS,E1030UE,W/c vent tray gimbaled,,,610.51,610.51,1
HCPCS,E1031,Rollabout chair with casters,,,30.19,301.87,8
HCPCS,E10310,Rollabout chair with casters,,,301.87,301.87,1
HCPCS,E1031MS,Rollabout chair with casters,,,30.19,30.19,1
HCPCS,E1031NU,Rollabout chair with casters,,,301.87,301.87,1
HCPCS,E1031RR,Rollabout chair with casters,,,30.19,85.67,4
HCPCS,E1031UE,Rollabout chair with casters,,,226.4,226.4,1
HCPCS,E1032,Wheelchair joystick drive,,,9.46,94.63,5
HCPCS,E10320,Wheelchair joystick drive,,,94.63,94.63,1
HCPCS,E1032MS,Wheelchair joystick drive,,,9.46,9.46,1
HCPCS,E1032NU,Wheelchair joystick drive,,,94.63,94.63,1
HCPCS,E1032RR,Wheelchair joystick drive,,,9.46,9.46,1
HCPCS,E1032UE,Wheelchair joystick drive,,,70.97,70.97,1
HCPCS,E1033,Wheelchair hardware headrest,,,9.46,94.63,5
HCPCS,E10330,Wheelchair hardware headrest,,,94.63,94.63,1
HCPCS,E1033MS,Wheelchair hardware headrest,,,9.46,9.46,1
HCPCS,E1033NU,Wheelchair hardware headrest,,,94.63,94.63,1
HCPCS,E1033RR,Wheelchair hardware headrest,,,9.46,9.46,1
HCPCS,E1033UE,Wheelchair hardware headrest,,,70.97,70.97,1
HCPCS,E1034,Wheelchair trunk hip support,,,9.46,94.63,5
HCPCS,E10340,Wheelchair trunk hip support,,,94.63,94.63,1
HCPCS,E1034MS,Wheelchair trunk hip support,,,9.46,9.46,1
HCPCS,E1034NU,Wheelchair trunk hip support,,,94.63,94.63,1
HCPCS,E1034RR,Wheelchair trunk hip support,,,9.46,9.46,1
HCPCS,E1034UE,Wheelchair trunk hip support,,,70.97,70.97,1
HCPCS,E1035,Patient transfer system <300,,,410.97,4109.71,8
HCPCS,E10350,Patient transfer system <300,,,4109.71,4109.71,1
HCPCS,E1035MS,Patient transfer system <300,,,410.97,410.97,1
HCPCS,E1035NU,Patient transfer system <300,,,4109.71,4109.71,1
HCPCS,E1035RR,Patient transfer system <300,,,410.97,1193.31,4
HCPCS,E1035UE,Patient transfer system <300,,,3082.28,3082.28,1
HCPCS,E1036,Patient transfer system >300,,,604.0,6040.03,8
HCPCS,E10360,Patient transfer system >300,,,6040.03,6040.03,1
HCPCS,E1036MS,Patient transfer system >300,,,604.0,604.0,1
HCPCS,E1036NU,Patient transfer system >300,,,6040.03,6040.03,1
HCPCS,E1036RR,Patient transfer system >300,,,604.0,1698.74,4
HCPCS,E1036UE,Patient transfer system >300,,,4530.03,4530.03,1
HCPCS,E1037,"Transport chair, ped size",,,77.59,775.83,8
HCPCS,E10370,"Transport chair, ped size",,,775.83,775.83,1
HCPCS,E1037MS,"Transport chair, ped size",,,77.59,77.59,1
HCPCS,E1037NU,"Transport chair, ped size",,,775.83,775.83,1
HCPCS,E1037RR,"Transport chair, ped size",,,77.59,210.98,4
HCPCS,E1037UE,"Transport chair, ped size",,,581.87,581.87,1
HCPCS,E1038,Transport chair pt wt<=300lb,,,10.04,100.45,8
HCPCS,E10380,Transport chair pt wt<=300lb,,,100.45,100.45,1
HCPCS,E1038MS,Transport chair pt wt<=300lb,,,10.04,10.04,1
HCPCS,E1038NU,Transport chair pt wt<=300lb,,,100.45,100.45,1
HCPCS,E1038RR,Transport chair pt wt<=300lb,,,10.04,30.98,4
HCPCS,E1038UE,Transport chair pt wt<=300lb,,,75.33,75.33,1
HCPCS,E1039,Transport chair pt wt >300lb,,,23.09,230.95,8
HCPCS,E10390,Transport chair pt wt >300lb,,,230.95,230.95,1
HCPCS,E1039MS,Transport chair pt wt >300lb,,,23.09,23.09,1
HCPCS,E1039NU,Transport chair pt wt >300lb,,,230.95,230.95,1
HCPCS,E1039RR,Transport chair pt wt >300lb,,,23.09,65.84,4
HCPCS,E1039UE,Transport chair pt wt >300lb,,,173.21,173.21,1
HCPCS,E1050,Whelchr fxd full length arms,,,82.54,825.49,8
HCPCS,E10500,Whelchr fxd full length arms,,,825.49,825.49,1
HCPCS,E1050MS,Whelchr fxd full length arms,,,82.54,82.54,1
HCPCS,E1050NU,Whelchr fxd full length arms,,,825.49,825.49,1
HCPCS,E1050RR,Whelchr fxd full length arms,,,82.54,202.12,4
HCPCS,E1050UE,Whelchr fxd full length arms,,,619.11,619.11,1
HCPCS,E1060,Wheelchair detachable arms,,,102.17,1021.68,8
HCPCS,E10600,Wheelchair detachable arms,,,1021.68,1021.68,1
HCPCS,E1060MS,Wheelchair detachable arms,,,102.17,102.17,1
HCPCS,E1060NU,Wheelchair detachable arms,,,1021.68,1021.68,1
HCPCS,E1060RR,Wheelchair detachable arms,,,102.17,250.17,4
HCPCS,E1060UE,Wheelchair detachable arms,,,766.26,766.26,1
HCPCS,E1070,Wheelchair detachable foot r,,,75.46,754.62,8
HCPCS,E10700,Wheelchair detachable foot r,,,754.62,754.62,1
HCPCS,E1070MS,Wheelchair detachable foot r,,,75.46,75.46,1
HCPCS,E1070NU,Wheelchair detachable foot r,,,754.62,754.62,1
HCPCS,E1070RR,Wheelchair detachable foot r,,,75.46,217.38,4
HCPCS,E1070UE,Wheelchair detachable foot r,,,565.96,565.96,1
HCPCS,E1083,Hemi-wheelchair fixed arms,,,63.82,638.14,8
HCPCS,E10830,Hemi-wheelchair fixed arms,,,638.14,638.14,1
HCPCS,E1083MS,Hemi-wheelchair fixed arms,,,63.82,63.82,1
HCPCS,E1083NU,Hemi-wheelchair fixed arms,,,638.14,638.14,1
HCPCS,E1083RR,Hemi-wheelchair fixed arms,,,63.82,156.26,4
HCPCS,E1083UE,Hemi-wheelchair fixed arms,,,478.6,478.6,1
HCPCS,E1084,Hemi-wheelchair detachable a,,,79.51,795.07,8
HCPCS,E10840,Hemi-wheelchair detachable a,,,795.07,795.07,1
HCPCS,E1084MS,Hemi-wheelchair detachable a,,,79.51,79.51,1
HCPCS,E1084NU,Hemi-wheelchair detachable a,,,795.07,795.07,1
HCPCS,E1084RR,Hemi-wheelchair detachable a,,,79.51,194.67,4
HCPCS,E1084UE,Hemi-wheelchair detachable a,,,596.3,596.3,1
HCPCS,E1085,Hemi-wheelchair fixed arms,,,36.2,362.43,5
HCPCS,E10850,Hemi-wheelchair fixed arms,,,362.43,362.43,1
HCPCS,E1085MS,Hemi-wheelchair fixed arms,,,36.2,36.2,1
HCPCS,E1085NU,Hemi-wheelchair fixed arms,,,362.43,362.43,1
HCPCS,E1085RR,Hemi-wheelchair fixed arms,,,36.2,36.2,1
HCPCS,E1085UE,Hemi-wheelchair fixed arms,,,260.29,260.29,1
HCPCS,E1086,Hemi-wheelchair detachable a,,,40.17,441.49,5
HCPCS,E10860,Hemi-wheelchair detachable a,,,441.49,441.49,1
HCPCS,E1086MS,Hemi-wheelchair detachable a,,,40.17,40.17,1
HCPCS,E1086NU,Hemi-wheelchair detachable a,,,441.49,441.49,1
HCPCS,E1086RR,Hemi-wheelchair detachable a,,,40.17,40.17,1
HCPCS,E1086UE,Hemi-wheelchair detachable a,,,320.63,320.63,1
HCPCS,E1087,Wheelchair lightwt fixed arm,,,99.75,997.44,8
HCPCS,E10870,Wheelchair lightwt fixed arm,,,997.44,997.44,1
HCPCS,E1087MS,Wheelchair lightwt fixed arm,,,99.75,99.75,1
HCPCS,E1087NU,Wheelchair lightwt fixed arm,,,997.44,997.44,1
HCPCS,E1087RR,Wheelchair lightwt fixed arm,,,99.75,251.1,4
HCPCS,E1087UE,Wheelchair lightwt fixed arm,,,748.08,748.08,1
HCPCS,E1088,Wheelchair lightweight det a,,,109.22,1092.25,8
HCPCS,E10880,Wheelchair lightweight det a,,,1092.25,1092.25,1
HCPCS,E1088MS,Wheelchair lightweight det a,,,109.22,109.22,1
HCPCS,E1088NU,Wheelchair lightweight det a,,,1092.25,1092.25,1
HCPCS,E1088RR,Wheelchair lightweight det a,,,109.22,299.21,4
HCPCS,E1088UE,Wheelchair lightweight det a,,,819.19,819.19,1
HCPCS,E1089,Wheelchair lightwt fixed arm,,,58.55,585.96,5
HCPCS,E10890,Wheelchair lightwt fixed arm,,,585.96,585.96,1
HCPCS,E1089MS,Wheelchair lightwt fixed arm,,,58.55,58.55,1
HCPCS,E1089NU,Wheelchair lightwt fixed arm,,,585.96,585.96,1
HCPCS,E1089RR,Wheelchair lightwt fixed arm,,,58.55,58.55,1
HCPCS,E1089UE,Wheelchair lightwt fixed arm,,,439.52,439.52,1
HCPCS,E1090,Wheelchair lightweight det a,,,58.55,604.15,5
HCPCS,E10900,Wheelchair lightweight det a,,,604.15,604.15,1
HCPCS,E1090MS,Wheelchair lightweight det a,,,58.55,58.55,1
HCPCS,E1090NU,Wheelchair lightweight det a,,,604.15,604.15,1
HCPCS,E1090RR,Wheelchair lightweight det a,,,58.55,58.55,1
HCPCS,E1090UE,Wheelchair lightweight det a,,,441.49,441.49,1
HCPCS,E1092,Wheelchair wide w/ leg rests,,,90.68,906.8,8
HCPCS,E10920,Wheelchair wide w/ leg rests,,,906.8,906.8,1
HCPCS,E1092MS,Wheelchair wide w/ leg rests,,,90.68,90.68,1
HCPCS,E1092NU,Wheelchair wide w/ leg rests,,,906.8,906.8,1
HCPCS,E1092RR,Wheelchair wide w/ leg rests,,,90.68,255.04,4
HCPCS,E1092UE,Wheelchair wide w/ leg rests,,,680.1,680.1,1
HCPCS,E1093,Wheelchair wide w/ foot rest,,,80.7,806.95,8
HCPCS,E10930,Wheelchair wide w/ foot rest,,,806.95,806.95,1
HCPCS,E1093MS,Wheelchair wide w/ foot rest,,,80.7,80.7,1
HCPCS,E1093NU,Wheelchair wide w/ foot rest,,,806.95,806.95,1
HCPCS,E1093RR,Wheelchair wide w/ foot rest,,,80.7,219.34,4
HCPCS,E1093UE,Wheelchair wide w/ foot rest,,,605.21,605.21,1
HCPCS,E1100,Whchr s-recl fxd arm leg res,,,71.51,715.12,8
HCPCS,E11000,Whchr s-recl fxd arm leg res,,,715.12,715.12,1
HCPCS,E1100MS,Whchr s-recl fxd arm leg res,,,71.51,71.51,1
HCPCS,E1100NU,Whchr s-recl fxd arm leg res,,,715.12,715.12,1
HCPCS,E1100RR,Whchr s-recl fxd arm leg res,,,71.51,206.0,4
HCPCS,E1100UE,Whchr s-recl fxd arm leg res,,,536.34,536.34,1
HCPCS,E1110,Wheelchair semi-recl detach,,,72.64,726.41,8
HCPCS,E11100,Wheelchair semi-recl detach,,,726.41,726.41,1
HCPCS,E1110MS,Wheelchair semi-recl detach,,,72.64,72.64,1
HCPCS,E1110NU,Wheelchair semi-recl detach,,,726.41,726.41,1
HCPCS,E1110RR,Wheelchair semi-recl detach,,,72.64,201.72,4
HCPCS,E1110UE,Wheelchair semi-recl detach,,,544.81,544.81,1
HCPCS,E1130,Whlchr stand fxd arm ft rest,,,23.24,232.37,5
HCPCS,E11300,Whlchr stand fxd arm ft rest,,,232.37,232.37,1
HCPCS,E1130MS,Whlchr stand fxd arm ft rest,,,23.24,23.24,1
HCPCS,E1130NU,Whlchr stand fxd arm ft rest,,,232.37,232.37,1
HCPCS,E1130RR,Whlchr stand fxd arm ft rest,,,23.24,23.24,1
HCPCS,E1130UE,Whlchr stand fxd arm ft rest,,,176.53,176.53,1
HCPCS,E1140,Wheelchair standard detach a,,,33.5,334.68,5
HCPCS,E11400,Wheelchair standard detach a,,,334.68,334.68,1
HCPCS,E1140MS,Wheelchair standard detach a,,,33.5,33.5,1
HCPCS,E1140NU,Wheelchair standard detach a,,,334.68,334.68,1
HCPCS,E1140RR,Wheelchair standard detach a,,,33.5,33.5,1
HCPCS,E1140UE,Wheelchair standard detach a,,,237.05,237.05,1
HCPCS,E1150,Wheelchair standard w/ leg r,,,66.12,661.12,8
HCPCS,E11500,Wheelchair standard w/ leg r,,,661.12,661.12,1
HCPCS,E1150MS,Wheelchair standard w/ leg r,,,66.12,66.12,1
HCPCS,E1150NU,Wheelchair standard w/ leg r,,,661.12,661.12,1
HCPCS,E1150RR,Wheelchair standard w/ leg r,,,66.12,162.09,4
HCPCS,E1150UE,Wheelchair standard w/ leg r,,,495.84,495.84,1
HCPCS,E1160,Wheelchair fixed arms,,,50.66,506.63,8
HCPCS,E11600,Wheelchair fixed arms,,,506.63,506.63,1
HCPCS,E1160MS,Wheelchair fixed arms,,,50.66,50.66,1
HCPCS,E1160NU,Wheelchair fixed arms,,,506.63,506.63,1
HCPCS,E1160RR,Wheelchair fixed arms,,,50.66,125.06,4
HCPCS,E1160UE,Wheelchair fixed arms,,,379.97,379.97,1
HCPCS,E1161,Manual adult wc w tiltinspac,,,191.76,1917.62,8
HCPCS,E11610,Manual adult wc w tiltinspac,,,1917.62,1917.62,1
HCPCS,E1161MS,Manual adult wc w tiltinspac,,,191.76,191.76,1
HCPCS,E1161NU,Manual adult wc w tiltinspac,,,1917.62,1917.62,1
HCPCS,E1161RR,Manual adult wc w tiltinspac,,,191.76,552.4,4
HCPCS,E1161UE,Manual adult wc w tiltinspac,,,1438.2,1438.2,1
HCPCS,E1170,Whlchr ampu fxd arm leg rest,,,61.54,615.38,8
HCPCS,E11700,Whlchr ampu fxd arm leg rest,,,615.38,615.38,1
HCPCS,E1170MS,Whlchr ampu fxd arm leg rest,,,61.54,61.54,1
HCPCS,E1170NU,Whlchr ampu fxd arm leg rest,,,615.38,615.38,1
HCPCS,E1170RR,Whlchr ampu fxd arm leg rest,,,61.54,177.28,4
HCPCS,E1170UE,Whlchr ampu fxd arm leg rest,,,461.54,461.54,1
HCPCS,E1171,Wheelchair amputee w/o leg r,,,55.22,552.18,8
HCPCS,E11710,Wheelchair amputee w/o leg r,,,552.18,552.18,1
HCPCS,E1171MS,Wheelchair amputee w/o leg r,,,55.22,55.22,1
HCPCS,E1171NU,Wheelchair amputee w/o leg r,,,552.18,552.18,1
HCPCS,E1171RR,Wheelchair amputee w/o leg r,,,55.22,159.05,4
HCPCS,E1171UE,Wheelchair amputee w/o leg r,,,414.14,414.14,1
HCPCS,E1172,Wheelchair amputee detach ar,,,67.5,675.02,8
HCPCS,E11720,Wheelchair amputee detach ar,,,675.02,675.02,1
HCPCS,E1172MS,Wheelchair amputee detach ar,,,67.5,67.5,1
HCPCS,E1172NU,Wheelchair amputee detach ar,,,675.02,675.02,1
HCPCS,E1172RR,Wheelchair amputee detach ar,,,67.5,194.45,4
HCPCS,E1172UE,Wheelchair amputee detach ar,,,506.27,506.27,1
HCPCS,E1180,Wheelchair amputee w/ foot r,,,72.5,724.98,8
HCPCS,E11800,Wheelchair amputee w/ foot r,,,724.98,724.98,1
HCPCS,E1180MS,Wheelchair amputee w/ foot r,,,72.5,72.5,1
HCPCS,E1180NU,Wheelchair amputee w/ foot r,,,724.98,724.98,1
HCPCS,E1180RR,Wheelchair amputee w/ foot r,,,72.5,201.1,4
HCPCS,E1180UE,Wheelchair amputee w/ foot r,,,543.74,543.74,1
HCPCS,E1190,Wheelchair amputee w/ leg re,,,83.38,833.8,8
HCPCS,E11900,Wheelchair amputee w/ leg re,,,833.8,833.8,1
HCPCS,E1190MS,Wheelchair amputee w/ leg re,,,83.38,83.38,1
HCPCS,E1190NU,Wheelchair amputee w/ leg re,,,833.8,833.8,1
HCPCS,E1190RR,Wheelchair amputee w/ leg re,,,83.38,232.32,4
HCPCS,E1190UE,Wheelchair amputee w/ leg re,,,625.35,625.35,1
HCPCS,E1195,Wheelchair amputee heavy dut,,,86.54,865.4,8
HCPCS,E11950,Wheelchair amputee heavy dut,,,865.4,865.4,1
HCPCS,E1195MS,Wheelchair amputee heavy dut,,,86.54,86.54,1
HCPCS,E1195NU,Wheelchair amputee heavy dut,,,865.4,865.4,1
HCPCS,E1195RR,Wheelchair amputee heavy dut,,,86.54,249.28,4
HCPCS,E1195UE,Wheelchair amputee heavy dut,,,649.05,649.05,1
HCPCS,E1200,Wheelchair amputee fixed arm,,,59.94,599.41,8
HCPCS,E12000,Wheelchair amputee fixed arm,,,599.41,599.41,1
HCPCS,E1200MS,Wheelchair amputee fixed arm,,,59.94,59.94,1
HCPCS,E1200NU,Wheelchair amputee fixed arm,,,599.41,599.41,1
HCPCS,E1200RR,Wheelchair amputee fixed arm,,,59.94,172.66,4
HCPCS,E1200UE,Wheelchair amputee fixed arm,,,449.55,449.55,1
HCPCS,E1220,Whlchr special size/constrc,,,635.87,6358.74,5
HCPCS,E12200,Whlchr special size/constrc,,,6358.74,6358.74,1
HCPCS,E1220MS,Whlchr special size/constrc,,,635.87,635.87,1
HCPCS,E1220NU,Whlchr special size/constrc,,,6358.74,6358.74,1
HCPCS,E1220RR,Whlchr special size/constrc,,,635.87,635.87,1
HCPCS,E1220UE,Whlchr special size/constrc,,,4769.05,4769.05,1
HCPCS,E1221,Wheelchair spec size w foot,,,38.51,385.1,8
HCPCS,E12210,Wheelchair spec size w foot,,,385.1,385.1,1
HCPCS,E1221MS,Wheelchair spec size w foot,,,38.51,38.51,1
HCPCS,E1221NU,Wheelchair spec size w foot,,,385.1,385.1,1
HCPCS,E1221RR,Wheelchair spec size w foot,,,38.51,94.29,4
HCPCS,E1221UE,Wheelchair spec size w foot,,,288.81,288.81,1
HCPCS,E1222,Wheelchair spec size w/ leg,,,51.58,515.78,8
HCPCS,E12220,Wheelchair spec size w/ leg,,,515.78,515.78,1
HCPCS,E1222MS,Wheelchair spec size w/ leg,,,51.58,51.58,1
HCPCS,E1222NU,Wheelchair spec size w/ leg,,,515.78,515.78,1
HCPCS,E1222RR,Wheelchair spec size w/ leg,,,51.58,134.5,4
HCPCS,E1222UE,Wheelchair spec size w/ leg,,,386.82,386.82,1
HCPCS,E1223,Wheelchair spec size w foot,,,59.98,599.89,8
HCPCS,E12230,Wheelchair spec size w foot,,,599.89,599.89,1
HCPCS,E1223MS,Wheelchair spec size w foot,,,59.98,59.98,1
HCPCS,E1223NU,Wheelchair spec size w foot,,,599.89,599.89,1
HCPCS,E1223RR,Wheelchair spec size w foot,,,59.98,146.88,4
HCPCS,E1223UE,Wheelchair spec size w foot,,,449.91,449.91,1
HCPCS,E1224,Wheelchair spec size w/ leg,,,65.77,657.74,8
HCPCS,E12240,Wheelchair spec size w/ leg,,,657.74,657.74,1
HCPCS,E1224MS,Wheelchair spec size w/ leg,,,65.77,65.77,1
HCPCS,E1224NU,Wheelchair spec size w/ leg,,,657.74,657.74,1
HCPCS,E1224RR,Wheelchair spec size w/ leg,,,65.77,161.05,4
HCPCS,E1224UE,Wheelchair spec size w/ leg,,,493.3,493.3,1
HCPCS,E1225,Manual semi-reclining back,,,27.75,277.46,8
HCPCS,E12250,Manual semi-reclining back,,,277.46,277.46,1
HCPCS,E1225MS,Manual semi-reclining back,,,27.75,27.75,1
HCPCS,E1225NU,Manual semi-reclining back,,,277.46,277.46,1
HCPCS,E1225RR,Manual semi-reclining back,,,27.75,76.16,4
HCPCS,E1225UE,Manual semi-reclining back,,,208.09,208.09,1
HCPCS,E1226,Manual fully reclining back,,,25.93,259.28,5
HCPCS,E12260,Manual fully reclining back,,,259.28,259.28,1
HCPCS,E1226MS,Manual fully reclining back,,,25.93,25.93,1
HCPCS,E1226NU,Manual fully reclining back,,,259.28,259.28,1
HCPCS,E1226RR,Manual fully reclining back,,,25.93,25.93,1
HCPCS,E1226UE,Manual fully reclining back,,,194.45,194.45,1
HCPCS,E1227,Wheelchair spec sz spec ht a,,,19.12,647.9,14
HCPCS,E12270,Wheelchair spec sz spec ht a,,,191.17,191.17,1
HCPCS,E1227MS,Wheelchair spec sz spec ht a,,,19.12,19.12,1
HCPCS,E1227NU,Wheelchair spec sz spec ht a,,,191.17,647.9,4
HCPCS,E1227RR,Wheelchair spec sz spec ht a,,,19.12,64.8,4
HCPCS,E1227UE,Wheelchair spec sz spec ht a,,,143.4,485.99,4
HCPCS,E1228,Wheelchair spec sz spec ht b,,,22.71,227.15,8
HCPCS,E12280,Wheelchair spec sz spec ht b,,,227.15,227.15,1
HCPCS,E1228MS,Wheelchair spec sz spec ht b,,,22.71,22.71,1
HCPCS,E1228NU,Wheelchair spec sz spec ht b,,,227.15,227.15,1
HCPCS,E1228RR,Wheelchair spec sz spec ht b,,,22.71,55.63,4
HCPCS,E1228UE,Wheelchair spec sz spec ht b,,,170.36,170.36,1
HCPCS,E1229,Pediatric wheelchair nos,,,68.04,682.56,5
HCPCS,E12290,Pediatric wheelchair nos,,,682.56,682.56,1
HCPCS,E1229MS,Pediatric wheelchair nos,,,68.04,68.04,1
HCPCS,E1229NU,Pediatric wheelchair nos,,,682.56,682.56,1
HCPCS,E1229RR,Pediatric wheelchair nos,,,68.04,68.04,1
HCPCS,E1229UE,Pediatric wheelchair nos,,,511.92,511.92,1
HCPCS,E1230,Power operated vehicle,,,180.3,4488.57,14
HCPCS,E12300,Power operated vehicle,,,1795.32,1795.32,1
HCPCS,E1230MS,Power operated vehicle,,,180.3,180.3,1
HCPCS,E1230NU,Power operated vehicle,,,1795.32,4488.57,4
HCPCS,E1230RR,Power operated vehicle,,,180.3,446.76,4
HCPCS,E1230UE,Power operated vehicle,,,1319.63,3549.92,4
HCPCS,E1231,Rigid ped w/c tilt-in-space,,,275.4,2754.0,5
HCPCS,E12310,Rigid ped w/c tilt-in-space,,,2754.0,2754.0,1
HCPCS,E1231MS,Rigid ped w/c tilt-in-space,,,275.4,275.4,1
HCPCS,E1231NU,Rigid ped w/c tilt-in-space,,,2754.0,2754.0,1
HCPCS,E1231RR,Rigid ped w/c tilt-in-space,,,275.4,275.4,1
HCPCS,E1231UE,Rigid ped w/c tilt-in-space,,,2065.5,2065.5,1
HCPCS,E1232,Folding ped wc tilt-in-space,,,173.33,1733.29,8
HCPCS,E12320,Folding ped wc tilt-in-space,,,1733.29,1733.29,1
HCPCS,E1232MS,Folding ped wc tilt-in-space,,,173.33,173.33,1
HCPCS,E1232NU,Folding ped wc tilt-in-space,,,1733.29,1733.29,1
HCPCS,E1232RR,Folding ped wc tilt-in-space,,,173.33,499.29,4
HCPCS,E1232UE,Folding ped wc tilt-in-space,,,1299.97,1299.97,1
HCPCS,E1233,Rig ped wc tltnspc w/o seat,,,179.57,1795.73,8
HCPCS,E12330,Rig ped wc tltnspc w/o seat,,,1795.73,1795.73,1
HCPCS,E1233MS,Rig ped wc tltnspc w/o seat,,,179.57,179.57,1
HCPCS,E1233NU,Rig ped wc tltnspc w/o seat,,,1795.73,1795.73,1
HCPCS,E1233RR,Rig ped wc tltnspc w/o seat,,,179.57,517.29,4
HCPCS,E1233UE,Rig ped wc tltnspc w/o seat,,,1346.79,1346.79,1
HCPCS,E1234,Fld ped wc tltnspc w/o seat,,,156.34,1563.41,8
HCPCS,E12340,Fld ped wc tltnspc w/o seat,,,1563.41,1563.41,1
HCPCS,E1234MS,Fld ped wc tltnspc w/o seat,,,156.34,156.34,1
HCPCS,E1234NU,Fld ped wc tltnspc w/o seat,,,1563.41,1563.41,1
HCPCS,E1234RR,Fld ped wc tltnspc w/o seat,,,156.34,450.37,4
HCPCS,E1234UE,Fld ped wc tltnspc w/o seat,,,1172.56,1172.56,1
HCPCS,E1235,Rigid ped wc adjustable,,,150.55,1505.5,8
HCPCS,E12350,Rigid ped wc adjustable,,,1505.5,1505.5,1
HCPCS,E1235MS,Rigid ped wc adjustable,,,150.55,150.55,1
HCPCS,E1235NU,Rigid ped wc adjustable,,,1505.5,1505.5,1
HCPCS,E1235RR,Rigid ped wc adjustable,,,150.55,433.67,4
HCPCS,E1235UE,Rigid ped wc adjustable,,,1129.12,1129.12,1
HCPCS,E1236,Folding ped wc adjustable,,,132.82,1328.18,8
HCPCS,E12360,Folding ped wc adjustable,,,1328.18,1328.18,1
HCPCS,E1236MS,Folding ped wc adjustable,,,132.82,132.82,1
HCPCS,E1236NU,Folding ped wc adjustable,,,1328.18,1328.18,1
HCPCS,E1236RR,Folding ped wc adjustable,,,132.82,382.61,4
HCPCS,E1236UE,Folding ped wc adjustable,,,996.14,996.14,1
HCPCS,E1237,Rgd ped wc adjstabl w/o seat,,,133.97,1339.71,8
HCPCS,E12370,Rgd ped wc adjstabl w/o seat,,,1339.71,1339.71,1
HCPCS,E1237MS,Rgd ped wc adjstabl w/o seat,,,133.97,133.97,1
HCPCS,E1237NU,Rgd ped wc adjstabl w/o seat,,,1339.71,1339.71,1
HCPCS,E1237RR,Rgd ped wc adjstabl w/o seat,,,133.97,385.92,4
HCPCS,E1237UE,Rgd ped wc adjstabl w/o seat,,,1004.78,1004.78,1
HCPCS,E1238,Fld ped wc adjstabl w/o seat,,,132.82,1328.18,8
HCPCS,E12380,Fld ped wc adjstabl w/o seat,,,1328.18,1328.18,1
HCPCS,E1238MS,Fld ped wc adjstabl w/o seat,,,132.82,132.82,1
HCPCS,E1238NU,Fld ped wc adjstabl w/o seat,,,1328.18,1328.18,1
HCPCS,E1238RR,Fld ped wc adjstabl w/o seat,,,132.82,382.61,4
HCPCS,E1238UE,Fld ped wc adjstabl w/o seat,,,996.14,996.14,1
HCPCS,E1239,Ped power wheelchair nos,,,175.98,1759.76,5
HCPCS,E12390,Ped power wheelchair nos,,,1759.76,1759.76,1
HCPCS,E1239MS,Ped power wheelchair nos,,,175.98,175.98,1
HCPCS,E1239NU,Ped power wheelchair nos,,,1759.76,1759.76,1
HCPCS,E1239RR,Ped power wheelchair nos,,,175.98,175.98,1
HCPCS,E1239UE,Ped power wheelchair nos,,,1319.82,1319.82,1
HCPCS,E1240,Whchr litwt det arm leg rest,,,83.51,835.05,8
HCPCS,E12400,Whchr litwt det arm leg rest,,,835.05,835.05,1
HCPCS,E1240MS,Whchr litwt det arm leg rest,,,83.51,83.51,1
HCPCS,E1240NU,Whchr litwt det arm leg rest,,,835.05,835.05,1
HCPCS,E1240RR,Whchr litwt det arm leg rest,,,83.51,204.46,4
HCPCS,E1240UE,Whchr litwt det arm leg rest,,,626.28,626.28,1
HCPCS,E1250,Wheelchair lightwt fixed arm,,,32.61,357.92,5
HCPCS,E12500,Wheelchair lightwt fixed arm,,,357.92,357.92,1
HCPCS,E1250MS,Wheelchair lightwt fixed arm,,,32.61,32.61,1
HCPCS,E1250NU,Wheelchair lightwt fixed arm,,,357.92,357.92,1
HCPCS,E1250RR,Wheelchair lightwt fixed arm,,,32.61,32.61,1
HCPCS,E1250UE,Wheelchair lightwt fixed arm,,,283.52,283.52,1
HCPCS,E1260,Wheelchair lightwt foot rest,,,41.79,418.26,5
HCPCS,E12600,Wheelchair lightwt foot rest,,,418.26,418.26,1
HCPCS,E1260MS,Wheelchair lightwt foot rest,,,41.79,41.79,1
HCPCS,E1260NU,Wheelchair lightwt foot rest,,,418.26,418.26,1
HCPCS,E1260RR,Wheelchair lightwt foot rest,,,41.79,41.79,1
HCPCS,E1260UE,Wheelchair lightwt foot rest,,,329.99,329.99,1
HCPCS,E1270,Wheelchair lightweight leg r,,,63.98,639.8,8
HCPCS,E12700,Wheelchair lightweight leg r,,,639.8,639.8,1
HCPCS,E1270MS,Wheelchair lightweight leg r,,,63.98,63.98,1
HCPCS,E1270NU,Wheelchair lightweight leg r,,,639.8,639.8,1
HCPCS,E1270RR,Wheelchair lightweight leg r,,,63.98,156.67,4
HCPCS,E1270UE,Wheelchair lightweight leg r,,,479.84,479.84,1
HCPCS,E1280,Whchr h-duty det arm leg res,,,97.34,973.39,8
HCPCS,E12800,Whchr h-duty det arm leg res,,,973.39,973.39,1
HCPCS,E1280MS,Whchr h-duty det arm leg res,,,97.34,97.34,1
HCPCS,E1280NU,Whchr h-duty det arm leg res,,,973.39,973.39,1
HCPCS,E1280RR,Whchr h-duty det arm leg res,,,97.34,260.48,4
HCPCS,E1280UE,Whchr h-duty det arm leg res,,,730.04,730.04,1
HCPCS,E1285,Wheelchair heavy duty fixed,,,53.86,539.13,5
HCPCS,E12850,Wheelchair heavy duty fixed,,,539.13,539.13,1
HCPCS,E1285MS,Wheelchair heavy duty fixed,,,53.86,53.86,1
HCPCS,E1285NU,Wheelchair heavy duty fixed,,,539.13,539.13,1
HCPCS,E1285RR,Wheelchair heavy duty fixed,,,53.86,53.86,1
HCPCS,E1285UE,Wheelchair heavy duty fixed,,,395.02,395.02,1
HCPCS,E1290,Wheelchair hvy duty detach a,,,55.84,557.68,5
HCPCS,E12900,Wheelchair hvy duty detach a,,,557.68,557.68,1
HCPCS,E1290MS,Wheelchair hvy duty detach a,,,55.84,55.84,1
HCPCS,E1290NU,Wheelchair hvy duty detach a,,,557.68,557.68,1
HCPCS,E1290RR,Wheelchair hvy duty detach a,,,55.84,55.84,1
HCPCS,E1290UE,Wheelchair hvy duty detach a,,,406.74,406.74,1
HCPCS,E1295,Wheelchair heavy duty fixed,,,91.05,910.55,8
HCPCS,E12950,Wheelchair heavy duty fixed,,,910.55,910.55,1
HCPCS,E1295MS,Wheelchair heavy duty fixed,,,91.05,91.05,1
HCPCS,E1295NU,Wheelchair heavy duty fixed,,,910.55,910.55,1
HCPCS,E1295RR,Wheelchair heavy duty fixed,,,91.05,241.04,4
HCPCS,E1295UE,Wheelchair heavy duty fixed,,,682.91,682.91,1
HCPCS,E1296,Wheelchair special seat heig,,,34.42,1147.86,14
HCPCS,E12960,Wheelchair special seat heig,,,338.71,338.71,1
HCPCS,E1296MS,Wheelchair special seat heig,,,34.42,34.42,1
HCPCS,E1296NU,Wheelchair special seat heig,,,338.71,1147.86,4
HCPCS,E1296RR,Wheelchair special seat heig,,,34.42,116.65,4
HCPCS,E1296UE,Wheelchair special seat heig,,,254.04,860.93,4
HCPCS,E1297,Wheelchair special seat dept,,,8.0,244.23,14
HCPCS,E12970,Wheelchair special seat dept,,,72.07,72.07,1
HCPCS,E1297MS,Wheelchair special seat dept,,,8.0,8.0,1
HCPCS,E1297NU,Wheelchair special seat dept,,,72.07,244.23,4
HCPCS,E1297RR,Wheelchair special seat dept,,,8.0,27.14,4
HCPCS,E1297UE,Wheelchair special seat dept,,,54.04,183.14,4
HCPCS,E1298,Wheelchair spec seat depth/w,,,29.86,877.79,14
HCPCS,E12980,Wheelchair spec seat depth/w,,,291.86,291.86,1
HCPCS,E1298MS,Wheelchair spec seat depth/w,,,29.86,29.86,1
HCPCS,E1298NU,Wheelchair spec seat depth/w,,,291.86,877.79,4
HCPCS,E1298RR,Wheelchair spec seat depth/w,,,29.86,87.78,4
HCPCS,E1298UE,Wheelchair spec seat depth/w,,,218.89,658.34,4
HCPCS,E1300,Whirlpool portable,,,43.52,435.24,5
HCPCS,E13000,Whirlpool portable,,,435.24,435.24,1
HCPCS,E1300MS,Whirlpool portable,,,43.52,43.52,1
HCPCS,E1300NU,Whirlpool portable,,,435.24,435.24,1
HCPCS,E1300RR,Whirlpool portable,,,43.52,43.52,1
HCPCS,E1300UE,Whirlpool portable,,,326.43,326.43,1
HCPCS,E1310,Whirlpool non-portable,,,133.88,4261.55,14
HCPCS,E13100,Whirlpool non-portable,,,1479.37,1479.37,1
HCPCS,E1310MS,Whirlpool non-portable,,,133.88,133.88,1
HCPCS,E1310NU,Whirlpool non-portable,,,1479.37,4261.55,4
HCPCS,E1310RR,Whirlpool non-portable,,,133.88,364.46,4
HCPCS,E1310UE,Whirlpool non-portable,,,1109.52,3196.14,4
HCPCS,E1352,O2 flow reg pos inspir press,,,36.44,36.44,1
HCPCS,E13520,O2 flow reg pos inspir press,,,36.44,36.44,1
HCPCS,E1353,Oxygen supplies regulator,,,2.3,66.12,8
HCPCS,E13530,Oxygen supplies regulator,,,22.95,22.95,1
HCPCS,E1353MS,Oxygen supplies regulator,,,2.3,2.3,1
HCPCS,E1353NU,Oxygen supplies regulator,,,22.95,22.95,1
HCPCS,E1353RR,Oxygen supplies regulator,,,2.3,2.3,1
HCPCS,E1353UE,Oxygen supplies regulator,,,17.22,17.22,1
HCPCS,E1354,"Wheeled cart, port cyl/conc",,,1.46,14.57,5
HCPCS,E13540,"Wheeled cart, port cyl/conc",,,14.57,14.57,1
HCPCS,E1354MS,"Wheeled cart, port cyl/conc",,,1.46,1.46,1
HCPCS,E1354NU,"Wheeled cart, port cyl/conc",,,14.57,14.57,1
HCPCS,E1354RR,"Wheeled cart, port cyl/conc",,,1.46,1.46,1
HCPCS,E1354UE,"Wheeled cart, port cyl/conc",,,10.93,10.93,1
HCPCS,E1355,Oxygen supplies stand/rack,,,1.73,49.83,8
HCPCS,E13550,Oxygen supplies stand/rack,,,17.3,17.3,1
HCPCS,E1355MS,Oxygen supplies stand/rack,,,1.73,1.73,1
HCPCS,E1355NU,Oxygen supplies stand/rack,,,17.3,17.3,1
HCPCS,E1355RR,Oxygen supplies stand/rack,,,1.73,1.73,1
HCPCS,E1355UE,Oxygen supplies stand/rack,,,12.98,12.98,1
HCPCS,E1356,"Batt pack/cart, port conc",,,36.91,369.1,5
HCPCS,E13560,"Batt pack/cart, port conc",,,369.1,369.1,1
HCPCS,E1356MS,"Batt pack/cart, port conc",,,36.91,36.91,1
HCPCS,E1356NU,"Batt pack/cart, port conc",,,369.1,369.1,1
HCPCS,E1356RR,"Batt pack/cart, port conc",,,36.91,36.91,1
HCPCS,E1356UE,"Batt pack/cart, port conc",,,276.83,276.83,1
HCPCS,E1357,"Battery charger, port conc",,,0.31,3.11,5
HCPCS,E13570,"Battery charger, port conc",,,3.11,3.11,1
HCPCS,E1357MS,"Battery charger, port conc",,,0.31,0.31,1
HCPCS,E1357NU,"Battery charger, port conc",,,3.11,3.11,1
HCPCS,E1357RR,"Battery charger, port conc",,,0.31,0.31,1
HCPCS,E1357UE,"Battery charger, port conc",,,2.33,2.33,1
HCPCS,E1358,"Dc power adapter, port conc",,,2.16,2.16,1
HCPCS,E13580,"Dc power adapter, port conc",,,2.16,2.16,1
HCPCS,E1372,Oxy suppl heater for nebuliz,,,9.49,265.27,14
HCPCS,E13720,Oxy suppl heater for nebuliz,,,94.89,94.89,1
HCPCS,E1372MS,Oxy suppl heater for nebuliz,,,9.49,9.49,1
HCPCS,E1372NU,Oxy suppl heater for nebuliz,,,94.89,265.27,4
HCPCS,E1372RR,Oxy suppl heater for nebuliz,,,9.49,26.54,4
HCPCS,E1372UE,Oxy suppl heater for nebuliz,,,71.17,198.97,4
HCPCS,E1390,Oxygen concentrator,,,55.77,557.71,8
HCPCS,E13900,Oxygen concentrator,,,557.71,557.71,1
HCPCS,E1390MS,Oxygen concentrator,,,55.77,55.77,1
HCPCS,E1390NU,Oxygen concentrator,,,557.71,557.71,1
HCPCS,E1390RR,Oxygen concentrator,,,55.77,163.04,4
HCPCS,E1390UE,Oxygen concentrator,,,418.28,418.28,1
HCPCS,E1391,"Oxygen concentrator, dual",,,55.77,557.71,8
HCPCS,E13910,"Oxygen concentrator, dual",,,557.71,557.71,1
HCPCS,E1391MS,"Oxygen concentrator, dual",,,55.77,55.77,1
HCPCS,E1391NU,"Oxygen concentrator, dual",,,557.71,557.71,1
HCPCS,E1391RR,"Oxygen concentrator, dual",,,55.77,163.04,4
HCPCS,E1391UE,"Oxygen concentrator, dual",,,418.28,418.28,1
HCPCS,E1392,Portable oxygen concentrator,,,25.98,259.88,8
HCPCS,E13920,Portable oxygen concentrator,,,259.88,259.88,1
HCPCS,E1392MS,Portable oxygen concentrator,,,25.98,25.98,1
HCPCS,E1392NU,Portable oxygen concentrator,,,259.88,259.88,1
HCPCS,E1392RR,Portable oxygen concentrator,,,25.98,78.0,4
HCPCS,E1392UE,Portable oxygen concentrator,,,194.91,194.91,1
HCPCS,E1399,TEST STIMULATION LEAD INTERSTIM,706.0,458.9,353.0,706.0,12
HCPCS,E1399,WALKER BRACE,297.0,193.05,148.5,297.0,12
HCPCS,E1405,O2/water vapor enrich w/heat,,,77.38,773.86,8
HCPCS,E14050,O2/water vapor enrich w/heat,,,773.86,773.86,1
HCPCS,E1405MS,O2/water vapor enrich w/heat,,,77.38,77.38,1
HCPCS,E1405NU,O2/water vapor enrich w/heat,,,773.86,773.86,1
HCPCS,E1405RR,O2/water vapor enrich w/heat,,,77.38,223.56,4
HCPCS,E1405UE,O2/water vapor enrich w/heat,,,580.4,580.4,1
HCPCS,E1406,O2/water vapor enrich w/o he,,,60.1,601.01,8
HCPCS,E14060,O2/water vapor enrich w/o he,,,601.01,601.01,1
HCPCS,E1406MS,O2/water vapor enrich w/o he,,,60.1,60.1,1
HCPCS,E1406NU,O2/water vapor enrich w/o he,,,601.01,601.01,1
HCPCS,E1406RR,O2/water vapor enrich w/o he,,,60.1,175.0,4
HCPCS,E1406UE,O2/water vapor enrich w/o he,,,450.76,450.76,1
HCPCS,E1500,Centrifuge,,,21.6,216.0,5
HCPCS,E15000,Centrifuge,,,216.0,216.0,1
HCPCS,E1500MS,Centrifuge,,,21.6,21.6,1
HCPCS,E1500NU,Centrifuge,,,216.0,216.0,1
HCPCS,E1500RR,Centrifuge,,,21.6,21.6,1
HCPCS,E1500UE,Centrifuge,,,162.0,162.0,1
HCPCS,E1510,Kidney dialysate delivry sys,,,106.95,1069.49,5
HCPCS,E15100,Kidney dialysate delivry sys,,,1069.49,1069.49,1
HCPCS,E1510MS,Kidney dialysate delivry sys,,,106.95,106.95,1
HCPCS,E1510NU,Kidney dialysate delivry sys,,,1069.49,1069.49,1
HCPCS,E1510RR,Kidney dialysate delivry sys,,,106.95,106.95,1
HCPCS,E1510UE,Kidney dialysate delivry sys,,,802.12,802.12,1
HCPCS,E1520,Heparin infusion pump,,,6.16,61.56,5
HCPCS,E15200,Heparin infusion pump,,,61.56,61.56,1
HCPCS,E1520MS,Heparin infusion pump,,,6.16,6.16,1
HCPCS,E1520NU,Heparin infusion pump,,,61.56,61.56,1
HCPCS,E1520RR,Heparin infusion pump,,,6.16,6.16,1
HCPCS,E1520UE,Heparin infusion pump,,,46.17,46.17,1
HCPCS,E1530,Replacement air bubble detec,,,8.96,89.64,5
HCPCS,E15300,Replacement air bubble detec,,,89.64,89.64,1
HCPCS,E1530MS,Replacement air bubble detec,,,8.96,8.96,1
HCPCS,E1530NU,Replacement air bubble detec,,,89.64,89.64,1
HCPCS,E1530RR,Replacement air bubble detec,,,8.96,8.96,1
HCPCS,E1530UE,Replacement air bubble detec,,,67.23,67.23,1
HCPCS,E1540,Replacement pressure alarm,,,5.51,55.08,5
HCPCS,E15400,Replacement pressure alarm,,,55.08,55.08,1
HCPCS,E1540MS,Replacement pressure alarm,,,5.51,5.51,1
HCPCS,E1540NU,Replacement pressure alarm,,,55.08,55.08,1
HCPCS,E1540RR,Replacement pressure alarm,,,5.51,5.51,1
HCPCS,E1540UE,Replacement pressure alarm,,,41.31,41.31,1
HCPCS,E1550,Bath conductivity meter,,,10.15,101.52,5
HCPCS,E15500,Bath conductivity meter,,,101.52,101.52,1
HCPCS,E1550MS,Bath conductivity meter,,,10.15,10.15,1
HCPCS,E1550NU,Bath conductivity meter,,,101.52,101.52,1
HCPCS,E1550RR,Bath conductivity meter,,,10.15,10.15,1
HCPCS,E1550UE,Bath conductivity meter,,,76.14,76.14,1
HCPCS,E1560,Replace blood leak detector,,,10.26,102.6,5
HCPCS,E15600,Replace blood leak detector,,,102.6,102.6,1
HCPCS,E1560MS,Replace blood leak detector,,,10.26,10.26,1
HCPCS,E1560NU,Replace blood leak detector,,,102.6,102.6,1
HCPCS,E1560RR,Replace blood leak detector,,,10.26,10.26,1
HCPCS,E1560UE,Replace blood leak detector,,,76.95,76.95,1
HCPCS,E1570,Adjustable chair for esrd pt,,,70.2,702.0,5
HCPCS,E15700,Adjustable chair for esrd pt,,,702.0,702.0,1
HCPCS,E1570MS,Adjustable chair for esrd pt,,,70.2,70.2,1
HCPCS,E1570NU,Adjustable chair for esrd pt,,,702.0,702.0,1
HCPCS,E1570RR,Adjustable chair for esrd pt,,,70.2,70.2,1
HCPCS,E1570UE,Adjustable chair for esrd pt,,,526.5,526.5,1
HCPCS,E1575,Transducer protect/fld bar,,,0.64,6.33,5
HCPCS,E15750,Transducer protect/fld bar,,,6.33,6.33,1
HCPCS,E1575MS,Transducer protect/fld bar,,,0.64,0.64,1
HCPCS,E1575NU,Transducer protect/fld bar,,,6.33,6.33,1
HCPCS,E1575RR,Transducer protect/fld bar,,,0.64,0.64,1
HCPCS,E1575UE,Transducer protect/fld bar,,,4.75,4.75,1
HCPCS,E1590,Hemodialysis machine,,,810.0,810.0,1
HCPCS,E15900,Hemodialysis machine,,,810.0,810.0,1
HCPCS,E1594,Cycler dialysis machine,,,950.62,9506.2,5
HCPCS,E15940,Cycler dialysis machine,,,9506.2,9506.2,1
HCPCS,E1594MS,Cycler dialysis machine,,,950.62,950.62,1
HCPCS,E1594NU,Cycler dialysis machine,,,9506.2,9506.2,1
HCPCS,E1594RR,Cycler dialysis machine,,,950.62,950.62,1
HCPCS,E1594UE,Cycler dialysis machine,,,7129.65,7129.65,1
HCPCS,E1600,Deli/install chrg hemo equip,,,36.27,362.62,5
HCPCS,E16000,Deli/install chrg hemo equip,,,362.62,362.62,1
HCPCS,E1600MS,Deli/install chrg hemo equip,,,36.27,36.27,1
HCPCS,E1600NU,Deli/install chrg hemo equip,,,362.62,362.62,1
HCPCS,E1600RR,Deli/install chrg hemo equip,,,36.27,36.27,1
HCPCS,E1600UE,Deli/install chrg hemo equip,,,271.97,271.97,1
HCPCS,E1610,Reverse osmosis h2o puri sys,,,356.49,3564.83,5
HCPCS,E16100,Reverse osmosis h2o puri sys,,,3564.83,3564.83,1
HCPCS,E1610MS,Reverse osmosis h2o puri sys,,,356.49,356.49,1
HCPCS,E1610NU,Reverse osmosis h2o puri sys,,,3564.83,3564.83,1
HCPCS,E1610RR,Reverse osmosis h2o puri sys,,,356.49,356.49,1
HCPCS,E1610UE,Reverse osmosis h2o puri sys,,,2673.63,2673.63,1
HCPCS,E1615,Deionizer h2o puri system,,,70.2,702.0,5
HCPCS,E16150,Deionizer h2o puri system,,,702.0,702.0,1
HCPCS,E1615MS,Deionizer h2o puri system,,,70.2,70.2,1
HCPCS,E1615NU,Deionizer h2o puri system,,,702.0,702.0,1
HCPCS,E1615RR,Deionizer h2o puri system,,,70.2,70.2,1
HCPCS,E1615UE,Deionizer h2o puri system,,,526.5,526.5,1
HCPCS,E1620,Replacement blood pump,,,10.48,104.76,5
HCPCS,E16200,Replacement blood pump,,,104.76,104.76,1
HCPCS,E1620MS,Replacement blood pump,,,10.48,10.48,1
HCPCS,E1620NU,Replacement blood pump,,,104.76,104.76,1
HCPCS,E1620RR,Replacement blood pump,,,10.48,10.48,1
HCPCS,E1620UE,Replacement blood pump,,,78.57,78.57,1
HCPCS,E1625,Water softening system,,,21.6,216.0,5
HCPCS,E16250,Water softening system,,,216.0,216.0,1
HCPCS,E1625MS,Water softening system,,,21.6,21.6,1
HCPCS,E1625NU,Water softening system,,,216.0,216.0,1
HCPCS,E1625RR,Water softening system,,,21.6,21.6,1
HCPCS,E1625UE,Water softening system,,,162.0,162.0,1
HCPCS,E1634,Peritoneal dialysis clamp,,,0.27,2.71,5
HCPCS,E16340,Peritoneal dialysis clamp,,,2.71,2.71,1
HCPCS,E1634MS,Peritoneal dialysis clamp,,,0.27,0.27,1
HCPCS,E1634NU,Peritoneal dialysis clamp,,,2.71,2.71,1
HCPCS,E1634RR,Peritoneal dialysis clamp,,,0.27,0.27,1
HCPCS,E1634UE,Peritoneal dialysis clamp,,,2.03,2.03,1
HCPCS,E1637,"Hemostats for dialysis, each",,,4.02,40.18,5
HCPCS,E16370,"Hemostats for dialysis, each",,,40.18,40.18,1
HCPCS,E1637MS,"Hemostats for dialysis, each",,,4.02,4.02,1
HCPCS,E1637NU,"Hemostats for dialysis, each",,,40.18,40.18,1
HCPCS,E1637RR,"Hemostats for dialysis, each",,,4.02,4.02,1
HCPCS,E1637UE,"Hemostats for dialysis, each",,,30.13,30.13,1
HCPCS,E1639,"Scale, each",,,2.17,21.75,5
HCPCS,E16390,"Scale, each",,,21.75,21.75,1
HCPCS,E1639MS,"Scale, each",,,2.17,2.17,1
HCPCS,E1639NU,"Scale, each",,,21.75,21.75,1
HCPCS,E1639RR,"Scale, each",,,2.17,2.17,1
HCPCS,E1639UE,"Scale, each",,,16.32,16.32,1
HCPCS,E1700,Jaw motion rehab system,,,23.76,237.6,8
HCPCS,E17000,Jaw motion rehab system,,,237.6,237.6,1
HCPCS,E1700MS,Jaw motion rehab system,,,23.76,23.76,1
HCPCS,E1700NU,Jaw motion rehab system,,,237.6,237.6,1
HCPCS,E1700RR,Jaw motion rehab system,,,23.76,80.53,4
HCPCS,E1700UE,Jaw motion rehab system,,,178.2,178.2,1
HCPCS,E1701,Repl cushions for jaw motion,,,0.86,23.51,7
HCPCS,E17010,Repl cushions for jaw motion,,,8.59,8.59,1
HCPCS,E1701MS,Repl cushions for jaw motion,,,0.86,0.86,1
HCPCS,E1701NU,Repl cushions for jaw motion,,,8.59,8.59,1
HCPCS,E1701RR,Repl cushions for jaw motion,,,0.86,0.86,1
HCPCS,E1702,Repl measr scales jaw motion,,,1.83,47.22,7
HCPCS,E17020,Repl measr scales jaw motion,,,18.28,18.28,1
HCPCS,E1702MS,Repl measr scales jaw motion,,,1.83,1.83,1
HCPCS,E1702NU,Repl measr scales jaw motion,,,18.28,18.28,1
HCPCS,E1702RR,Repl measr scales jaw motion,,,1.83,1.83,1
HCPCS,E1800,Adjust elbow ext & flex dev,,,99.28,992.88,8
HCPCS,E18000,Adjust elbow ext & flex dev,,,992.88,992.88,1
HCPCS,E1800MS,Adjust elbow ext & flex dev,,,99.28,99.28,1
HCPCS,E1800NU,Adjust elbow ext & flex dev,,,992.88,992.88,1
HCPCS,E1800RR,Adjust elbow ext & flex dev,,,99.28,243.11,4
HCPCS,E1800UE,Adjust elbow ext & flex dev,,,744.65,744.65,1
HCPCS,E1801,Sps/pass elbow device,,,104.57,1045.62,8
HCPCS,E18010,Sps/pass elbow device,,,1045.62,1045.62,1
HCPCS,E1801MS,Sps/pass elbow device,,,104.57,104.57,1
HCPCS,E1801NU,Sps/pass elbow device,,,1045.62,1045.62,1
HCPCS,E1801RR,Sps/pass elbow device,,,104.57,275.7,4
HCPCS,E1801UE,Sps/pass elbow device,,,784.21,784.21,1
HCPCS,E1802,Adjst forearm pro/sup device,,,264.88,2648.76,8
HCPCS,E18020,Adjst forearm pro/sup device,,,2648.76,2648.76,1
HCPCS,E1802MS,Adjst forearm pro/sup device,,,264.88,264.88,1
HCPCS,E1802NU,Adjst forearm pro/sup device,,,2648.76,2648.76,1
HCPCS,E1802RR,Adjst forearm pro/sup device,,,264.88,763.01,4
HCPCS,E1802UE,Adjst forearm pro/sup device,,,1986.57,1986.57,1
HCPCS,E1803,Adjust elbow extension dev,,,101.67,1016.69,8
HCPCS,E18030,Adjust elbow extension dev,,,1016.69,1016.69,1
HCPCS,E1803MS,Adjust elbow extension dev,,,101.67,101.67,1
HCPCS,E1803NU,Adjust elbow extension dev,,,1016.69,1016.69,1
HCPCS,E1803RR,Adjust elbow extension dev,,,101.67,243.11,4
HCPCS,E1803UE,Adjust elbow extension dev,,,762.52,762.52,1
HCPCS,E1804,Adjust elbow flexion dev,,,101.67,1016.69,8
HCPCS,E18040,Adjust elbow flexion dev,,,1016.69,1016.69,1
HCPCS,E1804MS,Adjust elbow flexion dev,,,101.67,101.67,1
HCPCS,E1804NU,Adjust elbow flexion dev,,,1016.69,1016.69,1
HCPCS,E1804RR,Adjust elbow flexion dev,,,101.67,243.11,4
HCPCS,E1804UE,Adjust elbow flexion dev,,,762.52,762.52,1
HCPCS,E1805,Adjust wrist ext & flex dev,,,102.41,1024.06,8
HCPCS,E18050,Adjust wrist ext & flex dev,,,1024.06,1024.06,1
HCPCS,E1805MS,Adjust wrist ext & flex dev,,,102.41,102.41,1
HCPCS,E1805NU,Adjust wrist ext & flex dev,,,1024.06,1024.06,1
HCPCS,E1805RR,Adjust wrist ext & flex dev,,,102.41,250.75,4
HCPCS,E1805UE,Adjust wrist ext & flex dev,,,768.04,768.04,1
HCPCS,E1806,Sps wrist device,,,85.86,858.57,8
HCPCS,E18060,Sps wrist device,,,858.57,858.57,1
HCPCS,E1806MS,Sps wrist device,,,85.86,85.86,1
HCPCS,E1806NU,Sps wrist device,,,858.57,858.57,1
HCPCS,E1806RR,Sps wrist device,,,85.86,226.3,4
HCPCS,E1806UE,Sps wrist device,,,643.93,643.93,1
HCPCS,E1807,Adjust wrist extension dev,,,104.87,1048.65,8
HCPCS,E18070,Adjust wrist extension dev,,,1048.65,1048.65,1
HCPCS,E1807MS,Adjust wrist extension dev,,,104.87,104.87,1
HCPCS,E1807NU,Adjust wrist extension dev,,,1048.65,1048.65,1
HCPCS,E1807RR,Adjust wrist extension dev,,,104.87,250.75,4
HCPCS,E1807UE,Adjust wrist extension dev,,,786.49,786.49,1
HCPCS,E1808,Adjust wrist flexion device,,,104.87,1048.65,8
HCPCS,E18080,Adjust wrist flexion device,,,1048.65,1048.65,1
HCPCS,E1808MS,Adjust wrist flexion device,,,104.87,104.87,1
HCPCS,E1808NU,Adjust wrist flexion device,,,1048.65,1048.65,1
HCPCS,E1808RR,Adjust wrist flexion device,,,104.87,250.75,4
HCPCS,E1808UE,Adjust wrist flexion device,,,786.49,786.49,1
HCPCS,E1810,Adjust knee ext & flex dev,,,100.98,1009.8,8
HCPCS,E18100,Adjust knee ext & flex dev,,,1009.8,1009.8,1
HCPCS,E1810MS,Adjust knee ext & flex dev,,,100.98,100.98,1
HCPCS,E1810NU,Adjust knee ext & flex dev,,,1009.8,1009.8,1
HCPCS,E1810RR,Adjust knee ext & flex dev,,,100.98,247.26,4
HCPCS,E1810UE,Adjust knee ext & flex dev,,,757.35,757.35,1
HCPCS,E1811,Sps/pass knee device,,,108.69,1086.97,8
HCPCS,E18110,Sps/pass knee device,,,1086.97,1086.97,1
HCPCS,E1811MS,Sps/pass knee device,,,108.69,108.69,1
HCPCS,E1811NU,Sps/pass knee device,,,1086.97,1086.97,1
HCPCS,E1811RR,Sps/pass knee device,,,108.69,286.68,4
HCPCS,E1811UE,Sps/pass knee device,,,815.22,815.22,1
HCPCS,E1812,Knee ext/flex w act res ctrl,,,69.69,696.95,8
HCPCS,E18120,Knee ext/flex w act res ctrl,,,696.95,696.95,1
HCPCS,E1812MS,Knee ext/flex w act res ctrl,,,69.69,69.69,1
HCPCS,E1812NU,Knee ext/flex w act res ctrl,,,696.95,696.95,1
HCPCS,E1812RR,Knee ext/flex w act res ctrl,,,69.69,200.77,4
HCPCS,E1812UE,Knee ext/flex w act res ctrl,,,522.71,522.71,1
HCPCS,E1813,Adjust knee extension device,,,103.4,1034.04,8
HCPCS,E18130,Adjust knee extension device,,,1034.04,1034.04,1
HCPCS,E1813MS,Adjust knee extension device,,,103.4,103.4,1
HCPCS,E1813NU,Adjust knee extension device,,,1034.04,1034.04,1
HCPCS,E1813RR,Adjust knee extension device,,,103.4,247.26,4
HCPCS,E1813UE,Adjust knee extension device,,,775.53,775.53,1
HCPCS,E1814,Adjust knee flexion device,,,103.4,1034.04,8
HCPCS,E18140,Adjust knee flexion device,,,1034.04,1034.04,1
HCPCS,E1814MS,Adjust knee flexion device,,,103.4,103.4,1
HCPCS,E1814NU,Adjust knee flexion device,,,1034.04,1034.04,1
HCPCS,E1814RR,Adjust knee flexion device,,,103.4,247.26,4
HCPCS,E1814UE,Adjust knee flexion device,,,775.53,775.53,1
HCPCS,E1815,Adjust ankle ext & flex dev,,,102.41,1024.06,8
HCPCS,E18150,Adjust ankle ext & flex dev,,,1024.06,1024.06,1
HCPCS,E1815MS,Adjust ankle ext & flex dev,,,102.41,102.41,1
HCPCS,E1815NU,Adjust ankle ext & flex dev,,,1024.06,1024.06,1
HCPCS,E1815RR,Adjust ankle ext & flex dev,,,102.41,250.75,4
HCPCS,E1815UE,Adjust ankle ext & flex dev,,,768.04,768.04,1
HCPCS,E1816,Sps/pass ankle device,,,110.43,1104.25,8
HCPCS,E18160,Sps/pass ankle device,,,1104.25,1104.25,1
HCPCS,E1816MS,Sps/pass ankle device,,,110.43,110.43,1
HCPCS,E1816NU,Sps/pass ankle device,,,1104.25,1104.25,1
HCPCS,E1816RR,Sps/pass ankle device,,,110.43,291.16,4
HCPCS,E1816UE,Sps/pass ankle device,,,828.19,828.19,1
HCPCS,E1818,Sps/pass forearm device,,,112.72,1127.24,8
HCPCS,E18180,Sps/pass forearm device,,,1127.24,1127.24,1
HCPCS,E1818MS,Sps/pass forearm device,,,112.72,112.72,1
HCPCS,E1818NU,Sps/pass forearm device,,,1127.24,1127.24,1
HCPCS,E1818RR,Sps/pass forearm device,,,112.72,297.3,4
HCPCS,E1818UE,Sps/pass forearm device,,,845.42,845.42,1
HCPCS,E1820,Soft interface material,,,6.26,190.86,14
HCPCS,E18200,Soft interface material,,,62.5,62.5,1
HCPCS,E1820MS,Soft interface material,,,6.26,6.26,1
HCPCS,E1820NU,Soft interface material,,,62.5,190.86,4
HCPCS,E1820RR,Soft interface material,,,6.26,19.05,4
HCPCS,E1820UE,Soft interface material,,,46.88,143.17,4
HCPCS,E1821,Replacement interface spsd,,,8.51,245.7,14
HCPCS,E18210,Replacement interface spsd,,,85.29,85.29,1
HCPCS,E1821MS,Replacement interface spsd,,,8.51,8.51,1
HCPCS,E1821NU,Replacement interface spsd,,,85.29,245.7,4
HCPCS,E1821RR,Replacement interface spsd,,,8.51,24.5,4
HCPCS,E1821UE,Replacement interface spsd,,,63.99,184.34,4
HCPCS,E1822,Adjust ankle extension dev,,,104.87,1048.65,8
HCPCS,E18220,Adjust ankle extension dev,,,1048.65,1048.65,1
HCPCS,E1822MS,Adjust ankle extension dev,,,104.87,104.87,1
HCPCS,E1822NU,Adjust ankle extension dev,,,1048.65,1048.65,1
HCPCS,E1822RR,Adjust ankle extension dev,,,104.87,250.75,4
HCPCS,E1822UE,Adjust ankle extension dev,,,786.49,786.49,1
HCPCS,E1823,Adjust ankle flexion device,,,104.87,1048.65,8
HCPCS,E18230,Adjust ankle flexion device,,,1048.65,1048.65,1
HCPCS,E1823MS,Adjust ankle flexion device,,,104.87,104.87,1
HCPCS,E1823NU,Adjust ankle flexion device,,,1048.65,1048.65,1
HCPCS,E1823RR,Adjust ankle flexion device,,,104.87,250.75,4
HCPCS,E1823UE,Adjust ankle flexion device,,,786.49,786.49,1
HCPCS,E1825,Adjust finger ext & flex dev,,,102.41,1024.06,8
HCPCS,E18250,Adjust finger ext & flex dev,,,1024.06,1024.06,1
HCPCS,E1825MS,Adjust finger ext & flex dev,,,102.41,102.41,1
HCPCS,E1825NU,Adjust finger ext & flex dev,,,1024.06,1024.06,1
HCPCS,E1825RR,Adjust finger ext & flex dev,,,102.41,250.75,4
HCPCS,E1825UE,Adjust finger ext & flex dev,,,768.04,768.04,1
HCPCS,E1826,Adjust finger extension dev,,,104.87,1048.65,8
HCPCS,E18260,Adjust finger extension dev,,,1048.65,1048.65,1
HCPCS,E1826MS,Adjust finger extension dev,,,104.87,104.87,1
HCPCS,E1826NU,Adjust finger extension dev,,,1048.65,1048.65,1
HCPCS,E1826RR,Adjust finger extension dev,,,104.87,250.75,4
HCPCS,E1826UE,Adjust finger extension dev,,,786.49,786.49,1
HCPCS,E1827,Adjust finger flexion device,,,104.87,1048.65,8
HCPCS,E18270,Adjust finger flexion device,,,1048.65,1048.65,1
HCPCS,E1827MS,Adjust finger flexion device,,,104.87,104.87,1
HCPCS,E1827NU,Adjust finger flexion device,,,1048.65,1048.65,1
HCPCS,E1827RR,Adjust finger flexion device,,,104.87,250.75,4
HCPCS,E1827UE,Adjust finger flexion device,,,786.49,786.49,1
HCPCS,E1828,Adjust toe extension device,,,104.87,1048.65,8
HCPCS,E18280,Adjust toe extension device,,,1048.65,1048.65,1
HCPCS,E1828MS,Adjust toe extension device,,,104.87,104.87,1
HCPCS,E1828NU,Adjust toe extension device,,,1048.65,1048.65,1
HCPCS,E1828RR,Adjust toe extension device,,,104.87,250.75,4
HCPCS,E1828UE,Adjust toe extension device,,,786.49,786.49,1
HCPCS,E1829,Adjust toe flexion device,,,104.87,1048.65,8
HCPCS,E18290,Adjust toe flexion device,,,1048.65,1048.65,1
HCPCS,E1829MS,Adjust toe flexion device,,,104.87,104.87,1
HCPCS,E1829NU,Adjust toe flexion device,,,1048.65,1048.65,1
HCPCS,E1829RR,Adjust toe flexion device,,,104.87,250.75,4
HCPCS,E1829UE,Adjust toe flexion device,,,786.49,786.49,1
HCPCS,E1830,Adjust toe ext & flex device,,,102.41,1024.06,8
HCPCS,E18300,Adjust toe ext & flex device,,,1024.06,1024.06,1
HCPCS,E1830MS,Adjust toe ext & flex device,,,102.41,102.41,1
HCPCS,E1830NU,Adjust toe ext & flex device,,,1024.06,1024.06,1
HCPCS,E1830RR,Adjust toe ext & flex device,,,102.41,250.75,4
HCPCS,E1830UE,Adjust toe ext & flex device,,,768.04,768.04,1
HCPCS,E1831,Static str toe dev ext/flex,,,53.55,535.43,8
HCPCS,E18310,Static str toe dev ext/flex,,,535.43,535.43,1
HCPCS,E1831MS,Static str toe dev ext/flex,,,53.55,53.55,1
HCPCS,E1831NU,Static str toe dev ext/flex,,,535.43,535.43,1
HCPCS,E1831RR,Static str toe dev ext/flex,,,53.55,148.35,4
HCPCS,E1831UE,Static str toe dev ext/flex,,,401.58,401.58,1
HCPCS,E1832,Sps finger device,,,54.83,548.26,5
HCPCS,E18320,Sps finger device,,,548.26,548.26,1
HCPCS,E1832MS,Sps finger device,,,54.83,54.83,1
HCPCS,E1832NU,Sps finger device,,,548.26,548.26,1
HCPCS,E1832RR,Sps finger device,,,54.83,54.83,1
HCPCS,E1832UE,Sps finger device,,,411.2,411.2,1
HCPCS,E1840,Adj shoulder ext/flex device,,,310.19,3101.87,8
HCPCS,E18400,Adj shoulder ext/flex device,,,3101.87,3101.87,1
HCPCS,E1840MS,Adj shoulder ext/flex device,,,310.19,310.19,1
HCPCS,E1840NU,Adj shoulder ext/flex device,,,3101.87,3101.87,1
HCPCS,E1840RR,Adj shoulder ext/flex device,,,310.19,847.95,4
HCPCS,E1840UE,Adj shoulder ext/flex device,,,2326.41,2326.41,1
HCPCS,E1841,Sps/pass shoulder device,,,367.14,3671.4,8
HCPCS,E18410,Sps/pass shoulder device,,,3671.4,3671.4,1
HCPCS,E1841MS,Sps/pass shoulder device,,,367.14,367.14,1
HCPCS,E1841NU,Sps/pass shoulder device,,,3671.4,3671.4,1
HCPCS,E1841RR,Sps/pass shoulder device,,,367.14,1057.59,4
HCPCS,E1841UE,Sps/pass shoulder device,,,2753.55,2753.55,1
HCPCS,E1902,Aac non-electronic board,,,19.22,192.24,5
HCPCS,E19020,Aac non-electronic board,,,192.24,192.24,1
HCPCS,E1902MS,Aac non-electronic board,,,19.22,19.22,1
HCPCS,E1902NU,Aac non-electronic board,,,192.24,192.24,1
HCPCS,E1902RR,Aac non-electronic board,,,19.22,19.22,1
HCPCS,E1902UE,Aac non-electronic board,,,144.18,144.18,1
HCPCS,E1905,Vr cbt therapy,,,383.75,3837.48,8
HCPCS,E19050,Vr cbt therapy,,,3837.48,3837.48,1
HCPCS,E1905MS,Vr cbt therapy,,,383.75,383.75,1
HCPCS,E1905NU,Vr cbt therapy,,,3837.48,3837.48,1
HCPCS,E1905RR,Vr cbt therapy,,,383.75,1105.43,4
HCPCS,E1905UE,Vr cbt therapy,,,2878.11,2878.11,1
HCPCS,E2000,Gastric suction pump hme mdl,,,42.01,420.08,8
HCPCS,E20000,Gastric suction pump hme mdl,,,420.08,420.08,1
HCPCS,E2000MS,Gastric suction pump hme mdl,,,42.01,42.01,1
HCPCS,E2000NU,Gastric suction pump hme mdl,,,420.08,420.08,1
HCPCS,E2000RR,Gastric suction pump hme mdl,,,42.01,110.74,4
HCPCS,E2000UE,Gastric suction pump hme mdl,,,315.06,315.06,1
HCPCS,E2001,Suct pum ext mgmt sys,,,37.11,371.08,8
HCPCS,E20010,Suct pum ext mgmt sys,,,371.08,371.08,1
HCPCS,E2001MS,Suct pum ext mgmt sys,,,37.11,37.11,1
HCPCS,E2001NU,Suct pum ext mgmt sys,,,371.08,371.08,1
HCPCS,E2001RR,Suct pum ext mgmt sys,,,37.11,106.89,4
HCPCS,E2001UE,Suct pum ext mgmt sys,,,278.31,278.31,1
HCPCS,E2100,Bld glucose monitor w voice,,,52.14,1276.38,14
HCPCS,E21000,Bld glucose monitor w voice,,,521.28,521.28,1
HCPCS,E2100MS,Bld glucose monitor w voice,,,52.14,52.14,1
HCPCS,E2100NU,Bld glucose monitor w voice,,,521.28,1276.38,4
HCPCS,E2100RR,Bld glucose monitor w voice,,,52.14,127.68,4
HCPCS,E2100UE,Bld glucose monitor w voice,,,390.98,957.33,4
HCPCS,E2101,Bld glucose monitor w lance,,,15.28,440.21,14
HCPCS,E21010,Bld glucose monitor w lance,,,152.82,152.82,1
HCPCS,E2101MS,Bld glucose monitor w lance,,,15.28,15.28,1
HCPCS,E2101NU,Bld glucose monitor w lance,,,152.82,440.21,4
HCPCS,E2101RR,Bld glucose monitor w lance,,,15.28,44.03,4
HCPCS,E2101UE,Bld glucose monitor w lance,,,114.62,330.17,4
HCPCS,E2102,Adju cgm receiver/monitor,,,9.9,99.61,5
HCPCS,E21020,Adju cgm receiver/monitor,,,99.61,99.61,1
HCPCS,E2102MS,Adju cgm receiver/monitor,,,9.9,9.9,1
HCPCS,E2102NU,Adju cgm receiver/monitor,,,99.61,99.61,1
HCPCS,E2102RR,Adju cgm receiver/monitor,,,9.9,9.9,1
HCPCS,E2102UE,Adju cgm receiver/monitor,,,74.76,74.76,1
HCPCS,E2103,Non-adju cgm receiver/mon,,,17.14,493.55,14
HCPCS,E21030,Non-adju cgm receiver/mon,,,171.33,171.33,1
HCPCS,E2103MS,Non-adju cgm receiver/mon,,,17.14,17.14,1
HCPCS,E2103NU,Non-adju cgm receiver/mon,,,171.33,493.55,4
HCPCS,E2103RR,Non-adju cgm receiver/mon,,,17.14,49.36,4
HCPCS,E2103UE,Non-adju cgm receiver/mon,,,128.5,370.16,4
HCPCS,E2104,Glucose monitor w cartridge,,,3.11,89.31,14
HCPCS,E21040,Glucose monitor w cartridge,,,31.01,31.01,1
HCPCS,E2104MS,Glucose monitor w cartridge,,,3.11,3.11,1
HCPCS,E2104NU,Glucose monitor w cartridge,,,31.01,89.31,4
HCPCS,E2104RR,Glucose monitor w cartridge,,,3.11,8.96,4
HCPCS,E2104UE,Glucose monitor w cartridge,,,23.27,67.04,4
HCPCS,E2120,Pulse gen sys tx endolymp fl,,,229.79,2297.89,8
HCPCS,E21200,Pulse gen sys tx endolymp fl,,,2297.89,2297.89,1
HCPCS,E2120MS,Pulse gen sys tx endolymp fl,,,229.79,229.79,1
HCPCS,E2120NU,Pulse gen sys tx endolymp fl,,,2297.89,2297.89,1
HCPCS,E2120RR,Pulse gen sys tx endolymp fl,,,229.79,661.93,4
HCPCS,E2120UE,Pulse gen sys tx endolymp fl,,,1723.42,1723.42,1
HCPCS,E2201,"Man w/ch acc seat w>=20""<24""",,,21.33,639.59,14
HCPCS,E22010,"Man w/ch acc seat w>=20""<24""",,,213.3,213.3,1
HCPCS,E2201MS,"Man w/ch acc seat w>=20""<24""",,,21.33,21.33,1
HCPCS,E2201NU,"Man w/ch acc seat w>=20""<24""",,,213.3,639.59,4
HCPCS,E2201RR,"Man w/ch acc seat w>=20""<24""",,,21.33,63.97,4
HCPCS,E2201UE,"Man w/ch acc seat w>=20""<24""",,,159.98,479.69,4
HCPCS,E2202,Seat width 24-27 in,,,31.61,898.93,14
HCPCS,E22020,Seat width 24-27 in,,,316.07,316.07,1
HCPCS,E2202MS,Seat width 24-27 in,,,31.61,31.61,1
HCPCS,E2202NU,Seat width 24-27 in,,,316.07,898.93,4
HCPCS,E2202RR,Seat width 24-27 in,,,31.61,89.9,4
HCPCS,E2202UE,Seat width 24-27 in,,,237.05,674.22,4
HCPCS,E2203,Frame depth less than 22 in,,,29.54,868.34,14
HCPCS,E22030,Frame depth less than 22 in,,,295.4,295.4,1
HCPCS,E2203MS,Frame depth less than 22 in,,,29.54,29.54,1
HCPCS,E2203NU,Frame depth less than 22 in,,,295.4,868.34,4
HCPCS,E2203RR,Frame depth less than 22 in,,,29.54,86.84,4
HCPCS,E2203UE,Frame depth less than 22 in,,,221.55,651.26,4
HCPCS,E2204,Frame depth 22 to 25 in,,,52.71,1499.09,14
HCPCS,E22040,Frame depth 22 to 25 in,,,527.15,527.15,1
HCPCS,E2204MS,Frame depth 22 to 25 in,,,52.71,52.71,1
HCPCS,E2204NU,Frame depth 22 to 25 in,,,527.15,1499.09,4
HCPCS,E2204RR,Frame depth 22 to 25 in,,,52.71,149.91,4
HCPCS,E2204UE,Frame depth 22 to 25 in,,,395.37,1124.32,4
HCPCS,E2205,"Manual wc accessory, handrim",,,2.45,69.61,14
HCPCS,E22050,"Manual wc accessory, handrim",,,24.53,24.53,1
HCPCS,E2205MS,"Manual wc accessory, handrim",,,2.45,2.45,1
HCPCS,E2205NU,"Manual wc accessory, handrim",,,24.53,69.61,4
HCPCS,E2205RR,"Manual wc accessory, handrim",,,2.45,6.97,4
HCPCS,E2205UE,"Manual wc accessory, handrim",,,18.39,52.22,4
HCPCS,E2206,Man wc whl lock comp repl ea,,,2.66,76.31,14
HCPCS,E22060,Man wc whl lock comp repl ea,,,26.63,26.63,1
HCPCS,E2206MS,Man wc whl lock comp repl ea,,,2.66,2.66,1
HCPCS,E2206NU,Man wc whl lock comp repl ea,,,26.63,76.31,4
HCPCS,E2206RR,Man wc whl lock comp repl ea,,,2.66,7.64,4
HCPCS,E2206UE,Man wc whl lock comp repl ea,,,19.98,57.23,4
HCPCS,E2207,Crutch and cane holder,,,3.24,88.2,14
HCPCS,E22070,Crutch and cane holder,,,32.43,32.43,1
HCPCS,E2207MS,Crutch and cane holder,,,3.24,3.24,1
HCPCS,E2207NU,Crutch and cane holder,,,32.43,88.2,4
HCPCS,E2207RR,Crutch and cane holder,,,3.24,8.82,4
HCPCS,E2207UE,Crutch and cane holder,,,24.33,66.15,4
HCPCS,E2208,Cylinder tank carrier,,,5.41,160.95,14
HCPCS,E22080,Cylinder tank carrier,,,54.05,54.05,1
HCPCS,E2208MS,Cylinder tank carrier,,,5.41,5.41,1
HCPCS,E2208NU,Cylinder tank carrier,,,54.05,160.95,4
HCPCS,E2208RR,Cylinder tank carrier,,,5.41,16.09,4
HCPCS,E2208UE,Cylinder tank carrier,,,40.54,120.71,4
HCPCS,E2209,Arm trough each,,,5.96,163.94,14
HCPCS,E22090,Arm trough each,,,59.55,59.55,1
HCPCS,E2209MS,Arm trough each,,,5.96,5.96,1
HCPCS,E2209NU,Arm trough each,,,59.55,163.94,4
HCPCS,E2209RR,Arm trough each,,,5.96,16.39,4
HCPCS,E2209UE,Arm trough each,,,44.66,122.95,4
HCPCS,E2210,Wheelchair bearings,,,0.4,10.53,14
HCPCS,E22100,Wheelchair bearings,,,4.01,4.01,1
HCPCS,E2210MS,Wheelchair bearings,,,0.4,0.4,1
HCPCS,E2210NU,Wheelchair bearings,,,4.01,10.53,4
HCPCS,E2210RR,Wheelchair bearings,,,0.4,1.05,4
HCPCS,E2210UE,Wheelchair bearings,,,3.0,7.89,4
HCPCS,E2211,Pneumatic propulsion tire,,,2.33,68.46,14
HCPCS,E22110,Pneumatic propulsion tire,,,23.3,23.3,1
HCPCS,E2211MS,Pneumatic propulsion tire,,,2.33,2.33,1
HCPCS,E2211NU,Pneumatic propulsion tire,,,23.3,68.46,4
HCPCS,E2211RR,Pneumatic propulsion tire,,,2.33,6.85,4
HCPCS,E2211UE,Pneumatic propulsion tire,,,17.47,51.35,4
HCPCS,E2212,Pneumatic prop tire tube,,,0.45,12.22,14
HCPCS,E22120,Pneumatic prop tire tube,,,4.49,4.49,1
HCPCS,E2212MS,Pneumatic prop tire tube,,,0.45,0.45,1
HCPCS,E2212NU,Pneumatic prop tire tube,,,4.49,12.22,4
HCPCS,E2212RR,Pneumatic prop tire tube,,,0.45,1.22,4
HCPCS,E2212UE,Pneumatic prop tire tube,,,3.37,9.16,4
HCPCS,E2213,Pneumatic prop tire insert,,,2.1,58.18,14
HCPCS,E22130,Pneumatic prop tire insert,,,20.88,20.88,1
HCPCS,E2213MS,Pneumatic prop tire insert,,,2.1,2.1,1
HCPCS,E2213NU,Pneumatic prop tire insert,,,20.88,58.18,4
HCPCS,E2213RR,Pneumatic prop tire insert,,,2.1,5.82,4
HCPCS,E2213UE,Pneumatic prop tire insert,,,15.66,43.65,4
HCPCS,E2214,Pneumatic caster tire each,,,2.29,61.98,14
HCPCS,E22140,Pneumatic caster tire each,,,22.87,22.87,1
HCPCS,E2214MS,Pneumatic caster tire each,,,2.29,2.29,1
HCPCS,E2214NU,Pneumatic caster tire each,,,22.87,61.98,4
HCPCS,E2214RR,Pneumatic caster tire each,,,2.29,6.2,4
HCPCS,E2214UE,Pneumatic caster tire each,,,17.15,46.49,4
HCPCS,E2215,Pneumatic caster tire tube,,,0.72,20.09,14
HCPCS,E22150,Pneumatic caster tire tube,,,7.2,7.2,1
HCPCS,E2215MS,Pneumatic caster tire tube,,,0.72,0.72,1
HCPCS,E2215NU,Pneumatic caster tire tube,,,7.2,20.09,4
HCPCS,E2215RR,Pneumatic caster tire tube,,,0.72,2.01,4
HCPCS,E2215UE,Pneumatic caster tire tube,,,5.41,15.07,4
HCPCS,E2216,Foam filled propulsion tire,,,3.35,89.6,14
HCPCS,E22160,Foam filled propulsion tire,,,33.42,33.42,1
HCPCS,E2216MS,Foam filled propulsion tire,,,3.35,3.35,1
HCPCS,E2216NU,Foam filled propulsion tire,,,33.42,89.6,4
HCPCS,E2216RR,Foam filled propulsion tire,,,3.35,8.97,4
HCPCS,E2216UE,Foam filled propulsion tire,,,25.06,67.21,4
HCPCS,E2217,Foam filled caster tire each,,,2.96,79.29,14
HCPCS,E22170,Foam filled caster tire each,,,29.57,29.57,1
HCPCS,E2217MS,Foam filled caster tire each,,,2.96,2.96,1
HCPCS,E2217NU,Foam filled caster tire each,,,29.57,79.29,4
HCPCS,E2217RR,Foam filled caster tire each,,,2.96,7.94,4
HCPCS,E2217UE,Foam filled caster tire each,,,22.18,59.47,4
HCPCS,E2218,Foam propulsion tire each,,,3.35,89.6,14
HCPCS,E22180,Foam propulsion tire each,,,33.42,33.42,1
HCPCS,E2218MS,Foam propulsion tire each,,,3.35,3.35,1
HCPCS,E2218NU,Foam propulsion tire each,,,33.42,89.6,4
HCPCS,E2218RR,Foam propulsion tire each,,,3.35,8.97,4
HCPCS,E2218UE,Foam propulsion tire each,,,25.06,67.21,4
HCPCS,E2219,Foam caster tire any size ea,,,2.96,79.29,14
HCPCS,E22190,Foam caster tire any size ea,,,29.57,29.57,1
HCPCS,E2219MS,Foam caster tire any size ea,,,2.96,2.96,1
HCPCS,E2219NU,Foam caster tire any size ea,,,29.57,79.29,4
HCPCS,E2219RR,Foam caster tire any size ea,,,2.96,7.94,4
HCPCS,E2219UE,Foam caster tire any size ea,,,22.18,59.47,4
HCPCS,E2220,"Solid propuls tire, repl, ea",,,1.93,58.92,14
HCPCS,E22200,"Solid propuls tire, repl, ea",,,19.38,19.38,1
HCPCS,E2220MS,"Solid propuls tire, repl, ea",,,1.93,1.93,1
HCPCS,E2220NU,"Solid propuls tire, repl, ea",,,19.38,58.92,4
HCPCS,E2220RR,"Solid propuls tire, repl, ea",,,1.93,5.9,4
HCPCS,E2220UE,"Solid propuls tire, repl, ea",,,14.53,44.2,4
HCPCS,E2221,"Solid caster tire repl, each",,,1.91,52.34,14
HCPCS,E22210,"Solid caster tire repl, each",,,19.07,19.07,1
HCPCS,E2221MS,"Solid caster tire repl, each",,,1.91,1.91,1
HCPCS,E2221NU,"Solid caster tire repl, each",,,19.07,52.34,4
HCPCS,E2221RR,"Solid caster tire repl, each",,,1.91,5.23,4
HCPCS,E2221UE,"Solid caster tire repl, each",,,14.3,39.25,4
HCPCS,E2222,"Solid caster integ whl, repl",,,1.58,44.28,14
HCPCS,E22220,"Solid caster integ whl, repl",,,15.77,15.77,1
HCPCS,E2222MS,"Solid caster integ whl, repl",,,1.58,1.58,1
HCPCS,E2222NU,"Solid caster integ whl, repl",,,15.77,44.28,4
HCPCS,E2222RR,"Solid caster integ whl, repl",,,1.58,4.43,4
HCPCS,E2222UE,"Solid caster integ whl, repl",,,11.83,33.22,4
HCPCS,E2224,Propulsion whl excl tire rep,,,6.31,187.75,14
HCPCS,E22240,Propulsion whl excl tire rep,,,63.08,63.08,1
HCPCS,E2224MS,Propulsion whl excl tire rep,,,6.31,6.31,1
HCPCS,E2224NU,Propulsion whl excl tire rep,,,63.08,187.75,4
HCPCS,E2224RR,Propulsion whl excl tire rep,,,6.31,18.78,4
HCPCS,E2224UE,Propulsion whl excl tire rep,,,47.31,140.82,4
HCPCS,E2225,Caster wheel excludes tire,,,1.32,36.33,14
HCPCS,E22250,Caster wheel excludes tire,,,13.21,13.21,1
HCPCS,E2225MS,Caster wheel excludes tire,,,1.32,1.32,1
HCPCS,E2225NU,Caster wheel excludes tire,,,13.21,36.33,4
HCPCS,E2225RR,Caster wheel excludes tire,,,1.32,3.63,4
HCPCS,E2225UE,Caster wheel excludes tire,,,9.9,27.24,4
HCPCS,E2226,Caster fork replacement only,,,2.82,77.35,14
HCPCS,E22260,Caster fork replacement only,,,28.16,28.16,1
HCPCS,E2226MS,Caster fork replacement only,,,2.82,2.82,1
HCPCS,E2226NU,Caster fork replacement only,,,28.16,77.35,4
HCPCS,E2226RR,Caster fork replacement only,,,2.82,7.74,4
HCPCS,E2226UE,Caster fork replacement only,,,21.11,58.02,4
HCPCS,E2227,Gear reduction drive wheel,,,151.62,1516.24,8
HCPCS,E22270,Gear reduction drive wheel,,,1516.24,1516.24,1
HCPCS,E2227MS,Gear reduction drive wheel,,,151.62,151.62,1
HCPCS,E2227NU,Gear reduction drive wheel,,,1516.24,1516.24,1
HCPCS,E2227RR,Gear reduction drive wheel,,,151.62,419.92,4
HCPCS,E2227UE,Gear reduction drive wheel,,,1137.19,1137.19,1
HCPCS,E2228,"Mwc acc, wheelchair brake",,,67.19,671.88,8
HCPCS,E22280,"Mwc acc, wheelchair brake",,,671.88,671.88,1
HCPCS,E2228MS,"Mwc acc, wheelchair brake",,,67.19,67.19,1
HCPCS,E2228NU,"Mwc acc, wheelchair brake",,,671.88,671.88,1
HCPCS,E2228RR,"Mwc acc, wheelchair brake",,,67.19,187.37,4
HCPCS,E2228UE,"Mwc acc, wheelchair brake",,,503.91,503.91,1
HCPCS,E2231,Solid seat support base,,,9.89,283.75,14
HCPCS,E22310,Solid seat support base,,,98.98,98.98,1
HCPCS,E2231MS,Solid seat support base,,,9.89,9.89,1
HCPCS,E2231NU,Solid seat support base,,,98.98,283.75,4
HCPCS,E2231RR,Solid seat support base,,,9.89,28.37,4
HCPCS,E2231UE,Solid seat support base,,,74.24,212.82,4
HCPCS,E2291,Planar back for ped size wc,,,20.84,208.45,5
HCPCS,E22910,Planar back for ped size wc,,,208.45,208.45,1
HCPCS,E2291MS,Planar back for ped size wc,,,20.84,20.84,1
HCPCS,E2291NU,Planar back for ped size wc,,,208.45,208.45,1
HCPCS,E2291RR,Planar back for ped size wc,,,20.84,20.84,1
HCPCS,E2291UE,Planar back for ped size wc,,,156.34,156.34,1
HCPCS,E2292,Planar seat for ped size wc,,,27.91,279.07,5
HCPCS,E22920,Planar seat for ped size wc,,,279.07,279.07,1
HCPCS,E2292MS,Planar seat for ped size wc,,,27.91,27.91,1
HCPCS,E2292NU,Planar seat for ped size wc,,,279.07,279.07,1
HCPCS,E2292RR,Planar seat for ped size wc,,,27.91,27.91,1
HCPCS,E2292UE,Planar seat for ped size wc,,,209.3,209.3,1
HCPCS,E2293,Contour back for ped size wc,,,48.24,482.48,5
HCPCS,E22930,Contour back for ped size wc,,,482.48,482.48,1
HCPCS,E2293MS,Contour back for ped size wc,,,48.24,48.24,1
HCPCS,E2293NU,Contour back for ped size wc,,,482.48,482.48,1
HCPCS,E2293RR,Contour back for ped size wc,,,48.24,48.24,1
HCPCS,E2293UE,Contour back for ped size wc,,,361.86,361.86,1
HCPCS,E2294,Contour seat for ped size wc,,,28.6,286.02,5
HCPCS,E22940,Contour seat for ped size wc,,,286.02,286.02,1
HCPCS,E2294MS,Contour seat for ped size wc,,,28.6,28.6,1
HCPCS,E2294NU,Contour seat for ped size wc,,,286.02,286.02,1
HCPCS,E2294RR,Contour seat for ped size wc,,,28.6,28.6,1
HCPCS,E2294UE,Contour seat for ped size wc,,,214.51,214.51,1
HCPCS,E2295,Ped dynamic seating frame,,,6.4,64.02,5
HCPCS,E22950,Ped dynamic seating frame,,,64.02,64.02,1
HCPCS,E2295MS,Ped dynamic seating frame,,,6.4,6.4,1
HCPCS,E2295NU,Ped dynamic seating frame,,,64.02,64.02,1
HCPCS,E2295RR,Ped dynamic seating frame,,,6.4,6.4,1
HCPCS,E2295UE,Ped dynamic seating frame,,,48.02,48.02,1
HCPCS,E2298,Pwr seat elev sys for crt,,,119.62,1196.26,8
HCPCS,E22980,Pwr seat elev sys for crt,,,1196.26,1196.26,1
HCPCS,E2298MS,Pwr seat elev sys for crt,,,119.62,119.62,1
HCPCS,E2298NU,Pwr seat elev sys for crt,,,1196.26,1196.26,1
HCPCS,E2298RR,Pwr seat elev sys for crt,,,119.62,344.59,4
HCPCS,E2298UE,Pwr seat elev sys for crt,,,897.19,897.19,1
HCPCS,E2301,Pwr standing,,,14.94,149.34,5
HCPCS,E23010,Pwr standing,,,149.34,149.34,1
HCPCS,E2301MS,Pwr standing,,,14.94,14.94,1
HCPCS,E2301NU,Pwr standing,,,149.34,149.34,1
HCPCS,E2301RR,Pwr standing,,,14.94,14.94,1
HCPCS,E2301UE,Pwr standing,,,112.01,112.01,1
HCPCS,E2310,Electro connect btw control,,,76.2,762.05,8
HCPCS,E23100,Electro connect btw control,,,762.05,762.05,1
HCPCS,E2310MS,Electro connect btw control,,,76.2,76.2,1
HCPCS,E2310NU,Electro connect btw control,,,762.05,762.05,1
HCPCS,E2310RR,Electro connect btw control,,,76.2,220.79,4
HCPCS,E2310UE,Electro connect btw control,,,571.54,571.54,1
HCPCS,E2311,Electro connect btw 2 sys,,,153.77,1537.75,8
HCPCS,E23110,Electro connect btw 2 sys,,,1537.75,1537.75,1
HCPCS,E2311MS,Electro connect btw 2 sys,,,153.77,153.77,1
HCPCS,E2311NU,Electro connect btw 2 sys,,,1537.75,1537.75,1
HCPCS,E2311RR,Electro connect btw 2 sys,,,153.77,445.56,4
HCPCS,E2311UE,Electro connect btw 2 sys,,,1153.31,1153.31,1
HCPCS,E2312,Mini-prop remote joystick,,,163.44,1634.4,8
HCPCS,E23120,Mini-prop remote joystick,,,1634.4,1634.4,1
HCPCS,E2312MS,Mini-prop remote joystick,,,163.44,163.44,1
HCPCS,E2312NU,Mini-prop remote joystick,,,1634.4,1634.4,1
HCPCS,E2312RR,Mini-prop remote joystick,,,163.44,452.76,4
HCPCS,E2312UE,Mini-prop remote joystick,,,1225.79,1225.79,1
HCPCS,E2313,"Pwc harness, expand control",,,25.97,259.7,8
HCPCS,E23130,"Pwc harness, expand control",,,259.7,259.7,1
HCPCS,E2313MS,"Pwc harness, expand control",,,25.97,25.97,1
HCPCS,E2313NU,"Pwc harness, expand control",,,259.7,259.7,1
HCPCS,E2313RR,"Pwc harness, expand control",,,25.97,71.95,4
HCPCS,E2313UE,"Pwc harness, expand control",,,194.78,194.78,1
HCPCS,E2321,Hand interface joystick,,,103.54,1035.41,8
HCPCS,E23210,Hand interface joystick,,,1035.41,1035.41,1
HCPCS,E2321MS,Hand interface joystick,,,103.54,103.54,1
HCPCS,E2321NU,Hand interface joystick,,,1035.41,1035.41,1
HCPCS,E2321RR,Hand interface joystick,,,103.54,300.01,4
HCPCS,E2321UE,Hand interface joystick,,,776.55,776.55,1
HCPCS,E2322,Mult mech switches,,,97.82,978.2,8
HCPCS,E23220,Mult mech switches,,,978.2,978.2,1
HCPCS,E2322MS,Mult mech switches,,,97.82,97.82,1
HCPCS,E2322NU,Mult mech switches,,,978.2,978.2,1
HCPCS,E2322RR,Mult mech switches,,,97.82,283.44,4
HCPCS,E2322UE,Mult mech switches,,,733.65,733.65,1
HCPCS,E2323,Special joystick handle,,,4.77,138.16,14
HCPCS,E23230,Special joystick handle,,,47.68,47.68,1
HCPCS,E2323MS,Special joystick handle,,,4.77,4.77,1
HCPCS,E2323NU,Special joystick handle,,,47.68,138.16,4
HCPCS,E2323RR,Special joystick handle,,,4.77,13.82,4
HCPCS,E2323UE,Special joystick handle,,,35.77,103.62,4
HCPCS,E2324,Chin cup interface,,,3.05,88.18,14
HCPCS,E23240,Chin cup interface,,,30.61,30.61,1
HCPCS,E2324MS,Chin cup interface,,,3.05,3.05,1
HCPCS,E2324NU,Chin cup interface,,,30.61,88.18,4
HCPCS,E2324RR,Chin cup interface,,,3.05,8.77,4
HCPCS,E2324UE,Chin cup interface,,,22.96,66.14,4
HCPCS,E2325,Sip and puff interface,,,93.48,934.9,8
HCPCS,E23250,Sip and puff interface,,,934.9,934.9,1
HCPCS,E2325MS,Sip and puff interface,,,93.48,93.48,1
HCPCS,E2325NU,Sip and puff interface,,,934.9,934.9,1
HCPCS,E2325RR,Sip and puff interface,,,93.48,270.9,4
HCPCS,E2325UE,Sip and puff interface,,,701.17,701.17,1
HCPCS,E2326,Breath tube kit,,,24.26,242.59,8
HCPCS,E23260,Breath tube kit,,,242.59,242.59,1
HCPCS,E2326MS,Breath tube kit,,,24.26,24.26,1
HCPCS,E2326NU,Breath tube kit,,,242.59,242.59,1
HCPCS,E2326RR,Breath tube kit,,,24.26,69.88,4
HCPCS,E2326UE,Breath tube kit,,,181.95,181.95,1
HCPCS,E2327,Head control interface mech,,,182.49,1824.83,8
HCPCS,E23270,Head control interface mech,,,1824.83,1824.83,1
HCPCS,E2327MS,Head control interface mech,,,182.49,182.49,1
HCPCS,E2327NU,Head control interface mech,,,1824.83,1824.83,1
HCPCS,E2327RR,Head control interface mech,,,182.49,525.66,4
HCPCS,E2327UE,Head control interface mech,,,1368.62,1368.62,1
HCPCS,E2328,Head/extremity control inter,,,345.18,3451.8,8
HCPCS,E23280,Head/extremity control inter,,,3451.8,3451.8,1
HCPCS,E2328MS,Head/extremity control inter,,,345.18,345.18,1
HCPCS,E2328NU,Head/extremity control inter,,,3451.8,3451.8,1
HCPCS,E2328RR,Head/extremity control inter,,,345.18,997.14,4
HCPCS,E2328UE,Head/extremity control inter,,,2588.85,2588.85,1
HCPCS,E2329,Head control nonproportional,,,123.38,1233.74,8
HCPCS,E23290,Head control nonproportional,,,1233.74,1233.74,1
HCPCS,E2329MS,Head control nonproportional,,,123.38,123.38,1
HCPCS,E2329NU,Head control nonproportional,,,1233.74,1233.74,1
HCPCS,E2329RR,Head control nonproportional,,,123.38,355.39,4
HCPCS,E2329UE,Head control nonproportional,,,925.3,925.3,1
HCPCS,E2330,Head control proximity switc,,,239.05,2390.44,8
HCPCS,E23300,Head control proximity switc,,,2390.44,2390.44,1
HCPCS,E2330MS,Head control proximity switc,,,239.05,239.05,1
HCPCS,E2330NU,Head control proximity switc,,,2390.44,2390.44,1
HCPCS,E2330RR,Head control proximity switc,,,239.05,688.6,4
HCPCS,E2330UE,Head control proximity switc,,,1792.82,1792.82,1
HCPCS,E2331,Attendant control,,,81.5,814.96,5
HCPCS,E23310,Attendant control,,,814.96,814.96,1
HCPCS,E2331MS,Attendant control,,,81.5,81.5,1
HCPCS,E2331NU,Attendant control,,,814.96,814.96,1
HCPCS,E2331RR,Attendant control,,,81.5,81.5,1
HCPCS,E2331UE,Attendant control,,,611.22,611.22,1
HCPCS,E2340,W/c wdth 20-23 in seat frame,,,29.06,836.64,14
HCPCS,E23400,W/c wdth 20-23 in seat frame,,,290.43,290.43,1
HCPCS,E2340MS,W/c wdth 20-23 in seat frame,,,29.06,29.06,1
HCPCS,E2340NU,W/c wdth 20-23 in seat frame,,,290.43,836.64,4
HCPCS,E2340RR,W/c wdth 20-23 in seat frame,,,29.06,83.7,4
HCPCS,E2340UE,W/c wdth 20-23 in seat frame,,,217.86,627.56,4
HCPCS,E2341,W/c wdth 24-27 in seat frame,,,43.57,1255.09,14
HCPCS,E23410,W/c wdth 24-27 in seat frame,,,435.7,435.7,1
HCPCS,E2341MS,W/c wdth 24-27 in seat frame,,,43.57,43.57,1
HCPCS,E2341NU,W/c wdth 24-27 in seat frame,,,435.7,1255.09,4
HCPCS,E2341RR,W/c wdth 24-27 in seat frame,,,43.57,125.49,4
HCPCS,E2341UE,W/c wdth 24-27 in seat frame,,,326.79,941.36,4
HCPCS,E2342,W/c dpth 20-21 in seat frame,,,36.31,1045.93,14
HCPCS,E23420,W/c dpth 20-21 in seat frame,,,363.09,363.09,1
HCPCS,E2342MS,W/c dpth 20-21 in seat frame,,,36.31,36.31,1
HCPCS,E2342NU,W/c dpth 20-21 in seat frame,,,363.09,1045.93,4
HCPCS,E2342RR,W/c dpth 20-21 in seat frame,,,36.31,104.59,4
HCPCS,E2342UE,W/c dpth 20-21 in seat frame,,,272.32,784.45,4
HCPCS,E2343,W/c dpth 22-25 in seat frame,,,58.08,1673.49,14
HCPCS,E23430,W/c dpth 22-25 in seat frame,,,580.94,580.94,1
HCPCS,E2343MS,W/c dpth 22-25 in seat frame,,,58.08,58.08,1
HCPCS,E2343NU,W/c dpth 22-25 in seat frame,,,580.94,1673.49,4
HCPCS,E2343RR,W/c dpth 22-25 in seat frame,,,58.08,167.33,4
HCPCS,E2343UE,W/c dpth 22-25 in seat frame,,,435.7,1255.09,4
HCPCS,E2351,Electronic sgd interface,,,48.82,1406.35,14
HCPCS,E23510,Electronic sgd interface,,,488.21,488.21,1
HCPCS,E2351MS,Electronic sgd interface,,,48.82,48.82,1
HCPCS,E2351NU,Electronic sgd interface,,,488.21,1406.35,4
HCPCS,E2351RR,Electronic sgd interface,,,48.82,140.63,4
HCPCS,E2351UE,Electronic sgd interface,,,366.15,1054.77,4
HCPCS,E2358,Gr 34 nonsealed leadacid,,,112.75,112.75,1
HCPCS,E23580,Gr 34 nonsealed leadacid,,,112.75,112.75,1
HCPCS,E2359,Gr34 sealed leadacid battery,,,12.04,333.0,14
HCPCS,E23590,Gr34 sealed leadacid battery,,,120.41,120.41,1
HCPCS,E2359MS,Gr34 sealed leadacid battery,,,12.04,12.04,1
HCPCS,E2359NU,Gr34 sealed leadacid battery,,,120.41,333.0,4
HCPCS,E2359RR,Gr34 sealed leadacid battery,,,12.04,33.3,4
HCPCS,E2359UE,Gr34 sealed leadacid battery,,,90.31,249.75,4
HCPCS,E2360,22nf nonsealed leadacid,,,8.16,241.59,14
HCPCS,E23600,22nf nonsealed leadacid,,,81.69,81.69,1
HCPCS,E2360MS,22nf nonsealed leadacid,,,8.16,8.16,1
HCPCS,E2360NU,22nf nonsealed leadacid,,,81.69,241.59,4
HCPCS,E2360RR,22nf nonsealed leadacid,,,8.16,24.16,4
HCPCS,E2360UE,22nf nonsealed leadacid,,,61.27,181.2,4
HCPCS,E2361,22nf sealed leadacid battery,,,8.08,226.85,14
HCPCS,E23610,22nf sealed leadacid battery,,,80.78,80.78,1
HCPCS,E2361MS,22nf sealed leadacid battery,,,8.08,8.08,1
HCPCS,E2361NU,22nf sealed leadacid battery,,,80.78,226.85,4
HCPCS,E2361RR,22nf sealed leadacid battery,,,8.08,22.69,4
HCPCS,E2361UE,22nf sealed leadacid battery,,,60.59,170.14,4
HCPCS,E2362,Gr24 nonsealed leadacid,,,7.45,214.76,14
HCPCS,E23620,Gr24 nonsealed leadacid,,,74.55,74.55,1
HCPCS,E2362MS,Gr24 nonsealed leadacid,,,7.45,7.45,1
HCPCS,E2362NU,Gr24 nonsealed leadacid,,,74.55,214.76,4
HCPCS,E2362RR,Gr24 nonsealed leadacid,,,7.45,21.47,4
HCPCS,E2362UE,Gr24 nonsealed leadacid,,,55.91,161.07,4
HCPCS,E2363,Gr24 sealed leadacid battery,,,10.55,293.33,14
HCPCS,E23630,Gr24 sealed leadacid battery,,,105.57,105.57,1
HCPCS,E2363MS,Gr24 sealed leadacid battery,,,10.55,10.55,1
HCPCS,E2363NU,Gr24 sealed leadacid battery,,,105.57,293.33,4
HCPCS,E2363RR,Gr24 sealed leadacid battery,,,10.55,29.34,4
HCPCS,E2363UE,Gr24 sealed leadacid battery,,,79.19,220.0,4
HCPCS,E2364,U1nonsealed leadacid battery,,,7.87,233.2,14
HCPCS,E23640,U1nonsealed leadacid battery,,,78.71,78.71,1
HCPCS,E2364MS,U1nonsealed leadacid battery,,,7.87,7.87,1
HCPCS,E2364NU,U1nonsealed leadacid battery,,,78.71,233.2,4
HCPCS,E2364RR,U1nonsealed leadacid battery,,,7.87,23.33,4
HCPCS,E2364UE,U1nonsealed leadacid battery,,,59.03,174.9,4
HCPCS,E2365,U1 sealed leadacid battery,,,5.39,155.29,14
HCPCS,E23650,U1 sealed leadacid battery,,,53.92,53.92,1
HCPCS,E2365MS,U1 sealed leadacid battery,,,5.39,5.39,1
HCPCS,E2365NU,U1 sealed leadacid battery,,,53.92,155.29,4
HCPCS,E2365RR,U1 sealed leadacid battery,,,5.39,15.52,4
HCPCS,E2365UE,U1 sealed leadacid battery,,,40.44,116.47,4
HCPCS,E2366,"Battery charger, single mode",,,11.22,331.54,14
HCPCS,E23660,"Battery charger, single mode",,,112.21,112.21,1
HCPCS,E2366MS,"Battery charger, single mode",,,11.22,11.22,1
HCPCS,E2366NU,"Battery charger, single mode",,,112.21,331.54,4
HCPCS,E2366RR,"Battery charger, single mode",,,11.22,33.15,4
HCPCS,E2366UE,"Battery charger, single mode",,,84.15,248.66,4
HCPCS,E2367,"Battery charger, dual mode",,,26.35,746.89,14
HCPCS,E23670,"Battery charger, dual mode",,,263.54,263.54,1
HCPCS,E2367MS,"Battery charger, dual mode",,,26.35,26.35,1
HCPCS,E2367NU,"Battery charger, dual mode",,,263.54,746.89,4
HCPCS,E2367RR,"Battery charger, dual mode",,,26.35,74.69,4
HCPCS,E2367UE,"Battery charger, dual mode",,,197.66,560.17,4
HCPCS,E2368,Pwr wc drivewheel motor repl,,,29.91,299.08,8
HCPCS,E23680,Pwr wc drivewheel motor repl,,,299.08,299.08,1
HCPCS,E2368MS,Pwr wc drivewheel motor repl,,,29.91,29.91,1
HCPCS,E2368NU,Pwr wc drivewheel motor repl,,,299.08,299.08,1
HCPCS,E2368RR,Pwr wc drivewheel motor repl,,,29.91,81.36,4
HCPCS,E2368UE,Pwr wc drivewheel motor repl,,,224.31,224.31,1
HCPCS,E2369,Pwr wc drivewheel gear repl,,,28.29,282.81,8
HCPCS,E23690,Pwr wc drivewheel gear repl,,,282.81,282.81,1
HCPCS,E2369MS,Pwr wc drivewheel gear repl,,,28.29,28.29,1
HCPCS,E2369NU,Pwr wc drivewheel gear repl,,,282.81,282.81,1
HCPCS,E2369RR,Pwr wc drivewheel gear repl,,,28.29,76.01,4
HCPCS,E2369UE,Pwr wc drivewheel gear repl,,,212.1,212.1,1
HCPCS,E2370,Pwr wc dr wh motor/gear comb,,,36.34,363.41,8
HCPCS,E23700,Pwr wc dr wh motor/gear comb,,,363.41,363.41,1
HCPCS,E2370MS,Pwr wc dr wh motor/gear comb,,,36.34,36.34,1
HCPCS,E2370NU,Pwr wc dr wh motor/gear comb,,,363.41,363.41,1
HCPCS,E2370RR,Pwr wc dr wh motor/gear comb,,,36.34,107.86,4
HCPCS,E2370UE,Pwr wc dr wh motor/gear comb,,,272.56,272.56,1
HCPCS,E2371,Gr27 sealed leadacid battery,,,9.99,275.48,14
HCPCS,E23710,Gr27 sealed leadacid battery,,,99.84,99.84,1
HCPCS,E2371MS,Gr27 sealed leadacid battery,,,9.99,9.99,1
HCPCS,E2371NU,Gr27 sealed leadacid battery,,,99.84,275.48,4
HCPCS,E2371RR,Gr27 sealed leadacid battery,,,9.99,27.55,4
HCPCS,E2371UE,Gr27 sealed leadacid battery,,,74.88,206.6,4
HCPCS,E2373,Hand/chin ctrl spec joystick,,,55.51,555.15,8
HCPCS,E23730,Hand/chin ctrl spec joystick,,,555.15,555.15,1
HCPCS,E2373MS,Hand/chin ctrl spec joystick,,,55.51,55.51,1
HCPCS,E2373NU,Hand/chin ctrl spec joystick,,,555.15,555.15,1
HCPCS,E2373RR,Hand/chin ctrl spec joystick,,,55.51,157.84,4
HCPCS,E2373UE,Hand/chin ctrl spec joystick,,,416.36,416.36,1
HCPCS,E2374,Hand/chin ctrl std joystick,,,35.11,351.12,8
HCPCS,E23740,Hand/chin ctrl std joystick,,,351.12,351.12,1
HCPCS,E2374MS,Hand/chin ctrl std joystick,,,35.11,35.11,1
HCPCS,E2374NU,Hand/chin ctrl std joystick,,,351.12,351.12,1
HCPCS,E2374RR,Hand/chin ctrl std joystick,,,35.11,101.75,4
HCPCS,E2374UE,Hand/chin ctrl std joystick,,,263.34,263.34,1
HCPCS,E2375,Non-expandable controller,,,47.11,471.11,8
HCPCS,E23750,Non-expandable controller,,,471.11,471.11,1
HCPCS,E2375MS,Non-expandable controller,,,47.11,47.11,1
HCPCS,E2375NU,Non-expandable controller,,,471.11,471.11,1
HCPCS,E2375RR,Non-expandable controller,,,47.11,136.75,4
HCPCS,E2375UE,Non-expandable controller,,,353.32,353.32,1
HCPCS,E2376,"Expandable controller, repl",,,87.23,872.35,8
HCPCS,E23760,"Expandable controller, repl",,,872.35,872.35,1
HCPCS,E2376MS,"Expandable controller, repl",,,87.23,87.23,1
HCPCS,E2376NU,"Expandable controller, repl",,,872.35,872.35,1
HCPCS,E2376RR,"Expandable controller, repl",,,87.23,252.76,4
HCPCS,E2376UE,"Expandable controller, repl",,,654.26,654.26,1
HCPCS,E2377,"Expandable controller, initl",,,32.31,323.14,8
HCPCS,E23770,"Expandable controller, initl",,,323.14,323.14,1
HCPCS,E2377MS,"Expandable controller, initl",,,32.31,32.31,1
HCPCS,E2377NU,"Expandable controller, initl",,,323.14,323.14,1
HCPCS,E2377RR,"Expandable controller, initl",,,32.31,93.64,4
HCPCS,E2377UE,"Expandable controller, initl",,,242.35,242.35,1
HCPCS,E2378,Pw actuator replacement,,,38.67,386.69,8
HCPCS,E23780,Pw actuator replacement,,,386.69,386.69,1
HCPCS,E2378MS,Pw actuator replacement,,,38.67,38.67,1
HCPCS,E2378NU,Pw actuator replacement,,,386.69,386.69,1
HCPCS,E2378RR,Pw actuator replacement,,,38.67,114.13,4
HCPCS,E2378UE,Pw actuator replacement,,,290.02,290.02,1
HCPCS,E2381,Pneum drive wheel tire,,,4.47,119.68,14
HCPCS,E23810,Pneum drive wheel tire,,,44.76,44.76,1
HCPCS,E2381MS,Pneum drive wheel tire,,,4.47,4.47,1
HCPCS,E2381NU,Pneum drive wheel tire,,,44.76,119.68,4
HCPCS,E2381RR,Pneum drive wheel tire,,,4.47,11.96,4
HCPCS,E2381UE,Pneum drive wheel tire,,,33.57,89.77,4
HCPCS,E2382,"Tube, pneum wheel drive tire",,,1.27,37.08,14
HCPCS,E23820,"Tube, pneum wheel drive tire",,,12.8,12.8,1
HCPCS,E2382MS,"Tube, pneum wheel drive tire",,,1.27,1.27,1
HCPCS,E2382NU,"Tube, pneum wheel drive tire",,,12.8,37.08,4
HCPCS,E2382RR,"Tube, pneum wheel drive tire",,,1.27,3.71,4
HCPCS,E2382UE,"Tube, pneum wheel drive tire",,,9.6,27.82,4
HCPCS,E2383,"Insert, pneum wheel drive",,,9.22,244.18,14
HCPCS,E23830,"Insert, pneum wheel drive",,,92.25,92.25,1
HCPCS,E2383MS,"Insert, pneum wheel drive",,,9.22,9.22,1
HCPCS,E2383NU,"Insert, pneum wheel drive",,,92.25,244.18,4
HCPCS,E2383RR,"Insert, pneum wheel drive",,,9.22,24.41,4
HCPCS,E2383UE,"Insert, pneum wheel drive",,,69.18,183.12,4
HCPCS,E2384,Pneumatic caster tire,,,4.55,123.57,14
HCPCS,E23840,Pneumatic caster tire,,,45.46,45.46,1
HCPCS,E2384MS,Pneumatic caster tire,,,4.55,4.55,1
HCPCS,E2384NU,Pneumatic caster tire,,,45.46,123.57,4
HCPCS,E2384RR,Pneumatic caster tire,,,4.55,12.37,4
HCPCS,E2384UE,Pneumatic caster tire,,,34.08,92.67,4
HCPCS,E2385,"Tube, pneumatic caster tire",,,3.07,89.0,14
HCPCS,E23850,"Tube, pneumatic caster tire",,,30.72,30.72,1
HCPCS,E2385MS,"Tube, pneumatic caster tire",,,3.07,3.07,1
HCPCS,E2385NU,"Tube, pneumatic caster tire",,,30.72,89.0,4
HCPCS,E2385RR,"Tube, pneumatic caster tire",,,3.07,8.91,4
HCPCS,E2385UE,"Tube, pneumatic caster tire",,,23.04,66.74,4
HCPCS,E2386,Foam filled drive wheel tire,,,7.24,214.97,14
HCPCS,E23860,Foam filled drive wheel tire,,,72.4,72.4,1
HCPCS,E2386MS,Foam filled drive wheel tire,,,7.24,7.24,1
HCPCS,E2386NU,Foam filled drive wheel tire,,,72.4,214.97,4
HCPCS,E2386RR,Foam filled drive wheel tire,,,7.24,21.51,4
HCPCS,E2386UE,Foam filled drive wheel tire,,,54.3,161.23,4
HCPCS,E2387,Foam filled caster tire,,,3.69,100.34,14
HCPCS,E23870,Foam filled caster tire,,,36.86,36.86,1
HCPCS,E2387MS,Foam filled caster tire,,,3.69,3.69,1
HCPCS,E2387NU,Foam filled caster tire,,,36.86,100.34,4
HCPCS,E2387RR,Foam filled caster tire,,,3.69,10.04,4
HCPCS,E2387UE,Foam filled caster tire,,,27.65,75.26,4
HCPCS,E2388,Foam drive wheel tire,,,3.35,96.83,14
HCPCS,E23880,Foam drive wheel tire,,,33.43,33.43,1
HCPCS,E2388MS,Foam drive wheel tire,,,3.35,3.35,1
HCPCS,E2388NU,Foam drive wheel tire,,,33.43,96.83,4
HCPCS,E2388RR,Foam drive wheel tire,,,3.35,9.69,4
HCPCS,E2388UE,Foam drive wheel tire,,,25.07,72.64,4
HCPCS,E2389,Foam caster tire,,,1.87,54.12,14
HCPCS,E23890,Foam caster tire,,,18.68,18.68,1
HCPCS,E2389MS,Foam caster tire,,,1.87,1.87,1
HCPCS,E2389NU,Foam caster tire,,,18.68,54.12,4
HCPCS,E2389RR,Foam caster tire,,,1.87,5.41,4
HCPCS,E2389UE,Foam caster tire,,,14.01,40.61,4
HCPCS,E2390,Solid drive wheel tire,,,2.89,83.82,14
HCPCS,E23900,Solid drive wheel tire,,,28.92,28.92,1
HCPCS,E2390MS,Solid drive wheel tire,,,2.89,2.89,1
HCPCS,E2390NU,Solid drive wheel tire,,,28.92,83.82,4
HCPCS,E2390RR,Solid drive wheel tire,,,2.89,8.37,4
HCPCS,E2390UE,Solid drive wheel tire,,,21.7,62.86,4
HCPCS,E2391,Solid caster tire,,,1.29,34.51,14
HCPCS,E23910,Solid caster tire,,,12.86,12.86,1
HCPCS,E2391MS,Solid caster tire,,,1.29,1.29,1
HCPCS,E2391NU,Solid caster tire,,,12.86,34.51,4
HCPCS,E2391RR,Solid caster tire,,,1.29,3.46,4
HCPCS,E2391UE,Solid caster tire,,,9.64,25.88,4
HCPCS,E2392,"Solid caster tire, integrate",,,3.18,83.33,14
HCPCS,E23920,"Solid caster tire, integrate",,,31.71,31.71,1
HCPCS,E2392MS,"Solid caster tire, integrate",,,3.18,3.18,1
HCPCS,E2392NU,"Solid caster tire, integrate",,,31.71,83.33,4
HCPCS,E2392RR,"Solid caster tire, integrate",,,3.18,8.34,4
HCPCS,E2392UE,"Solid caster tire, integrate",,,23.78,62.5,4
HCPCS,E2394,Drive wheel excludes tire,,,4.14,115.58,14
HCPCS,E23940,Drive wheel excludes tire,,,41.39,41.39,1
HCPCS,E2394MS,Drive wheel excludes tire,,,4.14,4.14,1
HCPCS,E2394NU,Drive wheel excludes tire,,,41.39,115.58,4
HCPCS,E2394RR,Drive wheel excludes tire,,,4.14,11.56,4
HCPCS,E2394UE,Drive wheel excludes tire,,,31.04,86.69,4
HCPCS,E2395,Caster wheel excludes tire,,,3.23,86.98,14
HCPCS,E23950,Caster wheel excludes tire,,,32.23,32.23,1
HCPCS,E2395MS,Caster wheel excludes tire,,,3.23,3.23,1
HCPCS,E2395NU,Caster wheel excludes tire,,,32.23,86.98,4
HCPCS,E2395RR,Caster wheel excludes tire,,,3.23,8.71,4
HCPCS,E2395UE,Caster wheel excludes tire,,,24.18,65.24,4
HCPCS,E2396,Caster fork,,,3.57,104.6,14
HCPCS,E23960,Caster fork,,,35.7,35.7,1
HCPCS,E2396MS,Caster fork,,,3.57,3.57,1
HCPCS,E2396NU,Caster fork,,,35.7,104.6,4
HCPCS,E2396RR,Caster fork,,,3.57,10.46,4
HCPCS,E2396UE,Caster fork,,,26.77,78.45,4
HCPCS,E2397,"Pwc acc, lith-based battery",,,31.58,860.15,14
HCPCS,E23970,"Pwc acc, lith-based battery",,,315.79,315.79,1
HCPCS,E2397MS,"Pwc acc, lith-based battery",,,31.58,31.58,1
HCPCS,E2397NU,"Pwc acc, lith-based battery",,,315.79,860.15,4
HCPCS,E2397RR,"Pwc acc, lith-based battery",,,31.58,86.01,4
HCPCS,E2397UE,"Pwc acc, lith-based battery",,,236.84,645.11,4
HCPCS,E2398,Wc dynamic pos back hardware,,,9.3,267.83,14
HCPCS,E23980,Wc dynamic pos back hardware,,,92.98,92.98,1
HCPCS,E2398MS,Wc dynamic pos back hardware,,,9.3,9.3,1
HCPCS,E2398NU,Wc dynamic pos back hardware,,,92.98,267.83,4
HCPCS,E2398RR,Wc dynamic pos back hardware,,,9.3,26.79,4
HCPCS,E2398UE,Wc dynamic pos back hardware,,,69.72,200.85,4
HCPCS,E2402,Neg press wound therapy pump,,,461.65,4616.45,8
HCPCS,E24020,Neg press wound therapy pump,,,4616.45,4616.45,1
HCPCS,E2402MS,Neg press wound therapy pump,,,461.65,461.65,1
HCPCS,E2402NU,Neg press wound therapy pump,,,4616.45,4616.45,1
HCPCS,E2402RR,Neg press wound therapy pump,,,461.65,1434.99,4
HCPCS,E2402UE,Neg press wound therapy pump,,,3462.34,3462.34,1
HCPCS,E2500,Sgd digitized pre-rec <=8min,,,31.7,912.98,14
HCPCS,E25000,Sgd digitized pre-rec <=8min,,,316.94,316.94,1
HCPCS,E2500MS,Sgd digitized pre-rec <=8min,,,31.7,31.7,1
HCPCS,E2500NU,Sgd digitized pre-rec <=8min,,,316.94,912.98,4
HCPCS,E2500RR,Sgd digitized pre-rec <=8min,,,31.7,91.3,4
HCPCS,E2500UE,Sgd digitized pre-rec <=8min,,,237.7,684.73,4
HCPCS,E2502,Sgd prerec msg >8min <=20min,,,96.93,2791.82,14
HCPCS,E25020,Sgd prerec msg >8min <=20min,,,969.16,969.16,1
HCPCS,E2502MS,Sgd prerec msg >8min <=20min,,,96.93,96.93,1
HCPCS,E2502NU,Sgd prerec msg >8min <=20min,,,969.16,2791.82,4
HCPCS,E2502RR,Sgd prerec msg >8min <=20min,,,96.93,279.22,4
HCPCS,E2502UE,Sgd prerec msg >8min <=20min,,,726.88,2093.9,4
HCPCS,E2504,Sgd prerec msg>20min <=40min,,,127.86,3682.83,14
HCPCS,E25040,Sgd prerec msg>20min <=40min,,,1278.47,1278.47,1
HCPCS,E2504MS,Sgd prerec msg>20min <=40min,,,127.86,127.86,1
HCPCS,E2504NU,Sgd prerec msg>20min <=40min,,,1278.47,3682.83,4
HCPCS,E2504RR,Sgd prerec msg>20min <=40min,,,127.86,368.32,4
HCPCS,E2504UE,Sgd prerec msg>20min <=40min,,,958.86,2762.13,4
HCPCS,E2506,Sgd prerec msg > 40 min,,,187.46,5400.07,14
HCPCS,E25060,Sgd prerec msg > 40 min,,,1874.61,1874.61,1
HCPCS,E2506MS,Sgd prerec msg > 40 min,,,187.46,187.46,1
HCPCS,E2506NU,Sgd prerec msg > 40 min,,,1874.61,5400.07,4
HCPCS,E2506RR,Sgd prerec msg > 40 min,,,187.46,539.98,4
HCPCS,E2506UE,Sgd prerec msg > 40 min,,,1405.92,4049.99,4
HCPCS,E2508,Sgd spelling phys contact,,,289.88,8350.34,14
HCPCS,E25080,Sgd spelling phys contact,,,2898.77,2898.77,1
HCPCS,E2508MS,Sgd spelling phys contact,,,289.88,289.88,1
HCPCS,E2508NU,Sgd spelling phys contact,,,2898.77,8350.34,4
HCPCS,E2508RR,Sgd spelling phys contact,,,289.88,835.03,4
HCPCS,E2508UE,Sgd spelling phys contact,,,2174.08,6262.77,4
HCPCS,E2510,Sgd w multi methods msg/accs,,,548.55,15801.91,14
HCPCS,E25100,Sgd w multi methods msg/accs,,,5485.55,5485.55,1
HCPCS,E2510MS,Sgd w multi methods msg/accs,,,548.55,548.55,1
HCPCS,E2510NU,Sgd w multi methods msg/accs,,,5485.55,15801.91,4
HCPCS,E2510RR,Sgd w multi methods msg/accs,,,548.55,1580.18,4
HCPCS,E2510UE,Sgd w multi methods msg/accs,,,4114.14,11851.4,4
HCPCS,E2511,Sgd sftwre prgrm for pc/pda,,,21.7,216.95,5
HCPCS,E25110,Sgd sftwre prgrm for pc/pda,,,216.95,216.95,1
HCPCS,E2511MS,Sgd sftwre prgrm for pc/pda,,,21.7,21.7,1
HCPCS,E2511NU,Sgd sftwre prgrm for pc/pda,,,216.95,216.95,1
HCPCS,E2511RR,Sgd sftwre prgrm for pc/pda,,,21.7,21.7,1
HCPCS,E2511UE,Sgd sftwre prgrm for pc/pda,,,162.71,162.71,1
HCPCS,E2512,"Sgd accessory, mounting sys",,,2.92,29.13,5
HCPCS,E25120,"Sgd accessory, mounting sys",,,29.13,29.13,1
HCPCS,E2512MS,"Sgd accessory, mounting sys",,,2.92,2.92,1
HCPCS,E2512NU,"Sgd accessory, mounting sys",,,29.13,29.13,1
HCPCS,E2512RR,"Sgd accessory, mounting sys",,,2.92,2.92,1
HCPCS,E2512UE,"Sgd accessory, mounting sys",,,21.85,21.85,1
HCPCS,E2513,"Sgd accessory, emg sensor",,,255.41,7357.31,14
HCPCS,E25130,"Sgd accessory, emg sensor",,,2554.05,2554.05,1
HCPCS,E2513MS,"Sgd accessory, emg sensor",,,255.41,255.41,1
HCPCS,E2513NU,"Sgd accessory, emg sensor",,,2554.05,7357.31,4
HCPCS,E2513RR,"Sgd accessory, emg sensor",,,255.41,735.76,4
HCPCS,E2513UE,"Sgd accessory, emg sensor",,,1915.54,5518.01,4
HCPCS,E2601,Gen w/c cushion wdth < 22 in,,,2.69,80.12,14
HCPCS,E26010,Gen w/c cushion wdth < 22 in,,,26.86,26.86,1
HCPCS,E2601MS,Gen w/c cushion wdth < 22 in,,,2.69,2.69,1
HCPCS,E2601NU,Gen w/c cushion wdth < 22 in,,,26.86,80.12,4
HCPCS,E2601RR,Gen w/c cushion wdth < 22 in,,,2.69,8.02,4
HCPCS,E2601UE,Gen w/c cushion wdth < 22 in,,,20.14,60.09,4
HCPCS,E2602,Gen w/c cushion wdth >=22 in,,,5.99,172.1,14
HCPCS,E26020,Gen w/c cushion wdth >=22 in,,,59.94,59.94,1
HCPCS,E2602MS,Gen w/c cushion wdth >=22 in,,,5.99,5.99,1
HCPCS,E2602NU,Gen w/c cushion wdth >=22 in,,,59.94,172.1,4
HCPCS,E2602RR,Gen w/c cushion wdth >=22 in,,,5.99,17.21,4
HCPCS,E2602UE,Gen w/c cushion wdth >=22 in,,,44.96,129.07,4
HCPCS,E2603,Skin protect wc cus wd <22in,,,7.21,214.39,14
HCPCS,E26030,Skin protect wc cus wd <22in,,,72.2,72.2,1
HCPCS,E2603MS,Skin protect wc cus wd <22in,,,7.21,7.21,1
HCPCS,E2603NU,Skin protect wc cus wd <22in,,,72.2,214.39,4
HCPCS,E2603RR,Skin protect wc cus wd <22in,,,7.21,21.44,4
HCPCS,E2603UE,Skin protect wc cus wd <22in,,,54.15,160.78,4
HCPCS,E2604,Skin protect wc cus wd>=22in,,,10.04,293.44,14
HCPCS,E26040,Skin protect wc cus wd>=22in,,,100.45,100.45,1
HCPCS,E2604MS,Skin protect wc cus wd>=22in,,,10.04,10.04,1
HCPCS,E2604NU,Skin protect wc cus wd>=22in,,,100.45,293.44,4
HCPCS,E2604RR,Skin protect wc cus wd>=22in,,,10.04,29.34,4
HCPCS,E2604UE,Skin protect wc cus wd>=22in,,,75.34,220.09,4
HCPCS,E2605,Position wc cush wdth <22 in,,,14.68,417.9,14
HCPCS,E26050,Position wc cush wdth <22 in,,,146.7,146.7,1
HCPCS,E2605MS,Position wc cush wdth <22 in,,,14.68,14.68,1
HCPCS,E2605NU,Position wc cush wdth <22 in,,,146.7,417.9,4
HCPCS,E2605RR,Position wc cush wdth <22 in,,,14.68,41.79,4
HCPCS,E2605UE,Position wc cush wdth <22 in,,,110.02,313.43,4
HCPCS,E2606,Position wc cush wdth>=22 in,,,24.55,671.66,14
HCPCS,E26060,Position wc cush wdth>=22 in,,,245.42,245.42,1
HCPCS,E2606MS,Position wc cush wdth>=22 in,,,24.55,24.55,1
HCPCS,E2606NU,Position wc cush wdth>=22 in,,,245.42,671.66,4
HCPCS,E2606RR,Position wc cush wdth>=22 in,,,24.55,67.17,4
HCPCS,E2606UE,Position wc cush wdth>=22 in,,,184.06,503.76,4
HCPCS,E2607,Skin pro/pos wc cus wd <22in,,,14.44,420.66,14
HCPCS,E26070,Skin pro/pos wc cus wd <22in,,,144.37,144.37,1
HCPCS,E2607MS,Skin pro/pos wc cus wd <22in,,,14.44,14.44,1
HCPCS,E2607NU,Skin pro/pos wc cus wd <22in,,,144.37,420.66,4
HCPCS,E2607RR,Skin pro/pos wc cus wd <22in,,,14.44,42.06,4
HCPCS,E2607UE,Skin pro/pos wc cus wd <22in,,,108.28,315.48,4
HCPCS,E2608,Skin pro/pos wc cus wd>=22in,,,18.04,520.57,14
HCPCS,E26080,Skin pro/pos wc cus wd>=22in,,,180.31,180.31,1
HCPCS,E2608MS,Skin pro/pos wc cus wd>=22in,,,18.04,18.04,1
HCPCS,E2608NU,Skin pro/pos wc cus wd>=22in,,,180.31,520.57,4
HCPCS,E2608RR,Skin pro/pos wc cus wd>=22in,,,18.04,52.05,4
HCPCS,E2608UE,Skin pro/pos wc cus wd>=22in,,,135.24,390.43,4
HCPCS,E2609,Custom fabricate w/c cushion,,,3620.12,3620.12,1
HCPCS,E26090,Custom fabricate w/c cushion,,,3620.12,3620.12,1
HCPCS,E2610,Powered w/c cushion,,,3.34,33.37,5
HCPCS,E26100,Powered w/c cushion,,,33.37,33.37,1
HCPCS,E2610MS,Powered w/c cushion,,,3.34,3.34,1
HCPCS,E2610NU,Powered w/c cushion,,,33.37,33.37,1
HCPCS,E2610RR,Powered w/c cushion,,,3.34,3.34,1
HCPCS,E2610UE,Powered w/c cushion,,,25.03,25.03,1
HCPCS,E2611,Gen use back cush wdth <22in,,,10.24,331.31,14
HCPCS,E26110,Gen use back cush wdth <22in,,,102.35,102.35,1
HCPCS,E2611MS,Gen use back cush wdth <22in,,,10.24,10.24,1
HCPCS,E2611NU,Gen use back cush wdth <22in,,,102.35,331.31,4
HCPCS,E2611RR,Gen use back cush wdth <22in,,,10.24,33.14,4
HCPCS,E2611UE,Gen use back cush wdth <22in,,,76.77,248.48,4
HCPCS,E2612,Gen use back cush wdth>=22in,,,21.19,632.16,14
HCPCS,E26120,Gen use back cush wdth>=22in,,,211.95,211.95,1
HCPCS,E2612MS,Gen use back cush wdth>=22in,,,21.19,21.19,1
HCPCS,E2612NU,Gen use back cush wdth>=22in,,,211.95,632.16,4
HCPCS,E2612RR,Gen use back cush wdth>=22in,,,21.19,63.21,4
HCPCS,E2612UE,Gen use back cush wdth>=22in,,,158.97,474.11,4
HCPCS,E2613,Position back cush wd <22in,,,21.7,622.76,14
HCPCS,E26130,Position back cush wd <22in,,,216.94,216.94,1
HCPCS,E2613MS,Position back cush wd <22in,,,21.7,21.7,1
HCPCS,E2613NU,Position back cush wd <22in,,,216.94,622.76,4
HCPCS,E2613RR,Position back cush wd <22in,,,21.7,62.28,4
HCPCS,E2613UE,Position back cush wd <22in,,,162.7,467.08,4
HCPCS,E2614,Position back cush wd>=22in,,,33.33,895.34,14
HCPCS,E26140,Position back cush wd>=22in,,,333.3,333.3,1
HCPCS,E2614MS,Position back cush wd>=22in,,,33.33,33.33,1
HCPCS,E2614NU,Position back cush wd>=22in,,,333.3,895.34,4
HCPCS,E2614RR,Position back cush wd>=22in,,,33.33,89.53,4
HCPCS,E2614UE,Position back cush wd>=22in,,,249.98,671.51,4
HCPCS,E2615,Pos back post/lat wdth <22in,,,24.38,704.33,14
HCPCS,E26150,Pos back post/lat wdth <22in,,,243.72,243.72,1
HCPCS,E2615MS,Pos back post/lat wdth <22in,,,24.38,24.38,1
HCPCS,E2615NU,Pos back post/lat wdth <22in,,,243.72,704.33,4
HCPCS,E2615RR,Pos back post/lat wdth <22in,,,24.38,70.43,4
HCPCS,E2615UE,Pos back post/lat wdth <22in,,,182.8,528.25,4
HCPCS,E2616,Pos back post/lat wdth>=22in,,,33.92,946.52,14
HCPCS,E26160,Pos back post/lat wdth>=22in,,,339.23,339.23,1
HCPCS,E2616MS,Pos back post/lat wdth>=22in,,,33.92,33.92,1
HCPCS,E2616NU,Pos back post/lat wdth>=22in,,,339.23,946.52,4
HCPCS,E2616RR,Pos back post/lat wdth>=22in,,,33.92,94.65,4
HCPCS,E2616UE,Pos back post/lat wdth>=22in,,,254.43,709.89,4
HCPCS,E2617,Custom fab w/c back cushion,,,3990.5,3990.5,1
HCPCS,E26170,Custom fab w/c back cushion,,,3990.5,3990.5,1
HCPCS,E2619,Replace cover w/c seat cush,,,3.43,99.71,14
HCPCS,E26190,Replace cover w/c seat cush,,,34.41,34.41,1
HCPCS,E2619MS,Replace cover w/c seat cush,,,3.43,3.43,1
HCPCS,E2619NU,Replace cover w/c seat cush,,,34.41,99.71,4
HCPCS,E2619RR,Replace cover w/c seat cush,,,3.43,9.98,4
HCPCS,E2619UE,Replace cover w/c seat cush,,,25.81,74.79,4
HCPCS,E2620,Wc planar back cush wd <22in,,,26.47,777.77,14
HCPCS,E26200,Wc planar back cush wd <22in,,,264.72,264.72,1
HCPCS,E2620MS,Wc planar back cush wd <22in,,,26.47,26.47,1
HCPCS,E2620NU,Wc planar back cush wd <22in,,,264.72,777.77,4
HCPCS,E2620RR,Wc planar back cush wd <22in,,,26.47,77.79,4
HCPCS,E2620UE,Wc planar back cush wd <22in,,,198.54,583.33,4
HCPCS,E2621,Wc planar back cush wd>=22in,,,31.98,908.51,14
HCPCS,E26210,Wc planar back cush wd>=22in,,,319.82,319.82,1
HCPCS,E2621MS,Wc planar back cush wd>=22in,,,31.98,31.98,1
HCPCS,E2621NU,Wc planar back cush wd>=22in,,,319.82,908.51,4
HCPCS,E2621RR,Wc planar back cush wd>=22in,,,31.98,90.85,4
HCPCS,E2621UE,Wc planar back cush wd>=22in,,,239.87,681.38,4
HCPCS,E2622,Adj skin pro w/c cus wd<22in,,,21.83,632.52,14
HCPCS,E26220,Adj skin pro w/c cus wd<22in,,,218.3,218.3,1
HCPCS,E2622MS,Adj skin pro w/c cus wd<22in,,,21.83,21.83,1
HCPCS,E2622NU,Adj skin pro w/c cus wd<22in,,,218.3,632.52,4
HCPCS,E2622RR,Adj skin pro w/c cus wd<22in,,,21.83,63.25,4
HCPCS,E2622UE,Adj skin pro w/c cus wd<22in,,,163.73,474.4,4
HCPCS,E2623,Adj skin pro wc cus wd>=22in,,,27.6,799.87,14
HCPCS,E26230,Adj skin pro wc cus wd>=22in,,,276.06,276.06,1
HCPCS,E2623MS,Adj skin pro wc cus wd>=22in,,,27.6,27.6,1
HCPCS,E2623NU,Adj skin pro wc cus wd>=22in,,,276.06,799.87,4
HCPCS,E2623RR,Adj skin pro wc cus wd>=22in,,,27.6,79.99,4
HCPCS,E2623UE,Adj skin pro wc cus wd>=22in,,,207.04,599.91,4
HCPCS,E2624,Adj skin pro/pos cus<22in,,,22.18,642.75,14
HCPCS,E26240,Adj skin pro/pos cus<22in,,,221.83,221.83,1
HCPCS,E2624MS,Adj skin pro/pos cus<22in,,,22.18,22.18,1
HCPCS,E2624NU,Adj skin pro/pos cus<22in,,,221.83,642.75,4
HCPCS,E2624RR,Adj skin pro/pos cus<22in,,,22.18,64.28,4
HCPCS,E2624UE,Adj skin pro/pos cus<22in,,,166.37,482.07,4
HCPCS,E2625,Adj skin pro/pos wc cus>=22,,,27.45,795.46,14
HCPCS,E26250,Adj skin pro/pos wc cus>=22,,,274.53,274.53,1
HCPCS,E2625MS,Adj skin pro/pos wc cus>=22,,,27.45,27.45,1
HCPCS,E2625NU,Adj skin pro/pos wc cus>=22,,,274.53,795.46,4
HCPCS,E2625RR,Adj skin pro/pos wc cus>=22,,,27.45,79.56,4
HCPCS,E2625UE,Adj skin pro/pos wc cus>=22,,,205.9,596.6,4
HCPCS,E2626,Seo mobile arm sup att to wc,,,44.66,1250.68,14
HCPCS,E26260,Seo mobile arm sup att to wc,,,446.63,446.63,1
HCPCS,E2626MS,Seo mobile arm sup att to wc,,,44.66,44.66,1
HCPCS,E2626NU,Seo mobile arm sup att to wc,,,446.63,1250.68,4
HCPCS,E2626RR,Seo mobile arm sup att to wc,,,44.66,125.07,4
HCPCS,E2626UE,Seo mobile arm sup att to wc,,,334.98,938.02,4
HCPCS,E2627,Arm supp att to wc rancho ty,,,65.18,1935.17,14
HCPCS,E26270,Arm supp att to wc rancho ty,,,651.72,651.72,1
HCPCS,E2627MS,Arm supp att to wc rancho ty,,,65.18,65.18,1
HCPCS,E2627NU,Arm supp att to wc rancho ty,,,651.72,1935.17,4
HCPCS,E2627RR,Arm supp att to wc rancho ty,,,65.18,193.52,4
HCPCS,E2627UE,Arm supp att to wc rancho ty,,,488.79,1451.38,4
HCPCS,E2628,Mobile arm supports reclinin,,,51.43,1512.0,14
HCPCS,E26280,Mobile arm supports reclinin,,,514.37,514.37,1
HCPCS,E2628MS,Mobile arm supports reclinin,,,51.43,51.43,1
HCPCS,E2628NU,Mobile arm supports reclinin,,,514.37,1512.0,4
HCPCS,E2628RR,Mobile arm supports reclinin,,,51.43,151.21,4
HCPCS,E2628UE,Mobile arm supports reclinin,,,385.78,1134.01,4
HCPCS,E2629,Friction dampening arm supp,,,68.69,1908.57,14
HCPCS,E26290,Friction dampening arm supp,,,686.92,686.92,1
HCPCS,E2629MS,Friction dampening arm supp,,,68.69,68.69,1
HCPCS,E2629NU,Friction dampening arm supp,,,686.92,1908.57,4
HCPCS,E2629RR,Friction dampening arm supp,,,68.69,190.86,4
HCPCS,E2629UE,Friction dampening arm supp,,,515.19,1431.43,4
HCPCS,E2630,Monosuspension arm/hand supp,,,45.33,1286.65,14
HCPCS,E26300,Monosuspension arm/hand supp,,,453.21,453.21,1
HCPCS,E2630MS,Monosuspension arm/hand supp,,,45.33,45.33,1
HCPCS,E2630NU,Monosuspension arm/hand supp,,,453.21,1286.65,4
HCPCS,E2630RR,Monosuspension arm/hand supp,,,45.33,128.67,4
HCPCS,E2630UE,Monosuspension arm/hand supp,,,339.92,965.0,4
HCPCS,E2631,Elevat proximal arm support,,,18.21,561.17,14
HCPCS,E26310,Elevat proximal arm support,,,182.08,182.08,1
HCPCS,E2631MS,Elevat proximal arm support,,,18.21,18.21,1
HCPCS,E2631NU,Elevat proximal arm support,,,182.08,561.17,4
HCPCS,E2631RR,Elevat proximal arm support,,,18.21,56.11,4
HCPCS,E2631UE,Elevat proximal arm support,,,136.57,420.89,4
HCPCS,E2632,Offset/lat rocker arm w/ela,,,11.57,337.51,14
HCPCS,E26320,Offset/lat rocker arm w/ela,,,115.78,115.78,1
HCPCS,E2632MS,Offset/lat rocker arm w/ela,,,11.57,11.57,1
HCPCS,E2632NU,Offset/lat rocker arm w/ela,,,115.78,337.51,4
HCPCS,E2632RR,Offset/lat rocker arm w/ela,,,11.57,33.75,4
HCPCS,E2632UE,Offset/lat rocker arm w/ela,,,86.83,253.12,4
HCPCS,E2633,Mobile arm support supinator,,,9.66,273.43,14
HCPCS,E26330,Mobile arm support supinator,,,96.54,96.54,1
HCPCS,E2633MS,Mobile arm support supinator,,,9.66,9.66,1
HCPCS,E2633NU,Mobile arm support supinator,,,96.54,273.43,4
HCPCS,E2633RR,Mobile arm support supinator,,,9.66,27.34,4
HCPCS,E2633UE,Mobile arm support supinator,,,72.41,205.08,4
HCPCS,E3000,Speech volume modulation sys,,,139.24,1392.4,8
HCPCS,E30000,Speech volume modulation sys,,,1392.4,1392.4,1
HCPCS,E3000MS,Speech volume modulation sys,,,139.24,139.24,1
HCPCS,E3000NU,Speech volume modulation sys,,,1392.4,1392.4,1
HCPCS,E3000RR,Speech volume modulation sys,,,139.24,401.11,4
HCPCS,E3000UE,Speech volume modulation sys,,,1044.3,1044.3,1
HCPCS,E3200,Gait mod systm rhym auditory,,,686.39,6863.97,5
HCPCS,E32000,Gait mod systm rhym auditory,,,6863.97,6863.97,1
HCPCS,E3200MS,Gait mod systm rhym auditory,,,686.39,686.39,1
HCPCS,E3200NU,Gait mod systm rhym auditory,,,6863.97,6863.97,1
HCPCS,E3200RR,Gait mod systm rhym auditory,,,686.39,686.39,1
HCPCS,E3200UE,Gait mod systm rhym auditory,,,5147.98,5147.98,1
HCPCS,E8000,Posterior gait trainer,,,195.8,1958.06,5
HCPCS,E80000,Posterior gait trainer,,,1958.06,1958.06,1
HCPCS,E8000MS,Posterior gait trainer,,,195.8,195.8,1
HCPCS,E8000NU,Posterior gait trainer,,,1958.06,1958.06,1
HCPCS,E8000RR,Posterior gait trainer,,,195.8,195.8,1
HCPCS,E8000UE,Posterior gait trainer,,,1468.55,1468.55,1
HCPCS,E8001,Upright gait trainer,,,206.81,2068.1,5
HCPCS,E80010,Upright gait trainer,,,2068.1,2068.1,1
HCPCS,E8001MS,Upright gait trainer,,,206.81,206.81,1
HCPCS,E8001NU,Upright gait trainer,,,2068.1,2068.1,1
HCPCS,E8001RR,Upright gait trainer,,,206.81,206.81,1
HCPCS,E8001UE,Upright gait trainer,,,1551.07,1551.07,1
HCPCS,E8002,Anterior gait trainer,,,229.96,2299.68,5
HCPCS,E80020,Anterior gait trainer,,,2299.68,2299.68,1
HCPCS,E8002MS,Anterior gait trainer,,,229.96,229.96,1
HCPCS,E8002NU,Anterior gait trainer,,,2299.68,2299.68,1
HCPCS,E8002RR,Anterior gait trainer,,,229.96,229.96,1
HCPCS,E8002UE,Anterior gait trainer,,,1724.76,1724.76,1
HCPCS,ECC,JOINT VENTURE DIGITAL SECOND OPINION,500.0,325.0,250.0,500.0,12
HCPCS,ECC,JV MULTIDISCIPLINARY BOARD REVIEW,700.0,455.0,350.0,700.0,12
HCPCS,G0008,ADMIN FLU VACCINE,231.0,150.15,25.75,207.9,40
HCPCS,G0008,Admin influenza virus vac,,,10.8,10.8,1
HCPCS,G00080,Admin influenza virus vac,,,10.8,10.8,1
HCPCS,G0009,Admin pneumococcal vaccine,,,10.8,100.04,21
HCPCS,G0009,MEDICAR PT ADMIN.PNEUMOCCAL VIR,43.0,27.95,21.5,43.0,13
HCPCS,G00090,Admin pneumococcal vaccine,,,10.8,10.8,1
HCPCS,G0010,ADMIN HEPATITIS B VACCINE,231.0,150.15,25.75,207.9,40
HCPCS,G0010,Admin hepatitis b vaccine,,,10.8,10.8,1
HCPCS,G0010,HEPATITIS B ADMINIS,99.0,64.35,33.58,99.0,13
HCPCS,G00100,Admin hepatitis b vaccine,,,10.8,10.8,1
HCPCS,G0011,"Hiv prep counsel, md 15-30m",,,23.27,51.49,7
HCPCS,G00110,"Hiv prep counsel, md 15-30m",,,23.27,23.27,1
HCPCS,G0012,Injection of hiv prep drug,,,14.53,154.31,21
HCPCS,G00120,Injection of hiv prep drug,,,14.53,14.53,1
HCPCS,G0013,"Hiv prep counsel, clin staff",,,9.04,64.59,21
HCPCS,G00130,"Hiv prep counsel, clin staff",,,9.04,9.04,1
HCPCS,G0017,Crisis psychotherapy 60m,,,163.8,206.9,7
HCPCS,G00170,Crisis psychotherapy 60m,,,198.45,198.45,1
HCPCS,G0018,Crisis psychotherapy add 30m,,,99.42,206.9,7
HCPCS,G00180,Crisis psychotherapy add 30m,,,99.42,99.42,1
HCPCS,G0019,Comm hlth intg svs sdoh 60mn,,,34.32,200.56,21
HCPCS,G00190,Comm hlth intg svs sdoh 60mn,,,52.3,52.3,1
HCPCS,G0022,Comm hlth intg svs add 30 m,,,34.32,43.36,7
HCPCS,G00220,Comm hlth intg svs add 30 m,,,36.51,36.51,1
HCPCS,G0023,Pin service 60m per month,,,34.32,200.56,21
HCPCS,G00230,Pin service 60m per month,,,51.79,51.79,1
HCPCS,G0024,Pin srv add 30 min pr m,,,34.32,43.36,7
HCPCS,G00240,Pin srv add 30 min pr m,,,36.16,36.16,1
HCPCS,G0027,ABSENCE/PRESENCE SPERM (POC) (POINT OF CARE LAB),57.0,37.05,2.34,51.3,37
HCPCS,G0027,Semen analysis,,,5.62,5.62,1
HCPCS,G00270,Semen analysis,,,5.62,5.62,1
HCPCS,G0031,Pall serv during meas,,,3020.88,3020.88,1
HCPCS,G00310,Pall serv during meas,,,3020.88,3020.88,1
HCPCS,G0032,2+ antipsy schiz,,,19.44,19.44,1
HCPCS,G00320,2+ antipsy schiz,,,19.44,19.44,1
HCPCS,G0035,Pt ed pos 23,,,3026.15,3026.15,1
HCPCS,G00350,Pt ed pos 23,,,3026.15,3026.15,1
HCPCS,G0037,Pt not able to participate,,,120.96,120.96,1
HCPCS,G00370,Pt not able to participate,,,120.96,120.96,1
HCPCS,G0047,Ped blunt hd traum,,,3236.26,3236.26,1
HCPCS,G00470,Ped blunt hd traum,,,3236.26,3236.26,1
HCPCS,G0050,Pt w/ lmted life expec,,,113.83,113.83,1
HCPCS,G00500,Pt w/ lmted life expec,,,113.83,113.83,1
HCPCS,G0068,Adm iv infusion drug in home,,,186.8,186.8,1
HCPCS,G00680,Adm iv infusion drug in home,,,186.8,186.8,1
HCPCS,G0069,Adm sq infusion drug in home,,,252.41,252.41,1
HCPCS,G00690,Adm sq infusion drug in home,,,252.41,252.41,1
HCPCS,G0070,Adm of chemo drug in home,,,314.0,314.0,1
HCPCS,G00700,Adm of chemo drug in home,,,314.0,314.0,1
HCPCS,G0071,Comm svcs by rhc/fqhc 5 min,,,27.04,34.15,6
HCPCS,G0076,Care manag h vst new pt 20 m,,,51.41,95.54,7
HCPCS,G00760,Care manag h vst new pt 20 m,,,51.41,51.41,1
HCPCS,G0077,Care manag h vst new pt 30 m,,,75.64,95.54,7
HCPCS,G00770,Care manag h vst new pt 30 m,,,76.5,76.5,1
HCPCS,G0078,Care manag h vst new pt 45 m,,,75.64,125.58,7
HCPCS,G00780,Care manag h vst new pt 45 m,,,125.58,125.58,1
HCPCS,G0079,Care manag h vst new pt 60 m,,,75.64,165.09,7
HCPCS,G00790,Care manag h vst new pt 60 m,,,165.09,165.09,1
HCPCS,G0080,Care manag h vst new pt 75 m,,,75.64,215.72,7
HCPCS,G00800,Care manag h vst new pt 75 m,,,215.72,215.72,1
HCPCS,G0081,Care man h v ext pt 20 mi,,,50.4,95.54,7
HCPCS,G00810,Care man h v ext pt 20 mi,,,50.4,50.4,1
HCPCS,G0082,Care man h v ext pt 30 m,,,75.64,95.54,7
HCPCS,G00820,Care man h v ext pt 30 m,,,81.16,81.16,1
HCPCS,G0083,Care man h v ext pt 45 m,,,75.64,127.4,7
HCPCS,G00830,Care man h v ext pt 45 m,,,127.4,127.4,1
HCPCS,G0084,Care man h v ext pt 60 m,,,75.64,180.04,7
HCPCS,G00840,Care man h v ext pt 60 m,,,180.04,180.04,1
HCPCS,G0085,Care man h v ext pt 75 m,,,75.64,215.72,7
HCPCS,G00850,Care man h v ext pt 75 m,,,215.72,215.72,1
HCPCS,G0086,Care man home care plan 30 m,,,75.64,95.54,7
HCPCS,G00860,Care man home care plan 30 m,,,76.38,76.38,1
HCPCS,G0087,Care man home care plan 60 m,,,75.64,107.15,7
HCPCS,G00870,Care man home care plan 60 m,,,107.15,107.15,1
HCPCS,G0088,Adm iv drug 1st home visit,,,227.2,227.2,1
HCPCS,G00880,Adm iv drug 1st home visit,,,227.2,227.2,1
HCPCS,G0089,Adm subq drug 1st home visit,,,306.97,306.97,1
HCPCS,G00890,Adm subq drug 1st home visit,,,306.97,306.97,1
HCPCS,G0090,Adm iv chemo 1st home visit,,,381.89,381.89,1
HCPCS,G00900,Adm iv chemo 1st home visit,,,381.89,381.89,1
HCPCS,G0101,"CERV/VAG CANC SCRN,PELV/BREAST EXAM",198.0,128.7,20.49,198.0,35
HCPCS,G0101,Ca screen;pelvic/breast exam,,,28.32,28.32,1
HCPCS,G0101,EST PATIENT SCREENING,198.0,128.7,20.49,198.0,35
HCPCS,G0101,PELVIC AND CLINICAL BREAST EXAM,198.0,128.7,20.49,198.0,35
HCPCS,G0101,SCREEN CERV/VAG & PELV/BREAST,463.0,300.95,32.46,416.7,32
HCPCS,G01010,Ca screen;pelvic/breast exam,,,28.32,28.32,1
HCPCS,G0102,PROSTATE CA SCREENING; DRE,79.0,51.35,7.53,79.0,31
HCPCS,G0102,Prostate ca screening; dre,,,9.04,9.04,1
HCPCS,G01020,Prostate ca screening; dre,,,9.04,9.04,1
HCPCS,G0103,PROSTATE SCREEN,127.0,82.55,5.23,114.3,37
HCPCS,G0103,Psa screening,,,16.69,16.69,1
HCPCS,G01030,Psa screening,,,16.69,16.69,1
HCPCS,G0104,Ca screen;flexi sigmoidscope,,,57.97,1976.74,23
HCPCS,G0104,SCREENING SIGMOIDOSCOPY,370.0,240.5,55.82,370.0,31
HCPCS,G01040,Ca screen;flexi sigmoidscope,,,57.97,57.97,1
HCPCS,G0105,"COLONOSCOPY, SCREENING, HIGH RISK",1434.0,932.1,177.19,1434.0,31
HCPCS,G0105,Colorectal scrn; hi risk ind,,,94.59,188.86,2
HCPCS,G0105,SCRN COLONOSCOPY ON HI RISK PT,4559.0,2963.35,220.97,6317.0,48
HCPCS,G01050,Colorectal scrn; hi risk ind,,,188.86,188.86,1
HCPCS,G010553,Colorectal scrn; hi risk ind,,,94.59,94.59,1
HCPCS,G0106,"COLOREC CANC SCRN,SIGMOIDOSCOPY+BE",542.0,352.3,39.91,542.0,38
HCPCS,G0106,Colon ca screen;barium enema,,,71.29,90.05,6
HCPCS,G0108,"DIAB OUTPT TRAINING INDIV, PER SESSN",396.0,257.4,40.12,396.0,32
HCPCS,G0108,DIABETES OP SELF MANAGEMENT INDIV PER 30,396.0,257.4,40.12,396.0,32
HCPCS,G0108,Diab manage trn  per indiv,,,55.88,139.89,22
HCPCS,G0108,Diab manage trn per indiv,,,41.57,52.51,6
HCPCS,G01080,Diab manage trn  per indiv,,,55.88,55.88,1
HCPCS,G0109,"DIAB TRAIN SERV, GROUP SESSN,INDIVID",110.0,71.5,11.12,110.0,32
HCPCS,G0109,Diab manage trn ind/group,,,16.07,39.91,28
HCPCS,G01090,Diab manage trn ind/group,,,16.07,16.07,1
HCPCS,G0117,GLAUCOMA SCRN HGH RISK DIREC,198.0,128.7,43.88,198.0,31
HCPCS,G0117,Glaucoma scrn hgh risk direc,,,24.58,63.44,15
HCPCS,G01170,Glaucoma scrn hgh risk direc,,,63.44,63.44,1
HCPCS,G0118,Glaucoma scrn hgh risk direc,,,39.0,85.1,15
HCPCS,G01180,Glaucoma scrn hgh risk direc,,,41.44,41.44,1
HCPCS,G0120,Colon ca scrn; barium enema,,,71.29,90.05,6
HCPCS,G0121,COLONOSCOPY SCRN NOT HIGH RISK,1434.0,932.1,177.8,1434.0,31
HCPCS,G0121,"COLOSCPY, SCRN;  NOT HI RISK",4559.0,2963.35,221.16,6317.0,48
HCPCS,G0121,Colon ca scrn not hi rsk ind,,,94.95,189.23,2
HCPCS,G0121,SCREENING COLONSCOPY NOT HIGH RISK,1434.0,932.1,177.8,1434.0,31
HCPCS,G0121,SCRN COLONOSCOPY PT NOT HI RISK,4559.0,2963.35,221.16,6317.0,48
HCPCS,G01210,Colon ca scrn not hi rsk ind,,,189.23,189.23,1
HCPCS,G012153,Colon ca scrn not hi rsk ind,,,94.95,94.95,1
HCPCS,G0122,Colon ca scrn; barium enema,,,33.81,42.71,6
HCPCS,G0123,PAP SMEAR THIN PREP,90.0,58.5,9.95,81.0,37
HCPCS,G0123,Screen cerv/vag thin layer,,,17.51,17.51,1
HCPCS,G01230,Screen cerv/vag thin layer,,,17.51,17.51,1
HCPCS,G0124,"SCR CYTOPATH,CERV/VAG, PHYS INTERPRE",114.0,74.1,14.51,114.0,31
HCPCS,G0124,Screen c/v thin layer by md,,,9.95,24.21,7
HCPCS,G01240,Screen c/v thin layer by md,,,24.21,24.21,1
HCPCS,G0127,"TRIMMING DYSTROPHIC NAILS,ANY NUMBER",75.0,48.75,6.67,75.0,34
HCPCS,G0127,Trim nail(s),,,7.71,128.79,21
HCPCS,G01270,Trim nail(s),,,7.71,7.71,1
HCPCS,G0128,Corf skilled nursing service,,,9.45,22.69,7
HCPCS,G01280,Corf skilled nursing service,,,9.45,9.45,1
HCPCS,G0129,Php/iop ot service,,,20.97,31.62,7
HCPCS,G01290,Php/iop ot service,,,31.62,31.62,1
HCPCS,G0130,Single energy x-ray study,,,25.34,252.18,25
HCPCS,G01300,Single energy x-ray study,,,25.34,25.34,1
HCPCS,G0130TC,Single energy x-ray study,,,25.34,25.34,1
HCPCS,G0136,"ADMINISTRATION OF A STANDARDIZED, EVIDENCE-BASED SOCIAL DETERMIN",79.0,51.35,8.35,79.0,27
HCPCS,G0136,Adm of pa/n assess 5-15 m,,,9.36,64.59,15
HCPCS,G0136,Adm of soc dtr assess 5-15 m,,,12.84,16.22,6
HCPCS,G01360,Adm of pa/n assess 5-15 m,,,9.36,9.36,1
HCPCS,G0137,"Inten outpt svs,min 9 pr 7 d",,,230.29,1371.37,9
HCPCS,G0138,Iv cipaglucosidase alfa-atga,,,168.44,1410.39,21
HCPCS,G01380,Iv cipaglucosidase alfa-atga,,,168.44,168.44,1
HCPCS,G0140,Nav srv peer sup 60 min pr m,,,34.32,200.56,21
HCPCS,G01400,Nav srv peer sup 60 min pr m,,,51.79,51.79,1
HCPCS,G0141,"Scr c/v cyto,autosys and md",,,9.95,24.21,7
HCPCS,G01410,"Scr c/v cyto,autosys and md",,,24.21,24.21,1
HCPCS,G0143,"Scr c/v cyto,thinlayer,rescr",,,9.95,45.2,21
HCPCS,G01430,"Scr c/v cyto,thinlayer,rescr",,,23.37,23.37,1
HCPCS,G0144,"Scr c/v cyto,thinlayer,rescr",,,9.95,73.47,21
HCPCS,G01440,"Scr c/v cyto,thinlayer,rescr",,,37.99,37.99,1
HCPCS,G0145,"Scr c/v cyto,thinlayer,rescr",,,9.95,44.26,21
HCPCS,G01450,"Scr c/v cyto,thinlayer,rescr",,,22.89,22.89,1
HCPCS,G0146,Nav srv peer sup add 30 pr m,,,34.32,43.36,7
HCPCS,G01460,Nav srv peer sup add 30 pr m,,,36.16,36.16,1
HCPCS,G0147,"Scr c/v cyto, automated sys",,,9.95,30.4,21
HCPCS,G01470,"Scr c/v cyto, automated sys",,,15.35,15.35,1
HCPCS,G0148,"Scr c/v cyto, autosys, rescr",,,9.95,53.37,21
HCPCS,G01480,"Scr c/v cyto, autosys, rescr",,,27.59,27.59,1
HCPCS,G0151,"Hhcp-serv of pt,ea 15 min",,,27.94,27.94,1
HCPCS,G01510,"Hhcp-serv of pt,ea 15 min",,,27.94,27.94,1
HCPCS,G0152,"Hhcp-serv of ot,ea 15 min",,,25.57,25.57,1
HCPCS,G01520,"Hhcp-serv of ot,ea 15 min",,,25.57,25.57,1
HCPCS,G0153,"Hhcp-svs of s/l path,ea 15mn",,,26.42,26.42,1
HCPCS,G01530,"Hhcp-svs of s/l path,ea 15mn",,,26.42,26.42,1
HCPCS,G0155,"Hhcp-svs of csw,ea 15 min",,,33.32,33.32,1
HCPCS,G01550,"Hhcp-svs of csw,ea 15 min",,,33.32,33.32,1
HCPCS,G0156,"Hhcp-svs of aide,ea 15 min",,,11.44,11.44,1
HCPCS,G01560,"Hhcp-svs of aide,ea 15 min",,,11.44,11.44,1
HCPCS,G0157,Hhc pt assistant ea 15,,,25.0,25.0,1
HCPCS,G01570,Hhc pt assistant ea 15,,,25.0,25.0,1
HCPCS,G0158,Hhc ot assistant ea 15,,,25.02,25.02,1
HCPCS,G01580,Hhc ot assistant ea 15,,,25.02,25.02,1
HCPCS,G0159,Hhc pt maint ea 15 min,,,23.93,23.93,1
HCPCS,G01590,Hhc pt maint ea 15 min,,,23.93,23.93,1
HCPCS,G0160,Hhc occup therapy ea 15,,,22.94,22.94,1
HCPCS,G01600,Hhc occup therapy ea 15,,,22.94,22.94,1
HCPCS,G0161,Hhc slp ea 15 min,,,16.63,16.63,1
HCPCS,G01610,Hhc slp ea 15 min,,,16.63,16.63,1
HCPCS,G0162,"Hhc rn e&m plan svs, 15 min",,,20.81,20.81,1
HCPCS,G01620,"Hhc rn e&m plan svs, 15 min",,,20.81,20.81,1
HCPCS,G0166,"Extrnl counterpulse, per tx",,,33.85,279.48,21
HCPCS,G01660,"Extrnl counterpulse, per tx",,,100.04,100.04,1
HCPCS,G0168,WOUND CLOSURE BY ADHESIVE,136.0,88.4,15.15,136.0,31
HCPCS,G0168,Wound closure by adhesive,,,15.51,146.39,7
HCPCS,G01680,Wound closure by adhesive,,,15.51,15.51,1
HCPCS,G0175,"Opps service,sched team conf",,,75.64,923.25,21
HCPCS,G01750,"Opps service,sched team conf",,,406.5,406.5,1
HCPCS,G0176,Opps/php/iop; activity thrpy,,,82.75,120.13,7
HCPCS,G01760,Opps/php/iop; activity thrpy,,,82.75,82.75,1
HCPCS,G0177,Opps/php/iop; train & educ,,,69.98,120.13,7
HCPCS,G01770,Opps/php/iop; train & educ,,,69.98,69.98,1
HCPCS,G0179,MD RECERTIFICATION HHA PT,198.0,128.7,34.69,198.0,31
HCPCS,G0179,Md recertification hha pt,,,42.41,95.54,7
HCPCS,G01790,Md recertification hha pt,,,42.41,42.41,1
HCPCS,G0180,MD CERTIFICATION HHA PATIENT,295.0,191.75,44.79,295.0,31
HCPCS,G0180,Md certification hha patient,,,54.54,95.54,7
HCPCS,G01800,Md certification hha patient,,,54.54,54.54,1
HCPCS,G0181,HOME HEALTH CARE SUPERVISION,761.0,494.65,89.11,761.0,31
HCPCS,G0181,Home health care supervision,,,75.64,107.81,7
HCPCS,G01810,Home health care supervision,,,107.81,107.81,1
HCPCS,G0182,Hospice care supervision,,,34.32,107.44,7
HCPCS,G01820,Hospice care supervision,,,107.44,107.44,1
HCPCS,G0183,Software meas of cardiac vol,,,64.08,99.97,10
HCPCS,G0186,"Dstry eye lesn,fdr vssl tech",,,550.67,1189.46,21
HCPCS,G01860,"Dstry eye lesn,fdr vssl tech",,,637.77,637.77,1
HCPCS,G0219,Pet img wholbod melano nonco,,,859.52,1296.0,8
HCPCS,G02190,Pet img wholbod melano nonco,,,1296.0,1296.0,1
HCPCS,G0219TC,Pet img wholbod melano nonco,,,1296.0,1296.0,1
HCPCS,G0235,PET NOT OTHERWISE SPECIFIED,643.0,417.95,321.5,643.0,24
HCPCS,G0235,Pet not otherwise specified,,,403.35,1296.0,25
HCPCS,G02350,Pet not otherwise specified,,,1296.0,1296.0,1
HCPCS,G0235TC,Pet not otherwise specified,,,1296.0,1296.0,1
HCPCS,G0237,THERAPEUTIC PROCD STRG ENDUR,113.0,73.45,8.76,113.0,31
HCPCS,G0237,Therapeutic procd strg endur,,,11.07,53.1,21
HCPCS,G02370,Therapeutic procd strg endur,,,11.07,11.07,1
HCPCS,G0238,"OTH RESP PROC, INDIV",119.0,77.35,9.33,119.0,31
HCPCS,G0238,"Oth resp proc, indiv",,,10.1,53.1,21
HCPCS,G02380,"Oth resp proc, indiv",,,10.1,10.1,1
HCPCS,G0239,"OTH RESP PROC, GROUP",72.0,46.8,10.77,72.0,31
HCPCS,G0239,"Oth resp proc, group",,,12.69,12.69,1
HCPCS,G0239,PROC RESP FUNC GROUP,196.0,127.4,21.02,509.0,41
HCPCS,G02390,"Oth resp proc, group",,,12.69,12.69,1
HCPCS,G0245,INITIAL FOOT EXAM PT LOPS,387.0,251.55,35.93,387.0,34
HCPCS,G0245,Initial foot exam pt lops,,,41.22,279.41,15
HCPCS,G02450,Initial foot exam pt lops,,,41.22,41.22,1
HCPCS,G0246,FOLLOWUP EVAL OF FOOT PT LOP,198.0,128.7,18.02,198.0,34
HCPCS,G0246,Followup eval of foot pt lop,,,20.64,279.41,15
HCPCS,G02460,Followup eval of foot pt lop,,,20.64,20.64,1
HCPCS,G0247,ROUTINE FOOTCARE PT W LOPS,220.0,143.0,19.7,220.0,34
HCPCS,G0247,Routine footcare pt w lops,,,21.29,430.81,15
HCPCS,G02470,Routine footcare pt w lops,,,21.29,21.29,1
HCPCS,G0248,DEMONSTRATE USE HOME INR MON,1322.0,859.3,97.52,1322.0,31
HCPCS,G0248,Demonstrate use home inr mon,,,41.57,279.41,21
HCPCS,G02480,Demonstrate use home inr mon,,,97.45,97.45,1
HCPCS,G0249,Provide inr test mater/equip,,,63.91,279.41,15
HCPCS,G02490,Provide inr test mater/equip,,,63.91,63.91,1
HCPCS,G0250,"HOME MONITORING, PT/INR",79.0,51.35,7.82,79.0,31
HCPCS,G0250,MD REVIEW HME INR TEST; PER 4 TEST,35.0,22.75,7.82,35.0,31
HCPCS,G0250,MD REVIEW INTERPRET OF TEST,79.0,51.35,7.82,79.0,31
HCPCS,G0250,Md inr test revie inter mgmt,,,9.04,9.04,1
HCPCS,G02500,Md inr test revie inter mgmt,,,9.04,9.04,1
HCPCS,G0252,Pet imaging initial dx,,,92.06,1296.0,14
HCPCS,G02520,Pet imaging initial dx,,,1296.0,1296.0,1
HCPCS,G025226,Pet imaging initial dx,,,99.64,107.98,3
HCPCS,G0252TC,Pet imaging initial dx,,,1296.0,1296.0,1
HCPCS,G0255,Current percep threshold tst,,,54.0,481.25,10
HCPCS,G02550,Current percep threshold tst,,,54.0,54.0,1
HCPCS,G0257,UNSCHEDULED DIALYS TX,3499.0,2274.35,565.8,3149.1,40
HCPCS,G0257,Unsched dialysis esrd pt hos,,,681.66,681.66,1
HCPCS,G02570,Unsched dialysis esrd pt hos,,,681.66,681.66,1
HCPCS,G0259,Inject for sacroiliac joint,,,275.41,347.89,7
HCPCS,G02590,Inject for sacroiliac joint,,,276.32,276.32,1
HCPCS,G0260,INJ FOR SACROILIAC JT ANESTH,1387.0,901.55,693.5,1387.0,12
HCPCS,G0260,Inj for sacroiliac jt anesth,,,281.13,281.13,1
HCPCS,G0260,SIJ INJ - ARTHROGR/ANESTHETIC,3463.0,2250.95,275.41,6317.0,47
HCPCS,G02600,Inj for sacroiliac jt anesth,,,281.13,281.13,1
HCPCS,G0268,"MEDICARE ONLY, REM IMP EAR WAX",153.0,99.45,25.7,3920.0,29
HCPCS,G0268,REMOVAL OF IMPACTED WAX MD,268.0,174.2,27.44,268.0,31
HCPCS,G0268,Removal of impacted wax md,,,34.42,34.42,1
HCPCS,G02680,Removal of impacted wax md,,,34.42,34.42,1
HCPCS,G0269,OCCLUSIVE DEVICE IN VEIN ART,75.0,48.75,37.5,75.0,12
HCPCS,G0269,Occlusive device in vein art,,,278.21,278.21,1
HCPCS,G0269,PLC OCCL DVC ARTERY VEIN,1048.0,681.2,176.06,3920.0,31
HCPCS,G02690,Occlusive device in vein art,,,278.21,278.21,1
HCPCS,G0270,MEDICAL NUTRITION REASSEMENT PER 15MIN,198.0,128.7,22.51,198.0,31
HCPCS,G0270,MEDICAL NUTRITION THERAPY; REASSESSMENT,198.0,128.7,22.51,198.0,31
HCPCS,G0270,Mnt subs tx for change dx,,,29.84,172.97,28
HCPCS,G02700,Mnt subs tx for change dx,,,37.35,37.35,1
HCPCS,G0271,GROUP MNT 2 OR MORE 30 MINS,110.0,71.5,12.38,110.0,31
HCPCS,G0271,Group mnt 2 or more 30 mins,,,16.62,172.97,28
HCPCS,G0271,MED NUT TX REASSESS GR/15,110.0,71.5,12.38,110.0,31
HCPCS,G02710,Group mnt 2 or more 30 mins,,,21.21,21.21,1
HCPCS,G0276,Pild/placebo control clin tr,,,381.0,15488.78,21
HCPCS,G02760,Pild/placebo control clin tr,,,381.0,381.0,1
HCPCS,G0277,"Hbot, full body chamber, 30m",,,138.42,304.86,21
HCPCS,G02770,"Hbot, full body chamber, 30m",,,177.53,177.53,1
HCPCS,G0278,ANGIO ILIAC ARTERY W CATH,8613.0,5598.45,15.36,7751.7,36
HCPCS,G0278,"ILIAC ART ANGIO,CARDIAC CATH",110.0,71.5,10.66,110.0,31
HCPCS,G0278,"Iliac art angio,cardiac cath",,,15.58,15.58,1
HCPCS,G02780,"Iliac art angio,cardiac cath",,,15.58,15.58,1
HCPCS,G0279,"TOMOSYNTHESIS, MAMMO",264.0,171.6,12.92,373.0,94
HCPCS,G0279,"Tomosynthesis, mammo",,,18.8,109.46,37
HCPCS,G02790,"Tomosynthesis, mammo",,,18.8,18.8,1
HCPCS,G0279TC,"Tomosynthesis, mammo",,,18.8,86.47,6
HCPCS,G0281,ELEC STIM UNATTEND FOR PRESS,79.0,51.35,11.26,79.0,31
HCPCS,G0281,Elec stim unattend for press,,,11.97,11.97,1
HCPCS,G0281,WND CARE UNATT ELECT STIM 15M,184.0,119.6,14.52,723.0,49
HCPCS,G02810,Elec stim unattend for press,,,11.97,11.97,1
HCPCS,G0282,Elect stim wound care not pd,,,10.67,146.39,7
HCPCS,G02820,Elect stim wound care not pd,,,10.67,10.67,1
HCPCS,G0283,ELEC STIM OTHER THAN WOUND,79.0,51.35,11.26,79.0,31
HCPCS,G0283,Elec stim other than wound,,,7.5,31.61,28
HCPCS,G02830,Elec stim other than wound,,,7.5,7.5,1
HCPCS,G0288,"RECON, CTA FOR SURG PLAN",1554.0,1010.1,46.94,1554.0,31
HCPCS,G0288,"Recon, cta for surg plan",,,42.87,42.87,1
HCPCS,G02880,"Recon, cta for surg plan",,,42.87,42.87,1
HCPCS,G0289,"ARTHRO, LOOSE BODY + CHONDRO",651.0,423.15,64.85,651.0,34
HCPCS,G0289,"Arthro, loose body + chondro",,,88.34,4304.69,7
HCPCS,G02890,"Arthro, loose body + chondro",,,88.34,88.34,1
HCPCS,G0293,"Non-cov surg proc,clin trial",,,1.92,85.1,21
HCPCS,G02930,"Non-cov surg proc,clin trial",,,1.92,1.92,1
HCPCS,G0294,"Non-cov proc, clinical trial",,,0.01,85.1,15
HCPCS,G02940,"Non-cov proc, clinical trial",,,0.01,0.01,1
HCPCS,G0295,Electromagnetic therapy onc,,,10.3,146.39,10
HCPCS,G02950,Electromagnetic therapy onc,,,10.3,10.3,1
HCPCS,G0296,VISIT TO DETERM LDCT ELIG,346.0,224.89999999999998,20.01,416.7,60
HCPCS,G0296,Visit to determ ldct elig,,,26.09,26.09,1
HCPCS,G02960,Visit to determ ldct elig,,,26.09,26.09,1
HCPCS,G0297,Ldct for lung ca screen,,,64.08,80.94,6
HCPCS,G0299,Hhs/hospice of rn ea 15 min,,,28.41,28.41,1
HCPCS,G02990,Hhs/hospice of rn ea 15 min,,,28.41,28.41,1
HCPCS,G0300,Hhs/hospice of lpn ea 15 min,,,24.31,24.31,1
HCPCS,G03000,Hhs/hospice of lpn ea 15 min,,,24.31,24.31,1
HCPCS,G0302,Pre-op service lvrs complete,,,389.68,1299.38,15
HCPCS,G03020,Pre-op service lvrs complete,,,1299.38,1299.38,1
HCPCS,G0303,Pre-op service lvrs 10-15dos,,,225.48,675.17,15
HCPCS,G03030,Pre-op service lvrs 10-15dos,,,366.74,366.74,1
HCPCS,G0304,Pre-op service lvrs 1-9 dos,,,389.68,1345.92,15
HCPCS,G03040,Pre-op service lvrs 1-9 dos,,,1345.92,1345.92,1
HCPCS,G0305,Post op service lvrs min 6,,,0.01,1150.43,15
HCPCS,G03050,Post op service lvrs min 6,,,0.01,0.01,1
HCPCS,G0306,Cbc/diffwbc w/o platelet,,,2.81,12.98,21
HCPCS,G03060,Cbc/diffwbc w/o platelet,,,6.72,6.72,1
HCPCS,G0307,Cbc without platelet,,,2.81,10.81,21
HCPCS,G03070,Cbc without platelet,,,5.59,5.59,1
HCPCS,G0308,180 d implant glucose sensor,,,254.67,321.68,6
HCPCS,G0309,Rem/inser glu sensor dif sit,,,254.67,321.68,6
HCPCS,G0310,Immunize counsel 5-15 min,,,40.76,88.02,7
HCPCS,G03100,Immunize counsel 5-15 min,,,88.02,88.02,1
HCPCS,G0311,Immunize counsel 16-30 mins,,,32.4,51.49,7
HCPCS,G03110,Immunize counsel 16-30 mins,,,32.4,32.4,1
HCPCS,G0312,Immunize couns < 21yr 5-15 m,,,40.76,51.49,7
HCPCS,G03120,Immunize couns < 21yr 5-15 m,,,41.15,41.15,1
HCPCS,G0313,Immunize couns < 21yr 6-30 m,,,40.76,51.49,6
HCPCS,G0314,Counsel immune <21 16-30 m,,,40.76,756.0,7
HCPCS,G03140,Counsel immune <21 16-30 m,,,756.0,756.0,1
HCPCS,G0315,Counsel immune <21  5-15 m,,,76.04,76.04,1
HCPCS,G0315,Counsel immune <21 5-15 m,,,40.76,51.49,6
HCPCS,G03150,Counsel immune <21  5-15 m,,,76.04,76.04,1
HCPCS,G0316,PROLONG INPT EVAL ADD15 M,268.0,174.2,22.13,268.0,28
HCPCS,G0316,Prolong inpt eval add15 m,,,31.29,31.29,1
HCPCS,G03160,Prolong inpt eval add15 m,,,31.29,31.29,1
HCPCS,G0317,PROLONG NURSIN FAC EVAL 15M,244.0,158.6,22.13,244.0,28
HCPCS,G0317,Prolong nursin fac eval 15m,,,31.29,31.29,1
HCPCS,G03170,Prolong nursin fac eval 15m,,,31.29,31.29,1
HCPCS,G0318,PROLONG HOME EVAL ADD 15M,244.0,158.6,21.67,244.0,28
HCPCS,G0318,Prolong home eval add 15m,,,31.01,31.01,1
HCPCS,G03180,Prolong home eval add 15m,,,31.01,31.01,1
HCPCS,G0322,Home h physio data collec tr,,,33.85,42.76,6
HCPCS,G0323,Care manage beh svs 20mins,,,29.9,64.59,21
HCPCS,G03230,Care manage beh svs 20mins,,,45.81,45.81,1
HCPCS,G0327,Colon ca scrn;bld-bsd biomrk,,,19.56,28.19,7
HCPCS,G03270,Colon ca scrn;bld-bsd biomrk,,,19.56,19.56,1
HCPCS,G0328,Fecal blood scrn immunoassay,,,5.23,30.16,24
HCPCS,G03280,Fecal blood scrn immunoassay,,,15.6,15.6,1
HCPCS,G0328QW,Fecal blood scrn immunoassay,,,27.83,30.16,3
HCPCS,G0329,Electromagntic tx for ulcers,,,10.61,146.39,28
HCPCS,G03290,Electromagntic tx for ulcers,,,10.61,10.61,1
HCPCS,G0330,Facility svs dental rehab,,,844.88,7031.51,20
HCPCS,G0333,Dispense fee initial 30 day,,,24.12,24.12,1
HCPCS,G03330,Dispense fee initial 30 day,,,24.12,24.12,1
HCPCS,G0337,Hospice evaluation preelecti,,,71.68,71.68,1
HCPCS,G03370,Hospice evaluation preelecti,,,71.68,71.68,1
HCPCS,G0339,"Robot lin-radsurg com, first",,,3066.36,3873.3,7
HCPCS,G03390,"Robot lin-radsurg com, first",,,3327.29,3327.29,1
HCPCS,G0340,Robt lin-radsurg fractx 2-5,,,2732.0,3873.3,7
HCPCS,G03400,Robt lin-radsurg fractx 2-5,,,2732.0,2732.0,1
HCPCS,G0341,PERCUTANEOUS ISLET CELLTRANS,3071.0,1996.15,276.67,3071.0,31
HCPCS,G0341,Percutaneous islet celltrans,,,322.24,4330.07,7
HCPCS,G03410,Percutaneous islet celltrans,,,322.24,322.24,1
HCPCS,G0342,Laparoscopy islet cell trans,,,786.74,4330.07,7
HCPCS,G03420,Laparoscopy islet cell trans,,,786.74,786.74,1
HCPCS,G0343,LAPAROTOMY ISLET CELL TRANSP,10039.5,6525.675,966.22,9774.0,59
HCPCS,G0343,Laparotomy islet cell transp,,,1287.65,1287.65,1
HCPCS,G03430,Laparotomy islet cell transp,,,1287.65,1287.65,1
HCPCS,G0372,MD SERVICE REQUIRED FOR PMD,75.0,48.75,7.25,75.0,31
HCPCS,G0372,Md service required for pmd,,,9.01,9.01,1
HCPCS,G03720,Md service required for pmd,,,9.01,9.01,1
HCPCS,G0378,Hospital observation per hr,,,64.52,64.52,1
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 1,165.0,107.25,27.72,8920.0,39
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 10,165.0,107.25,27.72,8920.0,39
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 2,165.0,107.25,27.72,8920.0,39
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 3,165.0,107.25,27.72,8920.0,39
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 4,165.0,107.25,27.72,8920.0,39
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 5,165.0,107.25,27.72,8920.0,39
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 6,165.0,107.25,27.72,8920.0,39
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 9,165.0,107.25,27.72,8920.0,39
HCPCS,G0378,OBSERV CARVE OUT GRP 7,165.0,107.25,27.72,8920.0,39
HCPCS,G0378,OBSERV CARVE OUT GRP 8,165.0,107.25,27.72,8920.0,39
HCPCS,G0378,OBSERVATION CARVE-OUT PER HR,165.0,107.25,27.72,8920.0,39
HCPCS,G0378,OBSERVATION PER HR NMN,114.0,74.1,19.15,8920.0,39
HCPCS,G0378,OBSERVATION PER HR-FIRST HOUR,1264.0,821.6,212.35,8920.0,39
HCPCS,G0378,OBSERVATION PER HR-SUBSEQUENT HOUR,111.0,72.15,18.65,8920.0,39
HCPCS,G03780,Hospital observation per hr,,,64.52,64.52,1
HCPCS,G0379,DIR ADMIT FOR HOSP OBV CARE,3065.0,1992.25,615.42,8920.0,43
HCPCS,G0379,Direct refer hospital observ,,,2296.52,2296.52,1
HCPCS,G03790,Direct refer hospital observ,,,2296.52,2296.52,1
HCPCS,G0380,Lev 1 hosp type b ed visit,,,77.62,182.28,15
HCPCS,G03800,Lev 1 hosp type b ed visit,,,133.48,133.48,1
HCPCS,G0381,Lev 2 hosp type b ed visit,,,97.0,239.93,15
HCPCS,G03810,Lev 2 hosp type b ed visit,,,138.39,138.39,1
HCPCS,G0382,Lev 3 hosp type b ed visit,,,179.5,404.56,15
HCPCS,G03820,Lev 3 hosp type b ed visit,,,223.13,223.13,1
HCPCS,G0383,Lev 4 hosp type b ed visit,,,269.27,619.12,15
HCPCS,G03830,Lev 4 hosp type b ed visit,,,269.27,269.27,1
HCPCS,G0384,Lev 5 hosp type b ed visit,,,405.42,931.13,15
HCPCS,G03840,Lev 5 hosp type b ed visit,,,931.13,931.13,1
HCPCS,G0390,Trauma respons w/hosp criti,,,1328.17,2868.85,15
HCPCS,G03900,Trauma respons w/hosp criti,,,1372.46,1372.46,1
HCPCS,G0396,Alcohol/subs interv 15-30mn,,,29.9,93.65,21
HCPCS,G03960,Alcohol/subs interv 15-30mn,,,32.76,32.76,1
HCPCS,G0397,Alcohol/subs interv >30 min,,,66.57,348.36,21
HCPCS,G03970,Alcohol/subs interv >30 min,,,66.57,66.57,1
HCPCS,G0398,HOME SLEEP TEST/TYPE 2 PORTA,573.0,372.45,234.07,573.0,13
HCPCS,G0398,Home sleep test/type 2 porta,,,90.87,339.23,22
HCPCS,G03980,Home sleep test/type 2 porta,,,123.28,123.28,1
HCPCS,G0398TC,Home sleep test/type 2 porta,,,123.28,123.28,1
HCPCS,G0399,HOME SLEEP TEST/TYPE 3 PORTA,783.0,508.95,74.7,3288.0,78
HCPCS,G0399,Home sleep test/type 3 porta,,,63.37,63.37,2
HCPCS,G03990,Home sleep test/type 3 porta,,,63.37,63.37,1
HCPCS,G0399TC,Home sleep test/type 3 porta,,,63.37,63.37,1
HCPCS,G0400,HOME SLEEP TEST/TYPE 4 PORTA,616.0,400.4,168.17,616.0,13
HCPCS,G0400,Home sleep test/type 4 porta,,,69.56,675.17,22
HCPCS,G04000,Home sleep test/type 4 porta,,,69.56,69.56,1
HCPCS,G0400TC,Home sleep test/type 4 porta,,,69.56,69.56,1
HCPCS,G0402,INIT PREVENTIVE EXAM NEW,644.0,418.6,129.36,579.6,32
HCPCS,G0402,INITIAL PREVENTIVE EXAM,1144.0,743.6,105.17,1144.0,31
HCPCS,G0402,Initial preventive exam,,,135.42,135.42,1
HCPCS,G04020,Initial preventive exam,,,135.42,135.42,1
HCPCS,G0403,EKG FOR INITIAL PREVENT EXAM,75.0,48.75,14.39,75.0,31
HCPCS,G0403,Ekg for initial prevent exam,,,16.03,20.24,7
HCPCS,G04030,Ekg for initial prevent exam,,,16.19,16.19,1
HCPCS,G0404,EKG TRACING FOR INITIAL PREV,201.0,130.65,6.38,359.0,80
HCPCS,G0404,Ekg tracing for initial prev,,,6.89,6.89,1
HCPCS,G04040,Ekg tracing for initial prev,,,6.89,6.89,1
HCPCS,G0405,EKG INTERPRET & REPORT PREVE,75.0,48.75,6.96,75.0,31
HCPCS,G0405,Ekg interpret & report preve,,,9.29,20.24,7
HCPCS,G04050,Ekg interpret & report preve,,,9.29,9.29,1
HCPCS,G0406,Inpt/tele follow up 15,,,42.68,42.68,1
HCPCS,G0406,TELEHEALTH FOLLOW-UP INPT CONSULTATION 15 MINS,334.0,217.1,29.39,334.0,32
HCPCS,G04060,Inpt/tele follow up 15,,,42.68,42.68,1
HCPCS,G0407,Inpt/tele follow up 25,,,74.31,74.31,1
HCPCS,G0407,TELEHEALTH FOLLOW-UP INPT CONSULTATION 25 MINS,612.0,397.8,54.17,612.0,32
HCPCS,G04070,Inpt/tele follow up 25,,,74.31,74.31,1
HCPCS,G0408,Inpt/tele follow up 35,,,108.28,108.28,1
HCPCS,G0408,TELEHEALTH FOLLOW-UP INPT CONSULTATION 35 MINS,880.0,572.0,77.91,880.0,32
HCPCS,G04080,Inpt/tele follow up 35,,,108.28,108.28,1
HCPCS,G0409,Corf related serv 15 mins ea,,,23.07,62.35,7
HCPCS,G04090,Corf related serv 15 mins ea,,,23.07,23.07,1
HCPCS,G0410,Grp psych php/iop 45-50,,,78.83,183.42,7
HCPCS,G04100,Grp psych php/iop 45-50,,,78.83,78.83,1
HCPCS,G0411,Interactive grp psyc php/iop,,,145.21,183.42,7
HCPCS,G04110,Interactive grp psyc php/iop,,,167.59,167.59,1
HCPCS,G0412,Open tx iliac spine uni/bil,,,753.53,8335.26,11
HCPCS,G04120,Open tx iliac spine uni/bil,,,753.53,753.53,1
HCPCS,G0413,Pelvic ring fracture uni/bil,,,1105.25,15488.78,21
HCPCS,G04130,Pelvic ring fracture uni/bil,,,1105.25,1105.25,1
HCPCS,G0414,Pelvic ring fx treat int fix,,,1042.19,8335.26,11
HCPCS,G04140,Pelvic ring fx treat int fix,,,1042.19,1042.19,1
HCPCS,G0415,OPEN TX POST PELVIC FXCTURE,9209.0,5985.85,1211.27,9209.0,31
HCPCS,G0415,Open tx post pelvic fxcture,,,1420.73,4252.73,11
HCPCS,G04150,Open tx post pelvic fxcture,,,1420.73,1420.73,1
HCPCS,G0416,"Prostate biopsy, any mthd",,,94.71,779.93,22
HCPCS,G0416,SAT BIOPSY PROSTATE 1-20 SPC,1440.0,936.0,218.9,1440.0,31
HCPCS,G04160,"Prostate biopsy, any mthd",,,186.66,186.66,1
HCPCS,G0416TC,"Prostate biopsy, any mthd",,,186.66,186.66,1
HCPCS,G0420,ED SVC CKD IND PER SESSION,933.0,606.45,89.94,933.0,31
HCPCS,G0420,Ed svc ckd ind per session,,,41.57,284.14,28
HCPCS,G04200,Ed svc ckd ind per session,,,112.33,112.33,1
HCPCS,G0421,ED SVC CKD GRP PER SESSION,220.0,143.0,20.88,220.0,31
HCPCS,G0421,Ed svc ckd grp per session,,,25.5,68.17,28
HCPCS,G04210,Ed svc ckd grp per session,,,27.97,27.97,1
HCPCS,G0422,Intens cardiac rehab w/exerc,,,92.65,272.99,21
HCPCS,G04220,Intens cardiac rehab w/exerc,,,131.44,131.44,1
HCPCS,G0423,Intens cardiac rehab no exer,,,92.65,272.99,21
HCPCS,G04230,Intens cardiac rehab no exer,,,131.44,131.44,1
HCPCS,G0424,Pulmonary rehab w exer,,,22.83,28.84,6
HCPCS,G0425,Inpt/ed teleconsult30,,,96.02,96.02,1
HCPCS,G0425,PR INPT TELEHEALTH CONSULT 30M,845.0,549.25,75.31,845.0,32
HCPCS,G04250,Inpt/ed teleconsult30,,,96.02,96.02,1
HCPCS,G0426,Inpt/ed teleconsult50,,,135.39,135.39,1
HCPCS,G0426,PR INPT TELEHEALTH CONSULT 50M,1148.0,746.2,102.22,1148.0,32
HCPCS,G04260,Inpt/ed teleconsult50,,,135.39,135.39,1
HCPCS,G0427,Inpt/ed teleconsult70,,,191.69,191.69,1
HCPCS,G0427,PR INPT TELEHEALTH CON 70/>M,1698.0,1103.7,151.62,1698.0,32
HCPCS,G04270,Inpt/ed teleconsult70,,,191.69,191.69,1
HCPCS,G0428,Collagen meniscus implant,,,1992.02,2516.23,6
HCPCS,G0429,Dermal filler injection(s),,,70.52,3966.07,21
HCPCS,G04290,Dermal filler injection(s),,,70.52,70.52,1
HCPCS,G0432,EIA HIV-1/HIV-2 SCREEN,80.0,52.0,4.02,72.0,37
HCPCS,G0432,Eia hiv-1/hiv-2 screen,,,16.91,16.91,1
HCPCS,G04320,Eia hiv-1/hiv-2 screen,,,16.91,16.91,1
HCPCS,G0433,Elisa hiv-1/hiv-2 screen,,,4.02,30.56,24
HCPCS,G04330,Elisa hiv-1/hiv-2 screen,,,15.8,15.8,1
HCPCS,G0433QW,Elisa hiv-1/hiv-2 screen,,,28.2,30.56,3
HCPCS,G0435,Oral hiv-1/hiv-2 screen,,,4.02,20.02,21
HCPCS,G04350,Oral hiv-1/hiv-2 screen,,,10.35,10.35,1
HCPCS,G0438,ANNUAL WELLNESS,1040.0,676.0,141.07,1040.0,31
HCPCS,G0438,NEW PREVENTATIVE MEDICINE G0438- ANNUAL WELLNESS,1040.0,676.0,141.07,1040.0,31
HCPCS,G0438,NEW PREVENTIVE ANNUAL WELLNESS,1040.0,676.0,141.07,1040.0,31
HCPCS,G0438,"PPPS, INITIAL VISIT",1040.0,676.0,141.07,1040.0,31
HCPCS,G0438,"Ppps, initial visit",,,170.12,418.46,22
HCPCS,G04380,"Ppps, initial visit",,,170.12,170.12,1
HCPCS,G0439,"ANNUAL WELLNESS PPPS, SUBSEQ VISIT",768.0,499.2,93.4,768.0,31
HCPCS,G0439,ANNUAL WELLNESS SUBSEQUENT G0439A,768.0,499.2,93.4,768.0,31
HCPCS,G0439,"PPPS, SUBSEQ VISIT",768.0,499.2,93.4,768.0,31
HCPCS,G0439,"Ppps, subseq visit",,,133.42,326.2,22
HCPCS,G04390,"Ppps, subseq visit",,,133.42,133.42,1
HCPCS,G0442,ANNUAL ALCOHOL SCREEN 15 MIN,258.0,167.7,11.31,232.2,38
HCPCS,G0442,Annual alcohol screen 15 min,,,9.36,9.36,1
HCPCS,G04420,Annual alcohol screen 15 min,,,9.36,9.36,1
HCPCS,G0443,BRIEF ALCOHOL MISUSE COUNSEL,798.0,518.7,37.21,718.2,38
HCPCS,G0443,Brief alcohol misuse counsel,,,23.27,23.27,1
HCPCS,G04430,Brief alcohol misuse counsel,,,23.27,23.27,1
HCPCS,G0444,DEPRESSION SCREEN ANNUAL,114.0,74.1,7.82,158.0,69
HCPCS,G0444,Depression screen annual,,,9.36,9.36,1
HCPCS,G04440,Depression screen annual,,,9.36,9.36,1
HCPCS,G0445,HIGH INTEN BEH COUNS STD 30M,798.0,518.7,37.58,718.2,38
HCPCS,G0445,High inten beh couns std 30m,,,23.27,23.27,1
HCPCS,G04450,High inten beh couns std 30m,,,23.27,23.27,1
HCPCS,G0446,INTENS BEHAVE THER CARDIO DX,258.0,167.7,12.84,232.2,38
HCPCS,G0446,Intens behave ther cardio dx,,,23.61,23.61,1
HCPCS,G04460,Intens behave ther cardio dx,,,23.61,23.61,1
HCPCS,G0447,BEHAVIOR COUNSEL OBESITY 15M,531.0,345.15000000000003,19.75,718.2,69
HCPCS,G0447,Behavior counsel obesity 15m,,,23.27,23.27,1
HCPCS,G04470,Behavior counsel obesity 15m,,,23.27,23.27,1
HCPCS,G0448,Place perm pacing cardiovert,,,41.4,16734.7,7
HCPCS,G04480,Place perm pacing cardiovert,,,41.4,41.4,1
HCPCS,G0451,DEVLOPMENT TEST INTERPT&REP,531.0,345.15,18.05,723.0,147
HCPCS,G0451,Devlopment test interpt&rep,,,11.39,11.39,1
HCPCS,G04510,Devlopment test interpt&rep,,,11.39,11.39,1
HCPCS,G0452,MOLECULAR PATHOLOGY INTERPR,372.0,241.8,47.69,372.0,27
HCPCS,G0452,Molecular pathology interpr,,,3.28,3.28,2
HCPCS,G04520,Molecular pathology interpr,,,3.28,3.28,1
HCPCS,G0452TC,Molecular pathology interpr,,,3.28,3.28,1
HCPCS,G0453,Cont intraop neuro monitor,,,32.92,32.92,1
HCPCS,G04530,Cont intraop neuro monitor,,,32.92,32.92,1
HCPCS,G0454,Md document visit by npp,,,9.04,9.04,1
HCPCS,G04540,Md document visit by npp,,,9.04,9.04,1
HCPCS,G0455,FECAL MICROBIOTA PREP INSTIL,4559.0,2963.35,84.54,4103.1,32
HCPCS,G0455,FECAL MICROBIOTA PREP INSTILL,590.0,383.5,65.73,590.0,27
HCPCS,G0455,FMT VIA COLONOSCOPY,4559.0,2963.35,84.54,4103.1,32
HCPCS,G0455,Fecal microbiota prep instil,,,72.66,72.66,1
HCPCS,G04550,Fecal microbiota prep instil,,,72.66,72.66,1
HCPCS,G0458,Ldr prostate brachy comp rat,,,1620.0,1620.0,1
HCPCS,G04580,Ldr prostate brachy comp rat,,,1620.0,1620.0,1
HCPCS,G0459,INPATIENT TELEHEALTH PHARMACOLOGIC MANAGEMENT,418.0,271.7,41.65,418.0,27
HCPCS,G0459,Telehealth inpt pharm mgmt,,,16.06,44.07,7
HCPCS,G04590,Telehealth inpt pharm mgmt,,,44.07,44.07,1
HCPCS,G0460,Autolog prp not diab ulcer,,,613.49,3966.07,21
HCPCS,G04600,Autolog prp not diab ulcer,,,743.8,743.8,1
HCPCS,G0463,Hospital outpt clinic visit,,,114.57,114.57,1
HCPCS,G0463,OFFICE VISIT,644.0,418.6,129.36,579.6,31
HCPCS,G04630,Hospital outpt clinic visit,,,114.57,114.57,1
HCPCS,G0465,Autolog prp diab wound ulcer,,,368.01,3966.07,21
HCPCS,G04650,Autolog prp diab wound ulcer,,,368.01,368.01,1
HCPCS,G0466,Fqhc visit new patient,,,131.28,131.28,1
HCPCS,G04660,Fqhc visit new patient,,,131.28,131.28,1
HCPCS,G0467,"Fqhc visit, estab pt",,,106.63,106.63,1
HCPCS,G04670,"Fqhc visit, estab pt",,,106.63,106.63,1
HCPCS,G0468,"Fqhc visit, ippe or awv",,,141.25,141.25,1
HCPCS,G04680,"Fqhc visit, ippe or awv",,,141.25,141.25,1
HCPCS,G0469,"Fqhc visit, mh new pt",,,140.95,140.95,1
HCPCS,G04690,"Fqhc visit, mh new pt",,,140.95,140.95,1
HCPCS,G0470,"Fqhc visit, mh estab pt",,,141.16,141.16,1
HCPCS,G04700,"Fqhc visit, mh estab pt",,,141.16,141.16,1
HCPCS,G0471,Ven blood coll snf/hha,,,2.52,18.53,21
HCPCS,G04710,Ven blood coll snf/hha,,,9.35,9.35,1
HCPCS,G0472,HEP SCREEN HIGH RISK/OTHER,293.5,190.77499999999998,19.47,264.6,74
HCPCS,G0472,Hep c screen high risk/other,,,40.05,77.45,4
HCPCS,G04720,Hep c screen high risk/other,,,40.05,40.05,1
HCPCS,G0472QW,Hep c screen high risk/other,,,71.47,77.45,3
HCPCS,G0473,Group behave couns 2-10,,,9.54,183.42,22
HCPCS,G04730,Group behave couns 2-10,,,9.54,9.54,1
HCPCS,G0473TC,Group behave couns 2-10,,,9.54,9.54,1
HCPCS,G0475,Hiv combination assay,,,5.23,40.24,24
HCPCS,G04750,Hiv combination assay,,,20.8,20.8,1
HCPCS,G0475QW,Hiv combination assay,,,37.13,40.24,3
HCPCS,G0476,Hpv combo assay ca screen,,,25.65,58.64,21
HCPCS,G04760,Hpv combo assay ca screen,,,30.32,30.32,1
HCPCS,G0480,%AMITRIPTYLINE,238.0,154.7,33.04,214.2,37
HCPCS,G0480,%IMIPRAMINE PL,157.0,102.05,33.04,157.0,37
HCPCS,G0480,%T2BPCR UNLISTED MOLEC,303.0,196.95,33.04,272.7,37
HCPCS,G0480,%TADID AMITRIPTYLINE,158.0,102.7,33.04,158.0,37
HCPCS,G0480,%UQNTPP AMPHET,65.0,42.25,16.25,125.87,37
HCPCS,G0480,%UQNTPP BUPRENORPHINE,65.0,42.25,16.25,125.87,37
HCPCS,G0480,%UQNTPP CANNABINOID NAT,85.0,55.25,21.25,125.87,37
HCPCS,G0480,%UQNTPP COCAINE,35.0,22.75,8.75,125.87,37
HCPCS,G0480,%UQNTPP FENTANYL,65.0,42.25,16.25,125.87,37
HCPCS,G0480,%UQNTPP HEROIN METABOLITE,85.0,55.25,21.25,125.87,37
HCPCS,G0480,%UQNTPP METHADONE,65.0,42.25,16.25,125.87,37
HCPCS,G0480,%UQNTPP OPIATE,98.0,63.7,24.5,125.87,37
HCPCS,G0480,%UQNTPP OPIOIDS 5+,98.0,63.7,24.5,125.87,37
HCPCS,G0480,%UQNTPP OXYCODONE,34.0,22.1,8.5,125.87,37
HCPCS,G0480,%UQNTPP TRAMADOL,57.0,37.05,14.25,125.87,37
HCPCS,G0480,*DRUG SCREEN QUAL SNGL,143.0,92.95,33.04,143.0,37
HCPCS,G0480,"6-MAM CONF, UR",242.0,157.3,33.04,217.8,37
HCPCS,G0480,"ALCOHOL CONF, UR",158.0,102.7,33.04,158.0,37
HCPCS,G0480,ALCOHOLS,178.0,115.69999999999999,33.04,191.7,111
HCPCS,G0480,ALKALOID DRUGS (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,ALKALOIDS NOS,143.0,92.95,33.04,143.0,74
HCPCS,G0480,ALPRAZOLAM,739.0,480.35,33.04,665.1,37
HCPCS,G0480,AMITRIPTYLINE,345.0,224.25,33.04,310.5,37
HCPCS,G0480,AMPCQ METHYLENDIOXY%,143.0,92.95,33.04,143.0,37
HCPCS,G0480,"AMPHETAMINE CONF, UR",375.0,243.75,33.04,337.5,37
HCPCS,G0480,AMPHETAMINES (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,AMPHETAMINES CONF URINE,739.0,480.35,33.04,665.1,37
HCPCS,G0480,AMPHETAMINES; 1 OR 2,143.0,92.95,33.04,143.0,37
HCPCS,G0480,ANABOLIC STEROID 1 OR 2,143.0,92.95,33.04,143.0,37
HCPCS,G0480,ANALGESICS NON-OPIOID 1 OR 2,143.0,92.95,33.04,143.0,185
HCPCS,G0480,ANTIDEPRESSANT NOT SPECIFIED,143.0,92.95,33.04,143.0,37
HCPCS,G0480,ANTIDEPRESSANT TRICYCLIC 1/2,143.0,92.95,33.04,143.0,370
HCPCS,G0480,ANTIDEPRESSANTS CLASS 1 OR 2,154.0,100.1,33.04,156.0,74
HCPCS,G0480,ANTIEPILEPTICS NOS 1-3,143.0,92.95,33.04,143.0,148
HCPCS,G0480,ANTIPSYCHOTICS NOS 1-3,143.0,92.95,33.04,143.0,111
HCPCS,G0480,ARIPIPRAZOLE AND METABOLITE,85.0,55.25,21.25,125.87,37
HCPCS,G0480,"BACLOFEN (BACLOF), SKELETAL MUSCLE RELAXANT 1 OR 2",370.0,240.5,33.04,333.0,37
HCPCS,G0480,BARBITURATES,143.0,92.95,33.04,143.0,111
HCPCS,G0480,BARBITURATES (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,"BENZO, SER PL, QNT RFLX",315.0,204.75,33.04,283.5,37
HCPCS,G0480,BENZODIAZEPINES1-12,301.5,195.975,33.04,414.0,259
HCPCS,G0480,BENZODIAZEPINES1-12 (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,BRWK ACETAMINOPHEN BL,219.0,142.35,33.04,197.1,37
HCPCS,G0480,CANNABANOIDS,246.0,159.9,33.04,221.4,37
HCPCS,G0480,CANNABINOIDS CONF UR,504.5,327.925,33.04,665.1,74
HCPCS,G0480,CANNABINOIDS NATURAL,143.0,92.95,33.04,143.0,74
HCPCS,G0480,CARBOXY-THC (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,CATHARITIC LAXATIVE UR,319.0,207.35,33.04,287.1,37
HCPCS,G0480,COCAINE,143.0,92.95,33.04,143.0,74
HCPCS,G0480,"COCAINE METABOLITE, SER OR PL, QNT RFLX",315.0,204.75,33.04,283.5,37
HCPCS,G0480,COLUMN CHROM QUANT,120.0,78.0,30.0,125.87,37
HCPCS,G0480,DESIPRAMINE,345.0,224.25,33.04,310.5,37
HCPCS,G0480,DESIPRAMINE PLASMA,164.0,106.6,33.04,164.0,37
HCPCS,G0480,DIGITOXIN,289.0,187.85,33.04,260.1,37
HCPCS,G0480,"DIPHENHYDRAMINE, SERUM/PLASMA",115.0,74.75,28.75,125.87,37
HCPCS,G0480,"DIPHENHYDRAMINE, URINE",589.0,382.85,33.04,530.1,37
HCPCS,G0480,"DIURETIC SURVEY, URINE",485.0,315.25,33.04,665.1,74
HCPCS,G0480,DOXEPIN/NORDOXEPIN,245.5,159.575,33.04,310.5,74
HCPCS,G0480,DRG BUPRENORPHINE (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,DRG COCAINE (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,DRGTOF AMPHETAMINES,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DRGTOF AMPHETAMINES 5 OR MORE,59.0,38.35,14.75,125.87,37
HCPCS,G0480,DRGTOF BENZODIAZEPINES1-12,143.0,92.95,33.04,143.0,37
HCPCS,G0480,DRGTOF DRG SCRN BARBITURATES,238.0,154.7,33.04,214.2,37
HCPCS,G0480,DRGTOF DRG SCRN BUPRENORPHINE,238.0,154.7,33.04,214.2,37
HCPCS,G0480,DRGTOF DRG SCRN COCAINE,238.0,154.7,33.04,214.2,37
HCPCS,G0480,DRGTOF DRG SCRN METHADONE,238.0,154.7,33.04,214.2,37
HCPCS,G0480,DRGTOF DRUG SCRN BENZODIAZ 13 OR MORE,59.0,38.35,14.75,125.87,37
HCPCS,G0480,DRGTOF DRUG SCRN GABAPENTIN NON-BLOOD,59.0,38.35,14.75,125.87,37
HCPCS,G0480,DRGTOF FENTANYL AND METABOLITE,162.0,105.3,33.04,162.0,37
HCPCS,G0480,DRGTOF GABAPENTIN,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DRGTOF METHYLENEDIOXYAMPHETAMINE,173.0,112.45,33.04,173.0,37
HCPCS,G0480,DRGTOF OPIATE CONFIRMATION,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DRGTOF OPIOIDS AND OPIATE ANALOGS,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DRGTOF OPIOIDS AND OPIATE ANALOGS 5 OR MORE,59.0,38.35,14.75,125.87,37
HCPCS,G0480,DRGTOF OPISEC DRG SCRN OXYCODONE,246.0,159.9,33.04,221.4,37
HCPCS,G0480,DRGTOF ORLOPI OPIATES 1 OR MORE,246.0,159.9,33.04,221.4,37
HCPCS,G0480,DRGTOF PHENCYCLIDINE,238.0,154.7,33.04,214.2,37
HCPCS,G0480,DRGTOF PROPOXYPHENE,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DRGTOF TAPENTADOL AND MET,162.0,105.3,33.04,162.0,37
HCPCS,G0480,DRGTOF TRAMADOL,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DRGTOF ZOLPIDEM,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DRUG SCREEN QUANTALCOHOLS,143.0,92.95,33.04,143.0,37
HCPCS,G0480,DRUG SCREENING BARBITURATES,143.0,92.95,33.04,143.0,37
HCPCS,G0480,DRUG TEST DEF 1-7 CLASSES,143.0,92.95,33.04,143.0,37
HCPCS,G0480,"DRUG TEST, DEFINITVE, PER DAY?1-7?DRUG CLASSES",742.0,482.3,33.04,667.8,37
HCPCS,G0480,DRUG/SUBSTANCE NOS 1-3,143.0,92.95,33.04,143.0,259
HCPCS,G0480,DTOFMP AMPHETAMINES,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP BARBITURATES,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP BENZODIAZEPINES,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP BUPRENORPHINE,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP COCAINE METABOLITE,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP FENTANYL,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP HEROIN METABOLITE,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP HYDROCODONE,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP MARIJUANA METABOLITE,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP MDMA,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP METHADONE,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP OPIOIDS,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP OPIOIDS AND OPIATE ANALOGS,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP OXYCODONE AND METABOLITE,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP PHENCYCLIDINE,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP PROPOXYPHENE,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP SEDATIVE HYPNOTICS,53.0,34.45,13.25,125.87,37
HCPCS,G0480,DTOFMP TAPENTADOL,53.0,34.45,13.25,125.87,37
HCPCS,G0480,Drug test def 1-7 classes,,,98.86,98.86,1
HCPCS,G0480,ENCAINIDE,184.0,119.6,33.04,184.0,37
HCPCS,G0480,ETHAMBUTOL,353.0,229.45,33.04,317.7,37
HCPCS,G0480,ETHANOL PLASMA,161.0,104.65,33.04,161.0,37
HCPCS,G0480,"ETHYL GLUCURONIDE, UR CONFIRM, QT",143.0,92.95,33.04,143.0,37
HCPCS,G0480,"FATTY ACID PROFILE,SER PL",333.0,216.45,33.04,299.7,37
HCPCS,G0480,FENTANYL AND METABOLITE (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,FENTANYL URINE,739.0,480.35,33.04,665.1,37
HCPCS,G0480,FLUOXETINE/NORFLUOXETINE,190.0,123.5,33.04,190.0,37
HCPCS,G0480,FLUVOXAMINE,583.0,378.95,33.04,524.7,37
HCPCS,G0480,GABAPENTIN (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,GHB CONF RFLX,156.0,101.4,33.04,156.0,37
HCPCS,G0480,GOLD SERUM,370.0,240.5,33.04,333.0,37
HCPCS,G0480,IMIPRAMINE,345.0,224.25,33.04,310.5,37
HCPCS,G0480,ISOPROPANOL,226.0,146.9,33.04,203.4,37
HCPCS,G0480,LAMOTRIGINE,24.0,15.6,6.0,125.87,37
HCPCS,G0480,LEVAMISOLE,304.0,197.6,33.04,273.6,37
HCPCS,G0480,LIBRIUM & METABOLITE,569.0,369.85,33.04,512.1,37
HCPCS,G0480,LORAZEPAM,210.0,136.5,33.04,191.21,37
HCPCS,G0480,MELATONIN,295.0,191.75,33.04,265.5,37
HCPCS,G0480,MEPHEDRONE MDPV CONF UR,152.0,98.8,33.04,152.0,37
HCPCS,G0480,MERCAPTOPURINE,516.0,335.4,33.04,464.4,37
HCPCS,G0480,METHADONE,143.0,92.95,33.04,143.0,37
HCPCS,G0480,METHADONE (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,"METHADONE QNT, UR",200.0,130.0,33.04,191.21,37
HCPCS,G0480,METHAQUALONE GC/MS UR,204.0,132.6,33.04,191.21,37
HCPCS,G0480,METHYLEEDIOXAMPHETAMINE (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,METHYLENEDIOXYAMPHETAMINES CONF URINE,739.0,480.35,33.04,665.1,37
HCPCS,G0480,"METHYLONE CONF, UR",152.0,98.8,33.04,152.0,37
HCPCS,G0480,METHYLPHENIDATE (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,"METOPROLOL, SER/PL",115.0,74.75,28.75,125.87,37
HCPCS,G0480,MITOTANE,506.0,328.9,33.04,455.4,37
HCPCS,G0480,NICOTINE AND METAB UR,158.0,102.7,33.04,158.0,37
HCPCS,G0480,NICOTINE/COTININE,238.0,154.7,33.04,214.2,37
HCPCS,G0480,NORTRIPTYLINE,345.0,224.25,33.04,310.5,37
HCPCS,G0480,NORTRIPTYLINE PLASMA,143.0,92.95,33.04,143.0,37
HCPCS,G0480,OLANZAPINE,277.0,180.05,33.04,249.3,37
HCPCS,G0480,OPIATE CONFIRMATION (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,OPIATE CONFIRMATION UR,226.0,146.9,33.04,203.4,37
HCPCS,G0480,OPIATES 1 OR MORE,143.0,92.95,33.04,143.0,37
HCPCS,G0480,OPIOID &OPIATE ANALOG 5/MORE,143.0,92.95,33.04,143.0,37
HCPCS,G0480,OPIOIDS & OPIATE ANALOGS 1/2,143.0,92.95,33.04,143.0,37
HCPCS,G0480,OPIOIDS & OPIATE ANALOGS 3/4,143.0,92.95,33.04,143.0,37
HCPCS,G0480,OPIOIDS AND OPIATE ANALOGS (DRGTOF),53.0,34.45,13.25,125.87,37
HCPCS,G0480,OPIOIDS AND OPIATE ANALOGS (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,OPISEC OPIATES 1 OR MORE,246.0,159.9,33.04,221.4,37
HCPCS,G0480,OPISEC OXYCODONE (MEDDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,ORLOPI OPIATES 1 OR MORE (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,OXYCODONE,143.0,92.95,33.04,143.0,74
HCPCS,G0480,"OXYCODONE CONF/QT, URINE",196.0,127.4,33.04,191.21,37
HCPCS,G0480,PCP CONFIRM URINE,739.0,480.35,33.04,665.1,37
HCPCS,G0480,PCP QUAN ASSAY,76.0,49.4,19.0,125.87,37
HCPCS,G0480,"PCP SER OR PL, QNT RFLX",315.0,204.75,33.04,283.5,37
HCPCS,G0480,PENTOBARBITAL,158.0,102.7,33.04,158.0,37
HCPCS,G0480,PHENCYCLIDINE (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,PHENCYCLIDINE (PCP),76.0,49.4,19.0,125.87,37
HCPCS,G0480,"PHENOLPHTHALEIN, STOOL",53.0,34.45,13.25,125.87,37
HCPCS,G0480,PHOSPHATIDYLETHANOL,314.0,204.1,33.04,282.6,37
HCPCS,G0480,PREGABALIN,105.5,68.575,17.0,143.0,111
HCPCS,G0480,QUETIAPINE,327.0,212.55,33.04,294.3,37
HCPCS,G0480,SERTRALINE,250.0,162.5,33.04,225.0,37
HCPCS,G0480,SOTAL DRUG NOS 1-3,742.0,482.3,33.04,667.8,37
HCPCS,G0480,SULFONYLUREA HYPO URINE,256.0,166.4,33.04,230.4,37
HCPCS,G0480,"SULFONYLUREA HYPOGLY PANEL,QT, UR",212.0,137.8,33.04,191.21,37
HCPCS,G0480,SULFONYLUREA HYPOGLY SER,143.0,92.95,33.04,143.0,37
HCPCS,G0480,"SULFONYLUREA HYPOGLY, SER",315.0,204.75,33.04,283.5,37
HCPCS,G0480,"SULFONYLUREA HYPOGLYCEMIA PANEL, QUANTITATIVE, URINE",739.0,480.35,33.04,665.1,37
HCPCS,G0480,SYNTH CANNABINOID METAB,191.0,124.15,33.04,191.21,74
HCPCS,G0480,TAPENTADOL AND MET (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,"TRAMADOL & METAB, QUANT",500.5,325.32500000000005,33.04,665.1,74
HCPCS,G0480,TRAMADOL (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G0480,TRICYCLIC & CYCLICALS 6/MORE,143.0,92.95,33.04,143.0,37
HCPCS,G0480,UQNTOX AMPHETAMINES,78.0,50.7,19.5,125.87,37
HCPCS,G0480,UQNTOX BUPRENORPHINE,78.0,50.7,19.5,125.87,37
HCPCS,G0480,UQNTOX CANNABINOIDS NATURAL,78.0,50.7,19.5,125.87,37
HCPCS,G0480,UQNTOX COCCAINE,78.0,50.7,19.5,125.87,37
HCPCS,G0480,UQNTOX FENTANYL,78.0,50.7,19.5,125.87,37
HCPCS,G0480,UQNTOX HEROINE METABOLITE,78.0,50.7,19.5,125.87,37
HCPCS,G0480,UQNTOX METHADONE,78.0,50.7,19.5,125.87,37
HCPCS,G0480,UQNTOX METHYLENEDIOXYAMPHETAMINES,78.0,50.7,19.5,125.87,37
HCPCS,G0480,UQNTOX OPIATES,78.0,50.7,19.5,125.87,37
HCPCS,G0480,UQNTOX OPIOIDS 5+,78.0,50.7,19.5,125.87,37
HCPCS,G0480,UQNTOX OXYCODONE,78.0,50.7,19.5,125.87,37
HCPCS,G0480,UQNTOX PHENCYCLIDINE,78.0,50.7,19.5,125.87,37
HCPCS,G0480,UQNTOX TRAMADOL,78.0,50.7,19.5,125.87,37
HCPCS,G0480,URDRG 6-MONOACETYLMORPHINE,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG ALKALOIDS NOS,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG AMPHETAMINES,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG ASSAY FOR PHENCYCLIDINE,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG BENZODIAZEPINES,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG BUPRENORPHINE,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG CANNABINOIDS,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG COCAINE,68.0,44.2,17.0,125.87,37
HCPCS,G0480,"URDRG DRUG SCREENING, TAPENTADOL",68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG DRUGS NOT OTHERWISE SPECIFIED,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG FENTANYL,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG GABAPENTIN,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG KETAMINE AND NORKETAMINE,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG METHADONE,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG METHYLENEDIOXYAMPHETAMINES,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG OPIATES,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG OPIOIDS,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG OXYCODONE,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG PREGABALIN,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG SKELETAL MUSCLE RELAXANTS,68.0,44.2,17.0,125.87,37
HCPCS,G0480,"URDRG STIMULANTS, SYNTHETIC",68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG TRAMADOL,68.0,44.2,17.0,125.87,37
HCPCS,G0480,URDRG ZOLPIDEM,68.0,44.2,17.0,125.87,37
HCPCS,G0480,"VOLATILE SCRN, UR",158.0,102.7,33.04,158.0,37
HCPCS,G0480,ZOLPIDEM (MECDRG),64.4,41.86,16.1,125.87,37
HCPCS,G04800,Drug test def 1-7 classes,,,98.86,98.86,1
HCPCS,G0481,"DRUG TEST, DEFINITVE, PER DAY?8-14?DRUG CLASSES",1015.0,659.75,74.65,913.5,37
HCPCS,G0481,DTOFMP GABAPENTIN,59.0,38.35,14.75,172.25,37
HCPCS,G0481,Drug test def 8-14 classes,,,135.29,135.29,1
HCPCS,G0481,MECDRG AMPHETAMINES 5 OR MORE,59.0,38.35,14.75,172.25,37
HCPCS,G0481,MECDRG DRUG SCRN BENZODIAZ 13 OR MORE,59.0,38.35,14.75,172.25,37
HCPCS,G0481,MECDRG OPIOIDS AND OPIATE ANALOGS 5 OR MORE,59.0,38.35,14.75,172.25,37
HCPCS,G04810,Drug test def 8-14 classes,,,135.29,135.29,1
HCPCS,G0482,"DRUG TEST, DEFINITVE, PER DAY?15-21 DRUG CLASSES",1288.0,837.2,74.65,1159.2,37
HCPCS,G0482,Drug test def 15-21 classes,,,171.71,171.71,1
HCPCS,G04820,Drug test def 15-21 classes,,,171.71,171.71,1
HCPCS,G0483,"DRUG TEST, DEFINITVE, PER DAY?22 OR MORE DRUG CLASSES",1600.0,1040.0,74.65,1440.0,37
HCPCS,G0483,Drug test def 22+ classes,,,213.34,213.34,1
HCPCS,G04830,Drug test def 22+ classes,,,213.34,213.34,1
HCPCS,G0490,"Home visit rn, lpn by rhc/fq",,,47.02,47.02,1
HCPCS,G04900,"Home visit rn, lpn by rhc/fq",,,47.02,47.02,1
HCPCS,G0491,Dialysis acu kidney no esrd,,,468.47,714.7,7
HCPCS,G04910,Dialysis acu kidney no esrd,,,468.47,468.47,1
HCPCS,G0492,Md/oth eval acut kid no esrd,,,565.8,714.7,7
HCPCS,G04920,Md/oth eval acut kid no esrd,,,678.24,678.24,1
HCPCS,G0493,Rn care ea 15 min hh/hospice,,,23.55,23.55,1
HCPCS,G04930,Rn care ea 15 min hh/hospice,,,23.55,23.55,1
HCPCS,G0494,Lpn care ea 15min hh/hospice,,,18.13,18.13,1
HCPCS,G04940,Lpn care ea 15min hh/hospice,,,18.13,18.13,1
HCPCS,G0495,Rn care train/edu in hh,,,47.53,47.53,1
HCPCS,G04950,Rn care train/edu in hh,,,47.53,47.53,1
HCPCS,G0496,Lpn care train/edu in hh,,,32.79,32.79,1
HCPCS,G04960,Lpn care train/edu in hh,,,32.79,32.79,1
HCPCS,G0498,CHEMO EXTEND IV INFUS W/PUMP,2614.0,1699.1,307.14,2352.6,48
HCPCS,G0498,CHEMO EXTEND IV INFUSION W/PUMP,1530.0,994.5,299.94,1530.0,13
HCPCS,G0498,Chemo extend iv infus w/pump,,,209.08,209.08,1
HCPCS,G04980,Chemo extend iv infus w/pump,,,209.08,209.08,1
HCPCS,G0499,Hepb screen high risk indiv,,,19.47,47.24,21
HCPCS,G04990,Hepb screen high risk indiv,,,24.43,24.43,1
HCPCS,G0500,MOD SEDAT ENDO SERVICE >5 YRS,876.0,569.4,7.13,788.4,28
HCPCS,G0500,MOD SEDAT ENDO SERVICE >5YRS,44.0,28.6,6.2,44.0,27
HCPCS,G0500,Mod sedat endo service >5yrs,,,5.96,5.96,1
HCPCS,G05000,Mod sedat endo service >5yrs,,,5.96,5.96,1
HCPCS,G0506,Comp asses care plan ccm svc,,,34.32,45.49,7
HCPCS,G05060,Comp asses care plan ccm svc,,,45.49,45.49,1
HCPCS,G0508,CRIT CARE TELEHEA CONSULT 60,1760.0,1144.0,195.9,1760.0,27
HCPCS,G0508,Crit care telehea consult 60,,,212.58,212.58,1
HCPCS,G05080,Crit care telehea consult 60,,,212.58,212.58,1
HCPCS,G0509,Crit care telehea consult 50,,,196.53,196.53,1
HCPCS,G05090,Crit care telehea consult 50,,,196.53,196.53,1
HCPCS,G0511,Ccm/bhi by rhc/fqhc 20min mo,,,34.32,112.07,9
HCPCS,G0512,Cocm by rhc/fqhc 60 min mo,,,45.19,225.16,9
HCPCS,G0513,"Prolong prev svcs, first 30m",,,50.0,50.0,1
HCPCS,G05130,"Prolong prev svcs, first 30m",,,50.0,50.0,1
HCPCS,G0514,"Prolong prev svcs, addl 30m",,,50.27,50.27,1
HCPCS,G05140,"Prolong prev svcs, addl 30m",,,50.27,50.27,1
HCPCS,G0516,"Insert drug del implant, >=4",,,98.33,865.18,21
HCPCS,G05160,"Insert drug del implant, >=4",,,99.3,99.3,1
HCPCS,G0517,Remove drug implant,,,98.33,865.18,21
HCPCS,G05170,Remove drug implant,,,113.19,113.19,1
HCPCS,G0518,Remove w insert drug implant,,,98.33,865.18,21
HCPCS,G05180,Remove w insert drug implant,,,185.94,185.94,1
HCPCS,G0519,New pt-cg dyad dem low cmplx,,,75.64,95.54,6
HCPCS,G0520,New pt-cg dyad dem mod cmplx,,,75.64,95.54,6
HCPCS,G0521,New pt-cg dyad dem hig cmplx,,,75.64,95.54,6
HCPCS,G0522,Mgt nw pt dementia low cmplx,,,75.64,95.54,6
HCPCS,G0523,Mgt nw pt dem mod-high cmplx,,,75.64,95.54,6
HCPCS,G0524,Est pt-cg dyad dem low cmplx,,,75.64,95.54,6
HCPCS,G0525,Est pt-cg dyad dem mod cmplx,,,75.64,95.54,6
HCPCS,G0526,Est pt-cg dyad dem hig cmplx,,,75.64,95.54,6
HCPCS,G0527,Mgt est pt dmentia low cmplx,,,75.64,95.54,6
HCPCS,G0528,Mgt est pt dem mod-hi cmplx,,,75.64,95.54,6
HCPCS,G0529,"In home respite care, 4 hr u",,,75.64,95.54,6
HCPCS,G0530,"Adult daycare center, 8 hr u",,,75.64,95.54,6
HCPCS,G0531,"Fclty-based respite, 24 hr u",,,75.64,95.54,6
HCPCS,G0532,Take home supp nasal spray,,,83.61,131.01,4
HCPCS,G05320,Take home supp nasal spray,,,83.61,83.61,1
HCPCS,G0533,Buprenorphone inj weekly,,,124.75,1075.79,10
HCPCS,G05330,Buprenorphone inj weekly,,,671.32,671.32,1
HCPCS,G0534,Coordinated care/or referral,,,43.26,157.58,10
HCPCS,G05340,Coordinated care/or referral,,,43.26,43.26,1
HCPCS,G0535,Pt navigat svs direct/ref,,,43.26,157.58,10
HCPCS,G05350,Pt navigat svs direct/ref,,,43.26,43.26,1
HCPCS,G0536,Peer recover support svs,,,43.26,157.58,10
HCPCS,G05360,Peer recover support svs,,,43.26,43.26,1
HCPCS,G0537,RISK ASCVD TST ONCE PR 12 MO,114.0,74.1,6.39,839.0,66
HCPCS,G0537,Risk ascvd tst once pr 12 mo,,,9.1,9.1,1
HCPCS,G05370,Risk ascvd tst once pr 12 mo,,,9.1,9.1,1
HCPCS,G0538,ASCVD RSK MNG CLIN STF PR MO,271.0,176.15,6.39,839.0,66
HCPCS,G0538,Ascvd rsk mng clin stf pr mo,,,9.1,9.1,1
HCPCS,G05380,Ascvd rsk mng clin stf pr mo,,,9.1,9.1,1
HCPCS,G0539,Initial care training 30 m,,,41.57,124.5,28
HCPCS,G05390,Initial care training 30 m,,,47.15,47.15,1
HCPCS,G0540,Train for caregiver add 15,,,25.27,67.07,28
HCPCS,G05400,Train for caregiver add 15,,,25.27,25.27,1
HCPCS,G0541,No pt prsnt train initial 30,,,30.2,64.4,18
HCPCS,G05410,No pt prsnt train initial 30,,,46.69,46.69,1
HCPCS,G0542,No pt prsnt train add 15,,,25.02,52.51,14
HCPCS,G05420,No pt prsnt train add 15,,,25.02,25.02,1
HCPCS,G0543,Group train w/o patient,,,10.83,33.22,18
HCPCS,G05430,Group train w/o patient,,,10.83,10.83,1
HCPCS,G0544,Post d/c phone follow up,,,34.32,200.56,20
HCPCS,G0545,INFECTIOUS DISEASE CONFIRMED/SUSPECTED INHERENT TO INPATIENT OR,392.0,254.8,31.54,392.0,25
HCPCS,G0545,Inherent visit to inpt,,,44.9,44.9,1
HCPCS,G05450,Inherent visit to inpt,,,44.9,44.9,1
HCPCS,G0546,Phone/internet ehr assess,,,18.08,18.08,1
HCPCS,G05460,Phone/internet ehr assess,,,18.08,18.08,1
HCPCS,G0547,Phone/internet svs 11-20 m,,,36.48,36.48,1
HCPCS,G05470,Phone/internet svs 11-20 m,,,36.48,36.48,1
HCPCS,G0548,Phone/inter svs 21-30 m,,,55.25,55.25,1
HCPCS,G05480,Phone/inter svs 21-30 m,,,55.25,55.25,1
HCPCS,G0549,Phone/inter for treat>31m,,,73.97,73.97,1
HCPCS,G05490,Phone/inter for treat>31m,,,73.97,73.97,1
HCPCS,G0550,Phone/inter for dx/treat >5m,,,34.17,34.17,1
HCPCS,G05500,Phone/inter for dx/treat >5m,,,34.17,34.17,1
HCPCS,G0551,Phn/intr svs fr dx treat 30m,,,35.76,35.76,1
HCPCS,G05510,Phn/intr svs fr dx treat 30m,,,35.76,35.76,1
HCPCS,G0552,SUPPLY OF DIGITAL DEVICE,446.0,289.9,41.57,675.0,53
HCPCS,G0553,MONTHLY TX FOR DMHT 20MINS,458.5,298.025,23.85,675.0,65
HCPCS,G0553,Monthly tx for dmht 20mins,,,31.06,31.06,1
HCPCS,G05530,Monthly tx for dmht 20mins,,,31.06,31.06,1
HCPCS,G0554,ADD 20 M OF MONTHLY TX,295.5,192.075,23.85,675.0,55
HCPCS,G0554,Add 20 m of monthly tx,,,30.08,30.08,1
HCPCS,G05540,Add 20 m of monthly tx,,,30.08,30.08,1
HCPCS,G0555,Replacment pt electronic sys,,,33.85,2205.87,20
HCPCS,G0556,ADV PRIM CARE MGMT LVL 1,110.0,71.5,8.79,110.0,25
HCPCS,G0556,Adv prim care mgmt lvl 1,,,12.51,64.59,21
HCPCS,G05560,Adv prim care mgmt lvl 1,,,12.51,12.51,1
HCPCS,G0557,ADV PRIM CARE MGMT LVL 2,339.0,220.35,26.56,339.0,25
HCPCS,G0557,Adv prim care mgmt lvl 2,,,29.9,64.59,21
HCPCS,G05570,Adv prim care mgmt lvl 2,,,37.82,37.82,1
HCPCS,G0558,ADV PRIM CARE MGMT LVL 3,735.0,477.75,58.63,735.0,25
HCPCS,G0558,Adv prim care mgmt lvl 3,,,34.32,200.56,21
HCPCS,G05580,Adv prim care mgmt lvl 3,,,83.47,83.47,1
HCPCS,G0559,POST-OP FOLLOW-UP PROVIDED BY A DIFFERENT PRACTICE FROM THE SURG,70.0,45.5,6.42,70.0,25
HCPCS,G0559,Unrelat prac follow up visit,,,9.13,9.13,1
HCPCS,G05590,Unrelat prac follow up visit,,,9.13,9.13,1
HCPCS,G0560,Safety plan interven,,,43.93,119.18,28
HCPCS,G05600,Safety plan interven,,,43.93,43.93,1
HCPCS,G0562,Complex simulation w/pet-ct,,,110.51,4229.01,20
HCPCS,G0563,Sbrt w/positron emission del,,,832.44,8131.7,20
HCPCS,G0564,365 d implant glucose sensor,,,254.67,7047.62,16
HCPCS,G0565,Rem/ins glu snsr 365 dif sit,,,254.67,7047.62,16
HCPCS,G0566,3d bn img algor drvd fr mri,,,134.37,352.04,7
HCPCS,G0567,Screening hep c detect,,,25.65,38.6,10
HCPCS,G0568,"Int psych care mng, 1 cal mo",,,45.19,116.7,10
HCPCS,G0569,"Subs psych care mng, subs mo",,,45.19,116.7,10
HCPCS,G0570,"Care manage serv, pr cal mo",,,39.13,57.08,10
HCPCS,G0571,INTRAOP NERVE CRYOABLATION,598.0,388.7,64.93,598.0,21
HCPCS,G0571,Intraop nerve cryoablation,,,62.62,62.62,1
HCPCS,G05710,Intraop nerve cryoablation,,,62.62,62.62,1
HCPCS,G0659,Drug test def simple all cl,,,33.04,103.84,21
HCPCS,G06590,Drug test def simple all cl,,,53.69,53.69,1
HCPCS,G0680,Cr art clc art vlv clc w rpt,,,64.08,80.94,6
HCPCS,G0681,App of non-sheet skin sub,,,1181.56,1492.5,6
HCPCS,G0682,App of non-sheet skin sub ad,,,1181.56,1492.5,6
HCPCS,G0683,App of non-sheet skin sub g,,,1181.56,1492.5,6
HCPCS,G0684,App non-sheet skin sb g add,,,1181.56,1492.5,6
HCPCS,G1028,Take home supply 8mg per 0.1,,,137.91,213.82,4
HCPCS,G10280,Take home supply 8mg per 0.1,,,137.91,137.91,1
HCPCS,G2000,Blinded conv. tx mdd clin tr,,,292.32,1150.43,21
HCPCS,G20000,Blinded conv. tx mdd clin tr,,,988.22,988.22,1
HCPCS,G2001,Post d/c h vst new pt 20 m,,,41.8,41.8,1
HCPCS,G20010,Post d/c h vst new pt 20 m,,,41.8,41.8,1
HCPCS,G2002,Post-d/c h vst new pt 30 m,,,62.2,62.2,1
HCPCS,G20020,Post-d/c h vst new pt 30 m,,,62.2,62.2,1
HCPCS,G2003,Post-d/c h vst new pt 45 m,,,102.11,102.11,1
HCPCS,G20030,Post-d/c h vst new pt 45 m,,,102.11,102.11,1
HCPCS,G2004,Post-d/c h vst new pt 60 m,,,134.23,134.23,1
HCPCS,G20040,Post-d/c h vst new pt 60 m,,,134.23,134.23,1
HCPCS,G2005,Post-d/c h vst new pt 75 m,,,175.4,175.4,1
HCPCS,G20050,Post-d/c h vst new pt 75 m,,,175.4,175.4,1
HCPCS,G2006,Post-d/c h vst ext pt 20 m,,,40.99,40.99,1
HCPCS,G20060,Post-d/c h vst ext pt 20 m,,,40.99,40.99,1
HCPCS,G2007,Post-d/c h vst ext pt 30 m,,,65.99,65.99,1
HCPCS,G20070,Post-d/c h vst ext pt 30 m,,,65.99,65.99,1
HCPCS,G2008,Post-d/c h vst ext pt 45 m,,,103.58,103.58,1
HCPCS,G20080,Post-d/c h vst ext pt 45 m,,,103.58,103.58,1
HCPCS,G2009,Post-d/c h vst ext pt 60 m,,,146.39,146.39,1
HCPCS,G20090,Post-d/c h vst ext pt 60 m,,,146.39,146.39,1
HCPCS,G2010,Remot image submit by pt,,,9.36,34.15,7
HCPCS,G20100,Remot image submit by pt,,,9.36,9.36,1
HCPCS,G2011,Alcohol/sub misuse assess,,,12.84,53.1,21
HCPCS,G20110,Alcohol/sub misuse assess,,,17.39,17.39,1
HCPCS,G2012,Brief check in by md/qhp,,,27.04,34.15,6
HCPCS,G2013,Post-d/c h vst ext pt 75 m,,,175.4,175.4,1
HCPCS,G20130,Post-d/c h vst ext pt 75 m,,,175.4,175.4,1
HCPCS,G2014,Post-d/c care plan overs 30m,,,62.1,62.1,1
HCPCS,G20140,Post-d/c care plan overs 30m,,,62.1,62.1,1
HCPCS,G2015,Post-d/c care plan overs 60m,,,87.12,87.12,1
HCPCS,G20150,Post-d/c care plan overs 60m,,,87.12,87.12,1
HCPCS,G2020,Hi inten serv for sip model,,,75.64,95.54,6
HCPCS,G2021,Hea care pract tx in place,,,34.47,34.47,1
HCPCS,G20210,Hea care pract tx in place,,,34.47,34.47,1
HCPCS,G2022,"Benef refuses service, mod",,,54.0,54.0,1
HCPCS,G20220,"Benef refuses service, mod",,,54.0,54.0,1
HCPCS,G2023,Specimen collect covid-19,,,2.52,3.18,6
HCPCS,G2024,Spec coll snf/lab covid-19,,,2.52,3.18,6
HCPCS,G2025,Dis site tele svcs rhc/fqhc,,,100.35,100.35,1
HCPCS,G20250,Dis site tele svcs rhc/fqhc,,,100.35,100.35,1
HCPCS,G2058,"CHRONIC CARE MANAGEMENT SERVICES, EACH ADDITIONAL 20 MINUTES",159.0,103.35,79.5,159.0,12
HCPCS,G2058,Ccm add 20min,,,34.32,43.36,6
HCPCS,G2061,Qual nonmd est pt 5-10m,,,12.46,12.46,1
HCPCS,G20610,Qual nonmd est pt 5-10m,,,12.46,12.46,1
HCPCS,G2062,Qual nonmd est pt 11-20m,,,13.78,13.78,1
HCPCS,G20620,Qual nonmd est pt 11-20m,,,13.78,13.78,1
HCPCS,G2063,Qual nonmd est pt 21>min,,,21.57,21.57,1
HCPCS,G20630,Qual nonmd est pt 21>min,,,21.57,21.57,1
HCPCS,G2064,Md mang high risk dx 30,,,34.32,43.36,6
HCPCS,G2065,Clin mang h risk dx 30,,,34.32,43.36,6
HCPCS,G2066,Inter devc remote 30d,,,23.85,30.13,6
HCPCS,G2067,Med assist tx meth wk,,,124.75,456.9,10
HCPCS,G20670,Med assist tx meth wk,,,271.36,271.36,1
HCPCS,G2068,Med assist tx bupre oral,,,124.75,501.99,10
HCPCS,G20680,Med assist tx bupre oral,,,304.89,304.89,1
HCPCS,G2069,Med assist tx inject,,,124.75,3402.54,10
HCPCS,G20690,Med assist tx inject,,,2157.48,2157.48,1
HCPCS,G2070,Med assist tx implant,,,230.29,290.89,6
HCPCS,G2071,Med tx remove implant,,,124.75,157.58,6
HCPCS,G2072,Med tx insert/remove imp,,,230.29,290.89,6
HCPCS,G2073,Med tx naltrexone,,,124.75,2865.06,10
HCPCS,G20730,Med tx naltrexone,,,1768.56,1768.56,1
HCPCS,G2074,Med assist tx no drug,,,124.75,365.66,10
HCPCS,G20740,Med assist tx no drug,,,215.15,215.15,1
HCPCS,G2075,Med tx meds nos,,,124.75,157.58,6
HCPCS,G2076,Intake act w/med exam,,,149.38,389.33,10
HCPCS,G20760,Intake act w/med exam,,,209.37,209.37,1
HCPCS,G2077,Periodic assessment,,,128.66,252.14,10
HCPCS,G20770,Periodic assessment,,,128.66,128.66,1
HCPCS,G2078,Take-home meth,,,43.97,70.4,4
HCPCS,G20780,Take-home meth,,,43.97,43.97,1
HCPCS,G2079,Take-hom buprenorphine,,,77.5,115.48,4
HCPCS,G20790,Take-hom buprenorphine,,,77.5,77.5,1
HCPCS,G2080,Add 30 mins counsel,,,16.06,61.36,10
HCPCS,G20800,Add 30 mins counsel,,,36.09,36.09,1
HCPCS,G2081,Pt 66+ snp or ltc pos > 90d,,,0.01,0.01,1
HCPCS,G20810,Pt 66+ snp or ltc pos > 90d,,,0.01,0.01,1
HCPCS,G2082,Visit esketamine 56m or less,,,36.98,2494.47,21
HCPCS,G20820,Visit esketamine 56m or less,,,36.98,36.98,1
HCPCS,G2083,"Visit esketamine, > 56m",,,36.98,3144.92,21
HCPCS,G20830,"Visit esketamine, > 56m",,,36.98,36.98,1
HCPCS,G2086,Off base opioid tx 70min,,,45.19,421.85,21
HCPCS,G20860,Off base opioid tx 70min,,,421.85,421.85,1
HCPCS,G2087,"Off base opioid tx, 60 m",,,45.19,407.64,21
HCPCS,G20870,"Off base opioid tx, 60 m",,,407.64,407.64,1
HCPCS,G2088,"Off base opioid tx, add30",,,40.18,57.08,7
HCPCS,G20880,"Off base opioid tx, add30",,,40.18,40.18,1
HCPCS,G2092,Ace arb arni,,,0.01,0.01,1
HCPCS,G20920,Ace arb arni,,,0.01,0.01,1
HCPCS,G2121,Psy dep anx ap and icd asse,,,0.01,0.01,1
HCPCS,G21210,Psy dep anx ap and icd asse,,,0.01,0.01,1
HCPCS,G2142,Fs odi 9-15mo postop<= 22,,,0.01,0.01,1
HCPCS,G21420,Fs odi 9-15mo postop<= 22,,,0.01,0.01,1
HCPCS,G2148,Mpm used,,,0.01,0.01,1
HCPCS,G21480,Mpm used,,,0.01,0.01,1
HCPCS,G2149,No mpm med rsn,,,0.01,0.01,1
HCPCS,G21490,No mpm med rsn,,,0.01,0.01,1
HCPCS,G2168,Svs by pt in home health,,,96.36,96.36,1
HCPCS,G21680,Svs by pt in home health,,,96.36,96.36,1
HCPCS,G2170,Avf by tissue w thermal e,,,2199.26,2778.01,6
HCPCS,G2171,Avf use magnetic/art/ven,,,2199.26,2778.01,6
HCPCS,G2172,Tx for opioid use demo proj,,,124.75,157.58,6
HCPCS,G2211,Complex e/m visit add on,,,0.01,0.01,1
HCPCS,G2211,VISIT CPLX INHERENT E&M ASSOC WITH MED CARE SRVC,145.0,94.25,15.01,145.0,27
HCPCS,G22110,Complex e/m visit add on,,,0.01,0.01,1
HCPCS,G2212,PROLONG OUTPT/OFFICE VIS,268.0,174.2,21.53,268.0,28
HCPCS,G2212,Prolong outpt/office vis,,,32.3,32.3,1
HCPCS,G22120,Prolong outpt/office vis,,,32.3,32.3,1
HCPCS,G2213,INITIAT MED ASSIST TX IN ER,572.0,371.8,58.61,572.0,27
HCPCS,G2213,Initiat med assist tx in er,,,16.06,62.95,7
HCPCS,G22130,Initiat med assist tx in er,,,62.95,62.95,1
HCPCS,G2214,Init/sub psych care m 1st 30,,,39.61,200.56,21
HCPCS,G22140,Init/sub psych care m 1st 30,,,39.61,39.61,1
HCPCS,G2215,Home supply nasal naloxone,,,59.86,67.44,4
HCPCS,G22150,Home supply nasal naloxone,,,59.86,59.86,1
HCPCS,G2216,Home supply inject naloxon,,,59.86,59.86,1
HCPCS,G22160,Home supply inject naloxon,,,59.86,59.86,1
HCPCS,G2250,"Remot img sub by pt, non e/m",,,9.36,34.15,28
HCPCS,G22500,"Remot img sub by pt, non e/m",,,9.36,9.36,1
HCPCS,G2251,"Brief chkin, 5-10, non-e/m",,,13.2,34.15,28
HCPCS,G22510,"Brief chkin, 5-10, non-e/m",,,13.2,13.2,1
HCPCS,G2252,"Brief chkin by md/qhp, 11-20",,,25.7,66.04,28
HCPCS,G22520,"Brief chkin by md/qhp, 11-20",,,25.7,25.7,1
HCPCS,G3002,Chronic pain mgmt 30 mins,,,34.32,76.72,7
HCPCS,G30020,Chronic pain mgmt 30 mins,,,76.72,76.72,1
HCPCS,G3003,Chronic pain mgmt addl 15m,,,26.72,43.36,7
HCPCS,G30030,Chronic pain mgmt addl 15m,,,26.72,26.72,1
HCPCS,G4000,Dermatology ss,,,37.8,37.8,1
HCPCS,G40000,Dermatology ss,,,37.8,37.8,1
HCPCS,G6001,Echo guidance radiotherapy,,,65.54,82.79,6
HCPCS,G6002,Stereoscopic x-ray guidance,,,136.83,172.84,6
HCPCS,G6003,Radiation treatment delivery,,,107.19,135.4,6
HCPCS,G6004,Radiation treatment delivery,,,107.19,135.4,6
HCPCS,G6005,Radiation treatment delivery,,,107.19,135.4,6
HCPCS,G6006,Radiation treatment delivery,,,107.19,135.4,6
HCPCS,G6007,Radiation treatment delivery,,,107.19,135.4,6
HCPCS,G6008,Radiation treatment delivery,,,107.19,135.4,6
HCPCS,G6009,Radiation treatment delivery,,,107.19,135.4,6
HCPCS,G6010,Radiation treatment delivery,,,107.19,135.4,6
HCPCS,G6011,Radiation treatment delivery,,,107.19,135.4,6
HCPCS,G6012,Radiation treatment delivery,,,107.19,135.4,6
HCPCS,G6013,Radiation treatment delivery,,,107.19,135.4,6
HCPCS,G6014,Radiation treatment delivery,,,107.19,135.4,6
HCPCS,G6015,Radiation tx delivery imrt,,,280.79,354.68,6
HCPCS,G6016,Delivery comp imrt,,,110.51,139.6,6
HCPCS,G8395,Lvef>=40% doc normal or mild,,,0.01,0.01,1
HCPCS,G83950,Lvef>=40% doc normal or mild,,,0.01,0.01,1
HCPCS,G8396,Lvef not performed,,,0.01,0.01,1
HCPCS,G83960,Lvef not performed,,,0.01,0.01,1
HCPCS,G8397,Dil macula/fundus exam/w doc,,,0.01,0.01,1
HCPCS,G83970,Dil macula/fundus exam/w doc,,,0.01,0.01,1
HCPCS,G8400,Pt w/dxa no results doc,,,0.01,0.01,1
HCPCS,G84000,Pt w/dxa no results doc,,,0.01,0.01,1
HCPCS,G8404,Low extemity neur exam docum,,,0.01,0.01,1
HCPCS,G84040,Low extemity neur exam docum,,,0.01,0.01,1
HCPCS,G8405,Low extemity neur not perfor,,,0.01,0.01,1
HCPCS,G84050,Low extemity neur not perfor,,,0.01,0.01,1
HCPCS,G8410,Eval on foot documented,,,0.01,0.01,1
HCPCS,G84100,Eval on foot documented,,,0.01,0.01,1
HCPCS,G8415,Eval on foot not performed,,,0.01,0.01,1
HCPCS,G84150,Eval on foot not performed,,,0.01,0.01,1
HCPCS,G8416,Pt inelig footwear evaluatio,,,0.01,0.01,1
HCPCS,G84160,Pt inelig footwear evaluatio,,,0.01,0.01,1
HCPCS,G8417,Calc bmi abv up param f/u,,,0.01,0.01,1
HCPCS,G84170,Calc bmi abv up param f/u,,,0.01,0.01,1
HCPCS,G8418,Calc bmi blw low param f/u,,,0.01,0.01,1
HCPCS,G84180,Calc bmi blw low param f/u,,,0.01,0.01,1
HCPCS,G8419,Calc bmi out nrm param nof/u,,,0.01,0.01,1
HCPCS,G84190,Calc bmi out nrm param nof/u,,,0.01,0.01,1
HCPCS,G8420,Calc bmi norm parameters,,,0.01,0.01,1
HCPCS,G84200,Calc bmi norm parameters,,,0.01,0.01,1
HCPCS,G8421,Bmi not calculated,,,0.01,0.01,1
HCPCS,G84210,Bmi not calculated,,,0.01,0.01,1
HCPCS,G8427,Docrev cur meds by elig clin,,,0.01,0.01,1
HCPCS,G84270,Docrev cur meds by elig clin,,,0.01,0.01,1
HCPCS,G8428,Cur meds not document,,,0.01,0.01,1
HCPCS,G84280,Cur meds not document,,,0.01,0.01,1
HCPCS,G8430,Doc med rsn no medrec,,,0.01,0.01,1
HCPCS,G84300,Doc med rsn no medrec,,,0.01,0.01,1
HCPCS,G8431,Pos clin depres scrn f/u doc,,,0.01,0.01,1
HCPCS,G84310,Pos clin depres scrn f/u doc,,,0.01,0.01,1
HCPCS,G8432,"Dep scr not doc, rng",,,0.01,0.01,1
HCPCS,G84320,"Dep scr not doc, rng",,,0.01,0.01,1
HCPCS,G8433,Scr for dep not cpt doc rsn,,,0.01,0.01,1
HCPCS,G84330,Scr for dep not cpt doc rsn,,,0.01,0.01,1
HCPCS,G8450,Beta-bloc rx pt w/abn lvef,,,0.01,0.01,1
HCPCS,G84500,Beta-bloc rx pt w/abn lvef,,,0.01,0.01,1
HCPCS,G8451,Pt w/abn lvef inelig b-bloc,,,0.01,0.01,1
HCPCS,G84510,Pt w/abn lvef inelig b-bloc,,,0.01,0.01,1
HCPCS,G8452,Pt w/abn lvef b-bloc no rx,,,0.01,0.01,1
HCPCS,G84520,Pt w/abn lvef b-bloc no rx,,,0.01,0.01,1
HCPCS,G8465,High risk recurrence pro ca,,,0.01,0.01,1
HCPCS,G84650,High risk recurrence pro ca,,,0.01,0.01,1
HCPCS,G8473,Ace/arb thxpy rx'd,,,0.01,0.01,1
HCPCS,G84730,Ace/arb thxpy rx'd,,,0.01,0.01,1
HCPCS,G8474,Ace/arb not rx'd; doc reas,,,0.01,0.01,1
HCPCS,G84740,Ace/arb not rx'd; doc reas,,,0.01,0.01,1
HCPCS,G8475,Ace/arb thxpy not rx'd,,,0.01,0.01,1
HCPCS,G84750,Ace/arb thxpy not rx'd,,,0.01,0.01,1
HCPCS,G8476,Bp sys <140 and dias <90,,,0.01,0.01,1
HCPCS,G84760,Bp sys <140 and dias <90,,,0.01,0.01,1
HCPCS,G8477,Bp sys>=140 and/or dias >=90,,,0.01,0.01,1
HCPCS,G84770,Bp sys>=140 and/or dias >=90,,,0.01,0.01,1
HCPCS,G8510,"Scr dep neg, no plan reqd",,,0.01,0.01,1
HCPCS,G85100,"Scr dep neg, no plan reqd",,,0.01,0.01,1
HCPCS,G8511,"Scr dep pos, no plan doc rng",,,0.01,0.01,1
HCPCS,G85110,"Scr dep pos, no plan doc rng",,,0.01,0.01,1
HCPCS,G8535,Eld maltreatment not doc,,,0.01,0.01,1
HCPCS,G85350,Eld maltreatment not doc,,,0.01,0.01,1
HCPCS,G8536,No doc elder mal scrn,,,0.01,0.01,1
HCPCS,G85360,No doc elder mal scrn,,,0.01,0.01,1
HCPCS,G8539,Doc funct and care plan,,,0.01,0.01,1
HCPCS,G85390,Doc funct and care plan,,,0.01,0.01,1
HCPCS,G8540,Foa not doc as being perf,,,0.01,0.01,1
HCPCS,G85400,Foa not doc as being perf,,,0.01,0.01,1
HCPCS,G8541,No doc cur funct assess,,,0.01,0.01,1
HCPCS,G85410,No doc cur funct assess,,,0.01,0.01,1
HCPCS,G8542,Doc funct no deficiencies,,,0.01,0.01,1
HCPCS,G85420,Doc funct no deficiencies,,,0.01,0.01,1
HCPCS,G8543,Cur funct asses; no care pln,,,0.01,0.01,1
HCPCS,G85430,Cur funct asses; no care pln,,,0.01,0.01,1
HCPCS,G8569,Prol intubation req,,,0.01,0.01,1
HCPCS,G85690,Prol intubation req,,,0.01,0.01,1
HCPCS,G8598,Asa/antiplat ther used,,,0.01,0.01,1
HCPCS,G85980,Asa/antiplat ther used,,,0.01,0.01,1
HCPCS,G8633,Pharm ther osteo rx,,,0.01,0.01,1
HCPCS,G86330,Pharm ther osteo rx,,,0.01,0.01,1
HCPCS,G8708,Antibiotic not pres,,,0.01,0.01,1
HCPCS,G87080,Antibiotic not pres,,,0.01,0.01,1
HCPCS,G8709,Uri ep compete diag,,,0.01,0.01,1
HCPCS,G87090,Uri ep compete diag,,,0.01,0.01,1
HCPCS,G8710,Pt pres antibiotic,,,0.01,0.01,1
HCPCS,G87100,Pt pres antibiotic,,,0.01,0.01,1
HCPCS,G8711,Pres antibx on/within 3 day,,,0.01,0.01,1
HCPCS,G87110,Pres antibx on/within 3 day,,,0.01,0.01,1
HCPCS,G8712,Not pres antibiotic,,,0.01,0.01,1
HCPCS,G87120,Not pres antibiotic,,,0.01,0.01,1
HCPCS,G8721,"Pt, pn, hist grade doc",,,0.01,0.01,1
HCPCS,G87210,"Pt, pn, hist grade doc",,,0.01,0.01,1
HCPCS,G8734,Doc neg eld req,,,0.01,0.01,1
HCPCS,G87340,Doc neg eld req,,,0.01,0.01,1
HCPCS,G8749,No signs melanoma,,,0.01,0.01,1
HCPCS,G87490,No signs melanoma,,,0.01,0.01,1
HCPCS,G8752,Sys bp less 140,,,0.01,0.01,1
HCPCS,G87520,Sys bp less 140,,,0.01,0.01,1
HCPCS,G8753,Sys bp > or = 140,,,0.01,0.01,1
HCPCS,G87530,Sys bp > or = 140,,,0.01,0.01,1
HCPCS,G8754,Dias bp less 90,,,0.01,0.01,1
HCPCS,G87540,Dias bp less 90,,,0.01,0.01,1
HCPCS,G8755,Dias bp > or = 90,,,0.01,0.01,1
HCPCS,G87550,Dias bp > or = 90,,,0.01,0.01,1
HCPCS,G8756,No bp measure doc,,,0.01,0.01,1
HCPCS,G87560,No bp measure doc,,,0.01,0.01,1
HCPCS,G8783,Bp scrn perf rec interval,,,0.01,0.01,1
HCPCS,G87830,Bp scrn perf rec interval,,,0.01,0.01,1
HCPCS,G8785,Bp scrn no perf at interval,,,0.01,0.01,1
HCPCS,G87850,Bp scrn no perf at interval,,,0.01,0.01,1
HCPCS,G8797,Specimen site not esophagus,,,0.01,0.01,1
HCPCS,G87970,Specimen site not esophagus,,,0.01,0.01,1
HCPCS,G8839,Sleep apnea assess,,,0.01,0.01,1
HCPCS,G88390,Sleep apnea assess,,,0.01,0.01,1
HCPCS,G8842,Ahi rdi rei doc win 2mo,,,0.01,0.01,1
HCPCS,G88420,Ahi rdi rei doc win 2mo,,,0.01,0.01,1
HCPCS,G8845,Pos airway press prescribed,,,0.01,0.01,1
HCPCS,G88450,Pos airway press prescribed,,,0.01,0.01,1
HCPCS,G8846,Mod or severe osa,,,0.01,0.01,1
HCPCS,G88460,Mod or severe osa,,,0.01,0.01,1
HCPCS,G8851,Adhere tx assess at lst ann,,,0.01,0.01,1
HCPCS,G88510,Adhere tx assess at lst ann,,,0.01,0.01,1
HCPCS,G8856,Ref for oto eval,,,0.01,0.01,1
HCPCS,G88560,Ref for oto eval,,,0.01,0.01,1
HCPCS,G8857,No elig ref for oto eval,,,0.01,0.01,1
HCPCS,G88570,No elig ref for oto eval,,,0.01,0.01,1
HCPCS,G8864,Pneumococcal vaccine admin,,,0.01,0.01,1
HCPCS,G88640,Pneumococcal vaccine admin,,,0.01,0.01,1
HCPCS,G8866,Doc pt reas no pneumococcal,,,0.01,0.01,1
HCPCS,G88660,Doc pt reas no pneumococcal,,,0.01,0.01,1
HCPCS,G8875,Breast cancer dx min invsive,,,0.01,0.01,1
HCPCS,G88750,Breast cancer dx min invsive,,,0.01,0.01,1
HCPCS,G8876,Doc reas no min inv dx,,,0.01,0.01,1
HCPCS,G88760,Doc reas no min inv dx,,,0.01,0.01,1
HCPCS,G8878,Sent lymph node biopsy,,,0.01,0.01,1
HCPCS,G88780,Sent lymph node biopsy,,,0.01,0.01,1
HCPCS,G8907,Pt doc no events on discharg,,,0.01,0.01,1
HCPCS,G89070,Pt doc no events on discharg,,,0.01,0.01,1
HCPCS,G8909,Pt doc no burn prior to d/c,,,0.01,0.01,1
HCPCS,G89090,Pt doc no burn prior to d/c,,,0.01,0.01,1
HCPCS,G8916,Pt w iv ab given on time,,,0.01,0.01,1
HCPCS,G89160,Pt w iv ab given on time,,,0.01,0.01,1
HCPCS,G8918,Pt w/o preop order iv ab pro,,,0.01,0.01,1
HCPCS,G89180,Pt w/o preop order iv ab pro,,,0.01,0.01,1
HCPCS,G8923,Lvef <= 40% or lvsd,,,0.01,0.01,1
HCPCS,G89230,Lvef <= 40% or lvsd,,,0.01,0.01,1
HCPCS,G8924,Spir res doc fev1/fvc<70%,,,0.01,0.01,1
HCPCS,G89240,Spir res doc fev1/fvc<70%,,,0.01,0.01,1
HCPCS,G8935,Rx ace or arb therapy,,,0.01,0.01,1
HCPCS,G89350,Rx ace or arb therapy,,,0.01,0.01,1
HCPCS,G8937,No rx ace/arb therapy,,,0.01,0.01,1
HCPCS,G89370,No rx ace/arb therapy,,,0.01,0.01,1
HCPCS,G8942,Doc fcn/care plan w/30 days,,,0.01,0.01,1
HCPCS,G89420,Doc fcn/care plan w/30 days,,,0.01,0.01,1
HCPCS,G8950,"Pre-htn or htn doc, f/u indc",,,0.01,0.01,1
HCPCS,G89500,"Pre-htn or htn doc, f/u indc",,,0.01,0.01,1
HCPCS,G8952,"Pre-htn/htn, no f/u, not gvn",,,0.01,0.01,1
HCPCS,G89520,"Pre-htn/htn, no f/u, not gvn",,,0.01,0.01,1
HCPCS,G8967,Warf or other fda drug presc,,,0.01,0.01,1
HCPCS,G89670,Warf or other fda drug presc,,,0.01,0.01,1
HCPCS,G8968,Doc med not presb,,,0.01,0.01,1
HCPCS,G89680,Doc med not presb,,,0.01,0.01,1
HCPCS,G8970,No rsk fac or 1 mod risk te,,,0.01,0.01,1
HCPCS,G89700,No rsk fac or 1 mod risk te,,,0.01,0.01,1
HCPCS,G9001,"Mccd, initial rate",,,0.01,95.54,7
HCPCS,G90010,"Mccd, initial rate",,,0.01,0.01,1
HCPCS,G9002,"Mccd,maintenance rate",,,0.01,95.54,7
HCPCS,G90020,"Mccd,maintenance rate",,,0.01,0.01,1
HCPCS,G9003,"Mccd, risk adj hi, initial",,,0.01,95.54,7
HCPCS,G90030,"Mccd, risk adj hi, initial",,,0.01,0.01,1
HCPCS,G9004,"Mccd, risk adj lo, initial",,,0.01,95.54,7
HCPCS,G90040,"Mccd, risk adj lo, initial",,,0.01,0.01,1
HCPCS,G9005,"Mccd, risk adj, maintenance",,,0.01,95.54,7
HCPCS,G90050,"Mccd, risk adj, maintenance",,,0.01,0.01,1
HCPCS,G9006,"Mccd, home monitoring",,,0.01,95.54,7
HCPCS,G90060,"Mccd, home monitoring",,,0.01,0.01,1
HCPCS,G9007,"Mccd, sch team conf",,,0.01,95.54,7
HCPCS,G90070,"Mccd, sch team conf",,,0.01,0.01,1
HCPCS,G9008,"Mccd,phys coor-care ovrsght",,,0.01,95.54,7
HCPCS,G90080,"Mccd,phys coor-care ovrsght",,,0.01,0.01,1
HCPCS,G9009,"Mccd, risk adj, level 3",,,75.64,95.54,6
HCPCS,G9010,"Mccd, risk adj, level 4",,,0.01,95.54,7
HCPCS,G90100,"Mccd, risk adj, level 4",,,0.01,0.01,1
HCPCS,G9011,"Mccd, risk adj, level 5",,,0.01,95.54,7
HCPCS,G90110,"Mccd, risk adj, level 5",,,0.01,0.01,1
HCPCS,G9012,Other specified case mgmt,,,0.01,95.54,7
HCPCS,G90120,Other specified case mgmt,,,0.01,0.01,1
HCPCS,G9013,Esrd demo bundle level i,,,353.32,446.3,6
HCPCS,G9014,Esrd demo bundle-level ii,,,353.32,446.3,6
HCPCS,G9016,Demo-smoking cessation coun,,,9.03,16.22,7
HCPCS,G90160,Demo-smoking cessation coun,,,9.03,9.03,1
HCPCS,G9037,Intrpro req fr rec phys/qhcp,,,50.45,52.97,7
HCPCS,G9038,Co-management services,,,62.87,95.54,13
HCPCS,G9050,Oncology work-up evaluation,,,0.01,0.01,1
HCPCS,G90500,Oncology work-up evaluation,,,0.01,0.01,1
HCPCS,G9051,Oncology tx decision-mgmt,,,0.01,0.01,1
HCPCS,G90510,Oncology tx decision-mgmt,,,0.01,0.01,1
HCPCS,G9052,Onc surveillance for disease,,,0.01,0.01,1
HCPCS,G90520,Onc surveillance for disease,,,0.01,0.01,1
HCPCS,G9053,Onc expectant management pt,,,0.01,0.01,1
HCPCS,G90530,Onc expectant management pt,,,0.01,0.01,1
HCPCS,G9054,Onc supervision palliative,,,0.01,0.01,1
HCPCS,G90540,Onc supervision palliative,,,0.01,0.01,1
HCPCS,G9056,Onc prac mgmt adheres guide,,,0.01,0.01,1
HCPCS,G90560,Onc prac mgmt adheres guide,,,0.01,0.01,1
HCPCS,G9057,Onc pract mgmt differs trial,,,0.01,0.01,1
HCPCS,G90570,Onc pract mgmt differs trial,,,0.01,0.01,1
HCPCS,G9058,Onc prac mgmt disagree w/gui,,,0.01,0.01,1
HCPCS,G90580,Onc prac mgmt disagree w/gui,,,0.01,0.01,1
HCPCS,G9059,Onc prac mgmt pt opt alterna,,,0.01,0.01,1
HCPCS,G90590,Onc prac mgmt pt opt alterna,,,0.01,0.01,1
HCPCS,G9060,Onc prac mgmt dif pt comorb,,,0.01,0.01,1
HCPCS,G90600,Onc prac mgmt dif pt comorb,,,0.01,0.01,1
HCPCS,G9061,Onc prac cond noadd by guide,,,0.01,0.01,1
HCPCS,G90610,Onc prac cond noadd by guide,,,0.01,0.01,1
HCPCS,G9063,Onc dx nsclc stgi no progres,,,0.01,0.01,1
HCPCS,G90630,Onc dx nsclc stgi no progres,,,0.01,0.01,1
HCPCS,G9064,Onc dx nsclc stg2 no progres,,,0.01,0.01,1
HCPCS,G90640,Onc dx nsclc stg2 no progres,,,0.01,0.01,1
HCPCS,G9065,Onc dx nsclc stg3a no progre,,,0.01,0.01,1
HCPCS,G90650,Onc dx nsclc stg3a no progre,,,0.01,0.01,1
HCPCS,G9066,Onc dx nsclc stg3b-4 metasta,,,0.01,0.01,1
HCPCS,G90660,Onc dx nsclc stg3b-4 metasta,,,0.01,0.01,1
HCPCS,G9068,Onc dx sclc/nsclc limited,,,0.01,0.01,1
HCPCS,G90680,Onc dx sclc/nsclc limited,,,0.01,0.01,1
HCPCS,G9069,Onc dx sclc/nsclc ext at dx,,,0.01,0.01,1
HCPCS,G90690,Onc dx sclc/nsclc ext at dx,,,0.01,0.01,1
HCPCS,G9070,Onc dx sclc/nsclc ext unknwn,,,0.01,0.01,1
HCPCS,G90700,Onc dx sclc/nsclc ext unknwn,,,0.01,0.01,1
HCPCS,G9071,"Onc dx brst stg1-2b hr,nopro",,,0.01,0.01,1
HCPCS,G90710,"Onc dx brst stg1-2b hr,nopro",,,0.01,0.01,1
HCPCS,G9072,Onc dx brst stg1-2 noprogres,,,0.01,0.01,1
HCPCS,G90720,Onc dx brst stg1-2 noprogres,,,0.01,0.01,1
HCPCS,G9073,"Onc dx brst stg3-hr, no pro",,,0.01,0.01,1
HCPCS,G90730,"Onc dx brst stg3-hr, no pro",,,0.01,0.01,1
HCPCS,G9074,Onc dx brst stg3-noprogress,,,0.01,0.01,1
HCPCS,G90740,Onc dx brst stg3-noprogress,,,0.01,0.01,1
HCPCS,G9075,Onc dx brst metastic/ recur,,,0.01,0.01,1
HCPCS,G90750,Onc dx brst metastic/ recur,,,0.01,0.01,1
HCPCS,G9077,Onc dx prostate t1no progres,,,0.01,0.01,1
HCPCS,G90770,Onc dx prostate t1no progres,,,0.01,0.01,1
HCPCS,G9078,Onc dx prostate t2no progres,,,0.01,0.01,1
HCPCS,G90780,Onc dx prostate t2no progres,,,0.01,0.01,1
HCPCS,G9079,Onc dx prostate t3b-t4noprog,,,0.01,0.01,1
HCPCS,G90790,Onc dx prostate t3b-t4noprog,,,0.01,0.01,1
HCPCS,G9080,Onc dx prostate w/rise psa,,,0.01,0.01,1
HCPCS,G90800,Onc dx prostate w/rise psa,,,0.01,0.01,1
HCPCS,G9083,Onc dx prostate unknwn nos,,,0.01,0.01,1
HCPCS,G90830,Onc dx prostate unknwn nos,,,0.01,0.01,1
HCPCS,G9084,"Onc dx colon t1-3,n1-2,no pr",,,0.01,0.01,1
HCPCS,G90840,"Onc dx colon t1-3,n1-2,no pr",,,0.01,0.01,1
HCPCS,G9085,"Onc dx colon t4, n0 w/o prog",,,0.01,0.01,1
HCPCS,G90850,"Onc dx colon t4, n0 w/o prog",,,0.01,0.01,1
HCPCS,G9086,Onc dx colon t1-4 no dx prog,,,0.01,0.01,1
HCPCS,G90860,Onc dx colon t1-4 no dx prog,,,0.01,0.01,1
HCPCS,G9087,Onc dx colon metas evid dx,,,0.01,0.01,1
HCPCS,G90870,Onc dx colon metas evid dx,,,0.01,0.01,1
HCPCS,G9088,Onc dx colon metas noevid dx,,,0.01,0.01,1
HCPCS,G90880,Onc dx colon metas noevid dx,,,0.01,0.01,1
HCPCS,G9089,Onc dx colon extent unknown,,,0.01,0.01,1
HCPCS,G90890,Onc dx colon extent unknown,,,0.01,0.01,1
HCPCS,G9090,Onc dx rectal t1-2 no progr,,,0.01,0.01,1
HCPCS,G90900,Onc dx rectal t1-2 no progr,,,0.01,0.01,1
HCPCS,G9091,Onc dx rectal t3 n0 no prog,,,0.01,0.01,1
HCPCS,G90910,Onc dx rectal t3 n0 no prog,,,0.01,0.01,1
HCPCS,G9092,"Onc dx rectal t1-3,n1-2noprg",,,0.01,0.01,1
HCPCS,G90920,"Onc dx rectal t1-3,n1-2noprg",,,0.01,0.01,1
HCPCS,G9093,"Onc dx rectal t4,n,m0 no prg",,,0.01,0.01,1
HCPCS,G90930,"Onc dx rectal t4,n,m0 no prg",,,0.01,0.01,1
HCPCS,G9094,Onc dx rectal m1 w/mets prog,,,0.01,0.01,1
HCPCS,G90940,Onc dx rectal m1 w/mets prog,,,0.01,0.01,1
HCPCS,G9095,Onc dx rectal extent unknwn,,,0.01,0.01,1
HCPCS,G90950,Onc dx rectal extent unknwn,,,0.01,0.01,1
HCPCS,G9096,Onc dx esophag t1-t3 noprog,,,0.01,0.01,1
HCPCS,G90960,Onc dx esophag t1-t3 noprog,,,0.01,0.01,1
HCPCS,G9097,Onc dx esophageal t4 no prog,,,0.01,0.01,1
HCPCS,G90970,Onc dx esophageal t4 no prog,,,0.01,0.01,1
HCPCS,G9098,Onc dx esophageal mets recur,,,0.01,0.01,1
HCPCS,G90980,Onc dx esophageal mets recur,,,0.01,0.01,1
HCPCS,G9100,Onc dx gastric no recurrence,,,0.01,0.01,1
HCPCS,G91000,Onc dx gastric no recurrence,,,0.01,0.01,1
HCPCS,G9101,Onc dx gastric p r1-r2noprog,,,0.01,0.01,1
HCPCS,G91010,Onc dx gastric p r1-r2noprog,,,0.01,0.01,1
HCPCS,G9102,Onc dx gastric unresectable,,,0.01,0.01,1
HCPCS,G91020,Onc dx gastric unresectable,,,0.01,0.01,1
HCPCS,G9103,Onc dx gastric recurrent,,,0.01,0.01,1
HCPCS,G91030,Onc dx gastric recurrent,,,0.01,0.01,1
HCPCS,G9105,Onc dx pancreatc p r0 res no,,,0.01,0.01,1
HCPCS,G91050,Onc dx pancreatc p r0 res no,,,0.01,0.01,1
HCPCS,G9106,Onc dx pancreatc p r1/r2 no,,,0.01,0.01,1
HCPCS,G91060,Onc dx pancreatc p r1/r2 no,,,0.01,0.01,1
HCPCS,G9107,Onc dx pancreatic unresectab,,,0.01,0.01,1
HCPCS,G91070,Onc dx pancreatic unresectab,,,0.01,0.01,1
HCPCS,G9109,Onc dx head/neck t1-t2no prg,,,0.01,0.01,1
HCPCS,G91090,Onc dx head/neck t1-t2no prg,,,0.01,0.01,1
HCPCS,G9110,Onc dx head/neck t3-4 noprog,,,0.01,0.01,1
HCPCS,G91100,Onc dx head/neck t3-4 noprog,,,0.01,0.01,1
HCPCS,G9111,Onc dx head/neck m1 mets rec,,,0.01,0.01,1
HCPCS,G91110,Onc dx head/neck m1 mets rec,,,0.01,0.01,1
HCPCS,G9112,Onc dx head/neck ext unknown,,,0.01,0.01,1
HCPCS,G91120,Onc dx head/neck ext unknown,,,0.01,0.01,1
HCPCS,G9113,Onc dx ovarian stg1a-b no pr,,,0.01,0.01,1
HCPCS,G91130,Onc dx ovarian stg1a-b no pr,,,0.01,0.01,1
HCPCS,G9114,Onc dx ovarian stg1a-b or 2,,,0.01,0.01,1
HCPCS,G91140,Onc dx ovarian stg1a-b or 2,,,0.01,0.01,1
HCPCS,G9115,Onc dx ovarian stg3/4 noprog,,,0.01,0.01,1
HCPCS,G91150,Onc dx ovarian stg3/4 noprog,,,0.01,0.01,1
HCPCS,G9116,Onc dx ovarian recurrence,,,0.01,0.01,1
HCPCS,G91160,Onc dx ovarian recurrence,,,0.01,0.01,1
HCPCS,G9123,Onc dx cml chronic phase,,,0.01,0.01,1
HCPCS,G91230,Onc dx cml chronic phase,,,0.01,0.01,1
HCPCS,G9124,Onc dx cml acceler phase,,,0.01,0.01,1
HCPCS,G91240,Onc dx cml acceler phase,,,0.01,0.01,1
HCPCS,G9125,Onc dx cml blast phase,,,0.01,0.01,1
HCPCS,G91250,Onc dx cml blast phase,,,0.01,0.01,1
HCPCS,G9126,Onc dx cml remission,,,0.01,0.01,1
HCPCS,G91260,Onc dx cml remission,,,0.01,0.01,1
HCPCS,G9128,Onc dx multi myeloma stage i,,,0.01,0.01,1
HCPCS,G91280,Onc dx multi myeloma stage i,,,0.01,0.01,1
HCPCS,G9129,Onc dx mult myeloma stg2 hig,,,0.01,0.01,1
HCPCS,G91290,Onc dx mult myeloma stg2 hig,,,0.01,0.01,1
HCPCS,G9130,Onc dx multi myeloma unknown,,,0.01,0.01,1
HCPCS,G91300,Onc dx multi myeloma unknown,,,0.01,0.01,1
HCPCS,G9133,Onc dx prostate clinical met,,,0.01,0.01,1
HCPCS,G91330,Onc dx prostate clinical met,,,0.01,0.01,1
HCPCS,G9134,Onc nhlstg 1-2 no relap no,,,0.01,0.01,1
HCPCS,G91340,Onc nhlstg 1-2 no relap no,,,0.01,0.01,1
HCPCS,G9140,Frontier extended stay demo,,,0.01,0.01,1
HCPCS,G91400,Frontier extended stay demo,,,0.01,0.01,1
HCPCS,G9143,Warfarin respon genetic test,,,22.32,201.72,10
HCPCS,G91430,Warfarin respon genetic test,,,104.31,104.31,1
HCPCS,G9147,Outpt iv insulin tx any mea,,,0.01,387.97,7
HCPCS,G91470,Outpt iv insulin tx any mea,,,0.01,0.01,1
HCPCS,G9150,Medical home level iii,,,0.01,0.01,1
HCPCS,G91500,Medical home level iii,,,0.01,0.01,1
HCPCS,G9153,Mapcp demo physician,,,0.01,0.01,1
HCPCS,G91530,Mapcp demo physician,,,0.01,0.01,1
HCPCS,G9157,Transesoph doppl cardiac mon,,,97.89,358.94,7
HCPCS,G91570,Transesoph doppl cardiac mon,,,97.89,97.89,1
HCPCS,G9187,Bpci home visit,,,47.07,95.54,7
HCPCS,G91870,Bpci home visit,,,47.07,47.07,1
HCPCS,G9189,Beta pres or already taking,,,0.01,0.01,1
HCPCS,G91890,Beta pres or already taking,,,0.01,0.01,1
HCPCS,G9225,Norsn no foot exam,,,0.01,0.01,1
HCPCS,G92250,Norsn no foot exam,,,0.01,0.01,1
HCPCS,G9226,3 comp foot exam completed,,,0.01,0.01,1
HCPCS,G92260,3 comp foot exam completed,,,0.01,0.01,1
HCPCS,G9227,"Foa doc, care plan not doc",,,0.01,0.01,1
HCPCS,G92270,"Foa doc, care plan not doc",,,0.01,0.01,1
HCPCS,G9228,Gc chl syp documented,,,0.01,0.01,1
HCPCS,G92280,Gc chl syp documented,,,0.01,0.01,1
HCPCS,G9230,Norsn for gc chl syp test,,,0.01,0.01,1
HCPCS,G92300,Norsn for gc chl syp test,,,0.01,0.01,1
HCPCS,G9231,Doc esrd dia trans preg,,,0.01,0.01,1
HCPCS,G92310,Doc esrd dia trans preg,,,0.01,0.01,1
HCPCS,G9243,Doc viral load <200,,,0.01,0.01,1
HCPCS,G92430,Doc viral load <200,,,0.01,0.01,1
HCPCS,G9247,2 enc enc/vir ld 90d,,,0.01,0.01,1
HCPCS,G92470,2 enc enc/vir ld 90d,,,0.01,0.01,1
HCPCS,G9273,Sys<140 and dia<90,,,0.01,0.01,1
HCPCS,G92730,Sys<140 and dia<90,,,0.01,0.01,1
HCPCS,G9275,Doc of non tobacco user,,,0.01,0.01,1
HCPCS,G92750,Doc of non tobacco user,,,0.01,0.01,1
HCPCS,G9276,Doc of tobacco user,,,0.01,0.01,1
HCPCS,G92760,Doc of tobacco user,,,0.01,0.01,1
HCPCS,G9277,Doc daily aspirin or contra,,,0.01,0.01,1
HCPCS,G92770,Doc daily aspirin or contra,,,0.01,0.01,1
HCPCS,G9286,Antibio rx w in 10d of sympt,,,0.01,0.01,1
HCPCS,G92860,Antibio rx w in 10d of sympt,,,0.01,0.01,1
HCPCS,G9287,No antibio w in 10d of sympt,,,0.01,0.01,1
HCPCS,G92870,No antibio w in 10d of sympt,,,0.01,0.01,1
HCPCS,G9296,Doc share dec prior proc,,,0.01,0.01,1
HCPCS,G92960,Doc share dec prior proc,,,0.01,0.01,1
HCPCS,G9298,Eval risk vte card 30d prior,,,0.01,0.01,1
HCPCS,G92980,Eval risk vte card 30d prior,,,0.01,0.01,1
HCPCS,G9313,Amoxic not presc as 1st line,,,0.01,0.01,1
HCPCS,G93130,Amoxic not presc as 1st line,,,0.01,0.01,1
HCPCS,G9314,Norsn not first line amox,,,0.01,0.01,1
HCPCS,G93140,Norsn not first line amox,,,0.01,0.01,1
HCPCS,G9315,Amox w/wo clav rx,,,0.01,0.01,1
HCPCS,G93150,Amox w/wo clav rx,,,0.01,0.01,1
HCPCS,G9316,Doc comm risk calc,,,0.01,0.01,1
HCPCS,G93160,Doc comm risk calc,,,0.01,0.01,1
HCPCS,G9317,No doc comm risk calc,,,0.01,0.01,1
HCPCS,G93170,No doc comm risk calc,,,0.01,0.01,1
HCPCS,G9321,Prev ct nuc med cnt doc 12mo,,,0.01,0.01,1
HCPCS,G93210,Prev ct nuc med cnt doc 12mo,,,0.01,0.01,1
HCPCS,G9322,No cnt ct nuc med doc 12mo,,,0.01,0.01,1
HCPCS,G93220,No cnt ct nuc med doc 12mo,,,0.01,0.01,1
HCPCS,G9347,No follow up pulm nod norsn,,,0.01,0.01,1
HCPCS,G93470,No follow up pulm nod norsn,,,0.01,0.01,1
HCPCS,G9357,Pp eval/edu perf,,,0.01,0.01,1
HCPCS,G93570,Pp eval/edu perf,,,0.01,0.01,1
HCPCS,G9364,Sinus caus bac inx,,,0.01,0.01,1
HCPCS,G93640,Sinus caus bac inx,,,0.01,0.01,1
HCPCS,G9367,>= 2 same hi-rsk med ord,,,0.01,0.01,1
HCPCS,G93670,>= 2 same hi-rsk med ord,,,0.01,0.01,1
HCPCS,G9368,>= 2 same hi-rsk med not ord,,,0.01,0.01,1
HCPCS,G93680,>= 2 same hi-rsk med not ord,,,0.01,0.01,1
HCPCS,G9380,Off assis eol iss,,,0.01,0.01,1
HCPCS,G93800,Off assis eol iss,,,0.01,0.01,1
HCPCS,G9418,Lungcx bx rpt docs class,,,0.01,0.01,1
HCPCS,G94180,Lungcx bx rpt docs class,,,0.01,0.01,1
HCPCS,G9422,Rpt doc class histo type,,,0.01,0.01,1
HCPCS,G94220,Rpt doc class histo type,,,0.01,0.01,1
HCPCS,G9428,Patho rpt incl pt ctg,,,0.01,0.01,1
HCPCS,G94280,Patho rpt incl pt ctg,,,0.01,0.01,1
HCPCS,G9473,Chap services at hospice,,,1404.0,1404.0,1
HCPCS,G94730,Chap services at hospice,,,1404.0,1404.0,1
HCPCS,G9477,Care coord at hospice,,,75.64,95.54,6
HCPCS,G9481,Remote e/m new pt 10mins,,,15.68,15.68,1
HCPCS,G94810,Remote e/m new pt 10mins,,,15.68,15.68,1
HCPCS,G9482,Remote e/m new pt 20mins,,,29.31,29.31,1
HCPCS,G94820,Remote e/m new pt 20mins,,,29.31,29.31,1
HCPCS,G9483,Remote e/m new pt 30mins,,,45.88,45.88,1
HCPCS,G94830,Remote e/m new pt 30mins,,,45.88,45.88,1
HCPCS,G9484,Remote e/m new pt 45mins,,,77.5,77.5,1
HCPCS,G94840,Remote e/m new pt 45mins,,,77.5,77.5,1
HCPCS,G9485,Remote e/m new pt 60mins,,,101.61,101.61,1
HCPCS,G94850,Remote e/m new pt 60mins,,,101.61,101.61,1
HCPCS,G9486,Remote e/m est. pt 10mins,,,15.68,15.68,1
HCPCS,G94860,Remote e/m est. pt 10mins,,,15.68,15.68,1
HCPCS,G9487,Remote e/m est. pt 15mins,,,31.06,31.06,1
HCPCS,G94870,Remote e/m est. pt 15mins,,,31.06,31.06,1
HCPCS,G9488,Remote e/m est. pt 25mins,,,47.6,47.6,1
HCPCS,G94880,Remote e/m est. pt 25mins,,,47.6,47.6,1
HCPCS,G9489,Remote e/m est. pt 40mins,,,67.64,67.64,1
HCPCS,G94890,Remote e/m est. pt 40mins,,,67.64,67.64,1
HCPCS,G9490,Cmmi mod home visit,,,47.07,47.07,1
HCPCS,G94900,Cmmi mod home visit,,,47.07,47.07,1
HCPCS,G9497,Rec inst no smoke day surg,,,0.01,0.01,1
HCPCS,G94970,Rec inst no smoke day surg,,,0.01,0.01,1
HCPCS,G9500,Rad expos ind/exp tm doc,,,0.01,0.01,1
HCPCS,G95000,Rad expos ind/exp tm doc,,,0.01,0.01,1
HCPCS,G9501,Rad expos ind/exp tm no doc,,,0.01,0.01,1
HCPCS,G95010,Rad expos ind/exp tm no doc,,,0.01,0.01,1
HCPCS,G9502,Med reas no perf foot exam,,,0.01,0.01,1
HCPCS,G95020,Med reas no perf foot exam,,,0.01,0.01,1
HCPCS,G9507,Doc reas on statin or contra,,,0.01,0.01,1
HCPCS,G95070,Doc reas on statin or contra,,,0.01,0.01,1
HCPCS,G9508,Doc pt not on statin,,,0.01,0.01,1
HCPCS,G95080,Doc pt not on statin,,,0.01,0.01,1
HCPCS,G9512,Indiv pdc > 0.8,,,0.01,0.01,1
HCPCS,G95120,Indiv pdc > 0.8,,,0.01,0.01,1
HCPCS,G9547,Cys ren les or adren,,,0.01,0.01,1
HCPCS,G95470,Cys ren les or adren,,,0.01,0.01,1
HCPCS,G9550,Imag rec,,,0.01,0.01,1
HCPCS,G95500,Imag rec,,,0.01,0.01,1
HCPCS,G9551,Imag no les,,,0.01,0.01,1
HCPCS,G95510,Imag no les,,,0.01,0.01,1
HCPCS,G9552,Inc thyr node <1.0 in rpt,,,0.01,0.01,1
HCPCS,G95520,Inc thyr node <1.0 in rpt,,,0.01,0.01,1
HCPCS,G9556,Ct/cta/mri/a no follup imag,,,0.01,0.01,1
HCPCS,G95560,Ct/cta/mri/a no follup imag,,,0.01,0.01,1
HCPCS,G9557,Ct/cta/mri/a no thyr <1.0cm,,,0.01,0.01,1
HCPCS,G95570,Ct/cta/mri/a no thyr <1.0cm,,,0.01,0.01,1
HCPCS,G9621,Scr unheal etoh w/counsel,,,0.01,0.01,1
HCPCS,G96210,Scr unheal etoh w/counsel,,,0.01,0.01,1
HCPCS,G9622,No unheal etoh user,,,0.01,0.01,1
HCPCS,G96220,No unheal etoh user,,,0.01,0.01,1
HCPCS,G9637,Doc >1 dose reduc tech,,,0.01,0.01,1
HCPCS,G96370,Doc >1 dose reduc tech,,,0.01,0.01,1
HCPCS,G9638,No doc >1 dose reduc tech,,,0.01,0.01,1
HCPCS,G96380,No doc >1 dose reduc tech,,,0.01,0.01,1
HCPCS,G9642,Current smoker,,,0.01,0.01,1
HCPCS,G96420,Current smoker,,,0.01,0.01,1
HCPCS,G9643,Elective surgery,,,0.01,0.01,1
HCPCS,G96430,Elective surgery,,,0.01,0.01,1
HCPCS,G9644,No smok b/4 anes day of surg,,,0.01,0.01,1
HCPCS,G96440,No smok b/4 anes day of surg,,,0.01,0.01,1
HCPCS,G9654,Mon anesth care,,,0.01,0.01,1
HCPCS,G96540,Mon anesth care,,,0.01,0.01,1
HCPCS,G9655,Toc tool incl key elem,,,0.01,0.01,1
HCPCS,G96550,Toc tool incl key elem,,,0.01,0.01,1
HCPCS,G9656,Pt trans from anest to pacu,,,0.01,0.01,1
HCPCS,G96560,Pt trans from anest to pacu,,,0.01,0.01,1
HCPCS,G9662,Prior dx/active clin ascvd,,,0.01,0.01,1
HCPCS,G96620,Prior dx/active clin ascvd,,,0.01,0.01,1
HCPCS,G9664,Taking statin or rec'd order,,,0.01,0.01,1
HCPCS,G96640,Taking statin or rec'd order,,,0.01,0.01,1
HCPCS,G9665,No statin/no order statin,,,0.01,0.01,1
HCPCS,G96650,No statin/no order statin,,,0.01,0.01,1
HCPCS,G9682,Acute care skin infection,,,0.01,0.01,1
HCPCS,G96820,Acute care skin infection,,,0.01,0.01,1
HCPCS,G9685,Acute nursing facility care,,,156.76,156.76,1
HCPCS,G96850,Acute nursing facility care,,,156.76,156.76,1
HCPCS,G9695,Long act inhal bronchdil pre,,,0.01,0.01,1
HCPCS,G96950,Long act inhal bronchdil pre,,,0.01,0.01,1
HCPCS,G9708,Bilat mast/hx bi /unilat mas,,,0.01,0.01,1
HCPCS,G97080,Bilat mast/hx bi /unilat mas,,,0.01,0.01,1
HCPCS,G9711,Pt hx tot col or colon ca,,,0.01,0.01,1
HCPCS,G97110,Pt hx tot col or colon ca,,,0.01,0.01,1
HCPCS,G9716,Bmi doc onl fup not cmpltd,,,0.01,0.01,1
HCPCS,G97160,Bmi doc onl fup not cmpltd,,,0.01,0.01,1
HCPCS,G9717,Doc pt dx bipol,,,0.01,0.01,1
HCPCS,G97170,Doc pt dx bipol,,,0.01,0.01,1
HCPCS,G9744,Pt not eli d/t act dig htn,,,0.01,0.01,1
HCPCS,G97440,Pt not eli d/t act dig htn,,,0.01,0.01,1
HCPCS,G9752,Urgent surgery,,,0.01,0.01,1
HCPCS,G97520,Urgent surgery,,,0.01,0.01,1
HCPCS,G9754,Incid pulm nodule,,,0.01,0.01,1
HCPCS,G97540,Incid pulm nodule,,,0.01,0.01,1
HCPCS,G9769,Bn den 2yr/got ost med/ther,,,0.01,0.01,1
HCPCS,G97690,Bn den 2yr/got ost med/ther,,,0.01,0.01,1
HCPCS,G9770,Perip nerve block,,,0.01,0.01,1
HCPCS,G97700,Perip nerve block,,,0.01,0.01,1
HCPCS,G9771,"Anes end, 1 temp >35.5(95.9)",,,0.01,0.01,1
HCPCS,G97710,"Anes end, 1 temp >35.5(95.9)",,,0.01,0.01,1
HCPCS,G9775,Recd 2 anti-emet pre/intraop,,,0.01,0.01,1
HCPCS,G97750,Recd 2 anti-emet pre/intraop,,,0.01,0.01,1
HCPCS,G9781,Doc rsn no statin,,,0.01,0.01,1
HCPCS,G97810,Doc rsn no statin,,,0.01,0.01,1
HCPCS,G9785,Path report sent,,,0.01,0.01,1
HCPCS,G97850,Path report sent,,,0.01,0.01,1
HCPCS,G9818,Doc sex activity,,,0.01,0.01,1
HCPCS,G98180,Doc sex activity,,,0.01,0.01,1
HCPCS,G9820,Doc chlam scr test w/follow,,,0.01,0.01,1
HCPCS,G98200,Doc chlam scr test w/follow,,,0.01,0.01,1
HCPCS,G9868,Cmmi asyntelehealth <10min,,,28.47,28.47,1
HCPCS,G98680,Cmmi asyntelehealth <10min,,,28.47,28.47,1
HCPCS,G9869,Cmmi asyntelehealth 10-20min,,,38.08,38.08,1
HCPCS,G98690,Cmmi asyntelehealth 10-20min,,,38.08,38.08,1
HCPCS,G9870,Cmmi asyntelehealth >20min,,,47.69,47.69,1
HCPCS,G98700,Cmmi asyntelehealth >20min,,,47.69,47.69,1
HCPCS,G9871,"Bhv couns dm prev, onln 60 m",,,40.76,51.49,6
HCPCS,G9873,1 em core session,,,22.37,43.36,7
HCPCS,G98730,1 em core session,,,22.37,22.37,1
HCPCS,G9874,4 em core sessions,,,34.32,45.07,7
HCPCS,G98740,4 em core sessions,,,45.07,45.07,1
HCPCS,G9875,9 em core sessions,,,34.32,81.05,7
HCPCS,G98750,9 em core sessions,,,81.05,81.05,1
HCPCS,G9876,2 em core ms mo 7-9 no wl,,,13.62,43.36,7
HCPCS,G98760,2 em core ms mo 7-9 no wl,,,13.62,13.62,1
HCPCS,G9877,2 em core ms mo 10-12 no wl,,,13.62,43.36,7
HCPCS,G98770,2 em core ms mo 10-12 no wl,,,13.62,13.62,1
HCPCS,G9878,2 em core ms mo 7-9 wl,,,34.32,54.15,7
HCPCS,G98780,2 em core ms mo 7-9 wl,,,54.15,54.15,1
HCPCS,G9879,2 em core ms mo 10-12 wl,,,34.32,54.15,7
HCPCS,G98790,2 em core ms mo 10-12 wl,,,54.15,54.15,1
HCPCS,G9880,Em 5 percent wl,,,34.32,155.03,7
HCPCS,G98800,Em 5 percent wl,,,155.03,155.03,1
HCPCS,G9881,Em 9 percent wl,,,26.73,43.36,7
HCPCS,G98810,Em 9 percent wl,,,26.73,26.73,1
HCPCS,G9882,2 em ongoing ms mo 13-15 wl,,,34.32,45.07,7
HCPCS,G98820,2 em ongoing ms mo 13-15 wl,,,45.07,45.07,1
HCPCS,G9883,2 em ongoing ms mo 16-18 wl,,,34.32,45.07,7
HCPCS,G98830,2 em ongoing ms mo 16-18 wl,,,45.07,45.07,1
HCPCS,G9884,2 em ongoing ms mo 19-21 wl,,,34.32,45.07,7
HCPCS,G98840,2 em ongoing ms mo 19-21 wl,,,45.07,45.07,1
HCPCS,G9885,2 em ongoing ms mo 22-24 wl,,,34.32,45.07,7
HCPCS,G98850,2 em ongoing ms mo 22-24 wl,,,45.07,45.07,1
HCPCS,G9886,In-person attendance g code,,,26.73,51.49,7
HCPCS,G98860,In-person attendance g code,,,26.73,26.73,1
HCPCS,G9887,Distance learning attendance,,,26.73,51.49,7
HCPCS,G98870,Distance learning attendance,,,26.73,26.73,1
HCPCS,G9888,5% wl maintnd from bsline wt,,,8.55,43.36,7
HCPCS,G98880,5% wl maintnd from bsline wt,,,8.55,8.55,1
HCPCS,G9890,Em bridge payment,,,26.73,43.36,7
HCPCS,G98900,Em bridge payment,,,26.73,26.73,1
HCPCS,G9891,Em session reporting,,,0.01,0.01,1
HCPCS,G98910,Em session reporting,,,0.01,0.01,1
HCPCS,G9900,Scrn mam perf rslts not doc,,,0.01,0.01,1
HCPCS,G99000,Scrn mam perf rslts not doc,,,0.01,0.01,1
HCPCS,G9902,Pt scrn tbco and id as user,,,0.01,0.01,1
HCPCS,G99020,Pt scrn tbco and id as user,,,0.01,0.01,1
HCPCS,G9903,Pt scrn tbco id as non user,,,0.01,0.01,1
HCPCS,G99030,Pt scrn tbco id as non user,,,0.01,0.01,1
HCPCS,G9905,No pt tbco scrn rng,,,0.01,0.01,1
HCPCS,G99050,No pt tbco scrn rng,,,0.01,0.01,1
HCPCS,G9906,Pt recv tbco cess interv,,,0.01,0.01,1
HCPCS,G99060,Pt recv tbco cess interv,,,0.01,0.01,1
HCPCS,G9908,No pt tbco cess interv rng,,,0.01,0.01,1
HCPCS,G99080,No pt tbco cess interv rng,,,0.01,0.01,1
HCPCS,G9911,Node neg pre/post syst ther,,,0.01,0.01,1
HCPCS,G99110,Node neg pre/post syst ther,,,0.01,0.01,1
HCPCS,G9916,Funct status past 12 months,,,0.01,0.01,1
HCPCS,G99160,Funct status past 12 months,,,0.01,0.01,1
HCPCS,G9919,Scrn nd pos nd prov of rec,,,0.01,0.01,1
HCPCS,G99190,Scrn nd pos nd prov of rec,,,0.01,0.01,1
HCPCS,G9920,Scrning perf and negative,,,0.01,0.01,1
HCPCS,G99200,Scrning perf and negative,,,0.01,0.01,1
HCPCS,G9923,Safty cncrns scrn and neg,,,0.01,0.01,1
HCPCS,G99230,Safty cncrns scrn and neg,,,0.01,0.01,1
HCPCS,G9931,No chad or chad scr 0 or 1,,,0.01,0.01,1
HCPCS,G99310,No chad or chad scr 0 or 1,,,0.01,0.01,1
HCPCS,G9978,Remote e/m new pt 10mins,,,23.33,23.33,1
HCPCS,G99780,Remote e/m new pt 10mins,,,23.33,23.33,1
HCPCS,G9979,Remote e/m new pt 20mins,,,39.85,39.85,1
HCPCS,G99790,Remote e/m new pt 20mins,,,39.85,39.85,1
HCPCS,G9980,Remote e/m new pt 30 mins,,,63.81,63.81,1
HCPCS,G99800,Remote e/m new pt 30 mins,,,63.81,63.81,1
HCPCS,G9981,Remote e/m new pt 45mins,,,107.29,107.29,1
HCPCS,G99810,Remote e/m new pt 45mins,,,107.29,107.29,1
HCPCS,G9982,Remote e/m new pt 60mins,,,143.0,143.0,1
HCPCS,G99820,Remote e/m new pt 60mins,,,143.0,143.0,1
HCPCS,G9983,Remote e/m est. pt 10mins,,,23.33,23.33,1
HCPCS,G99830,Remote e/m est. pt 10mins,,,23.33,23.33,1
HCPCS,G9984,Remote e/m est. pt  15mins,,,45.82,45.82,1
HCPCS,G99840,Remote e/m est. pt  15mins,,,45.82,45.82,1
HCPCS,G9985,Remote e/m est. pt 25mins,,,69.48,69.48,1
HCPCS,G99850,Remote e/m est. pt 25mins,,,69.48,69.48,1
HCPCS,G9986,Remote e/m est. pt 40mins,,,101.12,101.12,1
HCPCS,G99860,Remote e/m est. pt 40mins,,,101.12,101.12,1
HCPCS,G9987,Bpci advanced in home visit,,,38.28,38.28,1
HCPCS,G99870,Bpci advanced in home visit,,,38.28,38.28,1
HCPCS,G9988,Pall serv during meas,,,2559.6,2559.6,1
HCPCS,G99880,Pall serv during meas,,,2559.6,2559.6,1
HCPCS,H0001,Alcohol and/or drug assess,,,96.26,188.69,7
HCPCS,H00010,Alcohol and/or drug assess,,,96.26,96.26,1
HCPCS,H0002,Alcohol and/or drug screenin,,,43.33,188.69,7
HCPCS,H00020,Alcohol and/or drug screenin,,,43.33,43.33,1
HCPCS,H0003,Alcohol and/or drug screenin,,,4.97,8.36,7
HCPCS,H00030,Alcohol and/or drug screenin,,,4.97,4.97,1
HCPCS,H0004,Alcohol and/or drug services,,,31.92,93.65,7
HCPCS,H00040,Alcohol and/or drug services,,,31.92,31.92,1
HCPCS,H0005,Alcohol and/or drug services,,,10.25,183.42,7
HCPCS,H00050,Alcohol and/or drug services,,,10.25,10.25,1
HCPCS,H0006,Alcohol and/or drug services,,,49.36,62.35,7
HCPCS,H00060,Alcohol and/or drug services,,,61.97,61.97,1
HCPCS,H0007,Alcohol and/or drug services,,,9.76,206.9,7
HCPCS,H00070,Alcohol and/or drug services,,,9.76,9.76,1
HCPCS,H0008,Alcohol and/or drug services,,,320.64,2943.0,7
HCPCS,H00080,Alcohol and/or drug services,,,2943.0,2943.0,1
HCPCS,H0009,Alcohol and/or drug services,,,274.55,405.02,7
HCPCS,H00090,Alcohol and/or drug services,,,274.55,274.55,1
HCPCS,H0010,Alcohol and/or drug services,,,320.64,405.02,7
HCPCS,H00100,Alcohol and/or drug services,,,335.87,335.87,1
HCPCS,H0011,Alcohol and/or drug services,,,320.64,405.02,7
HCPCS,H00110,Alcohol and/or drug services,,,386.9,386.9,1
HCPCS,H0012,Alcohol and/or drug services,,,254.83,405.02,7
HCPCS,H00120,Alcohol and/or drug services,,,254.83,254.83,1
HCPCS,H0013,Alcohol and/or drug services,,,320.64,1614.6,7
HCPCS,H00130,Alcohol and/or drug services,,,1614.6,1614.6,1
HCPCS,H0014,Alcohol and/or drug services,,,16.06,195.43,7
HCPCS,H00140,Alcohol and/or drug services,,,195.43,195.43,1
HCPCS,H0015,Alcohol and/or drug services,,,198.79,251.1,7
HCPCS,H00150,Alcohol and/or drug services,,,208.04,208.04,1
HCPCS,H0016,Alcohol and/or drug services,,,264.36,264.36,1
HCPCS,H00160,Alcohol and/or drug services,,,264.36,264.36,1
HCPCS,H0017,Alcohol and/or drug services,,,320.64,766.02,7
HCPCS,H00170,Alcohol and/or drug services,,,766.02,766.02,1
HCPCS,H0018,Alcohol and/or drug services,,,260.41,405.02,7
HCPCS,H00180,Alcohol and/or drug services,,,260.41,260.41,1
HCPCS,H0019,Alcohol and/or drug services,,,214.55,405.02,7
HCPCS,H00190,Alcohol and/or drug services,,,214.55,214.55,1
HCPCS,H0020,Alcohol and/or drug services,,,16.06,30.36,7
HCPCS,H00200,Alcohol and/or drug services,,,30.36,30.36,1
HCPCS,H0021,Alcohol and/or drug training,,,29.15,29.15,1
HCPCS,H00210,Alcohol and/or drug training,,,29.15,29.15,1
HCPCS,H0022,Alcohol and/or drug interven,,,42.07,93.65,7
HCPCS,H00220,Alcohol and/or drug interven,,,42.07,42.07,1
HCPCS,H0023,Alcohol and/or drug outreach,,,473.29,473.29,1
HCPCS,H00230,Alcohol and/or drug outreach,,,473.29,473.29,1
HCPCS,H0024,Alcohol and/or drug preventi,,,15.99,15.99,1
HCPCS,H00240,Alcohol and/or drug preventi,,,15.99,15.99,1
HCPCS,H0025,Alcohol and/or drug preventi,,,18.92,18.92,1
HCPCS,H00250,Alcohol and/or drug preventi,,,18.92,18.92,1
HCPCS,H0026,Alcohol and/or drug preventi,,,432.0,432.0,1
HCPCS,H00260,Alcohol and/or drug preventi,,,432.0,432.0,1
HCPCS,H0027,Alcohol and/or drug preventi,,,8.64,8.64,1
HCPCS,H00270,Alcohol and/or drug preventi,,,8.64,8.64,1
HCPCS,H0028,Alcohol and/or drug preventi,,,243.0,243.0,1
HCPCS,H00280,Alcohol and/or drug preventi,,,243.0,243.0,1
HCPCS,H0029,Alcohol and/or drug preventi,,,54.0,54.0,1
HCPCS,H00290,Alcohol and/or drug preventi,,,54.0,54.0,1
HCPCS,H0030,Alcohol and/or drug hotline,,,37.09,37.09,1
HCPCS,H00300,Alcohol and/or drug hotline,,,37.09,37.09,1
HCPCS,H0031,Mh health assess by non-md,,,99.46,188.69,7
HCPCS,H00310,Mh health assess by non-md,,,99.46,99.46,1
HCPCS,H0032,Mh svc plan dev by non-md,,,49.36,70.34,7
HCPCS,H00320,Mh svc plan dev by non-md,,,70.34,70.34,1
HCPCS,H0033,Oral med adm direct observe,,,16.06,34.94,7
HCPCS,H00330,Oral med adm direct observe,,,34.94,34.94,1
HCPCS,H0034,Med trng & support per 15min,,,16.06,29.22,7
HCPCS,H00340,Med trng & support per 15min,,,29.22,29.22,1
HCPCS,H0035,Mh partial hosp tx under 24h,,,195.22,460.04,7
HCPCS,H00350,Mh partial hosp tx under 24h,,,195.22,195.22,1
HCPCS,H0036,Comm psy face-face per 15min,,,21.47,21.47,1
HCPCS,H00360,Comm psy face-face per 15min,,,21.47,21.47,1
HCPCS,H0037,Comm psy sup tx pgm per diem,,,364.2,604.74,7
HCPCS,H00370,Comm psy sup tx pgm per diem,,,604.74,604.74,1
HCPCS,H0038,Self-help/peer svc per 15min,,,11.38,11.38,1
HCPCS,H00380,Self-help/peer svc per 15min,,,11.38,11.38,1
HCPCS,H0039,Asser com tx face-face/15min,,,259.41,259.41,1
HCPCS,H00390,Asser com tx face-face/15min,,,259.41,259.41,1
HCPCS,H0040,Assert comm tx pgm per diem,,,187.97,187.97,1
HCPCS,H00400,Assert comm tx pgm per diem,,,187.97,187.97,1
HCPCS,H0041,Fos c chld non-ther per diem,,,14.04,14.04,1
HCPCS,H00410,Fos c chld non-ther per diem,,,14.04,14.04,1
HCPCS,H0042,Fos c chld non-ther per mon,,,7.56,7.56,1
HCPCS,H00420,Fos c chld non-ther per mon,,,7.56,7.56,1
HCPCS,H0043,"Supported housing, per diem",,,378.01,378.01,1
HCPCS,H00430,"Supported housing, per diem",,,378.01,378.01,1
HCPCS,H0044,"Supported housing, per month",,,632.15,632.15,1
HCPCS,H00440,"Supported housing, per month",,,632.15,632.15,1
HCPCS,H0045,Respite not-in-home per diem,,,343.33,343.33,1
HCPCS,H00450,Respite not-in-home per diem,,,343.33,343.33,1
HCPCS,H0046,"Mental health service, nos",,,1.25,93.65,7
HCPCS,H00460,"Mental health service, nos",,,1.25,1.25,1
HCPCS,H0047,Alcohol/drug abuse svc nos,,,74.14,519.24,7
HCPCS,H00470,Alcohol/drug abuse svc nos,,,519.24,519.24,1
HCPCS,H0048,Spec coll non-blood:a/d test,,,2.52,16.65,7
HCPCS,H00480,Spec coll non-blood:a/d test,,,16.65,16.65,1
HCPCS,H0049,Alcohol/drug screening,,,0.01,16.22,7
HCPCS,H00490,Alcohol/drug screening,,,0.01,0.01,1
HCPCS,H0050,Alcohol/drug service 15 min,,,28.94,93.65,7
HCPCS,H00500,Alcohol/drug service 15 min,,,28.94,28.94,1
HCPCS,H0052,Mmip mental health and care,,,74.14,93.65,6
HCPCS,H0053,Ht mental health and care,,,74.14,93.65,6
HCPCS,H1000,Prenatal care atrisk assessm,,,72.0,244.57,7
HCPCS,H10000,Prenatal care atrisk assessm,,,72.0,72.0,1
HCPCS,H1001,Antepartum management,,,176.09,176.09,1
HCPCS,H10010,Antepartum management,,,176.09,176.09,1
HCPCS,H1002,Carecoordination prenatal,,,31.5,95.54,7
HCPCS,H10020,Carecoordination prenatal,,,31.5,31.5,1
HCPCS,H1003,Prenatal at risk education,,,14.87,52.51,7
HCPCS,H10030,Prenatal at risk education,,,14.87,14.87,1
HCPCS,H1004,Follow up home visit/prental,,,41.87,41.87,1
HCPCS,H10040,Follow up home visit/prental,,,41.87,41.87,1
HCPCS,H1005,Prenatalcare enhanced srv pk,,,193.62,622.41,7
HCPCS,H10050,Prenatalcare enhanced srv pk,,,622.41,622.41,1
HCPCS,H1010,Nonmed family planning ed,,,41.57,52.51,7
HCPCS,H10100,Nonmed family planning ed,,,50.28,50.28,1
HCPCS,H1011,Family assessment,,,54.49,188.69,7
HCPCS,H10110,Family assessment,,,54.49,54.49,1
HCPCS,H2000,Comp multidisipln evaluation,,,49.36,63.66,7
HCPCS,H20000,Comp multidisipln evaluation,,,63.66,63.66,1
HCPCS,H2001,Rehabilitation program 1/2 d,,,38.6,86.21,7
HCPCS,H20010,Rehabilitation program 1/2 d,,,38.6,38.6,1
HCPCS,H2010,Comprehensive med svc 15 min,,,16.06,29.74,7
HCPCS,H20100,Comprehensive med svc 15 min,,,29.74,29.74,1
HCPCS,H2011,"Crisis interven svc, 15 min",,,103.32,206.9,7
HCPCS,H20110,"Crisis interven svc, 15 min",,,103.32,103.32,1
HCPCS,H2012,"Behav hlth day treat, per hr",,,77.43,245.46,7
HCPCS,H20120,"Behav hlth day treat, per hr",,,77.43,77.43,1
HCPCS,H2013,"Psych hlth fac svc, per diem",,,771.96,771.96,1
HCPCS,H20130,"Psych hlth fac svc, per diem",,,771.96,771.96,1
HCPCS,H2014,"Skills train and dev, 15 min",,,26.38,120.13,7
HCPCS,H20140,"Skills train and dev, 15 min",,,26.38,26.38,1
HCPCS,H2015,"Comp comm supp svc, 15 min",,,29.96,29.96,1
HCPCS,H20150,"Comp comm supp svc, 15 min",,,29.96,29.96,1
HCPCS,H2016,"Comp comm supp svc, per diem",,,52.74,52.74,1
HCPCS,H20160,"Comp comm supp svc, per diem",,,52.74,52.74,1
HCPCS,H2017,"Psysoc rehab svc, per 15 min",,,14.12,93.65,7
HCPCS,H20170,"Psysoc rehab svc, per 15 min",,,14.12,14.12,1
HCPCS,H2018,"Psysoc rehab svc, per diem",,,364.2,498.79,7
HCPCS,H20180,"Psysoc rehab svc, per diem",,,498.79,498.79,1
HCPCS,H2019,"Ther behav svc, per 15 min",,,30.25,93.65,7
HCPCS,H20190,"Ther behav svc, per 15 min",,,30.25,30.25,1
HCPCS,H2020,"Ther behav svc, per diem",,,228.32,460.04,7
HCPCS,H20200,"Ther behav svc, per diem",,,228.32,228.32,1
HCPCS,H2021,"Com wrap-around sv, 15 min",,,29.19,29.19,1
HCPCS,H20210,"Com wrap-around sv, 15 min",,,29.19,29.19,1
HCPCS,H2022,"Com wrap-around sv, per diem",,,122.12,122.12,1
HCPCS,H20220,"Com wrap-around sv, per diem",,,122.12,122.12,1
HCPCS,H2023,"Supported employ, per 15 min",,,5.81,5.81,1
HCPCS,H20230,"Supported employ, per 15 min",,,5.81,5.81,1
HCPCS,H2024,"Supported employ, per diem",,,12.97,12.97,1
HCPCS,H20240,"Supported employ, per diem",,,12.97,12.97,1
HCPCS,H2025,"Supp maint employ, 15 min",,,34.28,34.28,1
HCPCS,H20250,"Supp maint employ, 15 min",,,34.28,34.28,1
HCPCS,H2026,"Supp maint employ, per diem",,,285.13,285.13,1
HCPCS,H20260,"Supp maint employ, per diem",,,285.13,285.13,1
HCPCS,H2027,"Psychoed svc, per 15 min",,,40.47,93.65,7
HCPCS,H20270,"Psychoed svc, per 15 min",,,40.47,40.47,1
HCPCS,H2028,"Sex offend tx svc, 15 min",,,15.69,93.65,7
HCPCS,H20280,"Sex offend tx svc, 15 min",,,15.69,15.69,1
HCPCS,H2029,"Sex offend tx svc, per diem",,,364.2,745.98,7
HCPCS,H20290,"Sex offend tx svc, per diem",,,745.98,745.98,1
HCPCS,H2030,"Mh clubhouse svc, per 15 min",,,7.1,7.1,1
HCPCS,H20300,"Mh clubhouse svc, per 15 min",,,7.1,7.1,1
HCPCS,H2031,"Mh clubhouse svc, per diem",,,248.58,248.58,1
HCPCS,H20310,"Mh clubhouse svc, per diem",,,248.58,248.58,1
HCPCS,H2032,"Activity therapy, per 15 min",,,2.29,120.13,7
HCPCS,H20320,"Activity therapy, per 15 min",,,2.29,2.29,1
HCPCS,H2033,Multisys ther/juvenile 15min,,,92.23,120.13,7
HCPCS,H20330,Multisys ther/juvenile 15min,,,92.23,92.23,1
HCPCS,H2034,"A/d halfway house, per diem",,,155.39,405.02,7
HCPCS,H20340,"A/d halfway house, per diem",,,155.39,155.39,1
HCPCS,H2035,"A/d tx program, per hour",,,74.14,161.87,7
HCPCS,H20350,"A/d tx program, per hour",,,161.87,161.87,1
HCPCS,H2036,"A/d tx program, per diem",,,217.9,460.04,7
HCPCS,H20360,"A/d tx program, per diem",,,217.9,217.9,1
HCPCS,H2037,"Dev delay prev dp ch, 15 min",,,118.79,118.79,1
HCPCS,H20370,"Dev delay prev dp ch, 15 min",,,118.79,118.79,1
HCPCS,H2038,Skill train and dev/diem,,,65.88,65.88,1
HCPCS,H20380,Skill train and dev/diem,,,65.88,65.88,1
HCPCS,H2040,"Coord specialty care, month",,,45.19,57.08,6
HCPCS,H2041,Coord special care encounter,,,49.36,62.35,6
HCPCS,J0013,"Esketamine, nasal spray",,,15.44,15.44,1
HCPCS,J0013,SPRAVATO 28 MG NASAL SPRAY,1001.04,650.68,74.0,1001.04,29
HCPCS,J0013,SPRAVATO 56 MG (28 MG X 2) NASAL SPRAY,1001.04,650.68,74.0,1001.04,29
HCPCS,J0013,SPRAVATO 84 MG (28 MG X 3) NASAL SPRAY,1001.04,650.68,74.0,1001.04,29
HCPCS,J00130,"Esketamine, nasal spray",,,15.44,15.44,1
HCPCS,J0120,TETRACYCLIN INJECTION,29.0,18.85,14.5,29.0,13
HCPCS,J0120,Tetracyclin injection,,,14.37,36.47,4
HCPCS,J01200,Tetracyclin injection,,,14.37,14.37,1
HCPCS,J0121,"Inj., omadacycline, 1 mg",,,4.47,4.47,1
HCPCS,J0121,NUZYRA 100 MG INTRAVENOUS SOLUTION,1770.78,1151.01,3.38,1770.78,47
HCPCS,J01210,"Inj., omadacycline, 1 mg",,,4.47,4.47,1
HCPCS,J0122,"Inj., eravacycline, 1 mg",,,1.39,1.39,1
HCPCS,J0122,XERAVA 50 MG INTRAVENOUS SOLUTION,262.5,170.63,1.0,262.5,40
HCPCS,J01220,"Inj., eravacycline, 1 mg",,,1.39,1.39,1
HCPCS,J0129,ABATACEPT INJECTION,97.0,63.05,44.77,97.0,14
HCPCS,J0129,Abatacept injection,,,48.35,48.35,1
HCPCS,J0129,ORENCIA (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,5580.0,3627.0,38.56,5580.0,52
HCPCS,J01290,Abatacept injection,,,48.35,48.35,1
HCPCS,J0130,Abciximab injection,,,746.88,3546.27,10
HCPCS,J01300,Abciximab injection,,,1397.8,1397.8,1
HCPCS,J0131,ACETAMINOPHEN 650 MG/65 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.3,0.2,0.05,0.3,31
HCPCS,J0131,"Inj, acetaminophen (nos)",,,0.06,0.06,1
HCPCS,J01310,"Inj, acetaminophen (nos)",,,0.06,0.06,1
HCPCS,J0132,ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,6.0,3.9,0.69,6.0,31
HCPCS,J0132,Acetylcysteine injection,,,0.4,0.4,1
HCPCS,J01320,Acetylcysteine injection,,,0.4,0.4,1
HCPCS,J0133,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,5.16,3.35,0.05,5.52,93
HCPCS,J0133,Acyclovir injection,,,0.13,0.13,1
HCPCS,J01330,Acyclovir injection,,,0.13,0.13,1
HCPCS,J0134,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.36,0.23,0.05,0.36,31
HCPCS,J0134,Inj acetaminophen -fresenius,,,0.06,0.06,1
HCPCS,J01340,Inj acetaminophen -fresenius,,,0.06,0.06,1
HCPCS,J0135,Adalimumab injection,,,711.31,898.5,6
HCPCS,J0136,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.3,0.2,0.05,0.3,31
HCPCS,J0136,ACETAMINOPHEN 500 MG/50 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.45,0.29,0.05,0.45,31
HCPCS,J0136,"Inj, acetaminophen (b braun)",,,0.05,0.05,1
HCPCS,J01360,"Inj, acetaminophen (b braun)",,,0.05,0.05,1
HCPCS,J0137,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.855,0.5549999999999999,0.06,1.32,62
HCPCS,J0137,"Inj, acetaminophen (hikma)",,,0.05,0.05,1
HCPCS,J01370,"Inj, acetaminophen (hikma)",,,0.05,0.05,1
HCPCS,J0138,Inj acetaminoph 10mg/ibu 3mg,,,0.09,0.25,15
HCPCS,J01380,Inj acetaminoph 10mg/ibu 3mg,,,0.1,0.1,1
HCPCS,J0139,HUMIRA 40 MG/0.8 ML SUBCUTANEOUS SYRINGE KIT,12460.71,8099.46,74.0,12460.71,42
HCPCS,J0139,HUMIRA PEN 40 MG/0.8 ML SUBCUTANEOUS KIT,11537.7,7499.51,74.0,11537.7,42
HCPCS,J0139,HUMIRA(CF) 40 MG/0.4 ML SUBCUTANEOUS SYRINGE KIT,11537.7,7499.51,74.0,11537.7,42
HCPCS,J0139,HUMIRA(CF) PEN 40 MG/0.4 ML SUBCUTANEOUS KIT,15383.6,9999.34,74.0,15383.6,42
HCPCS,J0139,HUMIRA(CF) PEN CROHN'S-ULC COLITIS-HID SUP STRT 80 MG/0.8 ML SUBCUT KT,30767.32,19998.76,74.0,30767.32,42
HCPCS,J0153,ADENOSINE (DIAGNOSTIC) 3 MG/ML INTRAVENOUS SOLUTION,23.4,15.21,0.5,23.52,93
HCPCS,J0153,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,11.025,7.164999999999999,0.5,19.71,186
HCPCS,J0153,ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE,26.1,16.965,0.5,28.8,62
HCPCS,J0153,Adenosine inj 1mg,,,0.57,0.57,1
HCPCS,J01530,Adenosine inj 1mg,,,0.57,0.57,1
HCPCS,J0162,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,27.0,17.55,0.87,27.0,30
HCPCS,J0162,Inj epinephrine (fresenius),,,0.5,0.5,1
HCPCS,J01620,Inj epinephrine (fresenius),,,0.5,0.5,1
HCPCS,J0163,ADRENALIN IN 0.9 % SODIUM CHLORIDE 4 MG/250 ML (16 MCG/ML) IV SOLUTION,0.57,0.37,0.1,2.44,30
HCPCS,J0163,Epinephrine in nacl (endo),,,0.95,0.95,1
HCPCS,J01630,Epinephrine in nacl (endo),,,0.95,0.95,1
HCPCS,J0164,Epinephrine in nacl (baxter),,,1.02,2.6,11
HCPCS,J01640,Epinephrine in nacl (baxter),,,1.02,1.02,1
HCPCS,J0165,Inj epinephrine nos 0.1 mg,,,0.46,1.21,11
HCPCS,J01650,Inj epinephrine nos 0.1 mg,,,0.46,0.46,1
HCPCS,J0166,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,28.5,18.53,2.11,28.5,30
HCPCS,J0166,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,52.5,34.13,2.11,52.5,60
HCPCS,J0166,Inj epinephrine (bpi),,,1.2,1.2,1
HCPCS,J01660,Inj epinephrine (bpi),,,1.2,1.2,1
HCPCS,J0167,Inj epinephrine (hospira),,,1.53,3.95,11
HCPCS,J01670,Inj epinephrine (hospira),,,1.53,1.53,1
HCPCS,J0168,EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,4.95,3.22,0.83,8.3,30
HCPCS,J0168,Epinephrine (intl med sys),,,3.24,3.24,1
HCPCS,J01680,Epinephrine (intl med sys),,,3.24,3.24,1
HCPCS,J0169,ADRENALIN 1 MG/ML (1 ML) INJECTION SOLUTION,29.52,19.19,2.62,29.52,60
HCPCS,J0169,ADRENALIN 1 MG/ML INJECTION SOLUTION,11.76,7.64,1.98,11.76,30
HCPCS,J0169,Inj epinephrine (adrenalin),,,1.49,1.49,1
HCPCS,J01690,Inj epinephrine (adrenalin),,,1.49,1.49,1
HCPCS,J0171,EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTIONAUTO-INJECTOR,540.0,351.0,0.73,540.0,24
HCPCS,J0171,EPINEPHRINE 0.15 MG/0.15 ML AUTO-INJECTOR (FOR 33 TO 66 LB PATIENTS),741.03,481.67,0.73,741.03,24
HCPCS,J0171,EPINEPHRINE 0.3 MG/0.3 ML INJECTION AUTO-INJECTOR,540.0,351.0,0.73,540.0,24
HCPCS,J0171,EPIPEN 0.3 MG/0.3 ML INJECTION AUTO-INJECTOR,1095.51,712.08,0.73,1095.51,24
HCPCS,J0171,EPIPEN 2-PAK 0.3 MG/0.3 ML INJECTION AUTO-INJECTOR,1095.51,712.08,0.73,1095.51,24
HCPCS,J0171,EPIPEN JR 0.15 MG/0.3 ML INJECTIONAUTO-INJECTOR,1095.51,712.08,0.73,1095.51,24
HCPCS,J0171,EPIPEN JR 2-PAK 0.15 MG/0.3 ML INJECTIONAUTO-INJECTOR,1095.51,712.08,0.73,1095.51,24
HCPCS,J0172,"Inj, aducanumab-avwa, 2 mg",,,5.38,3236.72,23
HCPCS,J0173,"Inj, epinephrine (belcher)",,,1.7,1.7,1
HCPCS,J0174,LEQEMBI 100 MG/ML INTRAVENOUS SOLUTION,474.91499999999996,308.695,1.21,474.93,94
HCPCS,J0174,"Lecanemab-irmb, for iv inj",,,1.44,1.44,1
HCPCS,J01740,"Lecanemab-irmb, for iv inj",,,1.44,1.44,1
HCPCS,J0175,"Inj, donanemab-azbt, 2 mg",,,4.5,4.5,1
HCPCS,J0175,KISUNLA 17.5 MG/ML INTRAVENOUS SOLUTION,126.78,82.41,4.09,383.26,46
HCPCS,J01750,"Inj, donanemab-azbt, 2 mg",,,4.5,4.5,1
HCPCS,J0177,EYLEA HD 8 MG/0.07 ML INTRAVITREAL SOLUTION FOR INJECTION,140454.0,91295.1,306.98,140454.0,53
HCPCS,J0177,"Inj, aflibercept hd, 1 mg",,,331.55,331.55,1
HCPCS,J01770,"Inj, aflibercept hd, 1 mg",,,331.55,331.55,1
HCPCS,J0178,Aflibercept injection,,,825.01,825.01,1
HCPCS,J0178,EYLEA 2 MG/0.05 ML INTRAVITREAL SOLUTION FOR INJECTION,139847.76,90901.04,746.88,139847.76,53
HCPCS,J0178,EYLEA 2 MG/0.05 ML INTRAVITREAL SYRINGE,139847.76,90901.04,746.88,139847.76,53
HCPCS,J01780,Aflibercept injection,,,825.01,825.01,1
HCPCS,J0179,BEOVU 6 MG/0.05 ML INTRAVITREAL SYRINGE,150004.08,97502.65,293.11,150004.08,53
HCPCS,J0179,"Inj, brolucizumab-dbll, 1 mg",,,381.03,381.03,1
HCPCS,J01790,"Inj, brolucizumab-dbll, 1 mg",,,381.03,381.03,1
HCPCS,J0180,AGALSIDASE BETA INJECTION,594.0,386.1,230.32,594.0,14
HCPCS,J0180,Agalsidase beta injection,,,248.75,248.75,1
HCPCS,J0180,FABRAZYME 35 MG INTRAVENOUS SOLUTION,38699.0,25154.35,196.45,38699.0,53
HCPCS,J0180,FABRAZYME 5 MG INTRAVENOUS SOLUTION,5527.48,3592.86,196.45,5646.0,53
HCPCS,J01800,Agalsidase beta injection,,,248.75,248.75,1
HCPCS,J0184,"Inj, amisulpride, 1 mg",,,9.06,25.1,21
HCPCS,J01840,"Inj, amisulpride, 1 mg",,,9.89,9.89,1
HCPCS,J0185,CINVANTI 130 MG/18 ML (7.2 MG/ML) INTRAVENOUS EMULSION,92.73,60.27,1.5,93.47,47
HCPCS,J0185,"Inj., aprepitant, 1 mg",,,1.85,1.85,1
HCPCS,J01850,"Inj., aprepitant, 1 mg",,,1.85,1.85,1
HCPCS,J0190,Inj biperiden lactate/5 mg,,,2.8,7.1,3
HCPCS,J0200,Alatrofloxacin mesylate,,,17.31,43.92,6
HCPCS,J0202,"Injection, alemtuzumab",,,2642.87,2642.87,1
HCPCS,J0202,LEMTRADA 12 MG/1.2 ML INTRAVENOUS SOLUTION,118976.96,77335.02,2112.82,118976.96,53
HCPCS,J02020,"Injection, alemtuzumab",,,2642.87,2642.87,1
HCPCS,J0205,Alglucerase injection,,,64.81,93.47,9
HCPCS,J0206,Inj allopurinol sodium 1 mg,,,4.4,1355.53,35
HCPCS,J02060,Inj allopurinol sodium 1 mg,,,4.75,4.75,1
HCPCS,J0207,"AMIFOSTINE,500 MG",1516.0,985.4,758.0,1516.0,14
HCPCS,J0207,Amifostine,,,1110.83,1110.83,1
HCPCS,J0207,ETHYOL 500 MG INTRAVENOUS SOLUTION,3857.07,2507.1,647.99,3857.07,32
HCPCS,J02070,Amifostine,,,1110.83,1110.83,1
HCPCS,J0208,"Inj, pedmark, 100 mg",,,94.69,3407.66,27
HCPCS,J02080,"Inj, pedmark, 100 mg",,,94.69,94.69,1
HCPCS,J0209,"Inj, sod thiosulfate (hope)",,,0.83,0.83,1
HCPCS,J0209,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,7.2,4.68,0.88,3407.66,32
HCPCS,J02090,"Inj, sod thiosulfate (hope)",,,0.83,0.83,1
HCPCS,J0210,METHYLDOPATE 250 MG/5 ML INTRAVENOUS SOLUTION,28.8,18.72,4.84,105.22,29
HCPCS,J0210,Methyldopate hcl injection,,,41.47,41.47,1
HCPCS,J02100,Methyldopate hcl injection,,,41.47,41.47,1
HCPCS,J0211,"Inj, nithiodote, 3mg / 125mg",,,2.03,2.03,1
HCPCS,J0211,NITHIODOTE 300 MG/10 ML-12.5 GRAM/50 ML INTRAVENOUS SOLUTION,11.76,7.64,2.16,93.47,39
HCPCS,J02110,"Inj, nithiodote, 3mg / 125mg",,,2.03,2.03,1
HCPCS,J0215,Alefacept,,,64.21,652.67,9
HCPCS,J0216,"Inj, alfentanil hcl, 500mcg",,,2.21,5.62,4
HCPCS,J02160,"Inj, alfentanil hcl, 500mcg",,,2.21,2.21,1
HCPCS,J0217,Inj velmanase alfa-tycv 1 mg,,,502.45,502.45,1
HCPCS,J0217,LAMZEDE 10 MG INTRAVENOUS SOLUTION,16274.4,10578.36,442.0,18253.82,52
HCPCS,J02170,Inj velmanase alfa-tycv 1 mg,,,502.45,502.45,1
HCPCS,J0218,Inj olipudase alfa-rpcp 1mg,,,427.16,427.16,1
HCPCS,J0218,XENPOZYME 20 MG INTRAVENOUS SOLUTION,28092.66,18260.23,338.92,28092.66,53
HCPCS,J02180,Inj olipudase alfa-rpcp 1mg,,,427.16,427.16,1
HCPCS,J0219,Inj aval alfa-nqpt 4mg,,,87.8,87.8,1
HCPCS,J0219,NEXVIAZYME 100 MG INTRAVENOUS SOLUTION,7295.25,4741.91,68.4,18253.82,53
HCPCS,J02190,Inj aval alfa-nqpt 4mg,,,87.8,87.8,1
HCPCS,J0220,Alglucosidase alfa injection,,,10052.3,12697.64,6
HCPCS,J0221,LUMIZYME 50 MG INTRAVENOUS SOLUTION,3647.64,2370.97,177.57,18253.82,50
HCPCS,J0221,Lumizyme injection,,,223.98,223.98,1
HCPCS,J02210,Lumizyme injection,,,223.98,223.98,1
HCPCS,J0222,"Inj., patisiran, 0.1 mg",,,107.97,107.97,1
HCPCS,J0222,ONPATTRO 2 MG/ML INTRAVENOUS SOLUTION,7045.2,4579.38,89.28,12697.64,53
HCPCS,J02220,"Inj., patisiran, 0.1 mg",,,107.97,107.97,1
HCPCS,J0223,GIVLAARI 189 MG/ML SUBCUTANEOUS SOLUTION,158018.4,102711.96,100.82,158018.4,53
HCPCS,J0223,Inj givosiran 0.5 mg,,,130.35,130.35,1
HCPCS,J02230,Inj givosiran 0.5 mg,,,130.35,130.35,1
HCPCS,J0224,"Inj. lumasiran, 0.5 mg",,,286.29,12697.64,35
HCPCS,J02240,"Inj. lumasiran, 0.5 mg",,,354.26,354.26,1
HCPCS,J0225,AMVUTTRA 25 MG/0.5 ML SUBCUTANEOUS SYRINGE,859327.2,558562.68,4441.69,859327.2,53
HCPCS,J0225,"Inj, vutrisiran, 1 mg",,,5410.32,5410.32,1
HCPCS,J02250,"Inj, vutrisiran, 1 mg",,,5410.32,5410.32,1
HCPCS,J0248,"Inj, remdesivir, 1 mg",,,7.45,7.45,1
HCPCS,J0248,REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),93.6,60.84,5.45,345.3,47
HCPCS,J0248,VEKLURY 100 MG INTRAVENOUS POWDER FOR SOLUTION,2342.58,1522.68,5.45,2342.58,47
HCPCS,J02480,"Inj, remdesivir, 1 mg",,,7.45,7.45,1
HCPCS,J0256,ARALAST NP 500 MG INTRAVENOUS SOLUTION,2.34,1.52,0.61,943.43,47
HCPCS,J0256,Alpha 1 proteinase inhibitor,,,5.8,5.8,1
HCPCS,J0256,PROLASTIN-C 1000  MG (+/-)/20 ML INTRAVENOUS SOLUTION,2.22,1.44,0.57,943.43,94
HCPCS,J0256,ZEMAIRA 1000 MG INTRAVENOUS SOLUTION,2.28,1.48,0.59,943.43,47
HCPCS,J0256,ZEMAIRA 4000 MG INTRAVENOUS SOLUTION,2.28,1.48,0.59,943.43,47
HCPCS,J0256,ZEMAIRA 5000 MG INTRAVENOUS SOLUTION,2.28,1.48,0.59,943.43,47
HCPCS,J02560,Alpha 1 proteinase inhibitor,,,5.8,5.8,1
HCPCS,J0257,Glassia injection,,,4.86,943.43,35
HCPCS,J02570,Glassia injection,,,6.15,6.15,1
HCPCS,J0270,Alprostadil for injection,,,10.65,10.65,1
HCPCS,J0270,CAVERJECT 20 MCG INTRACAVERNOSAL SOLUTION,396.96,258.02,27.02,396.96,23
HCPCS,J0270,CAVERJECT 20 MCG INTRACAVERNOSAL SYRINGE,400.02,260.01,27.02,400.02,23
HCPCS,J0270,CAVERJECT 40 MCG INTRACAVERNOSAL SOLUTION,523.62,340.35,27.02,523.62,23
HCPCS,J0270,CAVERJECT IMPULSE 20 MCG INTRACAVERNOSAL KIT,400.02,260.01,27.02,400.02,23
HCPCS,J0270,EDEX 20 MCG INTRACAVERNOSAL KIT,1681.2,1092.78,27.02,2521.77,46
HCPCS,J0270,INJECT ALLPPROSTADIL PER 1.25 MCG,13.0,8.45,6.5,13.0,14
HCPCS,J0270,PROSTIN VR PEDIATRIC 500 MCG/ML INJECTION SOLUTION,609.63,396.26,27.02,609.63,46
HCPCS,J02700,Alprostadil for injection,,,10.65,10.65,1
HCPCS,J0275,Alprostadil urethral suppos,,,42.52,107.87,4
HCPCS,J02750,Alprostadil urethral suppos,,,42.52,42.52,1
HCPCS,J0278,AMIKACIN 1000 MG/4 ML INJECTION SOLUTION,12.87,8.37,0.77,12.87,31
HCPCS,J0278,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,13.95,9.07,0.77,14.4,93
HCPCS,J0278,AMIKACIN SULFATE INJECTION,13.0,8.45,0.62,13.0,14
HCPCS,J0278,Amikacin sulfate injection,,,0.67,0.67,1
HCPCS,J02780,Amikacin sulfate injection,,,0.67,0.67,1
HCPCS,J0280,AMINOPHYLLIN,36.0,23.4,10.41,36.0,14
HCPCS,J0280,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,4.08,2.6550000000000002,0.04,28.8,93
HCPCS,J0280,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,2.55,1.66,0.43,28.8,62
HCPCS,J0280,Aminophyllin 250 mg inj,,,11.24,11.24,1
HCPCS,J02800,Aminophyllin 250 mg inj,,,11.24,11.24,1
HCPCS,J0281,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,1.905,1.24,0.31,4.41,60
HCPCS,J0281,Inj aminocaproic acid 1 gram,,,1.72,1.72,1
HCPCS,J02810,Inj aminocaproic acid 1 gram,,,1.72,1.72,1
HCPCS,J0282,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,2.4,1.56,0.37,3.45,120
HCPCS,J0282,Amiodarone hcl,,,0.44,0.44,1
HCPCS,J0282,NEXTERONE 150 MG/100 ML (1.5 MG/ML) INTRAVENOUS SOLUTION,1.26,0.82,0.21,1.26,30
HCPCS,J0282,NEXTERONE 360 MG/200 ML (1.8 MG/ML) INTRAVENOUS SOLUTION,0.84,0.55,0.14,1.12,30
HCPCS,J02820,Amiodarone hcl,,,0.44,0.44,1
HCPCS,J0283,"Inj, amiodarone (nexterone)",,,2.29,6.99,15
HCPCS,J02830,"Inj, amiodarone (nexterone)",,,2.73,2.73,1
HCPCS,J0285,AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,180.0,117.0,30.24,180.0,31
HCPCS,J0285,Amphotericin b,,,46.75,46.75,1
HCPCS,J0285,"INJEC,AMPHOTERICIN B,50 MG",85.0,55.25,42.5,85.0,14
HCPCS,J02850,Amphotericin b,,,46.75,46.75,1
HCPCS,J0287,AMPHOTERICIN B LIPID COMPLEX,40.0,26.0,10.5,40.0,14
HCPCS,J0287,Amphotericin b lipid complex,,,10.89,93.47,23
HCPCS,J02870,Amphotericin b lipid complex,,,10.89,10.89,1
HCPCS,J0288,Ampho b cholesteryl sulfate,,,21.59,78.3,9
HCPCS,J0289,AMBISOME 50 MG INTRAVENOUS SUSPENSION,1145.91,744.84,20.72,1145.91,47
HCPCS,J0289,AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,842.46,547.6,20.72,842.46,47
HCPCS,J0289,Amphotericin b liposome inj,,,22.38,22.38,1
HCPCS,J02890,Amphotericin b liposome inj,,,22.38,22.38,1
HCPCS,J0290,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,22.935,14.91,0.9,25.92,155
HCPCS,J0290,AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,323.31,210.15,0.9,323.31,31
HCPCS,J0290,AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,104.25,67.76,0.9,104.25,31
HCPCS,J0290,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,49.004999999999995,31.849999999999998,0.9,50.25,124
HCPCS,J0290,AMPICILLIN 250 MG SOLUTION FOR INJECTION,12.57,8.17,0.9,12.57,31
HCPCS,J0290,AMPICILLIN 500 MG,6.0,3.9,0.59,6.0,14
HCPCS,J0290,AMPICILLIN 500 MG INJ,8.0,5.2,0.59,8.0,14
HCPCS,J0290,AMPICILLIN 500 MG SOLUTION FOR INJECTION,13.23,8.6,0.9,13.23,31
HCPCS,J0290,Ampicillin 500 mg inj,,,0.64,0.64,1
HCPCS,J02900,Ampicillin 500 mg inj,,,0.64,0.64,1
HCPCS,J0291,"Inj., plazomicin, 5 mg",,,3.24,93.47,35
HCPCS,J02910,"Inj., plazomicin, 5 mg",,,3.79,3.79,1
HCPCS,J0295,AMPICILLIN SODIUM PER 1.5 GM,51.0,33.15,1.33,51.0,14
HCPCS,J0295,AMPICILLIN-SULBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,19.38,12.6,1.91,19.38,62
HCPCS,J0295,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,15.12,9.83,1.91,23.22,93
HCPCS,J0295,AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,142.56,92.66,1.91,142.56,31
HCPCS,J0295,AMPICILLIN-SULBACTAM 3 GRAM INTRAVENOUS SOLUTION,33.24,21.61,1.91,33.24,31
HCPCS,J0295,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,43.8,28.47,1.91,54.0,186
HCPCS,J0295,Ampicillin sulbactam 1.5 gm,,,1.44,1.44,1
HCPCS,J0295,UNASYN 1.5 GRAM SOLUTION FOR INJECTION,27.75,18.04,1.91,27.75,31
HCPCS,J0295,UNASYN 15 GRAM SOLUTION FOR INJECTION,262.11,170.37,1.91,262.11,31
HCPCS,J0295,UNASYN 3 GRAM SOLUTION FOR INJECTION,52.41,34.07,1.91,52.41,31
HCPCS,J02950,Ampicillin sulbactam 1.5 gm,,,1.44,1.44,1
HCPCS,J0300,Amobarbital 125 mg inj,,,190.02,482.08,4
HCPCS,J03000,Amobarbital 125 mg inj,,,190.02,190.02,1
HCPCS,J0330,QUELICIN 20 MG/ML INJECTION SOLUTION,6.99,4.54,1.17,6.99,23
HCPCS,J0330,SUCCINYCHOLINE CHLORIDE INJ,13.0,8.45,0.85,13.0,14
HCPCS,J0330,Succinycholine chloride inj,,,0.89,0.89,1
HCPCS,J03300,Succinycholine chloride inj,,,0.89,0.89,1
HCPCS,J0348,Anidulafungin injection,,,0.55,0.55,1
HCPCS,J0348,ERAXIS(WATER DILUENT) 100 MG INTRAVENOUS SOLUTION,687.21,446.69,0.42,687.21,31
HCPCS,J03480,Anidulafungin injection,,,0.55,0.55,1
HCPCS,J0349,"Inj, rezafungin, 1 mg",,,11.69,11.69,1
HCPCS,J0349,REZZAYO 200 MG INTRAVENOUS SOLUTION,7673.16,4987.55,10.12,7673.16,46
HCPCS,J03490,"Inj, rezafungin, 1 mg",,,11.69,11.69,1
HCPCS,J0350,Injection anistreplase 30 u,,,2449.94,6215.58,9
HCPCS,J0360,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,53.175,34.565,5.0,61.35,124
HCPCS,J0360,HYDRALAZINE HCL INJECTION,12.0,7.8,4.39,12.0,14
HCPCS,J0360,Hydralazine hcl injection,,,4.74,4.74,1
HCPCS,J03600,Hydralazine hcl injection,,,4.74,4.74,1
HCPCS,J0364,Apomorphine hydrochloride,,,36.0,123.65,13
HCPCS,J03640,Apomorphine hydrochloride,,,36.0,36.0,1
HCPCS,J0365,"Aprotonin, 10,000 kiu",,,2.29,93.47,12
HCPCS,J0380,Inj metaraminol bitartrate,,,1.16,2.93,6
HCPCS,J0390,Chloroquine injection,,,17.91,45.43,4
HCPCS,J03900,Chloroquine injection,,,17.91,17.91,1
HCPCS,J0391,ARTESUNATE 110 MG INTRAVENOUS SOLUTION,16135.5,10488.08,51.82,16135.5,45
HCPCS,J0391,"Inj, artesunate, 1mg",,,50.7,50.7,1
HCPCS,J03910,"Inj, artesunate, 1mg",,,50.7,50.7,1
HCPCS,J0395,Arbutamine hcl injection,,,165.89,420.86,6
HCPCS,J0400,Aripiprazole injection,,,0.33,0.33,1
HCPCS,J04000,Aripiprazole injection,,,0.33,0.33,1
HCPCS,J0401,ABILIFY MAINTENA 300 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,7842.0,5097.3,6.13,7842.0,106
HCPCS,J0401,ABILIFY MAINTENA 300 MG SUSPENSIONEXTENDED REL. INTRAMUSCULAR SYRINGE,7842.0,5097.3,6.13,7842.0,53
HCPCS,J0401,ABILIFY MAINTENA 400 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,10455.99,6796.39,6.13,10455.99,159
HCPCS,J0401,ABILIFY MAINTENA 400 MG SUSPENSIONEXTENDED REL. INTRAMUSCULAR SYRINGE,10455.99,6796.39,6.13,10455.99,53
HCPCS,J0401,"Inj, abilify maintena, 1 mg",,,7.86,7.86,1
HCPCS,J04010,"Inj, abilify maintena, 1 mg",,,7.86,7.86,1
HCPCS,J0402,ABILIFY ASIMTUFII 960 MG/3.2 ML SUSPENSION EXTEND.REL. IM SYRINGE,6534.99,4247.74,5.23,6534.99,53
HCPCS,J0402,"Inj, abilify asimtufii, 1 mg",,,6.5,6.5,1
HCPCS,J04020,"Inj, abilify asimtufii, 1 mg",,,6.5,6.5,1
HCPCS,J0456,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,26.76,17.39,2.17,89.85,93
HCPCS,J0456,Azithromycin,,,2.2,2.2,1
HCPCS,J0456,ZITHROMAX 500 MG INTRAVENOUS SOLUTION,21.93,14.25,2.17,21.93,31
HCPCS,J04560,Azithromycin,,,2.2,2.2,1
HCPCS,J0457,AZACTAM 2 GRAM SOLUTION FOR INJECTION,214.02,139.11,2.32,214.02,31
HCPCS,J0457,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,205.92,133.85,2.32,241.02,124
HCPCS,J0457,"Injection, aztreonam, 100 mg",,,2.41,2.41,1
HCPCS,J04570,"Injection, aztreonam, 100 mg",,,2.41,2.41,1
HCPCS,J0458,Aztreonam/avibactam 10 mg,,,1.81,1.81,1
HCPCS,J0458,EMBLAVEO 2 GRAM INTRAVENOUS SOLUTION,1177.2,765.18,1.67,3407.66,39
HCPCS,J04580,Aztreonam/avibactam 10 mg,,,1.81,1.81,1
HCPCS,J0461,ATROPINE 0.1 MG/ML INJECTION SYRINGE,3.7199999999999998,2.42,0.06,3.75,62
HCPCS,J0461,ATROPINE SULFATE INJECTION,24.0,15.6,0.1,24.0,14
HCPCS,J0461,Atropine sulfate injection,,,0.11,0.11,1
HCPCS,J04610,Atropine sulfate injection,,,0.11,0.11,1
HCPCS,J0462,ATROPINE 0.4 MG/ML INJECTION SOLUTION,13.74,8.93,0.25,13.74,30
HCPCS,J0462,ATROPINE 0.4 MG/ML INTRAVENOUS SOLUTION,40.44,26.29,0.25,40.44,30
HCPCS,J0462,ATROPINE 1 MG/ML INJECTION SOLUTION,53.129999999999995,34.535,0.25,61.05,60
HCPCS,J0462,"Atropine sulf, nte, 0.01 mg",,,0.14,0.14,1
HCPCS,J04620,"Atropine sulf, nte, 0.01 mg",,,0.14,0.14,1
HCPCS,J0470,Dimecaprol injection,,,55.45,55.45,1
HCPCS,J04700,Dimecaprol injection,,,55.45,55.45,1
HCPCS,J0475,BACLOFEN 10 MG INJECTION,750.0,487.5,181.47,750.0,14
HCPCS,J0475,BACLOFEN 10000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION,21.24,13.81,5.5,502.19,47
HCPCS,J0475,BACLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SOLUTION,112.155,72.9,22.05,502.19,94
HCPCS,J0475,BACLOFEN INJ 10 MG,750.0,487.5,160.09,750.0,47
HCPCS,J0475,Baclofen 10 mg injection,,,195.99,195.99,1
HCPCS,J0475,GABLOFEN 10000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION,46.35,30.13,12.0,502.19,47
HCPCS,J0475,GABLOFEN 10000 MCG/20 ML (500 MCG/ML) INTRATHECAL SYRINGE,49.8,32.37,12.9,502.19,47
HCPCS,J0475,GABLOFEN 20000 MCG/20 ML (1000 MCG/ML) INTRATHECAL SOLUTION,92.73,60.27,24.02,502.19,47
HCPCS,J0475,GABLOFEN 20000 MCG/20 ML (1000 MCG/ML) INTRATHECAL SYRINGE,99.63,64.76,25.8,502.19,47
HCPCS,J0475,GABLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SOLUTION,185.43,120.53,48.03,502.19,47
HCPCS,J0475,GABLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SYRINGE,199.44,129.64,51.65,502.19,47
HCPCS,J0475,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,44.06,502.19,282
HCPCS,J0475,LIORESAL 500 MCG/ML INTRATHECAL SOLUTION,871.89,566.73,11.02,1701.24,188
HCPCS,J0475,W KIT REFILL LIORESAL INTRATHCL,50.0,32.5,12.95,502.19,47
HCPCS,J04750,Baclofen 10 mg injection,,,195.99,195.99,1
HCPCS,J0476,BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,158.4,102.96,26.61,164.7,31
HCPCS,J0476,Baclofen intrathecal trial,,,64.27,64.27,1
HCPCS,J0476,GABLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,345.0,224.25,52.12,345.0,31
HCPCS,J0476,"INJECT,BACLOFEN,50 MCG INTRATHECAL",420.0,273.0,59.51,420.0,14
HCPCS,J0476,LIORESAL 50 MCG/ML INTRATHECAL SOLUTION,118.68,77.14,19.94,164.7,31
HCPCS,J04760,Baclofen intrathecal trial,,,64.27,64.27,1
HCPCS,J0480,Basiliximab,,,5163.56,5163.56,1
HCPCS,J0480,SIMULECT 10 MG INTRAVENOUS SOLUTION,17007.04,11054.58,1073.13,17007.04,53
HCPCS,J0480,SIMULECT 20 MG INTRAVENOUS SOLUTION,22321.68,14509.09,1073.13,22321.68,53
HCPCS,J04800,Basiliximab,,,5163.56,5163.56,1
HCPCS,J0485,Belatacept injection,,,4.2,4.2,1
HCPCS,J0485,NULOJIX 250 MG INTRAVENOUS SOLUTION,3491.58,2269.53,3.48,3491.58,50
HCPCS,J04850,Belatacept injection,,,4.2,4.2,1
HCPCS,J0490,BELIMUMAB INJECTION,146.0,94.9,57.16,146.0,14
HCPCS,J0490,BENLYSTA 120 MG INTRAVENOUS SOLUTION,3169.92,2060.45,48.69,3169.92,50
HCPCS,J0490,BENLYSTA 200 MG/ML SUBCUTANEOUS AUTO-INJECTOR,6164.88,4007.17,48.69,6164.88,53
HCPCS,J0490,BENLYSTA 400 MG INTRAVENOUS SOLUTION,10565.6,6867.64,48.69,10565.6,53
HCPCS,J0490,Belimumab injection,,,61.73,61.73,1
HCPCS,J04900,Belimumab injection,,,61.73,61.73,1
HCPCS,J0491,Inj anifrolumab-fnia 1mg,,,19.81,19.81,1
HCPCS,J0491,SAPHNELO 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION,9793.14,6365.54,15.42,9793.14,53
HCPCS,J04910,Inj anifrolumab-fnia 1mg,,,19.81,19.81,1
HCPCS,J0500,DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION,56.91,36.99,7.33,70.2,62
HCPCS,J0500,DICYCLOMINE INJECTION,55.0,35.75,11.33,55.0,14
HCPCS,J0500,Dicyclomine injection,,,12.24,12.24,1
HCPCS,J05000,Dicyclomine injection,,,12.24,12.24,1
HCPCS,J0515,BENZTROPINE 1 MG/ML INJECTION SOLUTION,94.5,61.425,13.61,108.0,62
HCPCS,J0515,Inj benztropine mesylate,,,14.93,14.93,1
HCPCS,J05150,Inj benztropine mesylate,,,14.93,14.93,1
HCPCS,J0517,FASENRA 30 MG/ML SUBCUTANEOUS SYRINGE,21049.38,13682.1,148.72,21049.38,53
HCPCS,J0517,FASENRA PEN 30 MG/ML SUBCUTANEOUS AUTO-INJECTOR,21049.38,13682.1,148.72,21049.38,53
HCPCS,J0517,"Inj., benralizumab, 1 mg",,,177.09,177.09,1
HCPCS,J05170,"Inj., benralizumab, 1 mg",,,177.09,177.09,1
HCPCS,J0520,Bethanechol chloride inject,,,4.86,12.33,7
HCPCS,J05200,Bethanechol chloride inject,,,4.86,4.86,1
HCPCS,J0525,CEFOTETAN 1 GRAM SOLUTION FOR INJECTION,87.18,56.67,0.63,87.18,23
HCPCS,J0525,CEFOTETAN 2 GRAM SOLUTION FOR INJECTION,174.39,113.35,0.63,174.39,23
HCPCS,J0525,Inj cefotetan disodium 10 mg,,,0.25,0.25,1
HCPCS,J05250,Inj cefotetan disodium 10 mg,,,0.25,0.25,1
HCPCS,J0558,BICILLIN C-R 1200000 UNIT/2 ML INTRAMUSCULAR SYRINGE,437.61,284.45,15.63,437.61,94
HCPCS,J0558,Peng benzathine/procaine inj,,,21.08,21.08,1
HCPCS,J05580,Peng benzathine/procaine inj,,,21.08,21.08,1
HCPCS,J0561,BICILLIN L-A 1200000 UNIT/2 ML INTRAMUSCULAR SYRINGE,730.68,474.94,19.8,730.68,47
HCPCS,J0561,BICILLIN L-A 2400000 UNIT/4 ML INTRAMUSCULAR SYRINGE,748.65,486.62,19.8,748.65,94
HCPCS,J0561,BICILLIN L-A 600000 UNIT/ML INTRAMUSCULAR SYRINGE,843.78,548.46,19.8,843.78,47
HCPCS,J0561,PENICILLIN G BENZATHINE INJ,9.0,5.85,4.5,36.15,14
HCPCS,J0561,Penicillin g benzathine inj,,,34.53,34.53,1
HCPCS,J05610,Penicillin g benzathine inj,,,34.53,34.53,1
HCPCS,J0565,"Inj, bezlotoxumab, 10 mg",,,35.88,943.43,35
HCPCS,J05650,"Inj, bezlotoxumab, 10 mg",,,43.02,43.02,1
HCPCS,J0567,"Inj., cerliponase alfa 1 mg",,,121.19,12697.64,17
HCPCS,J05670,"Inj., cerliponase alfa 1 mg",,,121.54,121.54,1
HCPCS,J0570,Buprenorphine implant 74.2mg,,,516.7,1283.04,7
HCPCS,J05700,Buprenorphine implant 74.2mg,,,1283.04,1283.04,1
HCPCS,J0571,Buprenorphine oral 1mg,,,0.28,1.15,7
HCPCS,J05710,Buprenorphine oral 1mg,,,0.28,0.28,1
HCPCS,J0572,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM,9.82,6.38,1.65,10.3,22
HCPCS,J0572,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,7.8,5.075,1.02,10.3,44
HCPCS,J0572,Bupren/nal up to 3mg bupreno,,,4.06,4.06,1
HCPCS,J0572,SUBOXONE 2 MG-0.5 MG SUBLINGUAL FILM,12.02,7.81,2.02,12.02,44
HCPCS,J05720,Bupren/nal up to 3mg bupreno,,,4.06,4.06,1
HCPCS,J0573,Bupren/nal 3.1 to 6mg bupren,,,8.05,20.41,4
HCPCS,J05730,Bupren/nal 3.1 to 6mg bupren,,,8.05,8.05,1
HCPCS,J0574,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,17.6,11.44,2.95,20.41,88
HCPCS,J0574,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,18.880000000000003,12.275,2.84,20.84,44
HCPCS,J0574,Bupren/nal 6.1 to 10mg bupre,,,8.05,8.05,1
HCPCS,J0574,SUBOXONE 8 MG-2 MG SUBLINGUAL FILM,21.56,14.01,3.62,21.56,44
HCPCS,J05740,Bupren/nal 6.1 to 10mg bupre,,,8.05,8.05,1
HCPCS,J0575,BUPRENORPHINE 12 MG-NALOXONE 3 MG SUBLINGUAL FILM,36.86,23.96,6.19,40.83,23
HCPCS,J0575,Bupren/nal over 10mg bupreno,,,16.09,16.09,1
HCPCS,J05750,Bupren/nal over 10mg bupreno,,,16.09,16.09,1
HCPCS,J0577,BRIXADI WEEKLY 16 MG/0.32 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,4803.75,3122.44,363.68,4803.75,44
HCPCS,J0577,BRIXADI WEEKLY 24 MG/0.48 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,3202.5,2081.63,363.68,3202.5,44
HCPCS,J0577,BRIXADI WEEKLY 32 MG/0.64 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,2401.89,1561.23,363.68,2401.89,41
HCPCS,J0577,BRIXADI WEEKLY 8 MG/0.16 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,9607.5,6244.88,363.68,9607.5,47
HCPCS,J0577,"Inj, brixadi, 7 days or less",,,453.65,453.65,1
HCPCS,J05770,"Inj, brixadi, 7 days or less",,,453.65,453.65,1
HCPCS,J0578,BRIXADI MONTHLY 128 MG/0.36 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,17079.99,11101.99,1454.71,17079.99,47
HCPCS,J0578,BRIXADI MONTHLY 64 MG/0.18 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,34160.01,22204.01,1454.71,34160.01,47
HCPCS,J0578,BRIXADI MONTHLY 96 MG/0.27 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,22773.33,14802.66,1454.71,22773.33,47
HCPCS,J0578,"Inj brixadi, more than 7 day",,,1814.63,1814.63,1
HCPCS,J05780,"Inj brixadi, more than 7 day",,,1814.63,1814.63,1
HCPCS,J0582,Bivalirudin (endo) 1 mg,,,0.15,78.3,17
HCPCS,J05820,Bivalirudin (endo) 1 mg,,,0.15,0.15,1
HCPCS,J0583,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,1831.905,1190.74,0.22,3411.81,77
HCPCS,J0583,Bivalirudin,,,0.17,0.17,1
HCPCS,J05830,Bivalirudin,,,0.17,0.17,1
HCPCS,J0584,"Injection, burosumab-twza 1m",,,403.08,12697.64,35
HCPCS,J05840,"Injection, burosumab-twza 1m",,,537.86,537.86,1
HCPCS,J0585,BOTOX 100 UNIT INJECTION,2343.6,1523.34,5.69,2343.6,47
HCPCS,J0585,BOTOX 200 UNIT INJECTION,4687.2,3046.68,5.69,4687.2,50
HCPCS,J0585,BOTOX COSMETIC 100 UNIT INTRAMUSCULAR SOLUTION,2361.6,1535.04,5.69,2361.6,47
HCPCS,J0585,BOTOX COSMETIC 50 UNIT INTRAMUSCULAR SOLUTION,1303.2,847.08,5.69,1303.2,47
HCPCS,J0585,BOTOX PER UNIT,13.5,8.774999999999999,6.5,14.0,28
HCPCS,J0585,BOTULINUM TOXIN A PER 1 UNIT,26.0,16.9,6.51,26.0,14
HCPCS,J0585,BOTULINUM TOXIN ADD'L SITE,213.0,138.45,6.51,213.0,14
HCPCS,J0585,BOTULINUM TOXIN TYPE A/UNIT,26.0,16.9,5.69,345.3,47
HCPCS,J0585,"DYSPORT, PLASTIC FF",414.0,269.1,6.51,414.0,14
HCPCS,J0585,"Injection,onabotulinumtoxina",,,7.03,7.03,1
HCPCS,J05850,"Injection,onabotulinumtoxina",,,7.03,7.03,1
HCPCS,J0586,ABOBOTULINUMTOXINA,28.0,18.2,8.8,28.0,14
HCPCS,J0586,ABOBOTULINUMTOXINA 5 UNITS,28.0,18.2,7.25,345.3,47
HCPCS,J0586,Abobotulinumtoxina,,,9.5,9.5,1
HCPCS,J0586,BOTULINUM TOXIN A PER 1 UNIT,23.0,14.95,8.8,23.0,14
HCPCS,J0586,DYSPORT 300 UNIT INTRAMUSCULAR SOLUTION,1751.88,1138.72,7.81,1902.6,94
HCPCS,J0586,DYSPORT 5 UNITS (SP),23.35,15.18,8.8,23.35,14
HCPCS,J0586,DYSPORT 500 UNIT INTRAMUSCULAR SOLUTION,3169.8,2060.37,7.81,3169.8,50
HCPCS,J0586,"DYSPORT, PLASTIC FF",418.0,271.7,8.8,418.0,14
HCPCS,J05860,Abobotulinumtoxina,,,9.5,9.5,1
HCPCS,J0587,BOTULINUM TOX B INJ PER 100U,35.0,22.75,9.07,345.3,47
HCPCS,J0587,BOTULINUM TOXIN TYPE B,35.0,22.75,13.29,35.0,14
HCPCS,J0587,"Inj, rimabotulinumtoxinb",,,14.35,14.35,1
HCPCS,J0587,MYOBLOC 10000 UNIT/2 ML INTRAMUSCULAR SOLUTION,2286.3,1486.1,11.73,2286.3,47
HCPCS,J0587,MYOBLOC 2500 UNIT/0.5 ML INTRAMUSCULAR SOLUTION,2286.3,1486.1,11.73,2286.3,47
HCPCS,J0587,MYOBLOC 5000 UNIT/ML INTRAMUSCULAR SOLUTION,2286.3,1486.1,11.73,2286.3,47
HCPCS,J05870,"Inj, rimabotulinumtoxinb",,,14.35,14.35,1
HCPCS,J0588,INCOBOTULINUMTOXIN A,15.0,9.75,5.25,15.0,14
HCPCS,J0588,Incobotulinumtoxin a,,,5.67,5.67,1
HCPCS,J0588,XEOMIN 100 UNIT INTRAMUSCULAR SOLUTION,1787.4,1161.81,4.68,1839.6,94
HCPCS,J0588,XEOMIN 50 UNIT INTRAMUSCULAR SOLUTION,1402.1999999999998,911.4300000000001,4.68,1839.6,94
HCPCS,J0588,XEOMIN PER UNIT,9.96,6.47,4.98,9.96,14
HCPCS,J05880,Incobotulinumtoxin a,,,5.67,5.67,1
HCPCS,J0589,DAXXIFY 100 UNIT INTRAMUSCULAR SOLUTION,1512.0,982.8,3.11,1512.0,46
HCPCS,J0589,Inj daxibotulinumtoxina-lanm,,,3.36,3.36,1
HCPCS,J05890,Inj daxibotulinumtoxina-lanm,,,3.36,3.36,1
HCPCS,J0591,"Inj deoxycholic acid, 1 mg",,,15.55,15.55,1
HCPCS,J0591,KYBELLA 10 MG/ML SUBCUTANEOUS SOLUTION,2160.0,1404.0,23.59,2160.0,29
HCPCS,J05910,"Inj deoxycholic acid, 1 mg",,,15.55,15.55,1
HCPCS,J0592,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,57.19,37.17,3.54,65.36,62
HCPCS,J0592,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SYRINGE,115.2,74.88,3.54,115.2,31
HCPCS,J0592,Buprenorphine hydrochloride,,,4.55,4.55,1
HCPCS,J05920,Buprenorphine hydrochloride,,,4.55,4.55,1
HCPCS,J0593,"Inj., lanadelumab-flyo, 1 mg",,,87.19,12697.64,24
HCPCS,J05930,"Inj., lanadelumab-flyo, 1 mg",,,94.17,94.17,1
HCPCS,J0594,BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,189.68,123.29,0.89,189.68,46
HCPCS,J0594,Busulfan injection,,,0.96,0.96,1
HCPCS,J05940,Busulfan injection,,,0.96,0.96,1
HCPCS,J0595,BUTORPHANOL 1 MG/ML INJECTION SOLUTION,60.84,39.55,3.22,60.84,31
HCPCS,J0595,BUTORPHANOL 2 MG/ML INJECTION SOLUTION,74.43,48.38,3.22,74.43,31
HCPCS,J0595,Butorphanol tartrate 1 mg,,,5.98,5.98,1
HCPCS,J05950,Butorphanol tartrate 1 mg,,,5.98,5.98,1
HCPCS,J0596,"Injection, ruconest",,,30.06,5646.0,35
HCPCS,J05960,"Injection, ruconest",,,39.72,39.72,1
HCPCS,J0597,BERINERT 500 UNIT (10 ML) INTRAVENOUS KIT,15992.88,10395.37,57.98,15992.88,53
HCPCS,J0597,"C-1 esterase, berinert",,,81.93,81.93,1
HCPCS,J05970,"C-1 esterase, berinert",,,81.93,81.93,1
HCPCS,J0598,"C-1 esterase, cinryze",,,70.88,70.88,1
HCPCS,J0598,CINRYZE 500 UNIT (5 ML) INTRAVENOUS SOLUTION,11513.49,7483.77,56.31,11513.49,106
HCPCS,J05980,"C-1 esterase, cinryze",,,70.88,70.88,1
HCPCS,J0599,"Inj., haegarda 10 units",,,12.55,3236.72,13
HCPCS,J05990,"Inj., haegarda 10 units",,,12.55,12.55,1
HCPCS,J0600,EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,4676.13,3039.48,1211.12,17184.65,49
HCPCS,J0600,EDETATE CALCIUM DISODIUM 50 MG/ML INTRAVENOUS SOLUTION,126.0,81.9,32.63,17184.65,46
HCPCS,J0600,Edetate calcium disodium inj,,,6706.45,6706.45,1
HCPCS,J06000,Edetate calcium disodium inj,,,6706.45,6706.45,1
HCPCS,J0601,Sevelamer carbonate 20 mg,,,0.01,0.03,7
HCPCS,J06010,Sevelamer carbonate 20 mg,,,0.01,0.01,1
HCPCS,J0602,Sevelamer carbonate pdr 20mg,,,0.05,0.14,7
HCPCS,J06020,Sevelamer carbonate pdr 20mg,,,0.05,0.05,1
HCPCS,J0603,Sevelamer hydrochloride 20mg,,,0.11,0.27,7
HCPCS,J06030,Sevelamer hydrochloride 20mg,,,0.11,0.11,1
HCPCS,J0604,"Cinacalcet, esrd on dialysis",,,0.02,78.3,13
HCPCS,J06040,"Cinacalcet, esrd on dialysis",,,0.02,0.02,1
HCPCS,J0605,Sucroferric oxyhydroxide 5mg,,,0.18,0.47,7
HCPCS,J06050,Sucroferric oxyhydroxide 5mg,,,0.18,0.18,1
HCPCS,J0606,"Inj, etelcalcetide, 0.1 mg",,,2.29,78.3,14
HCPCS,J06060,"Inj, etelcalcetide, 0.1 mg",,,4.28,4.28,1
HCPCS,J0607,Lanthanum carbonate oral 5mg,,,0.04,0.11,7
HCPCS,J06070,Lanthanum carbonate oral 5mg,,,0.04,0.04,1
HCPCS,J0608,Lanthanum carbonate pwdr 5mg,,,0.06,0.16,7
HCPCS,J06080,Lanthanum carbonate pwdr 5mg,,,0.06,0.06,1
HCPCS,J0609,Ferric citrate orl 3 mg iron,,,0.11,0.27,7
HCPCS,J06090,Ferric citrate orl 3 mg iron,,,0.11,0.11,1
HCPCS,J0612,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,2.775,1.805,0.04,3.6,155
HCPCS,J0612,"Inj, calcium gluconate, nos",,,0.03,0.03,1
HCPCS,J06120,"Inj, calcium gluconate, nos",,,0.03,0.03,1
HCPCS,J0613,CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE ISO-OSM IV SOLUTION,1.41,0.92,0.08,1.41,31
HCPCS,J0613,Calcium glucon (wg critical),,,0.1,0.1,1
HCPCS,J06130,Calcium glucon (wg critical),,,0.1,0.1,1
HCPCS,J0614,"Inj, treosulfan, 50 mg",,,31.2,3407.66,21
HCPCS,J06140,"Inj, treosulfan, 50 mg",,,33.71,33.71,1
HCPCS,J0615,"Calcium acetate, oral, 23 mg",,,0.02,0.05,7
HCPCS,J06150,"Calcium acetate, oral, 23 mg",,,0.02,0.02,1
HCPCS,J0616,Inj metoprolol tartrate 1 mg,,,0.13,0.13,1
HCPCS,J0616,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,0.885,0.575,0.12,1.05,60
HCPCS,J06160,Inj metoprolol tartrate 1 mg,,,0.13,0.13,1
HCPCS,J0618,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,7.29,4.74,0.05,7.29,23
HCPCS,J0618,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,4.53,2.94,0.05,4.53,23
HCPCS,J0618,"Inj, calcium chloride, 2 mg",,,0.02,0.02,1
HCPCS,J06180,"Inj, calcium chloride, 2 mg",,,0.02,0.02,1
HCPCS,J0620,Calcium glycer & lact/10 ml,,,11.33,11.33,1
HCPCS,J06200,Calcium glycer & lact/10 ml,,,11.33,11.33,1
HCPCS,J0630,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,1440.0,936.0,241.92,2533.81,37
HCPCS,J0630,Calcitonin salmon injection,,,829.44,829.44,1
HCPCS,J06300,Calcitonin salmon injection,,,829.44,829.44,1
HCPCS,J0636,CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,28.695,18.65,2.6,35.82,46
HCPCS,J0636,Inj calcitriol per 0.1 mcg,,,1.03,1.03,1
HCPCS,J06360,Inj calcitriol per 0.1 mcg,,,1.03,1.03,1
HCPCS,J0637,CASPOFUNGIN 50 MG INTRAVENOUS SOLUTION,1213.2,788.58,5.97,1213.2,31
HCPCS,J0637,CASPOFUNGIN ACETATE,121.0,78.65,3.82,121.0,14
HCPCS,J0637,Caspofungin acetate,,,4.13,4.13,1
HCPCS,J06370,Caspofungin acetate,,,4.13,4.13,1
HCPCS,J0638,Canakinumab injection,,,159.56,159.56,1
HCPCS,J0638,ILARIS (PF) 150 MG/ML SUBCUTANEOUS SOLUTION,76983.66,50039.38,112.04,76983.66,53
HCPCS,J06380,Canakinumab injection,,,159.56,159.56,1
HCPCS,J0640,LEUCOVORIN CALCIUM 10 MG/ML INJECTION SOLUTION,7.845,5.1,1.31,10.63,62
HCPCS,J0640,LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,72.0,46.8,4.62,72.0,31
HCPCS,J0640,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,54.0,35.099999999999994,4.62,72.0,62
HCPCS,J0640,LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,252.0,163.8,4.62,252.0,31
HCPCS,J0640,LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,31.68,20.59,4.62,31.68,31
HCPCS,J0640,LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,310.29,201.69,4.62,310.29,31
HCPCS,J0640,LEUCOVORIN CALCIUM INJECTION,135.0,87.75,3.84,135.0,14
HCPCS,J0640,Leucovorin calcium injection,,,4.15,4.15,1
HCPCS,J06400,Leucovorin calcium injection,,,4.15,4.15,1
HCPCS,J0641,Inj levoleucovorin nos 0.5mg,,,0.05,28.24,18
HCPCS,J06410,Inj levoleucovorin nos 0.5mg,,,0.05,0.05,1
HCPCS,J0642,"Injection, khapzory, 0.5 mg",,,1.52,345.3,18
HCPCS,J06420,"Injection, khapzory, 0.5 mg",,,1.52,1.52,1
HCPCS,J0650,"Inj, levothyroxine nos 10mcg",,,6.46,6.46,1
HCPCS,J0650,LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,375.555,244.11,11.36,433.29,72
HCPCS,J0650,LEVOTHYROXINE 500 MCG INTRAVENOUS POWDER FOR SOLUTION,1900.47,1235.31,11.36,1900.47,36
HCPCS,J06500,"Inj, levothyroxine nos 10mcg",,,6.46,6.46,1
HCPCS,J0651,"Inj, levothyroxine, freskabi",,,7.5,7.5,1
HCPCS,J0651,LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,58.905,38.290000000000006,3.75,78.3,92
HCPCS,J0651,LEVOTHYROXINE 40 MCG/ML INTRAVENOUS SOLUTION,159.63,103.76,3.75,159.63,46
HCPCS,J06510,"Inj, levothyroxine, freskabi",,,7.5,7.5,1
HCPCS,J0652,"Inj, levothyroxine, hikma",,,5.14,78.3,30
HCPCS,J06520,"Inj, levothyroxine, hikma",,,8.31,8.31,1
HCPCS,J0654,"Inj, liothyronine, 1 mcg",,,39.52,115.9,14
HCPCS,J06540,"Inj, liothyronine, 1 mcg",,,45.68,45.68,1
HCPCS,J0665,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.75,0.49,0.01,0.84,93
HCPCS,J0665,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,0.99,0.64,0.01,2.79,186
HCPCS,J0665,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,0.81,0.525,0.01,1.05,62
HCPCS,J0665,BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.27,0.18,0.01,0.27,31
HCPCS,J0665,BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,0.21,0.14,0.01,0.21,31
HCPCS,J0665,"Inj, bupivacaine, nos, 0.5mg",,,0.01,0.01,1
HCPCS,J0665,MARCAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.6,0.39,0.01,0.6,31
HCPCS,J0665,MARCAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,1.86,1.21,0.01,1.86,31
HCPCS,J0665,MARCAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,1.89,1.23,0.01,1.89,31
HCPCS,J0665,SENSORCAINE 0.5 % (5 MG/ML) INJECTION SOLUTION,1.02,0.66,0.01,1.02,31
HCPCS,J0665,SENSORCAINE-MPF 0.5 % (5 MG/ML) INJECTION SOLUTION,2.07,1.35,0.01,2.07,31
HCPCS,J06650,"Inj, bupivacaine, nos, 0.5mg",,,0.01,0.01,1
HCPCS,J0666,EXPAREL (PF) 1.3 % (13.3 MG/ML) SUSPENSION FOR LOCAL INFILTRATION,75.36,48.98,1.46,91.2,120
HCPCS,J0666,"Inj, bupivacaine liposome",,,1.56,1.56,1
HCPCS,J06660,"Inj, bupivacaine liposome",,,1.56,1.56,1
HCPCS,J0668,"Instill, bupivac and meloxic",,,0.79,2.0,8
HCPCS,J06680,"Instill, bupivac and meloxic",,,0.79,0.79,1
HCPCS,J0670,Inj mepivacaine hcl/10 ml,,,4.05,4.05,1
HCPCS,J0670,POLOCAINE 1 % (10 MG/ML) INJECTION SOLUTION,1.14,0.74,0.19,10.38,31
HCPCS,J0670,POLOCAINE 2 % INJECTION SOLUTION,1.17,0.76,0.2,10.38,31
HCPCS,J0670,POLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,1.35,0.88,0.23,10.38,31
HCPCS,J0670,POLOCAINE-MPF 15 MG/ML (1.5 %) INJECTION SOLUTION,1.8,1.17,0.3,10.38,31
HCPCS,J0670,POLOCAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,2.22,1.44,0.37,10.38,31
HCPCS,J06700,Inj mepivacaine hcl/10 ml,,,4.05,4.05,1
HCPCS,J0675,CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,1148.37,746.44,13.7,1148.37,26
HCPCS,J0675,HEMABATE 250 MCG/ML INTRAMUSCULAR SOLUTION,504.0,327.6,13.7,504.0,52
HCPCS,J0675,"Inj, carboprost, 0.1 mg",,,31.1,31.1,1
HCPCS,J06750,"Inj, carboprost, 0.1 mg",,,31.1,31.1,1
HCPCS,J0681,Inj ceftobipole medocarl 3mg,,,1.1,93.47,14
HCPCS,J06810,Inj ceftobipole medocarl 3mg,,,1.1,1.1,1
HCPCS,J0687,Inj cefazolin (wg crit care),,,0.95,2.44,24
HCPCS,J06870,Inj cefazolin (wg crit care),,,0.95,0.95,1
HCPCS,J0688,CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,39.78,25.86,0.98,39.78,38
HCPCS,J0688,CEFAZOLIN 2 GRAM INTRAVENOUS SOLUTION,21.06,13.69,0.98,21.06,38
HCPCS,J0688,CEFAZOLIN 3 GRAM INTRAVENOUS SOLUTION,31.59,20.53,0.98,31.59,38
HCPCS,J0688,"Inj cefazolin sodium, hikma",,,0.95,0.95,1
HCPCS,J06880,"Inj cefazolin sodium, hikma",,,0.95,0.95,1
HCPCS,J0689,CEFAZOLIN 2 GRAM/100 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.33,0.21,0.06,3.51,31
HCPCS,J0689,"Inj cefazolin sodium, baxter",,,1.37,1.37,1
HCPCS,J06890,"Inj cefazolin sodium, baxter",,,1.37,1.37,1
HCPCS,J0690,CEFAZOLIN 1 GRAM INTRAVENOUS SOLUTION,9.84,6.4,0.73,9.84,31
HCPCS,J0690,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,6.375,4.145,0.64,22.5,124
HCPCS,J0690,CEFAZOLIN 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,25.155,16.35,0.07,49.92,62
HCPCS,J0690,CEFAZOLIN 10 GRAM INTRAVENOUS SOLUTION,45.15,29.35,0.73,45.15,31
HCPCS,J0690,CEFAZOLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,56.16,36.5,0.73,56.16,31
HCPCS,J0690,CEFAZOLIN 500 MG SOLUTION FOR INJECTION,6.48,4.21,0.73,7.2,62
HCPCS,J0690,CEFAZOLIN SODIUM INJECTION,8.0,5.2,0.83,8.0,14
HCPCS,J0690,Cefazolin sodium injection,,,0.9,0.9,1
HCPCS,J06900,Cefazolin sodium injection,,,0.9,0.9,1
HCPCS,J0691,Inj lefamulin 1 mg,,,0.71,93.47,10
HCPCS,J06910,Inj lefamulin 1 mg,,,0.71,0.71,1
HCPCS,J0692,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,21.405,13.91,1.2,21.93,62
HCPCS,J0692,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,35.91,23.345,1.2,36.18,62
HCPCS,J0692,CEFEPIME HCL FOR INJECTION,37.0,24.05,0.87,37.0,14
HCPCS,J0692,Cefepime hcl for injection,,,0.94,0.94,1
HCPCS,J06920,Cefepime hcl for injection,,,0.94,0.94,1
HCPCS,J0693,"Inj., cefiderocol, 5 mg",,,74.0,93.47,6
HCPCS,J0694,CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,22.98,14.94,3.86,22.98,62
HCPCS,J0694,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,61.035,39.67,4.41,71.82,62
HCPCS,J0694,CEFOXITIN 2 GRAM/50 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,120.75,78.49,4.41,120.75,31
HCPCS,J0694,CEFOXITIN SODIUM INJECTION,65.0,42.25,4.74,65.0,14
HCPCS,J0694,Cefoxitin sodium injection,,,5.12,5.12,1
HCPCS,J06940,Cefoxitin sodium injection,,,5.12,5.12,1
HCPCS,J0695,Inj ceftolozane tazobactam,,,9.67,9.67,1
HCPCS,J0695,ZERBAXA 1.5 GRAM INTRAVENOUS SOLUTION,627.69,408.0,6.56,627.69,47
HCPCS,J06950,Inj ceftolozane tazobactam,,,9.67,9.67,1
HCPCS,J0696,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,6.345000000000001,4.125,0.41,138.0,124
HCPCS,J0696,CEFTRIAXONE 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOT) INTRAVENOUS PIGGYBACK,35.94,23.36,0.17,70.86,62
HCPCS,J0696,CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,703.8149999999999,457.48,0.41,1345.29,62
HCPCS,J0696,CEFTRIAXONE 2 GRAM INTRAVENOUS SOLUTION,28.71,18.66,0.41,28.71,31
HCPCS,J0696,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,142.32000000000002,92.51,0.41,274.23,62
HCPCS,J0696,CEFTRIAXONE 2 GRAM/50 ML IN DEXTROSE (ISO-OSM) INTRAVENOUS PIGGYBACK,48.45,31.494999999999997,0.41,94.47,62
HCPCS,J0696,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,44.475,28.91,0.41,47.82,124
HCPCS,J0696,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,4.5,2.93,0.41,80.64,124
HCPCS,J0696,CEFTRIAXONE SODIUM INJECTION,2.0,1.3,0.46,2.0,14
HCPCS,J0696,"CEFTRIAXONE, PER 250 MG",2.0,1.3,0.46,2.0,14
HCPCS,J0696,Ceftriaxone sodium injection,,,0.5,0.5,1
HCPCS,J0696,ROCEPHIN 250 MG,44.0,28.6,0.46,44.0,14
HCPCS,J06960,Ceftriaxone sodium injection,,,0.5,0.5,1
HCPCS,J0697,CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,21.06,13.69,1.7,21.06,62
HCPCS,J0697,CEFUROXIME SODIUM 750 MG SOLUTION FOR INJECTION,11.01,7.16,1.7,11.01,31
HCPCS,J0697,Sterile cefuroxime injection,,,2.21,2.21,1
HCPCS,J06970,Sterile cefuroxime injection,,,2.21,2.21,1
HCPCS,J0698,CEFOTAXIME 1 GRAM SOLUTION FOR INJECTION,35.1,22.82,5.9,35.1,23
HCPCS,J0698,CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,70.32,45.71,11.81,70.32,23
HCPCS,J0698,CEFOTAXIME SODIUM INJECTION,45.0,29.25,9.8,45.0,14
HCPCS,J0698,Cefotaxime sodium injection,,,10.16,10.16,1
HCPCS,J06980,Cefotaxime sodium injection,,,10.16,10.16,1
HCPCS,J0699,FETROJA 1 GRAM INTRAVENOUS SOLUTION,838.23,544.85,1.96,838.23,94
HCPCS,J0699,"Inj, cefiderocol, 10 mg",,,2.61,2.61,1
HCPCS,J06990,"Inj, cefiderocol, 10 mg",,,2.61,2.61,1
HCPCS,J0701,Inj. cefepime hcl (baxter),,,5.18,16.52,12
HCPCS,J07010,Inj. cefepime hcl (baxter),,,6.45,6.45,1
HCPCS,J0702,BETAMETHASONE ACET&SOD PHOSP,15.0,9.75,6.91,15.0,14
HCPCS,J0702,BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,39.63,25.76,6.2,39.63,31
HCPCS,J0702,Betamethasone acet&sod phosp,,,7.46,7.46,1
HCPCS,J07020,Betamethasone acet&sod phosp,,,7.46,7.46,1
HCPCS,J0703,CEFEPIME 1 GRAM/50 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,70.86,46.06,4.46,70.86,31
HCPCS,J0703,CEFEPIME 2 GRAM/50 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,107.46,69.85,4.46,107.46,31
HCPCS,J0703,"Inj, cefepime hcl (b braun)",,,5.35,5.35,1
HCPCS,J07030,"Inj, cefepime hcl (b braun)",,,5.35,5.35,1
HCPCS,J0706,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,24.0,15.6,3.18,24.0,23
HCPCS,J0706,Caffeine citrate injection,,,1.25,1.25,1
HCPCS,J07060,Caffeine citrate injection,,,1.25,1.25,1
HCPCS,J0710,Cephapirin sodium injection,,,1.41,3.59,6
HCPCS,J0712,Ceftaroline fosamil inj,,,4.58,4.58,1
HCPCS,J0712,TEFLARO 400 MG INTRAVENOUS SOLUTION,926.85,602.45,3.47,926.85,47
HCPCS,J0712,TEFLARO 600 MG INTRAVENOUS SOLUTION,926.85,602.45,3.47,926.85,47
HCPCS,J07120,Ceftaroline fosamil inj,,,4.58,4.58,1
HCPCS,J0713,CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,16.2,10.53,1.49,16.2,31
HCPCS,J0713,CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,36.0,23.4,1.49,36.0,31
HCPCS,J0713,"INJECTION, CEFTAZIDIME, PER 500 MG",23.0,14.95,1.47,23.0,14
HCPCS,J0713,Inj ceftazidime per 500 mg,,,1.59,1.59,1
HCPCS,J0713,TAZICEF 1 GRAM SOLUTION FOR INJECTION,15.36,9.98,1.49,15.36,31
HCPCS,J0713,TAZICEF 2 GRAM SOLUTION FOR INJECTION,34.38,22.35,1.49,34.38,31
HCPCS,J0713,TAZICEF 6 GRAM SOLUTION FOR INJECTION,110.04,71.53,1.49,110.04,31
HCPCS,J07130,Inj ceftazidime per 500 mg,,,1.59,1.59,1
HCPCS,J0714,AVYCAZ 2.5 GRAM INTRAVENOUS SOLUTION,1495.32,971.96,85.89,1495.32,94
HCPCS,J0714,Ceftazidime and avibactam,,,113.09,113.09,1
HCPCS,J07140,Ceftazidime and avibactam,,,113.09,113.09,1
HCPCS,J0715,Ceftizoxime sodium / 500 mg,,,4.92,12.49,6
HCPCS,J0716,Centruroides immune f(ab),,,1051.33,13799.35,27
HCPCS,J07160,Centruroides immune f(ab),,,5439.16,5439.16,1
HCPCS,J0717,CERTOLIZUMAB PEGOL INJ 1MG,25.0,16.25,3.87,25.0,14
HCPCS,J0717,CIMZIA 400 MG/2 ML (200 MG/ML X 2) SUBCUTANEOUS SYRINGE KIT,21597.96,14038.67,3.86,21597.96,53
HCPCS,J0717,CIMZIA POWDER FOR RECON 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,28797.28,18718.23,3.86,28797.28,53
HCPCS,J0717,Certolizumab pegol inj 1mg,,,4.18,4.18,1
HCPCS,J07170,Certolizumab pegol inj 1mg,,,4.18,4.18,1
HCPCS,J0720,CHLORAMPHENICOL SODIUM SUCCINATE 1 GRAM INTRAVENOUS SOLUTION,175.14,113.84,43.79,175.14,26
HCPCS,J0720,Chloramphenicol sodium injec,,,50.44,50.44,1
HCPCS,J07200,Chloramphenicol sodium injec,,,50.44,50.44,1
HCPCS,J0725,APL CHORIONIC GONADOTROPIN 1000 U,10.0,6.5,5.0,17.42,14
HCPCS,J0725,APRESOLINE UP TO 20 MG,13.0,8.45,6.5,17.42,14
HCPCS,J0725,CHORIONIC GONADOTROPIN HUMAN 10000 UNIT IM POWDER FOR SOLUTION,1124.1,730.67,20.96,1124.1,31
HCPCS,J0725,CHORIONIC GONADOTROPIN/1000U,15.0,9.75,7.5,17.42,14
HCPCS,J0725,Chorionic gonadotropin/1000u,,,16.63,16.63,1
HCPCS,J0725,NOVAREL 5000 UNIT INTRAMUSCULAR SOLUTION,607.65,394.97,20.96,607.65,31
HCPCS,J07250,Chorionic gonadotropin/1000u,,,16.63,16.63,1
HCPCS,J0735,CLONIDINE (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,9.0,5.85,1.21,47.68,124
HCPCS,J0735,CLONIDINE (PF) 5000 MCG/10 ML EPIDURAL SOLUTION,63.0,40.95,10.58,63.0,31
HCPCS,J0735,"CLONIDINE HCL,1 MG",209.0,135.85,17.23,209.0,14
HCPCS,J0735,Clonidine hydrochloride,,,18.61,18.61,1
HCPCS,J0735,DURACLON (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,11.28,7.33,1.9,47.68,31
HCPCS,J07350,Clonidine hydrochloride,,,18.61,18.61,1
HCPCS,J0736,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.78,0.51,0.13,5.29,31
HCPCS,J0736,"Inj, clindamycin phosp 300mg",,,2.06,2.06,1
HCPCS,J07360,"Inj, clindamycin phosp 300mg",,,2.06,2.06,1
HCPCS,J0737,CLINDAMYCIN 300 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.5549999999999999,0.36,0.09,6.49,62
HCPCS,J0737,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.93,0.6,0.16,6.49,31
HCPCS,J0737,"Inj, clindamycin (baxter)",,,2.54,2.54,1
HCPCS,J07370,"Inj, clindamycin (baxter)",,,2.54,2.54,1
HCPCS,J0738,"Hiv prep, inj, lenacapavir",,,17.42,17.42,1
HCPCS,J0738,YEZTUGO 309 MG/ML SUBCUTANEOUS SOLUTION,16930.8,11005.02,16.13,16930.8,45
HCPCS,J07380,"Hiv prep, inj, lenacapavir",,,17.42,17.42,1
HCPCS,J0739,APRETUDE 600 MG/3 ML (200 MG/ML) IM SUSPENSION EXTENDED RELEASE,4677.285,3040.2349999999997,6.81,5074.8,101
HCPCS,J0739,"Hiv prep, inj, cabotegravir",,,7.72,7.72,1
HCPCS,J07390,"Hiv prep, inj, cabotegravir",,,7.72,7.72,1
HCPCS,J0740,CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,711.87,462.72,184.37,1451.46,47
HCPCS,J0740,"CIDOFOVIR,375 MG",3249.0,2111.85,524.48,3249.0,14
HCPCS,J0740,Cidofovir injection,,,566.44,566.44,1
HCPCS,J07400,Cidofovir injection,,,566.44,566.44,1
HCPCS,J0741,CABENUVA 400 MG/2 ML-600 MG/2 ML IM SUSPENSION EXTENDED RELEASE,4279.77,2781.85,20.36,4279.77,50
HCPCS,J0741,CABENUVA 600 MG/3 ML-900 MG/3 ML IM SUSPENSION EXTENDED RELEASE,4279.77,2781.85,20.36,4279.77,50
HCPCS,J0741,"Inj, cabote rilpivir 2mg 3mg",,,26.09,26.09,1
HCPCS,J07410,"Inj, cabote rilpivir 2mg 3mg",,,26.09,26.09,1
HCPCS,J0742,Inj imip 4 cilas 4 releb 2mg,,,2.81,2.81,1
HCPCS,J0742,RECARBRIO 1.25 GRAM INTRAVENOUS SOLUTION,1138.11,739.77,2.2,1138.11,88
HCPCS,J07420,Inj imip 4 cilas 4 releb 2mg,,,2.81,2.81,1
HCPCS,J0743,CILASTATIN SODIUM INJECTION,80.0,52.0,7.1,80.0,14
HCPCS,J0743,Cilastatin sodium injection,,,7.67,7.67,1
HCPCS,J0743,IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,61.53,39.99,6.8,61.53,31
HCPCS,J0743,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,74.16,48.205,6.78,107.94,62
HCPCS,J0743,PRIMAXIN 500 MG INTRAVENOUS SOLUTION,117.54,76.4,6.8,117.54,31
HCPCS,J07430,Cilastatin sodium injection,,,7.67,7.67,1
HCPCS,J0744,CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.12,0.08,0.02,5.53,31
HCPCS,J0744,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.09,0.06,0.01,5.53,62
HCPCS,J0744,CIPROFLOXACIN IV,29.0,18.85,2.0,29.0,14
HCPCS,J0744,Ciprofloxacin iv,,,2.16,2.16,1
HCPCS,J07440,Ciprofloxacin iv,,,2.16,2.16,1
HCPCS,J0745,INJ CODEINE PHOSPHATE /30 MG,15.0,9.75,1.52,15.0,13
HCPCS,J0745,Inj codeine phosphate /30 mg,,,1.0,1.0,1
HCPCS,J07450,Inj codeine phosphate /30 mg,,,1.0,1.0,1
HCPCS,J0750,"Hiv prep, ftc/tdf 200/300mg",,,1.34,10.52,28
HCPCS,J07500,"Hiv prep, ftc/tdf 200/300mg",,,1.45,1.45,1
HCPCS,J0751,"Hiv prep, ftc/taf 200/25mg",,,71.32,197.39,28
HCPCS,J07510,"Hiv prep, ftc/taf 200/25mg",,,77.04,77.04,1
HCPCS,J0752,"Hiv prep, oral lenacapavir",,,673.0,673.0,1
HCPCS,J0752,YEZTUGO 300 MG TABLET,1410.9,917.09,273.36,1724.5,39
HCPCS,J07520,"Hiv prep, oral lenacapavir",,,673.0,673.0,1
HCPCS,J0759,CLEVIPREX 25 MG/50 ML INTRAVENOUS EMULSION,6.54,4.25,1.64,78.3,32
HCPCS,J0759,CLEVIPREX 50 MG/100 ML INTRAVENOUS EMULSION,6.54,4.25,1.64,78.3,32
HCPCS,J0759,"Inj, clevidipine, 1 mg",,,3.65,3.65,1
HCPCS,J07590,"Inj, clevidipine, 1 mg",,,3.65,3.65,1
HCPCS,J0770,COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,100.785,65.50999999999999,11.56,100.8,62
HCPCS,J0770,Colistimethate sodium inj,,,13.05,13.05,1
HCPCS,J07700,Colistimethate sodium inj,,,13.05,13.05,1
HCPCS,J0775,"COLLAGENASE, CLOST HIST INJ",120.0,78.0,60.0,120.0,14
HCPCS,J0775,"Collagenase, clost hist inj",,,81.81,81.81,1
HCPCS,J0775,XIAFLEX 0.9 MG SOLUTION FOR INJECTION,26586.84,17281.45,62.07,26586.84,53
HCPCS,J07750,"Collagenase, clost hist inj",,,81.81,81.81,1
HCPCS,J0780,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,13.05,8.48,1.6,16.2,93
HCPCS,J0780,PROCHLORPERAZINE INJECTION,20.0,13.0,2.52,20.0,14
HCPCS,J0780,Prochlorperazine injection,,,2.72,2.72,1
HCPCS,J07800,Prochlorperazine injection,,,2.72,2.72,1
HCPCS,J0791,ADAKVEO 10 MG/ML INTRAVENOUS SOLUTION,874.32,568.31,114.62,874.32,47
HCPCS,J0791,Inj crizanlizumab-tmca 5mg,,,139.96,139.96,1
HCPCS,J07910,Inj crizanlizumab-tmca 5mg,,,139.96,139.96,1
HCPCS,J0795,Corticorelin ovine triflutal,,,9.46,383.26,12
HCPCS,J0800,CORTICOTROPIN INJECTION,52.0,33.8,26.0,52.0,12
HCPCS,J0800,Corticotropin injection,,,2562.41,3236.72,6
HCPCS,J0801,ACTHAR 80 UNIT/ML INJECTION GEL,32618.88,21202.27,2562.41,32618.88,46
HCPCS,J0801,ACTHAR H.P. 80 UNIT/ML INJECTION GEL,21514.5,13984.43,2562.41,21514.5,46
HCPCS,J0801,Inj. acthar gel to 40 units,,,4506.33,4506.33,1
HCPCS,J08010,Inj. acthar gel to 40 units,,,4506.33,4506.33,1
HCPCS,J0802,"Inj. (ani), up to 40 units",,,2562.41,9829.09,22
HCPCS,J08020,"Inj. (ani), up to 40 units",,,3835.88,3835.88,1
HCPCS,J0834,CORTROSYN 0.25 MG SOLUTION FOR INJECTION,383.7,249.41,25.73,383.7,31
HCPCS,J0834,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,303.07500000000005,197.0,25.73,317.43,62
HCPCS,J0834,COSYNTROPIN CORTROSYN INJ,193.0,125.45,20.65,193.0,14
HCPCS,J0834,"Inj., cosyntropin, 0.25 mg",,,22.3,22.3,1
HCPCS,J08340,"Inj., cosyntropin, 0.25 mg",,,22.3,22.3,1
HCPCS,J0840,CROFAB 1 GRAM SOLUTION FOR INJECTION,11512.8,7483.32,1762.35,11512.8,53
HCPCS,J0840,Crotalidae poly immune fab,,,1972.64,1972.64,1
HCPCS,J08400,Crotalidae poly immune fab,,,1972.64,1972.64,1
HCPCS,J0841,Inj crotalidae im f(ab')2 eq,,,942.56,13629.88,35
HCPCS,J08410,Inj crotalidae im f(ab')2 eq,,,5319.17,5319.17,1
HCPCS,J0850,CYTOGAM 50 MG/ML INTRAVENOUS SOLUTION,130.29,84.69,33.75,5004.36,47
HCPCS,J0850,Cytomegalovirus imm iv /vial,,,1953.0,1953.0,1
HCPCS,J0850,"INJECTION, CYTOMEGALOVIRUS IMMUNE GLOBULIN INTRAVENOUS (HUMAN),",4997.0,3248.05,1808.33,4997.0,14
HCPCS,J08500,Cytomegalovirus imm iv /vial,,,1953.0,1953.0,1
HCPCS,J0870,"Injection, imetelstat, 1 mg",,,62.96,62.96,1
HCPCS,J0870,RYTELO 188 MG INTRAVENOUS SOLUTION,49966.0,32477.9,54.15,49966.0,52
HCPCS,J0870,RYTELO 47 MG INTRAVENOUS SOLUTION,12491.52,8119.49,54.15,12491.52,52
HCPCS,J08700,"Injection, imetelstat, 1 mg",,,62.96,62.96,1
HCPCS,J0872,Daptomycin (xellia) unrefrig,,,0.04,0.16,24
HCPCS,J08720,Daptomycin (xellia) unrefrig,,,0.06,0.06,1
HCPCS,J0873,DAPTOMYCIN 350 MG INTRAVENOUS SOLUTION,86.22,56.04,0.03,86.22,38
HCPCS,J0873,Inj daptomycin (xellia),,,0.03,0.03,1
HCPCS,J08730,Inj daptomycin (xellia),,,0.03,0.03,1
HCPCS,J0874,DAPTOMYCIN 1000 MG/100 ML IN 0.9 % SODIUM CHLOR INTRAVENOUS PIGGYBACK,2.37,1.54,0.06,2.37,31
HCPCS,J0874,DAPTOMYCIN 350 MG/50 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,2.37,1.54,0.06,2.37,31
HCPCS,J0874,DAPTOMYCIN 500 MG/50 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,2.82,1.83,0.06,2.82,31
HCPCS,J0874,DAPTOMYCIN 700 MG/100 ML IN 0.9 % SODIUM CHLOR INTRAVENOUS PIGGYBACK,2.04,1.33,0.06,2.04,31
HCPCS,J0874,"Inj, daptomycin (baxter)",,,0.06,0.06,1
HCPCS,J08740,"Inj, daptomycin (baxter)",,,0.06,0.06,1
HCPCS,J0875,DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,6404.4,4162.86,13.61,6404.4,53
HCPCS,J0875,"Injection, dalbavancin",,,16.84,16.84,1
HCPCS,J08750,"Injection, dalbavancin",,,16.84,16.84,1
HCPCS,J0877,DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,62.1,40.37,0.06,62.1,31
HCPCS,J0877,"Inj, daptomycin (hospira)",,,0.06,0.06,1
HCPCS,J08770,"Inj, daptomycin (hospira)",,,0.06,0.06,1
HCPCS,J0878,DAPTOMYCIN INJECTION,17.0,11.05,0.03,17.0,14
HCPCS,J0878,Daptomycin injection,,,0.03,0.09,12
HCPCS,J08780,Daptomycin injection,,,0.03,0.03,1
HCPCS,J0879,"Difelikefalin, esrd on dialy",,,0.15,123.65,23
HCPCS,J08790,"Difelikefalin, esrd on dialy",,,0.24,0.24,1
HCPCS,J0881,ARANESP 100 MCG/0.5 ML (IN POLYSORBATE) INJECTION SYRINGE,5572.8,3622.32,2.61,5572.8,104
HCPCS,J0881,ARANESP 100 MCG/ML (IN POLYSORBATE) INJECTION,2786.4,1811.16,2.61,2786.4,49
HCPCS,J0881,ARANESP 150 MCG/0.3 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.61,13932.0,104
HCPCS,J0881,ARANESP 200 MCG/0.4 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.61,13932.0,52
HCPCS,J0881,ARANESP 200 MCG/ML (IN POLYSORBATE) INJECTION,5572.8,3622.32,2.61,5572.8,52
HCPCS,J0881,ARANESP 25 MCG/0.42 ML (IN POLYSORBATE) INJECTION SYRINGE,1658.58,1078.08,2.61,1658.58,92
HCPCS,J0881,ARANESP 25 MCG/ML (IN POLYSORBATE) INJECTION,696.6,452.79,2.61,696.6,46
HCPCS,J0881,ARANESP 300 MCG/0.6 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.61,13932.0,52
HCPCS,J0881,ARANESP 40 MCG/0.4 ML (IN POLYSORBATE) INJECTION SYRINGE,2786.4,1811.16,2.61,2786.4,98
HCPCS,J0881,ARANESP 40 MCG/ML (IN POLYSORBATE) INJECTION,1114.56,724.46,2.61,1114.56,46
HCPCS,J0881,ARANESP 500 MCG/ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.61,13932.0,52
HCPCS,J0881,ARANESP 60 MCG/0.3 ML (IN POLYSORBATE) INJECTION SYRINGE,5572.8,3622.32,2.61,5572.8,104
HCPCS,J0881,ARANESP 60 MCG/ML (IN POLYSORBATE) INJECTION,1671.84,1086.7,2.61,1671.84,46
HCPCS,J0881,"DARBEPOETIN ALFA, NON-ESRD",9.0,5.85,3.02,9.0,14
HCPCS,J0881,"Darbepoetin alfa, non-esrd",,,3.26,3.26,1
HCPCS,J08810,"Darbepoetin alfa, non-esrd",,,3.26,3.26,1
HCPCS,J0882,"DARBEPOETIN ALFA, ESRD USE",9.0,5.85,3.02,9.0,14
HCPCS,J0882,"Darbepoetin alfa, esrd use",,,2.61,93.47,35
HCPCS,J08820,"Darbepoetin alfa, esrd use",,,3.26,3.26,1
HCPCS,J0883,ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,14.25,9.26,0.6,78.3,46
HCPCS,J0883,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,734.4,477.36,0.6,1702.29,138
HCPCS,J0883,Argatroban nonesrd use 1mg,,,0.66,0.66,1
HCPCS,J08830,Argatroban nonesrd use 1mg,,,0.66,0.66,1
HCPCS,J0884,Argatroban esrd dialysis 1mg,,,0.66,78.3,17
HCPCS,J08840,Argatroban esrd dialysis 1mg,,,0.66,0.66,1
HCPCS,J0885,"EPOETIN ALFA, NON-ESRD",56.0,36.4,7.74,56.0,14
HCPCS,J0885,EPOGEN 10000 UNIT/ML INJECTION SOLUTION,596.88,387.97,7.45,596.88,92
HCPCS,J0885,EPOGEN 2000 UNIT/ML INJECTION SOLUTION,119.37,77.59,7.45,119.37,92
HCPCS,J0885,EPOGEN 20000 UNIT/2 ML INJECTION SOLUTION,596.88,387.97,7.45,596.88,46
HCPCS,J0885,EPOGEN 20000 UNIT/ML INJECTION SOLUTION,1193.76,775.94,7.45,1193.76,92
HCPCS,J0885,EPOGEN 3000 UNIT/ML INJECTION SOLUTION,179.07,116.4,7.45,179.07,92
HCPCS,J0885,EPOGEN 4000 UNIT/ML INJECTION SOLUTION,238.74,155.18,7.45,238.74,92
HCPCS,J0885,"Epoetin alfa, non-esrd",,,8.36,8.36,1
HCPCS,J0885,PROCRIT 10000 UNIT/ML INJECTION SOLUTION,962.1,625.37,7.45,962.1,46
HCPCS,J0885,PROCRIT 2000 UNIT/ML INJECTION SOLUTION,192.45,125.09,7.45,192.45,46
HCPCS,J0885,PROCRIT 20000 UNIT/2 ML INJECTION SOLUTION,962.1,625.37,7.45,962.1,46
HCPCS,J0885,PROCRIT 20000 UNIT/ML INJECTION SOLUTION,1924.2,1250.73,7.45,1924.2,92
HCPCS,J0885,PROCRIT 3000 UNIT/ML INJECTION SOLUTION,288.66,187.63,7.45,288.66,46
HCPCS,J0885,PROCRIT 4000 UNIT/ML INJECTION SOLUTION,384.84,250.15,7.45,384.84,92
HCPCS,J0885,PROCRIT 40000 UNIT/ML INJECTION SOLUTION,3848.4,2501.46,7.45,3848.4,98
HCPCS,J08850,"Epoetin alfa, non-esrd",,,8.36,8.36,1
HCPCS,J0887,Epoetin beta esrd use,,,1.29,3.37,12
HCPCS,J08870,Epoetin beta esrd use,,,1.32,1.32,1
HCPCS,J0888,Epoetin beta non esrd,,,1.16,3.37,25
HCPCS,J08880,Epoetin beta non esrd,,,1.32,1.32,1
HCPCS,J0889,Daprodustat oral 1mg esrd,,,4.05,93.47,12
HCPCS,J0890,Peginesatide injection,,,12.64,93.47,9
HCPCS,J0891,Argatroban nonesrd (accord),,,1.63,78.3,28
HCPCS,J08910,Argatroban nonesrd (accord),,,4.1,4.1,1
HCPCS,J0892,Argatroban dialysis (accord),,,1.63,78.3,11
HCPCS,J08920,Argatroban dialysis (accord),,,4.1,4.1,1
HCPCS,J0893,DECITABINE 50 MG INTRAVENOUS SOLUTION,480.0,312.0,0.84,480.0,35
HCPCS,J0893,"Inj, decitabine (sun pharma)",,,0.84,0.84,1
HCPCS,J08930,"Inj, decitabine (sun pharma)",,,0.84,0.84,1
HCPCS,J0894,DECITABINE 50 MG,6806.0,4423.9,0.65,6806.0,14
HCPCS,J0894,DECITABINE 50 MG INTRAVENOUS SOLUTION,2304.0,1497.6,0.7,2304.0,36
HCPCS,J0894,DECITABINE PER 1 MG,113.0,73.45,0.65,113.0,14
HCPCS,J0894,Decitabine injection,,,0.7,0.7,1
HCPCS,J08940,Decitabine injection,,,0.7,0.7,1
HCPCS,J0895,DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,147.465,95.85499999999999,8.12,148.32,62
HCPCS,J0895,DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,53.13,34.53,8.12,53.13,31
HCPCS,J0895,DEFEROXAMINE MESYLATE INJ,50.0,32.5,8.47,50.0,14
HCPCS,J0895,DESFERAL 500 MG SOLUTION FOR INJECTION,124.98,81.24,8.12,124.98,31
HCPCS,J0895,Deferoxamine mesylate inj,,,9.15,9.15,1
HCPCS,J08950,Deferoxamine mesylate inj,,,9.15,9.15,1
HCPCS,J0896,Inj luspatercept-aamt 0.25mg,,,46.19,46.19,1
HCPCS,J0896,REBLOZYL 25 MG SUBCUTANEOUS SOLUTION,19743.08,12833.0,35.98,19743.08,53
HCPCS,J0896,REBLOZYL 75 MG SUBCUTANEOUS SOLUTION,59228.96,38498.82,35.98,59228.96,53
HCPCS,J08960,Inj luspatercept-aamt 0.25mg,,,46.19,46.19,1
HCPCS,J0897,DENOSUMAB INJECTION,107.2,69.68,29.46,107.2,14
HCPCS,J0897,Denosumab injection,,,31.82,31.82,1
HCPCS,J0897,PROLIA 60 MG/ML SUBCUTANEOUS SYRINGE,6751.56,4388.51,22.67,6751.56,106
HCPCS,J0897,XGEVA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,7305.33,4748.46,22.67,7305.33,106
HCPCS,J08970,Denosumab injection,,,31.82,31.82,1
HCPCS,J0898,Argatroban nonesrd (auromed),,,1.49,78.3,30
HCPCS,J08980,Argatroban nonesrd (auromed),,,1.57,1.57,1
HCPCS,J0899,"Argatroban dialysis, auromed",,,1.57,78.3,17
HCPCS,J08990,"Argatroban dialysis, auromed",,,1.57,1.57,1
HCPCS,J0901,Vadadustat oral 1mg for esrd,,,0.15,0.38,14
HCPCS,J09010,Vadadustat oral 1mg for esrd,,,0.15,0.15,1
HCPCS,J0911,Inst tauro 1.35mg/hep 100u,,,5.97,93.47,27
HCPCS,J09110,Inst tauro 1.35mg/hep 100u,,,8.64,8.64,1
HCPCS,J0945,Brompheniramine maleate inj,,,0.8,2.03,7
HCPCS,J09450,Brompheniramine maleate inj,,,0.8,0.8,1
HCPCS,J1000,DEPO-ESTRADIOL 5 MG/ML INTRAMUSCULAR OIL,185.73,120.72,31.2,185.73,31
HCPCS,J1000,Depo-estradiol cypionate inj,,,55.97,55.97,1
HCPCS,J10000,Depo-estradiol cypionate inj,,,55.97,55.97,1
HCPCS,J1010,DEPO-MEDROL 20 MG/ML SUSPENSION FOR INJECTION,25.59,16.63,0.12,25.59,38
HCPCS,J1010,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,35.505,23.08,0.12,40.92,266
HCPCS,J1010,DEPO-MEDROL 80 MG/ML SUSPENSION FOR INJECTION,71.025,46.17,0.12,71.07,152
HCPCS,J1010,INJ METHYLPRED ACETATE 1 MG,1.29,0.84,0.12,1.29,38
HCPCS,J1010,"Inj, methylpred acetate 1 mg",,,0.13,0.13,1
HCPCS,J1010,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,34.71,22.56,0.12,34.71,38
HCPCS,J1010,METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION,58.74,38.18,0.12,58.74,38
HCPCS,J10100,"Inj, methylpred acetate 1 mg",,,0.13,0.13,1
HCPCS,J1020,"DEPO-MEDROL, 20 MG INJ",8.0,5.2,1.34,8.0,23
HCPCS,J1020,METHYLPREDNISOLONE 20 MG INJ,9.0,5.85,4.5,9.0,12
HCPCS,J1040,METHYLPREDNISOLONE 80 MG INJ,39.0,25.35,19.5,39.0,12
HCPCS,J1050,DEPO-PROVERA 150 MG/ML INTRAMUSCULAR SUSPENSION,189.48,123.16,1.42,189.48,23
HCPCS,J1050,DEPO-SUBQ PROVERA 104 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,291.48,189.46,1.42,291.48,23
HCPCS,J1050,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,293.25,190.61,1.42,293.55,115
HCPCS,J1050,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SYRINGE,171.0,111.15,1.42,252.0,46
HCPCS,J1050,Medroxyprogesterone acetate,,,0.56,0.56,1
HCPCS,J10500,Medroxyprogesterone acetate,,,0.56,0.56,1
HCPCS,J1071,DEPO-TESTOSTERONE 100 MG/ML INTRAMUSCULAR OIL,31.47,20.46,0.01,31.47,31
HCPCS,J1071,DEPO-TESTOSTERONE 200 MG/ML INTRAMUSCULAR OIL,67.69500000000001,44.0,0.01,85.65,62
HCPCS,J1071,Inj testosterone cypionate,,,0.03,0.03,1
HCPCS,J1071,TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,30.54,19.85,0.01,30.54,31
HCPCS,J1071,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,54.0,35.1,0.01,69.3,93
HCPCS,J10710,Inj testosterone cypionate,,,0.03,0.03,1
HCPCS,J1072,"Inj, testosterone, azmiro",,,1.32,3.67,15
HCPCS,J10720,"Inj, testosterone, azmiro",,,1.44,1.44,1
HCPCS,J1073,TESTOPEL 75 MG IMPLANT PELLET,259.64,168.77,64.91,383.26,64
HCPCS,J1073,Testosterone pellet 75 mg,,,109.0,109.0,1
HCPCS,J10730,Testosterone pellet 75 mg,,,109.0,109.0,1
HCPCS,J1094,Inj dexamethasone acetate,,,0.29,0.29,1
HCPCS,J10940,Inj dexamethasone acetate,,,0.29,0.29,1
HCPCS,J1095,"Injection, dexamethasone 9%",,,1.19,345.3,10
HCPCS,J10950,"Injection, dexamethasone 9%",,,1.19,1.19,1
HCPCS,J1096,DEXTENZA 0.4 MG INTRACANALICULAR INSERT,1536.0,998.4,97.89,1536.0,92
HCPCS,J1096,Dexametha opth insert 0.1 mg,,,106.55,106.55,1
HCPCS,J10960,Dexametha opth insert 0.1 mg,,,106.55,106.55,1
HCPCS,J1097,Phenylep ketorolac opth soln,,,61.99,310.39,24
HCPCS,J10970,Phenylep ketorolac opth soln,,,122.34,122.34,1
HCPCS,J1100,DEXAMETHASONE 1 MG INJ,6.0,3.9,0.11,6.0,14
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,22.935000000000002,14.91,0.11,27.0,62
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SYRINGE,20.82,13.53,0.11,20.82,31
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,5.16,3.35,0.11,5.58,124
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,4.23,2.75,0.11,10.38,186
HCPCS,J1100,Dexamethasone sodium phos,,,0.12,0.12,1
HCPCS,J11000,Dexamethasone sodium phos,,,0.12,0.12,1
HCPCS,J1105,"Dexmedetomidine film, 1 mcg",,,0.78,1.68,13
HCPCS,J1110,DEHYDROERGOTAMINE INJECTION,51.0,33.15,25.5,64.57,14
HCPCS,J1110,DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,378.0,245.7,33.41,378.0,62
HCPCS,J1110,Inj dihydroergotamine mesylt,,,61.65,61.65,1
HCPCS,J11100,Inj dihydroergotamine mesylt,,,61.65,61.65,1
HCPCS,J1120,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,158.25,102.86,23.61,158.25,31
HCPCS,J1120,Acetazolamid sodium injectio,,,27.64,27.64,1
HCPCS,J11200,Acetazolamid sodium injectio,,,27.64,27.64,1
HCPCS,J1130,Inj diclofenac sodium 0.5mg,,,0.22,0.55,4
HCPCS,J11300,Inj diclofenac sodium 0.5mg,,,0.22,0.22,1
HCPCS,J1160,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,10.56,6.865,1.66,26.5,93
HCPCS,J1160,DIGOXIN INJECTION,15.0,9.75,7.5,15.0,14
HCPCS,J1160,Digoxin injection,,,10.34,10.34,1
HCPCS,J1160,LANOXIN PEDIATRIC 100 MCG/ML (0.1 MG/ML) INJECTION SOLUTION,515.61,335.15,8.16,515.61,31
HCPCS,J11600,Digoxin injection,,,10.34,10.34,1
HCPCS,J1162,DIGIFAB 40 MG INTRAVENOUS SOLUTION,17906.4,11639.16,2697.73,17906.4,53
HCPCS,J1162,Digoxin immune fab (ovine),,,5580.35,5580.35,1
HCPCS,J11620,Digoxin immune fab (ovine),,,5580.35,5580.35,1
HCPCS,J1163,DILTIAZEM 100 MG INTRAVENOUS SOLUTION,41.07,26.7,0.08,41.07,60
HCPCS,J1163,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,1.4249999999999998,0.9299999999999999,0.08,2.46,240
HCPCS,J1163,"Inj, diltiazem hcl, 0.5 mg",,,0.03,0.03,1
HCPCS,J11630,"Inj, diltiazem hcl, 0.5 mg",,,0.03,0.03,1
HCPCS,J1165,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,1.77,1.155,0.2,2.49,155
HCPCS,J1165,Phenytoin sodium injection,,,0.65,0.65,1
HCPCS,J11650,Phenytoin sodium injection,,,0.65,0.65,1
HCPCS,J1170,Hydromorphone injection,,,4.28,4.28,1
HCPCS,J1171,DILAUDID (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,29.88,19.42,0.09,29.88,74
HCPCS,J1171,DILAUDID (PF) 1 MG/ML INJECTION SYRINGE,14.94,9.71,0.09,14.94,37
HCPCS,J1171,HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLUTION,15.54,10.1,0.09,15.54,37
HCPCS,J1171,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,13.44,8.74,0.09,13.44,37
HCPCS,J1171,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,17.04,11.075,0.09,281.01,148
HCPCS,J1171,HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,10.8,7.02,0.09,10.8,37
HCPCS,J1171,HYDROMORPHONE (PF) 4 MG/ML INJECTION SOLUTION,16.14,10.49,0.09,16.14,37
HCPCS,J1171,HYDROMORPHONE 0.25 MG/0.5 ML INJECTION SYRINGE,115.2,74.88,0.09,115.2,37
HCPCS,J1171,HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRINGE,108.0,70.2,0.09,108.0,37
HCPCS,J1171,HYDROMORPHONE 1 MG/ML INJECTION SYRINGE,41.400000000000006,26.909999999999997,0.09,43.2,111
HCPCS,J1171,HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,38.31,24.905,0.09,72.75,74
HCPCS,J1171,HYDROMORPHONE 2 MG/ML INJECTION SYRINGE,57.6,37.44,0.09,57.6,74
HCPCS,J1171,HYDROMORPHONE 4 MG/ML INJECTION SYRINGE,54.0,35.1,0.09,54.0,37
HCPCS,J1171,"Inj, hydromorphone, 0.1 mg",,,0.15,0.15,1
HCPCS,J11710,"Inj, hydromorphone, 0.1 mg",,,0.15,0.15,1
HCPCS,J1180,Dyphylline injection,,,8.2,20.8,4
HCPCS,J11800,Dyphylline injection,,,8.2,8.2,1
HCPCS,J1190,DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,987.33,641.76,58.01,987.33,46
HCPCS,J1190,DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,720.0,468.0,58.01,720.0,46
HCPCS,J1190,DEXRAZOXANE HCL INJECTION 250 MG,642.0,417.3,58.01,642.0,14
HCPCS,J1190,Dexrazoxane hcl injection,,,62.65,62.65,1
HCPCS,J11900,Dexrazoxane hcl injection,,,62.65,62.65,1
HCPCS,J1200,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,4.23,2.75,0.49,10.83,155
HCPCS,J1200,DIPHENHYDRAMINE 50 MG/ML INJECTION SYRINGE,9.36,6.08,0.74,9.36,31
HCPCS,J1200,DIPHENHYDRAMINE HCL INJECTIO,15.0,9.75,0.71,15.0,14
HCPCS,J1200,Diphenhydramine hcl injectio,,,0.77,0.77,1
HCPCS,J12000,Diphenhydramine hcl injectio,,,0.77,0.77,1
HCPCS,J1201,Inj. cetirizine hcl 0.5mg,,,13.47,47.29,29
HCPCS,J12010,Inj. cetirizine hcl 0.5mg,,,18.46,18.46,1
HCPCS,J1202,Miglustat oral 65 mg,,,35.2,35.2,1
HCPCS,J1202,OPFOLDA 65 MG CAPSULE,85.2,55.38,14.31,89.3,29
HCPCS,J12020,Miglustat oral 65 mg,,,35.2,35.2,1
HCPCS,J1203,"Inj, cipaglucosidase, 5 mg",,,98.5,98.5,1
HCPCS,J1203,POMBILITI 105 MG INTRAVENOUS SOLUTION,7052.4,4584.06,88.06,12697.64,52
HCPCS,J12030,"Inj, cipaglucosidase, 5 mg",,,98.5,98.5,1
HCPCS,J1205,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,375.645,244.17,19.16,1071.72,124
HCPCS,J1205,Chlorothiazide sodium inj,,,62.78,62.78,1
HCPCS,J12050,Chlorothiazide sodium inj,,,62.78,62.78,1
HCPCS,J1212,DIMETHYL SULFOXIDE 50% 50 ML,157.0,102.05,78.5,847.53,14
HCPCS,J1212,Dimethyl sulfoxide 50% 50 ml,,,809.17,809.17,1
HCPCS,J1212,RIMSO-50  50 % INTRAVESICAL SOLUTION,52.53,34.14,13.61,2073.41,47
HCPCS,J12120,Dimethyl sulfoxide 50% 50 ml,,,809.17,809.17,1
HCPCS,J1230,METHADONE 10 MG/ML INJECTION SOLUTION,76.95,50.02,12.93,76.95,31
HCPCS,J1230,Methadone injection,,,19.12,19.12,1
HCPCS,J12300,Methadone injection,,,19.12,19.12,1
HCPCS,J1240,DIMENHYDRINATE 50 MG/ML INJECTION SOLUTION,47.31,30.75,1.75,47.31,31
HCPCS,J1240,Dimenhydrinate injection,,,0.99,0.99,1
HCPCS,J12400,Dimenhydrinate injection,,,0.99,0.99,1
HCPCS,J1245,DIPYRIDAMOLE 5 MG/ML INTRAVENOUS SOLUTION,7.14,4.64,1.2,23.26,31
HCPCS,J1245,Dipyridamole injection,,,9.08,9.08,1
HCPCS,J12450,Dipyridamole injection,,,9.08,9.08,1
HCPCS,J1246,UNITUXIN 3.5 MG/ML INTRAVENOUS SOLUTION,20095.64,13062.17,3376.07,20095.64,26
HCPCS,J1250,DOBUTAMINE 1000 MG/250 ML(4000 MCG/ML) IN 5 % DEXTROSE IV,0.42,0.27,0.07,22.19,62
HCPCS,J1250,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,1.155,0.75,0.16,22.19,62
HCPCS,J1250,DOBUTAMINE 250 MG/250 ML (1 MG/ML) IN 5 % DEXTROSE INTRAVENOUS,0.33,0.21,0.06,22.19,62
HCPCS,J1250,DOBUTAMINE 500 MG/250 ML (2000 MCG/ML) IN 5 % DEXTROSE IV,0.57,0.37,0.1,22.19,62
HCPCS,J1250,"DOBUTAMINE HCL,PER 250 MG",37.0,24.05,8.02,37.0,14
HCPCS,J1250,DOBUTREX INJ PER 250 MG,29.0,18.85,4.87,29.0,31
HCPCS,J1250,Inj dobutamine hcl/250 mg,,,8.66,8.66,1
HCPCS,J12500,Inj dobutamine hcl/250 mg,,,8.66,8.66,1
HCPCS,J1260,Dolasetron mesylate,,,6.08,15.43,4
HCPCS,J1260,"INJECTION, DOLASETRON MESYLATE, 1 MG",44.0,28.6,6.31,44.0,14
HCPCS,J12600,Dolasetron mesylate,,,6.08,6.08,1
HCPCS,J1265,DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,3.18,2.07,0.53,3.18,31
HCPCS,J1265,DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,2.46,1.6,0.35,2.82,62
HCPCS,J1265,DOPAMINE 400 MG/250 ML (1600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,0.21,0.14,0.04,2.22,31
HCPCS,J1265,DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,2.37,1.54,0.4,2.37,31
HCPCS,J1265,DOPAMINE 800 MG/250 ML (3200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,0.315,0.20500000000000002,0.05,2.22,62
HCPCS,J1265,Dopamine injection,,,0.86,0.86,1
HCPCS,J12650,Dopamine injection,,,0.86,0.86,1
HCPCS,J1267,Doripenem injection,,,0.82,78.3,12
HCPCS,J1270,"Injection, doxercalciferol",,,0.33,0.88,12
HCPCS,J12700,"Injection, doxercalciferol",,,0.33,0.33,1
HCPCS,J1271,DOXY-100 100 MG INTRAVENOUS SOLUTION,78.585,51.08,0.19,94.8,90
HCPCS,J1271,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,60.03,39.02,0.19,60.03,30
HCPCS,J1271,Inj doxycycline hyclate 1 mg,,,0.11,0.11,1
HCPCS,J12710,Inj doxycycline hyclate 1 mg,,,0.11,0.11,1
HCPCS,J1290,Ecallantide injection,,,626.13,626.13,1
HCPCS,J1290,KALBITOR 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,20543.67,13353.39,491.06,20543.67,53
HCPCS,J12900,Ecallantide injection,,,626.13,626.13,1
HCPCS,J1299,"Inj, eculizumab, 2 mg",,,48.63,48.63,1
HCPCS,J1299,SOLIRIS 300 MG/30 ML INTRAVENOUS SOLUTION,782.76,508.79,45.02,18253.82,39
HCPCS,J12990,"Inj, eculizumab, 2 mg",,,48.63,48.63,1
HCPCS,J1300,Eculizumab injection,,,203.13,18253.82,21
HCPCS,J13000,Eculizumab injection,,,242.09,242.09,1
HCPCS,J1301,"Injection, edaravone, 1 mg",,,18.87,18.87,1
HCPCS,J1301,RADICAVA 30 MG/100 ML INTRAVENOUS SOLUTION,23.37,15.19,6.05,383.26,47
HCPCS,J13010,"Injection, edaravone, 1 mg",,,18.87,18.87,1
HCPCS,J1302,"Inj, sutimlimab-jome, 10 mg",,,15.99,3407.66,35
HCPCS,J13020,"Inj, sutimlimab-jome, 10 mg",,,20.55,20.55,1
HCPCS,J1303,"Inj., ravulizumab-cwvz 10 mg",,,242.78,242.78,1
HCPCS,J1303,ULTOMIRIS 100 MG/ML INTRAVENOUS SOLUTION,10712.6,6963.19,199.57,18253.82,106
HCPCS,J13030,"Inj., ravulizumab-cwvz 10 mg",,,242.78,242.78,1
HCPCS,J1304,Inj tofersen intrathec 1 mg,,,172.81,172.81,1
HCPCS,J1304,QALSODY 100 MG/15 ML (6.7 MG/ML) INTRATHECAL SOLUTION,3623.19,2355.07,135.75,12697.64,50
HCPCS,J13040,Inj tofersen intrathec 1 mg,,,172.81,172.81,1
HCPCS,J1305,"Inj, evinacumab-dgnb, 5mg",,,161.23,3407.66,35
HCPCS,J13050,"Inj, evinacumab-dgnb, 5mg",,,212.94,212.94,1
HCPCS,J1306,"Injection, inclisiran, 1 mg",,,13.71,13.71,1
HCPCS,J1306,LEQVIO 284 MG/1.5 ML SUBCUTANEOUS SYRINGE,8610.54,5596.85,10.91,8610.54,53
HCPCS,J13060,"Injection, inclisiran, 1 mg",,,13.71,13.71,1
HCPCS,J1307,"Inj, crovalimab-akkz, 10 mg",,,535.9,12697.64,34
HCPCS,J13070,"Inj, crovalimab-akkz, 10 mg",,,595.63,595.63,1
HCPCS,J1308,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,1.605,1.04,0.02,1.62,60
HCPCS,J1308,FAMOTIDINE (PF) 20 MG/50 ML IN 0.9 % NACL (ISO) INTRAVENOUS PIGGYBACK,0.39,0.25,0.02,0.39,30
HCPCS,J1308,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,1.605,1.04,0.02,1.62,90
HCPCS,J1308,"Inj, famotidine, 0.25 mg",,,0.01,0.01,1
HCPCS,J13080,"Inj, famotidine, 0.25 mg",,,0.01,0.01,1
HCPCS,J1320,Amitriptyline injection,,,2.28,5.78,4
HCPCS,J13200,Amitriptyline injection,,,2.28,2.28,1
HCPCS,J1322,"Elosulfase alfa, injection",,,254.9,5646.0,35
HCPCS,J13220,"Elosulfase alfa, injection",,,336.9,336.9,1
HCPCS,J1323,ELREXFIO 40 MG/ML SUBCUTANEOUS SOLUTION,37534.86,24397.66,163.51,37534.88,106
HCPCS,J1323,"Inj, elranatamab-bcmm, 1 mg",,,203.6,203.6,1
HCPCS,J13230,"Inj, elranatamab-bcmm, 1 mg",,,203.6,203.6,1
HCPCS,J1324,Enfuvirtide injection,,,0.69,1.75,7
HCPCS,J13240,Enfuvirtide injection,,,0.69,0.69,1
HCPCS,J1325,Epoprostenol injection,,,16.9,16.9,1
HCPCS,J1325,FLOLAN 0.5 MG INTRAVENOUS SOLUTION,67.29,43.74,11.3,67.29,31
HCPCS,J1325,VELETRI 0.5 MG INTRAVENOUS SOLUTION,99.48,64.66,14.08,99.48,31
HCPCS,J1325,VELETRI 1.5 MG INTRAVENOUS SOLUTION,198.93,129.3,14.08,198.93,31
HCPCS,J13250,Epoprostenol injection,,,16.9,16.9,1
HCPCS,J1326,"Inj, zolbetuximab-clzb, 2 mg",,,36.36,36.36,1
HCPCS,J1326,VYLOY 100 MG INTRAVENOUS SOLUTION,7680.0,4992.0,33.66,7680.0,45
HCPCS,J1326,VYLOY 300 MG INTRAVENOUS SOLUTION,23040.0,14976.0,33.66,23040.0,45
HCPCS,J13260,"Inj, zolbetuximab-clzb, 2 mg",,,36.36,36.36,1
HCPCS,J1327,EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,9.735,6.33,1.35,28.24,64
HCPCS,J1327,EPTIFIBATIDE 2 MG/ML INTRAVENOUS SOLUTION,56.295,36.59,3.52,56.34,64
HCPCS,J1327,Eptifibatide injection,,,10.37,10.37,1
HCPCS,J13270,Eptifibatide injection,,,10.37,10.37,1
HCPCS,J1330,Ergonovine maleate injection,,,7.51,8.14,3
HCPCS,J1335,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,144.0,93.6,10.71,144.0,62
HCPCS,J1335,ERTAPENEM INJECTION,75.0,48.75,9.16,75.0,14
HCPCS,J1335,Ertapenem injection,,,9.89,9.89,1
HCPCS,J13350,Ertapenem injection,,,9.89,9.89,1
HCPCS,J1364,ERYTHRO LACTOBIONATE /500 MG,44.0,28.6,20.16,44.0,14
HCPCS,J1364,ERYTHROCIN 500 MG INTRAVENOUS SOLUTION,507.72,330.02,38.3,711.12,62
HCPCS,J1364,ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,720.0,468.0,38.3,720.0,31
HCPCS,J1364,Erythro lactobionate /500 mg,,,21.77,21.77,1
HCPCS,J13640,Erythro lactobionate /500 mg,,,21.77,21.77,1
HCPCS,J1370,ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,125.64,81.67,0.52,125.64,23
HCPCS,J1370,"Inj, esomeprazole sod, 1 mg",,,0.21,0.21,1
HCPCS,J13700,"Inj, esomeprazole sod, 1 mg",,,0.21,0.21,1
HCPCS,J1380,DELESTROGEN 20 MG/ML INTRAMUSCULAR OIL,134.7,87.56,7.79,134.7,31
HCPCS,J1380,ESTRADIOL VALERATE 20 MG/ML INTRAMUSCULAR OIL,100.14,65.09,7.79,100.14,31
HCPCS,J1380,Estradiol valerate 10 mg inj,,,8.05,8.05,1
HCPCS,J13800,Estradiol valerate 10 mg inj,,,8.05,8.05,1
HCPCS,J1410,INJ ESTROGEN CONJUGATE 25 MG,215.0,139.75,107.5,443.16,14
HCPCS,J1410,Inj estrogen conjugate 25 mg,,,423.1,423.1,1
HCPCS,J1410,PREMARIN 25 MG SOLUTION FOR INJECTION,1393.41,905.72,97.89,1393.41,47
HCPCS,J14100,Inj estrogen conjugate 25 mg,,,423.1,423.1,1
HCPCS,J1411,"Inj, hemgenix, per tx dose",,,14450.94,7933464.0,23
HCPCS,J1412,Inj roctavian ml 2x10^13vc g,,,12007.81,31152.16,27
HCPCS,J14120,Inj roctavian ml 2x10^13vc g,,,12278.95,12278.95,1
HCPCS,J1413,Inj delandistrogene mox rokl,,,14450.94,7182982.28,23
HCPCS,J1414,"Inj, beqvez, per tx dose",,,14450.94,7786800.0,19
HCPCS,J1426,"Injection, casimersen, 10 mg",,,165.89,12697.64,17
HCPCS,J14260,"Injection, casimersen, 10 mg",,,165.89,165.89,1
HCPCS,J1427,Inj. viltolarsen,,,58.47,12697.64,10
HCPCS,J14270,Inj. viltolarsen,,,58.47,58.47,1
HCPCS,J1428,EXONDYS-51  50 MG/ML INTRAVENOUS SOLUTION,2880.0,1872.0,167.35,12697.64,35
HCPCS,J1428,"Inj, eteplirsen, 10 mg",,,165.89,165.89,1
HCPCS,J14280,"Inj, eteplirsen, 10 mg",,,165.89,165.89,1
HCPCS,J1429,Inj golodirsen 10 mg,,,165.89,12697.64,10
HCPCS,J14290,Inj golodirsen 10 mg,,,165.89,165.89,1
HCPCS,J1430,ETHAMOLIN 5 % INTRAVENOUS SOLUTION,951.48,618.46,246.43,1430.97,47
HCPCS,J1430,Ethanolamine oleate 100 mg,,,558.45,558.45,1
HCPCS,J14300,Ethanolamine oleate 100 mg,,,558.45,558.45,1
HCPCS,J1434,FOCINVEZ 150 MG/50 ML (3 MG/ML) INTRAVENOUS SOLUTION,33.93,22.05,2.63,33.93,40
HCPCS,J1434,"Inj, focinvez, 1mg",,,2.84,2.84,1
HCPCS,J14340,"Inj, focinvez, 1mg",,,2.84,2.84,1
HCPCS,J1435,Injection estrone per 1 mg,,,0.17,0.44,7
HCPCS,J14350,Injection estrone per 1 mg,,,0.17,0.17,1
HCPCS,J1436,Etidronate disodium inj,,,61.99,177.2,10
HCPCS,J14360,Etidronate disodium inj,,,69.84,69.84,1
HCPCS,J1437,Inj. fe derisomaltose 10 mg,,,24.66,24.66,1
HCPCS,J1437,MONOFERRIC 100 MG IRON/ML INTRAVENOUS SOLUTION,1314.78,854.61,17.94,1314.78,47
HCPCS,J14370,Inj. fe derisomaltose 10 mg,,,24.66,24.66,1
HCPCS,J1438,ENBREL 25 MG/0.5 ML (0.5 ML) SUBCUTANEOUS SYRINGE,7341.84,4772.2,303.41,7341.84,42
HCPCS,J1438,ENBREL 25 MG/0.5 ML SUBCUTANEOUS SOLUTION,7341.84,4772.2,303.41,7341.84,42
HCPCS,J1438,ENBREL 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,7341.84,4772.2,303.41,7341.84,42
HCPCS,J1438,ENBREL MINI 50 MG/ML (1 ML) SUBCUTANEOUS CARTRIDGE,7341.84,4772.2,303.41,7341.84,42
HCPCS,J1438,ENBREL SURECLICK 50 MG/ML (1 ML) SUBCUTANEOUS PEN INJECTOR,7341.84,4772.2,303.41,7341.84,42
HCPCS,J1438,ETANERCEPT INJECTION,673.0,437.45,336.5,1096.38,14
HCPCS,J1438,Etanercept injection,,,1057.22,1057.22,1
HCPCS,J14380,Etanercept injection,,,1057.22,1057.22,1
HCPCS,J1439,INJECTAFER 50 MG IRON/ML INTRAVENOUS SOLUTION,371.1,241.22,0.98,371.1,47
HCPCS,J1439,Inj ferric carboxymaltos 1mg,,,1.21,1.21,1
HCPCS,J14390,Inj ferric carboxymaltos 1mg,,,1.21,1.21,1
HCPCS,J1440,Fecal microbiota jslm 1 ml,,,69.8,69.8,1
HCPCS,J1440,REBYOTA 150 ML ENEMA,148.36,96.43,38.43,3407.66,94
HCPCS,J14400,Fecal microbiota jslm 1 ml,,,69.8,69.8,1
HCPCS,J1442,"INJ, FILGRASTIM G-CSF 1MCG",2.0,1.3,1.0,2.0,14
HCPCS,J1442,Inj filgrastim excl biosimil,,,1.08,1.08,1
HCPCS,J1442,NEUPOGEN 300 MCG/0.5 ML INJECTION SYRINGE,2402.6549999999997,1561.73,0.89,2402.67,141
HCPCS,J1442,NEUPOGEN 300 MCG/ML INJECTION SOLUTION,1133.4,736.71,0.89,1133.4,94
HCPCS,J1442,NEUPOGEN 480 MCG/0.8 ML INJECTION SYRINGE,2391.435,1554.43,0.89,2391.45,141
HCPCS,J1442,NEUPOGEN 480 MCG/1.6 ML INJECTION SOLUTION,1128.0,733.2,0.89,1128.0,94
HCPCS,J14420,Inj filgrastim excl biosimil,,,1.08,1.08,1
HCPCS,J1443,Inj ferric pyrophosphate cit,,,0.03,0.08,6
HCPCS,J1444,Fe pyro cit pow 0.1 mg iron,,,0.03,0.08,6
HCPCS,J1445,Inj triferic avnu 0.1mg iron,,,0.18,0.47,6
HCPCS,J1447,GRANIX 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,1798.995,1169.35,0.24,1799.01,92
HCPCS,J1447,GRANIX 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1799.49,1169.67,0.24,1799.49,46
HCPCS,J1447,Inj tbo filgrastim 1 microg,,,0.27,0.27,1
HCPCS,J14470,Inj tbo filgrastim 1 microg,,,0.27,0.27,1
HCPCS,J1448,"Injection, trilaciclib, 1mg",,,4.76,652.67,35
HCPCS,J14480,"Injection, trilaciclib, 1mg",,,5.85,5.85,1
HCPCS,J1449,Inj eflapegrastim-xnst 0.1mg,,,22.75,3236.72,35
HCPCS,J14490,Inj eflapegrastim-xnst 0.1mg,,,25.43,25.43,1
HCPCS,J1450,DIFLUCAN PER 200 MG,35.0,22.75,4.48,35.0,14
HCPCS,J1450,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,0.7350000000000001,0.48,0.11,12.38,62
HCPCS,J1450,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.315,0.20500000000000002,0.04,12.38,62
HCPCS,J1450,Fluconazole,,,4.84,4.84,1
HCPCS,J14500,Fluconazole,,,4.84,4.84,1
HCPCS,J1451,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,3600.0,2340.0,6.43,4155.87,123
HCPCS,J1451,"Fomepizole, 15 mg",,,13.1,13.1,1
HCPCS,J14510,"Fomepizole, 15 mg",,,13.1,13.1,1
HCPCS,J1452,Intraocular fomivirsen na,,,273.36,2192.0,12
HCPCS,J1453,FOSAPREPITANT INJECTION,9.0,5.85,0.11,9.0,14
HCPCS,J1453,Fosaprepitant injection,,,0.12,0.3,12
HCPCS,J14530,Fosaprepitant injection,,,0.12,0.12,1
HCPCS,J1454,"Inj fosnetupitant, palonoset",,,97.89,1513.58,35
HCPCS,J14540,"Inj fosnetupitant, palonoset",,,590.68,590.68,1
HCPCS,J1455,FOSCAVIR 24 MG/ML INTRAVENOUS SOLUTION,5.925000000000001,3.8550000000000004,0.83,108.69,86
HCPCS,J1455,Foscarnet sodium injection,,,7.25,7.25,1
HCPCS,J14550,Foscarnet sodium injection,,,7.25,7.25,1
HCPCS,J1456,FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION,234.0,152.1,0.6,234.0,41
HCPCS,J1456,"Inj, fosaprepitant (teva)",,,0.69,0.69,1
HCPCS,J14560,"Inj, fosaprepitant (teva)",,,0.69,0.69,1
HCPCS,J1457,Gallium nitrate injection,,,1.33,3236.72,10
HCPCS,J14570,Gallium nitrate injection,,,1.33,1.33,1
HCPCS,J1458,Galsulfase injection,,,554.97,554.97,1
HCPCS,J1458,NAGLAZYME 5 MG/5 ML INTRAVENOUS SOLUTION,1790.64,1163.92,420.22,12697.64,40
HCPCS,J14580,Galsulfase injection,,,554.97,554.97,1
HCPCS,J1459,Inj ivig privigen 500 mg,,,54.3,54.3,1
HCPCS,J1459,PRIVIGEN 10 % INTRAVENOUS SOLUTION,71.13,46.23,18.42,943.43,188
HCPCS,J14590,Inj ivig privigen 500 mg,,,54.3,54.3,1
HCPCS,J1460,GAMASTAN 15 %-18 % RANGE INTRAMUSCULAR SOLUTION,179.20499999999998,116.485,44.15,187.26,94
HCPCS,J1460,Gamma globulin 1 cc inj,,,53.91,53.91,1
HCPCS,J14600,Gamma globulin 1 cc inj,,,53.91,53.91,1
HCPCS,J1551,Inj cutaquig 100 mg,,,12.42,1355.53,22
HCPCS,J15510,Inj cutaquig 100 mg,,,16.01,16.01,1
HCPCS,J1552,"Inj, alyglo, 500 mg",,,123.84,943.43,34
HCPCS,J15520,"Inj, alyglo, 500 mg",,,133.75,133.75,1
HCPCS,J1553,Inj immune glob(yim)100mg,,,4469.75,5646.0,6
HCPCS,J1554,Inj. asceniv,,,442.26,1357.29,35
HCPCS,J15540,Inj. asceniv,,,529.7,529.7,1
HCPCS,J1555,"Inj cuvitru, 100 mg",,,14.24,943.43,35
HCPCS,J15550,"Inj cuvitru, 100 mg",,,18.64,18.64,1
HCPCS,J1556,"Inj, imm glob bivigam, 500mg",,,65.67,383.26,22
HCPCS,J15560,"Inj, imm glob bivigam, 500mg",,,86.02,86.02,1
HCPCS,J1557,Gammaplex injection,,,49.51,1355.53,35
HCPCS,J15570,Gammaplex injection,,,69.04,69.04,1
HCPCS,J1558,"Inj. xembify, 100 mg",,,12.72,383.26,35
HCPCS,J15580,"Inj. xembify, 100 mg",,,16.26,16.26,1
HCPCS,J1559,Hizentra injection,,,11.62,383.26,35
HCPCS,J15590,Hizentra injection,,,15.7,15.7,1
HCPCS,J1560,Gamma globulin > 10 cc inj,,,97.89,1076.8,35
HCPCS,J15600,Gamma globulin > 10 cc inj,,,112.88,112.88,1
HCPCS,J1561,GAMUNEX-C 1 GRAM/10 ML (10 %) INJECTION SOLUTION,55.14,35.84,14.28,943.43,47
HCPCS,J1561,GAMUNEX-C 10 GRAM/100 ML (10 %) INJECTION SOLUTION,55.14,35.84,14.28,943.43,47
HCPCS,J1561,GAMUNEX-C 2.5 GRAM/25 ML (10 %) INJECTION SOLUTION,55.14,35.84,14.28,943.43,47
HCPCS,J1561,GAMUNEX-C 20 GRAM/200 ML (10 %) INJECTION SOLUTION,55.14,35.84,14.28,943.43,47
HCPCS,J1561,GAMUNEX-C 40 GRAM/400 ML (10 %) INJECTION SOLUTION,55.14,35.84,14.28,943.43,47
HCPCS,J1561,GAMUNEX-C 5 GRAM/50 ML (10 %) INJECTION SOLUTION,55.14,35.84,14.28,943.43,47
HCPCS,J1561,Gamunex-c/gammaked,,,53.01,53.01,1
HCPCS,J1561,IMMUNE GLOBULIN INJECTION,128.0,83.2,49.08,128.0,14
HCPCS,J15610,Gamunex-c/gammaked,,,53.01,53.01,1
HCPCS,J1562,"Vivaglobin, inj",,,303.41,383.26,6
HCPCS,J1566,GAMMAGARD S-D (IGA < 1 MCG/ML) 10 GRAM INTRAVENOUS SOLUTION,8194.32,5326.31,70.62,8194.32,53
HCPCS,J1566,GAMMAGARD S-D (IGA < 1 MCG/ML) 5 GRAM INTRAVENOUS SOLUTION,4097.16,2663.15,70.62,4097.16,50
HCPCS,J1566,"IMMUNE GLOBULIN, POWDER",79.0,51.35,39.5,89.24,14
HCPCS,J1566,"Immune globulin, powder",,,85.2,85.2,1
HCPCS,J15660,"Immune globulin, powder",,,85.2,85.2,1
HCPCS,J1568,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,18.11,943.43,470
HCPCS,J1568,Octagam injection,,,51.18,51.18,1
HCPCS,J15680,Octagam injection,,,51.18,51.18,1
HCPCS,J1569,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,16.28,1355.53,376
HCPCS,J1569,GAMMAGARD LIQUID INJECTION,108.0,70.2,47.29,108.0,14
HCPCS,J1569,Gammagard liquid injection,,,51.07,51.07,1
HCPCS,J15690,Gammagard liquid injection,,,51.07,51.07,1
HCPCS,J1570,GANCICLOVIR SODIUM 500 MG,205.0,133.25,33.52,205.0,14
HCPCS,J1570,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,298.20000000000005,193.82999999999998,39.69,350.16,62
HCPCS,J1570,Ganciclovir sodium injection,,,36.2,36.2,1
HCPCS,J15700,Ganciclovir sodium injection,,,36.2,36.2,1
HCPCS,J1571,Hepagam b im injection,,,54.69,345.3,35
HCPCS,J15710,Hepagam b im injection,,,75.16,75.16,1
HCPCS,J1572,FLEBOGAMMA DIF 10 % INTRAVENOUS SOLUTION,38.13,24.78,9.88,943.43,38
HCPCS,J1572,Flebogamma injection,,,54.89,54.89,1
HCPCS,J15720,Flebogamma injection,,,54.89,54.89,1
HCPCS,J1573,"Hepagam b intravenous, inj",,,61.99,192.57,34
HCPCS,J15730,"Hepagam b intravenous, inj",,,75.16,75.16,1
HCPCS,J1574,"Inj, ganciclovir (exela)",,,51.84,131.52,7
HCPCS,J15740,"Inj, ganciclovir (exela)",,,51.84,51.84,1
HCPCS,J1575,HYQVIA 10 GRAM/100 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,15.25,1355.53,47
HCPCS,J1575,HYQVIA 2.5 GRAM/25 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,15.25,1355.53,47
HCPCS,J1575,HYQVIA 20 GRAM/200 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,15.25,1355.53,47
HCPCS,J1575,HYQVIA 30 GRAM/300 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,15.25,1355.53,47
HCPCS,J1575,HYQVIA 5 GRAM/50 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,15.25,1355.53,47
HCPCS,J1575,Hyqvia 100mg immuneglobulin,,,19.8,19.8,1
HCPCS,J15750,Hyqvia 100mg immuneglobulin,,,19.8,19.8,1
HCPCS,J1576,"Inj, panzyga, 500 mg",,,58.45,5646.0,35
HCPCS,J15760,"Inj, panzyga, 500 mg",,,76.92,76.92,1
HCPCS,J1580,GENTAMICIN 100 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,6.0,31
HCPCS,J1580,GENTAMICIN 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,6.0,31
HCPCS,J1580,GENTAMICIN 120 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,6.0,31
HCPCS,J1580,GENTAMICIN 40 MG/ML INJECTION SOLUTION,6.51,4.23,0.88,7.32,124
HCPCS,J1580,GENTAMICIN 60 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.27,0.18,0.05,6.0,31
HCPCS,J1580,GENTAMICIN 80 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,6.0,31
HCPCS,J1580,GENTAMICIN 80 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,6.0,31
HCPCS,J1580,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,9.75,6.34,1.64,9.75,62
HCPCS,J1580,GENTAMICIN TO 80 MG INJ,44.0,28.6,2.17,44.0,14
HCPCS,J1580,Garamycin gentamicin inj,,,2.34,2.34,1
HCPCS,J15800,Garamycin gentamicin inj,,,2.34,2.34,1
HCPCS,J1595,COPAXONE 20 MG/ML SUBCUTANEOUS SYRINGE,853.68,554.89,61.99,853.68,36
HCPCS,J1595,COPAXONE 40 MG/ML SUBCUTANEOUS SYRINGE,1837.08,1194.1,61.99,1837.08,36
HCPCS,J1595,GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRINGE,649.23,422.0,61.99,649.23,36
HCPCS,J1595,GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRINGE,1572.9,1022.39,61.99,1572.9,36
HCPCS,J1595,GLATOPA 20 MG/ML SUBCUTANEOUS SYRINGE,649.23,422.0,61.99,649.23,72
HCPCS,J1595,GLATOPA 40 MG/ML SUBCUTANEOUS SYRINGE,1572.9,1022.39,61.99,1572.9,72
HCPCS,J1595,Injection glatiramer acetate,,,64.8,64.8,1
HCPCS,J15950,Injection glatiramer acetate,,,64.8,64.8,1
HCPCS,J1596,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,36.54,23.75,0.45,46.8,152
HCPCS,J1596,"Inj, glycopyrrolate, 0.1 mg",,,0.41,0.41,1
HCPCS,J15960,"Inj, glycopyrrolate, 0.1 mg",,,0.41,0.41,1
HCPCS,J1597,"Inj glycopyrrolate, glyrx-pf",,,1.38,3.53,11
HCPCS,J15970,"Inj glycopyrrolate, glyrx-pf",,,1.38,1.38,1
HCPCS,J1598,Inj glycopyrrolate fres kabi,,,1.45,3.89,24
HCPCS,J15980,Inj glycopyrrolate fres kabi,,,1.45,1.45,1
HCPCS,J1599,"Ivig non-lyophilized, nos",,,122.98,652.67,10
HCPCS,J15990,"Ivig non-lyophilized, nos",,,122.98,122.98,1
HCPCS,J1600,Gold sodium thiomaleate inj,,,13.65,50.38,4
HCPCS,J16000,Gold sodium thiomaleate inj,,,13.65,13.65,1
HCPCS,J1602,Golimumab for iv use 1mg,,,12.56,12.56,1
HCPCS,J1602,SIMPONI 100 MG/ML SUBCUTANEOUS SYRINGE,26273.4,17077.71,10.62,26273.4,53
HCPCS,J1602,SIMPONI 50 MG/0.5 ML SUBCUTANEOUS SYRINGE,45692.85,29700.35,10.62,45692.85,53
HCPCS,J1602,SIMPONI ARIA 12.5 MG/ML INTRAVENOUS SOLUTION,1799.28,1169.53,10.62,1799.28,47
HCPCS,J16020,Golimumab for iv use 1mg,,,12.56,12.56,1
HCPCS,J1610,GLUCAGON EMERGENCY KIT 1 MG SOLUTION FOR INJECTION,1008.0,655.2,74.0,1008.0,47
HCPCS,J1610,GLUCAGON HYDROCHLORIDE/1 MG,172.0,111.8,86.0,186.49,14
HCPCS,J1610,Glucagon hydrochloride/1 mg,,,178.05,178.05,1
HCPCS,J16100,Glucagon hydrochloride/1 mg,,,178.05,178.05,1
HCPCS,J1611,GLUCAGON (HCL) EMERGENCY KIT 1 MG SOLUTION FOR INJECTION,1007.28,654.73,74.0,1007.28,47
HCPCS,J1611,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,797.94,518.66,74.0,909.66,141
HCPCS,J1611,"Inj glucagon hcl, fresenius",,,154.71,154.71,1
HCPCS,J16110,"Inj glucagon hcl, fresenius",,,154.71,154.71,1
HCPCS,J1612,Inj glucagon (gvoke) 0.01 mg,,,2.59,93.47,14
HCPCS,J16120,Inj glucagon (gvoke) 0.01 mg,,,2.61,2.61,1
HCPCS,J1620,Gonadorelin hydroch/ 100 mcg,,,183.7,466.05,3
HCPCS,J1626,GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,32.4,21.06,0.29,32.4,31
HCPCS,J1626,"GRANISETRON HCL, 100 MCG",69.0,44.85,0.15,69.0,14
HCPCS,J1626,Granisetron hcl injection,,,0.16,0.16,1
HCPCS,J16260,Granisetron hcl injection,,,0.16,0.16,1
HCPCS,J1627,"Inj, granisetron, xr, 0.1 mg",,,4.29,12.33,29
HCPCS,J16270,"Inj, granisetron, xr, 0.1 mg",,,4.64,4.64,1
HCPCS,J1628,"Inj., guselkumab, 1 mg",,,78.78,78.78,1
HCPCS,J1628,TREMFYA 100 MG/ML SUBCUTANEOUS SYRINGE,52439.19,34085.47,72.93,52439.19,52
HCPCS,J1628,TREMFYA 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,2621.97,1704.28,72.93,5646.0,49
HCPCS,J1628,TREMFYA ONE-PRESS 100 MG/ML SUBCUTANEOUS AUTO-INJECTOR,52439.19,34085.47,72.93,52439.19,52
HCPCS,J16280,"Inj., guselkumab, 1 mg",,,78.78,78.78,1
HCPCS,J1630,HALOPERIDOL INJECTION,29.0,18.85,0.73,29.0,14
HCPCS,J1630,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,10.8,7.02,0.73,21.57,155
HCPCS,J1630,Haloperidol injection,,,0.79,0.79,1
HCPCS,J16300,Haloperidol injection,,,0.79,0.79,1
HCPCS,J1631,HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,177.66,115.48,6.07,185.34,93
HCPCS,J1631,HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,93.75,60.94,6.07,101.1,93
HCPCS,J1631,Haloperidol decanoate inj,,,4.26,4.26,1
HCPCS,J16310,Haloperidol decanoate inj,,,4.26,4.26,1
HCPCS,J1632,"Inj., brexanolone, 1 mg",,,77.24,3407.66,10
HCPCS,J16320,"Inj., brexanolone, 1 mg",,,77.24,77.24,1
HCPCS,J1640,"Hemin, 1 mg",,,38.13,38.13,1
HCPCS,J1640,PANHEMATIN 350 MG INTRAVENOUS SOLUTION,41137.77,26739.55,28.22,41137.77,53
HCPCS,J16400,"Hemin, 1 mg",,,38.13,38.13,1
HCPCS,J1642,HEPARIN LOCK FLUSH (PORCINE) (PF) 10 UNIT/ML INTRAVENOUS SYRINGE,0.84,0.55,0.02,2.1,93
HCPCS,J1642,HEPARIN LOCK FLUSH (PORCINE) (PF) 100 UNIT/ML INTRAVENOUS SYRINGE,0.51,0.33,0.02,0.51,31
HCPCS,J1642,HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML INTRAVENOUS SOLUTION,3.495,2.27,0.02,5.79,62
HCPCS,J1642,HEPARIN PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE,0.42,0.27,0.02,0.42,31
HCPCS,J1642,HEPARIN PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE,0.48,0.31,0.02,0.81,93
HCPCS,J1642,HEPARIN SODIUM PER 10 U,2.0,1.3,0.02,2.0,14
HCPCS,J1642,Inj heparin sodium per 10 u,,,0.02,0.02,1
HCPCS,J16420,Inj heparin sodium per 10 u,,,0.02,0.02,1
HCPCS,J1643,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,1.23,0.8,0.21,5.81,31
HCPCS,J1643,HEPARIN PORCINE (PF) 1000 UNIT/ML INJECTION SOLUTION,18.72,12.17,3.14,18.72,31
HCPCS,J1643,"Inj heparin, pfizer, 1000u",,,2.27,2.27,1
HCPCS,J16430,"Inj heparin, pfizer, 1000u",,,2.27,2.27,1
HCPCS,J1644,HEPARIN (PORCINE) (PF) 1000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.49,155
HCPCS,J1644,HEPARIN (PORCINE) (PF) 2000 UNIT/1000 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.49,124
HCPCS,J1644,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,1.26,0.8200000000000001,0.14,6.69,217
HCPCS,J1644,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,15.165,9.855,0.25,31.32,248
HCPCS,J1644,HEPARIN (PORCINE) 20000 UNIT/ML INJECTION SOLUTION,48.165,31.305,0.25,60.33,62
HCPCS,J1644,HEPARIN (PORCINE) 25000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN,0.24,0.16,0.04,0.49,31
HCPCS,J1644,HEPARIN (PORCINE) 5000 UNIT/ML INJECTION SOLUTION,5.91,3.84,0.25,7.62,93
HCPCS,J1644,HEPARIN 1000UNIT/0.9NS 500ML,28.77,18.7,0.25,28.77,31
HCPCS,J1644,HEPARIN PORCINE (PF) 1000 UNIT/ML INJECTION SOLUTION,23.73,15.42,0.25,23.73,31
HCPCS,J1644,HEPARIN PORCINE (PF) 5000 UNIT/0.5 ML INJECTION SYRINGE,29.76,19.34,0.25,29.76,31
HCPCS,J1644,Inj heparin sodium per 1000u,,,0.19,0.19,1
HCPCS,J16440,Inj heparin sodium per 1000u,,,0.19,0.19,1
HCPCS,J1645,Dalteparin sodium,,,16.09,16.09,1
HCPCS,J1645,FRAGMIN 10000 ANTI-XA UNIT/ML SUBCUTANEOUS SYRINGE,1136.67,738.84,14.94,1136.67,31
HCPCS,J1645,FRAGMIN 12500 ANTI-XA UNIT/0.5 ML SUBCUTANEOUS SYRINGE,2841.93,1847.25,14.94,2841.93,34
HCPCS,J1645,FRAGMIN 15000 ANTI-XA UNIT/0.6 ML SUBCUTANEOUS SYRINGE,2841.75,1847.14,14.94,2841.75,34
HCPCS,J1645,FRAGMIN 18000 ANTI-XA UNIT/0.72 ML SUBCUTANEOUS SYRINGE,2841.75,1847.14,14.94,2841.75,34
HCPCS,J1645,FRAGMIN 2500 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRINGE,1751.55,1138.51,14.94,1751.55,31
HCPCS,J1645,FRAGMIN 5000 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRINGE,2841.69,1847.1,14.94,2841.69,34
HCPCS,J1645,FRAGMIN 7500 ANTI-XA UNIT/0.3 ML SUBCUTANEOUS SYRINGE,2842.02,1847.31,14.94,2842.02,34
HCPCS,J16450,Dalteparin sodium,,,16.09,16.09,1
HCPCS,J1650,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,52.56,34.165,0.56,71.58,62
HCPCS,J1650,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,52.08,33.855000000000004,0.56,54.24,62
HCPCS,J1650,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,78.78,51.205,0.56,107.31,93
HCPCS,J1650,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,33.24,21.61,0.56,33.24,31
HCPCS,J1650,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,33.12,21.53,0.56,33.12,31
HCPCS,J1650,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,51.9,33.735,0.56,71.58,93
HCPCS,J1650,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,52.425,34.08,0.56,71.55,62
HCPCS,J1650,"ENOXAPARIN SODIUM, 30 MG",20.0,13.0,0.53,20.0,14
HCPCS,J1650,Inj enoxaparin sodium,,,0.57,0.57,1
HCPCS,J1650,LOVENOX 100 MG/ML SUBCUTANEOUS SYRINGE,89.4,58.11,0.56,89.4,31
HCPCS,J1650,LOVENOX 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,134.16,87.2,0.56,134.16,31
HCPCS,J1650,LOVENOX 150 MG/ML SUBCUTANEOUS SYRINGE,134.16,87.2,0.56,134.16,31
HCPCS,J1650,LOVENOX 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,89.31,58.05,0.56,89.31,31
HCPCS,J1650,LOVENOX 300 MG/3 ML SUBCUTANEOUS SOLUTION,89.31,58.05,0.56,89.31,31
HCPCS,J1650,LOVENOX 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,89.31,58.05,0.56,89.31,31
HCPCS,J1650,LOVENOX 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,89.4,58.11,0.56,89.4,31
HCPCS,J1650,LOVENOX 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,89.4,58.11,0.56,89.4,31
HCPCS,J16500,Inj enoxaparin sodium,,,0.57,0.57,1
HCPCS,J1652,FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SOLUTION SYRINGE,482.28,313.48,0.93,482.28,31
HCPCS,J1652,FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE,327.9,213.14,0.93,327.9,31
HCPCS,J1652,FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SOLUTION SYRINGE,964.59,626.98,0.93,964.59,62
HCPCS,J1652,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,494.34,321.32,0.93,643.05,93
HCPCS,J1652,FONDAPARINUX SODIUM,386.0,250.9,0.88,386.0,14
HCPCS,J1652,Fondaparinux sodium,,,0.95,0.95,1
HCPCS,J16520,Fondaparinux sodium,,,0.95,0.95,1
HCPCS,J1655,Tinzaparin sodium injection,,,5.38,5.83,3
HCPCS,J1670,HYPERTET (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,2360.37,1534.24,97.89,2360.37,47
HCPCS,J1670,TETANUS IMMUNE GLOBULIN INJ,394.0,256.1,197.0,665.76,14
HCPCS,J1670,Tetanus immune globulin inj,,,635.62,635.62,1
HCPCS,J16700,Tetanus immune globulin inj,,,635.62,635.62,1
HCPCS,J1675,Histrelin acetate,,,1.0,943.43,10
HCPCS,J16750,Histrelin acetate,,,1.0,1.0,1
HCPCS,J1700,Hydrocortisone acetate inj,,,1.11,2.82,4
HCPCS,J17000,Hydrocortisone acetate inj,,,1.11,1.11,1
HCPCS,J1710,Hydrocortisone sodium ph inj,,,5.07,12.85,6
HCPCS,J1720,HYDROCORTISONE SODIUM SUCC I,23.0,14.95,11.5,24.95,14
HCPCS,J1720,Hydrocortisone sodium succ i,,,23.82,23.82,1
HCPCS,J1720,SOLU-CORTEF 100 MG SOLUTION FOR INJECTION,72.39,47.05,12.16,72.39,31
HCPCS,J1720,SOLU-CORTEF ACT-O-VIAL (PF) 100 MG/2 ML SOLUTION FOR INJECTION,90.13499999999999,58.584999999999994,15.0,90.96,62
HCPCS,J1720,SOLU-CORTEF ACT-O-VIAL (PF) 1000 MG/8 ML SOLUTION FOR INJECTION,723.78,470.46,16.61,723.78,31
HCPCS,J1720,SOLU-CORTEF ACT-O-VIAL (PF) 250 MG/2 ML SOLUTION FOR INJECTION,178.695,116.155,16.61,184.35,62
HCPCS,J1720,SOLU-CORTEF ACT-O-VIAL (PF) 500 MG/4 ML SOLUTION FOR INJECTION,362.01,235.31,16.61,362.01,31
HCPCS,J17200,Hydrocortisone sodium succ i,,,23.82,23.82,1
HCPCS,J1726,"Makena, 10 mg",,,14.46,78.3,20
HCPCS,J17260,"Makena, 10 mg",,,20.96,20.96,1
HCPCS,J1729,Inj hydroxyprogst capoat nos,,,14.15,78.3,10
HCPCS,J17290,Inj hydroxyprogst capoat nos,,,14.15,14.15,1
HCPCS,J1730,DIAZOXIDE INJECTION,459.0,298.35,115.96,459.0,14
HCPCS,J1730,Diazoxide injection,,,111.82,283.7,4
HCPCS,J17300,Diazoxide injection,,,111.82,111.82,1
HCPCS,J1737,Inj meloxicam (azurity) 1mg,,,1.04,2.63,8
HCPCS,J17370,Inj meloxicam (azurity) 1mg,,,1.04,1.04,1
HCPCS,J1738,Inj. meloxicam 1 mg,,,3.25,8.25,4
HCPCS,J17380,Inj. meloxicam 1 mg,,,3.25,3.25,1
HCPCS,J1740,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,500.01,325.01,24.97,505.2,148
HCPCS,J1740,IBANDRONATE SODIUM INJECTION,617.0,401.05,13.14,617.0,14
HCPCS,J1740,Ibandronate sodium injection,,,14.19,14.19,1
HCPCS,J17400,Ibandronate sodium injection,,,14.19,14.19,1
HCPCS,J1741,IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,594.0,386.1,6.04,594.0,30
HCPCS,J1741,Ibuprofen injection,,,3.43,3.43,1
HCPCS,J17410,Ibuprofen injection,,,3.43,3.43,1
HCPCS,J1742,CORVERT 0.1 MG/ML INTRAVENOUS SOLUTION,201.54,131.0,52.2,801.01,39
HCPCS,J1742,Ibutilide fumarate injection,,,315.73,315.73,1
HCPCS,J17420,Ibutilide fumarate injection,,,315.73,315.73,1
HCPCS,J1743,ELAPRASE 6 MG/3 ML INTRAVENOUS SOLUTION,3875.88,2519.32,488.6,12697.64,50
HCPCS,J1743,Idursulfase injection,,,602.75,602.75,1
HCPCS,J17430,Idursulfase injection,,,602.75,602.75,1
HCPCS,J1744,FIRAZYR 30 MG/3 ML SUBCUTANEOUS SYRINGE,13377.0,8695.05,122.75,13377.0,84
HCPCS,J1744,ICATIBANT 30 MG/3 ML SUBCUTANEOUS SYRINGE,12708.15,8260.3,122.75,12708.15,42
HCPCS,J1744,Icatibant injection,,,48.38,48.38,1
HCPCS,J17440,Icatibant injection,,,48.38,48.38,1
HCPCS,J1745,INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,1710.0,1111.5,28.5,1710.0,47
HCPCS,J1745,INFLIXIMAB INJECTION,285.0,185.25,32.42,285.0,14
HCPCS,J1745,Infliximab not biosimil 10mg,,,35.01,35.01,1
HCPCS,J1745,REMICADE 100 MG INTRAVENOUS SOLUTION,4204.14,2732.69,28.5,4204.14,50
HCPCS,J17450,Infliximab not biosimil 10mg,,,35.01,35.01,1
HCPCS,J1746,"Inj., ibalizumab-uiyk, 10 mg",,,83.74,83.74,1
HCPCS,J1746,TROGARZO 200 MG/1.33 ML (150 MG/ML) INTRAVENOUS SOLUTION,4126.47,2682.21,67.18,4126.47,50
HCPCS,J17460,"Inj., ibalizumab-uiyk, 10 mg",,,83.74,83.74,1
HCPCS,J1747,"Inj, spesolimab-sbzo, 1 mg",,,54.13,18253.82,35
HCPCS,J17470,"Inj, spesolimab-sbzo, 1 mg",,,70.99,70.99,1
HCPCS,J1748,"Inj, zymfentra, 10 mg",,,99.76,704.56,14
HCPCS,J17480,"Inj, zymfentra, 10 mg",,,277.71,277.71,1
HCPCS,J1749,"Inj, iloprost, 0.1 mcg",,,6.17,345.3,20
HCPCS,J17490,"Inj, iloprost, 0.1 mcg",,,6.17,6.17,1
HCPCS,J1750,INFED 50 MG/ML INJECTION SOLUTION,67.11,43.62,15.58,78.3,94
HCPCS,J1750,IRON DEXTRAN INJECTION,146.0,94.9,18.08,146.0,14
HCPCS,J1750,Inj iron dextran,,,19.53,19.53,1
HCPCS,J17500,Inj iron dextran,,,19.53,19.53,1
HCPCS,J1756,IRON SUCROSE INJECTION PER 1 MG,2.0,1.3,0.27,2.0,14
HCPCS,J1756,Iron sucrose injection,,,0.26,0.26,1
HCPCS,J1756,VENOFER 100 MG IRON/5 ML INTRAVENOUS SOLUTION,46.77,30.4,0.21,46.77,93
HCPCS,J1756,VENOFER 200 MG IRON/10 ML INTRAVENOUS SOLUTION,46.77,30.4,0.21,46.77,31
HCPCS,J1756,VENOFER 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,46.77,30.4,0.21,46.77,31
HCPCS,J17560,Iron sucrose injection,,,0.26,0.26,1
HCPCS,J1786,CEREZYME 400 UNIT INTRAVENOUS SOLUTION,6305.28,4098.43,39.55,6305.28,53
HCPCS,J1786,IMUGLUCERASE INJECTION,252.0,163.8,43.23,252.0,14
HCPCS,J1786,Imuglucerase injection,,,46.69,46.69,1
HCPCS,J17860,Imuglucerase injection,,,46.69,46.69,1
HCPCS,J1790,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,18.285,11.885,2.93,19.87,60
HCPCS,J1790,DROPERIDOL INJECTION,19.0,12.35,7.18,19.0,14
HCPCS,J1790,Droperidol injection,,,7.75,7.75,1
HCPCS,J17900,Droperidol injection,,,7.75,7.75,1
HCPCS,J1800,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,35.07,22.795,4.84,41.34,46
HCPCS,J1800,PROPRANOLOL INJECTION,65.0,42.25,9.74,65.0,14
HCPCS,J1800,Propranolol injection,,,10.1,10.1,1
HCPCS,J18000,Propranolol injection,,,10.1,10.1,1
HCPCS,J1805,BREVIBLOC 2000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSM) IV,18.15,11.8,0.2,18.15,31
HCPCS,J1805,BREVIBLOC 2500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSM) IV,1.86,1.21,0.2,1.86,31
HCPCS,J1805,"Inj, esmolol hcl, 10mg",,,0.23,0.23,1
HCPCS,J18050,"Inj, esmolol hcl, 10mg",,,0.23,0.23,1
HCPCS,J1806,ESMOLOL 2500 MG/250 ML (10 MG/ML) IN STERILE WATER INTRAVENOUS SOLN,1.71,1.11,0.29,1.71,31
HCPCS,J1806,Inj esmolol hcl wg crit care,,,0.44,0.44,1
HCPCS,J18060,Inj esmolol hcl wg crit care,,,0.44,0.44,1
HCPCS,J1807,ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,13680.0,8892.0,12.88,13680.0,38
HCPCS,J1807,"Inj, ethacrynate sod, 1 mg",,,59.1,59.1,1
HCPCS,J18070,"Inj, ethacrynate sod, 1 mg",,,59.1,59.1,1
HCPCS,J1808,FOLIC ACID 5 MG/ML INJECTION SOLUTION,23.01,14.96,0.1,23.01,30
HCPCS,J1808,"Inj, folic acid, 0.1 mg",,,0.05,0.05,1
HCPCS,J18080,"Inj, folic acid, 0.1 mg",,,0.05,0.05,1
HCPCS,J1809,"Inj, fosdenopterin, 0.1mg",,,17.23,3407.66,21
HCPCS,J18090,"Inj, fosdenopterin, 0.1mg",,,18.62,18.62,1
HCPCS,J1810,Droperidol/fentanyl inj,,,8.6,14.62,4
HCPCS,J18100,Droperidol/fentanyl inj,,,14.62,14.62,1
HCPCS,J1811,Fiasp for insulin pump use,,,6.68,21.87,25
HCPCS,J18110,Fiasp for insulin pump use,,,8.53,8.53,1
HCPCS,J1812,Inj. insulin (fiasp),,,1.5,3.81,4
HCPCS,J18120,Inj. insulin (fiasp),,,1.5,1.5,1
HCPCS,J1813,Lyumjev for insulin pump use,,,14.11,41.81,12
HCPCS,J18130,Lyumjev for insulin pump use,,,16.31,16.31,1
HCPCS,J1814,Inj. insulin (lyumjev),,,1.43,3.62,7
HCPCS,J18140,Inj. insulin (lyumjev),,,1.43,1.43,1
HCPCS,J1815,ADMELOG SOLOSTAR U-100 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS PEN,45.45,29.54,0.6,45.45,23
HCPCS,J1815,ADMELOG U-100 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLUTION,47.07,30.6,0.6,47.07,22
HCPCS,J1815,APIDRA SOLOSTAR U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,39.51,25.68,0.6,39.51,22
HCPCS,J1815,APIDRA U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,30.66,19.93,0.6,30.66,23
HCPCS,J1815,HUMALOG KWIKPEN (U-100) INSULIN 100 UNIT/ML SUBCUTANEOUS,38.19,24.82,0.6,38.19,44
HCPCS,J1815,HUMALOG MIX 50-50 KWIKPEN U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,38.19,24.82,0.6,38.19,44
HCPCS,J1815,HUMALOG MIX 75-25 (U-100) INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,30.75,19.99,0.6,30.75,22
HCPCS,J1815,HUMALOG U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,36.75,23.89,0.6,36.75,22
HCPCS,J1815,HUMALOG U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,61.394999999999996,39.905,0.6,98.88,46
HCPCS,J1815,HUMULIN 70/30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,16.05,10.43,0.6,16.05,44
HCPCS,J1815,HUMULIN 70/30 U-100 INSULIN KWIKPEN 100 UNIT/ML SUBCUTANEOUS,33.93,22.05,0.6,33.93,44
HCPCS,J1815,HUMULIN N NPH U-100 INSULIN (ISOPHANE SUSP) 100 UNIT/ML SUBCUTANEOUS,34.785000000000004,22.61,0.6,53.52,44
HCPCS,J1815,HUMULIN N NPH U-100 INSULIN KWIKPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS,33.93,22.05,0.6,33.93,44
HCPCS,J1815,HUMULIN R REGULAR U-100 INSULIN 100 UNIT/ML INJECTION SOLUTION,16.05,10.43,0.6,16.05,23
HCPCS,J1815,HUMULIN R U-500 (CONC) INSULIN KWIKPEN 500 UNIT/ML (3 ML) SUBCUTANEOUS,344.52,223.94,0.6,344.52,22
HCPCS,J1815,"INJECTION, INSULIN, PER 5 UNITS",8.5,5.525,0.22,12.0,28
HCPCS,J1815,INSULIN INJECTION,107.0,69.55,0.22,107.0,14
HCPCS,J1815,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS PEN,38.19,24.82,0.6,38.19,22
HCPCS,J1815,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,9.0,5.85,0.6,9.0,23
HCPCS,J1815,Insulin injection,,,0.24,0.24,1
HCPCS,J1815,LANTUS SOLOSTAR U-100 INSULIN 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN,23.13,15.03,0.6,23.13,22
HCPCS,J1815,LANTUS U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,23.13,15.03,0.6,23.13,23
HCPCS,J1815,MYXREDLIN (REGULAR INSULIN) 100 UNIT/100 ML (1 UNIT/ML) IV SOLUTION,1.26,0.82,0.21,1.26,23
HCPCS,J1815,NOVOLIN 70-30 FLEXPEN U-100 INSULIN 100 UNIT/ML (70-30) SUBCUTANEOUS,21.87,14.22,0.6,21.87,22
HCPCS,J1815,NOVOLIN 70/30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,17.34,11.27,0.6,17.34,22
HCPCS,J1815,NOVOLIN N FLEXPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS INSULIN PEN,21.87,14.22,0.6,21.87,22
HCPCS,J1815,NOVOLIN N NPH U-100 INSULIN ISOPHANE 100 UNIT/ML SUBCUTANEOUS SUSP,17.34,11.27,0.6,17.34,22
HCPCS,J1815,NOVOLIN R FLEXPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS INSULIN PEN,21.87,14.22,0.6,21.87,46
HCPCS,J1815,NOVOLIN R REGULAR U-100 INSULIN 100 UNIT/ML INJECTION SOLUTION,17.34,11.27,0.6,17.34,46
HCPCS,J1815,NOVOLOG FLEXPEN U-100 INSULIN ASPART 100 UNIT/ML (3 ML) SUBCUTANEOUS,33.54,21.8,0.6,33.54,22
HCPCS,J1815,NOVOLOG MIX 70-30 FLEXPEN U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,33.54,21.8,0.6,33.54,22
HCPCS,J1815,NOVOLOG MIX 70-30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,26.04,16.93,0.6,26.04,22
HCPCS,J1815,NOVOLOG U-100 INSULIN ASPART 100 UNIT/ML SUBCUTANEOUS SOLUTION,26.04,16.93,0.6,26.04,22
HCPCS,J18150,Insulin injection,,,0.24,0.24,1
HCPCS,J1817,Insulin for insulin pump use,,,3.46,8.85,12
HCPCS,J18170,Insulin for insulin pump use,,,3.46,3.46,1
HCPCS,J1823,"Inj. inebilizumab-cdon, 1 mg",,,535.19,535.19,1
HCPCS,J1823,UPLIZNA 10 MG/ML INTRAVENOUS SOLUTION,16829.82,10939.38,426.16,16829.82,53
HCPCS,J18230,"Inj. inebilizumab-cdon, 1 mg",,,535.19,535.19,1
HCPCS,J1826,Interferon beta-1a inj,,,516.7,5680.21,23
HCPCS,J18260,Interferon beta-1a inj,,,2238.92,2238.92,1
HCPCS,J1830,BETASERON 0.3 MG SUBCUTANEOUS KIT,2558.01,1662.71,61.99,2558.01,29
HCPCS,J1830,Interferon beta-1b / .25 mg,,,736.71,736.71,1
HCPCS,J18300,Interferon beta-1b / .25 mg,,,736.71,736.71,1
HCPCS,J1833,"Injection, isavuconazonium",,,0.98,123.65,27
HCPCS,J18330,"Injection, isavuconazonium",,,1.1,1.1,1
HCPCS,J1834,ISONIAZID 100 MG/ML INJECTION SOLUTION,105.63,68.66,0.3,105.63,26
HCPCS,J1834,"Inj, isoniazid, 1 mg",,,0.3,0.3,1
HCPCS,J18340,"Inj, isoniazid, 1 mg",,,0.3,0.3,1
HCPCS,J1835,Itraconazole injection,,,43.08,109.3,4
HCPCS,J18350,Itraconazole injection,,,43.08,43.08,1
HCPCS,J1836,"Inj, metronidazole, 10 mg",,,0.02,0.08,12
HCPCS,J18360,"Inj, metronidazole, 10 mg",,,0.03,0.03,1
HCPCS,J1837,"Inj, posaconazole, 1 mg",,,0.34,93.47,21
HCPCS,J18370,"Inj, posaconazole, 1 mg",,,0.38,0.38,1
HCPCS,J1885,KETOROLAC 15 MG/ML INJECTION SOLUTION,12.15,7.9,0.34,13.5,164
HCPCS,J1885,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,6.3,4.1,0.34,23.52,246
HCPCS,J1885,KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION,5.79,3.7649999999999997,0.34,14.76,205
HCPCS,J1885,KETOROLAC TROMETHAMINE INJ,19.0,12.35,0.33,19.0,14
HCPCS,J1885,Ketorolac tromethamine inj,,,0.36,0.36,1
HCPCS,J18850,Ketorolac tromethamine inj,,,0.36,0.36,1
HCPCS,J1890,Cephalothin sodium injection,,,9.33,14.44,4
HCPCS,J18900,Cephalothin sodium injection,,,9.33,9.33,1
HCPCS,J1920,"Inj, labetalol hcl, 5mg",,,0.38,0.38,1
HCPCS,J1920,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,14.4,9.36,0.15,14.4,62
HCPCS,J1920,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,0.66,0.425,0.07,0.96,62
HCPCS,J19200,"Inj, labetalol hcl, 5mg",,,0.38,0.38,1
HCPCS,J1921,"Inj labetalol hcl hikma, 5mg",,,1.18,1.18,1
HCPCS,J1921,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,0.795,0.515,0.07,3.81,124
HCPCS,J19210,"Inj labetalol hcl hikma, 5mg",,,1.18,1.18,1
HCPCS,J1930,Lanreotide injection,,,38.22,38.22,1
HCPCS,J1930,SOMATULINE DEPOT 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,71596.8,46537.92,35.38,71596.8,53
HCPCS,J1930,SOMATULINE DEPOT 60 MG/0.2 ML SUBCUTANEOUS SYRINGE,113976.0,74084.4,35.38,113976.0,53
HCPCS,J1930,SOMATULINE DEPOT 90 MG/0.3 ML SUBCUTANEOUS SYRINGE,101184.0,65769.6,35.38,101184.0,53
HCPCS,J19300,Lanreotide injection,,,38.22,38.22,1
HCPCS,J1931,ALDURAZYME 2.9 MG/5 ML INTRAVENOUS SOLUTION,833.7,541.91,33.7,5646.0,47
HCPCS,J1931,Laronidase injection,,,43.15,43.15,1
HCPCS,J19310,Laronidase injection,,,43.15,43.15,1
HCPCS,J1932,"Inj, lanreotide, (cipla) 1mg",,,41.28,41.28,1
HCPCS,J1932,LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,64027.14,41617.64,36.8,64027.14,53
HCPCS,J19320,"Inj, lanreotide, (cipla) 1mg",,,41.28,41.28,1
HCPCS,J1938,FUROSEMIDE 10 MG/ML INJ,2.37,1.545,0.04,7.53,360
HCPCS,J1938,"Inj, furosemide, 1 mg",,,0.02,0.02,1
HCPCS,J19380,"Inj, furosemide, 1 mg",,,0.02,0.02,1
HCPCS,J1939,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,1.95,1.2650000000000001,0.2,2.73,76
HCPCS,J1939,"Inj, bumetanide, 0.5 mg",,,0.39,0.39,1
HCPCS,J19390,"Inj, bumetanide, 0.5 mg",,,0.39,0.39,1
HCPCS,J1940,Furosemide injection,,,0.42,0.55,2
HCPCS,J19400,Furosemide injection,,,0.42,0.42,1
HCPCS,J1941,"INJ, FUROSCIX, 20 MG",882.8,573.82,245.15,882.8,14
HCPCS,J1941,"Inj, furoscix, 20 mg",,,254.17,644.83,7
HCPCS,J19410,"Inj, furoscix, 20 mg",,,254.17,254.17,1
HCPCS,J1943,ARISTADA INITIO 675 MG/2.4 ML SUSPENSION EXTEND.REL. IM SYRINGE,3652.83,2374.34,2.77,3652.83,50
HCPCS,J1943,"Inj., aristada initio, 1 mg",,,3.51,3.51,1
HCPCS,J19430,"Inj., aristada initio, 1 mg",,,3.51,3.51,1
HCPCS,J1944,ARISTADA 1064 MG/3.9 ML SUSPENSION EXTEND.REL. IM SYRINGE,3543.33,2303.16,2.81,3543.33,50
HCPCS,J1944,ARISTADA 441 MG/1.6 ML SUSPENSION EXTEND.REL. IM SYRINGE,3579.75,2326.84,2.81,3579.75,50
HCPCS,J1944,ARISTADA 662 MG/2.4 ML SUSPENSION EXTEND.REL. IM SYRINGE,3582.48,2328.61,2.81,3582.48,50
HCPCS,J1944,ARISTADA 882 MG/3.2 ML SUSPENSION EXTEND.REL. IM SYRINGE,3579.75,2326.84,2.81,3579.75,50
HCPCS,J1944,Aripiprazole lauroxil 1 mg,,,3.61,3.61,1
HCPCS,J19440,Aripiprazole lauroxil 1 mg,,,3.61,3.61,1
HCPCS,J1945,Lepirudin,,,97.89,953.37,9
HCPCS,J1950,DEPO LUPRON 11.25MG,1516.0,985.4,758.0,1995.29,14
HCPCS,J1950,LEUPROLIDE ACETATE /3.75 MG,1909.0,1240.85,954.5,1995.29,14
HCPCS,J1950,LUPRON DEPOT 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,19452.12,12643.88,516.7,19452.12,53
HCPCS,J1950,LUPRON DEPOT 3.75 MG INTRAMUSCULAR SYRINGE KIT,6483.99,4214.59,516.7,6483.99,53
HCPCS,J1950,LUPRON DEPOT PER 3.75 MG,1516.0,985.4,758.0,1995.29,14
HCPCS,J1950,LUPRON DEPOT-PED 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,42483.9,27614.54,516.7,42483.9,53
HCPCS,J1950,LUPRON DEPOT-PED 11.25 MG INTRAMUSCULAR KIT,14161.26,9204.82,516.7,14161.26,53
HCPCS,J1950,LUPRON DEPOT-PED 15 MG INTRAMUSCULAR KIT,15597.18,10138.17,516.7,15597.18,53
HCPCS,J1950,LUPRON DEPOT-PED 30 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,46791.75,30414.64,516.7,46791.75,53
HCPCS,J1950,LUPRON DEPOT-PED 7.5 MG (PED) INTRAMUSCULAR KIT,7800.3,5070.2,516.7,7800.3,53
HCPCS,J1950,Leuprolide acetate /3.75 mg,,,1904.98,1904.98,1
HCPCS,J19500,Leuprolide acetate /3.75 mg,,,1904.98,1904.98,1
HCPCS,J1951,FENSOLVI 45 MG SUBCUTANEOUS SYRINGE,103734.78,67427.61,118.53,103734.78,53
HCPCS,J1951,Inj fensolvi 0.25 mg,,,151.07,151.07,1
HCPCS,J19510,Inj fensolvi 0.25 mg,,,151.07,151.07,1
HCPCS,J1952,"Leuprolide inj, camcevi, 1mg",,,54.68,258.02,35
HCPCS,J19520,"Leuprolide inj, camcevi, 1mg",,,61.59,61.59,1
HCPCS,J1953,KEPPRA 500 MG/5 ML INTRAVENOUS SOLUTION,49.11,31.92,0.06,49.11,31
HCPCS,J1953,LEVETIRACETAM 1000 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK,1.8,1.17,0.06,1.8,62
HCPCS,J1953,LEVETIRACETAM 1500 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK,2.67,1.74,0.06,2.67,31
HCPCS,J1953,LEVETIRACETAM 500 MG/100 ML IN SODIUM CHLORIDE (ISO-OSM) IV PIGGYBACK,1.08,0.7,0.06,1.08,31
HCPCS,J1953,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,1.9649999999999999,1.275,0.06,2.97,217
HCPCS,J1953,Levetiracetam injection,,,0.04,0.04,1
HCPCS,J19530,Levetiracetam injection,,,0.04,0.04,1
HCPCS,J1954,Inj leu acet lutr dpt 7.5 mg,,,204.27,1955.62,35
HCPCS,J19540,Inj leu acet lutr dpt 7.5 mg,,,763.2,763.2,1
HCPCS,J1955,CARNITOR 200 MG/ML INTRAVENOUS SOLUTION,27.99,18.19,4.7,64.39,31
HCPCS,J1955,Inj levocarnitine per 1 gm,,,25.13,25.13,1
HCPCS,J1955,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,25.68,16.69,4.31,64.39,62
HCPCS,J19550,Inj levocarnitine per 1 gm,,,25.13,25.13,1
HCPCS,J1956,LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.42,0.27,0.07,5.97,31
HCPCS,J1956,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.21,0.14,0.02,5.97,124
HCPCS,J1956,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.15,0.1,0.01,5.97,93
HCPCS,J1956,"LEVOFLOXACIN, 250MG",43.0,27.950000000000003,2.16,54.0,28
HCPCS,J1956,Levofloxacin injection,,,2.33,2.33,1
HCPCS,J19560,Levofloxacin injection,,,2.33,2.33,1
HCPCS,J1960,Levorphanol tartrate inj,,,0.39,0.99,4
HCPCS,J19600,Levorphanol tartrate inj,,,0.39,0.39,1
HCPCS,J1961,Inj lenacapavir (hiv tx) 1mg,,,24.08,24.08,1
HCPCS,J1961,SUNLENCA 309 MG/ML SUBCUTANEOUS SOLUTION,23400.0,15210.0,19.81,23400.0,53
HCPCS,J19610,Inj lenacapavir (hiv tx) 1mg,,,24.08,24.08,1
HCPCS,J1980,HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,388.5,252.53,65.27,388.5,23
HCPCS,J1980,Hyoscyamine sulfate inj,,,55.99,55.99,1
HCPCS,J19800,Hyoscyamine sulfate inj,,,55.99,55.99,1
HCPCS,J1990,Chlordiazepoxide injection,,,22.73,57.68,7
HCPCS,J19900,Chlordiazepoxide injection,,,22.73,22.73,1
HCPCS,J2001,LIDOCAINE (PF) 4 MG/ML (0.4 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,24
HCPCS,J2001,LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,24
HCPCS,J2002,"Inj, lidocaine in d5w, 1 mg",,,0.01,0.01,1
HCPCS,J2002,LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,23
HCPCS,J20020,"Inj, lidocaine in d5w, 1 mg",,,0.01,0.01,1
HCPCS,J2003,"Inj, lidocaine hcl, 1 mg",,,0.01,0.01,1
HCPCS,J2003,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.29,0.84,0.03,4.62,161
HCPCS,J2003,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,5.85,3.8000000000000003,0.03,6.45,46
HCPCS,J2003,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,2.61,1.7,0.03,6.75,138
HCPCS,J2003,LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,2.7,1.76,0.03,2.7,23
HCPCS,J2003,LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,0.3,0.2,0.03,0.3,23
HCPCS,J2003,LIDOCAINE (PF) 50 MG/5 ML (1 %) INTRAVENOUS SYRINGE,10.8,7.02,0.03,10.8,23
HCPCS,J2003,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.7649999999999999,0.495,0.03,5.1,161
HCPCS,J2003,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,0.75,0.49,0.03,5.34,138
HCPCS,J2003,XYLOCAINE 10 MG/ML (1 %) INJECTION SOLUTION,0.51,0.33,0.03,0.6,46
HCPCS,J2003,XYLOCAINE 20 MG/ML (2 %) INJECTION SOLUTION,0.6,0.39,0.03,1.23,69
HCPCS,J2003,XYLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,2.82,1.83,0.03,4.02,92
HCPCS,J2003,XYLOCAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,2.58,1.68,0.03,4.59,69
HCPCS,J2003,XYLOCAINE-MPF 5 MG/ML (0.5 %) INJECTION SOLUTION,1.05,0.68,0.03,1.05,23
HCPCS,J20030,"Inj, lidocaine hcl, 1 mg",,,0.01,0.01,1
HCPCS,J2004,"Inj, lidocaine w epinephrine",,,0.01,0.01,1
HCPCS,J2004,LIDOCAINE 1 %-EPINEPHRINE 1:100000 INJECTION SOLUTION,1.02,0.66,0.03,1.86,115
HCPCS,J2004,LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.885,0.575,0.03,1.02,92
HCPCS,J2004,LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200000 INJECTION SOLUTION,3.45,2.24,0.03,4.68,69
HCPCS,J2004,LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200000 INJECTION SOLUTION,1.02,0.66,0.03,1.02,23
HCPCS,J2004,XYLOCAINE WITH EPINEPHRINE 1 %-1:100000 INJECTION SOLUTION,1.02,0.66,0.03,1.44,69
HCPCS,J2004,XYLOCAINE WITH EPINEPHRINE 2 %-1:100000 INJECTION SOLUTION,0.885,0.575,0.03,1.02,69
HCPCS,J2004,XYLOCAINE-MPF/EPINEPHRINE 1 %-1:200000 INJECTION SOLUTION,1.86,1.21,0.03,3.99,92
HCPCS,J2004,XYLOCAINE-MPF/EPINEPHRINE 1.5 %-1:200000 INJECTION SOLUTION,3.0300000000000002,1.9649999999999999,0.03,3.93,46
HCPCS,J2004,XYLOCAINE-MPF/EPINEPHRINE 2 %-1:200000 INJECTION SOLUTION,4.23,2.75,0.03,4.23,46
HCPCS,J20040,"Inj, lidocaine w epinephrine",,,0.01,0.01,1
HCPCS,J2010,Lincomycin injection,,,5.83,14.93,12
HCPCS,J20100,Lincomycin injection,,,5.83,5.83,1
HCPCS,J2020,LINEZOLID INJECTION,121.0,78.65,2.74,121.0,14
HCPCS,J2020,Linezolid injection,,,2.96,2.96,1
HCPCS,J2020,ZYVOX 600 MG/300 ML INTRAVENOUS PIGGYBACK,0.39,0.25,0.07,7.59,62
HCPCS,J20200,Linezolid injection,,,2.96,2.96,1
HCPCS,J2021,"Inj, linezolid (hospira)",,,14.79,59.87,12
HCPCS,J20210,"Inj, linezolid (hospira)",,,23.36,23.36,1
HCPCS,J2060,ATIVAN 2 MG/ML INJECTION SOLUTION,8.64,5.62,0.87,8.64,31
HCPCS,J2060,LORAZEPAM 2 MG/ML INJECTION SOLUTION,4.635,3.01,0.65,8.64,124
HCPCS,J2060,LORAZEPAM 2 MG/ML INJECTION SYRINGE,57.6,37.44,0.87,57.6,62
HCPCS,J2060,LORAZEPAM 4 MG/ML INJECTION SOLUTION,9.3,6.05,0.87,12.3,62
HCPCS,J2060,LORAZEPAM INJECTION,35.0,22.75,1.41,35.0,14
HCPCS,J2060,Lorazepam injection,,,1.52,1.52,1
HCPCS,J20600,Lorazepam injection,,,1.52,1.52,1
HCPCS,J2062,Loxapine for inhalation 1 mg,,,15.55,78.3,17
HCPCS,J20620,Loxapine for inhalation 1 mg,,,15.55,15.55,1
HCPCS,J2150,OSMITROL 20 % INTRAVENOUS SOLUTION,0.615,0.4,0.08,4.07,48
HCPCS,J2151,"Inj, mannitol, 250 mg",,,0.06,0.06,1
HCPCS,J2151,MANNITOL 25 % INTRAVENOUS SOLUTION,0.555,0.36,0.08,0.66,60
HCPCS,J21510,"Inj, mannitol, 250 mg",,,0.06,0.06,1
HCPCS,J2170,Mecasermin injection,,,273.36,967.0,10
HCPCS,J21700,Mecasermin injection,,,381.15,381.15,1
HCPCS,J2175,DEMEROL (PF) 25 MG/ML INJECTION SYRINGE,79.2,51.48,6.21,79.2,31
HCPCS,J2175,DEMEROL (PF) 50 MG/ML INJECTION SYRINGE,100.8,65.52,6.21,100.8,31
HCPCS,J2175,DEMEROL (PF) 75 MG/ML INJECTION SYRINGE,23.04,14.98,3.87,23.04,62
HCPCS,J2175,DEMEROL 50 MG/ML INJECTION SOLUTION,78.66,51.13,6.21,78.66,31
HCPCS,J2175,MEPERIDINE (PF) 100 MG/ML INJECTION SOLUTION,10.44,6.79,1.75,22.55,62
HCPCS,J2175,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,9.12,5.93,1.53,22.55,62
HCPCS,J2175,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,9.51,6.18,1.6,22.55,62
HCPCS,J2175,MEPERIDINE 50 MG TUBEX INJ,12.0,7.8,6.0,12.0,14
HCPCS,J2175,MEPERIDINE HYDROCHL /100 MG,14.0,9.1,7.0,14.0,14
HCPCS,J2175,Meperidine hydrochl /100 mg,,,8.8,8.8,1
HCPCS,J21750,Meperidine hydrochl /100 mg,,,8.8,8.8,1
HCPCS,J2180,Meperidine/promethazine inj,,,8.19,20.77,4
HCPCS,J21800,Meperidine/promethazine inj,,,8.19,8.19,1
HCPCS,J2182,"INJECTION, MEPOLIZUMAB, 1MG",133.0,86.45,31.89,133.0,14
HCPCS,J2182,"Injection, mepolizumab, 1mg",,,34.44,34.44,1
HCPCS,J2182,NUCALA 100 MG SUBCUTANEOUS SOLUTION,13229.58,8599.23,27.43,13229.58,53
HCPCS,J2182,NUCALA 100 MG/ML SUBCUTANEOUS AUTO-INJECTOR,14367.54,9338.9,27.43,14367.54,53
HCPCS,J2182,NUCALA 100 MG/ML SUBCUTANEOUS SYRINGE,14367.54,9338.9,27.43,14367.54,53
HCPCS,J21820,"Injection, mepolizumab, 1mg",,,34.44,34.44,1
HCPCS,J2183,Inj meropenem (wg crit care),,,1.7,1.7,1
HCPCS,J2183,MEROPENEM 2 GRAM INTRAVENOUS SOLUTION,115.485,75.065,1.62,118.44,74
HCPCS,J21830,Inj meropenem (wg crit care),,,1.7,1.7,1
HCPCS,J2184,"Inj, meropenem (b. braun)",,,2.17,2.17,1
HCPCS,J2184,MEROPENEM 1 GRAM/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,107.67,69.99,1.82,107.67,31
HCPCS,J2184,MEROPENEM 500 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,73.8,47.97,1.82,73.8,31
HCPCS,J21840,"Inj, meropenem (b. braun)",,,2.17,2.17,1
HCPCS,J2185,MEROPENEM,25.0,16.25,0.38,25.0,14
HCPCS,J2185,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,21.24,13.81,0.35,21.24,31
HCPCS,J2185,MEROPENEM 500 MG INTRAVENOUS SOLUTION,10.8,7.02,0.35,10.8,31
HCPCS,J2185,Meropenem,,,0.41,0.41,1
HCPCS,J21850,Meropenem,,,0.41,0.41,1
HCPCS,J2186,"Inj., meropenem, vaborbactam",,,2.31,2.31,1
HCPCS,J2186,VABOMERE 2 GRAM INTRAVENOUS SOLUTION,825.03,536.27,2.09,825.03,78
HCPCS,J21860,"Inj., meropenem, vaborbactam",,,2.31,2.31,1
HCPCS,J2210,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,91.875,59.715,11.95,112.62,93
HCPCS,J2210,Methylergonovin maleate inj,,,23.07,23.07,1
HCPCS,J22100,Methylergonovin maleate inj,,,23.07,23.07,1
HCPCS,J2212,Methylnaltrexone injection,,,1.62,1.62,1
HCPCS,J2212,RELISTOR 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,1120.5,728.33,4.11,1120.5,23
HCPCS,J2212,RELISTOR 12 MG/0.6 ML SUBCUTANEOUS SYRINGE,1120.5,728.33,4.11,1120.5,46
HCPCS,J2212,RELISTOR 8 MG/0.4 ML SUBCUTANEOUS SYRINGE,1680.75,1092.49,4.11,1680.75,23
HCPCS,J22120,Methylnaltrexone injection,,,1.62,1.62,1
HCPCS,J2246,"Inj, micafungin (baxter)",,,0.44,1.35,14
HCPCS,J22460,"Inj, micafungin (baxter)",,,0.44,0.44,1
HCPCS,J2247,"Inj, micafungin (par pharm)",,,0.24,0.24,1
HCPCS,J2247,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,538.56,350.06,0.24,538.56,31
HCPCS,J2247,MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,269.28,175.03,0.24,269.28,31
HCPCS,J22470,"Inj, micafungin (par pharm)",,,0.24,0.24,1
HCPCS,J2248,MICAFUNGIN SODIUM INJECTION,7.0,4.55,0.25,7.0,14
HCPCS,J2248,Micafungin sodium injection,,,0.27,0.69,12
HCPCS,J22480,Micafungin sodium injection,,,0.27,0.27,1
HCPCS,J2249,BYFAVO 20 MG INTRAVENOUS SOLUTION,157.74,102.53,5.75,157.74,23
HCPCS,J2249,"Inj, remimazolam, 1 mg",,,2.27,2.27,1
HCPCS,J22490,"Inj, remimazolam, 1 mg",,,2.27,2.27,1
HCPCS,J2250,Inj midazolam hydrochloride,,,0.15,0.15,1
HCPCS,J2250,MIDAZOLAM (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,1.08,0.7,0.12,1.08,31
HCPCS,J2250,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,0.99,0.64,0.11,2.13,124
HCPCS,J2250,MIDAZOLAM (PF) 2 MG/2 ML (1 MG/ML) INJECTION SYRINGE,5.64,3.67,0.12,5.64,31
HCPCS,J2250,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,3.39,2.2,0.12,5.01,124
HCPCS,J2250,MIDAZOLAM (PF) 50 MG/50 ML (1 MG/ML) IN SOD CHLORISO-OSM IV SYRINGE,1.5,0.98,0.12,1.5,31
HCPCS,J2250,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,0.9,0.585,0.12,1.17,124
HCPCS,J2250,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,2.595,1.69,0.12,5.1,217
HCPCS,J2250,"MIDAZOLAM HCI, PER 1 MG",6.0,3.9,0.14,6.0,14
HCPCS,J22500,Inj midazolam hydrochloride,,,0.15,0.15,1
HCPCS,J2251,Inj midazolam in 0.9% nacl,,,0.19,0.19,1
HCPCS,J2251,MIDAZOLAM (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.96,0.62,0.16,0.96,31
HCPCS,J22510,Inj midazolam in 0.9% nacl,,,0.19,0.19,1
HCPCS,J2252,Inj midazolam in 0.8% nacl,,,0.11,0.27,4
HCPCS,J22520,Inj midazolam in 0.8% nacl,,,0.11,0.11,1
HCPCS,J2260,INJ MILRINONE LACTATE / 5 ML,186.0,120.9,1.35,186.0,14
HCPCS,J2260,Inj milrinone lactate / 5 mg,,,1.46,1.46,1
HCPCS,J2260,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.25,1.46,0.24,3.73,279
HCPCS,J2260,MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,0.33,0.21,0.06,3.73,31
HCPCS,J22600,Inj milrinone lactate / 5 mg,,,1.46,1.46,1
HCPCS,J2265,MINOCIN 100 MG INTRAVENOUS SOLUTION,958.53,623.04,2.59,958.53,33
HCPCS,J2265,Minocycline hydrochloride,,,2.68,2.68,1
HCPCS,J22650,Minocycline hydrochloride,,,2.68,2.68,1
HCPCS,J2267,"Inj, mirikizumab-mrkz, 1 mg",,,45.27,45.27,1
HCPCS,J2267,OMVOH 300 MG/15 ML (20 MG/ML) INTRAVENOUS SOLUTION,2302.38,1496.55,39.54,3407.66,46
HCPCS,J22670,"Inj, mirikizumab-mrkz, 1 mg",,,45.27,45.27,1
HCPCS,J2270,MORPHINE (PF) 1 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.57,0.37,0.1,8.41,31
HCPCS,J2270,MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,1.11,0.72,0.19,8.41,31
HCPCS,J2270,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,9.18,5.97,1.54,9.18,62
HCPCS,J2270,MORPHINE 10 MG/ML INTRAVENOUS SYRINGE,100.8,65.52,4.01,100.8,31
HCPCS,J2270,MORPHINE 2 MG/ML INTRAVENOUS SYRINGE,28.275,18.38,3.45,36.0,62
HCPCS,J2270,MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,9.0,5.85,1.51,9.0,31
HCPCS,J2270,MORPHINE 4 MG/ML INTRAVENOUS SYRINGE,32.4,21.06,4.01,32.4,31
HCPCS,J2270,MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,15.66,10.18,2.63,15.66,31
HCPCS,J2270,MORPHINE 8 MG/ML INJECTION SOLUTION,10.59,6.88,1.78,10.59,31
HCPCS,J2270,MORPHINE 8 MG/ML INTRAVENOUS SOLUTION,10.17,6.61,1.71,10.17,31
HCPCS,J2270,MORPHINE SULFATE INJECTION,14.0,9.1,3.04,14.0,14
HCPCS,J2270,Morphine sulfate injection,,,3.28,3.28,1
HCPCS,J22700,Morphine sulfate injection,,,3.28,3.28,1
HCPCS,J2272,"Inj, morphine (fresenius)",,,7.31,7.31,1
HCPCS,J2272,MORPHINE 10 MG/ML INJECTION SOLUTION,10.98,7.14,1.84,18.74,31
HCPCS,J2272,MORPHINE 2 MG/ML INJECTION SOLUTION,10.32,6.71,1.73,18.74,31
HCPCS,J2272,MORPHINE 2 MG/ML INJECTION SYRINGE,10.32,6.71,1.73,18.74,31
HCPCS,J2272,MORPHINE 4 MG/ML INJECTION SOLUTION,10.32,6.71,1.73,18.74,31
HCPCS,J2272,MORPHINE 4 MG/ML INJECTION SYRINGE,10.32,6.71,1.73,18.74,62
HCPCS,J2272,MORPHINE 5 MG/ML INJECTION SYRINGE,10.32,6.71,1.73,18.74,31
HCPCS,J22720,"Inj, morphine (fresenius)",,,7.31,7.31,1
HCPCS,J2274,DURAMORPH (PF) 0.5 MG/ML INJECTION SOLUTION,10.44,6.79,1.75,37.35,31
HCPCS,J2274,DURAMORPH (PF) 1 MG/ML INJECTION SOLUTION,10.44,6.79,1.75,37.35,31
HCPCS,J2274,INFUMORPH P/F 10 MG/ML INJECTION SOLUTION,37.44,24.34,6.29,37.44,31
HCPCS,J2274,INFUMORPH P/F 25 MG/ML INJECTION SOLUTION,63.66,41.38,10.69,63.66,31
HCPCS,J2274,Inj morphine pf epid ithc,,,14.58,14.58,1
HCPCS,J2274,MITIGO (PF) 25 MG/ML INJECTION SOLUTION,69.45,45.14,11.67,69.45,31
HCPCS,J2274,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,8.37,5.44,1.41,37.35,62
HCPCS,J2274,MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,16.77,10.9,2.82,37.35,31
HCPCS,J22740,Inj morphine pf epid ithc,,,14.58,14.58,1
HCPCS,J2277,APHEXDA 62 MG SUBCUTANEOUS SOLUTION,21240.0,13806.0,25.22,21240.0,52
HCPCS,J2277,"Inj, motixafortide, 0.25 mg",,,28.6,28.6,1
HCPCS,J22770,"Inj, motixafortide, 0.25 mg",,,28.6,28.6,1
HCPCS,J2278,PRIALT 100 MCG/ML INTRATHECAL SOLUTION,4405.665,2863.6800000000003,8.14,4520.82,100
HCPCS,J2278,PRIALT 25 MCG/ML INTRATHECAL SOLUTION,1072.62,697.2,8.14,1072.62,47
HCPCS,J2278,"PRIALT, PER 1 MCG",21.0,13.65,10.5,21.0,14
HCPCS,J2278,ZICONOTIDE INJ 1 MCG,13.0,8.45,6.5,13.0,14
HCPCS,J2278,ZICONOTIDE INJECTION,26.0,16.9,10.57,26.0,14
HCPCS,J2278,Ziconotide injection,,,11.42,11.42,1
HCPCS,J22780,Ziconotide injection,,,11.42,11.42,1
HCPCS,J2280,"INJ, MOXIFLOXACIN 100 MG",13.0,8.45,6.5,13.0,14
HCPCS,J2280,"Inj, moxifloxacin 100 mg",,,9.89,9.89,1
HCPCS,J2280,MOXIFLOXACIN 400 MG/250 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.66,0.43,0.11,25.35,31
HCPCS,J22800,"Inj, moxifloxacin 100 mg",,,9.89,9.89,1
HCPCS,J2281,Inj moxifloxacin (fres kabi),,,7.17,7.17,1
HCPCS,J2281,MOXIFLOXACIN 400 MG/250 ML-SODIUM ACETSUL-WATER INTRAVENOUS PIGGYBACK,0.66,0.43,0.11,18.39,31
HCPCS,J22810,Inj moxifloxacin (fres kabi),,,7.17,7.17,1
HCPCS,J2290,"Inj, nafcillin sodium, 20 mg",,,0.06,0.06,1
HCPCS,J2290,NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,43.5,28.28,0.11,53.61,90
HCPCS,J2290,NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,104.01,67.61,0.11,104.01,30
HCPCS,J22900,"Inj, nafcillin sodium, 20 mg",,,0.06,0.06,1
HCPCS,J2291,"Inj, nafcillin (baxter) 20mg",,,0.16,0.16,1
HCPCS,J2291,NAFCILLIN 2 GRAM/100 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.87,0.57,0.15,0.87,30
HCPCS,J22910,"Inj, nafcillin (baxter) 20mg",,,0.16,0.16,1
HCPCS,J2300,Inj nalbuphine hydrochloride,,,3.73,3.73,1
HCPCS,J2300,NALBUPHINE 10 MG/ML INJECTION SOLUTION,19.77,12.85,2.17,22.29,155
HCPCS,J2300,NALBUPHINE 20 MG/ML INJECTION SOLUTION,38.64,25.12,2.54,40.26,93
HCPCS,J2300,"NALBUPHINE HCL, PER 10 MG",14.0,9.1,3.45,14.0,14
HCPCS,J23000,Inj nalbuphine hydrochloride,,,3.73,3.73,1
HCPCS,J2305,"Inj, nitroglycerin, 5 mg",,,1.64,1.64,1
HCPCS,J2305,NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE  INTRAVENOUS,0.3,0.2,0.05,4.22,31
HCPCS,J2305,NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,0.33,0.21,0.06,4.22,31
HCPCS,J2305,NITROGLYCERIN INTRACORONARY 0.2 MG/ML,2.88,1.87,0.48,4.22,31
HCPCS,J23050,"Inj, nitroglycerin, 5 mg",,,1.64,1.64,1
HCPCS,J2310,Inj naloxone hydrochloride,,,7.25,7.25,1
HCPCS,J2311,"Inj, naloxone hcl (zimhi)",,,5.66,5.66,1
HCPCS,J2312,"Inj naloxone hcl nos, 0.01mg",,,0.08,0.08,1
HCPCS,J2312,NALOXONE 0.4 MG/ML INJECTION SOLUTION,49.875,32.42,0.13,57.0,90
HCPCS,J2312,NALOXONE 0.4 MG/ML INJECTION SYRINGE,241.2,156.78,0.13,241.2,30
HCPCS,J2312,NALOXONE 1 MG/ML INJECTION SYRINGE,58.05,37.735,0.13,59.4,60
HCPCS,J23120,"Inj naloxone hcl nos, 0.01mg",,,0.08,0.08,1
HCPCS,J2313,"Inj, naloxone (zimhi) 0.01mg",,,0.02,0.05,11
HCPCS,J23130,"Inj, naloxone (zimhi) 0.01mg",,,0.02,0.02,1
HCPCS,J2315,"Naltrexone, depot form",,,4.58,4.58,1
HCPCS,J2315,VIVITROL 380 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,6085.23,3955.4,3.57,6085.23,53
HCPCS,J23150,"Naltrexone, depot form",,,4.58,4.58,1
HCPCS,J2320,Nandrolone decanoate 50 mg,,,3.67,9.32,4
HCPCS,J23200,Nandrolone decanoate 50 mg,,,3.67,3.67,1
HCPCS,J2323,NATALIZUMAB INJECTION,25.0,16.25,12.5,27.73,14
HCPCS,J2323,Natalizumab injection,,,26.47,26.47,1
HCPCS,J2323,TYSABRI 1 MG NATALIZUMAB,25.0,16.25,6.48,3407.66,47
HCPCS,J2323,TYSABRI 300 MG/15 ML INTRAVENOUS SOLUTION,2131.02,1385.16,21.8,3407.66,47
HCPCS,J23230,Natalizumab injection,,,26.47,26.47,1
HCPCS,J2325,Nesiritide injection,,,73.16,383.26,13
HCPCS,J23250,Nesiritide injection,,,73.16,73.16,1
HCPCS,J2326,"Inj, nusinersen, 0.1mg",,,1264.02,1264.02,1
HCPCS,J2326,SPINRAZA (PF) 12 MG/5 ML INTRATHECAL SOLUTION,105335.25,68467.91,1231.9,105335.25,45
HCPCS,J23260,"Inj, nusinersen, 0.1mg",,,1264.02,1264.02,1
HCPCS,J2327,Inj risankizumab-rzaa 1 mg,,,16.12,16.12,1
HCPCS,J2327,SKYRIZI 150 MG/ML SUBCUTANEOUS PEN INJECTOR,80580.57,52377.37,13.5,80580.57,53
HCPCS,J2327,SKYRIZI 60 MG/ML INTRAVENOUS SOLUTION,3827.52,2487.89,13.5,3827.52,50
HCPCS,J23270,Inj risankizumab-rzaa 1 mg,,,16.12,16.12,1
HCPCS,J2329,BRIUMVI 25 MG/ML INTRAVENOUS SOLUTION,6666.0,4332.9,60.51,12697.64,53
HCPCS,J2329,"Inj ublituximab-xiiy, 1 mg",,,75.79,75.79,1
HCPCS,J23290,"Inj ublituximab-xiiy, 1 mg",,,75.79,75.79,1
HCPCS,J2350,"Injection, ocrelizumab, 1 mg",,,64.07,64.07,1
HCPCS,J2350,OCREVUS 30 MG/ML INTRAVENOUS SOLUTION,7430.76,4829.99,52.88,18253.82,53
HCPCS,J23500,"Injection, ocrelizumab, 1 mg",,,64.07,64.07,1
HCPCS,J2351,Inj ocrelizumab 1mg hya-ocsq,,,50.81,50.81,1
HCPCS,J2351,OCREVUS ZUNOVO 920 MG-23000 UNIT/23 ML SUBCUTANEOUS SOLUTION,6461.52,4199.99,47.04,18253.82,45
HCPCS,J23510,Inj ocrelizumab 1mg hya-ocsq,,,50.81,50.81,1
HCPCS,J2353,"OCTREOTIDE INJECTION, DEPOT",264.0,171.6,132.0,264.0,14
HCPCS,J2353,"Octreotide injection, depot",,,215.1,215.1,1
HCPCS,J2353,SANDOSTATIN LAR DEPOT 10 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,12684.36,8244.83,189.5,12684.36,53
HCPCS,J2353,SANDOSTATIN LAR DEPOT 20 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,16618.68,10802.14,189.5,16618.68,106
HCPCS,J2353,SANDOSTATIN LAR DEPOT 30 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,24885.21,16175.39,189.5,24885.21,106
HCPCS,J23530,"Octreotide injection, depot",,,215.1,215.1,1
HCPCS,J2354,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,35.79,23.26,1.01,35.79,30
HCPCS,J2354,OCTREOTIDE ACETATE 1000 MCG/ML INJECTION SOLUTION,357.75,232.54,1.01,357.75,31
HCPCS,J2354,OCTREOTIDE ACETATE 200 MCG/ML INJECTION SOLUTION,71.55,46.51,1.01,71.55,31
HCPCS,J2354,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,17.205,11.184999999999999,1.01,18.21,124
HCPCS,J2354,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,178.89,116.28,1.01,178.89,31
HCPCS,J2354,"Octreotide inj, non-depot",,,0.71,0.71,1
HCPCS,J2354,SANDOSTATIN 100 MCG/ML INJECTION SOLUTION,98.58,64.08,1.01,98.58,31
HCPCS,J2354,SANDOSTATIN 50 MCG/ML INJECTION SOLUTION,50.82,33.03,1.01,50.82,31
HCPCS,J2354,SANDOSTATIN 500 MCG/ML INJECTION SOLUTION,475.44,309.04,1.01,475.44,31
HCPCS,J23540,"Octreotide inj, non-depot",,,0.71,0.71,1
HCPCS,J2355,Oprelvekin injection,,,97.89,1159.4,13
HCPCS,J23550,Oprelvekin injection,,,456.99,456.99,1
HCPCS,J2356,"INJ TEZEPELUMAB-EKKO, 1MG",14387.0,9351.55,17.82,14387.0,14
HCPCS,J2356,"Inj tezepelumab-ekko, 1mg",,,19.25,19.25,1
HCPCS,J2356,TEZSPIRE 210 MG/1.91 ML (110 MG/ML) SUBCUTANEOUS PEN INJECTOR,8811.84,5727.7,16.02,8811.84,53
HCPCS,J2356,TEZSPIRE 210 MG/1.91 ML (110 MG/ML) SUBCUTANEOUS SYRINGE,8234.7,5352.56,16.02,8234.7,53
HCPCS,J23560,"Inj tezepelumab-ekko, 1mg",,,19.25,19.25,1
HCPCS,J2357,OMALIZUMAB INJECTION,73.0,47.45,36.5,73.0,14
HCPCS,J2357,Omalizumab injection,,,49.14,49.14,1
HCPCS,J2357,XOLAIR 150 MG SUBCUTANEOUS SOLUTION,7069.24,4595.01,33.13,7069.24,53
HCPCS,J2357,XOLAIR 150 MG/ML SUBCUTANEOUS AUTO-INJECTOR,5301.93,3446.25,33.13,5301.93,53
HCPCS,J2357,XOLAIR 150 MG/ML SUBCUTANEOUS SYRINGE,5301.93,3446.25,33.13,5301.93,106
HCPCS,J2357,XOLAIR 300 MG/2 ML SUBCUTANEOUS AUTO-INJECTOR,5301.96,3446.27,33.13,5301.96,53
HCPCS,J2357,XOLAIR 300 MG/2 ML SUBCUTANEOUS SYRINGE,5301.96,3446.27,33.13,5301.96,53
HCPCS,J2357,XOLAIR 75 MG/0.5 ML SUBCUTANEOUS AUTO-INJECTOR,5301.93,3446.25,33.13,5301.93,53
HCPCS,J2357,XOLAIR 75 MG/0.5 ML SUBCUTANEOUS SYRINGE,5301.93,3446.25,33.13,5301.93,106
HCPCS,J23570,Omalizumab injection,,,49.14,49.14,1
HCPCS,J2358,Olanzapine long-acting inj,,,2.63,8.74,25
HCPCS,J23580,Olanzapine long-acting inj,,,3.41,3.41,1
HCPCS,J2359,"Inj. olanzapine, 0.5mg",,,0.87,0.87,1
HCPCS,J2359,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,124.5,80.93,0.86,142.17,93
HCPCS,J23590,"Inj. olanzapine, 0.5mg",,,0.87,0.87,1
HCPCS,J2360,ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION,24.84,16.145,3.63,28.08,62
HCPCS,J2360,ORPHENADRINE INJ TO 60 MG,21.0,13.65,6.39,21.0,14
HCPCS,J2360,Orphenadrine injection,,,6.9,6.9,1
HCPCS,J23600,Orphenadrine injection,,,6.9,6.9,1
HCPCS,J2370,PHENYLEPHRINE HCL INJECTION,19.0,12.35,9.5,19.0,12
HCPCS,J2371,Inj phenylephrine hcl 20 mcg,,,0.01,0.01,1
HCPCS,J2371,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,14.28,9.28,0.03,14.58,138
HCPCS,J23710,Inj phenylephrine hcl 20 mcg,,,0.01,0.01,1
HCPCS,J2372,"Inj, biorphen, 20 micrograms",,,0.16,0.44,12
HCPCS,J23720,"Inj, biorphen, 20 micrograms",,,0.17,0.17,1
HCPCS,J2373,"Inj, immphentiv, 20 mcg",,,0.15,0.38,24
HCPCS,J23730,"Inj, immphentiv, 20 mcg",,,0.15,0.15,1
HCPCS,J2401,CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,3.84,2.5,0.04,3.84,62
HCPCS,J2401,CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,4.02,2.61,0.04,4.02,62
HCPCS,J2401,Chloroprocaine hcl injection,,,0.04,0.04,1
HCPCS,J2401,NESACAINE 10 MG/ML (1 %) INJECTION SOLUTION,2.16,1.4,0.04,2.16,31
HCPCS,J2401,NESACAINE 20 MG/ML (2 %) INJECTION SOLUTION,2.22,1.44,0.04,2.22,31
HCPCS,J2401,NESACAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,4.38,2.85,0.04,4.38,62
HCPCS,J2401,NESACAINE-MPF 30 MG/ML (3 %) INJECTION SOLUTION,4.02,2.61,0.04,4.02,31
HCPCS,J24010,Chloroprocaine hcl injection,,,0.04,0.04,1
HCPCS,J2402,Chloroprocaine (clorotekal),,,0.32,0.82,7
HCPCS,J24020,Chloroprocaine (clorotekal),,,0.32,0.32,1
HCPCS,J2403,"Chloroprocaine opht gel, 1mg",,,0.58,1.62,29
HCPCS,J24030,"Chloroprocaine opht gel, 1mg",,,0.63,0.63,1
HCPCS,J2404,"Inj, nicardipine 0.1 mg",,,0.08,0.08,1
HCPCS,J2404,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,10.125,6.585,0.13,78.3,72
HCPCS,J24040,"Inj, nicardipine 0.1 mg",,,0.08,0.08,1
HCPCS,J2405,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,1.86,1.21,0.09,2.31,124
HCPCS,J2405,ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,1.35,0.88,0.09,1.41,62
HCPCS,J2405,ONDANSETRON HCL INJECTION,20.0,13.0,0.09,20.0,14
HCPCS,J2405,Ondansetron hcl injection,,,0.1,0.1,1
HCPCS,J2405,ZOFRAN INJ PER 1 MG,20.0,13.0,0.09,20.0,31
HCPCS,J24050,Ondansetron hcl injection,,,0.1,0.1,1
HCPCS,J2406,"Injection, oritavancin 10 mg",,,46.5,46.5,1
HCPCS,J2406,KIMYRSA 1200 MG INTRAVENOUS SOLUTION,20173.38,13112.7,36.81,20173.38,53
HCPCS,J24060,"Injection, oritavancin 10 mg",,,46.5,46.5,1
HCPCS,J2407,"Injection, oritavancin",,,24.22,943.43,35
HCPCS,J24070,"Injection, oritavancin",,,30.75,30.75,1
HCPCS,J2410,Oxymorphone hcl injection,,,3.24,8.22,7
HCPCS,J24100,Oxymorphone hcl injection,,,3.24,3.24,1
HCPCS,J2425,PALIFERMIN INJECTION,72.0,46.8,36.0,72.0,14
HCPCS,J2425,Palifermin injection,,,33.99,943.43,34
HCPCS,J24250,Palifermin injection,,,39.56,39.56,1
HCPCS,J2426,INVEGA SUSTENNA 117 MG/0.75 ML INTRAMUSCULAR SYRINGE,8565.84,5567.8,12.85,8565.84,53
HCPCS,J2426,INVEGA SUSTENNA 156 MG/ML INTRAMUSCULAR SYRINGE,8566.17,5568.01,12.85,8566.17,53
HCPCS,J2426,INVEGA SUSTENNA 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,8565.96,5567.87,12.85,8565.96,53
HCPCS,J2426,INVEGA SUSTENNA 39 MG/0.25 ML INTRAMUSCULAR SYRINGE,8565.27,5567.43,12.85,8565.27,53
HCPCS,J2426,INVEGA SUSTENNA 78 MG/0.5 ML INTRAMUSCULAR SYRINGE,8565.69,5567.7,12.85,8565.69,53
HCPCS,J2426,"Inj, invega sustenna, 1 mg",,,16.32,16.32,1
HCPCS,J24260,"Inj, invega sustenna, 1 mg",,,16.32,16.32,1
HCPCS,J2427,INVEGA HAFYERA 1092 MG/3.5 ML INTRAMUSCULAR SYRINGE,14684.85,9545.15,10.97,14684.85,53
HCPCS,J2427,INVEGA HAFYERA 1560 MG/5 ML INTRAMUSCULAR SYRINGE,15418.74,10022.18,10.97,15418.74,53
HCPCS,J2427,INVEGA TRINZA 410 MG/1.32 ML INTRAMUSCULAR SYRINGE,14600.88,9490.57,10.97,14600.88,53
HCPCS,J2427,INVEGA TRINZA 546 MG/1.75 ML INTRAMUSCULAR SYRINGE,14684.85,9545.15,10.97,14684.85,53
HCPCS,J2427,INVEGA TRINZA 819 MG/2.63 ML INTRAMUSCULAR SYRINGE,14656.59,9526.78,10.97,14656.59,53
HCPCS,J2427,"Inj, invega hafyera/trinza",,,14.03,14.03,1
HCPCS,J24270,"Inj, invega hafyera/trinza",,,14.03,14.03,1
HCPCS,J2428,"Inj, erzofri, 1 mg",,,15.3,652.67,21
HCPCS,J24280,"Inj, erzofri, 1 mg",,,16.52,16.52,1
HCPCS,J2430,PAMIDRONATE 30 MG INTRAVENOUS SOLUTION,67.65,43.97,11.37,67.65,30
HCPCS,J2430,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,9.72,6.32,0.87,31.24,90
HCPCS,J2430,PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,16.35,10.63,2.75,31.24,30
HCPCS,J2430,PAMIDRONATE 90 MG INTRAVENOUS SOLUTION,202.92,131.9,12.31,202.92,30
HCPCS,J2430,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,33.69,21.9,2.27,38.01,90
HCPCS,J2430,PAMIDRONATE DISODIUM /30 MG,1307.0,849.55,11.29,1307.0,14
HCPCS,J2430,Pamidronate disodium /30 mg,,,12.19,12.19,1
HCPCS,J24300,Pamidronate disodium /30 mg,,,12.19,12.19,1
HCPCS,J2440,PAPAVERIN HCL INJECTION,37.0,24.05,18.5,40.32,14
HCPCS,J2440,PAPAVERINE 30 MG/ML INJECTION SOLUTION,71.025,46.17,11.34,98.64,46
HCPCS,J2440,Papaverin hcl injection,,,38.88,38.88,1
HCPCS,J24400,Papaverin hcl injection,,,38.88,38.88,1
HCPCS,J2460,Oxytetracycline injection,,,0.95,2.41,7
HCPCS,J24600,Oxytetracycline injection,,,0.95,0.95,1
HCPCS,J2468,"Inj, palonosetron (posfrea)",,,58.57,162.1,28
HCPCS,J24680,"Inj, palonosetron (posfrea)",,,63.27,63.27,1
HCPCS,J2469,PALONOSETRON 0.25 MG/2 ML INTRAVENOUS SOLUTION,72.0,46.8,0.67,72.0,31
HCPCS,J2469,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,6.48,4.21,0.67,6.48,31
HCPCS,J2469,PALONOSETRON HCL,40.0,26.0,0.35,40.0,14
HCPCS,J2469,Palonosetron hcl,,,0.38,0.38,1
HCPCS,J24690,Palonosetron hcl,,,0.38,0.38,1
HCPCS,J2470,Inj pantoprazole sodium 40mg,,,1.97,1.97,1
HCPCS,J2470,PROTONIX 40 MG INTRAVENOUS SOLUTION,18.27,11.88,3.07,18.27,23
HCPCS,J24700,Inj pantoprazole sodium 40mg,,,1.97,1.97,1
HCPCS,J2471,Inj pantoprazole(hikma) 40mg,,,3.63,3.63,1
HCPCS,J2471,PROTONIX 40 MG INTRAVENOUS SOLUTION,12.54,8.155000000000001,1.14,18.27,46
HCPCS,J24710,Inj pantoprazole(hikma) 40mg,,,3.63,3.63,1
HCPCS,J2472,"Inj, pantoprazole sodium chl",,,9.14,23.18,4
HCPCS,J24720,"Inj, pantoprazole sodium chl",,,9.14,9.14,1
HCPCS,J2501,Paricalcitol,,,1.05,1.05,1
HCPCS,J2501,ZEMPLAR 5 MCG/ML INTRAVENOUS SOLUTION,54.54,35.45,0.68,54.54,62
HCPCS,J25010,Paricalcitol,,,1.05,1.05,1
HCPCS,J2502,"Inj, pasireotide long acting",,,621.08,621.08,1
HCPCS,J2502,SIGNIFOR LAR 60 MG IM SUSPENSION,78332.04,50915.83,479.84,78332.04,104
HCPCS,J25020,"Inj, pasireotide long acting",,,621.08,621.08,1
HCPCS,J2503,Pegaptanib sodium injection,,,516.7,1312.57,9
HCPCS,J2504,"Pegademase bovine, 25 iu",,,97.89,913.11,12
HCPCS,J2505,"Injection, pegfilgrastim 6mg",,,1073.13,1355.53,6
HCPCS,J2506,Inj pegfilgrast ex bio 0.5mg,,,132.67,132.67,1
HCPCS,J2506,NEULASTA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,38507.94,25030.16,27.11,38507.94,53
HCPCS,J2506,NEULASTA ONPRO 6 MG/0.6 ML WITH WEARABLE SUBCUTANEOUS INJECTOR,38507.94,25030.16,27.11,38507.94,53
HCPCS,J25060,Inj pegfilgrast ex bio 0.5mg,,,132.67,132.67,1
HCPCS,J2507,KRYSTEXXA 8 MG/50 ML INTRAVENOUS SOLUTION,2213.49,1438.77,573.29,12697.64,47
HCPCS,J2507,KRYSTEXXA 8 MG/ML INTRAVENOUS SOLUTION,110674.77,71938.6,3052.72,110674.77,53
HCPCS,J2507,Pegloticase injection,,,4070.31,4070.31,1
HCPCS,J25070,Pegloticase injection,,,4070.31,4070.31,1
HCPCS,J2508,ELFABRIO 2 MG/ML INTRAVENOUS SOLUTION,1626.21,1057.04,223.55,1626.21,46
HCPCS,J2508,Pegunigalsidase alfa-iwxj,,,244.03,244.03,1
HCPCS,J25080,Pegunigalsidase alfa-iwxj,,,244.03,244.03,1
HCPCS,J2510,PENICILLIN G SODIUM 5 MILLION UNIT SOLUTION FOR INJECTION,172.8,112.32,29.03,172.8,30
HCPCS,J2510,Penicillin g procaine inj,,,47.64,47.64,1
HCPCS,J25100,Penicillin g procaine inj,,,47.64,47.64,1
HCPCS,J2513,Pentastarch 10% solution,,,13.74,94.3,12
HCPCS,J2515,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,184.5,119.925,36.26,217.8,64
HCPCS,J2515,Pentobarbital sodium inj,,,43.8,43.8,1
HCPCS,J25150,Pentobarbital sodium inj,,,43.8,43.8,1
HCPCS,J2516,"Inj, pentamidine isethionate",,,0.26,0.26,1
HCPCS,J2516,PENTAM 300 MG SOLUTION FOR INJECTION,600.81,390.53,0.46,600.81,30
HCPCS,J2516,PENTAMIDINE 300 MG SOLUTION FOR INJECTION,337.5,219.38,0.46,337.5,30
HCPCS,J25160,"Inj, pentamidine isethionate",,,0.26,0.26,1
HCPCS,J2536,VASOPRESSIN 20 UNIT/100 ML (0.2 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV,9.54,6.2,1.6,9.54,22
HCPCS,J2540,PENICILLIN G POT 3 MILLION UNIT/50 ML-DEXTROSE INTRAVENOUS PIGGYBACK,0.78,0.51,0.13,2.16,31
HCPCS,J2540,PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,47.64,30.97,0.75,47.64,31
HCPCS,J2540,PENICILLIN G POTASSIUM INJ,2.0,1.3,0.78,2.0,14
HCPCS,J2540,PFIZERPEN-G 5 MILLION UNIT SOLUTION FOR INJECTION,45.81,29.78,0.75,45.81,31
HCPCS,J2540,Penicillin g potassium inj,,,0.84,0.84,1
HCPCS,J25400,Penicillin g potassium inj,,,0.84,0.84,1
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,10.8,7.02,0.95,10.8,31
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,37.65,24.47,0.95,55.38,93
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,528.36,343.43,0.95,528.36,31
HCPCS,J2543,PIPERACILLIN/TAZOBACTAM INJ,12.0,7.8,1.09,12.0,14
HCPCS,J2543,Piperacillin/tazobactam,,,1.18,1.18,1
HCPCS,J2543,ZOSYN 2.25 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,1.11,0.72,0.19,3.01,31
HCPCS,J2543,ZOSYN 3.375 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,1.47,0.96,0.25,3.01,31
HCPCS,J2543,ZOSYN 4.5 GRAM/100 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.93,0.6,0.16,3.01,31
HCPCS,J25430,Piperacillin/tazobactam,,,1.18,1.18,1
HCPCS,J2545,PENTAM 300 MG,193.5,125.775,48.0,291.0,28
HCPCS,J2545,PENTAMIDINE ISETHIONTE/300MG,275.0,178.75,90.0,275.0,14
HCPCS,J2545,Pentamidine non-comp unit,,,61.99,246.6,11
HCPCS,J25450,Pentamidine non-comp unit,,,97.2,97.2,1
HCPCS,J2547,"Injection, peramivir",,,1.64,1.64,1
HCPCS,J2547,RAPIVAB (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,57.0,37.05,1.67,943.43,39
HCPCS,J25470,"Injection, peramivir",,,1.64,1.64,1
HCPCS,J2550,PHENERGAN 50 MG INJ,12.0,7.8,3.97,12.0,14
HCPCS,J2550,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.48,4.215,1.06,10.99,186
HCPCS,J2550,PROMETHAZINE 50 MG/ML INJECTION SOLUTION,9.33,6.06,1.57,10.99,62
HCPCS,J2550,PROMETHAZINE HCL INJECTION,14.0,9.1,3.97,14.0,14
HCPCS,J2550,Promethazine hcl injection,,,4.29,4.29,1
HCPCS,J25500,Promethazine hcl injection,,,4.29,4.29,1
HCPCS,J2560,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,162.0,105.3,26.61,165.6,62
HCPCS,J2560,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,67.5,43.875,10.58,80.47,62
HCPCS,J2560,Phenobarbital sodium inj,,,31.41,31.41,1
HCPCS,J25600,Phenobarbital sodium inj,,,31.41,31.41,1
HCPCS,J2561,"Inj, sezaby, 1 mg",,,0.88,3.51,21
HCPCS,J25610,"Inj, sezaby, 1 mg",,,1.38,1.38,1
HCPCS,J2562,MOZOBIL 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,29904.21,19437.74,30.66,29904.21,53
HCPCS,J2562,PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,3171.0,2061.15,30.66,3407.66,50
HCPCS,J2562,Plerixafor injection,,,33.11,33.11,1
HCPCS,J25620,Plerixafor injection,,,33.11,33.11,1
HCPCS,J2590,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,5.94,3.86,0.62,10.8,115
HCPCS,J2590,Oxytocin injection,,,1.45,1.45,1
HCPCS,J2590,PITOCIN 10 UNIT/ML INJECTION SOLUTION,9.0,5.85,0.85,12.96,46
HCPCS,J25900,Oxytocin injection,,,1.45,1.45,1
HCPCS,J2596,Vasopressin (long grove) 1 u,,,1.93,4.96,11
HCPCS,J25960,Vasopressin (long grove) 1 u,,,1.93,1.93,1
HCPCS,J2597,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,152.4,99.06,5.42,285.2,352
HCPCS,J2597,"DESMOPRESSIN ACETATE,PER 4 MCG",15.0,9.75,3.41,15.0,14
HCPCS,J2597,Inj desmopressin acetate,,,3.68,3.68,1
HCPCS,J25970,Inj desmopressin acetate,,,3.68,3.68,1
HCPCS,J2598,"Inj, vasopressin, 1 unit",,,0.57,0.57,1
HCPCS,J2598,VASOSTRICT 0.2 UNIT/ML INTRAVENOUS SOLUTION,1.23,0.8,0.21,1.7,31
HCPCS,J2598,VASOSTRICT 20 UNIT/ML INTRAVENOUS SOLUTION,41.07,26.700000000000003,1.01,46.44,93
HCPCS,J25980,"Inj, vasopressin, 1 unit",,,0.57,0.57,1
HCPCS,J2599,Inj vasopressin (am reg) 1 u,,,0.25,2.38,12
HCPCS,J25990,Inj vasopressin (am reg) 1 u,,,0.93,0.93,1
HCPCS,J2601,"Inj, vasopressin (baxter)",,,2.22,8.14,28
HCPCS,J26010,"Inj, vasopressin (baxter)",,,2.4,2.4,1
HCPCS,J2650,Prednisolone acetate inj,,,0.43,1.1,7
HCPCS,J26500,Prednisolone acetate inj,,,0.43,0.43,1
HCPCS,J2670,Totazoline hcl injection,,,3.56,9.04,7
HCPCS,J26700,Totazoline hcl injection,,,3.56,3.56,1
HCPCS,J2675,INJ PROGESTERONE PER 50 MG,19.0,12.35,0.72,19.0,14
HCPCS,J2675,Inj progesterone per 50 mg,,,0.78,0.78,1
HCPCS,J2675,PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,10.8,7.02,0.63,11.64,93
HCPCS,J26750,Inj progesterone per 50 mg,,,0.78,0.78,1
HCPCS,J2679,FLUPHENAZINE 2.5 MG/ML INJECTION SOLUTION,69.15,44.95,7.1,69.15,38
HCPCS,J2679,Inj fluphenazine hcl 1.25 mg,,,7.98,7.98,1
HCPCS,J26790,Inj fluphenazine hcl 1.25 mg,,,7.98,7.98,1
HCPCS,J2680,FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION,108.0,70.2,8.75,111.57,93
HCPCS,J2680,Fluphenazine decanoate 25 mg,,,6.7,6.7,1
HCPCS,J26800,Fluphenazine decanoate 25 mg,,,6.7,6.7,1
HCPCS,J2690,PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,90.33,58.715,8.58,1179.51,82
HCPCS,J2690,PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,810.0,526.5,168.48,1179.51,41
HCPCS,J2690,PROCAINAMIDE HCL INJECTION,43.0,27.95,21.5,389.74,14
HCPCS,J2690,Procainamide hcl injection,,,372.09,372.09,1
HCPCS,J26900,Procainamide hcl injection,,,372.09,372.09,1
HCPCS,J2700,OXACILLIN 1 GRAM SOLUTION FOR INJECTION,42.78,27.810000000000002,1.01,43.5,62
HCPCS,J2700,OXACILLIN 10 GRAM SOLUTION FOR INJECTION,420.48,273.31,1.01,420.48,31
HCPCS,J2700,OXACILLIN 2 GRAM SOLUTION FOR INJECTION,84.09,54.66,1.01,87.0,124
HCPCS,J2700,OXACILLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,1.77,1.15,0.3,1.77,31
HCPCS,J2700,Oxacillin sodium injeciton,,,0.62,0.62,1
HCPCS,J27000,Oxacillin sodium injeciton,,,0.62,0.62,1
HCPCS,J2704,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.08,0.7,0.07,1.14,248
HCPCS,J2704,"Inj, propofol, 10 mg",,,0.1,0.1,1
HCPCS,J2704,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,0.78,0.51,0.11,0.78,93
HCPCS,J27040,"Inj, propofol, 10 mg",,,0.1,0.1,1
HCPCS,J2710,BLOXIVERZ 0.5 MG/ML INTRAVENOUS SOLUTION,27.45,17.84,1.84,27.45,23
HCPCS,J2710,NEOSTIGMINE METHYLSLFTE INJ,26.0,16.9,0.7,26.0,14
HCPCS,J2710,NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INTRAVENOUS SOLUTION,2.88,1.87,0.48,2.88,46
HCPCS,J2710,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,3.24,2.11,0.54,3.24,23
HCPCS,J2710,Neostigmine methylslfte inj,,,0.72,0.72,1
HCPCS,J2710,PROSTIGMIN UP TO 0.5 MG,21.0,13.65,0.7,21.0,14
HCPCS,J27100,Neostigmine methylslfte inj,,,0.72,0.72,1
HCPCS,J2711,Inj neostigmin/glycopyrrolat,,,0.73,1.86,4
HCPCS,J27110,Inj neostigmin/glycopyrrolat,,,0.73,0.73,1
HCPCS,J2720,INJ PROTAMINE SULFATE/10 MG,3.0,1.95,1.5,3.0,14
HCPCS,J2720,Inj protamine sulfate/10 mg,,,1.7,1.7,1
HCPCS,J2720,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,7.365,4.79,0.8,11.16,124
HCPCS,J27200,Inj protamine sulfate/10 mg,,,1.7,1.7,1
HCPCS,J2724,CEPROTIN (GREEN BAR) 1000 UNIT INTRAVENOUS SOLUTION,5.4,3.51,1.4,1355.53,47
HCPCS,J2724,Protein c concentrate,,,16.21,16.21,1
HCPCS,J27240,Protein c concentrate,,,16.21,16.21,1
HCPCS,J2725,Inj protirelin per 250 mcg,,,22.18,56.28,7
HCPCS,J27250,Inj protirelin per 250 mcg,,,22.18,22.18,1
HCPCS,J2730,PROTOPAM CHLORIDE 1 GRAM SOLUTION FOR INJECTION,312.12,202.88,52.44,312.12,58
HCPCS,J2730,Pralidoxime chloride inj,,,89.89,89.89,1
HCPCS,J27300,Pralidoxime chloride inj,,,89.89,89.89,1
HCPCS,J2760,PHENTOLAINE MESYLATE INJ,121.0,78.65,60.5,475.73,14
HCPCS,J2760,PHENTOLAMINE 5 MG INJECTION SOLUTION,1763.865,1146.51,74.0,1763.88,94
HCPCS,J2760,Phentolaine mesylate inj,,,454.2,454.2,1
HCPCS,J27600,Phentolaine mesylate inj,,,454.2,454.2,1
HCPCS,J2765,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,4.140000000000001,2.69,0.38,6.03,93
HCPCS,J2765,METOCLOPRAMIDE HCL INJECTION,15.0,9.75,1.08,15.0,14
HCPCS,J2765,Metoclopramide hcl injection,,,1.17,1.17,1
HCPCS,J27650,Metoclopramide hcl injection,,,1.17,1.17,1
HCPCS,J2770,QUINUPRISTIN/DALFOPRISTIN,386.0,250.9,193.0,501.05,14
HCPCS,J2770,Quinupristin/dalfopristin,,,4.26,1225.79,23
HCPCS,J27700,Quinupristin/dalfopristin,,,483.16,483.16,1
HCPCS,J2777,"Inj, faricimab-svoa, 0.1mg",,,35.53,35.53,1
HCPCS,J2777,VABYSMO 6 MG/0.05 ML INTRAVITREAL SOLUTION,168976.08,109834.45,31.9,168976.08,53
HCPCS,J2777,VABYSMO 6 MG/0.05 ML INTRAVITREAL SYRINGE,168976.08,109834.45,31.9,168976.08,53
HCPCS,J27770,"Inj, faricimab-svoa, 0.1mg",,,35.53,35.53,1
HCPCS,J2778,DARVOCET-N 50 50 MG-325 MG TAB,140400.0,91260.0,65.44,140400.0,53
HCPCS,J2778,LUCENTIS 0.3 MG/0.05 ML INTRAVITREAL SYRINGE,84240.0,54756.0,65.44,84240.0,53
HCPCS,J2778,LUCENTIS 0.5 MG/0.05 ML INTRAVITREAL SYRINGE,140400.0,91260.0,65.44,140400.0,53
HCPCS,J2778,Ranibizumab injection,,,70.68,70.68,1
HCPCS,J27780,Ranibizumab injection,,,70.68,70.68,1
HCPCS,J2779,"Inj, susvimo 0.1 mg",,,82.32,82.32,1
HCPCS,J2779,SUSVIMO (INITIAL FILL) 10 MG/0.1 ML INTRAVITREAL IMPLANT SOLUTION,288000.0,187200.0,72.34,288000.0,53
HCPCS,J2779,SUSVIMO 10 MG/0.1 ML INTRAVITREAL SOLUTION,288000.0,187200.0,72.34,288000.0,53
HCPCS,J27790,"Inj, susvimo 0.1 mg",,,82.32,82.32,1
HCPCS,J2780,RANITIDINE HCL (ZANTAC) 25MG INJ,5.0,3.25,2.5,5.0,12
HCPCS,J2780,RANITIDINE HYDROCHLORIDE ING,6.0,3.9,3.0,6.0,12
HCPCS,J2780,ZANTAC 50 MG INJ,44.0,28.6,22.0,44.0,12
HCPCS,J2781,"Inj, pegcetacoplan, 1mg",,,149.09,149.09,1
HCPCS,J2781,SYFOVRE (PF) 15 MG/0.1 ML INTRAVITREAL SOLUTION,84470.04,54905.53,134.91,84470.04,106
HCPCS,J27810,"Inj, pegcetacoplan, 1mg",,,149.09,149.09,1
HCPCS,J2782,IZERVAY (PF) 2 MG/0.1 ML INTRAVITREAL SOLUTION,75600.0,49140.0,100.17,75600.0,53
HCPCS,J2782,Inj avacincaptad pegol 0.1mg,,,111.15,111.15,1
HCPCS,J27820,Inj avacincaptad pegol 0.1mg,,,111.15,111.15,1
HCPCS,J2783,ELITEK 1.5 MG INTRAVENOUS SOLUTION,4025.04,2616.28,330.73,4025.04,100
HCPCS,J2783,ELITEK 7.5 MG INTRAVENOUS SOLUTION,20125.11,13081.32,330.73,20125.11,53
HCPCS,J2783,RASBURICASE,469.0,304.85,234.5,469.0,14
HCPCS,J2783,Rasburicase,,,414.04,414.04,1
HCPCS,J27830,Rasburicase,,,414.04,414.04,1
HCPCS,J2785,LEXISCAN 0.4 MG/5 ML INTRAVENOUS SYRINGE,185.58,120.63,5.09,185.58,31
HCPCS,J2785,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,72.06,46.84,3.02,126.12,93
HCPCS,J2785,REGADENOSON INJ 0.1 MG,441.0,286.65,5.09,441.0,31
HCPCS,J2785,REGADENOSON INJECTION,172.0,111.8,2.68,172.0,14
HCPCS,J2785,Regadenoson injection,,,2.89,2.89,1
HCPCS,J27850,Regadenoson injection,,,2.89,2.89,1
HCPCS,J2786,CINQAIR 10 MG/ML INTRAVENOUS SOLUTION,408.96,265.82,9.2,943.43,47
HCPCS,J2786,"Injection, reslizumab, 1mg",,,12.02,12.02,1
HCPCS,J27860,"Injection, reslizumab, 1mg",,,12.02,12.02,1
HCPCS,J2787,Riboflavin 5'phos opth<=3ml,,,2363.9,5997.31,4
HCPCS,J27870,Riboflavin 5'phos opth<=3ml,,,2363.9,2363.9,1
HCPCS,J2788,Rho d immune globulin 50 mcg,,,19.69,63.46,12
HCPCS,J27880,Rho d immune globulin 50 mcg,,,24.76,24.76,1
HCPCS,J2790,HYPERRHO 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,307.11,199.62,51.59,307.11,37
HCPCS,J2790,RHO D IMMUNE GLOBULIN INJ,1533.0,996.45,80.53,1533.0,14
HCPCS,J2790,RHO(D) IMMUNE GLOBULIN INJ,194.0,126.1,32.59,222.87,37
HCPCS,J2790,RHOGAM ULTRA-FILTERED PLUS 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,442.8,287.82,61.99,442.8,148
HCPCS,J2790,Rho d immune globulin inj,,,86.97,86.97,1
HCPCS,J27900,Rho d immune globulin inj,,,86.97,86.97,1
HCPCS,J2791,RHOPHYLAC 1500 UNIT (300 MCG)/2 ML INJECTION SYRINGE,304.05,197.63,4.32,318.54,74
HCPCS,J2791,Rhophylac injection,,,5.22,5.22,1
HCPCS,J27910,Rhophylac injection,,,5.22,5.22,1
HCPCS,J2792,"Rho(d) immune globulin h, sd",,,27.58,3236.72,35
HCPCS,J27920,"Rho(d) immune globulin h, sd",,,36.62,36.62,1
HCPCS,J2793,Rilonacept injection,,,28.1,345.3,13
HCPCS,J27930,Rilonacept injection,,,28.1,28.1,1
HCPCS,J2794,"Inj risperdal consta, 0.5 mg",,,12.07,12.07,1
HCPCS,J2794,RISPERDAL CONSTA 12.5 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,1161.66,755.08,10.96,1161.66,47
HCPCS,J2794,RISPERDAL CONSTA 25 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,2323.05,1509.98,10.96,2323.05,47
HCPCS,J2794,RISPERDAL CONSTA 37.5 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,3484.68,2265.04,10.96,3484.68,50
HCPCS,J2794,RISPERDAL CONSTA 50 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,4646.4,3020.16,10.96,4646.4,50
HCPCS,J27940,"Inj risperdal consta, 0.5 mg",,,12.07,12.07,1
HCPCS,J2795,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.74,1.13,0.06,4.08,186
HCPCS,J2795,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.4249999999999998,0.9299999999999999,0.06,1.74,310
HCPCS,J2795,NAROPIN (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,2.19,1.42,0.06,2.61,124
HCPCS,J2795,NAROPIN (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,3.39,2.2,0.06,3.39,62
HCPCS,J2795,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.38,0.9,0.06,2.16,124
HCPCS,J2795,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,1.02,0.66,0.06,1.26,93
HCPCS,J2795,Ropivacaine hcl injection,,,0.05,0.05,1
HCPCS,J27950,Ropivacaine hcl injection,,,0.05,0.05,1
HCPCS,J2796,Romiplostim injection,,,86.74,652.67,7
HCPCS,J2797,"Inj., rolapitant, 0.5 mg",,,0.92,93.47,13
HCPCS,J27970,"Inj., rolapitant, 0.5 mg",,,0.92,0.92,1
HCPCS,J2798,"Inj., perseris, 0.5 mg",,,13.11,13.11,1
HCPCS,J2798,PERSERIS 120 MG SUBCUTANEOUS EXTENDED RELEASE SUSPENSION SYRINGE,10435.83,6783.29,10.47,10435.83,53
HCPCS,J27980,"Inj., perseris, 0.5 mg",,,13.11,13.11,1
HCPCS,J2799,"Inj, uzedy, 1 mg",,,27.04,27.04,1
HCPCS,J2799,UZEDY 100 MG/0.28 ML SUBCUT EXT REL SUSPENSION SYRINGE,33771.87,21951.72,21.97,33771.87,53
HCPCS,J2799,UZEDY 125 MG/0.35 ML SUBCUT EXT REL SUSPENSION SYRINGE,33771.09,21951.21,21.97,33771.09,53
HCPCS,J2799,UZEDY 150 MG/0.42 ML SUBCUT EXT REL SUSPENSION SYRINGE,33770.58,21950.88,21.97,33770.58,53
HCPCS,J2799,UZEDY 200 MG/0.56 ML SUBCUT EXT REL SUSPENSION SYRINGE,33770.58,21950.88,21.97,33770.58,53
HCPCS,J2799,UZEDY 250 MG/0.7 ML SUBCUT EXT REL SUSPENSION SYRINGE,33771.09,21951.21,21.97,33771.09,53
HCPCS,J2799,UZEDY 50 MG/0.14 ML SUBCUT EXT REL SUSPENSION SYRINGE,33768.0,21949.2,21.97,33768.0,53
HCPCS,J2799,UZEDY 75 MG/0.21 ML SUBCUT EXT REL SUSPENSION SYRINGE,33769.71,21950.31,21.97,33769.71,53
HCPCS,J27990,"Inj, uzedy, 1 mg",,,27.04,27.04,1
HCPCS,J2800,METHOCARBAMOL 100 MG/ML INJECTION SOLUTION,3.6,2.34,0.6,12.55,31
HCPCS,J2800,Methocarbamol injection,,,4.9,4.9,1
HCPCS,J28000,Methocarbamol injection,,,4.9,4.9,1
HCPCS,J2801,"Inj, rykindo, 0.5 mg",,,12.74,345.3,27
HCPCS,J28010,"Inj, rykindo, 0.5 mg",,,12.74,12.74,1
HCPCS,J2802,"Inj, romiplostim 1 microgram",,,11.93,11.93,1
HCPCS,J2802,NPLATE 125 MCG SUBCUTANEOUS SOLUTION,4955.52,3221.09,10.11,4955.52,49
HCPCS,J2802,NPLATE 250 MCG SUBCUTANEOUS SOLUTION,9910.86,6442.06,10.11,9910.86,52
HCPCS,J2802,NPLATE 500 MCG SUBCUTANEOUS SOLUTION,19821.66,12884.08,10.11,19821.66,52
HCPCS,J28020,"Inj, romiplostim 1 microgram",,,11.93,11.93,1
HCPCS,J2804,"Inj, rifampin, 1 mg",,,0.16,0.16,1
HCPCS,J2804,RIFADIN 600 MG INTRAVENOUS SOLUTION,642.81,417.83,0.29,642.81,30
HCPCS,J2804,RIFAMPIN 600 MG INTRAVENOUS SOLUTION,550.8,358.02,0.29,550.8,30
HCPCS,J28040,"Inj, rifampin, 1 mg",,,0.16,0.16,1
HCPCS,J2805,CCK DOSE,320.0,208.0,53.76,320.0,37
HCPCS,J2805,KINEVAC 5 MCG SOLUTION FOR INJECTION,469.68,305.29,61.99,469.68,37
HCPCS,J2805,Sincalide injection,,,118.94,118.94,1
HCPCS,J28050,Sincalide injection,,,118.94,118.94,1
HCPCS,J2806,"Inj sincalide, maia, 5 mcg",,,61.99,78.3,6
HCPCS,J2810,Inj theophylline per 40 mg,,,0.63,0.69,3
HCPCS,J2820,LEUKINE 250 MCG SOLUTION FOR INJECTION,1132.65,736.22,53.51,1132.65,47
HCPCS,J2820,SARGRAMOSTIM INJECTION,206.0,133.9,61.75,206.0,14
HCPCS,J2820,Sargramostim injection,,,66.69,66.69,1
HCPCS,J28200,Sargramostim injection,,,66.69,66.69,1
HCPCS,J2840,Inj sebelipase alfa 1 mg,,,529.29,18253.82,27
HCPCS,J28400,Inj sebelipase alfa 1 mg,,,529.29,529.29,1
HCPCS,J2850,CHIRHOSTIM 16 MCG INTRAVENOUS SOLUTION,2379.6,1546.74,40.43,2379.6,39
HCPCS,J2850,Inj secretin synthetic human,,,42.83,42.83,1
HCPCS,J28500,Inj secretin synthetic human,,,42.83,42.83,1
HCPCS,J2860,"Injection, siltuximab",,,182.17,182.17,1
HCPCS,J2860,SYLVANT 100 MG INTRAVENOUS SOLUTION,7882.64,5123.72,136.18,7882.64,53
HCPCS,J2860,SYLVANT 400 MG INTRAVENOUS SOLUTION,31530.64,20494.92,136.18,31530.64,53
HCPCS,J28600,"Injection, siltuximab",,,182.17,182.17,1
HCPCS,J2865,Inj sulfameth/trim 5 mg/1 mg,,,0.04,0.04,1
HCPCS,J2865,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,4.545,2.95,0.08,4.56,150
HCPCS,J28650,Inj sulfameth/trim 5 mg/1 mg,,,0.04,0.04,1
HCPCS,J2910,Aurothioglucose injeciton,,,25.4,64.44,6
HCPCS,J2916,FERRLECIT 62.5 MG/5 ML INTRAVENOUS SOLUTION,22.89,14.88,1.97,22.89,31
HCPCS,J2916,NA FERRIC GLUCONATE COMPLEX,34.0,22.1,2.21,34.0,14
HCPCS,J2916,Na ferric gluconate complex,,,2.39,2.39,1
HCPCS,J2916,SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,22.89,14.88,1.97,22.89,62
HCPCS,J29160,Na ferric gluconate complex,,,2.39,2.39,1
HCPCS,J2919,"INJ, METHYLPRED SOD SUCC",3.05,1.98,0.26,3.05,14
HCPCS,J2919,"Inj, methylpred sod succ 5mg",,,0.28,0.28,1
HCPCS,J2919,METHYLPREDNISOLONE SODIUM SUCCINATE 1000 MG INTRAVENOUS SOLUTION,136.995,89.05,0.25,150.81,76
HCPCS,J2919,METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION,34.65,22.520000000000003,0.25,41.94,76
HCPCS,J2919,METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION,21.9,14.24,0.25,21.9,38
HCPCS,J2919,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,83.22,54.09,0.25,83.22,38
HCPCS,J2919,SOLU-MEDROL (PF) 1000 MG/8 ML INTRAVENOUS SOLUTION,248.1,161.27,0.25,248.1,38
HCPCS,J2919,SOLU-MEDROL (PF) 125 MG/2 ML SOLUTION FOR INJECTION,34.125,22.185,0.25,37.5,152
HCPCS,J2919,SOLU-MEDROL (PF) 40 MG/ML SOLUTION FOR INJECTION,21.3,13.845,0.25,23.28,152
HCPCS,J2919,SOLU-MEDROL (PF) 500 MG/4 ML INTRAVENOUS SOLUTION,170.58,110.88,0.25,170.58,38
HCPCS,J2919,SOLU-MEDROL 1000 MG INTRAVENOUS SOLUTION,158.34,102.92,0.25,158.34,38
HCPCS,J2919,SOLU-MEDROL 2 GRAM INTRAVENOUS SOLUTION,391.89,254.73,0.25,391.89,38
HCPCS,J2919,SOLU-MEDROL 500 MG INTRAVENOUS SOLUTION,87.42,56.82,0.25,87.42,38
HCPCS,J29190,"Inj, methylpred sod succ 5mg",,,0.28,0.28,1
HCPCS,J2920,METHYLPREDNISOLONE INJECTION,15.0,9.75,7.5,15.0,12
HCPCS,J2940,Somatrem injection,,,45.68,115.9,6
HCPCS,J2941,GENOTROPIN MINIQUICK 0.2 MG/0.25 ML SUBCUTANEOUS SYRINGE,115.26,74.92,19.36,408.89,30
HCPCS,J2941,GENOTROPIN MINIQUICK 0.6 MG/0.25 ML SUBCUTANEOUS SYRINGE,345.84,224.8,48.92,408.89,30
HCPCS,J2941,GENOTROPIN MINIQUICK 1.2 MG/0.25 ML SUBCUTANEOUS SYRINGE,691.68,449.59,48.92,691.68,30
HCPCS,J2941,NORDITROPIN FLEXPRO 10 MG/1.5 ML (6.7 MG/ML) SUBCUTANEOUS PEN INJECTOR,4262.16,2770.4,48.92,4262.16,33
HCPCS,J2941,NUTROPIN AQ NUSPIN 5 MG/2 ML (2.5 MG/ML) SUBCUTANEOUS PEN INJECTOR,1131.6,735.54,48.92,1131.6,30
HCPCS,J2941,Somatropin injection,,,161.17,161.17,1
HCPCS,J29410,Somatropin injection,,,161.17,161.17,1
HCPCS,J2950,Promazine hcl injection,,,0.9,2.27,4
HCPCS,J29500,Promazine hcl injection,,,0.9,0.9,1
HCPCS,J2993,Reteplase injection,,,2562.41,7946.52,27
HCPCS,J29930,Reteplase injection,,,3132.21,3132.21,1
HCPCS,J2995,Inj streptokinase /250000 iu,,,81.0,205.5,6
HCPCS,J2997,ACTIVASE 100 MG INTRAVENOUS SOLUTION,31681.29,20592.84,61.99,31681.29,53
HCPCS,J2997,ACTIVASE 50 MG INTRAVENOUS SOLUTION,15840.66,10296.43,61.99,15840.66,53
HCPCS,J2997,ALTEPLASE RECOMBINANT,142.0,92.3,71.0,142.0,14
HCPCS,J2997,Alteplase recombinant,,,101.34,101.34,1
HCPCS,J2997,CATHFLO ACTIVASE 2 MG INTRA-CATHETER SOLUTION,666.6,433.29,61.99,666.6,47
HCPCS,J29970,Alteplase recombinant,,,101.34,101.34,1
HCPCS,J2998,Inj plasminogen tvmh 1mg,,,32.55,383.26,27
HCPCS,J29980,Inj plasminogen tvmh 1mg,,,41.37,41.37,1
HCPCS,J3000,STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,149.625,97.255,4.91,270.0,62
HCPCS,J3000,STREPTOMYCIN INJECTION,19.0,12.35,9.5,38.33,14
HCPCS,J3000,Streptomycin injection,,,36.59,36.59,1
HCPCS,J30000,Streptomycin injection,,,36.59,36.59,1
HCPCS,J3010,FENTANYL (PF) 20 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,3.29,31
HCPCS,J3010,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,3.51,2.2800000000000002,0.32,7.53,310
HCPCS,J3010,FENTANYL (PF) 50 MCG/ML INJECTION SYRINGE,7.95,5.17,0.89,7.95,31
HCPCS,J3010,FENTANYL CITRATE INJECTION,17.0,11.05,1.19,17.0,14
HCPCS,J3010,Fentanyl citrate injection,,,1.29,1.29,1
HCPCS,J30100,Fentanyl citrate injection,,,1.29,1.29,1
HCPCS,J3030,IMITREX STATDOSE PEN 6 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1737.03,1129.07,97.32,1737.03,23
HCPCS,J3030,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,216.0,140.4,13.31,352.8,69
HCPCS,J3030,SUMATRIPTAN SUCCINATE / 6 MG,108.0,70.2,25.0,108.0,14
HCPCS,J3030,Sumatriptan succinate / 6 mg,,,38.36,38.36,1
HCPCS,J30300,Sumatriptan succinate / 6 mg,,,38.36,38.36,1
HCPCS,J3031,AJOVY SYRINGE 225 MG/1.5 ML SUBCUTANEOUS,1812.36,1178.03,8.82,1812.36,29
HCPCS,J3031,"Inj., fremanezumab-vfrm 1 mg",,,3.48,3.48,1
HCPCS,J30310,"Inj., fremanezumab-vfrm 1 mg",,,3.48,3.48,1
HCPCS,J3032,Inj. eptinezumab-jjmr 1 mg,,,22.14,22.14,1
HCPCS,J3032,VYEPTI 100 MG/ML INTRAVENOUS SOLUTION,6984.24,4539.76,16.24,6984.24,53
HCPCS,J30320,Inj. eptinezumab-jjmr 1 mg,,,22.14,22.14,1
HCPCS,J3055,Inj talquetamab-tgvs 0.25 mg,,,80.91,80.91,1
HCPCS,J3055,TALVEY 2 MG/ML SUBCUTANEOUS SOLUTION,2772.72,1802.27,60.94,3407.66,50
HCPCS,J3055,TALVEY 40 MG/ML SUBCUTANEOUS SOLUTION,55454.56,36045.46,60.94,55454.56,53
HCPCS,J30550,Inj talquetamab-tgvs 0.25 mg,,,80.91,80.91,1
HCPCS,J3060,ELELYSO 200 UNIT INTRAVENOUS SOLUTION,3397.65,2208.47,40.5,12697.64,50
HCPCS,J3060,"Inj, taliglucerase alfa 10 u",,,44.22,44.22,1
HCPCS,J30600,"Inj, taliglucerase alfa 10 u",,,44.22,44.22,1
HCPCS,J3070,Pentazocine injection,,,106.01,268.96,4
HCPCS,J30700,Pentazocine injection,,,106.01,106.01,1
HCPCS,J3090,Inj tedizolid phosphate,,,2.12,2.12,1
HCPCS,J3090,SIVEXTRO 200 MG INTRAVENOUS SOLUTION,1333.74,866.93,1.63,1333.74,47
HCPCS,J30900,Inj tedizolid phosphate,,,2.12,2.12,1
HCPCS,J3095,Telavancin injection,,,6.38,123.65,35
HCPCS,J30950,Telavancin injection,,,7.96,7.96,1
HCPCS,J3101,TNKASE 25 MG INTRAVENOUS SOLUTION,30766.26,19998.07,137.8,30766.26,53
HCPCS,J3101,TNKASE 50 MG INTRAVENOUS SOLUTION,29870.13,19415.58,137.8,29870.13,106
HCPCS,J3101,Tenecteplase injection,,,201.93,201.93,1
HCPCS,J31010,Tenecteplase injection,,,201.93,201.93,1
HCPCS,J3105,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,14.4,9.36,1.09,70.92,93
HCPCS,J3105,TERBUTALINE SULFATE INJ,15.0,9.75,2.47,15.0,14
HCPCS,J3105,Terbutaline sulfate inj,,,2.67,2.67,1
HCPCS,J31050,Terbutaline sulfate inj,,,2.67,2.67,1
HCPCS,J3110,Teriparatide injection,,,48.11,1355.53,10
HCPCS,J31100,Teriparatide injection,,,48.11,48.11,1
HCPCS,J3111,EVENITY 210 MG/2.34 ML (105 MG/1.17 ML X 2) SUBCUTANEOUS SYRINGE,4044.48,2628.91,9.62,4044.48,100
HCPCS,J3111,Inj. romosozumab-aqqg 1 mg,,,13.08,13.08,1
HCPCS,J31110,Inj. romosozumab-aqqg 1 mg,,,13.08,13.08,1
HCPCS,J3121,Inj testostero enanthate 1mg,,,0.05,0.05,1
HCPCS,J3121,TESTOSTERONE ENANTHATE 200 MG/ML INTRAMUSCULAR OIL,50.97,33.13,0.05,50.97,31
HCPCS,J31210,Inj testostero enanthate 1mg,,,0.05,0.05,1
HCPCS,J3145,AVEED 750 MG/3 ML (250MG/ML) INTRAMUSCULAR SOLUTION,2607.6,1694.94,1.73,2607.6,50
HCPCS,J3145,Testosterone undecanoate 1mg,,,2.24,2.24,1
HCPCS,J31450,Testosterone undecanoate 1mg,,,2.24,2.24,1
HCPCS,J3230,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,81.795,53.17,10.01,104.01,124
HCPCS,J3230,CHLORPROMAZINE HCL INJECTION,23.0,14.95,11.5,26.88,14
HCPCS,J3230,Chlorpromazine hcl injection,,,25.67,25.67,1
HCPCS,J32300,Chlorpromazine hcl injection,,,25.67,25.67,1
HCPCS,J3240,THYROGEN 0.9 MG INTRAMUSCULAR SOLUTION,6613.77,4298.95,516.7,6613.77,53
HCPCS,J3240,THYROTROPIN INJECTION,2068.0,1344.2,1034.0,2404.52,14
HCPCS,J3240,Thyrotropin injection,,,2295.69,2295.69,1
HCPCS,J32400,Thyrotropin injection,,,2295.69,2295.69,1
HCPCS,J3241,Inj. teprotumumab-trbw 10 mg,,,398.85,398.85,1
HCPCS,J3241,TEPEZZA 500 MG INTRAVENOUS SOLUTION,64868.22,42164.34,300.06,64868.22,53
HCPCS,J32410,Inj. teprotumumab-trbw 10 mg,,,398.85,398.85,1
HCPCS,J3243,TIGECYCLINE INJECTION,20.0,13.0,0.56,20.0,14
HCPCS,J3243,TYGACIL 50 MG INTRAVENOUS SOLUTION,360.0,234.0,0.6,360.0,31
HCPCS,J3243,Tigecycline injection,,,0.6,0.6,1
HCPCS,J32430,Tigecycline injection,,,0.6,0.6,1
HCPCS,J3244,Inj. tigecycline (accord),,,2.59,2.59,1
HCPCS,J3244,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,469.8,305.37,6.58,561.6,46
HCPCS,J32440,Inj. tigecycline (accord),,,2.59,2.59,1
HCPCS,J3245,ILUMYA 100 MG/ML SUBCUTANEOUS SYRINGE,64661.19,42029.77,123.78,64661.19,53
HCPCS,J3245,"Inj., tildrakizumab, 1 mg",,,133.69,133.69,1
HCPCS,J32450,"Inj., tildrakizumab, 1 mg",,,133.69,133.69,1
HCPCS,J3246,AGGRASTAT 12.5 MG/250 ML (50 MCG/ML) IN ISO-OSMOTIC SODIUM CHLORIDE IV,3.45,2.24,0.58,28.24,37
HCPCS,J3246,AGGRASTAT 5 MG/100 ML (50 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,3.3,2.15,0.55,28.24,74
HCPCS,J3246,AGGRASTAT CONCENTRATE 250 MCG/ML INTRAVENOUS,14.07,9.15,2.36,28.24,37
HCPCS,J3246,TIROFIBAN 12.5 MG/250 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS,2.31,1.5,0.39,28.24,37
HCPCS,J3246,Tirofiban hcl,,,3.73,3.73,1
HCPCS,J32460,Tirofiban hcl,,,3.73,3.73,1
HCPCS,J3247,COSENTYX 25 MG/ML INTRAVENOUS SOLUTION,1584.48,1029.91,17.54,1584.48,46
HCPCS,J3247,Inj secukinumab intrav 1mg,,,19.52,19.52,1
HCPCS,J32470,Inj secukinumab intrav 1mg,,,19.52,19.52,1
HCPCS,J3250,TIGAN 100 MG/ML INTRAMUSCULAR SOLUTION,118.95,77.32,19.98,159.39,31
HCPCS,J3250,TRIMETHOBENZAMIDE HCL INJ,15.0,9.75,7.5,65.15,14
HCPCS,J3250,Trimethobenzamide hcl inj,,,62.21,62.21,1
HCPCS,J32500,Trimethobenzamide hcl inj,,,62.21,62.21,1
HCPCS,J3260,NEBCIN UP TO 80 MG,20.0,13.0,2.07,20.0,14
HCPCS,J3260,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,294.3,191.295,2.3,708.75,124
HCPCS,J3260,TOBRAMYCIN 10 MG/ML INJECTION SOLUTION,23.01,14.96,2.3,23.01,31
HCPCS,J3260,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,3.57,2.32,0.43,6.09,279
HCPCS,J3260,TOBRAMYCIN SULFATE INJECTION,25.0,16.25,2.07,25.0,14
HCPCS,J3260,TOBRAMYCIN SULFATE UP TO 80MG,20.0,13.0,2.07,20.0,14
HCPCS,J3260,Tobramycin sulfate injection,,,2.24,2.24,1
HCPCS,J32600,Tobramycin sulfate injection,,,2.24,2.24,1
HCPCS,J3262,ACTEMRA 162 MG/0.9 ML SUBCUTANEOUS SYRINGE,6265.64,4072.67,5.44,6265.64,53
HCPCS,J3262,ACTEMRA 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,637.4,414.31,5.44,652.67,47
HCPCS,J3262,ACTEMRA 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,637.4,414.31,5.44,652.67,47
HCPCS,J3262,ACTEMRA 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,637.4,414.31,5.44,652.67,47
HCPCS,J3262,TOCILIZUMAB INJECTION,29.0,18.85,5.61,29.0,14
HCPCS,J3262,Tocilizumab injection,,,6.06,6.06,1
HCPCS,J32620,Tocilizumab injection,,,6.06,6.06,1
HCPCS,J3263,"Inj, toripalimab-tpzi, 1 mg",,,43.43,43.43,1
HCPCS,J3263,LOQTORZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION,7805.8,5073.77,38.87,7805.8,52
HCPCS,J32630,"Inj, toripalimab-tpzi, 1 mg",,,43.43,43.43,1
HCPCS,J3265,Injection torsemide 10 mg/ml,,,3.38,3.66,3
HCPCS,J3280,Thiethylperazine maleate inj,,,6.42,16.28,6
HCPCS,J3285,REMODULIN 1 MG/ML INJECTION SOLUTION,229.2,148.98,49.09,345.3,47
HCPCS,J3285,REMODULIN 10 MG/ML INJECTION SOLUTION,2291.97,1489.78,49.09,2291.97,47
HCPCS,J3285,REMODULIN 2.5 MG/ML INJECTION SOLUTION,573.0,372.45,49.09,573.0,47
HCPCS,J3285,REMODULIN 5 MG/ML INJECTION SOLUTION,1146.0,744.9,49.09,1146.0,47
HCPCS,J3285,TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,544.35,353.83,49.09,544.35,47
HCPCS,J3285,TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,1088.7,707.66,49.09,1088.7,47
HCPCS,J3285,Treprostinil injection,,,58.84,58.84,1
HCPCS,J32850,Treprostinil injection,,,58.84,58.84,1
HCPCS,J3290,"Inj, tranexamic acid 5 mg",,,0.02,0.02,1
HCPCS,J3290,TRANEXAMIC ACID 1000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION,1.875,1.2149999999999999,0.05,2.16,69
HCPCS,J32900,"Inj, tranexamic acid 5 mg",,,0.02,0.02,1
HCPCS,J3291,Tranexamic acid in sod chlor,,,0.11,0.27,4
HCPCS,J32910,Tranexamic acid in sod chlor,,,0.11,0.11,1
HCPCS,J3299,Inj xipere 1 mg,,,51.68,51.68,1
HCPCS,J3299,XIPERE (PF) 40 MG/ML SUPRACHOROIDAL SUSPENSION,6600.0,4290.0,43.72,6600.0,53
HCPCS,J32990,Inj xipere 1 mg,,,51.68,51.68,1
HCPCS,J3300,TRIAMCINOLONE A INJ PRS-FREE,12.0,7.8,6.0,27.71,14
HCPCS,J3300,TRIESENCE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,2606.4,1694.16,24.49,2606.4,42
HCPCS,J3300,Triamcinolone a inj prs-free,,,26.45,26.45,1
HCPCS,J33000,Triamcinolone a inj prs-free,,,26.45,26.45,1
HCPCS,J3301,KENALOG 10 MG/ML SUSPENSION FOR INJECTION,8.7,5.66,0.97,8.7,62
HCPCS,J3301,KENALOG 10MG,300.0,195.0,0.74,300.0,14
HCPCS,J3301,KENALOG 40 MG /PER 1 CC,36.0,23.4,0.97,36.0,31
HCPCS,J3301,KENALOG 40 MG/ML SUSPENSION FOR INJECTION,33.69,21.9,0.97,34.2,93
HCPCS,J3301,KENALOG 40MG/ML,36.0,23.4,0.97,36.0,31
HCPCS,J3301,KENALOG PER 10 MG 40MG VIAL,29.0,18.85,0.74,29.0,14
HCPCS,J3301,KENALOG PER 10MG,36.0,23.4,0.74,36.0,14
HCPCS,J3301,KENALOG PER 10MG/10MG VIAL,13.0,8.45,0.74,13.0,14
HCPCS,J3301,KENALOG-80  80 MG/ML SUSPENSION FOR INJECTION,67.38,43.8,0.97,67.38,31
HCPCS,J3301,TRIAMCINOLONE ACET INJ 10 MG,36.0,23.4,0.97,36.0,31
HCPCS,J3301,TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,8.07,5.25,0.97,8.07,31
HCPCS,J3301,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,29.34,19.07,0.97,31.2,279
HCPCS,J3301,Triamcinolone acet inj nos,,,0.8,0.8,1
HCPCS,J33010,Triamcinolone acet inj nos,,,0.8,0.8,1
HCPCS,J3302,Triamcinolone diacetate inj,,,0.24,0.6,4
HCPCS,J33020,Triamcinolone diacetate inj,,,0.24,0.24,1
HCPCS,J3303,Triamcinolone hexacetonl inj,,,8.42,21.37,4
HCPCS,J33030,Triamcinolone hexacetonl inj,,,8.42,8.42,1
HCPCS,J3304,Inj triamcinolone ace xr 1mg,,,15.74,345.3,35
HCPCS,J33040,Inj triamcinolone ace xr 1mg,,,20.07,20.07,1
HCPCS,J3305,Inj trimetrexate glucoronate,,,152.54,387.0,3
HCPCS,J3310,Perphenazine injeciton,,,6.49,16.47,6
HCPCS,J3315,TRELSTAR 11.25 MG IM SUSPENSION,10362.0,6735.3,343.08,10362.0,53
HCPCS,J3315,TRELSTAR 22.5 MG IM SUSPENSION,20724.0,13470.6,343.08,20724.0,53
HCPCS,J3315,TRIPTORELIN PAMOATE,617.0,401.05,308.5,617.0,14
HCPCS,J3315,Triptorelin pamoate,,,500.26,500.26,1
HCPCS,J33150,Triptorelin pamoate,,,500.26,500.26,1
HCPCS,J3316,"Inj., triptorelin xr 3.75 mg",,,3418.49,10419.23,34
HCPCS,J33160,"Inj., triptorelin xr 3.75 mg",,,4066.19,4066.19,1
HCPCS,J3320,Spectinomycn di-hcl inj,,,30.65,77.76,6
HCPCS,J3350,Urea injection,,,76.79,194.81,7
HCPCS,J33500,Urea injection,,,76.79,76.79,1
HCPCS,J3355,"Urofollitropin, 75 iu",,,74.0,329.18,12
HCPCS,J3357,STELARA 45 MG/0.5 ML SUBCUTANEOUS SOLUTION,104945.34,68214.47,137.31,104945.34,43
HCPCS,J3357,STELARA 45 MG/0.5 ML SUBCUTANEOUS SYRINGE,104945.34,68214.47,137.31,104945.34,43
HCPCS,J3357,STELARA 90 MG/ML SUBCUTANEOUS SYRINGE,104945.25,68214.41,137.31,104945.25,43
HCPCS,J3357,USTEKINUMAB INJECTION,442.0,287.3,221.0,442.0,14
HCPCS,J3357,"Ustekinumab sub cu inj, 1 mg",,,293.85,293.85,1
HCPCS,J33570,"Ustekinumab sub cu inj, 1 mg",,,293.85,293.85,1
HCPCS,J3358,STELARA 130 MG/26 ML INTRAVENOUS SOLUTION,293.49,190.77,11.24,3236.72,47
HCPCS,J3358,"Ustekinumab, iv inject, 1 mg",,,13.49,13.49,1
HCPCS,J33580,"Ustekinumab, iv inject, 1 mg",,,13.49,13.49,1
HCPCS,J3360,DIAZEPAM 5 MG/ML INJECTION SOLUTION,20.85,13.55,3.5,20.85,31
HCPCS,J3360,DIAZEPAM 5 MG/ML INJECTION SYRINGE,58.155,37.8,5.89,72.0,124
HCPCS,J3360,DIAZEPAM INJECTION,17.0,11.05,6.69,17.0,14
HCPCS,J3360,Diazepam injection,,,7.23,7.23,1
HCPCS,J33600,Diazepam injection,,,7.23,7.23,1
HCPCS,J3364,Urokinase 5000 iu injection,,,14.12,15.31,3
HCPCS,J3365,"Urokinase 250,000 iu inj",,,273.36,764.87,9
HCPCS,J3370,Vancomycin hcl injection,,,2.32,2.32,1
HCPCS,J3371,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,38.67,25.135,3.14,58.62,48
HCPCS,J3371,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,322.545,209.64999999999998,5.28,324.93,48
HCPCS,J3371,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,29.37,19.09,4.93,29.37,24
HCPCS,J3372,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,560.685,364.445,5.76,765.0,48
HCPCS,J3372,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,43.71,28.415,5.07,57.24,48
HCPCS,J3373,"Inj, vancomycin hcl, 10 mg",,,0.03,0.03,1
HCPCS,J3373,VANCOMYCIN 1 GRAM/200 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.48,0.31,0.06,0.48,30
HCPCS,J3373,VANCOMYCIN 1.25 GRAM/250 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.42,0.27,0.06,0.42,30
HCPCS,J3373,VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION,87.66,56.98,0.06,87.66,30
HCPCS,J3373,VANCOMYCIN 1.5 GRAM/300 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.39,0.25,0.06,0.39,30
HCPCS,J3373,VANCOMYCIN 100 GRAM SOLUTION FOR INJECTION,1440.0,936.0,0.06,1440.0,30
HCPCS,J3373,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,29.37,19.09,0.06,29.37,30
HCPCS,J3373,VANCOMYCIN 500 MG/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.27,0.18,0.05,0.27,30
HCPCS,J3373,VANCOMYCIN 750 MG/150 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,0.3,30
HCPCS,J3373,VANCOMYCIN 750 MG/150 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,0.3,30
HCPCS,J33730,"Inj, vancomycin hcl, 10 mg",,,0.03,0.03,1
HCPCS,J3374,"Inj, vancomycin (mylan) 10mg",,,0.11,0.11,1
HCPCS,J3374,VANCOMYCIN 1.25 GRAM INTRAVENOUS SOLUTION,72.36,47.03,0.19,72.36,30
HCPCS,J3374,VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION,86.82,56.43,0.19,86.82,90
HCPCS,J3374,VANCOMYCIN 2 GRAM INTRAVENOUS SOLUTION,154.08,100.15,0.19,154.08,30
HCPCS,J3374,VANCOMYCIN 750 MG INTRAVENOUS SOLUTION,29.729999999999997,19.325000000000003,0.19,35.4,90
HCPCS,J33740,"Inj, vancomycin (mylan) 10mg",,,0.11,0.11,1
HCPCS,J3375,Inj vancomycin (xellia) 10mg,,,0.14,0.38,11
HCPCS,J33750,Inj vancomycin (xellia) 10mg,,,0.14,0.14,1
HCPCS,J3376,Inj vancomycin (hikma) 10mg,,,0.02,0.02,1
HCPCS,J3376,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,782.04,508.33,0.04,782.04,30
HCPCS,J3376,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,57.75,37.54,0.04,57.75,30
HCPCS,J3376,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,71.97,46.78,0.04,71.97,30
HCPCS,J3376,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,15.165000000000001,9.855,0.04,19.53,90
HCPCS,J33760,Inj vancomycin (hikma) 10mg,,,0.02,0.02,1
HCPCS,J3379,"Inj, valproate sod, 5 mg",,,0.05,0.05,1
HCPCS,J3379,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,4.83,3.14,0.1,93.47,216
HCPCS,J33790,"Inj, valproate sod, 5 mg",,,0.05,0.05,1
HCPCS,J3380,ENTYVIO 300 MG INTRAVENOUS SOLUTION,36391.32,23654.36,19.67,36391.32,53
HCPCS,J3380,Inj vedolizumab iv 1 mg,,,23.08,23.08,1
HCPCS,J33800,Inj vedolizumab iv 1 mg,,,23.08,23.08,1
HCPCS,J3385,VPRIV 400 UNIT INTRAVENOUS SOLUTION,5418.03,3521.72,331.06,5646.0,53
HCPCS,J3385,Velaglucerase alfa,,,417.34,417.34,1
HCPCS,J33850,Velaglucerase alfa,,,417.34,417.34,1
HCPCS,J3387,Inj elivaldogene autotemecel,,,24125.92,3498000.0,10
HCPCS,J3389,Topi adm prad zami per treat,,,24125.92,3669402.0,10
HCPCS,J3391,"Inj, atidarsagene autotemcel",,,24125.92,4955500.0,10
HCPCS,J3392,CASGEVY 4X10EXP6 TO 13X10EXP6 CELL/ML INTRAVENOUS SUSPENSION,10560000.0,6864000.0,24125.92,9504000.0,37
HCPCS,J3393,ZYNTEGLO 2 X 10EXP6 TO 20 X 10EXP6 CELL/ML INTRAVENOUS SUSPENSION,13440000.0,8736000.0,24125.92,12096000.0,37
HCPCS,J3394,LYFGENIA 1.7 X TO 20 X 10EXP6 CELL/ML INTRAVENOUS SUSPENSION,14880000.0,9672000.0,24125.92,13392000.0,37
HCPCS,J3396,VISUDYNE 15 MG INTRAVENOUS SOLUTION,8206.6,5334.29,10.3,8206.6,53
HCPCS,J3396,Verteporfin injection,,,12.48,12.48,1
HCPCS,J33960,Verteporfin injection,,,12.48,12.48,1
HCPCS,J3397,"Inj., vestronidase alfa-vjbk",,,280.09,12697.64,17
HCPCS,J33970,"Inj., vestronidase alfa-vjbk",,,281.6,281.6,1
HCPCS,J3398,Inj luxturna 1 billion vec g,,,3026.79,12697.64,27
HCPCS,J33980,Inj luxturna 1 billion vec g,,,3157.92,3157.92,1
HCPCS,J3399,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,990
HCPCS,J3400,Triflupromazine hcl inj,,,11.23,28.5,6
HCPCS,J3401,"Vyjuvek 5x10^9pfu/ml, 0.1 ml",,,996.96,12697.64,35
HCPCS,J34010,"Vyjuvek 5x10^9pfu/ml, 0.1 ml",,,1095.97,1095.97,1
HCPCS,J3402,Inj. remestemcel-l-rknd/ td,,,217802.54,217802.54,1
HCPCS,J3402,RYONCIL 6.68 X 10EXP6 CELL/ML INTRAVENOUS SUSPENSION,931200.0,605280.0,24125.92,931200.0,45
HCPCS,J34020,Inj. remestemcel-l-rknd/ td,,,217802.54,217802.54,1
HCPCS,J3403,"Revakinagene, per implant",,,24125.92,733361.0,21
HCPCS,J34030,"Revakinagene, per implant",,,286200.0,286200.0,1
HCPCS,J3404,Inj zopap imad-drba,,,14450.94,18253.82,6
HCPCS,J3410,HYDROXYZINE HCL 25 MG/ML INTRAMUSCULAR SOLUTION,110.04,71.53,12.48,110.04,31
HCPCS,J3410,HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,102.44999999999999,66.595,12.48,121.35,62
HCPCS,J3410,HYDROXYZINE HCL INJECTION,3.0,1.95,1.5,14.71,14
HCPCS,J3410,Hydroxyzine hcl injection,,,14.04,14.04,1
HCPCS,J34100,Hydroxyzine hcl injection,,,14.04,14.04,1
HCPCS,J3411,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,15.99,10.39,1.54,17.91,124
HCPCS,J3411,THIAMINE HCL 100 MG,4.0,2.6,1.81,4.0,14
HCPCS,J3411,Thiamine hcl 100 mg,,,1.95,1.95,1
HCPCS,J34110,Thiamine hcl 100 mg,,,1.95,1.95,1
HCPCS,J3415,PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,78.24,50.86,13.14,78.24,31
HCPCS,J3415,Pyridoxine hcl 100 mg,,,16.8,16.8,1
HCPCS,J34150,Pyridoxine hcl 100 mg,,,16.8,16.8,1
HCPCS,J3420,ADMIN VITAMIN B12 INJ,14.0,9.1,0.64,14.0,14
HCPCS,J3420,B12 INJECTION IM PER 1000 MCG,2.0,1.3,0.64,2.0,14
HCPCS,J3420,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,12.825,8.34,0.6,25.17,310
HCPCS,J3420,VITAMIN B-12 INJ TO 1000 MCG,14.0,9.1,1.22,14.0,31
HCPCS,J3420,VITAMIN B12 INJECTION,2.0,1.3,0.64,2.0,14
HCPCS,J3420,Vitamin b12 injection,,,0.69,0.69,1
HCPCS,J34200,Vitamin b12 injection,,,0.69,0.69,1
HCPCS,J3424,CYANOKIT 5 GRAM INTRAVENOUS SOLUTION,3772.8,2452.32,5.03,3772.8,42
HCPCS,J3424,Inj hydroxocobalamin iv 25mg,,,5.43,5.43,1
HCPCS,J34240,Inj hydroxocobalamin iv 25mg,,,5.43,5.43,1
HCPCS,J3425,HYDROXOCOBALAMIN 1000 MCG/ML INTRAMUSCULAR SOLUTION,3.84,2.5,0.01,3.84,38
HCPCS,J3425,Hydroxocobalamin im 10mcg,,,0.01,0.01,1
HCPCS,J34250,Hydroxocobalamin im 10mcg,,,0.01,0.01,1
HCPCS,J3430,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,43.2,28.08,2.52,43.2,31
HCPCS,J3430,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,178.05,115.73,2.52,178.05,31
HCPCS,J3430,PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,153.96,100.07,2.52,153.96,31
HCPCS,J3430,VITAMIN K 1 MG/0.5 ML INJECTION SOLUTION,35.37,22.99,2.52,35.37,93
HCPCS,J3430,VITAMIN K PHYTONADIONE INJ,17.0,11.05,2.81,17.0,14
HCPCS,J3430,VITAMIN K1 10 MG/ML INJECTION SOLUTION,176.28,114.58,2.52,176.28,31
HCPCS,J3430,Vitamin k phytonadione inj,,,3.03,3.03,1
HCPCS,J34300,Vitamin k phytonadione inj,,,3.03,3.03,1
HCPCS,J3465,"Injection, voriconazole",,,0.81,0.81,1
HCPCS,J3465,VFEND IV 200 MG INTRAVENOUS SOLUTION,217.08,141.1,0.99,217.08,31
HCPCS,J3465,VORICONAZOLE 200 MG INTRAVENOUS POWDER FOR SOLUTION,126.0,81.9,0.99,126.0,31
HCPCS,J34650,"Injection, voriconazole",,,0.81,0.81,1
HCPCS,J3470,AMPHADASE 150 UNIT/ML INJECTION SOLUTION,200.88,130.57,33.75,200.88,36
HCPCS,J3470,HYALURONIDASE,2.0,1.3,1.0,35.99,14
HCPCS,J3470,HYALURONIDASE INJECTION,76.0,49.4,31.81,76.0,14
HCPCS,J3470,Hyaluronidase injection,,,34.35,34.35,1
HCPCS,J34700,Hyaluronidase injection,,,34.35,34.35,1
HCPCS,J3471,"Ovine, up to 999 usp units",,,0.54,78.3,17
HCPCS,J34710,"Ovine, up to 999 usp units",,,0.54,0.54,1
HCPCS,J3472,"Ovine, 1000 usp units",,,97.89,356.2,10
HCPCS,J34720,"Ovine, 1000 usp units",,,140.4,140.4,1
HCPCS,J3473,HYLENEX 150 UNIT/ML INJECTION SOLUTION,200.88,130.57,0.32,200.88,31
HCPCS,J3473,Hyaluronidase recombinant,,,0.39,0.39,1
HCPCS,J34730,Hyaluronidase recombinant,,,0.39,0.39,1
HCPCS,J3475,Inj magnesium sulfate,,,0.44,0.44,1
HCPCS,J3475,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.27,0.18,0.02,1.12,124
HCPCS,J3475,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.93,0.6,0.15,1.17,93
HCPCS,J3475,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.3,0.2,0.04,1.12,93
HCPCS,J3475,MAGNESIUM SULFATE 4 GRAM/50 ML (8 %) IN WATER INTRAVENOUS PIGGYBACK,0.54,0.35,0.08,1.12,93
HCPCS,J3475,MAGNESIUM SULFATE 40 GRAM/1000 ML (4 %) IN WATER INTRAVENOUS SOLUTION,0.03,0.02,0.01,1.12,31
HCPCS,J3475,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,1.8,1.17,0.11,3.57,279
HCPCS,J3475,"MAGNESIUM SULPHATE, PER 500 MG",6.0,3.9,0.41,6.0,14
HCPCS,J34750,Inj magnesium sulfate,,,0.44,0.44,1
HCPCS,J3480,Inj potassium chloride,,,0.13,0.13,1
HCPCS,J3480,POTASSIUM CHLORIDE 10 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.16499999999999998,0.11,0.03,0.33,62
HCPCS,J3480,POTASSIUM CHLORIDE 10 MEQ/50 ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.27,0.18,0.05,0.33,31
HCPCS,J3480,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.9,0.59,0.08,3.57,279
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,0.33,31
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/50 ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.27,0.18,0.05,0.33,31
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.33,31
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,0.33,93
HCPCS,J3480,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,0.33,31
HCPCS,J3480,"POTASSIUM CHLORIDE, PER 2 MEQ",2.0,1.3,0.12,2.0,14
HCPCS,J3480,SODIUM CHLORIDE 0.45 % WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,0.03,0.02,0.01,0.33,31
HCPCS,J3480,SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,0.03,0.02,0.01,0.33,31
HCPCS,J3480,SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,0.03,0.02,0.01,0.33,93
HCPCS,J34800,Inj potassium chloride,,,0.13,0.13,1
HCPCS,J3485,RETROVIR 10 MG/ML INTRAVENOUS SOLUTION,5.25,3.41,1.31,5.25,68
HCPCS,J3485,Zidovudine,,,1.63,1.63,1
HCPCS,J34850,Zidovudine,,,1.63,1.63,1
HCPCS,J3486,ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION,118.05,76.73,9.2,118.05,31
HCPCS,J3486,Ziprasidone mesylate,,,9.88,9.88,1
HCPCS,J34860,Ziprasidone mesylate,,,9.88,9.88,1
HCPCS,J3489,ZOLEDRONIC ACID 4 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,1.71,1.11,0.29,14.06,31
HCPCS,J3489,ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK,3.705,2.405,0.16,14.06,62
HCPCS,J3489,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,277.2,180.18,6.24,424.8,62
HCPCS,J3489,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,11.7,7.6049999999999995,0.6,30.12,124
HCPCS,J3489,Zoledronic acid 1mg,,,5.49,5.49,1
HCPCS,J34890,Zoledronic acid 1mg,,,5.49,5.49,1
HCPCS,J3490,"ACTEMRA, PER 200 MG",1803.0,1171.95,901.5,1803.0,12
HCPCS,J3490,ALLOPURINOL 300 MG PO,16.0,10.4,8.0,16.0,12
HCPCS,J3490,ARGININE 30GM,51.0,33.15,25.5,51.0,12
HCPCS,J3490,ASCLERA 1% 1CC,46.0,29.9,23.0,46.0,12
HCPCS,J3490,AZACTAM/AZTREONAM 500MG,101.0,65.65,50.5,101.0,12
HCPCS,J3490,AZERRA (OFATUMUMAB) 100MG,750.0,487.5,375.0,750.0,12
HCPCS,J3490,BELOTERO 1.0CC,600.0,390.0,300.0,600.0,12
HCPCS,J3490,CALCIUM CHLORIDE INJ,18.0,11.7,9.0,18.0,12
HCPCS,J3490,CANDIDA ANTIGEN PER .1 ML,37.0,24.05,18.5,37.0,12
HCPCS,J3490,CARDIZEM 2.5MG/5ML,5.0,3.25,2.5,5.0,12
HCPCS,J3490,CLINDAMYCIN 600 MG INJ,124.0,80.6,62.0,124.0,12
HCPCS,J3490,D5W 100 CC,10.0,6.5,5.0,10.0,12
HCPCS,J3490,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.09,66
HCPCS,J3490,DEXTROSE 50% 50 ML INJ,49.0,31.85,24.5,49.0,12
HCPCS,J3490,DIPRIVAN AMP 10 MG/20ML NDC 00310030022,36.0,23.4,18.0,36.0,12
HCPCS,J3490,DORIPENEM 500 MG,148.0,96.2,74.0,148.0,12
HCPCS,J3490,DUOVISC VISCO ELASTIC 3 %-4 %(0.5 ML) 1 %(0.55 ML) INTRAOCULAR SYRINGE,944.94,614.21,158.75,944.94,23
HCPCS,J3490,DYCLONE (DYCLONINE) 1% 15 ML TOPICAL,24.0,15.6,12.0,24.0,12
HCPCS,J3490,"EMEND, PER 115 MG IV",957.0,622.05,478.5,957.0,12
HCPCS,J3490,EPHEDRINE 50 MG INJ,13.0,8.45,6.5,13.0,12
HCPCS,J3490,EPINEPHRINE 1/10000 1MG/10ML,39.0,25.35,19.5,39.0,12
HCPCS,J3490,ERTAPENEM SODIUM(INVANZ) 1GRAM,75.0,48.75,37.5,75.0,12
HCPCS,J3490,ESOMPERAZOLE SODIUM PER 20 MG,107.0,69.55,53.5,107.0,12
HCPCS,J3490,FERAHEME INJ IV PER 1 MG,2.0,1.3,1.0,2.0,12
HCPCS,J3490,FLAGYL 500 MG IV,18.0,11.7,9.0,18.0,12
HCPCS,J3490,FOLOTYN (PRALATREXATE) PER 20 MG,16472.0,10706.8,8236.0,16472.0,12
HCPCS,J3490,HALAVEN 1 MG/2ML,4279.0,2781.35,2139.5,4279.0,12
HCPCS,J3490,HESPAN 500 ML,101.0,65.65,50.5,101.0,12
HCPCS,J3490,HURRICAINE 1/8 OZ,4.0,2.6,2.0,4.0,12
HCPCS,J3490,HYSKON 100 ML,40.0,26.0,20.0,40.0,12
HCPCS,J3490,INDIGO CARMINE 5 ML INJ,18.0,11.7,9.0,18.0,12
HCPCS,J3490,JEVTANA (CABAZITAXEL) INJ. PER 60 MG,41481.0,26962.65,20740.5,41481.0,12
HCPCS,J3490,JUVADERM,642.0,417.3,321.0,642.0,12
HCPCS,J3490,"KRYSTEXXA, 8 MG",7556.0,4911.4,3778.0,7556.0,12
HCPCS,J3490,KYBELLA  2CC PER VILE,845.0,549.25,422.5,845.0,12
HCPCS,J3490,LABETALOL 5 MG/ML,2.0,1.3,1.0,2.0,12
HCPCS,J3490,LEVOPHED 4 ML INJ,16.0,10.4,8.0,16.0,12
HCPCS,J3490,LEXISCAN 0.1 MG,137.0,89.05,68.5,137.0,12
HCPCS,J3490,LIDOCAINE 4% TOPICAL SOLUTION,24.0,15.6,12.0,24.0,12
HCPCS,J3490,LOPRESSOR 5 MG/5 ML INJ,40.0,26.0,20.0,40.0,12
HCPCS,J3490,MANNITOL 20 % INTRAVENOUS SOLUTION,0.24,0.155,0.03,0.33,69
HCPCS,J3490,MESTINON 10 MG INJ,15.0,9.75,7.5,15.0,12
HCPCS,J3490,METHOTREXATE 25 MG VIAL,34.0,22.1,17.0,34.0,12
HCPCS,J3490,MIFEPREX TABLETS 600MG DOSE,615.0,399.75,307.5,615.0,12
HCPCS,J3490,MOUNJARO 10 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,326.52,1943.58,23
HCPCS,J3490,MOUNJARO 12.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,326.52,1943.58,23
HCPCS,J3490,MOUNJARO 15 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,326.52,1943.58,23
HCPCS,J3490,MOUNJARO 2.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,326.52,1943.58,23
HCPCS,J3490,MOUNJARO 5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,326.52,1943.58,23
HCPCS,J3490,MOUNJARO 7.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,326.52,1943.58,23
HCPCS,J3490,MVI W/ VITAMIN K 1 MG/ML,39.0,25.35,19.5,39.0,12
HCPCS,J3490,NARCAN PER 1 MG INJ,18.0,11.7,9.0,18.0,12
HCPCS,J3490,"NEXIUM, PER 40 MG",23.0,14.95,11.5,23.0,12
HCPCS,J3490,NITROLINGUAL PUMPSPRAY 4.9 GM,284.0,184.6,142.0,284.0,12
HCPCS,J3490,NOREPINEPHRINE BITARTRATE 4 MG/250 ML (16 MCG/ML) IN DEXTROSE 5 % IV,0.345,0.22,0.06,0.36,46
HCPCS,J3490,NOROMDYNE 5MG IV INFUSION,96.0,62.4,48.0,96.0,12
HCPCS,J3490,NS 100 CC,7.5,4.875,3.5,8.0,24
HCPCS,J3490,PEGFILGRASTIM 6MG SYRINGE,9100.0,5915.0,4550.0,9100.0,12
HCPCS,J3490,"PERLANE, EACH ADDTL SITE BILL W 3349855",507.0,329.55,253.5,507.0,12
HCPCS,J3490,PITRESSIN 10 U AMP INJ,15.0,9.75,7.5,15.0,12
HCPCS,J3490,PRE-PEN (BENZYPENICILLOYL POLYLYSINE),536.0,348.4,268.0,536.0,12
HCPCS,J3490,"RESTYLANE, 0.5 CC",428.0,278.2,214.0,428.0,12
HCPCS,J3490,SANDOSTATIN OCTREOTIDE ACETATE PER 100 MC,13.0,8.45,6.5,13.0,12
HCPCS,J3490,SECRETIN VIAL 75U,528.0,343.2,264.0,528.0,12
HCPCS,J3490,SODIUM BICARBONATE 8.4% 50 ML,5.0,3.25,2.5,5.0,12
HCPCS,J3490,SYNTHROID INJECTION PER 200 MCG,98.0,63.7,49.0,98.0,12
HCPCS,J3490,TENSILON INJ,14.0,9.1,7.0,14.0,12
HCPCS,J3490,TESTOSTERONE PELLET 75 MG,206.0,133.9,103.0,206.0,12
HCPCS,J3490,THIAMINE 100 MG INJ,2.0,1.3,1.0,2.0,12
HCPCS,J3490,VALPROATE 100 MG,48.0,31.2,24.0,48.0,12
HCPCS,J3490,VASOPRESSIN INJECTION 20 UNITS,23.0,14.95,11.5,23.0,12
HCPCS,J3490,VERAPAMIL 5 MG INJECTION,14.0,9.1,7.0,14.0,12
HCPCS,J3490,"XGEVA (DENOSUMAB), PER 120 MG",8308.0,5400.2,4154.0,8308.0,12
HCPCS,J3490,XOLAIR 150 MG,1080.0,702.0,540.0,1080.0,12
HCPCS,J3490,YERVOY (IPILIMUMAB),100682.0,65443.3,50341.0,100682.0,12
HCPCS,J3490,ZOVIRAX ACYLOVIR 500 MG,86.0,55.9,43.0,86.0,12
HCPCS,J3520,Edetate disodium per 150 mg,,,0.33,2.12,4
HCPCS,J35200,Edetate disodium per 150 mg,,,0.33,0.33,1
HCPCS,J3535,SPIRIVA RESPIMAT 2.5 MCG/ACTUATION SOLUTION FOR INHALATION,180.72,117.47,7.56,316.44,46
HCPCS,J3590,AMEVIVE 15MG IM,2502.0,1626.3,1251.0,2502.0,12
HCPCS,J3590,JUV?DERM SKINVIVE,325.0,211.25,162.5,325.0,12
HCPCS,J3590,JUVADERM VOLBELLA 0.55CC SYRINGE,400.0,260.0,200.0,400.0,12
HCPCS,J3590,JUVADERM VOLBELLA 1CC SYRINGE,725.0,471.25,362.5,725.0,12
HCPCS,J3590,JUVADERM VOLUMA,800.0,520.0,400.0,800.0,12
HCPCS,J3590,JUVADERM VOLUX XC 1CC,800.0,520.0,400.0,800.0,12
HCPCS,J3590,JUVADERMVOLLURE,700.0,455.0,350.0,700.0,12
HCPCS,J3590,JUVEDERM ULTRA  XC 1CC,600.0,390.0,300.0,600.0,12
HCPCS,J3590,JUVEDERM ULTRA PLUS,600.0,390.0,300.0,600.0,12
HCPCS,J3590,JUVEDERM ULTRA PLUS .55CC,455.0,295.75,227.5,455.0,12
HCPCS,J3590,JUVEDERM ULTRA XC  .55CC,455.0,295.75,227.5,455.0,12
HCPCS,J3590,PROLIA DENOSUMAB PER 60 MG,2710.0,1761.5,1355.0,2710.0,12
HCPCS,J3590,RENUVA HYDRADTED 1.5 SYRINGE,1125.0,731.25,562.5,1125.0,12
HCPCS,J3590,RENUVA HYDRADTED 3.0 SYRINGE,2250.0,1462.5,1125.0,2250.0,12
HCPCS,J3590,RESTYLANE  .5CC,400.0,260.0,200.0,400.0,12
HCPCS,J3590,RESTYLANE 1CC SYRINGE,600.0,390.0,300.0,600.0,12
HCPCS,J3590,RESTYLANE CONTOUR,700.0,455.0,350.0,700.0,12
HCPCS,J3590,RESTYLANE DEFYNE,700.0,455.0,350.0,700.0,12
HCPCS,J3590,RESTYLANE EYELIGHT .5,400.0,260.0,200.0,400.0,12
HCPCS,J3590,RESTYLANE EYELIGHT 1CC,900.0,585.0,450.0,900.0,12
HCPCS,J3590,RESTYLANE KYSSE 1CC SYRINGE,700.0,455.0,350.0,700.0,12
HCPCS,J3590,RESTYLANE LYFT,600.0,390.0,300.0,600.0,12
HCPCS,J3590,RESTYLANE REFYNE,700.0,455.0,350.0,700.0,12
HCPCS,J3590,RESTYLANE SILK,600.0,390.0,300.0,600.0,12
HCPCS,J3590,RHA 2 (REVANCE),600.0,390.0,300.0,600.0,12
HCPCS,J3590,RHA 3 (REVANCE),600.0,390.0,300.0,600.0,12
HCPCS,J3590,RHA 4 (REVANCE),600.0,390.0,300.0,600.0,12
HCPCS,J3590,"STELARA (USTEKINUMAB), PER 45 MG",15778.0,10255.7,7889.0,15778.0,12
HCPCS,J3590,UNCLASSIFIED BIOLOGICS,3413.0,2218.45,1706.5,3413.0,12
HCPCS,J7030,F NACL .9 1000ML,16.0,10.4,2.35,16.0,31
HCPCS,J7030,NORMAL SALINE SOLUTION INFUS,40.0,26.0,1.99,40.0,14
HCPCS,J7030,Normal saline solution infus,,,2.15,2.15,1
HCPCS,J7030,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.09,0.06,0.01,5.51,279
HCPCS,J70300,Normal saline solution infus,,,2.15,2.15,1
HCPCS,J7040,"INFUSION, NORMAL SALINE 500ML",5.0,3.25,0.84,5.0,31
HCPCS,J7040,NORMAL SALINE SOLUTION INFUS,13.0,8.45,1.29,13.0,14
HCPCS,J7040,Normal saline solution infus,,,1.39,1.39,1
HCPCS,J7040,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.105,0.07,0.01,3.56,248
HCPCS,J7040,STRL SALINE SOLN 500 ML=1 UNIT,13.0,8.45,1.17,13.0,31
HCPCS,J70400,Normal saline solution infus,,,1.39,1.39,1
HCPCS,J7042,5% DEXTROSE/NORMAL SALINE,43.0,27.95,1.31,43.0,14
HCPCS,J7042,5% dextrose/normal saline,,,1.41,1.41,1
HCPCS,J7042,D5/0.9NS IV 500ML,32.63,21.21,1.02,32.63,62
HCPCS,J7042,DEXTROSE 2.5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,30
HCPCS,J7042,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,124
HCPCS,J7042,DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,62
HCPCS,J7042,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,124
HCPCS,J70420,5% dextrose/normal saline,,,1.41,1.41,1
HCPCS,J7050,NORMAL SALINE SOLUTION INFUS,43.0,27.95,0.66,43.0,14
HCPCS,J7050,"NRML SALINE SOLUTION, 250 CC",43.0,27.95,0.59,43.0,31
HCPCS,J7050,Normal saline solution infus,,,0.71,0.71,1
HCPCS,J7050,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.105,0.07,0.01,1.84,372
HCPCS,J70500,Normal saline solution infus,,,0.71,0.71,1
HCPCS,J7060,5% DEXTROSE/WATER,41.0,26.65,1.75,41.0,14
HCPCS,J7060,5% dextrose/water,,,1.89,1.89,1
HCPCS,J7060,D5W 500 CC,33.0,21.45,1.75,33.0,14
HCPCS,J7060,D5W 500ML,13.0,8.45,1.62,13.0,31
HCPCS,J7060,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.12,0.08,0.01,4.82,341
HCPCS,J70600,5% dextrose/water,,,1.89,1.89,1
HCPCS,J7070,D5W INFUSION,51.0,33.15,2.94,51.0,14
HCPCS,J7070,D5w infusion,,,3.18,3.18,1
HCPCS,J7070,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.18,0.12,0.01,8.14,155
HCPCS,J70700,D5w infusion,,,3.18,3.18,1
HCPCS,J7100,Dextran 40 infusion,,,69.01,69.01,1
HCPCS,J7100,LMD (DEXTRAN 40) 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,2.37,1.54,0.4,175.09,23
HCPCS,J7100,LMD (DEXTRAN 40) 10 % IN 5 % DEXTROSE INTRAVENOUS SOLUTION,2.28,1.48,0.38,175.09,23
HCPCS,J71000,Dextran 40 infusion,,,69.01,69.01,1
HCPCS,J7110,Dextran 75 infusion,,,12.55,31.84,4
HCPCS,J71100,Dextran 75 infusion,,,12.55,12.55,1
HCPCS,J7120,D5LR 500 CC,39.0,25.35,2.38,39.0,14
HCPCS,J7120,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,6.6,93
HCPCS,J7120,LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,6.6,93
HCPCS,J7120,POTASSIUM CHLORIDE 20 MEQ/L-LACTATED RINGERS-5 % DEXTROSE INTRAVENOUS,0.045,0.03,0.01,6.6,62
HCPCS,J7120,RINGERS LACTATE INFUSION,48.0,31.2,2.38,48.0,14
HCPCS,J7120,Ringers lactate infusion,,,2.57,2.57,1
HCPCS,J71200,Ringers lactate infusion,,,2.57,2.57,1
HCPCS,J7121,5% dextrose in lac ringers,,,8.27,20.99,7
HCPCS,J71210,5% dextrose in lac ringers,,,8.27,8.27,1
HCPCS,J7131,Hypertonic saline sol,,,0.17,0.17,1
HCPCS,J7131,SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,0.78,0.51,0.13,0.93,69
HCPCS,J7131,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,0.045,0.03,0.01,0.44,69
HCPCS,J7131,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,0.78,0.505,0.11,0.93,46
HCPCS,J7131,SODIUM CHLORIDE 5 % HYPERTONIC INTRAVENOUS SOLUTION,0.045,0.03,0.01,0.44,46
HCPCS,J71310,Hypertonic saline sol,,,0.17,0.17,1
HCPCS,J7165,"Inj, human-lans, per i.u",,,1.7,1355.53,27
HCPCS,J71650,"Inj, human-lans, per i.u",,,3.26,3.26,1
HCPCS,J7168,KCENTRA 1000 UNIT (800-1240 UNIT) INTRAVENOUS SOLUTION,10.74,6.98,2.09,1355.53,39
HCPCS,J7168,KCENTRA 500 UNIT (400-620 UNIT) INTRAVENOUS SOLUTION,10.74,6.98,2.09,1355.53,39
HCPCS,J7168,Prothrombin complex kcentra,,,3.09,3.09,1
HCPCS,J71680,Prothrombin complex kcentra,,,3.09,3.09,1
HCPCS,J7169,"Inj andexxa, 10 mg",,,129.6,12697.64,27
HCPCS,J71690,"Inj andexxa, 10 mg",,,129.6,129.6,1
HCPCS,J7170,HEMLIBRA 150 MG/ML SUBCUTANEOUS SOLUTION,65288.37,42437.44,45.76,65288.37,53
HCPCS,J7170,HEMLIBRA 30 MG/ML SUBCUTANEOUS SOLUTION,13057.68,8487.49,45.76,18253.82,53
HCPCS,J7170,HEMLIBRA 60 MG/0.4 ML SUBCUTANEOUS SOLUTION,65288.34,42437.42,45.76,65288.34,53
HCPCS,J7170,"Inj., emicizumab-kxwh 0.5 mg",,,60.98,60.98,1
HCPCS,J71700,"Inj., emicizumab-kxwh 0.5 mg",,,60.98,60.98,1
HCPCS,J7171,ADZYNMA 1500 (+/-) UNIT INTRAVENOUS KIT,12.18,7.92,3.15,98.17,40
HCPCS,J7171,ADZYNMA 500 (+/-) UNIT INTRAVENOUS KIT,12.18,7.92,3.15,98.17,80
HCPCS,J7171,"Inj, adzynma, 10 iu",,,38.32,38.32,1
HCPCS,J71710,"Inj, adzynma, 10 iu",,,38.32,38.32,1
HCPCS,J7172,"Inj marstacim-hncq, 0.5 mg",,,50.47,18253.82,21
HCPCS,J71720,"Inj marstacim-hncq, 0.5 mg",,,54.51,54.51,1
HCPCS,J7173,"Inj. concizumab-mtci, 0.5 mg",,,85.5,943.43,21
HCPCS,J71730,"Inj. concizumab-mtci, 0.5 mg",,,92.34,92.34,1
HCPCS,J7174,Injection fitusiran 0.04 mg,,,132.62,18253.82,21
HCPCS,J71740,Injection fitusiran 0.04 mg,,,143.23,143.23,1
HCPCS,J7175,COAGADEX 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,40.98,26.64,8.2,18253.82,47
HCPCS,J7175,"Inj, factor x, (human), 1iu",,,10.71,10.71,1
HCPCS,J71750,"Inj, factor x, (human), 1iu",,,10.71,10.71,1
HCPCS,J7177,"Inj., fibryga, 1 mg",,,1.11,943.43,35
HCPCS,J71770,"Inj., fibryga, 1 mg",,,1.33,1.33,1
HCPCS,J7178,Inj human fibrinogen con nos,,,1.65,1.65,1
HCPCS,J7178,RIASTAP 1 GRAM (900 MG-1300 MG) INTRAVENOUS SOLUTION,5.46,3.55,1.3,3407.66,47
HCPCS,J71780,Inj human fibrinogen con nos,,,1.65,1.65,1
HCPCS,J7179,VONVENDI 1300 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,7.14,4.64,1.68,3407.66,47
HCPCS,J7179,VONVENDI 650 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,7.14,4.64,1.68,3407.66,47
HCPCS,J7179,Vonvendi inj 1 iu vwf:rco,,,1.99,1.99,1
HCPCS,J71790,Vonvendi inj 1 iu vwf:rco,,,1.99,1.99,1
HCPCS,J7180,Factor xiii anti-hem factor,,,9.14,18253.82,35
HCPCS,J71800,Factor xiii anti-hem factor,,,11.62,11.62,1
HCPCS,J7181,Factor xiii recomb a-subunit,,,20.04,20.04,1
HCPCS,J7181,TRETTEN 2500 UNIT INTRAVENOUS SOLUTION,71.46,46.45,15.39,12697.64,47
HCPCS,J71810,Factor xiii recomb a-subunit,,,20.04,20.04,1
HCPCS,J7182,Factor viii recomb novoeight,,,1.24,3407.66,35
HCPCS,J71820,Factor viii recomb novoeight,,,1.67,1.67,1
HCPCS,J7183,Wilate injection,,,1.13,3236.72,35
HCPCS,J71830,Wilate injection,,,1.43,1.43,1
HCPCS,J7185,Xyntha inj,,,1.24,1355.53,35
HCPCS,J71850,Xyntha inj,,,1.72,1.72,1
HCPCS,J7186,ALPHANATE 1000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLUTION,5.1,3.32,1.07,3236.72,47
HCPCS,J7186,ALPHANATE 1500 (600 VWF) UNIT/10 ML INTRAVENOUS SOLUTION,5.1,3.32,1.07,3236.72,47
HCPCS,J7186,ALPHANATE 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,5.1,3.32,1.07,3236.72,47
HCPCS,J7186,Antihemophilic viii/vwf comp,,,1.34,1.34,1
HCPCS,J71860,Antihemophilic viii/vwf comp,,,1.34,1.34,1
HCPCS,J7187,HUMATE-P 1000 UNIT-2400 UNIT INTRAVENOUS SOLUTION,6.15,4.0,1.26,3236.72,47
HCPCS,J7187,HUMATE-P 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,6.15,4.0,1.26,3236.72,47
HCPCS,J7187,HUMATE-P 500 UNIT-1200 UNIT INTRAVENOUS SOLUTION,6.15,4.0,1.26,3236.72,47
HCPCS,J7187,"Humate-p, inj",,,1.61,1.61,1
HCPCS,J71870,"Humate-p, inj",,,1.61,1.61,1
HCPCS,J7188,Factor viii recomb obizur,,,3.49,3.49,1
HCPCS,J7188,OBIZUR 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,10.62,6.9,2.75,3407.66,47
HCPCS,J71880,Factor viii recomb obizur,,,3.49,3.49,1
HCPCS,J7189,FACTOR VIIA,3.0,1.95,1.5,3.0,14
HCPCS,J7189,Factor viia recomb novoseven,,,2.83,2.83,1
HCPCS,J7189,NOVOSEVEN RT 1 MG (1000 MCG) INTRAVENOUS SOLUTION,10.62,6.9,2.21,3407.66,47
HCPCS,J7189,NOVOSEVEN RT 2 MG (2000 MCG) INTRAVENOUS SOLUTION,10.62,6.9,2.21,3407.66,47
HCPCS,J7189,NOVOSEVEN RT 5 MG (5000 MCG) INTRAVENOUS SOLUTION,10.62,6.9,2.21,3407.66,47
HCPCS,J71890,Factor viia recomb novoseven,,,2.83,2.83,1
HCPCS,J7190,Factor viii,,,1.0,3236.72,35
HCPCS,J71900,Factor viii,,,1.2,1.2,1
HCPCS,J7191,Factor viii (porcine),,,1.9,3407.66,14
HCPCS,J71910,Factor viii (porcine),,,1.9,1.9,1
HCPCS,J7192,ADVATE 1000 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.36,3407.66,47
HCPCS,J7192,ADVATE 1500 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.36,3407.66,47
HCPCS,J7192,ADVATE 250 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.36,3407.66,47
HCPCS,J7192,ADVATE 500 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.36,3407.66,47
HCPCS,J7192,FACTOR VIII RECOMBINANT,3.0,1.95,1.5,3.0,14
HCPCS,J7192,Factor viii recombinant nos,,,1.72,1.72,1
HCPCS,J7192,RECOMBINATE 1000 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.36,3407.66,47
HCPCS,J71920,Factor viii recombinant nos,,,1.72,1.72,1
HCPCS,J7193,Factor ix non-recombinant,,,1.19,3407.66,35
HCPCS,J71930,Factor ix non-recombinant,,,1.48,1.48,1
HCPCS,J7194,Factor ix complex,,,1.45,3236.72,35
HCPCS,J71940,Factor ix complex,,,1.84,1.84,1
HCPCS,J7195,BENEFIX 1000 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.58,3407.66,47
HCPCS,J7195,BENEFIX 2000 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.58,3407.66,47
HCPCS,J7195,BENEFIX 3000 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.58,3407.66,47
HCPCS,J7195,BENEFIX 500 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.58,3407.66,47
HCPCS,J7195,Factor ix recombinant nos,,,1.98,1.98,1
HCPCS,J71950,Factor ix recombinant nos,,,1.98,1.98,1
HCPCS,J7196,Antithrombin recombinant,,,97.89,369.57,13
HCPCS,J71960,Antithrombin recombinant,,,145.67,145.67,1
HCPCS,J7197,Antithrombin iii injection,,,4.37,4.37,1
HCPCS,J7197,THROMBATE III 500 (+/-) UNIT INTRAVENOUS SOLUTION,16.53,10.74,3.36,3407.66,94
HCPCS,J71970,Antithrombin iii injection,,,4.37,4.37,1
HCPCS,J7198,Anti-inhibitor,,,2.64,2.64,1
HCPCS,J7198,FEIBA NF 1750 UNIT-3250 UNIT INTRAVENOUS SOLUTION,9.72,6.32,2.06,3407.66,47
HCPCS,J7198,FEIBA NF 350 UNIT-650 UNIT INTRAVENOUS SOLUTION,9.72,6.32,2.06,3407.66,47
HCPCS,J7198,FEIBA NF 700 UNIT-1300 UNIT INTRAVENOUS SOLUTION,9.72,6.32,2.06,3407.66,47
HCPCS,J71980,Anti-inhibitor,,,2.64,2.64,1
HCPCS,J7199,Hemophilia clot factor noc,,,74.0,93.47,6
HCPCS,J7200,Factor ix recombinan rixubis,,,1.38,3407.66,22
HCPCS,J72000,Factor ix recombinan rixubis,,,1.88,1.88,1
HCPCS,J7201,ALPROLIX 1000 UNIT INTRAVENOUS SOLUTION,14.55,9.46,3.12,3407.66,47
HCPCS,J7201,ALPROLIX 500 UNIT INTRAVENOUS SOLUTION,14.55,9.46,3.12,3407.66,47
HCPCS,J7201,Factor ix alprolix recomb,,,3.89,3.89,1
HCPCS,J72010,Factor ix alprolix recomb,,,3.89,3.89,1
HCPCS,J7202,Factor ix idelvion inj,,,4.58,3407.66,35
HCPCS,J72020,Factor ix idelvion inj,,,5.75,5.75,1
HCPCS,J7203,Factor ix recomb gly rebinyn,,,4.03,3407.66,35
HCPCS,J72030,Factor ix recomb gly rebinyn,,,4.91,4.91,1
HCPCS,J7204,ESPEROCT 3000 (+/-) UNIT INTRAVENOUS SOLUTION,10.2,6.63,1.9,3407.66,47
HCPCS,J7204,Inj recombin esperoct per iu,,,2.42,2.42,1
HCPCS,J72040,Inj recombin esperoct per iu,,,2.42,2.42,1
HCPCS,J7205,ELOCTATE 1000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
HCPCS,J7205,ELOCTATE 1500 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
HCPCS,J7205,ELOCTATE 2000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
HCPCS,J7205,ELOCTATE 250 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
HCPCS,J7205,ELOCTATE 3000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
HCPCS,J7205,ELOCTATE 4000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
HCPCS,J7205,ELOCTATE 500 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
HCPCS,J7205,ELOCTATE 5000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
HCPCS,J7205,ELOCTATE 6000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
HCPCS,J7205,ELOCTATE 750 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
HCPCS,J7205,Factor viii fc fusion recomb,,,2.67,2.67,1
HCPCS,J72050,Factor viii fc fusion recomb,,,2.67,2.67,1
HCPCS,J7207,Factor viii pegylated recomb,,,1.85,3407.66,35
HCPCS,J72070,Factor viii pegylated recomb,,,2.33,2.33,1
HCPCS,J7208,Inj. jivi 1 iu,,,2.1,3407.66,35
HCPCS,J72080,Inj. jivi 1 iu,,,2.86,2.86,1
HCPCS,J7209,Factor viii nuwiq recomb 1iu,,,1.13,3236.72,35
HCPCS,J72090,Factor viii nuwiq recomb 1iu,,,1.22,1.22,1
HCPCS,J7210,"Inj, afstyla, 1 i.u.",,,1.31,3407.66,35
HCPCS,J72100,"Inj, afstyla, 1 i.u.",,,1.71,1.71,1
HCPCS,J7211,"Inj, kovaltry, 1 i.u.",,,1.28,3407.66,35
HCPCS,J72110,"Inj, kovaltry, 1 i.u.",,,1.7,1.7,1
HCPCS,J7212,Factor viia recomb sevenfact,,,1.94,3407.66,22
HCPCS,J72120,Factor viia recomb sevenfact,,,2.54,2.54,1
HCPCS,J7213,"Inj, ixinity, 1 i.u.",,,1.65,3407.66,35
HCPCS,J72130,"Inj, ixinity, 1 i.u.",,,2.24,2.24,1
HCPCS,J7214,ALTUVIIIO 1000 (+/-) UNIT INTRAVENOUS SOLUTION,20.49,13.32,4.17,3236.72,47
HCPCS,J7214,Altuviiio per factor viii iu,,,4.98,4.98,1
HCPCS,J72140,Altuviiio per factor viii iu,,,4.98,4.98,1
HCPCS,J7294,Seg acet and eth estr yearly,,,61.99,6367.02,13
HCPCS,J72940,Seg acet and eth estr yearly,,,2509.63,2509.63,1
HCPCS,J7295,Eth estr and eton monthly,,,61.99,273.07,13
HCPCS,J72950,Eth estr and eton monthly,,,107.63,107.63,1
HCPCS,J7296,KYLEENA 17.5 MCG/24 HR (UP TO 5 YEARS) 19.5 MG INTRAUTERINE DEVICE,2915.12,1894.83,273.36,3328.09,32
HCPCS,J7296,"Kyleena, 19.5 mg",,,1311.8,1311.8,1
HCPCS,J7296,"LEVONORGESTREL-RELEASING INTR CONTRACEPTIVE  (KYLEENA), 19.5 MG",3312.0,2152.8,1214.63,3312.0,14
HCPCS,J72960,"Kyleena, 19.5 mg",,,1311.8,1311.8,1
HCPCS,J7297,LILETTA 20.4 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,2236.16,1453.5,273.36,2552.94,29
HCPCS,J7297,"Liletta, 52 mg",,,1006.27,1006.27,1
HCPCS,J72970,"Liletta, 52 mg",,,1006.27,1006.27,1
HCPCS,J7298,LEVONORGESTREL IU 52MG,1945.25,1264.41,273.36,3328.09,29
HCPCS,J7298,LEVONORGESTREL IU 52MG 5 YR,614.0,399.1,307.0,1360.39,14
HCPCS,J7298,MIRENA 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,2915.12,1894.83,273.36,3328.09,32
HCPCS,J7298,"Mirena, 52 mg",,,1311.8,1311.8,1
HCPCS,J72980,"Mirena, 52 mg",,,1311.8,1311.8,1
HCPCS,J7299,Intraut copp cont (miudella),,,61.99,2996.03,10
HCPCS,J72990,Intraut copp cont (miudella),,,1180.92,1180.92,1
HCPCS,J7300,INTRAUT COPPER CONTRACEPTIVE,802.0,521.3,401.0,1329.44,14
HCPCS,J7300,Intra copp contra (paragard),,,1281.96,1281.96,1
HCPCS,J7300,PARAGARD T380A (SINGLE HAND) 380 SQUARE MM INTRAUTERINE DEVICE,2732.0,1775.8,61.99,3252.38,32
HCPCS,J7300,W IUD COPPER CONTRACEPTIVE,540.0,351.0,61.99,3252.38,29
HCPCS,J73000,Intra copp contra (paragard),,,1281.96,1281.96,1
HCPCS,J7301,SKYLA,1012.0,657.8,506.0,1132.75,14
HCPCS,J7301,SKYLA 14 MCG/24 HR (UP TO 3 YEARS) 13.5 MG INTRAUTERINE DEVICE,2427.32,1577.76,273.36,2771.18,29
HCPCS,J7301,"Skyla, 13.5 mg",,,1092.29,1092.29,1
HCPCS,J73010,"Skyla, 13.5 mg",,,1092.29,1092.29,1
HCPCS,J7303,Contraceptive vaginal ring,,,61.99,78.3,6
HCPCS,J7304,Contraceptive hormone patch,,,42.22,107.11,10
HCPCS,J73040,Contraceptive hormone patch,,,42.22,42.22,1
HCPCS,J7306,Levonorgestrel implant sys,,,74.0,1112.44,13
HCPCS,J73060,Levonorgestrel implant sys,,,438.48,438.48,1
HCPCS,J7307,ETONOGESTREL IMPLANT SYSTEM,1404.0,912.6,235.87,3494.49,43
HCPCS,J7307,Etonogestrel implant system,,,1377.39,1377.39,1
HCPCS,J7307,NEXPLANON 68 MG SUBDERMAL IMPLANT,3060.86,1989.56,273.36,3494.49,32
HCPCS,J73070,Etonogestrel implant system,,,1377.39,1377.39,1
HCPCS,J7308,AMINOLEVULINIC ACID HCL TOP,1062.0,690.3,389.83,1062.0,14
HCPCS,J7308,Aminolevulinic acid hcl top,,,421.02,421.02,1
HCPCS,J7308,LEVULAN 20 % TOPICAL SOLUTION,943.72,613.42,97.89,1078.82,47
HCPCS,J73080,Aminolevulinic acid hcl top,,,421.02,421.02,1
HCPCS,J7309,"Methyl aminolevulinate, top",,,97.89,139.85,9
HCPCS,J7310,Ganciclovir long act implant,,,10052.3,28340.16,9
HCPCS,J7311,"Inj., retisert, 0.01 mg",,,366.06,366.06,1
HCPCS,J7311,RETISERT 0.59 MG INTRAVITREAL IMPLANT,45660.0,29679.0,333.48,45660.0,52
HCPCS,J73110,"Inj., retisert, 0.01 mg",,,366.06,366.06,1
HCPCS,J7312,Dexamethasone intra implant,,,220.9,220.9,1
HCPCS,J7312,OZURDEX 0.7 MG INTRAVITREAL IMPLANT,4798.8,3119.22,185.04,4798.8,50
HCPCS,J73120,Dexamethasone intra implant,,,220.9,220.9,1
HCPCS,J7313,ILUVIEN 0.19 MG INTRAVITREAL IMPLANT,22092.0,14359.8,438.78,22092.0,53
HCPCS,J7313,"Inj., iluvien, 0.01 mg",,,548.04,548.04,1
HCPCS,J73130,"Inj., iluvien, 0.01 mg",,,548.04,548.04,1
HCPCS,J7314,"Inj., yutiq, 0.01 mg",,,572.28,572.28,1
HCPCS,J7314,YUTIQ 0.18 MG INTRAVITREAL IMPLANT,22244.0,14458.6,474.38,22244.0,53
HCPCS,J73140,"Inj., yutiq, 0.01 mg",,,572.28,572.28,1
HCPCS,J7315,Ophthalmic mitomycin,,,61.99,1131.07,10
HCPCS,J73150,Ophthalmic mitomycin,,,445.82,445.82,1
HCPCS,J7316,"Inj, ocriplasmin, 0.125 mg",,,2562.41,3236.72,6
HCPCS,J7318,DUROLANE 60 MG/3 ML INTRA-ARTICULAR SYRINGE,1338.0,869.7,5.9,1338.0,47
HCPCS,J7318,"INJECTION, DUROLANE, 1 MG",27.0,17.55,5.9,345.3,47
HCPCS,J7318,"Inj, durolane 1 mg",,,7.04,7.04,1
HCPCS,J73180,"Inj, durolane 1 mg",,,7.04,7.04,1
HCPCS,J7320,"Genvisc 850, inj, 1mg",,,4.65,93.47,35
HCPCS,J73200,"Genvisc 850, inj, 1mg",,,5.14,5.14,1
HCPCS,J7321,HYALGAN 10 MG/ML INTRA-ARTICULAR SOLUTION,342.0,222.3,57.46,342.0,37
HCPCS,J7321,HYALGAN 10 MG/ML INTRA-ARTICULAR SYRINGE,342.0,222.3,57.46,342.0,37
HCPCS,J7321,HYALGAN/SUPARTZ INJ PER DOSE,373.0,242.45,72.97,373.0,14
HCPCS,J7321,Hyalgan supartz visco-3 dose,,,78.81,78.81,1
HCPCS,J7321,SUPARTZ FX 10 MG/ML INTRA-ARTICULAR SYRINGE,341.58,222.03,57.39,341.58,37
HCPCS,J73210,Hyalgan supartz visco-3 dose,,,78.81,78.81,1
HCPCS,J7322,HYMOVIS 24 MG/3 ML INTRA-ARTICULAR SYRINGE,860.4,559.26,15.76,860.4,47
HCPCS,J7322,"Hyaluronan, hymo or hymo one",,,19.05,19.05,1
HCPCS,J73220,"Hyaluronan, hymo or hymo one",,,19.05,19.05,1
HCPCS,J7323,EUFLEXXA 10 MG/ML (MW 2.4-3.6 MILLION) INTRA-ARTICULAR SYRINGE,649.14,421.94,74.0,649.14,47
HCPCS,J7323,EUFLEXXA INJ PER DOSE,407.0,264.55,105.46,407.0,14
HCPCS,J7323,Euflexxa inj per dose,,,113.9,113.9,1
HCPCS,J73230,Euflexxa inj per dose,,,113.9,113.9,1
HCPCS,J7324,ORTHOVISC 30 MG/2 ML INTRA-ARTICULAR SYRINGE,860.4,559.26,74.0,860.4,47
HCPCS,J7324,ORTHOVISC INJ PER DOSE,630.0,409.5,111.26,630.0,14
HCPCS,J7324,Orthovisc inj per dose,,,120.16,120.16,1
HCPCS,J73240,Orthovisc inj per dose,,,120.16,120.16,1
HCPCS,J7325,SYNVISC 16 MG/2 ML INTRA-ARTICULAR SYRINGE,821.76,534.14,7.56,821.76,47
HCPCS,J7325,SYNVISC ONE,34.0,22.1,7.56,34.0,14
HCPCS,J7325,SYNVISC OR SYNVISC-ONE,43.0,27.95,7.56,43.0,14
HCPCS,J7325,SYNVISC OR SYNVISC-ONE 1 MG,43.0,27.95,7.56,123.65,47
HCPCS,J7325,SYNVISC-ONE 48 MG/6 ML INTRA-ARTICULAR SYRINGE,821.76,534.14,7.56,821.76,47
HCPCS,J7325,Synvisc or synvisc-one,,,8.16,8.16,1
HCPCS,J73250,Synvisc or synvisc-one,,,8.16,8.16,1
HCPCS,J7326,GEL-ONE 30 MG/3 ML INTRA-ARTICULAR SYRINGE,1380.0,897.0,97.89,1461.32,47
HCPCS,J7326,GEL-ONE PER DOSE,1802.0,1171.3,528.05,1802.0,14
HCPCS,J7326,Gel-one,,,570.29,570.29,1
HCPCS,J73260,Gel-one,,,570.29,570.29,1
HCPCS,J7327,MONOVISC 88 MG/4 ML INTRA-ARTICULAR SYRINGE,1350.0,877.5,273.36,1562.95,47
HCPCS,J7327,MONOVISC INJ PER DOSE,2969.0,1929.85,564.77,2969.0,14
HCPCS,J7327,Monovisc inj per dose,,,609.95,609.95,1
HCPCS,J73270,Monovisc inj per dose,,,609.95,609.95,1
HCPCS,J7328,GELSYN-3  16.8 MG/2 ML INTRA-ARTICULAR SYRINGE,698.4,453.96,0.44,698.4,40
HCPCS,J7328,Gelsyn-3 injection 0.1 mg,,,0.72,0.72,1
HCPCS,J73280,Gelsyn-3 injection 0.1 mg,,,0.72,0.72,1
HCPCS,J7329,"Inj, trivisc 1 mg",,,3.6,123.65,35
HCPCS,J73290,"Inj, trivisc 1 mg",,,3.9,3.9,1
HCPCS,J7330,Cultured chondrocytes implnt,,,72339.26,183527.39,4
HCPCS,J73300,Cultured chondrocytes implnt,,,72339.26,72339.26,1
HCPCS,J7331,"Synojoynt, inj., 1 mg",,,3.37,123.65,18
HCPCS,J73310,"Synojoynt, inj., 1 mg",,,3.37,3.37,1
HCPCS,J7332,"Inj., triluron, 1 mg",,,9.44,123.65,35
HCPCS,J73320,"Inj., triluron, 1 mg",,,10.93,10.93,1
HCPCS,J7333,Visco-3 inj dose,,,61.99,78.3,6
HCPCS,J7336,Capsaicin 8% patch,,,3.69,3.69,1
HCPCS,J7336,QUTENZA 8 % TOPICAL KIT,4360.48,2834.31,2.99,8721.0,150
HCPCS,J73360,Capsaicin 8% patch,,,3.69,3.69,1
HCPCS,J7340,Carbidopa levodopa ent 100ml,,,74.0,674.64,35
HCPCS,J73400,Carbidopa levodopa ent 100ml,,,263.29,263.29,1
HCPCS,J7342,Ciprofloxacin otic susp 6 mg,,,29.35,29.35,1
HCPCS,J73420,Ciprofloxacin otic susp 6 mg,,,29.35,29.35,1
HCPCS,J7345,AMELUZ 10 % TOPICAL GEL,457.2,297.18,1.53,457.2,46
HCPCS,J7345,"Aminolevulinic acid, 10% gel",,,1.93,1.93,1
HCPCS,J73450,"Aminolevulinic acid, 10% gel",,,1.93,1.93,1
HCPCS,J7351,DURYSTA 10 MCG INTRACAMERAL IMPLANT,7290.0,4738.5,185.57,7290.0,53
HCPCS,J7351,Inj bimatoprost itc imp1mcg,,,231.0,231.0,1
HCPCS,J73510,Inj bimatoprost itc imp1mcg,,,231.0,231.0,1
HCPCS,J7352,"Afamelanotide implant, 1 mg",,,3266.51,3266.51,1
HCPCS,J7352,SCENESSE 16 MG SUBCUTANEOUS IMPLANT,120982.0,78638.3,2873.33,120982.0,45
HCPCS,J73520,"Afamelanotide implant, 1 mg",,,3266.51,3266.51,1
HCPCS,J7353,Anacaulase-bcdb 8.8% gel 1 g,,,57.17,150.65,27
HCPCS,J73530,Anacaulase-bcdb 8.8% gel 1 g,,,59.38,59.38,1
HCPCS,J7354,"Cantharidin top, applicator",,,97.89,1816.78,34
HCPCS,J73540,"Cantharidin top, applicator",,,709.02,709.02,1
HCPCS,J7355,Inj travoprost intra impl,,,196.22,652.67,34
HCPCS,J73550,Inj travoprost intra impl,,,211.93,211.93,1
HCPCS,J7356,Inj foscarb/foslevodopa 5 mg,,,0.76,345.3,17
HCPCS,J73560,Inj foscarb/foslevodopa 5 mg,,,0.76,0.76,1
HCPCS,J7401,Mometasone furoate sinus imp,,,303.41,383.26,6
HCPCS,J7402,Mometasone sinus sinuva,,,12.26,12.26,1
HCPCS,J7402,SINUVA 1350 MCG SINUS IMPLANT,3538.44,2299.99,10.21,3538.44,50
HCPCS,J74020,Mometasone sinus sinuva,,,12.26,12.26,1
HCPCS,J7500,AZATHIOPRINE 50 MG TABLET,2.96,1.9250000000000003,0.11,4.22,62
HCPCS,J7500,Azathioprine oral 50mg,,,0.06,0.06,1
HCPCS,J75000,Azathioprine oral 50mg,,,0.06,0.06,1
HCPCS,J7501,Azathioprine parenteral,,,61.99,657.6,27
HCPCS,J75010,Azathioprine parenteral,,,259.2,259.2,1
HCPCS,J7502,CYCLOSPORINE 100 MG ORAL CAP (SANDIMMUNE),37.519999999999996,24.39,2.07,39.72,62
HCPCS,J7502,CYCLOSPORINE MODIFIED 100 MG ORAL CAP (NEORALGENGRAF),11.0,7.15,1.85,11.0,93
HCPCS,J7502,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,14.98,9.74,2.07,14.98,31
HCPCS,J7502,Cyclosporine oral 100 mg,,,1.95,1.95,1
HCPCS,J7502,GENGRAF 100 MG CAPSULE,17.64,11.47,2.07,17.64,31
HCPCS,J7502,GENGRAF 100 MG/ML ORAL SOLUTION,24.9,16.19,2.07,24.9,31
HCPCS,J7502,NEORAL 100 MG CAPSULE,28.25,18.36,2.07,28.28,62
HCPCS,J7502,NEORAL 100 MG/ML ORAL SOLUTION,38.45,24.99,2.07,38.45,31
HCPCS,J7502,SANDIMMUNE 100 MG CAPSULE,43.82,28.48,2.07,43.82,31
HCPCS,J75020,Cyclosporine oral 100 mg,,,1.95,1.95,1
HCPCS,J7503,ENVARSUS XR 0.75 MG TABLETEXTENDED RELEASE,12.86,8.36,1.56,12.86,62
HCPCS,J7503,ENVARSUS XR 1 MG TABLETEXTENDED RELEASE,17.14,11.14,1.56,17.14,62
HCPCS,J7503,ENVARSUS XR 4 MG TABLETEXTENDED RELEASE,68.58,44.58,1.56,68.58,62
HCPCS,J7503,Tacrol envarsus ex rel oral,,,2.02,2.02,1
HCPCS,J75030,Tacrol envarsus ex rel oral,,,2.02,2.02,1
HCPCS,J7504,ATGAM 50 MG/ML INTRAVENOUS SOLUTION,3826.35,2487.13,991.02,14689.17,50
HCPCS,J7504,Lymphocyte immune globulin,,,5732.56,5732.56,1
HCPCS,J75040,Lymphocyte immune globulin,,,5732.56,5732.56,1
HCPCS,J7505,Monoclonal antibodies,,,711.31,898.5,6
HCPCS,J7507,PROGRAF 0.5 MG CAPSULE,8.88,5.77,0.24,8.88,31
HCPCS,J7507,PROGRAF 1 MG CAPSULE,17.76,11.54,0.24,17.76,31
HCPCS,J7507,TACROLIMUS 0.5 MG CAPSULE IMMEDIATE-RELEASE,4.46,2.9,0.24,4.46,62
HCPCS,J7507,TACROLIMUS 1 MG CAPSULE IMMEDIATE-RELEASE,8.92,5.8,0.24,8.92,93
HCPCS,J7507,TACROLIMUS 5 MG CAPSULE IMMEDIATE-RELEASE,44.6,28.99,0.24,44.6,93
HCPCS,J7507,Tacrolimus imme rel oral 1mg,,,0.22,0.22,1
HCPCS,J75070,Tacrolimus imme rel oral 1mg,,,0.22,0.22,1
HCPCS,J7508,ASTAGRAF XL 1 MG CAPSULEEXTENDED RELEASE,13.86,9.01,0.5,13.86,31
HCPCS,J7508,Tacrol astagraf ex rel oral,,,0.64,0.64,1
HCPCS,J75080,Tacrol astagraf ex rel oral,,,0.64,0.64,1
HCPCS,J7509,MEDROL (PAK) 4 MG TABLETS IN A DOSE PACK,0.74,0.48,0.12,0.74,31
HCPCS,J7509,MEDROL 16 MG TABLET,6.9,4.49,0.22,6.9,31
HCPCS,J7509,MEDROL 2 MG TABLET,3.94,2.56,0.22,3.94,31
HCPCS,J7509,METHYLPREDNISOLONE 16 MG TABLET,6.22,4.04,0.22,6.22,31
HCPCS,J7509,METHYLPREDNISOLONE 4 MG TABLET,4.3,2.8,0.22,4.3,31
HCPCS,J7509,METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK,3.08,2.005,0.22,3.3,62
HCPCS,J7509,METHYLPREDNISOLONE 8 MG TABLET,4.02,2.61,0.22,4.02,30
HCPCS,J7509,Methylprednisolone oral,,,0.15,0.15,1
HCPCS,J75090,Methylprednisolone oral,,,0.15,0.15,1
HCPCS,J7510,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLUTION,4.13,2.68,0.26,4.13,31
HCPCS,J7510,Prednisolone oral per 5 mg,,,0.99,0.99,1
HCPCS,J75100,Prednisolone oral per 5 mg,,,0.99,0.99,1
HCPCS,J7511,Antithymocyte globuln rabbit,,,1090.53,1090.53,1
HCPCS,J7511,THYMOGLOBULIN 25 MG INTRAVENOUS SOLUTION,4130.85,2685.05,835.15,4130.85,50
HCPCS,J75110,Antithymocyte globuln rabbit,,,1090.53,1090.53,1
HCPCS,J7512,PREDNISONE 1 MG TABLET,0.53,0.345,0.01,0.56,124
HCPCS,J7512,PREDNISONE 10 MG TABLET,0.51,0.32999999999999996,0.01,0.54,62
HCPCS,J7512,PREDNISONE 2.5 MG TABLET,0.35,0.225,0.01,0.36,93
HCPCS,J7512,PREDNISONE 20 MG TABLET,0.52,0.34,0.01,0.58,93
HCPCS,J7512,PREDNISONE 5 MG TABLET,0.46,0.3,0.01,0.54,155
HCPCS,J7512,PREDNISONE 5 MG/5 ML ORAL SOLUTION,1.925,1.25,0.01,2.0,62
HCPCS,J7512,PREDNISONE 50 MG TABLET,0.84,0.55,0.01,1.08,93
HCPCS,J7512,PREDNISONE INTENSOL 5 MG/ML ORAL CONCENTRATE,13.0,8.45,0.01,13.0,31
HCPCS,J7512,Prednisone ir or dr oral 1mg,,,0.01,0.01,1
HCPCS,J75120,Prednisone ir or dr oral 1mg,,,0.01,0.01,1
HCPCS,J7513,"Daclizumab, parenteral",,,746.88,943.43,6
HCPCS,J7514,Mycophenol (myhibbin) 100 mg,,,2.42,6.22,11
HCPCS,J75140,Mycophenol (myhibbin) 100 mg,,,2.42,2.42,1
HCPCS,J7515,CYCLOSPORINE 25 MG ORAL CAP (SANDIMMUNE),10.17,6.615,0.83,11.5,93
HCPCS,J7515,CYCLOSPORINE MODIFIED 25 MG ORAL CAP (NEORALGENGRAF),2.76,1.79,0.46,2.76,93
HCPCS,J7515,Cyclosporine oral 25 mg,,,0.57,0.57,1
HCPCS,J7515,NEORAL 25 MG CAPSULE,7.06,4.59,0.83,7.06,31
HCPCS,J7515,SANDIMMUNE 25 MG CAPSULE,10.98,7.14,0.83,10.98,31
HCPCS,J75150,Cyclosporine oral 25 mg,,,0.57,0.57,1
HCPCS,J7516,CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,28.17,18.31,4.73,203.91,30
HCPCS,J7516,"Inj, cyclosporine 250mg",,,79.57,79.57,1
HCPCS,J7516,SANDIMMUNE 250 MG/5 ML INTRAVENOUS SOLUTION,51.24,33.31,8.61,203.91,30
HCPCS,J75160,"Inj, cyclosporine 250mg",,,79.57,79.57,1
HCPCS,J7517,CELLCEPT 250 MG CAPSULE,21.6,14.04,0.18,21.6,31
HCPCS,J7517,CELLCEPT 500 MG TABLET,43.18,28.07,0.18,43.18,31
HCPCS,J7517,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,7.94,5.16,0.18,7.94,62
HCPCS,J7517,MYCOPHENOLATE MOFETIL 500 MG TABLET,9.5,6.175,0.18,15.88,62
HCPCS,J7517,Mycophenolate mofetil oral,,,0.16,0.16,1
HCPCS,J75170,Mycophenolate mofetil oral,,,0.16,0.16,1
HCPCS,J7518,MYCOPHENOLATE SODIUM 180 MG TABLETDELAYED RELEASE,9.14,5.94,0.45,9.14,31
HCPCS,J7518,MYCOPHENOLATE SODIUM 360 MG TABLETDELAYED RELEASE,18.28,11.88,0.45,18.28,31
HCPCS,J7518,MYFORTIC 360 MG TABLETDELAYED RELEASE,35.8,23.27,0.45,35.8,31
HCPCS,J7518,Mycophenolic acid,,,0.35,0.35,1
HCPCS,J75180,Mycophenolic acid,,,0.35,0.35,1
HCPCS,J7519,CELLCEPT INTRAVENOUS 500 MG INTRAVENOUS SOLUTION,388.71,252.66,0.64,388.71,37
HCPCS,J7519,Inj. mycophenolate mofetil,,,0.4,0.4,1
HCPCS,J7519,MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,261.0,169.65,0.64,345.3,37
HCPCS,J75190,Inj. mycophenolate mofetil,,,0.4,0.4,1
HCPCS,J7520,SIROLIMUS 0.5 MG TABLET,16.94,11.01,1.84,16.94,31
HCPCS,J7520,SIROLIMUS 1 MG TABLET,34.0,22.105,1.84,34.1,93
HCPCS,J7520,SIROLIMUS 1 MG/ML ORAL SOLUTION,83.225,54.1,1.84,87.5,62
HCPCS,J7520,SIROLIMUS 2 MG TABLET,67.8,44.07,1.84,67.8,31
HCPCS,J7520,"Sirolimus, oral",,,1.05,1.05,1
HCPCS,J75200,"Sirolimus, oral",,,1.05,1.05,1
HCPCS,J7521,Tacrolim granules oral susp,,,1.43,3.64,11
HCPCS,J75210,Tacrolim granules oral susp,,,1.43,1.43,1
HCPCS,J7525,PROGRAF 5 MG/ML INTRAVENOUS SOLUTION,918.09,596.76,74.0,918.09,47
HCPCS,J7525,Tacrolimus injection,,,283.45,283.45,1
HCPCS,J75250,Tacrolimus injection,,,283.45,283.45,1
HCPCS,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,20.08,13.05,2.24,20.08,31
HCPCS,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,41.21,26.785,2.24,42.28,62
HCPCS,J7527,Oral everolimus,,,1.27,1.27,1
HCPCS,J7527,ZORTRESS 0.5 MG TABLET,52.64,34.22,2.24,52.64,31
HCPCS,J7527,ZORTRESS 0.75 MG TABLET,78.96,51.32,2.24,78.96,31
HCPCS,J75270,Oral everolimus,,,1.27,1.27,1
HCPCS,J7528,CELLCEPT 200 MG/ML ORAL SUSPENSION,25.9,16.84,0.46,25.9,30
HCPCS,J7528,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,22.65,14.72,0.46,22.65,60
HCPCS,J7528,Mycophen mofetil for susp,,,0.26,0.26,1
HCPCS,J75280,Mycophen mofetil for susp,,,0.26,0.26,1
HCPCS,J7601,Ensifentrine inh 3 mg,,,56.29,144.23,14
HCPCS,J76010,Ensifentrine inh 3 mg,,,56.29,56.29,1
HCPCS,J7605,Arformoterol non-comp unit,,,0.78,1.97,12
HCPCS,J76050,Arformoterol non-comp unit,,,0.78,0.78,1
HCPCS,J7606,"Formoterol fumarate, inh",,,2.38,6.08,12
HCPCS,J76060,"Formoterol fumarate, inh",,,2.38,2.38,1
HCPCS,J7608,Acetylcysteine non-comp unit,,,8.42,23.4,15
HCPCS,J76080,Acetylcysteine non-comp unit,,,9.14,9.14,1
HCPCS,J7609,Albuterol comp unit,,,0.52,1.32,4
HCPCS,J76090,Albuterol comp unit,,,0.52,0.52,1
HCPCS,J7610,Albuterol comp con,,,1.25,3.18,4
HCPCS,J76100,Albuterol comp con,,,1.25,1.25,1
HCPCS,J7611,ALBUTEROL CONCENTRATED FORM,2.0,1.3,0.26,2.0,14
HCPCS,J7611,Albuterol non-comp con,,,0.15,0.71,12
HCPCS,J76110,Albuterol non-comp con,,,0.28,0.28,1
HCPCS,J7612,LEVALBUTEROL CONCENTRATED,13.0,8.45,0.38,13.0,14
HCPCS,J7612,Levalbuterol non-comp con,,,0.21,1.07,12
HCPCS,J76120,Levalbuterol non-comp con,,,0.41,0.41,1
HCPCS,J7613,ALBUTEROL UNIT DOSE,3.0,1.95,0.07,3.0,14
HCPCS,J7613,Albuterol non-comp unit,,,0.04,0.19,12
HCPCS,J76130,Albuterol non-comp unit,,,0.08,0.08,1
HCPCS,J7614,LEVALBUTEROL UNIT DOSE,7.0,4.55,0.08,7.0,14
HCPCS,J7614,Levalbuterol non-comp unit,,,0.04,0.22,12
HCPCS,J76140,Levalbuterol non-comp unit,,,0.09,0.09,1
HCPCS,J7615,Levalbuterol comp unit,,,1.46,3.7,4
HCPCS,J76150,Levalbuterol comp unit,,,1.46,1.46,1
HCPCS,J7620,ALBUTEROL SULFATE .O83% INH,3.0,1.95,0.2,3.0,14
HCPCS,J7620,Albuterol ipratrop non-comp,,,0.18,0.55,12
HCPCS,J76200,Albuterol ipratrop non-comp,,,0.22,0.22,1
HCPCS,J7622,Beclomethasone comp unit,,,0.02,0.05,4
HCPCS,J76220,Beclomethasone comp unit,,,0.02,0.02,1
HCPCS,J7624,Betamethasone comp unit,,,1.05,2.66,4
HCPCS,J76240,Betamethasone comp unit,,,1.05,1.05,1
HCPCS,J7626,Budesonide non-comp unit,,,1.08,2.9,12
HCPCS,J76260,Budesonide non-comp unit,,,1.13,1.13,1
HCPCS,J7627,Budesonide comp unit,,,0.31,0.79,4
HCPCS,J76270,Budesonide comp unit,,,0.31,0.31,1
HCPCS,J7629,Bitolterol mesylate comp unt,,,0.24,0.6,4
HCPCS,J76290,Bitolterol mesylate comp unt,,,0.24,0.24,1
HCPCS,J7631,Cromolyn sodium noncomp unit,,,0.84,2.52,12
HCPCS,J76310,Cromolyn sodium noncomp unit,,,0.98,0.98,1
HCPCS,J7632,Cromolyn sodium comp unit,,,0.33,0.33,1
HCPCS,J76320,Cromolyn sodium comp unit,,,0.33,0.33,1
HCPCS,J7633,Budesonide non-comp con,,,6.75,17.13,4
HCPCS,J76330,Budesonide non-comp con,,,6.75,6.75,1
HCPCS,J7635,Atropine comp con,,,0.11,0.27,4
HCPCS,J76350,Atropine comp con,,,0.11,0.11,1
HCPCS,J7636,Atropine comp unit,,,0.58,1.48,4
HCPCS,J76360,Atropine comp unit,,,0.58,0.58,1
HCPCS,J7637,Dexamethasone comp con,,,0.05,0.14,4
HCPCS,J76370,Dexamethasone comp con,,,0.05,0.05,1
HCPCS,J7638,Dexamethasone comp unit,,,0.11,0.27,4
HCPCS,J76380,Dexamethasone comp unit,,,0.11,0.11,1
HCPCS,J7639,Dornase alfa non-comp unit,,,46.83,152.65,18
HCPCS,J76390,Dornase alfa non-comp unit,,,59.57,59.57,1
HCPCS,J7640,Formoterol comp unit,,,2.55,6.47,7
HCPCS,J76400,Formoterol comp unit,,,2.55,2.55,1
HCPCS,J7641,Flunisolide comp unit,,,0.18,0.47,4
HCPCS,J76410,Flunisolide comp unit,,,0.18,0.18,1
HCPCS,J7642,Glycopyrrolate comp con,,,1.03,2.6,4
HCPCS,J76420,Glycopyrrolate comp con,,,1.03,1.03,1
HCPCS,J7644,Ipratropium bromide non-comp,,,0.3,1.1,12
HCPCS,J76440,Ipratropium bromide non-comp,,,0.43,0.43,1
HCPCS,J7645,Ipratropium bromide comp,,,0.05,0.14,4
HCPCS,J76450,Ipratropium bromide comp,,,0.05,0.05,1
HCPCS,J7648,Isoetharine non-comp con,,,0.15,0.38,4
HCPCS,J76480,Isoetharine non-comp con,,,0.15,0.15,1
HCPCS,J7649,Isoetharine non-comp unit,,,0.17,0.44,4
HCPCS,J76490,Isoetharine non-comp unit,,,0.17,0.17,1
HCPCS,J7658,Isoproterenol non-comp con,,,1.79,4.55,4
HCPCS,J76580,Isoproterenol non-comp con,,,1.79,1.79,1
HCPCS,J7659,Isoproterenol non-comp unit,,,1.79,4.55,4
HCPCS,J76590,Isoproterenol non-comp unit,,,1.79,1.79,1
HCPCS,J7665,Mannitol for inhaler,,,6.81,17.29,4
HCPCS,J76650,Mannitol for inhaler,,,6.81,6.81,1
HCPCS,J7668,Metaproterenol non-comp con,,,0.27,0.69,4
HCPCS,J76680,Metaproterenol non-comp con,,,0.27,0.27,1
HCPCS,J7669,Metaproterenol non-comp unit,,,0.38,0.96,4
HCPCS,J76690,Metaproterenol non-comp unit,,,0.38,0.38,1
HCPCS,J7674,METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION,218.4,141.96,1.01,218.4,31
HCPCS,J7674,"METHACHOLINE CHLORIDE, NEB",5.88,3.82,1.9,5.88,14
HCPCS,J7674,METHACHOLINE PER 1 MG,7.0,4.55,1.01,7.0,31
HCPCS,J7674,"Methacholine chloride, neb",,,2.05,2.05,1
HCPCS,J7674,PROVOCHOLINE 0 TO 48 MG/3 ML SOLUTION FOR NEBULIZATION,18.0,11.7,1.01,18.0,31
HCPCS,J7674,PROVOCHOLINE 100 MG SOLUTION FOR INHALATION,218.4,141.96,1.01,218.4,31
HCPCS,J76740,"Methacholine chloride, neb",,,2.05,2.05,1
HCPCS,J7677,Revefenacin inh non-com 1mcg,,,0.17,0.55,12
HCPCS,J76770,Revefenacin inh non-com 1mcg,,,0.22,0.22,1
HCPCS,J7680,Terbutaline sulf comp con,,,0.02,0.05,4
HCPCS,J76800,Terbutaline sulf comp con,,,0.02,0.02,1
HCPCS,J7681,Terbutaline sulf comp unit,,,0.02,0.05,4
HCPCS,J76810,Terbutaline sulf comp unit,,,0.02,0.02,1
HCPCS,J7682,Tobramycin non-comp unit,,,13.47,34.5,12
HCPCS,J76820,Tobramycin non-comp unit,,,13.47,13.47,1
HCPCS,J7683,Triamcinolone comp con,,,0.49,1.23,4
HCPCS,J76830,Triamcinolone comp con,,,0.49,0.49,1
HCPCS,J7684,Triamcinolone comp unit,,,0.49,1.23,4
HCPCS,J76840,Triamcinolone comp unit,,,0.49,0.49,1
HCPCS,J7685,Tobramycin comp unit,,,59.62,123.65,7
HCPCS,J76850,Tobramycin comp unit,,,59.62,59.62,1
HCPCS,J7686,"Treprostinil, non-comp unit",,,74.0,2191.73,18
HCPCS,J76860,"Treprostinil, non-comp unit",,,855.34,855.34,1
HCPCS,J7999,KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE,6.645,4.32,0.95,7.65,46
HCPCS,J7999,KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLORISO-OSMOTIC IV SYRINGE,4.77,3.1,0.8,4.77,23
HCPCS,J8490,REGLAN 10 MG TAB,3.0,1.95,1.5,3.0,12
HCPCS,J8499,ATIVAN 0.5 MG TAB,2.0,1.3,1.0,2.0,12
HCPCS,J8499,COMPAZINE 10 MG TABS,2.0,1.3,1.0,2.0,12
HCPCS,J8499,KAYEXALATE 15 GM (SPSS),11.0,7.15,5.5,11.0,12
HCPCS,J8499,PERCOCET 5 MG,2.0,1.3,1.0,2.0,12
HCPCS,J8499,ZANTAC 150 MG TAB,4.0,2.6,2.0,4.0,12
HCPCS,J8501,APREPITANT 125 MG CAPSULE,636.78,413.91,3.15,636.78,31
HCPCS,J8501,ORAL APREPITANT,51.0,33.15,2.77,51.0,14
HCPCS,J8501,Oral aprepitant,,,2.99,2.99,1
HCPCS,J85010,Oral aprepitant,,,2.99,2.99,1
HCPCS,J8510,MYLERAN 2 MG TABLET,720.86,468.56,10.12,720.86,33
HCPCS,J8510,Oral busulfan,,,142.42,142.42,1
HCPCS,J85100,Oral busulfan,,,142.42,142.42,1
HCPCS,J8515,CABERGOLINE 0.5 MG TABLET,73.32,47.66,3.53,73.32,66
HCPCS,J8515,"Cabergoline, oral 0.25mg",,,1.62,1.62,1
HCPCS,J85150,"Cabergoline, oral 0.25mg",,,1.62,1.62,1
HCPCS,J8520,"Capecitabine, oral, 150 mg",,,0.29,0.29,1
HCPCS,J8521,"CAPECITABINE, ORAL, 500 MG",62.0,40.3,31.0,62.0,12
HCPCS,J8521,"Capecitabine, oral, 500 mg",,,0.71,0.71,1
HCPCS,J8522,CAPECITABINE 150 MG TABLET,23.48,15.26,0.03,23.48,40
HCPCS,J8522,CAPECITABINE 500 MG TABLET,54.12,35.18,0.03,78.24,80
HCPCS,J8522,"Capecitabine, oral, 50 mg",,,0.04,0.04,1
HCPCS,J85220,"Capecitabine, oral, 50 mg",,,0.04,0.04,1
HCPCS,J8530,CYCLOPHOSPHAMIDE 25 MG CAPSULE,18.34,11.92,0.77,18.72,60
HCPCS,J8530,CYCLOPHOSPHAMIDE 50 MG CAPSULE,32.98,21.44,0.77,32.98,30
HCPCS,J8530,Cyclophosphamide oral 25 mg,,,1.97,1.97,1
HCPCS,J85300,Cyclophosphamide oral 25 mg,,,1.97,1.97,1
HCPCS,J8540,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,0.405,0.26,0.01,0.68,60
HCPCS,J8540,DEXAMETHASONE 0.75 MG TABLET,0.5,0.33,0.01,0.5,30
HCPCS,J8540,DEXAMETHASONE 1 MG TABLET,0.6699999999999999,0.435,0.01,0.74,60
HCPCS,J8540,DEXAMETHASONE 1.5 MG TABLET,0.96,0.62,0.01,0.96,30
HCPCS,J8540,DEXAMETHASONE 2 MG TABLET,1.48,0.96,0.01,1.72,120
HCPCS,J8540,DEXAMETHASONE 6 MG TABLET,3.8,2.47,0.01,3.8,30
HCPCS,J8540,ORAL DEXAMETHASONE,37.0,24.05,0.01,37.0,14
HCPCS,J8540,Oral dexamethasone,,,0.01,0.01,1
HCPCS,J85400,Oral dexamethasone,,,0.01,0.01,1
HCPCS,J8541,"Oral, hemady, 0.25 mg",,,0.38,0.96,4
HCPCS,J85410,"Oral, hemady, 0.25 mg",,,0.38,0.38,1
HCPCS,J8560,ETOPOSIDE 50 MG CAPSULE,207.72,135.02,22.35,240.19,39
HCPCS,J8560,Etoposide oral 50 mg,,,93.73,93.73,1
HCPCS,J85600,Etoposide oral 50 mg,,,93.73,93.73,1
HCPCS,J8562,Oral fludarabine phosphate,,,74.0,93.47,6
HCPCS,J8565,Gefitinib oral,,,145.37,145.37,1
HCPCS,J8565,IRESSA 250 MG TABLET,623.12,405.03,104.68,623.12,27
HCPCS,J85650,Gefitinib oral,,,145.37,145.37,1
HCPCS,J8600,ALKERAN 2 MG TABLET,27.16,17.65,4.56,27.16,22
HCPCS,J8600,Melphalan oral 2 mg,,,9.49,9.49,1
HCPCS,J86000,Melphalan oral 2 mg,,,9.49,9.49,1
HCPCS,J8610,METHOTREXATE SODIUM 2.5 MG TABLET,7.16,4.65,0.16,12.48,150
HCPCS,J8610,Methotrexate oral 2.5 mg,,,0.16,0.16,1
HCPCS,J86100,Methotrexate oral 2.5 mg,,,0.16,0.16,1
HCPCS,J8611,Oral methotrexate (jylamvo),,,18.64,51.59,28
HCPCS,J86110,Oral methotrexate (jylamvo),,,20.13,20.13,1
HCPCS,J8612,Oral methotrexate (xatmep),,,20.71,62.09,28
HCPCS,J86120,Oral methotrexate (xatmep),,,24.22,24.22,1
HCPCS,J8650,Nabilone oral,,,40.64,103.11,6
HCPCS,J8655,"Oral netupitant, palonosetro",,,74.0,1052.13,35
HCPCS,J86550,"Oral netupitant, palonosetro",,,410.61,410.61,1
HCPCS,J8670,"Rolapitant, oral, 1mg",,,1.47,5.53,29
HCPCS,J86700,"Rolapitant, oral, 1mg",,,2.16,2.16,1
HCPCS,J8700,TEMOZOLOMIDE 100 MG CAPSULE,152.84,99.35,0.17,152.84,30
HCPCS,J8700,TEMOZOLOMIDE 180 MG CAPSULE,1035.94,673.36,0.17,1035.94,30
HCPCS,J8700,TEMOZOLOMIDE 20 MG CAPSULE,115.11,74.82499999999999,0.17,115.12,58
HCPCS,J8700,TEMOZOLOMIDE 5 MG CAPSULE,28.75,18.689999999999998,0.17,28.92,58
HCPCS,J8700,Temozolomide,,,0.58,0.58,1
HCPCS,J87000,Temozolomide,,,0.58,0.58,1
HCPCS,J8705,Topotecan oral,,,97.89,346.17,22
HCPCS,J87050,Topotecan oral,,,135.1,135.1,1
HCPCS,J8999,CEENU(LOMUSTINER) 100MG CAPS,58.0,37.7,29.0,58.0,12
HCPCS,J8999,LEUCOVORIN CALCIUM ORAL 25 MG,36.0,23.4,18.0,36.0,12
HCPCS,J9000,DOXORUBIC HCL 10 MG VL CHEMO,172.0,111.8,2.78,172.0,14
HCPCS,J9000,DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLUTION,9.76,6.34,1.64,9.76,30
HCPCS,J9000,DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,6.4,4.16,1.08,7.7,30
HCPCS,J9000,DOXORUBICIN 20 MG/10 ML INTRAVENOUS SOLUTION,9.76,6.34,1.64,9.76,30
HCPCS,J9000,DOXORUBICIN 50 MG INTRAVENOUS SOLUTION,1262.56,820.66,3.03,1262.56,30
HCPCS,J9000,DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,6.4,4.16,1.08,7.7,30
HCPCS,J9000,Doxorubicin hcl injection,,,3.0,3.0,1
HCPCS,J90000,Doxorubicin hcl injection,,,3.0,3.0,1
HCPCS,J9003,Leup inj (camcevi etm) 1 mg,,,711.31,898.5,6
HCPCS,J9011,DATROWAY 100 MG INTRAVENOUS SOLUTION,23477.12,15260.13,51.55,23477.12,45
HCPCS,J9011,"Datopotamab deruxtecan, 1 mg",,,55.67,55.67,1
HCPCS,J90110,"Datopotamab deruxtecan, 1 mg",,,55.67,55.67,1
HCPCS,J9015,"ALDESLEUKIN, PER SINGLE USE VIAL",2613.0,1698.45,1306.5,6605.4,14
HCPCS,J9015,Aldesleukin injection,,,711.31,15940.22,27
HCPCS,J90150,Aldesleukin injection,,,6283.01,6283.01,1
HCPCS,J9017,ARSENIC TRIOXIDE,65.0,42.25,7.39,65.0,14
HCPCS,J9017,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,180.96,117.62,6.35,180.96,43
HCPCS,J9017,Arsenic trioxide injection,,,7.98,7.98,1
HCPCS,J90170,Arsenic trioxide injection,,,7.98,7.98,1
HCPCS,J9019,Erwinaze injection,,,417.92,12697.64,12
HCPCS,J9020,"Asparaginase, nos",,,74.65,94.3,6
HCPCS,J9021,"Inj, aspara, rylaze, 0.1 mg",,,60.67,60.67,1
HCPCS,J9021,RYLAZE 10 MG/0.5 ML INTRAMUSCULAR SOLUTION,50976.0,33134.4,46.08,50976.0,52
HCPCS,J90210,"Inj, aspara, rylaze, 0.1 mg",,,60.67,60.67,1
HCPCS,J9022,"Inj, atezolizumab,10 mg",,,101.42,101.42,1
HCPCS,J9022,TECENTRIQ 1200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION,2781.44,1807.94,75.54,5646.0,49
HCPCS,J9022,TECENTRIQ 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION,2781.44,1807.94,75.54,5646.0,49
HCPCS,J90220,"Inj, atezolizumab,10 mg",,,101.42,101.42,1
HCPCS,J9023,BAVENCIO 20 MG/ML INTRAVENOUS SOLUTION,1005.12,653.33,83.28,3407.66,46
HCPCS,J9023,"Injection, avelumab, 10 mg",,,113.39,113.39,1
HCPCS,J90230,"Injection, avelumab, 10 mg",,,113.39,113.39,1
HCPCS,J9024,Inj atezolizumb 5mg hya-tqjs,,,32.1,5646.0,21
HCPCS,J90240,Inj atezolizumb 5mg hya-tqjs,,,34.67,34.67,1
HCPCS,J9025,AZACITIDINE 100 MG SOLUTION FOR INJECTION,432.04,280.83,0.37,432.04,36
HCPCS,J9025,AZACITIDINE INJECTION,28.0,18.2,0.46,28.0,14
HCPCS,J9025,Azacitidine injection,,,0.5,0.5,1
HCPCS,J90250,Azacitidine injection,,,0.5,0.5,1
HCPCS,J9026,IMDELLTRA 1 MG INTRAVENOUS SOLUTION,7200.0,4680.0,1545.0,7200.0,52
HCPCS,J9026,IMDELLTRA 10 MG INTRAVENOUS SOLUTION,72000.0,46800.0,1545.0,72000.0,52
HCPCS,J9026,"Inj, tarlatamab-dlle, 1 mg",,,1691.92,1691.92,1
HCPCS,J90260,"Inj, tarlatamab-dlle, 1 mg",,,1691.92,1691.92,1
HCPCS,J9027,CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,704.32,457.81,11.48,704.32,46
HCPCS,J9027,Clofarabine injection,,,15.52,15.52,1
HCPCS,J90270,Clofarabine injection,,,15.52,15.52,1
HCPCS,J9028,ANKTIVA 400 MCG/0.4 ML INTRAVESICAL SOLUTION,322200.0,209430.0,92.19,322200.0,52
HCPCS,J9028,"Inj, nogapendekin pmln, 1mcg",,,102.31,102.31,1
HCPCS,J90280,"Inj, nogapendekin pmln, 1mcg",,,102.31,102.31,1
HCPCS,J9029,ADSTILADRIN 3X10EXP11 VP/ML INTRAVESICAL SUSPENSION,73080.0,47502.0,14450.94,177874.06,52
HCPCS,J9029,"Instill adstiladrin, tx dose",,,69416.77,69416.77,1
HCPCS,J90290,"Instill adstiladrin, tx dose",,,69416.77,69416.77,1
HCPCS,J9030,Bcg live intravesical 1mg,,,3.54,3.54,1
HCPCS,J9030,TICE BCG 50 MG INTRAVESICAL SUSPENSION,873.44,567.74,2.6,873.44,39
HCPCS,J90300,Bcg live intravesical 1mg,,,3.54,3.54,1
HCPCS,J9031,BCG VACCINE LIVE (PF) 50 MG PERCUTANEOUS INJECTION SUSPENSION,655.08,425.8,110.05,655.08,23
HCPCS,J9032,BELEODAQ 500 MG INTRAVENOUS SOLUTION,12327.52,8012.89,43.95,12327.52,52
HCPCS,J9032,"Injection, belinostat, 10mg",,,57.36,57.36,1
HCPCS,J90320,"Injection, belinostat, 10mg",,,57.36,57.36,1
HCPCS,J9033,"INJ, BENDAMUSTINE HCL, 1MG",121.0,78.65,2.05,121.0,14
HCPCS,J9033,"Inj, bendamustine hcl, 1mg",,,2.21,2.21,1
HCPCS,J9033,TREANDA 100 MG INTRAVENOUS POWDER FOR SOLUTION,14264.64,9272.02,2.04,14264.64,53
HCPCS,J9033,TREANDA 25 MG INTRAVENOUS POWDER FOR SOLUTION,3566.16,2318.0,2.04,3566.16,50
HCPCS,J90330,"Inj, bendamustine hcl, 1mg",,,2.21,2.21,1
HCPCS,J9034,BENDEKA 25 MG/ML INTRAVENOUS SOLUTION,2968.56,1929.56,12.45,2968.56,49
HCPCS,J9034,"Inj., bendeka 1 mg",,,13.86,13.86,1
HCPCS,J90340,"Inj., bendeka 1 mg",,,13.86,13.86,1
HCPCS,J9035,AVASTIN 25 MG/ML INTRAVENOUS SOLUTION,956.32,621.61,66.74,1355.53,92
HCPCS,J9035,BEVACIZUMAB INJECTION,252.0,163.8,73.63,252.0,14
HCPCS,J9035,Bevacizumab injection,,,79.52,79.52,1
HCPCS,J90350,Bevacizumab injection,,,79.52,79.52,1
HCPCS,J9036,BELRAPZO 25 MG/ML INTRAVENOUS SOLUTION,3120.0,2028.0,7.99,3120.0,49
HCPCS,J9036,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,2808.0,1825.2,7.99,2808.0,49
HCPCS,J9036,Inj. belrapzo/bendamustine,,,14.74,14.74,1
HCPCS,J90360,Inj. belrapzo/bendamustine,,,14.74,14.74,1
HCPCS,J9037,Inj belantamab mafodot blmf,,,45.76,5646.0,20
HCPCS,J90370,Inj belantamab mafodot blmf,,,45.76,45.76,1
HCPCS,J9038,Inj axatilimab-csfr 0.1 mg,,,60.1,60.1,1
HCPCS,J9038,NIKTIMVO 50 MG/ML INTRAVENOUS SOLUTION,94500.0,61425.0,55.65,94500.0,90
HCPCS,J90380,Inj axatilimab-csfr 0.1 mg,,,60.1,60.1,1
HCPCS,J9039,BLINCYTO 35 MCG INTRAVENOUS KIT,26672.48,17337.11,130.82,26672.48,52
HCPCS,J9039,BLINCYTO 35 MCG INTRAVENOUS SOLUTION,26672.48,17337.11,130.82,26672.48,52
HCPCS,J9039,"Injection, blinatumomab",,,176.77,176.77,1
HCPCS,J90390,"Injection, blinatumomab",,,176.77,176.77,1
HCPCS,J9040,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,181.65,118.07,20.81,274.56,90
HCPCS,J9040,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,449.36,292.08,20.81,509.28,90
HCPCS,J9040,BLEOMYCIN SULFATE INJECTION,1129.0,733.85,23.02,1129.0,14
HCPCS,J9040,Bleomycin sulfate injection,,,24.86,24.86,1
HCPCS,J90400,Bleomycin sulfate injection,,,24.86,24.86,1
HCPCS,J9041,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,201.6,131.04,1.86,336.0,108
HCPCS,J9041,BORTEZOMIB INJECTION,59.0,38.35,2.68,59.0,14
HCPCS,J9041,"Injection, bortezomib, 0.1mg",,,2.89,2.89,1
HCPCS,J9041,VELCADE 3.5 MG SOLUTION FOR INJECTION,7694.4,5001.36,1.86,7694.4,42
HCPCS,J90410,"Injection, bortezomib, 0.1mg",,,2.89,2.89,1
HCPCS,J9042,ADCETRIS 50 MG INTRAVENOUS SOLUTION,63216.76,41090.89,207.67,63216.76,52
HCPCS,J9042,Brentuximab vedotin inj,,,289.93,289.93,1
HCPCS,J90420,Brentuximab vedotin inj,,,289.93,289.93,1
HCPCS,J9043,CABAZITAXEL INJECTION,845.0,549.25,230.8,845.0,14
HCPCS,J9043,Cabazitaxel injection,,,249.26,249.26,1
HCPCS,J9043,JEVTANA 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION,47103.52,30617.29,190.58,47103.52,53
HCPCS,J90430,Cabazitaxel injection,,,249.26,249.26,1
HCPCS,J9044,"Inj, bortezomib, nos, 0.1 mg",,,74.65,94.3,6
HCPCS,J9045,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,7.5,4.875,0.59,12.88,300
HCPCS,J9045,CARBOPLATIN INJECTION,536.0,348.4,2.93,536.0,14
HCPCS,J9045,Carboplatin injection,,,3.16,3.16,1
HCPCS,J90450,Carboplatin injection,,,3.16,3.16,1
HCPCS,J9046,"Inj, bortezomib, dr. reddy's",,,3.46,120.48,27
HCPCS,J90460,"Inj, bortezomib, dr. reddy's",,,47.49,47.49,1
HCPCS,J9047,"Injection, carfilzomib, 1 mg",,,60.06,60.06,1
HCPCS,J9047,KYPROLIS 10 MG INTRAVENOUS SOLUTION,2829.76,1839.34,42.46,2829.76,49
HCPCS,J9047,KYPROLIS 30 MG INTRAVENOUS SOLUTION,8489.28,5518.03,42.46,8489.28,52
HCPCS,J9047,KYPROLIS 60 MG INTRAVENOUS SOLUTION,16978.52,11036.04,42.46,16978.52,52
HCPCS,J90470,"Injection, carfilzomib, 1 mg",,,60.06,60.06,1
HCPCS,J9048,"Inj, bortezomib freseniuskab",,,6.97,120.48,27
HCPCS,J90480,"Inj, bortezomib freseniuskab",,,47.49,47.49,1
HCPCS,J9049,"Inj, bortezomib, hospira",,,1.55,94.3,18
HCPCS,J90490,"Inj, bortezomib, hospira",,,1.57,1.57,1
HCPCS,J9050,BICNU 100 MG INTRAVENOUS SOLUTION,9845.259999999998,6399.415000000001,232.62,18867.76,98
HCPCS,J9050,CARMUS BISCHL NITRO INJ,399.0,259.35,199.5,399.0,14
HCPCS,J9050,CARMUSTINE 100 MG INTRAVENOUS SOLUTION,3600.0,2340.0,232.62,3600.0,49
HCPCS,J9050,Carmustine injection,,,251.23,251.23,1
HCPCS,J90500,Carmustine injection,,,251.23,251.23,1
HCPCS,J9051,"Inj, bortezomib (maia)",,,3.55,94.3,13
HCPCS,J90510,"Inj, bortezomib (maia)",,,3.55,3.55,1
HCPCS,J9052,"Inj, carmustine (accord)",,,0.05,1355.53,24
HCPCS,J90520,"Inj, carmustine (accord)",,,254.02,254.02,1
HCPCS,J9054,Inj bortezomib boruzu 0.1 mg,,,25.63,99.01,21
HCPCS,J90540,Inj bortezomib boruzu 0.1 mg,,,27.68,27.68,1
HCPCS,J9055,CETUXIMAB INJECTION,108.0,70.2,54.0,108.0,14
HCPCS,J9055,Cetuximab injection,,,86.77,86.77,1
HCPCS,J9055,ERBITUX 100 MG/50 ML INTRAVENOUS SOLUTION,80.32,52.21,40.16,1355.53,46
HCPCS,J9055,ERBITUX 200 MG/100 ML INTRAVENOUS SOLUTION,80.32,52.21,40.16,1355.53,46
HCPCS,J90550,Cetuximab injection,,,86.77,86.77,1
HCPCS,J9056,"Inj, vivimusta, 1 mg",,,27.84,1355.53,34
HCPCS,J90560,"Inj, vivimusta, 1 mg",,,34.55,34.55,1
HCPCS,J9057,"Inj., copanlisib, 1 mg",,,90.78,3236.72,23
HCPCS,J90570,"Inj., copanlisib, 1 mg",,,90.78,90.78,1
HCPCS,J9058,Inj apotex/bendamustine 1 mg,,,21.72,1355.53,7
HCPCS,J9059,"Inj bendamustine, baxter 1mg",,,21.72,1355.53,7
HCPCS,J9060,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,1.96,1.27,0.32,5.84,180
HCPCS,J9060,CISPLATIN 10 MG INJECTION,166.0,107.9,2.11,166.0,14
HCPCS,J9060,Cisplatin 10 mg injection,,,2.28,2.28,1
HCPCS,J90600,Cisplatin 10 mg injection,,,2.28,2.28,1
HCPCS,J9061,"Inj, amivantamab-vmjw",,,24.36,24.36,1
HCPCS,J9061,RYBREVANT 50 MG/ML INTRAVENOUS SOLUTION,2610.28,1696.68,17.99,3407.66,49
HCPCS,J90610,"Inj, amivantamab-vmjw",,,24.36,24.36,1
HCPCS,J9063,ELAHERE 5 MG/ML INTRAVENOUS SOLUTION,1627.76,1058.04,59.11,12697.64,46
HCPCS,J9063,"Inj, elahere, 1 mg",,,76.86,76.86,1
HCPCS,J90630,"Inj, elahere, 1 mg",,,76.86,76.86,1
HCPCS,J9064,"Inj, cabazitaxel (sandoz)",,,2697.73,3407.66,6
HCPCS,J9065,CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,188.4,122.46000000000001,7.41,208.8,92
HCPCS,J9065,INJ CLADRIBINE PER 1 MG,208.0,135.2,7.42,208.0,14
HCPCS,J9065,Inj cladribine per 1 mg,,,8.01,8.01,1
HCPCS,J90650,Inj cladribine per 1 mg,,,8.01,8.01,1
HCPCS,J9070,CYCLOPHOSPHAMIDE 100 MG INJ,55.0,35.75,27.5,55.0,12
HCPCS,J9070,"CYCLOPHOSPHAMIDE, PER 100 MG",44.0,28.6,22.0,44.0,12
HCPCS,J9070,"CYTOXAN, PER 100 MG",44.0,28.6,22.0,44.0,12
HCPCS,J9070,Cyclophosphamide 100 mg inj,,,74.65,94.3,6
HCPCS,J9071,Inj cyclophosphamd auromedic,,,0.6,94.3,35
HCPCS,J90710,Inj cyclophosphamd auromedic,,,0.66,0.66,1
HCPCS,J9072,Inj cyclophos frindovyx 5 mg,,,8.99,94.3,24
HCPCS,J90720,Inj cyclophos frindovyx 5 mg,,,9.71,9.71,1
HCPCS,J9073,CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,527.4,342.81,0.69,527.4,47
HCPCS,J9073,Inj cyclophos dr reddys 5 mg,,,0.76,0.76,1
HCPCS,J90730,Inj cyclophos dr reddys 5 mg,,,0.76,0.76,1
HCPCS,J9074,"Inj, cyclophosphamd, sandoz",,,3.84,94.3,34
HCPCS,J90740,"Inj, cyclophosphamd, sandoz",,,4.15,4.15,1
HCPCS,J9075,CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,3296.24,2142.56,0.58,3296.24,50
HCPCS,J9075,CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,6592.52,4285.14,0.58,6592.52,53
HCPCS,J9075,CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,1648.12,1071.28,0.58,1648.12,47
HCPCS,J9075,"Inj, cyclophosphamide, nos",,,0.64,0.64,1
HCPCS,J90750,"Inj, cyclophosphamide, nos",,,0.64,0.64,1
HCPCS,J9076,CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,2253.52,1464.79,4.92,2253.52,39
HCPCS,J9076,CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,7032.0,4570.8,4.92,7032.0,45
HCPCS,J9076,CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,1758.0,1142.7,4.92,1758.0,39
HCPCS,J9076,"Inj, cyclophos (baxter) 5mg",,,5.31,5.31,1
HCPCS,J90760,"Inj, cyclophos (baxter) 5mg",,,5.31,5.31,1
HCPCS,J9098,Cytarabine liposome inj,,,614.62,1559.31,12
HCPCS,J9100,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,5.4399999999999995,3.535,0.77,6.32,90
HCPCS,J9100,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,4.640000000000001,3.0149999999999997,0.74,4.88,60
HCPCS,J9100,CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,2.8,1.82,0.47,2.8,30
HCPCS,J9100,CYTARABINE 20 MG/ML INJECTION SOLUTION,3.2,2.08,0.54,3.2,30
HCPCS,J9100,CYTARABINE HCL 100 MG INJ,34.0,22.1,0.84,34.0,14
HCPCS,J9100,Cytarabine hcl 100 mg inj,,,0.91,0.91,1
HCPCS,J91000,Cytarabine hcl 100 mg inj,,,0.91,0.91,1
HCPCS,J9118,ASPARLAS 750 UNIT/ML INTRAVENOUS SOLUTION,21428.67,13928.64,65.59,21428.67,45
HCPCS,J9118,Inj. calaspargase pegol-mknl,,,88.65,88.65,1
HCPCS,J91180,Inj. calaspargase pegol-mknl,,,88.65,88.65,1
HCPCS,J9119,"Inj., cemiplimab-rwlc, 1 mg",,,30.99,30.99,1
HCPCS,J9119,LIBTAYO 50 MG/ML INTRAVENOUS SOLUTION,7772.32,5052.01,24.82,7772.32,52
HCPCS,J91190,"Inj., cemiplimab-rwlc, 1 mg",,,30.99,30.99,1
HCPCS,J9120,DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,2655.0,1725.75,282.13,2655.0,49
HCPCS,J9120,Dactinomycin injection,,,332.63,332.63,1
HCPCS,J91200,Dactinomycin injection,,,332.63,332.63,1
HCPCS,J9130,DACARBAZINE 10 MG INJ,47.0,30.55,4.12,47.0,14
HCPCS,J9130,DACARBAZINE 100 MG INTRAVENOUS SOLUTION,59.48,38.66,3.32,59.48,30
HCPCS,J9130,DACARBAZINE 200 MG INTRAVENOUS SOLUTION,57.6,37.44,3.32,57.6,30
HCPCS,J9130,Dacarbazine 100 mg inj,,,4.45,4.45,1
HCPCS,J91300,Dacarbazine 100 mg inj,,,4.45,4.45,1
HCPCS,J9144,DARZALEX FASPRO 1800 MG-30000 UNIT/15 ML SUBCUTANEOUS SOLUTION,2537.25,1649.21,43.92,3236.72,46
HCPCS,J9144,"Daratumumab, hyaluronidase",,,59.46,59.46,1
HCPCS,J91440,"Daratumumab, hyaluronidase",,,59.46,59.46,1
HCPCS,J9145,DARZALEX 20 MG/ML INTRAVENOUS SOLUTION,744.6,483.99,55.02,3236.72,92
HCPCS,J9145,"Injection, daratumumab 10 mg",,,76.45,76.45,1
HCPCS,J91450,"Injection, daratumumab 10 mg",,,76.45,76.45,1
HCPCS,J9150,DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,160.96,104.62,24.44,160.96,43
HCPCS,J9150,DAUNORUBICIN HCL INJECTION,315.0,204.75,26.33,315.0,14
HCPCS,J9150,Daunorubicin injection,,,28.44,28.44,1
HCPCS,J91500,Daunorubicin injection,,,28.44,28.44,1
HCPCS,J9151,Daunorubicin citrate inj,,,74.65,96.35,9
HCPCS,J9153,"Inj daunorubicin, cytarabine",,,281.33,281.33,1
HCPCS,J9153,VYXEOS 44 MG-100 MG INTRAVENOUS SOLUTION,52704.0,34257.6,209.52,52704.0,52
HCPCS,J91530,"Inj daunorubicin, cytarabine",,,281.33,281.33,1
HCPCS,J9155,DEGARELIX INJECTION,55.0,35.75,4.45,55.0,14
HCPCS,J9155,Degarelix injection,,,4.81,4.81,1
HCPCS,J9155,FIRMAGON KIT WITH DILUENT SYRINGE 120 MG SUBCUTANEOUS SOLUTION,3658.04,2377.73,3.92,3658.04,50
HCPCS,J9155,FIRMAGON KIT WITH DILUENT SYRINGE 80 MG SUBCUTANEOUS SOLUTION,1758.42,1142.97,3.92,1758.42,47
HCPCS,J91550,Degarelix injection,,,4.81,4.81,1
HCPCS,J9160,"DENILEUKIN DIFTITOX, 300 MCG",3885.0,2525.25,1942.5,3885.0,12
HCPCS,J9160,Denileukin diftitox inj,,,2697.73,3407.66,6
HCPCS,J9161,Inj denileuk difti-cxdl 1mcg,,,2697.73,3407.66,6
HCPCS,J9165,Diethylstilbestrol injection,,,13.11,33.26,3
HCPCS,J9171,DOCETAXEL (TAXOTERE) PER 1 MG,100.0,65.0,0.65,100.0,14
HCPCS,J9171,DOCETAXEL 160 MG/16 ML (10 MG/ML) INTRAVENOUS SOLUTION,151.04,98.18,0.78,151.04,37
HCPCS,J9171,DOCETAXEL 160 MG/8 ML (20 MG/ML) INTRAVENOUS SOLUTION,1460.6,949.39,0.78,1460.6,74
HCPCS,J9171,DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,991.9,644.735,0.78,1460.6,74
HCPCS,J9171,DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,991.3,644.345,0.78,1460.6,74
HCPCS,J9171,DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,151.24,98.31,0.78,151.24,37
HCPCS,J9171,DOCETAXEL INJECTION,669.0,434.85,0.65,1213.0,28
HCPCS,J9171,Docetaxel injection,,,0.7,0.7,1
HCPCS,J91710,Docetaxel injection,,,0.7,0.7,1
HCPCS,J9172,DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,167.48,108.86,22.35,167.48,45
HCPCS,J9172,"Docetaxel (docivyx), 1 mg",,,53.74,53.74,1
HCPCS,J91720,"Docetaxel (docivyx), 1 mg",,,53.74,53.74,1
HCPCS,J9173,IMFINZI 50 MG/ML INTRAVENOUS SOLUTION,2061.44,1339.94,72.46,2061.44,92
HCPCS,J9173,"Inj., durvalumab, 10 mg",,,93.17,93.17,1
HCPCS,J91730,"Inj., durvalumab, 10 mg",,,93.17,93.17,1
HCPCS,J9174,"Inj, docetaxel (beizray) 1mg",,,22.35,117.71,14
HCPCS,J91740,"Inj, docetaxel (beizray) 1mg",,,46.4,46.4,1
HCPCS,J9175,ELLIOTTS B (PF) 73 MG-19 MG-8 MG-3 MG/10 ML INTRATHECAL SOLUTION,37.8,24.57,6.35,37.8,22
HCPCS,J9175,Elliotts b solution per ml,,,10.57,10.57,1
HCPCS,J91750,Elliotts b solution per ml,,,10.57,10.57,1
HCPCS,J9176,EMPLICITI 300 MG INTRAVENOUS SOLUTION,10709.0,6960.85,6.66,10709.0,52
HCPCS,J9176,EMPLICITI 400 MG INTRAVENOUS SOLUTION,14278.52,9281.04,6.66,14278.52,52
HCPCS,J9176,"Injection, elotuzumab, 1mg",,,8.68,8.68,1
HCPCS,J91760,"Injection, elotuzumab, 1mg",,,8.68,8.68,1
HCPCS,J9177,Inj enfort vedo-ejfv 0.25mg,,,39.66,39.66,1
HCPCS,J9177,PADCEV 20 MG INTRAVENOUS SOLUTION,13483.2,8764.08,32.58,13483.2,52
HCPCS,J9177,PADCEV 30 MG INTRAVENOUS SOLUTION,20224.8,13146.12,32.58,20224.8,52
HCPCS,J91770,Inj enfort vedo-ejfv 0.25mg,,,39.66,39.66,1
HCPCS,J9178,ELLENCE 50 MG/25 ML INTRAVENOUS SOLUTION,9.24,6.01,1.2,9.24,30
HCPCS,J9178,"INJ, EPIRUBICIN HCL, 2 MG",84.0,54.6,1.97,84.0,14
HCPCS,J9178,"Inj, epirubicin hcl, 2 mg",,,2.13,2.13,1
HCPCS,J91780,"Inj, epirubicin hcl, 2 mg",,,2.13,2.13,1
HCPCS,J9179,ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,3084.0,2004.6,72.6,3084.0,50
HCPCS,J9179,ERIBULIN MESYLATE INJECTION,537.0,349.05,72.61,537.0,14
HCPCS,J9179,Eribulin mesylate injection,,,78.42,78.42,1
HCPCS,J9179,HALAVEN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,3384.0,2199.6,72.6,3384.0,50
HCPCS,J91790,Eribulin mesylate injection,,,78.42,78.42,1
HCPCS,J9181,ETOPOPHOS 100 MG INTRAVENOUS SOLUTION,817.68,531.49,0.94,817.68,30
HCPCS,J9181,ETOPOSIDE 10 MG INJ,47.0,30.55,1.04,47.0,14
HCPCS,J9181,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,9.08,5.9,0.94,11.96,150
HCPCS,J9181,Etoposide injection,,,1.12,1.12,1
HCPCS,J91810,Etoposide injection,,,1.12,1.12,1
HCPCS,J9183,"Gemcit intraves sys, 225 mg",,,14450.94,18253.82,6
HCPCS,J9184,Inj gemcitabin (avyxa) 200mg,,,78.38,1025.86,14
HCPCS,J91840,Inj gemcitabin (avyxa) 200mg,,,404.35,404.35,1
HCPCS,J9185,FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,587.26,381.72,87.7,652.52,74
HCPCS,J9185,FLUDARABINE PHOSPHATE INJ,1002.0,651.3,81.41,1002.0,14
HCPCS,J9185,Fludarabine phosphate inj,,,87.92,87.92,1
HCPCS,J91850,Fludarabine phosphate inj,,,87.92,87.92,1
HCPCS,J9190,5-FU 500 MG VIALS,13.0,8.45,1.94,13.0,14
HCPCS,J9190,"5-FU, 500 MG",15.0,9.75,2.12,15.0,30
HCPCS,J9190,FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,1.64,1.07,0.28,5.37,30
HCPCS,J9190,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,1.14,0.74,0.15,5.37,60
HCPCS,J9190,FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION,1.4,0.91,0.24,5.37,60
HCPCS,J9190,FLUOROURACIL 500 MG,7.0,4.55,1.94,7.0,14
HCPCS,J9190,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,1.64,1.07,0.22,6.36,150
HCPCS,J9190,FLUOROURACIL INJECTION,15.0,9.75,1.94,15.0,14
HCPCS,J9190,Fluorouracil injection,,,2.1,2.1,1
HCPCS,J91900,Fluorouracil injection,,,2.1,2.1,1
HCPCS,J9196,Inj gemcitabine hcl (accord),,,3.81,94.3,18
HCPCS,J91960,Inj gemcitabine hcl (accord),,,5.71,5.71,1
HCPCS,J9198,"Inj. infugem, 100 mg",,,39.4,99.96,20
HCPCS,J91980,"Inj. infugem, 100 mg",,,39.4,39.4,1
HCPCS,J9200,FLOXURIDINE 0.5 GRAM SOLUTION FOR INJECTION,17474.92,11358.7,3355.7,17474.92,46
HCPCS,J9200,Floxuridine injection,,,4595.31,4595.31,1
HCPCS,J92000,Floxuridine injection,,,4595.31,4595.31,1
HCPCS,J9201,GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION,238.32,154.91,3.29,243.76,90
HCPCS,J9201,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,5.66,3.6799999999999997,0.4,9.95,120
HCPCS,J9201,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,3.34,2.17,0.44,9.95,60
HCPCS,J9201,GEMCITABINE 200 MG INTRAVENOUS SOLUTION,55.480000000000004,36.06,3.29,57.6,60
HCPCS,J9201,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,7.32,4.76,0.71,9.95,90
HCPCS,J9201,"GEMCITABINE HCL, 200 MG",415.0,269.75,3.59,415.0,14
HCPCS,J9201,In gemcitabine hcl nos 200mg,,,3.88,3.88,1
HCPCS,J92010,In gemcitabine hcl nos 200mg,,,3.88,3.88,1
HCPCS,J9202,GOSERELIN ACETATE IMPLANT,1734.0,1127.1,777.5,1734.0,14
HCPCS,J9202,Goserelin acetate implant,,,839.7,839.7,1
HCPCS,J9202,ZOLADEX 10.8 MG SUBCUTANEOUS IMPLANT,15421.96,10024.27,516.7,15421.96,52
HCPCS,J9202,ZOLADEX 3.6 MG SUBCUTANEOUS IMPLANT,5659.28,3678.53,516.7,5659.28,52
HCPCS,J92020,Goserelin acetate implant,,,839.7,839.7,1
HCPCS,J9203,Gemtuzumab ozogamicin 0.1 mg,,,259.38,259.38,1
HCPCS,J9203,MYLOTARG 4.5 MG (1 MG/ML INITIAL CONCENTRATION) INTRAVENOUS SOLUTION,50407.44,32764.84,203.65,50407.44,52
HCPCS,J92030,Gemtuzumab ozogamicin 0.1 mg,,,259.38,259.38,1
HCPCS,J9204,"Inj mogamulizumab-kpkc, 1 mg",,,273.75,273.75,1
HCPCS,J9204,POTELIGEO 4 MG/ML INTRAVENOUS SOLUTION,4591.08,2984.2,210.75,5646.0,49
HCPCS,J92040,"Inj mogamulizumab-kpkc, 1 mg",,,273.75,273.75,1
HCPCS,J9205,Inj irinotecan liposome 1 mg,,,71.24,71.24,1
HCPCS,J9205,ONIVYDE 4.3 MG/ML INTRAVENOUS DISPERSION,1465.44,952.54,57.1,3236.72,46
HCPCS,J92050,Inj irinotecan liposome 1 mg,,,71.24,71.24,1
HCPCS,J9206,IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,21.08,13.7,1.95,21.08,30
HCPCS,J9206,IRINOTECAN 300 MG/15 ML INTRAVENOUS SOLUTION,32.0,20.8,1.95,32.0,30
HCPCS,J9206,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,36.32,23.61,1.95,41.2,120
HCPCS,J9206,IRINOTECAN 500 MG/25 ML INTRAVENOUS SOLUTION,32.0,20.8,1.95,32.0,30
HCPCS,J9206,"IRINOTECAN, 20 MG",658.0,427.7,1.79,658.0,14
HCPCS,J9206,Irinotecan injection,,,1.93,1.93,1
HCPCS,J92060,Irinotecan injection,,,1.93,1.93,1
HCPCS,J9207,IXABEPILONE INJECTION,422.0,274.3,139.98,422.0,14
HCPCS,J9207,IXEMPRA 15 MG INTRAVENOUS SOLUTION,9669.88,6285.42,114.75,9669.88,53
HCPCS,J9207,IXEMPRA 45 MG INTRAVENOUS SOLUTION,29009.68,18856.29,114.75,29009.68,53
HCPCS,J9207,Ixabepilone injection,,,151.18,151.18,1
HCPCS,J92070,Ixabepilone injection,,,151.18,151.18,1
HCPCS,J9208,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,278.64,181.12,23.8,290.24,90
HCPCS,J9208,IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,516.2,335.53,23.8,516.2,60
HCPCS,J9208,IFOSFOMIDE INJECTION,609.0,395.85,24.84,609.0,14
HCPCS,J9208,Ifosfamide injection,,,26.83,26.83,1
HCPCS,J92080,Ifosfamide injection,,,26.83,26.83,1
HCPCS,J9209,MESNA 100 MG/ML INTRAVENOUS SOLUTION,16.439999999999998,10.684999999999999,1.21,31.84,150
HCPCS,J9209,MESNA INJECTION,135.0,87.75,1.7,135.0,14
HCPCS,J9209,MESNEX 100 MG/ML INTRAVENOUS SOLUTION,12.0,7.8,1.58,12.0,30
HCPCS,J9209,Mesna injection,,,1.84,1.84,1
HCPCS,J92090,Mesna injection,,,1.84,1.84,1
HCPCS,J9210,GAMIFANT 5 MG/ML INTRAVENOUS SOLUTION,6679.8,4341.87,328.39,18253.82,106
HCPCS,J9210,"Inj., emapalumab-lzsg, 1 mg",,,414.86,414.86,1
HCPCS,J92100,"Inj., emapalumab-lzsg, 1 mg",,,414.86,414.86,1
HCPCS,J9211,IDAMYCIN PFS 1 MG/ML INTRAVENOUS SOLUTION,44.489999999999995,28.919999999999998,6.26,110.83,72
HCPCS,J9211,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,41.34,26.87,4.84,110.83,144
HCPCS,J9211,Idarubicin hcl injection,,,43.25,43.25,1
HCPCS,J92110,Idarubicin hcl injection,,,43.25,43.25,1
HCPCS,J9212,Interferon alfacon-1 inj,,,10.1,10.95,3
HCPCS,J9213,INTERFERON ALFA-2A INJ,135.0,87.75,40.53,135.0,14
HCPCS,J9213,Interferon alfa-2a inj,,,44.01,258.02,13
HCPCS,J92130,Interferon alfa-2a inj,,,44.01,44.01,1
HCPCS,J9214,INTERFERON ALFA-2B INJ,47.0,30.55,23.5,47.0,14
HCPCS,J9214,Interferon alfa-2b inj,,,31.86,898.5,10
HCPCS,J92140,Interferon alfa-2b inj,,,31.86,31.86,1
HCPCS,J9215,Interferon alfa-n3 inj,,,31.22,79.21,7
HCPCS,J92150,Interferon alfa-n3 inj,,,31.22,31.22,1
HCPCS,J9216,ACTIMMUNE 100 MCG (2 MILLION UNIT)/0.5 ML SUBCUTANEOUS SOLUTION,40606.35,26394.13,204.27,40606.35,34
HCPCS,J9216,Interferon gamma 1-b inj,,,8770.96,8770.96,1
HCPCS,J92160,Interferon gamma 1-b inj,,,8770.96,8770.96,1
HCPCS,J9217,ELIGARD 22.5 MG (3 MONTH) SUBCUTANEOUS SYRINGE,4878.24,3170.86,167.1,4878.24,98
HCPCS,J9217,ELIGARD 30 MG (4 MONTH) SUBCUTANEOUS SYRINGE,6504.33,4227.81,167.1,6504.33,104
HCPCS,J9217,ELIGARD 45 MG (6 MONTH) SUBCUTANEOUS SYRINGE,9756.48,6341.71,167.1,9756.48,104
HCPCS,J9217,ELIGARD 7.5 MG (1 MONTH) SUBCUTANEOUS SYRINGE,2168.12,1409.28,167.1,2168.12,92
HCPCS,J9217,ELIGARD 7.5MG,437.0,284.05,170.78,437.0,14
HCPCS,J9217,LEUPROLIDE ACETATE SUSPNSION,551.0,358.15,170.78,551.0,14
HCPCS,J9217,LUPRON DEPOT 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,23179.98,15066.99,167.1,23179.98,52
HCPCS,J9217,LUPRON DEPOT 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT,30906.72,20089.37,167.1,30906.72,52
HCPCS,J9217,LUPRON DEPOT 45 MG (6 MONTH) INTRAMUSCULAR SYRINGE KIT,46360.77,30134.5,167.1,46360.77,52
HCPCS,J9217,LUPRON DEPOT 7.5 MG,1383.0,898.95,170.78,1383.0,14
HCPCS,J9217,LUPRON DEPOT 7.5 MG INTRAMUSCULAR SYRINGE KIT,7726.71,5022.36,167.1,7726.71,52
HCPCS,J9217,Leuprolide acetate suspnsion,,,184.44,184.44,1
HCPCS,J92170,Leuprolide acetate suspnsion,,,184.44,184.44,1
HCPCS,J9218,LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,2673.0,1737.45,9.92,2673.0,26
HCPCS,J9218,LEUPROLIDE ACETATE INJECTION,579.0,376.35,50.4,579.0,14
HCPCS,J9218,Leuprolide acetate injeciton,,,52.26,52.26,1
HCPCS,J92180,Leuprolide acetate injeciton,,,52.26,52.26,1
HCPCS,J9219,LEUPROLIDE ACETATE IMPLANT,20962.0,13625.3,4318.56,20962.0,14
HCPCS,J9219,Leuprolide acetate implant,,,2697.73,10565.06,13
HCPCS,J92190,Leuprolide acetate implant,,,4164.33,4164.33,1
HCPCS,J9220,BLUDIGO 8 MG/ML (0.8 %) INTRAVENOUS SOLUTION,288.0,187.2,9.3,288.0,26
HCPCS,J9220,INDIGO CARMINE 8 MG/ML (0.8 %) INJECTION SOLUTION,5.19,3.37,1.3,26.3,26
HCPCS,J9220,Indigotindisulfonate sod 1mg,,,10.37,10.37,1
HCPCS,J92200,Indigotindisulfonate sod 1mg,,,10.37,10.37,1
HCPCS,J9223,"Inj. lurbinectedin, 0.1 mg",,,227.64,227.64,1
HCPCS,J9223,ZEPZELCA 4 MG INTRAVENOUS SOLUTION,39600.0,25740.0,179.57,39600.0,52
HCPCS,J92230,"Inj. lurbinectedin, 0.1 mg",,,227.64,227.64,1
HCPCS,J9225,HISTRELIN IMPLANT,21298.0,13843.7,4873.86,21298.0,14
HCPCS,J9225,Vantas implant,,,2562.41,12820.19,10
HCPCS,J92250,Vantas implant,,,5053.21,5053.21,1
HCPCS,J9226,SUPPRELIN LA 50 MG (65 MCG/DAY) IMPLANT KIT,180653.82,117424.98,14450.94,180653.82,53
HCPCS,J9226,Supprelin la implant,,,46640.17,46640.17,1
HCPCS,J92260,Supprelin la implant,,,46640.17,46640.17,1
HCPCS,J9227,Inj. isatuximab-irfc 10 mg,,,91.04,91.04,1
HCPCS,J9227,SARCLISA 20 MG/ML INTRAVENOUS SOLUTION,889.4,578.11,68.78,3236.72,92
HCPCS,J92270,Inj. isatuximab-irfc 10 mg,,,91.04,91.04,1
HCPCS,J9228,Ipilimumab injection,,,201.86,201.86,1
HCPCS,J9228,YERVOY 200 MG/40 ML (5 MG/ML) INTRAVENOUS SOLUTION,4346.28,2825.08,155.44,5646.0,50
HCPCS,J9228,YERVOY 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,4346.28,2825.08,155.44,5646.0,50
HCPCS,J92280,Ipilimumab injection,,,201.86,201.86,1
HCPCS,J9229,BESPONSA 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) INTRAVENOUS SOLUTION,117092.48,76110.11,2322.13,117092.48,52
HCPCS,J9229,Inj inotuzumab ozogam 0.1 mg,,,3042.11,3042.11,1
HCPCS,J92290,Inj inotuzumab ozogam 0.1 mg,,,3042.11,3042.11,1
HCPCS,J9230,Mechlorethamine hcl inj,,,74.65,814.66,10
HCPCS,J92300,Mechlorethamine hcl inj,,,321.11,321.11,1
HCPCS,J9245,"INJ MELPHALAN HYDROCHL, NOT OTHERWISE SPEC, 50 MG",8136.0,5288.4,86.94,8136.0,14
HCPCS,J9245,Inj melpha hydroch nos 50 mg,,,93.9,93.9,1
HCPCS,J9245,MELPHALAN HCL 50 MG INTRAVENOUS POWDER FOR SOLUTION,3236.64,2103.815,86.94,5513.28,98
HCPCS,J92450,Inj melpha hydroch nos 50 mg,,,93.9,93.9,1
HCPCS,J9246,"Inj., evomela, 1 mg",,,15.2,3407.66,35
HCPCS,J92460,"Inj., evomela, 1 mg",,,20.12,20.12,1
HCPCS,J9247,"Inj, melphalan flufenami 1mg",,,492.48,5646.0,10
HCPCS,J92470,"Inj, melphalan flufenami 1mg",,,492.48,492.48,1
HCPCS,J9248,HEPZATO (62 MM CATHETER) 50 MG INTRA-ARTERIAL SOLUTION,181536.0,117998.4,343.08,181536.0,52
HCPCS,J9248,HEPZATO 50 MG INTRA-ARTERIAL SOLUTION,181536.0,117998.4,343.08,181536.0,52
HCPCS,J9248,HEPZATO KIT,1660.0,1079.0,343.08,2200.08,46
HCPCS,J9248,Inj melphalan (hepzato) 1 mg,,,858.6,858.6,1
HCPCS,J92480,Inj melphalan (hepzato) 1 mg,,,858.6,858.6,1
HCPCS,J9249,"Inj, melphalan (apotex) 1 mg",,,63.35,433.37,14
HCPCS,J92490,"Inj, melphalan (apotex) 1 mg",,,63.35,63.35,1
HCPCS,J9255,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,4.220000000000001,2.745,0.67,4.64,80
HCPCS,J9256,IMAAVY 185 MG/ML INTRAVENOUS SOLUTION,6912.0,4492.8,32.74,6912.0,45
HCPCS,J9256,"Inj, nipocalimab-aahu, 3 mg",,,35.36,35.36,1
HCPCS,J92560,"Inj, nipocalimab-aahu, 3 mg",,,35.36,35.36,1
HCPCS,J9258,Paclitaxel (teva),,,746.88,943.43,6
HCPCS,J9259,Paclitaxel (american regent),,,13.63,943.43,7
HCPCS,J9260,Inj methotrexate sodium 50mg,,,2.79,2.79,1
HCPCS,J9260,METHOTREXATE SODIUM (PF) 1 GRAM SOLUTION FOR INJECTION,305.28,198.43,2.31,305.28,60
HCPCS,J9260,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,8.08,5.25,1.36,8.08,30
HCPCS,J9260,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,14.420000000000002,9.375,1.81,17.44,120
HCPCS,J9260,METHOTREXATE SODIUM INJ,19.0,12.35,2.58,19.0,14
HCPCS,J92600,Inj methotrexate sodium 50mg,,,2.79,2.79,1
HCPCS,J9261,NELARABINE 5 MG/ML INTRAVENOUS SOLUTION,63.44,41.24,31.72,3407.66,46
HCPCS,J9261,Nelarabine injection,,,70.37,70.37,1
HCPCS,J92610,Nelarabine injection,,,70.37,70.37,1
HCPCS,J9262,"Inj, omacetaxine mep, 0.01mg",,,3.56,433.37,24
HCPCS,J92620,"Inj, omacetaxine mep, 0.01mg",,,3.94,3.94,1
HCPCS,J9263,OXALIPLATIN,24.0,15.6,0.05,24.0,14
HCPCS,J9263,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,14.52,9.44,0.05,23.04,60
HCPCS,J9263,OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,23.04,14.98,0.05,23.04,30
HCPCS,J9263,Oxaliplatin,,,0.05,0.05,1
HCPCS,J92630,Oxaliplatin,,,0.05,0.05,1
HCPCS,J9264,ABRAXANE 100 MG INTRAVENOUS SUSPENSION,7584.28,4929.78,8.18,7584.28,52
HCPCS,J9264,PACLITAXEL PROTEIN BOUND,19.0,12.35,8.18,19.0,14
HCPCS,J9264,PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,7867.04,5113.58,8.18,7867.04,52
HCPCS,J9264,Paclitaxel protein bound,,,8.83,8.83,1
HCPCS,J92640,Paclitaxel protein bound,,,8.83,8.83,1
HCPCS,J9266,ONCASPAR 750 UNIT/ML INJECTION SOLUTION,26386.12,17150.98,7915.84,78660.74,52
HCPCS,J9266,"PEGASPARGASE, PER SINGLE DOSE VIAL",5123.0,3329.95,2561.5,32153.3,14
HCPCS,J9266,Pegaspargase injection,,,30697.98,30697.98,1
HCPCS,J92660,Pegaspargase injection,,,30697.98,30697.98,1
HCPCS,J9267,PACLITAXEL 6 MG/ML CONCENTRATEINTRAVENOUS,8.12,5.28,0.1,9.6,90
HCPCS,J9267,Paclitaxel injection,,,0.11,0.11,1
HCPCS,J92670,Paclitaxel injection,,,0.11,0.11,1
HCPCS,J9268,NIPENT 10 MG INTRAVENOUS SOLUTION,14661.92,9530.25,746.88,14661.92,52
HCPCS,J9268,PENTOSTATIN INJECTION,6414.0,4169.1,2537.1,6414.0,14
HCPCS,J9268,Pentostatin injection,,,2740.07,2740.07,1
HCPCS,J92680,Pentostatin injection,,,2740.07,2740.07,1
HCPCS,J9269,ELZONRIS 1000 MCG/ML INTRAVENOUS SOLUTION,162031.92,105320.75,293.99,162031.92,52
HCPCS,J9269,Inj. tagraxofusp-erzs 10 mcg,,,385.58,385.58,1
HCPCS,J92690,Inj. tagraxofusp-erzs 10 mcg,,,385.58,385.58,1
HCPCS,J9270,Plicamycin (mithramycin) inj,,,85.31,258.02,9
HCPCS,J9271,Inj pembrolizumab,,,64.51,64.51,1
HCPCS,J9271,KEYTRUDA 25 MG/ML INTRAVENOUS SOLUTION,7218.8,4692.22,51.58,7218.8,156
HCPCS,J92710,Inj pembrolizumab,,,64.51,64.51,1
HCPCS,J9272,"Inj, dostarlimab-gxly, 10 mg",,,267.24,267.24,1
HCPCS,J9272,JEMPERLI 50 MG/ML INTRAVENOUS SOLUTION,4417.53,2871.39,209.3,5646.0,49
HCPCS,J92720,"Inj, dostarlimab-gxly, 10 mg",,,267.24,267.24,1
HCPCS,J9273,"Inj tisotu vedotin-tftv, 1mg",,,211.76,211.76,1
HCPCS,J9273,TIVDAK 40 MG INTRAVENOUS SOLUTION,35523.84,23090.5,157.32,35523.84,52
HCPCS,J92730,"Inj tisotu vedotin-tftv, 1mg",,,211.76,211.76,1
HCPCS,J9274,"Inj, tebentafusp-tebn, 1 mcg",,,239.99,239.99,1
HCPCS,J9274,KIMMTRAK 100 MCG/0.5 ML INTRAVENOUS SOLUTION,201504.0,130977.6,188.03,201504.0,52
HCPCS,J92740,"Inj, tebentafusp-tebn, 1 mcg",,,239.99,239.99,1
HCPCS,J9275,"Inj cosibelimab-ipdl, 2 mg",,,22.42,3407.66,14
HCPCS,J92750,"Inj cosibelimab-ipdl, 2 mg",,,22.42,22.42,1
HCPCS,J9276,"Inj zanidatamab-hrii, 2 mg",,,27.0,27.0,1
HCPCS,J9276,ZIIHERA 300 MG INTRAVENOUS SOLUTION,17064.0,11091.6,24.99,17064.0,45
HCPCS,J92760,"Inj zanidatamab-hrii, 2 mg",,,27.0,27.0,1
HCPCS,J9277,Inj pem 1 mg bera alfa-pmph,,,4469.75,5646.0,6
HCPCS,J9280,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,2639.6400000000003,1715.7649999999999,26.1,2831.28,144
HCPCS,J9280,MITOMYCIN 40 MG INTRAVENOUS SOLUTION,5231.280000000001,3400.33,26.1,5662.56,153
HCPCS,J9280,MITOMYCIN 5 MG INJ,487.0,316.55,26.1,487.0,14
HCPCS,J9280,MITOMYCIN 5 MG INTRAVENOUS SOLUTION,1089.84,708.4,26.1,1089.84,46
HCPCS,J9280,Mitomycin injection,,,28.19,28.19,1
HCPCS,J92800,Mitomycin injection,,,28.19,28.19,1
HCPCS,J9281,JELMYTO 40 MG X 2 INTRA-PYELOCALYCEAL KIT,122136.0,79388.4,270.53,122136.0,52
HCPCS,J9281,Mitomycin instillation,,,349.82,349.82,1
HCPCS,J92810,Mitomycin instillation,,,349.82,349.82,1
HCPCS,J9282,Mitomycin intravesical inst,,,276.81,12697.64,14
HCPCS,J92820,Mitomycin intravesical inst,,,278.64,278.64,1
HCPCS,J9285,"Inj, olaratumab, 10 mg",,,50.92,3236.72,13
HCPCS,J92850,"Inj, olaratumab, 10 mg",,,50.92,50.92,1
HCPCS,J9286,COLUMVI 1 MG/ML INTRAVENOUS SOLUTION,5203.82,3382.4849999999997,1561.14,7869.33,104
HCPCS,J9286,"Inj glofitamab gxbm, 2.5 mg",,,3071.08,3071.08,1
HCPCS,J92860,"Inj glofitamab gxbm, 2.5 mg",,,3071.08,3071.08,1
HCPCS,J9289,Inj nivolumab 2 mg hyaluron,,,27.8,3407.66,21
HCPCS,J92890,Inj nivolumab 2 mg hyaluron,,,30.02,30.02,1
HCPCS,J9292,"Inj, pemetrexed dipotassium",,,81.23,943.43,24
HCPCS,J92920,"Inj, pemetrexed dipotassium",,,87.73,87.73,1
HCPCS,J9293,MITOXANTRONE 2 MG/ML CONCENTRATEINTRAVENOUS,85.72,55.72,30.87,195.68,184
HCPCS,J9293,MITOXANTRONE HYDROCHL / 5 MG,945.0,614.25,30.88,945.0,14
HCPCS,J9293,Mitoxantrone hydrochl / 5 mg,,,33.35,33.35,1
HCPCS,J92930,Mitoxantrone hydrochl / 5 mg,,,33.35,33.35,1
HCPCS,J9294,"Inj pemetrexed, hospira 10mg",,,4.53,4.53,1
HCPCS,J9294,PEMETREXED DISODIUM 25 MG/ML INTRAVENOUS SOLUTION,94.305,61.3,0.62,943.43,92
HCPCS,J92940,"Inj pemetrexed, hospira 10mg",,,4.53,4.53,1
HCPCS,J9295,"Injection, necitumumab, 1 mg",,,5.16,3407.66,35
HCPCS,J92950,"Injection, necitumumab, 1 mg",,,6.19,6.19,1
HCPCS,J9296,ALIMTA 500 MG INTRAVENOUS SOLUTION,19406.4,12614.16,9.66,19406.4,51
HCPCS,J9296,Inj pemetrexed (accord) 10mg,,,10.52,10.52,1
HCPCS,J9296,PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,720.0,468.0,9.66,943.43,45
HCPCS,J92960,Inj pemetrexed (accord) 10mg,,,10.52,10.52,1
HCPCS,J9297,Inj pemetrexed (sandoz) 10mg,,,1.28,943.43,18
HCPCS,J92970,Inj pemetrexed (sandoz) 10mg,,,1.61,1.61,1
HCPCS,J9298,Inj nivol relatlimab 3mg/1mg,,,217.78,217.78,1
HCPCS,J9298,OPDUALAG 240 MG-80 MG/20 ML INTRAVENOUS SOLUTION,3701.28,2405.83,168.3,18253.82,49
HCPCS,J92980,Inj nivol relatlimab 3mg/1mg,,,217.78,217.78,1
HCPCS,J9299,"Injection, nivolumab",,,36.26,36.26,1
HCPCS,J9299,OPDIVO 100 MG/10 ML INTRAVENOUS SOLUTION,1588.6,1032.59,27.98,3407.66,46
HCPCS,J9299,OPDIVO 120 MG/12 ML INTRAVENOUS SOLUTION,1588.6,1032.59,27.98,3407.66,46
HCPCS,J9299,OPDIVO 240 MG/24 ML INTRAVENOUS SOLUTION,1588.6,1032.59,27.98,3407.66,46
HCPCS,J9299,OPDIVO 40 MG/4 ML INTRAVENOUS SOLUTION,1588.64,1032.62,27.98,3407.66,46
HCPCS,J92990,"Injection, nivolumab",,,36.26,36.26,1
HCPCS,J9301,GAZYVA 1000 MG/40 ML INTRAVENOUS SOLUTION,1080.04,702.03,63.19,3407.66,46
HCPCS,J9301,Obinutuzumab inj,,,88.16,88.16,1
HCPCS,J93010,Obinutuzumab inj,,,88.16,88.16,1
HCPCS,J9302,ARZERRA 100 MG/5 ML INTRAVENOUS SOLUTION,579.24,376.51,62.23,3407.66,39
HCPCS,J9302,ARZERRA 1000 MG/50 ML INTRAVENOUS SOLUTION,579.24,376.51,62.23,3407.66,39
HCPCS,J9302,OFATUMUMAB INJECTION,277.0,180.05,60.34,277.0,14
HCPCS,J9302,Ofatumumab injection,,,62.55,62.55,1
HCPCS,J93020,Ofatumumab injection,,,62.55,62.55,1
HCPCS,J9303,PANITUMUMAB INJECTION,551.0,358.15,173.67,551.0,14
HCPCS,J9303,Panitumumab injection,,,187.56,187.56,1
HCPCS,J9303,VECTIBIX 100 MG/5 ML (20 MG/ML) INTRAVENOUS SOLUTION,1739.2,1130.48,136.11,3236.72,47
HCPCS,J9303,VECTIBIX 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,1739.2,1130.48,136.11,3236.72,47
HCPCS,J93030,Panitumumab injection,,,187.56,187.56,1
HCPCS,J9304,"Inj. pemetrexed, 10 mg",,,39.93,3407.66,35
HCPCS,J93040,"Inj. pemetrexed, 10 mg",,,43.12,43.12,1
HCPCS,J9305,ALIMTA 100 MG INTRAVENOUS SOLUTION,3881.28,2522.83,3.57,3881.28,49
HCPCS,J9305,"INJECTION, PEMETREXED, NOT OTHERWISE SPECIFIED, 10 MG",86.0,55.9,3.59,86.0,14
HCPCS,J9305,Inj. pemetrexed nos 10mg,,,3.88,3.88,1
HCPCS,J9305,PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,144.0,93.6,3.57,943.43,46
HCPCS,J93050,Inj. pemetrexed nos 10mg,,,3.88,3.88,1
HCPCS,J9306,"Injection, pertuzumab, 1 mg",,,18.37,18.37,1
HCPCS,J9306,PERJETA 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION,2338.44,1519.99,13.88,3236.72,46
HCPCS,J93060,"Injection, pertuzumab, 1 mg",,,18.37,18.37,1
HCPCS,J9307,PRALATREXATE 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,23913.44,15543.74,269.35,23913.44,53
HCPCS,J9307,PRALATREXATE 40 MG/2 ML (20 MG/ML) INTRAVENOUS SOLUTION,23913.44,15543.74,269.35,23913.44,53
HCPCS,J9307,Pralatrexate injection,,,424.14,424.14,1
HCPCS,J93070,Pralatrexate injection,,,424.14,424.14,1
HCPCS,J9308,CYRAMZA 10 MG/ML INTRAVENOUS SOLUTION,720.38,468.245,62.69,3407.66,92
HCPCS,J9308,"Injection, ramucirumab",,,81.63,81.63,1
HCPCS,J93080,"Injection, ramucirumab",,,81.63,81.63,1
HCPCS,J9309,"Inj, polatuzumab vedotin 1mg",,,147.71,147.71,1
HCPCS,J9309,POLIVY 140 MG INTRAVENOUS SOLUTION,89334.76,58067.59,111.63,89334.76,52
HCPCS,J9309,POLIVY 30 MG INTRAVENOUS SOLUTION,19143.2,12443.08,111.63,19143.2,52
HCPCS,J93090,"Inj, polatuzumab vedotin 1mg",,,147.71,147.71,1
HCPCS,J9311,"Inj rituximab, hyaluronidase",,,39.82,39.82,1
HCPCS,J9311,RITUXAN HYCELA 1400 MG/11.7 ML (120 MG/ML) SUBCUTANEOUS SOLUTION,2698.08,1753.75,33.52,3236.72,49
HCPCS,J9311,RITUXAN HYCELA 1600 MG/13.4 ML (120 MG/ML) SUBCUTANEOUS SOLUTION,2019.24,1312.51,33.52,3236.72,46
HCPCS,J93110,"Inj rituximab, hyaluronidase",,,39.82,39.82,1
HCPCS,J9312,"Inj., rituximab, 10 mg",,,80.75,80.75,1
HCPCS,J9312,RITUXAN 10 MG/ML CONCENTRATEINTRAVENOUS,450.96,293.12,70.98,3236.72,92
HCPCS,J93120,"Inj., rituximab, 10 mg",,,80.75,80.75,1
HCPCS,J9313,"Inj., lumoxiti, 0.01 mg",,,22.87,3407.66,27
HCPCS,J93130,"Inj., lumoxiti, 0.01 mg",,,22.87,22.87,1
HCPCS,J9314,Inj pemetrexed (teva) 10mg,,,5.52,943.43,35
HCPCS,J93140,Inj pemetrexed (teva) 10mg,,,16.56,16.56,1
HCPCS,J9315,Romidepsin injection,,,2697.73,3407.66,6
HCPCS,J9316,PHESGO 1200 MG-600 MG-30000 UNIT/15 ML SUBCUTANEOUS SOLUTION,4453.28,2894.63,58.79,4453.28,49
HCPCS,J9316,PHESGO 600 MG-600 MG-20000 UNIT/10 ML SUBCUTANEOUS SOLUTION,4453.12,2894.53,58.79,4453.12,49
HCPCS,J9316,"Pertuzu, trastuzu, 10 mg",,,65.84,65.84,1
HCPCS,J93160,"Pertuzu, trastuzu, 10 mg",,,65.84,65.84,1
HCPCS,J9317,Sacituzumab govitecan-hziy,,,39.94,39.94,1
HCPCS,J9317,TRODELVY 180 MG INTRAVENOUS SOLUTION,12304.8,7998.12,30.69,12304.8,52
HCPCS,J93170,Sacituzumab govitecan-hziy,,,39.94,39.94,1
HCPCS,J9318,Inj romidepsin non-lyo 0.1mg,,,30.8,30.8,1
HCPCS,J9318,ROMIDEPSIN 5 MG/ML INTRAVENOUS SOLUTION,7292.92,4740.4,28.51,7292.92,51
HCPCS,J93180,Inj romidepsin non-lyo 0.1mg,,,30.8,30.8,1
HCPCS,J9319,ISTODAX 10 MG/2 ML INTRAVENOUS SOLUTION,15353.52,9979.79,27.49,15353.52,52
HCPCS,J9319,Inj romidepsin lyophil 0.1mg,,,33.38,33.38,1
HCPCS,J9319,ROMIDEPSIN 10 MG/2 ML INTRAVENOUS POWDER FOR SOLUTION,15209.52,9886.19,27.49,15209.52,52
HCPCS,J93190,Inj romidepsin lyophil 0.1mg,,,33.38,33.38,1
HCPCS,J9320,STREPTOZOCIN INJECTION,454.0,295.1,227.0,1397.76,14
HCPCS,J9320,Streptozocin injection,,,78.38,3419.52,10
HCPCS,J93200,Streptozocin injection,,,1347.84,1347.84,1
HCPCS,J9321,EPKINLY 4 MG/0.8 ML SUBCUTANEOUS SOLUTION,8405.0,5463.25,48.4,8405.0,52
HCPCS,J9321,EPKINLY 48 MG/0.8 ML SUBCUTANEOUS SOLUTION,100859.76,65558.84,48.4,100859.76,52
HCPCS,J9321,Inj epcoritamab-bysp 0.16 mg,,,61.35,61.35,1
HCPCS,J93210,Inj epcoritamab-bysp 0.16 mg,,,61.35,61.35,1
HCPCS,J9322,Inj pemetrexed (bluepoint),,,9.44,943.43,17
HCPCS,J93220,Inj pemetrexed (bluepoint),,,9.44,9.44,1
HCPCS,J9323,Inj pemetrexed ditromethamin,,,0.12,943.43,35
HCPCS,J93230,Inj pemetrexed ditromethamin,,,0.14,0.14,1
HCPCS,J9324,"Inj, pemrydi rtu, 10 mg",,,73.31,943.43,34
HCPCS,J93240,"Inj, pemrydi rtu, 10 mg",,,79.19,79.19,1
HCPCS,J9325,IMLYGIC 10EXP6 (1 MILLION) PFU/ML SUSPENSION FOR INJECTION,335.36,217.98,60.12,3407.66,46
HCPCS,J9325,IMLYGIC 10EXP8 (100 MILLION) PFU/ML SUSPENSION FOR INJECTION,33531.8,21795.67,60.12,33531.8,52
HCPCS,J9325,INJ TALIMOGENE LAHERPAREPVEC,233.0,151.45,73.94,233.0,14
HCPCS,J9325,Inj talimogene laherparepvec,,,79.86,79.86,1
HCPCS,J93250,Inj talimogene laherparepvec,,,79.86,79.86,1
HCPCS,J9326,EMRELIS 100 MG INTRAVENOUS SOLUTION,67104.0,43617.6,145.87,67104.0,45
HCPCS,J9326,EMRELIS 20 MG INTRAVENOUS SOLUTION,13420.8,8723.52,145.87,13420.8,45
HCPCS,J9326,Telisotuzumab vedotin-tllv,,,157.54,157.54,1
HCPCS,J93260,Telisotuzumab vedotin-tllv,,,157.54,157.54,1
HCPCS,J9328,TEMODAR 100 MG INTRAVENOUS SOLUTION,4814.92,3129.7,9.36,4814.92,50
HCPCS,J9328,Temozolomide injection,,,11.23,11.23,1
HCPCS,J93280,Temozolomide injection,,,11.23,11.23,1
HCPCS,J9329,"Inj, tislelizumab-jsgr",,,58.37,3236.72,34
HCPCS,J93290,"Inj, tislelizumab-jsgr",,,63.04,63.04,1
HCPCS,J9330,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,4643.61,3018.35,20.31,4643.61,50
HCPCS,J9330,TEMSIROLIMUS INJECTION,309.0,200.85,20.32,309.0,14
HCPCS,J9330,TORISEL 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLUTION,7561.23,4914.8,20.31,7561.23,53
HCPCS,J9330,Temsirolimus injection,,,21.95,21.95,1
HCPCS,J93300,Temsirolimus injection,,,21.95,21.95,1
HCPCS,J9331,Inj sirolimus prot part 1 mg,,,87.11,5646.0,35
HCPCS,J93310,Inj sirolimus prot part 1 mg,,,94.08,94.08,1
HCPCS,J9332,Inj efgartigimod 2mg,,,34.8,34.8,1
HCPCS,J9332,VYVGART 20 MG/ML INTRAVENOUS SOLUTION,1136.55,738.76,28.86,5646.0,47
HCPCS,J93320,Inj efgartigimod 2mg,,,34.8,34.8,1
HCPCS,J9333,Inj rozanolixizum-noli 1 mg,,,25.25,25.25,1
HCPCS,J9333,RYSTIGGO 140 MG/ML SUBCUTANEOUS SOLUTION,11163.96,7256.57,20.57,11163.96,53
HCPCS,J93330,Inj rozanolixizum-noli 1 mg,,,25.25,25.25,1
HCPCS,J9334,Inj efgart-alfa 2mg hya-qvfc,,,36.85,36.85,1
HCPCS,J9334,VYVGART HYTRULO 1008 MG-11200 UNIT/5.6 ML SUBCUTANEOUS SOLUTION,10549.44,6857.14,29.85,10549.44,53
HCPCS,J93340,Inj efgart-alfa 2mg hya-qvfc,,,36.85,36.85,1
HCPCS,J9340,Thiotepa injection,,,78.38,451.48,20
HCPCS,J9341,Inj thiotepa (tepylute) 1 mg,,,41.63,106.7,17
HCPCS,J93410,Inj thiotepa (tepylute) 1 mg,,,41.63,41.63,1
HCPCS,J9342,Inj thiotepa nos 1 mg,,,9.57,9.57,1
HCPCS,J9342,TEPADINA 100 MG SOLUTION FOR INJECTION,8640.0,5616.0,8.86,8640.0,45
HCPCS,J9342,THIOTEPA 15 MG SOLUTION FOR INJECTION,960.0,624.0,8.86,960.0,39
HCPCS,J93420,Inj thiotepa nos 1 mg,,,9.57,9.57,1
HCPCS,J9345,"Inj, retifanlimab-dlwr, 1 mg",,,32.97,32.97,1
HCPCS,J9345,ZYNYZ 500 MG/20 ML INTRAVENOUS SOLUTION,3538.32,2299.91,26.55,5646.0,49
HCPCS,J93450,"Inj, retifanlimab-dlwr, 1 mg",,,32.97,32.97,1
HCPCS,J9347,IMJUDO 20 MG/ML INTRAVENOUS SOLUTION,13243.88,8608.52,122.17,13243.88,104
HCPCS,J9347,"Inj, tremelimumab-actl, 1 mg",,,154.46,154.46,1
HCPCS,J93470,"Inj, tremelimumab-actl, 1 mg",,,154.46,154.46,1
HCPCS,J9348,DANYELZA 4 MG/ML INTRAVENOUS SOLUTION,12511.64,8132.57,549.03,12697.64,52
HCPCS,J9348,"Inj. naxitamab-gqgk, 1 mg",,,740.97,740.97,1
HCPCS,J93480,"Inj. naxitamab-gqgk, 1 mg",,,740.97,740.97,1
HCPCS,J9349,"Inj., tafasitamab-cxix",,,15.38,15.38,1
HCPCS,J9349,MONJUVI 200 MG INTRAVENOUS SOLUTION,6700.16,4355.1,12.22,6700.16,52
HCPCS,J93490,"Inj., tafasitamab-cxix",,,15.38,15.38,1
HCPCS,J9350,"Inj mosunetuzumab-axgb, 1 mg",,,707.81,707.81,1
HCPCS,J9350,LUNSUMIO 1 MG/ML INTRAVENOUS SOLUTION,2996.42,1947.6750000000002,566.23,18253.82,98
HCPCS,J93500,"Inj mosunetuzumab-axgb, 1 mg",,,707.81,707.81,1
HCPCS,J9351,TOPOTECAN 4 MG INTRAVENOUS SOLUTION,1042.98,677.9350000000001,1.05,1433.0,60
HCPCS,J9351,TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,519.24,337.51,1.05,519.24,30
HCPCS,J9351,TOPOTECAN INJECTION,178.0,115.7,1.25,178.0,14
HCPCS,J9351,Topotecan injection,,,1.35,1.35,1
HCPCS,J93510,Topotecan injection,,,1.35,1.35,1
HCPCS,J9352,Injection trabectedin 0.1mg,,,422.36,422.36,1
HCPCS,J9352,YONDELIS 1 MG INTRAVENOUS SOLUTION,17708.84,11510.75,304.55,17708.84,52
HCPCS,J93520,Injection trabectedin 0.1mg,,,422.36,422.36,1
HCPCS,J9353,"Inj. margetuximab-cmkb, 5 mg",,,58.05,58.05,1
HCPCS,J9353,MARGENZA 25 MG/ML INTRAVENOUS SOLUTION,1034.73,672.57,42.33,3236.72,46
HCPCS,J93530,"Inj. margetuximab-cmkb, 5 mg",,,58.05,58.05,1
HCPCS,J9354,"Inj, ado-trastuzumab emt 1mg",,,45.57,45.57,1
HCPCS,J9354,KADCYLA 100 MG INTRAVENOUS SOLUTION,19150.24,12447.66,34.59,19150.24,52
HCPCS,J9354,KADCYLA 160 MG INTRAVENOUS SOLUTION,30640.32,19916.21,34.59,30640.32,52
HCPCS,J93540,"Inj, ado-trastuzumab emt 1mg",,,45.57,45.57,1
HCPCS,J9355,HERCEPTIN 150 MG INTRAVENOUS SOLUTION,7480.4,4862.26,72.04,7480.4,52
HCPCS,J9355,Inj trastuzumab excl biosimi,,,79.36,79.36,1
HCPCS,J9355,"TRASTUZUMAB, 10 MG",386.0,250.9,73.48,386.0,14
HCPCS,J93550,Inj trastuzumab excl biosimi,,,79.36,79.36,1
HCPCS,J9356,HERCEPTIN HYLECTA 600 MG-10000 UNIT/5 ML SUBCUTANEOUS SOLUTION,4488.24,2917.36,59.34,4488.24,49
HCPCS,J9356,"Inj. herceptin hylecta, 10mg",,,65.96,65.96,1
HCPCS,J93560,"Inj. herceptin hylecta, 10mg",,,65.96,65.96,1
HCPCS,J9357,"VALRUBICIN, 200 MG",2052.0,1333.8,1026.0,2052.0,14
HCPCS,J9357,VALSTAR 40 MG/ML INTRAVESICAL SOLUTION,1776.24,1154.56,888.12,3606.88,46
HCPCS,J9357,Valrubicin injection,,,1407.61,1407.61,1
HCPCS,J93570,Valrubicin injection,,,1407.61,1407.61,1
HCPCS,J9358,ENHERTU 100 MG INTRAVENOUS SOLUTION,14815.04,9629.78,24.54,14815.04,52
HCPCS,J9358,Inj fam-trastu deru-nxki 1mg,,,33.8,33.8,1
HCPCS,J93580,Inj fam-trastu deru-nxki 1mg,,,33.8,33.8,1
HCPCS,J9359,Inj lon tesirin-lpyl 0.075mg,,,238.92,238.92,1
HCPCS,J9359,ZYNLONTA 10 MG INTRAVENOUS SOLUTION,104507.16,67929.65,180.44,104507.16,52
HCPCS,J93590,Inj lon tesirin-lpyl 0.075mg,,,238.92,238.92,1
HCPCS,J9360,VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,25.8,16.77,4.33,25.8,30
HCPCS,J9360,VINBLASTINE SULFATE INJ,13.0,8.45,5.18,13.0,14
HCPCS,J9360,Vinblastine sulfate inj,,,5.59,5.59,1
HCPCS,J93600,Vinblastine sulfate inj,,,5.59,5.59,1
HCPCS,J9361,"Inj, efbemalenograstim alfa-",,,119.23,1355.53,10
HCPCS,J93610,"Inj, efbemalenograstim alfa-",,,119.23,119.23,1
HCPCS,J9370,VINCASAR PFS 1 MG/ML INTRAVENOUS SOLUTION,72.24,46.96,7.12,72.24,30
HCPCS,J9370,VINCASAR PFS 2 MG/2 ML INTRAVENOUS SOLUTION,72.24,46.96,7.12,72.24,30
HCPCS,J9370,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,58.980000000000004,38.335,4.78,89.48,60
HCPCS,J9370,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,35.96,23.375,4.45,45.44,60
HCPCS,J9370,VINCRISTINE SULFATE 1 MG INJ,121.0,78.65,8.15,121.0,14
HCPCS,J9370,Vincristine sulfate 1 mg inj,,,8.8,8.8,1
HCPCS,J93700,Vincristine sulfate 1 mg inj,,,8.8,8.8,1
HCPCS,J9371,"Inj, vincristine sul lip 1mg",,,4469.75,5646.0,6
HCPCS,J9376,"Inj pozelimab-bbfg, 1 mg",,,89.73,18253.82,17
HCPCS,J93760,"Inj pozelimab-bbfg, 1 mg",,,89.73,89.73,1
HCPCS,J9380,Inj teclistamab cqyv 0.5 mg,,,37.35,37.35,1
HCPCS,J9380,TECVAYLI 10 MG/ML SUBCUTANEOUS SOLUTION,3277.64,2130.47,27.69,3277.64,49
HCPCS,J9380,TECVAYLI 90 MG/ML SUBCUTANEOUS SOLUTION,29498.96,19174.32,27.69,29498.96,52
HCPCS,J93800,Inj teclistamab cqyv 0.5 mg,,,37.35,37.35,1
HCPCS,J9381,Inj teplizumab mzwv 5 mcg,,,32.74,18253.82,35
HCPCS,J93810,Inj teplizumab mzwv 5 mcg,,,41.46,41.46,1
HCPCS,J9382,BIZENGRI 375 MG/18.75 ML (20 MG/ML) INTRAVENOUS SOLUTION,3067.36,1993.78,33.56,3407.66,42
HCPCS,J9382,Inj zenocutuzumab-zbco 1 mg,,,36.26,36.26,1
HCPCS,J93820,Inj zenocutuzumab-zbco 1 mg,,,36.26,36.26,1
HCPCS,J9390,"INJECTION, VINORELBINE TARTRATE, 10 MG",488.0,317.2,5.44,488.0,14
HCPCS,J9390,VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,120.0,78.0,5.93,120.0,30
HCPCS,J9390,VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,86.4,56.16,5.93,86.4,30
HCPCS,J9390,Vinorelbine tartrate inj,,,5.88,5.88,1
HCPCS,J93900,Vinorelbine tartrate inj,,,5.88,5.88,1
HCPCS,J9393,"Inj, fulvestrant (teva)",,,20.74,94.3,27
HCPCS,J93930,"Inj, fulvestrant (teva)",,,20.74,20.74,1
HCPCS,J9394,FASLODEX 250 MG/5 ML INTRAMUSCULAR SYRINGE,930.76,604.99,4.76,930.76,46
HCPCS,J9394,FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,84.0,54.6,4.76,114.48,46
HCPCS,J9394,"Inj, fulvestrant (fresenius)",,,29.28,29.28,1
HCPCS,J93940,"Inj, fulvestrant (fresenius)",,,29.28,29.28,1
HCPCS,J9395,"INJECTION, FULVESTRANT",243.0,157.95,5.72,243.0,14
HCPCS,J9395,"Injection, fulvestrant",,,6.18,94.3,31
HCPCS,J93950,"Injection, fulvestrant",,,6.18,6.18,1
HCPCS,J9400,"Inj, ziv-aflibercept, 1mg",,,6.01,652.67,35
HCPCS,J94000,"Inj, ziv-aflibercept, 1mg",,,7.8,7.8,1
HCPCS,J9600,PHOTOFRIN 75 MG INTRAVENOUS SOLUTION,111950.4,72767.76,14450.94,111950.4,44
HCPCS,J9600,"PORFIMER SODIUM, 75 MG",16943.0,11012.95,8471.5,25076.89,14
HCPCS,J9600,Porfimer sodium injection,,,24181.29,24181.29,1
HCPCS,J96000,Porfimer sodium injection,,,24181.29,24181.29,1
HCPCS,J9601,Inj linvoselt-gcpt 1 mg,,,4469.75,5646.0,6
HCPCS,J9999,ABRAXANE 100 MG,1669.0,1084.85,834.5,1669.0,12
HCPCS,J9999,AVASTIN 100 MG,1375.0,893.75,687.5,1375.0,12
HCPCS,J9999,BRENTUXIMAB (VEDOTIN) 50 MG,18878.0,12270.7,9439.0,18878.0,12
HCPCS,J9999,HERCEPTIN 440 MG,3945.0,2564.25,1972.5,3945.0,12
HCPCS,J9999,PLENAXIS/ABARELIX 100MG NDC#68158-0149-51,1847.0,1200.55,923.5,1847.0,12
HCPCS,J9999,TALTZ AUTOINJECTOR 80 MG/ML SUBCUTANEOUS,26141.43,16991.93,4391.76,26141.43,26
HCPCS,J9999,VELCADE 3.5 MG,2273.0,1477.45,1136.5,2273.0,12
HCPCS,K0001,Standard wheelchair,,,16.61,166.15,8
HCPCS,K00010,Standard wheelchair,,,166.15,166.15,1
HCPCS,K0001MS,Standard wheelchair,,,16.61,16.61,1
HCPCS,K0001NU,Standard wheelchair,,,166.15,166.15,1
HCPCS,K0001RR,Standard wheelchair,,,16.61,50.55,4
HCPCS,K0001UE,Standard wheelchair,,,124.61,124.61,1
HCPCS,K0002,Stnd hemi (low seat) whlchr,,,28.07,280.72,8
HCPCS,K00020,Stnd hemi (low seat) whlchr,,,280.72,280.72,1
HCPCS,K0002MS,Stnd hemi (low seat) whlchr,,,28.07,28.07,1
HCPCS,K0002NU,Stnd hemi (low seat) whlchr,,,280.72,280.72,1
HCPCS,K0002RR,Stnd hemi (low seat) whlchr,,,28.07,88.08,4
HCPCS,K0002UE,Stnd hemi (low seat) whlchr,,,210.55,210.55,1
HCPCS,K0003,Lightweight wheelchair,,,24.41,244.08,8
HCPCS,K00030,Lightweight wheelchair,,,244.08,244.08,1
HCPCS,K0003MS,Lightweight wheelchair,,,24.41,24.41,1
HCPCS,K0003NU,Lightweight wheelchair,,,244.08,244.08,1
HCPCS,K0003RR,Lightweight wheelchair,,,24.41,76.46,4
HCPCS,K0003UE,Lightweight wheelchair,,,183.06,183.06,1
HCPCS,K0004,High strength ltwt whlchr,,,29.32,293.26,8
HCPCS,K00040,High strength ltwt whlchr,,,293.26,293.26,1
HCPCS,K0004MS,High strength ltwt whlchr,,,29.32,29.32,1
HCPCS,K0004NU,High strength ltwt whlchr,,,293.26,293.26,1
HCPCS,K0004RR,High strength ltwt whlchr,,,29.32,94.29,4
HCPCS,K0004UE,High strength ltwt whlchr,,,219.94,219.94,1
HCPCS,K0005,Ultralightweight wheelchair,,,149.83,4316.36,14
HCPCS,K00050,Ultralightweight wheelchair,,,1498.4,1498.4,1
HCPCS,K0005MS,Ultralightweight wheelchair,,,149.83,149.83,1
HCPCS,K0005NU,Ultralightweight wheelchair,,,1498.4,4316.36,4
HCPCS,K0005RR,Ultralightweight wheelchair,,,149.83,431.59,4
HCPCS,K0005UE,Ultralightweight wheelchair,,,1123.76,3237.16,4
HCPCS,K0006,Heavy duty wheelchair,,,43.2,431.96,8
HCPCS,K00060,Heavy duty wheelchair,,,431.96,431.96,1
HCPCS,K0006MS,Heavy duty wheelchair,,,43.2,43.2,1
HCPCS,K0006NU,Heavy duty wheelchair,,,431.96,431.96,1
HCPCS,K0006RR,Heavy duty wheelchair,,,43.2,139.41,4
HCPCS,K0006UE,Heavy duty wheelchair,,,323.97,323.97,1
HCPCS,K0007,Extra heavy duty wheelchair,,,61.45,614.55,8
HCPCS,K00070,Extra heavy duty wheelchair,,,614.55,614.55,1
HCPCS,K0007MS,Extra heavy duty wheelchair,,,61.45,61.45,1
HCPCS,K0007NU,Extra heavy duty wheelchair,,,614.55,614.55,1
HCPCS,K0007RR,Extra heavy duty wheelchair,,,61.45,196.51,4
HCPCS,K0007UE,Extra heavy duty wheelchair,,,460.91,460.91,1
HCPCS,K0008,Cstm manual wheelchair/base,,,13824.0,13824.0,1
HCPCS,K00080,Cstm manual wheelchair/base,,,13824.0,13824.0,1
HCPCS,K0009,Other manual wheelchair/base,,,60.25,602.55,8
HCPCS,K00090,Other manual wheelchair/base,,,602.55,602.55,1
HCPCS,K0009MS,Other manual wheelchair/base,,,60.25,60.25,1
HCPCS,K0009NU,Other manual wheelchair/base,,,602.55,602.55,1
HCPCS,K0009RR,Other manual wheelchair/base,,,60.25,166.87,4
HCPCS,K0009UE,Other manual wheelchair/base,,,451.92,451.92,1
HCPCS,K0010,Stnd wt frame power whlchr,,,324.09,3240.86,8
HCPCS,K00100,Stnd wt frame power whlchr,,,3240.86,3240.86,1
HCPCS,K0010MS,Stnd wt frame power whlchr,,,324.09,324.09,1
HCPCS,K0010NU,Stnd wt frame power whlchr,,,3240.86,3240.86,1
HCPCS,K0010RR,Stnd wt frame power whlchr,,,324.09,845.38,4
HCPCS,K0010UE,Stnd wt frame power whlchr,,,2430.65,2430.65,1
HCPCS,K0011,Stnd wt pwr whlchr w control,,,145.37,4151.89,9
HCPCS,K00110,Stnd wt pwr whlchr w control,,,4151.89,4151.89,1
HCPCS,K0011KF,Stnd wt pwr whlchr w control,,,145.37,145.37,1
HCPCS,K0011MS,Stnd wt pwr whlchr w control,,,415.18,415.18,1
HCPCS,K0011NU,Stnd wt pwr whlchr w control,,,4151.89,4151.89,1
HCPCS,K0011RR,Stnd wt pwr whlchr w control,,,415.18,1131.99,4
HCPCS,K0011UE,Stnd wt pwr whlchr w control,,,3113.91,3113.91,1
HCPCS,K0012,Ltwt portbl power whlchr,,,263.34,2633.39,8
HCPCS,K00120,Ltwt portbl power whlchr,,,2633.39,2633.39,1
HCPCS,K0012MS,Ltwt portbl power whlchr,,,263.34,263.34,1
HCPCS,K0012NU,Ltwt portbl power whlchr,,,2633.39,2633.39,1
HCPCS,K0012RR,Ltwt portbl power whlchr,,,263.34,694.4,4
HCPCS,K0012UE,Ltwt portbl power whlchr,,,1975.04,1975.04,1
HCPCS,K0013,Custom power whlchr base,,,1354.32,1354.32,1
HCPCS,K00130,Custom power whlchr base,,,1354.32,1354.32,1
HCPCS,K0014,Other power whlchr base,,,963.9,9639.0,5
HCPCS,K00140,Other power whlchr base,,,9639.0,9639.0,1
HCPCS,K0014MS,Other power whlchr base,,,963.9,963.9,1
HCPCS,K0014NU,Other power whlchr base,,,9639.0,9639.0,1
HCPCS,K0014RR,Other power whlchr base,,,963.9,963.9,1
HCPCS,K0014UE,Other power whlchr base,,,7229.25,7229.25,1
HCPCS,K0015,Detach non-adj ht armrst rep,,,10.45,104.54,8
HCPCS,K00150,Detach non-adj ht armrst rep,,,104.54,104.54,1
HCPCS,K0015MS,Detach non-adj ht armrst rep,,,10.45,10.45,1
HCPCS,K0015NU,Detach non-adj ht armrst rep,,,104.54,104.54,1
HCPCS,K0015RR,Detach non-adj ht armrst rep,,,10.45,28.56,4
HCPCS,K0015UE,Detach non-adj ht armrst rep,,,78.41,78.41,1
HCPCS,K0017,Detach adjust armrest base,,,3.32,96.0,14
HCPCS,K00170,Detach adjust armrest base,,,33.12,33.12,1
HCPCS,K0017MS,Detach adjust armrest base,,,3.32,3.32,1
HCPCS,K0017NU,Detach adjust armrest base,,,33.12,96.0,4
HCPCS,K0017RR,Detach adjust armrest base,,,3.32,9.59,4
HCPCS,K0017UE,Detach adjust armrest base,,,24.85,72.0,4
HCPCS,K0018,Detach adjust armrst upper,,,1.87,54.26,14
HCPCS,K00180,Detach adjust armrst upper,,,18.73,18.73,1
HCPCS,K0018MS,Detach adjust armrst upper,,,1.87,1.87,1
HCPCS,K0018NU,Detach adjust armrst upper,,,18.73,54.26,4
HCPCS,K0018RR,Detach adjust armrst upper,,,1.87,5.43,4
HCPCS,K0018UE,Detach adjust armrst upper,,,14.05,40.71,4
HCPCS,K0019,"Arm pad repl, each",,,0.95,25.65,14
HCPCS,K00190,"Arm pad repl, each",,,9.54,9.54,1
HCPCS,K0019MS,"Arm pad repl, each",,,0.95,0.95,1
HCPCS,K0019NU,"Arm pad repl, each",,,9.54,25.65,4
HCPCS,K0019RR,"Arm pad repl, each",,,0.95,2.57,4
HCPCS,K0019UE,"Arm pad repl, each",,,7.15,19.23,4
HCPCS,K0020,Fixed adjust armrest pair,,,3.24,93.49,14
HCPCS,K00200,Fixed adjust armrest pair,,,32.45,32.45,1
HCPCS,K0020MS,Fixed adjust armrest pair,,,3.24,3.24,1
HCPCS,K0020NU,Fixed adjust armrest pair,,,32.45,93.49,4
HCPCS,K0020RR,Fixed adjust armrest pair,,,3.24,9.36,4
HCPCS,K0020UE,Fixed adjust armrest pair,,,24.33,70.12,4
HCPCS,K0037,Hi mount flip-up footrest ea,,,2.55,90.32,14
HCPCS,K00370,Hi mount flip-up footrest ea,,,28.6,28.6,1
HCPCS,K0037MS,Hi mount flip-up footrest ea,,,2.55,2.55,1
HCPCS,K0037NU,Hi mount flip-up footrest ea,,,28.6,90.32,4
HCPCS,K0037RR,Hi mount flip-up footrest ea,,,2.55,8.64,4
HCPCS,K0037UE,Hi mount flip-up footrest ea,,,21.46,67.74,4
HCPCS,K0038,Leg strap each,,,1.65,47.97,14
HCPCS,K00380,Leg strap each,,,16.56,16.56,1
HCPCS,K0038MS,Leg strap each,,,1.65,1.65,1
HCPCS,K0038NU,Leg strap each,,,16.56,47.97,4
HCPCS,K0038RR,Leg strap each,,,1.65,4.8,4
HCPCS,K0038UE,Leg strap each,,,12.42,35.99,4
HCPCS,K0039,Leg strap h style each,,,3.55,103.02,14
HCPCS,K00390,Leg strap h style each,,,35.55,35.55,1
HCPCS,K0039MS,Leg strap h style each,,,3.55,3.55,1
HCPCS,K0039NU,Leg strap h style each,,,35.55,103.02,4
HCPCS,K0039RR,Leg strap h style each,,,3.55,10.31,4
HCPCS,K0039UE,Leg strap h style each,,,26.67,77.27,4
HCPCS,K0040,Adjustable angle footplate,,,3.67,106.51,14
HCPCS,K00400,Adjustable angle footplate,,,36.68,36.68,1
HCPCS,K0040MS,Adjustable angle footplate,,,3.67,3.67,1
HCPCS,K0040NU,Adjustable angle footplate,,,36.68,106.51,4
HCPCS,K0040RR,Adjustable angle footplate,,,3.67,10.64,4
HCPCS,K0040UE,Adjustable angle footplate,,,27.52,79.89,4
HCPCS,K0041,Large size footplate each,,,3.4,98.46,14
HCPCS,K00410,Large size footplate each,,,33.98,33.98,1
HCPCS,K0041MS,Large size footplate each,,,3.4,3.4,1
HCPCS,K0041NU,Large size footplate each,,,33.98,98.46,4
HCPCS,K0041RR,Large size footplate each,,,3.4,9.84,4
HCPCS,K0041UE,Large size footplate each,,,25.49,73.84,4
HCPCS,K0042,Standard size ftplate rep ea,,,2.18,63.23,14
HCPCS,K00420,Standard size ftplate rep ea,,,21.83,21.83,1
HCPCS,K0042MS,Standard size ftplate rep ea,,,2.18,2.18,1
HCPCS,K0042NU,Standard size ftplate rep ea,,,21.83,63.23,4
HCPCS,K0042RR,Standard size ftplate rep ea,,,2.18,6.33,4
HCPCS,K0042UE,Standard size ftplate rep ea,,,16.36,47.42,4
HCPCS,K0043,Ftrst lowr exten tube rep ea,,,1.35,39.03,14
HCPCS,K00430,Ftrst lowr exten tube rep ea,,,13.47,13.47,1
HCPCS,K0043MS,Ftrst lowr exten tube rep ea,,,1.35,1.35,1
HCPCS,K0043NU,Ftrst lowr exten tube rep ea,,,13.47,39.03,4
HCPCS,K0043RR,Ftrst lowr exten tube rep ea,,,1.35,3.91,4
HCPCS,K0043UE,Ftrst lowr exten tube rep ea,,,10.11,29.28,4
HCPCS,K0044,Ftrst upr hanger brac rep ea,,,1.17,33.49,14
HCPCS,K00440,Ftrst upr hanger brac rep ea,,,11.62,11.62,1
HCPCS,K0044MS,Ftrst upr hanger brac rep ea,,,1.17,1.17,1
HCPCS,K0044NU,Ftrst upr hanger brac rep ea,,,11.62,33.49,4
HCPCS,K0044RR,Ftrst upr hanger brac rep ea,,,1.17,3.36,4
HCPCS,K0044UE,Ftrst upr hanger brac rep ea,,,8.72,25.12,4
HCPCS,K0045,Ftrst compl assembly repl ea,,,3.86,111.71,14
HCPCS,K00450,Ftrst compl assembly repl ea,,,38.56,38.56,1
HCPCS,K0045MS,Ftrst compl assembly repl ea,,,3.86,3.86,1
HCPCS,K0045NU,Ftrst compl assembly repl ea,,,38.56,111.71,4
HCPCS,K0045RR,Ftrst compl assembly repl ea,,,3.86,11.18,4
HCPCS,K0045UE,Ftrst compl assembly repl ea,,,28.91,83.78,4
HCPCS,K0046,Elev lgrst lwr exten repl ea,,,1.35,39.27,14
HCPCS,K00460,Elev lgrst lwr exten repl ea,,,13.56,13.56,1
HCPCS,K0046MS,Elev lgrst lwr exten repl ea,,,1.35,1.35,1
HCPCS,K0046NU,Elev lgrst lwr exten repl ea,,,13.56,39.27,4
HCPCS,K0046RR,Elev lgrst lwr exten repl ea,,,1.35,3.91,4
HCPCS,K0046UE,Elev lgrst lwr exten repl ea,,,10.17,29.48,4
HCPCS,K0047,Elev legrst upr hangr rep ea,,,4.8,138.84,14
HCPCS,K00470,Elev legrst upr hangr rep ea,,,47.92,47.92,1
HCPCS,K0047MS,Elev legrst upr hangr rep ea,,,4.8,4.8,1
HCPCS,K0047NU,Elev legrst upr hangr rep ea,,,47.92,138.84,4
HCPCS,K0047RR,Elev legrst upr hangr rep ea,,,4.8,13.89,4
HCPCS,K0047UE,Elev legrst upr hangr rep ea,,,35.94,104.14,4
HCPCS,K0050,Ratchet assembly replacement,,,2.22,64.42,14
HCPCS,K00500,Ratchet assembly replacement,,,22.24,22.24,1
HCPCS,K0050MS,Ratchet assembly replacement,,,2.22,2.22,1
HCPCS,K0050NU,Ratchet assembly replacement,,,22.24,64.42,4
HCPCS,K0050RR,Ratchet assembly replacement,,,2.22,6.43,4
HCPCS,K0050UE,Ratchet assembly replacement,,,16.68,48.31,4
HCPCS,K0051,Cam rel asm ft/legrst rep ea,,,3.52,101.9,14
HCPCS,K00510,Cam rel asm ft/legrst rep ea,,,35.18,35.18,1
HCPCS,K0051MS,Cam rel asm ft/legrst rep ea,,,3.52,3.52,1
HCPCS,K0051NU,Cam rel asm ft/legrst rep ea,,,35.18,101.9,4
HCPCS,K0051RR,Cam rel asm ft/legrst rep ea,,,3.52,10.19,4
HCPCS,K0051UE,Cam rel asm ft/legrst rep ea,,,26.38,76.43,4
HCPCS,K0052,Swingaway detach ftrest repl,,,5.26,143.47,14
HCPCS,K00520,Swingaway detach ftrest repl,,,52.64,52.64,1
HCPCS,K0052MS,Swingaway detach ftrest repl,,,5.26,5.26,1
HCPCS,K0052NU,Swingaway detach ftrest repl,,,52.64,143.47,4
HCPCS,K0052RR,Swingaway detach ftrest repl,,,5.26,14.35,4
HCPCS,K0052UE,Swingaway detach ftrest repl,,,39.47,107.61,4
HCPCS,K0053,Elevate footrest articulate,,,5.92,166.55,14
HCPCS,K00530,Elevate footrest articulate,,,59.19,59.19,1
HCPCS,K0053MS,Elevate footrest articulate,,,5.92,5.92,1
HCPCS,K0053NU,Elevate footrest articulate,,,59.19,166.55,4
HCPCS,K0053RR,Elevate footrest articulate,,,5.92,16.66,4
HCPCS,K0053UE,Elevate footrest articulate,,,44.4,124.91,4
HCPCS,K0056,Seat ht <17 or >=21 ltwt wc,,,6.65,190.41,14
HCPCS,K00560,Seat ht <17 or >=21 ltwt wc,,,66.5,66.5,1
HCPCS,K0056MS,Seat ht <17 or >=21 ltwt wc,,,6.65,6.65,1
HCPCS,K0056NU,Seat ht <17 or >=21 ltwt wc,,,66.5,190.41,4
HCPCS,K0056RR,Seat ht <17 or >=21 ltwt wc,,,6.65,19.05,4
HCPCS,K0056UE,Seat ht <17 or >=21 ltwt wc,,,49.87,142.8,4
HCPCS,K0065,Spoke protectors,,,3.35,90.65,14
HCPCS,K00650,Spoke protectors,,,33.51,33.51,1
HCPCS,K0065MS,Spoke protectors,,,3.35,3.35,1
HCPCS,K0065NU,Spoke protectors,,,33.51,90.65,4
HCPCS,K0065RR,Spoke protectors,,,3.35,9.07,4
HCPCS,K0065UE,Spoke protectors,,,25.13,67.99,4
HCPCS,K0069,Rr whl compl sol tire rep ea,,,6.78,188.29,14
HCPCS,K00690,Rr whl compl sol tire rep ea,,,67.81,67.81,1
HCPCS,K0069MS,Rr whl compl sol tire rep ea,,,6.78,6.78,1
HCPCS,K0069NU,Rr whl compl sol tire rep ea,,,67.81,188.29,4
HCPCS,K0069RR,Rr whl compl sol tire rep ea,,,6.78,18.83,4
HCPCS,K0069UE,Rr whl compl sol tire rep ea,,,50.87,141.22,4
HCPCS,K0070,Rr whl compl pne tire rep ea,,,11.21,112.15,8
HCPCS,K00700,Rr whl compl pne tire rep ea,,,112.15,112.15,1
HCPCS,K0070MS,Rr whl compl pne tire rep ea,,,11.21,11.21,1
HCPCS,K0070NU,Rr whl compl pne tire rep ea,,,112.15,112.15,1
HCPCS,K0070RR,Rr whl compl pne tire rep ea,,,11.21,33.15,4
HCPCS,K0070UE,Rr whl compl pne tire rep ea,,,84.11,84.11,1
HCPCS,K0071,Fr cstr comp pne tire rep ea,,,7.82,214.04,14
HCPCS,K00710,Fr cstr comp pne tire rep ea,,,78.2,78.2,1
HCPCS,K0071MS,Fr cstr comp pne tire rep ea,,,7.82,7.82,1
HCPCS,K0071NU,Fr cstr comp pne tire rep ea,,,78.2,214.04,4
HCPCS,K0071RR,Fr cstr comp pne tire rep ea,,,7.82,21.41,4
HCPCS,K0071UE,Fr cstr comp pne tire rep ea,,,58.65,160.53,4
HCPCS,K0072,Fr cstr semi-pne tire rep ea,,,4.82,134.16,14
HCPCS,K00720,Fr cstr semi-pne tire rep ea,,,48.12,48.12,1
HCPCS,K0072MS,Fr cstr semi-pne tire rep ea,,,4.82,4.82,1
HCPCS,K0072NU,Fr cstr semi-pne tire rep ea,,,48.12,134.16,4
HCPCS,K0072RR,Fr cstr semi-pne tire rep ea,,,4.82,13.42,4
HCPCS,K0072UE,Fr cstr semi-pne tire rep ea,,,36.09,100.63,4
HCPCS,K0073,Caster pin lock each,,,2.54,69.86,14
HCPCS,K00730,Caster pin lock each,,,25.4,25.4,1
HCPCS,K0073MS,Caster pin lock each,,,2.54,2.54,1
HCPCS,K0073NU,Caster pin lock each,,,25.4,69.86,4
HCPCS,K0073RR,Caster pin lock each,,,2.54,6.98,4
HCPCS,K0073UE,Caster pin lock each,,,19.05,52.4,4
HCPCS,K0077,Fr cstr asmb sol tire rep ea,,,3.84,109.13,14
HCPCS,K00770,Fr cstr asmb sol tire rep ea,,,38.42,38.42,1
HCPCS,K0077MS,Fr cstr asmb sol tire rep ea,,,3.84,3.84,1
HCPCS,K0077NU,Fr cstr asmb sol tire rep ea,,,38.42,109.13,4
HCPCS,K0077RR,Fr cstr asmb sol tire rep ea,,,3.84,10.91,4
HCPCS,K0077UE,Fr cstr asmb sol tire rep ea,,,28.83,81.86,4
HCPCS,K0098,"Drive belt for pwc, repl",,,1.73,47.19,14
HCPCS,K00980,"Drive belt for pwc, repl",,,17.3,17.3,1
HCPCS,K0098MS,"Drive belt for pwc, repl",,,1.73,1.73,1
HCPCS,K0098NU,"Drive belt for pwc, repl",,,17.3,47.19,4
HCPCS,K0098RR,"Drive belt for pwc, repl",,,1.73,4.73,4
HCPCS,K0098UE,"Drive belt for pwc, repl",,,12.98,35.41,4
HCPCS,K0105,Iv hanger,,,7.15,197.04,14
HCPCS,K01050,Iv hanger,,,71.53,71.53,1
HCPCS,K0105MS,Iv hanger,,,7.15,7.15,1
HCPCS,K0105NU,Iv hanger,,,71.53,197.04,4
HCPCS,K0105RR,Iv hanger,,,7.15,19.7,4
HCPCS,K0105UE,Iv hanger,,,53.65,147.8,4
HCPCS,K0195,Elevating whlchair leg rests,,,7.41,74.13,8
HCPCS,K01950,Elevating whlchair leg rests,,,74.13,74.13,1
HCPCS,K0195MS,Elevating whlchair leg rests,,,7.41,7.41,1
HCPCS,K0195NU,Elevating whlchair leg rests,,,74.13,74.13,1
HCPCS,K0195RR,Elevating whlchair leg rests,,,7.41,22.14,4
HCPCS,K0195UE,Elevating whlchair leg rests,,,55.6,55.6,1
HCPCS,K0455,Pump uninterrupted infusion,,,214.66,2146.66,8
HCPCS,K04550,Pump uninterrupted infusion,,,2146.66,2146.66,1
HCPCS,K0455MS,Pump uninterrupted infusion,,,214.66,214.66,1
HCPCS,K0455NU,Pump uninterrupted infusion,,,2146.66,2146.66,1
HCPCS,K0455RR,Pump uninterrupted infusion,,,214.66,566.07,4
HCPCS,K0455UE,Pump uninterrupted infusion,,,1609.99,1609.99,1
HCPCS,K0462,Temporary replacement eqpmnt,,,113.54,113.54,1
HCPCS,K04620,Temporary replacement eqpmnt,,,113.54,113.54,1
HCPCS,K0552,Sup/ext non-ins inf pump syr,,,1.94,5.65,4
HCPCS,K05520,Sup/ext non-ins inf pump syr,,,1.94,1.94,1
HCPCS,K0601,Repl batt silver oxide 1.5 v,,,0.09,2.56,7
HCPCS,K06010,Repl batt silver oxide 1.5 v,,,0.89,0.89,1
HCPCS,K0601MS,Repl batt silver oxide 1.5 v,,,0.09,0.09,1
HCPCS,K0601NU,Repl batt silver oxide 1.5 v,,,0.89,2.56,4
HCPCS,K0601RR,Repl batt silver oxide 1.5 v,,,0.09,0.09,1
HCPCS,K0602,Repl batt silver oxide 3 v,,,0.5,14.44,7
HCPCS,K06020,Repl batt silver oxide 3 v,,,4.98,4.98,1
HCPCS,K0602MS,Repl batt silver oxide 3 v,,,0.5,0.5,1
HCPCS,K0602NU,Repl batt silver oxide 3 v,,,4.98,14.44,4
HCPCS,K0602RR,Repl batt silver oxide 3 v,,,0.5,0.5,1
HCPCS,K0603,Repl batt alkaline 1.5 v,,,0.04,1.3,7
HCPCS,K06030,Repl batt alkaline 1.5 v,,,0.44,0.44,1
HCPCS,K0603MS,Repl batt alkaline 1.5 v,,,0.04,0.04,1
HCPCS,K0603NU,Repl batt alkaline 1.5 v,,,0.44,1.3,4
HCPCS,K0603RR,Repl batt alkaline 1.5 v,,,0.04,0.04,1
HCPCS,K0604,Repl batt lithium 3.6 v,,,0.25,13.92,7
HCPCS,K06040,Repl batt lithium 3.6 v,,,4.81,4.81,1
HCPCS,K0604MS,Repl batt lithium 3.6 v,,,0.49,0.49,1
HCPCS,K0604NU,Repl batt lithium 3.6 v,,,4.81,13.92,4
HCPCS,K0604RR,Repl batt lithium 3.6 v,,,0.25,0.25,1
HCPCS,K0605,Repl batt lithium 4.5 v,,,1.14,33.27,7
HCPCS,K06050,Repl batt lithium 4.5 v,,,11.48,11.48,1
HCPCS,K0605MS,Repl batt lithium 4.5 v,,,1.14,1.14,1
HCPCS,K0605NU,Repl batt lithium 4.5 v,,,11.48,33.27,4
HCPCS,K0605RR,Repl batt lithium 4.5 v,,,1.14,1.14,1
HCPCS,K0606,Aed garment w elec analysis,,,2041.02,20410.2,5
HCPCS,K06060,Aed garment w elec analysis,,,20410.2,20410.2,1
HCPCS,K0606MS,Aed garment w elec analysis,,,2041.02,2041.02,1
HCPCS,K0606NU,Aed garment w elec analysis,,,20410.2,20410.2,1
HCPCS,K0606RR,Aed garment w elec analysis,,,2041.02,2041.02,1
HCPCS,K0606UE,Aed garment w elec analysis,,,15307.65,15307.65,1
HCPCS,K0607,Repl batt for aed,,,15.75,157.47,8
HCPCS,K06070,Repl batt for aed,,,157.47,157.47,1
HCPCS,K0607MS,Repl batt for aed,,,15.75,15.75,1
HCPCS,K0607NU,Repl batt for aed,,,157.47,157.47,1
HCPCS,K0607RR,Repl batt for aed,,,15.75,45.37,4
HCPCS,K0607UE,Repl batt for aed,,,118.1,118.1,1
HCPCS,K0608,Repl garment for aed,,,9.84,282.98,14
HCPCS,K06080,Repl garment for aed,,,98.24,98.24,1
HCPCS,K0608MS,Repl garment for aed,,,9.84,9.84,1
HCPCS,K0608NU,Repl garment for aed,,,98.24,282.98,4
HCPCS,K0608RR,Repl garment for aed,,,9.84,28.36,4
HCPCS,K0608UE,Repl garment for aed,,,73.68,212.23,4
HCPCS,K0609,Repl electrode for aed,,,369.71,2089.49,8
HCPCS,K06090,Repl electrode for aed,,,653.31,653.31,1
HCPCS,K0609KF,Repl electrode for aed,,,369.71,2089.49,4
HCPCS,K0669,Seat/back cus no dmepdac ver,,,63.59,63.59,2
HCPCS,K06690,Seat/back cus no dmepdac ver,,,63.59,63.59,1
HCPCS,K0669NU,Seat/back cus no dmepdac ver,,,63.59,63.59,1
HCPCS,K0672,Removable soft interface le,,,59.27,171.63,4
HCPCS,K06720,Removable soft interface le,,,59.27,59.27,1
HCPCS,K0730,Ctrl dose inh drug deliv sys,,,139.72,1397.21,8
HCPCS,K07300,Ctrl dose inh drug deliv sys,,,1397.21,1397.21,1
HCPCS,K0730MS,Ctrl dose inh drug deliv sys,,,139.72,139.72,1
HCPCS,K0730NU,Ctrl dose inh drug deliv sys,,,1397.21,1397.21,1
HCPCS,K0730RR,Ctrl dose inh drug deliv sys,,,139.72,402.49,4
HCPCS,K0730UE,Ctrl dose inh drug deliv sys,,,1047.9,1047.9,1
HCPCS,K0733,12-24hr sealed lead acid,,,2.0,55.78,14
HCPCS,K07330,12-24hr sealed lead acid,,,19.96,19.96,1
HCPCS,K0733MS,12-24hr sealed lead acid,,,2.0,2.0,1
HCPCS,K0733NU,12-24hr sealed lead acid,,,19.96,55.78,4
HCPCS,K0733RR,12-24hr sealed lead acid,,,2.0,5.58,4
HCPCS,K0733UE,12-24hr sealed lead acid,,,14.97,41.84,4
HCPCS,K0738,Portable gas oxygen system,,,25.98,259.88,8
HCPCS,K07380,Portable gas oxygen system,,,259.88,259.88,1
HCPCS,K0738MS,Portable gas oxygen system,,,25.98,25.98,1
HCPCS,K0738NU,Portable gas oxygen system,,,259.88,259.88,1
HCPCS,K0738RR,Portable gas oxygen system,,,25.98,78.0,4
HCPCS,K0738UE,Portable gas oxygen system,,,194.91,194.91,1
HCPCS,K0739,Repair/svc dme non-oxygen eq,,,10.44,32.72,4
HCPCS,K07390,Repair/svc dme non-oxygen eq,,,10.44,10.44,1
HCPCS,K0740,Repair/svc oxygen equipment,,,10.8,10.8,1
HCPCS,K07400,Repair/svc oxygen equipment,,,10.8,10.8,1
HCPCS,K0743,Portable home suction pump,,,19.22,192.24,5
HCPCS,K07430,Portable home suction pump,,,192.24,192.24,1
HCPCS,K0743MS,Portable home suction pump,,,19.22,19.22,1
HCPCS,K0743NU,Portable home suction pump,,,192.24,192.24,1
HCPCS,K0743RR,Portable home suction pump,,,19.22,19.22,1
HCPCS,K0743UE,Portable home suction pump,,,144.18,144.18,1
HCPCS,K0744,Absorp drg <= 16 suc pump,,,54.0,54.0,2
HCPCS,K07440,Absorp drg <= 16 suc pump,,,54.0,54.0,1
HCPCS,K0744NU,Absorp drg <= 16 suc pump,,,54.0,54.0,1
HCPCS,K0745,Absorp drg >16<=48 suc pump,,,27.0,27.0,1
HCPCS,K07450,Absorp drg >16<=48 suc pump,,,27.0,27.0,1
HCPCS,K0800,Pov group 1 std up to 300lbs,,,57.35,1721.85,14
HCPCS,K08000,Pov group 1 std up to 300lbs,,,573.51,573.51,1
HCPCS,K0800MS,Pov group 1 std up to 300lbs,,,57.35,57.35,1
HCPCS,K0800NU,Pov group 1 std up to 300lbs,,,573.51,1721.85,4
HCPCS,K0800RR,Pov group 1 std up to 300lbs,,,57.35,172.18,4
HCPCS,K0800UE,Pov group 1 std up to 300lbs,,,430.13,1291.38,4
HCPCS,K0801,Pov group 1 hd 301-450 lbs,,,104.11,3094.68,14
HCPCS,K08010,Pov group 1 hd 301-450 lbs,,,1041.11,1041.11,1
HCPCS,K0801MS,Pov group 1 hd 301-450 lbs,,,104.11,104.11,1
HCPCS,K0801NU,Pov group 1 hd 301-450 lbs,,,1041.11,3094.68,4
HCPCS,K0801RR,Pov group 1 hd 301-450 lbs,,,104.11,309.47,4
HCPCS,K0801UE,Pov group 1 hd 301-450 lbs,,,780.83,2321.0,4
HCPCS,K0802,Pov group 1 vhd 451-600 lbs,,,142.98,4094.42,14
HCPCS,K08020,Pov group 1 vhd 451-600 lbs,,,1429.77,1429.77,1
HCPCS,K0802MS,Pov group 1 vhd 451-600 lbs,,,142.98,142.98,1
HCPCS,K0802NU,Pov group 1 vhd 451-600 lbs,,,1429.77,4094.42,4
HCPCS,K0802RR,Pov group 1 vhd 451-600 lbs,,,142.98,409.45,4
HCPCS,K0802UE,Pov group 1 vhd 451-600 lbs,,,1072.33,3070.83,4
HCPCS,K0806,Pov group 2 std up to 300lbs,,,98.2,2845.48,14
HCPCS,K08060,Pov group 2 std up to 300lbs,,,982.03,982.03,1
HCPCS,K0806MS,Pov group 2 std up to 300lbs,,,98.2,98.2,1
HCPCS,K0806NU,Pov group 2 std up to 300lbs,,,982.03,2845.48,4
HCPCS,K0806RR,Pov group 2 std up to 300lbs,,,98.2,284.55,4
HCPCS,K0806UE,Pov group 2 std up to 300lbs,,,736.53,2134.12,4
HCPCS,K0807,Pov group 2 hd 301-450 lbs,,,152.19,4409.79,14
HCPCS,K08070,Pov group 2 hd 301-450 lbs,,,1521.91,1521.91,1
HCPCS,K0807MS,Pov group 2 hd 301-450 lbs,,,152.19,152.19,1
HCPCS,K0807NU,Pov group 2 hd 301-450 lbs,,,1521.91,4409.79,4
HCPCS,K0807RR,Pov group 2 hd 301-450 lbs,,,152.19,440.98,4
HCPCS,K0807UE,Pov group 2 hd 301-450 lbs,,,1141.44,3307.34,4
HCPCS,K0808,Pov group 2 vhd 451-600 lbs,,,235.27,6816.79,14
HCPCS,K08080,Pov group 2 vhd 451-600 lbs,,,2352.63,2352.63,1
HCPCS,K0808MS,Pov group 2 vhd 451-600 lbs,,,235.27,235.27,1
HCPCS,K0808NU,Pov group 2 vhd 451-600 lbs,,,2352.63,6816.79,4
HCPCS,K0808RR,Pov group 2 vhd 451-600 lbs,,,235.27,681.68,4
HCPCS,K0808UE,Pov group 2 vhd 451-600 lbs,,,1764.47,5112.59,4
HCPCS,K0812,Power operated vehicle noc,,,615.6,615.6,1
HCPCS,K08120,Power operated vehicle noc,,,615.6,615.6,1
HCPCS,K0813,Pwc gp 1 std port seat/back,,,183.87,1838.67,8
HCPCS,K08130,Pwc gp 1 std port seat/back,,,1838.67,1838.67,1
HCPCS,K0813MS,Pwc gp 1 std port seat/back,,,183.87,183.87,1
HCPCS,K0813NU,Pwc gp 1 std port seat/back,,,1838.67,1838.67,1
HCPCS,K0813RR,Pwc gp 1 std port seat/back,,,183.87,523.36,4
HCPCS,K0813UE,Pwc gp 1 std port seat/back,,,1379.0,1379.0,1
HCPCS,K0814,Pwc gp 1 std port cap chair,,,182.54,1825.43,8
HCPCS,K08140,Pwc gp 1 std port cap chair,,,1825.43,1825.43,1
HCPCS,K0814MS,Pwc gp 1 std port cap chair,,,182.54,182.54,1
HCPCS,K0814NU,Pwc gp 1 std port cap chair,,,1825.43,1825.43,1
HCPCS,K0814RR,Pwc gp 1 std port cap chair,,,182.54,548.51,4
HCPCS,K0814UE,Pwc gp 1 std port cap chair,,,1369.06,1369.06,1
HCPCS,K0815,Pwc gp 1 std seat/back,,,201.71,2017.11,8
HCPCS,K08150,Pwc gp 1 std seat/back,,,2017.11,2017.11,1
HCPCS,K0815MS,Pwc gp 1 std seat/back,,,201.71,201.71,1
HCPCS,K0815NU,Pwc gp 1 std seat/back,,,2017.11,2017.11,1
HCPCS,K0815RR,Pwc gp 1 std seat/back,,,201.71,609.45,4
HCPCS,K0815UE,Pwc gp 1 std seat/back,,,1512.83,1512.83,1
HCPCS,K0816,Pwc gp 1 std cap chair,,,190.93,1909.3,8
HCPCS,K08160,Pwc gp 1 std cap chair,,,1909.3,1909.3,1
HCPCS,K0816MS,Pwc gp 1 std cap chair,,,190.93,190.93,1
HCPCS,K0816NU,Pwc gp 1 std cap chair,,,1909.3,1909.3,1
HCPCS,K0816RR,Pwc gp 1 std cap chair,,,190.93,569.16,4
HCPCS,K0816UE,Pwc gp 1 std cap chair,,,1431.97,1431.97,1
HCPCS,K0820,Pwc gp 2 std port seat/back,,,186.15,1861.54,8
HCPCS,K08200,Pwc gp 2 std port seat/back,,,1861.54,1861.54,1
HCPCS,K0820MS,Pwc gp 2 std port seat/back,,,186.15,186.15,1
HCPCS,K0820NU,Pwc gp 2 std port seat/back,,,1861.54,1861.54,1
HCPCS,K0820RR,Pwc gp 2 std port seat/back,,,186.15,535.29,4
HCPCS,K0820UE,Pwc gp 2 std port seat/back,,,1396.15,1396.15,1
HCPCS,K0821,Pwc gp 2 std port cap chair,,,192.83,1928.31,8
HCPCS,K08210,Pwc gp 2 std port cap chair,,,1928.31,1928.31,1
HCPCS,K0821MS,Pwc gp 2 std port cap chair,,,192.83,192.83,1
HCPCS,K0821NU,Pwc gp 2 std port cap chair,,,1928.31,1928.31,1
HCPCS,K0821RR,Pwc gp 2 std port cap chair,,,192.83,569.69,4
HCPCS,K0821UE,Pwc gp 2 std port cap chair,,,1446.23,1446.23,1
HCPCS,K0822,Pwc gp 2 std seat/back,,,203.64,2036.42,8
HCPCS,K08220,Pwc gp 2 std seat/back,,,2036.42,2036.42,1
HCPCS,K0822MS,Pwc gp 2 std seat/back,,,203.64,203.64,1
HCPCS,K0822NU,Pwc gp 2 std seat/back,,,2036.42,2036.42,1
HCPCS,K0822RR,Pwc gp 2 std seat/back,,,203.64,610.07,4
HCPCS,K0822UE,Pwc gp 2 std seat/back,,,1527.3,1527.3,1
HCPCS,K0823,Pwc gp 2 std cap chair,,,193.05,1930.5,8
HCPCS,K08230,Pwc gp 2 std cap chair,,,1930.5,1930.5,1
HCPCS,K0823MS,Pwc gp 2 std cap chair,,,193.05,193.05,1
HCPCS,K0823NU,Pwc gp 2 std cap chair,,,1930.5,1930.5,1
HCPCS,K0823RR,Pwc gp 2 std cap chair,,,193.05,569.98,4
HCPCS,K0823UE,Pwc gp 2 std cap chair,,,1447.88,1447.88,1
HCPCS,K0824,Pwc gp 2 hd seat/back,,,290.81,2908.11,8
HCPCS,K08240,Pwc gp 2 hd seat/back,,,2908.11,2908.11,1
HCPCS,K0824MS,Pwc gp 2 hd seat/back,,,290.81,290.81,1
HCPCS,K0824NU,Pwc gp 2 hd seat/back,,,2908.11,2908.11,1
HCPCS,K0824RR,Pwc gp 2 hd seat/back,,,290.81,888.77,4
HCPCS,K0824UE,Pwc gp 2 hd seat/back,,,2181.08,2181.08,1
HCPCS,K0825,Pwc gp 2 hd cap chair,,,265.41,2654.11,8
HCPCS,K08250,Pwc gp 2 hd cap chair,,,2654.11,2654.11,1
HCPCS,K0825MS,Pwc gp 2 hd cap chair,,,265.41,265.41,1
HCPCS,K0825NU,Pwc gp 2 hd cap chair,,,2654.11,2654.11,1
HCPCS,K0825RR,Pwc gp 2 hd cap chair,,,265.41,804.77,4
HCPCS,K0825UE,Pwc gp 2 hd cap chair,,,1990.58,1990.58,1
HCPCS,K0826,Pwc gp 2 vhd seat/back,,,538.2,5382.0,8
HCPCS,K08260,Pwc gp 2 vhd seat/back,,,5382.0,5382.0,1
HCPCS,K0826MS,Pwc gp 2 vhd seat/back,,,538.2,538.2,1
HCPCS,K0826NU,Pwc gp 2 vhd seat/back,,,5382.0,5382.0,1
HCPCS,K0826RR,Pwc gp 2 vhd seat/back,,,538.2,1485.37,4
HCPCS,K0826UE,Pwc gp 2 vhd seat/back,,,4036.5,4036.5,1
HCPCS,K0827,Pwc gp vhd cap chair,,,463.92,4639.26,8
HCPCS,K08270,Pwc gp vhd cap chair,,,4639.26,4639.26,1
HCPCS,K0827MS,Pwc gp vhd cap chair,,,463.92,463.92,1
HCPCS,K0827NU,Pwc gp vhd cap chair,,,4639.26,4639.26,1
HCPCS,K0827RR,Pwc gp vhd cap chair,,,463.92,1307.66,4
HCPCS,K0827UE,Pwc gp vhd cap chair,,,3479.45,3479.45,1
HCPCS,K0828,Pwc gp 2 xtra hd seat/back,,,658.77,6587.7,8
HCPCS,K08280,Pwc gp 2 xtra hd seat/back,,,6587.7,6587.7,1
HCPCS,K0828MS,Pwc gp 2 xtra hd seat/back,,,658.77,658.77,1
HCPCS,K0828NU,Pwc gp 2 xtra hd seat/back,,,6587.7,6587.7,1
HCPCS,K0828RR,Pwc gp 2 xtra hd seat/back,,,658.77,1731.56,4
HCPCS,K0828UE,Pwc gp 2 xtra hd seat/back,,,4940.77,4940.77,1
HCPCS,K0829,Pwc gp 2 xtra hd cap chair,,,622.53,6225.3,8
HCPCS,K08290,Pwc gp 2 xtra hd cap chair,,,6225.3,6225.3,1
HCPCS,K0829MS,Pwc gp 2 xtra hd cap chair,,,622.53,622.53,1
HCPCS,K0829NU,Pwc gp 2 xtra hd cap chair,,,6225.3,6225.3,1
HCPCS,K0829RR,Pwc gp 2 xtra hd cap chair,,,622.53,1736.84,4
HCPCS,K0829UE,Pwc gp 2 xtra hd cap chair,,,4668.97,4668.97,1
HCPCS,K0830,Pwc gp2 std seat elevate s/b,,,518.4,5184.0,5
HCPCS,K08300,Pwc gp2 std seat elevate s/b,,,5184.0,5184.0,1
HCPCS,K0830MS,Pwc gp2 std seat elevate s/b,,,518.4,518.4,1
HCPCS,K0830NU,Pwc gp2 std seat elevate s/b,,,5184.0,5184.0,1
HCPCS,K0830RR,Pwc gp2 std seat elevate s/b,,,518.4,518.4,1
HCPCS,K0830UE,Pwc gp2 std seat elevate s/b,,,3888.0,3888.0,1
HCPCS,K0831,Pwc gp2 std seat elevate cap,,,369.88,3698.83,5
HCPCS,K08310,Pwc gp2 std seat elevate cap,,,3698.83,3698.83,1
HCPCS,K0831MS,Pwc gp2 std seat elevate cap,,,369.88,369.88,1
HCPCS,K0831NU,Pwc gp2 std seat elevate cap,,,3698.83,3698.83,1
HCPCS,K0831RR,Pwc gp2 std seat elevate cap,,,369.88,369.88,1
HCPCS,K0831UE,Pwc gp2 std seat elevate cap,,,2774.12,2774.12,1
HCPCS,K0835,Pwc gp2 std sing pow opt s/b,,,252.32,2523.26,8
HCPCS,K08350,Pwc gp2 std sing pow opt s/b,,,2523.26,2523.26,1
HCPCS,K0835MS,Pwc gp2 std sing pow opt s/b,,,252.32,252.32,1
HCPCS,K0835NU,Pwc gp2 std sing pow opt s/b,,,2523.26,2523.26,1
HCPCS,K0835RR,Pwc gp2 std sing pow opt s/b,,,252.32,731.13,4
HCPCS,K0835UE,Pwc gp2 std sing pow opt s/b,,,1892.44,1892.44,1
HCPCS,K0836,Pwc gp2 std sing pow opt cap,,,261.72,2617.16,8
HCPCS,K08360,Pwc gp2 std sing pow opt cap,,,2617.16,2617.16,1
HCPCS,K0836MS,Pwc gp2 std sing pow opt cap,,,261.72,261.72,1
HCPCS,K0836NU,Pwc gp2 std sing pow opt cap,,,2617.16,2617.16,1
HCPCS,K0836RR,Pwc gp2 std sing pow opt cap,,,261.72,758.32,4
HCPCS,K0836UE,Pwc gp2 std sing pow opt cap,,,1962.88,1962.88,1
HCPCS,K0837,Pwc gp 2 hd sing pow opt s/b,,,323.64,3236.41,8
HCPCS,K08370,Pwc gp 2 hd sing pow opt s/b,,,3236.41,3236.41,1
HCPCS,K0837MS,Pwc gp 2 hd sing pow opt s/b,,,323.64,323.64,1
HCPCS,K0837NU,Pwc gp 2 hd sing pow opt s/b,,,3236.41,3236.41,1
HCPCS,K0837RR,Pwc gp 2 hd sing pow opt s/b,,,323.64,937.75,4
HCPCS,K0837UE,Pwc gp 2 hd sing pow opt s/b,,,2427.31,2427.31,1
HCPCS,K0838,Pwc gp 2 hd sing pow opt cap,,,286.86,2868.54,8
HCPCS,K08380,Pwc gp 2 hd sing pow opt cap,,,2868.54,2868.54,1
HCPCS,K0838MS,Pwc gp 2 hd sing pow opt cap,,,286.86,286.86,1
HCPCS,K0838NU,Pwc gp 2 hd sing pow opt cap,,,2868.54,2868.54,1
HCPCS,K0838RR,Pwc gp 2 hd sing pow opt cap,,,286.86,831.16,4
HCPCS,K0838UE,Pwc gp 2 hd sing pow opt cap,,,2151.41,2151.41,1
HCPCS,K0839,Pwc gp2 vhd sing pow opt s/b,,,429.9,4299.02,8
HCPCS,K08390,Pwc gp2 vhd sing pow opt s/b,,,4299.02,4299.02,1
HCPCS,K0839MS,Pwc gp2 vhd sing pow opt s/b,,,429.9,429.9,1
HCPCS,K0839NU,Pwc gp2 vhd sing pow opt s/b,,,4299.02,4299.02,1
HCPCS,K0839RR,Pwc gp2 vhd sing pow opt s/b,,,429.9,1245.65,4
HCPCS,K0839UE,Pwc gp2 vhd sing pow opt s/b,,,3224.26,3224.26,1
HCPCS,K0840,Pwc gp2 xhd sing pow opt s/b,,,660.03,6600.36,8
HCPCS,K08400,Pwc gp2 xhd sing pow opt s/b,,,6600.36,6600.36,1
HCPCS,K0840MS,Pwc gp2 xhd sing pow opt s/b,,,660.03,660.03,1
HCPCS,K0840NU,Pwc gp2 xhd sing pow opt s/b,,,6600.36,6600.36,1
HCPCS,K0840RR,Pwc gp2 xhd sing pow opt s/b,,,660.03,1912.48,4
HCPCS,K0840UE,Pwc gp2 xhd sing pow opt s/b,,,4950.27,4950.27,1
HCPCS,K0841,Pwc gp2 std mult pow opt s/b,,,284.35,2843.48,8
HCPCS,K08410,Pwc gp2 std mult pow opt s/b,,,2843.48,2843.48,1
HCPCS,K0841MS,Pwc gp2 std mult pow opt s/b,,,284.35,284.35,1
HCPCS,K0841NU,Pwc gp2 std mult pow opt s/b,,,2843.48,2843.48,1
HCPCS,K0841RR,Pwc gp2 std mult pow opt s/b,,,284.35,823.9,4
HCPCS,K0841UE,Pwc gp2 std mult pow opt s/b,,,2132.61,2132.61,1
HCPCS,K0842,Pwc gp2 std mult pow opt cap,,,283.94,2839.38,8
HCPCS,K08420,Pwc gp2 std mult pow opt cap,,,2839.38,2839.38,1
HCPCS,K0842MS,Pwc gp2 std mult pow opt cap,,,283.94,283.94,1
HCPCS,K0842NU,Pwc gp2 std mult pow opt cap,,,2839.38,2839.38,1
HCPCS,K0842RR,Pwc gp2 std mult pow opt cap,,,283.94,822.72,4
HCPCS,K0842UE,Pwc gp2 std mult pow opt cap,,,2129.53,2129.53,1
HCPCS,K0843,Pwc gp2 hd mult pow opt s/b,,,337.07,3370.71,8
HCPCS,K08430,Pwc gp2 hd mult pow opt s/b,,,3370.71,3370.71,1
HCPCS,K0843MS,Pwc gp2 hd mult pow opt s/b,,,337.07,337.07,1
HCPCS,K0843NU,Pwc gp2 hd mult pow opt s/b,,,3370.71,3370.71,1
HCPCS,K0843RR,Pwc gp2 hd mult pow opt s/b,,,337.07,976.67,4
HCPCS,K0843UE,Pwc gp2 hd mult pow opt s/b,,,2528.03,2528.03,1
HCPCS,K0848,Pwc gp 3 std seat/back,,,553.73,5537.27,8
HCPCS,K08480,Pwc gp 3 std seat/back,,,5537.27,5537.27,1
HCPCS,K0848MS,Pwc gp 3 std seat/back,,,553.73,553.73,1
HCPCS,K0848NU,Pwc gp 3 std seat/back,,,5537.27,5537.27,1
HCPCS,K0848RR,Pwc gp 3 std seat/back,,,553.73,1595.09,4
HCPCS,K0848UE,Pwc gp 3 std seat/back,,,4152.96,4152.96,1
HCPCS,K0849,Pwc gp 3 std cap chair,,,532.36,5323.67,8
HCPCS,K08490,Pwc gp 3 std cap chair,,,5323.67,5323.67,1
HCPCS,K0849MS,Pwc gp 3 std cap chair,,,532.36,532.36,1
HCPCS,K0849NU,Pwc gp 3 std cap chair,,,5323.67,5323.67,1
HCPCS,K0849RR,Pwc gp 3 std cap chair,,,532.36,1533.56,4
HCPCS,K0849UE,Pwc gp 3 std cap chair,,,3992.75,3992.75,1
HCPCS,K0850,Pwc gp 3 hd seat/back,,,642.29,6422.87,8
HCPCS,K08500,Pwc gp 3 hd seat/back,,,6422.87,6422.87,1
HCPCS,K0850MS,Pwc gp 3 hd seat/back,,,642.29,642.29,1
HCPCS,K0850NU,Pwc gp 3 hd seat/back,,,6422.87,6422.87,1
HCPCS,K0850RR,Pwc gp 3 hd seat/back,,,642.29,1850.2,4
HCPCS,K0850UE,Pwc gp 3 hd seat/back,,,4817.15,4817.15,1
HCPCS,K0851,Pwc gp 3 hd cap chair,,,617.57,6175.7,8
HCPCS,K08510,Pwc gp 3 hd cap chair,,,6175.7,6175.7,1
HCPCS,K0851MS,Pwc gp 3 hd cap chair,,,617.57,617.57,1
HCPCS,K0851NU,Pwc gp 3 hd cap chair,,,6175.7,6175.7,1
HCPCS,K0851RR,Pwc gp 3 hd cap chair,,,617.57,1779.0,4
HCPCS,K0851UE,Pwc gp 3 hd cap chair,,,4631.77,4631.77,1
HCPCS,K0852,Pwc gp 3 vhd seat/back,,,742.12,7421.26,8
HCPCS,K08520,Pwc gp 3 vhd seat/back,,,7421.26,7421.26,1
HCPCS,K0852MS,Pwc gp 3 vhd seat/back,,,742.12,742.12,1
HCPCS,K0852NU,Pwc gp 3 vhd seat/back,,,7421.26,7421.26,1
HCPCS,K0852RR,Pwc gp 3 vhd seat/back,,,742.12,2137.79,4
HCPCS,K0852UE,Pwc gp 3 vhd seat/back,,,5565.94,5565.94,1
HCPCS,K0853,Pwc gp 3 vhd cap chair,,,762.36,7623.58,8
HCPCS,K08530,Pwc gp 3 vhd cap chair,,,7623.58,7623.58,1
HCPCS,K0853MS,Pwc gp 3 vhd cap chair,,,762.36,762.36,1
HCPCS,K0853NU,Pwc gp 3 vhd cap chair,,,7623.58,7623.58,1
HCPCS,K0853RR,Pwc gp 3 vhd cap chair,,,762.36,2196.08,4
HCPCS,K0853UE,Pwc gp 3 vhd cap chair,,,5717.68,5717.68,1
HCPCS,K0854,Pwc gp 3 xhd seat/back,,,1009.95,10099.54,8
HCPCS,K08540,Pwc gp 3 xhd seat/back,,,10099.54,10099.54,1
HCPCS,K0854MS,Pwc gp 3 xhd seat/back,,,1009.95,1009.95,1
HCPCS,K0854NU,Pwc gp 3 xhd seat/back,,,10099.54,10099.54,1
HCPCS,K0854RR,Pwc gp 3 xhd seat/back,,,1009.95,2909.33,4
HCPCS,K0854UE,Pwc gp 3 xhd seat/back,,,7574.66,7574.66,1
HCPCS,K0855,Pwc gp 3 xhd cap chair,,,954.05,9540.47,8
HCPCS,K08550,Pwc gp 3 xhd cap chair,,,9540.47,9540.47,1
HCPCS,K0855MS,Pwc gp 3 xhd cap chair,,,954.05,954.05,1
HCPCS,K0855NU,Pwc gp 3 xhd cap chair,,,9540.47,9540.47,1
HCPCS,K0855RR,Pwc gp 3 xhd cap chair,,,954.05,2748.28,4
HCPCS,K0855UE,Pwc gp 3 xhd cap chair,,,7155.36,7155.36,1
HCPCS,K0856,Pwc gp3 std sing pow opt s/b,,,594.35,5943.51,8
HCPCS,K08560,Pwc gp3 std sing pow opt s/b,,,5943.51,5943.51,1
HCPCS,K0856MS,Pwc gp3 std sing pow opt s/b,,,594.35,594.35,1
HCPCS,K0856NU,Pwc gp3 std sing pow opt s/b,,,5943.51,5943.51,1
HCPCS,K0856RR,Pwc gp3 std sing pow opt s/b,,,594.35,1712.11,4
HCPCS,K0856UE,Pwc gp3 std sing pow opt s/b,,,4457.62,4457.62,1
HCPCS,K0857,Pwc gp3 std sing pow opt cap,,,606.27,6062.67,8
HCPCS,K08570,Pwc gp3 std sing pow opt cap,,,6062.67,6062.67,1
HCPCS,K0857MS,Pwc gp3 std sing pow opt cap,,,606.27,606.27,1
HCPCS,K0857NU,Pwc gp3 std sing pow opt cap,,,6062.67,6062.67,1
HCPCS,K0857RR,Pwc gp3 std sing pow opt cap,,,606.27,1746.45,4
HCPCS,K0857UE,Pwc gp3 std sing pow opt cap,,,4546.99,4546.99,1
HCPCS,K0858,Pwc gp3 hd sing pow opt s/b,,,737.42,7374.22,8
HCPCS,K08580,Pwc gp3 hd sing pow opt s/b,,,7374.22,7374.22,1
HCPCS,K0858MS,Pwc gp3 hd sing pow opt s/b,,,737.42,737.42,1
HCPCS,K0858NU,Pwc gp3 hd sing pow opt s/b,,,7374.22,7374.22,1
HCPCS,K0858RR,Pwc gp3 hd sing pow opt s/b,,,737.42,2124.24,4
HCPCS,K0858UE,Pwc gp3 hd sing pow opt s/b,,,5530.66,5530.66,1
HCPCS,K0859,Pwc gp3 hd sing pow opt cap,,,703.27,7032.72,8
HCPCS,K08590,Pwc gp3 hd sing pow opt cap,,,7032.72,7032.72,1
HCPCS,K0859MS,Pwc gp3 hd sing pow opt cap,,,703.27,703.27,1
HCPCS,K0859NU,Pwc gp3 hd sing pow opt cap,,,7032.72,7032.72,1
HCPCS,K0859RR,Pwc gp3 hd sing pow opt cap,,,703.27,2025.89,4
HCPCS,K0859UE,Pwc gp3 hd sing pow opt cap,,,5274.55,5274.55,1
HCPCS,K0860,Pwc gp3 vhd sing pow opt s/b,,,1053.5,10535.01,8
HCPCS,K08600,Pwc gp3 vhd sing pow opt s/b,,,10535.01,10535.01,1
HCPCS,K0860MS,Pwc gp3 vhd sing pow opt s/b,,,1053.5,1053.5,1
HCPCS,K0860NU,Pwc gp3 vhd sing pow opt s/b,,,10535.01,10535.01,1
HCPCS,K0860RR,Pwc gp3 vhd sing pow opt s/b,,,1053.5,3034.77,4
HCPCS,K0860UE,Pwc gp3 vhd sing pow opt s/b,,,7901.26,7901.26,1
HCPCS,K0861,Pwc gp3 std mult pow opt s/b,,,595.31,5953.07,8
HCPCS,K08610,Pwc gp3 std mult pow opt s/b,,,5953.07,5953.07,1
HCPCS,K0861MS,Pwc gp3 std mult pow opt s/b,,,595.31,595.31,1
HCPCS,K0861NU,Pwc gp3 std mult pow opt s/b,,,5953.07,5953.07,1
HCPCS,K0861RR,Pwc gp3 std mult pow opt s/b,,,595.31,1714.86,4
HCPCS,K0861UE,Pwc gp3 std mult pow opt s/b,,,4464.81,4464.81,1
HCPCS,K0862,Pwc gp3 hd mult pow opt s/b,,,737.42,7374.22,8
HCPCS,K08620,Pwc gp3 hd mult pow opt s/b,,,7374.22,7374.22,1
HCPCS,K0862MS,Pwc gp3 hd mult pow opt s/b,,,737.42,737.42,1
HCPCS,K0862NU,Pwc gp3 hd mult pow opt s/b,,,7374.22,7374.22,1
HCPCS,K0862RR,Pwc gp3 hd mult pow opt s/b,,,737.42,2124.24,4
HCPCS,K0862UE,Pwc gp3 hd mult pow opt s/b,,,5530.66,5530.66,1
HCPCS,K0863,Pwc gp3 vhd mult pow opt s/b,,,1053.5,10535.01,8
HCPCS,K08630,Pwc gp3 vhd mult pow opt s/b,,,10535.01,10535.01,1
HCPCS,K0863MS,Pwc gp3 vhd mult pow opt s/b,,,1053.5,1053.5,1
HCPCS,K0863NU,Pwc gp3 vhd mult pow opt s/b,,,10535.01,10535.01,1
HCPCS,K0863RR,Pwc gp3 vhd mult pow opt s/b,,,1053.5,3034.77,4
HCPCS,K0863UE,Pwc gp3 vhd mult pow opt s/b,,,7901.26,7901.26,1
HCPCS,K0864,Pwc gp3 xhd mult pow opt s/b,,,1253.66,12536.67,8
HCPCS,K08640,Pwc gp3 xhd mult pow opt s/b,,,12536.67,12536.67,1
HCPCS,K0864MS,Pwc gp3 xhd mult pow opt s/b,,,1253.66,1253.66,1
HCPCS,K0864NU,Pwc gp3 xhd mult pow opt s/b,,,12536.67,12536.67,1
HCPCS,K0864RR,Pwc gp3 xhd mult pow opt s/b,,,1253.66,3611.37,4
HCPCS,K0864UE,Pwc gp3 xhd mult pow opt s/b,,,9402.5,9402.5,1
HCPCS,K0868,Pwc gp 4 std seat/back,,,916.6,9165.96,5
HCPCS,K08680,Pwc gp 4 std seat/back,,,9165.96,9165.96,1
HCPCS,K0868MS,Pwc gp 4 std seat/back,,,916.6,916.6,1
HCPCS,K0868NU,Pwc gp 4 std seat/back,,,9165.96,9165.96,1
HCPCS,K0868RR,Pwc gp 4 std seat/back,,,916.6,916.6,1
HCPCS,K0868UE,Pwc gp 4 std seat/back,,,6874.47,6874.47,1
HCPCS,K0869,Pwc gp 4 std cap chair,,,631.24,6312.38,5
HCPCS,K08690,Pwc gp 4 std cap chair,,,6312.38,6312.38,1
HCPCS,K0869MS,Pwc gp 4 std cap chair,,,631.24,631.24,1
HCPCS,K0869NU,Pwc gp 4 std cap chair,,,6312.38,6312.38,1
HCPCS,K0869RR,Pwc gp 4 std cap chair,,,631.24,631.24,1
HCPCS,K0869UE,Pwc gp 4 std cap chair,,,4734.29,4734.29,1
HCPCS,K0877,Pwc gp4 std sing pow opt s/b,,,739.8,7398.0,5
HCPCS,K08770,Pwc gp4 std sing pow opt s/b,,,7398.0,7398.0,1
HCPCS,K0877MS,Pwc gp4 std sing pow opt s/b,,,739.8,739.8,1
HCPCS,K0877NU,Pwc gp4 std sing pow opt s/b,,,7398.0,7398.0,1
HCPCS,K0877RR,Pwc gp4 std sing pow opt s/b,,,739.8,739.8,1
HCPCS,K0877UE,Pwc gp4 std sing pow opt s/b,,,5548.5,5548.5,1
HCPCS,K0878,Pwc gp4 std sing pow opt cap,,,0.32,3.24,5
HCPCS,K08780,Pwc gp4 std sing pow opt cap,,,3.24,3.24,1
HCPCS,K0878MS,Pwc gp4 std sing pow opt cap,,,0.32,0.32,1
HCPCS,K0878NU,Pwc gp4 std sing pow opt cap,,,3.24,3.24,1
HCPCS,K0878RR,Pwc gp4 std sing pow opt cap,,,0.32,0.32,1
HCPCS,K0878UE,Pwc gp4 std sing pow opt cap,,,2.43,2.43,1
HCPCS,K0879,Pwc gp4 hd sing pow opt s/b,,,748.71,7487.1,5
HCPCS,K08790,Pwc gp4 hd sing pow opt s/b,,,7487.1,7487.1,1
HCPCS,K0879MS,Pwc gp4 hd sing pow opt s/b,,,748.71,748.71,1
HCPCS,K0879NU,Pwc gp4 hd sing pow opt s/b,,,7487.1,7487.1,1
HCPCS,K0879RR,Pwc gp4 hd sing pow opt s/b,,,748.71,748.71,1
HCPCS,K0879UE,Pwc gp4 hd sing pow opt s/b,,,5615.33,5615.33,1
HCPCS,K0880,Pwc gp4 vhd sing pow opt s/b,,,1171.66,11716.6,5
HCPCS,K08800,Pwc gp4 vhd sing pow opt s/b,,,11716.6,11716.6,1
HCPCS,K0880MS,Pwc gp4 vhd sing pow opt s/b,,,1171.66,1171.66,1
HCPCS,K0880NU,Pwc gp4 vhd sing pow opt s/b,,,11716.6,11716.6,1
HCPCS,K0880RR,Pwc gp4 vhd sing pow opt s/b,,,1171.66,1171.66,1
HCPCS,K0880UE,Pwc gp4 vhd sing pow opt s/b,,,8787.45,8787.45,1
HCPCS,K0884,Pwc gp4 std mult pow opt s/b,,,2158.62,21586.22,5
HCPCS,K08840,Pwc gp4 std mult pow opt s/b,,,21586.22,21586.22,1
HCPCS,K0884MS,Pwc gp4 std mult pow opt s/b,,,2158.62,2158.62,1
HCPCS,K0884NU,Pwc gp4 std mult pow opt s/b,,,21586.22,21586.22,1
HCPCS,K0884RR,Pwc gp4 std mult pow opt s/b,,,2158.62,2158.62,1
HCPCS,K0884UE,Pwc gp4 std mult pow opt s/b,,,16189.66,16189.66,1
HCPCS,K0885,Pwc gp4 std mult pow opt cap,,,3.46,34.56,5
HCPCS,K08850,Pwc gp4 std mult pow opt cap,,,34.56,34.56,1
HCPCS,K0885MS,Pwc gp4 std mult pow opt cap,,,3.46,3.46,1
HCPCS,K0885NU,Pwc gp4 std mult pow opt cap,,,34.56,34.56,1
HCPCS,K0885RR,Pwc gp4 std mult pow opt cap,,,3.46,3.46,1
HCPCS,K0885UE,Pwc gp4 std mult pow opt cap,,,25.92,25.92,1
HCPCS,K0886,Pwc gp4 hd mult pow s/b,,,772.53,7725.35,5
HCPCS,K08860,Pwc gp4 hd mult pow s/b,,,7725.35,7725.35,1
HCPCS,K0886MS,Pwc gp4 hd mult pow s/b,,,772.53,772.53,1
HCPCS,K0886NU,Pwc gp4 hd mult pow s/b,,,7725.35,7725.35,1
HCPCS,K0886RR,Pwc gp4 hd mult pow s/b,,,772.53,772.53,1
HCPCS,K0886UE,Pwc gp4 hd mult pow s/b,,,5794.02,5794.02,1
HCPCS,K0890,Pwc gp5 ped sing pow opt s/b,,,1141.45,11414.52,5
HCPCS,K08900,Pwc gp5 ped sing pow opt s/b,,,11414.52,11414.52,1
HCPCS,K0890MS,Pwc gp5 ped sing pow opt s/b,,,1141.45,1141.45,1
HCPCS,K0890NU,Pwc gp5 ped sing pow opt s/b,,,11414.52,11414.52,1
HCPCS,K0890RR,Pwc gp5 ped sing pow opt s/b,,,1141.45,1141.45,1
HCPCS,K0890UE,Pwc gp5 ped sing pow opt s/b,,,8560.89,8560.89,1
HCPCS,K0891,Pwc gp5 ped mult pow opt s/b,,,1754.68,17546.76,5
HCPCS,K08910,Pwc gp5 ped mult pow opt s/b,,,17546.76,17546.76,1
HCPCS,K0891MS,Pwc gp5 ped mult pow opt s/b,,,1754.68,1754.68,1
HCPCS,K0891NU,Pwc gp5 ped mult pow opt s/b,,,17546.76,17546.76,1
HCPCS,K0891RR,Pwc gp5 ped mult pow opt s/b,,,1754.68,1754.68,1
HCPCS,K0891UE,Pwc gp5 ped mult pow opt s/b,,,13160.07,13160.07,1
HCPCS,K0900,Cstm dme other than wheelchr,,,550.8,550.8,1
HCPCS,K09000,Cstm dme other than wheelchr,,,550.8,550.8,1
HCPCS,K1007,Bil hkaf pc s/d micro sensor,,,54072.96,155765.11,4
HCPCS,K10070,Bil hkaf pc s/d micro sensor,,,54072.96,54072.96,1
HCPCS,K1027,Oral dev without fix mech,,,10899.86,10899.86,1
HCPCS,K10270,Oral dev without fix mech,,,10899.86,10899.86,1
HCPCS,K1034,Covid test self-admn/collect,,,12.96,12.96,1
HCPCS,K10340,Covid test self-admn/collect,,,12.96,12.96,1
HCPCS,L0112,Cranial cervical orthosis,,,978.21,2833.15,4
HCPCS,L01120,Cranial cervical orthosis,,,978.21,978.21,1
HCPCS,L0113,Cranial cervical torticollis,,,199.31,577.28,4
HCPCS,L01130,Cranial cervical torticollis,,,199.31,199.31,1
HCPCS,L0120,Cerv flex n/adj foam pre ots,,,18.49,56.63,4
HCPCS,L01200,Cerv flex n/adj foam pre ots,,,18.49,18.49,1
HCPCS,L0130,Flex thermoplastic collar mo,,,106.68,409.51,4
HCPCS,L01300,Flex thermoplastic collar mo,,,106.68,106.68,1
HCPCS,L0140,Cervical semi-rigid adjustab,,,41.84,141.3,4
HCPCS,L01400,Cervical semi-rigid adjustab,,,41.84,41.84,1
HCPCS,L0150,Cerv semi-rig adj molded chn,,,74.81,235.64,4
HCPCS,L01500,Cerv semi-rig adj molded chn,,,74.81,74.81,1
HCPCS,L0160,Cerv sr wire occ/man pre ots,,,109.24,335.52,4
HCPCS,L01600,Cerv sr wire occ/man pre ots,,,109.24,109.24,1
HCPCS,L0170,Cervical collar molded to pt,,,561.95,1419.78,4
HCPCS,L01700,Cervical collar molded to pt,,,561.95,561.95,1
HCPCS,L0172,Cerv col sr foam 2pc pre ots,,,98.98,287.86,4
HCPCS,L01720,Cerv col sr foam 2pc pre ots,,,98.98,98.98,1
HCPCS,L0174,Cerv sr 2pc thor ext pre ots,,,194.64,194.64,1
HCPCS,L0174,W CERV COLLAR W EXTENSION,84.0,54.6,14.11,82.32,29
HCPCS,L0174,W COLLAR CERV SEMIRIG 2PC THRC,288.0,187.2,48.38,282.24,29
HCPCS,L01740,Cerv sr 2pc thor ext pre ots,,,194.64,194.64,1
HCPCS,L0180,Cer post col occ/man sup adj,,,315.32,703.29,4
HCPCS,L01800,Cer post col occ/man sup adj,,,315.32,315.32,1
HCPCS,L0190,Cerv collar supp adj cerv ba,,,371.89,371.89,1
HCPCS,L0190,W CERVICAL COLLAR W ADJ BARS,589.0,382.85,98.95,577.22,29
HCPCS,L01900,Cerv collar supp adj cerv ba,,,371.89,371.89,1
HCPCS,L0200,Cerv col supp adj bar & thor,,,431.35,431.35,1
HCPCS,L0200,W COLLAR CERV ADJ BAR THRC FRM,541.0,351.65,90.89,530.18,29
HCPCS,L02000,Cerv col supp adj bar & thor,,,431.35,431.35,1
HCPCS,L0220,Thor rib belt custom fabrica,,,90.29,230.56,4
HCPCS,L02200,Thor rib belt custom fabrica,,,90.29,90.29,1
HCPCS,L0450,Tlso flex trunk/thor pre ots,,,69.16,69.16,1
HCPCS,L0450,W BRACE TLSO PRFB UPPR THORACIC,212.0,137.8,35.62,207.76,29
HCPCS,L04500,Tlso flex trunk/thor pre ots,,,69.16,69.16,1
HCPCS,L0452,Tlso flex custom fab thoraci,,,151.2,151.2,1
HCPCS,L04520,Tlso flex custom fab thoraci,,,151.2,151.2,1
HCPCS,L0454,Tlso trnk sj-t9 pre cst,,,242.4,702.05,4
HCPCS,L04540,Tlso trnk sj-t9 pre cst,,,242.4,242.4,1
HCPCS,L0455,Tlso flex trnk sj-t9 pre ots,,,128.4,438.27,4
HCPCS,L04550,Tlso flex trnk sj-t9 pre ots,,,128.4,128.4,1
HCPCS,L0456,PREFAB TLSO TO SCAPULAR SPINE,348.25,226.36,58.51,341.29,29
HCPCS,L0456,Tlso flex trnk sj-ss pre cst,,,695.13,695.13,1
HCPCS,L04560,Tlso flex trnk sj-ss pre cst,,,695.13,695.13,1
HCPCS,L0457,Tlso flex trnk sj-ss pre ots,,,368.23,1256.84,4
HCPCS,L04570,Tlso flex trnk sj-ss pre ots,,,368.23,368.23,1
HCPCS,L0458,Tlso 2mod symphis-xipho pre,,,623.33,1805.3,4
HCPCS,L04580,Tlso 2mod symphis-xipho pre,,,623.33,623.33,1
HCPCS,L0460,Tlso 2 shl symphys-stern cst,,,701.6,701.6,1
HCPCS,L0460,W BRACE TLSO PREFAB THORAC,1131.0,735.15,190.01,1108.38,29
HCPCS,L0460,W TLSO WITH T-BAR,340.0,221.0,57.12,333.2,29
HCPCS,L04600,Tlso 2 shl symphys-stern cst,,,701.6,701.6,1
HCPCS,L0462,Tlso 3mod sacro-scap pre,,,872.66,872.66,1
HCPCS,L0462,W TLSO TRIPLANAR PREFAB,1407.0,914.55,236.38,1378.86,29
HCPCS,L04620,Tlso 3mod sacro-scap pre,,,872.66,872.66,1
HCPCS,L0464,Tlso 4mod sacro-scap pre,,,1038.9,3008.85,4
HCPCS,L04640,Tlso 4mod sacro-scap pre,,,1038.9,1038.9,1
HCPCS,L0466,Tlso r fram soft ant pre cst,,,265.17,773.69,4
HCPCS,L04660,Tlso r fram soft ant pre cst,,,265.17,265.17,1
HCPCS,L0467,Tlso r fram soft pre ots,,,144.01,491.54,4
HCPCS,L04670,Tlso r fram soft pre ots,,,144.01,144.01,1
HCPCS,L0468,Tlso rig fram pelvic pre cst,,,332.32,970.1,4
HCPCS,L04680,Tlso rig fram pelvic pre cst,,,332.32,332.32,1
HCPCS,L0469,Tlso rig fram pelvic pre ots,,,183.49,626.31,4
HCPCS,L04690,Tlso rig fram pelvic pre ots,,,183.49,183.49,1
HCPCS,L0470,Tlso rigid frame pre subclav,,,459.85,1381.03,4
HCPCS,L04700,Tlso rigid frame pre subclav,,,459.85,459.85,1
HCPCS,L0472,Tlso rigid frame hyperex pre,,,282.96,282.96,1
HCPCS,L0472,W BRACE CASH,236.0,153.4,39.65,231.28,29
HCPCS,L0472,W BRACE TLSO TRPLN CTRL HYPRTSN,482.0,313.3,80.98,472.36,29
HCPCS,L04720,Tlso rigid frame hyperex pre,,,282.96,282.96,1
HCPCS,L0480,Tlso rigid plastic custom fa,,,1055.68,1055.68,1
HCPCS,L0480,W TLSO W 1PC PL SHELL WO LINER,1492.0,969.8,250.66,1462.16,29
HCPCS,L04800,Tlso rigid plastic custom fa,,,1055.68,1055.68,1
HCPCS,L0482,Tlso rigid lined custom fab,,,1179.2,3072.99,4
HCPCS,L04820,Tlso rigid lined custom fab,,,1179.2,1179.2,1
HCPCS,L0484,Tlso rigid plastic cust fab,,,1273.48,1273.48,1
HCPCS,L0484,W TLSO 2PC PL SHELL WO LINER,1994.0,1296.1,334.99,1954.12,32
HCPCS,L04840,Tlso rigid plastic cust fab,,,1273.48,1273.48,1
HCPCS,L0486,Tlso rigidlined cust fab two,,,1430.18,1430.18,1
HCPCS,L0486,W TLSO 2PC PL SHELL W LINER,1975.0,1283.75,331.8,1935.5,32
HCPCS,L04860,Tlso rigidlined cust fab two,,,1430.18,1430.18,1
HCPCS,L0488,Tlso rigid lined pre one pie,,,701.6,2032.02,4
HCPCS,L04880,Tlso rigid lined pre one pie,,,701.6,701.6,1
HCPCS,L0490,Tlso rigid plastic pre one,,,197.7,572.58,4
HCPCS,L04900,Tlso rigid plastic pre one,,,197.7,197.7,1
HCPCS,L0491,Tlso 2 piece rigid shell,,,536.76,1554.55,4
HCPCS,L04910,Tlso 2 piece rigid shell,,,536.76,536.76,1
HCPCS,L0492,Tlso 3 piece rigid shell,,,349.52,1007.5,4
HCPCS,L04920,Tlso 3 piece rigid shell,,,349.52,349.52,1
HCPCS,L0621,SIO FLEX PELVISACRAL PREFAB,87.0,56.55,14.62,85.26,29
HCPCS,L0621,Sio flex pelvic/sacr pre ots,,,36.46,36.46,1
HCPCS,L06210,Sio flex pelvic/sacr pre ots,,,36.46,36.46,1
HCPCS,L0622,Sio flex pelvisacral custom,,,186.81,489.44,4
HCPCS,L06220,Sio flex pelvisacral custom,,,186.81,186.81,1
HCPCS,L0623,Sio rig pnl pelv/sac pre ots,,,65.37,223.11,4
HCPCS,L06230,Sio rig pnl pelv/sac pre ots,,,65.37,65.37,1
HCPCS,L0624,Sio panel custom,,,43.2,43.2,1
HCPCS,L06240,Sio panel custom,,,43.2,43.2,1
HCPCS,L0625,LUMBOSACRAL SUPPORT,57.0,37.05,9.58,55.86,29
HCPCS,L0625,Lo flex l1-below l5 pre ots,,,20.4,20.4,1
HCPCS,L0625,W LUMBAR ORTHOSIS CORSET,62.0,40.3,10.42,60.76,29
HCPCS,L06250,Lo flex l1-below l5 pre ots,,,20.4,20.4,1
HCPCS,L0626,Lo sag rig pnl stays pre cst,,,54.48,54.48,1
HCPCS,L0626,W LSO BACK BRACE,174.0,113.1,29.23,170.52,29
HCPCS,L06260,Lo sag rig pnl stays pre cst,,,54.48,54.48,1
HCPCS,L0627,Lo sag ri an/pos pnl pre cst,,,287.27,287.27,1
HCPCS,L0627,W BRACE CYBERTECH SPINE FLEX PLUS,160.0,104.0,26.88,156.8,29
HCPCS,L06270,Lo sag ri an/pos pnl pre cst,,,287.27,287.27,1
HCPCS,L0628,Lso flex no ri stays pre ots,,,31.07,106.02,4
HCPCS,L06280,Lso flex no ri stays pre ots,,,31.07,31.07,1
HCPCS,L0629,Lso flex w/rigid stays cust,,,186.84,186.84,1
HCPCS,L06290,Lso flex w/rigid stays cust,,,186.84,186.84,1
HCPCS,L0630,Lso r post pnl sj-t9 pre cst,,,113.21,327.77,4
HCPCS,L06300,Lso r post pnl sj-t9 pre cst,,,113.21,113.21,1
HCPCS,L0631,Lso sag r an/pos pnl pre cst,,,717.48,717.48,1
HCPCS,L0631,W BRACE CYBERTECH PREMIUM PLUS,340.0,221.0,57.12,333.2,29
HCPCS,L06310,Lso sag r an/pos pnl pre cst,,,717.48,717.48,1
HCPCS,L0632,Lso sag rigid frame cust,,,48.6,48.6,1
HCPCS,L06320,Lso sag rigid frame cust,,,48.6,48.6,1
HCPCS,L0633,Lso sc r pos/lat pnl pre cst,,,200.42,580.47,4
HCPCS,L06330,Lso sc r pos/lat pnl pre cst,,,200.42,200.42,1
HCPCS,L0634,Lso flexion control custom,,,378.0,378.0,1
HCPCS,L06340,Lso flexion control custom,,,378.0,378.0,1
HCPCS,L0635,Lso sagit rigid panel prefab,,,698.38,2152.48,4
HCPCS,L06350,Lso sagit rigid panel prefab,,,698.38,698.38,1
HCPCS,L0636,Lso sagittal rigid panel cus,,,947.58,3176.15,4
HCPCS,L06360,Lso sagittal rigid panel cus,,,947.58,947.58,1
HCPCS,L0637,Lso sc r ant/pos pnl pre cst,,,905.45,905.45,1
HCPCS,L0637,W BRACE LSO SAG-CORONL PNL PRFB,1534.0,997.1,257.71,1503.32,29
HCPCS,L06370,Lso sc r ant/pos pnl pre cst,,,905.45,905.45,1
HCPCS,L0638,Lso sag-coronal panel custom,,,921.81,2669.79,4
HCPCS,L06380,Lso sag-coronal panel custom,,,921.81,921.81,1
HCPCS,L0639,Lso s/c shell/panel prefab,,,905.45,2755.68,4
HCPCS,L06390,Lso s/c shell/panel prefab,,,905.45,905.45,1
HCPCS,L0640,Lso s/c shell/panel custom,,,731.33,2118.18,4
HCPCS,L06400,Lso s/c shell/panel custom,,,731.33,731.33,1
HCPCS,L0641,Lo rig pos pnl l1-l5 pre ots,,,28.86,98.52,4
HCPCS,L06410,Lo rig pos pnl l1-l5 pre ots,,,28.86,28.86,1
HCPCS,L0642,Lo sag ri an/pos pnl pre ots,,,152.22,519.58,4
HCPCS,L06420,Lo sag ri an/pos pnl pre ots,,,152.22,152.22,1
HCPCS,L0643,Lso sag ctr rigi pos pre ots,,,59.97,204.7,4
HCPCS,L06430,Lso sag ctr rigi pos pre ots,,,59.97,59.97,1
HCPCS,L0648,Lso sag r an/pos pnl pre ots,,,380.15,1297.58,4
HCPCS,L06480,Lso sag r an/pos pnl pre ots,,,380.15,380.15,1
HCPCS,L0649,Lso sc r pos/lat pnl pre ots,,,106.19,362.46,4
HCPCS,L06490,Lso sc r pos/lat pnl pre ots,,,106.19,106.19,1
HCPCS,L0650,Lso sc r ant/pos pnl pre ots,,,439.86,1501.38,4
HCPCS,L06500,Lso sc r ant/pos pnl pre ots,,,439.86,439.86,1
HCPCS,L0651,Lso sag-co shell pnl pre ots,,,439.86,1501.38,4
HCPCS,L06510,Lso sag-co shell pnl pre ots,,,439.86,439.86,1
HCPCS,L0700,Ctlso a-p-l control molded,,,1391.37,4358.22,4
HCPCS,L07000,Ctlso a-p-l control molded,,,1391.37,1391.37,1
HCPCS,L0710,Ctlso a-p-l control w/ inter,,,1529.49,4757.27,4
HCPCS,L07100,Ctlso a-p-l control w/ inter,,,1529.49,1529.49,1
HCPCS,L0720,Ctlso a-p-l control custom,,,1386.72,1386.72,1
HCPCS,L07200,Ctlso a-p-l control custom,,,1386.72,1386.72,1
HCPCS,L0810,Halo cervical into jckt vest,,,1868.14,5053.94,4
HCPCS,L08100,Halo cervical into jckt vest,,,1868.14,1868.14,1
HCPCS,L0820,Halo cervical into body jack,,,1469.53,4088.4,4
HCPCS,L08200,Halo cervical into body jack,,,1469.53,1469.53,1
HCPCS,L0830,Halo cerv into milwaukee typ,,,2248.61,5903.21,4
HCPCS,L08300,Halo cerv into milwaukee typ,,,2248.61,2248.61,1
HCPCS,L0859,Mri compatible system,,,796.12,2293.36,4
HCPCS,L08590,Mri compatible system,,,796.12,796.12,1
HCPCS,L0861,Halo repl liner/interface,,,150.65,436.3,4
HCPCS,L08610,Halo repl liner/interface,,,150.65,150.65,1
HCPCS,L0970,Tlso corset front,,,74.69,215.16,4
HCPCS,L09700,Tlso corset front,,,74.69,74.69,1
HCPCS,L0972,Lso corset front,,,67.99,219.94,4
HCPCS,L09720,Lso corset front,,,67.99,67.99,1
HCPCS,L0974,Tlso full corset,,,122.14,449.38,4
HCPCS,L09740,Tlso full corset,,,122.14,122.14,1
HCPCS,L0976,Lso full corset,,,104.5,401.36,4
HCPCS,L09760,Lso full corset,,,104.5,104.5,1
HCPCS,L0978,Axillary crutch extension,,,131.52,362.37,4
HCPCS,L09780,Axillary crutch extension,,,131.52,131.52,1
HCPCS,L0980,Peroneal straps pair pre ots,,,11.94,32.87,4
HCPCS,L09800,Peroneal straps pair pre ots,,,11.94,11.94,1
HCPCS,L0982,Stocking sup grips 4 pre ots,,,10.94,35.83,4
HCPCS,L09820,Stocking sup grips 4 pre ots,,,10.94,10.94,1
HCPCS,L0984,Protect body sock ea pre ots,,,47.29,114.3,4
HCPCS,L09840,Protect body sock ea pre ots,,,47.29,47.29,1
HCPCS,L1000,Ctlso milwauke initial model,,,1417.24,3821.96,4
HCPCS,L10000,Ctlso milwauke initial model,,,1417.24,1417.24,1
HCPCS,L1001,Ctlso infant immobilizer,,,49.25,49.25,1
HCPCS,L10010,Ctlso infant immobilizer,,,49.25,49.25,1
HCPCS,L1005,Tension based scoliosis orth,,,2236.97,6478.9,4
HCPCS,L10050,Tension based scoliosis orth,,,2236.97,2236.97,1
HCPCS,L1006,Scoliosis orth sag/ cor,,,744.49,2144.59,4
HCPCS,L10060,Scoliosis orth sag/ cor,,,744.49,744.49,1
HCPCS,L1010,Ctlso axilla sling,,,58.48,153.92,4
HCPCS,L10100,Ctlso axilla sling,,,58.48,58.48,1
HCPCS,L1020,Kyphosis pad,,,75.31,210.3,4
HCPCS,L10200,Kyphosis pad,,,75.31,75.31,1
HCPCS,L1025,Kyphosis pad floating,,,108.66,239.02,4
HCPCS,L10250,Kyphosis pad floating,,,108.66,108.66,1
HCPCS,L1030,Lumbar bolster pad,,,54.72,159.66,4
HCPCS,L10300,Lumbar bolster pad,,,54.72,54.72,1
HCPCS,L1040,Lumbar or lumbar rib pad,,,61.97,192.2,4
HCPCS,L10400,Lumbar or lumbar rib pad,,,61.97,61.97,1
HCPCS,L1050,Sternal pad,,,70.12,166.38,4
HCPCS,L10500,Sternal pad,,,70.12,70.12,1
HCPCS,L1060,Thoracic pad,,,75.7,187.69,4
HCPCS,L10600,Thoracic pad,,,75.7,75.7,1
HCPCS,L1070,Trapezius sling,,,78.41,191.91,4
HCPCS,L10700,Trapezius sling,,,78.41,78.41,1
HCPCS,L1080,Outrigger,,,36.57,132.98,4
HCPCS,L10800,Outrigger,,,36.57,36.57,1
HCPCS,L1085,Outrigger bil w/ vert extens,,,122.43,369.41,4
HCPCS,L10850,Outrigger bil w/ vert extens,,,122.43,122.43,1
HCPCS,L1090,Lumbar sling,,,70.33,172.55,4
HCPCS,L10900,Lumbar sling,,,70.33,70.33,1
HCPCS,L1100,Ring flange plastic/leather,,,132.73,304.61,4
HCPCS,L11000,Ring flange plastic/leather,,,132.73,132.73,1
HCPCS,L1110,Ring flange plas/leather mol,,,222.54,515.94,4
HCPCS,L11100,Ring flange plas/leather mol,,,222.54,222.54,1
HCPCS,L1120,Covers for upright each,,,26.58,82.18,4
HCPCS,L11200,Covers for upright each,,,26.58,26.58,1
HCPCS,L1200,Furnsh initial orthosis only,,,1250.72,3271.6,4
HCPCS,L12000,Furnsh initial orthosis only,,,1250.72,1250.72,1
HCPCS,L1210,Lateral thoracic extension,,,171.0,492.58,4
HCPCS,L12100,Lateral thoracic extension,,,171.0,171.0,1
HCPCS,L1220,Anterior thoracic extension,,,166.44,417.06,4
HCPCS,L12200,Anterior thoracic extension,,,166.44,166.44,1
HCPCS,L1230,Milwaukee type superstructur,,,466.26,1070.13,4
HCPCS,L12300,Milwaukee type superstructur,,,466.26,466.26,1
HCPCS,L1240,Lumbar derotation pad,,,63.57,184.16,4
HCPCS,L12400,Lumbar derotation pad,,,63.57,63.57,1
HCPCS,L1250,Anterior asis pad,,,55.27,181.34,4
HCPCS,L12500,Anterior asis pad,,,55.27,55.27,1
HCPCS,L1260,Anterior thoracic derotation,,,65.91,186.38,4
HCPCS,L12600,Anterior thoracic derotation,,,65.91,65.91,1
HCPCS,L1270,Abdominal pad,,,57.93,186.17,4
HCPCS,L12700,Abdominal pad,,,57.93,57.93,1
HCPCS,L1280,Rib gusset (elastic) each,,,61.07,165.93,4
HCPCS,L12800,Rib gusset (elastic) each,,,61.07,61.07,1
HCPCS,L1290,Lateral trochanteric pad,,,54.31,188.12,4
HCPCS,L12900,Lateral trochanteric pad,,,54.31,54.31,1
HCPCS,L1300,Body jacket mold to patient,,,1204.56,3144.64,4
HCPCS,L13000,Body jacket mold to patient,,,1204.56,1204.56,1
HCPCS,L1310,Post-operative body jacket,,,1254.65,3235.82,4
HCPCS,L13100,Post-operative body jacket,,,1254.65,1254.65,1
HCPCS,L1600,Ho flex frejka w/cov pre cst,,,90.06,242.58,4
HCPCS,L16000,Ho flex frejka w/cov pre cst,,,90.06,90.06,1
HCPCS,L1610,Ho frejka cov only pre cst,,,38.25,82.65,4
HCPCS,L16100,Ho frejka cov only pre cst,,,38.25,38.25,1
HCPCS,L1620,Ho flex pavlik harns pre cst,,,109.81,272.16,4
HCPCS,L16200,Ho flex pavlik harns pre cst,,,109.81,109.81,1
HCPCS,L1630,Abduct control hip semi-flex,,,147.65,324.78,4
HCPCS,L16300,Abduct control hip semi-flex,,,147.65,147.65,1
HCPCS,L1640,Pelv band/spread bar thigh c,,,330.87,868.65,4
HCPCS,L16400,Pelv band/spread bar thigh c,,,330.87,330.87,1
HCPCS,L1650,Ho abduction hip adjustable,,,172.36,460.66,4
HCPCS,L16500,Ho abduction hip adjustable,,,172.36,172.36,1
HCPCS,L1652,Ho bi thighcuffs w sprdr bar,,,249.15,721.6,4
HCPCS,L16520,Ho bi thighcuffs w sprdr bar,,,249.15,249.15,1
HCPCS,L1653,Ho abduction static ots,,,249.15,721.6,4
HCPCS,L16530,Ho abduction static ots,,,249.15,249.15,1
HCPCS,L1660,Ho abduction static plastic,,,126.31,322.17,4
HCPCS,L16600,Ho abduction static plastic,,,126.31,126.31,1
HCPCS,L1680,Pelvic & hip control thigh c,,,796.25,2648.7,4
HCPCS,L16800,Pelvic & hip control thigh c,,,796.25,796.25,1
HCPCS,L1681,Ho bilateral hip abduction,,,1309.79,3749.92,4
HCPCS,L16810,Ho bilateral hip abduction,,,1309.79,1309.79,1
HCPCS,L1685,Post-op hip abduct custom fa,,,777.34,777.34,1
HCPCS,L1685,W CUSTOM HIP ABDUCTION CONTRL,1555.0,1010.75,261.24,1523.9,29
HCPCS,L16850,Post-op hip abduct custom fa,,,777.34,777.34,1
HCPCS,L1686,Ho post-op hip abduction,,,654.9,654.9,1
HCPCS,L1686,W ORTHOSIS HIP POSTOP,1043.0,677.95,175.22,1022.14,29
HCPCS,L16860,Ho post-op hip abduction,,,654.9,654.9,1
HCPCS,L1690,Combination bilateral ho,,,1351.53,3914.38,4
HCPCS,L16900,Combination bilateral ho,,,1351.53,1351.53,1
HCPCS,L1700,Leg perthes orth toronto typ,,,1087.39,3256.51,4
HCPCS,L17000,Leg perthes orth toronto typ,,,1087.39,1087.39,1
HCPCS,L1710,Legg perthes orth newington,,,1384.68,3827.83,4
HCPCS,L17100,Legg perthes orth newington,,,1384.68,1384.68,1
HCPCS,L1720,Legg perthes orthosis trilat,,,1031.02,2827.62,4
HCPCS,L17200,Legg perthes orthosis trilat,,,1031.02,1031.02,1
HCPCS,L1730,Legg perthes orth scottish r,,,870.42,2133.35,4
HCPCS,L17300,Legg perthes orth scottish r,,,870.42,870.42,1
HCPCS,L1755,Legg perthes patten bottom t,,,1251.41,3105.17,4
HCPCS,L17550,Legg perthes patten bottom t,,,1251.41,1251.41,1
HCPCS,L1810,DELUXE HINGED KNEE SUPPORT,170.0,110.5,57.29,170.0,17
HCPCS,L1810,"KNEE ORTHOSIS, NEOPRENE WRAP",107.0,69.55,53.5,112.75,17
HCPCS,L1810,KO ELASTIC W/JOINTS,215.0,139.75,57.29,215.0,17
HCPCS,L1810,Ko elastic with joints,,,71.95,71.95,1
HCPCS,L1810,PREFAB ELASTIC KO W JNTS,175.0,113.75,29.4,171.5,29
HCPCS,L18100,Ko elastic with joints,,,71.95,71.95,1
HCPCS,L1812,Ko elastic w/joints pre ots,,,44.09,139.44,4
HCPCS,L18120,Ko elastic w/joints pre ots,,,44.09,44.09,1
HCPCS,L1820,Ko elas w/ condyle pads & jo,,,99.33,99.33,1
HCPCS,L1820,PLAYMAKER KNEE BRACE,167.28,108.73,28.1,163.93,29
HCPCS,L18200,Ko elas w/ condyle pads & jo,,,99.33,99.33,1
HCPCS,L1821,Ko elas w/ condyle pads otf,,,99.33,244.08,4
HCPCS,L18210,Ko elas w/ condyle pads otf,,,99.33,99.33,1
HCPCS,L1830,KNEE IMMOBILIZER,101.0,65.65,29.2,101.0,17
HCPCS,L1830,KNEE IMMOBILIZER X-LARGE,38.0,24.7,19.0,93.94,17
HCPCS,L1830,"KO IMMOBILIZER, CANVAS LONGITUDE",128.0,83.2,29.2,128.0,17
HCPCS,L1830,Ko immob canvas long pre ots,,,39.72,125.66,4
HCPCS,L18300,Ko immob canvas long pre ots,,,39.72,39.72,1
HCPCS,L1831,Knee orth pos locking joint,,,205.71,205.71,1
HCPCS,L1831,W KNEE ORTH POS LOCKING JOINT,332.0,215.8,55.78,325.36,29
HCPCS,L18310,Knee orth pos locking joint,,,205.71,205.71,1
HCPCS,L1832,Ko adj jnt pos r sup pre cst,,,481.41,481.41,1
HCPCS,L1832,W BRACE ACL T-ROM KO ADJ JNT,1528.0,993.2,256.7,1497.44,29
HCPCS,L1832,W BRACE KNEE DJ ROM,849.0,551.85,142.63,832.02,29
HCPCS,L18320,Ko adj jnt pos r sup pre cst,,,481.41,481.41,1
HCPCS,L1833,Ko adj jnt pos r sup pre ots,,,286.18,905.15,4
HCPCS,L18330,Ko adj jnt pos r sup pre ots,,,286.18,286.18,1
HCPCS,L1834,Ko w/0 joint rigid molded to,,,507.3,507.3,1
HCPCS,L1834,W ORTHOSIS KNEE WO JOINT,999.0,649.35,167.83,979.02,29
HCPCS,L18340,Ko w/0 joint rigid molded to,,,507.3,507.3,1
HCPCS,L1836,Ko rigid w/o joints pre ots,,,56.17,177.68,4
HCPCS,L18360,Ko rigid w/o joints pre ots,,,56.17,56.17,1
HCPCS,L1840,Ko derot ant cruciate custom,,,657.27,1887.23,4
HCPCS,L18400,Ko derot ant cruciate custom,,,657.27,657.27,1
HCPCS,L1843,KO SINGLE UPRIGHT CUSTOM FIT,893.0,580.45,150.02,875.14,29
HCPCS,L1843,Ko single upright pre cst,,,627.11,627.11,1
HCPCS,L18430,Ko single upright pre cst,,,627.11,627.11,1
HCPCS,L1844,Ko w/adj jt rot cntrl molded,,,1064.34,3147.16,4
HCPCS,L18440,Ko w/adj jt rot cntrl molded,,,1064.34,1064.34,1
HCPCS,L1845,Ko double upright pre cst,,,585.47,585.47,1
HCPCS,L1845,OA KNEE BRACE,1041.52,676.99,174.98,1020.69,29
HCPCS,L1845,OTS BRACE - ACL/PCL,1041.52,676.99,174.98,1020.69,29
HCPCS,L1845,W KO W/ ADJ FLEX/EXT ROTAT CUS,1055.0,685.75,177.24,1033.9,29
HCPCS,L18450,Ko double upright pre cst,,,585.47,585.47,1
HCPCS,L1846,CUSTOM ACL/PCL W/PNEUMATIC KNE,1276.0,829.4,214.37,1250.48,29
HCPCS,L1846,"KO DBL UPRIGHT ADJ, CUSTOM FAB",1276.0,829.4,214.37,1250.48,29
HCPCS,L1846,Ko w adj flex/ext rotat mold,,,817.75,817.75,1
HCPCS,L18460,Ko w adj flex/ext rotat mold,,,817.75,817.75,1
HCPCS,L1847,Ko dbl upright w/air pre cst,,,402.0,1164.32,4
HCPCS,L18470,Ko dbl upright w/air pre cst,,,402.0,402.0,1
HCPCS,L1848,Ko dbl upright w/air pre ots,,,402.0,1164.32,4
HCPCS,L18480,Ko dbl upright w/air pre ots,,,402.0,402.0,1
HCPCS,L1850,Ko swedish type pre ots,,,129.38,409.21,4
HCPCS,L18500,Ko swedish type pre ots,,,129.38,129.38,1
HCPCS,L1851,Ko single upright prefab ots,,,377.73,1194.73,4
HCPCS,L18510,Ko single upright prefab ots,,,377.73,377.73,1
HCPCS,L1852,Ko double upright prefab ots,,,360.35,1139.76,4
HCPCS,L18520,Ko double upright prefab ots,,,360.35,360.35,1
HCPCS,L1860,Ko supracondylar socket mold,,,871.54,2101.72,4
HCPCS,L18600,Ko supracondylar socket mold,,,871.54,871.54,1
HCPCS,L1900,Afo sprng wir drsflx calf bd,,,199.41,569.39,4
HCPCS,L19000,Afo sprng wir drsflx calf bd,,,199.41,199.41,1
HCPCS,L1902,AFO ANKLE GAUNTLET,80.0,52.0,13.44,78.4,29
HCPCS,L1902,ANKLE BRACE / FOOT ANKLE ORTHOSIS,91.0,59.15,36.15,91.0,17
HCPCS,L1902,"ASO ANKLE GAUNTLET, CUSTOM FITTED",116.0,75.4,36.15,116.0,17
HCPCS,L1902,ASO ANKLE STABILIZER ANKLE/FOOT ARTHROSIS,200.0,130.0,36.15,200.0,17
HCPCS,L1902,Afo ankle gauntlet pre ots,,,52.17,52.17,1
HCPCS,L19020,Afo ankle gauntlet pre ots,,,52.17,52.17,1
HCPCS,L1904,Afo molded ankle gauntlet,,,315.47,885.23,4
HCPCS,L19040,Afo molded ankle gauntlet,,,315.47,315.47,1
HCPCS,L1906,AFO MULTILIGAMENTUS ANKLE SUPPORT,193.0,125.45,60.48,193.0,17
HCPCS,L1906,Afo multilig ank sup pre ots,,,78.59,258.7,4
HCPCS,L19060,Afo multilig ank sup pre ots,,,78.59,78.59,1
HCPCS,L1907,Afo supramalleolar custom,,,393.29,1139.02,4
HCPCS,L19070,Afo supramalleolar custom,,,393.29,393.29,1
HCPCS,L1910,Afo sing bar clasp attach sh,,,196.0,503.42,4
HCPCS,L19100,Afo sing bar clasp attach sh,,,196.0,196.0,1
HCPCS,L1920,Afo sing upright w/ adjust s,,,287.12,658.12,4
HCPCS,L19200,Afo sing upright w/ adjust s,,,287.12,287.12,1
HCPCS,L1930,Afo plastic,,,176.07,176.07,1
HCPCS,L1930,W PREFAB AFO,248.0,161.2,41.66,243.04,29
HCPCS,L19300,Afo plastic,,,176.07,176.07,1
HCPCS,L1932,Afo rig ant tib tcf/= custom,,,623.67,1806.35,4
HCPCS,L19320,Afo rig ant tib tcf/= custom,,,623.67,623.67,1
HCPCS,L1933,Afo rig ant tib tcf/= ots,,,638.64,638.64,1
HCPCS,L19330,Afo rig ant tib tcf/= ots,,,638.64,638.64,1
HCPCS,L1940,Afo molded to patient plasti,,,340.35,1006.41,4
HCPCS,L19400,Afo molded to patient plasti,,,340.35,340.35,1
HCPCS,L1945,Afo molded plas rig ant tib,,,784.52,1848.18,4
HCPCS,L19450,Afo molded plas rig ant tib,,,784.52,784.52,1
HCPCS,L1950,Afo spiral molded to pt plas,,,537.51,1402.2,4
HCPCS,L19500,Afo spiral molded to pt plas,,,537.51,537.51,1
HCPCS,L1951,Afo spiral prefab custom,,,586.95,1700.01,4
HCPCS,L19510,Afo spiral prefab custom,,,586.95,586.95,1
HCPCS,L1952,Afo spiral prefab ots,,,601.04,601.04,1
HCPCS,L19520,Afo spiral prefab ots,,,601.04,601.04,1
HCPCS,L1960,Afo pos solid ank plastic mo,,,433.24,433.24,1
HCPCS,L1960,W AFO CUSTOM PLASTIC,581.0,377.65,97.61,569.38,29
HCPCS,L19600,Afo pos solid ank plastic mo,,,433.24,433.24,1
HCPCS,L1970,Afo plastic molded w/ankle j,,,483.74,1543.39,4
HCPCS,L19700,Afo plastic molded w/ankle j,,,483.74,483.74,1
HCPCS,L1971,"Afo w/ankle joint, prefab",,,327.63,948.81,4
HCPCS,L19710,"Afo w/ankle joint, prefab",,,327.63,327.63,1
HCPCS,L1980,Afo sing solid stirrup calf,,,282.19,690.89,4
HCPCS,L19800,Afo sing solid stirrup calf,,,282.19,282.19,1
HCPCS,L1990,Afo doub solid stirrup calf,,,326.6,887.7,4
HCPCS,L19900,Afo doub solid stirrup calf,,,326.6,326.6,1
HCPCS,L2000,Kafo sing fre stirr thi/calf,,,781.86,1909.43,4
HCPCS,L20000,Kafo sing fre stirr thi/calf,,,781.86,781.86,1
HCPCS,L2005,Kafo sng/dbl mechanical act,,,2863.95,8294.78,4
HCPCS,L20050,Kafo sng/dbl mechanical act,,,2863.95,2863.95,1
HCPCS,L2006,Kaf sng/dbl swg/stn mcpr cus,,,22485.36,64511.16,4
HCPCS,L20060,Kaf sng/dbl swg/stn mcpr cus,,,22485.36,22485.36,1
HCPCS,L2010,Kafo sng solid stirrup w/o j,,,609.84,1740.63,4
HCPCS,L20100,Kafo sng solid stirrup w/o j,,,609.84,609.84,1
HCPCS,L2020,Kafo dbl solid stirrup band/,,,770.21,2198.13,4
HCPCS,L20200,Kafo dbl solid stirrup band/,,,770.21,770.21,1
HCPCS,L2030,Kafo dbl solid stirrup w/o j,,,757.06,1907.08,4
HCPCS,L20300,Kafo dbl solid stirrup w/o j,,,757.06,757.06,1
HCPCS,L2034,Kafo pla sin up w/wo k/a cus,,,1419.82,4156.41,4
HCPCS,L20340,Kafo pla sin up w/wo k/a cus,,,1419.82,1419.82,1
HCPCS,L2035,Kafo plastic pediatric size,,,121.09,350.68,4
HCPCS,L20350,Kafo plastic pediatric size,,,121.09,121.09,1
HCPCS,L2036,Kafo plas doub free knee mol,,,1295.75,3492.71,4
HCPCS,L20360,Kafo plas doub free knee mol,,,1295.75,1295.75,1
HCPCS,L2037,Kafo plas sing free knee mol,,,1159.03,3218.75,4
HCPCS,L20370,Kafo plas sing free knee mol,,,1159.03,1159.03,1
HCPCS,L2038,Kafo w/o joint multi-axis an,,,934.34,2691.51,4
HCPCS,L20380,Kafo w/o joint multi-axis an,,,934.34,934.34,1
HCPCS,L2040,Hkafo torsion bil rot straps,,,141.39,343.79,4
HCPCS,L20400,Hkafo torsion bil rot straps,,,141.39,141.39,1
HCPCS,L2050,Hkafo torsion cable hip pelv,,,340.59,915.56,4
HCPCS,L20500,Hkafo torsion cable hip pelv,,,340.59,340.59,1
HCPCS,L2060,Hkafo torsion ball bearing j,,,426.01,1175.08,4
HCPCS,L20600,Hkafo torsion ball bearing j,,,426.01,426.01,1
HCPCS,L2070,Hkafo torsion unilat rot str,,,108.49,337.56,4
HCPCS,L20700,Hkafo torsion unilat rot str,,,108.49,108.49,1
HCPCS,L2080,Hkafo unilat torsion cable,,,260.83,719.92,4
HCPCS,L20800,Hkafo unilat torsion cable,,,260.83,260.83,1
HCPCS,L2090,Hkafo unilat torsion ball br,,,347.52,887.32,4
HCPCS,L20900,Hkafo unilat torsion ball br,,,347.52,347.52,1
HCPCS,L2106,Afo tib fx cast plaster mold,,,550.9,1279.97,4
HCPCS,L21060,Afo tib fx cast plaster mold,,,550.9,550.9,1
HCPCS,L2108,Afo tib fx cast molded to pt,,,803.5,803.5,1
HCPCS,L2108,W BRACE FEMUR FX,1119.0,727.35,187.99,1096.62,29
HCPCS,L21080,Afo tib fx cast molded to pt,,,803.5,803.5,1
HCPCS,L2112,Afo tibial fracture soft,,,352.61,955.06,4
HCPCS,L21120,Afo tibial fracture soft,,,352.61,352.61,1
HCPCS,L2114,Afo tib fx semi-rigid,,,441.66,1092.68,4
HCPCS,L21140,Afo tib fx semi-rigid,,,441.66,441.66,1
HCPCS,L2116,Afo tibial fracture rigid,,,538.68,1439.62,4
HCPCS,L21160,Afo tibial fracture rigid,,,538.68,538.68,1
HCPCS,L2126,Kafo fem fx cast thermoplas,,,892.44,892.44,1
HCPCS,L2126,W ORTHOSIS KAFO FEM FX CUSTOM,1425.0,926.25,239.4,1396.5,29
HCPCS,L21260,Kafo fem fx cast thermoplas,,,892.44,892.44,1
HCPCS,L2128,Kafo fem fx cast molded to p,,,1120.6,3228.04,4
HCPCS,L21280,Kafo fem fx cast molded to p,,,1120.6,1120.6,1
HCPCS,L2132,Kafo femoral fx cast soft,,,680.18,1518.6,4
HCPCS,L21320,Kafo femoral fx cast soft,,,680.18,680.18,1
HCPCS,L2134,Kafo fem fx cast semi-rigid,,,805.42,1820.74,4
HCPCS,L21340,Kafo fem fx cast semi-rigid,,,805.42,805.42,1
HCPCS,L2136,Kafo femoral fx cast rigid,,,881.41,2226.29,4
HCPCS,L21360,Kafo femoral fx cast rigid,,,881.41,881.41,1
HCPCS,L2180,Plas shoe insert w ank joint,,,92.65,220.47,4
HCPCS,L21800,Plas shoe insert w ank joint,,,92.65,92.65,1
HCPCS,L2182,Drop lock knee,,,79.87,172.55,4
HCPCS,L21820,Drop lock knee,,,79.87,79.87,1
HCPCS,L2184,Limited motion knee joint,,,80.96,310.94,4
HCPCS,L21840,Limited motion knee joint,,,80.96,80.96,1
HCPCS,L2186,Adj motion knee jnt lerman t,,,107.67,344.54,4
HCPCS,L21860,Adj motion knee jnt lerman t,,,107.67,107.67,1
HCPCS,L2188,Quadrilateral brim,,,195.72,751.73,4
HCPCS,L21880,Quadrilateral brim,,,195.72,195.72,1
HCPCS,L2190,Waist belt,,,59.62,195.24,4
HCPCS,L21900,Waist belt,,,59.62,59.62,1
HCPCS,L2192,Pelvic band & belt thigh fla,,,233.01,671.22,4
HCPCS,L21920,Pelvic band & belt thigh fla,,,233.01,233.01,1
HCPCS,L2200,Limited ankle motion ea jnt,,,35.12,89.5,4
HCPCS,L22000,Limited ankle motion ea jnt,,,35.12,35.12,1
HCPCS,L2210,Dorsiflexion assist each joi,,,43.92,145.21,4
HCPCS,L22100,Dorsiflexion assist each joi,,,43.92,43.92,1
HCPCS,L2220,Dorsi & plantar flex ass/res,,,56.55,166.75,4
HCPCS,L22200,Dorsi & plantar flex ass/res,,,56.55,56.55,1
HCPCS,L2230,Split flat caliper stirr & p,,,66.85,144.44,4
HCPCS,L22300,Split flat caliper stirr & p,,,66.85,66.85,1
HCPCS,L2232,"Rocker bottom, contact afo",,,67.9,195.57,4
HCPCS,L22320,"Rocker bottom, contact afo",,,67.9,67.9,1
HCPCS,L2240,Round caliper and plate atta,,,66.55,157.46,4
HCPCS,L22400,Round caliper and plate atta,,,66.55,66.55,1
HCPCS,L2250,Foot plate molded stirrup at,,,233.45,668.92,4
HCPCS,L22500,Foot plate molded stirrup at,,,233.45,233.45,1
HCPCS,L2260,Reinforced solid stirrup,,,131.0,377.38,4
HCPCS,L22600,Reinforced solid stirrup,,,131.0,131.0,1
HCPCS,L2265,Long tongue stirrup,,,93.95,221.71,4
HCPCS,L22650,Long tongue stirrup,,,93.95,93.95,1
HCPCS,L2270,Varus/valgus strap padded/li,,,43.08,43.08,1
HCPCS,L2270,W STRAP PAD VARUS/VALGUS T,56.0,36.4,9.41,54.88,29
HCPCS,L22700,Varus/valgus strap padded/li,,,43.08,43.08,1
HCPCS,L2275,Plastic mod low ext pad/line,,,91.1,246.0,4
HCPCS,L22750,Plastic mod low ext pad/line,,,91.1,91.1,1
HCPCS,L2280,Molded inner boot,,,394.56,913.85,4
HCPCS,L22800,Molded inner boot,,,394.56,394.56,1
HCPCS,L2300,Abduction bar jointed adjust,,,175.95,515.87,4
HCPCS,L23000,Abduction bar jointed adjust,,,175.95,175.95,1
HCPCS,L2310,Abduction bar-straight,,,80.4,231.6,4
HCPCS,L23100,Abduction bar-straight,,,80.4,80.4,1
HCPCS,L2320,Non-molded lacer,,,134.83,387.34,4
HCPCS,L23200,Non-molded lacer,,,134.83,134.83,1
HCPCS,L2330,Lacer molded to patient mode,,,256.61,739.2,4
HCPCS,L23300,Lacer molded to patient mode,,,256.61,256.61,1
HCPCS,L2335,Anterior swing band,,,196.46,434.84,4
HCPCS,L23350,Anterior swing band,,,196.46,196.46,1
HCPCS,L2340,Pre-tibial shell molded to p,,,292.08,1026.13,4
HCPCS,L23400,Pre-tibial shell molded to p,,,292.08,292.08,1
HCPCS,L2350,Prosthetic type socket molde,,,582.31,1677.43,4
HCPCS,L23500,Prosthetic type socket molde,,,582.31,582.31,1
HCPCS,L2360,Extended steel shank,,,36.04,97.4,4
HCPCS,L23600,Extended steel shank,,,36.04,36.04,1
HCPCS,L2370,Patten bottom,,,223.68,483.25,4
HCPCS,L23700,Patten bottom,,,223.68,223.68,1
HCPCS,L2375,Torsion ank & half solid sti,,,86.0,212.7,4
HCPCS,L23750,Torsion ank & half solid sti,,,86.0,86.0,1
HCPCS,L2380,Torsion straight knee joint,,,90.2,231.77,4
HCPCS,L23800,Torsion straight knee joint,,,90.2,90.2,1
HCPCS,L2385,Straight knee joint heavy du,,,102.7,252.15,4
HCPCS,L23850,Straight knee joint heavy du,,,102.7,102.7,1
HCPCS,L2387,Add le poly knee custom kafo,,,133.42,342.19,4
HCPCS,L23870,Add le poly knee custom kafo,,,133.42,133.42,1
HCPCS,L2390,Offset knee joint each,,,71.54,206.07,4
HCPCS,L23900,Offset knee joint each,,,71.54,71.54,1
HCPCS,L2395,Offset knee joint heavy duty,,,102.25,314.62,4
HCPCS,L23950,Offset knee joint heavy duty,,,102.25,102.25,1
HCPCS,L2397,Suspension sleeve lower ext,,,85.31,220.64,4
HCPCS,L23970,Suspension sleeve lower ext,,,85.31,85.31,1
HCPCS,L2405,Knee joint drop lock ea jnt,,,60.93,176.51,4
HCPCS,L24050,Knee joint drop lock ea jnt,,,60.93,60.93,1
HCPCS,L2415,Knee joint cam lock each joi,,,84.91,245.9,4
HCPCS,L24150,Knee joint cam lock each joi,,,84.91,84.91,1
HCPCS,L2425,Knee disc/dial lock/adj flex,,,100.19,290.17,4
HCPCS,L24250,Knee disc/dial lock/adj flex,,,100.19,100.19,1
HCPCS,L2430,Knee jnt ratchet lock ea jnt,,,100.19,290.17,4
HCPCS,L24300,Knee jnt ratchet lock ea jnt,,,100.19,100.19,1
HCPCS,L2492,Knee lift loop drop lock rin,,,81.98,191.96,4
HCPCS,L24920,Knee lift loop drop lock rin,,,81.98,81.98,1
HCPCS,L2500,Thi/glut/ischia wgt bearing,,,218.71,593.89,4
HCPCS,L25000,Thi/glut/ischia wgt bearing,,,218.71,218.71,1
HCPCS,L2510,Th/wght bear quad-lat brim m,,,563.68,1590.07,4
HCPCS,L25100,Th/wght bear quad-lat brim m,,,563.68,563.68,1
HCPCS,L2520,Th/wght bear quad-lat brim c,,,375.68,867.25,4
HCPCS,L25200,Th/wght bear quad-lat brim c,,,375.68,375.68,1
HCPCS,L2525,Th/wght bear nar m-l brim mo,,,796.62,2975.32,4
HCPCS,L25250,Th/wght bear nar m-l brim mo,,,796.62,796.62,1
HCPCS,L2526,Th/wght bear nar m-l brim cu,,,447.62,1603.73,4
HCPCS,L25260,Th/wght bear nar m-l brim cu,,,447.62,447.62,1
HCPCS,L2530,Thigh/wght bear lacer non-mo,,,167.62,442.31,4
HCPCS,L25300,Thigh/wght bear lacer non-mo,,,167.62,167.62,1
HCPCS,L2540,Thigh/wght bear lacer molded,,,317.16,795.9,4
HCPCS,L25400,Thigh/wght bear lacer molded,,,317.16,317.16,1
HCPCS,L2550,Thigh/wght bear high roll cu,,,237.81,540.69,4
HCPCS,L25500,Thigh/wght bear high roll cu,,,237.81,237.81,1
HCPCS,L2570,Hip clevis type 2 posit jnt,,,311.28,1195.55,4
HCPCS,L25700,Hip clevis type 2 posit jnt,,,311.28,311.28,1
HCPCS,L2580,Pelvic control pelvic sling,,,303.31,1133.32,4
HCPCS,L25800,Pelvic control pelvic sling,,,303.31,303.31,1
HCPCS,L2600,Hip clevis/thrust bearing fr,,,149.07,386.64,4
HCPCS,L26000,Hip clevis/thrust bearing fr,,,149.07,149.07,1
HCPCS,L2610,Hip clevis/thrust bearing lo,,,164.72,457.19,4
HCPCS,L26100,Hip clevis/thrust bearing lo,,,164.72,164.72,1
HCPCS,L2620,Pelvic control hip heavy dut,,,174.73,503.34,4
HCPCS,L26200,Pelvic control hip heavy dut,,,174.73,174.73,1
HCPCS,L2622,Hip joint adjustable flexion,,,222.4,577.3,4
HCPCS,L26220,Hip joint adjustable flexion,,,222.4,222.4,1
HCPCS,L2624,Hip adj flex ext abduct cont,,,272.71,272.71,1
HCPCS,L2624,W A.L. EXT PCC HIP JNT,437.0,284.05,73.42,428.26,29
HCPCS,L26240,Hip adj flex ext abduct cont,,,272.71,272.71,1
HCPCS,L2627,Plastic mold recipro hip & c,,,1493.75,3233.42,4
HCPCS,L26270,Plastic mold recipro hip & c,,,1493.75,1493.75,1
HCPCS,L2628,Metal frame recipro hip & ca,,,1094.88,3798.22,4
HCPCS,L26280,Metal frame recipro hip & ca,,,1094.88,1094.88,1
HCPCS,L2630,Pelvic control band & belt u,,,161.83,161.83,1
HCPCS,L2630,W A.L. EXT PC BAND/BELT,259.0,168.35,43.51,253.82,29
HCPCS,L26300,Pelvic control band & belt u,,,161.83,161.83,1
HCPCS,L2640,Pelvic control band & belt b,,,219.62,632.62,4
HCPCS,L26400,Pelvic control band & belt b,,,219.62,219.62,1
HCPCS,L2650,Pelv & thor control gluteal,,,96.71,225.92,4
HCPCS,L26500,Pelv & thor control gluteal,,,96.71,96.71,1
HCPCS,L2660,Thoracic control thoracic ba,,,125.23,350.86,4
HCPCS,L26600,Thoracic control thoracic ba,,,125.23,125.23,1
HCPCS,L2670,Thorac cont paraspinal uprig,,,111.48,321.12,4
HCPCS,L26700,Thorac cont paraspinal uprig,,,111.48,111.48,1
HCPCS,L2680,Thorac cont lat support upri,,,102.27,294.58,4
HCPCS,L26800,Thorac cont lat support upri,,,102.27,102.27,1
HCPCS,L2750,Plating chrome/nickel pr bar,,,54.62,157.34,4
HCPCS,L27500,Plating chrome/nickel pr bar,,,54.62,54.62,1
HCPCS,L2755,Carbon graphite lamination,,,91.32,264.55,4
HCPCS,L27550,Carbon graphite lamination,,,91.32,91.32,1
HCPCS,L2760,Extension per extension per,,,39.71,114.38,4
HCPCS,L27600,Extension per extension per,,,39.71,39.71,1
HCPCS,L2768,Ortho sidebar disconnect,,,91.05,263.75,4
HCPCS,L27680,Ortho sidebar disconnect,,,91.05,91.05,1
HCPCS,L2780,Non-corrosive finish,,,44.23,135.3,4
HCPCS,L27800,Non-corrosive finish,,,44.23,44.23,1
HCPCS,L2785,Drop lock retainer each,,,20.71,79.54,4
HCPCS,L27850,Drop lock retainer each,,,20.71,20.71,1
HCPCS,L2795,Knee control full kneecap,,,57.33,159.96,4
HCPCS,L27950,Knee control full kneecap,,,57.33,57.33,1
HCPCS,L2800,Knee cap medial or lateral p,,,70.38,70.38,1
HCPCS,L2800,VAR/VAL KNEE CAP,101.0,65.65,16.97,98.98,29
HCPCS,L28000,Knee cap medial or lateral p,,,70.38,70.38,1
HCPCS,L2810,Knee control condylar pad,,,57.09,147.03,4
HCPCS,L28100,Knee control condylar pad,,,57.09,57.09,1
HCPCS,L2820,Soft interface below knee se,,,56.75,56.75,1
HCPCS,L2820,W LINER BRACE,91.0,59.15,15.29,89.18,29
HCPCS,L2820,W LINER INTERFACE BK SOFT,111.0,72.15,18.65,108.78,29
HCPCS,L28200,Soft interface below knee se,,,56.75,56.75,1
HCPCS,L2830,Soft interface above knee se,,,61.4,61.4,1
HCPCS,L2830,W LINER INTERFACE AK SOFT,125.0,81.25,21.0,122.5,29
HCPCS,L2830,W ORTHOSIS ADDTL ABOVE KNEE,102.0,66.3,17.14,99.96,29
HCPCS,L28300,Soft interface above knee se,,,61.4,61.4,1
HCPCS,L2840,Tibial length sock fx or equ,,,30.15,102.62,4
HCPCS,L28400,Tibial length sock fx or equ,,,30.15,30.15,1
HCPCS,L2850,Femoral lgth sock fx or equa,,,42.27,116.55,4
HCPCS,L28500,Femoral lgth sock fx or equa,,,42.27,42.27,1
HCPCS,L2861,Torsion mechanism knee/ankle,,,136.11,136.11,1
HCPCS,L28610,Torsion mechanism knee/ankle,,,136.11,136.11,1
HCPCS,L3000,Ft insert ucb berkeley shell,,,219.55,635.9,4
HCPCS,L30000,Ft insert ucb berkeley shell,,,219.55,219.55,1
HCPCS,L3001,Foot insert remov molded spe,,,92.45,267.74,4
HCPCS,L30010,Foot insert remov molded spe,,,92.45,92.45,1
HCPCS,L3002,Foot insert plastazote or eq,,,112.88,326.91,4
HCPCS,L30020,Foot insert plastazote or eq,,,112.88,112.88,1
HCPCS,L3003,Foot insert silicone gel eac,,,121.76,352.7,4
HCPCS,L30030,Foot insert silicone gel eac,,,121.76,121.76,1
HCPCS,L3010,Foot longitudinal arch suppo,,,121.76,352.7,4
HCPCS,L30100,Foot longitudinal arch suppo,,,121.76,121.76,1
HCPCS,L3020,CUSTOM FOOT ORTHOTIC,120.0,78.0,20.16,117.6,29
HCPCS,L3020,CUSTOM FOOT ORTHOTIC/ ORTHOTICS METARSAL SUPPORT,120.0,78.0,20.16,117.6,29
HCPCS,L3020,FOOT INSERT REMOVABLE LONG/MT SPPT,543.0,352.95,93.88,543.0,17
HCPCS,L3020,Foot longitud/metatarsal sup,,,138.67,138.67,1
HCPCS,L30200,Foot longitud/metatarsal sup,,,138.67,138.67,1
HCPCS,L3030,Foot arch support remov prem,,,53.33,154.5,4
HCPCS,L30300,Foot arch support remov prem,,,53.33,53.33,1
HCPCS,L3031,Foot lamin/prepreg composite,,,85.6,247.89,4
HCPCS,L30310,Foot lamin/prepreg composite,,,85.6,85.6,1
HCPCS,L3040,FOOT ARCH SUPPORT REMV LONG,64.0,41.6,22.27,64.0,17
HCPCS,L3040,Ft arch suprt premold longit,,,32.9,95.26,4
HCPCS,L30400,Ft arch suprt premold longit,,,32.9,32.9,1
HCPCS,L3050,Foot arch supp premold metat,,,32.9,95.26,4
HCPCS,L30500,Foot arch supp premold metat,,,32.9,32.9,1
HCPCS,L3060,Foot arch supp longitud/meta,,,51.55,149.3,4
HCPCS,L30600,Foot arch supp longitud/meta,,,51.55,51.55,1
HCPCS,L3070,Arch suprt att to sho longit,,,22.23,64.35,4
HCPCS,L30700,Arch suprt att to sho longit,,,22.23,22.23,1
HCPCS,L3080,Arch supp att to shoe metata,,,22.23,64.35,4
HCPCS,L30800,Arch supp att to shoe metata,,,22.23,22.23,1
HCPCS,L3090,Arch supp att to shoe long/m,,,28.45,82.41,4
HCPCS,L30900,Arch supp att to shoe long/m,,,28.45,28.45,1
HCPCS,L3100,Hallus-valgus nt dyn pre ots,,,30.24,87.49,4
HCPCS,L31000,Hallus-valgus nt dyn pre ots,,,30.24,30.24,1
HCPCS,L3140,Abduction rotation bar shoe,,,62.22,180.25,4
HCPCS,L31400,Abduction rotation bar shoe,,,62.22,62.22,1
HCPCS,L3150,Abduct rotation bar w/o shoe,,,56.89,164.78,4
HCPCS,L31500,Abduct rotation bar w/o shoe,,,56.89,56.89,1
HCPCS,L3160,Shoe styled positioning dev,,,6.58,6.58,1
HCPCS,L31600,Shoe styled positioning dev,,,6.58,6.58,1
HCPCS,L3170,Foot plas heel stabi pre ots,,,35.55,103.0,4
HCPCS,L31700,Foot plas heel stabi pre ots,,,35.55,35.55,1
HCPCS,L3201,Oxford w supinat/pronat inf,,,19.09,19.09,1
HCPCS,L32010,Oxford w supinat/pronat inf,,,19.09,19.09,1
HCPCS,L3202,Oxford w/ supinat/pronator c,,,18.74,18.74,1
HCPCS,L32020,Oxford w/ supinat/pronator c,,,18.74,18.74,1
HCPCS,L3203,Oxford w/ supinator/pronator,,,18.2,18.2,1
HCPCS,L32030,Oxford w/ supinator/pronator,,,18.2,18.2,1
HCPCS,L3204,Hightop w/ supp/pronator inf,,,18.2,18.2,1
HCPCS,L32040,Hightop w/ supp/pronator inf,,,18.2,18.2,1
HCPCS,L3206,Hightop w/ supp/pronator chi,,,18.91,18.91,1
HCPCS,L32060,Hightop w/ supp/pronator chi,,,18.91,18.91,1
HCPCS,L3207,Hightop w/ supp/pronator jun,,,19.28,19.28,1
HCPCS,L32070,Hightop w/ supp/pronator jun,,,19.28,19.28,1
HCPCS,L3208,Surgical boot each infant,,,10.09,10.09,1
HCPCS,L32080,Surgical boot each infant,,,10.09,10.09,1
HCPCS,L3209,Surgical boot each child,,,14.41,14.41,1
HCPCS,L32090,Surgical boot each child,,,14.41,14.41,1
HCPCS,L3211,Surgical boot each junior,,,15.31,15.31,1
HCPCS,L32110,Surgical boot each junior,,,15.31,15.31,1
HCPCS,L3212,Benesch boot pair infant,,,21.25,21.25,1
HCPCS,L32120,Benesch boot pair infant,,,21.25,21.25,1
HCPCS,L3213,Benesch boot pair child,,,25.76,25.76,1
HCPCS,L32130,Benesch boot pair child,,,25.76,25.76,1
HCPCS,L3214,Benesch boot pair junior,,,27.38,27.38,1
HCPCS,L32140,Benesch boot pair junior,,,27.38,27.38,1
HCPCS,L3215,Orthopedic ftwear ladies oxf,,,34.77,34.77,1
HCPCS,L32150,Orthopedic ftwear ladies oxf,,,34.77,34.77,1
HCPCS,L3216,Orthoped ladies shoes dpth i,,,42.15,42.15,1
HCPCS,L32160,Orthoped ladies shoes dpth i,,,42.15,42.15,1
HCPCS,L3217,Ladies shoes hightop depth i,,,45.58,45.58,1
HCPCS,L32170,Ladies shoes hightop depth i,,,45.58,45.58,1
HCPCS,L3219,Orthopedic mens shoes oxford,,,39.09,39.09,1
HCPCS,L32190,Orthopedic mens shoes oxford,,,39.09,39.09,1
HCPCS,L3221,Orthopedic mens shoes dpth i,,,46.83,46.83,1
HCPCS,L32210,Orthopedic mens shoes dpth i,,,46.83,46.83,1
HCPCS,L3222,Mens shoes hightop depth inl,,,51.87,51.87,1
HCPCS,L32220,Mens shoes hightop depth inl,,,51.87,51.87,1
HCPCS,L3224,Woman's shoe oxford brace,,,47.23,110.7,4
HCPCS,L32240,Woman's shoe oxford brace,,,47.23,47.23,1
HCPCS,L3225,Man's shoe oxford brace,,,51.58,127.35,4
HCPCS,L32250,Man's shoe oxford brace,,,51.58,51.58,1
HCPCS,L3230,Custom shoes depth inlay,,,61.06,61.06,1
HCPCS,L32300,Custom shoes depth inlay,,,61.06,61.06,1
HCPCS,L3250,Custom mold shoe remov prost,,,118.7,118.7,1
HCPCS,L32500,Custom mold shoe remov prost,,,118.7,118.7,1
HCPCS,L3251,Shoe molded to pt silicone s,,,16.39,16.39,1
HCPCS,L32510,Shoe molded to pt silicone s,,,16.39,16.39,1
HCPCS,L3252,Shoe molded plastazote cust,,,65.03,65.03,1
HCPCS,L32520,Shoe molded plastazote cust,,,65.03,65.03,1
HCPCS,L3253,Shoe molded plastazote cust,,,16.21,16.21,1
HCPCS,L32530,Shoe molded plastazote cust,,,16.21,16.21,1
HCPCS,L3254,Orth foot non-stndard size/w,,,19.26,19.26,1
HCPCS,L32540,Orth foot non-stndard size/w,,,19.26,19.26,1
HCPCS,L3255,Orth foot non-standard size/,,,26.9,26.9,1
HCPCS,L32550,Orth foot non-standard size/,,,26.9,26.9,1
HCPCS,L3257,Orth foot add charge split s,,,11.71,11.71,1
HCPCS,L32570,Orth foot add charge split s,,,11.71,11.71,1
HCPCS,L3260,AMBULATORY SURGICAL BOOT EAC,19.0,12.35,4.92,19.0,13
HCPCS,L3260,Ambulatory surgical boot eac,,,6.66,6.66,1
HCPCS,L3260,SURGICAL BOOT/SHOE EA,19.0,12.35,3.19,17.1,21
HCPCS,L32600,Ambulatory surgical boot eac,,,6.66,6.66,1
HCPCS,L3265,Plastazote sandal each,,,7.2,7.2,1
HCPCS,L32650,Plastazote sandal each,,,7.2,7.2,1
HCPCS,L3300,Sho lift taper to metatarsal,,,36.45,105.52,4
HCPCS,L33000,Sho lift taper to metatarsal,,,36.45,36.45,1
HCPCS,L3310,Shoe lift elev heel/sole neo,,,56.89,164.78,4
HCPCS,L33100,Shoe lift elev heel/sole neo,,,56.89,56.89,1
HCPCS,L3320,Shoe lift elev heel/sole cor,,,43.96,43.96,1
HCPCS,L33200,Shoe lift elev heel/sole cor,,,43.96,43.96,1
HCPCS,L3330,Lifts elevation metal extens,,,395.54,1145.59,4
HCPCS,L33300,Lifts elevation metal extens,,,395.54,395.54,1
HCPCS,L3332,Shoe lifts tapered to one-ha,,,51.55,149.3,4
HCPCS,L33320,Shoe lifts tapered to one-ha,,,51.55,51.55,1
HCPCS,L3334,Shoe lifts elevation heel /i,,,26.65,77.22,4
HCPCS,L33340,Shoe lifts elevation heel /i,,,26.65,26.65,1
HCPCS,L3340,Shoe wedge sach,,,59.56,172.55,4
HCPCS,L33400,Shoe wedge sach,,,59.56,59.56,1
HCPCS,L3350,Shoe heel wedge,,,15.98,46.3,4
HCPCS,L33500,Shoe heel wedge,,,15.98,15.98,1
HCPCS,L3360,Shoe sole wedge outside sole,,,24.88,72.09,4
HCPCS,L33600,Shoe sole wedge outside sole,,,24.88,24.88,1
HCPCS,L3370,Shoe sole wedge between sole,,,34.67,100.43,4
HCPCS,L33700,Shoe sole wedge between sole,,,34.67,34.67,1
HCPCS,L3380,Shoe clubfoot wedge,,,34.67,100.43,4
HCPCS,L33800,Shoe clubfoot wedge,,,34.67,34.67,1
HCPCS,L3390,Shoe outflare wedge,,,34.67,100.43,4
HCPCS,L33900,Shoe outflare wedge,,,34.67,34.67,1
HCPCS,L3400,Shoe metatarsal bar wedge ro,,,28.45,82.41,4
HCPCS,L34000,Shoe metatarsal bar wedge ro,,,28.45,28.45,1
HCPCS,L3410,Shoe metatarsal bar between,,,64.89,187.97,4
HCPCS,L34100,Shoe metatarsal bar between,,,64.89,64.89,1
HCPCS,L3420,Full sole/heel wedge btween,,,38.22,110.67,4
HCPCS,L34200,Full sole/heel wedge btween,,,38.22,38.22,1
HCPCS,L3430,Sho heel count plast reinfor,,,112.0,324.37,4
HCPCS,L34300,Sho heel count plast reinfor,,,112.0,112.0,1
HCPCS,L3440,Heel leather reinforced,,,53.33,154.5,4
HCPCS,L34400,Heel leather reinforced,,,53.33,53.33,1
HCPCS,L3450,Shoe heel sach cushion type,,,73.75,213.62,4
HCPCS,L34500,Shoe heel sach cushion type,,,73.75,73.75,1
HCPCS,L3455,Shoe heel new leather standa,,,28.45,82.41,4
HCPCS,L34550,Shoe heel new leather standa,,,28.45,28.45,1
HCPCS,L3460,Shoe heel new rubber standar,,,24.01,69.48,4
HCPCS,L34600,Shoe heel new rubber standar,,,24.01,24.01,1
HCPCS,L3465,Shoe heel thomas with wedge,,,40.91,118.41,4
HCPCS,L34650,Shoe heel thomas with wedge,,,40.91,40.91,1
HCPCS,L3470,Shoe heel thomas extend to b,,,43.55,126.13,4
HCPCS,L34700,Shoe heel thomas extend to b,,,43.55,43.55,1
HCPCS,L3480,Shoe heel pad & depress for,,,43.55,126.13,4
HCPCS,L34800,Shoe heel pad & depress for,,,43.55,43.55,1
HCPCS,L3485,Shoe heel pad removable for,,,6.66,6.66,1
HCPCS,L34850,Shoe heel pad removable for,,,6.66,6.66,1
HCPCS,L3500,Ortho shoe add leather insol,,,20.43,59.27,4
HCPCS,L35000,Ortho shoe add leather insol,,,20.43,20.43,1
HCPCS,L3510,Orthopedic shoe add rub insl,,,20.43,59.27,4
HCPCS,L35100,Orthopedic shoe add rub insl,,,20.43,20.43,1
HCPCS,L3520,O shoe add felt w leath insl,,,22.23,64.35,4
HCPCS,L35200,O shoe add felt w leath insl,,,22.23,22.23,1
HCPCS,L3530,Ortho shoe add half sole,,,22.23,64.35,4
HCPCS,L35300,Ortho shoe add half sole,,,22.23,22.23,1
HCPCS,L3540,Ortho shoe add full sole,,,35.55,103.0,4
HCPCS,L35400,Ortho shoe add full sole,,,35.55,35.55,1
HCPCS,L3550,O shoe add standard toe tap,,,6.25,18.05,4
HCPCS,L35500,O shoe add standard toe tap,,,6.25,6.25,1
HCPCS,L3560,O shoe add horseshoe toe tap,,,15.98,46.3,4
HCPCS,L35600,O shoe add horseshoe toe tap,,,15.98,15.98,1
HCPCS,L3570,O shoe add instep extension,,,59.56,172.55,4
HCPCS,L35700,O shoe add instep extension,,,59.56,59.56,1
HCPCS,L3580,O shoe add instep velcro clo,,,45.33,131.29,4
HCPCS,L35800,O shoe add instep velcro clo,,,45.33,45.33,1
HCPCS,L3590,O shoe convert to sof counte,,,37.34,108.15,4
HCPCS,L35900,O shoe convert to sof counte,,,37.34,37.34,1
HCPCS,L3595,Ortho shoe add march bar,,,29.31,84.94,4
HCPCS,L35950,Ortho shoe add march bar,,,29.31,29.31,1
HCPCS,L3600,Trans shoe calip plate exist,,,53.33,154.5,4
HCPCS,L36000,Trans shoe calip plate exist,,,53.33,53.33,1
HCPCS,L3610,Trans shoe caliper plate new,,,70.22,203.34,4
HCPCS,L36100,Trans shoe caliper plate new,,,70.22,70.22,1
HCPCS,L3620,Trans shoe solid stirrup exi,,,53.33,154.5,4
HCPCS,L36200,Trans shoe solid stirrup exi,,,53.33,53.33,1
HCPCS,L3630,Trans shoe solid stirrup new,,,70.22,203.34,4
HCPCS,L36300,Trans shoe solid stirrup new,,,70.22,70.22,1
HCPCS,L3640,Shoe dennis browne splint bo,,,30.24,87.49,4
HCPCS,L36400,Shoe dennis browne splint bo,,,30.24,30.24,1
HCPCS,L3650,SHOULDER ORTHOSIS,80.0,52.0,25.78,80.0,17
HCPCS,L3650,So 8 abd restraint pre ots,,,45.84,110.27,4
HCPCS,L36500,So 8 abd restraint pre ots,,,45.84,45.84,1
HCPCS,L3660,So 8 ab rstr can/web pre ots,,,65.73,189.34,4
HCPCS,L36600,So 8 ab rstr can/web pre ots,,,65.73,65.73,1
HCPCS,L3670,So acro/clav can web pre ots,,,72.32,263.88,4
HCPCS,L36700,So acro/clav can web pre ots,,,72.32,72.32,1
HCPCS,L3671,So cap design w/o jnts cf,,,573.13,1659.92,4
HCPCS,L36710,So cap design w/o jnts cf,,,573.13,573.13,1
HCPCS,L3674,So airplane w/wo joint cf,,,751.86,2177.6,4
HCPCS,L36740,So airplane w/wo joint cf,,,751.86,751.86,1
HCPCS,L3675,So vest canvas/web pre ots,,,111.64,323.29,4
HCPCS,L36750,So vest canvas/web pre ots,,,111.64,111.64,1
HCPCS,L3677,So hard plas stabili pre cst,,,48.09,48.09,1
HCPCS,L36770,So hard plas stabili pre cst,,,48.09,48.09,1
HCPCS,L3678,So hard plas stabili pre ots,,,95.04,95.04,1
HCPCS,L36780,So hard plas stabili pre ots,,,95.04,95.04,1
HCPCS,L3702,EO CUSTOM W/O WRIST,267.47,173.86,44.93,262.12,29
HCPCS,L3702,EO W/O JOINTS CF,34.0,22.1,17.0,244.73,17
HCPCS,L3702,Eo w/o joints cf,,,183.68,183.68,1
HCPCS,L37020,Eo w/o joints cf,,,183.68,183.68,1
HCPCS,L3710,ELBOW ORTHOSIS WITH METAL JOINTS,535.0,347.75,62.44,535.0,17
HCPCS,L3710,EO PREFAB ELASTIC W METAL JOINTS,123.9,80.54,20.82,121.42,29
HCPCS,L3710,Eo elas w/metal jnts pre ots,,,90.83,90.83,1
HCPCS,L37100,Eo elas w/metal jnts pre ots,,,90.83,90.83,1
HCPCS,L3720,Forearm/arm cuffs free motio,,,434.61,1332.54,4
HCPCS,L37200,Forearm/arm cuffs free motio,,,434.61,434.61,1
HCPCS,L3730,Forearm/arm cuffs ext/flex a,,,576.47,1754.13,4
HCPCS,L37300,Forearm/arm cuffs ext/flex a,,,576.47,576.47,1
HCPCS,L3740,Cuffs adj lock w/ active con,,,683.46,683.46,1
HCPCS,L3740,W BRACE ELBOW ROM,2098.0,1363.7,352.46,2056.04,32
HCPCS,L37400,Cuffs adj lock w/ active con,,,683.46,683.46,1
HCPCS,L3760,EO PREFAB W ADJ LOCK JNTS,513.0,333.45,86.18,502.74,29
HCPCS,L3760,Eo adj jt prefab custom fit,,,318.11,318.11,1
HCPCS,L37600,Eo adj jt prefab custom fit,,,318.11,318.11,1
HCPCS,L3761,"Eo, adj lock joint prefab ot",,,318.11,921.26,4
HCPCS,L37610,"Eo, adj lock joint prefab ot",,,318.11,318.11,1
HCPCS,L3762,EO PREFAB RIGID W/O JOINTS,77.4,50.31,13.0,75.85,29
HCPCS,L3762,Eo rigid w/o joints pre ots,,,68.39,68.39,1
HCPCS,L37620,Eo rigid w/o joints pre ots,,,68.39,68.39,1
HCPCS,L3763,EO CUSTOM W/WRIST,267.47,173.86,44.93,262.12,29
HCPCS,L3763,Ewho rigid w/o jnts cf,,,476.0,476.0,1
HCPCS,L37630,Ewho rigid w/o jnts cf,,,476.0,476.0,1
HCPCS,L3764,Ewho w/joint(s) cf,,,498.15,1458.65,4
HCPCS,L37640,Ewho w/joint(s) cf,,,498.15,498.15,1
HCPCS,L3765,Ewhfo rigid w/o jnts cf,,,815.61,2362.18,4
HCPCS,L37650,Ewhfo rigid w/o jnts cf,,,815.61,815.61,1
HCPCS,L3766,Ewhfo w/joint(s) cf,,,863.68,2501.4,4
HCPCS,L37660,Ewhfo w/joint(s) cf,,,863.68,863.68,1
HCPCS,L3806,WHFO CUSTOM W/JOINTS,475.0,308.75,79.8,465.5,29
HCPCS,L3806,Whfo w/joint(s) custom fab,,,288.92,288.92,1
HCPCS,L38060,Whfo w/joint(s) custom fab,,,288.92,288.92,1
HCPCS,L3807,SPLINT WRIST FOREARM MED,282.0,183.3,107.69,282.0,17
HCPCS,L3807,SPLINT WRIST FOREARM SML,282.0,183.3,107.69,282.0,17
HCPCS,L3807,SPLINT WRIST LARGE,282.0,183.3,107.69,282.0,17
HCPCS,L3807,SPLINT WRIST SMALL RIGHT,282.0,183.3,107.69,282.0,17
HCPCS,L3807,SPLINT WRIST/HAND RT LRG,282.0,183.3,107.69,282.0,17
HCPCS,L3807,"SPLINT, THUMB SPICA",30.0,19.5,15.0,211.93,17
HCPCS,L3807,W PREFAB WHFO WO JNTS,79.0,51.35,13.27,77.42,29
HCPCS,L3807,WHFO PREFAB W/O JOINTS,256.0,166.4,43.01,250.88,29
HCPCS,L3807,WHFO W INFLATABLE AIRCHAMBER,355.0,230.75,107.69,355.0,17
HCPCS,L3807,Whfo w/o joints pre cst,,,159.05,159.05,1
HCPCS,L38070,Whfo w/o joints pre cst,,,159.05,159.05,1
HCPCS,L3808,WHFO CUSTOM RIGID W/OUT JOINTS,141.0,91.65,23.69,138.18,29
HCPCS,L3808,"Whfo, rigid w/o joints",,,226.58,226.58,1
HCPCS,L38080,"Whfo, rigid w/o joints",,,226.58,226.58,1
HCPCS,L3809,Whfo w/o joints pre ots,,,159.05,460.66,4
HCPCS,L38090,Whfo w/o joints pre ots,,,159.05,159.05,1
HCPCS,L3891,Torsion mechanism wrist/elbo,,,133.88,133.88,1
HCPCS,L38910,Torsion mechanism wrist/elbo,,,133.88,133.88,1
HCPCS,L3900,Hinge extension/flex wrist/f,,,1030.41,2877.88,4
HCPCS,L39000,Hinge extension/flex wrist/f,,,1030.41,1030.41,1
HCPCS,L3901,Hinge ext/flex wrist finger,,,1350.41,3226.87,4
HCPCS,L39010,Hinge ext/flex wrist finger,,,1350.41,1350.41,1
HCPCS,L3904,Whfo electric custom fitted,,,2146.99,6569.02,4
HCPCS,L39040,Whfo electric custom fitted,,,2146.99,2146.99,1
HCPCS,L3905,WHO CUSTOM W/NONTORSION JOINTS,310.0,201.5,52.08,303.8,29
HCPCS,L3905,Who w/nontorsion jnt(s) cf,,,630.78,630.78,1
HCPCS,L39050,Who w/nontorsion jnt(s) cf,,,630.78,630.78,1
HCPCS,L3906,WHO CUSTOM W/O JOINTS,72.04,46.83,12.1,70.6,29
HCPCS,L3906,Who w/o joints cf,,,322.34,322.34,1
HCPCS,L39060,Who w/o joints cf,,,322.34,322.34,1
HCPCS,L3908,WHFO WRIST EXTENSION CONTROL,63.0,40.95,25.8,63.0,17
HCPCS,L3908,WHO PREFAB WRIST W/O JOINTS,61.0,39.65,10.25,59.78,29
HCPCS,L3908,Who cock-up nonmolde pre ots,,,46.63,46.63,1
HCPCS,L39080,Who cock-up nonmolde pre ots,,,46.63,46.63,1
HCPCS,L3912,Hfo flexion glove pre ots,,,67.01,67.01,1
HCPCS,L3912,WHFO PREFAB FLEXION GLOVE,30.0,19.5,5.04,29.4,29
HCPCS,L39120,Hfo flexion glove pre ots,,,67.01,67.01,1
HCPCS,L3913,HFO CUSTOM W/O JOINTS,175.0,113.75,29.4,171.5,29
HCPCS,L3913,Hfo w/o joints cf,,,172.26,172.26,1
HCPCS,L39130,Hfo w/o joints cf,,,172.26,172.26,1
HCPCS,L3915,Who nontorsion jnts pre cst,,,338.12,979.31,4
HCPCS,L39150,Who nontorsion jnts pre cst,,,338.12,338.12,1
HCPCS,L3916,Who nontorsion jnts pre ots,,,338.12,979.31,4
HCPCS,L39160,Who nontorsion jnts pre ots,,,338.12,338.12,1
HCPCS,L3917,Metacarp fx orthosis pre cst,,,67.17,194.6,4
HCPCS,L39170,Metacarp fx orthosis pre cst,,,67.17,67.17,1
HCPCS,L3918,Metacarp fx orthosis pre ots,,,67.17,194.6,4
HCPCS,L39180,Metacarp fx orthosis pre ots,,,67.17,67.17,1
HCPCS,L3919,HO CUSTOM W/O FINGERS,50.0,32.5,8.4,49.0,29
HCPCS,L3919,Ho w/o joints cf,,,172.26,172.26,1
HCPCS,L39190,Ho w/o joints cf,,,172.26,172.26,1
HCPCS,L3921,HFO CUSTOM W/JOINTS,300.0,195.0,50.4,294.0,29
HCPCS,L3921,Hfo w/joint(s) cf,,,204.33,204.33,1
HCPCS,L39210,Hfo w/joint(s) cf,,,204.33,204.33,1
HCPCS,L3923,HFO PREFAB W/O JOINTS RIGID,54.0,35.1,9.07,52.92,29
HCPCS,L3923,HFO PREFAB W/O JOINTS SOFT,30.0,19.5,5.04,29.4,29
HCPCS,L3923,HFO W/O JOINTS PF,46.0,29.9,23.0,73.72,17
HCPCS,L3923,Hfo without joints pre cst,,,61.44,61.44,1
HCPCS,L3923,SPLINT 4 PRONG,37.0,24.05,18.5,73.72,17
HCPCS,L3923,SPLINT BASEBALL,37.0,24.05,18.5,73.72,17
HCPCS,L3923,SPLINT FINGER VELCRO,37.0,24.05,18.5,73.72,17
HCPCS,L3923,SPLINT THUMB,37.0,24.05,18.5,73.72,17
HCPCS,L39230,Hfo without joints pre cst,,,61.44,61.44,1
HCPCS,L3924,Hfo without joints pre ots,,,61.44,160.25,4
HCPCS,L39240,Hfo without joints pre ots,,,61.44,61.44,1
HCPCS,L3925,FO PREFAB SPRING TENSION FINGER,25.0,16.25,4.2,24.5,29
HCPCS,L3925,Fo pip dip jnt/sprng pre ots,,,41.79,41.79,1
HCPCS,L39250,Fo pip dip jnt/sprng pre ots,,,41.79,41.79,1
HCPCS,L3927,FO PREFAB STATIC FINGER,27.0,17.55,4.54,26.46,29
HCPCS,L3927,Fo pip dip no jt spr pre ots,,,22.26,22.26,1
HCPCS,L39270,Fo pip dip no jt spr pre ots,,,22.26,22.26,1
HCPCS,L3929,HFO PREFAB HINGED W/ JOINTS,97.84,63.6,16.44,95.88,29
HCPCS,L3929,Hfo nontorsion jnts pre cst,,,58.1,58.1,1
HCPCS,L39290,Hfo nontorsion jnts pre cst,,,58.1,58.1,1
HCPCS,L3930,Hfo nontorsion jnts pre ots,,,58.1,155.09,4
HCPCS,L39300,Hfo nontorsion jnts pre ots,,,58.1,58.1,1
HCPCS,L3931,WHFO PREFAB W/ JOINTS,107.0,69.55,17.98,104.86,29
HCPCS,L3931,Whfo nontorsion joint prefab,,,132.62,132.62,1
HCPCS,L39310,Whfo nontorsion joint prefab,,,132.62,132.62,1
HCPCS,L3933,FO CUSTOM STATIC FINGER,25.0,16.25,4.2,24.5,29
HCPCS,L3933,FO STATIC FINGER CUSTOM,25.0,16.25,4.2,24.5,29
HCPCS,L3933,Fo w/o joints cf,,,135.71,135.71,1
HCPCS,L39330,Fo w/o joints cf,,,135.71,135.71,1
HCPCS,L3935,"FO CUSTOM STATIC-PROGRESSIVE, DYNAMIC",266.0,172.9,44.69,260.68,29
HCPCS,L3935,"FO STATIC-PROGRESSIVE, DYNAMIC CUSTOM",266.0,172.9,44.69,260.68,29
HCPCS,L3935,Fo nontorsion joint cf,,,140.51,140.51,1
HCPCS,L39350,Fo nontorsion joint cf,,,140.51,140.51,1
HCPCS,L3956,Add joint upper ext orthosis,,,24.67,24.67,1
HCPCS,L39560,Add joint upper ext orthosis,,,24.67,24.67,1
HCPCS,L3960,Sewho airplan desig abdu pos,,,507.31,1518.5,4
HCPCS,L39600,Sewho airplan desig abdu pos,,,507.31,507.31,1
HCPCS,L3961,Sewho cap design w/o jnts cf,,,1068.69,3095.16,4
HCPCS,L39610,Sewho cap design w/o jnts cf,,,1068.69,1068.69,1
HCPCS,L3962,Sewho erbs palsey design abd,,,458.83,1581.1,4
HCPCS,L39620,Sewho erbs palsey design abd,,,458.83,458.83,1
HCPCS,L3967,Sewho airplane w/o jnts cf,,,1261.74,3654.34,4
HCPCS,L39670,Sewho airplane w/o jnts cf,,,1261.74,1261.74,1
HCPCS,L3971,Sewho cap design w/jnt(s) cf,,,1197.7,3468.75,4
HCPCS,L39710,Sewho cap design w/jnt(s) cf,,,1197.7,1197.7,1
HCPCS,L3973,Sewho airplane w/jnt(s) cf,,,1261.74,3654.34,4
HCPCS,L39730,Sewho airplane w/jnt(s) cf,,,1261.74,1261.74,1
HCPCS,L3975,Sewhfo cap design w/o jnt cf,,,1068.69,3095.16,4
HCPCS,L39750,Sewhfo cap design w/o jnt cf,,,1068.69,1068.69,1
HCPCS,L3976,Sewhfo airplane w/o jnts cf,,,1068.69,3095.16,4
HCPCS,L39760,Sewhfo airplane w/o jnts cf,,,1068.69,1068.69,1
HCPCS,L3977,Sewhfo cap desgn w/jnt(s) cf,,,1197.7,3468.75,4
HCPCS,L39770,Sewhfo cap desgn w/jnt(s) cf,,,1197.7,1197.7,1
HCPCS,L3978,Sewhfo airplane w/jnt(s) cf,,,1261.74,3654.34,4
HCPCS,L39780,Sewhfo airplane w/jnt(s) cf,,,1261.74,1261.74,1
HCPCS,L3980,HUMERAL FRACT CUFF FIT & ADJ,110.0,71.5,18.48,107.8,29
HCPCS,L3980,"UE FX ORTHOSIS, HUMERAL",604.0,392.6,101.47,591.92,29
HCPCS,L3980,UE PREFAB HUMERAL BRACE,273.6,177.84,45.96,268.13,29
HCPCS,L3980,"UPPER LIMB FX ORTHOSIS, HUMERAL",422.0,274.3,133.13,422.0,17
HCPCS,L3980,Up ext fx orthos humeral nos,,,246.08,246.08,1
HCPCS,L3980,W BRACE HUMERUS FX,317.0,206.05,53.26,310.66,29
HCPCS,L39800,Up ext fx orthos humeral nos,,,246.08,246.08,1
HCPCS,L3981,Ue fx orth shoul cap forearm,,,640.25,1854.33,4
HCPCS,L39810,Ue fx orth shoul cap forearm,,,640.25,640.25,1
HCPCS,L3982,COLLUM SPLINT,431.0,280.15,164.48,431.0,17
HCPCS,L3982,UNIVERSAL FOREARM SML,431.0,280.15,164.48,431.0,17
HCPCS,L3982,"UPPER LIMB FX ORTHOSIS, RADIUS/ULNA",543.0,352.95,164.48,543.0,17
HCPCS,L3982,Upper ext fx orthosis rad/ul,,,249.86,703.59,4
HCPCS,L39820,Upper ext fx orthosis rad/ul,,,249.86,249.86,1
HCPCS,L3984,Upper ext fx orthosis wrist,,,220.1,751.03,4
HCPCS,L39840,Upper ext fx orthosis wrist,,,220.1,220.1,1
HCPCS,L3995,Sock fracture or equal each,,,26.11,26.11,1
HCPCS,L3995,"W ADD TO UE ORTHO,SOCK, FX EACH",35.0,22.75,5.88,34.3,29
HCPCS,L39950,Sock fracture or equal each,,,26.11,26.11,1
HCPCS,L3999,AIRCAST PNEUMATIC ARM BAN,96.0,62.4,48.0,96.0,12
HCPCS,L3999,UNLISTED UPPER LIMB ORTHOSIS PROCS,110.0,71.5,55.0,110.0,12
HCPCS,L4000,Repl girdle milwaukee orth,,,923.56,2455.84,4
HCPCS,L40000,Repl girdle milwaukee orth,,,923.56,923.56,1
HCPCS,L4002,"Replace strap, any orthosis",,,27.0,27.0,1
HCPCS,L40020,"Replace strap, any orthosis",,,27.0,27.0,1
HCPCS,L4010,Replace trilateral socket br,,,561.35,1381.98,4
HCPCS,L40100,Replace trilateral socket br,,,561.35,561.35,1
HCPCS,L4020,Replace quadlat socket brim,,,674.33,1726.23,4
HCPCS,L40200,Replace quadlat socket brim,,,674.33,674.33,1
HCPCS,L4030,Replace socket brim cust fit,,,428.52,950.46,4
HCPCS,L40300,Replace socket brim cust fit,,,428.52,428.52,1
HCPCS,L4040,Replace molded thigh lacer,,,290.2,768.44,4
HCPCS,L40400,Replace molded thigh lacer,,,290.2,290.2,1
HCPCS,L4045,Replace non-molded thigh lac,,,214.37,617.52,4
HCPCS,L40450,Replace non-molded thigh lac,,,214.37,214.37,1
HCPCS,L4050,Replace molded calf lacer,,,287.41,777.18,4
HCPCS,L40500,Replace molded calf lacer,,,287.41,287.41,1
HCPCS,L4055,Replace non-molded calf lace,,,174.7,503.26,4
HCPCS,L40550,Replace non-molded calf lace,,,174.7,174.7,1
HCPCS,L4060,Replace high roll cuff,,,227.09,598.27,4
HCPCS,L40600,Replace high roll cuff,,,227.09,227.09,1
HCPCS,L4070,Replace prox & dist upright,,,183.91,570.76,4
HCPCS,L40700,Replace prox & dist upright,,,183.91,183.91,1
HCPCS,L4080,Repl met band kafo-afo prox,,,69.43,201.22,4
HCPCS,L40800,Repl met band kafo-afo prox,,,69.43,69.43,1
HCPCS,L4090,Repl met band kafo-afo calf/,,,59.08,178.11,4
HCPCS,L40900,Repl met band kafo-afo calf/,,,59.08,59.08,1
HCPCS,L4100,Repl leath cuff kafo prox th,,,70.98,200.9,4
HCPCS,L41000,Repl leath cuff kafo prox th,,,70.98,70.98,1
HCPCS,L4110,Repl leath cuff kafo-afo cal,,,55.43,159.65,4
HCPCS,L41100,Repl leath cuff kafo-afo cal,,,55.43,55.43,1
HCPCS,L4130,Replace pretibial shell,,,334.99,1098.73,4
HCPCS,L41300,Replace pretibial shell,,,334.99,334.99,1
HCPCS,L4205,Ortho dvc repair per 15 min,,,15.49,48.73,4
HCPCS,L42050,Ortho dvc repair per 15 min,,,15.49,15.49,1
HCPCS,L4210,ORTH DEV REPAIR/REPL MINOR P,100.0,65.0,16.8,98.0,29
HCPCS,L4210,Orth dev repair/repl minor p,,,21.6,21.6,1
HCPCS,L4210,"REPAIR OF ORTHOTIC DEVICE, MINOR",122.0,79.3,61.0,122.0,12
HCPCS,L42100,Orth dev repair/repl minor p,,,21.6,21.6,1
HCPCS,L4350,Ankle control ortho pre ots,,,67.62,67.62,1
HCPCS,L4350,PNEUMATIC ANKLE CNTRL SPLINT,142.0,92.3,46.27,142.0,17
HCPCS,L4350,PREFAB ANKLE AIRCAST,271.58,176.53,45.63,266.15,29
HCPCS,L43500,Ankle control ortho pre ots,,,67.62,67.62,1
HCPCS,L4360,PNEUMATIC WALKING SPLINT,407.0,264.55,129.46,407.0,17
HCPCS,L4360,Pneumat walking boot pre cst,,,180.95,180.95,1
HCPCS,L4360,W AIRCAST FP ANKL-FT W/WO JNTS,88.0,57.2,14.78,86.24,29
HCPCS,L4360,W AIRCAST LEG BRACE,308.0,200.2,51.74,301.84,29
HCPCS,L4360,W AIRCAST SP ANKL-FT W/WO JNTS,78.0,50.7,13.1,76.44,29
HCPCS,L4360,WALKING BOOT MAXTRAX,60.0,39.0,10.08,58.8,29
HCPCS,L43600,Pneumat walking boot pre cst,,,180.95,180.95,1
HCPCS,L4361,Pneuma/vac walk boot pre ots,,,180.95,553.82,4
HCPCS,L43610,Pneuma/vac walk boot pre ots,,,180.95,180.95,1
HCPCS,L4370,Pneum full leg splnt pre ots,,,164.49,355.39,4
HCPCS,L43700,Pneum full leg splnt pre ots,,,164.49,164.49,1
HCPCS,L4386,Non-pneum walk boot pre cst,,,110.82,320.92,4
HCPCS,L43860,Non-pneum walk boot pre cst,,,110.82,110.82,1
HCPCS,L4387,Non-pneum walk boot pre ots,,,110.82,320.92,4
HCPCS,L43870,Non-pneum walk boot pre ots,,,110.82,110.82,1
HCPCS,L4392,Replace afo soft interface,,,16.44,47.67,4
HCPCS,L43920,Replace afo soft interface,,,16.44,16.44,1
HCPCS,L4394,Replace foot drop spint,,,12.0,12.0,1
HCPCS,L4394,W SHOE HEEL RELIEF DARCO,323.0,209.95,54.26,316.54,29
HCPCS,L43940,Replace foot drop spint,,,12.0,12.0,1
HCPCS,L4396,Static or dynami afo pre cst,,,117.29,117.29,1
HCPCS,L4396,W ORTHOSIS ANK/FT STATIC,323.0,209.95,54.26,316.54,29
HCPCS,L43960,Static or dynami afo pre cst,,,117.29,117.29,1
HCPCS,L4397,Static or dynami afo pre ots,,,117.29,339.78,4
HCPCS,L43970,Static or dynami afo pre ots,,,117.29,117.29,1
HCPCS,L4398,Foot drop splint pre ots,,,53.98,156.37,4
HCPCS,L43980,Foot drop splint pre ots,,,53.98,53.98,1
HCPCS,L4631,"Afo, walk boot type, cus fab",,,1030.31,3020.8,4
HCPCS,L46310,"Afo, walk boot type, cus fab",,,1030.31,1030.31,1
HCPCS,L5000,Sho insert w arch toe filler,,,364.86,1061.42,4
HCPCS,L50000,Sho insert w arch toe filler,,,364.86,364.86,1
HCPCS,L5010,Mold socket ank hgt w/ toe f,,,1019.44,2563.56,4
HCPCS,L50100,Mold socket ank hgt w/ toe f,,,1019.44,1019.44,1
HCPCS,L5020,Tibial tubercle hgt w/ toe f,,,1597.14,4353.44,4
HCPCS,L50200,Tibial tubercle hgt w/ toe f,,,1597.14,1597.14,1
HCPCS,L5050,Ank symes mold sckt sach ft,,,1744.37,4815.71,4
HCPCS,L50500,Ank symes mold sckt sach ft,,,1744.37,1744.37,1
HCPCS,L5060,Symes met fr leath socket ar,,,2150.3,5539.5,4
HCPCS,L50600,Symes met fr leath socket ar,,,2150.3,2150.3,1
HCPCS,L5100,Molded socket shin sach foot,,,1736.91,4826.33,4
HCPCS,L51000,Molded socket shin sach foot,,,1736.91,1736.91,1
HCPCS,L5105,Plast socket jts/thgh lacer,,,2451.16,6967.37,4
HCPCS,L51050,Plast socket jts/thgh lacer,,,2451.16,2451.16,1
HCPCS,L5150,Mold sckt ext knee shin sach,,,2725.1,7043.06,4
HCPCS,L51500,Mold sckt ext knee shin sach,,,2725.1,2725.1,1
HCPCS,L5160,Mold socket bent knee shin s,,,2992.03,7660.6,4
HCPCS,L51600,Mold socket bent knee shin s,,,2992.03,2992.03,1
HCPCS,L5200,Kne sing axis fric shin sach,,,2314.12,7336.11,4
HCPCS,L52000,Kne sing axis fric shin sach,,,2314.12,2314.12,1
HCPCS,L5210,No knee/ankle joints w/ ft b,,,1837.4,4866.75,4
HCPCS,L52100,No knee/ankle joints w/ ft b,,,1837.4,1837.4,1
HCPCS,L5220,No knee joint with artic ali,,,2024.03,5531.96,4
HCPCS,L52200,No knee joint with artic ali,,,2024.03,2024.03,1
HCPCS,L5230,Fem focal defic constant fri,,,3035.73,7629.65,4
HCPCS,L52300,Fem focal defic constant fri,,,3035.73,3035.73,1
HCPCS,L5250,Hip canad sing axi cons fric,,,3559.47,10406.17,4
HCPCS,L52500,Hip canad sing axi cons fric,,,3559.47,3559.47,1
HCPCS,L5270,Tilt table locking hip sing,,,3965.94,10360.02,4
HCPCS,L52700,Tilt table locking hip sing,,,3965.94,3965.94,1
HCPCS,L5280,Hemipelvect canad sing axis,,,3855.05,10280.68,4
HCPCS,L52800,Hemipelvect canad sing axis,,,3855.05,3855.05,1
HCPCS,L5301,Bk mold socket sach ft endo,,,1705.6,5516.84,4
HCPCS,L53010,Bk mold socket sach ft endo,,,1705.6,1705.6,1
HCPCS,L5312,"Knee disart, sach ft, endo",,,2687.3,7896.98,4
HCPCS,L53120,"Knee disart, sach ft, endo",,,2687.3,2687.3,1
HCPCS,L5321,Ak open end sach,,,2274.37,7996.79,4
HCPCS,L53210,Ak open end sach,,,2274.37,2274.37,1
HCPCS,L5331,Hip disart canadian sach ft,,,3331.12,10189.54,4
HCPCS,L53310,Hip disart canadian sach ft,,,3331.12,3331.12,1
HCPCS,L5341,Hemipelvectomy canadian sach,,,3540.93,10607.37,4
HCPCS,L53410,Hemipelvectomy canadian sach,,,3540.93,3540.93,1
HCPCS,L5400,Postop dress & 1 cast chg bk,,,1015.7,2731.3,4
HCPCS,L54000,Postop dress & 1 cast chg bk,,,1015.7,1015.7,1
HCPCS,L5410,Postop dsg bk ea add cast ch,,,280.61,837.97,4
HCPCS,L54100,Postop dsg bk ea add cast ch,,,280.61,280.61,1
HCPCS,L5420,Postop dsg & 1 cast chg ak/d,,,1282.78,3347.11,4
HCPCS,L54200,Postop dsg & 1 cast chg ak/d,,,1282.78,1282.78,1
HCPCS,L5430,Postop dsg ak ea add cast ch,,,348.2,1009.25,4
HCPCS,L54300,Postop dsg ak ea add cast ch,,,348.2,348.2,1
HCPCS,L5450,Postop app non-wgt bear dsg,,,301.08,821.06,4
HCPCS,L54500,Postop app non-wgt bear dsg,,,301.08,301.08,1
HCPCS,L5460,Postop app non-wgt bear dsg,,,394.9,1093.94,4
HCPCS,L54600,Postop app non-wgt bear dsg,,,394.9,394.9,1
HCPCS,L5500,Init bk ptb plaster direct,,,938.8,2575.85,4
HCPCS,L55000,Init bk ptb plaster direct,,,938.8,938.8,1
HCPCS,L5505,Init ak ischal plstr direct,,,1320.62,3562.51,4
HCPCS,L55050,Init ak ischal plstr direct,,,1320.62,1320.62,1
HCPCS,L5510,Prep bk ptb plaster molded,,,1121.08,2919.91,4
HCPCS,L55100,Prep bk ptb plaster molded,,,1121.08,1121.08,1
HCPCS,L5520,Perp bk ptb thermopls direct,,,1004.92,2884.16,4
HCPCS,L55200,Perp bk ptb thermopls direct,,,1004.92,1004.92,1
HCPCS,L5530,Prep bk ptb thermopls molded,,,1321.02,3464.15,4
HCPCS,L55300,Prep bk ptb thermopls molded,,,1321.02,1321.02,1
HCPCS,L5535,Prep bk ptb open end socket,,,1231.48,3401.12,4
HCPCS,L55350,Prep bk ptb open end socket,,,1231.48,1231.48,1
HCPCS,L5540,Prep bk ptb laminated socket,,,1304.31,3630.06,4
HCPCS,L55400,Prep bk ptb laminated socket,,,1304.31,1304.31,1
HCPCS,L5560,Prep ak ischial plast molded,,,1486.19,3898.06,4
HCPCS,L55600,Prep ak ischial plast molded,,,1486.19,1486.19,1
HCPCS,L5570,Prep ak ischial direct form,,,1442.4,4052.61,4
HCPCS,L55700,Prep ak ischial direct form,,,1442.4,1442.4,1
HCPCS,L5580,Prep ak ischial thermo mold,,,1790.23,4731.14,4
HCPCS,L55800,Prep ak ischial thermo mold,,,1790.23,1790.23,1
HCPCS,L5585,Prep ak ischial open end,,,2096.5,5822.42,4
HCPCS,L55850,Prep ak ischial open end,,,2096.5,2096.5,1
HCPCS,L5590,Prep ak ischial laminated,,,1866.49,4821.34,4
HCPCS,L55900,Prep ak ischial laminated,,,1866.49,1866.49,1
HCPCS,L5595,Hip disartic sach thermopls,,,2916.84,8517.55,4
HCPCS,L55950,Hip disartic sach thermopls,,,2916.84,2916.84,1
HCPCS,L5600,Hip disart sach laminat mold,,,3319.8,9155.98,4
HCPCS,L56000,Hip disart sach laminat mold,,,3319.8,3319.8,1
HCPCS,L5610,Above knee hydracadence,,,1601.12,4152.37,4
HCPCS,L56100,Above knee hydracadence,,,1601.12,1601.12,1
HCPCS,L5611,Ak 4 bar link w/fric swing,,,1019.78,3231.38,4
HCPCS,L56110,Ak 4 bar link w/fric swing,,,1019.78,1019.78,1
HCPCS,L5613,Ak 4 bar ling w/hydraul swig,,,1551.15,5052.17,4
HCPCS,L56130,Ak 4 bar ling w/hydraul swig,,,1551.15,1551.15,1
HCPCS,L5614,4-bar link above knee w/swng,,,1074.28,3422.49,4
HCPCS,L56140,4-bar link above knee w/swng,,,1074.28,1074.28,1
HCPCS,L5615,Ak 4 bar link hydl swg/stanc,,,3581.79,11208.73,4
HCPCS,L56150,Ak 4 bar link hydl swg/stanc,,,3581.79,3581.79,1
HCPCS,L5616,Ak univ multiplex sys frict,,,935.29,2730.15,4
HCPCS,L56160,Ak univ multiplex sys frict,,,935.29,935.29,1
HCPCS,L5617,Ak/bk self-aligning unit ea,,,356.19,1134.79,4
HCPCS,L56170,Ak/bk self-aligning unit ea,,,356.19,356.19,1
HCPCS,L5618,Test socket symes,,,212.72,600.34,4
HCPCS,L56180,Test socket symes,,,212.72,212.72,1
HCPCS,L5620,Test socket below knee,,,188.73,557.58,4
HCPCS,L56200,Test socket below knee,,,188.73,188.73,1
HCPCS,L5622,Test socket knee disarticula,,,254.26,727.09,4
HCPCS,L56220,Test socket knee disarticula,,,254.26,254.26,1
HCPCS,L5624,Test socket above knee,,,254.17,729.16,4
HCPCS,L56240,Test socket above knee,,,254.17,254.17,1
HCPCS,L5626,Test socket hip disarticulat,,,402.38,956.25,4
HCPCS,L56260,Test socket hip disarticulat,,,402.38,402.38,1
HCPCS,L5628,Test socket hemipelvectomy,,,407.46,1022.47,4
HCPCS,L56280,Test socket hemipelvectomy,,,407.46,407.46,1
HCPCS,L5629,Below knee acrylic socket,,,201.15,637.37,4
HCPCS,L56290,Below knee acrylic socket,,,201.15,201.15,1
HCPCS,L5630,Syme typ expandabl wall sckt,,,349.5,900.1,4
HCPCS,L56300,Syme typ expandabl wall sckt,,,349.5,349.5,1
HCPCS,L5631,Ak/knee disartic acrylic soc,,,278.1,881.22,4
HCPCS,L56310,Ak/knee disartic acrylic soc,,,278.1,278.1,1
HCPCS,L5632,Symes type ptb brim design s,,,171.41,491.81,4
HCPCS,L56320,Symes type ptb brim design s,,,171.41,171.41,1
HCPCS,L5634,Symes type poster opening so,,,214.36,610.08,4
HCPCS,L56340,Symes type poster opening so,,,214.36,214.36,1
HCPCS,L5636,Symes type medial opening so,,,163.85,511.03,4
HCPCS,L56360,Symes type medial opening so,,,163.85,163.85,1
HCPCS,L5637,Below knee total contact,,,243.8,579.4,4
HCPCS,L56370,Below knee total contact,,,243.8,243.8,1
HCPCS,L5638,Below knee leather socket,,,410.7,1009.28,4
HCPCS,L56380,Below knee leather socket,,,410.7,410.7,1
HCPCS,L5639,Below knee wood socket,,,709.64,2248.63,4
HCPCS,L56390,Below knee wood socket,,,709.64,709.64,1
HCPCS,L5640,Knee disarticulat leather so,,,466.45,1282.44,4
HCPCS,L56400,Knee disarticulat leather so,,,466.45,466.45,1
HCPCS,L5642,Above knee leather socket,,,432.38,1242.61,4
HCPCS,L56420,Above knee leather socket,,,432.38,432.38,1
HCPCS,L5643,Hip flex inner socket ext fr,,,1275.31,3121.6,4
HCPCS,L56430,Hip flex inner socket ext fr,,,1275.31,1275.31,1
HCPCS,L5644,Above knee wood socket,,,373.84,1184.59,4
HCPCS,L56440,Above knee wood socket,,,373.84,373.84,1
HCPCS,L5645,Bk flex inner socket ext fra,,,620.18,1600.25,4
HCPCS,L56450,Bk flex inner socket ext fra,,,620.18,620.18,1
HCPCS,L5646,Below knee cushion socket,,,393.02,1098.88,4
HCPCS,L56460,Below knee cushion socket,,,393.02,393.02,1
HCPCS,L5647,Below knee suction socket,,,503.49,1595.39,4
HCPCS,L56470,Below knee suction socket,,,503.49,503.49,1
HCPCS,L5648,Above knee cushion socket,,,464.39,1320.44,4
HCPCS,L56480,Above knee cushion socket,,,464.39,464.39,1
HCPCS,L5649,Isch containmt/narrow m-l so,,,1560.39,4784.71,4
HCPCS,L56490,Isch containmt/narrow m-l so,,,1560.39,1560.39,1
HCPCS,L5650,Tot contact ak/knee disart s,,,309.0,979.11,4
HCPCS,L56500,Tot contact ak/knee disart s,,,309.0,309.0,1
HCPCS,L5651,Ak flex inner socket ext fra,,,905.31,2408.56,4
HCPCS,L56510,Ak flex inner socket ext fra,,,905.31,905.31,1
HCPCS,L5652,Suction susp ak/knee disart,,,275.95,874.4,4
HCPCS,L56520,Suction susp ak/knee disart,,,275.95,275.95,1
HCPCS,L5653,Knee disart expand wall sock,,,430.56,1167.26,4
HCPCS,L56530,Knee disart expand wall sock,,,430.56,430.56,1
HCPCS,L5654,Socket insert symes,,,249.6,665.14,4
HCPCS,L56540,Socket insert symes,,,249.6,249.6,1
HCPCS,L5655,Socket insert below knee,,,180.21,563.68,4
HCPCS,L56550,Socket insert below knee,,,180.21,180.21,1
HCPCS,L5656,Socket insert knee articulat,,,273.78,756.16,4
HCPCS,L56560,Socket insert knee articulat,,,273.78,273.78,1
HCPCS,L5658,Socket insert above knee,,,288.98,729.22,4
HCPCS,L56580,Socket insert above knee,,,288.98,288.98,1
HCPCS,L5661,Multi-durometer symes,,,414.62,1220.52,4
HCPCS,L56610,Multi-durometer symes,,,414.62,414.62,1
HCPCS,L5665,Multi-durometer below knee,,,368.61,1026.91,4
HCPCS,L56650,Multi-durometer below knee,,,368.61,368.61,1
HCPCS,L5666,Below knee cuff suspension,,,48.81,140.38,4
HCPCS,L56660,Below knee cuff suspension,,,48.81,48.81,1
HCPCS,L5668,Bk molded distal cushion,,,72.71,226.45,4
HCPCS,L56680,Bk molded distal cushion,,,72.71,72.71,1
HCPCS,L5670,Bk molded supracondylar susp,,,171.75,544.23,4
HCPCS,L56700,Bk molded supracondylar susp,,,171.75,171.75,1
HCPCS,L5671,Bk/ak locking mechanism,,,314.84,1153.29,4
HCPCS,L56710,Bk/ak locking mechanism,,,314.84,314.84,1
HCPCS,L5672,Bk removable medial brim sus,,,227.28,598.05,4
HCPCS,L56720,Bk removable medial brim sus,,,227.28,227.28,1
HCPCS,L5673,Socket insert w lock mech,,,500.36,1426.1,4
HCPCS,L56730,Socket insert w lock mech,,,500.36,500.36,1
HCPCS,L5676,Bk knee joints single axis p,,,229.36,726.78,4
HCPCS,L56760,Bk knee joints single axis p,,,229.36,229.36,1
HCPCS,L5677,Bk knee joints polycentric p,,,351.27,988.86,4
HCPCS,L56770,Bk knee joints polycentric p,,,351.27,351.27,1
HCPCS,L5678,Bk joint covers pair,,,25.13,79.64,4
HCPCS,L56780,Bk joint covers pair,,,25.13,25.13,1
HCPCS,L5679,Socket insert w/o lock mech,,,416.97,1188.37,4
HCPCS,L56790,Socket insert w/o lock mech,,,416.97,416.97,1
HCPCS,L5680,Bk thigh lacer non-molded,,,192.65,664.74,4
HCPCS,L56800,Bk thigh lacer non-molded,,,192.65,192.65,1
HCPCS,L5681,Intl custm cong/latyp insert,,,837.41,2667.89,4
HCPCS,L56810,Intl custm cong/latyp insert,,,837.41,837.41,1
HCPCS,L5682,Bk thigh lacer glut/ischia m,,,395.83,1254.29,4
HCPCS,L56820,Bk thigh lacer glut/ischia m,,,395.83,395.83,1
HCPCS,L5683,Initial custom socket insert,,,837.41,2667.89,4
HCPCS,L56830,Initial custom socket insert,,,837.41,837.41,1
HCPCS,L5684,Bk fork strap,,,30.47,96.53,4
HCPCS,L56840,Bk fork strap,,,30.47,30.47,1
HCPCS,L5685,Below knee sus/seal sleeve,,,81.56,259.77,4
HCPCS,L56850,Below knee sus/seal sleeve,,,81.56,81.56,1
HCPCS,L5686,Bk back check,,,36.64,102.47,4
HCPCS,L56860,Bk back check,,,36.64,36.64,1
HCPCS,L5688,Bk waist belt webbing,,,38.92,122.52,4
HCPCS,L56880,Bk waist belt webbing,,,38.92,38.92,1
HCPCS,L5690,Bk waist belt padded and lin,,,79.44,196.26,4
HCPCS,L56900,Bk waist belt padded and lin,,,79.44,79.44,1
HCPCS,L5692,Ak pelvic control belt light,,,84.11,266.49,4
HCPCS,L56920,Ak pelvic control belt light,,,84.11,84.11,1
HCPCS,L5694,Ak pelvic control belt pad/l,,,114.83,363.84,4
HCPCS,L56940,Ak pelvic control belt pad/l,,,114.83,114.83,1
HCPCS,L5695,Ak sleeve susp neoprene/equa,,,103.23,335.85,4
HCPCS,L56950,Ak sleeve susp neoprene/equa,,,103.23,103.23,1
HCPCS,L5696,Ak/knee disartic pelvic join,,,124.69,371.08,4
HCPCS,L56960,Ak/knee disartic pelvic join,,,124.69,124.69,1
HCPCS,L5697,Ak/knee disartic pelvic band,,,59.22,161.0,4
HCPCS,L56970,Ak/knee disartic pelvic band,,,59.22,59.22,1
HCPCS,L5698,Ak/knee disartic silesian ba,,,75.96,263.27,4
HCPCS,L56980,Ak/knee disartic silesian ba,,,75.96,75.96,1
HCPCS,L5699,Shoulder harness,,,129.83,474.28,4
HCPCS,L56990,Shoulder harness,,,129.83,129.83,1
HCPCS,L5700,Replace socket below knee,,,1952.72,5746.44,4
HCPCS,L57000,Replace socket below knee,,,1952.72,1952.72,1
HCPCS,L5701,Replace socket above knee,,,2422.53,6901.05,4
HCPCS,L57010,Replace socket above knee,,,2422.53,2422.53,1
HCPCS,L5702,Replace socket hip,,,3053.22,8730.81,4
HCPCS,L57020,Replace socket hip,,,3053.22,3053.22,1
HCPCS,L5703,Symes ankle w/o (sach) foot,,,1606.09,4518.3,4
HCPCS,L57030,Symes ankle w/o (sach) foot,,,1606.09,1606.09,1
HCPCS,L5704,Custom shape cover bk,,,398.15,1075.04,4
HCPCS,L57040,Custom shape cover bk,,,398.15,398.15,1
HCPCS,L5705,Custom shape cover ak,,,729.96,1920.91,4
HCPCS,L57050,Custom shape cover ak,,,729.96,729.96,1
HCPCS,L5706,Custom shape cvr knee disart,,,711.98,1882.97,4
HCPCS,L57060,Custom shape cvr knee disart,,,711.98,711.98,1
HCPCS,L5707,Custom shape cvr hip disart,,,956.57,2482.39,4
HCPCS,L57070,Custom shape cvr hip disart,,,956.57,956.57,1
HCPCS,L5710,Kne-shin exo sng axi mnl loc,,,227.64,750.08,4
HCPCS,L57100,Kne-shin exo sng axi mnl loc,,,227.64,227.64,1
HCPCS,L5711,Knee-shin exo mnl lock ultra,,,382.05,1048.27,4
HCPCS,L57110,Knee-shin exo mnl lock ultra,,,382.05,382.05,1
HCPCS,L5712,Knee-shin exo frict swg & st,,,272.73,878.34,4
HCPCS,L57120,Knee-shin exo frict swg & st,,,272.73,272.73,1
HCPCS,L5714,Knee-shin exo variable frict,,,277.51,902.19,4
HCPCS,L57140,Knee-shin exo variable frict,,,277.51,277.51,1
HCPCS,L5716,Knee-shin exo mech stance ph,,,548.73,1461.76,4
HCPCS,L57160,Knee-shin exo mech stance ph,,,548.73,548.73,1
HCPCS,L5718,Knee-shin exo frct swg & sta,,,586.76,1827.05,4
HCPCS,L57180,Knee-shin exo frct swg & sta,,,586.76,586.76,1
HCPCS,L5722,Knee-shin pneum swg frct exo,,,713.55,1930.21,4
HCPCS,L57220,Knee-shin pneum swg frct exo,,,713.55,713.55,1
HCPCS,L5724,Knee-shin exo fluid swing ph,,,1099.81,3027.28,4
HCPCS,L57240,Knee-shin exo fluid swing ph,,,1099.81,1099.81,1
HCPCS,L5726,Knee-shin ext jnts fld swg e,,,1309.37,3488.88,4
HCPCS,L57260,Knee-shin ext jnts fld swg e,,,1309.37,1309.37,1
HCPCS,L5728,Knee-shin fluid swg & stance,,,1534.43,4772.33,4
HCPCS,L57280,Knee-shin fluid swg & stance,,,1534.43,1534.43,1
HCPCS,L5780,Knee-shin pneum/hydra pneum,,,844.82,2296.24,4
HCPCS,L57800,Knee-shin pneum/hydra pneum,,,844.82,844.82,1
HCPCS,L5781,Lower limb pros vacuum pump,,,2547.22,8115.13,4
HCPCS,L57810,Lower limb pros vacuum pump,,,2547.22,2547.22,1
HCPCS,L5782,Hd low limb pros vacuum pump,,,2685.36,8555.2,4
HCPCS,L57820,Hd low limb pros vacuum pump,,,2685.36,2685.36,1
HCPCS,L5783,Add low ext mec limb vol lam,,,1628.6,5160.55,4
HCPCS,L57830,Add low ext mec limb vol lam,,,1628.6,1628.6,1
HCPCS,L5785,Exoskeletal bk ultralt mater,,,328.85,1290.76,4
HCPCS,L57850,Exoskeletal bk ultralt mater,,,328.85,328.85,1
HCPCS,L5790,Exoskeletal ak ultra-light m,,,474.61,1442.07,4
HCPCS,L57900,Exoskeletal ak ultra-light m,,,474.61,474.61,1
HCPCS,L5795,Exoskel hip ultra-light mate,,,679.58,2871.2,4
HCPCS,L57950,Exoskel hip ultra-light mate,,,679.58,679.58,1
HCPCS,L5810,Endoskel knee-shin mnl lock,,,362.08,976.45,4
HCPCS,L58100,Endoskel knee-shin mnl lock,,,362.08,362.08,1
HCPCS,L5811,Endo knee-shin mnl lck ultra,,,499.67,1462.73,4
HCPCS,L58110,Endo knee-shin mnl lck ultra,,,499.67,499.67,1
HCPCS,L5812,Endo knee-shin frct swg & st,,,376.02,1133.77,4
HCPCS,L58120,Endo knee-shin frct swg & st,,,376.02,376.02,1
HCPCS,L5814,Endo knee-shin hydral swg ph,,,2364.33,7532.43,4
HCPCS,L58140,Endo knee-shin hydral swg ph,,,2364.33,2364.33,1
HCPCS,L5816,Endo knee-shin polyc mch sta,,,538.28,1715.95,4
HCPCS,L58160,Endo knee-shin polyc mch sta,,,538.28,538.28,1
HCPCS,L5818,Endo knee-shin frct swg & st,,,607.83,1926.03,4
HCPCS,L58180,Endo knee-shin frct swg & st,,,607.83,607.83,1
HCPCS,L5822,Endo knee-shin pneum swg frc,,,1115.05,3415.34,4
HCPCS,L58220,Endo knee-shin pneum swg frc,,,1115.05,1115.05,1
HCPCS,L5824,Endo knee-shin fluid swing p,,,1054.05,3075.71,4
HCPCS,L58240,Endo knee-shin fluid swing p,,,1054.05,1054.05,1
HCPCS,L5826,Miniature knee joint,,,1988.1,6333.78,4
HCPCS,L58260,Miniature knee joint,,,1988.1,1988.1,1
HCPCS,L5827,Endo knee shin single axis,,,4169.45,4169.45,1
HCPCS,L58270,Endo knee shin single axis,,,4169.45,4169.45,1
HCPCS,L5828,Endo knee-shin fluid swg/sta,,,1875.94,5663.7,4
HCPCS,L58280,Endo knee-shin fluid swg/sta,,,1875.94,1875.94,1
HCPCS,L5830,Endo knee-shin pneum/swg pha,,,1264.89,3805.7,4
HCPCS,L58300,Endo knee-shin pneum/swg pha,,,1264.89,1264.89,1
HCPCS,L5840,Multi-axial knee/shin system,,,2482.63,7036.75,4
HCPCS,L58400,Multi-axial knee/shin system,,,2482.63,2482.63,1
HCPCS,L5841,Addition endoskletl knee-shi,,,1455.04,4702.53,4
HCPCS,L58410,Addition endoskletl knee-shi,,,1455.04,1455.04,1
HCPCS,L5845,Knee-shin sys stance flexion,,,1141.05,3635.33,4
HCPCS,L58450,Knee-shin sys stance flexion,,,1141.05,1141.05,1
HCPCS,L5848,Knee-shin sys hydraul stance,,,684.58,2180.92,4
HCPCS,L58480,Knee-shin sys hydraul stance,,,684.58,684.58,1
HCPCS,L5850,Endo ak/hip knee extens assi,,,80.97,256.57,4
HCPCS,L58500,Endo ak/hip knee extens assi,,,80.97,80.97,1
HCPCS,L5855,Mech hip extension assist,,,195.48,689.42,4
HCPCS,L58550,Mech hip extension assist,,,195.48,195.48,1
HCPCS,L5856,Elec knee-shin swing/stance,,,15282.52,48688.29,4
HCPCS,L58560,Elec knee-shin swing/stance,,,15282.52,15282.52,1
HCPCS,L5857,Elec knee-shin swing only,,,5422.81,17276.39,4
HCPCS,L58570,Elec knee-shin swing only,,,5422.81,5422.81,1
HCPCS,L5858,Stance phase only,,,11831.66,37694.23,4
HCPCS,L58580,Stance phase only,,,11831.66,11831.66,1
HCPCS,L5859,Knee-shin pro flex/ext cont,,,9236.86,29427.6,4
HCPCS,L58590,Knee-shin pro flex/ext cont,,,9236.86,9236.86,1
HCPCS,L5910,Endo below knee alignable sy,,,229.24,726.38,4
HCPCS,L59100,Endo below knee alignable sy,,,229.24,229.24,1
HCPCS,L5920,Endo ak/hip alignable system,,,335.84,1064.16,4
HCPCS,L59200,Endo ak/hip alignable system,,,335.84,335.84,1
HCPCS,L5925,Above knee manual lock,,,212.67,898.53,4
HCPCS,L59250,Above knee manual lock,,,212.67,212.67,1
HCPCS,L5926,Endoskel posit rotat unit,,,409.34,1142.53,4
HCPCS,L59260,Endoskel posit rotat unit,,,409.34,409.34,1
HCPCS,L5930,High activity knee frame,,,2142.81,6826.64,4
HCPCS,L59300,High activity knee frame,,,2142.81,2142.81,1
HCPCS,L5940,Endo bk ultra-light material,,,317.49,1006.03,4
HCPCS,L59400,Endo bk ultra-light material,,,317.49,317.49,1
HCPCS,L5950,Endo ak ultra-light material,,,492.44,1573.0,4
HCPCS,L59500,Endo ak ultra-light material,,,492.44,492.44,1
HCPCS,L5960,Endo hip ultra-light materia,,,736.31,1933.48,4
HCPCS,L59600,Endo hip ultra-light materia,,,736.31,736.31,1
HCPCS,L5961,"Endo poly hip, pneu/hyd/rot",,,3038.74,9219.66,4
HCPCS,L59610,"Endo poly hip, pneu/hyd/rot",,,3038.74,3038.74,1
HCPCS,L5962,Below knee flex cover system,,,372.04,1272.45,4
HCPCS,L59620,Below knee flex cover system,,,372.04,372.04,1
HCPCS,L5964,Above knee flex cover system,,,713.64,1878.3,4
HCPCS,L59640,Above knee flex cover system,,,713.64,713.64,1
HCPCS,L5966,Hip flexible cover system,,,919.3,2393.41,4
HCPCS,L59660,Hip flexible cover system,,,919.3,919.3,1
HCPCS,L5968,Multiaxial ankle w dorsiflex,,,2313.39,7370.28,4
HCPCS,L59680,Multiaxial ankle w dorsiflex,,,2313.39,2313.39,1
HCPCS,L5969,Ak/ft power asst incl motors,,,67468.68,67468.68,1
HCPCS,L59690,Ak/ft power asst incl motors,,,67468.68,67468.68,1
HCPCS,L5970,Foot external keel sach foot,,,138.28,407.32,4
HCPCS,L59700,Foot external keel sach foot,,,138.28,138.28,1
HCPCS,L5971,"Sach foot, replacement",,,138.28,407.32,4
HCPCS,L59710,"Sach foot, replacement",,,138.28,138.28,1
HCPCS,L5972,Flexible keel foot,,,251.9,760.86,4
HCPCS,L59720,Flexible keel foot,,,251.9,251.9,1
HCPCS,L5973,Ank-foot sys dors-plant flex,,,11239.41,34894.31,4
HCPCS,L59730,Ank-foot sys dors-plant flex,,,11239.41,11239.41,1
HCPCS,L5974,Foot single axis ankle/foot,,,147.5,467.36,4
HCPCS,L59740,Foot single axis ankle/foot,,,147.5,147.5,1
HCPCS,L5975,Combo ankle/foot prosthesis,,,295.14,940.32,4
HCPCS,L59750,Combo ankle/foot prosthesis,,,295.14,295.14,1
HCPCS,L5976,Energy storing foot,,,374.12,1123.2,4
HCPCS,L59760,Energy storing foot,,,374.12,374.12,1
HCPCS,L5978,Ft prosth multiaxial ankl/ft,,,198.24,585.28,4
HCPCS,L59780,Ft prosth multiaxial ankl/ft,,,198.24,198.24,1
HCPCS,L5979,Multi-axial ankle/ft prosth,,,1587.27,4576.3,4
HCPCS,L59790,Multi-axial ankle/ft prosth,,,1587.27,1587.27,1
HCPCS,L5980,Flex foot system,,,2418.34,7436.2,4
HCPCS,L59800,Flex foot system,,,2418.34,2418.34,1
HCPCS,L5981,Flex-walk sys low ext prosth,,,2172.25,6007.45,4
HCPCS,L59810,Flex-walk sys low ext prosth,,,2172.25,2172.25,1
HCPCS,L5982,Exoskeletal axial rotation u,,,408.08,1159.46,4
HCPCS,L59820,Exoskeletal axial rotation u,,,408.08,408.08,1
HCPCS,L5984,Endoskeletal axial rotation,,,409.34,1142.53,4
HCPCS,L59840,Endoskeletal axial rotation,,,409.34,409.34,1
HCPCS,L5985,Lwr ext dynamic prosth pylon,,,179.78,572.7,4
HCPCS,L59850,Lwr ext dynamic prosth pylon,,,179.78,179.78,1
HCPCS,L5986,Multi-axial rotation unit,,,493.78,1270.93,4
HCPCS,L59860,Multi-axial rotation unit,,,493.78,493.78,1
HCPCS,L5987,Shank ft w vert load pylon,,,4579.68,14590.24,4
HCPCS,L59870,Shank ft w vert load pylon,,,4579.68,4579.68,1
HCPCS,L5988,Vertical shock reducing pylo,,,1271.76,4051.67,4
HCPCS,L59880,Vertical shock reducing pylo,,,1271.76,1271.76,1
HCPCS,L5990,User adjustable heel height,,,1154.92,3679.54,4
HCPCS,L59900,User adjustable heel height,,,1154.92,1154.92,1
HCPCS,L5991,Low pros ext osseo connector,,,6077.4,19257.52,4
HCPCS,L59910,Low pros ext osseo connector,,,6077.4,6077.4,1
HCPCS,L6000,Part hand thumb rem,,,1121.31,2664.83,4
HCPCS,L60000,Part hand thumb rem,,,1121.31,1121.31,1
HCPCS,L6010,Part hand little/ring,,,1247.84,2965.52,4
HCPCS,L60100,Part hand little/ring,,,1247.84,1247.84,1
HCPCS,L6020,Part hand no fingers,,,1163.41,2764.87,4
HCPCS,L60200,Part hand no fingers,,,1163.41,1163.41,1
HCPCS,L6026,Part hand myo exclu term dev,,,2769.21,10025.87,4
HCPCS,L60260,Part hand myo exclu term dev,,,2769.21,2769.21,1
HCPCS,L6050,Wrst mld sck flx hng tri pad,,,1582.47,3809.88,4
HCPCS,L60500,Wrst mld sck flx hng tri pad,,,1582.47,1582.47,1
HCPCS,L6055,Wrst mold sock w/exp interfa,,,2018.53,5310.0,4
HCPCS,L60550,Wrst mold sock w/exp interfa,,,2018.53,2018.53,1
HCPCS,L6100,Elb mold sock flex hinge pad,,,1601.4,3859.99,4
HCPCS,L61000,Elb mold sock flex hinge pad,,,1601.4,1601.4,1
HCPCS,L6110,Elbow mold sock suspension t,,,1694.17,4094.18,4
HCPCS,L61100,Elbow mold sock suspension t,,,1694.17,1694.17,1
HCPCS,L6120,Elbow mold doub splt soc ste,,,1916.13,4771.19,4
HCPCS,L61200,Elbow mold doub splt soc ste,,,1916.13,1916.13,1
HCPCS,L6130,Elbow stump activated lock h,,,2021.54,5191.93,4
HCPCS,L61300,Elbow stump activated lock h,,,2021.54,2021.54,1
HCPCS,L6200,Elbow mold outsid lock hinge,,,2082.43,5471.46,4
HCPCS,L62000,Elbow mold outsid lock hinge,,,2082.43,2082.43,1
HCPCS,L6205,Elbow molded w/ expand inter,,,2872.67,7303.54,4
HCPCS,L62050,Elbow molded w/ expand inter,,,2872.67,2872.67,1
HCPCS,L6250,Elbow inter loc elbow forarm,,,2048.75,5732.82,4
HCPCS,L62500,Elbow inter loc elbow forarm,,,2048.75,2048.75,1
HCPCS,L6300,Shlder disart int lock elbow,,,2825.79,7472.13,4
HCPCS,L63000,Shlder disart int lock elbow,,,2825.79,2825.79,1
HCPCS,L6310,Shoulder passive restor comp,,,2560.97,6451.86,4
HCPCS,L63100,Shoulder passive restor comp,,,2560.97,2560.97,1
HCPCS,L6320,Shoulder passive restor cap,,,1334.7,3524.49,4
HCPCS,L63200,Shoulder passive restor cap,,,1334.7,1334.7,1
HCPCS,L6350,Thoracic intern lock elbow,,,3096.19,7855.81,4
HCPCS,L63500,Thoracic intern lock elbow,,,3096.19,3096.19,1
HCPCS,L6360,Thoracic passive restor comp,,,2688.04,7065.04,4
HCPCS,L63600,Thoracic passive restor comp,,,2688.04,2688.04,1
HCPCS,L6370,Thoracic passive restor cap,,,1558.88,4227.51,4
HCPCS,L63700,Thoracic passive restor cap,,,1558.88,1558.88,1
HCPCS,L6380,Postop dsg cast chg wrst/elb,,,901.62,2449.74,4
HCPCS,L63800,Postop dsg cast chg wrst/elb,,,901.62,901.62,1
HCPCS,L6382,Postop dsg cast chg elb dis/,,,1073.33,3685.52,4
HCPCS,L63820,Postop dsg cast chg elb dis/,,,1073.33,1073.33,1
HCPCS,L6384,Postop dsg cast chg shlder/t,,,1357.82,5098.54,4
HCPCS,L63840,Postop dsg cast chg shlder/t,,,1357.82,1357.82,1
HCPCS,L6386,Postop ea cast chg & realign,,,297.65,805.42,4
HCPCS,L63860,Postop ea cast chg & realign,,,297.65,297.65,1
HCPCS,L6388,Postop applicat rigid dsg on,,,327.78,881.7,4
HCPCS,L63880,Postop applicat rigid dsg on,,,327.78,327.78,1
HCPCS,L6400,Below elbow prosth tiss shap,,,1732.31,4653.8,4
HCPCS,L64000,Below elbow prosth tiss shap,,,1732.31,1732.31,1
HCPCS,L6450,Elb disart prosth tiss shap,,,2264.05,6217.39,4
HCPCS,L64500,Elb disart prosth tiss shap,,,2264.05,2264.05,1
HCPCS,L6500,Above elbow prosth tiss shap,,,2223.24,6504.62,4
HCPCS,L65000,Above elbow prosth tiss shap,,,2223.24,2223.24,1
HCPCS,L6550,Shldr disar prosth tiss shap,,,2879.56,7818.66,4
HCPCS,L65500,Shldr disar prosth tiss shap,,,2879.56,2879.56,1
HCPCS,L6570,Scap thorac prosth tiss shap,,,3214.65,8778.28,4
HCPCS,L65700,Scap thorac prosth tiss shap,,,3214.65,3214.65,1
HCPCS,L6580,Wrist/elbow bowden cable mol,,,1285.3,3351.37,4
HCPCS,L65800,Wrist/elbow bowden cable mol,,,1285.3,1285.3,1
HCPCS,L6582,Wrist/elbow bowden cbl dir f,,,1079.47,3035.44,4
HCPCS,L65820,Wrist/elbow bowden cbl dir f,,,1079.47,1079.47,1
HCPCS,L6584,Elbow fair lead cable molded,,,1598.41,4760.36,4
HCPCS,L65840,Elbow fair lead cable molded,,,1598.41,1598.41,1
HCPCS,L6586,Elbow fair lead cable dir fo,,,1424.28,4454.92,4
HCPCS,L65860,Elbow fair lead cable dir fo,,,1424.28,1424.28,1
HCPCS,L6588,Shdr fair lead cable molded,,,2268.35,5853.66,4
HCPCS,L65880,Shdr fair lead cable molded,,,2268.35,2268.35,1
HCPCS,L6590,Shdr fair lead cable direct,,,1976.95,5560.05,4
HCPCS,L65900,Shdr fair lead cable direct,,,1976.95,1976.95,1
HCPCS,L6600,Polycentric hinge pair,,,144.4,376.21,4
HCPCS,L66000,Polycentric hinge pair,,,144.4,144.4,1
HCPCS,L6605,Single pivot hinge pair,,,148.63,371.46,4
HCPCS,L66050,Single pivot hinge pair,,,148.63,148.63,1
HCPCS,L6610,Flexible metal hinge pair,,,140.51,356.71,4
HCPCS,L66100,Flexible metal hinge pair,,,140.51,140.51,1
HCPCS,L6611,"Additional switch, ext power",,,262.11,835.02,4
HCPCS,L66110,"Additional switch, ext power",,,262.11,262.11,1
HCPCS,L6615,Disconnect locking wrist uni,,,136.39,384.35,4
HCPCS,L66150,Disconnect locking wrist uni,,,136.39,136.39,1
HCPCS,L6616,Disconnect insert locking wr,,,41.06,142.42,4
HCPCS,L66160,Disconnect insert locking wr,,,41.06,41.06,1
HCPCS,L6620,Flexion/extension wrist unit,,,238.43,614.98,4
HCPCS,L66200,Flexion/extension wrist unit,,,238.43,238.43,1
HCPCS,L6621,Flex/ext wrist w/wo friction,,,1456.14,4639.01,4
HCPCS,L66210,Flex/ext wrist w/wo friction,,,1456.14,1456.14,1
HCPCS,L6623,Spring-ass rot wrst w/ latch,,,454.2,1715.37,4
HCPCS,L66230,Spring-ass rot wrst w/ latch,,,454.2,454.2,1
HCPCS,L6624,Flex/ext/rotation wrist unit,,,2397.55,7638.26,4
HCPCS,L66240,Flex/ext/rotation wrist unit,,,2397.55,2397.55,1
HCPCS,L6625,Rotation wrst w/ cable lock,,,336.64,1218.76,4
HCPCS,L66250,Rotation wrst w/ cable lock,,,336.64,336.64,1
HCPCS,L6628,Quick disconn hook adapter o,,,362.35,960.79,4
HCPCS,L66280,Quick disconn hook adapter o,,,362.35,362.35,1
HCPCS,L6629,Lamination collar w/ couplin,,,123.47,293.43,4
HCPCS,L66290,Lamination collar w/ couplin,,,123.47,123.47,1
HCPCS,L6630,Stainless steel any wrist,,,181.88,432.25,4
HCPCS,L66300,Stainless steel any wrist,,,181.88,181.88,1
HCPCS,L6632,Latex suspension sleeve each,,,41.13,150.12,4
HCPCS,L66320,Latex suspension sleeve each,,,41.13,41.13,1
HCPCS,L6635,Lift assist for elbow,,,131.46,353.25,4
HCPCS,L66350,Lift assist for elbow,,,131.46,131.46,1
HCPCS,L6637,Nudge control elbow lock,,,257.36,753.45,4
HCPCS,L66370,Nudge control elbow lock,,,257.36,257.36,1
HCPCS,L6638,Elec lock on manual pw elbow,,,1592.02,5071.94,4
HCPCS,L66380,Elec lock on manual pw elbow,,,1592.02,1592.02,1
HCPCS,L6640,Shoulder abduction joint pai,,,214.34,669.37,4
HCPCS,L66400,Shoulder abduction joint pai,,,214.34,214.34,1
HCPCS,L6641,Excursion amplifier pulley t,,,124.82,321.75,4
HCPCS,L66410,Excursion amplifier pulley t,,,124.82,124.82,1
HCPCS,L6642,Excursion amplifier lever ty,,,183.51,436.11,4
HCPCS,L66420,Excursion amplifier lever ty,,,183.51,183.51,1
HCPCS,L6645,Shoulder flexion-abduction j,,,231.8,804.99,4
HCPCS,L66450,Shoulder flexion-abduction j,,,231.8,231.8,1
HCPCS,L6646,Multipo locking shoulder jnt,,,2007.89,6396.89,4
HCPCS,L66460,Multipo locking shoulder jnt,,,2007.89,2007.89,1
HCPCS,L6647,Shoulder lock actuator,,,330.57,1053.11,4
HCPCS,L66470,Shoulder lock actuator,,,330.57,330.57,1
HCPCS,L6648,Ext pwrd shlder lock/unlock,,,2070.86,6597.44,4
HCPCS,L66480,Ext pwrd shlder lock/unlock,,,2070.86,2070.86,1
HCPCS,L6650,Shoulder universal joint,,,251.41,835.77,4
HCPCS,L66500,Shoulder universal joint,,,251.41,251.41,1
HCPCS,L6655,Standard control cable extra,,,48.77,164.24,4
HCPCS,L66550,Standard control cable extra,,,48.77,48.77,1
HCPCS,L6660,Heavy duty control cable,,,65.26,184.09,4
HCPCS,L66600,Heavy duty control cable,,,65.26,65.26,1
HCPCS,L6665,Teflon or equal cable lining,,,29.15,92.36,4
HCPCS,L66650,Teflon or equal cable lining,,,29.15,29.15,1
HCPCS,L6670,Hook to hand cable adapter,,,30.36,102.13,4
HCPCS,L66700,Hook to hand cable adapter,,,30.36,30.36,1
HCPCS,L6672,Harness chest/shlder saddle,,,139.3,405.28,4
HCPCS,L66720,Harness chest/shlder saddle,,,139.3,139.3,1
HCPCS,L6675,Harness figure of 8 sing con,,,76.01,240.86,4
HCPCS,L66750,Harness figure of 8 sing con,,,76.01,76.01,1
HCPCS,L6676,Harness figure of 8 dual con,,,79.53,278.42,4
HCPCS,L66760,Harness figure of 8 dual con,,,79.53,79.53,1
HCPCS,L6677,Ue triple control harness,,,188.85,601.73,4
HCPCS,L66770,Ue triple control harness,,,188.85,188.85,1
HCPCS,L6680,Test sock wrist disart/bel e,,,195.79,465.31,4
HCPCS,L66800,Test sock wrist disart/bel e,,,195.79,195.79,1
HCPCS,L6682,Test sock elbw disart/above,,,216.48,514.47,4
HCPCS,L66820,Test sock elbw disart/above,,,216.48,216.48,1
HCPCS,L6684,Test socket shldr disart/tho,,,294.17,699.1,4
HCPCS,L66840,Test socket shldr disart/tho,,,294.17,294.17,1
HCPCS,L6686,Suction socket,,,436.5,1578.71,4
HCPCS,L66860,Suction socket,,,436.5,436.5,1
HCPCS,L6687,Frame typ socket bel elbow/w,,,365.09,1156.85,4
HCPCS,L66870,Frame typ socket bel elbow/w,,,365.09,365.09,1
HCPCS,L6688,Frame typ sock above elb/dis,,,404.06,1149.87,4
HCPCS,L66880,Frame typ sock above elb/dis,,,404.06,404.06,1
HCPCS,L6689,Frame typ socket shoulder di,,,481.56,1377.69,4
HCPCS,L66890,Frame typ socket shoulder di,,,481.56,481.56,1
HCPCS,L6690,Frame typ sock interscap-tho,,,566.97,1501.29,4
HCPCS,L66900,Frame typ sock interscap-tho,,,566.97,566.97,1
HCPCS,L6691,Removable insert each,,,223.8,694.85,4
HCPCS,L66910,Removable insert each,,,223.8,223.8,1
HCPCS,L6692,Silicon gel insert w/wo lock,,,407.16,1121.59,4
HCPCS,L66920,Silicon gel insert w/wo lock,,,407.16,407.16,1
HCPCS,L6693,Lockingelbow forearm cntrbal,,,1807.37,5757.95,4
HCPCS,L66930,Lockingelbow forearm cntrbal,,,1807.37,1807.37,1
HCPCS,L6694,Elbow socket ins use w/lock,,,500.36,1426.1,4
HCPCS,L66940,Elbow socket ins use w/lock,,,500.36,500.36,1
HCPCS,L6695,Elbow socket ins use w/o lck,,,416.97,1188.37,4
HCPCS,L66950,Elbow socket ins use w/o lck,,,416.97,416.97,1
HCPCS,L6696,Cus elbo skt in for con/atyp,,,837.41,2667.89,4
HCPCS,L66960,Cus elbo skt in for con/atyp,,,837.41,837.41,1
HCPCS,L6697,Cus elbo skt in not con/atyp,,,837.41,2667.89,4
HCPCS,L66970,Cus elbo skt in not con/atyp,,,837.41,837.41,1
HCPCS,L6698,Add up-ex prosthes lock mech,,,314.84,1153.29,4
HCPCS,L66980,Add up-ex prosthes lock mech,,,314.84,314.84,1
HCPCS,L6700,Ue add ext power myoel,,,17185.35,17185.35,1
HCPCS,L67000,Ue add ext power myoel,,,17185.35,17185.35,1
HCPCS,L6703,"Term dev, passive hand mitt",,,222.67,729.12,4
HCPCS,L67030,"Term dev, passive hand mitt",,,222.67,222.67,1
HCPCS,L6704,"Term dev, sport/rec/work att",,,429.82,1174.55,4
HCPCS,L67040,"Term dev, sport/rec/work att",,,429.82,429.82,1
HCPCS,L6706,Term dev mech hook vol open,,,266.73,699.8,4
HCPCS,L67060,Term dev mech hook vol open,,,266.73,266.73,1
HCPCS,L6707,Term dev mech hook vol close,,,943.55,2579.36,4
HCPCS,L67070,Term dev mech hook vol close,,,943.55,943.55,1
HCPCS,L6708,Term dev mech hand vol open,,,623.72,1686.19,4
HCPCS,L67080,Term dev mech hand vol open,,,623.72,623.72,1
HCPCS,L6709,Term dev mech hand vol close,,,885.22,2429.87,4
HCPCS,L67090,Term dev mech hand vol close,,,885.22,885.22,1
HCPCS,L6711,"Ped term dev, hook, vol open",,,428.0,1363.55,4
HCPCS,L67110,"Ped term dev, hook, vol open",,,428.0,428.0,1
HCPCS,L6712,"Ped term dev, hook, vol clos",,,788.07,2510.63,4
HCPCS,L67120,"Ped term dev, hook, vol clos",,,788.07,788.07,1
HCPCS,L6713,"Ped term dev, hand, vol open",,,994.58,3168.57,4
HCPCS,L67130,"Ped term dev, hand, vol open",,,994.58,994.58,1
HCPCS,L6714,"Ped term dev, hand, vol clos",,,842.41,2683.88,4
HCPCS,L67140,"Ped term dev, hand, vol clos",,,842.41,842.41,1
HCPCS,L6715,"Term device, multi art digit",,,2009.9,6403.27,4
HCPCS,L67150,"Term device, multi art digit",,,2009.9,2009.9,1
HCPCS,L6721,"Hook/hand, hvy dty, vol open",,,1497.32,4770.25,4
HCPCS,L67210,"Hook/hand, hvy dty, vol open",,,1497.32,1497.32,1
HCPCS,L6722,"Hook/hand, hvy dty, vol clos",,,1290.77,4112.28,4
HCPCS,L67220,"Hook/hand, hvy dty, vol clos",,,1290.77,1290.77,1
HCPCS,L6805,Term dev modifier wrist unit,,,244.17,682.37,4
HCPCS,L68050,Term dev modifier wrist unit,,,244.17,244.17,1
HCPCS,L6810,Term dev precision pinch dev,,,129.81,386.75,4
HCPCS,L68100,Term dev precision pinch dev,,,129.81,129.81,1
HCPCS,L6880,Elec hand ind art digits,,,15210.35,48458.47,4
HCPCS,L68800,Elec hand ind art digits,,,15210.35,15210.35,1
HCPCS,L6881,Term dev auto grasp feature,,,2602.66,8291.65,4
HCPCS,L68810,Term dev auto grasp feature,,,2602.66,2602.66,1
HCPCS,L6882,Microprocessor control uplmb,,,1974.24,6289.73,4
HCPCS,L68820,Microprocessor control uplmb,,,1974.24,1974.24,1
HCPCS,L6883,Replc sockt below e/w disa,,,1264.63,3182.65,4
HCPCS,L68830,Replc sockt below e/w disa,,,1264.63,1264.63,1
HCPCS,L6884,Replc sockt above elbow disa,,,1730.3,4723.75,4
HCPCS,L68840,Replc sockt above elbow disa,,,1730.3,1730.3,1
HCPCS,L6885,Replc sockt shldr dis/interc,,,2688.04,7065.04,4
HCPCS,L68850,Replc sockt shldr dis/interc,,,2688.04,2688.04,1
HCPCS,L6890,Prefab glove for term device,,,127.15,341.13,4
HCPCS,L68900,Prefab glove for term device,,,127.15,127.15,1
HCPCS,L6895,Custom glove for term device,,,425.15,1254.92,4
HCPCS,L68950,Custom glove for term device,,,425.15,425.15,1
HCPCS,L6900,Hand restorat thumb/1 finger,,,1234.6,3581.22,4
HCPCS,L69000,Hand restorat thumb/1 finger,,,1234.6,1234.6,1
HCPCS,L6905,Hand restoration multiple fi,,,1221.9,3560.87,4
HCPCS,L69050,Hand restoration multiple fi,,,1221.9,1221.9,1
HCPCS,L6910,Hand restoration no fingers,,,1201.22,3044.9,4
HCPCS,L69100,Hand restoration no fingers,,,1201.22,1201.22,1
HCPCS,L6915,Hand restoration replacmnt g,,,516.12,1535.2,4
HCPCS,L69150,Hand restoration replacmnt g,,,516.12,516.12,1
HCPCS,L6920,Wrist disarticul switch ctrl,,,5332.9,13384.86,4
HCPCS,L69200,Wrist disarticul switch ctrl,,,5332.9,5332.9,1
HCPCS,L6925,Wrist disart myoelectronic c,,,5697.31,18018.34,4
HCPCS,L69250,Wrist disart myoelectronic c,,,5697.31,5697.31,1
HCPCS,L6930,Below elbow switch control,,,5136.33,13467.86,4
HCPCS,L69300,Below elbow switch control,,,5136.33,5136.33,1
HCPCS,L6935,Below elbow myoelectronic ct,,,5670.54,18297.95,4
HCPCS,L69350,Below elbow myoelectronic ct,,,5670.54,5670.54,1
HCPCS,L6940,Elbow disarticulation switch,,,6632.68,17596.63,4
HCPCS,L69400,Elbow disarticulation switch,,,6632.68,6632.68,1
HCPCS,L6945,Elbow disart myoelectronic c,,,7399.62,21500.97,4
HCPCS,L69450,Elbow disart myoelectronic c,,,7399.62,7399.62,1
HCPCS,L6950,Above elbow switch control,,,6620.38,20001.05,4
HCPCS,L69500,Above elbow switch control,,,6620.38,6620.38,1
HCPCS,L6955,Above elbow myoelectronic ct,,,7677.56,23953.97,4
HCPCS,L69550,Above elbow myoelectronic ct,,,7677.56,7677.56,1
HCPCS,L6960,Shldr disartic switch contro,,,8076.5,27133.88,4
HCPCS,L69600,Shldr disartic switch contro,,,8076.5,8076.5,1
HCPCS,L6965,Shldr disartic myoelectronic,,,9567.86,28939.28,4
HCPCS,L69650,Shldr disartic myoelectronic,,,9567.86,9567.86,1
HCPCS,L6970,Interscapular-thor switch ct,,,10241.34,30155.2,4
HCPCS,L69700,Interscapular-thor switch ct,,,10241.34,10241.34,1
HCPCS,L6975,Interscap-thor myoelectronic,,,11288.37,32980.06,4
HCPCS,L69750,Interscap-thor myoelectronic,,,11288.37,11288.37,1
HCPCS,L7007,Adult electric hand,,,2325.25,6901.41,4
HCPCS,L70070,Adult electric hand,,,2325.25,2325.25,1
HCPCS,L7008,Pediatric electric hand,,,3605.76,10862.1,4
HCPCS,L70080,Pediatric electric hand,,,3605.76,3605.76,1
HCPCS,L7009,Adult electric hook,,,2379.01,7041.63,4
HCPCS,L70090,Adult electric hook,,,2379.01,2379.01,1
HCPCS,L7040,Prehensile actuator,,,1936.36,5654.15,4
HCPCS,L70400,Prehensile actuator,,,1936.36,1936.36,1
HCPCS,L7045,Pediatric electric hook,,,1023.04,3241.72,4
HCPCS,L70450,Pediatric electric hook,,,1023.04,1023.04,1
HCPCS,L7170,Electronic elbow hosmer swit,,,3829.39,14926.07,4
HCPCS,L71700,Electronic elbow hosmer swit,,,3829.39,3829.39,1
HCPCS,L7180,Electronic elbow sequential,,,24774.81,65517.27,4
HCPCS,L71800,Electronic elbow sequential,,,24774.81,24774.81,1
HCPCS,L7181,Electronic elbo simultaneous,,,25508.02,81265.39,4
HCPCS,L71810,Electronic elbo simultaneous,,,25508.02,25508.02,1
HCPCS,L7185,Electron elbow adolescent sw,,,4025.93,14739.72,4
HCPCS,L71850,Electron elbow adolescent sw,,,4025.93,4025.93,1
HCPCS,L7186,Electron elbow child switch,,,6768.15,17740.69,4
HCPCS,L71860,Electron elbow child switch,,,6768.15,6768.15,1
HCPCS,L7190,Elbow adolescent myoelectron,,,5342.03,15481.75,4
HCPCS,L71900,Elbow adolescent myoelectron,,,5342.03,5342.03,1
HCPCS,L7191,Elbow child myoelectronic ct,,,7119.03,18537.97,4
HCPCS,L71910,Elbow child myoelectronic ct,,,7119.03,7119.03,1
HCPCS,L7259,Electronic wrist rotator any,,,2609.01,6409.74,4
HCPCS,L72590,Electronic wrist rotator any,,,2609.01,2609.01,1
HCPCS,L7360,Six volt bat otto bock/eq ea,,,168.42,478.57,4
HCPCS,L73600,Six volt bat otto bock/eq ea,,,168.42,168.42,1
HCPCS,L7362,Battery chrgr six volt otto,,,183.99,502.5,4
HCPCS,L73620,Battery chrgr six volt otto,,,183.99,183.99,1
HCPCS,L7364,Twelve volt battery utah/equ,,,325.56,799.19,4
HCPCS,L73640,Twelve volt battery utah/equ,,,325.56,325.56,1
HCPCS,L7366,Battery chrgr 12 volt utah/e,,,447.71,1076.54,4
HCPCS,L73660,Battery chrgr 12 volt utah/e,,,447.71,447.71,1
HCPCS,L7367,Replacemnt lithium ionbatter,,,247.86,789.58,4
HCPCS,L73670,Replacemnt lithium ionbatter,,,247.86,247.86,1
HCPCS,L7368,Lithium ion battery charger,,,321.3,1023.62,4
HCPCS,L73680,Lithium ion battery charger,,,321.3,321.3,1
HCPCS,L7400,"Add ue prost be/wd, ultlite",,,195.11,621.65,4
HCPCS,L74000,"Add ue prost be/wd, ultlite",,,195.11,195.11,1
HCPCS,L7401,Add ue prost a/e ultlite mat,,,218.41,695.94,4
HCPCS,L74010,Add ue prost a/e ultlite mat,,,218.41,218.41,1
HCPCS,L7402,Add ue prost s/d ultlite mat,,,235.89,751.47,4
HCPCS,L74020,Add ue prost s/d ultlite mat,,,235.89,235.89,1
HCPCS,L7403,Add ue prost b/e acrylic,,,234.46,746.94,4
HCPCS,L74030,Add ue prost b/e acrylic,,,234.46,234.46,1
HCPCS,L7404,Add ue prost a/e acrylic,,,353.86,1127.22,4
HCPCS,L74040,Add ue prost a/e acrylic,,,353.86,353.86,1
HCPCS,L7405,Add ue prost s/d acrylic,,,462.76,1474.31,4
HCPCS,L74050,Add ue prost s/d acrylic,,,462.76,462.76,1
HCPCS,L7406,Add upp ext mec limb vol lam,,,1834.46,1834.46,1
HCPCS,L74060,Add upp ext mec limb vol lam,,,1834.46,1834.46,1
HCPCS,L7510,Prosthetic device repair rep,,,198.47,198.47,1
HCPCS,L75100,Prosthetic device repair rep,,,198.47,198.47,1
HCPCS,L7520,Repair prosthesis per 15 min,,,19.16,66.17,4
HCPCS,L75200,Repair prosthesis per 15 min,,,19.16,19.16,1
HCPCS,L7600,Prosthetic donning sleeve,,,49.04,49.04,1
HCPCS,L76000,Prosthetic donning sleeve,,,49.04,49.04,1
HCPCS,L7700,Pros soc insert gasket/seal,,,95.25,226.35,4
HCPCS,L77000,Pros soc insert gasket/seal,,,95.25,95.25,1
HCPCS,L7900,Male vacuum erection system,,,131.0,581.02,4
HCPCS,L79000,Male vacuum erection system,,,131.0,131.0,1
HCPCS,L7902,"Tension ring, vac erect dev",,,18.63,46.44,7
HCPCS,L79020,"Tension ring, vac erect dev",,,46.44,46.44,1
HCPCS,L7902NU,"Tension ring, vac erect dev",,,18.63,20.18,3
HCPCS,L8000,Mastectomy bra,,,26.96,88.21,4
HCPCS,L80000,Mastectomy bra,,,26.96,26.96,1
HCPCS,L8001,Breast prosthesis bra & form,,,79.88,254.39,4
HCPCS,L80010,Breast prosthesis bra & form,,,79.88,79.88,1
HCPCS,L8002,BRST PRSTH BRA & BILAT FORM,100.0,65.0,50.0,153.96,17
HCPCS,L8002,Brst prsth bra & bilat form,,,105.03,334.65,4
HCPCS,L80020,Brst prsth bra & bilat form,,,105.03,105.03,1
HCPCS,L8010,Mastectomy sleeve,,,13.59,13.59,1
HCPCS,L80100,Mastectomy sleeve,,,13.59,13.59,1
HCPCS,L8015,Ext breastprosthesis garment,,,38.16,121.55,4
HCPCS,L80150,Ext breastprosthesis garment,,,38.16,38.16,1
HCPCS,L8020,Mastectomy form,,,143.93,457.25,4
HCPCS,L80200,Mastectomy form,,,143.93,143.93,1
HCPCS,L8030,Breast prosthes w/o adhesive,,,222.51,661.38,4
HCPCS,L80300,Breast prosthes w/o adhesive,,,222.51,222.51,1
HCPCS,L8031,Breast prosthesis w adhesive,,,222.51,661.38,4
HCPCS,L80310,Breast prosthesis w adhesive,,,222.51,222.51,1
HCPCS,L8032,Reusable nipple prosthesis,,,24.94,79.44,4
HCPCS,L80320,Reusable nipple prosthesis,,,24.94,24.94,1
HCPCS,L8035,Custom breast prosthesis,,,2332.31,7430.49,4
HCPCS,L80350,Custom breast prosthesis,,,2332.31,2332.31,1
HCPCS,L8039,Breast prosthesis nos,,,57.27,57.27,1
HCPCS,L80390,Breast prosthesis nos,,,57.27,57.27,1
HCPCS,L8040,Nasal prosthesis,,,157.83,4902.46,14
HCPCS,L80400,Nasal prosthesis,,,1578.28,1578.28,1
HCPCS,L8040KM,Nasal prosthesis,,,882.63,4657.34,4
HCPCS,L8040KN,Nasal prosthesis,,,371.64,1960.99,4
HCPCS,L8040MS,Nasal prosthesis,,,157.83,157.83,1
HCPCS,L8040RR,Nasal prosthesis,,,157.83,157.83,1
HCPCS,L8041,Midfacial prosthesis,,,190.22,5909.02,14
HCPCS,L80410,Midfacial prosthesis,,,1902.16,1902.16,1
HCPCS,L8041KM,Midfacial prosthesis,,,1063.88,5613.56,4
HCPCS,L8041KN,Midfacial prosthesis,,,447.95,2363.61,4
HCPCS,L8041MS,Midfacial prosthesis,,,190.22,190.22,1
HCPCS,L8041RR,Midfacial prosthesis,,,190.22,190.22,1
HCPCS,L8042,Orbital prosthesis,,,213.72,6639.28,14
HCPCS,L80420,Orbital prosthesis,,,2137.26,2137.26,1
HCPCS,L8042KM,Orbital prosthesis,,,1195.37,6307.32,4
HCPCS,L8042KN,Orbital prosthesis,,,503.31,2655.7,4
HCPCS,L8042MS,Orbital prosthesis,,,213.72,213.72,1
HCPCS,L8042RR,Orbital prosthesis,,,213.72,213.72,1
HCPCS,L8043,Upper facial prosthesis,,,239.37,7436.03,14
HCPCS,L80430,Upper facial prosthesis,,,2393.73,2393.73,1
HCPCS,L8043KM,Upper facial prosthesis,,,1338.8,7064.15,4
HCPCS,L8043KN,Upper facial prosthesis,,,563.71,2974.38,4
HCPCS,L8043MS,Upper facial prosthesis,,,239.37,239.37,1
HCPCS,L8043RR,Upper facial prosthesis,,,239.37,239.37,1
HCPCS,L8044,Hemi-facial prosthesis,,,265.02,8232.7,14
HCPCS,L80440,Hemi-facial prosthesis,,,2650.2,2650.2,1
HCPCS,L8044KM,Hemi-facial prosthesis,,,1482.26,7821.12,4
HCPCS,L8044KN,Hemi-facial prosthesis,,,624.11,3293.14,4
HCPCS,L8044MS,Hemi-facial prosthesis,,,265.02,265.02,1
HCPCS,L8044RR,Hemi-facial prosthesis,,,265.02,265.02,1
HCPCS,L8045,Auricular prosthesis,,,207.53,5155.55,14
HCPCS,L80450,Auricular prosthesis,,,2075.28,2075.28,1
HCPCS,L8045KM,Auricular prosthesis,,,975.33,4897.75,4
HCPCS,L8045KN,Auricular prosthesis,,,410.66,2062.25,4
HCPCS,L8045MS,Auricular prosthesis,,,207.53,207.53,1
HCPCS,L8045RR,Auricular prosthesis,,,207.53,207.53,1
HCPCS,L8046,Partial facial prosthesis,,,170.99,5311.46,14
HCPCS,L80460,Partial facial prosthesis,,,1709.82,1709.82,1
HCPCS,L8046KM,Partial facial prosthesis,,,956.3,5045.87,4
HCPCS,L8046KN,Partial facial prosthesis,,,402.65,2124.53,4
HCPCS,L8046MS,Partial facial prosthesis,,,170.99,170.99,1
HCPCS,L8046RR,Partial facial prosthesis,,,170.99,170.99,1
HCPCS,L8047,Nasal septal prosthesis,,,87.63,2722.08,14
HCPCS,L80470,Nasal septal prosthesis,,,876.28,876.28,1
HCPCS,L8047KM,Nasal septal prosthesis,,,490.1,2585.97,4
HCPCS,L8047KN,Nasal septal prosthesis,,,206.36,1088.84,4
HCPCS,L8047MS,Nasal septal prosthesis,,,87.63,87.63,1
HCPCS,L8047RR,Nasal septal prosthesis,,,87.63,87.63,1
HCPCS,L8049,Repair maxillofacial prosth,,,59.4,59.4,1
HCPCS,L80490,Repair maxillofacial prosth,,,59.4,59.4,1
HCPCS,L8300,Truss single w/ standard pad,,,53.4,195.34,4
HCPCS,L83000,Truss single w/ standard pad,,,53.4,53.4,1
HCPCS,L8310,Truss double w/ standard pad,,,94.59,300.35,4
HCPCS,L83100,Truss double w/ standard pad,,,94.59,94.59,1
HCPCS,L8320,Truss addition to std pad wa,,,39.25,131.17,4
HCPCS,L83200,Truss addition to std pad wa,,,39.25,39.25,1
HCPCS,L8330,Truss add to std pad scrotal,,,31.24,130.04,4
HCPCS,L83300,Truss add to std pad scrotal,,,31.24,31.24,1
HCPCS,L8400,Sheath below knee,,,9.97,38.02,4
HCPCS,L84000,Sheath below knee,,,9.97,9.97,1
HCPCS,L8410,Sheath above knee,,,13.11,43.25,4
HCPCS,L84100,Sheath above knee,,,13.11,13.11,1
HCPCS,L8415,Sheath upper limb,,,13.58,42.99,4
HCPCS,L84150,Sheath upper limb,,,13.58,13.58,1
HCPCS,L8417,Pros sheath/sock w gel cushn,,,47.89,152.51,4
HCPCS,L84170,Pros sheath/sock w gel cushn,,,47.89,47.89,1
HCPCS,L8420,Prosthetic sock multi ply bk,,,13.28,50.25,4
HCPCS,L84200,Prosthetic sock multi ply bk,,,13.28,13.28,1
HCPCS,L8430,Prosthetic sock multi ply ak,,,15.04,55.29,4
HCPCS,L84300,Prosthetic sock multi ply ak,,,15.04,15.04,1
HCPCS,L8435,Pros sock multi ply upper lm,,,14.29,49.6,4
HCPCS,L84350,Pros sock multi ply upper lm,,,14.29,14.29,1
HCPCS,L8440,Shrinker below knee,,,29.68,29.68,1
HCPCS,L8440,W SHRINKER PROST BELOW KNEE,59.0,38.35,9.91,57.82,29
HCPCS,L84400,Shrinker below knee,,,29.68,29.68,1
HCPCS,L8460,Shrinker above knee,,,42.18,146.35,4
HCPCS,L84600,Shrinker above knee,,,42.18,42.18,1
HCPCS,L8465,Shrinker upper limb,,,38.99,130.44,4
HCPCS,L84650,Shrinker upper limb,,,38.99,38.99,1
HCPCS,L8470,Pros sock single ply bk,,,4.22,13.38,4
HCPCS,L84700,Pros sock single ply bk,,,4.22,4.22,1
HCPCS,L8480,Pros sock single ply ak,,,5.83,18.46,4
HCPCS,L84800,Pros sock single ply ak,,,5.83,5.83,1
HCPCS,L8485,Pros sock single ply upper l,,,7.84,22.31,4
HCPCS,L84850,Pros sock single ply upper l,,,7.84,7.84,1
HCPCS,L8500,Artificial larynx,,,418.94,1323.62,4
HCPCS,L85000,Artificial larynx,,,418.94,418.94,1
HCPCS,L8501,Tracheostomy speaking valve,,,76.46,76.46,1
HCPCS,L8501,W VALVE TRACH PASSY MUIR,127.0,82.55,21.34,124.46,29
HCPCS,L85010,Tracheostomy speaking valve,,,76.46,76.46,1
HCPCS,L8505,"Artificial larynx, accessory",,,106.92,106.92,1
HCPCS,L85050,"Artificial larynx, accessory",,,106.92,106.92,1
HCPCS,L8507,LOW PRESSURE,194.0,126.1,19.86,194.0,17
HCPCS,L8507,PROVOX NID,158.0,102.7,19.86,158.0,17
HCPCS,L8507,Trach-esoph voice pros pt in,,,26.65,84.95,4
HCPCS,L85070,Trach-esoph voice pros pt in,,,26.65,26.65,1
HCPCS,L8509,ADVANTAGE,533.0,346.45,51.78,533.0,17
HCPCS,L8509,CLASSIC,395.0,256.75,51.78,395.0,17
HCPCS,L8509,DUAL VALVE,618.0,401.7,51.78,618.0,17
HCPCS,L8509,PROVOX 2,443.0,287.95,51.78,443.0,17
HCPCS,L8509,TRACH-ESOPH VOICE PROS MD IN,437.5,284.375,51.78,546.0,46
HCPCS,L8509,Trach-esoph voice pros md in,,,69.53,69.53,1
HCPCS,L8509,VEGA,410.0,266.5,51.78,410.0,17
HCPCS,L8509,XTRA SEAL,482.0,313.3,51.78,482.0,17
HCPCS,L85090,Trach-esoph voice pros md in,,,69.53,69.53,1
HCPCS,L8510,Voice amplifier,,,160.88,512.55,4
HCPCS,L85100,Voice amplifier,,,160.88,160.88,1
HCPCS,L8511,Indwelling trach insert,,,46.3,147.52,4
HCPCS,L85110,Indwelling trach insert,,,46.3,46.3,1
HCPCS,L8512,Gel cap for trach voice pros,,,1.39,4.43,4
HCPCS,L85120,Gel cap for trach voice pros,,,1.39,1.39,1
HCPCS,L8513,Trach pros cleaning device,,,3.32,10.59,4
HCPCS,L85130,Trach pros cleaning device,,,3.32,3.32,1
HCPCS,L8514,Repl trach puncture dilator,,,60.04,191.25,4
HCPCS,L85140,Repl trach puncture dilator,,,60.04,60.04,1
HCPCS,L8515,Gel cap app device for trach,,,40.2,128.02,4
HCPCS,L85150,Gel cap app device for trach,,,40.2,40.2,1
HCPCS,L8600,Implant breast silicone/eq,,,526.99,526.99,1
HCPCS,L86000,Implant breast silicone/eq,,,526.99,526.99,1
HCPCS,L8603,COLLAGEN IMPLNT URIN TRCT 2.5CC,688.0,447.2,205.62,688.0,20
HCPCS,L8603,Collagen imp urinary 2.5 ml,,,277.16,277.16,1
HCPCS,L8603,W IMP COLLAGN A/S,1721.0,1118.65,289.13,1686.58,32
HCPCS,L86030,Collagen imp urinary 2.5 ml,,,277.16,277.16,1
HCPCS,L8604,Dextranomer/hyaluronic acid,,,102.6,102.6,1
HCPCS,L86040,Dextranomer/hyaluronic acid,,,102.6,102.6,1
HCPCS,L8605,INJ BULKING AGENT ANAL CANAL,4330.0,2814.5,339.59,4330.0,13
HCPCS,L8605,Inj bulking agent anal canal,,,1521.44,3859.95,4
HCPCS,L86050,Inj bulking agent anal canal,,,1521.44,1521.44,1
HCPCS,L8606,INJ BULKING AGENT SYNTHETIC PER 1ML,534.0,347.1,107.93,534.0,20
HCPCS,L8606,MACROPLASTIQUE 1ML,1443.0,937.95,107.93,1443.0,20
HCPCS,L8606,SYNTHETIC IMPLNT URINARY 1ML,2395.5,1557.0749999999998,107.93,2974.0,40
HCPCS,L8606,Synthetic implnt urinary 1ml,,,130.74,130.74,1
HCPCS,L8606,W INJ BULK AGENT COLLAGEN IMP U,600.0,390.0,100.8,588.0,29
HCPCS,L8606,W INJ BULKING AGENT 1ML MPQ-2.5,330.0,214.5,55.44,323.4,29
HCPCS,L86060,Synthetic implnt urinary 1ml,,,130.74,130.74,1
HCPCS,L8607,Inj vocal cord bulking agent,,,27.3,27.3,1
HCPCS,L86070,Inj vocal cord bulking agent,,,27.3,27.3,1
HCPCS,L8609,Artificial cornea,,,4147.85,4147.85,1
HCPCS,L86090,Artificial cornea,,,4147.85,4147.85,1
HCPCS,L8610,Ocular implant,,,432.75,432.75,1
HCPCS,L86100,Ocular implant,,,432.75,432.75,1
HCPCS,L8612,Aqueous shunt prosthesis,,,503.86,503.86,1
HCPCS,L86120,Aqueous shunt prosthesis,,,503.86,503.86,1
HCPCS,L8613,Ossicular implant,,,216.35,216.35,1
HCPCS,L86130,Ossicular implant,,,216.35,216.35,1
HCPCS,L8614,Cochlear device,,,12464.86,12464.86,1
HCPCS,L86140,Cochlear device,,,12464.86,12464.86,1
HCPCS,L8615,Coch implant headset replace,,,287.12,914.74,4
HCPCS,L86150,Coch implant headset replace,,,287.12,287.12,1
HCPCS,L8616,Coch implant microphone repl,,,66.87,213.07,4
HCPCS,L86160,Coch implant microphone repl,,,66.87,66.87,1
HCPCS,L8617,Coch implant trans coil repl,,,58.41,186.17,4
HCPCS,L86170,Coch implant trans coil repl,,,58.41,58.41,1
HCPCS,L8618,Coch implant tran cable repl,,,16.7,53.17,4
HCPCS,L86180,Coch implant tran cable repl,,,16.7,16.7,1
HCPCS,L8619,Coch imp ext proc/contr rplc,,,5351.02,16470.76,4
HCPCS,L86190,Coch imp ext proc/contr rplc,,,5351.02,5351.02,1
HCPCS,L8621,Repl zinc air battery,,,0.4,1.25,4
HCPCS,L86210,Repl zinc air battery,,,0.4,0.4,1
HCPCS,L8622,Repl alkaline battery,,,0.21,0.65,4
HCPCS,L86220,Repl alkaline battery,,,0.21,0.21,1
HCPCS,L8623,"Lith ion batt cid,non-earlvl",,,41.18,131.17,4
HCPCS,L86230,"Lith ion batt cid,non-earlvl",,,41.18,41.18,1
HCPCS,L8624,"Lith ion batt cid, ear level",,,102.66,327.03,4
HCPCS,L86240,"Lith ion batt cid, ear level",,,102.66,102.66,1
HCPCS,L8625,Charger coch impl/aoi battry,,,120.25,383.04,4
HCPCS,L86250,Charger coch impl/aoi battry,,,120.25,120.25,1
HCPCS,L8627,Cid ext speech process repl,,,4541.83,13961.74,4
HCPCS,L86270,Cid ext speech process repl,,,4541.83,4541.83,1
HCPCS,L8628,Cid ext controller repl,,,809.18,2509.07,4
HCPCS,L86280,Cid ext controller repl,,,809.18,809.18,1
HCPCS,L8629,Cid transmit coil and cable,,,113.99,363.14,4
HCPCS,L86290,Cid transmit coil and cable,,,113.99,113.99,1
HCPCS,L8630,Metacarpophalangeal implant,,,284.32,284.32,1
HCPCS,L86300,Metacarpophalangeal implant,,,284.32,284.32,1
HCPCS,L8631,Mcp joint repl 2 pc or more,,,1400.44,1400.44,1
HCPCS,L86310,Mcp joint repl 2 pc or more,,,1400.44,1400.44,1
HCPCS,L8641,Metatarsal joint implant,,,221.56,221.56,1
HCPCS,L86410,Metatarsal joint implant,,,221.56,221.56,1
HCPCS,L8642,Hallux implant,,,198.12,198.12,1
HCPCS,L86420,Hallux implant,,,198.12,198.12,1
HCPCS,L8658,Interphalangeal joint spacer,,,193.18,193.18,1
HCPCS,L86580,Interphalangeal joint spacer,,,193.18,193.18,1
HCPCS,L8659,Interphalangeal joint repl,,,1228.48,1228.48,1
HCPCS,L86590,Interphalangeal joint repl,,,1228.48,1228.48,1
HCPCS,L8670,"Vascular graft, synthetic",,,352.34,352.34,1
HCPCS,L86700,"Vascular graft, synthetic",,,352.34,352.34,1
HCPCS,L8678,Ext sply implt neurostim,,,6.5,6.5,1
HCPCS,L86780,Ext sply implt neurostim,,,6.5,6.5,1
HCPCS,L8679,Imp neurosti pls gn any type,,,5454.93,5454.93,1
HCPCS,L86790,Imp neurosti pls gn any type,,,5454.93,5454.93,1
HCPCS,L8680,IMPLANT NEUROSTIM ELECTRODE,464.0,301.6,92.09,464.0,17
HCPCS,L8680,Implt neurostim elctr each,,,113.49,113.49,1
HCPCS,L86800,Implt neurostim elctr each,,,113.49,113.49,1
HCPCS,L8681,Pt prgrm for implt neurostim,,,726.07,2290.79,4
HCPCS,L86810,Pt prgrm for implt neurostim,,,726.07,726.07,1
HCPCS,L8682,Implt neurostim radiofq rec,,,3897.43,3897.43,1
HCPCS,L86820,Implt neurostim radiofq rec,,,3897.43,3897.43,1
HCPCS,L8683,Radiofq trsmtr for implt neu,,,3430.64,10643.12,4
HCPCS,L86830,Radiofq trsmtr for implt neu,,,3430.64,3430.64,1
HCPCS,L8684,Radiof trsmtr implt scrl neu,,,538.32,1397.64,4
HCPCS,L86840,Radiof trsmtr implt scrl neu,,,538.32,538.32,1
HCPCS,L8685,Implt nrostm pls gen sng rec,,,3230.23,3230.23,1
HCPCS,L86850,Implt nrostm pls gen sng rec,,,3230.23,3230.23,1
HCPCS,L8686,Implt nrostm pls gen sng non,,,2061.18,5258.85,4
HCPCS,L86860,Implt nrostm pls gen sng non,,,2061.18,2061.18,1
HCPCS,L8687,Implt nrostm pls gen dua rec,,,4203.91,10725.76,4
HCPCS,L86870,Implt nrostm pls gen dua rec,,,4203.91,4203.91,1
HCPCS,L8688,Implt nrostm pls gen dua non,,,2682.46,2682.46,1
HCPCS,L86880,Implt nrostm pls gen dua non,,,2682.46,2682.46,1
HCPCS,L8689,External recharg sys intern,,,1098.13,3498.47,4
HCPCS,L86890,External recharg sys intern,,,1098.13,1098.13,1
HCPCS,L8690,"Aud osseo dev, int/ext comp",,,3028.47,3028.47,1
HCPCS,L86900,"Aud osseo dev, int/ext comp",,,3028.47,3028.47,1
HCPCS,L8691,Aoi snd proc repl excl actua,,,1096.35,3492.86,4
HCPCS,L86910,Aoi snd proc repl excl actua,,,1096.35,1096.35,1
HCPCS,L8692,Non-osseointegrated snd proc,,,2629.9,2629.9,1
HCPCS,L86920,Non-osseointegrated snd proc,,,2629.9,2629.9,1
HCPCS,L8693,"Aud osseo dev, abutment",,,965.31,3075.41,4
HCPCS,L86930,"Aud osseo dev, abutment",,,965.31,965.31,1
HCPCS,L8694,Aoi transducer/actuator repl,,,601.21,1915.43,4
HCPCS,L86940,Aoi transducer/actuator repl,,,601.21,601.21,1
HCPCS,L8695,External recharg sys extern,,,10.62,33.77,4
HCPCS,L86950,External recharg sys extern,,,10.62,10.62,1
HCPCS,L8696,Ext antenna phren nerve stim,,,137.97,439.64,4
HCPCS,L86960,Ext antenna phren nerve stim,,,137.97,137.97,1
HCPCS,L8699,RICHARDS T TUBE,43.0,27.95,7.22,38.7,27
HCPCS,L8699,TRUMPET TUBE,56.0,36.4,9.41,50.4,27
HCPCS,L8699,W H130006 IMP FENIX CONT RESTOR,10500.0,6825.0,1764.0,10290.0,35
HCPCS,L8699,W PROSTHESIS ENT STRUT INCUS,670.0,435.5,112.56,656.6,29
HCPCS,L8699,W PROSTHESIS OSSICULAR ALTO+HA,666.0,432.9,111.89,652.68,29
HCPCS,L8699,W PROXIMAL HUMERAL,4841.0,3146.65,813.29,4744.18,32
HCPCS,L8701,Ewh s/d uprt micro sensor,,,18079.69,57289.3,4
HCPCS,L87010,Ewh s/d uprt micro sensor,,,18079.69,18079.69,1
HCPCS,L8702,Ewhf s/d uprt micro sensor,,,35570.74,112713.39,4
HCPCS,L87020,Ewhf s/d uprt micro sensor,,,35570.74,35570.74,1
HCPCS,L9900,O&p supply/accessory/service,,,99.22,99.22,1
HCPCS,L99000,O&p supply/accessory/service,,,99.22,99.22,1
HCPCS,M0010,Eom meos payment,,,23.85,30.13,6
HCPCS,M0075,Cellular therapy,,,324.27,1230.91,7
HCPCS,M00750,Cellular therapy,,,324.27,324.27,1
HCPCS,M0076,Prolotherapy,,,151.21,274.4,7
HCPCS,M00760,Prolotherapy,,,274.4,274.4,1
HCPCS,M0100,Intragastric hypothermia,,,54.0,228.95,7
HCPCS,M01000,Intragastric hypothermia,,,54.0,54.0,1
HCPCS,M0201,Pne flu hepb cov home admin,,,25.75,79.9,20
HCPCS,M0220,Tixagev and cilgav inj,,,30.69,326.31,16
HCPCS,M0221,Tixagev and cilgav inj hm,,,30.69,543.13,16
HCPCS,M0222,Bebtelovimab injection,,,30.69,759.94,16
HCPCS,M0223,Bebtelovimab injection home,,,30.69,1193.57,16
HCPCS,M0224,PEMIVIBART INFUSION (IV INFUSION FOR IMMUNE-COMPROMISED COVID-19,2250.0,1462.5,44.0,2025.0,40
HCPCS,M0224,Pemivibart infusion,,,486.0,486.0,1
HCPCS,M02240,Pemivibart infusion,,,486.0,486.0,1
HCPCS,M0233,Iv inf toc hos ad cort ft ds,,,166.76,210.65,6
HCPCS,M0234,Iv inf toc hos ad cort sec,,,166.76,210.65,6
HCPCS,M0235,"Intrav inf, mon anti, fir do",,,166.76,506.52,10
HCPCS,M0236,"Intrav inf, mon anti, sec do",,,166.76,506.52,10
HCPCS,M0237,"Intrav inf, toci, first dose",,,166.76,506.52,10
HCPCS,M0238,"Intrav inf, toci, second dos",,,166.76,506.52,10
HCPCS,M0239,Bamlanivimab-xxxx infusion,,,166.76,210.65,6
HCPCS,M0240,Casiri and imdev repeat,,,166.76,976.76,16
HCPCS,M0241,Casiri and imdev repeat hm,,,753.34,1627.21,10
HCPCS,M0243,Casirivi and imdevi inj,,,166.76,976.76,16
HCPCS,M0244,Casirivi and imdevi inj hm,,,753.34,1627.21,10
HCPCS,M0245,Bamlan and etesev infusion,,,166.76,976.76,16
HCPCS,M0246,Bamlan and etesev infus home,,,753.34,1627.21,10
HCPCS,M0247,Sotrovimab infusion,,,166.76,976.76,16
HCPCS,M0248,"Sotrovimab inf, home admin",,,753.34,1627.21,10
HCPCS,M0249,ADM TOCILIZU COVID-19 1ST,1307.0,849.5500000000001,44.0,2027.7,53
HCPCS,M0249,Adm tocilizu covid-19 1st,,,486.0,486.0,1
HCPCS,M02490,Adm tocilizu covid-19 1st,,,486.0,486.0,1
HCPCS,M0250,ADM TOCILIZU COVID-19 2ND,1307.0,849.5500000000001,44.0,2027.7,53
HCPCS,M0250,Adm tocilizu covid-19 2nd,,,486.0,486.0,1
HCPCS,M02500,Adm tocilizu covid-19 2nd,,,486.0,486.0,1
HCPCS,M0300,Iv chelationtherapy,,,52.55,52.55,1
HCPCS,M03000,Iv chelationtherapy,,,52.55,52.55,1
HCPCS,M0301,Fabric wrapping of aneurysm,,,5148.42,6503.27,6
HCPCS,M1072,"ROM RAD THERAPY ANAL, PC",11472.0,7456.8,5736.0,11472.0,12
HCPCS,M1073,"ROM RAD THERAPY ANAL, TC",67428.0,43828.2,33714.0,67428.0,12
HCPCS,M1074,"ROM RAD THERAPY BLADDER, PC",10304.0,6697.6,5152.0,10304.0,12
HCPCS,M1075,"ROM RAD THERAPY BLADDER, TC",54154.0,35200.1,27077.0,54154.0,12
HCPCS,M1076,"ROM RAD THER BONE METS, PC",5342.0,3472.3,2671.0,5342.0,12
HCPCS,M1077,"ROM RAD THER BONE METS, TC",24248.0,15761.2,12124.0,24248.0,12
HCPCS,M1078,"ROM RAD THER BRAIN METS, PC",6097.0,3963.05,3048.5,6097.0,12
HCPCS,M1079,"ROM RAD THER BRAIN METS, TC",38984.0,25339.6,19492.0,38984.0,12
HCPCS,M1080,"ROM RAD THERAPY BREAST, PC",7614.0,4949.1,3807.0,7614.0,12
HCPCS,M1081,"ROM RAD THERAPY BREAST, TC",39712.0,25812.8,19856.0,39712.0,12
HCPCS,M1082,"ROM RAD THERAPY CERVICAL, PC",11224.0,7295.6,5612.0,11224.0,12
HCPCS,M1083,"ROM RAD THERAPY CERVICAL, TC",54252.0,35263.8,27126.0,54252.0,12
HCPCS,M1084,"ROM RAD THERAPY CNS, PC",9452.0,6143.8,4726.0,9452.0,12
HCPCS,M1085,"ROM RAD THERAPY CNS, TC",59412.0,38617.8,29706.0,59412.0,12
HCPCS,M1086,"ROM RAD THER COLORECTAL, PC",9269.0,6024.85,4634.5,9269.0,12
HCPCS,M1087,"ROM RAD THER COLORECTAL, TC",48679.0,31641.35,24339.5,48679.0,12
HCPCS,M1088,"ROM RAD THER HEAD/NECK, PC",11487.0,7466.55,5743.5,11487.0,12
HCPCS,M1089,"ROM RAD THER HEAD/NECK, TC",70144.0,45593.6,35072.0,70144.0,12
HCPCS,M1094,"ROM RAD THERAPY LUNG, PC",8246.0,5359.9,4123.0,8246.0,12
HCPCS,M1095,"ROM RAD THERAPY LUNG, TC",48030.0,31219.5,24015.0,48030.0,12
HCPCS,M1096,"ROM RAD THERAPY LYMPHOMA, PC",6373.0,4142.45,3186.5,6373.0,12
HCPCS,M1097,"ROM RAD THERAPY LYMPHOMA, TC",31717.0,20616.05,15858.5,31717.0,12
HCPCS,M1098,"ROM RAD THERAPY PANCREAS, PC",9168.0,5959.2,4584.0,9168.0,12
HCPCS,M1099,"ROM RAD THERAPY PANCREAS, TC",54386.0,35350.9,27193.0,54386.0,12
HCPCS,M1100,"ROM RAD THERAPY PROSTATE, PC",12493.0,8120.45,6246.5,12493.0,12
HCPCS,M1101,"ROM RAD THERAPY PROSTATE, TC",81221.0,52793.65,40610.5,81221.0,12
HCPCS,M1102,"ROM RAD THERAPY GI, PC",9858.0,6407.7,4929.0,9858.0,12
HCPCS,M1103,"ROM RAD THERAPY GI, TC",58634.0,38112.1,29317.0,58634.0,12
HCPCS,M1104,"ROM RAD THERAPY UTERUS, PC",10120.0,6578.0,5060.0,10120.0,12
HCPCS,M1105,"ROM RAD THERAPY UTERUS, TC",56879.0,36971.35,28439.5,56879.0,12
HCPCS,P2028,Cephalin floculation test,,,4.28,8.27,21
HCPCS,P20280,Cephalin floculation test,,,4.28,4.28,1
HCPCS,P2029,Congo red blood test,,,4.28,8.27,21
HCPCS,P20290,Congo red blood test,,,4.28,4.28,1
HCPCS,P2031,Hair analysis,,,4.28,8.27,10
HCPCS,P20310,Hair analysis,,,4.28,4.28,1
HCPCS,P2033,Blood thymol turbidity,,,2.08,8.27,21
HCPCS,P20330,Blood thymol turbidity,,,4.28,4.28,1
HCPCS,P2038,Blood mucoprotein,,,4.28,8.27,21
HCPCS,P20380,Blood mucoprotein,,,4.28,4.28,1
HCPCS,P3000,CYTOLOGY GYN SCREEN,107.0,69.55,9.95,96.3,37
HCPCS,P3000,Screen pap by tech w md supv,,,15.35,15.35,1
HCPCS,P30000,Screen pap by tech w md supv,,,15.35,15.35,1
HCPCS,P3001,Screening pap smear by phys,,,9.95,19.57,8
HCPCS,P30010,Screening pap smear by phys,,,19.57,19.57,1
HCPCS,P3001TC,Screening pap smear by phys,,,19.57,19.57,1
HCPCS,P7001,Culture bacterial urine,,,4.02,25.53,10
HCPCS,P70010,Culture bacterial urine,,,14.15,14.15,1
HCPCS,P9010,WHOLE BLOOD TXFUS PER UNIT,999.0,649.35,74.43,899.1,40
HCPCS,P9010,Whole blood for transfusion,,,33.53,33.53,1
HCPCS,P90100,Whole blood for transfusion,,,33.53,33.53,1
HCPCS,P9011,Blood split unit,,,47.95,47.95,1
HCPCS,P9011,SPLIT UNIT,330.0,214.5,74.43,813.0,40
HCPCS,P90110,Blood split unit,,,47.95,47.95,1
HCPCS,P9012,CRYOPRECIPITATE EA UNIT,189.0,122.85,48.95,813.0,40
HCPCS,P9012,Cryoprecipitate each unit,,,12.96,12.96,2
HCPCS,P90120,Cryoprecipitate each unit,,,12.96,12.96,1
HCPCS,P9012TC,Cryoprecipitate each unit,,,12.96,12.96,1
HCPCS,P9016,RBC LR EA UNIT,843.0,547.95,74.43,813.0,40
HCPCS,P9016,Rbc leukocytes reduced,,,224.36,224.36,2
HCPCS,P90160,Rbc leukocytes reduced,,,224.36,224.36,1
HCPCS,P9016TC,Rbc leukocytes reduced,,,224.36,224.36,1
HCPCS,P9017,FFP SNGL DONOR WITHIN 8 HR,327.0,212.55,74.43,813.0,40
HCPCS,P9017,Plasma 1 donor frz w/in 8 hr,,,78.13,78.13,2
HCPCS,P90170,Plasma 1 donor frz w/in 8 hr,,,78.13,78.13,1
HCPCS,P9017TC,Plasma 1 donor frz w/in 8 hr,,,78.13,78.13,1
HCPCS,P9019,PLT EA UNIT,319.0,207.35,54.35,813.0,40
HCPCS,P9019,"Platelets, each unit",,,179.79,179.79,2
HCPCS,P90190,"Platelets, each unit",,,179.79,179.79,1
HCPCS,P9019TC,"Platelets, each unit",,,179.79,179.79,1
HCPCS,P9020,PLATELET RICH PLASMA UNIT,499.0,324.35,74.43,1208.36,40
HCPCS,P9020,Plaelet rich plasma unit,,,314.55,314.55,2
HCPCS,P90200,Plaelet rich plasma unit,,,314.55,314.55,1
HCPCS,P9020TC,Plaelet rich plasma unit,,,314.55,314.55,1
HCPCS,P9021,RBC EA UNIT,606.0,393.9,74.43,813.0,40
HCPCS,P9021,Red blood cells unit,,,109.27,109.27,2
HCPCS,P90210,Red blood cells unit,,,109.27,109.27,1
HCPCS,P9021TC,Red blood cells unit,,,109.27,109.27,1
HCPCS,P9022,RED CELLS WASHED EA UNIT,750.0,487.5,172.65,860.48,40
HCPCS,P9022,WASHED RED BLOOD CELLS EA UNIT,583.0,378.95,151.0,860.48,40
HCPCS,P9022,Washed red blood cells unit,,,312.33,312.33,2
HCPCS,P90220,Washed red blood cells unit,,,312.33,312.33,1
HCPCS,P9022TC,Washed red blood cells unit,,,312.33,312.33,1
HCPCS,P9023,"Frozen plasma, pooled, sd",,,0.89,135.1,25
HCPCS,P90230,"Frozen plasma, pooled, sd",,,0.89,0.89,1
HCPCS,P9023TC,"Frozen plasma, pooled, sd",,,0.89,0.89,1
HCPCS,P9025,Plasma cryo redu path each,,,74.43,293.03,22
HCPCS,P90250,Plasma cryo redu path each,,,229.33,229.33,1
HCPCS,P9025TC,Plasma cryo redu path each,,,229.33,229.33,1
HCPCS,P9026,Cryo fib comp path redu each,,,74.43,680.31,22
HCPCS,P90260,Cryo fib comp path redu each,,,272.85,272.85,1
HCPCS,P9026TC,Cryo fib comp path redu each,,,272.85,272.85,1
HCPCS,P9027,Rbc o2 co2 reduced,,,74.43,1056.11,20
HCPCS,P9031,PLT LR EA UNIT,485.0,315.25,125.62,813.0,40
HCPCS,P9031,Platelets leukocytes reduced,,,374.97,374.97,2
HCPCS,P90310,Platelets leukocytes reduced,,,374.97,374.97,1
HCPCS,P9031TC,Platelets leukocytes reduced,,,374.97,374.97,1
HCPCS,P9032,PLATELETS IRRADIATED EA UNIT,558.0,362.7,136.29,813.0,40
HCPCS,P9032,"Platelets, irradiated",,,118.15,118.15,2
HCPCS,P90320,"Platelets, irradiated",,,118.15,118.15,1
HCPCS,P9032TC,"Platelets, irradiated",,,118.15,118.15,1
HCPCS,P9033,PLATELETS LEUKORED IRRAD EA UNIT,867.0,563.55,172.65,813.0,40
HCPCS,P9033,Platelets leukoreduced irrad,,,303.33,303.33,2
HCPCS,P90330,Platelets leukoreduced irrad,,,303.33,303.33,1
HCPCS,P9033TC,Platelets leukoreduced irrad,,,303.33,303.33,1
HCPCS,P9034,PLTS PHERESIS PER UNIT,1351.0,878.15,172.65,1215.9,40
HCPCS,P9034,"Platelets, pheresis",,,360.69,360.69,2
HCPCS,P90340,"Platelets, pheresis",,,360.69,360.69,1
HCPCS,P9034TC,"Platelets, pheresis",,,360.69,360.69,1
HCPCS,P9035,PLT PHERESIS LR EA UNIT,2233.0,1451.45,172.65,2009.7,40
HCPCS,P9035,Platelet pheres leukoreduced,,,554.49,554.49,2
HCPCS,P90350,Platelet pheres leukoreduced,,,554.49,554.49,1
HCPCS,P9035TC,Platelet pheres leukoreduced,,,554.49,554.49,1
HCPCS,P9036,PLATELET PHERESIS IRRAD EA UNIT,2762.0,1795.3,172.65,2485.8,40
HCPCS,P9036,Platelet pheresis irradiated,,,1913.3,1913.3,2
HCPCS,P90360,Platelet pheresis irradiated,,,1913.3,1913.3,1
HCPCS,P9036TC,Platelet pheresis irradiated,,,1913.3,1913.3,1
HCPCS,P9037,PLTS PHERESIS LEUKOR IRR,2841.0,1846.65,172.65,2556.9,40
HCPCS,P9037,Plate pheres leukoredu irrad,,,806.8,806.8,2
HCPCS,P90370,Plate pheres leukoredu irrad,,,806.8,806.8,1
HCPCS,P9037TC,Plate pheres leukoredu irrad,,,806.8,806.8,1
HCPCS,P9038,RBC IRRADIATED EACH UNIT,625.0,406.25,74.43,813.0,40
HCPCS,P9038,Rbc irradiated,,,332.12,332.12,2
HCPCS,P90380,Rbc irradiated,,,332.12,332.12,1
HCPCS,P9038TC,Rbc irradiated,,,332.12,332.12,1
HCPCS,P9039,RBC DEGLYCEROLIZED EA UNIT,1484.0,964.6,74.43,1417.42,40
HCPCS,P9039,RED CELL FROZ/THAW 1 UNIT,859.0,558.35,74.43,1417.42,40
HCPCS,P9039,Rbc deglycerolized,,,1123.56,1123.56,2
HCPCS,P90390,Rbc deglycerolized,,,1123.56,1123.56,1
HCPCS,P9039TC,Rbc deglycerolized,,,1123.56,1123.56,1
HCPCS,P9040,RBC LR IRRAD EA UNIT,1071.0,696.15,74.43,963.9,40
HCPCS,P9040,Rbc leukoreduced irradiated,,,285.81,285.81,2
HCPCS,P90400,Rbc leukoreduced irradiated,,,285.81,285.81,1
HCPCS,P9040TC,Rbc leukoreduced irradiated,,,285.81,285.81,1
HCPCS,P9041,ALBUTEIN 5 % INTRAVENOUS SOLUTION,2.37,1.54,0.59,94.02,33
HCPCS,P9041,"Albumin (human),5%, 50ml",,,11.47,11.47,1
HCPCS,P90410,"Albumin (human),5%, 50ml",,,11.47,11.47,1
HCPCS,P9043,"Plasma protein fract,5%,50ml",,,8.1,94.02,24
HCPCS,P90430,"Plasma protein fract,5%,50ml",,,23.35,23.35,1
HCPCS,P9044,Cryoprecipitatereducedplasma,,,136.74,136.74,2
HCPCS,P9044,PLASMA CRYOPRECIPITATE REDUCED EA UNIT,365.0,237.25,74.43,813.0,40
HCPCS,P90440,Cryoprecipitatereducedplasma,,,136.74,136.74,1
HCPCS,P9044TC,Cryoprecipitatereducedplasma,,,136.74,136.74,1
HCPCS,P9045,ALBURX (HUMAN) 5 % INTRAVENOUS SOLUTION,1.29,0.84,0.33,218.09,40
HCPCS,P9045,ALBUTEIN 5 % INTRAVENOUS SOLUTION,0.675,0.44,0.17,218.09,160
HCPCS,P9045,"Albumin (human), 5%, 250 ml",,,57.33,57.33,1
HCPCS,P9045,FLEXBUMIN 5 % INTRAVENOUS SOLUTION,0.84,0.55,0.22,218.09,40
HCPCS,P90450,"Albumin (human), 5%, 250 ml",,,57.33,57.33,1
HCPCS,P9046,ALBUTEIN 25 % INTRAVENOUS SOLUTION,5.01,3.26,1.3,94.02,40
HCPCS,P9046,"Albumin (human), 25%, 20 ml",,,22.93,22.93,1
HCPCS,P90460,"Albumin (human), 25%, 20 ml",,,22.93,22.93,1
HCPCS,P9047,"ALBUMIN (HUMAN), 25%, 50ML",336.0,218.4,53.08,336.0,14
HCPCS,P9047,ALBUTEIN 25 % INTRAVENOUS SOLUTION,3.36,2.18,0.84,146.89,132
HCPCS,P9047,"Albumin (human), 25%, 50ml",,,57.33,57.33,1
HCPCS,P9047,FLEXBUMIN 25 % INTRAVENOUS SOLUTION,4.17,2.71,1.04,146.89,66
HCPCS,P90470,"Albumin (human), 25%, 50ml",,,57.33,57.33,1
HCPCS,P9048,"Plasmaprotein fract,5%,250ml",,,36.1,159.84,24
HCPCS,P90480,"Plasmaprotein fract,5%,250ml",,,54.84,54.84,1
HCPCS,P9050,GRANUL LEUK 1U TRANSFUSED,6811.0,4427.15,172.65,6129.9,30
HCPCS,P9050,"Granulocytes, pheresis unit",,,4127.76,4127.76,2
HCPCS,P90500,"Granulocytes, pheresis unit",,,4127.76,4127.76,1
HCPCS,P9050TC,"Granulocytes, pheresis unit",,,4127.76,4127.76,1
HCPCS,P9051,"Blood, l/r, cmv-neg",,,479.78,479.78,2
HCPCS,P9051,WH BLD OR RBC L/R CMV NEG EA UNIT,750.0,487.5,74.43,813.0,40
HCPCS,P90510,"Blood, l/r, cmv-neg",,,479.78,479.78,1
HCPCS,P9051TC,"Blood, l/r, cmv-neg",,,479.78,479.78,1
HCPCS,P9052,PLTS PHERESIS LEUKOR HLA,1111.0,722.15,172.65,1685.73,40
HCPCS,P9052,"Platelets, hla-m, l/r, unit",,,16.2,16.2,2
HCPCS,P90520,"Platelets, hla-m, l/r, unit",,,16.2,16.2,1
HCPCS,P9052TC,"Platelets, hla-m, l/r, unit",,,16.2,16.2,1
HCPCS,P9053,PLT PHER IRR L/R CMV NEG EA UNIT,2004.0,1302.6,172.65,1803.6,40
HCPCS,P9053,"Plt, pher, l/r cmv-neg, irr",,,2332.63,2332.63,2
HCPCS,P90530,"Plt, pher, l/r cmv-neg, irr",,,2332.63,2332.63,1
HCPCS,P9053TC,"Plt, pher, l/r cmv-neg, irr",,,2332.63,2332.63,1
HCPCS,P9054,"Blood, l/r, froz/degly/wash",,,359.38,359.38,2
HCPCS,P9054,WSH LR FROZ DW WB/RBC EA UNIT,905.0,588.25,74.43,814.5,40
HCPCS,P90540,"Blood, l/r, froz/degly/wash",,,359.38,359.38,1
HCPCS,P9054TC,"Blood, l/r, froz/degly/wash",,,359.38,359.38,1
HCPCS,P9055,"Plt, aph/pher, l/r, cmv-neg",,,172.65,1184.53,22
HCPCS,P90550,"Plt, aph/pher, l/r, cmv-neg",,,1184.53,1184.53,1
HCPCS,P9055TC,"Plt, aph/pher, l/r, cmv-neg",,,1184.53,1184.53,1
HCPCS,P9056,"Blood, l/r, irradiated",,,74.43,549.44,22
HCPCS,P90560,"Blood, l/r, irradiated",,,549.44,549.44,1
HCPCS,P9056TC,"Blood, l/r, irradiated",,,549.44,549.44,1
HCPCS,P9057,RED CELL LEUKOREDUCED DEGLYCEROLIZED IRRADIATED,3145.0,2044.25,74.43,2830.5,40
HCPCS,P9057,"Rbc, frz/deg/wsh, l/r, irrad",,,384.52,384.52,2
HCPCS,P90570,"Rbc, frz/deg/wsh, l/r, irrad",,,384.52,384.52,1
HCPCS,P9057TC,"Rbc, frz/deg/wsh, l/r, irrad",,,384.52,384.52,1
HCPCS,P9058,RBC L/R IRR CMV NEG EA UNIT,985.0,640.25,74.43,886.5,40
HCPCS,P9058,"Rbc, l/r, cmv-neg, irrad",,,269.99,269.99,2
HCPCS,P90580,"Rbc, l/r, cmv-neg, irrad",,,269.99,269.99,1
HCPCS,P9058TC,"Rbc, l/r, cmv-neg, irrad",,,269.99,269.99,1
HCPCS,P9059,CONVALESCENT PLASMA,1210.0,786.5,71.36,1089.0,40
HCPCS,P9059,FR FRZ PLASMA FRZN 8-24 HOURS EA UNIT,303.0,196.95,71.36,813.0,40
HCPCS,P9059,"Plasma, frz between 8-24hour",,,99.18,99.18,2
HCPCS,P90590,"Plasma, frz between 8-24hour",,,99.18,99.18,1
HCPCS,P9059TC,"Plasma, frz between 8-24hour",,,99.18,99.18,1
HCPCS,P9060,FR FRZ PLASMA DONOR RETESTED EA UNIT,200.0,130.0,49.12,813.0,40
HCPCS,P9060,Fr frz plasma donor retested,,,83.88,83.88,2
HCPCS,P90600,Fr frz plasma donor retested,,,83.88,83.88,1
HCPCS,P9060TC,Fr frz plasma donor retested,,,83.88,83.88,1
HCPCS,P9070,Pathogen reduced plasma pool,,,56.32,121.66,22
HCPCS,P90700,Pathogen reduced plasma pool,,,94.66,94.66,1
HCPCS,P9070TC,Pathogen reduced plasma pool,,,94.66,94.66,1
HCPCS,P9071,PLASMA SNGL DONOR PATHOGEN REDUCED FRZN EACH UNIT,321.0,208.65,74.43,813.0,40
HCPCS,P9071,Pathogen reduced plasma sing,,,95.86,95.86,2
HCPCS,P90710,Pathogen reduced plasma sing,,,95.86,95.86,1
HCPCS,P9071TC,Pathogen reduced plasma sing,,,95.86,95.86,1
HCPCS,P9073,PLT PHER PATH-RED EA,2395.0,1556.75,172.65,2155.5,40
HCPCS,P9073,Platelets pheresis path redu,,,746.53,746.53,2
HCPCS,P90730,Platelets pheresis path redu,,,746.53,746.53,1
HCPCS,P9073TC,Platelets pheresis path redu,,,746.53,746.53,1
HCPCS,P9099,Blood component/product noc,,,36.1,106.09,20
HCPCS,P9100,PATHOGEN TEST FOR PLTS - LVDS PLTS,1967.0,1278.55,11.52,1770.3,37
HCPCS,P9100,Pathogen test for platelets,,,55.71,55.71,2
HCPCS,P91000,Pathogen test for platelets,,,55.71,55.71,1
HCPCS,P9100TC,Pathogen test for platelets,,,55.71,55.71,1
HCPCS,P9603,One-way allow prorated miles,,,0.97,3.18,11
HCPCS,P96030,One-way allow prorated miles,,,0.97,0.97,1
HCPCS,P9603TC,One-way allow prorated miles,,,0.97,0.97,1
HCPCS,P9604,One-way allow prorated trip,,,2.52,18.88,14
HCPCS,P96040,One-way allow prorated trip,,,9.61,9.61,1
HCPCS,P9604LR,One-way allow prorated trip,,,17.42,18.88,3
HCPCS,P9604TC,One-way allow prorated trip,,,9.61,9.61,1
HCPCS,P9612,CATH COLL SPEC SNGL PATIENT,20.0,13.0,2.52,2849.0,37
HCPCS,P9612,"CATH COLL SPEC,1 PT,ALL PLACES SERVC",17.0,11.05,2.34,17.0,17
HCPCS,P9612,Catheterize for urine spec,,,7.62,7.62,1
HCPCS,P9612,STRAIGHT CATH - SPECIMEN COLLECTION,20.0,13.0,2.52,2849.0,37
HCPCS,P96120,Catheterize for urine spec,,,7.62,7.62,1
HCPCS,P9615,Urine specimen collect mult,,,2.52,15.19,10
HCPCS,P96150,Urine specimen collect mult,,,7.62,7.62,1
HCPCS,PKGFETAL,FETAL INJECTION,1500.0,975.0,750.0,1500.0,12
HCPCS,PKGICG,ICG PACKAGE,3434.0,2232.1,1717.0,3434.0,12
HCPCS,PKGTERMC,PREGNANCY TERMINATION CONSULT,950.0,617.5,475.0,950.0,12
HCPCS,Q0035,Cardiokymography,,,10.5,85.1,22
HCPCS,Q00350,Cardiokymography,,,10.5,10.5,1
HCPCS,Q0035TC,Cardiokymography,,,10.5,10.5,1
HCPCS,Q0081,Infusion ther other than che,,,12.25,210.65,7
HCPCS,Q00810,Infusion ther other than che,,,12.25,12.25,1
HCPCS,Q0083,Chemo by other than infusion,,,30.69,79.81,7
HCPCS,Q00830,Chemo by other than infusion,,,79.81,79.81,1
HCPCS,Q0084,Chemotherapy by infusion,,,104.18,210.65,7
HCPCS,Q00840,Chemotherapy by infusion,,,104.18,104.18,1
HCPCS,Q0085,Chemo by both infusion and o,,,143.67,210.65,7
HCPCS,Q00850,Chemo by both infusion and o,,,143.67,143.67,1
HCPCS,Q0091,OBTAINING SCREEN PAP SMEAR,163.0,105.95,16.34,163.0,31
HCPCS,Q0091,Obtaining screen pap smear,,,10.42,10.42,1
HCPCS,Q0091,PAP SMEAR,143.0,92.95,9.95,163.0,107
HCPCS,Q00910,Obtaining screen pap smear,,,10.42,10.42,1
HCPCS,Q0092,Set up port xray equipment,,,14.07,14.07,1
HCPCS,Q00920,Set up port xray equipment,,,14.07,14.07,1
HCPCS,Q0111,OIL TEST (SCABIES) (POC) (POINT OF CARE LAB),191.0,124.15,2.34,171.9,37
HCPCS,Q0111,Wet mounts/ w preparations,,,15.35,15.35,1
HCPCS,Q01110,Wet mounts/ w preparations,,,15.35,15.35,1
HCPCS,Q0112,POTASSIUM HYDROXIDE (KOH) PREPS (POC) (POINT OF CARE LAB),47.0,30.55,2.34,42.3,37
HCPCS,Q0112,POTASSIUM HYDROXIDE PREPS,20.0,13.0,3.5,20.0,20
HCPCS,Q0112,Potassium hydroxide preps,,,5.03,5.03,1
HCPCS,Q01120,Potassium hydroxide preps,,,5.03,5.03,1
HCPCS,Q0113,Pinworm examinations,,,3.69,7.14,21
HCPCS,Q01130,Pinworm examinations,,,3.69,3.69,1
HCPCS,Q0114,FERN TEST (POINT OF CARE LAB),53.0,34.45,2.34,47.7,37
HCPCS,Q0114,Fern test,,,8.41,8.41,1
HCPCS,Q01140,Fern test,,,8.41,8.41,1
HCPCS,Q0115,Post-coital mucous exam,,,9.95,41.78,21
HCPCS,Q01150,Post-coital mucous exam,,,21.6,21.6,1
HCPCS,Q0138,FERAHEME 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,252.78,164.31,0.34,252.78,47
HCPCS,Q0138,"FERUMOXYTOL, NON-ESRD",2.0,1.3,0.36,2.0,13
HCPCS,Q0138,"Ferumoxytol, non-esrd",,,0.39,0.39,1
HCPCS,Q01380,"Ferumoxytol, non-esrd",,,0.39,0.39,1
HCPCS,Q0139,"FERUMOXYTOL, ESRD USE",2.0,1.3,0.36,2.0,13
HCPCS,Q0139,"Ferumoxytol, esrd use",,,0.34,123.65,35
HCPCS,Q01390,"Ferumoxytol, esrd use",,,0.39,0.39,1
HCPCS,Q0144,"Azithromycin dihydrate, oral",,,22.94,58.2,4
HCPCS,Q01440,"Azithromycin dihydrate, oral",,,22.94,22.94,1
HCPCS,Q0155,Dronabinol (syndros) 0.1 mg,,,3.36,8.52,4
HCPCS,Q01550,Dronabinol (syndros) 0.1 mg,,,3.36,3.36,1
HCPCS,Q0161,Chlorpromazine hcl 5mg oral,,,0.33,0.85,4
HCPCS,Q01610,Chlorpromazine hcl 5mg oral,,,0.33,0.33,1
HCPCS,Q0162,Ondansetron oral,,,0.01,0.03,12
HCPCS,Q01620,Ondansetron oral,,,0.01,0.01,1
HCPCS,Q0163,Diphenhydramine hcl 50mg,,,0.02,0.05,4
HCPCS,Q01630,Diphenhydramine hcl 50mg,,,0.02,0.02,1
HCPCS,Q0164,Prochlorperazine maleate 5mg,,,0.36,0.9,4
HCPCS,Q01640,Prochlorperazine maleate 5mg,,,0.36,0.36,1
HCPCS,Q0166,"GRANISETRON HYDROCHLORIDE,1MG,ORAL",135.0,87.75,3.0,135.0,13
HCPCS,Q0166,Granisetron hcl 1 mg oral,,,3.11,7.89,4
HCPCS,Q01660,Granisetron hcl 1 mg oral,,,3.11,3.11,1
HCPCS,Q0167,Dronabinol 2.5mg oral,,,0.76,3.75,12
HCPCS,Q01670,Dronabinol 2.5mg oral,,,1.46,1.46,1
HCPCS,Q0169,Promethazine hcl 12.5mg oral,,,0.09,0.22,4
HCPCS,Q01690,Promethazine hcl 12.5mg oral,,,0.09,0.09,1
HCPCS,Q0173,Trimethobenzamide hcl 250mg,,,0.3,1.4,7
HCPCS,Q01730,Trimethobenzamide hcl 250mg,,,0.3,0.3,1
HCPCS,Q0174,Thiethylperazine maleate10mg,,,0.53,1.34,6
HCPCS,Q0175,Perphenazine 4mg oral,,,0.49,1.23,4
HCPCS,Q01750,Perphenazine 4mg oral,,,0.49,0.49,1
HCPCS,Q0177,Hydroxyzine pamoate 25mg,,,0.13,0.33,4
HCPCS,Q01770,Hydroxyzine pamoate 25mg,,,0.13,0.13,1
HCPCS,Q0180,"DOLASETRON MESYLATE,100 MG,ORAL",201.0,130.65,60.32,201.0,14
HCPCS,Q0180,Dolasetron mesylate oral,,,62.53,158.65,4
HCPCS,Q01800,Dolasetron mesylate oral,,,62.53,62.53,1
HCPCS,Q0220,"Tixagev and cilgav, 300mg",,,0.02,93.47,9
HCPCS,Q0221,"Tixagev and cilgav, 600mg",,,0.02,93.47,9
HCPCS,Q0222,Bebtelovimab 175 mg,,,74.0,3579.28,9
HCPCS,Q0224,"Inj, pemivibart, 4500 mg",,,7818.12,7818.12,1
HCPCS,Q0224,PEMGARDA (EUA) 125 MG/ML INTRAVENOUS SOLUTION,635.01,412.76,106.68,3236.72,36
HCPCS,Q02240,"Inj, pemivibart, 4500 mg",,,7818.12,7818.12,1
HCPCS,Q0235,"Inj, monoclon antibody, 1 mg",,,5.08,12.88,4
HCPCS,Q02350,"Inj, monoclon antibody, 1 mg",,,5.08,5.08,1
HCPCS,Q0237,"Inj, tocilizumab-anoh, hospi",,,4.47,943.43,10
HCPCS,Q02370,"Inj, tocilizumab-anoh, hospi",,,4.47,4.47,1
HCPCS,Q0238,Inj tocilizumab-aazg 1 mg,,,746.88,943.43,6
HCPCS,Q0239,Bamlanivimab-xxxx,,,74.0,93.47,6
HCPCS,Q0240,Casirivi and imdevi 600 mg,,,0.02,93.47,9
HCPCS,Q0243,Casirivimab and imdevimab,,,0.02,93.47,9
HCPCS,Q0244,Casirivi and imdevi 1200 mg,,,0.02,93.47,9
HCPCS,Q0245,Bamlanivimab and etesevima,,,0.02,93.47,9
HCPCS,Q0247,Sotrovimab,,,0.02,93.47,9
HCPCS,Q0249,Tocilizumab for covid-19,,,5.91,652.67,21
HCPCS,Q02490,Tocilizumab for covid-19,,,8.18,8.18,1
HCPCS,Q0477,Pwr module pt cable lvad rpl,,,543.32,1573.6,4
HCPCS,Q04770,Pwr module pt cable lvad rpl,,,543.32,543.32,1
HCPCS,Q0478,"Power adapter, combo vad",,,152.09,152.09,1
HCPCS,Q0478,"VAD CABLE,PWR MODULE,DC INPUT,2230",381.0,247.65,87.12,381.0,17
HCPCS,Q0478,"W CABLE,PWR MODULE,DC INPUT,2230",360.0,234.0,60.48,352.8,29
HCPCS,Q0478,W HRTW CONTROLLER ADAPTER 1435,3600.0,2340.0,604.8,3528.0,32
HCPCS,Q04780,"Power adapter, combo vad",,,152.09,152.09,1
HCPCS,Q0479,HEARTMATE MOBILE POWER UNIT CAT#107754,11664.0,7581.6,1959.55,11664.0,33
HCPCS,Q0479,POWER MODULE,12474.0,8108.1,1995.84,13068.0,52
HCPCS,Q0479,"Power module combo vad, rep",,,9934.32,9934.32,1
HCPCS,Q0479,VAD MODULE POWER HEARTMATE,13245.0,8609.25,5681.31,13245.0,17
HCPCS,Q0479,W MODULE POWER HEARTMATE,12480.0,8112.0,2096.64,12480.0,35
HCPCS,Q0479,W UNIT MOBILE POWER W/AC CABLE,16000.0,10400.0,2688.0,16000.0,35
HCPCS,Q04790,"Power module combo vad, rep",,,9934.32,9934.32,1
HCPCS,Q0480,"Driver pneumatic vad, rep",,,74537.6,182667.5,4
HCPCS,Q04800,"Driver pneumatic vad, rep",,,74537.6,74537.6,1
HCPCS,Q0481,DEV LVAD HRTMT 3 EMER PWR 106531US,11000.0,7150.0,1848.0,11000.0,35
HCPCS,Q0481,HEARTMATE 3 CONTROLLER AND EBB CAT#106531US,7425.0,4826.25,1247.4,7425.0,35
HCPCS,Q0481,HMII SYSTEM DRIVER,7425.0,4826.25,1247.4,7425.0,35
HCPCS,Q0481,"Microprcsr cu elec vad, rep",,,12025.8,12025.8,1
HCPCS,Q0481,POCKET CONTROLLER INCL EMERGENCY BACK-UP-BATTERY,8985.0,5840.25,4492.5,13558.79,17
HCPCS,Q0481,POCKET CONTROLLER INCLUDING EMERGENCY BACK-UP-BATTERY,8168.0,5309.2,1372.22,8168.0,35
HCPCS,Q0481,"VAD POCKET CTRL,HEARTMATE,106762",14857.0,9657.05,6889.43,14857.0,17
HCPCS,Q0481,W HRTW CONTROLLER KIT 1403US,12800.0,8320.0,2150.4,12800.0,35
HCPCS,Q0481,"W POCKET CTRL,HEARTMATE,106762",11000.0,7150.0,1848.0,11000.0,35
HCPCS,Q04810,"Microprcsr cu elec vad, rep",,,12025.8,12025.8,1
HCPCS,Q0482,"Microprcsr cu combo vad, rep",,,3766.71,9230.99,4
HCPCS,Q04820,"Microprcsr cu combo vad, rep",,,3766.71,3766.71,1
HCPCS,Q0483,DISPLAY MODULE,18753.0,12189.45,3150.5,18753.0,35
HCPCS,Q0483,"Monitor elec vad, rep",,,15517.09,15517.09,1
HCPCS,Q04830,"Monitor elec vad, rep",,,15517.09,15517.09,1
HCPCS,Q0484,Monitor elec or comb vad rep,,,3013.37,7384.82,4
HCPCS,Q04840,Monitor elec or comb vad rep,,,3013.37,3013.37,1
HCPCS,Q0485,"Monitor cable elec vad, rep",,,290.95,712.98,4
HCPCS,Q04850,"Monitor cable elec vad, rep",,,290.95,290.95,1
HCPCS,Q0486,Mon cable elec/pneum vad rep,,,242.15,593.39,4
HCPCS,Q04860,Mon cable elec/pneum vad rep,,,242.15,242.15,1
HCPCS,Q0487,"Leads any type vad, rep only",,,282.5,692.31,4
HCPCS,Q04870,"Leads any type vad, rep only",,,282.5,282.5,1
HCPCS,Q0488,"Pwr pack base elec vad, rep",,,121.95,121.95,1
HCPCS,Q04880,"Pwr pack base elec vad, rep",,,121.95,121.95,1
HCPCS,Q0489,"Pwr pck base combo vad, rep",,,13452.49,32967.66,4
HCPCS,Q04890,"Pwr pck base combo vad, rep",,,13452.49,13452.49,1
HCPCS,Q0490,"Emr pwr source elec vad, rep",,,581.89,1426.03,4
HCPCS,Q04900,"Emr pwr source elec vad, rep",,,581.89,581.89,1
HCPCS,Q0491,Emr pwr source combo vad rep,,,914.79,2241.81,4
HCPCS,Q04910,Emr pwr source combo vad rep,,,914.79,914.79,1
HCPCS,Q0492,"Emr pwr cbl elec vad, rep",,,73.71,180.67,4
HCPCS,Q04920,"Emr pwr cbl elec vad, rep",,,73.71,73.71,1
HCPCS,Q0493,"Emr pwr cbl combo vad, rep",,,209.84,514.17,4
HCPCS,Q04930,"Emr pwr cbl combo vad, rep",,,209.84,209.84,1
HCPCS,Q0494,"Emr hd pmp elec/combo, rep",,,177.56,435.11,4
HCPCS,Q04940,"Emr hd pmp elec/combo, rep",,,177.56,177.56,1
HCPCS,Q0495,"Charger elec/combo vad, rep",,,3456.95,3456.95,1
HCPCS,Q0495,HEARTMATE UNIVERSAL BATTERY CHARGER CAT#1440,8398.0,5458.7,1410.86,8398.0,33
HCPCS,Q0495,UNIVERSAL BATTERY CHARGER (UBC),11226.5,7297.225,1796.26,11761.0,52
HCPCS,Q0495,VAD CHARGER BATTERY UNIVERSAL,12225.0,7946.25,1980.46,12225.0,17
HCPCS,Q0495,W CHARGER BATTERY UNIVERSAL,11520.0,7488.0,1935.36,11289.6,35
HCPCS,Q0495,W HRTW BATTERY CHARGER 1600US,12200.0,7930.0,2049.6,11956.0,35
HCPCS,Q04950,"Charger elec/combo vad, rep",,,3456.95,3456.95,1
HCPCS,Q0496,"Battery elec/combo vad, rep",,,1240.77,3040.74,4
HCPCS,Q04960,"Battery elec/combo vad, rep",,,1240.77,1240.77,1
HCPCS,Q0497,14V BATTERY CLIPS (SET OF 2),1094.0,711.1,71.9,1760.0,46
HCPCS,Q0497,"Bat clps elec/comb vad, rep",,,387.43,387.43,1
HCPCS,Q0497,HEARTMATE 14 VOLT LI-ION BATTERY CLIPS SET OF 2 CAT#2865,1426.0,926.9,239.57,1283.4,27
HCPCS,Q0497,VAD BATTERY CLIP SET 14V LI-ION,934.0,607.1,221.94,934.0,17
HCPCS,Q0497,W BATTERY CLIP SET 14V LI-ION,880.0,572.0,147.84,862.4,29
HCPCS,Q04970,"Bat clps elec/comb vad, rep",,,387.43,387.43,1
HCPCS,Q0498,"Holster elec/combo vad, rep",,,425.1,425.1,1
HCPCS,Q0498,LVAD BATTERY HOLSTER,593.0,385.45,99.62,593.0,46
HCPCS,Q0498,"LVAD HOLSTER VEST (SM, MED, LG)",717.0,466.05,243.53,717.0,17
HCPCS,Q0498,"LVAD HOLSTER VEST (SMALL, MEDIUM, LARGE)",652.0,423.8,109.54,638.96,29
HCPCS,Q0498,"VAD HOLSTR,GOGEAR HM, ALL SZ 1042XX",671.0,436.15,243.53,671.0,17
HCPCS,Q0498,"VAD VEST,HOLSTER,14V,ALL SZ",838.0,544.7,243.53,838.0,17
HCPCS,Q0498,"W HOLSTR,GOGEAR HM,ALL SZ 1042XX",632.0,410.8,106.18,619.36,29
HCPCS,Q0498,W HRTW CONVERTIBLE PT PACK 1475,850.0,552.5,142.8,833.0,29
HCPCS,Q0498,W HRTW SHOULDER PACK,900.0,585.0,151.2,882.0,29
HCPCS,Q0498,W HRTW WAIST PACK,850.0,552.5,142.8,833.0,29
HCPCS,Q0498,"W VEST,HOLSTER,14V,ALL SZ",790.0,513.5,132.72,774.2,29
HCPCS,Q04980,"Holster elec/combo vad, rep",,,425.1,425.1,1
HCPCS,Q0499,Belt/vest elec/combo vad rep,,,138.12,138.12,1
HCPCS,Q0499,"LVAD CONSOLIDATED BAG (RIGHT, LEFT)",488.0,317.2,79.13,488.0,46
HCPCS,Q0499,"VAD BELT,MODULAR,14V,10422X,ALL SZ",585.0,380.25,79.13,585.0,17
HCPCS,Q0499,"W BAG,GOGEAR CONSOLID,L/R,HRTMT",520.0,338.0,87.36,509.6,29
HCPCS,Q0499,"W BELT,MODULAR,14V,10422X,ALL SZ",552.0,358.8,92.74,540.96,29
HCPCS,Q04990,Belt/vest elec/combo vad rep,,,138.12,138.12,1
HCPCS,Q0500,"Filters elec/combo vad, rep",,,25.26,61.93,4
HCPCS,Q05000,"Filters elec/combo vad, rep",,,25.26,25.26,1
HCPCS,Q0501,LVAD SHOWER BAG,675.0,438.75,113.4,675.0,46
HCPCS,Q0501,"Shwr cov elec/combo vad, rep",,,422.65,422.65,1
HCPCS,Q0501,W HRTW SHOWER BAG,600.0,390.0,100.8,588.0,29
HCPCS,Q0501,"W SHOWER BAG,PKT CNTLR,104232",900.0,585.0,151.2,882.0,29
HCPCS,Q05010,"Shwr cov elec/combo vad, rep",,,422.65,422.65,1
HCPCS,Q0502,"Mobility cart pneum vad, rep",,,538.12,1318.67,4
HCPCS,Q05020,"Mobility cart pneum vad, rep",,,538.12,538.12,1
HCPCS,Q0503,BATTERY FOR PNEUMATIC VENTRICULAR ASSIST DEVICE,1039.5,675.675,166.32,1213.38,46
HCPCS,Q0503,Battery pneum vad replacemnt,,,1076.18,1076.18,1
HCPCS,Q05030,Battery pneum vad replacemnt,,,1076.18,1076.18,1
HCPCS,Q0504,"Pwr adpt pneum vad, rep veh",,,567.9,1391.64,4
HCPCS,Q05040,"Pwr adpt pneum vad, rep veh",,,567.9,567.9,1
HCPCS,Q0506,14V BATTERIES (SET OF 4),3375.0,2193.75,404.96,3375.0,49
HCPCS,Q0506,BACKUP BATTERY (11V) (FOR CONTROLLER),908.0,590.2,404.96,908.0,17
HCPCS,Q0506,BACKUP BATTERY FOR (11V) (FOR CONTROLLER),825.0,536.25,138.6,808.5,29
HCPCS,Q0506,HEARTMATE 14 VOLT LI-ION BATTERIES SET OF 4 CAT#2465,2916.0,1895.4,489.89,2624.4,30
HCPCS,Q0506,HEARTMATE STANDALONE BACK-UP BATTERY CAT#106128,750.0,487.5,126.0,735.0,29
HCPCS,Q0506,Lith-ion batt elec/pneum vad,,,706.86,706.86,1
HCPCS,Q0506,"VAD BTTRY BCKUP,PKT CNTRL,HM 106128",870.0,565.5,404.96,870.0,17
HCPCS,Q0506,W BATTERY SET 14V LI-ION,1000.0,650.0,168.0,980.0,29
HCPCS,Q0506,"W BTTRY BCKUP,PKT CTRL,HM 106128",1000.0,650.0,168.0,980.0,29
HCPCS,Q0506,W HRTW BATTERY 1650,375.0,243.75,63.0,367.5,29
HCPCS,Q05060,Lith-ion batt elec/pneum vad,,,706.86,706.86,1
HCPCS,Q0508,"DRIVELINE MANGEMENT SYSTEM (E.G., DRESSINGS)",22.0,14.3,3.7,22.0,41
HCPCS,Q0508,HEARTMATE MODULAR CABLE CAT#10652US,6682.0,4343.3,1122.58,6548.36,35
HCPCS,Q0508,HEARTMATE TRAVEL CASE CAT#1260,224.0,145.6,37.63,201.6,27
HCPCS,Q0508,"LVAD ACCESSORY KIT, 106129",544.0,353.6,91.39,489.6,27
HCPCS,Q0508,LVAD DRIVELINE CARE KIT PACK MCS (BIWEEKLY) CAT#03-6487,24.0,15.6,4.03,23.52,29
HCPCS,Q0508,LVAD DRIVELINE CARE KIT PACK MCS (DAILY) CAT#SBA29VACCG,22.0,14.3,3.7,21.56,29
HCPCS,Q0508,LVAD STABILIZATION BELT,175.0,113.75,29.4,175.0,41
HCPCS,Q0508,LVAD TRAVEL BAG,240.0,156.0,40.32,240.0,41
HCPCS,Q0508,POWER MODULE CABLE,1688.0,1097.2,283.58,1688.0,41
HCPCS,Q0508,"W CABLE,PATIENT POWR MODULE,14V",2500.0,1625.0,420.0,2450.0,32
HCPCS,Q0508,W HRTW PUMP IMP ACCSSRY KIT 1153,10600.0,6890.0,1780.8,10388.0,35
HCPCS,Q0508,W KIT DRESSING MCS VAD,25.0,16.25,4.2,24.5,29
HCPCS,Q0508,W KIT WEARABLE ACCESSORIES,272.0,176.8,45.7,266.56,29
HCPCS,Q0508,W THORATEC STABILIZATION BELT,160.0,104.0,26.88,156.8,29
HCPCS,Q0508,"W TRAVEL CASE,HRTMT DEV,1260",256.0,166.4,43.01,250.88,29
HCPCS,Q0508A,"VAD CABLE, PATIENT POWR MODULE,14V",2335.0,1517.75,1167.5,2335.0,12
HCPCS,Q0509,Mis sup/ac imp vad nopay med,,,67.28,67.28,1
HCPCS,Q05090,Mis sup/ac imp vad nopay med,,,67.28,67.28,1
HCPCS,Q0510,Dispens fee immunosupressive,,,56.88,56.88,1
HCPCS,Q05100,Dispens fee immunosupressive,,,56.88,56.88,1
HCPCS,Q0511,"Sup fee antiem,antica,immuno",,,1.7,1.7,1
HCPCS,Q05110,"Sup fee antiem,antica,immuno",,,1.7,1.7,1
HCPCS,Q0512,Px sup fee anti-can sub pres,,,3.28,3.28,1
HCPCS,Q05120,Px sup fee anti-can sub pres,,,3.28,3.28,1
HCPCS,Q0513,Disp fee inhal drugs/30 days,,,26.15,26.15,1
HCPCS,Q05130,Disp fee inhal drugs/30 days,,,26.15,26.15,1
HCPCS,Q0514,Disp fee inhal drugs/90 days,,,63.15,63.15,1
HCPCS,Q05140,Disp fee inhal drugs/90 days,,,63.15,63.15,1
HCPCS,Q0515,SERMORELIN ACETATE INJECTION,24.0,15.6,1.61,24.0,14
HCPCS,Q0515,Sermorelin acetate injection,,,1.56,898.5,13
HCPCS,Q05150,Sermorelin acetate injection,,,1.56,1.56,1
HCPCS,Q2004,BLADDER CALCULI IRRIG SOL,86.0,55.9,43.0,108.8,14
HCPCS,Q2004,Bladder calculi irrig sol,,,104.91,266.16,4
HCPCS,Q20040,Bladder calculi irrig sol,,,104.91,104.91,1
HCPCS,Q2009,CEREBYX 100 MG PE/2 ML INJECTION SOLUTION,72.78,47.31,1.34,72.78,26
HCPCS,Q2009,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,9.84,6.4,1.34,9.84,26
HCPCS,Q2009,FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,7.2,4.68,1.34,7.2,26
HCPCS,Q2009,Fosphenytoin inj pe,,,2.48,2.48,1
HCPCS,Q20090,Fosphenytoin inj pe,,,2.48,2.48,1
HCPCS,Q2017,"Teniposide, 50 mg",,,746.88,6565.34,12
HCPCS,Q2026,RADIESSE 0.8CC PER EA. SYRINGE,600.0,390.0,300.0,600.0,12
HCPCS,Q2026,RADIESSE 1.5CC EA. SYRINGE,800.0,520.0,400.0,800.0,12
HCPCS,Q2026,Radiesse injection,,,333.42,720.19,17
HCPCS,Q2028,"Inj, sculptra, 0.5mg",,,0.67,2.38,21
HCPCS,Q2028,SCULPTRA .5MG,800.0,520.0,0.67,800.0,14
HCPCS,Q20280,"Inj, sculptra, 0.5mg",,,0.67,0.67,1
HCPCS,Q2034,Agriflu vaccine,,,17.89,22.6,6
HCPCS,Q2035,"Afluria vacc, 3 yrs & >, im",,,17.89,52.61,13
HCPCS,Q20350,"Afluria vacc, 3 yrs & >, im",,,20.74,20.74,1
HCPCS,Q2036,"Flulaval vacc, 3 yrs & >, im",,,13.21,22.6,9
HCPCS,Q2037,"Fluvirin vacc, 3 yrs & >, im",,,17.89,51.02,13
HCPCS,Q2037,"PR FLUVIRIN VACC, 3 YRS & >, IM",24.0,15.6,12.0,24.0,13
HCPCS,Q20370,"Fluvirin vacc, 3 yrs & >, im",,,20.11,20.11,1
HCPCS,Q2038,"Fluzone vacc, 3 yrs & >, im",,,13.69,34.74,13
HCPCS,Q2038,"PR FLUZONE VACC, 3 YRS & >, IM",72.0,46.8,36.0,72.0,13
HCPCS,Q20380,"Fluzone vacc, 3 yrs & >, im",,,13.69,13.69,1
HCPCS,Q2039,"Influenza virus vaccine, nos",,,0.12,45.46,13
HCPCS,Q2039,"NOS FLU VACC, 3 YRS & >, IM",44.0,28.6,22.0,44.0,13
HCPCS,Q20390,"Influenza virus vaccine, nos",,,17.92,17.92,1
HCPCS,Q2041,Axicabtagene ciloleucel car+,,,574767.62,574767.62,1
HCPCS,Q2041,YESCARTA INTRAVENOUS SUSPENSION,2417184.0,1571169.6,24125.92,2175465.6,43
HCPCS,Q20410,Axicabtagene ciloleucel car+,,,574767.62,574767.62,1
HCPCS,Q2042,KYMRIAH 0.2 X 10EXP6 TO 2.5 X 10EXP8 CELL INTRAVENOUS SUSPENSION,2905939.24,1888860.51,24125.92,2615345.32,43
HCPCS,Q2042,KYMRIAH 0.6 X 10EXP8 TO 6 X10EXP8 CELL INTRAVENOUS SUSPENSION,2511128.6,1632233.59,24125.92,2260015.74,43
HCPCS,Q2042,Tisagenlecleucel car-pos t,,,611853.8,611853.8,1
HCPCS,Q20420,Tisagenlecleucel car-pos t,,,611853.8,611853.8,1
HCPCS,Q2043,PROVENGE 50 MILLION CELL/250 ML INTRAVENOUS SUSPENSION,901.47,585.96,233.48,118832.9,47
HCPCS,Q2043,SIPULEUCEL-T AUTO CD54+,168610.0,109596.5,54404.11,168610.0,13
HCPCS,Q2043,Sipuleucel-t auto cd54+,,,58756.44,58756.44,1
HCPCS,Q20430,Sipuleucel-t auto cd54+,,,58756.44,58756.44,1
HCPCS,Q2049,Imported lipodox inj,,,298.74,3236.72,27
HCPCS,Q20490,Imported lipodox inj,,,497.32,497.32,1
HCPCS,Q2050,DOXIL 2 MG/ML INTRAVENOUS SUSPENSION,238.5,155.025,76.84,383.26,90
HCPCS,Q2050,Doxorubicin inj 10mg,,,112.33,112.33,1
HCPCS,Q20500,Doxorubicin inj 10mg,,,112.33,112.33,1
HCPCS,Q2052,"Home ivig, services/supplies",,,979.06,979.06,1
HCPCS,Q20520,"Home ivig, services/supplies",,,979.06,979.06,1
HCPCS,Q2053,Brexucabtagene car pos t,,,528606.22,528606.22,1
HCPCS,Q2053,TECARTUS 1X10EXP6 TO 1X10EXP8 CELL INTRAVENOUS SUSPENSION,2217600.0,1441440.0,24125.92,1995840.0,45
HCPCS,Q2053,TECARTUS 2X10EXP6 TO 2X10EXP8 CELL INTRAVENOUS SUSPENSION,2217600.0,1441440.0,24125.92,1995840.0,45
HCPCS,Q20530,Brexucabtagene car pos t,,,528606.22,528606.22,1
HCPCS,Q2054,BREYANZI 1.5X TO 70X10EXP6 CELL/ML INTRAVENOUS SUSPENSION,2678006.0,1740703.9,24125.92,2410205.4,43
HCPCS,Q2054,Lisocabtagene mara car pos t,,,607177.34,607177.34,1
HCPCS,Q20540,Lisocabtagene mara car pos t,,,607177.34,607177.34,1
HCPCS,Q2055,ABECMA 300 X 10EXP6 TO 510 X 10EXP6 CELL INTRAVENOUS SUSPENSION,10447.92,6791.15,2611.98,1137429.19,129
HCPCS,Q2055,Idecabtagene vicleucel car,,,602728.27,602728.27,1
HCPCS,Q20550,Idecabtagene vicleucel car,,,602728.27,602728.27,1
HCPCS,Q2056,CARVYKTI 0.5X 10EXP6 TO 1X 10EXP8 CELL INTRAVENOUS SUSPENSION,2665490.12,1732568.58,24125.92,2398941.11,86
HCPCS,Q2056,Ciltacabtagene car-pos t,,,634661.54,634661.54,1
HCPCS,Q20560,Ciltacabtagene car-pos t,,,634661.54,634661.54,1
HCPCS,Q2057,Afamitresgene autoleucel,,,832269.6,832269.6,1
HCPCS,Q2057,TECELRA 2.68X 10EXP9 TO 10X 10EXP9 CELL INTRAVENOUS SUSPENSION,3489600.0,2268240.0,24125.92,3140640.0,37
HCPCS,Q20570,Afamitresgene autoleucel,,,832269.6,832269.6,1
HCPCS,Q2058,Obecbtge autol up to 400 mil,,,24125.92,690480.0,14
HCPCS,Q20580,Obecbtge autol up to 400 mil,,,272160.0,272160.0,1
HCPCS,Q3001,Brachytherapy radioelements,,,33.33,177.28,7
HCPCS,Q30010,Brachytherapy radioelements,,,33.33,33.33,1
HCPCS,Q3014,Telehealth facility fee,,,2.45,51.82,10
HCPCS,Q30140,Telehealth facility fee,,,32.36,32.36,1
HCPCS,Q3027,AVONEX 30 MCG/0.5 ML INTRAMUSCULAR SYRINGE KIT,7774.02,5053.11,48.85,7774.02,43
HCPCS,Q3027,Inj beta interferon im 1 mcg,,,74.63,74.63,1
HCPCS,Q30270,Inj beta interferon im 1 mcg,,,74.63,74.63,1
HCPCS,Q3028,Inj beta interferon sq 1 mcg,,,43.16,43.16,1
HCPCS,Q3028,REBIF (WITH ALBUMIN) 44 MCG/0.5 ML SUBCUTANEOUS SYRINGE,6592.98,4285.44,62.96,6592.98,35
HCPCS,Q30280,Inj beta interferon sq 1 mcg,,,43.16,43.16,1
HCPCS,Q3031,COLLAGEN SKIN TEST,79.0,51.35,39.5,79.0,12
HCPCS,Q3031,Collagen skin test,,,65.88,65.88,1
HCPCS,Q30310,Collagen skin test,,,65.88,65.88,1
HCPCS,Q4001,Cast sup body cast plaster,,,41.91,41.91,1
HCPCS,Q40010,Cast sup body cast plaster,,,41.91,41.91,1
HCPCS,Q4002,Cast sup body cast fiberglas,,,158.38,158.38,1
HCPCS,Q40020,Cast sup body cast fiberglas,,,158.38,158.38,1
HCPCS,Q4003,Cast sup shoulder cast plstr,,,30.1,30.1,1
HCPCS,Q40030,Cast sup shoulder cast plstr,,,30.1,30.1,1
HCPCS,Q4004,Cast sup shoulder cast fbrgl,,,104.2,104.2,1
HCPCS,Q40040,Cast sup shoulder cast fbrgl,,,104.2,104.2,1
HCPCS,Q4005,CAST SUP LONG ARM ADULT PLST,37.0,24.05,4.56,37.0,17
HCPCS,Q4005,Cast sup long arm adult plst,,,11.1,11.1,1
HCPCS,Q40050,Cast sup long arm adult plst,,,11.1,11.1,1
HCPCS,Q4006,CAST SUP LONG ARM ADULT FBRG,116.0,75.4,10.29,116.0,17
HCPCS,Q4006,"CAST SUPPLIES, LONG ARM CAST, 11 YRS +, FIBERGLASS",116.0,75.4,19.49,104.4,21
HCPCS,Q4006,Cast sup long arm adult fbrg,,,25.0,25.0,1
HCPCS,Q40060,Cast sup long arm adult fbrg,,,25.0,25.0,1
HCPCS,Q4007,Cast sup long arm ped plster,,,5.55,5.55,1
HCPCS,Q40070,Cast sup long arm ped plster,,,5.55,5.55,1
HCPCS,Q4008,"CAST SUPPLIES, LONG ARM CAST, PEDS, FIBERGLASS",30.0,19.5,5.04,27.0,21
HCPCS,Q4008,Cast sup long arm ped fbrgls,,,12.5,12.5,1
HCPCS,Q40080,Cast sup long arm ped fbrgls,,,12.5,12.5,1
HCPCS,Q4009,CAST SUP SHT ARM ADULT PLSTR,95.0,61.75,3.05,95.0,17
HCPCS,Q4009,Cast sup sht arm adult plstr,,,7.41,7.41,1
HCPCS,Q40090,Cast sup sht arm adult plstr,,,7.41,7.41,1
HCPCS,Q4010,CAST SUP SHT ARM ADULT FBRGL,80.0,52.0,6.86,80.0,17
HCPCS,Q4010,Cast sup sht arm adult fbrgl,,,16.66,16.66,1
HCPCS,Q40100,Cast sup sht arm adult fbrgl,,,16.66,16.66,1
HCPCS,Q4011,"CAST SUPPLIES, SHORT ARM CAST, PEDS, PLASTER",6.0,3.9,1.01,5.4,21
HCPCS,Q4011,Cast sup sht arm ped plaster,,,3.69,3.69,1
HCPCS,Q40110,Cast sup sht arm ped plaster,,,3.69,3.69,1
HCPCS,Q4012,Cast sup sht arm ped fbrglas,,,8.36,8.36,1
HCPCS,Q40120,Cast sup sht arm ped fbrglas,,,8.36,8.36,1
HCPCS,Q4013,Cast sup gauntlet plaster,,,13.49,13.49,1
HCPCS,Q40130,Cast sup gauntlet plaster,,,13.49,13.49,1
HCPCS,Q4014,Cast sup gauntlet fiberglass,,,22.74,22.74,1
HCPCS,Q40140,Cast sup gauntlet fiberglass,,,22.74,22.74,1
HCPCS,Q4015,Cast sup gauntlet ped plster,,,6.75,6.75,1
HCPCS,Q40150,Cast sup gauntlet ped plster,,,6.75,6.75,1
HCPCS,Q4016,Cast sup gauntlet ped fbrgls,,,11.36,11.36,1
HCPCS,Q40160,Cast sup gauntlet ped fbrgls,,,11.36,11.36,1
HCPCS,Q4017,CAST SUP LNG ARM SPLINT PLST,108.0,70.2,3.21,108.0,17
HCPCS,Q4017,Cast sup lng arm splint plst,,,7.8,7.8,1
HCPCS,Q40170,Cast sup lng arm splint plst,,,7.8,7.8,1
HCPCS,Q4018,CAST SUP LNG ARM SPLINT FBRG,41.0,26.65,5.12,41.0,17
HCPCS,Q4018,Cast sup lng arm splint fbrg,,,12.43,12.43,1
HCPCS,Q40180,Cast sup lng arm splint fbrg,,,12.43,12.43,1
HCPCS,Q4019,Cast sup lng arm splnt ped p,,,3.9,3.9,1
HCPCS,Q40190,Cast sup lng arm splnt ped p,,,3.9,3.9,1
HCPCS,Q4020,Cast sup lng arm splnt ped f,,,6.24,6.24,1
HCPCS,Q40200,Cast sup lng arm splnt ped f,,,6.24,6.24,1
HCPCS,Q4021,CAST SUP SHT ARM SPLINT PLST,51.0,33.15,2.38,51.0,17
HCPCS,Q4021,Cast sup sht arm splint plst,,,5.77,5.77,1
HCPCS,Q40210,Cast sup sht arm splint plst,,,5.77,5.77,1
HCPCS,Q4022,CAST SUP SHT ARM SPLINT FBRG,36.0,23.4,4.28,36.0,17
HCPCS,Q4022,Cast sup sht arm splint fbrg,,,10.42,10.42,1
HCPCS,Q40220,Cast sup sht arm splint fbrg,,,10.42,10.42,1
HCPCS,Q4023,Cast sup sht arm splnt ped p,,,2.89,2.89,1
HCPCS,Q40230,Cast sup sht arm splnt ped p,,,2.89,2.89,1
HCPCS,Q4024,Cast sup sht arm splnt ped f,,,5.22,5.22,1
HCPCS,Q40240,Cast sup sht arm splnt ped f,,,5.22,5.22,1
HCPCS,Q4025,Cast sup hip spica plaster,,,32.35,32.35,1
HCPCS,Q40250,Cast sup hip spica plaster,,,32.35,32.35,1
HCPCS,Q4026,Cast sup hip spica fiberglas,,,101.03,101.03,1
HCPCS,Q40260,Cast sup hip spica fiberglas,,,101.03,101.03,1
HCPCS,Q4027,Cast sup hip spica ped plstr,,,16.19,16.19,1
HCPCS,Q40270,Cast sup hip spica ped plstr,,,16.19,16.19,1
HCPCS,Q4028,Cast sup hip spica ped fbrgl,,,50.54,50.54,1
HCPCS,Q40280,Cast sup hip spica ped fbrgl,,,50.54,50.54,1
HCPCS,Q4029,CAST SUP LONG LEG PLASTER,79.0,51.35,10.17,79.0,17
HCPCS,Q4029,Cast sup long leg plaster,,,24.74,24.74,1
HCPCS,Q40290,Cast sup long leg plaster,,,24.74,24.74,1
HCPCS,Q4030,CAST SUP LONG LEG FIBERGLASS,230.0,149.5,26.79,230.0,17
HCPCS,Q4030,Cast sup long leg fiberglass,,,65.13,65.13,1
HCPCS,Q40300,Cast sup long leg fiberglass,,,65.13,65.13,1
HCPCS,Q4031,Cast sup lng leg ped plaster,,,12.37,12.37,1
HCPCS,Q40310,Cast sup lng leg ped plaster,,,12.37,12.37,1
HCPCS,Q4032,Cast sup lng leg ped fbrgls,,,32.57,32.57,1
HCPCS,Q40320,Cast sup lng leg ped fbrgls,,,32.57,32.57,1
HCPCS,Q4033,CAST SUP LNG LEG CYLINDER PL,75.0,48.75,9.49,75.0,17
HCPCS,Q4033,Cast sup lng leg cylinder pl,,,23.09,23.09,1
HCPCS,Q40330,Cast sup lng leg cylinder pl,,,23.09,23.09,1
HCPCS,Q4034,CAST SUP LNG LEG CYLINDER FB,186.0,120.9,23.62,186.0,17
HCPCS,Q4034,Cast sup lng leg cylinder fb,,,57.39,57.39,1
HCPCS,Q40340,Cast sup lng leg cylinder fb,,,57.39,57.39,1
HCPCS,Q4035,Cast sup lngleg cylndr ped p,,,11.55,11.55,1
HCPCS,Q40350,Cast sup lngleg cylndr ped p,,,11.55,11.55,1
HCPCS,Q4036,Cast sup lngleg cylndr ped f,,,28.72,28.72,1
HCPCS,Q40360,Cast sup lngleg cylndr ped f,,,28.72,28.72,1
HCPCS,Q4037,Cast sup shrt leg plaster,,,14.06,14.06,1
HCPCS,Q40370,Cast sup shrt leg plaster,,,14.06,14.06,1
HCPCS,Q4038,CAST SUP SHRT LEG FIBERGLASS,74.0,48.1,14.51,74.0,17
HCPCS,Q4038,Cast sup shrt leg fiberglass,,,35.27,35.27,1
HCPCS,Q40380,Cast sup shrt leg fiberglass,,,35.27,35.27,1
HCPCS,Q4039,Cast sup shrt leg ped plster,,,7.05,7.05,1
HCPCS,Q40390,Cast sup shrt leg ped plster,,,7.05,7.05,1
HCPCS,Q4040,Cast sup shrt leg ped fbrgls,,,17.64,17.64,1
HCPCS,Q40400,Cast sup shrt leg ped fbrgls,,,17.64,17.64,1
HCPCS,Q4041,CAST SUP LNG LEG SPLNT PLSTR,55.0,35.75,7.04,55.0,17
HCPCS,Q4041,Cast sup lng leg splnt plstr,,,17.12,17.12,1
HCPCS,Q40410,Cast sup lng leg splnt plstr,,,17.12,17.12,1
HCPCS,Q4042,CAST SUP LNG LEG SPLNT FBRGL,95.0,61.75,12.03,95.0,17
HCPCS,Q4042,Cast sup lng leg splnt fbrgl,,,29.24,29.24,1
HCPCS,Q40420,Cast sup lng leg splnt fbrgl,,,29.24,29.24,1
HCPCS,Q4043,Cast sup lng leg splnt ped p,,,8.56,8.56,1
HCPCS,Q40430,Cast sup lng leg splnt ped p,,,8.56,8.56,1
HCPCS,Q4044,Cast sup lng leg splnt ped f,,,14.63,14.63,1
HCPCS,Q40440,Cast sup lng leg splnt ped f,,,14.63,14.63,1
HCPCS,Q4045,CAST SUP SHT LEG SPLNT PLSTR,35.0,22.75,4.09,35.0,17
HCPCS,Q4045,Cast sup sht leg splnt plstr,,,9.94,9.94,1
HCPCS,Q40450,Cast sup sht leg splnt plstr,,,9.94,9.94,1
HCPCS,Q4046,CAST SUP SHT LEG SPLNT FBRGL,52.0,33.8,6.57,52.0,17
HCPCS,Q4046,Cast sup sht leg splnt fbrgl,,,15.98,15.98,1
HCPCS,Q40460,Cast sup sht leg splnt fbrgl,,,15.98,15.98,1
HCPCS,Q4047,Cast sup sht leg splnt ped p,,,4.95,4.95,1
HCPCS,Q40470,Cast sup sht leg splnt ped p,,,4.95,4.95,1
HCPCS,Q4048,Cast sup sht leg splnt ped f,,,8.0,8.0,1
HCPCS,Q40480,Cast sup sht leg splnt ped f,,,8.0,8.0,1
HCPCS,Q4049,"Finger splint, static",,,1.8,1.8,1
HCPCS,Q40490,"Finger splint, static",,,1.8,1.8,1
HCPCS,Q4051,SPLINT PADDING PER INCH,10.0,6.5,5.0,10.0,12
HCPCS,Q4051,SPLINT SUPPLIES MISC,12.0,7.8,6.0,12.0,12
HCPCS,Q4051,STOCKINETTE PER FT,5.0,3.25,2.5,5.0,12
HCPCS,Q4051,Splint supplies misc,,,13.69,13.69,1
HCPCS,Q40510,Splint supplies misc,,,13.69,13.69,1
HCPCS,Q4074,Iloprost non-comp unit dose,,,132.2,439.8,18
HCPCS,Q40740,Iloprost non-comp unit dose,,,171.63,171.63,1
HCPCS,Q4081,"EPOETIN ALFA, 100 UNITS ESRD",9.0,5.85,0.77,9.0,14
HCPCS,Q4081,"Epoetin alfa, 100 units esrd",,,0.74,78.3,18
HCPCS,Q40810,"Epoetin alfa, 100 units esrd",,,0.83,0.83,1
HCPCS,Q4101,Apligraf,,,27.56,142.95,6
HCPCS,Q41010,Apligraf,,,32.65,32.65,1
HCPCS,Q4102,Oasis wound matrix,,,11.18,142.95,6
HCPCS,Q41020,Oasis wound matrix,,,12.83,12.83,1
HCPCS,Q4103,Oasis burn matrix,,,11.3,142.95,6
HCPCS,Q41030,Oasis burn matrix,,,13.49,13.49,1
HCPCS,Q4104,Integra bmwd,,,43.99,142.95,6
HCPCS,Q41040,Integra bmwd,,,55.08,55.08,1
HCPCS,Q4105,Integra drt or omnigraft,,,22.14,142.95,6
HCPCS,Q41050,Integra drt or omnigraft,,,29.1,29.1,1
HCPCS,Q4106,Dermagraft,,,38.84,98.53,3
HCPCS,Q4107,Graftjacket,,,87.37,221.67,8
HCPCS,Q41070,Graftjacket,,,87.37,87.37,1
HCPCS,Q4108,DRSG BOVINE COLL GLYCOSAMINOGLYCAN 5X4IN,43.11,28.02,10.78,198.19,34
HCPCS,Q4108,Integra matrix,,,41.62,41.62,1
HCPCS,Q41080,Integra matrix,,,41.62,41.62,1
HCPCS,Q4110,Primatrix,,,70.64,142.95,5
HCPCS,Q41100,Primatrix,,,70.64,70.64,1
HCPCS,Q4111,Gammagraft,,,6.49,142.95,6
HCPCS,Q41110,Gammagraft,,,8.5,8.5,1
HCPCS,Q4112,Cymetra injectable,,,540.0,540.0,1
HCPCS,Q41120,Cymetra injectable,,,540.0,540.0,1
HCPCS,Q4113,Graftjacket xpress,,,775.44,1967.32,4
HCPCS,Q41130,Graftjacket xpress,,,775.44,775.44,1
HCPCS,Q4114,Integra flowable wound matri,,,1348.13,6205.11,5
HCPCS,Q41140,Integra flowable wound matri,,,2445.81,2445.81,1
HCPCS,Q4115,Alloskin,,,13.89,142.95,5
HCPCS,Q41150,Alloskin,,,13.89,13.89,1
HCPCS,Q4116,Alloderm,,,26.88,26.88,1
HCPCS,Q4116,MATRIX ALLODERM SELECT THK.4-2.4MM THICK LARGE CONTOUR PER CM TI,16.13,10.48,4.03,198.19,33
HCPCS,Q4116,W GRFT TISSUE ALLODERM PER SQCM,85.5,55.574999999999996,16.75,198.19,54
HCPCS,Q41160,Alloderm,,,26.88,26.88,1
HCPCS,Q4117,Hyalomatrix,,,24.79,142.95,8
HCPCS,Q41170,Hyalomatrix,,,24.79,24.79,1
HCPCS,Q4118,Matristem micromatrix,,,2.3,8.41,5
HCPCS,Q4118,PR MATRISTEM MICROMATRIX,6.0,3.9,3.0,6.0,13
HCPCS,Q41180,Matristem micromatrix,,,3.32,3.32,1
HCPCS,Q4121,Theraskin,,,41.52,142.95,6
HCPCS,Q41210,Theraskin,,,56.97,56.97,1
HCPCS,Q4122,"Dermacell, awm, porous sq cm",,,104.54,265.23,8
HCPCS,Q41220,"Dermacell, awm, porous sq cm",,,104.54,104.54,1
HCPCS,Q4123,Alloskin,,,77.27,142.95,5
HCPCS,Q41230,Alloskin,,,77.27,77.27,1
HCPCS,Q4124,Oasis tri-layer wound matrix,,,2.69,142.95,6
HCPCS,Q41240,Oasis tri-layer wound matrix,,,2.69,2.69,1
HCPCS,Q4125,Arthroflex,,,129.95,142.95,5
HCPCS,Q41250,Arthroflex,,,137.96,137.96,1
HCPCS,Q4126,Memoderm/derma/tranz/integup,,,67.4,142.95,6
HCPCS,Q41260,Memoderm/derma/tranz/integup,,,67.4,67.4,1
HCPCS,Q4127,Talymed,,,73.97,142.95,5
HCPCS,Q41270,Talymed,,,73.97,73.97,1
HCPCS,Q4128,Flexhd/allopatchhd/sq cm,,,27.62,142.95,6
HCPCS,Q41280,Flexhd/allopatchhd/sq cm,,,32.3,32.3,1
HCPCS,Q4130,Strattice tm,,,27.0,142.95,5
HCPCS,Q41300,Strattice tm,,,27.0,27.0,1
HCPCS,Q4132,"Grafix core, grafixpl core",,,99.4,142.95,6
HCPCS,Q41320,"Grafix core, grafixpl core",,,115.24,115.24,1
HCPCS,Q4133,Grafix stravix prime pl sqcm,,,128.9,149.84,6
HCPCS,Q41330,Grafix stravix prime pl sqcm,,,149.84,149.84,1
HCPCS,Q4134,Hmatrix,,,129.95,355.27,8
HCPCS,Q41340,Hmatrix,,,140.03,140.03,1
HCPCS,Q4135,Mediskin,,,70.2,142.95,5
HCPCS,Q41350,Mediskin,,,70.2,70.2,1
HCPCS,Q4136,Ezderm,,,1.53,142.95,5
HCPCS,Q41360,Ezderm,,,1.53,1.53,1
HCPCS,Q4137,Amnioexcel biodexcel 1sq cm,,,94.42,142.95,6
HCPCS,Q41370,Amnioexcel biodexcel 1sq cm,,,109.86,109.86,1
HCPCS,Q4138,"Biodfence dryflex, 1cm",,,105.96,142.95,5
HCPCS,Q41380,"Biodfence dryflex, 1cm",,,105.96,105.96,1
HCPCS,Q4139,"Amnio or biodmatrix, inj 1cc",,,1066.52,1066.52,1
HCPCS,Q41390,"Amnio or biodmatrix, inj 1cc",,,1066.52,1066.52,1
HCPCS,Q4140,Biodfence 1cm,,,129.95,174.55,5
HCPCS,Q41400,Biodfence 1cm,,,174.55,174.55,1
HCPCS,Q4141,"Alloskin ac, 1 cm",,,37.22,142.95,6
HCPCS,Q41410,"Alloskin ac, 1 cm",,,115.53,115.53,1
HCPCS,Q4142,Xcm biologic tiss matrix 1cm,,,87.48,142.95,5
HCPCS,Q41420,Xcm biologic tiss matrix 1cm,,,87.48,87.48,1
HCPCS,Q4143,"Repriza, 1cm",,,26.23,142.95,6
HCPCS,Q41430,"Repriza, 1cm",,,36.63,36.63,1
HCPCS,Q4145,"Epifix, inj, 1mg",,,25.92,65.76,4
HCPCS,Q41450,"Epifix, inj, 1mg",,,25.92,25.92,1
HCPCS,Q4146,"Tensix, 1cm",,,129.95,386.64,5
HCPCS,Q41460,"Tensix, 1cm",,,386.64,386.64,1
HCPCS,Q4147,Architect ecm px fx 1 sq cm,,,49.36,142.95,9
HCPCS,Q41470,Architect ecm px fx 1 sq cm,,,49.36,49.36,1
HCPCS,Q4148,Neox neox rt or clarix cord,,,129.95,142.95,5
HCPCS,Q41480,Neox neox rt or clarix cord,,,133.7,133.7,1
HCPCS,Q4149,"Excellagen, 0.1 cc",,,150.34,381.41,4
HCPCS,Q41490,"Excellagen, 0.1 cc",,,150.34,150.34,1
HCPCS,Q4150,Allowrap ds or dry 1 sq cm,,,70.45,142.95,6
HCPCS,Q41500,Allowrap ds or dry 1 sq cm,,,84.42,84.42,1
HCPCS,Q4151,"Amnioband, guardian 1 sq cm",,,119.59,145.68,6
HCPCS,Q41510,"Amnioband, guardian 1 sq cm",,,145.68,145.68,1
HCPCS,Q4152,ALLOGRFT 7X10CM DERMAPURE,2450.0,1592.5,40.41,2401.0,37
HCPCS,Q4152,Dermapure 1 square cm,,,54.78,54.78,1
HCPCS,Q41520,Dermapure 1 square cm,,,54.78,54.78,1
HCPCS,Q4153,"Dermavest, plurivest sq cm",,,113.0,148.96,6
HCPCS,Q41530,"Dermavest, plurivest sq cm",,,148.96,148.96,1
HCPCS,Q4154,Biovance 1 square cm,,,129.95,142.95,6
HCPCS,Q41540,Biovance 1 square cm,,,142.45,142.45,1
HCPCS,Q4155,Neoxflo or clarixflo 1 mg,,,33.18,84.17,4
HCPCS,Q41550,Neoxflo or clarixflo 1 mg,,,33.18,33.18,1
HCPCS,Q4156,Neox 100 or clarix 100,,,71.15,142.95,5
HCPCS,Q41560,Neox 100 or clarix 100,,,71.15,71.15,1
HCPCS,Q4157,Revitalon 1 square cm,,,129.95,459.36,8
HCPCS,Q41570,Revitalon 1 square cm,,,181.06,181.06,1
HCPCS,Q4158,KERECIS PER SQ CM,232.0,150.8,58.0,208.8,31
HCPCS,Q4158,"Kerecis omega3, per sq cm",,,72.65,72.65,1
HCPCS,Q41580,"Kerecis omega3, per sq cm",,,72.65,72.65,1
HCPCS,Q4159,Affinity1 square cm,,,129.95,278.62,6
HCPCS,Q41590,Affinity1 square cm,,,221.36,221.36,1
HCPCS,Q4160,Nushield 1 square cm,,,85.43,3007.13,6
HCPCS,Q41600,Nushield 1 square cm,,,3007.13,3007.13,1
HCPCS,Q4161,Bio-connekt per square cm,,,129.95,1717.78,5
HCPCS,Q41610,Bio-connekt per square cm,,,1717.78,1717.78,1
HCPCS,Q4162,"Wndex flw, bioskn flw, 0.5cc",,,1900.8,4822.4,4
HCPCS,Q41620,"Wndex flw, bioskn flw, 0.5cc",,,1900.8,1900.8,1
HCPCS,Q4163,"Woundex, bioskin, per sq cm",,,129.95,196.75,6
HCPCS,Q41630,"Woundex, bioskin, per sq cm",,,196.75,196.75,1
HCPCS,Q4164,"Helicoll, per square cm",,,129.95,1772.2,6
HCPCS,Q41640,"Helicoll, per square cm",,,1772.2,1772.2,1
HCPCS,Q4165,"Keramatrix, kerasorb sq cm",,,46.0,142.95,8
HCPCS,Q41650,"Keramatrix, kerasorb sq cm",,,46.0,46.0,1
HCPCS,Q4166,"Cytal, per square centimeter",,,21.57,21.57,1
HCPCS,Q4166,GRAFT MATRISTEM PORCINE URNARY BLADDER EXTRACELLULAR MATRIX PER,12.3,8.0,3.08,198.19,34
HCPCS,Q41660,"Cytal, per square centimeter",,,21.57,21.57,1
HCPCS,Q4167,"Truskin, per sq centimeter",,,104.49,265.1,8
HCPCS,Q41670,"Truskin, per sq centimeter",,,104.49,104.49,1
HCPCS,Q4168,"Amnioband, 1 mg",,,14.73,37.37,5
HCPCS,Q41680,"Amnioband, 1 mg",,,14.73,14.73,1
HCPCS,Q4169,"Artacent wound, per sq cm",,,129.95,2233.95,5
HCPCS,Q41690,"Artacent wound, per sq cm",,,2233.95,2233.95,1
HCPCS,Q4170,"Cygnus, per sq cm",,,42.45,142.95,6
HCPCS,Q41700,"Cygnus, per sq cm",,,42.45,42.45,1
HCPCS,Q4171,"Interfyl, 1 mg",,,10.37,85.49,5
HCPCS,Q41710,"Interfyl, 1 mg",,,33.7,33.7,1
HCPCS,Q4173,Palingen or palingen xplus,,,129.95,376.94,6
HCPCS,Q41730,Palingen or palingen xplus,,,376.94,376.94,1
HCPCS,Q4174,Palingen or promatrx,,,1290.82,3274.85,4
HCPCS,Q41740,Palingen or promatrx,,,1290.82,1290.82,1
HCPCS,Q4175,Miroderm,,,58.96,142.95,6
HCPCS,Q41750,Miroderm,,,98.86,98.86,1
HCPCS,Q4176,"Neopatch or therion, 1 sq cm",,,129.95,416.48,8
HCPCS,Q41760,"Neopatch or therion, 1 sq cm",,,164.16,164.16,1
HCPCS,Q4177,"Floweramnioflo, 0.1 cc",,,155.52,394.56,4
HCPCS,Q41770,"Floweramnioflo, 0.1 cc",,,155.52,155.52,1
HCPCS,Q4178,"Floweramniopatch, per sq cm",,,67.02,142.95,6
HCPCS,Q41780,"Floweramniopatch, per sq cm",,,96.56,96.56,1
HCPCS,Q4179,"Flowerderm, per sq cm",,,129.95,324.0,5
HCPCS,Q41790,"Flowerderm, per sq cm",,,324.0,324.0,1
HCPCS,Q4180,"Revita, per sq cm",,,129.95,708.61,6
HCPCS,Q41800,"Revita, per sq cm",,,708.61,708.61,1
HCPCS,Q4181,"Amnio wound, per square cm",,,129.95,142.95,4
HCPCS,Q4182,"Transcyte, per sq centimeter",,,40.78,142.95,8
HCPCS,Q41820,"Transcyte, per sq centimeter",,,40.78,40.78,1
HCPCS,Q4183,"Surgigraft, 1 sq cm",,,86.4,219.2,8
HCPCS,Q41830,"Surgigraft, 1 sq cm",,,86.4,86.4,1
HCPCS,Q4184,Cellesta or duo per sq cm,,,86.44,561.91,6
HCPCS,Q41840,Cellesta or duo per sq cm,,,86.44,86.44,1
HCPCS,Q4185,Cellesta flowab amnion 0.5cc,,,1777.71,1777.71,1
HCPCS,Q41850,Cellesta flowab amnion 0.5cc,,,1777.71,1777.71,1
HCPCS,Q4186,Epifix 1 sq cm,,,163.26,163.26,1
HCPCS,Q4186,GRAFT EPIFIX  18MM DISC 2.5CM2,502.0,326.3,125.5,491.96,34
HCPCS,Q4186,GRAFT EPIFIX  2X4CM 8CM2,353.0,229.45,88.25,345.94,34
HCPCS,Q4186,GRAFT EPIFIX 2X2CM 4 SQ CM,542.0,352.3,129.95,531.16,34
HCPCS,Q4186,GRAFT EPIFIX 2X3CM 6 SQ CM,419.0,272.35,104.75,410.62,34
HCPCS,Q4186,GRAFT EPIFIX 3.5X3.5CM 8SQ CM,328.0,213.2,82.0,321.44,34
HCPCS,Q4186,GRAFT EPIFIX 3X4CM 12CM2,420.0,273.0,105.0,411.6,34
HCPCS,Q4186,GRAFT EPIFIX 4X4.5CM 10.1SQ CM,285.0,185.25,71.25,279.3,34
HCPCS,Q4186,GRAFT EPIFIX 7X7CM 49 SQ CM,413.0,268.45,103.25,404.74,34
HCPCS,Q4186,GRAFT ST TIS 6X5CM EPIFIX,403.0,261.95,100.75,394.94,34
HCPCS,Q4186,GRAFT ST TIS EPIFIX 14MM AMNIO,329.0,213.85,82.25,322.42,34
HCPCS,Q4186,GRAFT ST TIS EPIFIX 16SQ CM,398.0,258.7,99.5,390.04,34
HCPCS,Q41860,Epifix 1 sq cm,,,163.26,163.26,1
HCPCS,Q4187,"EPICORD, PER SQUARE CM",205.0,133.25,51.25,223.53,28
HCPCS,Q4187,Epicord 1 sq cm,,,264.92,264.92,1
HCPCS,Q41870,Epicord 1 sq cm,,,264.92,264.92,1
HCPCS,Q4188,Amnioarmor 1 sq cm,,,129.95,573.87,6
HCPCS,Q41880,Amnioarmor 1 sq cm,,,526.6,526.6,1
HCPCS,Q4189,"Artacent ac, 1 mg",,,21.62,54.85,4
HCPCS,Q41890,"Artacent ac, 1 mg",,,21.62,21.62,1
HCPCS,Q4190,Artacent ac 1 sq cm,,,121.31,288.34,6
HCPCS,Q41900,Artacent ac 1 sq cm,,,121.31,121.31,1
HCPCS,Q4191,Restorigin 1 sq cm,,,129.95,1383.3,6
HCPCS,Q41910,Restorigin 1 sq cm,,,707.72,707.72,1
HCPCS,Q4192,"Restorigin, 1 cc",,,2678.4,2678.4,1
HCPCS,Q41920,"Restorigin, 1 cc",,,2678.4,2678.4,1
HCPCS,Q4193,Coll-e-derm 1 sq cm,,,129.95,1504.57,5
HCPCS,Q41930,Coll-e-derm 1 sq cm,,,1504.57,1504.57,1
HCPCS,Q4194,Novachor 1 sq cm,,,129.95,716.72,5
HCPCS,Q41940,Novachor 1 sq cm,,,716.72,716.72,1
HCPCS,Q4195,Puraply 1 sq cm,,,105.78,142.95,5
HCPCS,Q41950,Puraply 1 sq cm,,,105.78,105.78,1
HCPCS,Q4196,Puraply am 1 sq cm,,,93.75,142.95,6
HCPCS,Q41960,Puraply am 1 sq cm,,,109.11,109.11,1
HCPCS,Q4197,Puraply xt 1 sq cm,,,76.36,142.95,6
HCPCS,Q41970,Puraply xt 1 sq cm,,,76.36,76.36,1
HCPCS,Q4198,Genesis amnio membrane 1sqcm,,,129.95,142.95,4
HCPCS,Q4199,"Cygnus matrix, per sq cm",,,120.04,285.87,6
HCPCS,Q41990,"Cygnus matrix, per sq cm",,,120.04,120.04,1
HCPCS,Q4200,Skin te 1 sq cm,,,129.95,1078.95,5
HCPCS,Q42000,Skin te 1 sq cm,,,1078.95,1078.95,1
HCPCS,Q4201,Matrion 1 sq cm,,,82.18,142.95,5
HCPCS,Q42010,Matrion 1 sq cm,,,82.18,82.18,1
HCPCS,Q4203,"Derma-gide, 1 sq cm",,,129.95,1137.12,6
HCPCS,Q42030,"Derma-gide, 1 sq cm",,,1137.12,1137.12,1
HCPCS,Q4204,Xwrap 1 sq cm,,,129.95,3987.51,5
HCPCS,Q42040,Xwrap 1 sq cm,,,3987.51,3987.51,1
HCPCS,Q4205,Membrane graft or wrap sq cm,,,129.95,1336.26,6
HCPCS,Q42050,Membrane graft or wrap sq cm,,,1336.26,1336.26,1
HCPCS,Q4206,Fluid flow or fluid gf 1 cc,,,2488.32,6312.96,4
HCPCS,Q42060,Fluid flow or fluid gf 1 cc,,,2488.32,2488.32,1
HCPCS,Q4208,Novafix per sq cm,,,129.95,1052.16,8
HCPCS,Q42080,Novafix per sq cm,,,414.72,414.72,1
HCPCS,Q4209,Surgraft per sq cm,,,129.95,378.0,5
HCPCS,Q42090,Surgraft per sq cm,,,378.0,378.0,1
HCPCS,Q4210,Axolotl graf dualgraf sq cm,,,763.2,763.2,1
HCPCS,Q4211,Amnion bio or axobio sq cm,,,129.95,142.95,4
HCPCS,Q4213,"Ascent, 0.5 mg",,,59.56,151.11,4
HCPCS,Q42130,"Ascent, 0.5 mg",,,59.56,59.56,1
HCPCS,Q4214,Cellesta cord per sq cm,,,129.95,142.95,4
HCPCS,Q4215,"Axolotl ambient, cryo 0.1 mg",,,592.77,592.77,1
HCPCS,Q42150,"Axolotl ambient, cryo 0.1 mg",,,592.77,592.77,1
HCPCS,Q4216,Artacent cord per sq cm,,,129.95,142.95,4
HCPCS,Q4217,Woundfix biowound plus xplus,,,129.95,472.66,6
HCPCS,Q42170,Woundfix biowound plus xplus,,,343.44,343.44,1
HCPCS,Q4218,Surgicord per sq cm,,,129.6,328.8,8
HCPCS,Q42180,Surgicord per sq cm,,,129.6,129.6,1
HCPCS,Q4219,Surgigraft dual per sq cm,,,129.95,2630.4,8
HCPCS,Q42190,Surgigraft dual per sq cm,,,1036.8,1036.8,1
HCPCS,Q4220,"Bellacell hd, surederm sq cm",,,129.95,142.95,4
HCPCS,Q4221,Amniowrap2 per sq cm,,,129.95,2117.88,6
HCPCS,Q42210,Amniowrap2 per sq cm,,,2117.88,2117.88,1
HCPCS,Q4222,"Progenamatrix, per sq cm",,,103.76,157.13,6
HCPCS,Q42220,"Progenamatrix, per sq cm",,,157.13,157.13,1
HCPCS,Q4225,"Amnio or derma tl, per sq cm",,,129.95,1541.65,5
HCPCS,Q42250,"Amnio or derma tl, per sq cm",,,1541.65,1541.65,1
HCPCS,Q4226,Myown harv prep proc sq cm,,,1244.16,3156.48,4
HCPCS,Q42260,Myown harv prep proc sq cm,,,1244.16,1244.16,1
HCPCS,Q4227,Amniocore per sq cm,,,129.95,1266.36,5
HCPCS,Q42270,Amniocore per sq cm,,,1266.36,1266.36,1
HCPCS,Q4229,Cogenex amnio memb per sq cm,,,129.95,498.27,5
HCPCS,Q42290,Cogenex amnio memb per sq cm,,,498.27,498.27,1
HCPCS,Q4230,Cogenex flow amnion 0.5 cc,,,5398.57,5398.57,1
HCPCS,Q42300,Cogenex flow amnion 0.5 cc,,,5398.57,5398.57,1
HCPCS,Q4231,"Corplex p, per cc",,,1094.16,1375.83,2
HCPCS,Q42310,"Corplex p, per cc",,,1094.16,1094.16,1
HCPCS,Q4232,"Corplex, per sq cm",,,118.2,142.95,6
HCPCS,Q42320,"Corplex, per sq cm",,,118.2,118.2,1
HCPCS,Q4233,Surfactor /nudyn per 0.5 cc,,,5529.72,5529.72,1
HCPCS,Q42330,Surfactor /nudyn per 0.5 cc,,,5529.72,5529.72,1
HCPCS,Q4234,"Xcellerate, per sq cm",,,129.95,598.26,5
HCPCS,Q42340,"Xcellerate, per sq cm",,,598.26,598.26,1
HCPCS,Q4235,Amniorepair or altiply sq cm,,,95.02,142.95,6
HCPCS,Q42350,Amniorepair or altiply sq cm,,,95.02,95.02,1
HCPCS,Q4236,Carepatch per sq cm,,,129.95,540.96,6
HCPCS,Q42360,Carepatch per sq cm,,,485.36,485.36,1
HCPCS,Q4237,"Cryo-cord, per sq cm",,,129.95,1094.63,8
HCPCS,Q42370,"Cryo-cord, per sq cm",,,431.46,431.46,1
HCPCS,Q4238,"Derm-maxx, per sq cm",,,129.95,1568.43,6
HCPCS,Q42380,"Derm-maxx, per sq cm",,,1568.43,1568.43,1
HCPCS,Q4239,Amnio-maxx or lite per sq cm,,,129.95,2054.83,5
HCPCS,Q42390,Amnio-maxx or lite per sq cm,,,2054.83,2054.83,1
HCPCS,Q4240,Corecyte topical only 0.5 cc,,,486.0,486.0,1
HCPCS,Q42400,Corecyte topical only 0.5 cc,,,486.0,486.0,1
HCPCS,Q4242,"Amniocyte plus, per 0.5 cc",,,1688.04,1688.04,1
HCPCS,Q42420,"Amniocyte plus, per 0.5 cc",,,1688.04,1688.04,1
HCPCS,Q4246,"Coretext or protext, per cc",,,2671.2,10587.36,5
HCPCS,Q42460,"Coretext or protext, per cc",,,4173.12,4173.12,1
HCPCS,Q4247,"Amniotext patch, per sq cm",,,129.95,8066.56,9
HCPCS,Q42470,"Amniotext patch, per sq cm",,,3179.52,3179.52,1
HCPCS,Q4248,Dermacyte amn mem allo sq cm,,,129.95,975.49,6
HCPCS,Q42480,Dermacyte amn mem allo sq cm,,,599.62,599.62,1
HCPCS,Q4249,"Amniply, per sq cm",,,129.95,2127.48,5
HCPCS,Q42490,"Amniply, per sq cm",,,2127.48,2127.48,1
HCPCS,Q4250,Amnioamp-mp per sq cm,,,129.95,3217.92,5
HCPCS,Q42500,Amnioamp-mp per sq cm,,,3217.92,3217.92,1
HCPCS,Q4251,"Vim, per square centimeter",,,129.95,394.56,8
HCPCS,Q42510,"Vim, per square centimeter",,,155.52,155.52,1
HCPCS,Q4252,"Vendaje, per square centimet",,,57.24,142.95,6
HCPCS,Q42520,"Vendaje, per square centimet",,,57.24,57.24,1
HCPCS,Q4253,Zenith amniotic membrane psc,,,81.85,219.69,6
HCPCS,Q42530,Zenith amniotic membrane psc,,,81.85,81.85,1
HCPCS,Q4254,Novafix dl per sq cm,,,129.95,142.95,4
HCPCS,Q4255,"Reguard, topical use per sq",,,129.95,142.95,4
HCPCS,Q4256,"Mlg complet, per sq cm",,,129.95,793.85,5
HCPCS,Q42560,"Mlg complet, per sq cm",,,793.85,793.85,1
HCPCS,Q4257,"Relese, per sq cm",,,129.95,988.3,5
HCPCS,Q42570,"Relese, per sq cm",,,988.3,988.3,1
HCPCS,Q4258,"Enverse, per sq cm",,,64.2,142.95,6
HCPCS,Q42580,"Enverse, per sq cm",,,96.93,96.93,1
HCPCS,Q4259,Celera per sq cm,,,129.95,906.3,6
HCPCS,Q42590,Celera per sq cm,,,770.58,770.58,1
HCPCS,Q4260,"Signature apatch, per sq cm",,,129.95,142.95,4
HCPCS,Q4261,"Tag, per square centimeter",,,129.95,1586.65,8
HCPCS,Q42610,"Tag, per square centimeter",,,625.4,625.4,1
HCPCS,Q4262,"Dual layer impax, per sq cm",,,106.95,567.95,6
HCPCS,Q42620,"Dual layer impax, per sq cm",,,106.95,106.95,1
HCPCS,Q4263,"Surgraft tl, per sq cm",,,129.95,1961.04,6
HCPCS,Q42630,"Surgraft tl, per sq cm",,,1961.04,1961.04,1
HCPCS,Q4264,"Cocoon membrane, per sq cm",,,129.95,402.72,5
HCPCS,Q42640,"Cocoon membrane, per sq cm",,,402.72,402.72,1
HCPCS,Q4265,Neostim tl per sq cm,,,129.95,1497.37,5
HCPCS,Q42650,Neostim tl per sq cm,,,1497.37,1497.37,1
HCPCS,Q4266,Neostim per sq cm,,,129.95,583.52,5
HCPCS,Q42660,Neostim per sq cm,,,583.52,583.52,1
HCPCS,Q4267,Neostim dl per sq cm,,,129.95,787.05,6
HCPCS,Q42670,Neostim dl per sq cm,,,349.07,349.07,1
HCPCS,Q4268,Surgraft ft per sq cm,,,129.95,488.93,5
HCPCS,Q42680,Surgraft ft per sq cm,,,488.93,488.93,1
HCPCS,Q4269,Surgraft xt per sq cm,,,129.95,1949.36,5
HCPCS,Q42690,Surgraft xt per sq cm,,,1949.36,1949.36,1
HCPCS,Q4270,Complete sl per sq cm,,,129.95,3585.44,5
HCPCS,Q42700,Complete sl per sq cm,,,3585.44,3585.44,1
HCPCS,Q4271,Complete ft per sq cm,,,129.95,1574.1,6
HCPCS,Q42710,Complete ft per sq cm,,,1232.65,1232.65,1
HCPCS,Q4272,"Esano a, per sq cm",,,129.95,767.2,8
HCPCS,Q42720,"Esano a, per sq cm",,,302.4,302.4,1
HCPCS,Q4273,"Esano aaa, per sq cm",,,129.95,142.95,4
HCPCS,Q4274,"Esano ac, per sq cm",,,129.95,2032.02,5
HCPCS,Q42740,"Esano ac, per sq cm",,,2032.02,2032.02,1
HCPCS,Q4275,"Esano aca, per sq cm",,,129.95,2923.88,5
HCPCS,Q42750,"Esano aca, per sq cm",,,2923.88,2923.88,1
HCPCS,Q4276,"Orion, per sq cm",,,129.95,293.52,5
HCPCS,Q42760,"Orion, per sq cm",,,293.52,293.52,1
HCPCS,Q4278,"Epieffect, per sq cm",,,129.95,365.73,6
HCPCS,Q42780,"Epieffect, per sq cm",,,227.39,227.39,1
HCPCS,Q4279,"Vendaje ac, per sq cm",,,129.95,2292.54,5
HCPCS,Q42790,"Vendaje ac, per sq cm",,,2292.54,2292.54,1
HCPCS,Q4280,Xcell amnio matrix per sq cm,,,129.95,2544.32,5
HCPCS,Q42800,Xcell amnio matrix per sq cm,,,2544.32,2544.32,1
HCPCS,Q4281,Barrera slor dl per sq cm,,,129.95,796.2,6
HCPCS,Q42810,Barrera slor dl per sq cm,,,444.05,444.05,1
HCPCS,Q4282,Cygnus dual per sq cm,,,129.95,787.67,6
HCPCS,Q42820,Cygnus dual per sq cm,,,363.54,363.54,1
HCPCS,Q4283,"Biovance tri or 3l, sq cm",,,129.95,1167.78,6
HCPCS,Q42830,"Biovance tri or 3l, sq cm",,,492.2,492.2,1
HCPCS,Q4284,"Dermabind sl, per sq cm",,,129.95,142.95,4
HCPCS,Q4285,Nudyn dl or dl mesh pr sq cm,,,129.95,438.84,8
HCPCS,Q42850,Nudyn dl or dl mesh pr sq cm,,,172.97,172.97,1
HCPCS,Q4286,"Nudyn sl or slw, per sq cm",,,129.95,469.2,8
HCPCS,Q42860,"Nudyn sl or slw, per sq cm",,,184.94,184.94,1
HCPCS,Q4287,"Dermabind dl, per sq cm",,,129.95,142.95,4
HCPCS,Q4288,"Dermabind ch, per sq cm",,,129.95,142.95,4
HCPCS,Q4289,"Revoshield+ amnio, per sq cm",,,129.95,1644.89,5
HCPCS,Q42890,"Revoshield+ amnio, per sq cm",,,1644.89,1644.89,1
HCPCS,Q4290,Membrane wrap hydr per sq cm,,,129.95,2016.37,5
HCPCS,Q42900,Membrane wrap hydr per sq cm,,,2016.37,2016.37,1
HCPCS,Q4291,"Lamellas xt, per sq cm",,,129.95,7654.46,8
HCPCS,Q42910,"Lamellas xt, per sq cm",,,3017.09,3017.09,1
HCPCS,Q4292,"Lamellas, per sq cm",,,129.95,3156.48,8
HCPCS,Q42920,"Lamellas, per sq cm",,,1244.16,1244.16,1
HCPCS,Q4293,"Acesso dl, per sq cm",,,129.95,1711.48,5
HCPCS,Q42930,"Acesso dl, per sq cm",,,1711.48,1711.48,1
HCPCS,Q4294,"Amnio quad-core, per sq cm",,,129.95,3632.91,5
HCPCS,Q42940,"Amnio quad-core, per sq cm",,,3632.91,3632.91,1
HCPCS,Q4295,"Amnio tri-core, per sq cm",,,129.95,3137.89,5
HCPCS,Q42950,"Amnio tri-core, per sq cm",,,3137.89,3137.89,1
HCPCS,Q4296,"Rebound matrix, per sq cm",,,129.95,905.55,5
HCPCS,Q42960,"Rebound matrix, per sq cm",,,905.55,905.55,1
HCPCS,Q4297,"Emerge matrix, per sq cm",,,129.95,1406.48,5
HCPCS,Q42970,"Emerge matrix, per sq cm",,,1406.48,1406.48,1
HCPCS,Q4298,"Amniocore pro, per sq cm",,,129.95,2844.88,5
HCPCS,Q42980,"Amniocore pro, per sq cm",,,2844.88,2844.88,1
HCPCS,Q4299,"Amniocore pro+, per sq cm",,,129.95,3414.14,5
HCPCS,Q42990,"Amniocore pro+, per sq cm",,,3414.14,3414.14,1
HCPCS,Q4300,"Acesso tl, per sq cm",,,129.95,2292.56,5
HCPCS,Q43000,"Acesso tl, per sq cm",,,2292.56,2292.56,1
HCPCS,Q4301,"Activate matrix, per sq cm",,,129.95,1941.96,5
HCPCS,Q43010,"Activate matrix, per sq cm",,,1941.96,1941.96,1
HCPCS,Q4302,"Complete aca, per sq cm",,,129.95,1339.09,5
HCPCS,Q43020,"Complete aca, per sq cm",,,1339.09,1339.09,1
HCPCS,Q4303,"Complete aa, per sq cm",,,129.95,3637.86,5
HCPCS,Q43030,"Complete aa, per sq cm",,,3637.86,3637.86,1
HCPCS,Q4304,"Grafix plus, per sq cm",,,129.95,483.26,5
HCPCS,Q43040,"Grafix plus, per sq cm",,,483.26,483.26,1
HCPCS,Q4305,Amer am ac tri-lay per sq cm,,,129.95,142.95,4
HCPCS,Q4306,Americ amnion ac per sq cm,,,129.95,142.95,4
HCPCS,Q4307,"American amnion, per sq cm",,,129.95,142.95,4
HCPCS,Q4308,"Sanopellis, per sq cm",,,129.95,142.95,4
HCPCS,Q4309,"Via matrix, per sq cm",,,129.95,950.43,5
HCPCS,Q43090,"Via matrix, per sq cm",,,950.43,950.43,1
HCPCS,Q4310,"Procenta, per 100 mg",,,3068.64,13020.48,5
HCPCS,Q43100,"Procenta, per 100 mg",,,5132.16,5132.16,1
HCPCS,Q4311,"Acesso, per sq cm",,,129.95,142.95,4
HCPCS,Q4312,"Acesso ac, per sq cm",,,129.95,2604.7,5
HCPCS,Q43120,"Acesso ac, per sq cm",,,2604.7,2604.7,1
HCPCS,Q4313,"Dermabind fm, per sq cm",,,129.95,3577.52,5
HCPCS,Q43130,"Dermabind fm, per sq cm",,,3577.52,3577.52,1
HCPCS,Q4314,"Reeva, per sq cm",,,129.95,2518.56,5
HCPCS,Q43140,"Reeva, per sq cm",,,2518.56,2518.56,1
HCPCS,Q4315,Regenelink amniotic mem allo,,,129.95,142.95,4
HCPCS,Q4316,"Amchoplast, per sq cm",,,129.95,4566.21,5
HCPCS,Q43160,"Amchoplast, per sq cm",,,4566.21,4566.21,1
HCPCS,Q4317,"Vitograft, per sq cm",,,129.95,5151.6,5
HCPCS,Q43170,"Vitograft, per sq cm",,,5151.6,5151.6,1
HCPCS,Q4318,"E-graft, per sq cm",,,129.95,142.95,4
HCPCS,Q4319,"Sanograft, per sq cm",,,129.95,3033.72,5
HCPCS,Q43190,"Sanograft, per sq cm",,,3033.72,3033.72,1
HCPCS,Q4320,"Pellograft, per sq cm",,,111.27,142.95,5
HCPCS,Q43200,"Pellograft, per sq cm",,,111.27,111.27,1
HCPCS,Q4321,"Renograft, per sq cm",,,129.95,4121.28,5
HCPCS,Q43210,"Renograft, per sq cm",,,4121.28,4121.28,1
HCPCS,Q4322,"Caregraft, per sq cm",,,129.95,1971.67,5
HCPCS,Q43220,"Caregraft, per sq cm",,,1971.67,1971.67,1
HCPCS,Q4323,"Alloply, per sq cm",,,129.95,1688.2,5
HCPCS,Q43230,"Alloply, per sq cm",,,1688.2,1688.2,1
HCPCS,Q4324,"Amniotx, per sq cm",,,129.95,4340.16,8
HCPCS,Q43240,"Amniotx, per sq cm",,,1710.72,1710.72,1
HCPCS,Q4325,"Acapatch, per sq cm",,,129.95,1844.43,5
HCPCS,Q43250,"Acapatch, per sq cm",,,1844.43,1844.43,1
HCPCS,Q4326,"Woundplus, per sq cm",,,129.95,1147.74,5
HCPCS,Q43260,"Woundplus, per sq cm",,,1147.74,1147.74,1
HCPCS,Q4327,"Duoamnion, per sq cm",,,129.95,142.95,4
HCPCS,Q4328,"Most, per sq cm",,,129.95,3715.88,5
HCPCS,Q43280,"Most, per sq cm",,,3715.88,3715.88,1
HCPCS,Q4329,"Singlay, per sq cm",,,129.95,142.95,4
HCPCS,Q4330,"Total, per sq cm",,,129.95,142.95,4
HCPCS,Q4331,"Axolotl graft, per sq cm",,,129.95,1716.9,5
HCPCS,Q43310,"Axolotl graft, per sq cm",,,1716.9,1716.9,1
HCPCS,Q4332,"Axolotl dualgraft, per sq cm",,,129.95,1815.84,5
HCPCS,Q43320,"Axolotl dualgraft, per sq cm",,,1815.84,1815.84,1
HCPCS,Q4333,"Ardeograft, per sq cm",,,129.95,1972.8,8
HCPCS,Q43330,"Ardeograft, per sq cm",,,777.6,777.6,1
HCPCS,Q4334,"Amnioplast 1, per sq cm",,,129.95,142.95,4
HCPCS,Q4335,"Amnioplast 2, per sq cm",,,129.95,142.95,4
HCPCS,Q4336,"Artecent c, per sq cm",,,129.95,142.95,4
HCPCS,Q4337,"Artecent trident, per sq cm",,,129.95,142.95,4
HCPCS,Q4338,"Artacent velos, per sq cm",,,129.95,142.95,4
HCPCS,Q4339,"Artacent vericlen, per sq cm",,,129.95,2219.77,5
HCPCS,Q43390,"Artacent vericlen, per sq cm",,,2219.77,2219.77,1
HCPCS,Q4340,"Simpligraft, per sq cm",,,129.95,1488.12,5
HCPCS,Q43400,"Simpligraft, per sq cm",,,1488.12,1488.12,1
HCPCS,Q4341,"Simplimax, per sq cm",,,129.95,3806.04,5
HCPCS,Q43410,"Simplimax, per sq cm",,,3806.04,3806.04,1
HCPCS,Q4342,"Theramend, per sq cm",,,129.95,2452.89,5
HCPCS,Q43420,"Theramend, per sq cm",,,2452.89,2452.89,1
HCPCS,Q4343,Dermacyte ac matrx per sq cm,,,129.95,3188.27,5
HCPCS,Q43430,Dermacyte ac matrx per sq cm,,,3188.27,3188.27,1
HCPCS,Q4344,"Tri membrane wrap, per sq cm",,,129.95,3860.34,5
HCPCS,Q43440,"Tri membrane wrap, per sq cm",,,3860.34,3860.34,1
HCPCS,Q4345,Matrix hd allogrft per sq cm,,,129.95,2862.0,5
HCPCS,Q43450,Matrix hd allogrft per sq cm,,,2862.0,2862.0,1
HCPCS,Q4346,Shelter dm matrix per sq cm,,,129.95,3956.89,5
HCPCS,Q43460,Shelter dm matrix per sq cm,,,3956.89,3956.89,1
HCPCS,Q4347,Rampart dl matrix per sq cm,,,129.95,3347.38,5
HCPCS,Q43470,Rampart dl matrix per sq cm,,,3347.38,3347.38,1
HCPCS,Q4348,Sentry sl matrix per sq cm,,,129.95,2197.67,5
HCPCS,Q43480,Sentry sl matrix per sq cm,,,2197.67,2197.67,1
HCPCS,Q4349,Mantle dl matrix per sq cm,,,129.95,9206.4,8
HCPCS,Q43490,Mantle dl matrix per sq cm,,,3628.8,3628.8,1
HCPCS,Q4350,Palisade dm matrix per sq cm,,,129.95,3896.74,5
HCPCS,Q43500,Palisade dm matrix per sq cm,,,3896.74,3896.74,1
HCPCS,Q4351,"Enclose tl matrix, per sq cm",,,129.95,9864.0,8
HCPCS,Q43510,"Enclose tl matrix, per sq cm",,,3888.0,3888.0,1
HCPCS,Q4352,"Overlay sl matrix, per sq cm",,,129.95,5129.28,8
HCPCS,Q43520,"Overlay sl matrix, per sq cm",,,2021.76,2021.76,1
HCPCS,Q4353,Xceed tl matrix per sq cm,,,129.95,4480.75,5
HCPCS,Q43530,Xceed tl matrix per sq cm,,,4480.75,4480.75,1
HCPCS,Q4354,Palingen dl-palingen dl-x,,,129.95,10927.12,8
HCPCS,Q43540,Palingen dl-palingen dl-x,,,4307.04,4307.04,1
HCPCS,Q4355,Abio xpl abio xpl hy p sq cm,,,129.95,3062.58,5
HCPCS,Q43550,Abio xpl abio xpl hy p sq cm,,,3062.58,3062.58,1
HCPCS,Q4356,Abio mem abio hyd per sq cm,,,129.95,6576.0,8
HCPCS,Q43560,Abio mem abio hyd per sq cm,,,2592.0,2592.0,1
HCPCS,Q4357,"Xwrap plus, per sq cm",,,129.95,5151.6,5
HCPCS,Q43570,"Xwrap plus, per sq cm",,,5151.6,5151.6,1
HCPCS,Q4358,"Xwrap dual, per sq cm",,,129.95,6364.81,5
HCPCS,Q43580,"Xwrap dual, per sq cm",,,6364.81,6364.81,1
HCPCS,Q4359,"Choriply, per sq cm",,,129.95,3001.67,5
HCPCS,Q43590,"Choriply, per sq cm",,,3001.67,3001.67,1
HCPCS,Q4360,Amchoplast fd per sq cm,,,129.95,6126.64,8
HCPCS,Q43600,Amchoplast fd per sq cm,,,2414.88,2414.88,1
HCPCS,Q4361,"Epixpress, per sq cm",,,129.95,2289.6,5
HCPCS,Q43610,"Epixpress, per sq cm",,,2289.6,2289.6,1
HCPCS,Q4362,"Cygnus disk, per sq cm",,,129.95,142.95,4
HCPCS,Q4363,Am bur mem hydro per sq cm,,,129.95,142.95,4
HCPCS,Q4364,Am bur xp mem xpl hy p sq cm,,,129.95,8122.68,8
HCPCS,Q43640,Am bur xp mem xpl hy p sq cm,,,3201.64,3201.64,1
HCPCS,Q4365,Amnio bur dl mem per sq cm,,,129.95,142.95,4
HCPCS,Q4366,Dl amnio bur x-mem per sq cm,,,129.95,142.95,4
HCPCS,Q4367,"Amniocore sl, per sq cm",,,129.95,812.58,5
HCPCS,Q43670,"Amniocore sl, per sq cm",,,812.58,812.58,1
HCPCS,Q4368,Amchothick per sq cm,,,129.95,10214.72,8
HCPCS,Q43680,Amchothick per sq cm,,,4026.24,4026.24,1
HCPCS,Q4369,Amnioplast 3 per sq cm,,,129.95,142.95,4
HCPCS,Q4370,Aeroguard per sq cm,,,129.95,142.95,4
HCPCS,Q4371,Neoguard per sq cm,,,129.95,142.95,4
HCPCS,Q4372,Amchoplast excl per sq cm,,,129.95,142.95,4
HCPCS,Q4373,Membrane wrp lt per sq cm,,,129.95,7225.71,8
HCPCS,Q43730,Membrane wrp lt per sq cm,,,2848.09,2848.09,1
HCPCS,Q4375,Duograft ac per sq cm,,,129.95,142.95,4
HCPCS,Q4376,Duograft aa per sq cm,,,129.95,142.95,4
HCPCS,Q4377,Trigraft ft per sq cm,,,129.95,142.95,4
HCPCS,Q4378,Renew ft matrix per sq cm,,,129.95,10127.04,8
HCPCS,Q43780,Renew ft matrix per sq cm,,,3991.68,3991.68,1
HCPCS,Q4379,Amniodefend ft per sq cm,,,129.95,7496.64,8
HCPCS,Q43790,Amniodefend ft per sq cm,,,2954.88,2954.88,1
HCPCS,Q4380,Advograft one per sq cm,,,129.95,142.95,4
HCPCS,Q4382,Advograft dual per sq cm,,,129.95,142.95,4
HCPCS,Q4383,Axolotl graft ult per sq cm,,,129.95,142.95,4
HCPCS,Q4384,Axolotl dual ult per sq cm,,,129.95,142.95,4
HCPCS,Q4385,Apollo ft per sq cm,,,129.95,142.95,4
HCPCS,Q4386,Acesso trifaca per sq cm,,,129.95,142.95,4
HCPCS,Q4387,Neothelium ft per sq cm,,,129.95,142.95,4
HCPCS,Q4388,Neothelium 4l per sq cm,,,129.95,142.95,4
HCPCS,Q4389,Neothelium 4l+ per sq cm,,,129.95,142.95,4
HCPCS,Q4390,Ascendion per sq cm,,,129.95,142.95,4
HCPCS,Q4391,Amnioplast double per sq cm,,,129.95,142.95,4
HCPCS,Q4392,Grafix duo per sq cm,,,129.95,142.95,4
HCPCS,Q4393,Surgraft ac per sq cm,,,129.95,142.95,4
HCPCS,Q4394,Surgraft aca per sq cm,,,129.95,142.95,4
HCPCS,Q4395,Acelagraft per sq cm,,,129.95,142.95,4
HCPCS,Q4396,Natalin per sq cm,,,129.95,7365.12,8
HCPCS,Q43960,Natalin per sq cm,,,2903.04,2903.04,1
HCPCS,Q4397,Summit aaa per sq cm,,,129.95,142.95,4
HCPCS,Q4398,Summit ac per sq cm,,,69.01,142.95,5
HCPCS,Q43980,Summit ac per sq cm,,,69.01,69.01,1
HCPCS,Q4399,Summit fx per sq cm,,,69.01,142.95,5
HCPCS,Q43990,Summit fx per sq cm,,,69.01,69.01,1
HCPCS,Q4400,Polygon3 per sq cm,,,69.01,142.95,5
HCPCS,Q44000,Polygon3 per sq cm,,,69.01,69.01,1
HCPCS,Q4401,Absolv3 per sq cm,,,69.01,142.95,5
HCPCS,Q44010,Absolv3 per sq cm,,,69.01,69.01,1
HCPCS,Q4402,Xwrap 2.0 per sq cm,,,69.01,142.95,5
HCPCS,Q44020,Xwrap 2.0 per sq cm,,,69.01,69.01,1
HCPCS,Q4403,Xwrap dual plus per sq cm,,,69.01,142.95,5
HCPCS,Q44030,Xwrap dual plus per sq cm,,,69.01,69.01,1
HCPCS,Q4404,Xwrap hydro plus per sq cm,,,69.01,142.95,5
HCPCS,Q44040,Xwrap hydro plus per sq cm,,,69.01,69.01,1
HCPCS,Q4405,Xwrap fenestra plus sq cm,,,69.01,142.95,5
HCPCS,Q44050,Xwrap fenestra plus sq cm,,,69.01,69.01,1
HCPCS,Q4406,Xwrap fenestra per sq cm,,,69.01,142.95,5
HCPCS,Q44060,Xwrap fenestra per sq cm,,,69.01,69.01,1
HCPCS,Q4407,Xwrap tribus per sq cm,,,69.01,142.95,5
HCPCS,Q44070,Xwrap tribus per sq cm,,,69.01,69.01,1
HCPCS,Q4408,Xwrap hydro per sq cm,,,69.01,142.95,5
HCPCS,Q44080,Xwrap hydro per sq cm,,,69.01,69.01,1
HCPCS,Q4409,Amniomatrixf3x per sq cm,,,69.01,142.95,5
HCPCS,Q44090,Amniomatrixf3x per sq cm,,,69.01,69.01,1
HCPCS,Q4410,Amchomatrixdl per sq cm,,,69.01,142.95,5
HCPCS,Q44100,Amchomatrixdl per sq cm,,,69.01,69.01,1
HCPCS,Q4411,Amniomatrixf4x per sq cm,,,69.01,142.95,5
HCPCS,Q44110,Amniomatrixf4x per sq cm,,,69.01,69.01,1
HCPCS,Q4412,Choriofix per sq cm,,,69.01,142.95,5
HCPCS,Q44120,Choriofix per sq cm,,,69.01,69.01,1
HCPCS,Q4413,Cygnus solo per sq cm,,,69.01,142.95,5
HCPCS,Q44130,Cygnus solo per sq cm,,,69.01,69.01,1
HCPCS,Q4414,Simplichor per sq cm,,,69.01,142.95,5
HCPCS,Q44140,Simplichor per sq cm,,,69.01,69.01,1
HCPCS,Q4415,Alexiguard st-l per sq cm,,,69.01,142.95,5
HCPCS,Q44150,Alexiguard st-l per sq cm,,,69.01,69.01,1
HCPCS,Q4416,Alexiguard tl-t per sq cm,,,69.01,142.95,5
HCPCS,Q44160,Alexiguard tl-t per sq cm,,,69.01,69.01,1
HCPCS,Q4417,Alexiguard dl-t per sq cm,,,69.01,142.95,5
HCPCS,Q44170,Alexiguard dl-t per sq cm,,,69.01,69.01,1
HCPCS,Q4420,Nuform per sq cm,,,69.01,142.95,5
HCPCS,Q44200,Nuform per sq cm,,,69.01,69.01,1
HCPCS,Q4431,"Pma skin substitute, nos",,,129.95,142.95,4
HCPCS,Q4432,"510(k) skin subs, nos",,,129.95,142.95,4
HCPCS,Q4433,"361 hct/p skin subs, nos",,,129.95,142.95,4
HCPCS,Q5001,Hospice or home hlth in home,,,165.5,165.5,1
HCPCS,Q50010,Hospice or home hlth in home,,,165.5,165.5,1
HCPCS,Q5002,Hospice/home hlth in asst lv,,,13.07,13.07,1
HCPCS,Q50020,Hospice/home hlth in asst lv,,,13.07,13.07,1
HCPCS,Q5003,Hospice in lt/non-skilled nf,,,143.26,143.26,1
HCPCS,Q50030,Hospice in lt/non-skilled nf,,,143.26,143.26,1
HCPCS,Q5004,Hospice in snf,,,115.18,115.18,1
HCPCS,Q50040,Hospice in snf,,,115.18,115.18,1
HCPCS,Q5005,"Hospice, inpatient hospital",,,421.72,421.72,1
HCPCS,Q50050,"Hospice, inpatient hospital",,,421.72,421.72,1
HCPCS,Q5006,Hospice in hospice facility,,,443.16,443.16,1
HCPCS,Q50060,Hospice in hospice facility,,,443.16,443.16,1
HCPCS,Q5007,Hospice in ltch,,,445.45,445.45,1
HCPCS,Q50070,Hospice in ltch,,,445.45,445.45,1
HCPCS,Q5008,Hospice in inpatient psych,,,684.72,684.72,1
HCPCS,Q50080,Hospice in inpatient psych,,,684.72,684.72,1
HCPCS,Q5010,Hospice home care in hospice,,,64.65,64.65,1
HCPCS,Q50100,Hospice home care in hospice,,,64.65,64.65,1
HCPCS,Q5098,IMULDOSA 130 MG/26 ML INTRAVENOUS SOLUTION,205.44,133.54,34.51,3236.72,29
HCPCS,Q5098,"Inj ustekinumab-srlf, 1 mg",,,8.77,8.77,1
HCPCS,Q50980,"Inj ustekinumab-srlf, 1 mg",,,8.77,8.77,1
HCPCS,Q5099,"Inj ustekinumab-stba, 1 mg",,,12.8,12.8,1
HCPCS,Q5099,STEQEYMA 130 MG/26 ML INTRAVENOUS SOLUTION,42.06,27.34,7.07,3236.72,36
HCPCS,Q50990,"Inj ustekinumab-stba, 1 mg",,,12.8,12.8,1
HCPCS,Q5100,"Inj ustekinumab-kfce, 1 mg",,,26.65,26.65,1
HCPCS,Q5100,YESINTEK 130 MG/26 ML INTRAVENOUS SOLUTION,55.38,36.0,13.85,3236.72,39
HCPCS,Q5100,YESINTEK 90 MG/ML SUBCUTANEOUS SYRINGE,10799.94,7019.96,24.68,10799.94,45
HCPCS,Q51000,"Inj ustekinumab-kfce, 1 mg",,,26.65,26.65,1
HCPCS,Q5101,"Injection, zarxio",,,0.38,0.38,1
HCPCS,Q5101,ZARXIO 300 MCG/0.5 ML INJECTION SYRINGE,1975.395,1284.01,0.34,1975.41,141
HCPCS,Q5101,ZARXIO 480 MCG/0.8 ML INJECTION SYRINGE,1975.41,1284.02,0.34,1975.41,94
HCPCS,Q51010,"Injection, zarxio",,,0.38,0.38,1
HCPCS,Q5103,INFLECTRA 100 MG INTRAVENOUS SOLUTION,3406.62,2214.3,9.98,3406.62,50
HCPCS,Q5103,"Injection, inflectra",,,35.01,35.01,1
HCPCS,Q51030,"Injection, inflectra",,,35.01,35.01,1
HCPCS,Q5104,"INJECTION, RENFLEXIS",345.0,224.25,27.75,345.0,14
HCPCS,Q5104,"Injection, renflexis",,,29.97,29.97,1
HCPCS,Q5104,RENFLEXIS 100 MG INTRAVENOUS SOLUTION,2712.21,1762.94,27.18,2712.21,100
HCPCS,Q51040,"Injection, renflexis",,,29.97,29.97,1
HCPCS,Q5105,Inj retacrit esrd on dialysi,,,0.68,78.3,31
HCPCS,Q51050,Inj retacrit esrd on dialysi,,,0.82,0.82,1
HCPCS,Q5106,INJ RETACRIT NON-ESRD USE (RETACRIT),51.0,33.15,7.57,51.0,14
HCPCS,Q5106,Inj retacrit non-esrd use,,,8.18,8.18,1
HCPCS,Q5106,RETACRIT 10000 UNIT/ML INJECTION SOLUTION,406.86,264.46,6.76,406.86,47
HCPCS,Q5106,RETACRIT 2000 UNIT/ML INJECTION SOLUTION,81.36,52.88,6.76,123.65,47
HCPCS,Q5106,RETACRIT 20000 UNIT/2 ML INJECTION SOLUTION,406.86,264.46,6.76,406.86,47
HCPCS,Q5106,RETACRIT 20000 UNIT/ML INJECTION SOLUTION,813.69,528.9,6.76,813.69,94
HCPCS,Q5106,RETACRIT 3000 UNIT/ML INJECTION SOLUTION,122.07,79.35,6.76,123.65,47
HCPCS,Q5106,RETACRIT 4000 UNIT/ML INJECTION SOLUTION,162.75,105.79,6.76,162.75,47
HCPCS,Q5106,RETACRIT 40000 UNIT/ML INJECTION SOLUTION,1627.38,1057.8,6.76,1627.38,47
HCPCS,Q51060,Inj retacrit non-esrd use,,,8.18,8.18,1
HCPCS,Q5107,Inj mvasi 10 mg,,,25.75,25.75,1
HCPCS,Q5107,MVASI 25 MG/ML INTRAVENOUS SOLUTION,837.28,544.23,23.84,837.28,92
HCPCS,Q51070,Inj mvasi 10 mg,,,25.75,25.75,1
HCPCS,Q5108,FULPHILA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,12525.0,8141.25,98.87,12525.0,106
HCPCS,Q5108,"INJECTION, FULPHILA",19113.0,12423.45,98.87,19113.0,14
HCPCS,Q5108,"Injection, fulphila",,,106.78,106.78,1
HCPCS,Q51080,"Injection, fulphila",,,106.78,106.78,1
HCPCS,Q5109,"Injection, ixifi, 10 mg",,,97.89,123.65,6
HCPCS,Q5110,NIVESTYM 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,1576.8,1024.92,0.26,1576.8,94
HCPCS,Q5110,NIVESTYM 300 MCG/ML INJECTION SOLUTION,788.4,512.46,0.26,788.4,94
HCPCS,Q5110,NIVESTYM 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1576.8,1024.92,0.26,1576.8,94
HCPCS,Q5110,NIVESTYM 480 MCG/1.6 ML INJECTION SOLUTION,788.4,512.46,0.26,788.4,94
HCPCS,Q5110,Nivestym,,,0.3,0.3,1
HCPCS,Q51100,Nivestym,,,0.3,0.3,1
HCPCS,Q5111,"Injection, udenyca 0.5 mg",,,174.95,174.95,1
HCPCS,Q5111,UDENYCA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,25050.0,16282.5,121.94,25050.0,106
HCPCS,Q5111,UDENYCA ONBODY 6 MG/0.6 ML WITH WEARABLE SUBCUTANEOUS INJECTOR,25050.0,16282.5,121.94,25050.0,53
HCPCS,Q51110,"Injection, udenyca 0.5 mg",,,174.95,174.95,1
HCPCS,Q5112,Inj ontruzant 10 mg,,,29.45,29.45,1
HCPCS,Q5112,ONTRUZANT 150 MG INTRAVENOUS SOLUTION,6358.36,4132.93,27.27,6358.36,52
HCPCS,Q5112,ONTRUZANT 420 MG INTRAVENOUS SOLUTION,17803.4,11572.21,27.27,17803.4,208
HCPCS,Q51120,Inj ontruzant 10 mg,,,29.45,29.45,1
HCPCS,Q5113,HERZUMA 150 MG INTRAVENOUS SOLUTION,5235.6,3403.14,50.22,5235.6,52
HCPCS,Q5113,HERZUMA 420 MG INTRAVENOUS SOLUTION,14659.68,9528.79,50.22,14659.68,52
HCPCS,Q5113,Inj herzuma 10 mg,,,59.86,59.86,1
HCPCS,Q51130,Inj herzuma 10 mg,,,59.86,59.86,1
HCPCS,Q5114,Inj ogivri 10 mg,,,40.73,40.73,1
HCPCS,Q5114,OGIVRI 150 MG INTRAVENOUS SOLUTION,4514.44,2934.39,37.7,4514.44,49
HCPCS,Q5114,OGIVRI 420 MG INTRAVENOUS SOLUTION,12600.24,8190.16,37.7,12600.24,52
HCPCS,Q51140,Inj ogivri 10 mg,,,40.73,40.73,1
HCPCS,Q5115,Inj truxima 10 mg,,,32.56,32.56,1
HCPCS,Q5115,TRUXIMA 10 MG/ML INTRAVENOUS SOLUTION,405.88,263.82,27.88,1355.53,92
HCPCS,Q51150,Inj truxima 10 mg,,,32.56,32.56,1
HCPCS,Q5116,"Inj., trazimera, 10 mg",,,8.87,8.87,1
HCPCS,Q5116,TRAZIMERA 150 MG INTRAVENOUS SOLUTION,5813.28,3778.63,8.2,5813.28,52
HCPCS,Q5116,TRAZIMERA 420 MG INTRAVENOUS SOLUTION,16277.2,10580.18,8.2,16277.2,52
HCPCS,Q51160,"Inj., trazimera, 10 mg",,,8.87,8.87,1
HCPCS,Q5117,"Inj., kanjinti, 10 mg",,,55.56,55.56,1
HCPCS,Q5117,KANJINTI 150 MG INTRAVENOUS SOLUTION,6528.32,4243.41,15.91,6528.32,52
HCPCS,Q5117,KANJINTI 420 MG INTRAVENOUS SOLUTION,18279.28,11881.53,15.91,18279.28,52
HCPCS,Q51170,"Inj., kanjinti, 10 mg",,,55.56,55.56,1
HCPCS,Q5118,"Inj., zirabev, 10 mg",,,27.86,27.86,1
HCPCS,Q5118,ZIRABEV 25 MG/ML INTRAVENOUS SOLUTION,736.08,478.45,18.68,736.08,92
HCPCS,Q51180,"Inj., zirabev, 10 mg",,,27.86,27.86,1
HCPCS,Q5119,"Inj ruxience, 10 mg",,,14.33,14.33,1
HCPCS,Q5119,RUXIENCE 10 MG/ML INTRAVENOUS SOLUTION,344.08,223.65,13.27,1355.53,92
HCPCS,Q51190,"Inj ruxience, 10 mg",,,14.33,14.33,1
HCPCS,Q5120,Inj pegfilgrastim-bmez 0.5mg,,,33.53,1355.53,34
HCPCS,Q51200,Inj pegfilgrastim-bmez 0.5mg,,,128.83,128.83,1
HCPCS,Q5121,AVSOLA 100 MG INTRAVENOUS SOLUTION,2400.0,1560.0,21.29,2400.0,47
HCPCS,Q5121,"Inj. avsola, 10 mg",,,35.01,35.01,1
HCPCS,Q51210,"Inj. avsola, 10 mg",,,35.01,35.01,1
HCPCS,Q5122,"Inj, nyvepria",,,143.69,143.69,1
HCPCS,Q5122,NYVEPRIA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,23550.0,15307.5,58.96,23550.0,53
HCPCS,Q51220,"Inj, nyvepria",,,143.69,143.69,1
HCPCS,Q5123,"Inj. riabni, 10 mg",,,22.57,22.57,1
HCPCS,Q5123,RIABNI 10 MG/ML INTRAVENOUS SOLUTION,258.06,167.74,20.89,1355.53,92
HCPCS,Q51230,"Inj. riabni, 10 mg",,,22.57,22.57,1
HCPCS,Q5124,BYOOVIZ 0.5 MG/0.05 ML INTRAVITREAL SOLUTION,83800.8,54470.52,60.21,83800.8,53
HCPCS,Q5124,"Inj. byooviz, 0.1 mg",,,65.04,65.04,1
HCPCS,Q51240,"Inj. byooviz, 0.1 mg",,,65.04,65.04,1
HCPCS,Q5125,"Inj, releuko 1 mcg",,,0.33,93.47,35
HCPCS,Q51250,"Inj, releuko 1 mcg",,,0.37,0.37,1
HCPCS,Q5126,ALYMSYS 25 MG/ML INTRAVENOUS SOLUTION,646.74,420.38,33.01,652.67,90
HCPCS,Q5126,Inj alymsys 10 mg,,,35.65,35.65,1
HCPCS,Q51260,Inj alymsys 10 mg,,,35.65,35.65,1
HCPCS,Q5127,"Inj, stimufend, 0.5 mg",,,147.23,1355.53,35
HCPCS,Q51270,"Inj, stimufend, 0.5 mg",,,159.02,159.02,1
HCPCS,Q5128,CIMERLI 0.5 MG/0.05 ML INTRAVITREAL SOLUTION,97920.0,63648.0,83.34,97920.0,53
HCPCS,Q5128,"Inj, cimerli, 0.1 mg",,,90.01,90.01,1
HCPCS,Q51280,"Inj, cimerli, 0.1 mg",,,90.01,90.01,1
HCPCS,Q5129,"Inj, vegzelma, 10 mg",,,41.21,41.21,1
HCPCS,Q5129,VEGZELMA 25 MG/ML INTRAVENOUS SOLUTION,812.88,528.37,38.15,812.88,90
HCPCS,Q51290,"Inj, vegzelma, 10 mg",,,41.21,41.21,1
HCPCS,Q5130,FYLNETRA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,15000.0,9750.0,127.22,15000.0,53
HCPCS,Q5130,"Inj, fylnetra, 0.5 mg",,,137.41,137.41,1
HCPCS,Q51300,"Inj, fylnetra, 0.5 mg",,,137.41,137.41,1
HCPCS,Q5131,"Inj, idacio, 20 mg",,,2562.41,3236.72,6
HCPCS,Q5132,"Inj, abrilada, 10 mg",,,303.41,383.26,6
HCPCS,Q5133,"Inj, tofidence, 1 mg",,,6.04,6.04,1
HCPCS,Q5133,TOFIDENCE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,532.8,346.32,5.58,532.8,46
HCPCS,Q5133,TOFIDENCE 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,532.8,346.32,5.58,532.8,46
HCPCS,Q5133,TOFIDENCE 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,532.8,346.32,5.58,532.8,46
HCPCS,Q51330,"Inj, tofidence, 1 mg",,,6.04,6.04,1
HCPCS,Q5134,"Inj, tyruko, 1 mg",,,24.38,3407.66,14
HCPCS,Q51340,"Inj, tyruko, 1 mg",,,24.55,24.55,1
HCPCS,Q5135,"Inj, tyenne, 1 mg",,,4.53,4.53,1
HCPCS,Q5135,TYENNE 162 MG/0.9 ML SUBCUTANEOUS SYRINGE,4072.68,2647.24,4.19,4072.68,49
HCPCS,Q5135,TYENNE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,470.0,305.5,4.19,470.0,46
HCPCS,Q5135,TYENNE 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,470.0,305.5,4.19,470.0,46
HCPCS,Q5135,TYENNE 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,470.0,305.5,4.19,470.0,46
HCPCS,Q51350,"Inj, tyenne, 1 mg",,,4.53,4.53,1
HCPCS,Q5136,"Inj. denosumab-bbdz, 1 mg",,,30.49,30.49,1
HCPCS,Q5136,JUBBONTI 60 MG/ML SUBCUTANEOUS SYRINGE,5774.88,3753.67,28.23,5774.88,45
HCPCS,Q5136,WYOST 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,6793.95,4416.07,28.23,6793.95,45
HCPCS,Q51360,"Inj. denosumab-bbdz, 1 mg",,,30.49,30.49,1
HCPCS,Q5137,"Inj, wezlana, sub cu, 1 mg",,,64.15,5646.0,10
HCPCS,Q51370,"Inj, wezlana, sub cu, 1 mg",,,64.15,64.15,1
HCPCS,Q5138,"Inj, wezlana, iv, 1 mg",,,12.57,12.57,1
HCPCS,Q5138,WEZLANA 130 MG/26 ML INTRAVENOUS SOLUTION,27.69,18.0,6.92,3236.72,39
HCPCS,Q51380,"Inj, wezlana, iv, 1 mg",,,12.57,12.57,1
HCPCS,Q5139,"Inj, eculizumab-aeeb, 10 mg",,,14450.94,18253.82,6
HCPCS,Q5140,"Inj adalimumab-fkjp, 1 mg",,,74.0,188.22,19
HCPCS,Q5141,"Inj adalimumab-aaty, 1 mg",,,43.57,94.11,19
HCPCS,Q5142,"Inj adalimumab-ryvk, 1 mg",,,13.36,93.47,23
HCPCS,Q51420,"Inj adalimumab-ryvk, 1 mg",,,13.46,13.46,1
HCPCS,Q5143,"Inj adalimumab-adbm, 1 mg",,,14.15,188.22,19
HCPCS,Q5144,"Inj, idacio, 1 mg",,,11.65,93.47,23
HCPCS,Q51440,"Inj, idacio, 1 mg",,,11.65,11.65,1
HCPCS,Q5145,"Inj, abrilada, 1 mg",,,74.0,215.2,19
HCPCS,Q5146,"Inj, hercessi, 10 mg",,,37.15,1355.53,24
HCPCS,Q51460,"Inj, hercessi, 10 mg",,,40.12,40.12,1
HCPCS,Q5147,"Inj, aflibercept-ayyh, 1 mg",,,746.88,2397.14,21
HCPCS,Q51470,"Inj, aflibercept-ayyh, 1 mg",,,935.5,935.5,1
HCPCS,Q5148,"Inj, nyposi 1 mcg",,,0.99,93.47,21
HCPCS,Q51480,"Inj, nyposi 1 mcg",,,1.08,1.08,1
HCPCS,Q5149,"Inj, aflibercept-abzv, 1 mg",,,746.88,943.43,6
HCPCS,Q5150,"Inj, aflibercept-mrbb, 1 mg",,,746.88,943.43,6
HCPCS,Q5151,EPYSQLI 300 MG/30 ML INTRAVENOUS SOLUTION,730.56,474.86,31.67,943.43,39
HCPCS,Q5151,"Inj, eculizumab-aagh, 2 mg",,,34.2,34.2,1
HCPCS,Q51510,"Inj, eculizumab-aagh, 2 mg",,,34.2,34.2,1
HCPCS,Q5152,BKEMV 300 MG/30 ML INTRAVENOUS SOLUTION,939.32,610.56,42.34,943.43,39
HCPCS,Q5152,"Inj, eculizumab-aeeb, 2 mg",,,45.74,45.74,1
HCPCS,Q51520,"Inj, eculizumab-aeeb, 2 mg",,,45.74,45.74,1
HCPCS,Q5153,"Inj, aflibercept-yszy, 1 mg",,,746.88,943.43,6
HCPCS,Q5154,"Inj, omlyclo, 5 mg",,,516.7,652.67,6
HCPCS,Q5155,"Inj, aflibercept-jbvf, 1 mg",,,516.7,652.67,6
HCPCS,Q5156,"Inj, tocilizumab-anoh, 1 mg",,,4.47,652.67,10
HCPCS,Q51560,"Inj, tocilizumab-anoh, 1 mg",,,4.47,4.47,1
HCPCS,Q5157,"Inj, denosumab-bmwo, 1 mg",,,29.55,29.55,1
HCPCS,Q5157,OSENVELT 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,6940.05,4511.03,28.13,6940.05,38
HCPCS,Q5157,STOBOCLO 60 MG/ML SUBCUTANEOUS SYRINGE,6413.97,4169.08,28.13,6413.97,38
HCPCS,Q51570,"Inj, denosumab-bmwo, 1 mg",,,29.55,29.55,1
HCPCS,Q5158,BOMYNTRA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,7086.18,4606.02,28.72,7086.18,38
HCPCS,Q5158,CONEXXENCE 60 MG/ML SUBCUTANEOUS SYRINGE,6549.0,4256.85,28.72,6549.0,38
HCPCS,Q5158,"Inj, denosumab-bnht, 1 mg",,,30.18,30.18,1
HCPCS,Q51580,"Inj, denosumab-bnht, 1 mg",,,30.18,30.18,1
HCPCS,Q5159,"Inj, denosumab-dssb, 1 mg",,,16.85,898.5,10
HCPCS,Q51590,"Inj, denosumab-dssb, 1 mg",,,16.85,16.85,1
HCPCS,Q5160,"Inj, jobevne, 10 mg",,,82.53,1355.53,14
HCPCS,Q51600,"Inj, jobevne, 10 mg",,,82.53,82.53,1
HCPCS,Q5161,"Inj den (auk/bos),biosim 1mg",,,711.31,898.5,6
HCPCS,Q5162,"Injection, denosumab-nxxp",,,273.36,345.3,6
HCPCS,Q9950,Inj sulf hexa lipid microsph,,,19.62,19.62,1
HCPCS,Q9950,LUMASON 25 MG INTRAVENOUS SUSPENSION,522.0,339.3,17.04,522.0,24
HCPCS,Q99500,Inj sulf hexa lipid microsph,,,19.62,19.62,1
HCPCS,Q9951,"Locm >= 400 mg/ml iodine,1ml",,,1.04,1.04,1
HCPCS,Q99510,"Locm >= 400 mg/ml iodine,1ml",,,1.04,1.04,1
HCPCS,Q9953,"Inj fe-based mr contrast,1ml",,,15.14,38.41,4
HCPCS,Q99530,"Inj fe-based mr contrast,1ml",,,15.14,15.14,1
HCPCS,Q9954,"Oral mr contrast, 100 ml",,,17.17,17.17,1
HCPCS,Q99540,"Oral mr contrast, 100 ml",,,17.17,17.17,1
HCPCS,Q9955,"Inj perflexane lip micros,ml",,,14.0,35.51,4
HCPCS,Q99550,"Inj perflexane lip micros,ml",,,14.0,14.0,1
HCPCS,Q9956,"INJ OCTAFLUOROPROPANE MIC,ML",142.0,92.3,40.21,142.0,14
HCPCS,Q9956,"Inj octafluoropropane mic,ml",,,43.43,43.43,1
HCPCS,Q9956,OPTISON 0.22 MG/ML INTRAVENOUS SUSPENSION,154.44,100.39,25.95,154.44,24
HCPCS,Q99560,"Inj octafluoropropane mic,ml",,,43.43,43.43,1
HCPCS,Q9957,DEFINITY 1.1 MG/ML INTRAVENOUS SUSPENSION,675.0,438.75,40.03,675.0,24
HCPCS,Q9957,"INJ PERFLUTREN LIP MICROS, ML",444.0,288.6,40.03,444.0,24
HCPCS,Q9957,"INJ PERFLUTREN LIP MICROS,ML",459.0,298.35,40.21,459.0,14
HCPCS,Q9957,"Inj perflutren lip micros,ml",,,43.43,43.43,1
HCPCS,Q99570,"Inj perflutren lip micros,ml",,,43.43,43.43,1
HCPCS,Q9958,CONRAY-30 30 % INTRAVENOUS SOLUTION,0.57,0.37,0.07,0.57,21
HCPCS,Q9958,CYSTO-CONRAY II 17.2 % URETHRAL SOLUTION,0.39,0.25,0.06,0.42,42
HCPCS,Q9958,CYSTOGRAFIN 30 % URETHRAL SOLUTION,0.885,0.575,0.07,1.11,42
HCPCS,Q9958,"Hocm <=149 mg/ml iodine, 1ml",,,0.08,0.08,1
HCPCS,Q99580,"Hocm <=149 mg/ml iodine, 1ml",,,0.08,0.08,1
HCPCS,Q9959,"Hocm 150-199mg/ml iodine,1ml",,,0.1,0.25,4
HCPCS,Q99590,"Hocm 150-199mg/ml iodine,1ml",,,0.1,0.1,1
HCPCS,Q9961,CONRAY 60 % INJECTION SOLUTION,1.17,0.76,0.15,1.47,60
HCPCS,Q9961,"Hocm 250-299mg/ml iodine,1ml",,,0.28,0.28,1
HCPCS,Q99610,"Hocm 250-299mg/ml iodine,1ml",,,0.28,0.28,1
HCPCS,Q9962,"Hocm 300-349mg/ml iodine,1ml",,,0.27,0.69,4
HCPCS,Q99620,"Hocm 300-349mg/ml iodine,1ml",,,0.27,0.27,1
HCPCS,Q9963,GASTROGRAFIN 66 %-10 % ORAL SOLUTION,1.68,1.09,0.2,1.68,21
HCPCS,Q9963,"Hocm 350-399mg/ml iodine,1ml",,,0.24,0.24,1
HCPCS,Q99630,"Hocm 350-399mg/ml iodine,1ml",,,0.24,0.24,1
HCPCS,Q9964,"Hocm>= 400mg/ml iodine, 1ml",,,0.55,0.55,1
HCPCS,Q99640,"Hocm>= 400mg/ml iodine, 1ml",,,0.55,0.55,1
HCPCS,Q9965,"Locm 100-199mg/ml iodine,1ml",,,1.12,1.12,1
HCPCS,Q9965,OMNIPAQUE 180 MG IODINE/ML INTRATHECAL SOLUTION,17.34,11.27,0.91,17.34,21
HCPCS,Q99650,"Locm 100-199mg/ml iodine,1ml",,,1.12,1.12,1
HCPCS,Q9966,CNTRST RAD OMPQ 240 100ML,3.48,2.26,0.35,3.48,21
HCPCS,Q9966,ISOVUE-M 200  41 % INTRATHECAL SOLUTION,23.28,15.13,0.35,23.28,21
HCPCS,Q9966,"LOCM 200-299MG/ML IODINE,1ML",8.0,5.2,0.4,8.0,13
HCPCS,Q9966,"Locm 200-299mg/ml iodine,1ml",,,0.43,0.43,1
HCPCS,Q9966,OMNIPAQUE 240  50 ML,3.48,2.26,0.35,3.48,21
HCPCS,Q9966,OMNIPAQUE 240 / 20 ML,3.48,2.26,0.35,3.48,21
HCPCS,Q9966,OMNIPAQUE 240 / 50 ML,3.48,2.26,0.35,3.48,21
HCPCS,Q9966,OMNIPAQUE 240 MG IODINE/ML INTRAVENOUS SOLUTION,2.79,1.81,0.13,18.84,105
HCPCS,Q9966,VISIPAQUE 270 MG IODINE/ML INTRAVENOUS SOLUTION,3.9,2.54,0.35,3.99,63
HCPCS,Q99660,"Locm 200-299mg/ml iodine,1ml",,,0.43,0.43,1
HCPCS,Q9967,CONTR LOCM 300-399 MG 1 ML,3.48,2.26,0.12,3.48,21
HCPCS,Q9967,IODIXANOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.27,2.13,0.12,3.27,21
HCPCS,Q9967,"ISOVUE 300, 100 ML, PER ML",3.48,2.26,0.12,3.48,21
HCPCS,Q9967,"ISOVUE 370, 100 ML, PER ML",3.48,2.26,0.12,3.48,21
HCPCS,Q9967,ISOVUE-300  61 % INTRAVENOUS SOLUTION,1.68,1.09,0.12,2.64,63
HCPCS,Q9967,ISOVUE-370  76 % INTRAVENOUS SOLUTION,1.83,1.19,0.12,1.83,63
HCPCS,Q9967,ISOVUE-M 300  61 % INTRATHECAL SOLUTION,20.61,13.4,0.12,20.61,21
HCPCS,Q9967,"Locm 300-399mg/ml iodine,1ml",,,0.16,0.16,1
HCPCS,Q9967,OMNIPAQUE 300 (100 ML),3.0,1.95,0.15,3.0,13
HCPCS,Q9967,OMNIPAQUE 300 (150 ML),3.0,1.95,0.15,3.0,13
HCPCS,Q9967,OMNIPAQUE 300 / 10 ML PER ML,3.48,2.26,0.12,3.48,21
HCPCS,Q9967,OMNIPAQUE 300 / 100 ML,3.48,2.26,0.12,3.48,21
HCPCS,Q9967,OMNIPAQUE 300 / 150 ML,3.48,2.26,0.12,3.48,21
HCPCS,Q9967,OMNIPAQUE 300 / 200 ML,3.48,2.26,0.12,3.48,21
HCPCS,Q9967,OMNIPAQUE 300 / 500 ML,3.48,2.26,0.12,3.48,21
HCPCS,Q9967,OMNIPAQUE 300 150 ML,3.48,2.26,0.12,3.48,21
HCPCS,Q9967,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.36,2.18,0.12,17.4,147
HCPCS,Q9967,"OMNIPAQUE 300, 50 ML, PER ML",3.48,2.26,0.12,3.48,21
HCPCS,Q9967,"OMNIPAQUE 300, 75ML, PER ML",3.48,2.26,0.12,3.48,21
HCPCS,Q9967,OMNIPAQUE 350 (150 ML),3.0,1.95,0.15,3.0,13
HCPCS,Q9967,OMNIPAQUE 350 / 500 ML PER ML,3.48,2.26,0.12,3.48,21
HCPCS,Q9967,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.33,2.16,0.12,3.75,168
HCPCS,Q9967,"OMNIPAQUE 350, 100 ML, PER ML",3.48,2.26,0.12,3.48,42
HCPCS,Q9967,"OMNIPAQUE 350, 150 ML, PER ML",3.48,2.26,0.12,3.48,21
HCPCS,Q9967,"OMNIPAQUE 350, 200ML, PER ML",3.48,2.26,0.12,3.48,21
HCPCS,Q9967,"OMNIPAQUE 350, 50 ML, PER ML",3.48,2.26,0.12,3.48,21
HCPCS,Q9967,OPTIRAY 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.3,2.15,0.12,3.3,21
HCPCS,Q9967,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.75,2.44,0.12,4.74,105
HCPCS,Q9967,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SYRINGE,1.47,0.96,0.12,1.47,21
HCPCS,Q9967,OPTIRAY 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.42,2.22,0.12,3.96,63
HCPCS,Q9967,OPTIRAY 350 MG IODINE/ML INTRAVENOUS SYRINGE,1.3,0.85,0.12,1.3,21
HCPCS,Q9967,ULTRAVIST 300 MG IODINE/ML INJECTION SOLUTION,1.5,0.98,0.12,1.5,21
HCPCS,Q9967,VISIPAQUE 320 / 100 ML,3.48,2.26,0.12,3.48,21
HCPCS,Q9967,VISIPAQUE 320 MG IODINE/ML INTRAVENOUS SOLUTION,4.155,2.7,0.12,5.19,84
HCPCS,Q9967,VISIPAQUE 320/150 ML,3.48,2.26,0.12,3.48,21
HCPCS,Q99670,"Locm 300-399mg/ml iodine,1ml",,,0.16,0.16,1
HCPCS,Q9968,ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLUTION,874.23,568.25,8.53,874.23,33
HCPCS,Q9968,LYMPHAZURIN 1 % SUBCUTANEOUS SOLUTION,452.91,294.39,8.53,452.91,33
HCPCS,Q9968,METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,21.33,13.865,0.79,49.17,132
HCPCS,Q9968,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,48.6,31.59,8.53,48.6,33
HCPCS,Q9968,PROVAYBLUE 5 MG/ML INTRAVENOUS SOLUTION,84.39,54.85,8.53,84.39,66
HCPCS,Q9968,Visualization adjunct,,,2.8,2.8,1
HCPCS,Q99680,Visualization adjunct,,,2.8,2.8,1
HCPCS,Q9969,Non-heu tc-99m add-on/dose,,,2.69,21.6,14
HCPCS,Q99690,Non-heu tc-99m add-on/dose,,,2.69,2.69,1
HCPCS,Q9982,FLUTEMETAMOL F18 DIAGNOSTIC,8400.0,5460.0,874.4,7560.0,36
HCPCS,Q9982,Flutemetamol f18 diagnostic,,,3317.76,3317.76,1
HCPCS,Q99820,Flutemetamol f18 diagnostic,,,3317.76,3317.76,1
HCPCS,Q9983,"FLORBETABEN F18, DX, UP TO 8.1 MCI",6820.0,4433.0,1273.76,6138.0,36
HCPCS,Q9983,Florbetaben f18 diagnostic,,,3525.12,3525.12,1
HCPCS,Q9983,NEURACEQ 8.1 MCI (300 MBQ) INTRAVENOUS SOLUTION,6200.0,4030.0,1273.76,5580.0,36
HCPCS,Q99830,Florbetaben f18 diagnostic,,,3525.12,3525.12,1
HCPCS,Q9991,Buprenorph xr 100 mg or less,,,2158.41,2158.41,1
HCPCS,Q9991,SUBLOCADE 100 MG/0.5 ML SOLUTIONEXTENDED RELEASE SUBCUTANEOUS SYRINGE,15854.61,10305.5,303.41,15854.61,53
HCPCS,Q9991,SUBLOCADE 300 MG/1.5 ML SOLUTIONEXTENDED RELEASE SUBCUTANEOUS SYRINGE,5284.86,3435.16,303.41,5530.74,53
HCPCS,Q99910,Buprenorph xr 100 mg or less,,,2158.41,2158.41,1
HCPCS,Q9992,Buprenorphine xr over 100 mg,,,516.7,5530.74,35
HCPCS,Q99920,Buprenorphine xr over 100 mg,,,2158.41,2158.41,1
HCPCS,Q9996,Ustekinumab- ttwe sub cu inj,,,47.8,5646.0,10
HCPCS,Q99960,Ustekinumab- ttwe sub cu inj,,,47.8,47.8,1
HCPCS,Q9997,PYZCHIVA 130 MG/26 ML INTRAVENOUS SOLUTION,152.31,99.0,8.26,3236.72,39
HCPCS,Q9997,Ustekinumab-ttwe iv inj 1 mg,,,8.93,8.93,1
HCPCS,Q99970,Ustekinumab-ttwe iv inj 1 mg,,,8.93,8.93,1
HCPCS,Q9998,"Inj ustekinumab-aekn, 1 mg",,,46.66,46.66,1
HCPCS,Q9998,SELARSDI 130 MG/26 ML INTRAVENOUS SOLUTION,193.86,126.01,43.2,5646.0,39
HCPCS,Q99980,"Inj ustekinumab-aekn, 1 mg",,,46.66,46.66,1
HCPCS,Q9999,Inj ustekinumab-aauz 1 mg,,,35.6,35.6,1
HCPCS,Q9999,OTULFI 130 MG/26 ML INTRAVENOUS SOLUTION,233.4,151.71,32.95,3236.72,39
HCPCS,Q99990,Inj ustekinumab-aauz 1 mg,,,35.6,35.6,1
HCPCS,R0070,Transport portable x-ray,,,75.65,75.65,1
HCPCS,R00700,Transport portable x-ray,,,75.65,75.65,1
HCPCS,R0075,Transport port x-ray multipl,,,217.13,217.13,1
HCPCS,R00750,Transport port x-ray multipl,,,217.13,217.13,1
HCPCS,R0076,Transport portable ekg,,,30.13,30.13,1
HCPCS,R00760,Transport portable ekg,,,30.13,30.13,1
HCPCS,S0012,"Butorphanol tartrate, nasal",,,62.87,159.5,7
HCPCS,S00120,"Butorphanol tartrate, nasal",,,62.87,62.87,1
HCPCS,S0013,"Esketamine, nasal spray",,,15.44,93.47,12
HCPCS,S0014,"Tacrine hydrochloride, 10 mg",,,1.97,4.14,4
HCPCS,S00140,"Tacrine hydrochloride, 10 mg",,,1.97,1.97,1
HCPCS,S0017,"Injection, aminocaproic acid",,,8.45,13.87,4
HCPCS,S00170,"Injection, aminocaproic acid",,,8.45,8.45,1
HCPCS,S0021,"Injection, cefoperazone sod",,,15.55,39.46,7
HCPCS,S00210,"Injection, cefoperazone sod",,,15.55,15.55,1
HCPCS,S0023,"Injection, cimetidine hydroc",,,1.97,4.08,4
HCPCS,S00230,"Injection, cimetidine hydroc",,,1.97,1.97,1
HCPCS,S0028,"INJECTION, FAMOTIDINE, 20 MG",7.0,4.55,3.5,7.0,12
HCPCS,S0028,"Injection, famotidine, 20 mg",,,0.93,1.52,4
HCPCS,S00280,"Injection, famotidine, 20 mg",,,0.93,0.93,1
HCPCS,S0032,"Injection, nafcillin sodium",,,13.63,22.41,4
HCPCS,S00320,"Injection, nafcillin sodium",,,13.63,13.63,1
HCPCS,S0034,"Injection, ofloxacin, 400 mg",,,22.81,57.87,7
HCPCS,S00340,"Injection, ofloxacin, 400 mg",,,22.81,22.81,1
HCPCS,S0039,"INJECTION, SULFAMETHOXAZOLE, 10 ML",23.0,14.95,11.5,23.0,12
HCPCS,S0039,"Injection, sulfamethoxazole",,,13.0,21.37,4
HCPCS,S00390,"Injection, sulfamethoxazole",,,13.0,13.0,1
HCPCS,S0040,"Injection, ticarcillin disod",,,10.48,943.43,10
HCPCS,S00400,"Injection, ticarcillin disod",,,10.48,10.48,1
HCPCS,S0073,"INJECTION, AZTREONAM, 500 MG",128.0,83.2,64.0,128.0,12
HCPCS,S0074,"Injection, cefotetan disodiu",,,19.04,20.64,3
HCPCS,S0078,"Injection, fosphenytoin sodi",,,37.32,94.69,7
HCPCS,S00780,"Injection, fosphenytoin sodi",,,37.32,37.32,1
HCPCS,S0080,"Injection, pentamidine iseth",,,101.29,256.98,6
HCPCS,S0081,"Injection, piperacillin sodi",,,1.31,2.97,4
HCPCS,S00810,"Injection, piperacillin sodi",,,1.31,1.31,1
HCPCS,S0088,Imatinib 100 mg,,,3.08,258.02,13
HCPCS,S00880,Imatinib 100 mg,,,3.08,3.08,1
HCPCS,S0090,"Sildenafil citrate, 25 mg",,,0.28,0.71,7
HCPCS,S00900,"Sildenafil citrate, 25 mg",,,0.28,0.28,1
HCPCS,S0091,Granisetron 1mg,,,3.11,7.89,7
HCPCS,S00910,Granisetron 1mg,,,3.11,3.11,1
HCPCS,S0092,Hydromorphone 250 mg,,,86.49,219.42,7
HCPCS,S00920,Hydromorphone 250 mg,,,86.49,86.49,1
HCPCS,S0093,Morphine 500 mg,,,11.28,28.61,7
HCPCS,S00930,Morphine 500 mg,,,11.28,11.28,1
HCPCS,S0104,"Zidovudine, oral, 100 mg",,,1.58,4.0,7
HCPCS,S01040,"Zidovudine, oral, 100 mg",,,1.58,1.58,1
HCPCS,S0106,Bupropion hcl sr 60 tablets,,,15.16,38.47,7
HCPCS,S01060,Bupropion hcl sr 60 tablets,,,15.16,15.16,1
HCPCS,S0108,Mercaptopurine 50 mg,,,3.37,8.55,7
HCPCS,S01080,Mercaptopurine 50 mg,,,3.37,3.37,1
HCPCS,S0109,Methadone oral 5mg,,,0.28,0.71,7
HCPCS,S01090,Methadone oral 5mg,,,0.28,0.28,1
HCPCS,S0117,Tretinoin topical 5 g,,,4.28,10.85,7
HCPCS,S01170,Tretinoin topical 5 g,,,4.28,4.28,1
HCPCS,S0119,Ondansetron 4 mg,,,0.48,1.21,7
HCPCS,S01190,Ondansetron 4 mg,,,0.48,0.48,1
HCPCS,S0122,Inj menotropins 75 iu,,,261.75,664.07,7
HCPCS,S01220,Inj menotropins 75 iu,,,261.75,261.75,1
HCPCS,S0126,Inj follitropin alfa 75 iu,,,61.99,635.27,13
HCPCS,S01260,Inj follitropin alfa 75 iu,,,250.4,250.4,1
HCPCS,S0128,Inj follitropin beta 75 iu,,,225.5,572.11,7
HCPCS,S01280,Inj follitropin beta 75 iu,,,225.5,225.5,1
HCPCS,S0132,Inj ganirelix acetat 250 mcg,,,74.0,494.13,13
HCPCS,S01320,Inj ganirelix acetat 250 mcg,,,194.77,194.77,1
HCPCS,S0136,"Clozapine, 25 mg",,,0.77,1.95,7
HCPCS,S01360,"Clozapine, 25 mg",,,0.77,0.77,1
HCPCS,S0137,"Didanosine, 25 mg",,,0.58,1.48,7
HCPCS,S01370,"Didanosine, 25 mg",,,0.58,0.58,1
HCPCS,S0138,"Finasteride, 5 mg",,,0.15,0.38,7
HCPCS,S01380,"Finasteride, 5 mg",,,0.15,0.15,1
HCPCS,S0139,"Minoxidil, 10 mg",,,0.48,1.21,7
HCPCS,S01390,"Minoxidil, 10 mg",,,0.48,0.48,1
HCPCS,S0140,"Saquinavir, 200 mg",,,1.26,93.47,13
HCPCS,S01400,"Saquinavir, 200 mg",,,1.26,1.26,1
HCPCS,S0142,Colistimethate inh sol mg,,,74.0,93.47,6
HCPCS,S0145,Peg interferon alfa-2a/180,,,61.99,2928.73,13
HCPCS,S01450,Peg interferon alfa-2a/180,,,1154.39,1154.39,1
HCPCS,S0148,Peg interferon alfa-2b/10,,,74.0,395.71,13
HCPCS,S01480,Peg interferon alfa-2b/10,,,155.97,155.97,1
HCPCS,S0155,Epoprostenol dilutant,,,15.03,93.47,13
HCPCS,S01550,Epoprostenol dilutant,,,15.03,15.03,1
HCPCS,S0156,"Exemestane, 25 mg",,,1.73,4.38,7
HCPCS,S01560,"Exemestane, 25 mg",,,1.73,1.73,1
HCPCS,S0157,"Becaplermin gel 1%, 0.5 gm",,,46.99,119.22,7
HCPCS,S01570,"Becaplermin gel 1%, 0.5 gm",,,46.99,46.99,1
HCPCS,S0160,Dextroamphetamine,,,0.71,1.81,7
HCPCS,S01600,Dextroamphetamine,,,0.71,0.71,1
HCPCS,S0166,Inj olanzapine 2.5mg,,,273.36,345.3,6
HCPCS,S0169,Calcitrol,,,0.28,0.71,7
HCPCS,S01690,Calcitrol,,,0.28,0.28,1
HCPCS,S0170,Anastrozole 1 mg,,,0.5,1.26,7
HCPCS,S01700,Anastrozole 1 mg,,,0.5,0.5,1
HCPCS,S0172,Chlorambucil 2 mg,,,273.87,694.81,7
HCPCS,S01720,Chlorambucil 2 mg,,,273.87,273.87,1
HCPCS,S0174,Dolasetron 50 mg,,,30.65,77.76,7
HCPCS,S01740,Dolasetron 50 mg,,,30.65,30.65,1
HCPCS,S0175,Flutamide 125 mg,,,46.18,117.16,13
HCPCS,S01750,Flutamide 125 mg,,,46.18,46.18,1
HCPCS,S0176,Hydroxyurea 500 mg,,,0.41,1.04,7
HCPCS,S01760,Hydroxyurea 500 mg,,,0.41,0.41,1
HCPCS,S0177,Levamisole 50 mg,,,4.66,13.95,7
HCPCS,S01770,Levamisole 50 mg,,,5.5,5.5,1
HCPCS,S0178,Lomustine 10 mg,,,108.83,276.11,13
HCPCS,S01780,Lomustine 10 mg,,,108.83,108.83,1
HCPCS,S0179,Megestrol 20 mg,,,0.28,0.71,7
HCPCS,S01790,Megestrol 20 mg,,,0.28,0.28,1
HCPCS,S0182,"Procarbazine, oral",,,183.24,464.9,7
HCPCS,S01820,"Procarbazine, oral",,,183.24,183.24,1
HCPCS,S0183,Prochlorperazine 5 mg,,,0.36,0.9,7
HCPCS,S01830,Prochlorperazine 5 mg,,,0.36,0.36,1
HCPCS,S0187,Tamoxifen 10 mg,,,0.19,0.49,7
HCPCS,S01870,Tamoxifen 10 mg,,,0.19,0.19,1
HCPCS,S0189,TESTOSTERONE PELLET 75 MG,259.0,168.35,129.5,259.0,12
HCPCS,S0189,Testosterone pellet 75 mg,,,109.0,276.55,6
HCPCS,S0190,"Mifepristone, oral, 200 mg",,,37.15,94.26,13
HCPCS,S01900,"Mifepristone, oral, 200 mg",,,37.15,37.15,1
HCPCS,S0191,"Misoprostol, oral, 200 mcg",,,1.0,2.55,7
HCPCS,S01910,"Misoprostol, oral, 200 mcg",,,1.0,1.0,1
HCPCS,S0194,Vitamin suppl 100 caps,,,10.22,25.92,7
HCPCS,S01940,Vitamin suppl 100 caps,,,10.22,10.22,1
HCPCS,S0197,Prenatal vitamins 30 day,,,0.25,11.35,4
HCPCS,S01970,Prenatal vitamins 30 day,,,11.35,11.35,1
HCPCS,S0199,Med abortion inc all ex drug,,,297.69,1451.04,9
HCPCS,S0201,Partial hospitalization serv,,,258.96,460.04,7
HCPCS,S02010,Partial hospitalization serv,,,258.96,258.96,1
HCPCS,S0207,Paramedicintercep nonhospals,,,403.86,403.86,1
HCPCS,S02070,Paramedicintercep nonhospals,,,403.86,403.86,1
HCPCS,S0208,Paramed intrcept nonvol,,,209.23,345.3,4
HCPCS,S02080,Paramed intrcept nonvol,,,209.23,209.23,1
HCPCS,S0209,Wc van mileage per mi,,,1.8,1.8,1
HCPCS,S02090,Wc van mileage per mi,,,1.8,1.8,1
HCPCS,S0215,Nonemerg transp mileage,,,1.67,1.67,1
HCPCS,S02150,Nonemerg transp mileage,,,1.67,1.67,1
HCPCS,S0220,Medical conference by physic,,,52.41,95.54,7
HCPCS,S02200,Medical conference by physic,,,52.41,52.41,1
HCPCS,S0221,"Medical conference, 60 min",,,70.9,95.54,7
HCPCS,S02210,"Medical conference, 60 min",,,70.9,70.9,1
HCPCS,S0250,Comp geriatr assmt team,,,75.64,290.52,7
HCPCS,S02500,Comp geriatr assmt team,,,290.52,290.52,1
HCPCS,S0255,Hospice refer visit nonmd,,,95.02,95.02,1
HCPCS,S02550,Hospice refer visit nonmd,,,95.02,95.02,1
HCPCS,S0257,End of life counseling,,,1.62,95.54,7
HCPCS,S02570,End of life counseling,,,1.62,1.62,1
HCPCS,S0260,H&p for surgery,,,52.66,74.71,4
HCPCS,S02600,H&p for surgery,,,52.66,52.66,1
HCPCS,S0265,Genetic counsel 15 mins,,,34.44,117.11,4
HCPCS,S02650,Genetic counsel 15 mins,,,34.44,34.44,1
HCPCS,S0270,Home std case rate 30 days,,,15.82,108.0,10
HCPCS,S02700,Home std case rate 30 days,,,108.0,108.0,1
HCPCS,S0271,Home hospice case 30 days,,,34.32,518.4,7
HCPCS,S02710,Home hospice case 30 days,,,518.4,518.4,1
HCPCS,S0272,Home episodic case 30 days,,,34.32,43.36,6
HCPCS,S0273,Md home visit outside cap,,,75.64,95.54,6
HCPCS,S0274,Nurse practr visit outs cap,,,20.52,20.52,1
HCPCS,S02740,Nurse practr visit outs cap,,,20.52,20.52,1
HCPCS,S0280,"Medical home, initial plan",,,11.74,95.54,10
HCPCS,S02800,"Medical home, initial plan",,,42.42,42.42,1
HCPCS,S0281,"Medical home, maintenance",,,12.24,95.54,10
HCPCS,S02810,"Medical home, maintenance",,,12.24,12.24,1
HCPCS,S0285,Cnslt before screen colonosc,,,55.37,91.31,4
HCPCS,S02850,Cnslt before screen colonosc,,,55.37,55.37,1
HCPCS,S0302,Completed epsdt,,,6.27,39.44,4
HCPCS,S03020,Completed epsdt,,,39.44,39.44,1
HCPCS,S0310,Hospitalist visit,,,55.37,238.98,4
HCPCS,S03100,Hospitalist visit,,,238.98,238.98,1
HCPCS,S0311,Comp mgmt care coord adv ill,,,34.32,271.94,7
HCPCS,S03110,Comp mgmt care coord adv ill,,,271.94,271.94,1
HCPCS,S0315,Disease management program,,,75.64,308.26,10
HCPCS,S03150,Disease management program,,,91.8,91.8,1
HCPCS,S0316,Follow-up/reassessment,,,21.6,166.52,10
HCPCS,S03160,Follow-up/reassessment,,,21.6,21.6,1
HCPCS,S0317,Disease mgmt per diem,,,75.64,7417.86,10
HCPCS,S03170,Disease mgmt per diem,,,189.0,189.0,1
HCPCS,S0320,Rn telephone calls to dmp,,,55.37,55.37,1
HCPCS,S03200,Rn telephone calls to dmp,,,55.37,55.37,1
HCPCS,S0340,Lifestyle mod 1st stage,,,21.61,95.54,7
HCPCS,S03400,Lifestyle mod 1st stage,,,21.61,21.61,1
HCPCS,S0341,Lifestyle mod 2 or 3 stage,,,12.96,95.54,7
HCPCS,S03410,Lifestyle mod 2 or 3 stage,,,12.96,12.96,1
HCPCS,S0342,Lifestyle mod 4th stage,,,40.76,62.64,7
HCPCS,S03420,Lifestyle mod 4th stage,,,62.64,62.64,1
HCPCS,S0353,Cancer treatmentplan initial,,,75.64,667.18,10
HCPCS,S03530,Cancer treatmentplan initial,,,667.18,667.18,1
HCPCS,S0354,Cancer treatment plan change,,,75.64,194.02,10
HCPCS,S03540,Cancer treatment plan change,,,194.02,194.02,1
HCPCS,S0390,Rout foot care per visit,,,29.91,51.3,10
HCPCS,S03900,Rout foot care per visit,,,29.91,29.91,1
HCPCS,S0395,Impression casting ft,,,42.61,145.06,10
HCPCS,S03950,Impression casting ft,,,62.82,62.82,1
HCPCS,S0400,Global eswl kidney,,,1092.1,2236.98,7
HCPCS,S04000,Global eswl kidney,,,1092.1,1092.1,1
HCPCS,S0500,Dispos cont lens,,,8.34,33.48,4
HCPCS,S05000,Dispos cont lens,,,33.48,33.48,1
HCPCS,S0504,Singl prscrp lens,,,16.2,16.2,1
HCPCS,S05040,Singl prscrp lens,,,16.2,16.2,1
HCPCS,S0506,Bifoc prscp lens,,,20.52,20.52,1
HCPCS,S05060,Bifoc prscp lens,,,20.52,20.52,1
HCPCS,S0508,Trifoc prscrp lens,,,27.0,27.0,1
HCPCS,S05080,Trifoc prscrp lens,,,27.0,27.0,1
HCPCS,S0510,Non-prscrp lens,,,54.0,54.0,1
HCPCS,S05100,Non-prscrp lens,,,54.0,54.0,1
HCPCS,S0512,Daily cont lens,,,33.48,33.48,1
HCPCS,S05120,Daily cont lens,,,33.48,33.48,1
HCPCS,S0514,Color cont lens,,,66.96,66.96,1
HCPCS,S05140,Color cont lens,,,66.96,66.96,1
HCPCS,S0515,Scleral lens liquid bandage,,,1029.63,1549.39,4
HCPCS,S05150,Scleral lens liquid bandage,,,1029.63,1029.63,1
HCPCS,S0516,Safety frames,,,112.89,112.89,1
HCPCS,S05160,Safety frames,,,112.89,112.89,1
HCPCS,S0518,Sunglass frames,,,25.92,25.92,1
HCPCS,S05180,Sunglass frames,,,25.92,25.92,1
HCPCS,S0580,Polycarb lens,,,7.78,7.78,1
HCPCS,S05800,Polycarb lens,,,7.78,7.78,1
HCPCS,S0581,Nonstnd lens,,,39.74,39.74,1
HCPCS,S05810,Nonstnd lens,,,39.74,39.74,1
HCPCS,S0590,Misc integral lens serv,,,54.0,54.0,1
HCPCS,S05900,Misc integral lens serv,,,54.0,54.0,1
HCPCS,S0592,Comp cont lens eval,,,10.14,57.23,10
HCPCS,S05920,Comp cont lens eval,,,54.27,54.27,1
HCPCS,S0595,New lenses in pts old frame,,,6.48,6.48,1
HCPCS,S05950,New lenses in pts old frame,,,6.48,6.48,1
HCPCS,S0596,Phakic iol refractive error,,,648.0,648.0,1
HCPCS,S05960,Phakic iol refractive error,,,648.0,648.0,1
HCPCS,S0601,Screening proctoscopy,,,89.15,764.26,7
HCPCS,S06010,Screening proctoscopy,,,89.15,89.15,1
HCPCS,S0610,Annual gynecological examina,,,58.32,89.05,4
HCPCS,S0610,"GYN EXAM, NEW PT., ANNUAL",373.0,242.45,186.5,373.0,12
HCPCS,S06100,Annual gynecological examina,,,58.32,58.32,1
HCPCS,S0612,Annual gynecological examina,,,58.32,70.6,4
HCPCS,S0612,"GYN EXAM, EST PT., ANNUAL",303.0,196.95,151.5,303.0,12
HCPCS,S06120,Annual gynecological examina,,,58.32,58.32,1
HCPCS,S0613,Ann breast exam,,,23.78,36.24,4
HCPCS,S06130,Ann breast exam,,,36.24,36.24,1
HCPCS,S0618,Audiometry for hearing aid,,,19.1,48.88,10
HCPCS,S06180,Audiometry for hearing aid,,,45.71,45.71,1
HCPCS,S0620,Routine ophthalmological exa,,,35.99,41.04,4
HCPCS,S06200,Routine ophthalmological exa,,,41.04,41.04,1
HCPCS,S0621,Routine ophthalmological exa,,,35.78,41.04,4
HCPCS,S06210,Routine ophthalmological exa,,,41.04,41.04,1
HCPCS,S0622,Phys exam for college,,,38.83,38.83,1
HCPCS,S06220,Phys exam for college,,,38.83,38.83,1
HCPCS,S0630,Removal of sutures,,,18.45,61.68,4
HCPCS,S06300,Removal of sutures,,,61.68,61.68,1
HCPCS,S0800,LASER IN SITU KERATOMILEUSIS,3529.0,2293.85,1764.5,3529.0,12
HCPCS,S0800,Laser in situ keratomileusis,,,351.76,934.48,7
HCPCS,S08000,Laser in situ keratomileusis,,,934.48,934.48,1
HCPCS,S0810,Photorefractive keratectomy,,,351.76,1051.02,7
HCPCS,S08100,Photorefractive keratectomy,,,1051.02,1051.02,1
HCPCS,S0812,Phototherap keratect,,,351.76,1369.02,7
HCPCS,S08120,Phototherap keratect,,,1369.02,1369.02,1
HCPCS,S1001,Deluxe item,,,102.72,102.72,1
HCPCS,S10010,Deluxe item,,,102.72,102.72,1
HCPCS,S1002,Custom item,,,167.66,167.66,1
HCPCS,S10020,Custom item,,,167.66,167.66,1
HCPCS,S1015,Iv tubing extension set,,,10.8,28.08,4
HCPCS,S10150,Iv tubing extension set,,,10.8,10.8,1
HCPCS,S1016,Non-pvc intravenous administ,,,0.23,21.6,4
HCPCS,S10160,Non-pvc intravenous administ,,,21.6,21.6,1
HCPCS,S1030,Gluc monitor purchase,,,16.2,16.2,1
HCPCS,S10300,Gluc monitor purchase,,,16.2,16.2,1
HCPCS,S1031,Gluc monitor rental,,,9.72,9.72,1
HCPCS,S10310,Gluc monitor rental,,,9.72,9.72,1
HCPCS,S1034,Art pancreas system,,,9404.23,9404.23,1
HCPCS,S10340,Art pancreas system,,,9404.23,9404.23,1
HCPCS,S1036,Art pancreas ext transmitter,,,930.83,930.83,1
HCPCS,S10360,Art pancreas ext transmitter,,,930.83,930.83,1
HCPCS,S1040,Cranial remolding orthosis,,,1296.0,1951.73,7
HCPCS,S10400,Cranial remolding orthosis,,,1296.0,1296.0,1
HCPCS,S1040NU,Cranial remolding orthosis,,,1801.06,1951.73,3
HCPCS,S1091,Stent non-coronary propel,,,1788.48,4537.44,4
HCPCS,S10910,Stent non-coronary propel,,,1788.48,1788.48,1
HCPCS,S2053,Transplantation of small int,,,3411.14,4308.8,6
HCPCS,S2054,Transplantation of multivisc,,,3411.14,4308.8,6
HCPCS,S2055,Harvesting of donor multivis,,,3411.14,4308.8,6
HCPCS,S2060,Lobar lung transplantation,,,7770.52,9815.39,6
HCPCS,S2061,Donor lobectomy (lung),,,7770.52,9815.39,6
HCPCS,S2065,Simult panc kidn trans,,,4618.62,5834.04,6
HCPCS,S2066,Breast gap flap reconst,,,2548.59,5841.58,7
HCPCS,S20660,Breast gap flap reconst,,,2548.59,2548.59,1
HCPCS,S2067,"BREAST ""STACKED"" DIEP/GAP",21109.0,13720.85,10554.5,21109.0,12
HCPCS,S2067,"Breast ""stacked"" diep/gap",,,2548.59,5841.58,7
HCPCS,S20670,"Breast ""stacked"" diep/gap",,,2548.59,2548.59,1
HCPCS,S2068,BREAST DIEP FLAP RECONSTRUCT,21547.0,14005.55,10773.5,21547.0,12
HCPCS,S2068,Breast diep or siea flap,,,2548.59,5841.58,7
HCPCS,S20680,Breast diep or siea flap,,,2548.59,2548.59,1
HCPCS,S2070,Cysto laser tx ureteral calc,,,970.74,1226.2,7
HCPCS,S20700,Cysto laser tx ureteral calc,,,1040.04,1040.04,1
HCPCS,S2079,Lap esophagomyotomy,,,3143.0,5137.56,7
HCPCS,S20790,Lap esophagomyotomy,,,5137.56,5137.56,1
HCPCS,S2080,Laup,,,696.6,1060.7,7
HCPCS,S20800,Laup,,,696.6,696.6,1
HCPCS,S2083,ADJUSTMENT GASTRIC BAND,72.0,46.8,36.0,72.0,12
HCPCS,S2083,Adjustment gastric band,,,155.81,155.81,1
HCPCS,S20830,Adjustment gastric band,,,155.81,155.81,1
HCPCS,S2095,Transcath emboliz microspher,,,468.36,15767.03,10
HCPCS,S20950,Transcath emboliz microspher,,,468.36,468.36,1
HCPCS,S2102,Islet cell tissue transplant,,,3427.97,4330.07,6
HCPCS,S2103,Adrenal tissue transplant,,,3411.14,4308.8,6
HCPCS,S2107,Adoptive immunotherapy,,,974.47,1230.91,6
HCPCS,S2112,Knee arthroscp harv,,,427.92,1656.34,7
HCPCS,S21120,Knee arthroscp harv,,,427.92,427.92,1
HCPCS,S2115,Periacetabular osteotomy,,,1420.98,3019.97,7
HCPCS,S21150,Periacetabular osteotomy,,,1420.98,1420.98,1
HCPCS,S2117,"Arthroereisis, subtalar",,,1342.37,5695.55,7
HCPCS,S21170,"Arthroereisis, subtalar",,,5695.55,5695.55,1
HCPCS,S2118,Total hip resurfacing,,,2390.81,6969.76,7
HCPCS,S21180,Total hip resurfacing,,,6969.76,6969.76,1
HCPCS,S2120,Low density lipoprotein(ldl),,,974.47,12644.64,7
HCPCS,S21200,Low density lipoprotein(ldl),,,12644.64,12644.64,1
HCPCS,S2140,Cord blood harvesting,,,145.82,347.94,7
HCPCS,S21400,Cord blood harvesting,,,145.82,145.82,1
HCPCS,S2142,Cord blood-derived stem-cell,,,275.45,3094.2,7
HCPCS,S21420,Cord blood-derived stem-cell,,,3094.2,3094.2,1
HCPCS,S2150,Bmt harv/transpl 28d pkg,,,2646.54,5729.4,7
HCPCS,S21500,Bmt harv/transpl 28d pkg,,,5729.4,5729.4,1
HCPCS,S2152,Solid organ transpl pkg,,,1.08,4308.8,7
HCPCS,S21520,Solid organ transpl pkg,,,1.08,1.08,1
HCPCS,S2202,Echosclerotherapy,,,144.9,504.79,7
HCPCS,S22020,Echosclerotherapy,,,144.9,144.9,1
HCPCS,S2205,Minimally invasive direct co,,,1455.17,10785.67,7
HCPCS,S22050,Minimally invasive direct co,,,1455.17,1455.17,1
HCPCS,S2206,Minimally invasive direct co,,,8538.66,10785.67,6
HCPCS,S2207,Minimally invasive direct co,,,8538.66,10785.67,6
HCPCS,S2208,Minimally invasive direct co,,,8538.66,10785.67,6
HCPCS,S2209,Minimally invasive direct co,,,8538.66,10785.67,6
HCPCS,S2225,Myringotomy laser-assist,,,839.72,1060.7,6
HCPCS,S2230,Implant semi-imp hear,,,1634.08,2064.1,6
HCPCS,S2235,Implant auditory brain imp,,,14455.15,18259.14,6
HCPCS,S2260,Induced abortion 17-24 weeks,,,1148.74,1451.04,7
HCPCS,S22600,Induced abortion 17-24 weeks,,,1219.43,1219.43,1
HCPCS,S2265,Induced abortion 25-28 wks,,,1148.74,1451.04,6
HCPCS,S2266,Induced abortion 29-31 wks,,,1148.74,1451.04,6
HCPCS,S2267,Induced abortion 32 or more,,,1148.74,1451.04,6
HCPCS,S2300,"Arthroscopy, shoulder, surgi",,,1311.27,1890.0,7
HCPCS,S23000,"Arthroscopy, shoulder, surgi",,,1890.0,1890.0,1
HCPCS,S2325,HIP CORE DECOMPRESSION,2516.0,1635.4,1258.0,2516.0,12
HCPCS,S2325,Hip core decompression,,,1955.32,1955.32,1
HCPCS,S23250,Hip core decompression,,,1955.32,1955.32,1
HCPCS,S2340,Chemodenervation of abductor,,,1193.97,1508.17,6
HCPCS,S2341,Chemodenerv adduct vocal,,,425.52,1508.17,7
HCPCS,S23410,Chemodenerv adduct vocal,,,425.52,425.52,1
HCPCS,S2342,Nasal endoscop po debrid,,,239.89,451.94,7
HCPCS,S23420,Nasal endoscop po debrid,,,239.89,239.89,1
HCPCS,S2348,Decompress disc rf lumbar,,,48.6,3909.18,7
HCPCS,S23480,Decompress disc rf lumbar,,,48.6,48.6,1
HCPCS,S2350,"Diskectomy, anterior, with d",,,310.17,3909.18,7
HCPCS,S23500,"Diskectomy, anterior, with d",,,310.17,310.17,1
HCPCS,S2351,"Diskectomy, anterior, with d",,,34.77,3909.18,7
HCPCS,S23510,"Diskectomy, anterior, with d",,,34.77,34.77,1
HCPCS,S2400,Fetal surg congen hernia,,,615.35,777.29,6
HCPCS,S2401,Fetal surg urin trac obstr,,,615.35,777.29,6
HCPCS,S2402,Fetal surg cong cyst malf,,,176.04,777.29,7
HCPCS,S24020,Fetal surg cong cyst malf,,,176.04,176.04,1
HCPCS,S2403,Fetal surg pulmon sequest,,,615.35,777.29,6
HCPCS,S2404,Fetal surg myelomeningo,,,615.35,6597.09,7
HCPCS,S24040,Fetal surg myelomeningo,,,6597.09,6597.09,1
HCPCS,S2405,Fetal surg sacrococ teratoma,,,6.48,777.29,7
HCPCS,S24050,Fetal surg sacrococ teratoma,,,6.48,6.48,1
HCPCS,S2409,Fetal surg noc,,,615.35,777.29,6
HCPCS,S2411,Fetoscop laser ther ttts,,,127.35,8720.48,7
HCPCS,S24110,Fetoscop laser ther ttts,,,8720.48,8720.48,1
HCPCS,S2900,ROBOTIC SURGICAL SYSTEM,526.0,341.9,263.0,526.0,12
HCPCS,S2900,Robotic surgical system,,,63.43,63.43,1
HCPCS,S29000,Robotic surgical system,,,63.43,63.43,1
HCPCS,S3000,Bilat dil retinal exam,,,33.26,33.26,1
HCPCS,S30000,Bilat dil retinal exam,,,33.26,33.26,1
HCPCS,S3005,Eval self-assess depression,,,0.48,16.01,4
HCPCS,S30050,Eval self-assess depression,,,0.48,0.48,1
HCPCS,S3600,Stat lab,,,2.18,32.18,4
HCPCS,S36000,Stat lab,,,2.18,2.18,1
HCPCS,S3601,Stat lab home/nf,,,31.24,31.24,1
HCPCS,S36010,Stat lab home/nf,,,31.24,31.24,1
HCPCS,S3620,Newborn metabolic screening,,,4.31,65.36,10
HCPCS,S36200,Newborn metabolic screening,,,65.36,65.36,1
HCPCS,S3630,Eosinophil blood count,,,2.81,56.16,10
HCPCS,S36300,Eosinophil blood count,,,56.16,56.16,1
HCPCS,S3645,Hiv-1 antibody testing of or,,,5.23,20.61,7
HCPCS,S36450,Hiv-1 antibody testing of or,,,20.61,20.61,1
HCPCS,S3650,"Saliva test, hormone level;",,,5.78,249.4,7
HCPCS,S36500,"Saliva test, hormone level;",,,249.4,249.4,1
HCPCS,S3652,"Saliva test, hormone level;",,,5.78,81.15,7
HCPCS,S36520,"Saliva test, hormone level;",,,81.15,81.15,1
HCPCS,S3655,Antisperm antibodies test,,,5.23,232.2,7
HCPCS,S36550,Antisperm antibodies test,,,232.2,232.2,1
HCPCS,S3708,Gastrointestinal fat absorpt,,,5.78,7.3,6
HCPCS,S3722,Dose optimization auc - 5fu,,,5.81,324.0,7
HCPCS,S37220,Dose optimization auc - 5fu,,,324.0,324.0,1
HCPCS,S3800,Genetic testing als,,,22.32,189.0,7
HCPCS,S38000,Genetic testing als,,,189.0,189.0,1
HCPCS,S3840,Dna analysis ret-oncogene,,,22.32,28.19,6
HCPCS,S3841,Gene test retinoblastoma,,,22.32,28.19,6
HCPCS,S3842,Gene test hippel-lindau,,,22.32,28.19,6
HCPCS,S3844,Dna analysis deafness,,,22.32,28.19,6
HCPCS,S3845,Gene test alpha-thalassemia,,,22.32,28.19,6
HCPCS,S3846,Gene test beta-thalassemia,,,22.32,28.19,6
HCPCS,S3849,Gene test niemann-pick,,,22.32,363.96,7
HCPCS,S38490,Gene test niemann-pick,,,363.96,363.96,1
HCPCS,S3850,Gene test sickle cell,,,22.32,28.19,6
HCPCS,S3852,Dna analysis apoe alzheimer,,,22.32,28.19,6
HCPCS,S3853,Gene test myo musclr dyst,,,22.32,28.19,6
HCPCS,S3854,Gene profile panel breast,,,22.32,4872.7,7
HCPCS,S38540,Gene profile panel breast,,,4872.7,4872.7,1
HCPCS,S3861,Genetic test brugada,,,22.32,5832.0,7
HCPCS,S38610,Genetic test brugada,,,5832.0,5832.0,1
HCPCS,S3865,Comp genet test hyp cardiomy,,,22.32,5832.0,7
HCPCS,S38650,Comp genet test hyp cardiomy,,,5832.0,5832.0,1
HCPCS,S3866,Spec gene test hyp cardiomy,,,22.32,972.0,7
HCPCS,S38660,Spec gene test hyp cardiomy,,,972.0,972.0,1
HCPCS,S3870,Cgh test developmental delay,,,170.1,385.71,7
HCPCS,S38700,Cgh test developmental delay,,,385.71,385.71,1
HCPCS,S3900,Surface emg,,,82.59,248.13,7
HCPCS,S39000,Surface emg,,,248.13,248.13,1
HCPCS,S3902,Ballistocardiogram,,,16.03,20.24,6
HCPCS,S3904,Masters two step,,,33.85,42.76,6
HCPCS,S4005,Interim labor facility globa,,,506.2,2192.42,4
HCPCS,S40050,Interim labor facility globa,,,506.2,506.2,1
HCPCS,S4011,Ivf package,,,307.33,5574.02,7
HCPCS,S40110,Ivf package,,,5574.02,5574.02,1
HCPCS,S4013,Compl gift case rate,,,307.33,388.2,6
HCPCS,S4014,Compl zift case rate,,,307.33,2556.53,7
HCPCS,S40140,Compl zift case rate,,,2556.53,2556.53,1
HCPCS,S4015,Complete ivf nos case rate,,,307.33,8235.08,9
HCPCS,S4016,Frozen ivf case rate,,,307.33,4396.78,10
HCPCS,S40160,Frozen ivf case rate,,,3414.4,3414.4,1
HCPCS,S4017,Ivf canc a stim case rate,,,307.33,1240.68,10
HCPCS,S40170,Ivf canc a stim case rate,,,1240.68,1240.68,1
HCPCS,S4018,F emb trns canc case rate,,,307.33,2008.19,10
HCPCS,S40180,F emb trns canc case rate,,,649.75,649.75,1
HCPCS,S4020,Ivf canc b4 aspir case rate,,,307.33,2597.67,10
HCPCS,S40200,Ivf canc b4 aspir case rate,,,1695.25,1695.25,1
HCPCS,S4021,Ivf canc aftr aspr case rate,,,307.33,9041.28,10
HCPCS,S40210,Ivf canc aftr aspr case rate,,,4956.53,4956.53,1
HCPCS,S4022,Asst oocyte fert case rate,,,307.33,1231.03,10
HCPCS,S40220,Asst oocyte fert case rate,,,803.62,803.62,1
HCPCS,S4023,Incompl donor egg case rate,,,307.33,5685.18,7
HCPCS,S40230,Incompl donor egg case rate,,,5685.18,5685.18,1
HCPCS,S4024,Air polymer foam per study,,,964.22,2446.27,4
HCPCS,S40240,Air polymer foam per study,,,964.22,964.22,1
HCPCS,S4025,Donor serv ivf case rate,,,307.33,7218.72,10
HCPCS,S40250,Donor serv ivf case rate,,,2498.28,2498.28,1
HCPCS,S4026,Procure donor sperm,,,59.1,1521.14,10
HCPCS,S40260,Procure donor sperm,,,387.29,387.29,1
HCPCS,S4027,Store prev froz embryos,,,20.97,74.65,10
HCPCS,S40270,Store prev froz embryos,,,20.97,20.97,1
HCPCS,S4028,Microsurg epi sperm asp,,,307.33,1970.84,10
HCPCS,S40280,Microsurg epi sperm asp,,,1970.84,1970.84,1
HCPCS,S4030,Sperm procure init visit,,,307.33,702.0,7
HCPCS,S40300,Sperm procure init visit,,,702.0,702.0,1
HCPCS,S4031,Sperm procure subs visit,,,307.33,8413.2,7
HCPCS,S40310,Sperm procure subs visit,,,8413.2,8413.2,1
HCPCS,S4035,Stimulated iui case rate,,,307.33,2135.38,10
HCPCS,S40350,Stimulated iui case rate,,,2135.38,2135.38,1
HCPCS,S4037,Cryo embryo transf case rate,,,307.33,3623.93,10
HCPCS,S40370,Cryo embryo transf case rate,,,2094.17,2094.17,1
HCPCS,S4040,Monit store cryo embryo 30 d,,,9.67,74.65,10
HCPCS,S40400,Monit store cryo embryo 30 d,,,23.91,23.91,1
HCPCS,S4042,Ovulation mgmt per cycle,,,75.64,292.36,10
HCPCS,S40420,Ovulation mgmt per cycle,,,100.22,100.22,1
HCPCS,S4981,Insert levonorgestrel ius,,,21.01,167.33,10
HCPCS,S49810,Insert levonorgestrel ius,,,69.01,69.01,1
HCPCS,S4989,Contracept iud,,,136.81,345.3,10
HCPCS,S49890,Contracept iud,,,306.99,306.99,1
HCPCS,S4990,Nicotine patch legend,,,2.18,5.53,4
HCPCS,S49900,Nicotine patch legend,,,2.18,2.18,1
HCPCS,S4991,Nicotine patch nonlegend,,,2.06,5.23,4
HCPCS,S49910,Nicotine patch nonlegend,,,2.06,2.06,1
HCPCS,S4993,Contraceptive pills for bc,,,1.19,3.86,7
HCPCS,S49930,Contraceptive pills for bc,,,1.19,1.19,1
HCPCS,S4995,Smoking cessation gum,,,0.37,0.93,4
HCPCS,S49950,Smoking cessation gum,,,0.37,0.37,1
HCPCS,S5010,5% DEXTROSE AND 0.45% SALINE,23.0,14.95,9.32,23.0,13
HCPCS,S5010,5% dextrose and 0.45% saline,,,8.99,22.8,7
HCPCS,S50100,5% dextrose and 0.45% saline,,,8.99,8.99,1
HCPCS,S5012,5% dextrose with potassium,,,4.92,12.49,7
HCPCS,S50120,5% dextrose with potassium,,,4.92,4.92,1
HCPCS,S5035,Hit routine device maint,,,140.4,140.4,1
HCPCS,S50350,Hit routine device maint,,,140.4,140.4,1
HCPCS,S5100,Adult daycare services 15min,,,3.45,3.45,1
HCPCS,S51000,Adult daycare services 15min,,,3.45,3.45,1
HCPCS,S5101,Adult day care per half day,,,76.29,76.29,1
HCPCS,S51010,Adult day care per half day,,,76.29,76.29,1
HCPCS,S5102,Adult day care per diem,,,54.0,54.0,1
HCPCS,S51020,Adult day care per diem,,,54.0,54.0,1
HCPCS,S5105,Centerbased day care perdiem,,,99.21,99.21,1
HCPCS,S51050,Centerbased day care perdiem,,,99.21,99.21,1
HCPCS,S5108,Homecare train pt 15 min,,,18.31,18.31,1
HCPCS,S51080,Homecare train pt 15 min,,,18.31,18.31,1
HCPCS,S5109,Homecare train pt session,,,223.3,223.3,1
HCPCS,S51090,Homecare train pt session,,,223.3,223.3,1
HCPCS,S5110,Family homecare training 15m,,,3.22,3.22,1
HCPCS,S51100,Family homecare training 15m,,,3.22,3.22,1
HCPCS,S5111,Family homecare train/sessio,,,128.53,128.53,1
HCPCS,S51110,Family homecare train/sessio,,,128.53,128.53,1
HCPCS,S5115,Nonfamily homecare train/15m,,,12.96,12.96,1
HCPCS,S51150,Nonfamily homecare train/15m,,,12.96,12.96,1
HCPCS,S5116,Nonfamily hc train/session,,,23.9,23.9,1
HCPCS,S51160,Nonfamily hc train/session,,,23.9,23.9,1
HCPCS,S5120,Chore services per 15 min,,,12.12,12.12,1
HCPCS,S51200,Chore services per 15 min,,,12.12,12.12,1
HCPCS,S5121,Chore services per diem,,,270.13,270.13,1
HCPCS,S51210,Chore services per diem,,,270.13,270.13,1
HCPCS,S5125,Attendant care service /15m,,,0.15,0.15,1
HCPCS,S51250,Attendant care service /15m,,,0.15,0.15,1
HCPCS,S5126,Attendant care service /diem,,,101.36,101.36,1
HCPCS,S51260,Attendant care service /diem,,,101.36,101.36,1
HCPCS,S5135,Adult companioncare per 15m,,,8.23,8.23,1
HCPCS,S51350,Adult companioncare per 15m,,,8.23,8.23,1
HCPCS,S5136,Adult companioncare per diem,,,352.2,352.2,1
HCPCS,S51360,Adult companioncare per diem,,,352.2,352.2,1
HCPCS,S5140,Adult foster care per diem,,,98.38,98.38,1
HCPCS,S51400,Adult foster care per diem,,,98.38,98.38,1
HCPCS,S5141,Adult foster care per month,,,1713.96,1713.96,1
HCPCS,S51410,Adult foster care per month,,,1713.96,1713.96,1
HCPCS,S5145,Child fostercare th per diem,,,97.18,97.18,1
HCPCS,S51450,Child fostercare th per diem,,,97.18,97.18,1
HCPCS,S5150,Unskilled respite care /15m,,,2.59,2.59,1
HCPCS,S51500,Unskilled respite care /15m,,,2.59,2.59,1
HCPCS,S5151,Unskilled respitecare /diem,,,330.76,330.76,1
HCPCS,S51510,Unskilled respitecare /diem,,,330.76,330.76,1
HCPCS,S5160,Emer response sys instal&tst,,,41.6,41.6,1
HCPCS,S51600,Emer response sys instal&tst,,,41.6,41.6,1
HCPCS,S5161,Emer rspns sys serv permonth,,,33.25,33.25,1
HCPCS,S51610,Emer rspns sys serv permonth,,,33.25,33.25,1
HCPCS,S5162,Emer rspns system purchase,,,415.79,415.79,1
HCPCS,S51620,Emer rspns system purchase,,,415.79,415.79,1
HCPCS,S5165,Home modifications per serv,,,313.03,313.03,1
HCPCS,S51650,Home modifications per serv,,,313.03,313.03,1
HCPCS,S5170,Homedelivered prepared meal,,,7.64,7.64,1
HCPCS,S51700,Homedelivered prepared meal,,,7.64,7.64,1
HCPCS,S5175,"Laundry serv,ext,prof,/order",,,25.01,25.01,1
HCPCS,S51750,"Laundry serv,ext,prof,/order",,,25.01,25.01,1
HCPCS,S5180,Hh respiratory thrpy in eval,,,34.73,34.73,1
HCPCS,S51800,Hh respiratory thrpy in eval,,,34.73,34.73,1
HCPCS,S5185,Med reminder serv per month,,,55.88,55.88,1
HCPCS,S51850,Med reminder serv per month,,,55.88,55.88,1
HCPCS,S5190,Wellness assessment by nonph,,,105.41,105.41,1
HCPCS,S51900,Wellness assessment by nonph,,,105.41,105.41,1
HCPCS,S5497,Hit cath care noc,,,3.24,3.24,1
HCPCS,S54970,Hit cath care noc,,,3.24,3.24,1
HCPCS,S5498,Hit simple cath care,,,2.16,2.16,1
HCPCS,S54980,Hit simple cath care,,,2.16,2.16,1
HCPCS,S5501,Hit complex cath care,,,3.24,31.63,4
HCPCS,S55010,Hit complex cath care,,,3.24,3.24,1
HCPCS,S5502,Hit interim cath care,,,3.24,41.44,4
HCPCS,S55020,Hit interim cath care,,,3.24,3.24,1
HCPCS,S5517,Hit declotting kit,,,21.6,95.47,4
HCPCS,S55170,Hit declotting kit,,,21.6,21.6,1
HCPCS,S5518,Hit cath repair kit,,,25.92,25.92,1
HCPCS,S55180,Hit cath repair kit,,,25.92,25.92,1
HCPCS,S5520,Hit picc insert kit,,,3.63,27.0,4
HCPCS,S55200,Hit picc insert kit,,,27.0,27.0,1
HCPCS,S5521,Hit midline cath insert kit,,,10.8,10.8,1
HCPCS,S55210,Hit midline cath insert kit,,,10.8,10.8,1
HCPCS,S5522,Hit picc insert no supp,,,54.0,54.0,1
HCPCS,S55220,Hit picc insert no supp,,,54.0,54.0,1
HCPCS,S5523,Hip midline cath insert kit,,,54.0,54.0,1
HCPCS,S55230,Hip midline cath insert kit,,,54.0,54.0,1
HCPCS,S5550,Insulin rapid 5 u,,,0.24,0.6,7
HCPCS,S55500,Insulin rapid 5 u,,,0.24,0.24,1
HCPCS,S5551,Insulin most rapid 5 u,,,0.37,0.93,7
HCPCS,S55510,Insulin most rapid 5 u,,,0.37,0.37,1
HCPCS,S5552,Insulin intermed 5 u,,,0.24,0.6,7
HCPCS,S55520,Insulin intermed 5 u,,,0.24,0.24,1
HCPCS,S5553,Insulin long acting 5 u,,,0.6,1.53,7
HCPCS,S55530,Insulin long acting 5 u,,,0.6,0.6,1
HCPCS,S5561,Insulin reuse pen 3 ml,,,44.41,112.67,7
HCPCS,S55610,Insulin reuse pen 3 ml,,,44.41,44.41,1
HCPCS,S5566,Insulin cartridge 300 u,,,27.86,70.69,7
HCPCS,S55660,Insulin cartridge 300 u,,,27.86,27.86,1
HCPCS,S5570,Insulin dispos pen 1.5 ml,,,103.68,263.04,7
HCPCS,S55700,Insulin dispos pen 1.5 ml,,,103.68,103.68,1
HCPCS,S5571,Insulin dispos pen 3 ml,,,32.98,83.68,7
HCPCS,S55710,Insulin dispos pen 3 ml,,,32.98,32.98,1
HCPCS,S8030,Tantalum ring application,,,22.54,757.19,7
HCPCS,S80300,Tantalum ring application,,,22.54,22.54,1
HCPCS,S8035,Magnetic source imaging,,,97.2,183.74,7
HCPCS,S80350,Magnetic source imaging,,,97.2,97.2,1
HCPCS,S8037,Mrcp,,,285.23,445.94,11
HCPCS,S80370,Mrcp,,,445.94,445.94,1
HCPCS,S8037TC,Mrcp,,,445.94,445.94,1
HCPCS,S8040,Topographic brain mapping,,,170.94,456.18,10
HCPCS,S80400,Topographic brain mapping,,,170.94,170.94,1
HCPCS,S8042,Mri low field,,,145.46,874.8,8
HCPCS,S80420,Mri low field,,,874.8,874.8,1
HCPCS,S8042TC,Mri low field,,,874.8,874.8,1
HCPCS,S8055,Us guidance fetal reduct,,,65.54,204.99,9
HCPCS,S8080,Scintimammography,,,37.8,284.42,7
HCPCS,S80800,Scintimammography,,,37.8,37.8,1
HCPCS,S8085,Fluorine-18 fluorodeoxygluco,,,859.52,1296.0,8
HCPCS,S80850,Fluorine-18 fluorodeoxygluco,,,1296.0,1296.0,1
HCPCS,S8085TC,Fluorine-18 fluorodeoxygluco,,,1296.0,1296.0,1
HCPCS,S8092,Electron beam computed tomog,,,137.74,307.8,11
HCPCS,S80920,Electron beam computed tomog,,,307.8,307.8,1
HCPCS,S8092TC,Electron beam computed tomog,,,307.8,307.8,1
HCPCS,S8096,Portable peak flow meter,,,8.48,30.3,4
HCPCS,S80960,Portable peak flow meter,,,30.3,30.3,1
HCPCS,S8097,Asthma kit,,,4.74,17.28,4
HCPCS,S80970,Asthma kit,,,17.28,17.28,1
HCPCS,S8100,Spacer without mask,,,5.4,131.5,10
HCPCS,S81000,Spacer without mask,,,5.4,5.4,1
HCPCS,S8100NU,Spacer without mask,,,121.34,131.5,3
HCPCS,S8100UE,Spacer without mask,,,91.01,98.62,3
HCPCS,S8101,Spacer with mask,,,5.4,9.72,4
HCPCS,S81010,Spacer with mask,,,5.4,5.4,1
HCPCS,S8110,Peak expiratory flow rate (p,,,5.57,49.04,10
HCPCS,S81100,Peak expiratory flow rate (p,,,15.12,15.12,1
HCPCS,S8120,O2 contents gas cubic ft,,,1.08,8.63,4
HCPCS,S81200,O2 contents gas cubic ft,,,1.08,1.08,1
HCPCS,S8121,O2 contents liquid lb,,,1.08,2.89,4
HCPCS,S81210,O2 contents liquid lb,,,1.08,1.08,1
HCPCS,S8130,Interferential stim 2 chan,,,2322.0,2322.0,1
HCPCS,S81300,Interferential stim 2 chan,,,2322.0,2322.0,1
HCPCS,S8131,Interferential stim 4 chan,,,50.76,50.76,1
HCPCS,S81310,Interferential stim 4 chan,,,50.76,50.76,1
HCPCS,S8185,Flutter device,,,2.66,41.07,4
HCPCS,S81850,Flutter device,,,2.66,2.66,1
HCPCS,S8186,Swivel adaptor,,,3.99,9.87,10
HCPCS,S81860,Swivel adaptor,,,3.99,3.99,1
HCPCS,S8186NU,Swivel adaptor,,,9.11,9.87,3
HCPCS,S8186UE,Swivel adaptor,,,6.83,7.4,3
HCPCS,S8189,Trach supply noc,,,12.35,13.38,3
HCPCS,S8210,Mucus trap,,,7.56,7.56,1
HCPCS,S82100,Mucus trap,,,7.56,7.56,1
HCPCS,S8265,Haberman feeder,,,59.51,59.51,1
HCPCS,S82650,Haberman feeder,,,59.51,59.51,1
HCPCS,S8270,Enuresis alarm,,,58.98,306.56,4
HCPCS,S82700,Enuresis alarm,,,306.56,306.56,1
HCPCS,S8415,Supplies for home delivery,,,59.82,336.13,4
HCPCS,S84150,Supplies for home delivery,,,336.13,336.13,1
HCPCS,S8420,Custom gradient sleev/glov,,,8.24,426.94,4
HCPCS,S84200,Custom gradient sleev/glov,,,8.24,8.24,1
HCPCS,S8421,Ready gradient sleev/glov,,,95.68,103.69,4
HCPCS,S84210,Ready gradient sleev/glov,,,96.52,96.52,1
HCPCS,S8422,Custom grad sleeve med,,,89.69,121.98,4
HCPCS,S84220,Custom grad sleeve med,,,89.69,89.69,1
HCPCS,S8423,Custom grad sleeve heavy,,,20.92,146.38,4
HCPCS,S84230,Custom grad sleeve heavy,,,20.92,20.92,1
HCPCS,S8424,Ready gradient sleeve,,,30.14,48.79,4
HCPCS,S84240,Ready gradient sleeve,,,30.14,30.14,1
HCPCS,S8425,Custom grad glove med,,,73.77,182.97,4
HCPCS,S84250,Custom grad glove med,,,73.77,73.77,1
HCPCS,S8426,Custom grad glove heavy,,,3.95,243.97,4
HCPCS,S84260,Custom grad glove heavy,,,3.95,3.95,1
HCPCS,S8427,Ready gradient glove,,,25.05,42.69,4
HCPCS,S84270,Ready gradient glove,,,25.05,25.05,1
HCPCS,S8428,Ready gradient gauntlet,,,34.56,73.19,4
HCPCS,S84280,Ready gradient gauntlet,,,34.56,34.56,1
HCPCS,S8429,Gradient pressure wrap,,,15.4,355.09,4
HCPCS,S84290,Gradient pressure wrap,,,15.4,15.4,1
HCPCS,S8430,Padding for comprssn bdg,,,26.21,28.57,4
HCPCS,S84300,Padding for comprssn bdg,,,28.57,28.57,1
HCPCS,S8431,Compression bandage,,,11.26,16.7,4
HCPCS,S84310,Compression bandage,,,16.7,16.7,1
HCPCS,S8450,Splint digit,,,10.11,10.11,1
HCPCS,S84500,Splint digit,,,10.11,10.11,1
HCPCS,S8451,Splint wrist or ankle,,,11.88,11.88,1
HCPCS,S84510,Splint wrist or ankle,,,11.88,11.88,1
HCPCS,S8452,Splint elbow,,,28.0,28.0,1
HCPCS,S84520,Splint elbow,,,28.0,28.0,1
HCPCS,S8460,Camisole post-mast,,,178.31,178.31,1
HCPCS,S84600,Camisole post-mast,,,178.31,178.31,1
HCPCS,S8490,100 insulin syringes,,,33.87,85.93,4
HCPCS,S84900,100 insulin syringes,,,33.87,33.87,1
HCPCS,S8930,Auricular electrostimulation,,,7.25,104.33,10
HCPCS,S89300,Auricular electrostimulation,,,43.07,43.07,1
HCPCS,S8940,Hippotherapy per session,,,17.96,105.49,7
HCPCS,S89400,Hippotherapy per session,,,105.49,105.49,1
HCPCS,S8948,Low-level laser trmt 15 min,,,2.34,22.69,10
HCPCS,S89480,Low-level laser trmt 15 min,,,22.09,22.09,1
HCPCS,S8950,"Complex lymphedema therapy,",,,17.96,53.67,10
HCPCS,S89500,"Complex lymphedema therapy,",,,21.34,21.34,1
HCPCS,S8990,Pt or manip for maint,,,17.96,34.1,10
HCPCS,S89900,Pt or manip for maint,,,34.1,34.1,1
HCPCS,S8999,Resuscitation bag,,,28.67,41.42,9
HCPCS,S8999NU,Resuscitation bag,,,38.22,41.42,3
HCPCS,S8999UE,Resuscitation bag,,,28.67,31.06,3
HCPCS,S9001,Home uterine monitor with or,,,135.0,135.0,1
HCPCS,S90010,Home uterine monitor with or,,,135.0,135.0,1
HCPCS,S9024,Paranasal sinus ultrasound,,,66.35,493.31,10
HCPCS,S90240,Paranasal sinus ultrasound,,,493.31,493.31,1
HCPCS,S9025,Omnicardiogram/cardiointegra,,,16.03,81.0,7
HCPCS,S90250,Omnicardiogram/cardiointegra,,,81.0,81.0,1
HCPCS,S9034,Eswl for gallstones,,,189.0,1845.95,7
HCPCS,S90340,Eswl for gallstones,,,189.0,189.0,1
HCPCS,S9055,Procuren or other growth fac,,,397.65,774.94,7
HCPCS,S90550,Procuren or other growth fac,,,397.65,397.65,1
HCPCS,S9061,Medical supplies and equipme,,,14.74,27.0,4
HCPCS,S90610,Medical supplies and equipme,,,27.0,27.0,1
HCPCS,S9083,Urgent care center global,,,97.2,162.0,4
HCPCS,S90830,Urgent care center global,,,97.2,97.2,1
HCPCS,S9088,Services provided in urgent,,,5.49,10.76,4
HCPCS,S90880,Services provided in urgent,,,10.76,10.76,1
HCPCS,S9090,Vertebral axial decompressio,,,4.76,22.69,10
HCPCS,S90900,Vertebral axial decompressio,,,21.11,21.11,1
HCPCS,S9097,Home visit wound care,,,86.4,86.4,1
HCPCS,S90970,Home visit wound care,,,86.4,86.4,1
HCPCS,S9098,Home phototherapy visit,,,97.2,97.2,1
HCPCS,S90980,Home phototherapy visit,,,97.2,97.2,1
HCPCS,S9110,Telemonitoring/home per mnth,,,25.11,43.36,7
HCPCS,S91100,Telemonitoring/home per mnth,,,25.11,25.11,1
HCPCS,S9117,Back school visit,,,21.09,21.09,1
HCPCS,S91170,Back school visit,,,21.09,21.09,1
HCPCS,S9122,Home health aide or certifie,,,16.2,16.2,1
HCPCS,S91220,Home health aide or certifie,,,16.2,16.2,1
HCPCS,S9123,Nursing care in home rn,,,32.4,37.76,4
HCPCS,S91230,Nursing care in home rn,,,32.4,32.4,1
HCPCS,S9124,"Nursing care, in the home; b",,,27.98,32.4,4
HCPCS,S91240,"Nursing care, in the home; b",,,32.4,32.4,1
HCPCS,S9125,"Respite care, in the home, p",,,59.4,59.4,1
HCPCS,S91250,"Respite care, in the home, p",,,59.4,59.4,1
HCPCS,S9126,"Hospice care, in the home, p",,,59.4,151.89,4
HCPCS,S91260,"Hospice care, in the home, p",,,59.4,59.4,1
HCPCS,S9127,"Social work visit, in the ho",,,54.0,216.56,4
HCPCS,S91270,"Social work visit, in the ho",,,54.0,54.0,1
HCPCS,S9128,"Speech therapy, in the home,",,,33.9,153.0,4
HCPCS,S91280,"Speech therapy, in the home,",,,33.9,33.9,1
HCPCS,S9129,"Occupational therapy, in the",,,111.1,1005.53,4
HCPCS,S91290,"Occupational therapy, in the",,,111.1,111.1,1
HCPCS,S9131,Pt in the home per diem,,,87.79,219.42,4
HCPCS,S91310,Pt in the home per diem,,,87.79,87.79,1
HCPCS,S9140,"Diabetic management program,",,,21.6,86.4,10
HCPCS,S91400,"Diabetic management program,",,,21.6,21.6,1
HCPCS,S9141,"Diabetic management program,",,,27.0,89.59,10
HCPCS,S91410,"Diabetic management program,",,,27.0,27.0,1
HCPCS,S9145,Insulin pump initiation,,,10.8,59.73,10
HCPCS,S91450,Insulin pump initiation,,,10.8,10.8,1
HCPCS,S9150,Evaluation by ocularist,,,235.74,235.74,1
HCPCS,S91500,Evaluation by ocularist,,,235.74,235.74,1
HCPCS,S9152,"Speech therapy, re-eval",,,24.9,226.37,10
HCPCS,S91520,"Speech therapy, re-eval",,,64.85,64.85,1
HCPCS,S9208,Home mgmt preterm labor,,,54.0,54.0,1
HCPCS,S92080,Home mgmt preterm labor,,,54.0,54.0,1
HCPCS,S9209,Home mgmt pprom,,,49.65,49.65,1
HCPCS,S92090,Home mgmt pprom,,,49.65,49.65,1
HCPCS,S9211,Home mgmt gest hypertension,,,54.0,54.0,1
HCPCS,S92110,Home mgmt gest hypertension,,,54.0,54.0,1
HCPCS,S9212,Hm postpar hyper per diem,,,54.0,54.0,1
HCPCS,S92120,Hm postpar hyper per diem,,,54.0,54.0,1
HCPCS,S9213,Hm preeclamp per diem,,,54.0,88.82,4
HCPCS,S92130,Hm preeclamp per diem,,,54.0,54.0,1
HCPCS,S9214,Hm gest dm per diem,,,31.14,54.0,4
HCPCS,S92140,Hm gest dm per diem,,,54.0,54.0,1
HCPCS,S9325,Hit pain mgmt per diem,,,27.0,137.86,4
HCPCS,S93250,Hit pain mgmt per diem,,,27.0,27.0,1
HCPCS,S9326,Hit cont pain per diem,,,23.76,23.76,1
HCPCS,S93260,Hit cont pain per diem,,,23.76,23.76,1
HCPCS,S9327,Hit int pain per diem,,,10.8,10.8,1
HCPCS,S93270,Hit int pain per diem,,,10.8,10.8,1
HCPCS,S9328,Hit pain imp pump diem,,,23.76,55.39,4
HCPCS,S93280,Hit pain imp pump diem,,,23.76,23.76,1
HCPCS,S9329,Hit chemo per diem,,,36.29,200.52,4
HCPCS,S93290,Hit chemo per diem,,,36.29,36.29,1
HCPCS,S9330,Hit cont chem diem,,,23.76,23.76,1
HCPCS,S93300,Hit cont chem diem,,,23.76,23.76,1
HCPCS,S9331,Hit intermit chemo diem,,,10.8,10.8,1
HCPCS,S93310,Hit intermit chemo diem,,,10.8,10.8,1
HCPCS,S9335,Ht hemodialysis diem,,,97.2,714.7,7
HCPCS,S93350,Ht hemodialysis diem,,,97.2,97.2,1
HCPCS,S9336,Hit cont anticoag diem,,,23.76,23.76,1
HCPCS,S93360,Hit cont anticoag diem,,,23.76,23.76,1
HCPCS,S9338,Hit immunotherapy diem,,,23.76,23.76,1
HCPCS,S93380,Hit immunotherapy diem,,,23.76,23.76,1
HCPCS,S9339,Hit periton dialysis diem,,,21.6,714.7,7
HCPCS,S93390,Hit periton dialysis diem,,,21.6,21.6,1
HCPCS,S9340,Hit enteral per diem,,,6.48,6.48,1
HCPCS,S93400,Hit enteral per diem,,,6.48,6.48,1
HCPCS,S9341,Hit enteral grav diem,,,2.16,2.16,1
HCPCS,S93410,Hit enteral grav diem,,,2.16,2.16,1
HCPCS,S9342,Hit enteral pump diem,,,4.32,4.32,1
HCPCS,S93420,Hit enteral pump diem,,,4.32,4.32,1
HCPCS,S9343,Hit enteral bolus nurs,,,4.49,4.49,1
HCPCS,S93430,Hit enteral bolus nurs,,,4.49,4.49,1
HCPCS,S9345,Hit anti-hemophil diem,,,27.0,27.0,1
HCPCS,S93450,Hit anti-hemophil diem,,,27.0,27.0,1
HCPCS,S9346,Hit alpha-1-proteinas diem,,,27.0,27.0,1
HCPCS,S93460,Hit alpha-1-proteinas diem,,,27.0,27.0,1
HCPCS,S9347,Hit longterm infusion diem,,,27.0,27.0,1
HCPCS,S93470,Hit longterm infusion diem,,,27.0,27.0,1
HCPCS,S9348,Hit sympathomim diem,,,27.0,27.0,1
HCPCS,S93480,Hit sympathomim diem,,,27.0,27.0,1
HCPCS,S9349,Hit tocolysis diem,,,27.0,27.0,1
HCPCS,S93490,Hit tocolysis diem,,,27.0,27.0,1
HCPCS,S9351,Hit cont antiemetic diem,,,27.0,27.0,1
HCPCS,S93510,Hit cont antiemetic diem,,,27.0,27.0,1
HCPCS,S9353,Hit cont insulin diem,,,27.0,27.0,1
HCPCS,S93530,Hit cont insulin diem,,,27.0,27.0,1
HCPCS,S9355,Hit chelation diem,,,27.0,27.0,1
HCPCS,S93550,Hit chelation diem,,,27.0,27.0,1
HCPCS,S9357,Hit enzyme replace diem,,,27.0,27.0,1
HCPCS,S93570,Hit enzyme replace diem,,,27.0,27.0,1
HCPCS,S9359,Hit anti-tnf per diem,,,27.0,68.18,4
HCPCS,S93590,Hit anti-tnf per diem,,,27.0,27.0,1
HCPCS,S9361,Hit diuretic infus diem,,,27.0,27.0,1
HCPCS,S93610,Hit diuretic infus diem,,,27.0,27.0,1
HCPCS,S9363,Hit anti-spasmotic diem,,,27.0,27.0,1
HCPCS,S93630,Hit anti-spasmotic diem,,,27.0,27.0,1
HCPCS,S9364,Hit tpn total diem,,,54.0,54.0,1
HCPCS,S93640,Hit tpn total diem,,,54.0,54.0,1
HCPCS,S9365,Hit tpn 1 liter diem,,,54.0,54.0,1
HCPCS,S93650,Hit tpn 1 liter diem,,,54.0,54.0,1
HCPCS,S9366,Hit tpn 2 liter diem,,,54.0,54.0,1
HCPCS,S93660,Hit tpn 2 liter diem,,,54.0,54.0,1
HCPCS,S9367,Hit tpn 3 liter diem,,,54.0,54.0,1
HCPCS,S93670,Hit tpn 3 liter diem,,,54.0,54.0,1
HCPCS,S9368,Hit tpn over 3l diem,,,54.0,54.0,1
HCPCS,S93680,Hit tpn over 3l diem,,,54.0,54.0,1
HCPCS,S9370,Ht inj antiemetic diem,,,10.8,95.54,7
HCPCS,S93700,Ht inj antiemetic diem,,,10.8,10.8,1
HCPCS,S9372,Ht inj anticoag diem,,,10.8,95.54,7
HCPCS,S93720,Ht inj anticoag diem,,,10.8,10.8,1
HCPCS,S9373,Hit hydra total diem,,,27.0,27.0,1
HCPCS,S93730,Hit hydra total diem,,,27.0,27.0,1
HCPCS,S9374,Hit hydra 1 liter diem,,,27.0,102.81,4
HCPCS,S93740,Hit hydra 1 liter diem,,,27.0,27.0,1
HCPCS,S9375,Hit hydra 2 liter diem,,,27.0,27.0,1
HCPCS,S93750,Hit hydra 2 liter diem,,,27.0,27.0,1
HCPCS,S9376,Hit hydra 3 liter diem,,,27.0,27.0,1
HCPCS,S93760,Hit hydra 3 liter diem,,,27.0,27.0,1
HCPCS,S9377,Hit hydra over 3l diem,,,27.0,27.0,1
HCPCS,S93770,Hit hydra over 3l diem,,,27.0,27.0,1
HCPCS,S9379,Hit noc per diem,,,27.0,68.51,4
HCPCS,S93790,Hit noc per diem,,,27.0,27.0,1
HCPCS,S9381,Hit high risk/escort,,,432.0,432.0,1
HCPCS,S93810,Hit high risk/escort,,,432.0,432.0,1
HCPCS,S9401,Anticoag clinic per session,,,11.69,37.23,4
HCPCS,S94010,Anticoag clinic per session,,,37.23,37.23,1
HCPCS,S9430,Pharmacy comp/disp serv,,,0.01,57.52,4
HCPCS,S94300,Pharmacy comp/disp serv,,,0.01,0.01,1
HCPCS,S9432,Med food non inborn err meta,,,28.08,28.08,1
HCPCS,S94320,Med food non inborn err meta,,,28.08,28.08,1
HCPCS,S9433,Medical food oral 100% nutr,,,39.7,39.7,1
HCPCS,S94330,Medical food oral 100% nutr,,,39.7,39.7,1
HCPCS,S9434,Mod solid food suppl,,,9.72,9.72,1
HCPCS,S94340,Mod solid food suppl,,,9.72,9.72,1
HCPCS,S9435,Medical foods for inborn err,,,8.64,8.64,1
HCPCS,S94350,Medical foods for inborn err,,,8.64,8.64,1
HCPCS,S9436,Lamaze class,,,41.57,155.46,7
HCPCS,S94360,Lamaze class,,,155.46,155.46,1
HCPCS,S9437,Childbirth refresher class,,,41.57,54.0,7
HCPCS,S94370,Childbirth refresher class,,,54.0,54.0,1
HCPCS,S9438,Cesarean birth class,,,41.57,108.0,7
HCPCS,S94380,Cesarean birth class,,,108.0,108.0,1
HCPCS,S9439,Vbac class,,,41.57,52.51,6
HCPCS,S9441,Asthma education,,,0.14,52.51,10
HCPCS,S94410,Asthma education,,,21.1,21.1,1
HCPCS,S9442,Birthing class,,,41.57,193.32,7
HCPCS,S94420,Birthing class,,,193.32,193.32,1
HCPCS,S9443,Lactation class,,,41.57,111.55,10
HCPCS,S94430,Lactation class,,,77.22,77.22,1
HCPCS,S9444,Parenting class,,,41.57,109.08,7
HCPCS,S94440,Parenting class,,,109.08,109.08,1
HCPCS,S9445,Pt education noc individ,,,41.57,152.75,9
HCPCS,S9446,Pt education noc group,,,25.5,32.21,6
HCPCS,S9447,Infant safety class,,,41.57,52.51,7
HCPCS,S94470,Infant safety class,,,47.79,47.79,1
HCPCS,S9449,Weight mgmt class,,,41.57,124.25,7
HCPCS,S94490,Weight mgmt class,,,124.25,124.25,1
HCPCS,S9451,Exercise class,,,41.57,52.51,7
HCPCS,S94510,Exercise class,,,47.98,47.98,1
HCPCS,S9452,Nutrition class,,,6.08,32.21,7
HCPCS,S94520,Nutrition class,,,6.08,6.08,1
HCPCS,S9453,Smoking cessation class,,,12.84,16.22,7
HCPCS,S94530,Smoking cessation class,,,16.2,16.2,1
HCPCS,S9454,Stress mgmt class,,,41.57,66.97,7
HCPCS,S94540,Stress mgmt class,,,66.97,66.97,1
HCPCS,S9455,"Diabetic management program,",,,16.2,32.21,7
HCPCS,S94550,"Diabetic management program,",,,16.2,16.2,1
HCPCS,S9460,DM CGM-DIAGNOSTIC,279.0,181.35,139.5,279.0,12
HCPCS,S9460,"Diabetic management program,",,,27.0,32.17,4
HCPCS,S94600,"Diabetic management program,",,,27.0,27.0,1
HCPCS,S9465,DM MGMT X20 DIETICIAN VISIT,279.0,181.35,139.5,279.0,12
HCPCS,S9465,"Diabetic management program,",,,27.0,172.97,10
HCPCS,S94650,"Diabetic management program,",,,27.0,27.0,1
HCPCS,S9470,"Nutritional counseling, diet",,,19.39,172.97,10
HCPCS,S94700,"Nutritional counseling, diet",,,27.0,27.0,1
HCPCS,S9472,Cardiac rehabilitation progr,,,92.65,117.04,7
HCPCS,S94720,Cardiac rehabilitation progr,,,93.11,93.11,1
HCPCS,S9473,Pulmonary rehabilitation pro,,,22.83,43.2,7
HCPCS,S94730,Pulmonary rehabilitation pro,,,43.2,43.2,1
HCPCS,S9474,Enterostomal therapy by a re,,,54.0,54.0,1
HCPCS,S94740,Enterostomal therapy by a re,,,54.0,54.0,1
HCPCS,S9475,Ambulatory setting substance,,,74.83,460.04,10
HCPCS,S94750,Ambulatory setting substance,,,74.83,74.83,1
HCPCS,S9476,Vestibular rehab per diem,,,50.16,226.37,10
HCPCS,S94760,Vestibular rehab per diem,,,57.92,57.92,1
HCPCS,S9480,Intensive outpatient psychia,,,135.22,251.1,10
HCPCS,S94800,Intensive outpatient psychia,,,135.22,135.22,1
HCPCS,S9482,Family stabilization 15 min,,,7.39,123.6,7
HCPCS,S94820,Family stabilization 15 min,,,7.39,7.39,1
HCPCS,S9484,Crisis intervention per hour,,,36.1,206.9,10
HCPCS,S94840,Crisis intervention per hour,,,91.57,91.57,1
HCPCS,S9485,Crisis intervention mental h,,,102.75,460.04,10
HCPCS,S94850,Crisis intervention mental h,,,102.75,102.75,1
HCPCS,S9490,Hit corticosteroid/diem,,,27.0,100.26,4
HCPCS,S94900,Hit corticosteroid/diem,,,27.0,27.0,1
HCPCS,S9494,Hit antibiotic total diem,,,27.0,168.17,4
HCPCS,S94940,Hit antibiotic total diem,,,27.0,27.0,1
HCPCS,S9497,Hit antibiotic q3h diem,,,27.0,27.0,1
HCPCS,S94970,Hit antibiotic q3h diem,,,27.0,27.0,1
HCPCS,S9500,Hit antibiotic q24h diem,,,27.0,198.52,4
HCPCS,S95000,Hit antibiotic q24h diem,,,27.0,27.0,1
HCPCS,S9501,Hit antibiotic q12h diem,,,27.0,194.24,4
HCPCS,S95010,Hit antibiotic q12h diem,,,27.0,27.0,1
HCPCS,S9502,Hit antibiotic q8h diem,,,27.0,261.17,4
HCPCS,S95020,Hit antibiotic q8h diem,,,27.0,27.0,1
HCPCS,S9503,Hit antibiotic q6h diem,,,27.0,196.44,4
HCPCS,S95030,Hit antibiotic q6h diem,,,27.0,27.0,1
HCPCS,S9504,Hit antibiotic q4h diem,,,27.0,79.71,4
HCPCS,S95040,Hit antibiotic q4h diem,,,27.0,27.0,1
HCPCS,S9529,Venipuncture home/snf,,,2.16,3.18,7
HCPCS,S95290,Venipuncture home/snf,,,2.16,2.16,1
HCPCS,S9537,Ht hem horm inj diem,,,10.8,95.54,7
HCPCS,S95370,Ht hem horm inj diem,,,10.8,10.8,1
HCPCS,S9538,Hit blood products diem,,,10.8,347.94,7
HCPCS,S95380,Hit blood products diem,,,10.8,10.8,1
HCPCS,S9542,Ht inj noc per diem,,,10.8,19.03,4
HCPCS,S95420,Ht inj noc per diem,,,10.8,10.8,1
HCPCS,S9558,Ht inj growth horm diem,,,10.8,95.54,7
HCPCS,S95580,Ht inj growth horm diem,,,10.8,10.8,1
HCPCS,S9559,Hit inj interferon diem,,,10.8,95.54,7
HCPCS,S95590,Hit inj interferon diem,,,10.8,10.8,1
HCPCS,S9560,Ht inj hormone diem,,,10.8,95.54,7
HCPCS,S95600,Ht inj hormone diem,,,10.8,10.8,1
HCPCS,S9562,Ht inj palivizumab/ab diem,,,5.14,95.54,10
HCPCS,S95620,Ht inj palivizumab/ab diem,,,10.8,10.8,1
HCPCS,S9590,Ht irrigation diem,,,10.8,10.8,1
HCPCS,S95900,Ht irrigation diem,,,10.8,10.8,1
HCPCS,S9810,Ht pharm per hour,,,37.8,37.8,1
HCPCS,S98100,Ht pharm per hour,,,37.8,37.8,1
HCPCS,S9900,Christian sci pract visit,,,7.56,7.56,1
HCPCS,S99000,Christian sci pract visit,,,7.56,7.56,1
HCPCS,S9901,Christian sci nurse visit,,,18.49,18.49,1
HCPCS,S99010,Christian sci nurse visit,,,18.49,18.49,1
HCPCS,S9970,Health club membership yr,,,27.76,81.65,4
HCPCS,S99700,Health club membership yr,,,81.65,81.65,1
HCPCS,S9975,Transplant related per diem,,,79.23,79.23,1
HCPCS,S99750,Transplant related per diem,,,79.23,79.23,1
HCPCS,S9976,Lodging per diem,,,75.12,75.12,1
HCPCS,S99760,Lodging per diem,,,75.12,75.12,1
HCPCS,S9977,Meals per diem,,,24.35,24.35,1
HCPCS,S99770,Meals per diem,,,24.35,24.35,1
HCPCS,S9981,Med record copy admin,,,3.29,3.29,1
HCPCS,S99810,Med record copy admin,,,3.29,3.29,1
HCPCS,S9982,Med record copy per page,,,0.3,0.3,1
HCPCS,S99820,Med record copy per page,,,0.3,0.3,1
HCPCS,S9986,Not medically necessary svc,,,3.92,14.46,4
HCPCS,S99860,Not medically necessary svc,,,14.46,14.46,1
HCPCS,S9988,Serv part of phase i trial,,,27.0,27.0,1
HCPCS,S99880,Serv part of phase i trial,,,27.0,27.0,1
HCPCS,S9989,Services outside us,,,26460.0,26460.0,1
HCPCS,S99890,Services outside us,,,26460.0,26460.0,1
HCPCS,S9990,Services provided as part of,,,0.01,6.28,4
HCPCS,S99900,Services provided as part of,,,0.01,0.01,1
HCPCS,S9992,Transportation costs to and,,,0.01,0.01,1
HCPCS,S99920,Transportation costs to and,,,0.01,0.01,1
HCPCS,S9994,Lodging costs (e.g. hotel ch,,,106.79,106.79,1
HCPCS,S99940,Lodging costs (e.g. hotel ch,,,106.79,106.79,1
HCPCS,S9996,Meals for clinical trial par,,,1.08,1.08,1
HCPCS,S99960,Meals for clinical trial par,,,1.08,1.08,1
HCPCS,S9999,Sales tax,,,1.01,1.1,3
HCPCS,T1000,Private duty/independent nsg,,,5.4,6.31,4
HCPCS,T10000,Private duty/independent nsg,,,5.4,5.4,1
HCPCS,T1001,Nursing assessment/evaluatn,,,21.6,21.6,1
HCPCS,T10010,Nursing assessment/evaluatn,,,21.6,21.6,1
HCPCS,T1002,Rn services up to 15 minutes,,,10.8,14.35,4
HCPCS,T10020,Rn services up to 15 minutes,,,10.8,10.8,1
HCPCS,T1003,Lpn/lvn services up to 15min,,,7.2,7.8,4
HCPCS,T10030,Lpn/lvn services up to 15min,,,7.56,7.56,1
HCPCS,T1004,Nsg aide service up to 15min,,,5.4,13.75,4
HCPCS,T10040,Nsg aide service up to 15min,,,5.4,5.4,1
HCPCS,T1005,Respite care service 15 min,,,5.4,5.4,1
HCPCS,T10050,Respite care service 15 min,,,5.4,5.4,1
HCPCS,T1006,Family/couple counseling,,,21.37,155.46,10
HCPCS,T10060,Family/couple counseling,,,155.46,155.46,1
HCPCS,T1007,Treatment plan development,,,49.36,96.23,7
HCPCS,T10070,Treatment plan development,,,96.23,96.23,1
HCPCS,T1009,Child sitting services,,,9.72,9.72,1
HCPCS,T10090,Child sitting services,,,9.72,9.72,1
HCPCS,T1010,Meals when receive services,,,22.43,22.43,1
HCPCS,T10100,Meals when receive services,,,22.43,22.43,1
HCPCS,T1012,Alcohol/substance abuse skil,,,4.6,120.13,10
HCPCS,T10120,Alcohol/substance abuse skil,,,4.6,4.6,1
HCPCS,T1013,Sign lang/oral interpreter,,,4.76,4.76,1
HCPCS,T10130,Sign lang/oral interpreter,,,4.76,4.76,1
HCPCS,T1014,"Telehealth transmit, per min",,,0.01,0.14,4
HCPCS,T10140,"Telehealth transmit, per min",,,0.01,0.01,1
HCPCS,T1015,Clinic service,,,1.23,66.92,4
HCPCS,T10150,Clinic service,,,66.92,66.92,1
HCPCS,T1016,Case management,,,10.2,95.54,7
HCPCS,T10160,Case management,,,10.2,10.2,1
HCPCS,T1017,Targeted case management,,,0.43,95.54,10
HCPCS,T10170,Targeted case management,,,14.52,14.52,1
HCPCS,T1018,School-based iep ser bundled,,,37.22,37.22,1
HCPCS,T10180,School-based iep ser bundled,,,37.22,37.22,1
HCPCS,T1019,Personal care ser per 15 min,,,1.88,1.88,1
HCPCS,T10190,Personal care ser per 15 min,,,1.88,1.88,1
HCPCS,T1020,Personal care ser per diem,,,22.02,22.02,1
HCPCS,T10200,Personal care ser per diem,,,22.02,22.02,1
HCPCS,T1021,Hh aide or cn aide per visit,,,27.0,27.0,1
HCPCS,T10210,Hh aide or cn aide per visit,,,27.0,27.0,1
HCPCS,T1022,Contracted services per day,,,11.57,54.0,4
HCPCS,T10220,Contracted services per day,,,54.0,54.0,1
HCPCS,T1023,Program intake assessment,,,10.8,5416.03,10
HCPCS,T10230,Program intake assessment,,,10.8,10.8,1
HCPCS,T1024,Team evaluation & management,,,10.8,95.54,10
HCPCS,T10240,Team evaluation & management,,,10.8,10.8,1
HCPCS,T1025,"Ped compr care pkg, per diem",,,49.36,118.8,7
HCPCS,T10250,"Ped compr care pkg, per diem",,,118.8,118.8,1
HCPCS,T1026,"Ped compr care pkg, per hour",,,44.06,62.35,7
HCPCS,T10260,"Ped compr care pkg, per hour",,,44.06,44.06,1
HCPCS,T1027,Family training & counseling,,,4.32,4.32,1
HCPCS,T10270,Family training & counseling,,,4.32,4.32,1
HCPCS,T1028,Home environment assessment,,,20.82,52.02,4
HCPCS,T10280,Home environment assessment,,,52.02,52.02,1
HCPCS,T1029,Dwelling lead investigation,,,64.8,64.8,1
HCPCS,T10290,Dwelling lead investigation,,,64.8,64.8,1
HCPCS,T1030,Rn home care per diem,,,145.45,145.45,1
HCPCS,T10300,Rn home care per diem,,,145.45,145.45,1
HCPCS,T1031,Lpn home care per diem,,,43.2,43.2,1
HCPCS,T10310,Lpn home care per diem,,,43.2,43.2,1
HCPCS,T1040,Comm bh clinic svc per diem,,,107.46,460.04,7
HCPCS,T10400,Comm bh clinic svc per diem,,,107.46,107.46,1
HCPCS,T1041,Comm bh clinic svc per month,,,45.19,298.08,7
HCPCS,T10410,Comm bh clinic svc per month,,,298.08,298.08,1
HCPCS,T1502,Medication admin visit,,,2.16,38.77,10
HCPCS,T15020,Medication admin visit,,,2.16,2.16,1
HCPCS,T1503,"Med admin, not oral/inject",,,2.78,38.77,10
HCPCS,T15030,"Med admin, not oral/inject",,,9.07,9.07,1
HCPCS,T2001,N-et; patient attend/escort,,,1036.3,1036.3,1
HCPCS,T20010,N-et; patient attend/escort,,,1036.3,1036.3,1
HCPCS,T2002,N-et; per diem,,,12.31,12.31,1
HCPCS,T20020,N-et; per diem,,,12.31,12.31,1
HCPCS,T2003,N-et; encounter/trip,,,0.31,25.12,4
HCPCS,T20030,N-et; encounter/trip,,,25.12,25.12,1
HCPCS,T2004,N-et; commerc carrier pass,,,34.1,34.1,1
HCPCS,T20040,N-et; commerc carrier pass,,,34.1,34.1,1
HCPCS,T2005,N-et; stretcher van,,,164.71,164.71,1
HCPCS,T20050,N-et; stretcher van,,,164.71,164.71,1
HCPCS,T2007,Non-emer transport wait time,,,31.64,31.64,1
HCPCS,T20070,Non-emer transport wait time,,,31.64,31.64,1
HCPCS,T2011,Pasrr level ii,,,373.68,373.68,1
HCPCS,T20110,Pasrr level ii,,,373.68,373.68,1
HCPCS,T2012,"Habil ed waiver, per diem",,,703.08,703.08,1
HCPCS,T20120,"Habil ed waiver, per diem",,,703.08,703.08,1
HCPCS,T2013,Habil ed waiver per hour,,,7.79,7.79,1
HCPCS,T20130,Habil ed waiver per hour,,,7.79,7.79,1
HCPCS,T2014,"Habil prevoc waiver, per d",,,16.2,16.2,1
HCPCS,T20140,"Habil prevoc waiver, per d",,,16.2,16.2,1
HCPCS,T2015,Habil prevoc waiver per hr,,,3.24,3.24,1
HCPCS,T20150,Habil prevoc waiver per hr,,,3.24,3.24,1
HCPCS,T2016,Habil res waiver per diem,,,704.61,704.61,1
HCPCS,T20160,Habil res waiver per diem,,,704.61,704.61,1
HCPCS,T2017,Habil res waiver 15 min,,,4.19,4.19,1
HCPCS,T20170,Habil res waiver 15 min,,,4.19,4.19,1
HCPCS,T2018,Habil sup empl waiver/diem,,,320.76,320.76,1
HCPCS,T20180,Habil sup empl waiver/diem,,,320.76,320.76,1
HCPCS,T2019,Habil sup empl waiver 15min,,,9.73,9.73,1
HCPCS,T20190,Habil sup empl waiver 15min,,,9.73,9.73,1
HCPCS,T2020,Day habil waiver per diem,,,83.3,83.3,1
HCPCS,T20200,Day habil waiver per diem,,,83.3,83.3,1
HCPCS,T2021,Day habil waiver per 15 min,,,16.18,16.18,1
HCPCS,T20210,Day habil waiver per 15 min,,,16.18,16.18,1
HCPCS,T2022,"Case management, per month",,,34.32,194.4,7
HCPCS,T20220,"Case management, per month",,,194.4,194.4,1
HCPCS,T2023,Targeted case mgmt per month,,,34.32,216.0,7
HCPCS,T20230,Targeted case mgmt per month,,,216.0,216.0,1
HCPCS,T2024,Serv asmnt/care plan waiver,,,27.76,74.14,4
HCPCS,T20240,Serv asmnt/care plan waiver,,,74.14,74.14,1
HCPCS,T2026,Special childcare waiver/d,,,195.48,195.48,1
HCPCS,T20260,Special childcare waiver/d,,,195.48,195.48,1
HCPCS,T2027,Spec childcare waiver 15 min,,,4.54,4.54,1
HCPCS,T20270,Spec childcare waiver 15 min,,,4.54,4.54,1
HCPCS,T2028,"Special supply, nos waiver",,,0.49,0.54,3
HCPCS,T2030,Assist living waiver/month,,,46.18,46.18,1
HCPCS,T20300,Assist living waiver/month,,,46.18,46.18,1
HCPCS,T2031,Assist living waiver/diem,,,82.32,82.32,1
HCPCS,T20310,Assist living waiver/diem,,,82.32,82.32,1
HCPCS,T2034,Crisis interven waiver/diem,,,138.13,138.13,1
HCPCS,T20340,Crisis interven waiver/diem,,,138.13,138.13,1
HCPCS,T2035,Utility services waiver,,,0.01,0.01,1
HCPCS,T20350,Utility services waiver,,,0.01,0.01,1
HCPCS,T2036,Camp overnite waiver/session,,,0.01,0.01,1
HCPCS,T20360,Camp overnite waiver/session,,,0.01,0.01,1
HCPCS,T2037,Camp day waiver/session,,,0.01,0.01,1
HCPCS,T20370,Camp day waiver/session,,,0.01,0.01,1
HCPCS,T2038,Comm trans waiver/service,,,50.87,50.87,1
HCPCS,T20380,Comm trans waiver/service,,,50.87,50.87,1
HCPCS,T2039,Vehicle mod waiver/service,,,0.01,0.01,1
HCPCS,T20390,Vehicle mod waiver/service,,,0.01,0.01,1
HCPCS,T2040,Financial mgt waiver/15min,,,1.17,1.17,1
HCPCS,T20400,Financial mgt waiver/15min,,,1.17,1.17,1
HCPCS,T2041,Support broker waiver/15 min,,,0.01,0.01,1
HCPCS,T20410,Support broker waiver/15 min,,,0.01,0.01,1
HCPCS,T2042,Hospice routine home care,,,81.0,81.0,1
HCPCS,T20420,Hospice routine home care,,,81.0,81.0,1
HCPCS,T2043,Hospice continuous home care,,,27.0,27.0,1
HCPCS,T20430,Hospice continuous home care,,,27.0,27.0,1
HCPCS,T2044,Hospice respite care,,,594.0,594.0,1
HCPCS,T20440,Hospice respite care,,,594.0,594.0,1
HCPCS,T2045,Hospice general care,,,594.0,594.0,1
HCPCS,T20450,Hospice general care,,,594.0,594.0,1
HCPCS,T2046,"Hospice long term care, r&b",,,81.0,81.0,1
HCPCS,T20460,"Hospice long term care, r&b",,,81.0,81.0,1
HCPCS,T2047,Hab prevo waiver per 15,,,5.14,5.14,1
HCPCS,T20470,Hab prevo waiver per 15,,,5.14,5.14,1
HCPCS,T2048,"Bh ltc res r&b, per diem",,,242.74,405.02,7
HCPCS,T20480,"Bh ltc res r&b, per diem",,,242.74,242.74,1
HCPCS,T2049,"N-et; stretcher van, mileage",,,4.2,4.2,1
HCPCS,T20490,"N-et; stretcher van, mileage",,,4.2,4.2,1
HCPCS,T2101,Breast milk proc/store/dist,,,4.32,4.32,1
HCPCS,T21010,Breast milk proc/store/dist,,,4.32,4.32,1
HCPCS,T4521,Adult size brief/diaper sm,,,0.01,0.01,1
HCPCS,T45210,Adult size brief/diaper sm,,,0.01,0.01,1
HCPCS,T4522,Adult size brief/diaper med,,,0.01,0.01,1
HCPCS,T45220,Adult size brief/diaper med,,,0.01,0.01,1
HCPCS,T4523,Adult size brief/diaper lg,,,0.01,0.01,1
HCPCS,T45230,Adult size brief/diaper lg,,,0.01,0.01,1
HCPCS,T4524,Adult size brief/diaper xl,,,0.01,0.01,1
HCPCS,T45240,Adult size brief/diaper xl,,,0.01,0.01,1
HCPCS,T4525,Adult size pull-on sm,,,0.01,0.01,1
HCPCS,T45250,Adult size pull-on sm,,,0.01,0.01,1
HCPCS,T4526,Adult size pull-on med,,,0.01,0.01,1
HCPCS,T45260,Adult size pull-on med,,,0.01,0.01,1
HCPCS,T4527,Adult size pull-on lg,,,0.01,0.01,1
HCPCS,T45270,Adult size pull-on lg,,,0.01,0.01,1
HCPCS,T4528,Adult size pull-on xl,,,0.01,0.01,1
HCPCS,T45280,Adult size pull-on xl,,,0.01,0.01,1
HCPCS,T4529,Ped size brief/diaper sm/med,,,0.01,0.01,1
HCPCS,T45290,Ped size brief/diaper sm/med,,,0.01,0.01,1
HCPCS,T4530,Ped size brief/diaper lg,,,0.01,0.01,1
HCPCS,T45300,Ped size brief/diaper lg,,,0.01,0.01,1
HCPCS,T4531,Ped size pull-on sm/med,,,0.01,0.01,1
HCPCS,T45310,Ped size pull-on sm/med,,,0.01,0.01,1
HCPCS,T4532,Ped size pull-on lg,,,0.01,0.01,1
HCPCS,T45320,Ped size pull-on lg,,,0.01,0.01,1
HCPCS,T4533,Youth size brief/diaper,,,0.01,0.01,1
HCPCS,T45330,Youth size brief/diaper,,,0.01,0.01,1
HCPCS,T4534,Youth size pull-on,,,0.01,0.01,1
HCPCS,T45340,Youth size pull-on,,,0.01,0.01,1
HCPCS,T4535,Disposable liner/shield/pad,,,0.66,0.66,1
HCPCS,T45350,Disposable liner/shield/pad,,,0.66,0.66,1
HCPCS,T4536,Reusable pull-on any size,,,0.01,0.01,1
HCPCS,T45360,Reusable pull-on any size,,,0.01,0.01,1
HCPCS,T4537,Reusable underpad bed size,,,0.01,0.01,1
HCPCS,T45370,Reusable underpad bed size,,,0.01,0.01,1
HCPCS,T4538,Diaper serv reusable diaper,,,0.01,0.01,1
HCPCS,T45380,Diaper serv reusable diaper,,,0.01,0.01,1
HCPCS,T4539,Reuse diaper/brief any size,,,0.01,0.01,1
HCPCS,T45390,Reuse diaper/brief any size,,,0.01,0.01,1
HCPCS,T4540,Reusable underpad chair size,,,0.01,0.01,1
HCPCS,T45400,Reusable underpad chair size,,,0.01,0.01,1
HCPCS,T4541,Large disposable underpad,,,0.82,0.82,1
HCPCS,T45410,Large disposable underpad,,,0.82,0.82,1
HCPCS,T4542,Small disposable underpad,,,0.49,0.49,1
HCPCS,T45420,Small disposable underpad,,,0.49,0.49,1
HCPCS,T4543,Adult disp brief/diap abv xl,,,2.82,2.82,1
HCPCS,T45430,Adult disp brief/diap abv xl,,,2.82,2.82,1
HCPCS,T4544,Adlt disp und/pull on abv xl,,,2.76,2.76,1
HCPCS,T45440,Adlt disp und/pull on abv xl,,,2.76,2.76,1
HCPCS,T5001,Position seat spec orth need,,,2983.78,2983.78,1
HCPCS,T50010,Position seat spec orth need,,,2983.78,2983.78,1
HCPCS,U0001,2019-ncov diagnostic p,,,38.79,38.79,1
HCPCS,U0001,COVID19,150.0,97.5,15.09,150.0,13
HCPCS,U0001,COVID19 INHOUSE,138.0,89.7,4.02,124.2,37
HCPCS,U0001,COVID19 SENDOUT,141.0,91.65,4.02,126.9,37
HCPCS,U00010,2019-ncov diagnostic p,,,38.79,38.79,1
HCPCS,U0002,COVID19,150.0,97.5,21.55,150.0,13
HCPCS,U0002,COVID19 INHOUSE,138.0,89.7,4.02,124.2,37
HCPCS,U0002,COVID19 SENDOUT,141.0,91.65,4.02,126.9,37
HCPCS,U0002,Covid-19 lab test non-cdc,,,55.41,85.74,4
HCPCS,U00020,Covid-19 lab test non-cdc,,,55.41,55.41,1
HCPCS,U0002QW,Covid-19 lab test non-cdc,,,79.12,85.74,3
HCPCS,U0003,Cov-19 amp prb hgh thruput,,,25.65,162.0,16
HCPCS,U0004,Cov-19 test non-cdc hgh thru,,,25.65,162.0,16
HCPCS,U0005,Infec agen detec ampli probe,,,4.02,54.0,16
HCPCS,V2020,Vision svcs frames purchases,,,72.37,161.65,4
HCPCS,V20200,Vision svcs frames purchases,,,72.37,72.37,1
HCPCS,V2025,Eyeglasses delux frames,,,70.2,70.2,1
HCPCS,V20250,Eyeglasses delux frames,,,70.2,70.2,1
HCPCS,V2100,Lens spher single plano 4.00,,,44.72,78.57,4
HCPCS,V21000,Lens spher single plano 4.00,,,44.72,44.72,1
HCPCS,V2101,Single visn sphere 4.12-7.00,,,42.97,82.78,4
HCPCS,V21010,Single visn sphere 4.12-7.00,,,42.97,42.97,1
HCPCS,V2102,Singl visn sphere 7.12-20.00,,,74.3,117.42,4
HCPCS,V21020,Singl visn sphere 7.12-20.00,,,74.3,74.3,1
HCPCS,V2103,Spherocylindr 4.00d/12-2.00d,,,37.65,68.21,4
HCPCS,V21030,Spherocylindr 4.00d/12-2.00d,,,37.65,37.65,1
HCPCS,V2104,Spherocylindr 4.00d/2.12-4d,,,38.82,75.55,4
HCPCS,V21040,Spherocylindr 4.00d/2.12-4d,,,38.82,38.82,1
HCPCS,V2105,Spherocylinder 4.00d/4.25-6d,,,46.17,92.51,4
HCPCS,V21050,Spherocylinder 4.00d/4.25-6d,,,46.17,46.17,1
HCPCS,V2106,Spherocylinder 4.00d/>6.00d,,,51.14,93.88,4
HCPCS,V21060,Spherocylinder 4.00d/>6.00d,,,51.14,51.14,1
HCPCS,V2107,Spherocylinder 4.25d/12-2d,,,45.53,98.66,4
HCPCS,V21070,Spherocylinder 4.25d/12-2d,,,45.53,45.53,1
HCPCS,V2108,Spherocylinder 4.25d/2.12-4d,,,45.66,95.68,4
HCPCS,V21080,Spherocylinder 4.25d/2.12-4d,,,45.66,45.66,1
HCPCS,V2109,Spherocylinder 4.25d/4.25-6d,,,63.59,109.99,4
HCPCS,V21090,Spherocylinder 4.25d/4.25-6d,,,63.59,63.59,1
HCPCS,V2110,Spherocylinder 4.25d/over 6d,,,51.36,128.37,4
HCPCS,V21100,Spherocylinder 4.25d/over 6d,,,51.36,51.36,1
HCPCS,V2111,Spherocylindr 7.25d/.25-2.25,,,62.25,113.16,4
HCPCS,V21110,Spherocylindr 7.25d/.25-2.25,,,62.25,62.25,1
HCPCS,V2112,Spherocylindr 7.25d/2.25-4d,,,70.32,111.67,4
HCPCS,V21120,Spherocylindr 7.25d/2.25-4d,,,70.32,70.32,1
HCPCS,V2113,Spherocylindr 7.25d/4.25-6d,,,71.12,154.23,4
HCPCS,V21130,Spherocylindr 7.25d/4.25-6d,,,71.12,71.12,1
HCPCS,V2114,Spherocylinder over 12.00d,,,84.25,136.45,4
HCPCS,V21140,Spherocylinder over 12.00d,,,84.25,84.25,1
HCPCS,V2115,Lens lenticular bifocal,,,84.92,148.35,4
HCPCS,V21150,Lens lenticular bifocal,,,84.92,84.92,1
HCPCS,V2118,Lens aniseikonic single,,,92.4,147.08,4
HCPCS,V21180,Lens aniseikonic single,,,92.4,92.4,1
HCPCS,V2121,"Lenticular lens, single",,,83.33,151.84,4
HCPCS,V21210,"Lenticular lens, single",,,83.33,83.33,1
HCPCS,V2200,Lens spher bifoc plano 4.00d,,,50.37,102.83,4
HCPCS,V22000,Lens spher bifoc plano 4.00d,,,50.37,50.37,1
HCPCS,V2201,Lens sphere bifocal 4.12-7.0,,,53.97,112.06,4
HCPCS,V22010,Lens sphere bifocal 4.12-7.0,,,53.97,53.97,1
HCPCS,V2202,Lens sphere bifocal 7.12-20.,,,66.91,131.88,4
HCPCS,V22020,Lens sphere bifocal 7.12-20.,,,66.91,66.91,1
HCPCS,V2203,Lens sphcyl bifocal 4.00d/.1,,,51.87,103.74,4
HCPCS,V22030,Lens sphcyl bifocal 4.00d/.1,,,51.87,51.87,1
HCPCS,V2204,Lens sphcy bifocal 4.00d/2.1,,,53.37,112.49,4
HCPCS,V22040,Lens sphcy bifocal 4.00d/2.1,,,53.37,53.37,1
HCPCS,V2205,Lens sphcy bifocal 4.00d/4.2,,,59.18,123.42,4
HCPCS,V22050,Lens sphcy bifocal 4.00d/4.2,,,59.18,59.18,1
HCPCS,V2206,Lens sphcy bifocal 4.00d/ove,,,69.47,150.27,4
HCPCS,V22060,Lens sphcy bifocal 4.00d/ove,,,69.47,69.47,1
HCPCS,V2207,Lens sphcy bifocal 4.25-7d/.,,,58.71,125.43,4
HCPCS,V22070,Lens sphcy bifocal 4.25-7d/.,,,58.71,58.71,1
HCPCS,V2208,Lens sphcy bifocal 4.25-7/2.,,,57.69,126.96,4
HCPCS,V22080,Lens sphcy bifocal 4.25-7/2.,,,57.69,57.69,1
HCPCS,V2209,Lens sphcy bifocal 4.25-7/4.,,,67.74,139.65,4
HCPCS,V22090,Lens sphcy bifocal 4.25-7/4.,,,67.74,67.74,1
HCPCS,V2210,Lens sphcy bifocal 4.25-7/ov,,,72.99,179.67,4
HCPCS,V22100,Lens sphcy bifocal 4.25-7/ov,,,72.99,72.99,1
HCPCS,V2211,Lens sphcy bifo 7.25-12/.25-,,,71.05,153.2,4
HCPCS,V22110,Lens sphcy bifo 7.25-12/.25-,,,71.05,71.05,1
HCPCS,V2212,Lens sphcyl bifo 7.25-12/2.2,,,74.37,166.72,4
HCPCS,V22120,Lens sphcyl bifo 7.25-12/2.2,,,74.37,74.37,1
HCPCS,V2213,Lens sphcyl bifo 7.25-12/4.2,,,78.2,170.96,4
HCPCS,V22130,Lens sphcyl bifo 7.25-12/4.2,,,78.2,78.2,1
HCPCS,V2214,Lens sphcyl bifocal over 12.,,,81.72,183.23,4
HCPCS,V22140,Lens sphcyl bifocal over 12.,,,81.72,81.72,1
HCPCS,V2215,Lens lenticular bifocal,,,102.04,198.3,4
HCPCS,V22150,Lens lenticular bifocal,,,102.04,102.04,1
HCPCS,V2218,Lens aniseikonic bifocal,,,103.98,202.88,4
HCPCS,V22180,Lens aniseikonic bifocal,,,103.98,103.98,1
HCPCS,V2219,Lens bifocal seg width over,,,47.96,89.3,4
HCPCS,V22190,Lens bifocal seg width over,,,47.96,47.96,1
HCPCS,V2220,Lens bifocal add over 3.25d,,,42.61,72.42,4
HCPCS,V22200,Lens bifocal add over 3.25d,,,42.61,42.61,1
HCPCS,V2221,"Lenticular lens, bifocal",,,84.97,193.49,4
HCPCS,V22210,"Lenticular lens, bifocal",,,84.97,84.97,1
HCPCS,V2300,Lens sphere trifocal 4.00d,,,68.86,133.53,4
HCPCS,V23000,Lens sphere trifocal 4.00d,,,68.86,68.86,1
HCPCS,V2301,Lens sphere trifocal 4.12-7.,,,84.46,154.85,4
HCPCS,V23010,Lens sphere trifocal 4.12-7.,,,84.46,84.46,1
HCPCS,V2302,Lens sphere trifocal 7.12-20,,,78.89,169.62,4
HCPCS,V23020,Lens sphere trifocal 7.12-20,,,78.89,78.89,1
HCPCS,V2303,Lens sphcy trifocal 4.0/.12-,,,66.28,140.55,4
HCPCS,V23030,Lens sphcy trifocal 4.0/.12-,,,66.28,66.28,1
HCPCS,V2304,Lens sphcy trifocal 4.0/2.25,,,67.05,147.08,4
HCPCS,V23040,Lens sphcy trifocal 4.0/2.25,,,67.05,67.05,1
HCPCS,V2305,Lens sphcy trifocal 4.0/4.25,,,74.91,180.37,4
HCPCS,V23050,Lens sphcy trifocal 4.0/4.25,,,74.91,74.91,1
HCPCS,V2306,Lens sphcyl trifocal 4.00/>6,,,77.13,168.19,4
HCPCS,V23060,Lens sphcyl trifocal 4.00/>6,,,77.13,77.13,1
HCPCS,V2307,Lens sphcy trifocal 4.25-7/.,,,73.44,166.75,4
HCPCS,V23070,Lens sphcy trifocal 4.25-7/.,,,73.44,73.44,1
HCPCS,V2308,Lens sphc trifocal 4.25-7/2.,,,80.1,177.94,4
HCPCS,V23080,Lens sphc trifocal 4.25-7/2.,,,80.1,80.1,1
HCPCS,V2309,Lens sphc trifocal 4.25-7/4.,,,83.83,208.16,4
HCPCS,V23090,Lens sphc trifocal 4.25-7/4.,,,83.83,83.83,1
HCPCS,V2310,Lens sphc trifocal 4.25-7/>6,,,87.56,228.98,4
HCPCS,V23100,Lens sphc trifocal 4.25-7/>6,,,87.56,87.56,1
HCPCS,V2311,Lens sphc trifo 7.25-12/.25-,,,101.1,218.08,4
HCPCS,V23110,Lens sphc trifo 7.25-12/.25-,,,101.1,101.1,1
HCPCS,V2312,Lens sphc trifo 7.25-12/2.25,,,92.66,192.23,4
HCPCS,V23120,Lens sphc trifo 7.25-12/2.25,,,92.66,92.66,1
HCPCS,V2313,Lens sphc trifo 7.25-12/4.25,,,101.15,262.38,4
HCPCS,V23130,Lens sphc trifo 7.25-12/4.25,,,101.15,101.15,1
HCPCS,V2314,Lens sphcyl trifocal over 12,,,103.4,287.41,4
HCPCS,V23140,Lens sphcyl trifocal over 12,,,103.4,103.4,1
HCPCS,V2315,Lens lenticular trifocal,,,114.79,319.08,4
HCPCS,V23150,Lens lenticular trifocal,,,114.79,114.79,1
HCPCS,V2318,Lens aniseikonic trifocal,,,141.12,294.2,4
HCPCS,V23180,Lens aniseikonic trifocal,,,141.12,141.12,1
HCPCS,V2319,Lens trifocal seg width > 28,,,63.71,99.61,4
HCPCS,V23190,Lens trifocal seg width > 28,,,63.71,63.71,1
HCPCS,V2320,Lens trifocal add over 3.25d,,,67.2,105.07,4
HCPCS,V23200,Lens trifocal add over 3.25d,,,67.2,67.2,1
HCPCS,V2321,"Lenticular lens, trifocal",,,113.15,314.5,4
HCPCS,V23210,"Lenticular lens, trifocal",,,113.15,113.15,1
HCPCS,V2410,Lens variab asphericity sing,,,98.93,179.83,4
HCPCS,V24100,Lens variab asphericity sing,,,98.93,98.93,1
HCPCS,V2430,Lens variable asphericity bi,,,104.71,234.11,4
HCPCS,V24300,Lens variable asphericity bi,,,104.71,104.71,1
HCPCS,V2500,Contact lens pmma spherical,,,88.52,163.01,4
HCPCS,V25000,Contact lens pmma spherical,,,88.52,88.52,1
HCPCS,V2501,Cntct lens pmma-toric/prism,,,125.61,248.31,4
HCPCS,V25010,Cntct lens pmma-toric/prism,,,125.61,125.61,1
HCPCS,V2502,Contact lens pmma bifocal,,,170.2,305.89,4
HCPCS,V25020,Contact lens pmma bifocal,,,170.2,170.2,1
HCPCS,V2503,Cntct lens pmma color vision,,,164.39,292.69,4
HCPCS,V25030,Cntct lens pmma color vision,,,164.39,164.39,1
HCPCS,V2510,Cntct gas permeable sphericl,,,118.03,222.53,4
HCPCS,V25100,Cntct gas permeable sphericl,,,118.03,118.03,1
HCPCS,V2511,Cntct toric prism ballast,,,174.95,319.73,4
HCPCS,V25110,Cntct toric prism ballast,,,174.95,174.95,1
HCPCS,V2512,Cntct lens gas permbl bifocl,,,201.38,377.81,4
HCPCS,V25120,Cntct lens gas permbl bifocl,,,201.38,201.38,1
HCPCS,V2513,Contact lens extended wear,,,202.87,317.19,4
HCPCS,V25130,Contact lens extended wear,,,202.87,202.87,1
HCPCS,V2520,CONTACT LENS HYDROPHILIC,36.0,23.4,18.0,96.23,17
HCPCS,V2520,Contact lens hydrophilic,,,117.61,209.16,4
HCPCS,V25200,Contact lens hydrophilic,,,117.61,117.61,1
HCPCS,V2521,Cntct lens hydrophilic toric,,,232.91,364.14,4
HCPCS,V25210,Cntct lens hydrophilic toric,,,232.91,232.91,1
HCPCS,V2522,Cntct lens hydrophil bifocl,,,170.45,354.39,4
HCPCS,V25220,Cntct lens hydrophil bifocl,,,170.45,170.45,1
HCPCS,V2523,Cntct lens hydrophil extend,,,178.96,302.02,4
HCPCS,V25230,Cntct lens hydrophil extend,,,178.96,178.96,1
HCPCS,V2524,Cntct lens hydrophil photoch,,,134.76,253.04,4
HCPCS,V25240,Cntct lens hydrophil photoch,,,134.76,134.76,1
HCPCS,V2525,"Cl, hydrophilic, dual focus",,,173.88,173.88,1
HCPCS,V25250,"Cl, hydrophilic, dual focus",,,173.88,173.88,1
HCPCS,V2530,Contact lens gas impermeable,,,286.1,447.31,4
HCPCS,V25300,Contact lens gas impermeable,,,286.1,286.1,1
HCPCS,V2531,Contact lens gas permeable,,,523.93,1098.13,4
HCPCS,V25310,Contact lens gas permeable,,,523.93,523.93,1
HCPCS,V2600,Hand held low vision aids,,,99.53,99.53,1
HCPCS,V26000,Hand held low vision aids,,,99.53,99.53,1
HCPCS,V2610,Single lens spectacle mount,,,113.59,113.59,1
HCPCS,V26100,Single lens spectacle mount,,,113.59,113.59,1
HCPCS,V2615,Telescop/othr compound lens,,,799.91,799.91,1
HCPCS,V26150,Telescop/othr compound lens,,,799.91,799.91,1
HCPCS,V2623,Plastic eye prosth custom,,,907.2,1800.3,4
HCPCS,V26230,Plastic eye prosth custom,,,907.2,907.2,1
HCPCS,V2624,Polishing artifical eye,,,58.57,122.1,4
HCPCS,V26240,Polishing artifical eye,,,58.57,58.57,1
HCPCS,V2625,Enlargemnt of eye prosthesis,,,463.84,790.87,4
HCPCS,V26250,Enlargemnt of eye prosthesis,,,463.84,463.84,1
HCPCS,V2626,Reduction of eye prosthesis,,,191.95,501.75,4
HCPCS,V26260,Reduction of eye prosthesis,,,191.95,191.95,1
HCPCS,V2627,Scleral cover shell,,,1376.05,2872.55,4
HCPCS,V26270,Scleral cover shell,,,1376.05,1376.05,1
HCPCS,V2628,Fabrication & fitting,,,292.7,656.77,4
HCPCS,V26280,Fabrication & fitting,,,292.7,292.7,1
HCPCS,V2629,Prosthetic eye other type,,,611.54,611.54,1
HCPCS,V26290,Prosthetic eye other type,,,611.54,611.54,1
HCPCS,V2630,Anter chamber intraocul lens,,,114.52,114.52,1
HCPCS,V2630,W LENS AC MTA3U0 ALL SZS,130.0,84.5,21.84,117.0,21
HCPCS,V2630,W LENS AC MTA4U0 ALL SZS,130.0,84.5,21.84,117.0,21
HCPCS,V2630,W LENS AC MTA5U0 ALL SZS,130.0,84.5,21.84,117.0,21
HCPCS,V2630,W VISIAN ICL LENS,1698.0,1103.7,285.26,1528.2,21
HCPCS,V26300,Anter chamber intraocul lens,,,114.52,114.52,1
HCPCS,V2631,Iris support intraoclr lens,,,114.52,114.52,1
HCPCS,V26310,Iris support intraoclr lens,,,114.52,114.52,1
HCPCS,V2632,CRYSTALENS ACCOMMODATING IOL SELF PAY,1172.0,761.8,55.81,1172.0,13
HCPCS,V2632,CRYSTALENS IOL; UPGRADE INSURANCE PAYERS,1058.0,687.7,55.81,1058.0,13
HCPCS,V2632,Post chmbr intraocular lens,,,114.52,114.52,1
HCPCS,V2632,W LENS PC CZ70BD ALL SZS,130.0,84.5,21.84,117.0,21
HCPCS,V2632,W LENS PC MA60AC ALL SZS,248.0,161.2,41.66,223.2,21
HCPCS,V2632,W LENS PC MN60MA ALL SZS,298.0,193.7,50.06,268.2,21
HCPCS,V2632,W LENS PC SA60AT ALL SZS,268.0,174.2,45.02,241.2,21
HCPCS,V2632,W LENS PC SN60WF ALL SZS,298.0,193.7,50.06,268.2,21
HCPCS,V2632,W LENS POSTERIOR CHAMBER,298.0,193.7,50.06,268.2,21
HCPCS,V26320,Post chmbr intraocular lens,,,114.52,114.52,1
HCPCS,V2700,Balance lens,,,43.15,87.86,4
HCPCS,V27000,Balance lens,,,43.15,43.15,1
HCPCS,V2702,Deluxe lens feature,,,25.68,25.68,1
HCPCS,V27020,Deluxe lens feature,,,25.68,25.68,1
HCPCS,V2710,Glass/plastic slab off prism,,,70.72,128.6,4
HCPCS,V27100,Glass/plastic slab off prism,,,70.72,70.72,1
HCPCS,V2715,Prism lens/es,,,13.87,23.31,4
HCPCS,V27150,Prism lens/es,,,13.87,13.87,1
HCPCS,V2718,FRESNEL PRISM PRESS-ON LENS,44.0,28.6,7.39,44.0,44
HCPCS,V2718,Fresnell prism press-on lens,,,29.94,29.94,1
HCPCS,V27180,Fresnell prism press-on lens,,,29.94,29.94,1
HCPCS,V2730,Special base curve,,,25.07,42.29,4
HCPCS,V27300,Special base curve,,,25.07,25.07,1
HCPCS,V2744,Tint photochromatic lens/es,,,17.15,43.88,4
HCPCS,V27440,Tint photochromatic lens/es,,,17.15,17.15,1
HCPCS,V2745,"Tint, any color/solid/grad",,,9.87,24.86,4
HCPCS,V27450,"Tint, any color/solid/grad",,,9.87,9.87,1
HCPCS,V2750,Anti-reflective coating,,,19.26,51.05,4
HCPCS,V27500,Anti-reflective coating,,,19.26,19.26,1
HCPCS,V2755,Uv lens/es,,,16.12,36.9,4
HCPCS,V27550,Uv lens/es,,,16.12,16.12,1
HCPCS,V2756,Eye glass case,,,28.78,28.78,1
HCPCS,V27560,Eye glass case,,,28.78,28.78,1
HCPCS,V2760,Scratch resistant coating,,,15.89,15.89,1
HCPCS,V27600,Scratch resistant coating,,,15.89,15.89,1
HCPCS,V2761,Mirror coating,,,8.22,8.22,1
HCPCS,V27610,Mirror coating,,,8.22,8.22,1
HCPCS,V2762,"Polarization, any lens",,,46.46,57.68,7
HCPCS,V27620,"Polarization, any lens",,,57.68,57.68,1
HCPCS,V2762NU,"Polarization, any lens",,,46.46,50.35,3
HCPCS,V2770,Occluder lens/es,,,18.78,41.46,4
HCPCS,V27700,Occluder lens/es,,,18.78,18.78,1
HCPCS,V2780,Oversize lens/es,,,12.05,33.5,4
HCPCS,V27800,Oversize lens/es,,,12.05,12.05,1
HCPCS,V2781,Progressive lens per lens,,,86.88,86.88,1
HCPCS,V27810,Progressive lens per lens,,,86.88,86.88,1
HCPCS,V2782,"Lens, 1.54-1.65 p/1.60-1.79g",,,62.29,130.54,4
HCPCS,V27820,"Lens, 1.54-1.65 p/1.60-1.79g",,,62.29,62.29,1
HCPCS,V2783,"Lens, >= 1.66 p/>=1.80 g",,,70.25,147.2,4
HCPCS,V27830,"Lens, >= 1.66 p/>=1.80 g",,,70.25,70.25,1
HCPCS,V2784,Lens polycarb or equal,,,45.67,95.71,4
HCPCS,V27840,Lens polycarb or equal,,,45.67,45.67,1
HCPCS,V2785,Corneal tissue processing,,,1595.69,2416.33,7
HCPCS,V27850,Corneal tissue processing,,,2416.33,2416.33,1
HCPCS,V2786,Occupational multifocal lens,,,103.24,103.24,1
HCPCS,V27860,Occupational multifocal lens,,,103.24,103.24,1
HCPCS,V2787,*W LENS ASTIGMASTISM TRULIGN,950.0,617.5,159.6,855.0,21
HCPCS,V2787,Astigmatism-correct function,,,698.48,698.48,1
HCPCS,V2787,TORIC LENS,495.0,321.75,83.16,445.5,21
HCPCS,V2787,W LENS ASTIGMATISM CORRECTING,495.0,321.75,83.16,445.5,21
HCPCS,V27870,Astigmatism-correct function,,,698.48,698.48,1
HCPCS,V2788,CRYSTAL LENS,950.0,617.5,159.6,855.0,21
HCPCS,V2788,LENS IOL RESTOR SV25TX,895.0,581.75,150.36,805.5,42
HCPCS,V2788,LENS IOL SYMFONY ZXR00,745.0,484.25,125.16,670.5,21
HCPCS,V2788,Presbyopia-correct function,,,1163.81,1163.81,1
HCPCS,V2788,RESTOR LENS,895.0,581.75,150.36,805.5,21
HCPCS,V2788,W LENS PRESBYOPIA CORRECTING,895.0,581.75,150.36,805.5,21
HCPCS,V2788,W LENS PRESBYOPIA CRYSTALENS,950.0,617.5,159.6,855.0,21
HCPCS,V27880,Presbyopia-correct function,,,1163.81,1163.81,1
HCPCS,V2790,Amniotic membrane,,,253.24,253.24,1
HCPCS,V27900,Amniotic membrane,,,253.24,253.24,1
HCPCS,V2797,Vis item/svc in other code,,,16.48,121.69,4
HCPCS,V27970,Vis item/svc in other code,,,121.69,121.69,1
HCPCS,V5008,Hearing screening,,,19.1,53.43,10
HCPCS,V50080,Hearing screening,,,31.08,31.08,1
HCPCS,V5010,ASSESSMENT FOR HEARING AID,122.0,79.3,61.0,122.0,13
HCPCS,V5010,Assessment for hearing aid,,,19.1,69.97,10
HCPCS,V50100,Assessment for hearing aid,,,40.72,40.72,1
HCPCS,V5011,Hearing aid fitting/checking,,,19.1,109.22,10
HCPCS,V50110,Hearing aid fitting/checking,,,63.55,63.55,1
HCPCS,V5014,HEARING AID MAINTENANCE,35.0,22.75,5.88,450.0,30
HCPCS,V5014,HEARING AID REPAIR/MODIFYING,100.0,65.0,8.4,450.0,90
HCPCS,V5014,Hearing aid repair/modifying,,,76.76,76.76,1
HCPCS,V50140,Hearing aid repair/modifying,,,76.76,76.76,1
HCPCS,V5020,Conformity evaluation,,,19.1,61.46,10
HCPCS,V50200,Conformity evaluation,,,35.76,35.76,1
HCPCS,V5030,Body-worn hearing aid air,,,564.25,969.71,4
HCPCS,V50300,Body-worn hearing aid air,,,564.25,564.25,1
HCPCS,V5040,Body-worn hearing aid bone,,,428.89,737.09,4
HCPCS,V50400,Body-worn hearing aid bone,,,428.89,428.89,1
HCPCS,V5050,HEARING AID MONAURAL IN-THE-EAR,2565.0,1667.25,1040.65,2565.0,13
HCPCS,V5050,Hearing aid monaural in ear,,,495.74,851.98,4
HCPCS,V5050,ITE HEARING AID MOAURAL,2037.0,1324.05,1018.5,2037.0,13
HCPCS,V5050,REAL-EAR MONAURAL,2037.0,1324.05,1018.5,2037.0,13
HCPCS,V5050,TRITON I.Q.3004B;BTE-MONAURAL,2037.0,1324.05,1018.5,2037.0,13
HCPCS,V50500,Hearing aid monaural in ear,,,495.74,495.74,1
HCPCS,V5060,Behind ear hearing aid,,,414.31,712.03,4
HCPCS,V50600,Behind ear hearing aid,,,414.31,414.31,1
HCPCS,V5070,Glasses air conduction,,,230.27,395.73,4
HCPCS,V50700,Glasses air conduction,,,230.27,230.27,1
HCPCS,V5080,Glasses bone conduction,,,578.56,994.3,4
HCPCS,V50800,Glasses bone conduction,,,578.56,578.56,1
HCPCS,V5090,Hearing aid dispensing fee,,,19.1,353.65,10
HCPCS,V50900,Hearing aid dispensing fee,,,205.78,205.78,1
HCPCS,V5100,BODY-WORN BILAT HEARING AID,2565.0,1667.25,1282.5,2565.0,13
HCPCS,V5100,Body-worn bilat hearing aid,,,928.22,1595.22,4
HCPCS,V51000,Body-worn bilat hearing aid,,,928.22,928.22,1
HCPCS,V5110,Hearing aid dispensing fee,,,19.1,359.8,10
HCPCS,V51100,Hearing aid dispensing fee,,,209.36,209.36,1
HCPCS,V5120,Body-worn binaur hearing aid,,,811.3,1394.28,4
HCPCS,V51200,Body-worn binaur hearing aid,,,811.3,811.3,1
HCPCS,V5130,HEARING AID BINAURAL IN-THE-EAR,2400.0,1560.0,1200.0,2400.0,13
HCPCS,V5130,ITE HEARING AID BINAURAL,1907.0,1239.55,953.5,1907.0,13
HCPCS,V5130,In ear binaural hearing aid,,,863.29,1483.64,4
HCPCS,V5130,REAL-EAR BINAURAL,1907.0,1239.55,953.5,1907.0,13
HCPCS,V51300,In ear binaural hearing aid,,,863.29,863.29,1
HCPCS,V5140,BTE HEARING AID BINAURAL,3945.0,2564.25,1884.38,3945.0,13
HCPCS,V5140,Behind ear binaur hearing ai,,,897.67,1542.74,4
HCPCS,V5140,"HEARING AID BINAURAL, BEHIND-EAR",4968.0,3229.2,1884.38,4968.0,13
HCPCS,V5140,TRITON I.Q.2004B;BTE-BINAURAL,3945.0,2564.25,1884.38,3945.0,13
HCPCS,V51400,Behind ear binaur hearing ai,,,897.67,897.67,1
HCPCS,V5150,Glasses binaural hearing aid,,,958.48,1647.23,4
HCPCS,V51500,Glasses binaural hearing aid,,,958.48,958.48,1
HCPCS,V5160,Dispensing fee binaural,,,19.1,250.62,10
HCPCS,V51600,Dispensing fee binaural,,,250.62,250.62,1
HCPCS,V5171,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR",1100.0,715.0,184.8,990.0,84
HCPCS,V5171,Hearing aid monaural ite,,,2700.0,2700.0,1
HCPCS,V51710,Hearing aid monaural ite,,,2700.0,2700.0,1
HCPCS,V5172,Hearing aid monaural itc,,,2051.57,2051.57,1
HCPCS,V51720,Hearing aid monaural itc,,,2051.57,2051.57,1
HCPCS,V5181,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, BEHIND THE EAR",1100.0,715.0,184.8,1100.0,63
HCPCS,V5181,Hearing aid monaural bte,,,1599.23,1599.23,1
HCPCS,V51810,Hearing aid monaural bte,,,1599.23,1599.23,1
HCPCS,V5190,Hearing aid monaural glasses,,,659.44,1133.3,4
HCPCS,V51900,Hearing aid monaural glasses,,,659.44,659.44,1
HCPCS,V5200,Disp fee contralateral monau,,,19.1,238.12,10
HCPCS,V52000,Disp fee contralateral monau,,,207.44,207.44,1
HCPCS,V5211,Hearing aid binaural ite/ite,,,2700.0,2700.0,1
HCPCS,V52110,Hearing aid binaural ite/ite,,,2700.0,2700.0,1
HCPCS,V5212,Hearing aid binaural ite/itc,,,4860.0,4860.0,1
HCPCS,V52120,Hearing aid binaural ite/itc,,,4860.0,4860.0,1
HCPCS,V5213,Hearing aid binaural ite/bte,,,693.9,3672.0,4
HCPCS,V52130,Hearing aid binaural ite/bte,,,3672.0,3672.0,1
HCPCS,V5214,Hearing aid binaural itc/itc,,,1176.31,3292.92,4
HCPCS,V52140,Hearing aid binaural itc/itc,,,3292.92,3292.92,1
HCPCS,V5215,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE TIE",3900.0,2535.0,655.2,3510.0,21
HCPCS,V5215,Hearing aid binaural itc/bte,,,1620.0,1620.0,1
HCPCS,V52150,Hearing aid binaural itc/bte,,,1620.0,1620.0,1
HCPCS,V5221,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE TIE",1700.0,1105.0,285.6,1530.0,21
HCPCS,V5221,Hearing aid binaural bte/bte,,,2636.45,2636.45,1
HCPCS,V52210,Hearing aid binaural bte/bte,,,2636.45,2636.45,1
HCPCS,V5230,Hearing aid binaural glasses,,,719.41,1236.37,4
HCPCS,V52300,Hearing aid binaural glasses,,,719.41,719.41,1
HCPCS,V5240,Disp fee contralateral binau,,,19.1,238.12,10
HCPCS,V52400,Disp fee contralateral binau,,,214.86,214.86,1
HCPCS,V5241,"Dispensing fee, monaural",,,19.1,158.75,10
HCPCS,V52410,"Dispensing fee, monaural",,,122.64,122.64,1
HCPCS,V5242,"Hearing aid, monaural, cic",,,2160.0,2160.0,1
HCPCS,V52420,"Hearing aid, monaural, cic",,,2160.0,2160.0,1
HCPCS,V5243,"Hearing aid, monaural, itc",,,1547.75,1547.75,1
HCPCS,V52430,"Hearing aid, monaural, itc",,,1547.75,1547.75,1
HCPCS,V5244,"Hearing aid, prog, mon, cic",,,2676.78,2676.78,1
HCPCS,V52440,"Hearing aid, prog, mon, cic",,,2676.78,2676.78,1
HCPCS,V5245,"Hearing aid, prog, mon, itc",,,2376.55,2376.55,1
HCPCS,V52450,"Hearing aid, prog, mon, itc",,,2376.55,2376.55,1
HCPCS,V5246,"Hearing aid, prog, mon, ite",,,596.17,596.17,1
HCPCS,V52460,"Hearing aid, prog, mon, ite",,,596.17,596.17,1
HCPCS,V5247,"Hearing aid, prog, mon, bte",,,778.56,2511.0,4
HCPCS,V52470,"Hearing aid, prog, mon, bte",,,2511.0,2511.0,1
HCPCS,V5248,"Hearing aid, binaural, cic",,,1196.24,5402.76,4
HCPCS,V52480,"Hearing aid, binaural, cic",,,1196.24,1196.24,1
HCPCS,V5249,"Hearing aid, binaural, itc",,,4505.43,20520.0,4
HCPCS,V52490,"Hearing aid, binaural, itc",,,20520.0,20520.0,1
HCPCS,V5250,"Hearing aid, prog, bin, cic",,,2306.56,2306.56,1
HCPCS,V52500,"Hearing aid, prog, bin, cic",,,2306.56,2306.56,1
HCPCS,V5251,"Hearing aid, prog, bin, itc",,,2142.4,2142.4,1
HCPCS,V52510,"Hearing aid, prog, bin, itc",,,2142.4,2142.4,1
HCPCS,V5252,"Hearing aid, prog, bin, ite",,,1080.0,1080.0,1
HCPCS,V52520,"Hearing aid, prog, bin, ite",,,1080.0,1080.0,1
HCPCS,V5253,"Hearing aid, prog, bin, bte",,,616.18,1458.0,4
HCPCS,V52530,"Hearing aid, prog, bin, bte",,,1458.0,1458.0,1
HCPCS,V5254,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 1",1100.0,715.0,184.8,990.0,21
HCPCS,V5254,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 2",1800.0,1170.0,302.4,1620.0,21
HCPCS,V5254,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 3",2500.0,1625.0,420.0,2250.0,21
HCPCS,V5254,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 4",3200.0,2080.0,439.47,2880.0,21
HCPCS,V5254,"HEARING ID, DIGIT, MON, CIC",643.0,417.95,321.5,2500.0,13
HCPCS,V5254,"Hearing id, digit, mon, cic",,,891.0,891.0,1
HCPCS,V52540,"Hearing id, digit, mon, cic",,,891.0,891.0,1
HCPCS,V5255,"HEARING AID, DIGIT, MON, ITC",643.0,417.95,321.5,2500.0,13
HCPCS,V5255,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 1",1100.0,715.0,184.8,990.0,21
HCPCS,V5255,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 2",1800.0,1170.0,302.4,1620.0,21
HCPCS,V5255,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 3",2500.0,1625.0,420.0,2250.0,21
HCPCS,V5255,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 4",3200.0,2080.0,439.47,2880.0,21
HCPCS,V5255,"Hearing aid, digit, mon, itc",,,2046.6,2046.6,1
HCPCS,V52550,"Hearing aid, digit, mon, itc",,,2046.6,2046.6,1
HCPCS,V5256,"HEARING AID, DIGIT, MON, ITE",643.0,417.95,321.5,2500.0,13
HCPCS,V5256,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 1",1100.0,715.0,184.8,990.0,21
HCPCS,V5256,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 2",1800.0,1170.0,302.4,1620.0,21
HCPCS,V5256,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 3",2500.0,1625.0,420.0,2250.0,21
HCPCS,V5256,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 4",3200.0,2080.0,439.47,2880.0,21
HCPCS,V5256,"Hearing aid, digit, mon, ite",,,1242.0,1242.0,1
HCPCS,V52560,"Hearing aid, digit, mon, ite",,,1242.0,1242.0,1
HCPCS,V5257,"HEARING AID, DIGIT, MON, BTE",643.0,417.95,321.5,2500.0,13
HCPCS,V5257,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 1",1100.0,715.0,184.8,990.0,21
HCPCS,V5257,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 2",1800.0,1170.0,302.4,1620.0,21
HCPCS,V5257,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 3",2500.0,1625.0,420.0,2250.0,21
HCPCS,V5257,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 4",3200.0,2080.0,439.47,2880.0,21
HCPCS,V5257,"Hearing aid, digit, mon, bte",,,1674.0,1674.0,1
HCPCS,V52570,"Hearing aid, digit, mon, bte",,,1674.0,1674.0,1
HCPCS,V5258,"HEARING AID, DIGIT, BIN, CIC",1867.0,1213.55,933.5,5000.0,13
HCPCS,V5258,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 1",2200.0,1430.0,369.6,1980.0,21
HCPCS,V5258,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 2",3600.0,2340.0,604.8,3240.0,21
HCPCS,V5258,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 3",5000.0,3250.0,840.0,4500.0,21
HCPCS,V5258,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 4",6400.0,4160.0,1075.2,5760.0,21
HCPCS,V5258,"Hearing aid, digit, bin, cic",,,1782.0,1782.0,1
HCPCS,V52580,"Hearing aid, digit, bin, cic",,,1782.0,1782.0,1
HCPCS,V5259,"HEARING AID, DIGIT, BIN, ITC",1867.0,1213.55,933.5,5000.0,13
HCPCS,V5259,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 1",2200.0,1430.0,369.6,1980.0,21
HCPCS,V5259,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 2",3600.0,2340.0,604.8,3240.0,21
HCPCS,V5259,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 3",5000.0,3250.0,840.0,4500.0,21
HCPCS,V5259,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 4",6400.0,4160.0,1075.2,5760.0,21
HCPCS,V5259,"Hearing aid, digit, bin, itc",,,3240.0,3240.0,1
HCPCS,V52590,"Hearing aid, digit, bin, itc",,,3240.0,3240.0,1
HCPCS,V5260,"HEARING AID, DIGIT, BIN, ITE",1867.0,1213.55,933.5,5000.0,13
HCPCS,V5260,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 1",2200.0,1430.0,369.6,1980.0,21
HCPCS,V5260,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 2",3600.0,2340.0,604.8,3240.0,21
HCPCS,V5260,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 3",5000.0,3250.0,840.0,4500.0,21
HCPCS,V5260,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 4",6400.0,4160.0,1075.2,5760.0,21
HCPCS,V5260,"Hearing aid, digit, bin, ite",,,2484.0,2484.0,1
HCPCS,V52600,"Hearing aid, digit, bin, ite",,,2484.0,2484.0,1
HCPCS,V5261,"HEARING AID, DIGIT, BIN, BTE",1867.0,1213.55,933.5,5000.0,13
HCPCS,V5261,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 1",2200.0,1430.0,369.6,1980.0,21
HCPCS,V5261,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 2",3600.0,2340.0,604.8,3240.0,21
HCPCS,V5261,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 3",5000.0,3250.0,840.0,4500.0,21
HCPCS,V5261,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 4",6400.0,4160.0,1075.2,5760.0,21
HCPCS,V5261,"Hearing aid, digit, bin, bte",,,3348.0,3348.0,1
HCPCS,V52610,"Hearing aid, digit, bin, bte",,,3348.0,3348.0,1
HCPCS,V5262,"Hearing aid, disp, monaural",,,219.74,2759.23,4
HCPCS,V52620,"Hearing aid, disp, monaural",,,2759.23,2759.23,1
HCPCS,V5263,"Hearing aid, disp, binaural",,,219.74,4159.24,4
HCPCS,V52630,"Hearing aid, disp, binaural",,,4159.24,4159.24,1
HCPCS,V5264,"EARMOLDS, ANY TYPE QTY 1",100.0,65.0,16.8,90.0,21
HCPCS,V5264,"EARMOLDS, ANY TYPE QTY 2",200.0,130.0,21.97,180.0,21
HCPCS,V5264,Ear mold/insert,,,74.02,74.02,1
HCPCS,V52640,Ear mold/insert,,,74.02,74.02,1
HCPCS,V5265,"Ear mold/insert, disp",,,14.65,31.6,4
HCPCS,V52650,"Ear mold/insert, disp",,,31.6,31.6,1
HCPCS,V5266,Battery for hearing device,,,0.76,3.36,4
HCPCS,V52660,Battery for hearing device,,,3.36,3.36,1
HCPCS,V5267,AIR BLOWER,113.0,73.45,56.5,113.0,12
HCPCS,V5267,DRI-AID KIT,113.0,73.45,56.5,113.0,12
HCPCS,V5267,Hearing aid sup/access/dev,,,146.49,229.91,4
HCPCS,V5267,VOICE MIC,113.0,73.45,56.5,113.0,12
HCPCS,V52670,Hearing aid sup/access/dev,,,229.91,229.91,1
HCPCS,V5268,Ald telephone amplifier,,,277.24,277.24,1
HCPCS,V52680,Ald telephone amplifier,,,277.24,277.24,1
HCPCS,V5269,"Alerting device, any type",,,1999.61,1999.61,1
HCPCS,V52690,"Alerting device, any type",,,1999.61,1999.61,1
HCPCS,V5270,"ASSISTIVE LISTENING DEVICE, TV AMPLIFIER, ANY TYPE",160.0,104.0,26.88,144.0,21
HCPCS,V5270,"Ald, tv amplifier, any type",,,356.86,356.86,1
HCPCS,V52700,"Ald, tv amplifier, any type",,,356.86,356.86,1
HCPCS,V5271,"Ald, tv caption decoder",,,3780.0,3780.0,1
HCPCS,V52710,"Ald, tv caption decoder",,,3780.0,3780.0,1
HCPCS,V5273,Ald for cochlear implant,,,3402.0,3402.0,1
HCPCS,V52730,Ald for cochlear implant,,,3402.0,3402.0,1
HCPCS,V5275,Ear impression,,,7.32,33.76,4
HCPCS,V52750,Ear impression,,,33.76,33.76,1
HCPCS,V5281,"Ald fm/dm system, monaural",,,1469.57,1469.57,1
HCPCS,V5281,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, BEHIND THE EAR",1100.0,715.0,184.8,990.0,21
HCPCS,V52810,"Ald fm/dm system, monaural",,,1469.57,1469.57,1
HCPCS,V5282,Ald fm/dm system binaural,,,1519.56,1519.56,1
HCPCS,V52820,Ald fm/dm system binaural,,,1519.56,1519.56,1
HCPCS,V5284,Ald fm/dm ear level receiver,,,36.62,50.47,4
HCPCS,V52840,Ald fm/dm ear level receiver,,,50.47,50.47,1
HCPCS,V5285,Ald fm/dm aud input receiver,,,384.92,7129.65,4
HCPCS,V52850,Ald fm/dm aud input receiver,,,7129.65,7129.65,1
HCPCS,V5286,Ald blu tooth fm/dm receiver,,,274.86,666.73,4
HCPCS,V52860,Ald blu tooth fm/dm receiver,,,274.86,274.86,1
HCPCS,V5287,"Ald fm/dm receiver, nos",,,162.0,162.0,1
HCPCS,V52870,"Ald fm/dm receiver, nos",,,162.0,162.0,1
HCPCS,V5288,Ald fm/dm transmitter ald,,,140.42,140.42,1
HCPCS,V52880,Ald fm/dm transmitter ald,,,140.42,140.42,1
HCPCS,V5289,Ald fm/dm adapt/boot couplin,,,25.92,25.92,1
HCPCS,V52890,Ald fm/dm adapt/boot couplin,,,25.92,25.92,1
HCPCS,V5290,Ald transmitter microphone,,,594.5,1402.94,4
HCPCS,V52900,Ald transmitter microphone,,,594.5,594.5,1
HCPCS,V5298,Hearing aid noc,,,297.29,322.17,3
HCPCS,V5299,ADVANCED PROGAM AID REPAIR/1YR,323.0,209.95,161.5,323.0,12
HCPCS,V5299,COMPLETELY-IN-CANAL;MONAURAL,1877.0,1220.05,938.5,1877.0,12
HCPCS,V5299,DIGITAL AID REPAIR/12MTHS REPAIR,353.0,229.45,176.5,353.0,12
HCPCS,V5299,EARGENE,11.0,7.15,5.5,11.0,12
HCPCS,V5299,"HEARING AID, OTHER:",55.0,35.75,27.5,55.0,12
HCPCS,V5299,IN THRE CANAL HEARING AID,1114.0,724.1,557.0,1114.0,12
HCPCS,V5299,MINI CANAL HEARING AID,2353.0,1529.45,1176.5,2353.0,12
HCPCS,V5299,MISC - SUPPLY,100.0,65.0,16.8,90.0,21
HCPCS,V5299,MUSICIAN EAR PLUG,72.0,46.8,36.0,72.0,12
HCPCS,V5299,REPLACE TUBING,11.0,7.15,5.5,11.0,12
HCPCS,V5299,T-COIL,56.0,36.4,28.0,56.0,12
HCPCS,V5336,Repair communication device,,,112.29,112.29,1
HCPCS,V53360,Repair communication device,,,112.29,112.29,1
HCPCS,V5362,Speech screening,,,17.96,22.99,7
HCPCS,V53620,Speech screening,,,22.99,22.99,1
HCPCS,V5363,Language screening,,,15.12,22.69,7
HCPCS,V53630,Language screening,,,15.12,15.12,1
HCPCS,V5364,Dysphagia screening,,,17.96,235.44,7
HCPCS,V53640,Dysphagia screening,,,235.44,235.44,1
HCPCS,W0710,OT WK CNDITIONNG PER 15 MIN,303.0,196.95,50.9,723.0,32
HCPCS,W9759,"FAMILY PLANNING,ANNUAL,1ST OV-MCAID",116.0,75.4,58.0,116.0,12
HCPCS,W9850,"MCAID, F/U, COUNSELING FAM PLANNING",69.0,44.85,34.5,69.0,12
HCPCS,W9851,"MCAID, FAM PLANNING,RX REFILL,SUPPLIES",36.0,23.4,18.0,36.0,12
HCPCS,a9591,"FLUOROESTRADIOL F 18, DIAGNOSTIC, 1 MCI",1562.0,1015.3,460.42,2409.0,36
HCPCS,v2788,LENS SYMFONY TORIC ZXT,895.0,581.75,150.36,805.5,21
MS-DRG,001,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,,208665.96,510203.12,28
MS-DRG,001-A,Heart - Adult & Pediatric,,,335323.0,335323.0,1
MS-DRG,001-P,Heart - Pediatric,,,412594.0,412594.0,1
MS-DRG,002,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,,84376.58,415000.0,28
MS-DRG,002-A,Heart - Adult & Pediatric,,,335323.0,335323.0,1
MS-DRG,002-P,Heart - Pediatric,,,412594.0,412594.0,1
MS-DRG,003,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",,,158042.84,533240.7,28
MS-DRG,004,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",,,103137.52,347988.72,28
MS-DRG,005,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,,76771.98,250000.0,28
MS-DRG,005-DA,Liver (Deceased Donor) - Adult,,,397360.0,397360.0,1
MS-DRG,005-DP,Liver (Deceased Donor) - Pediatric,,,385169.0,385169.0,1
MS-DRG,005-LA,Liver (Live Donor) - Adult,,,458602.0,458602.0,1
MS-DRG,005-LP,Liver (Live Donor) - Pediatric,,,457752.0,457752.0,1
MS-DRG,006,LIVER TRANSPLANT WITHOUT MCC,,,34527.1,250000.0,28
MS-DRG,006-DA,Liver (Deceased Donor) - Adult,,,397360.0,397360.0,1
MS-DRG,006-DP,Liver (Deceased Donor) - Pediatric,,,385169.0,385169.0,1
MS-DRG,006-LA,Liver (Live Donor) - Adult,,,458602.0,458602.0,1
MS-DRG,006-LP,Liver (Live Donor) - Pediatric,,,457752.0,457752.0,1
MS-DRG,007,LUNG TRANSPLANT,,,109827.01,109827.01,7
MS-DRG,007,Lung transplant,,,96427.19,325347.87,21
MS-DRG,007-D,Lung (Double) - Adult,,,354264.0,354264.0,1
MS-DRG,007-S,Lung (Single) - Adult,,,349729.0,349729.0,1
MS-DRG,008,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,,,47531.04,47531.04,7
MS-DRG,008,Simultaneous pancreas/kidney transplant,,,41731.85,140804.37,21
MS-DRG,010,PANCREAS TRANSPLANT,,,60855.1,60855.1,7
MS-DRG,010,Pancreas,,,186135.0,186135.0,1
MS-DRG,010,Pancreas transplant,,,53430.26,180275.11,21
MS-DRG,011,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",,,46254.69,46254.69,7
MS-DRG,011,"Tracheostomy for face,mouth & neck diagnoses w MCC",,,40611.23,137023.35,21
MS-DRG,012,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",,,35754.71,35754.71,7
MS-DRG,012,"Tracheostomy for face,mouth & neck diagnoses w CC",,,31392.34,105918.57,21
MS-DRG,013,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",,,24439.73,24439.73,7
MS-DRG,013,"Tracheostomy for face,mouth & neck diagnoses w/o CC/MCC",,,21457.88,72399.46,21
MS-DRG,014,ALLOGENEIC BONE MARROW TRANSPLANT,,,89485.28,301925.7,28
MS-DRG,014-RA,Allogeneic Related BMT ? Adult,,,349444.0,349444.0,1
MS-DRG,014-RP,Allogeneic Related BMT ? Pediatric,,,394880.0,394880.0,1
MS-DRG,014-UA,Allogeneic Unrelated BMT ? Adult,,,392967.0,392967.0,1
MS-DRG,014-UP,Allogeneic Unrelated BMT ? Pediatric,,,444062.0,444062.0,1
MS-DRG,016,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,,,44152.55,148971.85,28
MS-DRG,016-A,Autologous BMT - Adult,,,196483.0,196483.0,1
MS-DRG,016-P,Autologous BMT - Pediatric,,,222030.0,222030.0,1
MS-DRG,017,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,,40448.91,136475.67,28
MS-DRG,017-A,Autologous BMT - Adult,,,196483.0,196483.0,1
MS-DRG,017-P,Autologous BMT - Pediatric,,,222030.0,222030.0,1
MS-DRG,018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,366221.22,366221.22,7
MS-DRG,018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL IMMUNOTHERAPY,,,321539.13,1084881.48,21
MS-DRG,019,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,,,53124.23,179242.56,28
MS-DRG,020,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,,,58591.08,197687.86,28
MS-DRG,021,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,,,39417.63,132996.14,28
MS-DRG,022,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,,,23658.92,79825.82,28
MS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,48597.06,48597.06,7
MS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,42667.81,143962.33,21
MS-DRG,024,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,,,29128.01,98278.66,28
MS-DRG,025,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,,,33854.73,114226.74,28
MS-DRG,026,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,,,23151.1,78112.43,28
MS-DRG,027,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,18785.51,63382.82,28
MS-DRG,028,SPINAL PROCEDURES WITH MCC,,,44737.8,150946.52,28
MS-DRG,029,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,,25402.77,85709.63,28
MS-DRG,030,SPINAL PROCEDURES WITHOUT CC/MCC,,,16345.46,55150.01,28
MS-DRG,031,VENTRICULAR SHUNT PROCEDURES WITH MCC,,,33361.8,112563.6,28
MS-DRG,032,VENTRICULAR SHUNT PROCEDURES WITH CC,,,15867.43,53537.11,28
MS-DRG,033,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,,,12381.95,41777.04,28
MS-DRG,034,CAROTID ARTERY STENT PROCEDURES WITH MCC,,,18158.0,97243.6,28
MS-DRG,035,CAROTID ARTERY STENT PROCEDURES WITH CC,,,17799.66,60056.53,28
MS-DRG,036,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,,,14466.09,48808.96,28
MS-DRG,037,EXTRACRANIAL PROCEDURES WITH MCC,,,24512.98,82707.43,28
MS-DRG,038,EXTRACRANIAL PROCEDURES WITH CC,,,12081.88,40764.58,28
MS-DRG,039,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,8752.77,29532.09,28
MS-DRG,040,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",,,28750.5,97004.93,28
MS-DRG,041,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",,,16371.52,55237.94,28
MS-DRG,042,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",,,12864.45,43405.01,28
MS-DRG,052,SPINAL DISORDERS AND INJURIES WITH CC/MCC,,,13486.94,45505.29,28
MS-DRG,053,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,,7291.12,24600.44,28
MS-DRG,054,NERVOUS SYSTEM NEOPLASMS WITH MCC,,,11369.3,38360.31,28
MS-DRG,055,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,,7591.94,25615.41,28
MS-DRG,056,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,,17297.8,58363.24,28
MS-DRG,057,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,,9647.04,32549.36,28
MS-DRG,058,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,,12728.94,42947.77,28
MS-DRG,059,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,,9239.74,31175.13,28
MS-DRG,060,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,,6848.83,23108.14,28
MS-DRG,061,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",,,20529.37,69266.62,28
MS-DRG,062,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",,,13084.11,44146.14,28
MS-DRG,063,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",,,10452.69,35267.67,28
MS-DRG,064,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,,14973.91,50522.35,28
MS-DRG,065,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,,7522.69,25381.77,28
MS-DRG,066,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,,5096.04,17194.18,28
MS-DRG,067,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,,10935.94,36898.15,28
MS-DRG,068,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,,6436.32,21716.32,28
MS-DRG,069,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,,5947.86,20068.25,28
MS-DRG,070,OTHER CEREBROVASCULAR DISORDERS WITH MCC,,,12396.1,41824.77,28
MS-DRG,071,OTHER CEREBROVASCULAR DISORDERS WITH CC,,,7639.6,25776.2,28
MS-DRG,072,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,,5630.67,18998.01,28
MS-DRG,073,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,,11945.62,40304.83,28
MS-DRG,074,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,,7675.34,25896.79,28
MS-DRG,075,VIRAL MENINGITIS WITH CC/MCC,,,14277.71,48173.35,28
MS-DRG,076,VIRAL MENINGITIS WITHOUT CC/MCC,,,6144.44,20731.5,28
MS-DRG,077,HYPERTENSIVE ENCEPHALOPATHY WITH MCC,,,21351.31,21351.31,1
MS-DRG,078,HYPERTENSIVE ENCEPHALOPATHY WITH CC,,,13779.0,13779.0,1
MS-DRG,079,HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC,,,9205.79,9205.79,1
MS-DRG,080,NONTRAUMATIC STUPOR AND COMA WITH MCC,,,13477.26,45472.63,28
MS-DRG,081,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,,6668.64,22500.16,28
MS-DRG,082,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,,,17018.58,57421.13,28
MS-DRG,083,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,,,10393.13,35066.68,28
MS-DRG,084,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,,,7116.89,24012.56,28
MS-DRG,085,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,,,16916.57,57076.94,28
MS-DRG,086,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,,,9699.9,32727.73,28
MS-DRG,087,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,,,6810.86,22980.01,28
MS-DRG,088,CONCUSSION WITH MCC,,,10065.5,33961.27,28
MS-DRG,089,CONCUSSION WITH CC,,,8180.18,27600.13,28
MS-DRG,090,CONCUSSION WITHOUT CC/MCC,,,6129.55,20681.25,28
MS-DRG,091,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,,13076.67,44121.01,28
MS-DRG,092,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,,7617.26,25700.83,28
MS-DRG,093,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,5929.25,20005.44,28
MS-DRG,094,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,,26205.45,88417.89,28
MS-DRG,095,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,,19204.72,64797.24,28
MS-DRG,096,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,19204.72,64797.24,28
MS-DRG,097,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,,26893.46,90739.25,28
MS-DRG,098,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,,17087.83,57654.77,28
MS-DRG,099,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,,10144.43,34227.58,28
MS-DRG,1,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,,244792.73,261429.12,6
MS-DRG,10,PANCREAS TRANSPLANT,,,62680.75,66940.61,6
MS-DRG,100,SEIZURES WITH MCC,,,14421.41,48658.23,34
MS-DRG,101,SEIZURES WITHOUT MCC,,,6720.76,22676.02,34
MS-DRG,102,HEADACHES WITH MCC,,,8346.22,28160.37,34
MS-DRG,103,HEADACHES WITHOUT MCC,,,6227.09,21010.36,34
MS-DRG,11,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",,,47642.33,50880.16,6
MS-DRG,113,ORBITAL PROCEDURES WITH CC/MCC,,,17506.29,59066.69,34
MS-DRG,114,ORBITAL PROCEDURES WITHOUT CC/MCC,,,10074.44,33991.42,34
MS-DRG,115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT,,,13017.05,14318.76,13
MS-DRG,115,Extraocular procedures except orbit,,,11428.87,38561.29,21
MS-DRG,116,INTRAOCULAR PROCEDURES WITH CC/MCC,,,13463.11,45424.9,34
MS-DRG,117,INTRAOCULAR PROCEDURES WITHOUT CC/MCC,,,8078.17,27255.94,34
MS-DRG,12,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",,,36827.35,39330.18,6
MS-DRG,121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,,,8661.93,29225.59,34
MS-DRG,122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,,,5851.07,19741.65,34
MS-DRG,123,NEUROLOGICAL EYE DISORDERS,,,6772.7,7449.97,13
MS-DRG,123,Neurological eye disorders,,,5946.38,20063.23,21
MS-DRG,124,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,,,9851.8,33240.24,34
MS-DRG,125,OTHER DISORDERS OF THE EYE WITHOUT MCC,,,5717.04,19289.44,34
MS-DRG,13,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",,,25172.92,26883.7,6
MS-DRG,135,SINUS AND MASTOID PROCEDURES WITH CC/MCC,,,16157.82,54516.91,34
MS-DRG,136,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,,,7559.92,25507.38,34
MS-DRG,137,MOUTH PROCEDURES WITH CC/MCC,,,11118.37,37513.66,34
MS-DRG,138,MOUTH PROCEDURES WITHOUT CC/MCC,,,6598.65,22264.0,34
MS-DRG,139,SALIVARY GLAND PROCEDURES,,,10479.62,11527.58,13
MS-DRG,139,Salivary gland procedures,,,9201.02,31044.49,21
MS-DRG,14,ALLOGENEIC BONE MARROW TRANSPLANT,,,104978.05,112112.48,6
MS-DRG,140,MAJOR HEAD AND NECK PROCEDURES WITH MCC,,,31759.42,107157.13,34
MS-DRG,141,MAJOR HEAD AND NECK PROCEDURES WITH CC,,,16240.47,54795.78,34
MS-DRG,142,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,,,11886.79,40106.36,34
MS-DRG,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",,,27897.18,94125.83,34
MS-DRG,144,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",,,12903.17,43535.65,34
MS-DRG,145,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",,,8952.33,30205.38,34
MS-DRG,146,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",,,15766.16,53195.44,34
MS-DRG,147,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",,,9467.59,31943.89,34
MS-DRG,148,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",,,5935.21,20025.54,34
MS-DRG,149,DYSEQUILIBRIUM,,,6374.1,7011.51,13
MS-DRG,149,Dysequilibrium,,,5596.41,18882.45,21
MS-DRG,150,EPISTAXIS WITH MCC,,,9914.35,33451.27,34
MS-DRG,151,EPISTAXIS WITHOUT MCC,,,5465.36,18440.28,34
MS-DRG,152,OTITIS MEDIA AND URI WITH MCC,,,8802.66,29700.41,34
MS-DRG,153,OTITIS MEDIA AND URI WITHOUT MCC,,,5496.64,18545.8,34
MS-DRG,154,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",,,11641.82,39279.81,34
MS-DRG,155,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",,,6824.26,23025.23,34
MS-DRG,156,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",,,5145.93,17362.51,34
MS-DRG,157,DENTAL AND ORAL DISEASES WITH MCC,,,12783.29,43131.17,34
MS-DRG,158,DENTAL AND ORAL DISEASES WITH CC,,,6774.37,22856.91,34
MS-DRG,159,DENTAL AND ORAL DISEASES WITHOUT CC/MCC,,,5275.49,17799.65,34
MS-DRG,16,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,,,51796.76,55316.93,6
MS-DRG,163,MAJOR CHEST PROCEDURES WITH MCC,,,33371.48,112596.26,34
MS-DRG,164,MAJOR CHEST PROCEDURES WITH CC,,,18793.7,63410.45,34
MS-DRG,165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC,,,14253.13,48090.45,34
MS-DRG,166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,,,27830.91,93902.24,34
MS-DRG,167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,,,13428.12,45306.82,34
MS-DRG,168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,10174.21,34328.07,34
MS-DRG,17,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,,47451.9,50676.79,6
MS-DRG,173,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM,,,25242.01,27766.21,13
MS-DRG,173,Ultrasound Accelerated and other Thrombolysis with Principal Diagnosis Pulmonary Embolism,,,22162.27,74776.1,21
MS-DRG,175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,,,10227.83,34508.95,34
MS-DRG,176,PULMONARY EMBOLISM WITHOUT MCC,,,5994.03,20224.02,34
MS-DRG,177,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,,,11635.86,39259.71,34
MS-DRG,178,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,,,7267.3,24520.05,34
MS-DRG,179,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,,,5621.73,18967.87,34
MS-DRG,18,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,377207.86,402843.34,6
MS-DRG,180,RESPIRATORY NEOPLASMS WITH MCC,,,13149.64,44367.22,34
MS-DRG,181,RESPIRATORY NEOPLASMS WITH CC,,,7974.67,26906.73,34
MS-DRG,182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC,,,5612.79,18937.72,34
MS-DRG,183,MAJOR CHEST TRAUMA WITH MCC,,,11391.64,38435.68,34
MS-DRG,184,MAJOR CHEST TRAUMA WITH CC,,,7923.29,26733.38,34
MS-DRG,185,MAJOR CHEST TRAUMA WITHOUT CC/MCC,,,5856.28,19759.24,34
MS-DRG,186,PLEURAL EFFUSION WITH MCC,,,11604.59,39154.2,34
MS-DRG,187,PLEURAL EFFUSION WITH CC,,,7364.84,24849.16,34
MS-DRG,188,PLEURAL EFFUSION WITHOUT CC/MCC,,,5340.27,18018.22,34
MS-DRG,189,PULMONARY EDEMA AND RESPIRATORY FAILURE,,,9198.79,31036.95,34
MS-DRG,19,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,,,62321.74,66557.19,6
MS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,,,8247.93,27828.75,34
MS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,,,6276.98,21178.69,34
MS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,,,4780.33,16128.97,34
MS-DRG,193,SIMPLE PNEUMONIA AND PLEURISY WITH MCC,,,9787.02,33021.67,34
MS-DRG,194,SIMPLE PNEUMONIA AND PLEURISY WITH CC,,,6000.73,20246.63,34
MS-DRG,195,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,,,4679.81,15789.81,34
MS-DRG,196,INTERSTITIAL LUNG DISEASE WITH MCC,,,14052.09,47412.13,34
MS-DRG,197,INTERSTITIAL LUNG DISEASE WITH CC,,,7067.0,23844.24,34
MS-DRG,198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,,,5332.83,17993.09,34
MS-DRG,199,PNEUMOTHORAX WITH MCC,,,13135.49,44319.48,34
MS-DRG,2,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,,98984.87,105712.0,6
MS-DRG,20,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,,,68735.07,73406.39,6
MS-DRG,200,PNEUMOTHORAX WITH CC,,,8185.39,27617.71,34
MS-DRG,201,PNEUMOTHORAX WITHOUT CC/MCC,,,5324.63,17965.46,34
MS-DRG,202,BRONCHITIS AND ASTHMA WITH CC/MCC,,,7231.56,24399.46,34
MS-DRG,203,BRONCHITIS AND ASTHMA WITHOUT CC/MCC,,,4988.82,16832.41,34
MS-DRG,204,RESPIRATORY SIGNS AND SYMPTOMS,,,6011.9,20284.31,34
MS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,,,13633.63,46000.21,34
MS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,,,7007.43,23643.26,34
MS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,,,47912.78,161658.97,34
MS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,,,20466.82,69055.59,34
MS-DRG,209,COMPLEX AORTIC ARCH PROCEDURES,,,86577.5,284362.21,24
MS-DRG,21,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,,,46242.09,49384.75,6
MS-DRG,212,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,,,92220.19,101442.21,13
MS-DRG,212,Concomitant Aortic and Mitral Valve Procedures,,,80968.55,273190.01,21
MS-DRG,213,ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES,,,43652.08,143374.45,24
MS-DRG,215,OTHER HEART ASSIST SYSTEM IMPLANT,,,84442.52,92886.77,13
MS-DRG,215,Other heart assist system implant,,,76161.09,250149.71,21
MS-DRG,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,,,74828.64,245773.28,34
MS-DRG,217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,,,50294.47,165191.26,34
MS-DRG,218,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,50294.47,165191.26,34
MS-DRG,219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,58731.32,192901.93,34
MS-DRG,22,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,,,27755.03,29641.29,6
MS-DRG,220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,,,40790.59,144404.0,34
MS-DRG,221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,38552.49,144404.0,34
MS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC,,,37842.66,124293.53,34
MS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,,,24090.53,79124.89,34
MS-DRG,23,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,50054.97,53456.77,6
MS-DRG,231,CORONARY BYPASS WITH PTCA WITH MCC,,,64480.31,211784.38,34
MS-DRG,232,CORONARY BYPASS WITH PTCA WITHOUT MCC,,,46372.83,152310.7,34
MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,,,64836.79,71320.47,13
MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MCC,,,58478.13,192070.36,21
MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,,,46327.62,50960.38,13
MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITHOUT MCC,,,41784.19,144404.0,21
MS-DRG,235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,44888.92,147436.84,34
MS-DRG,236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,,,32040.13,105235.22,34
MS-DRG,239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,,,37646.08,123647.87,34
MS-DRG,24,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,,,34170.99,36493.29,6
MS-DRG,240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,,,21803.47,71613.11,34
MS-DRG,241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,,,10589.28,34780.28,34
MS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,,,24421.73,80212.71,34
MS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,,,16299.25,63963.0,34
MS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,,,13825.57,63963.0,34
MS-DRG,245,AICD GENERATOR PROCEDURES,,,38692.43,42561.67,13
MS-DRG,245,AICD generator procedures,,,33473.0,114621.18,21
MS-DRG,25,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,,,39716.06,42415.21,6
MS-DRG,250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,,,12293.0,54830.95,34
MS-DRG,251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,,,11431.43,37546.32,34
MS-DRG,252,OTHER VASCULAR PROCEDURES WITH MCC,,,26682.01,87636.56,34
MS-DRG,253,OTHER VASCULAR PROCEDURES WITH CC,,,19853.74,65209.26,34
MS-DRG,254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,,,13628.22,44761.65,34
MS-DRG,255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,,,20632.41,67766.78,34
MS-DRG,256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,,,12987.24,42656.34,34
MS-DRG,257,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,,,8354.24,27439.34,34
MS-DRG,258,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,,,20570.0,78938.98,34
MS-DRG,259,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,,,15467.04,50801.22,34
MS-DRG,26,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,,,27159.3,29005.08,6
MS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,,,16750.0,81720.09,34
MS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,,,14460.43,47495.03,34
MS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,,,12467.11,40947.98,34
MS-DRG,263,VEIN LIGATION AND STRIPPING,,,23386.05,76811.06,34
MS-DRG,264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,,,28330.69,31163.76,13
MS-DRG,264,Other circulatory system O.R. procedures,,,25552.25,83925.89,21
MS-DRG,265,AICD LEAD PROCEDURES,,,30684.94,33753.43,13
MS-DRG,265,AICD lead procedures,,,27675.61,90900.04,21
MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,,,51973.24,57170.56,13
MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC,,,45632.07,153963.79,21
MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,,,40375.01,44412.51,13
MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O MCC,,,35448.92,119605.58,21
MS-DRG,268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,,,51212.84,172793.48,34
MS-DRG,269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,,,31445.95,106099.45,34
MS-DRG,27,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,22037.88,23535.6,6
MS-DRG,270,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,,,39287.33,132556.48,34
MS-DRG,271,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,,,26480.21,89344.92,34
MS-DRG,272,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,,,19009.64,64139.02,34
MS-DRG,273,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,,,34987.2,38485.92,13
MS-DRG,273,PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC,,,12293.0,103644.94,21
MS-DRG,274,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,,,27915.98,30707.58,13
MS-DRG,274,PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC,,,12293.0,82697.38,21
MS-DRG,275,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,,,53092.96,179137.04,34
MS-DRG,276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,,,44725.14,150903.81,34
MS-DRG,277,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,,,39168.2,43085.02,13
MS-DRG,277,Cardiac Defibrillator Implant without MCC,,,34389.35,116030.58,21
MS-DRG,278,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,,,47205.38,51925.92,13
MS-DRG,278,Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with MCC,,,41445.93,139839.64,21
MS-DRG,279,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,,,30584.86,33643.35,13
MS-DRG,279,Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures without MCC,,,26853.25,90603.59,21
MS-DRG,28,SPINAL PROCEDURES WITH MCC,,,52483.34,56050.17,6
MS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",,,12269.76,40299.8,34
MS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",,,7030.2,23090.55,34
MS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",,,5530.99,18166.44,34
MS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",,,15151.14,49763.64,34
MS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",,,5294.64,17390.14,34
MS-DRG,285,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",,,4580.99,15046.16,34
MS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",,,10247.0,55592.17,34
MS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",,,8185.19,26884.12,34
MS-DRG,288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,,,20699.72,67987.86,34
MS-DRG,289,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,,,13056.08,42882.45,34
MS-DRG,29,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,,29800.8,31826.1,6
MS-DRG,290,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,,,7111.28,23356.85,34
MS-DRG,291,HEART FAILURE AND SHOCK WITH MCC,,,9819.79,32252.91,34
MS-DRG,292,HEART FAILURE AND SHOCK WITH CC,,,6494.0,21329.43,34
MS-DRG,293,HEART FAILURE AND SHOCK WITHOUT CC/MCC,,,4329.33,14219.62,34
MS-DRG,294,DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC,,,16956.22,16956.22,1
MS-DRG,295,DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC,,,10905.56,10905.56,1
MS-DRG,296,"CARDIAC ARREST, UNEXPLAINED WITH MCC",,,11946.97,39239.61,34
MS-DRG,297,"CARDIAC ARREST, UNEXPLAINED WITH CC",,,4849.47,15927.98,34
MS-DRG,298,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",,,3481.06,11433.48,34
MS-DRG,299,PERIPHERAL VASCULAR DISORDERS WITH MCC,,,12488.52,41018.32,34
MS-DRG,3,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",,,185405.12,198005.47,6
MS-DRG,30,SPINAL PROCEDURES WITHOUT CC/MCC,,,19175.38,20478.56,6
MS-DRG,300,PERIPHERAL VASCULAR DISORDERS WITH CC,,,8165.31,26818.8,34
MS-DRG,301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,,,5504.99,18081.02,34
MS-DRG,302,ATHEROSCLEROSIS WITH MCC,,,9152.79,30062.18,34
MS-DRG,303,ATHEROSCLEROSIS WITHOUT MCC,,,5149.31,16912.8,34
MS-DRG,304,HYPERTENSION WITH MCC,,,9102.31,29896.37,34
MS-DRG,305,HYPERTENSION WITHOUT MCC,,,5775.76,18970.38,34
MS-DRG,306,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,,,12053.29,39588.82,34
MS-DRG,307,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,,,6985.07,22942.32,34
MS-DRG,308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,,,9209.4,30248.09,34
MS-DRG,309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,,,5627.37,18482.99,34
MS-DRG,31,VENTRICULAR SHUNT PROCEDURES WITH MCC,,,39137.8,41797.65,6
MS-DRG,310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,,,4330.1,14222.13,34
MS-DRG,311,ANGINA PECTORIS,,,5952.61,6547.87,13
MS-DRG,311,Angina pectoris,,,5368.83,17633.83,21
MS-DRG,312,SYNCOPE AND COLLAPSE,,,6666.87,21897.21,34
MS-DRG,313,CHEST PAIN,,,6106.11,6716.72,13
MS-DRG,313,Chest pain,,,5507.28,18088.56,21
MS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,,,15949.69,52386.48,34
MS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,,,7368.28,24200.99,34
MS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,,,5217.38,17136.4,34
MS-DRG,317,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION,,,51145.04,167984.94,30
MS-DRG,318,PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE,,,18527.41,60852.93,24
MS-DRG,319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,,,33230.75,112121.44,34
MS-DRG,32,VENTRICULAR SHUNT PROCEDURES WITH CC,,,18614.58,19879.65,6
MS-DRG,320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,,,17909.86,60428.35,34
MS-DRG,321,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,,,23074.34,25381.77,13
MS-DRG,321,Percutaneous Cardiovascular Procedures with Intraluminal Device with MMC or 4+ Arteries/Intraluminal Devices,,,17741.0,68354.66,21
MS-DRG,322,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,,,14951.5,16446.65,13
MS-DRG,322,Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC,,,13127.3,44291.85,21
MS-DRG,323,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,,,36699.46,40369.41,13
MS-DRG,323,Coronary Intravascular Lithotripsy with Intraluminal Device with MCC,,,17741.0,108717.27,21
MS-DRG,324,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,,,26722.74,29395.01,13
MS-DRG,324,Coronary Intravascular Lithotripsy with Intraluminal Device without MCC,,,23462.35,79162.57,21
MS-DRG,325,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,,,27226.5,29949.15,13
MS-DRG,325,Coronary Intravascular Lithotripsy without Intraluminal Device,,,23904.64,80654.88,21
MS-DRG,326,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",,,38148.62,125298.45,34
MS-DRG,327,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",,,18695.69,61405.64,34
MS-DRG,328,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",,,12255.99,40254.58,34
MS-DRG,329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,34588.0,115477.87,34
MS-DRG,33,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,,,14525.66,15512.84,6
MS-DRG,330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,18336.18,66093.0,34
MS-DRG,331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,12872.5,66093.0,34
MS-DRG,332,RECTAL RESECTION WITH MCC,,,27694.73,90962.85,34
MS-DRG,333,RECTAL RESECTION WITH CC,,,17915.49,58843.09,34
MS-DRG,334,RECTAL RESECTION WITHOUT CC/MCC,,,12528.3,41148.96,34
MS-DRG,335,PERITONEAL ADHESIOLYSIS WITH MCC,,,27313.81,89711.72,34
MS-DRG,336,PERITONEAL ADHESIOLYSIS WITH CC,,,16129.45,52976.87,34
MS-DRG,337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,,,11741.22,38563.81,34
MS-DRG,34,CAROTID ARTERY STENT PROCEDURES WITH MCC,,,33811.11,36108.95,6
MS-DRG,344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,19755.84,64887.68,34
MS-DRG,345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,11509.45,37802.58,34
MS-DRG,346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,9073.24,29800.9,34
MS-DRG,347,ANAL AND STOMAL PROCEDURES WITH MCC,,,17559.04,57672.36,34
MS-DRG,348,ANAL AND STOMAL PROCEDURES WITH CC,,,10011.01,32880.98,34
MS-DRG,349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,,,6659.22,21872.08,34
MS-DRG,35,CAROTID ARTERY STENT PROCEDURES WITH CC,,,20881.35,22300.48,6
MS-DRG,350,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,,,19060.54,62604.0,34
MS-DRG,351,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,,,11660.9,38300.01,34
MS-DRG,352,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,,,8932.5,29338.64,34
MS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,,,22197.4,72906.95,34
MS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,,,12868.68,42266.94,34
MS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,,,10287.91,33790.44,34
MS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,,,33600.53,110360.31,34
MS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,,,17787.75,58423.54,34
MS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,10692.54,35119.44,34
MS-DRG,359,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC,,,26301.85,86387.95,24
MS-DRG,36,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,,,16970.63,18123.97,6
MS-DRG,360,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC,,,18466.98,60654.46,24
MS-DRG,368,MAJOR ESOPHAGEAL DISORDERS WITH MCC,,,12176.44,39993.3,34
MS-DRG,369,MAJOR ESOPHAGEAL DISORDERS WITH CC,,,7650.53,25128.02,34
MS-DRG,37,EXTRACRANIAL PROCEDURES WITH MCC,,,28756.95,30711.31,6
MS-DRG,370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,,,5360.42,17606.2,34
MS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,,,13562.44,44545.59,34
MS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,,,7809.63,25650.58,34
MS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,,,5563.88,18274.47,34
MS-DRG,374,DIGESTIVE MALIGNANCY WITH MCC,,,16358.92,53730.56,34
MS-DRG,375,DIGESTIVE MALIGNANCY WITH CC,,,9252.23,30388.78,34
MS-DRG,376,DIGESTIVE MALIGNANCY WITHOUT CC/MCC,,,7069.97,23221.19,34
MS-DRG,377,GASTROINTESTINAL HEMORRHAGE WITH MCC,,,13982.37,45924.84,34
MS-DRG,378,GASTROINTESTINAL HEMORRHAGE WITH CC,,,7501.37,24638.13,34
MS-DRG,379,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,,,4821.93,15837.54,34
MS-DRG,38,EXTRACRANIAL PROCEDURES WITH CC,,,14173.63,15136.89,6
MS-DRG,380,COMPLICATED PEPTIC ULCER WITH MCC,,,15008.87,49296.35,34
MS-DRG,381,COMPLICATED PEPTIC ULCER WITH CC,,,8287.69,27220.77,34
MS-DRG,382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,,,6123.79,20113.47,34
MS-DRG,383,UNCOMPLICATED PEPTIC ULCER WITH MCC,,,10560.97,34687.33,34
MS-DRG,384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,,,6538.37,21475.14,34
MS-DRG,385,INFLAMMATORY BOWEL DISEASE WITH MCC,,,12103.01,39752.12,34
MS-DRG,386,INFLAMMATORY BOWEL DISEASE WITH CC,,,7467.72,24527.58,34
MS-DRG,387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,,,5211.26,17116.3,34
MS-DRG,388,GASTROINTESTINAL OBSTRUCTION WITH MCC,,,11296.04,37101.65,34
MS-DRG,389,GASTROINTESTINAL OBSTRUCTION WITH CC,,,6041.18,19842.15,34
MS-DRG,39,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,10268.15,10965.99,6
MS-DRG,390,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,,,4161.06,13666.91,34
MS-DRG,391,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",,,9701.23,31863.5,34
MS-DRG,392,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",,,5963.16,19585.89,34
MS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,,,12233.05,40179.21,34
MS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,,,7157.17,23507.59,34
MS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,4964.2,16304.83,34
MS-DRG,397,APPENDIX PROCEDURES WITH MCC,,,20310.47,22341.52,13
MS-DRG,397,Appendix Procedures with MCC,,,17832.43,60167.07,21
MS-DRG,398,APPENDIX PROCEDURES WITH CC,,,12836.41,14120.05,13
MS-DRG,398,Appendix Procedures without MCC/CC,,,11270.27,38026.17,21
MS-DRG,399,APPENDIX PROCEDURES WITHOUT CC/MCC,,,8523.44,28758.3,34
MS-DRG,4,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",,,120993.94,129216.82,6
MS-DRG,40,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",,,33728.12,36020.33,6
MS-DRG,402,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,30752.8,101007.02,30
MS-DRG,405,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",,,40733.34,137435.37,34
MS-DRG,406,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",,,21594.89,72861.72,34
MS-DRG,407,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",,,16527.14,55763.01,34
MS-DRG,408,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,,,26549.46,89578.57,34
MS-DRG,409,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,,,16212.18,54700.31,34
MS-DRG,41,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",,,19205.95,20511.21,6
MS-DRG,410,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,,,11822.01,39887.79,34
MS-DRG,411,CHOLECYSTECTOMY WITH C.D.E. WITH MCC,,,24596.37,82988.81,34
MS-DRG,412,CHOLECYSTECTOMY WITH C.D.E. WITH CC,,,15655.22,52821.11,34
MS-DRG,413,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,,,12364.08,41716.74,34
MS-DRG,414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,,,26527.12,89503.2,34
MS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,,,15388.65,51921.7,34
MS-DRG,416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,,,10151.13,34250.19,34
MS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,,,17769.13,59953.53,34
MS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,,,12595.65,42498.07,34
MS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,,,10169.75,34312.99,34
MS-DRG,42,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",,,15091.69,16117.34,6
MS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,,,25369.27,85596.57,34
MS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,,,12937.43,43651.21,34
MS-DRG,422,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,,,10420.68,35159.64,34
MS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,,,30923.24,104335.82,34
MS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,,,16291.1,54966.61,34
MS-DRG,425,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,,,11171.23,37692.04,34
MS-DRG,426,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,34247.0,276885.61,30
MS-DRG,427,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,,,34247.0,181352.89,30
MS-DRG,428,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,,,34247.0,141241.51,30
MS-DRG,429,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC,,,34247.0,226348.18,30
MS-DRG,430,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC,,,34247.0,144886.85,30
MS-DRG,432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,,,14655.22,49447.09,34
MS-DRG,433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,,,7864.47,26534.91,34
MS-DRG,434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,,,5305.28,17900.14,34
MS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,,,13676.07,46143.41,34
MS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,,,8422.17,28416.63,34
MS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,,,6353.67,21437.46,34
MS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,,,12138.47,40955.51,34
MS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,,,6263.58,21133.47,34
MS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,,,4626.94,15611.43,34
MS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",,,13363.34,45088.25,34
MS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",,,7187.62,24251.23,34
MS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",,,5209.97,17578.56,34
MS-DRG,444,DISORDERS OF THE BILIARY TRACT WITH MCC,,,12441.52,41978.02,34
MS-DRG,445,DISORDERS OF THE BILIARY TRACT WITH CC,,,8148.9,27494.61,34
MS-DRG,446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,,,6160.08,20784.26,34
MS-DRG,447,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,16436.0,167861.84,30
MS-DRG,448,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,16436.0,106541.62,30
MS-DRG,450,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,16436.0,133895.54,30
MS-DRG,451,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,16436.0,81157.34,30
MS-DRG,456,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",,,62571.72,211118.62,34
MS-DRG,457,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",,,44401.24,149810.96,34
MS-DRG,458,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",,,31069.18,104828.23,34
MS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,,,46839.01,51522.91,13
MS-DRG,461,Bilateral or multiple major joint procs of lower extremity w MCC,,,41124.26,138754.33,21
MS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,,,22558.71,24814.58,13
MS-DRG,462,Bilateral or multiple major joint procs of lower extremity w/o MCC,,,19806.36,66827.18,21
MS-DRG,463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,42438.48,143188.54,34
MS-DRG,464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,,,23192.06,78250.61,34
MS-DRG,465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,13579.27,45816.82,34
MS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,,,27263.0,130775.26,34
MS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC,,,26259.06,88598.77,34
MS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,,,20461.61,69038.0,34
MS-DRG,469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,,,25723.71,28296.08,13
MS-DRG,469,Major joint replacement or reattachment of lower extremity w MCC,,,22585.21,76203.08,21
MS-DRG,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,,,16358.46,17994.31,13
MS-DRG,470,Major joint replacement or reattachment of lower extremity w/o MCC,,,14362.59,52095.0,21
MS-DRG,471,CERVICAL SPINAL FUSION WITH MCC,,,18293.0,121311.43,34
MS-DRG,472,CERVICAL SPINAL FUSION WITH CC,,,18293.0,74014.87,34
MS-DRG,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,,,18177.92,61332.78,34
MS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,31964.93,107850.53,34
MS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,,,16944.86,57172.41,34
MS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,8787.77,29650.16,34
MS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,25722.95,86789.92,34
MS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,,,18311.2,61782.48,34
MS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,,,13841.37,46701.14,34
MS-DRG,480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,,,21684.99,73165.71,34
MS-DRG,481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,,,15595.65,52620.12,34
MS-DRG,482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,,,12144.43,52095.0,34
MS-DRG,483,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,,,23507.7,25858.47,13
MS-DRG,483,MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES,,,20639.57,69638.44,21
MS-DRG,485,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,,,24028.99,81074.43,34
MS-DRG,486,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,,,15570.33,52534.71,34
MS-DRG,487,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,11661.93,52095.0,34
MS-DRG,488,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,,,13171.23,52095.0,34
MS-DRG,489,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,8315.69,52095.0,34
MS-DRG,492,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",,,27338.73,92241.61,34
MS-DRG,493,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",,,18883.8,63714.44,34
MS-DRG,494,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",,,14940.4,50409.3,34
MS-DRG,495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,,,26996.96,91088.46,34
MS-DRG,496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,,,13431.84,45319.38,34
MS-DRG,497,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,,,8997.0,30356.12,34
MS-DRG,498,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,,,22463.09,75791.07,34
MS-DRG,499,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,,,15002.2,50617.82,34
MS-DRG,5,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,,90063.67,96184.51,6
MS-DRG,500,SOFT TISSUE PROCEDURES WITH MCC,,,23565.1,79509.27,34
MS-DRG,501,SOFT TISSUE PROCEDURES WITH CC,,,13016.35,43917.52,34
MS-DRG,502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC,,,10021.57,33813.05,34
MS-DRG,503,FOOT PROCEDURES WITH MCC,,,20782.53,70120.81,34
MS-DRG,504,FOOT PROCEDURES WITH CC,,,13918.06,46959.91,34
MS-DRG,505,FOOT PROCEDURES WITHOUT CC/MCC,,,13349.19,45040.51,34
MS-DRG,506,MAJOR THUMB OR JOINT PROCEDURES,,,11442.18,12586.4,13
MS-DRG,506,Major thumb or joint procedures,,,10046.14,33895.95,21
MS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,,,13450.45,45382.19,34
MS-DRG,508,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,,,11276.22,38046.27,34
MS-DRG,509,Arthroscopy,,,24256.51,24256.51,1
MS-DRG,510,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",,,25616.01,28177.61,13
MS-DRG,510,"Shoulder,elbow or forearm proc,exc major joint proc w MCC",,,22490.64,75884.02,21
MS-DRG,511,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",,,17634.8,19398.28,13
MS-DRG,511,"Shoulder,elbow or forearm proc,exc major joint proc w CC",,,15483.21,52240.77,21
MS-DRG,512,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",,,14038.98,15442.88,13
MS-DRG,512,"Shoulder,elbow or forearm proc,exc major joint proc w/o CC/MCC",,,12326.11,41588.61,21
MS-DRG,513,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",,,11722.24,39551.14,34
MS-DRG,514,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",,,7612.05,25683.24,34
MS-DRG,515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,,,23729.66,80064.49,34
MS-DRG,516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,,,15473.53,52208.11,34
MS-DRG,517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,,,11442.27,46001.0,34
MS-DRG,518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,,,10672.0,93892.19,34
MS-DRG,519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,,,10672.0,50251.02,34
MS-DRG,52,SPINAL DISORDERS AND INJURIES WITH CC/MCC,,,15821.95,16897.23,6
MS-DRG,520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,,,10672.0,37531.25,34
MS-DRG,521,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,,,21371.51,72108.03,34
MS-DRG,522,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,,,15768.39,53202.98,34
MS-DRG,53,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,,8553.45,9134.75,6
MS-DRG,533,FRACTURES OF FEMUR WITH MCC,,,11673.09,39385.33,34
MS-DRG,534,FRACTURES OF FEMUR WITHOUT MCC,,,6002.22,20251.65,34
MS-DRG,535,FRACTURES OF HIP AND PELVIS WITH MCC,,,9545.77,32207.69,34
MS-DRG,536,FRACTURES OF HIP AND PELVIS WITHOUT MCC,,,6013.39,20289.33,34
MS-DRG,537,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",,,7105.72,23974.88,34
MS-DRG,538,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",,,5363.35,18096.1,34
MS-DRG,539,OSTEOMYELITIS WITH MCC,,,14666.39,49484.77,34
MS-DRG,54,NERVOUS SYSTEM NEOPLASMS WITH MCC,,,13337.69,14244.13,6
MS-DRG,540,OSTEOMYELITIS WITH CC,,,9652.25,32566.94,34
MS-DRG,541,OSTEOMYELITIS WITHOUT CC/MCC,,,5862.98,19781.85,34
MS-DRG,542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,,,13153.36,44379.78,34
MS-DRG,543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,,,7654.49,25826.44,34
MS-DRG,544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,,,5618.75,18957.82,34
MS-DRG,545,CONNECTIVE TISSUE DISORDERS WITH MCC,,,18478.74,62347.75,34
MS-DRG,546,CONNECTIVE TISSUE DISORDERS WITH CC,,,8588.22,28976.87,34
MS-DRG,547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,6226.35,21007.85,34
MS-DRG,548,SEPTIC ARTHRITIS WITH MCC,,,14377.48,48510.0,34
MS-DRG,549,SEPTIC ARTHRITIS WITH CC,,,8988.81,30328.49,34
MS-DRG,55,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,,8906.35,9511.63,6
MS-DRG,550,SEPTIC ARTHRITIS WITHOUT CC/MCC,,,6508.55,21960.01,34
MS-DRG,551,MEDICAL BACK PROBLEMS WITH MCC,,,12480.24,42108.66,34
MS-DRG,552,MEDICAL BACK PROBLEMS WITHOUT MCC,,,7157.84,24150.74,34
MS-DRG,553,BONE DISEASES AND ARTHROPATHIES WITH MCC,,,9652.25,32566.94,34
MS-DRG,554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,,,6180.92,20854.6,34
MS-DRG,555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,9842.12,33207.58,34
MS-DRG,556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,,,6184.65,20867.16,34
MS-DRG,557,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",,,11071.46,37355.39,34
MS-DRG,558,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",,,6650.77,22439.86,34
MS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",,,13886.05,46851.88,34
MS-DRG,56,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,,20292.61,21671.72,6
MS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",,,8384.94,28291.01,34
MS-DRG,561,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",,,5985.84,20196.38,34
MS-DRG,562,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",,,12083.32,13291.65,13
MS-DRG,562,"Fx, sprn, strn & disl except femur, hip, pelvis & thigh w MCC",,,10609.06,35795.25,21
MS-DRG,563,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",,,7594.48,8353.93,13
MS-DRG,563,"Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o MCC",,,6667.89,22497.65,21
MS-DRG,564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,,,11493.65,38779.86,34
MS-DRG,565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,,,7255.38,24479.85,34
MS-DRG,566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,,,5579.29,18824.66,34
MS-DRG,57,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,,11317.25,12086.38,6
MS-DRG,570,SKIN DEBRIDEMENT WITH MCC,,,21899.43,73889.26,34
MS-DRG,571,SKIN DEBRIDEMENT WITH CC,,,12580.02,42445.31,34
MS-DRG,572,SKIN DEBRIDEMENT WITHOUT CC/MCC,,,8535.35,28798.49,34
MS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,48781.72,164590.82,34
MS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,,,25848.04,87211.98,34
MS-DRG,575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,13380.46,45146.03,34
MS-DRG,576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,36494.34,123132.85,34
MS-DRG,577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,,,19737.11,66593.54,34
MS-DRG,578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,11961.25,40357.59,34
MS-DRG,579,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",,,24113.87,81360.84,34
MS-DRG,58,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,,14932.72,15947.57,6
MS-DRG,580,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",,,12866.69,43412.54,34
MS-DRG,581,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",,,10745.32,36255.0,34
MS-DRG,582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC,,,14345.46,48401.97,34
MS-DRG,583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,,,12839.88,43322.1,34
MS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",,,15939.65,53780.81,34
MS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",,,14364.08,48464.78,34
MS-DRG,59,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,,10839.43,11576.09,6
MS-DRG,592,SKIN ULCERS WITH MCC,,,14410.24,48620.54,34
MS-DRG,593,SKIN ULCERS WITH CC,,,8833.19,29803.41,34
MS-DRG,594,SKIN ULCERS WITHOUT CC/MCC,,,6454.19,21776.62,34
MS-DRG,595,MAJOR SKIN DISORDERS WITH MCC,,,15790.73,53278.35,34
MS-DRG,596,MAJOR SKIN DISORDERS WITHOUT MCC,,,8060.3,27195.65,34
MS-DRG,597,MALIGNANT BREAST DISORDERS WITH MCC,,,12413.23,41882.55,34
MS-DRG,598,MALIGNANT BREAST DISORDERS WITH CC,,,8423.66,28421.65,34
MS-DRG,599,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,5728.95,19329.64,34
MS-DRG,6,LIVER TRANSPLANT WITHOUT MCC,,,40504.84,43257.6,6
MS-DRG,60,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,,8034.58,8580.62,6
MS-DRG,600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,,,7755.75,26168.12,34
MS-DRG,601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,4504.83,15199.42,34
MS-DRG,602,CELLULITIS WITH MCC,,,10583.0,35707.32,34
MS-DRG,603,CELLULITIS WITHOUT MCC,,,6484.72,21879.62,34
MS-DRG,604,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",,,10961.26,36983.57,34
MS-DRG,605,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",,,6820.54,23012.67,34
MS-DRG,606,MINOR SKIN DISORDERS WITH MCC,,,11267.29,38016.12,34
MS-DRG,607,MINOR SKIN DISORDERS WITHOUT MCC,,,6749.05,22771.49,34
MS-DRG,61,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",,,24083.66,25720.41,6
MS-DRG,614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,,,16320.14,55064.59,34
MS-DRG,615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,,,10419.19,35154.61,34
MS-DRG,616,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,25967.18,87613.95,34
MS-DRG,617,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,13926.25,46987.55,34
MS-DRG,618,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,10560.66,35631.95,34
MS-DRG,619,O.R. PROCEDURES FOR OBESITY WITH MCC,,,22085.72,72540.15,34
MS-DRG,62,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",,,15349.39,16392.55,6
MS-DRG,620,O.R. PROCEDURES FOR OBESITY WITH CC,,,12240.69,49126.0,34
MS-DRG,621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,,,11537.75,49126.0,34
MS-DRG,622,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,26501.8,89417.78,34
MS-DRG,623,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,13357.38,45068.15,34
MS-DRG,624,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,9321.65,31451.48,34
MS-DRG,625,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",,,22487.66,75873.97,34
MS-DRG,626,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",,,11164.53,37669.43,34
MS-DRG,627,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",,,9890.52,33370.88,34
MS-DRG,628,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",,,27749.75,93628.4,34
MS-DRG,629,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",,,16223.34,54737.99,34
MS-DRG,63,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",,,12262.39,13095.75,6
MS-DRG,630,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",,,10867.44,36667.02,34
MS-DRG,637,DIABETES WITH MCC,,,10697.67,36094.21,34
MS-DRG,638,DIABETES WITH CC,,,6673.11,22515.23,34
MS-DRG,639,DIABETES WITHOUT CC/MCC,,,4625.46,15606.41,34
MS-DRG,64,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,,17566.36,18760.19,6
MS-DRG,640,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",,,11326.84,12459.52,13
MS-DRG,640,Nutritional & misc metabolic disorders w MCC,,,9944.88,33554.28,21
MS-DRG,641,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",,,6599.69,7259.66,13
MS-DRG,641,Nutritional & misc metabolic disorders w/o MCC,,,5794.48,19550.72,21
MS-DRG,642,INBORN AND OTHER DISORDERS OF METABOLISM,,,12060.43,13266.47,13
MS-DRG,642,Inborn errors of metabolism,,,10588.96,35727.42,21
MS-DRG,643,ENDOCRINE DISORDERS WITH MCC,,,12256.86,41354.97,34
MS-DRG,644,ENDOCRINE DISORDERS WITH CC,,,7632.15,25751.08,34
MS-DRG,645,ENDOCRINE DISORDERS WITHOUT CC/MCC,,,5720.76,19302.0,34
MS-DRG,65,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,,8825.11,9424.88,6
MS-DRG,650,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,,,35006.62,215000.0,35
MS-DRG,650-DA,Kidney (Deceased ) - Adult,,,143039.0,143039.0,1
MS-DRG,650-DP,Kidney (Deceased) - Pediatric,,,166486.0,166486.0,1
MS-DRG,650-LA,Kidney ( Live Donor) - Adult,,,131556.0,131556.0,1
MS-DRG,650-LP,Kidney ( Live Donor) - Pediatric,,,153120.0,153120.0,1
MS-DRG,651,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,,,27593.39,215000.0,35
MS-DRG,651-DA,Kidney (Deceased ) - Adult,,,143039.0,143039.0,1
MS-DRG,651-DP,Kidney (Deceased) - Pediatric,,,166486.0,166486.0,1
MS-DRG,651-LA,Kidney ( Live Donor) - Adult,,,131556.0,131556.0,1
MS-DRG,651-LP,Kidney (Live Donor) - Pediatric,,,153120.0,153120.0,1
MS-DRG,652,KIDNEY TRANSPLANT,,,27388.48,30127.33,13
MS-DRG,652,Kidney transplant,,,24046.86,215000.0,22
MS-DRG,652-DA,Kidney (Deceased ) - Adult,,,143039.0,143039.0,1
MS-DRG,652-DP,Kidney (Deceased) - Pediatric,,,166486.0,166486.0,1
MS-DRG,652-LA,Kidney ( Live Donor) - Adult,,,131556.0,131556.0,1
MS-DRG,652-LP,Kidney (Live Donor) - Pediatric,,,153120.0,153120.0,1
MS-DRG,653,MAJOR BLADDER PROCEDURES WITH MCC,,,38692.39,130549.16,34
MS-DRG,654,MAJOR BLADDER PROCEDURES WITH CC,,,20843.59,70326.81,34
MS-DRG,655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,,,15760.2,53175.34,34
MS-DRG,656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,,,23706.57,79986.61,34
MS-DRG,657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,,,13626.18,45975.09,34
MS-DRG,658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,,,11554.7,38985.87,34
MS-DRG,659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,,,18919.54,63835.03,34
MS-DRG,66,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,,5978.33,6384.62,6
MS-DRG,660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,,,9841.38,33205.07,34
MS-DRG,661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,,,7709.59,26012.35,34
MS-DRG,662,MINOR BLADDER PROCEDURES WITH MCC,,,22795.93,76914.06,34
MS-DRG,663,MINOR BLADDER PROCEDURES WITH CC,,,11319.41,38191.98,34
MS-DRG,664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC,,,7795.22,26301.27,34
MS-DRG,665,PROSTATECTOMY WITH MCC,,,23240.46,78413.91,34
MS-DRG,666,PROSTATECTOMY WITH CC,,,13025.29,43947.66,34
MS-DRG,667,PROSTATECTOMY WITHOUT CC/MCC,,,8236.77,27791.06,34
MS-DRG,668,TRANSURETHRAL PROCEDURES WITH MCC,,,21742.32,73359.16,34
MS-DRG,669,TRANSURETHRAL PROCEDURES WITH CC,,,11556.19,38990.9,34
MS-DRG,67,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,,12829.3,13701.19,6
MS-DRG,670,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,,,7276.98,24552.71,34
MS-DRG,671,URETHRAL PROCEDURES WITH CC/MCC,,,13365.57,45095.79,34
MS-DRG,672,URETHRAL PROCEDURES WITHOUT CC/MCC,,,8037.96,27120.28,34
MS-DRG,673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,,,31285.11,105556.8,34
MS-DRG,674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,,,17413.22,58752.65,34
MS-DRG,675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,,,12221.86,41236.89,34
MS-DRG,68,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,,7550.65,8063.8,6
MS-DRG,682,RENAL FAILURE WITH MCC,,,11027.53,37207.16,34
MS-DRG,683,RENAL FAILURE WITH CC,,,6521.21,22002.72,34
MS-DRG,684,RENAL FAILURE WITHOUT CC/MCC,,,4469.83,15081.34,34
MS-DRG,686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,,,13430.35,45314.36,34
MS-DRG,687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,,,7801.92,26323.88,34
MS-DRG,688,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,,,5884.57,19854.71,34
MS-DRG,689,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,,,8639.59,29150.22,34
MS-DRG,69,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,,6977.62,7451.83,6
MS-DRG,690,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,,,6027.54,20337.07,34
MS-DRG,693,URINARY STONES WITH MCC,,,10011.15,33777.87,34
MS-DRG,694,URINARY STONES WITHOUT MCC,,,5820.54,19638.65,34
MS-DRG,695,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,,,8516.73,28735.69,34
MS-DRG,696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,,,5130.29,17309.75,34
MS-DRG,697,URETHRAL STRICTURE,,,9140.51,10054.56,13
MS-DRG,697,Urethral stricture,,,8025.3,27077.57,21
MS-DRG,698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,,,12318.66,41563.49,34
MS-DRG,699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,,,7557.69,25499.85,34
MS-DRG,7,LUNG TRANSPLANT,,,113121.82,120809.71,6
MS-DRG,70,OTHER CEREBROVASCULAR DISORDERS WITH MCC,,,14542.26,15530.57,6
MS-DRG,700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,,,5137.0,17332.36,34
MS-DRG,707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,,,12060.0,50253.54,34
MS-DRG,708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,,,11735.1,38543.71,34
MS-DRG,709,PENIS PROCEDURES WITH CC/MCC,,,17327.59,58463.73,34
MS-DRG,71,OTHER CEREBROVASCULAR DISORDERS WITH CC,,,8962.25,9571.33,6
MS-DRG,710,PENIS PROCEDURES WITHOUT CC/MCC,,,10433.34,35202.35,34
MS-DRG,711,TESTES PROCEDURES WITH CC/MCC,,,15515.97,52351.31,34
MS-DRG,712,TESTES PROCEDURES WITHOUT CC/MCC,,,8188.37,27627.76,34
MS-DRG,713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,,,11194.32,37769.92,34
MS-DRG,714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,,,7873.4,26565.06,34
MS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,,,16658.94,56207.69,34
MS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,,,10953.07,36955.93,34
MS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,,,14076.66,47495.03,34
MS-DRG,718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,,,10000.72,33742.7,34
MS-DRG,72,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,,6605.51,7054.43,6
MS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",,,13475.03,45465.09,34
MS-DRG,723,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",,,8508.54,28708.05,34
MS-DRG,724,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,4882.34,16473.15,34
MS-DRG,725,BENIGN PROSTATIC HYPERTROPHY WITH MCC,,,8713.31,29398.93,34
MS-DRG,726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,,,5376.01,18138.81,34
MS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,,,11041.67,37254.9,34
MS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,,,6040.2,20379.78,34
MS-DRG,729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,,,7883.08,26597.72,34
MS-DRG,73,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,,14013.78,14966.17,6
MS-DRG,730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,5003.71,16882.66,34
MS-DRG,734,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",,,7643.0,53511.99,34
MS-DRG,735,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",,,7643.0,33803.0,34
MS-DRG,736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,,,16438.0,89802.16,34
MS-DRG,737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,,,7643.0,51768.45,34
MS-DRG,738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,7643.0,36893.13,34
MS-DRG,739,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,,,30384.72,33423.19,13
MS-DRG,739,"Uterine,adnexa proc for non-ovarian/adnexal malig w MCC",,,7643.0,90010.68,21
MS-DRG,74,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,,9004.18,9616.11,6
MS-DRG,740,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,,,15346.71,16881.38,13
MS-DRG,740,"Uterine,adnexa proc for non-ovarian/adnexal malig w CC",,,7643.0,45462.58,21
MS-DRG,741,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,12094.35,13303.79,13
MS-DRG,741,"Uterine,adnexa proc for non-ovarian/adnexal malig w/o CC/MCC",,,7643.0,35827.91,21
MS-DRG,742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,,,7643.0,46095.68,34
MS-DRG,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,,,7643.0,31170.11,34
MS-DRG,744,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",,,15257.6,51479.54,34
MS-DRG,745,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",,,8469.83,28577.41,34
MS-DRG,746,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",,,12934.45,43641.16,34
MS-DRG,747,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",,,6401.33,21598.24,34
MS-DRG,748,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,11765.3,12941.83,13
MS-DRG,748,Female reproductive system reconstructive procedures,,,7643.0,34853.14,21
MS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,,,19118.35,64505.81,34
MS-DRG,75,VIRAL MENINGITIS WITH CC/MCC,,,16749.63,17887.96,6
MS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,10988.81,37076.52,34
MS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,13713.3,46269.03,34
MS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,8099.76,27328.8,34
MS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,7151.88,24130.64,34
MS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,10661.93,35973.62,34
MS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,7289.63,24595.42,34
MS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,4941.17,16671.62,34
MS-DRG,76,VIRAL MENINGITIS WITHOUT CC/MCC,,,7208.23,7698.11,6
MS-DRG,760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,,,7501.85,25311.42,34
MS-DRG,761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,,,4247.94,14332.67,34
MS-DRG,768,VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,,,0.01,26921.81,34
MS-DRG,769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,,,12582.25,42452.85,34
MS-DRG,770,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,7466.1,25190.83,34
MS-DRG,776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,,,4874.9,16448.03,34
MS-DRG,779,ABORTION WITHOUT D&C,,,6264.32,21135.98,34
MS-DRG,783,CESAREAN SECTION WITH STERILIZATION WITH MCC,,,0.01,61679.48,34
MS-DRG,784,CESAREAN SECTION WITH STERILIZATION WITH CC,,,0.01,26632.89,34
MS-DRG,785,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,,,0.01,24062.81,34
MS-DRG,786,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,,,0.01,41440.39,34
MS-DRG,787,CESAREAN SECTION WITHOUT STERILIZATION WITH CC,,,0.01,28057.37,34
MS-DRG,788,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,,,0.01,24087.93,34
MS-DRG,789,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",,,15283.95,16812.35,13
MS-DRG,789,"Neonates, died or transferred to another acute care facility",,,13419.18,45276.67,21
MS-DRG,790,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",,,50405.15,55445.67,13
MS-DRG,790,"Extreme immaturity or respiratory distress syndrome, neonate",,,44255.3,149318.55,21
MS-DRG,791,PREMATURITY WITH MAJOR PROBLEMS,,,30223.31,101974.26,34
MS-DRG,792,PREMATURITY WITHOUT MAJOR PROBLEMS,,,18236.74,61531.25,34
MS-DRG,793,FULL TERM NEONATE WITH MAJOR PROBLEMS,,,31046.84,104752.86,34
MS-DRG,794,NEONATE WITH OTHER SIGNIFICANT PROBLEMS,,,10989.55,37079.04,34
MS-DRG,795,NORMAL NEWBORN,,,1694.44,1863.88,13
MS-DRG,795,Normal newborn,,,1487.71,5019.58,21
MS-DRG,796,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,,,0.01,29318.54,34
MS-DRG,797,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,,,0.01,25133.05,34
MS-DRG,798,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,,,0.01,24045.22,34
MS-DRG,799,SPLENIC PROCEDURES WITH MCC,,,33722.19,113779.55,34
MS-DRG,8,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,,,48956.97,52284.14,6
MS-DRG,80,NONTRAUMATIC STUPOR AND COMA WITH MCC,,,15810.6,16885.11,6
MS-DRG,800,SPLENIC PROCEDURES WITH CC,,,20918.79,70580.56,34
MS-DRG,801,SPLENIC PROCEDURES WITHOUT CC/MCC,,,14213.67,47957.29,34
MS-DRG,802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,,,29665.61,100092.54,34
MS-DRG,803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,,,13841.37,46701.14,34
MS-DRG,804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,,,10096.78,34066.79,34
MS-DRG,805,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,,,0.01,27112.74,34
MS-DRG,806,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,,,0.01,18942.74,34
MS-DRG,807,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,,,0.01,16937.93,34
MS-DRG,808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,,,16440.02,55469.07,34
MS-DRG,809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,,,9425.89,31803.21,34
MS-DRG,81,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,,7823.19,8354.86,6
MS-DRG,810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,,,7792.98,26293.73,34
MS-DRG,811,RED BLOOD CELL DISORDERS WITH MCC,,,10456.42,35280.23,34
MS-DRG,812,RED BLOOD CELL DISORDERS WITHOUT MCC,,,6836.92,23067.94,34
MS-DRG,813,COAGULATION DISORDERS,,,12935.64,14229.2,13
MS-DRG,813,Coagulation disorders,,,11357.38,38320.11,21
MS-DRG,814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,,,15835.41,53429.08,34
MS-DRG,815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,,,7550.24,25474.72,34
MS-DRG,816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,,,4705.87,15877.74,34
MS-DRG,817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,,,16988.79,57320.64,34
MS-DRG,818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,,,8631.4,29122.58,34
MS-DRG,819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,6402.82,21603.27,34
MS-DRG,82,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,,,19965.04,21321.88,6
MS-DRG,820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,,,43669.3,147341.37,34
MS-DRG,821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,,,16668.62,56240.35,34
MS-DRG,822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,8964.98,30248.09,34
MS-DRG,823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,,,34138.42,115183.93,34
MS-DRG,824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,,,16869.66,56918.67,34
MS-DRG,825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,,,10047.63,33900.98,34
MS-DRG,826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,,,34830.9,117520.37,34
MS-DRG,827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,,,17209.2,58064.28,34
MS-DRG,828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,12686.49,42804.57,34
MS-DRG,829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,,,23529.36,79388.68,34
MS-DRG,83,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,,,12192.5,13021.12,6
MS-DRG,830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,,,11206.23,37810.12,34
MS-DRG,831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,,,8953.82,30210.41,34
MS-DRG,832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,,,5373.03,18128.76,34
MS-DRG,833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,,,3893.51,13136.82,34
MS-DRG,834,ACUTE LEUKEMIA WITH MCC,,,46558.3,51214.13,13
MS-DRG,834,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC,,,40877.8,137922.76,21
MS-DRG,835,ACUTE LEUKEMIA WITH CC,,,17689.08,19457.99,13
MS-DRG,835,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC,,,15530.87,52401.55,21
MS-DRG,836,ACUTE LEUKEMIA WITHOUT CC/MCC,,,10342.23,11376.45,13
MS-DRG,836,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,9080.4,30637.5,21
MS-DRG,837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,,,35772.82,120698.43,34
MS-DRG,838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,,,15542.78,52441.75,34
MS-DRG,839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,10751.28,36275.1,34
MS-DRG,84,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,,,8349.05,8916.46,6
MS-DRG,840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,,,24087.07,81270.39,34
MS-DRG,841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,,,12147.4,40985.66,34
MS-DRG,842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,,,7523.44,25384.28,34
MS-DRG,843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,,,14853.28,50115.36,34
MS-DRG,844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,,,9064.76,30584.74,34
MS-DRG,845,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,,,6341.01,21394.75,34
MS-DRG,846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,,,19303.76,65131.38,34
MS-DRG,847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,,,9740.86,32865.91,34
MS-DRG,848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,6324.63,21339.48,34
MS-DRG,849,RADIOTHERAPY,,,22978.51,25276.36,13
MS-DRG,849,Radiotherapy,,,20174.94,68070.77,21
MS-DRG,85,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,,,19845.36,21194.07,6
MS-DRG,850,ACUTE LEUKEMIA WITH OTHER PROCEDURES,,,66236.52,217552.62,30
MS-DRG,853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,,,36772.82,124072.45,34
MS-DRG,854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,,,14877.85,50198.27,34
MS-DRG,855,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,11148.15,37614.16,34
MS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,,,33869.62,114276.99,34
MS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,,,15945.61,53800.9,34
MS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,,,10371.53,34993.83,34
MS-DRG,86,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,,,11379.26,12152.61,6
MS-DRG,862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,,,13579.27,45816.82,34
MS-DRG,863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,,,7430.36,25070.24,34
MS-DRG,864,FEVER AND INFLAMMATORY CONDITIONS,,,6609.81,22301.69,34
MS-DRG,865,VIRAL ILLNESS WITH MCC,,,11156.34,37641.79,34
MS-DRG,866,VIRAL ILLNESS WITHOUT MCC,,,6475.04,21846.96,34
MS-DRG,867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,,,15585.97,52587.46,34
MS-DRG,868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,,,7677.57,25904.33,34
MS-DRG,869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,,,5433.35,18332.25,34
MS-DRG,87,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,,,7990.03,8533.04,6
MS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,,,51465.26,173645.15,34
MS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,,,14463.86,48801.43,34
MS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,,,7619.49,25708.37,34
MS-DRG,876,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,,,28778.05,97097.88,34
MS-DRG,88,CONCUSSION WITH MCC,,,11808.16,12610.65,6
MS-DRG,880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,,,7149.65,24123.1,34
MS-DRG,881,DEPRESSIVE NEUROSES,,,7979.5,8777.45,13
MS-DRG,881,Depressive neuroses,,,7005.94,23638.23,21
MS-DRG,882,NEUROSES EXCEPT DEPRESSIVE,,,9106.59,10017.25,13
MS-DRG,882,Neuroses except depressive,,,7995.51,26977.08,21
MS-DRG,883,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,,14641.07,49399.35,34
MS-DRG,884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,,,11979.87,40420.39,34
MS-DRG,885,PSYCHOSES,,,11845.86,13030.45,13
MS-DRG,885,Psychoses,,,10400.57,35091.81,21
MS-DRG,886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS,,,15452.68,52137.76,34
MS-DRG,887,OTHER MENTAL DISORDER DIAGNOSES,,,9082.0,9990.2,13
MS-DRG,887,Other mental disorder diagnoses,,,7973.92,26904.22,21
MS-DRG,89,CONCUSSION WITH CC,,,9596.42,10248.6,6
MS-DRG,894,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",,,5231.75,5754.93,13
MS-DRG,894,"Alcohol/drug abuse or dependence, left AMA",,,4593.44,15498.38,21
MS-DRG,895,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",,,12005.3,13205.83,13
MS-DRG,895,Alcohol/drug abuse or dependence w rehabilitation therapy,,,10540.56,35564.12,21
MS-DRG,896,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",,,14799.7,16279.67,13
MS-DRG,896,Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC,,,12994.01,43842.15,21
MS-DRG,897,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",,,7486.77,8235.45,13
MS-DRG,897,Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC,,,6573.33,22178.58,21
MS-DRG,90,CONCUSSION WITHOUT CC/MCC,,,7190.76,7679.45,6
MS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,,,31247.88,105431.18,34
MS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC,,,14255.37,48097.98,34
MS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,,,8708.84,29383.86,34
MS-DRG,904,SKIN GRAFTS FOR INJURIES WITH CC/MCC,,,27349.9,92279.29,34
MS-DRG,905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,,,11045.4,37267.46,34
MS-DRG,906,HAND PROCEDURES FOR INJURIES,,,16658.67,18324.54,13
MS-DRG,906,Hand procedures for injuries,,,14626.18,49349.11,21
MS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,,,28587.43,96454.73,34
MS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC,,,14856.26,50125.41,34
MS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,,,9774.36,32978.96,34
MS-DRG,91,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,,15340.66,16383.22,6
MS-DRG,913,TRAUMATIC INJURY WITH MCC,,,12171.23,41066.06,34
MS-DRG,914,TRAUMATIC INJURY WITHOUT MCC,,,6593.43,22246.42,34
MS-DRG,915,ALLERGIC REACTIONS WITH MCC,,,12521.19,42246.84,34
MS-DRG,916,ALLERGIC REACTIONS WITHOUT MCC,,,4961.27,16739.45,34
MS-DRG,917,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,,,11678.31,39402.91,34
MS-DRG,918,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,,,6381.97,21532.92,34
MS-DRG,919,COMPLICATIONS OF TREATMENT WITH MCC,,,13632.14,45995.19,34
MS-DRG,92,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,,8936.04,9543.35,6
MS-DRG,920,COMPLICATIONS OF TREATMENT WITH CC,,,7463.13,25180.78,34
MS-DRG,921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,,,5125.83,17294.67,34
MS-DRG,922,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",,,13026.03,43950.18,34
MS-DRG,923,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",,,7577.79,25567.68,34
MS-DRG,927,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,,,158975.82,536388.61,34
MS-DRG,928,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,,,53407.92,180199.74,34
MS-DRG,929,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,,,23982.08,80916.16,34
MS-DRG,93,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,6955.79,7428.51,6
MS-DRG,933,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT,,,28996.21,97833.99,34
MS-DRG,934,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,,,16460.13,55536.9,34
MS-DRG,935,NON-EXTENSIVE BURNS,,,17470.28,19217.31,13
MS-DRG,935,Non-extensive burns,,,15338.76,51753.38,21
MS-DRG,939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,,,27017.81,91158.81,34
MS-DRG,94,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,,30742.45,32831.74,6
MS-DRG,940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,,,17400.56,58709.94,34
MS-DRG,941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,,,15098.25,50941.91,34
MS-DRG,945,REHABILITATION WITH CC/MCC,,,11530.88,38905.48,34
MS-DRG,946,REHABILITATION WITHOUT CC/MCC,,,8539.07,28811.06,34
MS-DRG,947,SIGNS AND SYMPTOMS WITH MCC,,,9451.95,31891.14,34
MS-DRG,948,SIGNS AND SYMPTOMS WITHOUT MCC,,,5960.52,20110.96,34
MS-DRG,949,AFTERCARE WITH CC/MCC,,,8858.51,29888.83,34
MS-DRG,95,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,,22529.67,24060.82,6
MS-DRG,950,AFTERCARE WITHOUT CC/MCC,,,4673.85,15769.71,34
MS-DRG,951,OTHER FACTORS INFLUENCING HEALTH STATUS,,,4715.28,5186.81,13
MS-DRG,951,Other factors influencing health status,,,4139.98,13968.39,21
MS-DRG,955,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,57084.57,62793.03,13
MS-DRG,955,Craniotomy for multiple significant trauma,,,50119.77,169105.43,21
MS-DRG,956,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",,,28019.3,94537.85,34
MS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,56737.78,191434.75,34
MS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,31376.7,105865.81,34
MS-DRG,959,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,21921.77,73964.62,34
MS-DRG,96,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,22529.67,24060.82,6
MS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,20355.87,68681.26,34
MS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,11411.74,38503.51,34
MS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,7002.96,23628.18,34
MS-DRG,969,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,,,45579.2,153785.42,34
MS-DRG,97,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,,31549.58,33693.73,6
MS-DRG,970,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC,,,19638.08,66259.4,34
MS-DRG,974,HIV WITH MAJOR RELATED CONDITION WITH MCC,,,21489.16,72504.98,34
MS-DRG,975,HIV WITH MAJOR RELATED CONDITION WITH CC,,,9642.57,32534.29,34
MS-DRG,976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,,,6721.5,22678.53,34
MS-DRG,977,HIV WITH OR WITHOUT OTHER RELATED CONDITION,,,9662.67,32602.12,34
MS-DRG,98,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,,20046.27,21408.64,6
MS-DRG,981,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,34935.14,117872.09,34
MS-DRG,982,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,18305.99,61764.9,34
MS-DRG,983,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,12762.44,43060.82,34
MS-DRG,987,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,25527.87,86131.69,34
MS-DRG,988,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,12238.25,41292.16,34
MS-DRG,989,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,8929.24,30127.5,34
MS-DRG,99,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,,11900.75,12709.54,6
NDC,0002015201,ZEPBOUND 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION,538.2,349.83,90.42,538.2,23
NDC,0002120001,AMYVID 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,5720.0,3718.0,1390.0,5148.0,36
NDC,0002143301,TRULICITY 0.75 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1776.93,1155.0,298.52,1776.93,23
NDC,0002143401,TRULICITY 1.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1776.93,1155.0,298.52,1776.93,23
NDC,0002143601,EMGALITY PEN 120 MG/ML SUBCUTANEOUS PEN INJECTOR,2670.09,1735.56,448.58,2670.09,22
NDC,0002144511,TALTZ AUTOINJECTOR 80 MG/ML SUBCUTANEOUS,26141.43,16991.93,4391.76,26141.43,26
NDC,0002145701,MOUNJARO 15 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,326.52,1943.58,23
NDC,0002146001,MOUNJARO 12.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,326.52,1943.58,23
NDC,0002147101,MOUNJARO 10 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,326.52,1943.58,23
NDC,0002148401,MOUNJARO 7.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,326.52,1943.58,23
NDC,0002149501,MOUNJARO 5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,326.52,1943.58,23
NDC,0002150601,MOUNJARO 2.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1943.58,1263.33,326.52,1943.58,23
NDC,0002223601,TRULICITY 3 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1776.93,1155.0,298.52,1776.93,22
NDC,0002237711,EMGALITY 120 MG/ML SUBCUTANEOUS SYRINGE,2670.09,1735.56,448.58,2670.09,22
NDC,0002418230,OLUMIANT 2 MG TABLET,221.4,143.91,37.2,221.4,22
NDC,0002473230,OLUMIANT 1 MG TABLET,221.4,143.91,37.2,221.4,22
NDC,0002534060,RETEVMO 40 MG TABLET,316.36,205.63,53.15,316.36,22
NDC,0002556260,RETEVMO 160 MG TABLET,949.1,616.92,159.45,949.1,22
NDC,0002608260,RETEVMO 80 MG TABLET,474.56,308.46,79.73,474.56,22
NDC,0002612060,RETEVMO 120 MG TABLET,949.1,616.92,159.45,949.1,22
NDC,0002690230,JAYPIRCA 50 MG TABLET,614.46,399.4,103.23,614.46,22
NDC,0002702660,JAYPIRCA 100 MG TABLET,921.7,599.11,154.85,921.7,22
NDC,0002751001,HUMALOG U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,23.91,15.54,0.6,23.91,23
NDC,0002751017,HUMALOG U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,98.88,64.27,0.6,98.88,23
NDC,0002751101,HUMALOG MIX 75-25 (U-100) INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,30.75,19.99,0.6,30.75,22
NDC,0002751659,HUMALOG U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS CARTRIDGE,36.75,23.89,0.6,36.75,22
NDC,0002757501,OMVOH 300 MG/15 ML (20 MG/ML) INTRAVENOUS SOLUTION,2302.38,1496.55,39.54,3407.66,46
NDC,0002762301,ALIMTA 500 MG INTRAVENOUS SOLUTION,19406.4,12614.16,9.66,19406.4,51
NDC,0002764001,ALIMTA 100 MG INTRAVENOUS SOLUTION,3881.28,2522.83,3.57,3881.28,49
NDC,0002766901,CYRAMZA 10 MG/ML INTRAVENOUS SOLUTION,720.4,468.26,62.69,3407.66,46
NDC,0002767801,CYRAMZA 10 MG/ML INTRAVENOUS SOLUTION,720.36,468.23,62.69,3407.66,46
NDC,0002773701,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,9.0,5.85,0.6,9.0,23
NDC,0002821501,HUMULIN R REGULAR U-100 INSULIN 100 UNIT/ML INJECTION SOLUTION,16.05,10.43,0.6,16.05,23
NDC,0002822201,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS PEN,38.19,24.82,0.6,38.19,22
NDC,0002831501,HUMULIN N NPH U-100 INSULIN (ISOPHANE SUSP) 100 UNIT/ML SUBCUTANEOUS,16.05,10.43,0.6,16.05,22
NDC,0002831517,HUMULIN N NPH U-100 INSULIN (ISOPHANE SUSP) 100 UNIT/ML SUBCUTANEOUS,53.52,34.79,0.6,53.52,22
NDC,0002871501,HUMULIN 70/30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,16.05,10.43,0.6,16.05,22
NDC,0002871517,HUMULIN 70/30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,16.05,10.43,0.6,16.05,22
NDC,0002879801,HUMALOG MIX 50-50 KWIKPEN U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,38.19,24.82,0.6,38.19,22
NDC,0002879859,HUMALOG MIX 50-50 KWIKPEN U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,38.19,24.82,0.6,38.19,22
NDC,0002879901,HUMALOG KWIKPEN (U-100) INSULIN 100 UNIT/ML SUBCUTANEOUS,38.19,24.82,0.6,38.19,22
NDC,0002879959,HUMALOG KWIKPEN (U-100) INSULIN 100 UNIT/ML SUBCUTANEOUS,38.19,24.82,0.6,38.19,22
NDC,0002880301,HUMULIN 70/30 U-100 INSULIN KWIKPEN 100 UNIT/ML SUBCUTANEOUS,33.93,22.05,0.6,33.93,22
NDC,0002880359,HUMULIN 70/30 U-100 INSULIN KWIKPEN 100 UNIT/ML SUBCUTANEOUS,33.93,22.05,0.6,33.93,22
NDC,0002880501,HUMULIN N NPH U-100 INSULIN KWIKPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS,33.93,22.05,0.6,33.93,22
NDC,0002880559,HUMULIN N NPH U-100 INSULIN KWIKPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS,33.93,22.05,0.6,33.93,22
NDC,0002882427,HUMULIN R U-500 (CONC) INSULIN KWIKPEN 500 UNIT/ML (3 ML) SUBCUTANEOUS,344.52,223.94,0.6,344.52,22
NDC,0002940101,KISUNLA 17.5 MG/ML INTRAVENOUS SOLUTION,126.78,82.41,4.09,383.26,46
NDC,0003029305,KENALOG 40 MG/ML SUSPENSION FOR INJECTION,33.69,21.9,0.97,33.69,31
NDC,0003029320,KENALOG 40 MG/ML SUSPENSION FOR INJECTION,34.2,22.23,0.97,34.2,31
NDC,0003029328,KENALOG 40 MG/ML SUSPENSION FOR INJECTION,25.56,16.61,0.97,25.56,31
NDC,0003031505,KENALOG-80  80 MG/ML SUSPENSION FOR INJECTION,67.38,43.8,0.97,67.38,31
NDC,0003037113,NULOJIX 250 MG INTRAVENOUS SOLUTION,3491.58,2269.53,3.48,3491.58,50
NDC,0003049420,KENALOG 10 MG/ML SUSPENSION FOR INJECTION,8.7,5.66,0.97,8.7,31
NDC,0003085222,SPRYCEL 100 MG TABLET,1459.7,948.81,245.23,1459.7,22
NDC,0003085522,SPRYCEL 80 MG TABLET,1459.7,948.81,245.23,1459.7,22
NDC,0003085722,SPRYCEL 140 MG TABLET,1459.7,948.81,245.23,1459.7,23
NDC,0003089321,ELIQUIS 2.5 MG TABLET,24.26,15.77,4.08,24.26,22
NDC,0003089331,ELIQUIS 2.5 MG TABLET,24.26,15.77,4.08,24.26,22
NDC,0003089421,ELIQUIS 5 MG TABLET,24.26,15.77,4.08,24.26,22
NDC,0003089431,ELIQUIS 5 MG TABLET,24.26,15.77,4.08,24.26,22
NDC,0003161412,BARACLUDE 0.05 MG/ML ORAL SOLUTION,13.73,8.92,2.31,13.73,22
NDC,0003218713,ORENCIA (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,5580.0,3627.0,38.56,5580.0,52
NDC,0003229111,EMPLICITI 300 MG INTRAVENOUS SOLUTION,10709.0,6960.85,6.66,10709.0,52
NDC,0003232711,YERVOY 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,4346.28,2825.08,155.44,5646.0,50
NDC,0003232822,YERVOY 200 MG/40 ML (5 MG/ML) INTRAVENOUS SOLUTION,4346.28,2825.08,155.44,5646.0,50
NDC,0003257016,AZACTAM 2 GRAM SOLUTION FOR INJECTION,214.02,139.11,2.32,214.02,31
NDC,0003362212,REYATAZ 300 MG CAPSULE,115.96,75.37,19.48,115.96,22
NDC,0003363112,REYATAZ 200 MG CAPSULE,58.54,38.05,9.83,58.54,22
NDC,0003364111,EVOTAZ 300 MG-150 MG TABLET,128.44,83.49,21.58,128.44,22
NDC,0003373413,OPDIVO 240 MG/24 ML INTRAVENOUS SOLUTION,1588.6,1032.59,27.98,3407.66,46
NDC,0003375614,OPDIVO 120 MG/12 ML INTRAVENOUS SOLUTION,1588.6,1032.59,27.98,3407.66,46
NDC,0003377211,OPDIVO 40 MG/4 ML INTRAVENOUS SOLUTION,1588.64,1032.62,27.98,3407.66,46
NDC,0003377412,OPDIVO 100 MG/10 ML INTRAVENOUS SOLUTION,1588.6,1032.59,27.98,3407.66,46
NDC,0003404060,AUGTYRO 40 MG CAPSULE,307.4,199.81,51.64,307.4,22
NDC,0003452211,EMPLICITI 400 MG INTRAVENOUS SOLUTION,14278.52,9281.04,6.66,14278.52,52
NDC,0003712511,OPDUALAG 240 MG-80 MG/20 ML INTRAVENOUS SOLUTION,3701.28,2405.83,168.3,18253.82,49
NDC,0004025901,CELLCEPT 250 MG CAPSULE,21.6,14.04,0.18,21.6,31
NDC,0004026001,CELLCEPT 500 MG TABLET,43.18,28.07,0.18,43.18,31
NDC,0004026129,CELLCEPT 200 MG/ML ORAL SUSPENSION,25.9,16.84,0.46,25.9,30
NDC,0004029809,CELLCEPT INTRAVENOUS 500 MG INTRAVENOUS SOLUTION,388.71,252.66,0.64,388.71,37
NDC,0004080085,TAMIFLU 75 MG CAPSULE,36.46,23.7,6.13,36.46,22
NDC,0004080285,TAMIFLU 30 MG CAPSULE,33.44,21.74,5.62,33.44,22
NDC,0005010005,TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1621.14,1053.74,79.26,1621.14,29
NDC,0005010010,TRUMENBA 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1621.14,1053.74,79.26,1621.14,29
NDC,0005197101,PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,1624.89,1056.18,79.26,1624.89,30
NDC,0005197102,PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,1624.89,1056.18,79.26,1624.89,30
NDC,0005197105,PREVNAR 13 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,1675.86,1089.31,79.26,1675.86,30
NDC,0005200001,PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,2216.73,1440.87,79.26,2216.73,37
NDC,0005200010,PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,2149.2,1396.98,79.26,2149.2,37
NDC,0005250002,FIBERCON 625 MG TABLET,0.34,0.22,0.06,0.34,22
NDC,0005434462,CENTRUM 9 MG IRON/15 ML ORAL LIQUID,0.1,0.07,0.02,0.1,22
NDC,0005445174,CENTRUM COMPLETE 18 MG-400 MCG TABLET,0.14,0.09,0.02,0.14,22
NDC,0006003220,STROMECTOL 3 MG TABLET,11.16,7.25,1.87,11.16,22
NDC,0006011201,JANUVIA 50 MG TABLET,26.4,17.16,4.44,26.4,22
NDC,0006011228,JANUVIA 50 MG TABLET,26.4,17.16,4.44,26.4,22
NDC,0006011231,JANUVIA 50 MG TABLET,26.4,17.16,4.44,26.4,22
NDC,0006011254,JANUVIA 50 MG TABLET,26.4,17.16,4.44,26.4,22
NDC,0006022101,JANUVIA 25 MG TABLET,26.4,17.16,4.44,26.4,22
NDC,0006022128,JANUVIA 25 MG TABLET,26.4,17.16,4.44,26.4,22
NDC,0006022131,JANUVIA 25 MG TABLET,26.4,17.16,4.44,26.4,22
NDC,0006022761,ISENTRESS 400 MG TABLET,83.32,54.16,14.0,83.32,22
NDC,0006027701,JANUVIA 100 MG TABLET,26.4,17.16,4.44,26.4,22
NDC,0006027728,JANUVIA 100 MG TABLET,26.4,17.16,4.44,26.4,22
NDC,0006027731,JANUVIA 100 MG TABLET,26.4,17.16,4.44,26.4,22
NDC,0006027754,JANUVIA 100 MG TABLET,26.4,17.16,4.44,26.4,22
NDC,0006046102,EMEND 80 MG CAPSULE,525.04,341.28,88.21,525.04,22
NDC,0006047761,ISENTRESS 100 MG CHEWABLE TABLET,20.84,13.55,3.5,20.84,22
NDC,0006056840,ZOLINZA 100 MG CAPSULE,300.2,195.13,50.43,300.2,22
NDC,0006302601,KEYTRUDA 25 MG/ML INTRAVENOUS SOLUTION,7218.8,4692.22,51.58,7218.8,52
NDC,0006302602,KEYTRUDA 25 MG/ML INTRAVENOUS SOLUTION,7218.8,4692.22,51.58,7218.8,52
NDC,0006302604,KEYTRUDA 25 MG/ML INTRAVENOUS SOLUTION,7218.8,4692.22,51.58,7218.8,52
NDC,0006306901,PIFELTRO 100 MG TABLET,147.2,95.68,24.73,147.2,22
NDC,0006307502,PREVYMIS 240 MG TABLET,658.54,428.05,110.63,658.54,22
NDC,0006307602,PREVYMIS 480 MG TABLET,658.54,428.05,110.63,658.54,22
NDC,0006307604,PREVYMIS 480 MG TABLET,658.54,428.05,110.63,658.54,22
NDC,0006308001,ISENTRESS HD 600 MG TABLET,83.32,54.16,14.0,83.32,22
NDC,0006351659,PRIMAXIN 500 MG INTRAVENOUS SOLUTION,117.54,76.4,6.8,117.54,31
NDC,0006360361,ISENTRESS 100 MG ORAL POWDER PACKET,26.05,16.93,4.38,26.05,22
NDC,0006385601,RECARBRIO 1.25 GRAM INTRAVENOUS SOLUTION,1138.11,739.77,2.2,1138.11,44
NDC,0006385602,RECARBRIO 1.25 GRAM INTRAVENOUS SOLUTION,1138.11,739.77,2.2,1138.11,44
NDC,0006404741,ROTATEQ VACCINE 2 ML ORAL SOLUTION,153.0,99.45,25.7,153.0,29
NDC,0006409302,RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE,205.32,133.46,17.89,205.32,37
NDC,0006409402,RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SYRINGE,257.28,167.23,17.89,257.28,37
NDC,0006409502,VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,282.51,183.63,17.89,282.51,29
NDC,0006409601,VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE,298.74,194.18,17.89,298.74,37
NDC,0006409602,VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE,298.74,194.18,17.89,298.74,37
NDC,0006411903,GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION,2364.06,1536.64,79.26,2364.06,29
NDC,0006412101,GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,2364.06,1536.64,79.26,2364.06,29
NDC,0006412102,GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE,2364.06,1536.64,79.26,2364.06,29
NDC,0006417100,PROQUAD (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUBCUTANEOUS SUSPENSION,1030.2,669.63,17.89,1030.2,29
NDC,0006468100,M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION,344.67,224.04,17.89,344.67,29
NDC,0006468101,M-M-R II (PF) 1000-12500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION,344.67,224.04,17.89,344.67,29
NDC,0006482700,VARIVAX (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION,688.92,447.8,79.26,688.92,29
NDC,0006483141,VAQTA (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION,282.51,183.63,17.89,282.51,29
NDC,0006483701,PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE,842.97,547.93,17.89,842.97,37
NDC,0006483703,PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE,842.97,547.93,17.89,842.97,37
NDC,0006484141,VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION,298.74,194.18,17.89,298.74,37
NDC,0006489700,PEDVAX HIB (PF) 7.5 MCG/0.5 ML INTRAMUSCULAR SOLUTION,221.22,143.79,17.89,221.22,29
NDC,0006498100,RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION,205.32,133.46,17.89,205.32,37
NDC,0006498101,RECOMBIVAX HB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSPENSION,205.32,133.46,17.89,205.32,37
NDC,0006499200,RECOMBIVAX HB (PF) 40 MCG/ML INTRAMUSCULAR SUSPENSION,703.23,457.1,79.26,703.23,37
NDC,0006499541,RECOMBIVAX HB (PF) 10 MCG/ML INTRAMUSCULAR SUSPENSION,257.28,167.23,17.89,257.28,37
NDC,0006500301,PREVYMIS 240 MG/12 ML INTRAVENOUS SOLUTION,113.82,73.98,19.12,113.82,22
NDC,0006500401,PREVYMIS 480 MG/24 ML INTRAVENOUS SOLUTION,56.91,36.99,9.56,56.91,22
NDC,0006503401,ONTRUZANT 420 MG INTRAVENOUS SOLUTION,17803.4,11572.21,27.27,17803.4,52
NDC,0006503402,ONTRUZANT 420 MG INTRAVENOUS SOLUTION,17803.4,11572.21,27.27,17803.4,52
NDC,0006505509,LAGEVRIO 200 MG CAPSULE (EUA),59.84,38.9,10.05,59.84,22
NDC,0006508501,PREVYMIS 120 MG ORAL PELLETS IN PACKET,164.64,107.02,27.66,164.64,22
NDC,0006508601,PREVYMIS 20 MG ORAL PELLETS IN PACKET,27.44,17.84,4.61,27.44,22
NDC,0006542302,BRIDION 100 MG/ML INTRAVENOUS SOLUTION,245.04,159.28,41.17,245.04,22
NDC,0006542312,BRIDION 100 MG/ML INTRAVENOUS SOLUTION,245.04,159.28,41.17,245.04,22
NDC,0006542402,ANTIVENIN LATRODECTUS MACTANS 6000 UNIT SOLUTION FOR INJECTION,99.75,64.84,16.76,99.75,22
NDC,0006542505,BRIDION 100 MG/ML INTRAVENOUS SOLUTION,179.52,116.69,30.16,179.52,22
NDC,0006542515,BRIDION 100 MG/ML INTRAVENOUS SOLUTION,179.52,116.69,30.16,179.52,22
NDC,0008010001,BESPONSA 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) INTRAVENOUS SOLUTION,117092.48,76110.11,2322.13,117092.48,52
NDC,0008042303,ANTIVENIN MICRURUS FULVIUS 250 UNIT SOLUTION FOR INJECTION,33279.78,21631.86,5591.0,33279.78,29
NDC,0008084381,PROTONIX 20 MG TABLETDELAYED RELEASE,35.78,23.26,6.01,35.78,22
NDC,0008084401,PROTONIX 40 MG GRANULES DELAYED-RELEASE PACKET,35.62,23.15,5.98,35.62,22
NDC,0008084402,PROTONIX 40 MG GRANULES DELAYED-RELEASE PACKET,44.53,28.94,7.48,44.53,22
NDC,0008092351,PROTONIX 40 MG INTRAVENOUS SOLUTION,18.27,11.88,3.07,18.27,23
NDC,0008092355,PROTONIX 40 MG INTRAVENOUS SOLUTION,18.27,11.88,3.07,18.27,23
NDC,0008117901,TORISEL 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLUTION,7561.23,4914.8,20.31,7561.23,53
NDC,0008400125,PROTONIX 40 MG INTRAVENOUS SOLUTION,6.81,4.43,1.14,9.21,23
NDC,0008451001,MYLOTARG 4.5 MG (1 MG/ML INITIAL CONCENTRATION) INTRAVENOUS SOLUTION,50407.44,32764.84,203.65,50407.44,52
NDC,0008499020,TYGACIL 50 MG INTRAVENOUS SOLUTION,360.0,234.0,0.6,360.0,31
NDC,0009000302,SOLU-MEDROL (PF) 500 MG/4 ML INTRAVENOUS SOLUTION,170.58,110.88,0.25,170.58,38
NDC,0009000501,SOLU-CORTEF ACT-O-VIAL (PF) 1000 MG/8 ML SOLUTION FOR INJECTION,723.78,470.46,16.61,723.78,31
NDC,0009001103,SOLU-CORTEF ACT-O-VIAL (PF) 100 MG/2 ML SOLUTION FOR INJECTION,90.96,59.12,15.28,90.96,31
NDC,0009001104,SOLU-CORTEF ACT-O-VIAL (PF) 100 MG/2 ML SOLUTION FOR INJECTION,89.31,58.05,15.0,89.31,31
NDC,0009001201,CORTEF 5 MG TABLET,2.42,1.57,0.41,2.42,22
NDC,0009001305,SOLU-CORTEF ACT-O-VIAL (PF) 250 MG/2 ML SOLUTION FOR INJECTION,184.35,119.83,16.61,184.35,31
NDC,0009001306,SOLU-CORTEF ACT-O-VIAL (PF) 250 MG/2 ML SOLUTION FOR INJECTION,173.04,112.48,16.61,173.04,31
NDC,0009001612,SOLU-CORTEF ACT-O-VIAL (PF) 500 MG/4 ML SOLUTION FOR INJECTION,362.01,235.31,16.61,362.01,31
NDC,0009001820,SOLU-MEDROL (PF) 1000 MG/8 ML INTRAVENOUS SOLUTION,248.1,161.27,0.25,248.1,38
NDC,0009002001,MEDROL 2 MG TABLET,3.94,2.56,0.22,3.94,31
NDC,0009003101,CORTEF 10 MG TABLET,4.08,2.65,0.69,4.08,22
NDC,0009003928,SOLU-MEDROL (PF) 40 MG/ML SOLUTION FOR INJECTION,23.28,15.13,0.25,23.28,38
NDC,0009003930,SOLU-MEDROL (PF) 40 MG/ML SOLUTION FOR INJECTION,23.28,15.13,0.25,23.28,38
NDC,0009003932,SOLU-MEDROL (PF) 40 MG/ML SOLUTION FOR INJECTION,19.32,12.56,0.25,19.32,38
NDC,0009003933,SOLU-MEDROL (PF) 40 MG/ML SOLUTION FOR INJECTION,19.32,12.56,0.25,19.32,38
NDC,0009004722,SOLU-MEDROL (PF) 125 MG/2 ML SOLUTION FOR INJECTION,37.5,24.38,0.25,37.5,38
NDC,0009004725,SOLU-MEDROL (PF) 125 MG/2 ML SOLUTION FOR INJECTION,37.5,24.38,0.25,37.5,38
NDC,0009004726,SOLU-MEDROL (PF) 125 MG/2 ML SOLUTION FOR INJECTION,30.75,19.99,0.25,30.75,38
NDC,0009004727,SOLU-MEDROL (PF) 125 MG/2 ML SOLUTION FOR INJECTION,30.75,19.99,0.25,30.75,38
NDC,0009005604,MEDROL (PAK) 4 MG TABLETS IN A DOSE PACK,0.74,0.48,0.12,0.74,31
NDC,0009007301,MEDROL 16 MG TABLET,6.9,4.49,0.22,6.9,31
NDC,0009022502,CLEOCIN HCL 150 MG CAPSULE,0.36,0.23,0.06,0.36,22
NDC,0009027101,DEPO-ESTRADIOL 5 MG/ML INTRAMUSCULAR OIL,185.73,120.72,31.2,185.73,31
NDC,0009027401,DEPO-MEDROL 20 MG/ML SUSPENSION FOR INJECTION,25.59,16.63,0.12,25.59,38
NDC,0009028002,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,35.49,23.07,0.12,35.49,38
NDC,0009028003,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,35.52,23.09,0.12,35.52,38
NDC,0009028051,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,35.49,23.07,0.12,35.49,38
NDC,0009029703,GELFILM FOR THE EYE,595.08,386.8,99.97,595.08,22
NDC,0009030602,DEPO-MEDROL 80 MG/ML SUSPENSION FOR INJECTION,71.07,46.2,0.12,71.07,38
NDC,0009030612,DEPO-MEDROL 80 MG/ML SUSPENSION FOR INJECTION,71.04,46.18,0.12,71.04,38
NDC,0009032301,GELFOAM SPONGE SIZE 50,74.1,48.17,12.45,74.1,22
NDC,0009034702,DEPO-TESTOSTERONE 100 MG/ML INTRAMUSCULAR OIL,31.47,20.46,0.01,31.47,31
NDC,0009035301,GELFOAM COMPRESSED SIZE 100 100 CM SPONGE,110.56,71.86,18.57,110.56,22
NDC,0009041701,DEPO-TESTOSTERONE 200 MG/ML INTRAMUSCULAR OIL,85.65,55.67,0.01,85.65,31
NDC,0009041702,DEPO-TESTOSTERONE 200 MG/ML INTRAMUSCULAR OIL,49.74,32.33,0.01,49.74,31
NDC,0009043304,GELFOAM MUCOSAL POWDER,100.68,65.44,16.91,100.68,22
NDC,0009043601,R-GENE 10 % INTRAVENOUS SOLUTION,0.48,0.31,0.08,0.48,22
NDC,0009045003,COLESTID 1 GRAM TABLET,5.4,3.51,0.91,5.4,22
NDC,0009069801,SOLU-MEDROL 1000 MG INTRAVENOUS SOLUTION,158.34,102.92,0.25,158.34,38
NDC,0009072805,CLEOCIN 150 MG/ML INJECTION SOLUTION,1.47,0.96,0.25,1.47,22
NDC,0009072809,CLEOCIN 150 MG/ML INJECTION SOLUTION,1.47,0.96,0.25,1.47,22
NDC,0009074630,DEPO-PROVERA 150 MG/ML INTRAMUSCULAR SUSPENSION,189.48,123.16,1.42,189.48,23
NDC,0009075801,SOLU-MEDROL 500 MG INTRAVENOUS SOLUTION,87.42,56.82,0.25,87.42,38
NDC,0009077526,CLEOCIN 150 MG/ML INJECTION SOLUTION,2.64,1.72,0.44,2.64,22
NDC,0009082501,SOLU-CORTEF 100 MG SOLUTION FOR INJECTION,72.39,47.05,12.16,72.39,31
NDC,0009085001,SOLU-MEDROL 2 GRAM INTRAVENOUS SOLUTION,391.89,254.73,0.25,391.89,38
NDC,0009085605,HEMABATE 250 MCG/ML INTRAMUSCULAR SOLUTION,504.0,327.6,13.7,504.0,26
NDC,0009085608,HEMABATE 250 MCG/ML INTRAMUSCULAR SOLUTION,504.0,327.6,13.7,504.0,26
NDC,0009087026,CLEOCIN 150 MG/ML INJECTION SOLUTION,4.47,2.91,0.75,4.47,22
NDC,0009090218,CLEOCIN 150 MG/ML INJECTION SOLUTION,2.55,1.66,0.43,2.55,22
NDC,0009307301,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,40.89,26.58,0.12,40.89,38
NDC,0009307303,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,40.92,26.6,0.12,40.92,38
NDC,0009307322,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,14.37,9.34,0.12,14.37,38
NDC,0009307323,DEPO-MEDROL 40 MG/ML SUSPENSION FOR INJECTION,16.62,10.8,0.12,16.62,38
NDC,0009316901,PROSTIN VR PEDIATRIC 500 MCG/ML INJECTION SOLUTION,609.63,396.26,27.02,609.63,23
NDC,0009316906,PROSTIN VR PEDIATRIC 500 MCG/ML INJECTION SOLUTION,609.63,396.26,27.02,609.63,23
NDC,0009344801,CLEOCIN 2 % VAGINAL CREAM,4.5,2.93,0.76,4.5,22
NDC,0009347501,DEPO-MEDROL 80 MG/ML SUSPENSION FOR INJECTION,70.98,46.14,0.12,70.98,38
NDC,0009347503,DEPO-MEDROL 80 MG/ML SUSPENSION FOR INJECTION,71.01,46.16,0.12,71.01,38
NDC,0009370105,CAVERJECT 20 MCG INTRACAVERNOSAL SOLUTION,396.96,258.02,27.02,396.96,23
NDC,0009379401,CORVERT 0.1 MG/ML INTRAVENOUS SOLUTION,201.54,131.0,52.2,801.01,39
NDC,0009470913,DEPO-SUBQ PROVERA 104 104 MG/0.65 ML SUBCUTANEOUS SYRINGE,291.48,189.46,1.42,291.48,23
NDC,0009509101,ELLENCE 50 MG/25 ML INTRAVENOUS SOLUTION,9.24,6.01,1.2,9.24,30
NDC,0009513601,ZYVOX 100 MG/5 ML ORAL SUSPENSION,4.9,3.19,0.82,4.9,22
NDC,0009514001,ZYVOX 600 MG/300 ML INTRAVENOUS PIGGYBACK,0.39,0.25,0.07,7.59,31
NDC,0009514004,ZYVOX 600 MG/300 ML INTRAVENOUS PIGGYBACK,0.39,0.25,0.07,7.59,31
NDC,0009518201,CAVERJECT IMPULSE 20 MCG INTRACAVERNOSAL KIT,400.02,260.01,27.02,400.02,23
NDC,0009518211,CAVERJECT 20 MCG INTRACAVERNOSAL SYRINGE,400.02,260.01,27.02,400.02,23
NDC,0009722402,ATGAM 50 MG/ML INTRAVENOUS SOLUTION,3826.35,2487.13,991.02,14689.17,50
NDC,0009766304,AROMASIN 25 MG TABLET,96.7,62.86,16.25,96.7,22
NDC,0009768604,CAVERJECT 40 MCG INTRACAVERNOSAL SOLUTION,523.62,340.35,27.02,523.62,23
NDC,0013111415,CYKLOKAPRON 1000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION,10.95,7.12,1.84,10.95,22
NDC,0013258691,IDAMYCIN PFS 1 MG/ML INTRAVENOUS SOLUTION,51.72,33.62,8.69,110.83,36
NDC,0013259691,IDAMYCIN PFS 1 MG/ML INTRAVENOUS SOLUTION,37.26,24.22,6.26,110.83,36
NDC,0013264902,GENOTROPIN MINIQUICK 0.2 MG/0.25 ML SUBCUTANEOUS SYRINGE,115.26,74.92,19.36,408.89,30
NDC,0013265102,GENOTROPIN MINIQUICK 0.6 MG/0.25 ML SUBCUTANEOUS SYRINGE,345.84,224.8,48.92,408.89,30
NDC,0013265402,GENOTROPIN MINIQUICK 1.2 MG/0.25 ML SUBCUTANEOUS SYRINGE,691.68,449.59,48.92,691.68,30
NDC,0015301260,BICNU 100 MG INTRAVENOUS SOLUTION,822.76,534.79,232.62,1355.53,46
NDC,0019086207,CYSTO-CONRAY II 17.2 % URETHRAL SOLUTION,0.36,0.23,0.06,0.36,21
NDC,0019086250,CYSTO-CONRAY II 17.2 % URETHRAL SOLUTION,0.42,0.27,0.07,0.42,21
NDC,0019095211,CONRAY-30 30 % INTRAVENOUS SOLUTION,0.57,0.37,0.07,0.57,21
NDC,0019095305,CONRAY 60 % INJECTION SOLUTION,0.87,0.57,0.15,0.87,20
NDC,0019095313,CONRAY 60 % INJECTION SOLUTION,1.17,0.76,0.2,1.17,20
NDC,0019095323,CONRAY 60 % INJECTION SOLUTION,1.47,0.96,0.25,1.47,20
NDC,0019118881,SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,0.66,0.43,0.11,0.66,22
NDC,0019132302,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SOLUTION,4.74,3.08,0.12,4.74,21
NDC,0019132304,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SOLUTION,4.71,3.06,0.12,4.71,21
NDC,0019132306,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.75,2.44,0.12,3.75,21
NDC,0019132311,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SOLUTION,2.6,1.69,0.12,2.6,21
NDC,0019132316,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.0,1.95,0.12,3.0,21
NDC,0019132352,OPTIRAY 320 MG IODINE/ML INTRAVENOUS SYRINGE,1.47,0.96,0.12,1.47,21
NDC,0019133206,OPTIRAY 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.3,2.15,0.12,3.3,21
NDC,0019133275,OPTIRAY 300 MG IODINE/ML INTRAVENOUS SYRINGE,2.6,1.69,0.44,2.6,22
NDC,0019133306,OPTIRAY 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.96,2.57,0.12,3.96,21
NDC,0019133311,OPTIRAY 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.42,2.22,0.12,3.42,21
NDC,0019133316,OPTIRAY 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.18,2.07,0.12,3.18,21
NDC,0019133352,OPTIRAY 350 MG IODINE/ML INTRAVENOUS SYRINGE,1.3,0.85,0.12,1.3,21
NDC,0019318309,CONRAY-43 43 % INTRAVENOUS SOLUTION,6.87,4.47,1.15,6.87,22
NDC,0019905040,OCTREOSCAN 3 MCI/ML-10 MCG INTRAVENOUS KIT,10558.0,6862.7,1390.0,9502.2,39
NDC,0019909240,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,66.0,42.9,11.09,2409.0,29
NDC,0023024004,REFRESH P.M. 57.3 %-42.5 % EYE OINTMENT,5.88,3.82,0.99,5.88,22
NDC,0023031204,REFRESH LACRI-LUBE 56.8 %-42.5 % EYE OINTMENT,6.7,4.36,1.13,6.7,22
NDC,0023040330,REFRESH PLUS 0.5 % EYE DROPS IN A DROPPERETTE,0.72,0.47,0.12,0.72,22
NDC,0023040350,REFRESH PLUS 0.5 % EYE DROPS IN A DROPPERETTE,0.66,0.43,0.11,0.66,22
NDC,0023050601,REFRESH CLASSIC (PF) 1.4 %-0.6 % EYE DROPS IN A DROPPERETTE,0.74,0.48,0.12,0.74,22
NDC,0023050650,REFRESH CLASSIC (PF) 1.4 %-0.6 % EYE DROPS IN A DROPPERETTE,0.68,0.44,0.11,0.68,22
NDC,0023079815,REFRESH TEARS 0.5 % EYE DROPS,1.34,0.87,0.23,1.34,22
NDC,0023114501,BOTOX 100 UNIT INJECTION,2343.6,1523.34,5.69,2343.6,47
NDC,0023218105,ACULAR 0.5 % EYE DROPS,132.2,85.93,22.21,132.2,22
NDC,0023334807,OZURDEX 0.7 MG INTRAVITREAL IMPLANT,4798.8,3119.22,185.04,4798.8,50
NDC,0023391950,BOTOX COSMETIC 50 UNIT INTRAMUSCULAR SOLUTION,1303.2,847.08,5.69,1303.2,47
NDC,0023392102,BOTOX 200 UNIT INJECTION,4687.2,3046.68,5.69,4687.2,50
NDC,0023455430,REFRESH CELLUVISC 1 % EYE GEL IN A DROPPERETTE,0.88,0.57,0.15,0.88,22
NDC,0023585801,LILETTA 20.4 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,2236.16,1453.5,273.36,2552.94,29
NDC,0023608201,INFED 50 MG/ML INJECTION SOLUTION,67.11,43.62,15.58,78.3,47
NDC,0023608210,INFED 50 MG/ML INJECTION SOLUTION,67.11,43.62,15.58,78.3,47
NDC,0023614230,RAPAFLO 8 MG CAPSULE,20.92,13.6,3.51,20.92,22
NDC,0023916330,RESTASIS 0.05 % EYE DROPS IN A DROPPERETTE,25.82,16.78,4.34,25.82,22
NDC,0023917705,ALPHAGAN P 0.15 % EYE DROPS,99.5,64.68,16.72,99.5,22
NDC,0023920515,REFRESH LIQUIGEL 1 % EYE LIQUID GEL DROPS,1.38,0.9,0.23,1.38,22
NDC,0023923201,BOTOX COSMETIC 100 UNIT INTRAMUSCULAR SOLUTION,2361.6,1535.04,5.69,2361.6,47
NDC,0023932105,ALPHAGAN P 0.1 % EYE DROPS,88.88,57.77,14.93,88.88,22
NDC,0023963708,OXYTROL FOR WOMEN 3.9 MG/24 HOUR TRANSDERMAL PATCH,5.96,3.87,1.0,5.96,22
NDC,0023965201,DURYSTA 10 MCG INTRACAMERAL IMPLANT,7290.0,4738.5,185.57,7290.0,53
NDC,0024065401,SARCLISA 20 MG/ML INTRAVENOUS SOLUTION,889.4,578.11,68.78,3236.72,46
NDC,0024065601,SARCLISA 20 MG/ML INTRAVENOUS SOLUTION,889.4,578.11,68.78,3236.72,46
NDC,0024135202,NEO-SYNEPHRINE (PHENYLEPHRINE) 1 % NASAL SPRAY,0.86,0.56,0.14,0.86,22
NDC,0024159601,PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,4.92,3.2,0.83,4.92,22
NDC,0024279210,FERRLECIT 62.5 MG/5 ML INTRAVENOUS SOLUTION,22.89,14.88,1.97,22.89,31
NDC,0024414260,MULTAQ 400 MG TABLET,33.04,21.48,5.55,33.04,22
NDC,0024515006,CAMPHO-PHENIQUE 10.8 %-4.7 % TOPICAL SOLUTION,0.24,0.16,0.04,0.24,22
NDC,0024515010,ELITEK 1.5 MG INTRAVENOUS SOLUTION,4025.04,2616.28,330.73,4025.04,50
NDC,0024515011,ELITEK 1.5 MG INTRAVENOUS SOLUTION,4025.04,2616.28,330.73,4025.04,50
NDC,0024515175,ELITEK 7.5 MG INTRAVENOUS SOLUTION,20125.11,13081.32,330.73,20125.11,53
NDC,0024540131,AMBIEN 5 MG TABLET,51.56,33.51,8.66,51.56,22
NDC,0024542131,AMBIEN 10 MG TABLET,51.56,33.51,8.66,51.56,22
NDC,0024582411,JEVTANA 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION,47103.52,30617.29,190.58,47103.52,53
NDC,0024586201,MOZOBIL 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,29904.21,19437.74,30.66,29904.21,53
NDC,0024591001,KEVZARA 200 MG/1.14 ML SUBCUTANEOUS SYRINGE,7705.14,5008.34,1294.46,7705.14,29
NDC,0024591401,DUPIXENT 300 MG/2 ML SUBCUTANEOUS SYRINGE,3773.73,2452.92,633.99,3773.73,26
NDC,0024591502,DUPIXENT 300 MG/2 ML SUBCUTANEOUS PEN INJECTOR,3773.73,2452.92,633.99,3773.73,26
NDC,0024591801,DUPIXENT 200 MG/1.14 ML SUBCUTANEOUS SYRINGE,6620.58,4303.38,1112.26,6620.58,29
NDC,0024591902,DUPIXENT 200 MG/1.14 ML SUBCUTANEOUS PEN INJECTOR,6620.58,4303.38,1112.26,6620.58,29
NDC,0024592410,ADMELOG U-100 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLUTION,35.31,22.95,5.93,35.31,22
NDC,0024592505,ADMELOG SOLOSTAR U-100 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS PEN,45.45,29.54,0.6,45.45,23
NDC,0024592605,ADMELOG U-100 INSULIN LISPRO 100 UNIT/ML SUBCUTANEOUS SOLUTION,47.07,30.6,0.6,47.07,22
NDC,0025100131,ALDACTONE 25 MG TABLET,6.56,4.26,1.1,6.56,22
NDC,0025103131,ALDACTONE 100 MG TABLET,19.34,12.57,3.25,19.34,22
NDC,0025141160,ARTHROTEC 50 MG-200 MCG TABLETFILM-COATED,21.22,13.79,3.56,21.22,22
NDC,0025142160,ARTHROTEC 75  75 MG-200 MCG TABLETFILM-COATED,21.22,13.79,3.56,21.22,22
NDC,0025152534,CELEBREX 200 MG CAPSULE,39.4,25.61,6.62,39.4,22
NDC,0025171001,INSPRA 25 MG TABLET,35.48,23.06,5.96,35.48,22
NDC,0025273231,NORPACE CR 100 MG CAPSULEEXTENDED RELEASE,10.36,6.73,1.74,10.36,22
NDC,0025274231,NORPACE CR 150 MG CAPSULEEXTENDED RELEASE,12.24,7.96,2.06,12.24,22
NDC,0032004570,CREON 3000 UNIT-9500 UNIT-15000 UNIT CAPSULEDELAYED RELEASE,4.36,2.83,0.73,4.36,22
NDC,0032004670,CREON 6000-19000-30000 UNIT CAPSULEDELAYED RELEASE,5.16,3.35,0.87,5.16,22
NDC,0032004770,CREON 12000-38000-60000 UNIT CAPSULEDELAYED RELEASE,10.3,6.7,1.73,10.3,22
NDC,0032263601,CREON 24000-76000-120000 UNIT CAPSULEDELAYED RELEASE,20.42,13.27,3.43,20.42,22
NDC,0032301613,CREON 36000 UNIT-114000 UNIT-180000 UNIT CAPSULEDELAYED RELEASE,31.0,20.15,5.21,31.0,22
NDC,0037043001,FELBATOL 400 MG TABLET,37.04,24.08,6.22,37.04,22
NDC,0037043101,FELBATOL 600 MG TABLET,42.46,27.6,7.13,42.46,22
NDC,0037682210,PROCTOFOAM HC 1 %-1 %,48.98,31.84,8.23,48.98,22
NDC,0037682315,PROCTOFOAM 1 % TOPICAL,16.2,10.53,2.72,16.2,22
NDC,0037682410,EPIFOAM 1 %-1 % TOPICAL,25.24,16.41,4.24,25.24,22
NDC,0037683015,CORTIFOAM 10 % (80 MG) RECTAL,77.38,50.3,13.0,77.38,22
NDC,0037686010,DIPENTUM 250 MG CAPSULE,39.5,25.68,6.64,39.5,22
NDC,0039413012,MERIBIN 5 MG CAPSULE,0.56,0.36,0.09,0.56,22
NDC,00406030412,BISMUTH SUBGALLATE (BULK) POWDER,0.42,0.27,0.07,0.42,22
NDC,0046074905,PREMARIN 25 MG SOLUTION FOR INJECTION,1393.41,905.72,97.89,1393.41,47
NDC,0046087221,PREMARIN 0.625 MG/GRAM VAGINAL CREAM,37.86,24.61,6.36,37.86,22
NDC,0046110081,PREMARIN 0.3 MG TABLET,17.44,11.34,2.93,17.44,22
NDC,0046110181,PREMARIN 0.45 MG TABLET,17.44,11.34,2.93,17.44,22
NDC,0046110281,PREMARIN 0.625 MG TABLET,17.44,11.34,2.93,17.44,22
NDC,0046110381,PREMARIN 0.9 MG TABLET,17.44,11.34,2.93,17.44,22
NDC,0046110481,PREMARIN 1.25 MG TABLET,17.44,11.34,2.93,17.44,22
NDC,0046110611,PREMPRO 0.45 MG-1.5 MG TABLET,21.8,14.17,3.66,21.8,22
NDC,0046110711,PREMPRO 0.625 MG-2.5 MG TABLET,21.8,14.17,3.66,21.8,22
NDC,0046110811,PREMPRO 0.625 MG-5 MG TABLET,21.8,14.17,3.66,21.8,22
NDC,0049001383,UNASYN 1.5 GRAM SOLUTION FOR INJECTION,27.75,18.04,1.91,27.75,31
NDC,0049001483,UNASYN 3 GRAM SOLUTION FOR INJECTION,52.41,34.07,1.91,52.41,31
NDC,0049002428,UNASYN 15 GRAM SOLUTION FOR INJECTION,262.11,170.37,1.91,262.11,31
NDC,0049011628,ERAXIS(WATER DILUENT) 100 MG INTRAVENOUS SOLUTION,687.21,446.69,0.42,687.21,31
NDC,0049052083,PFIZERPEN-G 5 MILLION UNIT SOLUTION FOR INJECTION,45.81,29.78,0.75,45.81,31
NDC,0049233045,RELPAX 20 MG TABLET,193.84,126.0,32.57,193.84,22
NDC,0049276066,CARDURA 2 MG TABLET,13.8,8.97,2.32,13.8,22
NDC,0049277066,CARDURA 4 MG TABLET,14.48,9.41,2.43,14.48,22
NDC,0049319028,VFEND IV 200 MG INTRAVENOUS SOLUTION,217.08,141.1,0.99,217.08,31
NDC,0049345019,DIFLUCAN 40 MG/ML ORAL SUSPENSION,2.4,1.56,0.4,2.4,22
NDC,0049491041,ZOLOFT 100 MG TABLET,37.54,24.4,6.31,37.54,22
NDC,0052045016,ZEMURON 10 MG/ML INTRAVENOUS SOLUTION,14.64,9.52,2.46,14.64,22
NDC,0052060202,TICE BCG 50 MG INTRAVESICAL SUSPENSION,873.44,567.74,2.6,873.44,39
NDC,0052060302,BCG VACCINE LIVE (PF) 50 MG PERCUTANEOUS INJECTION SUSPENSION,655.08,425.8,110.05,655.08,23
NDC,0053720102,ZEMAIRA 1000 MG INTRAVENOUS SOLUTION,2.28,1.48,0.59,943.43,47
NDC,0053720202,ZEMAIRA 4000 MG INTRAVENOUS SOLUTION,2.28,1.48,0.59,943.43,47
NDC,0053720302,ZEMAIRA 5000 MG INTRAVENOUS SOLUTION,2.28,1.48,0.59,943.43,47
NDC,0054000713,CALCITRIOL 0.25 MCG CAPSULE,2.56,1.66,0.43,2.56,22
NDC,0054001020,FLECAINIDE 50 MG TABLET,4.04,2.63,0.68,4.04,22
NDC,0054001025,FLECAINIDE 50 MG TABLET,4.04,2.63,0.68,4.04,22
NDC,0054001120,FLECAINIDE 100 MG TABLET,7.16,4.65,1.2,7.16,22
NDC,0054001121,FLECAINIDE 100 MG TABLET,7.16,4.65,1.2,7.16,22
NDC,0054001225,FLECAINIDE 150 MG TABLET,8.68,5.64,1.46,8.68,22
NDC,0054001720,PREDNISONE 10 MG TABLET,0.54,0.35,0.01,0.54,31
NDC,0054001820,PREDNISONE 20 MG TABLET,0.58,0.38,0.01,0.58,31
NDC,0054001920,PREDNISONE 50 MG TABLET,0.84,0.55,0.01,0.84,31
NDC,0054001925,PREDNISONE 50 MG TABLET,0.82,0.53,0.01,0.82,31
NDC,0054002025,LITHIUM CARBONATE ER 450 MG TABLETEXTENDED RELEASE,1.08,0.7,0.18,1.08,22
NDC,0054002125,LITHIUM CARBONATE ER 300 MG TABLETEXTENDED RELEASE,0.94,0.61,0.16,0.94,22
NDC,0054004544,IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,7.44,4.84,1.25,7.44,22
NDC,0054004641,IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,12.76,8.29,2.14,12.76,22
NDC,0054005746,DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,7.0,4.55,1.18,7.0,22
NDC,0054006447,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,12.0,7.8,2.02,12.0,22
NDC,0054007928,BALSALAZIDE 750 MG CAPSULE,3.2,2.08,0.54,3.2,22
NDC,0054008013,EXEMESTANE 25 MG TABLET,40.46,26.3,6.8,40.46,22
NDC,0054014125,ACARBOSE 50 MG TABLET,1.96,1.27,0.33,1.96,22
NDC,0054017613,BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET,8.28,5.38,1.39,8.28,22
NDC,0054017713,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,15.48,10.06,2.6,15.48,22
NDC,0054018913,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,20.84,13.55,3.5,20.84,22
NDC,0054023524,MORPHINE 15 MG IMMEDIATE RELEASE TABLET,1.82,1.18,0.31,1.82,22
NDC,0054023525,MORPHINE 15 MG IMMEDIATE RELEASE TABLET,1.04,0.68,0.17,1.04,22
NDC,0054023624,MORPHINE 30 MG IMMEDIATE RELEASE TABLET,3.08,2.0,0.52,3.08,22
NDC,0054023749,MORPHINE 10 MG/5 ML ORAL SOLUTION,0.3,0.2,0.05,0.3,22
NDC,0054023763,MORPHINE 10 MG/5 ML ORAL SOLUTION,0.14,0.09,0.02,0.14,22
NDC,0054024324,CODEINE SULFATE 15 MG TABLET,1.72,1.12,0.29,1.72,22
NDC,0054024424,CODEINE SULFATE 30 MG TABLET,2.06,1.34,0.35,2.06,22
NDC,0054024425,CODEINE SULFATE 30 MG TABLET,1.86,1.21,0.31,1.86,22
NDC,0054028259,ALENDRONATE 70 MG/75 ML ORAL SOLUTION,2.88,1.87,0.48,2.88,22
NDC,0054028325,OXYMORPHONE 5 MG TABLET,6.48,4.21,1.09,6.48,22
NDC,0054029399,AZELASTINE 137 MCG (0.1 %) NASAL SPRAY,7.02,4.56,1.18,7.02,22
NDC,0054031950,LINEZOLID 100 MG/5 ML ORAL SUSPENSION,15.95,10.37,2.68,15.95,22
NDC,0054033425,CEVIMELINE 30 MG CAPSULE,6.98,4.54,1.17,6.98,22
NDC,0054038225,CYCLOPHOSPHAMIDE 25 MG CAPSULE,18.72,12.17,0.77,18.72,30
NDC,0054038663,HYDROMORPHONE 1 MG/ML ORAL LIQUID,0.9,0.59,0.15,0.9,22
NDC,0054039063,OXYCODONE 5 MG/5 ML ORAL SOLUTION,0.73,0.47,0.12,0.73,22
NDC,0054039168,METHADONE 10 MG/ML ORAL CONCENTRATE,0.17,0.11,0.03,0.17,22
NDC,0054047121,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,42.28,27.48,2.24,42.28,31
NDC,0054048113,EVEROLIMUS (ANTINEOPLASTIC) 5 MG TABLET,1193.72,775.92,200.54,1193.72,22
NDC,0054050823,ICOSAPENT ETHYL 1 GRAM CAPSULE,6.28,4.08,1.06,6.28,22
NDC,0054051744,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,1.26,0.82,0.21,1.26,22
NDC,0054057625,DEFERIPRONE 500 MG TABLET,164.52,106.94,27.64,164.52,22
NDC,0054062263,DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,0.75,0.49,0.13,0.75,22
NDC,0054063913,METHYLERGONOVINE 0.2 MG TABLET,134.38,87.35,22.58,134.38,22
NDC,0054071020,METHADONE 10 MG TABLET,0.88,0.57,0.15,0.88,22
NDC,0054087949,MERCAPTOPURINE 20 MG/ML ORAL SUSPENSION,40.85,26.55,6.86,40.85,22
NDC,0054252625,LITHIUM CARBONATE 150 MG CAPSULE,0.34,0.22,0.06,0.34,22
NDC,0054252725,LITHIUM CARBONATE 300 MG CAPSULE,0.56,0.36,0.09,0.56,22
NDC,0054253125,LITHIUM CARBONATE 600 MG CAPSULE,0.94,0.61,0.16,0.94,22
NDC,0054306844,ALPRAZOLAM INTENSOL 1 MG/ML ORAL CONCENTRATE,9.15,5.95,1.54,9.15,22
NDC,0054309036,BUTORPHANOL 10 MG/ML NASAL SPRAY,77.06,50.09,12.95,77.06,22
NDC,0054311763,CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1250 MG/5 ML) ORAL SUSPENSION,0.08,0.05,0.01,0.08,22
NDC,0054312041,CALCITRIOL 1 MCG/ML ORAL SOLUTION,29.83,19.39,5.01,29.83,22
NDC,0054317644,DEXAMETHASONE INTENSOL 1 MG/ML DROPS (CONCENTRATE),2.68,1.74,0.45,2.68,22
NDC,0054317757,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,0.68,0.44,0.01,0.68,30
NDC,0054317763,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,0.13,0.08,0.01,0.13,30
NDC,0054318863,DIAZEPAM 5 MG/5 ML (1 MG/ML) ORAL SOLUTION,0.4,0.26,0.07,0.4,22
NDC,0054319446,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,5.0,3.25,0.84,5.0,22
NDC,0054327099,FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAYSUSPENSION,11.66,7.58,1.96,11.66,22
NDC,0054329446,FUROSEMIDE 10 MG/ML ORAL SOLUTION,0.38,0.25,0.06,0.38,22
NDC,0054329450,FUROSEMIDE 10 MG/ML ORAL SOLUTION,0.38,0.25,0.06,0.38,22
NDC,0054329863,FUROSEMIDE 40 MG/5 ML (8 MG/ML) ORAL SOLUTION,0.25,0.16,0.04,0.25,22
NDC,0054350049,LIDOCAINE VISCOUS 2 % MUCOSAL SOLUTION,0.33,0.21,0.06,0.33,22
NDC,0054350547,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,1.92,1.25,0.32,1.92,22
NDC,0054353244,LORAZEPAM INTENSOL 2 MG/ML ORAL CONCENTRATE,2.4,1.56,0.4,2.4,22
NDC,0054355344,METHADONE INTENSOL 10 MG/ML ORAL CONCENTRATE,1.28,0.83,0.22,1.28,22
NDC,0054355563,METHADONE 5 MG/5 ML ORAL SOLUTION,0.12,0.08,0.02,0.12,22
NDC,0054355663,METHADONE 10 MG/5 ML ORAL SOLUTION,0.35,0.23,0.06,0.35,22
NDC,0054356699,MIDAZOLAM 2 MG/ML ORAL SYRUP,3.24,2.11,0.54,3.24,22
NDC,0054363063,NAPROXEN 125 MG/5 ML ORAL SUSPENSION,5.98,3.89,1.0,5.98,22
NDC,0054372144,PREDNISONE INTENSOL 5 MG/ML ORAL CONCENTRATE,13.0,8.45,0.01,13.0,31
NDC,0054372250,PREDNISONE 5 MG/5 ML ORAL SOLUTION,2.0,1.3,0.01,2.0,31
NDC,0054372263,PREDNISONE 5 MG/5 ML ORAL SOLUTION,1.85,1.2,0.01,1.85,31
NDC,0054372763,PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,0.33,0.21,0.06,0.33,22
NDC,0054373063,PROPRANOLOL 40 MG/5 ML (8 MG/ML) ORAL SOLUTION,0.48,0.31,0.08,0.48,22
NDC,0054417925,DEXAMETHASONE 0.5 MG TABLET,0.28,0.18,0.05,0.28,22
NDC,0054418025,DEXAMETHASONE 0.75 MG TABLET,0.5,0.33,0.01,0.5,30
NDC,0054418125,DEXAMETHASONE 1 MG TABLET,0.6,0.39,0.01,0.6,30
NDC,0054418325,DEXAMETHASONE 2 MG TABLET,1.2,0.78,0.01,1.2,30
NDC,0054418425,DEXAMETHASONE 4 MG TABLET,2.38,1.55,0.4,2.38,22
NDC,0054449625,LEUCOVORIN CALCIUM 5 MG TABLET,4.06,2.64,0.68,4.06,22
NDC,0054449705,LEUCOVORIN CALCIUM 10 MG TABLET,16.82,10.93,2.83,16.82,22
NDC,0054449911,LEUCOVORIN CALCIUM 25 MG TABLET,49.46,32.15,8.31,49.46,22
NDC,0054458111,MERCAPTOPURINE 50 MG TABLET,16.38,10.65,2.75,16.38,22
NDC,0054472825,PREDNISONE 5 MG TABLET,0.46,0.3,0.01,0.46,31
NDC,0054472831,PREDNISONE 5 MG TABLET,0.44,0.29,0.01,0.44,31
NDC,0054474125,PREDNISONE 1 MG TABLET,0.5,0.33,0.01,0.5,31
NDC,0054474225,PREDNISONE 2.5 MG TABLET,0.34,0.22,0.01,0.34,31
NDC,0054485825,TRIAZOLAM 0.125 MG TABLET,12.08,7.85,2.03,12.08,22
NDC,0054814622,CLOTRIMAZOLE 10 MG TROCHE,6.88,4.47,1.16,6.88,22
NDC,0054817425,DEXAMETHASONE 1 MG TABLET,0.74,0.48,0.01,0.74,30
NDC,0054817525,DEXAMETHASONE 4 MG TABLET,2.42,1.57,0.41,2.42,22
NDC,0054817625,DEXAMETHASONE 2 MG TABLET,1.48,0.96,0.01,1.48,30
NDC,0054817925,DEXAMETHASONE 0.5 MG TABLET,0.42,0.27,0.07,0.42,22
NDC,0054818325,DEXAMETHASONE 6 MG TABLET,3.8,2.47,0.01,3.8,30
NDC,0054829725,FUROSEMIDE 20 MG TABLET,1.04,0.68,0.17,1.04,22
NDC,0054829925,FUROSEMIDE 40 MG TABLET,1.18,0.77,0.2,1.18,22
NDC,0054830125,FUROSEMIDE 80 MG TABLET,3.14,2.04,0.53,3.14,22
NDC,0054849619,LEUCOVORIN CALCIUM 5 MG TABLET,5.6,3.64,0.94,5.6,22
NDC,0054852625,LITHIUM CARBONATE 150 MG CAPSULE,0.38,0.25,0.06,0.38,22
NDC,0054852725,LITHIUM CARBONATE 300 MG CAPSULE,0.74,0.48,0.12,0.74,22
NDC,0054852825,LITHIUM CARBONATE 300 MG TABLET,0.68,0.44,0.11,0.68,22
NDC,0054855025,METHOTREXATE SODIUM 2.5 MG TABLET,7.12,4.63,0.16,7.12,30
NDC,0054872425,PREDNISONE 5 MG TABLET,0.5,0.33,0.01,0.5,31
NDC,0054873925,PREDNISONE 1 MG TABLET,0.56,0.36,0.01,0.56,31
NDC,0054874025,PREDNISONE 2.5 MG TABLET,0.36,0.23,0.01,0.36,31
NDC,0065002315,MIOSTAT 0.01 % INTRAOCULAR SOLUTION,111.54,72.5,18.74,111.54,22
NDC,0065008515,NAPHCON-A 0.025 %-0.3 % EYE DROPS,1.26,0.82,0.21,1.26,22
NDC,0065019093,SYSTANE CONTACTS EYE DROPS,1.68,1.09,0.28,1.68,22
NDC,0065024610,BETOPTIC S 0.25 % EYE DROPSSUSPENSION,78.26,50.87,13.15,78.26,22
NDC,0065035604,OPTI-FREE REPLENISH SOLUTION,0.08,0.05,0.01,0.08,22
NDC,0065035902,CYCLOMYDRIL 0.2 %-1 % EYE DROPS,44.42,28.87,7.46,44.42,22
NDC,0065035905,CYCLOMYDRIL 0.2 %-1 % EYE DROPS,31.22,20.29,5.24,31.22,22
NDC,0065039515,CYCLOGYL 0.5 % EYE DROPS,16.2,10.53,2.72,16.2,22
NDC,0065039602,CYCLOGYL 1 % EYE DROPS,42.52,27.64,7.14,42.52,22
NDC,0065039605,CYCLOGYL 1 % EYE DROPS,30.58,19.88,5.14,30.58,22
NDC,0065039702,CYCLOGYL 2 % EYE DROPS,55.64,36.17,9.35,55.64,22
NDC,0065039705,CYCLOGYL 2 % EYE DROPS,36.8,23.92,6.18,36.8,22
NDC,0065039715,CYCLOGYL 2 % EYE DROPS,20.38,13.25,3.42,20.38,22
NDC,0065041130,BETADINE OPHTHALMIC PREP 5 % SOLUTION,1.42,0.92,0.24,1.42,22
NDC,0065042636,GENTEAL TEARS MODERATE 0.1 %-0.3 %-0.2 % EYE DROPS,1.06,0.69,0.18,1.06,22
NDC,0065045407,SYSTANE GEL 0.4 %-0.3 % EYE DROPS,2.48,1.61,0.42,2.48,22
NDC,0065050935,SYSTANE NIGHTTIME 94 %-3 % EYE OINTMENT,6.28,4.08,1.06,6.28,22
NDC,0065051801,GENTEAL TEARS SEVERE (PETROLATUM-MINERAL OIL) 94 %-3 % EYE OINTMENT,4.9,3.19,0.82,4.9,22
NDC,0065074114,TETRACAINE HCL (PF) 0.5 % EYE DROPS,8.32,5.41,1.4,8.32,22
NDC,0065079515,BSS INTRAOCULAR SOLUTION,2.02,1.31,0.34,2.02,22
NDC,0065079550,BSS INTRAOCULAR SOLUTION,0.18,0.12,0.03,0.18,22
NDC,0065080050,BSS PLUS INTRAOCULAR SOLUTION,0.5,0.33,0.08,0.5,22
NDC,0065080094,BSS PLUS INTRAOCULAR SOLUTION,0.48,0.31,0.08,0.48,22
NDC,0065143105,SYSTANE ULTRA 0.4 %-0.3 % EYE DROPS,2.32,1.51,0.39,2.32,22
NDC,0065179504,BSS INTRAOCULAR SOLUTION,0.18,0.12,0.03,0.18,22
NDC,0065179540,BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,0.03,0.02,0.01,0.03,22
NDC,0065806401,GENTEAL TEARS SEVERE 0.3 % EYE GEL,1.72,1.12,0.29,1.72,22
NDC,0067208601,4 WAY 1 % NASAL SPRAY,0.64,0.42,0.11,0.64,22
NDC,0067813902,EXCEDRIN TENSION HEADACHE 500 MG-65 MG TABLET,0.26,0.17,0.04,0.26,22
NDC,0067815202,VOLTAREN ARTHRITIS PAIN 1 % TOPICAL GEL,0.62,0.4,0.1,0.62,22
NDC,0067815203,VOLTAREN ARTHRITIS PAIN 1 % TOPICAL GEL,0.5,0.33,0.08,0.5,22
NDC,0068059701,RIFADIN 600 MG INTRAVENOUS SOLUTION,642.81,417.83,0.29,642.81,30
NDC,0069005801,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,1.23,0.8,0.21,5.81,31
NDC,0069010601,ELELYSO 200 UNIT INTRAVENOUS SOLUTION,3397.65,2208.47,40.5,12697.64,50
NDC,0069013501,BOSULIF 100 MG TABLET,444.96,289.22,74.75,444.96,22
NDC,0069013601,BOSULIF 500 MG TABLET,1779.84,1156.9,299.01,1779.84,22
NDC,0069014501,INLYTA 1 MG TABLET,282.16,183.4,47.4,282.16,22
NDC,0069015111,INLYTA 5 MG TABLET,846.48,550.21,142.21,846.48,22
NDC,0069018721,IBRANCE 75 MG CAPSULE,1881.38,1222.9,316.07,1881.38,22
NDC,0069018821,IBRANCE 100 MG CAPSULE,1881.38,1222.9,316.07,1881.38,22
NDC,0069018921,IBRANCE 125 MG CAPSULE,1881.38,1222.9,316.07,1881.38,22
NDC,0069019301,BOSULIF 400 MG TABLET,1779.84,1156.9,299.01,1779.84,22
NDC,0069019502,FRAGMIN 2500 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRINGE,1751.55,1138.51,14.94,1751.55,31
NDC,0069019602,FRAGMIN 5000 ANTI-XA UNIT/0.2 ML SUBCUTANEOUS SYRINGE,2841.69,1847.1,14.94,2841.69,34
NDC,0069019730,VIZIMPRO 15 MG TABLET,1386.84,901.45,232.99,1386.84,22
NDC,0069020602,FRAGMIN 7500 ANTI-XA UNIT/0.3 ML SUBCUTANEOUS SYRINGE,2842.02,1847.31,14.94,2842.02,34
NDC,0069020910,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,0.78,0.51,0.11,0.78,31
NDC,0069021702,FRAGMIN 10000 ANTI-XA UNIT/ML SUBCUTANEOUS SYRINGE,1136.67,738.84,14.94,1136.67,31
NDC,0069022002,FRAGMIN 12500 ANTI-XA UNIT/0.5 ML SUBCUTANEOUS SYRINGE,2841.93,1847.25,14.94,2841.93,34
NDC,0069022302,FRAGMIN 15000 ANTI-XA UNIT/0.6 ML SUBCUTANEOUS SYRINGE,2841.75,1847.14,14.94,2841.75,34
NDC,0069022701,LORBRENA 25 MG TABLET,598.06,388.74,100.47,598.06,22
NDC,0069022802,FRAGMIN 18000 ANTI-XA UNIT/0.72 ML SUBCUTANEOUS SYRINGE,2841.75,1847.14,14.94,2841.75,34
NDC,0069023101,LORBRENA 100 MG TABLET,1794.2,1166.23,301.43,1794.2,22
NDC,0069023801,RUXIENCE 10 MG/ML INTRAVENOUS SOLUTION,344.08,223.65,13.27,1355.53,46
NDC,0069024901,RUXIENCE 10 MG/ML INTRAVENOUS SOLUTION,344.08,223.65,13.27,1355.53,46
NDC,0069025160,XALKORI 20 MG ORAL PELLETS,95.1,61.82,15.98,95.1,22
NDC,0069027702,DOXORUBICIN 20 MG/10 ML INTRAVENOUS SOLUTION,9.76,6.34,1.64,9.76,30
NDC,0069028403,IBRANCE 75 MG TABLET,1937.82,1259.58,325.55,1937.82,22
NDC,0069029101,NIVESTYM 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,1576.8,1024.92,0.26,1576.8,47
NDC,0069029110,NIVESTYM 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,1576.8,1024.92,0.26,1576.8,47
NDC,0069029201,NIVESTYM 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1576.8,1024.92,0.26,1576.8,47
NDC,0069029210,NIVESTYM 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1576.8,1024.92,0.26,1576.8,47
NDC,0069029301,NIVESTYM 300 MCG/ML INJECTION SOLUTION,788.4,512.46,0.26,788.4,47
NDC,0069029310,NIVESTYM 300 MCG/ML INJECTION SOLUTION,788.4,512.46,0.26,788.4,47
NDC,0069029401,NIVESTYM 480 MCG/1.6 ML INJECTION SOLUTION,788.4,512.46,0.26,788.4,47
NDC,0069029410,NIVESTYM 480 MCG/1.6 ML INJECTION SOLUTION,788.4,512.46,0.26,788.4,47
NDC,0069029860,DAURISMO 25 MG TABLET,929.8,604.37,156.21,929.8,22
NDC,0069030501,TRAZIMERA 420 MG INTRAVENOUS SOLUTION,16277.2,10580.18,8.2,16277.2,52
NDC,0069030801,TRAZIMERA 150 MG INTRAVENOUS SOLUTION,5813.28,3778.63,8.2,5813.28,52
NDC,0069031501,ZIRABEV 25 MG/ML INTRAVENOUS SOLUTION,736.08,478.45,18.68,736.08,46
NDC,0069032401,NYVEPRIA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,23550.0,15307.5,58.96,23550.0,53
NDC,0069033801,REVATIO 10 MG/12.5 ML INTRAVENOUS SOLUTION,60.3,39.2,10.13,60.3,22
NDC,0069034201,ZIRABEV 25 MG/ML INTRAVENOUS SOLUTION,736.08,478.45,18.68,736.08,46
NDC,0069046856,CHANTIX 0.5 MG TABLET,8.56,5.56,1.44,8.56,22
NDC,0069046956,CHANTIX 1 MG TABLET,8.56,5.56,1.44,8.56,22
NDC,0069048603,IBRANCE 100 MG TABLET,1937.82,1259.58,325.55,1937.82,22
NDC,0069050130,XELJANZ XR 11 MG TABLETEXTENDED RELEASE,512.58,333.18,86.11,512.58,22
NDC,0069050760,XALKORI 50 MG ORAL PELLETS,224.28,145.78,37.68,224.28,22
NDC,0069055038,SUTENT 12.5 MG CAPSULE,553.4,359.71,92.97,553.4,22
NDC,0069068803,IBRANCE 125 MG TABLET,1937.82,1259.58,325.55,1937.82,22
NDC,0069077038,SUTENT 25 MG CAPSULE,1106.82,719.43,185.95,1106.82,22
NDC,0069080901,INFLECTRA 100 MG INTRAVENOUS SOLUTION,3406.62,2214.3,9.98,3406.62,50
NDC,0069083038,SUTENT 37.5 MG CAPSULE,1660.22,1079.14,278.92,1660.22,22
NDC,0069098038,SUTENT 50 MG CAPSULE,1926.82,1252.43,323.71,1926.82,22
NDC,0069100101,XELJANZ 5 MG TABLET,182.2,118.43,30.61,182.2,22
NDC,0069100201,XELJANZ 10 MG TABLET,256.28,166.58,43.06,256.28,22
NDC,0069119830,VIZIMPRO 30 MG TABLET,1386.84,901.45,232.99,1386.84,22
NDC,0069130510,RETACRIT 2000 UNIT/ML INJECTION SOLUTION,81.36,52.88,6.76,123.65,47
NDC,0069130610,RETACRIT 3000 UNIT/ML INJECTION SOLUTION,122.07,79.35,6.76,123.65,47
NDC,0069130710,RETACRIT 4000 UNIT/ML INJECTION SOLUTION,162.75,105.79,6.76,162.75,47
NDC,0069130810,RETACRIT 10000 UNIT/ML INJECTION SOLUTION,406.86,264.46,6.76,406.86,47
NDC,0069130904,RETACRIT 40000 UNIT/ML INJECTION SOLUTION,1627.38,1057.8,6.76,1627.38,47
NDC,0069131101,RETACRIT 20000 UNIT/ML INJECTION SOLUTION,813.69,528.9,6.76,813.69,47
NDC,0069131110,RETACRIT 20000 UNIT/ML INJECTION SOLUTION,813.69,528.9,6.76,813.69,47
NDC,0069131810,RETACRIT 20000 UNIT/2 ML INJECTION SOLUTION,406.86,264.46,6.76,406.86,47
NDC,0069150060,XALKORI 150 MG ORAL PELLETS,672.82,437.33,113.03,672.82,22
NDC,0069153130,DAURISMO 100 MG TABLET,1859.6,1208.74,312.41,1859.6,22
NDC,0069229930,VIZIMPRO 45 MG TABLET,1386.84,901.45,232.99,1386.84,22
NDC,0069246501,ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION,1148.64,746.62,17.89,1148.64,29
NDC,0069252202,ELREXFIO 40 MG/ML SUBCUTANEOUS SOLUTION,37534.88,24397.67,163.51,37534.88,53
NDC,0069252810,COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE,2038.14,1324.79,17.89,2038.14,37
NDC,0069303020,DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLUTION,9.76,6.34,1.64,9.76,30
NDC,0069313019,ZITHROMAX 200 MG/5 ML ORAL SUSPENSION,6.78,4.41,1.14,6.78,22
NDC,0069314019,ZITHROMAX 200 MG/5 ML ORAL SUSPENSION,2.65,1.72,0.45,2.65,22
NDC,0069315083,ZITHROMAX 500 MG INTRAVENOUS SOLUTION,21.93,14.25,2.17,21.93,31
NDC,0069419068,REVATIO 20 MG TABLET,155.88,101.32,26.19,155.88,22
NDC,0069420030,VIAGRA 25 MG TABLET,209.82,136.38,35.25,209.82,22
NDC,0069421030,VIAGRA 50 MG TABLET,209.82,136.38,35.25,209.82,22
NDC,0069422030,VIAGRA 100 MG TABLET,161.64,105.07,27.16,161.64,22
NDC,0069449402,ELREXFIO 40 MG/ML SUBCUTANEOUS SOLUTION,37534.84,24397.65,163.51,37534.84,53
NDC,0069504530,PAXLOVID 300 MG (150 MG X 2)-100 MG TABLETS IN A DOSE PACK,359.08,233.4,60.33,359.08,22
NDC,0069543420,PAXLOVID 150 MG-100 MG TABLETS IN A DOSE PACK (MODERATE RENAL DOSE),359.08,233.4,60.33,359.08,22
NDC,0069580060,TIKOSYN 125 MCG CAPSULE,26.86,17.46,4.51,26.86,22
NDC,0069581060,TIKOSYN 250 MCG CAPSULE,26.86,17.46,4.51,26.86,22
NDC,0069600125,CEREBYX 100 MG PE/2 ML INJECTION SOLUTION,72.78,47.31,1.34,72.78,26
NDC,0069600202,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,18.11,943.43,47
NDC,0069611102,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,18.11,943.43,47
NDC,0069623702,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,18.11,943.43,47
NDC,0069633902,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,18.11,943.43,47
NDC,0069655002,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,18.11,943.43,47
NDC,0069814020,XALKORI 250 MG CAPSULE,950.92,618.1,159.75,950.92,22
NDC,0069814120,XALKORI 200 MG CAPSULE,950.92,618.1,159.75,950.92,22
NDC,0069873030,VYNDAMAX 61 MG CAPSULE,1884.84,1225.15,316.65,1884.84,22
NDC,0071000724,DILANTIN INFATABS 50 MG CHEWABLE TABLET,3.98,2.59,0.67,3.98,22
NDC,0071015623,LIPITOR 20 MG TABLET,47.98,31.19,8.06,47.98,22
NDC,0071015723,LIPITOR 40 MG TABLET,47.98,31.19,8.06,47.98,22
NDC,0071023724,ZARONTIN 250 MG CAPSULE,3.28,2.13,0.55,3.28,22
NDC,0071035060,NARDIL 15 MG TABLET,6.36,4.13,1.07,6.36,22
NDC,0071036924,DILANTIN EXTENDED 100 MG CAPSULE,4.36,2.83,0.73,4.36,22
NDC,0071036940,DILANTIN EXTENDED 100 MG CAPSULE,4.82,3.13,0.81,4.82,22
NDC,0071041813,NITROSTAT 0.4 MG SUBLINGUAL TABLET,3.88,2.52,0.65,3.88,22
NDC,0071041924,NITROSTAT 0.6 MG SUBLINGUAL TABLET,1.78,1.16,0.3,1.78,22
NDC,0071052524,CELONTIN 300 MG CAPSULE,11.02,7.16,1.85,11.02,22
NDC,0071073720,LOPID 600 MG TABLET,3.16,2.05,0.53,3.16,22
NDC,0071101441,LYRICA 75 MG CAPSULE,26.72,17.37,4.49,26.72,22
NDC,0071101468,LYRICA 75 MG CAPSULE,24.28,15.78,4.08,24.28,22
NDC,0071101541,LYRICA 100 MG CAPSULE,26.72,17.37,4.49,26.72,22
NDC,0071101568,LYRICA 100 MG CAPSULE,24.28,15.78,4.08,24.28,22
NDC,0071101768,LYRICA 200 MG CAPSULE,24.28,15.78,4.08,24.28,22
NDC,0071101968,LYRICA 225 MG CAPSULE,24.28,15.78,4.08,24.28,22
NDC,0071374066,DILANTIN 30 MG CAPSULE,3.76,2.44,0.63,3.76,22
NDC,0073140106,ZINC-220 50 MG ZINC (220 MG) CAPSULE,0.24,0.16,0.04,0.24,22
NDC,0074012403,HUMIRA(CF) PEN CROHN'S-ULC COLITIS-HID SUP STRT 80 MG/0.8 ML SUBCUT KT,30767.32,19998.76,74.0,30767.32,42
NDC,0074024302,HUMIRA(CF) 40 MG/0.4 ML SUBCUTANEOUS SYRINGE KIT,11537.7,7499.51,74.0,11537.7,42
NDC,0074055402,HUMIRA(CF) PEN 40 MG/0.4 ML SUBCUTANEOUS KIT,15383.6,9999.34,74.0,15383.6,42
NDC,0074056111,VENCLEXTA 10 MG TABLET,31.22,20.29,5.24,31.22,22
NDC,0074056114,VENCLEXTA 10 MG TABLET,31.24,20.31,5.25,31.24,22
NDC,0074056607,VENCLEXTA 50 MG TABLET,156.22,101.54,26.24,156.22,22
NDC,0074056611,VENCLEXTA 50 MG TABLET,156.22,101.54,26.24,156.22,22
NDC,0074057611,VENCLEXTA 100 MG TABLET,312.36,203.03,52.48,312.36,22
NDC,0074057622,VENCLEXTA 100 MG TABLET,312.42,203.07,52.49,312.42,22
NDC,0074104004,SURVANTA 25 MG/ML INTRATRACHEAL SUSPENSION,344.7,224.06,57.91,344.7,22
NDC,0074104008,SURVANTA 25 MG/ML INTRATRACHEAL SUSPENSION,305.04,198.28,51.25,305.04,22
NDC,0074104328,RINVOQ 45 MG TABLETEXTENDED RELEASE,1080.44,702.29,181.51,1080.44,22
NDC,0074104401,EMRELIS 20 MG INTRAVENOUS SOLUTION,13420.8,8723.52,145.87,13420.8,45
NDC,0074105501,EMRELIS 100 MG INTRAVENOUS SOLUTION,67104.0,43617.6,145.87,67104.0,45
NDC,0074157521,KALETRA 100 MG-25 MG TABLET,10.24,6.66,1.72,10.24,22
NDC,0074165801,ZEMPLAR 5 MCG/ML INTRAVENOUS SOLUTION,54.54,35.45,0.68,54.54,31
NDC,0074165805,ZEMPLAR 5 MCG/ML INTRAVENOUS SOLUTION,54.54,35.45,0.68,54.54,31
NDC,0074194063,NORVIR 80 MG/ML ORAL SOLUTION,18.0,11.7,3.02,18.0,22
NDC,0074210001,SKYRIZI 150 MG/ML SUBCUTANEOUS PEN INJECTOR,80580.57,52377.37,13.5,80580.57,53
NDC,0074210803,LUPRON DEPOT-PED 7.5 MG (PED) INTRAMUSCULAR KIT,7800.3,5070.2,516.7,7800.3,53
NDC,0074228203,LUPRON DEPOT-PED 11.25 MG INTRAMUSCULAR KIT,14161.26,9204.82,516.7,14161.26,53
NDC,0074230630,RINVOQ 15 MG TABLETEXTENDED RELEASE,540.22,351.14,90.76,540.22,22
NDC,0074231030,RINVOQ 30 MG TABLETEXTENDED RELEASE,540.22,351.14,90.76,540.22,22
NDC,0074244003,LUPRON DEPOT-PED 15 MG INTRAMUSCULAR KIT,15597.18,10138.17,516.7,15597.18,53
NDC,0074262528,MAVYRET 100 MG-40 MG TABLET,377.14,245.14,63.36,377.14,22
NDC,0074301207,DUOPA 4.63 MG-20 MG/ML SUSPENSION IN J-TUBE PUMP,7.03,4.57,1.18,7.03,22
NDC,0074310932,GENGRAF 100 MG CAPSULE,17.64,11.47,2.07,17.64,31
NDC,0074334603,LUPRON DEPOT 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,23179.98,15066.99,167.1,23179.98,52
NDC,0074339930,NORVIR 100 MG ORAL POWDER PACKET,20.58,13.38,3.46,20.58,22
NDC,0074347303,LUPRON DEPOT 45 MG (6 MONTH) INTRAMUSCULAR SYRINGE KIT,46360.77,30134.5,167.1,46360.77,52
NDC,0074364103,LUPRON DEPOT 3.75 MG INTRAMUSCULAR SYRINGE KIT,6483.99,4214.59,516.7,6483.99,53
NDC,0074364203,LUPRON DEPOT 7.5 MG INTRAMUSCULAR SYRINGE KIT,7726.71,5022.36,167.1,7726.71,52
NDC,0074366303,LUPRON DEPOT 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,19452.12,12643.88,516.7,19452.12,53
NDC,0074368303,LUPRON DEPOT 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT,30906.72,20089.37,167.1,30906.72,52
NDC,0074372790,SYNTHROID 137 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074377903,LUPRON DEPOT-PED 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,42483.9,27614.54,516.7,42483.9,53
NDC,0074379902,HUMIRA 40 MG/0.8 ML SUBCUTANEOUS SYRINGE KIT,12460.71,8099.46,74.0,12460.71,42
NDC,0074387810,EMBLAVEO 2 GRAM INTRAVENOUS SOLUTION,1177.2,765.18,1.67,3407.66,39
NDC,0074395646,KALETRA 400 MG-100 MG/5 ML ORAL SOLUTION,9.6,6.24,1.61,9.6,22
NDC,0074433902,HUMIRA PEN 40 MG/0.8 ML SUBCUTANEOUS KIT,11537.7,7499.51,74.0,11537.7,42
NDC,0074434119,SYNTHROID 25 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074434190,SYNTHROID 25 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074437805,NIMBEX 2 MG/ML INTRAVENOUS SOLUTION,11.28,7.33,1.9,11.28,22
NDC,0074438010,NIMBEX 2 MG/ML INTRAVENOUS SOLUTION,9.9,6.44,1.66,9.9,22
NDC,0074438220,NIMBEX CONCENTRATE 10 MG/ML (ICU USE ONLY) INTRAVENOUS SOLUTION,53.46,34.75,8.98,53.46,22
NDC,0074455211,SYNTHROID 50 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074455290,SYNTHROID 50 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074501501,SKYRIZI 60 MG/ML INTRAVENOUS SOLUTION,3827.52,2487.89,13.5,3827.52,50
NDC,0074518211,SYNTHROID 75 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074518290,SYNTHROID 75 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074659490,SYNTHROID 88 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074662411,SYNTHROID 100 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074662419,SYNTHROID 100 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074663330,NORVIR 100 MG CAPSULE,20.58,13.38,3.46,20.58,22
NDC,0074706811,SYNTHROID 125 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074706890,SYNTHROID 125 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074706911,SYNTHROID 150 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074706919,SYNTHROID 150 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074706990,SYNTHROID 150 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074707019,SYNTHROID 175 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074707090,SYNTHROID 175 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074712611,DEPAKOTE ER 500 MG TABLETEXTENDED RELEASE,15.58,10.13,2.62,15.58,22
NDC,0074714811,SYNTHROID 200 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074714890,SYNTHROID 200 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074714990,SYNTHROID 300 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074726950,GENGRAF 100 MG/ML ORAL SOLUTION,24.9,16.19,2.07,24.9,31
NDC,0074929690,SYNTHROID 112 MCG TABLET,3.98,2.59,0.67,3.98,22
NDC,0074969403,LUPRON DEPOT-PED 30 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,46791.75,30414.64,516.7,46791.75,53
NDC,0075062040,LOVENOX 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,89.31,58.05,0.56,89.31,31
NDC,0075062160,LOVENOX 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,89.4,58.11,0.56,89.4,31
NDC,0075062280,LOVENOX 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,89.4,58.11,0.56,89.4,31
NDC,0075062300,LOVENOX 100 MG/ML SUBCUTANEOUS SYRINGE,89.4,58.11,0.56,89.4,31
NDC,0075062430,LOVENOX 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,89.31,58.05,0.56,89.31,31
NDC,0075062603,LOVENOX 300 MG/3 ML SUBCUTANEOUS SOLUTION,89.31,58.05,0.56,89.31,31
NDC,0075291201,LOVENOX 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,134.16,87.2,0.56,134.16,31
NDC,0075291501,LOVENOX 150 MG/ML SUBCUTANEOUS SYRINGE,134.16,87.2,0.56,134.16,31
NDC,0078010901,SANDIMMUNE 250 MG/5 ML INTRAVENOUS SOLUTION,51.24,33.31,8.61,203.91,30
NDC,0078018001,SANDOSTATIN 50 MCG/ML INJECTION SOLUTION,50.82,33.03,1.01,50.82,31
NDC,0078018101,SANDOSTATIN 100 MCG/ML INJECTION SOLUTION,98.58,64.08,1.01,98.58,31
NDC,0078018201,SANDOSTATIN 500 MCG/ML INJECTION SOLUTION,475.44,309.04,1.01,475.44,31
NDC,0078024015,SANDIMMUNE 25 MG CAPSULE,10.98,7.14,0.83,10.98,31
NDC,0078024115,SANDIMMUNE 100 MG CAPSULE,43.82,28.48,2.07,43.82,31
NDC,0078024615,NEORAL 25 MG CAPSULE,7.06,4.59,0.83,7.06,31
NDC,0078024815,NEORAL 100 MG CAPSULE,28.22,18.34,2.07,28.22,31
NDC,0078024861,NEORAL 100 MG CAPSULE,28.28,18.38,2.07,28.28,31
NDC,0078024915,FEMARA 2.5 MG TABLET,65.16,42.35,10.95,65.16,22
NDC,0078027422,NEORAL 100 MG/ML ORAL SOLUTION,38.45,24.99,2.07,38.45,31
NDC,0078033184,SIMULECT 20 MG INTRAVENOUS SOLUTION,22321.68,14509.09,1073.13,22321.68,53
NDC,0078035752,TRILEPTAL 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,5.88,3.82,0.99,5.88,22
NDC,0078036034,DIOVAN 320 MG TABLET,30.94,20.11,5.2,30.94,22
NDC,0078036405,LOTREL 10 MG-20 MG CAPSULE,35.46,23.05,5.96,35.46,22
NDC,0078038666,MYFORTIC 360 MG TABLETDELAYED RELEASE,35.8,23.27,0.45,35.8,31
NDC,0078039361,SIMULECT 10 MG INTRAVENOUS SOLUTION,17007.04,11054.58,1073.13,17007.04,53
NDC,0078040505,LOTREL 5 MG-10 MG CAPSULE,28.9,18.79,4.86,28.9,22
NDC,0078041420,ZORTRESS 0.5 MG TABLET,52.64,34.22,2.24,52.64,31
NDC,0078041520,ZORTRESS 0.75 MG TABLET,78.96,51.32,2.24,78.96,31
NDC,0078045605,TRILEPTAL 150 MG TABLET,13.98,9.09,2.35,13.98,22
NDC,0078045705,TRILEPTAL 600 MG TABLET,46.9,30.49,7.88,46.9,22
NDC,0078046791,DESFERAL 500 MG SOLUTION FOR INJECTION,124.98,81.24,8.12,124.98,31
NDC,0078046815,EXJADE 125 MG DISPERSIBLE TABLET,123.48,80.26,20.74,123.48,22
NDC,0078047015,EXJADE 500 MG DISPERSIBLE TABLET,493.86,321.01,82.97,493.86,22
NDC,0078051005,TEGRETOL XR 100 MG TABLETEXTENDED RELEASE,3.96,2.57,0.67,3.96,22
NDC,0078051205,TEGRETOL XR 400 MG TABLETEXTENDED RELEASE,15.82,10.28,2.66,15.82,22
NDC,0078052687,TASIGNA 200 MG CAPSULE,463.82,301.48,77.92,463.82,22
NDC,0078056751,AFINITOR 10 MG TABLET,1640.16,1066.1,275.55,1640.16,22
NDC,0078056845,COARTEM 20 MG-120 MG TABLET,12.26,7.97,2.06,12.26,22
NDC,0078059287,TASIGNA 150 MG CAPSULE,463.82,301.48,77.92,463.82,22
NDC,0078059451,AFINITOR 2.5 MG TABLET,1568.06,1019.24,263.43,1568.06,22
NDC,0078060715,GILENYA 0.5 MG CAPSULE,934.72,607.57,157.03,934.72,22
NDC,0078062051,AFINITOR 7.5 MG TABLET,1640.16,1066.1,275.55,1640.16,22
NDC,0078063968,COSENTYX PEN 150 MG/ML SUBCUTANEOUS PEN INJECTOR,27472.44,17857.09,4615.37,27472.44,29
NDC,0078063997,COSENTYX 150 MG/ML SUBCUTANEOUS SYRINGE,27472.44,17857.09,4615.37,27472.44,29
NDC,0078063998,COSENTYX 300 MG/2 SYRINGES (150 MG/ML) SUBCUTANEOUS SYRINGE,13736.22,8928.54,2307.68,13736.22,29
NDC,0078065006,FARYDAK 10 MG CAPSULE,5633.0,3661.45,946.34,5633.0,22
NDC,0078065106,FARYDAK 15 MG CAPSULE,5633.0,3661.45,946.34,5633.0,22
NDC,0078065206,FARYDAK 20 MG CAPSULE,5633.0,3661.45,946.34,5633.0,22
NDC,0078065415,JADENU 90 MG TABLET,132.38,86.05,22.24,132.38,22
NDC,0078065920,ENTRESTO 24 MG-26 MG TABLET,28.2,18.33,4.74,28.2,22
NDC,0078066913,ARZERRA 100 MG/5 ML INTRAVENOUS SOLUTION,579.24,376.51,62.23,3407.66,39
NDC,0078067119,TYKERB 250 MG TABLET,162.82,105.83,27.35,162.82,22
NDC,0078068166,TAFINLAR 75 MG CAPSULE,314.66,204.53,52.86,314.66,22
NDC,0078068266,TAFINLAR 50 MG CAPSULE,244.16,158.7,41.02,244.16,22
NDC,0078069061,ARZERRA 1000 MG/50 ML INTRAVENOUS SOLUTION,579.24,376.51,62.23,3407.66,39
NDC,0078069484,ZYKADIA 150 MG TABLET,393.82,255.98,66.16,393.82,22
NDC,0078069620,ENTRESTO 97 MG-103 MG TABLET,28.2,18.33,4.74,28.2,22
NDC,0078069899,RYDAPT 25 MG CAPSULE,523.0,339.95,87.86,523.0,22
NDC,0078070184,PIQRAY 200 MG/DAY (200 MG X 1) TABLET,2040.24,1326.16,342.76,2040.24,22
NDC,0078070802,PIQRAY 300 MG/DAY (150 MG X 2) TABLET,1020.12,663.08,171.38,1020.12,22
NDC,0078070956,TABRECTA 150 MG TABLET,500.0,325.0,84.0,500.0,22
NDC,0078071502,PIQRAY 250 MG/DAY (200 MG X 1 AND 50 MG X 1) TABLET,1020.12,663.08,171.38,1020.12,22
NDC,0078071656,TABRECTA 200 MG TABLET,500.0,325.0,84.0,500.0,22
NDC,0078073461,ILARIS (PF) 150 MG/ML SUBCUTANEOUS SOLUTION,76983.66,50039.38,112.04,76983.66,53
NDC,0078077720,ENTRESTO 49 MG-51 MG TABLET,28.2,18.33,4.74,28.2,22
NDC,0078079761,SANDOSTATIN LAR DEPOT 20 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,16618.68,10802.14,189.5,16618.68,53
NDC,0078080461,SANDOSTATIN LAR DEPOT 30 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,24885.21,16175.39,189.5,24885.21,53
NDC,0078081181,SANDOSTATIN LAR DEPOT 10 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,12684.36,8244.83,189.5,12684.36,53
NDC,0078081301,TOBREX 0.3 % EYE OINTMENT,192.0,124.8,32.26,192.0,22
NDC,0078081881,SANDOSTATIN LAR DEPOT 20 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,16618.68,10802.14,189.5,16618.68,53
NDC,0078082581,SANDOSTATIN LAR DEPOT 30 MG INTRAMUSCULAR SUSPEXTENDED RELEASE,24885.21,16175.39,189.5,24885.21,53
NDC,0078082760,BEOVU 6 MG/0.05 ML INTRAVITREAL SYRINGE,150004.08,97502.65,293.11,150004.08,53
NDC,0078084619,KYMRIAH 0.2 X 10EXP6 TO 2.5 X 10EXP8 CELL INTRAVENOUS SUSPENSION,2905939.24,1888860.51,24125.92,2615345.32,43
NDC,0078087601,TOBRADEX 0.3 %-0.1 % EYE OINTMENT,204.4,132.86,34.34,204.4,22
NDC,0078088361,ADAKVEO 10 MG/ML INTRAVENOUS SOLUTION,874.32,568.31,114.62,874.32,47
NDC,0078095166,TASIGNA 50 MG CAPSULE,463.82,301.48,77.92,463.82,22
NDC,0078095819,KYMRIAH 0.6 X 10EXP8 TO 6 X10EXP8 CELL INTRAVENOUS SUSPENSION,2511128.6,1632233.59,24125.92,2260015.74,43
NDC,0078100060,LEQVIO 284 MG/1.5 ML SUBCUTANEOUS SYRINGE,8610.54,5596.85,10.91,8610.54,53
NDC,0078100768,KESIMPTA PEN 20 MG/0.4 ML SUBCUTANEOUS PEN INJECTOR,84123.63,54680.36,14132.77,84123.63,29
NDC,0078102184,VIJOICE 50 MG TABLET,2785.72,1810.72,468.0,2785.72,22
NDC,0078102884,VIJOICE 125 MG TABLET,2785.72,1810.72,468.0,2785.72,22
NDC,0078103502,VIJOICE 250 MG/DAY(200 MG X 1 AND 50 MG X 1) TABLET,1392.86,905.36,234.0,1392.86,22
NDC,0078107766,VOTRIENT 200 MG TABLET,356.38,231.65,59.87,356.38,22
NDC,0078109120,SCEMBLIX 20 MG TABLET,894.6,581.49,150.29,894.6,22
NDC,0078109820,SCEMBLIX 40 MG TABLET,894.6,581.49,150.29,894.6,22
NDC,0078110515,MEKINIST 0.5 MG TABLET,401.5,260.98,67.45,401.5,22
NDC,0078111215,MEKINIST 2 MG TABLET,1366.5,888.23,229.57,1366.5,22
NDC,0078116861,COSENTYX 25 MG/ML INTRAVENOUS SOLUTION,1584.48,1029.91,17.54,1584.48,46
NDC,0078119620,SCEMBLIX 100 MG TABLET,894.6,581.49,150.29,894.6,22
NDC,0081073088,NEOSPORIN (NEO-BAC-POLYM) 3.5 MG-400 UNIT-5000 UNIT/GRAM TOP OINTMENT,0.74,0.48,0.12,0.74,22
NDC,0081079887,POLYSPORIN 500 UNIT-10000 UNIT/GRAM TOPICAL OINTMENT,0.68,0.44,0.11,0.68,22
NDC,0084795024,PHENYLADE ESSENTIAL (FLAX) 10 GRAM-156 KCAL/40 GRAM ORAL POWDER PACKET,9.94,6.46,1.67,9.94,22
NDC,0085132801,NOXAFIL 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,41.13,26.73,6.91,41.13,22
NDC,0085138101,TEMODAR 100 MG INTRAVENOUS SOLUTION,4814.92,3129.7,9.36,4814.92,50
NDC,0087020142,ENFAMIL A.R. 2.5-5.1-11.3 GRAM/100 KCAL ORAL POWDER,0.23,0.15,0.04,0.23,22
NDC,0087040203,POLY-VI-SOL 250 MCG-50 MG-10 MCG/ML ORAL DROPS,0.5,0.33,0.08,0.5,22
NDC,0087040303,TRI-VI-SOL 250 MCG-50 MG-10 MCG/ML ORAL DROPS,0.5,0.33,0.08,0.5,22
NDC,0087040501,POLY-VI-SOL WITH IRON 11 MG IRON/ML ORAL DROPS,0.5,0.33,0.08,0.5,22
NDC,0088210224,PRIFTIN 150 MG TABLET,12.16,7.9,2.04,12.16,22
NDC,0088216030,ARAVA 10 MG TABLET,119.56,77.71,20.09,119.56,22
NDC,0088216130,ARAVA 20 MG TABLET,119.56,77.71,20.09,119.56,22
NDC,0088221905,LANTUS SOLOSTAR U-100 INSULIN 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN,23.13,15.03,0.6,23.13,22
NDC,0088222033,LANTUS U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,23.13,15.03,0.6,23.13,23
NDC,0088250033,APIDRA U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,30.66,19.93,0.6,30.66,23
NDC,0088250205,APIDRA SOLOSTAR U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,39.51,25.68,0.6,39.51,22
NDC,0093001006,TOLTERODINE 1 MG TABLET,6.62,4.3,1.11,6.62,22
NDC,0093005301,BUSPIRONE 5 MG TABLET,1.54,1.0,0.26,1.54,22
NDC,0093005401,BUSPIRONE 10 MG TABLET,2.7,1.76,0.45,2.7,22
NDC,0093026215,FLUOCINONIDE 0.05 % TOPICAL CREAM,6.08,3.95,1.02,6.08,22
NDC,0093026230,FLUOCINONIDE 0.05 % TOPICAL CREAM,6.08,3.95,1.02,6.08,22
NDC,0093026292,FLUOCINONIDE 0.05 % TOPICAL CREAM,6.08,3.95,1.02,6.08,22
NDC,0093026415,FLUOCINONIDE 0.05 % TOPICAL OINTMENT,9.44,6.14,1.59,9.44,22
NDC,0093031401,KETOROLAC 10 MG TABLET,4.32,2.81,0.73,4.32,22
NDC,0093032001,DILTIAZEM 90 MG TABLET,4.28,2.78,0.72,4.28,22
NDC,0093075305,ATENOLOL 100 MG TABLET,2.44,1.59,0.41,2.44,22
NDC,0093075601,PIROXICAM 10 MG CAPSULE,5.22,3.39,0.88,5.22,22
NDC,0093075701,PIROXICAM 20 MG CAPSULE,8.98,5.84,1.51,8.98,22
NDC,0093078701,ATENOLOL 25 MG TABLET,1.64,1.07,0.28,1.64,22
NDC,0093081001,NORTRIPTYLINE 10 MG CAPSULE,1.48,0.96,0.25,1.48,22
NDC,0093081101,NORTRIPTYLINE 25 MG CAPSULE,2.94,1.91,0.49,2.94,22
NDC,0093094801,DICLOFENAC POTASSIUM 50 MG TABLET,5.52,3.59,0.93,5.52,22
NDC,0093101042,MUPIROCIN 2 % TOPICAL OINTMENT,7.78,5.06,1.31,7.78,22
NDC,0093102406,NEFAZODONE 100 MG TABLET,9.6,6.24,1.61,9.6,22
NDC,0093102506,NEFAZODONE 200 MG TABLET,9.96,6.47,1.67,9.96,22
NDC,0093106001,SOTALOL 120 MG TABLET,6.26,4.07,1.05,6.26,22
NDC,0093106101,SOTALOL 80 MG TABLET,4.7,3.06,0.79,4.7,22
NDC,0093106201,SOTALOL 160 MG TABLET,7.84,5.1,1.32,7.84,22
NDC,0093106301,SOTALOL 240 MG TABLET,10.18,6.62,1.71,10.18,22
NDC,0093111801,ETODOLAC ER 600 MG TABLETEXTENDED RELEASE 24 HR,6.54,4.25,1.1,6.54,22
NDC,0093117201,PENICILLIN V POTASSIUM 250 MG TABLET,2.38,1.55,0.4,2.38,22
NDC,0093117701,NEOMYCIN 500 MG TABLET,2.98,1.94,0.5,2.98,22
NDC,0093171201,WARFARIN 1 MG TABLET,1.22,0.79,0.2,1.22,22
NDC,0093172001,WARFARIN 10 MG TABLET,2.04,1.33,0.34,2.04,22
NDC,0093172301,WARFARIN 7.5 MG TABLET,1.96,1.27,0.33,1.96,22
NDC,0093202623,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,5.83,3.79,0.98,5.83,22
NDC,0093202631,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,2.9,1.89,0.49,2.9,22
NDC,0093202694,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,3.88,2.52,0.65,3.88,22
NDC,0093206406,CILOSTAZOL 100 MG TABLET,3.66,2.38,0.61,3.66,22
NDC,0093206506,CILOSTAZOL 50 MG TABLET,3.86,2.51,0.65,3.86,22
NDC,0093220301,METOCLOPRAMIDE 10 MG TABLET,0.56,0.36,0.09,0.56,22
NDC,0093220310,METOCLOPRAMIDE 10 MG TABLET,0.44,0.29,0.07,0.44,22
NDC,0093220401,METOCLOPRAMIDE 5 MG TABLET,0.66,0.43,0.11,0.66,22
NDC,0093220405,METOCLOPRAMIDE 5 MG TABLET,0.66,0.43,0.11,0.66,22
NDC,0093221001,SUCRALFATE 1 GRAM TABLET,1.6,1.04,0.27,1.6,22
NDC,0093226401,AMOXICILLIN 875 MG TABLET,1.74,1.13,0.29,1.74,22
NDC,0093226701,AMOXICILLIN 125 MG CHEWABLE TABLET,0.74,0.48,0.12,0.74,22
NDC,0093226801,AMOXICILLIN 250 MG CHEWABLE TABLET,1.48,0.96,0.25,1.48,22
NDC,0093300993,LANSOPRAZOLE 30 MG DELAYED RELEASEDISINTEGRATING TABLET,31.54,20.5,5.3,31.54,22
NDC,0093306156,RASAGILINE 1 MG TABLET,50.0,32.5,8.4,50.0,22
NDC,0093306634,ICATIBANT 30 MG/3 ML SUBCUTANEOUS SYRINGE,12708.15,8260.3,122.75,12708.15,42
NDC,0093309844,RISEDRONATE 35 MG TABLET,123.9,80.54,20.82,123.9,22
NDC,0093310701,AMOXICILLIN 250 MG CAPSULE,0.5,0.33,0.08,0.5,22
NDC,0093310953,AMOXICILLIN 500 MG CAPSULE,0.94,0.61,0.16,0.94,22
NDC,0093312301,DICLOXACILLIN 250 MG CAPSULE,3.0,1.95,0.5,3.0,22
NDC,0093312501,DICLOXACILLIN 500 MG CAPSULE,5.46,3.55,0.92,5.46,22
NDC,0093312701,DISOPYRAMIDE PHOSPHATE 100 MG CAPSULE,5.72,3.72,0.96,5.72,22
NDC,0093312901,DISOPYRAMIDE PHOSPHATE 150 MG CAPSULE,6.76,4.39,1.14,6.76,22
NDC,0093317431,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,17.42,11.32,2.93,17.42,22
NDC,0093322308,ESTRADIOL 10 MCG VAGINAL TABLET,48.5,31.53,8.15,48.5,22
NDC,0093342501,LORAZEPAM 0.5 MG TABLET,1.28,0.83,0.22,1.28,22
NDC,0093342601,LORAZEPAM 1 MG TABLET,1.76,1.14,0.3,1.76,22
NDC,0093354143,ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,16.9,10.99,2.84,16.9,22
NDC,0093354256,ATOMOXETINE 10 MG CAPSULE,28.46,18.5,4.78,28.46,22
NDC,0093354356,ATOMOXETINE 18 MG CAPSULE,28.46,18.5,4.78,28.46,22
NDC,0093354456,ATOMOXETINE 25 MG CAPSULE,28.46,18.5,4.78,28.46,22
NDC,0093354656,ATOMOXETINE 60 MG CAPSULE,30.94,20.11,5.2,30.94,22
NDC,0093365940,BUPRENORPHINE 20 MCG/HOUR WEEKLY TRANSDERMAL PATCH,406.34,264.12,68.27,406.34,22
NDC,0093412573,PENICILLIN V POTASSIUM 125 MG/5 ML ORAL SOLUTION,0.25,0.16,0.04,0.25,22
NDC,0093412574,PENICILLIN V POTASSIUM 125 MG/5 ML ORAL SOLUTION,0.18,0.12,0.03,0.18,22
NDC,0093412773,PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,0.28,0.18,0.05,0.28,22
NDC,0093412774,PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,0.2,0.13,0.03,0.2,22
NDC,0093415573,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,0.15,0.1,0.03,0.15,22
NDC,0093415579,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,0.18,0.12,0.03,0.18,22
NDC,0093416176,AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION,0.25,0.16,0.04,0.25,22
NDC,0093417573,CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION,0.6,0.39,0.1,0.6,22
NDC,0093417574,CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION,0.5,0.33,0.08,0.5,22
NDC,0093417773,CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,0.73,0.47,0.12,0.73,22
NDC,0093417774,CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,0.65,0.42,0.11,0.65,22
NDC,0093503056,TIAGABINE 2 MG TABLET,15.88,10.32,2.67,15.88,22
NDC,0093503156,TIAGABINE 4 MG TABLET,15.88,10.32,2.67,15.88,22
NDC,0093506201,HYDROXYZINE HCL 50 MG TABLET,2.24,1.46,0.38,2.24,22
NDC,0093523456,EFAVIRENZ 600 MG-EMTRICITABINE 200 MG-TENOFOVIR DISOPROX 300 MG TABLET,227.6,147.94,38.24,227.6,22
NDC,0093524565,OLANZAPINE 5 MG DISINTEGRATING TABLET,28.54,18.55,4.79,28.54,22
NDC,0093524665,OLANZAPINE 10 MG DISINTEGRATING TABLET,41.94,27.26,7.05,41.94,22
NDC,0093537684,CLOZAPINE 150 MG DISINTEGRATING TABLET,41.44,26.94,6.96,41.44,22
NDC,0093537784,CLOZAPINE 200 MG DISINTEGRATING TABLET,55.24,35.91,9.28,55.24,22
NDC,0093541601,CLOZAPINE 12.5 MG DISINTEGRATING TABLET,4.46,2.9,0.75,4.46,22
NDC,0093541784,CLOZAPINE 25 MG DISINTEGRATING TABLET,6.0,3.9,1.01,6.0,22
NDC,0093541984,CLOZAPINE 100 MG DISINTEGRATING TABLET,16.36,10.63,2.75,16.36,22
NDC,0093542088,CABERGOLINE 0.5 MG TABLET,73.32,47.66,3.53,73.32,22
NDC,0093550456,OLANZAPINE-FLUOXETINE 6 MG-25 MG CAPSULE,28.96,18.82,4.87,28.96,22
NDC,0093550656,OLANZAPINE-FLUOXETINE 12 MG-25 MG CAPSULE,43.66,28.38,7.33,43.66,22
NDC,0093550756,OLANZAPINE-FLUOXETINE 12 MG-50 MG CAPSULE,43.66,28.38,7.33,43.66,22
NDC,0093552706,ATAZANAVIR 200 MG CAPSULE,55.6,36.14,9.34,55.6,22
NDC,0093552856,ATAZANAVIR 300 MG CAPSULE,110.16,71.6,18.51,110.16,22
NDC,0093557101,ERYTHROMYCIN 250 MG TABLET,26.46,17.2,4.45,26.46,22
NDC,0093557156,ERYTHROMYCIN 250 MG TABLET,26.46,17.2,4.45,26.46,22
NDC,0093681545,BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,9.42,6.12,1.58,9.42,22
NDC,0093681573,BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,9.42,6.12,1.58,9.42,22
NDC,0093681645,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,11.08,7.2,1.86,11.08,22
NDC,0093681673,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,11.08,7.2,1.86,11.08,22
NDC,0093716405,TOLTERODINE ER 4 MG CAPSULEEXTENDED RELEASE 24 HR,16.08,10.45,2.7,16.08,22
NDC,0093717801,NEFAZODONE 50 MG TABLET,9.38,6.1,1.58,9.38,22
NDC,0093727156,PIOGLITAZONE 15 MG TABLET,14.02,9.11,2.36,14.02,22
NDC,0093727256,PIOGLITAZONE 30 MG TABLET,21.44,13.94,3.6,21.44,22
NDC,0093727398,PIOGLITAZONE 45 MG TABLET,23.26,15.12,3.91,23.26,22
NDC,0093733401,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,7.94,5.16,0.18,7.94,31
NDC,0093739398,NIACIN ER 750 MG TABLETEXTENDED RELEASE 24 HR,12.08,7.85,2.03,12.08,22
NDC,0093739498,NIACIN ER 1000 MG TABLETEXTENDED RELEASE 24 HR,14.98,9.74,2.52,14.98,22
NDC,0093762056,LETROZOLE 2.5 MG TABLET,36.28,23.58,6.1,36.28,22
NDC,0093762998,IMATINIB 100 MG TABLET,202.26,131.47,33.98,202.26,22
NDC,0093763056,IMATINIB 400 MG TABLET,728.82,473.73,122.44,728.82,22
NDC,0093766256,ERLOTINIB 25 MG TABLET,206.76,134.39,34.74,206.76,22
NDC,0093803501,GLYBURIDE MICRONIZED 3 MG TABLET,1.32,0.86,0.22,1.32,22
NDC,0093807656,TIAGABINE 16 MG TABLET,30.16,19.6,5.07,30.16,22
NDC,0093811756,FAMCICLOVIR 125 MG TABLET,11.62,7.55,1.95,11.62,22
NDC,0093811956,FAMCICLOVIR 500 MG TABLET,25.38,16.5,4.26,25.38,22
NDC,0093834301,GLYBURIDE 2.5 MG TABLET,0.92,0.6,0.15,0.92,22
NDC,0093834401,GLYBURIDE 5 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,0093873901,MEXILETINE 150 MG CAPSULE,5.08,3.3,0.85,5.08,22
NDC,0093874001,MEXILETINE 200 MG CAPSULE,6.06,3.94,1.02,6.06,22
NDC,0093874101,MEXILETINE 250 MG CAPSULE,7.0,4.55,1.18,7.0,22
NDC,0093901819,CYCLOSPORINE MODIFIED 25 MG ORAL CAP (NEORALGENGRAF),2.76,1.79,0.46,2.76,31
NDC,0093901865,CYCLOSPORINE MODIFIED 25 MG ORAL CAP (NEORALGENGRAF),2.76,1.79,0.46,2.76,31
NDC,0093902019,CYCLOSPORINE MODIFIED 100 MG ORAL CAP (NEORALGENGRAF),11.0,7.15,1.85,11.0,31
NDC,0093902065,CYCLOSPORINE MODIFIED 100 MG ORAL CAP (NEORALGENGRAF),11.0,7.15,1.85,11.0,31
NDC,0093922201,DIFLUNISAL 500 MG TABLET,4.14,2.69,0.7,4.14,22
NDC,0093922206,DIFLUNISAL 500 MG TABLET,4.14,2.69,0.7,4.14,22
NDC,0093929067,CLONAZEPAM 0.125 MG DISINTEGRATING TABLET,2.6,1.69,0.44,2.6,22
NDC,0093929167,CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,2.6,1.69,0.44,2.6,22
NDC,0093929267,CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,2.6,1.69,0.44,2.6,22
NDC,0093929367,CLONAZEPAM 1 MG DISINTEGRATING TABLET,2.96,1.92,0.5,2.96,22
NDC,0093943301,GLYBURIDE 2.5 MG TABLET,0.92,0.6,0.15,0.92,22
NDC,0093947753,GLYBURIDE 1.25 MG TABLET,0.56,0.36,0.09,0.56,22
NDC,0093970201,CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,1.74,1.13,0.29,1.74,22
NDC,0096070737,DRYSOL 20 % TOPICAL SOLUTION,0.54,0.35,0.09,0.54,22
NDC,0096070760,DRYSOL DAB-O-MATIC 20 % TOPICAL SOLUTION,0.5,0.33,0.08,0.5,22
NDC,0096073204,AQUANIL HC 1 % LOTION,0.3,0.2,0.05,0.3,22
NDC,0096073704,DHS TAR 0.5 % SHAMPOO,0.12,0.08,0.02,0.12,22
NDC,00998101002,MICROFIBRILLAR COLLAGEN HEMOSTAT POWDER,607.24,394.71,102.02,607.24,22
NDC,0115107001,DIPYRIDAMOLE 25 MG TABLET,2.84,1.85,0.48,2.84,22
NDC,0115124808,CARVEDILOL PHOSPHATE ER 10 MG CAPSULEEXT.RELEASE24HR MULTIPHASE,20.64,13.42,3.47,20.64,22
NDC,0115124908,CARVEDILOL PHOSPHATE ER 20 MG CAPSULEEXT.RELEASE24HR MULTIPHASE,20.64,13.42,3.47,20.64,22
NDC,0115125008,CARVEDILOL PHOSPHATE ER 40 MG CAPSULEEXT.RELEASE24HR MULTIPHASE,20.64,13.42,3.47,20.64,22
NDC,0115125108,CARVEDILOL PHOSPHATE ER 80 MG CAPSULEEXT.RELEASE24HR MULTIPHASE,20.64,13.42,3.47,20.64,22
NDC,0115148601,DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,2.06,12.26,22
NDC,0115164301,NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,4.26,2.77,0.72,4.26,22
NDC,0115164501,NITROFURANTOIN MACROCRYSTAL 100 MG CAPSULE,7.06,4.59,1.19,7.06,22
NDC,0115169549,EPINEPHRINE 0.15 MG/0.15 ML AUTO-INJECTOR (FOR 33 TO 66 LB PATIENTS),741.03,481.67,0.73,741.03,24
NDC,0115169606,HYDROCORTISONE 5 MG TABLET,0.68,0.44,0.11,0.68,22
NDC,0115191101,RIMANTADINE 100 MG TABLET,6.5,4.23,1.09,6.5,22
NDC,0115261101,TERBUTALINE 2.5 MG TABLET,10.88,7.07,1.83,10.88,22
NDC,0115262201,TERBUTALINE 5 MG TABLET,13.3,8.65,2.23,13.3,22
NDC,0115351101,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,2.56,1.66,0.43,2.56,22
NDC,0115441101,DANTROLENE 25 MG CAPSULE,2.14,1.39,0.36,2.14,22
NDC,0115442201,DANTROLENE 50 MG CAPSULE,3.46,2.25,0.58,3.46,22
NDC,0115443301,DANTROLENE 100 MG CAPSULE,4.34,2.82,0.73,4.34,22
NDC,0115703301,FLUDROCORTISONE 0.1 MG TABLET,1.5,0.98,0.25,1.5,22
NDC,0115703701,METHITEST 10 MG TABLET,167.78,109.06,28.19,167.78,22
NDC,0116200116,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,0.08,0.05,0.01,0.08,22
NDC,0121043130,MILK OF MAGNESIA 400 MG/5 ML ORAL SUSPENSION,0.2,0.13,0.03,0.2,22
NDC,0121048900,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,2.6,1.69,0.44,2.6,22
NDC,0121048905,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,2.6,1.69,0.44,2.6,22
NDC,0121050404,ACETAMINOPHEN 120 MG-CODEINE 12 MG/5 ML ORAL SOLUTION,0.09,0.06,0.02,0.09,22
NDC,0121053005,FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQUID,2.03,1.32,0.34,2.03,22
NDC,0121058104,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,1.13,0.73,0.19,1.13,22
NDC,0121058105,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,2.1,1.37,0.35,2.1,22
NDC,0121059500,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,0.98,0.64,0.16,0.98,22
NDC,0121059516,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,0.1,0.07,0.02,0.1,22
NDC,0121063800,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,1.25,0.81,0.21,1.25,22
NDC,0121063805,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,1.25,0.81,0.21,1.25,22
NDC,0121064610,AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,1.23,0.8,0.21,1.23,22
NDC,0121064616,AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,0.38,0.25,0.06,0.38,22
NDC,0121065304,FLUPHENAZINE 5 MG/ML ORAL CONCENTRATE,7.85,5.1,1.32,7.85,22
NDC,0121065402,FLUPHENAZINE 2.5 MG/5 ML ORAL ELIXIR,1.6,1.04,0.27,1.6,22
NDC,0121065416,FLUPHENAZINE 2.5 MG/5 ML ORAL ELIXIR,1.63,1.06,0.27,1.63,22
NDC,0121065705,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,0.98,0.64,0.16,0.98,22
NDC,0121065816,TRIHEXYPHENIDYL 0.4 MG/ML ORAL ELIXIR,0.28,0.18,0.05,0.28,22
NDC,0121067016,ETHOSUXIMIDE 250 MG/5 ML ORAL SOLUTION,1.25,0.81,0.21,1.25,22
NDC,0121067585,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SOLUTION,0.38,0.25,0.06,0.38,22
NDC,0121067616,POTASSIUM CITRATE-CITRIC ACID 1100 MG-334 MG/5 ML ORAL SOLUTION,0.28,0.18,0.05,0.28,22
NDC,0121067716,TRICITRATES 550 MG-500 MG-334 MG/5 ML ORAL SOLUTION,0.33,0.21,0.06,0.33,22
NDC,0121067816,NORTRIPTYLINE 10 MG/5 ML ORAL SOLUTION,1.2,0.78,0.2,1.2,22
NDC,0121072104,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,2.45,1.59,0.41,2.45,22
NDC,0121075908,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,0.78,0.51,0.13,0.78,22
NDC,0121076616,CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1250 MG/5 ML) ORAL SUSPENSION,0.08,0.05,0.01,0.08,22
NDC,0121077001,LORAZEPAM 2 MG/ML ORAL CONCENTRATE,2.4,1.56,0.4,2.4,22
NDC,0121077504,CODEINE 10 MG-GUAIFENESIN 100 MG/5 ML ORAL LIQUID,0.18,0.12,0.03,0.18,22
NDC,0121079916,LEVETIRACETAM 100 MG/ML ORAL SOLUTION,1.63,1.06,0.27,1.63,22
NDC,0121082016,THEOPHYLLINE 80 MG/15 ML ORAL ELIXIR,0.6,0.39,0.1,0.6,22
NDC,0121085340,SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,2.55,1.66,0.43,2.55,22
NDC,0121085416,SULFATRIM 200 MG-40 MG/5 ML ORAL SUSPENSION,0.6,0.39,0.1,0.6,22
NDC,0121086505,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,1.23,0.8,0.21,1.23,22
NDC,0121086802,NYSTATIN 100000 UNIT/ML ORAL SUSPENSION,0.6,0.39,0.1,0.6,22
NDC,0121086816,NYSTATIN 100000 UNIT/ML ORAL SUSPENSION,0.63,0.41,0.11,0.63,22
NDC,0121086850,NYSTATIN 100000 UNIT/ML ORAL SUSPENSION,1.18,0.77,0.2,1.18,22
NDC,0121087316,LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,0.18,0.12,0.03,0.18,22
NDC,0121087332,LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0121087416,CETIRIZINE 1 MG/ML ORAL SOLUTION,2.08,1.35,0.35,2.08,22
NDC,0121089300,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,0.35,0.23,0.06,0.35,22
NDC,0121089340,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,0.38,0.25,0.06,0.38,22
NDC,0121091400,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.43,0.28,0.07,0.43,22
NDC,0121094216,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,0.29,0.19,0.05,0.29,22
NDC,0121094500,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSPENSION,1.25,0.81,0.21,1.25,22
NDC,0121094540,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSPENSION,1.68,1.09,0.28,1.68,22
NDC,0121096600,CHILDREN'S ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION,0.7,0.46,0.12,0.7,22
NDC,0121097440,SUCRALFATE 100 MG/ML ORAL SUSPENSION,3.05,1.98,0.51,3.05,22
NDC,0121097800,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,1.3,0.85,0.22,1.3,22
NDC,0121097810,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,1.3,0.85,0.22,1.3,22
NDC,0121100840,ACETAMINOPHEN 300 MG-CODEINE 30 MG/12.5 ML (12.5 ML) ORAL SOLUTION,2.18,1.42,0.37,2.18,22
NDC,0121103640,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML (5 ML) ORAL SOLUTION,8.0,5.2,1.34,8.0,22
NDC,0121115400,LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,0.2,0.13,0.03,0.2,22
NDC,0121119000,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,0.53,0.34,0.09,0.53,22
NDC,0121119030,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,0.53,0.34,0.09,0.53,22
NDC,0121127600,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,0.7,0.46,0.12,0.7,22
NDC,0121127610,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,0.7,0.46,0.12,0.7,22
NDC,0121148800,GUAIFENESIN 100 MG/5 ML ORAL LIQUID,0.48,0.31,0.08,0.48,22
NDC,0121157610,METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,1.23,0.8,0.21,1.23,22
NDC,0121173000,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,0.68,0.44,0.11,0.68,22
NDC,0121174400,GUAIFENESIN 100 MG/5 ML ORAL LIQUID,0.95,0.62,0.16,0.95,22
NDC,0121176030,MAG-AL 200 MG-200 MG/5 ML ORAL SUSPENSION,0.48,0.31,0.08,0.48,22
NDC,0121176130,MAG-AL PLUS 200 MG-200 MG-20 MG/5 ML ORAL SUSPENSION,0.33,0.21,0.06,0.33,22
NDC,0121176230,MAG-AL PLUS EXTRA STRENGTH 400 MG-400 MG-40 MG/5 ML ORAL SUSPENSION,0.38,0.25,0.06,0.38,22
NDC,0121177540,CODEINE 10 MG-GUAIFENESIN 100 MG/5 ML ORAL LIQUID,2.15,1.4,0.36,2.15,22
NDC,0121178100,CHILDREN'S ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION,0.7,0.46,0.12,0.7,22
NDC,0121187000,DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,0.55,0.36,0.09,0.55,22
NDC,0121189410,CARBAMAZEPINE 200 MG/10 ML ORAL SUSPENSION,1.13,0.73,0.19,1.13,22
NDC,0121197100,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION,0.3,0.2,0.05,0.3,22
NDC,0121197121,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION,0.3,0.2,0.05,0.3,22
NDC,0121202495,LACOSAMIDE 10 MG/ML ORAL SOLUTION,16.85,10.95,2.83,16.85,22
NDC,0121223200,GUAIFENESIN 100 MG/5 ML ORAL LIQUID,0.38,0.25,0.06,0.38,22
NDC,0121282394,ACETAMINOPHEN 650 MG/20.3 ML ORAL SUSPENSION,0.28,0.18,0.05,0.28,22
NDC,0121457740,LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,0.38,0.25,0.06,0.38,22
NDC,0121467500,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,0.85,0.55,0.14,0.85,22
NDC,0121467505,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,0.85,0.55,0.14,0.85,22
NDC,0121467540,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,1.35,0.88,0.23,1.35,22
NDC,0121472105,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,3.43,2.23,0.58,3.43,22
NDC,0121472215,SENNA 176 MG/5 ML ORAL SYRUP,0.8,0.52,0.13,0.8,22
NDC,0121475950,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLUTION,4.13,2.68,0.26,4.13,31
NDC,0121476605,CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1250 MG/5 ML) ORAL SUSPENSION,1.55,1.01,0.26,1.55,22
NDC,0121477240,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,5.8,3.77,0.97,5.8,22
NDC,0121479940,LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLUTION,4.68,3.04,0.79,4.68,22
NDC,0121482040,THEOPHYLLINE 80 MG/15 ML ORAL ELIXIR,2.1,1.37,0.35,2.1,22
NDC,0121495040,LIDOCAINE HCL 2 % MUCOSAL SOLUTION,1.28,0.83,0.22,1.28,22
NDC,0131181067,VIMPAT 200 MG/20 ML INTRAVENOUS SOLUTION,17.85,11.6,3.0,17.85,23
NDC,0131247760,VIMPAT 50 MG TABLET,31.88,20.72,5.36,31.88,22
NDC,0131247835,VIMPAT 100 MG TABLET,45.3,29.45,7.61,45.3,22
NDC,0131247860,VIMPAT 100 MG TABLET,49.84,32.4,8.37,49.84,22
NDC,0131247960,VIMPAT 150 MG TABLET,52.78,34.31,8.87,52.78,22
NDC,0131248060,VIMPAT 200 MG TABLET,52.8,34.32,8.87,52.8,22
NDC,0131541072,VIMPAT 10 MG/ML ORAL SOLUTION,4.22,2.74,0.71,4.22,22
NDC,0132007912,FLEET GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.34,0.22,0.06,0.34,22
NDC,0132007924,FLEET GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.3,0.2,0.05,0.3,22
NDC,0132007950,FLEET GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.2,0.13,0.03,0.2,22
NDC,0132019012,PEDIA-LAX 2.8 GRAM/2.7 ML RECTAL SOLUTION,0.66,0.43,0.11,0.66,22
NDC,0132020140,FLEET ENEMA 19 GRAM-7 GRAM/118 ML,0.04,0.03,0.01,0.04,22
NDC,0132020220,FLEET PEDIATRIC 9.5 GRAM-3.5 GRAM/59 ML ENEMA,0.08,0.05,0.01,0.08,22
NDC,0132030140,FLEET MINERAL OIL ENEMA,0.04,0.03,0.01,0.04,22
NDC,0135019402,NICODERM CQ 21 MG/24 HR DAILY TRANSDERMAL PATCH,11.78,7.66,1.98,11.78,22
NDC,0135019502,NICODERM CQ 14 MG/24 HR DAILY TRANSDERMAL PATCH,11.78,7.66,1.98,11.78,22
NDC,0135020001,ABREVA 10 % TOPICAL CREAM,30.98,20.14,5.2,30.98,22
NDC,0135020003,ABREVA 10 % TOPICAL CREAM,30.98,20.14,5.2,30.98,22
NDC,0140000401,VALIUM 2 MG TABLET,8.16,5.3,1.37,8.16,22
NDC,0140000501,VALIUM 5 MG TABLET,12.7,8.26,2.13,12.7,22
NDC,0143117101,CAPTOPRIL 12.5 MG TABLET,3.12,2.03,0.52,3.12,22
NDC,0143117201,CAPTOPRIL 25 MG TABLET,3.34,2.17,0.56,3.34,22
NDC,0143117301,CAPTOPRIL 50 MG TABLET,5.8,3.77,0.97,5.8,22
NDC,0143124001,DIGOXIN 125 MCG (0.125 MG) TABLET,4.6,2.99,0.77,4.6,22
NDC,0143124101,DIGOXIN 250 MCG (0.25 MG) TABLET,4.6,2.99,0.77,4.6,22
NDC,0143145505,PHENOBARBITAL 60 MG TABLET,0.52,0.34,0.09,0.52,22
NDC,0143145801,PHENOBARBITAL 100 MG TABLET,1.48,0.96,0.25,1.48,22
NDC,0143176901,ISOSORBIDE DINITRATE 5 MG TABLET,1.98,1.29,0.33,1.98,22
NDC,0143177101,ISOSORBIDE DINITRATE 10 MG TABLET,2.16,1.4,0.36,2.16,22
NDC,0143177210,ISOSORBIDE DINITRATE 20 MG TABLET,2.38,1.55,0.4,2.38,22
NDC,0143301801,COLCHICINE 0.6 MG CAPSULE,15.0,9.75,2.52,15.0,22
NDC,0143314150,DOXYCYCLINE HYCLATE 50 MG CAPSULE,4.5,2.93,0.76,4.5,22
NDC,0143314250,DOXYCYCLINE HYCLATE 100 MG CAPSULE,11.06,7.19,1.86,11.06,22
NDC,0143913925,CEFAZOLIN 2 GRAM INTRAVENOUS SOLUTION,21.06,13.69,0.98,21.06,38
NDC,0143914025,CEFAZOLIN 3 GRAM INTRAVENOUS SOLUTION,31.59,20.53,0.98,31.59,38
NDC,0143914110,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,1.38,0.9,0.23,22.19,31
NDC,0143915301,VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION,86.82,56.43,0.19,86.82,30
NDC,0143915310,VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION,86.82,56.43,0.19,86.82,30
NDC,0143919901,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,64.8,42.12,0.86,64.8,31
NDC,0143920901,CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,3.84,2.5,0.04,3.84,31
NDC,0143920910,CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,3.84,2.5,0.04,3.84,31
NDC,0143921001,CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,4.02,2.61,0.04,4.02,31
NDC,0143921010,CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,4.02,2.61,0.04,4.02,31
NDC,0143921701,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,55.62,36.15,9.34,110.83,36
NDC,0143923210,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,37.08,24.1,6.23,37.08,22
NDC,0143923305,BENZTROPINE 1 MG/ML INJECTION SOLUTION,81.0,52.65,13.61,81.0,31
NDC,0143924001,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,274.56,178.46,20.81,274.56,30
NDC,0143924101,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,509.28,331.03,20.81,509.28,30
NDC,0143924701,DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLUTION,987.33,641.76,58.01,987.33,46
NDC,0143924801,DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,720.0,468.0,58.01,720.0,46
NDC,0143925425,DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,2.1,1.37,0.35,2.22,31
NDC,0143926225,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,3.78,2.46,0.64,3.78,31
NDC,0143926310,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,0.72,0.47,0.06,0.72,31
NDC,0143927301,DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,378.0,245.7,33.41,378.0,31
NDC,0143927310,DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,378.0,245.7,33.41,378.0,31
NDC,0143927901,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,2448.0,1591.2,26.1,2448.0,46
NDC,0143928001,MITOMYCIN 40 MG INTRAVENOUS SOLUTION,4800.0,3120.0,26.1,4800.0,49
NDC,0143929701,DANTROLENE 20 MG INTRAVENOUS SOLUTION,255.27,165.93,42.89,255.27,22
NDC,0143929910,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,246.24,160.06,39.69,246.24,31
NDC,0143930701,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,28.8,18.72,4.84,110.83,36
NDC,0143930801,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,28.8,18.72,4.84,110.83,36
NDC,0143931601,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.09,0.06,0.02,5.97,31
NDC,0143931701,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.06,0.04,0.01,5.97,31
NDC,0143933001,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.75,0.49,0.01,0.75,31
NDC,0143933401,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,0.36,0.23,0.01,0.36,31
NDC,0143936801,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,36.0,23.4,4.62,36.0,31
NDC,0143938010,MIDAZOLAM (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,1.08,0.7,0.12,1.08,31
NDC,0143938501,DECITABINE 50 MG INTRAVENOUS SOLUTION,480.0,312.0,0.84,480.0,35
NDC,0143950125,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,5.76,3.74,0.97,5.76,31
NDC,0143950201,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,10.8,7.02,1.14,10.8,31
NDC,0143950301,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,158.25,102.86,23.61,158.25,31
NDC,0143950710,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,1.2,0.78,0.2,1.2,22
NDC,0143950810,KETAMINE 50 MG/ML INJECTION SOLUTION,2.31,1.5,0.39,2.31,22
NDC,0143950901,KETAMINE 100 MG/ML INJECTION SOLUTION,9.18,5.97,1.54,9.18,22
NDC,0143950910,KETAMINE 100 MG/ML INJECTION SOLUTION,9.18,5.97,1.54,9.18,22
NDC,0143951001,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,9.0,5.85,0.94,9.0,30
NDC,0143951301,PALONOSETRON 0.25 MG/2 ML INTRAVENOUS SOLUTION,72.0,46.8,0.67,72.0,31
NDC,0143951525,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,17.43,11.33,2.93,19.87,30
NDC,0143951910,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,8.08,5.25,1.36,8.08,30
NDC,0143952901,FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION,87.12,56.63,8.75,87.12,31
NDC,0143955110,DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION,160.96,104.62,24.44,160.96,43
NDC,0143955901,ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,14.25,9.26,0.6,78.3,46
NDC,0143956401,PHENTOLAMINE 5 MG INJECTION SOLUTION,1763.88,1146.52,74.0,1763.88,47
NDC,0143956410,PHENTOLAMINE 5 MG INJECTION SOLUTION,1763.85,1146.5,74.0,1763.85,47
NDC,0143957001,SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,22.89,14.88,1.97,22.89,31
NDC,0143957010,SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,22.89,14.88,1.97,22.89,31
NDC,0143957710,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.21,0.14,0.03,0.21,23
NDC,0143959525,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.29,0.84,0.03,1.29,23
NDC,0143961901,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,3.6,2.34,0.6,3.6,31
NDC,0143963310,NICARDIPINE 40 MG/200 ML(0.2 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN,2.94,1.91,0.49,2.94,22
NDC,0143963701,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,1.77,1.15,0.1,93.47,36
NDC,0143963710,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,1.77,1.15,0.1,93.47,36
NDC,0143965901,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,54.0,35.1,0.01,54.0,31
NDC,0143967301,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,1.14,0.74,0.06,1.14,31
NDC,0143967325,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,1.14,0.74,0.06,1.14,31
NDC,0143967401,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,1702.29,1106.49,0.6,1702.29,46
NDC,0143968401,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,4.68,3.04,0.79,4.68,22
NDC,0143968410,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,4.68,3.04,0.79,4.68,22
NDC,0143968910,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,9.18,5.97,0.13,78.3,36
NDC,0143970201,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,18.0,11.7,1.95,18.0,30
NDC,0143970910,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,1.65,1.07,0.28,3.73,31
NDC,0143971010,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.25,1.46,0.38,3.73,31
NDC,0143972024,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,5.97,31
NDC,0143972101,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.21,0.14,0.04,5.97,31
NDC,0143972124,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.21,0.14,0.04,5.97,31
NDC,0143972224,LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.42,0.27,0.07,5.97,31
NDC,0143972401,CLONIDINE (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,15.12,9.83,2.54,47.68,31
NDC,0143972501,PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,10.8,7.02,0.63,10.8,31
NDC,0143972601,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,33.87,22.02,0.01,33.87,31
NDC,0143972905,BENZTROPINE 1 MG/ML INJECTION SOLUTION,108.0,70.2,14.8,108.0,31
NDC,0143974401,GRANISETRON HCL 1 MG/ML (1 ML) INTRAVENOUS SOLUTION,32.4,21.06,0.29,32.4,31
NDC,0143974610,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,14.4,9.36,2.42,14.4,31
NDC,0143975001,TESTOSTERONE ENANTHATE 200 MG/ML INTRAMUSCULAR OIL,50.97,33.13,0.05,50.97,31
NDC,0143978310,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,4.68,3.04,0.79,4.68,22
NDC,0143978410,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,4.68,3.04,0.79,4.68,22
NDC,0143978501,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,5.04,3.28,0.1,93.47,36
NDC,0143978510,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,5.04,3.28,0.1,93.47,36
NDC,0143978610,ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,17.07,11.1,2.87,17.07,22
NDC,0143978701,ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,19.11,12.42,3.21,19.11,22
NDC,0143978710,ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,19.11,12.42,3.21,19.11,22
NDC,0143980250,DOXYCYCLINE HYCLATE 50 MG CAPSULE,4.5,2.93,0.76,4.5,22
NDC,0143980305,DOXYCYCLINE HYCLATE 100 MG CAPSULE,11.06,7.19,1.86,11.06,22
NDC,0143980350,DOXYCYCLINE HYCLATE 100 MG CAPSULE,11.06,7.19,1.86,11.06,22
NDC,0143983001,METHOTREXATE SODIUM (PF) 1 GRAM SOLUTION FOR INJECTION,305.28,198.43,2.31,305.28,30
NDC,0143983601,PENICILLIN V POTASSIUM 500 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,0143983701,PENICILLIN V POTASSIUM 250 MG TABLET,1.7,1.11,0.29,1.7,22
NDC,0143985001,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,83.22,54.09,0.25,83.22,38
NDC,0143985101,METHYLPREDNISOLONE SODIUM SUCCINATE 1000 MG INTRAVENOUS SOLUTION,150.81,98.03,0.25,150.81,38
NDC,0143985201,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,25.68,16.69,4.31,64.39,31
NDC,0143985210,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,25.68,16.69,4.31,64.39,31
NDC,0143985701,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,7.2,4.68,0.41,7.2,31
NDC,0143985825,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,4.5,2.93,0.41,4.5,31
NDC,0143987201,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,28.8,18.72,4.84,28.8,23
NDC,0143987525,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,2.4,1.56,0.4,2.4,30
NDC,0143988601,AMOXICILLIN 200 MG/5 ML ORAL SUSPENSION,0.23,0.15,0.04,0.23,22
NDC,0143988675,AMOXICILLIN 200 MG/5 ML ORAL SUSPENSION,0.23,0.15,0.04,0.23,22
NDC,0143988701,AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION,0.25,0.16,0.04,0.25,22
NDC,0143988750,AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION,0.25,0.16,0.04,0.25,22
NDC,0143988775,AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION,0.25,0.16,0.04,0.25,22
NDC,0143988801,AMOXICILLIN 125 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.02,0.1,22
NDC,0143988815,AMOXICILLIN 125 MG/5 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,22
NDC,0143988880,AMOXICILLIN 125 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.02,0.1,22
NDC,0143988901,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,0.15,0.1,0.03,0.15,22
NDC,0143988915,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,0.13,0.08,0.02,0.13,22
NDC,0143988980,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,0.18,0.12,0.03,0.18,22
NDC,0143992390,CEFAZOLIN 500 MG SOLUTION FOR INJECTION,7.2,4.68,0.73,7.2,31
NDC,0143992490,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,4.92,3.2,0.73,4.92,31
NDC,0143997722,CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,21.06,13.69,1.7,21.06,31
NDC,0143997790,CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,21.06,13.69,1.7,21.06,31
NDC,0143998250,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,1.9,1.24,0.32,1.9,22
NDC,0143998303,CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,39.78,25.86,0.98,39.78,38
NDC,0149003904,PEPTO-BISMOL 262 MG/15 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,22
NDC,0149003916,PEPTO-BISMOL 262 MG/15 ML ORAL SUSPENSION,0.03,0.02,0.01,0.03,22
NDC,0168000215,TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,1.48,0.96,0.25,1.48,22
NDC,0168000315,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,0.6,0.39,0.1,0.6,22
NDC,0168000380,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,0.28,0.18,0.05,0.28,22
NDC,0168000415,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.48,0.31,0.08,0.48,22
NDC,0168000416,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.1,0.07,0.02,0.1,22
NDC,0168000480,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.22,0.14,0.04,0.22,22
NDC,0168000580,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,0.28,0.18,0.05,0.28,22
NDC,0168000615,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.74,0.48,0.12,0.74,22
NDC,0168000680,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.34,0.22,0.06,0.34,22
NDC,0168001531,HYDROCORTISONE 1 % TOPICAL CREAM,0.5,0.33,0.08,0.5,22
NDC,0168002031,HYDROCORTISONE 1 % TOPICAL OINTMENT,0.58,0.38,0.1,0.58,22
NDC,0168003315,BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,2.72,1.77,0.46,2.72,22
NDC,0168003346,BETAMETHASONE VALERATE 0.1 % TOPICAL OINTMENT,1.84,1.2,0.31,1.84,22
NDC,0168004015,BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,3.74,2.43,0.63,3.74,22
NDC,0168004046,BETAMETHASONE VALERATE 0.1 % TOPICAL CREAM,2.54,1.65,0.43,2.54,22
NDC,0168004160,BETAMETHASONE VALERATE 0.1 % LOTION,2.4,1.56,0.4,2.4,22
NDC,0168005515,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,7.04,4.58,1.18,7.04,22
NDC,0168005546,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,4.7,3.06,0.79,4.7,22
NDC,0168005615,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,8.2,5.33,1.38,8.2,22
NDC,0168005760,BETAMETHASONE DIPROPIONATE 0.05 % LOTION,1.6,1.04,0.27,1.6,22
NDC,0168006415,FLUOCINOLONE 0.025 % TOPICAL OINTMENT,4.5,2.93,0.76,4.5,22
NDC,0168006460,FLUOCINOLONE 0.025 % TOPICAL OINTMENT,3.38,2.2,0.57,3.38,22
NDC,0168008031,HYDROCORTISONE 2.5 % TOPICAL CREAM,0.26,0.17,0.04,0.26,22
NDC,0168012691,SWIM EAR 95 %-5 % DROPS,0.22,0.14,0.04,0.22,22
NDC,0168013460,FLUOCINONIDE 0.05 % TOPICAL SOLUTION,1.6,1.04,0.27,1.6,22
NDC,0168014630,HYDROCORTISONE 2.5 % TOPICAL OINTMENT,0.28,0.18,0.05,0.28,22
NDC,0168016315,CLOBETASOL 0.05 % TOPICAL CREAM,17.1,11.12,2.87,17.1,22
NDC,0168016330,CLOBETASOL 0.05 % TOPICAL CREAM,17.1,11.12,2.87,17.1,22
NDC,0168020130,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,2.72,1.77,0.46,2.72,22
NDC,0168020160,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,1.44,0.94,0.24,1.44,22
NDC,0168020230,CLINDAMYCIN 1 % TOPICAL GEL,6.92,4.5,1.16,6.92,22
NDC,0168020437,LIDOCAINE 5 % TOPICAL OINTMENT,16.94,11.01,2.85,16.94,22
NDC,0168025815,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,2.7,1.76,0.45,2.7,22
NDC,0168025846,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,1.94,1.26,0.33,1.94,22
NDC,0168026815,BETAMETHASONE AUGMENTED 0.05 % TOPICAL OINTMENT,11.1,7.22,1.86,11.1,22
NDC,0168027740,CLINDAMYCIN 2 % VAGINAL CREAM,6.52,4.24,1.1,6.52,22
NDC,0168029330,CLOBETASOL 0.05 % TOPICAL GEL,18.54,12.05,3.11,18.54,22
NDC,0168030115,CLOBETASOL-EMOLLIENT 0.05 % TOPICAL CREAM,9.08,5.9,1.53,9.08,22
NDC,0168032346,METRONIDAZOLE 0.75 % TOPICAL CREAM,3.8,2.47,0.64,3.8,22
NDC,0168034646,TERCONAZOLE 0.4 % VAGINAL CREAM,1.92,1.25,0.32,1.92,22
NDC,0168035755,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,3.96,2.57,0.67,3.96,22
NDC,0169183302,NOVOLIN R REGULAR U-100 INSULIN 100 UNIT/ML INJECTION SOLUTION,17.34,11.27,0.6,17.34,23
NDC,0169183311,NOVOLIN R REGULAR U-100 INSULIN 100 UNIT/ML INJECTION SOLUTION,17.34,11.27,0.6,17.34,23
NDC,0169183411,NOVOLIN N NPH U-100 INSULIN ISOPHANE 100 UNIT/ML SUBCUTANEOUS SUSP,17.34,11.27,0.6,17.34,22
NDC,0169183711,NOVOLIN 70/30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,17.34,11.27,0.6,17.34,22
NDC,0169300315,NOVOLIN R FLEXPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS INSULIN PEN,21.87,14.22,0.6,21.87,23
NDC,0169300325,NOVOLIN R FLEXPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS INSULIN PEN,21.87,14.22,0.6,21.87,23
NDC,0169300415,NOVOLIN N FLEXPEN 100 UNIT/ML (3 ML) SUBCUTANEOUS INSULIN PEN,21.87,14.22,0.6,21.87,22
NDC,0169300715,NOVOLIN 70-30 FLEXPEN U-100 INSULIN 100 UNIT/ML (70-30) SUBCUTANEOUS,21.87,14.22,0.6,21.87,22
NDC,0169368512,NOVOLOG MIX 70-30 U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS SOLUTION,26.04,16.93,0.6,26.04,22
NDC,0169369619,NOVOLOG MIX 70-30 FLEXPEN U-100 INSULIN 100 UNIT/ML SUBCUTANEOUS PEN,33.54,21.8,0.6,33.54,22
NDC,0169517603,VAGIFEM 10 MCG VAGINAL TABLET,51.04,33.18,8.57,51.04,22
NDC,0169633910,NOVOLOG FLEXPEN U-100 INSULIN ASPART 100 UNIT/ML (3 ML) SUBCUTANEOUS,33.54,21.8,0.6,33.54,22
NDC,0169701301,TRETTEN 2500 UNIT INTRAVENOUS SOLUTION,71.46,46.45,15.39,12697.64,47
NDC,0169720101,NOVOSEVEN RT 1 MG (1000 MCG) INTRAVENOUS SOLUTION,10.62,6.9,2.21,3407.66,47
NDC,0169720201,NOVOSEVEN RT 2 MG (2000 MCG) INTRAVENOUS SOLUTION,10.62,6.9,2.21,3407.66,47
NDC,0169720501,NOVOSEVEN RT 5 MG (5000 MCG) INTRAVENOUS SOLUTION,10.62,6.9,2.21,3407.66,47
NDC,0169750111,NOVOLOG U-100 INSULIN ASPART 100 UNIT/ML SUBCUTANEOUS SOLUTION,26.04,16.93,0.6,26.04,22
NDC,0169770521,NORDITROPIN FLEXPRO 10 MG/1.5 ML (6.7 MG/ML) SUBCUTANEOUS PEN INJECTOR,4262.16,2770.4,48.92,4262.16,33
NDC,0169830111,ESPEROCT 3000 (+/-) UNIT INTRAVENOUS SOLUTION,10.2,6.63,1.9,3407.66,47
NDC,0172208380,HYDROCHLOROTHIAZIDE 25 MG TABLET,0.16,0.1,0.03,0.16,22
NDC,0172208960,HYDROCHLOROTHIAZIDE 50 MG TABLET,0.34,0.22,0.06,0.34,22
NDC,0172409760,BACLOFEN 20 MG TABLET,10.26,6.67,1.72,10.26,22
NDC,0172640605,CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,6.8,4.42,1.14,6.8,22
NDC,0172640649,CROMOLYN 20 MG/2 ML SOLUTION FOR NEBULIZATION,6.8,4.42,1.14,6.8,22
NDC,0172731320,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,14.98,9.74,2.07,14.98,31
NDC,0173013555,WELLBUTRIN SR 150 MG TABLET 12 HR SUSTAINED-RELEASE,18.9,12.29,3.18,18.9,22
NDC,0173047900,IMITREX STATDOSE PEN 6 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1737.03,1129.07,97.32,1737.03,23
NDC,0173051700,FLOLAN 0.5 MG INTRAVENOUS SOLUTION,67.29,43.74,11.3,67.29,31
NDC,0173052100,SEREVENT DISKUS 50 MCG/DOSE POWDER FOR INHALATION,16.94,11.01,2.85,16.94,22
NDC,0173052700,LAMICTAL 25 MG CHEWABLE DISPERSIBLE TABLET,28.2,18.33,4.74,28.2,22
NDC,0173054700,MEPRON 750 MG/5 ML ORAL SUSPENSION,19.9,12.94,3.34,19.9,22
NDC,0173063302,LAMICTAL 25 MG TABLET,25.78,16.76,4.33,25.78,22
NDC,0173064255,LAMICTAL 100 MG TABLET,27.42,17.82,4.61,27.42,22
NDC,0173066518,MEPRON 750 MG/5 ML ORAL SUSPENSION,21.53,13.99,3.62,21.53,22
NDC,0173067601,MALARONE PEDIATRIC 62.5 MG-25 MG TABLET,5.98,3.89,1.0,5.98,22
NDC,0173068101,RELENZA DISKHALER 5 MG/ACTUATION POWDER FOR INHALATION,7.08,4.6,1.19,7.08,22
NDC,0173068220,VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER,7.6,4.94,1.28,7.6,22
NDC,0173068224,VENTOLIN HFA 90 MCG/ACTUATION AEROSOL INHALER,6.82,4.43,1.15,6.82,22
NDC,0173069600,ADVAIR DISKUS 250 MCG-50 MCG/DOSE POWDER FOR INHALATION,7.84,5.1,1.32,7.84,22
NDC,0173071520,ADVAIR HFA 45 MCG-21 MCG/ACTUATION AEROSOL INHALER,50.16,32.6,8.43,50.16,22
NDC,0173071522,ADVAIR HFA 45 MCG-21 MCG/ACTUATION AEROSOL INHALER,50.56,32.86,8.49,50.56,22
NDC,0173071620,ADVAIR HFA 115 MCG-21 MCG/ACTUATION AEROSOL INHALER,63.78,41.46,10.72,63.78,22
NDC,0173071622,ADVAIR HFA 115 MCG-21 MCG/ACTUATION AEROSOL INHALER,46.94,30.51,7.89,46.94,22
NDC,0173071720,ADVAIR HFA 230 MCG-21 MCG/ACTUATION AEROSOL INHALER,87.94,57.16,14.77,87.94,22
NDC,0173071722,ADVAIR HFA 230 MCG-21 MCG/ACTUATION AEROSOL INHALER,76.72,49.87,12.89,76.72,22
NDC,0173073500,IMITREX 25 MG TABLET,83.36,54.18,14.0,83.36,22
NDC,0173073601,IMITREX 50 MG TABLET,181.72,118.12,30.53,181.72,22
NDC,0173085702,PH 12 DILUENT FOR FLOLAN INTRAVENOUS SOLUTION,1.05,0.68,0.18,1.05,23
NDC,0173085910,BREO ELLIPTA 100 MCG-25 MCG/DOSE POWDER FOR INHALATION,16.28,10.58,2.74,16.28,22
NDC,0173085914,BREO ELLIPTA 100 MCG-25 MCG/DOSE POWDER FOR INHALATION,13.44,8.74,2.26,13.44,22
NDC,0173086906,ANORO ELLIPTA 62.5 MCG-25 MCG/ACTUATION POWDER FOR INHALATION,20.16,13.1,3.39,20.16,22
NDC,0173088101,NUCALA 100 MG SUBCUTANEOUS SOLUTION,13229.58,8599.23,27.43,13229.58,53
NDC,0173088210,BREO ELLIPTA 200 MCG-25 MCG/DOSE POWDER FOR INHALATION,16.28,10.58,2.74,16.28,22
NDC,0173088214,BREO ELLIPTA 200 MCG-25 MCG/DOSE POWDER FOR INHALATION,13.44,8.74,2.26,13.44,22
NDC,0173089201,NUCALA 100 MG/ML SUBCUTANEOUS AUTO-INJECTOR,14367.54,9338.9,27.43,14367.54,53
NDC,0173089242,NUCALA 100 MG/ML SUBCUTANEOUS SYRINGE,14367.54,9338.9,27.43,14367.54,53
NDC,0173089803,JEMPERLI 50 MG/ML INTRAVENOUS SOLUTION,4417.53,2871.39,209.3,5646.0,49
NDC,0173090913,ZEJULA 100 MG TABLET,1555.42,1011.02,261.31,1555.42,22
NDC,0173091213,ZEJULA 200 MG TABLET,1555.42,1011.02,261.31,1555.42,22
NDC,0173091301,BLENREP 70 MG INTRAVENOUS SOLUTION,115200.0,74880.0,19353.6,115200.0,29
NDC,0173091513,ZEJULA 300 MG TABLET,1555.42,1011.02,261.31,1555.42,22
NDC,0173093308,VALTREX 500 MG TABLET,32.22,20.94,5.41,32.22,22
NDC,0173094755,WELLBUTRIN SR 100 MG TABLET 12 HR SUSTAINED-RELEASE,17.64,11.47,2.96,17.64,22
NDC,0178061001,UROCIT-K 10 10 MEQ (1080 MG) TABLETEXTENDED RELEASE,5.14,3.34,0.86,5.14,22
NDC,0179805202,VITAMIN E (DL ACETATE) 45 MG (100 UNIT) CAPSULE,0.04,0.03,0.01,0.04,22
NDC,0185002201,ORPHENADRINE CITRATE ER 100 MG TABLETEXTENDED RELEASE,4.36,2.83,0.73,4.36,22
NDC,0185005501,METOLAZONE 5 MG TABLET,4.72,3.07,0.79,4.72,22
NDC,0185012801,BUMETANIDE 0.5 MG TABLET,2.16,1.4,0.36,2.16,22
NDC,0185012901,BUMETANIDE 1 MG TABLET,2.18,1.42,0.37,2.18,22
NDC,0185013001,BUMETANIDE 2 MG TABLET,4.04,2.63,0.68,4.04,22
NDC,0185084201,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,3.42,2.22,0.57,3.42,22
NDC,0185505001,METOLAZONE 2.5 MG TABLET,4.14,2.69,0.7,4.14,22
NDC,0185560001,METOLAZONE 10 MG TABLET,5.64,3.67,0.95,5.64,22
NDC,0186037020,SYMBICORT 160 MCG-4.5 MCG/ACTUATION HFA AEROSOL INHALER,55.12,35.83,9.26,55.12,22
NDC,0186037028,SYMBICORT 160 MCG-4.5 MCG/ACTUATION HFA AEROSOL INHALER,63.68,41.39,10.7,63.68,22
NDC,0186037228,SYMBICORT 80 MCG-4.5 MCG/ACTUATION HFA AEROSOL INHALER,48.14,31.29,8.09,48.14,22
NDC,0186077660,BRILINTA 60 MG TABLET,18.6,12.09,3.12,18.6,22
NDC,0186077739,BRILINTA 90 MG TABLET,18.6,12.09,3.12,18.6,22
NDC,0186077760,BRILINTA 90 MG TABLET,18.6,12.09,3.12,18.6,22
NDC,0186198804,PULMICORT 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,10.46,6.8,1.76,10.46,22
NDC,0186198904,PULMICORT 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,12.3,8.0,2.07,12.3,22
NDC,0186199004,PULMICORT 1 MG/2 ML SUSPENSION FOR NEBULIZATION,24.62,16.0,4.14,24.62,22
NDC,0186404001,NEXIUM PACKET 40 MG GRANULES DELAYED RELEASE FOR SUSP,28.73,18.67,4.83,28.73,22
NDC,0186502031,NEXIUM 20 MG CAPSULEDELAYED RELEASE,22.02,14.31,3.7,22.02,22
NDC,0186504031,NEXIUM 40 MG CAPSULEDELAYED RELEASE,22.02,14.31,3.7,22.02,22
NDC,0187045302,ZELAPAR 1.25 MG DISINTEGRATING TABLET,244.04,158.63,41.0,244.04,22
NDC,0187093801,TASMAR 100 MG TABLET,284.5,184.93,47.8,284.5,22
NDC,0187212010,SYPRINE 250 MG CAPSULE,510.4,331.76,85.75,510.4,22
NDC,0187301030,MESTINON 60 MG TABLET,57.04,37.08,9.58,57.04,22
NDC,0187301220,MESTINON 60 MG/5 ML ORAL SYRUP,12.25,7.96,2.06,12.25,22
NDC,0187301330,MESTINON TIMESPAN 180 MG TABLETEXTENDED RELEASE,108.18,70.32,18.17,108.18,22
NDC,0187320447,EFUDEX 5 % TOPICAL CREAM,3.6,2.34,0.6,3.6,22
NDC,0187355510,ANCOBON 500 MG CAPSULE,356.86,231.96,59.95,356.86,22
NDC,0187510001,ELIDEL 1 % TOPICAL CREAM,23.92,15.55,4.02,23.92,22
NDC,0187515060,RENOVA 0.02 % TOPICAL CREAM,11.76,7.64,1.98,11.76,22
NDC,0187560015,VISUDYNE 15 MG INTRAVENOUS SOLUTION,8206.6,5334.29,10.3,8206.6,53
NDC,0193288250,KETO-DIASTIX STRIPS,0.54,0.35,0.09,0.54,22
NDC,0223172001,SODIUM BICARBONATE 325 MG TABLET,0.1,0.07,0.02,0.1,22
NDC,0223172101,SODIUM BICARBONATE 650 MG TABLET,0.12,0.08,0.02,0.12,22
NDC,0223176001,SODIUM CHLORIDE 1000 MG SOLUBLE TABLET,0.2,0.13,0.03,0.2,22
NDC,0225029515,ANASPAZ 0.125 MG DISINTEGRATING TABLET,0.6,0.39,0.1,0.6,22
NDC,0225038280,AYR SALINE 0.65 % NASAL DROPS,0.1,0.07,0.02,0.1,22
NDC,0225052547,AYR SALINE NASAL GEL,0.48,0.31,0.08,0.48,22
NDC,0225052848,AYR SALINE GEL NASAL SPRAY,0.5,0.33,0.08,0.5,22
NDC,0225080047,NEO-SYNEPHRINE (PHENYLEPHRINE) 0.25 % NASAL SPRAY,0.56,0.36,0.09,0.56,22
NDC,0225080547,NEO-SYNEPHRINE (PHENYLEPHRINE) 0.5 % NASAL SPRAY,0.56,0.36,0.09,0.56,22
NDC,0225081047,NEO-SYNEPHRINE (PHENYLEPHRINE) 1 % NASAL SPRAY,0.62,0.4,0.1,0.62,22
NDC,0228207610,TEMAZEPAM 15 MG CAPSULE,1.48,0.96,0.25,1.48,22
NDC,0228207650,TEMAZEPAM 15 MG CAPSULE,1.42,0.92,0.24,1.42,22
NDC,0228207710,TEMAZEPAM 30 MG CAPSULE,1.78,1.16,0.3,1.78,22
NDC,0228212910,CLONIDINE HCL 0.3 MG TABLET,1.04,0.68,0.17,1.04,22
NDC,0228255111,DICLOFENAC SODIUM 75 MG TABLETDELAYED RELEASE,2.3,1.5,0.39,2.3,22
NDC,0228257111,INDAPAMIDE 2.5 MG TABLET,1.66,1.08,0.28,1.66,22
NDC,0228259711,INDAPAMIDE 1.25 MG TABLET,1.36,0.88,0.23,1.36,22
NDC,0228277811,PROPRANOLOL ER 60 MG CAPSULE24 HREXTENDED RELEASE,4.12,2.68,0.69,4.12,22
NDC,0228277911,PROPRANOLOL ER 80 MG CAPSULE24 HREXTENDED RELEASE,4.82,3.13,0.81,4.82,22
NDC,0228278111,PROPRANOLOL ER 160 MG CAPSULE24 HREXTENDED RELEASE,7.82,5.08,1.31,7.82,22
NDC,0228280111,PILOCARPINE 5 MG TABLET,3.04,1.98,0.51,3.04,22
NDC,0228284903,FLUVOXAMINE ER 150 MG CAPSULEEXTENDED RELEASE 24 HR,21.86,14.21,3.67,21.86,22
NDC,0228309011,MORPHINE ER 30 MG CAPSULEEXTENDED RELEASE 24 HR MULTIPHASE,11.46,7.45,1.93,11.46,22
NDC,0228315303,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,16.92,11.0,2.84,16.92,22
NDC,0228315603,BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET,9.0,5.85,1.51,9.0,22
NDC,0234057504,HIBICLENS 4 % TOPICAL LIQUID,0.06,0.04,0.01,0.06,22
NDC,0234057508,HIBICLENS 4 % TOPICAL LIQUID,0.04,0.03,0.01,0.04,22
NDC,0234057516,HIBICLENS 4 % TOPICAL LIQUID,0.04,0.03,0.01,0.04,22
NDC,0234057532,HIBICLENS 4 % TOPICAL LIQUID,0.02,0.01,0.01,0.02,22
NDC,0245021111,MIDODRINE 2.5 MG TABLET,3.38,2.2,0.57,3.38,22
NDC,0245021311,MIDODRINE 10 MG TABLET,19.44,12.64,3.27,19.44,22
NDC,0245086070,VANDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL,4.66,3.03,0.78,4.66,22
NDC,0245531501,KLOR-CON 8 MEQ TABLETEXTENDED RELEASE,1.32,0.86,0.22,1.32,22
NDC,0245531589,KLOR-CON 8 MEQ TABLETEXTENDED RELEASE,1.32,0.86,0.22,1.32,22
NDC,0245531701,KLOR-CON M10 MEQ TABLETEXTENDED RELEASE,1.24,0.81,0.21,1.24,22
NDC,0245531710,KLOR-CON M10 MEQ TABLETEXTENDED RELEASE,1.2,0.78,0.2,1.2,22
NDC,0245531711,KLOR-CON M10 MEQ TABLETEXTENDED RELEASE,1.2,0.78,0.2,1.2,22
NDC,0245531789,KLOR-CON M10 MEQ TABLETEXTENDED RELEASE,1.24,0.81,0.21,1.24,22
NDC,0245531901,KLOR-CON M20 MEQ TABLETEXTENDED RELEASE,1.36,0.88,0.23,1.36,22
NDC,0245531910,KLOR-CON M20 MEQ TABLETEXTENDED RELEASE,1.26,0.82,0.21,1.26,22
NDC,0245531911,KLOR-CON M20 MEQ TABLETEXTENDED RELEASE,1.26,0.82,0.21,1.26,22
NDC,0245531989,KLOR-CON M20 MEQ TABLETEXTENDED RELEASE,1.36,0.88,0.23,1.36,22
NDC,0254200001,PENICILLAMINE 250 MG TABLET,130.86,85.06,21.98,130.86,22
NDC,0254302802,LUBIPROSTONE 8 MCG CAPSULE,13.36,8.68,2.24,13.36,22
NDC,0254302902,LUBIPROSTONE 24 MCG CAPSULE,13.36,8.68,2.24,13.36,22
NDC,0259050116,CUVPOSA 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION,3.18,2.07,0.53,3.18,22
NDC,0259160501,XEOMIN 50 UNIT INTRAMUSCULAR SOLUTION,964.8,627.12,4.68,964.8,47
NDC,0259161001,XEOMIN 100 UNIT INTRAMUSCULAR SOLUTION,1839.6,1195.74,4.68,1839.6,47
NDC,0264151031,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.18,0.12,0.03,4.82,31
NDC,0264151032,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.09,0.06,0.02,0.09,23
NDC,0264180031,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.21,0.14,0.04,1.84,31
NDC,0264180032,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.09,0.06,0.02,1.84,31
NDC,0264193310,TROPHAMINE 10 % INTRAVENOUS SOLUTION,0.27,0.18,0.05,0.27,22
NDC,0264210100,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0264230410,ACETIC ACID 0.25 % IRRIGATION SOLUTION,0.06,0.04,0.01,0.06,22
NDC,0264310311,CEFAZOLIN 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,49.92,32.45,0.73,49.92,31
NDC,0264310511,CEFAZOLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,56.16,36.5,0.73,56.16,31
NDC,0264312511,CEFOXITIN 2 GRAM/50 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,120.75,78.49,4.41,120.75,31
NDC,0264315311,CEFTRIAXONE 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOT) INTRAVENOUS PIGGYBACK,70.86,46.06,0.41,70.86,31
NDC,0264315511,CEFTRIAXONE 2 GRAM/50 ML IN DEXTROSE (ISO-OSM) INTRAVENOUS PIGGYBACK,94.47,61.41,0.41,94.47,31
NDC,0264318311,MEROPENEM 500 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,73.8,47.97,1.82,73.8,31
NDC,0264318511,MEROPENEM 1 GRAM/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,107.67,69.99,1.82,107.67,31
NDC,0264319311,CEFEPIME 1 GRAM/50 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,70.86,46.06,4.46,70.86,31
NDC,0264319511,CEFEPIME 2 GRAM/50 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,107.46,69.85,4.46,107.46,31
NDC,0264446000,NUTRILIPID 20 % INTRAVENOUS EMULSION,0.15,0.1,0.03,0.15,22
NDC,0264446030,NUTRILIPID 20 % INTRAVENOUS EMULSION,0.36,0.23,0.06,0.36,22
NDC,0264738750,DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0264762200,DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0264762320,DEXTROSE 10 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,22
NDC,0264763600,POTASSIUM CHLORIDE 30 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,22
NDC,0264780010,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.56,31
NDC,0264780020,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,1.84,31
NDC,0264780510,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,0.03,0.02,0.01,0.44,23
NDC,0264780610,SODIUM CHLORIDE 5 % HYPERTONIC INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.44,23
NDC,0264785010,WATER FOR INJECTION STERILE 100 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0264785020,WATER FOR INJECTION STERILE 100 % INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,22
NDC,0264905748,PAB MIXING CONTAINER,6.84,4.45,1.15,6.84,22
NDC,0264934155,TROPHAMINE 10 % INTRAVENOUS SOLUTION,0.27,0.18,0.05,0.27,22
NDC,0264959820,LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,24
NDC,0264987210,HEPARIN (PORCINE) (PF) 1000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.49,31
NDC,0268024705,HISTATROL 1 MG/ML (2.75 MG/ML) PERCUTANEOUS SOLUTION,285.12,185.33,47.9,285.12,22
NDC,0268024805,HISTATROL 0.1 MG/ML (0.275 MG/ML) INTRADERMAL INJECTION SOLUTION,272.88,177.37,45.84,272.88,22
NDC,0270008320,CHOLETEC 45 MG INTRAVENOUS SOLUTION,62.0,40.3,10.42,2409.0,29
NDC,0270014957,CYSTOGRAFIN 30 % URETHRAL SOLUTION,0.66,0.43,0.07,0.66,21
NDC,0270014960,CYSTOGRAFIN 30 % URETHRAL SOLUTION,1.11,0.72,0.07,1.11,21
NDC,0270044540,GASTROGRAFIN 66 %-10 % ORAL SOLUTION,1.68,1.09,0.2,1.68,21
NDC,0270055615,KINEVAC 5 MCG SOLUTION FOR INJECTION,469.68,305.29,61.99,469.68,37
NDC,0270131525,ISOVUE-300  61 % INTRAVENOUS SOLUTION,2.64,1.72,0.12,2.64,21
NDC,0270131530,ISOVUE-300  61 % INTRAVENOUS SOLUTION,1.68,1.09,0.12,1.68,21
NDC,0270131535,ISOVUE-300  61 % INTRAVENOUS SOLUTION,1.65,1.07,0.12,1.65,21
NDC,0270131630,ISOVUE-370  76 % INTRAVENOUS SOLUTION,1.83,1.19,0.12,1.83,21
NDC,0270131635,ISOVUE-370  76 % INTRAVENOUS SOLUTION,1.83,1.19,0.12,1.83,21
NDC,0270131695,ISOVUE-370  76 % INTRAVENOUS SOLUTION,1.83,1.19,0.12,1.83,21
NDC,0270131702,ISOVUE-250  51 % INTRAVENOUS SOLUTION,1.44,0.94,0.24,1.44,23
NDC,0270141111,ISOVUE-M 200  41 % INTRATHECAL SOLUTION,23.28,15.13,0.35,23.28,21
NDC,0270141215,ISOVUE-M 300  61 % INTRATHECAL SOLUTION,20.61,13.4,0.12,20.61,21
NDC,0270516413,MULTIHANCE 529 MG/ML (0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,20.94,13.61,1.64,20.94,21
NDC,0270516414,MULTIHANCE 529 MG/ML (0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,20.43,13.28,1.64,20.43,21
NDC,0270516415,MULTIHANCE 529 MG/ML (0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,18.93,12.3,1.64,18.93,21
NDC,0270709916,LUMASON 25 MG INTRAVENOUS SUSPENSION,522.0,339.3,17.04,522.0,24
NDC,0281020502,SURGILUBE TOPICAL GEL,0.08,0.05,0.01,0.08,22
NDC,0281020512,SURGILUBE TOPICAL GEL,0.08,0.05,0.01,0.08,22
NDC,0281020536,SURGILUBE TOPICAL GEL,0.06,0.04,0.01,0.06,22
NDC,0281020543,SURGILUBE TOPICAL GEL,0.1,0.07,0.02,0.1,22
NDC,0281020545,SURGILUBE TOPICAL GEL,0.1,0.07,0.02,0.1,22
NDC,0281032608,NITRO-BID 2 % TRANSDERMAL OINTMENT,6.06,3.94,1.02,6.06,22
NDC,0281032630,NITRO-BID 2 % TRANSDERMAL OINTMENT,3.12,2.03,0.52,3.12,22
NDC,0281032660,NITRO-BID 2 % TRANSDERMAL OINTMENT,3.12,2.03,0.52,3.12,22
NDC,0283061026,HURRICAINE ONE 20 % MUCOSAL SPRAY,27.66,17.98,4.65,27.66,22
NDC,0283067902,HURRICAINE 20 % MUCOSAL SPRAY,1.54,1.0,0.26,1.54,22
NDC,0283067960,HURRICAINE 20 % MUCOSAL SPRAY,2.02,1.31,0.34,2.02,22
NDC,0283087131,HURRICAINE 20 % MUCOSAL GEL,0.96,0.62,0.16,0.96,22
NDC,0283118520,HURRICAINE SPRAY EXTENSION TUBE,0.24,0.16,0.04,0.22,21
NDC,0295752040,CALCIUM GLUCONATE 2.5% TOPICAL GEL,11.84,7.7,1.99,11.84,22
NDC,0299011024,CETAPHIL GENTLE CLEANSER TOPICAL CLEANSER,0.12,0.08,0.02,0.12,22
NDC,0299011026,CETAPHIL GENTLE CLEANSER TOPICAL CLEANSER,0.08,0.05,0.01,0.08,22
NDC,0299391408,CETAPHIL DAILYADVANCE LOTION,0.08,0.05,0.01,0.08,22
NDC,0299391702,CETAPHIL MOISTURIZING TOPICAL CREAM,0.18,0.12,0.03,0.18,22
NDC,0299391808,CETAPHIL MOISTURIZING LOTION,0.06,0.04,0.01,0.06,22
NDC,0299392708,CETAPHIL TOPICAL CLEANSER,0.06,0.04,0.01,0.06,22
NDC,0299591545,DIFFERIN 0.1 % TOPICAL CREAM,28.22,18.34,4.74,28.22,22
NDC,0299596230,DYSPORT 300 UNIT INTRAMUSCULAR SOLUTION,1601.16,1040.75,7.81,1601.16,47
NDC,0299622015,NEMLUVIO 30 MG SUBCUTANEOUS PEN INJECTOR,16027.2,10417.68,2692.57,16027.2,22
NDC,0310009590,DALIRESP 500 MCG TABLET,36.58,23.78,6.15,36.58,22
NDC,0310027110,SEROQUEL 100 MG TABLET,16.0,10.4,2.69,16.0,22
NDC,0310027460,SEROQUEL 300 MG TABLET,39.58,25.73,6.65,39.58,22
NDC,0310027510,SEROQUEL 25 MG TABLET,9.32,6.06,1.57,9.32,22
NDC,0310027810,SEROQUEL 50 MG TABLET,15.32,9.96,2.57,15.32,22
NDC,0310028060,SEROQUEL XR 50 MG TABLETEXTENDED RELEASE,19.7,12.81,3.31,19.7,22
NDC,0310028160,SEROQUEL XR 150 MG TABLETEXTENDED RELEASE,35.4,23.01,5.95,35.4,22
NDC,0310028260,SEROQUEL XR 200 MG TABLETEXTENDED RELEASE,38.96,25.32,6.55,38.96,22
NDC,0310028360,SEROQUEL XR 300 MG TABLETEXTENDED RELEASE,51.08,33.2,8.58,51.08,22
NDC,0310048230,IRESSA 250 MG TABLET,623.12,405.03,104.68,623.12,27
NDC,0310061060,KOSELUGO 10 MG CAPSULE,238.92,155.3,40.14,238.92,22
NDC,0310062560,KOSELUGO 25 MG CAPSULE,597.32,388.26,100.35,597.32,22
NDC,0310066860,LYNPARZA 100 MG TABLET,347.2,225.68,58.33,347.2,22
NDC,0310067960,LYNPARZA 150 MG TABLET,347.2,225.68,58.33,347.2,22
NDC,0310072010,FASLODEX 250 MG/5 ML INTRAMUSCULAR SYRINGE,930.76,604.99,4.76,930.76,46
NDC,0310075430,CRESTOR 40 MG TABLET,22.12,14.38,3.72,22.12,22
NDC,0310110530,LOKELMA 5 GRAM ORAL POWDER PACKET,68.92,44.8,11.58,68.92,22
NDC,0310111001,LOKELMA 10 GRAM ORAL POWDER PACKET,68.92,44.8,11.58,68.92,22
NDC,0310111030,LOKELMA 10 GRAM ORAL POWDER PACKET,68.92,44.8,11.58,68.92,22
NDC,0310111039,LOKELMA 10 GRAM ORAL POWDER PACKET,68.92,44.8,11.58,68.92,22
NDC,0310134930,TAGRISSO 40 MG TABLET,1410.46,916.8,236.96,1410.46,22
NDC,0310135030,TAGRISSO 80 MG TABLET,1410.46,916.8,236.96,1410.46,22
NDC,0310173030,FASENRA 30 MG/ML SUBCUTANEOUS SYRINGE,21049.38,13682.1,148.72,21049.38,53
NDC,0310183030,FASENRA PEN 30 MG/ML SUBCUTANEOUS AUTO-INJECTOR,21049.38,13682.1,148.72,21049.38,53
NDC,0310304000,SAPHNELO 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION,9793.14,6365.54,15.42,9793.14,53
NDC,0310351260,CALQUENCE (ACALABRUTINIB MALEATE) 100 MG TABLET,633.16,411.55,106.37,633.16,22
NDC,0310450012,IMFINZI 50 MG/ML INTRAVENOUS SOLUTION,2061.44,1339.94,72.46,2061.44,46
NDC,0310450525,IMJUDO 20 MG/ML INTRAVENOUS SOLUTION,13243.88,8608.52,122.17,13243.88,52
NDC,0310453530,IMJUDO 20 MG/ML INTRAVENOUS SOLUTION,13243.88,8608.52,122.17,13243.88,52
NDC,0310461150,IMFINZI 50 MG/ML INTRAVENOUS SOLUTION,2061.44,1339.94,72.46,2061.44,46
NDC,0310661502,SYMLINPEN 60 1500 MCG/1.5 ML SUBCUTANEOUS PEN INJECTOR,1243.08,808.0,208.84,1243.08,22
NDC,0310662702,SYMLINPEN 120 2700 MCG/2.7 ML SUBCUTANEOUS PEN INJECTOR,820.11,533.07,137.78,820.11,22
NDC,0310950101,TRUQAP 200 MG TABLET,885.36,575.48,148.74,885.36,22
NDC,0316019316,HYDROCORTISONE 2.5 % TOPICAL CREAM,0.32,0.21,0.05,0.32,22
NDC,0316022515,DESENEX 2 % TOPICAL POWDER,0.26,0.17,0.04,0.26,22
NDC,0316022530,DESENEX 2 % TOPICAL POWDER,0.2,0.13,0.03,0.2,22
NDC,0316023125,ZEASORB AF 2 % TOPICAL POWDER,0.22,0.14,0.04,0.22,22
NDC,0327000110,CLORPACTIN WCS-90 TOPICAL POWDER FOR SOLUTION,6.88,4.47,1.16,6.88,22
NDC,0327001230,RENACIDIN 1980.6 MG-59.4MG-980.4MG/30ML IRRIGATION SOLUTION,0.72,0.47,0.12,0.72,22
NDC,0338000344,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338000346,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338000347,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338000402,WATER FOR IRRIGATION STERILE SOLUTION,0.09,0.06,0.02,0.09,22
NDC,0338000403,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338000404,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338001304,WATER FOR INJECTION STERILE 100 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338001702,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.06,0.04,0.01,4.82,31
NDC,0338001703,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,4.82,31
NDC,0338001704,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.14,31
NDC,0338001710,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.42,0.27,0.07,4.82,31
NDC,0338001711,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.21,0.14,0.04,4.82,31
NDC,0338001718,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.09,0.06,0.02,4.82,31
NDC,0338001731,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.18,0.12,0.03,8.14,31
NDC,0338001738,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.09,0.06,0.02,0.09,23
NDC,0338001741,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.21,0.14,0.04,4.82,31
NDC,0338001748,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.09,0.06,0.02,0.09,23
NDC,0338002302,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,0.09,0.06,0.02,0.09,22
NDC,0338002303,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338002304,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338004303,SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338004304,SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338004727,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338004729,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338004744,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338004746,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338004747,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338004802,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.06,0.04,0.01,0.06,22
NDC,0338004803,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338004804,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338004902,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.06,0.04,0.01,1.84,31
NDC,0338004903,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.56,31
NDC,0338004904,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,5.51,31
NDC,0338004910,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.39,0.25,0.07,3.56,31
NDC,0338004911,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.21,0.14,0.04,0.21,23
NDC,0338004918,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,23
NDC,0338004931,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.18,0.12,0.03,0.18,23
NDC,0338004938,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.09,0.06,0.02,5.51,31
NDC,0338004941,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.18,0.12,0.03,0.18,23
NDC,0338004948,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.12,0.08,0.02,1.84,31
NDC,0338005403,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,0.06,0.04,0.01,0.44,23
NDC,0338005603,SODIUM CHLORIDE 5 % HYPERTONIC INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.44,23
NDC,0338006230,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.09,0.06,0.02,0.09,23
NDC,0338006301,DOXIL 2 MG/ML INTRAVENOUS SUSPENSION,153.68,99.89,76.84,383.26,45
NDC,0338006620,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,4.82,31
NDC,0338006701,DOXIL 2 MG/ML INTRAVENOUS SUSPENSION,323.32,210.16,103.44,383.26,45
NDC,0338007304,DEXTROSE 2.5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,30
NDC,0338007704,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,31
NDC,0338008503,DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,31
NDC,0338008504,DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,31
NDC,0338008903,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,31
NDC,0338008904,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,31
NDC,0338011220,NOREPINEPHRINE BITARTRATE 4 MG/250 ML (16 MCG/ML) IN DEXTROSE 5 % IV,0.33,0.21,0.06,0.33,23
NDC,0338011620,NOREPINEPHRINE BITARTRATE 16 MG/250 ML (64 MCG/ML) IN DEXTROSE 5 % IV,0.96,0.62,0.16,0.96,22
NDC,0338011702,LACTATED RINGERS INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,22
NDC,0338011703,LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,6.6,31
NDC,0338011704,LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,6.6,31
NDC,0338012204,VANCOMYCIN 1.25 GRAM/250 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.42,0.27,0.06,0.42,30
NDC,0338012404,VANCOMYCIN 1.5 GRAM/300 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.39,0.25,0.06,0.39,30
NDC,0338012503,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,6.6,31
NDC,0338012504,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,6.6,31
NDC,0338012612,MYXREDLIN (REGULAR INSULIN) 100 UNIT/100 ML (1 UNIT/ML) IV SOLUTION,1.26,0.82,0.21,1.26,23
NDC,0338013727,LACTATED RINGERS IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338013729,LACTATED RINGERS IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338018401,CLINIMIX 8 % IN 14 % DEXTROSE (SULFITE-FREE) INTRAVENOUS SOLUTION,0.21,0.14,0.04,0.21,22
NDC,0338018404,CLINIMIX 8 % IN 14 % DEXTROSE (SULFITE-FREE) INTRAVENOUS SOLUTION,0.21,0.14,0.04,0.21,22
NDC,0338020601,CLINIMIX E 8 % IN 14 % DEXTROSE (SULFITE-FREE) INTRAVENOUS SOLUTION,0.21,0.14,0.04,0.21,23
NDC,0338020604,CLINIMIX E 8 % IN 14 % DEXTROSE (SULFITE-FREE) INTRAVENOUS SOLUTION,0.21,0.14,0.04,0.21,23
NDC,0338022103,PLASMA-LYTE A INTRAVENOUS SOLUTION,0.09,0.06,0.02,0.09,22
NDC,0338022104,PLASMA-LYTE A INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,22
NDC,0338028947,GLYCINE UROLOGIC 1.5 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338032201,RECOTHROM 5000 UNIT TOPICAL SOLUTION,206.4,134.16,34.68,206.4,22
NDC,0338032601,RECOTHROM 20000 UNIT TOPICAL SOLUTION,825.6,536.64,138.7,825.6,22
NDC,0338035303,OSMITROL 10 % INTRAVENOUS SOLUTION,0.36,0.23,0.06,0.36,22
NDC,0338035702,OSMITROL 20 % INTRAVENOUS SOLUTION,0.78,0.51,0.13,4.07,24
NDC,0338035703,OSMITROL 20 % INTRAVENOUS SOLUTION,0.45,0.29,0.08,4.07,24
NDC,0338040903,LIDOCAINE (PF) 4 MG/ML (0.4 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,24
NDC,0338041102,LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,23
NDC,0338042418,HEPARIN (PORCINE) (PF) 1000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.49,31
NDC,0338043103,HEPARIN (PORCINE) (PF) 1000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.49,31
NDC,0338043304,HEPARIN (PORCINE) (PF) 2000 UNIT/1000 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.49,31
NDC,0338049906,PROSOL 20 % INTRAVENOUS SOLUTION,0.3,0.2,0.05,0.3,22
NDC,0338050206,CLINISOL SF 15 % INTRAVENOUS SOLUTION,0.24,0.16,0.04,0.24,22
NDC,0338050348,GENTAMICIN 80 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,6.0,31
NDC,0338050548,GENTAMICIN 100 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,6.0,31
NDC,0338050741,GENTAMICIN 60 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.27,0.18,0.05,6.0,31
NDC,0338050748,GENTAMICIN 120 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,6.0,31
NDC,0338050941,GENTAMICIN 80 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,6.0,31
NDC,0338051141,GENTAMICIN 100 MG/50 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,6.0,31
NDC,0338055111,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.48,0.31,0.08,0.48,22
NDC,0338055118,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.27,0.18,0.05,0.27,22
NDC,0338055311,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.51,0.33,0.09,0.51,22
NDC,0338055318,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.27,0.18,0.05,0.27,22
NDC,0338064404,TRAVASOL 10 % INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,22
NDC,0338064406,TRAVASOL 10 % INTRAVENOUS SOLUTION,0.09,0.06,0.02,0.09,22
NDC,0338065604,ACETIC ACID 0.25 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338066304,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,22
NDC,0338066904,POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,22
NDC,0338067104,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,22
NDC,0338067304,POTASSIUM CHLORIDE 30 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,22
NDC,0338067504,POTASSIUM CHLORIDE 40 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,22
NDC,0338068304,POTASSIUM CHLORIDE 20 MEQ/L IN 5 % DEXTROSE INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.33,31
NDC,0338069104,SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,0.03,0.02,0.01,0.33,31
NDC,0338069504,SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,0.03,0.02,0.01,0.33,31
NDC,0338070341,POTASSIUM CHLORIDE 20 MEQ/50 ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.27,0.18,0.05,0.33,31
NDC,0338070348,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,0.33,31
NDC,0338070434,SODIUM CHLORIDE 0.45 % WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,0.03,0.02,0.01,0.33,31
NDC,0338070541,POTASSIUM CHLORIDE 10 MEQ/50 ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.27,0.18,0.05,0.33,31
NDC,0338070548,POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,0.33,31
NDC,0338070948,POTASSIUM CHLORIDE 10 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,0.33,31
NDC,0338071224,DAPTOMYCIN 350 MG/50 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,2.37,1.54,0.06,2.37,31
NDC,0338071424,DAPTOMYCIN 500 MG/50 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,2.82,1.83,0.06,2.82,31
NDC,0338071612,DAPTOMYCIN 700 MG/100 ML IN 0.9 % SODIUM CHLOR INTRAVENOUS PIGGYBACK,2.04,1.33,0.06,2.04,31
NDC,0338071812,DAPTOMYCIN 1000 MG/100 ML IN 0.9 % SODIUM CHLOR INTRAVENOUS PIGGYBACK,2.37,1.54,0.06,2.37,31
NDC,0338071906,DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0338080304,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,0.33,31
NDC,0338080704,POTASSIUM CHLORIDE 40 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,0.03,22
NDC,0338081104,POTASSIUM CHLORIDE 20 MEQ/L-LACTATED RINGERS-5 % DEXTROSE INTRAVENOUS,0.03,0.02,0.01,6.6,31
NDC,0338100702,DOPAMINE 400 MG/250 ML (1600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,0.21,0.14,0.04,2.22,31
NDC,0338100902,DOPAMINE 800 MG/250 ML (3200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,0.3,0.2,0.05,2.22,31
NDC,0338101541,OXACILLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,1.77,1.15,0.3,1.77,31
NDC,0338101948,NAFCILLIN 2 GRAM/100 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.87,0.57,0.15,0.87,30
NDC,0338102541,PENICILLIN G POT 3 MILLION UNIT/50 ML-DEXTROSE INTRAVENOUS PIGGYBACK,0.78,0.51,0.13,2.16,31
NDC,0338104702,NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE  INTRAVENOUS,0.3,0.2,0.05,4.22,31
NDC,0338104902,NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,0.33,0.21,0.06,4.22,31
NDC,0338105102,NITROGLYCERIN IN D5W 100 MG/250 ML IV,0.36,0.23,0.06,0.36,22
NDC,0338105548,METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,0.09,0.06,0.02,0.09,22
NDC,0338107302,DOBUTAMINE 250 MG/250 ML (1 MG/ML) IN 5 % DEXTROSE INTRAVENOUS,0.33,0.21,0.06,22.19,31
NDC,0338107502,DOBUTAMINE 500 MG/250 ML (2000 MCG/ML) IN 5 % DEXTROSE IV,0.57,0.37,0.1,22.19,31
NDC,0338107702,DOBUTAMINE 1000 MG/250 ML(4000 MCG/ML) IN 5 % DEXTROSE IV,0.42,0.27,0.07,22.19,31
NDC,0338108904,CLINIMIX 4.25 % IN 5 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338109104,CLINIMIX 4.25 % IN 10 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338109904,CLINIMIX 5 % IN 15 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338110104,CLINIMIX 5 % IN 20 % DEXTROSE (SULFITE-FREE) INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338112304,CLINIMIX E 5 % IN 15 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338112504,CLINIMIX E 5 % IN 20 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338113003,PREMASOL 10 % INTRAVENOUS SOLUTION,0.39,0.25,0.07,0.39,22
NDC,0338113303,CLINIMIX 4.25 % IN 5 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338113403,CLINIMIX 4.25 % IN 10 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338113703,CLINIMIX 5 % IN 15 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338114403,CLINIMIX E 4.25 % IN 5 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338114703,CLINIMIX E 5 % IN 15 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338114803,CLINIMIX E 5 % IN 20 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338130501,MESNEX 100 MG/ML INTRAVENOUS SOLUTION,12.0,7.8,1.58,12.0,30
NDC,0338170840,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.9,0.59,0.15,1.12,31
NDC,0338170940,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.24,0.16,0.04,1.12,31
NDC,0338171540,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.24,0.16,0.04,1.12,31
NDC,0338171940,MAGNESIUM SULFATE 4 GRAM/50 ML (8 %) IN WATER INTRAVENOUS PIGGYBACK,0.45,0.29,0.08,1.12,31
NDC,0338341024,CLINDAMYCIN 300 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.51,0.33,0.09,6.49,31
NDC,0338350341,CEFAZOLIN 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.39,0.25,0.07,2.3,31
NDC,0338350841,CEFAZOLIN 2 GRAM/100 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.33,0.21,0.06,3.51,31
NDC,0338355148,VANCOMYCIN 500 MG/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.27,0.18,0.05,0.27,30
NDC,0338355248,VANCOMYCIN 1 GRAM/200 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.48,0.31,0.06,0.48,30
NDC,0338358048,VANCOMYCIN 750 MG/150 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,0.3,30
NDC,0338358201,VANCOMYCIN 750 MG/150 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,0.3,30
NDC,0338361224,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.78,0.51,0.13,5.29,31
NDC,0338381424,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.93,0.6,0.16,6.49,31
NDC,0338430102,TISSEEL VHSD (WITH APROTININ SYNTHETIC) 2 ML TOPICAL KIT,445.7,289.71,74.88,445.7,22
NDC,0338430204,TISSEEL VHSD (WITH APROTININ SYNTHETIC) 4 ML TOPICAL KIT,765.34,497.47,128.58,765.34,22
NDC,0338430310,TISSEEL VHSD (WITH APROTININ SYNTHETIC) 10 ML TOPICAL KIT,1857.92,1207.65,312.13,1857.92,22
NDC,0338500241,CEFTRIAXONE 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOT) INTRAVENOUS PIGGYBACK,1.02,0.66,0.17,1.29,31
NDC,0338500341,CEFTRIAXONE 2 GRAM/50 ML IN DEXTROSE (ISO-OSM) INTRAVENOUS PIGGYBACK,2.43,1.58,0.41,2.43,31
NDC,0338519741,FAMOTIDINE (PF) 20 MG/50 ML IN 0.9 % NACL (ISO) INTRAVENOUS PIGGYBACK,0.39,0.25,0.02,0.39,30
NDC,0338604537,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.39,0.25,0.07,12.38,31
NDC,0338604648,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,0.66,0.43,0.11,12.38,31
NDC,0338700304,CLINIMIX 4.25 % IN 5 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338701104,CLINIMIX 5 % IN 15 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338701504,CLINIMIX 5 % IN 20 % DEXTROSE (SULFITE-FREE) INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338702404,CLINIMIX E 4.25 % IN 5 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338702804,CLINIMIX E 4.25 % IN 10 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338703204,CLINIMIX E 5 % IN 15 % DEXTROSE SULFITE FREE INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0338850304,ARTISS 2.5 UNIT TO 6.5 UNIT/ML (4ML) TOPICAL SYRINGE,246.5,160.23,63.84,298.84,33
NDC,0338915130,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.51,0.33,0.09,0.51,22
NDC,0338915930,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.27,0.18,0.05,0.27,22
NDC,0338954005,FAT EMULSION-OLIVE OIL-SOYBEAN OIL-EGG PHOSPHOLIPID 20 % INTRAVENOUS,1.23,0.8,0.21,1.23,22
NDC,0338954006,FAT EMULSION-OLIVE OIL-SOYBEAN OIL-EGG PHOSPHOLIPID 20 % INTRAVENOUS,0.69,0.45,0.12,0.69,22
NDC,0338954007,FAT EMULSION-OLIVE OIL-SOYBEAN OIL-EGG PHOSPHOLIPID 20 % INTRAVENOUS,0.3,0.2,0.05,0.3,22
NDC,0338954301,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.09,0.06,0.02,1.84,31
NDC,0338954302,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.09,0.06,0.02,1.84,31
NDC,0338954303,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.56,31
NDC,0338954304,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.56,31
NDC,0338954305,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,5.51,31
NDC,0338954306,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,5.51,31
NDC,0338954924,CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,0.78,0.51,0.13,0.78,22
NDC,0338955524,DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,1.05,0.68,0.18,1.05,22
NDC,0338955712,DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,0.72,0.47,0.12,0.72,22
NDC,0338956001,TISSEEL VHSD (WITH APROTININ SYNTHETIC) 2 ML TOPICAL SYRINGE,207.68,134.99,34.89,207.68,23
NDC,0338963224,ZOSYN 2.25 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,1.11,0.72,0.19,3.01,31
NDC,0338963624,ZOSYN 3.375 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,1.47,0.96,0.25,3.01,31
NDC,0338963812,ZOSYN 4.5 GRAM/100 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,0.93,0.6,0.16,3.01,31
NDC,0338964012,VASOPRESSIN 20 UNIT/100 ML (0.2 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV,2.7,1.76,0.45,2.7,22
NDC,0338964101,ARTISS 2.5 UNIT TO 6.5 UNIT/ML(10ML) TOPICAL SYRINGE,220.66,143.43,57.15,298.84,33
NDC,0362055705,MARCAINE-EPINEPHRINE 0.5 %-1:200000 INJECTION CARTRIDGE,4.56,2.96,0.77,4.56,22
NDC,0362075305,CARBOCAINE 30 MG/ML (3 %) INJECTION DENTAL CARTRIDGE,2.13,1.38,0.36,2.13,22
NDC,0362089805,LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.84,0.55,0.14,0.84,22
NDC,0362901150,VIVACAINE 0.5 %-1:200000 INJECTION CARTRIDGE,2.01,1.31,0.34,2.01,22
NDC,0363016406,ORAL RELIEF SORE THROAT SPRAY 1.4 % AEROSOL,0.06,0.04,0.01,0.06,22
NDC,0363064526,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,0.13,0.08,0.02,0.13,22
NDC,0378001401,METHOTREXATE SODIUM 2.5 MG TABLET,12.48,8.11,0.16,12.48,30
NDC,0378002305,DILTIAZEM 30 MG TABLET,1.96,1.27,0.33,1.96,22
NDC,0378005301,CIMETIDINE 200 MG TABLET,3.1,2.02,0.52,3.1,22
NDC,0378007801,CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,1.54,1.0,0.26,1.54,22
NDC,0378008101,CAPTOPRIL 25 MG-HYDROCHLOROTHIAZIDE 15 MG TABLET,5.7,3.71,0.96,5.7,22
NDC,0378015601,PROBENECID 500 MG TABLET,2.3,1.5,0.39,2.3,22
NDC,0378018101,ALLOPURINOL 300 MG TABLET,1.84,1.2,0.31,1.84,22
NDC,0378021101,AMITRIPTYLINE-CHLORDIAZEPOXIDE 12.5 MG-5 MG TABLET,3.06,1.99,0.51,3.06,22
NDC,0378021301,CHLORTHALIDONE 50 MG TABLET,2.98,1.94,0.5,2.98,22
NDC,0378021401,HALOPERIDOL 2 MG TABLET,1.26,0.82,0.21,1.26,22
NDC,0378021801,ATENOLOL 25 MG TABLET,1.64,1.07,0.28,1.64,22
NDC,0378022101,TIMOLOL 10 MG TABLET,3.4,2.21,0.57,3.4,22
NDC,0378022201,CHLORTHALIDONE 25 MG TABLET,2.42,1.57,0.41,2.42,22
NDC,0378023101,ATENOLOL 50 MG TABLET,1.7,1.11,0.29,1.7,22
NDC,0378023205,FUROSEMIDE 80 MG TABLET,0.94,0.61,0.16,0.94,22
NDC,0378025701,HALOPERIDOL 1 MG TABLET,0.92,0.6,0.15,0.92,22
NDC,0378033001,PERPHENAZINE-AMITRIPTYLINE 2 MG-10 MG TABLET,3.08,2.0,0.52,3.08,22
NDC,0378035101,HALOPERIDOL 0.5 MG TABLET,0.66,0.43,0.11,0.66,22
NDC,0378044201,PERPHENAZINE-AMITRIPTYLINE 2 MG-25 MG TABLET,3.92,2.55,0.66,3.92,22
NDC,0378057401,PERPHENAZINE-AMITRIPTYLINE 4 MG-25 MG TABLET,4.26,2.77,0.72,4.26,22
NDC,0378057701,AMILORIDE 5 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,2.32,1.51,0.39,2.32,22
NDC,0378061101,METHYLDOPA 250 MG TABLET,0.84,0.55,0.14,0.84,22
NDC,0378061401,THIORIDAZINE 25 MG TABLET,1.68,1.09,0.28,1.68,22
NDC,0378061601,THIORIDAZINE 50 MG TABLET,2.1,1.37,0.35,2.1,22
NDC,0378061801,THIORIDAZINE 100 MG TABLET,2.38,1.55,0.4,2.38,22
NDC,0378075701,ATENOLOL 100 MG TABLET,2.44,1.59,0.41,2.44,22
NDC,0378082501,CLOZAPINE 25 MG TABLET,2.64,1.72,0.44,2.64,22
NDC,0378086001,CLOZAPINE 100 MG TABLET,6.84,4.45,1.15,6.84,22
NDC,0378087116,CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,66.24,43.06,11.13,66.24,22
NDC,0378087216,CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,111.54,72.5,18.74,111.54,22
NDC,0378087316,CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,154.72,100.57,25.99,154.72,22
NDC,0378102077,NICARDIPINE 20 MG CAPSULE,4.46,2.9,0.75,4.46,22
NDC,0378104901,DOXEPIN 10 MG CAPSULE,1.26,0.82,0.21,1.26,22
NDC,0378110101,PRAZOSIN 1 MG CAPSULE,1.8,1.17,0.3,1.8,22
NDC,0378113401,KETOROLAC 10 MG TABLET,4.54,2.95,0.76,4.54,22
NDC,0378119001,GUANFACINE 2 MG TABLET,2.36,1.53,0.4,2.36,22
NDC,0378143077,NICARDIPINE 30 MG CAPSULE,6.38,4.15,1.07,6.38,22
NDC,0378145401,ESTRADIOL 1 MG TABLET,0.76,0.49,0.13,0.76,22
NDC,0378181777,LEVOTHYROXINE 175 MCG TABLET,1.62,1.05,0.27,1.62,22
NDC,0378204501,TACROLIMUS 0.5 MG CAPSULE IMMEDIATE-RELEASE,4.46,2.9,0.24,4.46,31
NDC,0378204601,TACROLIMUS 1 MG CAPSULE IMMEDIATE-RELEASE,8.92,5.8,0.24,8.92,31
NDC,0378204701,TACROLIMUS 5 MG CAPSULE IMMEDIATE-RELEASE,44.6,28.99,0.24,44.6,31
NDC,0378206301,ATENOLOL 50 MG-CHLORTHALIDONE 25 MG TABLET,3.76,2.44,0.63,3.76,22
NDC,0378210001,LOPERAMIDE 2 MG CAPSULE,2.1,1.37,0.35,2.1,22
NDC,0378210005,LOPERAMIDE 2 MG CAPSULE,2.1,1.37,0.35,2.1,22
NDC,0378215001,MECLOFENAMATE 50 MG CAPSULE,8.34,5.42,1.4,8.34,22
NDC,0378240101,TRIFLUOPERAZINE 1 MG TABLET,1.76,1.14,0.3,1.76,22
NDC,0378240201,TRIFLUOPERAZINE 2 MG TABLET,2.58,1.68,0.43,2.58,22
NDC,0378240501,TRIFLUOPERAZINE 5 MG TABLET,3.24,2.11,0.54,3.24,22
NDC,0378241001,TRIFLUOPERAZINE 10 MG TABLET,4.9,3.19,0.82,4.9,22
NDC,0378306577,FENOFIBRATE NANOCRYSTALLIZED 48 MG TABLET,3.82,2.48,0.64,3.82,22
NDC,0378312501,DOXEPIN 25 MG CAPSULE,1.64,1.07,0.28,1.64,22
NDC,0378320501,PRAZOSIN 5 MG CAPSULE,4.36,2.83,0.73,4.36,22
NDC,0378322493,CANDESARTAN 4 MG TABLET,6.12,3.98,1.03,6.12,22
NDC,0378322593,CANDESARTAN 8 MG TABLET,6.12,3.98,1.03,6.12,22
NDC,0378323177,CANDESARTAN 16 MG TABLET,6.12,3.98,1.03,6.12,22
NDC,0378323277,CANDESARTAN 32 MG TABLET,8.34,5.42,1.4,8.34,22
NDC,0378326694,ETOPOSIDE 50 MG CAPSULE,207.72,135.02,22.35,240.19,39
NDC,0378334999,ESTRADIOL 0.025 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,7.8,46.42,22
NDC,0378335016,ESTRADIOL 0.05 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,7.8,46.42,22
NDC,0378335099,ESTRADIOL 0.05 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,7.8,46.42,22
NDC,0378335199,ESTRADIOL 0.075 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,7.8,46.42,22
NDC,0378335299,ESTRADIOL 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,7.8,46.42,22
NDC,0378336099,ESTRADIOL 0.0375 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,7.8,46.42,22
NDC,0378336199,ESTRADIOL 0.06 MG/24 HR WEEKLY TRANSDERMAL PATCH,46.42,30.17,7.8,46.42,22
NDC,0378363501,CETIRIZINE 5 MG TABLET,4.98,3.24,0.84,4.98,22
NDC,0378363701,CETIRIZINE 10 MG TABLET,4.98,3.24,0.84,4.98,22
NDC,0378395305,ATORVASTATIN 80 MG TABLET,11.54,7.5,1.94,11.54,22
NDC,0378404277,LOSARTAN 50 MG TABLET,4.84,3.15,0.81,4.84,22
NDC,0378405091,NEVIRAPINE 200 MG TABLET,21.66,14.08,3.64,21.66,22
NDC,0378412201,ALBUTEROL SULFATE ER 4 MG TABLETEXTENDED RELEASE12 HR,3.56,2.31,0.6,3.56,22
NDC,0378425001,DOXEPIN 50 MG CAPSULE,2.36,1.53,0.4,2.36,22
NDC,0378427193,AMBRISENTAN 10 MG TABLET,698.2,453.83,117.3,698.2,22
NDC,0378456077,POTASSIUM CHLORIDE ER 8 MEQ TABLETEXTENDED RELEASE,1.08,0.7,0.18,1.08,22
NDC,0378464126,ESTRADIOL 0.075 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,22.7,14.76,3.81,22.7,22
NDC,0378464426,ESTRADIOL 0.025 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,22.66,14.73,3.81,22.66,22
NDC,0378537501,DOXEPIN 75 MG CAPSULE,3.62,2.35,0.61,3.62,22
NDC,0378563159,SUMATRIPTAN 50 MG TABLET,50.28,32.68,8.45,50.28,22
NDC,0378563259,SUMATRIPTAN 100 MG TABLET,50.28,32.68,8.45,50.28,22
NDC,0378606001,DILTIAZEM ER 60 MG CAPSULEEXTENDED RELEASE 12 HR,6.34,4.12,1.07,6.34,22
NDC,0378609001,DILTIAZEM ER 90 MG CAPSULEEXTENDED RELEASE 12 HR,7.26,4.72,1.22,7.26,22
NDC,0378612001,DILTIAZEM ER 120 MG CAPSULEEXTENDED RELEASE 12 HR,9.46,6.15,1.59,9.46,22
NDC,0378617201,METOLAZONE 2.5 MG TABLET,5.16,3.35,0.87,5.16,22
NDC,0378617301,METOLAZONE 5 MG TABLET,5.86,3.81,0.98,5.86,22
NDC,0378638001,VERAPAMIL ER 180 MG 24 HR CAPSULEEXTENDED RELEASE,4.06,2.64,0.68,4.06,22
NDC,0378668877,PANTOPRAZOLE 20 MG TABLETDELAYED RELEASE,10.54,6.85,1.77,10.54,22
NDC,0378668910,PANTOPRAZOLE 40 MG TABLETDELAYED RELEASE,10.54,6.85,1.77,10.54,22
NDC,0378696093,GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRINGE,649.23,422.0,61.99,649.23,36
NDC,0378696112,GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRINGE,1572.9,1022.39,61.99,1572.9,36
NDC,0378698188,LANSOPRAZOLE 15 MG DELAYED RELEASEDISINTEGRATING TABLET,31.54,20.5,5.3,31.54,22
NDC,0378698789,SODIUM CHLORIDE 0.9 % FOR NEBULIZATION,0.12,0.08,0.02,0.12,22
NDC,0378699789,SODIUM CHLORIDE 3 % FOR NEBULIZATION,0.12,0.08,0.02,0.12,22
NDC,0378699889,SODIUM CHLORIDE 10 % FOR NEBULIZATION,0.12,0.08,0.02,0.12,22
NDC,0378715501,BUDESONIDE DR - ER 3 MG CAPSULEDELAYEDEXTENDED RELEASE,37.7,24.51,6.33,37.7,22
NDC,0378729353,NORGESTIMATE-ETHINYL ESTRADIOL 0.18MG/0.215MG/0.25MG-0.035MG(28)TABLET,2.8,1.82,0.47,2.8,22
NDC,0378730653,ETHYNODIOL DIACETATE-ETHINYL ESTRADIOL 1 MG-50 MCG TABLET,2.14,1.39,0.36,2.14,22
NDC,0378730753,ETHYNODIOL DIACETATE-ETHINYL ESTRADIOL 1 MG-35 MCG TABLET,2.14,1.39,0.36,2.14,22
NDC,0378730785,ETHYNODIOL DIACETATE-ETHINYL ESTRADIOL 1 MG-35 MCG TABLET,2.14,1.39,0.36,2.14,22
NDC,0378802093,FLUVASTATIN 20 MG CAPSULE,10.02,6.51,1.68,10.02,22
NDC,0378802193,FLUVASTATIN 40 MG CAPSULE,10.02,6.51,1.68,10.02,22
NDC,0378803093,LANSOPRAZOLE 30 MG CAPSULEDELAYED RELEASE,11.8,7.67,1.98,11.8,22
NDC,0378808515,TRETINOIN 0.01 % TOPICAL GEL,13.5,8.78,2.27,13.5,22
NDC,0378808615,TRETINOIN 0.025 % TOPICAL GEL,13.62,8.85,2.29,13.62,22
NDC,0378876793,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,18.46,12.0,3.1,20.41,22
NDC,0378908001,ENTACAPONE 200 MG TABLET,7.92,5.15,1.33,7.92,22
NDC,0378910216,NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,3.72,2.42,0.62,3.72,22
NDC,0378910293,NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,3.72,2.42,0.62,3.72,22
NDC,0378910493,NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,3.8,2.47,0.64,3.8,22
NDC,0378911293,NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,4.34,2.82,0.73,4.34,22
NDC,0378911616,NITROGLYCERIN 0.6 MG/HR TRANSDERMAL 24 HOUR PATCH,4.8,3.12,0.81,4.8,22
NDC,0378911693,NITROGLYCERIN 0.6 MG/HR TRANSDERMAL 24 HOUR PATCH,4.8,3.12,0.81,4.8,22
NDC,0378911998,FENTANYL 12 MCG/HR TRANSDERMAL PATCH,40.6,26.39,6.82,40.6,22
NDC,0378912198,FENTANYL 25 MCG/HR TRANSDERMAL PATCH,28.84,18.75,4.85,28.84,22
NDC,0378912398,FENTANYL 75 MCG/HR TRANSDERMAL PATCH,80.42,52.27,13.51,80.42,22
NDC,0378912498,FENTANYL 100 MCG/HR TRANSDERMAL PATCH,106.72,69.37,17.93,106.72,22
NDC,0386000102,ETHYL CHLORIDE 100 % TOPICAL SPRAY,0.72,0.47,0.12,0.72,22
NDC,0386000103,ETHYL CHLORIDE 100 % TOPICAL SPRAY,0.8,0.52,0.13,0.8,22
NDC,0386000104,ETHYL CHLORIDE 100 % TOPICAL SPRAY,0.86,0.56,0.14,0.86,22
NDC,0386000111,ETHYL CHLORIDE 100 % TOPICAL SPRAY,0.7,0.46,0.12,0.7,22
NDC,0386000802,PAIN EASE MIST SPRAY TOPICAL,0.74,0.48,0.12,0.74,22
NDC,0386000803,PAIN EASE MEDIUM STREAM SPRAY TOPICAL,0.72,0.47,0.12,0.72,22
NDC,0386000804,PAIN EASE MEDIUM STREAM SPRAY TOPICAL,1.08,0.7,0.18,1.08,22
NDC,0395004912,ALUM AMMONIUM (BULK) POWDER,0.12,0.08,0.02,0.12,22
NDC,0395009416,FLAVOR SWEET-SF ORAL LIQUID,0.08,0.05,0.01,0.08,22
NDC,0395024392,BENZOIN COMPOUND 10 %-2 %-8 %-4 % TOPICAL TINCTURE,0.36,0.23,0.06,0.36,22
NDC,0395024792,BENZOIN (BULK) TOPICAL TINCTURE,0.42,0.27,0.07,0.42,22
NDC,0395051592,CASTOR OIL 100 % ORAL,0.2,0.13,0.03,0.2,22
NDC,0395080716,EPSOM SALT 100 % CRYSTALS,0.01,0.01,0.01,0.01,22
NDC,0395100392,GENTIAN VIOLET 1 % TOPICAL SOLUTION,0.28,0.18,0.05,0.28,22
NDC,0395100592,GENTIAN VIOLET 2 % TOPICAL SOLUTION,0.54,0.35,0.09,0.54,22
NDC,0395103116,GLYCERIN 99.5 % TOPICAL SOLUTION,0.15,0.1,0.03,0.15,22
NDC,0395104916,GREEN SOAP TOPICAL TINCTURE,0.06,0.04,0.01,0.06,22
NDC,0395124928,ISOPROPYL ALCOHOL 70 % SOLUTION,0.02,0.01,0.01,0.02,22
NDC,0395166792,METHYL SALICYLATE TOPICAL LIQUID,0.32,0.21,0.05,0.32,22
NDC,0395194991,CLOVE OIL (BULK),0.91,0.59,0.15,0.91,22
NDC,0395199794,OLIVE OIL,0.2,0.13,0.03,0.2,22
NDC,0395201591,PEPPERMINT OIL,1.8,1.17,0.3,1.8,22
NDC,0395206394,SWEET OIL,0.12,0.08,0.02,0.12,22
NDC,0395224391,PEPPERMINT SPIRIT ORAL,0.85,0.55,0.14,0.85,22
NDC,0395232598,POVIDONE-IODINE 10 % TOPICAL SOLUTION,0.04,0.03,0.01,0.04,22
NDC,0395266116,SIMPLE SYRUP,0.1,0.07,0.02,0.1,22
NDC,0395266216,CHERRY FLAVOR (BULK) ORAL SYRUP,0.1,0.07,0.02,0.1,22
NDC,0395268594,SODIUM BICARBONATE (BULK) POWDER,0.07,0.05,0.01,0.07,22
NDC,0395392016,SYRPALTA VEHICLE ORAL SYRUP,0.13,0.08,0.02,0.13,22
NDC,0404001835,BENZOCAINE 20% TOPICAL SPRAY,1.48,0.96,0.25,1.33,21
NDC,0404040047,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT IN PACKET,0.44,0.29,0.07,0.44,22
NDC,0404651205,LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100000 INJECTION CARTRIDGE,1.29,0.84,0.22,1.29,22
NDC,0406012301,HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,1.38,0.9,0.23,1.38,22
NDC,0406012362,HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,2.22,1.44,0.37,2.22,22
NDC,0406012462,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET,2.46,1.6,0.41,2.46,22
NDC,0406012562,HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,3.36,2.18,0.56,3.36,22
NDC,0406030412,BISMUTH SUBGALLATE (BULK) POWDER,0.42,0.27,0.07,0.42,22
NDC,0406048301,ACETAMINOPHEN 300 MG-CODEINE 15 MG TABLET,1.54,1.0,0.26,1.54,22
NDC,0406048462,ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET,2.54,1.65,0.43,2.54,22
NDC,0406051262,OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,3.8,2.47,0.64,3.8,22
NDC,0406052201,OXYCODONE-ACETAMINOPHEN 7.5 MG-325 MG TABLET,5.44,3.54,0.91,5.44,22
NDC,0406052362,OXYCODONE-ACETAMINOPHEN 10 MG-325 MG TABLET,9.88,6.42,1.66,9.88,22
NDC,0406052710,METHADOSE 10 MG/ML ORAL CONCENTRATE,0.17,0.11,0.03,0.17,22
NDC,0406055201,OXYCODONE 5 MG TABLET,1.08,0.7,0.18,1.08,22
NDC,0406055262,OXYCODONE 5 MG TABLET,1.18,0.77,0.2,1.18,22
NDC,0406113052,FENTANYL CITRATE (BULK) 100 % POWDER,4999.98,3249.99,840.0,4999.98,22
NDC,0406114201,METHYLPHENIDATE 5 MG TABLET,1.46,0.95,0.25,1.46,22
NDC,0406114401,METHYLPHENIDATE 10 MG TABLET,2.08,1.35,0.35,2.08,22
NDC,0406114601,METHYLPHENIDATE 20 MG TABLET,3.0,1.95,0.5,3.0,22
NDC,0406117003,NALTREXONE 50 MG TABLET,11.04,7.18,1.85,11.04,22
NDC,0406123601,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,1.4,0.91,0.24,1.4,22
NDC,0406147301,METHYLPHENIDATE ER 20 MG TABLETEXTENDED RELEASE,15.5,10.08,2.6,15.5,22
NDC,0406152153,MORPHINE (BULK) 100 % POWDER,36.9,23.99,6.2,36.9,22
NDC,0406154832,CODEINE PHOSPHATE (BULK) 100 % POWDER,24.75,16.09,4.16,24.75,22
NDC,0406182001,METHYLPHENIDATE CD 20 MG BIPHASIC 30-70 CAPSULEEXTENDED RELEASE,16.84,10.95,2.83,16.84,22
NDC,0406222401,LEVORPHANOL TARTRATE 2 MG TABLET,106.8,69.42,17.94,106.8,22
NDC,0406322257,HYDROMORPHONE (BULK) 100 % POWDER,498.75,324.19,83.79,498.75,22
NDC,0406324301,HYDROMORPHONE 2 MG TABLET,1.24,0.81,0.21,1.24,22
NDC,0406324401,HYDROMORPHONE 4 MG TABLET,1.78,1.16,0.3,1.78,22
NDC,0406324901,HYDROMORPHONE 8 MG TABLET,3.58,2.33,0.6,3.58,22
NDC,0406511101,LISDEXAMFETAMINE 10 MG CAPSULE,23.08,15.0,3.88,23.08,22
NDC,0406511201,LISDEXAMFETAMINE 20 MG CAPSULE,23.08,15.0,3.88,23.08,22
NDC,0406511301,LISDEXAMFETAMINE 30 MG CAPSULE,23.08,15.0,3.88,23.08,22
NDC,0406511401,LISDEXAMFETAMINE 40 MG CAPSULE,23.08,15.0,3.88,23.08,22
NDC,0406511501,LISDEXAMFETAMINE 50 MG CAPSULE,23.08,15.0,3.88,23.08,22
NDC,0406511601,LISDEXAMFETAMINE 60 MG CAPSULE,23.08,15.0,3.88,23.08,22
NDC,0406511701,LISDEXAMFETAMINE 70 MG CAPSULE,23.08,15.0,3.88,23.08,22
NDC,0406575562,METHADONE 5 MG TABLET,1.18,0.77,0.2,1.18,22
NDC,0406800312,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,1.8,1.17,0.3,1.8,22
NDC,0406800330,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,1.13,0.73,0.19,1.13,22
NDC,0406831501,MORPHINE ER 15 MG TABLETEXTENDED RELEASE,3.36,2.18,0.56,3.36,22
NDC,0406831562,MORPHINE ER 15 MG TABLETEXTENDED RELEASE,4.08,2.65,0.69,4.08,22
NDC,0406833001,MORPHINE ER 30 MG TABLETEXTENDED RELEASE,6.34,4.12,1.07,6.34,22
NDC,0406833062,MORPHINE ER 30 MG TABLETEXTENDED RELEASE,7.36,4.78,1.24,7.36,22
NDC,0406838001,MORPHINE ER 60 MG TABLETEXTENDED RELEASE,12.42,8.07,2.09,12.42,22
NDC,0406838062,MORPHINE ER 60 MG TABLETEXTENDED RELEASE,11.6,7.54,1.95,11.6,22
NDC,0406839001,MORPHINE ER 100 MG TABLETEXTENDED RELEASE,18.4,11.96,3.09,18.4,22
NDC,0406839062,MORPHINE ER 100 MG TABLETEXTENDED RELEASE,18.18,11.82,3.05,18.18,22
NDC,0406851562,OXYCODONE 15 MG TABLET,5.16,3.35,0.87,5.16,22
NDC,0406853001,OXYCODONE 30 MG TABLET,7.18,4.67,1.21,7.18,22
NDC,0406880601,CLOMIPRAMINE 25 MG CAPSULE,22.48,14.61,3.78,22.48,22
NDC,0406880801,CLOMIPRAMINE 75 MG CAPSULE,22.48,14.61,3.78,22.48,22
NDC,0406888501,DEXTROAMPHETAMINE-AMPHETAMINE 15 MG TABLET,3.42,2.22,0.57,3.42,22
NDC,0406889101,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,3.42,2.22,0.57,3.42,22
NDC,0406889201,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,3.42,2.22,0.57,3.42,22
NDC,0406889301,DEXTROAMPHETAMINE-AMPHETAMINE 20 MG TABLET,3.42,2.22,0.57,3.42,22
NDC,0406895101,DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,2.06,12.26,22
NDC,0406895201,DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,2.06,12.26,22
NDC,0406895301,DEXTROAMPHETAMINE-AMPHETAMINE ER 15 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,2.06,12.26,22
NDC,0406895401,DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,2.06,12.26,22
NDC,0406895501,DEXTROAMPHETAMINE-AMPHETAMINE ER 25 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,2.06,12.26,22
NDC,0406895801,DEXTROAMPHETAMINE SULFATE 5 MG TABLET,5.8,3.77,0.97,5.8,22
NDC,0406896001,DEXTROAMPHETAMINE SULFATE ER 5 MG CAPSULEEXTENDED RELEASE,8.1,5.27,1.36,8.1,22
NDC,0406896101,DEXTROAMPHETAMINE SULFATE ER 10 MG CAPSULEEXTENDED RELEASE,10.12,6.58,1.7,10.12,22
NDC,0406896201,DEXTROAMPHETAMINE SULFATE ER 15 MG CAPSULEEXTENDED RELEASE,13.08,8.5,2.2,13.08,22
NDC,0406901276,FENTANYL 12 MCG/HR TRANSDERMAL PATCH,40.6,26.39,6.82,40.6,22
NDC,0406902576,FENTANYL 25 MCG/HR TRANSDERMAL PATCH,28.84,18.75,4.85,28.84,22
NDC,0406905076,FENTANYL 50 MCG/HR TRANSDERMAL PATCH,52.72,34.27,8.86,52.72,22
NDC,0406907576,FENTANYL 75 MCG/HR TRANSDERMAL PATCH,80.42,52.27,13.51,80.42,22
NDC,0406911276,FENTANYL 12 MCG/HR TRANSDERMAL PATCH,40.6,26.39,6.82,40.6,22
NDC,0406912576,FENTANYL 25 MCG/HR TRANSDERMAL PATCH,28.84,18.75,4.85,28.84,22
NDC,0406915076,FENTANYL 50 MCG/HR TRANSDERMAL PATCH,52.72,34.27,8.86,52.72,22
NDC,0406917576,FENTANYL 75 MCG/HR TRANSDERMAL PATCH,80.42,52.27,13.51,80.42,22
NDC,0406991501,RESTORIL 7.5 MG CAPSULE,74.74,48.58,12.56,74.74,22
NDC,0406996001,TEMAZEPAM 7.5 MG CAPSULE,19.88,12.92,3.34,19.88,22
NDC,0407069020,OMNISCAN 10 MMOL/20 ML (287 MG/ML) INTRAVENOUS SOLUTION,17.34,11.27,1.36,17.34,21
NDC,0407141110,OMNIPAQUE 180 MG IODINE/ML INTRATHECAL SOLUTION,17.34,11.27,0.91,17.34,21
NDC,0407141210,OMNIPAQUE 240 MG IODINE/ML INTRAVENOUS SOLUTION,18.84,12.25,0.35,18.84,21
NDC,0407141220,OMNIPAQUE 240 MG IODINE/ML INTRAVENOUS SOLUTION,9.96,6.47,0.35,9.96,21
NDC,0407141230,OMNIPAQUE 240 MG IODINE/ML INTRAVENOUS SOLUTION,0.97,0.63,0.16,0.97,21
NDC,0407141233,OMNIPAQUE 240 MG IODINE/ML INTRAVENOUS SOLUTION,2.79,1.81,0.35,2.79,21
NDC,0407141238,OMNIPAQUE 240 MG IODINE/ML INTRAVENOUS SOLUTION,0.8,0.52,0.13,0.8,21
NDC,0407141310,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,17.4,11.31,0.12,17.4,21
NDC,0407141359,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,5.13,3.33,0.12,5.13,21
NDC,0407141361,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.42,2.22,0.12,3.42,21
NDC,0407141363,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.36,2.18,0.12,3.36,21
NDC,0407141365,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.27,2.13,0.12,3.27,21
NDC,0407141372,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.06,1.99,0.12,3.06,21
NDC,0407141386,OMNIPAQUE 300 MG IODINE/ML INTRAVENOUS SOLUTION,3.33,2.16,0.12,3.33,21
NDC,0407141403,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.33,2.16,0.12,3.33,21
NDC,0407141448,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,2.88,1.87,0.12,2.88,21
NDC,0407141472,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.09,2.01,0.12,3.09,21
NDC,0407141476,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.12,2.03,0.12,3.12,21
NDC,0407141484,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.63,2.36,0.12,3.63,21
NDC,0407141489,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.75,2.44,0.12,3.75,21
NDC,0407141491,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.75,2.44,0.12,3.75,21
NDC,0407141493,OMNIPAQUE 350 MG IODINE/ML INTRAVENOUS SOLUTION,3.45,2.24,0.12,3.45,21
NDC,0407141509,OMNIPAQUE 9 MG IODINE/ML ORAL SOLUTION,0.02,0.01,0.01,0.02,23
NDC,0407141612,OMNIPAQUE 12  MG IODINE/ML ORAL SOLUTION,0.03,0.02,0.01,0.03,23
NDC,0407222216,VISIPAQUE 270 MG IODINE/ML INTRAVENOUS SOLUTION,3.99,2.59,0.35,3.99,21
NDC,0407222217,VISIPAQUE 270 MG IODINE/ML INTRAVENOUS SOLUTION,3.9,2.54,0.35,3.9,21
NDC,0407222219,VISIPAQUE 270 MG IODINE/ML INTRAVENOUS SOLUTION,3.78,2.46,0.35,3.78,21
NDC,0407222316,VISIPAQUE 320 MG IODINE/ML INTRAVENOUS SOLUTION,5.19,3.37,0.12,5.19,21
NDC,0407222317,VISIPAQUE 320 MG IODINE/ML INTRAVENOUS SOLUTION,4.32,2.81,0.12,4.32,21
NDC,0407222319,VISIPAQUE 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.99,2.59,0.12,3.99,21
NDC,0407222321,VISIPAQUE 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.69,2.4,0.12,3.69,21
NDC,0407270703,OPTISON 0.22 MG/ML INTRAVENOUS SUSPENSION,154.44,100.39,25.95,154.44,24
NDC,0407294301,CLARISCAN 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,18.0,11.7,0.12,18.0,21
NDC,0407294302,CLARISCAN 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,18.0,11.7,0.12,18.0,21
NDC,0407294305,CLARISCAN 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,18.0,11.7,0.12,18.0,21
NDC,0407294312,CLARISCAN 0.5 MMOL/ML INTRAVENOUS SYRINGE,19.8,12.87,0.12,19.8,21
NDC,0409000125,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,2.13,1.38,0.12,2.13,31
NDC,0409000710,LIDOCAINE 1 %-EPINEPHRINE 1:100000 INJECTION SOLUTION,1.02,0.66,0.03,1.02,23
NDC,0409012525,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,1.05,0.68,0.18,3.01,31
NDC,0409014710,LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100000 INJECTION SOLUTION,1.02,0.66,0.03,1.02,23
NDC,0409015201,METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,0.12,0.08,0.02,0.12,22
NDC,0409015224,METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,0.12,0.08,0.02,0.12,22
NDC,0409018101,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,8.28,5.38,1.39,9.95,30
NDC,0409018125,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,2.36,1.53,0.4,9.95,30
NDC,0409018225,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,2.6,1.69,0.44,9.95,30
NDC,0409018301,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,8.52,5.54,1.43,9.95,30
NDC,0409018325,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,4.24,2.76,0.71,9.95,30
NDC,0409018501,GEMCITABINE 200 MG INTRAVENOUS SOLUTION,53.36,34.68,3.29,53.36,30
NDC,0409018601,GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION,243.76,158.44,3.29,243.76,30
NDC,0409020102,DOCETAXEL 20 MG/2 ML (10 MG/ML) INTRAVENOUS SOLUTION,167.48,108.86,22.35,167.48,45
NDC,0409020110,DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,151.24,98.31,0.78,151.24,37
NDC,0409020120,DOCETAXEL 160 MG/16 ML (10 MG/ML) INTRAVENOUS SOLUTION,151.04,98.18,0.78,151.04,37
NDC,0409021201,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.58,1.68,0.43,3.73,31
NDC,0409021202,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.04,1.33,0.34,3.73,31
NDC,0409021210,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.58,1.68,0.43,3.73,31
NDC,0409021211,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.04,1.33,0.34,3.73,31
NDC,0409080101,NIPENT 10 MG INTRAVENOUS SOLUTION,14661.92,9530.25,746.88,14661.92,52
NDC,0409083011,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,241.02,156.66,2.32,241.02,31
NDC,0409104501,PEMETREXED DISODIUM 25 MG/ML INTRAVENOUS SOLUTION,99.0,64.35,0.62,943.43,46
NDC,0409110502,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,4.62,3.0,0.78,4.62,22
NDC,0409110522,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,4.62,3.0,0.78,4.62,22
NDC,0409110901,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,5.07,3.3,0.85,5.07,22
NDC,0409110911,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,5.07,3.3,0.85,5.07,22
NDC,0409111201,BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,189.68,123.29,0.89,189.68,46
NDC,0409114102,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,0.63,0.41,0.11,0.63,22
NDC,0409114402,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,29.1,18.92,4.89,29.1,22
NDC,0409114405,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,52.89,34.38,8.89,52.89,22
NDC,0409114410,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,52.89,34.38,8.89,52.89,22
NDC,0409115901,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.84,0.55,0.01,0.84,31
NDC,0409115902,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.3,0.2,0.01,0.3,31
NDC,0409116001,BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.27,0.18,0.01,0.27,31
NDC,0409116201,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,0.99,0.64,0.01,0.99,31
NDC,0409116202,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,0.33,0.21,0.01,0.33,31
NDC,0409116218,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,0.99,0.64,0.01,0.99,31
NDC,0409116301,BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,0.21,0.14,0.01,0.21,31
NDC,0409116501,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,1.05,0.68,0.01,1.05,31
NDC,0409116502,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,0.57,0.37,0.01,0.57,31
NDC,0409117630,DEMEROL (PF) 25 MG/ML INJECTION SYRINGE,79.2,51.48,6.21,79.2,31
NDC,0409117830,DEMEROL (PF) 50 MG/ML INJECTION SYRINGE,100.8,65.52,6.21,100.8,31
NDC,0409117903,DEMEROL (PF) 75 MG/ML INJECTION SYRINGE,23.04,14.98,3.87,23.04,31
NDC,0409117930,DEMEROL (PF) 75 MG/ML INJECTION SYRINGE,23.04,14.98,3.87,23.04,31
NDC,0409118130,DEMEROL 50 MG/ML INJECTION SOLUTION,78.66,51.13,6.21,78.66,31
NDC,0409120703,GENTAMICIN 40 MG/ML INJECTION SOLUTION,6.51,4.23,1.09,6.51,31
NDC,0409120901,LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200000 INJECTION SOLUTION,4.68,3.04,0.03,4.68,23
NDC,0409120910,LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200000 INJECTION SOLUTION,4.68,3.04,0.03,4.68,23
NDC,0409121501,NALOXONE 0.4 MG/ML INJECTION SOLUTION,57.0,37.05,0.13,57.0,30
NDC,0409121521,NALOXONE 0.4 MG/ML INJECTION SOLUTION,57.0,37.05,0.13,57.0,30
NDC,0409121901,NALOXONE 0.4 MG/ML INJECTION SOLUTION,42.75,27.79,0.13,42.75,30
NDC,0409127303,DIAZEPAM 5 MG/ML INJECTION SYRINGE,72.0,46.8,5.89,72.0,31
NDC,0409127332,DIAZEPAM 5 MG/ML INJECTION SYRINGE,72.0,46.8,5.89,72.0,31
NDC,0409128303,HYDROMORPHONE 1 MG/ML INJECTION SYRINGE,39.6,25.74,0.09,39.6,37
NDC,0409128331,HYDROMORPHONE 1 MG/ML INJECTION SYRINGE,39.6,25.74,0.09,39.6,37
NDC,0409128337,HYDROMORPHONE 1 MG/ML INJECTION SYRINGE,43.2,28.08,0.09,43.2,37
NDC,0409130431,HYDROMORPHONE 4 MG/ML INJECTION SYRINGE,54.0,35.1,0.09,54.0,37
NDC,0409131203,HYDROMORPHONE 2 MG/ML INJECTION SYRINGE,57.6,37.44,0.09,57.6,37
NDC,0409131230,HYDROMORPHONE 2 MG/ML INJECTION SYRINGE,57.6,37.44,0.09,57.6,37
NDC,0409131632,HEPARIN PORCINE (PF) 5000 UNIT/0.5 ML INJECTION SYRINGE,29.76,19.34,0.25,29.76,31
NDC,0409131901,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,782.04,508.33,0.04,782.04,30
NDC,0409132305,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,5.25,3.41,0.03,5.25,23
NDC,0409140101,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,126.12,81.98,5.09,126.12,31
NDC,0409140105,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,126.12,81.98,5.09,126.12,31
NDC,0409146301,NALBUPHINE 10 MG/ML INJECTION SOLUTION,22.29,14.49,2.54,22.29,31
NDC,0409146349,NALBUPHINE 10 MG/ML INJECTION SOLUTION,12.9,8.39,2.17,12.9,31
NDC,0409146371,NALBUPHINE 10 MG/ML INJECTION SOLUTION,22.29,14.49,2.54,22.29,31
NDC,0409146401,NALBUPHINE 10 MG/ML INJECTION SOLUTION,19.77,12.85,2.54,19.77,31
NDC,0409146461,NALBUPHINE 10 MG/ML INJECTION SOLUTION,19.77,12.85,2.54,19.77,31
NDC,0409146501,NALBUPHINE 20 MG/ML INJECTION SOLUTION,38.64,25.12,2.54,38.64,31
NDC,0409146701,NALBUPHINE 20 MG/ML INJECTION SOLUTION,29.37,19.09,2.54,29.37,31
NDC,0409155554,HEXTEND 6 % INTRAVENOUS SOLUTION,4.38,2.85,0.74,4.38,22
NDC,0409155930,MARCAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,0.6,0.39,0.01,0.6,31
NDC,0409156010,MARCAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,1.86,1.21,0.01,1.86,31
NDC,0409158210,MARCAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,1.89,1.23,0.01,1.89,31
NDC,0409159304,THAM 36 MG/ML (0.3 M) INTRAVENOUS SOLUTION,2.82,1.83,0.47,2.82,22
NDC,0409162301,BUTORPHANOL 1 MG/ML INJECTION SOLUTION,60.84,39.55,3.22,60.84,31
NDC,0409162601,BUTORPHANOL 2 MG/ML INJECTION SOLUTION,74.43,48.38,3.22,74.43,31
NDC,0409163010,ATROPINE 0.1 MG/ML INJECTION SYRINGE,3.69,2.4,0.06,3.69,31
NDC,0409163110,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,4.53,2.94,0.05,4.53,23
NDC,0409163802,PRECEDEX 100 MCG/ML INTRAVENOUS SOLUTION,10.8,7.02,1.81,10.8,22
NDC,0409166020,PRECEDEX 80 MCG/20 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV SOLUTION,4.77,3.1,0.8,4.77,22
NDC,0409166050,PRECEDEX 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV SOLUTION,2.01,1.31,0.34,2.01,22
NDC,0409174610,MARCAINE-EPINEPHRINE (PF) 0.25 %-1:200000 INJECTION SOLUTION,2.88,1.87,0.48,2.88,22
NDC,0409174630,MARCAINE-EPINEPHRINE (PF) 0.25 %-1:200000 INJECTION SOLUTION,1.53,0.99,0.26,1.53,22
NDC,0409174910,MARCAINE-EPINEPHRINE (PF) 0.5 %-1:200000 INJECTION SOLUTION,2.97,1.93,0.5,2.97,22
NDC,0409174929,MARCAINE-EPINEPHRINE (PF) 0.5 %-1:200000 INJECTION SOLUTION,1.65,1.07,0.28,1.65,22
NDC,0409175250,MARCAINE-EPINEPHRINE 0.25 %-1:200000 INJECTION SOLUTION,1.47,0.96,0.25,1.47,22
NDC,0409175550,MARCAINE-EPINEPHRINE 0.5 %-1:200000 INJECTION SOLUTION,1.56,1.01,0.26,1.56,22
NDC,0409176105,MARCAINE SPINAL (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,14.19,9.22,2.38,14.19,22
NDC,0409176110,MARCAINE SPINAL (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,14.19,9.22,2.38,14.19,22
NDC,0409176118,MARCAINE SPINAL (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,14.19,9.22,2.38,14.19,22
NDC,0409177510,DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,8.16,5.3,1.37,8.16,22
NDC,0409177805,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,1.05,0.68,0.18,1.05,30
NDC,0409178269,NALOXONE 0.4 MG/ML INJECTION SYRINGE,241.2,156.78,0.13,241.2,30
NDC,0409180501,HYDROMORPHONE 0.25 MG/0.5 ML INJECTION SYRINGE,115.2,74.88,0.09,115.2,37
NDC,0409188602,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,2.79,1.81,0.06,2.79,31
NDC,0409188622,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,2.79,1.81,0.06,2.79,31
NDC,0409189001,MORPHINE 2 MG/ML INTRAVENOUS SYRINGE,36.0,23.4,4.01,36.0,31
NDC,0409189023,MORPHINE 2 MG/ML INTRAVENOUS SYRINGE,20.55,13.36,3.45,20.55,31
NDC,0409189101,MORPHINE 4 MG/ML INTRAVENOUS SYRINGE,32.4,21.06,4.01,32.4,31
NDC,0409189323,MORPHINE 10 MG/ML INTRAVENOUS SYRINGE,100.8,65.52,4.01,100.8,31
NDC,0409189620,MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,15.66,10.18,2.63,15.66,31
NDC,0409190201,PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,147.54,95.9,38.21,1179.51,41
NDC,0409196602,SODIUM CHLORIDE 0.9 % BACTERIOSTATIC INJECTION SOLUTION,0.27,0.18,0.05,0.27,22
NDC,0409196607,SODIUM CHLORIDE 0.9 % BACTERIOSTATIC INJECTION SOLUTION,0.27,0.18,0.05,0.27,22
NDC,0409196612,SODIUM CHLORIDE 0.9 % BACTERIOSTATIC INJECTION SOLUTION,0.75,0.49,0.13,0.75,22
NDC,0409198503,LORAZEPAM 2 MG/ML INJECTION SYRINGE,57.6,37.44,0.87,57.6,31
NDC,0409198530,LORAZEPAM 2 MG/ML INJECTION SYRINGE,57.6,37.44,0.87,57.6,31
NDC,0409201105,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,0.99,0.64,0.06,0.99,31
NDC,0409201125,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,0.99,0.64,0.06,0.99,31
NDC,0409201232,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SYRINGE,115.2,74.88,3.54,115.2,31
NDC,0409205105,KETAMINE 100 MG/ML INJECTION SOLUTION,6.0,3.9,1.01,6.0,22
NDC,0409205310,KETAMINE 50 MG/ML INJECTION SOLUTION,1.32,0.86,0.22,1.32,22
NDC,0409206605,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,1.98,1.29,0.03,1.98,23
NDC,0409216877,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,1.8,1.17,0.3,1.8,31
NDC,0409218801,PEMETREXED DISODIUM 25 MG/ML INTRAVENOUS SOLUTION,89.61,58.25,0.62,943.43,46
NDC,0409222212,HEPARIN (PORCINE) (PF) 2000 UNIT/1000 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.49,31
NDC,0409226754,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,0.93,0.6,0.15,0.96,31
NDC,0409230024,CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.12,0.08,0.02,5.53,31
NDC,0409230504,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,0.99,0.64,0.12,0.99,31
NDC,0409230505,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,0.99,0.64,0.12,0.99,31
NDC,0409230550,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,0.63,0.41,0.11,0.63,31
NDC,0409230801,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,5.01,3.26,0.12,5.01,31
NDC,0409230802,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,2.43,1.58,0.12,2.43,31
NDC,0409230849,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,3.39,2.2,0.12,3.39,31
NDC,0409230869,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,3.39,2.2,0.12,3.39,31
NDC,0409233725,DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,146.61,95.3,8.12,146.61,31
NDC,0409233924,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,14.4,9.36,0.15,14.4,31
NDC,0409233934,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,14.4,9.36,0.15,14.4,31
NDC,0409234488,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,0.93,0.6,0.16,22.19,31
NDC,0409234632,DOBUTAMINE 250 MG/250 ML (1 MG/ML) IN 5 % DEXTROSE INTRAVENOUS,0.33,0.21,0.06,22.19,31
NDC,0409234732,DOBUTAMINE 500 MG/250 ML (2000 MCG/ML) IN 5 % DEXTROSE IV,0.57,0.37,0.1,22.19,31
NDC,0409258501,CEFAZOLIN 1 GRAM INTRAVENOUS SOLUTION,9.84,6.4,0.73,9.84,31
NDC,0409258705,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,0.81,0.53,0.12,0.81,31
NDC,0409259603,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,5.1,3.32,0.12,5.1,31
NDC,0409259605,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,2.7,1.76,0.12,2.7,31
NDC,0409263401,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,281.01,182.66,0.09,281.01,37
NDC,0409263405,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,16.35,10.63,0.09,16.35,37
NDC,0409263450,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,17.73,11.52,0.09,17.73,37
NDC,0409268901,AMPICILLIN-SULBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,19.38,12.6,1.91,19.38,31
NDC,0409268921,AMPICILLIN-SULBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,19.38,12.6,1.91,19.38,31
NDC,0409272001,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,6.69,4.35,0.25,6.69,31
NDC,0409272002,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,1.23,0.8,0.21,1.23,31
NDC,0409272003,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,0.93,0.6,0.16,0.93,31
NDC,0409272031,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,1.23,0.8,0.21,1.23,31
NDC,0409272101,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,11.85,7.7,0.25,11.85,31
NDC,0409272130,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,11.85,7.7,0.25,11.85,31
NDC,0409272301,HEPARIN (PORCINE) 5000 UNIT/ML INJECTION SOLUTION,7.62,4.95,0.25,7.62,31
NDC,0409272302,HEPARIN (PORCINE) 5000 UNIT/ML INJECTION SOLUTION,4.2,2.73,0.25,4.2,31
NDC,0409272330,HEPARIN (PORCINE) 5000 UNIT/ML INJECTION SOLUTION,7.62,4.95,0.25,7.62,31
NDC,0409298703,AMPICILLIN-SULBACTAM 3 GRAM INTRAVENOUS SOLUTION,33.24,21.61,1.91,33.24,31
NDC,0409317701,LIDOCAINE-EPINEPHRINE 0.5 %-1:200000 INJECTION SOLUTION,0.33,0.21,0.06,0.33,22
NDC,0409317802,LIDOCAINE 1 %-EPINEPHRINE 1:100000 INJECTION SOLUTION,1.86,1.21,0.03,1.86,23
NDC,0409317803,LIDOCAINE 1 %-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.93,0.6,0.03,0.93,23
NDC,0409317817,LIDOCAINE 1 %-EPINEPHRINE 1:100000 INJECTION SOLUTION,1.86,1.21,0.03,1.86,23
NDC,0409317818,LIDOCAINE 1 %-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.93,0.6,0.03,0.93,23
NDC,0409318101,LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200000 INJECTION SOLUTION,2.22,1.44,0.03,2.22,23
NDC,0409318202,LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.75,0.49,0.03,0.75,23
NDC,0409318203,LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.75,0.49,0.03,0.75,23
NDC,0409318221,LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100000 INJECTION SOLUTION,0.75,0.49,0.03,0.75,23
NDC,0409318301,LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200000 INJECTION SOLUTION,1.02,0.66,0.03,1.02,23
NDC,0409318910,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,2.67,1.74,0.45,2.67,22
NDC,0409321312,DIAZEPAM 5 MG/ML INJECTION SOLUTION,20.85,13.55,3.5,20.85,31
NDC,0409329425,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.78,0.51,0.13,0.78,22
NDC,0409329451,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.81,0.53,0.14,0.81,22
NDC,0409329461,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.81,0.53,0.14,0.81,22
NDC,0409329905,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.87,0.57,0.15,0.87,22
NDC,0409329906,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.33,0.21,0.06,0.33,22
NDC,0409329926,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.33,0.21,0.06,0.33,22
NDC,0409330703,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,2.43,1.58,0.41,2.43,22
NDC,0409330803,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,2.55,1.66,0.43,2.55,22
NDC,0409333024,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,5.97,31
NDC,0409336510,HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,72.75,47.29,0.09,72.75,37
NDC,0409337504,LEVOPHED 1 MG/ML INTRAVENOUS SOLUTION,20.22,13.14,3.4,20.22,22
NDC,0409338221,SUFENTANIL CITRATE 50 MCG/ML INTRAVENOUS SOLUTION,70.35,45.73,11.82,70.35,22
NDC,0409338513,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,37.65,24.47,0.95,37.65,31
NDC,0409341411,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,2.25,1.46,0.38,2.99,31
NDC,0409343524,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,0.81,0.53,0.14,12.38,31
NDC,0409351501,VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION,87.66,56.98,0.06,87.66,30
NDC,0409357801,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,5.37,3.49,0.9,5.73,31
NDC,0409357811,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,5.37,3.49,0.9,5.73,31
NDC,0409361301,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,6.15,4.0,1.03,6.15,22
NDC,0409372432,DOBUTAMINE 1000 MG/250 ML(4000 MCG/ML) IN 5 % DEXTROSE IV,0.42,0.27,0.07,22.19,31
NDC,0409379301,KETOROLAC 15 MG/ML INJECTION SOLUTION,10.83,7.04,0.34,10.83,41
NDC,0409379501,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,23.52,15.29,0.34,23.52,41
NDC,0409379519,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,23.52,15.29,0.34,23.52,41
NDC,0409379601,KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION,5.88,3.82,0.34,5.88,41
NDC,0409379619,KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION,5.88,3.82,0.34,5.88,41
NDC,0409381201,MARCAINE-EPINEPHRINE 0.25 %-1:200000 INJECTION SOLUTION,0.69,0.45,0.12,0.69,22
NDC,0409381411,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,8.37,5.44,1.41,37.35,31
NDC,0409381412,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,8.37,5.44,1.41,37.35,31
NDC,0409381512,MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,16.77,10.9,2.82,37.35,31
NDC,0409397701,WATER FOR INJECTION BACTERIOSTATIC INJECTION SOLUTION,0.93,0.6,0.16,0.93,22
NDC,0409397703,WATER FOR INJECTION BACTERIOSTATIC INJECTION SOLUTION,0.93,0.6,0.16,0.93,22
NDC,0409403101,MANNITOL 25 % INTRAVENOUS SOLUTION,0.66,0.43,0.11,0.66,30
NDC,0409409101,MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,13.89,9.03,2.33,13.89,22
NDC,0409409201,COPPER CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,11.43,7.43,1.92,11.43,22
NDC,0409409301,CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,7.38,4.8,1.24,7.38,22
NDC,0409426401,HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRINGE,108.0,70.2,0.09,108.0,37
NDC,0409427501,LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,0.3,0.2,0.05,0.3,22
NDC,0409427601,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.57,0.37,0.03,0.57,23
NDC,0409427602,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.21,0.14,0.03,0.21,23
NDC,0409427616,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.57,0.37,0.03,0.57,23
NDC,0409427617,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.21,0.14,0.04,0.21,22
NDC,0409427701,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,0.72,0.47,0.03,0.72,23
NDC,0409427702,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,0.27,0.18,0.03,0.27,23
NDC,0409427717,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,0.27,0.18,0.03,0.27,23
NDC,0409427801,LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,0.3,0.2,0.03,0.3,23
NDC,0409427902,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,0.39,0.25,0.03,0.39,23
NDC,0409427916,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,0.36,0.23,0.03,0.36,23
NDC,0409428201,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,3.48,2.26,0.03,3.48,23
NDC,0409428202,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,2.61,1.7,0.03,2.61,23
NDC,0409428212,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,2.61,1.7,0.03,2.61,23
NDC,0409428301,LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,3.18,2.07,0.53,3.18,22
NDC,0409428311,LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,3.18,2.07,0.53,3.18,22
NDC,0409428325,LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,3.18,2.07,0.53,3.18,22
NDC,0409433201,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,29.37,19.09,0.06,29.37,30
NDC,0409433211,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,29.37,19.09,4.93,29.37,24
NDC,0409434673,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,1.95,1.27,0.33,4.41,30
NDC,0409435003,DILTIAZEM 100 MG INTRAVENOUS SOLUTION,41.07,26.7,0.08,41.07,30
NDC,0409435013,DILTIAZEM 100 MG INTRAVENOUS SOLUTION,41.07,26.7,0.08,41.07,30
NDC,0409469924,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,0.78,0.51,0.11,0.78,31
NDC,0409469933,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,0.78,0.51,0.11,0.78,31
NDC,0409471302,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.11,0.72,0.03,1.11,23
NDC,0409471332,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,2.1,1.37,0.03,2.1,23
NDC,0409475503,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,2.31,1.5,0.09,2.31,31
NDC,0409475518,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,2.1,1.37,0.09,2.1,31
NDC,0409475901,ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,1.29,0.84,0.09,1.29,31
NDC,0409477601,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJECTION SOLUTION,1.65,1.07,0.28,1.65,22
NDC,0409477610,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJECTION SOLUTION,1.65,1.07,0.28,1.65,22
NDC,0409477702,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.06,0.04,0.01,5.53,31
NDC,0409488723,WATER FOR INJECTION STERILE 100 % INJECTION SOLUTION,0.36,0.23,0.06,0.36,22
NDC,0409488750,WATER FOR INJECTION STERILE 100 % INJECTION SOLUTION,0.63,0.41,0.11,0.63,22
NDC,0409488802,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.33,0.21,0.06,0.33,22
NDC,0409488803,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.42,0.27,0.07,0.42,22
NDC,0409488810,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.33,0.21,0.06,0.33,22
NDC,0409488820,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.42,0.27,0.07,0.42,22
NDC,0409488850,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.27,0.18,0.05,0.27,22
NDC,0409508216,TAZICEF 1 GRAM SOLUTION FOR INJECTION,15.36,9.98,1.49,15.36,31
NDC,0409508411,TAZICEF 2 GRAM SOLUTION FOR INJECTION,34.38,22.35,1.49,34.38,31
NDC,0409508611,TAZICEF 6 GRAM SOLUTION FOR INJECTION,110.04,71.53,1.49,110.04,31
NDC,0409555502,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,5.58,3.63,0.94,5.58,22
NDC,0409581610,STERILE EMPTY 10ML VIAL,1.9,1.24,0.32,1.9,22
NDC,0409582001,DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,3.18,2.07,0.53,3.18,31
NDC,0409592101,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,7.92,5.15,1.33,28.8,31
NDC,0409592116,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,7.92,5.15,1.33,28.8,31
NDC,0409592201,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,2.55,1.66,0.43,28.8,31
NDC,0409592216,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,2.55,1.66,0.43,28.8,31
NDC,0409610202,FUROSEMIDE 10 MG/ML INJ,7.53,4.89,0.04,7.53,30
NDC,0409610204,FUROSEMIDE 10 MG/ML INJ,2.64,1.72,0.04,2.64,30
NDC,0409610210,FUROSEMIDE 10 MG/ML INJ,2.1,1.37,0.04,2.1,30
NDC,0409610218,FUROSEMIDE 10 MG/ML INJ,2.64,1.72,0.04,2.64,30
NDC,0409610225,FUROSEMIDE 10 MG/ML INJ,6.06,3.94,0.04,6.06,30
NDC,0409610226,FUROSEMIDE 10 MG/ML INJ,2.64,1.72,0.04,2.64,30
NDC,0409610227,FUROSEMIDE 10 MG/ML INJ,1.8,1.17,0.04,1.8,30
NDC,0409610235,FUROSEMIDE 10 MG/ML INJ,6.15,4.0,0.04,6.15,30
NDC,0409647644,ERYTHROCIN 500 MG INTRAVENOUS SOLUTION,304.32,197.81,38.3,304.32,31
NDC,0409648201,ERYTHROCIN 500 MG INTRAVENOUS SOLUTION,711.12,462.23,38.3,711.12,31
NDC,0409650901,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,324.93,211.2,5.28,324.93,24
NDC,0409650949,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,71.97,46.78,0.04,71.97,30
NDC,0409653101,VANCOMYCIN 750 MG INTRAVENOUS SOLUTION,24.06,15.64,0.19,24.06,30
NDC,0409653102,VANCOMYCIN 750 MG INTRAVENOUS SOLUTION,35.4,23.01,0.19,35.4,30
NDC,0409653112,VANCOMYCIN 750 MG INTRAVENOUS SOLUTION,35.4,23.01,0.19,35.4,30
NDC,0409653321,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,58.62,38.1,5.28,58.62,24
NDC,0409653401,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,19.53,12.69,0.04,19.53,30
NDC,0409653501,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,30.18,19.62,5.07,30.18,24
NDC,0409655701,TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,30.54,19.85,0.01,30.54,31
NDC,0409662514,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,0.72,0.47,0.12,0.72,22
NDC,0409662530,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,0.66,0.43,0.11,0.66,22
NDC,0409662535,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,0.66,0.43,0.11,0.66,22
NDC,0409662902,QUELICIN 20 MG/ML INJECTION SOLUTION,6.99,4.54,1.17,6.99,23
NDC,0409663501,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,3.57,2.32,0.1,3.57,31
NDC,0409664802,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,0.42,0.27,0.07,0.42,22
NDC,0409664816,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,0.42,0.27,0.07,0.42,22
NDC,0409665106,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,1.38,0.9,0.1,1.38,31
NDC,0409665305,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.9,0.59,0.1,0.9,31
NDC,0409665318,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.9,0.59,0.1,0.9,31
NDC,0409666075,SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,0.75,0.49,0.13,0.75,23
NDC,0409669502,AMIDATE 2 MG/ML INTRAVENOUS SOLUTION,1.17,0.76,0.2,1.17,22
NDC,0409672723,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,1.12,31
NDC,0409672923,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,1.12,31
NDC,0409672924,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,1.17,0.76,0.2,1.17,31
NDC,0409673013,MAGNESIUM SULFATE 4 GRAM/50 ML (8 %) IN WATER INTRAVENOUS PIGGYBACK,0.54,0.35,0.09,1.12,31
NDC,0409703710,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,2.58,1.68,0.43,2.58,22
NDC,0409710002,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.09,0.06,0.02,0.09,22
NDC,0409710004,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.09,0.06,0.02,0.09,22
NDC,0409710066,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,0.3,22
NDC,0409710067,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,0.15,22
NDC,0409710068,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.3,0.2,0.05,0.3,22
NDC,0409710069,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,0.15,22
NDC,0409710102,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.09,0.06,0.02,0.09,22
NDC,0409710166,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.33,0.21,0.06,0.33,22
NDC,0409710167,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,0.15,0.1,0.03,0.15,22
NDC,0409724803,HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.45,0.29,0.08,0.45,22
NDC,0409729501,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,3.54,2.3,0.59,3.54,22
NDC,0409729925,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.57,0.37,0.1,0.57,22
NDC,0409729945,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.57,0.37,0.1,0.57,22
NDC,0409729973,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,2.25,1.46,0.38,2.25,22
NDC,0409729983,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,2.25,1.46,0.38,2.25,22
NDC,0409733201,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,5.49,3.57,0.41,5.49,31
NDC,0409733220,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,4.5,2.93,0.41,4.5,31
NDC,0409733410,CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,62.34,40.52,0.41,62.34,31
NDC,0409733503,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,10.41,6.77,0.41,10.41,31
NDC,0409733604,CEFTRIAXONE 2 GRAM INTRAVENOUS SOLUTION,28.71,18.66,0.41,28.71,31
NDC,0409733701,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,2.73,1.77,0.41,2.73,31
NDC,0409733801,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,3.48,2.26,0.41,3.48,31
NDC,0409733811,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,3.48,2.26,0.41,3.48,31
NDC,0409738501,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,0.24,0.16,0.04,28.8,31
NDC,0409739172,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,9.99,6.49,1.68,9.99,22
NDC,0409741803,LMD (DEXTRAN 40) 10 % IN 5 % DEXTROSE INTRAVENOUS SOLUTION,2.28,1.48,0.38,175.09,23
NDC,0409741903,LMD (DEXTRAN 40) 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,2.37,1.54,0.4,175.09,23
NDC,0409751716,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,1.56,1.01,0.26,1.56,22
NDC,0409762003,HEPARIN (PORCINE) (PF) 1000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.49,31
NDC,0409762049,HEPARIN (PORCINE) (PF) 2000 UNIT/1000 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.49,31
NDC,0409762059,HEPARIN (PORCINE) (PF) 2000 UNIT/1000 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.49,31
NDC,0409765030,HEPARIN (PORCINE) 25000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN,0.24,0.16,0.04,0.49,31
NDC,0409781022,DOPAMINE 800 MG/250 ML (3200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,0.33,0.21,0.06,2.22,31
NDC,0409796905,PLEGISOL 16 MEQ/L (POTASSIUM) PERFUSION SOLUTION,0.3,0.2,0.05,0.3,22
NDC,0409818301,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.96,0.62,0.16,0.96,22
NDC,0409818311,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.96,0.62,0.16,0.96,22
NDC,0409904201,BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200000 INJECTION SOLUTION,2.88,1.87,0.48,2.88,22
NDC,0409904217,BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200000 INJECTION SOLUTION,1.53,0.99,0.26,1.53,22
NDC,0409904501,BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200000 INJECTION SOLUTION,2.97,1.93,0.5,2.97,22
NDC,0409904517,BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200000 INJECTION SOLUTION,1.65,1.07,0.28,1.65,22
NDC,0409909417,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,3.66,2.38,0.61,3.66,31
NDC,0409909418,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,2.46,1.6,0.41,3.29,31
NDC,0409909422,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,7.53,4.89,0.89,7.53,31
NDC,0409909425,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,2.46,1.6,0.41,3.29,31
NDC,0409909428,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,3.66,2.38,0.61,3.66,31
NDC,0409909431,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,1.89,1.23,0.32,3.29,31
NDC,0409909461,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,3.36,2.18,0.56,3.36,31
NDC,0409910420,DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,2.82,1.83,0.47,2.82,31
NDC,0409913705,LIDOCAINE (PF) 50 MG/5 ML (1 %) INTRAVENOUS SYRINGE,10.8,7.02,0.03,10.8,23
NDC,0409915701,VITAMIN K 1 MG/0.5 ML INJECTION SOLUTION,35.37,22.99,2.52,35.37,31
NDC,0409915731,VITAMIN K 1 MG/0.5 ML INJECTION SOLUTION,35.37,22.99,2.52,35.37,31
NDC,0409915750,VITAMIN K 1 MG/0.5 ML INJECTION SOLUTION,35.37,22.99,2.52,35.37,31
NDC,0409915801,VITAMIN K1 10 MG/ML INJECTION SOLUTION,176.28,114.58,2.52,176.28,31
NDC,0409955805,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,2.67,1.74,0.45,2.67,22
NDC,0409955849,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,1.32,0.86,0.22,1.32,22
NDC,0409956610,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,21.93,14.25,1.2,21.93,31
NDC,0409973510,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,36.18,23.52,1.2,36.18,31
NDC,0414200007,FLORASTOR 250 MG CAPSULE,1.98,1.29,0.33,1.98,22
NDC,0430375414,ESTRACE 0.01% (0.1 MG/GRAM) VAGINAL CREAM,19.48,12.66,3.27,19.48,22
NDC,0436067216,DAKIN'S SOLUTION 0.125 %,0.08,0.05,0.01,0.08,22
NDC,0436093616,DAKIN'S SOLUTION 0.25 %,0.08,0.05,0.01,0.08,22
NDC,0436094616,DAKIN'S SOLUTION 0.5 %,0.08,0.05,0.01,0.08,22
NDC,0456040010,TEFLARO 400 MG INTRAVENOUS SOLUTION,926.85,602.45,3.47,926.85,47
NDC,0456045801,ARMOUR THYROID 30 MG TABLET,2.42,1.57,0.41,2.42,22
NDC,0456045901,ARMOUR THYROID 60 MG TABLET,2.7,1.76,0.45,2.7,22
NDC,0456046001,ARMOUR THYROID 90 MG TABLET,4.22,2.74,0.71,4.22,22
NDC,0456046101,ARMOUR THYROID 120 MG TABLET,4.94,3.21,0.83,4.94,22
NDC,0456060010,TEFLARO 600 MG INTRAVENOUS SOLUTION,926.85,602.45,3.47,926.85,47
NDC,0456111030,VIIBRYD 10 MG TABLET,29.18,18.97,4.9,29.18,22
NDC,0456112030,VIIBRYD 20 MG TABLET,29.18,18.97,4.9,29.18,22
NDC,0456114030,VIIBRYD 40 MG TABLET,29.18,18.97,4.9,29.18,22
NDC,0456155060,SAVELLA 50 MG TABLET,20.48,13.31,3.44,20.48,22
NDC,0456201001,LEXAPRO 10 MG TABLET,36.9,23.99,6.2,36.9,22
NDC,0456202001,LEXAPRO 20 MG TABLET,38.5,25.03,6.47,38.5,22
NDC,0456224030,FETZIMA 40 MG CAPSULEEXTENDED RELEASE,42.12,27.38,7.08,42.12,22
NDC,0456240560,SAPHRIS 5 MG SUBLINGUAL TABLET,50.44,32.79,8.47,50.44,22
NDC,0456241060,SAPHRIS 10 MG SUBLINGUAL TABLET,50.44,32.79,8.47,50.44,22
NDC,0456270001,AVYCAZ 2.5 GRAM INTRAVENOUS SOLUTION,1495.32,971.96,85.89,1495.32,47
NDC,0456270010,AVYCAZ 2.5 GRAM INTRAVENOUS SOLUTION,1495.32,971.96,85.89,1495.32,47
NDC,0456340733,NAMENDA XR 7 MG CAPSULE SPRINKLEEXTENDED RELEASE,37.18,24.17,6.25,37.18,22
NDC,0469012599,XTANDI 40 MG CAPSULE,298.12,193.78,50.08,298.12,22
NDC,0469052002,CRESEMBA 186 MG CAPSULE,277.8,180.57,46.67,277.8,22
NDC,0469060773,PROGRAF 0.5 MG CAPSULE,8.88,5.77,0.24,8.88,31
NDC,0469061773,PROGRAF 1 MG CAPSULE,17.76,11.54,0.24,17.76,31
NDC,0469062599,XTANDI 40 MG TABLET,245.52,159.59,41.25,245.52,22
NDC,0469067773,ASTAGRAF XL 1 MG CAPSULEEXTENDED RELEASE,13.86,9.01,0.5,13.86,31
NDC,0469072560,XTANDI 80 MG TABLET,573.3,372.65,96.31,573.3,22
NDC,0469142590,XOSPATA 40 MG TABLET,772.78,502.31,129.83,772.78,22
NDC,0469260190,MYRBETRIQ 25 MG TABLETEXTENDED RELEASE,36.82,23.93,6.19,36.82,22
NDC,0469260290,MYRBETRIQ 50 MG TABLETEXTENDED RELEASE,36.82,23.93,6.19,36.82,22
NDC,0469301601,PROGRAF 5 MG/ML INTRAVENOUS SOLUTION,918.09,596.76,74.0,918.09,47
NDC,0469305130,AMBISOME 50 MG INTRAVENOUS SUSPENSION,1145.91,744.84,20.72,1145.91,47
NDC,0469342510,VYLOY 100 MG INTRAVENOUS SOLUTION,7680.0,4992.0,33.66,7680.0,45
NDC,0469442530,VYLOY 300 MG INTRAVENOUS SOLUTION,23040.0,14976.0,33.66,23040.0,45
NDC,0469650189,LEXISCAN 0.4 MG/5 ML INTRAVENOUS SYRINGE,185.58,120.63,5.09,185.58,31
NDC,0472001304,GRISEOFULVIN MICROSIZE 125 MG/5 ML ORAL SUSPENSION,1.63,1.06,0.27,1.63,22
NDC,0472008216,ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,2.35,1.53,0.39,2.35,22
NDC,0472016615,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,2.34,1.52,0.39,2.34,22
NDC,0472037915,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,5.16,3.35,0.87,5.16,22
NDC,0472037945,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,3.7,2.41,0.62,3.7,22
NDC,0472038015,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,5.54,3.6,0.93,5.54,22
NDC,0472038045,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,3.7,2.41,0.62,3.7,22
NDC,0472038115,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,6.72,4.37,1.13,6.72,22
NDC,0472038215,BETAMETHASONE AUGMENTED 0.05 % TOPICAL OINTMENT,8.46,5.5,1.42,8.46,22
NDC,0472038245,BETAMETHASONE AUGMENTED 0.05 % TOPICAL OINTMENT,5.68,3.69,0.95,5.68,22
NDC,0472103016,HYDROMET 5 MG-1.5 MG/5 ML ORAL SOLUTION,0.48,0.31,0.08,0.48,22
NDC,0472173803,MICONAZOLE-3 200 MG VAGINAL SUPPOSITORY,38.2,24.83,6.42,38.2,22
NDC,0480372056,PYRIMETHAMINE 25 MG TABLET,1710.0,1111.5,287.28,1710.0,22
NDC,0480706356,PERAMPANEL 4 MG TABLET,93.26,60.62,15.67,93.26,22
NDC,0485015130,UROGESIC-BLUE 81.6 MG-40.8 MG-0.12 MG TABLET,13.48,8.76,2.26,13.48,22
NDC,0486111101,K-PHOS ORIGINAL 500 MG SOLUBLE TABLET,1.22,0.79,0.2,1.22,22
NDC,0486112501,K-PHOS-NEUTRAL 250 MG TABLET,1.7,1.11,0.29,1.7,22
NDC,0487020101,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,1.48,0.96,0.25,1.48,22
NDC,0487020160,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,1.4,0.91,0.24,1.4,22
NDC,0487278401,ASTHMANEFRIN REFILL 2.25 % SOLUTION FOR NEBULIZATION,5.0,3.25,0.84,5.0,22
NDC,0487590199,S2 RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,5.0,3.25,0.84,5.0,22
NDC,0487900330,SODIUM CHLORIDE 3 % FOR NEBULIZATION,0.4,0.26,0.07,0.4,22
NDC,0487900730,SODIUM CHLORIDE 7 % FOR NEBULIZATION,0.4,0.26,0.07,0.4,22
NDC,0487930103,SODIUM CHLORIDE 0.9 % FOR NEBULIZATION,0.2,0.13,0.03,0.2,22
NDC,0487930133,SODIUM CHLORIDE 0.9 % FOR NEBULIZATION,0.24,0.16,0.04,0.24,22
NDC,0487950101,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,0.54,0.35,0.09,0.54,22
NDC,0487950103,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,0.54,0.35,0.09,0.54,22
NDC,0487950125,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,0.54,0.35,0.09,0.54,22
NDC,0487950160,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,0.54,0.35,0.09,0.54,22
NDC,0487960101,BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,9.48,6.16,1.59,9.48,22
NDC,0487980101,IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,0.28,0.18,0.05,0.28,22
NDC,0487980125,IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,1.06,0.69,0.18,1.06,22
NDC,0487980160,IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,1.06,0.69,0.18,1.06,22
NDC,0487990130,ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,1.8,1.17,0.3,1.8,22
NDC,0487990425,ALBUTEROL SULFATE 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,1.1,0.72,0.18,1.1,22
NDC,0496051304,DETACHOL ADHESIVE REMOVER LIQUID,0.22,0.14,0.04,0.22,22
NDC,0496051306,DETACHOL ADHESIVE REMOVER LIQUID,0.3,0.2,0.05,0.3,22
NDC,0496052306,MASTISOL LIQUID ADHESIVE,1.14,0.74,0.19,1.14,22
NDC,0496074804,PRAX 1 % LOTION,0.34,0.22,0.06,0.34,22
NDC,0496088205,LMX 4 4 % TOPICAL CREAM,3.36,2.18,0.56,3.36,22
NDC,0496088206,LMX 4 4 % TOPICAL CREAM,3.36,2.18,0.56,3.36,22
NDC,0496088207,LMX 4 PLUS 4 % TOPICAL KIT,96.14,62.49,16.15,96.14,22
NDC,0496088215,LMX 4 4 % TOPICAL CREAM,3.9,2.54,0.66,3.9,22
NDC,0496088230,LMX 4 4 % TOPICAL CREAM,3.6,2.34,0.6,3.6,22
NDC,0496088330,LMX 5 5 % TOPICAL CREAM,4.32,2.81,0.73,4.32,22
NDC,0501373005,NEOSPORIN (NEO-BAC-POLYM) 3.5 MG-400 UNIT-5000 UNIT/GRAM TOP OINTMENT,0.54,0.35,0.09,0.54,22
NDC,0517003125,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,25.17,16.36,1.22,25.17,31
NDC,0517013001,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,12.84,8.35,1.22,12.84,31
NDC,0517013005,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,12.84,8.35,1.22,12.84,31
NDC,0517030110,METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,22.5,14.63,5.83,22.5,33
NDC,0517031010,METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,3.06,1.99,0.79,18.42,33
NDC,0517037271,METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,20.16,13.1,5.22,20.16,33
NDC,0517037370,METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION,49.17,31.96,8.53,49.17,33
NDC,0517037405,PROVAYBLUE 5 MG/ML INTRAVENOUS SOLUTION,84.39,54.85,8.53,84.39,33
NDC,0517037510,INDIGO CARMINE 8 MG/ML (0.8 %) INJECTION SOLUTION,5.19,3.37,1.3,26.3,26
NDC,0517038105,PROVAYBLUE 5 MG/ML INTRAVENOUS SOLUTION,84.39,54.85,8.53,84.39,33
NDC,0517042001,ESTRADIOL VALERATE 20 MG/ML INTRAMUSCULAR OIL,100.14,65.09,7.79,100.14,31
NDC,0517065001,INJECTAFER 50 MG IRON/ML INTRAVENOUS SOLUTION,371.1,241.22,0.98,371.1,47
NDC,0517071001,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,4155.87,2701.32,6.43,4155.87,42
NDC,0517072001,BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,39.63,25.76,6.2,39.63,31
NDC,0517073001,CLONIDINE (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,15.12,9.83,2.54,47.68,31
NDC,0517073101,CLONIDINE (PF) 5000 MCG/10 ML EPIDURAL SOLUTION,63.0,40.95,10.58,63.0,31
NDC,0517073510,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,11.07,7.2,0.13,78.3,36
NDC,0517074001,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,112.62,73.2,18.78,112.62,31
NDC,0517074020,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,112.62,73.2,18.78,112.62,31
NDC,0517086610,CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,28.17,18.31,4.73,203.91,30
NDC,0517095501,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,142.17,92.41,0.86,142.17,31
NDC,0517100125,ATROPINE 1 MG/ML INJECTION SOLUTION,61.05,39.68,0.25,61.05,30
NDC,0517100425,ATROPINE 0.4 MG/ML INTRAVENOUS SOLUTION,40.44,26.29,0.25,40.44,30
NDC,0517101025,ATROPINE 1 MG/ML INJECTION SOLUTION,45.21,29.39,0.25,45.21,30
NDC,0517182001,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,576.0,374.4,78.98,576.0,31
NDC,0517190525,DOPAMINE 400 MG/5 ML (80 MG/ML) INTRAVENOUS SOLUTION,2.37,1.54,0.4,2.37,31
NDC,0517198001,DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION,70.2,45.63,11.79,70.2,31
NDC,0517210225,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,11.52,7.49,1.94,11.52,22
NDC,0517231005,VENOFER 200 MG IRON/10 ML INTRAVENOUS SOLUTION,46.77,30.4,0.21,46.77,31
NDC,0517232510,VENOFER 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,46.77,30.4,0.21,46.77,31
NDC,0517234001,VENOFER 100 MG IRON/5 ML INTRAVENOUS SOLUTION,46.77,30.4,0.21,46.77,31
NDC,0517234010,VENOFER 100 MG IRON/5 ML INTRAVENOUS SOLUTION,46.77,30.4,0.21,46.77,31
NDC,0517234025,VENOFER 100 MG IRON/5 ML INTRAVENOUS SOLUTION,46.77,30.4,0.21,46.77,31
NDC,0517250201,CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,70.44,45.79,11.83,70.44,22
NDC,0517250210,CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,70.44,45.79,11.83,70.44,22
NDC,0517300525,STERILE WATER 100 % FOR INJECTION,2.07,1.35,0.35,2.07,22
NDC,0517400225,PAPAVERINE 30 MG/ML INJECTION SOLUTION,74.55,48.46,12.52,98.64,23
NDC,0517420125,HYDROXYZINE HCL 25 MG/ML INTRAMUSCULAR SOLUTION,110.04,71.53,12.48,110.04,31
NDC,0517430001,PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,7867.04,5113.58,8.18,7867.04,52
NDC,0517460125,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,46.8,30.42,0.45,46.8,38
NDC,0517460225,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,41.4,26.91,0.45,41.4,38
NDC,0517460525,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,31.68,20.59,0.45,31.68,38
NDC,0517462025,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,23.01,14.96,0.45,23.01,38
NDC,0517481001,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,5.61,3.65,0.94,5.61,22
NDC,0517481025,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,5.61,3.65,0.94,5.61,22
NDC,0517560125,HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,121.35,78.88,12.48,121.35,31
NDC,0517560225,HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,83.55,54.31,12.48,83.55,31
NDC,0517610125,ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,11.04,7.18,1.85,11.04,22
NDC,0517620225,MULTITRACE-4 NEONATAL 0.85 MCG-0.1 MG-25 MCG-1.5 MG/ML INTRAVENOUS,20.85,13.55,3.5,20.85,22
NDC,0517651025,SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,6.39,4.15,1.07,6.39,22
NDC,0517671010,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,7.29,4.74,0.05,7.29,23
NDC,0517730525,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,13.98,9.09,2.35,13.98,22
NDC,0517731525,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,9.9,6.44,1.66,9.9,22
NDC,0517750401,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,8.53,5.54,1.43,8.53,22
NDC,0517750425,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,8.53,5.54,1.43,8.53,22
NDC,0517760401,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,11.3,7.35,1.9,11.3,22
NDC,0517760425,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,11.3,7.35,1.9,11.3,22
NDC,0517800525,ZINC SULFATE 5 MG/ML INTRAVENOUS SOLUTION,55.26,35.92,9.28,55.26,22
NDC,0517890510,METHYLDOPATE 250 MG/5 ML INTRAVENOUS SOLUTION,28.8,18.72,4.84,105.22,29
NDC,0517912025,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,1.86,1.21,0.31,4.41,30
NDC,0517930525,TRALEMENT 3 MG-0.3 MG-55 MCG-60 MCG/ML INTRAVENOUS SOLUTION,101.49,65.97,17.05,101.49,22
NDC,0517970225,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,19.14,12.44,3.22,19.87,30
NDC,0525096690,FOLTX 2 MG-1.13 MG-25 MG TABLET,5.2,3.38,0.87,5.2,22
NDC,0525110290,DEPLIN (ALGAL OIL) 15 MG-90.314 MG CAPSULE,16.62,10.8,2.79,16.62,22
NDC,0525113990,DEPLIN (ALGAL OIL) 7.5 MG-90.314 MG CAPSULE,16.62,10.8,2.79,16.62,22
NDC,0527123101,PRIMIDONE 250 MG TABLET,2.0,1.3,0.34,2.0,22
NDC,0527130101,PRIMIDONE 50 MG TABLET,1.0,0.65,0.17,1.0,22
NDC,0527131101,TERBUTALINE 5 MG TABLET,13.3,8.65,2.23,13.3,22
NDC,0527131801,TERBUTALINE 2.5 MG TABLET,10.88,7.07,1.83,10.88,22
NDC,0527132601,URSODIOL 300 MG CAPSULE,14.7,9.56,2.47,14.7,22
NDC,0527136701,PROBENECID 500 MG TABLET,7.46,4.85,1.25,7.46,22
NDC,0527136801,DANAZOL 100 MG CAPSULE,10.88,7.07,1.83,10.88,22
NDC,0527136901,DANAZOL 200 MG CAPSULE,18.14,11.79,3.05,18.14,22
NDC,0527139201,DANAZOL 50 MG CAPSULE,7.26,4.72,1.22,7.26,22
NDC,0527139401,LOXAPINE SUCCINATE 5 MG CAPSULE,1.98,1.29,0.33,1.98,22
NDC,0527139501,LOXAPINE SUCCINATE 10 MG CAPSULE,2.54,1.65,0.43,2.54,22
NDC,0527139601,LOXAPINE SUCCINATE 25 MG CAPSULE,3.86,2.51,0.65,3.86,22
NDC,0527139701,LOXAPINE SUCCINATE 50 MG CAPSULE,5.14,3.34,0.86,5.14,22
NDC,0527163201,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG CAPSULE,0.82,0.53,0.14,0.82,22
NDC,0527169501,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,3.38,2.2,0.57,3.38,22
NDC,0527178801,FLUPHENAZINE 1 MG TABLET,8.78,5.71,1.48,8.78,22
NDC,0527178901,FLUPHENAZINE 2.5 MG TABLET,13.6,8.84,2.28,13.6,22
NDC,0527179001,FLUPHENAZINE 5 MG TABLET,18.4,11.96,3.09,18.4,22
NDC,0527179101,FLUPHENAZINE 10 MG TABLET,23.2,15.08,3.9,23.2,22
NDC,0527193206,CLARITHROMYCIN 500 MG TABLET,12.04,7.83,2.02,12.04,22
NDC,0527213335,POSACONAZOLE 100 MG TABLETDELAYED RELEASE,148.02,96.21,24.87,148.02,22
NDC,0527258037,FLUVASTATIN ER 80 MG TABLETEXTENDED RELEASE 24 HR,17.52,11.39,2.94,17.52,22
NDC,0527410737,MEXILETINE 150 MG CAPSULE,5.08,3.3,0.85,5.08,22
NDC,0527411637,PROPRANOLOL ER 60 MG CAPSULE24 HREXTENDED RELEASE,4.12,2.68,0.69,4.12,22
NDC,0527411837,PROPRANOLOL ER 120 MG CAPSULE24 HREXTENDED RELEASE,5.96,3.87,1.0,5.96,22
NDC,0527457937,METHYLPHENIDATE CD 10 MG BIPHASIC 30-70 CAPSULEEXTENDED RELEASE,11.54,7.5,1.94,11.54,22
NDC,0527458037,METHYLPHENIDATE CD 20 MG BIPHASIC 30-70 CAPSULEEXTENDED RELEASE,11.54,7.5,1.94,11.54,22
NDC,0527458137,METHYLPHENIDATE CD 30 MG BIPHASIC 30-70 CAPSULEEXTENDED RELEASE,11.54,7.5,1.94,11.54,22
NDC,0527466537,LISDEXAMFETAMINE 50 MG CAPSULE,26.56,17.26,4.46,26.56,22
NDC,0527600480,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,2.58,1.68,0.43,2.58,22
NDC,0527810637,DEXMETHYLPHENIDATE ER 5 MG CAPSULEEXTENDED RELEASE BIPHASIC50-50,16.26,10.57,2.73,16.26,22
NDC,0527810737,DEXMETHYLPHENIDATE ER 10 MG CAPSULEEXTENDED RELEASE BIPHASIC50-50,18.96,12.32,3.19,18.96,22
NDC,0527810837,DEXMETHYLPHENIDATE ER 15 MG CAPSULEEXTENDED RELEASE BIPHASIC50-50,15.42,10.02,2.59,15.42,22
NDC,0527810937,DEXMETHYLPHENIDATE ER 20 MG CAPSULEEXTENDED RELEASE BIPHASIC50-50,19.5,12.68,3.28,19.5,22
NDC,0536009185,ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,0.05,0.03,0.01,0.05,22
NDC,0536104610,SODIUM BICARBONATE 325 MG TABLET,0.04,0.03,0.01,0.04,22
NDC,0536105556,ACNE MEDICATION 5 % TOPICAL GEL,0.2,0.13,0.03,0.2,22
NDC,0536105656,ACNE MEDICATION 10 % TOPICAL GEL,0.22,0.14,0.04,0.22,22
NDC,0536110688,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,4.12,2.68,0.69,4.12,22
NDC,0536110788,NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,4.12,2.68,0.69,4.12,22
NDC,0536110945,UREA 20 % TOPICAL CREAM,0.2,0.13,0.03,0.2,22
NDC,0536114397,WHITE PETROLATUM 42 % TOPICAL OINTMENT,0.14,0.09,0.02,0.14,22
NDC,0536114398,WHITE PETROLATUM 42 % TOPICAL OINTMENT,0.06,0.04,0.01,0.06,22
NDC,0536118612,HEMORRHOIDAL (PHENYLEPH-COCOA) 0.25 %-88.44 % RECTAL SUPPOSITORY,0.58,0.38,0.1,0.58,22
NDC,0536121195,DIBUCAINE 1 % TOPICAL OINTMENT,0.42,0.27,0.07,0.42,22
NDC,0536122858,PHENASEPTIC 1.4 % MUCOSAL SPRAY,0.04,0.03,0.01,0.04,22
NDC,0536123441,ASPIRIN 81 MG TABLETDELAYED RELEASE,0.06,0.04,0.01,0.06,22
NDC,0536124801,STIMULANT LAXATIVE PLUS 8.6 MG-50 MG TABLET,0.06,0.04,0.01,0.06,22
NDC,0536125391,SODIUM CHLORIDE 5 % EYE OINTMENT,7.04,4.58,1.18,7.04,22
NDC,0536125494,SODIUM CHLORIDE 5 % EYE DROPS,0.7,0.46,0.12,0.7,22
NDC,0536126511,CLOTRIMAZOLE 1 % TOPICAL CREAM,0.2,0.13,0.03,0.2,22
NDC,0536126526,CLOTRIMAZOLE 1 % TOPICAL CREAM,0.12,0.08,0.02,0.12,22
NDC,0536126595,CLOTRIMAZOLE 1 % TOPICAL CREAM,0.18,0.12,0.03,0.18,22
NDC,0536127180,FIRST AID ANTISEPTIC (POVIDONE-IODINE) 10 % TOPICAL OINTMENT,0.16,0.1,0.03,0.16,22
NDC,0536128636,STOMACH RELIEF 262 MG/15 ML ORAL SUSPENSION,0.05,0.03,0.01,0.05,22
NDC,0536128806,HEMORRHOIDAL(PHENYLEPH-MIN OIL-PETROLAT)0.25 %-14 %-74.9 % RECTAL OINT,0.1,0.07,0.02,0.1,22
NDC,0536129434,DICLOFENAC 1 % TOPICAL GEL,0.42,0.27,0.07,0.42,22
NDC,0536130375,INFANTS SIMETHICONE 40 MG/0.6 ML ORAL DROPSSUSPENSION,0.23,0.15,0.04,0.23,22
NDC,0536131108,CHEST CONGESTION RELIEF 400 MG TABLET,0.14,0.09,0.02,0.14,22
NDC,0536131385,CHEST CONGESTION RELIEF DM 10 MG-100 MG/5 ML ORAL SYRUP,0.03,0.02,0.01,0.03,22
NDC,0536131543,TOLNAFTATE 1 % TOPICAL CREAM,0.24,0.16,0.04,0.24,22
NDC,0536131625,ZINC OXIDE 20 % TOPICAL OINTMENT,0.12,0.08,0.02,0.12,22
NDC,0536131628,ZINC OXIDE 20 % TOPICAL OINTMENT,0.16,0.1,0.03,0.16,22
NDC,0536132601,PAIN RELIEVER PLUS 250 MG-250 MG-65 MG TABLET,0.06,0.04,0.01,0.06,22
NDC,0536132710,ACETAMINOPHEN 325 MG TABLET,0.02,0.01,0.01,0.02,22
NDC,0536133632,CALCIUM ACETATE 667 MG TABLET,0.32,0.21,0.05,0.32,22
NDC,0536134957,MUSCLE RUB 15 %-10 % TOPICAL CREAM,0.1,0.07,0.02,0.1,22
NDC,0536136206,NICOTINE (POLACRILEX) 2 MG GUM,0.76,0.49,0.13,0.76,22
NDC,0536136223,NICOTINE (POLACRILEX) 2 MG GUM,0.5,0.33,0.08,0.5,22
NDC,0536137575,MICONAZOLE NITRATE 2 % TOPICAL CREAM,0.36,0.23,0.06,0.36,22
NDC,0536137801,VITAMIN B COMPLEX CAPSULE,0.14,0.09,0.02,0.14,22
NDC,0536140795,HYDROCORTISONE-ALOE VERA 1 % TOPICAL CREAM,0.12,0.08,0.02,0.12,22
NDC,0536140894,POLYVINYL ALCOHOL 1.4 % EYE DROPS,0.86,0.56,0.14,0.86,22
NDC,0536143097,MUCUS-CHEST CONGESTION 100 MG/5 ML ORAL LIQUID,0.08,0.05,0.01,0.08,22
NDC,0536143607,COENZYME Q10 30 MG CAPSULE,0.5,0.33,0.08,0.5,22
NDC,0536199553,ANTI-DANDRUFF 1 % SHAMPOO,0.04,0.03,0.01,0.04,22
NDC,0536252525,CAPSAICIN 0.025 % TOPICAL CREAM,0.28,0.18,0.05,0.28,22
NDC,0536302906,NICOTINE (POLACRILEX) 2 MG GUM,0.76,0.49,0.13,0.76,22
NDC,0536302923,NICOTINE (POLACRILEX) 2 MG GUM,0.5,0.33,0.08,0.5,22
NDC,0536302934,NICOTINE (POLACRILEX) 2 MG GUM,1.08,0.7,0.18,1.08,22
NDC,0536303023,NICOTINE (POLACRILEX) 4 MG GUM,0.68,0.44,0.11,0.68,22
NDC,0536344308,CEROVITE JR 18 MG IRON-10 MCG CHEWABLE TABLET,0.14,0.09,0.02,0.14,22
NDC,0536406301,CLASSIC PRENATAL 28 MG IRON-800 MCG TABLET,0.12,0.08,0.02,0.12,22
NDC,0536408501,PRENATAL 28 MG IRON-800 MCG TABLET,0.12,0.08,0.02,0.12,22
NDC,0536440601,VITAMIN B-6 25 MG TABLET,0.06,0.04,0.01,0.06,22
NDC,0536478701,VITAMINS B COMPLEX CAPSULE,0.14,0.09,0.02,0.14,22
NDC,0536479901,VITAMIN E 268 MG (400 UNIT) CAPSULE,0.16,0.1,0.03,0.16,22
NDC,0536589453,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,4.78,3.11,0.8,4.78,22
NDC,0536589588,NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,4.12,2.68,0.69,4.12,22
NDC,0536589688,NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,4.12,2.68,0.69,4.12,22
NDC,0548540000,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,90.0,58.5,1.42,90.0,23
NDC,0548570100,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SYRINGE,90.0,58.5,1.42,90.0,23
NDC,0548585000,GLUCAGON EMERGENCY KIT 1 MG SOLUTION FOR INJECTION,1008.0,655.2,74.0,1008.0,47
NDC,0548590000,CORTROSYN 0.25 MG SOLUTION FOR INJECTION,383.7,249.41,25.73,383.7,31
NDC,0548909010,AMPHADASE 150 UNIT/ML INJECTION SOLUTION,200.88,130.57,33.75,200.88,36
NDC,0555003302,CHLORDIAZEPOXIDE 10 MG CAPSULE,0.8,0.52,0.13,0.8,22
NDC,0555015802,CHLORDIAZEPOXIDE 5 MG CAPSULE,0.7,0.46,0.12,0.7,22
NDC,0555017178,MEFLOQUINE 250 MG TABLET,21.18,13.77,3.56,21.18,22
NDC,0555021110,NORETHINDRONE ACETATE 5 MG TABLET,5.3,3.45,0.89,5.3,22
NDC,0555030202,HYDROXYZINE PAMOATE 50 MG CAPSULE,1.22,0.79,0.2,1.22,22
NDC,0555032302,HYDROXYZINE PAMOATE 25 MG CAPSULE,1.14,0.74,0.19,1.14,22
NDC,0555057202,METHOTREXATE SODIUM 2.5 MG TABLET,7.12,4.63,0.16,7.12,30
NDC,0555060602,MEGESTROL 20 MG TABLET,2.08,1.35,0.35,2.08,22
NDC,0555060702,MEGESTROL 40 MG TABLET,3.42,2.22,0.57,3.42,22
NDC,0555063302,DANAZOL 50 MG CAPSULE,7.26,4.72,1.22,7.26,22
NDC,0555063402,DANAZOL 100 MG CAPSULE,10.88,7.07,1.83,10.88,22
NDC,0555063509,DANAZOL 200 MG CAPSULE,20.58,13.38,3.46,20.58,22
NDC,0555077902,MEDROXYPROGESTERONE 10 MG TABLET,0.98,0.64,0.16,0.98,22
NDC,0555087202,MEDROXYPROGESTERONE 2.5 MG TABLET,0.62,0.4,0.1,0.62,22
NDC,0555087302,MEDROXYPROGESTERONE 5 MG TABLET,0.94,0.61,0.16,0.94,22
NDC,0555088202,HYDROXYUREA 500 MG CAPSULE,2.94,1.91,0.49,2.94,22
NDC,0555088602,ESTRADIOL 1 MG TABLET,1.36,0.88,0.23,1.36,22
NDC,0555095202,DEXTROAMPHETAMINE SULFATE 5 MG TABLET,5.8,3.77,0.97,5.8,22
NDC,0555095302,DEXTROAMPHETAMINE SULFATE 10 MG TABLET,6.3,4.1,1.06,6.3,22
NDC,0555097102,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,3.42,2.22,0.57,3.42,22
NDC,0555097202,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,3.42,2.22,0.57,3.42,22
NDC,0555097302,DEXTROAMPHETAMINE-AMPHETAMINE 20 MG TABLET,3.42,2.22,0.57,3.42,22
NDC,0555097402,DEXTROAMPHETAMINE-AMPHETAMINE 30 MG TABLET,3.42,2.22,0.57,3.42,22
NDC,0555100901,CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,66.32,43.11,11.14,66.32,22
NDC,0555101001,CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,111.66,72.58,18.76,111.66,22
NDC,0555901058,NORTREL 1/35 (28) 1 MG-35 MCG TABLET,2.1,1.37,0.35,2.1,22
NDC,0555901658,SPRINTEC (28) 0.25 MG-0.035 MG TABLET,2.3,1.5,0.39,2.3,22
NDC,0555904358,APRI 0.15 MG-0.03 MG TABLET,2.18,1.42,0.37,2.18,22
NDC,0555912366,JOLESSA 0.15 MG-30 MCG (91) TABLETS3 MONTH DOSE PACK,3.54,2.3,0.59,3.54,22
NDC,0562780500,RHOGAM ULTRA-FILTERED PLUS 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,442.8,287.82,61.99,442.8,37
NDC,0562780501,RHOGAM ULTRA-FILTERED PLUS 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,442.8,287.82,61.99,442.8,37
NDC,0562780505,RHOGAM ULTRA-FILTERED PLUS 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,442.8,287.82,61.99,442.8,37
NDC,0562780525,RHOGAM ULTRA-FILTERED PLUS 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,442.8,287.82,61.99,442.8,37
NDC,0573017920,ADVIL JUNIOR STRENGTH 100 MG CHEWABLE TABLET,0.6,0.39,0.1,0.6,22
NDC,0573019120,INFANT'S ADVIL 50 MG/1.25 ML ORAL DROPSSUSPENSION,1.23,0.8,0.21,1.23,22
NDC,0573021341,ANBESOL (BENZOCAINE) 10 % ORAL MUCOSAL LIQUID,1.4,0.91,0.24,1.4,22
NDC,0573022567,ANBESOL (BENZOCAINE) MAXIMUM STRENGTH 20 % MUCOSAL GEL,1.58,1.03,0.27,1.58,22
NDC,0573266024,ALAVERT D-12 ALLERGY-SINUS 5 MG-120 MG TABLETEXTENDED RELEASE,1.42,0.92,0.24,1.42,22
NDC,0573287193,PREPARATION H 0.25 %-14 %-74.9 % OINTMENT,0.86,0.56,0.14,0.86,22
NDC,0573288320,PREPARATION H(PHENYLEPHCOCOA BUTTR) 0.25 %-88.44 % RECTAL SUPPOSITORY,1.18,0.77,0.2,1.18,22
NDC,0573445174,CENTRUM 18 MG-400 MCG TABLET,0.22,0.14,0.04,0.22,22
NDC,0574006716,ISOPROPYL ALCOHOL 70 % SOLUTION,0.01,0.01,0.01,0.01,22
NDC,0574006915,GLUTOSE-15 40 % ORAL GEL,0.22,0.14,0.04,0.22,22
NDC,0574006930,GLUTOSE-15 40 % ORAL GEL,0.22,0.14,0.04,0.22,22
NDC,0574007030,GLUTOSE-15 40 % ORAL GEL,0.22,0.14,0.04,0.22,22
NDC,0574010601,BROMOCRIPTINE 2.5 MG TABLET,7.52,4.89,1.26,7.52,22
NDC,0574010770,CLOTRIMAZOLE 10 MG TROCHE,3.22,2.09,0.54,3.22,22
NDC,0574010777,CLOTRIMAZOLE 10 MG TROCHE,2.86,1.86,0.48,2.86,22
NDC,0574011501,FLAVOXATE 100 MG TABLET,2.92,1.9,0.49,2.92,22
NDC,0574014560,TROSPIUM 20 MG TABLET,1.9,1.24,0.32,1.9,22
NDC,0574015004,MIDAZOLAM 2 MG/ML ORAL SYRUP,1.04,0.68,0.17,1.04,22
NDC,0574029201,AMILORIDE 5 MG TABLET,0.54,0.35,0.09,0.54,22
NDC,0574030216,ORA-SWEET SF ORAL LIQUID,0.13,0.08,0.02,0.13,22
NDC,0574030316,ORA-PLUS ORAL SUSPENSION,0.13,0.08,0.02,0.13,22
NDC,0574030416,ORA-SWEET ORAL SYRUP,0.13,0.08,0.02,0.13,22
NDC,0574031116,ORA-BLEND ORAL SUSPENSION,0.13,0.08,0.02,0.13,22
NDC,0574031216,ORA-BLEND SF ORAL SUSPENSION,0.13,0.08,0.02,0.13,22
NDC,0574050801,FERROUS GLUCONATE 324 MG (38 MG IRON) TABLET,0.12,0.08,0.02,0.12,22
NDC,0574050811,FERROUS GLUCONATE 324 MG (38 MG IRON) TABLET,0.22,0.14,0.04,0.22,22
NDC,0574052074,ACTIDOSE/SORBITOL 25 GRAM/120 ML ORAL SUSPENSION,0.35,0.23,0.06,0.35,22
NDC,0574052174,ACTIDOSE-AQUA 25 GRAM/120 ML ORAL SUSPENSION,0.35,0.23,0.06,0.35,22
NDC,0574060115,PODOCON 25 % TOPICAL LIQUID,20.43,13.28,3.43,20.43,22
NDC,0574060811,FERROUS SULFATE 324 MG (65 MG IRON) TABLETDELAYED RELEASE,0.22,0.14,0.04,0.22,22
NDC,0574061105,PODOFILOX 0.5 % TOPICAL SOLUTION,61.8,40.17,10.38,61.8,22
NDC,0574079101,METHAZOLAMIDE 50 MG TABLET,11.04,7.18,1.85,11.04,22
NDC,0574200815,NYSTOP 100000 UNIT/GRAM TOPICAL POWDER,3.66,2.38,0.61,3.66,22
NDC,0574200830,NYSTOP 100000 UNIT/GRAM TOPICAL POWDER,3.58,2.33,0.6,3.58,22
NDC,0574204230,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,1.2,0.78,0.2,1.2,22
NDC,0574206130,CICLOPIROX 0.77 % TOPICAL GEL,5.38,3.5,0.9,5.38,22
NDC,0574220145,TRETINOIN 0.1 % TOPICAL CREAM,10.94,7.11,1.84,10.94,22
NDC,0574220545,TRETINOIN 0.05 % TOPICAL CREAM,9.4,6.11,1.58,9.4,22
NDC,0574222545,TRETINOIN 0.025 % TOPICAL CREAM,8.46,5.5,1.42,8.46,22
NDC,0574402135,POLYCIN 500 UNIT-10000 UNIT/GRAM EYE OINTMENT,14.92,9.7,2.51,14.92,22
NDC,0574402235,BACITRACIN 500 UNIT/GRAM EYE OINTMENT,74.1,48.17,12.45,74.1,22
NDC,0574402435,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,10.26,6.67,1.72,10.26,22
NDC,0574402450,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,17.4,11.31,2.92,17.4,22
NDC,0574403105,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,36.5,23.73,6.13,36.5,22
NDC,0574403110,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,36.5,23.73,6.13,36.5,22
NDC,0574403125,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,36.42,23.67,6.12,36.42,22
NDC,0574416035,NEOMYCIN 3.5 MG/G-POLYMYXIN B 10000 UNIT/G-DEXAMETH 0.1 % EYE OINT,8.66,5.63,1.45,8.66,22
NDC,0574419035,SULFACETAMIDE SODIUM 10 % EYE OINTMENT,37.64,24.47,6.32,37.64,22
NDC,0574703412,ASPIRIN 300 MG RECTAL SUPPOSITORY,2.92,1.9,0.49,2.92,22
NDC,0574704012,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,66.9,43.49,11.24,66.9,22
NDC,0574704512,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-30 MG RECTAL SUPPOSITORY,55.04,35.78,9.25,55.04,22
NDC,0574705012,BISACODYL 10 MG RECTAL SUPPOSITORY,0.84,0.55,0.14,0.84,22
NDC,0574705050,BISACODYL 10 MG RECTAL SUPPOSITORY,0.64,0.42,0.11,0.64,22
NDC,0574709012,HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,28.86,18.76,4.85,28.86,22
NDC,0574711212,MORPHINE 10 MG RECTAL SUPPOSITORY,18.75,12.19,3.15,18.75,22
NDC,0574711412,MORPHINE 20 MG RECTAL SUPPOSITORY,22.5,14.63,3.78,22.5,22
NDC,0574722406,HYDROMORPHONE 3 MG RECTAL SUPPOSITORY,24.54,15.95,4.12,24.54,22
NDC,0574722612,COMPRO 25 MG RECTAL SUPPOSITORY,25.16,16.35,4.23,25.16,22
NDC,0574985510,BUDESONIDE DR - ER 3 MG CAPSULEDELAYEDEXTENDED RELEASE,2.38,1.55,0.4,2.38,22
NDC,0575620030,PROGLYCEM 50 MG/ML ORAL SUSPENSION,48.65,31.62,8.17,48.65,22
NDC,0591034301,VERAPAMIL 80 MG TABLET,1.06,0.69,0.18,1.06,22
NDC,0591034501,VERAPAMIL 120 MG TABLET,1.36,0.88,0.23,1.36,22
NDC,0591036901,LOXAPINE SUCCINATE 5 MG CAPSULE,1.98,1.29,0.33,1.98,22
NDC,0591037001,LOXAPINE SUCCINATE 10 MG CAPSULE,2.54,1.65,0.43,2.54,22
NDC,0591037101,LOXAPINE SUCCINATE 25 MG CAPSULE,3.86,2.51,0.65,3.86,22
NDC,0591039501,PENTAZOCINE 50 MG-NALOXONE 0.5 MG TABLET,4.94,3.21,0.83,4.94,22
NDC,0591040401,VERAPAMIL 40 MG TABLET,0.56,0.36,0.09,0.56,22
NDC,0591042401,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,0591044401,GUANFACINE 1 MG TABLET,1.74,1.13,0.29,1.74,22
NDC,0591045301,GUANFACINE 2 MG TABLET,2.36,1.53,0.4,2.36,22
NDC,0591046001,GLIPIZIDE 5 MG TABLET,0.76,0.49,0.13,0.76,22
NDC,0591046101,GLIPIZIDE 10 MG TABLET,1.2,0.78,0.2,1.2,22
NDC,0591046110,GLIPIZIDE 10 MG TABLET,1.18,0.77,0.2,1.18,22
NDC,0591079401,DICYCLOMINE 10 MG CAPSULE,1.08,0.7,0.18,1.08,22
NDC,0591079501,DICYCLOMINE 20 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,0591231215,ALVIMOPAN 12 MG CAPSULE,414.6,269.49,69.65,414.6,22
NDC,0591247319,TAMOXIFEN 20 MG TABLET,7.58,4.93,1.27,7.58,22
NDC,0591252001,CHLORZOXAZONE 500 MG TABLET,2.16,1.4,0.36,2.16,22
NDC,0591257920,VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,28.43,18.48,4.78,28.43,22
NDC,0591268201,POTASSIUM CITRATE ER 5 MEQ (540 MG) TABLETEXTENDED RELEASE,3.48,2.26,0.58,3.48,22
NDC,0591288830,HYDROXOCOBALAMIN 1000 MCG/ML INTRAMUSCULAR SOLUTION,3.84,2.5,0.01,3.84,38
NDC,0591292754,LEVALBUTEROL HFA 45 MCG/ACTUATION AEROSOL INHALER,9.82,6.38,1.65,9.82,22
NDC,0591312879,PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,11.64,7.57,0.63,11.64,31
NDC,0591315901,URSODIOL 300 MG CAPSULE,14.7,9.56,2.47,14.7,22
NDC,0591321730,TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GEL PACKET,6.0,3.9,1.01,6.0,22
NDC,0591336901,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,3.38,2.2,0.57,3.38,22
NDC,0591351004,CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,154.72,100.57,25.99,154.72,22
NDC,0591352430,TESTOSTERONE 50 MG/5 GRAM (1 %) TRANSDERMAL GEL,7.76,5.04,1.3,7.76,22
NDC,0591352530,LIDOCAINE 5 % TOPICAL PATCH,18.72,12.17,3.14,18.72,22
NDC,0591354060,BUPROPION HCL SR 100 MG TABLET12 HR SUSTAINED-RELEASE,3.38,2.2,0.57,3.38,22
NDC,0591354125,BUPROPION HCL SR 150 MG TABLET12 HR SUSTAINED-RELEASE,3.76,2.44,0.63,3.76,22
NDC,0591354160,BUPROPION HCL SR 150 MG TABLET12 HR SUSTAINED-RELEASE,3.88,2.52,0.65,3.88,22
NDC,0591367001,NABUMETONE 500 MG TABLET,2.6,1.69,0.44,2.6,22
NDC,0591372030,TRANEXAMIC ACID 650 MG TABLET,10.44,6.79,1.75,10.44,22
NDC,0591387544,MEMANTINE 10 MG TABLET,12.2,7.93,2.05,12.2,22
NDC,0591401201,VALPROIC ACID 250 MG CAPSULE,1.58,1.03,0.27,1.58,22
NDC,0591410101,PERPHENAZINE 2 MG TABLET,3.5,2.28,0.59,3.5,22
NDC,0591410401,PERPHENAZINE 16 MG TABLET,7.8,5.07,1.31,7.8,22
NDC,0591530701,PROMETHAZINE 25 MG TABLET,1.02,0.66,0.17,1.02,22
NDC,0591533501,TRIHEXYPHENIDYL 2 MG TABLET,0.36,0.23,0.06,0.36,22
NDC,0591533701,TRIHEXYPHENIDYL 5 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,0591534701,PROBENECID 500 MG TABLET,1.96,1.27,0.33,1.96,22
NDC,0591544205,PREDNISONE 10 MG TABLET,0.48,0.31,0.01,0.48,31
NDC,0591544305,PREDNISONE 20 MG TABLET,0.52,0.34,0.01,0.52,31
NDC,0591554301,ALLOPURINOL 100 MG TABLET,0.96,0.62,0.16,0.96,22
NDC,0591554401,ALLOPURINOL 300 MG TABLET,1.84,1.2,0.31,1.84,22
NDC,0591554405,ALLOPURINOL 300 MG TABLET,1.76,1.14,0.3,1.76,22
NDC,0591555701,PROPRANOLOL 80 MG TABLET,1.8,1.17,0.3,1.8,22
NDC,0591559001,TRANYLCYPROMINE 10 MG TABLET,7.2,4.68,1.21,7.2,22
NDC,0591564201,MINOXIDIL 2.5 MG TABLET,1.18,0.77,0.2,1.18,22
NDC,0591564301,MINOXIDIL 10 MG TABLET,2.58,1.68,0.43,2.58,22
NDC,0591566001,SULINDAC 200 MG TABLET,2.42,1.57,0.41,2.42,22
NDC,0591569401,MINOCYCLINE 50 MG CAPSULE,3.4,2.21,0.57,3.4,22
NDC,0591569550,MINOCYCLINE 100 MG CAPSULE,6.8,4.42,1.14,6.8,22
NDC,0591571301,AMOXAPINE 25 MG TABLET,1.6,1.04,0.27,1.6,22
NDC,0591571501,AMOXAPINE 100 MG TABLET,4.32,2.81,0.73,4.32,22
NDC,0592800099,NASOGEL 0.9 % NASAL GEL,0.56,0.36,0.09,0.56,22
NDC,0597000302,APTIVUS 250 MG CAPSULE,42.76,27.79,7.18,42.76,22
NDC,0597002402,COMBIVENT RESPIMAT 20 MCG-100 MCG/ACTUATION SOLUTION FOR INHALATION,311.48,202.46,52.33,311.48,22
NDC,0597007575,SPIRIVA WITH HANDIHALER 18 MCG AND INHALATION CAPSULES,29.2,18.98,4.91,29.2,22
NDC,0597008717,ATROVENT HFA 17 MCG/ACTUATION AEROSOL INHALER,57.08,37.1,9.59,57.08,22
NDC,0597010051,SPIRIVA RESPIMAT 2.5 MCG/ACTUATION SOLUTION FOR INHALATION,45.0,29.25,7.56,45.0,23
NDC,0597010061,SPIRIVA RESPIMAT 2.5 MCG/ACTUATION SOLUTION FOR INHALATION,316.44,205.69,53.16,316.44,23
NDC,0597010860,PRADAXA 110 MG CAPSULE,7.94,5.16,1.33,7.94,22
NDC,0597013730,GILOTRIF 30 MG TABLET,962.2,625.43,161.65,962.2,22
NDC,0597013830,GILOTRIF 40 MG TABLET,962.2,625.43,161.65,962.2,22
NDC,0597014130,GILOTRIF 20 MG TABLET,962.2,625.43,161.65,962.2,22
NDC,0597015230,JARDIANCE 10 MG TABLET,28.0,18.2,4.7,28.0,22
NDC,0597015237,JARDIANCE 10 MG TABLET,28.0,18.2,4.7,28.0,22
NDC,0597015290,JARDIANCE 10 MG TABLET,28.0,18.2,4.7,28.0,22
NDC,0597015330,JARDIANCE 25 MG TABLET,28.0,18.2,4.7,28.0,22
NDC,0597015337,JARDIANCE 25 MG TABLET,28.0,18.2,4.7,28.0,22
NDC,0597015390,JARDIANCE 25 MG TABLET,28.0,18.2,4.7,28.0,22
NDC,0597015570,STIOLTO RESPIMAT 2.5 MCG-2.5 MCG/ACTUATION SOLUTION FOR INHALATION,45.0,29.25,7.56,45.0,22
NDC,0597019705,PRAXBIND 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,187.35,121.78,31.47,187.35,23
NDC,0597035556,PRADAXA 75 MG CAPSULE,7.94,5.16,1.33,7.94,22
NDC,0597036082,PRADAXA 150 MG CAPSULE,7.94,5.16,1.33,7.94,22
NDC,0597925786,HERNEXEOS 60 MG TABLET,866.68,563.34,145.6,866.68,22
NDC,0600053772,CERAVE TOPICAL CREAM,0.08,0.05,0.01,0.08,22
NDC,0603020922,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,0.18,0.12,0.03,0.18,22
NDC,0603116158,DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,0.75,0.49,0.13,0.75,22
NDC,0603154258,POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,2.03,1.32,0.34,2.03,22
NDC,0603243321,BENZTROPINE 0.5 MG TABLET,0.78,0.51,0.13,0.78,22
NDC,0603243421,BENZTROPINE 1 MG TABLET,0.82,0.53,0.14,0.82,22
NDC,0603243521,BENZTROPINE 2 MG TABLET,1.04,0.68,0.17,1.04,22
NDC,0603459315,METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK,2.86,1.86,0.22,2.86,31
NDC,0603506121,PERPHENAZINE 4 MG TABLET,3.18,2.07,0.53,3.18,22
NDC,0603516621,PHENOBARBITAL 32.4 MG TABLET,1.36,0.88,0.23,1.36,22
NDC,0603516721,PHENOBARBITAL 64.8 MG TABLET,1.68,1.09,0.28,1.68,22
NDC,0603516821,PHENOBARBITAL 97.2 MG TABLET,2.38,1.55,0.4,2.38,22
NDC,0603533521,PREDNISONE 1 MG TABLET,0.5,0.33,0.01,0.5,31
NDC,0603533621,PREDNISONE 2.5 MG TABLET,0.34,0.22,0.01,0.34,31
NDC,0603548221,PROPRANOLOL 10 MG TABLET,0.82,0.53,0.14,0.82,22
NDC,0603548321,PROPRANOLOL 20 MG TABLET,1.02,0.66,0.17,1.02,22
NDC,0603548421,PROPRANOLOL 40 MG TABLET,1.44,0.94,0.24,1.44,22
NDC,06132210002,BENZOCAINE 20% TOPICAL SPRAY,0.56,0.36,0.09,0.5,21
NDC,0641036721,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,5.16,3.35,0.11,5.16,31
NDC,0641036725,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,5.16,3.35,0.11,5.16,31
NDC,0641037621,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,4.23,2.75,0.71,4.23,31
NDC,0641037625,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,4.23,2.75,0.71,4.23,31
NDC,0641047625,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,72.0,46.8,12.1,80.47,31
NDC,0641047725,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,165.6,107.64,27.82,165.6,31
NDC,0641049325,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,2.49,1.62,0.42,2.49,31
NDC,0641092825,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.66,4.33,1.12,10.99,31
NDC,0641094835,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.3,4.1,1.06,10.99,31
NDC,0641095521,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.3,4.1,1.06,10.99,31
NDC,0641095525,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.3,4.1,1.06,10.99,31
NDC,0641139735,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,104.01,67.61,17.47,104.01,31
NDC,0641139835,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,59.58,38.73,10.01,65.76,31
NDC,0641141035,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,9.9,6.44,1.66,26.5,31
NDC,0641149531,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.66,4.33,1.12,10.99,31
NDC,0641149535,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,6.66,4.33,1.12,10.99,31
NDC,0641149631,PROMETHAZINE 50 MG/ML INJECTION SOLUTION,9.33,6.06,1.57,10.99,31
NDC,0641149635,PROMETHAZINE 50 MG/ML INJECTION SOLUTION,9.33,6.06,1.57,10.99,31
NDC,0641234141,HYDROMORPHONE 2 MG/ML INJECTION SOLUTION,3.87,2.52,0.09,3.87,37
NDC,0641255541,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,1.44,0.94,0.24,1.64,31
NDC,0641256944,DIPYRIDAMOLE 5 MG/ML INTRAVENOUS SOLUTION,7.14,4.64,1.2,23.26,31
NDC,0641600125,ATIVAN 2 MG/ML INJECTION SOLUTION,8.64,5.62,0.87,8.64,31
NDC,0641600710,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,1.17,0.76,0.2,1.34,38
NDC,0641600810,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,2.73,1.77,0.46,2.73,38
NDC,0641601310,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,2.46,1.6,0.08,2.46,30
NDC,0641601410,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,2.25,1.46,0.08,2.25,30
NDC,0641601501,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,1.32,0.86,0.08,1.32,30
NDC,0641601510,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,1.32,0.86,0.08,1.32,30
NDC,0641601801,DOPRAM 20 MG/ML INTRAVENOUS SOLUTION,9.57,6.22,1.61,9.57,22
NDC,0641601910,DURAMORPH (PF) 1 MG/ML INJECTION SOLUTION,10.44,6.79,1.75,37.35,31
NDC,0641602010,DURAMORPH (PF) 0.5 MG/ML INJECTION SOLUTION,10.44,6.79,1.75,37.35,31
NDC,0641602725,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,3.81,2.48,0.64,3.81,31
NDC,0641602901,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,1.98,1.29,0.33,3.29,31
NDC,0641603901,INFUMORPH P/F 10 MG/ML INJECTION SOLUTION,37.44,24.34,6.29,37.44,31
NDC,0641604001,INFUMORPH P/F 25 MG/ML INJECTION SOLUTION,63.66,41.38,10.69,63.66,31
NDC,0641604225,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,5.7,3.71,0.34,5.7,41
NDC,0641604425,LORAZEPAM 2 MG/ML INJECTION SOLUTION,8.64,5.62,0.87,8.64,31
NDC,0641604525,LORAZEPAM 4 MG/ML INJECTION SOLUTION,12.3,8.0,0.87,12.3,31
NDC,0641604610,LORAZEPAM 2 MG/ML INJECTION SOLUTION,4.62,3.0,0.78,4.62,31
NDC,0641604710,LORAZEPAM 4 MG/ML INJECTION SOLUTION,6.3,4.1,0.87,6.3,31
NDC,0641604825,LORAZEPAM 2 MG/ML INJECTION SOLUTION,4.65,3.02,0.78,4.65,31
NDC,0641605010,LORAZEPAM 2 MG/ML INJECTION SOLUTION,3.84,2.5,0.65,3.89,31
NDC,0641605201,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,9.12,5.93,1.53,22.55,31
NDC,0641605225,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,9.12,5.93,1.53,22.55,31
NDC,0641605301,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,9.51,6.18,1.6,22.55,31
NDC,0641605325,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,9.51,6.18,1.6,22.55,31
NDC,0641605401,MEPERIDINE (PF) 100 MG/ML INJECTION SOLUTION,10.44,6.79,1.75,22.55,31
NDC,0641605425,MEPERIDINE (PF) 100 MG/ML INJECTION SOLUTION,10.44,6.79,1.75,22.55,31
NDC,0641605610,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,0.78,0.51,0.12,0.78,31
NDC,0641605725,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,1.17,0.76,0.12,1.17,31
NDC,0641605910,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,0.99,0.64,0.12,0.99,31
NDC,0641606010,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,2.49,1.62,0.12,2.49,31
NDC,0641606101,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,4.32,2.81,0.12,4.32,31
NDC,0641606125,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,4.32,2.81,0.12,4.32,31
NDC,0641606325,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,2.25,1.46,0.12,2.25,31
NDC,0641607901,ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,1.41,0.92,0.09,1.41,31
NDC,0641608025,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,1.08,0.7,0.09,1.08,31
NDC,0641611610,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,15.12,9.83,1.91,15.12,31
NDC,0641611701,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,14.4,9.36,1.91,14.4,31
NDC,0641611710,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,14.4,9.36,1.91,14.4,31
NDC,0641611801,AMPICILLIN-SULBACTAM 15 GRAM SOLUTION FOR INJECTION,142.56,92.66,1.91,142.56,31
NDC,0641612525,MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,9.0,5.85,1.51,9.0,31
NDC,0641612625,MORPHINE 8 MG/ML INTRAVENOUS SOLUTION,10.17,6.61,1.71,10.17,31
NDC,0641612701,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,9.18,5.97,1.54,9.18,31
NDC,0641612725,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,9.18,5.97,1.54,9.18,31
NDC,0641613525,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,13.05,8.48,2.19,13.05,31
NDC,0641613801,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,2.1,1.37,0.35,2.1,31
NDC,0641613825,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,2.1,1.37,0.35,2.1,31
NDC,0641613901,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,1.17,0.76,0.2,1.64,31
NDC,0641614201,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,14.4,9.36,0.03,14.4,23
NDC,0641614225,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,14.4,9.36,0.03,14.4,23
NDC,0641614501,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,3.48,2.26,0.11,3.48,31
NDC,0641614910,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,3.24,2.11,0.54,3.24,23
NDC,0641615001,NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INTRAVENOUS SOLUTION,2.88,1.87,0.48,2.88,23
NDC,0641615010,NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INTRAVENOUS SOLUTION,2.88,1.87,0.48,2.88,23
NDC,0641615125,HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,10.8,7.02,0.09,10.8,37
NDC,0641616710,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,14.4,9.36,0.77,14.4,31
NDC,0641616910,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,13.44,8.74,0.09,13.44,37
NDC,0641617310,DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION,43.62,28.35,7.33,43.62,31
NDC,0641617401,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,16.2,10.53,1.01,16.2,31
NDC,0641617410,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,16.2,10.53,1.01,16.2,31
NDC,0641618210,ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION,28.08,18.25,4.72,28.08,31
NDC,0641622925,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,3.03,1.97,0.03,3.03,23
NDC,0641623610,EPHEDRINE SULFATE 25 MG/5 ML (5 MG/ML) INTRAVENOUS SYRINGE,8.88,5.77,1.49,8.88,22
NDC,0641624410,DIAZEPAM 5 MG/ML INJECTION SYRINGE,44.31,28.8,5.89,44.31,31
NDC,0641624725,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,7.02,4.56,0.89,7.02,31
NDC,0641921810,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,1.44,0.94,0.08,1.44,30
NDC,0641921901,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,0.84,0.55,0.08,0.84,30
NDC,0641921910,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,0.84,0.55,0.08,0.84,30
NDC,0699310002,BENZOCAINE 20% TOPICAL SPRAY,1.16,0.75,0.19,1.04,21
NDC,0703024101,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,29.13,18.93,0.97,29.13,31
NDC,0703024301,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,29.55,19.21,0.97,29.55,31
NDC,0703024501,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,22.08,14.35,0.97,22.08,31
NDC,0703067601,TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,544.35,353.83,49.09,544.35,47
NDC,0703068601,TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,1088.7,707.66,49.09,1088.7,47
NDC,0703367501,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,4.32,2.81,0.73,4.32,20
NDC,0703367801,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,4.0,2.6,0.67,4.0,20
NDC,0703400401,ROMIDEPSIN 5 MG/ML INTRAVENOUS SOLUTION,7292.92,4740.4,28.51,7292.92,51
NDC,0703424601,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,5.04,3.28,0.85,8.11,30
NDC,0703440211,VINCASAR PFS 1 MG/ML INTRAVENOUS SOLUTION,72.24,46.96,7.12,72.24,30
NDC,0703441211,VINCASAR PFS 2 MG/2 ML INTRAVENOUS SOLUTION,72.24,46.96,7.12,72.24,30
NDC,0703450201,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,6.03,3.92,0.94,6.03,31
NDC,0703450204,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,6.03,3.92,0.94,6.03,31
NDC,0703574711,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,1.92,1.25,0.32,5.84,30
NDC,0703950303,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,4.53,2.94,0.08,4.53,30
NDC,0703951403,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,4.53,2.94,0.08,4.53,30
NDC,0703952601,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,4.53,2.94,0.08,4.53,30
NDC,0713013206,PROMETHEGAN 50 MG RECTAL SUPPOSITORY,71.54,46.5,12.02,71.54,22
NDC,0713013212,PROMETHEGAN 50 MG RECTAL SUPPOSITORY,71.54,46.5,12.02,71.54,22
NDC,0713013512,PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,24.52,15.94,4.12,24.52,22
NDC,0713016612,MIGERGOT 2 MG-100 MG RECTAL SUPPOSITORY,541.76,352.14,91.02,541.76,22
NDC,0713022415,FLUOCINOLONE 0.025 % TOPICAL OINTMENT,4.52,2.94,0.76,4.52,22
NDC,0713026831,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.24,0.16,0.04,0.24,22
NDC,0713028031,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,0.24,0.16,0.04,0.24,22
NDC,0713050306,ANUCORT-HC 25 MG SUPPOSITORY,45.3,29.45,7.61,45.3,22
NDC,0713050324,ANUCORT-HC 25 MG SUPPOSITORY,43.02,27.96,7.23,43.02,22
NDC,0713052612,PROMETHEGAN 25 MG RECTAL SUPPOSITORY,35.42,23.02,5.95,35.42,22
NDC,0713053606,PROMETHEGAN 12.5 MG RECTAL SUPPOSITORY,35.42,23.02,5.95,35.42,22
NDC,0713053612,PROMETHEGAN 12.5 MG RECTAL SUPPOSITORY,35.42,23.02,5.95,35.42,22
NDC,0713062231,TRIPLE ANTIBIOTIC PLUS 3.5 MG-500 UNIT-10000 UNIT/GRAM TOP OINTMENT,0.3,0.2,0.05,0.3,22
NDC,0713063337,METRONIDAZOLE 0.75 % TOPICAL CREAM,24.44,15.89,4.11,24.44,22
NDC,0713063415,MOMETASONE 0.1 % TOPICAL CREAM,3.88,2.52,0.65,3.88,22
NDC,0713063515,MOMETASONE 0.1 % TOPICAL OINTMENT,3.46,2.25,0.58,3.46,22
NDC,0713065615,CLOBETASOL 0.05 % TOPICAL OINTMENT,20.72,13.47,3.48,20.72,22
NDC,0713065631,CLOBETASOL 0.05 % TOPICAL OINTMENT,17.32,11.26,2.91,17.32,22
NDC,0713067815,NYSTATIN 100000 UNIT/GRAM TOPICAL CREAM,2.34,1.52,0.39,2.34,22
NDC,0713067831,NYSTATIN 100000 UNIT/GRAM TOPICAL CREAM,1.76,1.14,0.3,1.76,22
NDC,0713068215,GENTAMICIN 0.1 % TOPICAL OINTMENT,6.58,4.28,1.11,6.58,22
NDC,0713068231,GENTAMICIN 0.1 % TOPICAL OINTMENT,6.58,4.28,1.11,6.58,22
NDC,0713068315,GENTAMICIN 0.1 % TOPICAL CREAM,6.58,4.28,1.11,6.58,22
NDC,0713068331,GENTAMICIN 0.1 % TOPICAL CREAM,6.58,4.28,1.11,6.58,22
NDC,0713068615,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,2.34,1.52,0.39,2.34,22
NDC,0713068631,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,1.76,1.14,0.3,1.76,22
NDC,0713070915,FLUOCINOLONE 0.025 % TOPICAL CREAM,5.98,3.89,1.0,5.98,22
NDC,0713070960,FLUOCINOLONE 0.025 % TOPICAL CREAM,5.98,3.89,1.0,5.98,22
NDC,0761043310,VITAMIN A PALMITATE 3000 MCG (10000 UNIT) CAPSULE,0.06,0.04,0.01,0.06,22
NDC,0766145020,NICODERM CQ 21 MG/24 HR DAILY TRANSDERMAL PATCH,7.2,4.68,1.21,7.2,22
NDC,0781107701,ALPRAZOLAM 0.5 MG TABLET,1.74,1.13,0.29,1.74,22
NDC,0781148601,AMITRIPTYLINE 10 MG TABLET,0.36,0.23,0.06,0.36,22
NDC,0781148801,AMITRIPTYLINE 50 MG TABLET,1.42,0.92,0.24,1.42,22
NDC,0781163501,ISOSORBIDE DINITRATE 5 MG TABLET,1.98,1.29,0.33,1.98,22
NDC,0781187431,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 125 MG TABLET,11.84,7.7,1.99,11.84,22
NDC,0781194339,AMOXICILLIN-POTASSIUM CLAVULANATE 1000 MG-62.5 MG TABLETEXT.REL 12HR,16.86,10.96,2.83,16.86,22
NDC,0781196160,CLARITHROMYCIN 250 MG TABLET,12.04,7.83,2.02,12.04,22
NDC,0781196260,CLARITHROMYCIN 500 MG TABLET,12.04,7.83,2.02,12.04,22
NDC,0781202001,AMOXICILLIN 250 MG CAPSULE,0.5,0.33,0.08,0.5,22
NDC,0781206701,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,7.94,5.16,0.18,7.94,31
NDC,0781222801,THIOTHIXENE 5 MG CAPSULE,0.92,0.6,0.15,0.92,22
NDC,0781227001,BUTALBITAL-ASPIRIN-CAFFEINE 50 MG-325 MG-40 MG CAPSULE,2.74,1.78,0.46,2.74,22
NDC,0781232368,APREPITANT 125 MG CAPSULE,636.78,413.91,3.15,636.78,31
NDC,0781233501,DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULEEXTEND RELEASE,12.26,7.97,2.06,12.26,22
NDC,0781261301,AMOXICILLIN 500 MG CAPSULE,0.86,0.56,0.14,0.86,22
NDC,0781261305,AMOXICILLIN 500 MG CAPSULE,0.76,0.49,0.13,0.76,22
NDC,0781261460,RIVASTIGMINE 1.5 MG CAPSULE,8.48,5.51,1.42,8.48,22
NDC,0781304072,REGONOL 5 MG/ML INJECTION SOLUTION,57.6,37.44,9.68,57.6,22
NDC,0781304095,REGONOL 5 MG/ML INJECTION SOLUTION,57.6,37.44,9.68,57.6,22
NDC,0781305670,ISONIAZID 100 MG/ML INJECTION SOLUTION,105.63,68.66,0.3,105.63,26
NDC,0781305972,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,11.22,7.29,1.88,26.5,31
NDC,0781305995,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,11.22,7.29,1.88,26.5,31
NDC,0781311395,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,55.38,36.0,0.95,55.38,31
NDC,0781315606,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,1.32,0.86,0.06,1.32,31
NDC,0781315895,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,3411.81,2217.68,0.22,3411.81,40
NDC,0781315972,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,124.5,80.93,0.86,124.5,31
NDC,0781320695,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,44.49,28.92,0.41,44.49,31
NDC,0781320795,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,80.64,52.42,0.41,80.64,31
NDC,0781320895,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,138.0,89.7,0.41,138.0,31
NDC,0781320995,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,274.23,178.25,0.41,274.23,31
NDC,0781321046,CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION,1345.29,874.44,0.41,1345.29,31
NDC,0781323394,CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,1648.12,1071.28,0.58,1648.12,47
NDC,0781323434,GLATOPA 20 MG/ML SUBCUTANEOUS SYRINGE,649.23,422.0,61.99,649.23,36
NDC,0781323471,GLATOPA 20 MG/ML SUBCUTANEOUS SYRINGE,649.23,422.0,61.99,649.23,36
NDC,0781324494,CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,3296.24,2142.56,0.58,3296.24,50
NDC,0781325071,GLATOPA 40 MG/ML SUBCUTANEOUS SYRINGE,1572.9,1022.39,61.99,1572.9,36
NDC,0781325089,GLATOPA 40 MG/ML SUBCUTANEOUS SYRINGE,1572.9,1022.39,61.99,1572.9,36
NDC,0781325594,CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,6592.52,4285.14,0.58,6592.52,53
NDC,0781328891,CLINDAMYCIN 300 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.6,0.39,0.1,6.49,31
NDC,0781340295,AMPICILLIN 250 MG SOLUTION FOR INJECTION,12.57,8.17,0.9,12.57,31
NDC,0781340495,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,25.92,16.85,0.9,25.92,31
NDC,0781340795,AMPICILLIN 500 MG SOLUTION FOR INJECTION,13.23,8.6,0.9,13.23,31
NDC,0781340895,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,50.25,32.66,0.9,50.25,31
NDC,0781340995,AMPICILLIN 10 GRAM SOLUTION FOR INJECTION,323.31,210.15,0.9,323.31,31
NDC,0781341392,AMPICILLIN 2 GRAM INTRAVENOUS SOLUTION,104.25,67.76,0.9,104.25,31
NDC,0781344095,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,288.72,187.67,25.73,288.72,31
NDC,0781345196,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,22.5,14.63,0.73,22.5,31
NDC,0781346595,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,345.63,224.66,0.93,345.63,31
NDC,0781400332,LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT,2673.0,1737.45,9.92,2673.0,26
NDC,0781506101,AMOXICILLIN 875 MG TABLET,1.74,1.13,0.29,1.74,22
NDC,0781506120,AMOXICILLIN 875 MG TABLET,1.84,1.2,0.31,1.84,22
NDC,0781517501,MYCOPHENOLATE MOFETIL 500 MG TABLET,15.88,10.32,0.18,15.88,31
NDC,0781528364,CETIRIZINE 5 MG CHEWABLE TABLET,10.72,6.97,1.8,10.72,22
NDC,0781528464,CETIRIZINE 10 MG CHEWABLE TABLET,10.72,6.97,1.8,10.72,22
NDC,0781551501,GRISEOFULVIN MICROSIZE 500 MG TABLET,18.7,12.16,3.14,18.7,22
NDC,0781557801,ENTACAPONE 200 MG TABLET,7.9,5.14,1.33,7.9,22
NDC,0781562501,CARBIDOPA 18.75 MG-LEVODOPA 75 MG-ENTACAPONE 200 MG TABLET,7.5,4.88,1.26,7.5,22
NDC,0781563701,CARBIDOPA 25 MG-LEVODOPA 100 MG-ENTACAPONE 200 MG TABLET,7.5,4.88,1.26,7.5,22
NDC,0781564101,CARBIDOPA 31.25 MG-LEVODOPA 125 MG-ENTACAPONE 200 MG TABLET,7.5,4.88,1.26,7.5,22
NDC,0781565401,CARBIDOPA 37.5 MG-LEVODOPA 150 MG-ENTACAPONE 200 MG TABLET,7.5,4.88,1.26,7.5,22
NDC,0781566901,CARBIDOPA 50 MG-LEVODOPA 200 MG-ENTACAPONE 200 MG TABLET,7.5,4.88,1.26,7.5,22
NDC,0781600078,DIFLUPREDNATE 0.05 % EYE DROPS,88.56,57.56,14.88,88.56,22
NDC,0781602246,CLARITHROMYCIN 125 MG/5 ML ORAL SUSPENSION,3.75,2.44,0.63,3.75,22
NDC,0781602346,CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,5.45,3.54,0.92,5.45,22
NDC,0781602352,CLARITHROMYCIN 250 MG/5 ML ORAL SUSPENSION,5.9,3.84,0.99,5.9,22
NDC,0781613595,PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,47.64,30.97,0.75,47.64,31
NDC,0781613954,AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,1.65,1.07,0.28,1.65,22
NDC,0781613957,AMOXICILLIN 600 MG-POTASSIUM CLAVULANATE 42.9 MG/5 ML ORAL SUSPENSION,1.73,1.12,0.29,1.73,22
NDC,0781615395,PENICILLIN G SODIUM 5 MILLION UNIT SOLUTION FOR INJECTION,172.8,112.32,29.03,172.8,30
NDC,0781618667,CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPSSUSPENSION,74.72,48.57,12.55,74.72,22
NDC,0781620693,BIMATOPROST 0.03 % DROPS WITH APPLICATOR EYELASH BASE,96.44,62.69,16.2,96.44,22
NDC,0781712983,ESTRADIOL 0.025 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,27.18,17.67,4.57,27.18,22
NDC,0781713593,MOXIFLOXACIN 0.5 % EYE DROPS,116.22,75.54,19.52,116.22,22
NDC,0781714483,ESTRADIOL 0.05 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,27.18,17.67,4.57,27.18,22
NDC,0781716783,ESTRADIOL 0.1 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,27.22,17.69,4.57,27.22,22
NDC,0781729685,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,13.42,8.72,2.25,13.42,22
NDC,0781730431,RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH,33.8,21.97,5.68,33.8,22
NDC,0781730458,RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH,33.8,21.97,5.68,33.8,22
NDC,0781730931,RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH,33.8,21.97,5.68,33.8,22
NDC,0781730958,RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH,33.8,21.97,5.68,33.8,22
NDC,0781731331,RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH,33.8,21.97,5.68,33.8,22
NDC,0781802801,TRIFLUOPERAZINE 1 MG TABLET,1.76,1.14,0.3,1.76,22
NDC,0781803401,TRIFLUOPERAZINE 5 MG TABLET,3.24,2.11,0.54,3.24,22
NDC,0781940495,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,25.92,16.85,0.9,25.92,31
NDC,0781940880,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,50.25,32.66,0.9,50.25,31
NDC,0781940895,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,50.25,32.66,0.9,50.25,31
NDC,0799000102,CALMOSEPTINE 0.44 %-20.6 % TOPICAL OINTMENT,0.14,0.09,0.02,0.14,22
NDC,0799000104,CALMOSEPTINE 0.44 %-20.6 % TOPICAL OINTMENT,0.1,0.07,0.02,0.1,22
NDC,0799000105,CALMOSEPTINE 0.44 %-20.6 % TOPICAL OINTMENT IN PACKET,0.28,0.18,0.05,0.28,22
NDC,0832022500,MORPHINE ER 10 MG CAPSULEEXTENDED RELEASE PELLETS,9.46,6.15,1.59,9.46,22
NDC,0832022600,MORPHINE ER 20 MG CAPSULEEXTENDED RELEASE PELLETS,10.46,6.8,1.76,10.46,22
NDC,0832022700,MORPHINE ER 30 MG CAPSULEEXTENDED RELEASE PELLETS,11.38,7.4,1.91,11.38,22
NDC,0832022800,MORPHINE ER 50 MG CAPSULEEXTENDED RELEASE PELLETS,19.0,12.35,3.19,19.0,22
NDC,0832028500,BEXAROTENE 75 MG CAPSULE,536.7,348.86,90.17,536.7,22
NDC,0832051000,BETHANECHOL CHLORIDE 5 MG TABLET,1.8,1.17,0.3,1.8,22
NDC,0832051100,BETHANECHOL CHLORIDE 10 MG TABLET,4.0,2.6,0.67,4.0,22
NDC,0832051101,BETHANECHOL CHLORIDE 10 MG TABLET,4.0,2.6,0.67,4.0,22
NDC,0832051189,BETHANECHOL CHLORIDE 10 MG TABLET,4.0,2.6,0.67,4.0,22
NDC,0832051200,BETHANECHOL CHLORIDE 25 MG TABLET,5.34,3.47,0.9,5.34,22
NDC,0832051201,BETHANECHOL CHLORIDE 25 MG TABLET,5.34,3.47,0.9,5.34,22
NDC,0832058011,CLOBAZAM 10 MG TABLET,36.62,23.8,6.15,36.62,22
NDC,0832058111,CLOBAZAM 20 MG TABLET,73.22,47.59,12.3,73.22,22
NDC,0832059530,EXEMESTANE 25 MG TABLET,40.46,26.3,6.8,40.46,22
NDC,0832074260,PROPAFENONE ER 425 MG CAPSULEEXTENDED RELEASE 12 HR,20.0,13.0,3.36,20.0,22
NDC,0832107130,TOPIRAMATE XR 25 MG CAPSULE SPRINKLEEXTENDED RELEASE 24 HR,19.86,12.91,3.34,19.86,22
NDC,0832112035,TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GEL PACKET,5.5,3.58,0.92,5.5,22
NDC,0832601700,CHLORPROMAZINE 10 MG TABLET,8.4,5.46,1.41,8.4,22
NDC,0832601800,CHLORPROMAZINE 25 MG TABLET,15.28,9.93,2.57,15.28,22
NDC,0832603212,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,2.45,1.59,0.41,2.45,22
NDC,0869060243,EPSOM SALT 100 % CRYSTALS,0.01,0.01,0.01,0.01,22
NDC,0869068638,CITROMA ORAL SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0869420610,MINERAL OIL ORAL,0.03,0.02,0.01,0.03,22
NDC,0884629730,PHENOL EZ 89 % TOPICAL SWAB,10.92,7.1,1.83,10.92,22
NDC,0904001259,ALLERGY (CHLORPHENIRAMINE) 4 MG TABLET,0.02,0.01,0.01,0.02,22
NDC,0904001261,ALLERGY (CHLORPHENIRAMINE) 4 MG TABLET,0.18,0.12,0.03,0.18,22
NDC,0904027746,VITAMIN E (DL ACETATE) 450 MG (1000 UNIT) CAPSULE,0.3,0.2,0.05,0.3,22
NDC,0904027760,VITAMIN E (DL ACETATE) 450 MG (1000 UNIT) CAPSULE,0.28,0.18,0.05,0.28,22
NDC,0904052360,VITAMIN C 500 MG TABLET,0.06,0.04,0.01,0.06,22
NDC,0904052361,VITAMIN C 500 MG TABLET,0.1,0.07,0.02,0.1,22
NDC,0904052372,VITAMIN C 500 MG TABLET,0.06,0.04,0.01,0.06,22
NDC,0904053061,TAB-A-VITE 400 MCG TABLET,0.1,0.07,0.02,0.1,22
NDC,0904053961,THERA 400 MCG TABLET,0.12,0.08,0.02,0.12,22
NDC,0904078816,MILK OF MAGNESIA 400 MG/5 ML ORAL SUSPENSION,0.03,0.02,0.01,0.03,22
NDC,0904110309,POVIDONE-IODINE 10 % TOPICAL SOLUTION,0.04,0.03,0.01,0.04,22
NDC,0904188361,OYSTER SHELL CALCIUM-500  500 MG (AS CARBONATE 1250 MG) TABLET,0.1,0.07,0.02,0.1,22
NDC,0904198760,MAPAP (ACETAMINOPHEN) 500 MG CAPSULE,0.08,0.05,0.01,0.08,22
NDC,0904201559,TRI-BUFFERED ASPIRIN 325 MG TABLET,0.06,0.04,0.01,0.06,22
NDC,0904205112,DRIMINATE 50 MG TABLET,0.14,0.09,0.02,0.14,22
NDC,0904205159,DRIMINATE 50 MG TABLET,0.04,0.03,0.01,0.04,22
NDC,0904208560,VITAMIN A 3000 MCG (10000 UNIT) CAPSULE,0.1,0.07,0.02,0.1,22
NDC,0904227260,NIACIN 500 MG TABLET,0.08,0.05,0.01,0.08,22
NDC,0904250091,FIBER (CALCIUM POLYCARBOPHIL) 625 MG TABLET,0.16,0.1,0.03,0.16,22
NDC,0904253321,CALAMINE 8 %-ZINC OXIDE 8 % LOTION,0.02,0.01,0.01,0.02,22
NDC,0904385461,CARBAMAZEPINE 100 MG CHEWABLE TABLET,1.22,0.79,0.2,1.22,22
NDC,0904386575,DEEP SEA NASAL 0.65 % SPRAY AEROSOL,0.06,0.04,0.01,0.06,22
NDC,0904404073,ASPIRIN 81 MG CHEWABLE TABLET,0.06,0.04,0.01,0.06,22
NDC,0904429909,THERA-DERM LOTION,0.02,0.01,0.01,0.02,22
NDC,0904505359,SUDOGEST 30 MG TABLET,0.06,0.04,0.01,0.06,22
NDC,0904515460,GUAIFENESIN 200 MG TABLET,0.08,0.05,0.01,0.08,22
NDC,0904522452,DAIRY-AID 3000 UNIT TABLET,0.18,0.12,0.03,0.18,22
NDC,0904530016,LUBRISOFT LOTION,0.02,0.01,0.01,0.02,22
NDC,0904530661,DIPHENHYDRAMINE 25 MG CAPSULE,0.08,0.05,0.01,0.08,22
NDC,0904530909,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,22
NDC,0904530920,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.02,0.1,22
NDC,0904531346,PRENATAL VITAMIN 27 MG IRON-0.8 MG TABLET,0.14,0.09,0.02,0.14,22
NDC,0904535431,BANOPHEN ANTI-ITCH 2 %-0.1 % TOPICAL CREAM,0.16,0.1,0.03,0.16,22
NDC,0904539561,FERREX 150 MG IRON CAPSULE,0.3,0.2,0.05,0.3,22
NDC,0904544861,PENTOXIFYLLINE ER 400 MG TABLETEXTENDED RELEASE,0.74,0.48,0.12,0.74,22
NDC,0904546080,OYSTER SHELL CALCIUM-VITAMIN D3 500 MG-5 MCG (200 UNIT) TABLET,0.04,0.03,0.01,0.04,22
NDC,0904552261,DOXAZOSIN 1 MG TABLET,2.04,1.33,0.34,2.04,22
NDC,0904552461,DOXAZOSIN 4 MG TABLET,2.06,1.34,0.35,2.06,22
NDC,0904552952,HEARTBURN RELIEF (FAMOTIDINE) 10 MG TABLET,0.18,0.12,0.03,0.18,22
NDC,0904552987,HEARTBURN RELIEF (FAMOTIDINE) 10 MG TABLET,0.2,0.13,0.03,0.2,22
NDC,0904555159,BANOPHEN 25 MG TABLET,0.04,0.03,0.01,0.04,22
NDC,0904557720,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.02,0.1,22
NDC,0904567661,PAROXETINE 10 MG TABLET,1.92,1.25,0.32,1.92,22
NDC,0904567761,PAROXETINE 20 MG TABLET,0.6,0.39,0.1,0.6,22
NDC,0904572514,MINTOX MAXIMUM STRENGTH 400 MG-400 MG-40 MG/5 ML ORAL SUSPENSION,0.03,0.02,0.01,0.03,22
NDC,0904573182,WHITE PETROLATUM TOPICAL JELLY,0.02,0.01,0.01,0.02,22
NDC,0904579146,CHILDREN'S MAPAP 80 MG CHEWABLE TABLET,0.16,0.1,0.03,0.16,22
NDC,0904582360,VITAMIN D3 10 MCG (400 UNIT) TABLET,0.04,0.03,0.01,0.04,22
NDC,0904585361,IBUPROFEN 400 MG TABLET,0.16,0.1,0.03,0.16,22
NDC,0904589161,PRAVASTATIN 10 MG TABLET,0.94,0.61,0.16,0.94,22
NDC,0904592161,DIGOXIN 125 MCG (0.125 MG) TABLET,3.24,2.11,0.54,3.24,22
NDC,0904592261,DIGOXIN 250 MCG (0.25 MG) TABLET,3.24,2.11,0.54,3.24,22
NDC,0904595961,CLINDAMYCIN HCL 150 MG CAPSULE,0.8,0.52,0.13,0.8,22
NDC,0904598426,AMMONIUM LACTATE 12 % LOTION,0.04,0.03,0.01,0.04,22
NDC,0904598463,AMMONIUM LACTATE 12 % LOTION,0.04,0.03,0.01,0.04,22
NDC,0904608261,ZOLPIDEM 5 MG TABLET,0.2,0.13,0.03,0.2,22
NDC,0904608461,CITALOPRAM 10 MG TABLET,0.14,0.09,0.02,0.14,22
NDC,0904608561,CITALOPRAM 20 MG TABLET,0.14,0.09,0.02,0.14,22
NDC,0904617261,CARBAMAZEPINE 200 MG TABLET,2.16,1.4,0.36,2.16,22
NDC,0904625549,SORE THROAT (BENZOCAINE WITH MENTHOL) 15 MG-3.6 MG LOZENGES,0.38,0.25,0.06,0.38,22
NDC,0904626908,ZIPRASIDONE 20 MG CAPSULE,11.58,7.53,1.95,11.58,22
NDC,0904630521,SORE THROAT (PHENOL) 1.4 % AEROSOL SPRAY,0.04,0.03,0.01,0.04,22
NDC,0904632261,METOPROLOL SUCCINATE ER 25 MG TABLETEXTENDED RELEASE 24 HR,2.1,1.37,0.35,2.1,22
NDC,0904633724,SUDOGEST 30 MG TABLET,0.16,0.1,0.03,0.16,22
NDC,0904635161,LEVOFLOXACIN 250 MG TABLET,0.52,0.34,0.09,0.52,22
NDC,0904635261,LEVOFLOXACIN 500 MG TABLET,0.58,0.38,0.1,0.58,22
NDC,0904635361,LEVOFLOXACIN 750 MG TABLET,1.06,0.69,0.18,1.06,22
NDC,0904636961,AMLODIPINE 2.5 MG TABLET,0.34,0.22,0.06,0.34,22
NDC,0904637361,ROPINIROLE 0.25 MG TABLET,1.18,0.77,0.2,1.18,22
NDC,0904637461,ROPINIROLE 1 MG TABLET,1.36,0.88,0.23,1.36,22
NDC,0904640761,BISACODYL 5 MG TABLETDELAYED RELEASE,0.06,0.04,0.01,0.06,22
NDC,0904641292,CALCIUM ANTACID 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.04,0.03,0.01,0.04,22
NDC,0904641861,TIZANIDINE 4 MG TABLET,1.26,0.82,0.21,1.26,22
NDC,0904642661,ESCITALOPRAM 10 MG TABLET,0.36,0.23,0.06,0.36,22
NDC,0904642761,ESCITALOPRAM 20 MG TABLET,0.44,0.29,0.07,0.44,22
NDC,0904643604,TEMAZEPAM 7.5 MG CAPSULE,8.4,5.46,1.41,8.4,22
NDC,0904645061,ISOSORBIDE MONONITRATE ER 60 MG TABLETEXTENDED RELEASE 24 HR,1.0,0.65,0.17,1.0,22
NDC,0904646707,CLOPIDOGREL 300 MG TABLET,31.88,20.72,5.36,31.88,22
NDC,0904647761,DONEPEZIL 5 MG TABLET,0.32,0.21,0.05,0.32,22
NDC,0904657561,PHENOBARBITAL 32.4 MG TABLET,0.92,0.6,0.15,0.92,22
NDC,0904659961,PERPHENAZINE 2 MG TABLET,2.38,1.55,0.4,2.38,22
NDC,0904663861,QUETIAPINE 25 MG TABLET,0.7,0.46,0.12,0.7,22
NDC,0904663961,QUETIAPINE 50 MG TABLET,1.12,0.73,0.19,1.12,22
NDC,0904664524,CHILDREN'S MAPAP 160 MG CHEWABLE TABLET,0.2,0.13,0.03,0.2,22
NDC,0904672040,ACETAMINOPHEN 500 MG TABLET,0.04,0.03,0.01,0.04,22
NDC,0904672852,SUDOGEST 60 MG TABLET,0.14,0.09,0.02,0.14,22
NDC,0904673061,ACETAMINOPHEN 500 MG TABLET,0.08,0.05,0.01,0.08,22
NDC,0904673080,ACETAMINOPHEN 500 MG TABLET,0.04,0.03,0.01,0.04,22
NDC,0904673461,MEMANTINE 7 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,6.22,4.04,1.04,6.22,22
NDC,0904674860,BISACODYL 5 MG TABLETDELAYED RELEASE,0.04,0.03,0.01,0.04,22
NDC,0904675180,ASPIRIN 81 MG TABLETDELAYED RELEASE,0.02,0.01,0.01,0.02,22
NDC,0904675415,SUDOGEST 12-HOUR 120 MG TABLETEXTENDED RELEASE,0.94,0.61,0.16,0.94,22
NDC,0904676520,CHILDREN'S CETIRIZINE 1 MG/ML ORAL SOLUTION,0.13,0.08,0.02,0.13,22
NDC,0904677361,ACETAMINOPHEN 325 MG TABLET,0.12,0.08,0.02,0.12,22
NDC,0904679480,ASPIRIN 81 MG CHEWABLE TABLET,0.02,0.01,0.01,0.02,22
NDC,0904679761,LISINOPRIL 5 MG TABLET,0.16,0.1,0.03,0.16,22
NDC,0904680861,MONTELUKAST 10 MG TABLET,0.8,0.52,0.13,0.8,22
NDC,0904683620,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,0.1,0.07,0.02,0.1,22
NDC,0904686861,TRAZODONE 50 MG TABLET,0.3,0.2,0.05,0.3,22
NDC,0904690706,PSEUDOEPHEDRINE 60 MG TABLET,0.18,0.12,0.03,0.18,22
NDC,0904693181,POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,3.1,2.02,0.52,3.1,22
NDC,0904699061,PSEUDOEPHEDRINE 30 MG TABLET,0.1,0.07,0.02,0.1,22
NDC,0904701416,CHILDREN'S ACETAMINOPHEN 160 MG/5 ML ORAL LIQUID,0.03,0.02,0.01,0.03,22
NDC,0904701420,CHILDREN'S ACETAMINOPHEN 160 MG/5 ML ORAL LIQUID,0.05,0.03,0.01,0.05,22
NDC,0904702367,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT IN PACKET,0.26,0.17,0.04,0.26,22
NDC,0904702761,OXYBUTYNIN CHLORIDE 5 MG TABLET,1.44,0.94,0.24,1.44,22
NDC,0904705699,ASPIRIN 25 MG-DIPYRIDAMOLE 200 MG CAPSULEEXT.RELEASE 12 HR MULTIPHASE,25.34,16.47,4.26,25.34,22
NDC,0904710761,RIVASTIGMINE 1.5 MG CAPSULE,7.88,5.12,1.32,7.88,22
NDC,0904714110,METHOTREXATE SODIUM 2.5 MG TABLET,7.16,4.65,0.16,7.16,30
NDC,0904714504,DRONABINOL 5 MG CAPSULE,41.26,26.82,6.93,41.26,22
NDC,0904715661,METRONIDAZOLE 250 MG TABLET,0.96,0.62,0.16,0.96,22
NDC,0904717207,EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,4.68,3.04,0.79,4.68,22
NDC,0904717761,FUROSEMIDE 20 MG TABLET,0.18,0.12,0.03,0.18,22
NDC,0904717861,FUROSEMIDE 40 MG TABLET,0.18,0.12,0.03,0.18,22
NDC,0904718361,DOCUSATE SODIUM 100 MG CAPSULE,0.12,0.08,0.02,0.12,22
NDC,0904719106,THIAMINE HCL (VITAMIN B1) 100 MG TABLET,0.36,0.23,0.06,0.36,22
NDC,0904719260,FEXOFENADINE 60 MG TABLET,0.44,0.29,0.07,0.44,22
NDC,0904723661,MEGESTROL 40 MG TABLET,0.56,0.36,0.09,0.56,22
NDC,0904724361,CIPROFLOXACIN 500 MG TABLET,0.74,0.48,0.12,0.74,22
NDC,0904725261,SENNA LAX 8.6 MG TABLET,0.1,0.07,0.02,0.1,22
NDC,0904726261,OXCARBAZEPINE 150 MG TABLET,1.36,0.88,0.23,1.36,22
NDC,0904726361,OXCARBAZEPINE 300 MG TABLET,2.02,1.31,0.34,2.02,22
NDC,0904728060,DOCUSATE SODIUM 100 MG CAPSULE,0.04,0.03,0.01,0.04,22
NDC,0904731970,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLUTION,0.65,0.42,0.11,0.65,22
NDC,0904734661,FLUOXETINE 20 MG CAPSULE,0.22,0.14,0.04,0.22,22
NDC,0904748660,FEXOFENADINE 180 MG TABLET,0.32,0.21,0.05,0.32,22
NDC,0904750852,DAIRY RELIEF 3000 UNIT TABLET,0.18,0.12,0.03,0.18,22
NDC,0904750930,ASPIRIN 81 MG CHEWABLE TABLET,0.18,0.12,0.03,0.18,22
NDC,0904754012,LUBRIFRESH PM 83 %-15 % EYE OINTMENT,4.14,2.69,0.7,4.14,22
NDC,0904759160,FEROSUL 325 MG (65 MG IRON) TABLET,0.04,0.03,0.01,0.04,22
NDC,0904759161,FERROUS SULFATE 325 MG (65 MG IRON) TABLET,0.08,0.05,0.01,0.08,22
NDC,0904772512,ANTI-DIARRHEAL (LOPERAMIDE) 2 MG TABLET,0.36,0.23,0.06,0.36,22
NDC,0904772524,ANTI-DIARRHEAL (LOPERAMIDE) 2 MG TABLET,0.3,0.2,0.05,0.3,22
NDC,0904772714,ACID GONE ANTACID 95 MG-358 MG/15 ML ORAL SUSPENSION,0.05,0.03,0.01,0.05,22
NDC,0904773445,MICONAZOLE-7  2 % VAGINAL CREAM,0.34,0.22,0.06,0.34,22
NDC,0904773518,PROSIGHT 5000 UNIT-60 MG-30 UNIT TABLET,0.08,0.05,0.01,0.08,22
NDC,0904773552,PROSIGHT 5000 UNIT-60 MG-30 UNIT TABLET,0.08,0.05,0.01,0.08,22
NDC,0904775127,MINERIN CREME TOPICAL,0.02,0.01,0.01,0.02,22
NDC,0941040901,DIANEAL LOW CALCIUM WITH 1.5% DEXTROSE CALCIUM 2.5 MEQ/L-MAG 0.5 MEQ/L,0.03,0.02,0.01,0.03,22
NDC,0941040905,DIANEAL LOW CALCIUM WITH 1.5% DEXTROSE CALCIUM 2.5 MEQ/L-MAG 0.5 MEQ/L,0.06,0.04,0.01,0.06,22
NDC,0941040906,DIANEAL LOW CALCIUM WITH 1.5% DEXTROSE CALCIUM 2.5 MEQ/L-MAG 0.5 MEQ/L,0.06,0.04,0.01,0.06,22
NDC,0941041106,DIANEAL PD-2 WITH 1.5 % DEXTROSE CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.06,0.04,0.01,0.06,22
NDC,0941041301,DIANEAL PD-2 WITH 2.5 % DEXTROSE CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.06,0.04,0.01,0.06,22
NDC,0941041305,DIANEAL PD-2 WITH 2.5 % DEXTROSE CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.18,0.12,0.03,0.18,22
NDC,0941041306,DIANEAL PD-2 WITH 2.5 % DEXTROSE CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.12,0.08,0.02,0.12,22
NDC,0941041505,DIANEAL PD-2 WITH 4.25% DEXTROSE CALCIUM 3.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.15,0.1,0.03,0.15,22
NDC,0941041506,DIANEAL PD-2 WITH 4.25% DEXTROSE CALCIUM 3.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.06,0.04,0.01,0.06,22
NDC,0941042452,DIANEAL WITH 1.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.09,0.06,0.02,0.09,22
NDC,0941042453,DIANEAL WITH 1.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.09,0.06,0.02,0.09,22
NDC,0941042652,ULTRABAG/DIANEAL PD-2/1.5% DEXTROS CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.09,0.06,0.02,0.09,22
NDC,0941042653,DIANEAL PD-2 WITH 1.5 % DEXTROSE CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.06,0.04,0.01,0.06,22
NDC,0941042752,ULTRABAG/DIANEAL PD-2 WITH 2.5% DEXTROSE CA 3.5 MEQ/L-MAG 0.5 MEQ/L,0.09,0.06,0.02,0.09,22
NDC,0941042952,ULTRABAG/DIANEAL PD-2 WITH 4.25 % DEXTROSE CA 3.5 MEQ/L-MAG 0.5 MEQ/L,0.09,0.06,0.02,0.09,22
NDC,0941043052,ULTRABAG/DIANEAL DEXTROSE 2.5 %-LOW CALCIUM 2.5 MEQ-LOW MAG 0.5 MEQ/L,0.09,0.06,0.02,0.09,22
NDC,0941043053,DIANEAL WITH 2.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.06,0.04,0.01,0.06,22
NDC,0941043352,DIANEAL WITH 4.25 % DEXTROSE CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.09,0.06,0.02,0.09,22
NDC,0941043353,DIANEAL WITH 4.25 % DEXTROSE CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.06,0.04,0.01,0.06,22
NDC,0941045701,DIANEAL WITH 2.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,22
NDC,0941045702,DIANEAL WITH 2.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.06,0.04,0.01,0.06,22
NDC,0941045708,DIANEAL WITH 2.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.06,0.04,0.01,0.06,22
NDC,0941045901,DIANEAL LOW CALCIUM WITH 4.25% DEXTROSE CALCIUM 2.5 MEQ/L-MAG 0.5MEQ/L,0.03,0.02,0.01,0.03,22
NDC,0941045908,DIANEAL LOW CALCIUM WITH 4.25% DEXTROSE CALCIUM 2.5 MEQ/L-MAG 0.5MEQ/L,0.06,0.04,0.01,0.06,22
NDC,0941067906,EXTRANEAL 7.5 % WITH CALCIUM 3.5 MEQ/L-LOW MAGNESIUM 0.5 MEQ/L,0.21,0.14,0.04,0.21,22
NDC,0941067952,EXTRANEAL 7.5 % WITH CALCIUM 3.5 MEQ/L-LOW MAGNESIUM 0.5 MEQ/L,0.27,0.18,0.05,0.27,22
NDC,0941069606,DIANEAL LOW CALCIUM WITH 4.25% DEXTROSE CALCIUM 2.5 MEQ/L-MAG 0.5MEQ/L,0.03,0.02,0.01,0.03,22
NDC,0941069806,DIANEAL PD-2 WITH 2.5 % DEXTROSE CALCIUM 3.5 MEQ/L-LOW MAG 0.5 MEQ/L,0.03,0.02,0.01,0.03,22
NDC,0942064104,ACD-A 2.45-2.2 GRAM-730 MG/100 ML SOLUTION,0.01,0.01,0.01,0.01,22
NDC,0942950410,SODIUM CITRATE 4 GRAM/100 ML (4 %) SOLUTION,0.02,0.01,0.01,0.02,22
NDC,0942950510,SODIUM CITRATE 4 GRAM/100 ML (4 %) SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0944049301,FLEXBUMIN 25 % INTRAVENOUS SOLUTION,4.17,2.71,1.04,146.89,33
NDC,0944049302,FLEXBUMIN 25 % INTRAVENOUS SOLUTION,4.17,2.71,1.04,146.89,33
NDC,0944049505,FLEXBUMIN 5 % INTRAVENOUS SOLUTION,0.84,0.55,0.22,218.09,40
NDC,0944251002,HYQVIA 2.5 GRAM/25 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,15.25,1355.53,47
NDC,0944251102,HYQVIA 5 GRAM/50 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,15.25,1355.53,47
NDC,0944251202,HYQVIA 10 GRAM/100 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,15.25,1355.53,47
NDC,0944251302,HYQVIA 20 GRAM/200 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,15.25,1355.53,47
NDC,0944251402,HYQVIA 30 GRAM/300 ML (10 %) SUBCUTANEOUS SOLUTION,88.26,57.37,15.25,1355.53,47
NDC,0944265603,GAMMAGARD S-D (IGA < 1 MCG/ML) 5 GRAM INTRAVENOUS SOLUTION,4097.16,2663.15,70.62,4097.16,50
NDC,0944265804,GAMMAGARD S-D (IGA < 1 MCG/ML) 10 GRAM INTRAVENOUS SOLUTION,8194.32,5326.31,70.62,8194.32,53
NDC,0944270002,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,16.28,1355.53,47
NDC,0944270003,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,16.28,1355.53,47
NDC,0944270004,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,16.28,1355.53,47
NDC,0944270005,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,16.28,1355.53,47
NDC,0944270006,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,16.28,1355.53,47
NDC,0944270007,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,16.28,1355.53,47
NDC,0944270012,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,16.28,1355.53,47
NDC,0944270013,GAMMAGARD LIQUID 10 % INJECTION SOLUTION,62.85,40.85,16.28,1355.53,47
NDC,0944281401,ARALAST NP 500 MG INTRAVENOUS SOLUTION,2.34,1.52,0.61,943.43,47
NDC,0944284310,RECOMBINATE 1000 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.36,3407.66,47
NDC,0944284410,RECOMBINATE 1500 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.18,7.05,23
NDC,0944305102,ADVATE 250 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.36,3407.66,47
NDC,0944305202,ADVATE 500 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.36,3407.66,47
NDC,0944305302,ADVATE 1000 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.36,3407.66,47
NDC,0944305402,ADVATE 1500 (+/-) UNIT INTRAVENOUS SOLUTION,7.05,4.58,1.36,3407.66,47
NDC,0944417910,CEPROTIN (GREEN BAR) 1000 UNIT INTRAVENOUS SOLUTION,5.4,3.51,1.4,1355.53,47
NDC,0944500101,OBIZUR 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,10.62,6.9,2.75,3407.66,47
NDC,0944755102,VONVENDI 650 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,7.14,4.64,1.68,3407.66,47
NDC,0944755302,VONVENDI 1300 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,7.14,4.64,1.68,3407.66,47
NDC,0951110308,PYRIDOXAL-5-PHOSPHATE 33.8 MG CAPSULE,0.54,0.35,0.09,0.54,22
NDC,0955102001,DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,523.2,340.08,0.78,523.2,37
NDC,0955102104,DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,522.0,339.3,0.78,522.0,37
NDC,0990613822,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.09,0.06,0.02,0.09,22
NDC,0990613903,WATER FOR IRRIGATION STERILE SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0990614322,ACETIC ACID 0.25 % IRRIGATION SOLUTION,0.09,0.06,0.02,0.09,22
NDC,0990707426,POTASSIUM CHLORIDE 10 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,0.18,0.12,0.03,0.33,31
NDC,0990710709,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,0.33,31
NDC,0990711109,POTASSIUM CHLORIDE 20 MEQ/L-LACTATED RINGERS-5 % DEXTROSE INTRAVENOUS,0.06,0.04,0.01,6.6,31
NDC,0990711609,SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,0.03,0.02,0.01,0.33,31
NDC,0990713809,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0990717117,AMINOSYN II 15 % INTRAVENOUS SOLUTION,0.09,0.06,0.02,0.09,22
NDC,0990771502,MANNITOL 20 % INTRAVENOUS SOLUTION,0.33,0.21,0.06,0.33,23
NDC,0990771512,MANNITOL 20 % INTRAVENOUS SOLUTION,0.33,0.21,0.06,0.33,23
NDC,0990771513,MANNITOL 20 % INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,23
NDC,0990790209,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,22
NDC,0990791819,DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,22
NDC,0990792202,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.09,0.06,0.02,0.09,23
NDC,0990792203,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,4.82,31
NDC,0990792209,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.14,31
NDC,0990792261,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,23
NDC,0990792320,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,1.35,0.88,0.23,8.14,31
NDC,0990792323,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,23
NDC,0990792337,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.12,0.08,0.02,4.82,31
NDC,0990792409,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,31
NDC,0990792909,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,6.6,31
NDC,0990793002,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,0.09,0.06,0.02,0.09,22
NDC,0990793003,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0990793519,DEXTROSE 20 % IN WATER (D20W) INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,22
NDC,0990793619,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,0.12,0.08,0.02,0.12,22
NDC,0990794109,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,31
NDC,0990795303,LACTATED RINGERS INTRAVENOUS SOLUTION,0.03,0.02,0.01,6.6,31
NDC,0990797205,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0990798302,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.09,0.06,0.02,1.84,31
NDC,0990798303,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.56,31
NDC,0990798309,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,5.51,31
NDC,0990798355,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.06,0.04,0.01,3.56,31
NDC,0990798361,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.12,0.08,0.02,1.84,31
NDC,0990798420,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.54,0.35,0.09,1.84,31
NDC,0990798423,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.15,0.1,0.03,3.56,31
NDC,0990798436,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.24,0.16,0.04,0.24,23
NDC,0990798437,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.12,0.08,0.02,5.51,31
NDC,0990799009,WATER FOR INJECTION STERILE 100 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,0995803131,"""MEDIHONEY (CALCIUM ALGINATE-HONEY) 2"""" X 2"""" BANDAGE""",11.42,7.42,1.92,11.42,22
NDC,0995803361,MEDIHONEY (HONEY) 100 % TOPICAL PASTE,0.78,0.51,0.13,0.78,22
NDC,0995803470,MEDIHONEY (HONEY) 80 % TOPICAL GEL,0.78,0.51,0.13,0.78,22
NDC,0995803471,MEDIHONEY (HONEY) 80 % TOPICAL GEL,0.78,0.51,0.13,0.78,22
NDC,0998001530,AZO URINARY PAIN RELIEF 95 MG TABLET,0.48,0.31,0.08,0.48,22
NDC,0998001615,ALCAINE 0.5 % EYE DROPS,4.72,3.07,0.79,4.72,22
NDC,0998030305,ISOPTO ATROPINE 1 % EYE DROPS,17.62,11.45,2.96,17.62,22
NDC,0998035515,MYDRIACYL 1 % EYE DROPS,17.84,11.6,3.0,17.84,22
NDC,0998101009,MICROFIBRILLAR COLLAGEN HEMOSTAT 70 MM X 35 MM SHEETS,696.0,452.4,116.93,696.0,22
NDC,1000670012,PYRIDOXINE (VITAMIN B6) 50 MG TABLET,0.04,0.03,0.01,0.04,22
NDC,1000670020,NIACIN ER 250 MG CAPSULEEXTENDED RELEASE,0.22,0.14,0.04,0.22,22
NDC,1000670038,OYSTER SHELL CALCIUM-VITAMIN D3 500 MG-5 MCG (200 UNIT) TABLET,0.12,0.08,0.02,0.12,22
NDC,1000673013,SLOW RELEASE IRON 140 MG (45 MG IRON) TABLETEXTENDED RELEASE,0.34,0.22,0.06,0.34,22
NDC,1001905561,BREVIBLOC 2500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSM) IV,1.86,1.21,0.2,1.86,31
NDC,1001907587,BREVIBLOC 2000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSM) IV,18.15,11.8,0.2,18.15,31
NDC,1001907901,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,2808.0,1825.2,7.99,2808.0,49
NDC,1001911501,BREVIBLOC 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,7.68,4.99,1.29,7.68,22
NDC,1001955303,TRANSDERM-SCOP 1 MG OVER 3 DAYS TRANSDERMAL PATCH,51.12,33.23,8.59,51.12,22
NDC,1001992501,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,176.36,114.63,23.8,176.36,30
NDC,1001992602,IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,516.2,335.53,23.8,516.2,30
NDC,1001992616,IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,516.2,335.53,23.8,516.2,30
NDC,1001995301,MESNA 100 MG/ML INTRAVENOUS SOLUTION,9.0,5.85,1.51,9.0,30
NDC,1001995362,MESNA 100 MG/ML INTRAVENOUS SOLUTION,9.0,5.85,1.51,9.0,30
NDC,1001995501,CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,1758.0,1142.7,4.92,1758.0,39
NDC,1001995601,CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,2253.52,1464.79,4.92,2253.52,39
NDC,1001995701,CYCLOPHOSPHAMIDE 2 GRAM INTRAVENOUS POWDER FOR SOLUTION,7032.0,4570.8,4.92,7032.0,45
NDC,1004259001,SUSVIMO IMPLANT AND INSERTION TOOL INTRAVITREAL,3000.0,1950.0,504.0,2700.0,21
NDC,1011900252,EYE WASH (BORIC ACID) EYE WASH SOLUTION,0.06,0.04,0.01,0.06,22
NDC,1011902219,SOOTHE LUBRICANT 0.6 %-0.6 % EYE DROPS IN A DROPPERETTE,0.62,0.4,0.1,0.62,22
NDC,1011902239,SOOTHE NIGHT TIME LUBRICANT 80 %-20 % EYE OINTMENT,5.04,3.28,0.85,5.04,22
NDC,1011903048,RENU DISINFECTING SOLUTION,0.06,0.04,0.01,0.06,22
NDC,1011903582,BIO TRUE SOLUTION,0.08,0.05,0.01,0.08,22
NDC,1011905610,BOSTON CONDITIONING SOLUTION,0.18,0.12,0.03,0.18,22
NDC,1011905611,BOSTON SIMPLUS SOLUTION,0.2,0.13,0.03,0.2,22
NDC,1012216002,ELFABRIO 2 MG/ML INTRAVENOUS SOLUTION,1626.21,1057.04,223.55,1626.21,46
NDC,1012218002,LAMZEDE 10 MG INTRAVENOUS SOLUTION,16274.4,10578.36,442.0,18253.82,52
NDC,1012231301,CARDENE 20 MG/200 ML(0.1 MG/ML) IN SOD CHLOR(ISO-OSM) INTRAVENOUS SOLN,1.83,1.19,0.31,1.83,22
NDC,1012231310,CARDENE 20 MG/200 ML(0.1 MG/ML) IN SOD CHLOR(ISO-OSM) INTRAVENOUS SOLN,1.83,1.19,0.31,1.83,22
NDC,1012251001,CUROSURF 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,1507.95,980.17,253.34,1507.95,22
NDC,1012251003,CUROSURF 240 MG/3 ML INTRATRACHEAL SUSPENSION,1486.74,966.38,249.77,1486.74,22
NDC,1012261010,CLEVIPREX 25 MG/50 ML INTRAVENOUS EMULSION,6.54,4.25,1.64,78.3,32
NDC,1012261110,CLEVIPREX 50 MG/100 ML INTRAVENOUS EMULSION,6.54,4.25,1.64,78.3,32
NDC,1012262001,KENGREAL 50 MG INTRAVENOUS SOLUTION,3780.93,2457.6,18.82,3780.93,42
NDC,1012262010,KENGREAL 50 MG INTRAVENOUS SOLUTION,3780.93,2457.6,18.82,3780.93,42
NDC,1013518001,FOLIC ACID 400 MCG TABLET,0.04,0.03,0.01,0.04,22
NDC,1013540401,SALSALATE 750 MG TABLET,2.44,1.59,0.41,2.44,22
NDC,1013562101,PHENAZOPYRIDINE 200 MG TABLET,5.84,3.8,0.98,5.84,22
NDC,1013567191,CLOTRIMAZOLE 1 % TOPICAL SOLUTION,2.68,1.74,0.45,2.68,22
NDC,1014706881,METHYLPHENIDATE ER 27 MG TABLETEXTENDED RELEASE 24 HR,19.16,12.45,3.22,19.16,22
NDC,1014708913,GALANTAMINE ER 8 MG 24 HR CAPSULEEXTENDED RELEASE,12.2,7.93,2.05,12.2,22
NDC,1014709225,HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,177.66,115.48,6.07,177.66,31
NDC,1014717003,ITRACONAZOLE 100 MG CAPSULE,17.82,11.58,2.99,17.82,22
NDC,1015799512,BLISTEX MEDICATED 0.6 %-0.5 %-1.1 %-0.5 % TOPICAL OINTMENT,0.44,0.29,0.07,0.44,22
NDC,1022302013,CETACAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,21.62,14.05,3.63,21.62,22
NDC,1022302014,CETACAINE 2 %-2 %-14 % (200 MG/SEC) TOPICAL SPRAY,39.7,25.81,6.67,39.7,22
NDC,1036179301,E-Z-GAS II 2.21 GRAM-1.53 GRAM/4 GRAM ORAL EFFERVESCENT GRANULES PACK,5.68,3.69,0.95,5.68,22
NDC,1037036511,TOPIRAMATE XR 25 MG CAPSULEEXTENDED RELEASE 24 HR,26.56,17.26,4.46,26.56,22
NDC,1037036701,TOPIRAMATE XR 100 MG CAPSULEEXTENDED RELEASE 24 HR,68.54,44.55,11.51,68.54,22
NDC,1037082905,DILTIAZEM SR 120 MG 24 HR CAP,2.28,1.48,0.38,2.28,22
NDC,1037083005,DILTIAZEM SR 180 MG 24 HR CAP,2.74,1.78,0.46,2.74,22
NDC,1037083009,DILTIAZEM SR 180 MG 24 HR CAP,2.9,1.89,0.49,2.9,22
NDC,1037083105,DILTIAZEM SR 240 MG 24 HR CAP,3.9,2.54,0.66,3.9,22
NDC,1043201702,DELTA D3 10 MCG (400 UNIT) TABLET,0.1,0.07,0.02,0.1,22
NDC,1045471010,MYOBLOC 2500 UNIT/0.5 ML INTRAMUSCULAR SOLUTION,2286.3,1486.1,11.73,2286.3,47
NDC,1045471110,MYOBLOC 5000 UNIT/ML INTRAMUSCULAR SOLUTION,2286.3,1486.1,11.73,2286.3,47
NDC,1045471210,MYOBLOC 10000 UNIT/2 ML INTRAMUSCULAR SOLUTION,2286.3,1486.1,11.73,2286.3,47
NDC,1048101118,LUGOLS 5 %-10 % TOPICAL SOLUTION,2.74,1.78,0.46,2.74,22
NDC,1048101128,MONSEL'S 0.2 GRAM TO 0.22 GRAM/ML TOPICAL SOLUTION APPLICATOR,3.64,2.37,0.61,3.64,22
NDC,1048110511,SILVER NITRATE 10 % TOPICAL SOLUTION,4.5,2.93,0.76,4.5,22
NDC,1048130081,TRI-CHLOR 80 % TOPICAL SOLUTION,10.34,6.72,1.74,10.34,22
NDC,1051103001,HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLUTION,64.8,42.12,10.89,1189.66,24
NDC,1051130012,CYSVIEW 100 MG INTRAVESICAL SOLUTION,97.2,63.18,16.33,1189.66,24
NDC,1057210001,PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,0.03,0.02,0.01,0.03,22
NDC,1057230201,PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,0.03,0.02,0.01,0.03,22
NDC,1059900301,SINUVA 1350 MCG SINUS IMPLANT,3538.44,2299.99,10.21,3538.44,50
NDC,1063120601,RIOMET 500 MG/5 ML ORAL SOLUTION,4.23,2.75,0.71,4.23,22
NDC,1063120602,RIOMET 500 MG/5 ML ORAL SOLUTION,4.23,2.75,0.71,4.23,22
NDC,1063140701,PROCTOSOL HC 2.5 % TOPICAL CREAM PERINEAL APPLICATOR,5.92,3.85,0.99,5.92,22
NDC,1070201101,HYDROXYZINE HCL 25 MG TABLET,1.84,1.2,0.31,1.84,22
NDC,1070201301,BETAXOLOL 10 MG TABLET,2.48,1.61,0.42,2.48,22
NDC,1070201601,INDOMETHACIN ER 75 MG CAPSULEEXTENDED RELEASE,6.08,3.95,1.02,6.08,22
NDC,1070203615,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,1.8,1.17,0.3,1.8,22
NDC,1070205503,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG TABLET,2.98,1.94,0.5,2.98,22
NDC,1070207606,METHYLPHENIDATE ER 20 MG TABLETEXTENDED RELEASE,15.5,10.08,2.6,15.5,22
NDC,1081938852,POVIDONE-IODINE 10 % TOPICAL SWAB,0.32,0.21,0.05,0.32,22
NDC,1085808107,SITZMARKS 24 MARKERS CAPSULE,239.76,155.84,40.28,239.76,22
NDC,1093914533,CALDYPHEN 1 %-8 % LOTION,0.04,0.03,0.01,0.04,22
NDC,1093914833,CALAMINE 8 %-ZINC OXIDE 8 % LOTION,0.02,0.01,0.01,0.02,22
NDC,1093920444,ATHLETE'S FOOT (TERBINAFINE) 1 % TOPICAL CREAM,0.56,0.36,0.09,0.56,22
NDC,1093938033,MICONAZOLE NITRATE 2 % VAGINAL CREAM,0.4,0.26,0.07,0.4,22
NDC,1108603701,DRITHOCREME HP 1 % TOPICAL,16.8,10.92,2.82,16.8,22
NDC,1150900367,VAGISIL 5 %-2 % TOPICAL CREAM,0.22,0.14,0.04,0.22,22
NDC,1152309191,LOTRIMIN AF 2 % TOPICAL POWDER,0.12,0.08,0.02,0.12,22
NDC,1152311673,AFRIN (OXYMETAZOLINE) 0.05 % NASAL SPRAY,0.7,0.46,0.12,0.7,22
NDC,1152311676,AFRIN (OXYMETAZOLINE) 0.05 % NASAL SPRAY,0.98,0.64,0.16,0.98,22
NDC,1152343252,CORICIDIN HBP COLD AND FLU 2 MG-325 MG TABLET,0.76,0.49,0.13,0.76,22
NDC,1152371623,CLARITIN-D 12 HOUR 5 MG-120 MG TABLETEXTENDED RELEASE,2.22,1.44,0.37,2.22,22
NDC,1152371631,CLARITIN 5 MG/5 ML ORAL SOLUTION,0.23,0.15,0.04,0.23,22
NDC,1152802001,COVARYX H.S. 0.625 MG-1.25 MG TABLET,7.2,4.68,1.21,7.2,22
NDC,1153416501,FOLIC ACID 1 MG TABLET,0.14,0.09,0.02,0.14,22
NDC,1153416644,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,0.42,0.27,0.07,0.42,22
NDC,1167346162,IBUPROFEN 100 MG CHEWABLE TABLET,0.38,0.25,0.06,0.38,22
NDC,1170102214,ATRAC-TAIN (WITH AHA) 10 %-4 % TOPICAL CREAM,0.16,0.1,0.03,0.16,22
NDC,1170102223,ATRAC-TAIN (WITH AHA) 10 %-4 % TOPICAL CREAM,0.26,0.17,0.04,0.26,22
NDC,1170103816,MICRO-GUARD 2 % TOPICAL POWDER,0.2,0.13,0.03,0.2,22
NDC,1170104514,BAZA ANTIFUNGAL 2 % TOPICAL CREAM,0.18,0.12,0.03,0.18,22
NDC,1170104523,BAZA ANTIFUNGAL 2 % TOPICAL CREAM,0.26,0.17,0.04,0.26,22
NDC,1170105033,CRITIC-AID 20 %-51 % TOPICAL PASTE,0.24,0.16,0.04,0.24,22
NDC,1170106633,CRITIC-AID CLEAR 71.5 % TOPICAL OINTMENT,0.28,0.18,0.05,0.28,22
NDC,1170106723,CRITIC-AID CLEAR AF (MICONAZOLE) 2 % TOPICAL OINTMENT,0.28,0.18,0.05,0.28,22
NDC,1170462001,DUODOTE 600 MG/2 ML-2.1 MG/0.7 ML INTRAMUSCULAR PEN INJECTOR,56.46,36.7,9.49,56.46,22
NDC,1174302235,SUCROSE ORAL SOLUTION 24%,0.75,0.49,0.13,0.68,21
NDC,1174302237,SUCROSE ORAL SOLUTION 24%,1.53,0.99,0.26,1.38,21
NDC,1184507365,BIOTIN 800 MCG TABLET,0.16,0.1,0.03,0.16,22
NDC,1184514922,FISH OIL 360 MG-1200 MG CAPSULE,0.32,0.21,0.05,0.32,22
NDC,1184577901,PHYTONADIONE (VITAMIN K1) 100 MCG TABLET,0.1,0.07,0.02,0.1,22
NDC,1198017405,PRED MILD 0.12 % EYE DROPSSUSPENSION,77.0,50.05,12.94,77.0,22
NDC,1198018005,PRED FORTE 1 % EYE DROPSSUSPENSION,77.0,50.05,12.94,77.0,22
NDC,1198018010,PRED FORTE 1 % EYE DROPSSUSPENSION,77.0,50.05,12.94,77.0,22
NDC,1198021105,FML LIQUIFILM 0.1 % EYE DROPSSUSPENSION,80.84,52.55,13.58,80.84,22
NDC,1198022805,FML FORTE 0.25 % EYE DROPSSUSPENSION,80.84,52.55,13.58,80.84,22
NDC,1198077905,OCUFLOX 0.3 % EYE DROPS,59.54,38.7,10.0,59.54,22
NDC,1199400602,NEUROLITE 0.9 MG INTRAVENOUS SOLUTION,3766.0,2447.9,683.8,3389.4,39
NDC,1199401116,DEFINITY 1.1 MG/ML INTRAVENOUS SUSPENSION,675.0,438.75,40.03,675.0,24
NDC,1199412711,XENON XE-133  370 MBQ (10 MCI) GAS FOR INHALATION,460.0,299.0,77.28,2409.0,26
NDC,1216510001,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,0.48,0.31,0.08,0.48,22
NDC,1216520003,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,1.0,0.65,0.17,1.0,22
NDC,1249601001,SUBLOCADE 100 MG/0.5 ML SOLUTIONEXTENDED RELEASE SUBCUTANEOUS SYRINGE,15854.61,10305.5,303.41,15854.61,53
NDC,1249601201,PERSERIS 120 MG SUBCUTANEOUS EXTENDED RELEASE SUSPENSION SYRINGE,10435.83,6783.29,10.47,10435.83,53
NDC,1249603001,SUBLOCADE 300 MG/1.5 ML SOLUTIONEXTENDED RELEASE SUBCUTANEOUS SYRINGE,5284.86,3435.16,303.41,5530.74,53
NDC,1249612021,SUBOXONE 2 MG-0.5 MG SUBLINGUAL FILM,12.02,7.81,2.02,12.02,22
NDC,1249612023,SUBOXONE 2 MG-0.5 MG SUBLINGUAL FILM,12.02,7.81,2.02,12.02,22
NDC,1249612043,SUBOXONE 4 MG-1 MG SUBLINGUAL FILM,21.56,14.01,3.62,21.56,22
NDC,1249612081,SUBOXONE 8 MG-2 MG SUBLINGUAL FILM,21.56,14.01,3.62,21.56,22
NDC,1249612083,SUBOXONE 8 MG-2 MG SUBLINGUAL FILM,21.56,14.01,3.62,21.56,22
NDC,1254717162,BENADRYL ITCH STOPPING 1 %-0.1 % TOPICAL CREAM,0.3,0.2,0.05,0.3,22
NDC,1284310239,BAYER ASPIRIN 325 MG TABLET,0.14,0.09,0.02,0.14,22
NDC,1287000011,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,1.82,1.18,0.31,1.82,22
NDC,1287000012,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,1.68,1.09,0.28,1.68,22
NDC,1298002000,ILEX SKIN PROTECTANT TOPICAL PASTE,0.94,0.61,0.16,0.94,22
NDC,1310700130,MIRTAZAPINE 7.5 MG TABLET,5.26,3.42,0.88,5.26,22
NDC,1310700334,MIRTAZAPINE 30 MG TABLET,5.54,3.6,0.93,5.54,22
NDC,1310701401,GLYCOPYRROLATE 1 MG TABLET,2.62,1.7,0.44,2.62,22
NDC,1310703105,MIRTAZAPINE 15 MG TABLET,5.4,3.51,0.91,5.4,22
NDC,1331015307,QUALAQUIN 324 MG CAPSULE,15.72,10.22,2.64,15.72,22
NDC,1351710030,DIAZOXIDE 50 MG/ML ORAL SUSPENSION,30.98,20.14,5.2,30.98,22
NDC,1353331801,HYPERRAB (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,2498.79,1624.21,257.09,2498.79,47
NDC,1353331803,HYPERRAB (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,2498.79,1624.21,257.09,2498.79,47
NDC,1353331805,HYPERRAB (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,2498.79,1624.21,257.09,2498.79,47
NDC,1353333504,GAMASTAN 15 %-18 % RANGE INTRAMUSCULAR SOLUTION,187.26,121.72,44.15,187.26,47
NDC,1353333512,GAMASTAN 15 %-18 % RANGE INTRAMUSCULAR SOLUTION,171.15,111.25,44.15,171.15,47
NDC,1353360250,THROMBATE III 500 (+/-) UNIT INTRAVENOUS SOLUTION,16.53,10.74,3.36,3407.66,47
NDC,1353360612,THROMBATE III 500 (+/-) UNIT INTRAVENOUS SOLUTION,16.53,10.74,3.36,3407.66,47
NDC,1353363102,HYPERRHO 1500 UNIT (300 MCG) INTRAMUSCULAR SYRINGE,307.11,199.62,51.59,307.11,37
NDC,1353363402,HYPERTET (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,2360.37,1534.24,97.89,2360.37,47
NDC,1353363601,HYPERHEP B 220 UNIT/ML INTRAMUSCULAR SOLUTION,618.45,401.99,127.0,652.67,47
NDC,1353363603,HYPERHEP B NEONATAL 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,655.92,426.35,127.0,655.92,47
NDC,1353363605,HYPERHEP B 220 UNIT/ML (5 ML) INTRAMUSCULAR SOLUTION,593.46,385.75,127.0,652.67,47
NDC,1353370501,PROLASTIN-C 1000  MG (+/-)/20 ML INTRAVENOUS SOLUTION,2.22,1.44,0.57,943.43,47
NDC,1353370511,PROLASTIN-C 1000  MG (+/-)/20 ML INTRAVENOUS SOLUTION,2.22,1.44,0.57,943.43,47
NDC,1353380012,GAMUNEX-C 1 GRAM/10 ML (10 %) INJECTION SOLUTION,55.14,35.84,14.28,943.43,47
NDC,1353380015,GAMUNEX-C 2.5 GRAM/25 ML (10 %) INJECTION SOLUTION,55.14,35.84,14.28,943.43,47
NDC,1353380020,GAMUNEX-C 5 GRAM/50 ML (10 %) INJECTION SOLUTION,55.14,35.84,14.28,943.43,47
NDC,1353380024,GAMUNEX-C 20 GRAM/200 ML (10 %) INJECTION SOLUTION,55.14,35.84,14.28,943.43,47
NDC,1353380040,GAMUNEX-C 40 GRAM/400 ML (10 %) INJECTION SOLUTION,55.14,35.84,14.28,943.43,47
NDC,1353380071,GAMUNEX-C 10 GRAM/100 ML (10 %) INJECTION SOLUTION,55.14,35.84,14.28,943.43,47
NDC,1366800901,CITALOPRAM 10 MG TABLET,5.16,3.35,0.87,5.16,22
NDC,1366800905,CITALOPRAM 10 MG TABLET,4.92,3.2,0.83,4.92,22
NDC,1366801001,CITALOPRAM 20 MG TABLET,5.38,3.5,0.9,5.38,22
NDC,1366801005,CITALOPRAM 20 MG TABLET,5.12,3.33,0.86,5.12,22
NDC,1366801101,CITALOPRAM 40 MG TABLET,5.56,3.61,0.93,5.56,22
NDC,1366808830,OLANZAPINE 10 MG DISINTEGRATING TABLET,41.34,26.87,6.95,41.34,22
NDC,1366808930,OLANZAPINE 15 MG DISINTEGRATING TABLET,60.66,39.43,10.19,60.66,22
NDC,1366809190,PRAMIPEXOLE 0.125 MG TABLET,5.9,3.84,0.99,5.9,22
NDC,1366809290,PRAMIPEXOLE 0.25 MG TABLET,5.9,3.84,0.99,5.9,22
NDC,1366809390,PRAMIPEXOLE 0.5 MG TABLET,5.9,3.84,0.99,5.9,22
NDC,1366809490,PRAMIPEXOLE 1 MG TABLET,5.9,3.84,0.99,5.9,22
NDC,1366809590,PRAMIPEXOLE 1.5 MG TABLET,5.9,3.84,0.99,5.9,22
NDC,1366810290,DONEPEZIL 5 MG TABLET,15.58,10.13,2.62,15.58,22
NDC,1366810390,DONEPEZIL 10 MG TABLET,15.58,10.13,2.62,15.58,22
NDC,1366813201,FELODIPINE ER 2.5 MG TABLETEXTENDED RELEASE 24 HR,3.02,1.96,0.51,3.02,22
NDC,1366813301,FELODIPINE ER 5 MG TABLETEXTENDED RELEASE 24 HR,3.02,1.96,0.51,3.02,22
NDC,1366813401,FELODIPINE ER 10 MG TABLETEXTENDED RELEASE 24 HR,5.44,3.54,0.91,5.44,22
NDC,1366845301,ANAGRELIDE 0.5 MG CAPSULE,22.32,14.51,3.75,22.32,22
NDC,1366846201,ANAGRELIDE 1 MG CAPSULE,48.14,31.29,8.09,48.14,22
NDC,1366858630,ERYTHROMYCIN 250 MG TABLETDELAYED RELEASE,16.78,10.91,2.82,16.78,22
NDC,1366858730,ERYTHROMYCIN 333 MG TABLETDELAYED RELEASE,21.12,13.73,3.55,21.12,22
NDC,1366859181,APREPITANT 40 MG CAPSULE,219.88,142.92,36.94,219.88,22
NDC,1381100710,TRINATAL RX 1 60 MG IRON-1 MG TABLET,0.64,0.42,0.11,0.64,22
NDC,1381170110,HYDROMORPHONE ER 8 MG TABLETEXTENDED RELEASE 24 HR,18.48,12.01,3.1,18.48,22
NDC,1381170210,HYDROMORPHONE ER 12 MG TABLETEXTENDED RELEASE 24 HR,27.62,17.95,4.64,27.62,22
NDC,1381170610,METHYLPHENIDATE ER 18 MG TABLETEXTENDED RELEASE 24 HR,18.68,12.14,3.14,18.68,22
NDC,1381170710,METHYLPHENIDATE ER 27 MG TABLETEXTENDED RELEASE 24 HR,19.16,12.45,3.22,19.16,22
NDC,1381170810,METHYLPHENIDATE ER 36 MG TABLETEXTENDED RELEASE 24 HR,19.76,12.84,3.32,19.76,22
NDC,1392550401,DAPSONE 25 MG TABLET,4.4,2.86,0.74,4.4,22
NDC,1392552201,PENTAMIDINE 300 MG SOLUTION FOR INHALATION,361.0,234.65,60.65,361.0,22
NDC,1424720335,SUCROSE ORAL SOLUTION 24%,0.63,0.41,0.11,0.57,21
NDC,1453781775,ANTICOAGULANT CITRATE DEXTROSE(ACD) SOLN A 2.45-2.2 GRAM-800 MG/100 ML,0.03,0.02,0.01,0.03,22
NDC,1453796775,ANTICOAGULANT CITRATE DEXTROSE(ACD) SOLN A 2.45-2.2 GRAM-800 MG/100 ML,0.03,0.02,0.01,0.03,22
NDC,1453967306,DIFLUNISAL 500 MG TABLET,4.14,2.69,0.7,4.14,22
NDC,1465425314,Q-GEL MEGA 100 MG-150 UNIT CAPSULE,1.24,0.81,0.21,1.24,22
NDC,1478910205,TIROFIBAN 12.5 MG/250 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS,2.31,1.5,0.39,28.24,37
NDC,1478911605,ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,720.0,468.0,38.3,720.0,31
NDC,1478911905,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,48.6,31.59,8.53,48.6,33
NDC,1478912105,PAPAVERINE 30 MG/ML INJECTION SOLUTION,67.5,43.88,11.34,98.64,23
NDC,1478912705,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,63.0,40.95,10.58,80.47,31
NDC,1478912805,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,158.4,102.96,26.61,158.4,31
NDC,1478925110,EMERPHED 25 MG/5 ML (5 MG/ML) INTRAVENOUS SYRINGE,27.0,17.55,4.54,27.0,22
NDC,1505400431,ONIVYDE 4.3 MG/ML INTRAVENOUS DISPERSION,1465.44,952.54,57.1,3236.72,46
NDC,1505405001,DYSPORT 500 UNIT INTRAMUSCULAR SOLUTION,3169.8,2060.37,7.81,3169.8,50
NDC,1505405306,DYSPORT 300 UNIT INTRAMUSCULAR SOLUTION,1902.6,1236.69,7.81,1902.6,47
NDC,1505410604,SOMATULINE DEPOT 60 MG/0.2 ML SUBCUTANEOUS SYRINGE,113976.0,74084.4,35.38,113976.0,53
NDC,1505410904,SOMATULINE DEPOT 90 MG/0.3 ML SUBCUTANEOUS SYRINGE,101184.0,65769.6,35.38,101184.0,53
NDC,1505411204,SOMATULINE DEPOT 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,71596.8,46537.92,35.38,71596.8,53
NDC,1558401011,ATRIPLA 600 MG-200 MG-300 MG TABLET,239.58,155.73,40.25,239.58,22
NDC,1571889305,RETAINE PM 80 %-20 % EYE OINTMENT,6.38,4.15,1.07,6.38,22
NDC,1611051815,ALTABAX 1 % TOPICAL OINTMENT,57.78,37.56,9.71,57.78,22
NDC,1611091530,TAZORAC 0.05 % TOPICAL CREAM,40.3,26.2,6.77,40.3,22
NDC,1625253901,ISRADIPINE 2.5 MG CAPSULE,3.8,2.47,0.64,3.8,22
NDC,1647734003,UREA 40 % TOPICAL CREAM,3.78,2.46,0.64,3.78,22
NDC,1647773801,HYOSCYAMINE ER 0.375 MG TABLETEXTENDED RELEASE12 HR,3.2,2.08,0.54,3.2,22
NDC,1650002322,DOMEBORO 952 MG-1347 MG TOPICAL POWDER IN PACKET,1.28,0.83,0.22,1.28,22
NDC,1650002324,DOMEBORO 952 MG-1347 MG TOPICAL POWDER IN PACKET,1.6,1.04,0.27,1.6,22
NDC,1657112848,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,0.08,0.05,0.01,0.08,22
NDC,1657120310,DICLOFENAC SODIUM 25 MG TABLETDELAYED RELEASE,2.84,1.85,0.48,2.84,22
NDC,1657141250,CIPROFLOXACIN 500 MG TABLET,9.86,6.41,1.66,9.86,22
NDC,1657141305,CIPROFLOXACIN 750 MG TABLET,10.9,7.09,1.83,10.9,22
NDC,1657165906,SELEGILINE 5 MG CAPSULE,4.6,2.99,0.77,4.6,22
NDC,1657166101,MECLIZINE 25 MG TABLET,0.8,0.52,0.13,0.8,22
NDC,1657166901,PHENOBARBITAL 100 MG TABLET,1.48,0.96,0.25,1.48,22
NDC,1657167101,PHENOBARBITAL 16.2 MG TABLET,1.06,0.69,0.18,1.06,22
NDC,1657167516,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,0.3,0.2,0.05,0.3,22
NDC,1657168901,CARBIDOPA 12.5 MG-LEVODOPA 50 MG-ENTACAPONE 200 MG TABLET,7.5,4.88,1.26,7.5,22
NDC,1657172348,SULFAMYLON 85 MG/G TOPICAL CREAM,2.64,1.72,0.44,2.64,22
NDC,1657172360,SULFAMYLON 85 MG/G TOPICAL CREAM,3.06,1.99,0.51,3.06,22
NDC,1657173806,PROPAFENONE ER 425 MG CAPSULEEXTENDED RELEASE 12 HR,20.0,13.0,3.36,20.0,22
NDC,1657175809,NATEGLINIDE 60 MG TABLET,3.32,2.16,0.56,3.32,22
NDC,1657177301,GLIMEPIRIDE 1 MG TABLET,0.8,0.52,0.13,0.8,22
NDC,1657185601,PENTOXIFYLLINE ER 400 MG TABLETEXTENDED RELEASE,2.28,1.48,0.38,2.28,22
NDC,1671423401,PENICILLIN V POTASSIUM 250 MG TABLET,1.64,1.07,0.28,1.64,22
NDC,1671439001,CEFADROXIL 500 MG/5 ML ORAL SUSPENSION,2.1,1.37,0.35,2.1,22
NDC,1672902310,BICALUTAMIDE 50 MG TABLET,36.7,23.86,6.17,36.7,22
NDC,1672907212,CAPECITABINE 150 MG TABLET,23.48,15.26,0.03,23.48,40
NDC,1672909001,FINASTERIDE 5 MG TABLET,6.26,4.07,1.05,6.26,22
NDC,1672909512,QUETIAPINE ER 200 MG TABLETEXTENDED RELEASE 24 HR,35.06,22.79,5.89,35.06,22
NDC,1672909612,QUETIAPINE ER 300 MG TABLETEXTENDED RELEASE 24 HR,45.96,29.87,7.72,45.96,22
NDC,1672909712,QUETIAPINE ER 400 MG TABLETEXTENDED RELEASE 24 HR,54.02,35.11,9.08,54.02,22
NDC,1672910811,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,2831.28,1840.33,26.1,2831.28,49
NDC,1672911431,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,9.08,5.9,0.94,9.08,30
NDC,1672911505,MITOMYCIN 5 MG INTRAVENOUS SOLUTION,1089.84,708.4,26.1,1089.84,46
NDC,1672911638,MITOMYCIN 40 MG INTRAVENOUS SOLUTION,5662.56,3680.66,26.1,5662.56,52
NDC,1672913212,QUETIAPINE ER 50 MG TABLETEXTENDED RELEASE 24 HR,17.74,11.53,2.98,17.74,22
NDC,1672915131,TOPOTECAN 4 MG INTRAVENOUS SOLUTION,1433.0,931.45,1.05,1433.0,30
NDC,1672917501,AMITRIPTYLINE 100 MG TABLET,5.08,3.3,0.85,5.08,22
NDC,1672918401,HYDROCHLOROTHIAZIDE 50 MG TABLET,0.34,0.22,0.06,0.34,22
NDC,1672918929,MYCOPHENOLATE SODIUM 360 MG TABLETDELAYED RELEASE,18.28,11.88,0.45,18.28,31
NDC,1672921101,DOXAZOSIN 1 MG TABLET,2.7,1.76,0.45,2.7,22
NDC,1672921301,DOXAZOSIN 4 MG TABLET,2.84,1.85,0.48,2.84,22
NDC,1672924331,TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,519.24,337.51,1.05,519.24,30
NDC,1672924711,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,2831.28,1840.33,26.1,2831.28,49
NDC,1672924838,MITOMYCIN 40 MG INTRAVENOUS SOLUTION,5662.56,3680.66,26.1,5662.56,52
NDC,1672926003,EPTIFIBATIDE 2 MG/ML INTRAVENOUS SOLUTION,56.34,36.62,3.52,56.34,32
NDC,1672926763,DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,1460.6,949.39,0.78,1460.6,37
NDC,1672926764,DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,1460.6,949.39,0.78,1460.6,37
NDC,1672926765,DOCETAXEL 160 MG/8 ML (20 MG/ML) INTRAVENOUS SOLUTION,1460.6,949.39,0.78,1460.6,37
NDC,1672927210,PRASUGREL HCL 5 MG TABLET,33.02,21.46,5.55,33.02,22
NDC,1672927603,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,6.36,4.13,1.07,6.36,30
NDC,1672927668,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,6.36,4.13,1.07,6.36,30
NDC,1672927735,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,4.12,2.68,0.69,4.12,20
NDC,1672929212,DALFAMPRIDINE ER 10 MG TABLETEXTENDED RELEASE12 HR,96.9,62.99,16.28,96.9,22
NDC,1672941604,DIMETHYL FUMARATE 120 MG CAPSULEDELAYED RELEASE,296.94,193.01,49.89,296.94,22
NDC,1683787230,PEPCID AC 10 MG TABLET,0.78,0.51,0.13,0.78,22
NDC,1686424001,DOMEBORO 952 MG-1347 MG TOPICAL POWDER IN PACKET,1.6,1.04,0.27,1.6,22
NDC,1686468001,DERMOPLAST (WITH MENTHOL) 20 %-0.5 % TOPICAL AEROSOL,0.14,0.09,0.02,0.14,22
NDC,1686468002,DERMOPLAST (WITH MENTHOL) 20 %-0.5 % TOPICAL AEROSOL,0.2,0.13,0.03,0.2,22
NDC,1686468003,DERMOPLAST (WITH MENTHOL) 20 %-0.5 % TOPICAL AEROSOL,0.16,0.1,0.03,0.16,22
NDC,1715602101,INDIUM IN-111 OXYQUINOLINE 1 MCI/ML (37 MBQ/ML)(1 ML) INTRAVENOUS SOLN,5030.0,3269.5,772.64,4527.0,39
NDC,1715602205,CERETEC 0.5 MG INTRAVENOUS SOLUTION,3128.0,2033.2,802.34,2815.2,36
NDC,1715602630,MYOVIEW KIT 1.38 MG INTRAVENOUS SOLUTION,62.0,40.3,10.42,2409.0,29
NDC,1715625108,INDIUM IN-111 DTPA 1.5 MCI/1.5 ML INTRATHECAL SOLUTION,4518.0,2936.7,715.29,4066.2,39
NDC,1719100738,EXACTA-MIX EVA CONTAINER 500 ML,7.01,4.56,1.18,6.31,21
NDC,1719100739,EXACTA-MIX EVA CONTAINER 1000 ML,7.49,4.87,1.26,6.74,21
NDC,1719100741,EXACTA-MIX EVA CONTAINER 3000 ML,17.4,11.31,2.92,15.66,21
NDC,1719101100,STERL FLUID TRANSFER TUBE SET,30.36,19.73,5.1,27.32,21
NDC,1723890011,BIOGLO 1 MG EYE STRIPS,0.52,0.34,0.09,0.52,22
NDC,1723890030,BIOGLO 1 MG EYE STRIPS,0.42,0.27,0.07,0.42,22
NDC,1727007400,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,17.42,11.32,2.93,17.42,22
NDC,1727170105,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.12,0.08,0.02,1.84,31
NDC,1727170107,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,5.51,31
NDC,1743398763,ENEMEEZ 283 MG/5 ML ENEMA,1.56,1.01,0.26,1.56,22
NDC,1747825310,AK-FLUOR 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,51.84,33.7,8.71,2409.0,29
NDC,1747870102,IC GREEN 25 MG SOLUTION FOR INJECTION,410.16,266.6,68.91,410.16,22
NDC,1777210130,TROKENDI XR 25 MG CAPSULEEXTENDED RELEASE,31.28,20.33,5.26,31.28,22
NDC,1777210201,TROKENDI XR 50 MG CAPSULE EXTENDED RELEASE,36.26,23.57,6.09,36.26,22
NDC,1777212101,OXTELLAR XR 150 MG TABLETEXTENDED RELEASE,22.98,14.94,3.86,22.98,22
NDC,1777212201,OXTELLAR XR 300 MG TABLETEXTENDED RELEASE,31.92,20.75,5.36,31.92,22
NDC,1777212301,OXTELLAR XR 600 MG TABLETEXTENDED RELEASE,58.42,37.97,9.81,58.42,22
NDC,1777213130,QELBREE 100 MG CAPSULEEXTENDED RELEASE,32.02,20.81,5.38,32.02,22
NDC,1777213230,QELBREE 150 MG CAPSULEEXTENDED RELEASE,32.02,20.81,5.38,32.02,22
NDC,1777213330,QELBREE 200 MG CAPSULEEXTENDED RELEASE,32.02,20.81,5.38,32.02,22
NDC,1802983017,Q-CARE RX Q4 0.12 % KIT,71.08,46.2,11.94,71.08,22
NDC,1865711704,HYLENEX 150 UNIT/ML INJECTION SOLUTION,200.88,130.57,0.32,200.88,31
NDC,1990301021,INFANTS' MYLICON 40 MG/0.6 ML ORAL DROPSSUSPENSION,0.88,0.57,0.15,0.88,22
NDC,2055500100,ASCORBIC ACID (VITAMIN C) 250 MG TABLET,0.04,0.03,0.01,0.04,22
NDC,2055502500,CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,0.22,0.14,0.04,0.22,22
NDC,2055503300,CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1000 UNIT) TABLET,0.12,0.08,0.02,0.12,22
NDC,2158601102,CEFOTAXIME 1 GRAM SOLUTION FOR INJECTION,35.1,22.82,5.9,35.1,23
NDC,2158601202,CEFOTAXIME 2 GRAM SOLUTION FOR INJECTION,70.32,45.71,11.81,70.32,23
NDC,2181200975,AMMONIA AROMATIC 15 % (W/V) SOLUTION FOR INHALATION,1.02,0.66,0.17,1.02,22
NDC,2192200407,DESONIDE 0.05 % TOPICAL OINTMENT,10.7,6.96,1.8,10.7,22
NDC,2192201604,CLOBETASOL 0.05 % TOPICAL CREAM,0.8,0.52,0.13,0.8,22
NDC,2192201605,CLOBETASOL 0.05 % TOPICAL CREAM,0.8,0.52,0.13,0.8,22
NDC,2192201607,CLOBETASOL 0.05 % TOPICAL CREAM,0.8,0.52,0.13,0.8,22
NDC,2192201952,TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,5.76,3.74,0.97,5.76,22
NDC,2192202107,PERMETHRIN 5 % TOPICAL CREAM,3.94,2.56,0.66,3.94,22
NDC,2192202705,CLINDAMYCIN 1 % TOPICAL GEL,6.92,4.5,1.16,6.92,22
NDC,2192202707,CLINDAMYCIN 1 % TOPICAL GEL,6.22,4.04,1.04,6.22,22
NDC,2192203923,METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL,0.68,0.44,0.11,0.68,22
NDC,2192206122,CLOBETASOL 0.05 % SCALP SOLUTION,8.26,5.37,1.39,8.26,22
NDC,2192206304,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.74,0.48,0.12,0.74,22
NDC,2192206315,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.34,0.22,0.06,0.34,22
NDC,2192206330,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.18,0.12,0.03,0.18,22
NDC,2315501701,TETRACYCLINE 250 MG CAPSULE,15.76,10.24,2.65,15.76,22
NDC,2315505101,NYSTATIN 500000 UNIT TABLET,2.84,1.85,0.48,2.84,22
NDC,2315507001,METHIMAZOLE 5 MG TABLET,0.88,0.57,0.15,0.88,22
NDC,2315510301,METFORMIN 850 MG TABLET,2.4,1.56,0.4,2.4,22
NDC,2315510601,HYDROXYZINE HCL 25 MG TABLET,1.84,1.2,0.31,1.84,22
NDC,2315511401,PROPRANOLOL 80 MG TABLET,1.8,1.17,0.3,1.8,22
NDC,2315514801,ACARBOSE 50 MG TABLET,1.96,1.27,0.33,1.96,22
NDC,2315519101,BUPROPION HCL 75 MG TABLET,1.58,1.03,0.27,1.58,22
NDC,2315519201,BUPROPION HCL 100 MG TABLET,2.12,1.38,0.36,2.12,22
NDC,2315526141,BICNU 100 MG INTRAVENOUS SOLUTION,18867.76,12264.04,232.62,18867.76,52
NDC,2315528801,ACETAZOLAMIDE 250 MG TABLET,5.76,3.74,0.97,5.76,22
NDC,2315529041,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,13.5,8.78,0.77,13.5,31
NDC,2315529442,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,16.2,10.53,2.72,16.2,31
NDC,2315547341,FUROSEMIDE 10 MG/ML INJ,4.92,3.2,0.04,4.92,30
NDC,2315550101,HYDROXYZINE HCL 25 MG TABLET,1.84,1.2,0.31,1.84,22
NDC,2315553006,TROSPIUM 20 MG TABLET,5.68,3.69,0.95,5.68,22
NDC,2315553825,DOXERCALCIFEROL 0.5 MCG CAPSULE,15.82,10.28,2.66,15.82,22
NDC,2315560141,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,2.28,1.48,0.12,2.28,31
NDC,2315560601,GLYCOPYRROLATE 1 MG TABLET,2.62,1.7,0.44,2.62,22
NDC,2315574603,RASAGILINE 0.5 MG TABLET,6.88,4.47,1.16,6.88,22
NDC,2315582373,CABERGOLINE 0.5 MG TABLET,73.32,47.66,3.53,73.32,22
NDC,2315585878,VANCOMYCIN 125 MG CAPSULE,62.62,40.7,10.52,62.62,22
NDC,2315586301,GRISEOFULVIN ULTRAMICROSIZE 125 MG TABLET,9.98,6.49,1.68,9.98,22
NDC,2359450550,MILLIPRED 5 MG TABLET,33.74,21.93,5.67,33.74,22
NDC,2373160535,ACD-A SOLUTION,1.32,0.86,0.22,1.32,22
NDC,2420110024,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.39,0.25,0.06,0.39,31
NDC,2420120105,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,138.6,90.09,23.28,138.6,22
NDC,2420802401,INSTA-GLUCOSE (WITH DEXTRIN) 24 GRAM/31 GRAM ORAL GEL,0.4,0.26,0.07,0.4,22
NDC,2420804040,XIPERE (PF) 40 MG/ML SUPRACHOROIDAL SUSPENSION,6600.0,4290.0,43.72,6600.0,53
NDC,2420827615,MURO 128 2 % EYE DROPS,2.3,1.5,0.39,2.3,22
NDC,2420827715,MURO 128 5 % EYE DROPS,2.42,1.57,0.41,2.42,22
NDC,2420829005,TOBRAMYCIN 0.3 % EYE DROPS,5.64,3.67,0.95,5.64,22
NDC,2420829505,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,52.34,34.02,8.79,52.34,22
NDC,2420829525,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,52.2,33.93,8.77,52.2,22
NDC,2420831510,POLYMYXIN B SULFATE 10000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS,2.68,1.74,0.45,2.68,22
NDC,2420831705,SULFACETAMIDE-PREDNISOLONE 10 %-0.23 % (0.25 %) EYE DROPS,7.5,4.88,1.26,7.5,22
NDC,2420834205,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY,98.5,64.03,16.55,98.5,22
NDC,2420834425,FLUNISOLIDE 25 MCG (0.025 %) NASAL SPRAY,5.5,3.58,0.92,5.5,22
NDC,2420835305,ALREX 0.2 % EYE DROPSSUSPENSION,145.7,94.71,24.48,145.7,22
NDC,2420838555,MURO 128 5 % EYE OINTMENT,10.38,6.75,1.74,10.38,22
NDC,2420838556,MURO 128 5 % EYE OINTMENT,8.0,5.2,1.34,8.0,22
NDC,2420838760,OCUVITE WITH LUTEIN 300 MCG-200 MG-27 MG-2 MG TABLET,0.32,0.21,0.05,0.32,22
NDC,2420838762,OCUVITE WITH LUTEIN 300 MCG-200 MG-27 MG-2 MG TABLET,0.22,0.14,0.04,0.22,22
NDC,2420839915,IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY,6.08,3.95,1.02,6.08,22
NDC,2420841005,OFLOXACIN 0.3 % EAR DROPS,61.72,40.12,10.37,61.72,22
NDC,2420841105,BRIMONIDINE 0.2 % EYE DROPS,7.26,4.72,1.22,7.26,22
NDC,2420841110,BRIMONIDINE 0.2 % EYE DROPS,6.82,4.43,1.15,6.82,22
NDC,2420841115,BRIMONIDINE 0.2 % EYE DROPS,7.3,4.75,1.23,7.3,22
NDC,2420841601,RETISERT 0.59 MG INTRAVITREAL IMPLANT,45660.0,29679.0,333.48,45660.0,52
NDC,2420843262,PRESERVISION AREDS 2148 MCG-113 MG-45 MG-17.4 MG TABLET,0.26,0.17,0.04,0.26,22
NDC,2420844605,BESIVANCE 0.6 % EYE DROPSSUSPENSION,110.42,71.77,18.55,110.42,22
NDC,2420848510,DORZOLAMIDE 2 % EYE DROPS,9.18,5.97,1.54,9.18,22
NDC,2420850505,LEVOBUNOLOL 0.5 % EYE DROPS,9.68,6.29,1.63,9.68,22
NDC,2420850912,MAGONATE (MAGNESIUM CARB) 54 MG/5 ML ORAL LIQUID,0.08,0.05,0.01,0.08,22
NDC,2420853535,ZIRGAN 0.15 % EYE GEL,229.02,148.86,38.48,229.02,22
NDC,2420853920,MIOCHOL-E 1 % (10 MG/ML) INTRAOCULAR KIT,313.36,203.68,52.64,313.36,22
NDC,2420855555,BACITRACIN-POLYMYXIN B 500 UNIT-10000 UNIT/GRAM EYE OINTMENT,16.38,10.65,2.75,16.38,22
NDC,2420858060,GENTAMICIN 0.3 % EYE DROPS,17.14,11.14,2.88,17.14,22
NDC,2420858564,TROPICAMIDE 1 % EYE DROPS,5.0,3.25,0.84,5.0,22
NDC,2420859064,TROPICAMIDE 0.5 % EYE DROPS,3.34,2.17,0.56,3.34,22
NDC,2420863110,NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG/ML-10000 UNIT/ML-1 % EAR SOLUTION,20.14,13.09,3.38,20.14,22
NDC,2420863562,NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10000 UNIT/ML-1 % EAR DROPSSUSP,20.14,13.09,3.38,20.14,22
NDC,2420867004,SULFACETAMIDE SODIUM 10 % EYE DROPS,8.14,5.29,1.37,8.14,22
NDC,2420872002,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,25.88,16.82,4.35,25.88,22
NDC,2420873006,PROPARACAINE 0.5 % EYE DROPS,5.62,3.65,0.94,5.62,22
NDC,2420873501,CYCLOPENTOLATE 1 % EYE DROPS,16.34,10.62,2.75,16.34,22
NDC,2420873506,CYCLOPENTOLATE 1 % EYE DROPS,5.1,3.32,0.86,5.1,22
NDC,2420878055,NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10000 UNIT/GRAM EYE OINT,32.54,21.15,5.47,32.54,22
NDC,2420878555,NEOMYCIN-BACITRACIN-POLY-HC 3.5 MG-400-10000 UNIT/G-1 % EYE OINTMENT,37.18,24.17,6.25,37.18,22
NDC,2420879062,NEOMYCIN 1.75 MG-POLYMYXIN 10000 UNIT-GRAMICIDIN 0.025MG/ML EYE DROPS,12.38,8.05,2.08,12.38,22
NDC,2420879535,NEOMYCIN 3.5 MG/G-POLYMYXIN B 10000 UNIT/G-DEXAMETH 0.1 % EYE OINT,11.34,7.37,1.91,11.34,22
NDC,2420883060,NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10000 UNIT/ML-0.1% EYE DROPS,7.94,5.16,1.33,7.94,22
NDC,2420891019,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,24.84,16.15,4.17,24.84,22
NDC,2420891055,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,10.86,7.06,1.82,10.86,22
NDC,2427505251,GALLIUM GA-68 GOZETOTIDE 18.5 MBQ TO 185 MBQ/ML (0.5-5 MCI/ML) IV SOLN,16335.0,10617.75,363.5,14701.5,36
NDC,2433805008,GLIADEL WAFER 7.7 MG IMPLANT,23443.16,15238.05,3938.45,23443.16,22
NDC,2433810203,ERYTHROMYCIN 250 MG TABLET,27.86,18.11,4.68,27.86,22
NDC,2433810603,ERYTHROCIN (AS STEARATE) 250 MG TABLET,26.26,17.07,4.41,26.26,22
NDC,2433812203,ERY-TAB 250 MG TABLETDELAYED RELEASE,20.48,13.31,3.44,20.48,22
NDC,2433813013,ERYPED 400 MG/5 ML ORAL SUSPENSION,19.85,12.9,3.33,19.85,22
NDC,2433815401,DANZITEN 71 MG TABLET,386.26,251.07,64.89,386.26,23
NDC,2433815501,DANZITEN 95 MG TABLET,386.26,251.07,64.89,386.26,23
NDC,2433853025,SOTYLIZE 5 MG/ML ORAL SOLUTION,7.28,4.73,1.22,7.28,22
NDC,2433853048,SOTYLIZE 5 MG/ML ORAL SOLUTION,7.28,4.73,1.22,7.28,22
NDC,2435770105,ANECREAM 4 % TOPICAL,1.68,1.09,0.28,1.68,22
NDC,2435770106,ANECREAM 4 % TOPICAL,1.68,1.09,0.28,1.68,22
NDC,2435770130,ANECREAM 4 % TOPICAL,2.0,1.3,0.34,2.0,22
NDC,2435770230,ANECREAM5 5 % TOPICAL,2.96,1.92,0.5,2.96,22
NDC,2438500346,GENTIAN VIOLET 1 % TOPICAL SOLUTION,0.18,0.12,0.03,0.18,22
NDC,2438500934,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.02,0.1,22
NDC,2438502465,PINK BISMUTH 262 MG CHEWABLE TABLET,0.46,0.3,0.08,0.46,22
NDC,2438506003,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,0.38,0.25,0.06,0.38,22
NDC,2438507282,CALDYPHEN 1 %-8 % LOTION,0.08,0.05,0.01,0.08,22
NDC,2438511878,GAS RELIEF 80 (SIMETHICONE) 80 MG CHEWABLE TABLET,0.2,0.13,0.03,0.2,22
NDC,2438514976,DAIRY RELIEF 3000 UNIT TABLET,0.2,0.13,0.03,0.2,22
NDC,2438521003,ANTI-ITCH (DIPHENHYDRAMINE) WITH ZINC 2 %-0.1 % TOPICAL CREAM,0.34,0.22,0.06,0.34,22
NDC,2438527603,HYDROCORTISONE 1 % TOPICAL OINTMENT,0.28,0.18,0.05,0.28,22
NDC,2438537926,DIPHEDRYL 12.5 MG/5 ML ORAL LIQUID,0.13,0.08,0.02,0.13,22
NDC,2438541396,CALAMINE 8 %-ZINC OXIDE 8 % LOTION,0.06,0.04,0.01,0.06,22
NDC,2438544164,SLEEP AID (DOXYLAMINE) 25 MG TABLET,0.68,0.44,0.11,0.68,22
NDC,2438546843,STOOL SOFTENER 50 MG/5 ML ORAL LIQUID,0.05,0.03,0.01,0.05,22
NDC,2438547847,ANTACID 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.08,0.05,0.01,0.08,22
NDC,2438548547,ANTACID 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.08,0.05,0.01,0.08,22
NDC,2438552403,TERBINAFINE HCL 1 % TOPICAL CREAM,0.78,0.51,0.13,0.78,22
NDC,2438552405,TERBINAFINE HCL 1 % TOPICAL CREAM,1.1,0.72,0.18,1.1,22
NDC,2438559029,MICONAZOLE-7  2 % VAGINAL CREAM,0.52,0.34,0.09,0.52,22
NDC,2438590534,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.02,0.1,22
NDC,2438593191,CINNAMON OIL,0.58,0.38,0.1,0.58,22
NDC,2438593291,PEPPERMINT SPIRIT ORAL,0.63,0.41,0.11,0.63,22
NDC,2438599875,ALL DAY ALLERGY (CETIRIZINE) 10 MG TABLET,0.68,0.44,0.11,0.68,22
NDC,2447091710,ERGOTAMINE 1 MG-CAFFEINE 100 MG TABLET,27.76,18.04,4.66,27.76,22
NDC,2447807401,QUILLICHEW ER 20 MG CHEWABLE TABLET EXTENDED RELEASE,29.82,19.38,5.01,29.82,22
NDC,2451005010,NUCYNTA 50 MG TABLET,29.22,18.99,4.91,29.22,22
NDC,2451005860,NUCYNTA ER 50 MG TABLETEXTENDED RELEASE,30.58,19.88,5.14,30.58,22
NDC,2451007510,NUCYNTA 75 MG TABLET,34.14,22.19,5.74,34.14,22
NDC,2451010010,NUCYNTA 100 MG TABLET,45.5,29.58,7.64,45.5,22
NDC,2457110206,PRISMASOL BGK K (2 MEQ/L)-MG(1MEQ/L) HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,2457110306,PRISMASOL BGK K 2 MEQ-CA 3.5 MEQ-MG 1 MEQ/L HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,2457110506,PRISMASOL BGK K (4 MEQ/L)-CA (2.5)-MG (1.5) HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,2457110806,PRISMASOL BGK CA 2.5 MEQ-MG 1.5 MEQ/L HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,2457111106,PRISMASOL B22GK K 4 MEQ/L-MG 1.5 MEQ/L HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,2457111306,PRISMASOL BK MG 1.2 MEQ/L HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,2457111406,PRISMASOL BGK K 4 MEQ-MG 1.2 MEQ/L HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,2457111705,PHOXILLUM B22K K 4 MEQ-MG 1.5 MEQ-PO4 1 MMOL/L HEMODIALYSIS SOLUTION,0.03,0.02,0.01,0.03,22
NDC,2497900407,DONEPEZIL 23 MG TABLET,17.44,11.34,2.93,17.44,22
NDC,2497904113,MEGESTROL 625 MG/5 ML (125 MG/ML) ORAL SUSPENSION,14.73,9.57,2.47,14.73,22
NDC,2497920101,DICYCLOMINE 10 MG CAPSULE,1.08,0.7,0.18,1.08,22
NDC,2502100102,LATANOPROST 0.005 % EYE DROPS,7.2,4.68,1.21,7.2,22
NDC,2502111502,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,6.15,4.0,1.03,6.15,22
NDC,2502111506,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,3.27,2.13,0.55,3.27,22
NDC,2502111810,CEFUROXIME SODIUM 750 MG SOLUTION FOR INJECTION,11.01,7.16,1.7,11.01,31
NDC,2502113283,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.27,0.18,0.05,5.97,31
NDC,2502113610,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,14.4,9.36,0.9,14.4,31
NDC,2502113910,NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,34.2,22.23,0.11,34.2,30
NDC,2502115120,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,18.72,12.17,3.14,18.72,24
NDC,2502115899,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,356.37,231.64,5.76,356.37,24
NDC,2502116224,OXACILLIN 2 GRAM SOLUTION FOR INJECTION,32.4,21.06,1.01,32.4,31
NDC,2502116268,OXACILLIN 2 GRAM SOLUTION FOR INJECTION,32.4,21.06,1.01,32.4,31
NDC,2502117302,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,13.95,9.07,0.77,13.95,31
NDC,2502117304,AMIKACIN 1000 MG/4 ML INJECTION SOLUTION,12.87,8.37,0.77,12.87,31
NDC,2502117415,DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,62.1,40.37,0.06,62.1,31
NDC,2502117916,DAPTOMYCIN 350 MG INTRAVENOUS SOLUTION,86.22,56.04,0.03,86.22,38
NDC,2502118010,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,16.74,10.88,2.17,16.74,31
NDC,2502118487,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.24,0.16,0.04,12.38,31
NDC,2502119287,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,0.12,0.08,0.02,5.53,31
NDC,2502120110,MESNA 100 MG/ML INTRAVENOUS SOLUTION,7.2,4.68,1.21,7.2,30
NDC,2502120401,VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,120.0,78.0,5.93,120.0,30
NDC,2502120405,VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,86.4,56.16,5.93,86.4,30
NDC,2502120751,DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,6.4,4.16,1.08,7.7,30
NDC,2502121599,FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION,1.4,0.91,0.24,5.37,30
NDC,2502122320,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,4.4,2.86,0.74,4.4,30
NDC,2502122610,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,180.96,117.62,6.35,180.96,43
NDC,2502123002,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,41.2,26.78,1.95,41.2,30
NDC,2502123550,GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION,238.32,154.91,3.29,238.32,30
NDC,2502124202,FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,522.0,339.3,87.7,522.0,37
NDC,2502124410,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,336.0,218.4,1.86,336.0,36
NDC,2502124602,THIOTEPA 15 MG SOLUTION FOR INJECTION,960.0,624.0,8.86,960.0,39
NDC,2502125350,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,2.68,1.74,0.45,5.84,30
NDC,2502125351,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,1.92,1.25,0.32,5.84,30
NDC,2502126210,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,192.0,124.8,1.86,192.0,36
NDC,2502130167,ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE,28.8,18.72,0.5,28.8,31
NDC,2502130168,ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE,23.4,15.21,0.5,23.4,31
NDC,2502130566,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,114.06,74.14,19.16,160.87,31
NDC,2502131002,SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,234.0,152.1,39.31,234.0,22
NDC,2502131382,MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,0.33,0.21,0.06,3.73,31
NDC,2502131720,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,0.54,0.35,0.09,3.01,31
NDC,2502131910,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,1.41,0.92,0.08,1.41,30
NDC,2502132210,PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,33.12,21.53,8.58,1179.51,41
NDC,2502132302,PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,810.0,526.5,168.48,1179.51,41
NDC,2502140102,HEPARIN PORCINE (PF) 1000 UNIT/ML INJECTION SOLUTION,18.72,12.17,3.14,18.72,31
NDC,2502140304,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,6.84,4.45,0.25,6.84,31
NDC,2502140401,HEPARIN (PORCINE) 20000 UNIT/ML INJECTION SOLUTION,36.0,23.4,0.25,36.0,31
NDC,2502145101,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,16.2,10.53,1.01,16.2,31
NDC,2502146001,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,152.16,98.9,5.42,152.16,44
NDC,2502147174,FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,84.0,54.6,4.76,114.48,46
NDC,2502148101,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,4.23,2.75,0.71,4.23,31
NDC,2502150002,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,17.91,11.64,2.03,17.91,31
NDC,2502160103,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,24.0,15.6,3.18,24.0,23
NDC,2502165102,ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION,21.6,14.04,3.63,21.6,31
NDC,2502165905,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,5.76,3.74,0.97,5.76,22
NDC,2502167182,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.38,0.9,0.06,1.38,31
NDC,2502167187,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.38,0.9,0.06,1.38,31
NDC,2502167210,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,5.76,3.74,0.97,5.76,22
NDC,2502167376,GLYDO 2 % MUCOSAL JELLY IN APPLICATOR,2.38,1.55,0.4,2.38,22
NDC,2502167377,GLYDO 2 % MUCOSAL JELLY IN APPLICATOR,1.38,0.9,0.23,1.38,22
NDC,2502167620,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,217.8,141.57,36.26,217.8,32
NDC,2502167650,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,151.2,98.28,36.26,151.2,32
NDC,2502167820,BACLOFEN 10000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION,21.24,13.81,5.5,502.19,47
NDC,2502167920,BACLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SOLUTION,85.14,55.34,22.05,502.19,47
NDC,2502168171,BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,158.4,102.96,26.61,164.7,31
NDC,2502168220,KETAMINE 10 MG/ML INJECTION SOLUTION,4.38,2.85,0.74,4.38,22
NDC,2502170001,KETOROLAC 15 MG/ML INJECTION SOLUTION,13.47,8.76,0.34,13.47,41
NDC,2502170102,KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION,5.7,3.71,0.34,5.7,41
NDC,2502170582,ACETAMINOPHEN 500 MG/50 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.45,0.29,0.05,0.45,31
NDC,2502170587,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.3,0.2,0.05,0.3,31
NDC,2502179002,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,9.54,6.2,1.6,9.54,31
NDC,2502179120,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,11.79,7.66,1.98,11.79,23
NDC,2502179810,FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,7.2,4.68,1.34,7.2,26
NDC,2502180166,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,129.6,84.24,6.24,129.6,31
NDC,2502181230,ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,6.0,3.9,0.69,6.0,31
NDC,2502181310,LEUCOVORIN CALCIUM 50 MG SOLUTION FOR INJECTION,31.68,20.59,4.62,31.68,31
NDC,2502181430,LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,72.0,46.8,4.62,72.0,31
NDC,2502181530,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,72.0,46.8,4.62,72.0,31
NDC,2502181630,LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,252.0,163.8,4.62,252.0,31
NDC,2502182273,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,300.0,195.0,24.97,300.0,37
NDC,2502182667,ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK,0.93,0.6,0.16,14.06,31
NDC,2502182682,ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK,6.48,4.21,1.09,14.06,31
NDC,2502182761,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,300.0,195.0,24.97,300.0,37
NDC,2502183082,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,12.6,8.19,2.12,14.06,31
NDC,2520800104,AGGRASTAT CONCENTRATE 250 MCG/ML INTRAVENOUS,14.07,9.15,2.36,28.24,37
NDC,2520800201,AGGRASTAT 5 MG/100 ML (50 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,3.3,2.15,0.55,28.24,37
NDC,2520800202,AGGRASTAT 12.5 MG/250 ML (50 MCG/ML) IN ISO-OSMOTIC SODIUM CHLORIDE IV,3.45,2.24,0.58,28.24,37
NDC,2520800203,AGGRASTAT 5 MG/100 ML (50 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,3.3,2.15,0.55,28.24,37
NDC,2568200101,SOLIRIS 300 MG/30 ML INTRAVENOUS SOLUTION,782.76,508.79,45.02,18253.82,39
NDC,2568202501,ULTOMIRIS 100 MG/ML INTRAVENOUS SOLUTION,10712.6,6963.19,199.57,18253.82,53
NDC,2568202801,ULTOMIRIS 100 MG/ML INTRAVENOUS SOLUTION,10712.6,6963.19,199.57,18253.82,53
NDC,2724101531,MONTELUKAST 4 MG ORAL GRANULES IN PACKET,14.95,9.72,2.51,14.95,22
NDC,2724104011,ELETRIPTAN 40 MG TABLET,122.92,79.9,20.65,122.92,22
NDC,2724106203,VORICONAZOLE 50 MG TABLET,39.76,25.84,6.68,39.76,22
NDC,2724111203,TADALAFIL 5 MG TABLET,24.62,16.0,4.14,24.62,22
NDC,2724111603,FENOFIBRATE 54 MG TABLET,1.58,1.03,0.27,1.58,22
NDC,2724113909,OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,6.83,4.44,1.15,6.83,22
NDC,2724115704,OXYBUTYNIN CHLORIDE ER 15 MG TABLETEXTENDED RELEASE 24 HR,6.74,4.38,1.13,6.74,22
NDC,2724116201,CAPTOPRIL 50 MG TABLET,5.8,3.77,0.97,5.8,22
NDC,2724116301,CAPTOPRIL 100 MG TABLET,7.62,4.95,1.28,7.62,22
NDC,2724117456,VARENICLINE TARTRATE 1 MG TABLET,18.56,12.06,3.12,18.56,22
NDC,2724124949,FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,8.85,5.75,1.49,8.85,22
NDC,2724130501,OXCARBAZEPINE ER 300 MG TABLETEXTENDED RELEASE 24 HR,28.6,18.59,4.8,28.6,22
NDC,2780800201,RISPERIDONE 1 MG/ML ORAL SOLUTION,13.98,9.09,2.35,13.98,22
NDC,2780803301,THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,0.6,0.39,0.1,0.6,22
NDC,2780805102,PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,0.25,0.16,0.04,0.25,22
NDC,2780805801,METHYLPHENIDATE 5 MG/5 ML ORAL SOLUTION,2.25,1.46,0.38,2.25,22
NDC,2780809201,DEXMETHYLPHENIDATE 5 MG TABLET,1.94,1.26,0.33,1.94,22
NDC,2780822201,PALIPERIDONE ER 1.5 MG TABLETEXTENDED RELEASE 24 HR,61.2,39.78,10.28,61.2,22
NDC,2780822301,PALIPERIDONE ER 3 MG TABLETEXTENDED RELEASE 24 HR,61.2,39.78,10.28,61.2,22
NDC,2930012501,MELOXICAM 15 MG TABLET,9.7,6.31,1.63,9.7,22
NDC,2930012901,HYDROCHLOROTHIAZIDE 50 MG TABLET,0.34,0.22,0.06,0.34,22
NDC,2930016815,TIZANIDINE 2 MG TABLET,2.44,1.59,0.41,2.44,22
NDC,2930016910,TIZANIDINE 4 MG TABLET,2.94,1.91,0.49,2.94,22
NDC,2930016915,TIZANIDINE 4 MG TABLET,2.94,1.91,0.49,2.94,22
NDC,2930018701,BISOPROLOL 2.5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET,7.16,4.65,1.2,7.16,22
NDC,2930018801,BISOPROLOL 5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET,7.16,4.65,1.2,7.16,22
NDC,2930018901,BISOPROLOL 10 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET,7.16,4.65,1.2,7.16,22
NDC,2930024016,TOLTERODINE 2 MG TABLET,6.8,4.42,1.14,6.8,22
NDC,2930030816,QUETIAPINE ER 50 MG TABLETEXTENDED RELEASE 24 HR,17.74,11.53,2.98,17.74,22
NDC,2930034901,ALLOPURINOL 100 MG TABLET,0.96,0.62,0.16,0.96,22
NDC,2930035001,ALLOPURINOL 300 MG TABLET,1.84,1.2,0.31,1.84,22
NDC,2930042201,AMITRIPTYLINE 75 MG TABLET,3.82,2.48,0.64,3.82,22
NDC,2930042301,AMITRIPTYLINE 100 MG TABLET,5.08,3.3,0.85,5.08,22
NDC,2930042801,ZONISAMIDE 25 MG CAPSULE,1.1,0.72,0.18,1.1,22
NDC,2930042901,ZONISAMIDE 50 MG CAPSULE,2.2,1.43,0.37,2.2,22
NDC,3023789006,PROVENGE 50 MILLION CELL/250 ML INTRAVENOUS SUSPENSION,901.47,585.96,233.48,118832.9,47
NDC,3124800199,DRAMAMINE 50 MG TABLET,0.82,0.53,0.14,0.82,22
NDC,3138289805,LIDOCAINE 2 %-EPINEPHRINE BITARTRATE 1:100000 INJECTION CARTRIDGE,1.98,1.29,0.33,1.98,22
NDC,3160401160,VITAMIN E (DL ACETATE) 180 MG (400 UNIT) CAPSULE,0.18,0.12,0.03,0.18,22
NDC,3160402718,CYANOCOBALAMIN (VITAMIN B-12) 2500 MCG TABLET,0.38,0.25,0.06,0.38,22
NDC,3160402727,VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 400 MCG TABLET,0.16,0.1,0.03,0.16,22
NDC,3172200760,ZAFIRLUKAST 10 MG TABLET,8.2,5.33,1.38,8.2,22
NDC,3172200860,ZAFIRLUKAST 20 MG TABLET,8.2,5.33,1.38,8.2,22
NDC,3172201490,DROXIDOPA 100 MG CAPSULE,73.56,47.81,12.36,73.56,22
NDC,3172202015,ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,10.2,6.63,1.71,10.2,22
NDC,3172203523,AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,33.68,21.89,5.66,33.68,22
NDC,3172205030,EPLERENONE 50 MG TABLET,8.68,5.64,1.46,8.68,22
NDC,3172206701,BUPROPION HCL SR 150 MG TABLET12 HR SUSTAINED-RELEASE,3.86,2.51,0.65,3.86,22
NDC,3172206801,BUPROPION HCL SR 200 MG TABLET12 HR SUSTAINED-RELEASE,6.76,4.39,1.14,6.76,22
NDC,3172212101,HYDROMORPHONE ER 16 MG TABLETEXTENDED RELEASE 24 HR,36.82,23.93,6.19,36.82,22
NDC,3172212901,POTASSIUM CITRATE ER 5 MEQ (540 MG) TABLETEXTENDED RELEASE,3.5,2.28,0.59,3.5,22
NDC,3172213130,DUTASTERIDE 0.5 MG CAPSULE,12.1,7.87,2.03,12.1,22
NDC,3172213190,DUTASTERIDE 0.5 MG CAPSULE,12.1,7.87,2.03,12.1,22
NDC,3172213747,GLYCERIN 99.5 % TOPICAL SOLUTION,0.05,0.03,0.01,0.05,22
NDC,3172224030,LAMOTRIGINE ER 25 MG TABLETEXTENDED RELEASE 24 HR,28.08,18.25,4.72,28.08,22
NDC,3172230032,ELTROMBOPAG 12.5 MG POWDER PACKET FOR ORAL SUSPENSION,563.44,366.24,94.66,563.44,22
NDC,3172230132,ELTROMBOPAG OLAMINE 25 MG ORAL POWDER PACKET,563.46,366.25,94.66,563.46,22
NDC,3172250430,EFAVIRENZ 600 MG TABLET,74.52,48.44,12.52,74.52,22
NDC,3172250660,LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,31.06,20.19,5.22,31.06,22
NDC,3172250960,ZIDOVUDINE 300 MG TABLET,12.04,7.83,2.02,12.04,22
NDC,3172251210,SIMVASTATIN 20 MG TABLET,9.84,6.4,1.65,9.84,22
NDC,3172252101,HYDRALAZINE 50 MG TABLET,1.12,0.73,0.19,1.12,22
NDC,3172252201,HYDRALAZINE 100 MG TABLET,2.02,1.31,0.34,2.02,22
NDC,3172252630,FINASTERIDE 1 MG TABLET,5.42,3.52,0.91,5.42,22
NDC,3172253001,TORSEMIDE 10 MG TABLET,1.4,0.91,0.24,1.4,22
NDC,3172253301,METHOCARBAMOL 500 MG TABLET,1.02,0.66,0.17,1.02,22
NDC,3172253401,METHOCARBAMOL 750 MG TABLET,1.46,0.95,0.25,1.46,22
NDC,3172254401,LITHIUM CARBONATE 150 MG CAPSULE,0.28,0.18,0.05,0.28,22
NDC,3172255612,LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,18.44,11.99,3.1,18.44,22
NDC,3172255760,ABACAVIR 300 MG TABLET,20.1,13.07,3.38,20.1,22
NDC,3172256224,ABACAVIR 20 MG/ML ORAL SOLUTION,1.63,1.06,0.27,1.63,22
NDC,3172256424,CITALOPRAM 10 MG/5 ML ORAL SOLUTION,1.23,0.8,0.21,1.23,22
NDC,3172256560,INDOMETHACIN ER 75 MG CAPSULEEXTENDED RELEASE,6.0,3.9,1.01,6.0,22
NDC,3172257230,ESOMEPRAZOLE MAGNESIUM 20 MG CAPSULEDELAYED RELEASE,17.04,11.08,2.86,17.04,22
NDC,3172257390,ESOMEPRAZOLE MAGNESIUM 40 MG CAPSULEDELAYED RELEASE,17.04,11.08,2.86,17.04,22
NDC,3172257447,LEVETIRACETAM 100 MG/ML ORAL SOLUTION,1.63,1.06,0.27,1.63,22
NDC,3172258060,MARAVIROC 300 MG TABLET,58.78,38.21,9.88,58.78,22
NDC,3172259812,RUFINAMIDE 200 MG TABLET,28.5,18.53,4.79,28.5,22
NDC,3172259912,RUFINAMIDE 400 MG TABLET,57.02,37.06,9.58,57.02,22
NDC,3172262921,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,18.78,12.21,3.16,18.78,22
NDC,3172268147,ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,2.35,1.53,0.39,2.35,22
NDC,3172270090,LOSARTAN 25 MG TABLET,3.34,2.17,0.56,3.34,22
NDC,3172270110,LOSARTAN 50 MG TABLET,4.5,2.93,0.76,4.5,22
NDC,3172271030,SILDENAFIL 50 MG TABLET,132.92,86.4,22.33,132.92,22
NDC,3172272730,MONTELUKAST 4 MG CHEWABLE TABLET,11.32,7.36,1.9,11.32,22
NDC,3172272790,MONTELUKAST 4 MG CHEWABLE TABLET,11.32,7.36,1.9,11.32,22
NDC,3172275260,LAMIVUDINE 100 MG TABLET,32.22,20.94,5.41,32.22,22
NDC,3172281360,LACOSAMIDE 100 MG TABLET,35.94,23.36,6.04,35.94,22
NDC,3172282111,TETRABENAZINE 12.5 MG TABLET,157.62,102.45,26.48,157.62,22
NDC,3172283430,ENTECAVIR 1 MG TABLET,88.86,57.76,14.93,88.86,22
NDC,3172284130,ELTROMBOPAG OLAMINE 12.5 MG TABLET,563.44,366.24,94.66,563.44,22
NDC,3172284230,ELTROMBOPAG OLAMINE 25 MG TABLET,563.44,366.24,94.66,563.44,22
NDC,3172284330,ELTROMBOPAG OLAMINE 50 MG TABLET,1019.64,662.77,171.3,1019.64,22
NDC,3172284430,ELTROMBOPAG OLAMINE 75 MG TABLET,1529.46,994.15,256.95,1529.46,22
NDC,3172286803,TOLVAPTAN 15 MG TABLET,1123.5,730.28,188.75,1123.5,22
NDC,3172292901,OXYMORPHONE 5 MG TABLET,7.14,4.64,1.2,7.14,22
NDC,3172293747,SIMPLE SYRUP,0.1,0.07,0.02,0.1,22
NDC,3172293847,CHERRY FLAVOR (BULK) ORAL LIQUID,0.1,0.07,0.02,0.1,22
NDC,3172295901,SOSWEET SYRUP VEHICLE,0.13,0.08,0.02,0.13,22
NDC,3290910510,VARIBAR THIN LIQUID 81 % (W/W) ORAL POWDER,0.05,0.03,0.01,0.05,22
NDC,3290911500,VARIBAR NECTAR 40 % (W/V) 30 % (W/W) ORAL SUSPENSION,0.07,0.05,0.01,0.07,22
NDC,3290911600,VARIBAR NECTAR 40 % (W/V) 30 % (W/W) ORAL SUSPENSION,0.08,0.05,0.01,0.08,22
NDC,3290912107,VARIBAR THIN HONEY 40 % (W/V) 29 % (W/W) (1500 CPS) ORAL SUSPENSION,0.26,0.17,0.04,0.26,22
NDC,3290912522,VARIBAR PUDDING 40 % (W/V) 30% (W/W) ORAL PASTE,0.3,0.2,0.05,0.3,22
NDC,3290916755,LIQUID POLIBAR PLUS 105 % (W/V) 58 % (W/W) ORAL SUSPENSION,0.03,0.02,0.01,0.03,22
NDC,3290918601,LIQUID E-Z PAQUE 60 % (W/V) ORAL SUSPENSION,0.02,0.01,0.01,0.02,22
NDC,3290918702,LIQUID E-Z PAQUE 60 % (W/V) ORAL SUSPENSION,0.02,0.01,0.01,0.02,22
NDC,3290971103,READI-CAT 2   2 % (W/V) ORAL SUSPENSION,0.01,0.01,0.01,0.01,22
NDC,3290972403,READI-CAT 2   2 % (W/V) ORAL SUSPENSION,0.01,0.01,0.01,0.01,22
NDC,3290974103,READI-CAT 2   2 % (W/V) ORAL SUSPENSION,0.01,0.01,0.01,0.01,22
NDC,3290975003,E-Z-PAQUE 96 % (W/W) ORAL POWDER FOR SUSPENSION,0.03,0.02,0.01,0.03,22
NDC,3290977001,E-Z-PASTE 60 % ORAL CREAM,0.14,0.09,0.02,0.14,22
NDC,3290992703,NEULUMEX 0.1 % (W/V) 0.1 % (W/W) ORAL SUSPENSION,0.02,0.01,0.01,0.02,22
NDC,3334202407,FAMCICLOVIR 125 MG TABLET,11.62,7.55,1.95,11.62,22
NDC,3334205507,PIOGLITAZONE 30 MG TABLET,21.42,13.92,3.6,21.42,22
NDC,3334205510,PIOGLITAZONE 30 MG TABLET,21.42,13.92,3.6,21.42,22
NDC,3334206107,DONEPEZIL 23 MG TABLET,22.72,14.77,3.82,22.72,22
NDC,3334206110,DONEPEZIL 23 MG TABLET,22.72,14.77,3.82,22.72,22
NDC,3334206707,OLANZAPINE 2.5 MG TABLET,20.84,13.55,3.5,20.84,22
NDC,3334206807,OLANZAPINE 5 MG TABLET,24.58,15.98,4.13,24.58,22
NDC,3334206907,OLANZAPINE 7.5 MG TABLET,29.9,19.44,5.02,29.9,22
NDC,3334207007,OLANZAPINE 10 MG TABLET,37.06,24.09,6.23,37.06,22
NDC,3334209109,RIVASTIGMINE 4.5 MG CAPSULE,8.06,5.24,1.35,8.06,22
NDC,3334211407,CANDESARTAN 4 MG TABLET,6.12,3.98,1.03,6.12,22
NDC,3334223807,NEVIRAPINE ER 400 MG TABLETEXTENDED RELEASE 24 HR,39.66,25.78,6.66,39.66,22
NDC,3334227407,FEBUXOSTAT 40 MG TABLET,23.74,15.43,3.99,23.74,22
NDC,3334227809,TADALAFIL 20 MG TABLET (PULMONARY HYPERTENSION),152.3,99.0,25.59,152.3,22
NDC,3334230409,LACOSAMIDE 150 MG TABLET,35.6,23.14,5.98,35.6,22
NDC,3334232186,CLOBETASOL 0.05 % SCALP SOLUTION,8.26,5.37,1.39,8.26,22
NDC,3334232915,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.74,0.48,0.12,0.74,22
NDC,3334232980,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.32,0.21,0.05,0.32,22
NDC,3334240530,LIDOCAINE 5 % TOPICAL OINTMENT,15.24,9.91,2.56,15.24,22
NDC,3334240550,LIDOCAINE 5 % TOPICAL OINTMENT,15.22,9.89,2.56,15.22,22
NDC,3504600322,MAGNESIUM GLUCONATE 27 MG MAGNESIUM (500 MG) TABLET,0.16,0.1,0.03,0.16,22
NDC,3504606732,MELATONIN ORAL LIQUID 3.5 MG/2 ML ADS,0.23,0.15,0.04,0.23,22
NDC,3557343330,KETOCONAZOLE 200 MG TABLET,7.58,4.93,1.27,7.58,22
NDC,3557347302,PHENOXYBENZAMINE 10 MG CAPSULE,258.9,168.29,43.5,258.9,22
NDC,3566401053,"""ZINC OXIDE 4"""" X 10 YARD BANDAGE""",27.42,17.82,4.61,27.42,22
NDC,3600001225,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,1.62,1.05,0.09,1.62,31
NDC,3600003310,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,0.72,0.47,0.12,0.72,30
NDC,3600024201,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,2.58,1.68,0.43,5.73,31
NDC,3600028225,FUROSEMIDE 10 MG/ML INJ,1.23,0.8,0.04,1.23,30
NDC,3600028325,FUROSEMIDE 10 MG/ML INJ,0.99,0.64,0.04,0.99,30
NDC,3600028425,FUROSEMIDE 10 MG/ML INJ,0.57,0.37,0.04,0.57,30
NDC,3600032010,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,3.81,2.48,0.64,3.81,31
NDC,3600032201,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,0.39,0.25,0.07,0.96,31
NDC,3600032202,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,0.39,0.25,0.07,3.01,31
NDC,3600036401,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,18.0,11.7,3.02,18.0,31
NDC,3600037240,ACETAMINOPHEN 650 MG/65 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.3,0.2,0.05,0.3,31
NDC,3676542001,MAGTAB 84 MG TABLETEXTENDED RELEASE,0.84,0.55,0.14,0.84,22
NDC,3700001804,PEPTO-BISMOL 262 MG CHEWABLE TABLET,0.34,0.22,0.06,0.34,22
NDC,3700002404,METAMUCIL FIBER (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,0.88,0.57,0.15,0.88,22
NDC,3700002410,METAMUCIL FIBER (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,0.88,0.57,0.15,0.88,22
NDC,3700002444,METAMUCIL FIBER (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,0.98,0.64,0.16,0.98,22
NDC,3700003201,PEPTO-BISMOL 262 MG/15 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,22
NDC,3700047709,PEPTO-BISMOL 262 MG CHEWABLE TABLET,0.34,0.22,0.06,0.34,22
NDC,3700047710,PEPTO-BISMOL 262 MG CHEWABLE TABLET,0.32,0.21,0.05,0.32,22
NDC,3700074108,METAMUCIL FIBER (ASPARTAME) 3.4 GRAM ORAL POWDER PACKET,0.88,0.57,0.15,0.88,22
NDC,3780303812,CLONIDINE HCL (BULK) POWDER,516.0,335.4,86.69,516.0,22
NDC,3780320310,BACLOFEN (BULK) 100 % POWDER,49.45,32.14,8.31,49.45,22
NDC,3780322310,BUPIVACAINE (BULK) 100 % POWDER,55.01,35.76,9.24,55.01,22
NDC,3839650663,DEX4 GLUCOSE 4 GRAM CHEWABLE TABLET,0.38,0.25,0.06,0.38,22
NDC,3839654164,GLUCOSE 4 GRAM CHEWABLE TABLET,0.26,0.17,0.04,0.26,22
NDC,3848586335,THERMOTABS 287 MG-180 MG-15 MG TABLET,0.18,0.12,0.03,0.18,22
NDC,3874309001,AMMONIA AROMATIC 15 % (W/V) SOLUTION FOR INHALATION,1.02,0.66,0.17,1.02,22
NDC,3877900635,BENZOCAINE (BULK) POWDER,2.19,1.42,0.37,2.19,22
NDC,3877900715,DEXAMETHASONE SOD PHOS (BULK) 100 % POWDER,119.82,77.88,20.13,119.82,22
NDC,3877900728,DEXTROSE (BULK) POWDER,0.34,0.22,0.06,0.34,22
NDC,3877900825,LIDOCAINE HCL (BULK) 100 % POWDER,4.28,2.78,0.72,4.28,22
NDC,3877901653,TESTOSTERONE PROPIONATE (BULK) POWDER,205.2,133.38,34.47,205.2,22
NDC,3877903883,BACLOFEN (BULK) 100 % POWDER,35.63,23.16,5.99,35.63,22
NDC,3877905101,PROPYLENE GLYCOL (BULK) 99.5 % (NOT LESS THAN USP) LIQUID,0.48,0.31,0.08,0.48,22
NDC,3877905215,MENTHOL (BULK) CRYSTALS,2.28,1.48,0.38,2.28,22
NDC,3877905244,BUPIVACAINE (BULK) 100 % POWDER,91.2,59.28,15.32,91.2,22
NDC,3877905518,SODIUM BENZOATE (BULK) POWDER,0.45,0.29,0.08,0.45,22
NDC,3877905611,CLONIDINE HCL (BULK) POWDER,413.26,268.62,69.43,413.26,22
NDC,3877906255,FLEXIBLE COLLODION (BULK) LIQUID,3.43,2.23,0.58,3.43,22
NDC,3877906408,SODIUM BICARBONATE (BULK) POWDER,0.26,0.17,0.04,0.26,22
NDC,3877906409,SODIUM BICARBONATE (BULK) POWDER,0.26,0.17,0.04,0.26,22
NDC,3877907233,COCAINE (BULK) 100 % CRYSTALS,793.61,515.85,133.33,793.61,22
NDC,3877907236,COCAINE (BULK) 100 % CRYSTALS,2380.83,1547.54,399.98,2380.83,22
NDC,3877907311,HYDROMORPHONE (BULK) 100 % POWDER,2009.25,1306.01,337.55,2009.25,22
NDC,3877907313,HYDROMORPHONE (BULK) 100 % POWDER,2009.25,1306.01,337.55,2009.25,22
NDC,3877907314,HYDROMORPHONE (BULK) 100 % POWDER,2009.25,1306.01,337.55,2009.25,22
NDC,3877907316,HYDROMORPHONE (BULK) 100 % POWDER,2009.25,1306.01,337.55,2009.25,22
NDC,3877908843,PYRIMETHAMINE (BULK) POWDER,17.43,11.33,2.93,17.43,22
NDC,3877910408,BETAINE (BULK) 100 % POWDER,1.5,0.98,0.25,1.5,22
NDC,3877910464,BISMUTH SUBGALLATE (BULK) POWDER,11.04,7.18,1.85,11.04,22
NDC,3877910465,BISMUTH SUBGALLATE (BULK) POWDER,5.52,3.59,0.93,5.52,22
NDC,3877912168,COTTONSEED OIL (BULK),0.16,0.1,0.03,0.16,22
NDC,3877912845,FERRIC SUBSULFATE (BULK) 20 TO 22 GRAM/100 ML SOLUTION,1.8,1.17,0.3,1.62,21
NDC,3877912848,FERRIC SUBSULFATE (BULK) 20 TO 22 GRAM/100 ML SOLUTION,1.8,1.17,0.3,1.62,21
NDC,3877917563,FENTANYL CITRATE (BULK) 100 % POWDER,17296.08,11242.45,2905.74,17296.08,22
NDC,3877917791,SIMPLE SYRUP,1.43,0.93,0.24,1.43,22
NDC,3877919385,PHENOL (BULK) 89 % LIQUID,1.01,0.66,0.17,1.01,22
NDC,3877919388,PHENOL (BULK) 89 % LIQUID,1.01,0.66,0.17,1.01,22
NDC,3877920040,BIOTIN (BULK) 100 % POWDER,149.62,97.25,25.14,149.62,22
NDC,3877922985,HYDROGEL,0.63,0.41,0.11,0.63,22
NDC,3877923498,ORA-BLEND SF ORAL SUSPENSION,0.25,0.16,0.04,0.25,22
NDC,3877925118,ORAL SYRUP ORAL LIQUID,0.33,0.21,0.06,0.33,22
NDC,3877925128,ORAL MIX ORAL SUSPENSION,0.33,0.21,0.06,0.33,22
NDC,3877925495,SODIUM PHENYLBUTYRATE (BULK) 100 % POWDER,71.21,46.29,11.96,71.21,22
NDC,3877926008,ORAL MIX SF ORAL SUSPENSION,0.33,0.21,0.06,0.33,22
NDC,3877927909,MIDAZOLAM (BULK) 100 % POWDER,108.0,70.2,18.14,108.0,22
NDC,3877928979,L-ASPARTIC ACID POWDER,3.36,2.18,0.56,3.36,22
NDC,3877928988,L-GLUTAMIC ACID POWDER,2.4,1.56,0.4,2.4,22
NDC,3877932093,BACLOFEN (BULK) 100 % POWDER,35.63,23.16,5.99,35.63,22
NDC,3877977721,EMPTY VIAL,4.44,2.89,0.75,4.44,22
NDC,3877997104,LUER LOCK SYRINGE 30 ML,10.26,6.67,1.72,9.23,21
NDC,3932805110,HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,1.78,1.16,0.3,1.78,22
NDC,3932806250,HYSEPT 0.5 % SOLUTION,0.08,0.05,0.01,0.08,22
NDC,3932806325,HYSEPT 0.25 % SOLUTION,0.08,0.05,0.01,0.08,22
NDC,3932806412,H-CHLOR 12  0.125 % SOLUTION,0.08,0.05,0.01,0.08,22
NDC,3932810610,PRENATAL VITAMINS WITH CALCIUM NO.72-IRON 27 MG-FOLIC ACID 1 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,3932835760,CALCIDOL 200 MCG/ML (8000 UNIT/ML) ORAL DROPS,4.15,2.7,0.7,4.15,22
NDC,3982203105,NEOMYCIN 500 MG TABLET,3.26,2.12,0.55,3.26,22
NDC,3982203502,LINCOMYCIN 300 MG/ML INJECTION SOLUTION,45.24,29.41,7.6,45.24,22
NDC,3982204121,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,288.0,187.2,2.3,288.0,31
NDC,3982204126,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,270.0,175.5,2.3,270.0,31
NDC,3982207061,STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,29.25,19.01,4.91,93.76,31
NDC,3982207062,STREPTOMYCIN 1 GRAM INTRAMUSCULAR SOLUTION,270.0,175.5,20.76,270.0,31
NDC,3982210001,TRANEXAMIC ACID 1000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION,2.16,1.4,0.05,2.16,23
NDC,3982210302,IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,594.0,386.1,6.04,594.0,30
NDC,3982210555,AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,180.0,117.0,30.24,180.0,31
NDC,3982212011,NEOMYCIN 40 MG-POLYMYXIN B 200000 UNIT/ML GU IRRIGATION SOLUTION,39.33,25.56,6.61,39.33,22
NDC,3982212201,NEOMYCIN 40 MG-POLYMYXIN B 200000 UNIT/ML GU IRRIGATION SOLUTION,25.5,16.58,4.28,25.5,22
NDC,3982220001,CLONIDINE (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,9.0,5.85,1.51,47.68,31
NDC,3982221002,DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,2655.0,1725.75,282.13,2655.0,49
NDC,3982230502,PENTAMIDINE 300 MG SOLUTION FOR INJECTION,337.5,219.38,0.46,337.5,30
NDC,4002851230,SODIUM FLUORIDE F-18 10-200 MCI/ML (370-7400 MBQ/ML) INTRAVENOUS SOLN,500.0,325.0,84.0,2409.0,26
NDC,4009310196,SELENIUM 200 MCG TABLET,0.12,0.08,0.02,0.12,22
NDC,4056511182,BENZOIN TOPICAL TINCTURE,0.72,0.47,0.12,0.72,22
NDC,4056512249,IODOSORB 0.9 % TOPICAL GEL,5.14,3.34,0.86,5.14,22
NDC,4056512251,IODOFLEX 0.9 % TOPICAL PADS,38.52,25.04,6.47,38.52,22
NDC,4056512253,IODOFLEX 0.9 % TOPICAL PADS,78.08,50.75,13.12,78.08,22
NDC,4056512256,IODOSORB 0.9 % TOPICAL GEL,5.76,3.74,0.97,5.76,22
NDC,4098527086,ARGININE HCL (L-ARGININE) 1000 MG TABLET,0.16,0.1,0.03,0.16,22
NDC,4110007299,CORRECTOL 5 MG TABLET,0.22,0.14,0.04,0.22,22
NDC,4110008882,SOLARCAINE 20 %-0.13 % TOPICAL SPRAY,0.12,0.08,0.02,0.12,22
NDC,4110081122,A AND D (LANOLIN-PETROLATUM) TOPICAL OINTMENT,0.12,0.08,0.02,0.12,22
NDC,4110081124,A AND D (LANOLIN-PETROLATUM) TOPICAL OINTMENT,0.08,0.05,0.01,0.08,22
NDC,4110082076,MIRALAX 17 GRAM/DOSE ORAL POWDER,0.18,0.12,0.03,0.18,22
NDC,4116700609,UNISOM (DOXYLAMINE) 25 MG TABLET,0.82,0.53,0.14,0.82,22
NDC,4116700623,UNISOM (DOXYLAMINE) 25 MG TABLET,0.64,0.42,0.11,0.64,22
NDC,4116700881,ICY HOT 30 %-10 % TOPICAL CREAM,0.3,0.2,0.05,0.3,22
NDC,4116700883,ICY HOT 30 %-10 % TOPICAL CREAM,0.26,0.17,0.04,0.26,22
NDC,4116705723,ASPERCREME 10 % TOPICAL,0.24,0.16,0.04,0.24,22
NDC,4116705847,ASPERCREME (LIDOCAINE) 4 % TOPICAL PATCH,5.26,3.42,0.88,5.26,22
NDC,4116706003,ARTHRITIS HOT PAIN RELIEF 15 %-10 % TOPICAL CREAM,0.08,0.05,0.01,0.08,22
NDC,4116741312,ALLEGRA ALLERGY 60 MG TABLET,2.34,1.52,0.39,2.34,22
NDC,4116741314,ALLEGRA ALLERGY 60 MG TABLET,1.64,1.07,0.28,1.64,22
NDC,4116742444,CHILDREN'S ALLEGRA ALLERGY 30 MG/5 ML ORAL SUSPENSION,0.33,0.21,0.06,0.33,22
NDC,4116743102,ALLEGRA-D 12 HOUR 60 MG-120 MG TABLETEXTENDED RELEASE,3.74,2.43,0.63,3.74,22
NDC,4138821020,BLISTEX MEDICATED 0.6 %-0.5 %-1.1 %-0.5 % TOPICAL OINTMENT,0.44,0.29,0.07,0.44,22
NDC,4167936513,MCT OIL 7.7 KCAL/ML ORAL,0.2,0.13,0.03,0.2,22
NDC,4202310401,APLISOL 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,454.17,295.21,76.3,454.17,22
NDC,4202310501,BREVITAL 500 MG SOLUTION FOR INJECTION,401.52,260.99,67.46,401.52,22
NDC,4202311001,DELESTROGEN 10 MG/ML INTRAMUSCULAR OIL,95.58,62.13,16.06,95.58,22
NDC,4202311101,DELESTROGEN 20 MG/ML INTRAMUSCULAR OIL,134.7,87.56,7.79,134.7,31
NDC,4202311510,KETALAR 100 MG/ML INJECTION SOLUTION,9.6,6.24,1.61,9.6,22
NDC,4202311602,PITOCIN 10 UNIT/ML INJECTION SOLUTION,5.04,3.28,0.85,5.04,23
NDC,4202311625,PITOCIN 10 UNIT/ML INJECTION SOLUTION,12.96,8.42,2.18,12.96,23
NDC,4202311925,TIGAN 100 MG/ML INTRAMUSCULAR SOLUTION,118.95,77.32,19.98,159.39,31
NDC,4202312306,DANTRIUM 20 MG INTRAVENOUS SOLUTION,319.11,207.42,53.61,319.11,22
NDC,4202312401,DANTRIUM 25 MG CAPSULE,2.56,1.66,0.43,2.56,22
NDC,4202314625,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,9.75,6.34,1.64,9.75,22
NDC,4202315701,ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,13680.0,8892.0,12.88,13680.0,38
NDC,4202315901,ADRENALIN 1 MG/ML (1 ML) INJECTION SOLUTION,29.52,19.19,2.62,29.52,30
NDC,4202315925,ADRENALIN 1 MG/ML (1 ML) INJECTION SOLUTION,29.52,19.19,2.62,29.52,30
NDC,4202316401,VASOSTRICT 20 UNIT/ML INTRAVENOUS SOLUTION,46.44,30.19,1.01,46.44,31
NDC,4202316410,VASOSTRICT 20 UNIT/ML INTRAVENOUS SOLUTION,46.44,30.19,1.01,46.44,31
NDC,4202316425,VASOSTRICT 20 UNIT/ML INTRAVENOUS SOLUTION,35.7,23.21,1.01,35.7,31
NDC,4202316801,ADRENALIN 1 MG/ML INJECTION SOLUTION,11.76,7.64,1.98,11.76,30
NDC,4202317901,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,65.36,42.48,3.54,65.36,31
NDC,4202317905,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,49.02,31.86,3.54,49.02,31
NDC,4202318201,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,734.4,477.36,0.6,734.4,46
NDC,4202319501,POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,114.36,74.33,19.21,114.36,22
NDC,4202320501,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,1440.0,936.0,241.92,2533.81,37
NDC,4202321625,EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,104.55,67.96,17.56,104.55,22
NDC,4202322101,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,144.0,93.6,10.71,144.0,31
NDC,4202322110,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,144.0,93.6,10.71,144.0,31
NDC,4202322910,MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,269.28,175.03,0.24,269.28,31
NDC,4202323010,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,538.56,350.06,0.24,538.56,31
NDC,4202323710,VASOSTRICT 0.2 UNIT/ML INTRAVENOUS SOLUTION,1.23,0.8,0.21,1.7,31
NDC,4202331510,ADRENALIN IN 0.9 % SODIUM CHLORIDE 4 MG/250 ML (16 MCG/ML) IV SOLUTION,0.57,0.37,0.1,2.44,30
NDC,4203710475,GLY-OXIDE 10 % MUCOSAL SOLUTION,1.25,0.81,0.21,1.25,22
NDC,4203710476,GLY-OXIDE 10 % MUCOSAL SOLUTION,0.55,0.36,0.09,0.55,22
NDC,4203710478,DEBROX 6.5 % EAR DROPS,1.18,0.77,0.2,1.18,22
NDC,4219232701,NP THYROID 15 MG TABLET,1.78,1.16,0.3,1.78,22
NDC,4219232901,NP THYROID 30 MG TABLET,2.1,1.37,0.35,2.1,22
NDC,4219233001,NP THYROID 60 MG TABLET,2.32,1.51,0.39,2.32,22
NDC,4219233801,HYOSCYAMINE 0.125 MG DISINTEGRATING TABLET,1.7,1.11,0.29,1.7,22
NDC,4219233901,HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,1.7,1.11,0.29,1.7,22
NDC,4219234001,HYOSCYAMINE SULFATE 0.125 MG TABLET,1.7,1.11,0.29,1.7,22
NDC,4219260816,GABAPENTIN 250 MG/5 ML ORAL SOLUTION,2.08,1.35,0.35,2.08,22
NDC,4219260840,GABAPENTIN 300 MG/6 ML (6 ML) ORAL SOLUTION,3.0,1.95,0.5,3.0,22
NDC,4219260845,GABAPENTIN 250 MG/5 ML (5 ML) ORAL SOLUTION,3.6,2.34,0.6,3.6,22
NDC,4219555014,CIPROFLOXACIN 0.2 % EAR DROPS IN A DROPPERETTE,24.32,15.81,4.09,24.32,22
NDC,4222708101,CINRYZE 500 UNIT (5 ML) INTRAVENOUS SOLUTION,11513.49,7483.77,56.31,11513.49,53
NDC,4222708301,CINRYZE 500 UNIT (5 ML) INTRAVENOUS SOLUTION,11513.49,7483.77,56.31,11513.49,53
NDC,4229200120,METRONIDAZOLE 500 MG TABLET,1.66,1.08,0.28,1.66,22
NDC,4229203820,LEVOTHYROXINE 88 MCG TABLET,1.22,0.79,0.2,1.22,22
NDC,4229203920,LEVOTHYROXINE 112 MCG TABLET,1.42,0.92,0.24,1.42,22
NDC,4236752125,BELRAPZO 25 MG/ML INTRAVENOUS SOLUTION,3120.0,2028.0,7.99,3120.0,49
NDC,4236754032,RYANODEX 250 MG INTRAVENOUS SUSPENSION,9943.08,6463.0,1670.44,9943.08,22
NDC,4238592499,PIRFENIDONE 267 MG TABLET,88.24,57.36,14.82,88.24,22
NDC,4238592690,PIRFENIDONE 801 MG TABLET,264.72,172.07,44.47,264.72,22
NDC,4238801114,COMETRIQ 140 MG/DAY (80 MG X 1-20 MG X 3) CAPSULES,415.28,269.93,69.77,415.28,22
NDC,4238801214,COMETRIQ 100 MG/DAY (80 MG X 1-20 MG X 1) CAPSULES,830.54,539.85,139.53,830.54,22
NDC,4238801314,COMETRIQ 60 MG/DAY (20 MG X 3/DAY) CAPSULES,553.7,359.91,93.02,553.7,22
NDC,4238802326,CABOMETYX 60 MG TABLET,2104.1,1367.67,353.49,2104.1,22
NDC,4238802426,CABOMETYX 20 MG TABLET,2104.1,1367.67,353.49,2104.1,22
NDC,4238802526,CABOMETYX 40 MG TABLET,2104.1,1367.67,353.49,2104.1,22
NDC,4249445120,VANCOMYCIN 250 MG CAPSULE,115.44,75.04,19.39,115.44,22
NDC,4251500201,IXIARO (PF) 6 MCG/0.5 ML INTRAMUSCULAR SYRINGE,2124.57,1380.97,79.26,2124.57,29
NDC,4257113252,CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,3.25,2.11,0.55,3.25,22
NDC,4257113725,KETOROLAC 0.5 % EYE DROPS,42.4,27.56,7.12,42.4,22
NDC,4257117601,PIROXICAM 10 MG CAPSULE,5.22,3.39,0.88,5.22,22
NDC,4257117701,PIROXICAM 20 MG CAPSULE,8.98,5.84,1.51,8.98,22
NDC,4257124301,ACETAZOLAMIDE ER 500 MG CAPSULEEXTENDED RELEASE,8.58,5.58,1.44,8.58,22
NDC,4257125101,CLINDAMYCIN HCL 150 MG CAPSULE,2.38,1.55,0.4,2.38,22
NDC,4257125201,CLINDAMYCIN HCL 300 MG CAPSULE,7.44,4.84,1.25,7.44,22
NDC,4257133201,METHENAMINE HIPPURATE 1 GRAM TABLET,4.18,2.72,0.7,4.18,22
NDC,4257138519,TRIAMCINOLONE ACETONIDE 0.1 % LOTION,3.0,1.95,0.5,3.0,22
NDC,4274776101,POTELIGEO 4 MG/ML INTRAVENOUS SOLUTION,4591.08,2984.2,210.75,5646.0,49
NDC,4279400308,ADEFOVIR 10 MG TABLET,75.8,49.27,12.73,75.8,22
NDC,4279400402,PROTRIPTYLINE 5 MG TABLET,12.0,7.8,2.02,12.0,22
NDC,4279401208,GRISEOFULVIN MICROSIZE 500 MG TABLET,23.34,15.17,3.92,23.34,22
NDC,4279401610,ASENAPINE 5 MG SUBLINGUAL TABLET,9.0,5.85,1.51,9.0,22
NDC,4279401710,ASENAPINE 10 MG SUBLINGUAL TABLET,9.0,5.85,1.51,9.0,22
NDC,4279401812,LIOTHYRONINE 5 MCG TABLET,1.7,1.11,0.29,1.7,22
NDC,4279401912,LIOTHYRONINE 25 MCG TABLET,2.2,1.43,0.37,2.2,22
NDC,4279402012,LIOTHYRONINE 50 MCG TABLET,3.3,2.15,0.55,3.3,22
NDC,4279911901,BUMETANIDE 0.5 MG TABLET,4.8,3.12,0.81,4.8,22
NDC,4279912001,BUMETANIDE 1 MG TABLET,5.34,3.47,0.9,5.34,22
NDC,4279912101,BUMETANIDE 2 MG TABLET,5.88,3.82,0.99,5.88,22
NDC,4279912301,CARBIDOPA 25 MG TABLET,21.0,13.65,3.53,21.0,22
NDC,4279920801,TINIDAZOLE 500 MG TABLET,20.3,13.2,3.41,20.3,22
NDC,4279921701,OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL,15.7,10.21,2.64,15.7,22
NDC,4279980601,IVERMECTIN 3 MG TABLET,9.94,6.46,1.67,9.94,22
NDC,4279981501,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION,0.78,0.51,0.13,0.78,22
NDC,4279992030,BISOPROLOL 2.5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET,14.74,9.58,2.48,14.74,22
NDC,4280601801,SULINDAC 150 MG TABLET,1.96,1.27,0.33,1.96,22
NDC,4280605030,MEPERIDINE 50 MG TABLET,94.78,61.61,15.92,94.78,22
NDC,4280605801,FLAVOXATE 100 MG TABLET,4.32,2.81,0.73,4.32,22
NDC,4280608701,ESTRADIOL 0.5 MG TABLET,1.1,0.72,0.18,1.1,22
NDC,4280614448,DEMECLOCYCLINE 300 MG TABLET,68.28,44.38,11.47,68.28,22
NDC,4280626060,GEMFIBROZIL 600 MG TABLET,4.86,3.16,0.82,4.86,22
NDC,4280626695,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,8.38,5.45,1.41,8.38,22
NDC,4280627095,CHOLESTYRAMINE LIGHT 4 GRAM POWDER FOR SUSPENSION IN A PACKET,8.38,5.45,1.41,8.38,22
NDC,4280651230,QUINIDINE SULFATE 300 MG TABLET,31.8,20.67,5.34,31.8,22
NDC,4280651330,QUINIDINE SULFATE 200 MG TABLET,30.18,19.62,5.07,30.18,22
NDC,4280654930,DUTASTERIDE 0.5 MG CAPSULE,12.1,7.87,2.03,12.1,22
NDC,4280655212,OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,4.14,2.69,0.7,4.14,22
NDC,4280671401,BENZONATATE 100 MG CAPSULE,5.0,3.25,0.84,5.0,22
NDC,4280671405,BENZONATATE 100 MG CAPSULE,4.54,2.95,0.76,4.54,22
NDC,4280675760,SULFADIAZINE 500 MG TABLET,40.08,26.05,6.73,40.08,22
NDC,4285800210,OXYCODONE 10 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,4285805501,DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULEEXTEND RELEASE,1.44,0.94,0.24,1.44,22
NDC,4285813401,FENOFIBRATE MICRONIZED 134 MG CAPSULE,0.38,0.25,0.06,0.38,22
NDC,4285830125,HYDROMORPHONE 2 MG TABLET,0.4,0.26,0.07,0.4,22
NDC,4285849340,BUPRENORPHINE 10 MCG/HOUR WEEKLY TRANSDERMAL PATCH,193.28,125.63,32.47,193.28,22
NDC,4285850203,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,1.92,1.25,0.32,1.92,22
NDC,4285858640,BUPRENORPHINE 15 MCG/HOUR WEEKLY TRANSDERMAL PATCH,278.82,181.23,46.84,278.82,22
NDC,4285870303,PAROXETINE ER 12.5 MG TABLETEXTENDED RELEASE 24 HR,1.6,1.04,0.27,1.6,22
NDC,4285870503,PAROXETINE ER 25 MG TABLETEXTENDED RELEASE 24 HR,1.72,1.12,0.29,1.72,22
NDC,4285875040,BUPRENORPHINE 5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,128.86,83.76,21.65,128.86,22
NDC,4285883940,BUPRENORPHINE 20 MCG/HOUR WEEKLY TRANSDERMAL PATCH,342.18,222.42,57.49,342.18,22
NDC,4285886706,DRONABINOL 2.5 MG CAPSULE,4.94,3.21,0.83,4.94,22
NDC,4293770310,SALSALATE 500 MG TABLET,3.9,2.54,0.66,3.9,22
NDC,4306600801,TRANEXAMIC ACID 1000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION,1.59,1.03,0.05,1.59,23
NDC,4306600810,TRANEXAMIC ACID 1000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION,1.59,1.03,0.05,1.59,23
NDC,4306600910,CARDENE 20 MG/200 ML(0.1 MG/ML) IN SOD CHLOR(ISO-OSM) INTRAVENOUS SOLN,0.9,0.59,0.15,0.9,22
NDC,4306601610,CARDENE 40 MG/200 ML(0.2 MG/ML) IN SOD CHLOR(ISO-OSM) INTRAVENOUS SOLN,1.44,0.94,0.24,1.44,22
NDC,4306601910,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,1.26,0.82,0.06,1.26,31
NDC,4306602310,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,0.96,0.62,0.06,0.96,31
NDC,4306615010,NEXTERONE 150 MG/100 ML (1.5 MG/ML) INTRAVENOUS SOLUTION,1.26,0.82,0.21,1.26,30
NDC,4306636020,NEXTERONE 360 MG/200 ML (1.8 MG/ML) INTRAVENOUS SOLUTION,0.84,0.55,0.14,1.12,30
NDC,4306810102,FANAPT 1 MG TABLET,73.7,47.91,12.38,73.7,22
NDC,4306810202,FANAPT 2 MG TABLET,73.7,47.91,12.38,73.7,22
NDC,4306810402,FANAPT 4 MG TABLET,73.7,47.91,12.38,73.7,22
NDC,4306810602,FANAPT 6 MG TABLET,90.68,58.94,15.23,90.68,22
NDC,4306810802,FANAPT 8 MG TABLET,90.68,58.94,15.23,90.68,22
NDC,4306811002,FANAPT 10 MG TABLET,145.22,94.39,24.4,145.22,22
NDC,4306811202,FANAPT 12 MG TABLET,145.22,94.39,24.4,145.22,22
NDC,4329256000,VITAMIN B-2  100 MG TABLET,0.08,0.05,0.01,0.08,22
NDC,4329256336,CHOLECALCIFEROL (VITAMIN D3) 1250 MCG (50000 UNIT) CAPSULE,0.12,0.08,0.02,0.12,22
NDC,4337632230,FINTEPLA 2.2 MG/ML ORAL SOLUTION,99.03,64.37,16.64,99.03,22
NDC,4338648024,ORPHENADRINE CITRATE ER 100 MG TABLETEXTENDED RELEASE,4.62,3.0,0.78,4.62,22
NDC,4352800305,HEPLISAV-B (PF) 20 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1121.4,728.91,17.89,1121.4,37
NDC,4354727410,ROPINIROLE 5 MG TABLET,5.0,3.25,0.84,5.0,22
NDC,4354727509,DONEPEZIL 5 MG TABLET,17.32,11.26,2.91,17.32,22
NDC,4354734250,RISPERIDONE 2 MG TABLET,15.2,9.88,2.55,15.2,22
NDC,4354739910,CYCLOBENZAPRINE 5 MG TABLET,3.28,2.13,0.55,3.28,22
NDC,4354752403,NEBIVOLOL 2.5 MG TABLET,9.48,6.16,1.59,9.48,22
NDC,4354752509,NEBIVOLOL 5 MG TABLET,9.48,6.16,1.59,9.48,22
NDC,4354754510,ENALAPRIL MALEATE 2.5 MG TABLET,2.92,1.9,0.49,2.92,22
NDC,4354754610,ENALAPRIL MALEATE 5 MG TABLET,3.7,2.41,0.62,3.7,22
NDC,4354754710,ENALAPRIL MALEATE 10 MG TABLET,3.88,2.52,0.65,3.88,22
NDC,4354754810,ENALAPRIL MALEATE 20 MG TABLET,5.54,3.6,0.93,5.54,22
NDC,4354768810,CIPROFLOXACIN 250 MG TABLET,8.88,5.77,1.49,8.88,22
NDC,4359801252,AUGMENTIN 125 MG-31.25 MG/5 ML ORAL SUSPENSION,16.68,10.84,2.8,16.68,22
NDC,4359812925,METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION,27.36,17.78,0.25,27.36,38
NDC,4359816605,OLANZAPINE 10 MG TABLET,39.84,25.9,6.69,39.84,22
NDC,4359821025,SSD 1 % TOPICAL CREAM,0.72,0.47,0.12,0.72,22
NDC,4359821040,SSD 1 % TOPICAL CREAM,0.32,0.21,0.05,0.32,22
NDC,4359821055,SSD 1 % TOPICAL CREAM,0.6,0.39,0.1,0.6,22
NDC,4359834837,DECITABINE 50 MG INTRAVENOUS SOLUTION,2304.0,1497.6,0.7,2304.0,36
NDC,4359839467,TETRABENAZINE 12.5 MG TABLET,151.18,98.27,25.4,151.18,22
NDC,4359843901,METHYLPHENIDATE ER 27 MG TABLETEXTENDED RELEASE 24 HR,19.96,12.97,3.35,19.96,22
NDC,4359844674,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,4.26,2.77,0.72,4.26,22
NDC,4359844828,NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,3.84,2.5,0.65,3.84,22
NDC,4359850930,ESOMEPRAZOLE MAGNESIUM 20 MG CAPSULEDELAYED RELEASE,18.04,11.73,3.03,18.04,22
NDC,4359858201,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,17.6,11.44,2.96,20.41,22
NDC,4359858230,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,17.6,11.44,2.96,20.41,22
NDC,4359867611,TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,8.07,5.25,0.97,8.07,31
NDC,4382520001,TERLIVAZ 0.85 MG INTRAVENOUS SOLUTION,3556.8,2311.92,597.54,3556.8,26
NDC,4382560641,RECOTHROM 5000 UNIT TOPICAL SOLUTION,206.4,134.16,34.68,206.4,22
NDC,4390018215,BOOST VHC 0.09 GRAM-2.25 KCAL/ML ORAL LIQUID,0.03,0.02,0.01,0.03,22
NDC,4390022510,RESOURCE THICKENUP ORAL POWDER,0.05,0.03,0.01,0.05,22
NDC,4390028300,GLUTASOLVE 15 GRAM ORAL POWDER PACKET,4.54,2.95,0.76,4.54,22
NDC,4390035988,ARGINAID 4.5 GRAM-156 MG/9.2 GRAM ORAL POWDER PACKET,2.76,1.79,0.46,2.76,22
NDC,4390097647,NUTRISOURCE FIBER PACKET,1.14,0.74,0.19,1.14,22
NDC,4397530610,FENOFIBRATE MICRONIZED 200 MG CAPSULE,1.58,1.03,0.27,1.58,22
NDC,4397544410,FENOFIBRATE MICRONIZED 67 MG CAPSULE,0.54,0.35,0.09,0.54,22
NDC,4408700443,REBIF (WITH ALBUMIN) 44 MCG/0.5 ML SUBCUTANEOUS SYRINGE,6592.98,4285.44,62.96,6592.98,35
NDC,4408735351,BAVENCIO 20 MG/ML INTRAVENOUS SOLUTION,1005.12,653.33,83.28,3407.66,46
NDC,4420630001,RHOPHYLAC 1500 UNIT (300 MCG)/2 ML INJECTION SYRINGE,318.54,207.05,4.32,318.54,37
NDC,4420630010,RHOPHYLAC 1500 UNIT (300 MCG)/2 ML INJECTION SYRINGE,289.56,188.21,4.32,289.56,37
NDC,4420631050,ALBURX (HUMAN) 5 % INTRAVENOUS SOLUTION,1.29,0.84,0.33,218.09,40
NDC,4420643605,PRIVIGEN 10 % INTRAVENOUS SOLUTION,71.13,46.23,18.42,943.43,47
NDC,4420643710,PRIVIGEN 10 % INTRAVENOUS SOLUTION,71.13,46.23,18.42,943.43,47
NDC,4420643820,PRIVIGEN 10 % INTRAVENOUS SOLUTION,71.13,46.23,18.42,943.43,47
NDC,4420643940,PRIVIGEN 10 % INTRAVENOUS SOLUTION,71.13,46.23,18.42,943.43,47
NDC,4422930760,SODIUM CHLORIDE 7 % FOR NEBULIZATION,0.18,0.12,0.03,0.18,22
NDC,4452361701,UREA 40 % TOPICAL CREAM,7.3,4.75,1.23,7.3,22
NDC,4456721110,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,54.0,35.1,1.91,54.0,31
NDC,4456723525,CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,16.2,10.53,1.49,16.2,31
NDC,4456723610,CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,36.0,23.4,1.49,36.0,31
NDC,4456724625,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,71.82,46.68,4.41,71.82,31
NDC,4456740206,MEROPENEM 2 GRAM INTRAVENOUS SOLUTION,118.44,76.99,1.62,118.44,37
NDC,4456741024,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.12,0.08,0.02,1.12,31
NDC,4456760104,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,45.57,29.62,7.66,45.57,22
NDC,4456761110,MIDAZOLAM (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.96,0.62,0.16,0.96,31
NDC,4456762001,CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE ISO-OSM IV SOLUTION,1.41,0.92,0.08,1.41,31
NDC,4456762101,CALCIUM GLUCONATE 2 GRAM/100 ML IN SODIUM CHLORIDEISO-OSM IV SOLUTION,1.41,0.92,0.24,1.41,22
NDC,4456762124,CALCIUM GLUCONATE 2 GRAM/100 ML IN SODIUM CHLORIDEISO-OSM IV SOLUTION,1.41,0.92,0.24,1.41,22
NDC,4456762201,CALCIUM GLUCONATE 1 GRAM/100 ML IN SODIUM CHLORIDEISO-OSM IV SOLUTION,0.45,0.29,0.08,0.45,22
NDC,4456762224,CALCIUM GLUCONATE 1 GRAM/100 ML IN SODIUM CHLORIDEISO-OSM IV SOLUTION,0.45,0.29,0.08,0.45,22
NDC,4456770625,CEFAZOLIN 500 MG SOLUTION FOR INJECTION,5.76,3.74,0.73,5.76,31
NDC,4456781110,ESMOLOL 2500 MG/250 ML (10 MG/ML) IN STERILE WATER INTRAVENOUS SOLN,1.71,1.11,0.29,1.71,31
NDC,4467710202,LANOLIN (HPA) 100 % TOPICAL CREAM,1.42,0.92,0.24,1.42,22
NDC,4556700301,KIT FOR PREPARATION OF TC 99M-SODIUM THIOSULFATE 2 MG SOLUTION,200.0,130.0,33.6,2409.0,29
NDC,4556700601,KIT PREPARATION OF TC-99M-SODIUM PYROPHOSPHATE 12 MG IV SOLUTION,118.0,76.7,19.82,2409.0,29
NDC,4556706551,KIT FOR PREP TC-99M-MERTIATIDE (BETIATIDE) 1 MG INTRAVENOUS SOLUTION,568.0,369.2,95.42,2409.0,29
NDC,4562908901,FOTIVDA 0.89 MG CAPSULE,3633.82,2361.98,610.48,3633.82,22
NDC,4562913401,FOTIVDA 1.34 MG CAPSULE,3633.82,2361.98,610.48,3633.82,22
NDC,4580200402,HYDROCORTISONE 2.5 % TOPICAL CREAM,0.5,0.33,0.08,0.5,22
NDC,4580200403,HYDROCORTISONE 2.5 % TOPICAL CREAM,0.78,0.51,0.13,0.78,22
NDC,4580201402,HYDROCORTISONE 2.5 % TOPICAL OINTMENT,0.5,0.33,0.08,0.5,22
NDC,4580202146,BETAMETHASONE DIPROPIONATE 0.05 % LOTION,1.5,0.98,0.25,1.5,22
NDC,4580204064,SELENIUM SULFIDE 2.5 % LOTION,0.34,0.22,0.06,0.34,22
NDC,4580204501,TRIAMCINOLONE ACETONIDE 0.147 MG/GRAM TOPICAL AEROSOL,7.78,5.06,1.31,7.78,22
NDC,4580204635,GENTAMICIN 0.1 % TOPICAL OINTMENT,6.58,4.28,1.11,6.58,22
NDC,4580204811,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,1.76,1.14,0.3,1.76,22
NDC,4580204835,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,2.34,1.52,0.39,2.34,22
NDC,4580204935,TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL OINTMENT,1.34,0.87,0.23,1.34,22
NDC,4580205435,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,0.82,0.53,0.14,0.82,22
NDC,4580205436,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,0.26,0.17,0.04,0.26,22
NDC,4580205535,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.74,0.48,0.12,0.74,22
NDC,4580205536,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,0.32,0.21,0.05,0.32,22
NDC,4580205611,GENTAMICIN 0.1 % TOPICAL CREAM,6.58,4.28,1.11,6.58,22
NDC,4580205635,GENTAMICIN 0.1 % TOPICAL CREAM,6.58,4.28,1.11,6.58,22
NDC,4580206001,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,0.52,0.34,0.09,0.52,22
NDC,4580206070,BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,0.46,0.3,0.08,0.46,22
NDC,4580206335,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,0.6,0.39,0.1,0.6,22
NDC,4580206336,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,0.26,0.17,0.04,0.26,22
NDC,4580206435,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.52,0.34,0.09,0.52,22
NDC,4580206436,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.24,0.16,0.04,0.24,22
NDC,4580206535,TRIAMCINOLONE ACETONIDE 0.5 % TOPICAL CREAM,1.34,0.87,0.23,1.34,22
NDC,4580209851,MESALAMINE 4 GRAM/60 ML ENEMA,0.82,0.53,0.14,0.82,22
NDC,4580210752,PSEUDOEPHEDRINE ER 120 MG TABLETEXTENDED RELEASE,0.76,0.49,0.13,0.76,22
NDC,4580210901,TRIAMCINOLONE ACETONIDE 55 MCG NASAL SPRAY AEROSOL,2.0,1.3,0.34,2.0,22
NDC,4580211214,MUPIROCIN 2 % TOPICAL OINTMENT,0.98,0.64,0.16,0.98,22
NDC,4580211222,MUPIROCIN 2 % TOPICAL OINTMENT,1.02,0.66,0.17,1.02,22
NDC,4580211937,MOMETASONE 0.1 % TOPICAL OINTMENT,3.24,2.11,0.54,3.24,22
NDC,4580211942,MOMETASONE 0.1 % TOPICAL OINTMENT,1.98,1.29,0.33,1.98,22
NDC,4580212801,CLINDAMYCIN 1 % LOTION,3.84,2.5,0.65,3.84,22
NDC,4580213811,CICLOPIROX 0.77 % TOPICAL CREAM,3.76,2.44,0.63,3.76,22
NDC,4580213835,CICLOPIROX 0.77 % TOPICAL CREAM,4.22,2.74,0.71,4.22,22
NDC,4580214301,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.6,0.39,0.1,0.6,22
NDC,4580214303,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.44,0.29,0.07,0.44,22
NDC,4580214370,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT TOPICAL OINTMENT PACKET,0.56,0.36,0.09,0.56,22
NDC,4580218816,HEMORRHOIDAL(PHENYLEPH-MIN OIL-PETROLAT)0.25 %-14 %-74.9 % RECTAL OINT,0.18,0.12,0.03,0.18,22
NDC,4580220126,CHILDREN'S ACETAMINOPHEN 160 MG/5 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,22
NDC,4580221001,NITROGLYCERIN 400 MCG/SPRAY TRANSLINGUAL,91.62,59.55,15.39,91.62,22
NDC,4580221696,BENZOYL PEROXIDE 5 % TOPICAL GEL,0.68,0.44,0.11,0.68,22
NDC,4580224414,NYSTATIN-TRIAMCINOLONE 100000 UNIT/GRAM-0.1 % TOPICAL OINTMENT,2.5,1.63,0.42,2.5,22
NDC,4580226337,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SWAB,1.68,1.09,0.28,1.68,22
NDC,4580226937,PERMETHRIN 5 % TOPICAL CREAM,3.96,2.57,0.67,3.96,22
NDC,4580227603,HYDROCORTISONE 1 % TOPICAL OINTMENT,0.28,0.18,0.05,0.28,22
NDC,4580235803,ITCH RELIEF 2 %-0.1 % TOPICAL CREAM,0.28,0.18,0.05,0.28,22
NDC,4580236853,IMIQUIMOD 5 % TOPICAL CREAM PACKET,36.8,23.92,6.18,36.8,22
NDC,4580236862,IMIQUIMOD 5 % TOPICAL CREAM PACKET,5.0,3.25,0.84,5.0,22
NDC,4580239000,TACROLIMUS 0.03 % TOPICAL OINTMENT,5.6,3.64,0.94,5.6,22
NDC,4580239504,VITAMINS A AND D-WHITE PETROLATUM-LANOLIN TOPICAL OINTMENT,0.08,0.05,0.01,0.08,22
NDC,4580241059,NASAL SPRAY (OXYMETAZOLINE) 0.05 %,0.16,0.1,0.03,0.16,22
NDC,4580242335,DESONIDE 0.05 % TOPICAL OINTMENT,3.1,2.02,0.52,3.1,22
NDC,4580242337,DESONIDE 0.05 % TOPICAL OINTMENT,3.1,2.02,0.52,3.1,22
NDC,4580243321,DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,0.23,0.15,0.04,0.23,22
NDC,4580243411,CLOTRIMAZOLE 1 % TOPICAL CREAM,0.36,0.23,0.06,0.36,22
NDC,4580243803,HYDROCORTISONE 1 % TOPICAL CREAM,0.28,0.18,0.05,0.28,22
NDC,4580246564,KETOCONAZOLE 2 % SHAMPOO,0.5,0.33,0.08,0.5,22
NDC,4580246611,ECONAZOLE NITRATE 1 % TOPICAL CREAM,4.0,2.6,0.67,4.0,22
NDC,4580246635,ECONAZOLE NITRATE 1 % TOPICAL CREAM,4.0,2.6,0.67,4.0,22
NDC,4580246653,ECONAZOLE NITRATE 1 % TOPICAL CREAM,2.82,1.83,0.47,2.82,22
NDC,4580247265,HYDROCORTISONE-PRAMOXINE 2.5 %-1 % (4G) RECTAL CREAM,4.52,2.94,0.76,4.52,22
NDC,4580249535,DESOXIMETASONE 0.25 % TOPICAL CREAM,7.78,5.06,1.31,7.78,22
NDC,4580249537,DESOXIMETASONE 0.25 % TOPICAL CREAM,6.64,4.32,1.12,6.64,22
NDC,4580249614,DESOXIMETASONE 0.25 % TOPICAL OINTMENT,2.4,1.56,0.4,2.4,22
NDC,4580249696,DESOXIMETASONE 0.25 % TOPICAL OINTMENT,2.0,1.3,0.34,2.0,22
NDC,4580250584,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL OINTMENT,4.22,2.74,0.71,4.22,22
NDC,4580252555,AMMONIUM LACTATE 12 % LOTION,0.16,0.1,0.03,0.16,22
NDC,4580256201,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,1.94,1.26,0.33,1.94,22
NDC,4580262626,CETIRIZINE 1 MG/ML ORAL SOLUTION,0.75,0.49,0.13,0.75,22
NDC,4580265078,LORATADINE 10 MG TABLET,0.6,0.39,0.1,0.6,22
NDC,4580265087,LORATADINE 10 MG TABLET,0.6,0.39,0.1,0.6,22
NDC,4580270000,TACROLIMUS 0.1 % TOPICAL OINTMENT,8.0,5.2,1.34,8.0,22
NDC,4580270001,TACROLIMUS 0.1 % TOPICAL OINTMENT,8.0,5.2,1.34,8.0,22
NDC,4580273000,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,0.68,0.44,0.11,0.68,22
NDC,4580273030,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,1.34,0.87,0.23,1.34,22
NDC,4580273032,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,0.68,0.44,0.11,0.68,22
NDC,4580273033,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,0.5,0.33,0.08,0.5,22
NDC,4580273200,ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,0.74,0.48,0.12,0.74,22
NDC,4580273230,ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,0.74,0.48,0.12,0.74,22
NDC,4580273233,ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,0.48,0.31,0.08,0.48,22
NDC,4580286802,POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,0.08,0.05,0.01,0.08,22
NDC,4580286803,POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,0.1,0.07,0.02,0.1,22
NDC,4580288014,NYSTATIN-TRIAMCINOLONE 100000 UNIT/G-0.1 % TOPICAL CREAM,3.36,2.18,0.56,3.36,22
NDC,4580288094,NYSTATIN-TRIAMCINOLONE 100000 UNIT/G-0.1 % TOPICAL CREAM,2.36,1.53,0.4,2.36,22
NDC,4580291987,CETIRIZINE 10 MG TABLET,0.2,0.13,0.03,0.2,22
NDC,4580293716,HYDROCORTISONE 2.5 % LOTION,1.82,1.18,0.31,1.82,22
NDC,4580293726,HYDROCORTISONE 2.5 % LOTION,1.3,0.85,0.22,1.3,22
NDC,4580295243,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.15,0.1,0.03,0.15,22
NDC,4580297426,CETIRIZINE 1 MG/ML ORAL SOLUTION,0.23,0.15,0.04,0.23,22
NDC,4596314290,BUPROPION XL 300 MG 24 HR TAB,12.6,8.19,2.12,12.6,22
NDC,4596334102,DESIPRAMINE 10 MG TABLET,2.36,1.53,0.4,2.36,22
NDC,4596334202,DESIPRAMINE 25 MG TABLET,2.84,1.85,0.48,2.84,22
NDC,4596343864,ENULOSE 10 GRAM/15 ML ORAL SOLUTION,0.2,0.13,0.03,0.2,22
NDC,4596355611,GABAPENTIN 300 MG CAPSULE,2.66,1.73,0.45,2.66,22
NDC,4596355750,GABAPENTIN 400 MG CAPSULE,3.2,2.08,0.54,3.2,22
NDC,4601701816,VIVARIN 200 MG TABLET,0.48,0.31,0.08,0.48,22
NDC,4612210006,NATURAL FIBER LAXATIVE 0.52 GRAM CAPSULE,0.2,0.13,0.03,0.2,22
NDC,4612210846,LICE TREATMENT 1 % TOPICAL LIQUID,0.36,0.23,0.06,0.36,22
NDC,4612216510,NASAL SPRAY (OXYMETAZOLINE) 0.05 %,0.42,0.27,0.07,0.42,22
NDC,4612216660,PSEUDOEPHEDRINE ER 120 MG TABLETEXTENDED RELEASE,1.12,0.73,0.19,1.12,22
NDC,4612221126,CHILDREN'S PAIN AND FEVER RELIEF 160 MG/5 ML ORAL SUSPENSION,0.15,0.1,0.03,0.15,22
NDC,4612222163,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.36,0.23,0.06,0.36,22
NDC,4612222263,GLYCERIN (CHILD) RECTAL SUPPOSITORY,0.36,0.23,0.06,0.36,22
NDC,4612226530,SORE THROAT (PHENOL) 1.4 % AEROSOL SPRAY,0.06,0.04,0.01,0.06,22
NDC,4612233443,HYDROGEN PEROXIDE 3 % SOLUTION,0.02,0.01,0.01,0.02,22
NDC,4612239465,ACID REDUCER (FAMOTIDINE) 10 MG TABLET,0.62,0.4,0.1,0.62,22
NDC,4612239516,MINERAL OIL ORAL,0.05,0.03,0.01,0.05,22
NDC,4612241403,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.52,0.34,0.09,0.52,22
NDC,4612241405,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.74,0.48,0.12,0.74,22
NDC,4612242326,LORATADINE 5 MG/5 ML ORAL SOLUTION,0.2,0.13,0.03,0.2,22
NDC,4612243140,ANTACID-ANTIGAS 400 MG-400 MG-40 MG/5 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,22
NDC,4612243340,ANTACID REGULAR STRENGTH 200 MG-200 MG-20 MG/5 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,22
NDC,4612244062,ALLERGY RELIEF (DIPHENHYDRAMINE) 25 MG CAPSULE,0.42,0.27,0.07,0.42,22
NDC,4612244427,MICONAZORB AF 2 % TOPICAL POWDER,0.24,0.16,0.04,0.24,22
NDC,4612245773,ALERTNESS AID 200 MG TABLET,0.62,0.4,0.1,0.62,22
NDC,4612252413,CALLUS REMOVERS 40 % TOPICAL PATCH,0.56,0.36,0.09,0.56,22
NDC,4612253653,MOTION SICKNESS RELIEF 50 MG TABLET,1.14,0.74,0.19,1.14,22
NDC,4612254426,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,0.13,0.08,0.02,0.13,22
NDC,4612255705,EAR WAX REMOVAL DROPS 6.5 %,1.02,0.66,0.17,1.02,22
NDC,4612257310,ANTI-ITCH (MENTHOL-CAMPHOR) 0.5 %-0.5 % LOTION,0.1,0.07,0.02,0.1,22
NDC,4612259602,ASPIRIN 325 MG TABLETDELAYED RELEASE,0.1,0.07,0.02,0.1,22
NDC,4612267264,OLOPATADINE 0.1 % EYE DROPS,5.28,3.43,0.89,5.28,22
NDC,4612267746,HEMORRHOIDAL(PHENYLEPH-MIN OIL-PETROLAT)0.25 %-14 %-74.9 % RECTAL OINT,0.42,0.27,0.07,0.42,22
NDC,4612270165,PINK BISMUTH 262 MG CHEWABLE TABLET,0.46,0.3,0.08,0.46,22
NDC,4612271427,WHITE PETROLATUM TOPICAL JELLY,0.04,0.03,0.01,0.04,22
NDC,4612272626,VITAMINS A AND D-WHITE PETROLATUM-LANOLIN TOPICAL OINTMENT,0.1,0.07,0.02,0.1,22
NDC,4612274038,MAGNESIUM CITRATE ORAL SOLUTION,0.03,0.02,0.01,0.03,22
NDC,4612275051,MUCUS RELIEF ER 600 MG TABLET EXTENDED RELEASE,1.3,0.85,0.22,1.3,22
NDC,4612275252,DICLOFENAC 1 % TOPICAL GEL,0.3,0.2,0.05,0.3,22
NDC,4612277966,FEXOFENADINE 180 MG TABLET,0.82,0.53,0.14,0.82,22
NDC,4612278929,MICONAZORB AF 2 % TOPICAL POWDER,0.24,0.16,0.04,0.24,22
NDC,4616321295,DELFLEX-LC WITH 4.25 % DEXTROSE CALCIUM 2.5MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,22
NDC,4628700601,SPS (WITH SORBITOL) 15 GRAM-20 GRAM/60 ML ORAL SUSPENSION,1.4,0.91,0.24,1.4,22
NDC,4628700604,SPS (WITH SORBITOL) 30 GRAM-40 GRAM/120 ML ENEMA,2.42,1.57,0.41,2.42,22
NDC,4628700660,SPS (WITH SORBITOL) 15 GRAM-20 GRAM/60 ML ORAL SUSPENSION,1.3,0.85,0.22,1.3,22
NDC,4628700901,ISONIAZID 50 MG/5 ML ORAL SOLUTION,2.48,1.61,0.42,2.48,22
NDC,4628701401,ORACIT 490 MG-640 MG/5 ML ORAL SOLUTION,0.3,0.2,0.05,0.3,22
NDC,4628701430,ORACIT 490 MG-640 MG/5 ML ORAL SOLUTION,0.63,0.41,0.11,0.63,22
NDC,4628702001,CAROSPIR 25 MG/5 ML ORAL SUSPENSION,10.98,7.14,1.84,10.98,22
NDC,4628702004,CAROSPIR 25 MG/5 ML ORAL SUSPENSION,11.0,7.15,1.85,11.0,22
NDC,4628704515,TADLIQ 20 MG/5 ML (4 MG/ML) ORAL SUSPENSION,41.0,26.65,6.89,41.0,22
NDC,4628750001,SORBITOL 70 % SOLUTION,0.08,0.05,0.01,0.08,22
NDC,4628750030,SORBITOL 70 % SOLUTION,0.35,0.23,0.06,0.35,22
NDC,4628750816,PETROLATUM TOPICAL OINTMENT,0.26,0.17,0.04,0.26,22
NDC,4641422221,AMYL NITRITE 0.3 ML SOLUTION FOR INHALATION,0.32,0.21,0.05,0.32,22
NDC,4678316001,XEOMIN 100 UNIT INTRAMUSCULAR SOLUTION,1735.2,1127.88,4.68,1735.2,47
NDC,4678316101,XEOMIN 50 UNIT INTRAMUSCULAR SOLUTION,1839.6,1195.74,4.68,1839.6,47
NDC,4733500388,CARBIDOPA 25 MG-LEVODOPA 100 MG-ENTACAPONE 200 MG TABLET,7.42,4.82,1.25,7.42,22
NDC,4733500488,CARBIDOPA 31.25 MG-LEVODOPA 125 MG-ENTACAPONE 200 MG TABLET,7.42,4.82,1.25,7.42,22
NDC,4733500588,CARBIDOPA 37.5 MG-LEVODOPA 150 MG-ENTACAPONE 200 MG TABLET,7.42,4.82,1.25,7.42,22
NDC,4733517795,ILUMYA 100 MG/ML SUBCUTANEOUS SYRINGE,64661.19,42029.77,123.78,64661.19,53
NDC,4733518688,CARBIDOPA 10 MG-LEVODOPA 100 MG DISINTEGRATING TABLET,1.86,1.21,0.31,1.86,22
NDC,4733518788,CARBIDOPA 25 MG-LEVODOPA 100 MG DISINTEGRATING TABLET,2.76,1.79,0.46,2.76,22
NDC,4733518888,CARBIDOPA 25 MG-LEVODOPA 250 MG DISINTEGRATING TABLET,3.5,2.28,0.59,3.5,22
NDC,4733530383,ODOMZO 200 MG CAPSULE,1143.02,742.96,192.03,1143.02,22
NDC,4733574483,PALIPERIDONE ER 1.5 MG TABLETEXTENDED RELEASE 24 HR,61.12,39.73,10.27,61.12,22
NDC,4733578891,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),98.5,64.03,16.55,98.5,22
NDC,4742620101,CINVANTI 130 MG/18 ML (7.2 MG/ML) INTRAVENOUS EMULSION,92.73,60.27,1.5,93.47,47
NDC,4778135703,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,17.58,11.43,2.95,20.41,22
NDC,4778147013,OSELTAMIVIR 75 MG CAPSULE,30.92,20.1,5.19,30.92,22
NDC,4778160730,DISULFIRAM 250 MG TABLET,8.08,5.25,1.36,8.08,22
NDC,4778310101,KALBITOR 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,20543.67,13353.39,491.06,20543.67,53
NDC,4843311201,PRENATAL 28 MG IRON-800 MCG TABLET,0.52,0.34,0.09,0.52,22
NDC,4843320230,MINERAL OIL ORAL,0.2,0.13,0.03,0.2,22
NDC,4843323015,STRONG IODINE 5 % ORAL SOLUTION,7.98,5.19,1.34,7.98,22
NDC,4858200155,BIOTENE MOISTURIZING MOUTH MUCOSAL SPRAY,0.44,0.29,0.07,0.44,22
NDC,4858251201,BIOTENE ORALBALANCE (GLYCERIN) MUCOSAL GEL,0.46,0.3,0.08,0.46,22
NDC,4858280220,BIOTENE DRY MOUTH ORAL RINSE MOUTHWASH,0.08,0.05,0.01,0.08,22
NDC,4878311208,MONSEL'S 0.2 GRAM TO 0.22 GRAM/ML TOPICAL SOLUTION APPLICATOR,5.35,3.48,0.9,5.35,22
NDC,4881510011,SODIUM IODIDE-123 3.7 MBQ (100 MICROCI) CAPSULE,210.0,136.5,35.28,2409.0,29
NDC,4898500155,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,4.26,2.77,0.72,4.26,22
NDC,4902213112,THERAPEUTIC MOISTURIZING TOPICAL CREAM,0.06,0.04,0.01,0.06,22
NDC,4910036374,CULTURELLE 15 BILLION CELL SPRINKLE CAPSULE,1.64,1.07,0.28,1.64,22
NDC,4910036404,CULTURELLE 15 BILLION CELL SPRINKLE CAPSULE,1.64,1.07,0.28,1.64,22
NDC,4910040007,CULTURELLE 10 BILLION CELL CAPSULE,3.08,2.0,0.52,3.08,22
NDC,4910040009,CULTURELLE DIGESTIVE HEALTH 10 BILLION CELL-200 MG SPRINKLE CAPSULE,1.5,0.98,0.25,1.5,22
NDC,4910040021,CULTURELLE DIGESTIVE HEALTH 10 BILLION CELL-200 MG SPRINKLE CAPSULE,1.4,0.91,0.24,1.4,22
NDC,4923020692,DELFLEX-LC WITH 1.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5MEQ/L,0.03,0.02,0.01,0.03,22
NDC,4923020695,DELFLEX-LC WITH 1.5% DEXTROSE LOW CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5MEQ/L,0.03,0.02,0.01,0.03,22
NDC,4923020923,DELFLEX-LC WITH 2.5 % DEXTROSE CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.06,0.04,0.01,0.06,22
NDC,4923020992,DELFLEX WITH 2.5 % DEXTROSE CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,22
NDC,4923020995,DELFLEX WITH 2.5 % DEXTROSE CALCIUM 2.5 MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,22
NDC,4923021223,DELFLEX-LC WITH 4.25 % DEXTROSE CALCIUM 2.5MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,22
NDC,4923021292,DELFLEX-LC WITH 4.25 % DEXTROSE CALCIUM 2.5MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,22
NDC,4923021295,DELFLEX-LC WITH 4.25 % DEXTROSE CALCIUM 2.5MEQ/L-MAGNESIUM 0.5 MEQ/L,0.03,0.02,0.01,0.03,22
NDC,4928112565,FLUZONE HIGH-DOSE 2025-2026 (PF) 180 MCG/0.5 ML INTRAMUSCULAR SYRINGE,406.53,264.24,17.89,406.53,37
NDC,4928119020,IMOGAM RABIES-HT (PF) 150 UNIT/ML INTRAMUSCULAR SOLUTION,1629.24,1059.01,352.44,1629.24,39
NDC,4928121510,TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION,319.77,207.85,16.95,319.77,37
NDC,4928121515,TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE,319.77,207.85,16.95,319.77,37
NDC,4928121588,TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE,319.74,207.83,16.95,319.74,37
NDC,4928122510,TETANUSDIPHTHERIA TOXOID PED (PF) 5 LF UNIT-25 LF UNIT/0.5 ML IM SUSP,442.89,287.88,17.89,442.89,29
NDC,4928124858,IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION,1561.71,1015.11,79.26,1561.71,47
NDC,4928125051,IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION,1561.71,1015.11,79.26,1561.71,47
NDC,4928128610,DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP,210.75,136.99,17.89,210.75,29
NDC,4928128658,DAPTACEL (DTAP PEDIATRIC) (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP,210.75,136.99,17.89,210.75,29
NDC,4928129110,DECAVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE,141.48,91.96,16.95,141.48,37
NDC,4928140010,ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP,351.57,228.52,17.89,351.57,37
NDC,4928140020,ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE,351.57,228.52,17.89,351.57,37
NDC,4928140058,ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP,351.57,228.52,17.89,351.57,37
NDC,4928140089,ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE,351.57,228.52,17.89,351.57,37
NDC,4928142550,FLUZONE 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE,149.4,97.11,17.89,149.4,36
NDC,4928151105,PENTACEL (PF) 15 LF-20 MCG-5 LF-62 DU-10 MCG/0.5 ML INTRAMUSCULAR KIT,467.67,303.99,17.89,467.67,29
NDC,4928154503,ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION,47.37,30.79,7.96,47.37,29
NDC,4928154758,ACTHIB (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION,47.37,30.79,7.96,47.37,29
NDC,4928156210,QUADRACEL (PF) 15 LF-48 MCG-5 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION,443.34,288.17,17.89,443.34,29
NDC,4928157415,BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE,2142.21,1392.44,359.89,2142.21,29
NDC,4928157488,BEYFORTUS 100 MG/ML INTRAMUSCULAR SYRINGE,2142.21,1392.44,359.89,2142.21,29
NDC,4928157500,BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE,4284.42,2784.87,516.7,4284.42,32
NDC,4928157515,BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE,4284.45,2784.89,516.7,4284.45,32
NDC,4928159005,MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION,1269.78,825.36,79.26,1269.78,29
NDC,4928159058,MENQUADFI (PF) 10 MCG/0.5 ML INTRAMUSCULAR SOLUTION,1269.78,825.36,79.26,1269.78,29
NDC,4928172510,FLUBLOK 2025-2026 (PF) 135 MCG (45 MCG X 3)/0.5 ML IM SYRINGE,615.45,400.04,103.4,615.45,23
NDC,4928175221,TUBERSOL 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,454.17,295.21,76.3,454.17,22
NDC,4928175222,TUBERSOL 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,353.94,230.06,59.46,353.94,22
NDC,4928175278,TUBERSOL 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,454.17,295.21,76.3,454.17,22
NDC,4928179020,TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION,802.41,521.57,17.89,802.41,29
NDC,4928179051,TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1163.52,756.29,17.89,1163.52,29
NDC,4928186010,IPOL 40 UNIT-8 UNIT-32 UNIT/0.5 ML SUSPENSION FOR INJECTION,338.85,220.25,17.89,338.85,29
NDC,4940108801,BENLYSTA 200 MG/ML SUBCUTANEOUS AUTO-INJECTOR,6164.88,4007.17,48.69,6164.88,53
NDC,4940110101,BENLYSTA 120 MG INTRAVENOUS SOLUTION,3169.92,2060.45,48.69,3169.92,50
NDC,4940110201,BENLYSTA 400 MG INTRAVENOUS SOLUTION,10565.6,6867.64,48.69,10565.6,53
NDC,4941105030,AMICAR 500 MG TABLET,48.86,31.76,8.21,48.86,22
NDC,4941105208,AMICAR 250 MG/ML (25 %) ORAL SOLUTION,35.45,23.04,5.96,35.45,22
NDC,4945211551,BISMUTH SUBGALLATE (BULK) POWDER,6.48,4.21,1.09,6.48,22
NDC,4945211552,BISMUTH SUBGALLATE (BULK) POWDER,4.16,2.7,0.7,4.16,22
NDC,4945213132,BUPIVACAINE (BULK) 100 % POWDER,188.38,122.45,31.65,188.38,22
NDC,4945263031,ROPIVACAINE HCL (BULK) 100 % POWDER,30.42,19.77,5.11,30.42,22
NDC,4947100105,PRE-PEN 0.25 ML INTRADERMAL INJECTION SOLUTION,2557.44,1662.34,429.65,2557.44,22
NDC,4948322110,NITRO-TIME 2.5 MG CAPSULEEXTENDED RELEASE,1.38,0.9,0.23,1.38,22
NDC,4948322210,NITRO-TIME 6.5 MG CAPSULEEXTENDED RELEASE,1.62,1.05,0.27,1.62,22
NDC,4948368703,PARICALCITOL 1 MCG CAPSULE,16.0,10.4,2.69,16.0,22
NDC,4950210102,EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTIONAUTO-INJECTOR,540.0,351.0,0.73,540.0,24
NDC,4950210202,EPINEPHRINE 0.3 MG/0.3 ML INJECTION AUTO-INJECTOR,540.0,351.0,0.73,540.0,24
NDC,4950245093,CIMDUO 300 MG-300 MG TABLET,99.54,64.7,16.72,99.54,22
NDC,4950250001,EPIPEN 0.3 MG/0.3 ML INJECTION AUTO-INJECTOR,1095.51,712.08,0.73,1095.51,24
NDC,4950250002,EPIPEN 2-PAK 0.3 MG/0.3 ML INJECTION AUTO-INJECTOR,1095.51,712.08,0.73,1095.51,24
NDC,4950250101,EPIPEN JR 0.15 MG/0.3 ML INJECTIONAUTO-INJECTOR,1095.51,712.08,0.73,1095.51,24
NDC,4950250102,EPIPEN JR 2-PAK 0.15 MG/0.3 ML INJECTIONAUTO-INJECTOR,1095.51,712.08,0.73,1095.51,24
NDC,4950290001,EMSAM 6 MG/24 HR TRANSDERMAL 24 HOUR PATCH,189.18,122.97,31.78,189.18,22
NDC,4950290030,EMSAM 6 MG/24 HR TRANSDERMAL 24 HOUR PATCH,189.18,122.97,31.78,189.18,22
NDC,4950290130,EMSAM 9 MG/24 HR TRANSDERMAL 24 HOUR PATCH,189.18,122.97,31.78,189.18,22
NDC,4950290201,EMSAM 12 MG/24 HR TRANSDERMAL 24 HOUR PATCH,189.18,122.97,31.78,189.18,22
NDC,4950290230,EMSAM 12 MG/24 HR TRANSDERMAL 24 HOUR PATCH,189.18,122.97,31.78,189.18,22
NDC,4959153251,CYTOGAM 50 MG/ML INTRAVENOUS SOLUTION,130.29,84.69,33.75,5004.36,47
NDC,4970221301,RETROVIR 10 MG/ML INTRAVENOUS SOLUTION,5.25,3.41,1.31,5.25,34
NDC,4970221326,RETROVIR 10 MG/ML INTRAVENOUS SOLUTION,5.25,3.41,1.31,5.25,34
NDC,4970222248,ZIAGEN 20 MG/ML ORAL SOLUTION,1.83,1.19,0.31,1.83,22
NDC,4970222318,SELZENTRY 150 MG TABLET,65.32,42.46,10.97,65.32,22
NDC,4970222418,SELZENTRY 300 MG TABLET,65.32,42.46,10.97,65.32,22
NDC,4970222813,TIVICAY 50 MG TABLET,191.6,124.54,32.19,191.6,22
NDC,4970223113,TRIUMEQ 600 MG-50 MG-300 MG TABLET,321.14,208.74,53.95,321.14,22
NDC,4970224015,CABENUVA 600 MG/3 ML-900 MG/3 ML IM SUSPENSION EXTENDED RELEASE,4279.77,2781.85,20.36,4279.77,50
NDC,4970224213,JULUCA 50 MG-25 MG TABLET,300.98,195.64,50.56,300.98,22
NDC,4970224613,DOVATO 50 MG-300 MG TABLET,260.04,169.03,43.69,260.04,22
NDC,4970225018,RUKOBIA 600 MG TABLETEXTENDED RELEASE,386.06,250.94,64.86,386.06,22
NDC,4970225315,CABENUVA 400 MG/2 ML-600 MG/2 ML IM SUSPENSION EXTENDED RELEASE,4279.77,2781.85,20.36,4279.77,50
NDC,4970225537,TIVICAY PD 5 MG TABLET FOR ORAL SUSPENSION,19.16,12.45,3.22,19.16,22
NDC,4970226423,APRETUDE 600 MG/3 ML (200 MG/ML) IM SUSPENSION EXTENDED RELEASE,5074.8,3298.62,6.81,5074.8,52
NDC,4970228063,APRETUDE 600 MG/3 ML (200 MG/ML) IM SUSPENSION EXTENDED RELEASE,4279.77,2781.85,6.81,4279.77,49
NDC,4973011330,NITROGLYCERIN 0.6 MG/HR TRANSDERMAL 24 HOUR PATCH,4.12,2.68,0.69,4.12,22
NDC,4988402201,ISOSORBIDE DINITRATE 20 MG TABLET,2.38,1.55,0.4,2.38,22
NDC,4988406501,GLYCOPYRROLATE 1 MG TABLET,2.62,1.7,0.44,2.62,22
NDC,4988411074,ALPRAZOLAM 0.25 MG DISINTEGRATING TABLET,3.04,1.98,0.51,3.04,22
NDC,4988411701,AMILORIDE 5 MG TABLET,2.58,1.68,0.43,2.58,22
NDC,4988415676,VARENICLINE TARTRATE 1 MG TABLET,17.58,11.43,2.95,17.58,22
NDC,4988416111,CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,64.08,41.65,10.77,64.08,22
NDC,4988421255,RISPERIDONE 0.25 MG DISINTEGRATING TABLET,8.96,5.82,1.51,8.96,22
NDC,4988423183,PRAZIQUANTEL 600 MG TABLET,179.36,116.58,30.13,179.36,22
NDC,4988425601,MINOXIDIL 2.5 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,4988425701,MINOXIDIL 10 MG TABLET,3.38,2.2,0.57,3.38,22
NDC,4988430702,CLONAZEPAM 0.25 MG DISINTEGRATING TABLET,2.6,1.69,0.44,2.6,22
NDC,4988430802,CLONAZEPAM 0.5 MG DISINTEGRATING TABLET,2.6,1.69,0.44,2.6,22
NDC,4988430902,CLONAZEPAM 1 MG DISINTEGRATING TABLET,2.96,1.92,0.5,2.96,22
NDC,4988431002,CLONAZEPAM 2 MG DISINTEGRATING TABLET,4.1,2.67,0.69,4.1,22
NDC,4988431555,RISPERIDONE 1 MG DISINTEGRATING TABLET,11.5,7.48,1.93,11.5,22
NDC,4988434701,PIMOZIDE 1 MG TABLET,3.66,2.38,0.61,3.66,22
NDC,4988434801,PIMOZIDE 2 MG TABLET,4.88,3.17,0.82,4.88,22
NDC,4988436401,DANTROLENE 100 MG CAPSULE,3.9,2.54,0.66,3.9,22
NDC,4988446565,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,6.74,4.38,1.13,6.74,22
NDC,4988448454,LAMOTRIGINE 25 MG DISINTEGRATING TABLET,17.76,11.54,2.98,17.76,22
NDC,4988448611,LAMOTRIGINE 100 MG DISINTEGRATING TABLET,20.28,13.18,3.41,20.28,22
NDC,4988455601,ISOSORBIDE DINITRATE 40 MG TABLET,41.08,26.7,6.9,41.08,22
NDC,4988456111,LAMOTRIGINE ER 25 MG TABLETEXTENDED RELEASE 24 HR,13.1,8.52,2.2,13.1,22
NDC,4988456211,LAMOTRIGINE ER 50 MG TABLETEXTENDED RELEASE 24 HR,26.18,17.02,4.4,26.18,22
NDC,4988456311,LAMOTRIGINE ER 100 MG TABLETEXTENDED RELEASE 24 HR,28.06,18.24,4.71,28.06,22
NDC,4988456411,LAMOTRIGINE ER 200 MG TABLETEXTENDED RELEASE 24 HR,29.92,19.45,5.03,29.92,22
NDC,4988460411,LAMOTRIGINE ER 250 MG TABLETEXTENDED RELEASE 24 HR,40.8,26.52,6.85,40.8,22
NDC,4988460511,LAMOTRIGINE ER 300 MG TABLETEXTENDED RELEASE 24 HR,44.88,29.17,7.54,44.88,22
NDC,4988472401,HYDROXYUREA 500 MG CAPSULE,2.56,1.66,0.43,2.56,22
NDC,4988476854,TOLVAPTAN 15 MG TABLET,1123.56,730.31,188.76,1123.56,22
NDC,4988493666,QUESTRAN 4 GRAM ORAL POWDER,0.49,0.32,0.08,0.49,22
NDC,5000472500,DEFLUX 50 MG-15 MG/ML (1) SYRINGE,11438.85,7435.25,1921.73,10294.97,33
NDC,5001442850,ISOPROPYL ALCOHOL 70 % SOLUTION,0.64,0.42,0.11,0.64,22
NDC,5001695711,GEL-ONE 30 MG/3 ML INTRA-ARTICULAR SYRINGE,1380.0,897.0,97.89,1461.32,47
NDC,5002443203,ANBESOL (BENZOCAINE) MAXIMUM STRENGTH 20 % MUCOSAL GEL,1.26,0.82,0.21,1.26,22
NDC,5009002951,KENALOG 10 MG/ML SUSPENSION FOR INJECTION,8.7,5.66,0.97,8.7,31
NDC,5009018680,AZITHROMYCIN 100 MG/5 ML ORAL SUSPENSION,5.83,3.79,0.98,5.83,22
NDC,5009067050,HADLIMA 40 MG/0.8 ML SUBCUTANEOUS SYRINGE,2335.5,1518.08,392.36,2335.5,22
NDC,5009067060,HADLIMA PUSHTOUCH 40 MG/0.8 ML SUBCUTANEOUS AUTO-INJECTOR,2335.53,1518.09,392.37,2335.53,22
NDC,5010211101,ECONTRA EZ 1.5 MG TABLET,73.12,47.53,12.28,73.12,22
NDC,5010211112,ECONTRA EZ 1.5 MG TABLET,73.12,47.53,12.28,73.12,22
NDC,5011132703,HYDRALAZINE 25 MG TABLET,1.0,0.65,0.17,1.0,22
NDC,5011132801,HYDRALAZINE 50 MG TABLET,1.12,0.73,0.19,1.12,22
NDC,5011132803,HYDRALAZINE 50 MG TABLET,1.1,0.72,0.18,1.1,22
NDC,5011133402,METRONIDAZOLE 500 MG TABLET,1.38,0.9,0.23,1.38,22
NDC,5011139701,HYDRALAZINE 100 MG TABLET,2.02,1.31,0.34,2.02,22
NDC,5011139803,HYDRALAZINE 10 MG TABLET,0.8,0.52,0.13,0.8,22
NDC,5011145601,OXYBUTYNIN CHLORIDE 5 MG TABLET,1.52,0.99,0.26,1.52,22
NDC,5011164701,FLUOXETINE 10 MG CAPSULE,5.2,3.38,0.87,5.2,22
NDC,5011164803,FLUOXETINE 20 MG CAPSULE,5.24,3.41,0.88,5.24,22
NDC,5011191701,TORSEMIDE 20 MG TABLET,1.64,1.07,0.28,1.64,22
NDC,5019014123,SODIUM CHLORIDE 7 % FOR NEBULIZATION,0.38,0.25,0.06,0.38,22
NDC,5019014263,NEBUSAL 3 % SOLUTION FOR NEBULIZATION,0.38,0.25,0.06,0.38,22
NDC,5019074060,PULMOSAL 7 % SOLUTION FOR NEBULIZATION,0.4,0.26,0.07,0.4,22
NDC,5020124001,POTASSIUM BICARBONATE-CITRIC ACID 25 MEQ EFFERVESCENT TABLET,0.82,0.53,0.14,0.82,22
NDC,5022234602,ADBRY 150 MG/ML SUBCUTANEOUS SYRINGE,3662.43,2380.58,615.29,3662.43,26
NDC,5022814601,HYDROCHLOROTHIAZIDE 12.5 MG CAPSULE,0.86,0.56,0.14,0.86,22
NDC,5022845701,CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,1.54,1.0,0.26,1.54,22
NDC,5022846501,NABUMETONE 500 MG TABLET,2.48,1.61,0.42,2.48,22
NDC,5022846601,NABUMETONE 750 MG TABLET,2.92,1.9,0.49,2.92,22
NDC,5022848201,DILTIAZEM 60 MG TABLET,3.14,2.04,0.53,3.14,22
NDC,5022848301,DILTIAZEM 90 MG TABLET,4.28,2.78,0.72,4.28,22
NDC,5022848401,DILTIAZEM 120 MG TABLET,5.76,3.74,0.97,5.76,22
NDC,5024201403,TNKASE 25 MG INTRAVENOUS SOLUTION,30766.26,19998.07,137.8,30766.26,53
NDC,5024204062,XOLAIR 150 MG SUBCUTANEOUS SOLUTION,7069.24,4595.01,33.13,7069.24,53
NDC,5024204164,CATHFLO ACTIVASE 2 MG INTRA-CATHETER SOLUTION,666.6,433.29,61.99,666.6,47
NDC,5024204413,ACTIVASE 50 MG INTRAVENOUS SOLUTION,15840.66,10296.43,61.99,15840.66,53
NDC,5024205121,RITUXAN 10 MG/ML CONCENTRATEINTRAVENOUS,450.96,293.12,70.98,3236.72,46
NDC,5024205306,RITUXAN 10 MG/ML CONCENTRATEINTRAVENOUS,450.96,293.12,70.98,3236.72,46
NDC,5024206001,AVASTIN 25 MG/ML INTRAVENOUS SOLUTION,956.32,621.61,66.74,1355.53,46
NDC,5024206101,AVASTIN 25 MG/ML INTRAVENOUS SOLUTION,956.32,621.61,66.74,1355.53,46
NDC,5024207001,GAZYVA 1000 MG/40 ML INTRAVENOUS SOLUTION,1080.04,702.03,63.19,3407.66,46
NDC,5024207501,NUTROPIN AQ NUSPIN 5 MG/2 ML (2.5 MG/ML) SUBCUTANEOUS PEN INJECTOR,1131.6,735.54,48.92,1131.6,30
NDC,5024207701,HERCEPTIN HYLECTA 600 MG-10000 UNIT/5 ML SUBCUTANEOUS SOLUTION,4488.24,2917.36,59.34,4488.24,49
NDC,5024207812,SUSVIMO 10 MG/0.1 ML INTRAVITREAL SOLUTION,288000.0,187200.0,72.34,288000.0,53
NDC,5024207855,SUSVIMO (INITIAL FILL) 10 MG/0.1 ML INTRAVITREAL IMPLANT SOLUTION,288000.0,187200.0,72.34,288000.0,53
NDC,5024207908,ITOVEBI 9 MG TABLET,1960.02,1274.01,329.28,1960.02,22
NDC,5024208001,DARVOCET-N 50 50 MG-325 MG TAB,140400.0,91260.0,65.44,140400.0,53
NDC,5024208003,LUCENTIS 0.5 MG/0.05 ML INTRAVITREAL SYRINGE,140400.0,91260.0,65.44,140400.0,53
NDC,5024208203,LUCENTIS 0.3 MG/0.05 ML INTRAVITREAL SYRINGE,84240.0,54756.0,65.44,84240.0,53
NDC,5024208408,ITOVEBI 3 MG TABLET,980.02,637.01,164.64,980.02,22
NDC,5024208527,ACTIVASE 100 MG INTRAVENOUS SOLUTION,31681.29,20592.84,61.99,31681.29,53
NDC,5024208701,KADCYLA 160 MG INTRAVENOUS SOLUTION,30640.32,19916.21,34.59,30640.32,52
NDC,5024208801,KADCYLA 100 MG INTRAVENOUS SOLUTION,19150.24,12447.66,34.59,19150.24,52
NDC,5024209002,ZELBORAF 240 MG TABLET,126.32,82.11,21.22,126.32,22
NDC,5024209130,ROZLYTREK 100 MG CAPSULE,561.2,364.78,94.28,561.2,22
NDC,5024209490,ROZLYTREK 200 MG CAPSULE,561.2,364.78,94.28,561.2,22
NDC,5024209601,VABYSMO 6 MG/0.05 ML INTRAVITREAL SOLUTION,168976.08,109834.45,31.9,168976.08,53
NDC,5024209606,VABYSMO 6 MG/0.05 ML INTRAVITREAL SYRINGE,168976.08,109834.45,31.9,168976.08,53
NDC,5024210039,PULMOZYME 1 MG/ML SOLUTION FOR INHALATION,128.42,83.47,21.57,128.42,22
NDC,5024210040,PULMOZYME 1 MG/ML SOLUTION FOR INHALATION,128.42,83.47,21.57,128.42,22
NDC,5024210301,POLIVY 30 MG INTRAVENOUS SOLUTION,19143.2,12443.08,111.63,19143.2,52
NDC,5024210501,POLIVY 140 MG INTRAVENOUS SOLUTION,89334.76,58067.59,111.63,89334.76,52
NDC,5024210801,RITUXAN HYCELA 1400 MG/11.7 ML (120 MG/ML) SUBCUTANEOUS SOLUTION,2698.08,1753.75,33.52,3236.72,49
NDC,5024210901,RITUXAN HYCELA 1600 MG/13.4 ML (120 MG/ML) SUBCUTANEOUS SOLUTION,2019.24,1312.51,33.52,3236.72,46
NDC,5024212047,TNKASE 50 MG INTRAVENOUS SOLUTION,29870.13,19415.58,137.8,29870.13,53
NDC,5024212501,COLUMVI 1 MG/ML INTRAVENOUS SOLUTION,5203.8,3382.47,1561.14,7869.33,52
NDC,5024212701,COLUMVI 1 MG/ML INTRAVENOUS SOLUTION,5203.84,3382.5,1561.15,7869.33,52
NDC,5024213001,ALECENSA 150 MG CAPSULE,194.66,126.53,32.7,194.66,22
NDC,5024213201,HERCEPTIN 150 MG INTRAVENOUS SOLUTION,7480.4,4862.26,72.04,7480.4,52
NDC,5024213501,ACTEMRA 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,637.4,414.31,5.44,652.67,47
NDC,5024213601,ACTEMRA 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,637.4,414.31,5.44,652.67,47
NDC,5024213701,ACTEMRA 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,637.4,414.31,5.44,652.67,47
NDC,5024213801,ACTEMRA 162 MG/0.9 ML SUBCUTANEOUS SYRINGE,6265.64,4072.67,5.44,6265.64,53
NDC,5024214001,ERIVEDGE 150 MG CAPSULE,1180.24,767.16,198.28,1180.24,22
NDC,5024214201,LUNSUMIO 1 MG/ML INTRAVENOUS SOLUTION,2996.44,1947.69,566.23,18253.82,49
NDC,5024214501,PERJETA 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION,2338.44,1519.99,13.88,3236.72,46
NDC,5024215001,OCREVUS 30 MG/ML INTRAVENOUS SOLUTION,7430.76,4829.99,52.88,18253.82,53
NDC,5024215901,LUNSUMIO 1 MG/ML INTRAVENOUS SOLUTION,2996.4,1947.66,566.23,18253.82,49
NDC,5024217601,TNKASE 50 MG INTRAVENOUS SOLUTION,29870.13,19415.58,137.8,29870.13,53
NDC,5024221401,XOLAIR 75 MG/0.5 ML SUBCUTANEOUS SYRINGE,5301.93,3446.25,33.13,5301.93,53
NDC,5024221403,XOLAIR 75 MG/0.5 ML SUBCUTANEOUS SYRINGE,5301.93,3446.25,33.13,5301.93,53
NDC,5024221455,XOLAIR 75 MG/0.5 ML SUBCUTANEOUS AUTO-INJECTOR,5301.93,3446.25,33.13,5301.93,53
NDC,5024221501,XOLAIR 150 MG/ML SUBCUTANEOUS SYRINGE,5301.93,3446.25,33.13,5301.93,53
NDC,5024221503,XOLAIR 150 MG/ML SUBCUTANEOUS SYRINGE,5301.93,3446.25,33.13,5301.93,53
NDC,5024221555,XOLAIR 150 MG/ML SUBCUTANEOUS AUTO-INJECTOR,5301.93,3446.25,33.13,5301.93,53
NDC,5024222701,XOLAIR 300 MG/2 ML SUBCUTANEOUS SYRINGE,5301.96,3446.27,33.13,5301.96,53
NDC,5024222755,XOLAIR 300 MG/2 ML SUBCUTANEOUS AUTO-INJECTOR,5301.96,3446.27,33.13,5301.96,53
NDC,5024224501,PHESGO 1200 MG-600 MG-30000 UNIT/15 ML SUBCUTANEOUS SOLUTION,4453.28,2894.63,58.79,4453.28,49
NDC,5024226001,PHESGO 600 MG-600 MG-20000 UNIT/10 ML SUBCUTANEOUS SOLUTION,4453.12,2894.53,58.79,4453.12,49
NDC,5024255401,OCREVUS ZUNOVO 920 MG-23000 UNIT/23 ML SUBCUTANEOUS SOLUTION,6461.52,4199.99,47.04,18253.82,45
NDC,5024271701,COTELLIC 20 MG TABLET,310.64,201.92,52.19,310.64,22
NDC,5024291701,TECENTRIQ 1200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION,2781.44,1807.94,75.54,5646.0,49
NDC,5024291801,TECENTRIQ 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION,2781.44,1807.94,75.54,5646.0,49
NDC,5024292001,HEMLIBRA 30 MG/ML SUBCUTANEOUS SOLUTION,13057.68,8487.49,45.76,18253.82,53
NDC,5024292101,HEMLIBRA 60 MG/0.4 ML SUBCUTANEOUS SOLUTION,65288.34,42437.42,45.76,65288.34,53
NDC,5024292301,HEMLIBRA 150 MG/ML SUBCUTANEOUS SOLUTION,65288.37,42437.44,45.76,65288.37,53
NDC,5026803715,AMITRIPTYLINE 10 MG TABLET,1.0,0.65,0.17,1.0,22
NDC,5026803815,AMITRIPTYLINE 25 MG TABLET,1.0,0.65,0.17,1.0,22
NDC,5026803915,AMITRIPTYLINE 50 MG TABLET,1.3,0.85,0.22,1.3,22
NDC,5026804315,ARTIFICIAL TEARS(DEXTRAN-HYPROMEL-GLYCERN) 0.1 %-0.3 %-0.2 % EYE DROPS,1.06,0.69,0.18,1.06,22
NDC,5026805011,ACEBUTOLOL 200 MG CAPSULE,3.56,2.31,0.6,3.56,22
NDC,5026805015,ACEBUTOLOL 200 MG CAPSULE,3.56,2.31,0.6,3.56,22
NDC,5026805415,ACETAZOLAMIDE 250 MG TABLET,8.38,5.45,1.41,8.38,22
NDC,5026806115,ACYCLOVIR 400 MG TABLET,7.5,4.88,1.26,7.5,22
NDC,5026806915,AMANTADINE HCL 100 MG CAPSULE,6.96,4.52,1.17,6.96,22
NDC,5026808612,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,20.65,13.42,3.47,20.65,22
NDC,5026808712,ARIPIPRAZOLE 2 MG TABLET,61.18,39.77,10.28,61.18,22
NDC,5026808815,ARIPIPRAZOLE 5 MG TABLET,59.86,38.91,10.06,59.86,22
NDC,5026808915,ARIPIPRAZOLE 10 MG TABLET,59.86,38.91,10.06,59.86,22
NDC,5026809012,ARIPIPRAZOLE 15 MG TABLET,61.22,39.79,10.28,61.22,22
NDC,5026810213,BALSALAZIDE 750 MG CAPSULE,5.28,3.43,0.89,5.28,22
NDC,5026810515,BACLOFEN 5 MG TABLET,5.44,3.54,0.91,5.44,22
NDC,5026812815,BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET,5.74,3.73,0.96,5.74,22
NDC,5026813015,BUMETANIDE 0.5 MG TABLET,3.04,1.98,0.51,3.04,22
NDC,5026813111,BUMETANIDE 1 MG TABLET,3.0,1.95,0.5,3.0,22
NDC,5026813115,BUMETANIDE 1 MG TABLET,3.0,1.95,0.5,3.0,22
NDC,5026813515,BUSPIRONE 15 MG TABLET,1.38,0.9,0.23,1.38,22
NDC,5026814415,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,9.5,6.18,1.6,10.3,22
NDC,5026814515,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,16.92,11.0,2.84,20.41,22
NDC,5026814911,CALCIUM 500 MG (AS CALCIUM CARBONATE 1250 MG) CHEWABLE TABLET,0.54,0.35,0.09,0.54,22
NDC,5026815115,CEPHALEXIN 250 MG CAPSULE,1.36,0.88,0.23,1.36,22
NDC,5026816815,CELECOXIB 100 MG CAPSULE,8.74,5.68,1.47,8.74,22
NDC,5026817415,CLONAZEPAM 1 MG TABLET,1.42,0.92,0.24,1.42,22
NDC,5026817815,CLARITHROMYCIN 250 MG TABLET,11.68,7.59,1.96,11.68,22
NDC,5026818412,CLOPIDOGREL 300 MG TABLET,38.54,25.05,6.47,38.54,22
NDC,5026818715,COLCHICINE 0.6 MG TABLET,14.4,9.36,2.42,14.4,22
NDC,5026819015,CYCLOBENZAPRINE 5 MG TABLET,2.46,1.6,0.41,2.46,22
NDC,5026819115,CYCLOBENZAPRINE 10 MG TABLET,0.42,0.27,0.07,0.42,22
NDC,5026825915,DIVALPROEX ER 250 MG TABLETEXTENDED RELEASE 24 HR,1.24,0.81,0.21,1.24,22
NDC,5026826013,DIVALPROEX ER 500 MG TABLETEXTENDED RELEASE 24 HR,3.3,2.15,0.55,3.3,22
NDC,5026827715,DOXYCYCLINE HYCLATE 50 MG CAPSULE,5.56,3.61,0.93,5.56,22
NDC,5026827811,DOXYCYCLINE HYCLATE 100 MG CAPSULE,8.0,5.2,1.34,8.0,22
NDC,5026827815,DOXYCYCLINE HYCLATE 100 MG CAPSULE,8.0,5.2,1.34,8.0,22
NDC,5026829715,ERGOCALCIFEROL (VITAMIN D2) 1250 MCG (50000 UNIT) CAPSULE,3.84,2.5,0.65,3.84,22
NDC,5026829812,EZETIMIBE 10 MG TABLET,24.78,16.11,4.16,24.78,22
NDC,5026829915,FAMOTIDINE 20 MG TABLET,0.34,0.22,0.06,0.34,22
NDC,5026830415,FAMOTIDINE 40 MG TABLET,6.54,4.25,1.1,6.54,22
NDC,5026831211,FENOFIBRATE 54 MG TABLET,3.4,2.21,0.57,3.4,22
NDC,5026831215,FENOFIBRATE 54 MG TABLET,3.4,2.21,0.57,3.4,22
NDC,5026831311,FENOFIBRATE 160 MG TABLET,10.26,6.67,1.72,10.26,22
NDC,5026831315,FENOFIBRATE 160 MG TABLET,10.26,6.67,1.72,10.26,22
NDC,5026831415,FINASTERIDE 5 MG TABLET,6.26,4.07,1.05,6.26,22
NDC,5026833015,FLUDROCORTISONE 0.1 MG TABLET,3.2,2.08,0.54,3.2,22
NDC,5026833715,FLUCONAZOLE 100 MG TABLET,19.06,12.39,3.2,19.06,22
NDC,5026833915,FLUCONAZOLE 200 MG TABLET,32.62,21.2,5.48,32.62,22
NDC,5026834615,FOLIC ACID 400 MCG TABLET,0.56,0.36,0.09,0.56,22
NDC,5026837515,GLUCOSAMINE SULFATE 500 MG CAPSULE,0.92,0.6,0.15,0.92,22
NDC,5026839850,HYDROXYZINE PAMOATE 25 MG CAPSULE,1.14,0.74,0.19,1.14,22
NDC,5026843015,INDOMETHACIN 25 MG CAPSULE,0.86,0.56,0.14,0.86,22
NDC,5026843115,INDOMETHACIN 50 MG CAPSULE,1.32,0.86,0.22,1.32,22
NDC,5026844215,IRBESARTAN 300 MG TABLET,7.4,4.81,1.24,7.4,22
NDC,5026844715,ISOSORBIDE DINITRATE 5 MG TABLET,2.12,1.38,0.36,2.12,22
NDC,5026845012,ITRACONAZOLE 100 MG CAPSULE,11.32,7.36,1.9,11.32,22
NDC,5026847615,LETROZOLE 2.5 MG TABLET,36.1,23.47,6.06,36.1,22
NDC,5026848215,LOPERAMIDE 2 MG CAPSULE,1.98,1.29,0.33,1.98,22
NDC,5026850615,LOSARTAN 100 MG TABLET,1.54,1.0,0.26,1.54,22
NDC,5026852215,MECLIZINE 12.5 MG TABLET,1.4,0.91,0.24,1.4,22
NDC,5026852415,MELATONIN 3 MG TABLET,0.78,0.51,0.13,0.78,22
NDC,5026852511,MELOXICAM 7.5 MG TABLET,6.2,4.03,1.04,6.2,22
NDC,5026852515,MELOXICAM 7.5 MG TABLET,6.2,4.03,1.04,6.2,22
NDC,5026854915,METHENAMINE HIPPURATE 1 GRAM TABLET,6.84,4.45,1.15,6.84,22
NDC,5026855015,METFORMIN ER 500 MG TABLETEXTENDED RELEASE 24 HR,1.24,0.81,0.21,1.24,22
NDC,5026855115,METFORMIN ER 750 MG TABLETEXTENDED RELEASE 24 HR,2.42,1.57,0.41,2.42,22
NDC,5026855311,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,3.9,2.54,0.66,3.9,22
NDC,5026855313,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,3.9,2.54,0.66,3.9,22
NDC,5026855615,MONTELUKAST 10 MG TABLET,0.8,0.52,0.13,0.8,22
NDC,5026856815,MUPIROCIN 2 % TOPICAL OINTMENT,10.26,6.67,1.72,10.26,22
NDC,5026857411,MONTELUKAST 5 MG CHEWABLE TABLET,8.22,5.34,1.38,8.22,22
NDC,5026857415,MONTELUKAST 5 MG CHEWABLE TABLET,8.22,5.34,1.38,8.22,22
NDC,5026858215,NIACIN 100 MG TABLET,0.9,0.59,0.15,0.9,22
NDC,5026858413,NIACIN ER 500 MG TABLETEXTENDED RELEASE 24 HR,11.48,7.46,1.93,11.48,22
NDC,5026858515,PANTOPRAZOLE 20 MG TABLETDELAYED RELEASE,7.98,5.19,1.34,7.98,22
NDC,5026858713,MEMANTINE 5 MG TABLET,1.6,1.04,0.27,1.6,22
NDC,5026859411,NAPROXEN 250 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,5026859415,NAPROXEN 250 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,5026859515,NAPROXEN 375 MG TABLET,1.98,1.29,0.33,1.98,22
NDC,5026859715,NIFEDIPINE ER 30 MG TABLETEXTENDED RELEASE 24 HR,2.62,1.7,0.44,2.62,22
NDC,5026859915,NIFEDIPINE ER 90 MG TABLETEXTENDED RELEASE 24 HR,4.98,3.24,0.84,4.98,22
NDC,5026861513,OLANZAPINE 5 MG DISINTEGRATING TABLET,27.94,18.16,4.69,27.94,22
NDC,5026862115,ONDANSETRON HCL 4 MG TABLET,1.48,0.96,0.25,1.48,22
NDC,5026862315,NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,8.84,5.75,1.49,8.84,22
NDC,5026862415,NITROFURANTOIN MACROCRYSTAL 100 MG CAPSULE,6.9,4.49,1.16,6.9,22
NDC,5026863915,PANTOPRAZOLE 40 MG TABLETDELAYED RELEASE,8.06,5.24,1.35,8.06,22
NDC,5026864515,OXYCODONE-ACETAMINOPHEN 7.5 MG-325 MG TABLET,5.42,3.52,0.91,5.42,22
NDC,5026865212,PILOCARPINE 5 MG TABLET,6.76,4.39,1.14,6.76,22
NDC,5026867113,POTASSIUM CHLORIDE ER 10 MEQ CAPSULEEXTENDED RELEASE,8.0,5.2,1.34,8.0,22
NDC,5026868415,PROCHLORPERAZINE MALEATE 5 MG TABLET,3.22,2.09,0.54,3.22,22
NDC,5026868515,PROCHLORPERAZINE MALEATE 10 MG TABLET,3.54,2.3,0.59,3.54,22
NDC,5026871015,ROSUVASTATIN 20 MG TABLET,2.96,1.92,0.5,2.96,22
NDC,5026871115,ROSUVASTATIN 40 MG TABLET,3.18,2.07,0.53,3.18,22
NDC,5026872215,RANOLAZINE ER 500 MG TABLETEXTENDED RELEASE12 HR,3.78,2.46,0.64,3.78,22
NDC,5026872815,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,1.32,0.86,0.22,1.32,22
NDC,5026874015,TAMSULOSIN 0.4 MG CAPSULE,0.96,0.62,0.16,0.96,22
NDC,5026874215,ROPINIROLE 0.5 MG TABLET,1.28,0.83,0.22,1.28,22
NDC,5026874415,ROPINIROLE 2 MG TABLET,1.44,0.94,0.24,1.44,22
NDC,5026874514,SUCRALFATE 100 MG/ML ORAL SUSPENSION,2.15,1.4,0.36,2.15,22
NDC,5026875415,TORSEMIDE 5 MG TABLET,1.26,0.82,0.21,1.26,22
NDC,5026875515,TORSEMIDE 10 MG TABLET,1.42,0.92,0.24,1.42,22
NDC,5026875715,TORSEMIDE 100 MG TABLET,5.78,3.76,0.97,5.78,22
NDC,5026875812,TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,11.32,7.36,1.9,11.32,22
NDC,5026876212,TEMOZOLOMIDE 100 MG CAPSULE,152.84,99.35,0.17,152.84,30
NDC,5026878712,VALGANCICLOVIR 450 MG TABLET,298.86,194.26,50.21,298.86,22
NDC,5026878815,VALACYCLOVIR 500 MG TABLET,11.94,7.76,2.01,11.94,22
NDC,5026880312,VORICONAZOLE 200 MG TABLET,47.4,30.81,7.96,47.4,22
NDC,5026885115,VITAMIN B-1 (MONONITRATE) 100 MG TABLET,0.62,0.4,0.1,0.62,22
NDC,5026885215,VITAMIN B-12  100 MCG TABLET,0.62,0.4,0.1,0.62,22
NDC,5026885415,VITAMIN B-12 500 MCG TABLET,0.64,0.42,0.11,0.64,22
NDC,5026885511,VITAMIN B-12  1000 MCG TABLET,0.72,0.47,0.12,0.72,22
NDC,5026885515,VITAMIN B-12  1000 MCG TABLET,0.72,0.47,0.12,0.72,22
NDC,5026885811,VITAMIN B-6 50 MG TABLET,0.56,0.36,0.09,0.56,22
NDC,5026885815,VITAMIN B-6 50 MG TABLET,0.56,0.36,0.09,0.56,22
NDC,5026885915,VITAMIN B-6 100 MG TABLET,0.58,0.38,0.1,0.58,22
NDC,5026886011,VITAMIN C 250 MG TABLET,0.56,0.36,0.09,0.56,22
NDC,5026886015,VITAMIN C 250 MG TABLET,0.56,0.36,0.09,0.56,22
NDC,5026886315,CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) TABLET,0.56,0.36,0.09,0.56,22
NDC,5026886611,CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5000 UNIT) TABLET,0.66,0.43,0.11,0.66,22
NDC,5026886615,CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5000 UNIT) TABLET,0.66,0.43,0.11,0.66,22
NDC,5026886815,CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5000 UNIT) CAPSULE,0.76,0.49,0.13,0.76,22
NDC,5028932501,A.E.R. WITCH HAZEL 12.5 %-50 % TOPICAL PADS,0.18,0.12,0.03,0.18,22
NDC,5038308710,GUAIATUSSIN AC 10 MG-100 MG/5 ML ORAL LIQUID,0.2,0.13,0.03,0.2,22
NDC,5038308712,GUAIATUSSIN AC 10 MG-100 MG/5 ML ORAL LIQUID,0.16,0.1,0.03,0.16,22
NDC,5041917103,STIVARGA 40 MG TABLET,681.24,442.81,114.45,681.24,22
NDC,5041925001,ADEMPAS 0.5 MG TABLET,376.28,244.58,63.22,376.28,22
NDC,5041925101,ADEMPAS 1 MG TABLET,376.28,244.58,63.22,376.28,22
NDC,5041925201,ADEMPAS 1.5 MG TABLET,376.28,244.58,63.22,376.28,22
NDC,5041925301,ADEMPAS 2 MG TABLET,376.28,244.58,63.22,376.28,22
NDC,5041925401,ADEMPAS 2.5 MG TABLET,376.28,244.58,63.22,376.28,22
NDC,5041925491,ADEMPAS 2.5 MG TABLET,376.28,244.58,63.22,376.28,22
NDC,5041932005,EOVIST 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,51.12,33.23,8.59,51.12,21
NDC,5041934405,ULTRAVIST 300 MG IODINE/ML INJECTION SOLUTION,1.5,0.98,0.12,1.5,21
NDC,5041939001,VITRAKVI 25 MG CAPSULE,540.58,351.38,90.82,540.58,22
NDC,5041939101,VITRAKVI 100 MG CAPSULE,1621.78,1054.16,272.46,1621.78,22
NDC,5041939201,VITRAKVI 20 MG/ML ORAL SOLUTION,540.58,351.38,90.82,540.58,22
NDC,5041942201,SKYLA 14 MCG/24 HR (UP TO 3 YEARS) 13.5 MG INTRAUTERINE DEVICE,2427.32,1577.76,273.36,2771.18,29
NDC,5041942301,MIRENA 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,2915.12,1894.83,273.36,3328.09,32
NDC,5041942401,KYLEENA 17.5 MCG/24 HR (UP TO 5 YEARS) 19.5 MG INTRAUTERINE DEVICE,2915.12,1894.83,273.36,3328.09,32
NDC,5041945104,CLIMARA 0.05 MG/24 HR TRANSDERMAL PATCH,45.78,29.76,7.69,45.78,22
NDC,5041945204,CLIMARA 0.1 MG/24 HR TRANSDERMAL PATCH,45.78,29.76,7.69,45.78,22
NDC,5041945404,CLIMARA 0.025 MG/24 HR TRANSDERMAL PATCH,45.78,29.76,7.69,45.78,22
NDC,5041945604,CLIMARA 0.0375 MG/24 HR TRANSDERMAL PATCH,45.78,29.76,7.69,45.78,22
NDC,5041952435,BETASERON 0.3 MG SUBCUTANEOUS KIT,2558.01,1662.71,61.99,2558.01,29
NDC,5041954001,KERENDIA 10 MG TABLET,54.94,35.71,9.23,54.94,22
NDC,5041954101,KERENDIA 20 MG TABLET,54.94,35.71,9.23,54.94,22
NDC,5041954106,KERENDIA 20 MG TABLET,57.24,37.21,9.62,57.24,22
NDC,5041954201,KERENDIA 40 MG TABLET,54.94,35.71,9.23,54.94,22
NDC,5041954206,KERENDIA 40 MG TABLET,54.94,35.71,9.23,54.94,22
NDC,5041974701,BILTRICIDE 600 MG TABLET,199.3,129.55,33.48,199.3,22
NDC,5041975101,LAMPIT 120 MG TABLET,7.2,4.68,1.21,7.2,22
NDC,5041977301,CIPRO 500 MG/5 ML ORAL SUSPENSION,4.58,2.98,0.77,4.58,22
NDC,5041977701,CIPRO 250 MG/5 ML ORAL SUSPENSION,3.93,2.55,0.66,3.93,22
NDC,5041986251,PRECOSE 100 MG TABLET,2.9,1.89,0.49,2.9,22
NDC,5045802800,SPRAVATO 28 MG NASAL SPRAY,1001.04,650.68,74.0,1001.04,29
NDC,5045802802,SPRAVATO 56 MG (28 MG X 2) NASAL SPRAY,1001.04,650.68,74.0,1001.04,29
NDC,5045802803,SPRAVATO 84 MG (28 MG X 3) NASAL SPRAY,1001.04,650.68,74.0,1001.04,29
NDC,5045809801,ELMIRON 100 MG CAPSULE,28.74,18.68,4.83,28.74,22
NDC,5045814030,INVOKANA 100 MG TABLET,47.88,31.12,8.04,47.88,22
NDC,5045814130,INVOKANA 300 MG TABLET,47.88,31.12,8.04,47.88,22
NDC,5045829001,SPORANOX 100 MG CAPSULE,68.9,44.79,11.58,68.9,22
NDC,5045829004,SPORANOX 100 MG CAPSULE,68.9,44.79,11.58,68.9,22
NDC,5045830001,RISPERDAL 1 MG TABLET,11.76,7.64,1.98,11.76,22
NDC,5045830206,RISPERDAL 0.5 MG TABLET,11.06,7.19,1.86,11.06,22
NDC,5045830503,RISPERDAL 1 MG/ML ORAL SOLUTION,16.43,10.68,2.76,16.43,22
NDC,5045830611,RISPERDAL CONSTA 25 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,2323.05,1509.98,10.96,2323.05,47
NDC,5045830711,RISPERDAL CONSTA 37.5 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,3484.68,2265.04,10.96,3484.68,50
NDC,5045830811,RISPERDAL CONSTA 50 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,4646.4,3020.16,10.96,4646.4,50
NDC,5045830901,RISPERDAL CONSTA 12.5 MG/2 ML INTRAMUSCULAR SUSPEXTENDED RELEASE,1161.66,755.08,10.96,1161.66,47
NDC,5045832001,RISPERDAL 2 MG TABLET,19.66,12.78,3.3,19.66,22
NDC,5045832006,RISPERDAL 2 MG TABLET,19.66,12.78,3.3,19.66,22
NDC,5045835001,RISPERDAL 4 MG TABLET,31.0,20.15,5.21,31.0,22
NDC,5045855001,INVEGA 3 MG TABLETEXTENDED RELEASE,30.02,19.51,5.04,30.02,22
NDC,5045855101,INVEGA 6 MG TABLETEXTENDED RELEASE,30.02,19.51,5.04,30.02,22
NDC,5045855201,INVEGA 9 MG TABLETEXTENDED RELEASE,45.02,29.26,7.56,45.02,22
NDC,5045856001,INVEGA SUSTENNA 39 MG/0.25 ML INTRAMUSCULAR SYRINGE,8565.27,5567.43,12.85,8565.27,53
NDC,5045856101,INVEGA SUSTENNA 78 MG/0.5 ML INTRAMUSCULAR SYRINGE,8565.69,5567.7,12.85,8565.69,53
NDC,5045856201,INVEGA SUSTENNA 117 MG/0.75 ML INTRAMUSCULAR SYRINGE,8565.84,5567.8,12.85,8565.84,53
NDC,5045856301,INVEGA SUSTENNA 156 MG/ML INTRAMUSCULAR SYRINGE,8566.17,5568.01,12.85,8566.17,53
NDC,5045856401,INVEGA SUSTENNA 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,8565.96,5567.87,12.85,8565.96,53
NDC,5045857701,XARELTO 2.5 MG TABLET,23.92,15.55,4.02,23.92,22
NDC,5045857710,XARELTO 2.5 MG TABLET,23.92,15.55,4.02,23.92,22
NDC,5045857760,XARELTO 2.5 MG TABLET,23.92,15.55,4.02,23.92,22
NDC,5045857801,XARELTO 15 MG TABLET,47.84,31.1,8.04,47.84,22
NDC,5045857810,XARELTO 15 MG TABLET,47.84,31.1,8.04,47.84,22
NDC,5045857830,XARELTO 15 MG TABLET,47.84,31.1,8.04,47.84,22
NDC,5045857890,XARELTO 15 MG TABLET,47.84,31.1,8.04,47.84,22
NDC,5045857901,XARELTO 20 MG TABLET,47.84,31.1,8.04,47.84,22
NDC,5045857910,XARELTO 20 MG TABLET,47.84,31.1,8.04,47.84,22
NDC,5045857930,XARELTO 20 MG TABLET,47.84,31.1,8.04,47.84,22
NDC,5045858001,XARELTO 10 MG TABLET,47.84,31.1,8.04,47.84,22
NDC,5045858010,XARELTO 10 MG TABLET,47.84,31.1,8.04,47.84,22
NDC,5045858030,XARELTO 10 MG TABLET,47.84,31.1,8.04,47.84,22
NDC,5045858601,CONCERTA 36 MG TABLETEXTENDED RELEASE,32.74,21.28,5.5,32.74,22
NDC,5045858701,CONCERTA 54 MG TABLETEXTENDED RELEASE,35.62,23.15,5.98,35.62,22
NDC,5045860701,INVEGA TRINZA 410 MG/1.32 ML INTRAMUSCULAR SYRINGE,14600.88,9490.57,10.97,14600.88,53
NDC,5045860801,INVEGA TRINZA 546 MG/1.75 ML INTRAMUSCULAR SYRINGE,14684.85,9545.15,10.97,14684.85,53
NDC,5045860901,INVEGA TRINZA 819 MG/2.63 ML INTRAMUSCULAR SYRINGE,14656.59,9526.78,10.97,14656.59,53
NDC,5045861101,INVEGA HAFYERA 1092 MG/3.5 ML INTRAMUSCULAR SYRINGE,14684.85,9545.15,10.97,14684.85,53
NDC,5045861201,INVEGA HAFYERA 1560 MG/5 ML INTRAMUSCULAR SYRINGE,15418.74,10022.18,10.97,15418.74,53
NDC,5045863965,TOPAMAX 25 MG TABLET,16.04,10.43,2.69,16.04,22
NDC,5045864065,TOPAMAX 50 MG TABLET,32.02,20.81,5.38,32.02,22
NDC,5045864165,TOPAMAX 100 MG TABLET,43.72,28.42,7.34,43.72,22
NDC,5045864265,TOPAMAX 200 MG TABLET,51.18,33.27,8.6,51.18,22
NDC,5045864565,TOPAMAX 25 MG SPRINKLE CAPSULE,18.34,11.92,3.08,18.34,22
NDC,5045864765,TOPAMAX 15 MG SPRINKLE CAPSULE,15.18,9.87,2.55,15.18,22
NDC,5045883002,NUCYNTA 75 MG TABLET,21.54,14.0,3.62,21.54,22
NDC,5045884002,NUCYNTA 100 MG TABLET,28.72,18.67,4.82,28.72,22
NDC,5047400148,KEPPRA 100 MG/ML ORAL SOLUTION,5.85,3.8,0.98,5.85,22
NDC,5047400263,KEPPRA 500 MG/5 ML INTRAVENOUS SOLUTION,49.11,31.92,0.06,49.11,31
NDC,5047437066,BRIVIACT 10 MG TABLET,58.92,38.3,9.9,58.92,22
NDC,5047447066,BRIVIACT 25 MG TABLET,58.92,38.3,9.9,58.92,22
NDC,5047457009,BRIVIACT 50 MG TABLET,58.92,38.3,9.9,58.92,22
NDC,5047457066,BRIVIACT 50 MG TABLET,58.92,38.3,9.9,58.92,22
NDC,5047459440,KEPPRA 250 MG TABLET,19.88,12.92,3.34,19.88,22
NDC,5047459540,KEPPRA 500 MG TABLET,24.28,15.78,4.08,24.28,22
NDC,5047459640,KEPPRA 750 MG TABLET,32.9,21.39,5.53,32.9,22
NDC,5047465165,HEALON GV PRO 18 MG/ML INTRAOCULAR SYRINGE,638.22,414.84,107.22,638.22,22
NDC,5047470062,CIMZIA POWDER FOR RECON 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,28797.28,18718.23,3.86,28797.28,53
NDC,5047471079,CIMZIA 400 MG/2 ML (200 MG/ML X 2) SUBCUTANEOUS SYRINGE KIT,21597.96,14038.67,3.86,21597.96,53
NDC,5047477009,BRIVIACT 100 MG TABLET,58.92,38.3,9.9,58.92,22
NDC,5047477066,BRIVIACT 100 MG TABLET,58.92,38.3,9.9,58.92,22
NDC,5047478184,BIMZELX AUTOINJECTOR 160 MG/ML SUBCUTANEOUS AUTO-INJECTOR,28522.41,18539.57,4791.76,28522.41,29
NDC,5047478284,BIMZELX AUTOINJECTOR 320 MG/2 ML SUBCUTANEOUS AUTO-INJECTOR,38029.84,24719.4,6389.01,38029.84,29
NDC,5047480103,NEUPRO 1 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,69.12,44.93,11.61,69.12,22
NDC,5047480203,NEUPRO 2 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,69.12,44.93,11.61,69.12,22
NDC,5047480303,NEUPRO 3 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,69.12,44.93,11.61,69.12,22
NDC,5047480403,NEUPRO 4 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,69.12,44.93,11.61,69.12,22
NDC,5047480503,NEUPRO 6 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,57.0,37.05,9.58,57.0,22
NDC,5047480603,NEUPRO 8 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,69.12,44.93,11.61,69.12,22
NDC,5047487015,BRIVIACT 10 MG/ML ORAL SOLUTION,8.84,5.75,1.49,8.84,22
NDC,5047497075,BRIVIACT 50 MG/5 ML INTRAVENOUS SOLUTION,45.45,29.54,7.64,45.45,23
NDC,5047498079,RYSTIGGO 140 MG/ML SUBCUTANEOUS SOLUTION,11163.96,7256.57,20.57,11163.96,53
NDC,5048401030,SANTYL 250 UNIT/GRAM TOPICAL OINTMENT,26.66,17.33,4.48,26.66,22
NDC,5058022651,BENADRYL ALLERGY 25 MG TABLET,0.5,0.33,0.08,0.5,22
NDC,5058045711,TYLENOL EXTRA STRENGTH 500 MG TABLET,0.14,0.09,0.02,0.14,22
NDC,5058053408,BENADRYL ALLERGY 12.5 MG/5 ML ORAL LIQUID,0.13,0.08,0.02,0.13,22
NDC,5058053501,BENADRYL ALLERGY 12.5 MG/5 ML ORAL LIQUID,0.15,0.1,0.03,0.15,22
NDC,5058053504,BENADRYL ALLERGY 12.5 MG/5 ML ORAL LIQUID,0.15,0.1,0.03,0.15,22
NDC,5058057902,CHILDREN'S TYLENOL 160 MG/5 ML ORAL SUSPENSION,0.13,0.08,0.02,0.13,22
NDC,5063201001,RABAVERT (PF) 2.5 UNIT IM SUSPENSION,1564.59,1016.98,79.26,1564.59,47
NDC,5063201301,RABAVERT (PF) 2.5 UNIT IM SUSPENSION,1564.59,1016.98,79.26,1564.59,47
NDC,5063201602,VIVOTIF 2 BILLION UNIT CAPSULEDELAYED RELEASE,70.38,45.75,11.82,70.38,29
NDC,5063311012,CROFAB 1 GRAM SOLUTION FOR INJECTION,11512.8,7483.32,1762.35,11512.8,53
NDC,5063312011,DIGIFAB 40 MG INTRAVENOUS SOLUTION,17906.4,11639.16,2697.73,17906.4,53
NDC,5063321011,VORAXAZE 1000 UNIT INTRAVENOUS SOLUTION,155638.8,101165.22,448.69,155638.8,38
NDC,5063331011,CYANOKIT 5 GRAM INTRAVENOUS SOLUTION,3772.8,2452.32,5.03,3772.8,42
NDC,5063332010,EDETATE CALCIUM DISODIUM 50 MG/ML INTRAVENOUS SOLUTION,126.0,81.9,32.63,17184.65,46
NDC,5074211201,DESIPRAMINE 10 MG TABLET,3.34,2.17,0.56,3.34,22
NDC,5074211301,DESIPRAMINE 25 MG TABLET,4.02,2.61,0.68,4.02,22
NDC,5074211401,DESIPRAMINE 50 MG TABLET,7.56,4.91,1.27,7.56,22
NDC,5074211808,CABERGOLINE 0.5 MG TABLET,73.32,47.66,3.53,73.32,22
NDC,5074214201,METHENAMINE HIPPURATE 1 GRAM TABLET,4.18,2.72,0.7,4.18,22
NDC,5074215230,MODAFINIL 100 MG TABLET,44.14,28.69,7.42,44.14,22
NDC,5074223830,QUININE 324 MG CAPSULE,14.66,9.53,2.46,14.66,22
NDC,5074223901,MEXILETINE 150 MG CAPSULE,5.08,3.3,0.85,5.08,22
NDC,5074224001,MEXILETINE 200 MG CAPSULE,6.06,3.94,1.02,6.06,22
NDC,5074224101,MEXILETINE 250 MG CAPSULE,7.0,4.55,1.18,7.0,22
NDC,5074226101,NIFEDIPINE ER 60 MG TABLETEXTENDED RELEASE 24 HR,4.58,2.98,0.77,4.58,22
NDC,5074226750,NORETHINDRONE ACETATE 5 MG TABLET,5.3,3.45,0.89,5.3,22
NDC,5074227901,DICLOFENAC POTASSIUM 50 MG TABLET,5.5,3.58,0.92,5.5,22
NDC,5074235001,METOLAZONE 5 MG TABLET,5.86,3.81,0.98,5.86,22
NDC,5074236360,IVABRADINE 7.5 MG TABLET,21.98,14.29,3.69,21.98,22
NDC,5074236530,BUPRENORPHINE 12 MG-NALOXONE 3 MG SUBLINGUAL FILM,36.86,23.96,6.19,40.83,23
NDC,5074237304,BUPRENORPHINE 7.5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,233.08,151.5,39.16,233.08,22
NDC,5074239730,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM,9.82,6.38,1.65,10.3,22
NDC,5074250510,SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,45.94,29.86,7.72,45.94,22
NDC,5074251501,NITRO-DUR 0.3 MG/HR TRANSDERMAL 24 HOUR PATCH,127.18,82.67,21.37,127.18,22
NDC,5074251530,NITRO-DUR 0.3 MG/HR TRANSDERMAL 24 HOUR PATCH,127.18,82.67,21.37,127.18,22
NDC,5074251830,NITRO-DUR 0.8 MG/HR TRANSDERMAL 24 HOUR PATCH,137.94,89.66,23.17,137.94,22
NDC,5074252005,CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,527.4,342.81,0.69,527.4,47
NDC,5074263860,QUETIAPINE ER 300 MG TABLETEXTENDED RELEASE 24 HR,45.96,29.87,7.72,45.96,22
NDC,5074266701,PHENOBARB-HYOSCYAMN-ATROPINE-SCOP 16.2 MG-0.1037 MG-0.0194 MG TABLET,18.66,12.13,3.13,18.66,22
NDC,5088100560,JAKAFI 5 MG TABLET,704.0,457.6,118.27,704.0,22
NDC,5088100603,ZYNYZ 500 MG/20 ML INTRAVENOUS SOLUTION,3538.32,2299.91,26.55,5646.0,49
NDC,5088101060,JAKAFI 10 MG TABLET,704.0,457.6,118.27,704.0,22
NDC,5088101303,MONJUVI 200 MG INTRAVENOUS SOLUTION,6700.16,4355.1,12.22,6700.16,52
NDC,5088101560,JAKAFI 15 MG TABLET,704.0,457.6,118.27,704.0,22
NDC,5088102060,JAKAFI 20 MG TABLET,704.0,457.6,118.27,704.0,22
NDC,5088102311,NIKTIMVO 50 MG/ML INTRAVENOUS SOLUTION,94500.0,61425.0,55.65,94500.0,45
NDC,5088102560,JAKAFI 25 MG TABLET,704.0,457.6,118.27,704.0,22
NDC,5088102601,PEMAZYRE 4.5 MG TABLET,3477.6,2260.44,584.24,3477.6,22
NDC,5088102701,PEMAZYRE 9 MG TABLET,3477.6,2260.44,584.24,3477.6,22
NDC,5088102801,PEMAZYRE 13.5 MG TABLET,3477.6,2260.44,584.24,3477.6,22
NDC,5088103412,NIKTIMVO 50 MG/ML INTRAVENOUS SOLUTION,94500.0,61425.0,55.65,94500.0,45
NDC,5092407920,ACCU-CHEK SAFE-T-PRO PLUS 23 GAUGE,0.56,0.36,0.09,0.5,21
NDC,5107902320,METOLAZONE 2.5 MG TABLET,6.58,4.28,1.11,6.58,22
NDC,5107902420,METOLAZONE 5 MG TABLET,7.46,4.85,1.25,7.46,22
NDC,5107902820,TACROLIMUS 5 MG CAPSULE IMMEDIATE-RELEASE,44.6,28.99,0.24,44.6,31
NDC,5107905820,CHLORTHALIDONE 25 MG TABLET,4.6,2.99,0.77,4.6,22
NDC,5107908320,ISONIAZID 300 MG TABLET,2.58,1.68,0.43,2.58,22
NDC,5107908620,MIRTAZAPINE 15 MG TABLET,5.44,3.54,0.91,5.44,22
NDC,5107908720,MIRTAZAPINE 30 MG TABLET,5.6,3.64,0.94,5.6,22
NDC,5107908820,MIRTAZAPINE 45 MG TABLET,5.7,3.71,0.96,5.7,22
NDC,5107910320,SPIRONOLACTONE 25 MG TABLET,0.86,0.56,0.14,0.86,22
NDC,5107910903,BUPROPION XL 300 MG 24 HR TAB,12.6,8.19,2.12,12.6,22
NDC,5107911820,DICYCLOMINE 10 MG CAPSULE,1.2,0.78,0.2,1.2,22
NDC,5107912108,LANSOPRAZOLE 30 MG CAPSULEDELAYED RELEASE,11.32,7.36,1.9,11.32,22
NDC,5107913020,CHLORPROMAZINE 50 MG TABLET,27.66,17.98,4.65,27.66,22
NDC,5107913320,AMITRIPTYLINE 50 MG TABLET,2.12,1.38,0.36,2.12,22
NDC,5107914120,CHLORDIAZEPOXIDE 25 MG CAPSULE,1.34,0.87,0.23,1.34,22
NDC,5107914720,AMITRIPTYLINE 75 MG TABLET,3.82,2.48,0.64,3.82,22
NDC,5107916403,VORICONAZOLE 50 MG TABLET,18.76,12.19,3.15,18.76,22
NDC,5107916901,METOPROLOL SUCCINATE ER 25 MG TABLETEXTENDED RELEASE 24 HR,2.34,1.52,0.39,2.34,22
NDC,5107916920,METOPROLOL SUCCINATE ER 25 MG TABLETEXTENDED RELEASE 24 HR,2.34,1.52,0.39,2.34,22
NDC,5107917020,METOPROLOL SUCCINATE ER 50 MG TABLETEXTENDED RELEASE 24 HR,2.34,1.52,0.39,2.34,22
NDC,5107917101,METOPROLOL SUCCINATE ER 100 MG TABLETEXTENDED RELEASE 24 HR,3.52,2.29,0.59,3.52,22
NDC,5107917103,METOPROLOL SUCCINATE ER 100 MG TABLETEXTENDED RELEASE 24 HR,3.52,2.29,0.59,3.52,22
NDC,5107918220,CIPROFLOXACIN 500 MG TABLET,10.2,6.63,1.71,10.2,22
NDC,5107920001,METHYLDOPA 250 MG TABLET,0.74,0.48,0.12,0.74,22
NDC,5107920020,METHYLDOPA 250 MG TABLET,0.74,0.48,0.12,0.74,22
NDC,5107920120,METHYLDOPA 500 MG TABLET,1.34,0.87,0.23,1.34,22
NDC,5107920406,ABACAVIR 300 MG TABLET,20.08,13.05,3.37,20.08,22
NDC,5107920520,ALLOPURINOL 100 MG TABLET,0.76,0.49,0.13,0.76,22
NDC,5107920620,ALLOPURINOL 300 MG TABLET,1.52,0.99,0.26,1.52,22
NDC,5107920820,ATORVASTATIN 10 MG TABLET,0.74,0.48,0.12,0.74,22
NDC,5107920901,ATORVASTATIN 20 MG TABLET,1.06,0.69,0.18,1.06,22
NDC,5107920920,ATORVASTATIN 20 MG TABLET,1.06,0.69,0.18,1.06,22
NDC,5107921001,ATORVASTATIN 40 MG TABLET,1.06,0.69,0.18,1.06,22
NDC,5107921020,ATORVASTATIN 40 MG TABLET,1.06,0.69,0.18,1.06,22
NDC,5107921101,ATORVASTATIN 80 MG TABLET,3.84,2.5,0.65,3.84,22
NDC,5107921103,ATORVASTATIN 80 MG TABLET,3.84,2.5,0.65,3.84,22
NDC,5107924620,LORATADINE 10 MG TABLET,1.72,1.12,0.29,1.72,22
NDC,5107925501,METOPROLOL TARTRATE 25 MG TABLET,0.48,0.31,0.08,0.48,22
NDC,5107925520,METOPROLOL TARTRATE 25 MG TABLET,0.48,0.31,0.08,0.48,22
NDC,5107928401,DIAZEPAM 2 MG TABLET,0.48,0.31,0.08,0.48,22
NDC,5107928420,DIAZEPAM 2 MG TABLET,0.48,0.31,0.08,0.48,22
NDC,5107928501,DIAZEPAM 5 MG TABLET,0.64,0.42,0.11,0.64,22
NDC,5107928520,DIAZEPAM 5 MG TABLET,0.64,0.42,0.11,0.64,22
NDC,5107928620,DIAZEPAM 10 MG TABLET,0.86,0.56,0.14,0.86,22
NDC,5107930120,CLONIDINE HCL 0.3 MG TABLET,0.96,0.62,0.16,0.96,22
NDC,5107934820,NITROFURANTOIN MONOHYDRATE & MACROCRYSTAL 100 MG ORAL CAP,10.2,6.63,1.71,10.2,22
NDC,5107937401,CHLORDIAZEPOXIDE 5 MG CAPSULE,1.62,1.05,0.27,1.62,22
NDC,5107937420,CHLORDIAZEPOXIDE 5 MG CAPSULE,1.62,1.05,0.27,1.62,22
NDC,5107937520,CHLORDIAZEPOXIDE 10 MG CAPSULE,1.24,0.81,0.21,1.24,22
NDC,5107941721,LORAZEPAM 0.5 MG TABLET,1.4,0.91,0.24,1.4,22
NDC,5107941820,TEMAZEPAM 15 MG CAPSULE,1.42,0.92,0.24,1.42,22
NDC,5107941920,TEMAZEPAM 30 MG CAPSULE,1.66,1.08,0.28,1.66,22
NDC,5107943601,DOXEPIN 10 MG CAPSULE,1.28,0.83,0.22,1.28,22
NDC,5107943620,DOXEPIN 10 MG CAPSULE,1.28,0.83,0.22,1.28,22
NDC,5107943701,DOXEPIN 25 MG CAPSULE,1.68,1.09,0.28,1.68,22
NDC,5107943720,DOXEPIN 25 MG CAPSULE,1.68,1.09,0.28,1.68,22
NDC,5107943801,DOXEPIN 50 MG CAPSULE,2.34,1.52,0.39,2.34,22
NDC,5107943820,DOXEPIN 50 MG CAPSULE,2.34,1.52,0.39,2.34,22
NDC,5107944020,LEVOTHYROXINE 50 MCG TABLET,1.08,0.7,0.18,1.08,22
NDC,5107944120,LEVOTHYROXINE 75 MCG TABLET,1.2,0.78,0.2,1.2,22
NDC,5107944220,LEVOTHYROXINE 100 MCG TABLET,1.22,0.79,0.2,1.22,22
NDC,5107944320,LEVOTHYROXINE 125 MCG TABLET,1.44,0.94,0.24,1.44,22
NDC,5107944420,LEVOTHYROXINE 25 MCG TABLET,0.96,0.62,0.16,0.96,22
NDC,5107944520,LEVOTHYROXINE 150 MCG TABLET,1.48,0.96,0.25,1.48,22
NDC,5107945120,AMLODIPINE 5 MG TABLET,3.46,2.25,0.58,3.46,22
NDC,5107945320,MIDODRINE 5 MG TABLET,5.42,3.52,0.91,5.42,22
NDC,5107945420,SIMVASTATIN 10 MG TABLET,5.58,3.63,0.94,5.58,22
NDC,5107945520,SIMVASTATIN 20 MG TABLET,9.84,6.4,1.65,9.84,22
NDC,5107945801,PRAVASTATIN 20 MG TABLET,6.54,4.25,1.1,6.54,22
NDC,5107945820,PRAVASTATIN 20 MG TABLET,6.54,4.25,1.1,6.54,22
NDC,5107946620,DICLOFENAC SODIUM 50 MG TABLETDELAYED RELEASE,2.94,1.91,0.49,2.94,22
NDC,5107948020,VENLAFAXINE 37.5 MG TABLET,4.0,2.6,0.67,4.0,22
NDC,5107948520,FLUPHENAZINE 1 MG TABLET,1.16,0.75,0.19,1.16,22
NDC,5107951620,CHLORPROMAZINE 100 MG TABLET,44.48,28.91,7.47,44.48,22
NDC,5107951820,CHLORPROMAZINE 10 MG TABLET,13.26,8.62,2.23,13.26,22
NDC,5107951920,CHLORPROMAZINE 25 MG TABLET,19.12,12.43,3.21,19.12,22
NDC,5107956320,AMITRIPTYLINE 100 MG TABLET,5.08,3.3,0.85,5.08,22
NDC,5107956520,THIORIDAZINE 10 MG TABLET,1.08,0.7,0.18,1.08,22
NDC,5107956601,THIORIDAZINE 25 MG TABLET,1.52,0.99,0.26,1.52,22
NDC,5107956620,THIORIDAZINE 25 MG TABLET,1.52,0.99,0.26,1.52,22
NDC,5107956720,THIORIDAZINE 50 MG TABLET,1.9,1.24,0.32,1.9,22
NDC,5107957220,TRIFLUOPERAZINE 1 MG TABLET,2.68,1.74,0.45,2.68,22
NDC,5107957320,TRIFLUOPERAZINE 2 MG TABLET,4.0,2.6,0.67,4.0,22
NDC,5107957420,TRIFLUOPERAZINE 5 MG TABLET,5.1,3.32,0.86,5.1,22
NDC,5107957520,TRIFLUOPERAZINE 10 MG TABLET,6.16,4.0,1.03,6.16,22
NDC,5107958020,THIORIDAZINE 100 MG TABLET,2.18,1.42,0.37,2.18,22
NDC,5107958101,LEUCOVORIN CALCIUM 5 MG TABLET,6.5,4.23,1.09,6.5,22
NDC,5107958106,LEUCOVORIN CALCIUM 5 MG TABLET,6.5,4.23,1.09,6.5,22
NDC,5107959701,CETIRIZINE 10 MG TABLET,4.98,3.24,0.84,4.98,22
NDC,5107959720,CETIRIZINE 10 MG TABLET,4.98,3.24,0.84,4.98,22
NDC,5107963020,PRAZOSIN 1 MG CAPSULE,3.62,2.35,0.61,3.62,22
NDC,5107963120,PRAZOSIN 2 MG CAPSULE,5.04,3.28,0.85,5.04,22
NDC,5107963220,PRAZOSIN 5 MG CAPSULE,8.62,5.6,1.45,8.62,22
NDC,5107964420,CYCLOBENZAPRINE 10 MG TABLET,1.94,1.26,0.33,1.94,22
NDC,5107965101,DOXEPIN 100 MG CAPSULE,4.0,2.6,0.67,4.0,22
NDC,5107965120,DOXEPIN 100 MG CAPSULE,4.0,2.6,0.67,4.0,22
NDC,5107967005,METHOTREXATE SODIUM 2.5 MG TABLET,12.48,8.11,0.16,12.48,30
NDC,5107968401,ATENOLOL 50 MG TABLET,1.78,1.16,0.3,1.78,22
NDC,5107968420,ATENOLOL 50 MG TABLET,1.78,1.16,0.3,1.78,22
NDC,5107968520,ATENOLOL 100 MG TABLET,2.98,1.94,0.5,2.98,22
NDC,5107969001,LOPERAMIDE 2 MG CAPSULE,1.76,1.14,0.3,1.76,22
NDC,5107969020,LOPERAMIDE 2 MG CAPSULE,1.76,1.14,0.3,1.76,22
NDC,5107972320,OXYBUTYNIN CHLORIDE ER 10 MG TABLETEXTENDED RELEASE 24 HR,6.58,4.28,1.11,6.58,22
NDC,5107972420,ZOLPIDEM 5 MG TABLET,9.24,6.01,1.55,9.24,22
NDC,5107972501,ZOLPIDEM 10 MG TABLET,9.24,6.01,1.55,9.24,22
NDC,5107973320,HALOPERIDOL 0.5 MG TABLET,0.7,0.46,0.12,0.7,22
NDC,5107973420,HALOPERIDOL 1 MG TABLET,0.98,0.64,0.16,0.98,22
NDC,5107973520,HALOPERIDOL 2 MG TABLET,1.34,0.87,0.23,1.34,22
NDC,5107974520,DILTIAZEM 30 MG TABLET,0.9,0.59,0.15,0.9,22
NDC,5107974720,DILTIAZEM 90 MG TABLET,1.72,1.12,0.29,1.72,22
NDC,5107975301,SUCRALFATE 1 GRAM TABLET,0.76,0.49,0.13,0.76,22
NDC,5107975320,SUCRALFATE 1 GRAM TABLET,0.76,0.49,0.13,0.76,22
NDC,5107975901,ATENOLOL 25 MG TABLET,1.6,1.04,0.27,1.6,22
NDC,5107975920,ATENOLOL 25 MG TABLET,1.6,1.04,0.27,1.6,22
NDC,5107977120,CARVEDILOL 3.125 MG TABLET,4.26,2.77,0.72,4.26,22
NDC,5107978220,PRAVASTATIN 40 MG TABLET,9.54,6.2,1.6,9.54,22
NDC,5107978820,ALPRAZOLAM 0.25 MG TABLET,1.28,0.83,0.22,1.28,22
NDC,5107978920,ALPRAZOLAM 0.5 MG TABLET,1.52,0.99,0.26,1.52,22
NDC,5107979020,ALPRAZOLAM 1 MG TABLET,2.02,1.31,0.34,2.02,22
NDC,5107980120,METOPROLOL TARTRATE 50 MG TABLET,1.14,0.74,0.19,1.14,22
NDC,5107980220,METOPROLOL TARTRATE 100 MG TABLET,1.66,1.08,0.28,1.66,22
NDC,5107981020,GLIPIZIDE 5 MG TABLET,0.76,0.49,0.13,0.76,22
NDC,5107981220,NADOLOL 20 MG TABLET,12.38,8.05,2.08,12.38,22
NDC,5107981720,TACROLIMUS 0.5 MG CAPSULE IMMEDIATE-RELEASE,4.46,2.9,0.24,4.46,31
NDC,5107981820,TACROLIMUS 1 MG CAPSULE IMMEDIATE-RELEASE,8.92,5.8,0.24,8.92,31
NDC,5107985203,GALANTAMINE 4 MG TABLET,8.44,5.49,1.42,8.44,22
NDC,5107985303,GALANTAMINE 8 MG TABLET,8.44,5.49,1.42,8.44,22
NDC,5107987020,CARBAMAZEPINE 100 MG CHEWABLE TABLET,1.32,0.86,0.22,1.32,22
NDC,5107988121,CLONAZEPAM 0.5 MG TABLET,1.6,1.04,0.27,1.6,22
NDC,5107988220,CLONAZEPAM 1 MG TABLET,1.82,1.18,0.31,1.82,22
NDC,5107988320,CLONAZEPAM 2 MG TABLET,2.48,1.61,0.42,2.48,22
NDC,5107988601,METOCLOPRAMIDE 5 MG TABLET,1.8,1.17,0.3,1.8,22
NDC,5107988620,METOCLOPRAMIDE 5 MG TABLET,1.8,1.17,0.3,1.8,22
NDC,5107990120,LOXAPINE SUCCINATE 10 MG CAPSULE,2.54,1.65,0.43,2.54,22
NDC,5107990220,LOXAPINE SUCCINATE 25 MG CAPSULE,3.86,2.51,0.65,3.86,22
NDC,5107990320,LOXAPINE SUCCINATE 50 MG CAPSULE,5.14,3.34,0.86,5.14,22
NDC,5107991720,VERAPAMIL ER 120 MG 24 HR CAPSULEEXTENDED RELEASE,10.74,6.98,1.8,10.74,22
NDC,5107992120,CLOZAPINE 25 MG TABLET,2.64,1.72,0.44,2.64,22
NDC,5107992220,CLOZAPINE 100 MG TABLET,6.86,4.46,1.15,6.86,22
NDC,5107992320,CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLETEXTENDED RELEASE,3.48,2.26,0.58,3.48,22
NDC,5107992401,DILTIAZEM ER 60 MG CAPSULEEXTENDED RELEASE 12 HR,7.94,5.16,1.33,7.94,22
NDC,5107992420,DILTIAZEM ER 60 MG CAPSULEEXTENDED RELEASE 12 HR,7.94,5.16,1.33,7.94,22
NDC,5107992520,DILTIAZEM ER 90 MG CAPSULEEXTENDED RELEASE 12 HR,9.34,6.07,1.57,9.34,22
NDC,5107992620,DILTIAZEM ER 120 MG CAPSULEEXTENDED RELEASE 12 HR,13.04,8.48,2.19,13.04,22
NDC,5107992820,LABETALOL 100 MG TABLET,0.96,0.62,0.16,0.96,22
NDC,5107992920,LABETALOL 200 MG TABLET,1.36,0.88,0.23,1.36,22
NDC,5107993720,TERAZOSIN 2 MG CAPSULE,3.22,2.09,0.54,3.22,22
NDC,5107994320,BUPROPION HCL 75 MG TABLET,3.1,2.02,0.52,3.1,22
NDC,5107995820,DOXAZOSIN 2 MG TABLET,7.52,4.89,1.26,7.52,22
NDC,5107995920,DOXAZOSIN 4 MG TABLET,7.9,5.14,1.33,7.9,22
NDC,5107996620,FAMOTIDINE 20 MG TABLET,3.48,2.26,0.58,3.48,22
NDC,5107997820,CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLETEXTENDED RELEASE,1.86,1.21,0.31,1.86,22
NDC,5107997920,SPIRONOLACTONE 50 MG TABLET,1.76,1.14,0.3,1.76,22
NDC,5107998501,BUSPIRONE 5 MG TABLET,1.54,1.0,0.26,1.54,22
NDC,5107998520,BUSPIRONE 5 MG TABLET,1.54,1.0,0.26,1.54,22
NDC,5107998601,BUSPIRONE 10 MG TABLET,2.7,1.76,0.45,2.7,22
NDC,5107998620,BUSPIRONE 10 MG TABLET,2.7,1.76,0.45,2.7,22
NDC,5107999120,TRAMADOL 50 MG TABLET,1.6,1.04,0.27,1.6,22
NDC,5107999220,FLUVOXAMINE 50 MG TABLET,5.14,3.34,0.86,5.14,22
NDC,5107999320,FLUVOXAMINE 100 MG TABLET,5.28,3.43,0.89,5.28,22
NDC,5107999820,TIZANIDINE 4 MG TABLET,5.1,3.32,0.86,5.1,22
NDC,5114400160,TUKYSA 50 MG TABLET,270.44,175.79,45.43,270.44,22
NDC,5114400260,TUKYSA 150 MG TABLET,543.8,353.47,91.36,543.8,22
NDC,5114400301,TIVDAK 40 MG INTRAVENOUS SOLUTION,35523.84,23090.5,157.32,35523.84,52
NDC,5114402001,PADCEV 20 MG INTRAVENOUS SOLUTION,13483.2,8764.08,32.58,13483.2,52
NDC,5114403001,PADCEV 30 MG INTRAVENOUS SOLUTION,20224.8,13146.12,32.58,20224.8,52
NDC,5114405001,ADCETRIS 50 MG INTRAVENOUS SOLUTION,63216.76,41090.89,207.67,63216.76,52
NDC,5116729009,CASGEVY 4X10EXP6 TO 13X10EXP6 CELL/ML INTRAVENOUS SUSPENSION,10560000.0,6864000.0,24125.92,9504000.0,37
NDC,5128504001,ZIAC 10 MG-6.25 MG TABLET,21.62,14.05,3.63,21.62,22
NDC,5128504702,ZIAC 2.5 MG-6.25 MG TABLET,21.62,14.05,3.63,21.62,22
NDC,5128505002,ZIAC 5 MG-6.25 MG TABLET,21.62,14.05,3.63,21.62,22
NDC,5128536601,TREXALL 5 MG TABLET,55.36,35.98,9.3,55.36,22
NDC,5129362701,PHENOBARBITAL 64.8 MG TABLET,1.68,1.09,0.28,1.68,22
NDC,5129362801,PHENOBARBITAL 97.2 MG TABLET,2.38,1.55,0.4,2.38,22
NDC,5129369201,PHENOBARBITAL 30 MG TABLET,0.84,0.55,0.14,0.84,22
NDC,5129380401,SALSALATE 750 MG TABLET,5.5,3.58,0.92,5.5,22
NDC,5129381001,PHENAZOPYRIDINE 100 MG TABLET,5.4,3.51,0.91,5.4,22
NDC,5129383197,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,0.95,0.62,0.16,0.95,22
NDC,5140785330,ERYTHROMYCIN 250 MG TABLETDELAYED RELEASE,11.84,7.7,1.99,11.84,22
NDC,5140900700,NEW SKIN (BENZETHONIUM) 0.2 % TOPICAL FILM-FORMING LIQUID,0.7,0.46,0.12,0.7,22
NDC,5140900722,DERMOPLAST (WITH MENTHOL) 20 %-0.5 % TOPICAL AEROSOL,0.18,0.12,0.03,0.18,22
NDC,5152504311,FELBAMATE 600 MG TABLET,11.84,7.7,1.99,11.84,22
NDC,5155200516,ACETIC ACID (BULK) 3 % LIQUID,0.33,0.21,0.06,0.33,22
NDC,5155200556,ACETIC ACID (BULK) 5 % LIQUID,0.14,0.09,0.02,0.14,22
NDC,5155200715,POTASSIUM HYDROXIDE (BULK) 10 % SOLUTION,0.13,0.08,0.02,0.13,22
NDC,5155201174,FLEXIBLE COLLODION (BULK) LIQUID,1.6,1.04,0.27,1.6,22
NDC,5155201183,PHENOL (BULK) 89 % LIQUID,0.72,0.47,0.12,0.72,22
NDC,5155201944,STRONG IODINE 5 %-10 % TOPICAL SOLUTION,0.86,0.56,0.14,0.86,22
NDC,5155202025,BISMUTH SUBGALLATE (BULK) POWDER,1.19,0.77,0.2,1.19,22
NDC,5155202056,FORMALDEHYDE (BULK) 37 % SOLUTION,0.32,0.21,0.05,0.32,22
NDC,5155203573,FERRIC SUBSULFATE (BULK) 20 TO 22 GRAM/100 ML SOLUTION,1.14,0.74,0.19,1.03,21
NDC,5155204486,SODIUM BISULFITE (BULK) 100 % POWDER,0.14,0.09,0.02,0.14,22
NDC,5155208434,D-XYLOSE (BULK) POWDER,6.46,4.2,1.09,6.46,22
NDC,5155208979,ETHYL ALCOHOL (BULK) 95 % LIQUID,0.2,0.13,0.03,0.2,22
NDC,5155210795,SYRSPEND SF LIQUID ORAL SUSPENSION,0.33,0.21,0.06,0.33,22
NDC,5155213235,POVIDONE (BULK) K-30 POWDER,4.44,2.89,0.75,4.44,22
NDC,5164573108,CALCIUM 600 + D(3) 600 MG-5 MCG (200 UNIT) TABLET,0.1,0.07,0.02,0.1,22
NDC,5164582601,OYSTER SHELL + D3 250 MG-3.125 MCG (125 UNIT) TABLET,0.06,0.04,0.01,0.06,22
NDC,5164582899,CALCIUM 500 + D 500 MG-5 MCG (200 UNIT) TABLET,0.2,0.13,0.03,0.2,22
NDC,5164583701,PRENATAL 28 MG IRON-800 MCG TABLET,0.12,0.08,0.02,0.12,22
NDC,5164591401,VITAMIN B-12  1000 MCG TABLET,0.12,0.08,0.02,0.12,22
NDC,5166072415,ALLERGY RELIEF AND NASAL DECONGESTANT 10 MG-240 MG TABLETEXTENDED REL,1.14,0.74,0.19,1.14,22
NDC,5167212581,CLOBETASOL 0.05 % TOPICAL CREAM,17.1,11.12,2.87,17.1,22
NDC,5167212582,CLOBETASOL 0.05 % TOPICAL CREAM,17.1,11.12,2.87,17.1,22
NDC,5167212583,CLOBETASOL 0.05 % TOPICAL CREAM,15.3,9.95,2.57,15.3,22
NDC,5167212603,CLOTRIMAZOLE 1 % TOPICAL SOLUTION,4.98,3.24,0.84,4.98,22
NDC,5167212611,DESOXIMETASONE 0.05 % TOPICAL GEL,12.26,7.97,2.06,12.26,22
NDC,5167212621,DESOXIMETASONE 0.25 % TOPICAL OINTMENT,14.16,9.2,2.38,14.16,22
NDC,5167212623,DESOXIMETASONE 0.25 % TOPICAL OINTMENT,11.76,7.64,1.98,11.76,22
NDC,5167212631,NYSTATIN-TRIAMCINOLONE 100000 UNIT/G-0.1 % TOPICAL CREAM,14.92,9.7,2.51,14.92,22
NDC,5167212632,NYSTATIN-TRIAMCINOLONE 100000 UNIT/G-0.1 % TOPICAL CREAM,10.64,6.92,1.79,10.64,22
NDC,5167212641,FLUOCINONIDE 0.05 % TOPICAL OINTMENT,9.44,6.14,1.59,9.44,22
NDC,5167212642,FLUOCINONIDE 0.05 % TOPICAL OINTMENT,9.44,6.14,1.59,9.44,22
NDC,5167212643,FLUOCINONIDE 0.05 % TOPICAL OINTMENT,9.44,6.14,1.59,9.44,22
NDC,5167212675,TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,32.24,20.96,5.42,32.24,22
NDC,5167212701,DESOXIMETASONE 0.25 % TOPICAL CREAM,13.5,8.78,2.27,13.5,22
NDC,5167212703,DESOXIMETASONE 0.25 % TOPICAL CREAM,12.9,8.39,2.17,12.9,22
NDC,5167212713,DESOXIMETASONE 0.05 % TOPICAL CREAM,12.24,7.96,2.06,12.24,22
NDC,5167212721,NYSTATIN-TRIAMCINOLONE 100000 UNIT/GRAM-0.1 % TOPICAL OINTMENT,14.92,9.7,2.51,14.92,22
NDC,5167212751,CLOTRIMAZOLE 1 % TOPICAL CREAM,2.66,1.73,0.45,2.66,22
NDC,5167212752,CLOTRIMAZOLE 1 % TOPICAL CREAM,2.32,1.51,0.39,2.32,22
NDC,5167212791,FLUOCINONIDE 0.05 % TOPICAL GEL,7.94,5.16,1.33,7.94,22
NDC,5167212792,FLUOCINONIDE 0.05 % TOPICAL GEL,7.94,5.16,1.33,7.94,22
NDC,5167212793,FLUOCINONIDE 0.05 % TOPICAL GEL,7.94,5.16,1.33,7.94,22
NDC,5167212801,DESONIDE 0.05 % TOPICAL CREAM,10.7,6.96,1.8,10.7,22
NDC,5167212803,DESONIDE 0.05 % TOPICAL CREAM,10.7,6.96,1.8,10.7,22
NDC,5167212822,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.56,0.36,0.09,0.56,22
NDC,5167212891,NYSTATIN 100000 UNIT/GRAM TOPICAL CREAM,2.34,1.52,0.39,2.34,22
NDC,5167212892,NYSTATIN 100000 UNIT/GRAM TOPICAL CREAM,1.76,1.14,0.3,1.76,22
NDC,5167212901,HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,11.94,7.76,2.01,11.94,22
NDC,5167212906,HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,8.02,5.21,1.35,8.02,22
NDC,5167212981,KETOCONAZOLE 2 % TOPICAL CREAM,17.52,11.39,2.94,17.52,22
NDC,5167212982,KETOCONAZOLE 2 % TOPICAL CREAM,13.9,9.04,2.34,13.9,22
NDC,5167212983,KETOCONAZOLE 2 % TOPICAL CREAM,9.24,6.01,1.55,9.24,22
NDC,5167213014,AMMONIUM LACTATE 12 % TOPICAL CREAM,0.32,0.21,0.05,0.32,22
NDC,5167213020,TERCONAZOLE 0.8 % VAGINAL CREAM,4.1,2.67,0.69,4.1,22
NDC,5167213031,ECONAZOLE NITRATE 1 % TOPICAL CREAM,14.5,9.43,2.44,14.5,22
NDC,5167213032,ECONAZOLE NITRATE 1 % TOPICAL CREAM,14.5,9.43,2.44,14.5,22
NDC,5167213083,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % LOTION,11.18,7.27,1.88,11.18,22
NDC,5167213091,BETAMETHASONE AUGMENTED 0.05 % TOPICAL GEL,8.2,5.33,1.38,8.2,22
NDC,5167213093,BETAMETHASONE AUGMENTED 0.05 % TOPICAL GEL,5.46,3.55,0.92,5.46,22
NDC,5167213101,BETAMETHASONE AUGMENTED 0.05 % TOPICAL CREAM,5.06,3.29,0.85,5.06,22
NDC,5167213355,ORALONE 0.1 % DENTAL PASTE,35.82,23.28,6.02,35.82,22
NDC,5167213654,FLUOCINOLONE 0.01 % TOPICAL SOLUTION,6.26,4.07,1.05,6.26,22
NDC,5167213701,MUPIROCIN CALCIUM 2 % TOPICAL CREAM,32.68,21.24,5.49,32.68,22
NDC,5167213702,MUPIROCIN CALCIUM 2 % TOPICAL CREAM,22.16,14.4,3.72,22.16,22
NDC,5167213858,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.2,0.13,0.03,0.2,22
NDC,5167213859,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.15,0.1,0.03,0.15,22
NDC,5167213861,FLUOCINONIDE 0.05 % TOPICAL CREAM,6.08,3.95,1.02,6.08,22
NDC,5167220011,MICONAZOLE NITRATE 2 % TOPICAL CREAM,0.7,0.46,0.12,0.7,22
NDC,5167220012,MICONAZOLE NITRATE 2 % TOPICAL CREAM,0.48,0.31,0.08,0.48,22
NDC,5167220036,CLOTRIMAZOLE 1 % VAGINAL CREAM,0.36,0.23,0.06,0.36,22
NDC,5167220102,HYDROCORTISONE 0.5 % TOPICAL CREAM,0.38,0.25,0.06,0.38,22
NDC,5167220202,TOLNAFTATE 1 % TOPICAL CREAM,0.58,0.38,0.1,0.58,22
NDC,5167220356,MICONAZOLE NITRATE 2 % VAGINAL CREAM,0.5,0.33,0.08,0.5,22
NDC,5167220371,CLOTRIMAZOLE 1 % TOPICAL SOLUTION,9.02,5.86,1.52,9.02,22
NDC,5167220442,DOUBLE ANTIBIOTIC (BACITRCN ZN) 500 UNIT-10000 UNIT/GRAM TOP OINTMENT,0.46,0.3,0.08,0.46,22
NDC,5167220752,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,0.5,0.33,0.08,0.5,22
NDC,5167220801,TERBINAFINE HCL 1 % TOPICAL CREAM,1.08,0.7,0.18,1.08,22
NDC,5167220802,TERBINAFINE HCL 1 % TOPICAL CREAM,0.8,0.52,0.13,0.8,22
NDC,5167221142,FEVERALL 80 MG RECTAL SUPPOSITORY,1.6,1.04,0.27,1.6,22
NDC,5167221152,FEVERALL 120 MG RECTAL SUPPOSITORY,2.24,1.46,0.38,2.24,22
NDC,5167221162,FEVERALL 325 MG RECTAL SUPPOSITORY,1.6,1.04,0.27,1.6,22
NDC,5167230032,HYDROCORTISONE 2.5 % TOPICAL CREAM,0.68,0.44,0.11,0.68,22
NDC,5167230071,HYDROCORTISONE-ACETIC ACID 1 %-2 % EAR DROPS,45.16,29.35,7.59,45.16,22
NDC,5167230083,LIDOCAINE 5 % TOPICAL OINTMENT,15.24,9.91,2.56,15.24,22
NDC,5167240015,NORTRIPTYLINE 10 MG CAPSULE,0.26,0.17,0.04,0.26,22
NDC,5167240025,NORTRIPTYLINE 25 MG CAPSULE,0.36,0.23,0.06,0.36,22
NDC,5167240035,NORTRIPTYLINE 50 MG CAPSULE,0.42,0.27,0.07,0.42,22
NDC,5167240041,NORTRIPTYLINE 75 MG CAPSULE,8.44,5.49,1.42,8.44,22
NDC,5167240051,CARBAMAZEPINE 200 MG TABLET,3.2,2.08,0.54,3.2,22
NDC,5167240052,CARBAMAZEPINE 200 MG TABLET,3.16,2.05,0.53,3.16,22
NDC,5167240116,CLOMIPRAMINE 25 MG CAPSULE,22.48,14.61,3.78,22.48,22
NDC,5167240161,ETODOLAC 200 MG CAPSULE,2.88,1.87,0.48,2.88,22
NDC,5167240171,ETODOLAC 300 MG CAPSULE,3.24,2.11,0.54,3.24,22
NDC,5167240221,ACETAZOLAMIDE 125 MG TABLET,4.36,2.83,0.73,4.36,22
NDC,5167240231,ACETAZOLAMIDE 250 MG TABLET,5.76,3.74,0.97,5.76,22
NDC,5167240261,KETOCONAZOLE 200 MG TABLET,6.32,4.11,1.06,6.32,22
NDC,5167240266,KETOCONAZOLE 200 MG TABLET,6.32,4.11,1.06,6.32,22
NDC,5167240412,CARBAMAZEPINE 100 MG CHEWABLE TABLET,1.32,0.86,0.22,1.32,22
NDC,5167240461,ENALAPRIL 10 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,2.44,1.59,0.41,2.44,22
NDC,5167240479,CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,0.5,0.33,0.08,0.5,22
NDC,5167240481,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,4.1,2.67,0.69,4.1,22
NDC,5167240556,AMIODARONE 100 MG TABLET,14.86,9.66,2.5,14.86,22
NDC,5167240621,FLUOROURACIL 2 % TOPICAL SOLUTION,15.12,9.83,2.54,15.12,22
NDC,5167240794,DESONIDE 0.05 % LOTION,10.04,6.53,1.69,10.04,22
NDC,5167240913,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,12.0,7.8,2.02,12.0,22
NDC,5167241166,METRONIDAZOLE 0.75 % TOPICAL GEL,14.2,9.23,2.39,14.2,22
NDC,5167241186,FLUOROURACIL 5 % TOPICAL CREAM,19.24,12.51,3.23,19.24,22
NDC,5167241231,CARBAMAZEPINE ER 100 MG TABLETEXTENDED RELEASE12 HR,2.28,1.48,0.38,2.28,22
NDC,5167241461,PHENYTOIN 50 MG CHEWABLE TABLET,1.06,0.69,0.18,1.06,22
NDC,5167241543,CALCIPOTRIENE 0.005 % TOPICAL OINTMENT,12.06,7.84,2.03,12.06,22
NDC,5167242153,METRONIDAZOLE 1 % TOPICAL GEL,9.24,6.01,1.55,9.24,22
NDC,5167252961,PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,35.42,23.02,5.95,35.42,22
NDC,5167252971,PROMETHAZINE 25 MG RECTAL SUPPOSITORY,35.42,23.02,5.95,35.42,22
NDC,5175410073,ELCYS 50 MG/ML INTRAVENOUS SOLUTION,37.29,24.24,6.26,37.29,22
NDC,5175420014,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,0.96,0.62,0.16,0.96,22
NDC,5175450114,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,3.3,2.15,0.55,3.3,22
NDC,5175450124,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,2.67,1.74,0.45,2.67,22
NDC,5175920410,AJOVY SYRINGE 225 MG/1.5 ML SUBCUTANEOUS,1812.36,1178.03,8.82,1812.36,29
NDC,5175920813,EPYSQLI 300 MG/30 ML INTRAVENOUS SOLUTION,730.56,474.86,31.67,943.43,39
NDC,5175930510,UZEDY 50 MG/0.14 ML SUBCUT EXT REL SUSPENSION SYRINGE,33768.0,21949.2,21.97,33768.0,53
NDC,5175941010,UZEDY 75 MG/0.21 ML SUBCUT EXT REL SUSPENSION SYRINGE,33769.71,21950.31,21.97,33769.71,53
NDC,5175952010,UZEDY 100 MG/0.28 ML SUBCUT EXT REL SUSPENSION SYRINGE,33771.87,21951.72,21.97,33771.87,53
NDC,5175963010,UZEDY 125 MG/0.35 ML SUBCUT EXT REL SUSPENSION SYRINGE,33771.09,21951.21,21.97,33771.09,53
NDC,5175970813,SELARSDI 130 MG/26 ML INTRAVENOUS SOLUTION,193.86,126.01,43.2,5646.0,39
NDC,5175974010,UZEDY 150 MG/0.42 ML SUBCUT EXT REL SUSPENSION SYRINGE,33770.58,21950.88,21.97,33770.58,53
NDC,5175985010,UZEDY 200 MG/0.56 ML SUBCUT EXT REL SUSPENSION SYRINGE,33770.58,21950.88,21.97,33770.58,53
NDC,5175996010,UZEDY 250 MG/0.7 ML SUBCUT EXT REL SUSPENSION SYRINGE,33771.09,21951.21,21.97,33771.09,53
NDC,5180100101,EFFER-K 25 MEQ EFFERVESCENT TABLET,0.82,0.53,0.14,0.82,22
NDC,5180100701,EFFER-K 25 MEQ EFFERVESCENT TABLET,0.94,0.61,0.16,0.94,22
NDC,5180100730,EFFER-K 25 MEQ EFFERVESCENT TABLET,0.94,0.61,0.16,0.94,22
NDC,5180100940,GLOSTRIPS 1 MG FOR THE EYE,0.3,0.2,0.05,0.3,22
NDC,5180101301,EFFER-K 10 MEQ EFFERVESCENT TABLET,1.0,0.65,0.17,1.0,22
NDC,5180101330,EFFER-K 10 MEQ EFFERVESCENT TABLET,1.14,0.74,0.19,1.14,22
NDC,5186200560,DOFETILIDE 500 MCG CAPSULE,17.1,11.12,2.87,17.1,22
NDC,5186202560,DOFETILIDE 250 MCG CAPSULE,17.1,11.12,2.87,17.1,22
NDC,5186224030,AMIODARONE 100 MG TABLET,14.86,9.66,2.5,14.86,22
NDC,5186233201,ESTRADIOL 0.5 MG TABLET,1.1,0.72,0.18,1.1,22
NDC,5186233301,ESTRADIOL 1 MG TABLET,1.36,0.88,0.23,1.36,22
NDC,5186245847,CYCLOSPORINE MODIFIED 25 MG ORAL CAP (NEORALGENGRAF),2.76,1.79,0.46,2.76,31
NDC,5186246047,CYCLOSPORINE MODIFIED 100 MG ORAL CAP (NEORALGENGRAF),11.0,7.15,1.85,11.0,31
NDC,5186246260,TOLSURA 65 MG ORAL SOLID DISPERSION CAPSULE,94.52,61.44,15.88,94.52,22
NDC,5186256406,LOW-OGESTREL (28) 0.3 MG-30 MCG TABLET,2.18,1.42,0.37,2.18,22
NDC,5186268201,SOLTAMOX 20 MG/10 ML ORAL SOLUTION,13.85,9.0,2.33,13.85,22
NDC,5192711650,CITRIC ACID ANHYDROUS (BULK) 100 % GRANULES,0.6,0.39,0.1,0.6,22
NDC,5192713130,COTTONSEED OIL (BULK),0.17,0.11,0.03,0.17,22
NDC,5192732270,PCCA-PLUS BASE ORAL SUSPENSION,1.7,1.11,0.29,1.7,22
NDC,5199100298,METHADONE 10 MG/ML INJECTION SOLUTION,76.95,50.02,12.93,76.95,31
NDC,5199100633,DESVENLAFAXINE SUCCINATE ER 25 MG TABLETEXTENDED RELEASE 24 HR,22.94,14.91,3.85,22.94,22
NDC,5199107401,ASCOMP WITH CODEINE 30 MG-50 MG-325 MG-40 MG CAPSULE,5.48,3.56,0.92,5.48,22
NDC,5199108290,FOLBEE PLUS 5 MG TABLET,1.06,0.69,0.18,1.06,22
NDC,5199108490,FOLBEE 2.5 MG-25 MG-1 MG TABLET,1.38,0.9,0.23,1.38,22
NDC,5199114417,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,71.13,46.23,11.95,71.13,31
NDC,5199119811,FERREX 150 FORTE 150 MG-25 MCG-1 MG CAPSULE,0.56,0.36,0.09,0.56,22
NDC,5199120311,FERREX 150 MG IRON CAPSULE,0.56,0.36,0.09,0.56,22
NDC,5199120399,FERREX 150 MG IRON CAPSULE,0.56,0.36,0.09,0.56,22
NDC,5199125201,FOLPLEX 2.2 MG-25 MG-0.5 MG TABLET,0.78,0.51,0.13,0.78,22
NDC,5199129401,OXCARBAZEPINE 600 MG TABLET,9.66,6.28,1.62,9.66,22
NDC,5199131133,DESVENLAFAXINE SUCCINATE ER 50 MG TABLETEXTENDED RELEASE 24 HR,22.94,14.91,3.85,22.94,22
NDC,5199131233,DESVENLAFAXINE SUCCINATE ER 100 MG TABLETEXTENDED RELEASE 24 HR,22.94,14.91,3.85,22.94,22
NDC,5199135860,ASENAPINE 5 MG SUBLINGUAL TABLET,43.22,28.09,7.26,43.22,22
NDC,5199138490,FOLBIC 2.5 MG-25 MG-2 MG TABLET,1.84,1.2,0.31,1.84,22
NDC,5199152601,TERBINAFINE HCL 250 MG TABLET,26.16,17.0,4.39,26.16,22
NDC,5199154390,MULTIGEN 70 MG-150 MG-10 MCG-2 MG-75MG TABLET,2.5,1.63,0.42,2.5,22
NDC,5199161690,FOLBIC RF 2 MG-1.13 MG-25 MG TABLET,2.58,1.68,0.43,2.58,22
NDC,5199170390,FERREX 150 PLUS 150 MG-50 MG-50 MG CAPSULE,2.54,1.65,0.43,2.54,22
NDC,5199173520,GRANISETRON HCL 1 MG TABLET,118.1,76.77,19.84,118.1,22
NDC,5199173532,GRANISETRON HCL 1 MG TABLET,118.12,76.78,19.84,118.12,22
NDC,5201508001,DIFICID 200 MG TABLET,624.6,405.99,104.93,624.6,22
NDC,5224401006,EDEX 10 MCG INTRACAVERNOSAL KIT,1952.34,1269.02,327.99,1952.34,22
NDC,5224402002,EDEX 20 MCG INTRACAVERNOSAL KIT,840.63,546.41,27.02,840.63,23
NDC,5224402006,EDEX 20 MCG INTRACAVERNOSAL KIT,2521.77,1639.15,27.02,2521.77,23
NDC,5224410010,THEO-24 100 MG CAPSULEEXTENDED RELEASE,9.28,6.03,1.56,9.28,22
NDC,5224420010,THEO-24 200 MG CAPSULEEXTENDED RELEASE,13.8,8.97,2.32,13.8,22
NDC,5224430010,THEO-24 300 MG CAPSULEEXTENDED RELEASE,16.96,11.02,2.85,16.96,22
NDC,5226801201,SUPREP BOWEL PREP KIT 17.5 GRAM-3.13 GRAM-1.6 GRAM ORAL SOLUTION,1.0,0.65,0.17,1.0,22
NDC,5226810001,GOLYTELY ORAL SOLUTION,0.03,0.02,0.01,0.03,22
NDC,5226820001,SUTAB 1.479-0.188-0.225 GRAM TABLET,16.88,10.97,2.84,16.88,22
NDC,5237602102,PAROEX ORAL RINSE 0.12 % MOUTHWASH,0.05,0.03,0.01,0.05,22
NDC,5238001262,POVIDONE-IODINE 10 % TOPICAL OINTMENT,0.3,0.2,0.05,0.3,22
NDC,5238012724,CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,0.12,0.08,0.02,0.12,22
NDC,5238012727,CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,0.04,0.03,0.01,0.04,22
NDC,5238012728,CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,0.08,0.05,0.01,0.08,22
NDC,5238019054,POVIDONE-IODINE 10 % TOPICAL SOLUTION,0.02,0.01,0.01,0.02,22
NDC,5238019056,POVIDONE-IODINE 10 % TOPICAL SOLUTION,0.02,0.01,0.01,0.02,22
NDC,5238019057,POVIDONE-IODINE 10 % TOPICAL SOLUTION,0.02,0.01,0.01,0.02,22
NDC,5238019059,POVIDONE-IODINE 10 % TOPICAL SOLUTION,0.02,0.01,0.01,0.02,22
NDC,5253618003,ERYTHROMYCIN 250 MG TABLETDELAYED RELEASE,16.78,10.91,2.82,16.78,22
NDC,5253650001,DEXTROAMPHETAMINE SULFATE 5 MG TABLET,5.82,3.78,0.98,5.82,22
NDC,5253660011,BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,18.15,11.8,3.05,18.15,22
NDC,52579160005,KIT FOR THE PREP OF TC-99M-TILMANOCEPT 250 MCG SOLUTION FOR INJECTION,1190.0,773.5,199.92,2409.0,29
NDC,5260900015,ALKERAN 2 MG TABLET,27.16,17.65,4.56,27.16,22
NDC,5265220011,XATMEP 2.5 MG/ML ORAL SOLUTION,64.38,41.85,10.82,64.38,22
NDC,5265220016,XATMEP 2.5 MG/ML ORAL SOLUTION,67.65,43.97,11.37,67.65,22
NDC,5265230011,QBRELIS 1 MG/ML ORAL SOLUTION,14.08,9.15,2.37,14.08,22
NDC,5265240011,EPANED 1 MG/ML ORAL SOLUTION,13.98,9.09,2.35,13.98,22
NDC,5265250011,KATERZIA 1 MG/ML ORAL SUSPENSION,13.18,8.57,2.21,13.18,22
NDC,5265260011,FLEQSUVY 25 MG/5 ML (5 MG/ML) ORAL SUSPENSION,18.7,12.16,3.14,18.7,22
NDC,5265280011,ZONISADE 100 MG/5 ML ORAL SUSPENSION,8.65,5.62,1.45,8.65,22
NDC,5270915013,GRASTEK 2800 BAU SUBLINGUAL TABLET,29.46,19.15,4.95,29.46,22
NDC,5270916013,RAGWITEK 12 AMB A 1 UNIT SUBLINGUAL TABLET,29.46,19.15,4.95,29.46,22
NDC,5280048816,LUBRIDERM DAILY MOISTURE LOTION,0.04,0.03,0.01,0.04,22
NDC,5280048826,LUBRIDERM DAILY MOISTURE LOTION,0.04,0.03,0.01,0.04,22
NDC,5281711710,PRIMIDONE 125 MG TABLET,3.96,2.57,0.67,3.96,22
NDC,5281727130,BISOPROLOL FUMARATE 10 MG TABLET,4.5,2.93,0.76,4.5,22
NDC,5281736410,TRIAMTERENE 50 MG CAPSULE,23.88,15.52,4.01,23.88,22
NDC,5281761004,CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,156.56,101.76,26.3,156.56,22
NDC,5281761104,CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,263.6,171.34,44.28,263.6,22
NDC,5281781154,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.14,0.09,0.02,0.14,22
NDC,5281781615,ACETIC ACID 2 % EAR SOLUTION,6.4,4.16,1.08,6.4,22
NDC,5281781701,HYDROCORTISONE-PRAMOXINE 2.5 %-1 % RECTAL CREAM,10.48,6.81,1.76,10.48,22
NDC,5293700340,VASCEPA 0.5 GRAM CAPSULE,4.14,2.69,0.7,4.14,22
NDC,5319136201,CHOLECALCIFEROL (VITAMIN D3) 1250 MCG (50000 UNIT) CAPSULE,0.36,0.23,0.06,0.36,22
NDC,53276101001,AVITENE TOPICAL POWDER IN PACKET,289.2,187.98,48.59,289.2,22
NDC,53276101002,AVITENE FLOUR TOPICAL POWDER,456.0,296.4,76.61,456.0,22
NDC,53276101009,AVITENE 70 MM X 35 MM TOPICAL SHEETS,456.0,296.4,76.61,456.0,22
NDC,53276101015,ENDO AVITENE 10 MM TOPICAL SHEETS,480.0,312.0,80.64,480.0,22
NDC,53276101026,ENDO AVITENE 5 MM TOPICAL SHEETS,288.0,187.2,48.38,288.0,22
NDC,53276105003,ULTRAFOAM 8 CM X 6.25 CM X 1 CM SPONGE,132.0,85.8,22.18,132.0,22
NDC,53276105004,ULTRAFOAM 8 CM X 12.5 CM X 1 CM SPONGE,192.0,124.8,32.26,192.0,22
NDC,5332906801,PETROLEUM JELLY TOPICAL,0.64,0.42,0.11,0.64,22
NDC,5332941059,MEDIPLAST CORN-CALLUS-WART REMOVER 40 % TOPICAL PATCH,2.4,1.56,0.4,2.4,22
NDC,5332977144,SENSI-CARE PROTECTIVE BARRIER 15 %-49 % TOPICAL OINTMENT,0.12,0.08,0.02,0.12,22
NDC,5332977414,MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,0.22,0.14,0.04,0.22,22
NDC,5332994675,POVIDONE-IODINE 10 % TOPICAL SWAB,0.42,0.27,0.07,0.42,22
NDC,5343608430,VELTASSA 8.4 GRAM ORAL POWDER PACKET,85.2,55.38,14.31,85.2,22
NDC,5346200315,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,0.03,0.02,0.01,0.03,22
NDC,5346270520,CHLORHEXIDINE GLUCONATE 2 % TOWELETTE,3.28,2.13,0.55,3.28,22
NDC,5348914101,QUINIDINE GLUCONATE ER 324 MG TABLETEXTENDED RELEASE,18.12,11.78,3.04,18.12,22
NDC,5348914801,THIORIDAZINE 10 MG TABLET,1.08,0.7,0.18,1.08,22
NDC,5348917601,ALBUTEROL SULFATE 2 MG TABLET,11.76,7.64,1.98,11.76,22
NDC,5348933001,IMIPRAMINE 10 MG TABLET,0.86,0.56,0.14,0.86,22
NDC,5348937001,FELODIPINE ER 10 MG TABLETEXTENDED RELEASE 24 HR,5.44,3.54,0.91,5.44,22
NDC,5348937601,TRIMETHOBENZAMIDE 300 MG CAPSULE,3.28,2.13,0.55,3.28,22
NDC,5348938601,MINOXIDIL 2.5 MG TABLET,1.18,0.77,0.2,1.18,22
NDC,5348938701,MINOXIDIL 10 MG TABLET,2.58,1.68,0.43,2.58,22
NDC,5348947801,SULINDAC 150 MG TABLET,1.96,1.27,0.33,1.96,22
NDC,5348947901,SULINDAC 200 MG TABLET,2.42,1.57,0.41,2.42,22
NDC,5348955101,PROPAFENONE 150 MG TABLET,3.28,2.13,0.55,3.28,22
NDC,5374627101,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,5374627205,SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,2.3,1.5,0.39,2.3,22
NDC,5402385876,Q-GEL MEGA 100 MG-150 UNIT CAPSULE,1.24,0.81,0.21,1.24,22
NDC,5402392937,LIQ-10 100 MG/5 ML ORAL SYRUP,0.65,0.42,0.11,0.65,22
NDC,5402399617,ACTIVE Q 100 MG/5 ML ORAL SUSPENSION,1.15,0.75,0.19,1.15,22
NDC,5409206301,AGRYLIN 0.5 MG CAPSULE,19.84,12.9,3.33,19.84,22
NDC,5409217112,CARBATROL 100 MG CAPSULE EXTENDED RELEASE,4.26,2.77,0.72,4.26,22
NDC,5409218981,PENTASA 250 MG CAPSULECONTROLLED RELEASE,7.28,4.73,1.22,7.28,22
NDC,5409225290,FOSRENOL 500 MG CHEWABLE TABLET,28.82,18.73,4.84,28.82,22
NDC,5409225490,FOSRENOL 1000 MG CHEWABLE TABLET,28.82,18.73,4.84,28.82,22
NDC,5409238901,ADDERALL XR 25 MG CAPSULEEXTENDED RELEASE,17.1,11.12,2.87,17.1,22
NDC,5409239101,ADDERALL XR 30 MG CAPSULEEXTENDED RELEASE,17.1,11.12,2.87,17.1,22
NDC,5409247612,LIALDA 1.2 GRAM TABLETDELAYED RELEASE,22.46,14.6,3.77,22.46,22
NDC,5409251702,INTUNIV ER 3 MG TABLETEXTENDED RELEASE,23.32,15.16,3.92,23.32,22
NDC,5409251902,INTUNIV ER 4 MG TABLETEXTENDED RELEASE,23.32,15.16,3.92,23.32,22
NDC,5409270001,ELAPRASE 6 MG/3 ML INTRAVENOUS SOLUTION,3875.88,2519.32,488.6,12697.64,50
NDC,5409270104,VPRIV 400 UNIT INTRAVENOUS SOLUTION,5418.03,3521.72,331.06,5646.0,53
NDC,5409270202,FIRAZYR 30 MG/3 ML SUBCUTANEOUS SYRINGE,13377.0,8695.05,122.75,13377.0,42
NDC,5409270203,FIRAZYR 30 MG/3 ML SUBCUTANEOUS SYRINGE,13377.0,8695.05,122.75,13377.0,42
NDC,5428810301,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,52.5,34.13,2.11,52.5,30
NDC,5428810310,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,52.5,34.13,2.11,52.5,30
NDC,5428810515,ABLYSINOL 99 % INTRA-ARTERIAL SOLUTION,599.7,389.81,100.75,599.7,22
NDC,5428811105,HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,388.5,252.53,65.27,388.5,23
NDC,5428812001,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,28.5,18.53,2.11,28.5,30
NDC,5428812701,TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,163.89,106.53,27.53,163.89,22
NDC,5428812710,TETRACAINE HCL (PF) 1 % (10 MG/ML) INJECTION SOLUTION,163.89,106.53,27.53,163.89,22
NDC,5428816401,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,12.4,8.06,2.08,12.4,30
NDC,5428816501,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,8.72,5.67,1.46,8.72,30
NDC,5428816601,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,7.44,4.84,1.25,8.11,30
NDC,5428816701,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,6.03,3.92,1.01,8.11,30
NDC,5429530815,UREA 40 % TOPICAL CREAM,7.3,4.75,1.23,7.3,22
NDC,5429530824,UREA 40 % TOPICAL CREAM,3.78,2.46,0.64,3.78,22
NDC,5429530825,UREA 40 % TOPICAL CREAM,1.74,1.13,0.29,1.74,22
NDC,5448205401,MATULANE 50 MG CAPSULE,424.18,275.72,71.26,424.18,22
NDC,5448214407,CARNITOR 330 MG TABLET,3.1,2.02,0.52,3.1,22
NDC,5448214701,CARNITOR 200 MG/ML INTRAVENOUS SOLUTION,27.99,18.19,4.7,64.39,31
NDC,54629085401,MAGNESIUM (OXIDE/AA CHELATE) 300 MG CAPSULE,0.2,0.13,0.03,0.2,22
NDC,54629409760,ACETYLCYSTEINE 600 MG CAPSULE,0.24,0.16,0.04,0.24,22
NDC,5464356461,INFUVITE PEDIATRIC 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLUTION,17.31,11.25,2.91,17.31,22
NDC,5464356491,INFUVITE ADULT 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION,96.3,62.6,16.18,96.3,22
NDC,5464356502,INFUVITE ADULT 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION,5.13,3.33,0.86,5.13,22
NDC,5473898001,GUAIFENESIN 200 MG TABLET,0.04,0.03,0.01,0.04,22
NDC,5475800628,SWEET CHEEKS 1.2 GRAM/3 ML (40 %) ORAL GEL IN SYRINGE (ORAL USE ONLY),2.6,1.69,0.44,2.6,22
NDC,5476609306,RIDAURA 3 MG CAPSULE,62.64,40.72,10.52,62.64,22
NDC,5482800101,NEURACEQ 8.1 MCI (300 MBQ) INTRAVENOUS SOLUTION,6200.0,4030.0,1273.76,5580.0,36
NDC,5483800180,FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL ELIXIR,0.1,0.07,0.02,0.1,22
NDC,5483850115,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,6.68,4.34,1.12,6.68,22
NDC,5483850140,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,1.13,0.73,0.19,1.13,22
NDC,5483850280,HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,1.4,0.91,0.24,1.4,22
NDC,5483850615,HYOSYNE 0.125 MG/ML ORAL DROPS,6.68,4.34,1.12,6.68,22
NDC,5483851080,OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,0.28,0.18,0.05,0.28,22
NDC,5483851240,DOXEPIN 10 MG/ML ORAL CONCENTRATE,5.23,3.4,0.88,5.23,22
NDC,5487900101,ETHAMBUTOL 100 MG TABLET,0.92,0.6,0.15,0.92,22
NDC,5499500701,CAMPHO-PHENIQUE 10.8 %-4.7 % TOPICAL SOLUTION,0.3,0.2,0.05,0.3,22
NDC,5511112506,CIPROFLOXACIN 100 MG TABLET,30.44,19.79,5.11,30.44,22
NDC,5511117001,OXAPROZIN 600 MG TABLET,7.32,4.76,1.23,7.32,22
NDC,5511117915,TIZANIDINE 2 MG TABLET,2.44,1.59,0.41,2.44,22
NDC,5511128130,LEVOFLOXACIN 750 MG TABLET,50.16,32.6,8.43,50.16,22
NDC,5511129109,SUMATRIPTAN 25 MG TABLET,54.1,35.17,9.09,54.1,22
NDC,5511132001,GLIMEPIRIDE 1 MG TABLET,0.8,0.52,0.13,0.8,22
NDC,5511132101,GLIMEPIRIDE 2 MG TABLET,1.3,0.85,0.22,1.3,22
NDC,5511135460,RIVASTIGMINE 4.5 MG CAPSULE,8.48,5.51,1.42,8.48,22
NDC,5511164101,MEPROBAMATE 400 MG TABLET,16.5,10.73,2.77,16.5,22
NDC,5511168405,IBU 800 MG TABLET,0.62,0.4,0.1,0.62,22
NDC,5511168852,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,30.12,19.58,5.06,30.12,31
NDC,5511176260,VALGANCICLOVIR 450 MG TABLET,128.8,83.72,21.64,128.8,22
NDC,5513513201,TRODELVY 180 MG INTRAVENOUS SOLUTION,12304.8,7998.12,30.69,12304.8,52
NDC,5515011310,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,24.63,16.01,0.9,24.63,31
NDC,5515011420,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,47.76,31.04,0.9,47.76,31
NDC,5515011620,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,23.22,15.09,1.91,23.22,31
NDC,5515011720,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,43.8,28.47,1.91,43.8,31
NDC,5515011930,PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION,10.8,7.02,0.95,10.8,31
NDC,5515012030,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,19.8,12.87,0.95,19.8,31
NDC,5515012215,NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,43.5,28.28,0.11,43.5,30
NDC,5515012715,OXACILLIN 1 GRAM SOLUTION FOR INJECTION,43.5,28.28,1.01,43.5,31
NDC,5515015411,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,4.8,3.12,0.05,4.8,31
NDC,5515016102,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,4.62,3.0,0.03,4.62,23
NDC,5515016402,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,6.75,4.39,0.03,6.75,23
NDC,5515016505,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,2.16,1.4,0.03,2.16,23
NDC,5515016613,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLUTION,55.2,35.88,9.27,55.2,22
NDC,5515016910,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,1.08,0.7,0.01,1.08,31
NDC,5515017301,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,79.2,51.48,13.31,97.32,23
NDC,5515017305,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,79.2,51.48,13.31,97.32,23
NDC,5515019183,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,500.01,325.01,24.97,500.01,37
NDC,5515019410,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,2.64,1.72,0.44,2.64,22
NDC,5515019699,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,2.16,1.4,0.06,2.16,31
NDC,5515019720,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,1.02,0.66,0.06,1.02,31
NDC,5515021899,EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,5.4,3.51,1.35,28.24,32
NDC,5515022110,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,2.88,1.87,0.48,2.88,22
NDC,5515022310,METHOCARBAMOL 100 MG/ML INJECTION SOLUTION,3.6,2.34,0.6,12.55,31
NDC,5515023410,POLYMYXIN B SULFATE 500000 UNIT SOLUTION FOR INJECTION,52.5,34.13,8.82,52.5,22
NDC,5515023510,VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,19.8,12.87,3.33,19.8,22
NDC,5515025110,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.96,0.62,0.03,0.96,23
NDC,5515025410,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,1.38,0.9,0.03,1.38,23
NDC,5515025520,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,0.75,0.49,0.03,0.75,23
NDC,5515026705,FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION,108.0,70.2,8.75,108.0,31
NDC,5515029901,FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION,234.0,152.1,0.6,234.0,41
NDC,5515031825,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,104.01,67.61,17.47,104.01,31
NDC,5515031925,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,59.58,38.73,10.01,65.76,31
NDC,5515033001,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SYRINGE,252.0,163.8,1.42,252.0,23
NDC,5515033701,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,201.6,131.04,1.86,201.6,36
NDC,5515034510,NALOXONE 1 MG/ML INJECTION SYRINGE,56.7,36.86,0.13,56.7,30
NDC,5515035401,IRINOTECAN 300 MG/15 ML INTRAVENOUS SOLUTION,32.0,20.8,1.95,32.0,30
NDC,5529213801,SIGNIFOR LAR 60 MG IM SUSPENSION,78332.04,50915.83,479.84,78332.04,52
NDC,5529214301,SIGNIFOR LAR 60 MG IM SUSPENSION,78332.04,50915.83,479.84,78332.04,52
NDC,5529220111,CHEMET 100 MG CAPSULE,52.88,34.37,8.88,52.88,22
NDC,5529270255,PANHEMATIN 350 MG INTRAVENOUS SOLUTION,41137.77,26739.55,28.22,41137.77,53
NDC,5551300204,ARANESP 25 MCG/ML (IN POLYSORBATE) INJECTION,696.6,452.79,2.61,696.6,46
NDC,5551300304,ARANESP 40 MCG/ML (IN POLYSORBATE) INJECTION,1114.56,724.46,2.61,1114.56,46
NDC,5551300404,ARANESP 60 MCG/ML (IN POLYSORBATE) INJECTION,1671.84,1086.7,2.61,1671.84,46
NDC,5551300504,ARANESP 100 MCG/ML (IN POLYSORBATE) INJECTION,2786.4,1811.16,2.61,2786.4,49
NDC,5551300601,ARANESP 200 MCG/ML (IN POLYSORBATE) INJECTION,5572.8,3622.32,2.61,5572.8,52
NDC,5551302101,ARANESP 40 MCG/0.4 ML (IN POLYSORBATE) INJECTION SYRINGE,2786.4,1811.16,2.61,2786.4,49
NDC,5551302104,ARANESP 40 MCG/0.4 ML (IN POLYSORBATE) INJECTION SYRINGE,2786.4,1811.16,2.61,2786.4,49
NDC,5551302301,ARANESP 60 MCG/0.3 ML (IN POLYSORBATE) INJECTION SYRINGE,5572.8,3622.32,2.61,5572.8,52
NDC,5551302304,ARANESP 60 MCG/0.3 ML (IN POLYSORBATE) INJECTION SYRINGE,5572.8,3622.32,2.61,5572.8,52
NDC,5551302501,ARANESP 100 MCG/0.5 ML (IN POLYSORBATE) INJECTION SYRINGE,5572.8,3622.32,2.61,5572.8,52
NDC,5551302504,ARANESP 100 MCG/0.5 ML (IN POLYSORBATE) INJECTION SYRINGE,5572.8,3622.32,2.61,5572.8,52
NDC,5551302701,ARANESP 150 MCG/0.3 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.61,13932.0,52
NDC,5551302704,ARANESP 150 MCG/0.3 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.61,13932.0,52
NDC,5551302801,ARANESP 200 MCG/0.4 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.61,13932.0,52
NDC,5551303201,ARANESP 500 MCG/ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.61,13932.0,52
NDC,5551305701,ARANESP 25 MCG/0.42 ML (IN POLYSORBATE) INJECTION SYRINGE,1658.58,1078.08,2.61,1658.58,46
NDC,5551305704,ARANESP 25 MCG/0.42 ML (IN POLYSORBATE) INJECTION SYRINGE,1658.58,1078.08,2.61,1658.58,46
NDC,5551305901,IMDELLTRA 1 MG INTRAVENOUS SOLUTION,7200.0,4680.0,1545.0,7200.0,52
NDC,5551307330,SENSIPAR 30 MG TABLET,64.54,41.95,10.84,64.54,22
NDC,5551307701,IMDELLTRA 10 MG INTRAVENOUS SOLUTION,72000.0,46800.0,1545.0,72000.0,52
NDC,5551307801,IMLYGIC 10EXP6 (1 MILLION) PFU/ML SUSPENSION FOR INJECTION,335.36,217.98,60.12,3407.66,46
NDC,5551307901,IMLYGIC 10EXP8 (100 MILLION) PFU/ML SUSPENSION FOR INJECTION,33531.8,21795.67,60.12,33531.8,52
NDC,5551311101,ARANESP 300 MCG/0.6 ML (IN POLYSORBATE) INJECTION SYRINGE,13932.0,9055.8,2.61,13932.0,52
NDC,5551311201,TEZSPIRE 210 MG/1.91 ML (110 MG/ML) SUBCUTANEOUS SYRINGE,8234.7,5352.56,16.02,8234.7,53
NDC,5551312301,TEZSPIRE 210 MG/1.91 ML (110 MG/ML) SUBCUTANEOUS PEN INJECTOR,8811.84,5727.7,16.02,8811.84,53
NDC,5551312601,EPOGEN 2000 UNIT/ML INJECTION SOLUTION,119.37,77.59,7.45,119.37,46
NDC,5551312610,EPOGEN 2000 UNIT/ML INJECTION SOLUTION,119.37,77.59,7.45,119.37,46
NDC,5551313201,KANJINTI 420 MG INTRAVENOUS SOLUTION,18279.28,11881.53,15.91,18279.28,52
NDC,5551313760,OTEZLA 30 MG TABLET,212.94,138.41,35.77,212.94,22
NDC,5551314101,KANJINTI 150 MG INTRAVENOUS SOLUTION,6528.32,4243.41,15.91,6528.32,52
NDC,5551314401,EPOGEN 10000 UNIT/ML INJECTION SOLUTION,596.88,387.97,7.45,596.88,46
NDC,5551314410,EPOGEN 10000 UNIT/ML INJECTION SOLUTION,596.88,387.97,7.45,596.88,46
NDC,5551314801,EPOGEN 4000 UNIT/ML INJECTION SOLUTION,238.74,155.18,7.45,238.74,46
NDC,5551314810,EPOGEN 4000 UNIT/ML INJECTION SOLUTION,238.74,155.18,7.45,238.74,46
NDC,5551315001,BLINCYTO 35 MCG INTRAVENOUS SOLUTION,26672.48,17337.11,130.82,26672.48,52
NDC,5551316001,BLINCYTO 35 MCG INTRAVENOUS KIT,26672.48,17337.11,130.82,26672.48,52
NDC,5551318001,BKEMV 300 MG/30 ML INTRAVENOUS SOLUTION,939.32,610.56,42.34,943.43,39
NDC,5551319001,NEULASTA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,38507.94,25030.16,27.11,38507.94,53
NDC,5551319201,NEULASTA ONPRO 6 MG/0.6 ML WITH WEARABLE SUBCUTANEOUS INJECTOR,38507.94,25030.16,27.11,38507.94,53
NDC,5551320601,MVASI 25 MG/ML INTRAVENOUS SOLUTION,837.28,544.23,23.84,837.28,46
NDC,5551320701,MVASI 25 MG/ML INTRAVENOUS SOLUTION,837.28,544.23,23.84,837.28,46
NDC,5551320901,NEUPOGEN 480 MCG/0.8 ML INJECTION SYRINGE,2391.45,1554.44,0.89,2391.45,47
NDC,5551320910,NEUPOGEN 480 MCG/0.8 ML INJECTION SYRINGE,2391.42,1554.42,0.89,2391.42,47
NDC,5551320991,NEUPOGEN 480 MCG/0.8 ML INJECTION SYRINGE,2391.45,1554.44,0.89,2391.45,47
NDC,5551322101,NPLATE 250 MCG SUBCUTANEOUS SOLUTION,9910.86,6442.06,10.11,9910.86,52
NDC,5551322201,NPLATE 500 MCG SUBCUTANEOUS SOLUTION,19821.66,12884.08,10.11,19821.66,52
NDC,5551322301,NPLATE 125 MCG SUBCUTANEOUS SOLUTION,4955.52,3221.09,10.11,4955.52,49
NDC,5551322401,RIABNI 10 MG/ML INTRAVENOUS SOLUTION,258.06,167.74,20.89,1355.53,46
NDC,5551326701,EPOGEN 3000 UNIT/ML INJECTION SOLUTION,179.07,116.4,7.45,179.07,46
NDC,5551326710,EPOGEN 3000 UNIT/ML INJECTION SOLUTION,179.07,116.4,7.45,179.07,46
NDC,5551328301,EPOGEN 20000 UNIT/2 ML INJECTION SOLUTION,596.88,387.97,7.45,596.88,46
NDC,5551332601,RIABNI 10 MG/ML INTRAVENOUS SOLUTION,258.06,167.74,20.89,1355.53,46
NDC,5551347801,EPOGEN 20000 UNIT/ML INJECTION SOLUTION,1193.76,775.94,7.45,1193.76,46
NDC,5551347810,EPOGEN 20000 UNIT/ML INJECTION SOLUTION,1193.76,775.94,7.45,1193.76,46
NDC,5551353001,NEUPOGEN 300 MCG/ML INJECTION SOLUTION,1133.4,736.71,0.89,1133.4,47
NDC,5551353010,NEUPOGEN 300 MCG/ML INJECTION SOLUTION,1133.4,736.71,0.89,1133.4,47
NDC,5551354601,NEUPOGEN 480 MCG/1.6 ML INJECTION SOLUTION,1128.0,733.2,0.89,1128.0,47
NDC,5551354610,NEUPOGEN 480 MCG/1.6 ML INJECTION SOLUTION,1128.0,733.2,0.89,1128.0,47
NDC,5551367001,AVSOLA 100 MG INTRAVENOUS SOLUTION,2400.0,1560.0,21.29,2400.0,47
NDC,5551371001,PROLIA 60 MG/ML SUBCUTANEOUS SYRINGE,6751.56,4388.51,22.67,6751.56,53
NDC,5551371021,PROLIA 60 MG/ML SUBCUTANEOUS SYRINGE,6751.56,4388.51,22.67,6751.56,53
NDC,5551373001,XGEVA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,7305.33,4748.46,22.67,7305.33,53
NDC,5551373021,XGEVA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,7305.33,4748.46,22.67,7305.33,53
NDC,5551380060,CORLANOR 5 MG TABLET,25.04,16.28,4.21,25.04,22
NDC,5551381328,CORLANOR 5 MG/5 ML ORAL SOLUTION,6.25,4.06,1.05,6.25,22
NDC,5551388002,EVENITY 210 MG/2.34 ML (105 MG/1.17 ML X 2) SUBCUTANEOUS SYRINGE,4044.48,2628.91,9.62,4044.48,50
NDC,5551392401,NEUPOGEN 300 MCG/0.5 ML INJECTION SYRINGE,2402.64,1561.72,0.89,2402.64,47
NDC,5551392410,NEUPOGEN 300 MCG/0.5 ML INJECTION SYRINGE,2402.67,1561.74,0.89,2402.67,47
NDC,5551392491,NEUPOGEN 300 MCG/0.5 ML INJECTION SYRINGE,2402.64,1561.72,0.89,2402.64,47
NDC,5551395401,VECTIBIX 100 MG/5 ML (20 MG/ML) INTRAVENOUS SOLUTION,1739.2,1130.48,136.11,3236.72,47
NDC,5551395601,VECTIBIX 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,1739.2,1130.48,136.11,3236.72,47
NDC,5551399802,EVENITY 210 MG/2.34 ML (105 MG/1.17 ML X 2) SUBCUTANEOUS SYRINGE,4044.48,2628.91,9.62,4044.48,50
NDC,5556610501,ADSTILADRIN 3X10EXP11 VP/ML INTRAVESICAL SUSPENSION,73080.0,47502.0,14450.94,177874.06,52
NDC,5556615021,NOVAREL 5000 UNIT INTRAMUSCULAR SOLUTION,607.65,394.97,20.96,607.65,31
NDC,5556628001,CERVIDIL 10 MG VAGINAL INSERTCONTROLLED RELEASE,1320.44,858.29,221.83,1320.44,22
NDC,5556641001,EUFLEXXA 10 MG/ML (MW 2.4-3.6 MILLION) INTRA-ARTICULAR SYRINGE,649.14,421.94,74.0,649.14,47
NDC,5556665003,ENDOMETRIN 100 MG VAGINAL INSERT,35.38,23.0,5.94,35.38,22
NDC,5556683031,FIRMAGON KIT WITH DILUENT SYRINGE 80 MG SUBCUTANEOUS SOLUTION,1758.42,1142.97,3.92,1758.42,47
NDC,5556684031,FIRMAGON KIT WITH DILUENT SYRINGE 120 MG SUBCUTANEOUS SOLUTION,3658.04,2377.73,3.92,3658.04,50
NDC,5556698000,REBYOTA 150 ML ENEMA,148.36,96.43,38.43,3407.66,47
NDC,5556698002,REBYOTA 150 ML ENEMA,148.36,96.43,38.43,3407.66,47
NDC,5579200710,ELLIOTTS B (PF) 73 MG-19 MG-8 MG-3 MG/10 ML INTRATHECAL SOLUTION,37.8,24.57,6.35,37.8,22
NDC,56151146001,TRUE METRIX GLUCOSE TEST STRIP,1.24,0.81,0.21,1.24,22
NDC,56151161211,TRUEPLUS GLUCOSE 4 GRAM CHEWABLE TABLET,0.4,0.26,0.07,0.4,22
NDC,56151162501,TRUEPLUS GLUCOSE 15 GRAM/32 ML ORAL GEL PACKET,0.33,0.21,0.06,0.33,22
NDC,5618412105,LITTLE NOSES 0.125 % NASAL DROPS,0.74,0.48,0.12,0.74,22
NDC,5707400177,DOMEBORO 952 MG-1347 MG TOPICAL POWDER IN PACKET,1.6,1.04,0.27,1.6,22
NDC,5723700201,HYDROCHLOROTHIAZIDE 12.5 MG CAPSULE,0.86,0.56,0.14,0.86,22
NDC,5723700330,FLUCONAZOLE 50 MG TABLET,11.2,7.28,1.88,11.2,22
NDC,5723700511,FLUCONAZOLE 150 MG TABLET,27.86,18.11,4.68,27.86,22
NDC,5723701106,MIRTAZAPINE 15 MG DISINTEGRATING TABLET,4.72,3.07,0.79,4.72,22
NDC,5723701206,MIRTAZAPINE 30 MG DISINTEGRATING TABLET,4.86,3.16,0.82,4.86,22
NDC,5723704001,PENICILLIN V POTASSIUM 250 MG TABLET,1.7,1.11,0.29,1.7,22
NDC,5723704101,PENICILLIN V POTASSIUM 500 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,5723705160,GALANTAMINE 12 MG TABLET,6.36,4.13,1.07,6.36,22
NDC,5723707530,ONDANSETRON HCL 4 MG TABLET,49.56,32.21,8.33,49.56,22
NDC,5723707630,ONDANSETRON HCL 8 MG TABLET,78.66,51.13,13.21,78.66,22
NDC,5723707710,ONDANSETRON 4 MG DISINTEGRATING TABLET,44.56,28.96,7.49,44.56,22
NDC,5723707730,ONDANSETRON 4 MG DISINTEGRATING TABLET,44.58,28.98,7.49,44.58,22
NDC,5723708763,RIZATRIPTAN 5 MG TABLET,63.26,41.12,10.63,63.26,22
NDC,5723710101,METOPROLOL TARTRATE 50 MG TABLET,1.12,0.73,0.19,1.12,22
NDC,5723710199,METOPROLOL TARTRATE 50 MG TABLET,1.08,0.7,0.18,1.08,22
NDC,5723710201,METOPROLOL TARTRATE 100 MG TABLET,1.6,1.04,0.27,1.6,22
NDC,5723710299,METOPROLOL TARTRATE 100 MG TABLET,1.52,0.99,0.26,1.52,22
NDC,5723711490,ALFUZOSIN ER 10 MG TABLETEXTENDED RELEASE 24 HR,8.42,5.47,1.41,8.42,22
NDC,5723714935,FLUCONAZOLE 10 MG/ML ORAL SUSPENSION,2.58,1.68,0.43,2.58,22
NDC,5723715630,MOXIFLOXACIN 400 MG TABLET,54.4,35.36,9.14,54.4,22
NDC,5723718190,PRAMIPEXOLE 0.25 MG TABLET,5.9,3.84,0.99,5.9,22
NDC,5723722190,PIOGLITAZONE 45 MG TABLET,23.22,15.09,3.9,23.22,22
NDC,5723722501,RAMIPRIL 10 MG CAPSULE,4.44,2.89,0.75,4.44,22
NDC,5723727424,LAMIVUDINE 10 MG/ML ORAL SOLUTION,1.25,0.81,0.21,1.25,22
NDC,5723732552,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.64,0.42,0.11,0.64,22
NDC,5766447758,METOPROLOL TARTRATE 50 MG TABLET,0.06,0.04,0.01,0.06,22
NDC,5766449918,MIRTAZAPINE 15 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,5766450083,MIRTAZAPINE 30 MG TABLET,0.9,0.59,0.15,0.9,22
NDC,5766450389,TIZANIDINE 4 MG TABLET,2.94,1.91,0.49,2.94,22
NDC,5766464888,CHLORTHALIDONE 25 MG TABLET,0.58,0.38,0.1,0.58,22
NDC,5766465588,PINDOLOL 5 MG TABLET,2.12,1.38,0.36,2.12,22
NDC,5777005500,OCUCOAT 2 % INTRAOCULAR SYRINGE,226.8,147.42,38.1,226.8,22
NDC,5777005501,HYPROMELLOSE 2 % INTRAOCULAR SYRINGE,189.0,122.85,31.75,189.0,22
NDC,5778239726,CROMOLYN 5.2 MG/SPRAY (4 %) NASAL SPRAY,1.0,0.65,0.17,1.0,22
NDC,5782645502,CITRIC ACID-SOD CITPHOS-DEXTROSE 0.327 GRAM-2.63 GRAM/100 ML SOLUTION,0.12,0.08,0.02,0.12,22
NDC,5784413001,ADDERALL 30 MG TABLET,28.16,18.3,4.73,28.16,22
NDC,5789403001,REMICADE 100 MG INTRAVENOUS SOLUTION,4204.14,2732.69,28.5,4204.14,50
NDC,5789405060,AKEEGA 50 MG-500 MG TABLET,765.0,497.25,128.52,765.0,22
NDC,5789405427,STELARA 130 MG/26 ML INTRAVENOUS SOLUTION,293.49,190.77,11.24,3236.72,47
NDC,5789406002,STELARA 45 MG/0.5 ML SUBCUTANEOUS SOLUTION,104945.34,68214.47,137.31,104945.34,43
NDC,5789406003,STELARA 45 MG/0.5 ML SUBCUTANEOUS SYRINGE,104945.34,68214.47,137.31,104945.34,43
NDC,5789406103,STELARA 90 MG/ML SUBCUTANEOUS SYRINGE,104945.25,68214.41,137.31,104945.25,43
NDC,5789407001,SIMPONI 50 MG/0.5 ML SUBCUTANEOUS SYRINGE,45692.85,29700.35,10.62,45692.85,53
NDC,5789407002,SIMPONI 50 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,45692.85,29700.35,7676.4,45692.85,29
NDC,5789407101,SIMPONI 100 MG/ML SUBCUTANEOUS SYRINGE,26273.4,17077.71,10.62,26273.4,53
NDC,5789408060,LAZCLUZE 80 MG TABLET,727.92,473.15,122.29,727.92,22
NDC,5789410060,AKEEGA 100 MG-500 MG TABLET,765.0,497.25,128.52,765.0,22
NDC,5789411101,CARVYKTI 0.5X 10EXP6 TO 1X 10EXP8 CELL INTRAVENOUS SUSPENSION,2665490.12,1732568.58,24125.92,2398941.11,43
NDC,5789411102,CARVYKTI 0.5X 10EXP6 TO 1X 10EXP8 CELL INTRAVENOUS SUSPENSION,2665490.12,1732568.58,24125.92,2398941.11,43
NDC,5789416001,INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,1710.0,1111.5,28.5,1710.0,47
NDC,5789424030,LAZCLUZE 240 MG TABLET,1455.84,946.3,244.58,1455.84,22
NDC,5789435001,SIMPONI ARIA 12.5 MG/ML INTRAVENOUS SOLUTION,1799.28,1169.53,10.62,1799.28,47
NDC,5789444901,TECVAYLI 10 MG/ML SUBCUTANEOUS SOLUTION,3277.64,2130.47,27.69,3277.64,49
NDC,5789445001,TECVAYLI 90 MG/ML SUBCUTANEOUS SOLUTION,29498.96,19174.32,27.69,29498.96,52
NDC,5789446901,TALVEY 2 MG/ML SUBCUTANEOUS SOLUTION,2772.72,1802.27,60.94,3407.66,50
NDC,5789447001,TALVEY 40 MG/ML SUBCUTANEOUS SOLUTION,55454.56,36045.46,60.94,55454.56,53
NDC,5789450101,RYBREVANT 50 MG/ML INTRAVENOUS SOLUTION,2610.28,1696.68,17.99,3407.66,49
NDC,5789450301,DARZALEX FASPRO 1800 MG-30000 UNIT/15 ML SUBCUTANEOUS SOLUTION,2537.25,1649.21,43.92,3236.72,46
NDC,5789450505,DARZALEX 20 MG/ML INTRAVENOUS SOLUTION,744.6,483.99,55.02,3236.72,46
NDC,5789450520,DARZALEX 20 MG/ML INTRAVENOUS SOLUTION,744.6,483.99,55.02,3236.72,46
NDC,5789464001,TREMFYA 100 MG/ML SUBCUTANEOUS SYRINGE,52439.19,34085.47,72.93,52439.19,52
NDC,5789464011,TREMFYA ONE-PRESS 100 MG/ML SUBCUTANEOUS AUTO-INJECTOR,52439.19,34085.47,72.93,52439.19,52
NDC,5789465002,TREMFYA 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,2621.97,1704.28,72.93,5646.0,49
NDC,5789480101,IMAAVY 185 MG/ML INTRAVENOUS SOLUTION,6912.0,4492.8,32.74,6912.0,45
NDC,5789614314,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT TOPICAL OINTMENT PACKET,0.18,0.12,0.03,0.18,22
NDC,5789641501,GERI-KOT 8.6 MG TABLET,0.06,0.04,0.01,0.06,22
NDC,5789646208,SENNA 8.8 MG/5 ML ORAL SYRUP,0.13,0.08,0.02,0.13,22
NDC,5789666116,GERI-TUSSIN DM 10 MG-100 MG/5 ML ORAL LIQUID,0.03,0.02,0.01,0.03,22
NDC,5789670916,FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLUTION,0.03,0.02,0.01,0.03,22
NDC,5789690110,ASPIRIN 325 MG TABLET,0.02,0.01,0.01,0.02,22
NDC,5789692101,ASPIRIN 325 MG TABLETDELAYED RELEASE,0.04,0.03,0.01,0.04,22
NDC,5789692110,ASPIRIN 325 MG TABLETDELAYED RELEASE,0.02,0.01,0.01,0.02,22
NDC,5796200712,IMBRUVICA 70 MG/ML ORAL SUSPENSION,177.4,115.31,29.8,177.4,22
NDC,5796201428,IMBRUVICA 140 MG TABLET,849.42,552.12,142.7,849.42,22
NDC,5796207028,IMBRUVICA 70 MG CAPSULE,849.6,552.24,142.73,849.6,22
NDC,5796214012,IMBRUVICA 140 MG CAPSULE,283.2,184.08,47.58,283.2,22
NDC,5796228028,IMBRUVICA 280 MG TABLET,849.46,552.15,142.71,849.46,22
NDC,5796242028,IMBRUVICA 420 MG TABLET,849.54,552.2,142.72,849.54,22
NDC,5815111088,DILANTIN EXTENDED 100 MG CAPSULE,4.82,3.13,0.81,4.82,22
NDC,5816081052,INFANRIX (DTAP)(PF) 25 LF UNIT-58MCG-10 LF/0.5ML INTRAMUSCULAR SYRINGE,204.72,133.07,17.89,204.72,29
NDC,5816081152,PEDIARIX (PF) 10 MCG-25 LF-25 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE,773.7,502.91,17.89,773.7,29
NDC,5816081252,KINRIX (PF) 25 LF-58 MCG-10 LF/0.5 ML INTRAMUSCULAR SYRINGE,447.93,291.15,17.89,447.93,29
NDC,5816081552,TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE,504.36,327.83,79.26,504.36,29
NDC,5816081912,SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT,775.83,504.29,79.26,775.83,29
NDC,5816082043,ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE,211.38,137.4,17.89,211.38,37
NDC,5816082052,ENGERIX-B PEDIATRIC (PF) 10 MCG/0.5 ML INTRAMUSCULAR SYRINGE,211.38,137.4,17.89,211.38,37
NDC,5816082111,ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SUSPENSION,267.66,173.98,44.97,267.66,37
NDC,5816082152,ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE,267.66,173.98,17.89,267.66,37
NDC,5816082311,SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION KIT,844.89,549.18,79.26,844.89,29
NDC,5816082552,HAVRIX (PF) 720 ELISA UNIT/0.5 ML INTRAMUSCULAR SYRINGE,284.61,185.0,17.89,284.61,29
NDC,5816082652,HAVRIX (PF) 1440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE,319.74,207.83,17.89,319.74,37
NDC,5816082801,SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION,775.83,504.29,79.26,775.83,29
NDC,5816082803,SHINGRIX GE ANTIGEN COMPONENT 50 MCG IM SUSPENSION,844.89,549.18,79.26,844.89,29
NDC,5816084252,BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE,344.82,224.13,17.89,344.82,37
NDC,5816095509,MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS),633.45,411.74,79.26,633.45,29
NDC,5816097602,BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1804.02,1172.61,79.26,1804.02,29
NDC,5816097620,BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1804.02,1172.61,79.26,1804.02,29
NDC,5818130405,GLEOSTINE 10 MG CAPSULE,291.58,189.53,48.99,291.58,22
NDC,5818130415,GLEOSTINE 40 MG CAPSULE,1166.28,758.08,195.94,1166.28,22
NDC,5818130425,GLEOSTINE 100 MG CAPSULE,3219.5,2092.68,540.88,3219.5,22
NDC,5823207213,DESITIN 40 % TOPICAL PASTE,0.1,0.07,0.02,0.1,22
NDC,5828420801,BRIXADI WEEKLY 8 MG/0.16 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,9607.5,6244.88,363.68,9607.5,47
NDC,5828421601,BRIXADI WEEKLY 16 MG/0.32 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,4803.75,3122.44,363.68,4803.75,44
NDC,5828422401,BRIXADI WEEKLY 24 MG/0.48 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,3202.5,2081.63,363.68,3202.5,44
NDC,5828422801,BRIXADI MONTHLY 128 MG/0.36 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,17079.99,11101.99,1454.71,17079.99,47
NDC,5828423201,BRIXADI WEEKLY 32 MG/0.64 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,2401.89,1561.23,363.68,2401.89,41
NDC,5828426401,BRIXADI MONTHLY 64 MG/0.18 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,34160.01,22204.01,1454.71,34160.01,47
NDC,5828429601,BRIXADI MONTHLY 96 MG/0.27 ML SOLUTIONEXTEND.REL. SUBCUT.SYRINGE,22773.33,14802.66,1454.71,22773.33,47
NDC,5839463403,BENEFIX 500 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.58,3407.66,47
NDC,5839463503,BENEFIX 1000 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.58,3407.66,47
NDC,5839463603,BENEFIX 2000 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.58,3407.66,47
NDC,5839463703,BENEFIX 3000 UNIT INTRAVENOUS SOLUTION,6.42,4.17,1.58,3407.66,47
NDC,5840601001,ENBREL 25 MG/0.5 ML (0.5 ML) SUBCUTANEOUS SYRINGE,7341.84,4772.2,303.41,7341.84,42
NDC,5840602104,ENBREL 50 MG/ML (1 ML) SUBCUTANEOUS SYRINGE,7341.84,4772.2,303.41,7341.84,42
NDC,5840603204,ENBREL SURECLICK 50 MG/ML (1 ML) SUBCUTANEOUS PEN INJECTOR,7341.84,4772.2,303.41,7341.84,42
NDC,5840604401,ENBREL MINI 50 MG/ML (1 ML) SUBCUTANEOUS CARTRIDGE,7341.84,4772.2,303.41,7341.84,42
NDC,5840605504,ENBREL 25 MG/0.5 ML SUBCUTANEOUS SOLUTION,7341.84,4772.2,303.41,7341.84,42
NDC,5846800302,THYROGEN 0.9 MG INTRAMUSCULAR SOLUTION,6613.77,4298.95,516.7,6613.77,53
NDC,5846800401,FABRAZYME 35 MG INTRAVENOUS SOLUTION,38699.0,25154.35,196.45,38699.0,53
NDC,5846800411,FABRAZYME 5 MG INTRAVENOUS SOLUTION,5527.48,3592.86,196.45,5646.0,53
NDC,5846800501,XENPOZYME 20 MG INTRAVENOUS SOLUTION,28092.66,18260.23,338.92,28092.66,53
NDC,5846800701,ALDURAZYME 2.9 MG/5 ML INTRAVENOUS SOLUTION,833.7,541.91,33.7,5646.0,47
NDC,5846800801,THYMOGLOBULIN 25 MG INTRAVENOUS SOLUTION,4130.85,2685.05,835.15,4130.85,50
NDC,5846800901,SYNVISC 16 MG/2 ML INTRA-ARTICULAR SYRINGE,821.76,534.14,7.56,821.76,47
NDC,5846800903,SYNVISC-ONE 48 MG/6 ML INTRA-ARTICULAR SYRINGE,821.76,534.14,7.56,821.76,47
NDC,5846801311,RENVELA 2.4 GRAM ORAL POWDER PACKET,42.84,27.85,7.2,42.84,22
NDC,5846801312,RENVELA 2.4 GRAM ORAL POWDER PACKET,42.84,27.85,7.2,42.84,22
NDC,5846801322,RENVELA 0.8 GRAM ORAL POWDER PACKET,42.84,27.85,7.2,42.84,22
NDC,5846801601,LUMIZYME 50 MG INTRAVENOUS SOLUTION,3647.64,2370.97,177.57,18253.82,50
NDC,5846802001,LEMTRADA 12 MG/1.2 ML INTRAVENOUS SOLUTION,118976.96,77335.02,2112.82,118976.96,53
NDC,5846802251,CABLIVI 11 MG INJECTION KIT,32092.38,20860.05,802.25,32092.38,38
NDC,5846804261,NEXVIAZYME 100 MG INTRAVENOUS SOLUTION,7295.25,4741.91,68.4,18253.82,53
NDC,5846846631,CEREZYME 400 UNIT INTRAVENOUS SOLUTION,6305.28,4098.43,39.55,6305.28,53
NDC,5846878203,CAPRELSA 100 MG TABLET,724.06,470.64,121.64,724.06,22
NDC,5846878403,CAPRELSA 300 MG TABLET,1448.1,941.27,243.28,1448.1,22
NDC,5865731016,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,0.23,0.15,0.04,0.23,22
NDC,5865731116,POTAS AND SOD CITRATE-CITRIC ACID 550 MG-500 MG-334 MG/5 ML ORAL SOLN,0.38,0.25,0.06,0.38,22
NDC,5865731216,POTASSIUM CITRATE-CITRIC ACID 1100 MG-334 MG/5 ML ORAL SOLUTION,0.4,0.26,0.07,0.4,22
NDC,5865732250,FLUORIDE 0.5 MG (1.1 MG SODIUM FLUORIDE)/ML ORAL DROPS,0.7,0.46,0.12,0.7,22
NDC,5865752816,M-DRYL 12.5 MG/5 ML ORAL LIQUID,0.1,0.07,0.02,0.1,22
NDC,5865760250,LABETALOL 100 MG TABLET,1.02,0.66,0.17,1.02,22
NDC,5865767601,CIPROFLOXACIN 500 MG TABLET,9.9,6.44,1.66,9.9,22
NDC,5879000330,THERATEARS 1 % GEL IN A DROPPERETTE,1.04,0.68,0.17,1.04,22
NDC,5891450156,CANASA 1000 MG RECTAL SUPPOSITORY,92.94,60.41,15.61,92.94,22
NDC,5898001205,DOUBLE ANTIBIOTIC (BACITRCN ZN) 500 UNIT-10000 UNIT/GRAM TOP OINTMENT,0.62,0.4,0.1,0.62,22
NDC,5898040912,GLYCERIN (CHILD) RECTAL SUPPOSITORY,1.68,1.09,0.28,1.68,22
NDC,5898040925,GLYCERIN (CHILD) RECTAL SUPPOSITORY,1.22,0.79,0.2,1.22,22
NDC,5898041012,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.4,0.26,0.07,0.4,22
NDC,5898041025,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.3,0.2,0.05,0.3,22
NDC,5898060530,UREA 10 % TOPICAL CREAM,0.22,0.14,0.04,0.22,22
NDC,5898060880,UREA 10 % LOTION,0.08,0.05,0.01,0.08,22
NDC,5898082010,CASTELLANI PAINT 1.5 % TOPICAL LIQUID,2.18,1.42,0.37,2.18,22
NDC,5898096012,SONAFINE TOPICAL EMULSION,1.22,0.79,0.2,1.22,22
NDC,5898096031,SONAFINE TOPICAL EMULSION,1.0,0.65,0.17,1.0,22
NDC,5901141020,OXYCONTIN 10 MG TABLETCRUSH RESISTANTEXTENDED RELEASE,15.14,9.84,2.54,15.14,22
NDC,5901141510,OXYCONTIN 15 MG TABLETCRUSH RESISTANTEXTENDED RELEASE,21.72,14.12,3.65,21.72,22
NDC,5901141520,OXYCONTIN 15 MG TABLETEXTENDED RELEASE,22.28,14.48,3.74,22.28,22
NDC,5901142010,OXYCONTIN 20 MG TABLETCRUSH RESISTANTEXTENDED RELEASE,27.52,17.89,4.62,27.52,22
NDC,5901142020,OXYCONTIN 20 MG TABLETEXTENDED RELEASE,28.22,18.34,4.74,28.22,22
NDC,5901144010,OXYCONTIN 40 MG TABLETEXTENDED RELEASE,47.12,30.63,7.92,47.12,22
NDC,5901144020,OXYCONTIN 40 MG TABLETEXTENDED RELEASE,48.32,31.41,8.12,48.32,22
NDC,5901148020,OXYCONTIN 80 MG TABLETEXTENDED RELEASE,84.34,54.82,14.17,84.34,22
NDC,5901175104,BUTRANS 10 MCG/HOUR TRANSDERMAL PATCH,184.9,120.19,31.06,184.9,22
NDC,5901642019,MAGTAB 84 MG TABLETEXTENDED RELEASE,0.84,0.55,0.14,0.84,22
NDC,5913723101,GLEOLAN 30 MG/ML ORAL SOLUTION,9588.0,6232.2,1610.78,9588.0,22
NDC,5914800613,ABILIFY 2 MG TABLET,46.7,30.36,7.85,46.7,22
NDC,5914800713,ABILIFY 5 MG TABLET,46.7,30.36,7.85,46.7,22
NDC,5914800813,ABILIFY 10 MG TABLET,46.7,30.36,7.85,46.7,22
NDC,5914801870,ABILIFY MAINTENA 300 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,7842.0,5097.3,6.13,7842.0,53
NDC,5914801970,ABILIFY MAINTENA 400 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,10455.99,6796.39,6.13,10455.99,53
NDC,5914801971,ABILIFY MAINTENA 400 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,10455.99,6796.39,6.13,10455.99,53
NDC,5914802050,SAMSCA 15 MG TABLET,1248.48,811.51,209.74,1248.48,22
NDC,5914802150,SAMSCA 30 MG TABLET,1295.14,841.84,217.58,1295.14,22
NDC,5914803513,REXULTI 0.25 MG TABLET,121.26,78.82,20.37,121.26,22
NDC,5914803613,REXULTI 0.5 MG TABLET,121.26,78.82,20.37,121.26,22
NDC,5914803713,REXULTI 1 MG TABLET,121.26,78.82,20.37,121.26,22
NDC,5914803813,REXULTI 2 MG TABLET,121.26,78.82,20.37,121.26,22
NDC,5914803913,REXULTI 3 MG TABLET,121.26,78.82,20.37,121.26,22
NDC,5914804013,REXULTI 4 MG TABLET,121.26,78.82,20.37,121.26,22
NDC,5914804580,ABILIFY MAINTENA 300 MG SUSPENSIONEXTENDED REL. INTRAMUSCULAR SYRINGE,7842.0,5097.3,6.13,7842.0,53
NDC,5914807280,ABILIFY MAINTENA 400 MG SUSPENSIONEXTENDED REL. INTRAMUSCULAR SYRINGE,10455.99,6796.39,6.13,10455.99,53
NDC,5914811480,ABILIFY ASIMTUFII 960 MG/3.2 ML SUSPENSION EXTEND.REL. IM SYRINGE,6534.99,4247.74,5.23,6534.99,53
NDC,5914823212,ABILIFY MAINTENA 300 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,7842.0,5097.3,6.13,7842.0,53
NDC,5914824512,ABILIFY MAINTENA 400 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,10455.99,6796.39,6.13,10455.99,53
NDC,5921200201,DYRENIUM 50 MG CAPSULE,35.62,23.15,5.98,35.62,22
NDC,5921200301,DYRENIUM 100 MG CAPSULE,35.62,23.15,5.98,35.62,22
NDC,5921242304,DONNATAL 16.2 MG-0.1037 MG-0.0194 MG/5 ML ORAL ELIXIR,13.05,8.48,2.19,13.05,22
NDC,5921270112,ORAPRED ODT 15 MG DISINTEGRATING TABLET,74.4,48.36,12.5,74.4,22
NDC,5931030240,QVAR REDIHALER 40 MCG/ACTUATION HFA BREATH ACTIVATED AEROSOL,49.58,32.23,8.33,49.58,22
NDC,5931030480,QVAR REDIHALER 80 MCG/ACTUATION HFA BREATH ACTIVATED AEROSOL,66.4,43.16,11.16,66.4,22
NDC,5931061031,CINQAIR 10 MG/ML INTRAVENOUS SOLUTION,408.96,265.82,9.2,943.43,47
NDC,5931610212,BIOFREEZE (MENTHOL) 4 % TOPICAL GEL,0.2,0.13,0.03,0.2,22
NDC,5931611520,BIOFREEZE (MENTHOL) 5 % TOPICAL GEL,0.18,0.12,0.03,0.18,22
NDC,5931620510,BIOFREEZE (MENTHOL) 4 % TOPICAL GEL,0.22,0.14,0.04,0.22,22
NDC,5933877501,FERAHEME 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,252.78,164.31,0.34,252.78,47
NDC,5936551291,PARAGARD T380A (SINGLE HAND) 380 SQUARE MM INTRAUTERINE DEVICE,2732.0,1775.8,61.99,3252.38,32
NDC,5938502160,BELBUCA 75 MCG BUCCAL FILM,18.06,11.74,3.03,18.06,22
NDC,5938502260,BELBUCA 150 MCG BUCCAL FILM,18.06,11.74,3.03,18.06,22
NDC,5938502360,BELBUCA 300 MCG BUCCAL FILM,28.36,18.43,4.76,28.36,22
NDC,5938502460,BELBUCA 450 MCG BUCCAL FILM,38.54,25.05,6.47,38.54,22
NDC,5939003613,12 HOUR NASAL RELIEF SPRAY 0.05 %,0.48,0.31,0.08,0.48,22
NDC,5939017535,EYE WASH STERILE SOLUTION,0.09,0.06,0.02,0.09,22
NDC,5939020505,FLUORESCEIN 0.25 %-PROPARACAINE 0.5 % EYE DROPS,4.02,2.61,0.68,4.02,22
NDC,5939021805,ALTAFLUOR BENOX 0.25 %-0.4 % EYE DROPS,18.0,11.7,3.02,18.0,22
NDC,5941710210,VYVANSE 20 MG CAPSULE,31.02,20.16,5.21,31.02,22
NDC,5941710310,VYVANSE 30 MG CAPSULE,31.02,20.16,5.21,31.02,22
NDC,5941710510,VYVANSE 50 MG CAPSULE,31.02,20.16,5.21,31.02,22
NDC,5941710710,VYVANSE 70 MG CAPSULE,31.02,20.16,5.21,31.02,22
NDC,5952803312,CALPHRON 667 MG TABLET,0.34,0.22,0.06,0.34,22
NDC,5952844561,NEPHRON FA 66 MG IRON-1000 MCG TABLET,1.24,0.81,0.21,1.24,22
NDC,5957220514,THALOMID 50 MG CAPSULE,410.16,266.6,68.91,410.16,22
NDC,5957221015,THALOMID 100 MG CAPSULE,665.78,432.76,111.85,665.78,22
NDC,5957240228,REVLIMID 2.5 MG CAPSULE,2139.72,1390.82,359.47,2139.72,22
NDC,5957240528,REVLIMID 5 MG CAPSULE,2139.72,1390.82,359.47,2139.72,22
NDC,5957241028,REVLIMID 10 MG CAPSULE,2139.72,1390.82,359.47,2139.72,22
NDC,5957241521,REVLIMID 15 MG CAPSULE,2139.72,1390.82,359.47,2139.72,22
NDC,5957242021,REVLIMID 20 MG CAPSULE,2139.72,1390.82,359.47,2139.72,22
NDC,5957242521,REVLIMID 25 MG CAPSULE,2139.72,1390.82,359.47,2139.72,22
NDC,5957250121,POMALYST 1 MG CAPSULE,2739.54,1780.7,460.24,2739.54,22
NDC,5957250221,POMALYST 2 MG CAPSULE,2739.54,1780.7,460.24,2739.54,22
NDC,5957250321,POMALYST 3 MG CAPSULE,2739.54,1780.7,460.24,2739.54,22
NDC,5957250421,POMALYST 4 MG CAPSULE,2739.54,1780.7,460.24,2739.54,22
NDC,5957251501,ABECMA 300 X 10EXP6 TO 510 X 10EXP6 CELL INTRAVENOUS SUSPENSION,52239.52,33955.69,24125.92,1137429.19,43
NDC,5957251502,ABECMA 300 X 10EXP6 TO 510 X 10EXP6 CELL INTRAVENOUS SUSPENSION,10447.92,6791.15,5223.96,1137429.19,43
NDC,5957251503,ABECMA 300 X 10EXP6 TO 510 X 10EXP6 CELL INTRAVENOUS SUSPENSION,5223.96,3395.57,2611.98,1137429.19,43
NDC,5957270530,IDHIFA 50 MG TABLET,2882.74,1873.78,484.3,2882.74,22
NDC,5957271030,IDHIFA 100 MG TABLET,2882.74,1873.78,484.3,2882.74,22
NDC,5957271101,REBLOZYL 25 MG SUBCUTANEOUS SOLUTION,19743.08,12833.0,35.98,19743.08,53
NDC,5957272012,INREBIC 100 MG CAPSULE,552.0,358.8,92.74,552.0,22
NDC,5957273007,ONUREG 200 MG TABLET,4496.24,2922.56,755.37,4496.24,22
NDC,5957274007,ONUREG 300 MG TABLET,4496.24,2922.56,755.37,4496.24,22
NDC,5957277501,REBLOZYL 75 MG SUBCUTANEOUS SOLUTION,59228.96,38498.82,35.98,59228.96,53
NDC,5957298401,ISTODAX 10 MG/2 ML INTRAVENOUS SOLUTION,15353.52,9979.79,27.49,15353.52,52
NDC,5958413801,CANDIN FDA STANDARD ALLERGEN PREP INTRADERMAL,1155.0,750.75,194.04,1155.0,22
NDC,5962722205,AVONEX 30 MCG/0.5 ML INTRAMUSCULAR SYRINGE KIT,7774.02,5053.11,48.85,7774.02,43
NDC,5963026601,FETROJA 1 GRAM INTRAVENOUS SOLUTION,838.23,544.85,1.96,838.23,47
NDC,5963026610,FETROJA 1 GRAM INTRAVENOUS SOLUTION,838.23,544.85,1.96,838.23,47
NDC,5965101990,NIACIN ER 750 MG TABLETEXTENDED RELEASE 24 HR,12.08,7.85,2.03,12.08,22
NDC,5965102655,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,2.13,1.38,0.36,2.13,22
NDC,5965114601,CARBIDOPA 25 MG TABLET,43.7,28.41,7.34,43.7,22
NDC,5965115201,PROGESTERONE MICRONIZED 100 MG CAPSULE,4.2,2.73,0.71,4.2,22
NDC,5965115301,PROGESTERONE MICRONIZED 200 MG CAPSULE,8.0,5.2,1.34,8.0,22
NDC,5965120508,CAPECITABINE 500 MG TABLET,78.24,50.86,0.03,78.24,40
NDC,5965124090,IMATINIB 100 MG TABLET,202.26,131.47,33.98,202.26,22
NDC,5965125101,NADOLOL 40 MG TABLET,7.92,5.15,1.33,7.92,22
NDC,5965127860,PROPAFENONE ER 425 MG CAPSULEEXTENDED RELEASE 12 HR,20.0,13.0,3.36,20.0,22
NDC,5965129960,TAMOXIFEN 10 MG TABLET,3.78,2.46,0.64,3.78,22
NDC,5965133101,FLUCYTOSINE 250 MG CAPSULE,164.14,106.69,27.58,164.14,22
NDC,5965133201,FLUCYTOSINE 500 MG CAPSULE,317.62,206.45,53.36,317.62,22
NDC,5965140112,CLOBAZAM 2.5 MG/ML ORAL SUSPENSION,12.99,8.44,2.18,12.99,22
NDC,5965140430,MEMANTINE 7 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,30.56,19.86,5.13,30.56,22
NDC,5965140530,MEMANTINE 14 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,30.56,19.86,5.13,30.56,22
NDC,5965142011,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,131.09,85.21,22.02,131.09,22
NDC,5965145601,CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,1.42,0.92,0.24,1.42,22
NDC,5965149530,AMBRISENTAN 10 MG TABLET,681.18,442.77,114.44,681.18,22
NDC,5965153901,ISOSORBIDE MONONITRATE ER 30 MG TABLETEXTENDED RELEASE 24 HR,6.7,4.36,1.13,6.7,22
NDC,5965156360,RUFINAMIDE 40 MG/ML ORAL SUSPENSION,10.3,6.7,1.73,10.3,22
NDC,5965158901,NADOLOL 20 MG TABLET,6.78,4.41,1.14,6.78,22
NDC,5965162108,MYCOPHENOLATE SODIUM 180 MG TABLETDELAYED RELEASE,9.14,5.94,0.45,9.14,31
NDC,5965172001,DICYCLOMINE 20 MG TABLET,1.16,0.75,0.19,1.16,22
NDC,5965187350,CIPROFLOXACIN 750 MG TABLET,11.26,7.32,1.89,11.26,22
NDC,5967627801,EDURANT 25 MG TABLET,118.66,77.13,19.93,118.66,22
NDC,5967630201,PROCRIT 2000 UNIT/ML INJECTION SOLUTION,192.45,125.09,7.45,192.45,46
NDC,5967630301,PROCRIT 3000 UNIT/ML INJECTION SOLUTION,288.66,187.63,7.45,288.66,46
NDC,5967630400,PROCRIT 4000 UNIT/ML INJECTION SOLUTION,384.84,250.15,7.45,384.84,46
NDC,5967630401,PROCRIT 4000 UNIT/ML INJECTION SOLUTION,384.84,250.15,7.45,384.84,46
NDC,5967631001,PROCRIT 10000 UNIT/ML INJECTION SOLUTION,962.1,625.37,7.45,962.1,46
NDC,5967631204,PROCRIT 20000 UNIT/2 ML INJECTION SOLUTION,962.1,625.37,7.45,962.1,46
NDC,5967632000,PROCRIT 20000 UNIT/ML INJECTION SOLUTION,1924.2,1250.73,7.45,1924.2,46
NDC,5967632004,PROCRIT 20000 UNIT/ML INJECTION SOLUTION,1924.2,1250.73,7.45,1924.2,46
NDC,5967634000,PROCRIT 40000 UNIT/ML INJECTION SOLUTION,3848.4,2501.46,7.45,3848.4,49
NDC,5967634001,PROCRIT 40000 UNIT/ML INJECTION SOLUTION,3848.4,2501.46,7.45,3848.4,49
NDC,5967636001,ORTHOVISC 30 MG/2 ML INTRA-ARTICULAR SYRINGE,860.4,559.26,74.0,860.4,47
NDC,5967656201,PREZISTA 600 MG TABLET,86.32,56.11,14.5,86.32,22
NDC,5967656630,PREZISTA 800 MG TABLET,172.66,112.23,29.01,172.66,22
NDC,5967657001,INTELENCE 100 MG TABLET,29.96,19.47,5.03,29.96,22
NDC,5967657101,INTELENCE 200 MG TABLET,59.92,38.95,10.07,59.92,22
NDC,5967657530,PREZCOBIX 800 MG-150 MG TABLET,197.34,128.27,33.15,197.34,22
NDC,5967660012,ERLEADA 60 MG TABLET,306.0,198.9,51.41,306.0,22
NDC,5967660430,ERLEADA 240 MG TABLET,1224.04,795.63,205.64,1224.04,22
NDC,5967661001,YONDELIS 1 MG INTRAVENOUS SOLUTION,17708.84,11510.75,304.55,17708.84,52
NDC,5967680030,SYMTUZA 800 MG-150 MG-200 MG-10 MG TABLET,377.36,245.28,63.4,377.36,22
NDC,5967682001,MONOVISC 88 MG/4 ML INTRA-ARTICULAR SYRINGE,1350.0,877.5,273.36,1562.95,47
NDC,5974600314,METHYLPREDNISOLONE 16 MG TABLET,6.22,4.04,0.22,6.22,31
NDC,5974601032,RISPERIDONE 0.5 MG DISINTEGRATING TABLET,9.84,6.4,1.65,9.84,22
NDC,5974602022,RISPERIDONE 1 MG DISINTEGRATING TABLET,11.0,7.15,1.85,11.0,22
NDC,5974603022,RISPERIDONE 2 MG DISINTEGRATING TABLET,17.9,11.64,3.01,17.9,22
NDC,5974611306,PROCHLORPERAZINE MALEATE 5 MG TABLET,1.18,0.77,0.2,1.18,22
NDC,5974611506,PROCHLORPERAZINE MALEATE 10 MG TABLET,1.78,1.16,0.3,1.78,22
NDC,5974612106,MECLIZINE 25 MG TABLET,0.8,0.52,0.13,0.8,22
NDC,5974617710,CYCLOBENZAPRINE 10 MG TABLET,2.2,1.43,0.37,2.2,22
NDC,5974638306,TERAZOSIN 1 MG CAPSULE,3.22,2.09,0.54,3.22,22
NDC,5974638506,TERAZOSIN 5 MG CAPSULE,3.22,2.09,0.54,3.22,22
NDC,5976200382,DOFETILIDE 250 MCG CAPSULE,10.0,6.5,1.68,10.0,22
NDC,5976200392,DOFETILIDE 500 MCG CAPSULE,10.0,6.5,1.68,10.0,22
NDC,5976200401,TRIFLURIDINE 1 % EYE DROPS,41.36,26.88,6.95,41.36,22
NDC,5976200551,MEDROXYPROGESTERONE 2.5 MG TABLET,0.62,0.4,0.1,0.62,22
NDC,5976200581,MEDROXYPROGESTERONE 5 MG TABLET,0.94,0.61,0.16,0.94,22
NDC,5976200671,SERTRALINE 20 MG/ML ORAL CONCENTRATE,2.8,1.82,0.47,2.8,22
NDC,5976200731,HYDROCORTISONE 5 MG TABLET,0.68,0.44,0.11,0.68,22
NDC,5976200751,HYDROCORTISONE 20 MG TABLET,2.18,1.42,0.37,2.18,22
NDC,5976201045,SULFASALAZINE 500 MG TABLETDELAYED RELEASE,0.76,0.49,0.13,0.76,22
NDC,5976201046,SULFASALAZINE 500 MG TABLETDELAYED RELEASE,0.72,0.47,0.12,0.72,22
NDC,5976201191,PHENELZINE 15 MG TABLET,1.68,1.09,0.28,1.68,22
NDC,5976201315,SILVER SULFADIAZINE 1 % TOPICAL CREAM,0.6,0.39,0.1,0.6,22
NDC,5976201316,SILVER SULFADIAZINE 1 % TOPICAL CREAM,0.6,0.39,0.1,0.6,22
NDC,5976201318,SILVER SULFADIAZINE 1 % TOPICAL CREAM,0.64,0.42,0.11,0.64,22
NDC,5976201401,PIROXICAM 10 MG CAPSULE,1.48,0.96,0.25,1.48,22
NDC,5976201552,ATORVASTATIN 10 MG TABLET,0.5,0.33,0.08,0.5,22
NDC,5976201561,ATORVASTATIN 20 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,5976201562,ATORVASTATIN 20 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,5976201571,ATORVASTATIN 40 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,5976201581,ATORVASTATIN 80 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,5976203332,LATANOPROST 0.005 % EYE DROPS,76.22,49.54,12.8,76.22,22
NDC,5976204891,NITROGLYCERIN 0.6 MG SUBLINGUAL TABLET,0.94,0.61,0.16,0.94,22
NDC,5976205312,PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,0.4,0.26,0.07,0.4,22
NDC,5976210011,SIROLIMUS 0.5 MG TABLET,16.94,11.01,1.84,16.94,31
NDC,5976210021,SIROLIMUS 1 MG TABLET,33.9,22.04,1.84,33.9,31
NDC,5976210031,SIROLIMUS 2 MG TABLET,67.8,44.07,1.84,67.8,31
NDC,5976210611,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,0.98,0.64,0.16,0.98,22
NDC,5976210612,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,0.98,0.64,0.16,0.98,22
NDC,5976213501,RIFABUTIN 150 MG CAPSULE,34.98,22.74,5.88,34.98,22
NDC,5976215171,CELECOXIB 200 MG CAPSULE,2.46,1.6,0.41,2.46,22
NDC,5976215761,PREGABALIN 20 MG/ML ORAL SOLUTION,3.38,2.2,0.57,3.38,22
NDC,5976220126,ASENAPINE 5 MG SUBLINGUAL TABLET,14.42,9.37,2.42,14.42,22
NDC,5976222502,ETHOSUXIMIDE 250 MG CAPSULE,2.88,1.87,0.48,2.88,22
NDC,5976230511,AZITHROMYCIN 1 GRAM ORAL PACKET,58.26,37.87,9.79,58.26,22
NDC,5976230512,AZITHROMYCIN 1 GRAM ORAL PACKET,58.26,37.87,9.79,58.26,22
NDC,5976230602,AZITHROMYCIN 250 MG TABLET,5.1,3.32,0.86,5.1,22
NDC,5976230603,AZITHROMYCIN 250 MG TABLET,8.16,5.3,1.37,8.16,22
NDC,5976231101,AZITHROMYCIN 100 MG/5 ML ORAL SUSPENSION,4.0,2.6,0.67,4.0,22
NDC,5976231201,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,4.0,2.6,0.67,4.0,22
NDC,5976231401,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,2.0,1.3,0.34,2.0,22
NDC,5976233041,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,0.94,0.61,0.16,0.94,22
NDC,5976233043,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,2.06,1.34,0.35,2.06,22
NDC,5976237191,ALPRAZOLAM 0.25 MG TABLET,1.24,0.81,0.21,1.24,22
NDC,5976237201,ALPRAZOLAM 0.5 MG TABLET,1.48,0.96,0.25,1.48,22
NDC,5976237431,CLINDAMYCIN 1 % TOPICAL GEL,5.76,3.74,0.97,5.76,22
NDC,5976237441,CLINDAMYCIN 1 % LOTION,4.0,2.6,0.67,4.0,22
NDC,5976249003,SERTRALINE 50 MG TABLET,0.56,0.36,0.09,0.56,22
NDC,5976249005,SERTRALINE 50 MG TABLET,0.24,0.16,0.04,0.24,22
NDC,5976249103,SERTRALINE 100 MG TABLET,0.56,0.36,0.09,0.56,22
NDC,5976249211,NITROGLYCERIN 0.3 MG SUBLINGUAL TABLET,0.94,0.61,0.16,0.94,22
NDC,5976250005,SULFASALAZINE 500 MG TABLET,0.52,0.34,0.09,0.52,22
NDC,5976250071,MISOPROSTOL 100 MCG TABLET,1.64,1.07,0.28,1.64,22
NDC,5976250091,CLINDAMYCIN 2 % VAGINAL CREAM,5.44,3.54,0.91,5.44,22
NDC,5976250291,FLUCONAZOLE 10 MG/ML ORAL SUSPENSION,2.48,1.61,0.42,2.48,22
NDC,5976250301,FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,8.98,5.84,1.51,8.98,22
NDC,5976250507,GABAPENTIN 250 MG/5 ML ORAL SOLUTION,0.8,0.52,0.13,0.8,22
NDC,5976700401,PERTZYE 4000 UNIT-14375 UNIT-15125 UNIT CAPSULEDELAYED RELEASE,4.52,2.94,0.76,4.52,22
NDC,5976701601,PERTZYE 16000 UNIT-57500 UNIT-60500 UNIT CAPSULEDELAYED RELEASE,13.42,8.72,2.25,13.42,22
NDC,5976702401,PERTZYE 24000-86250-90750 UNIT CAPSULEDELAYED RELEASE,20.14,13.09,3.38,20.14,22
NDC,5992360110,PAMIDRONATE 30 MG INTRAVENOUS SOLUTION,67.65,43.97,11.37,67.65,30
NDC,5992360310,PAMIDRONATE 90 MG INTRAVENOUS SOLUTION,202.92,131.9,12.31,202.92,30
NDC,5992372010,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,2.79,1.81,0.01,2.79,31
NDC,6021916771,CHLORDIAZEPOXIDE-CLIDINIUM 5 MG-2.5 MG CAPSULE,79.5,51.68,13.36,79.5,22
NDC,6021917226,ETRAVIRINE 200 MG TABLET,53.64,34.87,9.01,53.64,22
NDC,6021917482,ATROPINE 1 % EYE DROPS,47.86,31.11,8.04,47.86,22
NDC,6021917493,ATROPINE 1 % EYE DROPS,23.36,15.18,3.92,23.36,22
NDC,6021917508,ATROPINE 1 % EYE DROPS,22.0,14.3,3.7,22.0,22
NDC,6021920561,DEXAMETHASONE 2 MG TABLET,1.2,0.78,0.01,1.2,30
NDC,6021939551,FOSFOMYCIN 3 G ORAL PACK,200.8,130.52,33.73,200.8,22
NDC,6025800216,CYTRA-3 550 MG-500 MG-334 MG/5 ML ORAL SOLUTION,0.38,0.25,0.06,0.38,22
NDC,6025800601,PHOS-NAK 280 MG-160 MG-250 MG ORAL POWDER PACKET,1.63,1.06,0.27,1.63,22
NDC,6025816001,RENA-VITE 0.8 MG TABLET,0.28,0.18,0.05,0.28,22
NDC,6025816201,RENAL CAPS 1 MG CAPSULE,1.34,0.87,0.23,1.34,22
NDC,6025817101,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,0.3,0.2,0.05,0.3,22
NDC,6025818601,POLY-IRON 150 FORTE 150 MG-25 MCG-1 MG CAPSULE,0.52,0.34,0.09,0.52,22
NDC,6026731110,SODIUM NITRITE 30 MG/ML INTRAVENOUS SOLUTION,36.0,23.4,6.05,36.0,22
NDC,6026770550,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,7.2,4.68,0.88,3407.66,32
NDC,6026781200,NITHIODOTE 300 MG/10 ML-12.5 GRAM/50 ML INTRAVENOUS SOLUTION,11.76,7.64,2.16,93.47,39
NDC,6043206500,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,2.15,1.4,0.36,2.15,22
NDC,6043206575,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 62.5 MG/5 ML ORAL SUSPENSION,2.15,1.4,0.36,2.15,22
NDC,6050500166,DILT-XR 240 MG CAPSULE EXTENDED RELEASE,2.86,1.86,0.48,2.86,22
NDC,6050500391,ETODOLAC 200 MG CAPSULE,2.88,1.87,0.48,2.88,22
NDC,6050500401,ETODOLAC 300 MG CAPSULE,3.24,2.11,0.54,3.24,22
NDC,6050500411,ETODOLAC 400 MG TABLET,2.92,1.9,0.49,2.92,22
NDC,6050500551,SELEGILINE 5 MG CAPSULE,4.6,2.99,0.77,4.6,22
NDC,6050500652,OMEPRAZOLE 20 MG CAPSULEDELAYED RELEASE,8.3,5.4,1.39,8.3,22
NDC,6050500800,SOTALOL 80 MG TABLET,5.12,3.33,0.86,5.12,22
NDC,6050500930,DOXAZOSIN 1 MG TABLET,2.7,1.76,0.45,2.7,22
NDC,6050501011,PAROXETINE 40 MG TABLET,5.94,3.86,1.0,5.94,22
NDC,6050501330,CYCLOSPORINE 25 MG ORAL CAP (SANDIMMUNE),8.84,5.75,0.83,8.84,31
NDC,6050501340,CYCLOSPORINE 100 MG ORAL CAP (SANDIMMUNE),35.32,22.96,2.07,35.32,31
NDC,6050501410,GLIPIZIDE 5 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,6050501412,GLIPIZIDE 5 MG TABLET,0.7,0.46,0.12,0.7,22
NDC,6050501420,GLIPIZIDE 10 MG TABLET,1.34,0.87,0.23,1.34,22
NDC,6050501590,SOTALOL 120 MG TABLET,6.84,4.45,1.15,6.84,22
NDC,6050501651,FLUVOXAMINE 50 MG TABLET,5.14,3.34,0.86,5.14,22
NDC,6050504025,PAXIL 10 MG/5 ML ORAL SUSPENSION,5.33,3.46,0.9,5.33,22
NDC,6050507495,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,7.83,5.09,0.73,7.83,31
NDC,6050508150,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),98.5,64.03,16.55,98.5,22
NDC,6050508291,FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAYSUSPENSION,10.66,6.93,1.79,10.66,22
NDC,6050508301,MOMETASONE 50 MCG/ACTUATION NASAL SPRAY,30.14,19.59,5.06,30.14,22
NDC,6050513211,MIDODRINE 5 MG TABLET,4.86,3.16,0.82,4.86,22
NDC,6050525799,ATORVASTATIN 20 MG TABLET,11.54,7.5,1.94,11.54,22
NDC,6050526561,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,0.78,0.51,0.13,0.78,22
NDC,6050526565,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,0.78,0.51,0.13,0.78,22
NDC,6050526571,TRIAMTERENE 75 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,2.22,1.44,0.37,2.22,22
NDC,6050532506,LAMIVUDINE 100 MG TABLET,32.22,20.94,5.41,32.22,22
NDC,6050532773,OLANZAPINE 15 MG DISINTEGRATING TABLET,61.86,40.21,10.39,61.86,22
NDC,6050534383,SELEGILINE 5 MG TABLET,4.2,2.73,0.71,4.2,22
NDC,6050547733,VILAZODONE 20 MG TABLET,22.7,14.76,3.81,22.7,22
NDC,6050561511,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,44.46,28.9,0.41,44.46,31
NDC,6050561514,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,47.82,31.08,0.41,47.82,31
NDC,6050570620,NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,4.58,2.98,0.77,4.58,22
NDC,6050570630,NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,5.14,3.34,0.86,5.14,22
NDC,6068710001,URSODIOL 300 MG CAPSULE,15.28,9.93,2.57,15.28,22
NDC,6068710411,KETOROLAC 10 MG TABLET,14.62,9.5,2.46,14.62,22
NDC,6068710421,KETOROLAC 10 MG TABLET,14.62,9.5,2.46,14.62,22
NDC,6068710511,MEDROXYPROGESTERONE 10 MG TABLET,3.36,2.18,0.56,3.36,22
NDC,6068710521,MEDROXYPROGESTERONE 10 MG TABLET,3.36,2.18,0.56,3.36,22
NDC,6068711211,ANASTROZOLE 1 MG TABLET,4.14,2.69,0.7,4.14,22
NDC,6068711221,ANASTROZOLE 1 MG TABLET,4.14,2.69,0.7,4.14,22
NDC,6068711301,CLONIDINE HCL 0.1 MG TABLET,0.74,0.48,0.12,0.74,22
NDC,6068711311,CLONIDINE HCL 0.1 MG TABLET,0.74,0.48,0.12,0.74,22
NDC,6068712201,PREDNISONE 5 MG TABLET,0.4,0.26,0.01,0.4,31
NDC,6068712401,CLONIDINE HCL 0.2 MG TABLET,0.74,0.48,0.12,0.74,22
NDC,6068714311,METFORMIN 850 MG TABLET,2.4,1.56,0.4,2.4,22
NDC,6068714501,PREDNISONE 20 MG TABLET,0.48,0.31,0.01,0.48,31
NDC,6068714994,CAPECITABINE 500 MG TABLET,30.0,19.5,0.03,30.0,40
NDC,6068715201,CEPHALEXIN 250 MG CAPSULE,1.42,0.92,0.24,1.42,22
NDC,6068715501,METFORMIN 500 MG TABLET,1.4,0.91,0.24,1.4,22
NDC,6068715511,METFORMIN 500 MG TABLET,1.4,0.91,0.24,1.4,22
NDC,6068716101,HALOPERIDOL 5 MG TABLET,2.18,1.42,0.37,2.18,22
NDC,6068716201,METFORMIN 1000 MG TABLET,3.04,1.98,0.51,3.04,22
NDC,6068716211,METFORMIN 1000 MG TABLET,3.04,1.98,0.51,3.04,22
NDC,6068716301,CEPHALEXIN 500 MG CAPSULE,2.7,1.76,0.45,2.7,22
NDC,6068716801,ARIPIPRAZOLE 5 MG TABLET,1.16,0.75,0.19,1.16,22
NDC,6068717901,ARIPIPRAZOLE 10 MG TABLET,1.5,0.98,0.25,1.5,22
NDC,6068718811,ENTACAPONE 200 MG TABLET,9.88,6.42,1.66,9.88,22
NDC,6068718821,ENTACAPONE 200 MG TABLET,9.88,6.42,1.66,9.88,22
NDC,6068719121,ARIPIPRAZOLE 15 MG TABLET,4.44,2.89,0.75,4.44,22
NDC,6068719501,DILTIAZEM SR 120 MG 24 HR CAP,1.94,1.26,0.33,1.94,22
NDC,6068719511,DILTIAZEM SR 120 MG 24 HR CAP,1.94,1.26,0.33,1.94,22
NDC,6068719901,MELOXICAM 15 MG TABLET,9.56,6.21,1.61,9.56,22
NDC,6068719911,MELOXICAM 15 MG TABLET,9.56,6.21,1.61,9.56,22
NDC,6068720221,ARIPIPRAZOLE 20 MG TABLET,3.4,2.21,0.57,3.4,22
NDC,6068720601,DILTIAZEM SR 180 MG 24 HR CAP,1.94,1.26,0.33,1.94,22
NDC,6068721001,SIMVASTATIN 40 MG TABLET,9.84,6.4,1.65,9.84,22
NDC,6068721501,PROPRANOLOL ER 60 MG CAPSULE24 HREXTENDED RELEASE,4.36,2.83,0.73,4.36,22
NDC,6068721625,ENTECAVIR 0.5 MG TABLET,44.58,28.98,7.49,44.58,22
NDC,6068721701,DILTIAZEM SR 240 MG 24 HR CAP,1.6,1.04,0.27,1.6,22
NDC,6068722401,GEMFIBROZIL 600 MG TABLET,4.64,3.02,0.78,4.64,22
NDC,6068722411,GEMFIBROZIL 600 MG TABLET,4.64,3.02,0.78,4.64,22
NDC,6068722794,LEUCOVORIN CALCIUM 25 MG TABLET,25.7,16.71,4.32,25.7,22
NDC,6068722801,DILTIAZEM SR 300 MG 24 HR CAP,5.36,3.48,0.9,5.36,22
NDC,6068722901,LOPERAMIDE 2 MG CAPSULE,2.04,1.33,0.34,2.04,22
NDC,6068723001,ZONISAMIDE 100 MG CAPSULE,1.8,1.17,0.3,1.8,22
NDC,6068723011,ZONISAMIDE 100 MG CAPSULE,1.8,1.17,0.3,1.8,22
NDC,6068723101,SERTRALINE 25 MG TABLET,0.8,0.52,0.13,0.8,22
NDC,6068723111,SERTRALINE 25 MG TABLET,0.8,0.52,0.13,0.8,22
NDC,6068723401,ROSUVASTATIN 5 MG TABLET,14.28,9.28,2.4,14.28,22
NDC,6068724201,SERTRALINE 50 MG TABLET,0.8,0.52,0.13,0.8,22
NDC,6068724501,ROSUVASTATIN 10 MG TABLET,14.28,9.28,2.4,14.28,22
NDC,6068725301,SERTRALINE 100 MG TABLET,1.06,0.69,0.18,1.06,22
NDC,6068727294,CEFUROXIME AXETIL 250 MG TABLET,8.26,5.37,1.39,8.26,22
NDC,6068727566,PHENYTOIN 100 MG/4 ML ORAL SUSPENSION,5.03,3.27,0.85,5.03,22
NDC,6068728394,CEFUROXIME AXETIL 500 MG TABLET,11.0,7.15,1.85,11.0,22
NDC,6068729925,ITRACONAZOLE 100 MG CAPSULE,8.0,5.2,1.34,8.0,22
NDC,6068729995,ITRACONAZOLE 100 MG CAPSULE,8.0,5.2,1.34,8.0,22
NDC,6068730301,DONEPEZIL 10 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,6068730411,CAPTOPRIL 12.5 MG TABLET,3.4,2.21,0.57,3.4,22
NDC,6068730421,CAPTOPRIL 12.5 MG TABLET,3.4,2.21,0.57,3.4,22
NDC,6068731521,CAPTOPRIL 25 MG TABLET,3.7,2.41,0.62,3.7,22
NDC,6068731911,TOLTERODINE ER 2 MG CAPSULEEXTENDED RELEASE 24 HR,24.1,15.67,4.05,24.1,22
NDC,6068731921,TOLTERODINE ER 2 MG CAPSULEEXTENDED RELEASE 24 HR,24.1,15.67,4.05,24.1,22
NDC,6068732501,LISINOPRIL 10 MG TABLET,0.3,0.2,0.05,0.3,22
NDC,6068732625,ATOMOXETINE 40 MG CAPSULE,15.18,9.87,2.55,15.18,22
NDC,6068732701,QUETIAPINE 25 MG TABLET,7.56,4.91,1.27,7.56,22
NDC,6068732711,QUETIAPINE 25 MG TABLET,7.56,4.91,1.27,7.56,22
NDC,6068732831,SEVELAMER CARBONATE 800 MG TABLET,13.08,8.5,2.2,13.08,22
NDC,6068733021,TOLTERODINE ER 4 MG CAPSULEEXTENDED RELEASE 24 HR,24.1,15.67,4.05,24.1,22
NDC,6068733301,LISINOPRIL 20 MG TABLET,0.3,0.2,0.05,0.3,22
NDC,6068733311,LISINOPRIL 20 MG TABLET,0.3,0.2,0.05,0.3,22
NDC,6068733611,MINOCYCLINE 100 MG CAPSULE,2.64,1.72,0.44,2.64,22
NDC,6068733665,MINOCYCLINE 100 MG CAPSULE,2.64,1.72,0.44,2.64,22
NDC,6068733801,QUETIAPINE 50 MG TABLET,12.4,8.06,2.08,12.4,22
NDC,6068733811,QUETIAPINE 50 MG TABLET,12.4,8.06,2.08,12.4,22
NDC,6068734501,CALCITRIOL 0.25 MCG CAPSULE,1.92,1.25,0.32,1.92,22
NDC,6068734901,QUETIAPINE 100 MG TABLET,12.96,8.42,2.18,12.96,22
NDC,6068734911,QUETIAPINE 100 MG TABLET,12.96,8.42,2.18,12.96,22
NDC,6068735101,BUPROPION HCL 100 MG TABLET,3.58,2.33,0.6,3.58,22
NDC,6068736001,QUETIAPINE 200 MG TABLET,24.44,15.89,4.11,24.44,22
NDC,6068736011,QUETIAPINE 200 MG TABLET,24.44,15.89,4.11,24.44,22
NDC,6068736901,DICYCLOMINE 10 MG CAPSULE,1.32,0.86,0.22,1.32,22
NDC,6068737101,QUETIAPINE 300 MG TABLET,32.04,20.83,5.38,32.04,22
NDC,6068737701,ALPRAZOLAM 0.25 MG TABLET,0.74,0.48,0.12,0.74,22
NDC,6068738194,PHYTONADIONE (VITAMIN K1) 5 MG TABLET,161.7,105.11,27.17,161.7,22
NDC,6068738201,QUETIAPINE 400 MG TABLET,37.66,24.48,6.33,37.66,22
NDC,6068738801,ALPRAZOLAM 0.5 MG TABLET,0.88,0.57,0.15,0.88,22
NDC,6068739101,PIOGLITAZONE 15 MG TABLET,2.52,1.64,0.42,2.52,22
NDC,6068740401,CLOZAPINE 25 MG TABLET,2.66,1.73,0.45,2.66,22
NDC,6068740411,CLOZAPINE 25 MG TABLET,2.66,1.73,0.45,2.66,22
NDC,6068740583,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,0.52,0.34,0.09,0.52,22
NDC,6068740677,OXYCODONE 5 MG/5 ML ORAL SOLUTION,2.13,1.38,0.36,2.13,22
NDC,6068741511,CLOZAPINE 100 MG TABLET,6.92,4.5,1.16,6.92,22
NDC,6068741771,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,0.83,0.54,0.14,0.83,22
NDC,6068741901,CHLORPROMAZINE 10 MG TABLET,10.28,6.68,1.73,10.28,22
NDC,6068741911,CHLORPROMAZINE 10 MG TABLET,10.28,6.68,1.73,10.28,22
NDC,6068742025,RITONAVIR 100 MG TABLET,22.5,14.63,3.78,22.5,22
NDC,6068742321,CLOBAZAM 10 MG TABLET,6.24,4.06,1.05,6.24,22
NDC,6068742601,CLOZAPINE 200 MG TABLET,13.08,8.5,2.2,13.08,22
NDC,6068743201,TRAZODONE 150 MG TABLET,2.94,1.91,0.49,2.94,22
NDC,6068743701,AMIODARONE 200 MG TABLET,1.22,0.79,0.2,1.22,22
NDC,6068743801,MYCOPHENOLATE MOFETIL 500 MG TABLET,3.12,2.03,0.18,3.12,31
NDC,6068743901,LABETALOL 100 MG TABLET,1.08,0.7,0.18,1.08,22
NDC,6068743911,LABETALOL 100 MG TABLET,1.08,0.7,0.18,1.08,22
NDC,6068744301,TRAZODONE 50 MG TABLET,0.32,0.21,0.05,0.32,22
NDC,6068744311,TRAZODONE 50 MG TABLET,0.32,0.21,0.05,0.32,22
NDC,6068744601,IBUPROFEN 400 MG TABLET,0.52,0.34,0.09,0.52,22
NDC,6068745121,EPLERENONE 25 MG TABLET,10.0,6.5,1.68,10.0,22
NDC,6068745401,TRAZODONE 100 MG TABLET,0.44,0.29,0.07,0.44,22
NDC,6068745411,TRAZODONE 100 MG TABLET,0.44,0.29,0.07,0.44,22
NDC,6068745701,IBUPROFEN 600 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,6068746101,LABETALOL 300 MG TABLET,2.38,1.55,0.4,2.38,22
NDC,6068746501,SPIRONOLACTONE 25 MG TABLET,0.46,0.3,0.08,0.46,22
NDC,6068746601,POTASSIUM CHLORIDE ER 10 MEQ TABLETEXTENDED RELEASE,1.22,0.79,0.2,1.22,22
NDC,6068746611,POTASSIUM CHLORIDE ER 10 MEQ TABLETEXTENDED RELEASE,1.22,0.79,0.2,1.22,22
NDC,6068746801,IBUPROFEN 800 MG TABLET,0.86,0.56,0.14,0.86,22
NDC,6068747301,PREGABALIN 25 MG CAPSULE,3.24,2.11,0.54,3.24,22
NDC,6068747601,SPIRONOLACTONE 50 MG TABLET,1.1,0.72,0.18,1.1,22
NDC,6068748401,PREGABALIN 50 MG CAPSULE,3.24,2.11,0.54,3.24,22
NDC,6068748411,PREGABALIN 50 MG CAPSULE,3.24,2.11,0.54,3.24,22
NDC,6068748701,SPIRONOLACTONE 100 MG TABLET,1.76,1.14,0.3,1.76,22
NDC,6068748801,AMLODIPINE 5 MG TABLET,0.38,0.25,0.06,0.38,22
NDC,6068749211,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,8.4,5.46,1.41,8.4,22
NDC,6068749221,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,8.4,5.46,1.41,8.4,22
NDC,6068749501,PREGABALIN 75 MG CAPSULE,3.24,2.11,0.54,3.24,22
NDC,6068749511,PREGABALIN 75 MG CAPSULE,3.24,2.11,0.54,3.24,22
NDC,6068749601,AMLODIPINE 10 MG TABLET,0.38,0.25,0.06,0.38,22
NDC,6068749611,AMLODIPINE 10 MG TABLET,0.38,0.25,0.06,0.38,22
NDC,6068750601,PREGABALIN 100 MG CAPSULE,3.24,2.11,0.54,3.24,22
NDC,6068750701,GABAPENTIN 600 MG TABLET,4.84,3.15,0.81,4.84,22
NDC,6068750711,GABAPENTIN 600 MG TABLET,4.84,3.15,0.81,4.84,22
NDC,6068751701,PREGABALIN 150 MG CAPSULE,3.24,2.11,0.54,3.24,22
NDC,6068751801,GABAPENTIN 800 MG TABLET,5.82,3.78,0.98,5.82,22
NDC,6068751811,GABAPENTIN 800 MG TABLET,5.82,3.78,0.98,5.82,22
NDC,6068752321,POSACONAZOLE 100 MG TABLETDELAYED RELEASE,113.2,73.58,19.02,113.2,22
NDC,6068752483,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,11.2,7.28,1.88,11.2,22
NDC,6068752601,METRONIDAZOLE 250 MG TABLET,0.98,0.64,0.16,0.98,22
NDC,6068752711,URSODIOL 250 MG TABLET,8.4,5.46,1.41,8.4,22
NDC,6068752721,URSODIOL 250 MG TABLET,8.4,5.46,1.41,8.4,22
NDC,6068753436,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,17.15,11.15,2.88,17.15,22
NDC,6068755001,METRONIDAZOLE 500 MG TABLET,1.84,1.2,0.31,1.84,22
NDC,6068755801,CYCLOBENZAPRINE 10 MG TABLET,0.42,0.27,0.07,0.42,22
NDC,6068755901,METHOCARBAMOL 500 MG TABLET,0.6,0.39,0.1,0.6,22
NDC,6068756021,REPAGLINIDE 1 MG TABLET,7.1,4.62,1.19,7.1,22
NDC,6068756711,ATOMOXETINE 25 MG CAPSULE,8.8,5.72,1.48,8.8,22
NDC,6068756801,METHOCARBAMOL 750 MG TABLET,0.74,0.48,0.12,0.74,22
NDC,6068757001,PRAMIPEXOLE 0.25 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,6068757011,PRAMIPEXOLE 0.25 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,6068757521,RIFAMPIN 150 MG CAPSULE,7.64,4.97,1.28,7.64,22
NDC,6068757701,ROPINIROLE 0.25 MG TABLET,1.32,0.86,0.22,1.32,22
NDC,6068757811,ACETAZOLAMIDE ER 500 MG CAPSULEEXTENDED RELEASE,11.42,7.42,1.92,11.42,22
NDC,6068757821,ACETAZOLAMIDE ER 500 MG CAPSULEEXTENDED RELEASE,11.42,7.42,1.92,11.42,22
NDC,6068758001,GABAPENTIN 100 MG CAPSULE,1.16,0.75,0.19,1.16,22
NDC,6068758121,PRAMIPEXOLE 0.5 MG TABLET,2.0,1.3,0.34,2.0,22
NDC,6068758201,HYDROCORTISONE 10 MG TABLET,4.0,2.6,0.67,4.0,22
NDC,6068758321,CARBAMAZEPINE ER 200 MG TABLETEXTENDED RELEASE12 HR,8.08,5.25,1.36,8.08,22
NDC,6068758421,MIRTAZAPINE 7.5 MG TABLET,6.84,4.45,1.15,6.84,22
NDC,6068758601,RIFAMPIN 300 MG CAPSULE,4.46,2.9,0.75,4.46,22
NDC,6068758701,PROPRANOLOL 10 MG TABLET,0.6,0.39,0.1,0.6,22
NDC,6068759001,HYDROMORPHONE 4 MG TABLET,1.44,0.94,0.24,1.44,22
NDC,6068759101,GABAPENTIN 300 MG CAPSULE,2.76,1.79,0.46,2.76,22
NDC,6068759221,PRAMIPEXOLE 1 MG TABLET,2.66,1.73,0.45,2.66,22
NDC,6068759301,HYDROCHLOROTHIAZIDE 25 MG TABLET,0.5,0.33,0.08,0.5,22
NDC,6068759421,CARBAMAZEPINE ER 400 MG TABLETEXTENDED RELEASE12 HR,13.94,9.06,2.34,13.94,22
NDC,6068759501,FAMOTIDINE 20 MG TABLET,0.48,0.31,0.08,0.48,22
NDC,6068759511,FAMOTIDINE 20 MG TABLET,0.48,0.31,0.08,0.48,22
NDC,6068759801,PROPRANOLOL 20 MG TABLET,1.1,0.72,0.18,1.1,22
NDC,6068760211,GABAPENTIN 400 MG CAPSULE,2.44,1.59,0.41,2.44,22
NDC,6068760601,DICLOFENAC SODIUM 50 MG TABLETDELAYED RELEASE,1.26,0.82,0.21,1.26,22
NDC,6068760721,DESVENLAFAXINE SUCCINATE ER 50 MG TABLETEXTENDED RELEASE 24 HR,5.14,3.34,0.86,5.14,22
NDC,6068760901,PROPRANOLOL 40 MG TABLET,1.34,0.87,0.23,1.34,22
NDC,6068761221,VALSARTAN 40 MG TABLET,2.0,1.3,0.34,2.0,22
NDC,6068761821,FENOFIBRATE NANOCRYSTALLIZED 48 MG TABLET,3.82,2.48,0.64,3.82,22
NDC,6068762001,METOCLOPRAMIDE 5 MG TABLET,1.38,0.9,0.23,1.38,22
NDC,6068762201,SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,0.38,0.25,0.06,0.38,22
NDC,6068762211,SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,0.38,0.25,0.06,0.38,22
NDC,6068762301,VALSARTAN 80 MG TABLET,2.58,1.68,0.43,2.58,22
NDC,6068762401,METOLAZONE 2.5 MG TABLET,6.6,4.29,1.11,6.6,22
NDC,6068762665,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,6.1,3.97,1.02,10.3,22
NDC,6068763101,METOCLOPRAMIDE 10 MG TABLET,1.44,0.94,0.24,1.44,22
NDC,6068763111,METOCLOPRAMIDE 10 MG TABLET,1.44,0.94,0.24,1.44,22
NDC,6068763401,VALSARTAN 160 MG TABLET,2.9,1.89,0.49,2.9,22
NDC,6068763411,VALSARTAN 160 MG TABLET,2.9,1.89,0.49,2.9,22
NDC,6068764111,NEBIVOLOL 5 MG TABLET,7.02,4.56,1.18,7.02,22
NDC,6068765621,LISINOPRIL 2.5 MG TABLET,1.36,0.88,0.23,1.36,22
NDC,6068765701,LEVETIRACETAM 500 MG TABLET,1.44,0.94,0.24,1.44,22
NDC,6068765711,LEVETIRACETAM 500 MG TABLET,1.44,0.94,0.24,1.44,22
NDC,6068765801,DICLOFENAC SODIUM 75 MG TABLETDELAYED RELEASE,1.62,1.05,0.27,1.62,22
NDC,6068765811,DICLOFENAC SODIUM 75 MG TABLETDELAYED RELEASE,1.62,1.05,0.27,1.62,22
NDC,6068766001,PROMETHAZINE 12.5 MG TABLET,1.24,0.81,0.21,1.24,22
NDC,6068766101,CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,1.64,1.07,0.28,1.64,22
NDC,6068766401,HYDROXYZINE HCL 10 MG TABLET,0.56,0.36,0.09,0.56,22
NDC,6068766801,LEVETIRACETAM 1000 MG TABLET,3.36,2.18,0.56,3.36,22
NDC,6068766901,METHIMAZOLE 5 MG TABLET,1.44,0.94,0.24,1.44,22
NDC,6068766911,METHIMAZOLE 5 MG TABLET,1.44,0.94,0.24,1.44,22
NDC,6068767140,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,1.61,1.05,0.27,1.61,22
NDC,6068767167,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,1.61,1.05,0.27,1.61,22
NDC,6068767311,NATEGLINIDE 60 MG TABLET,5.28,3.43,0.89,5.28,22
NDC,6068767321,NATEGLINIDE 60 MG TABLET,5.28,3.43,0.89,5.28,22
NDC,6068767501,HYDROXYZINE HCL 25 MG TABLET,0.8,0.52,0.13,0.8,22
NDC,6068767657,LACOSAMIDE 50 MG TABLET,4.72,3.07,0.79,4.72,22
NDC,6068767701,ALLOPURINOL 100 MG TABLET,1.0,0.65,0.17,1.0,22
NDC,6068767711,ALLOPURINOL 100 MG TABLET,1.0,0.65,0.17,1.0,22
NDC,6068767801,LISINOPRIL 40 MG TABLET,1.22,0.79,0.2,1.22,22
NDC,6068768001,METHIMAZOLE 10 MG TABLET,2.0,1.3,0.34,2.0,22
NDC,6068768101,FOLIC ACID 1 MG TABLET,0.42,0.27,0.07,0.42,22
NDC,6068768111,FOLIC ACID 1 MG TABLET,0.42,0.27,0.07,0.42,22
NDC,6068768421,NATEGLINIDE 120 MG TABLET,6.94,4.51,1.17,6.94,22
NDC,6068768711,LACOSAMIDE 100 MG TABLET,7.38,4.8,1.24,7.38,22
NDC,6068768757,LACOSAMIDE 100 MG TABLET,7.38,4.8,1.24,7.38,22
NDC,6068768801,ALLOPURINOL 300 MG TABLET,1.88,1.22,0.32,1.88,22
NDC,6068768811,ALLOPURINOL 300 MG TABLET,1.88,1.22,0.32,1.88,22
NDC,6068769101,DEMECLOCYCLINE 150 MG TABLET,21.26,13.82,3.57,21.26,22
NDC,6068769301,LAMOTRIGINE 150 MG TABLET,0.98,0.64,0.16,0.98,22
NDC,6068769411,METHENAMINE HIPPURATE 1 GRAM TABLET,5.92,3.85,0.99,5.92,22
NDC,6068769421,METHENAMINE HIPPURATE 1 GRAM TABLET,5.92,3.85,0.99,5.92,22
NDC,6068769857,LACOSAMIDE 200 MG TABLET,7.8,5.07,1.31,7.8,22
NDC,6068769921,CEFDINIR 300 MG CAPSULE,8.1,5.27,1.36,8.1,22
NDC,6068770001,BETHANECHOL CHLORIDE 25 MG TABLET,3.56,2.31,0.6,3.56,22
NDC,6068770011,BETHANECHOL CHLORIDE 25 MG TABLET,3.56,2.31,0.6,3.56,22
NDC,6068770701,HYDROXYZINE PAMOATE 50 MG CAPSULE,1.02,0.66,0.17,1.02,22
NDC,6068771521,COLESTIPOL 1 GRAM TABLET,10.02,6.51,1.68,10.02,22
NDC,6068771701,DILTIAZEM 30 MG TABLET,1.06,0.69,0.18,1.06,22
NDC,6068771801,DEXAMETHASONE 4 MG TABLET,2.42,1.57,0.41,2.42,22
NDC,6068772121,DESMOPRESSIN 0.1 MG TABLET,5.26,3.42,0.88,5.26,22
NDC,6068773001,MECLIZINE 25 MG TABLET,1.72,1.12,0.29,1.72,22
NDC,6068773501,MISOPROSTOL 100 MCG TABLET,4.96,3.22,0.83,4.96,22
NDC,6068774201,AZITHROMYCIN 250 MG TABLET,8.44,5.49,1.42,8.44,22
NDC,6068774601,MISOPROSTOL 200 MCG TABLET,5.46,3.55,0.92,5.46,22
NDC,6068774721,LURASIDONE 20 MG TABLET,10.22,6.64,1.72,10.22,22
NDC,6068775021,TRANEXAMIC ACID 650 MG TABLET,10.3,6.7,1.73,10.3,22
NDC,6068775321,AZITHROMYCIN 500 MG TABLET,13.74,8.93,2.31,13.74,22
NDC,6068775586,DIAZEPAM 5 MG/5 ML (1 MG/ML 5 ML) ORAL SOLUTION,2.35,1.53,0.39,2.35,22
NDC,6068775821,LURASIDONE 40 MG TABLET,10.26,6.67,1.72,10.26,22
NDC,6068777301,DEXAMETHASONE 2 MG TABLET,1.72,1.12,0.01,1.72,30
NDC,6068778021,LURASIDONE 80 MG TABLET,10.56,6.86,1.77,10.56,22
NDC,6068778194,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 125 MG TABLET,9.3,6.05,1.56,9.3,22
NDC,6068778201,BUPROPION XL 150 MG TAB,4.44,2.89,0.75,4.44,22
NDC,6068778701,AMOXICILLIN 500 MG CAPSULE,2.7,1.76,0.45,2.7,22
NDC,6068778821,SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,2.8,1.82,0.47,2.8,22
NDC,6068778901,PYRAZINAMIDE 500 MG TABLET,13.94,9.06,2.34,13.94,22
NDC,6068779021,ABIRATERONE 250 MG TABLET,12.0,7.8,2.02,12.0,22
NDC,6068779201,AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,3.56,2.31,0.6,3.56,22
NDC,6068779211,AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,3.56,2.31,0.6,3.56,22
NDC,6068779501,TRAMADOL 50 MG TABLET,0.36,0.23,0.06,0.36,22
NDC,6068780301,AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,3.8,2.47,0.64,3.8,22
NDC,6068780701,CHLORDIAZEPOXIDE 25 MG CAPSULE,1.6,1.04,0.27,1.6,22
NDC,6068781394,METHYLERGONOVINE 0.2 MG TABLET,132.0,85.8,22.18,132.0,22
NDC,6068782201,HYDRALAZINE 25 MG TABLET,0.5,0.33,0.08,0.5,22
NDC,6068783301,HYDRALAZINE 50 MG TABLET,0.88,0.57,0.15,0.88,22
NDC,6068784201,LORAZEPAM 2 MG TABLET,2.16,1.4,0.36,2.16,22
NDC,6068785401,PREDNISONE 50 MG TABLET,1.08,0.7,0.01,1.08,31
NDC,6068790301,PREDNISONE 5 MG TABLET,0.54,0.35,0.01,0.54,31
NDC,6075811905,PREDNISOLONE ACETATE 1 % EYE DROPSSUSPENSION,21.12,13.73,3.55,21.12,22
NDC,6075877305,KETOROLAC 0.4 % EYE DROPS,32.06,20.84,5.39,32.06,22
NDC,6075880105,TIMOLOL MALEATE 0.5 % EYE DROPS,2.62,1.7,0.44,2.62,22
NDC,6075888005,FLUOROMETHOLONE 0.1 % EYE DROPSSUSPENSION,37.18,24.17,6.25,37.18,22
NDC,6075888010,FLUOROMETHOLONE 0.1 % EYE DROPSSUSPENSION,37.16,24.15,6.24,37.16,22
NDC,6079311501,CYTOMEL 5 MCG TABLET,0.98,0.64,0.16,0.98,22
NDC,6079311601,CYTOMEL 25 MCG TABLET,1.34,0.87,0.23,1.34,22
NDC,6079311701,CYTOMEL 50 MCG TABLET,2.26,1.47,0.38,2.26,22
NDC,6079320505,THROMBIN-JMI 5000 UNIT NASAL SPRAY SYRINGE,212.32,138.01,35.67,212.32,22
NDC,6079321505,THROMBIN-JMI 5000 UNIT TOPICAL SOLUTION,272.82,177.33,45.83,272.82,22
NDC,6079321720,THROMBIN-JMI 20000 UNIT TOPICAL SOLUTION,717.26,466.22,120.5,717.26,22
NDC,6079321721,THROMBIN-JMI 20000 UNIT TOPICAL SPRAY,820.92,533.6,137.91,820.92,22
NDC,6079321722,THROMBIN-JMI 20000 UNIT TOPICAL SPRAY SYRINGE,820.92,533.6,137.91,820.92,22
NDC,6079360002,BICILLIN C-R 1200000 UNIT/2 ML INTRAMUSCULAR SYRINGE,437.61,284.45,15.63,437.61,47
NDC,6079360010,BICILLIN C-R 1200000 UNIT/2 ML INTRAMUSCULAR SYRINGE,437.61,284.45,15.63,437.61,47
NDC,6079370010,BICILLIN L-A 600000 UNIT/ML INTRAMUSCULAR SYRINGE,843.78,548.46,19.8,843.78,47
NDC,6079370110,BICILLIN L-A 1200000 UNIT/2 ML INTRAMUSCULAR SYRINGE,730.68,474.94,19.8,730.68,47
NDC,6079370204,BICILLIN L-A 2400000 UNIT/4 ML INTRAMUSCULAR SYRINGE,748.65,486.62,19.8,748.65,47
NDC,6079370210,BICILLIN L-A 2400000 UNIT/4 ML INTRAMUSCULAR SYRINGE,748.65,486.62,19.8,748.65,47
NDC,6079370505,THROMBIN-JMI 5000 UNIT TOPICAL SPRAY SYRINGE,202.24,131.46,33.98,202.24,22
NDC,6079385701,LEVOXYL 137 MCG TABLET,2.88,1.87,0.48,2.88,22
NDC,6079385801,LEVOXYL 150 MCG TABLET,2.94,1.91,0.49,2.94,22
NDC,6079386001,LEVOXYL 200 MCG TABLET,3.38,2.2,0.57,3.38,22
NDC,6084680401,UNITHROID 88 MCG TABLET,10.54,6.85,1.77,10.54,22
NDC,6084680801,UNITHROID 137 MCG TABLET,10.62,6.9,1.78,10.62,22
NDC,6092328410,EXONDYS-51  50 MG/ML INTRAVENOUS SOLUTION,2880.0,1872.0,167.35,12697.64,35
NDC,6097714101,PROTOPAM CHLORIDE 1 GRAM SOLUTION FOR INJECTION,312.12,202.88,52.44,312.12,29
NDC,6097714127,PROTOPAM CHLORIDE 1 GRAM SOLUTION FOR INJECTION,312.12,202.88,52.44,312.12,29
NDC,6101056013,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT IN PACKET,0.22,0.14,0.04,0.22,22
NDC,6116810104,KYBELLA 10 MG/ML SUBCUTANEOUS SOLUTION,2160.0,1404.0,23.59,2160.0,29
NDC,6126922063,CLOTRIMAZOLE 1 % VAGINAL CREAM,0.22,0.14,0.04,0.22,22
NDC,6126932560,FOLTABS 800 0.8 MG-10 MG-115 MCG TABLET,1.0,0.65,0.17,1.0,22
NDC,6126941020,ETOPOPHOS 100 MG INTRAVENOUS SOLUTION,817.68,531.49,0.94,817.68,30
NDC,6126991060,IRON CHEWS 15 MG TABLET,1.8,1.17,0.3,1.8,22
NDC,6131401425,DICLOFENAC 0.1 % EYE DROPS,35.82,23.28,6.02,35.82,22
NDC,6131401601,PROPARACAINE 0.5 % EYE DROPS,5.86,3.81,0.98,5.86,22
NDC,6131401910,DORZOLAMIDE 2 % EYE DROPS,13.36,8.68,2.24,13.36,22
NDC,6131404475,TRIFLURIDINE 1 % EYE DROPS,65.34,42.47,10.98,65.34,22
NDC,6131412605,KETOROLAC 0.5 % EYE DROPS,42.2,27.43,7.09,42.2,22
NDC,6131412610,KETOROLAC 0.5 % EYE DROPS,42.0,27.3,7.06,42.0,22
NDC,6131414305,BRIMONIDINE 0.2 % EYE DROPS,13.06,8.49,2.19,13.06,22
NDC,6131414405,BRIMONIDINE 0.15 % EYE DROPS,76.68,49.84,12.88,76.68,22
NDC,6131420315,PILOCARPINE 1 % EYE DROPS,13.14,8.54,2.21,13.14,22
NDC,6131420415,PILOCARPINE 2 % EYE DROPS,13.44,8.74,2.26,13.44,22
NDC,6131420615,PILOCARPINE 4 % EYE DROPS,14.1,9.17,2.37,14.1,22
NDC,6131422405,TIMOLOL MALEATE 0.25 % EYE GEL FORMING SOLUTION,79.3,51.55,13.32,79.3,22
NDC,6131422505,TIMOLOL MALEATE 0.5 % EYE GEL FORMING SOLUTION,86.9,56.49,14.6,86.9,22
NDC,6131422605,TIMOLOL MALEATE 0.25 % EYE DROPS,6.0,3.9,1.01,6.0,22
NDC,6131422610,TIMOLOL MALEATE 0.25 % EYE DROPS,5.56,3.61,0.93,5.56,22
NDC,6131422705,TIMOLOL MALEATE 0.5 % EYE DROPS,6.8,4.42,1.14,6.8,22
NDC,6131422710,TIMOLOL MALEATE 0.5 % EYE DROPS,6.48,4.21,1.09,6.48,22
NDC,6131422894,WYOST 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,6793.95,4416.07,28.23,6793.95,45
NDC,6131423710,CROMOLYN 4 % EYE DROPS,7.44,4.84,1.25,7.44,22
NDC,6131423805,CARTEOLOL 1 % EYE DROPS,8.52,5.54,1.43,8.52,22
NDC,6131424063,JUBBONTI 60 MG/ML SUBCUTANEOUS SYRINGE,5774.88,3753.67,28.23,5774.88,45
NDC,6131424501,BETAXOLOL 0.5 % EYE DROPS,26.5,17.23,4.45,26.5,22
NDC,6131431801,ZARXIO 300 MCG/0.5 ML INJECTION SYRINGE,1975.38,1284.0,0.34,1975.38,47
NDC,6131431805,ZARXIO 300 MCG/0.5 ML INJECTION SYRINGE,1975.41,1284.02,0.34,1975.41,47
NDC,6131431810,ZARXIO 300 MCG/0.5 ML INJECTION SYRINGE,1975.41,1284.02,0.34,1975.41,47
NDC,6131432601,ZARXIO 480 MCG/0.8 ML INJECTION SYRINGE,1975.41,1284.02,0.34,1975.41,47
NDC,6131432605,ZARXIO 480 MCG/0.8 ML INJECTION SYRINGE,1975.41,1284.02,0.34,1975.41,47
NDC,6131435401,TROPICAMIDE 0.5 % EYE DROPS,3.56,2.31,0.6,3.56,22
NDC,6131435501,TROPICAMIDE 1 % EYE DROPS,9.34,6.07,1.57,9.34,22
NDC,6131439601,CYCLOPENTOLATE 1 % EYE DROPS,16.8,10.92,2.82,16.8,22
NDC,6131439603,CYCLOPENTOLATE 1 % EYE DROPS,5.4,3.51,0.91,5.4,22
NDC,6131454701,LATANOPROST 0.005 % EYE DROPS,76.0,49.4,12.77,76.0,22
NDC,6131462810,POLYMYXIN B SULFATE 10000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS,3.48,2.26,0.58,3.48,22
NDC,6131463006,NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10000 UNIT/ML-0.1% EYE DROPS,17.6,11.44,2.96,17.6,22
NDC,6131463136,NEOMYCIN 3.5 MG/G-POLYMYXIN B 10000 UNIT/G-DEXAMETH 0.1 % EYE OINT,25.14,16.34,4.22,25.14,22
NDC,6131463305,GENTAMICIN 0.3 % EYE DROPS,8.68,5.64,1.46,8.68,22
NDC,6131463705,PREDNISOLONE ACETATE 1 % EYE DROPSSUSPENSION,22.12,14.38,3.72,22.12,22
NDC,6131463710,PREDNISOLONE ACETATE 1 % EYE DROPSSUSPENSION,22.1,14.37,3.71,22.1,22
NDC,6131463715,PREDNISOLONE ACETATE 1 % EYE DROPSSUSPENSION,21.28,13.83,3.58,21.28,22
NDC,6131464175,NEOMYCIN 3.5 MG-POLYMYXIN 10000 UNIT-HYDROCORT 10 MG/ML EYE DROPSUSP,49.9,32.44,8.38,49.9,22
NDC,6131464305,TOBRAMYCIN 0.3 % EYE DROPS,13.6,8.84,2.28,13.6,22
NDC,6131464511,NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10000 UNIT/ML-1 % EAR DROPSSUSP,20.98,13.64,3.52,20.98,22
NDC,6131464705,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,58.18,37.82,9.77,58.18,22
NDC,6131464725,TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPSSUSPENSION,58.04,37.73,9.75,58.04,22
NDC,6131465494,PYZCHIVA 130 MG/26 ML INTRAVENOUS SOLUTION,152.31,99.0,8.26,3236.72,39
NDC,6131465605,CIPROFLOXACIN 0.3 % EYE DROPS,18.92,12.3,3.18,18.92,22
NDC,6131465610,CIPROFLOXACIN 0.3 % EYE DROPS,18.88,12.27,3.17,18.88,22
NDC,6131465625,CIPROFLOXACIN 0.3 % EYE DROPS,20.02,13.01,3.36,20.02,22
NDC,6131466505,APRACLONIDINE 0.5 % EYE DROPS,34.7,22.56,5.83,34.7,22
NDC,6131466510,APRACLONIDINE 0.5 % EYE DROPS,34.46,22.4,5.79,34.46,22
NDC,6136418103,RAPIVAB (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,57.0,37.05,1.67,943.43,39
NDC,6144211505,GLIMEPIRIDE 1 MG TABLET,1.94,1.26,0.33,1.94,22
NDC,6147010141,AMERIGEL TOPICAL,1.34,0.87,0.23,1.34,22
NDC,6157007201,MENEST 0.3 MG TABLET,4.54,2.95,0.76,4.54,22
NDC,6157007301,MENEST 0.625 MG TABLET,6.44,4.19,1.08,6.44,22
NDC,6157007401,MENEST 1.25 MG TABLET,9.0,5.85,1.51,9.0,22
NDC,6157011001,ALTACE 1.25 MG CAPSULE,12.92,8.4,2.17,12.92,22
NDC,6157011101,ALTACE 2.5 MG CAPSULE,15.26,9.92,2.56,15.26,22
NDC,6157013120,SILVADENE 1 % TOPICAL CREAM,1.1,0.72,0.18,1.1,22
NDC,6157013125,SILVADENE 1 % TOPICAL CREAM,0.74,0.48,0.12,0.74,22
NDC,6157013140,SILVADENE 1 % TOPICAL CREAM,0.3,0.2,0.05,0.3,22
NDC,6157013155,SILVADENE 1 % TOPICAL CREAM,0.62,0.4,0.1,0.62,22
NDC,6170330346,CYTARABINE (PF) 20 MG/ML INJECTION SOLUTION,2.8,1.82,0.47,2.8,30
NDC,6170330436,CYTARABINE 20 MG/ML INJECTION SOLUTION,3.2,2.08,0.54,3.2,30
NDC,6170330538,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,6.32,4.11,0.82,6.32,30
NDC,6170330906,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,89.48,58.16,7.12,89.48,30
NDC,6170330916,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,45.44,29.54,7.12,45.44,30
NDC,6170330925,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,26.48,17.21,4.45,26.48,30
NDC,6170330926,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,28.48,18.51,4.78,28.48,30
NDC,6170331922,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,4.88,3.17,0.82,4.88,30
NDC,6170332322,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,449.36,292.08,20.81,449.36,30
NDC,6170332418,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,5.19,3.37,0.87,31.24,30
NDC,6170332518,PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION,16.35,10.63,2.75,31.24,30
NDC,6170332618,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,13.5,8.78,2.27,31.24,30
NDC,6170333218,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,181.65,118.07,20.81,181.65,30
NDC,6170333918,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,12.88,8.37,2.16,12.88,30
NDC,6170333922,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,7.44,4.84,1.25,8.11,30
NDC,6170333950,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,5.04,3.28,0.85,8.11,30
NDC,6170333956,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,3.54,2.3,0.59,8.11,30
NDC,6170334222,PACLITAXEL 6 MG/ML CONCENTRATEINTRAVENOUS,8.12,5.28,0.1,8.12,30
NDC,6170334250,PACLITAXEL 6 MG/ML CONCENTRATEINTRAVENOUS,6.84,4.45,0.1,6.84,30
NDC,6170334318,MITOXANTRONE 2 MG/ML CONCENTRATEINTRAVENOUS,82.84,53.85,30.87,118.04,46
NDC,6170334365,MITOXANTRONE 2 MG/ML CONCENTRATEINTRAVENOUS,82.84,53.85,30.87,118.04,46
NDC,6170334366,MITOXANTRONE 2 MG/ML CONCENTRATEINTRAVENOUS,85.72,55.72,30.87,118.04,46
NDC,6170334909,IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,21.08,13.7,1.95,21.08,30
NDC,6170334916,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,34.24,22.26,1.95,34.24,30
NDC,6170334936,IRINOTECAN 500 MG/25 ML INTRAVENOUS SOLUTION,32.0,20.8,1.95,32.0,30
NDC,6170335010,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,12.72,8.27,2.14,12.72,30
NDC,6170335038,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,17.44,11.34,2.31,17.44,30
NDC,6170336318,OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,23.04,14.98,0.05,23.04,30
NDC,6170336322,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,23.04,14.98,0.05,23.04,30
NDC,6170340841,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,4.64,3.02,0.78,4.64,20
NDC,6175500501,EYLEA 2 MG/0.05 ML INTRAVITREAL SYRINGE,139847.76,90901.04,746.88,139847.76,53
NDC,6175500502,EYLEA 2 MG/0.05 ML INTRAVITREAL SOLUTION FOR INJECTION,139847.76,90901.04,746.88,139847.76,53
NDC,6175500801,LIBTAYO 50 MG/ML INTRAVENOUS SOLUTION,7772.32,5052.01,24.82,7772.32,52
NDC,6175502001,PRALUENT PEN 75 MG/ML SUBCUTANEOUS PEN INJECTOR,938.82,610.23,157.72,938.82,22
NDC,6175502101,PRALUENT PEN 150 MG/ML SUBCUTANEOUS PEN INJECTOR,938.82,610.23,157.72,938.82,22
NDC,6175505001,EYLEA HD 8 MG/0.07 ML INTRAVITREAL SOLUTION FOR INJECTION,140454.0,91295.1,306.98,140454.0,53
NDC,6175505401,LYNOZYFIC 2 MG/ML INTRAVENOUS SOLUTION,902.4,586.56,96.82,5646.0,32
NDC,6175505601,LYNOZYFIC 20 MG/ML INTRAVENOUS SOLUTION,9024.0,5865.6,96.82,9024.0,38
NDC,6177259081,AMVISC 12 MG/ML INTRAOCULAR SYRINGE,567.0,368.55,95.26,567.0,22
NDC,6177260081,AMVISC PLUS 16 MG/ML INTRAOCULAR SYRINGE,684.0,444.6,114.91,684.0,22
NDC,6178706204,DIABETIC TUSSIN DM 10 MG-100 MG/5 ML ORAL LIQUID,0.18,0.12,0.03,0.18,22
NDC,6187411511,VRAYLAR 1.5 MG CAPSULE,121.52,78.99,20.42,121.52,22
NDC,6187411520,VRAYLAR 1.5 MG CAPSULE,121.52,78.99,20.42,121.52,22
NDC,6187413020,VRAYLAR 3 MG CAPSULE,121.52,78.99,20.42,121.52,22
NDC,6187413030,VRAYLAR 3 MG CAPSULE,121.52,78.99,20.42,121.52,22
NDC,6187414530,VRAYLAR 4.5 MG CAPSULE,121.52,78.99,20.42,121.52,22
NDC,6187416030,VRAYLAR 6 MG CAPSULE,121.52,78.99,20.42,121.52,22
NDC,6191979525,CIPROFLOXACIN 0.3 % EYE DROPS,26.6,17.29,4.47,26.6,22
NDC,6192418808,DERMASARRA ANTI-ITCH (MENTHOL-CAMPHOR) 0.5 %-0.5 % LOTION,0.06,0.04,0.01,0.06,22
NDC,6195300043,FLEBOGAMMA DIF 5 % INTRAVENOUS SOLUTION,19.05,12.38,3.2,19.05,22
NDC,6195300044,FLEBOGAMMA DIF 5 % INTRAVENOUS SOLUTION,19.05,12.38,3.2,19.05,22
NDC,6195300045,FLEBOGAMMA DIF 5 % INTRAVENOUS SOLUTION,19.05,12.38,3.2,19.05,22
NDC,6195300053,FLEBOGAMMA DIF 10 % INTRAVENOUS SOLUTION,38.13,24.78,9.88,943.43,38
NDC,6195804011,VIREAD 300 MG TABLET,100.28,65.18,16.85,100.28,22
NDC,6195806011,EMTRIVA 200 MG CAPSULE,42.92,27.9,7.21,42.92,22
NDC,6195806021,EMTRIVA 10 MG/ML ORAL SOLUTION,2.23,1.45,0.37,2.23,22
NDC,6195807011,TRUVADA 200 MG-300 MG TABLET,147.38,95.8,24.76,147.38,22
NDC,6195808015,LETAIRIS 5 MG TABLET,1099.7,714.81,184.75,1099.7,22
NDC,6195808021,LETAIRIS 10 MG TABLET,1099.72,714.82,184.75,1099.72,22
NDC,6195809011,CAYSTON 75 MG/ML SOLUTION FOR NEBULIZATION,362.56,235.66,60.91,362.56,22
NDC,6195811011,COMPLERA 200 MG-25 MG-300 MG TABLET,306.96,199.52,51.57,306.96,22
NDC,6195812011,STRIBILD 150 MG-150 MG-200 MG-300 MG TABLET,353.82,229.98,59.44,353.82,22
NDC,6195814011,TYBOST 150 MG TABLET,25.18,16.37,4.23,25.18,22
NDC,6195815011,SOVALDI 400 MG TABLET,2400.0,1560.0,403.2,2400.0,22
NDC,6195817011,ZYDELIG 100 MG TABLET,584.92,380.2,98.27,584.92,22
NDC,6195817021,ZYDELIG 150 MG TABLET,584.92,380.2,98.27,584.92,22
NDC,6195818011,HARVONI 90 MG-400 MG TABLET,2700.0,1755.0,453.6,2700.0,22
NDC,6195819011,GENVOYA 150 MG-150 MG-200 MG-10 MG TABLET,337.28,219.23,56.66,337.28,22
NDC,6195820021,DESCOVY 200 MG-25 MG TABLET,176.18,114.52,29.6,176.18,22
NDC,6195820022,DESCOVY 200 MG-25 MG TABLET,176.18,114.52,29.6,176.18,22
NDC,6195821011,ODEFSEY 200 MG-25 MG-25 MG TABLET,306.96,199.52,51.57,306.96,22
NDC,6195823011,VEMLIDY 25 MG TABLET,122.14,79.39,20.52,122.14,22
NDC,6195825011,BIKTARVY 50 MG-200 MG-25 MG TABLET,337.28,219.23,56.66,337.28,22
NDC,6195825013,BIKTARVY 50 MG-200 MG-25 MG TABLET,337.28,219.23,56.66,337.28,22
NDC,6195825051,BIKTARVY 30 MG-120 MG-15 MG TABLET,337.28,219.23,56.66,337.28,22
NDC,6195829012,VEKLURY 100 MG INTRAVENOUS POWDER FOR SOLUTION,2342.58,1522.68,5.45,2342.58,47
NDC,6195829022,REMDESIVIR 100 MG/20 ML (5 MG/ML) IV SOLN (FOR PTS 40 KG OR MORE),93.6,60.84,5.45,345.3,47
NDC,6195830011,SUNLENCA 300 MG TABLET,1950.0,1267.5,327.6,1950.0,22
NDC,6195830021,SUNLENCA 309 MG/ML SUBCUTANEOUS SOLUTION,23400.0,15210.0,19.81,23400.0,53
NDC,6195834011,YEZTUGO 300 MG TABLET,1410.9,917.09,273.36,1724.5,39
NDC,6195834021,YEZTUGO 309 MG/ML SUBCUTANEOUS SOLUTION,16930.8,11005.02,16.13,16930.8,45
NDC,6203210036,OBAGI NU-DERM BLENDER 4 % TOPICAL CREAM,1.92,1.25,0.32,1.92,22
NDC,6203210136,OBAGI NU-DERM CLEAR 4 % TOPICAL CREAM,2.0,1.3,0.34,2.0,22
NDC,6203210536,OBAGI-C THERAPY NIGHT 4 % TOPICAL CREAM,1.98,1.29,0.33,1.98,22
NDC,6203210610,OBAGI-C CLARIFYING SERUM 4 %-10 % TOPICAL,4.36,2.83,0.73,4.36,22
NDC,6206412202,TROGARZO 200 MG/1.33 ML (150 MG/ML) INTRAVENOUS SOLUTION,4126.47,2682.21,67.18,4126.47,50
NDC,6210333302,BOUDREAUXS BUTT PASTE 16 % TOPICAL OINTMENT,0.2,0.13,0.03,0.2,22
NDC,6210333304,BOUDREAUXS BUTT PASTE 16 % TOPICAL OINTMENT,0.16,0.1,0.03,0.16,22
NDC,6210333306,BOUDREAUXS BUTT PASTE 16 % TOPICAL OINTMENT,0.1,0.07,0.02,0.1,22
NDC,6213532190,METHYLDOPA 250 MG TABLET,18.0,11.7,3.02,18.0,22
NDC,6213534053,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,1.58,1.03,0.27,1.58,22
NDC,6213543690,SUCRALFATE 1 GRAM TABLET,9.6,6.24,1.61,9.6,22
NDC,6213575047,HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,3.18,2.07,0.53,3.18,22
NDC,6213577330,TRIMETHOBENZAMIDE 300 MG CAPSULE,43.2,28.08,7.26,43.2,22
NDC,6213596031,SULFASALAZINE 500 MG TABLET,4.8,3.12,0.81,4.8,22
NDC,6214455105,IMPROVUE (PF) 1.7 % EYE DROPS WITH APPLICATOR,40.02,26.01,6.72,40.02,22
NDC,6217526137,NIFEDIPINE ER 60 MG TABLETEXTENDED RELEASE 24 HR,4.62,3.0,0.78,4.62,22
NDC,6217532046,NIACIN ER 500 MG TABLETEXTENDED RELEASE 24 HR,10.44,6.79,1.75,10.44,22
NDC,6217532246,NIACIN ER 1000 MG TABLETEXTENDED RELEASE 24 HR,18.46,12.0,3.1,18.46,22
NDC,6217547032,PAROXETINE ER 12.5 MG TABLETEXTENDED RELEASE 24 HR,11.16,7.25,1.87,11.16,22
NDC,6217561743,PANTOPRAZOLE 40 MG TABLETDELAYED RELEASE,8.12,5.28,1.36,8.12,22
NDC,6232733343,STERITALC 3 GRAM INTRAPLEURAL AEROSOL POWDER,421.2,273.78,70.76,421.2,23
NDC,6232744404,STERITALC 4 GRAM INTRAPLEURAL SUSPENSION,469.2,304.98,78.83,469.2,22
NDC,6232744444,STERITALC 4 GRAM INTRAPLEURAL SUSPENSION,469.2,304.98,78.83,469.2,22
NDC,6233202531,THEOPHYLLINE ER 300 MG TABLETEXTENDED RELEASE12 HR,8.6,5.59,1.44,8.6,22
NDC,6233202631,THEOPHYLLINE ER 450 MG TABLETEXTENDED RELEASE12 HR,12.1,7.87,2.03,12.1,22
NDC,6233203031,ROPINIROLE 0.25 MG TABLET,5.0,3.25,0.84,5.0,22
NDC,6233203231,ROPINIROLE 1 MG TABLET,5.0,3.25,0.84,5.0,22
NDC,6233203431,ROPINIROLE 3 MG TABLET,5.0,3.25,0.84,5.0,22
NDC,6233203531,ROPINIROLE 4 MG TABLET,5.0,3.25,0.84,5.0,22
NDC,6233203631,ROPINIROLE 5 MG TABLET,5.0,3.25,0.84,5.0,22
NDC,6233206460,RIVASTIGMINE 3 MG CAPSULE,9.32,6.06,1.57,9.32,22
NDC,6233209531,LAMOTRIGINE 5 MG ORAL CHEWABLE,6.1,3.97,1.02,6.1,22
NDC,6233209631,LAMOTRIGINE 25 MG ORAL CHEWABLE,6.4,4.16,1.08,6.4,22
NDC,6233209730,ARIPIPRAZOLE 2 MG TABLET,64.0,41.6,10.75,64.0,22
NDC,6233209831,ARIPIPRAZOLE 5 MG TABLET,64.16,41.7,10.78,64.16,22
NDC,6233210230,ARIPIPRAZOLE 30 MG TABLET,90.0,58.5,15.12,90.0,22
NDC,6233210330,ARIPIPRAZOLE 10 MG DISINTEGRATING TABLET,83.78,54.46,14.08,83.78,22
NDC,6233210430,ARIPIPRAZOLE 15 MG DISINTEGRATING TABLET,83.78,54.46,14.08,83.78,22
NDC,6233214060,CELECOXIB 50 MG CAPSULE,4.32,2.81,0.73,4.32,22
NDC,6233214231,CELECOXIB 200 MG CAPSULE,15.14,9.84,2.54,15.14,22
NDC,6233219130,FEBUXOSTAT 80 MG TABLET,24.76,16.09,4.16,24.76,22
NDC,6233223430,VILAZODONE 40 MG TABLET,16.8,10.92,2.82,16.8,22
NDC,6233249630,LURASIDONE 60 MG TABLET,75.66,49.18,12.71,75.66,22
NDC,6233254505,TIMOLOL MALEATE 0.25 % EYE GEL FORMING SOLUTION,97.12,63.13,16.32,97.12,22
NDC,6233254605,TIMOLOL MALEATE 0.5 % EYE GEL FORMING SOLUTION,106.44,69.19,17.88,106.44,22
NDC,6233255660,SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,22.94,14.91,3.85,22.94,22
NDC,6233255760,SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,22.94,14.91,3.85,22.94,22
NDC,6233255860,SACUBITRIL 97 MG-VALSARTAN 103 MG TABLET,22.94,14.91,3.85,22.94,22
NDC,6233258231,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,1.82,1.18,0.31,1.82,22
NDC,6233260330,BISOPROLOL FUMARATE 5 MG TABLET,4.5,2.93,0.76,4.5,22
NDC,6233260331,BISOPROLOL FUMARATE 5 MG TABLET,4.5,2.93,0.76,4.5,22
NDC,6233261831,CYCLOPHOSPHAMIDE 25 MG CAPSULE,17.96,11.67,0.77,17.96,30
NDC,6233261931,CYCLOPHOSPHAMIDE 50 MG CAPSULE,32.98,21.44,0.77,32.98,30
NDC,6233274130,ACITRETIN 10 MG CAPSULE,62.4,40.56,10.48,62.4,22
NDC,6233279031,FLUPHENAZINE 5 MG TABLET,18.4,11.96,3.09,18.4,22
NDC,6237263015,INFANTS' MYLICON 40 MG/0.6 ML ORAL DROPSSUSPENSION,0.88,0.57,0.15,0.88,22
NDC,6248400155,XROMI 100 MG/ML ORAL SOLUTION,15.4,10.01,2.59,15.4,22
NDC,6248400202,PURIXAN 20 MG/ML ORAL SUSPENSION,40.95,26.62,6.88,40.95,22
NDC,6253000011,URE-NA 15 GRAM ORAL POWDER PACKET,10.88,7.07,1.83,10.88,22
NDC,6254140510,PANCREAZE 21000 UNIT-54700 UNIT-83900 UNIT CAPSULEDELAYED RELEASE,16.84,10.95,2.83,16.84,22
NDC,6255913807,HYDROCORTISONE 100 MG/60 ML ENEMA,0.86,0.56,0.14,0.86,22
NDC,6255915304,OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL,9.41,6.12,1.58,9.41,22
NDC,6255915801,FLUVOXAMINE 25 MG TABLET,4.6,2.99,0.77,4.6,22
NDC,6255915901,FLUVOXAMINE 50 MG TABLET,5.14,3.34,0.86,5.14,22
NDC,6255916001,FLUVOXAMINE 100 MG TABLET,5.26,3.42,0.88,5.26,22
NDC,6255917331,NILUTAMIDE 150 MG TABLET,450.48,292.81,75.68,450.48,22
NDC,6255923001,PROPAFENONE 150 MG TABLET,3.28,2.13,0.55,3.28,22
NDC,6255923101,PROPAFENONE 225 MG TABLET,4.66,3.03,0.78,4.66,22
NDC,6255924001,METHAZOLAMIDE 25 MG TABLET,10.22,6.64,1.72,10.22,22
NDC,6255924101,METHAZOLAMIDE 50 MG TABLET,20.44,13.29,3.43,20.44,22
NDC,6255925101,ETODOLAC 300 MG CAPSULE,3.1,2.02,0.52,3.1,22
NDC,6255927530,NEBIVOLOL 2.5 MG TABLET,11.36,7.38,1.91,11.36,22
NDC,6255927730,NEBIVOLOL 10 MG TABLET,11.36,7.38,1.91,11.36,22
NDC,6255927890,NEBIVOLOL 20 MG TABLET,11.36,7.38,1.91,11.36,22
NDC,6255928860,FLUOCINOLONE 0.01 % TOPICAL CREAM,4.46,2.9,0.75,4.46,22
NDC,6255935601,KIONEX (WITH SORBITOL) 15 GRAM-20 GRAM/60 ML ORAL SUSPENSION,1.3,0.85,0.22,1.3,22
NDC,6255939050,VANCOMYCIN 125 MG CAPSULE,62.62,40.7,10.52,62.62,22
NDC,6255943130,HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR,5.54,3.6,0.93,5.54,22
NDC,6255949001,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,1.4,0.91,0.24,1.4,22
NDC,6255963001,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,10.13,6.58,1.7,10.13,22
NDC,6255973101,FELBAMATE 600 MG TABLET,11.96,7.77,2.01,11.96,22
NDC,6255999212,FLUCONAZOLE 150 MG TABLET,27.96,18.17,4.7,27.96,22
NDC,6258426501,METOPROLOL TARTRATE 25 MG TABLET,0.22,0.14,0.04,0.22,22
NDC,6258426511,METOPROLOL TARTRATE 25 MG TABLET,0.22,0.14,0.04,0.22,22
NDC,6258426601,METOPROLOL TARTRATE 50 MG TABLET,0.26,0.17,0.04,0.26,22
NDC,6258426611,METOPROLOL TARTRATE 50 MG TABLET,0.26,0.17,0.04,0.26,22
NDC,6258426701,METOPROLOL TARTRATE 100 MG TABLET,0.68,0.44,0.11,0.68,22
NDC,6258481211,OXAZEPAM 10 MG CAPSULE,5.72,3.72,0.96,5.72,22
NDC,6258481311,OXAZEPAM 15 MG CAPSULE,6.3,4.1,1.06,6.3,22
NDC,6258498401,WARFARIN 2 MG TABLET,1.24,0.81,0.21,1.24,22
NDC,6258499401,WARFARIN 5 MG TABLET,1.28,0.83,0.22,1.28,22
NDC,6275622483,TIAGABINE 4 MG TABLET,15.24,9.91,2.56,15.24,22
NDC,6275625802,ZONISAMIDE 25 MG CAPSULE,0.5,0.33,0.08,0.5,22
NDC,6275625902,ZONISAMIDE 50 MG CAPSULE,0.7,0.46,0.12,0.7,22
NDC,6275652188,SUMATRIPTAN 50 MG TABLET,4.04,2.63,0.68,4.04,22
NDC,6275652926,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,92.64,60.22,5.42,93.47,44
NDC,6275652940,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,285.2,185.38,5.42,285.2,44
NDC,6275653886,RILUZOLE 50 MG TABLET,3.16,2.05,0.53,3.16,22
NDC,6285621201,LEQEMBI 100 MG/ML INTRAVENOUS SOLUTION,474.9,308.69,1.21,474.9,47
NDC,6285621501,LEQEMBI 100 MG/ML INTRAVENOUS SOLUTION,474.93,308.7,1.21,474.93,47
NDC,6285638901,HALAVEN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,3384.0,2199.6,72.6,3384.0,50
NDC,6285670405,LENVIMA 4 MG CAPSULE,1998.64,1299.12,335.77,1998.64,22
NDC,6285671030,LENVIMA 10 MG/DAY (10 MG X 1) CAPSULE,1998.64,1299.12,335.77,1998.64,22
NDC,6285671230,LENVIMA 12 MG/DAY (4 MG X 3) CAPSULE,666.22,433.04,111.92,666.22,22
NDC,6285671405,LENVIMA 14 MG/DAY(10 MG X 1-4 MG X 1) CAPSULE,999.32,649.56,167.89,999.32,22
NDC,6285671805,LENVIMA 18 MG/DAY (10 MG X 1 AND 4 MG X 2) CAPSULE,666.22,433.04,111.92,666.22,22
NDC,6285672430,LENVIMA 24 MG PER DAY (10 MG X 2 AND 4 MG X 1) CAPSULE,666.22,433.04,111.92,666.22,22
NDC,6293515350,FENSOLVI 45 MG SUBCUTANEOUS SYRINGE,103734.78,67427.61,118.53,103734.78,53
NDC,6293522305,ELIGARD 22.5 MG (3 MONTH) SUBCUTANEOUS SYRINGE,4878.24,3170.86,167.1,4878.24,49
NDC,6293522710,ELIGARD 22.5 MG (3 MONTH) SUBCUTANEOUS SYRINGE,4878.24,3170.86,167.1,4878.24,49
NDC,6293530330,ELIGARD 30 MG (4 MONTH) SUBCUTANEOUS SYRINGE,6504.33,4227.81,167.1,6504.33,52
NDC,6293530640,ELIGARD 30 MG (4 MONTH) SUBCUTANEOUS SYRINGE,6504.33,4227.81,167.1,6504.33,52
NDC,6293545345,ELIGARD 45 MG (6 MONTH) SUBCUTANEOUS SYRINGE,9756.48,6341.71,167.1,9756.48,52
NDC,6293546150,ELIGARD 45 MG (6 MONTH) SUBCUTANEOUS SYRINGE,9756.48,6341.71,167.1,9756.48,52
NDC,6293575375,ELIGARD 7.5 MG (1 MONTH) SUBCUTANEOUS SYRINGE,2168.12,1409.28,167.1,2168.12,46
NDC,6293575680,ELIGARD 7.5 MG (1 MONTH) SUBCUTANEOUS SYRINGE,2168.12,1409.28,167.1,2168.12,46
NDC,6299112035,PAPAVERINE (BULK) POWDER,83.0,53.95,13.94,83.0,22
NDC,6299113721,SODIUM CHLORIDE (BULK) GRANULES,0.19,0.12,0.03,0.19,22
NDC,6299114222,CLONIDINE HCL (BULK) POWDER,435.0,282.75,73.08,435.0,22
NDC,6299116483,BISMUTH SUBGALLATE (BULK) POWDER,3.6,2.34,0.6,3.6,22
NDC,6299117082,TETRACAINE (BULK) 100 % WAX,28.5,18.53,4.79,28.5,22
NDC,6299128121,PILOCARPINE NITRATE (BULK) POWDER,61.47,39.96,10.33,61.47,22
NDC,6299128632,EPINEPHRINE BITARTRATE (BULK) POWDER,97.5,63.38,16.38,97.5,22
NDC,6299130821,FORMALDEHYDE (BULK) 37 % SOLUTION,0.32,0.21,0.05,0.32,22
NDC,6300477311,ACTHAR H.P. 80 UNIT/ML INJECTION GEL,21514.5,13984.43,2562.41,21514.5,46
NDC,6300487101,ACTHAR 80 UNIT/ML INJECTION GEL,32618.88,21202.27,2562.41,32618.88,46
NDC,6301001030,VIRACEPT 250 MG TABLET,9.72,6.32,1.63,9.72,22
NDC,6302004901,VELCADE 3.5 MG SOLUTION FOR INJECTION,7694.4,5001.36,1.86,7694.4,42
NDC,6302009030,ALUNBRIG 90 MG TABLET,1663.44,1081.24,279.46,1663.44,22
NDC,6302011330,ALUNBRIG 30 MG TABLET,554.72,360.57,93.19,554.72,22
NDC,6302018030,ALUNBRIG 180 MG TABLET,1663.44,1081.24,279.46,1663.44,22
NDC,6302021021,FRUZAQLA 1 MG CAPSULE,752.92,489.4,126.49,752.92,22
NDC,6302022521,FRUZAQLA 5 MG CAPSULE,3011.08,1957.2,505.86,3011.08,22
NDC,6302023002,NINLARO 2.3 MG CAPSULE,10852.0,7053.8,1823.14,10852.0,22
NDC,6302039002,NINLARO 3 MG CAPSULE,10852.0,7053.8,1823.14,10852.0,22
NDC,6302040002,NINLARO 4 MG CAPSULE,10852.0,7053.8,1823.14,10852.0,22
NDC,6302053330,ICLUSIG 30 MG TABLET,1865.6,1212.64,313.42,1865.6,22
NDC,6302053430,ICLUSIG 45 MG TABLET,1865.6,1212.64,313.42,1865.6,22
NDC,6302053530,ICLUSIG 15 MG TABLET,1865.6,1212.64,313.42,1865.6,22
NDC,6302053630,ICLUSIG 10 MG TABLET,1865.6,1212.64,313.42,1865.6,22
NDC,6304420301,IFEREX 150 150 MG IRON CAPSULE,0.66,0.43,0.11,0.66,22
NDC,6304440420,AMMONIUM LACTATE 12 % TOPICAL CREAM,0.4,0.26,0.07,0.4,22
NDC,6304462201,RENO CAPS 1 MG CAPSULE,1.32,0.86,0.22,1.32,22
NDC,6304463510,TRICON 110 MG-0.5 MG CAPSULE,0.78,0.51,0.13,0.78,22
NDC,6309010030,NUPLAZID 10 MG TABLET,409.6,266.24,68.81,409.6,22
NDC,6309034030,NUPLAZID 34 MG CAPSULE,409.6,266.24,68.81,409.6,22
NDC,6325610030,SCLEROSOL INTRAPLEURAL 4 GRAM AEROSOL POWDER,8.4,5.46,1.41,8.4,22
NDC,6325620005,STERILE TALC 5 GRAM INTRAPLEURAL SUSPENSION,298.5,194.03,50.15,298.5,22
NDC,6326125021,LYMPHAZURIN 1 % SUBCUTANEOUS SOLUTION,452.91,294.39,8.53,452.91,33
NDC,6330419130,DESVENLAFAXINE ER 50 MG TABLETEXTENDED RELEASE 24 HR,11.14,7.24,1.87,11.14,22
NDC,6330469301,CLINDAMYCIN HCL 300 MG CAPSULE,1.04,0.68,0.17,1.04,22
NDC,6332300105,EMPTY STERILIZED VIAL,3.1,2.02,0.52,2.79,21
NDC,6332300110,EMPTY STERILIZED VIAL,1.36,0.88,0.23,1.36,22
NDC,6332301002,GENTAMICIN 40 MG/ML INJECTION SOLUTION,7.32,4.76,1.23,7.32,31
NDC,6332301003,GENTAMICIN 40 MG/ML INJECTION SOLUTION,5.25,3.41,0.88,6.0,31
NDC,6332301020,GENTAMICIN 40 MG/ML INJECTION SOLUTION,5.25,3.41,0.88,6.0,31
NDC,6332301115,CHLORAMPHENICOL SODIUM SUCCINATE 1 GRAM INTRAVENOUS SOLUTION,175.14,113.84,43.79,175.14,26
NDC,6332301203,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,10.8,7.02,1.81,10.8,23
NDC,6332301207,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,5.4,3.51,0.91,5.4,23
NDC,6332301210,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,3.69,2.4,0.62,3.69,23
NDC,6332301211,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,10.8,7.02,1.81,10.8,23
NDC,6332301230,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,6.48,4.21,1.09,6.48,23
NDC,6332301302,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,17.91,11.64,2.03,17.91,31
NDC,6332301309,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,9.18,5.97,1.54,9.18,31
NDC,6332302425,MANNITOL 25 % INTRAVENOUS SOLUTION,0.45,0.29,0.08,0.45,30
NDC,6332302605,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,1.83,1.19,0.31,1.83,22
NDC,6332303011,CHORIONIC GONADOTROPIN HUMAN 10000 UNIT IM POWDER FOR SOLUTION,1124.1,730.67,20.96,1124.1,31
NDC,6332304400,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,12.24,7.96,1.22,12.24,31
NDC,6332304401,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,12.24,7.96,1.22,12.24,31
NDC,6332306401,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,3.57,2.32,0.58,3.57,31
NDC,6332306402,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,2.85,1.85,0.48,2.85,31
NDC,6332306403,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,3.57,2.32,0.58,3.57,31
NDC,6332306410,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,0.63,0.41,0.11,1.12,31
NDC,6332306411,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,1.02,0.66,0.17,1.12,31
NDC,6332306421,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,2.16,1.4,0.36,2.16,31
NDC,6332306423,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,2.16,1.4,0.36,2.16,31
NDC,6332308303,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,16.95,11.02,2.85,16.95,22
NDC,6332308305,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,16.95,11.02,2.85,16.95,22
NDC,6332308605,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,10.65,6.92,1.79,10.65,22
NDC,6332308650,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,4.83,3.14,0.81,4.83,22
NDC,6332309020,SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,0.93,0.6,0.16,0.93,23
NDC,6332309040,SODIUM CHLORIDE 2.5 MEQ/ML INTRAVENOUS SOLUTION,0.78,0.51,0.13,0.78,23
NDC,6332309330,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,0.93,0.6,0.16,0.93,23
NDC,6332309561,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,0.63,0.41,0.11,0.63,23
NDC,6332310213,GEMCITABINE 200 MG INTRAVENOUS SOLUTION,57.6,37.44,3.29,57.6,30
NDC,6332310351,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,1.96,1.27,0.33,5.84,30
NDC,6332310364,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,1.96,1.27,0.33,5.84,30
NDC,6332310365,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,1.96,1.27,0.33,5.84,30
NDC,6332310406,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,11.96,7.77,0.94,11.96,30
NDC,6332310425,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,11.96,7.77,0.94,11.96,30
NDC,6332310450,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,11.96,7.77,0.94,11.96,30
NDC,6332310601,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.33,0.21,0.06,1.12,31
NDC,6332310605,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,0.93,0.6,0.16,1.12,31
NDC,6332310610,MAGNESIUM SULFATE 40 GRAM/1000 ML (4 %) IN WATER INTRAVENOUS SOLUTION,0.03,0.02,0.01,1.12,31
NDC,6332310705,MAGNESIUM SULFATE 4 GRAM/50 ML (8 %) IN WATER INTRAVENOUS PIGGYBACK,0.6,0.39,0.1,1.12,31
NDC,6332310801,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,0.33,0.21,0.06,1.12,31
NDC,6332311310,PENTAM 300 MG SOLUTION FOR INJECTION,600.81,390.53,0.46,600.81,30
NDC,6332311700,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,1.64,1.07,0.28,5.37,30
NDC,6332311710,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,1.64,1.07,0.28,5.37,30
NDC,6332311719,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,1.32,0.86,0.22,5.37,30
NDC,6332311720,FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,1.64,1.07,0.28,5.37,30
NDC,6332311751,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,1.4,0.91,0.24,5.37,30
NDC,6332311759,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,0.88,0.57,0.15,5.37,30
NDC,6332311761,FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION,1.4,0.91,0.24,5.37,30
NDC,6332312250,METHOTREXATE SODIUM (PF) 1 GRAM SOLUTION FOR INJECTION,305.28,198.43,2.31,305.28,30
NDC,6332312302,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,10.8,7.02,1.81,10.8,30
NDC,6332312310,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,16.12,10.48,2.31,16.12,30
NDC,6332312553,GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION,235.2,152.88,3.29,235.2,30
NDC,6332312710,DACARBAZINE 100 MG INTRAVENOUS SOLUTION,59.48,38.66,3.32,59.48,30
NDC,6332312820,DACARBAZINE 200 MG INTRAVENOUS SOLUTION,57.6,37.44,3.32,57.6,30
NDC,6332313002,DOXY-100 100 MG INTRAVENOUS SOLUTION,94.8,61.62,0.19,94.8,30
NDC,6332313011,DOXY-100 100 MG INTRAVENOUS SOLUTION,94.8,61.62,0.19,94.8,30
NDC,6332313013,DOXY-100 100 MG INTRAVENOUS SOLUTION,62.37,40.54,0.19,62.37,30
NDC,6332313210,MITOXANTRONE 2 MG/ML CONCENTRATEINTRAVENOUS,195.68,127.19,30.87,195.68,46
NDC,6332313610,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,158.96,103.32,20.81,158.96,30
NDC,6332313720,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,351.52,228.49,20.81,351.52,30
NDC,6332314010,CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,208.8,135.72,7.41,208.8,46
NDC,6332314210,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,278.64,181.12,23.8,278.64,30
NDC,6332314212,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,290.24,188.66,23.8,290.24,30
NDC,6332314397,ADDAMEL N 5.33 MCG-0.34 MG-0.54 MG/ML INTRAVENOUS SOLUTION,5.76,3.74,0.97,5.76,22
NDC,6332316101,KETOROLAC 15 MG/ML INJECTION SOLUTION,13.5,8.78,0.34,13.5,41
NDC,6332316112,KETOROLAC 15 MG/ML INJECTION SOLUTION,2.52,1.64,0.34,2.52,41
NDC,6332316201,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,20.52,13.34,0.34,20.52,41
NDC,6332316202,KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION,14.76,9.59,0.34,14.76,41
NDC,6332316212,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,2.52,1.64,0.34,2.52,41
NDC,6332316214,KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION,1.62,1.05,0.34,1.62,41
NDC,6332316501,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,10.38,6.75,0.11,10.38,31
NDC,6332316505,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,4.98,3.24,0.11,4.98,31
NDC,6332316530,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,5.58,3.63,0.11,5.58,31
NDC,6332317245,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,7.56,4.91,1.27,8.11,30
NDC,6332317301,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,9.75,6.34,1.64,9.75,31
NDC,6332317302,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,9.75,6.34,1.64,9.75,31
NDC,6332318001,PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,78.24,50.86,13.14,78.24,31
NDC,6332318410,FOLIC ACID 5 MG/ML INJECTION SOLUTION,23.01,14.96,0.1,23.01,30
NDC,6332318510,STERILE WATER 100 % FOR INJECTION,1.8,1.17,0.3,1.8,22
NDC,6332318520,STERILE WATER 100 % FOR INJECTION,1.17,0.76,0.2,1.17,22
NDC,6332318550,STERILE WATER 100 % FOR INJECTION,0.6,0.39,0.1,0.6,22
NDC,6332318600,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.42,0.27,0.07,0.42,22
NDC,6332318601,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.42,0.27,0.07,0.42,22
NDC,6332318602,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,1.92,1.25,0.32,1.92,22
NDC,6332318610,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.42,0.27,0.07,0.42,22
NDC,6332318620,SODIUM CHLORIDE 0.9 % INJECTION SOLUTION,0.33,0.21,0.06,0.33,22
NDC,6332319202,FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,652.52,424.14,88.8,652.52,37
NDC,6332319302,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,38.4,24.96,1.95,38.4,30
NDC,6332319420,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,41.34,26.87,6.95,110.83,36
NDC,6332320102,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,5.1,3.32,0.03,5.1,23
NDC,6332320110,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,0.96,0.62,0.03,0.96,23
NDC,6332320202,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,5.34,3.47,0.03,5.34,23
NDC,6332320500,OMEGAVEN 10 % INTRAVENOUS EMULSION,3.78,2.46,0.64,3.78,22
NDC,6332320805,LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,2.7,1.76,0.03,2.7,23
NDC,6332322905,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,11.16,7.25,1.87,11.16,31
NDC,6332322915,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,8.04,5.23,1.35,8.04,31
NDC,6332322930,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,6.69,4.35,1.12,6.69,31
NDC,6332322935,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,4.74,3.08,0.8,4.74,31
NDC,6332323861,CEFAZOLIN 10 GRAM INTRAVENOUS SOLUTION,45.15,29.35,0.73,45.15,31
NDC,6332324120,GLYCOPHOS 1 MMOL/ML INTRAVENOUS SOLUTION,2.34,1.52,0.39,2.34,22
NDC,6332325402,MURI-LUBE OIL,11.83,7.69,1.99,11.83,22
NDC,6332325410,MURI-LUBE OIL,2.73,1.77,0.46,2.73,22
NDC,6332325503,METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION,21.9,14.24,0.25,21.9,38
NDC,6332325803,METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION,41.94,27.26,0.25,41.94,38
NDC,6332326037,POLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,1.35,0.88,0.23,10.38,31
NDC,6332326110,PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,10.77,7.0,0.63,10.77,31
NDC,6332326530,METHYLPREDNISOLONE SODIUM SUCCINATE 1000 MG INTRAVENOUS SOLUTION,123.18,80.07,0.25,123.18,38
NDC,6332326910,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.08,0.7,0.11,1.08,31
NDC,6332326922,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.08,0.7,0.11,1.08,31
NDC,6332326929,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.08,0.7,0.11,1.08,31
NDC,6332326937,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,0.42,0.27,0.07,0.42,31
NDC,6332326950,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.08,0.7,0.11,1.08,31
NDC,6332326957,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.14,0.74,0.11,1.14,31
NDC,6332326965,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.08,0.7,0.11,1.08,31
NDC,6332326967,DIPRIVAN 10 MG/ML INTRAVENOUS EMULSION,1.14,0.74,0.11,1.14,31
NDC,6332327205,FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION,111.57,72.52,8.75,111.57,31
NDC,6332327301,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,352.8,229.32,59.27,352.8,23
NDC,6332327602,HEPARIN PORCINE (PF) 1000 UNIT/ML INJECTION SOLUTION,23.73,15.42,0.25,23.73,31
NDC,6332327810,VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,25.8,16.77,4.33,25.8,30
NDC,6332328110,FLUPHENAZINE 2.5 MG/ML INJECTION SOLUTION,69.15,44.95,7.1,69.15,38
NDC,6332328260,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,1.41,0.92,0.24,1.41,22
NDC,6332328357,POLOCAINE 1 % (10 MG/ML) INJECTION SOLUTION,1.14,0.74,0.19,10.38,31
NDC,6332328420,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,57.24,37.21,5.76,57.24,24
NDC,6332328503,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.74,1.13,0.06,1.74,31
NDC,6332328507,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.74,1.13,0.06,1.74,31
NDC,6332328510,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.74,1.13,0.06,1.74,31
NDC,6332328513,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.74,1.13,0.06,1.74,31
NDC,6332328520,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.74,1.13,0.06,1.74,31
NDC,6332328523,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.74,1.13,0.06,1.74,31
NDC,6332328561,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.38,0.9,0.06,1.38,31
NDC,6332328564,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.47,0.96,0.06,1.47,31
NDC,6332328565,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,1.47,0.96,0.06,1.47,31
NDC,6332328567,NAROPIN (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,0.75,0.49,0.06,0.75,31
NDC,6332328600,NAROPIN (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,2.19,1.42,0.06,2.19,31
NDC,6332328605,NAROPIN (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,2.61,1.7,0.06,2.61,31
NDC,6332328623,NAROPIN (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,2.61,1.7,0.06,2.61,31
NDC,6332328695,NAROPIN (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,0.6,0.39,0.06,0.6,31
NDC,6332328720,NAROPIN (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,3.39,2.2,0.06,3.39,31
NDC,6332328721,NAROPIN (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION,3.39,2.2,0.06,3.39,31
NDC,6332328803,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,4.08,2.65,0.06,4.08,31
NDC,6332328810,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,4.08,2.65,0.06,4.08,31
NDC,6332328811,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,4.08,2.65,0.06,4.08,31
NDC,6332328821,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,4.08,2.65,0.06,4.08,31
NDC,6332328827,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.74,1.13,0.06,1.74,31
NDC,6332328829,NAROPIN (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.35,0.88,0.06,1.35,31
NDC,6332329337,POLOCAINE-MPF 15 MG/ML (1.5 %) INJECTION SOLUTION,1.8,1.17,0.3,10.38,31
NDC,6332329427,POLOCAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,2.22,1.44,0.37,10.38,31
NDC,6332329657,POLOCAINE 2 % INJECTION SOLUTION,1.17,0.76,0.2,10.38,31
NDC,6332330351,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,300.6,195.39,2.3,300.6,31
NDC,6332330355,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,708.75,460.69,2.3,708.75,31
NDC,6332330502,TOBRAMYCIN 10 MG/ML INJECTION SOLUTION,23.01,14.96,2.3,23.01,31
NDC,6332330602,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,6.09,3.96,1.02,6.09,31
NDC,6332330630,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,2.64,1.72,0.44,5.73,31
NDC,6332330751,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,3.78,2.46,0.64,5.73,31
NDC,6332331461,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,765.0,497.25,5.76,765.0,24
NDC,6332331510,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,350.16,227.6,39.69,350.16,31
NDC,6332332110,POLYMYXIN B SULFATE 500000 UNIT SOLUTION FOR INJECTION,41.01,26.66,6.89,41.01,22
NDC,6332332225,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,107.94,70.16,6.8,107.94,31
NDC,6332332293,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,40.38,26.25,6.78,40.38,31
NDC,6332332620,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,20.88,13.57,1.2,20.88,31
NDC,6332332710,NAFCILLIN 1 GRAM SOLUTION FOR INJECTION,53.61,34.85,0.11,53.61,30
NDC,6332332820,NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,104.01,67.61,0.11,104.01,30
NDC,6332334020,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,35.64,23.17,1.2,35.64,31
NDC,6332334101,CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,22.98,14.94,3.86,22.98,31
NDC,6332334125,CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,22.98,14.94,3.86,22.98,31
NDC,6332334225,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,50.25,32.66,4.41,50.25,31
NDC,6332334925,IMIPENEM-CILASTATIN 250 MG INTRAVENOUS SOLUTION,61.53,39.99,6.8,61.53,31
NDC,6332335120,RIFAMPIN 600 MG INTRAVENOUS SOLUTION,550.8,358.02,0.29,550.8,30
NDC,6332335601,CASPOFUNGIN 50 MG INTRAVENOUS SOLUTION,1213.2,788.58,5.97,1213.2,31
NDC,6332336001,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,3.6,2.34,0.04,3.6,31
NDC,6332336003,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,1.95,1.27,0.04,1.95,31
NDC,6332336019,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,3.6,2.34,0.04,3.6,31
NDC,6332336059,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,1.95,1.27,0.04,1.95,31
NDC,6332336061,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,1.95,1.27,0.04,1.95,31
NDC,6332336501,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,18.21,11.84,1.01,18.21,31
NDC,6332336601,DIMENHYDRINATE 50 MG/ML INJECTION SOLUTION,47.31,30.75,1.75,47.31,31
NDC,6332336820,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,14.01,9.11,1.91,14.01,31
NDC,6332336920,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,27.75,18.04,1.91,27.75,31
NDC,6332337601,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,35.79,23.26,1.01,35.79,30
NDC,6332337701,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,178.89,116.28,1.01,178.89,31
NDC,6332337805,OCTREOTIDE ACETATE 200 MCG/ML INJECTION SOLUTION,71.55,46.51,1.01,71.55,31
NDC,6332337905,OCTREOTIDE ACETATE 1000 MCG/ML INJECTION SOLUTION,357.75,232.54,1.01,357.75,31
NDC,6332338510,CEFOTETAN 1 GRAM SOLUTION FOR INJECTION,87.18,56.67,0.63,87.18,23
NDC,6332338620,CEFOTETAN 2 GRAM SOLUTION FOR INJECTION,174.39,113.35,0.63,174.39,23
NDC,6332338910,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,21.24,13.81,0.9,21.24,31
NDC,6332339306,COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,100.77,65.5,11.56,100.77,31
NDC,6332339810,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,26.76,17.39,2.17,26.76,31
NDC,6332339812,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,89.85,58.4,2.17,89.85,31
NDC,6332340005,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,2.97,1.93,0.06,2.97,31
NDC,6332340120,AZTREONAM 1 GRAM SOLUTION FOR INJECTION,129.9,84.44,21.82,129.9,22
NDC,6332340201,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,205.92,133.85,2.32,205.92,31
NDC,6332340220,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,205.92,133.85,2.32,205.92,31
NDC,6332340230,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,185.22,120.39,2.32,185.22,31
NDC,6332340302,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,9.84,6.4,1.34,9.84,26
NDC,6332340510,CLONIDINE (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,7.2,4.68,1.21,47.68,31
NDC,6332340603,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,44.18,28.72,7.42,44.18,22
NDC,6332341605,CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,10.08,6.55,1.69,10.08,22
NDC,6332341710,CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,6.63,4.31,1.11,6.63,22
NDC,6332341820,CISATRACURIUM CONCENTRATE 10 MG/ML (ICU USE ONLY) INTRAVENOUS SOLUTION,30.0,19.5,5.04,30.0,22
NDC,6332342410,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,28.05,18.23,4.71,28.05,22
NDC,6332343441,ACETAMINOPHEN 1000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION,0.36,0.23,0.05,0.36,31
NDC,6332345101,MORPHINE 10 MG/ML INJECTION SOLUTION,10.98,7.14,1.84,18.74,31
NDC,6332345201,MORPHINE 2 MG/ML INJECTION SOLUTION,10.32,6.71,1.73,18.74,31
NDC,6332345401,MORPHINE 4 MG/ML INJECTION SOLUTION,10.32,6.71,1.73,18.74,31
NDC,6332345801,MORPHINE 8 MG/ML INJECTION SOLUTION,10.59,6.88,1.78,10.59,31
NDC,6332346037,SENSORCAINE-MPF/EPINEPHRINE 0.75 %-1:200000 INJECTION SOLUTION,1.77,1.15,0.3,1.77,22
NDC,6332346217,SENSORCAINE-MPF/EPINEPHRINE 0.5 %-1:200000 INJECTION SOLUTION,2.82,1.83,0.47,2.82,22
NDC,6332346237,SENSORCAINE-MPF/EPINEPHRINE 0.5 %-1:200000 INJECTION SOLUTION,1.56,1.01,0.26,1.56,22
NDC,6332346357,SENSORCAINE-EPINEPHRINE 0.5 %-1:200000 INJECTION SOLUTION,1.5,0.98,0.25,1.5,22
NDC,6332346617,SENSORCAINE-MPF 0.5 % (5 MG/ML) INJECTION SOLUTION,2.07,1.35,0.01,2.07,31
NDC,6332346757,SENSORCAINE 0.5 % (5 MG/ML) INJECTION SOLUTION,1.02,0.66,0.01,1.02,31
NDC,6332346901,HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,101.1,65.72,6.07,101.1,31
NDC,6332347101,HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,185.34,120.47,6.07,185.34,31
NDC,6332347401,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,21.57,14.02,1.14,21.57,31
NDC,6332347410,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,20.7,13.46,1.14,20.7,31
NDC,6332347537,NESACAINE 10 MG/ML (1 %) INJECTION SOLUTION,2.16,1.4,0.04,2.16,31
NDC,6332347637,NESACAINE 20 MG/ML (2 %) INJECTION SOLUTION,2.22,1.44,0.04,2.22,31
NDC,6332347701,NESACAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,4.38,2.85,0.04,4.38,31
NDC,6332347727,NESACAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,4.38,2.85,0.04,4.38,31
NDC,6332347827,NESACAINE-MPF 30 MG/ML (3 %) INJECTION SOLUTION,4.02,2.61,0.04,4.02,31
NDC,6332348157,XYLOCAINE WITH EPINEPHRINE 0.5 %-1:200000 INJECTION SOLUTION,0.66,0.43,0.11,0.66,22
NDC,6332348217,XYLOCAINE WITH EPINEPHRINE 1 %-1:100000 INJECTION SOLUTION,1.44,0.94,0.03,1.44,23
NDC,6332348227,XYLOCAINE WITH EPINEPHRINE 1 %-1:100000 INJECTION SOLUTION,1.02,0.66,0.03,1.02,23
NDC,6332348257,XYLOCAINE WITH EPINEPHRINE 1 %-1:100000 INJECTION SOLUTION,0.93,0.6,0.03,0.93,23
NDC,6332348303,XYLOCAINE WITH EPINEPHRINE 2 %-1:100000 INJECTION SOLUTION,1.02,0.66,0.03,1.02,23
NDC,6332348327,XYLOCAINE WITH EPINEPHRINE 2 %-1:100000 INJECTION SOLUTION,1.02,0.66,0.03,1.02,23
NDC,6332348357,XYLOCAINE WITH EPINEPHRINE 2 %-1:100000 INJECTION SOLUTION,0.75,0.49,0.03,0.75,23
NDC,6332348457,XYLOCAINE 5 MG/ML (0.5 %) INJECTION SOLUTION,0.39,0.25,0.07,0.39,22
NDC,6332348527,XYLOCAINE 10 MG/ML (1 %) INJECTION SOLUTION,0.6,0.39,0.03,0.6,23
NDC,6332348557,XYLOCAINE 10 MG/ML (1 %) INJECTION SOLUTION,0.42,0.27,0.03,0.42,23
NDC,6332348617,XYLOCAINE 20 MG/ML (2 %) INJECTION SOLUTION,1.23,0.8,0.03,1.23,23
NDC,6332348627,XYLOCAINE 20 MG/ML (2 %) INJECTION SOLUTION,0.6,0.39,0.03,0.6,23
NDC,6332348657,XYLOCAINE 20 MG/ML (2 %) INJECTION SOLUTION,0.51,0.33,0.03,0.51,23
NDC,6332348701,XYLOCAINE-MPF/EPINEPHRINE 1 %-1:200000 INJECTION SOLUTION,3.99,2.59,0.03,3.99,23
NDC,6332348717,XYLOCAINE-MPF/EPINEPHRINE 1 %-1:200000 INJECTION SOLUTION,3.99,2.59,0.03,3.99,23
NDC,6332348731,XYLOCAINE-MPF/EPINEPHRINE 1 %-1:200000 INJECTION SOLUTION,1.23,0.8,0.03,1.23,23
NDC,6332348737,XYLOCAINE-MPF/EPINEPHRINE 1 %-1:200000 INJECTION SOLUTION,1.86,1.21,0.03,1.86,23
NDC,6332348817,XYLOCAINE-MPF/EPINEPHRINE 1.5 %-1:200000 INJECTION SOLUTION,3.93,2.55,0.03,3.93,23
NDC,6332348837,XYLOCAINE-MPF/EPINEPHRINE 1.5 %-1:200000 INJECTION SOLUTION,2.13,1.38,0.03,2.13,23
NDC,6332348917,XYLOCAINE-MPF/EPINEPHRINE 2 %-1:200000 INJECTION SOLUTION,4.23,2.75,0.03,4.23,23
NDC,6332348927,XYLOCAINE-MPF/EPINEPHRINE 2 %-1:200000 INJECTION SOLUTION,4.23,2.75,0.03,4.23,23
NDC,6332349157,XYLOCAINE-MPF 5 MG/ML (0.5 %) INJECTION SOLUTION,1.05,0.68,0.03,1.05,23
NDC,6332349204,XYLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,4.02,2.61,0.03,4.02,23
NDC,6332349227,XYLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,4.02,2.61,0.03,4.02,23
NDC,6332349257,XYLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,2.82,1.83,0.03,2.82,23
NDC,6332349297,XYLOCAINE-MPF 10 MG/ML (1 %) INJECTION SOLUTION,2.13,1.38,0.03,2.13,23
NDC,6332349391,XYLOCAINE-MPF 15 MG/ML (1.5 %) INJECTION SOLUTION,2.16,1.4,0.36,2.16,22
NDC,6332349397,XYLOCAINE-MPF 15 MG/ML (1.5 %) INJECTION SOLUTION,2.4,1.56,0.4,2.4,22
NDC,6332349401,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,4.83,3.14,0.1,93.47,36
NDC,6332349405,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,4.83,3.14,0.1,93.47,36
NDC,6332349507,XYLOCAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,2.58,1.68,0.03,2.58,23
NDC,6332349527,XYLOCAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,4.59,2.98,0.03,4.59,23
NDC,6332349697,XYLOCAINE-MPF 20 MG/ML (2 %) INJECTION SOLUTION,2.49,1.62,0.03,2.49,23
NDC,6332350601,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,27.0,17.55,0.11,27.0,31
NDC,6332350720,MEROPENEM 500 MG INTRAVENOUS SOLUTION,10.8,7.02,0.35,10.8,31
NDC,6332350830,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,21.24,13.81,0.35,21.24,31
NDC,6332351610,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,5.58,3.63,0.11,5.58,31
NDC,6332351977,HEPARIN (PORCINE) (PF) 1000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.49,31
NDC,6332352603,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,465.12,302.33,0.6,465.12,46
NDC,6332353075,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,0.03,0.02,0.01,0.44,23
NDC,6332353190,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,71.55,46.51,0.56,71.55,31
NDC,6332353784,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,107.31,69.75,0.56,107.31,31
NDC,6332354011,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,2.61,1.7,0.25,2.61,31
NDC,6332354209,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,31.32,20.36,0.25,31.32,31
NDC,6332354213,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,31.32,20.36,0.25,31.32,31
NDC,6332354214,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,18.48,12.01,0.25,18.48,31
NDC,6332354401,HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML INTRAVENOUS SOLUTION,5.79,3.76,0.02,5.79,31
NDC,6332354411,HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML INTRAVENOUS SOLUTION,1.2,0.78,0.02,1.2,31
NDC,6332355993,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,33.24,21.61,0.56,33.24,31
NDC,6332356497,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,33.12,21.53,0.56,33.12,31
NDC,6332356621,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,32.22,20.94,0.56,32.22,31
NDC,6332356999,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,54.24,35.26,0.56,54.24,31
NDC,6332357270,CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION,704.32,457.81,11.48,704.32,46
NDC,6332358020,ATROPINE 0.4 MG/ML INJECTION SOLUTION,13.74,8.93,0.25,13.74,30
NDC,6332358282,GLUCAGON (HCL) EMERGENCY KIT 1 MG SOLUTION FOR INJECTION,1007.28,654.73,74.0,1007.28,47
NDC,6332358499,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,33.3,21.65,0.56,33.3,31
NDC,6332358696,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,33.54,21.8,0.56,33.54,31
NDC,6332358921,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,50.25,32.66,0.56,50.25,31
NDC,6332358994,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,50.25,32.66,0.56,50.25,31
NDC,6332359303,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,797.94,518.66,74.0,797.94,47
NDC,6332359403,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,540.0,351.0,74.0,540.0,47
NDC,6332359613,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,909.66,591.28,74.0,909.66,47
NDC,6332359710,DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,53.13,34.53,8.12,53.13,31
NDC,6332359930,DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,148.32,96.41,8.12,148.32,31
NDC,6332360401,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,41.34,26.87,6.95,41.34,23
NDC,6332360584,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,71.58,46.53,0.56,71.58,31
NDC,6332360701,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,71.58,46.53,0.56,71.58,31
NDC,6332360788,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,71.58,46.53,0.56,71.58,31
NDC,6332361400,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,61.35,39.88,5.0,61.35,31
NDC,6332361401,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,61.35,39.88,5.0,61.35,31
NDC,6332361421,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,45.0,29.25,5.0,45.0,31
NDC,6332361455,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,45.0,29.25,5.0,45.0,31
NDC,6332361603,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,2.4,1.56,0.4,2.4,30
NDC,6332361609,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,2.19,1.42,0.37,2.19,30
NDC,6332361710,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,2.91,1.89,0.49,3.73,31
NDC,6332361720,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,3.06,1.99,0.51,3.73,31
NDC,6332361750,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,1.44,0.94,0.24,3.73,31
NDC,6332362376,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,5.51,31
NDC,6332362410,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.03,0.02,0.01,8.14,31
NDC,6332362474,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.06,0.04,0.01,4.82,31
NDC,6332362601,SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,0.21,0.14,0.04,0.21,22
NDC,6332362603,SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,22
NDC,6332363110,LEUCOVORIN CALCIUM 10 MG/ML INJECTION SOLUTION,7.92,5.15,1.33,10.63,31
NDC,6332363150,LEUCOVORIN CALCIUM 10 MG/ML INJECTION SOLUTION,7.77,5.05,1.31,10.63,31
NDC,6332364220,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,1.62,1.05,0.27,1.62,31
NDC,6332364250,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,1.68,1.09,0.28,1.68,22
NDC,6332364810,LEVOTHYROXINE 500 MCG INTRAVENOUS POWDER FOR SOLUTION,1900.47,1235.31,11.36,1900.47,36
NDC,6332364907,LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,433.29,281.64,11.36,433.29,36
NDC,6332364916,LEVOTHYROXINE 100 MCG INTRAVENOUS POWDER FOR SOLUTION,317.82,206.58,11.36,317.82,36
NDC,6332365102,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,19.71,12.81,0.5,19.71,31
NDC,6332365130,ADENOSINE (DIAGNOSTIC) 3 MG/ML INTRAVENOUS SOLUTION,23.28,15.13,0.5,23.28,31
NDC,6332365210,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,6.48,4.21,1.09,6.48,22
NDC,6332365599,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,49.92,32.45,0.56,49.92,31
NDC,6332365820,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,1071.72,696.62,78.98,1071.72,31
NDC,6332365827,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,175.29,113.94,29.45,175.29,31
NDC,6332365903,INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,1904.19,1237.72,319.9,1904.19,22
NDC,6332366401,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,10.83,7.04,0.74,10.83,31
NDC,6332366416,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,2.94,1.91,0.49,2.94,31
NDC,6332366501,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,70.92,46.1,4.69,70.92,31
NDC,6332368810,SODIUM CHLORIDE 0.9 % WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,0.03,0.02,0.01,0.33,31
NDC,6332369210,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,5.18,3.37,0.87,5.18,22
NDC,6332369310,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,5.18,3.37,0.87,5.18,22
NDC,6332371100,LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION,310.29,201.69,4.62,310.29,31
NDC,6332372303,REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,231.51,150.48,38.89,231.51,22
NDC,6332373101,CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,21.57,14.02,2.6,21.57,23
NDC,6332373310,MESNA 100 MG/ML INTRAVENOUS SOLUTION,31.84,20.7,1.58,31.84,30
NDC,6332373311,MESNA 100 MG/ML INTRAVENOUS SOLUTION,23.88,15.52,1.58,23.88,30
NDC,6332373410,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,12.69,8.25,2.13,31.24,30
NDC,6332373510,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,38.01,24.71,6.39,38.01,30
NDC,6332373809,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,1.62,1.05,0.02,1.62,30
NDC,6332373820,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,1.62,1.05,0.02,1.62,30
NDC,6332373912,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,1.62,1.05,0.02,1.62,30
NDC,6332375101,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,11.52,7.49,0.03,11.52,23
NDC,6332376020,MELPHALAN HCL 50 MG INTRAVENOUS POWDER FOR SOLUTION,5513.28,3583.63,86.94,5513.28,52
NDC,6332376210,TOPOTECAN 4 MG INTRAVENOUS SOLUTION,652.96,424.42,1.05,652.96,30
NDC,6332377139,AZACITIDINE 100 MG SOLUTION FOR INJECTION,432.04,280.83,0.37,432.04,36
NDC,6332380811,FENTANYL (PF) 50 MCG/ML INJECTION SYRINGE,7.95,5.17,0.89,7.95,31
NDC,6332381100,OXACILLIN 10 GRAM SOLUTION FOR INJECTION,420.48,273.31,1.01,420.48,31
NDC,6332381220,OXACILLIN 2 GRAM SOLUTION FOR INJECTION,84.09,54.66,1.01,84.09,31
NDC,6332381320,OXACILLIN 1 GRAM SOLUTION FOR INJECTION,42.06,27.34,1.01,42.06,31
NDC,6332382000,SMOFLIPID 20 % INTRAVENOUS EMULSION,0.87,0.57,0.15,0.87,22
NDC,6332382004,SMOFLIPID 20 % INTRAVENOUS EMULSION,0.42,0.27,0.07,0.42,22
NDC,6332382010,SMOFLIPID 20 % INTRAVENOUS EMULSION,0.24,0.16,0.04,0.24,22
NDC,6332382050,SMOFLIPID 20 % INTRAVENOUS EMULSION,0.27,0.18,0.05,0.27,22
NDC,6332382074,SMOFLIPID 20 % INTRAVENOUS EMULSION,0.42,0.27,0.07,0.42,22
NDC,6332385074,MOXIFLOXACIN 400 MG/250 ML-SODIUM ACETSUL-WATER INTRAVENOUS PIGGYBACK,0.66,0.43,0.11,18.39,31
NDC,6332385150,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,12.24,7.96,0.09,12.24,37
NDC,6332385225,HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLUTION,15.54,10.1,0.09,15.54,37
NDC,6332385410,HYDROMORPHONE (PF) 4 MG/ML INJECTION SOLUTION,16.14,10.49,0.09,16.14,37
NDC,6332387074,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,31
NDC,6332387310,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,31
NDC,6332387374,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.03,0.02,0.01,3.62,31
NDC,6332387715,NEBUPENT 300 MG SOLUTION FOR INHALATION,400.54,260.35,67.29,400.54,22
NDC,6332388330,DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,6.4,4.16,1.08,7.7,30
NDC,6332388510,LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,63.87,41.52,3.75,78.3,46
NDC,6332388514,LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,53.94,35.06,3.75,78.3,46
NDC,6332388656,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,9.9,6.44,1.66,9.9,22
NDC,6332389010,LEVOTHYROXINE 40 MCG/ML INTRAVENOUS SOLUTION,159.63,103.76,3.75,159.63,46
NDC,6332391513,HEPARIN (PORCINE) 20000 UNIT/ML INJECTION SOLUTION,60.33,39.21,0.25,60.33,31
NDC,6332392430,SODIUM CHLORIDE 0.9 % BACTERIOSTATIC INJECTION SOLUTION,0.54,0.35,0.09,0.54,22
NDC,6332392688,ROMIDEPSIN 10 MG/2 ML INTRAVENOUS POWDER FOR SOLUTION,15209.52,9886.19,27.49,15209.52,52
NDC,6332396010,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,561.6,365.04,6.58,561.6,23
NDC,6332396502,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.48,0.31,0.08,0.48,31
NDC,6332396503,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.84,0.55,0.1,0.84,31
NDC,6332396510,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.84,0.55,0.1,0.84,31
NDC,6332396520,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.48,0.31,0.08,0.48,31
NDC,6332396600,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,10.8,7.02,1.81,14.06,31
NDC,6332396730,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,0.48,0.31,0.08,0.48,31
NDC,6336124310,VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SUSPENSION,1172.58,762.18,17.89,1172.58,29
NDC,6336124315,VAXELIS (PF) 15 UNIT-5 UNIT-10 MCG/0.5 ML INTRAMUSCULAR SYRINGE,1172.58,762.18,17.89,1172.58,29
NDC,6340220430,APTIOM 400 MG TABLET,107.76,70.04,18.1,107.76,22
NDC,6340220660,APTIOM 600 MG TABLET,107.76,70.04,18.1,107.76,22
NDC,6340230230,LATUDA 20 MG TABLET,113.5,73.78,19.07,113.5,22
NDC,6340230430,LATUDA 40 MG TABLET,113.5,73.78,19.07,113.5,22
NDC,6340230830,LATUDA 80 MG TABLET,113.5,73.78,19.07,113.5,22
NDC,6340231230,LATUDA 120 MG TABLET,169.42,110.12,28.46,169.42,22
NDC,6340291101,BROVANA 15 MCG/2 ML SOLUTION FOR NEBULIZATION,22.52,14.64,3.78,22.52,22
NDC,6340291130,BROVANA 15 MCG/2 ML SOLUTION FOR NEBULIZATION,22.52,14.64,3.78,22.52,22
NDC,6345910310,TRUXIMA 10 MG/ML INTRAVENOUS SOLUTION,405.88,263.82,27.88,1355.53,46
NDC,6345910450,TRUXIMA 10 MG/ML INTRAVENOUS SOLUTION,405.88,263.82,27.88,1355.53,46
NDC,6345930343,HERZUMA 150 MG INTRAVENOUS SOLUTION,5235.6,3403.14,50.22,5235.6,52
NDC,6345930547,HERZUMA 420 MG INTRAVENOUS SOLUTION,14659.68,9528.79,50.22,14659.68,52
NDC,6345934804,BENDEKA 25 MG/ML INTRAVENOUS SOLUTION,2968.56,1929.56,12.45,2968.56,49
NDC,6345939008,TREANDA 25 MG INTRAVENOUS POWDER FOR SOLUTION,3566.16,2318.0,2.04,3566.16,50
NDC,6345939120,TREANDA 100 MG INTRAVENOUS POWDER FOR SOLUTION,14264.64,9272.02,2.04,14264.64,53
NDC,6345941230,GABITRIL 12 MG TABLET,36.96,24.02,6.21,36.96,22
NDC,6345950230,ACTIQ 200 MCG LOZENGE ON A HANDLE,209.72,136.32,35.23,209.72,22
NDC,6345950630,ACTIQ 600 MCG LOZENGE ON A HANDLE,325.32,211.46,54.65,325.32,22
NDC,6345954128,FENTORA 100 MCG BUCCAL TABLET EFFERVESCENT,188.76,122.69,31.71,188.76,22
NDC,6345954228,FENTORA 200 MCG BUCCAL TABLET EFFERVESCENT,238.48,155.01,40.06,238.48,22
NDC,6345954428,FENTORA 400 MCG BUCCAL TABLET EFFERVESCENT,346.04,224.93,58.13,346.04,22
NDC,6345991011,GRANIX 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,1798.98,1169.34,0.24,1798.98,46
NDC,6345991015,GRANIX 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,1799.01,1169.36,0.24,1799.01,46
NDC,6345991211,GRANIX 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1799.49,1169.67,0.24,1799.49,46
NDC,6362987811,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.14,0.09,0.02,0.14,22
NDC,6371301972,SURGIFOAM 12 MM-7 MM SPONGE,13.48,8.76,2.26,13.48,22
NDC,6371301974,SURGIFOAM 100 SPONGE,65.8,42.77,11.05,65.8,22
NDC,6371301975,SURGIFOAM 100 CM SPONGE,65.8,42.77,11.05,65.8,22
NDC,63736003001,NIX CREME RINSE 1 % TOPICAL LIQUID,0.34,0.22,0.06,0.34,22
NDC,6373602403,NIX CREME RINSE 1 % TOPICAL LIQUID,0.34,0.22,0.06,0.34,22
NDC,6373612002,NIX CREME RINSE 1 % TOPICAL LIQUID,0.52,0.34,0.09,0.52,22
NDC,6373612003,NIX CREME RINSE 1 % TOPICAL LIQUID,0.42,0.27,0.07,0.42,22
NDC,6373633942,DERMAREST ECZEMA (HYDROCORTISONE) 1 % LOTION,0.18,0.12,0.03,0.18,22
NDC,6373637882,AMERICAINE 20 % TOPICAL AEROSOL,0.24,0.16,0.04,0.24,22
NDC,6373644101,1-DAY 6.5 % VAGINAL OINTMENT,9.62,6.25,1.62,9.62,22
NDC,6373644860,MONISTAT 3 200 MG-2 % (9 GRAM) VAGINAL KIT,50.58,32.88,8.5,50.58,22
NDC,6373921202,ASPIRIN 81 MG TABLETDELAYED RELEASE,0.12,0.08,0.02,0.12,22
NDC,6373925701,ACETAZOLAMIDE 250 MG TABLET,8.64,5.62,1.45,8.64,22
NDC,6373957010,SIMVASTATIN 5 MG TABLET,0.5,0.33,0.08,0.5,22
NDC,6380710001,SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,0.15,0.1,0.03,0.15,22
NDC,6380750055,HEPARIN LOCK FLUSH (PORCINE) (PF) 10 UNIT/ML INTRAVENOUS SYRINGE,2.1,1.37,0.02,2.1,31
NDC,6382400815,MUCINEX 600 MG TABLET EXTENDED RELEASE,1.02,0.66,0.17,1.02,22
NDC,6382400850,MUCINEX 600 MG TABLET EXTENDED RELEASE,0.9,0.59,0.15,0.9,22
NDC,6382405632,MUCINEX DM 30 MG-600 MG TABLETEXTENDED RELEASE 12 HR,1.54,1.0,0.26,1.54,22
NDC,6382405634,MUCINEX DM 30 MG-600 MG TABLETEXTENDED RELEASE 12 HR,1.34,0.87,0.23,1.34,22
NDC,6382405640,MUCINEX DM 30 MG-600 MG TABLETEXTENDED RELEASE 12 HR,1.88,1.22,0.32,1.88,22
NDC,6382405718,MUCINEX D 60 MG-600 MG TABLETEXTENDED RELEASE,1.7,1.11,0.29,1.7,22
NDC,6382417563,DELSYM 12 HOUR 30 MG/5 ML ORAL SUSPENSIONEXTENDED RELEASE,0.33,0.21,0.06,0.33,22
NDC,6382417565,DELSYM 12 HOUR 30 MG/5 ML ORAL SUSPENSIONEXTENDED RELEASE,0.25,0.16,0.04,0.25,22
NDC,6382471316,CEPACOL SORE THROAT (BENZOCAINE-MENTHOL) 15 MG-3.6 MG LOZENGES,0.36,0.23,0.06,0.36,22
NDC,6382471516,CEPACOL SORE THROAT (BENZOCAINE-MENTHOL) 15 MG-3.6 MG LOZENGES,0.36,0.23,0.06,0.36,22
NDC,6382473216,CEPACOL SORE THROAT (BENZOCAINE-MENTHOL) 15 MG-2.6 MG LOZENGES,0.36,0.23,0.06,0.36,22
NDC,6383338602,KCENTRA 500 UNIT (400-620 UNIT) INTRAVENOUS SOLUTION,10.74,6.98,2.09,1355.53,39
NDC,6383338702,KCENTRA 1000 UNIT (800-1240 UNIT) INTRAVENOUS SOLUTION,10.74,6.98,2.09,1355.53,39
NDC,6383361502,HUMATE-P 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,6.15,4.0,1.26,3236.72,47
NDC,6383361602,HUMATE-P 500 UNIT-1200 UNIT INTRAVENOUS SOLUTION,6.15,4.0,1.26,3236.72,47
NDC,6383361702,HUMATE-P 1000 UNIT-2400 UNIT INTRAVENOUS SOLUTION,6.15,4.0,1.26,3236.72,47
NDC,6383382502,BERINERT 500 UNIT (10 ML) INTRAVENOUS KIT,15992.88,10395.37,57.98,15992.88,53
NDC,6383389151,RIASTAP 1 GRAM (900 MG-1300 MG) INTRAVENOUS SOLUTION,5.46,3.55,1.3,3407.66,47
NDC,6406721601,UVADEX 20 MCG/ML INJECTION SOLUTION,302.88,196.87,50.88,302.88,22
NDC,6419342402,FEIBA NF 700 UNIT-1300 UNIT INTRAVENOUS SOLUTION,9.72,6.32,2.06,3407.66,47
NDC,6419342502,FEIBA NF 1750 UNIT-3250 UNIT INTRAVENOUS SOLUTION,9.72,6.32,2.06,3407.66,47
NDC,6419342602,FEIBA NF 350 UNIT-650 UNIT INTRAVENOUS SOLUTION,9.72,6.32,2.06,3407.66,47
NDC,6420877531,COAGADEX 500 (+/-) UNIT RANGE INTRAVENOUS SOLUTION,40.98,26.64,8.2,18253.82,47
NDC,6425311130,NORMAL SALINE FLUSH 0.9 % INJECTION SYRINGE,1.11,0.72,0.19,1.11,22
NDC,6425322235,HEPARIN PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE,0.42,0.27,0.02,0.42,31
NDC,6425333330,HEPARIN PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE,0.24,0.16,0.02,0.24,31
NDC,6425333333,HEPARIN PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE,0.81,0.53,0.02,0.81,31
NDC,6425333335,HEPARIN PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE,0.48,0.31,0.02,0.48,31
NDC,6425344425,HEPARIN PORCINE (PF) 1 UNIT/ML INTRAVENOUS SYRINGE,0.72,0.47,0.12,0.72,22
NDC,6428110000,METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION,218.4,141.96,1.01,218.4,31
NDC,6428110006,PROVOCHOLINE 100 MG SOLUTION FOR INHALATION,218.4,141.96,1.01,218.4,31
NDC,6428111006,PROVOCHOLINE 0 TO 48 MG/3 ML SOLUTION FOR NEBULIZATION,18.0,11.7,1.01,18.0,31
NDC,6438016001,MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,1.5,0.98,0.25,1.5,22
NDC,6438017202,OLANZAPINE 5 MG DISINTEGRATING TABLET,28.54,18.55,4.79,28.54,22
NDC,6438017302,OLANZAPINE 10 MG DISINTEGRATING TABLET,41.94,27.26,7.05,41.94,22
NDC,6438018401,PROPAFENONE ER 225 MG CAPSULEEXTENDED RELEASE 12 HR,15.78,10.26,2.65,15.78,22
NDC,6438018601,PROPAFENONE ER 425 MG CAPSULEEXTENDED RELEASE 12 HR,20.0,13.0,3.36,20.0,22
NDC,6438071003,LAMIVUDINE 150 MG TABLET,14.3,9.3,2.4,14.3,22
NDC,6438072406,CALCITRIOL 0.5 MCG CAPSULE,3.86,2.51,0.65,3.86,22
NDC,6438074206,BUSPIRONE 10 MG TABLET,2.7,1.76,0.45,2.7,22
NDC,6438075806,ACARBOSE 25 MG TABLET,1.8,1.17,0.3,1.8,22
NDC,6438075906,ACARBOSE 50 MG TABLET,1.94,1.26,0.33,1.94,22
NDC,6438078206,PREDNISONE 1 MG TABLET,0.5,0.33,0.01,0.5,31
NDC,6438078932,LIDOCAINE 5 % TOPICAL OINTMENT,17.88,11.62,3.0,17.88,22
NDC,6438078933,LIDOCAINE 5 % TOPICAL OINTMENT,15.24,9.91,2.56,15.24,22
NDC,6438087806,ETHOSUXIMIDE 250 MG CAPSULE,5.58,3.63,0.94,5.58,22
NDC,6438091906,URSODIOL 500 MG TABLET,9.5,6.18,1.6,9.5,22
NDC,6440600801,TYSABRI 300 MG/15 ML INTRAVENOUS SOLUTION,2131.02,1385.16,21.8,3407.66,47
NDC,6440601901,BYOOVIZ 0.5 MG/0.05 ML INTRAVITREAL SOLUTION,83800.8,54470.52,60.21,83800.8,53
NDC,6440602201,TOFIDENCE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,532.8,346.32,5.58,532.8,46
NDC,6440602301,TOFIDENCE 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,532.8,346.32,5.58,532.8,46
NDC,6440602401,TOFIDENCE 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,532.8,346.32,5.58,532.8,46
NDC,6440605801,SPINRAZA (PF) 12 MG/5 ML INTRATHECAL SOLUTION,105335.25,68467.91,1231.9,105335.25,45
NDC,6440610901,QALSODY 100 MG/15 ML (6.7 MG/ML) INTRATHECAL SOLUTION,3623.19,2355.07,135.75,12697.64,50
NDC,6467969902,OXACILLIN 2 GRAM SOLUTION FOR INJECTION,87.0,56.55,1.01,87.0,31
NDC,6476408060,AMITIZA 8 MCG CAPSULE,14.84,9.65,2.49,14.84,22
NDC,6476413001,ADZYNMA 500 (+/-) UNIT INTRAVENOUS KIT,12.18,7.92,3.15,98.17,40
NDC,6476414005,ADZYNMA 500 (+/-) UNIT INTRAVENOUS KIT,12.18,7.92,3.15,98.17,40
NDC,6476414505,ADZYNMA 1500 (+/-) UNIT INTRAVENOUS KIT,12.18,7.92,3.15,98.17,40
NDC,6476415104,ACTOS 15 MG TABLET,31.08,20.2,5.22,31.08,22
NDC,6476430020,ENTYVIO 300 MG INTRAVENOUS SOLUTION,36391.32,23654.36,19.67,36391.32,53
NDC,6476430114,ACTOS 30 MG TABLET,47.5,30.88,7.98,47.5,22
NDC,6476445124,ACTOS 45 MG TABLET,51.52,33.49,8.66,51.52,22
NDC,6476454311,PREVACID SOLUTAB 15 MG DELAYED RELEASEDISINTEGRATING TABLET,33.2,21.58,5.58,33.2,22
NDC,6476454411,PREVACID SOLUTAB 30 MG DELAYED RELEASEDISINTEGRATING TABLET,33.2,21.58,5.58,33.2,22
NDC,6476472030,TRINTELLIX 5 MG TABLET,43.18,28.07,7.25,43.18,22
NDC,6476473030,TRINTELLIX 10 MG TABLET,43.18,28.07,7.25,43.18,22
NDC,6476475030,TRINTELLIX 20 MG TABLET,43.18,28.07,7.25,43.18,22
NDC,6476480028,LIVTENCITY 200 MG TABLET,549.58,357.23,92.33,549.58,22
NDC,6476480530,ROZEREM 8 MG TABLET,31.12,20.23,5.23,31.12,22
NDC,6476491830,ULORIC 40 MG TABLET,26.4,17.16,4.44,26.4,22
NDC,6484207279,INQOVI 35 MG-100 MG TABLET,4163.94,2706.56,699.54,4163.94,22
NDC,6484210201,LONSURF 20 MG-8.19 MG TABLET,697.72,453.52,117.22,697.72,22
NDC,6484210251,LONSURF 15 MG-6.14 MG TABLET,523.3,340.15,87.91,523.3,22
NDC,6485091101,ISRADIPINE 5 MG CAPSULE,8.3,5.4,1.39,8.3,22
NDC,6487500101,MIFEPREX 200 MG TABLET,103.2,67.08,17.34,103.2,22
NDC,6489666101,RYTARY 23.75 MG-95 MG CAPSULEEXTENDED RELEASE,9.98,6.49,1.68,9.98,22
NDC,6489666201,RYTARY 36.25 MG-145 MG CAPSULEEXTENDED RELEASE,9.98,6.49,1.68,9.98,22
NDC,6489666301,RYTARY 48.75 MG-195 MG CAPSULEEXTENDED RELEASE,9.98,6.49,1.68,9.98,22
NDC,6489666401,RYTARY 61.25 MG-245 MG CAPSULEEXTENDED RELEASE,12.54,8.15,2.11,12.54,22
NDC,6489669501,OXYMORPHONE ER 5 MG TABLETEXTENDED RELEASE12 HR,12.66,8.23,2.13,12.66,22
NDC,6489696716,CREXONT 35 MG-140 MG CAPSULE EXTENDED RELEASE,10.96,7.12,1.84,10.96,22
NDC,6489696816,CREXONT 52.5 MG-210 MG CAPSULE EXTENDED RELEASE,10.96,7.12,1.84,10.96,22
NDC,6489696916,CREXONT 70 MG-280 MG CAPSULE EXTENDED RELEASE,10.96,7.12,1.84,10.96,22
NDC,6489697016,CREXONT 87.5 MG-350 MG CAPSULE EXTENDED RELEASE,10.96,7.12,1.84,10.96,22
NDC,6495034245,HYCODAN 5 MG-1.5 MG/5 ML (5 ML) ORAL SOLUTION,5.85,3.8,0.98,5.85,22
NDC,6495034316,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,1.25,0.81,0.21,1.25,22
NDC,6495037147,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML ORAL SOLUTION,0.2,0.13,0.03,0.2,22
NDC,6495037416,ACETAMINOPHEN 120 MG-CODEINE 12 MG/5 ML ORAL SOLUTION,0.99,0.64,0.17,0.99,22
NDC,6498010401,PHOSPHA NEUTRAL 250 MG TABLET,1.02,0.66,0.17,1.02,22
NDC,6498013301,DIPYRIDAMOLE 25 MG TABLET,2.84,1.85,0.48,2.84,22
NDC,6498013401,DIPYRIDAMOLE 50 MG TABLET,4.58,2.98,0.77,4.58,22
NDC,6498013501,DIPYRIDAMOLE 75 MG TABLET,6.12,3.98,1.03,6.12,22
NDC,6498014612,FLORANEX 100 MILLION CELL ORAL GRANULES IN PACKET,4.06,2.64,0.68,4.06,22
NDC,6498017750,CHLOROQUINE 250 MG TABLET,18.38,11.95,3.09,18.38,22
NDC,6498017802,CHLOROQUINE 500 MG TABLET,47.7,31.01,8.01,47.7,22
NDC,6498020612,ZILEUTON ER 600 MG TABLETEXTENDED RELEASE 12HR MPHASE,64.44,41.89,10.83,64.44,22
NDC,6498022003,PYRIDOSTIGMINE BROMIDE ER 180 MG TABLETEXTENDED RELEASE,49.62,32.25,8.34,49.62,22
NDC,6498029001,PERPHENAZINE 2 MG TABLET,3.5,2.28,0.59,3.5,22
NDC,6498030130,PROCTOZONE-HC 2.5 % TOPICAL CREAM PERINEAL APPLICATOR,5.82,3.78,0.98,5.82,22
NDC,6498030401,CHLORTHALIDONE 50 MG TABLET,2.98,1.94,0.5,2.98,22
NDC,6498032005,TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,32.24,20.96,5.42,32.24,22
NDC,6498032212,RISAMINE 0.44 %-20.6 % TOPICAL OINTMENT,0.08,0.05,0.01,0.08,22
NDC,6498033901,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,0.3,0.2,0.05,0.3,22
NDC,6498034003,ALENDRONATE 10 MG TABLET,5.86,3.81,0.98,5.86,22
NDC,6498034214,ALENDRONATE 70 MG TABLET,40.96,26.62,6.88,40.96,22
NDC,6498037503,ATOMOXETINE 25 MG CAPSULE,28.46,18.5,4.78,28.46,22
NDC,6498037603,ATOMOXETINE 40 MG CAPSULE,30.94,20.11,5.2,30.94,22
NDC,6498037703,ATOMOXETINE 60 MG CAPSULE,30.94,20.11,5.2,30.94,22
NDC,6498037903,ATOMOXETINE 100 MG CAPSULE,33.38,21.7,5.61,33.38,22
NDC,6498040524,ABACAVIR 20 MG/ML ORAL SOLUTION,1.63,1.06,0.27,1.63,22
NDC,6498040906,SERTRALINE 20 MG/ML ORAL CONCENTRATE,2.8,1.82,0.47,2.8,22
NDC,6498042712,TINIDAZOLE 500 MG TABLET,16.92,11.0,2.84,16.92,22
NDC,6498050312,LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,0.98,0.64,0.16,0.98,22
NDC,6498050448,CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,0.35,0.23,0.06,0.35,22
NDC,6498050924,DEXAMETHASONE 0.5 MG/5 ML ORAL ELIXIR,0.68,0.44,0.11,0.68,22
NDC,6498051301,TIMOLOL MALEATE 0.25 % EYE DROPS,5.56,3.61,0.93,5.56,22
NDC,6498051305,TIMOLOL MALEATE 0.25 % EYE DROPS,6.0,3.9,1.01,6.0,22
NDC,6498051401,TIMOLOL MALEATE 0.5 % EYE DROPS,6.48,4.21,1.09,6.48,22
NDC,6498051415,TIMOLOL MALEATE 0.5 % EYE DROPS,6.5,4.23,1.09,6.5,22
NDC,6498051501,OFLOXACIN 0.3 % EYE DROPS,27.14,17.64,4.56,27.14,22
NDC,6498051505,OFLOXACIN 0.3 % EYE DROPS,28.14,18.29,4.73,28.14,22
NDC,6498052660,NITAZOXANIDE 500 MG TABLET,330.42,214.77,55.51,330.42,22
NDC,6498058851,EDETATE CALCIUM DISODIUM 200 MG/ML INJECTION SOLUTION,4676.13,3039.48,1211.12,17184.65,49
NDC,6498059324,NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,36.53,23.74,6.14,36.53,22
NDC,6504450521,ALLERGENIC EXTRACT-CANDIDA ALBICANS 1:10 INJECTION SOLUTION,92.7,60.26,15.57,92.7,23
NDC,6504499981,POSITIVE SKIN TEST CONTROL-HISTAMINE 10 MG/ML INTRADERMAL SOLUTION,197.88,128.62,33.24,197.88,22
NDC,6516208774,ITRACONAZOLE 10 MG/ML ORAL SOLUTION,6.13,3.98,1.03,6.13,22
NDC,6516218810,NAPROXEN 250 MG TABLET,1.54,1.0,0.26,1.54,22
NDC,6516228003,PALIPERIDONE ER 1.5 MG TABLETEXTENDED RELEASE 24 HR,61.2,39.78,10.28,61.2,22
NDC,6516228103,PALIPERIDONE ER 3 MG TABLETEXTENDED RELEASE 24 HR,61.2,39.78,10.28,61.2,22
NDC,6516228203,PALIPERIDONE ER 6 MG TABLETEXTENDED RELEASE 24 HR,61.2,39.78,10.28,61.2,22
NDC,6516228303,PALIPERIDONE ER 9 MG TABLETEXTENDED RELEASE 24 HR,91.78,59.66,15.42,91.78,22
NDC,6516246410,IBUPROFEN 400 MG TABLET,0.78,0.51,0.13,0.78,22
NDC,6516247505,NORETHINDRONE ACETATE 5 MG TABLET,5.3,3.45,0.89,5.3,22
NDC,6516251210,SALSALATE 500 MG TABLET,3.9,2.54,0.66,3.9,22
NDC,6516251310,SALSALATE 750 MG TABLET,5.6,3.64,0.94,5.6,22
NDC,6516255410,DEMECLOCYCLINE 150 MG TABLET,18.8,12.22,3.16,18.8,22
NDC,6516255548,DEMECLOCYCLINE 300 MG TABLET,34.14,22.19,5.74,34.14,22
NDC,6516257410,BETHANECHOL CHLORIDE 50 MG TABLET,6.86,4.46,1.15,6.86,22
NDC,6516259606,ASPIRIN 25 MG-DIPYRIDAMOLE 200 MG CAPSULEEXT.RELEASE 12 HR MULTIPHASE,16.72,10.87,2.81,16.72,22
NDC,6516264978,OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,2.73,1.77,0.46,2.73,22
NDC,6516267384,RISPERIDONE 1 MG/ML ORAL SOLUTION,12.7,8.26,2.13,12.7,22
NDC,6516267684,AZELASTINE 137 MCG (0.1 %) NASAL SPRAY,9.7,6.31,1.63,9.7,22
NDC,6516268110,PHENAZOPYRIDINE 100 MG TABLET,5.4,3.51,0.91,5.4,22
NDC,6516268210,PHENAZOPYRIDINE 200 MG TABLET,8.0,5.2,1.34,8.0,22
NDC,6516269179,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,12.0,7.8,2.02,12.0,22
NDC,6516269388,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,16.4,10.66,2.76,16.4,22
NDC,6516273509,FELBAMATE 600 MG TABLET,11.96,7.77,2.01,11.96,22
NDC,6516274934,RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH,33.8,21.97,5.68,33.8,22
NDC,6516276110,WARFARIN 1 MG TABLET,1.16,0.75,0.19,1.16,22
NDC,6516276210,WARFARIN 2 MG TABLET,1.28,0.83,0.22,1.28,22
NDC,6516276310,WARFARIN 2.5 MG TABLET,1.26,0.82,0.21,1.26,22
NDC,6516276410,WARFARIN 3 MG TABLET,1.32,0.86,0.22,1.32,22
NDC,6516276510,WARFARIN 4 MG TABLET,1.32,0.86,0.22,1.32,22
NDC,6516276610,WARFARIN 5 MG TABLET,1.34,0.87,0.23,1.34,22
NDC,6516276710,WARFARIN 6 MG TABLET,1.84,1.2,0.31,1.84,22
NDC,6516276810,WARFARIN 7.5 MG TABLET,1.92,1.25,0.32,1.92,22
NDC,6516276910,WARFARIN 10 MG TABLET,2.0,1.3,0.34,2.0,22
NDC,6516278303,MEMANTINE 14 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,30.52,19.84,5.13,30.52,22
NDC,6516278403,MEMANTINE 21 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,30.52,19.84,5.13,30.52,22
NDC,6516278503,MEMANTINE 28 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,30.52,19.84,5.13,30.52,22
NDC,6516278509,MEMANTINE 28 MG CAPSULE SPRINKLEEXTENDED RELEASE 24HR,30.52,19.84,5.13,30.52,22
NDC,6516280114,TEMOZOLOMIDE 5 MG CAPSULE,28.92,18.8,0.17,28.92,29
NDC,6516280151,TEMOZOLOMIDE 5 MG CAPSULE,28.58,18.58,0.17,28.58,29
NDC,6516280214,TEMOZOLOMIDE 20 MG CAPSULE,115.1,74.82,0.17,115.1,29
NDC,6516280251,TEMOZOLOMIDE 20 MG CAPSULE,115.12,74.83,0.17,115.12,29
NDC,6516280551,TEMOZOLOMIDE 180 MG CAPSULE,1035.94,673.36,0.17,1035.94,30
NDC,6516289703,ARIPIPRAZOLE 5 MG TABLET,64.16,41.7,10.78,64.16,22
NDC,6516291446,TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,56.54,36.75,9.5,56.54,22
NDC,6516291838,LIDOCAINE 5 % TOPICAL OINTMENT,16.94,11.01,2.85,16.94,22
NDC,6516291853,LIDOCAINE 5 % TOPICAL OINTMENT,15.24,9.91,2.56,15.24,22
NDC,6517427030,DRAXIMAGE MAA 2.5 MG INTRAVENOUS SOLUTION,1092.0,709.8,183.46,2409.0,29
NDC,6517428801,DRAXIMAGE DTPA 20 MG INTRAVENOUS SOLUTION,426.0,276.9,71.57,2409.0,26
NDC,6517446105,SODIUM IODIDE-131 (I-131) 3.7 MBQ (100 MICROCI) CAPSULE,180.0,117.0,30.24,2409.0,26
NDC,6517466030,DRAXIMAGE MDP-25 25 MG INTRAVENOUS SOLUTION,56.0,36.4,9.41,2409.0,29
NDC,6517488025,HICON 250 MCI/0.25 ML ORAL KIT,675.95,439.37,113.56,2409.0,29
NDC,6519740010,A AND D (LANOLIN-PETROLATUM) TOPICAL OINTMENT,0.16,0.1,0.03,0.16,22
NDC,6519740101,A AND D (LANOLIN-PETROLATUM) TOPICAL OINTMENT,0.1,0.07,0.02,0.1,22
NDC,6521905229,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,17.28,11.23,2.9,17.28,22
NDC,6521905429,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,11.52,7.49,1.94,11.52,22
NDC,6521911810,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,0.33,31
NDC,6521912012,DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,6404.4,4162.86,13.61,6404.4,53
NDC,6521914404,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,22
NDC,6521914410,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,22
NDC,6521915075,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,22
NDC,6521915175,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,0.03,0.02,0.01,0.03,22
NDC,6521925600,PIPERACILLIN-TAZOBACTAM 40.5 GRAM INTRAVENOUS SOLUTION,528.36,343.43,0.95,528.36,31
NDC,6521929510,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,72.0,46.8,5.42,93.47,44
NDC,6521938302,IODIXANOL 320 MG IODINE/ML INTRAVENOUS SOLUTION,3.27,2.13,0.12,3.27,21
NDC,6521945830,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.06,0.04,0.01,0.06,23
NDC,6521947030,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.06,0.04,0.01,1.84,31
NDC,6521947410,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.03,0.02,0.01,5.51,31
NDC,6521953110,INTRALIPID 20 % INTRAVENOUS EMULSION,1.14,0.74,0.19,1.14,22
NDC,6521953325,INTRALIPID 20 % INTRAVENOUS EMULSION,0.69,0.45,0.12,0.69,22
NDC,6521953550,INTRALIPID 20 % INTRAVENOUS EMULSION,0.3,0.2,0.05,0.3,22
NDC,6521955001,PRALATREXATE 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,23913.44,15543.74,269.35,23913.44,53
NDC,6521955202,PRALATREXATE 40 MG/2 ML (20 MG/ML) INTRAVENOUS SOLUTION,23913.44,15543.74,269.35,23913.44,53
NDC,6521959004,TYENNE 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,470.0,305.5,4.19,470.0,46
NDC,6521959210,TYENNE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,470.0,305.5,4.19,470.0,46
NDC,6521959420,TYENNE 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,470.0,305.5,4.19,470.0,46
NDC,6521959810,TYENNE 162 MG/0.9 ML SUBCUTANEOUS SYRINGE,4072.68,2647.24,4.19,4072.68,49
NDC,6521962210,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,5.52,3.59,0.05,5.52,31
NDC,6521962420,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,5.16,3.35,0.05,5.16,31
NDC,6521966801,CONEXXENCE 60 MG/ML SUBCUTANEOUS SYRINGE,6549.0,4256.85,28.72,6549.0,38
NDC,6521967001,BOMYNTRA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,7086.18,4606.02,28.72,7086.18,38
NDC,6521967201,BOMYNTRA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SYRINGE,7086.18,4606.02,1190.48,7086.18,29
NDC,6521982805,OTULFI 130 MG/26 ML INTRAVENOUS SOLUTION,233.4,151.71,32.95,3236.72,39
NDC,6525013309,EXPAREL (PF) 1.3 % (13.3 MG/ML) SUSPENSION FOR LOCAL INFILTRATION,91.2,59.28,1.46,91.2,40
NDC,6525026609,EXPAREL (PF) 1.3 % (13.3 MG/ML) SUSPENSION FOR LOCAL INFILTRATION,56.7,36.86,1.46,56.7,40
NDC,6525026620,EXPAREL (PF) 1.3 % (13.3 MG/ML) SUSPENSION FOR LOCAL INFILTRATION,75.36,48.98,1.46,75.36,40
NDC,6559740601,ENHERTU 100 MG INTRAVENOUS SOLUTION,14815.04,9629.78,24.54,14815.04,52
NDC,6559740720,TURALIO 125 MG CAPSULE,494.32,321.31,83.05,494.32,22
NDC,6559750428,VANFLYTA 17.7 MG TABLET,1402.24,911.46,235.58,1402.24,22
NDC,6559751128,VANFLYTA 26.5 MG TABLET,1402.24,911.46,235.58,1402.24,22
NDC,6559780101,DATROWAY 100 MG INTRAVENOUS SOLUTION,23477.12,15260.13,51.55,23477.12,45
NDC,6564920175,MOVIPREP 100 GRAM-7.5 GRAM-2.691 GRAM ORAL POWDER PACKET,377.65,245.47,63.45,377.65,22
NDC,6564930103,XIFAXAN 200 MG TABLET,28.56,18.56,4.8,28.56,22
NDC,6564930302,XIFAXAN 550 MG TABLET,146.84,95.45,24.67,146.84,22
NDC,6564930303,XIFAXAN 550 MG TABLET,146.84,95.45,24.67,146.84,22
NDC,6564931112,DIURIL 250 MG/5 ML ORAL SUSPENSION,0.95,0.62,0.16,0.95,22
NDC,6564940130,ANUSOL-HC 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR,14.22,9.24,2.39,14.22,22
NDC,6564955102,RELISTOR 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,1120.5,728.33,4.11,1120.5,23
NDC,6564955103,RELISTOR 12 MG/0.6 ML SUBCUTANEOUS SYRINGE,1120.5,728.33,4.11,1120.5,23
NDC,6564955107,RELISTOR 12 MG/0.6 ML SUBCUTANEOUS SYRINGE,1120.5,728.33,4.11,1120.5,23
NDC,6564955204,RELISTOR 8 MG/0.4 ML SUBCUTANEOUS SYRINGE,1680.75,1092.49,4.11,1680.75,23
NDC,6570212810,COAGUCHEK XS STRIPS,16.0,10.4,2.69,14.4,21
NDC,6575730001,VIVITROL 380 MG INTRAMUSCULAR SUSPENSIONEXTENDED RELEASE,6085.23,3955.4,3.57,6085.23,53
NDC,6575740103,ARISTADA 441 MG/1.6 ML SUSPENSION EXTEND.REL. IM SYRINGE,3579.75,2326.84,2.81,3579.75,50
NDC,6575740203,ARISTADA 662 MG/2.4 ML SUSPENSION EXTEND.REL. IM SYRINGE,3582.48,2328.61,2.81,3582.48,50
NDC,6575740303,ARISTADA 882 MG/3.2 ML SUSPENSION EXTEND.REL. IM SYRINGE,3579.75,2326.84,2.81,3579.75,50
NDC,6575740403,ARISTADA 1064 MG/3.9 ML SUSPENSION EXTEND.REL. IM SYRINGE,3543.33,2303.16,2.81,3543.33,50
NDC,6575750003,ARISTADA INITIO 675 MG/2.4 ML SUSPENSION EXTEND.REL. IM SYRINGE,3652.83,2374.34,2.77,3652.83,50
NDC,6585715030,FLUDEOXYGLUCOSE F-18 20 MCI TO 500 MCI/ML INTRAVENOUS SOLUTION,250.0,162.5,42.0,2409.0,26
NDC,6586201105,SERTRALINE 25 MG TABLET,5.7,3.71,0.96,5.7,22
NDC,6586201130,SERTRALINE 25 MG TABLET,5.7,3.71,0.96,5.7,22
NDC,6586201330,SERTRALINE 100 MG TABLET,5.7,3.71,0.96,5.7,22
NDC,6586201501,AMOXICILLIN 875 MG TABLET,1.74,1.13,0.29,1.74,22
NDC,6586202106,MIRTAZAPINE 15 MG DISINTEGRATING TABLET,4.72,3.07,0.79,4.72,22
NDC,6586202206,MIRTAZAPINE 30 MG DISINTEGRATING TABLET,4.86,3.16,0.82,4.86,22
NDC,6586202460,ZIDOVUDINE 300 MG TABLET,12.04,7.83,2.02,12.04,22
NDC,6586202801,GLYBURIDE 1.25 MG TABLET,0.56,0.36,0.09,0.56,22
NDC,6586203001,GLYBURIDE 5 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,6586204824,ZIDOVUDINE 10 MG/ML ORAL SYRUP,0.6,0.39,0.1,0.6,22
NDC,6586204930,EFAVIRENZ 600 MG TABLET,74.52,48.44,12.52,74.52,22
NDC,6586205724,NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,1.98,1.29,0.33,1.98,22
NDC,6586207150,AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION,0.25,0.16,0.04,0.25,22
NDC,6586207360,ABACAVIR 300 MG TABLET,20.1,13.07,3.38,20.1,22
NDC,6586207601,CIPROFLOXACIN 250 MG TABLET,9.16,5.95,1.54,9.16,22
NDC,6586207930,TERBINAFINE HCL 250 MG TABLET,25.58,16.63,4.3,25.58,22
NDC,6586210701,ZIDOVUDINE 100 MG CAPSULE,4.04,2.63,0.68,4.04,22
NDC,6586214636,SUMATRIPTAN 25 MG TABLET,54.1,35.17,9.09,54.1,22
NDC,6586214736,SUMATRIPTAN 50 MG TABLET,50.28,32.68,8.45,50.28,22
NDC,6586214836,SUMATRIPTAN 100 MG TABLET,50.28,32.68,8.45,50.28,22
NDC,6586216001,ZOLPIDEM 10 MG TABLET,10.28,6.68,1.73,10.28,22
NDC,6586220768,RIBAVIRIN 200 MG TABLET,16.54,10.75,2.78,16.54,22
NDC,6586221150,MINOCYCLINE 100 MG CAPSULE,6.8,4.42,1.14,6.8,22
NDC,6586221801,CEFDINIR 125 MG/5 ML ORAL SUSPENSION,2.03,1.32,0.34,2.03,22
NDC,6586221860,CEFDINIR 125 MG/5 ML ORAL SUSPENSION,2.13,1.38,0.36,2.13,22
NDC,6586229084,RIBAVIRIN 200 MG CAPSULE,19.06,12.39,3.2,19.06,22
NDC,6586239010,ONDANSETRON 4 MG DISINTEGRATING TABLET,44.58,28.98,7.49,44.58,22
NDC,6586242001,SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,2.3,1.5,0.39,2.3,22
NDC,6586244890,VALACYCLOVIR 500 MG TABLET,14.14,9.19,2.38,14.14,22
NDC,6586245860,GALANTAMINE 4 MG TABLET,6.36,4.13,1.07,6.36,22
NDC,6586245960,GALANTAMINE 8 MG TABLET,6.36,4.13,1.07,6.36,22
NDC,6586246060,GALANTAMINE 12 MG TABLET,6.36,4.13,1.07,6.36,22
NDC,6586247401,RAMIPRIL 1.25 MG CAPSULE,3.06,1.99,0.51,3.06,22
NDC,6586247501,RAMIPRIL 2.5 MG CAPSULE,3.62,2.35,0.61,3.62,22
NDC,6586247601,RAMIPRIL 5 MG CAPSULE,3.8,2.47,0.64,3.8,22
NDC,6586247701,RAMIPRIL 10 MG CAPSULE,4.44,2.89,0.75,4.44,22
NDC,6586249647,SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,1.15,0.75,0.19,1.15,22
NDC,6586250220,AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,7.58,4.93,1.27,7.58,22
NDC,6586250320,AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,10.14,6.59,1.7,10.14,22
NDC,6586252730,VENLAFAXINE ER 37.5 MG CAPSULEEXTENDED RELEASE 24 HR,8.32,5.41,1.4,8.32,22
NDC,6586252790,VENLAFAXINE ER 37.5 MG CAPSULEEXTENDED RELEASE 24 HR,8.32,5.41,1.4,8.32,22
NDC,6586252830,VENLAFAXINE ER 75 MG CAPSULEEXTENDED RELEASE 24 HR,9.34,6.07,1.57,9.34,22
NDC,6586253350,AMOXICILLIN 200 MG-POTASSIUM CLAVULANATE 28.5 MG/5 ML ORAL SUSPENSION,0.93,0.6,0.16,0.93,22
NDC,6586253401,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,1.73,1.12,0.29,1.73,22
NDC,6586253450,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,1.75,1.14,0.29,1.75,22
NDC,6586253475,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,1.55,1.01,0.26,1.55,22
NDC,6586253650,LEVOFLOXACIN 250 MG TABLET,33.62,21.85,5.65,33.62,22
NDC,6586253750,LEVOFLOXACIN 500 MG TABLET,38.54,25.05,6.47,38.54,22
NDC,6586253820,LEVOFLOXACIN 750 MG TABLET,72.16,46.9,12.12,72.16,22
NDC,6586257290,VALSARTAN 160 MG TABLET,10.0,6.5,1.68,10.0,22
NDC,6586259601,CLINDAMYCIN PEDIATRIC 75 MG/5 ML ORAL SOLUTION,1.55,1.01,0.26,1.55,22
NDC,6586259602,CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,1.55,1.01,0.26,1.55,22
NDC,6586264169,AZITHROMYCIN 250 MG TABLET,15.56,10.11,2.61,15.56,22
NDC,6586264290,AZITHROMYCIN 500 MG TABLET,31.14,20.24,5.23,31.14,22
NDC,6586265401,ENTACAPONE 200 MG TABLET,9.08,5.9,1.53,9.08,22
NDC,6586266630,ARIPIPRAZOLE 30 MG TABLET,90.82,59.03,15.26,90.82,22
NDC,6586267001,REPAGLINIDE 0.5 MG TABLET,6.66,4.33,1.12,6.66,22
NDC,6586267201,REPAGLINIDE 2 MG TABLET,7.32,4.76,1.23,7.32,22
NDC,6586267801,ALPRAZOLAM 1 MG TABLET,2.32,1.51,0.39,2.32,22
NDC,6586268730,RITONAVIR 100 MG TABLET,18.52,12.04,3.11,18.52,22
NDC,6586270060,CEFUROXIME AXETIL 500 MG TABLET,16.0,10.4,2.69,16.0,22
NDC,6586270260,ZIPRASIDONE 20 MG CAPSULE,17.92,11.65,3.01,17.92,22
NDC,6586270360,ZIPRASIDONE 40 MG CAPSULE,17.92,11.65,3.01,17.92,22
NDC,6586270655,AMOXICILLIN 125 MG/5 ML ORAL SUSPENSION,0.08,0.05,0.01,0.08,22
NDC,6586270680,AMOXICILLIN 125 MG/5 ML ORAL SUSPENSION,0.1,0.07,0.02,0.1,22
NDC,6586271160,ATAZANAVIR 150 MG CAPSULE,55.6,36.14,9.34,55.6,22
NDC,6586271260,ATAZANAVIR 200 MG CAPSULE,55.6,36.14,9.34,55.6,22
NDC,6586273205,AMIODARONE 200 MG TABLET,6.76,4.39,1.14,6.76,22
NDC,6586273260,AMIODARONE 200 MG TABLET,6.76,4.39,1.14,6.76,22
NDC,6586276590,PREGABALIN 300 MG CAPSULE,16.86,10.96,2.83,16.86,22
NDC,6586276990,FENOFIBRATE NANOCRYSTALLIZED 145 MG TABLET,11.46,7.45,1.93,11.46,22
NDC,6586278201,METHENAMINE HIPPURATE 1 GRAM TABLET,4.18,2.72,0.7,4.18,22
NDC,6586282930,PRASUGREL HCL 5 MG TABLET,33.02,21.46,5.55,33.02,22
NDC,6586283030,PRASUGREL HCL 10 MG TABLET,33.02,21.46,5.55,33.02,22
NDC,6586284401,CLOZAPINE 25 MG TABLET,2.64,1.72,0.44,2.64,22
NDC,6586284601,CLOZAPINE 100 MG TABLET,6.86,4.46,1.15,6.86,22
NDC,6586292127,SEVELAMER CARBONATE 800 MG TABLET,12.2,7.93,2.05,12.2,22
NDC,6586292730,FINASTERIDE 1 MG TABLET,5.42,3.52,0.91,5.42,22
NDC,6586292790,FINASTERIDE 1 MG TABLET,4.88,3.17,0.82,4.88,22
NDC,6586293008,SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,36.58,23.78,6.15,36.58,22
NDC,6586293090,SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,36.58,23.78,6.15,36.58,22
NDC,6586293108,SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,36.58,23.78,6.15,36.58,22
NDC,6586293190,SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,36.58,23.78,6.15,36.58,22
NDC,6586298601,POTASSIUM CHLORIDE ER 8 MEQ TABLETEXTENDED RELEASE,1.08,0.7,0.18,1.08,22
NDC,6597610024,ARESTIN 1 MG DENTAL CARTRIDGE,99.15,64.45,16.66,99.15,22
NDC,6601911210,FLUMIST 2025-2026 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL SPRAY SYRINGE,61.06,39.69,10.26,61.06,36
NDC,6621510103,TRACLEER 62.5 MG TABLET,536.56,348.76,90.14,536.56,22
NDC,6621510206,TRACLEER 125 MG TABLET,536.56,348.76,90.14,536.56,22
NDC,6621540201,VELETRI 1.5 MG INTRAVENOUS SOLUTION,198.93,129.3,14.08,198.93,31
NDC,6621540301,VELETRI 0.5 MG INTRAVENOUS SOLUTION,99.48,64.66,14.08,99.48,31
NDC,6621550115,OPSUMIT 10 MG TABLET,1036.4,673.66,174.12,1036.4,22
NDC,6621550130,OPSUMIT 10 MG TABLET,1036.4,673.66,174.12,1036.4,22
NDC,6621560206,UPTRAVI 200 MCG TABLET,613.94,399.06,103.14,613.94,22
NDC,6621560806,UPTRAVI 800 MCG TABLET,954.76,620.59,160.4,954.76,22
NDC,6621561606,UPTRAVI 1600 MCG TABLET,954.76,620.59,160.4,954.76,22
NDC,6622016010,VAPRISOL IN 5 % DEXTROSE 20 MG/100 ML INTRAVENOUS SOLUTION,33.42,21.72,5.61,345.3,29
NDC,6622071930,KRISTALOSE 10 GRAM ORAL PACKET,24.48,15.91,4.11,24.48,22
NDC,6622072930,KRISTALOSE 20 GRAM ORAL PACKET,31.73,20.62,5.33,31.73,22
NDC,6628871001,VANCOMYCIN 100 GRAM SOLUTION FOR INJECTION,1440.0,936.0,0.06,1440.0,30
NDC,6629800456,COPPER CITRATE 2 MG CAPSULE,0.18,0.12,0.03,0.18,22
NDC,6630201401,UNITUXIN 3.5 MG/ML INTRAVENOUS SOLUTION,20095.64,13062.17,3376.07,20095.64,26
NDC,6630210101,REMODULIN 1 MG/ML INJECTION SOLUTION,229.2,148.98,49.09,345.3,47
NDC,6630210201,REMODULIN 2.5 MG/ML INJECTION SOLUTION,573.0,372.45,49.09,573.0,47
NDC,6630210501,REMODULIN 5 MG/ML INJECTION SOLUTION,1146.0,744.9,49.09,1146.0,47
NDC,6630211001,REMODULIN 10 MG/ML INJECTION SOLUTION,2291.97,1489.78,49.09,2291.97,47
NDC,6630220603,TYVASO 1.74 MG/2.9 ML (0.6 MG/ML) SOLUTION FOR NEBULIZATION,692.98,450.44,116.42,692.98,22
NDC,6630230002,ORENITRAM 0.125 MG TABLETEXTENDED RELEASE,18.34,11.92,3.08,18.34,22
NDC,6630230201,ORENITRAM 0.25 MG TABLETEXTENDED RELEASE,36.66,23.83,6.16,36.66,22
NDC,6630231001,ORENITRAM 1 MG TABLETEXTENDED RELEASE,146.66,95.33,24.64,146.66,22
NDC,6630231002,ORENITRAM 1 MG TABLETEXTENDED RELEASE,146.66,95.33,24.64,146.66,22
NDC,6630232501,ORENITRAM 2.5 MG TABLETEXTENDED RELEASE,366.66,238.33,61.6,366.66,22
NDC,6630246760,ADCIRCA 20 MG TABLET,166.8,108.42,28.02,166.8,22
NDC,6630261601,TYVASO DPI 16 MCG CARTRIDGE WITH INHALER,542.42,352.57,91.13,542.42,22
NDC,6630263201,TYVASO DPI 32 MCG CARTRIDGE WITH INHALER,224.0,145.6,37.63,224.0,22
NDC,6630264801,TYVASO DPI 48 MCG CARTRIDGE WITH INHALER,224.0,145.6,37.63,224.0,22
NDC,6630266401,TYVASO DPI 64 MCG CARTRIDGE WITH INHALER,542.42,352.57,91.13,542.42,22
NDC,6630271604,TYVASO DPI 16 MCG CARTRIDGE WITH INHALER,542.76,352.79,91.18,542.76,22
NDC,6630273204,TYVASO DPI 32 MCG CARTRIDGE WITH INHALER,542.76,352.79,91.18,542.76,22
NDC,6630274804,TYVASO DPI 48 MCG CARTRIDGE WITH INHALER,542.76,352.79,91.18,542.76,23
NDC,6630276404,TYVASO DPI 64 MCG CARTRIDGE WITH INHALER,542.76,352.79,91.18,542.76,22
NDC,6631217616,XYLOCAINE DENTAL WITH EPINEPHRINE 2 %-1:100000 INJECTION CARTRIDGE,1.8,1.17,0.3,1.8,22
NDC,6655300101,ASPIRIN 325 MG TABLET,0.12,0.08,0.02,0.12,22
NDC,6655300201,CHILDREN'S ASPIRIN 81 MG CHEWABLE TABLET,0.12,0.08,0.02,0.12,22
NDC,6655300401,CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.14,0.09,0.02,0.14,22
NDC,6665820490,ORFADIN 4 MG/ML ORAL SUSPENSION,356.38,231.65,59.87,356.38,22
NDC,6665823407,KINERET 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,1211.28,787.33,203.5,1211.28,22
NDC,6665850101,GAMIFANT 5 MG/ML INTRAVENOUS SOLUTION,6679.8,4341.87,328.39,18253.82,53
NDC,6665850501,GAMIFANT 5 MG/ML INTRAVENOUS SOLUTION,6679.8,4341.87,328.39,18253.82,53
NDC,6668920308,INSTA-CHAR-SORBITOL 50 GRAM/240 ML ORAL SUSPENSION,0.43,0.28,0.07,0.43,22
NDC,6668930708,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,22.65,14.72,0.46,22.65,30
NDC,6668932702,DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,6.2,4.03,1.04,6.2,22
NDC,6668934702,SIROLIMUS 1 MG/ML ORAL SOLUTION,87.5,56.88,1.84,87.5,31
NDC,6668940316,OXYCODONE 5 MG/5 ML ORAL SOLUTION,0.44,0.29,0.07,0.44,22
NDC,6668940610,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,15.9,10.34,2.67,15.9,22
NDC,6668973505,ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,5.2,3.38,0.87,5.2,22
NDC,6673394823,ERBITUX 100 MG/50 ML INTRAVENOUS SOLUTION,80.32,52.21,40.16,1355.53,46
NDC,6673395823,ERBITUX 200 MG/100 ML INTRAVENOUS SOLUTION,80.32,52.21,40.16,1355.53,46
NDC,6675808570,AZOPT 1 % EYE DROPSSUSPENSION,88.22,57.34,14.82,88.22,22
NDC,6675808770,CIPRO HC 0.2 %-1 % EAR DROPSSUSPENSION,87.48,56.86,14.7,87.48,22
NDC,6679415101,GABLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,345.0,224.25,52.12,345.0,31
NDC,6679415501,GABLOFEN 10000 MCG/20 ML (500 MCG/ML) INTRATHECAL SYRINGE,49.8,32.37,12.9,502.19,47
NDC,6679415502,GABLOFEN 10000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION,46.35,30.13,12.0,502.19,47
NDC,6679415601,GABLOFEN 20000 MCG/20 ML (1000 MCG/ML) INTRATHECAL SYRINGE,99.63,64.76,25.8,502.19,47
NDC,6679415602,GABLOFEN 20000 MCG/20 ML (1000 MCG/ML) INTRATHECAL SOLUTION,92.73,60.27,24.02,502.19,47
NDC,6679415701,GABLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SYRINGE,199.44,129.64,51.65,502.19,47
NDC,6679415702,GABLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SOLUTION,185.43,120.53,48.03,502.19,47
NDC,6679416202,MITIGO (PF) 25 MG/ML INJECTION SOLUTION,69.45,45.14,11.67,69.45,31
NDC,6679423042,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,9.45,6.14,1.59,9.45,22
NDC,6686920490,LIVALO 2 MG TABLET,25.58,16.63,4.3,25.58,22
NDC,6688700301,XIAFLEX 0.9 MG SOLUTION FOR INJECTION,26586.84,17281.45,62.07,26586.84,53
NDC,6688700401,TESTOPEL 75 MG IMPLANT PELLET,259.64,168.77,64.91,383.26,32
NDC,6688700410,TESTOPEL 75 MG IMPLANT PELLET,259.64,168.77,64.91,383.26,32
NDC,6697710003,REGENECARE WITH ALOE 2 % TOPICAL GEL,0.4,0.26,0.07,0.4,22
NDC,6697710005,REGENECARE WITH ALOE 2 % TOPICAL GEL,0.48,0.31,0.08,0.48,22
NDC,6699301968,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,6.94,4.51,1.17,6.94,22
NDC,6699306027,ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,14.82,9.63,2.49,14.82,22
NDC,6699307896,FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,44.0,28.6,7.39,44.0,22
NDC,6699307996,FLUTICASONE PROPIONATE 110 MCG/ACTUATION HFA AEROSOL INHALER,52.02,33.81,8.74,52.02,22
NDC,6699313597,FLUTICASONE FUROATE 100 MCG-VILANTEROL 25 MCG/DOSE INHALATION POWDER,14.58,9.48,2.45,14.58,22
NDC,6699314130,ALISKIREN 150 MG TABLET,15.62,10.15,2.62,15.62,22
NDC,6699337083,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,293.55,190.81,1.42,293.55,23
NDC,6699340732,CARBAMAZEPINE ER 100 MG CAPSULEEXTENDED RELEASE MPHASE12HR,3.92,2.55,0.66,3.92,22
NDC,6699345630,DAPAGLIFLOZIN PROPANEDIOL 5 MG TABLET,44.26,28.77,7.44,44.26,22
NDC,6699345730,DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,44.26,28.77,7.44,44.26,22
NDC,6699358497,FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,11.92,7.75,2.0,11.92,22
NDC,6699358597,FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,14.82,9.63,2.49,14.82,22
NDC,6699358697,FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,19.48,12.66,3.27,19.48,22
NDC,6699387778,CALCIPOTRIENE 0.005 % TOPICAL CREAM,13.5,8.78,2.27,13.5,22
NDC,6699396245,METRONIDAZOLE 0.75 % TOPICAL GEL,14.2,9.23,2.39,14.2,22
NDC,6706600501,CHIRHOSTIM 16 MCG INTRAVENOUS SOLUTION,2379.6,1546.74,40.43,2379.6,39
NDC,6710835659,MESNEX 400 MG TABLET,188.62,122.6,31.69,188.62,22
NDC,6715710150,ASCOR 500 MG/ML INTRAVENOUS SOLUTION,16.56,10.76,2.78,16.56,22
NDC,6715710151,ASCOR 500 MG/ML INTRAVENOUS SOLUTION,19.26,12.52,3.24,19.26,22
NDC,6717211131,PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,0.08,0.05,0.01,0.08,22
NDC,6725346110,GLYBURIDE MICRONIZED 3 MG TABLET,1.2,0.78,0.2,1.2,22
NDC,6725365110,PROPYLTHIOURACIL 50 MG TABLET,1.8,1.17,0.3,1.8,22
NDC,6730810106,LEVULAN 20 % TOPICAL SOLUTION,943.72,613.42,97.89,1078.82,47
NDC,6738611101,SABRIL 500 MG TABLET,461.3,299.85,77.5,461.3,22
NDC,6738613051,VYEPTI 100 MG/ML INTRAVENOUS SOLUTION,6984.24,4539.76,16.24,6984.24,53
NDC,6738621165,SABRIL 500 MG ORAL POWDER PACKET,576.63,374.81,96.87,576.63,22
NDC,6738631401,ONFI 10 MG TABLET,75.14,48.84,12.62,75.14,22
NDC,6738682219,NORTHERA 300 MG CAPSULE,307.02,199.56,51.58,307.02,22
NDC,6740583008,BENZOYL PEROXIDE 10 % TOPICAL CLEANSER,0.12,0.08,0.02,0.12,22
NDC,6745711850,ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,6.51,4.23,1.09,6.51,22
NDC,6745713450,MAGNESIUM CHLORIDE 200 MG/ML (20 %) INJECTION SOLUTION,1.14,0.74,0.19,1.14,22
NDC,6745714630,B COMPLEX 100 100 MG-2 MG-100 MG-2MG-2MG/ML INJECTABLE SOLUTION,22.17,14.41,3.72,22.17,22
NDC,6745715318,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,3.45,2.24,0.58,3.45,30
NDC,6745716200,SOTRADECOL 1 % (10 MG/ML) INTRAVENOUS SOLUTION,140.64,91.42,23.63,140.64,22
NDC,6745716202,SOTRADECOL 1 % (10 MG/ML) INTRAVENOUS SOLUTION,140.64,91.42,23.63,140.64,22
NDC,6745716302,SOTRADECOL 3 % (30 MG/ML) INTRAVENOUS SOLUTION,140.64,91.42,23.63,140.64,22
NDC,6745717750,RIMSO-50  50 % INTRAVESICAL SOLUTION,52.53,34.14,13.61,2073.41,47
NDC,6745718210,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,2.64,1.72,0.44,2.64,22
NDC,6745719602,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,15.99,10.39,2.03,15.99,31
NDC,6745721005,CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,711.87,462.72,184.37,1451.46,47
NDC,6745721102,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,2464.32,1601.81,6.43,2464.32,39
NDC,6745721810,DURACLON (PF) 1000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION,11.28,7.33,1.9,47.68,31
NDC,6745722005,ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLUTION,874.23,568.25,8.53,874.23,33
NDC,6745722702,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,317.43,206.33,25.73,317.43,31
NDC,6745725510,LEVETIRACETAM 500 MG/100 ML IN SODIUM CHLORIDE (ISO-OSM) IV PIGGYBACK,1.08,0.7,0.06,1.08,31
NDC,6745726500,LEVETIRACETAM 1000 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK,1.8,1.17,0.06,1.8,31
NDC,6745726510,LEVETIRACETAM 1000 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK,1.8,1.17,0.06,1.8,31
NDC,6745726610,LEVETIRACETAM 1500 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK,2.67,1.74,0.06,2.67,31
NDC,6745732325,MOXIFLOXACIN 400 MG/250 ML-SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,0.66,0.43,0.11,25.35,31
NDC,6745734001,VANCOMYCIN 1000 MG INTRAVENOUS INJECTION,57.75,37.54,0.04,57.75,30
NDC,6745734105,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,320.16,208.1,5.28,320.16,24
NDC,6745734910,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,46.11,29.97,1.91,46.11,31
NDC,6745738499,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,0.81,0.53,0.14,0.81,31
NDC,6745738599,HEPARIN (PORCINE) 1000 UNIT/ML INJECTION SOLUTION,1.29,0.84,0.22,1.29,31
NDC,6745739054,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,424.8,276.12,6.24,424.8,31
NDC,6745741013,HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,79.2,51.48,6.07,79.2,31
NDC,6745742010,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,1.44,0.94,0.11,1.44,31
NDC,6745742130,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,1.26,0.82,0.21,1.26,22
NDC,6745742200,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,1.41,0.92,0.24,1.41,22
NDC,6745742254,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,1.41,0.92,0.11,1.41,31
NDC,6745742300,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,2.97,1.93,0.5,2.97,22
NDC,6745742312,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,2.97,1.93,0.11,2.97,31
NDC,6745742612,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,4.32,2.81,0.73,4.32,31
NDC,6745742800,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,2.61,1.7,0.44,5.73,31
NDC,6745742830,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,2.61,1.7,0.44,5.73,31
NDC,6745743010,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,9.72,6.32,1.63,31.24,30
NDC,6745743322,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,1.59,1.03,0.02,1.59,30
NDC,6745743650,DOXORUBICIN 50 MG INTRAVENOUS SOLUTION,1262.56,820.66,3.03,1262.56,30
NDC,6745743710,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,60.03,39.02,0.19,60.03,30
NDC,6745743810,VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,20.52,13.34,3.45,20.52,22
NDC,6745744610,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,33.69,21.9,5.66,33.69,30
NDC,6745745010,CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,168.0,109.2,7.41,168.0,46
NDC,6745745500,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,4.56,2.96,0.77,4.56,30
NDC,6745745552,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,4.56,2.96,0.77,4.56,30
NDC,6745745720,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,1.59,1.03,0.02,1.59,30
NDC,6745747322,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,3.57,2.32,0.6,5.73,31
NDC,6745752433,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,505.2,328.38,24.97,505.2,37
NDC,6745756420,BACLOFEN 40000 MCG/20 ML (2000 MCG/ML) INTRATHECAL SOLUTION,139.17,90.46,36.05,502.19,47
NDC,6745757300,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,3.63,2.36,0.61,3.63,22
NDC,6745757305,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,3.63,2.36,0.61,3.63,22
NDC,6745758210,FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE,327.9,213.14,0.93,327.9,31
NDC,6745758300,FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SOLUTION SYRINGE,964.59,626.98,0.93,964.59,31
NDC,6745758304,FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SOLUTION SYRINGE,964.59,626.98,0.93,964.59,31
NDC,6745758400,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,643.05,417.98,0.93,643.05,31
NDC,6745758406,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,643.05,417.98,0.93,643.05,31
NDC,6745758508,FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SOLUTION SYRINGE,482.28,313.48,0.93,482.28,31
NDC,6745760305,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,6.84,4.45,0.25,6.84,31
NDC,6745760399,HEPARIN (PORCINE) 10000 UNIT/ML INJECTION SOLUTION,6.84,4.45,0.25,6.84,31
NDC,6745761610,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,7.32,4.76,1.23,9.95,30
NDC,6745761730,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,7.32,4.76,1.23,9.95,30
NDC,6745762910,EPTIFIBATIDE 2 MG/ML INTRAVENOUS SOLUTION,56.25,36.56,3.52,56.25,32
NDC,6745778108,DOCETAXEL 160 MG/8 ML (20 MG/ML) INTRAVENOUS SOLUTION,1460.6,949.39,0.78,1460.6,37
NDC,6745782399,VANCOMYCIN 1.25 GRAM INTRAVENOUS SOLUTION,72.36,47.03,0.19,72.36,30
NDC,6745782499,VANCOMYCIN 1.5 GRAM INTRAVENOUS SOLUTION,86.82,56.43,0.19,86.82,30
NDC,6745783306,FULPHILA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,12525.0,8141.25,98.87,12525.0,53
NDC,6745785404,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,9.0,5.85,0.5,9.0,31
NDC,6745785500,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,11.25,7.31,0.5,11.25,31
NDC,6745785502,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,11.25,7.31,0.5,11.25,31
NDC,6745785620,ADENOSINE (DIAGNOSTIC) 3 MG/ML INTRAVENOUS SOLUTION,23.4,15.21,0.5,23.4,31
NDC,6745785730,ADENOSINE (DIAGNOSTIC) 3 MG/ML INTRAVENOUS SOLUTION,23.52,15.29,0.5,23.52,31
NDC,6745788701,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,293.25,190.61,1.42,293.25,23
NDC,6745788799,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,293.55,190.81,1.42,293.55,23
NDC,6745792650,AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,842.46,547.6,20.72,842.46,47
NDC,6754611112,ALINIA 500 MG TABLET,323.12,210.03,54.28,323.12,22
NDC,6754621221,ALINIA 100 MG/5 ML ORAL SUSPENSION,26.1,16.97,4.38,26.1,22
NDC,6761811128,COLACE CLEAR 50 MG CAPSULE,0.62,0.4,0.1,0.62,22
NDC,6761815001,BETADINE 10 % TOPICAL SOLUTION,0.02,0.01,0.01,0.02,22
NDC,6761815004,BETADINE 10 % TOPICAL SOLUTION,0.04,0.03,0.01,0.04,22
NDC,6761815017,BETADINE 10 % TOPICAL SOLUTION,0.02,0.01,0.01,0.02,22
NDC,6761820016,BETASEPT SURGICAL SCRUB 4 % TOPICAL LIQUID,0.06,0.04,0.01,0.06,22
NDC,6761830050,SENOKOT 8.6 MG TABLET,0.48,0.31,0.08,0.48,22
NDC,6768419012,LIPIODOL 480 MG IODINE/ML OIL FOR INJECTION,440.64,286.42,74.03,440.64,23
NDC,6768420005,DOTAREM 0.5 MMOL/ML INTRAVENOUS SYRINGE,20.28,13.18,0.12,20.28,21
NDC,6768420006,DOTAREM 0.5 MMOL/ML INTRAVENOUS SYRINGE,19.92,12.95,0.12,19.92,21
NDC,6768420007,DOTAREM 0.5 MMOL/ML INTRAVENOUS SYRINGE,19.56,12.71,0.12,19.56,21
NDC,6768420010,DOTAREM 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,19.08,12.4,0.12,19.08,21
NDC,6768420011,DOTAREM 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,11.88,7.72,0.12,11.88,21
NDC,6768420012,DOTAREM 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,10.08,6.55,0.12,10.08,21
NDC,6768420013,DOTAREM 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION,10.08,6.55,0.12,10.08,21
NDC,6768430013,DOTAREM 0.5 MMOL/ML INTRAVENOUS SYRINGE,10.8,7.02,0.12,10.8,21
NDC,6768442301,ELUCIREM 0.5 MMOL/ML INTRAVENOUS SOLUTION,39.75,25.84,4.61,39.75,21
NDC,6768442302,ELUCIREM 0.5 MMOL/ML INTRAVENOUS SOLUTION,39.75,25.84,4.61,39.75,21
NDC,6768442312,ELUCIREM 0.5 MMOL/ML INTRAVENOUS SOLUTION,39.75,25.84,4.61,39.75,21
NDC,6768442322,ELUCIREM 0.5 MMOL/ML INTRAVENOUS SOLUTION,39.75,25.84,4.61,39.75,21
NDC,6777725101,AMMONIA AROMATIC 15 % (W/V) SOLUTION FOR INHALATION,0.96,0.62,0.16,0.96,22
NDC,6785014005,ASCLERA 0.5 % (10 MG/2 ML) INTRAVENOUS SOLUTION,35.46,23.05,5.96,35.46,22
NDC,6785014105,ASCLERA 1 % (20 MG/2 ML) INTRAVENOUS SOLUTION,40.68,26.44,6.83,40.68,22
NDC,6787147906,ETHAMOLIN 5 % INTRAVENOUS SOLUTION,951.48,618.46,246.43,1430.97,47
NDC,6787712405,SILVER SULFADIAZINE 1 % TOPICAL CREAM,0.84,0.55,0.14,0.84,22
NDC,6787712420,SILVER SULFADIAZINE 1 % TOPICAL CREAM,2.9,1.89,0.49,2.9,22
NDC,6787712425,SILVER SULFADIAZINE 1 % TOPICAL CREAM,1.08,0.7,0.18,1.08,22
NDC,6787712450,SILVER SULFADIAZINE 1 % TOPICAL CREAM,0.84,0.55,0.14,0.84,22
NDC,6787721520,CEFUROXIME AXETIL 250 MG TABLET,11.32,7.36,1.9,11.32,22
NDC,6787721660,CEFUROXIME AXETIL 500 MG TABLET,22.2,14.43,3.73,22.2,22
NDC,6787723022,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,22.65,14.72,0.46,22.65,30
NDC,6787724601,QUETIAPINE 200 MG TABLET,25.9,16.84,4.35,25.9,22
NDC,6787725001,QUETIAPINE 100 MG TABLET,13.72,8.92,2.3,13.72,22
NDC,6787725145,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.14,0.09,0.02,0.14,22
NDC,6787725180,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,0.36,0.23,0.06,0.36,22
NDC,6787726030,RASAGILINE 1 MG TABLET,49.96,32.47,8.39,49.96,22
NDC,6787726218,RIZATRIPTAN 10 MG TABLET,66.62,43.3,11.19,66.62,22
NDC,6787727590,LANSOPRAZOLE 30 MG CAPSULEDELAYED RELEASE,11.7,7.61,1.97,11.7,22
NDC,6787728660,RILUZOLE 50 MG TABLET,73.88,48.02,12.41,73.88,22
NDC,6787732005,IBUPROFEN 600 MG TABLET,1.04,0.68,0.17,1.04,22
NDC,6787741690,VALSARTAN 80 MG TABLET,9.22,5.99,1.55,9.22,22
NDC,6787741890,VALSARTAN 320 MG TABLET,12.56,8.16,2.11,12.56,22
NDC,6787741933,LINEZOLID 600 MG TABLET,367.32,238.76,61.71,367.32,22
NDC,6787741984,LINEZOLID 600 MG TABLET,367.32,238.76,61.71,367.32,22
NDC,6787745430,ITRACONAZOLE 100 MG CAPSULE,48.3,31.4,8.11,48.3,22
NDC,6787752790,SOLIFENACIN 5 MG TABLET,26.22,17.04,4.4,26.22,22
NDC,6787752890,SOLIFENACIN 10 MG TABLET,26.22,17.04,4.4,26.22,22
NDC,6787754588,CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,0.58,0.38,0.1,0.58,22
NDC,6787754798,CEFDINIR 125 MG/5 ML ORAL SUSPENSION,2.13,1.38,0.36,2.13,22
NDC,6787754898,CEFDINIR 250 MG/5 ML ORAL SUSPENSION,4.15,2.7,0.7,4.15,22
NDC,6787755130,DEFERASIROX 500 MG DISPERSIBLE TABLET,344.58,223.98,57.89,344.58,22
NDC,6787756110,METFORMIN 500 MG TABLET,1.42,0.92,0.24,1.42,22
NDC,6787758433,CEFIXIME 400 MG CAPSULE,47.06,30.59,7.91,47.06,22
NDC,6787763633,TOLVAPTAN 30 MG TABLET,1092.1,709.87,183.47,1092.1,22
NDC,6787771831,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,20.08,13.05,2.24,20.08,31
NDC,6787771931,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,40.14,26.09,2.24,40.14,31
NDC,6787772131,EVEROLIMUS (IMMUNOSUPPRESSIVE) 1 MG TABLET,80.12,52.08,13.46,80.12,22
NDC,6787773295,LACOSAMIDE 10 MG/ML ORAL SOLUTION,3.32,2.16,0.56,3.32,22
NDC,6787773360,LACOSAMIDE 50 MG TABLET,22.74,14.78,3.82,22.74,22
NDC,6787774701,SIROLIMUS 1 MG TABLET,33.9,22.04,1.84,33.9,31
NDC,6787783347,TOPIRAMATE 25 MG/ML ORAL SOLUTION,4.4,2.86,0.74,4.4,22
NDC,6787788271,RIVAROXABAN 1 MG/ML ORAL SUSPENSION,10.2,6.63,1.71,10.2,22
NDC,6791903001,ZERBAXA 1.5 GRAM INTRAVENOUS SOLUTION,627.69,408.0,6.56,627.69,47
NDC,6791904002,SIVEXTRO 200 MG INTRAVENOUS SOLUTION,1333.74,866.93,1.63,1333.74,47
NDC,6791904105,SIVEXTRO 200 MG TABLET,1116.2,725.53,187.52,1116.2,22
NDC,6797900101,VALSTAR 40 MG/ML INTRAVESICAL SOLUTION,1776.24,1154.56,888.12,3606.88,46
NDC,6797900201,SUPPRELIN LA 50 MG (65 MCG/DAY) IMPLANT KIT,180653.82,117424.98,14450.94,180653.82,53
NDC,6797951143,AVEED 750 MG/3 ML (250MG/ML) INTRAMUSCULAR SOLUTION,2607.6,1694.94,1.73,2607.6,50
NDC,6800111306,LEVETIRACETAM ER 500 MG TABLETEXTENDED RELEASE 24 HR,8.9,5.79,1.5,8.9,22
NDC,6800111406,LEVETIRACETAM ER 750 MG TABLETEXTENDED RELEASE 24 HR,13.36,8.68,2.24,13.36,22
NDC,6800115100,CARVEDILOL 12.5 MG TABLET,4.28,2.78,0.72,4.28,22
NDC,6800115103,CARVEDILOL 12.5 MG TABLET,4.28,2.78,0.72,4.28,22
NDC,6800115200,CARVEDILOL 25 MG TABLET,4.28,2.78,0.72,4.28,22
NDC,6800115203,CARVEDILOL 25 MG TABLET,4.28,2.78,0.72,4.28,22
NDC,6800115300,CARVEDILOL 3.125 MG TABLET,4.28,2.78,0.72,4.28,22
NDC,6800115303,CARVEDILOL 3.125 MG TABLET,4.28,2.78,0.72,4.28,22
NDC,6800115403,CARVEDILOL 6.25 MG TABLET,4.28,2.78,0.72,4.28,22
NDC,6800115600,VENLAFAXINE 100 MG TABLET,4.64,3.02,0.78,4.64,22
NDC,6800115700,VENLAFAXINE 25 MG TABLET,3.88,2.52,0.65,3.88,22
NDC,6800115800,VENLAFAXINE 37.5 MG TABLET,4.0,2.6,0.67,4.0,22
NDC,6800115900,VENLAFAXINE 50 MG TABLET,4.12,2.68,0.69,4.12,22
NDC,6800116000,VENLAFAXINE 75 MG TABLET,4.38,2.85,0.74,4.38,22
NDC,6800116100,PROMETHAZINE 12.5 MG TABLET,0.98,0.64,0.16,0.98,22
NDC,6800116200,PROMETHAZINE 25 MG TABLET,1.02,0.66,0.17,1.02,22
NDC,6800118000,QUETIAPINE 50 MG TABLET,13.14,8.54,2.21,13.14,22
NDC,6800118100,QUETIAPINE 400 MG TABLET,39.88,25.92,6.7,39.88,22
NDC,6800118200,QUETIAPINE 200 MG TABLET,25.88,16.82,4.35,25.88,22
NDC,6800118300,QUETIAPINE 300 MG TABLET,33.92,22.05,5.7,33.92,22
NDC,6800118400,QUETIAPINE 100 MG TABLET,13.72,8.92,2.3,13.72,22
NDC,6800118500,QUETIAPINE 25 MG TABLET,8.0,5.2,1.34,8.0,22
NDC,6800123700,CLONIDINE HCL 0.1 MG TABLET,0.52,0.34,0.09,0.52,22
NDC,6800123703,CLONIDINE HCL 0.1 MG TABLET,0.5,0.33,0.08,0.5,22
NDC,6800123800,CLONIDINE HCL 0.2 MG TABLET,0.76,0.49,0.13,0.76,22
NDC,6800123900,CLONIDINE HCL 0.3 MG TABLET,1.04,0.68,0.17,1.04,22
NDC,6800124200,ZONISAMIDE 25 MG CAPSULE,1.1,0.72,0.18,1.1,22
NDC,6800124400,ZONISAMIDE 100 MG CAPSULE,4.38,2.85,0.74,4.38,22
NDC,6800124604,ONDANSETRON 4 MG DISINTEGRATING TABLET,44.58,28.98,7.49,44.58,22
NDC,6800124616,ONDANSETRON 4 MG DISINTEGRATING TABLET,46.22,30.04,7.76,46.22,22
NDC,6800124617,ONDANSETRON 4 MG DISINTEGRATING TABLET,46.22,30.04,7.76,46.22,22
NDC,6800124716,ONDANSETRON 8 MG DISINTEGRATING TABLET,77.0,50.05,12.94,77.0,22
NDC,6800124717,ONDANSETRON 8 MG DISINTEGRATING TABLET,77.0,50.05,12.94,77.0,22
NDC,6800125104,FLUCONAZOLE 50 MG TABLET,11.2,7.28,1.88,11.2,22
NDC,6800125204,FLUCONAZOLE 100 MG TABLET,17.6,11.44,2.96,17.6,22
NDC,6800127900,DICLOFENAC SODIUM 25 MG TABLETDELAYED RELEASE,2.84,1.85,0.48,2.84,22
NDC,6800128100,DICLOFENAC SODIUM 75 MG TABLETDELAYED RELEASE,3.54,2.3,0.59,3.54,22
NDC,6800130900,BUPROPION HCL 100 MG TABLET,2.12,1.38,0.36,2.12,22
NDC,6800131400,LOVASTATIN 10 MG TABLET,2.7,1.76,0.45,2.7,22
NDC,6800131500,LOVASTATIN 20 MG TABLET,4.74,3.08,0.8,4.74,22
NDC,6800131600,LOVASTATIN 40 MG TABLET,8.54,5.55,1.43,8.54,22
NDC,6800132500,DESMOPRESSIN 0.1 MG TABLET,10.58,6.88,1.78,10.58,22
NDC,6800132800,TRIAMTERENE 75 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,2.22,1.44,0.37,2.22,22
NDC,6800133200,LISINOPRIL 2.5 MG TABLET,1.3,0.85,0.22,1.3,22
NDC,6800133300,LISINOPRIL 5 MG TABLET,1.94,1.26,0.33,1.94,22
NDC,6800133400,LISINOPRIL 10 MG TABLET,2.0,1.3,0.34,2.0,22
NDC,6800133500,LISINOPRIL 20 MG TABLET,2.16,1.4,0.36,2.16,22
NDC,6800133600,LISINOPRIL 30 MG TABLET,3.02,1.96,0.51,3.02,22
NDC,6800136206,CEFDINIR 300 MG CAPSULE,10.22,6.64,1.72,10.22,22
NDC,6800136500,METRONIDAZOLE 500 MG TABLET,1.46,0.95,0.25,1.46,22
NDC,6800137500,ISOSORBIDE DINITRATE 20 MG TABLET,2.38,1.55,0.4,2.38,22
NDC,6800137800,URSODIOL 500 MG TABLET,9.5,6.18,1.6,9.5,22
NDC,6800138100,LABETALOL 100 MG TABLET,1.02,0.66,0.17,1.02,22
NDC,6800138300,LABETALOL 300 MG TABLET,1.94,1.26,0.33,1.94,22
NDC,6800139700,FAMOTIDINE 20 MG TABLET,4.84,3.15,0.81,4.84,22
NDC,6800139708,FAMOTIDINE 20 MG TABLET,4.84,3.15,0.81,4.84,22
NDC,6800139900,FLUOXETINE 10 MG CAPSULE,5.2,3.38,0.87,5.2,22
NDC,6800140303,LEVETIRACETAM 500 MG TABLET,7.02,4.56,1.18,7.02,22
NDC,6800140307,LEVETIRACETAM 500 MG TABLET,7.02,4.56,1.18,7.02,22
NDC,6800142800,RAMIPRIL 1.25 MG CAPSULE,2.9,1.89,0.49,2.9,22
NDC,6800142900,RAMIPRIL 2.5 MG CAPSULE,3.62,2.35,0.61,3.62,22
NDC,6800143000,RAMIPRIL 5 MG CAPSULE,3.8,2.47,0.64,3.8,22
NDC,6800143100,RAMIPRIL 10 MG CAPSULE,4.44,2.89,0.75,4.44,22
NDC,6800143616,CETIRIZINE 10 MG TABLET,4.98,3.24,0.84,4.98,22
NDC,6800143900,FEXOFENADINE 60 MG TABLET,0.32,0.21,0.05,0.32,22
NDC,6800144000,FEXOFENADINE 180 MG TABLET,0.64,0.42,0.11,0.64,22
NDC,6800145106,ZIPRASIDONE 40 MG CAPSULE,17.92,11.65,3.01,17.92,22
NDC,6800145206,ZIPRASIDONE 60 MG CAPSULE,21.76,14.14,3.66,21.76,22
NDC,6800145306,ZIPRASIDONE 80 MG CAPSULE,21.76,14.14,3.66,21.76,22
NDC,6800147745,BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,0.46,0.3,0.08,0.46,22
NDC,6800147746,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,0.5,0.33,0.08,0.5,22
NDC,6800147747,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,0.24,0.16,0.04,0.24,22
NDC,6800147748,BACITRACIN 500 UNIT/GRAM TOPICAL PACKET,0.46,0.3,0.08,0.46,22
NDC,6800148145,MICONAZOLE NITRATE 2 % TOPICAL CREAM,0.2,0.13,0.03,0.2,22
NDC,6800148147,MICONAZOLE NITRATE 2 % TOPICAL CREAM,0.2,0.13,0.03,0.2,22
NDC,6800148148,MICONAZOLE NITRATE 2 % TOPICAL CREAM,0.28,0.18,0.05,0.28,22
NDC,6800148345,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.54,0.35,0.09,0.54,22
NDC,6800148346,TRIPLE ANTIBIOTIC 3.5 MG-400 UNIT-5000 UNIT/GRAM TOPICAL OINTMENT,0.76,0.49,0.13,0.76,22
NDC,6800148600,LISINOPRIL 40 MG TABLET,3.14,2.04,0.53,3.14,22
NDC,6800149404,FAMOTIDINE 10 MG TABLET,0.24,0.16,0.04,0.24,22
NDC,6800150555,POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,0.08,0.05,0.01,0.08,22
NDC,6800158500,GLIMEPIRIDE 2 MG TABLET,1.3,0.85,0.22,1.3,22
NDC,6800158600,GLIMEPIRIDE 4 MG TABLET,2.44,1.59,0.41,2.44,22
NDC,6800159100,ESCITALOPRAM 5 MG TABLET,8.28,5.38,1.39,8.28,22
NDC,6800161200,DICLOFENAC ER 100 MG TABLETEXTENDED RELEASE 24 HR,5.6,3.64,0.94,5.6,22
NDC,6807128704,ACETAMINOPHEN 160 MG/5 ML ORAL LIQUID,0.1,0.07,0.02,0.1,22
NDC,6808402121,ABACAVIR 300 MG TABLET,20.08,13.05,3.37,20.08,22
NDC,6808402701,WARFARIN 2.5 MG TABLET,1.28,0.83,0.22,1.28,22
NDC,6808402711,WARFARIN 2.5 MG TABLET,1.28,0.83,0.22,1.28,22
NDC,6808404401,PAROXETINE 10 MG TABLET,5.34,3.47,0.9,5.34,22
NDC,6808404411,PAROXETINE 10 MG TABLET,5.34,3.47,0.9,5.34,22
NDC,6808404501,PAROXETINE 20 MG TABLET,5.58,3.63,0.94,5.58,22
NDC,6808404511,PAROXETINE 20 MG TABLET,5.58,3.63,0.94,5.58,22
NDC,6808404601,PAROXETINE 30 MG TABLET,5.56,3.61,0.93,5.56,22
NDC,6808404611,PAROXETINE 30 MG TABLET,5.56,3.61,0.93,5.56,22
NDC,6808404701,PAROXETINE 40 MG TABLET,6.06,3.94,1.02,6.06,22
NDC,6808407521,TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,60.64,39.42,10.19,60.64,22
NDC,6808408201,ISOSORBIDE DINITRATE 10 MG TABLET,2.5,1.63,0.42,2.5,22
NDC,6808408211,ISOSORBIDE DINITRATE 10 MG TABLET,2.5,1.63,0.42,2.5,22
NDC,6808409701,ATORVASTATIN 10 MG TABLET,1.26,0.82,0.21,1.26,22
NDC,6808409801,ATORVASTATIN 20 MG TABLET,1.72,1.12,0.29,1.72,22
NDC,6808409811,ATORVASTATIN 20 MG TABLET,1.72,1.12,0.29,1.72,22
NDC,6808409901,ATORVASTATIN 40 MG TABLET,1.72,1.12,0.29,1.72,22
NDC,6808410309,ZIPRASIDONE 20 MG CAPSULE,16.94,11.01,2.85,16.94,22
NDC,6808410311,ZIPRASIDONE 20 MG CAPSULE,16.94,11.01,2.85,16.94,22
NDC,6808410409,ZIPRASIDONE 40 MG CAPSULE,16.94,11.01,2.85,16.94,22
NDC,6808410609,ZIPRASIDONE 80 MG CAPSULE,20.54,13.35,3.45,20.54,22
NDC,6808411901,MIRTAZAPINE 15 MG TABLET,2.1,1.37,0.35,2.1,22
NDC,6808412001,MIRTAZAPINE 30 MG TABLET,2.58,1.68,0.43,2.58,22
NDC,6808412011,MIRTAZAPINE 30 MG TABLET,2.58,1.68,0.43,2.58,22
NDC,6808414901,METHYLPREDNISOLONE 4 MG TABLET,4.3,2.8,0.22,4.3,31
NDC,6808415501,PROMETHAZINE 25 MG TABLET,1.08,0.7,0.18,1.08,22
NDC,6808415511,PROMETHAZINE 25 MG TABLET,1.08,0.7,0.18,1.08,22
NDC,6808415701,MORPHINE ER 15 MG TABLETEXTENDED RELEASE,3.68,2.39,0.62,3.68,22
NDC,6808418401,OXYCODONE 15 MG TABLET,3.74,2.43,0.63,3.74,22
NDC,6808418501,OXYCODONE 30 MG TABLET,7.12,4.63,1.2,7.12,22
NDC,6808420201,PRIMIDONE 50 MG TABLET,1.96,1.27,0.33,1.96,22
NDC,6808420211,PRIMIDONE 50 MG TABLET,1.96,1.27,0.33,1.96,22
NDC,6808420301,PRIMIDONE 250 MG TABLET,2.1,1.37,0.35,2.1,22
NDC,6808420311,PRIMIDONE 250 MG TABLET,2.1,1.37,0.35,2.1,22
NDC,6808420401,MINOXIDIL 2.5 MG TABLET,3.4,2.21,0.57,3.4,22
NDC,6808420411,MINOXIDIL 2.5 MG TABLET,3.4,2.21,0.57,3.4,22
NDC,6808420501,MINOXIDIL 10 MG TABLET,4.24,2.76,0.71,4.24,22
NDC,6808421401,BENZONATATE 100 MG CAPSULE,1.46,0.95,0.25,1.46,22
NDC,6808422001,ONDANSETRON HCL 4 MG TABLET,1.8,1.17,0.3,1.8,22
NDC,6808422101,ONDANSETRON HCL 8 MG TABLET,2.3,1.5,0.39,2.3,22
NDC,6808422901,AZATHIOPRINE 50 MG TABLET,1.7,1.11,0.11,2.3,31
NDC,6808424301,CLINDAMYCIN HCL 150 MG CAPSULE,1.26,0.82,0.21,1.26,22
NDC,6808424401,CLINDAMYCIN HCL 300 MG CAPSULE,2.6,1.69,0.44,2.6,22
NDC,6808424801,LORATADINE 10 MG TABLET,1.4,0.91,0.24,1.4,22
NDC,6808424811,LORATADINE 10 MG TABLET,1.4,0.91,0.24,1.4,22
NDC,6808424901,HALOPERIDOL 10 MG TABLET,3.8,2.47,0.64,3.8,22
NDC,6808426901,HYDROXYCHLOROQUINE 200 MG TABLET,8.78,5.71,1.48,8.78,22
NDC,6808427001,RISPERIDONE 0.25 MG TABLET,7.78,5.06,1.31,7.78,22
NDC,6808427101,RISPERIDONE 0.5 MG TABLET,8.54,5.55,1.43,8.54,22
NDC,6808427111,RISPERIDONE 0.5 MG TABLET,8.54,5.55,1.43,8.54,22
NDC,6808427201,RISPERIDONE 1 MG TABLET,9.08,5.9,1.53,9.08,22
NDC,6808427301,RISPERIDONE 2 MG TABLET,15.18,9.87,2.55,15.18,22
NDC,6808427401,RISPERIDONE 3 MG TABLET,17.82,11.58,2.99,17.82,22
NDC,6808428001,ETHAMBUTOL 400 MG TABLET,3.26,2.12,0.55,3.26,22
NDC,6808428401,HYDROXYUREA 500 MG CAPSULE,2.2,1.43,0.37,2.2,22
NDC,6808428801,FLUDROCORTISONE 0.1 MG TABLET,2.12,1.38,0.36,2.12,22
NDC,6808429121,NALTREXONE 50 MG TABLET,8.62,5.6,1.45,8.62,22
NDC,6808429901,TAMSULOSIN 0.4 MG CAPSULE,8.42,5.47,1.41,8.42,22
NDC,6808430011,DANTROLENE 25 MG CAPSULE,3.88,2.52,0.65,3.88,22
NDC,6808430021,DANTROLENE 25 MG CAPSULE,3.88,2.52,0.65,3.88,22
NDC,6808430921,VALACYCLOVIR 1 GRAM TABLET,12.4,8.06,2.08,12.4,22
NDC,6808431301,DIVALPROEX 125 MG CAPSULEDELAYED RELEASE SPRINKLE,2.84,1.85,0.48,2.84,22
NDC,6808431801,LAMOTRIGINE 25 MG TABLET,0.44,0.29,0.07,0.44,22
NDC,6808431811,LAMOTRIGINE 25 MG TABLET,0.44,0.29,0.07,0.44,22
NDC,6808431901,LAMOTRIGINE 100 MG TABLET,0.46,0.3,0.08,0.46,22
NDC,6808434201,TOPIRAMATE 25 MG TABLET,4.2,2.73,0.71,4.2,22
NDC,6808434211,TOPIRAMATE 25 MG TABLET,4.2,2.73,0.71,4.2,22
NDC,6808434401,TOPIRAMATE 100 MG TABLET,12.4,8.06,2.08,12.4,22
NDC,6808434411,TOPIRAMATE 100 MG TABLET,12.4,8.06,2.08,12.4,22
NDC,6808434521,TOPIRAMATE 200 MG TABLET,2.24,1.46,0.38,2.24,22
NDC,6808434601,LOSARTAN 25 MG TABLET,3.36,2.18,0.56,3.36,22
NDC,6808434611,LOSARTAN 25 MG TABLET,3.36,2.18,0.56,3.36,22
NDC,6808434701,LOSARTAN 50 MG TABLET,4.5,2.93,0.76,4.5,22
NDC,6808434711,LOSARTAN 50 MG TABLET,4.5,2.93,0.76,4.5,22
NDC,6808437101,AMIODARONE 200 MG TABLET,1.22,0.79,0.2,1.22,22
NDC,6808438101,BENZTROPINE 0.5 MG TABLET,1.18,0.77,0.2,1.18,22
NDC,6808438801,BENZTROPINE 1 MG TABLET,1.18,0.77,0.2,1.18,22
NDC,6808438901,BENZTROPINE 2 MG TABLET,1.34,0.87,0.23,1.34,22
NDC,6808440301,MORPHINE ER 15 MG TABLETEXTENDED RELEASE,3.68,2.39,0.62,3.68,22
NDC,6808445001,TACROLIMUS 1 MG CAPSULE IMMEDIATE-RELEASE,8.92,5.8,0.24,8.92,31
NDC,6808445101,TACROLIMUS 5 MG CAPSULE IMMEDIATE-RELEASE,44.6,28.99,0.24,44.6,31
NDC,6808448001,OXYBUTYNIN CHLORIDE ER 5 MG TABLETEXTENDED RELEASE 24 HR,6.02,3.91,1.01,6.02,22
NDC,6808449401,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,3.32,2.16,0.56,3.32,22
NDC,6808451101,SIMVASTATIN 10 MG TABLET,5.58,3.63,0.94,5.58,22
NDC,6808451201,SIMVASTATIN 20 MG TABLET,9.84,6.4,1.65,9.84,22
NDC,6808452501,OLANZAPINE 2.5 MG TABLET,22.34,14.52,3.75,22.34,22
NDC,6808452901,OLANZAPINE 20 MG TABLET,81.26,52.82,13.65,81.26,22
NDC,6808453901,TORSEMIDE 20 MG TABLET,1.68,1.09,0.28,1.68,22
NDC,6808453911,TORSEMIDE 20 MG TABLET,1.68,1.09,0.28,1.68,22
NDC,6808454921,TEMAZEPAM 7.5 MG CAPSULE,16.7,10.86,2.81,16.7,22
NDC,6808457201,MUCINEX 600 MG TABLET EXTENDED RELEASE,2.0,1.3,0.34,2.0,22
NDC,6808457211,MUCINEX 600 MG TABLET EXTENDED RELEASE,2.0,1.3,0.34,2.0,22
NDC,6808459701,NIFEDIPINE ER 30 MG TABLETEXTENDED RELEASE 24 HR,3.58,2.33,0.6,3.58,22
NDC,6808459801,NIFEDIPINE ER 60 MG TABLETEXTENDED RELEASE 24 HR,5.94,3.86,1.0,5.94,22
NDC,6808459811,NIFEDIPINE ER 60 MG TABLETEXTENDED RELEASE 24 HR,5.94,3.86,1.0,5.94,22
NDC,6808460201,PERPHENAZINE 4 MG TABLET,4.2,2.73,0.71,4.2,22
NDC,6808460211,PERPHENAZINE 4 MG TABLET,4.2,2.73,0.71,4.2,22
NDC,6808460701,PERPHENAZINE 8 MG TABLET,5.06,3.29,0.85,5.06,22
NDC,6808460801,TRAZODONE 150 MG TABLET,2.94,1.91,0.49,2.94,22
NDC,6808460811,TRAZODONE 150 MG TABLET,2.94,1.91,0.49,2.94,22
NDC,6808461021,OXYBUTYNIN CHLORIDE ER 10 MG TABLETEXTENDED RELEASE 24 HR,6.58,4.28,1.11,6.58,22
NDC,6808461701,ESCITALOPRAM 10 MG TABLET,8.64,5.62,1.45,8.64,22
NDC,6808461711,ESCITALOPRAM 10 MG TABLET,8.64,5.62,1.45,8.64,22
NDC,6808461801,ESCITALOPRAM 20 MG TABLET,9.2,5.98,1.55,9.2,22
NDC,6808461811,ESCITALOPRAM 20 MG TABLET,9.2,5.98,1.55,9.2,22
NDC,6808462121,MODAFINIL 100 MG TABLET,52.76,34.29,8.86,52.76,22
NDC,6808464001,LITHIUM CARBONATE ER 300 MG TABLETEXTENDED RELEASE,1.0,0.65,0.17,1.0,22
NDC,6808464011,LITHIUM CARBONATE ER 300 MG TABLETEXTENDED RELEASE,1.0,0.65,0.17,1.0,22
NDC,6808464301,PANTOPRAZOLE 20 MG TABLETDELAYED RELEASE,7.6,4.94,1.28,7.6,22
NDC,6808464501,TIZANIDINE 4 MG TABLET,3.02,1.96,0.51,3.02,22
NDC,6808465401,SOTALOL 80 MG TABLET,4.64,3.02,0.78,4.64,22
NDC,6808465411,SOTALOL 80 MG TABLET,4.64,3.02,0.78,4.64,22
NDC,6808465501,LITHIUM CARBONATE ER 450 MG TABLETEXTENDED RELEASE,1.52,0.99,0.26,1.52,22
NDC,6808465801,IBUPROFEN 400 MG TABLET,0.52,0.34,0.09,0.52,22
NDC,6808469701,BUPROPION HCL SR 100 MG TABLET12 HR SUSTAINED-RELEASE,3.32,2.16,0.56,3.32,22
NDC,6808469801,VENLAFAXINE ER 37.5 MG CAPSULEEXTENDED RELEASE 24 HR,7.48,4.86,1.26,7.48,22
NDC,6808469811,VENLAFAXINE ER 37.5 MG CAPSULEEXTENDED RELEASE 24 HR,7.48,4.86,1.26,7.48,22
NDC,6808470411,BETHANECHOL CHLORIDE 25 MG TABLET,3.56,2.31,0.6,3.56,22
NDC,6808470901,VENLAFAXINE ER 75 MG CAPSULEEXTENDED RELEASE 24 HR,8.4,5.46,1.41,8.4,22
NDC,6808471301,VENLAFAXINE ER 150 MG CAPSULEEXTENDED RELEASE 24 HR,9.14,5.94,1.54,9.14,22
NDC,6808471311,VENLAFAXINE ER 150 MG CAPSULEEXTENDED RELEASE 24 HR,9.14,5.94,1.54,9.14,22
NDC,6808472121,MODAFINIL 200 MG TABLET,70.78,46.01,11.89,70.78,22
NDC,6808472265,MOXIFLOXACIN 400 MG TABLET,53.82,34.98,9.04,53.82,22
NDC,6808472301,OLANZAPINE 5 MG TABLET,21.78,14.16,3.66,21.78,22
NDC,6808472921,GALANTAMINE 4 MG TABLET,9.58,6.23,1.61,9.58,22
NDC,6808473501,FLUCONAZOLE 200 MG TABLET,88.0,57.2,14.78,88.0,22
NDC,6808473511,FLUCONAZOLE 200 MG TABLET,88.0,57.2,14.78,88.0,22
NDC,6808474001,OLANZAPINE 10 MG TABLET,40.64,26.42,6.83,40.64,22
NDC,6808475225,CLOPIDOGREL 300 MG TABLET,53.26,34.62,8.95,53.26,22
NDC,6808476425,PHOSPHA NEUTRAL 250 MG TABLET,3.2,2.08,0.54,3.2,22
NDC,6808477525,TIZANIDINE 2 MG TABLET,3.5,2.28,0.59,3.5,22
NDC,6808477595,TIZANIDINE 2 MG TABLET,3.5,2.28,0.59,3.5,22
NDC,6808478825,GLIMEPIRIDE 1 MG TABLET,2.02,1.31,0.34,2.02,22
NDC,6808479025,CLOMIPRAMINE 25 MG CAPSULE,22.36,14.53,3.76,22.36,22
NDC,6808480521,METHYLPHENIDATE 5 MG TABLET,5.62,3.65,0.94,5.62,22
NDC,6808481825,CLOMIPRAMINE 50 MG CAPSULE,32.94,21.41,5.53,32.94,22
NDC,6808482321,METHYLPHENIDATE 10 MG TABLET,3.98,2.59,0.67,3.98,22
NDC,6808484311,CARVEDILOL 3.125 MG TABLET,3.9,2.54,0.66,3.9,22
NDC,6808484401,VENLAFAXINE 37.5 MG TABLET,4.0,2.6,0.67,4.0,22
NDC,6808485032,POTASSIUM CITRATE ER 10 MEQ (1080 MG) TABLETEXTENDED RELEASE,5.78,3.76,0.97,5.78,22
NDC,6808485033,POTASSIUM CITRATE ER 10 MEQ (1080 MG) TABLETEXTENDED RELEASE,5.78,3.76,0.97,5.78,22
NDC,6808485401,CARVEDILOL 6.25 MG TABLET,3.9,2.54,0.66,3.9,22
NDC,6808485411,CARVEDILOL 6.25 MG TABLET,3.9,2.54,0.66,3.9,22
NDC,6808485601,VENLAFAXINE 75 MG TABLET,4.38,2.85,0.74,4.38,22
NDC,6808485901,LEVETIRACETAM 250 MG TABLET,1.2,0.78,0.2,1.2,22
NDC,6808485911,LEVETIRACETAM 250 MG TABLET,1.2,0.78,0.2,1.2,22
NDC,6808487925,CYCLOSPORINE 25 MG ORAL CAP (SANDIMMUNE),11.5,7.48,0.83,11.5,31
NDC,6808487995,CYCLOSPORINE 25 MG ORAL CAP (SANDIMMUNE),11.5,7.48,0.83,11.5,31
NDC,6808488201,LEVETIRACETAM 750 MG TABLET,1.68,1.09,0.28,1.68,22
NDC,6808488211,LEVETIRACETAM 750 MG TABLET,1.68,1.09,0.28,1.68,22
NDC,6808489625,VENLAFAXINE 25 MG TABLET,4.14,2.69,0.7,4.14,22
NDC,6808491595,SIROLIMUS 1 MG TABLET,34.1,22.17,1.84,34.1,31
NDC,6808492125,CYCLOSPORINE 100 MG ORAL CAP (SANDIMMUNE),39.72,25.82,2.07,39.72,31
NDC,6808493025,HYDROCORTISONE 20 MG TABLET,4.16,2.7,0.7,4.16,22
NDC,6808496425,PROPYLTHIOURACIL 50 MG TABLET,6.72,4.37,1.13,6.72,22
NDC,6808496495,PROPYLTHIOURACIL 50 MG TABLET,6.72,4.37,1.13,6.72,22
NDC,6808498832,ANTACID 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,1.76,1.14,0.3,1.76,22
NDC,6808499601,PRAZOSIN 1 MG CAPSULE,3.58,2.33,0.6,3.58,22
NDC,6808499701,PRAZOSIN 2 MG CAPSULE,4.98,3.24,0.84,4.98,22
NDC,6809400159,MORPHINE 10 MG/5 ML ORAL SOLUTION,0.83,0.54,0.14,0.83,22
NDC,6809400162,MORPHINE 10 MG/5 ML ORAL SOLUTION,0.83,0.54,0.14,0.83,22
NDC,6809400459,CETIRIZINE 5 MG/5 ML ORAL SOLUTION,1.43,0.93,0.24,1.43,22
NDC,6809400462,CETIRIZINE 5 MG/5 ML ORAL SOLUTION,1.73,1.12,0.29,1.73,22
NDC,6809401861,DIPHENHYDRAMINE 25 MG TABLET,0.52,0.34,0.09,0.52,22
NDC,6809402959,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,0.88,0.57,0.15,0.88,22
NDC,6809402962,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,1.05,0.68,0.18,1.05,22
NDC,6809403062,ACETAMINOPHEN 650 MG/20.3 ML ORAL SUSPENSION,0.28,0.18,0.05,0.28,22
NDC,6809403162,METHADONE 5 MG/5 ML ORAL SOLUTION,0.72,0.47,0.12,0.72,22
NDC,6809403758,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,1.13,0.73,0.19,1.13,22
NDC,6809404558,MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY),8.88,5.77,1.49,8.88,22
NDC,6809405059,OSELTAMIVIR 75 MG CAPSULE,6.72,4.37,1.13,6.72,22
NDC,6809406162,CHILDREN'S ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION,0.93,0.6,0.16,0.93,22
NDC,6809407458,CLOBAZAM 10 MG/4 ML ORAL SYRINGE (ORAL USE),4.05,2.63,0.68,4.05,22
NDC,6809411061,MELATONIN 3 MG TABLET,0.54,0.35,0.09,0.54,22
NDC,6809411361,ASCORBIC ACID (VITAMIN C) 500 MG TABLET,0.48,0.31,0.08,0.48,22
NDC,6809412962,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,0.63,0.41,0.11,0.63,22
NDC,6809433061,ACETAMINOPHEN 325 MG/10.15 ML ORAL SUSPENSION,0.38,0.25,0.06,0.38,22
NDC,6809449459,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.48,0.31,0.08,0.48,22
NDC,6809449461,CHILDREN'S IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.55,0.36,0.09,0.55,22
NDC,6809450359,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.4,0.26,0.07,0.4,22
NDC,6809475659,FUROSEMIDE 40 MG/4 ML ORAL SOLUTION,1.55,1.01,0.26,1.55,22
NDC,6809475662,FUROSEMIDE 40 MG/4 ML ORAL SOLUTION,1.55,1.01,0.26,1.55,22
NDC,6809476262,MIDAZOLAM 2 MG/ML ORAL SYRUP,6.33,4.11,1.06,6.33,22
NDC,6809476459,MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,3.68,2.39,0.62,3.68,22
NDC,6809476462,MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,3.68,2.39,0.62,3.68,22
NDC,6809486762,FUROSEMIDE 40 MG/5 ML (8 MG/ML) ORAL SOLUTION,1.23,0.8,0.21,1.23,22
NDC,6813420116,NAPROXEN 125 MG/5 ML ORAL SUSPENSION,3.53,2.29,0.59,3.53,22
NDC,6813502001,NAGLAZYME 5 MG/5 ML INTRAVENOUS SOLUTION,1790.64,1163.92,420.22,12697.64,40
NDC,6817600010,DEKAS PLUS LIQUID 500 MCG/ML ORAL,1.35,0.88,0.23,1.35,22
NDC,6817600015,DEKAS PLUS (FOLIC ACID) 200 MCG-1000 MCG-10 MG CHEWABLE TABLET,1.22,0.79,0.2,1.22,22
NDC,6818012101,CEPHALEXIN 250 MG CAPSULE,1.38,0.9,0.23,1.38,22
NDC,6818012201,CEPHALEXIN 500 MG CAPSULE,2.76,1.79,0.46,2.76,22
NDC,6818012202,CEPHALEXIN 500 MG CAPSULE,2.46,1.6,0.41,2.46,22
NDC,6818015001,FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,8.85,5.75,1.49,8.85,22
NDC,6818028001,ETHAMBUTOL 100 MG TABLET,1.18,0.77,0.2,1.18,22
NDC,6818028101,ETHAMBUTOL 400 MG TABLET,3.58,2.33,0.6,3.58,22
NDC,6818029006,ESLICARBAZEPINE 200 MG TABLET,96.98,63.04,16.29,96.98,22
NDC,6818040501,CEFIXIME 100 MG/5 ML ORAL SUSPENSION,11.13,7.23,1.87,11.13,22
NDC,6818042201,MOXIFLOXACIN 0.5 % EYE DROPS,111.56,72.51,18.74,111.56,22
NDC,6818046403,SIMVASTATIN 40 MG TABLET,9.84,6.4,1.65,9.84,22
NDC,6818046406,SIMVASTATIN 40 MG TABLET,9.84,6.4,1.65,9.84,22
NDC,6818046509,SIMVASTATIN 80 MG TABLET,9.84,6.4,1.65,9.84,22
NDC,6818047902,SIMVASTATIN 20 MG TABLET,9.84,6.4,1.65,9.84,22
NDC,6818051202,LISINOPRIL 2.5 MG TABLET,1.28,0.83,0.22,1.28,22
NDC,6818051303,LISINOPRIL 5 MG TABLET,1.9,1.24,0.32,1.9,22
NDC,6818065701,DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,0.95,0.62,0.16,0.95,22
NDC,6818067511,OSELTAMIVIR 30 MG CAPSULE,28.36,18.43,4.76,28.36,22
NDC,6818067711,OSELTAMIVIR 75 MG CAPSULE,30.92,20.1,5.19,30.92,22
NDC,6818070909,RIVAROXABAN 2.5 MG TABLET,20.5,13.33,3.44,20.5,22
NDC,6818086306,AZITHROMYCIN 600 MG TABLET,37.36,24.28,6.28,37.36,22
NDC,6818094902,DESOXIMETASONE 0.05 % TOPICAL CREAM,12.24,7.96,2.06,12.24,22
NDC,6818095001,DESOXIMETASONE 0.25 % TOPICAL CREAM,7.78,5.06,1.31,7.78,22
NDC,6818095403,HYDROCORTISONE VALERATE 0.2 % TOPICAL CREAM,7.24,4.71,1.22,7.24,22
NDC,6818096301,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,17.42,11.32,2.93,17.42,22
NDC,6822920102,ALOCANE EMERGENCY BURN 4 % TOPICAL GEL,0.36,0.23,0.06,0.36,22
NDC,6838200106,PAROXETINE 40 MG TABLET,5.76,3.74,0.97,5.76,22
NDC,6838200301,AZATHIOPRINE 50 MG TABLET,4.22,2.74,0.11,4.22,31
NDC,6838200414,TOPIRAMATE 15 MG SPRINKLE CAPSULE,4.84,3.15,0.81,4.84,22
NDC,6838200514,TOPIRAMATE 25 MG SPRINKLE CAPSULE,5.84,3.8,0.98,5.84,22
NDC,6838200601,LAMOTRIGINE 25 MG TABLET,9.1,5.92,1.53,9.1,22
NDC,6838200610,LAMOTRIGINE 25 MG TABLET,9.1,5.92,1.53,9.1,22
NDC,6838200810,LAMOTRIGINE 100 MG TABLET,10.38,6.75,1.74,10.38,22
NDC,6838201014,LAMOTRIGINE 200 MG TABLET,12.4,8.06,2.08,12.4,22
NDC,6838203416,VENLAFAXINE ER 37.5 MG CAPSULEEXTENDED RELEASE 24 HR,8.32,5.41,1.4,8.32,22
NDC,6838203516,VENLAFAXINE ER 75 MG CAPSULEEXTENDED RELEASE 24 HR,9.34,6.07,1.57,9.34,22
NDC,6838203616,VENLAFAXINE ER 150 MG CAPSULEEXTENDED RELEASE 24 HR,10.16,6.6,1.71,10.16,22
NDC,6838204201,PROMETHAZINE 50 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,6838205001,MELOXICAM 7.5 MG TABLET,6.34,4.12,1.07,6.34,22
NDC,6838205101,MELOXICAM 15 MG TABLET,9.7,6.31,1.63,9.7,22
NDC,6838205105,MELOXICAM 15 MG TABLET,9.7,6.31,1.63,9.7,22
NDC,6838207901,HALOPERIDOL 5 MG TABLET,2.04,1.33,0.34,2.04,22
NDC,6838208001,HALOPERIDOL 10 MG TABLET,2.88,1.87,0.48,2.88,22
NDC,6838209605,HYDROXYCHLOROQUINE 200 MG TABLET,8.14,5.29,1.37,8.14,22
NDC,6838209706,PAROXETINE 10 MG TABLET,5.24,3.41,0.88,5.24,22
NDC,6838209716,PAROXETINE 10 MG TABLET,5.22,3.39,0.88,5.22,22
NDC,6838209801,PAROXETINE 20 MG TABLET,5.46,3.55,0.92,5.46,22
NDC,6838209805,PAROXETINE 20 MG TABLET,5.46,3.55,0.92,5.46,22
NDC,6838209806,PAROXETINE 20 MG TABLET,5.46,3.55,0.92,5.46,22
NDC,6838209906,PAROXETINE 30 MG TABLET,5.64,3.67,0.95,5.64,22
NDC,6838209916,PAROXETINE 30 MG TABLET,5.62,3.65,0.94,5.62,22
NDC,6838210101,VENLAFAXINE 100 MG TABLET,4.64,3.02,0.78,4.64,22
NDC,6838210601,DIVALPROEX 125 MG CAPSULEDELAYED RELEASE SPRINKLE,2.24,1.46,0.38,2.24,22
NDC,6838211214,RISPERIDONE 0.25 MG TABLET,7.8,5.07,1.31,7.8,22
NDC,6838211314,RISPERIDONE 0.5 MG TABLET,8.56,5.56,1.44,8.56,22
NDC,6838211414,RISPERIDONE 1 MG TABLET,9.1,5.92,1.53,9.1,22
NDC,6838211514,RISPERIDONE 2 MG TABLET,15.22,9.89,2.56,15.22,22
NDC,6838211614,RISPERIDONE 3 MG TABLET,17.86,11.61,3.0,17.86,22
NDC,6838212105,AMLODIPINE 2.5 MG TABLET,3.46,2.25,0.58,3.46,22
NDC,6838212205,AMLODIPINE 5 MG TABLET,3.46,2.25,0.58,3.46,22
NDC,6838212305,AMLODIPINE 10 MG TABLET,4.74,3.08,0.8,4.74,22
NDC,6838213201,TAMSULOSIN 0.4 MG CAPSULE,8.42,5.47,1.41,8.42,22
NDC,6838213610,LOSARTAN 50 MG TABLET,4.52,2.94,0.76,4.52,22
NDC,6838213805,TOPIRAMATE 25 MG TABLET,5.12,3.33,0.86,5.12,22
NDC,6838213814,TOPIRAMATE 25 MG TABLET,5.12,3.33,0.86,5.12,22
NDC,6838214005,TOPIRAMATE 100 MG TABLET,13.92,9.05,2.34,13.92,22
NDC,6838214014,TOPIRAMATE 100 MG TABLET,13.92,9.05,2.34,13.92,22
NDC,6838220401,GABAPENTIN 600 MG TABLET,5.06,3.29,0.85,5.06,22
NDC,6838222705,AMIODARONE 200 MG TABLET,6.46,4.2,1.09,6.46,22
NDC,6838231818,MINOCYCLINE 100 MG CAPSULE,6.8,4.42,1.14,6.8,22
NDC,6838237001,NYSTATIN 100000 UNIT/GRAM TOPICAL POWDER,3.74,2.43,0.63,3.74,22
NDC,6838237002,NYSTATIN 100000 UNIT/GRAM TOPICAL POWDER,3.34,2.17,0.56,3.34,22
NDC,6838237003,NYSTATIN 100000 UNIT/GRAM TOPICAL POWDER,3.2,2.08,0.54,3.2,22
NDC,6838238306,EXEMESTANE 25 MG TABLET,40.46,26.3,6.8,40.46,22
NDC,6838244614,BOSENTAN 62.5 MG TABLET,418.28,271.88,70.27,418.28,22
NDC,6838244714,BOSENTAN 125 MG TABLET,418.28,271.88,70.27,418.28,22
NDC,6838250010,OMEPRAZOLE 40 MG CAPSULEDELAYED RELEASE,14.8,9.62,2.49,14.8,22
NDC,6838253601,POTASSIUM CITRATE ER 5 MEQ (540 MG) TABLETEXTENDED RELEASE,3.5,2.28,0.59,3.5,22
NDC,6838256928,ACAMPROSATE 333 MG TABLETDELAYED RELEASE,3.52,2.29,0.59,3.52,22
NDC,6838262301,BUSPIRONE 7.5 MG TABLET,3.16,2.05,0.53,3.16,22
NDC,6838262483,ROFLUMILAST 250 MCG TABLET,31.12,20.23,5.23,31.12,22
NDC,6838265906,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,2.56,1.66,0.43,2.56,22
NDC,6838270718,DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE,4.74,3.08,0.8,4.74,22
NDC,6838272001,BUDESONIDE DR - ER 3 MG CAPSULEDELAYEDEXTENDED RELEASE,49.72,32.32,8.35,49.72,22
NDC,6838275805,METFORMIN 500 MG TABLET,1.4,0.91,0.24,1.4,22
NDC,6838275901,METFORMIN 850 MG TABLET,2.4,1.56,0.4,2.4,22
NDC,6838277177,LANSOPRAZOLE 15 MG DELAYED RELEASEDISINTEGRATING TABLET,31.54,20.5,5.3,31.54,22
NDC,6838278301,DOXAZOSIN 1 MG TABLET,2.7,1.76,0.45,2.7,22
NDC,6838278401,DOXAZOSIN 2 MG TABLET,2.7,1.76,0.45,2.7,22
NDC,6838278501,DOXAZOSIN 4 MG TABLET,2.84,1.85,0.48,2.84,22
NDC,6838279901,LABETALOL 200 MG TABLET,2.28,1.48,0.38,2.28,22
NDC,6838280505,TRAZODONE 50 MG TABLET,1.68,1.09,0.28,1.68,22
NDC,6838280601,TRAZODONE 100 MG TABLET,2.78,1.81,0.47,2.78,22
NDC,6838285701,TRIAMTERENE 75 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,2.22,1.44,0.37,2.22,22
NDC,6838291406,ERLOTINIB 100 MG TABLET,567.88,369.12,95.4,567.88,22
NDC,6838291506,ERLOTINIB 150 MG TABLET,642.3,417.5,107.91,642.3,22
NDC,6838291711,METHYLPREDNISOLONE 8 MG TABLET,4.02,2.61,0.22,4.02,30
NDC,6838297906,LAMOTRIGINE ER 25 MG TABLETEXTENDED RELEASE 24 HR,13.1,8.52,2.2,13.1,22
NDC,6838298006,LAMOTRIGINE ER 50 MG TABLETEXTENDED RELEASE 24 HR,26.18,17.02,4.4,26.18,22
NDC,6838298106,LAMOTRIGINE ER 100 MG TABLETEXTENDED RELEASE 24 HR,28.06,18.24,4.71,28.06,22
NDC,6840311006,BABYBIG 100 MG INTRAVENOUS SOLUTION,51570.0,33520.5,8663.76,51570.0,22
NDC,6841879396,DIACOMIT 250 MG CAPSULE,91.92,59.75,15.44,91.92,22
NDC,6841879406,DIACOMIT 500 MG CAPSULE,183.82,119.48,30.88,183.82,22
NDC,6841879416,DIACOMIT 250 MG ORAL POWDER PACKET,91.92,59.75,15.44,91.92,22
NDC,6841879426,DIACOMIT 500 MG ORAL POWDER PACKET,183.82,119.48,30.88,183.82,22
NDC,6845510690,STOMAHESIVE PASTE,0.32,0.21,0.05,0.32,22
NDC,6845510763,"""UNNA-FLEX ELASTIC UNNA BOOT 3"""" X 10 YARD BANDAGE""",24.44,15.89,4.11,24.44,22
NDC,6845510764,"""UNNA-FLEX ELASTIC UNNA BOOT 4"""" X 10 YARD BANDAGE""",27.42,17.82,4.61,27.42,22
NDC,6846212801,ZONISAMIDE 25 MG CAPSULE,1.1,0.72,0.18,1.1,22
NDC,6846212901,ZONISAMIDE 50 MG CAPSULE,2.2,1.43,0.37,2.2,22
NDC,6846213001,ZONISAMIDE 100 MG CAPSULE,4.4,2.86,0.74,4.4,22
NDC,6846215713,ONDANSETRON 4 MG DISINTEGRATING TABLET,46.22,30.04,7.76,46.22,22
NDC,6846215813,ONDANSETRON 8 MG DISINTEGRATING TABLET,77.0,50.05,12.94,77.0,22
NDC,6846218022,MUPIROCIN 2 % TOPICAL OINTMENT,3.88,2.52,0.65,3.88,22
NDC,6846218801,NAPROXEN 250 MG TABLET,1.56,1.01,0.26,1.56,22
NDC,6846218901,NAPROXEN 375 MG TABLET,2.12,1.38,0.36,2.12,22
NDC,6846219001,NAPROXEN 500 MG TABLET,2.6,1.69,0.44,2.6,22
NDC,6846219590,PRAVASTATIN 10 MG TABLET,6.44,4.19,1.08,6.44,22
NDC,6846222401,LITHIUM CARBONATE ER 450 MG TABLETEXTENDED RELEASE,1.0,0.65,0.17,1.0,22
NDC,6846223301,FELODIPINE ER 2.5 MG TABLETEXTENDED RELEASE 24 HR,3.16,2.05,0.53,3.16,22
NDC,6846225301,ROPINIROLE 0.25 MG TABLET,5.02,3.26,0.84,5.02,22
NDC,6846225501,ROPINIROLE 1 MG TABLET,5.02,3.26,0.84,5.02,22
NDC,6846225601,ROPINIROLE 2 MG TABLET,5.02,3.26,0.84,5.02,22
NDC,6846225801,ROPINIROLE 4 MG TABLET,5.2,3.38,0.87,5.2,22
NDC,6846225901,ROPINIROLE 5 MG TABLET,5.2,3.38,0.87,5.2,22
NDC,6846226001,VERAPAMIL ER (SR) 240 MG TABLETEXTENDED RELEASE,3.28,2.13,0.55,3.28,22
NDC,6846230450,NORETHINDRONE ACETATE 5 MG TABLET,5.3,3.45,0.89,5.3,22
NDC,6846240444,ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,14.3,9.3,2.4,14.3,22
NDC,6846240467,ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,14.3,9.3,2.4,14.3,22
NDC,6846240601,INDOMETHACIN 25 MG CAPSULE,0.8,0.52,0.13,0.8,22
NDC,6846243518,ACAMPROSATE 333 MG TABLETDELAYED RELEASE,3.52,2.29,0.59,3.52,22
NDC,6846250165,CALCIPOTRIENE 0.005 % TOPICAL CREAM,20.3,13.2,3.41,20.3,22
NDC,6846263925,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,2.06,1.34,0.35,2.06,22
NDC,6846263945,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,2.06,1.34,0.35,2.06,22
NDC,6846272101,THEOPHYLLINE ER 300 MG TABLETEXTENDED RELEASE12 HR,8.6,5.59,1.44,8.6,22
NDC,6851646171,ALPHANATE 500 (200 VWF) UNIT/5 ML INTRAVENOUS SOLUTION,5.1,3.32,1.07,3236.72,47
NDC,6851646182,ALPHANATE 1000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLUTION,5.1,3.32,1.07,3236.72,47
NDC,6851646192,ALPHANATE 1500 (600 VWF) UNIT/10 ML INTRAVENOUS SOLUTION,5.1,3.32,1.07,3236.72,47
NDC,6851652141,ALBUTEIN 5 % INTRAVENOUS SOLUTION,0.69,0.45,0.18,218.09,40
NDC,6851652142,ALBUTEIN 5 % INTRAVENOUS SOLUTION,0.69,0.45,0.18,218.09,40
NDC,6851652145,ALBUTEIN 5 % INTRAVENOUS SOLUTION,2.37,1.54,0.59,94.02,33
NDC,6851652149,ALBUTEIN 5 % INTRAVENOUS SOLUTION,0.66,0.43,0.17,218.09,40
NDC,6851652160,ALBUTEIN 25 % INTRAVENOUS SOLUTION,3.36,2.18,0.84,146.89,33
NDC,6851652161,ALBUTEIN 25 % INTRAVENOUS SOLUTION,3.36,2.18,0.84,146.89,33
NDC,6851652162,ALBUTEIN 25 % INTRAVENOUS SOLUTION,3.36,2.18,0.84,146.89,33
NDC,6851652165,ALBUTEIN 25 % INTRAVENOUS SOLUTION,5.01,3.26,1.3,94.02,40
NDC,6851652169,ALBUTEIN 25 % INTRAVENOUS SOLUTION,3.36,2.18,0.84,146.89,33
NDC,6851652192,ALBUTEIN 5 % INTRAVENOUS SOLUTION,0.69,0.45,0.18,218.09,40
NDC,6854614256,AZILECT 0.5 MG TABLET,100.08,65.05,16.81,100.08,22
NDC,6854622956,AZILECT 1 MG TABLET,100.08,65.05,16.81,100.08,22
NDC,6854631730,COPAXONE 20 MG/ML SUBCUTANEOUS SYRINGE,853.68,554.89,61.99,853.68,36
NDC,6854632512,COPAXONE 40 MG/ML SUBCUTANEOUS SYRINGE,1837.08,1194.1,61.99,1837.08,36
NDC,6854700501,GIAPREZA 0.5 MG/ML INTRAVENOUS SOLUTION,1890.0,1228.5,317.52,1890.0,23
NDC,6854711110,XACDURO 1 GRAM-1 GRAM (0.5 GRAM X 2) INTRAVENOUS SOLUTION,630.0,409.5,105.84,630.0,23
NDC,6854721120,SULBACTAM SODIUM 1 GRAM INTRAVENOUS SOLUTION,630.0,409.5,105.84,630.0,22
NDC,6854731130,DURLOBACTAM 0.5 GRAM INTRAVENOUS SOLUTION,630.0,409.5,105.84,630.0,22
NDC,6854750102,GIAPREZA 2.5 MG/ML INTRAVENOUS SOLUTION,6836.4,4443.66,1148.52,6836.4,29
NDC,6858500575,MAG 64 64 MG TABLETDELAYED RELEASE,0.28,0.18,0.05,0.28,22
NDC,6861118001,YUTIQ 0.18 MG INTRAVITREAL IMPLANT,22244.0,14458.6,474.38,22244.0,53
NDC,6861119002,ILUVIEN 0.19 MG INTRAVITREAL IMPLANT,22092.0,14359.8,438.78,22092.0,53
NDC,6868200610,DILTIAZEM 30 MG TABLET,2.0,1.3,0.34,2.0,22
NDC,6868200710,DILTIAZEM 60 MG TABLET,3.14,2.04,0.53,3.14,22
NDC,6868201110,ETHACRYNIC ACID 25 MG TABLET,47.9,31.14,8.05,47.9,22
NDC,6868210910,NIFEDIPINE ER 60 MG TABLETEXTENDED RELEASE 24 HR,4.44,2.89,0.75,4.44,22
NDC,6868211001,PIMECROLIMUS 1 % TOPICAL CREAM,20.3,13.2,3.41,20.3,22
NDC,6868299398,DILTIAZEM SR 120 MG 24 HR CAP,1.86,1.21,0.31,1.86,22
NDC,6872771201,ZEPZELCA 4 MG INTRAVENOUS SOLUTION,39600.0,25740.0,179.57,39600.0,52
NDC,6872774502,VYXEOS 44 MG-100 MG INTRAVENOUS SOLUTION,52704.0,34257.6,209.52,52704.0,52
NDC,6872780002,DEFITELIO 80 MG/ML INTRAVENOUS SOLUTION,1720.8,1118.52,289.09,1720.8,22
NDC,6872790003,RYLAZE 10 MG/0.5 ML INTRAMUSCULAR SOLUTION,50976.0,33134.4,46.08,50976.0,52
NDC,6872795002,ZIIHERA 300 MG INTRAVENOUS SOLUTION,17064.0,11091.6,24.99,17064.0,45
NDC,6880361210,VISIONBLUE 0.06 % INTRAOCULAR SYRINGE,623.73,405.42,104.79,623.73,22
NDC,6880372225,TISSUEBLUE 0.025 % INTRAOCULAR SYRINGE,1208.73,785.67,203.07,1208.73,22
NDC,6881713450,ABRAXANE 100 MG INTRAVENOUS SUSPENSION,7584.28,4929.78,8.18,7584.28,52
NDC,6887501031,GATTEX ONE-VIAL 5 MG SUBCUTANEOUS KIT,6472.56,4207.16,1087.39,6472.56,22
NDC,6896855523,DAYTRANA 10 MG/9 HR DAILY PATCH,14.44,9.39,2.43,14.44,22
NDC,6896855543,DAYTRANA 20 MG/9 HR DAILY PATCH,14.44,9.39,2.43,14.44,22
NDC,6898285001,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,18.11,943.43,47
NDC,6898285002,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,18.11,943.43,47
NDC,6898285003,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,18.11,943.43,47
NDC,6898285004,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,18.11,943.43,47
NDC,6898285005,OCTAGAM 10 % INTRAVENOUS SOLUTION,69.93,45.45,18.11,943.43,47
NDC,6899230101,ENVARSUS XR 1 MG TABLETEXTENDED RELEASE,17.14,11.14,1.56,17.14,31
NDC,6899230103,ENVARSUS XR 1 MG TABLETEXTENDED RELEASE,17.14,11.14,1.56,17.14,31
NDC,6899230401,ENVARSUS XR 4 MG TABLETEXTENDED RELEASE,68.58,44.58,1.56,68.58,31
NDC,6899230403,ENVARSUS XR 4 MG TABLETEXTENDED RELEASE,68.58,44.58,1.56,68.58,31
NDC,6899230751,ENVARSUS XR 0.75 MG TABLETEXTENDED RELEASE,12.86,8.36,1.56,12.86,31
NDC,6899230753,ENVARSUS XR 0.75 MG TABLETEXTENDED RELEASE,12.86,8.36,1.56,12.86,31
NDC,6905130001,IMPAVIDO 50 MG CAPSULE,1427.14,927.64,239.76,1427.14,22
NDC,6909722316,ALENDRONATE 35 MG TABLET,40.98,26.64,6.88,40.98,22
NDC,6909730102,EFAVIRENZ 600 MG TABLET,71.54,46.5,12.02,71.54,22
NDC,6909731602,EXEMESTANE 25 MG TABLET,26.06,16.94,4.38,26.06,22
NDC,6909731987,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,11.08,7.2,1.86,11.08,22
NDC,6909732187,BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION,23.08,15.0,3.88,23.08,22
NDC,6909736202,ABACAVIR 600 MG-LAMIVUDINE 300 MG TABLET,93.0,60.45,15.62,93.0,22
NDC,6909741002,CINACALCET 30 MG TABLET,61.32,39.86,10.3,61.32,22
NDC,6909741102,CINACALCET 60 MG TABLET,122.62,79.7,20.6,122.62,22
NDC,6909743105,DARIFENACIN ER 7.5 MG TABLETEXTENDED RELEASE 24 HR,22.12,14.38,3.72,22.12,22
NDC,6909743205,DARIFENACIN ER 15 MG TABLETEXTENDED RELEASE 24 HR,22.12,14.38,3.72,22.12,22
NDC,6909764202,EMTRICITABINE 200 MG CAPSULE,38.62,25.1,6.49,38.62,22
NDC,6909770896,PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,153.96,100.07,2.52,153.96,31
NDC,6909770996,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLUTION,43.2,28.08,2.52,43.2,31
NDC,6909780232,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,69.3,45.05,0.01,69.3,31
NDC,6909782103,GEMFIBROZIL 600 MG TABLET,4.86,3.16,0.82,4.86,22
NDC,6909782112,GEMFIBROZIL 600 MG TABLET,4.64,3.02,0.78,4.64,22
NDC,6909782502,RALOXIFENE 60 MG TABLET,14.26,9.27,2.4,14.26,22
NDC,6909786107,ZONISAMIDE 100 MG CAPSULE,4.38,2.85,0.74,4.38,22
NDC,6909787067,LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,64027.14,41617.64,36.8,64027.14,53
NDC,6923030001,ALLERGY RELIEF (FEXOFENADINE) 180 MG TABLET,0.64,0.42,0.11,0.64,22
NDC,6923811201,OXAPROZIN 600 MG TABLET,15.46,10.05,2.6,15.46,22
NDC,6923811709,DOXEPIN 25 MG CAPSULE,1.64,1.07,0.28,1.64,22
NDC,6923811739,DOXEPIN 100 MG CAPSULE,3.94,2.56,0.66,3.94,22
NDC,6923812651,OSELTAMIVIR 45 MG CAPSULE,28.36,18.43,4.76,28.36,22
NDC,6923813196,DIMETHYL FUMARATE 240 MG CAPSULEDELAYED RELEASE,297.6,193.44,50.0,297.6,22
NDC,6923813421,ETODOLAC 400 MG TABLET,2.94,1.91,0.49,2.94,22
NDC,6923814592,POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,2.03,1.32,0.34,2.03,22
NDC,6923815324,CLOBETASOL 0.05 % TOPICAL CREAM,17.1,11.12,2.87,17.1,22
NDC,6923815943,SIROLIMUS 1 MG/ML ORAL SOLUTION,78.95,51.32,1.84,78.95,31
NDC,6923816171,POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,21.48,13.96,3.61,21.48,22
NDC,6923816173,POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,21.48,13.96,3.61,21.48,22
NDC,6923816781,FLUPHENAZINE 1 MG TABLET,8.78,5.71,1.48,8.78,22
NDC,6923816791,FLUPHENAZINE 2.5 MG TABLET,13.6,8.84,2.28,13.6,22
NDC,6923818301,LEVOTHYROXINE 25 MCG TABLET,0.88,0.57,0.15,0.88,22
NDC,6923818311,LEVOTHYROXINE 50 MCG TABLET,1.0,0.65,0.17,1.0,22
NDC,6923818321,LEVOTHYROXINE 75 MCG TABLET,1.1,0.72,0.18,1.1,22
NDC,6923818331,LEVOTHYROXINE 88 MCG TABLET,1.12,0.73,0.19,1.12,22
NDC,6923818341,LEVOTHYROXINE 100 MCG TABLET,1.12,0.73,0.19,1.12,22
NDC,6923818351,LEVOTHYROXINE 112 MCG TABLET,1.3,0.85,0.22,1.3,22
NDC,6923818361,LEVOTHYROXINE 125 MCG TABLET,1.32,0.86,0.22,1.32,22
NDC,6923818371,LEVOTHYROXINE 137 MCG TABLET,1.34,0.87,0.23,1.34,22
NDC,6923818381,LEVOTHYROXINE 150 MCG TABLET,1.36,0.88,0.23,1.36,22
NDC,6923818391,LEVOTHYROXINE 175 MCG TABLET,1.62,1.05,0.27,1.62,22
NDC,6923818397,LEVOTHYROXINE 175 MCG TABLET,1.62,1.05,0.27,1.62,22
NDC,6923818401,LEVOTHYROXINE 200 MCG TABLET,1.62,1.05,0.27,1.62,22
NDC,6923818411,LEVOTHYROXINE 300 MCG TABLET,2.18,1.42,0.37,2.18,22
NDC,6923821417,ENALAPRIL MALEATE 1 MG/ML ORAL SOLUTION,10.2,6.63,1.71,10.2,22
NDC,6929272225,FLURBIPROFEN 0.03 % EYE DROPS,34.56,22.46,5.81,34.56,22
NDC,6931511601,FUROSEMIDE 20 MG TABLET,0.28,0.18,0.05,0.28,22
NDC,6931511610,FUROSEMIDE 20 MG TABLET,0.28,0.18,0.05,0.28,22
NDC,6931511701,FUROSEMIDE 40 MG TABLET,0.32,0.21,0.05,0.32,22
NDC,6931511710,FUROSEMIDE 40 MG TABLET,0.32,0.21,0.05,0.32,22
NDC,6931512701,FOLIC ACID 1 MG TABLET,0.72,0.47,0.12,0.72,22
NDC,6931512710,FOLIC ACID 1 MG TABLET,0.16,0.1,0.03,0.16,22
NDC,6931513301,IMIPRAMINE 10 MG TABLET,0.86,0.56,0.14,0.86,22
NDC,6931513401,IMIPRAMINE 25 MG TABLET,1.44,0.94,0.24,1.44,22
NDC,6931513501,IMIPRAMINE 50 MG TABLET,2.64,1.72,0.44,2.64,22
NDC,6931515501,HYDROCHLOROTHIAZIDE 12.5 MG TABLET,0.34,0.22,0.06,0.34,22
NDC,6931518403,LEUCOVORIN CALCIUM 5 MG TABLET,4.1,2.67,0.69,4.1,22
NDC,6931518624,LEUCOVORIN CALCIUM 15 MG TABLET,23.56,15.31,3.96,23.56,22
NDC,6931518725,LEUCOVORIN CALCIUM 25 MG TABLET,48.0,31.2,8.06,48.0,22
NDC,6931521101,NIFEDIPINE 10 MG CAPSULE,2.14,1.39,0.36,2.14,22
NDC,6931521201,NIFEDIPINE 20 MG CAPSULE,4.6,2.99,0.77,4.6,22
NDC,6931530130,RECTASMOOTHE 5 % TOPICAL CREAM,1.28,0.83,0.22,1.28,22
NDC,6931530802,CIPROFLOXACIN 0.3 % EYE DROPS,10.08,6.55,1.69,10.08,22
NDC,6931530805,CIPROFLOXACIN 0.3 % EYE DROPS,6.72,4.37,1.13,6.72,22
NDC,6933913634,DIAZEPAM 5 MG/ML INJECTION SYRINGE,44.31,28.8,5.89,44.31,31
NDC,6933913819,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,0.35,0.23,0.06,0.35,22
NDC,6933915105,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,1.28,0.83,0.22,1.28,22
NDC,6933915117,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,1.28,0.83,0.22,1.28,22
NDC,6933915119,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,1.23,0.8,0.21,1.23,22
NDC,6933915217,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,0.73,0.47,0.12,0.73,22
NDC,6933916317,LUBIPROSTONE 24 MCG CAPSULE,31.5,20.48,5.29,31.5,22
NDC,6934410101,INDOCIN 25 MG/5 ML ORAL SUSPENSION,27.28,17.73,4.58,27.28,22
NDC,6936719430,CLOPIDOGREL 300 MG TABLET,55.68,36.19,9.35,55.68,22
NDC,6936722001,SODIUM CHLORIDE 1000 MG SOLUBLE TABLET,0.34,0.22,0.06,0.34,22
NDC,6936728302,ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8000 UNIT/ML) ORAL DROPS,4.18,2.72,0.7,4.18,22
NDC,6936731401,WESCAPS 1 MG CAPSULE,1.34,0.87,0.23,1.34,22
NDC,6944801926,IMULDOSA 130 MG/26 ML INTRAVENOUS SOLUTION,205.44,133.54,34.51,3236.72,29
NDC,6944802563,UDENYCA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,25050.0,16282.5,121.94,25050.0,53
NDC,6945211721,TETRABENAZINE 12.5 MG TABLET,157.46,102.35,26.45,157.46,22
NDC,6945211821,TETRABENAZINE 25 MG TABLET,314.9,204.69,52.9,314.9,22
NDC,6945215020,VALPROIC ACID 250 MG CAPSULE,1.68,1.09,0.28,1.68,22
NDC,6945215773,RIZATRIPTAN 10 MG DISINTEGRATING TABLET,66.48,43.21,11.17,66.48,22
NDC,6945215825,COLESEVELAM 625 MG TABLET,7.48,4.86,1.26,7.48,22
NDC,6945215913,DEFERASIROX 125 MG DISPERSIBLE TABLET,86.14,55.99,14.47,86.14,22
NDC,6945220920,NIMODIPINE 30 MG CAPSULE,36.82,23.93,6.19,36.82,22
NDC,6948972130,EXELDERM 1 % TOPICAL SOLUTION,38.44,24.99,6.46,38.44,22
NDC,6954735302,NARCAN 4 MG/ACTUATION NASAL SPRAY,150.0,97.5,25.2,150.0,22
NDC,6954762702,NARCAN 4 MG/ACTUATION NASAL SPRAY,53.98,35.09,9.07,53.98,22
NDC,6958411110,CARISOPRODOL 350 MG TABLET,1.2,0.78,0.2,1.2,22
NDC,6961627230,FYCOMPA 2 MG TABLET,49.68,32.29,8.35,49.68,22
NDC,6961627430,FYCOMPA 4 MG TABLET,98.16,63.8,16.49,98.16,22
NDC,6961627630,FYCOMPA 6 MG TABLET,98.16,63.8,16.49,98.16,22
NDC,6961628230,FYCOMPA 12 MG TABLET,98.16,63.8,16.49,98.16,22
NDC,6961629038,FYCOMPA 0.5 MG/ML ORAL SUSPENSION,8.39,5.45,1.41,8.39,22
NDC,6961800858,MULTI-VITE 9 MG IRON/15 ML ORAL LIQUID,0.05,0.03,0.01,0.05,22
NDC,6961801501,ASPIRIN 325 MG TABLETDELAYED RELEASE,0.04,0.03,0.01,0.04,22
NDC,6961801854,LIQUID C 500 MG/5 ML ORAL,0.15,0.1,0.03,0.15,22
NDC,6961801959,CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,0.18,0.12,0.03,0.18,22
NDC,6961806782,CALPROTECT 0.44 %-20.6 % TOPICAL OINTMENT,0.1,0.07,0.02,0.1,22
NDC,6961806958,SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,0.1,0.07,0.02,0.1,22
NDC,6961807059,FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,0.15,0.1,0.03,0.15,22
NDC,6968011210,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,16.2,10.53,1.22,16.2,31
NDC,6968012035,LIDOCAINE 5 % TOPICAL OINTMENT,1.48,0.96,0.25,1.48,22
NDC,6968013160,PROPAFENONE ER 325 MG CAPSULEEXTENDED RELEASE 12 HR,3.4,2.21,0.57,3.4,22
NDC,6968013260,PROPAFENONE ER 425 MG CAPSULEEXTENDED RELEASE 12 HR,3.4,2.21,0.57,3.4,22
NDC,6972411210,SOTALOL 150 MG/10 ML (15 MG/ML) INTRAVENOUS SOLUTION,1186.56,771.26,22.83,1186.56,39
NDC,6980042031,NABI-HB GREATER THAN 1560 UNIT/5 ML INTRAMUSCULAR SOLUTION,569.07,369.9,127.0,652.67,47
NDC,6991810101,DESMOPRESSIN 0.1 MG TABLET,10.58,6.88,1.78,10.58,22
NDC,6991820101,DESMOPRESSIN 0.2 MG TABLET,15.24,9.91,2.56,15.24,22
NDC,6991873110,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,450.0,292.5,75.6,450.0,22
NDC,6991873510,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,100.8,65.52,16.93,100.8,22
NDC,6991889901,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,182.4,118.56,5.42,182.4,44
NDC,6991889910,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,182.4,118.56,5.42,182.4,44
NDC,6991889911,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,152.4,99.06,5.42,152.4,44
NDC,6991890110,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,189.6,123.24,5.42,189.6,44
NDC,6993200101,AXUMIN 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,9888.0,6427.2,268.42,8899.2,36
NDC,6993200201,POSLUMA 296 MBQ/ML TO 5846 MBQ/ML INTRAVENOUS SOLUTION,9836.0,6393.4,651.67,8852.4,39
NDC,6994506401,DETECTNET 148 MBQ/4 ML (4 MCI/4 ML) INTRAVENOUS SOLUTION,7700.0,5005.0,594.28,6930.0,36
NDC,6994506820,ULTRATAG RBC INTRAVENOUS SOLUTION,350.0,227.5,58.8,2409.0,29
NDC,6994509120,TECHNESCAN HDP 3.15 MG INTRAVENOUS SOLUTION,82.0,53.3,13.78,2409.0,26
NDC,6994516605,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5 ML) INTRAVENOUS SOLUTION,3150.0,2047.5,1231.65,2998.12,39
NDC,6996800603,POLYSPORIN 500 UNIT-10000 UNIT/GRAM TOPICAL OINTMENT,0.7,0.46,0.12,0.7,22
NDC,6996800609,POLYSPORIN 500 UNIT-10000 UNIT/GRAM TOPICAL OINTMENT IN PACKET,0.52,0.34,0.09,0.52,22
NDC,6996800614,ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,0.12,0.08,0.02,0.12,22
NDC,7001000601,DEXMETHYLPHENIDATE ER 15 MG CAPSULEEXTENDED RELEASE BIPHASIC50-50,20.46,13.3,3.44,20.46,22
NDC,7001001201,METHYLPHENIDATE LA 10 MG BIPHASIC 50-50 CAPSULEEXTENDED RELEASE,24.66,16.03,4.14,24.66,22
NDC,7001001301,METHYLPHENIDATE LA 20 MG BIPHASIC 50-50 CAPSULEEXTENDED RELEASE,25.96,16.87,4.36,25.96,22
NDC,7001004201,METHYLPHENIDATE ER 10 MG TABLETEXTENDED RELEASE,16.0,10.4,2.69,16.0,22
NDC,7001004301,METHYLPHENIDATE ER 20 MG TABLETEXTENDED RELEASE,16.5,10.73,2.77,16.5,22
NDC,7001013901,NAPROXEN 500 MG TABLET,2.3,1.5,0.39,2.3,22
NDC,7001014901,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,3.38,2.2,0.57,3.38,22
NDC,7002019101,IXEMPRA 15 MG INTRAVENOUS SOLUTION,9669.88,6285.42,114.75,9669.88,53
NDC,7002019111,IXEMPRA 45 MG INTRAVENOUS SOLUTION,29009.68,18856.29,114.75,29009.68,53
NDC,7006900501,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,12.81,8.33,1.22,12.81,31
NDC,7006900510,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,13.35,8.68,1.22,13.35,31
NDC,7006902125,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,18.87,12.27,0.11,18.87,31
NDC,7006903003,HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,93.75,60.94,6.07,93.75,31
NDC,7006905101,DORZOLAMIDE 22.3 MG-TIMOLOL 6.8 MG/ML EYE DROPS,5.0,3.25,0.84,5.0,22
NDC,7006912101,TROPICAMIDE 1 % EYE DROPS,4.76,3.09,0.8,4.76,22
NDC,7006913101,TOBRAMYCIN 0.3 % EYE DROPS,2.5,1.63,0.42,2.5,22
NDC,7006917201,CYANOCOBALAMIN (VIT B-12) 1000 MCG/ML INJECTION SOLUTION,5.85,3.8,0.98,5.85,31
NDC,7006918101,PILOCARPINE 1 % EYE DROPS,12.36,8.03,2.08,12.36,22
NDC,7006919101,PILOCARPINE 2 % EYE DROPS,12.64,8.22,2.12,12.64,22
NDC,7006920101,PILOCARPINE 4 % EYE DROPS,13.26,8.62,2.23,13.26,22
NDC,7006923101,BRIMONIDINE 0.2 % EYE DROPS,5.0,3.25,0.84,5.0,22
NDC,7006923201,BRIMONIDINE 0.2 % EYE DROPS,1.68,1.09,0.28,1.68,22
NDC,7006923301,BRIMONIDINE 0.2 % EYE DROPS,1.5,0.98,0.25,1.5,22
NDC,7006936210,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,4.56,2.96,0.08,4.56,30
NDC,7006936301,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,4.56,2.96,0.08,4.56,30
NDC,7006938301,HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,145.5,94.58,6.07,145.5,31
NDC,7006942101,LATANOPROST 0.005 % EYE DROPS,76.0,49.4,12.77,76.0,22
NDC,7006950625,CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,9.75,6.34,1.64,9.75,22
NDC,7006959601,TETRACAINE 0.5 % EYE DROPS,14.4,9.36,2.42,14.4,22
NDC,7006967210,NALBUPHINE 20 MG/ML INJECTION SOLUTION,40.26,26.17,2.54,40.26,31
NDC,7006981001,VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,28.23,18.35,4.74,28.23,22
NDC,7007440707,ENSURE PLUS 0.05 GRAM-1.5 KCAL/ML ORAL LIQUID,0.03,0.02,0.01,0.03,22
NDC,7007440729,TWOCAL HN 0.08 GRAM-2 KCAL/ML ORAL LIQUID,0.03,0.02,0.01,0.03,22
NDC,7007450241,GLUCERNA 1 CAL 0.04 GRAM-1 KCAL/ML ORAL LIQUID,0.03,0.02,0.01,0.03,22
NDC,7007450775,PROMOTE 0.06 GRAM-1 KCAL/ML ORAL LIQUID,0.03,0.02,0.01,0.03,22
NDC,7007456974,SIMILAC ADVANCE ORAL CONCENTRATE,0.05,0.03,0.01,0.05,22
NDC,7007457536,SIMILAC SENSITIVE FUSS AND GAS 2.1-5.4-11.1 GRAM/100 KCAL ORAL CONC,0.03,0.02,0.01,0.03,22
NDC,7007460850,SIMILAC PM ORAL POWDER,0.1,0.07,0.02,0.1,22
NDC,70092100736,DILTIAZEM 125 MG/125 ML (1 MG/ML) IN DEXTROSE 5 % IV,0.84,0.55,0.14,0.84,22
NDC,70092103417,NOREPINEPHRINE BITARTRATE 4 MG/250 ML (16 MCG/ML) IN DEXTROSE 5 % IV,0.36,0.23,0.06,0.36,23
NDC,70092103817,NOREPINEPHRINE BITARTRATE 16 MG/250 ML (64 MCG/ML) IN DEXTROSE 5 % IV,0.72,0.47,0.12,0.72,22
NDC,70092104646,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,2.28,1.48,0.38,2.28,22
NDC,70092107124,OXYTOCIN IN LACTATED RINGERS 30 UNIT/500 ML INTRAVENOUS SOLUTION,0.21,0.14,0.04,0.21,22
NDC,70092109436,FENTANYL (PF) 20 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,0.03,0.02,0.01,3.29,31
NDC,70092111944,KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE,5.64,3.67,0.95,5.64,23
NDC,70092113036,MORPHINE 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,0.75,0.49,0.13,0.75,22
NDC,70092113343,MORPHINE (PF) 2 MG/2 ML(1 MG/ML) IN 0.9% SODIUM CHLORIDE IV SYRINGE,13.74,8.93,2.31,13.74,22
NDC,70092114843,SODIUM CITRATE 4 % (3 ML) INTRA-CATHETER INJECTION SYRINGE,15.3,9.95,2.57,15.3,22
NDC,70092116037,FENTANYL (PF) 2 MCG/ML-BUPIVACAINE 0.1 %-NACL INJECTION SOLUTION,0.6,0.39,0.1,0.6,22
NDC,70092117546,BUFFERED LIDOCAINE 0.9 % (10 ML) INJECTION SYRINGE,2.91,1.89,0.49,2.91,22
NDC,70092121650,HEPARIN (PORCINE)(PF) 50 UNIT/50 ML (1 UNIT/ML) IN 0.9% NACL IV SYRING,1.92,1.25,0.32,1.92,22
NDC,70092131046,METHOHEXITAL 100 MG/10 ML (10 MG/ML) IN STERILE WATER (PF)  IV SYRINGE,14.73,9.57,2.47,14.73,22
NDC,70092138036,MORPHINE (PF) 1 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS SOLUTION,0.57,0.37,0.1,8.41,31
NDC,70092140043,FENTANYL (PF) 10 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,30.75,19.99,5.17,30.75,22
NDC,70092143350,ROPIV 2.46-EPI 0.005-CLONID 0.0008-KETOROL 0.3 MG/ML PERIARTICULR SYRG,4.77,3.1,0.8,4.77,22
NDC,70092144343,BUFFERED LIDOCAINE 0.9 % (1 ML) INJECTION SYRINGE,25.98,16.89,4.36,25.98,22
NDC,70092151246,EPINEPHRINE HCL 100 MCG/10 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,1.56,1.01,0.26,1.56,22
NDC,70092157536,DILTIAZEM 125 MG/125 ML (1 MG/ML) IN DEXTROSE 5 % IV,0.48,0.31,0.08,0.48,22
NDC,70092158643,LIDOCAINE 15 MG/3 ML(0.5%)-EPINEPH 1:100000-SOD CHL INJECTION SYRINGE,11.37,7.39,1.91,11.37,22
NDC,70092161144,L.E.T. (LIDOCAINE-EPINEPHRINE-TETRACAINE) 4 %-0.05 %-0.5 % TOPICAL GEL,12.92,8.4,2.17,12.92,22
NDC,70092161243,L.E.T. (LIDOCAINE-EPINEPHRINE-TETRACAINE) 4 %-0.05 %-0.5 % TOPICAL GEL,25.64,16.67,4.31,25.64,22
NDC,70092161746,EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,3.36,2.18,0.56,3.36,22
NDC,70092165517,NOREPINEPHRINE BITARTRATE 16 MG/250 ML (64 MCG/ML) IN DEXTROSE 5 % IV,0.78,0.51,0.13,0.78,22
NDC,70092168846,EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,3.36,2.18,0.56,3.36,22
NDC,70092169244,SODIUM CITRATE 4 % (3 ML) INTRA-CATHETER INJECTION SYRINGE,15.3,9.95,2.57,15.3,22
NDC,70092911944,KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE,7.65,4.97,1.29,7.65,23
NDC,70092926937,FENTANYL (PF) 2 MCG/ML-BUPIVACAINE 0.0625 %-NACL INJECTION SOLUTION,0.51,0.33,0.09,0.51,22
NDC,70092933807,VANCOMYCIN 2 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,0.36,0.23,0.06,0.36,22
NDC,70092940043,FENTANYL (PF) 10 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,39.36,25.58,6.61,39.36,22
NDC,7010042402,INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,764.07,496.65,128.36,764.07,22
NDC,7010082502,IC GREEN 25 MG SOLUTION FOR INJECTION,1029.0,668.85,172.87,1029.0,22
NDC,7011410101,UDENYCA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,25050.0,16282.5,121.94,25050.0,53
NDC,7011413001,UDENYCA ONBODY 6 MG/0.6 ML WITH WEARABLE SUBCUTANEOUS INJECTOR,25050.0,16282.5,121.94,25050.0,53
NDC,7011434001,LOQTORZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION,7805.8,5073.77,38.87,7805.8,52
NDC,7011444101,CIMERLI 0.5 MG/0.05 ML INTRAVITREAL SOLUTION,97920.0,63648.0,83.34,97920.0,53
NDC,7012110491,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,30.6,19.89,0.97,30.6,31
NDC,7012110492,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,30.6,19.89,0.97,30.6,31
NDC,7012110495,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,30.6,19.89,0.97,30.6,31
NDC,7012111681,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,31.2,20.28,0.97,31.2,31
NDC,7012111691,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,23.31,15.15,0.97,23.31,31
NDC,7012114822,CARMUSTINE 100 MG INTRAVENOUS SOLUTION,3600.0,2340.0,232.62,3600.0,49
NDC,7012115731,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,34.71,22.56,0.12,34.71,38
NDC,7012115741,METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION,58.74,38.18,0.12,58.74,38
NDC,7012115787,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,14.58,9.48,0.03,14.58,23
NDC,7012115791,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,14.28,9.28,0.03,14.28,23
NDC,7012116271,FYLNETRA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,15000.0,9750.0,127.22,15000.0,53
NDC,7012116311,TEPADINA 100 MG SOLUTION FOR INJECTION,8640.0,5616.0,8.86,8640.0,45
NDC,7012116515,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,30.6,19.89,0.97,30.6,31
NDC,7012116807,CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,1148.37,746.44,13.7,1148.37,26
NDC,7012116942,PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,3171.0,2061.15,30.66,3407.66,50
NDC,7012117434,NELARABINE 5 MG/ML INTRAVENOUS SOLUTION,63.44,41.24,31.72,3407.66,46
NDC,7012117541,ALYMSYS 25 MG/ML INTRAVENOUS SOLUTION,646.74,420.38,33.01,652.67,45
NDC,7012117551,ALYMSYS 25 MG/ML INTRAVENOUS SOLUTION,646.74,420.38,33.01,652.67,45
NDC,7012125011,LIORESAL 500 MCG/ML INTRATHECAL SOLUTION,42.54,27.65,11.02,502.19,47
NDC,7012125031,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,44.06,502.19,47
NDC,7012125042,LIORESAL 500 MCG/ML INTRATHECAL SOLUTION,1701.24,1105.81,160.09,1701.24,47
NDC,7012125052,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,44.06,502.19,47
NDC,7012126311,FOCINVEZ 150 MG/50 ML (3 MG/ML) INTRAVENOUS SOLUTION,33.93,22.05,2.63,33.93,40
NDC,7012710010,EPIDIOLEX 100 MG/ML ORAL SOLUTION,30.78,20.01,5.17,30.78,22
NDC,7012710060,EPIDIOLEX 100 MG/ML ORAL SOLUTION,30.78,20.01,5.17,30.78,22
NDC,7019902611,AQUASOL A 50000 UNIT/ML INTRAMUSCULAR SOLUTION,1293.75,840.94,217.35,1293.75,22
NDC,7025501002,MEKTOVI 15 MG TABLET,227.2,147.68,38.17,227.2,22
NDC,7025502501,BRAFTOVI 75 MG CAPSULE,231.58,150.53,38.91,231.58,22
NDC,7025756001,LIORESAL 500 MCG/ML INTRATHECAL SOLUTION,42.54,27.65,11.02,502.19,47
NDC,7025756002,LIORESAL 500 MCG/ML INTRATHECAL SOLUTION,1701.24,1105.81,160.09,1701.24,47
NDC,7025756102,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,44.06,502.19,47
NDC,7025756255,LIORESAL 50 MCG/ML INTRATHECAL SOLUTION,118.68,77.14,19.94,164.7,31
NDC,7025756301,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,44.06,502.19,47
NDC,7025756302,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,44.06,502.19,47
NDC,7025756320,LIORESAL 2000 MCG/ML INTRATHECAL SOLUTION,170.13,110.58,44.06,502.19,47
NDC,7037010801,INGREZZA 80 MG CAPSULE,704.64,458.02,118.38,704.64,22
NDC,7037020401,INGREZZA 40 MG CAPSULE,644.0,418.6,108.19,644.0,22
NDC,7038220401,DEXTENZA 0.4 MG INTRACANALICULAR INSERT,1536.0,998.4,97.89,1536.0,46
NDC,7038220410,DEXTENZA 0.4 MG INTRACANALICULAR INSERT,1536.0,998.4,97.89,1536.0,46
NDC,7043602780,EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION,14.07,9.15,3.52,28.24,32
NDC,7043603901,GUANFACINE ER 1 MG TABLETEXTENDED RELEASE 24 HR,20.98,13.64,3.52,20.98,22
NDC,7043604001,GUANFACINE ER 2 MG TABLETEXTENDED RELEASE 24 HR,20.98,13.64,3.52,20.98,22
NDC,7043615541,PROMETHAZINE-DM 6.25 MG-15 MG/5 ML ORAL SYRUP,0.23,0.15,0.04,0.23,22
NDC,7043619082,ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION,125.64,81.67,0.52,125.64,23
NDC,7043622748,FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,9.28,6.03,1.56,9.28,22
NDC,7043623039,VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,35.18,22.87,5.91,35.18,22
NDC,7043724018,NERLYNX 40 MG TABLET,316.0,205.4,53.09,316.0,22
NDC,7046000401,VAXCHORA VACCINE 4X10EXP8 TO 2X10EXP9 CF UNIT ORAL SUSPENSION,8.25,5.36,1.39,8.25,22
NDC,7050520260,NITISINONE 2 MG CAPSULE,100.0,65.0,16.8,100.0,22
NDC,7051021712,RADICAVA 30 MG/100 ML INTRAVENOUS SOLUTION,23.37,15.19,6.05,383.26,47
NDC,7051526310,LANOXIN PEDIATRIC 100 MCG/ML (0.1 MG/ML) INJECTION SOLUTION,515.61,335.15,8.16,515.61,31
NDC,7053900101,TYMLOS 80 MCG/DOSE (3120 MCG/1.56 ML) SUBCUTANEOUS PEN INJECTOR,6523.89,4240.53,1096.01,6523.89,22
NDC,7059402304,COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,100.8,65.52,11.56,100.8,31
NDC,7062110110,AMELUZ 10 % TOPICAL GEL,457.2,297.18,1.53,457.2,46
NDC,7070031527,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,293.55,190.81,1.42,293.55,23
NDC,7071010102,OSELTAMIVIR 75 MG CAPSULE,30.92,20.1,5.19,30.92,22
NDC,7071010141,PHYTONADIONE (VITAMIN K1) 5 MG TABLET,133.98,87.09,22.51,133.98,22
NDC,7071010471,ERYTHROMYCIN 250 MG TABLET,26.46,17.2,4.45,26.46,22
NDC,7071010473,ERYTHROMYCIN 250 MG TABLET,26.46,17.2,4.45,26.46,22
NDC,7071010611,ALBUTEROL SULFATE 2 MG TABLET,11.76,7.64,1.98,11.76,22
NDC,7071011101,CYPROHEPTADINE 4 MG TABLET,2.14,1.39,0.36,2.14,22
NDC,7071011271,URSODIOL 250 MG TABLET,5.36,3.48,0.9,5.36,22
NDC,7071011281,URSODIOL 500 MG TABLET,9.5,6.18,1.6,9.5,22
NDC,7071011583,LEFLUNOMIDE 20 MG TABLET,32.82,21.33,5.51,32.82,22
NDC,7071011793,AMBRISENTAN 5 MG TABLET,665.6,432.64,111.82,665.6,22
NDC,7071012855,BACLOFEN 10 MG TABLET,4.52,2.94,0.76,4.52,22
NDC,7071012861,BACLOFEN 20 MG TABLET,10.26,6.67,1.72,10.26,22
NDC,7071013027,MESALAMINE 1000 MG RECTAL SUPPOSITORY,76.4,49.66,12.84,76.4,22
NDC,7071013653,EMTRICITABINE 133 MG-TENOFOVIR DISOPROXIL FUMARATE 200 MG TABLET,140.02,91.01,23.52,140.02,22
NDC,7071013663,EMTRICITABINE 167 MG-TENOFOVIR DISOPROXIL FUMARATE 250 MG TABLET,140.02,91.01,23.52,140.02,22
NDC,7071014781,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,3600.0,2340.0,6.43,3600.0,42
NDC,7071017416,DASATINIB 20 MG TABLET,384.7,250.06,64.63,384.7,22
NDC,7071017426,DASATINIB 50 MG TABLET,769.4,500.11,129.26,769.4,22
NDC,7071017436,DASATINIB 70 MG TABLET,769.4,500.11,129.26,769.4,22
NDC,7071018527,INDOMETHACIN 50 MG RECTAL SUPPOSITORY,825.14,536.34,138.62,825.14,22
NDC,7072072010,PRIALT 100 MCG/ML INTRATHECAL SOLUTION,4520.82,2938.53,8.14,4520.82,50
NDC,7072072210,PRIALT 100 MCG/ML INTRATHECAL SOLUTION,4290.51,2788.83,8.14,4290.51,50
NDC,7072072310,PRIALT 25 MCG/ML INTRATHECAL SOLUTION,1072.62,697.2,8.14,1072.62,47
NDC,7072095036,ZOLADEX 3.6 MG SUBCUTANEOUS IMPLANT,5659.28,3678.53,516.7,5659.28,52
NDC,7072095130,ZOLADEX 10.8 MG SUBCUTANEOUS IMPLANT,15421.96,10024.27,516.7,15421.96,52
NDC,7074812906,LEFLUNOMIDE 10 MG TABLET,32.84,21.35,5.52,32.84,22
NDC,7074817530,ARFORMOTEROL 15 MCG/2 ML SOLUTION FOR NEBULIZATION,20.26,13.17,3.4,20.26,22
NDC,7075621590,FENOFIBRATE 160 MG TABLET,4.76,3.09,0.8,4.76,22
NDC,7075640411,NITROFURANTOIN MONOHYDRATE & MACROCRYSTAL 100 MG ORAL CAP,8.16,5.3,1.37,8.16,22
NDC,7075660915,OFLOXACIN 0.3 % EAR DROPS,62.94,40.91,10.57,62.94,22
NDC,7075661430,PHENYLEPHRINE 10 % EYE DROPS,20.0,13.0,3.36,20.0,22
NDC,7075662925,PHENYLEPHRINE 2.5 % EYE DROPS,40.64,26.42,6.83,40.64,22
NDC,7075664935,PHENYLEPHRINE 2.5 % EYE DROPS,15.0,9.75,2.52,15.0,22
NDC,7075680630,LANSOPRAZOLE 15 MG CAPSULEDELAYED RELEASE,9.44,6.14,1.59,9.44,22
NDC,7083915030,TEKTURNA 150 MG TABLET,27.62,17.95,4.64,27.62,22
NDC,7083930030,TEKTURNA 300 MG TABLET,34.86,22.66,5.86,34.86,22
NDC,7083936204,COCAINE 4 % NASAL SOLUTION,193.8,125.97,4.66,193.8,23
NDC,7084212001,VABOMERE 2 GRAM INTRAVENOUS SOLUTION,825.03,536.27,2.09,825.03,39
NDC,7084212006,VABOMERE 2 GRAM INTRAVENOUS SOLUTION,825.03,536.27,2.09,825.03,39
NDC,7084216010,MINOCIN 100 MG INTRAVENOUS SOLUTION,958.53,623.04,2.59,958.53,33
NDC,7084222501,KIMYRSA 1200 MG INTRAVENOUS SOLUTION,20173.38,13112.7,36.81,20173.38,53
NDC,7084224001,REZZAYO 200 MG INTRAVENOUS SOLUTION,7673.16,4987.55,10.12,7673.16,46
NDC,7086020005,PACLITAXEL 6 MG/ML CONCENTRATEINTRAVENOUS,9.6,6.24,0.1,9.6,30
NDC,7086021051,ZOLEDRONIC ACID 4 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,1.71,1.11,0.29,14.06,31
NDC,7086021461,MELPHALAN HCL 50 MG INTRAVENOUS POWDER FOR SOLUTION,960.0,624.0,86.94,960.0,46
NDC,7086080101,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,6.48,4.21,1.09,6.85,31
NDC,7095401510,THIOTHIXENE 2 MG CAPSULE,3.14,2.04,0.53,3.14,22
NDC,7095401610,THIOTHIXENE 5 MG CAPSULE,4.76,3.09,0.8,4.76,22
NDC,7095401710,THIOTHIXENE 10 MG CAPSULE,6.72,4.37,1.13,6.72,22
NDC,7095402110,PRAZOSIN 5 MG CAPSULE,4.36,2.83,0.73,4.36,22
NDC,7095404110,RIFABUTIN 150 MG CAPSULE,34.98,22.74,5.88,34.98,22
NDC,7095405110,FELBAMATE 600 MG/5 ML ORAL SUSPENSION,6.78,4.41,1.14,6.78,22
NDC,7095413520,DAPSONE 25 MG TABLET,4.4,2.86,0.74,4.4,22
NDC,7095413610,DAPSONE 100 MG TABLET,6.04,3.93,1.01,6.04,22
NDC,7095413620,DAPSONE 100 MG TABLET,5.4,3.51,0.91,5.4,22
NDC,7095414010,LEVOCARNITINE 100 MG/ML ORAL SOLUTION,0.98,0.64,0.16,0.98,22
NDC,7095414810,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,7.08,4.6,1.19,7.08,22
NDC,7095415110,NAPROXEN 125 MG/5 ML ORAL SUSPENSION,5.98,3.89,1.0,5.98,22
NDC,7095415720,CLORAZEPATE DIPOTASSIUM 15 MG TABLET,10.9,7.09,1.83,10.9,22
NDC,7095415850,CLORAZEPATE DIPOTASSIUM 7.5 MG TABLET,10.04,6.53,1.69,10.04,22
NDC,7095415950,CLORAZEPATE DIPOTASSIUM 3.75 MG TABLET,8.06,5.24,1.35,8.06,22
NDC,7095431910,PAROXETINE 10 MG/5 ML ORAL SUSPENSION,3.95,2.57,0.66,3.95,22
NDC,7095440110,DEXAMETHASONE 1.5 MG TABLET,0.96,0.62,0.01,0.96,30
NDC,7095440310,DEXAMETHASONE 4 MG TABLET,2.38,1.55,0.4,2.38,22
NDC,7095451810,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,2.58,1.68,0.43,2.58,22
NDC,7095454110,TRIMETHOPRIM 100 MG TABLET,4.66,3.03,0.78,4.66,22
NDC,7095456510,ESTRADIOL 1 MG TABLET,1.36,0.88,0.23,1.36,22
NDC,7095456610,ESTRADIOL 2 MG TABLET,1.88,1.22,0.32,1.88,22
NDC,7095497820,BROMOCRIPTINE 2.5 MG TABLET,7.52,4.89,1.26,7.52,22
NDC,7110480101,ELOCTATE 250 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
NDC,7110480201,ELOCTATE 500 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
NDC,7110480301,ELOCTATE 750 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
NDC,7110480401,ELOCTATE 1000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
NDC,7110480501,ELOCTATE 1500 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
NDC,7110480601,ELOCTATE 2000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
NDC,7110480701,ELOCTATE 3000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
NDC,7110480801,ELOCTATE 4000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
NDC,7110480901,ELOCTATE 5000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
NDC,7110481001,ELOCTATE 6000 UNIT INTRAVENOUS SOLUTION,10.05,6.53,1.99,3407.66,47
NDC,7110491101,ALPROLIX 500 UNIT INTRAVENOUS SOLUTION,14.55,9.46,3.12,3407.66,47
NDC,7110492201,ALPROLIX 1000 UNIT INTRAVENOUS SOLUTION,14.55,9.46,3.12,3407.66,47
NDC,7110498101,ALTUVIIIO 1000 (+/-) UNIT INTRAVENOUS SOLUTION,20.49,13.32,4.17,3236.72,47
NDC,7126665191,PHENOL 6 % INJECTION SOLUTION,26.79,17.41,4.5,26.79,22
NDC,7126666703,GENTAMICIN 960 MCG/3 ML IN 4 % SODIUM CITRATE INTRA-CATHETER SYRINGE,5.76,3.74,0.97,5.76,22
NDC,7126680201,AMINOPROTECT 25 MG-25 MG/ML INTRAVENOUS SOLUTION,0.63,0.41,0.11,0.63,22
NDC,7128500091,CARDIOPLEGIA REPERFUSATE 4:1  15 MEQ/500 ML (POTASSIUM) PERFUSION SOLN,1.02,0.66,0.17,1.02,22
NDC,7128501011,CARDIOPLEGIA INDUCTION 4:1  36 MEQ/500 ML(POTASSIUM)PERFUSION SOLUTION,0.72,0.47,0.12,0.65,21
NDC,7128501041,CARDIOPLEGIA MAINTENANCE 4:1  36 MEQ/L (POTASSIUM) PERFUSION SOLUTION,0.48,0.31,0.08,0.48,22
NDC,7128502021,CARDIOPLEGIA DEL NIDO FORMULA 26 MEQ/1052.8 ML (POTASSIUM) PERFUSION,0.18,0.12,0.03,0.18,22
NDC,7128560581,PHENYLEPHRINE 10 MG/250 ML(40 MCG/ML)IN 0.9 % SOD.CHLORIDE INTRAVENOUS,0.15,0.1,0.03,0.15,22
NDC,7128560731,VANCOMYCIN 1.25 GRAM/250 ML IN DEXTROSE 5 % INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,22
NDC,7128560751,VANCOMYCIN 1.5 GRAM/250 ML IN DEXTROSE 5% INTRAVENOUS SOLUTION,0.18,0.12,0.03,0.18,22
NDC,7128570181,EPINEPHRINE HCL 4 MG/250 ML (16 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,0.24,0.16,0.04,0.24,22
NDC,7128570231,HEPARIN (PORCINE) 5000 UNIT/500 ML(10 UNIT/ML) IN 0.9 % NACL IV SOLN,0.09,0.06,0.02,0.09,22
NDC,7128580862,TROMETHAMINE 1.8 GRAM/50 ML (0.3 MOLAR) IN STERILE WATER IV SYRINGE,5.79,3.76,0.97,5.79,22
NDC,7128590001,VASOPRESSIN 20 UNIT/100 ML (0.2 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV,9.54,6.2,1.6,9.54,22
NDC,7128711901,YESCARTA INTRAVENOUS SUSPENSION,2417184.0,1571169.6,24125.92,2175465.6,43
NDC,7128721901,TECARTUS 2X10EXP6 TO 2X10EXP8 CELL INTRAVENOUS SUSPENSION,2217600.0,1441440.0,24125.92,1995840.0,45
NDC,7128722001,TECARTUS 1X10EXP6 TO 1X10EXP8 CELL INTRAVENOUS SUSPENSION,2217600.0,1441440.0,24125.92,1995840.0,45
NDC,7128801911,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,378.0,245.7,6.58,378.0,23
NDC,7128802730,VORICONAZOLE 200 MG INTRAVENOUS POWDER FOR SOLUTION,126.0,81.9,0.99,126.0,31
NDC,7128811728,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,4.0,2.6,0.67,9.95,30
NDC,7128811754,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,4.08,2.65,0.69,9.95,30
NDC,7128816610,PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,144.0,93.6,3.57,943.43,46
NDC,7128816750,PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,720.0,468.0,9.66,943.43,45
NDC,7128840905,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,6.48,4.21,0.67,6.48,31
NDC,7128842711,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,252.0,163.8,0.22,252.0,37
NDC,7128870105,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,3.42,2.22,0.57,3.42,22
NDC,7128870210,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,3.39,2.2,0.57,3.39,22
NDC,7128870211,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,3.39,2.2,0.57,3.39,22
NDC,7128880321,MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,261.0,169.65,0.64,345.3,37
NDC,7128880651,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,3.6,2.34,0.6,14.06,31
NDC,7132180230,VITAMIN E (DL ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS,3.38,2.2,0.57,3.38,22
NDC,7132180320,CALCIUM ACETATE 667 MG TABLET,0.3,0.2,0.05,0.3,22
NDC,7133200101,TAVALISSE 100 MG TABLET,614.0,399.1,103.15,614.0,22
NDC,7133200201,TAVALISSE 150 MG TABLET,614.0,399.1,103.15,614.0,22
NDC,7133610001,ONPATTRO 2 MG/ML INTRAVENOUS SOLUTION,7045.2,4579.38,89.28,12697.64,53
NDC,7133610011,GIVLAARI 189 MG/ML SUBCUTANEOUS SOLUTION,158018.4,102711.96,100.82,158018.4,53
NDC,7133610031,AMVUTTRA 25 MG/0.5 ML SUBCUTANEOUS SYRINGE,859327.2,558562.68,4441.69,859327.2,53
NDC,7134907006,YCANTH 0.7 % TOPICAL SOLUTION APPLICATOR,1725.6,1121.64,97.89,1725.6,29
NDC,7139001111,BYFAVO 20 MG INTRAVENOUS SOLUTION,157.74,102.53,5.75,157.74,23
NDC,7139900396,ONELAX DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,0.08,0.05,0.01,0.08,22
NDC,7139901224,VITAMINS A AND D-WHITE PETROLATUM-LANOLIN TOPICAL OINTMENT,0.08,0.05,0.01,0.08,22
NDC,7139901606,CHILDREN'S PAIN RELIEF 160 MG/5 ML ORAL ELIXIR,0.03,0.02,0.01,0.03,22
NDC,7139905001,CLOTRIMAZOLE 1 % TOPICAL SOLUTION,3.28,2.13,0.55,3.28,22
NDC,7139910271,DIPHENHYDRAMINE 25 MG CAPSULE,0.26,0.17,0.04,0.26,22
NDC,7139982452,SENNA LAXATIVE 8.6 MG TABLET,0.04,0.03,0.01,0.04,22
NDC,7144909042,LIDOCAINE 1 %-PHENYLEPHRINE 1.5 % IN STERILE WATER INTRAOCULAR SOLN,101.52,65.99,17.06,101.52,22
NDC,7144909190,BEVACIZUMAB 2.75 MG/0.11 ML INTRAVITREAL SYRINGE,2814.54,1829.45,472.84,2814.54,22
NDC,7144909199,BEVACIZUMAB 2.25 MG/0.09 ML INTRAVITREAL SYRINGE,1045.44,679.54,175.63,1045.44,22
NDC,7144909245,CYCLOPENTOLATE 1 %-TROPICAM 1 %-PHENYLEPHRINE 2.5 % IN WATER EYE DROPS,115.2,74.88,19.35,115.2,22
NDC,7144909246,CYCLOPENTOLATE 1 %-TROPICAM 1 %-PHENYLEPHRINE 2.5 % IN WATER EYE DROPS,35.04,22.78,5.89,35.04,22
NDC,7144909742,MOXIFLOXACIN (PF) 5 MG/ML IN SODIUM CHLORIDEISO-OSM INTRAOCULAR SOLN,68.04,44.23,11.43,68.04,22
NDC,7146923101,GLEOLAN 30 MG/ML ORAL SOLUTION,55.78,36.26,9.37,55.78,22
NDC,7165606620,LIKMEZ 500 MG/5 ML ORAL SUSPENSION,8.18,5.32,1.37,8.18,22
NDC,7165606675,LIKMEZ 500 MG/5 ML ORAL SUSPENSION,8.18,5.32,1.37,8.18,22
NDC,7169902530,XCOPRI 25 MG TABLET,100.16,65.1,16.83,100.16,22
NDC,7169905030,XCOPRI 50 MG TABLET,100.16,65.1,16.83,100.16,22
NDC,7169910030,XCOPRI 100 MG TABLET,100.16,65.1,16.83,100.16,22
NDC,7169915030,XCOPRI 150 MG TABLET,100.16,65.1,16.83,100.16,22
NDC,7169920030,XCOPRI 200 MG TABLET,100.16,65.1,16.83,100.16,22
NDC,7171500102,NUZYRA 100 MG INTRAVENOUS SOLUTION,1770.78,1151.01,3.38,1770.78,47
NDC,7174011230,SSKI 1 GRAM/ML ORAL SOLUTION,47.6,30.94,8.0,47.6,22
NDC,7177010560,SIKLOS 100 MG TABLET,15.44,10.04,2.59,15.44,22
NDC,7177305012,XERAVA 50 MG INTRAVENOUS SOLUTION,262.5,170.63,1.0,262.5,40
NDC,7177610005,FLAREX 0.1 % EYE DROPSSUSPENSION,60.02,39.01,10.08,60.02,22
NDC,7177912502,COPIKTRA 25 MG CAPSULE,774.62,503.5,130.14,774.62,22
NDC,7183710002,BIZENGRI 375 MG/18.75 ML (20 MG/ML) INTRAVENOUS SOLUTION,3067.36,1993.78,33.56,3407.66,42
NDC,7183758435,LEUKINE 250 MCG SOLUTION FOR INJECTION,1132.65,736.22,53.51,1132.65,47
NDC,7188110145,PALFORZIA (LEVEL  1) 3 MG (1 MG X 3) SPRINKLE CAPSULE,31.16,20.25,5.23,31.16,22
NDC,7188110290,PALFORZIA (LEVEL  2) 6 MG (1 MG X 6) SPRINKLE CAPSULE,15.58,10.13,2.62,15.58,22
NDC,7188110345,PALFORZIA (LEVEL  3) 12 MG (1 MG X 2 10 MG X 1) SPRINKLE CAPSULE,31.16,20.25,5.23,31.16,22
NDC,7188110415,PALFORZIA (LEVEL  4) 20 MG SPRINKLE CAPSULE,93.48,60.76,15.7,93.48,22
NDC,7188110530,PALFORZIA (LEVEL  5) 40 MG (20 MG X 2) SPRINKLE CAPSULE,46.74,30.38,7.85,46.74,22
NDC,7188110660,PALFORZIA (LEVEL  6) 80 MG (20 MG X 4) SPRINKLE CAPSULE,23.38,15.2,3.93,23.38,22
NDC,7188110730,PALFORZIA (LEVEL  7) 120 MG (20 MG X 1 100 MG X1) SPRINKLE CAPSULE,46.74,30.38,7.85,46.74,22
NDC,7188110860,PALFORZIA (LEVEL  8) 160 MG (20 MG X 3 100 MG X1) SPRINKLE CAPSULE,23.38,15.2,3.93,23.38,22
NDC,7188110930,PALFORZIA (LEVEL  9) 200 MG (100 MG X 2) SPRINKLE CAPSULE,46.74,30.38,7.85,46.74,22
NDC,7188111060,PALFORZIA (LEVEL 10) 240 MG(20 MG X 2 100 MG X 2) SPRINKLE CAPSULE,23.38,15.2,3.93,23.38,22
NDC,7188111115,PALFORZIA (LEVEL 11 UP-DOSE) 300 MG ORAL POWDER PACKET,93.48,60.76,15.7,93.48,22
NDC,7188111130,PALFORZIA (LEVEL 11 MAINTENANCE) 300 MG ORAL POWDER PACKET,93.48,60.76,15.7,93.48,22
NDC,7188111313,PALFORZIA INITIAL(4-17YRS) 0.5 MG/1 MG/1.5 MG/3 MG/6 MG SPRNK CAPSULE,7.28,4.73,1.22,7.28,22
NDC,7189412002,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189412103,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189412203,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189412303,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189412404,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189412504,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189412604,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189412705,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189412805,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189412905,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189413006,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189413106,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189413206,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189413307,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189413407,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189413507,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189413608,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189413708,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189413808,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189413909,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189414009,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7189414109,ZOLGENSMA 2 X 10EXP13 VG/ML INTRAVENOUS SUSPENSION KIT,7650000.0,4972500.0,10052.3,7650000.0,45
NDC,7190420001,POMBILITI 105 MG INTRAVENOUS SOLUTION,7052.4,4584.06,88.06,12697.64,52
NDC,7190430001,OPFOLDA 65 MG CAPSULE,85.2,55.38,14.31,89.3,29
NDC,7192117820,ABIRATERONE 250 MG TABLET,4.5,2.93,0.76,4.5,22
NDC,7192130856,VARENICLINE TARTRATE 0.5 MG TABLET,18.56,12.06,3.12,18.56,22
NDC,7193002890,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,2.44,1.59,0.41,2.44,22
NDC,7206014240,CAPLYTA 42 MG CAPSULE,136.8,88.92,22.98,136.8,22
NDC,7206411030,AYVAKIT 100 MG TABLET,3266.96,2123.52,548.85,3266.96,22
NDC,7206412030,AYVAKIT 200 MG TABLET,3266.96,2123.52,548.85,3266.96,22
NDC,7206412530,AYVAKIT 25 MG TABLET,3266.96,2123.52,548.85,3266.96,22
NDC,7206413030,AYVAKIT 300 MG TABLET,3266.96,2123.52,548.85,3266.96,22
NDC,7206415030,AYVAKIT 50 MG TABLET,3266.96,2123.52,548.85,3266.96,22
NDC,7207803300,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,10.8,7.02,0.5,10.8,31
NDC,7207803302,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,10.8,7.02,0.5,10.8,31
NDC,7207803401,ULTIVA 1 MG INTRAVENOUS SOLUTION,242.49,157.62,40.74,242.49,22
NDC,7207803502,ULTIVA 2 MG INTRAVENOUS SOLUTION,484.98,315.24,81.48,484.98,22
NDC,7207803605,ULTIVA 5 MG INTRAVENOUS SOLUTION,1031.88,670.72,173.36,1031.88,22
NDC,7207806699,VANCOMYCIN 2 GRAM INTRAVENOUS SOLUTION,154.08,100.15,0.19,154.08,30
NDC,7207808106,MEROPENEM 2 GRAM INTRAVENOUS SOLUTION,112.53,73.14,1.62,112.53,37
NDC,7214000021,EUCERIN TOPICAL CREAM,0.1,0.07,0.02,0.1,22
NDC,7214000022,EUCERIN TOPICAL CREAM,0.22,0.14,0.04,0.22,22
NDC,7214001945,AQUAPHOR HEALING 41 % TOPICAL OINTMENT,0.2,0.13,0.03,0.2,22
NDC,7214003147,AQUAPHOR ORIGINAL 41 % TOPICAL OINTMENT,0.12,0.08,0.02,0.12,22
NDC,7214003868,EUCERIN TOPICAL CREAM,0.3,0.2,0.05,0.3,22
NDC,7214011047,AQUAPHOR HEALING 41 % TOPICAL OINTMENT,0.86,0.56,0.14,0.86,22
NDC,7214045231,AQUAPHOR HEALING 41 % TOPICAL OINTMENT,0.34,0.22,0.06,0.34,22
NDC,7214063377,AQUAPHOR HEALING 41 % TOPICAL OINTMENT,0.3,0.2,0.05,0.3,22
NDC,7214063608,AQUAPHOR HEALING 41 % TOPICAL OINTMENT,0.14,0.09,0.02,0.14,22
NDC,7218701013,ORSERDU 86 MG TABLET,660.92,429.6,111.03,660.92,22
NDC,7218701023,ORSERDU 345 MG TABLET,1982.74,1288.78,333.1,1982.74,22
NDC,7218704011,ELZONRIS 1000 MCG/ML INTRAVENOUS SOLUTION,162031.92,105320.75,293.99,162031.92,52
NDC,7219601011,CARDIOPLEGIC SOLN 30 (INDUCT 4:1) 36 MEQ/500 ML (POTASSIUM) PERFUSION,0.72,0.47,0.12,0.65,21
NDC,7219601041,CARDIOPLEGIC SOLN NO.26(MAINT 4:1) 36 MEQ/L (POTASSIUM) FOR PERFUSION,0.48,0.31,0.08,0.48,22
NDC,7219604181,AMINO ACID 2.5 % PED-D10-CALC 3.75 MEQ-HEPARIN 125 UNIT/250 ML IV SOLN,0.57,0.37,0.1,0.57,22
NDC,7219660751,VANCOMYCIN 1.5 GRAM/250 ML IN DEXTROSE 5% INTRAVENOUS SOLUTION,0.18,0.12,0.03,0.18,22
NDC,7220502390,ATORVASTATIN 20 MG TABLET,10.98,7.14,1.84,10.98,22
NDC,7220503960,DOFETILIDE 125 MCG CAPSULE,19.48,12.66,3.27,19.48,22
NDC,7220505108,ALBENDAZOLE 200 MG TABLET,457.82,297.58,76.91,457.82,22
NDC,7220508430,TIAGABINE 2 MG TABLET,15.88,10.32,2.67,15.88,22
NDC,7220508530,TIAGABINE 4 MG TABLET,15.88,10.32,2.67,15.88,22
NDC,7220509191,DOXEPIN 75 MG CAPSULE,3.62,2.35,0.61,3.62,22
NDC,7220520030,ROFLUMILAST 500 MCG TABLET,24.76,16.09,4.16,24.76,22
NDC,7220526030,VILAZODONE 10 MG TABLET,20.6,13.39,3.46,20.6,22
NDC,7220526130,VILAZODONE 20 MG TABLET,20.6,13.39,3.46,20.6,22
NDC,7223710103,XPOVIO 60 MG TWICE WEEKLY (120 MG/WEEK) (20 MG X 6) TABLET,3472.2,2256.93,583.33,3472.2,22
NDC,7223710202,XPOVIO 80 MG/WEEK (40 MG X 2) TABLET,10416.6,6770.79,1749.99,10416.6,22
NDC,7223710206,XPOVIO 40 MG TWICE WEEK (40 MG X 2) TABLET,10416.6,6770.79,1749.99,10416.6,22
NDC,7223710305,XPOVIO 100 MG/WEEK (50 MG X 2) TABLET,10416.6,6770.79,1749.99,10416.6,22
NDC,7223710401,XPOVIO 60 MG/WEEK (60 MG X 1) TABLET,20833.2,13541.58,3499.98,20833.2,22
NDC,7224101303,RIVASTIGMINE 4.5 MG CAPSULE,0.4,0.26,0.07,0.4,22
NDC,7224101403,RIVASTIGMINE 6 MG CAPSULE,0.4,0.26,0.07,0.4,22
NDC,7224103122,PAROXETINE ER 37.5 MG TABLETEXTENDED RELEASE 24 HR,1.26,0.82,0.21,1.26,22
NDC,7226611825,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,6.3,4.1,0.34,6.3,41
NDC,7226616010,ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION,118.05,76.73,9.2,118.05,31
NDC,7226616201,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,6.0,3.9,0.05,6.0,30
NDC,7226625110,CALCITRIOL 1 MCG/ML INTRAVENOUS SOLUTION,35.82,23.28,2.6,35.82,23
NDC,7231900602,SELEGILINE 5 MG TABLET,4.2,2.73,0.71,4.2,22
NDC,7242611803,NEXLETOL 180 MG TABLET,34.62,22.5,5.82,34.62,22
NDC,7248511310,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,50.4,32.76,8.47,50.4,22
NDC,7248520290,IMATINIB 100 MG TABLET,202.0,131.3,33.94,202.0,22
NDC,7248521730,ERLOTINIB 25 MG TABLET,206.76,134.39,34.74,206.76,22
NDC,7248550725,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,11.16,7.25,1.87,11.16,22
NDC,7248561110,LIDOCAINE HCL 2 % MUCOSAL JELLY,1.34,0.87,0.23,1.34,22
NDC,7248562513,CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPSSUSPENSION,41.02,26.66,6.89,41.02,22
NDC,7249310303,JELMYTO 40 MG X 2 INTRA-PYELOCALYCEAL KIT,122136.0,79388.4,270.53,122136.0,52
NDC,7251139301,REPATHA SURECLICK 140 MG/ML SUBCUTANEOUS PEN INJECTOR,1030.86,670.06,173.18,1030.86,22
NDC,7251175001,REPATHA SYRINGE 140 MG/ML SUBCUTANEOUS SYRINGE,1030.86,670.06,173.18,1030.86,22
NDC,7251177001,REPATHA PUSHTRONEX 420 MG/3.5 ML SUBCUTANEOUS WEARABLE INJECTOR,638.19,414.82,107.22,638.19,22
NDC,7251292801,QUTENZA 8 % TOPICAL KIT,2180.26,1417.17,2.99,2180.26,47
NDC,7251292901,QUTENZA 8 % TOPICAL KIT,4360.48,2834.31,2.99,4360.48,50
NDC,7251293001,QUTENZA 8 % TOPICAL KIT,8721.0,5668.65,2.99,8721.0,53
NDC,7251603150,METOPROLOL SUCCINATE ER 50 MG TABLETEXTENDED RELEASE 24 HR,2.52,1.64,0.42,2.52,22
NDC,7257805601,FELBAMATE 400 MG TABLET,5.58,3.63,0.94,5.58,22
NDC,7257808601,DESONIDE 0.05 % TOPICAL CREAM,10.7,6.96,1.8,10.7,22
NDC,7257808602,DESONIDE 0.05 % TOPICAL CREAM,10.7,6.96,1.8,10.7,22
NDC,7257808901,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,2.24,1.46,0.38,2.24,22
NDC,7257808904,NYSTATIN 100000 UNIT/GRAM TOPICAL OINTMENT,1.78,1.16,0.3,1.78,22
NDC,7257809501,DESOXIMETASONE 0.25 % TOPICAL OINTMENT,14.16,9.2,2.38,14.16,22
NDC,7257809818,LEVOFLOXACIN 250 MG TABLET,33.62,21.85,5.65,33.62,22
NDC,7257809918,LEVOFLOXACIN 500 MG TABLET,38.54,25.05,6.47,38.54,22
NDC,7257817301,THEOPHYLLINE ER 300 MG TABLETEXTENDED RELEASE12 HR,8.6,5.59,1.44,8.6,22
NDC,7257901102,BRUKINSA 80 MG CAPSULE,314.88,204.67,52.9,314.88,22
NDC,7260601101,VEGZELMA 25 MG/ML INTRAVENOUS SOLUTION,812.88,528.37,38.15,812.88,45
NDC,7260601201,VEGZELMA 25 MG/ML INTRAVENOUS SOLUTION,812.88,528.37,38.15,812.88,45
NDC,7260602901,STEQEYMA 130 MG/26 ML INTRAVENOUS SOLUTION,42.06,27.34,7.07,3236.72,36
NDC,7260603701,STOBOCLO 60 MG/ML SUBCUTANEOUS SYRINGE,6413.97,4169.08,28.13,6413.97,38
NDC,7260603801,OSENVELT 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,6940.05,4511.03,28.13,6940.05,38
NDC,7260710000,TAZVERIK 200 MG TABLET,207.76,135.04,34.9,207.76,22
NDC,7261176101,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,10.8,7.02,0.04,10.8,30
NDC,7261176110,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,10.8,7.02,0.04,10.8,30
NDC,7261178502,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,4643.61,3018.35,20.31,4643.61,50
NDC,7261830002,NURTEC ODT 75 MG DISINTEGRATING TABLET,322.58,209.68,54.19,322.58,22
NDC,7262627011,SOFOSBUVIR 400 MG-VELPATASVIR 100 MG TABLET,685.72,445.72,115.2,685.72,22
NDC,7262722021,TESTOSTERONE 100 MG IMPLANT PELLET,174.0,113.1,29.23,174.0,22
NDC,7264733104,METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK,3.3,2.15,0.22,3.3,31
NDC,7269451501,ASPARLAS 750 UNIT/ML INTRAVENOUS SOLUTION,21428.67,13928.64,65.59,21428.67,45
NDC,7269461760,TIBSOVO 250 MG TABLET,1415.14,919.84,237.74,1415.14,22
NDC,7269472840,VORANIGO 40 MG TABLET,3293.24,2140.61,553.26,3293.24,22
NDC,7269487910,VORANIGO 10 MG TABLET,1646.62,1070.3,276.63,1646.62,22
NDC,7269495401,ONCASPAR 750 UNIT/ML INJECTION SOLUTION,26386.12,17150.98,7915.84,78660.74,52
NDC,7288808401,ISOSORBIDE DINITRATE 30 MG TABLET,2.62,1.7,0.44,2.62,22
NDC,7288811201,MIDODRINE 2.5 MG TABLET,3.04,1.98,0.51,3.04,22
NDC,7288811401,MIDODRINE 10 MG TABLET,17.48,11.36,2.94,17.48,22
NDC,7288815401,CLONAZEPAM 2 MG TABLET,2.36,1.53,0.4,2.36,22
NDC,7288817246,LITHIUM CITRATE 8 MEQ/5 ML ORAL SOLUTION,1.63,1.06,0.27,1.63,22
NDC,7289300201,BELEODAQ 500 MG INTRAVENOUS SOLUTION,12327.52,8012.89,43.95,12327.52,52
NDC,7289300704,ZEVALIN (Y-90) 3.2 MG/2 ML INTRAVENOUS KIT,148248.86,96361.76,14774.74,148248.86,45
NDC,7290385301,ELAHERE 5 MG/ML INTRAVENOUS SOLUTION,1627.76,1058.04,59.11,12697.64,46
NDC,7296011201,DAXXIFY 100 UNIT INTRAMUSCULAR SOLUTION,1512.0,982.8,3.11,1512.0,46
NDC,7297412001,ORGOVYX 120 MG TABLET,227.62,147.95,38.24,227.62,22
NDC,7304220101,DANYELZA 4 MG/ML INTRAVENOUS SOLUTION,12511.64,8132.57,549.03,12697.64,52
NDC,7309042001,SYLVANT 100 MG INTRAVENOUS SOLUTION,7882.64,5123.72,136.18,7882.64,53
NDC,7309042101,SYLVANT 400 MG INTRAVENOUS SOLUTION,31530.64,20494.92,136.18,31530.64,53
NDC,73090800002,SALIVA SUBSTITUTE COMBO NO.2,1.0,0.65,0.17,1.0,22
NDC,7315015006,BRIUMVI 25 MG/ML INTRAVENOUS SOLUTION,6666.0,4332.9,60.51,12697.64,53
NDC,7315390001,BREYANZI 1.5X TO 70X10EXP6 CELL/ML INTRAVENOUS SUSPENSION,2678006.0,1740703.9,24125.92,2410205.4,43
NDC,7317710102,KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLORISO-OSMOTIC IV SYRINGE,4.77,3.1,0.8,4.77,22
NDC,7317710201,FENTANYL (PF) 20 MCG/2 ML (10 MCG/ML) IN 0.9 % SOD CHLORIDE IV SYRINGE,10.77,7.0,1.81,10.77,22
NDC,7317710401,HYDROMORPHONE (PF) 0.4 MG/2 ML (0.2 MG/ML) IN NACL ISO-OSM IV SYRINGE,11.4,7.41,1.92,11.4,22
NDC,7317710405,HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN NACL ISO-OSM IV PCA SYR,1.02,0.66,0.17,1.02,22
NDC,7317710505,MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,1.11,0.72,0.19,8.41,31
NDC,7317710605,MIDAZOLAM (PF) 50 MG/50 ML (1 MG/ML) IN SOD CHLORISO-OSM IV SYRINGE,1.5,0.98,0.12,1.5,31
NDC,7317710803,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,2.25,1.46,0.38,2.25,22
NDC,7317712119,L.E.T. (LIDOCAINE-EPINEPHRINE BIT-TETRACAINE) 4 %-0.09 %-0.5 % TOP GEL,8.82,5.73,1.48,8.82,22
NDC,7317712302,DEXMEDETOMIDINE 20 MCG/5 ML (4 MCG/ML) IN 0.9 % SODIUM CHLR IV SYRINGE,8.61,5.6,1.45,8.61,22
NDC,7317714633,ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,6.0,3.9,1.01,6.0,22
NDC,7317714902,METHADONE 5 MG/5 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SYRINGE,14.4,9.36,2.42,14.4,22
NDC,7317715527,KETAMINE (PF) 5 MG/ML IN SODIUM CHLORIDE ISO-OSMOTIC IV SOLUTION,1.05,0.68,0.18,1.05,22
NDC,7317715602,KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLORISO-OSMOTIC IV SYRINGE,4.77,3.1,0.8,4.77,23
NDC,7317716333,ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,6.0,3.9,1.01,6.0,22
NDC,7320710130,QINLOCK 50 MG TABLET,1243.2,808.08,208.86,1243.2,22
NDC,7320730240,ROMVIMZA 14 MG CAPSULE,8308.8,5400.72,1395.88,8308.8,22
NDC,7320730340,ROMVIMZA 20 MG CAPSULE,8308.8,5400.72,1395.88,8308.8,22
NDC,7320730440,ROMVIMZA 30 MG CAPSULE,8308.8,5400.72,1395.88,8308.8,22
NDC,7330245601,ELLA 30 MG TABLET,93.0,60.45,15.62,93.0,22
NDC,7337201161,SCENESSE 16 MG SUBCUTANEOUS IMPLANT,120982.0,78638.3,2873.33,120982.0,45
NDC,7344180004,OMISIRGE INTRAVENOUS SUSPENSION,3330720.0,2164968.0,559560.96,2997648.0,21
NDC,7347530415,VYVGART 20 MG/ML INTRAVENOUS SOLUTION,1136.55,738.76,28.86,5646.0,47
NDC,7347531023,VYVGART HYTRULO 1008 MG-11200 UNIT/5.6 ML SUBCUTANEOUS SOLUTION,10549.44,6857.14,29.85,10549.44,53
NDC,7353650001,BESREMI 500 MCG/ML SUBCUTANEOUS SYRINGE,33084.0,21504.6,5558.11,33084.0,29
NDC,7355411111,LYFGENIA 1.7 X TO 20 X 10EXP6 CELL/ML INTRAVENOUS SUSPENSION,14880000.0,9672000.0,24125.92,13392000.0,37
NDC,7355431111,ZYNTEGLO 2 X 10EXP6 TO 20 X 10EXP6 CELL/ML INTRAVENOUS SUSPENSION,13440000.0,8736000.0,24125.92,12096000.0,37
NDC,7355550000,REVUFORJ 25 MG TABLET,830.0,539.5,139.44,830.0,23
NDC,7355550100,REVUFORJ 110 MG TABLET,1639.26,1065.52,275.4,1639.26,23
NDC,7355550200,REVUFORJ 160 MG TABLET,1639.26,1065.52,275.4,1639.26,23
NDC,7355616801,TAVNEOS 10 MG CAPSULE,238.42,154.97,40.05,238.42,22
NDC,7355616802,TAVNEOS 10 MG CAPSULE,238.38,154.95,40.05,238.38,22
NDC,7356210410,VIOKACE 10440 UNIT-39150 UNIT-39150 UNIT TABLET,10.44,6.79,1.75,10.44,22
NDC,7356211201,ZENPEP 20000 UNIT-63000 UNIT-84000 UNIT CAPSULEDELAYED RELEASE,20.6,13.39,3.46,20.6,22
NDC,7356211501,ZENPEP 5000 UNIT-17000 UNIT-24000 UNIT CAPSULEDELAYED RELEASE,5.32,3.46,0.89,5.32,22
NDC,7356220810,VIOKACE 20880 UNIT-78300 UNIT-78300 UNIT TABLET,20.6,13.39,3.46,20.6,22
NDC,7359493101,MONOFERRIC 100 MG IRON/ML INTRAVENOUS SOLUTION,1314.78,854.61,17.94,1314.78,47
NDC,7360602001,SYFOVRE (PF) 15 MG/0.1 ML INTRAVITREAL SOLUTION,84470.04,54905.53,134.91,84470.04,53
NDC,7360602002,SYFOVRE (PF) 15 MG/0.1 ML INTRAVITREAL SOLUTION,84470.04,54905.53,134.91,84470.04,53
NDC,7360701111,ARTESUNATE 110 MG INTRAVENOUS SOLUTION,16135.5,10488.08,51.82,16135.5,45
NDC,7364811303,RYONCIL 6.68 X 10EXP6 CELL/ML INTRAVENOUS SUSPENSION,931200.0,605280.0,24125.92,931200.0,45
NDC,7377600111,AMTAGVI 7.5 X 10EXP9 TO 72 X 10EXP9 CELL INTRAVENOUS SUSPENSION,2940384.0,1911249.6,493984.51,2646345.6,21
NDC,7430000070,DESITIN 40 % TOPICAL PASTE,0.18,0.12,0.03,0.18,22
NDC,7430000300,DESITIN DAILY DEFENSE 13 % TOPICAL CREAM,0.16,0.1,0.03,0.16,22
NDC,7430000301,DESITIN DAILY DEFENSE 13 % TOPICAL CREAM,0.12,0.08,0.02,0.12,22
NDC,7430000421,RID COMPLETE LICE ELIMINATION KIT 0.5 % SPRAY,0.08,0.05,0.01,0.08,22
NDC,7431200640,VITAMIN B-2  100 MG TABLET,0.12,0.08,0.02,0.12,22
NDC,7431202832,MELATONIN 1 MG TABLET,0.06,0.04,0.01,0.06,22
NDC,7452702202,MARGENZA 25 MG/ML INTRAVENOUS SOLUTION,1034.73,672.57,42.33,3236.72,46
NDC,7467659041,TRELSTAR 11.25 MG IM SUSPENSION,10362.0,6735.3,343.08,10362.0,53
NDC,7467659061,TRELSTAR 22.5 MG IM SUSPENSION,20724.0,13470.6,343.08,20724.0,53
NDC,7583360102,HEPZATO (62 MM CATHETER) 50 MG INTRA-ARTERIAL SOLUTION,181536.0,117998.4,343.08,181536.0,52
NDC,7583380001,HEPZATO 50 MG INTRA-ARTERIAL SOLUTION,181536.0,117998.4,343.08,181536.0,52
NDC,7583415801,VERAPAMIL ER (SR) 180 MG TABLETEXTENDED RELEASE,2.88,1.87,0.48,2.88,22
NDC,7583415901,VERAPAMIL ER (SR) 240 MG TABLETEXTENDED RELEASE,3.28,2.13,0.55,3.28,22
NDC,7583417001,ZINC OXIDE 20 % TOPICAL OINTMENT,0.46,0.3,0.08,0.46,22
NDC,7583424230,ERYTHROMYCIN 250 MG TABLET,26.46,17.2,4.45,26.46,22
NDC,7583428008,POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,6.45,4.19,1.08,6.45,22
NDC,7583428030,POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,33.48,21.76,5.62,33.48,22
NDC,7583432001,VERAPAMIL ER (SR) 120 MG TABLETEXTENDED RELEASE,2.14,1.39,0.36,2.14,22
NDC,7598705801,KRYSTEXXA 8 MG/50 ML INTRAVENOUS SOLUTION,2213.49,1438.77,573.29,12697.64,47
NDC,7598706008,BUPHENYL 500 MG TABLET,65.42,42.52,10.99,65.42,22
NDC,7598707009,BUPHENYL 0.94 GRAM/GRAM ORAL POWDER,61.48,39.96,10.33,61.48,22
NDC,7598708010,KRYSTEXXA 8 MG/ML INTRAVENOUS SOLUTION,110674.77,71938.6,3052.72,110674.77,53
NDC,7598711111,ACTIMMUNE 100 MCG (2 MILLION UNIT)/0.5 ML SUBCUTANEOUS SOLUTION,40606.35,26394.13,204.27,40606.35,34
NDC,7598713015,TEPEZZA 500 MG INTRAVENOUS SOLUTION,64868.22,42164.34,300.06,64868.22,53
NDC,7598715003,UPLIZNA 10 MG/ML INTRAVENOUS SOLUTION,16829.82,10939.38,426.16,16829.82,53
NDC,7601490210,BLOXIVERZ 0.5 MG/ML INTRAVENOUS SOLUTION,27.45,17.84,1.84,27.45,23
NDC,7604500120,MIDAZOLAM (PF) 2 MG/2 ML (1 MG/ML) INJECTION SYRINGE,5.64,3.67,0.12,5.64,31
NDC,7604500411,MORPHINE 2 MG/ML INJECTION SYRINGE,10.32,6.71,1.73,18.74,31
NDC,7604500510,MORPHINE 4 MG/ML INJECTION SYRINGE,10.32,6.71,1.73,18.74,31
NDC,7604500511,MORPHINE 4 MG/ML INJECTION SYRINGE,10.32,6.71,1.73,18.74,31
NDC,7604500610,MORPHINE 5 MG/ML INJECTION SYRINGE,10.32,6.71,1.73,18.74,31
NDC,7604500906,DILAUDID (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,29.88,19.42,0.09,29.88,37
NDC,7604500911,DILAUDID (PF) 1 MG/ML INJECTION SYRINGE,14.94,9.71,0.09,14.94,37
NDC,7604500996,DILAUDID (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,29.88,19.42,0.09,29.88,37
NDC,7604510210,DIPHENHYDRAMINE 50 MG/ML INJECTION SYRINGE,9.36,6.08,0.74,9.36,31
NDC,7604510910,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SYRINGE,20.82,13.53,0.11,20.82,31
NDC,7607510101,KYPROLIS 60 MG INTRAVENOUS SOLUTION,16978.52,11036.04,42.46,16978.52,52
NDC,7607510201,KYPROLIS 30 MG INTRAVENOUS SOLUTION,8489.28,5518.03,42.46,8489.28,52
NDC,7607510301,KYPROLIS 10 MG INTRAVENOUS SOLUTION,2829.76,1839.34,42.46,2829.76,49
NDC,7612815575,PHOTOFRIN 75 MG INTRAVENOUS SOLUTION,111950.4,72767.76,14450.94,111950.4,44
NDC,7620402160,SODIUM CHLORIDE 7 % FOR NEBULIZATION,0.42,0.27,0.07,0.42,22
NDC,7620402260,SODIUM CHLORIDE 3 % FOR NEBULIZATION,0.42,0.27,0.07,0.42,22
NDC,7620420001,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,0.94,0.61,0.16,0.94,22
NDC,7620420030,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,0.88,0.57,0.15,0.88,22
NDC,7620460030,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,1.46,0.95,0.25,1.46,22
NDC,7620460060,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,1.46,0.95,0.25,1.46,22
NDC,7620470001,LEVALBUTEROL 0.31 MG/3 ML SOLUTION FOR NEBULIZATION,1.34,0.87,0.23,1.34,22
NDC,7620470011,LEVALBUTEROL 0.31 MG/3 ML SOLUTION FOR NEBULIZATION,1.34,0.87,0.23,1.34,22
NDC,7620480001,LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,1.34,0.87,0.23,1.34,22
NDC,7620480011,LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,1.34,0.87,0.23,1.34,22
NDC,7620490001,LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,1.34,0.87,0.23,1.34,22
NDC,7629700122,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,0.15,0.1,0.03,0.15,23
NDC,7629943004,NITROMIST 400 MCG/SPRAY TRANSLINGUAL AEROSOL,176.86,114.96,29.71,176.86,22
NDC,7631001750,ETHYOL 500 MG INTRAVENOUS SOLUTION,3857.07,2507.1,647.99,3857.07,32
NDC,7631002401,FOSCAVIR 24 MG/ML INTRAVENOUS SOLUTION,4.95,3.22,0.83,108.69,43
NDC,7631002425,FOSCAVIR 24 MG/ML INTRAVENOUS SOLUTION,6.9,4.49,1.16,108.69,43
NDC,7632912401,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,178.05,115.73,2.52,178.05,31
NDC,7632930115,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,2.88,1.87,0.48,2.88,22
NDC,7632930135,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,1.7,1.11,0.29,1.7,22
NDC,7632930155,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,1.22,0.79,0.2,1.22,22
NDC,7632933181,EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,4.95,3.22,0.83,8.3,30
NDC,7632933401,ATROPINE 0.1 MG/ML INJECTION SYRINGE,3.75,2.44,0.06,3.75,31
NDC,7632933521,SODIUM BICARBONATE 50 MEQ/50 ML (8.4 %) INTRAVENOUS SYRINGE,1.41,0.92,0.24,1.41,22
NDC,7632933691,NALOXONE 1 MG/ML INJECTION SYRINGE,59.4,38.61,0.13,59.4,30
NDC,7632933901,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,6.45,4.19,0.03,6.45,23
NDC,7632963005,LIDOCAINE HCL 4 % LARYNGOTRACHEAL SOLUTION,18.12,11.78,3.04,18.12,22
NDC,7632990600,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,27.0,17.55,0.87,27.0,30
NDC,7633608060,LYSODREN 500 MG TABLET,46.7,30.36,7.85,46.7,22
NDC,7633645518,METOPIRONE 250 MG CAPSULE,154.6,100.49,25.97,154.6,22
NDC,7638510001,METHSCOPOLAMINE 2.5 MG TABLET,5.58,3.63,0.94,5.58,22
NDC,7638510201,PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,3.6,2.34,0.6,3.6,22
NDC,7638511501,SOTALOL 120 MG TABLET,6.84,4.45,1.15,6.84,22
NDC,7638513101,PINDOLOL 5 MG TABLET,4.28,2.78,0.72,4.28,22
NDC,7638513201,PINDOLOL 10 MG TABLET,5.34,3.47,0.9,5.34,22
NDC,7733312050,FIBER LAXATIVE (CALCIUM POLYCARBOPHIL) 625 MG TABLET,1.38,0.9,0.23,1.38,22
NDC,7733351625,MELATONIN 3 MG TABLET,0.52,0.34,0.09,0.52,22
NDC,7733371510,PRENATAL VITAMIN 27 MG IRON-0.8 MG TABLET,0.42,0.27,0.07,0.42,22
NDC,7733381210,SIMETHICONE 80 MG CHEWABLE TABLET,0.48,0.31,0.08,0.48,22
NDC,7733383110,SODIUM BICARBONATE 650 MG TABLET,0.4,0.26,0.07,0.4,22
NDC,7733383510,SODIUM CHLORIDE 1000 MG SOLUBLE TABLET,0.58,0.38,0.1,0.58,22
NDC,7733384410,SODIUM CHLORIDE 1000 MG SOLUBLE TABLET,0.58,0.38,0.1,0.58,22
NDC,7733386110,THERA-VITE MAX-M 9 MG IRON-400 MCG TABLET,0.52,0.34,0.09,0.52,22
NDC,7733386125,THERA-VITE MAX-M 9 MG IRON-400 MCG TABLET,0.52,0.34,0.09,0.52,22
NDC,7733394010,PYRIDOXINE (VITAMIN B6) 50 MG TABLET,0.34,0.22,0.06,0.34,22
NDC,7733394025,PYRIDOXINE (VITAMIN B6) 50 MG TABLET,0.34,0.22,0.06,0.34,22
NDC,7733394825,CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) TABLET,0.46,0.3,0.08,0.46,22
NDC,7733395110,VITAMIN E (DL ACETATE) 180 MG (400 UNIT) CAPSULE,0.52,0.34,0.09,0.52,22
NDC,7733395125,VITAMIN E (DL ACETATE) 180 MG (400 UNIT) CAPSULE,0.52,0.34,0.09,0.52,22
NDC,7733398310,ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,0.46,0.3,0.08,0.46,22
NDC,7733398325,ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,0.46,0.3,0.08,0.46,22
NDC,7779002215,VISTA GONIO 2.5 % EYE DROPS,4.92,3.2,0.83,4.92,22
NDC,7811201103,CHLORASEPTIC THROAT SPRAY 1.4 % AEROSOL,0.1,0.07,0.02,0.1,22
NDC,7811201106,CHLORASEPTIC SORE THROAT 6 MG-10 MG LOZENGES,0.46,0.3,0.08,0.46,22
NDC,7811201266,CHLORASEPTIC SORE THROAT 6 MG-10 MG LOZENGES,0.46,0.3,0.08,0.46,22
NDC,7811210189,CHLORASEPTIC WARMING SORE THROAT 15 MG LOZENGES,0.46,0.3,0.08,0.46,22
NDC,7811210256,CHLORASEPTIC THROAT SPRAY 1.4 % AEROSOL,0.1,0.07,0.02,0.1,22
NDC,7820611402,ASMANEX TWISTHALER 220 MCG/ACTUATION(60 DOSES) BREATH ACTIVATED INHALR,282.96,183.92,47.54,282.96,22
NDC,7820611403,ASMANEX TWISTHALER 220 MCG/ACTUATION(14 DOSES) BREATH ACTIVATED INHALR,93.12,60.53,15.64,93.12,22
NDC,7820611404,ASMANEX TWISTHALER 220 MCG/ACTUATION(30 DOSES) BREATH ACTIVATED INHALR,241.12,156.73,40.51,241.12,22
NDC,7820611501,ASMANEX TWISTHALER 110 MCG/ACTUATION(30 DOSES) BREATH ACTIVATED INHALR,223.3,145.15,37.51,223.3,22
NDC,7820612601,DULERA 200 MCG-5 MCG/ACTUATION HFA AEROSOL INHALER,63.26,41.12,10.63,63.26,22
NDC,7820612602,DULERA 200 MCG-5 MCG/ACTUATION HFA AEROSOL INHALER,63.26,41.12,10.63,63.26,22
NDC,7820612701,DULERA 100 MCG-5 MCG/ACTUATION HFA AEROSOL INHALER,63.26,41.12,10.63,63.26,22
NDC,7820612702,DULERA 100 MCG-5 MCG/ACTUATION HFA AEROSOL INHALER,63.26,41.12,10.63,63.26,22
NDC,7820614501,NEXPLANON 68 MG SUBDERMAL IMPLANT,3060.86,1989.56,273.36,3494.49,32
NDC,7820614701,ONTRUZANT 150 MG INTRAVENOUS SOLUTION,6358.36,4132.93,27.27,6358.36,52
NDC,7820614801,ONTRUZANT 420 MG INTRAVENOUS SOLUTION,17803.4,11572.21,27.27,17803.4,52
NDC,7820614899,ONTRUZANT 420 MG INTRAVENOUS SOLUTION,17803.4,11572.21,27.27,17803.4,52
NDC,7820616201,RENFLEXIS 100 MG INTRAVENOUS SOLUTION,2712.21,1762.94,27.18,2712.21,50
NDC,7820616299,RENFLEXIS 100 MG INTRAVENOUS SOLUTION,2712.21,1762.94,27.18,2712.21,50
NDC,7820619301,BILDYOS 60 MG/ML SUBCUTANEOUS SYRINGE,3038.4,1974.96,510.45,3038.4,26
NDC,7820619501,BILPREVDA 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,3574.59,2323.48,600.53,3574.59,26
NDC,7861320130,SYNDROS 5 MG/ML ORAL SOLUTION,291.72,189.62,49.01,291.72,22
NDC,7867000367,REVONTO 20 MG INTRAVENOUS SOLUTION,252.0,163.8,42.34,252.0,22
NDC,7867015001,IWILFIN 192 MG TABLET,243.84,158.5,40.97,243.84,22
NDC,7980220030,REZUROCK 200 MG TABLET,1523.48,990.26,255.94,1523.48,22
NDC,7995211001,ZYNLONTA 10 MG INTRAVENOUS SOLUTION,104507.16,67929.65,180.44,104507.16,52
NDC,8019629660,SILVASORB TOPICAL GELEXTENDED RELEASE,1.18,0.77,0.2,1.18,22
NDC,8021513548,MULTI-AD TRANSFER SET,10.6,6.89,1.78,10.6,22
NDC,8044640101,KIMMTRAK 100 MCG/0.5 ML INTRAVENOUS SOLUTION,201504.0,130977.6,188.03,201504.0,52
NDC,8065183055,PROVISC 10 MG/ML INTRAOCULAR SYRINGE,1223.4,795.21,205.53,1223.4,22
NDC,8065183085,PROVISC 10 MG/ML INTRAOCULAR SYRINGE,1039.17,675.46,174.58,1039.17,22
NDC,8065183135,DUOVISC VISCO ELASTIC 3 %-4 %(0.35 ML) 1 %(0.4 ML) INTRAOCULAR SYRINGE,1250.55,812.86,210.09,1250.55,22
NDC,8065183150,DUOVISC VISCO ELASTIC 3 %-4 %(0.5 ML) 1 %(0.55 ML) INTRAOCULAR SYRINGE,944.94,614.21,158.75,944.94,23
NDC,8065183710,DISCOVISC 40 MG-17 MG/ML INTRAOCULAR SYRINGE,1189.44,773.14,199.83,1189.44,22
NDC,8065183905,VISCOAT 4 %-3 % (40 MG-30 MG/ML) INTRAOCULAR SYRINGE,1427.55,927.91,239.83,1427.55,22
NDC,8065183975,VISCOAT 4 %-3 % (40 MG-30 MG/ML) INTRAOCULAR SYRINGE,1250.55,812.86,210.09,1250.55,22
NDC,8068101900,NIACINAMIDE 500 MG TABLET,0.08,0.05,0.01,0.08,22
NDC,8068102500,PYRIDOXINE (VITAMIN B6) 100 MG TABLET,0.08,0.05,0.01,0.08,22
NDC,8068104100,MELATONIN 1 MG TABLET,0.04,0.03,0.01,0.04,22
NDC,8068104900,CHILDREN'S MULTIVITAMIN CHEWABLE TABLET,0.06,0.04,0.01,0.06,22
NDC,8068105200,EYE MULTIVITAMIN 2148 MCG-113 MG-45 MG-17.4 MG TABLET,0.16,0.1,0.03,0.16,22
NDC,8068105700,NIACIN 100 MG TABLET,0.04,0.03,0.01,0.04,22
NDC,8068107100,CYANOCOBALAMIN (VIT B-12) 100 MCG TABLET,0.04,0.03,0.01,0.04,22
NDC,8068107400,FOLIC ACID 800 MCG TABLET,0.04,0.03,0.01,0.04,22
NDC,8068108500,MELATONIN 3 MG TABLET,0.14,0.09,0.02,0.14,22
NDC,8068110000,GLUCOSE 3.75 GRAM CHEWABLE TABLET,0.56,0.36,0.09,0.56,22
NDC,8068111701,GLUCOSAMINE-CHONDROITIN 500 MG-400 MG CAPSULE,0.4,0.26,0.07,0.4,22
NDC,8068112600,B-COMPLEX WITH VITAMIN C TABLET,0.06,0.04,0.01,0.06,22
NDC,8068112900,ASCORBIC ACID (VITAMIN C) 250 MG CHEWABLE TABLET,0.06,0.04,0.01,0.06,22
NDC,8068113100,CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5000 UNIT) CAPSULE,0.08,0.05,0.01,0.08,22
NDC,8068113400,VITAMIN E (DL ACETATE) 45 MG (100 UNIT) CAPSULE,0.04,0.03,0.01,0.04,22
NDC,8068113500,ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,0.06,0.04,0.01,0.06,22
NDC,8068114000,CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,0.08,0.05,0.01,0.08,22
NDC,8068116900,CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1000 UNIT) TABLET,0.04,0.03,0.01,0.04,22
NDC,8072525001,HUMATIN 250 MG CAPSULE,291.74,189.63,49.01,291.74,22
NDC,8072561025,LEUKERAN 2 MG TABLET,1386.16,901.0,232.87,1386.16,22
NDC,8072562025,MYLERAN 2 MG TABLET,720.86,468.56,10.12,720.86,33
NDC,8072563025,TABLOID 40 MG TABLET,1297.52,843.39,217.98,1297.52,22
NDC,8073981218,KRAZATI 200 MG TABLET,301.24,195.81,50.61,301.24,22
NDC,8077711380,SPIKEVAX 2025-26 (6M-11Y) (PF) 25 MCG/0.25 ML INTRAMUSCULAR SYRINGE,1857.6,1207.44,17.89,1857.6,37
NDC,8080200055,MONOJECT DISPOSABLE SYRINGE 20 ML,0.94,0.61,0.16,0.85,21
NDC,8080431302,"""XEROFORM PETROLATUM OVERWRAP 1"""" X 8"""" BANDAGE""",1.8,1.17,0.3,1.8,22
NDC,8080431605,"""XEROFORM PETROLATUM OVERWRAP 5"""" X 9"""" BANDAGE""",3.8,2.47,0.64,3.8,22
NDC,8080432000,"""XEROFORM PETROLATUM DRESSING 4"""" X 3 YARD""",14.9,9.69,2.5,14.9,22
NDC,8080433301,"""XEROFORM PETROLATUM DRESSING 1"""" X 8""""""",1.86,1.21,0.31,1.86,22
NDC,8080433501,"""XEROFORM PETROLATUM DRESSING 4"""" X 4""""""",2.64,1.72,0.44,2.64,22
NDC,8083023292,TRANEXAMIC ACID 1000 MG/100 ML(10 MG/ML)IN SOD CHLORISO IV PIGGYBACK,0.75,0.49,0.13,0.75,22
NDC,8083023293,TRANEXAMIC ACID 1000 MG/100 ML(10 MG/ML)IN SOD CHLORISO IV PIGGYBACK,0.75,0.49,0.13,0.75,22
NDC,8103300230,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION,0.38,0.25,0.06,0.38,22
NDC,8103300240,ACETAMINOPHEN 325 MG/10.15 ML ORAL SOLUTION,0.33,0.21,0.06,0.33,22
NDC,8105213810,CYTALUX 3.2 MG/1.6 ML INTRAVENOUS SOLUTION,9562.5,6215.63,1606.5,9562.5,26
NDC,8128431505,BLUDIGO 8 MG/ML (0.8 %) INTRAVENOUS SOLUTION,288.0,187.2,9.3,288.0,26
NDC,8129838901,ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,3084.0,2004.6,72.6,3084.0,50
NDC,8129886603,AK-FLUOR 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,51.84,33.7,8.71,2409.0,29
NDC,8137003640,AVEENO SOOTHING BATH PACKET,1.6,1.04,0.27,1.6,22
NDC,8148180301,ANKTIVA 400 MCG/0.4 ML INTRAVESICAL SOLUTION,322200.0,209430.0,92.19,322200.0,52
NDC,8164392701,FLOXURIDINE 0.5 GRAM SOLUTION FOR INJECTION,17474.92,11358.7,3355.7,17474.92,46
NDC,8166520301,SODIUM BENZOATE 10 %-SODIUM PHENYLACETATE 10 % INTRAVENOUS SOLUTION,360.0,234.0,60.48,360.0,22
NDC,8186410130,OJJAARA 200 MG TABLET,2372.82,1542.33,398.63,2372.82,22
NDC,8186410230,OJJAARA 150 MG TABLET,2372.82,1542.33,398.63,2372.82,22
NDC,8186410330,OJJAARA 100 MG TABLET,2372.82,1542.33,398.63,2372.82,22
NDC,8196003103,PEMGARDA (EUA) 125 MG/ML INTRAVENOUS SOLUTION,635.01,412.76,106.68,3236.72,36
NDC,8196420501,AMOXICILLIN 500 MG CAPSULE,0.9,0.59,0.15,0.9,22
NDC,8196804530,AUVELITY 45 MG-105 MG TABLET EXTENDED RELEASE,49.92,32.45,8.39,49.92,22
NDC,8212427181,ILEX SKIN PROTECTANT TOPICAL PASTE,0.24,0.16,0.04,0.24,22
NDC,8213009005,IODOFLEX 0.9 % TOPICAL PADS,16.24,10.56,2.73,16.24,22
NDC,8226029910,LOTEPREDNOL ETABONATE 0.5 % EYE DROPSSUSPENSION,102.58,66.68,17.23,102.58,22
NDC,8234704055,DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL 12 HOUR PATCH,24.5,15.93,4.12,24.5,22
NDC,82415501300,ZINC OXIDE-METHYL SALICYLATE-EUCALYPTOL-CLOVE OIL OINTMENT,0.08,0.05,0.01,0.08,22
NDC,8244805018,OGSIVEO 50 MG TABLET,417.6,271.44,70.16,417.6,22
NDC,8244810014,OGSIVEO 100 MG TABLET,1327.98,863.19,223.1,1327.98,22
NDC,8244813042,GOMEKLI 1 MG CAPSULE,534.6,347.49,89.81,534.6,23
NDC,8244813442,GOMEKLI 1 MG TABLET FOR ORAL SUSPENSION,534.6,347.49,89.81,534.6,22
NDC,8244815014,OGSIVEO 150 MG TABLET,1327.98,863.19,223.1,1327.98,22
NDC,8244826042,GOMEKLI 2 MG CAPSULE,1069.2,694.98,179.63,1069.2,23
NDC,8262588011,MOVANTIK 12.5 MG TABLET,34.92,22.7,5.87,34.92,22
NDC,8262588021,MOVANTIK 25 MG TABLET,34.92,22.7,5.87,34.92,22
NDC,8262588023,MOVANTIK 25 MG TABLET,34.92,22.7,5.87,34.92,22
NDC,8266720001,IOPIDINE 1 % EYE DROPS IN A DROPPERETTE,66.54,43.25,11.18,66.54,22
NDC,8266760005,MAXIDEX 0.1 % EYE DROPSSUSPENSION,33.12,21.53,5.56,33.12,22
NDC,8266780001,TRIESENCE (PF) 40 MG/ML INTRAOCULAR SUSPENSION,2606.4,1694.16,24.49,2606.4,42
NDC,8270500201,EPKINLY 4 MG/0.8 ML SUBCUTANEOUS SOLUTION,8405.0,5463.25,48.4,8405.0,52
NDC,8270501001,EPKINLY 48 MG/0.8 ML SUBCUTANEOUS SOLUTION,100859.76,65558.84,48.4,100859.76,52
NDC,8273707301,APHEXDA 62 MG SUBCUTANEOUS SOLUTION,21240.0,13806.0,25.22,21240.0,52
NDC,8282900201,IZERVAY (PF) 2 MG/0.1 ML INTRAVITREAL SOLUTION,75600.0,49140.0,100.17,75600.0,53
NDC,8290094010,BD POSIFLUSH NORMAL SALINE 0.9 % INJECTION SYRINGE,0.18,0.12,0.03,0.18,22
NDC,8290301032,BD SYRINGE SLIP TIP NON-STERILE 20 ML,1.02,0.66,0.17,0.92,21
NDC,8290301604,BD SLIP TIP SYRINGE 10 ML,0.36,0.23,0.06,0.32,21
NDC,8290302831,B-D SLIP TIP SYRINGE 20 ML,1.54,1.0,0.26,1.39,21
NDC,8290302832,LUER-LOK TIP 30 ML SYRINGE,1.44,0.94,0.24,1.3,21
NDC,8290302995,BD LUER-LOK SYRINGE 10 ML,0.2,0.13,0.03,0.18,21
NDC,8290305196,"""BD REGULAR BEVEL NEEDLES 18 GAUGE X 1 1/2""""""",0.32,0.21,0.05,0.29,21
NDC,8290305201,"""BD FILTER NEEDLE 5-MIRCON NOKOR POINT 18 GAUGE X 1 1/2""""""",0.62,0.4,0.1,0.62,22
NDC,8290305211,"""FILTER NEEDLES 18 GAUGE X 1 1/2""""""",0.72,0.47,0.12,0.72,22
NDC,8290305617,BD LUER-LOK BULK SYRINGE 20 ML,1.0,0.65,0.17,0.9,21
NDC,8290305618,SYRINGE (DISPOSABLE) 30 ML,0.14,0.09,0.02,0.13,21
NDC,8290305620,"""BD TUBERCULIN SYRINGE 1/2 ML 27 X 1/2""""""",0.48,0.31,0.08,0.43,21
NDC,8290306413,HEPARIN LOCK FLUSH (PORCINE) (PF) 10 UNIT/ML INTRAVENOUS SYRINGE,0.84,0.55,0.02,0.84,31
NDC,8290306414,HEPARIN LOCK FLUSH (PORCINE) (PF) 10 UNIT/ML INTRAVENOUS SYRINGE,0.48,0.31,0.02,0.48,31
NDC,8290306424,HEPARIN LOCK FLUSH (PORCINE) (PF) 100 UNIT/ML INTRAVENOUS SYRINGE,0.51,0.33,0.02,0.51,31
NDC,8290306544,BD POSIFLUSH NORMAL SALINE 0.9 % INJECTION SYRINGE,0.54,0.35,0.09,0.54,22
NDC,8290306545,BD POSIFLUSH NORMAL SALINE 0.9 % INJECTION SYRINGE,0.33,0.21,0.06,0.33,22
NDC,8290306546,BD POSIFLUSH NORMAL SALINE 0.9 % INJECTION SYRINGE,0.18,0.12,0.03,0.18,22
NDC,8290306547,NORMAL SALINE FLUSH 0.9 % INJECTION SYRINGE,0.18,0.12,0.03,0.18,22
NDC,8290306553,NORMAL SALINE FLUSH 0.9 % INJECTION SYRINGE,0.45,0.29,0.08,0.45,22
NDC,8290308341,SYRINGE LUER TIP CAP,0.14,0.09,0.02,0.13,21
NDC,8290309605,BD SYRINGE LUER-LOK STERILE 10 ML,0.88,0.57,0.15,0.79,21
NDC,8290309644,"""BD LUER-LOK SYRINGE 10 ML 20 X 1""""""",0.66,0.43,0.11,0.59,21
NDC,8290309680,BD SYRINGE LUER-LOK STERILE 50 ML,2.28,1.48,0.38,2.05,21
NDC,8295911101,RYTELO 188 MG INTRAVENOUS SOLUTION,49966.0,32477.9,54.15,49966.0,52
NDC,8295911201,RYTELO 47 MG INTRAVENOUS SOLUTION,12491.52,8119.49,54.15,12491.52,52
NDC,8304741004,AUCATZYL INTRAVENOUS SUSPENSION,2520000.0,1638000.0,24125.92,2268000.0,27
NDC,8309000310,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,1.56,1.01,0.03,1.56,23
NDC,8310702204,PRAMOSONE 1 %-1 % LOTION,8.24,5.36,1.38,8.24,22
NDC,8320500012,TECELRA 2.68X 10EXP9 TO 10X 10EXP9 CELL INTRAVENOUS SUSPENSION,3489600.0,2268240.0,24125.92,3140640.0,37
NDC,8325700111,OGIVRI 150 MG INTRAVENOUS SOLUTION,4514.44,2934.39,37.7,4514.44,49
NDC,8325700412,OGIVRI 420 MG INTRAVENOUS SOLUTION,12600.24,8190.16,37.7,12600.24,52
NDC,8325700541,FULPHILA 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,12525.0,8141.25,98.87,12525.0,53
NDC,8325702541,YESINTEK 90 MG/ML SUBCUTANEOUS SYRINGE,10799.94,7019.96,24.68,10799.94,45
NDC,8325702611,YESINTEK 130 MG/26 ML INTRAVENOUS SOLUTION,55.38,36.0,13.85,3236.72,39
NDC,8345701210,OSPOMYV 60 MG/ML SUBCUTANEOUS SYRINGE,3510.0,2281.5,589.68,3510.0,22
NDC,8349020760,HYPER-SAL 7 % SOLUTION FOR NEBULIZATION,0.46,0.3,0.08,0.46,22
NDC,8349030760,SODIUM CHLORIDE 7 % FOR NEBULIZATION,0.18,0.12,0.03,0.18,22
NDC,8385110030,FLUORESCEIN 1 MG EYE STRIPS,0.48,0.31,0.08,0.48,22
NDC,8438311001,LENTOCILIN S  1.2 MILLION UNIT IM SUSPENSION,52.38,34.05,8.8,52.38,22
NDC,8452100686,VASELINE WHITE PETROLEUM TOPICAL OINTMENT IN PACKET,0.12,0.08,0.02,0.12,22
NDC,8452701492,"""XEROFORM PETROLATUM DRESSING 1"""" X 8""""""",1.86,1.21,0.31,1.86,22
NDC,8461206601,WEZLANA 130 MG/26 ML INTRAVENOUS SOLUTION,27.69,18.0,6.92,3236.72,39
NDC,8541203196,BAG EMPTY VIAFLEX 250 ML,7.76,5.04,1.3,6.98,21
NDC,8541229561,BAG EMPTY INTRAVIA 500 ML,3.9,2.54,0.66,3.51,21
NDC,8541229578,BAG EMPTY INTRAVIA 250 ML,3.84,2.5,0.65,3.46,21
NDC,8541246162,EMPTY CONTAINER BOTTLE,10.75,6.99,1.81,10.75,22
NDC,8544508321,SODIUM HYALURONATE 23 MG/ML INTRAOCULAR SYRINGE,856.47,556.71,143.89,856.47,22
NDC,8544636971,HEALON PRO 10 MG/ML INTRAOCULAR SYRINGE,654.54,425.45,109.96,654.54,22
NDC,8544636981,HEALON PRO 10 MG/ML INTRAOCULAR SYRINGE,588.72,382.67,98.9,588.72,22
NDC,8765176030,AZO BORIC ACID 600 MG VAGINAL SUPPOSITORY,1.38,0.9,0.23,1.38,22
NDC,8770140065,GLYCERIN 99.5 % TOPICAL SOLUTION,0.13,0.08,0.02,0.13,22
NDC,8770140073,GENTIAN VIOLET 1 % TOPICAL SOLUTION,0.18,0.12,0.03,0.18,22
NDC,8770140729,VITAMIN B-1 100 MG TABLET,0.1,0.07,0.02,0.1,22
NDC,8770140730,VITAMIN B-6 100 MG TABLET,0.1,0.07,0.02,0.1,22
NDC,8770140731,CYANOCOBALAMIN (VIT B-12) 500 MCG TABLET,0.1,0.07,0.02,0.1,22
NDC,8770140734,BIOTIN 5 MG CAPSULE,0.18,0.12,0.03,0.18,22
NDC,8770140752,VITAMIN D3 125 MCG (5000 UNIT) TABLET,0.18,0.12,0.03,0.18,22
NDC,8770140753,VITAMIN E (DL ACETATE) 90 MG (200 UNIT) CAPSULE,0.2,0.13,0.03,0.2,22
NDC,8770140754,VITAMIN E (DL ACETATE) 180 MG (400 UNIT) CAPSULE,0.2,0.13,0.03,0.2,22
NDC,8770140813,MELATONIN 3 MG TABLET,0.08,0.05,0.01,0.08,22
NDC,8770140816,COENZYME Q10 100 MG CAPSULE,0.94,0.61,0.16,0.94,22
NDC,8770142510,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.36,0.23,0.06,0.36,22
NDC,8884430100,WHITE PETROLEUM JELLY TOPICAL,0.1,0.07,0.02,0.1,22
NDC,8884433605,"""XEROFORM PETROLATUM DRESSING 5"""" X 9""""""",2.76,1.79,0.46,2.76,22
NDC,88888000066,NITROGLYCERIN INTRACORONARY 0.2 MG/ML,2.88,1.87,0.48,4.22,31
NDC,89122049663,HYMOVIS 24 MG/3 ML INTRA-ARTICULAR SYRINGE,860.4,559.26,15.76,860.4,47
NDC,89122072412,HYALGAN 10 MG/ML INTRA-ARTICULAR SOLUTION,342.0,222.3,57.46,342.0,37
NDC,89122072420,HYALGAN 10 MG/ML INTRA-ARTICULAR SYRINGE,342.0,222.3,57.46,342.0,37
NDC,8913020201,DUROLANE 60 MG/3 ML INTRA-ARTICULAR SYRINGE,1338.0,869.7,5.9,1338.0,47
NDC,8913031111,GELSYN-3  16.8 MG/2 ML INTRA-ARTICULAR SYRINGE,698.4,453.96,0.44,698.4,40
NDC,8913044441,SUPARTZ FX 10 MG/ML INTRA-ARTICULAR SYRINGE,341.58,222.03,57.39,341.58,37
NDC,9697400002,MG-PLUS-PROTEIN 133 MG TABLET,0.16,0.1,0.03,0.16,22
NDC,9866900201,OASIS MOISTURIZING MOUTH 35 % MUCOSAL SPRAY,0.48,0.31,0.08,0.48,22
NDC,9999003590,SODIUM CHLORIDE 0.9 % (FLUSH) INJECTION SYRINGE,0.15,0.1,0.03,0.15,22
NDC,9999103016,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML ORAL SOLUTION,0.48,0.31,0.08,0.48,22
NDC,9999317763,DEXAMETHASONE ORAL LIQUID 0.5 MG/5 ML ADS,0.13,0.08,0.02,0.13,22
NDC,9999545209,SENNOSIDES ORAL LIQUID 8.8 MG/5 ML ADS,0.13,0.08,0.02,0.13,22
NDC,9999568216,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,1.28,0.83,0.22,1.28,22
NDC,99998020218,MIDAZOLAM 2 MG/ML ORAL SYRUP,1.73,1.12,0.29,1.73,22
NDC,9999998266,ACETYLCHOLINE 10% SOLUTION - CCHS COMPOUNDING,0.5,0.33,0.08,0.5,22